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10D-021 (4)
159 MAIN ST-LEEDS BP-2021-1085 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I OD-021 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-2021-1085 Project# JS-2021-001830 Est.Cost:$5321.00 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.): 87120.00 Owner: LANGHELD JENNIFER Zoning: URB(125)/WP(95)/URA(0)/ Applicant: ALL STAR INSULATION & SIDING CO INC AT: 159 MAIN ST - LEEDS 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:I NSTALL 7 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 NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. I ,� Certificate of Occupancy Sinaturc: i , FeeType: Date Paid: Amount: Building 3/30/20210:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner S., The Commonwealth of Massachus s 4R ' , ?�� a Board of Building Regulations and St ndards C g ,�OR '? 1MU'sj''CIPALITY Massachusetts State Building Code,780 CfvIRT o,��U / USE Building Permit Application To Construct,Repair, Renovate ri ReJsed liar 2011 One-or Two-Family Dwelling -, , c; ,;ve3,,,°Ns This Section For Official Use Only BuildingPermit Nu/mber� /fd�� rDatte Applied: RI �v,n) ` �055 ____i — 3-30-2.OzI Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 159 main -- 1d 17 DA/ 1.1 a Is this an accepted street?yes no Map umber 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*stem 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: nn L4ngheld I eerie) Mt, 0/053 Name(Print) City.State.ZIP 157 /M?a/0areal— L13•-78y-2gaaC'e.,[J No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) Nev.Construction 0 Existing Building II Owner-Occupied 0 Repairs(s) 0 Alteration(s) MI Addition 0 Demolition 0 Accessory Bldg.❑ Number of Units Other 0 Specify Brief Description of Proposed Work: tj li.._ U i I 1 y tip 0 ld (,v)he-In,Q, //1,/)/QP -7 n{W viby 02piace to/ a/us . U I SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) , I.Building S I. Building Permit Fee:S 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 S Suppression) Total All F s:�Sr #4 Check No. �J Check Amount: Cash Amount: 6.Total Project Cost: S 5 i i ,t70 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-22 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 I&2 Family Dwelling City/Town,State,ZIP M Masonry. RC Roofing Covering 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. 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 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 QD No . ❑ 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 authori ed by this building permit application. Jenn Langheki,Homeowner CA 3//64 /r Print Owner's Name(Electronic Signature "Date 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 � 3//e/c i Print Owner's or Authorized Agent 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. )42A.Other important information on the HIC Program can be found at Www_nrtsS.tttiV Oca Information on the Construction Supervisor License can be found at www.mass.zor_dJr.; 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: 159 \t ►n 51Y of The debris will be transported by: X3 — 1-kAu\i►'1 f fL a 111 •Qoolicl-E.:61-i2cad The debris will be received by: U.)0.*Y n_12eff Q►n U I I hro yr ynr a►c ,5 Building permit number: Name of Permit Applicant Ed 1;1I Skr Tosao ont ic�i��cl ,Sri. 3k-71a L 4.‘enacc4---- Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents (77 I 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): I.. 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]** 4.❑ We are a non-profit organization, staffed by volunteers, 11•❑ Health Care with no employees. [No workers' comp. insurance req.] I2.❑■ Other CONSTRUCT/ HOME IMPROV *Any applicant that checks box#I must also fill out the section below shm%ing their%%orkers•compensation policy information. **If the corporate officers ha%a exempted themselx es.but the corporation has other employees.a%%orkers'compensation police is required and such an organization should check box#I. am an employer that is providing workers'compensation insurance for my employees. Below is the policy 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 certify, under the pains and penalties of perjury that the information provided above is true and correct. Signature: 3 ([ i� C Date: 3// 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): II:Board of Health 2.❑Building Department 3D City/Town Clerk 4.[]Licensing Board 50 Selectmen's Office 6.['Other Contact Person: Phone#: w%v .mass.go%/dia ALLSTAR-05 BROOKE ACORO CERTIFICATE OF LIABILITY INSURANCE °"' DD,YYYY' `-� 8/14/14/2020 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 _ ACT Brooke Barre Phillips Insurance Agency,Inc. PHONE,. :(413)594-5984 FAX 97 Center Street (NC,No):(413)592-8499 Chicopee,MA 01013 Vass:brookeQphillipsinsurance.com INSURERS)AFFORDING COVERAGE NMI NSu A:State Automobile Mutual Ins Co INSURED NSURER B:State Auto Property&Casualty All Star Insulation&Siding Co.,Inc. INSURER c:Travelers Insurance Company 36161 56 Franklin St INSURER D: Easthampton,MA 01027 NSURERE: NSURER 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 POLICY EXP LTR TYPE OF INSURANCENSO LI 4WD POCY NUMBER y Su POUCY�YY) h LIMITS A X COMMERCIAL GENERAL LABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PBP2903632 DAMAG RENTED 8/13/2020 8/13/2021 ISETO(Ea occurrence) $ 300,E MED EXP(Any one person) S 15,000 _ -- PERSONAL&ADV INJURY S 1,000,000 GENL AGGREGATE UNIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY X JECT LOC PRODUCTS-COMPAOP AGG S 2,000,000 OTHER S B AUTOMOBILE LIABILITY IBINED SINGLE UMIT $ 1,000,000 acadentl X ANY AUTO BAP2482222 8/13/2020 8/13/2021 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(PeraoodenI) S ------- Fp .pyy�. I OPERTY WWMAGE AUTOS ONLY AUTOS ONLDY (Per aaodera) S S A X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS W1B _ -CLAMS-MADE PBP2903632 8/13/2020 8/13/2021 AGGREGATE $ 1,000,000 DED X RETENTION S 0 S C WORKERS coaPENSATION X PERTURTE X ERH W AND EMPLOYERS' 16IITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 6HUB-5N06911-1-20 8/13/2020 8/13/2021 E.L EACH ACCIDENT $ 1,000,000 OFFICy„BE;EXCLUDED N NIA 1,000,000 (W NII E.L.DISEASE-EA EMPLOYEE S "yes d rbe O10ef 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/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&Sidingnc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Co.,, ACCORDANCE WITH THE POLICY PROVISIONS. 56 Franklin Street Easthampton,MA 01027 AUTHORIZED REPRESENTATIVE i`, ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ro-/n/746vmoeizli ar)e)-aoleiodAti- Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation 1858 ALL STAR INSULATION & SIDING CO. Registration:pi 6/28/2 56 FRANKLIN STREET Expiration: 06/28/2022 EASTHAMPTON, MA 01027 Update Address and Return Card. SCA 1 C 20M-05 17 //Y///.,,/'/,i/',i!/, //. i�.i v,/, //i,//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 p, is 'c'i.-.-z• ." 56 FRANKLIN STREET • Not valid without signature EASTHAMPTON, MA 01027 Undersecretary 9 Apr 02 20,05:09p Florida Office 13524833575 p.1 Commonwealth of Massachusetts Division of Professional Licensure • Board of Building Regulations and Standards Construction'SuperVi6ctr Specialty CSSL-099739 expires:02/14/2022 EDWIN W.LOSACANO,f 128 GLENDAJ E RD. SOUTHAMPTajV MA 01073 - j• , ti ()14t,.ti� l ' r • Commissioner Sr; ECEOVE uas 1 sir INSUL.A.TION .,, MAR 1 6 2021 & s 130 , -700 . cl ii Easthampton Office SIDING CO., INC. WeigalcRfffiCP 413-527-0044 `5 f�4114. 56 Franklin Street • Easthampton, MA 01027 4as-513 7-6J CSL License #CS SL99739/MA H1C#101858/CT HIC#0630805 C fax 413-527-1222 • email:alistar5270044@gmail.com • www.allstarinsulationsiding:com Proposal Submitted to Phone Date Jenn Langheld "Purchaser"413-789-8922 Cell March 15, 2021 Street Job Name 159 Main Street City,State and Zip Code Job Location Job Phone Leeds, MA 01053 Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW VINYL REPLACEMENT WINDOW UNITS - HARVEY TRIBUTE JNSTALLATION OF NEW VINYL REPLACEMENT WINDOW UNITS - HARVEY TRIBUTE 1. We will remove and dispose of existing wood and or aluminum storm windows or vinyl replacement windows. 2. We will install (3) Double Hung and (4)Two-lite Gliders Harvey Tribute Energy Star Rated Vinyl Replacement Window Units in designated areas. 3. They will have double pane insulated glass with Half Screens in the double hung window units and F 4-laW Screens in the Two-lite glider units. Color will be White without grid work. 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. We will remove and reinstall existing wood window casing around interior of window units installed in order to perform our work. We will be as careful as possible. Homeowner will be responsible for any painting or staining of window casing. if needed. 7.Vinyl Replacement Window Unit has a"Manufacturer's Lifetime Warranty" and the glass has a"20-Year Warranty". PRICE: $5.321.00 **APPROXIMATE START DATE WILL BEG-12 WEEKS FROM DATE OF DEPOSIT AND RECEIPT OF WINDOW UNITS FROM MANUFACTURER LESS ANY INCLEMENT WEATHER. LABOR IS GUARANTEED FOR "1-YEAR". ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY FEES REQUIRED FOR BUILDING PERMITS. ** HOMEOWNER WILL BE RESPONSIBLE FOR REMOVAL OF CURTAINS. MINI BLINDS. AND SHELVES. ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY&ALL ELECTRICAL OR PLUMBING FEES THAT MAY BE NEEDED. ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY SECURITY SYSTEM INSTALLED IN WINDOWS ** PRODUCT & LABOR WARRANTIES WILL NOT BE ISSUED UNTIL WE RECEIVE FINAL PAYMENT. **A CERTIFICATE OF INSURANCF FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORWARDED UPON REQUEST. ** PHII L IPS INSURANCF AGENCY. INC. OF CHICOPEE, MA IS OUR AGENT. WE PROPOSE to furnish material and labor,complete in accordance with above specifications, for the sum of: $5,321.00 dollars($ 50% DOWN, BALANCE DUE ), payment due upon receipt of invoice. If payment late, interest at 1 1/2%may be added. COMPLETION OF JOB NOTE:This proposal may be withdrawn by us if not accepted within THIRTY days. ED LOSACANO JR., OWNER Contractor Salesman Jenn Langheld 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 CONDITION PRINTED ON REVERSE SIDE �