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17C-304 INSULATION SIDING CO., INC. EASTHAMPTON OFFICE 413-527-0044 CSL License #CS SL 99739 WESTFIELD OFFICL 13-568-641 1 56 FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 FAX: 413-527-1222 Proposal Submitted to Phone Date John Dunphy "Purchaser"413-335-9757(C) May 8,2015 Street Job Name 111 Chestnut Street City,State and Zip Code Job Location Job Phone Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW VINYL SIDING ON MAIN HOUSE 1 We will install new Vinyl Siding on all exterior walls Homeowner will have choice of color style and brand name, 2.We will nail all siding approximately 16-24"on center using aluminum nails so they will not rust underneath the siding 3.We will install a 3/8"insulated Styrofoam backer behind the siding 4.Wood trim around(18)windows and(4)doors will be covered with White aluminum coil stock material, 5.Windowsills will be trimmed out with White aluminum coil stock material, 6 Wood trim soffit and fascia will be covered with White aluminum coil stock and perforated White vinyl soffit material.We will drill out wood soffit areas to increase attic ventilation 7.Wood rake fascia will be covered with White aluminum coil stock material. 8 Any caulking that needs to be done will be done with Silicone Caulking, 9 Any existing wood that is loose will be renaifed 10.Any existing wood that is deteriorated which needs to be replaced so that we can perform our work will be replaced This does not include any structural or dimensional lumber or sub sheathing. 11.We will install(3)White gable end louvers in designated areas, (2)White vinyl lite blocks behind light fixtures (1)White dryer vent and(2)faucet blocks in designated areas i2 We will install White regular outside corner posts on all corners, ',3.'Ode vA�,ei—nove and reinstall emisting g--,fters_ancl dr)wnspQUts 14.We will remove ant--' fexistinu shutters, 15.Areas to be covered on rear screen porch will be as follows Soffit and fascia trim with aluminum coil stock material and vinyl soffit material and(2)Gable end cheek walls with vinyl siding 16.Areas to be covered on front porch will be as follows- main house wall with vinyl siding and soffit and fascia trim with aluminum coal stock material and vinyl soffit material, 17.Job site will be cleaned upon completion of job, 18,Vinyl Siding has a"Manufacturer's Lifetime Warranty". I— PRICE$10 532.00 —APPROXIMATE START DATE WILL BE I ME ONCE WE RECEIVE THE REQUIRED DEPOSIT AND: SIGNED CONTRACT, LESS ANY INCLEMENT WEATHER ALL STAR WILL SECURE BUILDING PERMIT IF NEEDED. HOMEOWNER WILL BE RESPONSIBLE FOR ANY &ALL FEES REQUIRED, NO PRODUCT&LABOR WARRANTIES WILL RE ISSUED UNTIL WE RECEIVE FINAL PAYMENT, A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FOR1.1%1ARDED UPON REQUEST—T.P. DALEY 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: $10,532.00 — dollars($ 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 may be withdrawn by us if not accepted within THIRTY days. ED LOSACANO,OWNER Contractor Salesman john uunphy 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations r 600 Washington Street Boston, MA 02111 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: Easthampton, MA 01027 Phone #: 413-527-0044 Are you an employer? Check the appropriate box: Type of project(required): 1.E3 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. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working or me in an capacity. employees and have workers' g Y 9. E] Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 131-1 Other comp. insurance required.] *Any applicant that checks box#1 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. I 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. #: WC0681114 Expiration Date: 8/13/15 Job Site Address: 111 Chestnut Street City/State/Zip: Florence, MA 01062 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. I do hereby certi y under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 413-527-0044 Official use only. Do not write in this area, to be completed by city or town officiaL 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 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-16 EDWIN W LOSACANO License Number Expiration Date Name of CSL Holder 128 GLEN DALE ROAD List CSL Type(see below) R No.and Street Type Description SOUTHAMPTON, MA 01073 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-527-0044 alistar561@verizon.net I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 6-29-16 ALL STAR INSULATION & SIDING CO., INC. 101858 HIC Registration Number Expiration Date HIC Company Name or HIC Re istrant Name 56 FRANKLIN STREET _ allstar561 @verizon.net No.and Street Email address EASTHAMPTON, MA 01027 413-527-0044 City/Town,State,ZIP Telephone SECTION 6: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..........IR No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Ed Losacano to act on my behalf,in all matters relative to work authori by this ilding permit application. Homeowner vaha� 14 Prjpl Owner's Name(Electronic Signatur ) Date SECTION 7b:OWNER' AUTHORIZED Ai&EAT DECLARATION By entering my name below,I hereby attest under the 'ains and penalties of perjury that all of the information contained in this application is true d accurate a best of my knowledge and understanding. Ed Losacano C" J�- Print Owner's or Authorized Agent's Nan jpdletronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" 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 C Ct 9 Reaistered 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 6-29-16 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....... EY, No...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(l) 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 ED Accessory Bldg. ❑ Demolition ❑ New Signs [[--3] Decks [p Siding[0] Other[d] Brief Description of Proposed Work: Installation of new vinyl siding on all exterior walls on main house (NO strip) 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 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 1 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 1 Ed Losacano, Owner 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 Print Nam ✓�/® � q ,� Signature of Owner/Agent Date 6-1-15 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/Finding ever been issued for/on the site? NO © DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO () DON'T KNOW 0 YES 0 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 0 YES 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 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,excavation, 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 JUN 8 212 Main Street Sewer/Septic Availability Room 100 Water/Well Avatlablllty Elect °, Fr , Northampton, MA 01060 TWO Sets of Structural Plans North '1. -,phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: 111 Chestnut Street Map Lot Unit Florence, MA 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: John Dunphy 111 Chestnut St Florence, MA 01062 Name(Print) Current Mailing Address: 413-335-9757 Telephone Signature 2.2 Authorized Agent: Ed Losacano, Owner 56 Franklin Street Name rpt) Current Mailing Address: jaw_&NQ:_:� 413-527-004 4 Signature Telephone_T SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com leted by ermit applicant 1. Building 10,532.00 (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) 10 532.00 Check Number i This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date I I 1 CHESTNUT ST BP-2015-1269 GIs#: COMMONWEALTH OF MASSACHUSETTS MM:Block: 17C-304 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: vinyl siding BUILDING PERMIT Permit# BP-2015-1269 Project# JS-2015-002328 Est. Cost: $10532.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sq. ft.): 24611.40 Owner: DUNPHY JOHN J JR&MARY M MICHAEL J DUNPHY&MARGARET J JEKANOWSKI Zoning: URB(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT.- 111 CHESTNUT ST Applicant Address: Phone: Insurance: 56 Franklin Street (413)527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON:61912015 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: Date Paid: Amount: Building 6/9/2015 0:00:00 $35.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner