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29-208 (2) r P . ..a t ti INSULATION , ; ; ( �-SIDING CO INC.C/3, , 56 FRANKLIN STREET EAS'1 HAMPTON, MASSACLi�7SET"t'S 01027 EASTHAMPTON OFFICE: :,27`O() i._t WES` FIELD,OFFICE: ,:>O,8 �>t : t l:OIIIF,t I li Proposal Submitted to Phone Date ire 1i; Sarlt:� �:; "Purchoser" Street Job Name Y t ''E?`Jf'l n I)r i 1'r: City, Stag and Tip Code Job location Job Phone Contractor hereby submih to Purchaser specifications and estimates for: f• ti ! `, :"; r.'Sl;tt-r 1''Ai^vv C V 1 --- ,�. I,KIC 'rl lE dl:h fly, Siding. __-------.--------_ —_ l.rtst,. IY1,U. —�'1 •,��X� tr�I,,rl i :Lti h. l. (�;(!� Z d�7 ' i(` �(� fr . r:1,r 'r,Y1 rr;f,i 1 t'iV `- — `-- — ",fly ex Sri F?fif, try $1.t r l� f rlG�. fy 1 ,t,�r rafx q ..`, ...... Witi �l' 'r�l r,c(I T ll`� A., ~vi tl tn,:i !11 (7) vlrlyl ) t `)IncLc iI(IC ?t' tl( 1 n �k` w r' ;'IF' F�l�� +�Yrr71" r�i K1 tr°I(lcl'.�+�-1 s',,:. Sr t, }rc>,"•r � ', �;��t �, i � � rr 'E'2 c, CO !)r. ��:. ..r.� : �C?. r,lI j - ------ — —____ Ivflt?Y'� fit`,>51})tF . 7. tx I ea n,—,(' t ;,-njrtf 1,411 ny,1 ::1 r,!;;vF, i'«f;; it 1•1;!t-1LJ W�-. �...{ 1��.e t. '1. t:J li�1��. t � � I-4, t ��) r•fi --.... __.� ___J._.. `,_ _ .---_�_.__._..—.^._— ------__. A ��. �a. �irr. , t., "�P�, l �I f Li hJt,.�T 1(1 7.4' F t iN IV1. > V11�r r dollars 'y f., complete n1 actor:o,^ce with above specifications, for the sum of .R PpSf: to furnish material and iabo _---- —.—____— —. 1. payment oue upon receipt of invoke If payment late, interest at 1 1/2% may be added NOTE: This proposal may ber/withdrawn by us it not accepted wunin — — days Contractor Salesman Acceptance by Purchaser, and Title "You may cancel this agreement if it has been consummated by a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 S'ECTIQN"S-CONSTRUCTION SERVICES 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone "r 1„'tfii`e��mpro� rm`erit ContractilMIA4A � Not Applicable ❑ Comfy Name Registration Number Address Expiration Date Telephone 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...... ❑ MR O'aievYiiex E" emtion 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 n r ' • Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front L R: L: R: Rear Building Height Bldg, Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW y YES IF YES: enter Book _ Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES 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 NO ✓ IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: � a �tt/utifpko 2 'y `� • ; e Crx� of ��ztllanl�t�i� i 9 6 �lasaRrhnsrtta x DEPARTMENT OP BUILDNO INSPECTION5 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORXER'S COMPENSATION INSURANCE AFFMAVTr I, ED LOSACANO, NNER OF ALL STAR INSULATION & SIDING CO. , INC. Ncens�permicuux) with a principal place of business/residence at: 56 FRANKLIN STREET, EASTMWTON, MA (phone#) 413-527-0044 (strtxt/ci ty/state/a p) do hereby certify, under the pains and penalties of penury, than. (X) I am an employer providing the following worker's compensation coverage for my employees worming on this job: (osuana Comps') (Policy Number) (Expire oa Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the fodowLng worker's compensation policies: (Name of Contractor) (Iasu = Compa y/Poucy Ntunba) (Bxpiraboa Date) (Name of Contractor) (Insurance Compalry/Policy Number) (Expiration Date) (Name of Conuacior) (Insurance Compally/Policy Number) (Expiration Date) (Name of Contractor) (Insurancc CompaoyiPolicy Number) (Expiration Date) (attach addeboml sbcd if neecaary to wclude infonr.=oo perA4aing to all ooaw"wn) ( ) I am a sole proprietor and have no one worming for me. ( ) I am a home owner perfonuing all the work myself. NOTE:place bo award that wttdo boa=wom who er-ap lay pasoaa to do .lace.cocrr xuoo or rcppa.ir work oa a dwell of not an(v than throe units in which the boawow=r=da a oc u5e tax:,ca app rtenaa txrcto a-t one Eesmlty oomicka to be ecoploym undar ahs wW*='s Qoa=a.4On Art(01.152'=f(5)", r{q',:aac^.,by a ha W wW fer a Ucwx or permit MAY evtda=tho legal ctatu.s of as amployar uddK the W ork4es compoosalioa Act I WXkrsuad dLA a COFY of thin ctat=4=any be fore Wdod to tho Dc9anmaa2 of laaurn al Acadcon/MOO of Inwr~000 for do oovexage vcrificslioo and thu isilure w soaue covrrnbo vr. section 2 S A of MOL 152 cac lac'w tbo irz>po»fioo of M=131 penalties oomiaing of a&ae of up to S1,500.00 and/or =of up to orm ycar Lad civil p=Pia w tt4 forty of a Stop Work otda tad a nun of 4100.00 t day aping ma For dcpartma[>VJ uio only Pc7rrn i Number Lot# Signahxt of Lioausee/Permiau � M 'ECTION 5-DESCRIPTION OF PROPOSE WORK(check all ap ' a 1 New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding ] Other [ ] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 • Sheet❑ 6 addition to existing housing, complete the following: a. Use of building : One Family I 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. Mascheck Energy Compliance form attached? 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 . 1. 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 I' 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 Edwin L.osacano 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-R,enalties of perjury. Print Name Edwin Losacano / Signature of Owner/Agent Date City of Northampton Sta p tus of:,}?et it;1 � Building Department Cur,b'Cut/DrtveWay Permit "'111111 NOV 212 Main Street Sewer/Se tic•M lab tlit � ��` 9 2401 s� a, --- Room 100 Water/WeIIAvai.Ibi1,Gy. �� � � �• ��t e Northampton, MA 01060 Two Sets of$trWc,t Plans s phone 413.587. 12:40 Fax 413 8 1 Pt4t/ ,ite'F'lena Other SpeGlty APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Pr,Qp.erty Address This section to be completed by office 80 Acrebrook Drive, Florence Map_— Lot ___.__ Unit Zone_....,_.____...-______._. Overlay District,_,,.,.,_,_.. Elm St, District_ CB District__ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Corhelib Santiago Name(Print) Currrnt Mailing/ �ciress. T S'r';ph0nr Signature 2.2 Authorized Agen ; ALL SPAR INSULA��fION �& SIDING CO., INC. `43 �RANKI-VI S� If EE�i�, EAFTHAM�TOI�d, MA 01027 Name(Print) C,�-re-,t Mail ng Adr.ress: Y 413-527-0044 Signature or SECTION 3 - ESTIMAT„ED �QN�IB_Q TIQN COSTS !tern Estim�a ­d Cost (Dollars) , , Official 'j ,' Only com icted by perm!t apr' , a 1 Building 'a) Building Perrr,it f=ee 2 Electrical ;) Est!rriated i of l Cost of Constn from, ��- j 3 Plumbing i Building Permit Fee i 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 5) —! neck h Ire r This Section For Official Use Only _ ! E3ui!ding Permit Nun',Ler._ Signature, _ _ _ Buildin g __ Commissioner/Inspector n! Buildings a- .40 46REBROOK DR BP-2002-0519 CIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:29-208 CITY OF NORTHAMPTON Lot: -001 Permit: Buildln2 Category: vinyl siding BUILDING PERMIT Permit# BP-2002-0519 Proiect# JS-2002-0792 Est.Cost: $9900.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: UseGrou. All Star Insulation & Siding Co Inc 101858 Lot size(sg. ft.): 26658.72 Owner: , SANTIAGO CORNEL10 Zoning:_URA Applicant. All Star Insulation & Siding Co Inc AT: 80 ACREBROOK DR Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.•11/I5/01 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/15/010:00:00 26328 $25.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Building Commissioner-Anthony Patillo INSULATION SIDING CO., INC. 56 FRANKLIN STREET EASTHAMPTON, MASSACHUSETTS 01027 EASTHAMPTON OFFICE:527-0044 WESTFIELD OFFICE:568-6411 Contractors license#101858 Proposal Submitted to Phone Date `V•' Cornelius Santiago "Purchaser' 413-584-4177 Home October 19, 2005 +' Street Job Name 80 Acrebrook Drive- City,State and Zip-Code Job Location Job-Phone 1' Florence, MA 01062 Contractor herebysubmits to Purchaser specifications and estimates for: INSTALLATION OF A NEW ROOF J MAIN HOUSE v t pl,f "`~ t�.f r 4 W •II + II Architect hingfes They •lrh "Manufacturer's�factl Irer's 30 Year r i larantee'r Owner will'have choice of color. VY W111 I11 OII new 2_,All shingles will be nailed with at least(4) nails per shingle We •ll install �I aluminum rake a on rake _,. vvG will install new aluminum drib edg?on all eves and new`.�,.,.,,,�,., .`..�.�d�P areas. 4 We will approximately(40)'of roll vent on peak of roof for additional ventilation PRICE-$3.251-00 T py) o d ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY FEES REOI IRED FOR BUILDING DING PERMITS **A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY ITY WI I RE FORWARDED UPON REQUEST. **T P DALEY INSURANCE AGENCY OF WEST SPRINGFIELD, MA IQ OUR AGENT WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of: v ;25t.0t3 dollars($ 50% Qown, Balance Clue Upon ) payment due upon receipt of invoice. If payment late, interest at 1 1/2%inay-beadded. Completion of Job. NOTE:This proposal may be withdrawn by us if not accepted within THIRTY days. ,�:_,�_•� Ed Losacano,Owner Y,o jo Contractor Salesman- Cornelius Santiago Acceptance by Purchaser,and Tifle "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. of JKazthantptan . w �1d35Atl(liSlftD a DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building '>o Northampton,MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CNM 108.3.4 to act as hds/lier construction sups:-visor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or hvo fame y 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 fegulations. 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 i 4�iw-rnT r.. �it5e itch nsrtie' _ o DEPARTMENT OP BUILDr)-\)C INSPECTIO).'S 212 Main Strcet ' Municipal Dudding Northampton, Mass. OIOGO r'O'RJCCR'S CONfPENSA`nO.N MSURANCF AIZFMAVII. I, All Star Insulation & Siding Co., Inc. (]i C=ScrJperml ttCC) vrith a principal place of businessfresidencc at: - -- -- I - 56 Franklin Street Eastharmton, MA 01027 (phonc-')413-527-0044 (su>x-t/c;ty/siai�ra p) do hereby certify, under the.pzins and penalties of pcg'Ury, :hat (X)O I am an employer providing the followine!%vorkcr's comocnsaoon covems.0 for Ind emplovees worlang on Li is job: T. P. Daley WC 930-12-8-7 -- 8/13/06 (Lasar'o Corer .m) (Polio: l~ttmbccr) Date) O I am a sole proprietor, general contractor or homeowner(c cie ore) and have hired the contractors listed below wbo have the `olio%viog workers compen_saaon policies: I ; (i+IIIDC Of C0 ' CiO:) (Insuralic-c Coinpany/1 oucy lqui h--r) (E':J1rJGQ l l�alC) (Namc of Contraor) (Uisivanec ComoaativPolie; Nurncrr) (-DDir.6oa Date) (Name of Conrraetor) (Iasu aac; Compare}•/Folic}• tv;urbc ) (Expui z600 Date) (Name of Contractor) Jnsumn= Comcauy/Policy Numb:r) (Expiraiioa Date) (naxh:6digoal rxa,ifaccrr 1•to a�lv&info M- a Z oo pe-teiai.ac to ett O I am a code-proprietor and have no one work-jog for me- I n—m..a home oNvner performing all the work myself. NOTE:ple be ewuc the w} ye hemeo vacs_ttio etapl%PC710 to C=—:e,ao c rrnc Woric oa.d• LL*--z of nDl mOC't t1L'D t�;l"O:—'s to\.icb 4}X t]O�rLAd.oc oc Eric r�puaC{j 2�7pV.(t�Q:y7 lbC-G'a Lt oJr C-_n:.Uy OC.�C:derC�is be eiiptoye�ua,e the-- ch­�ca Acs(GL11 52=1(5)1=4VUco6oa by bommava fm a hez.or PC-Mn n_y a id=oc[he of ca-=Ploy-uo&r the worScora CoaxPomitioa AaL I unda*teod tha -'Off or this entaaxia t y be for--nrded to the Dop.nmaoa e f iadsrsri d Accidrati'Offioe of I,_,,oe for tb. covcnb Leif c:600 and aw L-iliac to sazue kovR undo soaioa 23 A of MOL 152 t.a IcA uo IJx i�oa of aimi—I pca+lt- oo=L%L=g of a Fine orup to S 1300.00 erdf- o(up to ooc yc mod o%il panda is tSc Form ora stop wort;ord=end. rim o(SIOOAO t d_y tpiaA t� - For dc9.r — u only - Permit NuIDlxs .�� 10/28/05 t.�.,p Lot rt -- 1 Siena orL10:371 Pctrniticc X11 e SECTION.& CONSTRUCTION SERVICES + 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature -- Telephone 9`2e s' ere ommp t' Not Applicable 13 All Star Insulation & Siding Co., Inc. 101858 Company Name Reg istratio-n Num er —` 56 Franklin Street 6/06 Address Expiration Date Easthampton, MA 01027 Telephone 413-527-0044 SECTION 10-WORKERS'COMFENSATION'INSURANCE AFFIDAVIT(M:Gt 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....... g( No...... ❑ �. III. �� o MIAMI current exemption for"homeowners"was extended to include Owner-occupied Dwelling-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 12eriod 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 buildine 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 SECTION 5-<DESCRIPTION'OF.PROPOSED`WI.ORK.(check-al[applicable)' New House ❑ Addition [];: Replacement Windows Alteration(s) Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [p Siding[O] Other[E:� Brief Description of Proposed Work: Installation of a New Roof - NO strip. Alteration of existing bedroom Yes No Adding new bedroom Yes No . Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ga Ie osnrcictiaotls. iio-.uslna �co alete th �1 u: 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 i 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 Al7THORIZATION TO BE COMPLETED WHEN- OWNERSAGENT OR=CONTRAGTOR;APPLiES FOR BUILDINGGPERMiT` I, 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 I, All Star Insulation & Siding Co., 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 Losacano, Owner/President MPrint Name,\ �\ (T�C� Q.� 'uT October 28, 2005 Signature of OwnedAgent Date r , Section 4. ZONING All Informatioh 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 Frontage Setbacks Front Side L:= R:` ? Lf i R:i Rear Building Height —j —i -- Bldg.Square Footage �- Open Space Footage r� � % (Lot area minus bldg&paved l� 1 parking) #of Parking Spaces Fill: i t = i (volume,&Location) I --— 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:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES 0 IF YES: enter Book I 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 s IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES NO 0 IF Yta, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it pat of a common plan that will disturb over 1 acre? YES 0 - NO 0 I IF YES,then a Northampton Storm Water Management Permit from the DPW is required. F ' City of Nort ampton -m Building Department 212 Main Street e E Room 100 Northampton; MA 01060 u pllore 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE INFORMATION This section to be compTefed bar,.office 1.1 Property Address: s" ..S.i ' 80 Acrebrook Drive �� Florence, MA 01062 Zones r 4 Overlay D�strrct im 4 7 N5C Rill SECTION-2-PROPERTY OWNERSHIP./AUTHORIZED AGENT 2.1 Owner of Record: Cornelius Santiago 80 Acrebrook Drive - Florence, MA 01062 Name(Print) Cwief1t 9ailing.Address: 433 ��444411���� Telephone Signature 2.2 Authorized Agent: All Star Insulation & Siding Co., Inc. 56 Franklin Street - Easthampton, MA 01027 Name(Print) Current Mailing Address: `sx (�/l 413-527-0044 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building ,(a)Building Permit Fee $3,251.00 2. Electrical -(b)Estimated Total Cost of Cons fruct ion.from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) $3,251.00 Check Number d This Secti6fi For'Official`Use Ohl Buildin Permit Number." Date g I"s"sued: Signature: r Building Commissioner/Inspector of Buildings Date s: 80 ACREBROOK DR BP-2006-0487 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-208 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category BUILDING PERMIT Permit# BP-2006-0487 Project# JS-2006-0709 Est. Cost: $3251.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: All Star Insulation & Siding Co Inc 101858 Lot Size(sq. ft.): 26658.72 Owner: SANTIAGO CORNELIO&RAMONA Zoninjz:URA Applicant: All Star Insulation & Siding Co Inc AT. 80 ACREBROOK DR Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.111212005 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL NEW 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 11/2/2005 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo