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23D-154 (11) BP-2022-1269 130 HINCKLEY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-154-001 CITY OF NORTHAMPTON PPermit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-1269 PERMISSION IS HEREBY GRANTE TO: Project# WINDOWS Contractor: License: YANKEE HOME IMPROVEMENT Est. Cost: 5480 INC 066324 Const.Class: Exp.Date:03/28/2023 Use Group: Owner: ANN SNYDER JOYCE Lot Size (sq.ft.) Zoning: URB Applicant: YANKEE HOME IMPROVEMENT 1NC Applicant Address Phone: Insurance: 36 JUSTIN DR (413)341-5259 XWO56702381 CHICOPEE, MA 01022 ISSUED ON:10/05/2022 TO PERFORM THE FOLLOWING WORK: REPLACE 3 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ft • r • 51.-11 • Fees Paid: $65.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner CT he Commonwealth of Massachusetts 4 2022 Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE [31;'°r,Bttilding_ , , 't A1plication To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number: p,'4 3_1'1 ( G/ Date Applied:pp �� ► I� �1 �3 )O/S/Pa Building Official(Print Name) 1 Signature / Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers t ?1.. 1--k.k n L 1f 1 �5� vZ� /"-� l 1.1a Is this an accepted strt?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' 2.1Owner"of Record: 6 rkk c '. Sic\ c\ei e�r �1«v ce . M u\o, .Da Name(Print) City,State,ZIP \3 \--VnV\'\)) Sk- . yP)-57>`-1- 11ac r.smo4ctx.e.\ahoo COcl-, No.and Street Telephone mail Ad ss 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 IS/Specify:Qpc\ac v6 3 1�)\nQp W s Brief Description of Proposed Work': RI,rnay0c1R 'RPp\ac\n ?-, \'‘)O\Kb\-e bu`r, \)6\ do‘53S . `Ak\ 1n etccSA-ocnc0-ra Pwr)t k . ti4 chc kr-,r • 1 . N 5 -rc acl-U.:3._.\ c ho.r\c eS . SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ Q op 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No. t f 3 Check Amount (� Cash Amount: 6. Total Project Cost: $ cj , $ Op 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS_Dliolci-SaUt -2,-a 3 1 C\la) -e_r f k c 0. License Number Expiration Date Name of CSL Holder • � • ,C (DX \��� List CSL Type(see below) R. No.and Street Type Description �1(� U Unrestricted(Buildings up to 35,000 cu.ft.) V1� JQC c e - ` Q U` OR? R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 1--\12. -3L1't- 5D.59 \-.3knde\--\,c)c: _ar,VeehoMe. I Insulation Telephone Email address LDM D Demolition 45. Registered Home Improvement Contractor(HIC) 1 .%IA ,\ - ay an f bM-e ZmproJ C'M-e r\-1 HIC Registration Number Expiration Date HIC Cornigny Narmur HIC Rezistrant Name UL.z5 r ‘)r- • huNderwood(a an16-e \name- No.and Street Email address CUM Ch<< ee. '(NAcx nto`ag- y\3- yi- SaS9 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 Issu ce 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 V(),n Ye 2 nc,0 e_ IC p V C\I e m P IA Ttt to act on my behalf,in all matters relative to work authorized by this building permit application. V\eaGe s sccnec.), cDn-c-cO,CF a ached q- a3 - 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. M1CVGL`QA c(1- q -- Q3 - g.Q- 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 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 � 6�'� SAS.,.. ". SiC "'' Massachusetts 41," q DEPARTMENT OF BUILDING INSPECTIONS a} =j 212 Main Street • Municipal Building �`., Northampton, MA 01060 yh, 4 ,. 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: ?Ap uS n \-)r . C,1-1‘c \y() . 'm r), c> Q=-)q The debris will be transported by: Name of Hauler: \IQClk.f_,C., r Signature of Applicant: \(Lekr( , - Date: q II The Commonwealth of Massachusetts n ,...h j0 Department of Industrial Accidents i 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass a ov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TiIE PERMITTING AUTHORITY. Applicant Information PIease Print Legibly Name (Business/Organization/Individual): \ Q \ f.e \---kcicn.e_ T mpit`v e e V1-‘- Address: -Li7 U'LS-c-Ct'1 tk • City/StateiZip:Cf (Dp?e2• 11 r., DN(Za. Phone#: L-\1'3 A.\ - c-,D.,Sc 1 Are you an employer?Check the appropriate box: Type of project(required): l.❑I.am a employer with employees(full and/or part-time).'" 7. 0 New construction 2.0]am a sole proprietor nr parota•ship and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'camp.insurance required.) 9. 0 Demolition 3.0 1 zm a homeowner doing all work myself.[No workers'comp.insurance required.)' 10 0 Building addition 4.0 tam 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 are snit I 1.0 Electrical repairs or additions J opricmrs with no employees. 1'_.J Plumbing repairs or additions im a general contractor and I have hired the sub-contractors listed on the attached sheet. 13_ ROOf repairs These sub-contractors have employees and have workers'comp.insurance: - 6.0 We arc a corporation and its officers have exercised their right of exemption per MCI.c. l4 Other piQC}LYZ 152,+41(4),and we have no employees.[No workers'comp.insurance required.] loknclok.z "Any applicant that checks box 41 must also fill out the section bolo,.'showing their workers'compensation policy information. t 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 employees. If the sub-contractors have employees,they must provide their workers'comp.pol icy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �(� Insurance Company Name: P�I 111: ' S --�-� 1 cs�1 Yt c_f_____ (' e n Ck — Policy#or Self-ins.Lie.#: y1„),)() tr.o`1 wd 2 �.._t. Expiration I,C) - 1- a Q Job Site Address: 1 C I—{'\n V,Ve t &• City/State/Zip: V16 V e 1(1 r _.111 1 r2Lc) oZ am 01 0 L Attach a copy of the workers',compensatin policy declaration page(showing the policy number and expiration dare)./ Failure to secure coverage as required underMGL c. 152, t25A is a criminal violation:punishable by 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 tine 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 t pail and penalties ofperjury that the information provided above is true and correcn Signature: lG%- Date: dk-- 3 -Qa- Phone#: _ _a 3'i ( �i a„S9 _... Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# 1 Issuing Authority(circle one): . 1.. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing inspector 6. Other Contact Person: _ Phone#: r--'I 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: 160584 YANKEE HOME IMPROVEMENT INC Expiration: 08/11/2024 36 JUSTIN DR. 0 CHICOPEE, MA 01022 Cie 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 Registration Expiration 1000 Washington Street -Suite 710 160584 08/11/2024 Boston, MA 02118 'ANKEE HOME IMPROVEMENT INC 4-j ;ERARD RONAN ;6 JUSTIN DR. 'F ;HICOPEE, MA 01022 Undersecretary Not valid without signature ACORO® DATE(MMIDDIYYYV) C 7 CERTIFICATE OF LIABILITY INSURANCE 07/12/2022 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 CONTACT David Jarry Neill&Neill Insurance Agency Inc PHONE FAX 662 Riverdale Street IA/C.No.Ext►: 413-732-4137 (A/C,No):413-731-6629 West Springfield, MA 01089 E--MAIL RESS: 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 D: 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 SUER POLICPOLICY NUMBER IMDDY EFF POLICY EXP /YYYY) (MM TYPE OF INSURANCE LTR INSD WVD MI /DD//YYYY) LIMITS A J COMMERCIAL GENERAL LIABILITY NPP8746152 07/11/2022 07/11/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 CLAIMS-MADE iviOCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 VI POLICY PRO LOC PRODUCTS-COMP/OP AGG $ 1,000,000 JECT $OTHER: AUTOMOBILE LIABILITY (Ea ac COMBINED accident) LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB — OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 1151034 11/04/2021 11/04/2022 vi PER STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? n N/A rJ00 000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LI NIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I 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 010600 .��� AUTHORIZED REPRESENTATIVE R���—�--� . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD iii 0 n . t2 a I t s t Massachusetts Board of Buddrdi nq arkd Standards CoristoY . a ism °` ° C S-0 6 6 324 xplres: 03/2812(323 MICHAEL PEREIRA . PO BOX 1056 • WARREN MA .01083 �� a ca ak a�L� e • • v y L a` K COMMISSIOner • N O N c0 Page 1 of 10 / lk 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 Joyce Snyder Cell: 413-584-1129 Date: 08/12/2022 130 Hinkley St Home: 413-586-0080 Rep: David Curtis Florence MA 01062 jasmayan@yahoo.com The following windows will be installed by Yankee Home Improvement Total number of windows being installed 3 Window Item Quantity 1 Window Brand Veridis 1800 Window Type Double Hung Location Kitchen Size 27 x 38 Coil Color Glacier White Interior Window Color Winchester I Exterior Window Color White Hardware Color Adobe Screen Type Half Window Item Quantity 1 Window Brand Veridis 1800 Window Type Double Hung r______:__. _,:__ 1 Location Den Size 39 x 54 Coil Color Glacier White Interior Window Color Winchester Exterior Window Color White Hardware Color Adobe Screen Type Half Window Item Quantity 1 1 Window Brand Veridis 1800 Window Type Double Hung �- -I- Location Full Bathroom Size 27 x 38 j Coil Color Glacier White Interior Window Color Winchester Exterior Window Color White Hardware Color Adobe Screen Type Half Tempered Glass Both Sashes 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. Q0k co (Customer Initials) This space intentionally left blank Page 2 of 10 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) S 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) (Q S 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 11/12/2022 Barring delay caused by circumstances beyond Contractor's control,the work will be completed by 01/12/2023 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) CDC7- P(A Joyce Snyder 08/12/2022 Date This space intentionally left blank