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25C-048 (8) 224 NORTH ST BP-2020-0329 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C-048 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2020-0329 Project# JS-2020-000554 Est.Cost: $16950.00 Fee: $40.00 PERMISSION IS HEREB Y GRANTED TO: Const. Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sq. ft.): 7579.44 Owner: BRODWYN JANE MEYERSON Zoning: URB(102)/ Applicant: JAMES FLANNERY AT. 224 NORTH ST Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 WC EASTHAMPTONMA01027 ISSUED ON.9/11/2019 0:00:00 TO PERFORM THE FOLLOWING WORKSTRIP & 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 9/11/2019 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner L - - - Department use only -" City of North mpt IVott s of Permit: .� Building Dep rtme Curbu"D iveway Permit_ A 212 Main S reet Sew /Sep c Availability__ Room 1 0 SEP 1 1 • 201 ate/Well Availability Northampton, A 01 60 Two ets o Structural Plans phone 413-587-1240 F x 41 e PI ns --• DEPT.OF GUILDINr;WSP NORTHAMPTON.MAI Get er Spg APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH AONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION r640-0)o -3 '-2 This section to"677 e c�Ompl by office 1.1 Property Address: �l�j('' ol�tl' 224 North Street Map /' y Lot Unit Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Jane Brodwyn 224 North St, Northampton, 01060 Name(Pri ) Current Mailing Address: Telephone 413-374-8883 Signatur 2.2 Authorized Agent: James J. Flannery 1 Lovefield St., Easthampton MA 01027 Name(Print) 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 $16,950.00 (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanicai(HVAC) 0"14 5. Fire Protection 6. Total=0 +2 + 3+4 +5) $16,950.00 Check Number This Section For Official Use Only Date Building Permit Number: — Issued: Signature: 6d&�� VU Building Commissioner/Inspector of Buildings Date peakperformanceroofingllc�gmail.com.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[0] Other[Ol 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 Jane Brodwyn as Owner of the subject property hereby authorize James J. Flannery / Peak Performance Roofing, LLC _ to act on my behalf all matters relative to work authorized by this building permit application. i Signator of caner Date James J. Flannery I. , 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 C,I Signature of Owner/Agent Date a 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 Holyoke, MA 01040 Expiration Date Signature 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....... I/ No...... ❑ City of Northampton ° �s Massachusetts A i 6 DEPARTMENT OF BUILDING INSPECTIONS x 212 Main Street *Municipal Building y`�4 CDS Northampton, MA 01060 ffwjy ��, 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: 224 North Street (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) � q u-)l Iq 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 Office'of Investigations 600 Washington Street Boston, MA 02111 IF 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 Are ypu an employer?Check the appropriate box: Type of project(required): L E 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 g. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. msurance.1 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.[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. lContractors 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. BerkShlr2 Hathaway Guard Insurance Company Name: Policy#or Self-ins. Lic.#: R2,WCO21353 Expiration Date: 4/27/2020 C�y !�)�( �C City/State/Zip: �, ) Job Site Address: `�\Y Q�� Ci C\_\ 0 LG.0 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 correct. Signature: Date: L� 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#: Worker's Compensation and Employer's Liability Policy Berkshire Hathaway AmGUARD Insurance Company-A Stock Co. Y Policy Number R2WCO21353 G��D Insurance 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 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 : RZWCO21353 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. Expiration: 11/03/2019 EASTHAMPTON,MA 01027 SCA 1 204-05117 Update Address and Return Card. � Office of Consuaw Affairs i Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:LLC before the expiration date. If found return to: g2giablum Eimiiadan Office of Consumer Affairs and Business Regulation 183896 11/03/2019 10 Park Plaza-Suite 5170 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02116 JAMES FLANNERY 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Undersecretary Wt valid without signature ® Cornnwnwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor Unrestricted-Buildings of any use group which contain CS-103061 Eapires:QW2112020 less than 35,000 cubic feet(991 cubic meters)of enclosed space. JAMES J FLANNERY 1 WILLIAMS ST HOLYOKE MA 01040 uys Commissioner Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For infomwtion about this license Call(617)727-3200 or visit www.mass.gov/dpI K Peak Performance Roofing LLC Contract P E R F O R C E I Lovefield St Date Contract# Easthampton, MA 01027 9/3/2019 1000 MA CSL#,103061 1 413-203-5888 peakperformanceroofingllc@gmail.cvm www.peakperformanceroofingllc.com MA HIC# 183698 Bill To Job Location Jane Brodwyn Jane Brodwyn 224 North St. 224 North St. Northampton,MA 01060 Northampton, MA 01060 413-374-8883 413-374-8883 janebrodwyn@gmail.com janebrodwyn@gmail.com Description Total -This contract is for the main roof and lower main roof- 16,950.00 1.Remove the existing roof material 2. Install new 1/2 inch CDX plywood over boards 3. Install 6 feet of ice and water shield at eaves and three feet around pipes 4.Cover remaining roof with Certainteed"Roof Runner"synthetic underlayment 5.Install new 8" aluminum drip edge on all eaves and rake edges 6.Install architectural shingles by Certainteed(Landmark 30yr) http://www.certainteed.com/residential-roofing/products/landmark/ Color Choice: �� 7.Install new ridge vent of peaks of roof 8.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 shingles=$16,950 A deposit of$8,475.00 is due prior to the beginning of the job.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: C stow Si atu Date C Total' L ' $16,950.00