24A-050 (3) 137 BARRETT ST BP-2020-0791
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A-050 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-2020-0791
Project# JS-2020-001372
Est.Cost: $5150.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES FLANNERY 103061
Lot Size(sa. ft.): 11238.48 Owner: CURRIE-RUBIE RACHEL
Zoning: URB(100)/ Applicant: JAMES FLANNERY
AT. 137 BARRETT ST
Applicant Address: Phone: Insurance:
I LOVEFIELD ST (508) 294-4052 WC
EASTHAMPTONMA01027 ISSUED ON:1/10/2020 0:00:00
TO PERFORM THE F(bLLOWING WORK.-STRIP & SHINGLE GARAGE ROOF
POST THIS CARD SO IT ISI'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 Dovartment Fireplace/Chimney:
i
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 1/10/2020 0:00:00 $40.00
12 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
1 Department use only
City of Northampto! __1!:.Cj/ �,� Status of Permit:
Building Department '`r tlrt;Cut/Driveway Permit
_.,
A 212 Main Street` Ser/Septic Availability
Room 100
JA^� 10 X01 W er/W�I Availability
Northampton, MA-0-r 9 "o Set of Structural Plans
phone 413-587-1240 Fax 4 11 P oUSit Plans
ther pecify
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR_ID MO ISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
137 Barrett St.
Map,� Lot 0 S'O Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Rachel Currie-Rubin 137 Barrett St, Northampton MA
Name(Print) Current Mailing Address: 413-320-3429
Telephone -
/Signature
2.2 Authorized Agent:
James J. Flannery 1 Lovefield St., Easthampton MA 01027
Name(Print) _ Current Mailing Address:
Y',` 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 $5,150.00 (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) $5,150.00 Check Number
/This Section For Official Use Only
Building Permit Number: -��.. 7 �J Date
Issued:
Signature: I NUV
�D
Building Commissioner/Inspector of Buildings Date
peakperformanceroofingllc (& gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
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 [0) Decks Siding [0] Other(QJ
Brief Description of Proposed Strip and replace shingles — CUCQ C-0- b V1
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
Rachel Currie-Rubin as Owner of the subject
property
hereby authorize James J. Flannery / Peak Performance Roofing, LLC
to act on my,behalf, in all matte relative to work authorized by this building permit application.
' 2
Sign e o
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 ❑
CS-103061
Name of License Holder
License Number
James J. Flannery 09/21/2020
Address Holyoke, MA 01040 Expiration Date
\1* 1
Signature Telephone
� t 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 11/03/2021
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....... V No...... ❑
City of Northampton
Massachusetts ��25`S s,��``
� A a
DEPARTMENT OF BUILDING INSPECTIONS °
. �� 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:
137 Barrett 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)
?r-1�—�
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
F. Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.tgov/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/Lip: Easthampton. MA 01027 Phone #: 413-203-5888
AVI
u an employer? Check the appropriate box: Type of project(required):
1. 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
working for me in any capacity. employees and have workers'
9. Building addition
[No workers' comp. insurance comp. insurance
� ❑
.
required.] 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 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
employees. [No workers' 13.❑ Other
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.
lContractors 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 roust 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.
Insurance Company Name: Berkshire Hathaway Guard
Policy#or Self-ins. Lie. #: R2WCO21353 Expiration Date: 4/27/2020
k �i lACL,n qAtJob Site Address: 1 rQ t Ciy/ p
0101 W
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 andpenaid es ofperjury that the information provided above is true and correct.
Signature: Date: IT�j ,
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 S. 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
Registration: 183696
PEAK PERFORMANCE ROOFING,LLC.
Expiration: 11/03/2021
1 LOVEFIELD ST.
EASTHAMPTON,MA 01027
Update Address and Return Card.
SCA 1 O 20M-W17
office of Consumer Affairs tt Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
TYPE:LLC before the expiration date. M found return to:
R2gistimban i oratio I Office of Consumer Affairs and Business Regulation
183666 11/03/2021 1000 Washington Street -Suite 710
PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118
JAMES FLANNERY
1 LOVEFIELD ST.
EASTHAMPTON,MA 01027 , Undersecretary No valid withoutgnatule
i
19
Commonwealth of Massachusetts
Division of Professional Licensure Construction Supervisor
Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain
less than 36,000 cubic feet(881 cubic meters)of enclosed
m . space.
CS-103061 FApireu OY121Q020
JAIWES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01010
Failure to possess a current edition of the Massadwsetts
State Building Code is cause for revocation of this license.
Commissioner CIL For information about Phis License
Can(617)727-3200 or visit www.nwss.gov/dpi
Worker's Compensation and Emolaver°s Liabdijy PoNcy
Berkshire Hathaway AmGUARD Insurance Company-A Mock Co.
Y Policy Number R2WCO21353
GUARDInsurance Renewal of R2WC943835
Companies NCCI No. [21873]
PoMcy Ddbrmst on Page(AR)
[1]Namsd Insured and NaMng Address Agency
PEAK PERFORMANM ROOFING LLC WEBBER&GRINNELL INSURANCE AGENCY, INC.
1 LONEtTBD STREET 8 NORTH KING STREET
EASTHAMPTON,MA 01027 Northampton, MA 01060
Agency Code: MAMAINI5
Federal Employer's ID 00-1191951 Insured Is Limited Liability Co. (LLC)
[21 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 PartTWo 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-WC2003065 {{
D. This policy includes these endorsements and schedules: I
See Extension of Information Page- Schedule of Forms
[4] Premium
s
The Premium Basis and,therefore,the premium will be determined by our Manual of Rules, Ij
Classifications, Rates, and Rating Plans. All required information is subject to verification and change by
audit. (Continued on another page) !
Total Eidnmftd Policy Premium 31,202
Total Surds/Assessments $ $1,181.00
Toth retlmabad Cost $32.383.00
1N ERNAL USE XX Page- 1 - IMorrnation Page
MGA :RZWCO21353 WC 000001A
DOM :04/01/2019
MMOTE
IMWng Office:P.O.sox A-H,16 S.River Sbug,W1Nces-11line,PA 18703.0020 a www4m dAwn
P E K Peak Performance Roofing LLC
Contract
C E I Lovefield St
P E R F O R Date Contract#
• Easthampton, MA 01027 11/19/2019 1083
UAW
MA CSL#103061 1 413-203-5888 peakperformanceroofmgllc@gmail.cwm www.peakperformanceroofingllc.com
MA HIC# 183698
Bill To Job Location
Rachel Currie-Rubin Rachel Currie-Robin
137 Barrett St. 137 Barrett St.
Northampton, MA 01060 Northampton, MA 01060
413-320-3429 413-320-3429
rachelcurrierubin@gmail.com rachelcurrierubin@gmail.com
Description Total
-This contract is for the garage only- 5,150.00
1.Remove the existing roofing shingles
2.Install new 1/2 inch CDX plywood over boards on entire house/garage
3.Install six feet of ice and water shield on eaves and three feet in valley/around pipes
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: t 1�f;a Aa f
7.Install ridge vent on peaks of roof
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.Contractor will obtain building permit.
Total=$5150.00 Garage Only
inst
An initial deposit of$500 is due at contract oho installation. The finag to lock in price l balance shallction for tbe dueu pon�lation.
The balance of the deposit,$2075,1s due prior
completion. Accounts outstanding over 10 days past final invoice date subject to 2%finance charge,
compounded monthly.
Total:
Date:
at m,
Customer Sign r
Contractor Sip tom- � r
J;