38D-008 23 CHARLES ST BP-2019-0630
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:38D-008 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-2019-0630
Project# JS-2019-001031
Est.Cost: $13215.00
Fee: $40.00 PERMISSION IS HEREB Y GRANTED TO:
Const.Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sq, ftp: 7492.32 Owner., HANSEN RUSSELI A&JOYCE M
Zoning:URB(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC
AT.- 23 CHARLES ST
Applicant Address: Phone: Insurance:
56 Franklin Street (41 3) 527-0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON:11/27/2018 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 Si€!mature:
FeeTj e: Date Paid: Amount:
Building 11/27/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
M i The Commonwealth of Massachusetts FOR
Z; Board of Building Regulations and Standards
o MUNICIPALITY
1 o Massachusetts State Building Code,780 CMR
^ USE
IL
C ` ! Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
8-2 M One-or Two-Family Dwelling
z This Section For Official Use Only
o m uild rmit Number: 1310- a" 3 ate Applied:
Z � El7)o ( '3 11-27- 1g
N Building 2
fficial(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assess rs Map&Parcel Numbers
23 Charles Street 3�� 04
1.1 a Is this an accepted street?yes no Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
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.40,154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Russ Hansen Northampton,MA 01060
Name(Print) City,State,ZIP
23 Charles Street 413-584-0766 Home
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORI O(check all that apply)
New Construction❑ Existing Building IN Owner-Occupied D Repairs(s) ❑ Alteration(s) N Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work 2: We will strip and dispose of(1)existing layer of shingles on main house and(2)
existing layers of asphalt shingles on second floor rear dormer and install new architectural shingles on both areas.
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 $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All F s $
Check No. heck Amount. Cash Amount:
6.Total Project Cost: $13,215.00 0 Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CSSL-099739 2-1420
Ed Losacano License Number Expiration Date
Name of CSL holder
List CSL Type(see below) R
128 Glendale Road
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
Southampton, MA 01073 R Restricted 1812 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-527-0044 allstar52700440gmail.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
101858 6-28-20
All Star Insulation&Siding-Co., Inc. HIC Registration Number Expiration Date
HIC Company Name or HTC Registrant Name
56 Franklin Street allstar5270044@gmaii.com
No.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 ..........® No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby a orize Ed Losacano
to act on my behalf,in all matters r iv o work au zed by this building permit applicati
Russ Hansen, Homeowner - \ U J
Print Owner's Name(Electrons i ature) J Date]
SECTIO 7b:OWNERt OR AUTHO ED AGENT DECLARATION
By entering my name below,I hereby attest under the pai a penalties of perjury that all of the information
contained in this application is true a ccu to of my knowledge and understanding.
Ed Losacano, Owner �/ -1� -162
Print Owner's or Authorized Agent's are( rc Signa re) Date
!fOTES:
i. An Owner who obtains a building permit to do hisJi► r 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
1\•ww_ma ._uc oca Information on the Construction Supervisor License can be found at w���t.nra��.�o� drys
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"
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: Cj\",O � .
The debris will be transported by: �
_
� �
The debris will be received by: 7.. i- , -)J11R oICV3
Building permit number:
Name of Permit Applicant L lc� �c�cca�,� (�11hr -�"�'LsL��a�ar� �c�ir► Vic; �InC`.
I L.-1 9c�
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
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. E]New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
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 10.E] 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.❑ 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 decks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
YContractors 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: THE TRAVELERS INSURANCE COMPANIES
Policy#or Self-ins.Lic.#: 6HUB-8H26302-8-18 Expiration Date: 08/13/19
Job Site Address: o� l hA 5kLA City/State/Zip: Or 0/
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiVation 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: Date:
Phone#: 413-527-0044 -
Official use only. Do not write in this area,to be completed by city or town off iciaL
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#:
Client#:13250 ALLST
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MYIDDIYYYIf)
812212018
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(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 endorssment(s).
PRODUCER NAME: Ryan Daley
T.P.Daley Insurance Agcy,Inc WW E,):413 788-0971 AC.No): 413 739-2645
1381 Westfield St. Ems: ryandaley@tpdaloyinsurance.com
y�tpdale insurance.com
P.O.Box 1150
West Springfield,MA 01090 tNSURt7t(S)AFFORDING COVERAGE MAIC i
NISURER A:Wed"A,nrlo lm .Co.
INSURED INSURER 8:OWo Csrrarq Yw.Co.
All Star Insulation&Siding Co.,inc.
56 Franklin Street INSURER C:Trarrwe rrarnrray Co dMw,fca
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 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.
TYPE OF INSURANCE POLICY NUMBER POI ICY EFF POLICY EXPINSR Lon
A GENS LIABILITY BKS1957957626 111811312018 08M312019 EEpAAqCM�HgqGGOEECCC7URRENCE $1.000,000
X COMMERCIAL GENERAL LIABILITY PREMISESr erne $100,000
CLAIMS-MADE F—XI OCCUR MED EXP(Any one person) $15,000
PERSONAL 6 ADV INJURY $1,000,000
GENERAL AGGREGATE 62,000,000
GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMP/OP AGG 62,000,000
POLICY X PELT LOC $
B AUTOMOBILE LIABILITY BA01957957626 8/13/2018 08/13/201 (CFO d n SINGLE LIMB
Ea accident
ANY AUTO BODILY INJURY(Per person) $100,000
ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $W07000
AUTOS AUTOS
X HIRED AUTOS X AUTOS
ED DAMAGE $100,000
s
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED I I RETENTIONS $
WORKERS COMPENSATION WC STATU- OTH
C 6HU68H26302818 8H 3/2018 08N3/201 X
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $100 OOO
OFFICER/MEMBER EXCLUDED? N I A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,AddltlaW RenwIts Scbsdule,N more spece Is regdred)
General Certificate
CERTIFICATE HOLDER CANCELLATION
All Star Insulation S Siding SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CO.,Inc. ACCORDANCE WITH THE POLICY PROVISIONS.
56 Franklin Street
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
#S148645/M148605 RTD
ri
Commomresltlh of M8228a11400s
(Xvision of Professional Manure
Hoard of auitdiny Regadations and Standards
Construction Supervisor Specialty
CSSL-MT39 Expires;0211412020
OM W.LOSACM0
r 121 GLENDALE ROAD .
80UTNAMPTON MA 01t1TS
c ..
Commissioner
-' ---.Office of Consumer Affairs and Business Regulation
1000 Washington Street- Suite 710
_ =: Boston, Massachusetts 02118
_..._ ::-••� -• Home Improvement Contractor Registration
_. Type: Corporation
ALL STAR-INSULATION&SIDING.CO. Registration: 101858
' 5e FRANKLIN STREET E�iradon: 08J28J2020
__.... ... EASTHAMPTON,MA 01027
• ....17 -..... ....... Updab Addrew and Return Card.
WA 1 4 2OM4Wi7
- - :M ME WPRO1lEMENT CONTRACTOR Repistradon wad for bldlvldual use only
TYPE:Cwpara8an beton the upUadon dab. K found return to:
OMIoe of Caawrw ANake and ewl w Regulation
0812812020 1000 Washhpbn Street-Bulb 710
ALL STAR INSULATION&SIDING CO. Sos0on,MIA 02118
- EDWIN W.LOSACANO
50 FRANKLIN STREET
- - -- EASTRXMPTGN;"WOV Undersecrebry Not out signature
A
t �� � .....�
1
�
V �
INSLILATION �!o�� 1 5 2018 f
SIDING CO., INC. __
CU
Easthampton Office Westfield Office
413-527-0044 56 Franklin Street - Easthampton, MA 0102.7 A TT
CSL License #CS SL99739/MA HIC#101858/CT HIC#0630805
fax 413-527-1222 • email:allstar5270044@gmail.com - www.allstarinsulationsiding.com
Proposal Submitted to Phone Date
Russ Hansen "Purchaser"413-584-0766 Home November 8, 2018
Street Job Name
23 Charles Street 413-535-9691 Cell
City,State and Zip Code Job Location Job Phone
Northampton, MA 01060
Contractor hereby submits to Purchaser specifications and estimates for: INSTALL NEW ROOF ON MAIN HOUSE, REAR DORMER,
AND TWO CAR GARAGE, AND WINDOW TRIM
w _
OPTION 1: INSTALLATION OF NEW ROOF
1. We will remove (1) layer of existinaasphalt shingles on main house and two car garage and dispose of in a
dumpster supplied by us.
2. We will remove (2) layers of existing asphalt shingles on rear dormer and dispose of in a dum stn er sub lied by
us.
3. We will install Titanium Rhino Deck or Elephant Skin underlavment over entire stripped roof surface.
4. We will install new CertainTeed Landmark, Owens Corning or Gaf Timberline Architect shjpgles. They
will have a"Manufacturer's Lifetime Limited Warranty". Owner will have choice of color.
5. All shingles will be nailed with at least(5) nails per shingle.
6. We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas. We will
install (2) new pipe boots and metal step flashing where needed.
7. We will install approximately(62)'of roll vent on peak of roof for additional ventilation.
8. We will install a 72"wide asphalt ice and water barrier on eave lines/valleys of heated areas.
9. We will install a asphalt ice and water barrier on entire surface of heated areas of rear dormer.
10. Job site will be cleaned upon completion of job.
** IF ANY SUB SHEATHING IS NEEDED, THERE WILL BE AN ADDITIONAL CHARGE OF $52 PER SHEET TO
•
INSULATION
&
SIDING CO., INC.
Easthampton Office Westfield Office
56 Franklin Street • Easthampton, MA 01027
C,SL Ucense #CS SL99i39./1A X-IIC#t(aI�5,1,/CT IIIC#O?q3O,9o'
fax 413-527-1222 • emaii:allstar527OO440gmail.com • www.allstarinsulationsiding.com
Proposal Submitted to Phone Date
Russ Hansen "Purchaser"413-584-0766 Home November 8, 2018
Street Job Name
23 Charles Street 413-535-9691 Cell
City,State and Zip Code Job Location Job Phone
Northampton, MA 01060
Contractor hereby submits to Purchaser specifications and estimates tor INSTALL NEW ROOF ON MAIN HOUSE, REAR DORMER,
AND TWO CAR GARAGE, AND WINDOW TRIM
**APPROXIMATE START DATE WILL BE DECEMBER/JANUARY/FEBRUARY ONCE WE RECEIVE DEPOSIT
AND SIGNED CONTRACT LESS ANY INCLEMENT WEATHER. LABOR IS GUARANTEED FOR 1-YEAR".
`ALL STAR WILL SECURE BUILDING PERMIT IF NEEDED. HQMEOWNER WILL BE RESPONSIBLE FOR ANY
&ALL FEES REQUIRED.
* ALL STAR IS NOT RESPONSIBLE FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHTS APPLICABLE)
* HOMEOWNER WILL BE RESPONSIBLE FOR ANY&ALL ELECTRICAL OR PLUMBING WORK.
** NO PRODUCT& LABOR WARRANTIES WILL BE ISSUED UNTIL WE RECEIVE FINAL PAYMENT.
** HOMEOWNER WILL BE RE,9PON,51BLE FOR COV RING ANY STORED ITEMS AND FOR ANY CLEANUP
WORK IN THE ATTIC NEEDED FROM DUST& DEBRIS FROM ROOF REMOVAL.
*`A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED
UPON REQUEST.
T.P. DALEY INSURANCE AGENCY OF WEST SPRINGFIELD, MA IS OUR AGENT.
i4
PAGE 2 OF 2 t `