24C-074 (3) 44 MASSASOIT ST BP-2019-0173
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24C-074 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateeorv:ROOF BUILDING PERMIT
Permit# BP-2019-0173
Proiectft JS-2019-000288
Est.Cost: $10625.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grouo� JAMES FLANNERY 103061
Lot Size(sp.ft.): 19340.64 Owner: PETER POST
Zoning: URB(100)/ Applicant: JAMES FLANNERY
AT: 44 MASSASOIT ST
Applicant Address: Phone: Insurance:
I LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.8,11012018 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:
FeeType: Date Paid: Amount:
Building 8/10/20180:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck-Building Commissioner
I7ap.IM.pRlWewdy
City of Northampton sh"dP"O*
0
Building Department Curb OWD*X WPWA
212 Main Street Ses"SepYO Awk6MRy -
o - Room 100 WMerRMi
? Northampton, MA 01060 "SaY dabrleNwlPMII,_.T;
o phone 413-587-1240 Fax 413-587-1272 pmvuopkm
Down
ATI TO CONSTRUCT,ALTER,REPAIR RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION i-SITE INFORMATION 4
1.�1ProDarh Adder: JJ This aaetlm to be cxsn aM
�l�d by aR
1
y masa G(SO;C s-L Map a'NG Lot n 7 / Unit
Zona Oawlay DMNIa
Sea at Distrkt CB ObArw
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 ORnerof litaewd:
pe4eR Pos yyNone(P /7lasAmskeawso 't Sf, , Norlharrylanl
dnU `41 4 L 2 7-l4
Telephone
signatum
2.2 Auuaadred Agent
JRMES S, FLRNNER `/ l Leiye l eld St, 0-119 hAM,0fON MA
Name(Ping CWRM Malin;Addrow: OIO
03 - a? 3- 5-8? 8
31gneWre Td plane
SECTION a-ESTIMATED CONSTRUCTION COSTS
lawn Estimated Coat(Dollars)to be Official Use Only
1. Building /0) -: r (a)BuWlnp Pwmb Fee
2. Sactical (b)Estimated Total Cost of
Construction from e
3. Rumbing Building Permit I"
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) /d (pZ Check Number
Thh Section For Official the Only
Building Permit Nu Data
Isaretl:
SI/p/nSWre: ��
BL"rig mpectar of eWMkpe Deb
yeNKp�l2FORnIgN[EROOF/AI(rLLC � 6/»RiC. C'o/�/
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-OEWAMPT M OF PROPOSED WORK(check all aoogcaMeT
Naw Nana ❑ 1 AdW. ❑ RaPla -MW-down, AMaM.0) ❑ Rooting
or Donn �
Access"Bldg. ❑ Demolition /❑ New Signs [I7] /1 Decks [O Siding Do[ Other[l7[
Brief Desoiptionof l'roponed �LP ( erly,�i Tad to I� 9 l
wok: 2� nov� ax,sl�s/,n s , r:�s1u1/ 1nu� dr, vs P, v�nf
�lashinySr
Alteration of atlatinp bedroom_Yes_No Atltlirp new bedroom_Yes No a-{G
Attached Nanalive Renovating unfinished basement _Yes __No
Plana Attachad Roll -Stand
ga.tf ihW house mW at addldoR to>xto Bohahm tNMaWSIa Vw foMowim
a. Use of bugling:One Famgy Two Famity Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is them a garage attached?
d. Proposed Square footage of new cornbuction. Di one
e. Number of stories?
f. Method of healing? Fireplaces or WoodsWves Number of each
g. Energy Consermfion Compliance. Massc eck Energy Compliance foam attached?
h. Type of consauctlon
I. Is construction within 700 wetienda?_Yes _No. Is construction within 100 yr. floodplain_Yes_No
j. Depth of or cellar floor below finished grade
k. Will Wil ' confons to the Building and Zoning regulations? Yes_No.
I. S ' Tank— City Sewer-_ Private wag_ City wafer Supply
SECTION 7a-OWNER AUTHORV,ATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLAES FOR BULDWG PERMIT
I. PCItk as Owner of the subject
property
herebylut,,,;m O-AME75 7. FLl+NNEy2)/ Dail PEAK 0ERF6izM N a R00F/iu6 G[
to act on my behelf all myytars relatva to work authoized by this building permit application.
Signature W Omier Data
J
am E$ �. FLaN/U>E2y ,as OwnedAuthorized
Agent hereby dedare that the statements and information on the foregoing application am true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
-JAMES T FLANNERY
Prim Name
30
Signature of OwnemApem Date
SECTION 6-CONSTRUCTION fiERVICES
•1 Limned sAStM96e11VARMAem: Not Applicable 0
Netm eI I.kare IIpIl: 3RI7iE5 'T, F -AtvNE'RY C S — 1 D 301n/
l.iceneaNumlbr
1 ty;lhaM5 5f, f&o�oka M)q OloLJ� _ ; /0 L2 D/
Ad*M y13 - 003 - 58,��,F
swoh. Telephp
NctAppft" ❑
PF,4X PE)ZPdR/YIRNGE 1ZypF/216-, LLC IF 3 (O 90
Comm"Nome Regi NumM
Gove� e!d 5� ERfsfharr��onf Pl)l 2+rD � r1 03 /2orq
Address ��//3� Em ra n Date
Tekphom aZD3-JTB�"�
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e.162.126C(s))
Wodrere Compensabm insv affidavit moat be oo VWod and subs~with ING 8ppocaw.FOOM to PMvAe Gds alfidW*WO fesuft
in the denial of the issuance of the bu�ildi/ng pGM -
Syf! AfPolawt Attached Yes....... 41" No...... ❑
City of Northampton _
Massachusetts
Llf�waasrer os avraorsa rwspscrr
212 Me SG t *Nu "pnl Building ,
Northe ton, eB 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:
t/ V maSsaS f- 5f—
(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:
taaRonsRoll-o�� J � bm;s wac�, �as><hamp n11
(Company Name and Address) J a
Sign re of Permit 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 Industria!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/OrganieadoMndividuap: Peak Performance Roofing LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 phone#: 413-203-5888
Are you an employer? Check the appropriate box:
1.,M✓1 am a employer with 4 4. ❑ I am a general contractor and I Type of project(required):
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'
[No workers' comp. insurance comp. insurance. 9. E] Building addition
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 I1.❑ 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' 1311 Other
comp. insurance required.]
Any applicant that checks box kl most 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.
=Cmdracmts that clack this box most attached an additional sheet showing the name of the sub-contractors and state whether or net those entities have
employees. If the subcontractors 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. Lic.#: R2WC943835 _ Expiration Date: 4/27/2019
Job Site Address: yY 177a ;_5d Sbl'lL .S'� City/State/Zip: NO('khar( e/OA)
o/o(aO
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 perji�ury that the information provided aone is rue and correct c
Signature: y-'��1 (t] Date: /A� O
Phone#: 413-203-5888 r
Official use only. Do not write in this area, to be completed by city or town ofliciat
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
11187
Berkshire Hathaway AmGUARD Insurance Company -A Stock Co.
Y Policy Number R2WC943835
GUARDCompanies RenewalNCCI 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 Employers 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/Assassments ; 606.00
Total Estimated Cost S 14 256.00
VHEKNf USE xx Page- 1 - Information Page
MGA :R2WC943835 WC 000001A
Date :04/N/2018
MANOTE
Issuing Orrice:P.O. Box A-R, 16 S.River Street,Wilkes-gape,PA 18703-0020•www.guard.tnm
vfte �a�n�no�nu>�cr� o�C��ccaacre�ivae�#
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
TYpe: LLC
o
PEAK PERFORMANCE ROOFING,LLC. ReBora0on: 103W0
1 LOVEFIELD ST. E> ation: 11/03121119
EASTHAMPTON,MA 01027
Upda AOOma Ano Ra .OaM.
seal O zaraov»
�3sa. n.„sztts pa —em, u .. ;•-t1
3aarn c. 3.•,..IUnq �ec7 s.ta•��ns � c a a a.i=os
Lce,s=_ CS-100061 ..°••,'- `
JAMES J FLANAERY
1 WILLIAMS ST
HOLYOKE MA 01010 .".
MCA_ a r,x:oi,
Con�mss�o:er 0y1R016
MFO E KE
Peak Performance Roofing LLC Contract
1 Lovefield St Data Cordr.4
P E R Easthampton, MA 01027 4/302018 536
MA CSLI 103061
MA HIC 0 183698 413-203-5888 peekpafotmenceroofmglk®�ail.mm wwp,pedmerfonnaocetco6ngllc.com
Job Location Bill To
Peter Post Peter Post
44 Maasasmit St. 44 Masseaoit St.
Northampton,MA 01060 Northampton,MA 01060
petawantposlQ®nail.com petergrautpost@gmail.com
Description Total
1.Remove me existing roof shingles and cm back plywood on all mke edges 10,625.00
2.Install six feet ofice and rater shield at eaves and valleys
3.Cover remaining toofwith synthetic unrkrlsyment
4.Insall 8"aluminum drip edge
S.Ins W1 L sadmark shingles by Cermint«d
httpJlwww.cerlainteed.comrmidentialronfiny/psoduomOmd,nukl
Color Choice:Clmrtnel Black
6.Install ridge seat
7.Complain all necessary aeshinp including near pipe boom
Remove all debris from Promisee,and tluoughout the job,resource cleanup and keep the promises undamaged.
Landmark shingles=110,275
Added dormer cost=1350
Total rost=110,625
A deposit of50%(15312.50)is due prior to wart ofwork.
The balance(15312.50)9"I be due upon completion.
Deposit
y�
Deposit Received on: O / T /�O Deposit$ 1531Z
-We ere nM spo dirr/debris that may fall into attic-
Customer S'
Contractor Signatme: TQ�' 110,623A0