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17A-100 (2)
23 GRANDVIEW ST BP-2016-1434 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A- 100 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2016-1434 Project# JS-2016-002467 Est. Cost:$1807.53 Fee;$65.00 PERMISSION IS HEREBY GRANTED TO: Cost.Class: Contractor: License: Lyc Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq.fl.); 9365.40 Owner; CH_WALE_R T *HEN : PAULA F'6PP Zoninv:R1(I00);URA(100)/ Applicant: AMERICAN INSTALLATIONS LLC AT: 23 GRANDVIEW ST Applicant Address: Phone: Insurance: 130 COLLEGE ST (4131 552-Q200 WC SOUTH HADLEYMA01075 ISSUED ON::616/201b 0:00:00 TO PERFORM THE FOLLOWING WORK:ATTIC AND BASEMENT INSULATION &AIR SEALING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.F.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 OE NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeTvpe: Date Paid: Amount: Building 6/6/2016 0:00:00 565.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck --Building Commissioner File 4 BP-2016-1434 APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY (413)552-0200 PROPERTY LOCATION 23 GRANDVIEW ST MAP 17A PARCEL 100 001 ZONE RI(100)/URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid GC: a1 U '7 Building Permit Filled out Fee Paid Typeof Construction: ATTIC AND BASEMENT INSULATION&AIR SEALING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 106178 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: proved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance' Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Dem.liti .y ' Signa r Btu ding •' cial 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. 0' !RECEIVED Depa�enla�v City of Northampton stat s of Pennht M Building Department Curb CutThweway Permit ,ll —3 212 Main Street $gwerlSepacAyailabllIty Room 160 WateimenAva@e6 'i(y. ocrr.cF _ Northampton, MA 01060 We Sated St detural Plans phone 413-587-1240 Fax 413-587-1272 V?rous3ta Paans ' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION IA Property Address: This section to be completed by office 23 Grandview Street Map Lot Unit. _ Florence, MA 01062 zone OvarlayDistrict Elm St.District - - CS DistrKt SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT g,t Owner of Record: Steyben Chevalier 23 Grandview Street, Florence. MA 01062 Name(Print) Cunenet4eMg 2dtlress, See attached - TelephoneeeSSSS-LL 1l 1l�� Signature 2.2 Authorized Agent American Installations 130 College St., Ste 100 South Hadley, MA 01075 Name(Nog Current MO%sg Mdress: 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. Bolding $1807.53 (a)Balding Perm*Fee 2 Eiecbicai (o)Estimated Total Cost of Constructionfrom(6) 3. Plumbing Building Permit Pea 4. Mechanical(HVAC) 5.Fire Pmfeu&n, / ,,.�(Y1,r 6. Total=(1 +2+3+4+5) 51807.53 Check Number , 74/1 6~ This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building CommisstanWanspeoNr of Beadings Dale Section 4. ZONING AU Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size l I 1 Frontage I II Setbacks Front Side L: R r Rear Building Height i I I Bldg.Square Footage 1 I % J I Open Space Footage (Lot area minus bldg&paved neriine #of Parking Spaces Fill: (volme&Locadm) A. Etas a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES 0 IF YES,date issued:) IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW 0 YES O IF YES: enter Book I Page and/or Document#1 i 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 0 NO O IF YES, describe size,type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES,describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is It part of a common plan that will disturb over 1 acre? YES 0 NO 0 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 [D Addition ❑ Replacement Windows Alteration(s) ❑ Roofing 0 Or Doors 1:3 Accessory Bldg. ❑ Demolition 0 New Signs rn Decks 10 Siding 031 Other(IN Brief Desai t ofpro posed Work: Attie and basemen insulation and air sealing throughout Alteration ofeHsting bedroom Yes__No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement --Yes No Plans Attached Roll -Sheet Oa.It New house Mut or addition to exisklnq-housinq,.completo the following: a. Use ofbuilding:One Family Two Family Other b. Number of rooms In each family unit Number of Bathrooms e. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each_,_ g. Energy Conservation Compliance, Masschedc Energy Compliance form attached? h. Type of construction Is construction within 100 fl of wetlands? Yes No. Is construction within 100 yr. floodplain Yes_No J. Depth of basement or cellar floor below finished grade k Wal building conform to the Building and Zoning regulations? Yes No. I. Septic Tank_ City SewerPrivate well, City water Supply _ SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 4 Stephen Chevalier es Owner of the subject ProPedy hereby authorize American Installations to act on my behalf,In all matters relative to work authorized by this budding permit appliicalion. .See attached 6/7J16 Signature of Wvmer Date I, American Installations as Owner/Fwthodzed Agent hereby dedare that the statements and information on the foregoing application are true and accurate,tot he best of my knowledge and belief. Signed under the pains and penalties of perjury. American Installations Picot Name American Installations 6/1/16 Stanature ofOwneriAgent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of license Nolte: Wesley K. Couture 106178 License Number 130 College St.,Ste 100 South Hadley, MA 01075 9/29/17 Address E'pkason Dote Cr( 413-552-0200 Sighaoaa Telephone S.Registered Hornetmprovemerd Do:tractor:" Not Applicable Wesley Couture 175982 Company Name Registration Number American Installations 6127/17 Address Expiration Date 130 College St., Ste 100 South 11adley, MA 01075 Telephone 413-552-0200 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(0)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Faure to provide this affidavit will result mthe denial of the issuance of the building permit Signed Affidavit flinched Yes.._.. mi No...... 0 11. -Rome Owner Exemption The current exemption for"homeowners"was extended to include Owner-occaoledDwain es of one(1) or two(2)families and to allow such homeowner to engage en individual for hire who does not possess a limns- provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 188351. Definition of Homeowner.Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.b person who constructs more than one home in a two•vear period shun not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shalt be ruaat.. Oran an..t. "'er! L I tU.,` undery rnlidi , ixa.4_ As acting t"-onstruction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this penitis 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 Ammtated,van any be liable for person(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 Q - k� IF • DEPA 212 M In S Ore =WING*'ni a R15P8 TIONS idang 212 Nein rtreat a Kuracipal /Wildin0 .ec? -._ Northampton, 1® 01060 ' y�� Property Address: 23 Grandview Street Contractor Name: American Installations Address: 130 College Street Ste. 100 City, State: South Hadley, MA Phone: 43-552-0200 Property Owner Name: Stephen Chevalier Address: 23 Grandview Street City, State: Florence, MA I,American Installations (contractor)attest and affirm that the building I intend to insulate does not have any open air(knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. / Contractor signature r � Date 611116 • Ot a�l Licensed&Insured • www.Americanlnstallations.eom MACSL It 106178 American Installations MA Registration#175932 -Efficient Home Services- 130 College Street Suite 100,South Hadley.MA 01075 • Office:(413)552-0200 Fax:(413)552-0202 • Email:support®Amedcanlmtallations.com AIR SEALING PROPOSAL Stephen ClevaMa 23 Grandview Si Florence.MA 01062-1027 Site ID:SOI05O139524 Project ID:P0OOS0159403 Customer ID:CO0050140676 Contract ID:20160330 ASEAL 1Mactlptlere OUYMIy Location Partin Air Salina at estimated 62.6 CT/ASO Per Ham 2 _ Lola Sops _ 2109_64 Sub Teat 516864 Grea Customer t Car o SIMI 64 Customer Contribution 90.00 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_$ 600 are satisfactory and are hereby accepted.You are authorized to do work as Down Payment=$ 000 ® 3130/2016 specified.Payment will be 1/3 down prior to start of work,and balance due PAID upon Completion. Balance Due Upon Completion=$ 000 Signature Q1�1I ISI,, ��/DDaattee� Propend Owner(Print) Chevalier,Stephen (Sign) �'�^"` [�.W Dote 3/30/2016 Representative:(Print) Julian Ross (sign) ✓ ///t✓ Dote 3/30/2016 LLC SERE INArER RE"ED TO ss COMPANY,AND THEMERIS NAMED Ames,HERoNAfR REPS"ED mass.CLIENT,NND WILL n SVLEn TO ALL APPROPRIATE LAWS,REDr mows ANDMDEDNANaz or ones. THE FOLLOWING TERMS AND CONDITIONS ALSO APPLY 1. THIS AGREEMENT ISSUBJECT TO THE APPROVAL OF A MANAGER OF THE COMPANY FOR THIS AGREEMENT TO BE EFFECTIVE UNDER ANYCONDITION. 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 I1-1/EI PERCENT PER MONTH.(18%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 'ALL 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 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 CLIENT FOR COMPLETION OF ALL WORKDESCRIBED IN A TIMELY 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 INSURANCE COVERAGE,ANY SUCH ADDIEDONAL 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 EXTENT THOSE DAMAGES ARE PROVEN TO BE SOLEY DUE TO THE COMPANY'S NEGLIGENCE. 6. N 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 ANO VENT PIPES,DECKING DEFLECTION,ETC.IiPRE-EXISTING DEFICIENCY OR HAZARDOUS MATERIAL IS ENCOUNTERED PRIOR TO OR DURING CONSTRUCEION,AND COMPANY IS NOTIFIED IN WRITING,COMPANY WILL TRY TO ASSIST CLIENT WITHIN THE COMPANY'S MEANS AND CAPABILITIES TO CORRECT THE PROBLEM(SI ON A TIME AND NT 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. REPLACEMENT OF DETERIORATED DECKING,FASCIA BOARDS,ROOF TACKS,VENTILATORS.FLASHING,RAFTERS,JOISTS,INSULATION OR OTHER MATERIALS ARE NOT INCLUDED UNLESS OTHERWISE NOTED HEREIN 11. THE COMPANY WILL NOT BE RESPONSIBLE FORTHE SCRATCHING OR DENTING OF INTERIOR WALLS ANDCEILINGS,FLOORS,TRIM,GUTTERS,DOWNSPOUTS,EX STING SIDING AND WINDOWS.DOORS, OIL DROPLETS IN LINE FRACTURES IN CONCRETE OR BLACKTOP DRIVES AND WALKS,OR DAMAGE TO PLANTS OR SHRUBBERY. IF EXCESSIVE DAMAGE IS CAUSED BY COMPANY, COMPANY WILL REPAID OR REPLACE DAMAGED AREA ONLY AT COMPANY'S EXPENSE. 12. 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. 13. 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 CUENT. 14 NY 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. 15. THIS AGREEMENT CANNOT BE CANCELLED WITHOUT THE MUTUAL WRITTEN CONSENT OF BOTH PARTIES EXCEPT AS OTHERWISE SET FORTH HEREIN. LELTHIS AGREEMENT, WARRANTY(S)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THE COMPANY. 17. IF THE CLIENT FAILS TO PERFORM ITS OBLIGATIONS HEREUNDER OR TERMINATES THIS AGREEMENT WITHOUT THE PRIOR WRITTEN CONSENT OF THE COMPANY,THE CLIENT SHALL BE LIABLE FOR DAMAGES FOR THE GREATER OF THE COMPANY'S ACTUAL DAMAGES OR 25%OF THE AGREEMENT FOR RESTOCKING FEE. IB. ANY CON THE CO T OF SBY MATERIALS. RLSIEM BRAN D.STYLE,COLOR.ETC)PETER SAB MATERIAL HAS BEEN DELIVERED 00.151N ROUTE TO THE CLIENT COULD RESULT IN PS%0.E-SiOIXING FEE BASEDIS AGRN EEMENT SHA SAIDEEFFECTIVE 19. YUPON ID EXECUTION )PARTIES HEARTq PRIOR UODBY WHICH CLESHALL THDEEMED IEPROPOSAL.PAYMENT THE CORECEIVED RESERVES RIOR TO TOE EXPIRATION TION REVOKE THISC PROPOSAL 90 SAFTER FROM DATE IT S IN EXECUTED VENT COMPANYTHE F ISNEARLIER EXECUTED L,THEOMPO Y AND VE THEREQRED DOWNOREVISE ISE ITS PRICE I IV EC PRIDANC THE ITS ST ON 90 DAYH PERIOD;AR EP 90 DAYS.AND IN THE EVENT COMPANY DOES NOT REVOKE THE PROPOSAL,COMPANY RESERVES THE RIGHT TO REV ISE ITS PRICE IN ACCORDANCE WITH ITS COSTS IN EFFECT ATNSXTIME. TO. BEIF ANYPROVISION OF AGREEMENT SHOULD BE HELD TO BE INVALID OR VNEN FO RCPBLE THE VAUDITY AND ENFORCEBILITY OF THE REMAINING PROVISIONS OF THIS AGREEMENT SNAIL NOT AFFECTEDN:INTHEREBY. 11. ARBITRATION::IXAND BEFORE ANINDEPENDENT DEPEAENTURBREGARDING IGANY D THETERMS,E EICAN RBHRPROVISIONS,00.PN TO RESOLVE OF THEIR AGREEMENT.THE PARTIES AGREE THETO PLACE EVENT THE HENT REIWA90EBENT,OR OTHER PROGRA0.THIAT IS ARBITRATORASSIGNEDA BY SPONSEEDUARBRROIRA (IO.MASSNAVRESOLVE J CT TDISPUTE. II. TNSORPROMOTION,M AND BULL BE SUBJEC TT O ERMIATIO THAT N IF EPART OSPONSETE SPONSERED PR GRAMLITY POGBMQ.EUD. FUVAERMORE,SUBJECT TO TERMSHE AVAILA BILITY QUALIFYING STATE SPONSORED LASERED UTILITY PROGRAMS MAY BE ALTERED WILL BE D OR UPDATED PERIIODIGLLYWTHEOR WITHOUT NOTICE RED UTILITY e0.PROGRAM IS DISCOUNTINUED. FURTHERMORE,ORE,iXE AND COxpm pxS OF STATE SPO33. ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,THROUGH.OR UNDER THE MASS SAVES ENERGY PROGRAM. 24. COMPANYF ITN E UTILITY)IS ENTITLED TO 100%OF THE ENERGY BENEFITS ASSOCIATED WITH Al ENERGY CONSERVATION MEASURES,EXCLUDING THE VALUE OFENERGYMASSACHUSETTSST SAVINGS BY THE CLIENT,BUT INCLUDING ALL RIGHTS TO ALL ASSOCIATED ISO.N E ENERGY,CAPACITY AND RESERVES PRODUCTS.COMPANY AGREES TO PROVIDE THE UTILITY WITH SUCH FURTHER DOCUMENTATION AS THE UTILITY MAY REQUEST TO CONFIRM THE UTILITY'S OWNERSHIP OF SUCH BENEFITS AND PRODUCTS. /A CLIENT UNDERSTANDS AND ACKNOWLEDGES THAT COMPANY IS NOT AN AGENT,VENDOR OR SUB-VENDOR OF THE UTILITY WIDE RESPECT TO THE INSTALLATION OF ANY ENERGY EFFICIENCY MEASURES.IN THE EVENT OF THE FAILURE OF ANY ENERGY CONSERVATION DEVICE TO PERFORM AS EXPECTED,CLIENT AGREES THAT CLIENT'S SOLE RECOURSE IS TO THE COMPANY AND NOT TO CONSERVATION SERVICES GROUP 060)OR TO THE UTILITY.THE UTILITY AND ITS OPERATING COMPANIES SHALL NOT MAINTAIN,REMOVE OR PERFORM ANY WORK WHATSOEVER ON THE ENERGY CONSERVAllON MEASURES INSTALLED.CLIENT UNDERSTANDS AND ACKNOWLEDGES THAT ITS PARTICIPATION IN THE MASS SAVE HOME ENERGY SERVICES PROGRAM IS VOLUNTARY AND THAT IT HAS CONSENTED FOR THE PROPOSED ENERGY CONSERVATION MEASURES. E6. CLIENT AGREES THAITHIT SHALL HOL)CSG ,THE UTILITY,THEIR AFFILIATES OR OPERATING COMPANIES LIABLE FOR COMPANY'S FAILURE TO PERFORM ITS OBLIGATIONS UNDER THIS AGREEMENT, FOR FAILURE OF HE ENERGY CONSERVATION MEASURES TO FUNCTION.FOR ANY DAMAGE TO CLIENT'S PREMISES CAUSED BY COMPANY OR FOR ANY AND ALL DAMAGES TO PROPERTY OR INJURY TO PERSONS CAUSED BY THE ENERGY CONSERVATION MEASURES. 17. CLIENT IS RESPONSIBLE FOR THE PAYMENT OF ANY AND ALL FEDERAL,STATE.OR LOCAL TAXES THAT ARE APPLICABLE TO THIS AGREEMENT. UMITED TIME OFFER.THE PRICES AND INCENTIVE OFFERED IN THIS CONTRACT ARE SUBJECT TO CHANGE IN ACCORDANCE WITH THE WESTERN MASSACHUSETTS ELECTRIC COMPANY MASS SAVE HOME ENERGY SERVICES PROGRAM OFFERS. MA CLIENTS:You may cancel this agreement H N has been signed by a party thereto at a place other than an address of the seller,which may be his main office or branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not Later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DATE CLIENT'S SIGNATURE DATE COMPANY REPRESENTATIVE'S SIGNATURE licensing Insuredcommunal mama- \• www.Americanlnstallations.com MA CSt tt 106178 American Installations MA Registration p 125982 -Efficient Home Services- 13O College Street Suite 100,South Hadley,MA 01075 • Office:(413)552-0200 Fax:(413)5S1-0201 • Email:support@AmerianlmGllations.com WEATHERIZATION PROPOSAL Stephen Chevalier 23 Grandview St Florence,MA 01062-1027 Site ID:5/1150139524 Project ID:P00050159403 Customer ID:C00050140676 Cwmacl ID:20160330-2 WORK Desrip4en Clonseily Location Maass Rin-Mat With r Thema)Barrier PalWo 100 Lisa Space $1400.00_ Instal r Thermal EletW Pdyiso On Open Goble Wal I9 Living Spam $831.60 Imolai,Gable Wall Wth C Deme Pack Calieme 159 living Stam $367.29 SB That $1,638.9 Maya aaYiee Shan $1.229.17 Customer Conttudon $49.]2 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 $ 409'12 are atisfactory and are hereby accepted. You are authorized to do work as 136.00 specified.Payment will be 1/3 down prior to start of work,and balance due Down Payment El 3/30/2016 PAID upon Completion. Balance Due Upon Completion $ 273.72 Signature Date Chevalier,Stephen 3/30/2016pro art<Owner(print) (Sign) Date (Pont Julian Ross 3/30/2016 Representative: 1 (Sign) Date TM*AGREEM ENT IS COMPOSED or MI5 PAGE AN PIE RWERSE FOE OF MI5 [AND SHALL BE CONSIDEREDME Olt At AGREEMENT n THE roan nlxv«vED THIS AGREEMENT is 8f ro TWE N An MOWwnAnDNS.n DN rrcxueixAFrza REFERRED TO.CompANr.AND Tx Tomany)LAMED Aeore HEEENAFTER REFERTOAs•rusxr.AND,,,LL „mnaTTO ALLAPPROPRiAil uws.REauumoxs AGO ORDIXANcE OF me 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 I1-1/2)PERCENT PER MONTH.(15%PER ANNUM)WITH A MINIMUM CHARGE OF S2.09 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 3. THE COMPANY AGREES THAT WHEN DELAYS BECOME KNOWN TO THE COMPANY,THE COMPANY WILL ADVISE THE CLIENT AS SOON AS REASONABLE. A. COMPANY AGREES 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. 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 REG.STER OR MAIL IN A WARRANTY CARD OR OTHER EVIDENCE OF OWNERSHIP AND USE OF SUCH EQUIPMENT AND/OR PRODUCTS IN ORDER TO ACTIVATE SUCH WARRANTIES. 6 THE QUOTATION ON THE PAGE HEREOF DOES NOT INCLUDE EXPENSES OR CHARGES FOR BOND OR INSURANCE PREMIUMS OR COSTS BEYOND NORMAL INSURANCE COVERAGE,ANY SUCH ADDITIONAL EXPENSES,PREMIUMS OR COST SHALL BE ADDED TO THE TOTAL AGREEMENT AMOUNT. 7. THE COMPANY'S UABILNY 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. B. DURING THE DURATION 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. SNOT RESPONSIBLE FOR PREEXISTING DEFICIENCIES OR HAZARDOUS MATERIALS THAT MANIFEST THEMSELVES DOSING THE CONSTRUCTION PROCESS.E WOOD ROT,MOLD, ASBESTOS,COMPANYL 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 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 ONS THE DURATION OF THE WORK AND SCHEDULED DATE OF COMPLETION MAY DIFFER FROM THAT AGREED UPON,IF APPLICABLE,UNDER THIS AGREEMENT. 10. REPLACEMENT OF DETERIORATED DECKING,FASCIA BOARDS,ROOF JACKS,VENTILATORS,FLASHING,RAFTERS,JOISTS,INSULATION OR OTHER MATERIALS ARE NOT INCLUDED UNLESS OTHERWISE NOTED HEREIN. 11 THE COMPANY WILL NOT BE RESPONSIBLE FORTHE 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. 12. THE COMPANY UNDER PROVISIONS OF CHAPTER 142A OF THE GENERAL LAWS IS REQUIRED TO APPLY FOR AND OBTAIN ALL CONSTRUCTION-RELATED PERMITS.THESHALL NOT BE DEEMED RESPONSIBLE FOR DELAYS IN THE WORK DESCRIBED IN THIS AGREEMENT CAUSED BY REGULATORY PERMIT GRANTING OR INSPECTIONAL AGENCIES,AUTIOBUIES,OR INDMDUALS. 13. THIS AGREEMENTANCLUDI NG THE PROVISIONS RELATING TO PRICE AND PAYMENT SCHEDULE,CANNOT BE CHANGED OR ALTERED EXCEPT BY A WRITTEN STATEMENTSIGNED BY BOTH THECOMPANY AND THE CLIENT. SA. ANY EPRESENTATIONS,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, 15. THIS AGREEMENT CANNOT BE CANCELLED WITHOUT THE MUTUAL WRITTEN CONSENT OF BOTH PARTIES EXCEPT AS OTHERWISE SET FORTH HEREIN. 16. THIS AGREEMENT,AND ANY WARRANTYIS)PROVIDED HEREUNDER SHALL NOT BE ASSIGNED EXCEPT BY OR WITH THE WRITTEN PERMISSION OF THECOMPANY. /7 IF THE CUENT LS 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 15%OF HE AGREEMENT FOR RESTOCKING FEE. LB. ANY ES TO MATERIALS BY THE CLIENT(BRAND,STYLE,COLOR,ETC.)AFTER SAID MATERIAL HAS BEEN DELIVERED OR IS IN ROUTE TO THE CLIENT COULD RESULT IN A 5%RESTOCKING FEE BASEDON THE COST OF SAID MATERIALS. 19, 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. ID ROVISION 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. 21. 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. 22 MOTION,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 DYPROGRAM AAMA AND WILL ILL BEL SUBSUBJECT CT TPTERTERMINATION ATIONI IF THE HE STATEOR SPONSERED NOTICE. AMERICAN23. PROGRAM IS DISCOUNTIINUEO. FURTHERMORE,NE TERMS AND CONDITIONS OF STATE Y A D ED WI SPONSERED INSTALLERS,LLC IS NOT AN AGENT OF ANY UTILITY COMPANY OF OTHER VENDOR WORKING BY,THROUGH,OR UNDER THE MASS SAVE'ENERGY PROGRAM. 24. WESTERN MASSACHUSETTS ELECTRIC COMPANY/THE UTILITY)IS ENTITLED TO 1CO%OF THE ENERGY BENEFITS ASSOCIATED WITH ALL ENERGY CONSERVATION MEASURES,EXCLUDING THE VALUE ASSOCIATED ISO.NE ENERGY,CAPACITY AND RESERVES PRODUCTS.COMPANY AGREES TO PROVIDE THE UTILITY WITH SUCH FURTHER DOCUMENTATION AS THE UTINCLUDINGT UTILITY REQUEST TO CONFIRM THE UTILITY'S OWNERSHIP OF SUCH BENEFITS AND PRODUCTS. 25. CCLIENT UNDERSTANDS AND ACKNOWLEDGES THAT COMPANY IS NOT AN AGENT,VENDOR OR SUB-VENDOR OF THE UTILITY WITH RESPECT TO THE INSTALLATION OF ANY ENERGY EFFICIENCY MEASURES.IN THE EVENT OF THE FAILURE OF ANY ENERGY CONSERVATION DEVICE TD PERFORM AS EXPECTED,CLIENT AGREES THAT CLIENT'S SOLE RECOURSE IS TO THE COMPANY AND NOT TO CONSERVATION SERVICES GROUP(CSG)OR TO THE UTILITY THE UTILITY AND ITS OPERATING COMPANIES SHALL NOT MAINTAIN,REMOVE OR PERFORM ANY WORK WHATSOEVER ON THE ENERGY CONSERVATION MEASURES INSTALLED.CLIENT UNDERSTANDS AND ACKNOWLEDGES THAT ITS PARTICIPATION IN THE MASS SAVE HOME ENERGY SERVICES PROGRAM IS VOLUNTARY AND THAT IT HAS CONSENTED FOR COMPANY TO INSTALL THE PROPOSED ENERGY CONSERVATION MEASURES. 26. CLIENT AGREES THAT IT SHALL NOT HOLD CSG,THE UTILITY,THEIR AFFILIATES OR OPERATING COMPANIES LIABLE FOR COMPANY'S FAILURE TO PERFORM ITS OBLIGATIONS UNDER THIS AGREEMENT, FOR FAILURE OF THE ENERGY CONSERVATION MEASURES TO FUNCTION,FOR ANY DAMAGE TO CUENT'S PREMISES CAUSED BY COMPANY OR FOR ANY AND ALL DAMAGES TO PROPERTY OR INJURY TO NS CAUSED BY THE ENERGY CONSERVATION MEASURES. 27. CLIENT I5 RESPONSIBLE FOR THE PAYMENT OF ANY AND ALL FEDERAL,STATE,OR LOCAL TAXES THAT ARE APPLICABLE TO THIS AGREEMENT. MUEDTIME OFFER.THE PRICES AND INCENTIVE OFFERED IN THIS CONTRACT ARE SUBJECT TO CHANGE IN ACCORDANCE WITH THE WESTERN MASSACHUSETTS ELECTRIC COMPANY MASS SAVE HOME ENERGY SERVICES PROGRAM OFFERS. MA CLIENTS:You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office or branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DATE CLIENT'S SIGNATURE DATE COMPANY REPRESENTATIVE'S SIGNATURE �ttThe Commonwealth of Massachusetts W Department ofIndutrial Amidenls Office of Investigations 600 Washington Street Boston,Mast 02111 www.masegov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information /� 'r Please Print Legibly Name(amioess/Ugao®ounder vidn9: 171(1 et l o w, in s f a I10.'f1 ones I_LC Address: 130 en S-IC 0 .,' City/State/Zip: 5SOut-C‘ ley MA CMS Phond: 413-5502- 0r9,Oo Ara an empb1W.CSeuh appropriate hake TYPe of project(repdrvd): 1I a am an employer with_ &. 4.01am a general coninotor and I 6.0 New mostruMan employees(full and/or pert time).' hove hued the mbcootmemss 7.ORmmdcliog 2.01 am a sole proprietor or punier- listed on the attached sheet. ship and have no employees These sub-contactors have 8.0 Demolition wwklog for me in any r.pw.lty. employees and have sedan' 9.0 Bund'mg addition [No workers'comp.insurance comp.insurance.j required] 5.0W a am a corporation and its 10,OElemical repaia or additions 3.01 am a homeowner doing all work - officers Ian exercised Weir myself [No workers'comp. right of exemption aMGL 11.❑Plumbing repdrsmaddiiwworkers' ero insurance required]t c.152,11(41,and we have no 12.Moot'mans employaus.[no workers' 13. comp.Insurance required.] sr(Other S4�airUn `Any'polkaed that Mae bac II moil iso GUM the tabu brim slain Welt misers'mmpeentfou poesy hdmmrnou tHommwoenwbo ouhma this smenit lar'etadoc may are Mann mit end Wn biro outside eootneten mut. boa a noir Wdnilhanaoe suet. teonm<mee net ebetathbee mut attach ma bdtliamistem Magogde neat alik eub-cntnrmn ad Ouse whether ex eel Woe roes:"haw malaria if as obaansetms tom emir,"dug moil Imelda Web meters'imp mazy woke. I am en enrptoyrrthee isproviding workers'compennaon tannneefor my employes.Below is the policy and job Me information. Insurance Company Name: A l A G rd_ -- _ Policy Mor Self-ins.Led:_ u Onde (.06C\Cli-1Expiration Dese_—i I Li I I_(0_ Job She Address: ,R'3 & n )k(2t 0-51--- Q'tyistaternp:Oorncs t'`2r (111c'L..1 / Attach a copy of the workers'compensation policydeclaration page(showing thepopolicy number and expiration(date). Failure to secme coverage as required under Section 25a of MOL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Invesdgeliora of the DIA for coverage verification. I do herby }ccJerst certify ander the epp�ubissaand penalties ofperjwy Met the information fprowdedd above is true and correct s mtun/ 71 ( ///�44.4— lL Dae: 10 •� 1 \ \ Print Name:cl nano l/Z, l,nu'[rwwt. PAmm t: yds-5sa-ODOD Official use only Do not write in this area to be completed by dry or town official City or Town: Permit/license It:Issuing Authority(circle one): LBoard or Heath 2. IbsAding Department 3.Oty/Pswo Oak 4.Gmdrkal ftatpedor 5.PWmiiag hipster 6.Other Contact person: Phone a: A CERTIFICATE OF LIABILITY INSURANCE Aie/P015 D n Y 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. TIPS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TXE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(es)must be endorsed. It 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). pRommEn CONTACT Lind. Powers Webber 6 Grinnell RPHONE Jnr (933)586-0111 PAX 01 Inc.**.* 1315¢6-cam 8 North King Street lboilfgss,1powers6webberandgrinnell.cote INSURERS)AFFORDING COVERAGE NAM Y Northampton INA 01060 wsumRA Employers Mutual Casualty H95URED ...SURER a AmGQARD/BE GUARD American Installations, ZLC INSURER C: Attn: Res & Suzanne Couture INSURER D: 130 College Street Suite 100 INSURER E: South Radley MA 01075 INSURERS: COVERAGES CERTIFICATE NUFABERtdaster 9-2015 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 NRIICH 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.YEEa ILTR E TYPE OF INSURANCE m POLICY NUMBER {PD HOWD�f TO NMRS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1..000,000 A X CLAIMS-MADE —tC UR PREM ES Er2 aa PPEPcI W 50,000 5/13533216 9/4/2015 9/4/2016 MED EXP FIM 04ep.cs1I 10,000 PERSONAL S ALM INJURY 1,000,000 GENE AGGREGATE LIMIT APPUES PER GENERAL AGGREGATE 2,000,090 X PIXCT' Tref ILac PRROC&CTS-COMPAP EGG •.-2,000,000 OTHER: AUTOMOmLE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _ L modern A ANY AUTO BODILY INJURY Or per AU,OWNED SCHEDULED _AUTOS x AmgS SS3535216 914/251$ 9/4/2016 BODILY INJUAY(PM UGeE) X WRED ATOS X L AGG"WERMesoic _ I FlPassic 9,000 X UMOREL.IA LAB OCCUR EACH OCCURRENCE $ 1,000,000 A MESS LIB CLAIMS-MADE AGGREGATE S 1,000,000. 06O X RETENTIONS 10 000 533535216 9/4)2015 9/4/2016 S IWOBCE'S COIPENSAMON PER_T EOR SAND EMPLOYERS ummu Y YIN MT FAOPNETCRRARTNE(OLAECLMVE EL EACH ACCIDENT 5 500,000 OFFICER/MEMBER EXCLUDED? N/A B I yes. ttm DRNC609917 9/4/2015 9/1/2016 EL DISEASE•FA EMPLOYEE S 500,000 OE awnwOFM GESCRIPTIONOF OPERATIONS below ILL DISEASE pajoy LIMB S 500,000 A Commercial Property 53536216 9/4/2015 9/4/2016 dedoeStae4O404 20,000 Mmr:4Ne 51.0.00 40,000 DESCRIPDON OF OPERATORS/I ORATORS VEHICLES IACORD tof.AddlonN Remarks SORdule.may be MaMwf Itmare apace Is required) Proof of Coverage. Workers' Compensation policy includes class code 5974 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCE'I PD BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORISED REPRESENTAPVE J Kevin Joyce/LHP . "r-" ••••••` ©1988-2014 ACORD CORPORATION. All tights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025r20uon Massachusetts -Department of Public Safety Unrestricted-Buildings of any use group which Board of Building Regulations and Standards contain less than 35,000 cubic feet(991m)of Construction Supenisor enclosed space. License: CS-106178 t\VT 1 1), WESLEY COUTU)tE sp. 166 NORTH MALS S1�f _ South Hadley MAP 01l - eFailure to possess a wrrem edition of the Massachusetts N nm sa a, - State Building Code is cause for revocation oft is license. ,i^(on is,d Expiration Commissioner 00/29/2017 Fm DIS licensing olormaeona4t www.Mass.Gov/caps C/ WG OW 0z i� etZs Office of Consumer Affairs and Busi ss Reg-talon $ 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 175982 Type: LLC Expiration: 627/2017 TO 265208 AMERICAN INSTALLATIONS, LLC WESLEY COUTURE 130 COLLEGE STREET SUITE 100 s._.. __. - SOUTH HADLEY, MA 01075 Update Address and return card.Mark reason for change. SCA r, eau-osn, fl Address fl Renewal EIEmployment Q Lost Card H1-2, ,..w../U,eirit sinioc,,eii Office of Consumer Affairs&Business Regulation License or registration valid for individul use only NOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: istration: 175902 Type: Office of Consumer Affairs and Business Regulation Expiration -:6272017 LLC lO Park PlazaSuite 5170 _ Boston,MA 02116 AMERICAN INSTALLATIONS;LLC WESLEY COUTURE 130 COLLEGE STREET SUITE IW s _,. `,„�_ SOUTH HADLEY MA 01075 Undersecretary - - N valid without signature