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23A-132 (11) B P-202 2-0484 58 MIDDLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-132-001 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-2022-0484 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: PEAK PERFORMANCE ROOFING Est. Cost: 4800 LLC CS-103061 Const.Class: Exp.Date:09/21/2022 Use Group: Owner: RAPHAEL REILY JOHN & ANDREA P Lot Size (sq.ft.) Zoning: URB Applicant: PEAK PERFORMANCE ROOFING LLC Applicant Address Phone: Insurance: 1 LOVEFIELD ST 413-203-5888 R2WC202869 EASTHAMPTON, MA 01027 ISSUED ON:05/04/2022 TO PERFORM THE FOLLOWING WORK: ROOF REPAIRS 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: )2 . (nia, , • v . Fees Paid: S40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner DocuSign Envelope ID:814FDD39-905D-4591-8685-083BAO9BB7DB ----:-O_V 1. ii r MAY - 3 2Z2 7 . . The Commonwealth of Massachusetts ' FOR I Board of Building Regulations and Standards ..-- _ T j i Y yierrit Massachusetts State Building Code;7$0 CMl;€;T;7,;11-01N INC" �_ �,ti t)SE Building Permit Application To Construct,Repair,Renovate Or Deih[slai 06.Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building ermit Number. BP-?- = .5/FS/ Date Applied: evuo acy5-, )//,l 5-4-zozZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 58 Middle St. Florence 23A-132-001 I.1 a Is this an accepted street?yes no Map Number Parcel Number 1 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(it) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private CI ___ Outside Flood Zone? Municipal O On site disposal system 0 Check if yesD SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: John Reily Florence MA 01062 Name(Print) City,State.ZIP 58 Middle St. Florence (413) 588-1349 johnreily0228@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building!f Owner-Occupied ❑ Repairs(s) I Alteration(s) ❑ Addition ❑ Demolition El Accessory Bldg.0 Number of Units Other ISpecify: Roofing. . Brief Description of Proposed Work2: Strip and replace asphalt shingles on sections only. See diagram SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building S 4,800 00 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical S ' O Standard City/Town Application Fee 0 Tout]Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: S 4.Mechanical (IIVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ �/ 6.Total Project Cost: S. Check No 410 W Check Amount. /V Cash Amount: 4,800.00 0 Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:814FDD39-905D-4591-8685-083BAO9BB7DB SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-103061 09/21/2022 James J. Flannery License Number Expiration Date Name of CSL Holder List CSL Type(see below) U No.and Street Type Description Holyoke, MA 01040 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town.State,ZIP M Masonry RC Roofing Covering WS Window and Siding 413-203-5888 peakperformanceroofingllc@gmail.cot rr ISF Solid Fuel Burning Appliances Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 183698 11/03/2023 Peak Performance Roofing LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 1 Lovefield St. peakperformanceroofingllc@gmail.com No.and Street Email address Easthampton, MA 01027 413-203-5888 , City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide 1 this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ,d No .❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize James J. Flannery/Peak Performance Roofing LLC to act on my behalf,in all matters relative to work authorized by this building permit application. -o«usgnoa by: 4/22/2022 John Reily tro Print Owner's Name(Elm 'c g E Date SECTION 7b:OWNERI OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understandin . James J. Flannery (./ Z1 I2-' 22- ' Print Owner's or Authorized Agent's Name(Electronic Signature) / Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.aov/dns 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" DocuSign Envelope ID: 814FDD39-905D-4591-8685-083BAO9BB7DB 1 3 I`:, 91 218 � 1 # 212 78 170 DS 698 55 31 � 55 '351 � - - , 58 I N31 55> _ _J 55 - 150 33 203 DocuSign Envelope ID:814FDD39-905D-4591-8685-083BAO9BB7DB City of Northampton 1i �fi Massachusetts ' DEPARTMENT OF BUILDING INSPECTIONS S;, f --*0. 0) , . 1ii 212 Main Street • Municipal Building v' —! Northampton, MA 01060 '$ .),` CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility:Valley Recycling, 234 Easthampton Rd., Northampton MA 01060 413-587-4279 The debris will be transported by: Name of Hauler: Aaron's Roll-Off Service 413-529-1100 Signature of Applicant: James J. Flannery Date: q(7;1 7/e7,2 The Commonwealth of Massachusetts .. .. Deportment of Industrial Accidents • Office of Investigations l *` 600 Washington Street 4 : Boston,MA 02111 •v.S-2at 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 ypu an employer? Check the appropriate box: 1. I am a employer with 4 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors b_ 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. ❑ Demolition working for me in any capacity. employees and have workers' 9. ®Building addition [No workers'comp.insurance comp_insurance: required.] 5. ❑ We arc a corporation and its 10.n 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 c. 152,§1 4 12.[l_Roof repairs insurance required.] _ O,and we have no 13.❑ Other_ employees.[No workers' ---.-- _ --- comp_insurance required.] *Any applicant that checks box NI must also fill out the section below showing their workers'compensation policy information. 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. Insurance Company Name: Berkshire Hathaway Guard Policy#or Self-ins.Lic.#: R2WC202869 _ _ Expiration Date: `7/2` i-/.2 -- f� I/�n ` , - 1( -Y �Job Site Address: �U {�I l��� � �• CitylStatelZip: t•�! OW 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$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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signatures rif‘r"-Ift ° Date: Phone . 413-203-5888 i 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#: ACCoR CERTIFICATE OF LIABILITY INSURANCE DATE(MNDWYYYY) 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 INC.No,Eat); (NC,No). 8 North King Street E-MAIL aedgett@webberandgrinnell.com ADDRESS: INSURERIS►AFFORDING COVERAGE NAIC 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 0612022 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. 1 TTRR TYPE OF INSURANCE pL YYVDD POLICY NUMBER P ifo W Y EFF POLICY EXP LIMITS {IIMNDD/VY) (MMIDD/VVYM) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1D00'000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) E MED EXP(Any one person) E 5,000 A CA00003521803 07/07/2021 07/07/2022 PERSONAL is ADV INJURY $ 1'000,000 GENt AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2'000'000 X POLICY JE T LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER Employee Benefit S 2,000,000 AUTOMOBILE UABILITY '60NRINElfSINOLE LIMIT (Eaacc,dent) S 1,000,000 ANY AUTO BODILY INJURY(Per person) S B OWNED x SCHEDULED PRC00001007091 06/27/2021 06/27/2022 BODILY INJURY(Per accident) S AUTOS ONLY /� AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY �e AUTOS ONLY (Per accident) Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE E DED RETENTION $ $ _ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N I STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 500,000 C OFFICEFVMEMBEREXCLUDED? Y N/A R2WC202869 04/27/2022 04/27/2023 E.L.EACH ACCIDENT S (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes.descnbe under 50,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 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 IL.._ u/7 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • Me; Fe-pe?xeneweifieezdio//0-acelege:46;te/4i 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 t 0 20M-05117 /ir yrri.riiriir rr///r�. //47.;•:,rr/.iir//.i Oftfa of Consumer AnaIrs&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 11/03/2023 1000 Washington Street -Suite 710 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118 JAMES FLANNERY j 1 LOVEFIELD ST. �t,,.K tL/fis..k (/ JJJ EASTHAMPTON,MA 01027 Undersecretary Not valid without signature ® Commonwealth of Massachusetts Division of Professional Licensure Construction Supervisor Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain :onstructiOn Supervisor less than 36,000 cubic feet(991 cubic meters)of enclosed �� )1�` space. CS-103061 Expires: 09/211.132i . JAMES J FLANNERY 1 WILUAMS ST HOLYOKE MA 01040 Q Failure to possess a current edition of the Massachusetts Commissioner (v�-�_ 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 .Q.fa uu-L; a C Alvs2 0 i'1 i Q • (142A l.LAJ-V\ C a.rc.) 5 DocuSign Envelope ID:814FDD39-905D-4591-8685-083BA09B87DB Peak Performance Roofing LLC 1 Lovefield St. P E K Easthampton,MA 01027 413-203-5888 P E R F O R CE peakperformanceroofingllc@gmail.com ROOFING MA HIC#183698 MA CSL#103061 Contract ADDRESS CONTRACT# 10654 John Reily DATE 04/22/2022 58 Middle St. Florence,MA 01062 joluireily0228@gmail.com (413) 588-1349 DESCRIPTION -This contract is only for certain parts of the house roof. Please see the marked diagram attached to the email. 1. Remove the existing roofing shingles 2.Inspect the sheathing for any rot or deterioration.Any new plywood necessary will be $100 per sheet installed.Any new roofing boards will be $6 per foot installed. (Wood prices subject to change based on market fluctuations) 3.Install six feet of ice and water shield on eaves,three feet in any valleys,and three feet around all penetrations 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) http://w ww.certainteed.com/residential-roofing/products/landmark/ Color Choice: Georgetown Gray 7.Install Shingle Vent 11 ridge vent on peaks of roof(where applicable) https://www.certainteed.com/residential-roofing/products/certainteed-ridge-vent-12-filtered/ 8.Complete all necessary flashings including new LIFETIME pipe boots and base flashing around chimney Includes CertainTeed Lifetime Limited Warranty (Transferable) with 10 year SureStart period. https://www.certainteed.com/resources/Asphalt_Warranty_CTR3782_1912_E.pdf 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. DocuSign Envelope ID:814FDD39-905D-4591-8685-083BA09BB7DB DESCRIPTION Total: Landmark shingles=$4,800 A one-third deposit of$1,600 will secure contract,permitting,material order,and priority scheduling. The balance shall be due upon completion,within 10 days of invoice. Accounts outstanding over 30 days subject to 2% finance charge monthly. Warranty confirmation shall be provided upon final payment. Installation and manufacturer warranties are not in effect until Paid In Full. TOTAL $4,800.00 Accepted By t 0 C11 fpi�''°� Accepted Date 4/22/2022 -06209466898A4 E..