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30A-027 (7) • BP-2022-0169 22 LEXINGTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-027-001 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-2022-0169 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: PEAK PERFORMANCE ROOFING Est.Cost: 14300 LLC CS-103061 Const.Class: Exp.Date:09/21/2022 Use Group: Owner: BELUZO ASHLEY N & SIMON HILDT Lot Size (sq.ft.) Zoning: URB Applicant: PEAK PERFORMANCE ROOFING LLC Applicant Address Phone: Insurance: 1 LOVEFIELD ST 4132035888 R2WC202869 EASTHAMPTON, MA 01027 ISSUED ON:02/22/2022 TO PERFORM THE FOLLOWING WORK: NEW 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney': Final: 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 cgo, I I i Fees Paid: $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner DocuSign Envelope ID:35ABCFC4-5150-44AE-AEEA-DA45E31799AB C •-• -, The Commonwealth of Massachusetts r Er 8 2 , Fi* \ I• Board of Building Regulations and Standards 2VINICIPAL4T Massachusetts State Building Code,780 CMR / _ USE Building Permit Application To Construct,Repair,Renovate OrOetn44--.4—,., Revised Mar 2011 One- or Two-Fanzily Dwelling This Section For Official Use Only Building Permit Number: G," /01 Date Appled: Building Official(Print Name) Signature Datt SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 22 Lexington Ave. 30A-027-001 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(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,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 0 Private 0 — Municipal 0 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Simon Hildt Northampton, MA 01060 Name(Print) City,State,ZIP 22 Lexington Ave. 413-588-4795 shildt22@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building I Owner-Occupied 0 Repairs(s) I Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other Specify: Roofing. Brief Description of Proposed Work2: strip & re-roof in standing seam metal. SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1.Building $ 14,300.00 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical 0 Total Project Cost3(Item 6)x multiplier 3.Plumbing S 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Total All Fees:h Suppression) Check N4Ul t heck Amount: II° Cash Amount: 6.Total Project Cost: $ 14,300.00 0 Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:35ABCFC4-5150-44AE-AEEA-DA45E31799AB 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 I /,,t f l�•�C rn. Ste/—• List CSL Type(see below) U No.and Street I 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 SF Solid Fuel Burning Appliances peakperformanceroofinglIc@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 183698 11/03/2023 Peak Performance Roofing LLC 111C 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.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. DocuSigned by: Simon Hildt S;it obt, 12/10/2021 Print Owner's Name(Electronic Signature) 49946163F65341A... Date SECTION 7b: OWNER1 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 understanding. James J. Flannery � ../4/ 22 Print Owner's or Authorized Agent's Name lec'!.is Signatty ate 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.govroca Information on the Construction Supervisor License can be found at www.mass.govldps 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:35ABCFC4-5150-44AE-AEEA-DA45E31799AB City of Northampton o�TnnM ro, _ 1 Massachusetts 5 . ,:L"s!cr� A./ ti Ai rti DEPARTMENT OF BUILDING INSPECTIONS 002 ;. ' J 212 Main Street • Municipal Building ZJ6, 1� Northampton, MA 01060 sf67`"0� 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 The debris will be transported by: Name of Hauler: Aaron's Roll-Off Service Signature of Applicant: James J. Flannery Date: 14 Z r ne uuminunweutin ud inussucnusetts Department of Industrial Accidents Office of Investigations I alma--�-r 600 Washington Street fist " Boston, MA 02111 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 you an employer? Check the appropriate box: Type of project(required): n 1.L� 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 �' 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 are 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.[V'Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.El Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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: 4/27/2022 a` Job Site Address: ? Cmi iunp ,MivA� /q �� City/State/Zip: Ai0f4- -) m M- O /060 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 $250.00 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 abov is tr e and correct. Signature: 31 Date: a 3I 72_ Phone#: 413-203-5888 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#: / Worker's Comoensation and Employer's Liability Policy 1'I,�°'Berkshire HathawayAmGUARD Insurance Company- A Stock Co. Insuran Policy Number R2WC202869 GUARD Renewal of R2WC130849 Ala Companies NCCI No. [21873] Policy Information Page(AR) [1]Named Insured and Mailing Address Agency _ �9 PEAK PERFORMANCE ROOFING LLC WEBBER &GRINNELL INSURANCE AGENCY, INC. 1 Lovefie d St 8 NORTH KING STREET Easthampton, MA 01027 Northampton, MA 01060 Agency Code: MAMAIN15 Federal Employer's ID XX-XXX1951 Insured is Limited Liability Co. (LLC) [2] Policy Period From April 27, 2021 to April 27, 2022, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident- each accident $500,000 Bodily Injury by Disease - each employee $500,000 Bodily Injury by Disease - policy limit $500,000 C. Refer to Residual Market Limited Other States Insurance Endorsement-WC200306B D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms ' [4] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium 27,082 Total Surcharges/Assessments $ $926.00 Total Estimated Cost 28,008.00 INTERNAL USE XX Page 1 - Information Page MGA :R2WC202869 WC 000001A Date :03/23/2021 MANOTE Issuing Office: P.O. Box AH, 39 Public Square,Wilkes-Barre, PA 18703-0020 • www.guard.com ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/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 Webber&Grinnell PHONE (413)586-0111 FAX (A/C,No,Ext): (A/C,No): (413)586-6481 8 North King Street ADDRIESS: aedgett@webberandgrinnell.com INSURER(S)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 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 AUUL SUHR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE1 0 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 BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO PRODUCTS-COMP/OP AGG $ 20 0,0 JECT LOC , 000 OTHER: Employee Benefit $ 2,000,000 AUTOMOBILE LIABILITY GOMBlNEl3SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED PRC00001007091 06/27/2021 06/27/2022 $ AUTOS ONLY X BODILY INJURY(Per accident)) X HIRED v NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per accident) AUTOS ONLY $ Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE EOTH AND EMPLOYERS'LIABILITY Y/N - C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A R2WC202869 04/27/2021 04/27/2022 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 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 I ,111« �� ©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 010.27 Update Address and Return Card. SCA 1 0 20M-05/17 Off(ce o ^f(or�l8ume� ��/�� / /(iv,i-)evr/riiir//-.' �fffairs&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 rt'f— "/ 1 LOVEFIELD ST, ec(weAd % !i- 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 `onstructton Supe.,,,,so,_ a� '1 less than 36,000 cubic feet(991 cubic meters)of enclosed +7. space. CS-103061 Expires: 09/21>t< JAMES J FLANNERY 1 WILLIAMS ST • HOLYOKE MA 01040 •0, • Qr Failure to possess a current edition of the Massachusetts Commissioner «w 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 'R L0.9_w t cQ 4. 0 QA-ALQ vne I il-e • w l -\n Ca Try S DocuSign Envelope ID 35ABCFC4-5150-44AE-AEEA-DA45E31799AB Peak Performance Roofing LLC 1 Lovefield St. P E 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# 10519 Simon Hildt DATE 12/08/2021 22 Lexington Ave. Florence, MA 01062 �^O 413-588-4795 shi1dt22@gmail.com JOB LOCATION . 22 Lexington Ave., Florence DESCRIPTION 1. Remove the existing roof materials 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 cliange based on market fluctuations) 3. Install 3'of CertainTeed Winterguard HT(High Temperature) ice &water shield at the eaves, and any applicable valleys. 2' at any applicable transitions/chimneys/skylights 4. Install synthetic underlayment on all remaining areas of the roof. 5. Install 24-gauge standing seam metal roof system. 16" wide panels with 1.5" mechanical lock seams. Brand: Sheffield or equal https://sheffieldmetals.com/products/metal-coils-sheets/ Color Choice: REGAL BLUE Note: Please let us know if the roof is to receive solar. If so, additional fasteners will be installed: clips 18"on center 6. Ensure the sheathing is cut at the ridge to allow for proper exhaust ventilation. Install vented "z" enclosures and fasten ridge cap to "z" enclosures. https://www.standingseamroofvent.com/roof-vent- products 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 THE ATTIC. Please use reasonable caution during the installation; do not walk or drive under active work, or on areas of potential roofing debris. Peak Performance Roofing will obtain the building permit. Expected installation: Spring 2022. Lead time on metal stock is currently estimated at 8 weeks. Installations are weather permitting. DocuSign Envelope ID: 35ABCFC4-5150-44AE-AEEA-DA45E31799AB DESCRIPTION ztt Standing seam total = $14,300.00 A 1/3 deposit of$4,700 will secure contract, material order,permitting, and priority scheduling. The balance shall be due upon completion, within 10 days of invoice date. Accounts past due 30+days subject to 2% finance charge monthly. Optional: Colorgard snow rails. Additional $30 per linear foot installed. Recommended for any areas where protecting people/vehicles/plantings/animals/gutters from sliding snow is a concern. Snow rails are installed last, or can be added at a later date. http://www.metalplusllc.com/documents/metalplus- colorgard-brochure.pdf TOTAL $14,300.00 Accepted By DocuSigned by. Accepted Date 12/10/2021 Siw,et&, 4994B163F65341A_.