35-050 (7) 966 RYAN RD BP-2019-0305
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35 -050 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-2019-0305
Proiect# JS-2019-000496
Est. Cost: $15700.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sg. ft.): 14897.52 Owner: JONES MICHAEL E&MEGAN E
zoniniz: Applicant: JAMES FLANNERY
AT. 966 RYAN RD
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.9/16/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE 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:
FeeType: Date Paid: Amount:
Building 9/16/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
�Z OOF
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
41
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240ax - / Site ans
V s
APPLICATION TO CONSTRUCT,ALTEI t, REPAIR,RENOVATE OR DEN OLIS i A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION 6p— ' q
DEPT OF BUILDING INSPFCTIONITrhIs on to be completed by off1w
1.1 Property Address: NORTHAMPTON.MA 01060
96 6 R a nAaL r Map Lot > v Unit
Zone Overlay District
Elm St.Dlshlct CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
M dla'el C1()/,/' I VAA_) AM r--e 410A
- Name(Pri `- Current Mailing Address:
Telephone 13 _ 9
\ Signature O CO 7
2.2 Authorized Agent:
JPMES T CO) VAIER ca sAaYTRMN Njq
Name(Print) Current Mailing Address: �JQ
X113 - a03 - s,Y
Signature U V Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building C"7 (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 +2+3+4+5) /,5 a Check Number 120 X 17
This Section For Official Use Only
Building Permit Number: Date
Issued:
19 19
Signature: /6tt(9
Building Commissioner/inspector of Buildings Date
pe4KPft?Fonrn6Ai(6'AOOFIIV6- id-C (a G rn V c , COM
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
L� rr.. F L .-.��. =.i t'�� n
r ,.,_
I
2�:� ' ! :iVa�
e
... . . �
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[o] OtherBrief [C]J
Work: -f-of Proposed p -1- /Q-e t7 C) T LA_A'< -C.. S/AJI)d //?q S V_11 M t" 6
Sfn;
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
se.if New house and or addition to existing housing,complete the following:
a. Use of 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. DimeRsm" ns
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 below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. !:rnk City Sewer Private well City water Supply
,SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT
OR CONTRACTOR APPLIES
�FOR
�BUILDING PERMIT
as Owner of the subject
property
hereby authorize TAm�S �r rFL#gNAJ&/2y D&4 OF14K 0Z;RF02Y) 14NCC A0Dr-1b6 LL
to act on my behalf,in all matters rela ive to work authorized by this building permit application.
b
Signature of Owner Date
��m E 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.
-J'qML=S 7, FL141VIJ>r91/
Print Name
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: r� Not
Applicable ❑
Name of License Holder: y Am ES J7 P L,q1V1V&ice y (r. S "' 1030&' l
License Number
l ry;llr m5 5 , , okQ meq o�oyo 09/a1 f 2a/
Address Expiration Date
Signature Telephone
9.Realistered Home Improvement Contractor. Not Applicable ❑
)06A4K PCrz Foi21?,7R1y eC 2vOFlruG, LLC / (o q
Company Name Registratio Number
o L-DV-0- ,,-0ld 5f. �a s haMRIZA; MA D �� r100-3 12-0
Address V /V1 3) Expiration Date
Telephone 1,3
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....... l` No...... ❑
City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS 7=.
212 Main Street a Municipal Building
Northampton, MA 01060 ,,0
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:
q6 6� Y'y/�-�j P c/-
(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:
(Company Name and Address) d a
Signa re 6Y Permit Aeplicant 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.
14CThX
e 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
AWylu an employer?Check the appropriate box: Type of project(required):
1. am a employer with 4 4. ❑ I atn a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
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 tY• 9. E] Building addition
[No 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 I I.❑ 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#1 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.
tContractors 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. Li//c.#: R2WC943835 Expiration Date: 4/27/2019
Job Site Address: 9&! &,lyf741 City/State/Zip: AI'D 2'"'M n 0/0&z
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 a ove is true and correct.
ILSignature: Date: 3
Phone#:
413-203-5888
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#:
A �. � '�
`'�
lwl,3&sach,usetts -aepa,,-iment,of Pubhc Safety
Board Of Suldmg Requfat€ons ind Standards
Lscense CS-103061
JAMES J FLANNERY
I WI LUAMS S.T
HOLYOKE MA 010"
ZCK- (.A, Expiravon.
0912112018
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.
20M-05/17
Worker's Comoensation and Emuloyer's Liability Policy
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 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)
[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 Office: P.O. Box A-H, 16 S. River Street,winces-Barre, PA 18703-0020 a www.guard.com
P E Peak Performance Roofing LLC
Contract
P E R F O R C 1 Lovefield St Date Contract#
Easthampton, MA 01027 8/23/2018 640
MA CSL#103061
MA HIC# 183698 413-203-5888 peakperformanceroofingllc@gmail.com www.peakperformanceroofinglic.com
Bill To Job Location
Michael Jones Michael Jones
966 Ryan Rd. 966 Ryan Rd.
Florence,MA 01062 Florence, MA 01062
413-727-8669 413-727-8669
enoch.jones@gmail.com enoch.jones@gmail.com
Description Total
Install Standing Seam Metal Roof System(Includes front addition/porch): $15,700.00 15,700.00
1.Remove the existing roof materials
2.Inspect the sheathing and replace up to 100 square feet of rotted/deteriorated wood as needed at no additional cost.
Additional plywood needed is an additional$60 per sheet installed.
3.Install Y of CertainTeed Winterguard HT(High Temperature)ice&water shield at the eaves&valleys.
4.Install synthetic underlayment on all remaining areas of roof.
5.Install Englert 24 gauge standing seam metal roof system.Panels will be 16"wide with 1.5"mechanical lock seams.
https://www.englertinc.com/1%C2%BD-mechanically-seamed-metal-roof-system-a1300.html
6.Install vented ridge cap.
Color Choice:
Estimate includes choice of any of Englert's 24 standard colors. Englert"Premium"paint coatings(Mill Finish,
Champagne,Metallic Copper,Preweathered Galvalume)are special order and have an upcharge.
Property will be protected at all times to prevent any damage to the home or plantings.We are not responsible for
dirt/debris that may fall into attic.All exterior debris will be removed from the premises.Contractor will obtain building
permit.
Optional:Colorgard snow rails. Additional$30 per linear foot installed.
http://www.metalpluslic.conVdocuments/metalp lus-colorgard-brochure.pdf
Cost:$15,700.00
A deposit of 1/3($5200)is due at contract signing. A progress payment of 1/3($5200)is due at 50%completion.The
balance shall be due upon completion. Accounts past due 30+days are subject to a finance charge of 1.5%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 Signa Date:
VA�jj�1 $15,700.00
it