30B-027 (2) 16 FORT HILL TER BP-2019-1497
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:38B-027 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: BUlldlntl DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
CateRom ROOF BUILDING PERMIT
Permit# BP-2019-1497
Project# JS-2019-002427
Est.Cost: S 14400.00
Fee, $40.0 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot size(sc.ft.): 4007.52 Owner: HARRISON SUSAN
zoning: URC(100y Applicant: JAMES FLANNERY
AT: 16 FORT HILL TER
Applicant Address. Phone: Insurance:
1 LOVEFIELD ST (508)294-4052 WC
EASTHAMPTONMA01027 ISSUED ON:612712079 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 62720190:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
6p- 7 ,'oar
Department use only
City of North a pt CE I V Of P n:
Building Depa me uvDr way Parma
�* 212 Main St at S
ense spill Availability
Room 1 JUN 2 6 20 ell variability
Northampton, M 01 60 of Structural Plans
phone 413-587-1240 F x 4'� s
,.,i S111LDINGINSP IONS
i tMYPTON,VA p86
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Prowrty Address: This auction to be completed by office
16-18 Fort Hill Terrace Map �7b 6 Lot 6&; / unit
Zone Ovariay,District
EIn SL District CS District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Susan Harrison /(o ;xI /-A'// TgfflQint Norfl dm410
me( int) Current Meting Address: /n/4 0/17Y D
Telephone 413-588-6818
Sp aWre
2.2 Authorized Agent:
James J. Flannery 1 Lovefield St., Easthampton MA 01027
Nemo(Print) Current Megng Atltreae:
413-203-5888
Signature Telephone,
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permite licant
1. Building $14,400.00 (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) $14400.00 Check Number
This Section For Official Use Only
Building Permit Num r: Date
Issued: / / -�W�^^ �+
Signature: 4'2G- ('7
Building Commissionedlnspeclor of Buildings Dale
peakperformanceroofinglic ®gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable
New Nouse ❑ Addition ❑ Replacement Windows Alleratili ❑ Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [OI Decks IM Siding t0l Other[El
Brief Description of Proposed Strip& re-shingle roof.
Work.
Alteration of existing bedroom_Vas No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement _Yes No
Plans Attached Roll -Sheet
ea.H New house and or addition to existing housinD comolete the fallowanD:
a. Use of building: One Fari Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is mere a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stones?
I. Method of healing? Fireplaces or W oodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 a.of wetlands?_Yes No. Is construction within 100 yr. floodplain Yes_No
J. Depth of basement or teller floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank City Sewer Private wail_ City water Supply
SECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Susan Harrison ,as Owner of the subject
James J. Flannery/ Peak Performance Roofing, LLC
T:4.
eheg,' hers relative to work authorized by Mis building permit application.
6 z /
Signature of Owner Date
James J. Flannery
as OwnedAulhor¢ed
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
�"—�Ioi i0 las l i q
Signature of OwnedAgent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Nemo of Li n Holder: CS-103061
I kense Number
James J. Flannery 09/21/2020
Address Expiration Cob
1 Williams St., Holyoke MA 01040
Signature Telephone
41 -
413-200
3-5886
9.Rettlebrad Noma Improvamarn Contracbor: Not Applicable 0
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 Ili c.154 f 25C(8))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will mull
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... d No...... 0
city of Northampton
Massachusetts tee<<
A c
t usptxllaxz or aortarxc rxsptcrroxs
212 win acewt *Municipal suilcU" Ct
�� xoecn..pton, xA 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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:
16-18 Fort Hill Terrace
(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 onshe rented or leased from:
Aaron's Roll-Off, 1 Loomis Way, Easthampton MA 01027
(Company Name and Address)
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 of Massachusetts
pp Department oflndustrialAccidents
Office of Investigations
PtV 600 Washington Street
Boston, MA 01111
www.mass gov/dia
Workers' Compensation Insurance Affidavit•. Builders/Contractors/Electricians/Plumbers
AonHcant Information Please Print Leeibly
Name(BusinesdOrganindionandividual): 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):
1.pf I am a employer with 4 4. ❑ I am a general contractor and 1
employees
tim(full and/or part- e).• have hired the subcontractors 6. E] New construction
2.E3I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These subcontractors have g, ❑ Demolition
workingfor me in m aci employees and have workers'
Y capacity. 9. ❑ Building addition
workers'comp.insurance comp.insurance
required.]aired 5. E] We are a corporation and its Io.❑ Electrical repairs or additions
] officers have exercised their 11. Plumbing repairs or additions
3.❑ I am a homeowner doing all work ❑ g Pa
myself. [No workers' comp. right of exemption per MGL 12 LDJRoof repairs
insurance required.] r c. 152,§1(4),and we have no
employees. [No workers' 13.❑Other
comp. insurance required.]
'Any applicant that checks box#1 man also fill onl Ne section below showing their workers'compensation policy information.
'Homeowners who submit this affidavit indicating they arc doing all wok and then hire outside contractors must submit a new affidavit indicating such.
lCionestors Nal check this box most aura ted m additional sheet showing the name of the sub-eontractors and slam whether or out hose entities have
employees. II'the sub-cosmuctors 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.
Insurance Company Name: Berkshire Hathaway Guard
Policy#or Self-ins.Lic.#: R2WCO21353 Expiration Date: 4/27/2020
Job Site Address: Ila Faf-1- Nell yorq _ City/State/Zip: nloeo
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 cerdfvpu..n..deer the polar and penahles of perjury that the information provided above is true and correct
Si�ature, J 0lDate:
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#:
Worker's Compensation and Employer's Liability Policy
;�Berkshire Hathaway AmGUARD Insurance Company - A Stock Co.
��\� Policy
Insurance Renewal oR2WC943835
�A GUARD Companies NCCI No. [21873]
Policy Information Page(AR)
[1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER a GRINNELL INSURANCE AGENCY, INC.
1 LOVERELD STREET 8 NORTH KING STREET
EASTNAMPTON, 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 policyapplies 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
I 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 Mans. All required Information Is subject to verification and change by
audit (Continued on another page)
Total Estimated Policy Premium $ 31,202
Total surcharges/Assessments $ $1,181.00
Total Estimated Cost $32.383.00
INIERNRL USE xx Page- 1 - Information Page
MW :RZWC031353 WC 000001A
Date 04/01/2019
MANOTE
Issuing Office: P.O. Box A-M, 16 S. River Street,Wilkes-Barre, PA 18703-0020 a www.guard.com
,lie a�n�nanurealt olC-Aawackoe&
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Type: LLC
vifimPEAK PERFORMANCE ROOFING,LLC. - RBgl91mbw: 1&9 8
1 LOVEFELD ST. E1�inlaon: 11/03/2019
EASTHAMPTON.MA 01027
llpdMs Address amid ReW.Csnd.
scnN O zmaosrlm
eXldarE IMM /EMM aCONN RrT Won
IMJYEIYRIOTrIIEM CONTRACTOR gogbtretlon WMfor MMdlat isms arty
TYPE:LLC 4aMaaC mnperbn dWe. XlaurNdrWmfo:
9� faRaaPB OMd of f:ansunlar Aaaee anm BuehNw RapdWm
1tC10BB 11p3(20/9 10 PMk Plm-�u1b 5170
PEAK PERFORMANCE ROORNO,LLC. B n,MA W110
JAMES FI
1
JAMES IO SET. `I'PFF
EASTHAINPTON.MA 01027 Unden rotary Wt valid MOIOYt/IgnaWNI
e Camron ms or Massaclwaerts
OSd W Professio.1 Licenwre
Boam of Building St"aXans Slid Standards
Camlmction Suprsvis«
. . O«estrktsd-BulldYlgs of any nWe WWP Wh-M—M-1-
CS-103061 FAPires: CW2102020 kss t 36,000 Cubic fWp91 CUXiC mSlers)of enclosed
sWca.
JAMES l FLAXN Y
1 WXIJAMS ST
NOLYOKE MA 010W
Commissioner
We B to pot Coe a currant ndieon orale i.1 MIS
Stale Building Cade is cause far d this San or mis 0cense.
F«7NZ2 w abolvisa mC MCMue
CSII(SIT)]27x200«v1aX www.ms W.gov/dpl
MFO E KE
Peak Performance Roofing LLC
Contract
P E R 1 Lovefield St Date Contnxt#
Easthampton, MA 01027 6n4n019 918
MA CSL#107061 413-203-5888 peak xrfomnancemnfingllc@gmeilsom www.peakperfa,mamceroofimgllc.com
MA HIC 0 183698
Bill To Job Location
An Hanson Susan Harrison
16- d�H. Hill Terrace. 16-18 Fort Hill Terrace.
orthampton,MA 01060 Northampton, MA 01060
413-588-6818 413-588-6818
Susancasamaya@gmail.com Susancasamaya@gmail.com
Description Total
1.Remove the existing shingles and inspect plywood for rot/deterioration 14,406.00
2.We will install up to 64 square feet of plywood at no cost.Any additional plywood will be$75 per sheet
installed
3.Install six feet of ice and water shield at eaves and three feet around pipes and chimneys
4.Cover remaining roof with Certainteed'Roof Runner"synthetic underlayment
5.Install new 8"aluminum drip edge on all eaves and rake edges 6(e W
6.Install architectural shingles by Cerminteed (Landmark PRO 40yr)
https://www.cerWnteed.com/msidential-roofing/products/landmark-pro/
Color Choice: W,N'1s7
7.Install new Cerminteed ridge vent on peaks of roof
8.Complete all necessary flashings including new pipe hoots and new base flashing around chimney
Remove all debris from premises,and throughout the job,continue cleanup and keep the premises
undamaged. We are not responsible for debris that may fall into attic.Please use caution during the process
and after dumpster is removed;do not walk/drive over areas of potential roofing debris. Contractor Will
obtain building permit.Installations are weather permitting.
Total:Landmark PRO shingles=$14,400
A deposit of$7200 is due at contract signing. The balance shall be due upon completion. Accounts
outstanding over 10 days post-completion subject to 2%finance charge,compounded monthly.
Contmcmr Signature: anomer S. anuc: Datc:
Total:
6 zy l9 $14,400.00