Loading...
35-065 (3) BP-2023-1050 897 RYAN RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 35-065-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1050 PERMISSIO IS HEREBY GRANTED TO: Project# BATH RENO 2023 Contractor: License: Est.Cost: 15000 BATH BUSTERS IN 072772 Const.Class: Exp.Date: 04/07/202 Use Group: Owner: BLISS ATHBUN PATRICK W&NAOMI Lot Size (sq.ft.) Zoning: WSP Applicant: BATH USTERS INC Applicant Address Phone: Insurance: 30 NORTH MAIN ST UB6N457719 LEOMINSTER, MA 01453 ISSUED ON: 08/07/2023 TO PERFORM THE FOLLOWING WORK: BATH RENO POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector l nderground: 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: Fees Paid: $98.00 212 Main Street,Phone(413)587-1240,Fax (413)587-1272 Office of the Building Commissi ner RECEIVED . The Commonwealth of Massachusetts i. :w 4UG 7 2023 oar of Building Regulations and Standards MUNICIPALITYFOR ,{?(; assitchusetts State Building Code, 780 CMR USE a...NOR ofTH cuA, r rf l Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number:bee ,3P^)-3.050 Date Applied: ilet,H.) r �2055 j' / 6-7 ZDZ3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Prorty Address,:(> J 1.2 Assessors Map& Parcel Numbers j.rci-7I / aecAiO 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 Yar1/d Side Yards Re Yard Required ro ded Requiredf/.1 4ided Requir Provided 1.6 Water Supply: ( .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' 2.1 Owner'of Record: A/400V A.,)4-45'S e. ---7.e.1(x.--;(..c4r- m4 Name(Print) ity,State,Z1P 7 Z 4.t. ,(Z , 0-5- 7 - 5-A0Y AiiivrvR4/6 ,',+,,/ . CA-%._ No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Propose Work': 70 j-91,1014S ,rglfGrC;.r 6,....*"/Z.- / / / C /.77/.//e,C0'4-) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /O ®vv 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ / ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier /5, op? x (0 3.Plumbing $ u‘ t 2. Other Fees: $ / 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees:$ 73 !LI' / Check No. 10') Check Amount: Cash Amount: 6.Total Project Cost: $ ! 5-�UU 0 Paid in Full 0 Outstanding Balance Due: / / / / -P/�1�tLtc,l,•J BCD 16121+SFca'i 64YY1 YhiA,( Ora ne9 SECTION 5: CONSTRUCTION SERVICES 5.1 Construc 'on Supervisor License(CSL) 02 27 7 L/ Z Y e� �� License Number Expiration Date r Name of CSL Holder y 4- List CSL Type(see below) No and Street Description 04A)VC-riff //14 61 Ereer1tOQOcu.ft.) �_yrV � welling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding 917- V V3,r/ oreet,1 SF Solid Fuel Burning Appliances Insulation Telephone Email address I '' D Demolition 5.2 Regis d Home Impr ement Contractor(HIC) -� c HIC Registration Number Expiration Date HIC Companny lame or C eggstratlaIne No.And Street Email address 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 .❑ SECTION 7a:OWNE UTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize. /TLLIae S s 7 9f6 ' to act on my behalf,in all matters relative to work authorized by this building permit application. 1 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 applicatio C'nd urate to the best of my knowledge and understanding. Owner uthorized Agent's Name(Electronic Signature) Date NOTES: 1. 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 te 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 SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD I SIDE YARD ( .) FRONT SETBACK FRONTAGE ,\ [ne commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I~� Lafayette City Center 2Avenue de Lafayette, Boston,MA 02111-1750 T"~ www.mass.gov/dia 4 Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Bath Busters Inc Address:30NMainST. City/State/Zip:Leominster Ma. 01453 Phone#:508-925-4300 Are you an employer?Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 8 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. f Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' P h' 9. ❑Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] + c. 152,§1(4),and we have no bath tubs employees. [No workers' 13.®Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below 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. 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:Universal Insurance Agency Inc _ Policy#or Self-ins. Lic.#:UB6N457719 Expiration Date:`6/99/2 Job Site Address: ��7 7 /Y4.4., /Q1 City/State/Zip. ,L QfC . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance c rage verification. I do hereby certify under the p ' s es of perjury that the information provided above is true and correct Signature: -- Date: 7/-7/2 3 Phone#: 508-925- 3 Official use on y. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 21:1 Building Department 3LJCity/Town Clerk 4..0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: AR a' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/06/2023 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 NOAMEACT Mosarene Scalzer Universal Insurance,Agency,Inc. PHONE (508)752-9333 FAX (508)752-9303 INC,No.Est): (AIC,No): 374 Belmont Street ADDRESS: C mscalzer©universalinsagency. om INSURER(S)AFFORDING COVERAGE NAIC# Worcester MA 01604 INSURER A: Berkshire Hathaway Guard Ins Co. INSURED INSURER B: Travelers Indemnity Co of CT 25682 BATH BUSTERS INC INSURER C: 30 North Main St INSURER D: INSURER E: Leominster MA 01453 INSURERF: COVERAGES CERTIFICATE NUMBER: Master 05 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-SUBit POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD.WVO POLICY NUMBER (MMIDDIYYYY).(MMIDDIYYYY) X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ 1,000,000 ��// DAMAGE TO RENTED 50,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) S MED EXP(Any one person) $ 5,000 A Y BABP367156 11/120022 11/12/2023 PERSONAL BADVINJURY S 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S 2,000,000 RO- 2,000,000 P POLICY xl JECT n LOC PRODUCTS-COMP/OPAGG 5 OTHER: $ AUTOMOBILE LIABILITY r COMBINED SINGLE LIMIT $ (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ 100,000 A OVVNEO SCHEDULED BABP367156 11/12/2022 11/122023 BODILY INJURY(Per accident) $ 300,000 AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 100,000 _ AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION$ S WORKERS COMPENSATION I. sel SSTTR OTH- ATUTE ER AND EMPLOYERS'LIABILITY "'NI N 1 000 000 B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA UB6N457719 05/08/2023 05/062024 EL EACH ACCIDENT S , OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L DISEASE-EA EMPLOYEE S It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Town of Lexington is listed as additional insured on the above General Liability Policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Lexington ACCORDANCE WITH THE POLICY PROVISIONS. 1625 Massachusetts Ave AUTHORIZED REPRESENTATIVE Lexington MA 02420 _ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD City of Northampton oat J r.�p�u "S • Si / fir• te Massachusetts �5' - fee (ii c 14. r DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building J` ca \!i0rw«'r.' Northampton, MA 01060 J' HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born (insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I ant not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualifij for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of , 20 . (Signature) Home Improvement Agreement: Page 1 Home Depot License#'s-For the most current listing visit www.Homedepot.com/LicenseNumbers 9875,112785,CS-107774 (MANNY ALVES • Salesperson Name Registration#(Req.in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A.,Inc.("Home Depot")or Authorized Service Provider named below will furnish,install and/or service the equipment listed below at the price,terms and conditions as outlined on this form. 1.Service Provider Contact Information • manny@bathbusters.com , Bath Busters Inc. Service Provider Contact Name Service Provider Company Name 508-308-4435 (manny@bathbusters.com 879995 Phone# Service Provider Email Address Service Provider License#(s) 2.Customer Information bliss naomi 8452 (F34954309 Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 897 Ryan Road , Florence MA (01062 Customer Address City State Zip 4135528105 (4135528105 naomibliss@gmail.com Home Phone# Work Phone# Cell Phone# Customer Email Address 3.NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY;EMAILING SERVICE PROVIDER AT: manny@bathbusters.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 30 North Main St. , :Leominster :01453 - (01453 Address City State Zip BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING,UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD.THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE.YOUR PAYMENT(S)WILL BE RETURNED WITHIN TEN(10)BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE.YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER,AT YOUR SERVICE ADDRESS,AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED,ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU.OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL.PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: 6/12/2023 Customer's Signature Date The Home Depot-2455 Paces Ferry Road,N.W.Bldg,B-3,Atlanta,Georgia 30339-Customer Care:1-800-4663337 316 Generic AGMT(07 Dec.20) Generated Date j2nm t Lead/PO#F34954309 v 6.0 https://homeserrices.my.site.ccrn;sp(sjfiti-document-temptate?...0000012wget1AA%2Fcoi34854309' 3Fshowtabr/3DDocuments 6/12123, 8:28 PM Page 1 of 10 1 41.�,6 Home Improvement Agreement: Page 2 4.Description of Work to be Performed A detailed description of the work to be performed is included in the paragraph entitled Scope of Work,Specification,Customer Summary Sheet,Quote Form,Estimate,Invoice or Measure which is included in this Agreement. 5.Anticipated Delivery Date/Installation Schedule Approximate Start Date: 7/28/2023 ) Approximate Finish Date: 7/29/2023 All dates are approximate and subject to change based on unforeseen events including inclement weather,permitting delays,and delays in confirming insurance coverage of Your claim for any repair,if applicable. 6.Electronic Records Authorization You are entitled to a paper copy of this Agreement if you choose.If you consent to an e-mailed copy,your consent applies to this Agreement and all subsequent documents and written communications related to this Agreement By contacting your Service Provider,you may update your email address, withdraw your consent,or obtain a paper copy of the Agreement or related documents at no charge.By providing your consent and verifying your email address above,you confirm that you have access to a computer that can receive and open emails and PDF documents. 7.Contract Price and Payment Schedule Payment of the Contract Price is due upon signing unless a different payment schedule is required by law,specified below or in a payment addendum. Contract Price: $ 15000.00 Includes all applicable taxes.Excludes finance charges.* Sales Tax: $ (If applicable,total amount of taxes included in Contract Price) *Maximum deposit ONLY applicable in MD,MA,ME(33%),NJ,WI(99%) Deposit% Deposit Amount $ 5000.00 Remaining Balance $ 10000.00 8.Finance Charges Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement,to which Home Depot is NOT a party,and will be in addition to Customer's payment under this Agreement.Customer is subject to the terms and conditions of the cardholder or loan agreement,as applicable.No hinds should be made payable to Service Provider;however,Service Provider may collect Customer's payments made payable to Home Depot. 9.Acceptance and Authorization By signing below,you authorize Home Depot to:(a)arrange for Service Provider to perform any Services or(b)order and arrange for the delivery of special order merchandise,including special order merchandise that may be custom made,as specified in this Agreement.Do not sign if blank or incomplete.(Service Provider's or permitting information may need to be provided to You later.)By signing,you acknowledge that:(i)You have read, understand,and accept this Agreement in its entirety,including the General Conditions and State Supplement,if any;(ii)You are receiving a complete copy of this Agreement;(iu)all rights and interests under this Agreement are solely vested in the person listed as"Customer"above;and(iv)Electronic signatures will be deemed originals for all purposes. X ' 6/12/2023 Customer's Signature Date X (/s/The Home Depot ) 6/122023 The Home Depot Digital Signature Date For questions related to your installation,contact Service Provider at (508-308-4435 For any other concerns,contact The Home Depot at 1-800-466-3337 The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 316 Genetic AGMT(07 Dec.20) Generated Date 6/12/2023 Leed/PO8 F34954309 v 6.0 • https:(/homeservices.my.site.cem;sprsjfill-document-te.npiate?...0000012ergvUAA':52Fcof3495 309%3Fshowtab:.3DDocuments 6112/23,8:28 PM Page 2 of 10 ,`$ Home Services Installation Customer Approval Home Depot License#'a-For the most current listing visit 9875,112785,CS-107774 bliss ) (naomi ) (8452 ) (F34954309 Customer Last Name Customer First Name Store# Lead or PO# 897 Ryan Road ) Florence ) MA (01062 Job Site Address City State Zip 4135528105 4135528105 • (naomiblissOgmail.com Home Phone# Work Phone# Cell Phone# Customer Email Address Additional PO(s): ( Waiver:Upon receipt of payment from Home Depot U.S.A.,Inc.("Home Depot")on behalf of the customer named above,this document shall be effective to waive,relinquish,and forever release any right of the undersigned Service Provider to a mechanic's lien,stop notice,or any right against a labor or material bond on the job performed for the customer and the property at the job site address listed above.The undersigned Service Provider represents that all laborers,mechanics,and materialmen furnishing services or materials on the job either have been or will be fully paid for the services or materials. Release and Indemnification:The undersigned Service Provider agrees to cause the prompt release of any liens,stop notices or other property encumbrance that may be filed against the property at the job site address by any laborer,mechanic,or materialman claiming the right to file such lien,stop notice or encumbrance through or under the undersigned.The undersigned Service Provider further agrees to defend,hold harmless and indemnify Home Depot,the customer named above,and the owner of said property,from and against all costs and expenses arising from or by reason of such lien,stop notice or encumbrance,or the release or discharge thereof. Acknowledgment:The undersigned acknowledges and agrees to the above terms and conditions. (Bath Batters Inc. ) e 508-308-4435 ) ( Service Provider Name Service Provider Phone# Service Provider License#(SF&I) 30 North Main St. (Lernnintter j (01453 ) 01453 Service Provider Address City State Zip X ) Service Provider Signature Date NOTICE TO OWNER Do not sign this completion certificate or any agreement stating that you are satisfied with the entire project before this project Is complete.Home repair contractors are prohibited by law from requesting or accepting a certificate of completion signed by the owner prior to the actual completion of the work to be performed under the home repair contract. f(Certificate of Completion:Customer sign here only upon your acknowledgement of actual completion and final approval of the work. (bliss naomm 1 ( J l Customer Last Name Customer First Name Customer Signature Date The Home Depot-2455 paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-500-466-3337 329 Customer Approval(01 Oct 20) Generated Date 6/12(MQa3, Lead/PON F34954309 v 111.0.0 https:J(homeservices.my.site.coin;sp;sifi0-documem-template?...0000012wgvUAA ZFcot34954309c 3F show tab°'.3DDocuments 6/12/23, 8:29 PM Page 1 of 1 Scope of Work Scope of Work will be found below or in separate document. bliss naomi 8452 , F34954309 Customer Last Name Customer First Name Store# Customer Lead/PO# Program Name: Other. r Description: Remove and dispose of existing tile shower and tile base Remove and dispose of existing wall and cabinet(save cabinet) Install new plumbing feeds and drain for new bath tub Repair walls and subfloor where needed Install new wall board materials Install custom acrylic tub and walls to ceiling Install Delta valve and hand held Install 4 shelf corner unit and recessed(2 x 1)shelf Install toilet and vanity(customer provided) . Pack area around vent fan Install semi frameless shower doors 60x32 LH white tub(17 deep tub) White subway walls Ceiling panel(white) 4 shelf corner unit and recessed(1 x 2 white) Delta valve with magnetic hand held(matte black) Semi frameless shower doors(clear glass)(matte black) The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 316 Generic AGMT(07 Dec.20) Generated Date Afl2nea} Lead/PON F34954309 v 6.0 https://homeservices.m,.site.cor-;spiaifill-document-ter:notate?...0000012vvg:UAA".:2Fccf346=»3^u':3Fshoatab`::_3DDacuments 6/12;23, 8:28 PM Page 3 of 10 Commonwealth of Massachusetts � �=� Division of Occupational Licensure .-ram r, Board of Building Re ulations and Standards Cons . fSe isor - 27?2 ,, ,� E3 ires: 04107/2024 EFF C STE E ..* - - : .. ii � + 24 SHERwt? AV DANVERS M 0192 I ,,, ioner cv '. - n _4 y'. 4„ais,7„.„, "f �d x t t # L r �yM � Y h ,P ,;�.,Vp{ ',k ii d ; a ✓ ' ;� G .T . ,f I THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washing �a 'C- Suite 710 Bosto -- :.c.- �_, 118 Home im ro .1=__``== istration t-' pa- " ' �� rr� /M .ter """�r.�. n mst_v :'s r, Type: Corporation —_ ..�..� eg,istration: 159805 BATH BUSTERS, INC. 7 si.Hi �i= i it E>iplration: 07/14/2024 30 NORTH MAIN ST =� LEOMINSTER, MA 01453 -11 1 — Ll :1tamow __}.-. 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 Reaisfratian Expiration 1000 Washington Street -Suite 710 159805 07/14/2024 Boston,MA 02118 TH BUSTERS, INC. ;` FINER ALMEIDA ' kIORTH MAIN ST. ,e„,,,,..(a. r /.4.' -46 .-.7-1 .' MINSTER,MA 01453 : : Undersecretary Not valid ut signature 1 Y: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 77 /7i1ti /e/2 The debris will be transported by: /6-4-7t,4L.) i i /)°c-/.-‹- The debris will be received by: 7/-e-9 4 i°YTJ 7 rzz,0 G%fc c Building permit number: Name of Permit Applicant L/-2-7 Date ign re of Permit Applicant