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02-021 (8) BP-2023-0474 671 NORTH FARMS RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 02-021-001 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-2023-0474 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: Est. Cost: 20200 MATTHEW CARRIER CSL117335 Const.Class: Exp.Date: 06/03/2026 Use Group: Owner: YESENIA GREEFF ADAM BRIAN& Lot Size (sq.ft.) Zoning: WSP Applicant: STONE MOUNTAIN ROOFING LLC Applicant Address hone: Insurance: 36 LYON HILL RD (413)998-9010 STWC370718 CHESTER,MA 01011 ISSUED ON: 04/19/2023 TO PERFORM THE FOLLOWING WORK: STRIP AND RE-ROOF HOUSE, GARGAE AND SHED 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 1-1 ,t •. Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner DocuSign Envelope ID: BA963F29-BCA2-425F-A368-724BA9F4E023 IC() - , qp1 The Commonwealth of Massachusetts rpl. "O93Board of Building Regulations and StandardsYot?qt./,/ �� M UNI �AL 1TY we Massachusetts State Building Code, 780 CMR .4,Mn�oN liv, USE Building Permit Application To Construct,Repair,Renovate lOr Demolish a"-- '"Rev ed Mar 2011 One- or Two-Family Dwelling ,/� This Section For Official Use Only Buildin Permit Number.• /'' 3' 6 7 y Date Applied: Eviv (i?c,-).5 /1Z 11-IQ 2vz3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 671 North Farms Rd. Florence 02 -021-001 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 ft) Frontage(ft) 1.5 Building Setbacks(ft) I 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 ElPrivate 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Adam Greeff Florence, MA 01062 Name(Print) City,State,ZIP 671 North Farms Rd, 617-947-8119 Adam.greeff@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) f New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 90§pecify: Roofing Brief Description of Proposed Work2: strip and replace asphalt roof on house, attached garage, and shed. Install zinc strips on shaded slopes SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 20,200.00 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical S ❑ Standard City/Town pplication Fee ❑Total Project Cost (It m 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees;$ Check No. 1151 Check Amount: liliash Amount: 6.Total Project Cost: $ 20,200.00 ❑Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:BA963F29-BCA2-425F-A368-724BA9F4E023 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 U List CSL Typ@(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/ 024 Stone Mountain Roofing LLC inc Registration Number Expirati Date HIC Company Name or HIC Registrant Name 36 Lyon Hill Rd stonemountainroofingllc©gmail.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 V 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. 1-Docusigned by: 3/31/2023 Adam Greeff Ma* Gruff Print Owner's Name(Electw Igo Date SECTION 7b: OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of plrjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. �I Matthew Carrier ' cak.\'-" 3/30/2023 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),wi 1 not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important inform tion on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License an 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:BA963F29-BCA2-425F-A368-724BA9F4E023 City of Northampton ✓ ` Massachusetts *Jt :G DEPARTMENT OF BUILDING INSPECTIONS fr .".� 212 Main Street • Municipal Building yJ �.�• Northampton, MA 01060 ssfrkt 4;')\'��� 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: 3/30/2023 .v.. , IUC t.0 III Mt 111 VO/Cliiili Vf ir1UaaUt.iiU.Cii. Department of Industrial Accidents r Office of Investigations s Mill Lafayette City Center C1 2 Avenue de Lafayette, Boston,MA 02111-1750 ,:1 wwwmass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibl r 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. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.El 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' ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. 0 We are a corporation and its 1 0 ❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 1.❑ Plumbing repairs or additions [No myself. workers' comp. right of exemption per MGL , y p 1_ ❑✓ Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' I;.❑ Other 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. tContractors 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. k 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: 671 North Farms Rd. City/State/Zip: Florence, MA 01062 ff Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration da'te). 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 n fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and p,n [ties o erjury that the information provided above is true and correct. Si y °., Date: 4/13/2023 Phone#: 413-998-9010 i Official use only. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 31:City/Town Clerk 4.❑Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: - N, Commonwealth of Massachusetts tDivision of Occupational Licensure Board of Building RegI iations and Standards Const ion S ,rvisor CS-117335 ;� Ei;tpires: MATTHEW C RRIER •,,. 44 p 36 LYON HILT ROAD ' CHESTER Mk,O1011 .1) rb• ,. 0/.1.vall.1 • Commissioner daega /;. Dnrila THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer AfffiN Business Regulation 1000 Washingt .�y�,�ruij,_Suite 710 Bosto =Massachusetf-.0 118 Home Im.ro e a _v. tore istration v STONE MOUNTAIN ROOFING,LLC "' Type: LLC �`l ••e$is ration: 206447 36 LYONESTE HILL RD _M �j ation: 09/15/2024 CHESTER,MA 01011A. ` ,,j .' L 1,ty , s,,,* Update Address and Return Card. • THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs,„&Business Regulation Registration valid for individual uae only before the HOME IMPROVEMENDCONTRACTOR expiration date. If found return to: "- ri-`C Office of Consumer Affairs and Business Regulation Reatstra(g -- " 1000 Washington Street -Suite 710 29 -1- N0945/2924 Boston,MA 02118 STONE MOUNTAIN ROOFi' L J MATTHEW CARRIER 38 LYON HILL RD T$` ,.. CHESTER,MA 01011 • ,� ��"`"ra'�"�r'r'�`• ' Undersecretary Not valid without signature l ® DATE(MM/DD/YYYY) ACCPRo CERTIFICATE OF LIABILITY INSURANCE 40.....-----' 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 Michelle Lastowski Alera Group,Inc. PnHONE Ext): (413)586-0111 FAX Na): (413)586-6481 Webber&Grinnell Division E-MAIL mlastowski@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC C 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: 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. IICY EXP NSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DPOLI D//YYYY MMCY EFF /DDIIYYYY) LIMITS LTR INS!) V/VD ( ) ( X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A CGL0159193 02/18/2023 02/18/2024 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 2,000,000 1 POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 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 OTH- ER AND EMPLOYERS'LIABILITY Y/N 100,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA 7PJUB6R27941623 02/17/2023 02/17I2024 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 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ID: BA963F29-BCA2-425F-A368-724BA9F4E023 li Stone Mountain Roofing LLC 36 Lyon Hill Rd., ." .A%1/4 S_ Chester, MA 01011 A�ake� 413-998-9010 stonemountainroofingllc@gmail.com STONE MOUNTAIN www.stonemountainroofingllc.com/ ROOFING Contract ADDRESS CONTRACT# 1 103 Adam Greeff DATE 03/30/2023 671 North Farms Rd. Florence, MA 01062 Adam.greeff@gmail.com 617-947-8119 DESCRIPTION 1. Remove the existing roofing shingles. Remove the clapboard siding at roof-to-wall intersec ion to allow for proper flashing (We are not responsible for installing new siding) 2. Inspect the existing plywood for any rot or deterioration. Any new plywood will be $85 per sheet installed. (Wood prices subject to change) 3. Install six feet of ice and water shield on eaves and three feet in valleys/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)t https://www.certainteed.com/residential-roofing/products/landm rk-pro/ Color Choice: MAX DEFINITION MOIRE BLACK 7. Install Shingle Vent 11 ridge vent on peaks of roof(where applicable) http://www.airvent.com/index.php/products/exhaust-vents/ridge-events/shinglevent2 8. Complete all necessaryflashings includingnew LIFETIME pipe boots and base flashing mound the P g chimney. https://lifetimetool.com/product/ultimate-pipe-flashing-shingle-kynar-coated/ 9. Install zinc strips to the shaded slopes Includes Certainteed 4-Star extended warranty. https://certainteed.showpad.com/share/FujWoUnUwAfvG558w1E7P/0 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 be proactive and prepare for the worst by covering everything in the attic. We recommend covering with tarps or plastic sheeting. 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 MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 Fe ID: BA963F29-BCA2-425F-A368-724BA9F4E023 I DESCRIPTION delays. COST SUMMARY: House/Garage: Landmark PRO shingles=$15,150 Shed: Landmark PRO shingles= $3,600 , Zinc Strips=$550 4-Star Extended Warranty=$900 TOTAL= $20,200 Thank you for choosing Stone Mountain Roofing. Expected Installation: Spring 2023. A $500 deposit will secure contract, permitting, material order, and priority scheduling. The balance of the one-third deposit, $6,200 will be due prior to ikistallation. The balance shall be due upon completion, within 10 days of invoice. Accounts outstanding over 30 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 $20,200.00 Accepted By a°° 9ned b Accepted Date 3/31/2023 kom Gruff "-EC994A58653A4C2... MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 i