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38B-019 (2)
29 FORT HILL TER BP-2017-0016 GIS#. COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B-019 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-2017-0016 Project# JS-2017-000031 Est.Cost:$9335.00 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.): 4791.60 Owner: PANDIRI THALIA A Zoning: URC(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT: 29 FORT HILL TER 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:STRIP & SHINGLE 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 ft 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 IS, The Commonwealth of Massachusetts iI°,, . Board of Building Regulations and Standards FOR �'�,� Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 r-} One-or Two-Family Dwelling +J:I This Section For Official Use Only l. . I r-. ,g ilding Permit Number: Date Applied: 12 �. F. ,, • '.6 Building Official(Print Name) Signature Date Itl.i o SECTION 1:SITE INFORMATION I. Property Address: 1.2 Assessors Map& Parcel Numbers 9 Fort Hill Terrace,Northampton,MA I.1a 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(R) 1.5 Building Setbacks(ft) � a Front Yard Side Yards Rear Yard N. re 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 0 Private 0 Zone: Outside Zone? Municipal 0 On site disposal system 0 Check iffves ves❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner of Record: Thalia Pandiri --- Northampton Northam ton MA Q1QRQ Name(Print) City.State.ZIP 29 Fort Hill Terrace 413-584-5065 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ 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 $ I. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire — $ -- Suppression) Total All Fees: yQ 9,335.00 Check No. I Check AmounNl(,i((�1 1J Cash Amount: 6.Total Project Cost: $ ❑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 of CSL Holder R 128 Glendale Road List CSL Type(see below) No.and Street -. Type Description Southampton, MA 01073 a Unrestricted(Buildings up to 35,000 cu.R.) _._.. R Restricted l&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 6-29-18 All Star Insulation & Siding Co., INC. _ lEC Registration Number Expiration Date Ffdrlklln J[reetC Registrant Name _.__ allstar561@verizon.net N and Street Email address No, 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 f1 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 e to work authorized by this building permit application. Thalia Pandiri atter A 7 - - jt Print Owners Name(Electronic Signature) Date SECTION 7b:OWNER'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 ace': to the best of my knowledge and understanding. Ed Losacano _ _ _ 7-1 -lb Print Owner's or Authorized Agent's (El tronic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her am 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. 142.A.Other important information on the HIC Program can be found at uww_mass.nov0ca Information on the Construction Supervisor License can be found at www.mass goy/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.H.) _ 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" • • • n 0�iie (62I2242?on�/sea i 1 1 4 PCZ` ft Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 101858 Type: Private Corporation Expiration: 629/2018 Toe 419291 ALL STAR INSULATION & SIDING CO. Edwin Losacano _ • 56 Franklin Street Easthampton, MA 01027 Update Address and return card.Mark reason for change. gni o 20M-051110 Address C Renewal 0 Employment 0 Lost Card , r7/.. *�m�mrm.w.///../r//joeA.urn, Office of Consumer Affairs&Business Regulation t..`, License or regbtrstlon valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ReglMradon: 101858 Type: Office of Consumer Affairs and Business Regulation Expiration: 0/29/2010 Private Corporation 10 Park Plea-Suite 5170 Boston,MA 02116 ALL STAR INSULATION&SIDING CO. Edwin Losacano A 58 Franklin Street , _i. ..., r_ _ Easthampton,MA 01027 Uadersecntary Not valid with.o' stare itMassachusetts Department of Pattie Safety Board al Building Regulations and SlandaNs License'.CScv(soc7]9 Construction Supervisor SuttUAlty EDWINW.LOSACANO 10BGLENDALE ROAD SOUTHAMPTON MA 01070 if g Exlitation: a Commissioner 0111417011 to Gr Qa ti• 0 Clientk: 13250 ALLST ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDOIYYYYI 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 certificate M1 policy,Cane ADDITIONAL ayURED,the endorsement. must be endorsed. on this SUBROGATION IS WAIVED,subjecttto the terms and milieus 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 CONTACT NAME: Jane Eitel T.P.DaleyInsurance Agency,Inc ILIEMl413788- 0971739-2646 FAX ANC,""1' 413 1381 Westfield St. IL Ianee.rtel t dale Insurance.coAADDREss.P.O.Box 1150 --- E-MA - West Springfield,MA 01090 INSURER(S)AFFORDING COVERAGE 1_ NAZCA INSURER A'Peerless Insurance INSURED INSURER e_Star Insurance Company All Star Insulation&Siding Co.,Inc. INSURER C: 56 Franklin Street - _--- - -- ~ 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 ADDL SUoR --- POLICY EFF . POLICY EXP LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER S MMICD/YYVYI IMMIOWYYYYZ_ LIMIT A GENERAL LIABILITY CBP8052996 08/13/201508/13/2016 EACH[O�[CCpURpRpENCE (61,000,000 .CO COMMERCIAL GENERAL PREMIbt51E NcwEDncx sI00,000 'CLAIMS-MADE X OCCUR MED EEP/Any one persons s5,000 _ PERSONAL S ADV INJURY s7,000 000 GENERAL AGGREGATE S 2,000,000 GENLAGGREGATE DME APPLIES PER PRODUCTS-COMP/OP AGG is 2,000,000 POLICY XPRo-T 7 LOC _.. IS JEC A AUTOMOBILE LIABILITY BA8054496 08/73/201508/13/20161EoraDEe SINGLE nun $ - ANY AUTO BODILY INJURY(Per Person $100,000 ALL ONNEO �SCHEDULED _ AUTOS ,e"AUTOS BODILYINJURYP wdm11.6300,000 X HIRED AUTOS h_iIX AUTTOSMJED per PROPERTY MAGE ~$100,000 Is UMBRELLA LAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE DEC RETENTION B x IA WC0681114 08113/2015 s AND EMPLOYERS' YERS' AMM WC 6TAi0. LITH ANV PROPRIETOR/PARTNER/EXECUTIVE' R P O E 5 MAMMY 08/13/2016.X ANYCER/MEMBERm CLJDE EcunvE Yl" ELE c ACCIDENT 6100,000 OFFICER/MEMBER E%C CJDED. (Mandatory NRI .Ni EL DISEASE.EA EMPLOYEE 5100000 U es aesmbe unser O�scRImION OF OPERATIoxs oelm. I E.L.DISEASE-POLICY LIMIT,s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.AtltlRiona/Remarks schedule,if more space is required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation&$IdIng CO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 56 Franklin Street ACCORDANCE WITH THE POLICY PROVISIONS. Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE -.rC /l'-Z'.LJL. �. (9"LC-Gv _---- I ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #5123221/M123220 JXE The Commonwealth of Massachusetts "e.El Department of Industrial Accidents ]l( Office of Investigations _ =:46= 600 Washington Street • =41=1= d Boston, 414 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): I.[2} I am a employer with 10 4. ❑ I am a general contractor and I have hired the sub-contractors employees(full and/or part-time).' 6. ❑New construction listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers comp. insurance comp. insurance./ 9. Building addition 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 I I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL I2.0 Roof repairs insurance required.] f c. 152, 61(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that check box k I must also till out the section below showing their workers compensation policy information. e Homeowners who submit this affidavit indicating they arc 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: 29 Fort Hill Terrace 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 cerl.&u der the pains and penalties ofperjury that the information provided above is true and correct Signature: LS /se # ' 2 Date: 2-/-/6 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#: C trey t5CKt. .t (sa t\(,) � �� 5tf EC EILIVE `'i 6/(44- 3`1 INSULATIONoonnW� Easthampton Office T1 $z JUL WasitWln Office 413-527-0044 SIDING CO., INC. 413-568-64 CSL License MCS SL99739 (,t 'S '00 0 0 www.sidingandroofingwesternma.c I •• 56 Franklin Street • Easthampton, MA 01027 • fax 413-527-1222 • email:allstar561@verizon.net Proposal Submitted to Phone Date Thalia Pandiri 'Purchaser 413-584-5065-H June 24, 2016 Street Job Name 29 Fort Hill Terrace MA HIC REG#101858 City.State and Zip Code Job Location Job Phone Northampton, MA 01060 413-330-1331-C Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF A NEW ROOF • • OPTION 1- INSTALL NEW ROOF ON 1ST FLUOR FRONT PORCH 1ST FLOOR SIDE SUN PORCH AND 2ND Fl OOR IS � - vu - - • - l. - ... .l. - -.. • •• - • '. - • u• •• • • 2 We will install Titanium Rhino Deck or Elephant Skin underlayment over entire striooed ronf surface 3 We will install new CertainTeed 1 andmark Owens Corning or Gaf/Elk Timberline Architect shingles They will have a"Manufacturer's Lifetime I imited Warranty" Owner will have choice of color 4 All shingles will be nailed with at least(51 nails per shingle a We w Il install new alum num drip edge on all eves and new alum num rake edge on rake areas W will install pipe boots and metal step flashi g where needed B We will install anoroximately (501 of roll vent on peak of roof for additional ventilation PRICF'$8 352 00 OPTION 2 INSTALL NEW GIITTFRS AND DOWNSPOUTS � - -no - •• - • - .. • r- .•• .• + • •. ••• _• . .' r .-- • 1. white 5" Residential Seamless aluminum gutters and downspouts We will use the Canadian hanger or Vamnire hang tnethndref instatatinn 4pplicnttion Y^.I bac=^, nn the existiro d-s)gniQJ fascia board If — Vampire hanger method is used. hanger may be placed nn too of the shingle if shingle w➢1 not lift or is too h 70 Thera win he a cox mat Iy ,BB)_of lliar and (941 of downspo its w th (4)drpns Downspo its w II he installed 6%12" fromground 2 I orations will he as fnllows' Where existin0. PRICF-$983 00 ** IF ANY SUB SHEATHING IS NEFDFD THERE WII L RE AN ADDITIONAL CHARGE OF $38 PER SHEET TO • REMOVE DISPOSE OF AND INSTAI L NFW 7/16 STRAND BOARD SUB SHEATHING 1t4, 1C IL 1 "nt+.•a' 1 •L 1 • • •• :LJ L • L :s :L L It L L A . C Ott (Ti 1Cs soh • AlL STAR WILL SECURE Bull DING PERMIT IF NEFDFD HOMFOWNFR WII L BE RESPONSIBLE FOR ANY &AI L FEES REQUIRED •L L 14 •• Qa.WE PROPOSE to furnish material and labor, compiete in aecordance'wTh above specifications, .`or the sum of: -'-' tf'? 1/3 D1AT ST OF JOB _/) i! �1Z,.tl __OPbV• r,._a. �dollars OWN, /3 TAR ($ — ), payment due upon receipt of invoice. If payment lat4, interest at 1 1/2% may be added. BALANCE DUE COMPLETION OF JOB NOT - his proposal may be withdrawn by us if not accepted within THIRTY _ _ days. —TY , • + - rl—l-f�o EDLOSACANO OWN l _.! �g— i. — _ ._ --- -- � _ Contractor Salesman _ _ _ __ TfiaTlaPani�l - - Acceptance by Purchases 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