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31B-121 (7) 5 EDWARDS SQ BP-2017-0017 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31B- 121 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-2017-0017 Project# JS-2017-000032 Est.Cost:$16982.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 101858 Lot Size(so. ft.): 3789.72 Owner: David Hernandez Zoning: URC(I00)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT: 5 EDWARDS SQ Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAM PTO N MA01027 ISSUED ON:7/8/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE 2 LAYERS OF ASPHALT ROOF & INSTALL NEW 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 r/ 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: FeeTvpe: Date Paid: Amount: Building 7/8/2016 0:00:00 $40.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner The Commonwealth of Massachusetts , Board of Building Regulations and Standards FOR �,E .EL b/ Massachusetts State Building Code,780 CMR MUNICIPALITY E Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 Iw ;zj One-or Two-Family Dwelling 1 i` This Section For Official Use Only Il I ;J a uilding Permit Number: Date Applied: ccI z Building Official(Print Name) Signature Date SECTION I:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 5 Edwards Square.Northampton,MA I.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Ilse Lot Area(sq R) Frontage(h) 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 0 Zone: Outside Flood Love? Municipal 0 On site disposal Check ifves❑ P system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: David Hernandez&lyko Day Northampton,MA 01060 Name(Print) City.State.ZIP 5 Edwards Square 424-832-0116 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': REMOVE 2 LAYERS OF ASPHALT AND INSTALL NEW ROOF SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Cost?(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Total All Fels: Suppression) I� Check Nokia I urAeck Amount:40 Cash Amount: 6.Total Project Cost: $ 16,982.00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL -099739 2-14-18 Ed Losacano License Number Expiration Date Name olCSL Ilolder R List CSI.type isce Nino 128 Glendale Road __.__._. Description No.and Street Southampton, MA 01073 U U viand(Buildings up to 35,000 cu.it.) R Restricted 182 Family Dwelling City/Town.Slate.ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Poet Burning Appliances 413-527-0044 allstar561@verizon.net 1 Insulation Telephone bmail address D Demolition 5.2 Registered Home Improvement Contractor CHIC) 101858 6-29-18 All Star Insulation & Siding Co. INC nu rz , .- ,,,; Expiration.h r ;b 1- me Finranaki\ o a('_ eg t int RName n btreallstar561@venzon,net M1'Nw.and SInflect _ __-- — Email address -- Easthampton, MA 01027 413-527-0044 Cirydlawn.State.ZIP 1'elcphoe 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 L 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 h f all mane relative to work authorized by this building permit application. David Hernandez & Day ' ' Cr- (o �"'I U Print jOwner's Num.(Electronic Signature) Danz SECTION 7b:OW'NER1 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 Cosi At _i -ie .AP.. ..�_/-1(p Print owner's AudunizedA Name l Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do hisiber own work,or an owner who hires an unregistered contractor (not registered in the biome 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 wwww.mass.,,oiroca Information on the Construction Supervisor License can he found at lav tutu.ntass.gov Lips 2. When substantial work is planned.pros ide the information below: Total floor area(sq. e.) (including garage, finished basementratties,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number ofbedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks'porches Type of cooling stem Enclosed Open 3. `Total Project Square Footage'may be substituted for"Total Project Cost' Massachusetts Depattmant ci Pubhc SMe1y Board at Building Regu ations and Standards Licens fuC%Qn SuperVi501 p D C0081fug100 Supervisor SpedaAy y II EDWIN W.LO$ACANO 128 GLENDALE ROAD m SOUTHAMPTON MA 01013 / � � NI-Tr. - Expiration'. o: Commissioner 021160018 t • • co co C" N _�y C_/4e ir011.4M2JZUI-G'ala ?CAE; ,I'd et== e Office of Consumer Affairs and Business Regulation -=a 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 101888 Type: Private Corporation Expiration: 6129/2018 Trd 419291 ALL STAR INSULATION & SIDING CO. Edwin Losacano 56 Franklin Street Easthampton, MA 01027 Update Address and return cord.Mark reason for change. ap"I p mumn 0 Address it Renewal Q Employment fl Lost Card r92..lDrnmrn,naSlir.//namrd ndA Office.(Consumer Attars d:Bmioen Regulation License or registration sand for ied{vldvai use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Reg istration: 101858 Type: Office of Consumer Affairs and Business Regulation Expiration: &2912010 PrivateCorporation10 Park Plaa-Suite 5170 Boston,MA 02116 ALL STAR INSULATION B SIDING CO. Edwin Losacano - A •• SS Franklin Groot .s.�..,.__ all I Easthampton,MA al°27 Uodenaraarf Nat vaNd••c The Commonwealth of Massachusetts Department of Industrial Accidents l -.t. Et_=2 = Office of Investigations 7-1111'== 600 Washington Street Boston,MA 02111 n'' 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): I.[2} I am a employer with 10 4. ❑ I am a general contractor and 1 employees(full and/or part-time).' have hired the sub-contractors 6. LI New construction 2.❑ 1 am a sole proprietor or partner- These on the attached sheet. 7. ❑ Remodeling shipand have no employees These sub-contractors have g ❑ Demolition workingfor me in anycapacity. employees and have workers' P y' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] c. 152. §I(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box 41 must also fill out section below showing their workers'compensation policy information. 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 show ing 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: 5 Edwards Square 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 certifyunder the pains and penalties of perjury that the information provided above is true and correct. SiunatureX� .4Qq:✓.J'j Date: 7—f—74' 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): I. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Client#: 13250 ALLST ACORD,„ CERTIFICATE OF LIABILITY INSURANCE DATE"MIDO"YY) 09/04/2015 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 certificatesf holder is an ADDITIONAL yUREDr the enlic emust bet endorsed.on If SUBROGATION Isnot co WAIVED,subjecttto the terms and conditions s 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 CONTACT Jane Eitel T.P.Daley Insurance Agency,Inc Pat FAx We xd E.+1:413788-0971 Li L413739-2645 1381 Westfield St E-MAIL r — - ----- ADDRESS; laneeitel�tpdaleyinsurance.com P.O.Box 1150 West Springfield, MA 01090 _ _ INSURER(S)AFFORDING COVERAGE RAMC• INSURER A'.Peerless Insurance INSURED • All Star Insulation&Siding Co.,lnc. IxsUREe e:Star Insurance Company INSURER c: 56 Franklin Street ---_---_ I Easthampton, MA 01027 INSURER 0 _ xsuRERE -I INSURER 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 'MUCH 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 A DODSUBR POLICY EFF I POLICY EXP LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER (MWDOIYYYY)101MIOOIYYYY) LIMITS A GENERAL UABILITY CBP8052996 18/13/2015108/13/2016 EACH OCCURRENCE 51,000,000 © COMMERCIAL GENERAL LIABILITY O ENcEO RR�'RIC3FEs�I nauNence) 5100000 I CLAIMs.M.ADE X OCCUR I MED EXP(Any one person) s5,000 ! PERSONAL.ADV INJURY 51,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPIE ER PRODUCTS-COMPIOP AGO s2,000,000 POLICY�. Po=T_ 1 o- LOC 5 3E . OC AAUTOMOBILE LIABILITY BA8054496 18/13/2015108/13/2016 Ed'cadent, OMBINED SINGLE LIMIT 5 h ANY AUTOI BODILY IN URY rper personi 5100,000 ALL OWNED I— SCHEDULED BODILYRV(Perave s AUTOS 'X AIRDs ) 300,000 X HIRED AUTOS X AUTOS Ec I PRO E D MFG E 5100,000 Inas IPereoFldenn 5 -- �- UMBRELLA UAB OCCUR EACH OCCURRENCE s -- --- EXCESS LIAR CLAIMS.MADE AGGREGATE 5 iANO EMPLOYERS'RETENTIONS 5 Deo / B COMPLIAPON WC0681 ii4 18/13/2015 08/13/2016 X we STA V OTH• PARTNER T EACH IMITS� ER FYCERIMEISER CUDEXwurrvE,Y�" LCL EACHncGOENT $10Q000 (mandaRM.EM NH) EXCLUDED' N NIA (mandatory decry In NII) =_i.DISEASE-EA EMPLOYEE a100,000 n S Resmm Omer L. DESCRIPTION DF DPERAno)xs denim EL DISEASE-POLICY LIMIT s500000 DESCRIPTION OF OPERATIONS r LOCATIONS/VEHICLES(Mad(ACORD 101,Additional Remarks Schedule.a more space is required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation&Sidin CO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Siding THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 56 Franklin Street ACCORDANCE WITH THE POLICY PROVISIONS. Easthampton, MA 01027 AUTHORIZED REPRESENTATIVE Gi+t. �. C)&.LLS --- ..„..<4C71-4(.. I ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S123221/M123220 JXE WT-11 bo1i5irk , ‘‘ Stir / � ` ' , m is© lEBV D� INSUI_.ATION :, J j7 Easthampton Office $Ta t L Id fi r 43-527-9044 SIDING CO., INC. JUN 2`*, it lr, t! J CSL License RCS-Si99739 - www.sidingandroofingwesternma. om 56 Franklin Street • Easthampton, MA 01027 • fax 413-527-1222 • emaiballstar561@yerizon.net Proposal Submitted to Phone Date David Hernandez& lyko Day "Purchaser'424-832-0116-C June 17, 2016 Street Job Name 5 Edwards Square MA HIC REG#101858 City State and Zip Code Job Location Job Phone Northampton, MA 01060 510-541-0497-lyko Contractor hereby submits to Purchaser specifications and estimates for INSTALLATION OF A NEW ROOF ON MAIN HOUSE AND , PORCHES J1 We will remove (2) layers of existing asphalt shingles and dispose of in a dumoster supplied by us 2 We will install Titanium Rhino Deck or Eeohant Skin underlavment over entire stripped roof surface 3 We will install new CertainTeed I andmark Owens Corning or Gaf/Elk Timberline Architect shingles They will have a"Manufacturer's Lifetime I invited Warranty" Owner will have choice of color 4 All shingles will be nailed with at least(51 nails per shingle I/ ` 5 We will install new aluminum drin edge nn all eves and new aluminum rake edge on rake areas We will install pipe boots and metal step flashing where needed ,j 6 We will install approximately(401 of roll vent on peak of roof for additional ventilation •D 7 We will install a 36"wide asphalt ice and water barrier on eave lines/valleys of heated areas PRICF•816 982 00 N ** IF ANY SUB SHEATHING IS NEFDFD THERE WILL BE AN ADDITIONAL CHARGE OF$38 PER SHEET TO REMOVE DISPOSE OF AND INSTALL NEW 7/16 STRAND BOARD SUB SHEATHING "APPROXIMATE START DATE WII 1 BE JULY/AUGIIST ONCE WE RECEIVE DEPOSIT AND SIGNED 'N CONTRACT LESS ANY INCI FMFNT WFATHFR "Al I STAR Wil I SFCURF BIIILDWG PERMIT IF NEEDED HOMFOWNFR WILT BE RESPONSIBI E FOR ANY &Al L FFFS RFOl11RFD "Al L STAR IS NOT RFSPONSIBI E FOR ANY LEAKS THAT OCCUR IN EXISTING SKY! IGHT (IF APPI (CABLE) HOMEOWNER WII I BE RESPONSIBI F FOR ANY&ALL ELECTRICAL OR PLUMBING WORK " NO PRODUCT &LABOR WARRANTIES WILL BE ISSUED UNTIL WE RFCEJVE FINAL PAYMENT " HOMEOWNER WII L BE RESPONSIBLE FOR COVERING ANY STORED ITFMS AND FOR ANY CLFANl1P WORK IN THE ATTIC NEFDFD FROM DUST& DEBRIS FROM ROOF RFMOVAL "A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPFNSATION AND LIABILITY WII L BE FORWARDED 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: $16,982 dollars($ 1/3 DOWN, 1/3 AT START OF JOB, ), payment due upon receipt of invoice. BALANCE DUE COMPLETION OF JOB If payment late interest at 1 1/2% maybe added. - NOTE: is propp yal may be withTHIRTY tlrawn b us if not accepted within days. V ,Y L — ED LOSACANO, OWNER � { ( -- Contractor Salesman no_c David Hernandez�FylcO l7ay --- �-- - _7( 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