36-041 (5) 1053 BtIRTS PIT RD BP-2017-0510
01$#: COMMONWEALTH OF MASSACHUSETTS
Map;Block:36-041 CITY OF NORTHAMPTON
Lvt -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A)
Category:Siding BUILDING PERMIT
Permit# BP-2017-0510
Project# JS-2017-000832
Est. Cost: $10321.00
Fee;$60.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Ua rou : ALL STAR INSULATION & SIDING CO INC 101858
Lot Sizetsca 11); 12501.72 Owner: STARR ROBERT E h STEPHANIE D
zoain& Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 1053 HURTS PIT RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON:10/17/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:NEW VINYL SIDING &TRIM
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 Frost:
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 signal II rc:
FeeType: Date Paid: Amount:
Building 10/17/20160:00:00 $60.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
m,a The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
f d h Massachusetts State Building Code,780 CMR MUNICIPALITY
USE
— Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011
Two-Family Dwelling
6P I / - FIp
{ o g This Section For Official Use
Only
F
s
t in Permit Number. [Date Applied: _
Building Official(Print Name) ifi ���� Date
SECTION I:SITE INFORMAT ON
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
1053 Burts Pit Road,Florence, MA
1.1a Is this an accepted street?yes_,,,_ no_ Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Usesese 1_o;Area{sq fl) Frontage(6)
1.5 Building Setbacks(ft) --
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M,Gi.c.40.554) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Ione: _ Outside Flood Zone?
SECTION 2: PROCheek if yes0
PERTY OWNERSHIP' psystem13Public Private Municipal On site disposal system
2.1 Owner of Record:
Robert Starr Florence, MA 01062
Name(Print) Gm.Stale.LIP
1053 Burts Pit Road 413-584-0472
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg.0 Number f Links Other 0 Spudtco_ _
Brief Description of Proposed Work2:
REMOVE WOOD SHAKES AND INSTALL NEW VINYL SIDING
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I_Building $ I. Building Permit Fee:$ _indicate how tee is determined:
2.Electrical 0 Standard CiydTown Application Fee
—..- 0 Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ _ 2. Other Fees: $_ _
4. Mechanical (HVAC) $ List:____—
5.Mechanical (Fire
Suppression) $ Total All Fees:
10,321.00 Check No 4/#A1 heck Amount:( Cash Amount:
6,Total Project Cost: $ ❑Paid in Full I❑ Outstanding Balance Due:,
x, „
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSI)
CSSL-099739 2-14-18
Ed Losacano license Number __._. Expiration Date
Name of CSL Holder R
128 Glendale Road List CSI,rive(see below)
..._.._.—
No.and StreeType- - ---' ------- TvDe cription
1 II Unrested(Buildings up to 35,000 cu.11.)
Southampton, MA 01073
_. _... I R Restricted It.?Family Dwelling
CII)/TOwtt.State,ZIP I 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(HFC) 101$5$ 6-29-18
All Star Insulation & Siding Co.. INC. -HFC Regtwmrnn Number Expiration Date
Fn 11 C Regist t S,m,e
bb l-rmanKnn auger allstar561@verizon.net
N dad Strict Email address
Easthampton MA 01027 413-527-0044
_. __ ---_- -- - --_-
City/Tmvq State.ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.C.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 C>f Nu 0
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 re • a to work auth rized by this building permit application.
Robert Starr )13 zee I..)
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below, 1 hereby attest under th. pains and penalties of perjury that all of the information
contained in this application is tru d ccur to t II - •est of my knowledge and understanding.
Ed Losacano -✓//.,-C.r.�.- J ' J,2—_I-t;__
t OOwner's or AtI ized Age amei Elie.Signature) Date
NOTES:
I. An Owner who obtains a building permit to do is/ter own work.or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(RIC)Program),will not have access to the arbitration
program or guaranty fund under 14G.L.c. W2A.Other important information on the WC Program can be found at
a w w.Illass.glvkma Information on the Construction Supervisor License can be found at ww w.mass.eta:dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) (including garage,finished basemenVattics.decks or porch)
Gross living area(sq.H.) Habitable room count
Number of replaces Number of bedrooms
Number of bathrooms Number of halGbaths
Type of heating system Number of decks/porches
Type ofcooling system Enclosed Open
3. "Total Project Square Footage'may be substituted for"Total l'roject Cost'
`fin( .c_A` kv\ COze DL'S(.-f'" (, .0 �a�
9,\,,_€,,, Ct,c.-4 uar1l
`lE rat'6 p? Bike \ INSULATION
San $t INC. Westfield Office
413-527-0044 SIDING Ca, IN - 413.568-6411
CSL License #CS 5499739 •
www.sidingandroofingwesternma.cOm
56 Franklin Street • Easthampton, MA 01027 - fax 413-527.1222 • emalhalistar561@vertzon.net
Proposal Submitted to Phone Date
Robert Starr
"Purchaser 413-584-0472-H October 4, 2016
Street Job Name
1053 Burrs Pit Road MA HIC REG#101858
City,State and Zip Code Job Location Job Phone
Florence, MA 01062 413-221-6916-C
Contractor hereby submits to Purchaser specifications and estimates tor: INSTALLATION OF NEW VINYL SIDING ON MAIN HOUSE,
} BREEZEWAY AND TWO-CAR GARAGE
y
I _,
OPTION 1 INSTALL NEW VINYL SIDING AND TRIM �l
1 We will remove existing_Wood Shakes from exterior walls and dispose of in a dumpster st potted by us
7 We will install new Vinyl Siding on all exterior walls Homeowner will have chplge of brand name style and
color
?, 31 We will nail all siding approximately 16-24'on center using all minl Im nails so they will not rust underneath
the siding
4_. LP will install a SIA"insulated Styrofoam banker behind the siding.
/ so 'II . . .. I ..... . ier • - -. , ' .. 1 ( - - 55511 • •. . n. - .
6 Windowsills will lr.e trimmed nut with Willie aluminum coil stock material
7 Wood trim around 1131 doors will be covered with White aluminum coil stock material
b Wood trim soffit and fascia will be covered with White aluminum coil stock and Perforated White vinyl soffit
•
1 #. .l - r-' . .- •.r- .' • ••.- , - AI' - . .•
11 Any existing wood that is loose will be reneged
i1 .•.. i-.' •• - .. . -• '!•. . a. .- -1 - -• . •1• ♦ .1 .-e• a . . i• t... .
replaced This dues not include any stturdunaLasacteusionai lumber pr sub sheathing
14 Wp w II instalLl3i White 12X 18"gable end lei vFrs with`screens in designated areas _.........,_
14 We will insta11181 White vinyl lite blocks behind light fixtures _..
• i - ,' '1 • • '.g corner posts on all corners Color win be white or will match vinyl siding
17 We will install white aluminum coil stock around (21 garage doors —
18.We will remove and reinstall existing gutters and downspouts .
2QJA?nod trim around rear slider and front bow window will be covered with white aluminum coil stock materjal .._
71 .lob site will be cleaned upon completion of jnh
— _ • 1 n
CONTINUED ON PAGE 2
2ai Y
•
%N. g1/43‘SaSg S74
Vs. NsuusTioN 4
SIDING CO., INC. .
EASTHAMPCON OFFICE 413-527-0044 Ca License *CS SL 99739 WFSTPIELD OFFICE413-568.6411
56 FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 • FAX: 413-527-1222
—
Proposal Submitted to Phone Date
Robert Starr "Purchaser 413-584-0472-H October 4,2016
Street Job Name
1053 Burrs Pit Road MA HIC REG#101858
City,State and Zip Code Job Location Job Phone
Florence, MA 01062 413-221-6916-C
Contractor hereby submits to Purchaser specifications and estimates for INSTALLATION OF NEW VINYL SIDING ON MAIN HOUSE,
BREEZEWAY AND TWO-CAR GARAGE
f ONTIN I cROM P"GF t o
OPTION 2-TRIM WORK ONI Y
T .y .tt - ,r• •- as,• '.it1 . r , .rlOTiigRfn'1R5iG„•a _rr $yt(Si:'. -.. Jl'i- "t -• k \
e -
Material We • + 4 4 : • 1 -r r /.K _
'”APPROXIMATE START DATE WI L• u: • e IA' : •L i ..1 C • "•"IT AND SIGNED
_CONTRACT ESS ANYIN M NT AF,�TH R _
sA Y. . II • :t" • •1J -• 1A •' "'Si T. •: AL -_
&Al L FEES REQUIRED
•_•• At. A:I. .BULL 3 . All . -0 L i • Li a II. L
HOMEOWNER WII 1 BE RFSPONSIRI F FOR ANY 8 A IAFt E_CTRICAI nR pl IMBING WORK THAT MAY BF
L •
"A OERTIFICATT OF fNSURANCF R'$_W_ORKMAN's; CQMPENSATIQN AND I IAFILILY.yLI 1 SF FORWARDED
UPON RFOUFS'r
** " I . Lr' a1 A L • •: L . • LA 4, • : . T L
WE PROPOSE to furnish material and labor, complete in accordance with above specifications, for the sum of'.
101� 1/3 DOWN, 1/3 AT START OF JOB,
-a j , j: � dollars($ ),payment due upon recept of invoice
If payment late interest at 1 1/2% maybe added. BALANCE DUE COMPLETION OF JOB
NOTE, This proposal may be withdrawn by us if not accepted within THIRTY _ _.__ _, __ days.
ED LOSACANO, OWNER
1 _ J -7--/ T�,entractor Salesman
Robert Starr' - '" t 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 seder 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
Cijent#: 13250 ALLST
ACORa CERTIFICATE OF LIABILITY INSURANCE DATEIMMYOD(YYYY)
07/27/2016
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 CONS I I i UTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER.
IMPORTANT:If he certificate holder is an ADDITIONAL INSURED,the policy(les)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 neet"RTACi Jane Eitel
T.P,Daley Insurance Agency, Inc vN6NE ' 413 788-0971 FAX 413 739-2645
1381 Westfield St. IIAmiiiii ezq J(Arc Not_
9BAESs laneei[ei@Iptlateyinsurance.cpm
P.O.Box 7150 _ wsweERISI AFFORown eavcwsE NNE!
West Springfield,MA 01090 INSURER A:Peerless Insurance
INSURED - INSURER e:Star Insurance Company
All Star Insulation&Siding Cosine.
56 Franklin Street _wauRFrzc_„
IN9VRERn: —. ....
Easthampton,MA 01027 '- --
INSURERE:
'INSURER F'.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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.
(NSR POOL SUER POLICY EFF POLI YERP QTS
LTR TYPE OE INSURANCE IINyg_Wyg NUMBER MBER MWOATruo _ _
A GENERAL LIABILITY CEP80929960/13/2015 08/13/2017enC oL uRBBNOE -s1,000
,000, _
o MAGI( RENTED
XYI COMMERQAL GENERAL LIABILITY P� ' sEs� VlneLamnce) 5100,000
iI CLAIMS-MADE XI OCCUR 'LHDEXP ng maporIMI `3/1000
PERSONAL&AIN INJURY 51,000,000
i-
'
'GENERAL AGGREGATE $2,0001000
GENT AGGREGATETLIMIT AP LES PER. �PRODUCTS-COMP/OP AGG $2000,000
I
� I ILOC 51 e� �Lr+n
A AUTOMOBILE LIABILITY BA8054496 811312016 08/13/201EI Mo a dy li $
.BOD IN v(Perperson) $100,000
ALL OWNSTO
ALL OWNED SCHEDULED BODILY INJURY lPe,a,',Gae„p $300,000
AUTOS X AUTOS
— — —_
X HIRED AUTOS X AUTOswNED 11Pr EURdrm))D . 3!00000
woNNLLA LIAR OCCUR
II )ACIII OCCURRENCE1 E-
.EXCESS LIAR CLAIMS HAUF AGGREGATE —3
I DEO I RETENTIONS
S
WORKERSCOIRENSATWH IWC STATU- las...
B AxoEMPLOYERS'LIABILITY WCO681t id 0811312016 08113/201 %._WBY11Mfsj_ FFc _..__....
ANY PRORIETORIARTNER/EXECUTIVE Y�"" .L.EACH ACCIDENT 16700,000
OFEroEPoMELABER EXCLUDED' ( N N(A'.
(mandatory In I EL.DISEASE EA EMPLOYEE'6100000
If yes.s R Lame.
DEStaMTIN OF OPERAnONSM.w+ __.... _... ES,DISEEASE-Pouc MO $500,000
i
DESCRIPTION OF OPERATIONS)LOCATIONS r VEHICLES(MGM ACORD 101,Additional RnmaM°Schedule.If mere space IF required)
GENERAL CERTIFICATE
CERTIFICATE HOLDER CANCELLATION
All Star lnsuiatlon8CO. 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
AUTHORIED REPRESENTATIVE T /� /
wit ,t
,... ,a,"12!' ,.-
I
61988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) 1 of I The ACORD name and logo are registered marks of ACORD
115131574/M123220 JXE
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
LicSupervisor
CSS
L-4or739
Construction Specialty
12L R
1
0GNDALE AD
m
SOUTHAMPTON
0107) •
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` Exp .
Commissioner 02)1412011a
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J;a,
, Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston,Massachusetts 02116
Home Improvement Contractor Registration
Registration: 101858
Type: Private Corporation
Eviration: 6/29/2018 TM 419291
ALL STAR INSULATION & SIDING CO.
Edwin Losacano
56 Franklin Street
Easthampton, MA 01027
Update Address and return card.Mark reason for change.
SCA I O -05/11 ❑ Address El Renewal Q Employment 0 Lost Card
Yi r*ono/nrn,,n,///fir//nun/.o^
Office of Consumer Affairs&Business Reguladon•
License or registration valid for Individual use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 101858 Typo: Office of Consumer Affairs and Business Regulation
Expiration: 6/29/2018 Private Corpontlon 10 Park Plaza-Suite 5170
Boston,MA 02116
ALL STAR INSULATIONS SIDING CO.
Edwin Losacano A
58 Franklin Street \.,.._. "...__ r
Easthampton.MA 01027 - -s' �....
Undersecretary Not valid with , ature
The Commonwealth of Massachusetts
Department of Industrial Accidents
v fi OfftceofInvestigations
600Washin ton Street
= � g
�,'-"-t'� Boston, MA 02111
'';.^.ce www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/ContractorsfElectrieians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): All Star Insulation & Siding Co., Inc. v
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.113 I am a employer with 10 4. D 1 am a general contractor and I
employees(full and/or part-time).
* have hired the sub-contractors 6. Q New construction
2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have s. 0 Demolition
working fur me in any capacity. employees and have workers'
9Building addition
[No workers`comp. insurance comp, insurance
required] 5. Q 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 I I.Q Plumbing repairs or additions
myself. [No workers comp. right of exemption per MU- 12.0 Roof repairs
insurance required.]` c. 152,§1(4),and we have no
employees. [No workers' 1.3.0 Other .--
comp. insurance required.]
`Any applicant that checks box e I must also III out the section hclow showing their workers'compensation policy information.
'Homeowners who submit this affidavit indicating they arc doing all work and then lure 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
employeeslithe sub-contractors have employees,they must provide their workers comppolicy number,
l am an employer that is providing workers'compensation insurance for my employees. Below k the policy and job site
information.
Insurance Company Name: Star Insurance
Policy*or Self-ins.Lie.#: WWC06811,14 „--- —-- Expiration Date: 08//3117
Job Site Address: 1053 Burls Pit Road i City.State2ip: Florence, MA 01062
Attach a copy of the workers'compensation pokey 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
tine 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.
Ho hereby cerci ,un er the pain and penalties of perjury that the information provided above is true and correct
Signature: _ to tOl!5..,.4Sifri'f'rt Date: JL2'/O -11a
Phone u: 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): I
I. Board of Health 2. Building Department 3. CityITown Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other '
Contact Person: Phone it
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: 1053 Burts Pit Road, Florence, MA
The debris will be transported by: Cpmplete Disposal
The debris will be received by: Holyoke Transfer Station
Building permit number:
Name of Permit Applicant Ed Losacano
10-14-16 E-- ,�11�,,-L
Date Signature of Permit Applicant