25C-218 *1. • • •
/.
V', INSULATION
&
SIDING CO., INC.
EASTHAMPTON OFFICE 413-527-0044 CSL License #CS SL 99739 WESTFIELD OFFICE 413.568 -64
56 FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 • FAX: 413 -527 -1222
Proposal Submitted to Phone Date
Karl Knapp "Purchaser" 413 - 585 -0209 Home July 30, 2012
Street Job Name
219 Elm Street
City, State and Zip Code Job Location Job Phone
Northampton, MA 01060
Contractor hereby submits to Purchaser specifications and estimates for : INSTALLATION OF VINYL SIDING
FOUR - FAMILY
NOTE: Approximate start date will he Awg ust •or September less any inclement weather.
** NO PRODUCT & I AROR WARRANTIES WILT BE ISSUED UNTIL WF RECEIVE FINAI PAYMENT,
'* HOMEOWNER WII I RF RFSPONSIRLE FOR ANY FEES REQUIRED FOR B1111 DING PERMITS.
* * HOMEOWNER WII I RE RFSPONSIRI F FOR ANY & Al I Fl FCTRICAI OR PI UMRING FFFS THAT MAY BF NEEDED.
* 't ! -i ! •l/ 1 ! 01 All it I ► 41:11,;11 r . •I► i 0
** T.P. DAI FY INSI IRANCF AGENCY OF WEST SPRINGFIFI 0. MA IS OUR AGENT.
WE PROPOSE to furnish material and labor, complete in accordance with above specifications, for the sum of:
dollars ($ 50% Down, Balance Due Upon Completion, payment due upon receipt of invoice.
if payment late, interest at 1 1/2% may be added. of Job.
NOTE: This proposal may be withdrawn by us if not accepted within THIRTY days.
Ed Losacano, Owner
Contractor Salesman
Karl Knapp ' 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
08/24/2012 11:22 14135871272 NTON BLD DEPT PAGE 06/06
The Commonwealth of Massachusetts
.1- Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.rnass.gov /dia
Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers
A..Iicant Information Please Print Legibly
Name (Business/Organization/Individual): {: ;- ♦ 1
Address: �LC
o.
Cit J /State /Zi - - - ° e : -
Are you an employer? Check the appro • riate box: Type of project (required):
m a employer with 4. 0 1 am a general contractor and 1
employees (full and/or part-time).*
have hired the sob contractors G. n New construction
2. I a a sole proprietor or partner listed on the attached sheet. 7emodelinR
ship and have no employees These sub - contractors hav g, b Demolition
working . for me in any capacity. employees and have workers'
Y ca A $ 9. (i Building addition
[No workers' comp. insurance comp. insurance.
required 5. ❑ We are a corporation and its 10.0 Electrical. repairs or additions
3. 0 T amt a homeowner doing all work officers have exercised their 114 ' Plumbing repairs or additions
myself. (No workers' comp. right of exemption per MGT-
12.0 Roof repairs
insurance required.] t c. 152, $1(4), and we have no
employees. [No workers' 13.0 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 Ihen 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 havc
employees. if the sub-contractors have employees, thcy must provide their workers' comp. policy number.
.1 am an employer that is providing workers' compensation insurance for my employees. below is the policy and job site
information.
Insurance Company Name: i
Policy # or Self -ins, Lk. #: l 1 0T Expiration. Date: <�j l
Job Site Address: City /State /Zip: r(` (j">,r?
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 fins
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.
1 do hereby certify untie he pains and penalties of perjury that the information provided above is true and correct.
Si_nature: — Datc:
Phone #: ' I
Official use only. Do not 3vrite in this area, to be completed by city or town official
City or Town: , PermitfLicense # _
Issuing Authority (circle one):
1, Board of Health 2. Building Departltiient 3. City/Town Clerk 4. Electrical Inspector 5. Plumping Inspector
6. Other
Contact Person.: Phone #:
A
08/24/2012 11 :22 14135871272 NTON BLD DEPT PAGE 05/06
Vermont Commercial Building Permit May 15, 2000
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes ® No 0
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner of the subject property
hereby authorize to
act on my behalf, in ail matters relative to work authorized by this building permit application.
Signature of Owner Date ---)
I , . , ` , . . ? i 1 , . . . . i k A ( A . , � , r a I c . 1 . . t j . ` . , , , „ , . . , ` ' 1 I t , as Own Authorized
( Dent by declare that the statements and information on the foregoing app ion are true and accurate, to the best of my e ge
an clef.
Signed under the pains and penalties of periury,
Print Name
y am .
i h • . - NO ......... ..
Signature of "'miner/A Date
SECTION 12 -CONSTRUCTION SERVICES
10,1 Licensed Construction Supervisor: Not Applicable ❑
Name of License N old ®; :. _. a ..... ��.'•� °._�: �,_.. .... , -�. u c) 9 3 ..
,,
, J-
CD-, Number
Address , Expiration Date
.49 C4 __.rte.,.- -- - - - sDlp`N
Slgna aiephone
SECTION 13 - 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
0812412012 11:22 14135871272 NTON BLD DEPT PAGE 04r0b
Version l.7 Commercial Building Permit May 15, 2000
SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable
Name (Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Resporsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
—
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
A\\ ` - \ t 0 cA t, 1, ,- ,
Not Applicable ❑
Company Name.
.. ( . — C ( ...
Responsible In Charge of Construction
Address
E .,, ,,s _
r t- .._
Signature Telephone
08/24/2012 11:22 14135871272 NTON BLD DEPT PAGE 03/06
Version 1.7 Commercial Building Permit May 15, 2000
8. NOWT IAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
RUilding Department
Lot Size
Frontage .......... .. . .
Setbacks Front
Side L : .............. R:. L I2.:
Rear
Building Height
Bldg. Square Footage
Open. Space Footage °
(Lot area minus bldg & paved
parking)
#/ of Parkin. S. aces
Fill;
(volume & Location)
A. Hasa Special Permit /Variance /Finding ever been issued for /on the site?
NO (3 DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW fl YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained ,pate 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 0
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 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
6
08/24/2012 11:22 14135871272 NTON BLD DEPT PAGE 02/06
Versionl-7 Commercial Building Permit May .15, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑
Exterior Alteration ❑ Existing Ground Sign0 New Signs ❑ Roofing Chango of Use ❑ OtheiF�
Brief Description :,Enter a brief description here.
Of Proposed Work: ,
) \(\:,, 1 4[ 3
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly CI A - 1 l A -2 ❑ A -3 0 1A ❑
A -4 ❑ A -5 ❑ 1B 0
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F -1 ❑ F -2 0 2C ❑
H High Hazard 0 , 3A ❑
1 Institutional ❑ 1 -1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A 0
S Storage ❑ S -1 ❑ S -2 ❑ 5B D
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE
E xisting Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): ,.,.. Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (sf)
1'
i st
2 "`'
3
4 th
q tn
Total Area (sf) Total Proposed New Construction (sf)
Total Height (ft)
Total Height ft
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system:
f
08/24/2012 11:22 14135871272 NTON ELD DEPT PAGE 01/06
Version1.7 Commercial Buildin• Permit Ma 15 2000
' �7pPiOM �l t,u hl !il
City of Northampton '" i
s w. tj, p tui� �'�r�i�: `
� Building Department h urts �w' I Wi v+r�3i r to
>> aVG 2 i L 212 Main Street seweriiSapt10,*.atlatnhty,,i
Room 100 UYar/VN!
Ns el AV
l itllBl�'il {ty
L - •tcTiO Northampton, MA 01060 :Two St h, f 5ttuctural flirt's
�e a o1oso
D- ' .: phone 413- 587 -1240 Fax 413- 587 -1272 Pfot/Site; „ t ; ,
Ottier,Spfy...... . .
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 property Address:
This section to be completed by office
Lo -qq r- i ('t3 . ') C Map Lot Unit
V T3 C ��� m W -) Zone Overlay District
Sim St. District Ca District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: Qk
h
Name ........
(Print) Current Mailing Address
Signature _ _ Telephone
/2 Authorized A en • 01.
k C' 1. I`1 ' ,-. .. c . --kt n I- _ . E ` —''a
Trent Mailing Address
Name (Print) u 6 ` C .
Signature �� ° .:.. . t ) ae --- -- Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
`-! '+ —
1. Building (a) Building Permit Fee
2, Electrical (b) Estimated Total Cost of
Construction from (6)
3, Plumbing Building Permit Fee
4. Mechanical (HVAC) 1
5. Fire Protection 9 0 I' °
6, Total = (1 +2 +3 +4 +5) * - ' - Check Number
v
This Section For Official Use Only 11 t , b
Building Permit Number 1.3 p i S 3 b V Date !
Issued
Signature:
Building Commissloner/inepector of Buildings Date
File # BP- 2013 -0206
APPLICANT /CONTACT PERSON ALL STAR INSULATION & SIDING CO INC
ADDRESS/PHONE 56 Franklin Street EASTHAMPTON (413) 527 -0044
PROPERTY LOCATION 42 WALNUT ST
MAP 25C PARCEL 218 001 ZONE URC(105)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out i,C /3 171 4
Fee Paid v I �V / J
Tvpeof Construction: INSTALL VINYL SIDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 99739
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
V Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission _ Permit DPW Storm Water Management
Demolition Delay
872.7
l
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
42 WALNUT ST BP- 2013 -0206
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C - 218 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: vinyl siding BUILDING PERMIT
Permit # BP -2013 -0206
Project # JS- 2013- 000337
Est. Cost: $20505.00
Fee: $123.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sq. ft.): 9278.28 Owner: KNAPP KARI S & KARL E
Zoning: URC(105)/ Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 42 WALNUT ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527 -0044 Workers Compensation
EASTHAMPTONMAO1027 ISSUED ON:8/28/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING
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 8/28/2012 0:00:00 $123.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner