31A-098 (4) 21 VERNONST BP-2017-1473
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:3IA-089 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cgtegory:INSULATION BUILDING PERMIT
Pit# BP-2017-1473
Project# JS-2017-002455
Est,Cost:$2765.00
Fee:$65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Gat Group: AMERICAN INSTALLATIONS LLC 106178
Lot Size(sa.ft.): 12719.52 Owner BOSCO JOHN E&CAITLIN C
Lhaing:URBtI(I0)/ Applicant: AMERICAN INSTALLATIONS LLC
AT: 21 VERNON ST
Applicant Address: Phone: Insurance:
130 COLLEGE ST (413)552-0200 WC
SOUTH HADLEYMA01075 ISSUED ON:6119/2017 0:00:00
TO PERFORM THE FOLLOWING WORIGATTIC AND BASEMENT INSULATION AIR
SEALING THROUGHOUT
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: 001: Insulation:
Final: Smoke: Final:
THIS PERMTT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 6/19/2017 0:00:00 $65.00
212 Main Street.Phone(413)587-1:40,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-1473
APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC
ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY (413)552-0200
PROPERTY LOCATION 21 VERNON ST
MAP 31A PARCEL 089 001 ZONE URB(I00)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid t,
Building Permit Filled out , tll,
Fee Paid
Typeof Construction: ATTIC AND BASEMENT INSULATION AIR SEALING THROUGHOUT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 106178
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF MATION PRESENTED:
V Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR _Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
Si ature of Building Official 4. Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning& Development for more information.
171419
�• - De�tment use ally"
cC ' AIty of Northampton slaws of Fennic
' Building Department Barb CuUDrireway Pamdt:
212 Main Street sewerlseptic Availe$lty
\ Room 100 WatermellAvalability.
Northampton,MA 01060 T .. Sats gtstruauml Plane
N %phone 413-5574240 Fax 413587-1272 PmuSlte.Plans
other Spedfy _. ..
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE ORT WO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 ProPertvMdreas: This section to be coomi e,,j}Fd by office
21 Vernon Street Northampton, MA 01060 Map 514 Lot Ij.'_ it 1 Unit,
Zone Overlay District
Elm St.District- CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Caitlin Carvatho 21 Vernon Street Northampton. MA 01060
Name(NM) Current Mailing Address:
(413)262-3999
See attached Telephone
Signature
22 Authorized Mont
American Installations 130 College St., Ste 100 South Hadley,MA 01075
Name(Print) - Current Matting Address:
American Installations 413-552-0200
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by pent applicant
1. Building $2,765 15 (a)Budding Permit Fee
2. Electrical (b)Estimated Total Cost of
Consbuction frau(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection / s7.3 V
6. Total=(1 +2+3+4+5) $2,765.15 Check Number 4y
This Section Fos Official Use Only
Date
Building Permit Number: nom:
Signature:
Building commissioner/inspector of Buildings Date
•
Section 4. ZONING AU information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Depaemtmt
Lot Size I I
Frontage I II
Setbacks Front
Side L:1 I R: I L: R I I
Rear I
Building Height
Bldg.Square Footage j % I I f
Open Space Footage
(Lot area minusbldg k paved L I F-1
peeking)
it of Parking Spaces F-i I _I
Fill: -- (----
(volume&Loauon)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW 0 YES 0
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DON'T KNOW O YES O
IF YES: enter Book I I Page ' and/or Document pl
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES 0
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO 0
IF YES,describe size, type and location: I
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES,describe size,type and location:
E. Will the construction activity dstett(cleating,grading.excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over l acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House Q Addition [] Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors O
Accessory Bldg. D Demolition 0 New Signs iCtl Decks KJ Siding gni Other 1St
Brief Description of proposed
Work Attic and basement insulation and air sealing throughout
Alteration of epsfng bedroom Yes No Adding new bedroom Yes No
Attached Nanetma Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Oa.If New house and of addition to existing housinq,.cotnUlete the following:
a. Use of bulidhng:One Family Two Family Other
b. Number of rooms in each family unit Number of Bathrooms
c. Is there a garage attached?
d. rYwu ed Square footage of new constmclion. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodsloves Number of each
g. Energy Cawervaton Compgance. Masscheck Energy Compliance form attached?
h. Type of construction
I. Is construction within 100 ft.of wetlands? Yes No. Is constmction within 100 yr. floodplain Yes No
j. Depth of basement or ceflarfloor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank City Sewer Private well City water Supply
SECTION Ta-OWNER AUTHORIZATION•TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Caitlin Carvalho as Owner*Mho subject
property
hereby authorize American Installations
to act on my behalf,in all matters relative to work authorized by this building permit application.
See attached 6/8/17
dOwwr Dam
I, American Installations as Owner/Authorized
Agme hereby declare that the statements and Intimation on the foregoing application are hue and=orate,to the best of my knowledge
and bagel.
Signed under the pains and penalties of perjury.
American Installations
Print Name
American Installations 6/8/17
Signature of Owner/Agent Dam
SECTION 8-CONSTRUCTION SERVICES
8A Licensed Cpnstruction Supervisor: Not Applicable ❑
Name of License Holder Wesley K Couture W6178
License Number
130 College St.,Ste 100 South Hadley,MA 01075 9/29117 _
Address/ / (9,7":;---.3-552-0200
^ � Expimgon Date
l d,' 41 4 4/ ( 9't t�/,(ii 73-552-0200
re J Telephone
8.Registered Horne Improvement Contractor: Not Applicable ❑
Wesley Couture _ 175982
Company Name Registration Number
American Installations 6127117
Address Etgrimiimt Date
130 College St., Ste 100 South Hadley,MA 01075 Telephone 413-552-0200
SECTION 10-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 issuance of the building permit.
Signed Affidavit Attached Yes iN No...... ❑
11. -Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-aaoupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,prodded that the owner acts
as supervisor.CMR 789, Sixth Edition Section 18833,1,
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and,or farm
structures.A person who constructs more than one home in a two-year period shall not be considered a honkcowueI.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official.that he/she shall he
responsible for all such work performed under the bmidingnermit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for whirl this permit is issued.
Also be advised that with reference to Chapter 152(Worker?Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of tbe Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local 7nnin f Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
City of Northampton
/P fT imt,oh.. SS 'py
Massachusetts rC
DaeARRaEN1' OF aVZZO2PG SaSePCT20R$
Cb
y yp. 212 ILin Street • W 01l 0uiiQinq g
_.:[_ sortNvg+ten, IA 01060
Property Address: 21 Vernon Street Northampton,MA 01060
Contractor
Name: American Installations
Address: 130 College Street Ste. 100
City, State: South Hadley,MA
Phone: 43-552-0200
Property Owner
Name: Caitlin Carvalho
Address: 21 Vernon Street
City, State: Northampton. MA 01060
i, American Installations (contractor)attest and affirm that the building I intend to
insulate does not have any open air(knob and tube)wiring in the spaces to be insulated and that I have
provided the property owner with a copy of this affidavit.
Contractor s' n C4.74(fitiq K
Date
6/8117
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111 , S 150A.
Address of the work: 21 Vernon Street Northampton,MA 01060
The debris will be transported by: American In,tnlla„„„,
The debris will be received by: Waste Management of New England- Chicopee Landfill
Building permit number:
Name of Permit Applicant
miit Applicant American Installations on behalf of Caitlin Carvalho
6/8/17 i
•
01, wwe.Amenveolonamtmn.com
BBB • ranged&Insured
MACSL#:106178
American Installations MA Reganorlon 4175982
130College SMA Suite LW,South Hadley,MA 01075 •Office:1413)552.0200 w.: 4131 552-0702•final.:support@AmerlonlnmlYtlon:com
Carvalho,Caitlin 6/7/2017
yor
21 Vernon St. Northampton MA 01060
413.262,3999 m Caitlinaarvalho@gmaii.comn bon
� �
442024 �o 17-1419
IS.n 1.6AMI
Quantity Unit Unit Cost Total
All/Duct Sealing
AIR SEALING 6 man hour $ 85.00 $ 510.00
DUCT SEALING 4 man hour $ 80.00 $ 320.00
WEATHERSTRIP DOOR&ADD SWEEP 2 each $ 80.00 $ 160.00
Air/Duct Sealing $ 990.00
Air/Duct Sealing Incentive $ (990.00)
Air/Duct Selaing WV Balance $ -
WeatheriatIon
BASEMENT-INSULATE BULKHEAD DOOR&INSULATE 1 each 110.00 $ 110.00
CRAWLSPACE-6MIL GROUND COVER 126 soft 0.77 $ 97.02
PULL-DOWN STAIR-THERMAL TENT 1 each 226.65 $ 226.65
VENTILATION CHUTES 84 each 2.50 $ 210.00
ATTIC DAMMING.R-38 FIBERGLASS 144 soft 2.05 $ 295.20
ATTIC FLAT-T'OPEN R-26 CELLULOSE 606 soft 1.38 $ 836.28
•
•
Total Weatherization $ 7775.15
Weatherization Incentive $ 1,33136
Pre-Weatherization Incentive $ 100.00
Total Project $ 2,765.15
Total Utility Contribution $ 2,421.36
Total Customer Contribution $ 343.79
.de
s Lon
ner won a 2 year workmanship wanante.
ATeriCart installations,mananiLLC evety puce too umi as materialand labeevto=Wee the above:ope al work in accordance with the abeve epeefcaume and all local and state building
reputations tee the Total Contract Value as stated hereln.
ACCEPTANCE OF pROPOucThe above pnces,specifications and TOTAL CONTRACT VALUE= $ 343.79
conditions ere satisfactory and are hereby accepted.you yr
authorized to do work s specified.Paymentwill be 1/3 down priorto Down Payment= $ 114.00M 6-7-2017
start of work,and balance due upon Cnmple on. roc Io
Balance Due Upon Completion= $ 229.79
n Carvalho,Caitlin / 6/7/2017
openye
me,PIM
Craig A.Dragovich 6/7/2017
•
THIS AGREEMENT IS COMPOSED OF THIS PAGE AND THE REVERSE SIDE OF THIS PAGE ANO SHALL BE CONSIDERED THE ENTIRE AGREEMENT BY THE PARTIES INVOLVED.THIS AGREEMENT IS
BETWEEN AMERICAN INSTALLATIONS,LLC HEREINAFTER REFERRED TO AS"COMPANY',AND THE CUSTOMER(S1 NAMED ON THE REVERSE SIDE,HEREINAFTER REFEREED TO AS"CLIENT".AND
WILL BE SUBJECT TO ALL APPROPRIATE LAWS.REGULATIONS AND ORDINANCES OF THE STATE Of MASSACHJSETTS OR CONNECTICUT RESPECTIVELY,AS WELL AS ALL LOCAL JURISDICTIONS.
THE FOLLOWING TERMS AND CONDITIONS ALSO APPLY
L THIS AGREEMENT I5SUBJECT TO THE APPROVAL OF A MANAGER OF THE COMPANY FOR THIS AGREEMENT TO BE EFFECTIVE UNDER ANY CONDITION.
2.SHOULD DEFAULT BE MADE IN THE PAYMENT OF THIS AGREEMENT,CHARGES SHALL BE ADDED FROM THE DATE THEREOF AT A RATE OF ONE AND ONE-HALF(1-1/1)PERCENT PER MONTH.
(18%PER ANNUM)WITH A MINIMUM CHARGE OF$2.00 PER MONTH,AND IF PLACED IN THE HANDS OF AN ATTORNEY DR COLLECTION AGENCY FOR COLLECTION,ALL ATTORNEYS'FEES,
EXPENSES AND COSTS OF COLLECTION SHALL BE PAID BY THE CLIENT.IN ADDITION,CLIENT UNDERSTANDS THAT IN FAILING TO PAY ACCORDING TO THE ABOVE TERMS,COMPANY MAY
HAVE THE RIGHT TO A LEIN ON THE PROPERTY.
3.THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,THE COMPANY WILL ADVISE THE CLIENT AS SOON AS REASONABLE.
4.COMPANY AGREES THAT, NOTWITHSTANDING ANY AGREEMENT FOR MATERIALS AND/OR LABOR BETWEEN COMPANY AND THIRD PARTY,COMPANY IS RESPONSIBLE TO CLIENT FOR
COMPLETION OF ALL WORK DESCRIBED IN ATIMELY AND WORKMANLIKE MANNER.
5.ALL WARRANTIES FOR EQUIPMENT AND PRODUCTS SUPPLIED BY THE COMPANY UNDER THIS AGREEMENT SHALL BE THOSE GIVEN BY THE MANUFACTURERS OF SUCH EQUIPMENT AND
PRODUCTS.UNDER SUCH MANUFACTURER'S WARRANTIES.THE CLIENT MAY BE REQUIRED TO REGISTER OR MAIL IN A WARRANTY CARD OR OTHER EVIDENCE OF OWNERSHIP AND USE OF
SUCH EQUIPMENT AND/OR PRODUCTS IN ORDER TO ACTIVATE SUCH WARRANTIES.
6.THE QUOTATION ON THE PAGE HEREOF DOES NOT INCLUDE EXPENSES OR CHARGES FOR BOND OR INSURANCE PREMIUMS OR COSTS BEYOND NORMAL INSURANCE COVERAGE.ANY SUCH
ADDITIONAL EXPENSES,PREMIUMS OR COST SHALL BE ADDED TO THE TOTAL AGREEMENT AMOUNT.
J.THE COMPANY'S LIABILITY FOR CLAIMS ARISING OUT OF THIS AGREEMENT SHALL NOT EXCEED THE TOTAL AGREEMENT PRICE EXCEPT TO THE EXTENT THOSE DAMAGES ARE PROVEN TO BE
SOLE(DUE TO THE COMPANY'S NEGLIGENCE.
8.DURING THE DURATION OF THE WORK,THE CLIENT'S HOMEOWNERS INSURANCE WILL BE RESPONSIBLE FOR ANY AND ALL DAMAGES AS LONG AS THE COMPANY HAS TAKEN THE
APPROPRIATE ACTION TO PROTECT AREAS OF WORK.
9.THE COMPANY IS NOT RESPONSIBLE FOR PREEXISTING DEFICIENCIES OR HAZARDOUS MATERIALS THAT MANIFEST THEMSELVES DURING THE CONSTRUCTION PROCESS E.G.WOOD ROT,
MOLD,ASBESTOS,NAIL POPS,DUCTWORK AND CONNECTIONS,PLUMBING AND VENT PIPES,DECKING DEFLECTION,ETC. IF A PREEXISTING DEFICIENCY OR HAZARDOUS MATERIAL IS
ENCOUNTERED PRIOR TO OR DURING CONSTRUCTION,AND COMPANY IS NOTIFIED IN WRITING,COMPANY WILL TRY TO ASSIST CLIENT WITHIN THE COMPANY'S MEANS AND CAPABILITIES
TO CORRECT THE PROBLEM(S)ON A TIME AND MATERIAL BASIS.CLIENT AGREES THAT SUCH CONDITIONS ARE UNAVOIDABLE BY THE COMPANY AND SHALL NOT BE CONSIDERED A
VIOLATION OF THE AGREEMENT AND THAT DUE TO THESE CONDITIONS THE DURATION OF THE WORK AND SCHEDULED DATE OF COMPLETION MAY DIFFER FROM THAT AGREED UPON,IF
APPLICABLE UNDER THIS AGREEMENT.
10.THE COMPANY IS NOT RESPONSIBLE,AND THE CLIENT AGREES TO HOLD THE COMPANY HARMLESS,FOR ANY PROBLEMS ANO/OR DAMAGES,INLNOING BUT NOT LIMITED TO MOLD
GROWTH.ARISING FROM THE PERFORMANCE OF AIR SEALING WORK BY THE COMPANY AS A RESULT OF ANY KNOWN OR UNKNOWN MOISTURE CONDITIONS.
11.THE COMPANY IS NOT RESPONSIBLE FOR,AND THE CLIENT AGREES TO HOLD THE COMPANY HARMLESS,FOR ANY PROBLEMS AND/OR DAMAGES RELATING TO ICE DAMMING THAT MAY
ARISE DURING AND/OR AFTER THE PERFORMANCE OF WORK BY THE COMPANY
12.REPLACEMENT OF DETERIORATED DECKING,FASCIA BOARDS,ROOF JACKS,VENTILATORS,FLASHING,RAFTERS,JOISTS,INSULATION OR OTHER MATERIALS ARE NOT INCLUDED UNLESS
OTHERWISE NOTED HEREIN.
13.THE COMPANY WILL NOT BE RESPONSIBLE FOR THE SCRATCHING OR DENT NG OF INTERIOR WALLS AND CEILINGS, FLOORS,TRIM,GUTTERS, DOWNSPOUTS, EXISTING SIDING AND
WINDOWS,DOORS,OIL DROPLETS IN DRIVEWAYS,HAIRLINE FRACTURES IN CONCRETE OR BLACKTOP DRIVES AND WALKS,OR DAMAGE TO PLANTS OR SHRUBBERY.IF EXCESSIVE DAMAGE IS
CAUSED BY COMPANY,COMPANY WILL REPAIR OR REPLACE DAMAGED AREA ONLY AT COMPANY'S EXPENSE.
14.THE COMPANY UNDER PROVISIONS OF CHAPTER 142A OF THE GENERAL LAWS IS REQUIRED TO APPLY FOR AND OBTAIN ALL CONSTRUCTION RELATED PERMITS.THE COMPANY SHALL NOT
BE DEEMED RESPONSIBLE FOR DELAYS IN THE WORK DESCRIBED IN THIS AGREEMENT CAUSED BY REGULATORY PERMIT GRANTING OR INSPECTIONAL AGENCIES,AUTHORITIES,OR
INDIVIDUALS.
15.THIS AGREEMENT,INCLUDING THE PROVISIONS RELATING TO PRICE AND PAYMENT SCHEDULE,CANNOT BE CHANGED OR ALTERED EXCEPT BYA WRITTEN STATEMENT SIGNED BY BOTH THE
COMPANY AND THE CLIENT.
16.ANY REPRESENTATIONS STATEMENTS,OR OTHER COMMUNICATION NOT WRITTEN ON THIS AGREEMENT ARE AGREED TO BE IMMATERIAL AND NOT REUED ON BY EITHER PARTY,AND DO
NOT SURVIVE THE EXECUTION OF THIS AGREEMENT.
17.THIS AGREEMENT CANNOT BE CANCELLED WITHOUT THE MUTUAL WRITTEN CONSENT OF BOTH PARTIES EXCEPT AS OTHERWISE SET FORTH HEREIN.
18.THIS AGREEMENT,AND ANY WARRANTY(S)PROVIDEDNOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THE COMPANY.
19.IF FAILS TO PERFORM ITS OBUGATIONHEREUNDER OR TERMINATES THIS AGREEMENT WITHOUT THE PRIOR WRITTEN CONSENT OF THE COMPANY,THE CUENT SHALL BE
LIABLE FOR DAMAGES FOR THE GREATER OF THE COMPANY'S ACTUAL DAMAGES OR 25%OF THE AGREEMENT FOR RESTOCKING FEE.
20.ANY CHANGES TO MATERIALS BY THE CUENT(BRAND,STYLE,COLOR,ETC.)AFTER SAID MATERIAL HAS BEEN DELIVERED OR IS IN ROUTE TO THE CLIENT COULD RESULT IN A 5%RE-STOCKING
FEE BASED ON THE COST OF SAID MATERIALS
21.THIS AGREEMENT SHALL BE EFFECTIVE ONLY UPON ITS EXECUTION BY ALL PARTIES HERETO,PRIOR TO WHICH TIME IT SHALL BE DEEMED A PROPOSAL.THE COMPANY RESERVES THE RIGHT
TO REVOKE THIS PROPOSAL 90 DAYS FROM DATE R IS EXECUTED BY THE COMPANY IF IT IS NOT EARLIER EXECUTED BY THE CJENT AND THE REQUIRED DOWN PAYMENT RECEIVED PRIOR TO
THE EXPIRATION OE SUCH 90 DAY PERIOD;AFTER 90 DAYS,AND IN THE EVENT COMPANY DOES NOT REVOKE THE PROPOSAL.COMPANY RESERVES THE RIGHT TO REVISE ITS PRICE IN
ACCORDANCE WITH ITS COSTS IN EFFECT AT SUCH TIME.
22.
PROVISION OF THIS AGREEMENT SHOULD BE HELD TO BE INVALID OR UNENFORCABLE,THE VALIDITY AND ENFORCEBILITY OF THE REMAINING PROVISIONS OF THIS AGREEMENT
SHALL NOT BE AFFECTED THEREBY.
23.ARBITRATION:IN THE EVENT THE CLIENT AND COMPANY HAVEA DISPUTE REGARDING ANY OF THE TERMS,CONDITIONS,PROVISIONS,OR PERFORMANCE OF THIS AGREEMENT,THE PANTIES
AGREE TO PLACE THE MATTER INTO ARBITRATION BEFORE AN INDEPENDENT ARBITRATOR ASSIGNED BY THE AMERICAN ARBITRATION ASSOCIATION TO RESOLVE THEIR DISPUTE.
24 ANY DISCOUNT,PROMOTION,REIMBURSEMENT,OR OTHER PROGRAM THAT IS PART OF A STATE SPONSERED UTILITY PROGRAM(LE.MASS SAVE)IS SUBJECT TO THE AVAILABILITY OF
QUALIFYING STATE SPONSERED PROGRAM AND WILL BE SUBJECT TO TERMINATION IF THE STATE SPONSERED UTILITY PROGRAM IS DISCOUNTINUED.FURTHERMORE,THE TERMS AND
CONDITIONS OF STATE SPONSERED UTILITY PROGRAMS MAY BE ALTERED OR UPDATED PERIODICALLY WITH OR WITHOUT NOTICE.
25.AMERICAN INSTALLERS,LLC ISNOT AN AGENT OF ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,THROUGH,OR UNDER THE MASS SAVE°ENERGY PROGRAM.
26,CLIENT IS REPSONSIBLE FOR THE PAYMENT OF ANY AND ALL FEDERAL STATE,OR LOCAL TAXES THAT ARE APPLICABLE TO THIS AGREEMENT.
le Massachusetts - Unrestricted-Buildings of any use group which
MY Department of Publie Safety contain less than 35,000 cubic feet(99 tm3)of
Board of Building Regulations and Standards enclosed space.
CLi c License:
n C -16178
Liunse:CS-70678
` brf
WESLEY COLTUJIB - F4's. 111
166 NORTH MAW
Swab Hadley MK 01
*, Failure to possess a current edition of the Massachusetts
✓
State Building Code Is rause for revocation of this license.
��.o- s
St L Expiration For DVS Licensing information viae www.Mass.Gov/DVS
Commissioner 00/29/2017
Cr4e VO 0 ., 1,a0/2Q-164oftClIft/i ein
al-
=d_L Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
Home Improvement'Contractor Registration
Type: LLC
AMERICAN INSTALLATIONS,LLC. Re iration: 175982
130 COLLEGE STREET SURE 100 Expxpiration: 08/2812018
SOUTH HADLEY,MA 01075
update Address end return card. Mars reason for change.
SCA I o 2OMO5/ti
❑ Address n R!�!memo ❑Employment OlsoetS.ant
Office of Consumer Main a Business RsauR6on
L)o
�i
. HOME IMPROVEMENT CONTRACTORTYPE:LLCRegistrationation validfor Individual Liss ordy
before me expiration date. If found return to:
Hitatn iiOfficeLice of Consumer Affairs d Business Regulation
10ParkPlexa-Suite5170
�a+' 175982 0626/2019
AMERICAN INSTALLATIONS,LL.C. Boston,MA 02116 (/
WESLEY CO COUTURE 2CrAa /// //�/T
130 LEY COU STREET SUITE 100 Un e 0 666'/H-O%f 999
SOUTH HADLEY,MA 01075 Urlderoecrelary- valid without signature
.it . The Commonwealth of Massachusetts
�*
.r.=—rt Department of Industrial Accidents
�c�M Office of Investigations
�— ' 600 Washington Street
'.=}.'
"�.,/ w Boston,MA 02111
+•, www.mass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual : American Installations,LLC
Address: 130 College Street,Suite 100
City/State/Zip: South Hadley,MA 01075 Phone N: 413-552-0200
Are you an employer?Check the appropriate box: ` Type of project(required):
1. t am a employer with 31 4. ❑ lam a general contractor and 1 1 6. ❑New construction
employees(full and/or part-time).* have hired the sob-contractors
2.❑ I am a sole proprietor or partners listed on the attached Meet.t 7. ❑ Remodeling
ship and have no employees These subcontractors have 8. ❑ Demolition
working for me in any capacity. workers'comp. insurance. 9. ❑Building addition
(No workers comp.insurance 5- ❑ We are acoiporation and its !o. El
required.) officers have exercised their ❑ oetrieai repairs or additions
3-0 I am a homeowner doing all work right of exemption per Ma 11.0 Plumbing repairs or additions
myself. [No workers'comp. c. 152,§1(4),and we have no 12.9 Roof repairs
insurance requiredj t employees.[No workers' 13.N Other Insulation
comp.insurance required.]
•Any applicant Mat creeks box Ill must also rill out the section below showing their woken'compensation policy information.
t Homeownnn who submit this affidavit indicating they arc doing all work usd Then hue outside cnmaetors must submit a new affidavit indicating such.
eContractors that cheek this box must attached an additional sheet showing the name of the sub-contractors and dick worths'crimp.polity inlnmsaiion.
I amen employer Maas providing workers'canpensadon insurance for my employees. Below is the paltry and jobshe
information.
Insurance Company Name: Guard Insurance Companies _
Policy#or Self-ins.Lic.ti; A� tMWC731485 Expiration Date: 09/04/2017t(� z�
lob Site Address: eat Y e is o rs Zit. City/State/Zip: NI b.T. .... . kDni MA
Attach a copy of the workers'eompeeaatton policy declaration page(showing the policy number and expiration date). O up L p
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$t,S00.00 and/or one-year impciaonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to 5250.00 a day against the violator. Be advised that a copy of this statement may he forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
..........
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Sianature:APaaptvna. LS (1.491.1&151--- _Date; Ca 181 1T"
Phone e: 413-551/-0200
Official use only. Do not write in this arca,m be completed by city or lawn official
City or Town: Permit/License a
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical laspeetor 5.Plumbing inspector
b.Other
Contact Person: Phone tl:
Act,Rya CERTIFICATE OF LIABILITY INSURANCE o n,«woq,rrn
9/1/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFHRMATIVELY OR NEGATIVELY MEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCHES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORIZED
REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER.
IMPORTANT: If the co.dflcsta holder Is an ADDITIONAL INSURED,IN I/0900 es)must be endorsed If SUBROGATION IS WANED,$u*tt to
UN bans and conditions of the policy,certain polkies may require an endorsement A statement on this certificate don not colder rights la the
mytIfIcate holder In Lieu of such endorsemem(s). O0NT�
SmearsPR0OUC!R BEIR:CT Linda Smears
Webber & Grinnell sea ¢n. 013)586-0111 MC
. ,(411)596-66x3
8 North icing Street yyAAx,. 1poeere@Mahberandgsinnell_coe
WngppS11PPoImWO COYESAGENAK•
Hortllampton 1fA 01080
NeuBEo SOURER e]Gaxkshizr Hathaway GUAM Ins. Co.
American installations, 1.1,C INSURER c:
-----
Attu:
_Attu: Weis G Susanne Couture N6URM 0: _,...-
130 College Street, Suits 100 INSURER E:
South Hadley tB1 01075 MOW,:
COVERAGES CERTIFICATE NUMBERNsater Hap 9-201T REVISIONNUMBER:
THS IS TO CERTIFY THAT THE PONGEES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO PIE INSURED NAMED ABOVE FOR THE POLICY PERS
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF MY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 1W THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAM CLAIMS.
II TYPE OF INSURANCE N/104POLICY NUMBER I n MMIDdYWW —.......• DNn
0001.1B1CW.04AEP4l Lees nY EACH OG:URRWE 1,000,000
A H ClANS4UCE I 1 OCCUR RISES/Fs amxal. 900.000
X Liquor Liability ___. i 15D3536217 9/4/2016 9/4/2017 MED MP(Any cos Ann) 10,000
I. I PERSONAL AOVINJURY 1.000,000
E3 Parr
LIMIT APPUESPER GENERAL AGGREGATE 2.000.000
fide PCUCYi 1 Pak
ILOG PRODUCTS-CGWAPA00 2,000,0W
OTHER-. 411NNE0 SINGLE uNn
AUTOMOBILEtNEWiY I 1,000,000
A ANY ANO eOLNLY INJURY(Per new)
Ate&EG H ED so 523536217 9/4/2016 9/4/2011 ROCAY INJURY(Pwendan
A RFD AU/OS A_A{R DAMAGE
mPxuiF 8.000
][IMB
UMBRELLA IAB -_OCCUR EACM OCCURRENCE 1,000 00e
A —II FrcEM HAS CLAIM'u_ I AGGREGATE 1,000,000
ILEO 1 T` RETENTIONS 10,000 113535217 9/4/2016 1 •/4/2017'WORIEUMDOPISLCOW/VIS
�p�t
.Airco m -tIIAi µ
'ANY PgimETORFARTNEREFEWINE Yix EL.EACHACCIDENT SOD 000
I OfFCEPAEME2R EXCLUDED, I N/A _ __ ..._._..—
B Imanneeo-X In NM) OW0609917 9/4/2016 9/4/2017 EL DISEASE-EA EMPLCYEE 500000
;ft ya Ureale
DESCRIPTION OF OPEMTlNS beim E.L.DWARF-POLICYUMIT 500,000
A COWreisl Property SA3535217 9/4/2016 ) 9/4/2017 I W,Y s,6n 020.000
I
;ammo stoop 040,000
DesemPININ 0€OMRMIONS I IOCADONS I VEWCL6(AC0 O nM,AosaaW Roosts SHAY.may M SncM R AIWA vial M,pita)
CERTIFICATE HOLDER CANCELLATION
SHOULD MO'OF THE ABOVE DESCRIBED POUCES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PRONSIONt
AUTNOa®REPRESEMAVWE
Kevin Joyce/LMP �
0 19 8 8 4014 ACORD CORPORATION. All rights marred.
ACORD 25(2014/01) The ACORD name and logo are registered merge of ACORD
INH025myrm,