24C-033 (3) 60 NORTH ELM ST BP-2020-0970
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24C-033 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-2020-0970
Proiect# JS-2020-001647
Est.Cost: $16180.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sa.ft.): 17816.04 Owner: GAUBINGER JOSEPH R
Zoning,: URB(100)/ Applicant. JAMES FLANNERY
AT. 60 NORTH ELM ST
Applicant Address: Phone: Insurance:
I LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.212812020 0:00.00
TO PERFORM THE FOLLOWING WORK.STRIP & SHINGLE ROOF, REPLACE 4
SKYLIGHTS
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 Si<mature:
FeeType: Date Paid: Amount:
Building 2/28/2020 0:00:00 . $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
1
F
DocuSign Envelope ID:EBA63D84-0255-4D24-AOOB-8ACA97821A71
Department use only
-- City of Northampton. `" Status of Permit:
Building Department / Curb Cut/Driveway Permit
212 Main Street` Sewer/Septic Availability
!
a Room 100 <' Water/Well Availability
Northampton, MA 0109b`'>�F �*6$ets of StruCp'ral Plans
phone 413-587-1240 Fax 413-58�Y111 PIoUSite Plans
%n
•�'n>na=%uc ther
Specify_,
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE 012bEtll 61 ISH k ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
Map Lot 6 3t-3—Unit
60 N. Elm St.
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Joseph Gaubinger 60 N. Elm St., Northampton MA 01060
Name(Print) Current Mailing Address: 413-961-9136
DocuSigned by:
d
(I ntl_ ub1iA Telephone
Signature 7 �`
2.2 Authorized Agent:
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 Official Use Only
completed by permit applicant
1. Building $16,180.00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee 4zt4z)4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+ 3+4 + 5) $16,180.00 Check Number
This Section For Official Use Only
Building Permit Number: o -q la Date— Issued:
Signature: 2-27- Zb ZL)
Building Commissioner/inspector of Buildings Date
peakperformanceroofinglic na gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
z
DocuSign Envelope ID:EBA63D84-0255-4D24-AOOB-8ACA97821A71
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House F-1Addition F-1ReplacementWindows Alteration(s) ❑ Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks Siding[O] Other(�]
Brief Description of Proposed Strip and replace shingles, replace 4 skylights. Excludes back roof.
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa. If New house and or addition to existing housing, complete 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?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. 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 Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Joseph Gaubinger
as Owner of the subject
property
hereby authorize James J. Flannery / Peak Performance Roofing, LLC
to act on my behalf, in all matters relative to work authorized by this building permit application.
Docusigned by: 2/26/2020
Signature of Owner Date
James J. Flannery
1, ,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 Date
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 Expiration Date
Holyoke MA 01040
Signature � Telephone
r—t 413-203-5888
9.Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Peak Performance Roofing, LLC 183698
Address Expiration Date
1 Lovefield St., Easthampton MA 01027 Telephone 413-203-5888 11/03/2021
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...... ❑
City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building yJp CDS
Northampton, MA 01060 rSN�y \1J"
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:
60 N. Elm St.
(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:
Aaron's Roll-Off, 1 Loomis Way, Easthampton MA 01027
(Company Name and Address)
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
Department of Industrial 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/Organization4ndividual): Peak Performance Roofing, LLC
Address: 1 Lovefield St.
Easthampton, MA 01027 413-203-5888
City/State/Zip: Phone #:
Are ypu an employer? Check the appropriate box: Type of project(required):
1. I am a employer with 4 4. ❑ I am a general contractor and I 6. ❑ New construction
employees (full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached 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. 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.YrRoof 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 thcir 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.
$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 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.
Berkshire Hathaway Guard
Insurance Company Name:
Policy#or Self-ins. Lic.#: R2WCO21353 Expiration Date: 4/27/2020
�O lUc�-� ��
Job Site Address: �(]�� D JA City/State/Zip: M P� GI 11_U
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 penal 'es of perjury that the information provided above is true and correct.
Signature: Date: CIQ �c
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#:
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, MaseaChuSettS 02118
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE ROOFING,LLC. Registration: 183696
1 LOVEFIELD ST. Expiration: 11/03/2021
EASTHAMPTON,MA 01027
Update Address and Return Card.
SCA I o znWosirr
Office of Consumer Affairs it Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. If found return to:
Conation Office of Consumer Affairs and Business Regulation
183608 11//01/2021 1000 Washington Street -Suite 710
PEAK PERFOR1600CE ROOFING,LLC. Boston,MA 02118
JAMES FLANNERY I
1 LOVEFIELD ST. �i4✓�'rY� "_4
EASTHAMPTON,MA 01027 , Undersecretary NO valid without gnature
Commonwealth of Massachusetts .
Division of Professional Licensure Construction Supervisor
Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain
'Sope ,; d, less than 36,000 cubic feet(881 cubic meters)of enclosed
space.
CS-103061 EltpirM 09/2112020
. u
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01080 %
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
Commissioner For information about this license
Call(617)727-3200 or visit www.mass.gov/dpi
MgrkWs Comoensedon and Emol nines Liability Policy
Berkshire Hathawa AmGUARD Insurance Co"'pany'"Stock Co.
Y Policy Number R2WCO21353
GUARD Insurance Renewal of R2WC943835
Companies MCCI No. [21873]
i(
Polio►information Page(AR)
[1]Named Insured and Mailing Address Icy
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
1 LAYEFIEID STREET S NORTH KING STREET
FASTMAMRTON,MA 01027 Northampton, MA 01060
Agency Code: MAMAINi5
Federal Employees ID 00-1191951 Insured Is Limited Liability Co. (LLC)
i,
[2] Policy Period
From April 27, 2019 to April 27,2020, 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. 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 Ynjury by Accident-each accident $100,000
Bodily Injury by Disease-each employee $100,000
Bodily Injury by Disease-policy limit $500,000
i
C. Refer to Residual Market Limited Other States Insurance Endorsement WC200306B
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 Rafting Pians. All required.infdrmation is subject to verification and change by
audit. (Continued on another page)
Total Estimated Policy Premium * 31,202
Total Sur+dTerliss/Assessment $1,181.00
Total Estimated Cost 383.00 J
DnERNAL USE XX Page- 1 - Infbrmatlon Page
MGA :RZWCD21353
DNM :04/01/2019 WC OOOOOlA
MANOrE
Issubw 01108:P.O.sox A-H,16 S.aver Sbut,Wilke*-111wre,PA 18703-0020 0 www.guwdA nr
DocuSgn Envelope ID:EBA63D84-0255-4D24-A00B-8ACA97821A71
Peak Performance Roofing LLC
1 Lovefield St. PE Is Easthampton,MA 01027
413-203-5888 P E R F O R
peakperformanceroofingllc@gmail.com m • •
MA HIC#183698 MA CS0103061
Contract
ADDRESS CONTRACT# 10032
Ann and Joseph Gaubinger DATE 02/21/2020
60 N. Elm St.
Northampton,MA 01060
agaubinger@gmail.com
413-961-9136
JOB LOCATION
60 N.Elm St.,Northampton
a SCWnQN AMOUNT
-This contract excludes the back roof- 16,180.00
1.Remove the existing roofing shingles
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 will be $75 per sheet installed
3.Remove and replace 4 skylights with new Velux manual venting skylights
4. Install six feet of ice and water shield on eaves and three feet around pipes and chimneys
5. Cover remaining roof with synthetic underlayment
6. Install new 8" aluminum drip edge on all eaves and rake edges
f 7.Install architectural shingles by Certainteed (Landmark)
+ http://www.certainteed.com/residential-roofing/products/landmark/
Color Choice: Best Match
8.Install ridge vent on peaks of roof
9. Complete all necessary flashings including new pipe boots
Remove all debris from premises, and throughout the job, continue cleanup and keep the
premises undamaged. WE ARE NOT RESPONSIBLE FOR DEBRIS THAT MAY FALL
INTO ATTIC. Contractor will obtain building permit.Installations are weather permitting;
long periods of inclement weather will cause scheduling delays.
DocuSign Envelope ID:EBA63DB4-0255-4D24-A00B-8ACA97821A71
DESCRIPTION AMOUNT
$9700 Landmark shingles
$6480 Replace 4 skylights
Total Job= $16,180
A deposit of$8090 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.
..............................
TOTAL $169180.00
Accepted By �U°ublgnC°by Accepted Date 2/26/2020
S�,�I,t, 6 A&lk.l�X�
1 7FOD2529D8024-"..