23A-134 (29) BP-2024-0867
77 PINE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23A-134-001 CITY OF NORTHAMPTON
Permit: Temp Structure
(Tents)
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2024-0867 PERMISSION IS HEREBY GRANTED TO:
TENTS 2024 I Temp Structure
Project# (Tents) 101/03/2024 Contractor: License:
Est. Cost: 0
Const.Class: 1?xp. Date:
Use Group: Owner: HILL INSTITUTE
Lot Size (sq.ft.)
Zoning: URB applicant: HILL INSTITUTE
Anplicant Address Phone: Insurance:
83 PINE ST
FLORENCE, MA 01062
ISSUED ON: 07/08/2024
TO PERFORM THE FOLLOWING WORK:
2 -20X40 TENTS
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: Oe • fr •2 it S�
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 1/Z.
Fees Paid: $45.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
City of Northampton
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Sic'�
, Massachusetts
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1� :• l a t• .r �'a®8�rmr 81C3'SOATS yJ s C
212 Main Street • Municipal Building ,� V I /}^�
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TENT PERMIT APPLICATION 8 8024
ofipr.of
Residential Tents over 200 sq NpR 8 UI(p!N p
Commercial-Tents over 120 sgft 4M7 roZ, NspECTlp�y
Permit Fee:$45.00 Check# 3 17? 01oso S
g
P — i- 807
Pu.EASE TOWS @Aa PRRINTANUL IMFROfAMbAmrmw
1. Name of Applicant: `-h hiS - ctn n1 e' / r 1 i I!
Address: 83 Pine Skeet, Florence KR 01062Telephone: 013) 594-125
Owner ofProperty: Hill :Eh Stif(de
Addreer 83 Pthe Flow ce T (46) 584- 1725
a SeemsatApsgilit Osier Ceadrraetimr MA 1o1062
SdWei ,Ad►ninisf 4or _ f/
4. Ters Location Addressk Q"t the back or the parlor fold• Oh �lje r4ss Q�Oh "M€ fel)Ce
Paoli Mt Zoning Map* Paorl# Dislrirt(s)
(MBE IFUESIIM MIME B+lw19 R'mil)
S. Use err hmpeTt mat camp
a. DISIZc0lM aft Tsonfi: 2 1-eh Is
Size: 20 k 11-0
Ctcupant Capacity: unsure
Dares du S . Sept, 7 20 2/ I die tufts will be set up
o
_7. ALL INFORMATION MUST BE COMPLETED:PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. h7 e m 0 r r 'r1 ! i 2 e
So ia1 'iieI— ) be iuispecf-ed
after iz Pn). of, Fi/ . la
a Certification.:1 hereby certify that the intonstation contained heron"s true and aamealle to the best
of my iearoeledge.
DATE: 'T/g/Z021 APPLICANT'S SIGNATURE Chit 0.4114144Q
NOTE Issuance da permit does net refi we an applicants burden b can*alb ai zoning regeiemeris
and obtain al regaled penile foam the Carsensiort Canoisdoq Derailment of Pubic Walla and finer
applicable peal granting anemrtths.
A/ ® DATE(MMIDD(YYYY)
l� CERTIFICATE OF LIABILITY INSURANCE 04/25/2024
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 Hollie Kochapski
NAME:
Aquadro 8 Associates (NC,No,Eel): (413)586-7373 F No): (413)584-0859
355 Bridge St.,P.O.Box 357 E-MAIL hollie@aquadroinsurance.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC N
Northampton MA 01061 INSURER A: EVANSTON INSURANCE
INSURED INSURER B: National Grange Mutual Insurance Company 14788
Northampton Rental Center Inc. INSURER C: AIM Mutual
59 Service Center Road INSURER 0: Preferred Mutual Insurance Co 15024
INSURER E:
Northampton MA 01060-0000 INSURER F:
COVERAGES CERTIFICATE NUMBER: CL217210395 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 INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100'000
MED EXP(Any one person) $ 5.00
A 3AA403213 06/01/2023 06/01/2024 PERSONAL d ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000
XI POLICY PRO- 2,000,000
JECT LOC PRODUCTS-COMP/OPAGG $
OTHER $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY(Per person) S
B OWNED SCHEDULED M1 S4081 R 12/16/2023 12/16/2024 BODILY INJURY(Per accident) $
AUTOS ONLY X AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X AUTOS ONLY X AUTOS ONLY (Per accident)
PIP-Basic S 8,000
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB ^— CLAIMS-MADE AGGREGATE S
DED RETENTION$ S
WORKERS COMPENSATION PER OTH.
AND EMPLOYERS'LIABILITY STATUTE ER
Y/N 100,000
C ANYPROPRIETORPARTNER/EXECUTIVE Y N/A WCC500-5006728-2021A 01/0112024 01/0112025 E.L.EACH ACCIDENT
OFFICER'MEMBER EXCLUDED? $
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500.000
If yes,describe under 100,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
PROPERTY LIMIT $665.000
COMMERCIAL PROPERTY COVERAGE
D CPP0100600509 05/01/2024 05/01/2025 DEDUCTIBLE $2500
DESCRIPTION OF OPERATIONS:LOCATIONS'VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached it 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
ACCORDANCE WITH THE POLICY PROVISIONS
AUTHORIZED REPRESENTATIVE
I
(c)1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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� , ISSUED BY:
EUREKA! TENTS / a div. of Johnson Outdoors Gear LLC C 11
BINGHAMTON, NEW YORK 13902
i'
(16.,, Manufacturers of the Finest !v�'�5 ERF ,!
,,,„.,
Tent Products Described Herein ;16
a;� ',��''d
DEALER NAME: Northampton Rental Center, Inc
ADDRESS: 59 Service Center Rd
CITY: Northampton STATE/ZIP: Mass. 01060
O ♦ O
This is to certify that the products herein have been manufactured from material inherently flame
retardant as here after specified by the material supplier.
Certification is hereby made that: The articles described on this certificate have been manufactured with
an approved flame retardant chemical that was tested and passed the following codes: California State Fire
Marshal Code, NFPA-701, Underwriters Laboratory of Canada (ULC-S109-M87) and (ULC-S109-2003).
A scription of item certified• 2Q'X40'X14'VSlhii Ply Can9py
Flame Retardant Process Used Will Not Be Removed By Washing And
Is Effective For The Life Of The Fabric
TENT DEPARTMENT.JOHNSON 0 DO S GEAR LLC
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