35-071 U."
7'.1
INSULATION�?
SIDING CO, INC.
56 FRANKLIN STREET EASTHAMPTON, MASSACHUSETTS 01027
EASTHAMPTON OFFICE: 527-0044 WESTFIELD OFFICE: 568-6411
(,(mtrii( tors license # lo i
Proposal Submitted to Phone Date
,
Donne iiervy "Purchaser" )3A- ".42 Octcuer 2, ?002
Strw Job Nome
892 Ryan Road 2- x EF 9 V/
Ci State and Zip Code Job Lotion
one
7 L"
iorenca, Pala. 01G(A) ?age i 2_ r
Contractor hereby submits to Purchaser specifications and estimates for; vlhy� I NOV
1. 'vie Will 41 nst,,d I thvJ `limy' -i cv� (xi al'.
—
and bravo oaue.
2. We wi 11 nai I al I si di ng approx. 111--24" on center—, ',IS i 11 iI;ri ft-U; tIc.i i l s so drv-,y wi I I rK)t rust mit-m-,al-n
the siding.
3. ti,ie wi I I i nstal I a 3/8" 4)IS1 i I-r, E
L
4. 14)aJ
NOV 1
'I'i ndovis i I vii I I L)o tr i v& �ii-, almdrim coil SWck $ 2002
u. 1, J (1) d(x)r CQil jal
vb(X trim a.r(md -=k L22
7. 1.,k)cc trim sof fi t arxi I1 .,fc' aluiioirui, cf,j I i nvl
rjBterial. Je I,,fifl (,,rill -)o-1 "'-x-"" �,,�:a
VTj 11 j)e COVCr,
4
6. 'D�xxl ,ake 'C UY 1"4
My cat: k i nq LI-tat rK-�ecis t�) i:�e doiv •11 Lx-, 6m-, vii t)I i I i C c,I K i•
r
10. Any existing ;lord tnat is loose v.�iIil be renii
11. Any exi,:tinq I-xxkt 1,rzl try Al !J !"
replacexc. h1is (j(z-s
I ie X1111 is (z) I(XV
13. Yje install (5) vinyl -)Jl J�-
J 11;A1,
x
A wil i inst4?,l 1 �Y' =111 cci-f-;Ors.
wi-H rc-nove arKj, re i ns tz ,x 1 s+i ri,-, s-!u r i;
tn-, nn VJ I I
7(its I'Ay 'r SI-
7, o4t�ij-
so Tri 7� j'I
d n(i yl nyl f 1 J i N*
18. job si to �-j 11 be clearK�,-! -:ofv, �%.lpl,2ti,)r
19. Vinyl sidit-ic, his 3 Li —-----
20. We will remve and reinstall existing gutters and downspouts.
PRICE:
i
� r
�tiM�
��_' ��P.a "�$�'
(I,
it
�I�
,._
O KliMfp�O
"•� GIN of Yort4anlvton ;
9 6 Ji Aso schnactls
R
DEPARTMENT OF BUILDDJ G INSPECTIONS
212 Main Street e Municipal Building
Northampton, Mass. 01060 v
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, ED LOSACANO, 34NER OF ALL STAR INSULATION & SIDING CO., INC.
s. (licensec/peru,;ttec)
with a principal place of business/residence at.
56 FRANKLIN STREET, EASTHAMPTON, MA (phone#) 413-527-0044
(strtxi/city/state/gip)
do hereby certify, under the pains and penalties of per}ury, that:
(X) I am an employer providing the following worker's compensation coverage for my ,
employees working on this job:
G UJC 33FS7 'F'1i3l03
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (insurance Compary/Policy Numbcr) (Expiration Date)
(Name of Contractor) (Insurance Compaiiy/Poticy Number) (Expiration Date)
s,
(Name of Contractor) (insumce Compauy/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(au*ch addibooal abed if neoesury to mchWo iaforma6oa pata=mg to all oowtaa.ora)
r)`
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be awaro that whilo homeowoers wbo employ prisons w do maia tame,omura loo or repair work on a dweAing of
1W mote than thine units in which the bomeownar rtadcs or oa the tern&tppvRanam thercto are not gw=Lty w-Worod to be
employees under the worker's coct=satica Am(GL152,ss 1(5)),AlTUcation by a hocnaowoer for a UCCMsa or PmLa may evidc=the
legal states of an amployor uadorthe Workars Compomation AcL
I underst=d that a oogy of this uatcmcai=y be for warddnd to Lb*Dope:tmcm of Icadusrial Aocideati Ofe0c of Imurwoe for the
covattge verific3um and that ai=to secure oowmp undcr so=oa 25 A of MGL 152 can Icad to the imposition of criminal penalties
oomistiag of a fine of up to S 1,300.00 and/or iwpriso� of up w one year and 6 v peaatt cs is the form of a Stop Work Order anti a
ftao of 5100.00 a day agb.=Me.
For departmeaw wo only
/ Permit Number
Maps# Lot#
igaaaut of Li ermittee `
ALA
�V.. 3
S
t . ,
t1_;-4t �s JS( tit I , . '. , ,�',�� r^'•,
, m q
5 " i� 4NS"TRl19TJON"' VICES y {
1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder;
Llcenj9 Number !
Address Expiration Date
Slgnaturo'` w Telephone
Not Applicable ❑
} } 7", � Registration Number�/')ry(�/
Address,:, Expiration Date ,
Telephone
SECTION 10•WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G1, 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 o the building permit,
Signed Affidavit Attached Yes.,.,,., No....,. ❑
j„
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
its 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
gn{�
, r
r , ,
�Y
`.CTIgN 5. DESCRIPTION 0 PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding Dq Other [ ]
Brief Description of Proposed Work: �16)(O—U alN�l SidtA)(?-
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 r Renovating unfinished basement Yes No
Plans Attached Roil o • Sheet D
flW6 id.,or.`addition to.existing housing, complete:,the foliowtn;x:
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. Mascheck Energy Compliance form attached?
Type of construction
i, is construction within 100 ft. of wetlands? Yes No. is construction within 100 yr. fioodplain 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
l , as Owner of the subject property
hereby authorize to act or
my behalf, inYall matters relative to work authorized by this building permit application.
Signature of Owner Date
' Wxn/ ,6 oSAe1+A10 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 upAer the pains and alties of perjury,
Print Name
Signature of Owner/Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front y
L: R: L: R:
$�I
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW ✓ YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES NO t/
IF YES, describe size, type and location:
D. Ar
N o eXhere any proposed changes to or additions of signs intended for the property ?YES
N 11//
IF YES, describe size, type and location:
rthampton
ridR'.bepartment
In- ---2-112i Moin Street
R,opm 100
DE_-C 10 Nbilha��o€n, MA 01060
phone 413-58T, 124 Fax 413.587.1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
r
S RT QM' , SITE INFORMATION 777
1.1 Property Address, This $eiIlia
c t�IP�glrlY
.. ��ry a» 1�` r a t� .^�}4�{:r iT•'
Map ,
x
qry Wd- #
Zone ,,QV��r},�ykU�str.►ct
Ts r'.
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record-
Name(Print) Currgat14aZ dr�
Telephone � �/
Signature ��-
2.2 Authorized Artent:
,Sr
FN j
�C s,I ""alE Cl `Cut
Nam Print) F rif;'_ ^`u�l Mfg O'iOZurrent Mailing Address;
G � /1 (4,i 527-0044
Si ature Telephone
SECTION 3 ESTIMATED CONS UCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by ermlt applicant
1. Building 3 (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) Check Number S'
This Section For Official Use Only
Building Permit Number: Date issued;
Signature:
Building Commissioner/Inspector of Buildings Date
� a
i BP-2003-0562
GIS#: COMMONWEALTH OF MASSACHUSETTS
V CITY OF NORTHAMPTON
,..
Lot:-001
Permit: Buildinl?
Category: BUILDING PERMIT
Permit# BP-2003-0562
Project# JS-2003.0925
Est.Cost: $4583.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: All Star Insulation & Siding Co Inc 101858
Lot Size(sq. ft.): 19994.04 Owner: HENRY DOREEN&MARJORIE FRANK
Zoning: SR Applicant: All Star Insulation & Siding Co Inc
AT: 892 RYAN RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413)527-0044 Workers
Compensation
EASTHAMPTONMA01027 ISSUED ON:12110102 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL VINYL 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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 12/10/02 0:00:00 27907 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo