25C-133 (6) 7") 13,;1"�t
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INSULATION ✓�/ v
; SIDING CO., INC. �
56 FRANKLIN STREET EASTHAMPTON, MASSACHUSETTS 01027
EASTHAMPTON OFFICE: 527-0044 WESTFIELD OFFICE: 568-6411
Cotitrii tors IicE?nse # 101858
Proposal Subnfitted to Phone Date
Terry Lee "Pvrchoser" 413-58�--2454 iWt� Noveiter 6, 2W3
Street Job Name
=k; C i za:letJ.I Street PA(-'E 1 of 2
City, State and Tip Cods! Job location Job Phone
44-4c") E I 1 ZZO;,;I. i
Contractor hereby submits to Pvrchoser specifications and estimotes for•, lidSi!�LLf'Vi"tt'! i)f �li'iY�_ JLIJl°7(: 11+`di1
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=jt .Tei using al ixi-i iiut�, ro I_; su hey tit !) tlU rizt
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4/ -� WE PROPOSE to furnish material and labcr, cc,Mpiete in accordance with above specifications, for the sum of.
dollars (S ' ), payment due upon receipt of invoice.
If payment late, interest at 1 1/2% may be added
NOTE: This/proposal may be withdrawn by us if not accepted within 1' I` _days.
i y
"' .UL i S;:.., _-, 'rS ! �`' Contractor Salesman
t
r,•�; �;.,, 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
'e,` Clifp '�7z_t[� Z�it�i�
y�'+X 5i Nt17 tiK(lltl
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass, 01060
WORKER'S COMPENSATION LNSURANCE AFMAVIT
I, ED LOSACANO, NNER OF ALL STAR I�1SU�_AT:C & SIDING_ CO. , INC.
with a principal place of btlstness/res;dence a,.
56 FRANKLIN STREET, EASTHAMPTON, MA (phope#) 413-527-0044
do hereby certify, under the pairs a.nd
(X) I am an employer providing the compensation coverage Cor my
employees working on this )ob'.
(Insusaaee Compazy) (Expiration Date)
O I am a sole proprietor, general conk or or `:c,eowneT (ct;cie one) and 'aave hae:d
the contractors listed below wbo have the fo�io u:g worker's compensat policies:
(Name of Contractor) (Insurance Compaay/Policy Number) (Expiration Datc)
(Name of Contactor) (Iruvrancc Cou pa,y�Ps'„c� Nuznbcr; (Expiration Date)
(Name of Contractor) Qnsnce Compw.'/Po,icy Number) (Expirarjac Date)
(Name of Contractor) CLasuraax Cow pa y'?o!:cy Nl:m' -r1 (EirapoQ Data)
addrttooal d1bCt irabo=ury tO me}'< iLfC(TaacOa pC(".\:.q]i;8 t0.L' ncl.on}
( ) I am a sole propnetor and have no one wor4iing for me.
( ) I am a home owner performing all f,he work Myself.
NOTE:Pteaae be aware ttut'-tc;o bomccw pc. =s m i
W an"tban limo wait$t w+ycb tye u'ocl cr-C ;e ;^'.�.�� t��:.^.racA lhcrcto a.-c pot y ooar.dcred tz x
emPloYtra undct LtW CCC sV.:xi A.Ct'„ I S:-= . .. ..�:. .�;.: e'r. .ur,,w xr e czax a perr A may cVdcr”L,n
legal rtxtui of as employes wade*C:b ''::ert.arc Coav-tic�)cm �a
i uaderstxad d�.d a copy of lhis=LL=a c MAY bo ro(w --1ec w t8a [cp vc�ax o!'Inm fire n c� Offioo of tRSil!'ADCO for }ao
covatgc vccihCslioa and that fi lu7t to scr�rc aovcrz�c _r a-:�� ;c q;r i,r,'_ '�52 —U..a..^,tc'x i zr alai-of cr=:1,
ooasiuing of a fma of up to S I.3,A.00 tr.; r
rum of S 100.00 a day LP.I=Me
For d.;x�Uao onty
Permit Number
Map;t Lot �
Signahrre of Lins�lPcrmiutt -T- ate
5 „' $'F? 0(�STRtJCTION SERVICES j
Licensed CQris,tryctipnSupervisor, Not Applicable O
Name of License Holder
License Number
Address Expiration Date
Signature t Telephone
'�ul� `�il� t' 5f:rriFi�uh7'gb kn
Ift Not Applicable ❑
d
'Y Registration Number
Address". Expiration Date
An
elephone R�—�C
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,,.....Zl,�' No...... D
,{i1
WW1*
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 108,15,1,
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, Ar)erson 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
f
,
.1 4
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s,
'%CTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition O Replacement Windows Alteration(s) FRoof ng ❑
Or Doors ❑
Accessory Bldg, ❑ DemolitionO New Signs [ ] Decks [ ] Siding 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 0
6:a f T evv h : s'e and`or.`a�dition to exi` i"ng housing, omglete.Ahe foll'ti .Ift:
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 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
1, ., as Owner of the subject property
hereby authorize to act or
my behalf, iniall matters relative to work authorized by this building permit application.
e of Owner Date
° -- —=�'� ca J--) �(U"�1 `►'�} � � 1� ` �r s Owner/Authorized Agent
hereby declare that the statements anTd 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.
Print
of Owner/Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
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 Issued:
C. Do any signs exist on the property?
IF YES, describe size, type and location:
YES NO
D. Are there any proposed changes to or additions of signs intended for the property ?YES _.
No
IF YES, describe size, type and location:
I
Existing
Proposed
Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
'
L: R:
U R:
Building Height
Bldg, Square Footage
%
Open Space Footage
(Lot area minus bldg&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 Issued:
C. Do any signs exist on the property?
IF YES, describe size, type and location:
YES NO
D. Are there any proposed changes to or additions of signs intended for the property ?YES _.
No
IF YES, describe size, type and location:
I
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413.587.1240 Fax 413.587.1272
APPLICATION TO CONSTRUCT, ALTER, REPAIRjLRQ I
r
MAR - 4 2004
MATION
E1 H A ONE OR TWO FAMILY DWELLING
i
1.1 Property Address: r 5 $ ;�.�mqPs�
l�.jj 11b. /��-" 1 /�
1 Lr 1�Zli �. ;,'��d �
*
t Zone QY FDl�tf iFt
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(PrIntp
i Signature
Curren ailing Address, Gt ( M
C e L U ] '-�1`'i�
Telephone
2.2 Authorized Agent:
ALL STAR INSU_ATION & SIDING CO., INC. 56 FRANKLIN STREET, EASRMTON, VA 01027 _
Name(Print) Current Mailing Address:
413-527-0044
Signature Telephone
SECTION g-ESTIMATED CONSTRUCTION
COSTS
Item
Estimated Cost(Dollars) to be
Com leted by ermit applicant
Official Use Only
1, Building
(a) Building Permit Fee
2. Electrical i
(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 issued;
— I
Signature:
Building Commissioner/Inspector of Buildings Date
44 ELIZABETH Sf BP-2004-0849
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C- 133 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2004-0849
Project# JS-2004-1260
Est. Cost: $12000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin: All Star Insulation & Siding Co Inc 101858
Lot Size(sq. ft.): 7056.72 Owner: LEE TERRENCE J
Zoning_URB Applicant: All Star Insulation & Siding Co Inc
AT. 44 ELIZABETH ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers
Compensation
EASTHAMPTONMA01027 ISSUED ON:318104 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 3/8/04 0:00:00 29692 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo