42-052 (7) BP-2022-1476
587 WESTHAMPTON RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
42-052-001 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-2022-1476 PERMISSION IS HEREBY GRANTED TO:
Project# ROOF Contractor: License:
PEAK PERFORMANCE ROOFING
Est. Cost: 16950 LLC CS-103061
Const.Class: Exp.Date: 09/21/2024
Use Group: Owner: RAWLINGS FRANK V& ELIZABETH WITTE
Lot Size (sq.ft.)
Zoning: WSP Applicant: PEAK PERFORMANCE ROOFING LLC
Applicant Address Phone: Insurance:
1 LOVEFIELD ST 413-203-5888 R2WC342657
EASTHAMPTON, MA 01027
ISSUED ON: 11/15/2022
TO PERFORM THE FOLLOWING WORK:
STRIP AND RE-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: 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:
.59 9-9
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
DocuSign Envelope ID:A5312559-583C-49A1-13C05-8ED59A5C4319
i
cQ'�l t \�
g� The Commonwealth of 4j0 �►.' '
Tii, Board of Building Regulations d S . dards V 7 ) j'`
Massachusetts State Building Code,� ,' Q CIPALITY
A,,o �0� SE
Building Permit Application To Construct,Repair,Reno�a 'it : molis�a Rem, 201I
�� �� I
One-or Two-Family Dwelling 'oh''^<sp
This Section For Official Use Only �q 00 oNs
Building Permit Number. _ -3 x•i y7 GE__ Date Applied:
r-urtJ /Doss I// 11- 15-20ZZ
Building Official(Prim Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 A��sors Map&Parcel l u�ab�
al587 Westhampton Rd.Florence CC//,,77
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1,4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(£t)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.t3.L c.40,554) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private O Zone: — outside Flood Zane? Municipal a on site disposal system O
Check if yes0
SECTION 2: PROPERTY OW 4ERSIIIP'
2.1 Owner'of Record:Elizabeth Witte&Frank Victor Florence, MA
Rawlings
Name(hint) 587 Westhampton Rd. City,State.ZIP
734-709-2774 witte.elizabeth G gmaiI.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building CI Owner-Occupied O Repairs(s) Cl Alteration(s) 0 Addison 0
Demolition O Accessory Bldg.Cl Number of Units I Other 4i Specify: Roofing
Brief Description of Proposed Work': Strip and replace asphalt'roof.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item I Estimated Costs:
(Labor and Materials) Official Use Only
1.Building s 16950 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical S ' 0 Standard City/Pown Application Fee
l7 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2, Other Fees: $
4.Mechanical (NVAC) $ Last: _,
5.Mechanical (Fire S .
Suppression) Total All Fees:S
16950 Check No. 44A14 Check Amount~ T4V Cash Amount:
6,Total Project Cost: f 0 Paid in Full Cl Outstanding Balance Due:
Docusign Envelope ID:A5312559-563C-49A1-BCDS-SED59A5C4319
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor T•lr�ee(CSL) - CSL-10301 09/21/2024
James J. Flannery
License Number Expiration Date
Name of CSL Holder L)
List CSL Type(see below)
No. d Sl sit Type Description
riolyoke, MA 01040 U Unrestricted(Buildings up to 35,001 cu.ft.)
R Restricted l&2 Famil Dwelling
CityrTown,State.ZIP M Masonry
RC Roofry Covering
WS Window and Siding
413-203-5888 Peakperforrnanceroofingllc@gmall.com SF Solid Fuel Burning Appliances
I Insulation
Telephone - __Email address D Demolition
5.2 gi `ira edryorr naln et Cent .` °r(WC) 183698 11/03/2023
' illC HiC Registrant Namepeakperfonnanceroofinglle@gmail.com
Registration Number Expiration Date
'mTI i. peakperformanceroofinglle@gmafi,com
Na.and Street Easthampton, MA 01027 413-203-5888 Email address
City/Town,State,ZIP Telephone
SECTION b: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? Yea ' ] No 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of tbesubject herebyauthorise James J. Flannery/ Peak Performance Roofing LLC
property,to act on my behalf,in all matters relative to work authorized by this building permit application,
rRt&ma c'rr,1 X4wliA4 11/4/2022
'P tlrvillr's Name(Electronic Signature) Date
SECTION 7b:OBI OR AUTHORIZED D 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 understanding,
James J. Flannery 1 '
Prim Owner's or Authorized Agent's Nam l aTr ills" Sigtw 121 Date
,MOTES:
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/dtls
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 balf/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"
The Commonwealth of Massachusetts
=1,--, ,`.. Department of Industrial Accidents
=kOffice of Investigations
' 600 Washington Street
= '� ' Boston,MA min-__' www.mass,govfdia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (businessiorganizationllndividual): Peak Performance Roofing, LLC
Address: 1 Lovefietd St.
City/State/Zip: Easthampton, MA 01027 phone#: 413-203-5888
Are ypn an employer?Check the appropriate box: .-
�/ 4 4. t-1 I am a eneral contractor and I Type of project(required):1. I am a employer with i
6_ 0 New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I ant a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have g. ❑t etnolititm
working for me in any capacity. employees and have workers' 9. D Building addition
[No workers'comp.insurance comp.insurance'.-
required.1 5. LI We arc a corporation and its 10.0 Electrical repairs or additions
3.0 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.r•'/Roof repairs
insurance required.] : c. 152,,1(4).and we have no LJ
employees.[No workers` 13.❑ .
comp.insurance required.)
*Any applicant chat checks box St must also fill out the section below showing their workers'compensation policy information.
t Honuwwncrs who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 entlities have
employees. If the sub-contractors have employees.they must provide their workers'comp.polies number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy aired,job site
information.
Berkshire Hathaway Guard
Insurance Company Name; _ �-
Policy#or Self-ins.Lic.It: R2WC202869 Expiration Date: 04/27/20 3
Job Site Address: 61 w t5`k 4 City/State/Zipr 1Y-0
Attach a copy of the workers'compensation policy declaration page(showing the policy number and atimn date).
Failure to secure coverage as required under Station 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1.500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK OR$)Ek and a fine
of up to 8250.00 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:
Pb i1: Date: I I (1_ fil '
413-203-5888 14"#PC-11
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/Lieense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityli'own Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
DATE(MAI/DD/YYYY)
Ati C)RII CERTIFICATE OF LIABILITY INSURANCE T MU D(YY
2022
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 be endorsed. If SUBROGATION IS WAIVEf,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 I CONTACT msma fed ett, CISR
NAME: Q .. ..
Webber & Grinnell PHONE (413)586-0111 FAX aulse6 4$1
tMC,No.ERG: IIVC.Not
8 North King Street oMAI ass aedgettOwebborandgrinnell,Coa1
INSURER(S)AFFORDING COVERAGE NAIL e
Northampton MA 01060 INSURER A.Crum & Forster Specialty/BRECR
INSURED INSURER B:Plymouth Rock Assurance __ 14737
Peak Performance Roofing, LLC INSURERc:WCAR— Berkshire Hathaway GUARD
-
Attn: James Flannery INSURER D.
1 Lovefield Street INSURER E
Easthampton MA 01027 INSURERF:
COVERAGES CERTIFICATE NUMBER:Zip 06/23 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iiirr$
LTR TYPE OF IN311RAMCE INS! WV!)ISUBR POLICY EFF POLICY EXPWV!) POLICY NUMBER IlA YI DOVYYY tNINAN lYYYYf
X COMMERCIAL GENERAL LIABILITY
INSR
EACH OCCURRENCE 1,000,000
A CLAIMS-MADE I OCCUR DAMAGE TO RENTED 100,000
PREMISES(Ea=wrens* f
GL0089451 7/7/2022 7/7/2022 MED EXP(Any one person) S 5,000
— PERSONAL&ADV INJURY $ 1,000,000
GEM.AGGREGATE IJMITAPPUESPER: GENERAL AGGREGATE $ 2,000,000
Z POLICY JECT. LOC PRODUCTS•COMP/OPAGO $ 2,000,000
OTHER S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000
(Ea ecOderl0
B ANY AUTO BODILY INJURY(Per per I) 8...
ALL OWNED SCHEDULED
AUTOS x AUTOS PRC00001007091 6/27/2022 6/27/2021 BODILY INJURY(Per aced ) S
E X NON-OWNED PROPERTY DAMAGE
HIRED AUTOS AUTOS (Per accdent)
Medea payments 1 5,000
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION PER 0TH'
,AND EMPLOYERS'LABIUM YIN _ STATUTE I ER ,
ANY PROPRIETOR/PARTNER/EXECUTIVE NIA EL EACH ACCIDENT $ S00,000;
_ OFFICER/MEMBER EXCLUDE? R2HC342657 4127/2022 6/27I2023
pMndelory In NM) EL DISEASE-EA EMPLOYEE $ 500,000
N yyeess descrbe wider
DESCRIPTION OF OPERATIONS below .lames Flannery is excluded EL DISEASE-POLICY MIT $ 500,000
I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it mote space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES as CANCELLED BEFORE
Proof Of Insurance THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE A
W Grinnell, CPCU, CIC fl� .-.-) .-y+-1 4Y
')�1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025:2IJ14U ;
offer 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 1$
1 LOVEFIELD ST. Expiration; 11/01/2022
EASTHAMPTON,MA 01027
Update Address and Relm''l.•
17
Otfic%uT ConsumeirAtfafrs ar8usfness Regalia!jj�
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. if found return to:
Regiskation 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. fe"-1
fff
EASTHAMPTOK,MA 01027 Undersecreta ry Not alid without signature
® _— Commonwealth of Massachusetts
D v,s,on of Professional Ljcensure
Board of Budding Regulations and Standards Construction Supervisor
Unrestricted-Buildings of any use group Which contain
less than 35,000 cubic feet(991 cubic meters)of enclosed
space
CS-103061 Expires 0912U 2 2.4
JAMES J FLANNERY
1 WILUAMS ST
HOL..YQKE MA 01040
�, Q ✓2 Failure to possess a current edition of the Massachusetts
I�/L�_ State Building Code is cause for revocation of this license.
Commissioner
For information about this license
Call 1617)727-3Z00 csr visit WWW,.fltdtr-gov/dpi
112f3iv e cliZq (;oZL
tf tc, 14 e " k ,'o( d4eI G4
a5 c /2/ (2 bZ
4.01pro!:.f The City of Northampton
Building Department
• •�47 212 Main Street
°4hrED
Northampton. Massachusetts 01060
Phone (413) 58%-1240
Fax (413) 587-1272
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVAT ION PROJECTS)
In accordance with the provisions of MGL c40, 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, s150A.
The debris will be disposed of in: A/le/6i (Lc,.
Location of Facility
Ptiti o
The debris will be transported by:
Name of Hauler 61"-`S7/C(//
Signature of Date:
Applicant: 1 z
P
DocuSign Envelope ID:A5312559-563C-49A1-BCD5-8ED59A5C4319
Peak Performance Roofing LLC
1 Lovefield St.
Easthampton, MA 01027
413-203-5888 P E
peakperformanceroofingllc@gmail.com PERFOR C E
R OO F I N G
MA HIC #183698 MA CSL#103061
Elizabeth Witte & Frank Victor
Rawlings
587 Westhampton Rd. Florence, MA
E:734-395-3806 F: 617-529-9451
witte.elizabeth@gmail.com
ESTIMATE#
10836 11/04/2022
JOB LOCATION
587 Westhampton Rd.. Florence
ACTIVITY DESCRIPTION QTY RATE AMOUNT
Asphalt 1. Remove the existing roofing shingles. 1 1: 950.00 16,950,00
Residential
2. Inspect the sheathing for any rot or deterioration. Any new plywood necessary
will be $80 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 PRO: MAX DEF COBBLESTONE GRAY
https 1/www.certainteed.com/residential-roofing/products/landmark-pro!
7. Install Shingle Vent II ridge vent on peaks of roof (where applicable).
https://www.certainteed.comiresidential-roofing/products/certai nteed-ridge-vent-
12-filtered/
8. Complete all necessary flashings including new LIFETIME 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 DEBRIS
THAT MAY FALL INTO ATTIC.
DocuSign Envelope ID:A5312559-563C-49A1-BCD5-8ED59A5C4319
ACTIVITY DESCRIPTION QTY RATE AMOUNT
Please use reasonable caution during the installation process: do not walk or
drive under active work or on areas of potential roofing debris. Installations are
weather permitting; inclement weather will cause scheduling delays.
Peak Performance Roofing will obtain the building permit.
Warranty confirmation shall be provided upon final payment. Installation and
manufacturer warranties are not in effect until Paid In Full.
Includes CertainTeed Lifetime Limited Warranty (Transferable) with 10 year
SureStart period.
https://www.certainteed.com/resources/Asphalt Warranty_CTA3782 1912 E.pdf
Total: $16,950
A one-third deposit of $5650 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.
TOTAL $16,950.00
Docu3ipnad by:
, ,L 'r4 r'a1AtnlS 11/4/2022
Accepted By `-598FCC96C13764132. Accepted Date