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25A-058 (8)
B P-2022-0358 16 MARSHALL ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25A-058-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0358 PERMISSIONIS HEREBY GRANTED TO: Project# siding Contractor: License: ALLIANCE HOME IMPROVEMENT Est. Cost: 54542 INC 104327 Const.Class: Exp.Date: 11/29/2023 Use Group: Owner: N MOOS STEPHEN E &SH EI LA Lot Size (sq.ft.) Zoning: URB Applicant: ALLIANCE HOME IMPROVEMENT INC Applicant Address Phone: Insurance: 375 CHICOPEE ST (413)883-3802 6562UB-4N622734 CHICOPEE,MA 01013 ISSUED ON:04/08/2022 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: >2 . Fees Paid: $60.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 11 _a _ _, The Commonwealth of Massachusjetts7Board of Building Regulations and StWndar is A pp dlP FOR Tr - 8 7Q 1 TNICtPALITY Massachusetts State Building Code, 7$0 CMR I i SE Building Permit Application To Construct,Repair, 1 enovater. _f r R vised Mar 2011 : - One- or Two-Family Dwellink .+'rn�7 ' . . , plNe, p, ;i;r,NS This Section For Official Use Only Buildin Permit Number: ,P' 3 dA " 56-g Date Applied: EV IL) 055 ///12 17-6 ZOZF., Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1;rope{tyA doiress:s It / s� 1.2 Assessors Map& Parcel Ir O�e 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public ❑ Private 0 Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.}, ner'of Y1Record; !MOOS' Ma f VA r 4014 M 7Q Of€d Name(Print) City,State,ZIP J g6t S (l ELI i g+ 9/3 3 20 3.52.9 d u[,Aess Y539(?/(o4 iari. cop, No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg. 0 1 Number of Units Other l$ Specify: cI VII N B 'of Descti of Proposed Work2: S T( b S y� I K �K tA j� N�2[.V e _ crac- tr,iip"-a-j 1.4,-01.414 okor !1 kc"S Q '1� if �O i Nsfeirlgfl ovi U `('i' lw der oufe moo / e)araoe , < < SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 5L/ .'/2 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ i 0 Standard City/Town Application Fee ❑Total Project Costa (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees;,�$� Check No.� Check Amount: Cash Amount: 6. Total Project Cost: $ S y ..6-72_ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) e'5 Icy 324, /� 2 9lV. Z3 c� �� (u V1 � � p License Number Ex ira'on Date Name of C t-Lot er , "'(3 7 S //�/ 60 Pe n List CSL Type(see below) No.an Street (/� J Type Description iy§ O/ 0 / 2 U Unrestricted Buildin up to 35,000 cu.ft.) City/Town,Sta ,ZIP R Restricted Dwelling M Masonry RC Roofing Covering t� WS Window and Siding ®D cer$V 6 eu1 .ee G°' SF Solid Fuel Burning Appliances 98 Sig 3 3 O I h C • ec"''t I Insulation Telephone Email address D Demolition 5.2 Riekistered Home I provement Contractor(HIC) / y2 !8 D2 O /23M1I 1q,N a 14O wte- / O ' /k HIC Registration Number Ex atio/n Date H Cgany e:r HIC Registrant N t S'elliNp,�p Street Alee Liii if ?j'Oe c/ Email address City/To wn, tate,ZIP /" d OTeelephone 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 t� No . 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDIING PERMIT �Pi� L/—I,as Owner of the subject property,hereby authorize ON 7/lq 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 penaltie : l er' i that all of the information contained in this application is true and accurate to the best of my ,,wleddge .67 understandin.. r' r t['u-� C ! I' 0V /22, y ! Print Owl!�r Authorize gent's Name(Electronic Sig Date `OTES: / / i 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" The C'oavnnnonluea!th of Massachusetts Department of Industrial Accidents Congress Street.Suite 100 Boston, MA 02114-2017 � wrw,iw.rass.gollidia 11uniters'Compensation Insurance Aflidat,it:BuildersiC"onlracton lleetricia IslPluinherm. TO BE FILED►%I II 'IIIE:l'E:RaIIrrLNt::%t l'HO l fl Applicant Information Please Print "hair Name Iliusltacss Organization inapt,Adualr__ e /-1Ua""'C I Q(/ I . e Address: 3 .7S G(A4 el e¢_ City/State/Zip: & e �€ l `v Phtmc : 4/(2 &'i _ye 2 Are Asa an rntipWnre." •I ark the appruircuge has: Ti pe of project(required): 1. I ant a employer with 3 employees(foil andarr p ut-titre l_' 7. New construction . I am a sok pnrprictax or purtncrship and lune no etsploy'crs wa,rkita (or NEW ire S. Q Retnoddling any capacity_[Nu workers'comp.i_surancs n.quiredi 9. Demolition 3.1::]I am a 11.4.1nr.wwnt tluimg all work in►a lf.1No wawkarx`comp_insurance 4.0 I an..a lwnreaw stir and w ill be ht m contractors to conduct all wick on my property. 1 x ill I0Q Building addition ca�utc that all contractors tractors either hraic workers'coattperoatrot uuurancr arc sole 11.0 Electrical rlepiiti Or additions proprietors with no employees. 12.0 Plumbing tlepairs or additions 5.1=1 I ant a general contractor and I hone hired[hc sub-contractors listed un tic attaelheil sheet_ 1 (''�RODfrepairs These sub-contractors hate employees and frail:w rs urkc 'comp.uuurancc.: L_Je. 14. r /GYI vtO &El we area corporation aril its Wiliam hat c exercised their night of cm:mi'9ion per iw#iL c. 152.v l i 4l.anti we Itate no employees.[No w utters comp.insurance retina al.j t 'Any applicant that checks boa 41 must also till out the section below slow imp their wurkurs compeosativa policy information. a Homeowners who submit this at foul it itdicating they are doing all work and then hire outside casntracton must submit a new aii.alati i6 indicating xtr.h. :C'untracturs that check this box must attached an additional sheet show ant;the mirk:of the sub-contractors anal:state N Ite1hins s.r not those.7,tiGes llata mpluyecs. It the sub-contracturs Irate nnpluytxs.they mom plot idcMew workers"coop.policy number_ f um on a ntployer that is providing workers'contpensotion insurance for any eml loyer& Below is the policy and job site inftirrmotion. Insurance Company Name: A' Wt.Q f Cam! l A sCr1t € etc)''"t ey ^/ e 22 G2 O722.na Po11a.y #or Self-ms.Lie.#: C� � � o � r� 7 /V �3 / Expiration Date: J / J6° Ma; kod! '� : N 14 M� Job Site Address: City��'StateFZip O Attach a copy of the workers'compensation policy declaration page(showing the policy number and expire on date). Failure to secure coverage as required under MGL e•. 152,*25A is a criminal violation punishable by a fine up to 51 50(I_00 and/or one-year imprisonment,as well as civil penalties in the foam of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA fire insurance coverage verification. I de hereby certify u th s the information provided above is true and rrect. Signature: Date: 0‘-//0 V Phone t: 11(3 3 3g 92 (.1 j"j"teazel ate only_ Do not write in Mil,area. to be completed by city or town official City or loon: PerntiliLicense#.i Issuing.authority (circle one): I. Board of health 2. Building Department 3.C'ity4own Clerk 4.Electrical Inspector 5. Pluothinri Inspector 6.Other Contact Person: Phone#: City of Northampton ,4 ,. Massachusetts $ *� ct� j�, I i fit-_ w \' 4 L. $..t * DEPARTMENT OF BUILDING INSPECTIONS j;; ,� 'w FT1f0 212 Main Street • Municipal Building yJti Cam yi Northampton, MA 01060 S1'N,y 3,'DN'l CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: g7C �a� W s i dr k e Ai( 4 Location of Facility: The debris will be transported by: Coe ,fie // , �e I--wr Name of Hauler: vac s Signature of Applican • Date: W.°77-/.2. ____ 0Z-Z, Faigre/nwrizemeaYo/ Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration .-— Type: Corporation , yr>A.` _ Registration: 154218 ALLIANCE HOME IMPROVEMENT,INC E IY Expiration: 02/90/202$ 375 CHICOPEE ST CHICOPEE,MA 01013 •�* '=: �--! efu Update Address and Return Card. SCA 1 0 9IM4W17 Office of ConaumerAffairs!I,®ueinc ss itegulet!on HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Saglidoggn t Office of Consumer Affairs and Business Regulation 1COO Washington Street-Suite 710,... ALLIANCE HOME IMPROVEMENT,INC l'oston,A 021 SERGIY SUPRUNCHUK 375 CHICOPEE ST Commonwealth of Massafau liV Division of Professional Ltc.mas:ara Board of Building s aaci 8ilandec pis Cons • ` t CS-104327 4, E t iy° h:'I 1,2012,020 SEROIV SUPRUNCIIUK SO LEWIS RD i. WESTFIELD MA 01,, Commissioner r'fkli& ® DATE(MM/OD/YY 22 �"( REP CERTIFICATE OF LIABILITY INSURANCE YY) 03r02/2N 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 REF RESENTATIVE 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 i. certificate holder in lieu of such endorsement(s). CONTACT David Jarry PRODUCER NAME: Neill&Neill Insurance Agency Inc PHONE 413-732-4137 FAX 413-731-6629 662 Riverdale Street (A/C.No.Est): (NC,No): West Springfield,MA 01089 E-MAIL ADDRESS: dj@neillins.com . INSURER(S)AFFORDING COVERAGE NAIL* _ INSURER A: State Auto Insurance Companies STA INSURED Alliance Home Improvement, Inc INSURER B: SAFETY INSURANCE COMPANY 39454 Sergiy Suprunchuk I 375 Chicopee Street INSURER c: Ace American Insurance Company 12165 Chicopee, MA 01013 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: f MI IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD II4DICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS f 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( TYPE OF INSURANCE 71 IYDDL SUBR POLICY EFF POLICY EXP LIMITS 'LTR , INSR,WVD, POLICY NUMBER IMM/DD/YYYY) (MMIDDYYY) - A GENERAL LIABILITY PBP2689283 03/12/2022 03/12/2023 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 POLICY JP I LOC $ B AU roMOBILE LIABILITY 6226463 12/04/2021 12/04/2022 COMBINED SINGLE LIMIT 1,000,000 ( (Ea accident) $ _ ANY AUTO BODILY INJURY(Per person) $ ,,,,, . ALL OWNED / SCHEDULED AUTOS BODILY INJURY(Per accident) $ 1 AUTOS Y NON-OWNED PROPERTY DAMAGE �V HIRED AUTOS AUTOS (Per accident) $ $ UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ i'—" L EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEO RETENTION$ _ $ C WORKERS COMPENSATION 6S62UB-4N622734 12/05/2021 12/05/2022 WC STATU- OTH- ! AN')EMPLOYERS'LIABILITY TORY LIMITS ER ' ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED'? Y N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • • • DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CEF TIF,CATE IS FOR PROOF OF INSURANCE PURPOSES ONLY •.ERTIFICATE 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 /,w (j AUTHORIZED REPRESENTATIVE a ! . a r. I ©1988-2010 ACORD COR ORATION. ights reserved. r ACCORD 25(2010/05) The ACORD name and logo are registered marks of ACORD dome �,�b All home improvement contractors and subcontractors engaged in VIVO home improvement contracting, unless specifically exempt from s registration by Provisions of Chapter 142A of the general laws. �� 0 "�' must be registered with the Commonwealth of Massachusetts. µ Inquiries about registration and status should be made to the �fi o �� fa v /I/49 Director. Home Improvement Contract Registration, One \\ Ashburton Place,Room 1301,Boston,MA 02108(617)727-8598 375 Chicopee St. T \ IChicopee,MA 01013 • � • Phones: 413 883-3802 9 , Fax:(413)331-4358 '(413)331-4357 Ou can pay more,but you can't buy be en I MAALic#154218 CT Lic#0635847 www.AllianceHomelnc.com /// h0 (.IYIIGI, /� 9/ S?r MITT D TO: I t;/ G r/ MOOS Pho e: �3� tj29 Cell: Itry�iv(� ` `� ShaI(La rr✓// r ,�( Ql - 4 L S , Email: P4J uci f '73/o /e H� �! 'CO/14 We hereby submit specifications and estimates for work to be performed and materials to be used: At / �/' 111M �, �/ /�a[r .1i/� I r.�%' t I Or iffil1' riR'1 tat gL ' ,u1.ffeMiELIE&LI_Erl ti w "ArI �rL�11�fu.�►�Ti �.�_ . i � ., ^� ll�' 60( Art' (A 1( I' 1MV1s , pf J hp 0AO • . wry-44m 1A W - a-Lot do gegt-1- I/4.a WORK SCHEDULE Proiyo(led Start�r Compl•tl� he ule-The following schedule will be adhered to unless circ stances freed the c ac ontrol arise: 61� / �, / V�i' Date when contractor will begin contracted work. / J / Date when contracted work will be substantially completed. Contracted work may not begin ntil both parties have received a fully executed copy of the contract,and the three day rescission period has expired.The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including,but not limited to strikes,Acts of God,shortages of materials,accidents,and all other delays beyond its control,shall not be considered as violations of chi Agreement. WARRANTY All materials have D Warranty or as otherwise specified by manufacturer.Labor and workmanship have a warranty of one full year from the date of installation. All work to be completed in a workmanlike manner according to standard practices ny alteration or deviation from the above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. /�� ,�/ PAYMENTS iiI/ PL/(n ) We propose hereby to furnish materl nd I bor om le 'n accorda a with Payments to be made as folio `l• �,. vVv r__ +(//]r��/ ov ecifi do II.. um o• /?`,N_T—/ %($ -•S ^/ u on signing Contract; dollars �O %($ �I el?.' )upon delivery of materials; �� //D�� %(5 �-/r 1(or/�(j//')'(upon job completion; Name of Salesman dee t L// %($ �_ v)shall be made forthwith upon cdmpYetion work u er this contract. Authorized Signature The customer hereby understands and agrees to pay finance charge of 1.5%per month(or annual percentage rate of 18%)on the outstanding balance n paid with 30 d er completion of work.All payments received after 30 days after completion of work shall be applied first to unpaid finance charges and then to outstanding balances.In the event of default,customer hereby understands and agrees to pay,in addition to the outstanding indebtedness,all costs associated with collection including reasonable attorney's fees. Acceptance of Proposal:I have read both sides of this document and accept the prices,specification and conditions stated.I understand that upon signing,this proposal becomes a binding contract.You are authorized to do work as specified.Payments will be made as outlined above.You,the Buyer,may cancel this transaction at any ti prior to midnight of the 3rd business day after the date of this transaction.Cancellation must be done in writing. D OT SIGN TH CONTRACT IF THERE ARE ANY BLANK SPACES. Sign 1 Date / / a2? _ Signature /....€4../4. ki. ?" z/?/a NOTICE OF CANCELLATION:YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE.IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED.TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM TO:ALLIANCE HOME IMPROVEMENT,INC.,375 CHICOPEE ST.,CHICOPEE,MA 01013 (Date.Sunday and holidays excluded) I HEREBY CANCEL THIS TRANSACTION (Buyers Signature)