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25c-050 (8) 227 NORTH ST BP-2017-0709 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25C-050 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-2017-0709 Project# JS-2017-001168 Est.Cost: $2653.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 101858 Lot Size(sq.ft.): 9583.20 Owner: WILLIAMS STEPHEN E&KATHLEEN M O'NEILL Zoning: URB(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT: 227 NORTH ST Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAM PTO N MA01027 ISSUED ON:11/22/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE 2 LAYERS OF ASPHALT SHINGLES FROM 1ST FLOOR REAR LIVING ROOM AREA & INSTALL NEW ROOF IN SAME AREA 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 11/22/2016 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 c•-• =�cL • Massachusetts State Building Code,780 CMR MUNICIPALITY >_.. USE je 0Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 o One-or Two-Family Dwelling 11 r Z c Thisection For Official Use Only Building Permit Number: • j "lag 11,w = •' 'ed: / , ",//1 Building Official(Print Name) 'fnatu - Date SE ON 1:SITE INFO' ATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 227 North Street, Northampton, MA 01060 1.1a 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) 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 0 Private 0 Zone: Outside Flood Zone? _ Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Kathleen O'Neill Northampton, MA 01060 Name(Print) City,State,ZIP 227 North Street 718-930-9672-C 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 Work2: REMOVE 2 LAYERS OF ASPHALT SHINGLES FROM 1ST FLOOR REAR LIVING ROOM AREA AND INSTALL NEW ROOF IN SAME AREA 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: 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 $ Total All Fees:$ Suppression) �` �) 6.Total Project Cost: $ $2,653.00 Check Nc 12�IGheck Amount: L o Cash Amount: 0 Paid in Full 0 Outstanding Balance Due: r SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-18 Ed Losacano I.icense Number Expiration Date Name of CSL Holder R List CSL Type(see below) 128 Glendale Road No.and Street Type Description Southampton, MA 01073 t1 Unrestricted(Buildings up to 35,000 cu.R.) R Restricted 1&2 Family Dwelling City/Town.State.ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-527-0044 ailstar5270044@gmail.com I Insulation Telephone Ismail address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101858 6-29-18 All Star Insulation & Siding Co., INC. HIC Registration Number Expiration Date b rmarmlNn ag roeItC Registrant Name allstar5270044@gmail.com N and Street Email address Easthampton, 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 I2c No 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 relat' 'e to work authorized by this building permit application. Kathleen O'Neill • Print Owner's Name(Electronic.'igna Dat SECTION 7h: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 accurate to the best of my knowledge and understanding. Ed Losacano ,,i1 i/ Print nti‘ner's or Authorized Agent's W(Electronic 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(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 ww•w.mass.eov/oca Information on the Construction Supervisor License can be found at wvww.mass.eov!dos 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 3. "Total Project Square Footage"may be substituted for"Total Project Cost" • • • �. • • -44 �. • } �� (62 4e, }' :§ -; 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: 227 North Street, Northampton, MA The debris will be transported by: Complete Disposal The debris will be received by: Holyoke Transfer Station Building permit number: Name of Permit Applicant Ed Losacano Date Signature of Permit Applicant � � \\ � � � � � � \ � • • K+ 0: s. ;\ � � § .% � • " -- �. , .; ; +tITV (�� 11a s INSULATION #j Ck_ 912"0 Easthampton Office & Ve 'e r Office 413-527-0044 SIDING CO., �� l 20141 �. 11-6411 CSL License #CS SL997 .i 6106.61 www.sidingandroofingweste nma.coln 56 Franklin Street • Easthampton, MA 01027 • fax 413-527-1222 • email:allstar561@verizon.net Proposal Submitted to Phone Date Kathleen O'Neill &Stephen Williams "Purchaser"718-930-9672-C October 7, 2016 Street Job Name 227 North Street MA HIC REG#101858 City,State and Zip Code Job Location Job Phone Northampton, MA 01060 rContractor hereby submits to Purchaser specifications and estimates for• INSTALLATION OF A NEW ROOF ON 1ST FLOOR REAR LIVING ROOM AREA 1 We will remove (2) layers of existing asphalt shingles and dispose of in a dumpster supplied by us. 2.We will install Titanium Rhino Deck or Elephant Skin underlayrnent over entire stripped roof surface_ ki, 13_We will install new CertainTeed Landmark. Owens Corning or Gaf/Elk Timberline Architect shingles. They will have a"Manufacturer's Lifetime Limited Warranty". Color to match. 4. All shingles wilLbe nailed with at least(5) nails per shingle. A - i I l- a I a ►. • -••- •I - - - .10 i- . n I . I -S• •I . l - , • instalLmetal.step flashing where needed fi.We will install ice and water barrier on entire surface. PRICE$2 653.00 ** IF ANY SUB SHEATHING IS NEEDED. 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 WILL.BE NOVEMBFR/DFCFMBER ONCE WE RECEIVF DEPOSIT AND $IGNFD CONTRACT LESS ANY WCIF.MFNT WEATHER **ALL STAR WILL SECURE BUILDING PERMIT IF NEEDED. HOMFOWNER WILL BE RFSPONSIBLF FOR ANY &ALL FEES RFQUI.RFD **ALL STAR la NOT RESPONSIBLF FOR ANY LFAKS THAT OS;CUR IN EXISTING SKYLIGHT(IF APPI ICABLF) HOMFOWNFR Wil I RF RFSPONSIBLF FOR ANY &All El FCTRICAL OR PI UMBING WORK. ** NO PRODUCT& l ABOR WARRANTIFS WILL BF ISS.UFD UNTII WEBFCFIVF FINAL PAYMENT ** HOMFOWNFR WILL BE RFSPONSIBI F FOR COVFRING ANY STORED ITFMS AND FOR ANY CI FANUP WORK IN THF ATTIC NFFDFD FROM DUST& DFBRIS FROM ROOF REMOVAL **A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED UPON REQUFST **T.P. DALEY INSURANCE AGENCY OF WEST SPRINGFIELD. MA IS OUR AGENT. :. • e k r? • �. �} �} �} ! • The Commonwealth of Massachusetts ...- Department of Industrial Accidents .,._?� Office of Investigations c =� .v 600 Washington Street t _ . .7 Boston, MA 02111 ems"' 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): 1.[2f 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. ❑ New construction listed on the attached sheet. 7. 0Remodeling 2.❑ 1 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' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its l0.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box#I 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. *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. lithe 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: 08/13/17 Job Site Address: 227 North 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: c,...e.,Pze...e .<0Dated/K/ t!o 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#: d {f � � • • � \\ • � • • �.._- 9?L Wo7rl//lAo Vl.Vec�i��l//l/ o/Qadu€ieét s=.illi Office of Consumer Affairs and Business Regulation - y1-- 10 Park Plaza - Suite 5170 .--- Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 101858 Type: Private Corporation Expiration: 6/29/2018 Tr# 419291 ALL STAR INSULATION & SIDING CO. Edwin Losacano — — 56 Franklin Street Easthampton, MA 01027 Update Address and return card.Mark reason for change. EAddress n Renewal El Employment 0 Lost Card SCA 1 0 20M-05/11 1 ,--7Ir T ,/,/inr nil will/e n llf,JJ re/m.107J .•` Office of Consumer Affairs&Business Regulation License or registration valid for individual use only -.gii HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 'Erig Registration: 101858 Type:kb, Office of Consumer Affairs and Business Regulation .. . Expiration: 6/29/2018 Private Corporation 10 Park Plaza-Suite 5170 ' Boston,MA 021 1 6 ALL STAR INSULATION&SIDING CO. Edwin Losacano 56 Franklin Street -4.C� Easthampton,MA 01027 _____&64A, :/e-4.,-.0-.. M� Undersecretary Not valid with s sture Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-099739 Construction Supervisor Specialty EDWIN W.LOSACANO 128 GLENDALE RO143 SOUTHAMPTON MA 01073 Exp«attork Commissioner 02/1412018 iW w � � � �. v � }2 Client#: 13250 ALLST ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM!DDYYYYY) 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 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 CONTACT NAME: Jane Eitel T.P. Daley Insurance Agency, Inc 571/8100.413788-0971 )FIUC,Not 413739-2645 1381 Westfield St. ADEREss:janeeitel@tpdaleyinsurance.com P.O. Box 1150 West Springfield, MA 01090 INSURER(S)AFFORDING COVERAGE NAZCA INSURER A:Peerless Insurance 15SURED - -_-- - - - All Star Insulation &Siding CO..InC. INSURER B:Star Insurance Company 56 Franklin Street INSURER C: Easthampton, MA 01027 INSURER D: 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 WTH 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 ADDLSUBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSR WYE) POLICY NUMBER JMM/DDIYYYY) (MMIDDIYYYY) UMTS A GENERALUABIUTY 'CBP8052996 08/13/2015 08113/2017 EACHOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY gREM18EST(Eaoa frena) $100,000 I CLAIMS-MADE ri OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE 52,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG 52,000,000 7 POLICY FT( jE 4 n LOC $ A AUTOMOBILE LIABIUTY BA8054496 08/13/2016 08/13/2017 OWNED $ ANY AUTO BODILY INJURY(Per person) $100,000 ALL AUTOS OWNED X AL TOSJLED BODILY INJURY(Per ecddent) 5300,000 PROX HIRED AUTOS X AAUUTTO-0S,hNED ((Para cciderlt) E 5100,000 S UMBRELLA UAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WC0681114 08/13/2016 08/13/2017 X WC STATLL OTH- AND EMPLOYERS UABIUTY y IN TORY OMITS ER ANY PROPRIETOR/PARTNERIEXECUTIVEEEACH ACCIDENT 51MAO OFFICER/MEMBER EXCLUDED? n N!A .L. (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 I'yes,describe under 2ESCRIPTION OP OPERATIONS belay E.L.DISEASE-POLICY LIMIT 5500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation &Siding 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 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S131574/M123220 JXE t. • 4 , • • �: