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23A-134 (14) 83 PINE ST-HILL INSTITUTE BP-2020-1237 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A- 134 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2020-1237 Project# JS-2020-002067 Est. Cost: $37500.00 Fee: $70.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LANCE KIRLEY 112063 Lot Size(sq. ft.): 74052.00 Owner: Hill Institute Zoning: URB(100)/ Applicant: LANCE KIRLEY AT. 83 PINE ST - HILL INSTITUTE Applicant Address: Phone: Insurance: 123 MEADOW ST (413) 341-3375 O SOLE PROPRIETOR FLORENCEMA01062 ISSUED ON.6/25/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-BUILD AN ATTACHED 12X16 SHED ADDITION TO EXISTING STORAGE BARN 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 6/25/2020 0:00:00 $70.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2020-1237 / APPLICANT/CONTACT PERSON LANCE KIRLEY ADDRESS/PHONE 123 MEADOW ST FLORENCE (413)341-3375 Q It PROPERTY LOCATION 83 PINE ST-HILL INSTITUTE GV Sr" t MAP 23A PARCEL 134 001 ZONE URB(100)/ F OFFICIAL E THIS SECTIONORO IAL US ONLY- PERMIT C PERMIT APPLICATION CHECKLIS OSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid _ Building Permit Filled out _ Fee Paid TvpeofConstruction: BUILD AN ATTACHED 1 -HED ADDITION TO EXISTING STORAGE BARN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 112063 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 ' Signature of Building Official Date 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. M Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: 3 Z Building Department Curb Cut/Driveway Permit - Gv�i 212 Main Street Sewer/Septic Availability o Room 100 WaterM/ell Availability oN o Q Northampton, MA 01060 Two Sets of Structural Plans �o o hone 413-587-1240 Fax 413-587-1272 Plot/Site Plans 0 Other Specify XPPI-Iii� NSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 83 Pine Street, Florence, MA 01062 Map Lot unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: !Hill Institute 83 Pine Street, Florence, MA 01062 Name(Print) Current Mailing Address: (413) 584-1725 Signature (�l> lna • c. )1�1► Telephone 2.2 Authorized Agent: Lance Kirley - Classic Colonial Homes, Inc. 123 Meadow Street, Florence, MA 01062 Name(Print) Current Mailing Address: (413) 341-3375 Signature Telephone SECTION 3-ES IMATED ONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $35,100.001 (a) Building Permit Fee 2. Electrical $2,400.001 (b) Estimated Total Cost of $37,500.00 Construction from 6 3. Plumbing $0.00 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection $0.00 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date 70 -M,37 Issued Signature: Building Commissioner/Inspector of Buildings Date Versionl.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑✓ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description building an attached 12' x 16'-6" timber frame shed addition onto an existing storage barn in the Of Proposed Work: sparking lot area of the Hill Institute Private School in Florence, MA SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ j 5A ❑ S Storage ❑✓ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1 St 440 1 St 198] 2nd 440 2nd 3 3rd rd 4 t 4th , Total Area (sf) 880 Total Proposed New Construction (sf) 198 Total Height(ft) 23] Total Height ft 13 7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zoned Municipal E] On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage 225' Setbacks Front 160 148 Side L: 180' R: 15' L: 182' R: 17' Rear 130 150' ' Building Height 23' 13' Bldg.Square Footage 880 % 198 Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW Q YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW O YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , Date Issued: C. Do any signs exist on the property? YES Q NO O IF YES, describe size, type and location: Hill Institute School ground mounted sign D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): F- t-- Name —aName Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Classic Colonial Homes, Inc. Not Applicable ❑ Company Name: Lance A. Kirley Responsible In Charge of Construction 123 Mealrweet, Florence,MA 01062 Address (413) 341-3375 Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Chris Hammel,agent of 1 fill Institute Private School as Owner of the subject property hereby authorize Classic Colonial Homes, Inc. to act on my behalf, in all matters relative t work authorized by this building permit application. i V✓uJtiY i �rn n 61 r 20 Signature of Owner Date Chris Hammel, agent of Hill Institute Private School as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Chris Hammel Print Name 1/ 4L �. r11y1 6/17/20 ( 4( 0t4�, Signature of Owner/Agent I Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder.. Lance Kirley CCS-1 12063 License Number 123 M Street, Florence,MA 01062 03/19/2022 Address Expiration Date (413) 341-3375 Signature Telephone SECTION 13-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 Q No 0 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: Hill Institute School, 83 Pine St., Florence, MA 01062 Complete Concrete Co. The debris will be transported by: 48 Parsons St., Easthampton, MA 01027 The debris will be received by: Palmer Paving Co., 23 Arthur St., Easthampton, MA 01027 Building permit number: Name of Permit Applicant Lance Kirley, Classic Colonial Homes, Inc. 0&//(a /z-,o Date Li lure of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents d I Congress Street, Suite 100 Boston, MA 02114-2017 �y www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/Individual):Lance Kirley, Classic Colonial Homes, Inc. Address: 123 Meadow Street City/State/Zip:Florence, MA 01062 Phone#:413-341-3375 Are you an employer?Check the appropriate box: Type of project(required): 1.0 1 am a employer with 12 employees(full and/or part-time).' 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.F_1 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 ✓� Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.E:]Plumbing repairs or additions 5.❑I am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.; 6.❑We are a corporation and its officers have exercised their right of exemption per MGL a 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I 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. �rl✓I /IM�t� Utft, Insurance Company Name: ,{ ,• ' >�+ Policy#or Self-ins.Lic.#: AIJC!10a 7d 3 7 d 362.4)1�Ap Expiration Date: 6 7/10 20 2-0 Job Site Address:83 Pine Street City/State/Zip:Florence, MA 01062 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$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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificati 1 do hereby certify u t p s a d enalt' of perjury that the information provided abov is lrue.and correct Si ature: Date: D �r l Phone#:413-341-3375 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MMIDD/YYYY) ACORO° CERTIFICATE OF LIABILITY INSURANCE 06/16/2020 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 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 NAME: Stephen Brochu PIONEER VALLEY AUTOMOBILE CLUB INSURANCE AGENCY INC -PHONE ad"a,E,�, (413)205-2320 FAX No): E-MAIL sbrochu aaa v com ADDRESS: Cagy P 150 CAPITAL DRIVE INSURER(S)AFFORDING COVERAGE NAIC# WEST SPRINGFIELD MA 01089 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B: _ CLASSIC COLONIAL HOMES INC INSURERC: INSURER 0: 123 MEADOW ST INSURER E: FLORENCE MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: 544475 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 TYPE OF INSURANCE ADDL SUBR POLICY POLICY NUMBER MMIDD EFF MPSI DEXP I LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ NTED CLAIMS-MADE 1:1 OCCUR PREMISES E ToEaEoccurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PECOT- LOC PRODUCTS-COMP/oP AGG E OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS N/A BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION v j AND EMPLOYERS'LIABILITY X STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? NIA NIA N/A AWC40070370362019A 07/10/2019 07/10/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/- CERTIFICATE HOLDER CANCELLATION Northampton MA 01060 I Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD / 1 DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 06/16!2020 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 Denise Sawicki NAME: Amherst Insurance Agency Inc PAHCNNo Ext): (413)253-5555 FAX(AJC No): (413)256-8354 20 Gatehouse Rd. E-MAIL dsawicki@nathanagencies.com ADDRESS: P.O.Box 48 INSURER(S)AFFORDING COVERAGE NAIC# Amherst MA 01002 INSURERA: Preferred Mutual 15024 INSURED INSURER 8: Commerce Insurance 34754 Shimon Washburn INSURER C 48 PARSONS STREET UNIT#3 INSURER D: INSURER E: EASTHAMPTON MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2043003237 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. ILTR INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE (MMIDD/YYYY) MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RrNTE CLAIMS-MADE Fx_]OCCUR PREMISES Ea occur ence $ 300,000 MED EXP(Any one person) $ 10,000 A BOP0100731509 04/06/2020 04/06/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- LOC 2.000.000POLICY 1-1JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ 100,000 B OWNED X SCHEDULED BCNJ82 03/15/2020 03/15/2021 BODILY INJURY(Per accident) $ 300,000 AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 250,000 AUTOS ONLY AUTOS ONLY (Per accident Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE _—] NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I 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 Classic Colonial Homes ACCORDANCE WITH THE POLICY PROVISIONS. 123 Meadow Street AUTHORIZED REPRESENTATIVE `' Florence MA 01062 V ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD File#BP-2020-1226 APPLICANT/CONTACT PERSON LANCE KIRLEY ADDRESS/PHONE 123 MEADOW ST FLORENCE (413)341-3375 Q PROPERTY LOCATION 83 PINE ST- HILL INSTITUTE MAP 23A PARCEL 134 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildina Permit Filled out Fee Paid Typeof Construction: 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 INFORMATION 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 Signature of Building Official Date 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 •.t Massachusetts RE %PARTMENT CEI OF BUILDING INSPECTIONS �'• ;1;� in st'eet • Municipal Building yJ`•4 Cam V Nor ampton, MA 01060 JUN 10 2020 i DEPT OF�UILDrNO IN NOgTHAA4PTON SPECTfONS A 070 ACCESS CTURE PERMIT APPLICATION (For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure) Check# A i.n PLEASE TYPE ORPRINT ALL INFORMATION 1. Name of Applicant: LoyACk 01 � �� nr- C�Itrn a.,,L- Address: 9-3 14to-Aow E4 +Iurevn(e 146 010LZTelephone: +3 -3A-1-3375- _ 2. Owner of Property: Sf, Address: �3 fine- S4• ' *We MA 0042- Telephone: 413 SS 72,-5- 3. 'Z"S3. Status of Applicant:_Owner X Contractor �1�/� 64 4. Structure Location: $35 Vint SianLr ;10y8Ae� i�/ 6696A Parcel ID: Zoning Map# Parcel # 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.ft.:__ 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 S. Does the site contain a brook, body of water or wetlands? NO______ 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 ssued___CONTINUED ON NEXT PAGE C�23 4- /-391 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 Frontage N/A N/A N/A Front: Setbacks: Side: Rear. Height % Open space: (Lot area minus bldg and paved parking) 10.Certification: 1 hereby certify that the informatio ntained herein is true and accurate to the best of my knowledge. DATE: O&JO &APPLICANT'S SIGNATURE NOTE: Issuance of a permit does not relieve an applicant's bur o comply with all zoning requirements and obtain all required permits from the Conservation Commission, Department of Public Works and other applicable permit granting authorities aM4; I /"c eg ccs, ail I;P?,e . cc.--r� 6/8/2020 20200608_105106.jpg PPOk 964 '" 257 KNOW ALL ISM BY THESE PRESENTS That We. Lyman K.Bridgman and Helen E. MORTGAGE Brldgran, husband and rife, both of Florence,Northampton, Hampshire County, Yassachuaetts, for consideration Lyman K. Brldg- paid, grant to Hill Institute, a charitable corporation duly organizedM man et ux law and having a usual pince of business at said Northampton with MORTGAGE To COVENANTS, t0 secure the payment of TrFN Ty THREE H'QNDRED (j2300.00) DOLLARS Hill Institute on demand with 5j per cent Interest per annum, payable Quarterly as pro- vided in our note of even date, the land In said Florence,Northampton, bounded and described as follows: Beginning at a point on the northerly side of Pine Street at the south- Pine Street .easterly corner of the premises herein conveyed and at the southwesterly Florence corner of land now or formerly of one Cramer; thence running NORTHERLY Northampton along the westerly line of land now or formerly of said Cramer sixty four and two tenths (64.2) feet, more or less; thence turning and running PA97FMY along land now or formerly of said Cramer twenty seven and six tenths (27,6) feet, more or less, to a point at the southwesterly corner of land now or formerly of one Carr; thence running NORTHERLY along land now or formerly of said Carr ninety nine (99) feet, more or leas, to land now or formerly Of J.F. Heffernan; thence running WESTERLY along land now or formerly of of a'0 v said Heffernan one hundred and four tenths (100.4) feet, more or lona, N 1 to a point; thence running SOUTHERLY along land now or formerly of Charles ma < W. Lyn one hundred seventy (170) feet, more or leas, to the northerly s side of Pine Street; thence EASTERLY along Pine Street seventy three (73) �` feet, more or less, to the place of beginning. Be ` ing the same tract as �" e v � described in plan recorded in Hampshire County Registry of Deeds in Plan s A c o Book 210 page 41. e For title reference see deed from Helen 0.Williams, alias, to Lyman K. Bridgman and Helen E.Bridgman, dated January 18,1938 and recorded In Hamp- t m r � a shire County Registry of Deeds in hook 930, page 69. This mortgage is upon the statutory condition, for any breach of which the mortgagee shall have the statutory power of sale. WITNESS our hands and seals this 9th day of January 1942. William E.Dwyer to both X Lyman K. Bridgman Seal X Helen E. Bridgman Seal � I THE COMMONWEALTH OF MASSACHUSETTS Hampshire, ps. January 9.1962 Th.o personally appeared Lhr aboye numed Lyman K. Bri [m Ln -and ackeowledsad the foreaoing b-trument to be his free act and deed. 4- Brforemc, William E.Dwyer Notary Public NOTARIAL SEAL at,orrre.a.evew March 4, 1943 ✓d�.�,._...,L HUYraH=.as January 9.1942 at_.$____,'bock and S2 r mle Cts https://mai1.google.com/mail/u/0/?tab=rm&ogbl#inbox/QgrcJHsThhfHtz DJpQgBsngvhsmnDXgjbgq?projector=l&messagePartld=0.1 1/1 i . y ` +y _—.w...o....,...�.."."«"£.y�q FwrM 23A 132 7 3 -05 of —6643Lir I �......b�...�.;p�x 23A-131 r 23A-1,3C 23A-129 2 A= 23A-133 �'S e (-3A- 13Ole 12t 3A-1 4 _A-�tj!5 1 238.5 { `I j �' `�• `� "� �� 1 I �'0000r I 10617 r 225 1 84 1 ' . 5,16 9t , fyt� °�7 t 70 115 23 -15 16 r 140.42 3 - s, 23 ea 57.42 107.9 23A- 3A-- 3A-3Aw` } 7'2.42 74.9 50 5.= 40 -r "5740 -30 95 or w . rte• 41 i b • � 1 RICHARD J.LaBARCE SR. 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