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30A-061 250 FLORENCE RD BP-2017-1390 GIs#: COMMONWEALTH OF MASSACHUSETTS Mao:Block.3M-061 CITY OF NORTHAMPTON Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildins DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ROOF BUILDING PERMIT Permit# BP-2017-1390 Project# JS-2017-002318 Est.Cost: $11852.00 Fee:540.00 PERMISSION IS HEREBY GRANTED TO: onstclasc_ Contractor: License: Use Group; . ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(so. ft.): 36808.20 Owner: BOWE JOHN F& PAULINE MARNEY Zoning: URA(1003rWSP(100W Applicant: ALL STAR INSULATION & SIDING CO INC AT: 250 FLORENCE RD Applicant Address: Phone: Insurance: 56 Franklin Street (41.3) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON:6/I/2017 0:00:00 TO PERFORM THE FOLLOWING WORK STRIP & SHINGLE ROOF ON MAIN HOUSE AND GARAGE 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 MAYBE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy signature: FeeType: Date Paid: Amount: Building 6/1/2017 0:00:00 540.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck-Building Commissioner DepaNment use only City of Northampton Status of Permit rO \ Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability f Room 100 WaterhMe Av&ability Northampton, MA 01060 Two Sets of Structural Plans r phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify ' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 15 q 7- /3q0 1.1 Property Address. /� ��/{} This section to be completed by office ot qo 5 /Flo re n 'yy- r dZane LOvedayD Unit -FkorPocc i m' 0/04) a--- Elm St Dadct Ce District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT j.1 Owner of Record: _...._ _.. JOHN AND PAULINE BO W E 250 FLORENCE ROAD FLORENCE,MA 01062 Name(Print) Current Mailing Address: 413-584-3398 Tefephone Signature 2.2 Authorized Agent: E-1 l nsaar no 5e2 firrtvkl i n SfrQe+ aslitterkftirnml9- Name(Print). Current Mailing Address: _s. 44.42, . L 1 413-527-0044 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(S) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) T11,852 Check Number y� This Section For Official Use Only 4/o 9' fX (l Building Permit Number Da teed:ed: AleSignature: �e �/ "17 Jailor Commissioner/Inspector of Buildings Dale Section 4. ZONING AEI Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage °o Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&location) A. Has a Special Permit/Variance/Fint�dii;nstg ever been issued for/on the site? (" NO Q DONT KNOW < YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Documeenttcc# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW SX/ YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO 0 IF YES, describe size, type and location: t,.,,, D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES, describe size, type and location: E. WII the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part ot a common plan that will disturb over 1 acre? YES O NO {(W7_t IF YES.then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House in Addition ❑ Replacement Windows Alteration(s) l Roofing i Or Doors CI Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[01 Other[C] Brief Description of Pqp P existing roof and install a new roof on main house and garage Alteration of existing bedroomefYes X No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ba. If New house and or addition to existing housing,complete the following: a. Use of building : One Family Two Family Other b Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN . OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT John and Pauline Bowe as Owner of the subject property hereby authorize „a2. ar Insulation & Siding Co. Inc. ir to act on my beh-Orir r • . w.=.Ithorized by this building permit application. prbe /- / . a-07(— / 7 Signature of Owner Date I, Ed Losacano ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sign-. under(eiiir era T., ties oi.erjury. • yi Print Nam dr ._ gi , 5-'07617 Signature of Owner/...e Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: f �c/!'�1 /�//�� Vt /� Not Applicable ❑/1 ' Name of License Holder: (te•t n �.�1 W 12 V c55�( ,927_` _ License Number A .c 9 _ sti. O. _/w&4„Jjttj •Il ■ _aJLyi_/g Address Expiration Date SIi arS •AA A4. _ /—t Signature Telephone :.R , stored Nome im•row:in:nt Coh�tractor: Not Applicable ❑ A zit -11 in 9 d- 1 Co . �� �JO Company Name Registration Number cA linnklin S* e-f _ ____ Address Expiration Date _ . al id AA• P ,a11-- 1 Oa Telephone 3—~ SECTION 10-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 No 0 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,Slate and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature The Commonwealth of Massachusetts Ci Department of Industrial Accidents ,51r ., Office of Investigations 600 Washington Street Sildr. Boston, MA 02111 e� 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.121 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. ❑ New construction listed on the attached sheet. i 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have ] g, ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.- 9. ❑ Building addition [No workers' comp. insurance required.] 5. 11] We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I l.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ 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 NI 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 him 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. Lich�#: WCh0681114 n I Expiration Date:: 0[8/13/17 L —� Job Site Address: <Da..) yIU t Qt\QQ,rK(�, City/State/Zip: FlOre n , hitt 0104(7c2, 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 ceerrtifyi under[fC the and penalties o perjury that the information provided above is true and correct. c-i Signature: / ek )LLC1 Date: 5/042/1_9_____ 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 H 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 ft: Client#: 13250 ALLST ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDMY" 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 BV 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 TACT NAME: Jane Eitel T.P.Daley Insurance Agency,Inc Binz No,Ertl;413 788-0971 FAX413 739-2645 1381 Westfield SL pDDREss, janeeitel@tpdaleyinsurance.com P.O.Box 1150 -- 'ERAGE West Springfield,MA 01090 INSURER(S)AFFORDING COVEIUGE NMCa INSURER A:Peerless Insurance INSURED INSURER B:Star Insurance Company All Star Insulation&Siding Co.,lnc. 56 Franklin Street INSURER C: Easthampton, MA 01027 INSURERO: 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 SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE _IN R_i/VD, POLICY NUMBER (MMIDDIYYYY) (MM)DM%YI LIMITS A GENERAL LIABILITY CBP8052996 08/13/2015 08/13/2017 EACHOCCURRENCE181,000,000 X COMMERCIAL GENERAL LIABILITY BREMISES(ESE,,TEancel 1$100,000 CLAIMS-MADE X',OCCUR MED EXP(Any one person) 85,000 I PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE 82,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO s2,000,000 POLICY X JEST I LOC 8 A AUTOMOBILE LIABILITY BA8054496 08113/201608/13/2017 coueINEDSINGLE LIMIT (Eaawde $ I ANY AUTO BODILY INJURY(Perperson) $100,000 ALL OWNED SCHEDULED BODILY INJURY{Per accident) $300,000 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS AUTOS (Per acadenll $100,000 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR I CLAIMS-MADE AGGREGATE _$ _ DED . RETENTIONS $ B WORKS COMPENSATION ' WC0681114 08/13/2016 08/13/20171 X mRYIIMITS �RH EMPLOYERS' ARIUT" OFFICCiwMEMBER EXCLUUDEDiEcu.rvE YNN INA El.EACH ACCIDENT 8100,000 (Mandatory In NHI LEL.DISEASE-EA EMPLOYEE 000,000 DEeaCOF EL.DISEASE-POLICY LIMIT $500,000 DESCRIPTION R. N under F d OPERATIONS below _ _ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if space b required) GENERAL CERTIFICATE CERTIFICATE HOLDER CANCELLATION All Star Insulation$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 - Qi/ie Waozn e/-eaN o/o/Hroaanitiu4a = Fr Office of Consumer Affairs and Business Regulation - a 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 101858 Type: Private Corporation Expiration: 629/2018 Tr0 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 G 20M-05/110 Address 0 Renewal 0 Employment 0 Lost Card Ar*r..I,n,on/Pev.//G fin./L.,,,.d.,uea, >� Office of Consumer Affairs&Business Regulation License or registration valid for individual ase only HOME IMPROVEMENT CONTRACTOR before the expiration data V found ratans to; 9 Registration: 101858 Typo: Office of Consumer Affairs and Business Regulation Expiration: 629/2018 Private Corporation before Park Playa-Suite 5170 Boston,MA 02116 ALL STAR INSULATION&SIDING CO. Edwin Losacano A 58 Franklin Street ' ......, �.....� _ V Easthampton,MA 01027 Undersecretary Not valid w ,. i attire ® Massachusetts Depadmenl of Public Safety I Board of Building Regulations and Standards License:CSSL-099739 Construction Supervisor Specialty EDWIN W LOSACANO giaa -gen, 12$GLENOALE ROAD SOUTHAMPTON MA 01073 2 O Cf...— Expiration: Commissioner 02/141011 • p 1 -• E1012OVE " 4✓ .�' MAY 2 E 2011 INSULATION ea 353c L SIDING CO., INC. " •,ow. ei Easthampton Office - • ice _trs-527-6044" 56 Franklin Street • Easthampton, MA 01027 41.3-56s-6411 CSL License NCS SL99739/MA HIC$I OI R5R/CT 191CN0030805 fax 413-527-1222 • emaiballstar5270044@gmail.com • www.allstarinsulationsiding.com Pmpasal Subinllled lo - Thong - - - - Data John & Pauline Bowe "Purchaser" 413.684-339B May 22, 2017 Street Job Name 250 Florence Rand Cry,Slate and Zip Code Joh Location - Job Phone Florence, MA 01062 Contreetpr hareby sunlnua la Puronasar spacifleationa and oslinuttss tor. NEW ROOF ON MAIN HOUSE AND TWO CAR GARAGE (DOES NOT INCLUDE RUBBARIZED ROOF) 1 We will remove (7) lavers of existing asphalt shingles and dispose of in a dumocter suoolied by us 2 We will install Titanium Rhino Dank or Elephant Skin underlayment over entire ctrpped roof surface We will install new CertainTeed I andmark Owens Corning or Oaf/Elk Timberline Architect shingles They will have a "Manufacturer's Lifetime I invited Warranty" Owner will have rhoice of color 4 AU shingles will be nailed with at least(51 nails per shingle 5 We will install new ahnnintim drip edgy on all eves and new aluminum rake edge on rake areas We will install pipa boots and metal step flashing where needed 5 We will install approximately (1071 of roll vent on peak of roof for additional ventilation 2 We will install a 36"wide asphalt ire and water barrier on save lines/valleys of heated areas 8 Job site will be cleaned upon completion of iob IF ANY SUB SHEATHING IS NEEDED THERE WII L BE AN ADDITIONAL CHARGE OF 838 PFR SHEET TO REMOVE DISPOSE OF AND INSTAI L NEW 7116 STRAND BOARD SUB SHEATHING PRICE $1185200 icrri. if APPROXIMATE START DATE WILE BE JUI Y/AUGUST ONCE WE RECEIVE DEPOSIT AND (4,1 +, _SIGNED CONTRACT LESS ANY INCLEMENT WEATHER " ALI STAR WILL SECURE BUII DING PERMIT IF NEEDED HOMEOWNER WILL BE RESPONSIBI E FOR ANY &AI L FEES REQUIRED LAI_ $TAR IS NOT RESPONSIBI E FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHT (IF APPUCABLF) :: HOMEOWNER WII L BE RESPONSIBLE FOR ANY & AlL ELECTRICAL OR PLUMBING WORK _. " k• •:•• & ::•: I :::AL 1 : • 1 : IA 'd II L _ _.. " e•II 11 : 1 • • ••h : •: • : k AL •: • Li AL • •: :L AL • .. . . . . - _ WORK.111 TUE ATTIC NEEDED FROM DUST& DEBRIS FROM ROOF REMOVAL °'A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND I !ABILITY WILL BE FORWARDED. UPON REQUEST T P DALEY INSURANCE AGENCY OF WEST SPRINGFIEI D MA IS OUR AGFNT WE PROPOSE to furnish material and labor. complete In accordance with above specifications, for the sum of: $11,852.00 dollars ($ 1/3 DOWN 1/3 AT START OF JOB, ), payment due upon receipt of Invoice. If payment Iola, Interest at 1 1/2% nlay be added. BALANCE DUE COMPLETION OF JOB NOTE: This proposal may be withdrawn by us if not accepted within _.. ...- THIRTY days. ED LOSACANO, OWNER Connector Salesman John& Pauline Bowe r 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