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11A-008 (2) BP-2022-1270 37 EVERGREEN RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 11 A-008-001 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-2022-1270 PERMISSIONIS HEREBY GRANTE'I TO: Project# windows Contractor: License: YANKEE HOME IMPROVEMENT Est. Cost: 12000 INC 066324 Const.Class: Exp.Date:03/28/2023 CODDING ELIZABETH A. &KRISTA WATHNE CO- Use Group: Owner: TRUSTEES Lot Size (sq.ft.) Zoning: URA Applicant:- YANKEE HOME IMPROVEMENT INC Applicant Address Phone: Insurance: 36 JUSTIN DR (413)341-5259 XWO56702381 CHICOPEE,MA 01022 ISSUED ON:10/04/2022 TO PERFORM THE FOLLO WING WORK: 7 REPLACEMENT WINDOWS 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 VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I I x 51-1,� Fees Paid: $78.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner R.. Z The Commonwealth of Massachu efts `)P FOR rut Board of Building Regulations and tanddigt Massachusetts State Building/Code;',' 80 CMR ICIP�{ITY 4 i USE kit, p Building Permit Application To Construct, Repair;" ,• Or De r3lish Devised Mar 011 One-or Two-Family Dwelling �q1 h�lir,,1 /. This Section For Official Use OnlyCpi I Building Permit Number: '-) .1..- I �''7C) Date Applied: °so'4%9 Building Official(Print Name) Signature � --i SECTION 1: SITE INFORMATION 1.1 operty Address: 1.2 Assess s Flap&Parcel Numberg n 1.1 a Is this an acceplted street?yes no Map Numter 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 i 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 1 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Ei-Lab-#k Cork.din3 _e_eds . Ma 01C ?) ; Name(Print) City,State,ZIP 31 EN-er c\r-cexl Zd. . (ooq-1 a1 -ta?vt,,3 P aCodc�.i r o @ a mac l c om No. and Street < Telephone Email ddr 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 Et/Specify:ZeplaC_in `11.0tisrl01,,S Brief Description of Proposed Work': QCM 6\1 R q re P 1(Irk ci CA 1 b(- �,� �t 1 ‘nun 11.ITCkuti.) all i f\ � S�\.I. IY1 ( cent k_oov-k. U-fac k-c>r • 123 • 1.1t1 , �hal` gfS • SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ t 00D 6D 1. Building Permit Fee: $ Indicate how fee is determltned: ' ❑ Standard City/Town Application Fee I 2. Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) — Total All b0 Check 1 Check Amount: 9��Cash Amount: 6. Total Project Cost: $ 1 Q , oboZ • 0 Paid in Full 0 Outstandmg Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS- © oLo 3Qy 3 ag -Q3 ti CheA.e p -e\r a License Number Expiration Date Name of CSL Holder p (� List CSL Type(see below) R_ D - ti)(nt, No.and Street Type Description a 1�Q Unrestricted(Buildings up to 35,000 Cu.ft.) e�(1 W , O3 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 4Z-It-11-SaSCI bUnAen eht me. I Insulation Telephone Email address Lprn D Demolition 5.2 Registered Home Improvement Contractor(HIC) LPO5$y -11-a' \l an K,ee \--1t\m Tm p-M e m e HIC Registration Number Expiration Date HIC Company N e or HIC Re strant Name Flo c kLS r r\ t - bur,a-e -wood Cya RV.ee -Name• No.and Street Email address C Love .\T'o, , of baa (tii�> k\-55q corn City/Town,State,ZIP 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 Issuaance of the building permit. Signed Affidavit Attached? Yes 12 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 la‘(-)Yee \('1-e p)rc\) to act on my behalf,in all matters relative to work authorized by this building permit application. Please ee s�Cne cfcxhe arA- c a-a� as Print Owner'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. MAI. 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(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 foulnd 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 Boa .� r, - %a--- Massachusetts ' c A DEPARTMENT OF BUILDING INSPECTIONS '& • 212 Main Street • Municipal Building Northampton, MA 01060 h A/.j,0 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: - L: FA' Nr - C1\*COTP•e - Ma OW a'a The debris will be transported by: Name of Hauler: 0,AU__ C-cbm-e— -1-111 ii. • ka • ..-,- Signature of Applicant: ip,k4 _.,QJ, _ Date: q - Q3- -'a -\ The Commonwealth of Massachusetts '�'1 Department of Industrial Accidents i 1 Con,;ress Street,Suite 100 t j < Boston,MA 02114-2017 ', s www mass.bov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TiiE PERMITTING AUTHORITY. Applicant Information ` Please Print Legibly Name (Business!Organization./Individual): �(),'(-)V e e \---\m1 c T`(.(1cx--1,\le vi1,YlT Address: ?>lo Ul1Sk:a )r . _ City/Stare/Zip:C LPee . Ma. , bloda: Phone#: (J-\ 3k-1\-5' 59 Are you an employer?Check the appropriate box: Type of project(required): 1.0 lam a employer with employees(full and/or pan-time)."` 7. 0 New construction 2.01 ama sole proprietor or partnership and have no employees working for me in 8. []Remodeling any capacity.fNo workers'comp.insurance required.] 9. ❑Demolition 3.0 I am a homeowner doing all work myself.fNo workers'comp.insurance required.)' 10 0 Building addition. 4.0 Cam a homeowner and will be hiring contractors to conduct all work on my property. i will ensure that all conoactos either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions roprictors with no employees. v dditions I2.0 Plumbing repairs or a 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repai rs These sub-contractors have employees and have workers'comp.insurance• - 14.[/Other QUP‘QGUR - 6E1 We ere a corporation and its officers have exercised their right of exemption per h1Gt.c. . 152,§1(4),and we have no employees.[No workers'comp.insurance required.; 11.)1T WS• ',Any applicant that checks box 41 must also fill out the section bolo':showing their workers'compensation policy information. 1.Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating sue h. Contractors tha: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 the sub-contractors 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 corner and job site information. • Insurance Company Name: a Yl���� Cl C�......_N \C Policy#or Self-ins.Lic.#: 'WO 5t0"1 b oa'2,7,i...._.... Expiration Date: \b— \`as Job Site Address: 3-1 F\Iex tfef_ ..6 • City/State/Zip: I jf� OA0S3 Attach a copy of the workers' con 4ensation policy declaration page(showing the policy number and expiratio date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation:punishable by 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 up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. I do hereby certify u 'der a pail rid penalties ofperjury that the information provided above is true and correct. Si nature: G. Date: (A- a3- a'a' Phone;:: Ly\ ,_91—_a59 _..._ Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License icense# i (issuing Authority(circle one): I l I.. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical inspector 5.Plumbing inspector 5. Other CorrlaetPerson: Phone=: it THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingt strut - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation YANKEE HOME IMPROVEMENT INC Registration: 160584 Expiration: 08/11/2024 36 JUSTIN DR. : CHICOPEE, MA 01022 .044/ <,, , 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 mess Regulation Registration Expiration 1000 Washington Street -Suite 710 160584 08/11/2024 Boston, MA 02118 'ANKEE HOME IMPROVEMENT INC . . ;ERARD RONAN ' ffi i6 JUSTIN DR. ie; 5; ((,%.i' ' HICOPEE, MA 01022 Undersecretary Not valid without signature tip �4}i t„ ;,2,,, 14 M j ' u s z 111 Uu . x�. �) ;4 ✓, 5f P -'�y,r .,it.`'.:4 3 �r t£ I , ' tP at :,,,`' its r sss s't sar s S�j�,fs�' r si 1yak�S t } st4ti�,< t ? < sE i ? ,'r !{s},1,643{c7p£5„?i� gigs}ji. u tli g, si i5,ai 3 r 1{ t s - � , i cl 4s Z �r,4,r? >S s is 2 s{rc, , _> t S c t s ` }s tSO66324 .. nA 5 r 'l,n:. 9. t .r �3.w ^T dMh �" � h • S. 5) ,' ;� °' ° • @ v } v,� � �� "4'F iy�yt)•,. .,l t.; i?t:> Za�' ,i�ti'�T'ti {�= t��� t 'y:l; t\tj , ,#. ;•, tqi ,,,rrt1$>i2 t k;A�l")•q.�?.,.,,�s ) :,tsl�i�:� i ti 5 \�'a'' sc lstititip� �n`}S>}i1t;t.,ls i st(�+�'a i.},y t •tii` �,tl.;14 F+l ;i,,S..t '1 r s -i ) `�xbs,V�e;�'�S,ir.iil a„q�•�1��t;t.3<;� .,�; ��. .h,,.�,}ti��� :�� °{ '.`���� s tzf iS :c � > t � ,� ��Z ',a,•„ :o'Vm,i .T,)�), ?-'-J.1,,?. � ° 1 *,/ }4\ . . v Y:t.; i 1fi C E n }sit, tU ,? £#rat -.� t� }r�1,� n��tID ?� +`��4��\.. ,s � di�l. ��i,��;}�1 t � `�`�i� � r 1�.,�ns;,f- �s�::/��.r s'•;.'r;,\:'cn;<�a�<i`s C,s:. t�1H i'� a',aN `, .,l� •01, ti1.,t l.t 4 .1-#1�,. fci,,w'M rt;?;.. „,.�u,'•k ;:' Q? ; ''' 5' 't ;...�,. 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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 CONTACT David Jarry Neill 8 Neill Insurance Agency Inc PHONE 413732-4137 FAX 413-731-6629 - 662 Riverdale Street JA/C,No.Extl: (A/C,lk o): West Springfield, MA 01089 E-MAIL @ ADDRESS: dj@neillandneill.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Western World Insurance Co. 13196 INSURED Pro Solution Construction, Inc. INSURER B: Zurich-American Insurance Grou ZUR 116 Lancaster Ave West Springfield, MA 01089 INSURER C: INSURER 0: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) UNITS A V COMMERCIAL GENERAL LIABILITY NPP8746152 07/11/2022 07/11/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADEFV1 OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 VI POLICY 1 PRO 1,000,000 JECT LOC PRODUCTS-COMP/OP A6G $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per perscn) $ OWNED SCHEDULED BODILY INJURY(Peraccident $ AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ $ UMBRELLA LIAR OCCUR `EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 1151034 11/04/2021 11/04/2022 PER 01H- AND EMPLOYERS'LIABILITY Y/N V I STATUTE EF ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory In NH) E.L.DISEASE-EA EMPLC YEE $ 500,000 - yes, O E.L. N under DISEASE-POLICY LI AIT $ yes, OF OPERATIONS below 500,000 D 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 Yankee Home Improvement THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 82 Industrial Drive ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE bai4:64 4.var ..1 ©1988-2015 ACORD CORPORATI N. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 14 /( Yankee Home Improvement MA Lic#160584 CT Lic#0673924 yiYANKEE 36 Justin Drive RI Lic#33382 HOME Chicopee, MA 01022 413-341-5259 or 877-88-YANKEE www.yankeehome.com Customer Information Elizabeth Codding 609-707-6363 Date: 07/08/2022 37 Evergreen Road eacodding@gmail.com Rep: David Curtis Leeds MA 01053 The following windows will be installed by Yankee Home Improvement Total number of windows being installed 7 Window Item Quantity 1 Window Brand Veridis 1800 Window Type Double Hung Location Full Bathroom Size 28 x 41 1 Coil Color Glacier White Interior Window Color White Exterior Window Color White Hardware Color White Screen Type Half Obscure Glass Standard Tempered Glass Both Sashes Obscure Glass Location Bottom Sash Window Item Quantity 1 Window Brand Veridis 1800 Window Type Double Hung Location Bedroom 1 Size 27 x 51 Coil Color Glacier White Interior Window Color White Exterior Window Color White Hardware Color White Screen Type Half Window Item Quantity 1 Window Brand Veridis 1800 Window Type Double Hung Location Bedroom 1 Size 28 x 52 1 Coil Color Glacier White Interior Window Color White Exterior Window Color White Hardware Color White Screen Type Half Window Item I r— Quantity 2 1 Window Brand Veridis 1800 Window Type Double Hung 1- Location Master Bedroom Size 28 x 52 Coil Color Glacier White Interior Window Color White Exterior Window Color White Hardware Color White r=---=-----J Screen Type Half Window Item Quantity 1 1'1 Window Brand Veridis 1800 Window Type Double Hung ---- -------- Location Bedroom 2 Size 28 x 52 Coil Color Glacier White Interior Window Color White j Exterior Window Color White Hardware Color White [___-----..____ Screen Type Half Page 2 of 14 Window Item Quantity 1 Window Brand Veridis 1800 Window Type Double Hung Location Bedroom 3 Size 28 x 52 Coil Color Glacier White Interior Window Color White 1Exterior Window Color White Hardware Color White Screen Type Half Unforeseen costs that could occur. - Homeowner is responsible for removing and replacing any window treatments or air conditioning units in or around any windows/doors to be replaced. Yankee Home cannot guarantee that window air conditioning units will fit in any windows that are replaced. - Homeowner is responsible for removal and re-installation of alarm components on any windows and/or doors to be replaced. Contractor will NOT replace alarm components. (Customer Initials) Acknowledgements & Notifications. -Any furniture must moved at least 5 feet away from windows and/or doors to be replaced. - All pets shall remain secured in safe location inside of the home away from windows and/or doors to be replaced. -All driveways shall remain clear during date of installation. (Customer Initials) HOA & Condominium Acknowledgements - Homeowners Association or Condominium approvals, including but not limited to contracts and permits, are the responsibility of the homeowner and will be obtained by the homeowner unless otherwise stated on this contract. (Customer Initials)_ Special Instructions All discounts applied. Labor discount applied. Do Not Do We do not do any painting or staining. Work Schedule Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified herein. Contractor will begin the work on or about 10/08/2022 This space intentionally left blank Page 3 of 14 Barring delay caused by circumstances beyond Contractor's control,the work will be completed by 12/08/2022 The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, but not limited to strikes, Acts of God, shortages of materials, accidents, and all other delays beyond its control, shall not be considered as violations of this Agreement. (Customer's Initials) Elizabeth Codding 07/08/2022 Date • This space intentionally left blank Page 4 of 14 Payment Schedule YHI agrees to perform the work,furnish the material and labor specified above for the total sum of: $12,002 Form of Payment Check Deposit Amount $4,001 Deposit Type Check Check# 396 Cash Due Upon Completion $8,001 Uor 'C David Curtis Notice: No agreement for home improvement contract work shall require a down payment (advance deposit) of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make, in advance, to oder and/or otherwise obtain delivery of special order materials and equipment, whichever amount is greater. flt9pati-A4 (7=4Q-1 Elizabeth Codding 07/08/2022 Date This space intentionally left blank