30B-024 (5) BP 022-1311
21 LIBERTY ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30B-024-001 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-2022-1311 PERMISSION IS HEREBY GRANT, D TO:
Project# ROOF Contractor: License:
PEAK PERFORMANCE ROOFING
Est. Cost: 3200 LLC CS-103061
Const.Class: Exp.Date: 09/21/2024
Use Group: Owner: CURTIS CURTIS IRA& H I LARY
Lot Size (sq.ft.)
Zoning: URB Applicant: PEAK PERFORMANCE ROOFING LL
Applicant Address Phone: Insurance:
1 LOVEFIELD ST 413-203-5888 R2WC342657
EASTHAMPTON, MA 01027
ISSUED ON: 10/13/2022
TO PERFORM THE FOLLOWING WORK:
ROOF ON NEW ADDITION
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 VI I LATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: I
IS Tit *
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
DocuSign Envelope ID:FCD9C4EF-C126-4A5F-930D-922A948A5474
rl
�IVa
. O
., CT 1 �� / Thee Commonwealth of Massachusetts
"
FOR
., <C e2 //Boarld of Building Regulations and Standards
TY
, Masitachusetts State Building Code,780 CAR USE
qMn�'r3 n
ti N it lication To Construct,Re •ir,Renovate Or Demolish a Revised.t/dr2011
sA One- or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: fj.' I 2., I I Date Applied: i
eui Z Jti2 l0-13-z02.2.
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 21 Liberty St., Florence 1 'Asses ors31ap&Parcel iinmb ci
%(/lJ .
l.la Is this an accepted greet?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 i Rear Yard
Required Provided Required Provided I Required Provided
1.6 Water Supply:(M.G.L c.40,554) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private O Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yesID
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: Ira Curtis Florence, MA
Name(Print) 21 Liberty St. City,State,ZIP ira@cchonline.com
413-270-2336
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition Li Accessory Bldg. 0 Number of Units Other )i Specify: Roofing
Brief Description of Proposed Work2: Install asphalt root on new addition.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building s 3200 1. Building Permit Fee: S Indicate bow fee is determined:
0 Standard Cityl1'own Application Fee
Z.Electrical S 0 Total Project Cost'(Item 6)x multiplier x
3. Plumbing . S 2. Other Fees: S
4.Mechanical (I-1VAC) S . List:
S.Mechanical (Fire $
Suppression) Total All Fees: S __ j�
3200 Check No. ylg Check Amount: -v Cash Amount
j 6. Total Project Cost: 1 0 Paid in Full 0 Outstanding Balance Due:
DocuSign Envelope ID: FCD9C4EF-C126-4A5F-930D-922A948A5474
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) L-1 3 61 09/21/2 24
James J. Flannery
• License Number `;xpiration Date
Name of CSL Holder U
List CSL Type(see below)
No.and 'r t • Type Description
F o�yoke, MA 01040 1
U_ Unrestricted Buildings up to 35.000 mi.)
R Restricted 18..2 Family Dwelling
City/]own,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
413-203-5888 peakperformanceroofingllc@gmail.com SF Solid Fuel Burning Appliances
I Insulation
Teierhon Email address D Demolition
5.2 I- 'a e.rrd ome Imnrrmance NH nertCo, LLU. (HIC) 183698 11/03/2023
i TIC:Registration Number Expiration Date
HIC:{:gmpanie jaria(slit-IC Registrant Name peakperformanceroofingllc@gmail.com
No.and StreetEaUsthhampton, MA 01027 413-203-5888 Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)I)
i 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 WNEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUT DING 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.
Ira Curtis
10/5/2022
Print Owner's Name(ri annuc 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 all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
James J. Flannery
Print Owner's or Authorized Aeeur's Name(Electronic Signature)
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 tinder VJ.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.eovioca Information on the Construction Supervisor License can be found at ww\v.mass.20v!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.) I-Iabitable 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"
�� " �� The City of hamp ton
ry„,., Building Department
t„!, :,,,,, , .4
`_ , 212 Main Street
Northampton, Massachusetts 01060
Phone(413) 587-1240
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 ma.c 111, s150A.
LelThe debris will be disposed of in: VC411-11-16-A-471—
Location of Facility pe,,,,A4i, (,/i
The debris will be transported by:
Name c(' Hauler
IDS 724/ `ct
lr�'1'� 0 / , •
Signature of Applicant: rY- -4 Date: i 6 J q /i2""
ACQRL CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDiYYYYi
�� 7/21/2022
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 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 LQ ett CISR
NAME:
Webber s Grinnell PNOfiE (413)586-0111 FAX tisitf//-sss,
fNG.No.Eat]. ovic.N� - _ 1
8 North King Street AE-MAILDDRESS: aedgett@webberandgrinaell.coel
INSURER(S) AFFORDING COVERAGE NAIC/
Northampton MA 01060 INSURER A.Crum & Forster Specialty/BRECK
INSURED INSURER B:Plymouth Rock Assurance 14737
Peak Performance Roofing, LLC INSURERC:VICAR- Berkshire Hathaway GUARD
Attn: James Flannery INSURERD:
_ ,
1 Lovefield Street INSURER E! ._.._t_.
Easthampton MA 01027 INSURERF: T.
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 OFt 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 AWL SUER POLICY EFF POLICY EXP
TYPE OF INSURANCE
LTR INSD WVD POLICY NUMBER IMM.DO/YYYY) 1MM/DWYYYY) UMRS
X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE i 1,000,000
A —1 CLAMS-MADE I OCCUR DAMAGE TO RENTED S 100,000
PREMISES 1E4 as cl/r/rIa/) 1
__ 0L0089451 7/7/2022 7/7/2023 MED EXP IAny orrpnson) $ 5,000
IPERSONAL i ADV INJURY $ 1,000,000
GEM_AGGREGATE UM/IT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
= POLICY PERO�- LOC PRODUCTS-COMP/OP A@7 $ 2,000,000
OTHER S
AUTOMOBILE UABILITY C MBI SINGLE LIMIT 5 1,000,000
,lea
B ANY AUTO BODILY INJURY(Pa person` $
ALL OWNED SCHEDULED
AUTOS AUTOS M000001007091 4/27/2022 X/27/2023 BODILY INJURY(Per amadod) $
x HIRED AU f OS R PIO -OWNED PROPERTY DAMAGE i ,,
AUTOS I IPer ACCId/RI))
Miami p i 5,000
UMBRELLA UAB OCCUR EACH OCCURRENCE S
EXCESS UAB Cum AGGREGATE S
I
DED RETENIION 5 i
WORKERS COMPENSATION w P U7E TH}
AND EMPLOYERS'LIABILITY Y/NER
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 500,000
C OFFICER+MEMBER LV EXCDED7 n N/A R2WC342657 4/27/2022 i/27/202i
(MrldolorY In NH) E.L DISEASE-EA EMPLOYEE i 500,000 t
N yyens descree ur er
DESCRIPTION OF OPERATIONS below James Flannery is excluded E.L.DISEASE•POLICY LMt1 $ 500,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule.may be attached it 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 1i1._-) 'ir,-14
c, 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025
The Commonwealth of Massachusetts
Department of Industrial Accidents
iv--.. Office of Investigations
Ekogyri
.5� 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/Organization/Individual): Peak Performance Roofing, LLC _ _
Address: 1 Lovefield St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Are y u an employer?Check the appropriate box: Type of project(required)•
1. am a employer with, 4 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. j Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addit
[No workers'comp.insurance comp.insurance.t i
required.] 5. ❑ We are a corporation and its 10.E]Electrical repaint or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.Lj Plumbing repaint or additions
myself.[No workers' comp. �t of �MGL 12.Ll/�Roof repairs
insurance required.] ` c. 152,f1(4),and we have no
employees.(No workers' 13.0 Other,....
1 comp.insurance required.]
,Any applicant that chccl s box 1 must also fill out section below showing their workers'compensation nsation policy information.
' Hon cowners who submit this atitdhp.it indicating they are duinp all work and then hire outside concracttrrs must submit a new affidavit indicating such.
`Contractors that cheek this box:MS(attached an additional sheet showing the matte of the sub-contractors and state whether or not Most:entities has
employees. If the sub-contractor.,ha%c a plo'ccs_they mug pl %idc their %orkers'comp.policy number.
1 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.Lie.#: R2WC202869 Expiration Date: 04/27/20 3
Job Site Address: City/State/Lip. -0 �
Attach a copyof '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]rod to the imposition of criminal penalties of a
fine up to$1500.00 and/or one-year iniptisonment.as well as civil penalties in the form of a STOP WORK O1WhR and a line
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Of ice 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,
Signaturt 11 I Date: I (4 6- 1 -7/
Phone I:
413-203-5888 1/ 0 r 1
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: ._ Permit/License S ,...---
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#:
L Wi ,m /WC/. //e ., %a.
Office of Consumer Affairs and Business Regulation'
1000 Washington Street - Suite 710
Boston. Massachusetts 02118
Home Improvement Contractor Registration
rype_ 'AC
PEAK PERFORMANCE ROOFING.LLC. ' eyistratiUn. q 98
1 LOVEFIELD ST. x(raration !1/49/2423
EASTHAMPTON,MA 01027
Update Address and Return Card.
IrC,4 9 14,144407
oHio>;of Consumer Affairs ti business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. If found return to:
ResisJrati°n Fj5pir4ggn Office of Consumer Affairs and Business Regulation
183698 11/03/2023 1000 Washington Street -Suite 710
PEAK PERFORMANCE ROOFING.LLC Boston,MA 02118
DAMES FLANNERY
1 LOVEFIELD ST.
EASTHAMPTON,MA 01027 UndersecretaryNot valid without signature
Commonwealth of f,tassachuselts
Division of Professional Licensure Construction Supervisor
Board of Building Regulations and Standards Unrestricted-Buildings of any use group which contain
.'�:. .'Lwi.�EG.^.Yitu�r'v.r✓' less than 35,000 cubic feet(891 cubic meters)of enclosed
space.
CS-103061 Expires 0912412)2.4
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01040
n p � Failure to possess a current edition of the Massachusetts
Commissioner l/ State Building Code is cause for revocation of this license.
For information about this license
Call(617)727-3200 or visit www.tnasa.govidpl
4(101 arAt /L& CliZq 1;°U
tfu5 i et-1" old ?i o►
a5 & Ocrirc [2,624-
DocuSign Envelope ID: FCD9C4EF-C126-4A5F-930D-922A948A5474
Peak Performance Roofing LLC
1 Lovefield St.
Easthampton, MA 01027
413-203-5888
peakperformanceroofingllc@gmail.com PERFORMANCE
ROOFING
MA HIC #183698 MA CSC,#103061
ADDRESS
Ira Curtis
21 Liberty St., Florence
413-270-2336
ira@cchonline.com
FSTIMATF#
10814 10/05/2022
JOB LOCATION
21 Liberty St., Florence
ACTIVITY DESCRIPTION QTY RATE AMOUNT
Asphalt The contract is for the new addition area ONLY. 1 3,200.00 3,200.00
Residential
Please see email for visuals. (Area to encompass labor is highlighted in Green.
Area to be avoided is crossed out in Red.)
1. Install six feet of ice and water shield on eaves, three feet in any valleys, and
three feet around all penetrations.
2. Cover remaining roof with synthetic underlayment.
3. Install new 8" aluminum drip edge on all eaves and rake edges.
4. Install architectural shingles by CertainTeed:
Landmark: GEORGETOWN GRAY
http://www.certainteed.com/residential-roofing/products/landmark/
5. Install CertainTeed Flintlastic two-ply roof system, Mule-Hide, or equal on low
slope portion under window.
httpsi/www.certainteed.com/commercial-roofing/products/flintlastic-sa-cap/
https://www.mulehide.com/en-us/Roofing-Products/p/SASBSCapSheet
6. 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:FCD9C4EF-C126-4A5F-930D-922A948A5474
ACTIVIT
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_CTR37821912E.pdf
Total: $3200
A one-third deposit of$1066 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 $3,200.00
�—oocuSign.d ay
v _/ld 10/5/2022
Accepted By s•--17714e037394406,., Accepted Date