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24C-118 (2) BP-2022-0431 10 FIFTH AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-118-001 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-2022-0431 PERMISSION IS HEREBY GRANTED TO: Project# Contractor: License: PEAK PERFORMANCE ROOFING Est. Cost: 9860 LLC CS-103061 Const.Class: Exp.Date:09/21/2022 Use Group: Owner: QUINTEROS GUILLERMO& ELSIE M PARRILLA 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:04/26/2022 TO PERFORM THE FOLLOWING WORK: STRIP AND RESHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.VV. 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: r yQ� 0 1 • Fees Paid: $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner DocuSign Envelope ID:341D0162-CE7B-49C4-91F4-39DA2F6BAO7E f C— / RECF The Commonwealth of Massachusetts APR 2 2 2Q22 ** Board of Building Regulations and Stand FOR t i Massachusetts State Building Code,7(80 --- W MLIIJIUCl AL1TY ^.OF Rill D� tNspEC i GN;; SE Building Permit Application To Construct,Repair,Renovate'or Peth I f ai ev scd Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number:$P— }- Lf 31 Date Applied: I 5 YZ y-25-2OZZ Building Official(Print Name) Signature Date SECTION I:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 10 Fifth Avenue 24C-118-001 1.1 a Is this an accepted street?yes no Map Number Parcel Number 11.3 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: Public 0 Private 0 Zone: ^ Outside Flood Zone? Municipal 0 On site disposal system El Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Elsie Parrilla Northampton, MA 01060 Name(Prim) City,State.ZIP 10 Fifth Avenue 413-559-0106 elsieparrilla@msn.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 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 Work: Strip and replace asphalt roof SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building S 9,860.00 1. Building Permit Fee: S Indicate how fee is determined: 2.Electrical S ❑Standard City/Town Application Fee 0 Total Project Costs(Item 6)x multiplier x 3.Plumbing S 2. Other Fees: S 4.Mechanical (UVAC) S List: 5.Mechanical (Fire Suppression) Total All Fees:S Check No.'1 0):I Check Amount ° Cash Amount: 6.Total Project Cost: S 9,860.00 0 Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:341DD162-CE7B-49C4-91F4-39DA2F6BAO7E 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 j _ 'Unrestricted(Buildings up to 35.000 cu. IL) R Restricted l&.2 Family Dwelling C'itvrl'own,State,ZIP j lvt Masonry RC Roofing Covering WS Window and Siding 413-203-5888 peakperformanceroofingllc@gmail.corr>j SF Solid Fuel Burning Appliances Insulation Telephone Email address D DemoIition 5.2 Registered Home Improvement Contractor(HIC) 183698 11/03/2023 Peak Performance Roofing LLC hIIC Registration Number Expiration hate 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 Us1SURANCE 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. 1 Signed Affidavit Attached? Yes No . 0 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 ail matters relative to work authorized by this building permit application. DocuSigned by: 4/13/2022 Elsie Parrilla _ Print Owner's Name(El runtik y Ip,{g); Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION I3y 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 lotowledge and understanding. i)James J. Flannery ` U Print Owner's or Authorized Agent's Name(Electronic Signature) Datte 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 cau be found at w.ww.mass.<eov/oca Information on the Construction Supervisor License can be found at wwv.mass.gov!dos 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage,finished basementiattics,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:341 DD162-CE7B-49C4-91 F4-39DA2F6BAO7E City of Northampton p� Massachusetts .1 DEPARTMENT OF BUILDING INSPECTIONS ...:. 10)) ., 4: Jr 212 Main Street • Municipal Building yNorthampton, MA 01060 i',.y,, x,)x\ CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, SS4, 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: W/;/ ;%i The Commonwealth of Massachusetts Department of Industrial Accidents 0 4 Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationhlndividual): Peak Performance Roofing, LLC Address: 1 Lovefieid St. City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888 Are ypu an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4 4. l I am a general contractor and I employees(full and/or part-time).* have hired the sub contractors b. New construction 2.[1 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 workingfor me in anycapacity. 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.❑ Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.[ Roof 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 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. Berkshire Hathaway Guard Insurance Company Name: Policy#or Self-ins.Lic.#: R2WC202869 Expiration Date: 4/27/2022 /ff,, �/ 1 AC D/o� Job Site Address:< V ,�� / ' "`��`� CityiState/Zip:�� " "' ' 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. Signature, , "' ' I' Date: Li 1Z02-2 413-203-5888 �� f Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License it 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#: ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 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 (A/C,No,Ext): (A/C,No): 8 North King Street E-MAIL aedgett©webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC iF 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 INSURERF: 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 (MMIDD/YYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGE TO 000 CLAIMS-MADE X OCCUR PREMISES(Ea occu erx:e) $ 300'000 MED EXP(Any one person) $ 5,000 A CA00003521803 07/07/2021 07/07/2022 PERSONAL a ADV INJURY $ 1,00Q000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY PELT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER Employee Benefit $ 2,000,000 AUTOMOBILE LIABILITY IS BlN )-SIN©LE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED /�X SCHEDULED PRC00001007091 06/27/2021 06/27/2022 BODILY INJURY(Per accident) $ AUTOS ONLY . AUTOS XHIRED \/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /\ AUTOS ONLY (Per accident) _ Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH X PEATUTE ER AND EMPLOYERS'LIABILITY Y I N C ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A R2WC202869 04/27/2021 04/27/2022 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) El.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 CO 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ✓/Gt�% F 7mT.veeoeezgi6> v''r_%at/.CIe/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 ti Update Address and Return Card. sCA t 0 20M-0SHyy7 Offfc of Consumer A faairrsss it 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 -Suits 710 PEAK PERFORMANCE ROOFING,LLC. Boston,MA 02118 JAMES FLANNERY 7 r t;It 1 LOVEFIELD ST. EASTHAMPTON,MA 01027 Undersecretary Not valid without signature 117 Commonwealth of Massachusetts Division of Professional Licensure Construction Supervisor Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain Construction Supervisor ,W�)% less than 35,000 cubic feet(991 cubic meters)of enclosed space. CS-103061 Expires:09/21(1;11;C', JAMES J FLANNERY 1 WILLIAMS ST HOLYOKE MA 01040 /j _ Failure to possess a current edition of the Massachusetts Commissioner c%— �4i�' State Building Code is cause for revocation of this license. For information about this license j� y ,/1 Call(617)727-3200 or visit www.mass.gov/dpl t' Itj Wkfin Ca ft)S . DocuSign Envelope ID:341DD162-CE7B-49C4-91F4-39DA2F6BAO7E 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# 10635 Elsie Parrilla& Guillermo DATE 04/07/2022 Quinteros 10 Fifth Avenue, Northampton,MA E: 413-559-0106 G: 413-695-5170 elsieparrilla@msn.com guillermoquinteros2017 @ g mail.com DESCRIPTION 1. Remove the existing roofing shingles and the antenna. 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) ** Worst case scenario if it determined that we need to install 1/2" CDX plywood over the entire roof surface,the price will be $5,000** 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) https://www.certainteed.com/residential-roofing/products/landmark-pro/ Color Choice: MAX DEFINITION COLONIAL SLATE 7.Install Shingle Vent 11 ridge vent on peaks of roof(where applicable) https://w ww.certainteed.com/residenti al-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 DocuSign Envelope ID:341 DD162-CE7B-49C4-91 F4-39DA2F6BAO7E DESCRIPTION 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. Total: Landmark PRO shingles=$9,860 A one-third deposit of$3,200 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 $9,860.00 Dock'Si nedbr 4/13/2022 Accepted By Accepted Date 636D673043FA427..