32C-143 (22) 297 PLEASANT ST BP-2018-1304
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:32C- 143 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv,ROOF BUILDING PERMIT
Permit BP-2018-1304
Project# JS-2018-002324
Est.Cost: 59300.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(so.ft.), 7710.12 Owner. MORIN CHARLES R&MARLENE A
Zorn= GB(100)/ Applicant. JAMES FLANNERY
AT. 297 PLEASANT ST
ApplicantAddress: Phone: Insurance:
1 LOVEFIELD ST (508)294-4052 WC
EASTHAMPTONMA01027 ISSUED ON:6/1812018 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVE EXISTING MATERIAL, INSTALL R-28
POLYISO & ROOFING SYSTEM
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 q 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 signature:
FeeType: Date Paid: Amount:
Building 6/18/20180:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
tgv . / �- 1,31) Y
PLEhSE NOTE - 'f►NS IsA OArL Sly L7PlN6
ompoonw�a*
City Of Northampton Sh"CfM1wi
Building Department Gap OIeGRSOIaa Perm
00 212 Main Street Baead8q*
Room 100 WMWWd
,6 Northampton, MA 01060 avaerstack"PWA
z o phone 413-587-1240 Fax 413587-1272 P6tlaw Plea
ate N cww
T
c� m A TION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH 40 IEEIR
u SECTION I-31 INFORMATION (1-Vu Kaxq-W
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SECTION 2-PROPERTY OWNERSNIP/AUTHORIZED AGENT
2.1 O mmar M Record:
79p �PYIL iYIGl2/ti 1.21 Floruice Rd , c/r,r,,tyt mg k
Name IPraal GurMnt MakV Address: G/O
�^ TabpMne yl3 - 3a C - /3 F l
za AuNKWbMd Amnt:
-14MES T G[ ANNa=fly l tovR z/d St, 6aSlllarn laNMA
Name(PrM Cures Ma"Aadiess:
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SECTION 3-BSTSaATEO CONSTRLM=>'nM mens
Item Estimated Cost(Dollats)at be OlScud Use Only
cam it
I.
Buldlna93 CO, n0 (a)Building Permit Fee
2. Electrical (p)Estlmatad Total Cost of
CcrM6uction from 6
3. Plumbing Bulldlnp Penne Fes
4. Mecherlical(HVAC)
S.Fire Protection
6. Total=(1 .2+3-4i5) 3C E' check NumlaxjqqU
Thte 8sc0on For CHR"Uas Orft
Build ft Pamal Nunpen: Data
4ssued:
signature: U ?�- 17– I E
aw .cr��
pe4KPOeFoRm9AlCEROOFIN6-LL.C® A/// F
ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
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SECTION 6 DESCRIPTION OF PROPOSED WORK check ag aoWlc")
Near Nape ❑ Addmon ❑ Replacement Windows Altaratlon(s) ❑ RooBog
Or Dooms O
Accaasory Bldg. ❑ Demolition ❑ New Sigma [O] Decks [q Sidings l] Other[E:Q
BdBf DeacriPdan°f P10PO'ed O/ �SO d UIlQ C`'el�r-[X EPD/19
werk:�semav� �xrsh'n� iu0.><eyia/� inslzil/ R-2$ P .NX
room q
Attached of existing bedroom_Yes_No Adding new,bedroom_Vee No sy5
ASSCpd Ned Roll
o
Renvagng unfinished basement Vas !No
Plans Attaclhwd Roll -Sheet
`.N WM hOirR Md Of addWors to 01t151h10 hOwhmL C0111010fl5 UN/0110*11ra
a. Use of building:One Farcy Tao Famiy Omer
b. Number of moms in each family unit: Number of Bathrooms
a Is them a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodsfoves Number of each
g. Energy Conservatlon Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 S.of wetlands?_Vee —No. la construction within 100 yr. floodplain_Yes_No
j. Depth of basement or cellar floor below finished grade
k. W91 building conform to the Building and Zoning regulations? Yee_No.
I. Septic Tank_ Cay Seaver_ Private well_ City water Supply
SECTION 7Y-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUS.DING PERMIT
1, MARLENE MD/2//U as Owner of the subject
property
hembyamhaira TAMES 7• FL4tVAJ 2y D614 PEAK PERFORM4NCF 400FlN6 U
to as on my ,in all matters work authorized by this building permit appliestion.
1' Signature of Danar y Dale
JAMES U. r-LANA)ERy 'as
OwnedAuthorized
Agent hereby declare that the statements and information on the foregoing application am true end accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
-JAMES T FI-ANN=R�/
Pnm Nam
i8
S rahreo/OwredAgemv if-
Dare
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Sumnd w: NM Applicable 0
Wm.MLlram.Ndd.r:_ "JAmES a, Ft-l91.uv ERY CS - 1030&1
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Adam E pWw tete
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Slgnffw Telepl
Not Applirsbb ❑
PERK I
LLC
Comm"Nome Registry io Number
Lova 2ld Fas�ham��oN M)q1� �a3/20/9
Address
4//3) E)¢irelldl Date
Telephone aD3-.�88b
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT p6.G.L.c.162.1 28C{8))
Workers Compensation Imurance affidavit must be completed and submdbd with this application.Failure to provide this affldeW wire result
in the denial of the issuance of the building permit
Signed Affclavit Attached Yes....... W/ No...... ❑
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
wi 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/organizatioNlndividuap: Peak Performance Roofing LLC _
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Are u 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 E] New construction
employees(full and/or part-time).- have hired the sub-contractors
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'
[No workers' comp. insurancecomp. insurance.9 . E] Building addition
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 11.m❑yPlumbing repairs or additions
myself. [No workers' comp. 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 p I must also fill out the section below showing their workers compensation policy information.
I Homeowmers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
iContractors that check this box most 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 most 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. Lie.#: R22 WC943835 Expiration Date: 4/27/2019
Sob Site Address: / 'ele -StCJ'L�. �t- City/State/Zip: Nat-lhai'Yt�7l�llu O D�O
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 penallties of perjury that the information provided above is true and correct
Signature, 54,. _ /I. Date'
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
AmGUARD Insurance Company -A Stock Co.
Berkshire Hathaway Policy Number R2WC943835
InsuranceGUARD Companies of NCCI No.[21873]
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
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
IlVrE A USE xx Page- 1 - Information Page
MGA :R2WC943835
MIN12018 WC OOOOOlA
Date :
MANOTE
Issuing Office: P.O. Box A-H, 16 S.River Street,Wilkes-Barre,PA 18703-0020•www.guard.com
City of Northampton (i)Massachusetts
I�AR1ffiPZ Od BpZLlIZaG ZNSPZ;C1'IOH3
212 Nein Slr •Nuoicipal euil6.,
m
north n, M 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 property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
a9 ,7 jD1',7aSjL"f sf
(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:
'amon`s I(ol%o ; / Loomis wa�, �rxs�hamp �l�
(Company Name and Address)
Sign replicant or Owner Dat / b
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.
CJ�Xe olCA74�kedeCt
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. Registration' 183646
1 LOVEFIELD ST. E)#ra00n. 11/03/2019
EASTHAMPTON,MA 01027
Upde A&I.en0 Ra .Cx .
scnl O sa.�ovn
30a-n o+B-atl q Reg, ".'n' Inn rams
z•r.a CS-100061
JAMES J FLANNERY
1 WILLIAMS ST Am
HOLYOKE MA 01640
C.A_ =xpv.iPGP
somniss:,^t>- OW2112019
MFO E K Peak Performance Roofing LLC
c«bap#
Contract
P E R CE I Lovefield St 3a�
Easthampton, MA 01027 5/4/2018 532
MA CSU 103061
MANIC# 103698 413-203-5888 pealmrfommnceroofmgllc@gmaiLoom an—peakperfomnnceraofiogffc.com
Job Location Nil To
Marlene Morin Marlene Morin
297 Pleases S' 121 Florence Rd.
Northampton,MA 01060 Florence,MA 01062
413-320-1881 413-320-1881
anomeymarle temorin@yahoo.mm ameneymmlenemorin@ynhoo.mm
Description Total
1.Remove existing roofmaterials 9,300.00
2.Replace W 10100 square fmt of sheathing m needed al m additional cost. Any additional plywood needed would
be billed at$50 per sheet.
3.Mechanically fasten 2layers oft"polyisocyanumm insulation with approved screws and plates(required by
building code).
4.Insm112 turbine vents.
5.hums Genfim mochanirdly attached EPDM soofsysson to acmrdmce with the mmufactureYa specifications:
http://gmfl".cam/wpconfN/uploads/2014/11/CB02_C.enFlex-EPDM-Bmcbure_1014_web.pdf
6.Inna11.032 gauge bronze aluminum drip age on perimeter.
9.Warranty: Matedalsand labor shall be wamnded for 10 yeamby Gentkx Roofing System and Peak
Performevce Roofing.
htip://gm0m.cosdwpceomnt(wloadd2016/05/GenFlex-Registered-Warranty-SAMPLE.pdf
Property will be pvAected from damW at a0 times. M debris will be rernuved from premises.
Total con: 59300
A deposit of54650 is required prior to start ofwork.
The balance ofS4650 shall be due upon compktion.�
Deposit received on: —3—/1Y ''3 Deposit$'/J 5 610
O Check#F-1
*We ave not responsible for din/debris that my falulay suit.
Customer Signature;
Counselorsign. Tp�� 59,300.00