17C-083 (6) BP-2023-0012
53 HIGH ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17C-083-001 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-2023-0012 PERMISSION IS HEREBY GRANTED TO:
Project# roof 2022 Contractor: License:
PEAK PERFORMANCE ROOFING
Est. Cost: 10130 LLC CS-103061
Const.Class: Exp.Date: 09/21/2024
Use Group: Owner: KIRITSIS SARAH F
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: 01/05/2023
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 VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
a
97
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
DocuSign Envelope ID:A78DCCC8-4E36-45ED-95F7-7A5FF1 BFO7C1
m
d •
c`ts, The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR 1v1IJN1UrAMY
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family
This Section For Official Use Only
Building Pen nit 6 0• 3- /2 Date Applied:
Kry <Kon // I-5-2623
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: High St. 1.2 Assessors Map& Parcel Numb rs.j
1.l a Is this an accepted street?yes no Map Num er53
r Parcel Number T
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) tt
Front Yard Side Yards I Rear Yard
Required Provided Required Provided I Required Provided
1.6 Water Supply:(M.G.L c.40,b 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private❑ Zone. ---- Outsid::Flood Lone?
Check if Yes❑ Municipal❑ Ott site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of:Record:Sarah Kiritsis Florence, MA
Name(Print) City,State,ZIP J
53 High St. 413-695-8823 skiritsis@verizon.net
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORIC2(check all that apply)
New Construction El Existing Building D Owner-Occupied 0 Repairs(s) 0 T A1terstion(s) 0 Addition CI
Demolition 0 j Accessory Bldg.❑ Number of Units Other )i Specify: Hooting
Brief Description of Proposed Work: Strip ana replace asphalfroof.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
I.Building S 10130 1. Building Permit Fee: S - Indicate bow fee is determined:
2.Electrical i S CIStandard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier r.
3. Plumbing S 2. Other Pees: S
4.Mechanical (HVAC) S List:
5.Mechanical (Fire S
Suppression) Total All Fees:S CV 10130 Check No.1 '4 Checkm Aoitar: 1 Cash Amount:
6.Total Project Cost S ❑Paid in Full El Outstanding Balance Due:
DocuSign Envelope ID:A78DCCC8-4E36-45ED-95F7-7A5FF1 BFO7C1
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CSL-103061 09/21/2024
James J. Tannery
License Number Expiration Date
Name of CSL Holder f
List CSL Type(see below)
No
'andSucct
tiolyoke, MA 01040 TypeU Unrestricted(Buildings up 35,00lcu ft.)
R Restricted ldi2 Family Dwelling
Cityrrown.State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
413-203-5888 peakperformanceroofingllc@gmail.com SF Solid Fuel Burning Appliances
1 Insulation
Telephone Email address D Demolition
5,2 -' a e ' ra "erentgL (HIC) 183698 11/03/2023
e romncen , L . HIC Registration Number Expiration Date
HICf gem(sIIIC Registrant Name peakperformanceroofinglIc@gmail.com
No.and Street Easthampton, MA 01027 413-203-5888 Email address
City/Town,Stets ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152. 23C(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,
SaKdit WINS 12/19/2022
's Name(Electronic Signature) Date
SECTION 7b:OWNERS 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 qVt I(2-c
•
Print Owner's or Authorized Agent's Name 4,119.4 Signatur Date
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.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/d s
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"
The Commonwealth of Massachusetts
; Department of Industrial Accidents
=.47�- ' Office of investigations
k
600 Washington Street
Boston,MA 02111
fi
L r'�� 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 Lovefieid St.
City/State/Zip: Easthampton, MA 01027 Phone #: 413-203-5888
Are ypu an employer?Cheek the appropriate box:
1. I am a employer with-, 4 .�_ 4. ❑ I am a general contractor and I Type of project(required):
employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
2.Li 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'
(No workers' comp.insurance comp.insurance.
# 9. ❑ Building addition
required.] 5. ❑ We arc a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.1] Plumbing repairs or additions
myself.[No workers'comp. right of exemption per MGL 12.gRoof repairs
insurance required.]' c. 152,*I(4),and we have no
employees.(No workers' l3.❑ 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 are doing all work and then hire outside contractors must submit a new affidavit indkcating 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.
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 11 or Self-ins.Lic.11: R2WC202869 •_ Expiration Date: 04/27/2023
Job Site Address:.___, —_- City/State/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$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.
r- ./
Signature:. sit
Date: ....
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#:
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 LOVE FIELD ST. Expiration: 11/03/2023
EASTHAMPTON,MA 01027
Update Address and Return
sca 1 0 2-00.4-can
mHicee of Conseer/ter Affairrss I ritual/6/4
Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. If found return to:
Registration Egn 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, `'wo�,a,( ri4(81191
EASTHAMPTON,MA 01027 (lnd�1lrip10�ry Not valid without signature
® _ Commonwealth of Massachusetts
Division of Professional Licensure
Construction
Board of Building Regulations and Standards fSupervisor
Unrestricted-Buildingsgsoof arty use group which contain
;4t1Stri41:ion Suy74:'v.,' less than 35,000 cubic feet(991 cubic meters)of enclosed
space
CS-103061 Expires-09Jz{j�24
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01040
�,� [p {� f Failure to possess a current edition of the Massachusetts
Commissioner �/"y.• State Building Code is cause for revocation of this license.
For information about this license
Call 1617)727-3Z00 or visit www.mass.govldpi
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AFRO CERTIFICATE OF LIABILITY INSURANCE LDMZ a1/'' '�`Y'''
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 art endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Ed eft CISR
,.NAME; g • _
Webber 0 Grinnell PHONE (413)586-0111 I FAX (a1)Isai-usa
(A/C.No.ExO: :tAA;,Nuj:
8 North King Street E-MAIL ADDRESS aedgettNwebberandgrinnell.com
,
INSURERISI AFFORDING COVERAGE NAIC 0
NorthsSSpton NA 01060 INSURER A:Crum & Forster Specialty/BRRCK
INSURED INSURER s:Plymouth Rock Assurance 14737
Peak PertOrSsance Roof Lug, Yd,C I INSURER C WCAR- Berkshire Hathaway GUARD
Attn: Jassees Flannery INSURER D
1 Lovefield Street SMUREHE
Easthampton MA 01027 INSURER F
COVERAGES CERTIFICATE NUMBER:B=p 06/23 REVISION NUMBER
r His Is 10 GERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDINO 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.
4T11 TYPE Or INSURANCE MAX Susie
PAW NNW ---- OMIRfAArrY17 I111{Dt1ryYYY} I-Or s
X COMMERCIAL GENERAL UADILITY EACH OCCURRENCE S 1,000,000
A CLAIMS-MADE n OCCUR DAMAGE TO RENTED PREMISES 000
PREMISES(Ea occurrence) S
CLO0a9e51 7/7/2022 7/7/2023 MED EXP(Arty one peredn) $ 5,000
PERSONAL &ADV INJURY S 1,000,000
—
GERI AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000
POLICY 1-1
PRO, LOC PRODUCTS COMPlOPAGQ S 2,000,000
OTHER S
AUTOMOSI.E UASIUTY 1 CEMBI OG NNEEDDISINGLE LIMIT S 1,000,000
B ANY AUTO BODILY INJURY(Per person) S
ALL X AUTULEDU OS PRC00001007091 6/27/2022 6/27/2023 BODILY INJURY(Perecedent) S
It HIRED AUTOS 2 AUTN�NED (peOPE r accident)
S
Mod cal payments S 5,000
UMBRELLA UAB — OCCUR EACH OCCURRENCE $
EXCESS LIAO CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION PER OTF-I-
AND EMPLOYERS'LIADUJTV YIN * STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000
C OFFICERIMEMBER EXCLUDED' a N/A
(MandetorYlnNH) R2NC242657 f a/27/2022 4/27/2023 E.L.DISEASE EA EMPLOYEE S 500,000
II vS describe under James Flannery is easleaed
DESCRIPTION
RIPTION OF OPERATIONS below James DISEASE-POLICY OMIT 5 500,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACON 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
Proof of Insurance THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
W Grinnell, CPCU, CIC • -,i, 'F
I
1988-2014 ACORD CORPORATION. All fights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025 .:,n'CA
crrQ�;f The City of Naithampton
4 Building Department
'� 14. Main Street
Northampton, Massachusetts 01060
Phone (413) 5 7-1240
Fax (413) 5 7-1272
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLrON 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 MGL c 111, s150A.
atel .
The debris will be disposed of in: V
Location of Facility A ` ( 1 ) I
The debris will be transported by:
Name of Hauler (1111(0/1. S 2 °/tli-
Signature of Applicant: 9t"—* (VJ Z
Date:1�2 /
DocuSign Envelope ID:A78DCCC8-4E36-45ED-95F7-7A5FF1 BF07C1
Peak Performance Roofing LLC
1 Lovefield St.
Easthampton, MA 01027
413-203-5888 P E
peakperformanceroofingllc@gmail.com P E R F 0 R C E
ROOFING
MA H1C #183698 MA CSL#103061
ADDRESS
Sarah Kiritsis
53 High St.
Florence
skiritsis@verizon.net
413-695-8823
ESTIMATE#
10863 12/19/2022
JOB LOCATION
53 High St., Florence
ACTIVITY DESCRIPTION QTY RATE AMOUNT
Asphalt This contract does NOT include the main house. 1 10,130.00 10,130.00
Residential Garage & attached In-Law Apartment ONLY.
Avoid all areas with slate shingles.
See email for visuals.
1. Remove the existing roofing shingles.
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 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: MAX DEF COLONIAL SLATE
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-roofing/products/certainteed-ridge-vent-
12-filtered/
8. Complete all necessary flashings including new LIFETIME pipe boots and
base flashing around chimney.
DocuSign Envelope ID:A78DCCC8-4E36-45ED-95F7-7A5FF1 BFO7C1
ACTIVITY DESCRIPTION OTY 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 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_CTR3782_1912_E.pdf
Total: $10,130
A one-third deposit of $3376 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 $10,130.00
---DocuSigned by:
Salk WPM S 12/19/2022
Accepted By '[ '"`'"��i'`"'"' Accepted Date