17D-074 (10) 16 GARFIELD AVE BP-2019-0186
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mau:Block: 17D-074 CITY OF NORTHAMPTON
Lap-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv, ROOF BUILDING PERMIT
Permit# BP-2019-0186
Project# JS-2019-000309
Est Cost $19300.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sp.It.): 13460.04 Owner. MCCUSKER KATHERINE
zoning URB(100N Applicant. JAMES FLANNERY
AT: 16 GARFIELD AVE
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.8.11512018 0.00:00
TO PERFORM THE FOLLOWING WORKSTRIP & SHINGLE ROOF - STANDING SEAM
METAL 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:
FeeTvoe: Date Paid: Amount:
Building 8/15/20180:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner
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rre40VI2 Fax 413-587-1272 PWABSP
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APPLICATION TO CONSTRUCT,ALTER REPAIR RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DINIF LING
SECTION 1 -SITE INFORMATION 6 —
1.1 PreoeM Addrpe: Thb aMion to be co lPleled by oRloo
v
/(a GrR R F� L f} zG , Mao —0-74J
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zone Overlay DIMCt
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SECTION 2-PROPERTY OWNERSHIP/AUTHORRED AGENT
2.1 Owner of Rw&rd:
KR7,4EklAE Me Cu5Ae /6 63RF/El-AAWE / Lore-Ajc6 MR
Name(P4nt) Cwmnl Meana Mid.: 0/0&L
sigron,a Telephone y/3 - q30 - 7733
7grYlES T 11CLANA15AY l Lova7ke/d St Eaghamp1oN1*4
Name(Pnrn) Cwsr MaiNq Add.:
y13 - a03 - 5"888
ftrolure Tel phone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
hem Estimated Coat(Dollars)to be OI6olM Use Only
=pletod by nemnit applicint
1. Building 00 (a)Bueolng Permb Fee
2. 0ectrical I (b)Fffgmmed Total Cost of
Consbucdnn from B
3. Plumbing Building Permit Few 17�
4. Mechanical(HVAC) ((��
S.Fin,Prolectim
6. Total=(1+2+3+4+5) , 30G, ao Check Number
This Sedlon Fw Official Use Only
Data
Building Permit Number. Issued:
Sip m:
BUM "Con Inspector of Buildings Date
yesl!(p�l2Forerng+vc6R oFiti��-�-� � Gmr+l<, eaM
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION B-DESCRIPTION OF PROPOSED WORK/chock all policabNl
New Howe ❑ Addltlon Rephcefies Windows Alteretbn(s) Roofing
Er
Sroops 13
AccessoryBldg. ❑ Demolition ❑ New Signs 1011 Decks M Siding jot Oliver[Co
Brief Desch n of Proposed
Werk: S K/p m�chpC¢ ;nsfd,// r/�r.L.2/Lla�rnD�ts a- SlAc��l,i1G ,;.Payy�tr,0
Alteration of wasting bedroom_Yee_No Adding new bedroom Yes No
Attached Nar ire, Renovating unfinished basement Yes No
Plans Attached Rail -Sheet
M.if skm ilia a and of a mobs to umom holuichie.cORWbeba tb1O fGGOWNLD:
a. Use of building:One Famiy Taro Famiy Other
b. Number of rooms In each family unit: Number of Bethroorns
m Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of healing? Fireplaces or Woodstoves Number of each
g. Energy Cowervation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
I. Is construction within 100 ft.off wetlands?_Yee No. Is ooneW _
ction within 100 yr. floodplain Yea_No
a
j. Depth ofbaeemM or cyernoor below finished grade
k. Will buildup n to the Building are Zoning regulations? Yes No.
I. Seote'fank_ Cly Sewer_ Private well_ Cly water Supply
SECTION 7e-OWNER AUTHORIZATION-To BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMR
I, AP-01ERINE /71(2CVSAtEY' .as Owner of the subject
Property
hembysuthodm TAMES 7. F/ �NN�/Zy �6R PEAK PbRPoamF}NCS ROOF/iU6 G[
to act on my behalf,in all matters relative to work authorimd by this building permit application.
Sigmture of Oxer % Date
I, 7AmES 'J. F&AtiMERy as OwnerrAuthonzed
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 to pains and penalties of perjury.
7AmES T F/ANN£R1/
Print Name
Signature of OenerrAgeM ate
SECTION 8.CONSTRUCTION SERVICES
8.1 Licensed Co shumeon Suparvleer: Not Applicable ❑
Nameoftjcffw ' _J09MES T P"9/VNEPZy Cs - /03010/
Uoerwe Number
l Gy;llrams :51, 11olvDkg miq DIDyO 09/a1420/8
Adtlmaw ' Expiration IMIe
v13-
Slanebna Tal.pM
Not Applicable ❑
PERK PE2POR/hRNGE RGOF//Ulr, LLG 1?3647, '
Company Name Registmti
"VP-r,-#;C)-r,-#;C) 5* FAs�{fttrr��an! M4 DMXa // 7o Number g-o /q
Address (L/13) Expiration Deb
Telephone
SECTION 16 WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O.L.c 182,;2W46))
Workem 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....... WinNm...... ❑
City of Northampton _
Massachusetts
s
L Aa OH 9UILDItiG LNNYNCTIONa
212 1 in street erNnioipal suilang
North pt n, M 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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 properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
/6 GHRF) Et-b RVE
(Please prim house 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:
/-�a�tons Ro/%o�� � /-oomis tUa,���as><l,amp�on� n9fJ
(rompany Name and Address)
T` �tQi 7�3o�i�
Sign re of Permit Applicant 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 when;the debris will be disposed.
The Commonwealth ofMassaehusetts
Department of Industrial Accidents
Office oflnvestigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name(Business/Organiaz6on/Individua0: 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):
1.fL�S-✓I am a employer with 4 4. ❑ I am a general contractor and I 6. E] New construction
employees(Poll 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 i
req 9. L] Building addition
workers'comp.insurance comp. insurance.
required] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑/Plumbing repairs or additions
myself. [No workers'comp. right ofexemption per MGL 12 u Roofrepairs
insurance required.]i e. 152, §1(4),and we have no
employees. [No workers' 13.El Other
comp,insurance required.]
*My applicant that checks box#1 most also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside comm ctors must submit a new affidavit indicating such.
tCo tudee rs that check this box must attached an additional sheet showing the name of the sub-convectors end state whether or not those entities have
employees. Tribe sub-contractors have employees,they most provide their workers'comp.policy number.
I 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.#: R2W/1C9438355 Expiration Date: 4/27/2019
Job Site Address:�& 6i O Ye� !7✓�/ City/Statc/Zip: /VO f�0/000
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.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and coerce&
Sig Po Date
Phone#: 413-203-5888
Oficial use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector
6.Other
Contact Person: Phone#:
G�71ae l&alnma)acaea1l,Ca a ^,2 aaltcc eCZd
Office of Consumer Affairs and Business Regulation
One Ashburton Plaoe- Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE ROOFING,LLC. Regis"dw: 183(I88
1 LOVERELD ST. E)qxra6On. 11/03/2019
EASTHAMPrON,MA 01027
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Roam at ?oed ,g leg 'aAon in ate uaros
i..cer+s> M103061
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01010 -
•,m+cm.3s•c•-..' ON7l,7018
Worker's Compensation and Employer's Liability Polies
Berkshire Hathaway AmGUARD Insurance Company -A Stock Co.
Y Policy Number R2WC943835
GUARDInsurance Renewal of R2WC811187
Companies NCCI No. [21873]
Policy Information Page (AR)
1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
1 LAVEFIELD STREET 8 NORTH KING STREET
EASTHAMPTON, MA 01027 Northampton, MA 01060
Agency Code: MAMAIN35
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 $ 606.00
Total Estimated Cost 14 256.00
INTERNAL USE xx Page- 1 - Information Page
MGA :R2WC943835 WC 000001A
Date : 04/04/2018
MANOTE
Issuing Once: P.O.Box A-N, 16 S. River Street,Wllkes-Barre,PA 18703-0020•www.guard.cem
P E K Peak Performance Roofing LLC
Contract
P E R F O R (+ E 1 Lovefield St Date Contract'
Easthampton, MA 01027 7/27/2018 613
MA CSW 103061
MAHIC' 183698 413-203-5888 peanerfomanccroofingllc@gmail.mm www.peakperfomrencesoofingllc.com
Bill To Job Location
Katherine McCusker Katherine McCusker
16 Garfield Ave. 16 Garfield Ave.
Florence,MA 01062 Florence, MA 01062
413.230.7733 413.230.7733
mccuskerkj@gmail.com mccuskerkj@gmail.com
Description Total
Standing Seam Metal Roof Estimate: 19,300.00
1.Remove the existing mof materials(multiple layers).
2.Inspect the sheathing and replace up W 100 square feet of mtted/deteriorated wood as needed at no additional
cost. (If additional plywood is needed,$50 per sheet installed.)
3.Install 3'ofCanainTeed Winterguard HT(High Temperature)ice&water shield at the eaves,around chimney(s),
2"at roof/wall transitions
4.Install synthetic underlayment on all remaining areas of roof.
5.Install Engle'24 gauge standing seam metal roof system.Panels will be 16"wide with 1.5"mechanical lock
seams.
hapsl/w .englertinc.mm/l-9/*C2*jWD-mechanically-seamed-metal-roof-system-al300.html
6.Ensure the sheathing is cut at the ridge to allow for proper exhaust ventilation.Install vented"a"enclosures and
fasten ridge cap to"a"enclosures. Remove existing gable vents. Install plywood and trim.
property will be protected at all times to prevent any damage in the home or plantings.All debris will be removed
from the premises. Contractor will obtain building permit.
Total cost$19,300.00
Optional: Colorgard snow rails.Additional S30 per linear foot installed. Length and placement TBD.
oc-
hnpl/www.meWplusllc.wm/documents/meWpims lorgud.bmchm.pdf t ote d
A 50%deposit of$9650.00 is due prior to start of work. ! �Q
The balance shall be due upon completion.
'We are mm responsible for dirt/debris that may fell into Wic.Please check for debris after dumpater is removed.' v Y 11 Total:
Contractor Signature: Customer Signature: Date: lP
2 19) $19,300.00