25A-075 (11) 59 COOLIDGE AVE BP-2019-0092
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25A-075 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2019-0092
Proiect# JS-2019-000147
Est Cost: $3800.00
Fee: $65.00 PERMISSIONIS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use Group: AMERICAN INSTALLATIONS LLC 106178
Lot Siae(sp. ft.): 5314.32 Owner: BRESNITZ VIVIAN
Zoning URB(1GO)/ Applicant. AMERICAN INSTALLATIONS LLC
AT: 59 COOLIDGE AVE
Applicant Address: Phone: Insurance:
130 COLLEGE ST (413) 552-0200 WC
SOUTH HADLEYMA01075 ISSUED ON:7124120180:00:00
TOPERFORM THE FOLLOWING WORKATfIC AND BASEMENT INSULATION &AIR
SEALING THROUGHOUT
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: 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 Occuoancv signature:
FeeTvoe: Date Paid: Amount:
Building 7/24/2018 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Depadment use onh
City of Northampton Status Of Perms:
JUL 232018 Buil ing Department Curb GWDriveway Pemdt
2 2 Main Street SewerlSeipticAvailabnRy
Room 100 WathdWellAmilability
,,-F o=SUR oiuc,INsaecnIth pton, MA 01080 TwotetsofStrudturgl:Plans
wnwami=ron A010 _1240 Fax 413-587-1272 PIOUS)(e Plane
OMer.Spedfy
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH ACNE OR TWO FAMILY DWELLING
SECTION i-SITE INFORMATION I�/0'Iq
1.1 Property Address: This anon to be completed b since
59 Coolidge Avenue, lst and 2nd floor Map 'tI t Urgt
Northampton MA 01060 Zone Overlay DWat
EIm SL Diatrmi CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Vivian Bresnitz 59 Coolidge Avenue Northampton MA 01060
Name(Pres) Current Mating Address:
,t41 11
See attached Te@phwie 348-0412
bTgurWre
2.2 Authorized Agent:
American Installations 130 College SL, Ste 100 South Hadley, MA 01075
Name(Print) - Camara Meting Address
1 n�.011 e m s lL. L.OUAAA/t a 413-552-0200
grwWra Teleptorre
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Donate)to be Offidai Use Orgy
completed by pannit applicant
1. Building 3,800.00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from
3. Plumbing Building Pemit Fee
4. Mechanical(WAC)
5.Fire Protection
S. Total=(1 +2+3+4+5) 3,800.00 Check Number a
This Section For Official Use Only
Date
Building Permit Nu r. Issued:
r
SigneW /
Build mmsslonemnspector of BdMngs now
Section 4. ZONING An Information Must Be Completed.Perms[Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
nic column robe fiBei in by
IhdNntag Dciea
Lot Size --^—� ��-1 rr--- - —�)
Frontage
Setbacks Front O
Side L= R:= L= R:= Q
Rear ;-j
Building Height L_ U
Bldg.Square Footage % —� O
Open Space Footage J %Open
acer.ft Footage
Paved
n �
XofPuking Spaces
Fill: j ---- --- - --
volume&.inodov
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IFYES,dateissued:I I�
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or DocumentAF --!
L_
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(oration: 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 corWmclion activity disturb(clearing,grading,excavation,or filing)over t acre or is B part of a rolmlon plan
that wm disturb overt acre? YES O NO O
IF VES,then a Northampton Storm Water Management ParmKfinm the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK leheck all amillcablei
New House Q I Addition ❑ Replacement Windows Alteration(s) ❑ Roofirg ❑
Or Doors O
Accessory Bldg. ❑ Demolition ❑ New Signs IO) Decks M Slding101 Other[E�iil
Brief Description of Proposed
Work:_Alhc and basement insulation and air sealing throughout
Alteration of existing bedroom_Yw_No Adding new bedroom Yes No
Attached Narragi a
PlansAttached Roll -Sheet Renovating unfinished basement _Yes No
ea.If New house and or addition to existing housing co late the following,
a. Use of building:One Fairly Two Family Other
b. Number of rooms M each family unit Number of Bathrooms
Q Is them a garage attached?
d. Proposed Square footage of new,wnsWctien. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woudstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
1. is wnsbuction wkhin iOD 1.of wetianda?_Yw No. Is construction wNrri 100 yr. 0oodptaln Yee_No
J. Depth of basement or celar goo below finished grade
k. Will building conform to the Buikfing and Zoning regulations? _Yes_No.
I. Septic Tank_ City Sewer_ Pdvatewell_ Clywater Supply_
SECTION 7a-OWNER AUTHORIZATION-TD BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMR
I, Vivian Rrecnitz as Owneroftho subject
Property
hereby authorize American Installations
to act on my behal,in al matters relative b wwk authorized by this building permit application.
See attached 7/18/2018
Slgnawra AOwner Date
I, American Installations .as Oener/Authorized
Agent hereby declare that the statements and Information on the foregoing application are We and accurate,to the best of my knowledge
and belef.
Signed under the Paris and penalties of perjury.
American Installations
Prim Name
7/18/2018
Slgnswre of er/logo Date
SECTION 8-CONSTRUCTION SERVICES
8.1 licensed Construction Supervisor: Not Applicable ❑
Name of Lieua- Hold r: Wesley K. Couture 106178
License Number
130 Colleee St., Ste 100 South Hadley, MA 01075 9129119
Address - E*Msan Data
�. -bl -413-552-0200
5prmlyre Telephone
9.RepisteredHome Improvement Contractori _ , - Not AppOcade ❑
Wesley Couture 175982
Company Name Registration Number
American Installations 6126!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(e))
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affalavit will result
In the denial of the Issuance of the building permit
Signed AfildavtAttached Ves...... 9f No...... ❑
11. Home Owner Exemption
The emrent exemption for"homeowners"was extended to include Owner-occupied Dwel inys of one(1) or two(2)f&mdIics
and to allow such homeowner to engage an individual for hire who does rot possess a licease,provided that the owner acts
as supervisor.CMR 780, Slrth Edition Section 1083.5.1.
Definition ofHomeowner:Perron(s)who num a parcel ofland on which he/she residue or intands to reside,on which there
is,or is intended m be,a one or two family dwelling,attached or detached structures accessory to each use and/or farm
strucnues.A person who constructs more than One home In a two-Yeaur perbod shall not be onsid ed a Y mown .
Such"homeowner'shall submit to the Building Official,on a form acceptable to the Building Ot6cial,t4Mhelshe shall be
responsible for sU such work performed under the buildber permit
As acting Construction Supervisor your presence onihejob site will be required from time to time,daring and upon
completion ofibe work for which this permit is issued
Also be advised that with refinance to Chapter 152(Wodmrs'Compensation) and Chapter 153(Liability offimployers to
Employees for injuries not resulting in Death)ofthe Massachusetts Genial Laws Annotated,you my be Wble fmpeamer(s)
you hire to perform work for you under this permit
The undersigned"homeoveraP certifies and assumes responsibility for compliance with the StafeBuilding Code,City of
Northampton Ordinances,State and Local Zoning Laws and State ofMassachuseps General Laws Annotated.
Homeowner Signature
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: 59 Coolidge Avenue
The debris will be transported by: American Installations
The debris will be received by: Waste Management of N.E
Building permit number:
Name of Permit Applicant American Installations
7/18/2018 ` a,9xQt6 V . J
Date Signature of Permit Applicant
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enEI I . !Iet PARTNER
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130 Wil 56M Surra IN,I Ndr,MA OJEWS•OR:"151 SSb0ID0 n-too SSIOWL a 1I auppl®amerkana UtwEUN eean
Customer Name:Vivian Bresnitz
Email:Not provided
Phone:413-3490412
Premise Address:59 Coolidge Ave, 1,Northampton,MA 01060
Project ID:3415826
Date:May 21,2018
Job Description
RT r, "o
Rim Joist- 2" Thermal Barrier Polyiso 26 SF j $124.28 $12.43
Exterior Perimeter-4" Dense Pack Cellulose 771 SF $1,904.37 $190.43
Project Total $2,028.65
Weatherization incentive ($1,825.79)
Total Program Incentive -$1,825.79
Customer Total $202.86
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buldrs rEaW llom(o,Me Total cmoxt value m amre]Mren.
ncceeraxct o• ExarI: rip aeo.re stet, awI .m ..onaelbp are ro.At comxacr VALUE-s 202.86
:aanarm.vanea,erwabr assn .vo„areadronM aopoa.atawaxm.vwnw,. :nva�r.r::p�t-a 6800 ❑
all be 5n eo.n eaorma .nn,ane bdaree e.eorrpleaon. EAIo
open comolmwn//-sr�1�34.86
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,EII ar,p,tEantl Vivian BresniC, Ise-1 arc 5-22-18
xwerenu<we(ra,n1 B.Lane' ISaol B. a•-"--- b 5-22-18
THIS AGREEMENT IS COMPOSED OF THIS PAGE AND THERE VERSE SIOF OF THIS PAGE AND SHALL BE CONSIDERED THE ENTI RE AGREEMENT BY THE PARTIES INVOLVED. THIS
AGREEMENT IS BETWEEN AMERICAN INSTALLATIONS,LLC HEREINAFTER REFERRED TOM-00MPANW,AND THE CUSTOMERS)NAMED ON THE REVERSES I DE,HEREINAFTER
REFERRED TO AS"CLIENT-,AND WILL BE SUBJECT TO All APPROPRIATE LAWS,REGULATIONS AND ORDINANCES OF ME STATE OF MASSACHUSETTS OR CONNECTICUT
RESPECTYELY,AS WELL AS ALL LOCAL JURISDICTIONS,
THE FOLLOWING TERMS AND CONDITIONS ALSO APPLY
1. THISAGREEMENT 15 SUBJECT TO THE APPROVAL OF A MANAGER OF THE COMPANY FOR THIS AGREEMENTTO BE EFFECTIVE UNDER ANYCONDIPON.
3, SHOULD DEFAULT BE MADE IN THE PAYMENT OF THIS AGREEMENT,CHARGES SHALL BE ADDED FROM ME DATE THEREOF AT A RATE OF ONE AND ONE-HALF IF 112)
PERCENT PER MONTH.(18%PER ANNUM)WITH A MINIMUM CHARGE OF$2X0 PER MONTH,AND IF PLACED IN THE HANDS OF AN ATTORNEY OR COLLECTION AGENCY
FOR COLLECTION,ALL ATTORNEYS'FEES,EXPENSES AND COSTS OF COLLECTION SHALL BE PAID BY THE CLIENT. IN ADDITION,CLIENT UNDERSTANDS THAT IN FAILING
TO PAY ACCORDING TO THE ABOVE TERMS,COMPANY MAY HAVE THE RIGHT TO A LEIN ON THE PROPERTY
3. THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,ME COMPANY WILL ADVISE THE CLIENT AS SOON AS REASONABLE.
6. COMPANY AGREES THAT,NOTWITHSTANDING ANY AGREEMENT FOR MATERIALS AND/OR LABOR BETWEEN COMPANY AND THIRD PAM ,,COMPANY IS RES PONSIBLE
TO CLIENT FOR COMPLETION OF ALL WORK DESCRIBED IN ATIMELY AND WORKMANLIKE MANNER,
5. ALL WARRANTIES FOR EQUIPMENT AND PRODUCTS SUPPLED BY THE COMPANY UNDER THIS AGREEMENT SHALL BE THOSE GIVEN BY THE MANUFACTURERS OF SUCH
EQUIPMENT AND PRODUCTS, UNDER SUCH MANUFACTURERS WARRANTIES,THE HENT MAY BE REQUIRED TO REGISTER OR MAIL IN A WARRANTY CARD OR OTHER
EVIDENCE OF OWNERSHIP ANY USE OF SUCH EQUIPMENT ANO/OR PRODUCTS IN ORDER TO ACTIVATE SUCH WARRANTIES.
6. THE QUOTATION ON THE PAGE HEREOF DOES NOT INCLUDE EXPENSES OR CHARGES FOR WIND OR INSURANCE PREMIUMS OR COSTS BEYOND NORMAL INSURANCE
COVERAGE,ANY SUCH ADDITIONAL EXPENSES,PREMIUMS OR COST SHALL BE ADDED TO ME TOTAL AGREEMENT AMOUNT.
J. THE COMPANY$LIABILITY FOR CLAIMS ARISING OUT OF THIS AGREEMENT SHALL NOT EMCEED THE TOTAL AGREEMENT PRICE EXCEPT TO THE EXTENT THOSE DAMAGES
ARE PROVEN TO BE SOUCY DUE TO THE COMPANY'S NEGLIGENCE.
S. DURING THE DURATION OF ME WORK,THE CLIENT'S HOMEOWNERS INSURANCE WILL BE RESPONSIBLE FOR ANY AND ALL DAMAGES AS LONG AS ME COMPANY HAS
TAKEN ME APPROPNATE 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.
ED WOOD ROT,MOLD,ASBESTOS,NAIL POPS,DUCMORK AND CONNECTIONS,PLUMBING AND VENT PIPES,DECKING DEDUCTION,ETC IFA PRE-EXIffING DEFICIENCY
OR HAZARDOUS MATERIAL 15 ENCOUNTERED PRIOR TO OR DURING CONSTRUCTION,AND COMPANY 15 NOTIFIED IN WRITING,COMPANY WILL TRY TO ASSIST CLIENT
WITHIN THE COMPANY'S MEANS AND CAPABIUUES TO CORRECTTHE PROBLEM(S)ON A TIME AND MATERIAL BMIS CLIENT AGREES THAT SUCH CONDITIONS ARE
UNAVOIDABLE BY ME COMPANY AND SHALL NOT BE CONSIDERED A VIOLATION OF THE AGREEMENT AND MAT DUE TO THESE CONDITIONS ME DURATION OF THE
WORK AND SCHEDULED DATE OF COMPLETION MAY DIFFER FROM MAT 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 FOR,AND THE CLIENT AGREES TO HOLD ME 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,FUSHING,METERS,JOISTS,INSULATION OR OTHER MATERIALS ARE NOT
INCLUDED UNLESS OTHERWISE NOTED HEREIN.
13. THE COMPANY WILL NOT OE RESPONSIBLE FOR THE SCRATCHI NG OR DENTING OF INTERIOR WALLS AND CEILINGS,FLOORS,TRIM,GUTTERS,DOWNSPOUTS EXISTI NG
SIDING AND WINDOWS,0000.5,OIL DROPLETS IN DRIVEWAYS HAIRLINE FRACTURES IN CONCRETE OR BLACKTOP DRIVES AND WALKS,OR DAMAGE TO PLANTS OR
SHRUBBERY, IF EXCESSIVE DAMAGE 15 CAUSED BY COMPANY,COMPANY WILL REPAIR OR REPLACE DAMAGED AREA ONLY AT COMPANY'S EXPENSE.
14. THE COMPANY UNDER PROVISIONS OF CHAPTER I42A 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 WRIIIEN ON THIS AGREEMENT ARE AGREED TO BE IMMATERIAL AND NOT RELIED ON BY
EITHER PARTY,AND DO NOT SURVIVE THE EXECUTION OF THIS AGREEMENT,
P. THIS AGREEMENT CANNOT BE CANCELLED WITHOUT M E MUTUAL WR17ENCONSENT OF BOTH PARTIES EXCEPT AS OTH ERWISE SET FORTH HEREIN,
18. THIS AGREEMENT,AND ANY WARRANTYS)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WIN THE WRIIIEN PERMISSION OF THE COMPANY.
19. IF THE WENT 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 CLIENTS RAND,STYLE,COLOR.LED)AFTER SAID MATERIAL HAS BEEN DELIVERED OR IS IN ROUTE TO THE WENT COULD RESULT
IN A 5%RE-STOCKING FEE BASED ON ME COST OF MID 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 CAREER 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 ME 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 UNENFORCAOLE,THE VAUD"AND ENFORCEBILITY OF THE REMAINING PROVISIONS OF
THIS AGREEMENT SHALL NOT BE AFFECTED THEREBY
23. ARBITMPON: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 MAT IS PART OF A STATE SHOWERED UTILITY PROGRAM HE MASS SAVE')IS SUBJECT TO THE
AVAILABILITY OF QUALIFYING STATE SPONSORED PROGRAM AND WILL BE SUBJECT TO TERMINATION IF THE STATE SPONSORED UTILITY PROGRAM IS DISCOUNTINVED.
FURTHERMORE,THE TERMS AND CONDITIONS OF STATE SPONSERED UTILITY PROGRAMS MAY BE ALTERED OR UPDATED PERIODICALLY WITH OR WIN OUT NOTICE.
25. AMERICAN LNSTAl1ERS,LLC IS NOT AN AGENT OF ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,THROUGH,OR UNDER THE MASS SAVE'ENERGY
PROGRAM.
26. CLIENT IS REPSONS18LE FOR THE PAYMENTOF ANYAND ALL FEDERAL STATE,OR LOCALTAXESMAT ARE APPLICABLE TO THIS AGREEMENT.
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59Coolidge Avenue 2nd Floor Northampton MA 01060
14131348-0912 w vannapnk@yahoo... a.
454494 um u..n 17-3051 B
swam Quantity unit Unit Cost m Total
Air Sealing
Air Sealing $ -
Air Seat,Incentive $
Air Selaing M Balance $ -
we itMrlulion
WALLS-VINYL SIDED ala CELLUMSE 877 salt $ 1.95 $ 1,710.15
Total Weatherixation $ 1,710.15
Weatherixation Incentive $ 1,539.14
Total Reject $ 1,710.15
Total Utility Contribution $ 1,539.14
Total Customer Contribution $ 173.02
anMnre Pmenean Inablbrunf.LLCvillpro'Na Ne abrteerM nemeownerwM1A a E WrrwaM1manAlpwarnnry.
arabr wn rarxaneewrmrampMremearo.e.rope<rwnlnarrnmanaawnma.m».p.rinrarwneana au 1-1,,drora Wines
rcrvlado.�:ro.�n<*aai n
w.an vaw.,Y.a,�ee n..m u m
ACCEPTANCE OF pnI The above price.specmranons and TOTAL CONTMCTVALUE a $ 171.02
ramamna are aamnrwrvane ere nerceaaprcNea.vau are
.u,no.la.am aowon.a apxlfi.a.prym.n<wlll be Ua aoxn prior ro Downpaymen[= $ 57.00 ❑
vertWwark,brie Wlanradmupanf mpletm. No
q _ Balance Due Upon Completion= $ 114.02
Vivian BrBresI 5-22-18
,rvBarry J.Zamer Pa �,...xeb . 5-22-18
THIS AGREEMENT IS COM POSED OF TH IS PAGE AND THE REVERSE SIDE OF THIS PAGE AND SHALL BE CONSIDERED THE ENP RE AGREEMENT BY THE PARTI ES I NVOWED.THIS AGREEMENT IS
BETWEEN AMERICAN INSTALLATION,LLC HEREINARER REFERRED TO AS'COMPANI AND THE LSTOMEIRS)NAMED ON THE REVERSE SIDE,HEREINAFTER REFERRED TO XS-CUE NI",AND
WILL BE SUBJECT TO ALL APPROPRIATE LAWS,REGUU➢ONS AND ORDINANCES OF THE STATE OF MASSACHUSETTS OR CONNECTICUT RESPECTIVELY,AS WEILAS ALL LOCAL JURISDICTIONS.
THE FOLLOW ING TERMS AND CONDITIONS A6OAPPLY
1,WI5 AGREEMENT IS SUBIECTTO THE APPROVALOF A MANAGER OF THE COMPANY FOR THIS ASREEMENTTO BE EFFECTIVE UNDER ANY CONDITION.
3.SHOULD DEFAULT REMADE IN THE PAYMENT OF THIS AGREEMENT,CHARGES SHALL BE ADDED FROM THE DATE THEREOF AT A RAR OF ONE AND ONE-HALF(1-1/2)PERCENT PER MONTH,
(18%PER ANNUM)WITH A MINIMUM CHARGE OF$3 W PER MONTH,AND IF PLACED IN THE HANDS OF AN ATTORNEY OR COLLECTION AGENCY FOR COLLECTION,ALL ATTORNEYSFEES,
EXPENSES AND COSTS OF COLLECTION SHALL BE PAID BY THE CLIENT.IN ADDITION,WENT UNDERSTANDS THAT IN FAILING TO PAY ACCORDING TO THE ABOVE TERMS,COMPANY MAY
HAVE THE RIGHT TOA ZEIN ON THE PROPERTY.
3.THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,WE COMPANY WILL ADVISE THE CLIENT AS SOON AS REASONABLE.
6,COMPANY AGREES THAT, NOTVITHSTANOING ANY AGREEMENT FOR MATERIALS AND/OR LABOR BETVEEN COMPANY AND THIRD PAWS.COMPANY IS RESPONSIBLE TO CLIENT FOR
COMPLETION OF ALL WORK DESCRIBED IN ATIMELY AND WORKMANLIKE MANNER.
5.ALL WARRANTIES FOR EQUIPMENT AND PRODUCTS SUPPLIED BY THE COMPANY UNDER THIS AGREEMENT SHALL BE THOSE GIVEN BY THE MANUFARURERS OF SUCH EQUIPMENT AND
PRODUCT.UNDER SUCH MANUFACTURER'S WARRANTIES,THE CLIENT MAY BE REQUIRED TO REGISTER OR MAIL IN A WARMMY CPRD OR OTHER EVIDENCE OF OWNERSHIP AND USE OF
SUCH EQUIPMENT AND/OR PRODUCTS IN ORDER TO ACTIVATE SUCH WARRANTIES.
G THE QUOTATION ON THE PAGE HEREOF DOES NOT INCLUDE EXPENSES OR CHARGES FOR BOND OR INSURANCE PREMIUMS OR COSI BEYOND NORMAL INSURANCE COVERAGE,ANY SUCH
ADDITIONAL EXPENSES,PREMIUMS OR COST SHALL BE ADDED TO THE TOTAL AGREEMENT AMOUNT.
J.THE COMPANY'S LIABILITY FOR CLAIMS ARISING OUT OF THIS AGREEMENT SHALL NOT EXCEED WE TOTAL AGREEMENT PRICE EXCEPT TO ME EXTENT THOSE DAMAGES ARE PROVEN TO BE
SOLES DUE TO THE COMPANY'S NEGLIGENCE.
8.DURING THE PUPATION OF THE WORK,THE CLIENTS 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.WE COMPANY IS NOT RESPONSIBLE FOR PREEXISTING DEFICIENCIES OR HATARDOUS MATERIALS THAT MANIFEST THEMSELVES DURING THE CONSTRUCTION PROCESS E G.WOOD AOT,
MOLQ ASBESTOS.NAIL POPS,DUCTWORK AND CONNECTIONS,PLUMBING AND VENT PIPES,DECKING DEFLECTION,ETC. IF A PREEXISTING DEFICIENCY OR HAZARDOUS MATERIAL IS
ENCOUNTERED PRIOR TO OR DURING CONSTRUCTION,AND COMPANY IS NOTIFIED IN WADING,COMPANY WILL TRY TO ASSIST CLIENT WITHIN WE COMPANY'S MERG AND CAPABILITIES
TO CORRECT THE PROBLEM)S)ON A TIME AND MATERIAL BASIS.CLIENT AGREES THAT SUCH CONDITIONS ARE UNAVOIDABLE BY WE COMPANY AND SHALL NOT BE CONSIDERED A
VIOLATON OF THE AGREEMENT AND THAT DUE TO THESE CONDITIONS WE DURATION OF THE WOW AND SCHEW LED DATE OF COMPLETION MAY DIFFER FROM THAT AGREED UPON,IF
APPLICABLE,UNDER THIS AGREEMENT.
10.THE COMPANY IS NOT RESPONSIBLE,AND WE CLIENT AGREES TO HOLD THE COMPANY HARMLESS,FOR ANY PROBLEMS AND/OR DAMAGES,INLCUDING BUT NOT UNITED TO MOLD
GROWTH,ARISING FROM THE PERFORMANCE OF AIR STALING WORK IN THE COMPANY AS A RESULT OF ANY KNOWN OR UNKNOWN MOISTURE CONDITIONS.
IL THE COMPANY IS NOT RESPONSIBLE FOR,AND THE CLIENT AGREES TO HOLD THE COMPANY HARMLESS,FOR ANY PROBLEMS AND/OR DAMAGES RE WING TO ICE DAMMING THAT MAY
ARISE DURING AND/OR AFTER THE PERFORMANCE OF WORK BY THE COMPANY.
22 REPLACEMENT OF DETERIORATES ENDING,FASCIA BOARDS,ROOF JACKS,VENTILATORS,WASHING,RAKERS,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,HNRLINE 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 ARTA ONLY AT COMPANYS EXPENSE.
24 THE COMPANY UNDER PROVISIONS OF CHAPTER HDA OF THE GENERAL LAWS IS REQUIRED TO APPLY FOR AND OBTAIN ALL CONSTRUCTI 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.
1S.THIS AGREEMENT,INCLUDING THE PROVISIONS RELATING TO PRICE AND PAYMENT SCHEDULE,CANNOT BE CHANGED OR ALTERED EXCEPT BY WRITTEN STATEMENT SIGNED BY BOTH THE
COMPANYANDTXECLEM.
10.ANY REPRESENTATIONS STATEMENTS,OF OTHER COMMUNICATION NET WRIIIEN ON THIS AGREEMENT ARE AGREES TO BE IMMATERIAL AND NOL RELIED ON BY EITHER PARTY,AND OO
NOT SURVIVE THE EXECUTDN 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 WARMNONS)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THE COMPANY.
19.IF THE CLIENT FABS 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 COMPANYS ASTI DAMAGES OR 35%OF WE AGREEMENT FOR RESTOCKING FEE.
30.ANY CHANGES TO MATERIALS BY THE CLIENT(BRAND,STYLE,COLOR,ETC.)AFTER MID MATERIAL HAS BEEN DELIVERED OR IS IN ROUTE TO THE CLIENT COULD RESULT IN A 5%RE-AOCKING
FEE BASED ON ME COST OF SAID MATERIALS.
31,THIS AGREEMENT SHALL BE EFFECTIVE ONLY UPON ITS EXECUTION BY ALL PARTIES HERM,PRIOR TO WHICH TIME IT SHALL BE DEEMED A PROPOSAL THE COMPANY RESERVES THE RIGHT
TO EVOKE THIS PROPOSAL 90 DAYS FROM GATE TIS EXULTED BY THE COMPANY IF IT IS NOT EARLIER EXECUTED BY WE 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 II COStt IN EFFERATSUCH TIME.
23.IF ANY PROVISION OF THIS AGREEMENT SHOULD BE HELD TO BE INVALID OR UNENFORUBLE,THE VALIDITY AND ENFORCEBILTY 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 PARIES
AGREE TO PLACE THE MATTER IMO ARBITRATION BEFORE AN INDEPENDENT ARBITRATOR ASSIGNED BY THE AMERICAN ARBITRATION ASSOCIATION TO RESOLVE THEIR DISPUTE.
36.ANY DISCOUNT,PROMOTION,REIMBURSEMENT,OR OTHER PRW RAM THAT IS PART OFA STATE$PONSERED UCIUIY PROGRAM NE.NAM MVP)15 SUBJECT TO THE AVAILABILITY OF
QUALIFYING STATE SPONSORED PROGRAM AND WILL BE SUBJECT TO TERMINATION IF THE STATE SPONSERED UTILITY PROGRAM 15 DISCOUNTAR EO 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 OF OTHER VENDOR WORKING BY,THROUGH,OR UNOERTHE MASS SAVE'ENERGY BROCADED.
26.CLIENT I5 REP5ONSIBLE FORTHE PAYMENTOFANYANDALL FEDERAL,STATE,OR LCCALTAXESWATARE APPLICABLE TOTHIS AGREEMENT.
The Commonweatrh of Massachusetts
Department of Industrial Accidents
Office of Investigations
wi 600 Washington Street
Boston,MA 01111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leil
Name(Busbleex/OrganimdarVIadividael): American Installations,LLC
Address: 130 College Street,Suite 100
City/State/Zip: South Hadley,MA 01075 phone#: 4I3-552-0200
Are you an employer?Check the appropriate box: Type of project(required):
I.[x] I am a employer with 46 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or pan-time)! have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet.1 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in anv capacity. workers'comp. insurance. 9, ❑ Building addition
[No workers'comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL. I I.❑ Plumbing repairs or additions
myself [No workers'comp. c. 152,§1(4),and we have no 12.❑ Roof repairs
insurance required.]I employees. [No workers' 13 LN Other Insulation
comp. insurance required.] --------- --
"Any apptieanl that checks bar#1 mon also rill not the waian below showing their workena mpenulion policy infiam inion.
t I lameawnea w1h.,olima this affidavit imlkating they arc doing all wort and am him oNsidu contractors mon submit anew alfuhvil indicating sUclh
:Cemruton Ihal chunk IM1n boa moat anuched xn additional sheet showing the name of the sub-conbucmrs aM their waken'comp.Nlie,,e f navioon.
I am an employer that is providing wnrkers'rompemotion insurance far my employees. Below is the policy and jab site
Information.
Insurance Company Name: Guard Insurance Companies
Policy 4 or Self-im. Lic.#: AMWC897387_ ______ Expiration Date: 09/04/2018 _
Job Site Address: 59 CMPAd kin,V— _City/Scute/Zip:NEIL"''�D.{�,-�'-rM
Annaba copy of the workers'con causation 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 a
fine up to$1,500.00 and/or'one-year unta sunmem,an well as civil penalties in the form of a STOP WORK ORDER and a tine
of up to 5250.00 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,
l da hereby ceeHify�under she pains'a�nd penalties of perjury that the information provided above is true and earrect
Sianaturg ,d/d n0. �. l nl
Phone#: 413-55 -0200
Official use only. Do not write In this area,to be completed by city or town official
City or Town: Permit/License b
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City?own Clerk 4. Electrical Inspector S. Plumbing Inspector
6.Other
Contact Person: phone ll:
Commonwean of Massachusetts Conduct.SuparvMor
�. Caisson of Professional Licensure Unrestricted•Starlings of any use group vrMeh contain
Board of Building Regulations and Standards IssstM 86,000 cubic Mel tMi eWk neetersl ofenclosed
Construction Supervisor fie'
CS-108178 Etpires: 09/2912019
d
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SOUTH HADLEYMA 01075
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Suite Binding Cede Is CMIR Mr rMOCaden of tllM amass.
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Commissioner Can(6171727-200 or visa wwwmses.gwlep
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(ra»r�ytn�lr�reTr�f rJC���rJrrT�ttJet1
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: 175982
130 COLLEGE STREET SUITE 100 E>�iratlon: 08/28/2019
SOUTH HADLEY,MA 01075
Update Address and refam cera. Mark reason for change.
SCA I 0 AAM-05'11
M—Adf,nT�- ❑o.".,_..I r—FTMoymanE 17 Lost Card
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�'•� Ofew of Co Mlmer WlWn 68WinoY apuletlen
{ j13 HOME IMPROVEMENT CONTRACTOR Registration valid for Individual we only
TYPE:LLC before Me expiration date. 0 bund return to:
t yl
Reeflaturaftlien Exoinition Off"of Consumer Again and Business Regulation
.✓, 175962 OS26=19 10 Park Plana-Suite 5170
AMERICAN INSTALLATIONS,LLC. Sa-ern,MA 02116
130 COL RE
WESLE COUTUOUTUREET SUITE 100
SOUTH HADLEY,MA 01075 Undersecretary tvalid without signature
A� CERTIFICATE OF LIABILITY INSURANCE
8/14/2017
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 certNicate holder Is an ADDITIONAL INSURED,the pollcy(les) must be Endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,Certain policies may require an Endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such endomement(s).
PRODUCER AME. T Linda POMOrB
Webber L Grinnell PHONE . (413)586-0111 FMC No' '413'58'-6481
B North Hing Street .DMDARa s.lp.ra@wabberandgrinnell.corn
INSURE SAFFOROINO COVERAGE NAIC6
Northampton LII, 01060 INSURER A' 10 ra Mutusl Casualt
INSURED INSURER B Berkshire HatJhMay GUARD Ina. CO,
A00r1can Installations, LLC IXSURERC:
Attu: Wes 6 Suzanne Couture INSURENO:
130 College Street, Suite 100 INSURER E:
South Hadley MA 01075 1 INSURER F:
COVERAGES CERTIFICATE NUMBERTIaster ET¢ 9-2018 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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSSDZM� .
INSR TYPE OF INSURANCE pOL1CY HUMBER pVMCOSONTOTCYEFF RESSUDO,YYY P DMnS
COMMERCIAL GENERAL UABIUBY EACH OCCURRENCE E 1,000,000
A X CI NSUMADE1:1 OCCUR PREMISES IRA— S 500,000
5D3535217 9/4/2017 9/4/2018 MED DAR(my one anon) $ 10,000
PERSONAL S ADV INJURY S 11000,000
GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000
R POLICY0PEj LCC PRODUCTS-CAMPOP AGG S 2,000,000
OTHER. E
AUTOMOBILE OABIIRY EMBIINED SINGLE LIMITS 1,000,000
AANV AUTO BODILY NJURY(Perp—) S
ALL OSNNED X SCHEDULED 583535217 9/4/2017 9/4/2018 BODILY INJURY(per eccieeM) S
X
HIREDAUTOS X NON-0KNED PROPERTY UNAG
AUTOSAUTOS PorettiOenl
PFs,, E 8,000
R UMBRELLA LWB OCCUR EACH OCCURRENCE $ 1,000,000
A EXCESS LNa CIAIKESACE AGGREGATE E 1 000 000
DEC I -T I RETENTION 10 000 573535217 9/4/2017 9/4/2018 S
WORXERE COMPENSATOR
AND EMPLOYEESLUBI1lTYr BTATUTE ER
IN
B
ANY PRCVRIETORTARTW
XERIFXETIVE Y❑NIA EL EACH ACCT DEM S 500,000 OFFICER,MEMBER EXCWDEB?
IMentleWryln XmVANC60"n, 9/4/2017 9/4/2018 EL DISEASE-EA EMPLOYE E 500 000
if 6e.6mbe Xnee
CEI,RIPTION OF OPERATIONS PNI E L.DISEASE.PoLICY LIME E 500,000
A Commercial Property SA3535217 9/4/2017 9/4/2018 Eedueebe$1 BA"
DESCRIPTION OF ORERATONSI LOCATIONS I VEMCLES IACORD 101,A66IUmMl R enzla YIIeOule Tey beeHxAM n mon ses e n re amo)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
EV1deuC0 OE Insurance THE EXPIRATION MTE THEREOF, NONCE WALL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORQED REPRESENTATIVE �J
Kevin Joyce/LMP Jam"' ZL� --
(D1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
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