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41-018 (2) 9X9 -C Office of Consumer Affairs and Efusiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 101858 Type: Private Corporation Expiration: 6/29/2016 Tr# 252104 ALL STAR INSULATION & SIDING,-'M-_'1 Edwin Losacano = 56 Franklin Street -- Easthampton, MA 01027 - Update Address and return card.Mark reason for change. E] Address [] Renewal E:] Employment F� Lost Card DPS-CAI Co 50M-04/04-G101216 ofrice�1on err"% airs �Viness egu at License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ,;=101858 Type: Office of Consumer Affairs and Business Regulation Expiration: -6/2912016 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 A AR INSUL1i,TlOIJ CO. Edwin Losacano 56 Franklin Street Easthampton, MA 01027: Undersecretary Not val' hou signature D u: su 5 N C N O 7 Sk rn Q as t®( Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Snpet�i+nr Sperialt� License: CSSL-099739 EDWIN W.LOSAOANU 128 GLENDALE RD. = ! Southampton hU 01073 „ •�:. J fir ` n t�+`' Expiration .h Commissioner 02/14/2018 CO w cn v CTI Client#: 13250 ALLST DATE(MMIDD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 09104/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Jane Eitel T.P.Daley Insurance Agency,Inc PHONE 413 788-0971 FAX 413 739-2645 AIC,No,Ext: INC,No: 1381 Westfield St. E-MAIL ADDRESS: y aneeitel t p dale nsurance.com P.O.Box 1150 INSURER(S)AFFORDING COVERAGE NAIC# West Springfield, MA 01090 INSURER A:Peerless Insurance INSURED INSURER B:Star Insurance Company All Star Insulation&Siding Co.,lnc. INSURER C 56 Franklin Street INSURER D: Easthampton,MA 01027 .INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY CBP8052996 8/13/2015 08/131201 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence $100000 CLAIMS-MADE 4 OCCUR MED EXP(Anyone person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X JECOT- LOC $ A AUTOMOBILE LIABILITY BA8054496 8/13/2015 08/13/201 EOa accc S id.n1INGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $100,000 ALL OWNED X A SCHEDULED AUTOS UT OS BODILY INJURY(Per accident) $30Q000 X HIRED AUTOS )( NON-OWNED PROPERccident TY DAMAGE $100,000 AUTOS Per a UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WC0681114 8/13/2015 08/13/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100,000 OFFICERIMEMBER EXCLUDED? N] N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation&Siding CO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 56 Franklin Street ACCORDANCE WITH THE POLICY PROVISIONS. Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S123221/M123220 JXE The Commonwealth of Massachusetts Department of Industrial Accidents V,V, Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): All Star Insulation & Siding Co., Inc. Address: 56 Franklin Street City/State/Zip: Easthampton, MA 01027 Phone #: 413-527-0044 Are you an employer?Check the appropriate box: Type of project(required): 1.[?11 am a employer with 10 4. ❑ I am a general contractor and [ employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition working or me in an capacity. employees and have workers' g Y p Y• 9. E] Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 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' 13.171 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: 1209 Westhampton Road 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. I do hereby certify under th,a pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#. 413 27-0044 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 Type Description No.and Street 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 a-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 Com an-Y Name or HIC Re istrant Name 56 FRANKLIN STREET alistar561 @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 Nlative to work a horized by this building permit application. Crystal Kaufman �,, L�� i� vL I L 7- S _ 1 _ Print Owner's Name(Electronic Signature)C f� `�s l �-L C� —/�/� A/ Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attes nder the pains and penalties of perjury that all of the information contained in this application*true and urate to the best of my knowledge and understanding. Ed Losacano Print Owner's or Authorized Agent a(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.mass. og v/oca Information on the Construction Supervisor License can be found at www.mass.eov/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" The Commonwealth of Massachusetts v Board of Building Regulations and Standards FOR MUNICIPALITY r Massachusetts State Building Code, 780 CMR USE C3 3 t Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 M �' _i � One-or Two-Family Dwelling This Section For Official Use Only &ing Permit Number: Date Applied: E Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 1209 Westhampton Road, Northampton, MA Lla Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) 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: Christel Kaufman Northampton, MA 01060 Name(Print) City,State,ZIP 1209 Westhampton Road 413-584-8949-H No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. [] Number of Units I Other ❑ Specify: Brief Description of Proposed Work 2: STRIP 1 LAYER ON ROOF, INSTALL NEW ROOF ON MAIN HOUSE, BREEZEWAY,AND TWO CAR GARAGE 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: 2.Electrical $ •Standard City/Town Application Fee •Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Suppression) Lin Check Check Amoun -7v Cash Amount: 6.Total Project Cost: $15,231.00 ❑Paid in Full ❑ Outstanding Balance Due: 1209 WESTHAMPTON RD BP-2016-0603 GIs#: COMMONWEALTH OF MASSACHUSETTS Ma :Block:41 -018 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-2016-0603 Project# JS-2016-001015 Est.Cost: $15231.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sq. ft.): 41382.00 Owner: KAUFMAN 2006 REVOCABLE TRUST Zoning: Applicant: ALL STAR INSULATION & SIDING CO INC AT: 1209 WESTHAMPTON RD Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.-111212015 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE HOUSE, GARAGE & BREEZEWAY ROOF 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 11/2/2015 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner INSULATION Easthampton Office & Westfield Office 413-527-0044 SIDING CO,, INC. 413-568-6411 CSL License #CS SL99739 WWW.sidingandroofingwesternma.com 56 Franklin Street • Easthampton, MA 01027 - fax 413-527-1222 - email:allstar561 @verizon.net Proposal Submitted to Phone Date Crystal Kaufman "Purchaser"413-584-8949-H October 27, 2015 Street Job Name 1209 Westhampton Road City,State and Zip Code Job Location Job Phone Northampton, MA 01060 860-268-7775-son Harold Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW ROOF ON MAIN HOUSE, BREEZEWAY, AND TWO CAR GARAGE 1 We will remove(1) layer of existing_asphalt shingles and dispose of in a dum st�up leed by us. 2 We will install Titanium Rhino Deck or Flenhant Skin underlayment over entire stripped roof surface- 3- We will install new Certa(nTeed landmark- Owens Corning or Gaf/Elk Timharline Architect shingles. They will have a"Manufacturer's Lifetime Limited Warranty"- Owner will have choice of color. 4. All h'ngl .c will be nailed with at least(,5.nails per sh'ngle- 5. We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas. We will insta(I pipe hoots and metal step flashong where needed 6 We will install approximately(114)'of roll vent on peak of roof for additional ventilation 7 We w fl) install a 36"wide asphalt ice and water barrier on eve lines /valleys of heated areas- PRICES1 5-2'i1 00 ** IF ANY SUB SHEATHING IS NEEDED THERE WILL BE AN ADDITIONAL CHARGE OF 138 PER SHEET TO REMOVE,_DISPOSE OF AND IUSTALI NEW 7/16 STRAND BOARD SUB SHEATHING APPROXIMATE START. DATE W_ ILL.(BE JAN SIGNED CONTRACT LESS ANY INC LF. NT WEATHER- ALL STAR WILL SECURE BUILDING P RMII IF NEEDED HOMEOWNER,WILL BE RESPONSIBLE FOR ANY &ALL FEES REQUIRED — **ALL STAR IS NOT RESPONSIBLE FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHT(IF APPLICABLE) ** HOMEOWNER WILL RF RESPONSIBLE FOR ANY &ALL ELECTRICAL OR PLUMBING WORK **NO PRODUCT& LABOR WARRANTIES WILL BE ISSUED UNTIL WE FINAL PAYMENT. - **HOMEOWNER WILL BE RESPONSIBLE FOR COVERING ANY STORED ITEMS AND FOR ANY CLEANUP -_ WORK IN THE ATTIC NEEDED FROM DUST& DEBRIS FROM ROOF REMOVAL. **A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED l PON REQUEST **T a DAL EY INSURANCE AGENCY OF WEST SPRINGFIELD MA IS OUR AGENT. oo WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of: $15,231.00 dollars($ 50% DOWN, BALANCE DUE i payment due upon receipt of invoice. If payment late, irlterest at 1 1/2%may be added. COMPLETION OF JOB NOTE:Thi ro osal may be withdr wn by us if not accepted within THIRTY - - - - - days. ED LOSACANO, OWNER ----- --= =— ---- -r ----- -------------------- -- - --- - --ContractorSalesman CrystalKau mart 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