23A-245 (2) 37 MANN TER BP-2020-0290
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23A-245 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 P E RM I T
Permit# BP-2020-0290
Project# JS-2020-000485
Est.Cost: $9700.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sq.ft.): 7579.44 Owner. KOVAR THOMAS&
Zoning: URB(100)/ Applicant. JAMES FLANNERY
AT: 37 MANN TER
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.9/6/2019 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:
FeeTyae: Date Paid: Amount:
Building 9/6/2019 0:00:00 $40.00
X12 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
DocuSign Envelope ID: 3E2AEA94-0839-4D4B-9D20-7D30BDE91 1 A4 IiEll��
- Department use only
- City of Northampton �;;9/�� Status of Permit:
Building Depart ent !�^CCut/Driveway Permit_
212 Main Str et we! p Availability
r Room 10 SEP Waie ell AV ilability
Northampton, MA 01660 r ' Two S is of tructural Plans
phone 413-587-1240 axT,'7-1272 I lot/ to I s�r�gipin 0th Spe fy
APPLICATION TO CONSTRUCT, ALTER, REPAIR,RE Ebb LIS A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be complplete by office
37 Mann Terrace
Map �3�_ Lot / , Unit
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Thomas Kovar 37 Mann Terrace, Florence, MA 01062
Name(Print) Current Mailing Address:
FDocuSigned by_
a,S_�___>!buta� _____ Telephone 413-221-5845
Signature —_-- _ ----
2.2 Authorized Agent:
James J. Flannery 1 Lovefield St., Easthampton MA 01027
Name(Pant) Current Mailing Address'
413-203-5888
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $9,700.00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) �(f'
5. Fire Protection
6. Total= (1 +2+3+4 + 5) $9,700.00 Check Number
This Section For Official Use Only
Building Permit Number: DateIssued:
Signature: r
Building Commissioner/Inspector of Buildings Date
peakperformanceroofingllc as gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
DocuSign Envelope ID:3E2AEA94-0839-4D4B-9D20-7D30BDE911A4
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
oe
New House ❑ Addition ❑ Replacement Windows Alteratlon(s) Roofing
Or Doors !]
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [[] Siding[O] Other[O]
Brief Description of Proposed Strip & re-shingle roof.
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.-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. 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 below finished grade
k. Will building conform 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
Thomas Kovar
I• ___ ________ as Owner of the subject
property
hereby authorize
James J. Flannery / Peak Performance Roofing, LLC
_
to act on my behalf, in all matters relative to work authorized by this building permit application.
DocuSigned by:
AA L6441C
Signature of Own Date 8/30/2019
James J. Flannery
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 J. Flannery
Print Name
i/ Jf 156 l
Signature of Owner/Agent Date
DocuSign Envelope ID: 3E2AEA94-0839-4D4B-9D20-7D30BDE911A4
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: CS-103061
License Number
James J. Flannery 09/21/2020
Address Expiration Date
I U,I'I tt rn Holyoke, MA 01040
Signature �r Telephone
413-203-5888
9.Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Peak Performance Roofing, LLC 183698
Address Expiration Date
1 Lovefield St., Easthampton MA 01027 Telephone 413-203-5888 11/03/2019
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...... ❑
DocuSign Envelope ID:3E2AEA94-0839-4D4B-9D20-7D30BDE91 1 A4
_ City of Northampton
Massachusetts
� c
t DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building
Northampton, MA 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 properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
37 Mann Terrace
(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:
Aaron's Roll-Off, 1 Loomis Way, Easthampton MA 01027
(Company Name and Address)
�� k o// /
Signature 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 where the debris will be disposed.
The.Commonwealth of Massachusetts
Department of Industrial Accidents
Ofce'of Investigations
liv 600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Peak Performance Roofing, LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Ayu an employer?Check the appropriate box: Type of project(required):
1. 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.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ 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 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.gRoof repairs
insurance required.] t c. 152, §1(4),and we have no 13.❑ Other
employees. [No workers'
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.
1 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.#: R2WCO21353 Expiration Date: 4/27/2020
M e Vl d r
Mft-
JobSiteAddress: 37 11 1 CL l'1 n -.(l rra City/State/Zip: GYDba�
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 penal
Phone#: ' s of perjury that the information provided above ' tnrue and correct
Signature:
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#:
Worker's Compensation and Employer's Liability Policy
Be PICS11 I t"e H atl l a Wa V AmGUARD Insurance Company-A Stock Co.
7 Policy Number R2WCO21353
GUARDInsurance Renewal of R2WC943835
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, 2019 to April 27, 2020, 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
f
C. Refer to Residual Market Limited Other States Insurance Endorsement-WC200306B
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 $ 31,202
Total Surcharges/Assessments $ $1,181.00
Total Estimated Cost $32,383.00
INTERNAL USE XX Page- 1 - Information Page
MGA : R2WCO21353 WC 000001A
Date :04/01/2019
MANOTE
Issuing Office: P.O. Box A-H, 16 S.River Street,Wilkes-Barre,PA 18703-0020 www.guard.com
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. viEration: 11/03/2019
EASTHAMPTON,MA 01027
SCA 9 20M-05117 Update Address and Return Card.
�
rITI�o�fnHrwroH/rnv�/�i��•^. /1a1.:ia�u:P/1.•
0111as of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration data. If found return to:
R2gistration 9WIration Office of Consumer Affairs and Business Regulation
183906 11/03/2019 10 Park Plaza-Suite 5170
PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02116
JAMES FLANNERY
1 LOVEFIELD ST.
EASTHAMPTON,MA 01027 Undersecretary t valid without signature
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Construction Supervisor
Unrestricted-Buildings of any use group which contain
CS-103061 p �/21i2020 ICss than 36,000 cubic feet(991 cubic meters)of enclosed
Ex
Expires: space.
JAMES J FLANNERY
1WRUAMSST
HOLYOKE MA 01040
Commissioner C'L Failure toPo ssess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For information about this license
Call(617)727-3200 or visit www.mass-gov/dpi
DocuSign Envelope ID:3E2AEA94-0839-4D4B-9D20-7D30BDE911A4
Contract
PE K Peak Performance Roofing LLC
P E R F O R C E I Lovefield St Date Contract#
IkELq 0 o Easthampton, MA 01027 8/28/2019 994
MA CSL#103061 413-203-5888 peakperformanceroofingllc@gmail.cwm www.peakperformanceroofingllc.com
MA HIC# 183698
Bill To Job Location
Thomas Kovar Thomas Kovar
37 Mann Terrace. 37 Mann Terrace.
Florence, MA 01062 Florence, MA 01062
413-727-6068 413-727-6068
tomasa37@comcast.net tomasa37@comcast.net
Description Total
1.Remove the existing roof material 9,700.00
2.Inspect plywood sheathing for rot or deterioration
3. Replace up to 64 square feet of CDX plywood if necessary at no cost.Any additional plywood will be$75
per sheet installed
4.Install 6 feet of ice and water shield at eaves and three feet around pipes
5.Cover remaining roof with Certainteed"Roof Runner" synthetic underlayment
6.Install new 8" aluminum drip edge on all eaves and rake edges
7. Install architectural shingles by Certainteed (Landmark PRO 40yr)
https://www.certainteed.com/residential-roofing/products/landmark-pro/
Color Choice:
8. Install new ridge vent of peaks of roof
9.Complete all necessary flashings including new pipe boots
Remove all debris from premises, and throughout the job, continue cleanup and keep the premises
undamaged.We are not responsible for debris that may fall into attic.Please use caution during the process;
do not walk/drive under active work,or on areas of potential roofing debris.Contractor will obtain building
permit. Installations are weather permitting.
Landmark PRO shingles=$9,700
A deposit of$4,850 is due at contract signing. The balance shall be due upon completion. Accounts
outstanding over 10 days past final invoice date subject to 2%finance charge,compounded monthly.
Contractor Signature: Customer Signature: oocus 9nea by: Date: 8/30/2019 Total:
OwtaS h, 6W 59,700.00