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31B-053 (7) BP-2022-1458 26 LANGWORTHY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31B-053-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-1458 PERMISSION IS HEREBY GRANTED TO: Project# SIDING/WINDOWS/DOOR Contractor: License: Est. Cost: 81845 PHIL BEAULIEU 62638 Const.Class: Exp.Date: 06/13/2023 Use Group: Owner: YANG GULLERUD STEVEN 0& BEI ,I Lot Size (sq.ft.) Zoning: URA Applicant: PHIL BEAULIEU & SON HOME IMPROVEMENT Applicant Address Phone: Insurance: 217 Grattan St 413-592-1498 WMZ80062050 CHICOPEE,MA 01020 ISSUED ON: 11/08/2022 TO PERFORM THE FOLLOWING WORK: SIDING, 5 WINDOWS AND DOOR 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: Final: Final: Final: Rough Frame: Gas: Fire Department Dri‘emas Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIO .ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: cfr y4 - Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner -ECG,_ _ 1:,__, The Commonwealth of Massach etts I Board of Building Regulations and Stand ds N�V �8 IC ALITY J Massachusetts State Building Code/780i,, R (00�2 pr pSE Building Permit Application To Construct, Repair, Rio ° ' h a e��ised Mar 2011 V" One- or Two-Family Dwelling 'oN I��spFcr I This Sion For Official Use Only -M��z.o s / Building Permit Number: 6, ).1 ' 61 X Date Applied: K eV t L) 455 /9L� 11431021, Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 sse ors Map& Parcel Nun gl,3 267 Laniwor-t-IN Road 3t ����jj 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) G 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.'.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 l Owner'of Record: 23teve Gu I lerud Is (3ei I. Yang Nvr+k ct.rrlp+on, M la0(0(.90 Name(Print) City,State,ZIP 26 LeAngwor-fky POad (4o8)4410i- 2318 beili. nJ Pqma; /• CI" No.and Street Telephone Em ' Ad ss SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building I Owner-Occupied Si� Repairs(s) CIAlteration(s) Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other Cl Specify: Brief Description of Proposed Work2: Strip exiS%inq siding , ins-tail TnSaf04-ion , ins-mil nev✓ Vinyl s 4 + rev,' -Fr;In. Rerrrore tend IYplacx s' w%ndOW WI tS• IQgmo and rq'ic ct frvei# en-trtd door t S*/wn ddor. tJ- rvi-vcT0i2 4wu. -1.6 1DN . -27 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only I. Building $ b'I d I. 5. 0 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ CIStandard City/Town Application Fee ❑Total Project Cost- (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ ;/{ Suppression) Total All Fees: S rf 00 Check No.14 7Atheck Amount: S Cash Amount: 6.Total Project Cost: �i 8 N5. 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS— o02t' 36 (9 . ' 3.23 �*' Phil Beaulieu&Sons Home Imp.,Inc. License Number CJ Expiration Date i\" 217 Grattan Street,Chicopee,MA 01020 HI REG#100073 List CSL Type(see below) CSL#CS-062638 Type Description Alain Beaulieu Unrestricted(Buildings up to 35,000 cu. ft.) PH:(413)592.1498/Fax:(413)594.6008 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding p SF Solid Fuel Burning Appliances I2"1q@ /'n�jeatiiiGtl n�1J PQ . /1Gt i Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor OHO 1 o 00 73 La • .fir, Phil Beaulieu&Sons Home Imp.,Inc. HIC Registration Number Expiration ate ' 217 Grattan Street,Chicopee,MA 01020 HI REG#100073 tfI'lbeacf lieL1 P801.nc-1- No CSL#CS-062638 Email address Alain Beaulieu Cil PH:(413)592.1498/Fax:(413)594.6008 Telephone SECTION 6: 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 [ir No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT p 1,as Owner of the subject property,hereby authorize 1 hr I Bea-au tu f Sons Horn Horng IM or rcrt i.i t- to act on my behalf,in all matters relative to work authorized by this building permit application. 5e;b; ye,n1t Sft vy &kik!04 I! - 7 - 2 0 2 2 Print Owner's N (Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Ph'I Beaulieki and Sons HomL.. Irnprovem,Mt // - 7 - 22 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will got have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton Oats AMP eow Massachusetts "` Via. K DEPARTMENT OF BUILDING INSPECTIONS err r fop 212 Main Street • Municipal Building tiv� ODD �� '! v Northampton, MA 01060 sfh 3 �°J CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 5 M(.c ntf) Road Li /d cr The debris will be transported by: Name of Hauler: us 4u and c fc//0 Signature of Applicant: //ngeo'Ij''`" Date: // - 7 ` 2 2 Phil Beaulieu & Sons Home Improvement, Inc 217 Grattan Stree Chicopee, MA 0102( Phone: (413) 592-149 BeaulieuFax: (413) 594-600i S&SONS ROOFING SONG WIDOWS DCORS "The Exterior Ea,x'rh," ...... .••.... �u 392-7498 5522 E'rS n�t-<l a t c�: 4-15-202 2 Steve G AIlerud 4 Bei (i Y�r9 26 Langworthy Road Northampton, MA 01060 6ei . \Ian 2 ' I. CeCerrorPhone: 408-464-2318 (Belli)/ 650-291-1064 5!nal Email: sgullerud@gmail.com Siding, Door Surround, Gutters, and Guards Siding Strip the existing siding on the house,breezeway and garage-dispose of all debris Furnish and install 1/2"R-3.0 insulation board and tape all seam Furnish and install Mastic Carvedwood D4 woodgrain siding-Body color:English Wedgewood/Corner color:6"white Cover all fascia and rake trim with break formed aluminum-Color:White Cut holes in the soffit for continuous venting Cover all soffit-Color:White Cover and flash all window and door casings with break formed aluminum-Color:White Install"J' blocks,split blocks and dryer vents as needed Licensed electrician to reattach all electrical equipment Specifics Install new garage door weather stripping—Color:To match as close as possible Furnish and install crown lineal window toppers on six(6)windows on the front of the house All porch ceilings to remain untouched Remove and dispose of the existing shutters Entire porch(inside and outside)on the left side of the house is to remain untouched All window casings in the foundation are to be left untouched All interior porch/mudroom walls are to he left untouched Door Surround Furnish and install a new Beaulieu Classic PVC door surround on the front storm door breezeway opening Gutters and Guards Remove and dispose of the existing gutters and downspouts Furnish and install new seamless white aluminum 5"K-style gutters and downspouts Two(2)downspouts are to be installed in the back where there is currently only one Furnish and install new Proguard gutter guard system on the new gutters Total-Siding,Door Surround.Gutters and Guards $60,810.00 Continued on to 2nd page • 1Vof Beaulieu I X71 K! !AY.. *WON, tx)SFi "Th'Ex ter k U1prrn" .. +"»02-1408 Garage Door Surround Frunish and install a new Beaulieu Signature door surround on the garage door $950.00 • z --- • Windows House Majesty Windows Remove and dispose three(3)existing windows Furnish and install one(1)Harvey Majesty double hung new construction window • Furnish and install one(1)Harvey Majesty awning new construction window Furnish and install one(1)Harvey Majesty double hung-picture-double hung new construction window(1/4-1/2-1/4 or as close as possible) Energy Star glass/Insulated glass LowE glass/Argon gas Prefinished white pine interior/white aluminum clad exterior No screens on picture windows Full screen on double hung and awning windows Grids between the glass(see window specifics) Manufacturer warranty 10 years on parts/20 years on glass Seal exterior casing New 2%"primed colonial casings-To be painted or stained by others Insulate and caulk the perimeter of windows Complete finished carpentry inside and outside Specifics-House Windows Living Room Majesty Window Routed top and bottom lift rails White jamb liners Flat PVC exterior casings Picture framed interior trim White hardware Grids between the glass on the top sash of the double hung windows only Bedroom Majesty Awning Window Cut the opening in the wall as needed Use the existing header and window frame that has been previously blocked in Eight(8)lite grids between the glass Rough opening size of 45"x 25" Bedroom Majesty Double Hung Window Cut the opening in the wall as needed Use the existing header and window frame that has been previously blocked in Frame the opening width in and down to accommodate a rough picture window size of 48"x 50" 6/1 Grids Note:Any additional framing from what was described above is to be done at the hourly rot rate found below Total-House Windows $11,450.00 Continued on to 3rd page Beaulieu NON:, "The Exterior Experts" •• •”592-1400 Garage Windows Garage Slimline Windows Remove and dispose two(2)existing garage windows Furnish and install two(2)Harvey Slimline double hung replacement windows 7/8"Insulated glass White interior'white exterior Full screens 6/1 grids between the glass Manufacturer lifetime warranty Seal exterior casing New primed interior stops if needed-To be painted or stained by others Insulate and caulk the perimeter of windows $1,360.00 Entry Doors Front Entry Door Remove one(1)existing front entry door-dispose of all debris Furnish and install one(1)36x80 ThermaTru by Reeb S607-SDL-LE entry dour system Energy Star glass Primed door-To be painted by others 5 1/4 jamb depth-Primed Composite Jamb Mill finish threshold/Light cap Swing: RHIS Interior Hardware:Schlage Accent Lever standard lockset and deadbolt Exterior Hardware:Plymouth large grip handle set Hardware Color:Black Hinges to match the lockset as close as possible 314"primed colonial interior casing-To be painted or stained by others Furnish and install a new Beaulieu Signature door surround on the front entry door $5,525.00 Breezeway Storm Door Ron iove and dispose at Dire(I)existing breezeway storm door Trim the opening with white PVC trim hoards to accommodate the new storm door Spray foam under the two(2)PVC legs on the sides of the door to seal the gap as best as possible Furnish and install one(1)36x80 Provia Spectrum 291 full view white premium storm door with retractable screen Traditional Handle I Color: Black/Handle Location:Right(custom inswing) $1,750.00 Continued on to 4th page • Beaulieu .. ,'''' &so:ss , :� .rxv M. !.t.•r. *.Ocxm, rx%+r. "rho f:xecrktcExperts' General Includes removal and disposal of all debris Any rot found during the project is to be repaired or replaced at a rate of(5185.00)per hour+materials+15%of material Payment Schedule $7,200.00 deposit is due upon signing: $20,000.00 payment is due at the start of the project; $15.000.00 payment is due after the windows and doors are installed: $20,000.00 payment is due upon starting the siding portion of the project: $15.000.00 payment is due midway during the siding project; The remaining balance is due upon completion Total Price: $81,845.00 ,-.„ ,,, , ,I , .;I ... 11-i s":,t will he added to the unpaid portion of the tie to pa} . uaranlee pay nwnt or these charges.in the meta of default or paentent,I agree to pay reasonable,\ttorney's fees&emit t cost. IIns agreement does Ill nyoly114! i - coit will be executed only 1111011 written older, and will become an extra .er,lclerexl with the 1rneetor of Nome Itnplo\emenl harp:....•1 :tad allow the estimate. All agreements contingent upon strikes, accidents or ontract or RcgL,lt,tum. Certificate of Registration I..%I,A he)oMt/our ccnwtvl.1'13I11 agrees to be solely responsible lin completion or the work #100073 I coed'. Mess ul the aetitats or any third panyaubeoutraetor utilized by Nil II. 1'BI11 Phil.outlet donee Inlpt.oaei n•nt to early.tine', Im . v1 age,. , ,.fie soleh, re,!•'n,ibl.Mr all pi.nleni to all sahrnntra,9ors for material.,and and other ii a sar) insurance Our a c,rker c.. .bar tinder this agreemm i ne red by\vorlunen's rompimsation Insurance. lour•r.I,..prur I P.',y,,., r I p.m 1 the document heroines a hinting contract ,meaner & homeowner hereby InaluaIl .,view. a coder tea unless mhos.,pc noted within to •rurlenl.the contract.hall tau unpl list Ian arloance that in the CSent the contractor has a dispute 'Wit or other ):c Arlie interest hits heel p•t..cd or the residence. the shoes pi toe, oncenrng this contra!, the cotu-lctor may submit a •Itecitieatiems and candni+nts are satictitctnty and are hereby accepted.You arc tutthori,cd to Milano to a ',Mate .Irtnn:titan tine which has hers to d e work:t,specified.Payment will be made as outlined in tie Paynnern schcdtle. Qrpproycd by the Secretary nt die 1'.:c,..r'I,c (Mice i t 1'ontrrctor may wtlhrlrnw this proposal it not accepted within 30 days. k'.msumer \Il'hirs & the i.•,.. Itc.'i'rr,.n and the „,,ncnt withal).pntaly.or.J•liiation within.lure I t,1,n.ir.a.,!., s ouuurr Jtall he regains; mina,' -Ii,ilraion .I. ',!town in MASS(iencral Lair. .L,Iptcl taf.g 1 'Stay Connected with our social media and helpful links above ' Click here to find information on Consumer Affairs and Business • Proposal Date:April 15,2022 Revised from April 6,April 5,and March 23,2022 Estimate Date: March 17,2022 • PBHI Representative Cameron Beaulieu Authorized Signature I confirm that my action hero represents my electronic signature and is binding. Signature: ilid..Z Print Name: 5 —'e,ve h 6j i46-3 . . Date: (L_ / .- -Z Z I nt; Lutrurturt[weuttrt IV./ trIUoaucrtuaetta Department of Industrial Accidents =) t� .+__ 11. Office of Investigations 1'; ‘\ ( _ Lafayette City Center v`�s 2Avenue de Lafayette, Boston, MA 02111-1750 ,,•. •` www.mass.gov/dia Workers'Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/individual): Phil Beaulieu & Sons Home Improvement, Inc. Address: 217 Grattan Street City/State/Zip: Chicopee, MA 01020 Phone #: 41 3-592-1498 Are you an employer? Check the appropriate box: Type of project (required): 1.11 1 am a employer with 25 4. ❑ I am a general contractor and I 6 El New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ i am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' 4 P tY 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 1 1.❑ Plumbing repairs or additions 3.El I am a homeowner doing all work myself'. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] i c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *My applicant that checks box 41 must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A.I.M. Mutual Insurance Company Policy#or Self-ins. Lic. #:WMZ-800-6205-2022A Expiration Date:2/25/2023 Joh Site Address: L La j WOfllj /1 Oeta City/State/Zip: /V O'#4 n MA O1O1A0 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 a fine up to $I,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORD1;R and a fine of up to$250.00 a da}lagainst the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of th(,DIA for insurance coverage verification. I do hereby certify under the pains and penalties of pedury that the information provided above is true and correct. Signature: 4 gZaZ Date: I t — 7 " 22 Phone#: 413-592-1498 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority (check one): 10Board of Health 20 Building Department 3OCity/7'own Clerk 4.0 Electrical Inspector 5E'lumbing inspector 6.0Other Contact Person: Phone#: ACC)RL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYYJ 03/02/22 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 policy(ies) must have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER CONTNAME: ERIC ERIC MASON THE MASON AGENCY INC PHONE No,Ext1: (413)569-2307 (AX AtC,No): (413)569-2308 504 College Hwy E-MAIL themasonagencyt amerlean-natlonal.com Southwick, MA 01077 INSURER(S)AFFORDING COVERAGE NAIC tl INSURER A: FARM FAMILY CASUALTY INSURANCE 13803 INSURED INSURER B: PHIL BEAULIEU&SONS HOME IMPROVEMENT, INSURER C INC. INSURER D: _ 217 GRATTAN STREET INSURERE: Chicopee, MA 01020 MA 01020 INSURERF: COVERAGES CERTIFICATE NUMBER: 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 CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR MD POLICY NUMBER (MM M'IDDNYYYI IMMIDDYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES EaENTED ocarrence) $ 300,000 BUSINESS OWNER'S MED EXP(Ally onaparson) $ 25,000 A x x 2001X2810 02/25/22 02125/23 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY JEC LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A AWNED UTOS ONLY X AUTOSULED X 2001C7139 02/25/22 I 02125/23 BODILY INJURY(Per accident) $ XHIRED \( NON-OWNED PROPERTY DAMAGE AUTOS ONLY o'N AUTOS ONLY (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESSLIAB CLAIMS-MADE 2001E1738 02/25/22 02/25/23 AGGREGATE $ 3,000,000 DED X RETENTION$ 10.000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CARPENTRY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SAMPLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV O 1988- D15 ORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD PHILBEA-01 CHRISTINE ACORO CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) `-/ 2/18/218/2022 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 policy(ies)must have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER C2NTACT Christine Sullivan NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,Ext):(413)594-5984I(NC,No):(413)592-8499 Chicopee,MA 01013 n�Dss:christine@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC IY INSURER A:A.I.M.Mutual Insurance Company INSURED INSURER B: Phil Beaulieu&Sons Home Improvement Inc. INSURER C: Phil Beaulieu 217 Grattan Street INSURER D: Chicopee,MA 01020 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POUCY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DDIYYYYI IMMIDDIYYYYI COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ I CLAIMS-MADE + +OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $— OWNED SCHEDULED _ AUTOSEE�� ONLY _ AUTOS WNE BODILY INJURY(Per accident) $ AbRTOS ONLY _ AUOTOS ONLDY (Per ardent)DAMAGE _ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY YIN WMZ-800 -6205-2022A 2/25/2022 2/25/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $�OFFIICdEER/MEn BE R EXCLUDED? N N/A (M NH E.L.DISEASE-EA EMPLOYEE, $ 1'���'��� If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • Commonwealth of Massachusetts `;®i Division of Professional Licensure Board of Building Reguiations and Standards ConstwdtkultiSupervisor CS-062638 Expires:06/13/2023 ALAIN M BEAULIEU • 217 GRATTAN STREET CHICOPEE MA 01020 7lt �� ' ifti"C.i 1C) Commissioner cgad2A K. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration z .........8= 1, f _. L r.+. 77- " Type: Corporation i- Registration: 100073 PHIL BEAULIEU&SONS HOME IMPROVEMENT, INC. . r - Expiration: 06/07/2024 217 GRATTAN STREET CHICOPEE, MA 01020 - \rrI` ` . f 1A,f ,..-,._.r — �� Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 100073 06/0712024 Boston,MA 02118 'NIL BEAULIEU&SONS HOME IMPROVEMENT,INC. A Il trjd LAfN M,BEAULIEU ' = ' '17 GRATTAN STREET . --- r _ : t • ;HICOPEE,MA 01020 „(�n.N l` ��� Undersecretary Not valid without signature