07-005 uw bipte Lip Uov; Job Location xm pnnno
*orenoe.rNAO1O82 [ 413-537~0832 Suzanne's Cell
Contractor hereby submits to Purchser spec'fictions and estirnates for: INSTALLATION OF A NEW ROOF
MAIN HOUSE, SIDE PORCH, & FRONT ENTRANCE
--' ---- --------
- ^ ^ u»• ^ A ~ . • .^ : x . ~ . . • •
t- o ~ ' - "~°' • - '^ � - ••-• '*^ «~ -
3. We will install newCertninTeed Landmark orGef/E|k Timberline Architect shingles. They will have a "Manufacturer's Lifetime
Limited Warranty" Owner will have choice of color.
4. All shingles will he nailed with at least (5) nails per shingle.
5. We will install new aluminum drip edge on all eves and new aliiminiim rake edge on rake areas.
6. We witl instalt pipe hoots where needed.
7. We will install approximately (32)' of roll vent on peak of roof for additional ventilation.
8.VVewill install a36" wide asphalt ice and water harrier on eve |in*nnfy@nin Hm/se.
P. We will install a 6' wide asphalt ice and water harrier on Rear Dormer.
10. We will re-point (1) chimney where neecled. -�.'`', /i ''`'
^*|FJANYSUR SHEATHING |SNFFDFD.THERFVVU| RE AN ADDITIONA CHARGFOF$38PFRSHFFTT0RFM0VE,
D/SP0SFDF. AND |NSTA|| NRW71/16 STRAND R0ARDS|/RSHFATH|NG.
** HOMEOWNER VYI|| BF RFSPONSIB1F FOR COVFRING ANY STORED ITFMS AND FOR ANY CLEAN 11P WORK IN THE ATTIC
__u_EELIE 7 ( )4 FRR|S FROM ROOF RFN1UVA|.
� �U�Q � ��*`�� ,`,� ,"o~ --- -- --'--
PRK�: $0.982.00
NOTF: Approximate start date will he July or August less any inclement weather.
+*/V| STAR |S NOT RFSP0NS|H1F FOR ANY LEAKS THAT OCCUR |NFXISTNGSKYKlHT8 (IF APP ICAR|[l
++N0 PRODUCT &LAR0R WARRANTIES VN|| BFBSUFDUNTl| WF RFC,FIVF FINAI PAYMENT.
�^ HOK4FOVVNFRVVULRFRFSP0NSBLFR}RANYFEESRFQU|RFDFORBi)|LD/NGP[RyN|TS.
ACFRT|F/CATFOF|NSURANCFF0RVVORKMAN'SC0MPFNSAT0NA0D!|ARU|TYVVU| RF FORWARDED \/PONRE0()ESl
^* T P DA/FY/NS!1RANCFAGFNCYOFVVFSTSPR|NGF|F)D,K8A!SO1)RAGFNl
WE PROPOSE to furnish material and labor, complete in accordance with above specifications, for the sum of:
�6arzoV ooAa�<* o^a/! Bala 'It u`/a�!�Y^�;omplet/Y , payr; due upon receipt n/invoice.
If payrnent ate. interes a 1 1/2% may be added.
NOTE: Ths proposat may be withdrawn by us if not accepted within THIRTY days.
Ed Losacano,Ownor
, `� Contractor Salesman
S���s 9r Mi�Ue�iUi� ------ Acceptance by Purchaser, and Title
"You maytancel this agreement 11 it has been consummated by a party thereto at a place other than an address of the
selier, which may be his main office or a branch thereof, provided you notify the selier in writing at his main office or
branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day
following the signing of this agreement.
See0hemttmchedmoticmcfcancwHmtimmfwrmfwrmnmxplamat}mnwfthisri@bK'
SUBJECT TO TERMS AND CONDITIONS PRINTED ON REVERSE SIDE
1,sttAM pT
421 � � _ *=..
A �r��q 1$ ,.(city oaf Nor f -Taniatnn • � 1 �__
$tf ;�i� " �"� Gtassac3�itsetts = _=
' �� DEPARTMENT OF BUILDING INSPECTIONS _ °.3 _ /`
INSPECTOR 2 Main. Street • Munici Buildin ' >
Northampton, MA 01060 5
ei
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as Lis /her construction sup':.•i sor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he /she resides or intends to be, a orie or two fanu
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
home owner."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation /footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection..The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
I, understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
r
' � ADO i _ --- �:
�c3iv y
E (riff of Pcirf lianipfon
A a 1 6 �lc3aarlinsrtle•
`� - tom,?•
- DEPARTMENT OP IIUILDflC INSPECTIONS 4 •
et —
212 Main Strcct Municipal Building
NorLhamplon, Mass. 01060 r'"
`'r'ORKER'S COMTENSA"11ON MSURANCIL AFFIDAVIT
I, All Star Insulation & Siding Co., Inc.
0icc'nt 1pcTmJttcx)
with a pr place of business/residence at: --
.56 Franklin Street- Easthampton, MA 01027 (phone')413 527 - 0044
(sa tJc i ty /said z p)
do hereby certify, under the patris and penalties of perjury, h21
(x) I am an employer providing the following ' worker's comocnsz bon cove mgc for Iny
employees wor.6ng on this job:
•
(Lisur - n Comr,au) (Policy Nu ibcr) (114irzuon Dat^
I '
( ) I am a sole proprietor, general conu actor or homeowner (circie one) and have hired
the cooiractors listed below who have the following worker's compen_adon policies:
(Maroc of Con cior) (Insurancz Company/Policy (-xpirauon Datc)
i .
(Name of Con tractor) (lnsurznc:, ComcanwPo!ie,' Nunn -er) (EN Date)
(Name of Conn (Insuran Company/PotiCy Nadu) (Expiraon Dale)
(Name of Contractor) (Insuranc Comoaay/Policy Numb r) (N Date) .
(1c th o.c 1 l.ifncoc . v ca alcu•d_ inf«-maaoo pctn.iainc w .11 vxc --a.or3)
( ) I am a sole proprietor and bane no one working for me.
( ) I am.a home owner performing all Lbe work myself.
NOTE: ecrirc (✓_ while 6emeo ubo eapl oy peiom to do � �� .•r�oo r re„au ..•ori on a d. of
not mote tb= t `Sur ter,, in ix—Sidi the bomoowncr residc or cc the 1-nu r s�pir ca r the n L-c ox Ga !ty nen:d d to be
caiploye-3 ux - the wuk c -c--•. czi Act (GU152.m 1(5)), appliadon by n boacoa fcr e tip _ cc pcmit cry nih the
1c-E7-1 et c or en 1 « uede- Elan W o -k t Cocromition Ad.
1 undcrruiad tb-d a copy of thi, mtcrost oa..y b.o forwarded rded to tba peputmms of I irrid Anodeaii' Otfioo of InW + for L^
cove ->Lsc v+eifiatioo e.'1d t1Lt C_iltac to soattc bovernse txodc sociion 23A of } 132 no led to the impoaitioa of r- +.n;c.t pcnaltica
coo:liras of a floc of up to 51,.../00.00 at>dior Conpri3oomcat of up to ono yr: r tad c vi1 pco+hic io tx form or. Stop Work Ordc marl a
fica of 5100.00 1 day a. pyiast me
For dcpsna y u,c only
permit Number
•
S ipaa ' ofLio cr/Pc rmiucc D3>:e _ ..l
SECTION 8 - CONSTRUCTION SERVICES t
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : Edwin LosaCano CS SL 99739
License Number
128 Glendale Road - Southampton, MA 01073
Address I Expiration Date
` (413) 527 -0044
Signature Telephone
�..,: .. ...#f-"�.w""'£ -. ,z, -�" �.i, emu,
9 ,RegrsTerecf Nome_ Improvement Co ntractors WZEMKTI �„ �, ,� � ; , � , ,� ,. Not Applicable ❑
All Star Insulation & Siding Co., Inc. 1 � S
Company Name Registration Number - — — -
56 Franklin Street n 9 ,1
Address Expiration Date
Easthampton, MA 01027 Telephone 413 - 527 -0044
SECTION 10- 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 t e building permit.
Signed Affidavit Attached Yes No ❑
IikAiliiiii&OwnevEtertiption
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
- as 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 - vear 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, von 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
P
i
r..
SECTION 5- DESCRIPTION OF- PROPOSED WORK (check applicable)
New House n Addition El , Replacement Windows Alteration(s) I I Roofing ‘fK3s
Or Doors D
Accessory Bldg. n Demolition n New Signs [El] Decks [0 Siding [CI] Other [CI]
Brief o Description s1, roc
Work: p \ r { \ \c l I L'() �l
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a, i Nevin: HousWiird -`a adcfit alxtoaezis.tiriqlous nq.:'coritiplet6Ahe ffill6VTtT y:
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. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
L 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
, as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
All Star Insulation & Siding Go. , Inc. , 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 under the pains and penalties of perjury.
Ed Losacann, Ownw/Prpcidrant
Print Name
Al . —
Signature o %caner /Agent Date
Section 4. ZONING All Informatioh Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoni 1
' This column to be filte
Building Department
Lot Size
Frontage ?
Setbacks Front j t I I
i
Side L: I R:'---- L: R:: ,
Rear 1 1
Building Height .W�
Bldg. Square Footage I i i i% 1 1 i
i
Open Space Footage %
i i i
(Lot area minus bldg & paved i ( I i
parking)
# of Parking Spaces
Fill: ___ _ __ 1, _. — — -
(volume'Vc Location) - — ----
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:l
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page; and /or Document #
i
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES I
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO Q
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 r NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
,‘", p," ''.,.■11,,,,i4' _.E...'ANI,,,,t''',7'0,..^A,' "e*r,-.."'..7"-. ' ,..4 ik,.34,TW' ,Pikt4 i- -"".',:ty'cA,"‘4.,,'il%:1",4%
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L-6- !... t.-!,- . ..c .,:iiilti..;,..,..... --;-,1-,F1434.-4
i it—•-#;.....- - ny ofNortpa ?,,, 7 .. 4.,'-'?itil ..,,,4::....c,,,- Awttiy.lik*i..7
7--------- mptont
BuldinDepartmen
JUL i 1 2112
12 ain Street „
R om 100
_ ton' MA 01060
W it
DEE
:i---N1,- BUILT
\ t,...
-7'-'71Pt ,
ilaill- ' Fax 413-587-1272 ..,..,- 6 - t dub' -=.-• --:"",..,,,a;
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,.,,,.-.,ier:,-,,,,,i k ...41. ::::;. - L -..„- ai .. !:(7 , i#3.4.4...460 , ..,...v .t. ., 4vA , ;; ,.- J ,
,q9...04%)*,,
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APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
1 - ' q . -- - -r''
This sectioi, comPl
,
SECTION, 1 _ SITE INOOR MATION
,,---':..., ,,,,,, . '' '-- .':::"':: '' ' ' ''''''''' --■■■:4't';i7L ..)?:''''''
1.1 Property Address:
- 1 1 ? .._ ..:!? -.:`::-'-:,--- r.--
*11FJ:'': ''''' -.±‘'Zrj:;-:;:r:;71, ::- -'7'-':7''...:77:777, ''''''':''''' n '''''' ' .': .1c, 1 ■ : 1 ': ':‘,. -
q rss,' cirnt <:-1 ' -.-. — -' ,6iT6 , ;" : 1 3 : 7 ; - , , ,! :... '.17.,,r ,.;:,.*:'':,,'„,':::1'.6■eiiip!#,..t15!,;:t„.„•::-::--.::..,,-,;_:.,:...--
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V)-0(Q.n p z k oThe „.,..„,,„:„:„,•,,.,:„.„..,::,:„.:,.....„..„,f,...„L._:.,„:..:,.:,:„,th,trict,,:„....
,.. ......,, r..,.._ _ . ,.
AGENT
L '^ ' • Ei s L. Distnct :
-.,...
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIED A
( o cai (-\ - - HOlOaC-C--
2.1 Owner of Record:
xfi\lk 0 .A-5-\-- q3V
Curr9,04q49
Name (Print) Adcir6% .--
Telephone
Signature
2.2 Authorized Agent:
All Star Insulation & Siding Co.. Inc. 56 Franklin Street - Eastharmton, MA 01027
Name )It) / Current
Mailing
413
-
T
,1/ '
Signature Telephone
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item - c E o s m tima e t t e e d d by m
Cost applicant
Official Use Only
pl t
1. Building (le,
■ (a) Building
Fe
2. Electrical Total Fee
(b) Estimated
Cost of
E C s o t nst a ru ted
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
see 7 67 9
, n0 03,5
5. Fire Protection
6. Total = (1 + 2 + 31- 4 + 5) Check Number i
(- " - 1 . " -- his 8
'S ction For Offialat Use Only
Date
Building Permit Number. ' 'Issued:
i
Signature:
Building Commissioner/Inspector of Buildings Date
480 NORTH FARMS RD BP- 2013 -0045
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 07 - 005 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- 2013 -0045
Project # JS- 2013- 000059
Est. Cost: $6982.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sq. ft.): 25221.24 Owner: ATKINS SUZANNE E
Zoning: RR(100)/WSP(100)/WP(16)/ Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 480 NORTH FARMS RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527 -0044 Workers Compensation
EASTHAM PTON MA01027 ISSUED ON: 7/11/2012 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 NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 7/11/2012 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner