35-290 (6) 120 WOODLAND DR BP-2020-0245
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:35-290 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buk[M DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:ROOF BUILDING PERMIT
Permit# BP-2020-0245
Project# JS-2020-000422
Est.Cost: $20450.00
Fee: $40.00 PERMISSION, IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sq.ft.): 31973.04 Owner: ROHLICH THOMAS H&WAKAKO S
Zoning: Applicant. JAMES FLANNERY
AT: 120 WOODLAND DR
Applicant Address:' Phone: i Insurance:
I LOVEFIELD ST (508) 294-4052 WC
.EASTHAMPTONMA01027 ISSUED ON.8/28/2019 0:00:00
TO PERFORM THE=OWING WORK:STRIP & SHINGLE ROOF, REPLACE SKYLIGHT
POST THIS CARD SO ITIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service'' Meter:
Footings:
Rough: Rough: House# Fou6dation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke•
Final:
THIS PERMIT MAY BE RE OKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy 'Signature:
FeeType: Date Paid: Amount:
Building 8/28/2019 0:00:00 $40.00
2 12 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
Department use o lye,
Clty of Northa pto Statu 'ofP mit
B l ilding Depa met " AUG 2 20�urb ut/Dr away Permit
212 Main St eet Segue Septi Availability.
Room 1011, ell vailabdily`
"t NOlhamptOn, Mil 01® OF BUILDING IN � e SaQtf trtldt, ral PIaris
phone 413-587-1240 Fa - TON'nn o i e Ptans`"
_ Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR;RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: -
This section to be completed by office
Map Lot Unit
120 Woodland Drive
Zone 'Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Thomas Rohlich 120 Woodland Dr., Northampton MA 01060
Nam (Print) ( Current Mailing Address:
Vl00 Telephone p 413-221-5845
2.2 Authorized A-gent:
James J. Flannery 1 Lovefield St., Easthampton MA 01027
Name(Print) Current Mailing Address:
413-203-5888
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be I Official Use Only
�completed by permit applicant
1. Building $20,450.00 (a)Building Permit Fee
I '
2. Electrical (b)Estimated Total Cost of
Construction from!6
3. Plumbing Building Permit feel
4. Mechanical(HVAC)
5.Fire Protection
6. Total=0 +2+3+4+5) li $20,450.0 Check Number
This Section For Official Use Only
Building Permit Num er: I Date
Issued: I
}
Signature:
Building Commissioner/Inspector of Buildings I Date
peakperforma Iceroofingllc gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
' I
i
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
oe
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing NT
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[lam] Other[Cl]
Brief Description of Proposed Strip& re-shingle roof. Replace 1 skylight.
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a,.7f Now house and of Addition to existing-'housing, COnlpiete' he.fol[owinq:
a. Use of building :One Family_ Two Family Other
b. Number of rooms in each family I nit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of ne construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliancy. 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
k. Will building conform to the Building and Zoning regulations? Yes No
I. Septic Tank City Sewerl Private well City water Supply
SECTION 7a-OWNER AUTHORIZAITION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Thomas Rohllch as Owner of the subject
property
James J. Flannery/ Peak Performance Roofing, LLC
hereby authorize
to act on my behalf, in 11 afters relative to work authorized by this building permit application.
James J. Flannery
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.
James J. Flannery
Print Name
Signature of Owner/Agent D to
I
i
I
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: CS-103061
License Number
James J. Flannery 09/21/2020
Address Holyoke, MA 01040 Expiration Date
Signature Telephone j
413-203-5888
9:Registered Nome'ImprovementCoiitractor: Not Applicable ❑
Company Registration Number
Peak Performance Roofing, LLC 183698
Address Expiration Date
1 Lovefield St., Easthampton MA 01027 413-203-5888 11/03/2019
I Telephone
SECTION 10-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 affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... l/ No...... ❑
i
i
I
I
e
I
i
i
City of Northampton
s s
$} ' ' Massachusetts �Vg, !��G
` DEPARTMENT OF BUILDING INSPECTIONS 'fin
SV "ate
� 212 Main Street •Municipal Building &.
Q
J Northampton, MA 01060
Deb=is 'DisP osal Affidavit
i
1n accordance of the provisions of MGL c 40, S54, I.acknowledge that as a;condition of the building
permit all debris resulting friom the construction activity governed by this Building Permit shall be disposed
of in a properly licensed so id waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
120 Woodland Driv
(Please print house number and street name)
Is to be disposed of at:
i
(Please print name and location of facility)
' f
Or will be disposed of in a dumpster onsite rented or leased from:
Aaron's Roll-Off, 1 Loon his Way, Easthampton MA 01027
(Company Name and Address)
/9
Signature of Permit Appliant or Owner Date
If, for any reason,the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
f
I
The.Commonwealth of Massachusetts
Department of Industrial Accidents
Office-ofInvestigations
600 Washington Street
Boston,MA 02111
www mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contrac ors/Electricians/Plumbers
Applicant Information Please Print Le ibbly
Name(Business/Organization/Individual): Peak Performance Roofing, LLCI
Address: 1 Lovefield St.
I
City/State/Zip: Easthampton , MA 01027 phone#: 413-208,-5888
Are y u an employer?Check the appropriate box:
1. I'llam a employer with 44. E] I am a general contractor and I Type of project trequired):
employees(full and/or part-time).* have hired the sub-contractors 6. El New construction
2.El am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any caps ity. employees and have workers'
insurance.$ 9. El Building addition
coinP•
[No workers'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.�Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
comp.insurance required.]
*Any applicant that checks box#1 must also 11 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.
tcontractors 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 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.#: RM021353 Expiration Date: 4127/2020
Job Site Address:_1a b (,u b(3 C� lLl�U l� �� /
City/State/Zip: �(aa ng
I
Attach a copy of the workers'cop
ensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as require d 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-yea>j 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 maybe forwarded to the-Office of
Investigations of the DIA for insurance coverage verification.
Ido hereby certify under the painsand penal ' s of perjury that the informationprovidedahreis re and correct.
I
Signature: Date:
Phone#: 413-203-5888
r
Oficial 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): I
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#•
Kgrker%Compensation and Employer's Liability Policy
Berkshire Hathawa AmGUARD Insurance Company-A stock Co.
Y Policy Number R2WCO21353
jfI
G UARD Insurance Renewal of R2WC943835 _
Companies NCCI No. [21873]
Pollcy Informaitlon Page(AR)
[1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
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)
i
I
f
[2] Policy Period
From April 27, 2019 to April 27, 2020, 12:01 AM,standard time at the insured's mailing address.
I
[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 I jury by Disease- policy limit $500,000
C. Refer to Residual)Market Limited Other States Insurance Endorsement-WC2003068
D. This policy includes these endorsements and schedules:
See Extension of Information Page-Schedule of Forms
I
[4] Premium
The Premium.Basis arid,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)
I
Total Estimatxad Policy Premium $ 31,202 1
Total Surcharges/Assessments $ $1,181.00
Total Estimated Cost 6 $32,383.00
"INTERNAL USE XX Page- 1 - Information Page
MGA R2WCO21353 WC 000001A
Date 09/01/2019
MANOTE
Issuing Office:P.OBox A-H,16 S.River Street,Wilkes-Barre,PA 1870 8-0020•www.guard.wm
I
Cie W� o�+n�w�uu� ��ucQe
Office of Consumer Aftairs and Business Regulation
One Ashburton Place-Suite 1301
Boston, Massachusetts. 02106
Home Improvement Contracbor Registration
Type: LLC
-PEAK PERFORMANCE RI ORNG.LLC. Re0(stratlon: 183898
I LOVEFEW ST. E1�trfitlon: 11/0312019
EA87UAMPT0N.MA 010 V
1
I
WA, o smr M? Addrsse rind Rebum C"
ano.a t�aawr�.rAern.a au.�...ReAu4aoe
NOPEIMPROVEMENT L CONTRACTOR R000111on valid for hW1vmWd use ardy
before ON erOW11on date. S found return to:
Omm of Convener m1drsand Business Rapulatlon
169 8 11p4r2p18 10 Park Plass-Sudo 5170
PEAK PERFORMANCE'ROOFm.LLC. Boskm%NA 02116
JAMi S R ANNERY
1 LOVEFIELD ST. ` ` —
EASTHAMPTON.MA 01027 llrrdereeCrerary Vifllfid wfthoi signn—Wrq
I
I
Cammonweaft or Massachusetts
.. Division of Pro(essbnal Li ensure
Board of Suffftg Regulations gird Standards
CS403061 Unnmkkkd-60dbms of any use group which cW*M
Upire s:f WIrA20 -less than 25.000 cubic het(581 cubic milers)of enclosed
spme
JAMES J FL44AM
HOLYOKE MA`0'ION
Commissioner l/�!"�
Fagum to possess a wrent adRion aftheMasaedsrs011s
State Bolksm Code is cause for ro ocom efthh■o@M&
For it fe nod, about d&rr wm
cab(677)i 27-0=00 or vbR www.rnsayovldAl
i
I
i
i
PE K Peak Performance Roofing LL,C
Contract
1 Lovefield St Date Contract#
PERF O.R. C E Easthampton, MA 01027 1> > 8/23/2019 981
MA CSL#103061
MA HIC# 183698 413-203-5888 peakperformariceroofingllc@gmail.cwm www.peakperformanceroofmgllc.com
Bill To Job Location
Tom Rohlich Tom Rohlich Ar WaKa KO
120 Woodland Dr. 120 Woodland Dr.
Florence,MA 01062 Florence,MA 01062
413-221-5845 413-221-5845
trohlich@smith.edu trohlich@smith.edu
Description Total
1.Remove the existing roofing shingles 20,450.00
2.Inspect the plywood for any rot or deterioration. We will provide up to 64 square feet of plywood at no
cost.Any additional plywood �ill be$75 per sheet installed
3.Install six feet of ice and water shield on eaves and three feet in valleys/around pipes and chimney
.4.Cover remaining roof with s thetic underlayment
5.Install new 8"aluminum drip edge on all eaves and rake edges
6.Install architectural shingles b Certainteed
g1 y (Landmark PRO 40yr)
https://www.certainteed.com/residential roofing/products/landmark-pro/ j
Color Choice:_/d1�uC D-f PEU `T E R LO/00 D
7.Install ridge vent on peaks of roof
8.Complete all necessary flashi gs including new pipe boots
9.Replace 1 skylight with new Velux manual vent
Remove all debris from premises,and throughout the job,continue cleanup and keep the premises
undamaged.We are not responsiIIble for debris that may fall into attic.Please use caution during the process;
do not walk/drive under active work,or on areas of potential roofing debris.Contractor will obtain building
permit.Installations are weather permitting.Warranty shall be furnished after contract is Paid In Full.
Landmark PRO shingles=$18,550
Skylight replacement=$1,100
Certainteed 4-Star Warranty=$800 https://certainteed.showpad.com/share/FujWoUnUwAfvG558wlE7P/0
Total=$20,450
A deposit of•$10,225 is due at contract signing. The balance shall be due upon completion. Accounts
outstanding over 10 days past final invoice date subject to 2%finance charge,compounded monthly.
Contractor Signature: Customer Signature: Date: Total:
a yy
3Ul $20,450.00
i
• I