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35-199 (13) 1144 BURTS PIT RD BP-2020-0135 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:35- 199 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-2020-0135 Proiect# JS-2020-000214 Est.Cost:$7832.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sg.ft.): 11543.40 Owner: O'LEARY STEVEN J&NINA M zoning: Applicant: ALL STAR INSULATION & SIDING CO INC AT. 1144 BURTS PIT RD Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.81212019 0:00.00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF ON MAIN HOUSE AND REAR DINING ROOM 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 8/2/2019 0:00:00 $40.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner M Z�' The Commonwealth of Massa huseits � n c°r Board of Building Regulations an Standards FOR >c Ja MU ICIPALITY Massachusetts State Building Cod , 780 CNM� — 1 20USE Buildin Permit A lication To Construct, Re a r, Re ovate Or DemolisRev* d Mar 2011 g PP PoOne-or Two-Familv Dw ling,P=T o�r>un_n�ric wsP co This Section For Official Us `offr .Buildin rtnit Number. 04—cR0 ^ Date Applied: i Building Official(Print Name) - �ature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Nurn 1144 Burts Pit Road TW 1.1 a Is this an accepted street?yes no Map umber 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.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: Outside Flood Zone? Municipal❑ On site disposal s}stem ❑ Check ifyes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Nina&Steve O'Leary Florence,MA 01062 Name(Print) City.State,ZIP 1144 Burts Pit Road 413-478-2128 Cell No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction❑ Existing Building QI Owner-Occupied 101Repairs(s) ❑ Alteration(s) Q9 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units her ❑ Specify: Brief Description of Proposed Work': We will strip(1)layer of existing shingles and install new architectural shingles _ on main house and rear dining room area approximately(13 sq) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building S 1. Building Permit Fee:S Indicate how fee is determined: 2.Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost I(Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire $ Total All Fees Suppression) D Check N(A Vcheck Amount: Cash Amount: 6.Total Project Cost: $7,832.00 0 Paid in Full 0 Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-20 Ed Losacano License Number Expiration Date Name of CSL Holder List CSL Typc(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 1&2 Family Dwelling Cityrrown,State,ZIP M Masonry RC Roofing Covering WS Window and Siding Sr Solid Fuel Burning Appliances 413-527-0044allstar5270044agmail.00m I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101858 6-28-20 All Star Insulation 8 Siding Co., Inc. HIC Registration Number Expiration Date HIC Company Fume or HIC Registrant Name 56 Franklin Street allstar5270044@gmail.com No.and Street Email address Easthampton,MA 01027 413-527-0044 Ci /Town,Stale,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.I. 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..........M 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 authorize Ed Losacano to act on my behalf,in all matters relative to work authorized by this building permit application. Nina&Steve O'Leary,Homeowner ? _3; " 7 Q i Print Owners Name(Electronic Signa(ure) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,l 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. �y Ed Losacano,Owner 61 7—off 7 Z 9 nt' Print Owner's or Authorized Ages lame(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 wwxv.mg,s.s %oca Information on the Construction Supervisor License can be found at t�t+w.rnassbu�d1s 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: 114 L/ 6W IS P* Rood The debris will be transported by: Sp - 4 an B n� The debris will be received by: 1k)[) eCAA n(1 t tjil h�ahn►m R o10 Building permit number: Name of Permit Applicant EA- Lo- crena X11 mar 5aoAion-t 2/��t Q 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 boa: Type of project(required): 1.E?l 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 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 workingfor me in an capacity. employees and have workers' y p tT• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.*+ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I 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 ❑ 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. 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-8H26,3L02-8-18 Expiration Date: 08/13/19 Job Site Address: �� y y lA,�f 1 PET �1X�C. City/State/Zip: I C)Yf'1V _ ,Mf} of Lx, 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. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si ature: —amu Date: Phone#: 413-527-0044 Official use only. Do not write in this area,to be completed by city or town offliciaL 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(YNVDDN s/z2/ o1 s2018YYY) 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 endorsement(s). PRODUCER CONTACT NAME: Ryan Daley T.P.Daley Insurance Agcy,Inc PHIONE E>R;413 788-0977 No; 413 739-2645 1381 Westfield St. E.YAaandale p ,,,�"ale insuranCe.COm ADDRESS: rY y `YY P.O.Box 1150 West Springfield,MA 01090 Nsur�rys)AFFORDING COVERAGE NAIL s INSURER A:yyesUM Arrrrlur bw Co. ---------- — INSURER B:ON.Ceuray Yrs Co. All Star Insulation&Siding Co.,lnc. 56 Franklin Street NSURERC:Trn elves .May codNrnrica INSURER D: Easthampton,MA 01027 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. IEm TYPE OF INSURANCE ADDLSUBR POLICY NUMBERPOLICY EFF POLICY EXP(NNKXYYYYY) (N UNITS A GENERAL LIABILrTY BKS1957957626 8/13/2018 08/13/201 EACH GGOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PRA RISES �occirrrence $100000 CLAIMS-MADE F—w]OCCUR MED EXP(Arty one person) s 15 000 PERSONAL a ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 62,000,000 POLICY X JPE O 11 LOC $ B AUTOMOBILE LIA LITY BA01957957626 8/13/2018 08/13/201 COMBINEDt SINGLE LIMB Ea acciden ANY AUTO BODILY INJURY(Per person) $100,000 ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $300000 AUTOS AUTOS s XHIRED AUTOS X AUTOSNON-OWNED DAMAGE(Per accident) $100,000 s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ -- DED RETENTIONS $ C woRl�es COYPBISATION 6HU68H26302818 8/13/2018 08/13/201 X YVC$TAM, OTU+ rp AND EMPLOYERSB� •LIA .rTY ANY PROPRIETORIPARTNER/EXECUTE YIN N NE.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? a N/A (Yardrtory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 K yes,descnbe hider DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach^CORD 101.Addtional Penw n ScheMle,It morn space is re(pirnd) General Certificate CERTIFICATE HOLDER CANCELLATION All Star Insulation 8 Siding SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Co.,Inc. ACCORDANCE WTIH THE POLICY PROVISIONS. 56 Franklin Street Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S148645/M148605 RTD CL Cornnwnwalth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor Specialty CSSL-099739 � a Expires:02/1412020 EDWIN W.LOBACANO 121 GLENDALE ROAD C SOUTHAMPTON MA 01073 a Commissioner l/ c;� � r • =' - Office of Consumer Affairs and Business Regulation • 1000 Washington Street- Suite 710 ' Boston, Massachusetts 02118 _.... •• �"_ "• Home Improvement Contractor Registration Type: Corporation . . ALL STAR_INSULATION&30INt3 CO. Registration: 101858 58 FRANKLIN STREET Expiration: 08!28/2020 _- EASTHAMPTON,MA 01027 ....rr.: ,. Update Address and Return Cud. SCA 1 Q 20M-Wi? �Lrb +sf3�}�Ir�a�'�i16(Yitl " tion HOME IMPROVEMENT CONTRACTOR Regisb Ion valid for Individual use only TYPE:Corooration before the expiration data. if found return to: EOglalration zx2bal a Office of Consumer Affairs and Business Regulation 101858 06=020 1000 Washington Street.Suite 710 ALL STAR INSULATION&SIDING CO. Boston,MA 02 118 EDWIN W.LOSACANO Cr✓,'C _ 58 FRANKLIN STREET C ~ EASTHAWITON;"'V071 "'- Not wit out signature Undersecretary 2019 �f INSULATION JUL 2 9 (o' i' SIDING CO., INC. t St 1/15 I Easthampton Office wP�**'P'd ieelt- 4113-527-0044 56 Franklin Street • Easthampton, MA 01027 413-568-6411 CSL License #CS SL99739/MA.HIC#101858/CT 111C#0630805 o fax 413-527-1222 • email:allstar5270044@gmail.com • www.allstarinsulationsiding.com 0 Proposal Submitted to Phone Date Nina and Steve 411O'Leary "Purchaser"413-478-2128 Cell July 22, 2019 Street Job Name 1144 Burts Pit Road 413-586-9820 Home City,State and Zip Code Job Location Job Phone RL Florence, MA 01062CbmCct lle� 0- Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW ROOF ON MAIN HOUSE AND V` REAR DINING ROOM AREA OPI ION 1� INSTALLATION OF NEW ROOF ON MAIN HOUSE ANW40Q0S�S 1- We will remove (1) layer of existing asphalt shingles and dispose of in a dum stn er supplied by us- 2. We will Titanium Rhino Deck or FIPphjjnt Skon underlayme t over entire stripped roof surface. Architect shingles, They will 3. We will new QtV�" dj6j2jFjj-ark-5Qwea5 a=nu)Qr have a"Manufacturer's Lifetime Limited Warranty". Owner will have choice of color- 4- All shingles will be nailed with at least(5) nailsep r shingle- s. We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas. We will install pope boots and metal step flashing where needed. We will install new step flashing around base of chimney underneath new shingles. 6- We will install approximately(56)' of roll vent on peak of roof for additional ventilation. 7 We will install a 36"wide asphalt ice and water barrier on eave lines/valleys of heated areas. R Joh site will he cleaned upon completion of job. IF ANY SUB SHEATHING ISN D D THERE WILL BE AN ADDITIONAL CHAR OF PER SHEET TO REMOVE DISPOSE OF AND INSTALL NEW 7/16 OSB SUB SHEATHING- . PRICE $7-832,00 -APPROXIMATE START DATE WILL BE AUGUST/SEPTEMBER/OCTOBER ONCE WE RE-CEIVE DEPOSIT AND SIGNED CONTRACT LESS ANY INCLEMENT WEATHER LABOR IS GUARANTEED FOR "1-YEAR". "ALL STAR WILL SECURE BUILDING PERMIT IF NEEDED HOMEOWNER WILL BE RESPONSIBLE FOR ANY &ALL FEES REQUIRED -ALL STAR 1S NOT RESPONSIBLE FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHT(IF APPLICABLE) ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY &ALL ELECTRICAL OR PLUMBING WORK. ** NO PRODUCT & LABOR WARRANTIFS WII I RF ISSUED UNTIL WE RECEIVE FINAL PAYMENT. ** HOMEOWNER WILL BE RESPONSIBLE FOR COVERING ANY STORED ITEMS AND FOR ANY CLEANUP WORK IN THE ATTIC NEEDED FROM DUST R DEBRIS FROM ROOF REMOVAL *A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED - UPON REQUEST. T P DALEY INSURANCE AGENCY OF WEST SPRINGFIELD MA IS OUR AGENT- WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of: dollars($ 1/3 DOWN, 1/3 AT START OF JOB, payment due upon receipt of invoice. If payment late, interest at 1 1/2% may be added. GALANCE DUE COMPLETION OF JOB NOTE:This proposal may be withdrawn by us if not accepted within THIRTYdays. �_�_- - Y ED LOSACANO, OWNER - -- ------ --- -- - - = -- - — - ., Contractor Salesman --- Nina antl Steve O'Leary Acceptance by Purchaser,and Title "You may cancel this agreement if it has been consummated by a party thereto at a t Lace 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