22B-039 (2) 34 CORTICELLI ST BP-2019-1117
GIS#: COMMONWEALTH OF MASSACHUSETTS
MO.Block:22B-039 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permir. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: ROOF BUILDING PERMIT
Remit# BP-2019-1117
Proiect# JS-2019-001816
Est Cost:$2950.00
Fee $40 00 PERMISSION IS HEREBY GRANTED TO.-
Const.
O:const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sp.fl.): 13939.20 Owner: GOTTLIEB DEBBI
Zorn= WP(100)IURB(68)/URA(32)/ Applicant: JAMES FLANNERY
AT: 34 CORTICELLI ST
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.41MO19 0:00:00
TOPERFORM THE FOLLOWING WORKtSTRIP & SHINGLE PORCH ROOF 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# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: OSE 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 Occuoancv Sienature:
FeeTvpe: Date Paid: Amount:
Building 4/9/2019 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
DoouSgn EnvebpelD:AC395A5B-D56A4D9A-%E2-E0A1 D9D6 EC— EI ` ED
Depadment use oMY
City of North pto 9 2 $,dam 'c
.r 1111, Building Cape met APO CurbC yParmn
A ` 212 Main St set "gab6Sy
! Room 10 T pF ouanitir to yell A
Northampton, M 011 �o m Plena
giHnAdFION.I
phone 413.587-1240 Fax -587-1272 PloVSse Plsro
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH,A//��ONEE OR T/yWO FAMILY DWELLING
SECTION 1-SITE INFORMATION �(J 1'/(` /
1.1 PronsM Address: This section to be completed by ON"
34 COrticelli St. Map Lot 039 Unit
Zone Oasrlay District
—
Etas at weldct CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Debbi G ttllab 34 Corticelli St., Northampton MA 01060
e
(Print, Current Meting Address:
0S. I Tdepnoe8 413-530-8273
2.2 Authorised Anent
James J. Flannery 1 Lovefield Sl., Easthampton MA 01027
Name(Print) Current Wang Addreea:
413-203-5888
signature resist.
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Rem Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $2,950.00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construcllon from 6
3. Plumbing Building PemnN Fee
4. Mea-hanicel(HVAC) /
5.Fire Protection I
6. Total=(1 ♦2+3+4+5) $2950.90 Check Number a.
This Section For Official flee On
Building Permit Number. Dole
Issued J
Signori I-q-Z�6!q
Budng Commissionerlinspeclor olBuiNngs Data
peakperforrnanceroofingllc (Cpgmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
DocuSign Envelope ID:AC395A6B-DMAAD9A-96E2.EOAlWD306FA
SECTION S DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Atltlltlon ❑ Replacement Windows Aftemtion(s) ❑ Roofing 56
Or Doom ❑
Accessory BH g. ❑ Demollllpn ❑ New signs [o) Decks, Ill Suring[0] Other[q
Brief Description of Proposed Strip & shingle porch roof only
Work:
Alteration of edsting bedroom_Yes_No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement _Vas _N0
Ram Attached Roll -Sheet
te.N New house and or addition to existing housing complete the followim:
a. Use of building:One Family Twa Family Other
b. Number of rooms in each family unit: Number of Bathrooms
CL Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stone?
f. Method of healing? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. M6sscheck Energy Compliance farm attached?
In. Type of construction
i. Is construction within 100 h.of""lands?_Yes No. Is construction within 100 yr. floodplain_Yes_No
j. Depth of basement or cater floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes_No.
I. Septic Tarso_ City Sewer_ Private wet_ City water Supply_
SECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1. Debbi Gottlieb ,as owner of the subject
property
here the James J. Flannery/ Peak Performance Roofing, LLC
to a on ma mal ars relative to work authorized by this building ps lt application.
Sen oar 13,11.
James J. Flannery as Owner/Authorized
Agent hereby declare Mal the statements and information on the foregoing application am true and accurate,to the best of my krwnMedge
and belief.
Signed under the pains and penalties of perjury.
James J. Flannery
Pian Name
03/27/19
Signature of O.manggenl Date
SECTION 6-CONSTRUCTION SERVICES
8.1 Licenced Construction Supervisor: Not Applicable 0
Name of usense Holder. CS-103061
License Number
James J. Flannery 09/21/2020
Address Expiration Date
1 Williams St., Holyoke MA 01040
SgneNre ` Telephone
413-203-5888
0.Repfetand Nome sn insini nem ContracW. Not Applicable 0
Company Name Registration Number
Peak Performance Roofing, LLC 183698
Address Expiration Date
1 Lovefield St., Easthampton MA 01027 Telephone 413-203-5888 11/03/2019
SECTION 16•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 affdavd will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... d No- ... ❑
City of Northampton
Massachusetts
' DEPAItTEENT OF BDILDINO ZNEPECTZON3
212 Min St..t •Nunicipnl Building
Norihsagton, N2. 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:
34 Corticelli St.
(Please pant 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)
03/27/19
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
DepartmentofIndustrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
If rvww.m rss gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractor /Electricians/Plumbers
Applicant Information Please Print Leaibis
Name(Businn:a'ors nizatiaanndividuau: Peak Performance Roofing LLC
Address; 1 Lovefield St.
Ci /State/Zi : Easthampton, MA 01027 Phone* 413-203-5888
Are In*an employer?Check the appropriate box: Type of prof(required):
1.re�'1 am a employerwith 4 4. ❑ I am a general contractor and 1 6
employees(full and/or pan-time)." have hired the sub-contractors New construction
2.❑ 1 am a sole proprietor or partner- listed on the ansched 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.mumu cc.'
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their l l.❑ Plumbing repairs or additions
myself(No workers'comp. right of exemption per MGL 12 goof repairs
imumuce required.]t a 152.§114)•and we have no
employees. [No workers' 13.❑Other
comp-insurancerequired.]
'Any oMicann tlmt checks tun til nun also fill out tM oration below awwins thek waken'conVmWitm policyinformation.
t Hnmeorn wlu wbmit Ihia annlmn indu'ming they are dining all work aM then hire ouhide"uacuns mon wbmil anew amdnsii itdieming%mb.
:Caomctam that click thu box must auwhed an additional shat slu mi rhe none of the subroaoctm and nate whether m tort those made,hvc
enpbyees. vs,.sub<anrta'rms live employees.dory must p,taid.their amke,x'svmp.policy number.
I an an employer that is providing workers'compessedon insurance for my employees. Below it the poBcy mad job she
Infmrmatlmt..
Insurance company Name: Berkshire Hathaway Guard
Policy k or Self-ins.Lic.o: R2WC943835l� _ Expiration Date: / 4/27/2019 7
Job Site Address: *2tf Ooy-bcoI6 J/ City/State/Zip: fl''20((, /11/)
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as squired under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a
fine up to 51.500.00 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.OD a day against the violator Be a&tied that a copy of this statement may be forwarded to the Office of
lavestigations of the DIA for insurance coverage verification.
I do hereby cerdffp ander the pains and penah/lesofperjar) that Or infomaaan provided a"&/line and co—rrM..�.
Si® mre' V Date:
Phone a: 413-203-5888 if
Offlcia/ase only. Do not write in this area,to be completed by city or town offlelat
City or Town: Perm@/Lieem e M
taming Authority(circle one):
1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone a:
Worker's Comnensation and Employer's Liability Poli"
Berkshire Hathawa AmGUARD Insurance Company -A Stock Co.
y Policy Number R2WC943835
UARDInsurance of G 11187
Compan es RenewalNCCI No.[218 3]
Policy Information Page (AR)
[1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
I LOVERELD 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 adtlress.
[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
IN ERNAL USE M Page- 1 - Information Page
MGA : R C%3835 WC 000001A
Dale :04/04/2018
MANOTE
Issuing Omoe: P.O.Box A-M, 16 S.River street,Wilkes-Barre,PA 18703-0020•Www.guard.can
fee cpo�n�no�reurea/� o�C��aoeac,�u�ael�
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. Re8lsaefbn: 183088
1 LOVEFIELD ST. - - Dphaft: 11/03/2019
EASTHAMPTON.MA 01027
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p Peak Performance Roofing LLC Contract
PERF 0 c ( Lovefield St Data Contracts
Easthampton, MA 01027 32MO19 735
MAMA Cg1N30306I 413.103-5988 peel@adnmmcemodryacgroad.mm www.peNtpwfbnouasmofm9tk.mm
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&II To Job Location
Debbi Gottlieb Debbi Gottlieb
34 Corticelli St. 34 Corticelli SL
Fknnce,MA 01062 Florence, MA 01062
413-530-8273 413-530-8273
deb60erchQayahoo.com deb60arch@yahoo.com
Desmon Total
-This is for the porch roof only- 2.950-00
1.Remove the existing roof shingly and add 12 inch CDX plywood over boards.Add 3/8 CDX plywood in mining
was as an attempt to plane 006 rooahm
2.Install Grace ultra ice and water hurler on entim porch roof
3.Install 9'aluminum drip edge on ewe and take edges
4.Insall architectural shingles by Cenainteed (Landmark)30yr rated
haps://www.ce 6dwd.mmMmidentiai-roofing/pmdmts4aidnwk/
Color Choice:Weathered Wood
5.Clem all guaen,redirect downspout
6.Complete all necessary flashings including kick out flashing
Remove all debris from premien,and throughout the job,continue cleanup and keep the premises undamaged.
Contractor will obtain building permit.
Total cost.$2,950
A deposit of S 1475 is due at contract signing. The balance shall be due upon completion. Accounts pmt due W days
subject to 2%threats charge monthly.
Warranty Information:
10 year labor and workmanship guarantee by Peak Perfommce Roofing.
Materials warranty by Ce tainTeed,see details here:
haps://www.ceminneeicoFWreourceslCxnecelAspha115hinglnWart tyEnglidr.pdf
'We rte net respomblc for owdebris dust my fill ina snit.Flow check Aar debris after dumpser is removed.' Tota
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$2,950.00