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36-246 (7) } o4`��pTO of 'Nartflump#art _ — B �. � � �aesachuartta DEPARTMENT OF BUILDING INSPECTIONS ` INSPECTOR 212 Nfain Street ' Municipal Building \�, Northampton, Mass. 01060 Square Footage Amount Basement @ .10 1st Floor @ _40 j D 3 6 2nd Floor @ .20 1/2 Floors, Attic, Garage .10 Deck, Porches .10 TOTAL �O C1 C Commonwealth of Massachusetts V M ( of Building Regulations and Standards ' I r� i Manufactured Buildings Program i LABEL REQUEST FORM L--- --------------Jrhis Section for State Use Only Date Rec ived ti '' 1 '`' �' Label Numbers Issued: Fee Received _ $ Doo .GO W59 &(o � 93 4 8 99399 Check Number S Lt6 Date Issued: 4 p Z 1 Issued by: This Section to be Completed by Manufacturer-PLEASE PRINT OR TYPE SECTION 1 - MANUFACTURER INFORMATION BBRS\DPS I.D. # 39 60 9 Manufacturer Name A V I S A M E R I C A/ E X C E L H O M E S I MC# 0 2 7 Street P . O . SOX 420 - HENRY STREET City/State/Zip A V I S , P A 1 7 7 2 1 Manufacturer Telephone Number: (5 7 0) 7 5 3 - 3 7 0 0 Fax Number: (5 7 0) 7 5 3 - 5 0 0 9 Manufacturer-Plant Inspector 7Ho m R S PAC�C,19/P-Q Third Party Agency P F S TPIA # 0 2 Number of Labels 4/ Total Amount Attached $ oZ Q O • O Manufacturer's Serial Q ax,-rE # /D 5 O/ Manufacturer's Model sT 0 R y Number rl / y(o Q a Designation ��� SECTION 2 - LOCATION OF BUILDING Street City/State/Zip ffQkZ14A M P T O W C) ! U SECTION 3-BUILDER/DEALER/CERTIFIED INSTALLER INFORMATION Builder/Dealer 7-/-/E H6 M S TQP E Street 9,3 TA T L jE o a 1) U . L3 Cox- 0 00 City/State/Zip / 1/-J q TLC- Y Certified Installer U t-LG PEgs Licensed Construction License Number: J O Supervisor J l In klA kk I T y Expiration Date: (a _ a6 - 63 This form shall be completed by the manufacturer when requesting manufactured building labels. All information shall be clearly indicated_ Incomplete forms will be returned to the manufacturer unprocessed. This request shall be forwarded to the State Board of Building Regulations and Standards- CERC Building, Paul A. Dever School-1380 Bay Street,Taunton,MA 02780 Bbrs\Forms2\mf&Labe1Request June 15,2001 m:Janet Trudeau At: Blair, Cutting&Smith To KATIE I•ax#. (41s)zDlyibv uate: uii/ul iu:DuAm rage i ACORD CERTIFICATE OF LIABILITY INSURANCE OP HONES-I OA08/01/O1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Blair, Cutting & Smith Ins. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 7 North Pleasant Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Amherst MA 01002 INSURERS AFFORDING COVERAGE Phone: 413-256-8541 INSURED INSUREPA Eastern Casualty Insurance Co. INSUPEP-E Acadia Insurance Company The Home Store Inc. & INSURER Blue Ridge Insurance Company Andrew & Janice Gianino P.O. Box 300 INSUPEP 0 Whately MA 01093-0300 fNSUPEA E COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MMIDDlYY DATE MMIDDIYV GENERAL LIABILITY J,CHCCC'JRRENCE s 1000000 A % COMMERC'ALGEIEPALLwEIUT'1 CP00003300 Ce/01/01 I 08/01/02 FIRE^AMAGE(4^io^e Ile) s 300000 c AMS reADE r%I oc-uR I MED E-P(AM Ole ces-) s 5000 `J I PERSONAL&AD\'id1URY S 1000000 GENERALAGGREGATE I S 2000000 GEN'L AGGPEGATE LIMIT APPLES PER. Pz?OD'JCTS-COMPiCP AGG I s 2000000 POL:CY I Eb LCC I Ben' 0 AUTOMOBILE LIABILITY COMENEO SINGLE'-;M^ S 1000000 C A.:APG CA008284900 I 08/01/01 I 08/01/02 [E2 311 11'1; j ALL OV,4ED AUTOS (Pe,L�eS IoIL•'' -AUTOS$ SCHEDULE Iy.HIPED A TOS ECDI!- NOT? U RY S C",,EJ AUTOS pf�OPFC-/OAVAGE S I � GARAGE LIABILITY I — A3G S EXCESS LIABILITY sc c_'RP_.acE s2000000 B �7 Occ'_R C'-AMS'AGE CU53419 08/01/01 08/01/02 1 AcGREOA z I— - D E er 5000 WORKERS COMPENSATION AND g R� v;s A EMPLOYERSLUi[ialTY WC00747093 08/01/01 1 08/01/02 __ c'-.Ac-'.DE S100000 _ __ __ �EVP--,_E S100000 3500000 OTHER I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONSADDED BY ENOORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER 11 ADDITIONAL:NSURED:INSURER LETTER: CANCELLATION HOMESTO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL THE HOME STORE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR ROUTE 5 WHATELY MA 01093 REPRESENTATIVES. W , ACORD 25-5(7197) 'ACORD CORPORATION 1988 iinI VV CVVC I]UH VI 41) ril MV10 rniL.nivn OnLGD , rHA NU DIU (DJ )C7t r UUU4 chvirman `�6i� t"�i" �Prrrl i"rrvi,...�r.Tr�irv'a^•T3''r.:4�"'vvvvvw�/�'.,::v f�Ai 7 Imo}/�A( /}y'y� /.7WJK�I/w//V�HJ.IKK�'N<✓ LAY'L'�� !! � '/ .f�W••w'wu'Vi�� '�Liv:�ii.C..^ii:_w�.�:.�G JaN'c S1S'ir �q[a/s�sN4idlV - 1.�V7 �� t(C i4 Tn 0/l TCI 1'r`UW Governor e�(_aa•w—ssj-N���sw j w_�crc/, Vice Chairmen V 210 JAIMES JAIUGA THOMAS L.ROGERS Secretary TEL: (617)727-7532 FAX: (617)227.1754 Admrcicrnror April 29, 2002 Avis America Henry Street—P. 0, Box 420 Avis, PA. 17721 RE: RE-CERTIFICATION IN THE MASSACHUSETTS 1MAVT_FACTURF;7 R1j11.D1N1 3C PROC D AM Mr:Uh'f'1 To Whom It May Concern: This letter is to confirm your re-ce-Ttifi.cation in the Massachusetts Manufactured Buildings Program as a producer of Manufactured Buildings has been approved for the period May 1.2002 through April 30,2003. This approval is contingent upon compliance with all previously listed conditions of vour approval and compliance with the provisions of 780 CMR the Massachusetts State Buildinno Code 6" Edition,the Electrical Conde—and Fuel/Ga-s Code. SinrerPjv, CT A TE Pn D Din (1F T11 711 111ATC= D C,'(_T TT ATTn'KTC A ATTI CT A ATT'1 A D nQ L v.�..✓a.•v l"_VV1.. a4%l&4V Al V1J J1l11•✓[ZlW..7 1 h maS L. K oocr s e Adrnin istrator cc: MA. Board of Examiners of Plumbers and Gas Fitters MA. Board of F.xwniners of Electricians c nnn l-, A" b"" ircit"d frv.rn the Board of Building Regulations and Standards a: a t A380 o , Suez r, °0. $az 871, Taunton, .M..a 0 7Rn Taunt;vi. u.:;i ILI v,�.(.f: ui