Loading...
17A-217 (2) BP-2024-1623 158 NORTH MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-217-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-1623 PERMISSION IS HEREBY GRANTED TO: Project# 2024 ROOF Contractor: License: Est.Cost: 25129 NEWPRO OPERATING LLC CS-110763 Const.Class: Exp.Date:05/05/2026 Use Group: Owner: TACY EUGENE A&MARGARET TOBIN TACY Lot Size(sq.ft.) Zoning. URB Applicant: NEWPRO OPERATING LLC Applicant Address Phone: Insurance: 26 CEDAR ST (781)844-8249 100 0005655 WOBURN, MA 01801 ISSUED ON: 12/09/2024 TO PERFORM THE FOLLOWING WORK: STRIP&REROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: /(72 Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Asf-Vi The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 CD _ One- or Two-Family Dwelling This Section For Official Use Onl Building Permit Number: OP 2024-/623 Date Applied: Building Official(Print Name) Sir attire Date SECTION 1:SITE INFORMATION /v^ j� 1.1 Propertyin ss p 1.2 Assessors Map&Parcel Numbers /7/3 -217--ten/ 1.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: u R A i 333 acre- Zoning District Proposed Use Lot Area(sq II) Frontage(tt) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP` 2.1 ric� faefAz0/14- D>D bZName Print) A _ rA��� �,. . Crty le4,24, _3 N No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check a that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Spec'fy: Brief scri t'on of Pro s•. •rk �J Q'd?SL } z � Al�G E , 45 ; t ^ram G' 6Da rh11r : J � � 7 N� - 11,a' /26P L' l S SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $cc>'2� - 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost3(Itei 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 6,0 T" 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total Ales: $ r, Check f 72Check Amount: Cash Amount: 6.Total Project Cost: 2 7,29,-, 2) ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Su rvisor L� �gnse AloA ")/D ��-,/ //(fin License Number Expiration Date �o Name of CSL Hold r7 06 �g /, Ja f i > XP List CSL Type(see below) 4 Description No.and Street Ffi2 ,,MeA 7f P �Q Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP / / / R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding q9-0) i2, „/L,/� SF Solid Fuel Burning Appliances /� I Insulation Telephone Email address D Demolition 5.2 Reg4teredAIome Ian ovemeniCo racto�G a l 1� - 9 ' /2 2� 1 HICRegistration Number Expiration Date I f ICan) ��Regis�a 'l�ame Ny//ayt� eCyC,�n f' 17/9. )//4 / 11i/—'f �%�. Email address City/Town,fitW', / State,a' ZIP,'/ / `7 Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuan of the building permit. Signed Affidavit Attached? Yes . No .0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIEES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Z 1z4 5®"`' " U to act on my behalf,in all matters relative to work authorized by this buillding permit application. Cif — Gi C6%r�iz c7"-- /2-3-z / Print Owner's Name f lectronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION • By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this applica ion is true and accurate to .- of y nowledge and understanding. Jiff/2 Print Owner's or g6thorized Agent's Name ' f • ems- Date V / OTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.eoA/oca Information on the Construction Supervisor License can be found at www.mass.govidps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" • City of Northampton oar H Mr�o� = Massachusetts DEPARTMENT OF BUILDING INSPECTIONS • 212 Main Street • Municipal Building �_ ji°�> ,• Northampton, MA 01060 L, • , . {. ,\``` CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: The debris will be transported by: Name of Hauler: 2 .727/2 „), 6,g; /5e N pk ate: � 3Z/ g Si nature of Applicant: Pagel of 13 T Reg#0605216•MA Reg# 46589•RI Reg e26463 c � , 2. 26 Cedar St Woburn, MA 01801 800-242-9974 Federal ID #20-2625129 Roofing Contract Customer Information Gene Tacy (413) 626-3716 0 Date: 11/23/2024 158 N Maple St genetacy1@gmail.com Rep: Travis Caron Florence MA 01062 Purchase A reement Owner(s)jointly and severally agrees to purchase the goods and/or services of NEWPRO OPERATING, LLC("NEWPRO" or "Contractor") in accordance with the terms and conditions described on this agreement ("Agreement") and the accompanying specification sheet(s). Owner(s) hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Owner(s) hereby acknowledges that he or she owns the home at the address written above. Shingle Style Color Midnight Plum Owens Corning Supermax Duration Shingle Underlayment: Protect-All Deck Protection Drip Edge Color: Black Layers to Strip: 1 Rolled Roof Details Roofing: Roll Roofing Color: Gunmetal Gray Underlayment: Self Adhering Base/Ply Sheet Drip Edge Color: Black Layers to Strip: 1 Rolled Roofing - 10 Year Warranty Materials& Labor(Excluded from Platinum Plus) d Roof Installation Options Chimney Lead QTY 2 Ridge Vent Included Discounts A lied Senior Discount Veteran Discount Installation& Promotion Details NEWPRO will remove any demolition and/or installation debris from the property. All promotions were applied at the time of purchase and cannot be combined with any future offers. Page 2 of 13 betails •Tarp from roof to ground to keep clean •Starter course at all roof edges • Install 8" drip edge • Replace all chimney flashing with new lead as needed • Replace all pipe collars with new heavy duty aluminum •Clean up&haul away of job related debris • Matching Hip and Ridge shingles on all roof peaks • Customer to remove breakables from walls • Customer asked to cover items in attic Page 3 of 13 Payment NPC Discounted Price: $25,129 Deposit: $0 Due Upon Completion: $25,129 Payment Method: Finance Estimated Start&Completion Estimated Start: 4 to 6 weeks Estimated Completion: 1 to 4 days Customer understands they will be contacted to set a firm installation date once all product is received. Year Home was Built 1890 LSWP LSWP YES • Page 13 of 13 Terms and Conditions Continued Mold and Related Matters: Owner(s) agrees that the scope of work under this Agreement does not include the identification, detection, abatement, encapsulation, or removal of mold, asbestos, lead based paint (except as required by law), or other hazardous substances inside or outside of Owner's property and accordingly, Contractor is not responsible for any such activities. Owner(s)acknowledges being orally advised of Owner's ability to engage a qualified third party for such activities. Contractor is not responsible for condensation, which may form on or within a window or between windows resulting from preexisting conditions in Owner's property and internal or external temperatures. Reducing the humidity in a home will often remedy any condensation problems. Miscellaneous: The section headings contained in this Agreement are inserted for convenience only and shall not affect in any way the meaning or interpretation of this Agreement. In construing this Agreement, the gender and number of words used may be changed to meet the context. This Agreement shall be governed by and construed in accordance with the laws of the state in which work is performed, except as may be preempted by federal law. Any part of this Agreement contrary to the law of the state in which work is performed shall not invalidate other parts of this Agreement. Owner(s) has read and agrees to the terms and conditions of this Agreement. Owner(s) specifically agrees to the(1)Total Cash Price; (2) work being performed; and (3) work not being performed. Owner(s) understands that this Agreement and any attachments contain all of the promises made by NEWPRO. Owner(s) has been orally advised of his right to cancel this transaction at any time prior to midnight of the third business day after the date of this transaction and Owner(s) was provided with two (2) copies of a cancellation form explaining this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. The undersigned gives NEWPRO permission to debit their checking/savings account, or process a credit card transaction, for the deposit amount indicated on or after the contract date. Subsequent payments, such as start payments, or completion payments will remain in effect until Owner(s) cancels it in writing, and agree to notify NEWPRO of alternate payment intentions. If the above noted payment dates fall on a weekend or holiday, Owner(s) understands that the payments may be executed on the next business day. For ACH debits to my checking/savings account, Owner(s) understands that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. in the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) Owner(s) understands that NEWPRO may at its discretion attempt to process the charge again within 30 days. Owner(s)acknowledges that the origination of ACH transactions to my account must comply with the provisions of U.S. law. Owner(s)certifies that Owner(s) is an authorized user of this credit card/bank account and will not dispute the scheduled transactions with Owner's bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form. Future Communication & Product Update Acknowledgement NEWPRO OPERATING, LLC may contact me in the future about its products and services at the phone number I provided in this Agreement using an automatic telephone dialing system. I understand I am not required to provide consent as a condition of entering into this Agreement or purchasing from NEWPRO OPERATING, LLC, and I may revoke this consent by calling 800-242-9974. By initialing, I acknowledge that I have read, understand and agree to the above conditions. YOU THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY OF THIS TRANSACTION. SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. Gene Tacy 11/23/2024 Date Travis Caron 11/23/2024 Date Page 1 of 6 OC Roofing Work Order Customer Information Gene Tacy (413) 626-3716 0 Date: 11/23/2024 158 N Maple St genetacy1@gmail.com Rep: Travis Caron Florence MA 01062 Rep# (800) 242-9974 Additional Details Bad leaks needs done ASAP. Shingle Style Color Midnight Plum Owens Corning Supermax Duration Shingle Underlayment: Protect-All Deck Protection Drip Edge Color: Black Layers to Strip: 1 Squares: 12 R lied Roof Details Shingle: Roll Roofing Squares: 5 Color: Gunmetal Gray Underlayment: Self Adhering Base/Ply Sheet Drip Edge Color: Black Layers to be Stripped: 1 Roof Installation Options Ridge Vent Feet 58 - Pitch Over 8/12 (Unwalkable) Squares 9 - Chimney Lead QTY 2 - Pipe Collars QTY 1 - Black Low Profile Clean Flow Intake Vent Do Not Install Page 2 of 6 1.1 Gene - H Roof Measurements 158 North Maple Street, Northamp... ' i ] _ : ROOF SUMMARY Home Improvement Solutions Roof Area Total Length Roof Facets 1538 ft' 12 Ridges/Hips - 5 58'4" r I __ Valleys - 4 23'4" Rakes - 14 154'6" Eaves - 13 146'8" l Flashing - 10 55' Step Flashing - 16 78'11" Drip Edge/Perimeter - - 301'2" -i Roof Pitch' Area Percentage /� 9/12 952 ft' 61.9% / I 3/12 426 ft' 27.7% \ 5/12 104ft' 676% 6/12 36 ft2 2.34% I. •On,too 4 value,shorn Reference Roof Pitch page for all vahns L_______ ______ 1 Example Waste Factor Calculations Zero Waste +5% +10% +15% +20% Area 1538 ft' 1615 ft' 1692 ft' 1769 ft' 1846 ft' Squares 152,i 16'-, 17 18 liV', "he table abc n•WO._.-<tie:Jta rOof area of a green property sting waste percentages as noted Please consider that area values and specific waste factors can be,nfh,encen by tr a size and cOmpler,ty of the property.captured,r'a,e yr.al.ty specific roofng tKMloves.and your owe level ofexpertse.Additional sowre!Wage',lip Ridge and Starter sh.rv)les are not,nch.ded a'shy waste factor asoreal-eower add.torel materials Tess table s,n.'y vftendo d to make Cameron waste Calculat•ons Cater are sho.Jd not oe.nterpr etc as race^,n`endat.ons -2.C24•ICVCR.nc AI.el.ts reso..ea TN*de<,,"o"land Os.maws—.I.., r•data',Tatsrdco.'enr,.va ma.fc,..u.europrtr ofr•O'.tU 00vER.,.e•ae,tt..M 1•..arw. MOP**tY 16:14327f20 ee.e,e.t Cr HOVER o••.ova.lcc Aroma.bravos Cred,.cf,ere I r•e.',ro•*v memnnea oaf,'ma.be t•Doe.,...o•.ev.,,;•.t l.aaamerl.t cr teen re,na�.0 w at m MODEL ID.14325283 Vse of t v.tlloe...hMt, vbrect to POvER,1e•n,or use and s Crov,ocd es s •Koif R make,•C gun.n'.,,, e^f'vo,o... tiro .of ae.bM.e,meuor.mdlRO a GENE a...o,cthwwne relahno tit thn Ifocumert rn o.toiler..,.,M-no—deg Mat tot Ian ot.n:t,n... , Dv.o.otene,t.<,a.:If,,moo.I.^mt ro,a inn Wet pepow•.,V 23 NOV 2024 Page 2 • Page 3 of 6 1.2 Gene ��— ^ ' ' 158 North Maple Street, Northamp... Roof Measurements FOOTPRINT Home Improvement Solutions BACK {j.µ II W S N Number of Stories:>1 Footprint Perimeter:143'1" Footprint Area:1079 ft' 41 II FRONT 2024 rrOVER,nc AI rights reser,ea.Tn,t ot<vfant.fld M eoes.Yeas,Wean Wu_feereetanOCOeffebe Ye the o.cwvveoroea.ty CA Ovta',OVER tme PROPERTY ID:1432782e Of rr0vOf in Au Otner beefleb rOOduCti and C0n`da'Y bee,ei mebtfdad baern may be lredOT.).4e Or roQiif Prod lredeffu k.Of fhen feiRabve rg10Nf rewend cr HOVER n..M _ „_. _. 2 NOVio.I4325283 Of*of tnn fkKumert n t to mOveir,tams of Vie errwntai 0f any lone)a+Me»a.,Onn a♦.,0 GENE b.wn w Lbw,pox fYobbo to lb.,duwnwnl m.q"Ontat•w uae.tncLanu but rut Grnnartl,.ausFly.e.cmoev wmu3o(ene»-rm�w,f.ty w In.e»too a wr,.war w,ww 7t NO 2024 Page 4 of 6 1.3 Gene SOFFIT Home Improvement Solutions ►a 18 r-- #- 12 - 17 Soffit Summary Depth Type Count Total Length Total Area • O"-1" eaves 1 4' 2 ft' 41) • ,q 1"-6" rakes 3 31'3" 9 ft' "..._____—.. • eaves 5 9'4" 4 ft' 6"-12" rakes 13 105'4" 95 ft' eaves 9 77'9" 63 ft' 12"-18" eaves 1 11" l ft' 8 22 • 18"-24" eaves 3 51'1" 76 ft' Totals 279'8" 250 ft' /.\\ 2 t I 24 • t, 5 2 34 2, 26 4 l 3_32 c 2.6.,C.Le' AI.y,.,, n,.o:<„—a^F',r.^t"'OW, a-,,.-,.!. , .-C.,' :.( ,.a•,,,ie.<.,...,.,.. > Y.,e,bHC+pM..f„r.J'r.,er,..•�^vs.nt.�l..r•�0"ae ^,� a .. ... ^.- - .. PROPERTY SO:1412792$ kM,,_- HOVER ,i.. t:,,a ,.:F, a, _ _.- 17,1A North MAnIP StrPat Nnrthamn • Page 5 of 6 1.4 E- Gene Roof Measurements 158 North Maple Street, Northamp... ROOF MEASUREMENTS Home Improvement Solutions d 111:1 t�. l r t u, P I• ..tJ I I I I t I I Roof Length Ridges(RI) 54'S" z Hips(H) 4' Valleys(V) 23'4" Rakes(RA) 154'6" Eaves(E) 146'8'. a I: Flashing(F)' 55' ul„„ Step Flashing(SF)' 78'11" Transition Line(TL) 31'7" tR '`t 'Please view the 30 model for mo'e detail(e g flashing.stet,flashing and some other roof Ore:may be difficult to see on the PDF) p t t• •H\IJ•' II:\1JV Ik\1J••' tR\IJ•r Ill t In II IJ V 2014 KOVER inc An r•p.tsreserved thn occurrent end thymeg,s messofWent ona famat ana«nten'se.rt"ee.<ton.or004•tr or'.o+•tk.rgvtk.s tree•co':to•ty:,•.x••s•r PROPERTY ID:14127928 a M HOVER K an ere• At ether Wands,Peeve.and e e. company names menbo d• em"say ho t'ddawt44 C.rob,st•'ed traoema4 p t el mein•escctvc nobe.r MODEL ID ,4325233 e'"'"h GENEUu of Mr document n ubrect to MOVER'.TMen>offlu and n1>or•ded-es s'MOVER melor.no gums Heq rebresehtebama nar•amn.n•enY sM end....o•n`e''nl m+ny byIaaa OtM'aeu.eWr <.r or to das'to.ascontents ute-ev'md.g0.4 not lon•teetn Rut IY,ac<✓acY.<am0atenast•Metaltr.N rtNn fa•datc.to.stu•oosa 22 NOV 2024 Page 7 it AC C?RL) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI f`,r 10/31/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to tho certificate holder In lieu of such endorsement(s). _ 1-CONTACT PRODUCER NAME. True Vaughan Oakbridge Insurance Agency LLC I PHONE 706-866-3394 FAX No' 706 8ii-1619 P.O. Box 460 NO. Rossville GA 30741 E-MAILSS: certificates@brockins.com INSURERS)AFFORDING COVERAGE NAIC N INSURER A: Navigators Specialty Insurance Company 36056 INSURED RENOVOH-i5 INSURER B_:_Starr Indemnity A Liability Co 38318 Home Solutions 26 Ced INSURER C: Starr Specialty Insurance Company 16109 26 Cedar St - - Woburn MA 01801 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:622480785 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR CTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE _—'AODL:SUBR' POLICY EFF POLICY EXP LTR 1N1$0 i WVD POLICY NUMBER AMM/DD/YYYY1 (MM/PDIYYYYI. LIMITS A X COMMERCIAL GENERAL LIABILITY . Y RK24CGLZOFGX9IC 11i1i2024 11/1/2025 EACH OCCURRENCE $2.000,000 X OCCUR . DAMAGE TO RENTED CLAIMS-MADE '-`---`- PREMISES tEo ocwrrenca) ,$1,000,000 _ MEO EXP(Any ono person) $10,000 ' I PERSONAL&ADV INJURY $1,000,000 GENII AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 4.000,000 POLICY X LOCJECT PRODUCTS-COMP/OP AGG S 4,000.000-_OTHER S n AUTOMOBILE LIABILITY • 1000673036241 11/1/2024 11/112025 •COMBINED SINGLE Low 2.000,000 (En occident) X ANY AUTO ! . BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accdent) $ -__ AUTOS ONLY AUTOS X AUTOS ONLY HIRED x . AUTOS ONLNON-OWNEDY PerraE�n 1 S DAMAGE $ I 3 UMBRELLA UAB X OCCUR 1000579769241 1 1/1r2024 11l1l2025 EACH OCCURRENCE S 5.000,000 X EXCESS UAB CLAIMS-MADE AGGREGATE S 5,000,000 CEO RETENTION$ $ (; WORKERS COMPENSATION N 1000005655 11/1/2024 11/1/2025 X PER OtH- AND EMPLOYERS'LIABILITY Y N STATUTE ER __ ___, ANYPROPRIETORIPARTNER:EXECUTIVE E.L.EACH ACCIDENT $1.000_000 OFFICERMEMBEREXCLUDED? N N/A (Mandatory In NH) ( i E.L.DISEASE-EA EMPLOYEE $1.000.000 II yes describe under _DESCRIPTION OF OPERATIONS below ,---- E L.DISEASE-POLICY LIMIT $1,000,000 __ f 1 DESCRIPTION OF OPERATIONS,LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule.may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. • AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD _ The Commonwealth of Massachusetts A E� 1. Department of Industrial Accidents tl ais irtM 1 Congress Street,Suite 100 : ;1j i 4 ' Boston, MA. 02114-2017 ..4,•«,.„,,, ivww.»tass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/I'tutuber's. TO BE FILED WITH TIIE PERMITTING AUTHORITY. A nnlicant Infgrmation i cI'riptLebly Name(3usiness/Orgaticatiot/ dividuai): 4 /k/"'�/��� CUz'//Asf /. v _ Address: iiiii City/State/Zip:eb 2-Iti Mel VW Phone#: ./--- 'l"^ -5:t9 Y,3' .iAre yet n employer?Check the upproprlute hex: Type of project(required): i. t am a employer with employees(full and/or pact-time).• 7. 0 New construction 2.0 I nin s sole proprietor or partnership and have no employees working for um in 8. [l Remodeling any capacity,(No workers'comp.insurance required.) 1.0 I me a homeowner doing all work myself.No workers'comp.lttitrntru;u required.'r 9. Q Demolition 4.01 ion a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition mum that all contractors either have workers'compensation in unmee or are sole 11.❑Electrical repairs of additions proprietors with no employees. 12.❑P bing repairs or additions 5.0 I ant a general conireotor ued I have hied the sub•oocuactors listed on the attached sheet. 13 Roof repairS These sub•contrartors have cmptoyeev and have workers'comp.inaneintee:.) 6.0 We aro itAr corporation Arai its oflicrta have exorcised their right of exemption per tviCrL o. 14.0 Other 152,§1(4),and we have no employeca.[No workers'comp.insurance required.] •Any applicant that checks box fl1 mat also fill out the section below showing their workers'compensation policy theorematic. t Homeowners who submit this affidavit indicating they are doing all ware and then hire outside contractors must submit a now affidavit indicating such. teontraatoru that check this box mown attached un additional shoot showing the name of the sub•eontraotors and state whether or not those anatwu have . employees. If the sub-contractors have employees,they most provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy untiJob site ittfurHratlnu. p4prL ' mpany Name: /1 _ 4) ,_ _ Policy#or Self-ins,Lie, #. it)b 0495 Expiration Date: /L f 2 / �(f � �' C 0 ' J'ob Site Address:,, ! �� �� City/Stuwte/Zip; ® _OfeM4' Attach a copy of the workers'compensation policy declaration page(showing the policyy number and expiration date). Failure to secure coverage as required under MOL c. 152,§25A is a criminal violation punishable by a fine up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Bite of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the D.T.A.for insurance coverage verification. ==== =. do hereby c ' tinder they pains and penalties of perjury that the information provided above Is trite earl eorrt signatµp_ ,//, _ Date: /1-1 -� 2c 2V Phon4#: 72~ 7 7 --'s �,( / Official use only. Do not write in this area,to be conupieIel by city or town official. City or Town; _._M. Permit/License# Issuing Authority(circle one): I.Board of health 2. Building fepsu•tment 3.City/Posen Clerk 4.Elech•ical Inspector 5.Plumbing Inspector 6.Other • - - — Contact Peveen:_ Phone r;1; _ Commonwealth of Massachusetts Construction Supervisor 4' Division of Occupational Licensure Unrestricted•Buildings of any use group which contain less than Board of Building RLg_lations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space. Consion ig$ rvisor CS-110763 ki pires: 05/05/2026 JEFFREY CONORS - } 66 YORK WOODS ROAD O ,,/, '.4-s-t..----,/7a--- SOUTH BERI CK ME 03908 2' ,17 i b0 lbMU1.LF d.".1�0 , Failure to possess a current edition of the Massachusetts State Building Code Is cause for revocation of this license. H n 1+ru,s; i(,r,,_,r Et /Aa Contact OPSI:(617)727-3200 or visit www.mass.gov/dpl/opsl THE COMMONWEALTH OF MASSACHUSETTS L Office of Consumer Aff. !. aiV Business Regulation 1000 Washing - Suite 710 Bosto •••- - _-__ _ 44118 Home Im•ro ._ =_ - •istration mow•wit imu mt • Will' )•�� Type: Supplement Card • .tion: 146589 NEWPRO OPERATING LLC. �_ 14:lion 05/04/2025 26 CEDAR ST. -- WOBURN, MA 01801 , ii 1 Q! le* w-- a arw #9 �y — 1-�7 v Nztit. s� Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer &Business Regulation Registration valid for individual use only before the HOME IMPROVE I.CONTRACTOR expiration date. If found return to: TYP • .'4..:•.. -'- d Office of Consumer Affairs and Business Regulation ;: ' '.1n",— ,•..• 1000 Washington Street -Su 710 'ffil -. J it;'. Boston,MA 0211E r =WPRO OPERATI 14'�-.i.� — '+ 4 t re, :FFREY CONNORS _=fc r !CEDAR ST. OBURN,MA 01801 ' .` a' RL `ian'� Undersecretary t va without signature