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29-118 (3) 82 FOREST GLEN DR BP-2020-0069 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:29- 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: Siding BUILDING PERMIT Permit# BP-2020-0069 Proiect# JS-2020-000109 Est.Cost:$9982.00 Fee:$60.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sg.ft.): 11935.44 Owner. BIGDA IAN TYLER&MEGAN EILEEN DAVIS Zoning: Applicant. ALL STAR INSULATION & SIDING CO INC AT. 82 FOREST GLEN DR Applicant Address: Phone: Insurance: 56 Franklin Street (413)527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.7/18/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP EXISTING WOOD SHAKES AND DISPOSE OF, INSTALL NEW VINYL SIDING AND TRIM ON MAIN HOUSE & CARPORT 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 7/18/2019 0:00:00 $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner RECEIVED fill 1 -7 �l The Commonwealth of Massachusetts Q Board of Building Regulations and Standards FOR \ Massachusetts State Building Code,780 CMR (DEPT.OF F Us NORTHAMPTON, 1060 Building Permit Application To Construct, Repair, Renovate Or Demolish a Revise-a-r- I One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number. D#te Applied: Building Official(Print Name) Date SECTION 1:SITE INFOOVIATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 82 FOREST GLEN DRIVE 1'11N ' - as 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 ifyes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Ian Bigda&Megan Davis Florence,MA 01062 Name(Print) City,State,ZIP 82 Forest Glen Drive 413-559-9965 Ian C# No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building INOwner-Occupied ❑ Repairs(s) ❑ Alteration(s) N Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': We will strip existing wood shakes and dispose of in dumpster supplied by us. We will install new vinyl siding and trim on main house and carport(approx. 14 square) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building 1. Building Permit Fee:S Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical S ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5.Mechanical (Fire S Suppression) Total All F Check No. eck Amount: C Amount: 6.Total Project Cost: S $9.982.00 0 Paid in Fu ❑(hiLctaw a once 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 I&2 Family Dwelling Cirylfown,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-527-00" allstar5270044ftgmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(NIC) 101858 6-28-20 All Star Insulation&Siding Co.,Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 56 Franklin Street allstar5270044@9-mail.00m 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..........M 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 t au t rued by this buil ing permit application. Ian Bkjcla 8 lkftan Davis,Homeow Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT 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 my knowledge and understanding. Ed Losacano,Owner 1{ __ Print Owner's or Authorized Agen s am Electronic Signature) at 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 x\,,.vw muss gov;oca information on the Construction Supervisor License can be found at t�'«ti�'.nmss.s nv-_dps 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 arca(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: 'Ra F,�r�f5#- C len DL-1ye _ The debris will be transported by: ` - 1 The debris will be received by: � O E'%►� C11cr6 v Building permit number: C{. Name of Permit Applicant C�-1 L �c-co r,) �i��inqq �c..� .. J -� �-1� i� Date Signature of Permit Applicant The Commonwealth of Massachusetts n a2 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 UV 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): 1. 1 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.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8• ❑ Demolition workingfor me in an capacity. employees and have workers' y ty 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 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 employee& 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 � p (�,�� ;'� City/State/Zip: DuEe Rc : MR ©t dLD, 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 certifyunder the pains and penalties of perjury that the information provided above/is true and correct. SiQxtature: kz,�a�.��_AN -711Date: l /( Phone#: 413-527-0044 Oficial use only. Do not write in this area,to be completed by city or town offliciaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. CitylTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Client#: 13250 ALLST DATE(MM1DONYYY) 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(ies)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 CONTACT NAME; Ryan Daley _ T.P.Daley Insurance Agcy,Inc g2,N Eat,413 788-0971 FAXNI;413 739-2645 1381 Westfield St. E-IAILandale ale Insurance.com ADOREss: rY y@ttpd Y P.O.Box 1150 AFFORDING Springfield,MA 01090 suRER(s)AFFOROG COVERAGE MAIC s NSURER A:Warn r..Co. NS1RED INSURER IS:Ohio Caunky Yn.Co. All Star Insulation&Siding Co.,lnc. erdT-4—A.&---.My Co d A—ka INSURER c T 56 Franklin Street INSURER 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 I TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP UMITS A GENERAL UANUTY BKS1957957626 8/13/2018 08/13/201 EEpAAcH or-cURRENCE $1,000,000 X COMMERCIAL GENERAL UAB&F Y PREM ES Ea=.D $100S 1 OO OOO CLAIMS-MADE I l%,OCCUR MED EXP(Arty one person) s15,000 PERSONAL R ADV INJURY $1,000,000 GENERAL AGGREGATE 62,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 62,000,000 POLICY X PE T LOC $ B AuroMoelLE LIABILm BA01957957626 138018 08/13/201 COMBINED sINGLE uMIT Ea acc,,aent ANY AUTO BODILY INJURY(Per person) $100,000 ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $300,000 AUTOS X AUTOS X HIRED AUTOS X �OS"ED R DAMAGE $100,000 S H IYEIREr UAB OCCUR EACH OCCURRENCE $ EXCESS UM CLAIMS-MADE AGGREGATE $ DED RETENTIONS S C y m 6HU68H26302818 13/2018 08/13/201 X `"C srAM IER orl+ YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? � N/A (Mardabory In NII) E.L.DISEASE-EA EMPLOYEE1$100,000 H yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT I s5OO,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Add conal Remarks SWednie,I more space is reqtdred) General Certificate CERTIFICATE HOLDER CANCELLATION All Star Insulation 8 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 AUTHOORVIED REPRESENTATIVE 151�7i��.. �•-(/Q-� ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S148645/M148605 RTD CL Commonwsatth of Massachusetts �. Division of Professional Lkensure Board of Building Regulations and Standards Construction Supervisor Specialty CSSLa9739 Expires:02/1412020 eta ' EDWW W.LOSACANO 121 GLENDALE ROAD SOUTHAMPTON MA 01073 C: Z Commissioner Office of Regulation . _ _. ._ .. ...... . .. .. . ...•:• • _ . Consumer Affairs and Business 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 _.... • •• ::...'-:._ Home Improvement Contractor Registration Type: Corporation ALL STAR:INSULATION.4 SIDING CO. Registration: 101858 58 FRANKLIN STREET Expiretion: 08/28/2020 -_ EASTHAMPTON,MA 01027 ....--..,.•r.:• ....... Update Address and Return Card. HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Conor ion before the expiration data. If found return to: t.:.: 529MMUM 1A2kKd5II Office of Consumer Affairs and Business Regulation • 101858 - Od12812020 1000 Washington Street-Suite 710 :.• ALL STAR INSULATION&SIDING CO. Boston,MA 02118 -- EDWIN W.LOSACANO C�L,C CSC' 58 FRANKLIN STREET ) EASTHAMPT•ON;MA10V _ Undersecretary' Not wit out signature INSULATION Easthampton Office SIDING CO., INC. Westfield Office 413-527-0044 56 Franklin street • Easthampton, MA 01027" CSL License #CS SL99739/MA HIC#101858/CT HIC#0630805 fax 413-527-1222 • email:allstar5270044@gmail.com • www.alistarinsulationsiding.com Proposal Submitted to Phone Date Ian Bigda and Megan Davis "Purchaser"413-559-9965 Ian C# May 17, 2019 Street Job Name 82 Forest Glen Drive City,State and Zip Code Job Location Job Phone Florence, MA 01062 818-653-6152 Megan C# Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW VINYL SIDING 2.1, Vinyl Siding has a"Manufacturer's i ffetime Warranty".- 71 PRICE $9,982-00 **APPROXIMATE START DATE WILL BE J [}J 1 Y/Ai IG ICT ONCE WE RECEIVE DEPOSIT AND SIGNED CONTRACT LESS ANY INCLEMENT WEATHER LABOR IS GUARANTEED FOR 111-YEAR". **ALL STAR WILL SECURE BUILDING DING_ PERMIT IF NEEDED HQMEOWNFR WILL RF RESPONSIBLE FOR ANY &ALL FEES REQUIRED. ** PRODUCT& LABOR WARRANTIES WILL NOT RE ISSUED UNTIL WE RECEIVE FINAL PAYMENT ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY&ALL ELECTRICAL OR PLUMBING IMBING WORK THAT MAY BE NEEDED **A CERTIFICATE OF INSURANCE FOR WORKMAN'S COM FNCATION AND LIABILITY ITY WII I RF FORWARDED UPON REQUEST **T P DALEY INSURANCE AGENCY OF WEST SPRINGFIELD MA IS OUR AGENT PAGE 2-OF 2 WE PROPOSE to furnish material and labor,complete in accordance with above specifications,for the sum of: $9,982.00 dollars($ 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:T iS posal may withdrawn by us if not accepted within THIRTY days. r711�f. k ED LOSACANO, OE --——7--- :_---1-- ---- -- - - -- --- - --- -- — Contractor Sale W smari ---------- fan ljl da and egan DaVIS �. 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