35-297 (6) 63 WOODLAND DR BP-2019-1015
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map'Block: 35-297 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-2019-1015
Project# JS-2019-001667
Est Cost $21750.00
Fee $40 00 PERMISSION IS HEREBY GRANTED TO.
Const.Class Contractor: License:
Use Gro= JAMES FLANNERY 103061
Lot Size(sg. IT): 32365.08 Owner: ELDER ROBERT T&PATaICIA PATRICIAR
Zoning: Applicant. JAMES FLANNERY
AT. 63 WOODLAND DR
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508) 29 -4052 WC
EASTHAMPTONMA01027 ISSUED ON:3/19/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:ST RI P & 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: Oih 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 Sienalure•
FeeType: Date Paid: Amount:
Building 3/19/2019 0:00:00 $40.00
212 Main Street,Phone(413)587-1240, Pax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Department use or y
as City of Northampton Status of Parmh:
QBuilding Department Curb CutiOnvinay,Permit
�, A 212 Main Street Seaver/SeptIc AvaNebipry
'�. Room 100 water/WON Avalabnty
Northampton, MA 01060 Two Sets of Structural Plane
� .. phone 413-587-1240 Fax 413-587-1272 PIoUSia Plena
ocher specity
APPLICATION TO CONSTRUCT, -TE @&*)0 ®R DE AOLISH A ONE OR/ TWO F Y DWELLING
SECTION 1 -SITE INI UAR I
1.1 Property Address: This section to be completed by oMce
63 Woodland Drive DEPT o=ruu ni..o.insv. N Lot WUnit
NOaTHAmaTon.r.wmoso
one Overlay District
Elm SL District CO Damd
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Robert Elder 63 Woodland Drive, Florence MA 01062
Name(Pnm) �� Current Mailing Address:
Signature Telephone 413-588-7993
2.2 Authorized Allard:
James J. Flannery 1 Lovefield St., Easthampton MA 01027
Name(Pont) Ganem Meiling Address:
413-203-5888
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Ony
completed b permit applicant
1. Building 21,750.00 (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=(1 +2+3+4+5) 21,750.00 1 Check Number
This Section For Official Use Only
Building Permit Numbs : Date
Issued:
Signature:
Building Commissioner/inspector of Buildings Dale
peakperformanceroofingllc Ccp gmail.com
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
�BECInQN 5 DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteratlon(s) Roofing
Or Doors El
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [[] Siding[D] Other[DJ
Brief Description of Proposed Strip & Shingle
Wong
Alteration of existing bedroom_Yes_No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Ga.If New house and or addition to existino housing, complete the follonsi
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?
I. Method of heating? Fireplaces of Woodstoves Number of each_
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 fl.of wetlands?_Yes _No. Is construction within 100 yr. Floodplain_Yes_No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Robert Elder as Owner of the subject
property
hereby authorize James J. Flannery / Peak Performance Roofing, LLC
to act on my b If, in all mina`armor five to work authorized by this building permit application.
L/v( 311'5-11Z
Signature of Owner Date
James J. Flannery ,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. Flannery
Print Name �-1 l
03/14/19
Signature of Owner/Agent Date
SECTION 6-CONSTRUCTION SERVICES
61 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: CS-103061
License Number
James J. Flannery 09/21/2020
Address Expiration Date
1 Williams St., Holyoke MA 01040
Signature ,/ V /� Telephone
413-203-5888
9 Realil Nome Imeroyament Contractor. Not Applicable ❑
Company Name Registration Number
Peak Performance Roofing, LLC 183698
Address Expiration Date
1 Lovefield St., Easthampton MA 01027 Telephone 413-203-5888 11/03/2019
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....... V No...... ❑
City of Northampton
Massachusetts
A c
1
DEPARTMENT OF BUILDING ZNSP&CTIONS i p
212 asin Stcaat •aunicipal Building iYc
Northae¢ton, M 01060 (1
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:
63 Woodland Drive, Florence MA 01062
(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:
Aaron's Roll-Off, 1 Loomis Way, Easthampton MA 01027
(Company Name and Address)
r -- 03/14/19
Signature of Permit Applicant 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 ofMassachusetls
Department of Industrial Accidents
Offi ce of Investigadons
600 Washington Street
Boston, MA 02111
wnw.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/6lectricians/Plumbers
Applicant Information Please Print Legibly
Name (Businesslorgenim9on/Individual): Peak Performance Roofing LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Are an employer?Check the appropriate box: Type of project(required):
I.@f 1 am a employer with 4 4. ❑ I am a general contractor and I
employees(full and/or pan-timet'. have hired the sub-contractors 6. ❑ New construction2.❑ 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 worker: q ❑ 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 I1.[]Plumbing repairs or additions
myself.[No workers' comp. right of exemption per MGL 12 LI Roof repairs
insurance required.]t c. 152,$1(4).and we have no
employees. [No workers' 13.0 Other
comp. insurance required]
-Any applicant Nat check.boa al must also fill nm the section hclnw shooing their x'oderi mm's'leinn poli,informntl.n.
t
Hcmeoinnen,viholaibonso dei:amdacn indicating they urn doing all wad amt then hire outside commewrs must whmit a nex a(rJmit indicating such.
-Contra mn thin chsk this box mint uuached an additional sheet shox lug the Damn,of the wha.ntracte,aril state whether or not those entince have
employee<. If tic soh-contract.,hats employees.the must pmside their workers'comp.policy...her.
lam an employer that is providing w orkers'compensaaon insurance for my employees. Below is the policy and jab site
information.
Insurance Company Name: Berkshire Hathaway Guard
Policy*or Self-ins.Lin,.#: R2WC943835 Expiration Date: 4/27/2019
Job Site Address:6 3 oi6od 1a*I d City/State/Zip: F 60"O" `M9 O/c.e.Ii a
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$1.500M and/or one-year imprisonment,as well as civil penalties in the tonin of a STOP WORK ORDER and a fine
of up to S250.00 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 penatl�ties of perjury mat the information provided aave is true and correct.
Signature, _ f `_'^'I(jl Datc 3 S
Phone#. 413-20-1-5888 11 1
Ofjteial use only. Do not write in this area,to be completed by circ or town official
City or To": 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#:
Worker's Compensation and Emolover's Liability Policy
of R2WC811187
Al
rkshire Hathaway AmGUARD Insurance Company- AStock Co.
Y Policy Number RZWC943935
UARDCompanies Renewal CI No. [215 3]
Policy Information Page (AR)
[1]Named Insured and Mailing Address _ Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
I 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
INTERNAL USE—)D( Page- 1 - - Information Page
MGA : R2WC943835 WC 000001A
Date :04/04/2018
MANOTE
Issuing Olnos: P.O. Box A-N,16 S.River Street,Wilkes-Barre,PA 18703-0020 a Vrww.gyard.COrrr
v� �n�rnoozusea�i oy°e�a�lr,�t�
Office of Consumer Affairs and Business Regulation
One Ashburton Place- Suite 1301
Boston, Massechusetls 02108
Home Improvement Contractor Registration
TYPIK Luc
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EASTHAMPfON,MA 01027
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1 ASTHA EID ST. – —�
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1 YISAIAMS ST
HOLYOKE MA NMS
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MFO E 'SCE Peak Performance Roofing LLC
Contract
P E R (CE l Lovefield St Dare con red9
Easthampton, MA 01027 3naao19 790
MA CSL0107061 913-203-598a peakperfonaaoceroofiugllcQgmail.wm www.peakperm—ranfingllc.com
MA mC 0 103698
Bill To Job Location
Rob Elder Rob Elder
63 Woodland Drive 63 Woodland Drive
Florence,MA 01062 Florence, MA 01062
413-588-7993 413-588-7993
rte625@comcastnet rte625@comcasLnet
Description Total
1.Remove the existing roof shingles 21,750.00
2.Inspect plywood sheathing
3. Replace up to 64 square feet of CDX plywood if necessary m no cost.Any additional plywood will be 875 per sheet
installed
4.Install six feet of ice and water shield at eaves and three fat in all valleys,around pipes and chimneys
5.Cover remaining roof with Cenainteed'Roof across"synthetic underlayment
6.Install new 8"aluminum drip edge on all eaves and rake edges
7. Install architectural shingles by Cerminteed
(Landmark 30yr) httpJ/www.certainmed.mm/residential-mofrng/pmducL4mdmark/
Color Choice:
S.Install new Cemainteed ridge vent on peaks of roof -
9.Complete all necessary flashings including new lifetime heavy duty pipe boots and new base flashing=and chimney
Remove all debris from premises,and throughout thejob,coming cleanup and kap the premises undamaged
Contractor will obtain building permit.Installations are weather permitting.
Total cost:
Landmark shingle"21,750
A deposit of 810,875 is due at contract signing. The balance shall be due upon completion. Accounts past due 14+days
subject to 2%finurce charge monthly.
*We are not responsible for dirt/debris that may fall into attic.Please check for debris after dumpster is removed.*
Total:
Conaacter Signature: Cusmmersigoatwx Daze:
3 /S / $21,750.00