37-077 (27) BP-2023-1760
790 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
37-077-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-1760 PERMISSION IS HEREBY GRANTED TO:
Project# GENERATOR 2023 Contractor: License:
Est.Cost: 20000 WILLIS DICENTES 090406
Const.Class: Exp.Date: 08/25/2024
CONTINENTAL CABLEVISION OF WESTERN NEW
Use Group: Owner: ENGLAND INC
Lot Size (sq.ft.)
Zoning: SR/WSP Applicant: BEAR HILL ELECTRIC LLC
Applicant Address Phone: Insurance:
PO BOX 59 (207)899-5592 5101801141
HOLLIS CENTER,ME 04042
ISSUED ON: 12/20/2023
TO PERFORM THE FOLLOWING WORK:
INSTALL BACK UP GENERATOR ON 4X10 CONCRETE PAD
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:
•
$• 1 11 ► ;
Fees Paid: $140.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
File #BP-2023-1760 Z• a K
APPLICANT/CONTACT PERSON:BEAR HILL ELECTRIC LLC
PO BOX 59 HOLLIS CENTER, ME 04042(207)899-5592
PROPERTY LOCATION 790 FLORENCE RD
MAP:LOT 37-077-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $140.00
Type of Construction: INSTALL BACK UP GENERATOR ON 4X10 CONCRETE PAD
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
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
ture of Building Official Date
,/ Cit
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.
� L
,mac
The Commonwealth of Massachuset
S
�,I 2Office of Public Safety and Inspecti• •
Massachusetts State Building Code(780 C%I c),
Building Permit Application for any Building other than a One?�4/'Peyoj• amily Dwelling
(This Section For Official Use Only) rti'_
•
Building Permit Number ,2 3'/7 `/Q Date Applied: Building Official:
SECTION 1:LOCATION
790 Florence Road Northampton 01060
No.and Street City/Town Zip Code Name of Building(if applicable)
37 077 / 001
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building 0 Repair 0 Alteration I9' Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes EX No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No E'
Brief Description of Proposed Work:Install back-up self-contained 30kw diesel generator and 4'x'10'concrete pad
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) '
Existing Use Group(s): u Proposed Use Group(s):u
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) N/A N/A N/A N/A
Total Area(sq.ft.)and Total Height(ft.) N/A N/A N/A N/A
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 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 0 I-3 0 I-4 0 M: Mercantile 0 R: Residential R-ID R-2 0 R-3 0 R-4 0
S: Storage S-1 0 S-2 0 U: Utility Er Special Use 0 and please describe below:
Special Use Description.
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB Er IIIA 0 IIIB 0 IV 0 VA 0 VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit Debris Removal:
Public 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Licensed Disposal Site 0
required 0 or trench or specify:
Private 0 or indentify Zone: or on site system 0 permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable I9' Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No I2' 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 Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
IWG Towers 1199 North Fairfax Street, # 700 Alexandria 22314
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
703. 535 3009 -
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Catherine Conklin/Agent for AT&T 4603 Kemper Rockville MD 20853
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 fill 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 l4'.
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)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Next Level Realty
Company Name
Adam Bailey CS-090406
Name of Person Responsible for Construction License No. and Type if Applicable
287 South Street#4 Douglas MA 01516
Street Address City/Town State Zip
413-281-3303 - - abailey@nextlevelrealty.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 Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes 0 No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $15,000 Building Permit Fee=Total Constructio o t x_ ti-rt here
2.Electrical $ 5,000 appropriate municipal facto i = 11.�17
3.Plumbing
4.Mechanical (HVAC) $ Note:Minimum fee=$ (co -• ::'pality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $20,000 (contact municipality)and write check number here / 7
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my knowledge and understanding.
Catherine Conklin enl Site Acquisition Specialist 301 _ 266.0258
Please print and sign name Title Telephone No. Date
4603 Kemper Street Rockville MD 20853 catherine.conklin@gdit.com
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: _ � � a0
Name Da
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: 37 LOT: 001
LOT SIZE: 5.59
REAR LOT DIMENSION:
REAR YARD 947
SIDE YARD 1000 SIDE YARD 110°
FRONT SETBACK 1235
FRONTAGE
City of Northampton
tr+a - • .o� -..
\ /
a° >` Massachusetts 7' a-- r`
14,
1, ' DEPARTMENT OF BUILDING INSPECTIONS
' : rr
' 212 Main Street • Municipal Building
d`.x oottlif
Northampton, MA 01060 JS7,Jy 301
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: 910 Riverside Street, Portland, ME 04103
The debris will be transported by:
Name of Hauler: Riverside Recycling Facility
Signature of Applicant: C141aaf-42- Cane Date: 11/21/2023
Appendix 1
Construction Documents are required for structures that must comply with 780 CMR 107. The
checklist below is a compilation of the documents that may be required. The applicant shall fill out
the checklist and provide the contact information of the registered professionals responsible for the
documents. This appendix is to be submitted with the building permit application.
Checklist for Construction Documents*
Mark"x"where applicable
No. Item Submitted Incomplete Not Required
1 Architectural
2 Foundation X
3 Structural X
4 Fire Suppression X
5 Fire Alarm(may require repeaters) X
6 HVAC X
7 Electrical X
8 Plumbing(include local connections) X
9 Gas(Natural,Propane,Medical or other) X
10 Surveyed Site Plan(Utilities,Wetland,etc.) X
11 Specifications X
12 Structural Peer Review X
13 Structural Tests&Inspections Program X
14 Fire Protection Narrative Report X
15 Existing Building Survey/Investigation X
16 Energy Conservation Report X
17 Architectural Access Review(521 CMR) X
18 Workers Compensation Insurance X
19 Hazardous Material Mitigation Documentation X
20 Other(Specify)
21 Other(Specify)
22 Other(Specify)
*Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified
must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the
authority having jurisdiction.
Registered Professional Contact Information
Jeffrey Zander 608_643_ 4100 tbeatty@ramaker.com 55191
—"— Registration Number
Name(Registrant) Telephone No. e-mail address
855 Commuity Drive Sauk City WI 53583 Civil 11/20/2024
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip
Discipline Expiration Date
Please follow this link for construction control forms to be used by Registered Design Professionals.
01317
November 27, 2023
City of Northampton
212 Main Street
Northampton, MA 01060
Attn: Kim Carson
Phone: 413-587-1240
RE: AT&T Site Name: Northampton Mountain Laurel / FA#10578083
Building Permit Application Fee (AT&T Generator Add Installation)
Site Address: 790 Florence Road, Northampton, MA 01060
Dear Ms. Carson,
Please find enclosed herewith our check in the amount of One Hundred Forty Dollars and Zero Cents
($140.00) for the Building Permit Application Fee.
Please return any documentation or applicable receipts in the FedEx Mailer enclosed. If you require
assistance having the FedEx mailer picked up at your location, please feel free to call or email me
and I will be happy to arrange for FedEx to come to your location or identify the nearest drop box.
Sincerely,
Catherine Conklin
Site Acquisition Specialist
M 301-266-0258
catherine.conklin a(�,gdit.com
4603 Kemper Street
Rockville, MD 20853
www.gdit.corn
GENERAL DYNAMICS INFORMATION TECHNOLOGY 13150 FAIRVIEW PARK DRIVE,FALLS CHURCH,VA 22042 I GDIT.COM
GOIT
DATE: November 21, 2023
TO: City of Northampton
ADDRESS: 210 Main Street
Northampton, MA 01060
ATTN: Building Commissioner's Office
PHONE: 413-587-1240
RE: AT&T Generator Project: 790 Florence Road,Northampton, MA 01060
PROJECT: Northampton Mountain Laurel Path—FA10578083
Please find enclosed the following documents submitted for your review and approval:
2 Sets Signed and Sealed Construction Drawings
1 Building Permit Application
1 Electrical Permit Application
1 Workers' Compensation
To facilitate the payment of any fees due,please email the following information to:
catherine.conklin@gdit.com.Total Cost due,whom the payment is to be made,where to send the payment
and if the payment can be made online with a Credit Card.
Please direct all questions regarding the Permit Applications to the writer at 301-266-0258 or by email at
catherine.conklin@gdit.com
Truly
Catherine Conklin
Site Acquisition Specialist
4603 Kemper Street
Rockville, MD 20853
M 301-266-0258
catherine.conklin@gdit.com
www.gdit.com
GD1T
�"1 BEARHIL-03 MLEDOUX
.a► �RO. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY)
11/27/2023
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
NAME:
Clark Insurance PHONE FAX
1945 Congress Street,Bldg A (A/C,No,Ext):(207)774-6257 (NC,No):(207)774-2994_
PO Box 3543 E-MAIL info@clarkinsurance.com
Portland,ME 04104-3543 ADDRESS: r
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Citizens Ins Co of America 31534
INSURED INSURER B:Allmerica Financial Benefit 41840
Bear Hill Electric,LLC INSURER C:Maine Employers Mutual Ins Co 11149
P.O.Box 59
INSURER D
Hollis Center,ME 04042
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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.
LTRINSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
INSD,WVD IMM/DD/YYYY) IMM/DD/YYYY)
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X] OCCUR OBPH479182 1/15/2023 1/15/2024 DAMAGE TO RENTED 500,000
PREMISES(Ea occurrence) 3
MED EXP(Any one person) 5 5,000
PERSONAL 8 ADV INJURY __$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY PRO-
JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER:
B COMBINED SINGLE LIMIT $
AUTOMOBILE LIABILITY 1,000,000
X (Ea accident) $
ANY AUTO AWPH479179 1/15/2023 1/15/2024
BODILY INJURY(Per person) ,$
OWNED SCHEDULED BODILY INJURY(Per accident) $ ___
AUTOSRE ONLY AUTOS
AUTOS ONLY NON-OWNEDUUS (Per PROPERTY DAMAGE $
$
A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
EXCESS LIAB CLAIMS-MADE OBPH479182 1/15/2023 1/15/2024 AGGREGATE $ 5,000,000
1 I DED X RETENTION$ 0 $
C I WORKERS COMPENSATION 1 AND EMPLOYERS'LIABILITY Y/N X STATUTE ERy PER H
ANY PROPRIETOR/PARTNER/EXECUTIVE 5101801141 6/1/2023 6/1/2024 1,000,000
AFFICER/MEMBER EXCLUDED? Y N/A E.L.EACH ACCIDENT $
(Mandatory In NH) 1,000 000
If yes,describe under
E.L.DISEASE-EA EMPLOYEE $ '
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
RE: Northampton Mountain Laurel FA10578083.
I
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Northhampton City Hall THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
210 Main St
Northampton,MA 01060
AUTHORIZED REPRESENTATIVE
1
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