32C-225 (3) �... A�l
INSULATION APR 17 201.4
&
SIDING CO,, INC.
EASTHAMP]FON OFFICE a 13 d,Vt'C-Ivic #(-,s 5V q�?!'�;_°2w WESTFIELD OFFICE 4
56 FRAT,KKLIN STREET EASTHAMP"I'ON, MASSACUIUSETTS 0I027 • FAY. : ,4 I3-S27-1221;
Proposal Submitted to Phone Date
Lawrence West "Purchaser" 413-268-3315 Home April 11, 2014
Street Job Name
95 Main Road 73 Hawley Street
City,State and Zip Code Job Location Job Phone
Haydenville, MA 01039 Northampton, MA
Contractor hereby submits to Purchaser specifications and estimates for: NEW ROOF - UNIT 73 ONLY 2ND FL MAIN ROOF, 2ND FL
REAR EXTENSION, & FIRST FL FRONT PORCH
OPTION 1: NEW ROOF-UNIT 73 ONLY-2ND FL MAIN ROOF 2ND FL REAR EXTENSION AND 1ST FL
FRONT PORCH
1. We will remove (2) layers of existing shingles and (1) layer of sheeting and dispose of in a dumpster supplied by
rl u, We will build (1) cricket on chimney
2 We will install Titanium Rhino Deck over entire stripped roof surface.
3. We will install new Gaf Timberline Architect shingles. They will have a "Manufacturer's Lifetime
a J Limited Warranty'Solor will be Hickory 4. All shingles will be nailed with at least(5) nails per shingle-
5.
^t We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas.
6 We will install pipe boots and step-flashing where needed.
Z. We will install approximately (50)'of roll vent on peak of roof for additional ventilation.
8 We will install a 36"wide asphalt ice and water barrier on eve lines.
PRICE $8.632 00
OPTION 2, (ASR SUB SHEATHING
1 We will install all new 7/16 OSB sub sheathing in designated areas.
PRICE $1.563.00
*1 HOIViEOWN ' WILL F = L; n°ON`IBL-E F0k AL4,( + ' ._
F . RC_ Le L C�_i_�%L1�UL.DL� ;x 3 _ r_ V__ ._
IF ANY SUB SHEATHING IS NEEDED THERE WILL BE AN ADDITIONAL CHARGE OF $38 PER SHEET TO
REMOVE DISPOSE OF AND INSTALL NEW 7 1/16 STRAND BOARD SUB SHEATHING.
"* HOMEOWNER WILL BE RESPONSIBLE FOR COVERING ANY STORED ITEMS AND FOR ANY CLEAN UP
,NOORKIN THE ATTIC NEEDED FROM DUST & DEBRIS FROM ROOF REMOVAL
**APPROXIMATE START DATE WILL BE MAY OR JUNE LESS ANY INCLEMENT WEATHER.
ALL STAR IS NOT RESPONSIBLE FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHTS (IF
APPLICABLE)
* O PRODUCT & LABOR WARRANTIES WILL BE ISSUED UNTIL WE RECEIVE FINAL PAYMENT
**A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED
UPON REQUEST
T P DAL Y INSURANCE AGENCY OF WEST SPRINGFIELD MA IS OUR AGENT
WE PROPOSE to furnish material and labor, complete in accordance with above specifications, for the sum of:
dollars($ 1!3 DOWN, 113 UPON START ), payment due upon receipt of invoice.
If payment(ate, interest at 1 112% may be added. AND 1/3 UPON COMPLETION
NOTE: This proposal may be withdrawn by us if not accepted within THIRTY days.
Ed Losacano, Owner
f �. ••--_ - - -Contractor Salesman
Lawrence West 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,CONE)I f IONS PRINTED ON REVERSE- SIC--
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
I Congress Street, Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/individual):
ALL STAR INSULATION&SIDING CO.,INC.
Address:56 FRANKLIN STREET
City/State/Zip:EASHAMPTON, MA 01027 Phone #:413-527-0044
Are you an employer?Check the appropriate box: Type of project(required):
L ✓❑ I am a employer with 10 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 7 Remodeling
ship and have no employees These sub-contractors have 8, ❑ Demolition
working for me in any capacity. employees and have workers'
9. E] Building addition
[No workers' comp. insurance comp. insurance.*
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] c. 152, §1(4),and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#I 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 then 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 have
employees. If the sub-contractors have employees,they 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:STAR INSURANCE
Policy#or Self-ins. Lic.#:WC 068114 Expiration Date:8-13/14
Job Site Address:73 Hawley Street City/State/Zip:Northampton, MA 01060
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 fine
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 under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date: �o
Phone 4:413-527-0044
Official use only. Do not write in this area,to be completed by city or town official
Project: Project Address:
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Ed LOsacano CSSL 099739
License Number
128 Glendale Road, Southampton, Ma 01073 2-14-16
Address Expiration Date
413-527-0044
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
All Star Insulation & Siding Co. Inc.
Company Name Registration Number
56 Franklin Street, Easthampton, MA 01027 101858
Address Expiration Date
Telephone 413-527-0044 6-29-14
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....... EX No...... ❑
11. - Home Owner Exemption
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 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
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors I]
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding[0] Other[p]
Brief Description of Proposed New roof Unit 73 Only
Work:
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 house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family X 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
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
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.
`I, Oct o C)
Print Name
Signature of Owner/Agent r Date
Section 4. ZONING All Information 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: 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/Find in ver been issued for/on the site?
NO 0 DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Reg! try of Deeds?
NO 0 DON'T KNOW YES
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 (2( YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO ®'f
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
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing, grading, exc vation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
City of Northampton Status of Permit.
Building Department Curb Cut/Driveway Permit
{U 212 Main Street Sewer/Septic Availability
MAY _ 2 2014 V Room 100 WaterANell Availability:—i orthampton, MA 01060 Two Sets of Structural Plans
Electric Plumbing MA Plumbing Gas e° �I -587- 1240 Fax 413-587-1272 Plot/Site Plans
N
Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
Map Lot Unit
73 Hawley Street, Northampton
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Lawrence West 95 Main Road, Haydenville, MA 01039
Name(Print) Current Mailing Address:
413-268-3315-H
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building $10,195.00 (a)Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = 0 +2+3+4+5) Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
73 HAWLEY ST BP-2014-1146
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-225 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-2014-1146
Project# JS-2014-001940
Est. Cost: $10195.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sg.ft.): 7797.24 Owner: WEST LAWRENCE E&LINDA A&JENNIFER L WEST
Zoning. URC(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC
AT. 73 HAWLEY ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON.51212014 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF,1ST FLR FRONT
PORCH,2ND FLR MAIN & REAR ROOF ONLY
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 Sisnature:
FeeType: Date Paid: Amount:
Building 5/2/2014 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner