36-195 ie woe Q
INSULATION �-
&
SIDING CO., INC.
56 FRANKLIN STREET EASTHAMPTON, MASSACHUSETTS 01027
STHAMPTON OFFICE:527-0044 WESTFIELD OFFICE:568-6411
EA Contractors license #101858
Proposal Submitted to Phone Date
John LaFlamme "Purchaser" 413-586-4303 Home 19/16/05
Street Job Name
778 Burts Pit Road 413-584-7200 x 0 Work ,
City,State and Zip Code Job Location Job Phone
Florence, MA 01062
Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF A NEW ROOF
MAIN HOUSE&GARAGE
1 We will install new Architect shingles They will have a"Manufacturer's 30 Year Guarantee" Owner will have choice of color,
2.All shingles will be nawled with atle@st(4) nails per shingle,
3.We will install new drop edge around outside peromejer of roof- r
4.We will reuse existing roll vent,
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" HOMEOWNER WILL BE RESPONSIBLE FOR ANY FEES REQUIRED FOR BUILDING PERMITS -
**A CERTIFICATE OF INSURANCE FOR WORKMAN'S cOMP 'NSATION AND LIABILITY ITY WII I RF FORWARDED UPON REQUEST.
** T P DALEY INSUSANcE AGENCY OF WEST SPRINGFIELD- MA Is OUR AGENT
WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of:
-53.00 _ dollars($ 50% Down, Balance-Due Upon- ) payment due upon receipt of invoice.
If payment late, interest at 1 1/2% may be added. Completion of Job
NOTE: This proposal ma be withdrawn b us if not accepted within THIRTY days.
y P -- -- _ --- -
-- --- -- -
Ed Losacano, Owner
Contractor Salesman
Jb n LaFlamme Acceptance by Purchaser, d t
an Tile
"You may cancel this reement 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
"bFa 6 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.
� d j�i[assachusrtfs
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR ,
2112 Main Street • Municipal Building 5,
Northampton,MA 01060
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 78OCNM 108.3.4 to
act as has/her construction sups: -;sor. The state defines"Homeowner" as, "-Person(s)
who owns a parcel on which he/she resides or intends to be,a one-or-two fami -'
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 backfll),
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
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PJ E J31 a3 aItChrtsr110' -
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DEPART).-IENT OP BUILDI7\C INSPECTION'S ;
212 Alain Strcct Municipal Building
Northampton, Mass. 01060
WOR.1C:R'S CON[PENSA`)TON LNSUR CE All=, A V1?'
I, _All Star_ ns-u..La iion&Si r1i nq Co , Inr
j (li ccus x/permi cicc)
%rgth a principal placz of business[residcncc at:
56 Franklin Street - Eastharrpton MA- 01027 (-Ph o n c-')413-527-0044
(sue-c/d rr/statcl�p)
do hereby certify, under thc.pi'i as and penalties of penury, i.)1:1
(X) I am an employer providing the follo%vine'workcrs colnpcns-tion covcmgc for Inv
employees wortang on ulis job:
.T. P. Daley X 930-12-87 8/13/06
OMSUJ-an=Compa-m') (PcUc-Nt-mb-cr) -- ( :-pirzrion Day^)
( } I am a sole proprietor, general coonacor or homeowner(c cie ohe) and lave hired
the cooua(nors listed below wbo leave the folloWi.ng worker's coMoen_t26on policies:
i
(i+amc Of Conrmcw) On--L' rlc; Colrlpan)-i'l ouc NIUMIC) (r'::dinauon Dmc)
(Name of Coolracior) (1n.aLraacc Compaq)vPoUc: \LLm6cr) (-Ea-pir lion Date)
(Name of COMMCld.) (IAS-Uf C; Compan y/Pock}' tvu.mbzr) (Exairrtioa Dale)
(Name of Contractor) (Lasuran�Compalry/Policy Numbs) (Expiration DatL).
(aaar�adlr,:ocil rScrl,iracoci.�-to mcudc iaror MAEOC pctaiaiab to.11 cDc=- .on)
{ ) I
am'a sole-proprietor and bave no one work3og for me.
1 —P-l..a home owner performing all Lbe.work myself.
NOTE:ply be aararc tbx NL^1e b*ax o Amer]Hto ccaploy p--- a=Lo S3 o, c oo a rrau-ori oa.d..e -F of
ant more thm tbroe tnrx is w!Mch the bomoaw reazde a oo the p ouz,6 aapurLc==the* &-c we C=� -Uy==d_-rad to be
eitploye-untie the--kcr4 O=p=:1ica Act(GU1152=I(5)�:ppti=L6=by a bomcoava far a 6c:r-v a pamrt r=y--id—tLc
I egal rt=^„of.n eegloyor ceder dh WorkoeL Comipemalioa Act_
- [uodcs d cb�a copy or tbij crit=,at MAY Ix to the popartmcaa of Induxricl Acadca y Office of Lu+r.00+ror th.
eovcrasc"a i c=iioa and Oul L11=to.o3uc'c*%'t se trade vx tioa 23 A of).(OL 151 can led to the imPo5i6oa of aimiaal pemltic
cocsisa of a fine of up to S 1 500.00 artdlor or up to one yr-r Lod viva pco.hia io 6,form or.Stop Work Ordcr and.
fim of S 100.00 a dry.ptinst ED--
For dcpvtm� u.e only
Permit Numbcr -
,t ._ 9/26/05 t.�px Lot n '
Si�sazLtrr of Li=L'Cr�cMnitrcc —I JS Ee-
SECTION 8'r-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
9�:Re usi�ee . e1m raY!etrt2c�tat clG Not Applicable ❑
All Star Insulation & Siding Co., Inc. 101858
Company Name Registration Num er
56 Franklin Street 6/06
Address Expiration Date
Easthampton, MA 01027 Telephone 413-527-0044
SECTION 10-WORKERS'COmoet4SATION.1NSUR,4NCE I AMP4 VIT(M.-Gi.c:152,§25G(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....... q No...... ❑
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
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SECTION 5-DESCRIPTIONOF:PROPOSED'WORK(check�allapplicable
New House Addition []:;: Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [p) Decks [0 Siding(p] Other[0]
Brief Work e�ni tio�r�a�tior�opa new Roof.
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
roa f t�evv se ah r c rr of # ex><s#1 nctaGio.,uslna: orrig>fe#e th' `otlQ ing:
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
L 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 , CO
TO BE MPLETED WHEN'
OWNERS AGENT OR CONTRACTOR APPLIES FOR;BU.ICD(NGSPERMiT`
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
Print Name
Wte llber 26, 2005
Signature f Owner/Agent Date
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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 - i
Frontage y I
Setbacks Front
Side L7 R:= L:� R:I I
Rear `
Building Height -_--! —I
Bldg.Square Footage �i % i^';
Open Space Footage [� %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume I&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q I DON'T KNOW 0 YES 0
IF YES, date issuedd
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES
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 Obtained Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
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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 YtS, 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
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IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
City of Nortl;iam.pton
.Building Department "
�n ' 212 Main Street h
Room 100 e a
f,( Northampton;MA 01060 r
D 7 S ��ll✓ a€
SE PI 415- 8j-1240 Fax 413-587-1272 'to a N
NA L`{CATICIAL Q 62NSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
'SECT.ION 1 SITE INFQRIVIATION
<;;�r h� , dais"section'to be rKompleted)office �,�K
1.1 Property Address:
i- d ig:. e °iYR-v K 9 .Ni
�y
778 Burts Pit Roadti
Florence' MA 01062
rM S r 1 f`k sr tN+1'se,t'c
ElrirSt atsttct, r r ?._rte ,* rCiStnC#*t
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`SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
I
John LaFlamme' 778 Rurts Pit Road - FlnrPnce, MA 01062
Name(Print) Currer�.AAailica,Address:
413—�25b-43U�
Telephone
Signature
2.2 Authorized Agent:
All Star Insulation & Siding Co., Inc. 56 Franklin Street - Easthampton, MA 01027
Name(Print n Current Mailing Address:
FA cl� 413-527-0044
Sign ure Telephone
SECTION 3-ESTIMATED-CON§TRUCTION COSTS
Item - Estimated Cost(Dollars)to be Official'Use Only
completed by ermit applicant
1. Building ,(a)Building Permit Fee
$2,653.00
2. Electrical -;(b)Estimated Total Cost of
Constriction"froth 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) $2,653.00 Check Number
This'Section Fo� iciat"Use;Onl
.Date;.,
Building Permit Wumbe'r. Issued:
Signature: '
i
Building Commissioner/Inspectorof Buildings Date
778 BURTS PIT RD BP-2006-0345
CIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36- 195 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0345
Project# JS-2006-0506
Est.Cost: $2653.00
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.): 31450.32 Owner: LAFLAMME JOHN&CHRISTINE A
Zoning: SR Applicant: All Star Insulation & Siding Co Inc
AT. 778 BURTS PIT RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers
Compensation
EASTHAMPTON MA01 027 ISSUED ON.912912005 0:00:00
TO PERFORM THE FOLLOWING WORK.-SHINGLE ROOF OVER EXISTING 1 LAYER
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 9/29/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo