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24B-044 (2) 40 BARRETT ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1882 Map:Block:Lot:24B-044- 001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-1882 PERMISSIONIS HEREBY GRANTED TO: Project# VINYL SIDING Contractor: License: Est.Cost: 27680 104327 Const.Class: Exp.Date: 11/29/2021 Use Group: Owner: HART THOMAS G&REGINA E GRANT Lot Size(sq.ft.) Zoning: URA/WP Applicant: ALLIANCE HOME IMPROVEMENT INC Applicant Address hone: Insurance: 375 CHICOPEE ST (413)883-3802 6S62UB-4N622734 CHICOPEE,MA 01013 ISSUED ON:09/14/2021 TO PERFORM THE FOLLOWING WORK: 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. Signature: • • .y.2 Fees Paid: $60.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner <(%% 6/FA i sZ, The Commonwealth of Massac 1 se e �.0 w Board of Building Regulations and Sta .k FO Massachusetts State Building Code, 780 A ?�</ ICIP ITY r'l's,, Building Permit Application To Construct,Repair,Renovate a Revis=/Mar 2011 One-or Two-Family Dwelling -107e Ti0 s� `IS This S tion For Official Use Only � r g 7�-Buildin Permit Number: g P Al � D Applied: 5 9- N-zezi Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.j Proper k Address: 1.2 Assessors Map&Parcel Numbers O I&rre f� c+ 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❑ Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 kwnes1 of Record, 4/0/4,a {�l ¢ /Ket 6 e tM� /0 / l Name(Print) City,State,ZIP yo & r✓'e-h C4 "6'o ,9s/Sy.5"-C No. and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units Other 0 Specify: Brie Des 'ption of reposed Work': � overt fit.,if t OC4'c IA/" t/ i Ci I h_ 4.C7 ul� /t/e cO, / 1, 4a v► �/f0O/", [l7r ys e1 S 44 a du, c SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials 1. Building $ 2 ? 4�1,6) 1. Building Permit Fee: $ Indicate how fee is determined: / ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ �/ Suppression) Total All Fees: $ 4' eO (j/-, Check No3'70 Check Amount: Cash Amount: 6.Total Project Cost: $ 2 2 6 z V 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Z_'.-it0 932 77 /1/2 9/2D 2 �e r (, ,� ra pi ( � License Number Expiation Date Name of I older i Li 3 7 2 / i e Qz f List CSL Type(see below) No.and Street (� Type Description l7//1 NQ Op �— (il U Unrestricted(Buildings up to 35,000 Cu.ft.) City/lT/own,•rState,ZIP /7 R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding yt 3 Sg3 3gD2 S'e r* g�/t SF Solid Fuel Burning Appliances t t fa k .c(.c t .I Insulation Telephone Email address e o to D Demolition 5.2 registered Home Improvement Contractor(HIC) i�C'2 /2 /,g/ 1 e �- o�.e d tle ' l� a HIC Registration Number Expiration Date HIC C. m ny N ci HIC Registrant Na t t 3 #� ,eo`0ee. �' S'e/�,y Bey.//�,eekow.e i.,c, c.o...._ No.and e opeI I 4 c/13 to 380 2 C� Email address City/Town,St te,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 Iss ce of the building permit. Signed Affidavit Attached? Yes 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 e a:), 7Y6c el-- to act on my behalf,in all matters relative to work authorized by this building permit application. 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. ezesete...ek a 9A2 7 1 2/ Print O n r Auth zed Agent's Name(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 www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 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 aSHAMPY Massachusetts ( f • *11 .� ,: , 44 DEPARTMENT OF BUILDING INSPECTIONS • 4'*" 212 Main Street • Municipal Building vti. O� �`_ Northampton, MA 01060 �SH;y 3,.)<‘J CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 43 57e,/gi �a/ �e The debris will be transported by: Name of Hauler: . .e, , /' fce Signature of Applicant: Date: 09 a7/z/ The Commonwealth of Massachusetts t Deportment of Industrial Accidents 4s or, 1 Congress Street,Suite 100 ��-�'�`� Boston, MA 02114-2017 w y own mrtss go► dirt !hatters'Compensation Insurance_ flidasit:Builders'('ontractarsfl:lectriciautIPlunnbers. to BE t•u.f:n%%LIB HIE Pi.R.trr lint;Al'-'FHORITI. Applicant Information Please Print Leeibav t Name musics Orgarurstion Individual): I1'I Qaee #0c41.42 /76raVa-tekti /''1 e Address: 3.S arts` S- CityfStatefZip: c_ntO62 ri A coo Phone#: ya3 iv Y2O2_ Are yea mu estpkt rev?(Art*title appropriate hat: Type of project(required): iitil ant a ennnplaylr SA Ilk 3 cnapltL'SYes(fuel and au part-tinriel--' 7. a New constructiori 20 I ama soil•p cirprietan or pr.tntne ship and Italic ILOclnlployll9 working Cur nse in g. 0 Remodcltng arty cahaacits-[NLn workers•dump.insurance rexhuire .] 30 I ant a Itanwr,twttea doing all sure nnyself.'1No sure a`eunnn.irmuraruce m-quinlI.1" 9. ❑Dentulition 10 Q Building addition 40 I ant a hunwvstat«and will the hiring ltnrtraciurska cuadraet ail w ink on Ink p%ruPlrtt- I%ill ensure that all en ntraciurs either has workers"oaempensatnnt insurance or an sole I I.Q Electrical repairs or additions proprietors with no lat>pluyren. 12.0 Plumbing repairs or additions 30 I ant a sesl-ral contractor and I luxe hired the sub-contractors List.tt um tls attainsd sheet. Throw sub-contractors hose einpluyeesaril tux wurkers minim.insurance.. I Rowf'repairaI V 14. Other >/ G'/A1(. 6.D an:a LYlrpXxa1iunn and ib officers has c exercnscd their ngh ut exemption per Will.c. L _ 1 K2,y5 II 41,and we hat. w lm�p rluktics.[No winker;camp.insanei le rcyuind.I `l/�� "any al/04..o that citcCk%but m I trust slut till nut the section hcluw shls Ins them workers.'compensating]limlicy u icinaLiun. iiumeo vier%a.bo submit this attsits it nuheaung they arc doing all work and den hire outside comm.:nap,nnu.,t subuut a new alhdot it mIlicutnng such. It'untraciors that cbtxk this box mint atmeheil an additional sheet show ink;the mine of du saih—e niracturs and state a holier in nut tlrnse sa lines IIase ernplum:en. lithe sub-cuntrsctors fuse empltyces.thcs must pros ide their worker:,"comp.s.licy numh.r.. I am an employer that is providing workers'compensation insurance for my employees. Below is the police'and job site information. Insurance Company Name: hide- 4 t i er-lie l� Sto r®r.4 esz Co Policy#or Self ins.Lie.#: b ' — 622-Z? Expiration Date; 2 z u� y�v y P � / / Job Site Address: LIC ea ere+± --C-1-- City/State:Zip: /Vo Mil- Attack a copy alike workers'compensation pullet declaration page Ishussiug the policy number and espi Lion date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal s iegation punishable by a tine up to S I,500_00 aruk+or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violator.A copy of this statement ma be forwarded to the Otliee of Investigations of the DIA for insurance cos crai e verification. I do hereby certify under t - .s and >e ofpe -ur +nation provided above is true and co reds* Si a lure: 1aaiC: o 2 t Phone 4: I 3 Official use only: Do not write in this area,to be completed by city or town official 1 ('its lii-Tusstt: Permit!! icense 4 Issuing Authority Icirclr one): I. Board of llealth 2.Building,Department 3.City[lossn Clerk 4.Electrical Inspector 5. Plumbing Inspector ti.Other ('ontact Person: Phone 4: ‘7,4 W0,12,126014€11e40014)/tAbaeMa40490/4 Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Mchusetts 02118 Home Improvem tcilitractor Registration 4 ^ _ __ • Type: Corporation ALLIANCE HOME IMPROVEMENT,INC - _ `= n: 154218 376 CHICOPEE ST t-= -= tri �o0n: 0?l191202f CHICOPEE,MA 01013 ;;• = 1 4: '~ q, au 1 6 pa��n�ppan7 �� Update Address and Muni Card. JZ, Kwi idairme rl8 1✓ as40.16 CMos of Consumer Mahe£Bushas Rp uMtlon HOME IMPROVEMENT NTRAC'7OR `arsondlon �WM far WAN ems o nly $R� siOdd Q�s 81whM Mud sia Repletion ALLIANCE HO , '' , ,t � -? ,INC ESMIII,MA SERGIY SUPRUfr 1,__ : 378 CHICOPEE BT ?,_, , " ..,,� CHICOPEE,MA 01018 g• UndersecretaryN vall without signature • II), emels■eIPW ills al raagachuaattam otvwa& IBaal II Liconau • Board of Building R and Standards Co Igor I CS-1.04327 z l pirgs:11/2912024 SEROIY SUPR di 148 BERKSHIRE WESTFIELD MA 01 0 fy' Commissioner -- • ® DATE(MMIDDIYYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 03/01/2021 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 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 David Jerry NAME: Neill&Neill Insurance Agency Inc PHONE 662 Riverdale Street (,vc.No,EMI: 413-732 4137 FAX No):413 731-6629 West Springfield,MA 01089 L ADDRESS: dj@neillins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: State Auto Insurance Companies STA INSURED Alliance Home Improvement, Inc INSURER B: SAFETY INSURANCE COMPANY 39454 Sergiy Suprunchuk Ace American Insurance Company 12165 375 Chicopee Street INSURER C: p y Chicopee,MA 01013 INSURER 0: 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 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. INSR I ADDL SUER POUCY EFF POLICY EXP LTR Ii TYPE OF INSURANCE LIMITS INSR NND POLICY NUMBER (MMIDDIYYYY) (MM/pD/YYYY) A GENERAL LIABILITY PBP2689283 03/12/2021 03/12/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE V OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 I1 POLICY PRO- 7 $ JECT LOC B AUTOMOBILE LIABILITY 6226463 12/04/2020 12/04/2021 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED _ / SCHEDULED AUTOS V AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION 6S62UB-4N622734 12/05/2020^12/05/2021 `n WC STATU- OTH- AND EMPLOYERS'LIABILITY V 1 TORY LIMITS ER / ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I LYYNI NIA E.L.EACH ACCIDENT $ 1,000,000(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,0 00,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE IS FOR PROOF OF INSURANCE PURPOSES ONLY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sergiy Suprunchuk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 375 Chicopee Street ACCORDANCE WITH THE POLICY PROVISIONS. Chicopee,MA 01013 AUTHORIZED R; NTATIVE - . , r ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD All home improvement contractors and subcontractors engaged in Ahome improvement contracting, unless specifically exempt from Estimate w 1i/I 1 _ registration by Provisions Chapter weal of the general laws, `✓`,it Twp must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the A libis)ie//Im ® "t'i' t t Director. Home Improvement Contract Registration, One Nein gear Imagination in eurhanda // \\\\\ Ashburton Place,Room 1301,Boston,MA 02108(617)727-8598 375 Chicopee St. / ///���� � Chicopee,MA 010'_:' • /fin� 1. , _sil • Office Phones: -it, (413)883-3• :: r (413)331-3:_,.J= b can Pay more,but you can't buy better MA Lic#154218 CT Lic#0635847 Office Fa,.:(413,3:,i-4358 www.AllianceHorneinc.com MrAlliance@allianceho�meiinc.com10 (� PROVrE.) .-0: ''-"8 r net, Grairr Phone: Cell: ?( O (�j�� �( YO 110Gl t t-ei"4 -c -• Email: N o r+k� 1a O p smil- e hereby submit specifications and estimates for work to be performed and materials to be used for: /,� / , Windows din �V"' L4��nettetve ❑ g ❑Roofing ❑Doors ❑Gutters ❑Other p.AA /Ai , —__-f) ve /n f I1'N r u 1 • ,d n o- S is 3rd �oir Secif1`oh -i ' I S 6l u e • Oo h o f w retP w,i aoLos 444.4-W' a/ reod tt'e p1/c --f--riil t e `nJDVC , _ 4.'-o -uotL-rdp s:ct- f -.7fVe.4-14- &II Pooq, -r-res-htit vi-14: ,. cf pc, wit", at -'� +.:cltu per64 , fv...j2 s r, k/we tr--PU. ore. f!`oSAL ahA a Tk Pgasi-L beeoi a, / +v"e Cat up . i V We propose hereby to furnish material and labor-complete in accordance with above specification for the sum of: PAYMENTS l� n�'l �A ($ t�7 r0 i? O . c0 Payments to be ma a as follow c v 01 60 n . t 0( ` to %($ 7 C upon signing of contract Name of Estimator /�,"i 413 %($ II C? a t upon delivery of materials Phone of Estimator CH31/98' ag2# %i$ sec. " upon job completion Email of Estimator twice.. 0 1 IN n� 10 � ' Signature of Estimator )%($ � upon completion of work Date 7 /� a I