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18C-141 BP-2023-0948 680 BRIDGE RD COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 18C-141-001 CITY OF NORTHA PTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGIS ERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0948 PERMISSION IS HEREBY GRANTED TO: THE MEETING HOUSE ROOF Project# 2023 Contractor: License: Est. Cost: 35000 MATTHEW CARRIE CSLI 17335 Const.Class: Exp.Date: 06/03/202 Use Group: Owner: LATH OP COMMUNITY INC Lot Size(sq.ft.) Zoning: RI/RR/URB/WP Applicant: STONE OUNTAIN ROOFING LLC Applicant Address Phone: Insurance: 36 LYON HILL RD (413)998-9010 7PJUB6R27941623 CHESTER,MA 01011 ISSUED ON: 07/20/2023 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF MEEING HOUSE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Scrs ice: 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 NO HAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • r . >2 311 • Fees Paid: $245.00 212 Main Street,Phone(413)587-1240,Fa : (413)587-1272 Office of the Buildinc Commis 'oner Re- / lv The Commonwealth of Mas ac se Office of Public Safety and Ins ecHo s 1 9 rMassachusetts State Building Code 80 R Building Permit Application for any Building other th a difef -Family Dwel ng Q (This Section For Official Use Only) NOHTNA ,►NSpec Building Permit Number: 3 Ity 0 Date Applied: Building Official: _ N.Mq oio O°NS SECTION 1:LOCATION 680 Bridge Rd Northampton 01060 "The Meeting House" No.and Street City/Town Zip Code Name of Building(if applicable) 18C-141-001 Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check herb 0 or check all that apply in the two rows below Existing Buildind Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 I Other% Specify: Roofing Are building plans and/or construction documents being supplied as part of his permit application? Yes 0 No Is an Independent Structural Engineering Peer Review required? Yes 0 No Brief Description of Proposed Work: strip and replace existing asphalt roof on "Meeting House" 1 Shallowbrook Dr.. Northampton SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub ❑ A-3 0 A-4 0 A-5 0 B Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3 0 I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA CI IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA El VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Dis osal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal❑ A trench will not be p Private 0 or indentify Zone: or on site system 0 required❑or trench or specify: permit is enclosed 0 Railroad right-of-wa • Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No❑ Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: _Special Stipulatiors: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Lathrop Communities Inc 100 Bassett Brook Dr. Easthampton MA 01027 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Chris Hague- Facilities Manager 413 _437 _ 5894 413.320 _ 3909 chague@lathrop.kendal.org Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please f ll out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here C. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Matthew Carrier 411-998-$010 stonemountainroofinglIc@grnail.com CS-117335 Name(Registrant) Telephone No. e-mail address , Registration Number 156 Northampton St.. Easthampton MA 01027 U 09/15/2024 Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Stone Mountain Roofing LLC Company Name Matthew Carrier HIC:206447 Name of Person Responsible for Construction License No. and Type if Applicable 156 Northampton St.. Easthampton MA 01027 Street Address City/Town State Zip 413-998-9010 413214-9525 stonernountainroofinglIc@gmail.com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Irdustrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the 4suance of the building permit. Is a signed Affidavit submitted with this application? Yeslqr No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 35,000.00 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropr_ate municipal factor)=$ . 3.Plumbing $ O� 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to (1( SECTION 6.Total Cost $ 35,000.00 (contact municipality and write check number here a(a(f SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under ,the �pains and penalties of perjuily that all of the information contained in this application is true and accurate to the b m ledge and understanding. Matthew Carrier ou Owner 413-998-9010 7/13/2023 Please print and sign name Title Telephone No. Date 156 Northampton St. Easthampton MA 01027 stonemountainroofinglIc@gmail.com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: //�e 7 l +- z3 Name Date City of Northampton OaS M SAS SjCf,.. t"--:+ " Massachusetts , <<, I � `(.� t' '�� DEPARTMENT OF BUILDING INSPECTIONS y. �i t x r 212 Main Street • Municipal Building `� D _`° Northampton, MA 01060 �SSN{y q,7�^��C 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 RPcyrIing, Nnrthamptnn MA The debris will be transported by: Name of Hauler: Aaron's 24/7 Towing & Roll Off Services Inc Signature of Applicant: Coz Date: 07/13/2023 The Commonwealth of Mass chusetts Department of Industrial A idents y Office of Investigatio s Lafayette City Cente 2 Avenue de Lafayette, Boston,M 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ ontractors/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): 1.0 I am a employer with 1 4. 0 I am a general contracto and I employees (full and/or part-time).* have hired the sub-contr ctors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sh et. 7. ❑ Remodeling ship and have no employees These sub-contractors h e 8. ❑ Demolition workingfor me in anycapacity. employees and have wo ers' P tY 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation anc its 10.❑ Electrical repairs or additions 3.0 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 M_GL 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:02/17/2024 Job Site Address: (S�� h C1� S ��O°Y W City/State/Zip: NO( CX rO U � �r ty p: �7��. im� � 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 certifyy yu�nder theth pains and penalties of perjury that the information provided above is true and correct. Signature:G�[:2>!Gtieu� L,ar%tr'eti Date: j I IL) I e)R 0& 9� 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 2❑Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5�Plumbing Inspector 6.0Other Contact Person: Phoie#: ACCWO® DATE(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 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. PAHONNE,Ext): (413)586-0111 FAX No): (413)586-6481 Webber 8,Grinnell Division E-MAILD mlastpwski@webberandgrinnell.com 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC N Northampton MA 01060 INSURERA: 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 NAILED 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 ADUL SUHR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD wVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) 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 a ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000'000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2'000'000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED �/ SCHEDULED 1020114776 02/18/2123 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/N i100,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA 7PJUB6R27941623 02/17/2C�23 02/17/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (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 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 Commonwealth of Massachusetts \ Division of Occupational Licensure V Board of Building Regulations and Standards Constton Srvisor CS-117335 15pires:06/03/2026 MATTHEW WRIER s 36 LYON HILti ROAD .., CHESTER Mit01011 ,...._ ,_,..„ ..,-..„... .,"/.1.,V,0'- Commissioner Cli,i�• K. Y&+di, THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingto, reept-Suite 710 Boston,_Massachusetts 02118 Home Im.ro'e`eat= "e tractor-Re istration l IIPt' 17 m.;e ll stitf r, Type: LLC STONE MOUNTAIN ROOFING,LLC a r ..egisttation: 206447 HILL RD tit = Ejo{ration: 09/15/2024 CHESTER,MA 01011 , �_ rr -+art/ mos Update Address and Re m 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: TYPE`LCC Office of Consumer Affairs and Business Regulation Reglstratloj r- explratsj 1000 Washington Street -Suite 710 2Q6447", ,+3.09/15/2024 Boston,MA 02118 STONE MOUNTAIN ROOFING;'LLC, MATTHEW CARRIERAI?36 LYON HILL RD � ,� ,&, ' ew►�.� CHESTER,MA 01011 Undersecretary Not valid without signature Doc ign Envelope ID:592CE189-74FD-4523-9E75-85D32D4CFD94 Stone Mountain Roofing LLC 156 Northampton St Easthampton, MA 01027 'AC�� 413-998-9010 stonemountainroofingllc@gmail.com STONE MOUNTAIN www.stonemountainroofingllc.com/ R O O F I N G un�wi Contract ADDRESS CONTRACT# 1153 Lathrop Communities, Inc. DATE 07/13/2023 c/o Chris Hague 1 Shallowbrook Drive Northampton,MA 01060 chague@lathrop.kendal.org DESCRIPTION : ' Job Location: Northampton Meeting 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) http://www.certainteed.com/residential-roofing/products/landmar c/ Color Choice: Pewterwood 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 https://lifetimetool.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, contint.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. Installations are weather permitting; inclement weather will cause scheduling delays. MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 • Doct.:3ign Envelope ID.592CE189-74FD-4523-9E75-85D32D4CFD94 DESCRIPTION Landmark shingles = $35,000 Thank you for choosing Stone Mountain Roofing. The balance shall be due upon completion,within 30 days of invo ce. Accounts outstanding over 30 days subject to 2%finance charge monthly. Warranty confirmation shall be provided upon final payment. Ins I allation and manufacturer warranties are not in effect until Paid In Full. • TOTAL $35,000.00 e—DocuSigned by: Accepted By ciLI,1� Accepte I Date 7i 13i 202 3 '-D407FCA6D09A46D... MA-CSL#117335 MA-HIC#206447 CT-HIC.0668321 DocuSign Envelope ID:592CE189-74FD-4523-9E75-85D32D4CFD94 LATHRof Northampton Campus s NORTHAMPTON , a- 4 25 AK-pm-DAL Together,transforming 4' ::fr ! ' 2aaar� 2 t ►, MT. 4 212.... e 4r.ft.,tl 1 ''' .F,-.;‘, I I29 35�� (Iw 41- �``70 71 72 73 �r►t 74 °s / 2oL n �f . Vic:` ,. 1ts 10..dis - � 30 �V 1142 • :p lane '♦! `75 1 g' U u .� 1 a 1 6 9 Hawct*o 31 # 32 tap 33!! Aim �r 4 5 =. 1 43 t,a ♦ . 75 .� 4 ati. ite 77 . /s 6 -,-.1,), , _ Ikt1S;N's '"•` •' „., `.`'a�_ owbYook)""e 7 _, ,40 5 5 5 b `��01 6'T ,, + c , C`t�3 � ' s I� .+- • 54 1 f�r� 'ft�.- 58 :.. 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