17C-246 (8) 81 NORTH MAIN ST BP-2020-0481
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C-246 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv.: ROOF BUILDING PERMIT
Permit# BP-2020-0481
Project# JS-2020-00082
Est.Cost:$24050.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sa. ft.): 20560.32 Owner. WELLAND PAM
Zoning URB(100)/ Applicant: JAMES FLANNERY
AT: 81 NORTH MAIN ST
Applicant Address: Phone: Insurance:
I LOVEFIELD ST 508 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON.1011612019 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspec or of Wiring D.P.W. Building Inspector
Underground: Servic : Meter:
Footings:
Rough: Rough House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire D artment Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smok : Final:
THIS PERMIT MAY BE VOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND GULATIONS.
Certificate of Occupancy Sip_nature:
Feer e: Date Paid: Amount:
Building 10/1(/2019 0:00:00 $40.00
12 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Department use only
City of Northamp"AR Status of Permit:
Building Department _ t Cut/Drweway Permit
212 Main Street '""' r
ern' tic Availability
Room 100 Oct ' ter ell Availability
Northampton, NAA 01060 S wo S s of Structural Plans
phone 413-587-1240 oax -587-12 2��9 lotus a Plans
Othe Specify
rr
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENt 0.rk-b*DEOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
'�f
1.1 Property Address: This section to be completed by office
81 North Main Street Map 7c, Lot � ` (tl Unit
Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Pan Welland 81 N Main Street, Florence, 01062
Name(Pri Current Mailing Address:
Telephone 413-387-8854
Signature
2.2 Authorized Agent:
James J. Flannery 1 Lovefield St., Easthampton MA 01027
Name(Pant) � 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 $24,050.00 (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) $24,050.00 Check Number
This Section For Official Use Only
Building Permit Number: DateIssued:
i
Signature:
Building Commissioner/inspector of Buildings Date
peakperformanceroofingllc Cd gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑] Addition ❑ Replacement Windows Alterations) ❑ Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[01 Other(O]
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
i Pan Welland_ as Owner of the subject
property
hereby authorize
James J. Flannery / Peak Performance Roofing, LLC
_
to act on-�-P'yj))ehalf, in a matters reja a to work authorized by this building permit application. may^
Sign ure of Owner Date
I,
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
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
CS-103061
Name of License Holder
License Number
James J. Flannery 09/21/2020
Address Holyoke, MA 01040 Expiration Date
Signature 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 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....... L/ No...... ❑
City of Northampton
�. ?S`S S�Ci
Massachusetts
,A WK
DEPARTMENT OF BUILDING INSPECTIONS z
212 Main Street •Municipal Building Jp CD
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:
81 North Main 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
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
Are y, u an employer?Check the appropriate box: Type of project(required):
1.l��-t/I am a employer with 4 4. ❑ 1 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'
[No workers' comp. insurance comp, insurance.$ 9. Building addition
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 I I.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.VrRoof repairs
insurance required.] t c. 152, §1(4),and we have no 13.❑ Other
employees. [No workers'
comp. insurance required.]
*Any applicant that checks box#1 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
information.
Berkshire Hathaway Guard
Insurance Company Name:
Policy#or Self-ins.Lic.#: R2WCO21353 Expiration Date: 4/27/2020
Job Site Address: f�1COY-tel mcg\`(1 cSATQ Q-1 City/State/Zip: Q\ C)u o�
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 i�sa
true and correct.
Signature: __- 4�� � --_._-- _ Date: h I L I 1 -1
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#:
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: LLC
PEAK PERFORMANCE ROOFING,LLC. Registration: 1
1 LOVEFIELD ST. Expiration: 111/03//03/2021
EASTHAMPTON,MA 01027
Update Address and Return Card.
SCA 1 0 2010-M17
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. If found return to:
fl@g1strahQp Expiration Office of Consumer Affairs and Business Regulation
183698 11/03/2021 1000 Washington Street -Suite 710
PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118
JAMES FLANNERY i
1LOVEFiELDST.
EASTHAMPTON,MA 01027 Undersecretary y NO valid Without gnature
Comrnonweakh of Massachusetts
Division of Professional Licensure Construction Supervisor
Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain
worms+ r¢<i, less than 35,000 cubic feet(991 cubic meters)of enclosed
space.
CS-103051 Expires: 09x21 x2020
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01050
e Failure to possess a current edition of the Massachusetts
t//�' 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
Worker's Compensation and Emolovees Liability Policy
Berkshire Hathaway AmGUARD Insurance Company-"Stock Co.
Y Policy Number R2WCO21353
GUARD Insurance Renewal of R2WC943835
Companies NCCI No. [21873]
i(
Polky Inf matlon Pape(AR)
[1]111amed Insured and Mailing Address Agency
PEAK PERFORMANCE ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
LOVEFIE.D STREET S NORTH IQNG STREET
EASTHAMFM,MA 01027 Northampton, MA 01060
Agency Code: MAMAINIS
Federal Employer's ID 00-1191951 Lfsured Is Limited Liability Co. (LLC)
[2] Polley 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. Employers 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)
TORN Esumalled Policy Pr viawl 31,202
Total aw&" as/ $1,181.00
Tafel Estl11d cost $32,31KLOO
�lr»aAL115E lily Page-1- Inibrr mew Paye
MGA :RZWCOZ1353 WC 000001A
Dabs :OW01mi9
MANM
Iafl1111p 0111=P.O.Box A-%is S.Rhm Ureal,Wllimpaane,PA 18705-0020•www.gumd.00m
PE LCE
K Peak Performance Roofing LLC
Contract
P E R F O R 1 Lovefield St Date contract#
Easthampton, MA 01027 9/16/2019 1021
MA CS"103061 1 413-203-5888 peakperformanceroofingllc@gmail.wm www.peakperfonnanccrooftngllc.com
MA HIC# 183698
Bill To Job Location
Pan Welland Pan "Morigan" Welland
81 N. Main St. 81 N. Main St.
Florence, MA 01062 Florence,MA 01062
413-387-8854 413-387-8854
panmorigan@gmail.com panmorigan@gmail.com
Description Total
1.Remove the existing roof shingles. We will provide up to 64 square feet of CDX plywood if necessary at no 4,050.00
cost.Any additional plywood will be$60 per sheet installed
2.Install six feet of ice and water shield at eaves and three feet in all valleys,around pipes,chimneys,
skylights,and low slope roofs
3.Cover remaining roof with Certainteed"Roof Runner" synthetic underlayment
4.Install new 8"aluminum drip edge on all eaves and rake edges
5.Install architectural shingles by Certainteed(Landmark PRO 40yr)
https://www.certainteed.com/residential-roofing/productsAandmark-pro/
Color Choice: / czG , d'VIC 16'--tA
6.Complete all necessary flashings including new lifetime heavy duty pipe boots and new base flashing
around chimney
7.Low slope portion will receive Flintlastic SA rolled roofing.
8.Venting: Install new box vents on main house(hip roof sections cannot accomodate ridge vent.) Install
ridge venting on ridge sections(backside of house.)
Remove all debris from premises,and throughout the job,continue cleanup and keep the premises
undamaged. WE ARE NOT RESPONSIBLE FOR DIRT/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 cost: $24,050 (Includes ALL roofing: main house,porches,low slope section).
A deposit of$12,025 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: Customer 'gnature: Dater Total:
_Z, ,/ 0
qq
( $24,050.00