35-020 (3) INSULATION
SIDING CO., INC
7-:/'_S"'1AMPTON OFFICE 413-527.0044 CSL License #CS SL 99739 WESTFIELD OFFICE 4 13-568-641 I
7 FRANKLIN FRAKLIN STREET Is EASTHAMPTON, MASSACHUSETTS 01027 , FAX: 41 5-27-1
Proposal Submitted to Phone Date
Bill Turomsha "Purchaser"413-575-7846-C September 11, 2015
Street Job Name
P. O. Box 141 120 West Farms Road
City,State and Zip Code Job Location Job Phone
Leeds, MA 01053 Florence, MA 01062
Contractor hereby submits to Purchaser specifications and estimates for: VINYL SIDING AND TRIM WO
1. We will install new Vinyl Siding on One Front Wall. Color will match-
2 We will nail all siding approximately 16-24" on center using aluminum nails so they will nol rllqt A-R4ArRtAAUq--
the siding.
2 We will install a 318" insulated Styrofoam backer behind the siding on Front Great Room Wall
4 ,Wood trim around (1) door and (1)windo w will be covered with White aluminum coil stock material-
5. We will install existing vinyl siding supplied by the Homeowner where vinyl siding is missing from Contractor
removal @;b -MF-%9 IS nau ao��l �►�r�,
6. We will use existing vinyl siding supplied ied by the Homaowner to do patchwork IN134,0-t,w -*j W"pt►
PRICE$1„982 00 pa,b� A'T zRamis,
btA-re p-
APPROXIMATE START DATE WILL BE NOVFMBFR/DECEMBER ONCE WE RECEIVE DEPOSIT AND
SIGNED CONTRACT LESS ANY INCLEMENT WEATHER
I STAR WILL SECURE BUILDING PERMIT IF NEEDED HOMEOWNER WILL BE RFSPONSIBLE FOR ANY
&ALL 1-FFS REQUIRED
HOMEOWNER WIL RF RESPONSIBLE FOR ANY &ALL ELFQTRICAL OR PLUMBING WORK THAT MAY BE
_ NEEDED,
"A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY ITY WII I BE FORWARDED
UPON REQUEST
<-y 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:
$1,982.00 dollars($ 50% DOWN, BALANCE DUE ) 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NOTE: This proposal may be withdrawn by us if not accepted within THIRTY days.
�t//rj,_ ft/ •�s ED LOSACANO 9WNER
Contractor Salesman
BIII TurOmSha Acceptance by Purchaser,and Title
-,ou may cancel this agreement if it has been consummated by a party thereto at a place other than an address of V-)
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 d^�+
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
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):
L[3 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.❑ 1 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. ❑ Building addition
[No workers' comp. insurance comp. insurance.+
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.❑ 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: 08/13/16
Job Site Address: 120 West Farms Road 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 certify under the pains and penalties of perjury that the information provided above is true and correct.
Si nature: `r''
ano 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 GLENDALE 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 allstar561 @verizon.net I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 101858 6-29-16
ALL STAR INSULATION & SIDING CO., INC. 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 authorized by this building permit application.
Bill Turomsha
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNERI OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Ed Losacano �V a_&i,�-cz 3—/5^
Print Owner's or Authorized Age Vs Name(Electronic Signature) Date
NOTES:
I. 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.niass. og v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dl2s
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"
' y
-9 0 -)ni�
The om onwealth of Massachusetts
ing Regulations and Standards FOR
WP0,plumbing& s n: MUNICIPALITY
Northam on, � use State Building Code,780 CMR USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Propgrt AdVs! /0-4
.2 Assessors Map& Parcel Numbers
I.la Is this Can accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 11) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Bill Turomsha Florence, MA 01062
Name(Print) City,State,ZIP
120 West Farms Road 413-575-7846
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work 2: VINYL SIDING AND TRIM WORK ON 1 WALL
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Su ression Total All F /s:
1,982.00 Check No. ( heck Amount: Cash Amount:
6.Total Project Cost: $ ❑Paid in Full ❑ Outstanding Balance Due:
120 WEST FARMS RD BP-2016-0427
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35-020 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-2016-0427
Project# JS-2016-000682
Est.Cost: $1982.00
Fee: $60.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sg. ft.): 67082.40 Owner: MARTINEZ DANIEL R&ELIZABETH J
Zoning: Applicant: ALL STAR INSULATION & SIDING CO INC
AT. 120 WEST FARMS RD
Applicant Address: Phone: Insurance:
56 Franklin Street (.413) 527-0044 Workers Compensation
EASTHAMPTON MAO 1027 ISSUED ON.912812015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTAL VINYL SIDING ON ONE WALL
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 9/28/2015 0:00:00 $60.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner