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23D-026 (3) 480 ELM ST BP-2020-0966 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D-026 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-2020-0966 Project# JS-2020-001643 Est.Cost:$10500.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sa. ft.): 8015.04_ Owner: JENNIFER L JAKOWSKI Zoning: URB(100)/ Applicant: JAMES FLANNERY AT. 480 ELM ST Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 WC EASTHAMPTONMA01027 ISSUED ON:2/27/2020 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: Footin-s: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Dmartment 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: FeeTyue: Date Paid: Amount: Building 2/27/2020 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner DocuSign Envelope ID: E4AC6CE6-3237-4C7A-9786-AFA6F49F7435 Department use only City of Northampton i' tatus of Permit: �. Building Departreii# -,INrb Cut/Driveway Permit 212 Main Stre6f po er/Septic Availability Room 100 ��'� c� r/Well Availability Northampton, MA 01 � 15 7wn;, ets of Structural Plans phone 413-587-1240 Fax 413 12.7205 Plans O Oecify APPLICATION TO CONSTRUCT,ALTER, REPAIR, A DEMOLISH A ONE OR TWO FAMILY DWELLING N SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot 0.�& Unit 480 Elm Street Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jennifer Jakowski 480 Elm St, Northampton Name(Print Docusignedby: Current Mailing Address: 413-273-3131 Telephone Signature 661A132DF0D6F4C2.. 2.2 Authorized 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 $10,500.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee , 4. Mechanical(HVAC) V 5.Fire Protection 6. Total=0 +2+3+4+5) $10,500.00 Check Number O /� /� This Section For Official Use Only 6qb�Building Permit Number: ,0 a" 1 Date Issued: Signature: ' _ Z' 21,-ZOZD Building Commissioner/Inspector of Buildings Date peakperformanceroofingllc (& gmail.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) DocuSign Envelope ID:E4AC6CE6-3237-4C7A-9786-AFA6F49F7435 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors 13 Accessory Bldg. ❑ Demolition ❑ New Signs [ED] Decks [O Siding[C3] Other(ol Brief Description of Proposed Strip and replace architectural shingles 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. 1. 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 Jennifer Jakowski I. , as Owner of the subject property hereby authorize James J. Flannery / Peak Performance Roofing, LLC to act on m behalf ip,all matters relative to work authorized by this building permit application. Docu igndd y: 2/25/2020 0 Signatur o 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 B SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of Llcense Holder: CS-103061 License Number James J. Flannery 09/21/2020 Address Expiration Date UJt111 4_ff) St, Holyoke MA 01040 Signature o Telephone r—`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 413-203-5888 Telephone 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....... No...... ❑ City of Northampton Massachusetts i .A c N DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building yJy Cs 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: 480 Elm Street, Northampton (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) ) �_,�>j_x' 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 A;71 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. EJNew 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. E] Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.VRoof 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 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 �4?0 F 1 fn ,_x� +ho_ n 0-on Job Site Address: Q��� City/State/Zip: 1 )pr Q 10(00 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 andpena 'es ofperjury that the information provided above is true and correct Signature: Date: Phone#: 413-203-5888 V if 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#: Worker's Comoensation and Emolavees L-ability Policy Berkshire Hathawa AmOUMD Insurance Many-A `Co. Policy Number R2WCO21353 GUARD Insurance Renewal of R2WC903635 Companies NCCCI No. [21673] i( Pofty tnfonnintlon Page(AR) [1]Named Insured and Nailing Address Agency PEAK PERFORMANCE ROOFING LLMC WEBBER&GRINNELL INSURANCE AGENCY, INC. 1 LOVEFIEI.D 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) i! fi t j [2] Policy Perlod From April 27, 2019 to April 27,2020, 12:01 AM,standard time at the insured's mailing address. [3] Coverage 1 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 i Bodily Injury by Disease-policy limit $500,000 C. Refer to Residual Market Limited Other Stages Insurance Endorsement-WC200306B w D. This policy Includes these endorsements and schedules: See Extension of Information Page-Schedule of Fortes j [4] Premium i' The Premium Basis and,therefore,the premium will be determined by our Manual of Rules, Classifications,Rates,and Rating Pians. All required information is subject to verification and change by Page) E' audit. (Continued on another e Total Esdmabi Polley Premium 31,202 Tool Mwdmroes/Assassmenb $1,181.00 Total Esdmsbsd Cost 6 $32.383AO WERNAL USE XX Page- 1- Inkmotion Page MGA :RZWCD21353 WC 000001A Date :OgOIM19 MANOTE Unuing Ounce:P.O.sox A-%16 S.River Sbw*e WIC PA 18703-0020 0 wwwAwrdA=n 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. Expiration: 11/03/2021 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Update Address and Return Card. SCA 1 O 2OM-05//117 .�� rilYlN//!Y!//Y7�1�/'� �LMaiJI/�N/31✓�'3 Offles of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. K found return to: ffilgishybort Eoration Office of Consumer Affairs and Business Regulation 183668 11//03/2021 1000 Washington Street -Suite 710 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118 JAMES FLANNERY 1 LOVEFIELD ST. ri'L illc EASTHAMPTON,MA 01027 Undersecretary No valid withoutgnature i Commonwealth of Massachusetts . Division of Professional Licensure Construction Supe Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(881 cubic meters)of enclosed space. CS-103061 Eatpirm 091211= JAMES J FLANNERY - 1 WIWAMS ST HOLYOKE MA 01050 w Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner For information about this license Call(617)7273200 or visit www.mass gov/dpi DocuSign Envelope ID:E4AC6CE6-3237-4C7A-9786-AFA6F49F7435 Peak Performance Roofing LLC 1 Lovefield St. MF E K Easthampton,MA 01027 413-203-5888 P E R C E peakperformanceroofingllc@gmail.com • • MA HIC#183698 MA CSL#103061 Contract ADDRESS CONTRACT# 10033 Jen Jakowski DATE 02/24/2020 480 Elm Street Northampton,MA 01060 jennifer.jakowski@gmail.co in JOB LOCATION 480 Elm St,Northampton 3► �TO1*1 AMOUNT 1.Remove the existing roofing shingles 10,500.00 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 around pipes(low slope roof will receive full ice and water shield) 4. Cover remaining roof with synthetic underlayment 5. Install,new 8" aluminum drip edge on all eaves and rake edges 6.Install Landmark architectural shingles by Certainteed(please choose) http://www.certainteed.com/residential-roofing/products/landmark/ Color Choice; 7. Install ridge vent on peaks of roof 8. Complete all necessary flashings including new pipe boots and base flashing around chimney Remove all debris from premises, and throughout the job,continue cleanup and keep the premises undamaged. WE ARE NOT RESPONSIBLE FOR ANY 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.Long periods of inclement weather will cause scheduling delays. DocuSign Envelope ID:E4ACBCE8-3237-4C7A-9788-AFA6F49F7435 DERI AMOUNT Landmark shingles=$10,500 A deposit of$5,250 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. TOTAL $109500.00 Accepted By Accepted Date 2/25/2020 C86IAB2DF0D6F4C2..