22-015 (6) BP-2023-0744
53 SPRUCE HILL AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
22-015-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0744 PERMISSION IS HEREBY GRANTED TO:
Project# 2023 SHOWER Contractor: License:
YANKEE HOME IMPROVEMENT
Est. Cost: 18013 INC
Const.Class: Exp.Date:
Use Group: Owner: WINTLE KEITH D
Lot Size(sq.ft.)
Zoning: WSP Applicant: YANKEE HOME IMPROVEMENT INC'
Applicant Address Phone: Insurance:
36 JUSTIN DR (413)341-5259 WC 9099267
CHICOPEE,MA 01022
ISSUED ON: 06/07/2023
TO PERFORM THE FOLLOWING WORK:
INSTALL SHOWER IN 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 NOR HAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
je,410,1k, J • /1l[��17
Fees Paid: $118.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissi ner
.s The Commonwealth of Massac ,•etts fr
r Board of Building Regulations an. St n..rds✓(/ �10 FOR -
t Massachusetts State BuildingCo. 7:t MR N .j "�UNI V PALiTY
„��. oro �O SE
•
Building Permit Application To Construct, Repair, ' .f•: 6.00 IIemolisiYa Revi•ed Mar 2011
One-or Two-Family Dwelling A' T N�'/NSo
This Section For Official Use Only Mqo nst'io,v9
• Building Permit Number: AP— A,- 7q`i Date Applied
. if jg
: ov,,, , , a, ._,
e.DIr , 7/33
0 • . _
Building Official(Print Name) Signature r 9 Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
S3spr,.ta 14,`ll4-vf, Home we
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 Watei Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 SewageDisposal System:
Public Private 0 Zone: _ Outside Flood Zane? Municipal rd/On site disposal system 0
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Qwner'of Recorcl: G/ /
Ke��h W:.� {. rib .h(-P MA 0104
Name(Print) City,State,ZIP /
S Strt.c f, i,4,`i l/4,V L 41s- S86-o '11 1cd c. ,'-t/Je 0 cC r 5Pi,he f
No.and Street Telephone Email Address
SECTION 3: DESCRIPTFN OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. ❑ Number of Units Other LEI Specify:
Brief Description of Proposed Work': 14e",7r't- sito��' n ly crc l� n° S�
ot,,,b7
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials) _
1. Building $ (g i 0 I 1. Building Permit Fee: $ Indicate how fee is determined:
0 Standard City/Town Application Fee
2.Electrical $ 0 Total Project Cost' (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fee /, r
Check No. heck Amoun . H 9 Cash Amount:
6. Total Project Cost: S 17,0 13 0 Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
Construction Supervisor License(CSL)
g (;d if c 3 < ��
�;1' 1� 1 Pox \ra License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) t 1
No.and Street pe Description
0.1 a V,re��i r\A Y I 01 3 �U,�}+ UnrestrictedRestrictedl&2(BuildingsFamily up tolDwelling 35,000 Cu. ft.)
1 r R
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
` SF Solid Fuel Burning Appliances
14 135141,551 (V� �C i(*pro.a e•c om 1 Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) ,-
Nanv±e home t,J tI 1 �� it HIC Registration Number Expiration Date
HIC Company Name or HIC Regi trans Name
t 0
..TO S 1fl I f '.rnq fiZLiAn Let hr,:rn..,, cool
Islo.and Street 4.. r , mail address
op)341
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 , No 0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
T,as Owner of the subject property,hereby authorize l O.11 tf et 1) 'rt, \irmv yyte; )
to act on-my behalf,in all matters relative to work authorized by this building permit application.
. � con1i c-
Prt t 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.
OY11 VCla
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
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
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
"Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Mass chusetts
IWO(/' Department of Industrial Ac idents
W. 1i 1 Congress Street,Suite 00
•:00
salit�nlaw
11 r w Boston,MA 02114-201
�'!"""!, ' www mass.gov/dia.
Workers'Compensation Insurance Affidavit:Builders/Co tractors/Electricians/Plumbers.
TO BE PILED WITH TILE PERMITTING AUTHORITY.
Applicant Information _.._ Please� ly Print Legib
Name (Business/Organization/Individual): �(�n�—I _: �! i� ,. V�o�.., a se'
Address: (i,) _511S�1 in br _......___.....__- .._..._..
City/State/Zip: OA" a_..COP 01 a. Phone#: .413 ." 1"I'1 5& _
Are you an employer?Check the appropriate boa.: Type of project(required):
1. lam a employer with (CD employees(full and/or part-time).* 7. ew construction
2. I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling
any capacity.[No workers'comp,insurance required.] -
9. ❑Demolition
.3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]'
4.0 I sin a homeowner and will be hiring contractors to conduct all work on my properly. I will
10 0 Building addition'
ensure that all contractors either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions
proprietors with no employees. 12.0 Plumbing repairs Or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached shoot, 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.0 We are a corporation and its officers have exercised their tight of exemption per M(,L c. 14.0 Other
152,*1(4),and we have no employees.[No workers'comp.insurance required,,)
*Any applicanrthat checks box III must also fill out the section below showing their workers'compensation policy information.
'llomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors 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.policy 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:
Policy#or Self-ins.Lie.#: WC) 0� (, ?._..:_............... Expiration Date:_ P. .,1_4.< 4.. )...__..
Job Site Address: ity/State/Zip:_
Attach a copy of the workers' compensation policy declaration page(shawl.g the policy number and expiry on date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal vi elation.punishable by a fine up to$. .500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP ' ORK ORDER and a fine of up to 250.00 a
day against the violator.A copy of this statement may be forwarded to the Offic_ of Investigations of the DIA for insurance '
coverage verification. .__ ___
I do hereby certif de the paIi. and penalties ofperjury that the information provided above is true and correct.
v Signature: • , - _.. Date:
Phone
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):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
(a.Other
Contact Person:. _....... Phone#:
YANKHOM-04 Q.C.E1
'AC-C.1W t.:x
DATE(MilliDD/YYTY:
Niewiwwww*-- CERTIFICATE OF LIABILITY INSURANCE 10/12/2022 ,
E AS A
I THIS CERTIFICAT'E IS ISSU D ------------
) caILROTIWFICATE DOES NOT AFFIRMATIV—mILELY"O G
"R ON Fe I AN 7 IF OvREM AL y AMEND,TI 0N EXTEND
ONLY
ExAN AND t CONFERS 14 ALTER 0 RIGHTS THE G
CO UPONVE RA THE E C AFFORDEDE R T I F l C B A TEYTHE
HOLDER.upo THISciE
PRESENTATIVE OR PRODUCER,AND t
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTE
UT17 A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
RE THE CERTIFICATE HOLDER, ......._IMPORTANT; If the so ejrnsals hob:Ise IS an If SUBROGAT IS WAIVED ADDMONAL INSURED,the policy(ies)must have ADDMONAL INSURED provisions or be endorsed.
ION
, subject to the terms and conditions of the policy,tenaln
tnis I
not confer r t
l his o the certificate holder In lieu of such endorserrient(s).
policies may require an endorsement. A statement on
seonucEe .._.... . .._
F,IgiiAcr Jocelyn M Douglas ,
Phillips Insurance Agency,Inc ............____
,
97 Center Street -.i>tot•IE ' —
_ (*lc./NO -
ChleoPoo,MA 01013 ki.,.!„c.N,?„,,e.,_.1,__ _ -
litlieujocelinAphillipsinsurance.corli _ .....1 —
, HAIIC,0
INSURERIALWORDIRO__COMMA,91_
' -
1,11572
----
Selective Insurance Co of Amer
____ ... •INSURED ...._ ..... . •_ __.
119259 .,
Yankee Home Improvement Inc. m_s_u_e_kep.Se_I it ctive Ins_c9pl South Carolina_...
INSURER C i_ _ — .,.....,— ..._
36 Justin Drtve
Chicopee, MA 01022 lttli.Y.9.g.f.I.P... — . ----
,_NsurtEe s .......—
INSuRER F:
SSI_VERAG.ES -
...____ CERTIFICATE NUMBER: REVISION N MBER:
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 REOUIRE.MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUE() OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
, EXCLUSIONS
.
OF SUCH POLICIES.LIMITSAY HAVE BEEN REDUCED BY PAID CLAIMS. _.. .....
--' —EXCLUSIONS AND CONDITIONS — SHOWN MAY HAVE
UP _
mars
_Lia.....______ TYPE or INSURANCE .114:141j SUSS
POLICY NUMBER MEINIYYTY1 I alf&Birarn f7doc-17ei
A X commEaciAL GENERAL LIABILITY
_EACH OCCLIRBIN5.g.- $
-----/-I
CLAIMS-MADE I X]OCCUR S 2517693 10/112022 1011/2023 t
AMAGF TO RENTED
lekmiskailaQrsuummiL. - soo,b
+ mED EXpiAm_o_mosotoni __)_, _
---
1-- 1,000,0
. PERSONAL&Any INJORY #
-- -...
sgpn AGGREGATE LIMIT APPLIES PER: GENERALL AGgFacgArF,, $
000
. l,
i o
,POLICY 1-11 12a- [ 1 Loci ob
PRpOLICTA:COMP/OP AGG $ , _:...._,...„...___
OTHER ______________COMBINED SINGLE LIMIT 1,000,0i
vo AUTOMOBILE LIABILITY (Ea accident) I ,._
ANY AUTO
X A
OWNED 9106918 101112022 10/1/2023 BODILY INJURY(Por person) $ --
"--- --
SCHEDULED
AUTOS ONLY AUTOS
BODILY INAJRYif!er accident) j
OROPERTY DAMAGE
MESS ONLY 'Avvastle (Par Rmatmu S
1. i ... , .
A X UMBRELLA LIAB X OCCUR . • EACH OCCU 1,000,01RRENCE _l_
_._
EXCESS LIAB CLAIMS-MADE S 2517693 10/1/2022 10/112023 1,000,01
AGGREGATE
_ -
DED _ X , RETENTIONS 0 $, .
A WORKERS COMPENSATION • y i PER Z. VI-
AND EMPLOYERS'LIABILITY STATUTE
ANY PROPRIETOR/PARTNER/EXECUTIVE
Y/N N,A WC 9099267 10/1/2022 10/1/2023
E.i..EACH ACCIDENT $ 1,000,01
N i
Kititilitt4TAAMExcluDE" E.L.DISEASE;EA EMPLOYEE$ 1,000,01
1,000,01
II yes describe under
j
DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may bit attached If more space le required)
Workers Compensation coverage Is included for the following states:MA,CT,NY
CERTIFICATE HOLDER _ CANCELLATION
SHOULD AN OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIR TION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
rki 1, ,,
-
ACORD 25(2016103)I
C 1988-2015 ACORD CORPORATION, All rights reserver
The ACORD name and logo are registered marks of ACORD
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
egIStfiation: 160584
YANKEE HOME IMPROVEMENT INC s Expiration: 08/11/2024
36 JUSTIN DR.
CHICOPEE, MA 01022 (�$
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
;ERARD RONAN
t6 JUSTIN DR.
:HICOPEE,MA 01022
Page 1 of 11
Yankee Home Improvement MA Lic#160584
CT Lic#0673924
Yal YANKEE 36 Justin Drive RI Lic#33382
HOME Chicopee, MA 01022
413-341-5259 or 877-88-YANKEE
www.yankeehome.com
Customer Information
Keith Wintle Land line: 413-586-0074 Date: 04/20/2023
53 Spruce Hill Ave Cell: 413-387-9398 Rep: Ryan Irizarry
Florence MA 01062 kdwintle@comcast.net
Replacement Work Details
Replace and Dispose of Existing Tub
Install Base
Base Type Acrylic Shower Pan Single Threshold
Base Color White
Drain Location Center Drain
Wet Area Wall
Quantity 1
Type Acrylic Surround
Color/Style Santorini White Marble Smooth
Ceiling Panel
Ceiling Panel Qty 1
Ceiling Panel: Yes
Color
White
Bath/Shower Door
Door Type Standard Sliding Door-46-48" wide base
Door Finish Brushed Nickle
Glass Type Clear
Shower and Bath Accessories
Quantity
2
Accessory Single Tier Corner Shelf
Color Santorini White Marble
Shower and Bath Seat
Accessory Acrylic Bench
Description Bench w/bracket 26" wide x 14" deep
Color
White
Seat Location Right Hand
Grab Bar
Grab Bar
Quantity 1 Grab Bar Size 18"
Finish Brilliance Stainless Linden Grab Bar Location Soap Dish Wall
1
Ins space intentionally felt b1a as.
Page 2 of 11
Hardware
Delta Fixture Selection
Linden
\go ill In2ition
Shower
Head
Trim Kit Finish
Brilliance
Stainless
Temp Assure Valve?
Yes, style
only
available
with temp
adjust valve
J
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.
Misc Additions
Description Header/Beam Removal
Description Move/Build Wall
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Page 3 of 11
Scope of Work and Special Instructions
All discounts applied. (Spring clearance 50% off labor, free door ,free seat)
Eliminate header and wall that separates shower from tub.
Remove tub and and cap plumbing.
Build new wall 48" from the shower plumbing wall to create rough opening for larger 48x34 shower.
New wall should be built to 40" length so its on the same plane as the pluming wall.
Install 2 shelves on the plumbing wall corner at 46" and 60" heights.
Install grab bar centered horizontally on soap dish wall at 38" height.
Do Not Do
We do not do any painting or staining.
this space intentionally left blank
Page 4 of 11
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 06/15/2023
Barring delay caused by circumstances beyond Contractor's control,the work will be completed by 07/27/2023
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)
Keith Wintle
04/20/2023
Date
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Page 11 of 11
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