32C-184 (7) 382 PLEASANT ST BP-2016-1366
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C- 184 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-2016-1366
Project# JS-2016-002347
Est. Cost: $9532.00
Fee: $60.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sa.ft.): 3484.80 Owner: GRYGORCEWICZ FELIX J&MELODIE
Zoning: GB(100) Applicant. ALL STAR INSULATION & SIDING CO INC
AT. 382 PLEASANT ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON.5/18/2016 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 5/18/2016 0:00:00 $60.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
RECEIVED
1 hif
Co monwealth of Massachusetts
Board B ilding Regulations and Standards FOR
OF BUILDINGIWA-9 usei ts State Building Code,780 CMR MUNICIPALITY
NoarH^"'r'TOH MA 01060 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 Property Address: 1.2 Assessors Map& Parcel Numbers
382 Pleasant Street, Northampton, MA
l.la 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:
Felix r-mmnrcewicz 01071
Name(Print) Ci,State,Z
12 Manhan Road 413-250-8743
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ElAlteration(s) ❑ Addition 1:1Demolition
El Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed WorkZ:
INSTALL NEW VINYL SIDING
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 Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
6.Total Project Cost: $ 9,532.00 Check No. Check Amount: Cash Amount:
0 Paid in Full 11 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSI.) CSSL -099739 _2-14-18
Ed Losacan o I.icense Number Expiration Date
Nance ol'CSI I lolder
128 Glendale Road List CSI'Type(see below) - R
No.and Street "�------ _ Type Description
Southampton, MA 01073 11 Unrestricted(Buildings up to 35.000 cu.ft.)
R Restricted 1&2 Family Dwelling
City!"Town.State,LII' M Masonry
RC Rooting Covering
_.____ __ _ —. -------.______. - WS Window and Siding
Si- Solid Fuel Burning Appliances
413-527-0044 allstar561@ve_rizon.net I Insulation
'felt hone -- -- -�� ('.mail address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 101858 6-29-16
All Star Insulation & Skiing Co., INC. ---- --- --- -- ----
___ _ _ _._ I IK'Reeisiration Number Expiration Date
1 - m a Na or tl C'Rcgistran1 Nana.
Fra{'n�c�in reel! ail_star561@verizon.net
_.._ ------------- __._._. _-._..______ --
N and Street Email address v—
_as_tha_mpton, MA 01027 413-527-0_044
Cit /'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 .......... Cil No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR,APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize_ _Ed_Losacano
to act on my behalf,in all matt r dative ark authorized by this building permit application.
- Felix Grygorcewicz _ . _ . T_
Print Owner's Name(E'lectroni St at a Date —-
SECT ON 7 WNERt OR AU ORIZED 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 iii true and ac trate to the best of my knowledge and understanding.
Ed Losacano
Print 0ssner s or Authori/ed Agent's i arae l lectronnc 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(1IIC)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
+»w.masti.eov oca Inforination on the Construction Supervisor License can be found at wuw.mass.eovrdns
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 w
3. "-Total Project Square Footage"may be substituted for"7-otal Project Cost"
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 Leeibly
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.[21 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. E]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
workingfor me in an capacity. employees and have workers'
y p �'� 9. E] Building addition
[No workers' comp. insurance comp. insurance.+
required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
q ]
3.❑ I am a homeowner doing all work officers have exercised their I l.[I 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.❑ Other
comp. insurance required.]
*Any applicant that checks box#I 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.
1 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: 382 Pleasant Street 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.
1 do hereby certify ungfef the p ins and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone#: 413-52 -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#:
Y
0 V
F
Cit1 a7
Easthampton Office & MAY. 1 3wMiel ce
INSULATION
413-527-0044
SIDNG413-56 1
CSL License#C=979'
www.sidingandroofingwesternm 177 'SS
56 Franklin Street - Easthampton, MA 01027- fax 413-527-1222 • email:allstar561@verizon.net
Proposal Submitted to Phone Date
Felix Grygorcewicz "Purchaser"413-256-8743-C April 6,2016
Street Job Name
12 Manhan Road2 Pleasant Street
City,State and Zip Code Job Location Job Phone
Southampton, MA 01073 /Northampton,MA 01060
Contractor hereby submits to Purchaser specifications and estimates for I�STALLATION OF NEW VINYL SIDING ON SECOND
F 00 R WHERE ASPHAOT SIDING EXISTS
1 We will install new Vinyl Siding on the following designated walls-Three sides of second floor Left Front and
Right on house and(2)third floor dormers and gables where asphalt exists Color will match rear house as
close as possible,
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 windows where not done will be covered with White aluminum coil stock material,
5.Wood trim around doors where not done will be covered with White aluminum coil stock material
6 Wood trim soffit and fascia where not done will be covered with White aluminum coil stock and perforated
White vinyl soffit material This includes front porch.
7 Wood rake fascia where not done 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 renailed.
10 We will install White vinyl lite blocks dryer vents.and faucet blocks where needed
11.We will install regular outside corner posts on all corners Color will be white or will match vinyl sidinQ.
12.Area to be covered on Second Floor Front Porch as follows-Soffit and Fascia Trim Only
13,Job site will be
14 Vinyl Siding has 2"Manufacturer's Lifetime Warranty"
PRICE$9 532.00
APPROXIMATE START DATE WILL BEAPY/jUNE ONCt WE RECEIVE DEPOSIT AND SIGNED CONTRACT
LESS ANY INCLEMENT WEATHER
ALL STAR WILL SECURE BUILDING PERMIT IFNEEDED. HOMEOWNER WILL BE RESPONSIBLE FOR ANY
&ALL FEES REQUIRED
NO PRODUCT&LABOR WARRANTIES WILL BF IS1,0FD UNTIL WE RECEIVE FINAL PAYMENT,
HOMFOWNFR WILL BERESPONSIBLE FOR ANY&ALL FLECTRICAL OR PLUMBING WORK THAT MAY BE
NEEDED.
A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED
UPON RFQ(JFI;T
T.P DALEY INSURANCE AGENCY OF WEST SPRINGFIELD. MA IS OUR AGENT,
A!(
Vviz PROPOSE to furnish material and labor,complete in accordance with above specification,s,forthe sum of:
$9,532.00dollars($ DOWN,BALANCE DUE
-- payment due upon receipt of invoice.
If payment late,interest at 1 1/2%may be added. CIO
I PLETION OF JOB
NOTE:This proposal may be withdrawn by us if not accepWwithin THIRTY days.
ED LOSACANO,OWNER
-----C–o-i5t—ra—ct o F-Sil e-!iiman
FWitt'roorcewirz Y 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