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32C-349 (5) BP-2022-041 4 71 PLEASANT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-349-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0414 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: PEAK PERFORMANCE ROOFING Est. Cost: 24900 LLC CS-103061 Const.Class: Exp.Date:09/21/2022 Use Group: Owner: TRUSTEE CHAMPAGNE GARY R Lot Size (sq.ft.) Zoning: CB Applicant: PEAK PERFORMANCE ROOFING LLC Applicant Address Phone: Insurance: 1 LOVEFIELD ST 413-203-5888 R2WC202869 EASTHAMPTON, MA 01027 ISSUED ON:04/26/2022 TO PERFORM THE FOLLO WING WORK: ROOF ONLY -NO PARAPET REMOVAL 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Q 51- 1 * vI4 A ' I Fees Paid: $175.00 212 Main Street, Phone(413)587-1240,Fa x:(413)587-1272 Office of the Building Commissioner DocuSign Envelope ID:677B384B-2805-40A7-B51E-743B8CE4FBA1 -7a f Version I.7 Commercial Building Permit May 15.2O(X) r _ Department use only -_ ! City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit APR 1 q 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans o ;'?or r,t., _ n ,,,_,, phone 413 587 1240 Fax 413 587 1272 Plot/Site Plans Other Specify_______ APPLICATION TO CONSTRUCT, REPAIR, RENOVATE.CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map 3a C___ Lot ( `-1 y' Unit 71 Pleasant St., Northampton Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Gary Champagne do Ashley Mckenney PO Box 2515, Holyoke MA 01041 Name(Print) Current Mailing Address: (--OocuSigned by. 1 Signature , 2 S-4d Telephone th 2.2 Autho O AS7eilioosoa James J. Flannery/Peak Performance Roofing LLC 1 Lovefield St., Easthampton MA 01027 Name(Print) Current Mailing Address: 413-203-5888 Signature ;1 Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $24,900.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 7/y/ 4. Mechanical (HVAC) `�' 1 76.- 5. Fire Protection - 6. Total= (1 +2 +3 +4 +5) $24,900.00 Check Number Q.I.Z. This Section For Official Use Only Building Permit Number Date 6, -- _ ) r /l/c( Issued Signature://2 Zi Z5 2z Building Commissioner/Inspector of Buildings Date DocuSign Envelope ID:677B384B-2805-40A7-B51E-74388CE4FBA1 Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35.000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ] Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing Change of Use❑ Other ❑ Brief Description Strip existing material, replace wood decking as needed, and install Genflex TPO fully adhered roof Of Proposed Work: system �� C'r✓L`� — ►JO ► V.11 f' i�Er►OvRL SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1 B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 0 F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I-1 0 1-2 El 1-3 ❑ 3B ❑ M Mercantile El 4 ❑ R Residential ❑ R-1 ❑ R-2 0 R-3 ❑ 5A ❑ S Storage ❑ S-1 0 S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1" nd 2nd 2 3rd 3rd Total Area (sf) Total Proposed New Construction (sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public 0 Private 0 Zone Outside Flood Zone Municipal ® On site disposal systems DocuSign Envelope ID:677B384B-2805-40A7-B51E-743B8CE4FBA1 Version 1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: Re Rear Building Height Bldg.Square Footage °Ir Open Space Footage �7c (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YEST-1 IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued. C. Do any signs exist on the property? YES I I NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YEF1 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,gradin excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. DocuSign Envelope ID:6778384B-2805-40A7-B51E-743B8CE4FBA1 Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable te Name(Registrant): Registration Number Address E,gpiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Peak Performance Roofing, LLC -------------_-----------_-.__...__-- Not Applicable Company Name James J. Flannery Responsible In Charge of Construction 1 Lovefield St.. Easthampton. MA 01027 Address 413-203-5888 SignaturertH Telephone DocuSign Envelope ID:677B384B-2805-40A7-B51E-743B8CE4FBA1 Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes El No 13./ SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Gary Champagne c/o Ashley Mckenney as Owner of the subject property hereby authorize James J. Flannery/ Peak Performance Roofing, LLC to act orw ieeNf,in all matters relative to work authorized by this building permit application. S 419)ft111018j'i 4/5/2022 Date 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 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: James J. Flannery CS-103061 License Number Holyoke. MA 01040 09/21/2022 Address Expiration Date 413-203-5888 Signature Telephone SECTION 13-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 bui ing permit. Signed Affidavit Attached Yes No I 1 DocuSign Envelope ID:67713384B-2805-40A7-B51E-743B8CE4FBA1 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: 71 Pleasant St., Northampton The debris will be transported by: Aaron's Zan Roil off Valley Recycling, 234 Easthampton Rd., Northampton MA 01060 The debris will be received by: Building permit number: Name of Permit Applicant James J. Flannery, Peak Performance Roofing. LLC (qGI Date Signature of Permit Applicant The Commonwealth of Massachusetts fi _ Department of Industrial Accidents ......:, ._„ Office of Investigations Via.�,� 600 Washington Street Si ilt' ;' Boston,MA 02111 rill. = www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Businesstorganizationrindividual): Peak Performance Roofing, LLC Address: 1 Lovefield St. City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888 Are Type project ypu an employer? Check the appropriate box: of (required): � 1. 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. 0 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 8. El Demolition workingfor me in anycapacity. employees and have workers' P y + 9. 0 Building addition [No workers' comp.insurance comp.insurance., required.] 5. [] We arc a corporation and its 10.0 Electrical 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.gRoof repairs insurance required.] : c. 152,*1(4),and we have no employees.[No workers' 13.0 Outer._ _______ comp.insurance required.' "`Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. t Hotmxiwners 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-contnictors and state whether or not those entities have employees. II the sub-contractors have employees they must provide their workers'comp.policy number 1 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 fi or Self-ins.Lic.ii: R2WC202869 Expiration Date: 4/27/2022 Job Site Address: 111 R4"L'E1CA7' 9 City/State/Zip:�v� 24/ l 01 0 IO 1 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 Iead to the imposition of criminal penalties of a fine up to$1500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: f �7 Date: ._ __ Phone#: 413-203-5888 y > Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License ft 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#: •.!/e Fooe riY CIfieezi t,0exie�G�C/lle!c 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 1 LOVEFIELD ST. Expiration 11/03/2023 EASTHAMPTON,MA 01027 • ' Update Address and Return Card. SCA 1 8 2011-05f17 Office/orCrnsumer Affairrss&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: RegistLatign Expiration Office of Consumer Affairs and Business Regulation 183698 11/012023 1000 Washington Street . Suite 710 PEAK PERFORMANCE ROOFING.LLC Boston,MA 02118 JAMES FLANNERY '""''( 1 LOVEFIELD ST. / J EASTHAMPTON,MA 01027 Not valid without signature Undersecretary ® Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor Unrestricted-Buildings of any use group which contain :ORStfuC;csOr' Supewisu` ^� less than 35,000 cubic feet(991 cubic meters)of enclosed aoA+2` space. CS-103061 Expires:09121t1In< JAMES J FLANNERY 1 WILUAMS ST HOLYOKE MA 01040 Failure to possess a current edition of the Massachusetts Commissioner '/•� State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov dpl igLaaw.k 0 c*hvs? 061 dcial wo-Vn Ca CcI 5 AC€ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/12/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Adina Edgett,CISR NAME. Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 (A/C,No.Ext): (A/C,No): 8 North King Street ADD E'mnlLRESS: g aed ett webberan rinnell.com INSURER(S)AFFORDING COVERAGE NAIC if Northampton MA 01060 INSURER A: Admiral Ins Co/BRECK INSURED INSURER B. Plymouth Rock Assurance Peak Performance Roofing,LLC INSURER C: WCAR-Berkshire Hathaway GUARD Attn:James Flannery INSURER D 1 Lovefield Street INSURER E Easthampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 06/2022 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A CA00003521803 07/07/2021 07/07/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000.000 X POLICY PET LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Employee Benefit $ 2,000,000 AUTOMOBILE LIABILITY 66MBRI.EaSIN©!E LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED )/ SCHEDULED PRC00001007091 06/27/2021 06/27/2022 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS XHIRED 'we NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY (Per accident) Medical payments $ 5,000 UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION STATUTE EOTH AND EMPLOYERS'LIABILITY Y I N C ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A R2WC202869 04/27/2021 04/27/2022 500000 OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT $ , (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ WC:James Flannery is excluded DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:87783848-2805-40A7-851E-743B8CE4F8A1 Peak Performance Roofing LLC 1 Lovefield St. P Easthampton,MA 01027 413-203-5888 PERFOR SCE peakperformanceroofingllc@gmail.com ROOFING MA HIC#183698 MA CSL#103061 Contract ADDRESS CONTRACT# 10631 Gary Champagne c/o DATE 04/05/2022 Ashley Mckenney PO BOX 2515 Holyoke,MA 01041 ashley @virtuousbookkeepin gservices.com ,JOB LOCATION 71 Pleasant St.Northampton DESCRIPTION 1.Remove the existing roof materials down to the wood deck. Inspect the sheathing.Parapet wall on the right side of the building will remain in place along with the front wall Remaining walls will be repointed and repaired as needed. 2.Wood deck replacement will be billed on a time and materials basis with labor cost at$75 per hour. 3.Fasten pressure treated 2x6 on perimeter to equal height of the insulation. 4.Mechanically fasten 2 layers of 2.5" polyisocyanurate insulation with approved screws and plates 5.Install Genflex TPO fully adhered roof system,all details per Genflex specifications. http://genflex.com/wp-content/uploads/2014/I 1/CB04_GenFlex-TPO-Brochure_1014_web.pdf 6.Fabricate and install .032 gauge bronze aluminum drip edge on perimeter. 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 reasonable caution during the installation process: do not walk or drive under active work,or on areas of potential roofing debris.Peak Performance Roofing will obtain the building permit.Installations are weather permitting; inclement weather will cause scheduling delays. Total Cost=$24,900 A one-third deposit of$8,300 will secure contract,permitting,material order,and priority scheduling. The balance shall be due upon completion,within 30 days of invoice. Accounts outstanding over 30 days subject to 2% finance charge monthly. TOTAL $24 .00 Accepted By Ciitivcatc1/41cus'gnedbY' Accepted Date 4/5/2022 7B88E3E109408...