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8 TIFFANY LN BP-2022-0159 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:42- 151 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# BP-2022-0159 Project# JS-2022-000281 Est.Cost: $14852.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sq. ft.): 30099.96 Owner: DELISLE RUTH GLICKMAN&SCOTT F DELISLE Zoning: Applicant: ALL STAR INSULATION & SIDING CO INC AT: 8 TIFFANY LN Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON:8/12/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE 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: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORT . AMP ON UP N AQLATION OF ANY OF ITS RULES AND REGULATIONS. ' C' • I Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 8/12/2021 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner The Commonwealth of Massachusetts I Board of Building Regulations and Standards FOR Massachusetts State Building Code,780 CMR MUNICIPALITY . IVy USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 o ,I One-or Two-Family Dwelling J !I This Section For Official Use Only E. Buildi�g Permit Number:t3'.2.o2Z^'D k67 Date Ap lied: 0 424 En C` ____� !, -U1�V ` J�055 �2ZUZ� Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 1.1a Is this cc ted treet?yes no Map Number Parcel Number 1.3 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2Owner'of Record: lam-p \c l lorev Y`r1A- ono D; Name( rin +t) iu State ZIP SLTIaeLt Lan e... 14 I g—a4—A.173 C3C-45CLat No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building II Owner-Occupied 0 Repairs(s) 0 Alteration(s) ® Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: -t .1 ct 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 $ ' t0 o—a Suppression) Total All Fees:$ `� Do Check No.*l 77 Check Amount: 410— Cash Amount: 6.Total Project Cost: $ )4?551 ,"c' 0 Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-22 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 Siding SF Solid Fuel Burning Appliances 413-527-0044 allstar5270044 angmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101858 6-28-22 All Star Insulation&Siding 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 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must he 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 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. Scott Delisle, Homeowner ' ' l 262,1 Print Owner's Name(Electronic Signature Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below.I hereby attest under the p s and penalties of perjury that all of the information contained in this application is t d c rate for best of my knowledge and understanding. V Ed Losacano, Owner — .L/ A'1-1 _9- Print Owner's or Authorized Agent's Na .lectr is 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(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 %% % .-nia�>_o} ara Information on the Construction Supervisor License can be found at w\Vw.mass.guv 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 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 systetn Enclosed Open_ _ 3. "Total Project Square Footage"may be substituted for"Total Project Cost" ' ,\ The Commonwealth of Massachusetts Department of Industrial Accidents r, ." ►- Office of Investigations Lafayette City Center -1 2 Avenue de Lafayette, Boston, MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: 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: Business Type(required): 1.❑■ I am a employer with 10 employees (full and/ 5. ❑ Retail or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl. real estate, auto,etc.) employees working for me in any capacity. [No workers' comp. insurance required] 8 ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per c. 152, §1(4),and we have 10.❑ Manufacturing no employees. [No workers' comp. insurance required]** 11.❑ Health Care 4.❑ We are a non-profit organization, staffed by volunteers, CONSTRUCT/ HOME IMPROV with no employees. [No workers' comp. insurance req.] 12.❑■ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policv information. Insurance Company Name: THE TRAVELERS INSURANCE COMPANIES Insurer's Address: 97 CENTER STREET City/State/Zip: CHICOPEE, MA 01013 Policy#or Self-ins. Lic. # 6HUB-5N06911-1-20 Expiration Date: 8/13/21 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under§ 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 and penalties of perjury that the information provided above is true and correct. Signature: & � L,t Date: . /?/off/ Phone#: 413-527-0044 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): I.❑Board of Health 2.0 Building Department 3.0 City/Town Clerk 4.❑Licensing Board 5.❑Selectmen's Office 6.❑Other Contact Person: Phone#: www.mass.gov/dia 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: S TL --fin I nP 4--161--`€ Y 1 The debris will be transported by: A-Dn - 00al_,i►'l(‘`f-RP:Li C',11'y{ `J1 tau � 3c 00-2cck The debris will be received by: Ai,)):* ' '\ f.(itbra Y M;rnr)- o►cfi,3 Building permit number: Name of Permit Applicant cn SkAr Tmu-QoVon-+sai1-1(c, 3 c. `Oct Rj_ Date Signature of Permit Applicant ALLSTAR-05 BROOKE ACORt DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/14/2020 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 have ADDITIONAL INSURED provisions or 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 Brooke Barre NAME: Phillips Insurance Agency, Inc. PHONE Fax 97 Center Street (A/C,No,Ext):(413)594-5984 (A/C,No):(413)592-8499 Chicopee, MA 01013 ADDARESS:brooke@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:State Automobile Mutual Ins Co INSURED INSURER B:State Auto Property&Casualty All Star Insulation&Siding Co.,Inc. INSURER C:Travelers Insurance Company 36161 56 Franklin St 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 CONTRACT OR 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI (CIA/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PBP2903632 8/13/2020 8/13/2021 DAMAGE TO RENTED 300,000 PREMISES{Ea occurrence) $ MED EXP(My one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JEa LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO BAP2482222 8/13/2020 8/13/2021 BODILY INJURY(Per person) $ — OWNED SCHEDULED _ AUTOSRE� ONLY AUTOS BODILYBODILY INJURYp (Per accident) $ _ AUTOS ONLY AUTO ONLY (Perr accideent)AMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE PBP2903632 8/13/2020 $/13/2021 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ C WORKERS COMPENSATION X STATUTE X ERH AND EMPLOYERS'LIABILITY Y/N 6HUB-5N06911-1-20 8/13/2020 8/13/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FICER/MEMBER EXCLUDED? N N/A 1,000,000 andatory m NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE All Star Insulation&SidingInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Co., ACCORDANCE WITH THE POLICY PROVISIONS. 56 Franklin Street Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD J Ie)t �� Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 101858 ALL STAR INSULATION&SIDING CO. Expiration: 06/28/2022 56 FRANKLIN STREET EASTHAMPTON, MA 01027 Update Address and Return Card. SCA 1 i0 20M-05,17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corooration before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 101858 06/28/2022 1000 Washington Street -Suite 710 ALL STAR INSULATION&SIDING CO. Boston,MA 02118 • EDWIN W.LOSACANO • ��'LG ?tj> 56FRANKLIN STREET ' "4• EASTHAMPTON,MA 01027 Not valid without signature Undersecretary i®� Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor Specialty CSSL-099739 Expires:02/14/2022 EDWIN W.LOSACANO - 128 GLENDALE RD. SOUTHAMPTON MA 01073 1 Commissioner sr. • n ECEOVERp �. Ch � -ail �� +��► �' INSULATION AUG - 9 2121 SIDING CO., INC. Easthampton Office 1�3 413-527-0044 56 Franklin Street • Easthampton, MA O CSSL License # CSSL-099739/MA HIC# 101858/CT HIC# 0630805 0"Irt-N fax 413-527-1222 • emai1:allstar5270044Cgmail.com • www.allstarinsulationsiding.c Proposal Submitted to Phone Date Scott& Ruth Delisle "Purchaser" 413-834-2175 Scott Cell July 26, 2021 Street Job Name 8 Tiffany Lane 413-834-2165 Ruth Cell City,State and Zip Code Job Location Job Phone Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for: INSTALL NEW ROOF ON MAIN HOUSE, GARAGE, REAR SCREEN PORCH, AND POOL FILTER SHED INSTAL LATION OF NEW ROOF ON MAIN HOUSE TWO CAR GARAGE. FIRST FLOOR REAR SCREEN PORCH. AND FIRST Fl OUR POO1 Fli TER SHED 1 We will remove (1) layer 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_o.n_rake areas We will install pipe boots and metal step flashing where needed. We will install new step flashing around base of chimney underneath new shingles. 6 We will install approximately (62)' of roll vent on peak of roof for additional ventilation. 7. We will install a 36"wide asphalt ice and water harrier on eave lines/valleys of heated areas and 72"wide asphalt ice and water barrier on rear garage_shed dormerarea 8. Job site will be cleaned upon completion of job. ** IF ANY SUB SHEATHING IS NEEDED THERE Wll I BF AN ADDITIONAL CHARGE OF $88 PER SHEET OR CURRENT MARKET VAI IIF OF OSB TO REMOVE DISPOSE OF AND INSTAL L NEW 7/16 OSB SUB