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30A-079 (7)
BP-2022-0500 8 HIGH MEADOW RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-079-001 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-2022-0500 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: PEAK PERFORMANCE ROOFING Est. Cost: 21400 LLC CS-103061 Const.Class: Exp.Date:09/21/2022 Use Group: Owner: MALIKIN-SIROIS JARA &DANIEL A SIROIS Lot Size (sq.ft.) Zoning: WSP Applicant: PEAK PERFORMANCE ROOFING LLC Applicant Address Phone: Insurance: 1 LOVEFIELD ST 413-203-5888 R2WC202869 EASTHAMPTON, MA 01027 ISSUED ON:05/19/2022 TO PERFORM THE FOLLOWING WORK: STRIP AND RESHINGLE &REPLACE 2 SKYLIGHTS 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 i,I • Fees Paid: $80.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner DocuSign Envelope ID:FA59C6C4-A557-4C61-B2B1-3175F893FD4F ,_ �- 6R /1 r rA The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code,780 CMR MUNICIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only i - Building Permit Number: iJIO- ? )- 5`(TO Date Applied: v // 5- Kr ZOZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 8 High Meadow Rd Florence 30A-079-001 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Usc Lot Arca(sq ft) Frontage(ft) 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.40,554) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone:Public 0 Private CI — Outside fyesFloo Lone? Municipal 0 On site disposal system 0 Check if yeses SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Jara Malikin-Sirois Florence MA 01062 Name(Print) City,State,ZIP 8 High Meadow Rd 413-329-6563 _ danjara@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORKZ(check all that apply) New Construction❑ I Existing Building 11 Owner-Occupied 0 Repairs(s) Alteration(s) 0 Addition 0 Demolition Cl j Accessory Bldg.0 Number of Units Other llSpecify: Roofing. Brief Description of Pmposed Work`• strip and replace asphalt roof. Replace 2 existing skylights SECTION 4:ESTIMATED CONSTRUCTION COSTS Item I Estimated Costs: (Labor and Materials) Official Use Only 1. Building Permit Fee:S Indicate how fee is determined: I.Building S 21,400.00 2.Electrical S O Standard City/Town Application Fee O Total Project Costs(hem 6)x multiplier x 3. Plumbing S 2, Other Fees: S 4.Mechanical (kIVAC) S List 5.Mechanical (Fire �'Suppression) Total AU Fees:S Check No.401 theck Amount: 'Z Cash Amount: 6.Total Project Cost: S 21,400 00 0 Paid in Full 0 Outstanding Balance Due: 4O DocuSign Envelope ID:FA59C6C4-A557-4C61-B2B1-3175F893FD4F SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-103061 09/21/2022 +� James J. Flannery License Number T.xpirarion Date Name of CSL Holder List CSL Type(see below) U No.and Street Type Description HOI Oke, MA 01040 U Unrestricted(Buildings up to35,000 ca. ft.) y R Restricted 1&2 Family Dwelling Citvrl own,State,ZIP i a~t Masonry RC Roofing Covering WS Window and Siding 413 203 5888 SF Solid Fuel Burning Appliances peakperformanceroofinglic@gmail.corrri insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(I-BC) 183698 11/03/2023 Peak Performance Roofing LLC lnr,I{ce strahoe Number Exniratino bate HIC Company Name or I-DC Registrant Name 1 Lovefield Si. 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.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 ❑ • 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. �— ooeuSlpncdby: 5/4/2022 Jara Malikin-Sirois __- Prins Owner's Name(EleerrornetigAtsMAK.E43E Date SECTION 7b: OWNER' 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 mire and accurate to the best of my imowledge and understandin James J. Flannery 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 i www.mass.gov/oca Information on the Construction Supervisor License can be found at awv.mass.tov!dos 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:FA59C6C4-A557-4C61-B2B1-3175FB93FD4F City of Northampton `' '" Massachusetts `�s 1 „ i��, ' i ; iDEPARYMENT OF BUILDING INSPECTIONS •� r y 212 Main Street • Municipal Building �� A,." Northampton, MA 01060 JJph ‘t r 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: 'c l `' The Commonwealth of Massachusetts ----- Department of Industrial Accidents ...v' t.,._ Office of investigations ` _ . #�-!'— 600 Washington Street rt, • "r�= = Boston,MA 02111 ,y T'q tvY A==' www.mass.govldia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/O ganizationMdividual): 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: Type of project(required): 1.Nil am a employer with_ 4 __ 4. n I am a general contractor and 1 b. [1] New construction employees(full and/or part-time).* have hired the sub-contractors 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_ t 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 11.0 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.❑ Other _______- comp.insurance required.] :Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they arc doing ail 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.Lie.#: R2WC202869 Expiration Date:/1 21 (2- Job Site Address: X li V l 11 At u tot City/State/Zip:207..vvt_e-e_. 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 pedury that the information provided ab jv is true and correct. Z�Signature: y� � Phone If: Date: � _... 413-203-5888 Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitfLicense# 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#: 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 Edges,CISR + NAME: Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 (A/C,No,Ext): (NC,No): 8 North King Street E-MAIL aed ett webberan rinnell.com ADDRESS: g INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Admiral Ins Co/BRECK INSURED Plymouth Rock Assurance INSURER B: ry 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 (MM/DD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 5,000 A CA00003521803 07/07/2021 07/07/2022 PERSONAL&ADV INJURY $ 1.00Q000 GEN'L AGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $ 2.000,000 POLICY PRO- POLICY LOC PRODUCTS-COMP/OPAGG $ 2,000,000 1 OTHER. Employee Benefit $ 2,000,000 AUTOMOBILE LIABILITY GOMBINEL*91N©!E LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED "s/ SCHEDULED PRC00001007091 06/27/2021 06/27/2022 BODILY INJURY(Per accident) $ AUTOS ONLY /", AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY (Per accident) Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y I N C ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A R2WC202869 04/27/2022 04/27/2023 500,000 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 I LOCATIONS I 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 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 0 20M-05/17 Office oitsumer r/. 7�iw•irir/u/:c//:: Of 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 11/03/2023 1000 Washington Street -Suite 710 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118 JAMES FLANNERY 9 1 LOVEFIELD ST. �G '''Y .(�r0k• (! JJJ EASTHAMPTON,MA 01027 Undersecreta Not valid without signature ry Commonwealth of Massachusetts Division of Professional Licensure Construction Supervisor Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain '.oEnstroc-tio Supervisor less than 35,000 cubic feet(991 cubic meters)of enclosed 1 space. CS-103061 Expires: 09/21✓ 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 • Laa t.u-k C 8 a C ivs2 o v i ri.(_ • S r2' 13 t.0 j\n C \ir'c*) S DocuSign Envelope ID:FA59C6C4-A557-4C61-B2B1-3175FB93FD4F Peak Pettfonmance Roofing LLC 1 Lovefield St. Easthampton,MA 01027 413-203-5888 PERFORMANCE peakperformanceroofingllc@gmail.com ROOFING MA HIC#183698 MA CSL#103061 Contract ADDRESS CONTRACT# 10658 Jara Malikin-Sirois DATE 05/04/2022 8 High Meadow Rd., Florence,MA 01062 413-329-6563 danjara@comcast.net DESCRIPTION 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://www.certainteed.com/residential-roofing/products/landmark./ Color Choice: Moire Black 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 9.Replace (2)existing skylights with new Velux fixed non-venting skylights with room darkening solar powered blinds Includes CertainTeed Lifetime Limited Warranty (Transferable) with 10 year SureStart period. https://www.certainteed.com/resources/Asphalt_Warranty_C R.3782_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:FA59C6C4-A557-4C61-B2B1-3175FB93FD4F DESCRIPTION COST SUMMARY: Landmark shingles=$16,800 Fixed non-venting skylights: $1,900 x (2)=$3,800 Room darkening solar blinds: $400 x (2)= $800 TOTAL= $21,400.00 A one-third deposit of$7,100 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 $21,400.00 Accepted By °oci°'W Qd bY: Accepted Date 5/4/2022 70207CA1A24E43E,.