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32A-165 (3)
63 HAWLEY ST BP-2018-1121 GIS n: COMMONWEALTH OF MASSACHUSETTS Mao:Block:32A- 165 CITY OF NORTHAMPTON Lot -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateymv� ROOF BUILDING PERMIT Permit# BP-2018-1121 Proiect# JS-2018-002013 Est.Cost:$13900.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sa.ft.): 5837.04 Owner: COHEN JILL Zo mw URC(looy Applicant: JAMES FLANNERY AT. 63 HAWLEY ST Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 WC EASTHAMPTONMA01027 ISSUED ON.•413 01201 8 0:00.00 TO PERFORM THE FOLLOWING WORK:REMOVE EXISTING SHINGLES, INSTALL NEW PLYWOOD, SHINGLES, RIDGE VENT 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 OccuoancV signature: FeeTvpe: Date Paid: Amount: Building 4/30/20180:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner RECEIVED Department use only A� .rT� rth n n Status of Permit: BUlld ep do nt Curb CuUDnveway Perna 212 Main tree SeaarlSeptic Availability_ DERTOFWLDINGI AMMO WallerlWell Availabdity t NORTH 4 0,g 060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 PIOUSda Plans carer Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION ep0 18 - 1.11 1.1 Property Address: This section to be completed by office Sl Map Lot /U-61. unit �0 J fl I Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: mill Co�N (03 Ilawleu St Name(Pont) Current Mailing Atltlress: Signature Telephone // 2.2 Author4d�pent: DAMES FI-ANNL" I LOVA-46 St, AAs}IAantp3 m MA OIOa-t Name(Pont) Current Mailing Address: N13 -2D3 - 5885 Signatu Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit a lioent 1. Building )3 q b0.oo (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 8 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 6. Total=(1 +2.3+4+5) F 131 DD , b Check Number 1177 This Section For Official Use Only Building Permit Number. Date Issued: Signature: Building Co ssionerlinspecror of Buildings Date P EA KP E 2F D f2.M ANCE ROOPI/U(a LL C (d C- "AA L. CDM EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 6-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) Roofing Or Doors Accessory Bltlg. ❑ Demolition ❑ New Signs [01 Decks [p Siding[0] Other[0] BnI Description of Propos Werk: 1�r, ve txl r� shr�c�l�sa tnslall rww P �IuoOd ,shl�� rid �e V-0-nt Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.H New house and or addition to existing housina, complete the following: a. Use of building:One Famili 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_ C4Sewer_ Private wdl_ City water Supply_ SECTION 7a-OWNER AUTHORLZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 7y1 11 CC)hPN as Owner of the subject property hereby authorize �ANU� FL PN NE(Zy b 6 A FUAK- QErZF01ZV 4KCE 14 L)b AA-) ]_LG to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date I, DAMES VLAwoERY ,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 Fl ANf� Et2 Print Name Signature of IAg t Date Section 4. ZONING ALL Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to bo filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage an (Cot area minus bldg at paved Parlors) #or'Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan lhalwill disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction ��Sl1ummisor. Not Applicable ❑ Name of Leena Holden ✓Rrn FS YL f}�1 �i � CS -/d3L,)(0/ License Number Wilti,4M-5 ST, /-,teLyDk--E MA 016y0 692//20/ 8 Address Expiration Date a,, yi3 - aD3 - �8�� Signatur Telephone 9.Remistered Home Improvement Contractor: Not Applicable ❑ / e31� 9A Company Name Registration Number PEAK 0FRCO2Mi r2DbFiu� , LAG 111o312-6/9 Address (c/o3) Expiration Date � LOy,P{-�Q�l� 5-1 E�4sf �IQ1'Y�p}dNMArelepnoneab3 -588Fi SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§2SC(6p 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....... yyinNo...... ❑ The Commonwealth afMassachusetts Department oflndustrial 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 Leaibiv Name (Business/Organization/Individual): Peak Performance Roofing LLC Address: 1 Lovefield St. City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888 Are y, an employer? Check the appropriate box: Type of project(required): I. I am a employer with 4 4. ❑ 1 am a general contractor and I employees(full and/or part-time)." have hired the sub-contractors 6. ❑ New construction 2.❑ 1 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' . insurance3 9. ❑ Building addition [No workers' comp. icpmnsurance p 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 l Lr❑r�Plumbing repairs or additions myself. [No workers' camp, right of exemption per MGL 12.0 Roof 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#1 most also fill at the section below showing their workerscompensation 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. �Commcmrs that ebock this box most attached an additional sheet showing the name of the sub-coatrarma and state whether or not those entities have employees. If the sub-conuaccon 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. B Insurance Company Name: Hathaway Guard_ Policy#or Sell-ins. Lic.#:_R2WC943835 / _ _ Expiration Date: 4/27/2019 Job Site Address: l03 57 City/State/Zip: N0ffkCU7&A) i"Vl f) DIDa� 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 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$250.00 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. Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature- "2-: Date: FS 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#: A Worker's Compensation and Employer's Liability Policy Berkshire Hathaway AmGUARD Insurance Company - AStock Co. Y Policy Number R2WC943835 11187 4 N G U A R DCompanies RenewalNCCI No.[218 3] Policy Information Page (AR) [S]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 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 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/Assessments $ 606.00 Total Estimated Cost 14 256.00 INIERNAL USE X Page- 1 - Information Page MW : UWC943835 WC OOOOOlA Date :"1"12018 MANOIE Issuing Office: P.O.Box A-H, 16 S.River Street,Wilkes-Barre, PA 18703-0020 •vsrw.guard.mm City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS p P 212 Mein street municipal Building Northampton, ex 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: 63 /la wley S-7' (Please print house nurrr6er 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: awns /eofl-'Wl / way, Eti(i xrpb" /7( 6 (Company Namen and Address) Signa e o ermit AMlicant 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. d�xm fommonuvea64 0/0-4"ekaea 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. R BppgistraOon: 111 j03�20re0on: 1M3 19 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Uptl Atldn rM RH m CW. 9Cnt 6 �V CS-103081 . JAMES J FLANNERY 1 WILLIAMS 87 HOLYOKE MA 01040 r-jz�-� CA 100A 00/712010 PE K Peak Performance Roofing LLC ° eo Contract 1 Lovefield St PERF O R C E Easthampton, MEQ 01027 4/122018 508 • . . MA CSLO 103061 MA HIC8 183698 413-203-5888 peukperforecancerooBnglic@gneil.eom www.peakparfoxmaztcetoo6vgl1c.com Job Location Bill To Jill Cuban Jill Coban 63 Hawley St. 63 Hawley SL Northampton,MA 01060 Northamplem MA01060 jilliknecoben@eol.mm jillilenecehen@aoLcom Descnption Total 1.Remove the existing mofmg material and install 12 inch CDX plywood 13,900A0 2.Remove the porch mofmilings 3.Install new Flintlastic SA rolled roofing on low slope porch mof 4.Reinstall porch anfrallings 5.Install sic feel of ice and water shield m cavy and valleys,12"named roof/wall intersections 6.Cover remaining ruofwith Certamtced"RoofRunnar"synthetic underlayment 7.Install new 8"aluminum drip edge on a0 caves and rake edges 8.lnaWl mr,hitmhasl shingly by CerWiofeed (LndrmkPRO 40yr) httpsl/www.certainmed.corn/residmtiW-mofingoiAucWkndmark-pro/ Color Choice: 9.lndall new,Ccrwmtxd ridge neat 10.Complete all necessary flashings including new pipe boob and new base Clashing around ch'immy Remove all debris from premiss,and fluoughout the jab,continue cleanup and keep the premises undamaged Total cal Landmark PRO shingles=S13,900 —p A deposit of l2 is due prior to the beginning ofthejob=$6950 The balance of$6950 shall be due upon completion. / rn ^ ©.`3050 ✓ Deposit Received On: �/A/A Deposit$ G ysa Check k C C a fianya[heus *We are not responsible for dirtdebris that rosy fall into attic* Customer Sign come: " Contractor Signamre: I / (,fJ1.1 TOafa� $13,900.00