35-292 (5) 109 WOODLAND DR BP-2019-0701
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35-292 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-2019-0701
Proiect# JS-2019-001143
Est.Cost: $14256.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sq.ft.): 34325.28 Owner: ARMSTRONG KIPP S&PATRICIA S
Zoning: Applicant: JAMES FLANNERY
AT. 109 WOODLAND DR
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508)294-4052 WC
EASTHAMPTONMA01027 ISSUED ON:12/11/2018 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 12/11/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
FDECEIVED f-w ' -11'
City of No am 4on D E C 1 0 X01 of DWWbralt ues only
Building D part ent Curb Pyirnit
212 Mai StrSet?T OF SUJ-DAN(;iNSPF Availability
Roo NORTHAMPTON.MA 01 AnkhEIV
Northampton, MA 01060 is�kud"PMM
phone 413-587-1240 Fax 413-587-1272 Pbuti bs Plans
Oaw Spedf-
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
6P- !q Z0
1.1 Property Address: T �jThis section to be cora feted by olMM:e
/0'7 �1_?L1'''d la (k-) U/2/ (�1, Map Lot trait
Zone Overlay District
Elm 8L DIs41ct CS Dbtrict
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
�(;pp a �alrrcia /�K►rl�t ar)� /09 u."ce)d/avo D1,210 ,
Name(Print)� Current Mailing Address: /� G
1L Telephone 1113
2.2 Authortaed Agent:
-JgmtcS T, �t aNN��y -ov��;��cl Sf, Ea s�-l�ampMR
Name(Print) Current Mailing Address: O�Q
X13 - dO3 - ,TF? F
Signature U V Telephone
SECTION 3-ESTIMATED CON3WtUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction tion from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) Check Number o�
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/inspector of Buildings Date
PeAX��l2Forern�ucERooF/�vlr ts-C � �rrl�}i c, �/t'J
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New Nouse [] Addition E] Replacement Windows Alterations) EJ Roofing
Or Doors D
Accessory Bldg. Demolition New Signs [c3] Decks [0 Siding[p] Other[(SIJ
Brief Description of Proposed J
Work: S p {" l jw'r")
Alteration of epsting bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
ft!f New home and or Iltlon to exh>0m housing.conv*b 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? r
f. Method of heating? �`l Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. / Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within100,A--Of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of base or cellar floor below finished grade
k. Will g conform to the Building and Zoning regulations? Yes No.
1. ept' Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
'I, lC op Ar— sf'rv"y as Owner of the subject
property
herebyauthorize J'"F_S T, FL41V/U&12y Dag PE14K PERFORMI C0oFiN6LL
to act on my behalf,' all matters relative to work authorized by this building permit a7 /plication.
AJ93l�
nature Of OWner'. Date
l 1A m F S �. Ft, N N&k y 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.
1s�m�s s. F4AA1A)&R 1/
Print Name
Signature of Owner/Agent Date
SECTIONS-CONSTRUCTION SERVICES
81 Licensed y Constructio�n—STuoervlsro-r�. —� r� Not Applicable ❑
Name of Llconse Holder: o9l"E J �J, P L-�1VIN E-i,y C S -- 1030&
/
License Number
l GUiIlial�s Sf, , 110km4 0D /Z2d% /
Address f Expiration Date
y13 - 063 -- 5-9�g
Signature Telephone
Not Applicable ❑
PFaK PCR,Foper»A,ry CF 206F11L)6_, LL c /?3 (a 9S'
Company Name Registratio Number
0-3 /2097
Address /y�3� Expiration Date
Telephone v2 b3-57 ZY
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(S))
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....... No...... ❑
City of Northampton
Massachusetts
:c
DEPARMEN'T OF BUILDING ZNSPECTZONS
212 Main Street a Municipal Building 's f,
Northampton, MA 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, 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:
9 toond 14-n Dr t y,&
(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:
'am on s )�O X 0, , l Loomis
(Company Name and Address) 0 d al
12-1& I �
Sign re o 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 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/Flectricians/Plumbers
Applicant Information Please Print Legibly
Name (Busier«S/Orbanization/individuai): Peak Performance Roofing, LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Are v u an employer?Check toe 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 New construction
- listed on the attached sheet. ?. ❑ Remodeling
2.[1 1 am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in any capacity. employees and have workers'
Y P Y• 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.*
required.] 5• ❑ We are a corporation and its 10.❑ Electrical repairs or additions
q ]
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.VRoof 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#I 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 anti then hire outside contractors.must submit a new affidavit indicating such.
Contractors 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 pros ide 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.
Berkshire Hathaway Guard
Insurance Company Name:
Policy#or Self-ins. Lie.#: R2WC943835 _ Expiration Date: 4/27/2019
Job Site Address: fdq City/State/Zip: Irl'ormu rnx B/LYDZ
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 e. 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;
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#:
Berkshire Hathaway "ni6"ARD="'"PolkV .
GUARDCmpne N =21887
PalkV Infornudion PaW(AR)
[i]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY,INC.
1 LONERELD STREET 8 NORTH IQNG STREET
EASTFIAMPTON,MA 01027 Northampton, MA 01060
Agency Code: MANAIN15
Federal Employers ID 00-1191951 Insured In Limited Liability Co. (LLC)
[23 Policy Period
From April 27, 2018 to April 27, 2019, 12:01 AM,standard time at the Insured's mailing address.
[3] Coverage
A. Wwkers'Compensation insurance-Part One of this policy applies to the Workers'Compensation
Law of the following states: Massachusetts
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 $1001000
Bodily Injury by Disease-policy limit $500,000
C. Refer to Residual Market Limited 0t1w 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,
Classiflcatlons,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 So dw gue/Aseaesnmeta !� 606.00
Tool 6tlmatsd Cost 256.00
MEBlRM_USE xx Page- 1- Information Page
NM :R2wC94305 WC 00000IA
Date :OgO4/2018
MANOTE
=awing ONloe P.O.am A416 16 S.Riva gbvm%WRl0&4Wr ,PA 18709-0020•MMIP50rd.aom
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
83098
1 LOVEFIELD ST. Expiration: 11/03/2019
EASTHAMPTON,MA 01027
Update Address and Return Card.
sC►e q 20M4V17
OMIa of Conauaw Afhirs a Business Regulation
HOME MNPROVEMENT CONTRACTOR Registration valid for tngvidwl use only
TYPE:LLC before the aapiratbn date. If found realm to:
81191111110M EiIRI1:11111W Oflice of Conswner Afhirs and Business Regulation
163!!06 11/03/2019 10 Park Plaza-Suit 5170
PEAK PERFORMANCE ROOFMIO,LLC. Boston,MA 02116
JAMES FLANNERY
1 LOVEFIELD ST.
EASTHAMPTON.MA 01027 Undersecretm V81Id WIthoik slgfl8ture
Commonwealth of Massachusetts
Division of Professional Lonsure
Board of Building Reguistions end Standards
': Construction supervisor
Unrestricted-Buildings of any use group which contain
CS-103061 E1[pires:QW2112020 Icss than 35,000 cubic feet(891 cubic meters)of enclosed
Space.
JAMES J FLAWARY
1 WILLIAMS ST
HOLYOKE MA 0108
C04
Commissioner Failure to possess a current edition of the Meatts
State Building Code is cause for revocation of this license.
For information about 1Ms license
CaN(6^17)727-3260 or visit www.mass4pv/dpi
Peak Performance Roofing LLC Contract
P E Date Contract#
P E R F O R C E 1 Lovefield St
� Easthampton,MA 01021 IMM018 711
MA CSI#103061 413-203-5888 peakperfoimanceroofingllc®gma>l.com www.peAperformanceroofingllc.com
MA 1HIC# 183698
Bill To Job Location
Kipp Armstrong Kipp Armstrong
109 Woodland Dr. 109 Woodland Dr.
Florence,MA 01062 Florence,MA 01062
413-250-1382 413-250-1382
kipp.armstrong c@gm".com kip p.amnstrong a@gmail.com
Description Total
1.Remove the existing roof shingles and inspect sheathing 17,350.00
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 Certamteed(Landmark)30yr rated
httpsJ/www.certainftAcorn/reside#W-roofing/products4andma&
Color Choice: w
7.Install ridge vent
8.Complete all necessary flashings lincluding 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
Contractor will obtain building permit.
Total cost:=517,350
$500 initial deposit to secure contract. $8175 due prior to building permit application/start of work.
The balance shall be due upon completion.
*Price subject to material supply increase between October 2018 and Spring 2019. If necessary,any cost adjustments
will be declared before start of work and a new contract furnished. If homeowner does not agree to materials cost
adjustment,deposit shall be refunded.
'We are not responsible for dnttdebnis that may fall into attic.Please check for debris atter dumpster is removed' Total
Contracoar s' Customer signature: tj Bate: J b.'Sp. 1 V,
$17,350.00