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25-069 (3) BP-2023-0878 59 RIVERBANK RD COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 25-069-001 CITY OF NORTHA PTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0878 PERMISSIO IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: Est. Cost: 8400 MATTHEW CARRI:R CSL117335 Const.Class: Exp.Date: 06/03/20 . Use Group: Owner: KW 'IEN, ANDREA CAROL RICHARDS,ROBERT Lot Size (sq.ft.) Zoning: SC Applicant: STONE MOUNTAIN ROOFING LLC Applicant Address Phone: Insurance: 36 LYON HILL RD (413)998-9010 7PJUB6R27941623 CHESTER,MA 01011 ISSUED ON: 07/05/2023 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: • )2 - cfr , Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissii ner Docu gn En'elope ID,Df pf-5 - 52F-4339-BC2C-90069F6DA94E/ '41 061Sli s t �1 J uL 3 2023 T Commonwealth of Massachusetts oar. of Building Regulations and Standards FOR y t DING�n�sP ass chusetts State Building Code, 780 CMR MUNICIPALITY o _ Ecr1ON ��i'Prmrst Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling getion For Official Use Only Building Permit Number: r'56 °0" / Date Applied: /Z/ 7-6-ZOZ3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map 81 Parcel Numbers 59 Riverbank Rd. 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 Waiter 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? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Andrea Kwapien Northampton MA 01060 Name(Print) City,State,ZIP 59 Riverbank Rd. (413) 559-7175 agent.andreak@gmail.com 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 V§pecify: Roofing Brief Description of Proposed Work2: .strp_and.replace asphalt roof.__ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 8,400.00 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fee Check No.1( Check Amount: qb . Cash Amount: 6.Total Project Cost: $ 8,400.00 ❑Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:D33AF5E5-552F-4339-BC2C-90069F6DA94E 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 156 Northampton St., List CSL Typ (see below) U No.and Street Type I 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 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 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 Roofi g LLC/Matthew Carrier to act on my behalf,in all matters relative to work authorized by this building pe it application. -DocuSIgned by: Andrea Kwapien Ktvap e.n. 6/28/2023 Print Owner's Name(EleotranioSiNAiff42 Date SECTION 7b:OWNER' OR AUTHORIZED AGENT ECLARATION By entering my name below,I hereby attest under the pains and penalties of perj that all of the information contained in this application is true and accurate to the best of my knowledge an understanding. Matthew Carrier /4/ - 6/28/2023 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" DocuSign Envelope ID:D33AF5E5-552F-4339-BC2C-90069F6DA94E City of Northampton •o�tNrM }oA \5 �' Si, S C �. ' Massachusetts 44' "- 's- w i. 4:per 14 °,1 DEPARTMENT OF BUILDING INSPECTIONS 9: M * 212 Main Street • Municipal Building of cb, + Northampton, MA 01060 �cfr wcv'‘ 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: Al 0.7t. «.Z_ Date: 6/28/2023 The Commonwealth of Massaphusetts Department of Industrial Accidents mit=6-=. Office of Investigations T. 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 L LC 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): 1.0 I am a employer with 1 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contr tors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached she t. 7. ❑ Remodeling ship and have no employees These sub-contractors ha a 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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. ✓❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other 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. 1 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: 59 K\V QY \n O XI'C Q ck, ' City/State/Zip:,A joyea,c003, V- 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. Signature:iia2 eco 6/Wed- Date: OlC I r9C) ) 3 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/Licenfe # Issuing Authority(check one): 10Board of Health 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Pho a#: ACORL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) kift,.....---- 06/27/2023 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 NAME: Alera Group,Inc. PHONE (41 )586-0111 FAX (413)586-6481 (A/C,No,Ext): (A/C,No): Webber&Grinnell Division E-MAIL mlastbwski@webberandgrinnell.com ADDRESS: 8 North King Street I 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: 156 Northampton Street INSURER D: INSURER E: Easthampton MA 01027 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 AODL 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 $ 1,000,000 RETEU CI.AIMS-MADE X OCCUR PREMISESDAMAGE TO(Ea occurrence) $ 100,000 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,I)00 X POLICY n PRO- n 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED N/ SCHEDULED 1020114776 02/18/2023 02/18/2024 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 X STATUTE EOTH AND EMPLOYERS'LIABILITY Y 1 N 1l)0()Ol) ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBEREXCLUDED? Y N/A 7PJUB6R27941623 02/17/20 3 02/17/2024 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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 Commonwealth Massachusetts VDivision o Occupationalof Licensure Board of Building Rel rations and Standards ,xiConstton Srvisor CS-117335 6pires: 06/03/2026 MATTHEW CARRIER s 36 LYON HILL ROAD CHESTER Mk01011 r_ k p f1 �� Commissioner dicta f'. Fi'y+ THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingto rwt-Suite 710 Boston, Massachusetts 02118 Home Im ro eriilent-.'. traittorRet istration z' 17 to ■I I Type: LLC ist ation: 206447 STONE MOUNTAIN ROOFING,LLC m e g 36 LYON HILL RD Epiration: 09/15/2024 CHESTER,MA 01011Ai.lij F �FJj 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 expir:air n date. if found return to: TYPE`LIC Office of Consumer Affairs and Business Regulation Reglstratlort r EXniration 1000 Washington Street -Suite 710 2064471' :At 09/15/2024 Boston,MA 02118 STONE MOUNTAIN ROOFING'LLC, MATTHEW CARRIER ` � ,.�� 36 LYON HILL RD ', �„�a.,7 "mot Ow�� CHESTER,MA 01011 Undersecretary Not valid without signature j R DocuSign Envelope ID:D33AF5E5-552F-4339-BC2C-90069F6DA94E Stone Mountain Roofing LLC 156 Northampton St Easthampton, MA 01027 AN VA h/A 413-998-9010 stonemountainroofingllc@gmail.com STONE MOUNTAIN www.stonemountainroofingllc.com/ ROOFING Contract ADDRESS CONTRACT# 1 149 Andrea Kwapien&Bob DATE 06/28/2023 Richards 59 Riverbank Rd. Northampton, MA agent.andreak@gmail.com bar500@gmail.com DESCRIPTION 1. Remove the existing roofing shingles 2. Inspect the existing plywood for any rot or deterioration. Any ew plywood will be $85 per sheet installed. (Wood prices subject to change) *** If new plywood is being installed on the entire house= $4,211 3. Install six feet of ice and water shield on eaves and three feet . ound 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) http://www.certainteed.com/residential-roofing/products/landmar Color Choice: Driftwood 7. Install Shingle Vent 11 ridge vent on peak of roof(where appli•.ble) http://www.airvent.com/index.php/products/exhaust-vents/ridge- ents/shinglevent2 8. Complete all necessary flashings including new LIFETIME pi p a boots https://lifetimetool.com/product/ultimate-pipe-flashing-shingle- ar-coated/ Includes CertainTeed Lifetime Limited Warranty(Transferable) ith 10 year SureStart period. https://www.certainteed.com/resources/Asphalt-LowSlope-Res- arranty-e-2201 ctr.pdf Remove all debris from premises, and throughout the job, contin e 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 delays. MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 DocuSign Envelope ID:D33AF5E5-552F-4339-BC2C-90069F6DA94E hls �` r�i Q�r� �, i�J Wit i Ti`� it Total: Landmark shingles= $8,400 Thank you for choosing Stone Mountain Roofing. A one-third deposit of$2,800 will secure contract, permitting,material order, and priority scheduling. The balance shall be due upon completion,within l 0 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 $8,400.00 - DocuSigned by: Accepted By K«, Accepted Date 6/28/2023 -2F7016CC90C54E2... MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321