35-118 • ••
sot1AMPl. _
4::) $ , . if Er rd Northampton 1— — *- /,
$ �+� � , � "Massachusetts =&�
221
`" " "= DEPARTMENT OF BUILDING INSPECTIONS , = = i— /
INSPECTOR 212 Main Street • Municipal Building
Northampton, MA 01060 ,~ say
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his /her construction s pc:.•isor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he /she resides or intends to be, a one or two fame -
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."
The building department for the City of Northampton wants any person(s) who seek to
use the, home owner exemption, to act as their on construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation /footings (before backfill)
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection.: The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
I, understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
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+ `�, r y (L ti r �cal:t um)1ptoil •
i e E �i.7•krhasrtta =
DEPARTMENT OR IIUILDr C INSPECTIONS
212 Main Street • Municipal Building
Northampton, Mass. 01060 . r' `
WORKER'S CON'C ENSN1iO.N ft SURANC_r AF TITM,Vf'
•
I I, All Star Insulation &Siding Co., Inc.
(li ccnsaJ perini tics)
��.�t1i principal place of business/residence at:
56 Franklin Street - Easthampton, MA 01027 (phooe0 413 -527 -0044
(st1_UcitJ /s- Latta p)
do hereby certify, under the pains and penalties of perjury, that
(x) I am an employer providing the following wworkcr's compensation coverage for my
1 employees worldng on this job:
Q9k f �[ ZZ �T 15
( 11 -:ice Coop v) (Policy No r) (Ex p irvon DL)
1 •
i
( ) I am a sole proprietor, general contractor or homeowvoer (cicle one) and have hised
the contractors listed below who have the following worker's compen sation policies:
(ilsme of Contractor) (Insuranc:c Coinparry Potici NUMIX.r) C.': imuon Date)
(Name of Conoaor) (insurance CompaaviPo!ic; Nw b-er) C »i radon Date)
•
(Name of Courracro,) (Insurance Company/Policy Ntui bu) (EXpir.:tien Date)
-
(Nzmc of Contractor) (Insuranca Company/Policy Numb (Expiration Dale)
(attach sd•!iz elcc.tfncecm.l• to inc+& inform. ioa pctrinin6 to .11 coos -rte:- )
( ) I am a sole proprietor and have no one worhdng for me.
( ) I am.a home owner performing all the work myself.
NOTE: pl-- be eorare the! while h000nowocra .ibo cam lay pc-Loos co do motes•onr., rrarr wort oo . dwcialz of
to mocc th a `Sr_ tmrj in which the bomooM1wa raid.= o- oo the p zpp t • n t re c oo( C-a i1y o-^c:d. --si to be
citployes untie the t txkets m�- v --.,. Act (GUI 5 Zsn 1(5)), _pplucAoo by a bomwam fora hccnne oc pcmi1 ray m-id oce the
Icgal rt .^=, of en en;rloyor under drip Workoet C c pom.. ioa Ate_
1 undcsr.ad th.d . cop of thi, mtcmmr m...y b foc,- d.d to tho pcp.jtmrced or1 •• •ic1 Atcidcati OILoo of inv..r".000 for th.
coversc vjf aiioa and °I_1 L-iltat to secure tovcrase t o 1 wa,ion 25A of MCI 151 can lead to the inctpositioa of cialioal P""
cocci `i p of a floe o(up to S1 500.00 .ndlor irmsris.00meai of up to ooc yt3r e.od cri) pm.ltia is on form of. stop Work Ord'" and •
fjm of 5100.00 . d_y •puns( ax
For dcp.rtmf- 11 u,c only - - -• — .
/ Pcrmit Numlxs
if /%!! - 17-:+/-10 Map :" Lots
Si Amur, of Licaism/Pernuucc Date
VI,- 1 INV, JJL. 1.V 1,41111,11 11,14,1141 4.411a, 417,1 , ..,a - mq,”••■■••• •• • - _
$9,852.00 d ($ wn, clic/1)c, Due Upon Goinpletton),
50 Do - e
payment due upon receipt of invoice.
If payment late, interest at 1 1/2% may be added. of Job ,
NOTE: This proposal may be withdrawn by us if not accepted within THIRTY days.
Ed Losacano, Owner
Contractor Salesman
Lea GIFO15en , Acceptance by Purchaser, and Title
"You may cancel this agreement if it has been consummated by a party thereto at a place other than an address of the
seller, which may be his main office or a branch thereof, provided you notify the seller in writing at his main office or
branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day
following the signing of this agreement.
See the attached notice of cancellation form for an explanation of this right!'
SUBJECT TO TERMS AND CONDITIONS PRINTED ON REVERSE SIDE
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•` �• � r. N DEC - 9 2010 M t ; INSLJITION CK= I t3
SIDING CO., INC. 6S00
EASTHAMPTON OFFICE 413-527 -0044 CSL License #CS SL 99739 WESTFIELD OFFICE 413 -568 -641 1
56 FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 • FAX: 413 -527 -1222
Proposal Submitted to Phone Date
Lea Grippen "Purchaser" 413 - 727 -8732 Home 11/23/10
Street Job Name
49 Drewsen Drive �<
City, State and Zip Code Job Location Job Phone
Florence, MA 01062
Contractor hereby submits to Purchaser specifications and estimates for : INSTALLATION OF VINYL SIDING
MAIN HOUSE & GARAGE
�_. We will remove xiisting Vinyl Siding from exterior walls and dispose of in a dumpster supplied by us.
2. We will install new Vinyl Siding on all exterior walls. Homeowner will have choice of color. style and brand name.
3. We will nail all siding approximately 16 -24" on center using aluminum nails so they will not rust underneath the siding.
4. We will install a 3/8" insulated Styrofoam hacker hehind the siding.
5. Wood trim around (13) windows will be covered with White aluminum coil stock material.
6. Windowsills will he trimmed otit with White all coil stock material.
7. Wood trim around (3) doors will he covered with White aluminum coil stock material.
8. Wood trim soffit and fascia will be covered with White aluminum coil stock and perforated White vinyl soffit material. We will
drill out wood soffit areas to increase attic ventilation.
9. Wood rake fascia will he covered with White aluminum coil stock material.
10. Any caulking that needs to he done will he done with Silicone Caulking;
11. Any existing wood that is loose will be renailed.
12. Any existing wood that is deteriorated which needs to he replaced so that we can perform our work will he replaced.
This does not include any structural or dimensional lumber or sub sheathing.
• ,' - A ► � - - • • • - m'1• •• -
14. We will install (1) Whit drvor vent in de.at"d area.
X
15. We will install W6ite Mastic Fluted or`rWhite Traditional corner 'hosts on all corners. F
• I - - i m • - . Y • - • • • • • . . , 1 • • • .111 •• L I Si .11 1 . i •. i - . • I • " :- • - i • .0 -
alliminum gutters and downspouts where now existing using the hanger or T -Rar method of installation. There will he
approximatew (126)' of gutter and (48)' of downspouts with (4) drops.
17. We will remove and dispose of (14) pairs of existing shutters and install O "nevi pairs 'of heavy dufy vinyl "Girardin" shutters.
1 01
Homeowner will have choice of color and style,
18, We will remove and reinstall (1) Rear Roll -up Deck canopy.
19 Wood trim around Garage Door & Front Picture Window will he covered with White aluminum coil stock material.
21 lob site will he cleaned Lj c
on omoletion of job. + .
22. Vinyl Siding has a "Marnlfacturer's Lifetime Warranty ".
NOTF• Approximate start date will he December less any inclement weather `' '
PRICF: $9.852.00
CONTINl1FD
_ a • - • . a _tea , h ,.+ ., ornnrei ahnvp sneeifications -for the sum of:
/HAMPTON OFFICE �,• INS n A'j` T + ' W1E STFIELD OFFICE
413-527-0044 �' IJI�C 11 1 j� 41A-568-6411
idSz—
SIDING CO., INC.
Contractors License #101858
56 ,FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 • FAX: ` 413- 527 -1222
Proposal Submitted to Phone Date
Lea Grippen "Purchaser" 413 727 - 8732 Home 11/23/10
Street Job Name
49 Drewsen Drive
City, State and Zip Code w< Job Location Job Phone
Florence, MA 01062
Contractor hereby submits to Purchaser specifications and estimates for : INSTALLATION OF VINYL SIDING
MAIN HOUSE & GARAGE
** NO PRODIJCT& I AROR WARRANTIFS WII L RF ISSIIFD IJNTIL WF RFCEIVF FINAL PAYMFNT.
** HOMFOWNFR WII L RF RFSPONSIRLF FOR ANY FFFS RFQUIRFD FOR RINl DING PFRMITS.
** HOMFOWNFR WILL RF RFSPONSIBLF FOR ANY & Al L Fl FCTRICAI OR P1 (IMBING FFES THAT MAY BF NFFC)ED.
** Al 1 STAR . SFAMI FSS Gl1TTFRS IS NOT RFSPONSIRI F FOR WATER I EAKING BFTWEFN FASCIA BOARD AND GI ITTFR DLJF
TO IMPROPFRI Y INSTAI I Fr) DRIP EDGF.
** SFAMI ESS ALI IMINIIM GIJTTFRS AND DOWNSPOIITS HAVF A "20 -YFAR MANUFACTIIRFR'S LIMITED WARRANTY ". I ABOR
IS GIIARANTFFD FOR "1- YFAR ". IGF DAMAGE IS NOT COVFRED (JNDFR MATFRIAL OR TABOR WARRANTY.
** ALL STAR SFAMI FSS (;TITTERS WII L NOT RF RFSPONSIBLE FOR REMOVING OR REINSTALI ING HEATING CABLES IF
FXISTING.
** DQWNSPOtITS WILI RF INSTAL! FD APPROXIMATFI Y G" 12" FROJVI THE GROI IND.
** A CFRTIFICATF OF INSI TRANCE FOR WORKMAN'S COMPENSATION AND LIABII ITY WII L BF FORWARDED UPON RFQIIEST.
** T.P. DAI FY INSIIRANCF AGFNCY ()F WFST SPRINGFIELD. MA IS Ot IR AGFNT.
WE PROPOSE to furnish material and labor, complete in accordance With above specifications, for the sum of:
_ $9,852.00 dollars ($ °A Down, Balance Due Upon Completion), payment due uponsreceipt of invoice.
If payment interest at 1 1/2% may be added. of ,Job : ' r t,;
NOTE: This proposal may withdrawn by us if not accepted within THIRTY days.
Ed Losacano, Owner
r Contractor Salesman
Leanppen Acceptance by Purchaser, and Title
"You may cancel this agreement if it has been consummated by a party thereto at a place other than an address of the
seller, which may be his _main office or a branch thereof, provided you notify the seller in writing at his main office or
branch by ordinarymali posted, by telegram sent or by delivery, not later than midnight of the third business day
following the signing of this agreement.
See the attached notice of cancellation form for an explanation of this right:'
SUBJECT TO TERMS AND CONDITIONS PRINTED ON REVERSE SIDE
SECTION 8 - 'CONSTRUCTION SERVICES 1 •
8.1 Licensed Construction Supervisor: N ot Applicable ❑
Name of License Holder : Edwin Losacano CS SL 99739
License Number
128 Glendale Road - Southampton, MA 01073 to 1 Z__
Addr / Expiration Date
t'r _— (413) 527 -0044
Signatu - Telephone
9112e itir a Hord:Ndii ovementttiintracto : ilk el F. - ,w,,,,,,,, ,, v;,, Not Applicable ❑
All Star Insulation & Sidin Co., Inc. DV jF)S
Company Name Registration 1Tumber -- --
56 Franklin Street CO61 ?
Address Expiration Date
Easthanpton, MA 01027 Telephone 413 -527 -0044
SECTION 10= WORKERS' COMPENSATION INSURANCE AFFIDAVIT "(M.0 L: a. 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
?AC
No ❑
1 '1 . _.� er tempiro
The current exemption for "homeowners" was extended to include Owner occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
- as supervisor. CMR 780. Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own 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 homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
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SECTION 5- DESCRIPTION OF. PROPOSED WORK (check all applicable)
New House [] Addition 0 . Replacement Windows Alteration(s) n Roofing n
Or Doors CI
Accessory Bldg. D Demolition n New Signs [O] Decks [Q Sidind7 Other [D]
Brief Description f Pro�e
os�� i - •�
Work: r:
n � \ si / t
�`
Alteration of existing bedroom Yes No Adding new bedrooffi Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
"*� y -.w.. '"4"°..F -" ,r a + +. .r:,;, n ."•f.--:.r. °y^..;..:.
Ola It�Na horse- andbilikriteo:�r id- inq=,hOusir ci,..cdmptetethe:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? —
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank_ City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT, OR CONTRACTOR APPLIES FOR BUILDING PERMIT
, as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, All Star Insulation & Siding Co., Inca , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
d • . .i• 1„u- • - .4 -i
Print Name
� .s,�,� j 2- IS- ID i
Signature of i' nerlAgent Date
Section 4. ZONING All Informatioh Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
(' _ _ W
Lot Size
Frontage H i ' I
Setbacks Front
Side L:i ; R:.- L:' i R: _ ,_
Rear
Building Height , ; _ __ __
Bldg. Square Footage t i i% f I 1 i
Open Space Footage %
(Lot area minus bldg & paved I i i _ I______ I
( I !
parking)
# of Parking Spaces - --- '
Fill: , — ----- ---------.___----
(volume & Location) ----- — — ----
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DON'T KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW Q YES 0
IF YES: enter Book Page; ; and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES (2)
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained
0 , Date Issued:
C. Do any signs exist on the property? YES Q NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q
IF YES, describe size, type and location: 1
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O r NO Q
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
e=a `� Deparfinenl use onl}rss ��
City of Northampton S erntv�
*Mgt:
Building Department CdrbCu ® vevra r � F � gf
`;,l, 212 Main Street Sevue e c ai aba6ty xv 3 }
,�
Room 100 Wa er a 4 i0E4f.it
Northampton; MA 01060 T —. e r c urafPtans t
phone 413- 587 -1240 Fax 413- 587 -1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Pro ert Address: • This;section to be coo, pleted by office
� �s
�Map Lat Untt
Zone Dverfay District
q9
Elm St. District C &Distract ..
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED`AGENT
2.1 Owner of Record:
l Qo� C c Li/ ' (vizzatc - )
Name (Print) Current Mailing Address:
Telephone
Signature
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2.2 Authorized Agent:
All Star Insulation & Siding Co., Tnc. 56 Franklin Street - Easthampton, MA 01027
Name (Pri ) Current Mailing Address:
(e2 413 -527 -0044
Signatur Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total= (1 +2 +3 +4 +5) 5 i Check Number 371 35
This Section For Official Use Only
Building Permit Number. IIsssued:
Signature: !'
Building Commissioner /Inspector of Buildings Date
BP- 2011 -0633
GIS #: COMMONWEALTH OF MASSACHUSETTS
35 118 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2011 -0633
Project # JS- 2011- 001021
Est. Cost: $9852.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sq. ft.): 10018.80 Owner: GRIPPEN LEA
Zoning: SR(100) / /WSP II Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 49 DREWSEN DR
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527 -0044 Workers
Compensation
EASTHAMPTONMAO1027 ISSUED ON:1/13/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: I NSTALL SIDING
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 1/13/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner