17C-025 (3) 9 KING AVE BP-2019-0420
G15#: COMMONWEALTH OF MASSACHUSETTS
hjN:Block: 17C-025 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-2019-0420
Proiect# JS-2019-000670
Est.Cost: $2995.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: .License:
Use Group: JAMES FLANNERY, 103061
Lot Size(sq.ft.): 7753.68 Owner: FLYNN 1M,�ICHAFL B&THERESA M
Zoning:URB(100)/ Aalicant. JAMES FLANNERY
AT. 9 KING AVE
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508)2.94-4052 WC
EASTHAMPTONMA01027 ISSUED ON:10/5/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE PORCH 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]2epartment Fireplace/Chimney:
Rough: Qil: Insulation:
Final: m ke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeTyue: Date Paid: Amount:
Building 10/5/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
goo
City of Northampton Status of Pei"d: Depattrient use only
Building Department Curb Ctt�l'Dd wrby Peft
212 Main Street Seft SepticAv& ie ft
Room 100 wwwwol
Northampton, MA 01060 Two Soy of Skuct"pyo
phone 413-587-1240 Fax 413-587-1272 Pbwft PbM
Ottter SpscBy
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION �j P� q—q'2-0
1.1 Property Address: This section to be completed by offk:s
9 Map—>f'--"--'` Lot d aS7 Unit
' '' 1✓ �" ` Zone Overlay District
Elm 8L District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
M1(11'gCL
Name(Print Current Mailing Address:
Telephone '113
Signature
2.2 Authorized Anent:
Ifil"ES T, JCL141V/Ji.P;A y ! �oY� �/� Sf, ea sMarnp&N mq
Name(Print) Current Mailing Address: t�IO
L113 - ao-3 -- 6-9
Signature )V Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) 01 r 1 ` 5, Check Number o2/
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
�eAK p f/2 Fole rngAl c�'RboF/�vG-1-t-� � c� rn tai c , �p/'�f
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SEDC Its 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House M Addition [] Replacement Windows Altention(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [O Siding 101 Other[L7j
Brief Description of Proposed 1
Work: S rz1 t �� u1?� 4' Ur?� �Jh12Cf�I leoj;
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
ea 4f Now hclu and or adsittlon to e400hguslng,complete f following:
/f
a. Use of bui".One Family Two Family Other
b. Number of rooms in 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? ,,,,F' aces or Woodstoves Number of each
g. Energy Conservation Compliance. �'� Masscheck Energy Compliance form attached?
h. Type of construction r�i
i. Is construction within 100 ft.of ands? Yes No. Is construction Whin 100 yr_ floodplain Yes No
j. Depth of basement lar floor below finished grade
k. Will buildi nform to the Building and Zoning regulations? Yes No.
1. S�c Tank City Sewer Private well City water Supply
SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, N I M L L L`�/�11 rl ,as Owner of the subject
property
herebyauthorize J-)"F-5 T' FLt4Niv€t2,y 2)6144 0,r. K PERFoRm/4Nt".6 40OOV6 U-6
toact on my eh I,'n all t rs relative to work authorized by this building permit application.
-- nature of r — ate
l JAMES -J, FIANNUkI 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-AIV/ E9 Y
Print Name
Signature of Owner/AgentDate
SECTION Ni-DESCRIPI N OF PROPOSED WORK(check all aoolleable)
New Nouse Addition ❑ Replacement Windows Alterations) Roofing
Or Doors ❑
Accessory Blft. ❑ Demolition ❑ New Signs [o] Decks [C7 Siding[A] Other[t:Q
Brite Description of Proposed
Work: .C'- U/�}� �7�Cf7 2�,9�
Alteration of wasting bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Rolf -Sheet
es.-It Natlt►Wim and or addition to e>rlsttna housirm,comolet0 the following:
a. Use of W":One Family Two Family Other
b. Number of room each family unit. Number of Bathrooms
c. Is there a garage attached? ____
d. Proposed Square footage of new ooniltruction. Dimensions
e. Number of stories? /-✓f�
f. Method of heating? F' aces 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 ands? Yes No. Is construction within 100 yr_ floodplain Yes No
j. Depth of basement lar floor below finished grade
k. Will buildlr�g::rnm Ito the Building and Zoning regulations? Yes No.
f
I. Sc Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, 1(�{fa t: F L`/!L�/�1 ,as Owner of the subject
property
herebyalthonze TAmFS �". FLA1VA)9(2y 2)6a PWK PERFORm19-1VG6 /e01)FIA)6 u
to act on r eh D,'n allp000rs relative to work authorized by this building permit application.
912- '7 457-
nature of Ower 6 date
l UR M E S U. F L*}N NEP-y 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. F4a4NNiFR�/
Print Name Q
S' nature of Omwftent U X Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Constructio
�n
-SSupervisor: Not Applicable /❑
ane of Lkrense Hol for: —JAMES ES �.J.-� P L191VIN Fir�0,y C J — / 0,30
1p 1
License Number
l U) M a M Sf, , //0/yokQ rn 0101-110 9/a/Zd_0
Address Expiration Date
y13- A03 - ,SJ?�4
Signature Telephone
Not Applicable ❑
PEAK PER r_6P1MAN CC 2OOF1206-, LIC / ' 3 6 g S
Company Name Registrat7;;7;z.,o
"V,1- _g)Cj 5�, Fasfharn,��N JyJA ���� /i /9
Address (y�3� Expiration Date
Telephone 203 5_127
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§25C(8))
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....... QP"' No...... ❑
City of Northampton
Massachusetts
sG
DWARTtMCNT OF BUILDING ZANSPSCTIONS .0
212 Main Street •Municipal Building
Northampton, MA 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:
Xm6 Pye-
(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:
14M019,5 401/-O iV1 J zoomi s wu,
(Company Name and Address)
2
Sign re OY Perms A#piicant 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/Flectricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/organization/individual): Peak Performance Roofing, LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Are pu an employer?Check the appropriate box: Type of project(required):
1.pz l am a employer with 4 4. ❑ I am a general contractor and t
employees(full and/or part-time).* have hired the sub-contractors 6 E] 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 g• ❑ Demolition
workingfor me in an • capacity. employees and have workers'
y p 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.*
required.] 5. [:] We are a corporation and its 10.❑ Electrical repairs or additions
q �
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself No workers' com right of exemption per MGL
Y [ P• 12.[/Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#I must also 511 out the section below showing their 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 pro%ide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance fur my employees. Below is the policy and job site
information.
Berkshire Hathaway Guard
Insurance Company Name:
Policy#or Self-ins.(Laic.#: R2WC943835 Expiration Date: 4/27/2019
/
Job Site Address: 14 q /� City/State/Zip: l' K0 00 M11 Dl OeO v�
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 S 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 penalties of perjury that the information provided ab ve is true and correct.
Signature: Date:
Phone#: 413-203-5888
Official use only. Do not write in this area, to be completed by city or town official
Cit'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#:
i(Berkshire Hathaway "in6"""t'D='�'' „ Co.
GUARDCmpane M W1873;
Polity Infwam ion Pape(AR)
[i]Named Inwrad and Mailing Addreie 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: MAMMN15
Federal Employer's ID 00-1191951 Insured In Limited Liability Co. (LLC)
.�
[2] POliq PariOd
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. employee'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 $1001000
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-Sdwdule of Forms
[4] Premium
The Premium Basis and,therefore,the premium will be determined by our Manual of Runts,
CAcatlons, Rates,and Rating Plans. All required information Is subject to verification and change by
audlt. (Continued on another Rage)
I
ab»i Estimated Polkv Premium $ 13,650
oth 9md�aryas/AreMmeMs $ 606.00
otal EWreabd cost 146256.00
ncr�NA�
USE lot Page- 1- Inrornhation Pape
MGA :R2WC943835 WC 000001A
Date :04/04/2018
MANOTE
=rrdnp 0ffl=P.0.soot A-H,16 8.Wm Oboe%111flNra PA 18763-0026•menu p mwd aom
cv/-W C29n��
Office of Consumer Affairs and Business Regulation
One Ashburton Place- Suite 1301
Boston, Massachusetts 02106
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE ROOFING,LLC. Reosbution. 183696
1 LOVEFIELD ST. E.1pira#w: 11/0312019
EASTHAMPTON,MA 01027
Update Address and Retum Card.
SCA 18 20M-0517
Office of Consuaw Aflairs i Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for kxkvkkad use ordy
TYPE:LLC before the expiration data. B found return to:
R29VUROM fUlklitim Ww of Coraunrer Affairs and Business Regulation
183!!06 11/0312019 10 Park Plaza-Suit 5170
PEAK PERFORMANCE ROOFING.LLC. Boston,MA 02116
JAMES FLANNERY
1 LOVEFIELD ST.
EASTHAMPTON.MA 01027 Undersecretary t valid Without signature
CommonweaRh of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Construction Supervisor
s of an
Unrestricted-&iNdhg y use group which contain
CS-103061 E.apires:QW2112020 *as than 36,000 cubic feet(891 cubic maters)of enclosed
space.
JAMES J FLANNERY
1 WRMAMS ST
HOLYOKE MA 0{040
Commissioner l " Failure to possess a currant edNion oithe Massachusetts
State Building Code is cause for revocation otthis NCO=.
For InWrrftion about this licanse
CaN(617)727-3200 or visit www.mass.gov/dq
P E K Peak Performance Roofing LLC
Contract
P E R F R CE I Lovefield St Date Contract#
m m Easthampton, MA 01027 9/24/2018 677
MA CS"103061 1 413-203-5888 peakperformanceroofingllc@gmail.com www.peakperfonmanceroofingllc.com
MA HIC# 183698
Bill To Job Location
Michael Flynn &Megan Allen Michael Flynn&Megan Allen
9 King Ave.,Florence, MA 01062 9 King Ave.,Florence, MA 01062
813-748-1709,413-320-3098 813-748-1709, 413-320-3098
mallen@mtholyoke.edu mallen@mtholyoke.edu
mflynn@mtholyoke.edu mflynn@mtholyoke.edu
Description Total
Porch roof on front of the house: 2,995.00
1.Remove the existing roof shingles
2.Install new 1/2 inch CDX plywood over boards
3.Install ice and water barrier over entire porch roof
4.Install 8"aluminum drip edge on eaves and rake edges
5.Install architectural shingles by Certainteed (Landmark)30yr rated
https://www.certainteed.com/residential-roofing/products/landmark/
Color Choice:Georgetown Gray
6.Complete all necessary flashings
Remove all debris from premises,and throughout the job,continue cleanup and keep the premises undamaged.
Contractor will obtain building permit.
Total cost:$2,995
A deposit-of$1497.50 is due at contract signing. The balance shall be due upon completion.
Accounts past due 30+days subject to 2%finance charge monthly.
*We are not responsible for dirt/debris that may fall into attic.Please check for debris after dumpster is removed.*
Total:
Contractor Signature: Customer Signature: Date:
$2,995.00