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29-042 (5) 49 PIONEER KNLS BP-2020-0018 GIS a: COMMONWEALTH OF MASSACHUSETTS Migl.&ck:29-042 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-2020-0018 Proiect4 JS-2020-000019 EsL Cost:$18500.00 Fee:540.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Sim(sp.ft.): 80150.40 Owner., CAREY DENNIS P&JOANNE L Zoning, Applicant: JAMES FLANNERY AT: 49 PIONEER KNLS Applicant Address: Phone: Insurance: I LOVEFIELD ST (508)294-4052 WC EASTHAMPTONMA01027 ISSUED ON.71312019 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 N 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 Occuoancv Signature: FeeTYDe: Date Paid: Amount: Building 7/320190:00:00 540.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner P " F City of North mp _ C E I V Delrertrrlerd use only sof amnit: Building De rtm nt lite c w"y Permit 212 Main tre JUL /Sa tic Availadlxy Room 00 - 3 2019 /W 11Availability Northampton, MA 1060 ets of Structural Plans \. phone 413-587-1240 FaxN N iNSPSG lens n"44MCON.MAp1S City APPLICATION TO CONSTRUCT,ALTER,REPAIR.RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION i -SITE INFORMATION 9P -aG -/ 9 1.1 Prooerry Addreae: This section to be completed by oNlea 49 Pioneer Knolls Mw C-45? — Lot 0y;- Unit zomi, _Overlay Disblct Elm SL District CB Dlamct SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Dennis Carey 49 Pioneer Knolls, Florence MA 01062 Na (Pnm) Cummt Meting Address: n r lep ver 413-5848100 1,3-Authorized.Aow4 James J. Flannery 1 Lovefield St., Easthampton MA 01027 Name(Print) ` Cum m Meiling Address: 9-•-•'•1' 413-203-5888 Siputurs Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Oficial Use Only completed brmitapplicant 1. Building /pr {� (a)Building Permit FN 2. Electrical Ea J (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 1/. �t 4. Mechanial(HVAC) ,�1 i (/ 5.Fire Protection 6. Total=(1 r2+3+4+5) r Check Number This Section For OMeW Use Only Building Permit Numbw. Dale Issued: Signature: Building Cam "onwllmWctur of BulMrV Date peakperforrnanceroofingllc ®gmail.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement windows Alleratlon(s) E Roofing Or Doors 13 Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks [O Siding(0) Other[OI Brief Description of Proposed Strip work: & re-shingle roof. Standing seam metal on low slope dormer section. Alteration of existing bedroom_Yes No Adding new bedroom_Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ga.N Now house and or addition to existing housing. Dornglate the following: a. Use of building:One Fari Two Family Other b. Number of rooms m 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 or Woodslo nis Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 fl.of wellands? 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. I. SepticTank CitySini Private well City water Supply SECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I Dennis Carey as Owner of the subject properly hereby authorizeJames J. Flannery/ Peak Performance Roofing, LLC to act on my bah in all matters====five to work authorized by this building permit applies ion.�y I/ / 7� � 'l S' eluro of OwWDale 1. James J. Flannery ,as Ownenauthonzed 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 Signshre of O~AOM Data SECTION 8•CONSTRUCTION SERVICES 8,11 Licensed Construction Supervisor: Not Applicable ❑ Nam,or Llc,nee Holder: CS-103061 License Number James J. Flannery 09/21/2020 Address EWration Date 1 Williams St., Holyoke MA 01040 Signature 413- ro 413-203-5888 9.Realsbred Nome Imtxowment Contraclx: Nod Applicable ❑ Conisamr 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.O.L o.132,§230(8)) 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....... a, No-.... ❑ City of Northampton Massachusetts 1 DBPART W OF BULLDLNO LNBPBCPLOBB 212 win Btra t Wnicipal Building C RocthY Wn, eB 01060 n\�i 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: 49 Pioneer Knolls (Please pdnt 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) s /2419 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 Massachuselts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02177 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organiration4ndividml): Peak Performance Roofing, LLC Address: 1 Lovefield St. Cit./State/zip: Easthampton, MA 01027 Phone#: 413-203-5888 A,r�e,ryp o an employer?Check the appropriate box: Type of project(required): 1.(>•! I sin a employer with 4 4. ❑ I am a general contractor and[ employees(full and/or part-time).• have hired the subcontractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition world for me in an capacity. employees and have workers' working Yap ty 9. ❑ Building addition [No workers'comp.insurance comP. ,mmm.t required] 5. ❑ We are a corporation and its I0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers'comp. right of exemption 12 per MGL .0 Roof repairs insurance required.]t c. 152,§I(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] •Any applicant that checks box#1 mut also fill out the section below showing their woken'compeveton policy information. I Homeowners who submit this affidavit indicating they am doing all work and Wen hire ouaide cunlnetors must submit anew emdsvit indicating each. tConmcmu the check this box must attached an additional sheet showing the name ofthe sub< nuectou and state whether or net those endtiea have employees. If the subronnactms have employees,they mus,provide Web workers'comp.policy number. I ton an employer that is providing workers'compensation insuranro for my employees. Below is due polfry and job site iafammdon. Insurance company Name: Berkshire Hathaway Guard Policy#or Self-ins.Lic..M R2WCO21353 Expiration Date: 4/27/2020 f Job Site Address: r 9 �0/[.0M Ki'i0/%S City/State/Zip: Fie PML? M14 O��'aS 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 cerdfy under the pains raa�d��pe� ofperjury that the information provided vie y' true and correct Signamm: a'� `"'1ICL Deft ZZZ119 Phone#: 413-203-5888 Official use only. Do not write in this area,to be completed by city or town ofJ7ciat 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#: vfie �a�nmarecueat a�Ciaaac<ucoeCt Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type LLC PK PERFORMANCE ROOFING,LLC. R1Borabon. 11/1=88 EA 1 LOVEFIEID ST. EsplrtWOn: 111031'1011/ EASTHAMPrON.MA 01027 IV"AdlYwand R'bin Crd scn+ O aawasm Otliw W CanrunNrAMln■alRaleaa RyWaegn IIOYEIYPROVEYENTCONTRI1CT011 RegMtrabn vaM br hid. "lis uw Only TYPE:LLC ha1Ms01aetp6'11Ytd16. MWM=nettb: a' M Films OMewCm-SLd NYY'MM BY'Yle'sRg1'IMn tli36ge 11N3(tOts Ig Prk Plm•8dY 6170 PEAK PERFORMANCE ROOFING,LLC, R MA 08116, �,1y JAMES FLAN ST 1 ASTHA ELT ST. �l� E0.5TMANPTON,MA 0102] lllld�e�fy rl=I WMI WIMIOYt 619118U1r6 CommnReaOh of Massachusetts Division of Professional Licensure B08W Of Building ROOMms a"Standards Coostnicti n Supsm1w - . tlwesttloled-%IMings of arty uM group vmich motain CS-103061 Expires;QW2112020 Irss than 30,000 cubic lest(661 cubic meters)of enclosed space. JAMES J FUINN6ty 1 WIWAMS ST HOLYOKE MA OSOM Cwnmissioner CIL A;-- Falum W Possess a clareot edition Of the Msssachuse=s stile SuiMing Code is cause W revrcaliwl of ttlis wen's. For W000stim'loof this Rcanae Gal(s 17)TV42M w Visit srww.mes+_govMd • Worker's Compensation and Employer's Liability Poiicv v AmGUARD Insurance Company - A Stock Co. �v Berkshire Hathaway Policy NumberR2WCO21353 Insurance� of R2WC943835 �" GUARD Companies Renew NCCI No. [21873] 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 EASTHAMPMN,MA 01027 Northampton, MA 01060 Agency Code: MAMAIN15 Federal Employer's ID 00-1191951 Insured is Limited Uabllity 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 $ $1,181.00 Taal Estimated cost $32,383.00 INTERNAL USE XX Page- 1 - Information Page MW :RZWCO21353 WC DOODDIA Date : 09/01/2019 MANOTE Issuing Office: P.O. Box A-H, 16 S.River street,Wilkes-Barre, PA 18703-0020 0 www.guard.wm DocuSign Envelope 10:2088CF0D-F887AEC3-924(}FOEFDWAW K Peak Performance Roofing LLC PE Contract P E R F O R C E I Lovefield St Date Contract# Easthampton, MA 01027 6/27/2019 919 MA CSL#103061 413-203-5888pe.k,rf..anccmofrngll a. MA HICR 193698 c(iigmail.com www.pcakperfommnceroofmgllccem Bill To Job Location Dennis Carey Dennis Carey 49 Pioneer Knolls. 49 Pioneer Knolls. Florence,MA 01062 Florence,MA 01062 413-584-8100 413-584-8100 dpc853@aol.com dpc853Qaol.com Description Total I. Remove the existing roof material 18,500.00 2. Inspect plywood sheathing 3. Replace up to 64 square feet of COX plywood if necessary at no cost.Any additional plywood will be$75 per sheet installed 4.Install six feet of ice and water shield at eaves and three feet around pipes 5.Cover remaining roof with Certainteed'Roof Runner" synthetic underlayment 6.Install new 8"aluminum drip edge on all eaves and rake edges 7.Install architectural shingles by Certainteed (Landmark 30yr) http://www.certainteed.com/residential-roofiing/products/landmuk/ Color Choice:PEWTERWOOD 8. Install new Cenainteed ridge vent on peaks of roof 9.Complete all necessary flashings including new pipe boots and new base flashing on chimney,and new metal in valleys 10. Install standing seam metal on low slope dormer. Color choice:CHARCOAL GRAY Conaaaor Signature: Customer Signature: �fff111b"""""" �� aa. Dew: 7/1/2019 Total:S (A" Page t 6ocuEign Envelope ID 2C98CFOD-FB87<EC3-8240-FOEFDB E;AfIA7 Contract P E K Peak Performance Roofing LLC P E R F O R C E I Lovefield St Date Contra Easthampton, MA 01027 6r27f2019 929 MACSL4103061 q13.203-SRRtl peakperfonnnnce.fo .gllc@gmail.com w .pcakperformazoe, gllc.com MA NIC N ISM96 Bill To Job Location Dennis Carey Dennis Carey 49 Pioneer Knolls. 49 Pioneer Knolls. Florence,MA 01062 Florence,MA 01062 413-584-8100 413-584-8100 dpc853@aol.com dpc853@aol.com Description Total We are not responsible for dirt/debris that may fall into attic. We will remove all exterior debris from premises,and throughout the job,continue cleanup and keep the premises undamaged. Please use caution during the process and after dumpster is removed;do not walk/drive on areas of potential roofing debris. Contractor will obtain building permit. Installations are weather permitting. Landmark shingles=$14,900 Standing seam metal on low slope corme—$3,600 Total=$18,500 A deposit of$8550 is due at contract signing. The balance shall be due upon completion. Accounts outstanding over 10 days post-completion subject to 2%finance charge monthly. Contractor Sigtnu. Customer Signature: 0-0, W. Dere: 7/1/2019 Total: 2 LMAat1 " I SfB SUU.UU xeasmarmaown.. Page 2