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31B-030 (2) 43 SUMMER ST BP-2019-1055 GIS#: COMMONWEALTH OF MASSACHUSETTS Map.Block:31B-030 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-2019-1055 Proiect# JS-2019-001721 Es[ Cost,$3900,00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: JAMES FLANNERY 103061 Lot Size(sp ft.): 14287.68 Owner: CAINE THOMAS P zoning:URC(100)/ Applicant.- JAMES FLANNERY AT: 43 SUMMER ST Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 WC EASTHAMPTON MA01 027 ISSUED ON.,312712019 0:00:00 TO PERFORM THE FOLLOWING WORK STRIP & SHINGLE ROOF PORCH AND SLATE ROOF SECTIONS 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: FeeTyae- Date Paid: Amount: Building 3/27/2019 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner ga)r Department use only City of Northampton Status of Permit: r Building Department Cult CutiDnvawsy Pe"It �. 212 Main Street Sewer/Septic Availability Room 100 Water/WON Availebfitty _ Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 PlotSite Plans Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION I -$ITE INFORMATIO E ME QP_ jil-roc 5 1.1 Property Address: This section to be completed by office 43 Summer S[. MAR 2 6 2019 Ma Lot -o unit Zo Overlay District DEPT OF 6lliL�l"<G PI'P°CTIDN$ �.:r r «.:r.gnmm�se tDistrict CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Thomas P. Caine 43 Summer St., 2nd Floor Name(P �w� Current Mailing Address: signature o Telephone 413-586-1993 II 2.2 Authorized Agent: James J. Flannery 1 Lovefield St., Easthampton MA 01027 Name(Print) Current Mailing Address: 413-203-5888 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimatetl Cost(Dollars)to be Official Use Only cpm leted b ermile )(cant 1. Building 3,900.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Coal of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection D 6, Total=(1 +2+3+4+5) 3,900.00 Check Number 6� This Section For Official Use Only Building Permit Number: Date ssui 141--7 Signature: Budding Commissionerlinspector of Buildings Data peakperformanceroofingllc at gmail.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablel New House ❑ Addition ❑ Replacement Windows iterations) E] Roofing NY Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding(0] Other(o] Brief Description of Proposed Porch and slate roof sections: strip, plywood, install EPDM & asphalt shingles Work: Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes __No Plans Attached Roll -Sheet ea.If New house and or addition to existina housing complete the following. 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 or Woodstoves Number of each g. Energy Conservation Compliance, Masscheck Energy Compliance farm attached? h. Type of construction I. Is construction within 100 ff.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. L Septic 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. Thomas P. Caine as Owner or the subject property hereby authorize James J. Flannery / Peak Performance Roofing, LLC © to a;; may ehalL in all Matters relative to work authorized by this building permit application. /2�ix�tc5 Signature of Owner Data I• James J. Flannery he Owner/best of my kno.le zed Agent hereby declare that the statements antl 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 03/14/19 Signature of OwnerlAgent Date Oate City of Northampton S fSMLMassachusettsnzlk OJ PUILO4NG212 W" St t •Wn10ip" 6u11Qiu0 NarGheq, , W 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: `{3 v�r,rnPK' S`-IL: (Please print house number and sliest 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: 14mon5 f 011-L' ' / /�omis lya�, tas'4AAMjV�N M4 (company Name and Address) g 9 SignaMre or Permit Afiplicant 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 01111 IF ww•w.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/F.lectricians/Plumbers Applicant Information Please Print Legibly Name IBusiness/Organimtionnndividaau: Peak Performance Roofing LLC Address: 1 Lovefield St. City/State/Zip: Easthampton, MA 01027 Phone#: 413-203-5888 Are vy°u an employer?Check the appropriate box: Type of project(required): L;'I am a employer with 4 a. ❑ I am a general contractor and I fi. El New construction(full and/or part-time).• have hired the sub-contracmrs 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8, ❑ Demolition workingfor me in m �ca acity. employees and have workers' Y P9. ❑ Building addition [No workers' camp. 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.E] Plumbing repairs or additions myself [Nu workers' comp, right of exemption per MGL 12 Roof repairs insurance required.]r c. 152,§1(4),and we have no employees. [No workers' 13.[D Other comp. insurance required.] •Any applicant that checks hox nl most also fill om the sevum Wane shown,their worker'cnmpenso.ion policy infurmmmo t Homeowners who submit this amda,it indicating the,are doing all,v,A unit then hire nmnide conuoamn most submit a new affida,a indicating sueh. �Comracmn that chsk this hos must attached an additional shect showing the came of the sub,contractor,anal slots whether or not those amities have employes. If the sub-conmcmn have employees.they must m,.dc their u,okc, campput ier numher. I 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.#: R2WC943835 _ Expiration Datc: 4/27/2019 Job Site Address: y3 3,M_0 S i City/State/Zip: ltlnrmar)?AAn &lq ci/oai7 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 5250.00 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. Ido hereby certify under the pains and penalties of perjury•that the information provided above is n e and correct. Si nature: ( Dat 3 20 C Phone#: 413-203-5888 Official use only. Do not write in this area,to be completed by ciV 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#: Worker's Compensation and Employer's Liability Policy 11187 kshire Hathaway AmGUARD Insurance Company -A Stock Co. Y Policy Number R2WC943835 AlG UARD Companies RenewalNCCIRNo.[218 31 Policy Information Page (AR) [1]Named Insured and Mailing Address _ 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: 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. [33 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 Forns [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 IMrEMAL USE YK Page- 1 - - IMornation Page MGA :RIWC943835 WC 000001A Date : 04/04/2018 MANOTE Issuing Office: P.O.Box A-H, 16 S.Rl"r Street,Wilkes-Barre,PA 18703-0020 •www.guard.com vfaerarreovuvea o��aQaacfu�6eba Office of Consumer Affairs and Business Regulation One Ashburton Place-Suite 1301 Boston, Massachusetts 02108 Hone Improvement Contractor Registration Typw LLC PEAK PERFORMANCE ROOFING,LLC. 1ftiBBB 1 LOVEFELD ST. - Ettpkae00: 11109/4019 EASTHAMPTON,MA 01027 IfPdaFa AddtwsMM Rearm Card. au O m 17 1YPMa,O�,w 11I'�Ib,;e„L.,,w: otAk a Canaxer AI18Ya•snakes nep01aw NOPE YRIOVEME2RCONmACrd1 RpYtraOonvala"M aldlvefualuae My TYPE:LLC bMIftoaw fC ealbn wb. Yfou6skeen b: flukkalks 11/m a 10 Pm Lbn-SUNMap artl Buelnaa Repaeam 1YtMB nlm2ola 10 Pad[Raia-salt M7o PEAK PERFORMANCE ROOFING,U.C. Baoft%MA 02116 JAMES FUWNERY I OVEF(ELD ST. EASTNMPrON.MA 01027 llndareeke18ry valid withoet sIgnatury came rth of MaeaaclwsaSa .. PMa18n of Pmfaaxi al Licero m Board M Buditg Regulations aka Slandxes :ani^uc1¢:^ &:rc�. , croslRtcum$Up-A k .. UI GWICted•BUadbae of MY ass POW`Mem COMMA CS-103061 EaPlrss:0WUA20 Isaathm 3C*00 oublC tan 0*1 CWc Md"O'"dosad spap. JAMES J FLAMBtY e 1INKAJAM8 ST HOLYOIE MA "m . Commhsioeec Faaanto PYas a CleraYedMm afthe Msasas)aueaa mok%,"no Codecs aauw for MVOCOM 610118 aeMtr. Fk ILIS, nUm abort SIN hanks cap INT)724m w visa 2n+ Awft9wpq P E K Peak Performance Roofing LLC Contract P E R F O R C E I Levefield St Data Contradli Easthampton, MA 01027 2/7/2019 769 MA CSIJt 103061 413-203-5888 peakperformincemofingllc@gmail.com www.peal;performanceroofingllc.wm MA HI 0 183698 Bin To Job Location Caine Miner c/o Mauryne Van Dusen Caine Mitter c/o Mauryne Van Dusen 43 Summer St.,2nd Fluor 43 Summer St.,2nd Floor Northampton,MA 01060 Northampton,MA 01060 mvandusen@cainemitteccom mvmdusen@cainemitteccom 413-586-1993 413-586-1993 Description Total Estimate for porch roof and adjacent slate roof. 3.900.00 I.Remove the slate and wood shingles. 2.Install 112 inch CDX plywood over the existing roof boards. 3.Install six feet of ice and water shield end cover the remaining area of the roof with synthetic underlaymem. 4.On the low slope rcetal roof over the porch,install 1/2 inch high density polyisocyanutate insulation with screws and plates. 5.Adhere Genflex white epdm roof to the insulation extending IS"up the door of the shingle roof(prior to install of shingles),and 12"up the sidewalis of the house. 6.Install white aluminum drip edge to match the upper roof recently completed. 7.Install Pewterwood Certaimeed Landmark,shingles(same as upper root) 8.Install new outlet and reattach the downspout in the comer. Remove all debris from premises,and throughout thejob,continue cleanup and keep the premises undamaged. Contractor will obtain building pennit. Installations are weather permitting. $3900.00 A deposit of$1950 is due at contract signing. The balance shall be due upon completion. Accounts past due 14+days subject to 2%finance charge monthly. 'We are set responsible for dirt/debris that may fall into attic.Please check for debris after dumpster is removed' Total: Contractor Signature: `Customer Sigrmture: Date: All �"`JgLRp / ✓��z 3\ICIVC� $3,980.00