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03-015 (3) BP-2023-0362 587 COLES MEADOW RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 03-015-001 . 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-2023-0362 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: Est. Cost: 24500 MATTHEW CARRIER CSL117335 Const.Class: Exp.Date: 06/03/2026 Use Group: Owner: FROST SUE A Lot Size (sq.ft.) Zoning: WSP Applicant: STONE MOUNTAIN ROOFING LLC Applicant Address Phone: Insurance: 36 LYON HILL RD (413)998-9010 STWC370718 CHESTER,MA 01011 ISSUED ON: 03/24/2023 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: • 2 �' I , Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner DocuSign Envelope ID:48FF2FC9-6563-4A13-B547-0A4DDE8AFE45 / / ' 4" The Commonwealth of Massachusetts o •r ? Board of Building Regulations and Stands do o� 0I�'�Y Massachusetts State Building Code, 780 CMR 9,;(,440i `) /SE ,VBuilding Permit Application To Construct,Repair,Renovate Or DeMar 2011 One-or Two-Family Dwelling '�o„�% .` This Section For Official Use Only Building Permit Number: 16e .1."--, x2. /Date Applied: 1S--uiNg5 ,/L �atG 3 Z3 Z023 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 587 Coles Meadow Rd. Li Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimehsions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1 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 OWNERSHIP' 2.1 Owner'of Record: Randy Frost Northampton, MA A 01060 Name(Print) City,State,ZIP 587 Coles Meadow Rd. 413-320-1741 rfrost@smith.edu 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) 0 Alteration(s) 0 Additidn 0 Demolition 0 Accessory Bldg. 0 Number of Units Other pecify: Roofing Brief Description of Proposed Work2: strip and replace asphalt roof SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 24,500.00 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost3 (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ rrl Suppression) Total All Fee (,`Yll Check No. ( b Check Amount: Cash Amount: 6. Total Project Cost: $ 24,500.00 ❑Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:48FF2FC9-6563-4A13-B547-0A4DDE8AFE45 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-117335 06/03/2026 Matthew Carrier License Number Expiration Date Name of CSL Holder List CSL Type(see below) 36 Lyon Hill Rd No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Chester, MA 01011 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-998-9010 stonemountainroofinglIc@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 206447 09/15/2'024 Stone Mountain Roofing LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 36 Lyon Hill Rd stonemountainroofinglIc@gmaii.com No.and Street Email address Chester, MA 01011 413-998-9010 City/Town,State,ZIP 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 QI 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 Stone Mountain Roofing LLC/Matthew Carrier to act on my behalf,in all matters relative to work authorized by this building permit application. e--DocuSigned by: Randy Frost KoA,611 VreSS 11/7/2022 Print Owner's Name(.Legg ature) 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. Matthew Carrier 'tIat 11/5/2022 Print Owner's or Authorized Agent's Name(Electronic Signature) 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: 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" DocuSign Envelope ID:48FF2FC9-6563-4A13-B547-0A4DDE8AFE45 _ City of Northampton �t N Mpj.� �S :' S� /�� "'"�: Massachusetts ��s j ale ,r Vic' 11.4 , . ,11 DEPARTMENT OF BUILDING INSPECTIONS ' i 4` �. .,, - 212 Main Street • Municipal Building 0 Cb rt '� Northampton, MA 01060 'I' " j‘�`� lT 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: Valley Recycling, 234 Easthampton Rd., Northampton MA 01060 The debris will be transported by: Name of Hauler: Aaron's 24/7 Towing & Roll Off Services Signature of Applicant: °��"""" Date: 11/5/2022 ® DATE(MMIDDIYYYY) A O CERTIFICATE OF LIABILITY INSURANCE 02/13/2023 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 NAME: Michelle Lastowski Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 (A/C No,Ext): (A/C,No): Webber&Grinnell Division E-MAUL mlastowski@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Berkley Specialty Insurance Co INSURED INSURER B: WCAR-Travelers Stone Mountain Roofing,LLC INSURER C: 36 Lyon Hill Road INSURER D: INSURER E: Chester MA 01011 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 2/2024 REVISION NUMBER: 1 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 (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGE 1 000 ED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A CGL0159193 02/18/2023 02/18/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 X POLICY PRO- 2,000.000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ —y OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y N 100,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A 7PJUB6R27941623 02/17/2023 02/17/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/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 Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD :\ l/Le i..0 tiiiL V/{rvCubll{ Vf API uaaut-rtu. CLLa Department of Industrial Accidents r ` _ Office of Investigations 11):, �;_ Lafayette City Center nr — , -�- 2Avenue de Lafayette, Boston,MA 02111-1750 '4-,,,' 'i'" www.mass.gov/dia ;.e Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Stone Mountain Roofing LLC Address:36 Lyon Hill Rd. City/State/Zip:Chester, MA 01011 _ _ Phone #:413-998-9010 Are you an employer? Check the appropriate box: Type of project(required): 1.El I am a employer with 1 4. 0 I am a general contractor and I 6. IDNew construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 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. 0 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.❑ 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 12.0 Roof repairs insurance required.] t c. 152,§1(4),and we have no 13.❑Other employees. [No workers' comp.insurance required.] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation 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 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. Insurance Company Name: Travelers Policy#or Self-ins. Lic.#:7PJUB6R27941623 Expiration Date:02/17/2024 Job Site Address: 587 Coles Meadow Rd. City/State/Zip:Northampton, MA 010 0 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration d te). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penaltie 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 an 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. 1 do hereby certify under the pains and realties of perjmy that the information provided above is true and correct. Signature: °ts l.T'�-- Date: 3 )Q0 f rC&3 413-998-9010 Phone#: •r Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 10Board of Health 20 Building Department 3.DCity/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Const IoniS rvisor - CS-117335 spires: 06/03/2026 MATTHEW CLRRIER 36 LYON HILT ROAD CHESTER MA"_,01011 � Commissioner d'ca Bj THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Im.rovement Contractor Registration x ..._..., .._. ... m . la l Vrairag Type: LLC STONE MOUNTAIN ROOFING, LLC 'egisfration: 206447 36 LYON HILL RD �` Expiration: 09/15/2024 Inn 1 CHESTER, MA 01011 �,iik WU Mgr Ig! .......,. - 7 1/4v Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE: LLC Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 206447 09/15/2024 Boston, MA 02118 ;TONE MOUNTAIN ROOFING, LLO, :ir. AATTHEW CARRIERAi?16 LYON HILL RD } d�`j CatO � HESTER, MA 01011 'i, ` '" Undersecretary Not valid without signature elope ID:48FF2FC9-6563-4A13-B547-OA4DDE8AFE45 Stone Mountain Roofing LLC 36 Lyon Hill Rd., " %S Chester, MA 01011 413-998-9010 STONE MOUNTAIN stonemountainroofingllc@gmail.com ROOFING www.stonemountainroofingllc.com/ Contract ADDRESS CONTRACT # 106 Randy Frost DATE 11/ 5/2022 587 Coles Meadow Rd. Northampton, MA 01060 413-320-1741 rfrost@smith.edu DESCRIPTION 1. Remove the existing roofing shingles 2. Inspect the existing plywood for any rot or deterioration. Any new plywood will be $90 per sheet installed. (Wood prices subject to change) 3. Remove one section of plywood from the eave to the peak and add new insulation(Section is pertaining to one rafter bay) 4. Install six feet of ice and water shield on eaves and three feet in valleys/around all penetrations 5. Cover remaining roof with synthetic underlayment 6. Install new 8" aluminum drip edge on all eaves and rake edges 7. Install architectural shingles by CertainTeed(Landmark PRO) https://www.certainteed.com/residential-rooting/products/landmark-pro/ Color Choice: Max Definition Pewterwood 8. Install Shingle Vent 11 ridge vent on peaks of roof(where applicable) http://www.airvent.com/index.php/products/exhaust-vents/ridge-vents/shinglevent2 9. Complete all necessary flashings including new LIFETIME pipe boots hops://lifetimetool.com/product/ultimate-pipe-flashing-shingle-kynar-coated/ Includes CertainTeed Lifetime Limited Warranty (Transferable)with 10 year SureStart period. hops://www.certainteed.com/resources/Asphalt-LowSlope-Res-Warranty-a-2201 ctr.pdf 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. Stone Mountain Roofing will obtain the building permit if necessary. Installations are weather permitting; inclement weather will cause scheduling delays. 1111 ope ID:48FF2FC9-6563-4A13-B547-0A4DDE8AFE45 DESCRIPTION Total: Landmark PRO shingles= $24,500 Expected Installation: Spring 2023. A$500 deposit will secure contract,permitting, material order, and priority scheduling. The balance of the one-third deposit, $7,600 will be due prior to installation. The balance shall be due upon completion, within 10 days of invoice. Accounts outstanding over30 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 $24,500.00 Accepted By Docusigned by. Accepted Date 11/7/2022 `—9506885548 F B4 D4...