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38B-088 (4)
BP-2023-0461 45 LYMAN RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38B-088-001 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-2023-0461 PERMISSION IS HEREBY GRANTED TO: Project# SIDING 2023 Contractor: License: ALLIANCE HOME IMPROVEMENT Est. Cost: 28787 INC 104327 Const.Class: Exp.Date: 11/29/2023 Use Group: Owner: BANKS GISH,JANE &KRISTOPHER Lot Size (sq.ft.) Zoning: URB Applicant: ALLIANCE HOME IMPROVEMENT INC Applicant Address Phone: Insurance: 375 CHICOPEE ST (413)883-3802 6S62UB-4N622734 CHICOPEE,MA 01013 ISSUED ON: 04/18/2023 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: 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: ( (� . l • • ,r y(SO Fees Paid: S60.00 212 Main Street,Phone(413)587-1240,Fax! (413)587-1272 Office of the Building Commissioner CEIVED I ¢ , 1 APR 1 R 2023 The Commonwealth of Massachusetts FOR ,.I° I Board of Building Regulations and Standards ----- T.OF sun n�No tNS I�IPALITY ��J; Massachusetts State Building Code, 780 CMR° ��,nF,THa�*�•.�;�.;.+n^.^ -USE l : Building Permit Application To Construct,Repair,Renovate r Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only I Building Permit Number: 6P•p?T yCi/ Date A plied: ,I�L�.lu t/ lac , Li'le"ZO Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1` �1 Property ill v J 1.2 Assessors Map&',Parcel Numbers 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; J CO1 e al 6 AriltatAA.H611A , 1-/A? 0l o6 a Name(Print City,State,ZIP kc I LI1/14A-vl ed 6CM 3°13'1® 03 „khPrp/s4/ calo). cog, No.and Street/ Telephone Email d ess 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 dOther lVSpecify: Brief Description of Proposed Work2: I ns foi I t -3 ►G 'f. ;rickI oil over— �Titia. Gl 600u4S H;& {-rah' soil 3-f"i i ,Vi yeottwh;1- cohie.r5 �° SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 0 T�4 1. Building Permit Fee: $ I Indicate how fee is determined: ❑Standard City/Town Ap lication Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ ee Suppression) Total •All Fe�e f: $� �, Check No.7 Check Amount: Cash Amount: 6.Total Project Cost: $ ��i 7f 7 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICS 5.1 Construction Supervisor License(CSL) ✓✓QQ— 9/ 2 y� , (fie�(h L'LLG{I. �cense Numb Expir 'onate�7 Name of CSL.Herder / jW,S C/vacc ee / List CSL Type see below) 1 i No.and Street Type Description C'L`' ' ee A Q( /3 U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,Sta ZIP / R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding ' / SF Solid Fuel Burning Appliances 103 /193 3FD.2 S'el�6D 4;l//'a c'' /LO4f se!{4e I Insulation Telephone Email address t!( j D Demolition 5.2 Registered////-- Home Improvement Contractor(HIC) ?,6-tro2/� �� 17L/�fnkti /ur€ ik./.71 VP � 71 HIC [R'jlegistration Number xp' ion Date HIC Company Npme or HIC Registr t ame No.and&met �O 3��Z Email address f'� , /.///7 D/O/3 W3 O City/Town,State,qIP Telephone i 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 V No ❑ 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"' CO VI +a es/- 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 belo. eby attest under the pains and penalties of perjury that all of the information contain- ' P this a.: ,: l" e and accurate to the best of my knowledge and understanding. , � 0Li7/V/ 23 Pri 4 ' s .i'Authori.id Agent's Name(Electronic Signature) Date NOTES: 1. An t. er w r s 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(WC)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,finish d basement/attics,decks or porch) Gross living area(sq. ft.) Habitable ro4m 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" 4% ,., The Contmoniveahh of Massachusetts :,.\ Department of 1nthtstrial Accidents 1 CongresA Street,Suite 100 Bo.ston, I1.-102114-2017 www.mass.gov/dia - `1. .. "' % lOi ker. ('onipe!ISA(ion Insurance,,tflitla%it:Buiklersitontradon/Electrichum/Planaben. i ti U . i it.ED N%I I II I ttE r) usim ING AUTHORITY. Appliesal lo for 1111141l100 Please Print Legiblv r 1/3 Name IL ' ' . I ., '.'.'-,,,: '. , ). A (/'ci,t tei /./t)a,,,. , reecfrrii,442ver Address: 3.7-g- !co e ' CityiState"Zip- ()/zilc/t ( r"(19 av/5 phone#: c,« gy3 . 8O9Z A„ tiLi An cruplut tr..t bra the appropriate but: Type of project(umpired): I 26iien a asploye widi 3 employees(thl*sedior pert-tines)-• 7. CI New constructioe 20 lam•ink proprietor or paitnership aed have so employees working for me ia it. 0 Remodeling in rapacity.No workers'crag.11111111211Cit reepled.1 9. 0 Demolitioo 3.1:1 I am a homeowner&rig all work myself.No workers'comp.aseniece required]' 4.0 I 0 El Building addition I am a homeowner mid will be hiring contractors to conduct all work on ray property. 1 era mane the all collars:tors elder have workers'coamemation ineenace or ore role I l.C3 Electrical repairs or additions proprietors with no employee& 12.0 Plumbing repairs or additions SO l ani a peers'contractor mid I have hued dee sids-comractors heed no dot seethed sheet 13E3 Roof repairs / Them els-comaciees have amplores led have warless'camp.immemicat ILO We are a comoration and its officers have exercised Mari right of exemption per IIKIL c_ 14.00ther SiO(/V I 152.;IOW aid me hove so employee&No worliess'comp.imarsece renamed.) 'Any apphane that checks boa al sant aho fill not the section below showing their wadies'compmeation policy inforautios. *Haeriovrams who rebate der affidavit itificating dray are doing all work sod&se hire outside comractors at submit a new affidnvit zing' tech SColorecton that check the box mum attached so additional sheet showing the sank of the stibmiosamors red an whether re not those amities have employees Ude sub-contractoni lase amployeea.day OM pain Or their 'A ork L'rl.1.1 mir rulicyoomber I WM on employer dust it providing workers'compensation insurance for my euiptusee.c Below is the polio.and nth site information. I,- il 7 r,7 Insunmce Company Name: 7) (..-i)t..-- Niki..aft.64,1„/ gaccfr-ezilet (-14-141-1/a2/p, Policy#oe Seif-iim Lac.#: 6,9Asoq0 g z// 62„2-73 -t( Expiration Dote: /2/ 5/„Z,? Job Site Address: /5 Z,vipleiti I i /1/0,44(1‘,00)t-ICity/StatelZip: /1-7/19 0(et50 m Attach a copy of the workers'kipeimation policy des-Laredo.pa (showing(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,*25A lea criminal violation punishable by a tine up to S1,500.00 andior one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and•fine of up to$250.00 a day spinet the violator.A copy of this statement may be forwarded to the Office of Investiiptions of the DIA for insurance coverage verification. f do hereby eerie . of perjury'hut the int. pookled above k tree and correct s3,...Thiture: Date: Official use unit-. Do not write in this area,to he completed by Cif I'or town official ( it or I pen: Permit/License t „ Issuing Authority leirele one): I. Board of Health 2. Building Department 3.CO jun n Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other ('ontact Person: Phone 4: _ City of Northampton /boa'£ s Massachusetts !c DEPARTMENT OF BUILDING INSPECTIONS �? 212 Main Street fa Municipal Building y0ti.. aC. Northampton, MA 01060 rskki two.�Q 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: C Ye—//C1 Cb/S 0.fr( 6 cf)4 /tia.,/h WO ( 01—e 1-//' The debris will be transported by: Name of Hauler: ri9S&//i 3l40I Signature of Applicant: Date: THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Imfro e e t C. tractor Registration ('11Z Type: Corporation w __ Registration: 154218 ALLIANCE HOME IMPROVEMENT, INC Expiration: 02119/2025 375 CHICOPEE ST CHICOPEE, MA 01013 L* .•; 414 Update Address and Return Card. IE COMMONWEALTH OF MASSACHUSETTS Of;: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 \LLIANCE HOME IMPROVEMENT,INC I it- IERGIY SUPRUNCHUK QW,;•r . .75 CHICOPEE ST g✓� GL `O� 'i�%gles•k :HICOPEE,MA 01013 Undersecretary Not /lid thout signature Comm Qt Wissailtusatts Board of Building Regulations Standards daps `r')meta [apt Super/lam CS-104327 Expires:11/29/2023 SERGIY SU I P so LEWIS V I WESTFIELD ;' .;Clibf Commissioner .. A�RD CERTIFICATE OF LIABILITY INSURANCE DA02/16/2023 ) 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 David Jarry Neill&Neill Insurance Agency Inc PHONE 413-732-4137 FAX 413-731-6629 662 Riverdale Street lac.No.Exty (NC,No): West Springfield, MA 01089 E-MAIL dj@neillandneill.com INSURER(S)AFFORDING COVERAGE NAIC S INSURERA: State Auto Insurance Companies STA INSURED Alliance Home Improvement, Inc. INSURER B: Safety Insurance Company 39454 Sergiy Suprunchuk INSURER C: Ace American Insurance Company 12165 375 Chicopee Street Chicopee,MA 01013 INSURERD: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE NSD WVD POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) LIMITS A V COMMERCIAL GENERAL LIABILITY PBP2689283 03/12/2023 ..03/12/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED l CLAIMS-MADE V OCCUR PREMISES(Ea occurrence) $ 100 000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- 2,000,000 V POLICY L____I JECT LOC PRODUCTS-COMP/OP AGG S 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 $ V AUTOS ONLY V AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION 6S62UB-4N62273-4 12/05/2022 12/05/2023 , PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Home Improvement Contractor CERTIFICATE HOLDER CANCELLATION Sergiy Suprunchuk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 375 Chicopee Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Chicopee, MA 01013 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J ba...aR ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 4/12/23,3:14 PM 20230411_180700.jpg $t)0{l)P All holm'unpruv marl contractors and subcontractors engaged in pCobelfl� home improve •nt contracting,unless specifically exempt from Alinregistration by rovisions of Chapter 142A of the general laws, 1 V�� O�ru�� must be regiute ed with the Commonwealth of dehto ths. e J `1 Inquiries about eglstratlon and status should be made to the Director, Home, Improvement Contract Registration, One / Ashburton Place,Room 1301,Boston,MA 02100(617)727.0598 wwww.rrwrWt�n.w«re.wr ��/r,, • 8 \ S Chicopee St / , /A ilcopee,MA 01013 a r7 '1 1 1t .511 e ones (413)883 3802 lqt - ff MA Ucg154218 CT Lid/0635847 13)331-4357 you c pity more,but you can't hLsy b® t iX:(413)331.4358 ww,AilianceHomelnc.com �f' K� 9 02o3 Cell: �n,a/G7 3 I SUBMITTED TO J« G ��S Phone: G .3� re &.iCQ/ ay .• Email: � 1C clsh I hereby submit specs' ations and estimates for work to be performed and materials to be used: 'Amax' t71r,i1�air- % e • -- r ire • mc -, ,, dra� 8 PORK SCHEDULE Start le-The following schedule will be adhered to unless cir bncez yond t ^ ors control arise / Date when contractor we begin contracted work. / i I -J, Date when contracted work set MMMt 0001P completed. nit red work y—not n until 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 scneduling date•, e 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 at other delays beyond Its cOntrd,shall not be 'maimed as violations of this Agreement, JARRANTY I materials have Warranty or as otherwise specifiedby manufacturer.Labor and workmanship have a warranty of one full year from the date of insutlation. I work to be completed in a workmanlike manner according to standard practices.Any iteration or deviation from the above specifications invofmg extra costs w,N be exacsted only upon writer orders,and will icome an extra charge over and above the estimate. AYMENTS We propose hereby to furnish material and la -complete in ac orda with syments to be made as follows; above specific ion fo t�hee tre of .._ - y$ a 1 upon signing Contract; ♦}c LLa/kVl/� „�' dollars kso n delivery of matenah; ($42 :� 4� INS lobcompletiorc Name of Salesman_ 14:i yH$, shall be made forthwith upon ' imp etion work under this contract. Authorized Signature he customer hereby understands and agrees to pay finance charge of 15%per month tor annual percentage rate of 18%)on the outstanding balance n 30 days after completion of work.AP payments • %eided after 30 days after completion of work shah be applied first to unpaid finance charges and then to outstanding balances.In the tent of defa • er hereby understands and agrees to pay,in addition to the utstanding indebtedness,all costs associated with collection mclding reasonable attornly's fees. cceptance 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 ate authorized to o work as specified.Payments will be made as outlined above.You,the Buyer,may cancel this transaction at any time 'r to m the 3rd business day after the date of this transaction.Cancellation must be done n writing,DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature , Date k t-3 Signature Date ital. 23 • NOTICE OF NCEL TION:YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENA OR OBLIGATI ,WITHIN THREE BUSINESS DAYS FROM THE MOVE DATE.tf YOU CANCEL.ANY PROPERTY PAGED IN,ANY P 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 CHKOIEE St,CHICOPEE,MA 01013 ........_. ._._...._-______(Date.Sunday and holidays excluded) I HERESY CANCEL THIS TRANSACTION _ _ ___,_tourers*nature) • • https://mail.google.com/mail/u/0/#search/keithe/b40alliencehomeinc.net/FMfcgzGsltTpflQFMrQPLrrvXrCbxRph?projector=1&messagePartld=0.1 1/1