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17A-112 (4)
59 CAROLYN ST BP-2021-1086 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A- 112 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2021-1086 Project# JS-2021-001832 Est.Cost:$2983.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL STAR INSULATION & SIDING CO INC 99739 Lot Size(sq.ft.): 8668.44 Owner: HAYDEN JENNIFER Zoning: R1(100)/URA(100)/WSP(82)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT: 59 CAROLYN ST Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAM PTO N MA01027 ISSUED ON:3/30/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 4 REPLACEMENT WINDOWS 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 NORTHAMP ON ON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy signatt e: I FeeType: Date Paid: Amount: Building 3/30/2021 0:00:00 $40.00 212 Main Street; Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner f• 6 /1 c,\\ . if <<>/ _ &, The Commonwealth of Massachusetts Q Board of Building Regulations and S .' 'at c.",, �•f` , FOR 1! Massachusetts State Building Code,780 • it„ `-2q0, IU EALITY Building Permit Application To Construct, Repair, Renovate OrY\`Ftlolish a Revised Mar 2011 One-or Two-Family Dwelling '�, This Section For Official Use Only ��\Ltis *^ / Build/in�Permit Number: 60.2)..j7�p Date Applied: J�= 5 -36-2621 V1� 0 5 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property 5 1 Caro tAddress:n Sire e--� 1.2 Assessar;,Map& Parcel Numbers 2_ 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: nrirc'-r- 1- iicke n f org r\ tm e O lO Name(Print) City.State.ZIP 59 ('aroILinSir-e - 1-113-gy-9998e4 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building la Owner-Occupied 0 Repairs(s) 0 Alteration(s) El Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': (Ale LA,9 A 1 r.e v V-e._-1 C3 pose- y r)w4 ►Aj► otos a. l -Q (4 ni r aa�-4- 1-i�dm.L vua SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: S 4.Mechanical (HVAC) S List: 5.Mechanical (Fire $ Suppression) Total All Fees,:,$ Check No./ ✓'1((Check Amount: ° Cash Amount: 6.Total Project Cost: Sa19 g3 � 0 Paid in Full 0 Outstanding Balance Due: • SECTION 5: CONSTRUCTION SERVICES j 5,1 Construction Supervisor License(CSL) CSSL-099739 2-14-22 Ed Losacano License Number F poration t)atc Name of CSL IIo!dc, List CSL.Type(see below) R 128 Glendale Road No.and Street i Type. Description U Unrestricted(Buildings up to 35,000 cu. ft.) Southampton,MA 01073 _-_ R ' Restricted I&2 Family Dwelling i Cit?rrown.State. IP M Masonry l RC Roofing Coverina --------- WS Window and Siding SF Solid Fuel Burning Appliances 413-527-0044 allstar5270044©gmail.com — I insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101858 6-28-22 All Star Insulation&Siding Co.,Inc. HI( Registration Number Expiration.Date HIC Company Name or HIC Registrant Name 56 Franklin Street _ allstar5270044@9maii.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....._...II No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR 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 author d by this building permit application. Jenn La held,Homeowner Print Owner's Name(Electronic Signature) -,_ ate SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below.I 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. ' Ed Losacano,Owner ? G . L- r. /bP . i Print Owner's or Authorized Agent's Nat Electronic 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 nut 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 al \VV.,.".a KISS,1;1A ()Ca information on the Construction Supervisor License can be found at WWW.111iISS.UOVAillS 2. When substantial work is planned,provide the informati rn.bclow: 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: florQ , I'Y1141 oloGa The debris will be transported by: liv3n - WA L\i n C14`R�c' C MCA t added'$c br cad The debris will be received by: \Lo,*ylf\ ,r�{��j�('1 tutithmlY,tmfl- clocks Building permit number: U Name of Permit Applicant E-t. Lc<ncan - 11 r Ismao on-t 8ktyc,,abc. 31 I 7 PI se 4.12CV_OL-e--6-- Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents 9 Office of Investigations Lafayette City Center i.. 2 Avenue de Lafayette, Boston, MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: 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: Business Type(required): 1.111 I am a employer with 10 employees (full and/ 5. ❑ Retail or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl. real estate, auto, etc.) employees working for me in any capacity. [No workers' comp. insurance required] 8. ❑ Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing no employees. [No workers' comp. insurance required]** I l.❑ Health Care 4.❑ We are a non-profit organization, staffed by volunteers, CONSTRUCT/ HOME IMPROV with no employees. [No workers' comp. insurance req.] 12.❑■ Other 'Am applicant that checks box#I must also till out the section below showing their%corkers'compensation polic} information. "If the corporate officers hate exempted themsehes.but the corporation has other employees.a workers'compensation police is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the police information. Insurance Company' Name: THE TRAVELERS INSURANCE COMPANIES Insurer's Address: 97 CENTER STREET City/State/Zip: CHICOPEE, MA 01013 Policy #or Self-ins. Lic. # 6HUB-5N06911-1-20 Expiration Date: 8/13/21 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under § 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 certif, under the pains and penalties of perjury that the information provided above is true and correct Signature: Ed4r1.10a.-604.---4--4---- Date: 3/ai /M 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(check one): 1.Board of Health 2.0 Building Department 3DCity/Town Clerk 4.0Licensing Board 5fl Selectmen's Office 6.['Other Contact Person: Phone#: ‘v w.mass.goc/dia ALLSTAR-05 BROOKE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 8/14/2020 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 have ADDITIONAL INSURED provisions or 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 Brooke Barre Phillips Insurance Agency,Inc. PHONE (413)594�984 FAX 97 Center Street um,No):(413)59243499 Chicopee,MA 01013 ISOftss,brookeftphillipsinsurance.com INSURERS)AFFORDING COVERAGE NAIC I/ PSURER A:State Automobile Mutual Ins Co INSURED INSURER B:State Auto Property&Casualty All Star Insulation&Siding Co.,Inc. INSURER C:Travelers Insurance Company 36161 56 Franklin St NSURERD: 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 CONTRACT OR OTHER DOCUMENT VNTH 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 N POLICY EXP TR TYPE OF INSURANCE NSD 1�MID POLICY NUMBER frAM POLICY YYYYYYI IMINDONYTY1 UNITS A X COMMERCIAL GENERAL mom"( EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR PBP2903632 8/13/2020 8/13/2021 DAMPREMISAGEES l TO Ea RENTED S 300,000 xaarence) _ MED EXP(Any one person) S 15,000 _ PERSONAL&ADV INJURY S 1,000,000 GENT AGGREGATE pURNIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY X JECT LOC PRODUCTS•COMP/OP AGG S 2,000,000 OTHER S B AUTONOBLE LABILITY COMBINEDe SINGLE LIMIT S 1,000,000 (EaX ANY AUTO BAP2482222 8/13/2020 8/13/2021 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOSOE ONLY _AUTOS yy�� pBROpDIIL�Y INJURY(Per acoden) S - IlAGE AUTODS ONLY _AUTOS ONLY (Per er 1) S S A X UMBRELLA LAB X OCCUR EACH OCCURRENCE s 1,000,000 EXCESS UAB CLAIMS-MADE PBP2903632 81 3/2020 8/13/2021 AGGREGATE s 1.000,000 DED X RETENTION S 0 S C WORKERS COMPENSATION X PEATUTE X TRH- AND EMPLOYERS'LIABILITY - ANY PROPRIETORRARTNERlEXECUTIVE YIN 6HUB-5N06911-1-20 8/13/2020 8/13/2021 E-L.EACH ACCIDENT S 1,000,000 OFRC EMBFNR)EXCLUDED"? _ N NIA 1,000,000 WW yiron N E.L.DISEASE-EA EMPLOYEE S "yes aesrnbe un0er 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE All Star Insulation&Siding nc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g Co.,, ACCORDANCE WITH THE POLICY PROVISIONS. 56 Franklin Street Easthampton,MA 01027 AMMO=INVIRESENTATTVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ray/?mno- d a�- �AatJ Qc a4e14- Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: '101858 ALL STAR INSULATION & SIDING CO. Expiration: 06/28/2022 56 FRANKLIN STREET EASTHAMPTON, MA 01027 Update Address and Return Card. SCA 1 C. 20M-05,17 `iv./ir/iivi:rrir/// i/. .rii�r��u-:�//i Office of Consumer Affairs& Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 101858 06/28/2022 1000 Washington Street - Suite 710 ALL STAR INSULATION & SIDING CO. Boston, MA 02118 EDW IN W. LOSACANO 56 FRANKLIN STREET s et..1:• EASTHAMPTON, MA 01027 Not valid without signature Undersecretary Apr 02 20,05:09p Florida Office 13524833575 p.1 • Commonwealth of Massachusetts Division of Professional Licensure • Board of Building Regulations and Standards Construction50pidisar Specialty CSSL-099739 4pires:02/14/2022 EDWIN W.LOSACANO 128 GLENDAI E RD. SOUTHAMPTOJV MA 01073 , • i. �� • 1 Commissioner Sr70E11\. r h k 11-1 rx f s zl \` INSULATION ►; /hiF E B - 5 2021, i, SIDING CO., INC. 000. • Easthampton Office :eA t ie • Oa c • 413-527-0044 56 Franklin Street • Easthampton, MA 01 c • , 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 Jennifer Hayden "Purchaser"41 - 4-9998 Cell February 5, 2021 Street ob Name P5me $rm PO Box 60262 I 9 Carolyn Street City,State and Zip Code Job Location Job Phone Florence, MA 01062 Florence, MA 413-584-2517 Home Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF (4) NEW VINYL REPLACEMENT BASEMENT WINDOWS • 1. We will remove and dispose of existing wood and or aluminum storm windows or vinyl replacement windows. 2. We will install (4) Two-lite Basement sliders MI Energy Star Rated Vinyl Replacement Window Units in designated areas. 3 They will have double pane insulated Zone 5- Northeastern rated glass with Full Screens. Color will be White with no grid work. Windows will have U-Factor of.25. 4. We will install foam insulation around window units installed and seal with Silicone Caulking on interior and exterior. 5. Window Units will have ProSolar Low E glass with Argon Gas. 6. Vinyl Replacement Window Unit has a "Manufacturer's)ifetime Warranty" and the glass has a"20-Year Warranty". PRICE: $2.983.00