49-042 (2) 711 PARK HILL RD BP-2017-1247
GIs#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:49-042 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: shed BUILDING PERMIT
Permit It BP-2017-1247
Project# JS-2017-002086
Est. Cost:
Fee: $30.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use Group: Homeowner as Contractor
Lot Size(sq.It): 197588.16 Owner: Scott Mahar
zoning: Applicant: Scott Mahar
AT: 711 PARK HILL RD
Applicant Address: Phone: Insurance:
711 Park Hill Rd. (413) 586-5561 0
FLORENCE ,MA01062 ISSUED ON:5/4/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:200 SQ FT SHED
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 5/42017 0:00:00 $30.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-1247
APPLICANT/CONTACT PERSON Scott Mahar
ADDRESS/PHONE 711 Park Hill Rd. FLORENCE , (413)586-5561 ()
PROPERTY LOCATION 711 PARK HILL RD
MAP 49 PARCEL 042 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: 200 SQ FT SHED
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9RMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
C���l�
Signature of Building Official Dat
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,
Department of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
City of Northampton
÷,-..." -PA,. Zs
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street r Municipal Building tA'
!� \ Northampton, MA 01060AA
I�f� I� � amp NW 301
m
. N eg- oya
Ji ACCESSORY STRUCTURE PERMIT APPLICATION
(For freestanding structures less than 200 sq.K., least 5 feet from any other structure)
_—.---.__. Check# ya 1
PLEA E TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:/ Co /q` / coo/
/�/ l
Address: 7/? wltt Will V`d Telephone: . /.) 6d6 .--6G\(/a
2. Owner of Property: SO/7,1—C.
Address: Telephone:
3. Status of Applicant: Owner
yard4. Structure Location: Side (.tr(n
Parcel ID: Zoning Map# Parcel ill# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: /Multifamily: Commercial:
6. Description of Proposed Structure:
One Story Shed under 200 sq.H.: ✓/Freestanding Deck under 200 sq.ft., less than 30"above grade:
SIZE OF STRUCTURE:
Other(describe):
7. Attached Plans:Sketch Plan _Site Plan Plot Plan
8. Does the site contain a brook, body of water or wetlands? NO `r DON'T KNOW YES
IF YES: Has a permit been, or need to be, obtained from the Conservation Commission?
Needs to be obtained Obtained , Date issued
CONTINUED ON NEXT PAGE
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The Commonwealth of Massachusetts
=__== '/ Department of IndustrialAccldents
;gybe_ 1 Congress Street,Suite 100
a
' 1iI N Boston,MA 02114-2017
a wwntmassgovldia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information PIease Print LeaibtY
Name(Business+Organimtionfindividuaf): William R. Lamore DBA Lamore Lumber
Address: 724 Greenfield Rd.
City/State/Zip: Deerfield, MA 01342-9752 phone#: 413-773-8388
Are you an employer?CIS the appropriate box: Type of project(required):
la I am a employer with 1- employees(full and/orpancimey* 7. ❑New construction
20 I am a sok proprietor or partnership Shave no employees working for me in 8. _IC Remodeling
any capacity.Mo workers'comp.Simms required.)
3.0 I am a homeowner doing all work myself.Mworkers'o workecomp.insurance required.]t 9. Demolition
401 am a homeowner and will be hiring ronoactors to conduct all work on my property. I will 10 El Building addition
ensure that all contractors either have workers compensaian insuranu or are sole I I.0 Electrical repairs or additions
proprietors with no employees. I2.0Plumbing repairs or additions
50 I am a general conoactor and I have hired the sub-compactors limed on the marled sheet
Tlesesubconum:mrs have employees and have workers'comp.Same d3.❑Rtwfrepairs
60We are a corporation and its officers have exercised their right of exemption per MGI.c. I4.❑lhller_,
152,§1(4).and we have no employes fNo workers'comp.insurance required.]
*Any applicant that cheeks box HI must also fill out the section below showing their workers'cosge nation policy information.
t Homeowners who submit this affidavit Skating they are doing all work and then hire outside contractors mutt submit a new affidavit indicating such
:Contractors that check this box must mashed an additional sheet showing the name of the sub-contractors and stare wisher or not Orem entities have
employees. If the sub-contractors have employees,they neat provide their woks'comp.pofityy nwnber. <
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site
information.
Insurance Company Name: The Travelers Indemnity Company
Policy#or Self-ins.Lie-#: 6111.111-02481415—A-16 Expiration Dam: 04/08/17
Job Site Address: 711 !"pa c < j4 . II led City/State/Zip; F/of?eicge ll"ti din G -1-
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to SI,5O0.00
and/or one-year imprisonment,as well as civil penalties in the Tam of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby cartify under the pains and nada alp • ry Martha information provided above is true andcenceL
914:6,ars
Sianature: Date: 9—y - / 7
Phone it: 413-773-83388
Official use only. Do not write Mikis areato be completed by city artown official
City or Town: Permit/License
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 3.Plumbing Inspector
6.Other
Contact Person: Phone it:
- ' ;le ` 'on"moilroe( /?A c r,. �cr trc ie e
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 120052
Type: DBA
Expiration: 10/10/2017 Trp 271588
LAMORE LUMBER & SON
WILLIAM LAMORE ---_--- _ -- _---_-
724 GREEN FIELD RD. --_--- - -
DEERFIELD, MA 01342 ------------ ------- --
Update Address and return card.Mark reason for change.
-, - - Address —. Renewal Employment Lost Card
Office of Consumer Affairs&gusloesr Regulation License or registration valid for individul use only
=C HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to:
,wk; .Registration: 120052 Type: Office of Consumer Affairs and Business Regulation
10 Park Plaza-Suite 5170
Exp10/10/2017 DBA
Boston.MA 02116
IAMORE LUMBER&SON
77/7„7:66„.
WILLIAM LAMORE ���S
724 GREEN FIELD RD.
DEERFIELD.MA 01342
Undersecretary Not valid without signature
D. YYII/ Cul° o:LL:DE AN PAGE 2/002 Fax Server
��sy+� py CERTIFICATE OF LIABILITY INSURANCE j°AT�04/1s/20�fi`'�'
TMIi,GER_ TIFICATE 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 TIE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SI,AUTHORIZED REPRESENTATIVE
OR PRODUCER AND THE CERTIFICATF HOLDER
IMPORTANT:If the cediticate holder is an ADDITIONAL INSURED,the policyjies(must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer tights to
the certificate holder in lieu of such endorsements).
PRODUCER CONTACT
NAME:
PARTRIDGE ZSCHAU ENS PHONE FAX
25 MILLERS FALLS ROAD IA/C,No,Exp: Guy No)
EMAIL
TURNERS FAt I S,MA 01316 ADDRESS:
25DIE ptsuRERISI AFFORDING COVERAGE HNUCi
INSURE) INSURER A: TRAVELERS INDEMNITY COMPANY DF AMERICA
LAMORE,WILLIAM IA DBA LAMORE LUMBER CO. INSURER e:
(NEMER c:
INSURER DI
124 GREENFIELD ROAD ATE 5&10 .
INSURERS: _
DEERFIELD,MA 01342 INSURER F.:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THEM TO CERTIFY THAT THE POLICIES OFMSURANCE LISTED 1110-OW PAVE SEEM ISSOEO TO THE INSURES NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WRHSTANDNG
ANY REQUIREFEIIT,TPM OR CONOFI N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH NM CERTFCATE MAY SE ISSUED OR NW PERTHt THE MMIRANCE
A!YOROEDBY TEE POLICIES DESCRIBED I®IEEI RSUSJECT TO ALL THE TERGA,EnCIuaeINs ANO COROMONS OF SUCK POLICIES. LIMITS MOWN MAY HAVE SON REDUCED SY
PAW CLAIMS.
NSR AO0 SOS POLICY EFF DATE POLCY EYE DATE
LTR TYPE OF INSURANCE L R FOLLY NULBER IRMDDIYVYY IANODIYYYYI LINTS
GENERAL LIABILITY EACH OCCURRENCE $
fCOMMERCIAL GENERAL tIABILITV
CLAIMS MADE El OCCUR. FREMMES(ESocsS
I
I DAMAGE TO
(Ea RENTEDDsge)
L MED EXP(Any one person) S
PERSONALS ADV INJURY S
GEM.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S
0 POLICY El PROJECT❑LOC PRODUCTS-COMP/OP AGG I
AUTOMOBILE LIABILITY COMBINED SINGLE S
ANY AUTO ow"(Ea SCCI tt)
ALL OWNED AUTOS BODILY INJURY (S
SCHEDULE AUTOS {PerpersoTI
HIRED AUTOS BODILY INJURY S
r FELT accident)
NON-OWNED AUTOS
PROPERTY DAMAGE IS
{Per T., MAN
—'UMBRELLA LAB OCCUR EACH OCCURRENCE IS
—
EXCESS OAP CLAIMS-MADE AGGREGATE S
DEDUCTIBLE S
I RETENTION S S
A WORKER'S COMPENSATION AND A' IMC STATNann OTHER
EMPLOYER'S LIABILITY YIN up -16 09/08/2016 09/082017 LIMITS
AVIV PROPER1 C ff'.RTNERrEAECUTIVE IMA E.L EACH ACCIDENT S 100,000
OFFICERS/DEMOBS:X0.wEM
INlnauay In NNP EL.DISEASE-EA EMPLOYEES 100,000
u Fes,aeeome sneer
OESCPDPMN OF OPERATIONS Senn/ E DISEASE-POLICY LIMIT S 590,600
DESCRIPTION OF OPBW TIONSILOCATIONSNEHICLESALEETRICTlONS/SPECIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSU®TO THE LbtenFTCAIE HOLDER AFFECTING WORKERS COMP COVERAGE.
THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR LAMORE.WILLIAM R..
CERTIFICATE HOLDER j CANCELLATION
LAMORE LUMBER SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE TKEREOF,NOTICE WILL BE DELIVERED
724 GREENFIELD RD IN ACCORDANCE WITH WE POLICY PROVISIONS.
AUTHORIZED REPRESEBITfVE
EWER SITE Il MA 0114, !1'.L ✓-1�.
lir Board of Building Regulations and Standards
License: CS-076123
Construction Supervisor ��✓R-
WILLIAM R LAMORE
15 STONE HILL RD
ROWE MA 01367//
�r 1._A'A C_&L_ Expiration:
Commissioner 05/23/2018
•
Construction Supervisor
Restricted to:
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of
enclosed space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation ofthis license.
DPS Licensing information visit:W W W.MASS.GOV/DPS
ArcGIS Web Map
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pack tin Rd(closed)
December 12,2016 1:5,039
- 0 0.04 0.08 0.16 mi
road_names — Interstate - Minor lots_condos_asr _ bts I r 0 - - V 1
G 00475 0095 0.19 km
road_ctrline — Highway -- Access ' [.._I hydro_surface a1uema
<all other values> j. condo
Major --- rail_trail
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9. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
This column to be filled In by
the Building Department
Existing Proposed Required by Zoning
Lot size !r C�
Frontage E NIA N/A N/A
Front:
Setbacks: Side:
Rear:
Height
% Open space:
(Lot area minus bldg and
paved parking)
10.Certification: I hereby certify that the Informat to ed he -In is true and accurate to
the best of my knowledge.
DATE: i /� 7 APPLICANT'S SIGNATUR
/ • i _
NOTE: Issuance of a permit does not relieve an applicant'. • � • comply with all zoning requirements
and obtain all required permits from the Conservation C mmissi• • Department of Public Works and other
applicable permit granting authorities
mem/7o4Dey4 /A60- ((per