12C-006 (4) B P 022-0956
44 NORTH FARMS RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
12C-006-001 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-2022-0956 PERMISSIONISHEREBYGRANTE I TO:
Project# roof Contractor: License:
PEAK PERFORMANCE ROOFING
Est. Cost: 16125 LLC CS-103061
Const.Class: Exp.Date:09/21/2022
Use Group: Owner: GELLER HUGHES, THEODORE, Q. & LLEN
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:08/11/2022
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 V IO ATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: V
•• Tal
yU Q
I
Fees Paid: $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
DocuSign Envelope ID:09DC7A08-118A-4380-87F1-06F5028BCEED
The Commonwealth of Massachus s ' G
Board of Building Regulations mid Sta dards 0 2
il�>` 022 OR
C �LITY
Massachusetts State Building Code,7: "
(
OF USE
1.
Building Permit Application To Construct, Repair, . n'�/ .b$�ir Rev( ed Mar 2011
One- or Two-Family Dwelling otoso
This Section For Official Use Only •
Buildin Permit Number: C - q £S Date Applied:
•
tl,L) Koss _1/12 �-lI zDzZ
Building Official(Print Name) Signature I)ItCC
SECTION 1: SITE INFORMATION
1.1 Property Address: 44 North Farms Road 1.2 Assessors Map& Parcel Numbers
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 It) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Sine Yards 1 Rear Yard
Required Provided Required Provided Required I Piolided
1.6 Water Supply:(M.Ci-L c.40,b54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Uuuidc Flood Zone? Munii.tpal 0 Gn site disposal system 0
Ciurcl.if yes❑ _--
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: Dean&Linda Flower Haydenville, MA
Name(Print' 44 North Farms Road City,State.ZIP
413-268-7725 Imfh23@icloud.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 13 Existing Building 0 Owner-Occupied 0 I Repairs(s)x❑ Alteration(s) 0 Addition ❑
Demolition Cl Accessory Bldg.0 Number of Units Other 'E7 Specify: Hooting
Brief Description of Proposed Work`: Strip & replace asphalt rooting
SECTION 4:ESTIMATED CONSTRUCTION COSTS
item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building S 16125 1. Building Permit Fee: S Indicate bow fee is determined:
❑Standard City/Town Application Fee
2.Electrical ? S 1
❑Total Project Wit;(Item 6)x multiplier %
3. Plumbing i S 2. Other Fees: S
4.Mechanical (1IVACj S List:
S.Mechanical (Fire
Suppression) Total All Fees:S /�
16125 Check N I#4) Check Amount: ( O Cash Amount:
6.Total Project Cost: S 0 Paid in Full 0 Outstanding Balance Due:
DocuSign Envelope ID:09DC7A08-118A-4380-87F1-06F5028BCEED
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) • L-10 / 1/2 2
James J. Flannery
License Number Expiration Date
Name of CSL I'older U
List CSL Type(see below)
No.and `
r r Type Description
I olyoke, MA 01040 v Unrestricted(Buildings up to 35.000 ft '
R Restricted 1S:2 Family Dwelling
City/Town,State,ZIP M Masonry
RC hoofing Covering
I { WS Window and Siding
413-203-5888 peakperformanceroofingllc@gmail.coml SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 vex.ast-eriormano oxemee ting, LL ,. (HIC) 183698 11/03/2023
i I IC kcgistration Number F_Xnrrattor,Date
HIC f rrariffie rsj-UIC Registrar;Name peakperformanceroofingllc@gmail.com
No;and Sheet Easthampton, MA 01027 413-203-5888 Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION I_NSURAI'CE 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 0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN -OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDItN'G PERMIT
James J. Flannery / Peak Performance Roofing LLC
1,as Owner of the subject property. hereby authorize
to act on my behalf.in all matters relative to work authorized by this building permit application.
tosiaseregfr
(J >✓'fewcr 8/4/2022
'miner s. dme(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that al] of the information
contained in this application is true and accurate to the best of my knowledge and understanding,
James J. Flannery 816. 2-0 -2-
'
Print Owner's or Authorized Agent's Name(El 'c gnature) Jaetc NOTES:
1. An Owner who obtains a building permit to do his/her owns 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
;^ww.mass.tt ovioca Information on the Construction Supervisor License can be found at www mass.iov/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/batlts
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"
�rsrro , The City of North amp ton
Cfi'
Building Department
; 212 Main Street
'1*19/441
1
04'0 NOrthaMIXOn, Massachusetts 01060
Phone(413)587-1240
Fax(413) 587-1272
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOI:ITION AND RENUVAT ION PROJECTS)
In accordance with the provisions of MGL c40. s54, a condition of Building Permit
Number is that ail debris resulting from this work shall be disposed of in a
property licensed waste disposal facility as defined by MGL c 1 1 1, s150A.
The debris will be disposed of in: V ,A)6}741-64/VV-1
Location of Facility " /! 1 " I ((44-
The debris will be transported by:
/r/ALe
Name of Hauler
Signature of Applicant: Date:
The Commonwealth of Massachusetts
wi Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
'" • ;: www.mass.gov/dla
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electrician
Applicant Information • Phrase Prill L. Ibly
Name(Bush .+/Organizati inMdivaddai): Peak Performanco. _Roofing. LLc_
Address; 1 Lovefield St
City/State/Zip: Easthampton, MA 01027 Phone#: 413-203-5888
ar_e ra!Il lYlpby.r?Check the appropriate box.:
1. am a employer with 4 4. ❑ 1 am a general contractor and 1 1 Witte(roegl�ed):
employees(full and/or past-time); have hired the sub-contractors b. ❑New raristzuctien
2.0 1 ant a sole proprietor or partner- listed on the attached sheet. 7. 0 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 come.insurance,t
required.] S. ❑ We arc a corporation and its 10,❑Electrical rcpalrs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself.(No waiters'comp. right of 1(4)� 12,FiRoof repairs
insurance required.) c. 13.❑Other
employees.(No workers'
comp.insurance required.]
`Any apphcaat that checks box it must also fill out foe section below showing their workers'compatuttios paltry iafie>dfioo. _
Homeownen who submit Ibis affidavit indicating they arc doing all wodt and thsa hire outside eoastsaaes mist auhssit a new affidavit such,
!"Contractors that chock this box must attached as additiusal sheet showing the some sidle and state whether or not those entities base
employees. If the sub-contractors have employees,they must proi.id then wadtmra'coup.policy number.
I am an employer that is providing workers'compensation Insurance for my employees. Below is the policy aid.*site
information. Berkshire Hathaway Guard
Insurance Company Name:
Policy s or Self-ins.Lie,a: R2WC202869 Expiration Date: A4/27/2o23
lob She3?
Address: IN �� �ran� � citistmt�rzi � �'�� �'a
Attach a copy of the welters'compensation policy dedication page(shawls&the policy number and ea parades date).
Failure to secure coverage as required under Swim icm 25A of MOL e.152 can lead to the imposition of criminal penalties of a
fine up to 51.500.00 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,
l do hereby certify under the pains and penalties of perjury that the information provided above is true and orrc1,
Signature: Dale: . 61i2,
Phone t
413-203-5888
Official use unl}'_ Do nut write in this area,to be completed by city or ton official.
City or Town: Penult/License s
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cliylfown Clerk 4.Electrical Inspector 3.Plumbing Inspector
6.Outer
Contact Person: _.._... --.--_ Phone a: ,._.____........... . . .-
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 Cart,
o K) 4JJ17
it w/iviio/ii• , /4 i//aiir//d
Mc of Consumer ATafrs E t3usMess 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
1 LOVEFIELD ST. C/-r�:<% '-w/.%:r1
EASTHAMPTON,MA 01027 Undersecretary Not valid
lid without signature
® V Commonwealth of Massachusetts
Division of Professional Licensure Construction Supervisor
Board of Budding Regulations and Standards Unrestricted -Buildings of any use group which contain
:0114tri:Ct1071 less than 35,000 cubic feet(991 cubic meters)of enclosed
space.
CS-103061 Expires 09/21II:Er i_
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01040
Q /� Failure to possess a current edition of the Massachusetts
Commissioner (v, -__ //i•••~ 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
111.1la woad 8 ( c V.Q °A`iviz
A tIaLLj t,LAitAn card S
AcORcf CERTIFICATE OF LIABILITY INSURANCE D T,s� 022Y'
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 poltcy(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 CONTACT Adina Edgett, CISR
NAME. 9
Webber & Grinnell v HONNo.Exg,
A (413)586-0111 tstSI660-4161
8 North King Street EMAIL SS l@ aedgettwebberandgrinnell.com
DDRE
INSURERIS) AFFORDING COVERAGE NAIC I
,
Northampton MA 01060 iINsuRERA,Crum S Forster Specialty/HRECK
INSURED 1
1 INSURER B.P11:tgth Rock Assurance 9<A9$9
Peak Performance Roofing, LLC INSURER C;WCAR.- Berkshire Hathaway GUARD
Attn: James Flannery INSURERD; �
1 Lovefield Street INSURER
es
Easthampton MA 01027 INSURERFs I
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 i POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMM/DD/YYYY) 1(MM/DWYYYY) LIr'S
X COMMERCIAL GENERAL LIABILITY LALH cH 6 U NPfi $ 1,000,000
fiMAiA NT
A wain
-woe silimmiaimisilffm., f 100,000
GL0089451 7/7/2022 7/7/2023 Mf0 EX►(My rot wolf 'If 5,000
—
PeRSONAL a PM INJURY i 1,000,000
6EMLA6GRECIATE WIT ANLII!.PER: OMR&A001MOATE A 2,000,000
1,0LIC'n QLOC •
.. 2,000,000
PRODUCTS=CCIrOP AAQ $
OT HEN f
AUTOMOBILE UABILITY . fLFaAiiWla SLai r s 1,000,000
B ANY AUTO HOOKY INJURY(�N/MpIA ($
..
AtAutoALLOstD f x_4 AU TUSULEL' PRC00001007091 6/27/2022 6/27/2023 N.Y INJURY ror assamme f._...
HIRED AUTC)fi X I NON-UWNE[7
AUTOS i1� j
L— �1 i 1,000
UMBRELLA UM) OCCUR ' EACH OCCURRENCE $ _ _7
EXCESS LIAR CLAIMBMAM
MOT—
fit IEN1IUN 1 A , 1
WORKERS COMPENSATION l!R iau E--T T ----
AND EMPLOYERS'LIABILITY Y/N s t _. 4
i.r;r P40PI11E IOIVNANTNERJEXECUTAE C.EACH ACCIOLNT } 5007 000
_�I r ICER'MF1AULTi EXCWOEO7 Q LA
N/A
C (Mandatory in NH) R2WC342657 4/27/2022 4/27/2027 ELF=EAEMLoYee ) 500f000
+e5.deu Ge under
__SCI+,IF I ION OF OPERATIONSDBi0F .laces Flannery is excluded ELOIEEAU=P JCY1Mf S 500,000
, 1
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule.may be attached i1 more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Proof of Insurance THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE W Grinnell, CPCU, CIC 1A., % ` ;,
t 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025 :,;1�,1
DocuSign Envelope ID:09DC7A08-118A-4380-87F1-06F5028BCEED
Peak Performance Roofing LLC
1 Lovefield St.
Easthampton, MA 01027
413-203-5888 P E
peakperformanceroofingllc@gmail.com P E R F O R ANC E
ROOFING
MA HIC#183698 M CSL#103061
ADORE
Dean and Linda Flower
44 North Farms Road
Haydenville, MA 01039
413-268-7725
Imfh23@icloud.com
ESTIMATE#
10760 08/03/2022
JOB LOCATION
44 North Farms Rd, Haydenville
ACTIVITY DESCRIPTION QTY RATE AMOUNT
Asphalt 1. Remove the existing roofing shingles 1 16,125.00 16,125.00
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 CertainTeed Winterguard ice and water shield on eaves,
three feet in any valleys, and three feet around all penetrations
4. Cover the remaining roof with CertainTeed RoofRunner synthetic
underlayment.
https://www.certainteed.com/residential-roofing/products/roofrunner/
5. Install new 8" aluminum drip edge on all eaves and rake edges
6. Install architectural shingles by CertainTeed:
Landmark PRO: MAX DEF PEWTERWOOD
https://www.certainteed.com/residential-roofing/products/landmark-pro/
7. Install Shingle Vent II ridge vent on peaks of roof(where applicable)
https://www.certainteed.com/residential-roofi ng/products/certainteed-ridge-vent-
12-filtered/
8. Complete all necessary flashings including new LIFETIME pipe boots and
base flashing around chimney
9. Replace existing bathroom fan vents with 2 new Broan vents
DocuSign Envelope ID:09DC7A08-118A-4380-87F1-06F5028BCEED
ACTIVITY DESCRIPTION CITY RATE AMOUNT
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 on 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_ CTR37821912E.pdf
TOTAL: Landmark PRO shingles=$16.125
A '/DEPOSIT OF$5,375 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 $16,125.00
-DocuSigned by.
blln,A cuA,41, �,(AA FLbWtY 8/4/2022
Accepted By -EFoc1Daeaa20 Accepted Date