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23A-238 (3)
65 MANN TER BP-2018-1370 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A-238 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category: ROOF BUILDING PERMIT Permit# BP-2018-1370 Project# JS-2018-002429 Est.Cost: $9200.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: JAMES FLANNERY 103061 Lot Size(sp.ft.): 6882.48 Owner: HOTT LAWRENCE R&DIANE K GAREY zoning,URB(100)/ Applicant. JAMES FLANNERY AT: 65 MANN TER Applicant Address: Phone: Insurance: I LOVEFIELD ST (508) 294-4052 WC EASTHAMPTONMA01027 ISSUED ON.612012018 0.00:00 TO PERFORM THE FOLLOWING WORK STRIP & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspectorof 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: Obi ; 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: FeeTyr e: Date Paid: Amount: Building 6/20/2018 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax(413)587-1272 Louis Hasbrouck—Building Commissioner RE FWD City of Nort am n abbnofpbmc JUN IIilod rt ent CurDCIM000WPlNma 212 Main Stre SWM $Pdc AvltSlmft O:N OF SUI �N OO ORTMq r m`�hNSPB"'%!A 1080 Tva6fbofftlockod PIrI phone 4l&587-124 ax 413587-1272 FWM Pte_. . aemagiodry APPLICATION TO CONSTRUCT.ALTER REPAIR,RENOVATE OR DEMOLISH A ONE 7OR TWO FAIRLY DWELLING SECTION 1-SITE INFORMATION a v- 19 - I �,, 70 1.1 ProoaMAddress: Inds sectiad to be WnglsmQ by am" 65 MAIYAI TC,R P- a C le, Map 1�3/4 Lot d j,7,/ —Unit Zone Overlay DlWkk- tem at Disbft CB Dbbk1 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Omer of Record: -D%SNL Go-e-oV MaNti -(zZt2)xaCa- r.2✓o/JL NMrre .Uu Comm Me"Addnns: O IOG stgwv — Tim Ll 13 a 7- 2/1 rw� 2.2 Authortsd Agent: 7pmg T GtANNER`/ i �o„R��/d sf, Eas111arnpfoaMR Name(Red) Cu eRt M eire Address: 1�13 - ao-38 SgnaWm TeNwure SECTION S-ESIYAATED CONSTRUCTION COSTS Item Estimated CM(Dollars)to be Official Use Only cors bled bV uemmi 800liCant 1. welding 9doo (a)Building Permit Fee 2. EbGdmt U (b)Estimated Total Cost of cwummdon from 6 3. Plumbing Building Permit FN 4. Nbcharkel(HVAC) !� 5.Fire Protection 6. Total=(1 +2+3+4+5) V1 Check Number This Section I"Official Use OnlY DaU Su)Mirg Permit Number IssueQ: Sk BUole repecEmoraukligs Date p2AKP,Fi2FoiemAmeCA06FlN6-L-4,egI K-frM1, 'C TM EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 6 DESCRIPTION OF PROPOSED WORK(olwdr all aoollpdH New Kouse ❑ Addition ❑ Reptaconwm Windows Alnreaon(s) E] RoofingEr Sr Donn ❑ Aorwesory Bldg. ❑ Demolition ❑ New Signs [p] Docks [p SidingU=3] Other ICY SNefDs oA of Proposed 1 work: f(E-IZeo F, 2eInOV1 2XIS�� ; 1I75�dl/ 1//1dty`kyYY1D Alteration of ewsting bedroom—yes No Adding new bedroom Yes No S y'1 n9LQsr Attached Nmwfiw Renovating unfinished basement _Yee No J Plans Attached Roll -Sheet ft If IISIBbom and D7 aft to sickl t hayie]DO..coNN'!lleb So fO#mwh O: a. Use of building:One Family Tyro Family Other b. Number of=me In each family unit Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Numberofsuaies? f. Method of heating? Fireplaces or Woodstoves Number W each g. Energy Conservation Compliance. Messciwck Energy Compliance form attached? h. Type of construction I. Is construction within d0o fLof wetlands?_Yes —No. le construotioa within 100 yr. floodplain_Yes_No j. Depth of basement or cellar floor belay finished grade k. Will building conform to the Building and Zoning regulabons? Yes NO. 1. Septic Tank_ Cily Sewer_ Private well_ City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Caner of the subject p1opem { herebyauthnze JAMES 7, FLR/VAJQZY 2)6)1 PEAK PERFORM4WE fODFIiu6 to act onpit behalf,in all re relOw to work augwri ed by this building pemnit application. .t)&,m-e � ' 15 _moo/F� Signature of Owwr Date I, JAMES �, FLAN N>c2Y ,as Ownedfi uthodzed 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. '7ameS 3. FLANIVEK1/ print Nemo S � sig atue of Ovmx/AaeM Deis, SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Suoondw r. Not Applicable 17 x.ns of tlane9 tbMsr: J,9nE5 S FLA1VNE2Y Cs - /030&1 License Number l Williams 5f, llyoke MJ4 6110W 09A?/ /.2ai8 AddmeaI FapimWn Date y13 - a03 - 5885 SDre,tare Telephone, Not Applicable ❑ PERK PERFoR/YiH/yCE RvoF/iul>, LLC /P36 Cotn"M Name Registratio Number ) Lov�� akj 5+, Fasa. )-hrn��� ioa M)g a31 /1Z,�3 /zoi9 Address /y13) Expiration Dam Telephone 2ai:588J SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.0.L c Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this alfitlavit will reeutt in the denial of the issuance of the building perms. Signed Affidavit Attached Yes....... win No...... O City of Northampton0 MassachusettsDaPAR"s'e" or BO ZDIari xX"Xcr1oaB 212 win St et am—icipul Building (i) Borthu ton, M 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c40, 554, 1 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: 65- MAnn -r2✓ZCto'o (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: �a�ton (CompanyAdares/-B)oam;s uJa.�, �asftiam�opo} 61���i6 Sign re Permit plicant 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 ofMassaehusetts Department oflndustrial 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/Individuap: 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: L��-✓ Type of project(required): 1. I 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.❑ 1 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 Y 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 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 employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 most also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box most attached an additional sheen 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. Insurance Company Name: Berkshire Hathaway Guard Policy#or Self-ins. Lie.#: R2WC943835 Expiration Date: 4/27/2019 Job Site Address: G S 38 Ina ti n Tait?/?a C2_ City/State/Zip: floa VILP M� 0106 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. Ido hereby certify under the pains and penal,ties of peflriury that the information provided above is true and correct. mature C�-�.?Y" 1p _ Dete: 3 k 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- AStock Co. Y Policy Number R2WC943835 Insurance 11187 - G U A R DCompanies Renew N CI No.l of [218 3] Policy Information Page(AR) [1]Named Insured and Mailing Address Agency PEAK PERFORMANCE ROOFING LLC WEBBER a GRINNELL INSURANCE AGENCY, INC. 1 LOVEFIELD STREET 8 NORTH KONG 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 1425600 INTERNAL USE xK Page- 1 - Information Page MGA :R2WC 3835 WC 000001A Date :04/04/2018 MANOTE Issuing Office: P.O. Box A-H, 16 S.River Street,Wilkes-Barre,PA 18703-0020 s WV W.guard.com ✓,lie f0immonwea,4 o��ac,Cuule%�a 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. Registraecn: 18.9898 1 LOVEFIELD ST. E1gtra0an: 11103=19 EASTHAMPTON,MA 01027 Upd.b ACerap aM RM m CQM. scn, O xR 17 ® 8oa.a,, naid eea en•. "ct; . e, e,,mla- q Reg '.on nn aaros t.eeno� M103061 JAMES J FLANNERY 1 WILLIAMS 97 HOLYOKE MA 01//010 r'j=; CA— E>o .an. •;v,: ' SS o"'- OW2112019 K Peak Performance Roofing LLC P E Contract P E R F O R (� E 1 Lovefield St Date Convect' Easthampton, MA 01027 6/13/2018 566 MA CSL'103061 MA HIC Al 183698 413-203-5888 peakperformanmmofingllc(ajgmail.com www.peakperfonnanceroofingllc.com Bill To Job Location Diane Garey Diane Gary 65 Mann Terrace 65 Marr Terrace Florence,MA 01062 Florence,MA 01062 Hou@flm minefilms.org Non©0orentinefilms.org 413-727-8117 413-727-8117 Descnption Total 'Please note that we would require me contractor doing the interior work for the skylights to mark the enact location --I6 00.08 of the skylights prior to insmllation.They will also be responsible for any interior work needed.Thank you. 9 2611r I.Remove the existing roof shingles GQ/1 -Ao((-- elux tem 'ex n 3.Install six feet of ice and water shield at eaves and valleys, 12"armed roof/wall intersections 4.Cover remaining roof with Certainteed"ima fRunneY'synthetic underlayment 5.huvll new 8"aluminum drip edge on all eaves and rake edges 6.Install architectural shingles by Cerlainteed-Landmark PRO 40yr https://www.mrminteed.cam/residential-roofing/pmducts/lmdmuk-pro/ Color Choice:Max Def Hamer Green 7.Insall new Certaintad ridge vent 8.Complete all necessary flashings including new pipe boots and new base Flashing around chimney Remove all debris from premises,and throughout the job,continue cleanup and keep the premises undamaged Landmark PRO shingle¢59,200 A deposit of$5200 is due prior to start of work. The be]anve of 55200 shall be due upon completion. , n Deposit Received On: (0 Deposit$��OCheck k 3�((0 'Weare net.=thin fo�irt/debris that mey fall inm attic' Customer Signature: �� /C/-/� e , .f,PJ/-�j�� Conimmor Signature: Total 9te.40800- Z� 00