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35-281 (8)
114 WOODLAND DR BP-2017-0793 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35-281 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-2017-0793 Project# JS-2017-001320 Est.Cost: $4221.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq.ft.): 30317.76 Owner: DUGGAN PETER J JR& STACY L Zoning: Applicant: AMERICAN INSTALLATIONS LLC AT: 114 WOODLAND DR Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON:12/16/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:ATTIC & BASEMENT INSULATION &AIR SEALING 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 ft 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: FeeTvpe: Date Paid: Amount: Building 12/16/2016 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0793 APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY (413)552-0200 PROPERTY LOCATION 114 WOODLAND DR MAP 35 PARCEL 281 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT r/ Fee Paid iti Building Permit Filled out Fee Paid Typeof Construction: ATTIC& • • INSULATION&AIR SEALING 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 INFpRMATION 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 Dem ition Delay. Signature of ilding ffrcial 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. 16-2060 . �� Uepaztnuntbse as r ' // '\City of Northampton Status of Permit t / building Department club cuVonreway Pemdt <T \k j 212 Main Street SewedSepticAveihablily , i - Room 100 WaterAVeu Avanabaityy. Northampton,MA 01060 Two serepfsBdca,retplans . one 413-587-1240 Fax 413-587-1272 Plot/Site Plans w`< OClerpedy -__. ' - ! ATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR IWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: This section to be completed by office 114 Woodland Drive Map Lot Unit. Florence, MA 01062 zone overlay District Elm SI Mulct CB Diatrict SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 24 Owner of Record: .} fA C y 7 / ter' fl t4 7 a c r) 114 Woodland Drive FIorence, MA 01062 Name / /J �a� r�ss See ached Tetridt P2/1760 663 %unsure $2 Authorized Anent American Installations 130 College St., Ste 100 South Hadley, MA 01075 Name(Pmol) Current Mate Addams: American Installations 413-552-0200 Signature Teieatone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $4,221.40 (a)8uidwg Permit Foe 2. Electrical (b)Estimated Total Coat of ConsWdton from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection KP 6. Totale(1 +2+3+4+5) $4,221.40 Check Number 36-'/3 This Section For Official Use Only Building Permit Number. Isu Isssued: Signature: Building Comdsabnedlnspector of Buildings Date t Section 4. ZONING An Information Most Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Huil&og Department Lot Size - - Frontage I Setbacks Front Side L:I I R: L: RI I I I I Rear I Building Height Bldg.Square Footage I I Open Space Footage got arta minas bldg&paved I II I I I parkin) #of Parking Spaces I--j I I Fill: (volume a.i:et) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW O YES O IF YES, date issued:) IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book I I Page I and/or Document# 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 O Obtained O , Date Issued: C. Do any signs exist on the property? 'YES O NO O IF YES,describe size,type and location: 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 disturb(dealing,grading,excavation,or filling)over I acre or is B part of a common plan that will disturb overt acre? YFS O NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. r SECTION 5-DESCRIPTION OF PROPOSED WORK fcheok all applicable) New House 0 Addition 0 Replacement Windows ADeration{s) Q Roofing 0 Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [n] Decks j0 Siding 8li Other* — Brief Desaiption of Proposed Ware Mho and basement insulation and air sealing throughout Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes `No Plans Attached Rog -Sheet Pa.It New house and or addition to existing housing,complete the following: a. Use of building One Family Two Family Other b. Number of rooms In each family unit Number of Bathrooms o is them a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? L Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction I. Is construction within 100 ft.of wetlands? Yes No. Is construction wIthin 100 yr. floodplain Yes_No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank city SewerPrivate well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Peter e'r Stacy Duggan as Omierofthe subject PeonertY hereby authorize American Installations to act on my behalf,in ail matters relative to work authorized by this building permit application. See attached 12/14/16 Signalum of Owner tate I. American Installations ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are Sue and accurate.to he best of my knowledge and belief. Signed under the pains and penaides of perjury. American Installations Print Name American Installations 12//14/16 Signature of Ovmert neat Date I t SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: Wesley K. Couture 106178 Llceme Number 130 College St., Ste 100 South Hadley, MA 01075 9/29/17 Address g / Expiration Data IN 11LC(!(� (: 7:(. .w413-5 - 00 Signature X Telephone 9.Registered Home Improvement Contractor: _ Not Applicable 0 Wesley Couture - 175982 Company Name Registration Number American Installations 6/27/17 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 N No ❑ li. -Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 sets as supervisor.CMR 780, Sixth Edition Section 10835.1. 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 sad/or Than 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 bnildine 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 maybe liable forperson(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 ec Massachusetts ti 'rte LA '"°4' ' Seip i 1 L /T[ t0PARTMENT of 002/41ING INSPECTIONS u 212 Main BCr.st • 15,aicipal Building Nosthaopton, 21‘ 01060 Property Address: 114 Woodland Drive Contractor Name: American Installations Address: 130 Colleke Street Ste. 100 City, State: South Hadley, MA Phone: 43552-0200 Property owner Peter e"r,Stacy Duggan Name: Address: 114 Woodland Drive City State: Florence, MA 01062 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 signature Date 12/14/16 i 2t Licensed&Insured L • www.Americae nstanationseom MA CSca:SrMIlB American Installations MA 8c4istro[mn a 17598Z -Efficient Home Services- 13OCollege Street Suite 100,South Hadley,MA 01075 • Office:(413)552-0IDJ Far 14131 S52-0202 • Email:54pport@AmenpnlnRAllations.com AIR SEALING PROPOSAL Stacy Duggan 114 Woodland Dr Lot 10 Florence.MA 01062-9617 Site ID: 500050254820 Project ID:P00050292671 Customer ID:C00050256555 Contract ID: 20161201 MEAL Description Quantity Location Perform Air Sealing at Estimated 62.5 CRAW Per Four AAA A. 18_.._...-Livinairace . .$1,34811... _ __. Sub Thal: $1,349.12 Ublty Incentive Share $1,349.11 Customer Contribution $0.00 WARRANTY:American Installations.LLC will provide the above stated homeowner with a 2 year workmanship warranty. American Installations,tic hereby proposes to famish all material and labor to cornpletethe above scope of work in Accordance with the above specifications andand st tebnik6ngregdatans FC(the Total contract Value as stated herein. ACCEPTANCE OF PROPDSAC The above prices,specifications and conditions TOTAL CONTRACT VALUE=$ 0 are Satisfactory and are hereby accepted. you are authorized to do work as Down Payment=$ 0 0 'Witted.Payment will he 3/3 down prior to start of work,and balance due PAID upon Completion. Balance Due Upon Completion=$ 0 Signature ✓ Date 12-1-16 Property Owner(Print/ (Son} �� Date Representative.MOM/,,,,, Joel Martell (Sign)_. r'(�y/})/"✓ Date 12-1-16 MISAWEEMENt 15 COMPOSO OP MI5 PAGE MID MP emu IK Ern RE AGREEMENTS.TM PARTIES m.TILVED... TIE.HER IN•FTtR RE"AAFOTO AL'COM PAW.ANO ME ..MERCJNAMED�MOO-aRENNAFTER AEPERn0'VA .aeNr.AlD.4LL w wWECTTO ALL A.,wPi.n LLAAWS,SEG UL SOl:..o ORDI"NCESO Mia. THE FOLLOWING TERMS AND CONDITIONS ALSO APPLY 1. THIS AGREEMENT IS SUBJECT ID THE APPROVAL OF A MANAGER OF THE COMPANY FOR THIS AGREEMENT TO BE EFFECTIVE UNDER ANY CONDITION. t 2, SHOULDOEFAULT BE MADE IN MAEPAYMENT OF THIS AGREEMENT,CHARGES SHALL BE ADDEDDPROM THE DATE THEREOF AT A RATE OF ONE AND ONE-HALF(14/21 PERCENT PER MONTH.(113%PER ANNUMEWITH AMINIMUM CHARGEOG$7.00 PER MONTH,AND IF P(M',EOINTHE HANDSOF ANATTORNEYOR COLLECTION AGENCY PoRCOLLECTIION,ALLAnTORNEYS'FEES,EXPENSESANOCOST5 OF COLLECTION SHALL BE PAID BY THECLIENT.IN ADDITION.CLIENT UNDERSTANDS THAT IN FADING TO PAY ACCORDING TOTHE ABOVE TEAMS COMPANY MAY NAVE THE NIGHTEOA 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. A. COMPANY AGREES THAI.NOTWITHSTANDING ANY AGREEMENT FOR MATERIALS AND/OR LABOR BEIWEEN COMPANY AND THIRD PARTY,COMPANY IS RESPONSIBLE TO CLIENT FORCOMPLETION OF ALL WORK DESCRIBED IN A TIMELY AND WORKMANLIKE MANNER, 5. ALL WARRANTIIESFOR EQUIPMENT AND PRODUCTS SUPPLIED BY THE COMPANY UNDER TMS AGREEMENT SHALL BE THOSE GIVEN 8Y 111E MANUFACTURERS Of SUCH EQUIPMENT AND PRODUCTS. UNDER SUCH MANUFACTURER'S WARRANTIES,INE CLIENT MAY BE REQUIREDTO REGISTER OR MAIL IN A WARRANTY CARD OR OTHER EVIDENCEOF 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 TIP)TOTAL AGREEMENT AMOUNT. 7. THE COMPANY'S LIABILITY FOR CLAIMS ARISING OUT OF THIS AGREEMENT SHALL NOT EXCEED THE TOTAL AGREEMENT PRICEEXCET4"0 THE EXTENT THOSE DAMAGES ARE PROVEN TO BE SOLEY DUE TO THE COMPANY'S NEGUG£NCE. S DURING THE ORATION OF THE WORK,THE COMES HOMEOWNERS INSURANCE WILL Be RESPONSIBLE FOR ANY AND ALL DAMAGES AS LONG AS THE COMPANY SEAS 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 ANDCONNECTIONS,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 TMEAND MATENALBASIS.CII NT AGREES THAT SUCH CONDITIONS AREUNAVOIDABLE BY THE COMPANY AND SHALL NOT BE CONSIDERED A VIOLATION OF THE AGREEMENT AND THAT DUE TO THESE CONDTIWR THE DURATION OF THE WORK ANDSCHEDU=ED DATE OF COMPLITON MAY DIFFER FROM THAT AGREED UPON.IF APffiCAFF%LINDER WKKSAGREEMENT. 10 REPLACEMENT OF DETERIORATED DECKING,FASCIA BOARDS,RODE JACKS.VENTTLATORS.FLASHING.RAFTERS,MHSR INSULATION OR OMER MATERIALS ARE NOT INCLUDED UNLESS OTHERWISE NOTED HEREIN. 11, THE COMPANY WILL NOT OF RESPONSIBLE FOR THE SCRATCHING OR DENTING OF INTERIOR WALLS AND CEILINOe FLOORS.TRIM,GUTTERS.DOWNSPOUTS,EXISTING SIDING AND WINDOWS,DOORS, OIL DROPLETS IN DRIVEWAYS,HRACTURES IN CONCRETE OR BLACKTOP DRIVES AND WALKS,OR DAMAGE TO PLANTS OR SHRUBBERY. IF EXCESSIVE DAMAGE IS CAUSED 3Y COMPANY, COMPANY WILL REPAIR OR REPLACE DAMAGED AREA ONLY AT COMPANY'S EXPENSE. 12. IHECOMPANYUNOERPBONSKKYSOFCMPTER IA2AWINE GENERALLAWSISREQUIREDTOAPPYYFOR ANO OMAN AitCONSTRUCDONREUTED PERMITS.T NECOMPANY SHALL NOT BEDEWED RESPONSIBLE FOR DELAYS ITL TME WORK DESCRIBED IN THIS AGREEMENT CAUSED BY REGULATORY PERMIT GRANTING OR INSPECTIONAL.AGENCIES AUTHORITIES.OR INDIVIDUALS, 13. THIS AGREEMENT INCLUDING THE PROVISIONS RELATING TO PRICE AND PAYMENT SCHEDULE,CANNOT BE CHANGED OR ALTERED EXCEPT BY A WRITTEN STATEMENT SIGNED BY BOTHTHECOMPANY AND THE CLIENT. 14 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. Q. THIS AGREEMENTCANNOT BECANCBIED WITHOUT THE MUTUAL WRITTEN CONSENTOF BOTH PARTIESEXCEPT AS OTHERWISE SETEORTM THEREIN. 15 THISAGREEMEN,AND ANY WARRANTY(5)PROVIDED HEREUNDER STALL NOT BF ASSIGNED EXCEPTS'?OR WITH THE WRITTEN PERMISSION OE THE COMPANY, 17. 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 THECOMPANY'!ACTUAL DAMAGES OR 25%OF THE AGREEMENT FOR RESTOCKING FEE, IS. ANY CHANGES TO MATERIALS BY THE CLIENT HIRANO,STYLE,COLOR,ETC.)AFTER SAID MATERIAL HAS BEEN DELIVERED OR IS IN ROUTE TO THE CLIENT COULD RESULT IN A 5%RESTOCKING FEE BASED ON THE COST OF SAID MATERIALS. 19. TRIS AGREEMENTSHALt BE EtfERIVEONLY UPON ITS EXECUTION BY ALL PARTIES HERETO.PRIOR TO WHICH TIME IT SNARL BE DEEMED%PROPOSAL.THE COMPANY RESERVES ENE RIGHT TO REVOKE THIS PROPOSAL90DAYS FROM DATE)9 IS EXECUTED BYTHE COMPANY If IT IS NOTEAANEN EXECUTED8YT ECLIE3Q AND THEREQUIREDDOWN PAYMENT RECEIREDPRIOR TO LAE 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 R$PRICE IN ACCORDANCE WITH ITS COSTS IN EFFECT AT SUCH TIME. 20. IF ANY PROVISION OF THIS AGREEMENT SHOULD BF HELDTO BE INVALID OR UNENFORCABLE,THE VALIDITY AND ENFORCEBILITY OF THE REMAINING PROVIB OHS OF THIS AGREEMENT SHALL NOT BE AFFECTED THEREBY, ZL AR81'TRATIONCIN THE EVENT THE CLIENT AND COMPANY HAVE A WSPIEE REGARDING ANY OF THE TERMS,CONDITIONS,PROVISIOONS,OR PEREORMANCE Of THIS AGREEMENT,THE PARTIES AGREE TO PUCE THE MATTER INTO ARTTmATION BEFORE AN INDEPENDENT ARBITRATOR ASSIGNED BY THE AMERICAN ARBITRATION ASSDOA:HON TORESOLVE THEIR DISPUTE. 22. ANY DISCOUNT,PROMOTION.REIMBURSEMENT,OR OTHER PROGRAM THAT LSPA T OF A STATE SPONSERED VILE PROGRAMIE MASS SAVE%IS SUBIECI TO THE AVAILABILITY OF QUALIFYING STATE SPONSERFD PROGRAM AND WILL BE SURJECE TO TERMINATION IF THE STATE SPONSERED UTILITY PROGRAM IS DISCOUNTINUEO FURTHERMORE,THE TERMS AND CONDITIONS OF STATE SPONSERED UTILITY PROGRAMS MAY BE ALTERED OR UPDATED PERIODICALLY H OR WITHOUT NOTICE. 23. AMERICAN INSTALLERS.LLC IS NOT AN AGENT OF ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,TH ROUGH,OR UNDER THE MASS SAVER ENERGY PROGRAM. 24 WESTERN MASSACHUSETTS ELECTRIC COMPANY fINE UTLITY)ISI ENTITLED TO 100%OF THE ENERGY BENEFITS ASSOCIATED WITH ALL ENERGY CONSERVATION MEASURES,EXCLUDING THE VALUE OF ENERGY COSTSAVINGSBY TMEUIEHT,BUT INCLUDING ALE 01GNTS TO ALLASSOGATED ISO.NE ENERGY,CAPACITY AND RESERVES PRODUCTS.COMPANY AGREES TO PROVIDE THE UTILITY WITH SUCH FURTHER W CUMENTAMON AS TM UTILETY MAY REQUEST TO CONFIRM THE OKAYS OWNERSHIP OF SUCH BENEFITS AND PRODUCTS ZS CLIENT UNDERSTANDS AND ACRNOWtEDGES ENO COMPANY IS NOT AN AGENT,VENDOR OR SUB-VENDOR OF THE UTILITY WITH RESPECT TO THE INSTALLATION OE ANY ENERGY EFFICIENCY MEASURES.IN THE EVENT OP THE FAILURE OF ANY ENERGY CONSERVATION DEVICE TO PERFORM AS EXPECTED.CLIENT AGREES THAT CLIENT'S SOLE RECOURSE ES TO THE COMPANY AND NOT TO CONSERVATION SERVICES GROUP(CSG)OR TO THE UTILITY.THE UTILITY AND ITS OPERATNG COMPANIES SHALL.NOT MAINTAIN,REMOVE OR PERFORM ANY WORK WHATSOEVER ON THE ENERGY CONSERVATON MEASURES INSTALLED.CLIENT UNDERSTANDS AND ACKNOWLEDGES THAT ITS PARTIOPATION IN THE MASS SAVE NOME ENERGY SERVICES PROGRAM IS VOLUNTARY AND THAT IT HAS CONSENTED FOR COMPANY TO INSTALL THE PROPOSED ENERGY CONSERVATION MEASURES. 1% CLIENT AGREES THAT ITSHALLHOT HOLD CSG.THE VTILITY,THEIR AFFILIATES OR OPERATING COMPANIES LIABLE FOR COMPANY'S FAILURE TO PERFORM FM OBLIGATIONS UNOER THIS AGREEMENT FOR FAILURE OF THE ENERGY CONSERVATION MEASURES TO FUNCTION.FOR ANY DAMAGE TO CLIENT'S PREMISESCAUSED BY COMPANY OR FOR ANY AND ALLIMMAEES TO PROPERTY OR INIURY YO PERSONS SAISED BY TEEN NEW CONSERVATION MEASURES. 27. CLIENT IS RESPONSIBLE FOR THE PAYMENT OF ANY AND ALL FEDERAL,STATE,OR LOCAL TAXES-NAT ARE APPLICABLETO THISAGREEMENT. LIMITED TIME OFFER.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. MACLIENTS:You may camel this agreement H h has been signed by a party thereto at a place other than an address of the seder,whzh 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 thanmidnight of the third business day following the signing of this agreement. See the attached notice of cancellationform for an explanation of this right. DATE CLIENT'S SIGNATURE DATE COMPANY REPRESENTATIVE'S SIGNATURE - e • i t i • NNWtOMMTOR Licensed&Insured www.Americanlnstallations.com MA a2 It 106178 American Installations MA Registration p 175982 -Efficient Home Services- 130 College Street Suite 100,South Hades,MA 010]5 • Office:(413)552-0200 Fax:(413)552-0202 • Email:wpport®Amencanlmtalfations.com WEATHERIZATION PROPOSAL Stacy Duggan 114 Woodland Dr Lot 10 Florence,MA 01062-9617 Site ID:S00050254820 Project ID:P00050292671 Customer ID: C00050256555 Conrracl ID: 20161201 WORK Description Quantity Location Hatch_Thermal Barrier Polyleo 2 inch jAlbcj t LiWN Space . .. . $4111 Hach:Thermal Berner Poly`Iso 2 inch(Atbc� 1 LtingSpec, $41,71 Damming __ .... 60 NIA -- - - _ $39904 ANC Floor Open Blow Cellulose 6' -._. 1632 Liv Space -- - $2399.00 Vent bath fan to roof flapper _. . .. 2 Attic $25842 Sub Total: $2,87228 Utility Incentive Share $2.000.00 Customer Contribution $872.28 WARRANTY:American Installations LLC will provide the above stated homeowner with a 2 year workmanship warranty. American Installations,LLC hereby proposes to furnish all material and labor to complete the above scope of work In accordance with the above specifications and all local and state building regulations for the Total Contract Value as stated herein. ACCEPTANCE OF PROPOSAL:The above prices specifications and conditions TOTAL CONTRACT VALUE=$ 872.28 are satisfactory and are hereby accepted. You are authorized to do work as specied.Payment will be 1/3 down prior to start of work,and balance due Down Payment 290.00 12-1-16 upon Completion. Palo � Balance Due Upon Completion=$ 58228 Signature Date 12-1-16 Property Owner(Print) 1Sign) Date 1 Representative:(Print) Joel Merrell (Sign) � Dat 12-1-16 • 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 TMS AGREEMENT,CHARGES SHALL BE ADDED FROM THE DATE THEREOF AT A RATE OF ONE AND ON E-HALF 11E12)PERCENT PER MONTH.i18%PER ANNUM)WITH A MINIMUM CHARGE OF 52AGPER MONTH AND IF PLACEDIN TUE HANDS OF AN ATTORNEY ORCOLUCTKKi AGENCY FOR COLLECTION,ALL ATTORNEYS.FEES.EXPENSES AND COSTS OF COLLECTION SHALL BE PAID BYTP.E CLIENT.IN ADDITION,CLIENT UNDERSTANDSEHAT IN FARJNGEO PAY ACCORDING TO THE ABOVETERAINCOMPANY MAY HAVE THE RGHT TO A LON ON THE PROPERTY. 3. THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,THE COMPANY WILL ADVISE TRE CLIENT AS SOON A5 REASONABLE. A. COMPANY AGREES THAT,NOTWITHSTANDING ANY AGREEMENT FOR MATERIALS AND/OR LABOR BETWEEN COMPANY AND THIRD PARIY,COMPANY IS RESPONSIBLE TO CLIENT FOR COMPLETION OF N.J.WORK DESCRIBED IN ATIMELY AND W CRKM ANOKE MANNER. 5. ALL WARRANTIES FOR EQUIPMENT AND POOUCFS SUPPLIED BY ME COMPANY UNDER THIS AGREEMENT SHALL BE THOSE GIVEN BY THE MANUcACWILFR5 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. >. ENE COMPANY'S LIABILITY ECR CLAIMS ARISING OUT OF THIS PORE-WHEAT SHALL NOT EXCEED THE TOTAL AGREEMENT PRICE EXCEPT TO THE EXTENT THOSE DAMAGES ARE PROVEN TO BE SOLEY OHE TO THE COMPANY'S NEGLIGENCE, @ DURING THE DURAT.YRL OF WE WOW W,E CLANGS HOMEOWNERS INSURANCE WILL BX RESPONSIBLE FOR ANY AND ALL DAMAGES AS LONG AS THE COMPANY HAS TAKEN WE 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,PLU MBINO AND VENT PIPES.DECKING DEFLECTION,ETC.IF A PRE-EXISTING DEFICIENCY OR HAZARDOUS MATERIAL IS ENCOUNTERED PRIOR TO OR DURING CONSTRUONON,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 PSIS.CLIENT AGREES MAT SUCH CONDITIONS ARE UNAVOIDABLE RY THE COMPANY AND SHALL NOT BB CONSIDERED A VIOLATION OF THE AGREEMENT ANDTNATDUE TO THESE CONDITIONS DOE DURATION OF THE WORK ANDSCHEDULED TATE OT COMPLETION MAY DIFFER FROM THAT AGREED UPON.IF APPLICABLE,UNDER TMS AGREEMENT. 10. REPLACEMENT OF DETERIORATED DECKING,FASCIA BOARDS ROOF TAC%S.VENHATORS FLASHING.RAFTERS,JOISTS,INSULATION OR O?WEN MATERIALS ARE NOT INCLUDED UNLESS OTHERWISE NOTED HEREIN. II. THE COMPANY WILL NOT BE RESPONSIBLE FORTH I SCRATCHING OR DENTING OF INTERIOR WALLSAND 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. 12, THECOMPANY UNDER PROVISI2SOEC4APRB LAZAOFTHE GENERAL EAW56 REQUIRED IOAPRY FOR AND OBTAIN ALICONSTRUCTION-REEATEDPERMITS,THECOMPANY MTALLNOT OEOEEMEO RESPONSIBLE FOR DELAYS IN THE WORK DESCRIBED IN THI5AGREEMPNi CAUSED BY REGULATORY PEEWIT GRANTING OR INSPECTIONAL AGENCIES,AUTHORITIES OR INDIVIDUALS 13. THIS AGREEMENT,INCLUDING THE PROVISIONS RELATING TO PRICE AND PAYMENT SCHEDULE CANNOT BE CHANGED OR ALTERED EXCEPT OY A WRITTEN STATEMENT SIGNED BY BOTH THECOMPANY AND THE CLIENT. 14. 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 SURVIVETHEEXECUTION OP THIS AGREEMENT, IS THIS AGREEMENT-CANNOT BE CANCELLEDWPWOIH.THE MUTUAL WRITTEN CONSENT CF OUCH PARTIES EXCEPT AS OTHERWISE SET PORTA HEREIN, IS THISAGREEMEM,D ANY WARRANTYIS)FROVIDEDHEREUNDER SHALT ACT BE ASSIGNED EXCEPT BY OR WITH WE WRITTEN PERMISSION OF CCMPMAi IT IF THE CLIENT FAILS TO PERFORM ITS OBLIGATIONS HEREUNDER OR TERMINATES THIS AGREEMENT WITHOUT-WE PRIOR WRITTEN CONSENT OF THE COMPANY,THE CLIENT SHALL BE LIABLE FOR DAMAGES FOR THE GREAT ER OF THE COMPANY'S ACTUAL DAMAGES OR S%OF THE AGREEMENT FOR RESTOCKING FEE. 10. ANY CHANGES TO MATERIALS BY THE CLIENT(BRAND)STYLE,COLOR ETC.)AFTER SAID MATERIAL HAS BEEN GEL IVERED OR IS IN ROUTE TO THE CLIENT COULD RESULT IN A 5%RESTOCKING FEE BASED ON THE COST or SAID MATERIALS. 39. THIS AGREEMENT SHALL BE EFFECTW£ONLY UPON ITS EXECUTION BY ALL PARTIESHERETO,PRIOR TO WHICH TIME IT SHALL SC Of MEDA PROPOSAL THE COMPANYRESERVES THE BIGHTTO REVOKE THIS PROPOSAL 93 DAYS FROM DATE IT ISEXPCUTED BTME COMPANY iF ITS NOT EARLIER EXECUTED XX THE CLIENT ANDTHE REQUIRED Dow%PAYMENT RECEIVED PRIOR TO THE IXORATION OF SUCH SE DAY PERIOD',AFTER 90 DAYS,ARD 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 UNENFORCA OLE,THE VALIDITY AND ENFORCEBILITY OF THE REMAINING PROVISIONS OF THIS AGREEMENT SHALL NOT BE AFFECTED THEREBY. 21. ARBITRATION,IN THE EVENT THE CLIENT AND COMPANY HAVE A DISPUTE REGARDING ANY OF THE TERMS.CONDITIONS,PROVISIONS,OR PERFORMANCE Of THISAGREEMENT,THE PARTIES AGREE TOPLACETHE MATTER INTO ARETRATYIN BEFORE AN MOEPENDENTARBITRATOR ASSIGNED SO THE AMERICANA AMERICA%MIIRTRAO0t1 ASSO TATgn TO RESOLVE THOR DISPUTE. S2 ANY DISCOUNT,PROMOTION.RCMBURSEMENi,OR OTHER PROGRAM T TIS FART OFASTATE SPONSEREO VOW%FROGRAM iI.EMASSSAVE}ISSUWECT TOIN£AVAILA BILRY OF QUALIFYING STATESPONSERED PROGRAM AND WILL BE SUBJECT TO TERMINATION H THE STATE SPONSEREO UTILITY PROGRAM IS DISCOUNTINUSO FURTHERMORE,THE TERMS AND CONDITIONS OF STATE SPONSERED UTILITY PROGRAMS MAY BE ALTERED OR UPDATED PERIODICALLY WITH OR WITHOUT NOTICE. 23. AMERICAN INSTALLERS,LLC I5 NOT AN AGENT or ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,THROUGH,OR UNDER THE MASS SAVE`ENERGY PROGRAM. 24. WESTERN MASSACHUSETTS ELECTRIC COMPANY THE UTILITY)IS ENTITLED TO 100%OF THE ENERGY BENEFIT'S ASSOCIATED WITH ALL ENERGY CONSERVATION MEASURES,EECLUUNG THE VALUE OF ENERGYCOST SAVINGS BY THE CLIENT,BUT INCWOING ALL RIGHTS TO ALL ASSOCIATED ISO.NEENERGY,<ARAM%AND RESERVES PRODUCTS.COMPANY AGREES TO PROVIDE THE UTILITY WITH SUCH FURTHER OCCUMEN'TATIN AS THE UTILITY MAY REQUEST TO CONFIRM THE UTILDY'S OWNERSHIP OF SIKH BENEFITS AND PRODUCTS. a GIANT UNDERSTANDS AND ACKNOWLEDGES MAT COMPANY IS NOT AN AGENT,VENDOR OR WO- DORM THE unto%WITH RESPECT TO THE INSTALLATION OE ANY ENERGY EFFICIENCY MEASURED IN THE EVENT OP THE FAILURE OF ANY ENERGY CONSEBVATON 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 IR OPERATING COMPANIES SHALL NOT MAINTAIN,REMOVE OR PERFORM ANY WORK WHATSOEVER ON THE ENERGY CONSERVATiON MEASURES INSTALLED.CLIENT UNDERSTANDS AND ACKNOWLEDGES THAT ITS PARTICIPATION IN THE MASS SAVE HOME ENERGY SERVICES PROGRAM IS VOIUNUBY AND THAT IT HAS CONSENTED FOR COMPANY TO INSTALL HE PROPOSED ENERGY CONSERVATION MEASURES. 26. CLIENT AGREESTHAT IT SHALL NOT HOLD 050,THE UTWTY,THEIR APFRHATES.OR OPERATING COMPANIESLIABLE FOR COMPANY'S FAILURE TO PERFORM ITS OBLIGATIONS UNDER THIS AGREEMENT, EOR FARUREOF TUE ENERGY CONSERVATION MEASURES TO FUNCTION,FOR ANY DAMAGE TO[DENT'S PREMISES CAUSED BY COMPANY OR FOR ANY AND ALL DAMAGES TO PROPERTY OR INJURY TO PERSONS CAUSED OY THE ENERGY CONSERVATION MEASURES, 27 CLIENT IS RESPONSIBLE FOR THE PAYMENT OF ANY AND ALL FEDERAL.STATE,OR LOCAL TAXES THAT ARE APPLICABLE TOTHIS AGREEMENT. UMDEO TIME OFFER 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. AIA CLIENTS:You may Lancet this agreement IF it has been signed try party thereto at a place other than an address of the setter,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 mInight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DATE CLIENTS SIGNATURE, DATE COMPANY REPRESENTATIVE'S SIGNATURE The Commonwealth of Massachusetts a Department of Industrial Accidents t- :=cl = _ k{€ • t Office of Investigations '=„r 4 600 Washington Street SI•ie Boston,MA 02171 %,:—..fir wonv.nmss.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers . Applicant Information Please Print Legibly Name(BusinestdOreanlvatioNlndividual): American Installations,LW Address: 130 College Street,Suite 100 City/State/Zip: South Hadley,MA 01075 Phone 0: 413-552-0200 Arc you an employer?Check the appropriate box: I Type of project(required): ( i.J I am a employer with 31 4. CI tam a general contractor and I 6. ❑New construction _ employees(full and/or part-time).' have hired the sub-contractors 2.U I am a sole proprietor or pammr- hsced on the attached sheet.: 7, 0 Remodeling ship and have no employees These sub-contractors have S. 0 Demolition working for me in any capacity. workers'comp.insurance. 9 P 9. 9 Electricangl addition [No workers'comp.insurance 5. We are a corporation and its _ required.) officers have exercised their 10.� repairs or additions 3.0 I am a homeowner doing all work right of exemption per 41GL 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 152,§I(4),and we have no 12.0 Roof repairs insurance required.]' employees. No workers' comp.insurance required.) 13: Other InS'nlfltioii __. Ym)'applicant Out checks hog ill must also till out'he section below iflawiay Ihtir c S err cumpe¢ytion policy(nTrtmntoo. Hamann whosuhmih the aft-playa indi.aimg they are doing all work and then dim outside evrurxtals must submit a new alfdevit indivatiny suck -C ontmnors neat cheek OM bon must alraehcd un additional sheet showing the name of the subconlranms and their workers"romp.pokey informarion. I am an employer shut Lv providing workers'compensation insurance for my employees. Below is the policy and fah site information. Insurance Company Name: Guard Insurance Companies Policy d or Self-iris.L.ic.I.: URWC609917j1 ` `� Expiration Dater: 09/04/2017 gyp^ 1� /ry '} Joh Site Address: 11 k f MCk.ind ri1, City/State/Zip: r\Vrefl��t 1'\P( 0 C")(o 2_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of fine up to 51300110 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a Ern: 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 rha hereby certify under the pains and penufties of perjury that the information provided above is true mutmul correct Signature:/>Say*_r.& S i :.2 Date: 12 I19..*___ Phone F: 413-552-0200 _ i Official use only. Do not write in this urea,to be completed by clot or town official. I IICity or"Town: Permit/License. Issuing Authority(circle one): {({I llI. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other IContact Person: Phone a: 1 AL IS CERTIFICATE OF LIABILITY INSURANCE D 9/1/2 1 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 polieypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may requite an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Linda Powers NAME: ._.... Webber & Grinnell PRONE MID ptNicA Fdt (413)$86-0111 'F Not(413)586-6481 8 North Xing Street n3�DRIFss:1powersewebberandgrinnell.com 615URE TM AFFORDING COVERAGE NAIL r Northampton MA 01060 INSURER A Emp1oyere Mutual Casualty_, INSURED INsunERB:Berkshire Hathaway GDARD Ins. CO. American Installations, TaLC INSURER C: .—.... ._ Attn: Wes S Suzanne Couture INSURER D: 130 College Street, Suite 100 WSUIIERE: South Hadley HA 01075 INSURERS: COVERAGES CERTIFICATE NUMBER95aster exp 9-2017 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 OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMOS SHOWN MAY HAVE BEEN REDUCED BY PAID CU MS. INSRTYPEOFINSURANCE —A�L306Yt Po EFF IMW'OLI 3P thins LIR )NSD PND PoUCy NUMBER )MIND COMMERCIAL GENERAL Wi&Litt EACH OCCURRENCE 1,000,000 RENTED A R CIAIMSJAAOE L l OCCUR DAMAGE TO 500,000 PREMISESEB0041 _ _lX Liquor Liability 533535217 9/4/2316 9/4/2017 MEOExp(My puyetlgP 10,000 __ PERSONAL 6 AOV INJURY 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 R- POLICY I JJEECCTT 100 PRODUCTS-COMP(PAGG 2,000,009 OTHER: AUTOMOBILE Lb1BIUll' ANE°SINGLE Ti AI S 1,000,000 446 A `ANY AUTO BODILY INJURY(Per Faaonl $ ALL OWNED SCHEDULED ANION X AU}CO 523535217 9/4/2816 9/4/2017 BODILY INJURY{ ECken0 $ X HIRED AUTOS X AUT OHNEO WS`ERTYDAMAGAGE 6 Amps IPilaaileml PIP-Basic $ 8,000 X UMBRELLA LMB OCCUR EACHOCCURRENCE $ 1,000,000 A EXCESS DAB CLAIMSMAOE AGGREGATE $ 1,000,000 DEO X f RETENTIONS 10,000 5.73535217 9/4/2016 9/4/2017 6 WORKERS COMPENSATIONx PER DTH• AND EMPLOYERS'LIABILITY YIN STATIAL_ ER ANY PR3°RIETOWPARTNEWEXE0OVE EL EACH ACCIDENT 5 500,000 OFFICEWMEMSER EXCLUDED? NIA B (emeneyM NHI UENC609917 9/4/2016 9/4/2017 EL.DISEASE-EA EMPLOYEE S 500,000 DS RIuyNNuMs, DESLRIPTgN OFOPEPATIONS Etlw: EL DISEASE-POLICY LIMIT 5 SOD,Ogtl A Commercial Property 583530217 W4/2016 9/4/2017 aee259$1,9 0 $20,000 eeax4Ne 21.000 $40,000 DESCRIPTION Off OPEF UONSIIoc4TION9/VEBIcUS DWOR0101,AdAtional Reu,M,lsSMWuk,nvy se smiths If more spaceI4 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. AUT110RI2E0 REPRESENTATIVE Kevin Joyce/LMP FC._ ©1988-2014 ACORD CORPORATION. AU tights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS0251Sm40n FMassachusetts-Department of Public Safety I Unrestricted-Buildings of any use group which f Board of Building Regulations and Standards I contain less than 35,000 cubic feet(991ms)of 7 Construction Supervisor License:CS-106178 I enclosed space. , sT. rs a s 166 NOR MAIN h.! y - South Hadley MA<ol Failure to possess a current edition of the Massachusetts ,s,'o^s'va J.i:..11ExpirationStn[e BuildirB[ade is cause forreyota[bn ofthis6cense. Commissioner 09/29/2017 r For DAS Licensing inaavniaonviat vnvw.Masseov/DPS j L i 1 Office of Consumer Affairs and Busi- ss Regrlation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Ctre'etor Registration Registration: 175982 Type: LLC r=: I L.�7 Expiration: 612712017 Tt# 265206 AMERICAN INSTALLATIONS, LLC.._, '.. _ .I WESLEY COUTURE - 130 COLLEGE STREET SUITE 100,o:',7,-,,,- ;:f s7 r;.r' SOUTH HADLEY, MA 01075 -i Update Address and return card.Mark reason for change. SCA 1 0 20M-05/11 "II 0 Address ❑ Renewal EIEmployment o Lost Card A.5am,no uoea&h otddGrmnd meb Office or Committer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 9Btr+Hon: ->i75982 Type: Office of Consumer Affairs and Business Regulation ExPiratlon: f2417._? LLC 10 Park Plaza-Suite5170 • `= Boston,MA 02116 AMERICAN INSTAIDA fiI'.7%1-III aSr , WESLEY COUTURE`E i / / SOUTH130 COLLEGEST MA ,,et i ' -ham Y y (/`/,— --� SOUTH HADLEY MA 01075 Undersecretary / ' N valid without signature