20-006 (4) 508 SYLVESTER RD BP-2019-0126
GIS#: COMMONWEALTH OF MASSACHUSETTS
MV.Block:20-006 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Categorv� ROOF BUILDING PERMIT
Permit# BP-2019-0126
Proiect# JS-2019-000204
Est.Cost: $5950.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group- JAMES FLANNERY 103061
Lot Size(sa. ft.): Owner: SWAN SARA&ZACHARY
Zoning: Applicant JAMES FLANNERY
AT: 508 SYLVESTER RD
Applicant Address: Phone: Insurance:
I LOVEFIELD ST (508)294-4052 WC
EASTHAMPTONMA01027 ISSUED ON:713112018 0:00:00
TO PERFORM THE FOLLOWING WORKSTRIP & SHINGLE ROOF on main house
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:
FeeTYpe: Date Paid: Amount:
Building 7/31/20180:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
mor
0
°° City of Northampton 8bsr raPsrrrR
a Building Department CUA Oi*DdMAW P--
90 212 Main Street awmrn Pao MwIsbty
z� Room 100 Waft~
Northampton, MA 01060 TWO Falx agWM*itl PWN
phone 413-587-1240 Fax 413-587-1272 Ploaal.PAn
Y Oar eOeab
A CATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY OWELLING
SECTION 1-SRE INFORMATION '3 a, I l"�'
1.1 Probeft AddreM: TNN Section to as comPINIMal by OMM
5 � S��VQSf lac M.P d0 La60V t
zom Omrby Dbmk[
lImK OMM CS DYbkt,
SECTION 2-PROPERTY OWNERSHIPIAUTHORMED AGENT aarrhh
1 z.ac�A SWb(.' o"S S �V15�-N ✓d 0
TMaphne
7 T, LUMIA15R1/ Lovpf'- 0 5f, EagAarnpl*NMFI
Name(Prix) Cumml Mary Abea.
yla - aos- s88 8
SECTION 3-ESTIMATES TION Goan
eisaalkaa Tabpaoro
Rem EsbmeW Cost Polars)M W Mail UM Orgy
completetlby pennit
1. BaiNbg �( ,C•y1.. CID (a)Building PemD FM
2. Elechical ✓ J�✓ (b)Esbmebd Total Cost Of
Cambucgon mom e
3. Plumbing BuOding Puma FM
4. ANchanMCW(HVAC) 7v
5.Fine n
G. Total=(1-2+3+4+51 1 Check Nwnbar
This Section Far OffieW USS On
Dab
euk"Ponos Number laved:
Bw
BUMV COm Wrw r"saora Rub" Done
PPAKPf9F0)I!MV*VCER00F1N6-"-C j (7I RI • CU/"l
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
ALI =a-OEICRIMON DP PROPOSIM WORK Ichock all soptl 1
NOW Noua9 ❑ Addition ❑ Orchestra ftPWMMM noowa ANMMbnls) ❑ RrMang
A-ugt"Bldg. ❑ DemeollNon ❑ Naw Signs 031 Docks M Siding JC31 Other tlQ
Brief Description«Proposedp/a(I. /�' dJY .JYI inQ Q.,,$ on kwa%n
work: !
Annuitant«wtictlng bedroom_Ysa_No Adding new bedroom Yea _No
Attached Nwrative fianovaUrg unRasbed beesmant Vee _No
Plain Atsd*d R«I -Sheat
an,If Now hom Srld or odd idan to exividna how Comobb ft foRoWinD,
a. Use«building:One Family Two Fatuity Omar
b. NunAx«rooms In each family unit: Number«Balhmome
e Is there a gauge adecled?
d. Proposed Square assets,«new construction. Dimensions
9. Number«elwies?
I. M«hbe«beawg? Fbeplacaa or Woodsiow Numberof each
g. Energy Comervaeon Compliance. Wrenched EneW Co nPeance to=attached?
h. Type«oonanweon
I. Is coneWgim within 100 a.otwedands?_Yes _No. Is mrsdnrdion within 100 yr. floodplain_Yes_No
I. Dapm«baawn r t or 0611ter floor below Mieled grade
k. Will buidYq conform te tle Building and Zoning regulations? Yes—No.
I. Sapflc Tank_ City Sewer_ Private wap_ City water Supply_
RECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUNGING PERMIT
I, G ✓�vh L-.
an Owner aline subject
properly
heMbyaualorl>e 7 c 7. FL41vlucAy D&,) PEAK pSRFDRMRNL6 RODOV6 LC
to Md on MMAIR mistmetwaks, reed by this building Permit katlgn.
agmesm ower Did
1. lllftVS. U. FLRN 10ERY .as owrenAunnnie0
Agard hNeby(Indere that the statements and nfonnation an the foregoing applicaban ale true and a=rate,to gra best of my kllDAledge
and belief.
Signed under the palm and penanee of o nn"
7AYnES 1. FLANAJrkY
"Na.
aglrwaa Oftled-Gand Dan
SECTION 8-CONSTRUCTION SERVICES
8.1 LleanoW Conshue8on Supervisor, Not Applicable ❑
Nameof Lleensellomer: —Jqr/ES SFU9/vNEFty CS - /03010/
Liwee Number
l Guillrams 5t,� / /yoke rn,4 Oloyo 09/a/�aoi8
AdtlreesI E)Imtlon Dole
N13-
SgreWre Telephone
Not Applicable D
/0E4K PC PORMHNGE 906F/1U6-, LLC /F3 (acIo?
Company Name /aaRegisbatio Number
Love� �ld 5f Fasfharr{p�orl YYIA a31 117;3720 /9'
Address /N13� Expiration Date
Telephone a�3-.�PB�
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O.L.m 162.If 25q6))
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this alfidevd will reeu8
in the deNal of the issuance of the buildingpermit
Si nailAffidaWAttached Yes....... DY No...... ❑
City of Northampton _
Massachusetts L.
Di4?M1fffilT OF BMWIaG INBpaCTIONa
212 Nein etnet *r Cipel Bu Idinq '
9orNeepton, 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:
5-6k ,;��l�� a � eIQ
(Please print houde 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:
,4aA00'5 R011-0(4'1 /-oom;-S -o-o ampY60 mA
(Company Name and Address) a
aW oT -7A&Z C
Sign re Permit A45plicant 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 oflndustrial Accidents
Ogee 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(Huainess/OrgmieadoWlndividuaq: 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):
L 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.❑ 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 ry� 9. E] Building addition
[No workers'comp. insurance comp. insurance
required.] 5. ❑ Weare a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I I.a❑y Plumbing 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#1 most also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit his affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tCommems that check this box must attached an additional sheet showing the name of the subcontractors and sum,whether or not those entities have
employees. tribe sub-convectors have employees,hey most provide their workers'camp.policy number.
7 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.#: R2WC94((3835 Expiration Date: 4/27/2019
Job Site Address: '5-68SUw.e s/'Q-� M City/State/Zip: Flo rene_o SMA O/C&2
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.
1 do hereby certify under the pains and penalties of perjury that the information provided Above if true and correct.
S' atue� Date 7 2lD p
Phone#: 413-203-5888
Official use only. Do not write in this area,to be completed by city or fawn officiat
City or Town: Permit/License It
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
b.Other
Contact Person: Phone#:
Worker's Compensation and Employer's Liability Policy
11187
kshire Hath awa AmGUARD Insurance Company -A Stock Co.
Y Policy Number R2WC943835
AlInsurance G UA RD Companies Renew N CI No.l of [21873]
Policy Information Page (AR)
[3]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER a GRINNELL INSURANCE AGENCY, INC.
1 LOVEFIELD STREET 8 NORTH KING STREET
EASTHAMP ON,MA 01027 Northampton, MA 01060
Agency Code: MAMAINIS
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 j 606.00
Total Estimated Cost 14 256.00
INTERNI USE xx Page- 1 - Information Page
MGA R2WC943835 WC 000001A
Date :09/04/2018
MANOTE
Issuing Office; P.O.Box A-N, 16 S.RWer street,Wilkes-Barre,PA 18703-0020 s www.guare.com
71w I "
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. Regie mdw: 183898
1 LOVERELD ST. Fi�iratlort 11/03/2019
EASTHAMPTON,MA 01027
upE A&Ire and RM mCaM.
SCRs � IDEVO`WT]
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JAMES J FLANNERY
1 YAWAM887
HOLYOKE MA 81/8'18
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snmmiss.cre- OW2112018
pKPeak Performance Roofing LLC Contract
PE R F O R CE I Lovefield St Da1B cOnh°
0 Easthampton, MA 01027 nz6rzou 6a
MA CSUa I0.Nft
MA NICk 185698 J13.203-5888 Naperfurmonmruafingllnn:gmail,vm wvw.peekperf....ru F.,s co.
Bill To Job Location
Zach Swan Zach Swan
508 Sylvester Rd. 508 Sylvester Rd.
Florence,MA 01062 Florence,MA 01062
znh@wrtheast-solar.com northeast-solarcom zach@nonhcast-solaccorn
413-335-7652 413-335-7652
Descdpfion Total
Main House,excluding porch roofs: 3.950.00
I.Remove the aA.1mg roofshingles
2.Insall is fed of ice and water shield d eaves and valleys, 12"around mo(:well intersections
3.Cover remaining maf with Cesainmed"Roof Runner"synthetic undedaymem
4.Insall 8"aluminum drip edge on eaves and take edges '
5.Irmall architectural shingles by Ceminteed(Landmark PRO)00yr rated
Itttps:;rwww.certainleed.mMreetdmtial-mofingipmducwlmdmark.pm,
ColorChoiee:
6.Install ridge vent
7.Complete all necessary fllashings including new pipe bests and new base flashing on chimney
We will replace up to 100 square feet of plywood if necessary d no cost.Any additional plywood will be$50 per
shed installed
Remove,all debris flown premises,and throughout the job,continue cleanup and keep the premises undamaged
Total cost-S5950
A deposit off2975 is due prior to son of work
The balance off2975 shall be due upon completion.
Deposit Received On: i___ Deposit S Check u
•We am not m,"ble for din/debris that nay full into anic.Place check Por debris aticr dumpmcr is mnnvvd.• Total,
Conaacanesr 8igaature ruse nS m. Desk: "
ter 2-;a I 55,950.00
i