30B-114 89 FEDERAL ST BP-2018-1182
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 30B- 114 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-2018-1182
Project JS-2018-002121
Est.Cost:54850.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grow JAMES FLANNERY 103061
Lot Size(so ft.): 22607.64 Owner: CROMBIE SCOTT
Zoning,URB(100V A ['cant: JAMES FLANNERY
AT: 89 DERAL ST
AonlicantAddress: Phone: Insurance:
1 LOVERELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON:5/11/1018 0:00:00
TO PERFORM THE FOLLOWING WORIGSTRIP & 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: Oe: 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:
FeeTyvc: Date Paid: Amount:
Building 5/11/20180:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(4)3)587-1272
Louis Hasbrouck—Building Commissioner
RECEIVED ez-(jzF
Dgr.bb.WaaNWy
MAY 1 Pt TWO he ton $madPasb!
Building part nt Cub CWA) AWAVuMl .
2 Str tNarlbrllaPrls
.. EPTOFOUILOINGIN56fiTlgy`�Qg WaI
NORTHAM TON MA
1080 8rYdlMmsr Piw���„.
phone 413587-1240 Fax 413587-1272 PkVSFA Pkft -
OBurSpe*
APPLICATION TO CONSTRUCT,ALTER,REPAIR RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 7.SITEINFORMATION
1.1 ProDwW Addnea: This aeallon to be o0M~by ofllce
99 GQ d 2 ra l S4- Map Lot ` —Unt --
rence. zene Ov-"DismaL—
Cla
Elm RL DI wIv CB Dxbl—
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owruir of Record:
Scott crowbl-e89 F-42d2ra) S+ FlorznC2 o/OCaa
Nemo(Prim) Cl M Mererg Adds :
q 4 - aao Dela
STeleumm
2.2 Aidhwk�f Art
'antnES T GLaNNER y l [ oylt� e/d 5� , Ea s�l>arnpfoa MR
Nemo(Phot) Cuaert Meiling Addy :
yl3 - ao3 - s888
a~ Tslsot
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Mem Estimated Coat(Dollars)to be Ololal Use Only
completed R appliourt
1. Building 4l ya
- ' '90 (a)Balding peonit Fee
2. Elechical (b)Estimated Tore)Costa
Construction ham 8
3. Plumbing Building Permit I" (�n
4. Mechanical(HVAC) ! V
5.Fim Protection
S. Total=(i -2.3+4.5) j Q 4 Cheat Number
This SwWn For Official Use Only
BuildingPMmE cow
ssued:
Si /
BUMrp Ieunernmpxmra BUlMnpe Dare
�PAXpERFoRrnRN[EROOF/N(rLl-C � �rnRl�, �v/t'/
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION a-DESCRIPTION OF PROPOSED WORK(cMtlr 2)0 a_linpraSNa)
New Houw ❑ Addition ❑ ReplacementWindows AXerallon(s) ❑ Roofing
Or Door O
Accessory Bldg. ❑ DBmolticm ❑ New Signa [01 Decks [0 Sktiri [DI Other[q
Brief Description of Proposed
Work:
Alteration of ousting bedroom_Yes_No Adding new bedroom Yes No
Atieehed Narrative Renovefirg unfinished basement Yes No
Plane Attectwd Roll -Sheet
Y.V MDIN hoses MM Or adtdlVA R to exbOm housbuil CODtdpb OW%NO13IRO'
a. Use of building:One Famity Tiro Famiy Other
b. Number of rooms in sach family unit: Number of Bathrooms
c. Is there a garage atleched7
d. Proposed Square footage of new consWction. Dimensions
e. Numherofstones?
f. Melted of heating? Fireplaces or Woodsbves Number of each
g. Energy Conservation Complianos. Masscheck Energy Compliance form attached?
h. Type of construction
I. Is construction within 100 R of wetlands?_Yea _No. Is construction within 100 yr. floodplain_Yes_No
I. Depth of basement or caller floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes NO.
L Septic Tank_ City Sewer Private well_ City water Supply
SECTION 78-OWNER AUTHOR¢AT10N-TO BE COMPLETED WHEN
OWNERS AGENT
1OR CONTRACTOR APPLIES FOR BULGING PERMIT
c..J
1, o 0 lit o r0 m D/ a— as Owner of the subject
property
herebyaumonze Sam ES 7. FL.'WAJ -/2y 2)614 PEAK PERFORmF}Ncc A00r-1b6 L
to act on my behalf,in all matters relative to work authorired by this building permit application.
Signalursof r Dale
1, JAMES U. FLANMERY
as OwnAuthorized
herebyAgent hereby declare that the statements accurate,and Information on the foregoing application ame and acrete,m best ofthe hest of my knowledge
and belief.
Signed under the palm and penalties of perjury.
-JAMES S. FLANK,FRy
Prim Name
s y ig
Signature of Owner/Agent Dale
SECTION S-CONSTRUCTION SERVICES
&I Lleanaad Construction Suoarvlsor. Not Applicable ❑
Namoof Lkamaa NoNar: -JgMES T PLRA//VE/ZY Cs - /03042/
LiCMbNumlror
l wdliam 5-F,A l�lyo w rn>4 o/ogo o9/a/1aa/8
Address y EVratim Date
N13- a03 - 588
SgreWre Telephone
Not Applicable ❑
PERK P6-kr-6R hRNCE 97oFItV&-1 Lee- /8369
Company Name Registrai Number
) "Via i-elcl 64, EdSfharr�fDAJ YEA C95/60'0' /17;; ?0/9
Address /v13) Expiration Date
Telephone aQ -5LY
SECTION t0.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a 162,$26C(6))
Workers Compensation Insurance affidavit must be completed and submitted with thio application. Failure to Provide this atfidwit will result
in the denial of the issuance of the buuiiWii g permit.
Signed Affidavit Attached Yes._.... rye No...... ❑
�\ 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 Leeibly
Name (Business/OrganizadoNtndividmi): Peak Performance Roofing LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
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 1 6. E] 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
workingfor me in an capacity. employees and have workers'
Y P ty 9. E] 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.VRoof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.El Other
comp. insurance required.]
"Any applicant that checks box#1 most also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing al I work and then hire outside contractors must submit anew 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. lithe sub-contractors have employees,they must provide their workers damp.policy number.
I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site
information.
Insurance Company Name: Berkshire Hathaway Guard
Policy#or Self-ins. Lic.#: R2WC943835I _ Expiration Date: 4/27/2019
Job Site Address: ?9 F�derad S+ City/State/Zip: YI O ayY_a m,4 olW a
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 maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penaifies,,o//f perjury�l that the information provided above is or and correct.
Signature Ih _- Data Sly /.p
Phone#: 413-203-5888 is`
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):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
Worker's Compensation and Employer's Liability Poliev
Berkshire Hathaway AmGUARD Insurance Company- AStock Co.
Y Policy Number R2WC943835
Insurance 11187
litGUARD Companies Renew NCCI No.il of [218 3]
Policy Information Page (AR)
[1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
1 LOVEFIELD STREET 8 NORTH KING STREET
EASTHAMPION, NA 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
IN7TRNAL use KK Page- 1 - Information Page
MGA : R2WC943835 WC 000001A
Date :04/04/2018
MANOTE
Issuing Office: P.O. Box A-H, 16 S.Riser Street,Wilkes-Barre,PA 18703-0020 s www.guard.com
City of Northampton
Massachusetts
s
IffiPAR19AlIT O1 BBILOZBG ZBSPSClZ0H3
212 Win 6tret •Wniotpal euild n12 ,r
Borth� n, M 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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 property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
89 Federal Sl , Fl6r�y7cL MA 6ID& O-
(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:
�aRons Rol%o�-l; � /Aom;s u�ac�, �asfhamp� �'l�
(Company Name and Address)
(
Sign re dT Permit Aoplicant 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.
c�/�ie �ammanuu�u/l� ,�{3��6ac�tu�tef�„�
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE RO0F0i0,U.C. Re0i&a00m 183698
1 L.OVERELO ST. SOMUM: 11/03/2019
EASTHAMPTON,MA 010V
scni a axMavir UpEaM AWWRN CW.
lasga n 'S vs tll '.mc 9btrpt
3aaro or @„bry g �ege,{arso to g*�rrc..rsns
CS-413081
JAMU i FLANMERY
1 WLu&MB w
wXY'OKEMA 01010
- jCA—
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:. 6:,-:n %s•o r 0021/2010
PE K Peak Performance Roofing LLC
Contract
P E R F O R C E 1 Lovefield St Conha
Easthampton, MA 01027 5/42018 543
MA CSL#103061
MA RIC# 193698 1 413-203-5888 peakperfotmemeroofmglle@gmail.com www.pealrped'onnueemofinglle.com
Job Location BIII To
Scott Crombie Scott Crombie
89 Federal St. 99 Federal SL
Florence,MA 01062 Flamer,MA 01062
413-320-0312 413-320-0312
sd=nrbie58®gmail.com sdcrombie58@@mail..m
Description Total
'This warrant is for replacing sections(QE)please see diagram attached.We will replace up to 100 square feet of 4,850.00
plywood if necessary a no east Any additional plywood will be of a ate of$50 per sheet.
I.Remove the existing roof shingles
2.Install six feel of ice and water shield a eaves
3.Coves remaining roof with Certainteed"RmofRanner"synthetic uvdedayment
4.Install new 8"aluminum drip edge on all eaves and take edges
5.Install XT-25 3-tab shingles by Cedemreed
haps://www.certamteed.mm/residmtiel-mofing*oducts./#-25/
Color Choi.:
6.Install mew Carminteed ridge vent
7.Complete as mecemrry 8sshin including new pipe boob and new base Flashing around chimney
Remove all debris from prerni.s,and throughout thejob,confine cleanup and keep the premises undamaged
Total mat$4,850
A deposit of 12 is due prior be the beginning ofthe job=$2,425
The Immune of$2,425 shag be due upon completion.
Deposit Received On:_/_/_ Deposit$ Check#
*We are not responsible for d' debris that may fell into stair"
Cos o
Con Signature:
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