10B-092 (9) 195 MAIN ST-LEEDS BP-2020-0814
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 1 O-092 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-2020-0814
Proiect# JS-2020-001406
Est.Cost:$11400.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sq. ft.): 89733.60 Owner: Cynthia Roberts
Zoning: URB(100)/WP(50)/ Applicant. JAMES FLANNERY
AT. 195 MAIN ST - LEEDS
Applicant Address: Phone: Insrurance:
I LOVEFIELD ST (508) 294-4052
EASTHAMPTONMA01027 ISSUED ON.1/17/2020 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:
FeeTvpe: Date Paid: Amount:
Building 1/17/2020 0:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
�V
\ Deparfment use only
City of Northampto�i �` talus of Permit:
Building Deprtmtt ' . firl� Cut/Rriveway Permit
212 Maintreef ✓qN , �.✓/r/Se tic Availability
'
Room.100 ` t5 �� W te
P r/WI Availability
Northampton, MSF 20 T o Se of Structural Plans
phone 413-587-1240 Fay 41,a; lot/Si Plans
ther Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE O �-BEM6LISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address:
This section to be completed by office
191 Main Street, Leeds Map 10f Lot Unit
Zone Overlay District
Elm St.District CB District
i2SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
.1 Owner of Record:
G Vr,q/,a
Name(PrintCurrent M fling Address:
Telephone
Signa.-�r�
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 $11,400.00 (a) Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) #LID
5. Fire Protection
6. Total = 0 + 2 + 3+4+ 5) $11,400.00 Check Number
This Section For Official Use Only
a0 Al Date
Building Permit Number: H� Issued:
f
Signature: _ /�Lo
Building Commissioner/Inspector of Buildings Date
pea kperformanceroofingllc na gmail.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 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding [0) Other[d)
i Brief Description of Proposed Strip and replace shingles
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa. 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 R. 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
c L 7 as Owner of the subject
propei y --_-
James J. Flannery / Peak Performance Roofing, LLC
hereby authorize
to a n my behal]_in_Jall rs relativ to work authorized by this building permit application.
--",mac-- �-��
ature Owner 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
Signature of OwnerlAgent Date
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
cin S
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 11/03/2021
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....... Its No...... ❑
City of Northampton
Massachusetts
-A
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street *municipal Building svC`D
Northampton, MA 01060 ssNjy �1J
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:
191 Main St, Leeds
(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)
1--��
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
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.
Gity/State/zip: Easthampton, MA 01027 Yhone It: 413-203-5888
AVI
u an employer? Check the appropriate box: Type of project(required):
1. am a employer with 4 4. ❑ I am a general contractor and 1
employees (full and/or part-time).
* have hired the sub-contractors 6. E] 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. insurance.
t ❑
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 worker'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.Lie.#: R2WCO21353 Expiration Date: 4/27/2020
Job Site Address: I ` I 1 �� 1((�t�l't" L Q QdS Q
City/State/Zip: (`,, (',;
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 andpenalll es ofperjury that the information provided above is true and correct.
Signature: T � �-
Date•
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#:
Office of Consumer Affairs and Business Regulation
1000 Washington Street- Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE ROOFING,LLC. Registration: 183698
1 LOVEFIELD ST. 6cpiratton 11/03/2021
EASTHAMPTON,MA 01027
Update Address and Return Card.
SCA 1 O 20M-W17
OfHa of Consumer Affairs t1 Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the wcplratlon date. If found return to:
Ril9L8tniffim EI ratl.Qn Office of Consumer Affairs and Business Regulation
183666 11/03/2021 1000 Washington Street -Suite 710
PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118
JAMES FLANNERY
1 LOVERELD ST.
EASTHAMPTON,MA 01027 , Undersecretary No valid without gnature
i
Commonwealth of Massachusetts
® Division of Professional Licensure Construction Supervisor
Board of Building Regulations and Standards unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of enclosed
space.
CS-103061 Expires:09/2112020
JAMES J FLANNERY
1 W WAMS ST
HOLYOKE MA 01048
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
Commissioner For information about}his license
Call(617)727-3200 or visit www.noss.gov/dpi
Worker's Com and Ranalo nes Liability Polley
Berkshire Hathaway /in ARD Insurance
Company-A StOd`Co.
y Polley Number R2WCO21353
GUARD Insurance Renetival of R2WC943835
Companies NaCl No. [21873]
i(
Policy InfommNon Page(AR)
[1]Named Insured and Malting Address
WE
PPERFORMANCE ROOFING LLC EAK BBER&GRINNELL INSURANCE AGENCY, INC.
1 LOVEFIl3.D STREET 8 NORTH KING STREET
EASTHAMPTON,MA 01027 Northampton, MA 01060
Agency Code: MAMAIN15
Federal Employer's ID 00-1191951 Imured 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.
131 Coverage
A. Workers'Compensation Insurance -Part One of this policy applies to the Workers'Compensation
Law of the following states: Massachusetts E'
B. Employers 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 Ij
Bodily Injury by Disease-policy limit $500,000
i
C. Refer to Residual Market Limited Other States Insurance Endorsement WC200305B
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 Estinvand Policy Premium # 31,202
Total Surdherges/Awasssmanb $ $1,181.00
Total t3tlarebed cost $32, .00
INiElaiAl usac hoc Page- 1 - Information Pape
MGA :RZWCD21353 WC 000001A
DOX :04/01/2019
MANOTE
ZeKdno olllce:P.O.Bow A-%16 S.Rhrer Street,WINoa-Barre,PA 18709-0020 www4uardA=n
P E K Peak Performance Roofing LLC
Contract
P E R F O R C E 1 Lovefield St Date Contract#
Easthampton, MA 01027 11/22/2019 1085
MA CSU 103061 413-203-5888 peakperformanceroofmgllc@gmail.com www.peakperformanceroofmgllc.com
MA HIC# 183698
Bill To Job Location
Jodi Lacoff Jodi Lacoff
191 Main St. 191 Main St.
Leeds,MA 01053 Leeds,MA 01053
413-923-1924 413-923-1924
jlacoff@gmail.com jlacoff@gmail.com
Description Total
1.Remove the existing roof shingles and inspect sheathing or boards 11,400.00
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/produccts/landmark/
Color Choice:(Please choose prior to installation): ,1, fw ver woo
7.Install ridge vent
8.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. WE ARE NOT RESPONSIBLE FOR DEBRIS THAT MAY FALL INTO ATTIC. Please use
caution during the process; do not walk/drive under areas of active work,or on areas of potential roofing
debris. Contractor will obtain building permit. Installations are weather permitting.
Total cost(Whole house,excluding low slope portion already replaced): Landmark 30yr shingles=$11,400
An initial deposit of$500 will secure priority scheduling and lock in price protection for installation in Spring
2020. The balance of the deposit,$5200,shall be due prior to start of job. The final balance shall be due
upon completion. Accounts outstanding over 10 days past final invoice date subject to 2%finance charge,
compounded monthly.
Contractor Signature: A
st Signa Date: Total:
��. Z� / $11,400.00