11A-010 (10) 38 LEONARD ST BP-2018-1222
GIS a: COMMONWEALTH OF MASSACHUSETTS
Map Block: IIA-010 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-2018-1222
Proiect4 JS-2018-002183
Est Cost: $4375.0
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sq.ft.), 29010.96 Owner: WHITE GREGORY W&PATRICIA I REIDY
Zoning: URA(1001/ Applicant: JAMES FLANNERY
AT: 38 LEONARD ST
Applicant Address: Phone: Insurance:
1 LOVERELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.511812018 0.00.00
TO PERFORM THE FOLLOWING WORK:REMOVE EXISTING ROOF AND REPLACE WITH
METAL ROOF ON FRONT PORCH AND 2 BAY WINDOWS ONLY
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 f! 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 5/18/20180:00:00 540.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
4NORTHAMPTMM
ECEIVED 2cy0 r"
Department use only
AWAY 7 B G (�f rtn pton Stews of Pemdt
�''[1 Ing ep ment Curb CutlDrivexayPoll
212 M in S eet Se r*epbeAveilabhr4
OF BUILDING INSPEdtDY11111 Water/Well Availability
1060 01080 TWO So%of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PioV&te Plena.. .
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION t -SITE INFORMATION
va ( f
1.1 Property Address: ci This section to be oompieted by ottim
38 i ona/Zj JI Map fik— Lot 0 Unit
F I o r,Q r7 j#C M14 /7 /Os3 Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
/'A791CM Rs+ DY 3k d 5t, Flov�»cam
Name P'nl Current Mailing Address'
Telephone
Signature
2.2 Authorized Agent
-JAmE3 U. Fc 9M/U le y I It, v� �I d S+. , Ens+l�arnplanL)
Name(Pont) Current Mailing Morass:
y/3 - 2D3 -5886
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
nonvilAtadb nmin annificant
1. Building `/ 3 Z7 �b (a)Building Permit Fee
5.
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee ,f
4. Mechanical(HVAC) ++010
5. Fire Protection
6. Total=(1 +2+3+4+5) °-/3Check Number /
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature' �B
BuimingC isslonerllnspector of Bulltlings Dole
pe4,,ye(Arm dOu90o4nGLlC Gn,&*dC .CD/✓t-
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION S-DESCRIPTION OF PROPOSED WORK(check all applicablel
New House ❑ Addition 0 Replacement Windows Alterations) ❑ Roofing
Or Doors El
Accessory Bldg. ❑ Demolition ❑ New Signs [DI Decks [O Siding[0) Other[p]
Brief Description of Proposed
Work: R�mav_ - 9<x154,1na roof + re.�laco Ui4i� En6-&,-4 W61 aN -I"✓�t'T�- /'
ba rl u �d
Alteration of existing bedroom-Yes_No Adding new betlroom a
Yes No /
Attached Narrative Renovating unfinished basement Yes No
Plans Attacheded Roll -Sheet
w:N New house and sof adds tion to existina housing complete the tollowlna
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?
I 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
It. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank_ CitySewar Private well_ City water Supply_
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, PA7KICIp REifb
as Owner of the subject
property
hereby authorize �q'm6S FLAN.0 EJ2`f .DPA PEAK PE12F6{2M/kAJCt- AbOr—los LLC
to act behalf in ell matters relative to work authorized by this building permit application.
Signature of Ower Date
4MF-S F1I9N AJGR / ,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.
-TAMES FLNNNF12
Print Name
y a��
Signature of er/Agent Data
SECTICN 8-CONSTRUCTION SERVICES
8.1 Lleeruad Combue8en Sumarvior: Not Applicable ❑
NomeoitJmmattmkler:_-J,9MES �T FLA/yNERy CS — /030101
Litere0 Nwnlier
/ 6uilliam5 5f" ! /yoke rnl4 O10y0 09/.? Z) 8
Addmas I Eq—* t Date
L113- a03 - 588 '
Slgrewm Telephone
Nm Applicable ❑
PERK PERFoRry1F�N LE /LUOF//Ufr, LLC I F 3 6 9Y
Comment,Name Registrad Number
Dove eld 5f Fas-b a& -l-onl M)q Nba31 117Z /20I9
Address i
(1/13) Expiretlon Date
Telephpm e1D3-,S88r�
SECTION 10-WORKERS'COMPENSATION WSURANCE AFFIDAVrr(M.O.L a 182,f 280(8))
Workers Compensation Insumrke affidavit must be completed and submitted with this eppficaWn. Failure to provide this affidavit will meult
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... M No...... ❑
City of Northampton _
Massachusetts �.
lSPeaaQQlx 0l nlxrw SS IWs1?zc7I0aS
.s
212 Win stroek •WnieiPsl euilUi�p
9ortEsyton, M01060
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:
3Y CeOn/AR cl 5 >t F/oy�hc�
(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:
,4�ons l�ol%off-><; J �oom;s uJac��as�fhamp�i� i�'!t7
(Company Name and Address)
Signafdre drPermit Alliplicant 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.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
A,r-e-,/yp u an employer? Check the appropriate box: Type of project(required):
1.L; l 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 S. ❑ Demolition
working for me in any capacity. employees and have workers'
insurance., 9. E] Building addition
comp.[No workers' comp. insurance P.
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 monrmatinn.
I Flonnowner,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
/Connactots that check this box most attached an additional sheet showing the name of the sub-contractors and state whcthcr m not those entities have
employees. If the sub-contactors have employees,they most 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.
Insurance Company Name. Berkshire Hathaway Guard
Policy#or Self-ins. Lk.#: R2WC,943835 / Expiration Date: 4/27/2019
Sob Site Address: 3ff L-eonar- / ST City/State/Zip: &.e ee mfl 010-',3Attach 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.
do hereby certify under the pains(antedpen�aes
QlQ' ofp(e�rjury 6
that the information provided above is trope and correct.
Sianamre: jr /1 ' I Yy 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#:
Worker's Compensation and Employer's Liability Pol[cv
of R2W11187
a AmGUARD Insurance Company -A Stock Co.
Berkshire Hathaway Policy Number R2WC943835
InsuranceGUARD Companies Renew NCCI No.[218 3]
Policy Information Page (AR)
[1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER 8 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
MGP : UWC'943835 WC 000001A
Date :00/04/2018
mmoO
leading Office:P.O.Box A-H, 16 S. Riwx Street,Wilkes-Barre, PA 18703-0020 •www.guard.com
vfze Cpa7nmonulea� o�C>�aoaac`ucae�
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: 1 /03/
1 LAVEFIELD ST. E>�Iratlon: 111/03/2019
EASTHAMPTON,MA 01027
Upde Addro ane Realm Cnd.
uni O ROMLYi1
.tassaensxts Fa -ac�
Soaro a+ 9u.iq ng Req noon "d a.a�ms
L cense CS-103061
JAMES J FLANNERY
1 WILLIAMS 0T
HOLYOKE MA 010"
P-I.nn L//am_
�a� riss v.:e' 09121/2010
PE K Peak Performance Roofing LLC Contract
PERF O R CE 1 Lovefield St Dale oOn
aI Easthampton, MA 01027 4/272018 534
MA CSIA 103061
MA RIC 8183698 413-203-5888 peakparfh..caoofi.gUc@gmaiL— www.prakperfmmureercofin811cwm
Job Location Bill To
Tricia Reidy Tricks Reidy
38 Lwnwd SL 38 Leonard SL
Florence,MA 01053 Florence,MA 01053
413-5884313 413-588-1313
trieiareidy@gmatl.com hfciareidy@grneiLwm
Description Total
I.Remove the existing roofmmerials 4,375.00
2.Inspect the sheathing and replace up to 100 square feel ofroued/datrriorated rood as needed m no additional cost.
3.losto0 3'ofCcrwinTmd Winterguard HT(High Tempereture)ice&outer shield at the eaves,and weer remaining
roof surface with synthetic undedaymenL
4.Insall E:nglwt 24 gauge standing seam mina roofaystem.Panels will be 16"wide with 1.5"merhndcel lock
semen.
htlpe://www.engkatine�.cioat/1-9LC2%BD-m1echeoirsl -aeemW-mchl-sof-sysema1300.htm1
Color Choice:
6.Insall Colorgvd avow rails or porches.
hop:/Ace .meWpluslo.con✓domneoWmetspluasolorp,d-brochure.pdf
Thu estimate is for a wmpietejob including repaving&re-insaling siding/hien to xwmodek inefalation of
fleshing at roo8wal transitions and removing&reinstating genres.
Property will be Protected mal firm;to prevent any damage to the home or plantings.At debris will be remnved
from the premien.
From poach and bay window=84375
A deposit of 50%(52187.50)is required prior to asset ofwork
The baanw($2187.50)shall be due upon completion.
•We rrenot responsible tLiWtdcbri.that mayfall into attic-
emomerSignature: t �`
Contueoor Signature' t TO ' I 54,375.00