17C-078 (5) BP-2023-0207
35 HIGH ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17C-078-001 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-2023-0207 PERMISSION IS HEREBY GRANTED TO:
Project# ROOF 2023 Contractor: License:
PEAK PERFORMANCE ROOFING
Est. Cost: 12890 LLC CS-103061
Const.Class: Exp.Date: 09/21/2024
Use Group: Owner: A HOFFMAN BERYL
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: 02/21/2023
TO PERFORM THE FOLLOWING WORK:
STRIP AND RE-SHINGLE
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:
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
r
t, The Commonwealth of Massaehuset�s - ;,
U Board of Building Regulations and Stafldar, FOR
Massachusetts State Building Code,780 C 1'' MU1CIPAT�'
1 (20'., USE
Building Permit Application To Construct,Repair,Reif Or Dem h a Revised Mar 2011
One-or Two-Family Dwelling '��y'�i<n_,
This Section For Official Use Only t m'`N^r',sc . ,
Building Permit Num her:6al 2 3 z 0 7 Date Applied: �0`"
I� ► f ; �. � a di
Building Official(Print Name) Signature D c
SECTION 1:SITE INFORMATION
1.1 Properyddxsiii s.f( go r 1.2 Assessors Map&Parcel Numbers
1.la 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:
Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSIIIP1
2.1 OwytaeCgrd:,/ "/ rt,i9a9jtel
r
Name(Print) a. State
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 0 Accessory Bldg. 0 Number of Units Other 0 Specify .
Brief Description of Proposed W 2:
(11/9 .11040 ak (1#41/ °S
SECTION 4:ESTIMATED CONSTRUCTION COSTS
item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ ` I. Building Permit Fee: $ Indicate how fee is determined:
2 Electrical $ - ) 0 Standard City/Town Application Fee
0 Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (I-IVAC) $ List:
5. Mechanical (Fire S
Suppression) Total All Fees:
Check NoII- Check Amount: Cash Amount:
6. Total Project Cost: S 121 D 0 Paid in Full 0 Outstanding Balance Due:
i
SECTION 5: CONSTRUCTION SERVICES
5.1 4A$t?S
Construction Supervisor License(CSL)
f�. f�u Q License Number Expiration Date
Name of CSL Holder
list CSL Type(see below)
No.and Street Type Description
6 (5) 0 [6 U Unrestricted(Buildings up to 35,000 ctp ft.)
R Restricted 1&2 Family Dwelling
City/Town,State ZIP M Masonry
RC Roofing Covering
WS Window and Siding
/111 w2 � r • SF Solid Fuel Burning Appliances
'J ' . 1' r'6�1� g 4 &s I Insulation
Telephone Email address D Demolition
4416 5.2 Re is /red Home •• • • men Contractor(HIC) l 8 5 4 lxptmDete
C�uHIC Registration Number
ni-,,Corn 'Nhio R ant Name eadeU i �E ►a s)k ee41.
c
4)'►-.
Noal Itau,Z ki� 0 lOLlZ.a'c
City/Town,StateIP 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 ..._...z 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 .
to act on my behalf,in all mattes relative tq work authorized by this building permit application.
q-ZPII—ilOffiiYIM
Atii°444a)64/ ' - • . 24 lc.I 1-07-*
Print Owner's Name(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 all of the information
contained in this application is true and accurate to the best of m knowledge and understanding.
j •e5 kAA 2E to, iv)�
Print Owner's or Authorized Agent's Name(electronic Sig e) 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.gov/dps
2. When substantial work is planned,provide the information below: 1
Total floor area(sq.ft.) (including garage,fmished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count _ _
Number of fireplaces Number of bedrooms 1
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"
City of Northampton
4,�; Massachusetts a i.. 'i
* tG
'11
L
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building tit
Northampton, MA 01060 ,g inn 3,.)%v'
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: VA /
0-e.\4"14-1
The debris will be transported by:
Name of Hauler: Ael1/41(3 ` 1
PeHll
ZA“/Pb ›
Signature of Applicant: Date:
ZZIN The Commonwealth of Massachusetts
;, Department of Industrial Accidents
"-c .�,•- Office of Investigations
'=�""" 601)Washington Street
�,,,,,,,,
„, Roston,MA 02111
www,rnass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information _, Please Print Ditty
Name(Business/Organization/Individual): Peak Performance Roofing, LLC _
Address: 1 Lovefield St,
City/State/Zip: Easthampton, MA 01027 Phone H: 413-203-5888
Are yptt an employer?Check the appropriate box: Type of project(required):
1.MI am a employer with 4 _ 4. ® 1 am a general contractor and 1
employees(full and/or part-time).* have hired the sub-contractors tie New cntuttttteticm
2.0 I am 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. 0 Building addition
[No workers'comp.insurance comp.insurance.
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.EI 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.( 1Toof repairs
insurance required.( ' c. 152,11(4),and we have no
employees.(No workers` 13.0 Other
comp.insurance required.[
*Any applicant that checks box 8l must also fill out the section below showing their workers"cotupsnsation 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 show ing t e mere of the sub-contractors and state whether or not those entities haw
employed.. If the vub-contractors have employees.they most provide thou workers'comp,pc►lic)number
.. ,. r�,l. J -ma-vie -o.. .. - .�,, .....---.----
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance CompanyName: Berkshire Hathaway Guard
Policy it or Self-ins.Lie.#:., R2WC202869 Expiration Date: 04/27/2023
Job Site Address:' 1/251-5:f-- City/State/ZiP /kV.",t JiA
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 ve is true and correct.
Signature: . . Dater /(¢ l 1 '�
Phone ii•
41 3-203-5888 v r /
Official use only. Do not write in this area,to be completed by city or town official,
City or Town: Perm1JLicense 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#:
ACCWRL CERTIFICATE OF LIABILITY INSURANCE DATE IMM7DD/YYYYI
ft.....----- 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 I►ou of ouch endorsement(s).
PRODUCER CONTACT -J
NAME: AdinaEdgett, CISR
Webber & Grinnell 1 Ext. (413)586-0111 � I r&ttMs-4 S1
8 North King Street E-MAIL aedgettPwebberandgrinnell.com
ADDRESS:
INSURERIS) AFFORDING COVERAGE NAIL
Northampton HA 01060 INSURERA:Crow & Forster Specialty/BRECK
INSURED I INSURER B;Plywoutb Rock Assurance 14737
Peak Performance Roofing, LLC INSURER CsMAR- Berkshire Hathaway GUARD
Attn: James Flannery INSURERD:
1 Lovefield Street INSURER E:
Easthampton HA 01027 iit1NRER6:
COVERAGES CERTIFICATE NUMBER:Zxp 06/23 REVISION NUMBER:
THIS IS r0 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. _
LTR TYPE OF INSURANCE ITINSIII �lSO M VD POLICY NUMBER IYAUDQ/YYTY1,IIrIN YI LIMRS.��_��...��
Z COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S _1,000,000
A CLAIMS-MADE IOCCUR DAMAGE PREMISESST LEe iTED occurrence] $ 100,000
E4I
—
1 GI-0089451 7/7/2022 9/7/2023 MED EXP(Any ern Person) $ 5,000
PERSONAL$AM INJURY 3 1,000,000
—
GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY n J LOC PRODUCTS•COMPIOPA00 $ 2,000,000J
•
OTHER $ 4_—J
AUTOMOBILE LIABILITY L�DIED SINGLE LIMIT
$ 1,000,000
ANY AUTO BOOI.Y INJURY(Per person) $
IS °® ALL OWNED x SCHEDULED AUTOS AUTOScidsM PRc00001007091 6/27/2022 6/27/2023 BODILY INJURY(Pr ac ) $
E A NON OWNED PROPERTY DAMAGE $
HIRED AUTOS AL,TOs (Par accident]
MoMmi pelmets S 5,000
UMBRELLA LIAR OCCUR EACH OCCURRENCE S_
EXCESS IJAB RT
CLAIMS-MADE AGGREGATE $
1 DED RETENTION$ f j $
WORKERS COMPENSATION ' e PEA OT STATUTE 1 1
AND EMPLOYERS'LIABILITY Y/N /
ANY PROPRIETOR/PARTNER/EXECUTIVE I ,^N/A E.L EACH ACCIDENT $ 500,000
C OFFICER/MEMBEREXCLUDED9 R2wC342657 4/27/2022 �/2T/2027(M.ndmtory in NH) E.L DISEASE•EA EMPLOYEE $ 500,000
N ye tlrfc16 OXlde! Jewes Flannery Is excluded
DESCf.RIPTION OF OPERATIONS bNow E.L.DISEASE•POLICY LOOT 1 $00,000
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 �f �}
W Grinnell, CPCU, CIC j,IL €,.. - 'r
1988-2014 ACORD CORPORATION. All rights rMNMOd.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025 . ' .1
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 Card.
v 2OM4i/17
is ;n,
OffeofCtllaune ifair &�uslness Regulatio HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. If found return to:
RegisIrratioc Emgr_alion 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 Yt
1 LOVEFIELD ST,
ILOVEFIELD
i A JJJ
EASTHAMPTON,MA 01027 UnGersecreta Not valid without signature
ry
® Commonwealth of Massachusetts
Division of Professional Licensure Construction Supervisor
Board of Budding Regulations and standards Unrestricted-Buildings of any use group which contain
(;"rdlar t,GTiO.^.Su}1e'e suf less than 35,000 cubic feet 1991 cubic meters)of enclosed
space.
CS-103061 Expires 0914JZ)2.4
JAMES J FLANNERY
1 WILLIAMS ST
HOLYOKE MA 01040
Cie"
IQ 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(617)727-3200 or visit www.mass_gov/dpi
11/1401 im te f Ci 'f Z (zaZ-
Hitc, 14 #-1-- vied' ufee‘Gfzi cd1-06
a5 ocrir.tctwi / 1 (2oL
DocuSign Envelope ID:C8C6274A-6B1F-4C71-9FBB-29BE7E7751F1
Peak Performance Roofing LLC
1 Lovefield St.
Easthampton, MA 01027
413-203-5888
' E
peakperformanceroofingllc@gmail.com P E R F O R $W A* C E
ROOFING
MA HIC#183698 MA CSL#103061
ADDRESS
Beryl Hoffman
35 High St.
Florence, MA
hoffmanb@elms.edu
413-237-8377
ESTIMATE#
10853 11/25/2022
JOB LOCATION
35 High St., Florence
ACTIVITY DESCRIPTION i;1 f Y RA I r. MOUN l
Asphalt For Spring 2023 Installation. 1 12,890.00 12,890.00
Residential
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: GEORGETOWN GRAY
http://www.certainteed.com/residential-roofing/products/landmark/
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.
9. Install CertainTeed Flintlastic two-ply roof system or equal on low slope
portions.
DocuSign Envelope ID:C8C6274A-6B1F-4C71-9FBB-29BE7E7751F1
ACTIVITY DESCRIPTION OTY RATE AMOUNT
htt s://www.certainteed.com/commercial-r fin P oo g/products/fllntlastic sa cap/
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: $12,890
A one-third deposit of$4296 will secure contract, permitting, material order, and
priority scheduling FOR SPRING 2023.
The balance shall be due upon completion, within 10 days of invoice. Accounts
outstanding over 30 days subject to 2%finance charge monthly.
TOTAL $12,890.00
DoeuSigned by:
WiL„ 11/25/2022
8E94680E 1552491.
Accepted By Accepted Date