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44-049 (5) BP-2024-1033 14 AUTUMN DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 44-049-001 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-2024-1033 PERMISSION IS HEREBY GRANTED TO: Project# 2024 BATH RENO Contractor: License: Est.Cost: 29837 LONG BATHS LLC 116396 Const.Class: Exp.Date:05/20/2025 Use Group: Owner: A PATILLO ANTHONY L& VICKI Lot Size (sq.ft.) Zoning: WSP Applicant: LONG BATHS LLC Applicant Address Phone: Insurance: 300 MYLES STANDISH BLVD (339)333-6118 WC5-31 S-626143-013 TAUNTON, MA 02780 ISSUED ON: 08/19/2024 TO PERFORM THE FOLLOWING WORK: REPLACE LAV& SHOWER ON 1ST FLOOR 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: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: / ././12.. Fees Paid: $225.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner T----R-7e-a---i_ E------,---ivE, , , AUG 1 The Commonwealth of Massachusetts 4 `�2'� F Board of Building Regulations and andards`;- IC ALTTY Massachusetts State Building Code,'88'CAdR 'WISP ..d'40r -OS U E Building Permit Application To Construct,Repair,Renovate Or Demo is �''o ised ar 2011 One-or Two-Family Dwelling /nJ This Section For Official Use Only Building Peit Numbejri�� 4''lQ 3, Date Applied: �SEut� • 1/2 6- 61-ZOz Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 14 Autumn Dr,Florene,MA 01602 1.1 a 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,§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 OWNERSHIP' 2.1 Owner'of Record: Vicki Patillo Florence, MA 01602 Name(Print) City,State,ZIP 14 Autumn Dr (413)218-8944 vapatillo@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2:Demo 1st floor bathtub replace with Shower, inspection for fire safing and or insulation. And adding 1 Vanity. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $23837.00 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $6,000.00 2. Other Fees: $ 4.Mechanical (HVAC) $ List: __ 5.Mechanical (Fire $ Suppression) Total All Fees:$ t b Check No.(WO'Check Amount: -Cash Amount: _ 6.Total Project Cost: $29 837.00 Cl Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-116396 Brandon Boyle License Number Expiration Date Name of CSL Holder List CSL Type(see below) 142 Rhode Island Ave No.and Street Type Description Cumberland,RI,02864 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 339-333-6118 Lhppermits@longhp.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 187510 04/20/2025 Long Home Products HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 300 Myles Standish Blvd Lhppermits©longhp.com No.and Street Email address Taunton.MA,02780 339-333-6118 City/Town,State,ZIP elephone SECTION 6:WORKERS'COMPENSA N INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must completed and submitted with this application. Failure to provide this affidavit will result in the denial of the lssu of the building permit. Signed Affidavit Attached? Yes No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Long Home Products to act on my behalf,in all matters relative to work authorized by this building permit application. Vicki Patillo 8/5/2024 Print Owner's Name(Electronic Signature) l)ate SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalti perjury that all of the information contained in this application is true d accurate to t best of owledge and understanding. Brandon Boyle 8/5/2024 Print Owner's or Authorized Agent ame(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 not 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 •P' - Massachusetts 4u: i._ c�, `G ti e�' DEPART1 NT OF BUILDING INSPECTIONS Z ., �' .. ..' -� 212 Main Street • Municipal Building 0. �a �✓Y/1_ Northampton, MA 01060 :'r�7Y `�o 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: 1071 Washington St, Weymouth MA The debris will be transported by: Name of Hauler: Doctor Disposal Signature of Applicant: Date: 8/5/2024 The Commonwealth of Massachusetts * Department of Industrial Accidents _i/t` s 1 Congress Street,Suite 100 ,. _, .7 Boston, MA 02114-2017 x wx:nrass.gol'/din Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO DE FILED WITH THE PERMUTING AUTHORITY. Applicant Information Please Print Legibly Name(Busines.cxgmization/lndi idual): Long Home Products Address: 300 Myles Standish Blvd City/State/Zip: Taunton, MA, 02780 phone#: 339-333-6118 Are you an employer?Cheek the appropriate hoe: Type of project(required): 1.Q 1 am a employer with 25 employees(full arnl'or part-time).' 7. []New construction 201 am a tole proprietor or partnership and have no employees working forme in K. In Remodeling any capacity_(No workers'comp.insurance requireal.) 9. ® Demolition 30 I am a hunaowner doing all work myself.(No workers'comp_insurance rcquired.l" 10 0 Building addition 4.a lam a horn:yin weir and will be hiring oontractun to conduct all work on my property. 1 will n endue that all contractors either have workers'compensation insurance or are sole I I.1 Electrical repairs or additions proprietors with oo cmploycu. 12.E Plumbing repairs or additions 50 lam a general contractor and I have hired the sub-contractors listed on the attached street (3tl Roof repairs These sub-contractors have employees and love workers'comp.insurance. _ 6.0 wen:a a corporation and its officers have exercised their right of exemption per MUe. 14.El Other 152.§t(4).and we have no employees.(No workers'comp.insurance required.( 'Any applicant that checks box al must also fill out the section below showing their workers'compensation policy information. t Homeowrurs 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 tlic sub-contracture have employees.they must provide their corkers`deep.policy number. I am an employer that is providing taorkers'compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Name: fej\_ sS Policy#or Self-ins.Lic.#:_ -21Q.-r .1 c_ ` /1: Expiration Date: 12/31/2024 Job Site Address:14 Autumn Dr ' v�IJL/� "� City/State/Zip: Florence, MA 01602 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a fine up to S 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.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 ti 'al nd r ena ' erjury that the information provided above is true card correct. r>ttaiU1C: � Date: 8/5/2024 pi:on,:,: 339-333-6118 Official use only. Do not write in this area.to be completed by city or town official (its or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ('ontaut Person: Phone#: �...IN LONGFEN-04 DHARRIS AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDN ) 8/1/2024 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 galleCT Danielle Harris Alliant Insurance Services,Inc. PHONE FAX 16901 Melford Blvd Ste 123 (A/C,No,Ext): 1(A/C,No): Bowie,MD 20715 Miss:danielle.harris@alliant.com ' INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:United Specialty Insurance Company 12537 INSURED INSURER B:Arch Excess&Surplus Insurance Company 10946 Long Roofing LLC NSURERC:Burlington Insurance Company 23620 300 Myles Standish Boulvard INSURER D:Arch Insurance Company _11150 Taunton,MA 02780 INSURER E: INSURER F: 1 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 ADM OF INSURANCE AD SUBR W POLICY NUMBER POUCY� EFF POLICY EXP i UNITS LTR INSD VD (MMIDD/YYYY1 (MMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ' X OCCUR ATN2317978 12/31/2023'12/31/2024 DPAMG OE R ENcwTErOence). $ 50,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1s000r040 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY pi JE PRO-CT L. PRODUCTS•COMP/OP AGO $ 2,000,000 OTHER: EBL AGGREGATE $ 2,000,000 B AUTOMOBILE LIABILITY (Ea aacdaD SINGLE LIMIT , 1,000,000 X ANY AUTO ZACAT9316600 7/31/2024 7/1/2025 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOS p BODILY INJURYSPer accident) $ AUTOS ONLY UTOS ONLY (Per DAMAGE (P accident) $ $ C I UMBRELLA UAB X OCCUR I EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE1 60013E00525-04 12/31/2023 12/31/2024 AGGREGATE $ DED RETENTIONS Aggregate $ 5,000,000 D WORKERS COMPENSATION 1 X STATUTE ERH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN ZAWC19789400 7/31/2024 7/1/2025 E.L.EACH ACCIDENT $ 1,000,000 FFICER/M MBgEER EXCLUDED? n N/A (Mandatory n NH) E.L.DISEASE-EA EMPLOYEE,$ 1,000,000 If yes,describe under 1,000,000 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) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE Aii,e/& 4-0-1-1:5 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 lucensure Board of Building Regulations and Standards Const(tit't,On S rvlsOr r CS-116396 6tplres 05/20/2025 BRANDON LOOYLE ', 142 RHODE ISLAND AVE, CUMBERLANQ RI 021N4 ' ..; ill Commissioner ' THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvemeht Contractor Registration Type: Supplement Card ( _ F2ogisVatlon: 187510 LONG ROOFING LLC �' Ezp✓•atlan: 04/20/2025 D/B/A LONG HOME PRODUCTS 8530 CORRIDOR RD,SUITE 200 �. SUITE 200 1• j T 2h� SAVAGE,MD 20763 `,: t.. ). Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for Individual use only before tie HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Ror)ulaton Registration i, Expiration 1000 Washington Street -Suite 710 187510 t' 04/20/2025 Boston,MA 02118 LONG ROOFING LLC.�. ;;, • . D/B/A LONG HOME PRODUCTS 'i BRANDON BOYLE -� //'.r,: 8530 CORRIDOR RD.SUITE 200 SUITE 2C3 SAVAGE.MD 20763 Undersecretary Not valid without signature MA HIC #187510 Page 4 of 27 Long Roofing of Massachusetts, LLC •24 Walpole Park S LONG HOME Unit 8, Walpole, MA 02081 (800)470-LONG • (240)473-1400 • LongRoofing.com PRODUCTS By Long Roofing, LLC Vicki Patillo 4132188944 Date: 08/01/2024 14 Autumn Dr vapatillo@comcast.net Product Specialist: Shawndel Evans Florence MA 01062 License Number: The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed herein, in accordance with the prices and terms described in this "Agreement." Homeowner's Association Approval Required NO I do not belong to an HOA. I accept FULL responsibility for this project and authorize installation I confirm that the above information is accurate Dumpster Required NO I confirm that the above information is accurate r� Are there electric lines within 3 feet of where LHP will be performing work? NO Preferred Method of Contact Phone Phone/Text/Email 4132188944 Total Purchase Price $29,837 Deposit with Order $7,000 Amount Due on Substantial Completion $8,000 Amount Financed $14,837 Form of Deposit Check Deposit Notes Customer in paying a deposit of$7,000 today and the remaining deposit of$8,000 on the date of install. The Estimated Date of Commencement of the Work Is 16-20 Weeks The Estimated Completion Date Is 16-20 Weeks I am aware that the above dates are an ESTIMATE The Project Is Contingent Upon Obtaining Approved Financing THERE ARE NO ORAL AGREEMENTS �kP Promotion Selected(Cannot be combined with other offers) Promotional Financing Customer Promotion Acknowledgment �'� It is agreed and understood by and between the parties that this Agreement, constitutes the entire understanding bd W of 27 the parties, and there are no verbal understandings, changing or modifying any of the terms of this Agreement. Buyer(s) hereby acknowledge that Buyer(s)has read Agreement and has received a completed, signed and dated copy of this Agreement, including the two accompanying Notice of Cancellation forms, on the date first written above. Buyer(s) acknowledge that they were orally informed of their right to cancel this transaction. gid.406.‘ Shawndel Evans Vicki Patillo 08/01/2024 08/01/2024 Date Date You,the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the accompanying notice of cancellation form for an explanation of this right. This space intentionally left blank Page 1 of 10 Measure Sheet LONG HOME PRODUCTS Bath Measure Sheet Vicki Patillo 14 Autumn Dr Florence MA 01062 08/01/2024 Existin• Wet Area S•ecifications Job Type Tub to Shower Priority 1 Tub Cast Iron Bath Location First Floor Walls Thinset Tile (-__Y ,, • Shower Pan N/A Ceiling Drywall SWIM .w� o...... Floor Tile Unit Shut Off Basement -, .� ��� Main Water Shut Off Basement Crown Molding NO C ;�:=""` .... .. 'C Existing Bench Seat NO Drain Location Right . »rs.q.wr OY. O .to..w. ,t Jl Plumbing Wall B Outside Corner Needed On Curb NO None e (—)< <;.- -- Window NO 4, ) - - 6 ICY 4`r _j_ N ' 1r) 1 Measure Sheet Corner to Wall End - Left- Measure Sheet A 32 Corner to Wall End - Right- Measure Sheet B 32.5 Floor to Ceiling - Left- Measure Sheet C 89 Top of Tub/Pan to Ceiling - Measure Sheet D 74 Floor to Ceiling - Right- Measure Sheet E 89 Corner to Edge of Tub/Pan - Measure Sheet F 29 Corner to Corner- Measure Sheet G 59 Middle of SD Wall to Edge of Tub/Pan - Measure Sheet H 29 Corner to Edge of Tub/Pan - Measure Sheet I 29 Measure from Drywall to Drywall - Measure Sheet J 59 Page 9 of 10 1.15 , . "mulling Wan _. -- -fir d Sr - S1 14 IS N IF }A 11 T• y i., s. ;4y l 1*-'j • ••• • ,6.ily,. . . 00111101 .„.....r --i, i I -1. t' .,.,_ I 1.16 4.).\P \ , I 4 5,-ok/ —is\:—/":"--------)Nk n ...\14, /14. 6 / _. .4 (Q;7"v t.„, ? fro v190re.ct/ MA OI G 62— \` 1.17 Page 10 of 10 4 --"\-- 0 ‘1.) I „--, _ 1 4</(<<1 - -- cz,... 6:0:1 olo ‘ v - .-1.. 4 1 4