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17C-058 (9) BP-2023-0371 190 CHESTNUT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-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-2023-0371 PERMISSION IS HEREBY GRA ED TO: Project# SIDING 2023 Contractor: Licens : ALLIANCE HOME IMPROVEMENT Est. Cost: 25155 INC 104327 Const.Class: Exp.Date: 11/29/2023 Use Group: Owner: WHITTIER SARAH JANE Lot Size (sq.ft.) Zoning: URA Applicant: ALLIANCE HOME IMPROVEMENT INC Applicant Address Phone: Insurance: 375 CHICOPEE ST (413)883-3802 6562UB-4N622734 CHICOPEE,MA 01013 ISSUED ON: 03/2712023 TO PERFORM THE FOLLOWING WORK: SIDING &GUTTERS 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner /- -- • The Commonwealth of Massachusetts \�- � �, i. c, Board of Building Regulations and Standards *A6 FOR Massachusetts State Building Code, 780 CMR u 90 MUNICIPALITY ,_y% USE Building Permit Application To Construct,Repair,Renovate orzt'iinolish a Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only BuildingPermit Number: ,P, (19.-3 7/ Date Applied: K`uri,-) /l<o•>s i/ - 3 Zy.20Z3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers Icro ckes-I-ht+ s+ Florence. Mk om. 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 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: Sarah /A;4-1-ter Florenc.P, , MA r 01062, Name(Print) City,State,ZIP '190 CI,2_5-htuJ Si- 4-1332.Q 8 722. sara1t3'1,4.117-1-+;er0 read.c.aN. 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. 0 Number of Units Other RI Specify: 5►ik ny& GCAtierS Brief Description of Proposed Work': Qepi oue, te1 5!—n.1� 'furylfn / 5 q o!/LJ 4ri r4. lnstaJ/ new Jain, M1Prs , IaVns(oQ ! 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 25 155 1. Building Permit Fee: $ Indicate how fee is determined: r 0 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Costa (Item 6)x multiplier x r . Plumping $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fels. / 6. Total Project Check No.�� ,'Check Amou Cash Amount: oleo Cost: $ 2.5/ 155 0 Paid in Full 0 Outstanding Balance Due: i tiL SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS'-- I04-3 2.7 I I/2.' /2023 Se r S rthchuk License Number Expiration Date Name of CSL Holder 3�5 C h j List CSL Type(see below) (A CCfeie, No.and Street Type Description C k`co AAA/ I /t / O 1 O''_ U Unrestricted(Buildings up toel 35,000 cu.ft.) City/Town,S{ate,ZIP' /Vlf'� R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 1-I 3 813"38 O2 S5I f/o GJIicelcz orvie nc.c I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement-{ Contractor(HIC) 'ST�I$ 0211112025 1I I j Oulu HO1 + .L. prove ttet f HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 576 Ch;co f€� Sr- 5enfy ot/hovu-e1tarhetic.conk No.and Street Email address C'.h i copeR t AAA 01013 4 f 3..FS3-3Ffo2 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 No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR AP LIES FOR BUILDLVG PERMIT 1,as Owner of the subject property,hereby authorize evo B v 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 h- eby attest under the pains and penalties of perjury that all of the information contained:. ts a.. . ,+on i e and accurate to the best of my knowledge and understanding. � O3l22 23 Print t A" u orized •. ent's Name(Electronic Signature) Date 1 NOTES: 1. An Owne. i o obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not regis ed 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"maybe substituted for"Total Project Cost" The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street.Suite 100 t. -� : Boston, IlA 02114-2017 WWW.mass.goiVdla Workers'C:onipen►ation Insurance Allidat it:Buildersl('ontractorslElectriciansiPlunthcrs. It)BE 1-11.1•:I)11I III I HE PERMITTING At THORITt. :applicant Information Please Print Lettihh Name 4Busin sx()rgantzalion I milt.idual►: 'iligtica ialtiz 1 4 ftOVeMejlf Address: 75 Ch t C.optL Jf City State,Zip:ChiCQf'e-ed/ MA/ QI013_ Phone#: �3 5 ' 3�2 pre tUtl an ern ploycrl'( btvk the appropriate box: Tape of project(required): ?.Nil am a cnrpluwts with 3 _employees Oa anitor part-tinr.l_' 7. CI New construction = I am a auk proprietor or partnership and have no employees working ton m:in B. 0 Remodeling any capacity [No wurkeri comp.insurance myai e!.J 10 I ant a humoownet doing all wink.myself.[No workers"comp_insurance mowed-I' 9. ❑ Demolition 10 0 Building addition +.Q I am a humruwna and will be hirutg commetors to conduct all work on my property_ I will ensure that all contractors citber hate workers"compensation insurance or are Yale I I.a Electrical repairs or additions prupncrore with uo employeca I2.1:Plumbing,repairs or told.ttion 3{ ■I am a Central contractor and I hale hired the sub-contractors listed on ibc attached sheet 1J,hex sub-contractors bate employees and hate worker'dump.insurance.: 130 Roof r�c+patr� h.Q We are a corporation and its utiiicers have exercised[heir nett of exemption per 11(at.c. 14.[Other S j'047.7 a G( 152.§If4).and we hate no employees.[No workers'comp.insurance required.' 'Any applicant that checks box c 1 roes alxr till out the section be luw show in their u urkcr,'compensation policy information t liorncutwncrs who submit this atlidatit utdacating they are do ing all work and then hueautside.contractors mnaat subnut a new al idat it indicting su:b. Cunt/actor,that check thin bur rnust attached an additiunaJ shut show ing[is:name of tic tub-cumtraclurs anti late w briber na not druse eniathcs butt employ eca, If the sub-cnnlractrrr.hat.:c-nprluyee's.they must prutidetheir tsorkers'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: ACE. Ar►'leri e.At i Co Policy#or Self-ins. Lie.#: 65 C 2.(A.f- 4-N G22.73—4 ' Expiration Date. I 2.,/,O 5/20.23 Job Site Address: NO d e frgF 5-1— CitylStateJZip:Florence!MA oto62, Attach a copy of the workers' compensation policy declaration page(showing the polic) number and expiration date). Failure to secure coverage as required under MGL e. 15 §25A is a criminal violation punishable by a litre up to 51 500.00 and'or one-year imprisonment.as well as civil penalties in the farm of a STOP WORK ORDER and a tine of up to 5250.00 a day against the triolatur_A copy of this statement may be forwarded to the Office of In%estigationn of the DIA for insurance coverage verification. -- I do hereby certify and the . an yes of perjury that the information provided above its t pre and co rect. Signature: Dale.: /9 J 2 2 2_3 Phone -: '9"1 —373 38 2 Official use only, Do not write in thin area,to be completed by city or town of ciaL h City or Town: Permit/License h INS uing A utltorit% (circle one): I. Board of Health 2.Building Department 3.C'ity(Tossn Clerk 4. Electrical Inspector 5. Plumbing Inspector (i.Other Contact Person: Phone 41 City of Northampton Sh1T •0, SS «... Si '�t Massachusetts DEPARTMENT OF BUILDING INSPECTIONS y, j 212 Main Street • Municipal Building vti. O Northampton, MA 01060 skn a'`^� 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: GM Main Sf / Holyoke, / MA The debris will be transported by: Name of Hauler: CdLS icri Signature of Applicant: Date: e' 22 2� u,r Q AC ® DATE(MM/DDIYYYI) �� CERTIFICATE OF LIABILITY INSURANCE 12/02/2022 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 DAVE JARRY Neill&Neill Insurance Agency Inc NAME: • 662 Riverdale Street (NC.N .Eat):ONE 413-732-4137 (NC,No):413-731-6629, West Springfield,MA01089 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: STATE AUTO INSURANCE COMPANIES STA INSURED Alliance Home Improvement,Inc. INSURERS: SAFETY IND INS CO 33616_ 375 Chicopee Street INSURER C: ACE AMERICAN CO I 12165 Chicopee, MA 01013 INSURER D. • 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 PERIOp 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. IUCY EXP LT R ADDL TYPE OF INSURANCE IN SD SWVD (MM/DDUBR Y/YYYY) (M EFF M/DD/YYYY) LTR POLICY NUMBER LIMITS - A JI COMMERCIAL GENERAL LIABILITY PBP2689283 03/12/2022 03/12/2023 EACH OCCURRENCE 1 $ 1,000,000 CLAIMS-MADE [Vi OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 ' _ GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 V POLICY ' OTHER: $ B AUTOMOBILE LIABILITY 6226463 12/04/2022 12/04/2023 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) __ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY V AUTOS - / HIRED NON-OWNED PROPERTY DAMAGE $ LY_ AUTOS ONLY V AUTOS ONLY (Per accident) $ • UMBRELLA LIAB OCCUR EACH OCCURRENCE $ -- EXCESS LIAR CLAIMS-MADE AGGREGATE $ -• DED RETENTION$ $ C WORKERS COMPENSATION 6S62UB-4N62273-4 12/05/2022 12/05/2023 V SPER TATUTE ER H AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1;900,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,900,b0� DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE IS FOR PROOF OF INSURANCE PURPOSES ONLY CERTIFICATE HOLDER CANCELLATION Sergiy Suprunchuk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFC,RE 375 Chicopee Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN' Chicopee, MA 01013 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0„.......„.4RA., ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) _ The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Im•ro en]ent Contractor Registration 1111111111U1111111111 4.# 1 Type: Corporation v �It a�1 Registration: 154218 ALLIANCE HOME IMPROVEMENT, INC Expiration: 02/19/2025 375 CHICOPEE ST CHICOPEE, MA 01013 '� _ :; -r ='t• Y Igor rr ...... .. %vim r Update Address and Return Card. iE COMMONWEALTH OF MASSACHUSETTS ,. :e of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 154218 02/19/2025 Boston,MA 02118 kLUANCE HOME IMPROVEMENT,INC`. - i iERGIY SUPRUNCHUK ,,�r ` ,.1 ��%/ / ,75 CHICOPEE ST 1i0/1 *4' iatsda.i;.zG4.k :HICOPEE,MA 01013 .'y, ��� Undersecretary Not 1 Ild thout signature ea11M of illmpmw gas Division of A+ofseeki el Lksrewre 110Board of Building and Standards Cans `lfss+�r e C8-104327 pires:11I291 � a SERGIY S 's'`' l BO LEWIS WESTFIELD 414 I.;', 4dir io Commissioner elfstja 1. Strati& 3/22/23,9:37 AM 20230320_160504.jpg All home Improvement contractors aril subcontract engaged m 1/kW �j TBbPfl(� home Improvement contracting unless specifluliy raempt from registration by Provisions of Chapter 142A of the general laws. 13ropo6411,..... must be registered with the Commonwealth of Meesachuwtb Inquiries about registration and status should he made to the Director Home Improvement Contract Registration, One Alliance�pg►g!Im�!/OVg u.... agg ..S.N, Ashburton Place,Room 1301,Boston,MA 02108(617)727-8548 rw..ar.•r rrweal.rtryw,ru w.r n.,.a. � ` ' 375 Chicopee St. //�0114 w{1`f / Chicopee,MA 0101 A e Phones (413)883-3802 • T• • '�YR•r^'ice (413)331-4357 you curl pay more,but you can't hUy bCt1CC MA Lic0154218 CT Uc#O6358q 7 Fax:14131331.4358 www.AlllanceHomelnc.com / f SUBMITTED TO:$ t IN IVII /1L. Phone: Cell �2-7v1� -- Nm f.G VMCI I ,l/1► _ Email: S We hereby submit specifications and estimates for work to be performed and materials to be used: - /w oaf L s .. a r / . •• IAA / Ar�� � oglEl ai t e ��V •■ •�G / �� _ , Visraillilir 1 IP Sp i G� trtNt � 4 —"tO h • lit/ t WORK SCHEDULE PrgPo�ad Sta detyn Schedule The folrowing schedule will be adhered to unless ure stancesXd the eigictor s control arise Nt/a / I)✓( Date when contractor will begin contracted wort. 4 / / 0)/S OWe when contracted work will be substantially completed. Cont cted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has e.pired the Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not inoidable by the Contractor Including,but not fended to strikes.Acts of God,shortages of materials,accidents,and all other delays beyond its control,shall not be considered as violations of this Agreement. WARRANTY /I All materials have I a Warranty oe as otherwise specified by manufacturer.Labor and workmanship have a warranty of one full rear from the date of mtahatron All work to be completed in a workmanlike manner according to standard practices Any alteration or deviation from the above specdcabons involving mire rosts will be eaeculyd only upon written orders,end Will become an extra charge over and above the estimate. ///tit PAYMENTSir 13 //` We propose hereby to furnish mazer al and labor complete in accordance wit Payments to be made as follows 1 r` T/T ff-- �T /_„,a' J aboovvvee wecrf aau�on/Jk�o�r¢a su}rm��'o� /O §lets e )upon SrgNng Contract: (/4— 'r' l V(/960 /O06?�` Tupon delivery of materials, 1$4,15 " I. zt5 / t 91"upon job comoletion, Name of Salesman A" v( ___ JO %IS r a )shall be made forthwith upon on work under this contract Authorized Signature The customer hereby understands and agrees to pay finance charge of 1.5%per month tor annual percentage rate of 1B%)on the outstanding balance wehin 30 days after 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 yeses.specificaton and conddions stated I understand that upon signing,this proposal becomes a boding 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 tone prior to midnight of the 3rd business day after the date of this transaction Cancellation must be done in writing, DO NOT /SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature/� Date 2i'2 4 Signature Date 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.,CHK:OPEE,MA 01013 (Date.Sunday and holidays excluded) I HEREBY CANCEL This TRANSACTION (Buyers Signature) - https:;mail.google.com/mail/u/0/#inbox/FMfcgzGsIbPRFDCtxIVXxTNntkkGnHxD?projector=l&messagePartld=0.4 1