17A-251 J/(
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56 FRANKLIN MASSACHUSETTS 01027
EASTHAMPTON OFFICE: WESTFIELD OFFICE: 568-6411
185/8_t
j� roposal SVbmitted to one dv1` 7"4L.a.i
r+V7 a'Don-AhY Shimel "Purchaser" 413-584-171 °H
Street Job Nome
114 Lake Stmt
City, state and Zip Cade Job location PAW 1 of 2 on (�
1 012,9
Contractor hereby submits to Purchoser specifications and estimates for; INSTALLATION U7 VINY- SIDING 1 Qa
1, We wi 11 r'a iye exi s•ti no rmsoni to si din, from extp.rior val 15 and di sDose of in chrmster gt4)Dl ipd
US.
2 We will �i netal 1 ter Mastic Dv .t Vinyl Mdi M ar >1 l extPriar w1 h howc� kd l l have choice
of color. ----— __ -- _--� --- -- ------- ----
3. 'tie will nail all .s eli n`fg ctt IiRas y r; ? 'i '' } 'yi r (,Sl lc n k.gr rqn la?l� SC tbpy V41 i i'Ot rust;
ur )atrl tits sidincl>
4. We will inst�a I a 3,18" st rf)r i,-cwr ' ' K£?' benirKi r`cw sic irlr,.
•
.ie-N-:�t rr i+{"1i-r .l;"_-i ur!
f_ r i tayti't a1
�, f1Yt s'
� t� !`--x- � -j'.l' `i1i,,f L'%i
L"l �,. Wbiod, trim arY! I,r' 1 C J bay
I h?r 'i,_:z,21 c13*A tL-�iiin?tff-:_.��.-1-
8. 'Wood. trim soy Fit and fascia +hell b(, rover xi with Wto altmiruri coil stack aril perforated vinyl
Soffit We vii 11 til^i' I Qt1'�. yxx✓1 SOY'fi1, cmeas tr} iru:; ease a-tic, yerlti1at1oc.
is "di:t° t ; p. wf t 1 i,<'• „" .; r; Tt'r; . i t,r.;} � z„• n '' � - ,l-+• `P
A {� ti t r. � h,..
'10. tiny. rrt�ill i�� :t.ti1Cl,. :'�`( }�� L�
11. Arty existing ywd Ufa t is se he r ti l ec .
12. Any existing + that i s deleri orated 6hi ch rft.As to be rwl aced so that %A e ca fam Our WC4
viii be r ,1ta,. ;ltis r'a.s ict -;,nr IEOCiE any stncturI r _.rii!? .n-r ,r��Ilt� � 1.
13. We wlll iristal =.mile Gist"' 1 �Sg4;t �`'t" / JGI(�lLrI19� ✓ 3 ff� ,_ � ,
14, We lid II irstt)l1 l31 0ritl 1 i tfi tlrnkS h*-t-irr 1ioloYi ��;r'i*°� _ 'r°
—15. °JE' w1 l l f nsta l l vhf i to I`'�isti r, i I i -f d or Tr;" i ti- C^vfxa". e s�S ".t'--1- nk
NC 1 ,� 1.6. Vie V l and c sny)Sc ff J rif atf 1 r04 r e? .f t
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4 -74 "• lft h r:f ( Pit
r rF Ililrll.lP', C1 LtE �,:�,? a I.' if 0t ,:1 it { �^ ?fit (._ .a t 'ii�Jl�s rr€i
r
, r�, .� 7 fi� r.t�a a�rr}•;�.'� !t. ,. % . . r. .'- � ' � f.d l' r � (,�� t`f ��- r(1 f�
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at - ,Y' 7cr°n •,. , r �., ti fq., . .'i ! ^e a}i 'Jf f'riL�tl IJU{.Y
+^cWa t • �'t,. t•, t , .h y I '� 11 I i? " 1 I r L` 1 i ��'^'�I -`Ci .a: � V 1
—
r,
G.J. V}tly i .,,ir`.i 'rk35 a
`7�3lo�av CINTimum
WE PROPOSE to furnish material arW, lapor, co p ete in accordance with above specifications, for the sum of:
dollars (3 _— f', "�+ 3rd DW I. payment due upon receipt of invoice.
It payment late, interest at 1 1/2% may be added 11})n (;wpletion of
NOTE: This proposal may be withdrawn by us if not accepted within 11111`t.Y days.
;, Contractor Salesman
,
,E 'r"ams :dtcDmild, Salesman
f,, i"t7ttlyilifi�rs" 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.
O �\
9 6 jlcexathno to
DEPARTMENT OP BUII..DNO INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Muss. 01060 v
WORIER'S COMPENSATION LNSURA.NCE A.FMAVrr
I, ED LOSACANO, OWNER OF ALL STAR INSULATION & SIDING CO. , INC.
(liccnsx/permittce)
with a principal place of busi.ness/residence at'.
A
56 FRANKLIN STREET, EASTHAPPTON, MA (phone#) 413-527-0044
lsa•ccv ci ry/sta;.cJ a p)
do hereby certify, under the p?-'J:s and penahes of pcf�u ", chat.
(� I am an employer providing the fotlowing woTkees compensation coverage for my
employees working on this )ob,
4 .—) C-
(Lasur,nca Compauy) (Policj Number) (Expiration Date)
��fLQ,ttiiCi9�n c �,�c�iQ� �t•P.
( ) I am a sole proprietor, ge eral contractor or homeowner (circle one) and have hired
the contractors listed be!o'x who have the foiio7rng worker's compensation policies:
(Name of Contractor) iLlsurana Cor rpany/Pclicy Ntunbcr) (Expiraaoa Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) �'Lnsl;razcs COMnP�/Palicy Number) (Expiration Dale)
(Name of Contra(ztor) (Insw-a lcc Companyfpolicy Number) (Expiration Date)
(sUach Uidttiooal ttkd Jnoocswy to uxluda nformaAOC pata.inicg W a.11 oo=r rl)
( ) I am a sole proprietor and have no one woT�. g for me.
( ) I am a home owner performing all the work myself.
r
NOTE'.please be aurae dw VA i O bomeowacn wbo alloy mom ta do iv a�aace,cocisu�et on or try0.R work oa►ct.yelliag of
W Moro thta tTe uniu in which the k> e- rcr'cam oe x t5e rr-�-.Cz a,7kj-Ms LSaYto e.-c oot Gcxatky cowidaro to be
employers u.nda the twrkrs`s O=P=ssLca Act(GL15�-=s :(5); w p'•:a io try a h==w=for a lioave cc petal may cv1dcnoe tho
legx!stxtw of on arsployet coder da wwiczes Cox'—Oa"Loa'A ,_--
A
I undcMaxod that a 007y of thin c atci axt zay bo Amdcate Offioc of raunvooe for t}se
corm Be Yetnfi=oa and thst 2 5 A c:f?.(GL 152 car.':ac 14 Lao of awemnl pcmartica
of x five orup to S1,5OO.N ar4lcr c - of uq 'j OM ycar ea4 avi:;xm:'-era w to form 011L SWp wor't Order anti a
fine of 5100,00 x C4 Lpni Me.
For depaIIaatil taco oa►Y
Pcrmit Number
Map'�1
Signature of Liocnse'- PC rn.itIct a e
5' j QNTRUCT.ION SERVICES
1 Licensed Construction Supervisor; Not Applicable O
Name 2f License Holder;
License Number
Address Expiration Date
i
Signature Telephone
ti
w
-t , ,.s ^ , .a .tallitI� „t' ', Not Applicable O
S%ornpa Registration Number
2Ad ress t Expiration Date
' Telephone
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 o he building permit,
Signed Affidavit Attached Yes....... No...... O fil $k
NMI��ffljfeMRWOI:b
The current exemption for"homeowners" was extended to include Owner-occupied Dwellings of one (]) 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
,Z X
tr.
Aw,
,CTI,ON 5. DESCRIPTION OF PROPOSED WORK(cJjeck all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s)lb/ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ J Siding Other [ ]
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 r Renovating unfinished basement Yes No
Plans Attached Roll C • Sheet C
t4N�irttt his' and or.*a_d�on to,existift housing, completw,the folI'o
lz
a. Use of building : One Family_._3� 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, Mascheck Energy Compliance form attached?
Type of construction
i. 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 BUILDING PERMIT
I, as Owner of the subject property
hereby authorize to act or
my behalf, in bll matters relative to work authorized by this building permit application.
Signature of Owner Date
I, ItV i as Owner/Authorized Agent
hereby eclare that the statements n information o the foregoing application are true and accurate, to the best of my
knowledge and belief.
Sind under the pains and penalties of perjury.
Pmo
Signature of Owner/ gent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Fronta e
Setbacks y
L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW v' YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW "� YES
IF YES: enter Book Page and/or Document #
i
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
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 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
City of Northam
Y ton p
Building Department
212 Main Street t
r Room 100
or,Y�iampton, MA 006
^ � _-- „e1I:8'7 1240 Fax 41 s �;� E :
! LAPP TIO T CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
3 01W Z�SITE INFORMATION
1.1 Property Address: This 58c�tiQ y; s cQtjtp.{gGy of �� ,
,. n W S�.
r Map �. _.� ---- �! : n
Y�{strict
Zone
�- ,4��,t�
Elm St. District CB District_____
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Own2r.of Record:
(30d-i__h,0aA(j
Name(Print) Current Mailing Address: ' (� �}�J O
y 5S ! ��J
Signature Telephone
2,2 Authorized Agent: _
Name(Print) j Current Mailing Address: d rl
Signature Telephone
=Q1 QK3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to oe Official Use Only
completed by ermit ap ! can*,
1. Building ,po ;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 T 2 + 3 * + 5) Check Number _
This Section For Official Use Only
Building Permit Number, Date ssued:
Signature:
Building Commissioner/Inspector of Buildings Date
BP-2003-1126
GIs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-1126
Project# ]S-2003-1777
Est.Cost: $9363.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: All Star Insulation & Siding Co Inc 101858
Lot Size(sq. ft.): 17511.12 Owner: SHIMEL BRAD A&DOROTHY A
Zoning_URB Applicant: All Star Insulation & Siding Co Inc
AT. 114 LAKE ST
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers
Compensation
EASTHAMPTON MAO 1027 ISSUED ON:6110103 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL 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.
Certificate of Occupancy SiLynature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 6/10/03 0:00:00 28492 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo