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16B-050
217 NORTH MAIN ST BP-2020-0185 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16B-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: Siding BUILDING PERMIT Permit# BP-2020-0185 Proiect# JS-2020-000310 Est.Cost: $23981.00 Fee:$60.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sq.ft.): 20386.08 Owner: ADAMS THOMAS H Zoning: URB(,100)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT. 217 NORTH MAIN ST Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.8/13/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-VINYL SIDING 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: FeeTyue: Date Paid: Amount: Building 8/13/2019 0:00:00 $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)5874272 Louis Hasbrouck—Building Commissioner The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR C j `, Massachusetts State Building Code, 780 CMR MUNICIPALITY USE �' Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 M One-or Two-Family Dwelling This Section For Official Use Only Buil ermit Number: g — / $5� to Applied: Building fficial(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assesse As Map& Parcel Numb rs 217 North Main Street I.la Is this an accepted street?yes no Map Rifinb& 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 I 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 O Private O Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Thomas Adams Florence,MA 01062 Name(Print) City.State.ZIP 217 North Main Street 413-222-4744 Cell No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building fd Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) 191Addition ❑ Demolition ❑ 1 Accessory Bldg.❑ Number of Units I Other ❑ Specify: Brief Description of Proposed Work'': We will install new vinyl siding on main house(approx.30 squares) 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 O Standard City/Town Application Fee O Total Project Costa(Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire $ Total All Fees- Suppression) r Q Check No.� eck Amount. W Cash Amount: 6.Total Project Cost: S 23.981.00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: 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 Type(see below) R 128 Glendale Road No.and Street Type Description Southampton, MA 01073 U Unrestricted(Buildings u to 35,000 cu.ft.) P R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering --- WS Window and Siding SF Solid Fuel Burning Appliances 413-527-00_44 allstar5270044@gmail.corn 1 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 HIC Registrant Name 56 Franklin Street allstar5270044@gmail.com No.and Street Email address Easthampton,MA 01027 413-527-0044 Ci Mown,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 .......... 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 w u ori b his building permit application. Thomas Adams,Homeowner Print Owner's Name(Electronic Sibmat c) Datc SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby Vaccue a pains and penalties of perjury that all of the information contained in this application is true anhe best of myknowledge and understanding. Ed Losacano,Owner Print Owner's or Authorizedt' a(E ctronic Signature) Date NOTES: I. 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 w oca Information on the Construction Supervisor License can be found at dis 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 cowling 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: - 1 `7 No rtV) ft)n l n FbrenCQ The debris will be transported by: ' ' I The debris will be received by: tft Cts Building permit number: Name of Permit Applicant E:8 l -n-ac—,inn X 11 :S}czr Ti' ao-Aico-<2k4l 1q Oamn . Date Signature of Permit Applicant The Commonwealth of Massachusetts E Department of Industrial Accidents Office of Investigations x = H 600 Washington Street r 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): 1.21 1 am a employer with 10 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E] New construction 2.❑ l 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. E] Building addition [No workers' comp. insurance comp. insurance.* 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.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeo%vners who submit this affidavit indicating they are doing all wort: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-8H26302-8-18 Expiration Date: 08/13/19 Job Site Address: J I 7 No. rrffi Mot I M1 '5111e 1 City/State/Zip: -FlOr4ena .m R O lOH. 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: Date: r 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#: Client#: 13250 ALLST DATE(MM/DO/YYYY) ACORD- CERTIFICATE OF LIABILITY INSURANCE 8/22/2018 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 terns 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 NAMEACONTCT Ryan Daley T.P.Daley Insurance Agcy,Inc 413 788-0971 FAX 1AX No):413 739-2645 1381 Westfield St. E4WL andale ale Mnsurance.com ADDRESS: rY y@tpd Y P.O. Box 1150 INSURER(E)AFFORDING COVERAGE NAIL t West Springfield,MA 01090 INSURER A:V11sa.^Aerrfran an.ta INSURED I INSURER B:Ohio C—M'ru Co. All Star Insulation&Siding Co.,lnc. USURER C:TrawWs YKbrn-MY Co of Mwica 56 Franklin Street 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. INSISR--LTR I -- TYPE OF INSURANCE I/SR Wyp POLICY NUMBER POLICY EFF MP Y EXP UMRS A GENERAL UABRAY BKS1957957626 8/13/2018 08113/2019 EUAACMHAGOECCTURRENCE $1,000,000 X COMMERCIAL GENERAL LImcrrY PREMISES Ewa om Die $100,000 CLAIMS-MADE C OCCUR MED EXP(Arty one person) $15,000 PERSONAL&ADV INJURY S1 000 000 GENERAL AGGREGATE 62,000,000 GENT AGGREGATE LIMIT APPLIES PER PRoOucTs-COMP/OP AGG 52,000,000 POLICY X. PRO- LOC $ B AUTOMOBILE LIABILITY BA01957957626 8/13/2018 08/13/2019 COMBcctidenINEDl SINGLE LIMIT Ea a ANY AUTO BODILY INJURY(Per person) $100,000 ALL OWNEDX SCHEDULED BODILY INJURY(Per accident) $300000 AUTOS AUTOS + X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $100,000 AUTOS Per accident S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ — DICESS LIAR CLAIMSAMADE AGGREGATE S DED I I RETENTIONS S C "IOC COMPENS"TIDN 6HUB8H26302818 8/13/2018 08113/20119 X M STATU JOT ER"- AND EMPLOYERS'LIABILITY YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICERIMEMBER EXCLUDED? a N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000If _ describe under DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT S500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Addltbnal RerrwM Schedule,M mwe space Is regrired) General Certificate CERTIFICATE HOLDER CANCELLATION All Star Insulation&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(2010105) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S148645/M148605 RTD ... .... . c; G -" 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.&S_IDING CO. Registration: 101858 58 FRANKLIN STREET Expiration: 08/28/2020 EASTHAMPTON,MA 01027 - Update Address and Return Cud. SCA 1 4 20M-06117 ` offal7i':�frie"i(k&1wd 0ation - HOME IMPROVEMENT CONTRACTOR RegistrstIon valid for Individual use only TYPE:Corvoradon before the expiration data. If found return to: $gglstration )FxpJratIon Office of Consumer Affarn and Business Regulation -- 101858 0012812020 1000 Washington Street-Suite 710 ALL STAR INSULATION 8 SIDING CO. Boston,MA 02118 EDWIN W.LOSACANO _ C 50 FRANKLIN STREET _ EASTHAMP ON;MA'V021 Not Wlt out signature • Undersecretary a 00mmonweatth of Massachusetts Division of Professional Licensure 80ard or Building Regulatlons and"!sndards Construction Supervisor Specialty CSSL-099739 �s Exp±res:02/14/1024 EDtfiISW W.LOStACANO 129 GLENOALE ROAD c SOUTHAMPTON MA 01073 a Commissioner l/4 � r INSULATION SIDING CO., INC. Easthampton Office Westfield Office 1e3-52,7-0044 56 Franklin Street • Easthampton, MA 01027 CSL License #CS SL99739/MA k11C#101858/C'1'HIC#0630805 fax 413-527-1222 • email:allstar5270044@gmaii.com • www.alistarinsulationsidin .com Proposal Submitted to Phone Date rtes Adams "Purchaser"413-222-4744 Cell July 30, 2019 Street Job Name 217 North Main Street City,State and tip Code -' ' ' � Job LocationJob r�hone �m Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for; INSTALLATION OF NEW VINYL SIDING ON ENTIRE MAIN HOUSE SIGNED CQNTRAQT LESS 6NY INCLEMENT WEATHER LABOR 1,� QIjAB6bljLLD EQR "j-yE6B"- &ALL FEES REQUIRED. HOMEOWNE A CERTIFIC41L O_ F MURAN CF FOR WORKMAN'S Q0MELNSATION AND LIABI 11Y WILL BLFOH1( ARQED WE PROPOSE to furnish material and labor, complete In accordance with above specifications, for the sum of. :$411151 11111FAlk 1/3 DOWN, 1/3 AT START OF ., dollars($ OALANCr OUL COMP TI O B.JO I' payment due upon receipt of invoice. It payment late, Interest at 1 112%may be added.. NOTE. This proposal may be withdrawn by us If not accepted within THIRTY days. ED LOSACANO, OWNER Contractor Salesman ThitihtlS At�lis 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 At:l�(AP TV C J4' f t, S� INSULATION r4UG ' 6 2019 SIDING CO ., INC. ' Easthampton office West 1' e , 413-527-0044 56 Franklin Street Easthampton, MA 0102 --- -, tT CSL License #CS SL99739/MA HIC#101858/CT HIC#0630805 fax 413-527-1222 • email:allstar5270044@gmail.com • www.alistarinsulationsiding.com Proposal Submitted to Phone Bate Thomas Adams "Purchaser"413-222-4744 Cell July 30, 2019 Street Job Name 217 North Main Street ' City,State and Zip Code Job Location Job Phone Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for. INSTALLATION OF NEW VINYL SIDING ON ENTIRE MAIN HOUSE 3 Wg will 13all all Sidlog approxilmajoig 15-24"on cglDtgjr USiDa ali,irninUM n8115 So thfky will ngt rU-qt underneath the aiding, r. 4. Wood trim around (30)wlndowS will �a Qoyargd with White aIurnI0WM rQII StoQk L11atfiriji 5. WIndows'lls)Uill ba trimmed gut With White aluminuiM Qp1l Stock majaclal- 1 J. Any existing Wood that iS datadoCaled wh'rh Deads IQ be Caplar,,gd so Wall We ran Qfidocm DUE wock Will be s needed thara will bg an additional charoe Uf$52 00 Wer S lb obf1Atbinc 1f any boalowner 12, We will hatall White 12"X 18"gabip.and IgWypra)&'th acreeaa in designaled aroaa Where needed 1,1 We will hatall Whitg vinyl IIjFj bInCks. bfih'nd light fixtU[gs. Mile dQjar venis aud fauret hlgrkS wbgre neaded- j 5 F'r5j figar frol3t porch and drigayijag Bidet pgrcb will hgr-QjtgL0d as follgtjs� gillg figfflt a0d faaGja Will Ug ggyarga �Y , t , PRIQE� $21 352 00 WE PROPOSE to furnish material and labor,complete In accordance with above specifications,for the sum of; START 3 AT OF JOB, .'� �.. . . _ .... . . . dollars($ 1/3 DOWN, 1/_ . ,-- - ?, payment due upon receipt of involve. if pa�nent late, interest at 1 1/2%. may be added. BALANCE DUE CONIF'LETION OF JOB NOTE:This proposal may be withdrawn by us If not accepted within THIRTY days.. ED LOSACANO, OWNER,," 7 Cantrac of a eaman Thof As AdAM9 j /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