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28-012 (6) i 272 SYLVESTER RD BP-2020-0483 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:28-012 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-2020-0483 Proiect# JS-2020-000822 Est.Cost: $8352.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO.- Const. O.Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sa.ft.): 34891 .56 Owner: BLAKESLEY BERNARD A&GAIL A Zoning: Applicant. ALL STAR INSULATION & SIDING CO INC AT. 272 SYLVESTER RD Applicant Address: Phone: Insurance: 56 Franklin Street 413 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.10/16/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.STRIP & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspec or of Wiring D.P.W. Building Inspector Underground: Servic : Meter: Footings: Rough: Rough House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire D partment Fireplace/Chimney: Rough: Oil: Insulation: Final: Smok : Final: THIS PERMIT MAY BE VOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND GULATIONS. Certificate of Occupancy signature: FeeTyae: Date Paid: Amount: Building 10/1 /2019 0:00:00 $40.00 12 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 0 ___7 4,C0 i�7 T The Commonwealth of Massachusetts o Board of Building Regulations and Standards FOR MUNICIPALITY D c Massachusetts State Building Code, 780 CMR USE Ci° #�n Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised.Var 2011 One-or Two-Family Dwelling D o m , This Section For Official Use Only Qui Build ng Permit Number. 3 1 Date Applied: 00 _ Building Oficial(Print Name) Signature Datd SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 As G� ap& Parcel Numbers 272 Sylvester Road .l a Is this an accepted street?yes no Map Number Parcel Number 13 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Pro%ided 1.6 Water Supply:(M.G.L c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Pri%ate❑ Zone: Outside Flood Zone? Municipal❑ On site disposal s}stem ❑ Check if v es❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Gail and Bernard Blakesley Florence, MA 01062 Name(Print) City.State.ZIP 272 SYlvester Road 413-584-2569 Home No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building IN Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) N Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units I Other ❑ Specify: Brief Description of Proposed Work: We will strip(2)existing layer of shingles and install new architectural shingles on garage only(approximately 9 squares) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building S 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5.Mechanical (Fire $ Total All Fees:S Suppression) Check No.`i'l`.7 heck Amount: `�0 Cash Amount: 6.Total Project Cost: $ 8,352.00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construetion Supervisor License(CSL) CSSL-099739 2-1420 Ed Losacano License Number Expiration Date Name of CSL I lolder List CSL Type(sec below) R 128 Glendale Road _ No.and Street - - Typc Description U Unrestricted(Buildinits up to 35,000 cu.ft.) Southampton,MA 01073 . �_. R Restricted 1&2 Family Dwelling ZIP M Masonry =�_.. RC ltootin+Covering - WS Window and Siding SF Solid Fuel Burning Appliances 413-527-0044 allstar5270044@gmail.00m _ I insulation Tel hone --- l m..i l aecire.s D Demolition 5.2 Registered Home Improcerucrit Contractor(HIC) 101858 6-28-20 All Star Insulation&Siding Co., Inc. HIC Registration Number Expiration Date HIC Company Name or Hl( Rup,tram Nano 56 Franklin Street allstar5270044@gmaii.com No.and Street Ernail iddreN% Easthampton,MA 01027 413-527-0044 Ci /Town,State.ZIP Telephone SECTION 6:WORK F,RS'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 .......... 00 No . ......0 SECTION 7a: OWNER AUTHORIZATION TO BE Comm,ETF.D"WHEN OWNER'S AGENT OR CONTRAC-FOIZ APPLIES FOR BUILDING PERMIT I,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. Gail Blakesley,HomeownerM01404141 0 �'��L_ Print Owners Name(Electronic Signature) Date SECTION 7b.OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below.I hereby attest rider the pains and penalties of perjury that all of the tntbnnanoii contained in this application i•true and a rate to the bast of my knowledge and understanding. Ed Losacano,Owner Print Owner's or Authorized Age is ame Electronic Sigrwture) 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 mvm�mv.nius guy-ora information on the Construction Supervisor License can be found at 2. When substantial work is planned,provide the information below: Total floor area(sq. R.) (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"maybe substituted for"Total Project Cost" J t �V �� n �� � �� a 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: a 22 <' ) The debris will be transported by: � — �+ I aC.► r��Cr� The debris will be received by: �_ : Pt�p Qinfi 311hycL YAmpft C)IM5 U Building permit number: Name of Permit Applicant F-A, LAna anp—ill Slav- Date lavDate Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents it Ogee of Investigations 600 Washington Street / Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly 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 bog: Type of project(required): 1.[?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.❑ 1 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 ty• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.+ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 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.] *Am applicant that checks box#I 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. :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-8H26302-18-19 Expiration Date: 08/13/20 Job Site Address: Gt City/State/Zip: Q1t? Q , �� �1��� Attach a copy of the workers' c4mpensation 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: 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. CityfTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Client#: 13250 ALLST DATE(MMMD/YYYY) ACORD- CERTIFICATE OF LIABILITY INSURANCE 8/21/2019 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.H SUBROGATION IS WANED,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 CONTACT NAME: Ryan Daley _ T.P. Daley Insurance Agency,Inc. PHONE413 788.0971 413 739-2645 (AIC,No,Eaq: AIC,No 1381 Westfield St. E-YML arcate ale insuranCe.com ADDRESS: rY Y@tpd Y P.O.Box 1150 INSURER(S)AFFORDING COVERAGE MAIC i West Springfield,MA 01090 INSURER A:ysssswn Aa-4ah ti.Ca INSURED INSURER B:01M.� I'Ir-ro. All Star Insulation&Siding Co.,Inc. INSURER rMws:Tral hdnhhnay Co cr Amer" 56 Franklin Street INSURER D: Easthampton,MA 01027 /!SURER 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. iL1.S�R TYPE OF 94SURANCE ADOLISUBR - POLICY NUMBER POLICY EFF POLICY EXPWVD UYrr3 A GENERAL LIABILITY BKS57957626 lIU1312019 08113/2020 EACH OCCURRENCE $110001000 X COMMERCIAL GENERAL LIABILITY PREMISES E oNop enoe S100,000 CLAIMS-MADE C OCCUR MED EXP(Arty one person) $15,000 PERSONAL a ADV INJURY $1,000,000 GENERAL AGGREGATE 52,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY X JECTPRO- Loc 5 A AUTOLE LIABILITY 13/2019 08/13/2020(Ea aOCCKl nntSINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $10Q000 ALL OWNED X SCHEDULEDAUTOS AUTOS BODILY INJURY(Per accident) $300,000 X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $100,000 AUTOS Per soodent $ UNIORELLALJAB OCCUR ---- EACH OCCURRENCE $ EXCESS LUB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ S B WORKERS COT1ON 6HUB8H26302819 8/13/2019 08113/2020 X "C sTATu OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUT VE YIN N E.L.EACH ACCIDENT 5100 000 OFFICERIMEMBER EXCLUDED? � N I A (Mandatory In NH) E-L.DISEASE-EA EMPLOYEE $100,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule.It more space is requhvd) General Certificate CERTIFICATE HOLDER CANCELLATION All Star Insulation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN &Siding Co.,Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 56 Franklin Street Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE 1�s Gh -/•li2l Z/� ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S152251/M 152159 RTD a Commonweatfh of Massachusatis Division of Professional Lkensure Board of Building Regulations and standards Construction Supervisor Specialty CSSL-099738 Expires:01/10/2020 r` EDWW W.LO$ACANO 128 GLENDALE ROAD C SOUTHAMPTON MA 01073 a /► Commissioner l/'�- c;� •-' • • -:.:::: - ...Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation ALL STAR-INSULATIO d 8DNG CO. Registration: 101858 N. , Expiration: 09128/2020 58 FRANKLIN STRHIT-- - -- EASTHAMPTON,MA 01027 Update Address and Return Card. SCA 14 20M.oa17 HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Carvorsdon before the expiration data. If found return to: Realstration 1mn1rat1ffi Office of Consumer Affairs and Business Regulation • --- -- 101858 _ 06/2812020 1000 Washington Street-Sulte 710 ALL STAR INSULATION 8 SIDING CO. Boston,MA 02118 EDWIN W.LOSACANO C � 56 FRANKLIN STREET EASTHAMPMN;MA'(Y102y " " Not wit out signature" Undersecretary , oa m r44 CLS(0 INSULATION OCT 1 0 2019 & SIDING CO., INC. / 0 t� Easthampton Office 413-527-0044 56 Franklin Street • Easthampton, MA 01027 1,41 413-568-6411 CSL License #CS SL99739/NtA HIC#101858/CT HIC#0630805 fax 413-527-1222 • email:allstar5270044@gmail.com • www.allstarinsulationsiding.com +D Prop sal Submitted to Phone Date Gail Blakesley "Purchaser"413-584-2569 Home ..Octob r 7,,.2 19 Street Job Name 272 Sylvester Road t ,. City,State and Zip Code Job LocationJob Phone f Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW ROOF ON GARAGE OPTinnl L INSTaI I ATIO riI NEIN ROOF ON GARAGE ONLY _ 1. We will remove (2) layers of existing asphalt shingles and dispose of in a dum ct��er Supplied by us. 2. We will install r Titanium Rhino Deck or Elephant Skin underlayment over entire stripped roof slurface. Z We will install new CertainTeed Landmark Owens Corning or ,af Timberline Architect Shingles. They will have a "Manufacturer's Lifetime Limited Warranty" Owner will have choice of color. 4 All shingles will be nailed with at least(5) nails per Shingle F We will install neje/aluminum drip edge on all eves and new aluminum rake edge on rake areas We will install pipe boots and metal step flashing where needed) 6 We will install approximately(30)' of roll vent on peak of roof for additional ventilation. 7. Job site will be cleaned upon Som}+)stip on of job_R �.. F_. — IF ANY SUR SHEATHING IS NEEDED THFRF WILL BE AN AL CHARGE OF PER SHFFT TO REMOVE DISPOSE OF AND INSTALL NEW 7/16 OSB Sl IR SHEATHING i. PRICE $4,532-00 OPTION 2 REMOVE AND REINSTALL EXISTING SOLAR PANELS AND BRACKETS ON GARAGE ROOF We will remove existing solar panels and brackets so that we may perform our work- 2. will ill reinstall existing solar panel brackets andsolar panels once roof has been replaced by us V YG 111 G PRICE $Q►SP&W e�„�© ��t�--Ah, r *APPROXIMATE START DATE WILL BE OCTOBER ONCE WE RECEIVE DEPOSIT AND SIGNED CONTRACT LESS ANY INCLEMENT WEATHER LABOR IS GUARANTEED FOR "1-YEAR" *`ALL STAR WILL SECURE BUILDING PERMIT IF NEEDED HOMEOWNER WILL BE RESPONSIBLE FOR ANY &ALL FEES REQUIRED - ** ALL STAR IS NOT RESPONSIBLE FOR ANY LEAKS THAT OCCUR IN EXISTING SKYLIGHT(IF APPLICABLE) ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY &ALL ELECTRICAL OR PLUMBING WORK ** NO PRODUCT& LABOR WARRANTIES ;nm I RF ISSI IFn UNTIL WE RECEIVE FINAL PAYMENT. *'HOMEOWNER WILL BE RESPONSIBLE FOR COVERING ANY STORED ITEMS AND FOR ANY CLEANUP___ WORK IN THE ATTIC NEEDED FROM DUST R DEBRIS FROM ROOF REMOVAL *A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY ITY WILL BE FORWARDED UPON REQUEST T P DALEY INSURANCE AGENCY OF WEST SPRINGFIELD MA IS OUR AGENT, ** WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of: .T A,____ *j_�- __ _____________- dollars ($ 1/3 DOWN, 1/3 AT START OF JOB, payment due upon receipt of invoice. If payment Iate�interest at 1 1/2%may be added.' BALANCE DUE COMPLETION OF JOB NOTE: This proposal may be withdrawn by us if not accepted within _ THIRTY days. ED LYS NO, OWNS -- - -- --- - - --- - - - ---- - - —_--- - Contractor Salesman 7 aGa Blakesley e I 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 SI6E �'