35-223 (7) 42 LADYSLIPPER LN BP-2019-0599
QIS#: COMMONWEALTH OF MASSACHUSETTS
Mao:Bl Sk: 35-223 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category:ROOF BUILDING PERMIT
Permit# BP-2019-0599
Project# JS-2019-000967
Fit.Cost: $13982.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
cons . lass• Contractor: License:
sGoo_ ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sa.ft.): 58370.40 Owner., DUQUETTE CLAME D&ANN
nin Applicant: ALL STAR INSULATION & SIDING CO INC
AT. 42 L6DYSLIPPER LN
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON:11/14/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
POST THIS CARD SO IT IS VISIBLE FROM TH,,,E 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!enadiint Fireplace/Chimney:
Rough: 2,11: 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 Qqcugancy §iggature:
Feer Date ai • Amo
Building 11/14/201$0:00:00 $40.00
212 Main Street,Phone(413)5874240,Fax:(413)5$74272
Louis Hasbrouck Building Commissioner
The Commonwealth of Massachusetts
°v Board of Building Regulations and Standards FOR
MUNICIPALITY
o Massachusetts State Building Code,780 CMR USE
D c Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
6 - One-or Two-Family Dwelling
"" This Section For Official Use Only
v Build rmit Number: I Date Applied:
IRm
00
rl� t3�l�
ED Building ficial(Print Name) Signature —�— Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
42 Ladyslipner Lane 3K ;?aI j
1.1 a Is this an accepted street?yes no Map Number Parcel Number
13 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❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Claude and Ann Duquette Northampton,MA 01060
Name(Print) City,State,ZIP
42 Ladyslipper Lane 413-586-9821 Home
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORI O(check all that apply)
New Construction❑ Existing Building INOwner-Occupied IN Repairs(s) ❑ Alteration(s) N Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work2: We will strip(2)layers of existing shingles and install new architectural
shingles with new ridge vent and ice and water barrier of all heated areas.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined:
2 Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fee��sll,,d$
CheckNoq%dI 90hock Amount: Cash Amount:
6.Total Project Cost: $ 13,982.00 13 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-20
Ed Losacano License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) R
128 Glendale Road
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
Southampton,MA 01073 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and biding
SF Solid Fuel Burning Appliances
413-527-0044 allstar5270044@gmail.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
101858 6-28-20
All Star Insulation&Sidina Co.,Inc. HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
56 Franklin Street allstar5270044@gmail.com
No.and Street Email address
Easthampton,MA 01027 413-527-0044
Ci /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...........0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize Ed Losacano
to act on my behalf,in all matters relative to work authorize y this building permit application.
Claude and Ann Duquette,Owne ,: `9 ,2cDl
Print Owner's Name(Electronic SignatureDate
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under pains and penalties of perjury that all of the information
contained in this application is true and accurate the best of my knowledge and understanding.
Ed Losacano,Owner /1-79 71 '
Print Owner's or Authorized Agent's am ctronic Signature) 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
«-%N'%v.masS.eovioca Information on the Construction Supervisor License can be found at wutiv.tnassxovidns
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,fmished 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 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: i TUB
The debris will be transported by: SA -
�
The debris will be received by: 1k.).o, Yn,. gCAA Qi nn 1 i 1 y-oJy m I'm 010%,5
Building permit number:
Name of Permit Applicant LananC)-Rit ' av-lMdo-`Wont8idinq (1-1`x.
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
k9i www.mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
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):
1.[21 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. EJ New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ 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 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.❑Other
comp. insurance required.]
*Any applicant that checks box#1 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.
: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
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: THE TRAVELERS INSURANCE COMPANIES
Policy#or Self-ins. Lic.#: 6HUB-8H26302-8-18 Expiration Date: 08/13/19
Job Site Address: a City/State/Zip: ���
, U
Attach a copy of the workers'cbJpensation policy declaration page(showing the policy number and ex iration 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 certify under the pains andpenalties ofperjury that the information provided above isl true and correct,
Si ature• &- Zjcj4- /� r-` Date:
Phone#: 413-527-0044
Oficial use only. Do not write in this area,to be completed by city or town oftwi laL
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#:
Client#:13250 ALLST
DATE(MMIDD/YYM
ACORD. CERTIFICATE OF LIABILITY INSURANCE 8/22/2018
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(les)must 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 co"ACT Ryan Daley
T.P.Daley Insurance Agcy,Inc PNONE Edi.413 788-0971 AIO,,,e:413 739-2645
1381 Westfield St. E-MAIL andale ale insurance.com
ADDRESS: rY YCtpd Y
P.O.Box 1150
INSURERS)AFFORDING COVERAGE NAIL i
West Springfield,MA 01090 INSURER A-VW d—Anterlmnr..C..
INSURED RMIJER B:Ohio casuslb Ins.co.
All Star Insulation&Siding Co.,lnc.
USURER C:TwvMrs Co of Mrriu
56 Franklin Street
N18UREft D
Easthampton,MA 01027
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 CONTRACTOR 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.
LTR TYPE OF INSURANCE U POLICY NUMBER POLICY EFF POLICY EXP LIMITS
A GENERAL LIABILITY BKS1957957626 8113/2018 08113/201 -EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea om enoe $100,000
CLAIMS-MADE EXOCCUR MED EXP(Any one person) $15,000
PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE 62,000,000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 32,000,000
POLICY X PRO LOC $
B AUTOMOBILE LIABILITY BAO1957957626 8113/2018 08/13/201 (EaBINEnUtSINGLE LIMIT
ANY AUTO
BODILY INJURY(Per person) $100,000
ALL OWNEDX SCHEDULED BODILY INJURY(Per accident) $3009000
AUTOS AUTOS
X HIRED AUTOS X NON—O ED PROPERTY� GE $100,000
AUTOS (Per aooden $
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED RETENTIONS $
C WORKERS COMPENSATION 6HUB8H263O2818 DI&MV2018 0811312019 X I n STATU OTH
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT $100,000
OFFICER/MEMBEREXCLUDED? N/A
(MarWaLory In NH) E.L.DISEASE-EA EMPLOYEE $100,000
It yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,AddMonal Remarks Sdredule,I more specs is regdred)
General Certificate
CERTIFICATE HOLDER CANCELLATION
All Star Insulation&Siding SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Co.,Inc. ACCORDANCE WITH THE POLICY PROVISIONS.
56 Franklin Street
Easthampton,MA 01027 AUTHORUM REPRESENTATIVE
J.
1� ®1988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S148645/M1486O5 RTD
r
CL
r
CommoBYreatth of masuebusdta
Division of Professional Lleensm
Board of Quitdinq Regpdatfons and Standards
Construction Supervisor Specialty
CSSL-099739 Expires:0211412020
t
eti
�,. EOIIYIH W.LOftAd W `
in GLEtRMUE RM. .
966THAwrim MA 010»
Commissioner
M.0,
'Office of Consumer Affairs and Business Regulation
1000 Washington Street- Suite 710
Boston, Massachusetts 02118
_..._ •• Home Improvement Contractor Registration
__. ........ .. . Type: Corporation
ALL STAR-INSULATION*&SIDING•CO. Regiatradon. 101858
56 FRANKLIN STREET Expiration: 08/28/2020
EASTHAMPTON,MA 01027
77'7. -...... ., Updab Addmn and Return Cud.
WA 1 4 2OM-MM7
- HOME IMPROVEMENT CONTRACTOR Regboind n valid for kxlividuai use only
•TYPE:Coroarallm beton the expkation dab. If found Tatum to:
OMke of Cmato r Af irs and Businedd Reguladon
------'-"1018b8' _ 081M020 1000 Washh*w street•sulb 710
ALL STAR INSULATION&SIDING CO. 9odbn.MA 02118
- EDWIN W.LOSACANO d-4�0�
_ 50 FRANKLIN STREET
- EASTFIXMIlTON,KRK ff=_._. .. ._. Undersecretary Not wdftrwfttout signature
�
c dr 4SA �121
INSULATION NOV 9 2018
_. & 4z
Easthampton office SUJIN CO�' INC.' Westfield Office
P 56 Franklin Street • Eastharn ton, MA 010
413-527-0044 p 413-369-6411'
CSL
13-5 -
CSL License #CS SL99739/MA HIC#101858/CT HIC#0630805
fax 413-527-1222 • email:allstar5270044@gmail.com • www.allstarinsulationsiding.com
Proposal Submitted to Phone Date
Claude and Ann Duquette "Purchaser"413-586-9821 Home November 9, 2018
3 Street Job Name
42 Laddyslipper Lane 413-427-9329 Claude Cell
City,State and Zip Code Job Location Job Phone
Northampton,'MA 01060 413-427-8487 Ann Cell
Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW ROOF
INSTALLATION OF NEW ROOF ON SECOND FLOOR MAIN HOUSE- TWO CAR GARAGE FAMILY ROOM AND
REAR SUN PORCH
1. We will remove(2) layers of existing asphalt shingles and dispose of in a dumpster supplied by us-
2. We will install Titanium Rhino Deck or Elephant Skin underlayment over entire stripped roof surface-
3. We will install new CertainTeed Landmark Owens Corning or Gaf Timberline Architect shingles. They
—will have a"Manufacturer's Lifetime Limited Warranty". Owner will have choice of color.
4_All shingles will be nailed with at least(5) nails per shingle.
5. We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas. We will
nstall pine boots and metal'ste fln ashing where needed.
6. We will install approximately(92)' 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,
8. Job site will be cleaned upon completion of;ob.
** IF ANY SUB SHEATHING IS NEEDED THERE WILL BE ADDITIONAL CHARGE OF $52 PER SHEET TO
REMOVE DISPOSE OF, AND INSTALL NEW 7/16 OSB'SUB SHEATHING.
PRICE- $13,982.00
APPROXIMATE START DATE ILL BE DECEMBER/JANUARY EEBRUA ONCE WE gEr.FIVF nFpoSIT
AND SIGNED CO TRACT LES,�'ANY INCLEMENT WEATHER.-LABOR I&LARANTEED FOR 1-YEAR".
**ALL STAR WILL SECURE BUILDIN'(�"'PERMI IF NEEDEDH 011NI'VER WILL BE RESPONSIBLE FOR ANY
.�
&ALL FEES REQUIRED.
**ALL STAR IS NOT RESPONSIBLE FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHTOE APPLICABLE)
**HOMEOWNER WILL BE RESPONSIBLE FOR ANY&ALL ELECTRICAL OR PLUMBING WORK.
** NO PRODUCT& LABOR WARRANTIES WILL BE ISSUED UNTIL WE RECEIVE FINAL PAYMENT.
** HOMEOWNER WILL BE RESPONSIBLE FOR COVERING ANY STORED ITEMS AND FOR ANY CLEANUP
WORK IN THE ATTIC NEEDED FROM DUST& DEBRIS FROM ROOF REMOVAL.
**A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED
UPON REQUEST-
**T.P. DALEY INSURANCE AGENCY OF WEST SPRINGFIELD MA IS OUR AGENT,
WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of:
$13,982.00 dollars($ 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 This proposal may be withdrawa,by-us-if not accepted within -----------.-- --_---
THIRTY_— _ _ _ days.
ED LOSACANO,.OWNE
/ 4 r -� --
(j 1 d. � i.�-(r�!��- +\,�------ -- �.!` ----� ---- -----�oniractorSalesman
Claude an nnu ue e
q Acce tante by Purchaser,and Title
"You may cancel this agreement if it has been consummated by a party thereto at alace 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