23D-067 301S 3Sd3A321 NO aaiNIdd SNOLLIONOD ()NV SIANI31011331ens
;:oiBp son jo uoljeueldxo Lie Jo) WJO) uonelleaue3 jo 03y1OU patinae en eas
-1uauJoaJ6e JO 6ug16!s oqj tiulmoiloj
kap ssoulsnq eqj Jo jq6iupiw ueqj Joie( jou 'AJamep Aq JO was weifialej Aq Valsod pew AJeulpao Aq tpueiq
JO g)o:, u!eu, SL BumJAA Jallas GI j Amou noA pewoJd `joaseqj qauelq e Jo amlo uletu snj aq AMU 143I4M 'Janes
aul sso-ippe ue ueqj Jatoo apeld e ojeJetn Aped e Aq pejeununsuo uaeq seq 4! I! luatuaaJoe s!qj leaue AMU no),„
eau pue`.1aseqoind Aq aoueldaoov
• )UP11.1:5GleS Joloaquoo
,IGUMO 'ou2oeso1 ID]
Ale:IIHI uNiv,A paidaoae loil 4!sn Aq umeipom aq Aew iesodoid soil:310N
qor lo "PPP e aci Aew%Z/T T le jsalaw! B1i uoLuAed JI
:,ao!oAui o dioi uodn anp luawhed'(00,1@idwoD uocin @na @;)Lieies 'woo,x,0G $)slellop
()07,WPA;
:jo urns aup Aoj'suoneowoads anocre onn aauepione u!oajdwo ioqe pue lepalew qs!iun4 O sododd 3/v\
ThiDV H110 SI VIN '0 l]liONIHdS ISAM:JO AONdeki NVOSNI Ai I VU
n : cm
.
• • -
1,r / r �
fir-
;�� • 7'" 4 N :1 sir E .I r . - }i , �l
L�SULATION i .,-
t��'e..-, r`J �' Q7-» .4.,`1
SIDING CO., INC.
EASTHAMPTON OFFICE 4 I:I-527°004-1 CSC, License #CS SL 99739 WESTFIELD OFFICE J t 7(' ,6.-1 N 'i
56 FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 • FAX: 413-527- 1222
Proposal Submitted to Phone Date
Rue Walther "Purchaser" 413-387-8031 Cell October 14, 2013
Street Job Name
16 Warner Street
City.State and Zip Code Job Location Job Phone i
Florence, MA 01062 °
Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF A NEW ROOF 1,,t
2ND FLOOR MAIN ROOF CO►J+ti)
1.We will remove(. layers of existing shingles and dispose of in a dumpster supplied by us.
A - ,' / . • .1• . 1 :e 1• a- : • - -1 - -• •• a- (v
A - / • 1-. -' ,•1 --• ./• 1. . • . 1•- .1- 1, s. 1.11! - 1- A /. - "14. .. ' 1
II' -• AO. .I " S L I" A 11.... - 1• :1• • • ►i r ^ 1"'/ "' �"'
44\
4.All shingles will be nailed with at least(5) nails per attingLe. ilrNIIIIIIIIIIII .'1 '‘,17
1 - A . 1-, . .0 .11 • • -••- •/ . - - .1. 1-I . II 1 H ••- -••- •1 ...," .141.11E 1: 1 "1'
6. We will install pipe boots where needed.
- A 1 . .•• •. 1. - •..'.A. • 'a -1 •e .-.. • • • .•• .•/. -1 ' . .• t . �l
: A A 1 . . •" I.5" ... •1.. . - .1• A. - O. •1 - .I- . ` .-.11.,I'......,„, .....�... ..
IF ANY SUB SHEATHING IS NEEDED.THFRF WILL BE AN ADDITIONAL CHARGE OF $38 PER SHEET TO REMOVE. y;
S'■
DISPOSE OF.AND INSTALL NEW 7 1/16 STRAND BOARD SUB SHEATHING.
** HOMEOWNER WILL BE RESPONSIBI E FOR CDV_FRING ANY STOREDITFMS AND FOR ANY CLEAN UP WORK ii`>i II-IF ATTIC j
NEEDED FROM DUST& DEBRIS FROM ROOF REMOVAL .
PRICE: $3.852.00 (\---0.'( OLt.A./ G506.1
.1
Note:Approximate start date will be November or December less any inclement weather.
ALL STAR IS NOT RESPONSIBLE FOR ANY I FAKS THAT OCCUR IN EXISTING SKYI IGHTS(IF APPLICABI F).
' * NO PRODUCT& LABOR WARRANTIES WILT BE ISSUED UNTIL WE RECEIVE FINAL PAYMENT.
ALI STAR WIl I SECURE BUR DING PERMIT IF NEEDED. HOMEOWNER WIL LBLRESPONSIBLF FOR ANY&ALL FEES
REQUIRED.
- -
O4-(KAMpp_ ,4,4, yjit'll
4.���I�. (J xf r of az#fj lit #art $ *__0 _
$'1 i jltassariptortts =_ '�
,,." DEPARTMENT OF BUILDING INSPECTIONS -, _f°/.
INSPECTOR 212 Main Street • Municipal Building
Northampton, MA 01060 �,M -.
'
e
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.14 to
act as his/her construction supc:-.• sor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be,a one or twofanuly
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 oivn 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)1
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
-<3a,-,¢,,,,-f p,O� _, .. .
R� ` � r,��6 (L iN i f �Lt�:fl�i iiipton / -
' i r e ��0 �i
- DEPARTMENT OP BUILDING INSPECTIONS 4
212 Main Street. - ASunicipal Budding \kir— ,,--
Northampton, Mass. 01060 r'
WORKER'S COilff ENS A'1LON G`TSURANC-r A.1717 DA\TIT
•
I, _All Star Insulation & Siding Co., Inc.
(lice- sxJpc-mittec)
with a principal place of business/residence at: -
i
56 Franklin Street - Easthampton, MA 01027 (phonel9 413-527-0044
(a .ticlty/suie' p)
do hereby certify, under the.pa_ins and penalties of perjury, that
(X) I am an employer providing tilt followint iworkcr's corrlocnsaaon coverage for my •
employees worting on this job:
(Lana-:mac Coarse) 4 (-Policy Nurnl cr) (Expiration Date
( ) I am a sole proprietor, general contractor or homeowner(c tie one) and have hired
the contractors listed below who have the following worker's comnen_cadon policies:
•
(mare o.Con=ctor) (Instlrancc Company/Policy Numb 1) (t-`a irimon Date)
(Name of CouCZCtor) (Lns.lra.nc� Co moanynDoLi cv Nuncsr) (fiioir:tion Date)
(Name o(Conuamo;) (Lnsurancc Company/Policy Number) (EXPir ion Date)
(Name of Contractor) (Losuran CompenyfPo[icy Numlr`r) (E-�irttion Dais) .
(ea...]..duct ,J encc if oca-u_y-to uxlu&iaforml ioa pc-ta:Laing to.J1 tw_,_.con)
1 .( ) I am a sole proprietor and bave no one worid_ng for me.
( ) I am.a home owner performing all the -work myself.
NOTE:pies-Ix..,--,-c Lt.!-- J.bemeovocr '..{o employ pc-tool to di 3- c—.r.,b e moan,York 00.d.•-ti:=E;of
on mote 11=iSc. wilt in u',ticin the bomoovwoc med.=or on the p-atnrS 2-713,1/10133-3i the-.-�.-cot g-=.r,Jty coed._--o to to
erI:playct ttnG_the s.+-skd; 1ica Act(G1.2152ss 1(5)),:cplieitioo by e booa coa-oc-far a licno_or pa-ran t>_y c.-idw•the
I cpJ n:.nu of en a Ioy.o under rho Workc-o!.C, , uo..ion A-c-
1 undczt.nd that a copy of this mlcmaat r=v.y bo for,oudod to tbo D-opanmcal of Ir,.i,.rricl Atvdast.1 DIM.'of Im-vao"'for th.
CovcZsc v>ZiGeaioo.--rd th-.t L-iltae to roc rc toverabz trrvle-r to tioo 25A of l.(OL 152 an Ic.d to the impo0itioo of •tmrosl p--"ltio
cocoi.mg of a frnc of up to S I)00.00 and/or iapruoc®e3t of up to 013C-y-car rod Evil pno..ltio in tx form of e Stop Work Ord •node _
frt:of S 1 00.00.d•y rE2Lia4 me
1 For dcp.nrr+==a1 uac only ---•-- ..Ail Permit]]timber Iti — '. Lot " 4:
Signature of Lials /Permiucc e
SECTION 8-CONSTRUCTION SERVICES /
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Edwin Losacano CS SL 99739
License N mber
128 Glendale Road - Southampton, MA 01073 1� �I<
Addre s
Expi ion ate
527-0044
Signature, Telephone
:§1.Re4sire.-homeTnpovem entxCUtaCOEif.itMaTrdiatA }Z . * r Not Applicable ❑
All Star Insulation & Siding Co., Inc.
Company Name Registration Number
56 Franklin Street (.0-„ Alb 1114
Address Expiration late
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 the building permit.
Signed Affidavit Attached Yes No ❑
•
na4:4116.40;i4itleitSitetbiatifoil
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-year 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,you 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
r
•
r,;
SECTION 5-DESCRIPTION.OF PROPOSED WORK(check all applicable)
New House Fn Addition n Replacement Windows Alteration(s) J Roofing 4111,
Or Doors L
-
Accessory Bldg. n Demolition n New Signs [El] , Decks [C] Siding[II] Other[1]j
Brief Descriptio of Pr.p sed (� c660_ ir\atz
Work: 11 �
Alteration of existing bedroom Yes No Adding new bedroom Yes
No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.,If'=New h use nd cir acidi#corasto ez►stingliousinq,: omptefethe ollQ�ruinq:
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.
I. 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
L All Star Insulation & Siding Co., Inca , 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.
d lo . /4o, ONmPr/PrPsidPnt
Print m:
iiMIO
Signature of Owner/Agent Date
p
Section 4. ZONING All Informati6h Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size _r._.-_—__..
Frontage — —
Setbacks Front I
Side L:I�.__ ' R:--. 'L R:! -
Rear
Building Height
Bldg. Square Footage i ; i i % 1 , I ' •
__
Open Space Footage of
(Lot area minus bldg&paved ` ;-
parking).
1
#of Parking Spaces -_---- — �___._
Fill: '
.,--- --
(volumelk Location) -
— -
- "-
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YESE
IF YES: enter Book Page; and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 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 Q 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 Q ,- NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
< ; '�14( I' �, ,bye Deparfmsntrt�se only i�
I \ V i ,City F a' k 5. ii'A`Sc:.s h K i 3't. '])4 " } Y
1" DEC - 2 of Northampton tilt ofi,t4t t ;r''� g li `± g� R'
N' t• � 's y �* 3xr{. r-„"+--xs s, "d t` x4 2. �.La'�� Y Y ><
Ld uil Ing Department �ti'-' 5'21 l—1 Pier lilt; tiaft,�`�,��. �,N ,,;A� fi:
-__ -- -- :ctio � Main Street -Q”erve a;t, l �V i"z� Y
Electric F �` t, � s�" Vi ,., s a k
t`Icrtn�� � Room 1001Na�er�ttV`eYi'Avarla�dlf�!-- �"�" ����"`,��'��� t,
Northampton; MA 01060 Two Sets otS acurafr t`ans�S � `r.
phone 413-587-1240 fax 413-587-1272 Plot/Site fans-- h "f lk � h Ole Yt c +„
APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
• SECTION 1 SITE INFORMATION
1.1 Property Address: pleted by office ,r 1. This section to be com
,,,1
U�' �� I . iMap Lot Untf
/ ? �1 , � Zone OverlayUistrict
, e
Elm St District CS District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record: �} 1 (} / �y /� � ,-
°.(2-- . - 1���C Y ELK lX_ 1.' t 1� (S-1— 't''11=1+`2—I l
Name(Print) Curre PAailing ress:
Telephone
Signature
2.2 Authorized Agent:
All Star I ul ati on & Siding Co., Inc, 56 Franklin Street - Easthampton, MA 01027
Name(Print, Current Mailing Address:
F) ' , , – '` ` 413-527-0044
Signature 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)Et
Construction'from stimated Total Cos(6)of
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
41,6. Total=(1 +2+3+4+5) L3 Check Number �oo& t�,j j
This Section For Official'"Use Only
Building Permit Number, Date-.
Issued:
Signature: ,
i
Building Commissioner/Inspector of Buildings Date
16 WARNER ST BP-2014-0691
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D-067 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-2014-0691
Project# JS-2014-001172
Est. Cost: $3852.00
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.): 8668.44 Owner: WALTHER MARY L
Zoning:URB(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 16 WARNER ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON:12/5/2013 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 12/5/2013 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner