25C-078 LI OJ A LJ INSULAFION&
MAY
SIDING CO, INC.
56 FRANKLIN STREET l:,,\'-;'1'11,,\Nll"l'()N, NIA,,--',SA(',IiLISETI'SOIO27
EASTHAN4p,rON OFFICE: :I--T-()k)-l-4 WESTFIELD OFFICE: 1,368-6411
Proposal Submitted to Phone Date
Stew F'rbi rszon
Street Job Norns
4 Cor,,2
City, State and Zip Code Job Locofion job Phone
I%runw ton, MA CIC6`,
Contractor hereby submits to Purchaser specifications and estimates fol.
CATION�! V�INYL -S�IDING -------
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WE PROPOSE to furnish material and labor cpmpiete in accordance with above specifications, for t)
dollars i$ payment due upon reCelpl
If payment late, interest at 1 1/2% may be added
NOTE: This proposal may be withdrawn by us if not accepted within
Contractor
'Jl
Acceptance by Purchaser,
"You may cancel this agreement if it has been consummated by a party thereto at a place other than an adds
seller, which may be his main office or a branch thereat, provided you notify the seller in writing at his mail
branch by ordinary mail posted, by telegram seat or by delivery, not iater than midnight of the third busi
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
4► e Lii cif ' o"�tlI uIIl:p toll
F)i N(f)f`,Ke tie ^
DEPARTMENT OF BUILDTNGG INSPECTIONS
212 Main Street ' 'Municiped Building '
Northampton, Mass, 01060
WORKER'S CQMPENSATXO�; 2 SURANCE AFMAVTT
L, ED LOSACANO, 3+ NER OF ALL STAR I NSCLA7 G�. 5 SIDING CO. , INC
with a principal place'of btls nesslresiaence a:
56 FRANKLIN STREET, EASTNAMPTOk, MA _ (I%.phooe#) 413-527-0044
do hereby certify, under the pains and
( I am an employer provI,ding the for my
employees worcing on this )ob.
P s G (,c)_ C, 53(cs3,3 -13_0 3
(Lu% mce Company) (Expirybon Dais)
( ) I am a sole proprietor, general ccn c-or or hcme�owner (ci:cle one) and have Hired
the contxaotors listed below wqo have ;e c o;Y�:ng worke's compensation poLces
(Name of Contractor) Numbcz) (zxpiraaou Date)
(Name of CoDtTaclor) (1n urancc Compu;ylPclicy Number; (Expirnuon Date)
(Name of Contractor) (Expiradoo Date)
(Name of Contractor) Date)
(KMI}#Cb&d&6 oral lb"-:(if Z00=uy t.o cLxh,rpe utt--mY ..�c U. i.. ccc�ra<xgn j
Y
O I am a sole proprietor and gave no nr.e 'Vos-'Klng for me.
O I am a home owner peri==' g all
NOTE:Fleau ba award aw wtty o b�woo y ac:ccm c ro o Z--ccincc.cow aoa cu cpwu r�oc ng o;
W mom than three urwj 4 utvcb:'.x rt=d=c� x,x � :,,s:��crMA tdrr a s c oa gcna'al?y'cowl-"czc `. 'c
etaployen under tba�wrka:cvc� za:.x Aa' a :cr,, e sax a perms:may rntkM<r lx
lcga!vAua of w employer�ac-e=0 w orxorg coca,cc-"K-: a Y
I uodcma d bias a copy of h aLL. n may bo 0t5(x or ttrnuvro For Use
coverage vrxificslioc ar:a'hst ra:!=t to$c --t m, ro _ .r. : �. ... 5^ ca. c:_; tx oa aioo
ooasuvinz of a aax of up to S 1'�X Gl: urJo =a i�cn c'_ rr� }�-3` , i::r.l�xaa;'.,a �n�_K I�X n o!K SWD'a%ors nw 41A a
fiAo of 5100.00 t day aga cxsl ur
For ooty
Permit �Llint�7
�_ ��� MaI ��_ __Lot H
Sipawrt of I.lQ=SM?cCII1.lU=
ECTION 5• DESCRIPTION OF PROPOSE WORK-Uheck all applicable)
New House ❑ Addition O Replacement Windows Aiteration(s) Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ DemolitionO New Signs [ J Decks [ ] Siding [yJ*" Other ( ]
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 r Renovating unfinished basement Yes No
Plans Attached Roll 0 • Sheet o
6:a IUINV ir",zh'bus'eaand'or`addition to existing housing, complete Jhq following
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, 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 N
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
l as Owner of the subject property
hereby authorize _ _ to act c
my behalf, inall matters relative to work authorized by this building permit application.
Signature of Owner Date
I,�(`�IJUC�t. Qx PS��t �f��� 3-1aC �h���Jr d i,Va &0 �Cd as Owner/Authorized Agent
hereby declare that the stat' ments and information on the foregoing applic on are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury,
("'d,wc;r�- Lo is Nn
Print Name
d'Ly&�- Ao�-IA'r- /1')(p (o a o -o.5)1
Signature of Owner/Agent Date
1 {h 1 t
( I „ � GNSTRUCT.ION"SERVICES
„I Licensed Construction Sy rvisor; Not Applicable ❑
Nalpr of Llcensg Holder ;
t `f , r License Number
Address I Expiration Date "
Slgnatule, Telephone
i�.'.C.•hi�r�hit:., 1 .��`�^�? 'F.f:u��ufiYGUUIri:'' ”".f� ; Not Applicable ❑
nmpanx bAm @ Registration Number
Address y 1 :• �/ Expiration Date
SECTION110.WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G•L. c. 152, 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with tors application, Fall,.re to provide this affidav
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... D
'L� Y+A+'it''� ,'Jf�l,.��� r�to7'T.•'�1,QN?l:,
win"er; xeM-6,on
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 heishe 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 Offic a', that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the ,ob site will be required from time to time, a,,1,M6 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 persons)
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
is � ��• if�;Rt; _ .. _ .
t;' f St,4'r t'• 1
,
4 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 E y
g L: R: L: R:
B�
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bid&&paved
arkin
#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 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 lssued:
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:
City of Northampton
_._- ---- i g Department
(sa Main Street
m
o 100
i Nor ton, MA 01060
Sa it �tJ�{ p e?-V3• 1240 Fax 413.557,1272 Jf'
AP I He TI TRUCT ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
• r
1{' ' ITE�INFORMATION
1.1 Property Address; Thfs Segf� tggtlpl
Map rYti ;... � •,f�� -r
'i
Zone QIiY`,Distri�t
4
Elrn t't. District__ CB District___
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
�.S..1 P (-)-p.�. b f y�s /l� ��7 L 1��
Name(Print) Current Mailin dr ss
Telephone
Signature
2.2 Authorized 6gent;
ALL STAR INSUAATION & SIDING CO., INC. _ 56 FRANKLIN STREET, EASTrIWTON, MA 01027
Name(Print) Current Mailing Address:
Ed W&&' m 413-527-0044
Signature Telephone
SECTION 3- ESTIMATED )N COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit apphcant
1, Building # /0j 3312 (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 =(1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Only
Building Permit Number: { Date ssued:
Signature:
Building Commissioner/inspector of Buildings Date
. BP-2003-1197
GIS#: COMMONWEALTH OF MASSACHUSETTS
. P. CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cate og ry. BUILDING PERMIT
Permit# BP-2003-1197
Project# IS-2003-1860
Est.Cost: $10331.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: All Star Insulation & Siding Co Inc 101858
Lot Size(sy. ft.): 7840.80 Owner: ROBINSON STEPHEN C
Zoning:URB Applicant: All Star Insulation & Siding Co Inc
AT. 4 GLENWOOD AVE
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers
Compensation
EASTHAMPTONMA01027 ISSUED ON:6123103 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• Receipt No: Date Paid: Check No: Amount:
Building 6/23/03 0:00:00 28585 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo