08-028 279 COLES MEADOW RD BP-2018-1254
GIS 4: COMMONWEALTH OF MASSACHUSETTS
Man-Block: 08-028 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 4 BP-2018-1254
Pro jeel# JS-2018-002230
Est. Cost' $1085200
Fee $71.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use Group: ALL STAR INSULATION & SIDING CO INC 101858
Lot Size(sp.It.): 33062.04 OWner: PELTIER JOSEPH N&CYNTHIA WHITE PELTIER
zoning RI(100)/RR(100)/ Applicant. ALL STAR INSULATION & SIDING CO INC
AT. 279 COLES MEADOW RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED OM5/2512018 0:00:00
TO PERFORM THE FOLLOWING WORK:ST RI P & 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# 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:
FeeTvoe: Date Paid: Amount:
Building 5/252018 0:00:00 $71.50
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Y
C9tC 1
q-a 9NIet"no sI '
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The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
8 Add Massachusetts State Building Code,780 CMR MUNICIPALITY
USE
Build ng P rmit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
aOne-or Two-Family Dwelling
This Section For Official Use Only
=6.11
-7 Date Applied:
Sig mre Date
SECTION 1:SITE INFORMATION
LI Properly Address: II f 1.2 Assesso Map&Parcel Numbers
a�q CP[o 0 moZlje
Lla is this an accepted street?yes_ no Map NParcel Number
IJ Zoning Information: 1.4 Propv&Dimensions
Zoning District Proposed Use Lot Area(sq In Frontage(R)
1.5 Building Setbacks III)
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❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if es❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of R or
-sah � ,Pr t �rVlA�yd� ��_ mw o�oc
Name(Pnntt �� City,State,ZIP + J
G- (7-I- Wit,'-tazi�- �Ix ] 2MA
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building fd 1 Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ® I Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work':Ulp
S l
c W n
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee:S_Indicate how fee is determined:
2.Electrical $ ❑Standard Cityfrown Application Fee
❑Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: S
4.Mechanical (HVAC) $ List
5.Mechanical (Fire $ Total All Fees:$
Su ression ' J� 1eck 1
e h Check No.'lAmount: � 'S Q Cash Amount_
6.Total Project Cos[: $ 1O�p5or, 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-1$
Ed Losacano Im n,Namber L>piration Date
�ninc uI C51.I InIJtt
I
128 Glendale Road "I est, ryrv�t,1e neww,l R
_--
\ nJ Strttt I" Dv v ,,lion
Southampton, MA 01073 1' llnneuicred(Buildinsuto35.ouo<u.n.)
It Rvsoiucd(&?Tamil Daellin
c'ih/'fav,.Gam./IP M hfasoo,
RlRonfin ( ,i,rwg
____ --_.. ---____ --..-- -WS Wl Woo mW Siding
413-527-0044 alistar5270044@!gmail.com sl' Solid Poul Burring Appliaares
_ _ @9 Insmadoa
lclr hma I-.moil add... - - D Dvinewon
5.2 Registered Home Improve...ent Coniractor(11 IC) 101858 5-29-ta
All Star Insulation & Siding Co., INC -Itic Irg.boon Nnmtkr l aplrmm ia�w
I m,at n nrlicl L_ n\u6c_. __. .
���r�nkllnN �'lree� allstar5270044@gaol(coat
V and Soret
Fannin gddress
Easthampton, MA 01027 413-527-0044
oty1 town.Sale.ZIP I ciu hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c. 152.§ 25C(6))
Workers Cunip arsation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit,rill result in the denial of lire Issuance of lire building pemtit.
Signed AtEduvit Alummd^, 1'cs ..._..... CK `:o...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject pr Z here , authorvc Ed Losacano
to net on my behalf. in all man(rs rein .c m work authorized by this building remain application
,bSe�d Peltier Homeowner .---/S_—/�_
1'nm hrn ea l l[3ecmmmc S,pnnmrcl... _.: ____ Dale
SECTION'7b:O ':'ERt OR AUTHORIZED AGENT DECLARATION
By entering my name bel.,,. I hereby attest under III- 7rins and penalties of perjury that all of the information
contained in this application is erne'od accurate t c best of my knmvledge and understanding. p
EdLosacano._4wner_..
Print Oaa.. ....Authon,x d Apcn :I. n ,ic Sipn:mucl Law
NOTES:
I. An Owner who obtains a building permit do Itis/her ,own work,or an owner who hires an unregistered contractor
(not registered in the Hunte Improvement Contractor MIC)Program),will not have access to the arbitration
program or guarnnp fund under\I G.L.c. 142% Other important information on the HIC Program can be found at
...I..ata5,.^ 'oca Infon uitim on the Construction Supervisor License can be found at„o w.niass sn+dns
\Then satbsmmial work is planned,provide lire information below_
Total Bon.ores Isq. R.I (including garage,finished busement/altics,decks or porch)
Gross living area(sq.R.) Habitable room count
Nwnber of fireplaces Number ofbedrooms
Number of bathrooms Number of halObaths_
'type of hcAmg ss stem _. Nuvtbcrofdecks/porches
lypsofcnoittysystem _ Enclosed __,__Open
3. "total Project Square Footage"'ntay be substituted for 'Total Project Cost'
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 byMGL c 111, S 150A.
Address of the work: a ')9 Cc�nQ &L,-3 Val
The debris will be transported by: ( l5 fa ga-L&w\q 4 k,
The debris will be received by: UJe 4rn Oa c' cZU �� Ido hld L36�r)W o 025
Building permit number:
Name of Permit Applicant �Ecl L1��ca n C7 -A l� ,33 6U Ima-6vv S 0
CO . ,�� C
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
Offrce of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/die
Workers' Compensation Insurance Affidavit: Builders/Contmctors/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name(Businessrorganiradonladividua0: All Star Insulation & Siding Co., Inc.
Address: 56 Franklin Street
City/State/Zip: Eastham ton, MA 01027 Phone#: 413-527-0044
Are you an employer?Check the appropriate box: Type of project(required):
I.[3 1 am a employer with 10 4. ❑ 1 am a general contractor and I
employees(full and/or part-time).- have hired the sub-contactors 6. ❑New construction
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling
ship and have no employees These sub-contactors have g, ❑Demolition
workingfor me in an capacity. employees and have workers'
Y a ty 9. ❑Building addition
req workers'comp.insurance comp. ,a umil
corporal
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 1 L❑ Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required.]' c. 152, §I(4),and we have no
employees.]No workers' 1311 Other
comp. insurance required.]
'Any applicant that checks box g I must also fill out the section below showing their workers compensation policy infanurion.
t Homecwners who submit this affidavit indicating they art doing all work end Nen hire outside om mucmrs must submit a new affda k indicating such.
�Contrectom that check this box most ateched an additional sheet showing the mime ofda subrunlram sm and sum whether m not those entities have
employees. If the subconmctM have employes,they must provide(heir workers'comp.policy number.
Jam an employer ihm is providing workers'compemation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Western American Ins. Co. A
Policy k or Self-ins.Lie.N: BH263028 Expiration Date: 08/13/18
Job Site Address: ,D')9 'OUA m Irl Q00A City/State/Zip: t1 fl 1)'11�Qiou)
Attach a copy of the workers'compensation policy declaratbo page(showing the policy number and expiration date).
Faillue 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$250.110 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
J do hereby certifyunder the pains and penau
hies ofperjry than the information provided above is trete and correct
n � �7—j
Simat �t�Q.<dtJ�-�l� Date- S' ltshg
Phone N: 413-527-0044
ficial me only. Do not write in this area,to be completed by city or town offrciat
City or Town: PermiMicense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/fowo Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone M
Cliewd:13250 ALLST
ACORD- CERTIFICATE OF LIABILITY INSURANCEWTEm`°°°"'"D
0811412017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATTVELY AMEND,EXIMND 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:Htha certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.N SUBROGATION IS WAIVED,subjeel W
the tans and conditions of 61e III certain Policies may raquIm an andOmement.A stalwlwnt on this cerlificele does not confer right W the
Beata holder in lieu M such erMoreanwM(s).
.ER Jane ENaI
T.P.Daley Insurance Agency,Inc .413788-0971 Xn:413739-2645
1381 Wastfield SL J1R6 ,janswitelCltpdaleylnsurance.com
P.O.Boz 1150 "URER AFFORDxocovERAaE NUca
West Springfield,MA 01090 INSURER A:Wastem American Ins.Co. A 44393
xsuan xwREae:Ohio Casualty Ins.Co. A 24074
All Star Insulation&Siding Co.,lnc. WauAEAc:Travelers Indent ,of Ammicalk— 25658
56 Franklin Street
xno:
Easthampton,MA 01027
xsu.RER 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 MY REQUIREMENT. TERM OR CONDITION OF MY CONTRACTOR 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.
ajp TYPEaFINLxA"LE PPLILY MXXIEA xwc FFF PoIILY Users
A GENERAL UAeury BKW1857957626 D811312017081131201 EACHUCCURRENCE $1000000
X COMMITO.GE.Iim UMI Fe rm xvz $100000
C.— OOCCUR MEUEXP(A,—,—) $5000
PERSCHI A.NARY $1000000
GENE.AGGREGATE S2AOg,000
GENT AGGREGATE LIMIippRIES PER: PRGOLCffi-COMAOPA. ST DDD,DDD
rvUcv X P"o- Lac $
B AUTOMONIE LI.ABRRY BA01857957626 D8113/20117 08113/201 ��NINEUISWGIE UNIT
ANYAUTO BOOAYINJURYIPr Fastin) $100,000
AJLMVNEO X SCHEDULED eooav euURr lPaameanp $300,000
AMOS AUTOS
X HINEOAuros % IgHOW'ED PROPERTY'DAMAGE $100,000
Aur0S Pw xxtla,I
s
UXXRELLAUAB CLDun EACHCCCURRENCE S
Aa
EY-CESe UOLAU IMDE AGGREGATE $
DED RETEMICNS S
C RaRloRscoMPEXWnox 814263028 01011312017 08/131201 X WC STAID OTH,
AXDERPLOYERa•UMULD
My MOPNIETORNARTNELXEOVAE N El,EACH ACCIDENT Inn 000
OEFICERIMEMBER EXCLUDEOt IIIACID
pIpFfWYxy In MII EL DISEASE-EA EMPLOYEE 5100000
oESLRIPr=IM,HAT, exow EL.DSEASE-PCIICYLMIr I s500,000
GENERAL CERTIFIERTIFI EC1aPTMx OF xs ILOCAIwNa IvFMCLFa Nmnn AC010 ta.AC/Mbm1RnMn BMxYUN,X mp,e yLu Y,puYWI
GENERAL
CERTIFICATE HOLDER CANCELLATION
All Star Insulation 8 SHWID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL,ED BEFORE
THE EXPIMTX]N DATE THEREOF, NOTICE WILL BE DELIVERED IN
Siding Co.,Inc. ACCORDANCE WITH THE POLICY PROVIBXINS.
56 Franklin Street
Easthampton,MA 01027 Am"Dwa=D RREPRIBMADATNE
®1988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010105) 1 oft The ACORD name and logo are regttred mNts of ACORD
SS1424591MI42457 JXE
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston,Massachusetts 02116
Home Improvement Contractor Registration
Replslretlon: 1018W
Type: rd.aro cmoratim
Etmketlan: 828/2018 Trill Algal
ALL STAR INSULATION & SIDING CO
Edwin Losacano
56 Franklin Street
Easthampton, MA 01027
Update Addrm red reran mrd Mark rename liar change.
ac•+ 0 awovn O Address ❑ Removal O Smploymeat C] last Card
or
datleACRndrtlna ISmanerexplaationdva8dlrrlad We arc ealy
awC.OttTRACfIA Offenthenromer dab aloatllnee, to:
10166° TYpo: Oa °ofCoemmn Aaaln aM&ulam Regnlatloa
hatlan: 1p2GT016 Private Cam01011M 10 Park Plan-Sake S170
Illusion,MA 03116
ALL STAR INSULATION d SIDING CO.
Edwin LoNmro .
66 Frrnift 8Vae1
Faa hanV on,MA 01027 Uadrrann fry Not v.Rd wNl amre
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INSULATION
SIDING CO., INC. I
Easthampton office 56 Franklin Street • Easthampton, MA 01027
413-629�U044 F 613-568-6411
CSL License ACs SL99739/MA HICM 101858/CT HICl1063mi
fax 413-527-1222 • emaiLallstar5270044®glnail.com • www.allstariilsulationsiding.Coln
Proposal Submitted to Phone Oate
Joseph Peltier "purchaser"413-335-2893 Cell April 12, 2018
Street Job Name
279 Coles Meadow Road
City,State and Zip Code Job Location Job Phone
Northampton, MA 01062
Contractor hereby submits to Purchaser specifications and estimates for INS I ALLH I ION OF NEW ROOF ON MAIN HOUSE FAMILY
ROOM, AND GARAGE
INSTALLATION OF NEW ROOF ON MAIN HOUSE FAMILY ROOM AND GARAGE
1 We wit I remove(2) layers of ex sting asphalt shingles on Ma'n House and (1) layer of ax sting asphalt shingles
on Family Room and Garage and dispose of in a dnmoster supplied by us
2 W w II install T'tai Rhino DPrk or Flenhant Skin undarlavmenl over ent re stripped roof surface
7 We willnstall new CedainTeed Landmark Owens Corn ng or Gaf/Elk Timberline Architect sHnplrc They will
have a "Man facturers Lifetime Limited Warranty.Owner will have choice of color.
4 All shingles will be nailed with at least IS) nails per shingles
5 We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas We will install
Dina boots and metal ste fn lash no where needed
6 We will install approximately($8,)' of roll vent on peak of roof for add tonal ventilation.
7 We will install a 36"wide asphalt 'ice and water barrier on eave fn s of heated ar a.
8 Job site wII be cleaned pp nn Completion ofjob !)
"IF ANY SUE SHEATHING ISNEEDED THERE WII L RE AN ADDITIONAI CHARGE OF S42 PER SHFFT TO
REMOVE DISPOULQF AND INSTAI I NEW 7116 OSR STIR SHEATHIL$�
PRICE $10 852 00
1 _
279 COLES MEADOW RD BP-2018-1254
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mia :Block:08-028 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateeorv' ROOF BUILDING PERMIT
Permit# BP-2018-1254
Proiect# JS-2018-002230
Est.Cost: $10852.00
Fee: $71.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 101858
Lot Size(sp. R.): 33062.04 Tuner: PELTIER JOSEPH N&CYNTHIA WHITE PELTIER
zonine,RI(100)/RR(100)/ Applicant. ALL STAR INSULATION & SIDING CO INC
AT. 279 COLES MEADOW RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413)527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON.•512512018 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# 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 5/25/2018 0:00:00 $71.50
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner