25C-071 (12) 42 DAY AVE BP-2021-1360
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-071 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit# BP-2021-1360
Project# JS-2021-002235
Est.Cost: $4532.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ALL STAR INSULATION & SIDING CO INC 99739
Lot Size(sq. ft.): 7318.08 Owner: MCKAHN DANIELLE
Zoning: URB(100)/ Applicant: ALL STAR INSULATION & SIDING CO INC
AT: 42 DAY AVE
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAM PTO N MA01027 ISSUED ON:5/17/20210:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE GARAGE 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 Occupancysignature: ��rya± yX - 3.--)015/
r
FeeType: Date Paid: Amount: (►
Building 5/17/2021 0:00:00 $40.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
The Commonwealth of Massachusetts i
tiv Board of Building Regulations and Standards J FOR
Massachusetts State Building Code,780vtR ���� MUNICIPALITY
nq�ik,� / USE
Building Permit Application To Construct, Repair, Renovfte.br,;, tolish a / Revised Mar 2011
One-or Two-Family Dwelling ,A"'S:F'
This Section For Official Use Only
n°� i,,„
Building Permit Number.6P ,2),.1 ,(/1) Date App led:lii
KU4...) ,
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
Lta bay <live n(AS _ -25-C- 0'7 1
1.l a Is this an aetepted 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)
13 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:
b(i t l Ile 0 c- file kahn Nn► a 'ion ) Mid- 01O6O
Name(Print) City,State,ZIP
,3. A)nkinS C','ento_ yt3-Sao-7aoq-Cv11.Q
No_and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building IX Owner-Occupied 0 Repairs(s) 0 Alteration(s) 1S1 Addition ❑
Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:
Brief Description of Proposed Work`: v , II .S`hYL Cp) ) ` S) I T) J ail
Roo Oa r ( 4- Tns- nP�..,P r G f �v 9
,si-,i i�.Pi SD-co X -7 53i t cx.Lc 1)
vv SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building S 1. Building Permit Fee:S Indicate how fee is determined:
2.Electrical S ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing S 2. Other Fees: S
4.Mechanical (HVAC) S List:
5.Mechanical (Fire S Total All F
Suppression) �}
Check No-1 heck Amount: Cash Amount:
6.Total Project Cost: S y/53a , 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-22
Ed Losacano License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) R
128 Glendale Road
No.and Street Type Description
U Unrestricted(Buildings up to 35.000 Cu_ft.)
Southampton,MA 01073 R Restricted 182 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-527-0044 allstar5270044@gmail.com 1 Insulation
Telephone — _ Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
101858 6-28-22
All Star Insulation&Siding Co., Inc.
_..___. _ HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
56 hranklin Street allstar5270044@gmail.com
No.and Street Email address
Easthampton,MA 01027 413-527-0044
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 11D No... ....._.❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I.as Owner of the subject properly,hereby authorize Ed Losacano
to act on my behalf.in all matters relative to work authorized by this building permit application. /
Danielle McKahn,Homeowner /t ki/J 6/3
Print Owner's Name(Electronic Sienaturc) Date
SECTION 7U:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below.I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Ed Losacano,Owner E c( J,,2 I
Print siwner's or Authorized Agent's Name(Elec wine to Signature) Date,
NOTES:
I. 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(I IIC)Program).will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the H1C Program can be found at
wwwina s.st�s oc,i Information on the Construction Supervisor License can be found at tvttiw.m:iss,govidns
2. When substantial work is planned,provide the information below:
Total floor area(sq. II) (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 Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
�a
;i Lafayette City Center
��a l 2 Avenue de Lafayette, Boston, MA 02111-1750
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: General Businesses
Applicant Information Please Print Legibly
Business/Organization Name: ALL STAR INSULATION & SIDING CO., INC.
Address: 56 FRANKLIN STREET
City/State/Zip: EASTHAMPTON, MA 01027 Phone #: 413-527-0044
Are you an employer? Check the appropriate box: Business Type(required):
1.0 1 am a employer with 10 employees (full and/ 5. ❑ Retail
or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment
2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl. real estate, auto,etc.)
employees working for me in any capacity.
[No workers' comp. insurance required] 8. ❑ Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing
no employees. [No workers' comp. insurance required]**
4.❑ We are a non-profit organization, staffed by volunteers, 11.0 Health Care
with no employees. [No workers' comp. insurance req.] 12.1.1 Other CONSTRUCT/HOME IMPROV
*Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information.
••If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an
organization should check box#I.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name: THE TRAVELERS INSURANCE COMPANIES
Insurer's Address: 97 CENTER STREET
City/State/Zip: CHICOPEE, MA 01013
Policy#or Self-ins. Lic. # 6HUB-5N06911-1-20 Expiration Date: 8/13/21
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under§25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up
to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to
$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of
the DIA for insurance coverage verification.
I do hereby certify, under the pains and penalties of perjury that the information provided above is true and correct
Signature: a� ArOGL-COA-4-4 Date:
Phone#: 413-527-0044
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(check one):
1❑Board of Health 2.0 Building Department 30 City/Town Clerk 4.❑Licensing Board
5❑Selectmen's Office 6.['Other
Contact Person: Phone#:
www.mass.gov/dia
i'.moN ALLSTAR-05 BROOKE
A`ORO CERTIFICATE OF LIABILITY INSURANCE ��1a�2' o o�'
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.
MPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(Ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WANED, 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).
PR OUCE R USLACT Brooke Barre
iIenter fIC Agency,Inc. (NONE FAX
(NC,No Ex*(413)594-5984 (NC,No):(413)592-8499
Street
Chicopee,MA 01013 was:brookellphillipsinsurance.com
pNSl1RER(S)AFFORDING COVERAGE NAIL s
NSMRER A:State Automobile Mutual Ins Co
POURED POURER B:State Auto Property&Casualty
All Star Insulation&Siding Co.,Inc_ NsuRER c:Travelers Insurance Company 36161
56 Franklin St 1 NsuRER D:
Easthampton,MA 01027
NSU RBR E:
POURER 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.
pR TYPE OF INSURANCE ISD S<W1VBR POLICY NUMBER 11 TYYYI (IW/DONY Y
LIR INSURANCEN ) WADS
A X COrIERCML GENERAL Lamm EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X OCCUR PBP2903632 8/13/2020 8/13/2021 DAMAGE TO RENTED 300,000
PREMISES(Ea mammal $
-—--- MED EXP(Any one person) $ 15,000
__ 1 PERSONAL&ADV INJURY $ 1'000,000
GENL AGGREGATE UNIT APPLIES PER GENERAL AGGREGATE $ 2,000,000
POLICY X LOC PRODUCTS-COMPIOP AGG S 2,000,000
OTHER
B AUTOMOBILE LIABILITY rsSINGLE uurr $ 1,000,000
X ANY AUTO — BAP2482222 8/13/2020 8/13/2021 BODILY INJURY(Per person) S
ONR�EDSCHEDULED
_AUTOSREp ONLY AUplfµOSSW�Ep pBOODIILEY IINJJUpRWY(Per accident) S
_AUTOS ONLY _ AUTOS ONLY (Per auidert) MAGE $
$
A X uf�.LA LL1B X OCCUR 1 EACH OCCURRENCE S 1,000,000
EXCESSLY.B CLAIMS-WIDE PBP2903632 8/13/2020 8/13/2021 AGGREGATE $ 1,000,000
DED X RETENTIONS 0 S
CAND INORICEILS
EMPLOYERS'LIABILITYCOMPENSATION
X MUTE X OETH-
ANY PROPRIETOR 'ARTHERIFJCECUTNE Y/N 8HUB-5N06911-1-20 8/13/2020 8/13I2021 EL EACH ACCIDENT $ 1'�'�
OFFICERMEMUER FXO UDED, i N NIA
IM�oIY In IW) EL DISEASE-EA EMPLOYEE $ 1,000,000Wye ducat° '°a 1,000,000
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMB $
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VBUCLES(ACORD 1M Addllionel Rewr rb Schedule,nary be aaedrd If eloma epees Y ngdnd)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
All Star Insulation&SidingCo,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
56 Franklin Street
Easthampton,MA 01027 --
AUTHOR®REPRESBITATIVE
;Jiiv yyt. 1''^T.4
ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
e 6/?www,ette.-ezdX-` _
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
Registration: 101858
ALL STAR INSULATION & SIDING CO. Expiration: 06/28/2022
56 FRANKLIN STREET
EASTHAMPTON, MA 01027
Update Address and Return Card.
SCA 1 t3 20M-05,17
//,
Office of Consumer Affairs& Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE: Corporation before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
101858 06/28/2022 1000 Washington Street - Suite 710
ALL STAR INSULATION & SIDING CO. Boston, MA 02118
EDW I N W. LOSACANO
56 FRANKLIN STREET .2
EASTHAMPTON, MA 01027 Not valid without signature
Undersecretary
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Construction SIipe'visor Specialty
CSSL-099739 Expires:02/14/2022
EDWIN W.LOSACANO
128 GLENDALE RD.
SOUTHAMPTON MA 01073
Commissioner A,f.,,,c.4
".•*c-1Vim' I .• /� �- ( E_
, t° D
• INSULATION +, APR 2 6 2021
SIDING CO., INC. rIt.a 6 . 0-13
Easthampton Office
413-527-0044 56 Franklin Street • Easthampton, MA 01027 v
--11/4.) Ty . r
CSL License #CS SL99739/MA HIC#101858/CT HIC#0630805
fax 413-527-1222 • email:allstar5270044@gmail.com • www.allstarinsulationsiding.com
Proposal Submitted to Phone Date
Danielle McKahn "Purchaser"413-320-7208 Cell April 5, 2021
Street Job Name
32 Perkins Avenue 42 Day Avenue
City,State and Zip Code Job Location Job Phone
Northampton, MA 01060 Northampton, MA
Contractor hereby submits to Purchaser specifications and estimates for INSTALLATION OF NEW ROOF ON TWO CAR GARAGE
OPTION 1: INSTALLATION OF NEW ROOF ON TWO CAR GARAGE
1. We will remove (2) layers of existing asphalt shingles and dispose of in a dumpster supplied by us.
2. We will install Titanium Rhino Deck or Elephant Skin underlayment over entire stripped roof surface.
3. We will install new CertainTeed Landmark Pro-Silver Birch Architect shingles. They will have a
"Manufacturer's Lifetime Limited Warranty".
4. All shingles will be nailed with at least(5) nails per shingle.
5. We will install new aluminum drip edge on all eves and new aluminum rake edge on rake areas.
6. Job site will be cleaned upon completion of job.
** IF ANY SUB SHFATHING IS NFEDFQ. THFRE WII L BF AN ADDITIONAL CHARGF OF 68 PFR SHEET TO
RFMOVF DISPOSF OF. AND INSTAI I NFW 7/16 OSB SUB SHFATHING
PRICE $4,532 00
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