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23A-044 (7) BP-2024-1047 19 WEST CENTER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-044-001 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-2024-1047 PERMISSION IS HEREBY GRANTED TO: Project# ROOF/SKYLIGHT 2024 Contractor: License: Est.Cost: 21800 MATTHEW CARRIER CSL117335 Const.Class: Exp.Date:06/03/2026 Use Group: Owner: CARLSON BIRD MARK J&SUSAN M Lot Size(sq.ft.) Zoning: URB Applicant: STONE MOUNTAIN ROOFING LLC Applicant Address Phone: Insurance: 36 LYON HILL RD (413)998-9010 7PJUB6R2794I623 CHESTER,MA 01011 ISSUED ON: 08/19/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF AND REPLACE SKYLIGHT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: \leter: Footings: Rough: Rough: !louse# Foundation: Final: Final: Final: Rough Frame: (:as: 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: 7 2- Fees Paid: S 120.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner oc Envelope ID:D69E8DD3-0FE4-465A-B93E-D5D3796B26AF C c� Ici. 1 The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number:Or ZO 2AI f 7 Date Applied: At' Clc) Building Official(Print Name) " ature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 19 W Center St. Florence 23A-044-001 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) 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: Mark Bird Florence MA 01062 Name(Print) City,State,ZIP 19 W Center St. 413-588-1620 mbird12013@comcast.net 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 li"pecify: Roofing Brief Description of Proposed Work': Strip and replace asphalt roof and replace (1) existing skylight on house. Gaco coat detached garage. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 21,800.00 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire Total All Fees: $ Suppression) $ Check No.152.3 Check Amo J f 2)-Cash Amount: 6.Total Project Cost: $ 21,800.00 ❑Paid in Full 0 Outstanding Balance Due: Docusign Envelope ID:D69E8DD3-OFE4-465A-B93E-D5D3796B26AF 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 Easthampton, MA O1 O27 U Unrestricted(Buildings up to 35,000 cu.ft) p R Restricted 18c2 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 1 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 Registrant 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 4' No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,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. © r—DocuSigned by: 7/9/2024 Mark Bird MARK BIRD Print Owner's Nam;LEF4E2662 ture) 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. Matthew Carrier SI��la0a1/4{ Print Owner's or Authorized Agent's Name(E10A, nic Si nature) 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:D69E8DD3-0FE4-465A-B93E-D5D3796B26AF City of Northampton •" I Massachusetts A R( 4 DEPARTMENT OF BUILDING INSPECTIONS d 212 Main Street • Municipal Building J`, ' Northampton, MA 01060 J' TOX. ' 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: «r^-- Date: g, 1141,D -\ Docusign Envelope ID: F4958165-DE58-4CEE-B192-57E042A65E32 f Massachusetts Department of Industrial Accidents Office of Investigations �'. Lafayette City Center 2 Avenue de Lafayette, Boston, MA 02111-1750 Myles:iG'�// www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Andrade Brothers Construction Inc. Address: 16 Jefferson St., Apt 4 City/State/Zip: Milford MA 01757 Phone #:413-505-6124 Are you an employer? Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 18 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction listed on the attached sheet. 7. ❑ Remodeling 2.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. 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 q ] employees. [No workers' 13.❑✓ Other Roofing 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. #: 7PJ UB 1 W09136224 Expiration Date:7/31/2025 Job Site Address: (A) C City/State/Zip: 1 tYQi(-\cD (svc Oi012 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$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. (�Do Si red by: Si ature:l �arS - Date: 114 o�011o 1-1 Phone#: �'e1241 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): 11=1Board of Health 2❑Building Department 31:City/Town Clerk 4.1:Electrical Inspector 5E:Plumbing Inspector 6.0Other Contact Person: Phone#: DATE(MM/DD/YYYY)CO CERTIFICATE OF LIABILITY INSURANCE 08/09/2024 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 Mosarene Scalzer NAME: UNIVERSAL INSURANCE AGENCY •_AHw No ); (508)752-9333 FAX No): EMAIL ADDRESS: �• mscalzer©universalinsag en com 374 BELMONT ST INSURER(S)AFFORDING COVERAGE NAIC# WORCESTER MA 01604 INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED ! INSURER 8: ANDRADE BROTHERS CONSTRUCTION INC INSURERC: INSURER D: 16 JEFFERSON ST APT 4 INSURER E: MILFORD MA 01757 )INSURER F: COVERAGES CERTIFICATE NUMBER: 1034722 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP ' LIMITS LTR INSD WVD POUCY NUMBER (MMIDD/YYYY) IMMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEMAGE TO RENTED $ CLAIMS-MADE I I OCCUR PREMSES(Ea occurrence) $ MED EXP(Any one person) _$ N/A PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I J J C [ J LOC PRODUCTS-COMP/OP AGG $ OTHER. $ AUTOMOBILELIABILITY COMBINED SINGLE LIMIT $ (Ea accident__ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED N/A 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 N/A AGGREGATE DED r RETENTION; I/� STATUTE J ER WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABIUTY Y/N A OFFICER/MEMBER EXCLUDED?ECUTIVE E.L.EACH ACCIDENT $ 1,000,000 N/A N/A N/A 7PJUB1W09136224 07/31/2024 07/31/2025 (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage- Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationlinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Stone Mountain Roofing LLC ACCORDANCE WITH THE POLICY PROVISIONS. 156 Northampton St AUTHORIZED REPRESENTATIVE Easthampton MA 01027 i LLB DanielieI M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents 'fa Office of Investigations <<} I Lafayette City Center 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): Stone Mountain Roofing LLC Address: 156 Northampton St. City/State/Zip: Easthampton MA 01027 Phone#:413-998-9010 Are you an employer? Check the appropriat box: Type of project(required): 1.❑ I am a employer with 4. 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction listed on the attached sheet. 7. ❑ Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ 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 q ] employees. [No workers' 13.❑✓ Other Roofing comp. insurance required.] *Any 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:2/17/2025 Job Site Address: \C1 Ui C Est. City/State/Zip: .i or'QJ CQ ft\Pv Q 1O(Q 2- 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$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 perjusy that the information provided above is true and correct. Signature: Date: I LI I(0(t-1 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): 11:1Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5E'lumbing Inspector 6.0Other Contact Person: Phone#: A`oR�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDYYYY) 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 NAME: Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 LAIC,.No,Ext,): INC,No): Webber&Grinnell Division E-MAIL mlastowski@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC M Northampton MA 01060 INSURERA: 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. INSR RNr D YU rD POUCY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE (MMIDD/YYYY) (MM/DO/YYYY), X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea Occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A CGL0159193 02/18/2024 02/18/2025 PERSONALEADVINJURY $ 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 UABIUTY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accdent) ANY AUTO BODILY INJURY(Per person) $ B — 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 LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS' ABIUTY STATUTE ER LI Y/N 500,000 C ANYCER/MEMBERIPARTNER/EXECUTIVE Y NIA 7PJUB6R27941623 02/17/2024 02/17/2025 E.L.EACH ACCIDENT $ OFFICE ory In N ER 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 rl,!t_ „) --..;.-- I ©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 I I' Board of Building Re ulations and Standards ' Cons - tonITS rvisor CS-117335 r kpires:06/03/2026 MATTHEW C RRIER p 36 LYON HILk ROAD CHESTER M1__,01011 '")i.r.v,tiV3' ft' Commissioner ,c)r ,• � . I THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs a'rtd Business Regulation 1000 Washingtojt-Suite 710 Boston, Massachusetts 02118 Home Im•roement + 1:ctor=R istration =z....-.-_-. ik,,.,.. .. s.0 ---" it, V Type: LLC { tan: 206447 STONE MOUNTAIN ROOFING,LLC :=� —• :,ration: 09f15/2024 36 LYON HILL RD CHESTER,MA 01011 �- c,i� — s.1M ``e MIN 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: TYPES"U c Office of Consumer Affairs and Business Regulation Registration ^ Eanlntion 1000 Washington Street-Suite 710 2Q6447-"; .i1109/15/2024 Boston.MA 02118 STONE MOUNTAIN ROOFING;LLC,` MATTHEW CARRIER IS/ / 1 '& - ors 36 LYON HILL RD s= /,1;.// „...„,a,7,�/,,,,/. CHESTER,MA 01011 '•y " ..;7 t•-y. Undersecretary Not valid without signature Docis!n Envelope ID:D69E8DD3-0FE4-465A-B93E-D5D3796B26AF Stone Mountain Roofing LLC 156 Northampton St Easthampton, MA 01027 Al2k4L 413-998-9010 stonemountainroofingllc@gmail.com STONE MOUNTAIN www.stonemountainroofingllc.com/ R U O F I N C Contract ADDRESS CONTRACT# 1388 Mark Bird DATE 07/09/2024 19 W Center St. Florence, MA 01062 DESCRIPTION House: 1. Remove the existing roofing shingles 2. Inspect the existing plywood for any rot or deterioration. Any new plywood will be$75 per sheet installed. (Wood prices subject to change) 3. Remove (1) existing skylight and replace with (1)new Manual Venting Velux skylight *Stone Mountain Roofing is not responsible for any necessary interior trim work* 4. Install six feet of ice and water shield on eaves and three feet in the 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) http://www.certai nteed.com/residential-roofing/products/landmark/ Color Choice: 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/shingl event2 9. Complete all necessary flashings including new LIFETIME pipe boots and base flashing around the chimney https://lifetimetool.com/producdultimate-pipe-flashing-shingle-kynar-coated/ Detached garage: 1. Clean roofing surface using"GacoWash" concentrated cleaner or equivalent. Requires spraying product, agitating surface with a bristle brush, and washing off with water https://gaco.com/product/gacowash/ 2. Allow surface to dry 3. Make any necessary repairs to the EPDM rubber roof 4. Install one coat of GacoFlex "S42" onto the entire roofing. Requires rolling on the product MA-CSL#117335 MA-HIC#206447 CT-IIIC.0668321 Docii yn Envelope ID: D69E8DD3-OFE4-465A-B93E-D5D3796B26AF DESCRIPTION https://gaco.com/product/gacoflex-s42/ (Please note,the GacoFlex "S42" is the high performing one coat system) Color: White Includes CertainTeed Lifetime Limited Warranty(Transferable)with 10 year SureStart period. https://certainteed.widen.net/content/srzvlkjewe/pdf/SureStart-warranty-brochure-00-02-203 NA-EN- 2301.pdf?u=nwk4fd 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 delays. Either party may 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. House: Landmark shingles=$14,400 Detached garage=$6,000 Manual Venting Vella Skylight=$1,400 TOTAL=$21,800 Thank you for choosing Stone Mountain Roofing. Expected Installation: Fall 2024. A$500 deposit will secure contract,permitting,material order,and priority scheduling. The balance of the one-third deposit, $6,700 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 $219800°00 DocuSigned by: 7/9/2024 Accepted By MARK BIRD Accepted Date -Cf 7876A071D6467 MA-CSL#117335 MA-IlIC#206447 C'T-IIIC.066832I