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29-584 (6) BP-2024-0050 111 WOODS RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-584-001 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-2024-0050 PERMISSION IS HEREBY GRANTED TO: Project# shower 2024 Contractor: License: YANKEE HOME IMPROVEMENT Est. Cost: 18048 INC 066324 Const.Class: Exp.Date: 03/28/2025 Use Group: Owner: M TOSSWILL ANDREW R& PATRICIA Lot Size (sq.ft.) Zoning: URA Applicant: YANKEE HOME IMPROVEMENT INC Applicant Address Phone: Insurance: 36 JUSTIN DR (413)341-5259 WC 9099267 CHICOPEE, MA 01022 ISSUED ON: 01/18/2024 TO PERFORM THE FOLLOWING WORK: replace tub with shower 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: +. • '1,. yg . /'I • f Fees Paid: $123.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner I1 e t.l 1—1 a i'. 1 I 1 JAN N i The Commonwealth of Massachus 1 7 r 4 etts FOR Board of Building Regulations and Standatds I1UNICIPALITY f i Massachusetts State Building Code, '7�80 CMRO=sun[Div',,i;.JsPFc-ous USE Building Permit Application To Construct,Repair,Renovate Or-DeinolighTa--_ Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number: i ' .2 4-5-0 Date Applied: / uI _) aS ________Z ///' I-173ZH Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 1 k\ 9-6 . 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 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 1 Owner'of cor : .'471\ \A a- k) TOIStj I 1 l nor err e , ry1P1 oio c� 2 Name(Pr t) City,State,ZIP • \ \ W )(A . y13 3 AI11 .to550.il1\i9imctLk.Conk No.and Street Telephone t Email Address SECTION 3:DESCRIPTIONT OF PROPOSED WORK2(check all that apply) C� New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work': vi_e.oa(C_ Q XS-}-indloi� lJh LI.+ i \—r (C.r 11 P. hhou.e,r pan , rpa� we t • (Iwa I t clr r.o is,) , rnl>, a CeetSSO r= -) . 2 ryl 1r) e)< % F+rc.rr Q u �r • PA ontj . SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ t 00 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ 1 Suppression) Total All Fees,A C4‘i Check No.14 WI Check AmoutiA Cash Amount: 6. Total Project Cost: $ k , ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 1 5.1 fConstr�ucttiion Supervisor License(CSL) v ). rC ?�aLl , L- (2c [1 1 r.' t,e. PErti10\ License Number Expiration Date Name of CSL Holder ; I 3( 1-«�- ir\ br Ul List CSL Type(see below) No.and Street � Type 1 Description �^ i _ r U Unrestricted(Buildings up to 35,000 Cu. ft.) f `! i ���P > t 11� ���l/� R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering I WS Window and Siding i SF Solid Fuel Burning Appliances yr3.3_-I I ,9`L,q ix L r i 11,S \tsl.r 0LC2.1'11;1 Q'C©NAl Insulation Telephone Email address D Demolition i 5.2 Registered Home Improvement Contractor(HIC) ltoo 6 R2 I Eli ) > ,2_I `y a i PR., �l7C e, HIC Registration ,Number OExpirationDate HI.0 Company Name or HIC Registrant Name 6 �rtn >v pex n 1600 qe r e .u:rn?..C M N hand Street s� �r+ 3 Email address CCity`1 wn,C�State,ZIP m1 3 oil LIR (--11- e 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 Issuuance of the building permit. Signed Affidavit Attached? Yes tV/ No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT i.e.CONTRACTOR APPLIES FOR BUILD(IIN`G PERMIT( I,as Owner of the subject property,hereby authorize ytin,v,e)eficrf)e_, j l e` el. E } -erfe_i r0 to act on my behalf, in all matters relative to work authorized by this building permit application. Past T(mot `1 ( 'i coC*rac-t - 1212-)123 Print Own is Name SIGNATURE Date SECTION 7b: OWNER' OR AUTHORIZED AGENT(CONTRACTOR)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 m,knowledge and understanding. 1 tCha e_I Pe-re-t r a � �''`� t�I 2� 23 Print Owner's or Authorized Agent's(Contractor's)Name S NATURE 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.govIdps 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. Solar projects:Total#of Panels ,Total SF of Each.Panel , Total kW The Commonwealth of Massachusetts Department of Industrial Accidents �1 Office of Investigations Lafayette City Center 1�__ • 2 Avenue de Lafayette,Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses Applicant Information Please Ptptj.e>tibly Business/Organization Name: /cinhee Home T p(ou e I' n e nt" ITU C7 Address: 3 CI 30,56 rl O r City/State/Zip:(} (-free I I 7 DU/ Phone#: N/3 3 1. 5015C1 A - •u an employer?Check the appropriate box: Business Type(required): 1.► F I am a employer with I', employees(fa and/ 5, ❑Retail or part-time).' 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7, D Office and/or Sales(incL real estate,auto,etc.) employees working for me in any capacity. o workers' insurance 8. ❑Non-profit 3.0 We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.0 mazwfixtming no employees [No workers'comp.insurance requiredj•" 4.❑ We are a non-profit organization,staffed by volunteers, 1 l.❑Health Can with no employees. [No workers' comp.insurance req.] 12.@ Other f //�A�r/110.1.) *Any applicant that cheats box I t must*be fill out the section below shoving weir workers'compensation policy bttbantalon. "If the corpond°oMoms have exempted themselves,but the commotion has other emeto ens.a workers'ooeipmtion policy is rewired and such an argon should check hot 0 I. I am an employer that ts preview workers'compensation insurance fo employees. allow is the policy biformatbon. Insurance Company Name: I t I s , nU1C nC,e. enG Insurer's Address: —V 7 �kr &fe "� city/state/zip: Ch ; colIpe r n fl O C)►3 O Policy#or Self-ins. Lic.# WC —I Q po 7 Expiration Date: 10///o)1-L/ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under§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 S250.00 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 coverage verification. I do hereby cater under the d penabdes of perjury that the information provided above Is true and correct. Phone#: /-113, 3 y i. t Official acts oat,. Do not write hi thk area,to be completed by city or town official • City or Town: _Permit/License# Issuing Authority(check one): f 1Z]Board of Health 2.0 Building Department 3r]City/Town Clerk 4.❑Licensing Board SO Selectmen's Office 6.❑Other Contact Person: Phone#: www.mns.gov/dim /....411 YANKHOM-01 BROOKE ACORN CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) �� 9/28/228/2023 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 CONTACT Brooke Barre NAME: . Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,Eat):(413)594-5984 I(A/C,No):(413)592-8499 Chicopee,MA 01013 ADDRESS:brooke@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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI IMMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR S 2517693 10/1/2023 10/1/2024 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 7 POLICY n Fief [1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _ (Ea accident) $ X ANY AUTO A 9106918 10/1/2023 10/1/2024 BODILY INJURY(Per person) $ OWNED - SCHEDULED AUTOSRE� ONLY _ AUTOS BODILYBODILY INJURY(Per accident) _$ AUTOS ONLY AUTO ONLY (Per accideYrtDAMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE S 2517693 10/1/2023 10/1/2024 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ A WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE ER YIN WC 9099267 10/1/2023 10/1/2024 1,000,000 ANY OFFICER/MEMTOERR/PARTNER/EXEXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT $ (Mandatory 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 I LOCATIONS I 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 ,/Y 1'• I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • Commonwealth of Massachusetts j�F Division of Occupational Licensure r Board of Building Regulations and Standards Const zart yam` fS CS-066324 E 4pires:03/2812025 MICHAEL PEpEIRA )�,I PO BOX 1056.. WARREN MA'O1083. s Commissioner dry0, >i'. W rtatct. Page 1 of 10 ,,"* Yankee Home Improvement MA Lic#160584 p CT Lic#0673924 YANKEE 36 Justin Drive RI Lic#33382 v-..., Chicopee, MA 01022 413-341-5259 or 877-88-YANKEE www.yankeehome.com Customer Information Patty Tosswill (413) 563-2914 0 Date: 12/27/2023 111 Woods Rd patty.tosswill@gmail.com Rep: Daniel Richard Florence MA 01062 Replacement Work Details Replace and Dispose of Existing Tub Install Base Base Type Acrylic Shower Pan Single Threshold Base Color White Drain Location LH 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- 56 - 60" wide base Door Finish Brushed Nickle Glass Type Clear Shower and Bath Accessories Quantity 6 Accessory Single Tier Corner Shelf Color Santorini White Marble Grab Bar Grab Bar Quantity 2 Grab Bar Size 12" Finish Brilliance Stainless Linden Grab Bar Location Soap Dish Wall This space intentionally left blank Ieapiodigit<i.com 2.16.4 Page 2 of 10 Hardware Delta Fixture Selection . t:Fs.. Linden .. . In2ition "`*"`. Shower Head Trim Kit Finish Brilliance Stainless Temp Assure Valve? Yes, style only available , with temp adjust valve { f i Li 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. Scope of Work and Special Instructions One bar on dry wall vertically one bar on soap wall horizontally. Be careful of floors upstairs, make sure to put carpet down. Do Not Do We do not do any painting or staining. This space intentional!), Isaptodigital.com 2.16.4 Page 3 of 10 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 01/22/2024 Barring delay caused by circumstances beyond Contractor's control,the work will be completed by 02/19/2024 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) �T 6:7 --701, Patty Tosswill 12/27/2023 Date /e am 2.16.4 Page 9 of 10 Payment Schedule YHI agrees to perform the work,furnish the material and labor specified above for the total sum of: $18,048 Form of Payment Finance Deposit Amount $1,805 Deposit Type Credit Card Measure Payment $0 Start Payment $0 Progress Payment $0 Cash Due Upon Completion $16,243 Daniel Richard 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. Patty Tosswill 12/27/2023 Date This space intentionally left blank • leaptodigita.com 2.16.4