17C-303 (2) r
Ott j
lo �.�
INSULATION
&
SIDING CO, INC.
EASTII,,\NlPTON, MASSACHL.ISET'FS01027
EASTHAMPTON OFFICE: 7,27-004-4- WESTFIELD OFFICE: 568-6411
(Amir;wtorci
Proposal Submitted to Phone
"Y Date
AL7-jq "Purchaser"
�evid -4f
Street Job Name
105 Chestno'. Str,, �t 41.3 56-j�-47
City, State and Zip Code Job Location I Of Job Phone I
Florence, I'l;',
0F �, WYL SUM"i, rV'V. CARPU0,6
Contractor Hereby submits to Purchaser specifications and estimates for: T
.4c., w
2. We YJ I I ro i I all siding all. least: center akr,nurn nai Is so they Mull rnt ri'St
urnenvaU Une, Siding.
3. 41e will insta
W a 3/8" st,.rofoarfl bai:kc �ir)d new siding.
'.Icoi tri VC, f,19) rc v,-, J I coy--r�-,d wl 11'ti t:', ,b.,rJ nto ccd I stcck C!-ia&.Y'i 0 1
Y
i; coil cl. i a I
I t e,
1
a r'd -Y r t
t "v: nc'-' ' 'e J 1t ve
w-�
A -----------
At ly Cj: KI T C"-j rig.
J X' i'1011" 41 U(!
III). Any '..x i s n i r.x:r, �hat i S 'I tJ..c %"l (r"
t' at we can �'per fti nn -ktr
fills, ri`)"
nrr Iciuvers, in
lik iiql 11 instz,111 (z) vi nyl -1
A
r°y
cif 'Nort i7allip toil
R � �:�i■chRC�tt•
DEPARTMENT OP BUIL NG INSPECTIONS
212 MaLn Street ' ' ,,�n;cipal Building '
Northamptv�, `.:ass. 01060 "
wORACER'S COMPENSATION C SURA.NOE �,J IDAVIT
I, ED LOSACANO, NNF_R OF ALL STAR INSULATION & SIDING CO. , INC
N ce^�sac1 pe;t�:�cc j
with a principal place of at.
56 FRANKLIN STREET, EASTNAMPTON, MA (p hone#) 413-527-0044
t;suxt!ci ry/statrJ n p)
do hereby certify, under the pains and penalties cf r',eryary, that.
(� I am an employer compensataon coverage for my
employees wooing on Liis job.
C=�a Cody) (Poucy Nmber} (Expiration Dace)
O I am a sore proprietor, genera c e��ctor or ......,e�w�er (c :c'e oee) and have 'w-ed
tr e con�ati;o.s s beio�% wao have L,e cvmper,saLion poucles.
(Name of Contractor) (Iusurana Compacyi�'cliry Nt,cix ) (Fixation Dacc)
(Name of Contractor) (Insl rancc Co rpi '% c',. ; '�ura'xr) (Expiration Date)
(Name of Contractor) Qtraa� rem;�any/?ol;cy Number) (E)cpiraaoo Datc)
(NamC of ._ C GC (E XPLrdGOa Da-,t)
(ltlaCtl 71.�.jlb OCl:: [S'.6G: [1 tficzlary W Cri:.f.✓SC LrJW rLA.Z�1.a 7cl'1:II�..:t fr.:r�CZ,pr,)
( ) 7 am a sole proprietor and have no one worL.ng for me.
( ) 7 am a home owner performing all cue work myse'.f.
NOTE�pl=4c be aware ttn who banco.�,x
AUl morn l�1.0'`...t"on 1".ih^J lq u^.7 C�]l5c'7..-�)b.:z?i�rc::.p•ar x ',-x — .-, .. _. _,�._ ..,c�.a e.Z :r;,t 6crcra;Iy cocrL'.�rx Lo'oc
amloym �z .:,c . xs xccp :on A:ry
a perma may cvrOaYx tho
lcgzi ran r o;an oc loya �n t54'W orxa i Compaou:>oo nu
I undastw�t 4l a oopy o!this wlc=-=may be or La3"r%non ro ;he
oovtmt-t vtnL=x and '.a sea c oov� c c ,.ri „a ::gy=ajJC Ora a x a d
com-=V,:f& izx ,(ua a S! S G: u^;.`cr c� Sr_r- of ca n ore ���• ��.:��. c�+',� w:c(o*m of a SW9 W a'c Cxda u>d
flaw o(S I',7J Vi t ca y �Mr-
C—F Cr uJ-0 ocitY
Pc-ru�it Ntunber
1 Map,1 Lot #
Signature of Lio=secRcrm.iacc ____
i N.-
7.
� ' � ONS'TRUCTION"SERVICES
Licensed Construction Supervlsor: Not Applicable 0
Name of License kJolde r ;
i I License Number
1, t
Address Expiration Date
i ,
Signature i Telephone
1W1°.I1lJ� 1L3i Q il�±Qj[trBCtol� i417�e1� ,lw' +,h.i.. :( vu�:�4'` 't Not ApQhcaU e •_
ir2/ �-5�,
f Registration Number
Address t. � Expiration Date
Teleahone
SECTION 10• WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G,L, c. 152, § 25C(6)) j
Workers Compensation Insurance afficavit must oe co- )letec an- s:'r—m tteci with this application. ray ,, re tc provide this attioav -
will result in the denial of the issuance of the buildin permit
Signed Affidavit Attached Yes—.... � No.,. .. ❑
rt
U�waier.:E: emp- on
The current exemption for"homeowners" was extended to ncl ;d? 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 parce, 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 buildim.' Hermit,
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
+ 1J
0 ,
'�CTION 5- DESCRIPTIQN OF PROPOSED WORK(check all applicable)
New House O Addition O Replacement Windows Alteration(s) Roofing 0
Or Doors D
Accessory Bldg, 0 Demolition❑ New Signs [ ] Decks [ ] Siding j Other ( J
I
Brief Description of Proposed Work:
I
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ r Renovating unfinished basement Yes No
Plans Attached Roll o - Sheet c
6�a:°I hb ;of rii ar`addition to existing-h housing, com Ip eteAhe gllowi'ng:
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
l 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
as Owner/Authorized Agent
hereby declare that the statem nts and inforriation on the foregoing applicati are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury,
(n �1 G
Print Name
`;"9-(�I C4 , 0-MV-) �- D
Signature of Owner/Agent Date
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 F= '
L: R: L: R:
Building Height _
Bldg, Square Footage
Open Space Footage a/o
(Lot area minus bldg&paved
parking)
4 of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW IZI YES
IF YES, dale issued:
IF YES; Was the permit recorded at the Registry of Deeds?
N0 DON'T KNOW y YES
IF YES, enter Book Page and/or Document #
$r
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued;
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location.T__
D, Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
.n
City of Northampton
' Building Departme,-)t
212 Main Stree'
Room 100
Northampton, MA OiO6C
prone 413.587, 1240 Fax 413 587 '_ 272 ,
APPLICATION TO CONSTRUCT, ALTER, REPAS-4 4�" Oft DEMOLISH A ONE OR TWO FAMILY DWELLING
' M AY - 9 2003
S0CR'1CN" ZA SITE INFORMATION
_--
1.1 Prooerty Address, ThsRy1$.�r c�jprCIPi� Ly,0 .: ,�
Map
Li
Zone QY� VFW;
V106z Elm St. District CB District_____
SECTION 2 • PROPERTY OWNERSHIP/AUTHORIZED AGENT I
2,1 QwDVr of Record: _
Name Print) Current Mailing Add
Telephone
Signature
2.2 Authorized Agent:
ALL STAR INSUATION & SIDING CO., INC. _ 56 FRANKLIN STREET, EASTHANPTON, MA 01027
Name(Print) Current Mailing Address:
413-527-0044
Signature Te�ephone
SECTION 3 ESTIMATED CONE$UCTION COSTS
Item Estimated Cost (Doiiars) tc ce Official Use Only
completed by ermit applicant
1, Building ( .pp (a) Building Permit Fee `
2, Electrical, (b) Estimated Total Cost of i
Construction from 6
3, Plumbing Building Permit Fee
4, Mechanical (HVAC) 4
5, Fire Protection
6 Total = (1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Only
Building Permit Number; Dare issued:
Signature:
Building Commissioner/Inspector of Buildings Date
BP-2003-0994
COMMONWEALTH OF MASSACHUSETTS
GIs#
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0994
Project# JS-2003-1594
Est. Cost: $8563.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: All Star Insulation & Siding Co Inc 101858
Lot Size(sq.ft.): 28488.24 Owner: BOLLING DAVID A&
Zoning:URB Applicant: All Star Insulation & Siding Co Inc
AT. 105 CHESTNUT ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers
Compensation
EASTHAMPTONMA01027 ISSUED ON:519103 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 Occupangy Signature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 5/9/03 0:00:00 28402 $25.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo