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29-299 (10) BP-2022-0862 315 ACREBROOK DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-299-001 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-2022-0862 PERMISSIONISHEREBYGRANTED TO: Project# 2022 SHOWER Contractor: License: YANKEE HOME IMPROVEMENT Est. Cost: 13973 INC 066324 Const.Class: Exp.Date:03/28/2023 Use Group: Owner: COTE THOMAS M &MELISSA M ROBERTS-COTE Lot Size (sq.ft.) Zoning: WSP Applicant: OBE COTE Ai'CC-E HarmE i/»P o fEne7E-- j7- Applicant Address Phone: Insurance: 44 ACREBROOKDR 3G JuShn �i. FLORENCE, MA-0.14362 01 4Go,atL 1114 a lO2 Z ISSUED ON:07/21/2022 TO PERFORM THE FOLLO WING WORK: REPLACE 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:7-Za.. z Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: (Sk. 90/92, pc THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Q 1:130V- Fees Paid: $182.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner Gk.:4j 35 q MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUM ING WORK r • . CITY/TOWN AiU4h/ V) MA DATE 7 // [�l� PERMIT rr1' • O 0272- JO��.r ADDRESS, y �� vie, OWNER'S NAME !tiS Hp co OW DDRESS TEL FAX TYPE OFFS OC UP' CY TYPE COMMERCIAL El EDUCATIONAL ❑ RESIDENTIAL f4 PRINT Gv`� LEARLY RENOVATION: ❑ REPLACEMENT:, ] PLANS SUBMITTED. YES El NO El Q. >1FI TURE -. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM , DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK P UMBING & GAS INSPECTOR LAVATORY N e RTH AMPTON ROOF DRAIN A"PROVED NOT APPROVED SHOWER STALL SERVICE/MOP SINK I f` TOILET URINAL WASHING MACHINE CONNECTION _ WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES, NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY X OTHER TYPE OF INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the be f my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance h all Pertin ovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME .4 LICENSE#15.'��— N TURF MPX JP❑ CORPORATION, # lt/15-17 PARTNERSHIP❑# LLC ❑# COMPAN Y NAME Q / F�Y121Q, ADDRESS 3h �L 7Li CITY STATF/' ZIP (7/'�'�-'�' TEL '1/3 " 7 FAX Ce03- 3- 7ggV EMAIL jyb yi4ti4r "L% j 7 Zv - geskf-e- 7,6 l 0 /Jc?I/oy�'1G pc { )I r 'rcc'd, �� r►-►h,n 712cpc Al gyp-207-- O27 2 Page 1 of 10 Yankee Home Improvement MA Lic#CT Lic#0660584 YANKEE 36 Justin Drive RI Lic#33382 HOME Chicopee, MA 01022 413-341-5259 or 877-88-YANKEE www.yankeehome.com Customer Information Melissa & Thomas Roberts / (413) 588-1628 (Mobile) Date: 06/25/2022 Cote mrobertscote@gmail.com Rep: Patrick Shaughnessy 315 Acrebrook Dr Florence MA 01062 Replacement Work Details Replace and Dispose of Existing Tub Install Base Base Type Acrylic Shower Pan Single Threshold Base Color White Drain Location LH Wet Area Wall Quantity 1 Type Acrylic Surround Color/Style White Smooth Ceiling Panel Ceiling Panel Qty 1 Ceiling Panel: Yes Color White Bath/Shower Door Door Type Standard Sliding Door- 56 - 60" wide base Door Finish Chrome Glass Type Clear Shower and Bath Accessories Quantity 1 Accessory Tower Caddy w/Shaving Stand Four Shelf Tower Caddy w/Shaving Stand Color White Shower and Bath Seat Accessory Acrylic Corner Seat Description Hexagon 28" wide x 18.5' deep Color White Seat Location Right Hand This space intentionally left blank ` The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 1 Boston,MA 0211 4-2017 wwwmass.bov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TiiE PERMITTING AUTHORITY. Applicant Information Please Print Lenibly Name (Business/Organization/individual): No.v\Vee doe-e_ Tr 's )T 1-e me-r f' Address: ZUD 3--N c. Ci ok- • City/State/Zip:Ck CO('''? .VCt , ()kr)as Phone 4: u11' `--k\ — 3a3 Are v u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with yt ) employees(full and/or pa t-time)." 7. ❑New construction 2.D I sin a sole proprictor or parmership and have ito employees working for Inc in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 lam a homeowner doing all work myself.[No workers'comp.insurance required.]' 10 []Building addition 4.1 l am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions proprietors with no employees. ]2.0 Plumbing repairs or additions 5.0 l am a general contractor and I have hired the sub-contractors listed on the attached sheet. 1 1 of re airs These sub-contractors have employees and have workers'comp.insurance. 14. . Other 6.0 We arc a corporation and its officers have exercised their right of exemption per 1v4GL c. 152,il(4),and we have no employees.[No workers'comp.insurance required.] :� WC_`A.,c ''Any applicant that checks box 41 must also fill out the section bolo+ :•showing their workers'compensation policy information. I.Homeowners who submit this affidavit indicating they are doing al/work and then hire outside contractors must submit a new affidavit indicating st ch. :Contractors that check this box must attached an additional sheet showing the name attic.sub-contractors and state whether or not those entities hav employees. If the subcontractors 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 ite information. Insurance Company Name: Pr\\�`\-),S TfiS\i anC-e- Pt e-..ri • Expiration Da e: 1 b - `- a Policy#or Self-ins.Ltc.n.����01 ����C l4 'S,_ .. — Job Site Address: 1 CNCS2\--/r Q� \ ) . City/State/Zip: nC'Q e. • rr 0UD LC)Q_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration afe). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation.punishable by a fine up to S1,501►.00 and/or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S2511.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DLA for incur•nce coverage verification. 1 do hereby certify a derr11 e pail rid penalties ofperjury that the it formation provided above is true and correct %�y/v Date: I� \ o��. Signature: / Phone n: (4\ ,may\- s zESot...._.._ Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing inspecto 6.Other !' Contact Person: Phone r: Page 2 of 10 Hardware Delta Fixture Selection I ., Linden ♦„'t` In2ition *' . A!, Shower , Head Trim Kit Finish I, Chrome Temp Assure Valve? Yes, style I only I: available I with temp f= adjust valve ' r' ' I' ,, , \ 1 1 i 3 S Job Specifications Remove existing DrywalV Plaster in the wet area and replace with moisture resistant board per code. Inspect insulation on exterior walls and replace as needed. Inspect Sub-floor under wet area and replace as needed. Replace mixing valve, inspect drain and trap and bring up to code. Scope of Work and Special Instructions 60x32 white base LH drain, white wall enclosure, white ceiling panel, sliding door clear glass chrome finish, corner hexagon bench white rh side, tower caddy white with shaving stand LH side, linden in2ition handheld shower head chrome Do Not Do We do not do any painting or staining. This space intentionally left blank GK-#f AR,y 4r50 • MASSACHUSETTSy � / UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK g� �I CITY/TOWN /V 241?ar 6 MA DATE 7 /% t 4 PERMIT#PP 7i022 (72-72-•' O SIT ADDRESS/<.$ ,4 %'_b k Doe, OWNER'S NAME irtV �S C J o,Ea. co OWist4DDRESS c2-444e-- TEL FAX ry _ TYPE 01c; OCgU -�P NCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL 14 PRINT L>vi LEARLY _NEW:9 RENOVATION:❑ REPLACEMENT:.] PLANS SUBMITTED: YES❑ NO [1] 3 4TUREs, " _r:==—FLOOR-• BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB _ CROSS CONNECTION DEVICE _ _ DEDICATED SPECIAL WASTE SYSTEM _ -DEDICATED GAS/OIUSAND SYSTEM _ _ DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _ _ _ _ _ _ DISHWASHER _ _ DRINKING FOUNTAIN _ L _ 1 - FOOD DISPOSER _ _ _ _ FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR)KITCHEN SINK P UMBING & GAS INSPECTOR LAVATORY N 0 RTF'AM PTON ROOF DRAIN A"PROVED NOT APPROVEb , 1 SHOWER STALL _ / _ _ I SERVICE/MOP SINK TOILET URINAL _ . --t _WASHING MACHINE CONNECTION WATER HEATER ALL TYPES _ WATER PIPING OTHER 1 - INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES,' NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY JK OTHER TYPE OF INDEMNITY ❑ BOND ❑ • OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the be f my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance h all Pertine o ision of the Massachusetts State Plumbing Codeo/ and Chapter 142 of the General Laws. JCS A PLUMBER'S NAME '2.-1 kS LICENSE#/5 )7 N TURE MP,QI JP ❑ CORPORATION,X# 1111l517 PARTNERSHIP LI# LLC❑# COMPANY NAME J�r o_ /4' ,2,, �N'i ADDRESS rill�//CITY y q,,_-- STAT�i� e17 S�l i ZIP TEL 11/3 ' ",Qj 17 FAX / Cl /3',1 lX EMAIL_ 24'M/T a 12. ifr °--2 -c ..N..L _ ,...� " CASH ONLY IF ALL Checkl.ockT'"SECURITY FEATURES LISTED ON BACK INDICATE NO TAMPERING OR COPYING y p 157 Yankee Home Improvement Inc Greenfield Savings Bank 1 3259 400 MAIN STREET I 36 Justin Drive GREENFIELD,MA 01302 Chicopee,MA 01022 53-7079/2118 i 413-341-5259 07/13/2022 j LPl Y TO THE City of Northampton ** ORDER OF 50.00 2 Fifty and 00/100******,,,,«***,,.,,****************„*************************,,,..*******************************,� oN ols„ _ �`,! 4 r Ft©4 GTE®AGAINST r TlAlf®B w 4p City of Northampton )) - _ .. . "Isgp z Puchalski Municipal Building t w 212 Main St, ,°°" ,za,gg� �o e .. yhec' `"""`" Northampton, MA 01060 a , / Not valid more than 180 daysafter issue 47, N0 Pee'242Z-0 277 N, 549 ' n:e n0s_ �° t' MEMO/ 315 Acrebrook Dr k® ' „! g tl'0L325911' 1: 2L18707991: LEI 00049884lI'