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10B-072 (6) BP-2023-0788 30 WATER ST COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 10B-072-001 CITY OF NORTHA PTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0788 PERMISSIO IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: Est. Cost: 7200 MATTHEW CARRI R CSL117335 Const.Class: Exp.Date: 06/03/202 Use Group: Owner: LE GREENE JASON & 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: 06/14/2023 TO PERFORM THE FOL L O WING 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 NORFHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I >2 . TIT 1 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissi'net. Docullgn Envelope ID:2B089FB3-DOC8-4E6A-9120-1A8CDFBF146E --- JUN 1 4 2023 T e Commonwealth of Massachusetts '; rit oar a of Building Regulations and Standards MUNICIPALITY ' sun DING INSPECTIO ass:chusetts State Building Code, 780 CMR — ._`nT , HAvrTON.MA 01060 USE :ut a . ' :,lication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 - One- or Two-Family Dwelling 'Tilts Section For Official Use Only Building Permit Number: VA '7 Date A lied: Zliip-iVx-irlam-N ZOZ3 Building Official(Print Name) Signature I Date I SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 30 Water St., Leeds 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 CIPrivate 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Leanne Greene Leeds MA 01053 Name(Print) City,State,ZIP 30 Water St. 413-588-1944 jlgreene5@gmail.com No.and Street Telephone I 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 9/Specify: Roofing Brief Description of Proposed Work2: strip and replace asphalt roof on sections only (see diagram) SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 7,200.00 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 Suppression) $ Total All Fee g$1 A 0 Check No. (t Check Amount: —1 Cash Amount: 6. Total Project Cost: S 7,200.00 ❑Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:2B089FB3-DOC8-4E6A-9120-1A8CDFBF146E 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 36 Lyon Hill Rd List CSL Type(see below) U No.and Street Type Description Chester, MA 01011 U Unrestricted(Buildings up to 35,000 Cu.ft.) 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 Registrant Name 36 Lyon Hill Rd stonemountainroofinglIc@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. r—DocuSiyned by: 6/7/2 02 3 Leanne Greene Print Owner's Name(Electsimi 'dillIg)asE._ Date SECTION 7b: OWNER1 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 6/5/2023 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),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" uuuuaign tnveiope iu:[BU89FB3-DOC8-4E6A-9120-1A8CDFBF146E City of Northampton �� / r Massachusetts %, �l I , DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building yJti a Northampton, MA 01060 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: 6/5/2023 + � ne a vnrnwisweuun vJ 1r1ua.144.,iou.eii. Department of Industrial Accidents =,gam Office of Investigations =��'- Lafayette City Center 72.-314 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: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): 1.0 I am a employer with 1 4. D I am a general contractor and 1 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. 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.Ei 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 a d 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: ah Ltaw,y- • City/S to/Zip: LeLdS O\063 Attach a copy of the workers' compensation policy declaration page(showing the olicy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to t imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the fo 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 m y be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penal ies of perjury that the information provided above is true and correct. Si.nature:I '!� I Date: (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): IDBoard of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.DOther Contact Person: Phone#: Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standards Constt t onIT Srvisor CS-117335 _L icpires: 06/03/2026 MATTHEW CARRIER , Le 36 LYON HILL ROAD CHESTER MFt01011 VJ Commissioner ri,. K. f7 &J - THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington refit-Suite 710 Boston, Massachusetts`02118 Home Im ro erile`f rac or-Re istration x r' _ rf pe: LLC ist ation: 206447 STONE MOUNTAIN ROOFING,LLC m e 9 36 LYON HILL RD EPiration: 09/15/2024 CHESTER,MA 01011 `" �r� kr `7r )fW 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 tound return to: TYPEr.LEC Office of Consumer Affairs and Business Regulation Registration P Expiration 1000 Washington Street -Suite 710 2Q6447 ', .i.09/15/2024 Boston,MA 02118 STONE MOUNTAIN ROOFING?LLC, , MATTHEW CARRIER —' _ 38 LYON HILL RD ,, a 4 Oar�� CHESTER,MA 01011 `; t� �` � i ``--r- Undersecretary Not valid without signature AC ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) Li..../. 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 CONE:CONTACT Michelle Lastowski Alera Group,Inc. PHONE (413)586-0111 FA Ne: (413)586-6481 LAIC No,Ext): ( ) Webber&Grinnell Division E-MAIL 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: 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 LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �� X7� DAMAGE TO RENTED 100,000 CLAIMS-MADE 1' 1I OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A CGL0159193 02/18/2023 02/18/2024 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 X POLICY JE0 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 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 LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ . $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 B OFFICER/MEMBER EXCLUDED? Y NIA 7PJUB6R27941623 02/17/2023 02/17/2024 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 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 ill,- yLjiO ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD - -----•�••�••..•..� �uv�aroruwo-•►COH-a1ZU-1AiUOF5F146E Stone Mountain Roofing LLC 36 Lyon Hill Rd., Chester, MA 01011 413-998-9010 41Akes stonemountainroofingllc@gmail.com STONE MOUNTAIN www.stonemountainroofingllc.com/ R 0 0 F I N C Contract ADDRESS CONTRACT# 1122 Leanne Greene DATE 06/05/2023 30 Water St. Leeds, MA 01053 jlgreene5@gmail.com 413-588-1944 DESCRIPTION . - This contract is for the sections labeled "A" "B" "C" "D" see attached diagram. 1. Remove the existing roofing shingles 2. Inspect the existing plywood for any rot or deterioration. Any n-w 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 ar1und 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/landmar -pro/ Color Choice: MAX DEFINITION COBBLESTONE GRAY 7. Install Shingle Vent 11 ridge vent on peak of roof(where applica•le) http://www.airvent.com/index.php/products/exhaust-vents/ridge-v;nts/shinglevent2 8. Complete all necessary flashings including new LIFETIME pip: boots https://lifetimetool.com/product/ultimate-pipe-flashing-shingle-k ar-coated/ Includes CertainTeed Lifetime Limited Warranty (Transferable) w th 10 year SureStart period. https://www.certainteed.com/resources/Asphalt-LowSlope-Res-W.rranty-e-2201ctr.pdf Remove all debris from premises, and throughout the job, continu= cleanup and keep the premises undamaged. WE ARE NOT RESPONSIBLE FOR DEBRIS THA MAY FALL INTO ATTIC. Please be proactive and prepare for the worst by covering everything in the a ic. We recommend covering with tarps or plastic sheeting. Please use reasonable caution during the • stallation process: do not walk or drive under active work, or on areas of potential roofing debris. Stone M s untain Roofing will obtain the building permit if necessary. Installations are weather permitting; i clement weather will cause scheduling delays. MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 uocuign Lnvelope ID:2B089FB3-DOC8-4E6A-9120-1A8CDFBF146E DESCRIPTION ,14 Total: Landmark PRO shingles= $7,200 Thank you for choosing Stone Mountain Roofing. A one-third deposit of$2,400 will secure contract,permitting, ma erial order, and priority scheduling. The balance shall be due upon completion, within 10 days of invo'ce. Accounts outstanding over 30 days subject to 2% finance charge monthly. Warranty confirmation shall be provided upon final payment. Ins llation and manufacturer warranties are not in effect until Paid In Full. TOTAL $7,200.00 Acce ted Bye—Docu Signed by: 6/7/202 3 p G Accepte Date s.—F3D8042B64D348E... MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 uocuslgn tnvelope ID:2B089FB3-DOC8-4E6A-9120-1A8CDFBF146E r , B v ` I A Front of the house