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16B-060 (14) BP-2022-1399 9 HAYWARD RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 16B-060-001 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-2022-1399 PERMISSION IS HEREBY GRANT:I D TO: Project# SHOWER Contractor: License: YANKEE HOME IMPROVEMENT Est. Cost: 13737 INC 066324 Const.Class: Exp.Date: 03/28/2023 Use Group: Owner: PAUL &MARY WEINBERG/FAGO Lot Size (sq.ft.) Zoning: URB Applicant: YANKEE HOME IMPROVEMENT INC II Applicant Address Phone: Insurance: 36 JUSTIN DR (413)341-5259 WC 9099267 CHICOPEE,MA 01022 ISSUED ON: 10/28/2022 TO PERFORM THE FOLLOWING WORK: SHOWER REPLACEMENT 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: .52 TAIT Fees Paid: $91.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner -,/1 6ii/aQ i Wrik R whirl rid m p The Commonwealth of Massachusetts r' o i Board of Building Regulations and Standards FOR - Massachusetts State Building Code, 780 CMR MUNICIPALITY -„�. USE ru Buildigg) ermit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011 rn One-or Two-Family Dwelling o ' This Section For Official Use Only 1;.....? C Building rermit Num r: 6e- 1 - / '7 Date Applied: 1_— f� &cr5-5 // �—�Ut� ]D'26-202Z ` Buildiag_Official t Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers Ci ‘-katIMair& R d . t(Q 6 00.(3 1.la Is this-in 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 ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP` 2.1 Owner'of Record: Prins k Mir) �,�P nhc) I ' r,c\o Vint- er 1� . (1la , ctO<<,a Name(Print) ,, City,State,ZIP el Pak wanst Rr . 4l3-3P0-1615pt>JeiuYbrefc&@ W- lab.) •corn No.and Street" Telephone Ema+I1Address " 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 lilSpecify: lS Brief Description of Proposed Work': V.e m oV e. re_fo l O.c_e, eY,C t-t 6 Sh U���+r , \s) - �CLA\'S I Ylt,w af.Y 1� wri l\4,, htt,.) r'i.cart 1c �-c)b), rl?�.� fkre4 sS grits . Li14..e Li\C2 . 0kl� , -tr,k cVI aj CharN -es SECTION 4:ESTIMATED CONSTRUCTTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ \ , Th, bo I. Building Permit Fee: $ Indicate how fee is detetflmined: 2.Electrical $ ❑ 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: .1 �� b p Check No. 1 3 IkCheck Amount: q I Cash Amount: 6. Total Project Cost: $\3 , - 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS—OL9t.p. y 3 -ac& m��h ci l Pese ro` License Number Expiration Date Name of CSL Holder List CSL Type(see below) R_ P•b PlbX 1 b ct.p No.and Street Type Description U Unrestricted(Buildings up to 35,000 Cu. ft.) k),_a-r r2 to • Vn , 01(i5 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances �IVb-?1141-SaSol bun derwood @Nanlcee\-NDvat. Insulation Telephone Email address COnn D Demolition `5.2 Registered1 `Home Improvement Contractor(HIC) U y 5� $_11 _a y !4fl�.t_Z t-\c v e- Tt*Op'CUV e HIC Registration Number Expiration Date HIC Company Na e r HIC Registrant Name r• buncitr‘oNock @\10 14-ee_klt)m e No.and Street Email address au _ONe .!(`Clc\ t),va Cyl?) 3yl-Sa Set Coy, 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 Issuance of the building permit. Signed Affidavit Attached? Yes 13'/ 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 \tOr LeL. Otx-1 e S.M pc QV e 'Yl e Yl to act on my behalf, in all matters relative to work authorized by this building permit application. 'P1-efISe see qr,P d ak\-cvr-ed chrAk1-ar . to -ati- as Print Owner's Name(Fle ronic 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. L�QCt ' � ` I o to -au-aa use PrMt 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/dp: 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 it!- :~ Massachusetts r DEPARTMENT OF BUILDING INSPECTIONS J 212 Main Street • Municipal Building -�;1► Northampton, MA 01060 t,IV p-'' 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: ?�(.0 -A\aS\-tc .)C . (`ini(t; e . Ma , mb D, The debris will be transported by: Name of Hauler: lox\Ilee 6,0e 7 M \1Pmfrt-1- 7)Signature of Applicant: li' 1, ei Date: Ip-aL`-a2' N The Commonwealth of Massachusetts �-- r Department of Ind ustrial Accdents 1 congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Cornpensation insurance Affidavit:Builders/Contractors/ElectriciansJPIumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information ` -� Please Print Legibly Name (Business/Organization:'Indi+'idual):McrnV.Q� ,t-koM2 . 1 ANp*-r ern.e.cy# Address: No c S -r V . City/StateiZip:(\-\U O�•C . Mo,, 0 tug.- Phone#: L, t \\ `5 1 Are you an employer?Check lthe appropriate box: Type of project(required): l.�I am a employer with t4O employees(full andior pat-time).'" 7. D New construction 2.0 I ama sole proprietor or parvrership and have no employees working for me in S. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 4. ❑Demolition 3.❑lam a homeowner doing all work myself[No workers'comp.insurance required.)' 10 0 Building addition 4.0 tam a homeowner and will he hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I i.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or adoptions 5. m a I contractor and I have hired the sub-contractors listed on the attached sheet. ❑I a '° 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance- tt 6.0 tit arc a corporation and its officers have exercised their right of exemption per MGL c. 14.QrOtlter� �l�T 132,¢1(4),and we have no employees.'No workers'camp.insurance required.; W • *Any applicant that checks box f t must also fill our the section laclor7 showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating sue . Contractors the: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 nnployer s,they must provide their workers'comp.policy number. 1 am an employer that is providing, workers'compensation insurance for my employees Below is the policy and job site information. (� 1� Insurance Company Name: k lk 1A 1�����1� 1�QYIC .,,.�I(�r — Policy#or Self-ins.Lic.#: VOC CVC) q U.a k.0--1 ._.... Expiration Date: — -_ _5 Job Site Address: ek Hf �Or d. Rd • City,State/Zip: r\(� ex,e_e . 1 l o t Vn ow a Attach a copy of the worker ompensation 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 tine 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. 1 do hereby certify u•der pails nd penalties ofperjury that the information provided above is true and correct. Signature: //%' Date: lO ` ay - as S � C Phone t`r: r l k. -�7�<7, c ,- ar,9 _... Official use only. Do not write in this area,to be completed by city or town official !l City or Town: Permit/License R j Issuing Authority(circle one): 1 l.. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical inspector 5.Plumbing inspector 6. Other ( I - Phone r: THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration ,44 r 4 ` Type: Corporation Registration: 160584 YANKEE HOME IMPROVEMENT INC 36 JUSTIN DR. Expiration: 08/11/2024 CHICOPEE, MA 01022 �� t 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 3ERARD RONAN ;6 JUSTIN DR. ;HICOPEE, MA 01022 Undersecretary Not valid without sianature i...,N YANKHOM-01 JOCELYN ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmvv) `--� 10/12/2022 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 Jocelyn M Douglas Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,Ext): (NC,No): Chicopee,MA 01013 ittARIIEss:jocelyn@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Co of Amer 12572 INSURED INSURER B:Selective Ins Co Of South Carolina 19259 Yankee Home Improvement,Inc. INSURER C:_ 36 Justin Drive INSURER D: Chicopee,MA 01022 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 ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS-MADE X OCCUR S 2517693 10/1/2022 10/1/2023 DAMAGES(Eao cED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X SECT L LOG PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _ (Ea accident) $ X ANY AUTO A 9106918 10/1/2022 10/1/2023 BODILY INJURY(Per person) $ AUTOS ONLY _WNED AUTOS SULED BODILY INJURY(Per accident) $ _ _ AUTOS ONLY NON-OWNEDUUO YY PROPERTY DAMAGE _� — accident) $ A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE S 2517693 10/1/2022 10/1/2023 • AGGREGATE _ _ I_ 1,000,000 DED i X RETENTION$ 0 $ A WORKERS COMPENSATION X PER H AND EMPLOYERS'LIABILITY STATUTE ER YIN WC 9099267 10/1/2022 10/1/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? andatory in 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) Workers Compensation coverage is included for the following states: MA,CT,NY 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 o mo wealtlh . t Nit A s s « uu stoY J P ( ¢Gs y 11 i _t ,`q �, ... Board „o# }Buitdnmq ulan -Bid Standard, Y O O 5 't'l MICHAEL PEREIRA .., ,. ,,, lo •0,,. ��, , � � ,, m . ,, ,, ,,, ..,\i•q • t , . „..., ..—., 4 . \' .. t A tit( ��`�,� „,.w,4� \,-, �lZz €, ,, �`A' " „ �Y i�ti h,S}.ye�i 4 �1�u�( �ll„ 1 t, 3 ,' 'fit ,, ',\ l4 t , A t\z »3 ti �s y �Ik 1,�S; t��{s� �OMIt t ` 00?V' }l Vic, S'• >f c SJ�;`,'cat7`\�\ .�a l��i1��.y�2 y�� t � �3� t� �s�7' � ij Lt4�\�L'`d�?jSi�\\N 4��aF�t1,%\L����2 �Z1�.t v } :i�'�11 .'l�i k ,'' �i. �`, W„r{ roc - , R tiY N O N_ i7') Page 1 of 11 Yankee Home Improvement MA Lic#160584 CT Lic#0673924 yYANKEE 36 Justin Drive RI Lic#33382 HOME Chicopee, MA 01022 413-341-5259 or 877-88-YANKEE www.yankeehome.com Customer Information Paul & Mary Weinberg/Fago (413) 320-7375 (Primary Date: 10/13/2022 9 Hayward Rd. Mobilekbr>(413) 584-1732 Rep: Emery Messier Florence MA 01062 (Home)<br>(413) 582-6886 (Secondary Work) pweinberg@w-g-law.com Replacement Work Details Replace and Dispose of Existing Shower Install Base Base Type Acrylic Replacement Tub Base Color White Skirt 19" Straight Skirt Drain Location LH Wet Area Wall Quantity 1 Type Acrylic Surround Color/Style Santorini White Marble Smooth Shower and Bath Accessories Quantity 2 Accessory Single Tier Corner Shelf Color Santorini White Marble Grab Bar Grab Bar Quantity 1 Grab Bar Size 12" Finish Brilliance Stainless Linden Grab Bar Location Dry Wall Grab Bar Quantity 1 Grab Bar Size 18" Finish Brilliance Stainless Linden Grab Bar Location Soap Dish Wall Page 2 of 11 Hardware Delta Fixture Selection Linden • I n2ition Shower Head Trim Kit Finish Brilliance Stainless Temp Assure Valve? Yes, style only available with temp adjust valve k Ord 33�K Job Specifications Remove existing Drywall/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. Custom Product Door Quantity 1 No charge Scope of Work and Special Instructions Door will be brushed nickel Do Not Do Homeowner will be changing vanity, This space intentionally left blank