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24C-013 (4) BP-2023-0659 265 PROSPECT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-013-001 CITY OF NORTHA1!'IPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARAfTY FUND (MGL c.142A) BUILDING P RMIT Permit# BP-2023-0659 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: PEAK PERFORMANCE ROOFING Est. Cost: 9000 LLC CS-103061 Const.Class: Exp.Date: 09/21/2024 Use Group: Owner: NORTHAMPTON CITY OF RECREATION DEPT Lot Size (sq.ft.) Zoning: URB Applicant: PEAK PERFORMANCE ROOFING LLC Applicant Address Phone: Insurance: 1 LOVEFIELD ST 413-203-5888 R2WC342657 EASTHAMPTON, MA 01027 ISSUED ON: 05/22/2023 TO PERFORM THE FOLLOWING WORK: POWER WASH, REPAIR AND APPLY GACOFLEX 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: ( i Tit I Fees Paid: $ 212 Main Street,Phone(413)587-1240,Fa 4. (413)587-1272 Office of the Building Commiss oner tU4/1- IUC9 Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: MAY 1 8 2023 Building Department Curb Cut/Driveway Permit f 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability WEPT. '--.-_..-_.-_..._......_.-___j RT saTNc;INSPECTIONS Northampton, MA 01060 Two Sets of Structural Plans non ON.MA 01060 "'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 This section to be completed by office 1.1 Property Address: Map Lot Unit 265 Prospect St, Northampton Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: City of Northampton 210 Main Street Name(Print) Current Mailing Address: 413-587-4900 Signature Telephone 2.2 Authorized Agent: James J. Flannery/ Peak Performance Roofing LLC 1 Lovefield St., Easthampton MA 01027 Name(Print) Current Mailing Address: 413-203-5888 �a}"Q" �ahhvrl Signature ( Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 9000 (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= (1 +2 +3 +4 +5) 9000 Check Number *72( This Section For Official Use Only Building Permit Number Date 2 11 Issued , 01 Signatur : `-5/) 9 3 Building ommissioner/Inspector of Buil s Date Version1.7 Commercial Building Permit May 15, 2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration 0 Existing Ground Sign❑ New Signs ❑ Roofing 0 Change of Use❑ Other ❑ Brief Description FLAT ROOF: Power wash, repair, and apply GacoFlex per manufacturer's specifications. Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ElA-1 ❑ A-2 ElA-3 ❑ 1A I El A-4 ❑ A-5 ❑ 1 B ❑ B Business ❑ 2A El E Educational ❑ 2B I El F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard 0 3A El I Institutional ❑ I-1 El 1-2 ❑ 1-3 El 3B El M Mercantile ❑ 4 ❑ R Residential 0 R-1 ❑ R-2 ❑ R-3 El 5A ❑ S Storage ❑ S-1 ❑ S-2 El 5B I El 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 St 15t 2nd 2nd 3rd 3rd 4th 4th 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 ❑ Private ❑ Zone Outside Flood Zone❑ Municipal 0 On site disposal system Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes n No w SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT City of Northampton , 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. City of Northampton Signature of Owner 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 a.11^,eS ar.rer . 5/15/2023 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 09/21/2024 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❑ 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: Northampton Survival Center, 265 Prospect St. The debris will be transported by: Aaron's 24/7 & Roll-Off The debris will be received by: Valley Recycling, 234 Easthampton Rd., Northampton MA 01060 Building permit number: Name of Permit Applicant James J. Flannery, Peak Performance Roofing, LLC 5/15/2023 �ame CaN.rer Date Signature of Permit Applicant ..,-, The Commonwealth of Massachusetts Department of Industrial Accidents k ,:,,,,,, '"--.7.--•,7-1 Office of Investigations ), 600 Washington Street Boston,MA 02111 www.tnass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Peak Performance Roofing, LLC 1 Address: Lovefield St. Easthampton, MA 01027 413-203-5888 City/State/Zip: Phone #: , II Are y;on att employer? Check the appropriate box: i Type of project(required): I.WI am a employer with_.,4,____ 4. i 1 I am a general contractor and 1 i 1 6 Fl New construction employees(full and/or part-time).* have hired the sub-contractors - 2.[1 I am a sole proprietor or partner- listed on the attached sheet. 7. ri Remodeling ship and have no employees These sub-contractors have 8. —1 Demolition . working for me in any capacity_ employees and have workers" 9. ri Building addition [No workers comp.insurance comp.insurance.* required.1 5. fl We arc a corporation and its io.fl Electrical repairs or additions 3.LI I am a homeowner doing all work officers have exercised their i 11.0 Plumbing repairs or additions right of exemption per MGL myself. [No workers' comp. 12.gRoof repairs insurance required.] * c. 152.§1(4).and we have no 1 employees. [No workers' 13.1— Other, comp.insurance required.] .., . . n) 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 are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that cheek thi..box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities hine 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 sh`c information. Berkshire Hathaway Guard insurance Company Name: Policy it or Self-ins.Lie. ti: R2WC202869_ ___ Expiration Date: 04/27/2024 _ Job Site Address; Northampton Survival Center, 265 Prospect St. cityistateizip:___No .Ma _ 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 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, ,1: 5/12/2023 Signature: C r „-,1 413-203-5888 Phones: Official use only. Do not write in this area,to be completed by city or town official. City or Town; PermitiLicense# Issuing Authority(circle one): 1.Board or Health 2.Building Department 3.City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone #: .... . ® A� CERTIFICATE OF LIABILITY INSURANCE DAT/(M /202Y ) 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 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 CONTA g CT 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 E-MAIL aed ett@webberand rinnell.com ADDRESS: g g INSURER(S) AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA:CrUm & Forster Specialty/BRECK INSURED INSURER B:Plymouth Rock Assurance 14737 Peak Performance Roofing, LLC INSURERC:WCAR- Berkshire Hathaway GUARD Attn: James Flannery INSURER D: 1 Lovefield Street INSURERE: Easthampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER:Exp 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 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 TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 100,000 GL0089451 7/7/2022 7/7/2023 MED EXP(Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY OTHER: PRO- JECT LOC PRODUCTS-COMP/OP AGG $$ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED PAC00001007091 6/27/2022 6/27/2023 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X AUTOS (Per accident) $ X HIRED AUTOS Medical payments $ 5,000 UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? Y N/A C (Mandatory in NH) R2WC342657 4/27/2023 4/27/2024 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below James Flannery is excluded E.L.DISEASE-POLICY LIMIT $ 500,000 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 /J W Grinnell, CPCU, CIC !r,4/�_ '---k ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(zo14o1) • e • tv.imnenipeez_ .. / 0 - ,"/ ia,,,646tY* ,I,ki . ,st.i. 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 11/0312023 EASTHAMPTON,MA 01027 i'. Update Address and Return Card. SCA 1 0 2041.06/17 Offriftif gri;i61;iro(17a6iLeduitt<ivigt/gUitliitl' HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LW before the expiration date. If found return to: aafiligrAdi911 Expiration Office of Consumer Affairs and Business Regulation , 183698 1/103/2023 1000 Washington Street -Suite 710 PEAK PERFORMANCE ROOFING,LLC Boston,MA 02118 Ames FLANNERY 1 LOVE r''.*'''1 Crt RELD ST 104.t....0 4,241(ovvi' EASTHAMPTON,MA 01027 Undersecretary Not valid without signature Commonwealth of Massachusetts tk )IV Division of Occupational Licensure - Board of Budding Regulations and Standards ,E1 r • ° • ' Cons - . - - - tsar , ‘ . CS-10306i ires: 09/21/2024 As, JAMES J FLSMN `,,;•••' 1 LOVEFIEUYSTS, * EASTHAMPT4N •, :47: 4 7 * *,,c)s• , 4'6 1,LV AP-1 ' I, c-117 *is Commissioner dei..,.. ,I. ,1 „.....,-; ,,- . 1 DocuSign Envelope ID:765343FB-137F-423C-8804-2C0A8D07302A Peak Performance Roofing LLC 1 Lovefield St. Easthampton, MA 01027pE K 413-203-5888 "' peakperformanceroofingllc@gmail.com P E R F 0 R C E ROOFING MA HIC #183698 MA CSC#103061 ADDRESS Northampton Survival Center Heidi Nortonsmith, Executive Director Chris Oakley, Office Manager 265 Prospect St. Northampton heidi@northamptonsurvival.org, chris@northamptonsurvival.org 413-586-6564 ES ATE. 10955 05/11/2023 JOB LOCATION 265 Prospect St. Northampton ACTIVITY TICNI AMC r . ,,3 r. Flat Roofing FLAT AREA ONLY 1 9,000.00 9,000.00 Commercial 10 YR WARRANTY ROOF COATING 1. Powerwash the surface of the roof. 2. Make any necessary repairs including replacing Ice & Water Shield patching with EPDM patching. 3. Apply white GacoFlex S42 coating according to manufacturers specifications. https://gaco.com/product/gacoflex-s42/ *A Gaco representative will visit the site and inspect the roofing system to ensure it is a good candidate for this product. Upon completion of the job, there will be a final inspection prior to the issuance of the manufacturer warranty. 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/INTERIOR. 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. DocuSign Envelope ID:765343FB-137F-423C-8804-2C0A8D07302A ACTIVITY DESCRIPTION QTY RATE AMOUNT Peak Performance Roofing LLC 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. Total: $9000 A one-third deposit of$3000 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 $9,000 00 DocuSigned by: 1� L�U� 1461n.S►MIILI, 5/16/2023 Accepted By `-017BBC7S7CAE4CD Accepted Date