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38D-057 (3) BP-2024-0421 43 REVELL AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38D-057-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0421 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: Est. Cost: 10800 MATTHEW CARRIER CSL117335 Const.Class: Exp.Date: 06/03/2026 Use Group: Owner: ALLEVA ERNEST L &LISA J LEIZMAN Lot Size (sq.ft.) Zoning: URB Applicant: STONE MOUNTAIN ROOFING LLC Applicant Address Phone: Insurance: 36 LYON HILL RD (413)998-9010 7PJUB6R27941623 CHESTER,MA 01011 ISSUED ON: 04/10/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 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: 7777 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildinn Commissioner / DocuSign Envelope ID:CEA3F4DB-286A-45D6-B708-D4D3BBAC32F0 The Commonwealth of MassachusettttA (90 „ * • Board of Building Regulations and Starida FOR Massachusetts State Building Code, 780 CM1i:,;,Mr, /F MUM?, USE CITY .� '� / sp It'evised Mar 2011 Building Permit Application To Construct,Repair,Renovate Oi-•l l h One-or Two-Family Dwelling lliis Section For Official Use Only A r,�, Building Permit Number ' er'- Date Applied: K l _) 4,5 /l/Z L/./0 ZO2Y Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 43 Revell Ave. - 38D-057-001 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Ownerl of Record: Ernie Alleva Northampton, MA 01060 Name(Print) City,State,ZIP 43 Revell Ave. 413-586-2724 ealleva@hampshire.edu No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other Q/$pecify: Roofing Brief Description of Proposed Work2: Spring 2024. Strip and replace asphalt roof except newly shingled slope located on the backside of the house SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 10,800.00 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fe-esi6f°Check Noll,W Check Amount: Cash Amount: 6.Total Project Cost: $ 10,800.00 0 Paid in Full ❑Outstanding Balance Due: DocuSign Envelope ID:CEA3F4DB-286A-45D6-B708-D4D3BBAC32F0 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) U 156 Northampton St., No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Easthampton, MA 01027 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 09/15/2024 Stone Mountain Roofing LLC HIC Registration Number Expiration Date HIC Company Name or HIC Re istrant Name 156 Northampton St. stonemountainroofinglIc@gmail.com No.and Street Email address Easthampton, MA 01027 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 .i# 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 Stone Mountain Roofing LLC/Matthew Carrier to act on my behalf,in all matters relative to work authorized by this building permit application. ,-°ocuSaned by. 10/27/2023 Ernie Alleva fvyt,it, I1U t Print Owner's Nanaejqkt8oture) 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 t the best of my knowledge and understanding. A , `11312_024 Matthew Carrier ° 10/27/2023 Print Owner's or Authorized Agent's Name(Elec nic 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:CEA3F4DB-286A-45D6-B708-D4D3BBAC32F0 City of Northampton ors r. ?' �K; Massachusetts W2S. •r`�.` * Gl (j The ° ;10, k h DEPARTMENT OF BUILDING INSPECTIONS n� x _��.t� , ,q. 212 Main Street • Municipal Building s0 b� � Northampton, MA 01060 srNW ����� 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: Ail - Date: 10/27/2023 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations h —. Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 �t www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Stone Mountain Roofing LLC Address: 156 Northampton St. City/State/Zip: Easthampton MA 01027 Phone #:413-998-9010 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.yI 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. D 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 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 employees. [No workers' 13.❑ 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. :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:02/17/2025 Job Site Address: 4?) 'RQV Q-k\ PNO, City/State/Zip: NO(-rhar1n 1^61c 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 fme 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 fme 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 penalties of perjury that the information provided above is true and correct. Signature:G2o [.th .-G ' Date: Lf 13 I OOI4 Phone#: 413-998-9010 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): 1DBoard of Health 20 Building Department 3E1City/Town Clerk 4.111 Electrical Inspector 5EPlumbing Inspector 6.0Other Contact Person: Phone#: A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY) 01/23/2024 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. PHONE (413)586-0111 FAX No: (413)586-6481 1AIC No,Extl: ( ) Webber&Grinnell Division E-MAIL mlastowski@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC e Northampton MA 01060 INSURER A: Berkley Specialty Insurance Co INSURED INSURER B: Arbella Protection 41360 Stone Mountain Roofing LLC INSURER C: WCAR-Travelers 156 Northampton Street INSURER D: INSURER E: Easthampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 2025 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. I EXP NSR TYPE OF INSURANCE ADD SUER POLICY NUMBER MMIDDIYYYY MMIDDPOLICY EFF Y/YYYY) LIMITS LTR INSD WVD ( ) ( X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO REN I EU 100,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A CGL0159193 02/18/2024 02/18/2025 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO 0000 X POLICY JECT LOC 20 , OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ g OWNED X SCHEDULED 1020114776 02/18/2024 02/18/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) PIP-Basic $ 8,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS'LIABILITY YIN 500 000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA 7PJUB6R27941623 02/17/2024 02/17I2025 E.L.EACH ACCIDENT $ , C OFFICER/MEMBER EXCLUDED? 500,000 (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 I 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 DocuSign Envelope ID:C3F8DBF1-4786-4A078C3B-95A95F5724F0' . [Massachusetts Department of Industrial Accidents _ , t Office of Investigations _ Lafayette City Center ;g 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): PINGUINS CONSTRUCTION LLC Address:39 Serwan Ave City/State/Zip:Willimantic, CT 06226 Phone#:413-799-0210 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 18 4. 0 I am a general contractor and I 6. ❑New 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. 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 13.0 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: National Specialty Insurance Company Policy#or Self-ins.Lic. #:NXT7EUNZ2I-02-WC Expiration Date:07/18/2024 Job Site Address: 4?) Qo U Q X\ Q, City/State/Zip: NQ+f-N^OLl'p (\ 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 fme 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 fme 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 penalties of perjury that the information provided above is true and correct. oc nstl by: Signature: ttf,V� Date: 9 13 2J-1 Phone#: 41 T0Cei�143E ... 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): IDBoard of Health 20Building Department 3.0City/Town Clerk 4.0 Electrical Inspector 5Plumbing Inspector 6.0Other Contact Person: Phone#: Ac R® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/18/2023 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: Next First Insurance Agency,Inc. PHONE (855)222-5919 FAX PO BOX 60787 _(AIC No.Ert4: (A/C.No): Palo Alto,CA 94306 EMAIL ADDRESS: support@nextinsurance.com ort@nextinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: National Specialty Insurance Company 22608 INSURED INSURER B: PINGUINS CONSTRUCTION LLC 39 Serwan Ave INSURER C: Willimantic,CT 06226 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:648092494 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO-wvn POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ]PRO- JECT J LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOSIREDONLY AUTOS N-O PROPERTY DAMAGE HIRED NON-OWNED $ _ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER A ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000.00 OFFICER/MEMBEREXCLUDED? NIA X NXT7EUNZ2I-02-WC 07/18/2023 07/18/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) The Certificate Holder is STONE MOUNTAIN ROOFING LLC.A Waiver of Subrogation applies in favor of this Certificate Holder on the following policies:Workers Compensation. All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured,and are subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION STONE MOUNTAIN ROOFING LLC LIVE CERTIFICATE 36 Lyon Hill Rd y • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Chester,MA 01011 °! . THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN r�s ACCORDANCE WITH THE POLICY PROVISIONS. ° is °F AUTHORIZED REPRESENTATIVE r lit a : 624-fL'f";""— Click or scan to view ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Cons fonTS ,rvisor ,fr CS-117335 spires 06/03/2026 MATTHEW C RRIER ,,„ .4 5 ,. 36 LYON HILL ROAD s - CHESTER Mkj01011 f b 9 {"s ly`k�TGL�',��1I- 7 Commissioner jcv A,. t7 Lita.. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affai a Business Regulation 1000 Washingt' c t-Suite 710 Boston},•-Massachusetts=0?118 Home Impro•emen grs'a tractor Re9iisstration imp. i; i. Type: LLC .— j e IS ration: 206447 � STONE MOUNTAIN ROOFING,LLC 'sr. E �iration: 09/15/2024 36 LYON HILL RD .... . I CHESTER,MA 01011 . = .—... -;� / c i '*� !`� kl, �,�`✓ w " Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affafrs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMEN CONTRACTOR expiration date. If found return to: . rrfrE:tre _ Office of Consumer Affairs and Business Regulation :fdtptratiop 1000 Washington Street -Suite 710 7g, xr .9t15/242.4 Boston,MA 02118 STONE MOUNTAIN Ref .,- ,L*-7 -3' MATTHEW CARRIER f 38 LYON HILL RD �;,� a, i• CHESTER,MA 01011 `y a i �` � i *-__-'5_" Undersecretary Not valid without signature DocuSign Envelope ID:CEA3F4DB-286A-45D6-B708-D4D3BBAC32F0 Stone Mountain Roofing LLC 156 Northampton St Easthampton, MA 01027 /\ 413-998-9010 yAw stonemountainroofingllc@gmail.com STONE MOUNTAIN www.stonemountainroofingllc.com/ ROOFING Contract ADDRESS CONTRACT# 1219 Ernie Alleva DATE 10/27/2023 43 Revell Ave. Northampton, MA 01060 ealleva@hampshire.edu 413-586-2724 DESCRIPTION - This contract excludes the newly shingled slope located on the backside of the house. 1. Remove the existing roofing shingles 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) https://www.certainteed.com/residential-roofing/products/landmark-pro/ Color Choice: MAX DEFINTION GEORGETOWN GRAY 7. Install Shingle Vent 11 ridge vent on peaks of roof(where applicable) http://www.airvent.com/index.php/products/exhaust-vents/ridge-vents/shinglevent2 8. Complete all necessary flashings including new LIFETIME pipe boots and base flashing around the chimney https://lifetimetoo 1.com/product/ultimate-pipe-flashing-shingle-kynar-coated/ Includes CertainTeed Lifetime Limited Warranty(Transferable)with 10 year SureStart period. https://www.certainteed.com/resources/Asphalt-LowSlope-Res-Warranty-e-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 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 necessary building permit. Installations are weather permitting; inclement weather will cause scheduling MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 DocuSign Envelope ID:CEA3F4DB-286A-45D6-B708-D4D3BBAC32F0 DESCRIPTION . m. party. may delays. Either cancel this contract for any reason, up until the time of firm scheduling and/or the second deposit,with a full refund of deposit less any permit fees paid. Total: Landmark PRO shingles=$10,800 Thank you for choosing Stone Mountain Roofing. Expected Installation: Spring 2024. A $500 deposit will secure contract,permitting, material order, and priority scheduling. The balance of the one-third deposit, $3,100 will be due prior to installation. 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 $10,800.00 pDocuSigned by: Accepted By fV1n.ic, Accepted Date 10/27/2023 Q�,tu.a �—E344B3EF3ACD4E2... MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321