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30A-022 (6)
BP-2024-1402 393 RIVERSIDE DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-022-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTR;AC'TING \VITII UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2024-1402 PERMISSION IS HEREBY GRANTED TO: Project# SHED ROOF 2024 Contractor: License: PHIL BEAULIEU &SONS HOME Est. Cost: 2785 IMPROVEMENT 62638 Const.Class: Exp.Date: 06/13/2025 Use Group: Owner: TRUSTEE VANN JORETTA JOYCE Lot Size (sq.ft.) Zoning: URB Applicant: PHIL BEAULIEU & SONS HOME IMPROVEMENT Applicant Address Phone: Insurance: 217 GRATTAN ST (413)592-1498 WMZ-800-6205 CHICOPEE,MA 01020 ISSUED ON:10/23/2024 TO PERFORM THE FOLLOWING WORK: REPLACE ROOF ON SHED 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 Driveway Final: 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. Signature: idiffr � Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner .. I The Commonwealth of Massachu efts f---------„L„, 2 202„ ' Vti Board of Building Regulations and S'anda ds F R Massachusetts State Building Code, 80 f • •1' .), M NI(' PALITY No'r suitor/v.r r Building Permit Application To Construct, Repair, Renov ,$ •err• ,isec Mir 2011 One-or Two-Family Dwelling io0) This Section For Official Use Only Building Permit Number:44 '/4020 Date Applied: S l 61FiEG,c) S21- /e-41 '2f/ Building Official(Print Name) Sign Date SECTION 1:SITE INFORMATION 1.1 Propfftv Address: /� I I_�� .2 Assessors Map& Parcel Numbers 313 �di br ve- IV rT"i t I.la 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) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,154) 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 ifyes❑ SECTION 2: PROPERTY OWNERSHIP' JOwner'of Ni 170o , /U4 0/0(DO Namcrint) City.State.ZIP 393 Ki 64 e Dies;ve (c}.►3)581{42169 JoretfabaeaVma,;/, cow No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 11" Owner-Occupied iliRepairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. Number of Units� Other ❑ Specify: /�, B 'ef Description of Pro sed Work': 'act tel9 on 417 S .$�Q'•-ci �Ad Brief i1 �i1 ag. r SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $217 es- . - 1. Building Permit Fcc: $ Indicate how fee is determined: 2.Electrical $ r ❑Standard 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: Check No. 14 blitheck Amount: iffl Cash Amount: 6.Total Project Cost: S 2 1 g S .. 0 Paid in Full 0 Outstanding Balance Due: $ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSI.► CS_Olo2ie36 (p )I3/25 Phil Beaulieu&Sons Home Imp.,Inc. CJ 217 Grattan Street,Chicopee,MA 01020 License Number Expiration Date HIC REG#100073 CSL#CS-062638 List CSL Type(sec below) Alain Beaulieu Type Description PH:(413)592.1498/Fax:(413)594.6008 U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding Sd 4135921498 /Ytbea Itil het O?8 H Z;n'1 I InsSolulation Telephone Email address i) Demolition 5.2 Registered Home Improvement Contractor(HIC) t 000 73 to/7/2 Phil Beaulieu&Sons Home Imp.,Inc. HIC Registration Number Expiration Date 217 Grattan Street,Chicopee,MA 01020 HIC REG#100073 mbt'_ .M h e.a 0 pe HT,nef-- CSL#CS-062638 Email address Alain Beaulieu 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 . No O SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize r ni l -port l t-ekt t,Il S Tf�.i/yet "meal ye/IAA-fit to act on my behalf,in all matters relative to work authorized by this building permit application. Joyce. Vane. 1p/is/29 Print Own s Name(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. Pis I $•ehti.ti�r,& c o nS 1 aika / /,s/2/ 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(1IIC)Program),will no have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the MC 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 halflbaths 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 ..sic Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 4 4 212 Main Street • Municipal Building yJ�• !' Northampton, MA 01060 r'J `^00 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: -)vt-IMPS Location of Facility: 55 5 T Ca( Pet . � t( d Cr- Location The debris will be transported by: USA H1/z Vy-i GSA tia,44v1 n -t- Name of Hauler: _ ,� Signature of Applicant: Date: /D/ks/lc/ Approved by Joyce Vance on Oct 8,2024 Approved Phil Beaulieu&Sons Home Improvement, Inc. 217 Grattan Street Beau ell Chicopee,MA 01020 HOME IMPROVEMENT, INC. Phone:(413)592-1498 43824 Fax:(413)594-6008 Joyce Vance Phone:413-584-7296 Cell: +14135844293 Job Address: 393 Riverside Drive Northampton,MA 01062 Print Date: 10-8-2024 Shed Roof Description Price ; Strip all layers of roofing on the shed-dispose of all debris $2,725.00 Scab in one(1)partial piece of plywood to fix the existing hole in the sheathing Furnish and install synthetic underlayment Furnish and install ice and water barrier to meet local code Install new aluminum drip and rake edge—Color:Brown Furnish and install ridge vent wherever applicable Furnish and install new GAF HDZ roofing-Color:To be determined Shea Roc' Sheathing If plywood needs to be replaced with 1/2"CDX plywood there will be an up-charge of(S115.00)per sheet not included in price If plywood needs to be replaced with 1x8 boards or 3/4"CDX plywood there will be an up-charge of($140.00)per sheet not included in price ' General Includes removal and disposal of debris Any siding repairs needed once the roofing is stripped is to be paired at a rate of$195.00 per hour per lead carpenter or$115.00 per hour per apprentice+ materials + 15%of material Any rot found during the project is to be repaired or replaced at a rate of$195.00 per hour per lead carpenter or$115.00 per hour per apprentice+ materials+ 15%of material Total - $2,725.00 a r Contractor Obligations: All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Alterations or deviations from above specifications involving extra cost will be executed only upon written orders, and wilt become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. The Home Improvement Contractor Regulation Statute, M.G.L. c. 142A gives you certain warranties and homeowner's rights thereunder. Contractor shall inform Homeowner of any and all necessary permits, and it shall be the obligation of the contractor to obtain said permits. Homeowner is responsible for the cost of the permit fee.The permit fee will be determined by the local building department and will be billed immediately to the Homeowner. If Homeowner secures his/her own permits,he/she will be excluded from the guaranty fund provisions of M.G.L.c.142A. Registration: Contractor to have all registration, license number and insurance required by the state.Contractor to be registered with the Director of Home Improvement Contractor Registration. Certificate of Registration #100073. Any inquiries about Contractor relating to registration should be directed to the Consumer Hotline at(617)973-8787.Contractor to carry commercially reasonable insurance.Contractor's workers are covered by Worker's Compensation Insurance. Customer Acceptance of Proposal: Upon signing, this document becomes a binding contract under law. The above prices, specifications and conditions are satisfactory and are hereby accepted. Contractor is authorized to do the work as specified. Payment will be made as outlined in the payment schedule. Contractor may withdraw this proposal at any time prior to signature by Homeowner. Homeowner may cancel this Contract without penalty or obligation within three(3)business days from the date signed.Contractor may withdraw this proposal if not accepted within 30 days. Customer Consents: Contractor is authorized to use media for promotional purposes.Contractor is granted permission to access property after signing until project completion.Homeowner's signature grants permission to Contractor to obtain all necessary building permits. 41,42 vAkim Beaulieu HOME IMPROVEMENT,INC. *Stay Connected with our social media and helpful links above Proposal Date:Oct 8,2024 Revised From:Sept 30,2024 Estimate Date:Sept 26,2024 PBHI Representative:Cameron Beaulieu I confirm that my action here represents my electronic signature and is binding. Do not sign this contract if there are any blank spaces. Signature: Date Oct 8,2024,9:31 AM Joyce Vance Approved by: c. \ me I. UAtntunWCuttn of IYIUJ'JUCfUitSttJ'Department of Industrial Accidents y Office of Invest igations ( ,Y_ _ Lafayette City Center r1 4 ;•'; 2 Avenue de Lafayette, Boston, MA 02111-1750 r ,, www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information L� Please Print Legibly Name (Business/Organization/Individual): F�t + CJ talk(I tiles. it gQ1iS ern,¢_ ZrYv,p rD t z.&t.a4.'+ Address: 2 ( -1 bra st• Ctrt: L op et- Pl.(c ©l 0'10 City/State/Zip: Phone#: 4,3—S9 2 — 1 `-E q 8 Are u an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 25 4. 0 1 am a general contractor and 16. El New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub contractors have g. ❑ Demolition workingfor me in anycapacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. 0 We arc a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 [ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. s 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 employers. If the sub-contractors have employees,they must provide their workers'comp.policy number. l am an employer that is providing workers'compensation insurance for my employees. Below i►the policy and job site information. �n L. Insurance Company Name: l' ' ',I/�(AT�,,, 2-- n&.r a o cL c 0 M p,,,, Policy#or Self-ins. Lie. #: (��2-—8OO—(D205 — 20 2 3 4 Expiration Date: J 2I 25 12 5 Job Site Address: 3613 I iV'2(t�tl.CJft D i City/State/Zip: AJOHkerbettVisMil Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).(9/t 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 imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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. I do hereby certify under ns nalti , perjury that the information provided above is true and correct. Si nature: Date: Phoneik /i 3 - 55g2 -i49 3 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): 1❑Board of Health 2❑Building Department 3❑City/Town Clerk 4.❑Electrical Inspector 50Plumhing Inspector 6.0Other Contact Person: Phone#: ACO® DATE(MMIDDIYYYY) C CERTIFICATE OF LIABILITY INSURANCE 2/13/2024 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(les)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 NAMEAcT : ERIC MASON THE MASON AGENCY INC PHONE ituc .EtaC (413)569-2307 (AX awc,Nor: (413)569-2308EMAIL 504 College Hwy ACOR SS: themasonauencvlkamerIcan-natlonalcom Southwick,MA 01077 INSURER(S)AFFORDING COVERAGE HNC _,_. — INSURER A: Farm Family Casualty Ins 13803 . INSURED INSURER B: PHIL BEAULIEU &SONS SlASIMrRC: HOME IMPROVEMENT, INC. INSURERD: 217 GRATTAN STREET INSURERS: Chicopee,MA 01020 MA 01020 IvsURERF: 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 !ADEL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WSO wvr POLICY NUMBER IMMIDD!YYYYI (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE S 1,000,000 I DAMAGE TO RENTED J CLAMS-MADE 7 OCCUR PREMISES(Ea occurrence) ,$ 300,000 BUSINESS OWNER'S . MED EXP(Any one person) $ 25,000 A 2001X2810 2/25/2024 2125/2025 PERSONAL S ADV INJURY S 1,000,000 GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 3,000,000 XI POLICY LOC PRODUCTS-COMP/OP AGG S 3,000.000 I OTHER: S AUTOMOBILE LIABILITY COM .D SINGLE LIMIT S 1,000,000 ' 1ANY AUTO BODILY YINJURY(PerRereon) $ A x OWNED SCHEDULED BOOILV INJURY AUTOS ONLY x AUTOS 2001 C7139 2/25/2024 2/25/2025 (Peraccident) S X HIRED V NON-OWNED PROPERTY DAMAGE S AUTOS ONLY /� AUTOS ONLY (Per acdduni) _ S i 1.X UMBRELLAUAB X OCCUR EACH OCCURRENCE S 3,000,000 A EXCESS LIAR CLAIMS-MADE ' 2 0 01 E 1738 2/25/2024 2/25/2025 AGGREGATE s 3,000,000 DED X RETENTtoNs 10,000 S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY V I N STATUTE ER ANY PROPRIETORiPARTNER/EXECUTIVE I E.L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? l N!A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE S II yes desabe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT'S DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 1D1,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 PROOF OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT IVE )1 -2 CORD CORPORATION. All rights reserved. ACORD 25(2016/03)• The ACORD name and logo are registered marks of ACORD PHILBEA-01 ABI ACORO CERTIFICATE OF LIABILITY INSURANCE °� ` Y"" 2/13/202/2024 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 wpm'Abijanled Fontanez Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street A/C No E,1►:(413)594-5984 I(A/C,No): Chicopee,MA 01013 �B,abi@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC e INSURER A:A.I.M.Mutual Insurance Company 33758 INSURED INSURER 8: Phil Beaulieu&Sons Home Improvement Inc. INSURER C: Phil Beaulieu 217 Grattan Street INSURER D: Chicopee,MA 01020 INSURER E: 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 SUER POLICY NUMBER POLICY EFF POUCY EXP LIMITS LIR INSD WVD IMMIDDIYYYYI (MMIDO)YYYYI COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT n LOC PRODUCTS-COMP/OP AGG $ I OTHER: f AUTOMOBILE LIABILITY (CO O ac uciden81NGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ — OWNED ^SCHEDULED AUTOS ONLY AUTOS BODILYpR INJURY(Peracaden0 $ AUTOS� ONLY ^ AAUUTOS WN�p ONLY (Pe? RDAMAGE _ $ UMBRELLA(JAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ S A WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY ANY PROPR�TgOER/PARTNER/EXECUTIVE Y/N WMZ-800-6205-2023A 2I25/2024 2/25/2025 E.L.EACH ACCIDENT $ 1,000,000 QFF EIEIABER EXCLUDED', N N I A (w In N E L DISEASE-EA EMPLOYEE,$ 1,000,000 Ayes,desc lbeunder 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I 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 Division of Occupational Licensure Board of Building Regulations and Standards Const(t l�ii rSll rvisor CS-062638 - E eaires: 06/13/2025 ALAIN M BE_ LIEU 217 GRATTAN STREET CHICOPEE Mtn 01020 • ,C) _ +r�lJ.Ydi1�- r! Commissioner w e v,utza.., • THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 100073 PHIL BEAULIEU &SONS HOME IMPROVEMENT,INC. • Expiration: 06/07/2026 217 GRATTAN STREET CHICOPEE, MA 01020 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 Registtojr Expiration 1000 Washington Street -Suite 710 100073 06/07/2026 Boston,MA 02118 'NIL BEAULIEU&SONS HOME IMPROVEMENT,INC. \LAIN M.BEAULIEU ?17 GRATTAN STREET :HICOPEE,MA 01020 Undersecretary Not valid without signature