Loading...
10B-007 74 AUDUBON RD BP-2020-1297 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: IOB-007 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-2020-1297 Project# JS-2020-002169 Est.Cost: $13450.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES FLANNERY 103061 Lot Size(sa. ft.): 94960.80 Owner: STAUB ADRIAN Zoning:RR(100)/URB(0)/ Applicant. JAMES FLANNERY AT. 74 AUDUBON RD Applicant Address: Phone: Insurance: 1 LOVEFIELD ST (508) 294-4052 WC EASTHAMPTON MAO 1027 ISSUED ON.6/26/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.—STRIP & SHINGLE ROOF ON HOUSE ONLY 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 Si(naturc: FeeType: Date Paid: Amount: Building 6/26/2020 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner DocuSign Envelope ID:4EC599EC-39844978-83D4-4A74B9466BF4 Department use only City of Northampton � ;�^�\ Status of Permit: ,r= Building De artme lni' Curb Cut/Driveway Permit � 212 Main Street Sewer/Septic Availability ; ROOM 1150., Water/Well Availability a Northampton, MA 01 60 �� Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 ' PloUSite Plans Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: 74 AUDUBON RD, LEEDS Map �� J Lot unit Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERS HIPIAUTHORIZED AGENT 2.1 Owner of Record: Adrian Staub 74 Audubon Rd, Leeds MA 01053 Name(,Print Current Mailing Address: DocuSigned by: Telephone 413-320-8995 Signature 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 $13,450.00 (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) $13,450.00 Check Number d This Section For Official Use Only r� Building Permit Number ''� / A/'7 DateIssued: _ Signature: 26 30W Building Commissioner/Inspector of Buildings Date peakperformanceroofinglic Ca gmail.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) DocuSign Envelope ID:4EC599EC-3984-4978-83D4-4A74B9466BF4 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) E j7 Roofing EV Or Doors E-1 Accessory Bldg. ❑ Demolition ❑ New Signs Decks [[771 Siding [O] Other[O] Brief Description of Proposed Strip & re-shingle asphalt roof on house only 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. L 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 Adrian Staub as Owner of the subject property James J. Flannery / Peak Performance Roofing, LLC hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. DocuSign d by: 6/22/2020 V1 Al� 14 n Y Date James J. Flannery as Owner/Authorized I. 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 Da e DocuSign Envelope ID:4EC599EC-3984-4978-83D4-4A74B9466BF4 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: CS-103061 License Number James J. Flannery 09/21/2020 Address Expiration Date I tai YYIS S , Holyoke, MA 01040 Signature r Telephone 413-203-5888 9.Registered Home Improvement Contractor: Not Applicable O 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....... I/ No...... ❑ DocuSign Envelope ID:4EC599EC-3984-4978-83D4-4A74B9466BF4 City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS ti 212 Main street •Municipal Building ilf Northampton, MA 01060 SSNjy `1�ti 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: 74 Audubon Rd, Leeds_ (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) 6/Z3'Z,o LO 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 you an employer? Check the appropriate box: Type of project(required): 1.I� 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 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.❑ 1 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.gRoof 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. $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.#: R2WC130849 Expiration Date: 4/27/2021 Job Site Address: qq A u A V J b ti RA City/State/Zip: �p Q� $ III 0 6103 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 is true and correct Signature: Date: 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#: A Worker's Compensation and Employer's Liability Policy �!�Berkshire Hathaway AmGUARD Insurance Company - A Stock Co. Y Policy Number R2WC130849 ���► G ARD Insurance Renewal of R2WCO21353 Ps Companies NCCI No. [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 XX-XXX1951 Insured is Limited Liability Co. (LLC) [2] Policy Period From April 27, 2020 to April 27, 2021, 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 Pians. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium $ 25,108 Total Surcharges/Assessments $ $867.00 Total Estimated Cost $25,975.00 INTERNAL USE XX Page - 1 - Information Page MGA : R2WC130849 WC 000001A Date : 04/07/2020 MANOTE Issuing Office: P.O. Box A-H, 39 Public Square, Wilkes-Barre, PA 18703-0020 a www.guard.com J0� 22G�/ZCC�CL !� 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: 183698 Expiration: 11/03/2021 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Update Address and Return Card. SCA i O 20rs-05i17 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: Registration Expiration Office of Consumer Affairs and Business Regulation 183698 11103!2021 1000 Washington Street -Suite 710 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118 JAMES FLANNERY 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Undersecretary ' No valid without 'gnature Commonwealth of Massachusetts10 � Division of Professional Licensure Construction Supervisor Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. CS-103061 Expires: 09/2112020 JAMES J FLANNERY 1 WILLIAMS ST HOLYOKE MA 01040 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner C4 For information about this license Call(617)727-3200 or visit www.mass.gov/dpl DocuSign Envelope ID:4EC599EC-3984-4978-83D4-4A74B9466BF4 Peak Performance Roofing LLC 1 Lovefield St. PE Easthampton,MA 01027 413-203-5888 ���JL E R F Opeakperformanceroofingllc@gmail.com MA HIC#183698 MA CSL#103061 Contract ADDRESS CONTRACT# 10124 Adrian Staub DATE 06/19/2020 74 Audubon Rd. Leeds, MA 01053 ^ 413-320-8995 ``p astaub@umass.edu � DESCRIPTION AMOUNT This contract is for the House only(excludes garage): 13,450.00 1. Remove the existing roof shingles and inspect sheathing 2. Replace up to 64 square feet of plywood if necessary at no cost. Any additional plywood will be $60 per sheet installed 3. Install six feet of ice and water shield at eaves and valleys, 12" around roof/wall intersections 4. Cover remaining roof with Certainteed "Roof Runner" synthetic underlayment 5. Install 8" aluminum drip edge on eaves and rake edges 6. Install architectural shingles by Certainteed(Landmark PRO) https://www.certainteed.com/residential-roofing/products/landmark-pro/ Color Choice: 7. Install ridge vent 8. Install Flintlastic SA rolled roofing by Certainteed on low slope porch roof 9. Complete all necessary flashings including new pipe boots and new base flashing on chimney 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. 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 stretches of inclement weather will cause scheduling delays. DocuSign Envelope ID:4EC599EC-3984-4978-83D4-4A74B9466BF4 DESCRIPTION TOTAL: Landmark PRO shingles=$13,450 An initial deposit of$500.00 will secure contractibuilding permit/priority scheduling for Summer 2020. The balance of the deposit, $6,225.00, is due prior to start of work/material order. The balance will be due Upon Completion. Accounts outstanding over 10 days past final invoice date subject to 2%finance charge, compounded monthly. TOTAL $13,450.00 Docusigned by: 6/22/2020 Accepted By ��� Sfax Accepted Date 2B01F0E5BB334BA...