18C-131 73 BLACKBERRY LN BP-2017-1474
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: I8C- 131 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2017-1474
Project# JS-2017-002456
Est. Cost: $2871.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: AMERICAN INSTALLATIONS LLC 106178
Lot Size(sq. ft.): 11151.36 Owner: ROY NORMAN E&CATHERINE M
Zoning:URB(l00)/ Applicant: AMERICAN INSTALLATIONS LLC
AT: 73 BLACKBERRY LN
Applicant Address: Phone: Insurance:
130 COLLEGE ST (413) 552-0200 WC
SOUTH HADLEYMA01075 ISSUED ON:6/19/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:ATTIC AND BASEMENT INSULTION AND 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: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT 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)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-1474
APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC
ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY (413)552-0200
PROPERTY LOCATION 73 BLACKBERRY LN
MAP I8C PARCEL 131 001 ZONE IJRB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED QUI
Fee Paid
Building Permit Filled out
Fee Paid
Tvpeof Construction: ATTIC AND BASEMENT INSULTIO • I a • R 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
INFORMATION PRESENTED:
_I/Approved j 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 al 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 //
/13—,21e . �t l6 117
Signature of Building Official 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.
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17-1414
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JA / City of Northampton status of Permit
/ - Building 6epartment Gprb ODDtldvwar pemdt
\ // ,.`� 212 Main Street SewerlSepHt3hyallab&ry , ,
z Room 100 Wat&AVell`A1alability,
Northampton, MA 01060 Two sets W 3Wctuml piens,
phone 413-587-1240 Fax 413-587-1272 PIotISite Plans ' .
spacty ,
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTIONS-SITE INFORMATION
This section to be completed byoffice
1.1 proverW Address: p p Z
73 Blackberry Lane Map /0 V Lot 1 ✓ 1 unit
Northampton,MA 0I060 Zorn Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
21 Owner of Record:
Warman Roy 73 Blackberry 1 ane Northa pton,MA 01060
Name(Mint) Current Mailing Address:
(4E3)584-7767
See attached Telephone
Srahn
22 Authorized Ment:
American Installations 130 College St., Ste 100 South Hadley,MA 01075
Name(MIX} Cuaent 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 permit applicant
1, Building $2,874.18 (a)Building Permit Fee
2. Electrical (le)Estimated Total Cost of
Cansbugion from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection `f jpl�'
6. Total=(1 +2+3+4+5) $2,874.18 Check Number 416/51 j,„..`-'
This Section For Official Use Only
Building Permit Numben Iss
Dt Issued:
Signature: —,
Bolding Commissioner/Inspector of Buildings Date
eraseN
Section 4. ZONING AD Information Must Be Completed.Penult Can Be Denied Due To Incomplete Information
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Building Gapanmmt
6=M=
Setbacks Front PT LJ
Side L= R:� L.-J R:= I— I
Rear C I
Bldg.Square Footage ®®®
Open Space Footage Bill ®®®
(Lm era mime bldg a paved ;,
Fill:
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A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 0 YES Q
IF YES,date issued
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES 0
IF YES: enter Book( I Page[ ( andfor Document at 1
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained O , Date Issued:f
C. Do any signs exist on the property? YES O NO O
IF YES,descry size,type and location: I
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 0
IF YES,describe size,type and location:
E. MI the construction activity disturb(clearing,grading,(��cevalion,or Chug)over 1 acre or Is it part of a common plan
that will disturb over t acre? YES O NO V
IF YES,then a Northampton Stonn Water Management Permit from the DPW isrequired.
t
SECTION 5-DESCRIPTION OF PROPOSED WORK(check aft applicable)
New House [J Addition 3 Replacement Windows Alterations! ❑ Roofing 0
Or Doors O
Arreasory Bldg. 0 DemolitIon 0 New Signs (t7j Decks ip Siding la Other la
Brief Descdptiono�pproposed — — —`
wprk: A(t:c aart basement insulation and air sealing throughout
Alteration of existing bedroom�Yes_ No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Planks Attached Rog -Shed
Tia.if New house and or addition to existing housing,comelete file following:
a. Use of bulWmg:One Family Two Family Other
b. Number of rooms in each family unit Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stones?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservatlon Compliance. Masseheck Energy Compliance form attached?
h. Type of construction
I. Is construction within 100 LL of wetlands?__Yes No. Is construction within 100 yr. floodplain Yes No
J. Depth of basement or cellar floor below finished grade
k. WE building conform to the Budding and Zoning regulations? Yes No
I. Septic Tank City sewery Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
i. Norman Roy as Omer of the subject
property
hereby authorize American Installations
to act on my behalf,in ail matters relative to work authored by this buikfing permit application.
See attached 6/15117
Slanders of Owner Dau
I, American Installations as OwmedAuthonzed
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
American Installations
PHA Name
American Installations 6/15/17
Signature of Owner/Agent Date
I
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable U
Name of License Holder: Wesley K. Couture 106178 _ -
License Number
130 College St., Ste 100 South Hadley, MA 01075 9/29/17
Adddreess/ Expiration Date
'tL41w4 (/ J/413-552-0200
/
nature Telephone
9.Registered Home Improvement Contractor. Not Applicable U
Wesley Couture 199982
Company Name Registration Number
American Installations 6/26/19
Address Expiration 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 CsiNo...._ U
11. .-Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellines of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780. Sixth Edition Section 108.35.1.
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 homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the buidine permit,
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 which this permit is issued.
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the 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 Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature ,_ _.
City of Northampton
Massachusettss.
C f rranuermser OF BUZLB1260 INSPECTIONS .\-111
212 Main Streak a Municipal BuildingqF
Northampton, Ma 01060 44'10
Property Address: 73 Blackberry Lane 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: Norman Roy
Address: 74 Blackberry 1 ane
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.
Caret igarit A - �.•tTt 2
Date
(/J
6/1S/17
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 150k
Address of the work: 73 Blackberry r ane Northampton, MA 01060
The debris will be transported by: American Installations
The debris will be received by: Waste Management of New England - Chicopee Landfill
Building permit number:
Name of Permit li/ le
Applicant// Wesley Couture on behalf of Norman Roy
6/15/17 �.�/�'(uQ l�
Dategnature of Permit Applicant
4.11 Licensed .anted ! w.W.AmerIcanlnstallatfon.cam
MASLs&o051'X1J5�/ American Installations
-Efficient Horne Servkes-
]W College Street Suite 100.South Hadley,NIA 01015•Office:(413)5520200 fan:013)552-0202•Email:supper@NrcrkanlnsblWwns.eem
AIR SEALING PROPOSAL
Norman Ray
73 Blackberry Ln
Northampton.MA 01060-1616
Site ID:S00050319214
Project ID:P00050363118
Customer ID:00005032124%
Contract ID:20170608 ASEAL
Description Quantity Location
Perform ArSeatiw at ESbmetee 625CFM50Per Hwa 12 Living Space $1011.84
ExtenOr Poor Weather SNPPn➢ 3 N/A _.. $827?
Door SWeep _. . 3 N/A $69.54
Sub rola]: $1.184.15
Utility Incentive Share $1164.15
Customer Conmbuuen $000
WARRANTY American Installations,LLC will provide the above aced homeowner vnb a 2 year workmanship wamnty.
Ante dean Instalbtions,LLC hereby proposes to turmoil all mammal and labor to complete We above scope of work in accordance with the a hove specifications
and all local and state boiIJ y regulations for the Total Contract Value as stated herein.
e above prices,acecreatlom and conditions Tout CONTRACT VALUE=5 0.00
are satisfactory OF PROPOSAL:
heebyaccepted.. authorized to de work a¢
specified Payment Will be 1/3 down prior to sena work.am balance due PAID
mw, ayment=5 p
upon nrCompletion
g sears Doe upon Completion s
Oce nW
V 6--101?
Roy.Norman
Property ON net(APO I5a n1 Date
RepresnrNtrve Phnp plgA 11 ragunch 154n1 pate 68101?
•
THIS AGREEMENT 15 COMPOSED OF THIS PAGE AND THE REVERSE SIDE OF THIS PAGE AND SHALL BE CONSIDERED THE ENTIRE AGREEMENT BY THE PARTIES INVOLVED, THIS
AGREEMENT 15 BETWEEN AMERICAN INSTALLATIONS,LLC HEREINAFTER REFERRED TO AS"COMPANY',AND THE CUSTOMERIS)NAMED ON THE REVERSE SIDE,HEREINAFTER REFERRED
TO AS"CLIENT,AND WILL BE SUBJECTED ALL APPROPRIATE LAWS,REGULATIONS AND ORDINANCES OF THE STATE OF MASSACHUSETTS OR CONNECTICUT RESPECTIVELY,AS WELL AS
ALL LOCAL JURISDICTIONS.
THE FOLLOWING TERMS AND CONDITIONS ALSO APPLY
1. THIS AGREEMENT IS SUBJECT TO THE APPROVAL OF A MANAGER OF NE 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(1-1/2)PERCENT PER
MONTH.(IS%PER ANNUM)WITH A MINIMUM CHARGE OF$2.00 PER MONTH,AND IF PLACED IN THE HANDS OF AN ATTORNEY OR 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 RIGHTTO A LEIN ON THE PROPERTY.
3, THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,THE COMPANY WILL ADVISE NE CLIENT AS SOON AS REASONABLE,
A. THE 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 A TIMELY AND WORKMANLIKE MANNER,AND IN CONFORMITY W OH THE STANDARDS OF THE MASS SAVE HOME ENERGY
SERVICES PROGRAM.
5. THE COMPANY WARRANTS ALL EQUIPMENT AND PRODUCTS SUPPLIED BY THE COMPANY UNDER THIS AGREEMENT AGAINST ANY DEFECT IN MATERIALS, MANUFACTURE,
DESIGN,OR INSTALLATION FOR ONE YEAR FROM THE DATE THE MATERIALS ARE PROVIDED AND/OR INSTALLED,WHICHEVER IS LATER.
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 SHALOM ADDED TO THE TOTAL AGREEMENT AMOUNT,
7. 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 SOLED'DUE TO THE COMPANY'S NEGLIGENCE.
B. DURING THE DURATION OF THE WORK,THE CLIENT'S HOMEOWNERS INSURANCE WILL BE RESPONSIBLE FOR ANY AND ALL DAMAGES,TO THE EXTENT SUCH DAMAGES WERE NOT
THE FAULT OF THE COMPANY,AND SO LONG AS THE COMPANY HAS TAKEN THE APPROPRIATE ACTION TO PROTECT AREAS OF WORK.ANY DAMAGES DIRECTLY RESULTING FROM
THE FAULT OF THE COMPANY SHALL BE COVERED BY THE COMPANY'S INSURANCE.
9. THE COMPANY IS NOT RESPONSIBLE FOR PREEXISTING DEFICIENCIES OR HAZARDOUS MATERIALS THAT MANIFEST THEMSELVES DURING THE CONSTRUCTION PROCESS. EG.
WOOD ROT, MOLD,ASBESTOS, NAIL POPS, DUCTWORK AND CONNECTIONS,PLUMBING AND VENT PIPES,DECKING DEFLECTION, ETC. IF A PRE-EXISTING 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 PROBLEMISI 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 AND/OR DAMAGES,INLCUDING 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,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 BYTHE 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 ANY MINOR DAMAGES,SUCH AS SCRATCHING OR DENTING 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.THE COMPANY MAY CHOOSE TO VOLUNTARILY REPAIR ANY MINOR DAMAGE CAUSED BY THE COMPANY AT THE COMPANY'S EXPENSE.IF EXCESSIVE
DAMAGE IS CAUSED BY THE COMPANY,THE COMPANY WILL BE RESONSIBLE FOR THE REPAIR OR REPLACEMENT OF THE DAMAGED AREA ONLY AT COMPANY'S EXPENSE.
16. THE COMPANY UNDER PROVISIONS OF CHAPTER N2A 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 BEA 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 RELIED 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.
N. THIS AGREEMENT,AND ANY WARRANTY(S)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THECOMPANY.
19 IF THE CLIENT FAILS TO PERFORM ITS OBLIGATIONS HEREUNDER OR TERMINATES THIS AGREEMENT WITHOUT THE PRIOR WRITTEN CONSENT OF THE COMPANY,THE CLIENT
SHALL BE LIABLE FOR DAMAGES FOR THE GREATER OF THE COMPANY'S ACTUAL DAMAGES OR 2S%OF THE AGREEMENT FOR RESTOCKING FEE.
20. ANY CHANGES TO MATERIALS BY THE CLIENT{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 IT IS EXECUTED BY THE COMPANY IF IT IS NOT EARLIER EXECUTED BY THE CLIENT AND THE REQUIRED DOWN
PAYMENT RECEIVED PRIOR TO THE EXPIRATION OF SUCH 50 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. IF ANY PROVISION OF THIS AGREEMENT SHOULD BE HELD TO BE INVALID OR UNENFORCABIE 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 HAVE A DISPUTE REGARDING ANY OF THE TERMS,CONDITIONS,PROVISIONS,OR PERFORMANCE OF THIS AGREEMENT,
THE PARTIES AGREE TO PLACE THE MATTER INTO ARBITRATION BEFORE AN INDEPENDENT ARBITRATOR ASSIGNED BY ME AMERICAN ARBITRATION ASSOCIATION TO RESOLVE
THEIR DISPUTE.
N. ANY DISCOUNT, PROMOTION, REIMBURSEMENT, OR OTHER PROGRAM THAT IS PART OF A STATE SPONSERED UTILITY PROGRAM NE. 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 IS NOT AN AGENT OF ANY UTILITY COMPANY OR OTHER VENDOR WORKING BY,THROUGH,OR UNDER THE MASS SAVE'ENERGY PROGRAM.
NEITHER THE UTILITY COMPANY NOR ANY OTHER VENDOR WORKING BY,THROUGH,OR UNDER THE MASS SAVE'ENERGY PROGRAM SHALL HAVE LIABILITY TO THE CLIENT
FOR ANY ACTIONS OF THE COMPANY UNDER THIS AGREEMENT.
26, THE COMPANY IS RESPONSIBLE TO PAY ANY REQUIRED FEDERAL STATE,AND LOCAL PROPERTY,LICENSE,PRIVILEGE,SALES,USE,EXCISE,GROSS RECEIPTS,AND OTHER LIKE TAXES
WHICH MAY,NOW OR THEREAFTER,BE APPLICABLE TO THE INSTALLATION WORK UNDER THIS AGREEMENT.
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commenn
n.n,ed 4 www.Ame i ltlationz.wm
M*a`*• &146178 American Installations
64.4116017/676066176662
-Emelmt Home Service;
1306flrye 50-eft 541te 100,South Nadhey,MA 01075•Of&a,(40)552-0200 Fax:W3)5524202•57061170101•751€16711•1"0/071•077/6175-10171
WEATHERIZATION PROPOSAL
Norman Roy
73 Blackberry Ln
Nonhemptom MA 010604616
Site ID:S0005O3I9314
Project ID:P000503631 IR
Cw4ornca 3D €00.050321248
ContraM ID:20170608 WORK
Description Quantity Location
AM Fess Open Blow Cellulose 4• 1.196 LION Space 51.6284
Prtsectt4T oro' 8 ... Atte _ $3064
AAAA
Hatch:Thermal Sorrier PoIy1b02inch(Anti 1 4N1195peW 54131
Damm ng Is N)A 71503
Sub Total: 51.710,03
Utility td re $
.282.51
Customer ContnEuton $427
91
WAFMNtt:,m,enan wtahwmm.tin.a:Pr«tle me ache atal.a mrmmwnaa w1M a z t"e.•vrgmmsstm.anamy
• Mmllatle64 LLCheaM wapurzaro07615656 matenal iM 4l*.to mvplete the above wpeafa ainao[wdann«4n the atwrc sA+lIKatbna
and all bol and state b' ding rtgulatlnnsfr @p Total Contract value as noted herein.
ACCEPTANCE OF PROP06157 The aboveper.apmelom m tioand condnlnTOTAL CONTRACT VALUE•0 427.51
ri
• ursytlory and afe hereby accepted.tot me antnrbed to do wort a5 142.00
5{6•6166d Co Payment
will be u3 down prior to man of week and ba rce(te Down Payment=557 -s-zon
upon Cvmd62p¢ WGee 077 Dpo6 Cmpiemn=£ 26551
SlRnat re nme 62-2017
PropertyOwner{enact Roy Norman _ MP/ / Date
Bewrenume:t$$$$) ($161g A.17277:L.. .13540I fi/�'!// oarc 64.24I7
THE FOLLOWING TERMS AND CONDITIONS ALSO APPLY
1, THIS AGREEMENT IS SUBJECT 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-HAV)1-1/2)PERCENT PER MONTH,(10%PER
ANNUM)WITH A MINIMUM CHARGE OF 52.00 PER MONTH,AND IF PLACED IN THE HANDS OF AN ATTORNEY OR 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 iO THE ABOVE TERMS,COMP ANY MAY HAVE THE RIGHT TO A LEIN ON IHE
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 A TIMELY 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.
2, 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 SOLEY
DUE TO THE COMPANY'S NEGLIGENCE.
8. DURING THE DURATION OF THE WORK,THE CLIENT'S HOMEOWNERS INSURANCE WILL BE RESPONSIBLE FOR ANY ANO ALL DAMAGES AS LONG AS THE COMPANY HAS TAKEN THE APPROPRIATE
ACTION TO PROTECT AREAS OF WORK.
9. COMPANY IS NOT RESPONSIBLE FOR PREEXISTING DEFICIENCIES OR HAZARDOUS MATERIALS THAT MANIFEST THEMSELVES DURING THE CONSTRUCTION PROCESS.E.G OD ROT,MOLD,
ASBESOS, 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'MY TO ASSIST CLIENT WITHIN THE COMPANY'S MEANS AND CAPABILITIES TO CORRECT THE PROBLEM%)
ON A TIME AND MATERIAL BASIS.CT AGREES THAT SUCH CONDITIONS ARE UNAVOIDABLE BY THE COMPANY AND SHALL NOT RECONSIDERED A VIOLATION OF THE AGREEMENT AND THAT DUE
CONDITIONSTO THESE THE DURATION OF THE WORK AND SCHEDULED DATE Of COMPLETION MAY DIFFER FROM THAT AGREED U,'ON,IF APPLICABLE,UNDER THIS AGREEMENT.
10. REPLACEMENT DETERIORATED DECKING,FASCIA BOARDS,ROOF TACKS,VENTILATORS,FLASHING,RAFTERS,JOISTS,INSULATION OR OTHER MATERIALS ARE NOT INCLUDED UNLESS OTHERWISE
NOTED HEREIN.
11. THE COMPANY WILL NOT BE RESPONSIBLE FOR THE SCRATCHING OR DENTING OF INTERIOR WALLS AND CEILINGS FLOORS. RIM.GUrItRS,DOWNSPOUTS,EXISTING SIDING AND WINDOWS,DOORS,
OIL DROPLETS IN DRIVEWAYS,HLINE FRACTURES IN CONCRETE OR BLACKTOP DRIVES AND WALKS,OR DAMAGE TO PANTS OR SHRUBBERY. IF EXCESSIVE DAMAGE IS CAUSED BY COMPANY,
COMPANY WILL REPAIR OR REPLACE DAMAGED AREA ONLY AT COMPANY'S EXPENSE.
12. UNDER PROVISIONS OF CHAPTER 142A OF THE GENERAL LAWS IS REQUIRED TO APPLY FOR AND OBTAIN ALL CONSTRUCTION-RELATED PERMITS.THESHALL NOT BE DEEMED
THEESCOMPAEF [O INDIVIDUALS
RESPONSIBLE FOR DELAYS IN THE ROV DESCRIBED
NSI THIS AGREEMENT AYMEN BY REGULATORY OT BE HANGEDOA INSPECTIONAL AGENCIES,WRITTEN
STATEMENT
ED BU BLS
13. EHL INCLUDING THE PROVISIONS RELATING TO PRICE AND PAVMENTSCMEDV LE CANNOT BE CHANGED OR ALTERED EO EXCEPT BY A STATEMENT51GHE0 BY BOTH THE COMPANY
ANDITHE CLIENT.
14. ANY REPRESENTATIONS,STATEMENTS,OOTHER COMMUNICATION NOT WRITTEN ON THIS AGREEMENT ARE AGREED TO BE IMMATERIAL AND NOT RELIED ON BY EITHER PARTY,AND DO NOT
SURVIVE THE EXECUTION OF THIS AGREEMENT.
15. THIS AGREEMENT CANNOT BE CANCELLED WITHOUT THE MUTUAL WRITTEN CONSENT OF BOTH PARTIES EXCEPT AS OTHERWISE SET FORTH HEREIN.
16. AGREEMENT,AND ANY WARRANT (S)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THE COMPANY.
12. IF THE CUENT FAILS TO PERFORM ITS OBLIGATIONS HEREUNDER OR TERMINATES THIS AGREEMENT WITHOUT THE PRIOR WRITTEN CONSENT OF THE COMPANY,THE CLIENT SHALL BE LIABLE FOR
FOR THE GREATER OF THECOMPANY'S ACTUAL DAMAGES OR 25%OF HE AGREEMENT FOR RESTOCKING FEE.
18. ANY TCHANGES TO MATERIALS BY THE CLIENT(BRAND,STYLE.COLOR,ETC.(AFTER SAID MATERIAL HAS BEEN OELIVERED OR IS IN ROUTE TO THE CLIENT COULO RESULT IN A 5%RE-STOCKING FEE
BASED ON THE COST OF SAID MATERIALS.
19. THIS AGREEMENT SHALL BE EFFECTIVE ONLY UPONIREXECUTION BY ALL PARTIES HERETO, RIORTO WHICH TIME IT SHALL BE DEEMED A PROPOSAL THE COMPANY RESERVES THE RIGHT TO REVOKE
PROPOSALTHIS 90 DAYS FROM DATE IT IS EXECUTED BY THE COMPANY IF IT IS NOT EARLIER EXECUTED BY THECLIENT AND THE REQUIRED DOWN PAYMENT RECEIVED PRIOR TO THE EXPIRATION OF
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.
20 IF ANY 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.
21. N)IN THE EVENT THE CLIENT AND COMPANY HAVE A DISPUTE REGARDING ANY OF THE TERMS,CONDITIONS,PROVISIONS,OR PERFORMANCE OF THIS AGREEMENT,THE PARTIES AGREE
TO RE THE MATTER INTO ARBITRATION BEFORE AN INDEPENDENT ARBITRATOR ASSIGNED BY THE AMERICAN ARBITRATION ASSOCIATION TO RESOLVE THEIR DISPUTE.
22. ANY DISCOUNT,PROMOTION,REIMBURSEMENT,OR OTHER PROGRAM THAT IS PART OF A STATE SPONSERED UTILITY PROGRAM{I.E.MASS SAVE`)IS SUBJECT TO THE AVAILABILITY OF QUALIFYING
STATE SPONSERED PROGRAM AND WILL BE SUBJECT TO TERMINATION IF THE STATE SPONSERED JTILITY PROGRAM 15 D'SC00 NTINUED. FURTHERMORE,THE TERMS AND CONDITIONS OF MATE
ALTERED OR UPDATED PERIODICALLY WITH OR WITHOUT NOTICE.
23. AMERICAN INSTALLIRS,PROGRAMS
IS NOT ANeAGENT OF ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,TH ROUGH,OR UNDER THE MASS SAVE.ENERGY PROGRAM.
29. WESTERN MASSACHUSETTS ELECTRIC COMPANY{THE UTILITY)IS ENTITLED TO TLV%OF THE ENERGY BENEFITS ASSOCIATED WITH ALL ENERGY CONSERVATION MEASURES,EXCLUDING THE VALVE
SAVINGS BY THE CLIENT,BUT INCLUDING ALL RIGHTS TO ALL ASSOCIATED ISO-NE ENERGY,CAPACITY AND RESERVES PRODUCTS.COMPANY AGREES TO PROVIDE THE NIUTY WITH
SUCH REQUEST TO CONFIRM THE UTILITY'S OWNERSHIP OF SUCH BEN ER)S AND PRODUCTS.
25, CCLIENT UNDERSTANDS NDS AND A ACKNOWLEDGESUTILITY THAT COMPANY IS NOT AN AGENT,VENDOR OR SUB-VENDOR OF THE UTILITY WITH RESPECT TO THE INSTALLATION OF ANY ENERGY EFFICIENCY
MEASURE&IN THE EVENT OF THE FAILURE OF ANY ENERGY CONSERVATION DEVICE TO PERFORM AS EXPECTED,CLIENT AGREES THAT CLIENT'S SOLE RECOURSE IS TO THE COMPANY AND NOT TO
CONSERVATION SERVICES GROUP(CSG)OR TO THE UTILITY.THE UTILITY AND ITS OPERATING COMPANIES SHALL NOT MAINTAIN,REMOVE OR PERFORM ANY WORK WI'ATSOEVER ON THE ENERGY
CONSERVATION MEASURES INSTALLED,CLIENT UNDERSTANDS AND ACKNOWLEDGES THAT ITS PARTICIPATION IN THE MASS SAVE HOME ENERGY SERVICES PROGRAM IS VOLUNTARY AND THAT IT
HAS CONSENTED FOR COMPANY TO INSTALL THE PROPOSED ENERGY CONSERVATION MEASURES.
26. CLIENT AGREES THAT IT SHALL NOT HOLD CSG,THE UTILITY,THEIR AFFILIATES OR OPERATINGCOMPANIESLIABLE FOR COMPANY'S FAILURE TO PERFORM ITS OBLIGATIONS UNDER THIS AGREEMENT,
FOR FAILURE OF THE ENERGY CONSERVATION MEASURES TO FUNCTION,FOR ANY DAMAGE TO CLIENT'S PREMISES CAUSED BY COMPANY OR FOR ANY AND ALL DAMAGES TO PROPERTY OR INJURY
iO PERSONS CAUSED BY THE ENERGY CONSERVATION MEASURES.
27. CLIENT IS RESPONSIBLE FOR THE PAYMENT OF ANY AND ALL FEDERAL,STATE,OR LOCAL TAXES THAT ARE APPLICABLE TO THIS AGREEMENT.
LIMITED TIME OFFEL THE PRICES AND INCENTIVE OFFERED IN THIS CONTRACT ARE SUBJECT TO CHANGE IN ACCORDANCE WITH THE WESTERN MASSACHUSETTS ELECTRIC COMPANY MASS SAVE HOME
ENERGY SERVICES PROGRAM OFFERS.
MA CLIENTS:You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office or
branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight
of the third business day fallowing the signing of this agreement.See the attached notice of cancellation form for an explanation of this right.
DATE CLIENT'S SIGNATURE
DATE COMPANY REPRESENTATIVE'S SIGNATURE
The Commonwealth of Massachusetts
I._-_-=q Department of Industrial Accidents
1! Office of Investigations
' 600 Washington Street
Boston,M4 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly,
Name(Busineanhgmlaationrindivid,ail: American Installations,LLC
Address: 130 College Street,Suite 100
City/State/Zip: South Hadley,MA 01075 _ Phone#: 413-552-0200
Are you an employer?Check the appropriate box: Type of project(required):
I. I am a employer with 31 4. 0 I am a general contractor and i 6. 0 New construction
employees(full and/or pan-lime).* have hired the sub-contractors
2.0 lam a sole proprietor or partner- listed on the attached sheet.t 7. 0 Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
working for me in any capacity. workers'comp. insurance. 9. 0 Building addition
[No workers'comp.insurance 5. 0 We area corporation and its
required.) officers have exercised their 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work right of exemption per MGL 31.0 Plumbing repairs or additions
myself.(No workers'comp. c. 152,§I(4),and we have no 12.0 Roof repairs
insurance required.)r employees.[No workers'
O
comp.insurance required.] t3.Lr Insulation
'AM applicant that chaks box NI must also fill out the section below showing their woherg Wmpcnsarbn policy Information.
r lameawnvn who submit the affidavit Ndianwg they arc dnmgan work tat taco hoc outside canaanos mist submit a new affidavit indicating such.
tea-actors that check this box must attached an additional sheet showing the name of the subcontractors ad their waters'comp.policy information.
tam an employer that la providing workers'compensation insurance for my employees. Below a the policy and job site
information.
Insurance Company Name: Guard Insurance Companies
Policy#or Self-ins. Lie.If AMWC73r
1485 ` hExpiration Date: 09/04/2017
lob Site Address: 73 [,`)'pckko 4" rl L . `,
city/state/zip: �r r\0.rsl r Mit'
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Do
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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I ik hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Sienatartjarti ft. jC7!2 —, .Da ; 15 }
11—
Phone#: 413-55200
Official use only. Do not write in this area,to be completed by city or town official
City or To : Permit/License 0
Issuing Authority(circle one):
I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6,Other
Contact Person: Phone#:
A d WMD
CERTIFICATE OF LIABILITY INSURANCE DATE IWY Y0
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 AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES
BELOW TT9S 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 Pollcy(MN)must be entlotsed. If SUBROGATION IS WAIVED,subject to
the Arms and condition*of the policy.certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such a.domament(e).
PRGNICFR Linda Dowers
Webber & Grinnell PFAOXE (213)586-0111 1FMIRAG. ryt.(6133566-6483.
8 North King Street Itaat 1powers@embberandgrimsll.cm
emu/imam AMt4G COMM t tat eNorthampton !A 01060 INSUROM Employers Mutual Casualty
mountNJSINERSBee=bshize NatAasay OTAFD ins. Ca.
American Installations, LLC wwReRm
Attn: Wee & Susanne Couture MSUPZR II ..
130 College Street, Suite 100 IxwREn e: ,_ _____._.........
Swath Badley hA 01075 INsugA F:
COVERAGES CERTIFICATE NUMBER#Sstr asp 9-2011 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE GOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUER OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS MID CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
MA-- AD.siAlit
LT8, T3411ef9411088XR8 web Mlle' Pm1CV N140611I F MS% �-•_— Llan;
COMNeact8L WNfllt t4fl•t 1 E EACH OCCURRENCE 1,000,000
A CLAMS-MCC OCCUR i RR6M9M
E6(11E.00r4Uel 500,000
CLAMS-MCC
X Liquor liability SDE535217 9/4/2016 9/4/2017 MED EXPtany me anon) 10,000
..... .. PERSONAL it ADV INJURY 1,000,000
_GEN.AGGREGATE UNIT APPt)ES K_R. 1 GENERAL AGGREGATE 2,000,000
XJCv
X P ' ,R4' I I LOC PRODUCTS,CXMG:06AGO 2,000,000
OTHER:
AM/MOMS LMMIIFY
COMM 'O SINGLE UNIT 1,000,000
A I IAN(AUTO BODILY IINVHY(Pmr Prowl
AUTOS EO tt--%--�;�0E651:IAEC SC3635217 0/4/2016 9/4/2017 SOOILY INJURY(Poem o)
R Ne2E0 AUTOS j X1AP% Yd£OPROPERIYy(JLWn)..
i imp-84s 8,000
X I UMBRELLA UAB OCCUR EACH OCCURRENCE } 1,000,000
A : EACF89 LIO CLAIMS-MACE AGGREGATE F 1,000,000
GEP . X RErem&NF 20,000 SJ5015217 9/4/2016 9/4/2017 S
WORKERS GOYS'LAMW YIN Ir mAME PER (ERN
AND EMPLOYERS'UA9NJlY
arc oERMEMBERexc NE14ExECImYe '- �E L.EACH ACCIDENT $ 400,000
B I(Y.ICERIM in 100 E%Ct WEf �... MIA 1
gWyRmrealmL:1 tAiNC609911 9/4/2016 9/4/3017 EL pSEAT�Y-EA EMIiOVEj3 500,400
der
0ESCmPTION Of OPERATIONS Mw IELDISEASE-POUCVUMIT IS 500,000
A I Commercial Property 51353521' 9/4/2016 9/4/2011 I emcee Wtme S20,000
jdebar 61.006 $40,000
I
DE3G40PCON OF OPERATIONS/LOGAnONS I VEMCIES(ARD1in,AO]MauL Rau*.04MIN,nay l'SMl'MA86 amare*moots rewired)
CERTIFICATE HOLDER CANCELLATN]N
SHOULD ANY OF THE ABOVE MSC ROW POLICES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERER N
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTwRDSD REPRESENTATIVE
Kevin Joyce/LMP —
E)1g5&2014 ACORD CORPORATION, All rights reserved.
ACORD 25(2014/01) The ACORD name and logo an registered marks of ACORD
bilteMIm,401,
Massachusetts-Department of Public Safety Unrestricted-Buildings of ally use group which
contain
Board of Building Regulations and Standards than 35,000 cubic feet(991m )of
Construction SupeM Aar
enclosed space.
License:CS-106778
Erna /
�,„
WESLEYCOi7I1gtE rs.
166NORTHMAIN
Soatb Ridley big BJ
Failure to possess a current edition of the Massachusetts
i. State Building Code is cause for revocation of this license.
Expiration Fce DcsLicensing informauon visit ane.Mass.Gov/D9S
Commissioner 09/29/2017
Crie fa . jf ?C.17 ac�,�,�i.�e 6
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Type: LLC
AMERICAN INSTALLATIONS,LLC. Registration: 175882
130 COLLEGE STREET SURE 100 Expiration: 08/28/2010
SOUTH HADLEY,MA 01075
Update Address and return card. Mark reason for charge.
-A 1 Co 20M-05/11
n Addr�• n.Res e-.i fEmplayment_Qtp.W_Cerel
-T lf-rnime iiwredd,/"4.,orAu,.m
Office of Corte/mar Affairs a Business Repiallon
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
TYPE:LLC More the expiration date. If found return to:
Ra LL.S.n EttgirAIL011 Office of Consumer Affairs and Business Regulation
175982 08/26/2019 10 Perk Plaza-Sults 5170
AMERICAN INSTALLATIONS,LLC. Boston,MA 02116
WESLEY COUTURE
130 COLLEGE STREET SUITE 100
SOUTH HADLEY,MA 01075Cha r valid without signature