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20-006 (4) 508 SYLVESTER RD BP-2019-0126 GIS#: COMMONWEALTH OF MASSACHUSETTS MV.Block:20-006 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Categorv� ROOF BUILDING PERMIT Permit# BP-2019-0126 Proiect# JS-2019-000204 Est.Cost: $5950.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group- JAMES FLANNERY 103061 Lot Size(sa. ft.): Owner: SWAN SARA&ZACHARY Zoning: Applicant JAMES FLANNERY AT: 508 SYLVESTER RD Applicant Address: Phone: Insurance: I LOVEFIELD ST (508)294-4052 WC EASTHAMPTONMA01027 ISSUED ON:713112018 0:00:00 TO PERFORM THE FOLLOWING WORKSTRIP & SHINGLE ROOF on main house 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 Occuoancv signature: FeeTYpe: Date Paid: Amount: Building 7/31/20180:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner mor 0 °° City of Northampton 8bsr raPsrrrR a Building Department CUA Oi*DdMAW P-- 90 212 Main Street awmrn Pao MwIsbty z� Room 100 Waft~ Northampton, MA 01060 TWO Falx agWM*itl PWN phone 413-587-1240 Fax 413-587-1272 Ploaal.PAn Y Oar eOeab A CATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY OWELLING SECTION 1-SRE INFORMATION '3 a, I l"�' 1.1 Probeft AddreM: TNN Section to as comPINIMal by OMM 5 � S��VQSf lac M.P d0 La60V t zom Omrby Dbmk[ lImK OMM CS DYbkt, SECTION 2-PROPERTY OWNERSHIPIAUTHORMED AGENT aarrhh 1 z.ac�A SWb(.' o"S S �V15�-N ✓d 0 TMaphne 7 T, LUMIA15R1/ Lovpf'- 0 5f, EagAarnpl*NMFI Name(Prix) Cumml Mary Abea. yla - aos- s88 8 SECTION 3-ESTIMATES TION Goan eisaalkaa Tabpaoro Rem EsbmeW Cost Polars)M W Mail UM Orgy completetlby pennit 1. BaiNbg �( ,C•y1.. CID (a)Building PemD FM 2. Elechical ✓ J�✓ (b)Esbmebd Total Cost Of Cambucgon mom e 3. Plumbing BuOding Puma FM 4. ANchanMCW(HVAC) 7v 5.Fine n G. Total=(1-2+3+4+51 1 Check Nwnbar This Section Far OffieW USS On Dab euk"Ponos Number laved: Bw BUMV COm Wrw r"saora Rub" Done PPAKPf9F0)I!MV*VCER00F1N6-"-C j (7I RI • CU/"l EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) ALI =a-OEICRIMON DP PROPOSIM WORK Ichock all soptl 1 NOW Noua9 ❑ Addition ❑ Orchestra ftPWMMM noowa ANMMbnls) ❑ RrMang A-ugt"Bldg. ❑ DemeollNon ❑ Naw Signs 031 Docks M Siding JC31 Other tlQ Brief Description«Proposedp/a(I. /�' dJY .JYI inQ Q.,,$ on kwa%n work: ! Annuitant«wtictlng bedroom_Ysa_No Adding new bedroom Yea _No Attached Nwrative fianovaUrg unRasbed beesmant Vee _No Plain Atsd*d R«I -Sheat an,If Now hom Srld or odd idan to exividna how Comobb ft foRoWinD, a. Use«building:One Family Two Fatuity Omar b. NunAx«rooms In each family unit: Number«Balhmome e Is there a gauge adecled? d. Proposed Square assets,«new construction. Dimensions 9. Number«elwies? I. M«hbe«beawg? Fbeplacaa or Woodsiow Numberof each g. Energy Comervaeon Compliance. Wrenched EneW Co nPeance to=attached? h. Type«oonanweon I. Is coneWgim within 100 a.otwedands?_Yes _No. Is mrsdnrdion within 100 yr. floodplain_Yes_No I. Dapm«baawn r t or 0611ter floor below Mieled grade k. Will buidYq conform te tle Building and Zoning regulations? Yes—No. I. Sapflc Tank_ City Sewer_ Private wap_ City water Supply_ RECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUNGING PERMIT I, G ✓�vh L-. an Owner aline subject properly heMbyaualorl>e 7 c 7. FL41vlucAy D&,) PEAK pSRFDRMRNL6 RODOV6 LC to Md on MMAIR mistmetwaks, reed by this building Permit katlgn. agmesm ower Did 1. lllftVS. U. FLRN 10ERY .as owrenAunnnie0 Agard hNeby(Indere that the statements and nfonnation an the foregoing applicaban ale true and a=rate,to gra best of my kllDAledge and belief. Signed under the palm and penanee of o nn" 7AYnES 1. FLANAJrkY "Na. aglrwaa Oftled-Gand Dan SECTION 8-CONSTRUCTION SERVICES 8.1 LleanoW Conshue8on Supervisor, Not Applicable ❑ Nameof Lleensellomer: —Jqr/ES SFU9/vNEFty CS - /03010/ Liwee Number l Guillrams 5t,� / /yoke rn,4 Oloyo 09/a/�aoi8 AdtlreesI E)Imtlon Dole N13- SgreWre Telephone Not Applicable D /0E4K PC PORMHNGE 906F/1U6-, LLC /F3 (acIo? Company Name /aaRegisbatio Number Love� �ld 5f Fasfharr{p�orl YYIA a31 117;3720 /9' Address /N13� Expiration Date Telephone a�3-.�PB� SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O.L.m 162.If 25q6)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this alfidevd will reeu8 in the deNal of the issuance of the buildingpermit Si nailAffidaWAttached Yes....... DY No...... ❑ City of Northampton _ Massachusetts L. Di4?M1fffilT OF BMWIaG INBpaCTIONa 212 Nein etnet *r Cipel Bu Idinq ' 9orNeepton, M 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a property licensed solid waste disposal facility, as defined by MGL c 111. S 150A. The debris from construction work being performed at: 5-6k ,;��l�� a � eIQ (Please print houde number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: ,4aA00'5 R011-0(4'1 /-oom;-S -o-o ampY60 mA (Company Name and Address) a aW oT -7A&Z C Sign re Permit A45plicant or Owner Date If,for any reason,the debris will not be disposed of as indicated,the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department oflndustrial Accidents Ogee of Investigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name(Huainess/OrgmieadoWlndividuaq: Peak Performance Roofing LLC Address: 1 Lovefield St. City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888 Are ypu an employer?Check the appropriate box: Type of project(required): L I am a employer with 4 4. ❑ I am a general contractor and I 6. E] New construction employees(full and/or part-time).' have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P ry� 9. E] Building addition [No workers'comp. insurance comp. insurance required.] 5. ❑ Weare a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.a❑y Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 most also fill out the section below showing their workers'compensation policy information. t Homeowners who submit his affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tCommems that check this box must attached an additional sheet showing the name of the subcontractors and sum,whether or not those entities have employees. tribe sub-convectors have employees,hey most provide their workers'camp.policy number. 7 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job.site information. Insurance Company Name: Berkshire Hathaway Guard Policy#or Self-ins.Lic.#: R2WC94((3835 Expiration Date: 4/27/2019 Job Site Address: '5-68SUw.e s/'Q-� M City/State/Zip: Flo rene_o SMA O/C&2 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 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. 1 do hereby certify under the pains and penalties of perjury that the information provided Above if true and correct. S' atue� Date 7 2lD p Phone#: 413-203-5888 Official use only. Do not write in this area,to be completed by city or fawn officiat City or Town: Permit/License It Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phone#: Worker's Compensation and Employer's Liability Policy 11187 kshire Hath awa AmGUARD Insurance Company -A Stock Co. Y Policy Number R2WC943835 AlInsurance G UA RD Companies Renew N CI No.l of [21873] Policy Information Page (AR) [3]Named Insured and Mailing Address Agency PEAK PERFORMANCE ROOFING LLC WEBBER a GRINNELL INSURANCE AGENCY, INC. 1 LOVEFIELD STREET 8 NORTH KING STREET EASTHAMP ON,MA 01027 Northampton, MA 01060 Agency Code: MAMAINIS Federal Employer's ID 00-1191951 Insured is Limited Liability Co. (LLC) [2] Policy Period From April 27, 2018 to April 27, 2019, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance- Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident- each accident $100,000 Bodily Injury by Disease - each employee $100,000 Bodily Injury by Disease - policy limit $500,000 C. Refer to Residual Market Limited Other States Insurance WC200306B Endorsement- D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms [4] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium 13,650 Total Surcharges/Assessments j 606.00 Total Estimated Cost 14 256.00 INTERNI USE xx Page- 1 - Information Page MGA R2WC943835 WC 000001A Date :09/04/2018 MANOTE Issuing Office; P.O.Box A-N, 16 S.RWer street,Wilkes-Barre,PA 18703-0020 s www.guare.com 71w I " Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: LLC PEAK PERFORMANCE ROOFING,LLC. Regie mdw: 183898 1 LOVERELD ST. Fi�iratlort 11/03/2019 EASTHAMPTON,MA 01027 upE A&Ire and RM mCaM. SCRs � IDEVO`WT] assn nsetts pa 3oec- a h c- SN.In y 'teg c -c.t•us 4.,ce CB-103061 JAMES J FLANNERY 1 YAWAM887 HOLYOKE MA 81/8'18 ��M l_A_ Exmgi:o^ snmmiss.cre- OW2112018 pKPeak Performance Roofing LLC Contract PE R F O R CE I Lovefield St Da1B cOnh° 0 Easthampton, MA 01027 nz6rzou 6a MA CSUa I0.Nft MA NICk 185698 J13.203-5888 Naperfurmonmruafingllnn:gmail,vm wvw.peekperf....ru F.,s co. Bill To Job Location Zach Swan Zach Swan 508 Sylvester Rd. 508 Sylvester Rd. Florence,MA 01062 Florence,MA 01062 znh@wrtheast-solar.com northeast-solarcom zach@nonhcast-solaccorn 413-335-7652 413-335-7652 Descdpfion Total Main House,excluding porch roofs: 3.950.00 I.Remove the aA.1mg roofshingles 2.Insall is fed of ice and water shield d eaves and valleys, 12"around mo(:well intersections 3.Cover remaining maf with Cesainmed"Roof Runner"synthetic undedaymem 4.Insall 8"aluminum drip edge on eaves and take edges ' 5.Irmall architectural shingles by Ceminteed(Landmark PRO)00yr rated Itttps:;rwww.certainleed.mMreetdmtial-mofingipmducwlmdmark.pm, ColorChoiee: 6.Install ridge vent 7.Complete all necessary fllashings including new pipe bests and new base flashing on chimney We will replace up to 100 square feet of plywood if necessary d no cost.Any additional plywood will be$50 per shed installed Remove,all debris flown premises,and throughout the job,continue cleanup and keep the premises undamaged Total cost-S5950 A deposit off2975 is due prior to son of work The balance off2975 shall be due upon completion. Deposit Received On: i___ Deposit S Check u •We am not m,"ble for din/debris that nay full into anic.Place check Por debris aticr dumpmcr is mnnvvd.• Total, Conaacanesr 8igaature ruse nS m. Desk: " ter 2-;a I 55,950.00 i