24A-227 27 PILGRIM DR BP-2020-0325
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24A-227 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-2020-0325
Proiect# JS-2020-000543
Est. Cost: $12400.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sq. ft.): 11412.72 Owner: YARROWS DAVID F&MARY A C/O JAMES A YARROWS
Zoning: URA(100)/ Applicant: JAMES FLANNERY
AT. 27 PILGRIM DR
Applicant Address: Phone: Insurance:
1 LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMAO 1027 ISSUED ON.9/11/2019 0:00:00
TO PERFORM THE FOLLOWING WORKSTRIP & 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 9/11/2019 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
,._ Department use only
City of Northampton—� - "E braGof Pe it:
.� Building Qepa►ftmetlt jee
/Dri eway Permit
i ., 212 Main Sheet SEPepti Availability
Room 100 20'1ell vailability
Northampton, MA 01 o Structural Plans
hone 413-587-1240 � ep Fax 14W 0 q�fl�iPI ns
HAP,IPTON,MA 0
er Sp
Ify
APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION )Y 2 Z
1.1 Property Address: This section to be completed by office
27 Pilgrim Drive Map � Unit
Lot ��
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
James Yarrows 27 Pilgrim Drive, Northampton, 01060
Name(Print) Current Mailing Address.
Telephone 413-563-9138
Signatur
2.2 Au orized 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 $12,400.00 (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=0 +2+3 +4 + 5) $12,400.00 Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
peakperformanceroofingllc d gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House F-1 Addition Replacement Windows Alteration(s) Roofing
Or Doors 1:1
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks (Q Siding fo] Other(Ol
Brief Description of Proposed Strip & re-shingle roof.
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.-If New house and or addition to existing 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 form attached?
h. Type of construction
i. Is construction within 100 ft. 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 .
I. 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
James Yarrows
as Owner of the subject
property
hereby authorize
James J. Flannery / Peak Performance Roofing, LLC
on my behalf, in all maV#rs relative to work authorized by this building permit application.
❑- - (� -
Sgnatur of caner 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
q u. - 1c1
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:— CS-103061
License Number
James J. Flannery 09/21/2020
Address Holyoke, MA 01040 Expiration Date
U; ��lCLMis( ---
SignatureTelephone
J( ` 413-203-5888
9.Registered Home Improvement 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....... Id No...... ❑
City of Northampton
" Massachusetts
c
AW
DEPARTMENT OF BUILDING INSPECTIONS
rm ` 212 Main Street •Municipal Building 9J`� JCD
Northampton, MA 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 properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
27 Pilgrim Drive
(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)
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
Department of Industrial Accidents
Office,of Investigations
600 Washington Street
Boston, MA 02111
IF www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organizationandividual): Peak Performance Roofing, LLC
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 phone #: 413-203-5888
Areypu an employer?Check the appropriate box: Type of project(required):
1. I am a employer with 4 _ 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 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
workingfor me in an capacity. employees and have workers'
Y p �'• 9. ❑ 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 11.❑ Plumbing repairs or additions
myself No workers' comp. right of exemption per MGL
Y [ P 12.gRoof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Berkshire Hathaway Guard
Insurance Company Name:
Policy#or Self-ins. Lic.#: R2WCO21353 Expiration Date: 4/27/2020
K)6y 1 Oafs P�h
Job Site Address: C)1 \ \GY\M Y \y Q 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 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 certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone#: 413-203-5888
Official use only. Do not write in this area, to be completed by city or town oficial
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
ck Co.
Berkshire Hathaway AmGUARD InsuPo;;cy Number R2WCO21353
GUARDCompanies RenewalNCCI No. [2 873]
Policy Information Page (AR)
[1]Named Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
LOVEFIELD STREET S 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
P
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:
�I
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
Total Estimated Cost $32,383.00
INTERNAL USE XX Page- 1 - Information Page
MGA : R2WCO21353 WC OOOOOIA
Date :04/01/2019
MANOTE
Issuing Office: P.O. Box A-N, 16 S.River Street,Wilkes-Barre, PA 18703-0020 •www.guard.coro
C���ie �pa�n-r►�,c�n��etz��
Office of Consumer Affairs and Business Regulation
One Ashburton Place- Suite 1301
Boston, Massachusetts' 02106
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE ROOFING,LLC. Registration: 183698
1 LOVEFIELD ST. Eviration: 11/03/2019
EASTHAMPTON,MA 01027
SCA t 2a�-cern
Update Address and Return Card.
�
17T21�fo,irM►ene.er,/I�r ref, /lat.,.�iu r/1.
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the exVtratlon date. If found return to:
Bit EMIT. Office of Consumer Affairs and Business Regulation
183098 11/03/2019 10 Park plaza-Suite 5170
PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02116
JAMES FLANNERY
1 LOVEFIELD ST. r\
EASTHAMPTON,MA 01027 Undersecretary t valid without signature
-------------------
® Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
s*' Construction Supervisor
Unrestricted-Buildings of any use group which contain
CS-103061 Eatpires:QW21IM20 less than 35,000 cubic feet(991 cubic meters)of enclosed
space.
JAMES J FLANNERY �
1 WLLIAMS ST
HOLYOKE MA 01040
Commissioner
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For information about this license
C.aH(617)727-3200 or visit www.mass.gov/dpi
Contract
P E Peak Performance Rooring LLC
P E R F O RLICE I Lovefield St Date Contract#
Easthampton, MA 01027 9/6/2019 1 1005
MA CSL#103061 1 413-203-5888 peakperformanceroofingilc@gmail.com www.peakperformancerooftngllc.com
MA HIC# 183698
Bill To Job Location
James Yarrows James Yarrows
27 Pilgrim Drive 27 Pilgrim Drive
Northampton MA, 01035 Northampton MA, 01035
413-563-9138 413-563-9138
elijames.jy@icloud.com elijames.jy@icloud.com
Description Total
1. Remove the existing roofing shingles 12,400.00
2.Inspect the plywood for any rot or deterioration. We will provide 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 on eaves and three feet in valleys/around pipes and chimneys
4.Cover remaining roof with synthetic underlayment
5.Install new 8"aluminum drip edge on all eaves and rake edges
6. Install architectural shingles by Certainteed(Landmark 30yr)
http://www.certainteed.com/residential-roofing/products/landmark/
Color Choice: Charcoal Black shingles
7.Install ridge vent on peaks of roof
8.Complete all necessary flashings including new pipe boots
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;
do not walk/drive under active work or on areas of potential roofing debris. Contractor will obtain building
permit. Installations are weather permitting.
Total:Landmark shingles=$12,400
A deposit of$6,200 is due at contract signing.The balance shall be due upon completion. Accounts
outstanding over 10 days past final invoice date subject to 2%finance charge,compounded monthly.
Contractor Signature: stomer Signature: Dater _T Total:
$12,400.00