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42-106 1024 WESTHAMPTON RD BP-2017-0018 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:42 - 106 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit 14 BP-2017-0018 Project# JS-2017-000033 Est.Cost:$4852.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 069281 Lot Size(sq. ft.): 32582.88 Owner: SANBORN CHRISTINE E Zonino: Applicant: ALL STAR INSULATION & SIDING CO INC AT: 1024 WESTHAMPTON RD Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON::7/8/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE 1 LAYER AND INSTALL NEW ROOF 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: OI: 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 7/8/2016 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner -- The Commonwealth of Massachusetts _ X Board of Building Regulations and Standards FOR i Massachusetts State Building Code,780 CMR MUSE CIPAL[TY Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only P 311Dding Permit Number: Date Applied: -I nz L �Binding Official(Print Name) Signature Date SECTION I:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 1024 Westhampton Rd,Florence.MA I.1a 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 R) Frontage(R) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (MGI.c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Lone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' N., 2.1 Owner'of Record: p Christine Sanborn Florence.MA 01062 Name(Print) City,State.ZIP 1024 Westhampton Road 413-586-1156 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work: REMOVE 1 LAYER AND INSTALL NEW ROOF SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only I.Building $ I. 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 Suppression) Total All FI�s: 6.Total Project Cost: $ 4,852.00 Check No.4 ]heck Amo O Cash Amount: 0 Paid in Full 0 Outstanding Balance Due: • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL -099739 2-14-18 Ed Losacano _-_.--_ -- -----__-_._e. License Number Expiration Date Name of C51 I folder R 128 Glendale Road List CM, rypu(see boom No.and street Type Description Southampton, MA 01073 Unrestricted(Buildings up to 35,000 ea,n.) ---- --- - - _ R Restricted I&t Family Dwelling Cit 'lown.State.ZIP NI hlasonn. RC Roofing Covering -- ---- — ----- ------ -- I \\'S Window.and Siding SI- Solid Fuel Burning Appliances 413-527-0044 allstar561@verizon.net I Insulation rclephmm Email address n Demolition 5.2 Registered Home Improvement Contractor(111C) All Star Insulation & Siding Co. INC 101858 6-29-18 - -- ilk'RegistrationN tabu Expiration Date IbbI-r nklhnnablreeC Registrant Came _ ._ allslar561@verizon.net Nm and Street Email address Easthampton, MA 01027 413-527-0044 _ ---- Citv/l own.State.ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c152.§ 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 (2w ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I.as Owner of the subject property.hereby authorize Ed Losacano to act on my behalf, in all matters relative to work authorized by this building permit application. Christine Sanborn jep j J2hc - 6-3e - /,$ Prim(Tanen_,Nano(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering ow name below. 1 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. Ed Losacano � S/ Y 9 _7_ _ Print Owner'sAuthorized Name 11etronie signature) Date NOTES: I. 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 IHIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HR'Program can be found at www mass. to•oca Information on the Construction Supervisor License can be found at www.mass.gov:dos 2. When substantial work is planned.provide the information below: Total floor area(sq.Pa (including garage, finished btssement/atties,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" The Commonwealth of Massachusetts Department of Industrial Accidents N= f/ ='W!__: Office of Investigations F -'` 600 Washington Street =`flit= 3 Boston,MA 02111 1 .1, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): All Star Insulation & Siding Co., Inc. Address: 56 Franklin Street City/State/Zip: Easthampton, MA 01027 Phone #: 413-527-0044 Are you an employer?Check the appropriate box: Type of project(required): L I23 I am a employer with 10 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- These on the attached sheet. 7. ❑ Remodeling shipand have no employees These sub-contractors have g ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. [No workers' right of exemption per MGL Y comp. 12.❑ Roof repairs insurance required.]` e. 152, §7(4),and we have no employees. [No workers' 13.0 Other_ comp. insurance required.] *Any applicant that checks box d l must also fill out the section below showing their workers compensation policy information. Homeowners who submit this affidavit indicating they arc doing all work and then him outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employerslithe sub-contractors have employees,they must pros ide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Star Insurance Policy#or Self-ins. Lic.#: WC0681114 Expiration Date: 08/13/16 Job Site Address: 1024 Westhampton Road City/State/Zip: Florence, MA 01062 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 coverage verification. I do hereby certifyer'' under the pains and penalties of perjury that the information provided above is true and correct Signature: c( y/ Date: 7—f'��P Phone#: 413-337-0044 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): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: • • • . cS a 7=...„11[,,±E I11 ' Office of Consumer Affairs and Business Regulation Y i . j 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 101858 Type: Private Corporation Expiration: 6/29/2018 Tru 419291 ALL STAR INSULATION & SIDING CO . Edwin Losacano 56 Franklin Street Easthampton, MA 01027 Update Address and return card.Mark reason for change. steal o 201A-05/110 Address 0 Renewal 0 Employment 0 Lost Card r 14e in.....n,.ww///./c./G.JJn h urth Office of Consumer Attain&Business Regulation License or registration valid for individual use only it ROME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 101858 Type: Office of Consumer Affairs and Business Regulation Expiration: 8/29/2018 Private ComoratIon 10 Park Plaza-Suite 5170 Boston,MA 02116 ALL STAR INSULATION&SIDING CO. Edwin Losacano A 58 Franklin Street w..__ Easthampton,MA 01027 Undersecretary Not valid with.i' • stare Massachusetts Department at Public Safely Board at Building Regulations and Standards License',C88L499TE9 Construction Supervisor Specialty EOW7N W.LOSAGANO 170 OLENDAIE ROAD SOUTHAMPTONMA 01073 S. I 1 ' 1^M CA- Expiration: g; Commissioner 02114g010 • UWi W Client#: 13250 ALLST ACORD., CERTIFICATE OF LIABILITY INSURANCE 0ATE(MMIDO Y1 09/04/2015 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. certificate_.. _- - ted terms an:Ii the sft holder y,en ADDITIONAL yUREDr the policy(ies)drm must A be endorsed. on tis SUBROGATION IS WAIVED,subjecthtto to thetermsand conditionsofsuchpolicy,certain policies may require an endorsement As[afement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:ME' Jane Eitel T.P.Daley insurance Agency,IncE-MAIx Eat,413 788-0971 FAX No 413 739-2645 1361 Westfield St. eauL • 1- --_ P.O.Box 1150 ADDRESS: laneeitel@tpdaleyinsuroG COVERAGE West Springfield,MA 01090 sIInsuraIAFFonDlxccovE_RADE nAlce INSURER A:Peerless Insurance INSURED INSURER e:Star Insurance Company All Star Insulation&Siding Co.,lnc. INSURER c. 56 Franklin Street _----- - -- _ Easthampton, MA 01027INSURER D: 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 MTH 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 SUBR - -- - POLICY EFF i POLICY EXP LTR TYPE OF INSURANCE INSR WVO_.. POLICY NUMBER IMMIDDIVYYY I(MMODMVVV UNITS A GENERAL LIARNTV CBP8052996 08113/2015,08/13/2016 EACH OCCURRENCE x1,000,000 - Eo Xi COMMERCIAL GENERAL._IASILITY RmaQEon°„GEIsiDD,DDD CLAIMS-MADF X OCCUR MED EXP(Any one person., 55,000 PERSONAL a AOV INJURY .lo$1,_000,000 GENERAL AGGREGATE 52,000,000 GENGENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $2,000,000 E dEEDD SINGLE LIMIT I POLICY X .7EGT I' $ — AN CANED 'SCHEDULED 08/13/2016 GO I5 :cc A AUTOMOBILE LIABILITY BA8054496 08113/2015 ANY AUTO BODILY INJURY Pe.person/ $100,000 AUTOS �X AOTos BODILYINJURY lPeraw nL,I$300,000 O NvmED PROPERTYDAMAGE HIRED AUTOS ,X AUTOS P.scadenll I$100,000 UMBRELLA UAB OCCUR EACH OCCURRENCE i$ EXCESS JAB CLAIMS-MADE AGGREGATE_ _ $ BANo MPsovsaS UAR1UTr WORKERCOMPENSATION WC0661114 08/13/2015108/13/2016 X__Tosy Limrus DTH OFYPROPRIETORIPARTNER/EXECUTIVEI[YIN EACH 00,000 FICERIMEMBER EXCLUDED' I EL ACCIDENT SiN A . . (Mandatory in mil E.L DISEASE-EA EMPLOYEE 5100;000_ II yes desmbe under DESCRIPTION OF OPERATIONS below EI.DISEASE.POLICY LIMIT 6500,000 DESCRIPTION OF OPERAPONS I LOCATIONS I VEHICLES(Anach ACORD 101,Additional Remarks Schedule.it more space IIs required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation Siding Co. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 56 Franklin Street ACCORDANCE WITH THE POLICY PROVISIONS. Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE >X-G'e,,, 7.a,t/cy ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #5123221/M123220 JXE 619,-ria 5� Wlh�41 \-- at ��G�l.+���� ��� t kc �. w� c / �!t ,Jet- \to ✓ \'� INSULATION G Easthampton Office & Westfield Office • INC.413-527-0044 SIDING CO., I 413-568-6411 CSL License MCS SL99739 www.sidingandroofingwesternma.corn 56 Franklin Street • Easthampton, MA 01027 • fax 413-527-1222 • emaihallstar561@verizon.net Proposal Submitted to Phone Date Christine Sanborn "purchaser"413-586-1156-H June 22, 2016 Street Job Name 1024 Westhampton Road City,State and Zip Code Job Location Job Phone Florence, MA 01062 MA HIC REG#101858 Contractor hereby submits to Purchaser specifications and estimates for INSTALLATION OF A NEW ROOF ONION 1 INSTALL NEW ROOF ON MAIN HOUSE 1 We will remove(11 layer of existing asphalt shingles and dispose of in a dumnster sunnlied by is 2 We will install Titanium Rhino Deck or Eeohant Skin underleyment over entire stripped roof surface 3 We will install new CertainTeed I andmark Owens Corning or Gaf/Elk Timberline Architect shingles They will have a"Manufacturer's I ifetime Limited Warranty" Owner will have choice of color 4 All shingles will he nailed with atleastf 51 nails per shingle 5 We will install new aluminum tin edge on all eves and new aluminum rake edge on rake areas We will 6 We will install aooroximately (361' of roll vent on peak of roof for additional ventilation 7 We will install a 36"wide asphalt ice and water barrier on eave lines/valleys of heated areas PRICF•S4 852 00 FOPTION RONT R I AR R� W 1 AREAS I E Ca (F F'IpORCf3FRONT PORCH— VERMANQ BATHROOM AND 1 We will install new CertainTeed Landmark Owens Corning or Gaf/Elk Timberline Architect shingles over existing roof They MI/ have a"Manufacturer's ) ifetime Limited Warranty" Owner will have choice of color 3 We will install new aluminum drip edge on all eves and new aluminum rake edge nn rake areas 1 - . '• . .- ..• -nu- - -• ass . r- - .--r-• " IF ANY SUB SHEATHING IS NEFDED THERE MI L BE AN ADDITIONAL CHARGE OF S38 PER SHEET TO RFMOVE_DISPOSE OF AND INSTAI L NEW 7/16 STRAND BOARD-Skil?, SHEATHING **APPROXIMATE START DATE WILL BEJ AUGUST ONCE WE RECEIVE DEPOSIT AND SIGNED CONTRACT LESS ANY iNCLEMFNT WFHER S-A-Ch.le17 i ., Al L STAR WILL SECURE BUII DING PER F NEEDED HOMEOWNER WII I BE RESPONSIBI E FOR ANY &ALL FEES REQUIRED_ -------- "ALL STAR IS NOT RFSPONCIRL F FOR ANY[FAKS THAT O LIR IN XI TIN SKY IGHT(IF APPI (CABLE) CONTINIIFD ON PAGE 2 qLL� /UWE PROPOSE to furnish material and labor,complete in accordance with above specifications,for the sum of 41L_IIS6J 00 dollars($ 1/3 DOWN, 1/3 AT START OF JOB, ), payment due upon receipt of invoice. If payment late, interest at 1 1/2% may be added. BALANCE DUE COMPLETION OF JOB NOTE.Thjs$roposal may be withdrawn by us if not accepted within _—.. THIRTY days. // ED LOSACANO, OWNER Contredor Salesman ChrTsfineSan�orn - I.l,3.ar Acceptancey 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