17A-072 MAY 62011"
INSULATION
&
SIDING CO., INC.
EASTHAMPTON OFFICE 413- 527 -0041 CSL License #CS SL 99739 WESTFIELD OFFICE 413 -565 -641 1
56 FRANKLIN STREET • EASTHAMPTON, MASSACHUSETTS 01027 • FAX: 413- 527 -1222
Proposal Submitted to Phone Date
Ron & Donna Adams "Purchaser" 413 - 584 -7877 Home April 26, 2011
Street Job Name
21 Mountain Street 413 - 584 -4252 Work
City, State and Zip Code Job Location Job Phone
Florence, MA 01062
Contractor hereby submits to Purchaser specifications and estimates for : INSTALLATION OF A NEW ROOF
MAIN HOUSE
1 We will remove (2) lavers of existing shingles, and dispose of in a dim er stj,nnlied by us
2. We will install # 15 felt Qaper over entire sWpped rnof surface.
3 We will install new Architect shingles. They will have a "Manufa ur is 0 -Year Guarantee". Owner will have hoi of color.
4. All shing)es will be nailed with at leas (5 ) nail ershingle
5 We will install new aluminum drip edge on all ev s and new aluminum rake edge on rake areas,
6. We will install annroxima ly (30)' of roll vent on peak of roof for additional ventilation.
7. We Will r nstall a 36" wide asphalt ice and water barrier on eye lines,
* ANY SUB SHEATHING IS NEEDED. THERE WILL BE AN ADDITIONAL CHARGE OF $38 PER SHEETTO REMOVE.
-_ DISPOSE OF, AND INSTALL NEW 7 1/16 STRAND BOARD SUB SHEATHING.
`*
HOMEOWNER WILL BE RESPONSIBLE FOR COVERING ANY STORED ITEMS AND FOR ANY CLEANUP WORK IN TH ATTIC
NEEDED FROM DUST & DEBRIS FROM ROOF REMOVAL-
PRICEa $4.983,00
NOTE: ApUroximate start date will be W . 4y or June less any inclement weather.
*'
ALL STAR IS NOT RESPONSIBLE FOR ANY LEAKS THAT OQCUR IN EXISTING SKYLIGHTS OF APPLICABLE)
N3 PRODUCT & LA 0R WAR - WiD BE ISSUED l TIL WE Rr'C`r1VFFIN PAYMENT
**
HOMEOWNER WILL RE RESPONSIBLE FOR ANY FEES REQUIRED FOR BUILDING PERMITS
** A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY ITY WILL BE FORWARD D UPON REQUEST,
* * T.P. DALEY INSURANCE AGENCY OF WEST SPRINGFIELD, MA IS OUR AGENT,
WE PROPOSE to furnish material and labor, complete in accordance with above specifications, for the sum of:
$4,983.00 _ dollars ($ 50% Down Balance Due Upon due u
- - - - - ...... - ----- - - .....- - - -------- - - - - - -- - -- - ----------- - - -- -- ------ P--- - - - - -- - ------ ), payment pon 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NOTE: This proposal may be withdrawn by us if not accepted within _ - -_ THIRTY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, Owner
Contractor Salesman
-- - - - - -- - - - -- -- . - - -- -- - - - - - -- -- - - -- -- ,!: . -
-- - -- - -- - - - -- --
Ron & Donna Adams 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 CONDITIONS PRINTED ON REVERSE SIDE
4 TtV�Mp TO � _
$ � �iTdassac3�usetfa -
�-, DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR '212 Main. Street • Municipal Building '
Northampton, MA 01060 '
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as Ills /her construction swp(:: - -isor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he /she resides or intends to be, a one or trvo fanu -
dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two -year period shall not be considered a
home owner."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and eegulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation /footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
L understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
r
f •
¢� tw f pT _
4 -• E ��cnakc}lnnclf e"
DEpAR 1 MENT OP BUILDr>\G INSPECTIONS
:Q —
212 Alain Street 1\Tunicipcd Duildirtg
Northampt.on, ATass. 01000
Wo RICE 1Z'S COIYMENSA`XIOI`I MSURA -NCF: Al= e1VIT
I, All Star Insulati & Sid ing Co., Inc.
0i ccvsxlpcnni ttrx )
% a principal place of business/resldence it:
56 Franklin Stree - Easthawton, MA 01027 (ph one =) 413 -527 -0044
— (st»tici tr /sta l 1 2D' P)
do hereby certify, under (he pa and penalties of perjury, il] =l
( I am an employer providing the followinS' %vorkcr's comocnsn Op cove sc for my
elupiovccs wori.Jag on tills job:
i
(Insiar� Conn: Crclic: Nt ter) :*trtior, Dar-)
I -
i
O I am a sole propr,ecor, general coo=aor or homeowner (curie one) aid live hired
the c000 listed below wbo have the F60oW'Mg worker's c00pen_"P_Don peGcies:
i
j 0"iamc Of Conn: -aao') Gn_n_ 3nc'. CoIno3n) lho6c, >�ttl�'1 =�;) fY>:i)IidL•oR Dlic)
j (Na of Conc (In
oor) surance Comoanw?olic; tiunisr) � »u trop Die)
-mc
(Name of COa[r2C O) (Laurance Comp-ao) fPolic} Numbjr) (&�ptruon Da tc )
(Namc of Contraclor) (insurance ComGacyfPoticy Numbcf) (E - pir Da1c) .
(aasc3 �'=i Oc=d d Z, irnca _-y to c> v4c informAjoa pc-taini to .11 ooar-_Clnn) .
( ) I am -a sole pr-opnetor and bave no ooe working for me.
( ) I am..a home owner perfonTn-ing all the work, myself.
NOTE: pl=_c be -w-aux dfi u•bo C=Ploy P's' a= to Qi ao c reair + Cti- oa c d11_j: of
ON twee lace i}7uc u—j is u the tv,dl a ea the the -••n LT we ccr) _iy ac-c-_rd= to roc
calploy u C the waia� = - --' oa An (GL'152sa 1(5)� zjvU= 6cn by n bca as O� fcr c bcc_ « pc cart 2y e' tdyoc the
e-3
legs] rl =u of c ploy,, nnd<r duo wo(+[ 'c cocr op ioa. A,&-
[ undc�twd tha : oopy of thv macma� m. be for�nrded to tbo Dopa�timcod arinduYaicl Accidarti �ioe of tna+�`n°O roc the
coverx c vmLatioa and that Utac to sccurc'cvvcrnse under soe oc 25A of 1,10L 152 m Icd to the i=P=iioo cfimiO l PC°�w°
oomi oCa Goe orup to S1_�00.00 °for mmFaiso� orup to ooe e.D d a%il p tia in tx form Of Slop Work Ord— nzd
f = O( :S 100.00 t day t9daa Cr_
For dcq'rta'= -?) u,c only -
Pcrm)t ttttmbcs
".� M_3p�
Si n Lia�scclPcrrniucL
e J
SECTION 8 -CONSTRUCTION SERVICES 71
8.1 Licensed Construction Supervisor Not Applicable ❑
Name of License Holder : EM n Losacano CS SL 99739
License Number
128 Glendale Road - Southarrpton, MA 01073 _� 1
Addrs Expiration Date
(413) 527 -0044
S l i ' J ' natW Telephone
9- Registere Homelmyrovement�Confaclor• Not Applicable ❑
Al l Star Insulation & Siding` Co., Inc.
Company Name Registration Rum er – —
56 Franklin Street (r;2.\ ('Z
Address Expiration Date
Eastharlpton, MA 01027 Telephone 413-527-0044
SECTION 10 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...... ❑
11. _� �olmte- ���v�er� Eg�mptzoii
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
r
SECTION 5- DESCRIPTION OF, PROPOSED w.ORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing
Or Doors
Accessory Bldg. U Demolition ❑ New Signs [m] Decks [0 Siding [0] Other [❑]
Brief Des�(lptio� e t ^ —
I i
Work: \'{ l i �1� (�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a t6_K1 6iMnc [iousing,..cbrr pletethe- o`tforncinci:
a. Use of building: One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
L Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION.- TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES; FOR BuiCDfNG'PERMIT
as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, All Star Insulation & Siding Co Inc as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury. '
E d
Print Name,, _
Signature of Date
Section 4. ZONING All Informat16h Must Be Completed. Permit Can Be Denied Due To Incomplete Informs ion
Existing Proposed Required by Zoning
This column to be fille by t 'A
Building Department
Lot Size
Frontage I 1 —�
Setbacks Front
i
Side L: I R. `:._—' L= R: —`
I --
Rear
Building Height
Bldg. Square Footage i % f
Open Space Footage %
(Lot area minus bldg & paved
p arkin g).
# of Parking Spaces — ---
Fill: � - -- -- - - -_ _.. — ��__-- - - - - -- --
(volume & Location) -- -
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DON'T KNOW 0 YES 0
IF YES, date issued:!
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW Q YES I
IF YES: enter Book ( Page; and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES Q NO 0
IF YES, describe size, type and location: 1
D. Are there any proposed changes to or additions of signs intended for the property ? YES NO Q
IF YES, describe size, type and location: i
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0- NO Q
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
City of Nortfaampton
Building Department _ 0�
212 Main Street =R v-
r
Room 100
orthampton; MA 01060 TwSets�o S ura r
dF one 413 -587 -1240 Fax 413 -587 -1272 an
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address This section to be completed byoffice
� Q� Map� Lot Unit
1 �JQ �� t • ° l J `
Zone Overlay D�strrct , r
EI►tSf Distract GB Distric _
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) CiArre nt Mailing Addr ss:
Telephone
Signature
2.2 Authorized Agent:
All Star Insulation & Siding Co., Inc. 56 Franklin Street - Easthampton, MA 01027
Name (Pri ) r Current Mailing Address:
LL &� �11-------� 413 - 527 - 0044
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
- Construction from 6
3. Plumbing Building Permit Fee-
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 +4+5) Check Number
This Section For Official Use Onl
Date ,
Building Permit Number. Issued:
Signature:
Building .Commissioner /Inspector of Buildings Date
21 MOUNTAIN ST e BP- 2011 -0932
GIs #: COMMONWEALTH OF MASSACHUSETTS
Ma :Bloc 17A - 072 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cate roofing BUILDING PERMIT
Permit # BP- 2011 -0932
Project # JS- 2011- 001515
Est. Cost: $4983.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sq. ft.): 11020.68 Owner: ADAMS RONALD S & DONNA C
Zoning: URA (I 00)//RI/WSP Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 21 MOUNTAIN ST
Applicant Address: Phone: Insurance:
56 Franklin Street 413 527 -0044 Workers Compensation
EASTHAMPTONMA01027 ISSUED ON :511212011 0:00:00
TO PERFORM THE FOLLOWING WORK.- & SHINGLE ROOF
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.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 5/12/20110:00 :00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner