Loading...
23B-022 (5) 204 NORTH ELM ST BP-2019-0362 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23B-022 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cattery:roofing BUILDING PERMIT Permit# BP-2019-0362 Project# JS-2019-000589 Est.Cost: $16250.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 183698 Lot Size(sa. ft.): 13198.68 Owner. RYAN.TAY&JUDITH SECTOR RYAN Zoning: URB(100)/ Applicant: JAMES FLANNERY AT. 204 NORTH ELM ST Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 EASTHAMPTONMA01027 ISSUED ON.9/24/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & RE-ROOF SHINGLES; EPDM ON LOW SLOPE PORTION 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 9/24/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck--Building Commissioner RECEIVED Department use only �of2JQrtt��to Status of Permit: u``i�l''ding Depa me Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability DEPT OF BlR@��ht��TIONS Water/Well Availability NORTHAM ,IN.P 010 0 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION /- 3(a� 1.1 Property Address: � This section to be completed by ofte (3011f ltl ALM S�. Map l/)_";)L:�1 Lot 0 as Unit Zone Overlay District Elm St.Dlstrlct CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: hEyiAl y691\11 toy 1y F nrn Sf Name(Print) Current Mailing Address: i Telephone �V ignature 2.2 Authorized Anent: 1111"ES T, f-LIM)NEP, Name(Print) Current Mailing Address: O JQ 5�?_-4LJ � — Y 13 - a®3 s� Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 25/0VV, 60 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) `0 Ov 5. Fire Protection 6. Total=0 +2+3+4+5) / a �, " Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) i ��• ,i c,. •�� gra s U ECI t.. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House � Addition El Replacement Windows Alteration(s) Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding[d] Other[d] Wo _5h,./-73 Description of Proposed C fit , 0, E PI) (V oil l6e,eJ -51 ore- rk: J r Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a:ff New house and or addition to existing housing, complete the following: a. Use 4—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 / 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 be:ow finished grade k. Will building ,cerflorm 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 Il I, e✓ i''J ✓ L as Owner of the subject property hereby authorize TAm�S 'F Lf4N/U,&/2Y D614 OF14 K p 1 R F®R►' 4N C.6 K OD ICW G u to act on my behalf, in all matters relative to work authorized by this building permit application. lk 4 5 -('�'Zo r$ Signature of Owner Date LA N A)£k y 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. --JamEs 7. F1_/4A/Ai R`/ Print Name � y Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: 1� d� Not Applicable 1❑ Name of License Holder: y�mES !�L-����^y C J - / 3o(moo License Number l Guillra � 5- , , 1-161 0 /Laa/ ,? Address Expiration Date q13 - d63 — 5 Y cF S Signat��4�71 ure Telephone 9.Registered Home Improvement Contractor. Not Applicable ❑ PC1gX PC)? FoRmAav e-C 2v®FIruG, LLC /F 3 tea q Company Name Registratio Number Address (V13) Expiration Date Telephone �0,3-54 7 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....... C�t� No...... ❑ City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS �'• 212 Main Street *Municipal Building Northampton, MA 01060 f ` �j�10 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 properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: Y Ail (Please print 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: /Inions I�o�/D �, J CoomiS L� , ro_S4 !Amr6u 1)1)q (Company Name and Address) Signa re oY Permit Al6plicant 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. P E K Peak Performance Roofing LLC Contract P E R F O R C E I Lovefield St Date Contract# O Easthampton, MA 01027 9/13/2018 662 MA CSL#103061 MA HIC# 183698 413-203-5888 peakperformanceroofingllc@gmail.com www.peakperfomtancerooftngllc.com Bill To Job Location Kevin Verni Kevin Verni 204 N Elm St. 204 N Elm St. Northampton, MA 01060 Northampton, MA 01060 978-407-2017 978-407-2017 kevin.verni@gmail.com kevin.verni@gmail.com Description Total 1.Remove the existing roof material and inspect sheathing or boards 16,250.00 2.Replace up to 64 square feet of plywood if necessary at no cost.Any additional plywood will be$60 per sheet installed 3.Install six feet of ice and water shield at eaves and valleys, 12"around roof/wall intersections 4.Cover remaining roof with Certainteed"Roof Runner"synthetic underlayment 5.Install 8"aluminum drip edge on eaves and rake edges 6.Install architectural shingles by Certainteed(Landmark)30yr rated https://www.certainteed.com/residential-roofing/products/landmark/ Color Choice: 7.Install ridge vent 8.Install new 1/2 inch polyisocyanurate insulation on low slope roof 9.Fasten using approved screws and plates 10.Install.060 EPDM rubber on low slope roof in compliance with manufacturer specification 11.Complete all necessary flashings including new pipe boots and new base flashing on chimney Remove all debris from premises,and throughout the job,continue cleanup and keep the premises undamaged. Contractor will obtain building permit. Total cost:Landmark shingles=$16,250 A deposit of$8125 is due at contract signing. The balance shall be due upon completion. Accounts past due 30+days subject to 2%finance charge monthly. *We are not responsible for dirt/debris that may fall into attic.Please check for debris after dumpster is removed.* Total: Contractor Signature: Customer Signature: Date: Af /�— -Z $16,250.00 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leuibly Name (Business/Organization/Individual): Peak Performance Roofing, LLC Address: 1 Lovefield St. City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888 Are you an employer?Check the appropriate box: Type of project(required): 1.VI am a employer with 4 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ 1 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 h'• 9. E] Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. 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#I must 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 contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must 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. Berkshire Hathaway Guard Insurance Company Name: Policy#or Self-ins.Lic.(#: R2WC943835 Expiration Date: 4//27/2019 Job Site Address: d b 7 S1 City/State/Zip: ���'�cQ rn��ti N,4 bvo�'eo 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 thepainq a d penalt'es of perjury that the information provided above i�re and correct. Si nature: Date: Phone#: 413-203-5898 Official 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#: f '.f ■ Worker's Compensation and Emolo Wr's Liability Policy Berkshire Hathaway AmGUARD Insurance Company - A Stock Co. ♦ 1 Policy Number R2WC943835 GUARDCompanies RenewalNCCI No.[Insurance 218 3] Policy Information Page (AR) [1]Named Insured and Mailing Address Agency PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC. 1 LOVEFIELD STREET 8 NORTH KING STREET EASTHAMPTON, MA 01027 Northampton, MA 01060 Agency Code: MAMAIN15 Federal Employer's ID 00-1191951 Insured is Limited Liability Co. (LLC) sJ` [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) t' 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 Office: P.O. Box A-H, 16 S. River Street,Wilkes-Barre, PA 18703-0020 0 www.guard.00m Massachusetts Department of PubItc Safety � 801r,:� of gtOdmg Regulations r; CS-103081 JAMES J FLANNERY 1 WILLIAMS ST HOLYOKE MA 01040 i ,....::. 09/2112010 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. Registration: 183698 1 LOVEFIELD ST. Expiration: 11/03/2019 EASTHAMPTON, MA 01027 Update Address and Return Card. 23^A-05117 i i