32C-026 I BREWSTER CT BP-2019-1498
GIs k� COMMONWEALTH OF MASSACHUSETTS
Map Block: 32C-026 CITY OF NORTHAMPTON
Lot:-001 PERSONS CON'PRACTING WI ITI UNREGISTERED CONTRACTORS
Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateenry: ROOF BUILDING PERMIT
Permit 0 BP-2019-1498
Pro ject# JS-2019-002428
Est. Cost: $24900.00
Fee $175.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Group JAMES FLANNERY 103061
Lot Size(sa. ft.): 5227.20 Owner: WATER LILLY LLC
Zoning CB(100) Applicant. JAMES FLANNERY
AT. 1 BREWSTER CT
Applicant Address: Phone: Insurance:
1LOVEFIELDST (508)294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.6127/1019 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: 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 027/20190:00:00 $175.00
212 Main Street, Phone(4131587-1240,Fax: (413)587-1272
Louis Hasbrouck Building Commissioner
�`I cySpirFi6e�b d: -A3�C 7384 25C-8138-098E06466C7E f—Gro r
Versionl.7 Commercial Buildin Permit May 15,2000
JUN 26 2019 ity of Northampton Statue of Permit mead his
wilding Department Cure CuUDrK way Permit
oevt oa rrinDINr.iNScl=c*'°"s 212 Main Street Sevem/Septic AvailabAity
Nonn+AMr*oN.haAoroeo Room 100 Water/Well Aval lily
- Northampton, MA 01060 Two Seta of Structural Plane
phone 413-587-1240 Fax 413-587-1272 Plot/Sits Peens
Other Specl
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION i -SRE INFORMATION IV,
1.1 Probers,Address. +y�T/^h�is section to be completed by oBlce
_.. Map !/O� Lot OGf( Unit
1 Brewster Ct. Zone Overlay District
---- -- --- Elm St District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
.'Water Lily LLC (Ken Cheung) 40 Middle St., PO Box 60242, Florence MA 01062
Name(Print) oa�so,,,a4,. Current Mailing Address:
7; ""E 413-320-7724
Signature V n Telephone
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 Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $24,900.00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing : Building Permit Fee
4. Mechanical(HVAC) 76
5. Fire Protection /
6. Total=(1 +2+3+4+5) $24,900.00 Check Number
This Section For Official Use Only
Building Permit Number Dale
Issued
Signature:
G-26 -2oi9
Bulltlirg Co missimerllnspeclor of Buildings Date
DocuSign Envelope ID:70BFA32C-7384-425C-8138-D98EDe468C7E
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 36,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition Repairs❑ Additions ❑ Accessory Building EI
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing 3 Change of Use❑ Other❑
Brief Description Mechanically fasten 2 layers of 2.5'polyisocyanurate insulation.
Of Proposed Work: Install fully adhered EPDM roof system, including cornice and parapet walls. New drip edge.
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly13A-1 13A-2 11A-3 El IA [:1
A4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
5 Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify ',
S Special Use ❑ Specify: ..
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(60
is iai
2 e.. 2n
3- 3,a
4m 4"'
Total Area(sf) Total Proposed New Construction(sq
Total Height(ft)
Total Height ft
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private ❑ Zone Outside Flood Zone❑ I Municipal 13 On site disposal system❑
DocuSign Envelope ID:70BFA32C-73134-425C-8138-D98ED6466C7E
Versioni.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to le filled in by
Building DcparOnent
Lot Size
Fromm e
Setbacks Front - -
Side L:' - R: U R: ....
Rear
Building Height
Bldg.Square Footage %
Open Space Footage
(Lot arca minus bldg&paved --.
,varkni,)
#of Puking S aces
Fill: - ----
volume&location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO = DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NOF-1 DONT KNOW= YES=
IF YES: enter Book Page and/or Document#.
B. Does the site contain a brook, body of water or wetlands? NO= DONT KNOW® YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ® Obtained E , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES NOF-7
IF YES, describe size, type and location:
E. Will the construction activity disturb clearing,gradin excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES M NO=
IF YES,then a Northampton Storm Water Management Permit from the DPW is required
DowSign Envelope ID'.70BFA32C-73B4425C-813&D98EDf3 86CM
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Archlteet:
Not Applicable E3
Name(Registrant)'. _.
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
NameArea of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registraton Number
Signature Telephone Expiration Date
9.3 General Contractor
Peak Performance Roofing, LLC Not Applicable m
Company Name'.
James J Flannery
Responsible In Charge of Construction
1 Lovefield St_.Easthamoton. MA 01027
Address
413-203-5888.
Signature Telephone
DocuSign Envelope ID:70BFA32C-7384-425C-8138-D98ED6466C7E
Version1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑
SECTION II -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Ken Cheung /Water Lily LLC as Owner of the subject property
hereby authorize'James J. Flannery / Peak Performance Roofing, LLC --..to
act on my behalf,in all matters relative to work authorized by this building permit application.
6/21/2019
6 /I
Signature of Owner Date
aaeeoosnxaeam.
I 'dames 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 - -
Signature of Owner/Agen" t Date
SECTION 12-CONSTRUCTION SERVICES
101 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder James J. Flannery CS-103061
License Number
1.Wiilliams St.. Holvoke. MA 0104009/21/2020
Address 5 Expiration Date
413-203-5888
Signature Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C.152,§25C(5))
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 ❑ No❑
DowSign Envelope ID',70BFA32C-73B4425C-813&DOER 6UE
City of Northampton 212 Main Street,Northampton, MA 01060
Solid Waste 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.
Address of the work: 1 Brewster Ct.
The debris will be transported by: Aaron's Roll-Off Service, 1 Loomis Way, Easthampton
The debris will be received by:
Building permit number:
Name of Permit Applicant James J. Flannery, Peak Performance Roofing, LLC
Date Signature of Permit Applicant
(91L rponnmeo�wea o��ac�ucePa
Office of Consumer Affairs and Business Regulation
One Ashburton Place- Suite 1301
Boston, Massachusetts 02108
Home Improved Contractor Registration
TyPx LLC
PEAK PERFORMANCE ROOFING,LLC. Registrag n: 193088
1 LOVEFELO ST. - Eviatim: 11/03/2019
EASTHAMPTON,MA 01027
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INCE G.LLC.018 10Pd[Pom-Sum 6170
PEAK PERFORMANCE igx1RN0.LLC. gmbn,MA 02110
JAMES FIANNEW ``'
1 LOVERELO ST. � i
EASTNAMPTOK MA 01W N7 1111dBfaBcleMty NO[VYwithout d9nat ire
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CS-103061 E;pirm:OW2112020 heathen 36,000 cubic feet 11101 cubic nMaWQ Ofenaload
JAMES J FlJm1ERY
1 y0SJJAMS ST
I*XYONE MA 010411 . .
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Worker's Compensation and Employer's Liability Policy
shire Hathaway AmGUARD Insurance Company -A Stock Co.
Y Policy Number R2WCO21353
Insurance l of R2WC943835
*GNARDCompanles RenewaNCCI No. [21873]
Policy Information Page (AR)
[I]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
I LOVEFIEUI 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, 2019 to April 27, 2020, 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 Endorsement-WC200306B
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 ; 31,202
Total Surcharges/Assessments S $1,181.00
Total Estimated Cost 3 383.00
INIERNAL ME XX Page- 1 - Information Page
MGA :RZWCO21353 WC 000001A
Det. N/01/2019
MANOTE
Issuing Office: P.O.BOX A-M, 16 S.River Street,Wilkes-Barre,PA 18703-0020 0 www.guard.com
DocuSIV Envelope 10:]aBFA C-73B6J25C4138-098EOUSS ]E
MFO E K Peak Performance Roofing LLC
Contract
P E R CE 1 Lovefield St Dare contmcar
Easthampton, MA 01027 5/3/2019 939
MA CSW 1071161 413.203-5888 peekperfammncemofmgllc@gmail.com w .pcekperfonoeocaooEngllc.com
MA HIC ill
163696
Bill To Job Location
Water Lily LLC Ken Cheung
40 Middle St. I Brewster Ct.
PO Box 60242 Northampton,MA 01060
Florence,MA 01062 413-320-7724
kkcl957@gmail.wm
Description Total
Roof replacement with EPDM: 24,900.00
1.Mechanically fasten 2 layers of 2.5" insulation with approved screws and plates. (Required to bring
insulation up to code. Enforced by the Nordtarnpton Building Commissioner)
2.Install Genflex EPDM fully adhered roof system over the existing roof,including cornice and parapet
walls. All details per Genflex specifications.
hup://genflex wnitwp-content/uploads/2014/l1/CB02_GenFlex-EPDM-Brochure_1014_web.pdf
3.Fabricate and install .032 gauge bronze aluminum drip edge on perimeter.
Property will be protected at all times to prevent any damage.All debris will be removed from the premises.
Contractor will obtain building permit.Installations are weather permitting.
Total cast=$24,900.00
Payment schedule: A deposit of$8300 is due at contract signing. A progress payment of$8300 is due no
later than 500/6 completion. The balance shall be due following approved inspection by building
commissioner.
Conwcmr3 Customer SignsNre: � nea. Dere; 6/21/2019 Total•
" Grp $24,900.00
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 01111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/COptractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Hushtcss/Organizatiowindividaaq: Peak Performance Roofing LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
A,rree,/ypu an employer?Check the appropriate box: Type of project(required):
L t am a employer with 4 4. ❑ I am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).. have hired the sub-contractors
2.❑ l 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. insurances
required.] 5. ❑ We are a corporation and its ME] Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 1 L�❑y Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL l2.Ll Roof repairs
insurance required.] c. 152, §1(4),and we have no
employees.[No workers' 13.❑ Other
comp. insurance required.]
"My applicant not checks buy NI must also fill out the section below showing their workerscompensation policy information.
f Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such.
:Cnmractors Nei check Nis box must attached an additional sheet showing the name of the sub-convectors and sate wheater m not Nose entities havc
erryloym. 1f the sub-emanxims have employees,they must provide their workers'wrap_Policy number.
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 got Self-ins.Lic.##Q ��R2WCO21353 Expiration Date: 4/27/2020
lA
Job Site Address: � C I 1C{-e( C+ City/State/Zip:
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 a 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 ardor one-year imprisonment,as well as civil penalties in the form of 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.
1 do hereby cert](v under tthhe��oams and penalties oliperjury that the information provided above is nue and correct
lure' 9 )Y Date' (�2 1ae� h j
Phone#: 413-203-5888
Official use only. Do not write in this area,to be completed by city or town offchd
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#:
From: /�
Pec V, Qff' rOC✓ C n n 2 C Y4"9
,C)Ue�iel� S�
MP, neoa r
To:
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code,section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, 1 request that you
grant a modification to waive the requirement for construction control of the project at
1 �fewS�Cr C4 K10(-4,r oA
bemuse the work is of a minor nature,will not affect structural elements, health,accessibility,life or fire
safety,and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,