43-058 51 WESTHAMPTON RD BP-2017-0837
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:43-058 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGLLcc.1144/2�A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2017-0837
Project# JS-2017-001401
Est.Cost: $4084.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: AMERICAN INSTALLATIONS LLC 106178
Lot Siee(su. ft.): 15333.12 Owner: NGUYEN OUEHUONG
Zoning: Applicant: AMERICAN INSTALLATIONS LLC
AT: 51 WESTHAMPTON RD
Applicant Address: Phone: Insurance:
130 COLLEGE ST (413) 552-0200 WC
SOUTH HADLEYMA01075 ISSUED ON:I/6/2017 0:00:00
TO PERFORM THE FOLLOWING WORK ATTIC & 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: 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 1/6/2017 0:00:00 $65.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File N BP-2017-0837
APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC
ADDRESS/PHONE 230 COLLEGE ST SOUTH HADLEY (413)552-0200
PROPERTY LOCATION 51 WESTHAMPTON RD
MAP 43 PARCEL,058 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
Es '.OSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid j- 1n'
Building Permit Filled out Q,7 A
Fee Paid
TypeofConstruction: ATTIC&BASEMENT - • IQN&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
INFORMATION PRESENTED:
p-cpproved 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
Pennit from Elm Street Commission Permit DPW Storm Water Management
D o
itT achy
Signature-PT 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.
\ \ )��.,j 16-2183
\ l,)/""
/� IR \ A ' ' Depanmehf use only
( #.
i.4 Z v'City of Northampton Stabrs of Permflb
-'/Building Department CumCutl0dveway Permit
212 Main Street $awe116apbc-AvaAeb�llty
` \ Room 100 WafereWeA Ava(IeblAly _
Northampton,MA 01060 �'vro-setsofsw�nnatHans,
phone 413-567-1240 Fax 413587-1272 ?IoUSite Plans„
APPLICATION 70 CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 Property Address: This section to be completed by office
51 Westhampton Road Map Lot Unit
Florence, MA 01062 Zone OverlayDistrist
Elm St Disutct CB DIsklct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
g.t Omer of Record:
Quehuong Nguyen ehr Eli Nachtman 51 Westhampton Road Florence, MA 01062
Name(Pant) Current Mang Address:
(714)393-1495
See attached Telephone
Signature
2.2 Authorized Anent:
,American Installations 130 College St., Ste 100 South Hadley, MA 01075
Name(Pdntl Current Mantas Adelman.
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 $4,084.18 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Coasbucilon from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fins Protection ,�/� /J //
6. Totale.(1+2+3+4+5) $4,084.18 Check Number 'LC /(l (.�./
This Section For Official Use Only
Date
Building Permit Number. Issued:
Signature:
Budding Commissioner/Inspector of Bult Ings 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 to filled in by
Building Depmhneot
Lot Sin I I I I
Frontage �—
Setbacks Front
Side L: i R:I—J L:I I R:
Rear
I
Building Height I I
Bldg.Square Footage _I % I I I I
Open Space Footage
(Lot area minus bldg&pawl I I I I
parking)
#of Parking Spaces r— I I I
Fill ---� -- I,�
(volume& ocaticn)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW Q YES 0
IF YES, date issued:(
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES O
IF YES: enter Book I Page and/or Document#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 O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES,describe size, type and location: I 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 disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb overt 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 n Addition ❑ Replacement Windows Alterations) ❑ Roofing
Or Doors n
Arrossory Bldg• El Demoliion ❑ New Signs [o) Decks to Siding ED) Otherl
Brief tlescnpton of joroposed ..—
Wortc Attic 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 Roll -Sheet
sa.If New house and or addition to existing housing,complete the following:
a. tise of building: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
a. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance.i Masscheck Energy Compliance form attached?
h. Type of constuction
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 Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
(, Quehuong Nguyen d Eli Nachtman ,as Owner of the subject
PmPerty
hereby autinortze American Installations
to act on my behalf,in aR matters relative to work au hodzed by this building penult application.
See attarhed 1/3/17
Signature of Omer Date
I, American Installations asawner/Authorized
Agent hereby declare that the statements and kdonnation on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pais end penalties of perjury.
American Installations
Pant Name
American Installations 1/3/17
Signature of Omer/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Wesley K. Couture 106178
License Number
130 College St., Ste 100 South Hadley, MA 01075 9/29/17
rens
Expiration Date
/� ��
/0'1J •ta. WiI�L//7,LZ413-552-0200
Signature Telephone
..
9:Registered Home Improvement Contractor: _ - _ _ Not Applicable 0
Wesley Couture 175982
Company Name Registration Number
American Installations 6/77/17
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.._.. BI No 0
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 sets
as supervisor.CMR 780, Sixth Edition Section 1083.5.1.
Dermition 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,attacked or detached structures arr.csory 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 building 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 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
Massachusetts r S- N.
c� . . ,
i DEPARSDRNT OF BUILDING INSPECTIONS 1p
-. 212 Main Street • Maicipel Building =JL\ C"
-=--_. Northampton, NH 01060 "if)
Property Address: 51 Westhampton Road
Contractor
Name: American Installations
Address: 130 College Street Ste. 100
City, State: South Hadley, MA
Phone: 43-552-0200
Property OwnerQuehuong Nguyen d Eli Nachtman
Name:
Address: 51 Westhampton Road
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.
Contreytor si� re (0-Z/14/-t-----
Date Date (�L/ ,(ti(i-
1/3/17
:P
rae
licenseaamsured 6.11,11:41 www.America�stalations.com
MA CSI>:1061M American Installations
MA Registration p 175982
-Efficient Home services-
130College Street Suite 100,South Hadley,FM 01015 • Office:(413)552-0200 Fax:(413)552-0302 • Email:Support@AmericanImbllations.cam
AIR SEALING PROPOSAL
Que Nguyen
51 Westhampton Rd
Northampton-MA 01062-9715
Site ID: 500050267776
Project ID: P00050307902
Customer ID:C00050269577
Contract ID:20161216 ASEAL
Description Quantity Location
Parlor Air Sealing at Estimated 62.5 CFM50 Per Hour 12 Living Space $1.011.84
Exterior Door Weather Stripping ,.- -,-_ 3 NIA $82.77
Door
_.....�.—__ .. _.... .. .___.
DSweep 3 N/A $69.54
Sub Total: $1,164.15
Utility Incentive Share $1.164.15
Customer Contribution $0.00
WARRANTY:American Installations,DLC will provide the above stated homeowner with a 2 year workmanship warranty.
American Installations,LLC hereby proposes to furnish all material and labor to complete the above scope of work in accordance with the above specifications
and all local and state building regulations for the Total Contract Value as stated herein.
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions TOTAL CONTRACT VALUE_$ 0.00
are satisfactory and are hereby accepted.You are authorized to do work as
specified.Payment will be 1/3 down prior to start of work,and balance due Down Payment-$ 0.00
PAID
upon Completion. aalano Rue Upon Completion=$ 0.00
Signature I Date 12-16-2016
Property Owner(Print) Nguyen&Nachtman Que&Eli (Sign) Date
Craig A.Dragovich ///�//�/ 12-16-2016
Representative:Pint) (Sign) a(// Date
The 61^11Meg IS COM P05t0 TH'S'ATE AND ME VERSE r'E T"PAGE AND SHALL B€MNSI DERE°THE ENTIRE AGREEMENT RV ME rur ES INVOLVED.THIS AGREEMENT IS IETWEEN AM EFLICAN INSTALUVriONS.
uc nrSRN•rrtn REFERRED TO AS mMPANr.AND THCUSTOMER(5i NAMED APPROPRIATE LAWS.REGULATIONS AND onINANCES OP THE
THIS AGREEMENT IS COMPOSED OF THIS PAGE AND THE REVERSE SIDE OF THIS PAGE AND 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(S)NAMED ON THE REVERSE SIDE,HEREINAFTER
REFERRED TO AS"CLIENT",AND WILL BE SUBJECT TO ALL APPROPRIATE LAWS,REGULATIONS MID 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 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(1-1/2)
PERCENT PER MONTH.(18%PER ANNUM)WITH A MINIMUM CHARGE OF$2.03 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 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 CUENT 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 I NSURANCE
COVERAGE,ANY SUCH ADDITIONAL EXPENSES,PREMIUMS OR COST SHALL BE 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 EXTENTTHOSE 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 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.IFA PPE-IXISTING 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 AND/OR DAMAGES,INLCUDING BUT NOT
LIMITED TO MOLD GROWTH,ARISING FROM THE PERFORMANCE OF AIR SEAUNG 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 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. 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 BY A 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.
18. 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 25%OF THE AGREEMENT FOR RESTOCKING FEE.
20. ANY CHANGES TO MATERIALS BY THE CLIENT(BRAND,STYLE,COLOR,ETC.)AFTER SAID MATERIAL HAS BEEN DEUVERED 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 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. 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.
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 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(I.E.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 UTLITY 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 TAKES THAT ARE APPLICABLE TO THIS AGREEMENT.
parianns
COMILICIOR
Licensed&Insured • www.Amerieanlnstallations.eam
MA`SLp /OD 7S American Installations
MA Registration#175982
-Efficient Home Services-
130 College Street Suite 100,South Hadle ,MA0107S • Office:(4131552-0200 Fax:(413)551-0301 • Email:support@AmericanInslalladom.com
WEATHERIZATION PROPOSAL
Que Nguyen
5I Westhampton Rd
Northampton,MA 0I 062-9715
She ID:S00050267776
Project ID: P00050307902
Customer ID:C00050269577
Contract ID:20161216 WORK
Description Duantny Location
InsuMte Rim Joist W M 2'Thermal Danser Polyiso 52uvirrs Space $22B.80
.. ___. __. $_.8
Insulation Renwval 52 N/A §59800
insulation Removal 40 N/A E4600
Hatch:Thermal Barrer Polxlso 2inch jftbcl 1 Living Spare $41.11
- _
MatM'Thermal Gamer PsHyiso2 nchSAtbc) _.... 1 Lmrrq Space... §4111
Ream Bath Fan Mose 3 NIA E]22]
Propavent 2'0r4 56 Attic $214.4B
_.
AMC Floor Open Blow Cellulose 5' 5I6 L'rnrg Spam $806 40
RR:event 2'or 48 Attic $183.84
.. . _..
Attic Fbor Open Blow Cellulose 9' 672 Living Space . 81,115.52
Damming 50 WA $109.50
Sub Total: $2.920.03
Utility Incentive Share $Z000.00
Customer Contrihudon $920.03
WARRANTY:American Installations,LLC will provide the above stated homeowner with a 2 year workmanship warranty.
American Installations,LLC hereby proposes to furnish all material and labor to complete the above scope of work in accordance with the above specifications
and all local and state building regulations for the Total Contract Value as stated herein.
ACCEPTANCE OF PROPOSAL:The above prices specifications and conditions TOTAL CONTRACT VALUE=$ 92003
e satisfactory and are hereby accepted.You are authorized to do work as Down Payment=$ 30000 12/I6/2016
specified.Payment will be 1/3 down prior to start of work,and balance due
PAID
upon Completion.
BalanceUpon Completion=$ 62003
Signature Date 12-16-2016
Nguyen&Nachtman
Property Owner(print) (Sign)Craig
Date
Representative:{Print) Craig A.Dragovsch (Sign) Date
Ibi62016
tic HE RERAFTR REFERRED TOR comps,wD THE SW,
ERpNAPPROPRIATE uws.asuou.iox:AND ORINANCENOF THE
THIS AGREEMENT IS COMPOSED OF THIS PAGE AND THE REVERSE SIDE Of THIS PAGE AND 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%)NAMED ON THE REVERSE SIDE,HEREINAFTER REFERRED
TO AS'CLIENT",AND WILL BE SUBJECT TO 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 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 AODEO FROM THE DATE THEREOF AT A RATE OF ONE AND ONE-HALF(1-112)PERCENT PER
MONTH.(L8%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 RIGHT TO A LEIN ON THE PROPERTY.
I THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,THE COMPANY WILL ADVISE THE CLIENT AS SOON AS REASONABLE.
4. 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 WITH 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 15 LATER.
5. THE QUOTATION ON THE PAGE HEREOF DOES NOT INCLUDE EXPENSES OR CHARGES FOR BOND OR INSURANCE PREMIUMS OR COSTS BEYOND NORMAL I NSURANCE COVERAGE,
ANY SUCH ADDITIONAL EXPENSES,PREMIUMS OR COST SHALL BE ADDED TO THE TOTAL AGREEMENT AMOUNT.
I. 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 SOLEY DUE TO THE COMPANY'S NEGLIGENCE.
0. 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.E.G.
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 NODFIED 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 CUENT 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 ASA RESULT OF ANY KNOWN OR UNKNOWN MOISTURE CONDITIONS.
Il. 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 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 ANY MINOR DAMAGES,SUCH AS SCRATCHING OR DENTING OF INTERIOR WALLS AND CEIUNGS 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.
14 THE COMPANY UNDER PROVISIONS OF CHAPTER 142A OF THE GENERAL LAWS IS REQUIRED TO APPLY FOR ANO 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 BY A 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 WITHOUTTHE MUTUAL WRITTEN CONSENT OF BOTH PARTIES EXCEPT AS OTHERWISE SET FORTH HEREIN.
18. THIS AGREEMENT,AND ANY WARRANTY(S)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THE COMPANY.
W. 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 25%OF THE AGREEMENT FOR RESTOCKING FEE.
20. ANY CHANGES TO MATERIALS BYTHE CLIENT(BRAND,STYLE,COLOR,ETC.)AFTER SAID MATERIAL HAS BEEN DELIVERED OR IS IN ROUTE TO THE CLIENT COULD RESULT IN A PP 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 EARUER EXECUTED BY THE CLIENT 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.
22. 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.
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 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 (I.E. 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 MLT'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 ACIIONS OF THE COMPANY UNDER THIS AGREEMENT.
28. 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.
tIs The Commonwealth of Massachusetts
n r- a Department of Industrial Accidents
t Office of'nvestigations
Itfia
� .t 600 Washington Street
Vila
eau_ -. Boston,MA 02111
. > www.mass.go ldia
Workers' Compensation Insurance Affidavit: Builders!ContractorslElectriciuns/Plumbers
Applicant Information Please Print Legibly
Name(nnsi„esst rganinvonnndividualy: American Installations,LLC
Address: 130 College Street,Suite 100
City/State/Zi South Hadley,MA 01075 Phone#: 413-552-0200
Are you an employer?Check the appropriate buy: _ Type of project(required):
L[ I am a employer with 31 4. 9 I am a general contractor and t 6. 9 New construction
employees(full and/or part-time).' have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.I 7. 9 Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
working for me in any capacity. workers'comp. insurance. 9. 9 Building addition
(No workers'comp. insurance 5. We arca corporation and its 10.'j_1 Electrical repairs or additions
required.) officers have exorcised their
3..3 I am a homeowner doing all work right of exemption per MGI. ILO Plumbing repairs re additions
myself.[No workers'comp. c. 152,§I(4),and we have no 129 Roof repairs
insurance required.)d employees. [No workers'
comp_insurance required-) w1= Other Insulation
^Airy applicant that checks basal must also Mout the.section below showing their workers'minimisation policy information.
limn-maws who submit this affidavit indicating May arc doing all work the that hi,eoatsiam contractors must submit comas affitizrncy iitormi such.
K nnmcmn that check this box mast attached an additional sheet Mowing the name of the sulaconrradlurrs and their workers-comp.policy information.
l am an employer that is providing workers'compensation Insurancejar r+9'employees. Below is the policy and job site
information.
Insurance Company Name Guard Insurance Companies
Policy#or Self-ins. Lie,#. AMWC731485 } _ Expiration Date:(009/04/201.7
es1 _
Joh Site Address: 51 WIZ. ill §.fes _City/Smle/Zip:_ Florence ,AAA- 01O(Z.
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 ofa
fine up to S 1,500.00 andJor one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a fine
of up to 5750.00 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.
do hereby certify under the pains and penalties of perjury that the information provided above is truet
and correct.
Signatur : w1„ 4 •tja..a
u !/t ' ,. t/7 Date: 1 g� 1 11
Phone#: . 413-55_0200
Official use only. Do not write in this area,to be completed by miry or town official
City or Town: Permit/License tt
Issuing Authority(circle one):
1 I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector A Plumbing Inspector
6.Other
Contact Person: Phone#:
ACORDM CERTIFICATE OF LIABILITY INSURANCE I DATEHIPAID VYVI
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 POLICIES
RFI OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed If SUBROGATION IS WAIVED,subject to
the terms and tondidgns 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 endorsement(s).
ACT
PRODUCERRIME: rant Powers
Webber & Grinnell SIN. . (413)586-0111 IIm Nol_(4135566.8481
S North King Street q REse lPoTrers@vebberandg vnnell.con
MAURE-SI AFFORDING COVERAGE NAME
Northampton MA 01060 _ INSURER A'Emp1oyers Mutual Casualty
INSURED xwREaa13exkahire Hathaway PD1 RD Insco
American Installations, LLC INSURER 0:
Attn: Wes 4 Suzanne Couture INFIRM 01 _ _
130 College Street, Suite 100 ,deme: _.
South Hadley IA OSOTS I14aun6a R:
COVERAGES CERTIFICATE NUMBERMaster Exp 9-2017 REVISION NUMBER:
THIS 1$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 SE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED EY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDEHONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAWS.
IRSRI .—Rry
•. SCYEFF FO VEMP _ _....... IbMfv
LTRI TYPE OF INE W PAMPER rete POLICY MMIDP'Y1YY11MWQN
OVYYI
i COMMERCLLL GENERAL ILLW TR I EPOS OCCU4RA3KE IS 1,000,000
A X CLAIMS-MADE L.!GCCUR „PREMISE ^E^ice ii
Air 500,000
X{guor Liability 503535211 9/412015 9/4/2017 MEDEXP¢my oneYrSon) IS 10.000
PERSONAL A ADVINJORT '$ 1,000,000
_..J _.....—.. I _.... .._
I GEML AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE 8 2,090,000
X POLICY'�y(IT I incC rym HTS_COMP/OPAGG It 2,000.000
MUOTHER'. 9
I^ T LIABILITY L"' E EDINGLE LIMIT(rear t 3,090,000
A .,`—MYY AUEO — PODS,INJURY Met Hutson) 1
ALL OPINED 'SCHEDULED
AUTOS ,X'Autos SL3535219 9/6/2014 . 9/4/2012 BODILY INJURY:per uwOent) 1
HIRED AUTOS AUTOS U I HRrPERTL DAMAGE. S ..—
XX .AUTOS :1110. 111 _ ....—
'�)Resasn tS 8,000
I A I IWBRELLA LIAS I.o u EACH OCCURRENCE t$ 1,000 Of 00
—.
A EXCES4 W8 URIMS�MADEJ Ir AGGREGATE 15 1,000,000
X 56/3535219 9/4/2016 9/4/2017 I IDI
DEC RETENTION 10.000 PER
AEEPLOYERSXSAtfl - x I aTATVSE I _L.ERN ___
AND PRPIOIETRW'W&Litt
:ANY PRJILtMIW EXCLUDED,
Pi II Fl EACH ACCIDENT $ 500,000
B '•Lunsuc:y inm eExCLUDEO? -M/A
EWM*LHIN me "`- LTNC60993] 51/4/2016 9/6(2pR Et dSEA.%_EL EMfLOYE25 500,000
EstKsmbvantler
DE.^9PImHJN OOP OPERATIONS*My • L.DISEASE-POLICY LIMIT b 500,000
A I Commercial Property : -511.3535II7 9/4/2016 9/4/2011 LeSstib1,6 S1W0 $20,000
aLgumet Stam 540,000
DESCRIPTIONOF OPERATIONS I LOCATIONS.VEHICLES Iacono tot ACderre RemeYO Schedule,may sr*Raclin,xeOrewte D MEADS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE , J
Kevin Joyce/LMP .%�"" "-----C— --
C11985-2014 ACORD CORPORATION. All rights reserved.
ACORD 25)2014/01) The ACORD name and logo are registered marks of ACORD
INS025 omen.)
ipMassachusetts-Department of Public Safety Unrestricted-Buildings of any use group which
Board of Building Regulations and Standards contain less than 35,000 cubic feet(991m3)of
Construction Supervisor Mlle enclosed space.
License GS-106178 '
r. o.
WESLEY COU'CUJIE Vis. 111111
166 NORTH MAIN sap r.
South HadIcy llf.>FOl0j *`-
VVFailure to possess a current edition of the Massachusetts
9-2....,,ry .." nn sx Expiration State Building Code is cause for revocation of this license.
se.Commissioner 09/29/2017 rot DPS licensing information vitt wnw.Mass.Gov/DPS
C/lie W Um -nwea,! a 0/ i29arytcrdim61
- y Office of Consumer Affairs and Busi ss Reg' lation
_Slr 10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 175982
Type: LLC
Expiration: 6/27/2017 Trp 265208
AMERICAN INSTALLATIONS, LLC.
WESLEY COUTURE
130 COLLEGE STREET SUITE 100
SOUTH HADLEY, MA 01075
Update Address and return card.Mark reason for change.
scan Co 201.105/110 Address 9 Renewal ❑ Employment ❑ Lost Card
c9G.`F ,,,.,ecru cAlireltoe4aJeal
Office ofCona Affairs&Business Regulation License or registration valid for individul use only
N OME IMPROVEMENT CONTRACTORFeg
before the expiration date. If found return to:
istratlon: 175962 Type: Office of Consumer Affairs and Business Regulation
Expiration: '62772017 LLC 10 Park Plaza-Suite 5190
Boston,MA 02116
AMERICAN INSTALLATIONSLEt
WESLEY COUSTRE / /
130 COLLEGE STREET SUITE 100 y�- ij ALT /%/(,/
SOUTH HADLEY,MA 01075 Undersecretary N 41id without signature