38B-211 218 SOUTH ST BP-2019-0503
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38B-211 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: ROOF BUILDING PERMIT
Permit# BP-2019-0503
Proiect# JS-2019-000815
Est.Cost: $21600.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Groin: JAMES FLANNERY 103061
Lot Size(sg.ft.): 15289.56 Owner: WAGENHEIM JEFF&SARAH SWERSEY
tonin :URB(100)/ Applicant: JAMES FLANNERY
AT. 218 SOUTH ST
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.1012412018 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & 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: 0,,il: 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 Sisnature:
FeeTyne: Date Paid: Amount:
Building 10/24/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
/V
PLO-
Ott uae only
City of Northampton IMe�ulsef
Building Department w"P"*
212 Main Street Sswerc
Room 100 Wd
Northampton, MA 01060 ca
phone 413-587-1240 Fax 413-587-1272 Pboaft Pfsns ,
APPLICATION TO CONSTRUCT,J LLTEF"TM, DEM LISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
is section to be completed by offke
1.1 Property Address: -
Ma
1�
Lot � 1 unit
DEPTOF BUILDING INSPFCTIONSdQ JvUTI^ S��
NORTHAMPTON.MA Overlay District
Elm St.Dislrlct CB
Dialrict-
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
SA P,A 3 W 6-2 s 67 a1 ? 36Lr&tjSf Aj6 r -h&mp),v AIA
ZNarri rint) Current Mailing Address:
Telephone y/ 3 -
Signature
2.2 Authorized Anent:
7)}IVES T, F��NN�JQ y l L-ov� e/� Sf, �Q s1�Gcarnp�nN M�
Name(Print) Current Mailing Address: LIVOR-5L
1113 — ao 3 — 5-8
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building /_oO bd (a)Building Permit Fee
2. Electrical U/ (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) 02 dd Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature: 1
Building Commissioner/Inspector of Buildings Date
PP4KP&eF61e1W6Ne-C-A66F1A16-LL-c (a 4�-
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aeolicable)
New House Addition ❑ Replacement Windows Alteration(a) TRoofi
Or Doors 1:1Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [Q Siding[O] Other[CA
Brief Description of Proposed
Work: S-Tte-W
r 14-Li
Alteration of e)dsbng bedroom Yes No Adding new bedroom Yes No �c.,,a
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Oql :
a. Use of building: Family Two Family Other
b. Number of rooms in each fa ' unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensio
e. Number of stories?
f. Method of heating? places oodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy liance form attached?
h. Type of construction
i. Is construction within 100 ft. bands? Yes No. Is construction within 100 yr. flood Yes No
j. Depth of basemen cellar floor below finished grade
k. Will build' conform to the Building and Zoning regulations? Yes No.
I. c Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT,,OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, S 1 k A-P �E�C S� 7 ,as Owner of the subject
property
hereby authorize JRmF-S --, F LA/V/U&r2 y 2)d4 PEAK PERFORM/3-N(6 R ooFI%U6 LC
to n7A����to work authorized by this building pe it pplication.
/o is
Si tura of Owner D
I, JAMES T f LANNEAJ 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.
-J'AmEs s. FU4NA)£9V
Print Name
LL-5-
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed JAMES
—�1,� Not Applicable ❑
Name of license Hoklor: PL491VA)sf2 y 019 — /D30&
License Number
l Gyilharns Sf, , 1161yoke M)4 010416 9ZalZa-0
Address Expiration Date
y13- aD3 - 5-9�4
Signature Telephone
�!i
S. mom Not Applicable ❑
P€RK P�/Z Foi2�Yi�q/y cE RyoFI2�G-, LLC /F 3 60
Company Name Registratio Number
Address V /y13Expiration Date
Telephone x203 5-. 01
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
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....... i`tinNo...... ❑
City of Northampton
Massachusetts '� - <i
:G
Q0 DEPARTMWff OF BUILDING INSPECTIONS
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:
(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:
14911q0ns Boll-oiVI J Loamis W!'!R,
(Company Name and Address) d
Sign re o Permit Mplicant 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/lndividual): Peak Performance Roofing, LLC
Address: 1 Lovefield St.
City/State/Zi . Easthampton, MA 01027 phone#: 413-203-5888
Are u an employer?Check the appropriate box: Type of project(required):
1.EVI am a employer with 4 4. ❑ 1 am a general contractor and
employees(full and/or part-time).* have hired the sub-contractors l' 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
working for me in any capacity. employees and have workers' 9 ❑ Building addition
[No workers' comp. insurance comp. insurance.+
required.) 5• ❑ We are a corporation and its 10.❑ Electrical repairs or additions
q ]
3.❑ 1 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.gRoof 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 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 contractor,must submit a new affida%it indicating such.
,C'ontractors 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 employee::.they must provide their workers'comp.policy number.
1 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. Lie.#: R2WI1C-943e8335 Expiration Date: 4/27/2019
Job Site Address: dry Sam, JC City/State/Zip: Mp dld�0
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 penalties of perjury that the information provided above is true and correct.
Signature: Date.: __. /0
1/9
Phone#:
413-203-5888
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/Torun Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
Workees cam Meg u1mift Pa
Berkshire Hathaway Ain61A"D="�' NcCo.umber
GUARDCmane aNc�CIRNo [2873;
Pofiry Inilbrmetion Pqp(AR)
11]Named Insured and Mailing Addreiia Agenry
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY,INC.
1 t OVEREI D STREEr 8 NORTH IQNG STREET
EASTHAM PTON,MA 01027 Northampton, MA 01060
Agency Code: MAMAINI5
Federal Employer's ID 00-1191951 Insured Is Limited Liability Co. (LLC)
[2] Polkal/Period
From April 27, 2018 to April 27, 2019, 12:01 AM,standard time at the insured's mailing address.
[3] coverage
A. WorkeW Compensation Insurance-Part Ona of this policy applies to the Worlds'Compensation
Law of the following states: Massachusetts
B. employees 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
6�dorsement-
D. This policy Includes these endorserherhts and schedules:
See Extension of Information Page-Schedule of Forms
[4] Premium
The Pn!rnium Basis and,therefore,the premium will be determined by our Manual of Rules,
Clamificatlons,Rates,and Rating Plans. All required information Is subject to verification and change by
audit. (Contlrhued on another Rage)
E
ated Pollcv Premium $ 13,650�/Assa=nmw s 606.00
u N.d Cost 14623&00
DaMML USE hoc Page- 1- Irdarmatlon Pape
MGA :R2YIIC943835 wC 000001A
Daft :04/0 /2018
MANORS
Is=**0111cm P.O.soot A-H,10 S.River 9MOat,VMkow-barre,PA IWGS-0020 0 www4wrd.ao�e
C��e ulea" GJAWadW,4e&
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. Regtstratlon. 183698
1 LOVEFIELD ST. Dpiration: 11/03/2019
EASTHAMPTON,MA 01027
Update Address and Return Card.
SCA i d 20M-W7
Office of Coneuaw Affairs i Bwinen Rpdetim
ROME IMPROVEMENT CONTRACTOR Registration valid for individual use only
I min e the expi Up, deft. 9 found return 11o:
a LLCFJAUUM ORtos of Consumer Affairs mid Business Regulation
183688 11A)312019 10 Park Plan-Sint 5170
PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02116
JAMES FLANNERY
1 LOVEFIELD ST. �.
EASTHAMPTON.MA 01027 Undersecretary Valid Without signature
CaMnonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
�.� Construction Supervisor
Unrestricted-Buildings of any use group which contain
CS-103061 Elipires:QW2112020 less than 35,000 cubic fast�e
(991 cubic meters)of enclosed
JAMES J FLANNERY
1 WILL1AMS ST
HOLYOKE MA 040411
Commissioner CLFallure to possess a cu anent edition of the Massachusetts
State Bonding Code is cause for revocation of this Wxnse.
For information abort this license
Call(617)727-34.60 or visit www.mss gov/dpI
PE K Peak Performance Roofing LLC
Contract
P E R F O R CE 1 Lovefield St Date c°ntract#
Easthampton, MA 01027 1/25/2011 671
MA CSU 103,161 1 413-203-5888 peakperformanceroofingllc@gmail.com www.peakperformanceroofmgllc.com
MA HIC# 183698
Bill To Job Location
Sarah Swersey Sarah Swersey
218 South St. 218 South St.
Northampton, MA 01060 Northampton,MA 01060
413-262-5798 413-262-5798
sarah@swersey.com Sarah@swersey.com
Description Total
1.Remove the existing roof shingles and inspect sheathing or boards 21,600.00
2.Replace up to 64 square feet of plywood if necessary at no cost.Any additional plywood will be$60 per sheet
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 PRO)40yr rated
https,//www.certainteed.com/residential-roofing/products/landmark-pro/
Color Choice:
7.Install Flintlastic SA rolled roofing by Certainteed on low slope porch roofs
S.Complete all necessary flashings including new pipe boots and new base flashing on chimney
9.Remove gutters from perimeter of house,remove and replace all rotted wood facia molding. *We will not be
responsible for reinstalling gutters*
Remove all debris from premises,and throughout the job,continue cleanup and keep the premises undamaged.
Contractor will obtain building permit
Landmark PRO shingles=$18,100
Remove gutters,replace fascia molding=$3,500
Total cost=$21,600
A deposit of$10,800 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 Signatu Date:
$21,600.00