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23A-149 (9)
110 PINE ST - BP-2020-0415 GIS#: COMMONWEALTH OF ASSACHUSETTS Map:Block:23A- 149 CITY OF NORT AMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO.THE GUARANTY FUND (MGL c.142A) Category:ROOF ' BUILDING PERMIT Permit# BP=2020-0415 Project# JS-2020-000702 Est.Cost: $2900.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sq.ft.): 43995.60 Owner: SAGE LISA Zoning: URB(100)/ Applicant: JAMES FLANNERY AT: 110 PINE ST Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 WC EASTHAMPTON MAO 1027 ISSUED ON:101112019 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE FRONT PORCH 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 10/11/2019 0:00:00 $40.00 212.Main Street, Phone(413)587-1240,Fax: (413)587-1.272 Louis Hasbrouck—Building Commissioner DocuSign Envelope ID:81A7F2F1-1300-4C41-BOFC-816CB D i pepartmof use only City of Nort am to Building D part ent rb C t/priveway Permit I 21.2 Mai Str et OCT - ewer ep#iC Availability xv ) ", ;` Roo 10 ZO19 ;ate etl Av�ailabEl>ty _ v E Northampt n 1 h p Two ets of Structural Pians i �,� phone 413-587-124 � N FcPlot/ w#e Plan °N MAotoso°N �I1 r51 APPLICATION TO CONSTRUCT,ALTER,REPAIR,-RENOVATE-OR-DEMOLISH A ONE OR TWO FAMILY DWELLING -SECTION"1 -SITE INFORMATION bo 1.1 ProAefirAddress: This sectk 6',t •be:cgmpleted by;o fixe 110:Pine Street �aP �''9 �L°t �' un`t,«u Zone ,•'Overlay District Elm St.District CB District SECTION.2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Lisa'Sage 110 Pine St. Florence, 01062 Name(Print)' Docuftnedby: Current Mailing Address: Telephone 917-52311626 Signature 2.2 Authorized Accent: Jarnes'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 $2,900.00 (a)Building Permit Fee 2. Electrical. (b)-Estimated Total Cost of Construction,from 6 3. Plumbing Building Permit Feed ° 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) $2,900.00 Check-Nurnber . This Section For Official Use Only Date Building Permit Number: Issued: Signature:. �,( Buildingp ; DocuSign Envelope ID:81A7F2F1-1300-4C41-BOFC-816CB42E727D SECTION°5-DESCRIPTION OF PROPOSED WORK(check all aualicable) New House ❑ Addition ❑ Replacement Windows Alteratiorj(s) ❑ Roofing Or Doors 1:3 AccessoryBldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[0] Other[o] Brief Description of Proposed Strip & re-shingle front porch Work: Alteration of existing bedroom Yes No Adding new bedroomYe,Is No Attached Narrative Renovating unfinished basement ! Yes No Plans Attached--Roll -Sheet sa 1fNew.°Molise aria"or..aticiiron�#o�exifstiina lcustna`' I- complete thel,t6W—Ina: 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 Compliai we 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 I Lisa Sage ,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. ® Uoepsigned by: 9/27/2019 v Signature of Owner Date 1 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 ?ZLa 1 i Signature of Owner/Agent Date DocuSign Envelope ID:81A7F2F1-1300-4C41-BOFC-816CB42E727D SECTION 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: CS-103061 License Number James J. Flannery 09/21/2020 Address Holyoke, MA 01040 Expiration Date � wiJ1� \ 6-T Signature Telephone 413-203-5888 9.ReOis#gyred Homealmproyemen#Contractor .„ . . - Not Applicable ❑ Company Name Registration Number Peak Performance Roofing, LLC 18.3698 Address Expiration.Date 1 Lovefield St., Easthampton MA 01027 tele hone 413-203-5888 11/03/2019 p - 0 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. i Signed Affidavit Attached Yes....... I/ No...... ❑ DocuSign Envelope ID:81A7F2F1-1300-4C41-BOFC-816CB42E727D City of Northampton �s s, Massachusetts DEPARTMENT OF BUIZLDXNG INSPECTIONS 212 Main Street •Municipal Building yb C 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 c111, S 150A. The debris from construction work being performed at: 110 Pine Street (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 . Off ce'of Invesdgadons kv, 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contras ors/Mectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/lndividual): Peak Performance Roofing, LLC Address: 1Lovefield St. City/State/Zip: Easthampton, MA 01027 phone#: 413-2031 5888 Are ypu 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 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole,proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑ Building addition comp' [No workers' comp.insurance required.] 5. E] 10. Electrical We are a corporation and its ❑ 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 12 Roof repairs insurance required.] t c. 1.52, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1must 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 96ate 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 information. Berkshire Hathaway Guard Insurance Company Name: Policy#or Self-ins.Lie.#: R2WCO21353 Expirati n Date: 4/27/2020 F Qf1CQ, Mfi Job Site Address: 1, 1 Q 0— City/Stat/Zip: p pCo 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 unposition 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 thepains andpenal 'es of perjury that the information provided above is true and correct Si ature: Date: y Phone#. 413-203-5888 Oficial 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 Ins ector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i 111f2dwes Comoensaflan and Emalmrar's Usiarft Polim Berkshire 'Hathawa AmGU=D Insurance CAMPanV-A�'`co. Y Policy Number R2WCO21353 GUARDInsurance Renewal of R2WC94M5 Companies NCCI No. [21873] Polley Ddlomufflon Pie(AR) [13 flamed Insured and Melling Addnm Agency PEAK PERFORir AHM ROOFING LLC WEBW R A GRINN_ELL INSURANCE AGENCY,INC. 1 LOVEFERD STREET S NORTH,KING STREET EAST H MP TON,MA 01027 Northampton,MA Q1060 Ageniy Code: MANAIN15 FadorW Employers.I® 00-1191951 Insured Is Limited Liability Co.(LLC) Q23. Policy Period From April 27,2019 to April 27,2020, 12:01 AM,standard time at the i ured's mailing address. A [3] Coverage A. WorlLW Compensation Insurance-Part One of ,his policy applies the Workers'Compensation Law of the following states: Massachusetts B. Employer's Lability Insurance-Part Two of this policy applies to work In each of the states listed in hent[3]A. The limits of our liability under Part•7Wo are: Bodily Injuryby Accident-each acddent $100,000 Bodily Injury by Disease-each employee $100,000 Bodily Injury by Disease-policy 11mit $500,000 C. Refer to Residual Market Limited Other States Insurance Endorsement WC2003068 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 o r Manual of Rules Classilications,Rates,and Rating Plans. All required information is subject to verification and change by audlL (Continued on another page) Told Eytintalved Policy Premium $ © 31,202 Total,Swdorgm/ $ $1,181.00 Total Estimated cost .00 211MULU E roc Page 1- InfornmUof,Page WA, RZM=53 DOB :"01=19 WC 000091A MANORE Inuling Ofllos:P.O.11=A-%16 S.Rhmr Stns VWUWr-dsee,PA 1e703 00=•www.gusWAMU Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 183698 PEAK PERFORMANCE ROOFING,LLC 1 LOVEFIELD ST. Expiration: 11/03/2021. EASTHAMPTON,MA 01027 Ulidate Address and Return Card. SCA 1 ® 20M-W17 .Tim Yniiiiii�iinm///1 r�://.��•�i�fi�sr//� Orrice of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:LLC before the.expiratlon data. if found return to: Real ExpirA lon Office of Consumer Affairs and Business Regulation 1838911,_ 11/03/2021 1000 Washington Street -Suite 710 PEAK PERFORMANCE AdOFING,LLC. Boston,MA 02118 JAMES FLANNERY • 1 Y„�� 1 LOVEFIELD ST. ,x.�1''G %dGfiwk' EASTHAMPTON,MA.01027 Undersecretary , No valid without 91lature 1 i I j Commonwealth of Massachusetts ,al Division of Professional Licensure Construction Supervisor Board of Building Regulations and Standards Unrestricted- ldings of any use group which contain .�+ r Zd tai r teas than 36,000 cubic feet(891 cubic meters)of enclosed space. CS-103061 Expires:0912112020 JAMES J FL ANN .A* 1 WILLIAMS STF HOLYOKE MA410!0 " ' ® Failure to possess a current edition of the Massachusetts (CL State Building Code is cause for revocation of this license. Commissioner For information about this license Call(617)727-3200 or visit www.mass.gov/dpl A DocuSign Envelope ID:8lA7F2F1-1300-4C41-BOFC-816CB42E727D Contract E Is Peak Performance Roofing L C P K R I Lovefield St Date Contract# Easthampton, MA 01027 9/27/2019 1034 MA CSL#103061 1 413-203-5888 peakperformanceroofingllc@gmail.com t�vww.peakperformanceroofingllc.com MA RIC# 183698 Bill To J Job Location Lisa Sage Lisa Sage 110 Pine Street 110 Pine Street Florence, MA 01062 Florence, MA 01062 917-523-1626 917-523-1626 lisa.sage218@yahoo.com lisa.sage2l8@yahoo.com Description Total -This contract is for the front porch roof only- 2,900.00 1. Remove the existing roofing shingles 2. Inspect the plywood for any rot or deterioration. We will provide up to 64 square eet of plywood at no cost. Any additional plywood will be$75 per sheet installed 3. Cover entire roof with synthetic underlayment 4. Install new 8" aluminum drip edge on all eaves and rake edges 5. Install architectural shingles by Certainteed(Landmark 30yr) http://www.certainteed.com/residential-roofing/products/landmark/ Color Choice: 6. Complete all necessary flashings Remove all debris from premises, and throughout the job, continue cleanup and keep the premises undamaged.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: $2,900 (If full plywood replacement is needed add$1,000) A deposit of$1,450 is due prior to the beginning of the job.The balance shall be due upon completion. Accounts outstanding over 10 days past final invoice date subject to 2%finance changes, compounded monthyl. Contractor Signa Ye: Customer Signature: DOCUSIgnea by: Date: 9/27/2019 Total: Itril-14-1 L $2,900.00