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38B-120 14 STEARNS CT BP-2019-0451 G15#: COMMONWEALTH OF MASSACHUSETTS M Block: 38B- 120 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-2019-0451 Proiect# JS-2019-000722 Est.Cost: $8500.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sa.ft.); 6490.44 Owner: HOPPIN MARTHA J Zoning:URB(100)/ Applicant: JAMES FLANNERY AT. 14 STEARNS CT Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508)294-4052 WC EASTHAMPTONMA01027 ISSUED ON.10/15/2018 0:00.00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF - EXCLUDING SMALL REAR DORMER 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 Occupancy Signature: FeeType: Date Paid: Amount: Building 10/15/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner City of Northampton Itlsttfl ; i Building Department cwb Cuvoowvjpsrmx. 212 Main Street SeM�ll Room 100 W Northampton, MA 01060 t� phone 413-587-1240 APPLICATION TO CONSTRUCT,ALTER, EPA R,RENOVATE OR DEMO ISH ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION OCT 1 1 6 p jq-'�sj 1.1 Properly Address: DEPT.OF BUILDING INSPECTI s On t4 be I:Orrlpleted Offlce NORTHAMPTON.MA 0 r 5ticcaJ2IVS C ,r "" _ lot unit Zone Overlay Dftftkt- Elin St CB SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: M ART 4A 14O P PI N /L/ 5t-'O' /�s C 7r Name(Print) Current Mailing Address: Telephone 'z "5G _ r! �} Signature ✓ 0 i 2.2 Authorized Agent: �'1ii"ES TFC-ANN�ii2 y/ l Lev. :e/c� Sf, �a s�-��rnpMA/ M� Name(Print) Current Mailing Address: Q�Q '1I3 - PO - ,5-F 8 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 00 (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=0 +2+3+4+5) `j C�r�, a Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: 1 Ott yt8 Building Commissioner/Inspector of Buildings Date pinpfreFoien76Nce'A©OFIN6-LL-C (& EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 8-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E] Siding[b] Other[Cf] Brief WorkDescription of Proposed _91n i p + ROO t x d ud/n)q small re a r d ra wd, Alteration of epsting bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet &L N NOW 60118116 OW Or OOMM tO 91ENOW 111011JISM,t:Qlfi ft fONOWInG: a. Use of building:One Family 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 oodstoves Number of each g. Energy Conservation Compliance. Magicheck 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 Ji. Depth of basement or cellar flop low finished grade k. Will building conform Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SEC a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNE AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT V1_ as Owner of the subject property hereby authorize 3AJ'Y>FS 7J, F LA1VAJQZy DDA ARM p E R FO R M4N GE A OD OV 6 LL to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner v Date 1 J,4m FS -J, Ft_AN/VERY 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 S. FFLA/ NEN Y Print Name f' Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: � Not Applicable (3m NaeofLfcenasHolder: c�Am�S J: PLlgnV/yE7P y os - 1030101 License Number l Wilhgm5 5-, , leol *,Q miq oIDyD 8 Address EViration Date L113 - a636- 5-8�'S Signature Telephone Not Applicable ❑ pFgK /?,3 6 Company Name Registratio Number 1 !-DV-f-Pi4j l 5�: FGl s�-�iQrnp n1 1')'IA a/�2►� /1 ;; Address / 3� Expiration Date Telephone A SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§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....... Woo' No...... ❑ City of Northampton Massachusetts � . :G 'L ZWARTJdZN7 OF BUILDING INSPECTIONS 212 Main Street •Municipal Building + fi 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: `/ S"f-eA-R ry s C� (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: 'aAAon, 6//-a�� l /-oomis (Company Name and Address) O>d a Sign re o Permit Al6plicant 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/Zi . Easthampton, MA 01027 phone #: 413-203-5888 Are Vu an employer?Check the appropriate box: Type of project(required): 1.pS l am a employer with 4 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 r-1 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. 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 l3.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#I must also fill 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. 11Contractors 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. It the sub-contractors 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. Berkshire Hathaway Guard Insurance Company Name: Policy#or Self-ins. Lic.#: R2WC943835 Expiration Date: 4/27/2019 Job Site Address: P/ 5V" IQM5 City/State/Zip: 1Vd r44,f- r 6K 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 15A 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 penalties of perjury that the information provided above is true and correct Signature: _ L 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#: workeemcoffn� ErnRJU3M1fA Liability Berkshire HathawayAmGUARD Insurance Company-A Stock Co. Insurance � oNumim R2WC GUARDCompanies NCCI No. [21873] PdIcV linfamothm Pa"(AR) [i]Named bred and Mailing Addrma Agency PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY,INC. 1 Lr VERE.D STREET 8 NORTH IQNG STREET SON,MA 01027 Northampton, MA 01060 Agency Code: MAMAINIS Federal Employer's ID 00-1191951 Insur+ad Is I Imited Uability Co. (LLC) ., [2] Polley Period From April 27, 2018 to April 27, 2019, 12:01 AM,standard time at the Insured's mailing address. [3] Covera" A. 1Nb*m'Compensation Insurance-Part One of this policy applies to the Workers'Compensation Law of the following states: Massachusetts B. Employees Uability Insurance-Part Two of this policy applies to work in each of the states listed In item[3]A. The limfts of our liability under Part Two are: Bodily Injury by Accident-each accident $1001000 Bodily Injury by Disease-each employee $1001000 Bodily Injury by Disease- policy limit $500,000 C, Refer th)Residual Market Limited Other States Insurance WC200306B Endosernent 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, Classificatiohs,Rates,and Rating Plans. All required information is subject to verification and change by audit. (Continued on anottner page) Tafel Estlmtbd Paiiry Primum $ 13,650 Tabd Sw dm- 1AIN $ 606.00 Total Ebthmabd Cost 8 14625COD nmshNu new hoc Page-1- Inibrtnebon Pape N" :R2wC943835 WC 000001► Dace :04/8411018 MnNOTE Imuhm ofnow P.O.soot AA if S.River street, PA 1x703-0020•www4 pwd!A om 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. 183698 1 LOVEFIELD ST. Ems: 11/03/2019 EASTHAMPTON,MA 01027 Update Address and Return Card. SCA 1 8 2CM-W17 �i�i 1�fnwrwr�+Hnw�/!��"/ria.�air�u,:e✓/ Offke of Coni Affairs&Buskme Regulation HOME IMPROVEMENT CONTRACTOR Registration vaiid for individual use only TYPE.H Lzmkdhm L OfBas of Consumer Af ins and Business Regulation 183606 11/0=019 10 Park Plass-Suffe 5170 PEAK PERFORMANCE ROOFING,LLC. Bosfon,MA 02116 JAMES FLANNERY r*Ic! — 1 LOVERELD ST. �' � EASTHAMPTON.MA 01027 Vey Va id Witho signature Cornnwnweaith of Massachusetts Division of Professional Licensure Board of BuMng Regulations and Standards Construction Supervisor Unrestricted-Buildings of any use group which contain CS-103061Ez es:QW2112020 loss than 36,000 cubic feet(661 cubic meters)of enclosed . plr space. JAMES J FLANNERY 1 WILLIAMS ST HOLYOKE MA 01040 t� Commissioner Falure to Possess a curmd edition of the Massaclwsdts State Building Code is cause for MvOcad=of this icense. Far information about this license ' can(617)727-32.00 or visit www.mass govidpl P E K Peak Performance Roofing LLC Contract P E R F O R C E 1 Lovefield St Date Contract# Easthampton, MA 01027 9/1UM18 660 MA CSU 103061 MA HIC# 183698 413-203-5888 peakperformanceroofingllc@gmail.com www.peakperforTnanceroofinglic.com Bill To Job Location Martha Hoppin Martha Hoppin 14 Stearns Ct. 14 Stearns Ct. Northampton,MA 01060 Northampton, MA 01060 413-584-1139 413-584-1139 jgbrown20@aol.com jgbrown20@aol.com Description Total *Excludes the small dormer on back of house.* 8,500.00 1.Remove the existing roof shingles and inspect the boards 2.Replace up to 4 boards if necessary at no cost.Any additional boards will be$15 per board installed 3.Install six feet of ice and water shield at eaves and valleys, 12"around roof/wall intersections 4.Cover remaining roof with Certainteed"Roof Runner"synthetic underlayment 5.Install 8"aluminum drip edge on eaves and rake edges 6.Install architectural shingles by Certainteed -(Landmark)30yr rated https://www.certainteed.com/residential-roofing/products/landmark/ Color Choice: CleaOe.1 Wak 7.Install ridge vent 8.Complete all necessary flashings including new pipe boots and new base flashing on chimney Remove all debris from premises,and throughout the job,continue cleanup and keep the premises undamaged. Contractor will obtain building permit. Total cost:$8,500 A deposit of$4250 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: ��,�.., Fr $8,500.00 _2r-4��