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30C-083
144 CLEMENT ST BP-2017-0498 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30C-083 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-2017-0498 Project# JS-2017-000819 Est.Cost:$7853.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Graun: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sq. ft.): 32539.32 Owner: DAVIS I MICHAEL&ALINE LABORWIT-DAVIS Zoning: SR(I00)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT: 144 CLEMENT ST 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: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 10/17/20160:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner "Che Commonwealth oY Massachusetts co ,i Board of Building Regulations and Standards FOR i Massachusetts State Building Code,780 CMR MUNICIPALITY USE CO Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 -_ One-or Two-Family Dwelling T -4.Section For Official Use Only .mg Permit Number:iij-1 j 7 &to • �ilding Official(Print Name) iirt!tur �t/ "�' ! � _ SEC I•N 1:SITE INFORMATION _ 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 144 Clement Street, Florence, MA I.la Is this an accepted street?yes no._ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ..... _..t.. ._ . _. Luning District Proposed Ilse Lot Area(sq ft) Frontage(R) 1.5 Building Setbacks(ft) From Yard Side Yards Rear Yard Required Pro ided Required Provided Required Provided 1.6 Water Supply:(ALM,c.46,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private 0 Zone: __ Outs MunicipalEi yes Zane? Municipal 0 On site disposal system 0 Check yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: —Mike. _ _FloralCSrJA 01062 Name(Print) City,State,Z. 144 Clement Street 413-320-6335 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units _ Other 0 Speei ':_ Brief Description of Proposed W ork2: REMOVE 2 LAYERS OF SHINGLES 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: """"' 0 Standard City/Town Application Fee 2.Electrical $ _ 0 Total Project Cost?(Item 6)x multiplier x_ 3.Plumbing S 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ - Suppression) Total All F es: ?nt_ [(� Check Noi? Check Amout `Tu' Cash Amount: 6.Total Project Cost: $ 7,853.00 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 Expiration -__ L ens Number Dmc Na nv of CSI I Inldcr. 128 Glendale Road Sest C51.T)pe tree bit __. _...__._......------... ._----- —_.--'"-- ,Pe Description No.and Street ........ Southampton, MA 01073 1f Unrestricted(aa;fatngsap o3S,000<n n.) ( ,ilortn,'�i,is PSP _—.. . - - R Il , aed Del lamas u. Dweluna Nt masonry RC goofing Coverin: ...__._., [ WS Window and Sidin_ 413-527-0044 Sr Solid Fuel Homing Appliances @ et I insulation allstar561 venzon. n telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 6-29-18 All Star Insulation & Siding Co., INC. _ 101858 _-.-- —_. — ill(' Registration Number Expiration Dare arHf6g ' g`i•`iriklln �'Yree� to tName _ allstarsst @verizon.net astdtitrem Email address Easthampton, MA 01027 413-527-0044 City town State,ZIP _...—. .. Telephone _.. SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this afrdavit will result in the denial of the Issuance of the building pemtit. Signed Affidavit Attached^..,. Yes CK No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner or the subject pros hereby authorize Ed L0sacano to act on my behalf,a all ' literrs relytiv ork authorizeny this building permit application. Mike Davis t lj't1 ' ,-1 /0 ,_C; Prim{hyper Name de�fis nSgmnure) Date SECTION 7b:OWNER' OR.AUTHORIZED AGENT DECLARATION B) 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 accur. -to the best of m) knowledge and understanding. / Ed Losacano S �" s ;«�a-`v"� /C)-/0-/C z_._ pni,,(Jnner -or WiwInniped Ay l e t leopinic Signature) Date NOTES: ._ I. An Owner who obtains a building permit to do hisrher own work.or an owner who hires an unregistered contractor (tot registered in the Home Improvement Contractor(HIC)Program).will not have access to the arbitration program or guaranty fund under N.G.L.c. LOA.Other important information on the HIC Program can be found at www.masn.govmgp Infonnation on the Construction Supervisor License can be found at www.mass, ovadns 2. When substantial work is planned.provide the information below: Total floor area(sq.f.)- _ _ ,,,,,,,_._,_,__(including garage.finished basementtauics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplacesNumber of bedrooms Number of bathrooms Number of hal06ama 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 Cosi' poker r-5\C. 0 .'. csfr .i . •CLQ/ r, (NI➢- SATION ' : r I` Easthampton Office & ' Westfield u. 413-527-0044 SIDING CO., INC. OCT 10429a V CSI,License acs SL99739 IJ www.sidingandroofingwesternma. om 56 Franklin Street • Easthampton, MA 01027 • fax 413-527-I - - .. . - . - t ' on.net Proposal Submitted to Phone Date Mike &Aline Davis "Purchaser'413-320-6335-C Mike October 6, 2016 Street Job Name 144 Clement Street MA HIC REG#101858 City,State and Zip Code Job Location Job Phone Florence, MA 01062 413-586-5441 SContractor hereby submits to Purchaser specifications and estimates for. INSTALLATION OF A NEW ROOF ON SECOND FLOOR MAIN HOUSE AND GARAGE 1 We will remove (21 layers of existing asphalt shingles and dispose of in a dumoster shpolied by us 2 We will install Titanium Rhino Deck or Elephant Skin underlayment over entire sir-Aged roof surface 3 We will install new CertainTeed I nndmark Owens Corning or,af/Flk Timberline Architect shingles They wilt have a"Manufacturer's 1 ifetime Limited Warranty" Owner witl have choice of color 4 All shingles will be nailed with at least(51 nails oer shingle 5 We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas We will ,) instalyjpe boots and metal step flashing where needed fi We will install approximate (621'of roll vent on peak of roof for additional ventilation 8 7 We will install a 36"wide asphalt ice and water barrier on eave lines/valleys of heated areas a PRICE'S7 853 00 ** IF ANY SUB SHEATHING IS NEEDED THERF Wil L BEAN ADDITIONAL CHARGE OF£38 PFR SHFFT TO REMOVE DISPOSE OF AND INSTAI I NFW_7.L15-STR&NB-QGARD SI IR SHEXITHING --V-\1 ( I ""APPROXIMATE START DATE WW ILLIBE NOVFMBFR/DFCEMBFR ONCE FAtIFCR FPOSIT AND SIGNED CONTRACT I FSS ANY INCIIFMFNT WFATHFR ___,- n Al I STAR WILL SECURE 81111 DING PFRMIT IF NEEDED HOMFOWNFR WII L BE RESPONSIBI F FOR ANY &Al I FFF$ RFOUIRFD **Al L STAR IS NOT RESPONSIBI E FOR ANY LFAKS THAT OCCIIR IN FXIRTING SKYLIGHT(IF APPLICABLFI 1-kc Cc:.., � e„ l )e�--T—K”1-(C:-li, O�r.ls1 ILY"� 14,r,L.,.t ISCILC 1. ** HOMEOWNFR WILT BE RFSPONSIBLE FOR ANY&AI L El FCTRICAL OR PI UMBING WORK t.-L-- ** NO PRODUCT & I ABOR WARRANTIES WIl I BF ISSUFD UNTIL WE RECEIVE FINAL PAYMFNT ** HOMFOWNFR WII I RE RESPONSIBLE FOR COVFRING ANY STORFD ITFMS AND FOR ANY CI FANIIP WORK IN THE ATTIC NEFDFD FROM DUST& DFBRIS FROM ROOF REMOVAL *"A CFRTIFICATF OF INSURANCE FOR WORKMAN'S COMPFNSATION AND I (ABILITY WII L BE FORWARDFD UPON REQUEST **T P AAI EY INSURANCE AGENCY OF WEST SPRINGFIFI 0 MA IS OUR AGENT Client#: 13250 ALLST ACORDn, CERTIFICATE OF LIABILITY INSURANCE tunearwooro n 07/27/2016 THIS CERTIFICATE IS ISSUED AS A MAI TER 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 holder is an ADDITIONAL INSURED,the policy(ies)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 NAME. Jane Eitel T.P.Daley Insurance Agency,Inc I Wow 413 788 0971 IFAX-413 73g-2645__ 1381 Westfield St. :(NC.NL But).413 <ugxnL E-MAILD •aneeitel t dale insurance.com P.O.Box 1150 oogass,l__ P Y _ - West Springfield,MA 01090 HxiuRERis,ArroRomocovEPar Win 9 INsuane a•Peerless Insurance INSURED 'INSURER S:Star Insurance Company All Star Insulation&Siding CO.,lnc. - —' 56 Franklin Street NEWER c_ INSURER D'. Easthampton,MA 01027 . . -- MS RERE - _ •. 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 BELILSUBR - ENUMB wow EFF Y U C I LIMITS LTRI TYPE OF INSURANCE _BEN WyR POLICY NUMBER (MMN61YYVYI IMINDD ) A 1GENERAL LIABILITY CBP8052996 148113/2015081137201FEAC�,rpp000UARem.E s11000A00 X COMMERCIAL GENERAL LIABILITY PREM ISEB(Ear,iccuvnen, slop 000 CLAIMS-MADE i X'OCCUR IMEN EXP Dwg age perwn) S5 000 PERSONAL OV INJURY $1,000,000 • , GENERAL AGGREGATE 52,000,000 BEM AGGREGATE UMWAPrPLILIES PER: PRODUCTS=COMWOPAGG 52,000,000 l JkI POLICY Xd LOC _ $ A AUTOMOBILE LIABILITY j BA8054496 08/13/201608/13/2017;CDEaM„zI"EaEDSNCLE LIN" ANY AUTO BODILY INJURY(Per person) $100,000 ALL OWNED X SCHEDULED ' BODILY INJURY(Per amOmll 530.0,000_ AUTOS _AUTOS j PROPERTY DAMAGE X HIRED AUTOS X AUTOSW"ED (Per.�eanD _ 1100,000 I umEIRELLA um/ OCCUR EACH OCCI1RRGrvCE s EXCESS LIA1B CLAIMS-MADE 'AGGREGATE - $ OED (1RETENTIONS i 5 B WORKERS COMPENSATION : WC0681114 08/13/201608/13/20171X WC4HTLMstISA Qb �R IDH AND EMPLOYERS'LIABILITYT .ANY PROPRIETOR/PARTNER/EXECUTIVE' ' R4 'EL.EACH ACCIDENT IT TO0,000 'UFSICEREMSER EXCLUDED' N. NfAI _— :MendamryInNHiEL.DISEASE.EA EMPLOYEEI$i 00,000 DESCRIPTION OF OPERATIONS below I EL.DISEASE.POLICY LIMIT I s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AJJI*DMI Remarks Schedule,X more apace is required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation SSidin 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 AUTHORIIZEEDREPPRESENSATE I YO / RGli - Q ' ''C)1980-2010 .r+©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of I The ACORD name and logo are registered marks of ACORD 0131574/M123220 JXE i, Massachusetts Depadment of Public Safety Board of Building Regulations and Standards License:CSSL-099739 Construction EDWSupervisor Specialty >y 123 G& NDALE CAAO D SROAD SOUTHAMPTON MA 01073 1 Commissioner t Lsptcmion'. av144e1e Li • it C9'ie Volivmozybecea&Ao/g/ a4oa betze& se t 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: 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. sag I o 20mazam f] Address 0 Renewal 0 Employment 0 Lost Card 1 nil,Y,o...,.rv./,v.,///e�' , thwack/Jr/6 OIBce of Consumer Affairs&Business Regulation 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 end Business Regulation Expiration: 629/2018 Private Corporation 10 Park Plan-Suite 5170 Boatel,MA 02116 ALL STAR INSULATION&SIDING CO. Edwin Losacano A 56 Franklin Street ♦ _ 44. Easthampton,MA 01027 Undersecretary Net valid with. attire The Commonwealth of Massachusetts Department of Industrial Accidents z ft Office of Investigations _; 600 Washington Street .7. Boston, MA 02.111 S. x`'o www.mass-gox/dia Workers' Compensation Insurance Affidavit:Builders/ContractorsfEleetricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizatia>nndividtuJ): 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): 1.125 I am a employer with 10 4. ❑ 1 am a general contractor and 1 employees(full and/or part-time).' have hired the sub-contractors 6. [J New construction 2.❑ l am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g. 0 Demolition working for me in any capacity. employees and have workers' 0 Building addition [No workers'comp.insurance comp.insurance.: required.I 5. Q We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 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 12.0 Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 13,0 Other__ comp. insurance required.] 'Any applicant that checks box 41 must also fill out the 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. :Contmctos that check this box must attached an additional sheet showing the name of sub,-connzcrors and state whether or not those entities have employees. If the sub-contractors have:mph!,ces,they must provide their workers'comp.policy nurnbec l am an employer that is providing workers'compensation insurance for nn,employees. Below is the policy and job site information. Insurance Company Name: Star Insurance Policy#or Self-ins.Lie.4t WC0681114Expiration Date: 08113/17 Job Site Address: 144 Clement Street City/State/Zip: Florence, MA 01062 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 Wit c. 152 can lead to the imposition of criminal penalties of a foe 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 certify under the pains and penalties of perjury that the information provided above is true and correct Signature: ��,— eSe `r. _—.--. Date: /0 1O-110 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#: