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23C-104 (4) 103 BLISS ST BP-2019-1438 GIS#: COMMONWEALTH OF MASSACHUSETTS MU.Block:23C- 104 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-2019-1438 Proiect# JS-2019-002324 Est.Cost: $21275.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO. Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sg.ft.): 80019.72 Owner: WILBY BRIAN& LINDSEY Zoning. ORA(100)/WSP(100Applicant. JAMES FLANNERY AT. 103 BLISS ST Applicant Address: Phone: Insurance: I LOVEFIELD ST (508) 294-4052 WC EASTHAMPTONMAO 1027 ISSUED ON:6/19/2019 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: FeeTvpe: Date Paid: Amount: Building 6/19/2019 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 NortLA0106&F33U1LD1NG1NSpE Stat s of ermit: Building DeCu Cut/ riveway Permit 212 Main1 Se er/Se tic Availability RoomWa r/W I Availability Northampton, E SSets f Structural Plans phone 413-587-1240 , ot/Site F ilans Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 6p, , This section to be completed by office 1.1 Property Address. 103 Bliss St. Map Lot IO`j Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Brian Wilby 103 Bliss St., Northampton MA 01060 Name Print) Current Mailing Address: 07 � � I Telephone 413-218-0430 Sig ature i 2.2 Authorized Agent: James J. Flannery 1 Lovefieid 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. Buildingi $21,275.00 (a)Building Permit Fee 2. Electrical (b)Estimated Fotal Cost of Construction from 6 3. Plumbing Building Permit Fee / m 4. Mechanical(HVAC) `�V 5. Fire Protection 6. Total= 0 +2+3+4 + 5) $21,275.00 Check Number This Section For Official Use Only Building Permit Numb Date Issued: Q Signature: Building Commissioner/Inspector of Buildings Date p e a k p e rfo rm a n ce ro o f i n g I I c no gmail.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) h SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks Siding [O] Other[CI) Brief Description of Proposed Strip & re-roof with standing seam metal. Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. 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 Brian Wilby as Owner of the subject property --_-_-------- - hereby authorize James J. Flannery / Peak Performance Roofing, LLC to aft on my behalf, in all matters relative to work authorized by this building permit japlication. LL i Signature of Owner Date James J. Flannery I, ,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/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of license Holder: CS-1 03061 License Number James J. Flannery 09/21/2020 Address Expiration Date 1 Williams St., Holyoke MA 01040 Signature J � �Telephone 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 16-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....... I/ No...... ❑ _ City of Northampton Massachusetts �S � c H + DEPARTMENT OF BUILDING INSPECTIONS S 212 Main Street •Municipal Building 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: 103 Bliss St. (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 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Peak Performance Roofing, LLC Address: 1 Lovefield St. City/State/Zip: Easthampton, MA 01027 phone#: 413-203-5888 Aree an employer?Check the appropriate box: Type of project(required): 1.pS 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 ty• 9. ❑ Building addition [No workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.1:11 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[Roof 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. :Contractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site inrmation. Insurance company Name: Berkshire Hathaway Guard Policy#or Self-ins.Lic.#: R2WCO21353 Expiration Date: 4/27/2020 L / Job Site Address: /0 3 l/f �T City/State/Zip: 6/��G � l 0 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 certifyunder the pains and penalties of perjury that the information provided 7abei trueandcorrect Si ature: ✓ J` Date: 6 Phone#: 413-203-5888 Official use only. Do not write in this area, to be completed bl,c•itl•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#: A Worker's Compensation and Employer's Liability Policy sir AmGUARD Insurance Company - A Stock Co. 'Berkshire Hathaway Policy Number R2WCO21353 /%'' G U A R DCompanies InsuranceRenewalNCC INo. [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 EASTHAMPTON, MA 01027 Northampton, MA 01060 Agency Code: MAMAIN15 Federal Employer's ID 00-1191951 Insured is Limited Liability Co. (LLC) [2] Policy Period I 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 Total Estimated Cost $32,383.00 i INTERNAL USE XK Page - 1 Information Page MGA R2wCO21353 WC 000001A Date 04/01/2019 MANOTE Issuing Office: P.O. Box A-H, 16 S. River Street, Wilkes-Barre, PA 18703-0020 • www.guard.com ' �JG—l2P 2'iQ7�2��2�C Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301 Boston, Massachusetts' 02108 Home Improvement Contractor Registration Type: LLC PEAK PERFORMANCE ROOFING,LLC. Registration. 183698 Boration: 11/03/2019 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Update Address and Retum Card. SCA 1 ® 20M-0/5117 �/��I%iAiM1ANllNpl(fI!��(®,till�IlyCI�'.' Office of Consumer Affairs 8 Businas Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:LLC before the w[pirstion date. If found return to: Real bidim 150radon Office or Consumer Affairs and Business Regulation 183088 11/032019 10 Park Plaza-Suite 5170 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02116 JAMES FLANNERYal— G 1 LOVEFIELD ST. E STHAMPTON.MA 01027 Undersecretary t valid without signature ® Commonwealth of Massachusetts 6 Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor Unrestricted-Buildings of any use group which contain CS-103061 Expires: 119/2112020 loss than 35,000 cubic feet(991 cubic meters)of enclosed space. JAMES J FL ANNERY 1 WILLIAMS ST HOLYOKE MA 01040 Commissioner C /Ilk, Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license can(617)727-3200 or visit www.rrrees.90vldPl p E Is Peak Performance Roofing LLC Contract P E R F O R 1 Lovefield St Date Contract# Easthampton, MA 01027 5/31/2019 897 MA CSU 103061 413-203-5888 peakperformanceroofingllc@gmail.com www.Ni&performanceroofngllc.com MA HIC# 183698 Bill To Job Location Brian Wilby Brian Wilby 103 Bliss St. 103 Bliss St. Northampton,MA 01060 Northampton,MA 01060 413-218-0430 413-218-0430 bawilby@gmail.com bawilby@gmail.com Description Total 1.Remove the existing roof shingles. Inspect the sheathing and replace up to 64 square feet of 21,275.00 rotted/deteriorated wood as needed at no added cost. Any additional plywood will be$75 per sheet installed 2.At roof/sidewall transition,remove siding to allow for propert installation of flashing. Reinstall siding after flashing is completed. 2. Install Y of Englert HT(High Temperature)ice&water shield at the eaves,and Yat all rakes,ridges, sidewalls and penetrations wherever possible. https://www.englertinc.com/images/stories/documents/panels/lit_underlayment.pdf 4. Install Englert symethic underlayment on remaining roof area. https://www.englertinc.com/images/stories/documents/panels/premium_underlayment.pdf 5. Install Englert 24 gauge metal roof panels,profile A 1300. https://www.englertinc.com/1"/*C2%BD-mechanically-geatned-metal-roof-system-al300.htmi 6. Seams will be double locked. 7.Clips will be spaced 24" on center on front side of house and garage,and 12"on center in the rear. 8.Drip edge will be installed on all eaves and rakes. 9.Ridge cap will be installed with vented Z-enclosures. 10.All penetrations will be flashed according to Englert specifications. 11. Colorgard snow rails will be installed on the front of the house and garage extending the entire length of the eaves. http://www.metalplusllc.com/documents/metalplus-colorgard-brochure.pdf Contractor Signature: Customer Signature: Date: TOt1I' Page 1 Peak Performance Roofing LLC Contract PE � Date Contract# P E R F O R C E 1 Lovefield St Easthampton, MA 01027 5/31/2019 897 MA CS"103061 1 413-203-5888 peakperformanceroofingllc@gmail.com www.peakperformanceroofingllc.com MA HIC# 183698 Bill To Job Location Brian Wilby Brian Wilby 103 Bliss St. 103 Bliss St. Northampton, MA 01060 Northampton, MA 01060 413-218-0430 413-218-0430 bawilby@gmail.com bawilby@gmail.com Description Total Color Choice: Charcoal Gray Property will be protected at all times to prevent any damage to the home or plantings. We are not responsible for dirt/debris that may fall into attic. All exterior debris will be removed from the premises. Please use caution during the process and after dumpster removal; do not walk/drive on areas of potential roofing debris. Contractor will obtain building permit. Installations are weather permitting. Total cost(House&garage)=$21,275.00 A deposit of 1/2 is due prior to start of work,at contract signing. The balance shall be due upon completion. Accounts oustanding over 10 days post-completion subject to 2%finance charge,compounded monthly. Contractor Signature: Customer Signature: Date: Total: ,. V v r r I q $21,275.00 Page 2