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32A-153 (19) I m_ 0 4_ - a Ln CD bo z 6'-10' Y _ ') N 10'—Y o a \ I ��-J� � C' 1r—s'• - Y o m » ` m x 0 j ZD Lid LL z U7 I I -I 00 I O 0 I I 10•-6° 8'-3,. r T-0" I a r, f O O I ti Z .�. v o � I 12'—1 1.5'" O4-�ttlJ-! Az Jaf �,Trrffjalltpton 4 F 'alasanrhnsrlta' _ DEPARTX4EhJT OP DU(LDMIC INSPECTION'S 212 Main Strect ' Municipal DwIding Northampton, Mass. 01060 W O MCIE R'S C O NIT E'N SA` 7O N LN S URAN CE A I'T LD A TIT (11 perjttcc) _. ),kl'] h a pr-Mcipal place of businessJresi once at: X24 /��1�-�/�4� fC ✓�'- cllphonc- ) /32S-�Z �/� (sIZ>wt/c�tylsfaicra p) do hereby certify, under dic puns and penalties of pefJury, :hat an employer providing the Following worker's cotnnensadon cove age for fny etuployces \vor�bng on Oils job: O=Uxan= Comr. ny) (Pclic: >;u_a_r) O I a:n-1 a sole proprietor, general contractor or homeowner (circ?e one) a-Dd have hired the consa(nors bsteH below who have the follo%ving worker's coM:)ensa6on policies: (Namc of Co=aor) (InR ranC CoInpar1)Yl�Gbc-, Tgtt1IDi_-) id 0❑ Da[c) (Name of Contrac-for) (insurance Companw?o6m, Nu.mcrr) (i x-Dir,-.6on Date) (Name of Connaetor) (in_turaac; Company[Pobcy N:unbcr) (Exairrdon Date) (Name of Contractor) (Insurance Compauy/Po6cy Number) (E.xp rim ioa Darr) . (aMxcb-16iic;octil dcC ifnocc _,v to arc'uctc uxror=inoa peru'^' .11 oocrssr_. n) ( ) I am a sole proprietor and bave no one wor4d.og for me. ( ) I arn.a home owner performing all the work myself. NOTE:plc3c be awlrc the.EJe boMWI,c�wbo cspfoy p=%oa eo w cr rgau�orz cm.d.,c1L&of not more th-t,­-—is uby the bom�o-v rtcdo or oo the giouacb zapurten_ri tbee o�c ooc -z!!y oc.erd=c i to be ctnployc-u-o,c the pr t(GL.152_=i(5)).appU=600 by a boa=%-=fv a 6c=-or perinh r=y c%-rdrm tire IcJP1 MAX-of to c=ployer uoder dao Wcrti t Co�o Act f nodvna.ad that a oo,"of thia mu-=ca may bo to tbo Dopartmow of 1ad.+sriJ Amdada'0moo of t vwr ooa for tba ' ooveaSc varc-yoa=%d tiu f,:il=to z-=r bovcia�e u=j,=r soct cc 25.&cd MGL 151 eta tad to the=Poii iw of aimiat!pcaalite+ oo-ilzi g of a fine of up to S 1500.00 and/or of up to occ year and aril pmai".io is 6c fo m of a Stop Work Order and a fim of S 100.00 a rLy apti=me Far d�.rta.:.st vae Doty Pcrmit Number i_i n tuyt of Licr�se ct i Late 1 ::: i Version 1.7 Commercial Building Permit May 15,2000 SECTION 10 STRUCTURAL PEER REVIEW(7$D CM11 110 1,1) Independent Structural Engineering Structural Peer Review Required Yes......❑ No...... ®� SECTION 11 OWNER AIiTHORIZATION TO BE COMPLfT.ED WHEN OWNERS AGENT QR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize �i9r�< /�'G``�7 to act on my ben If in all matters relative to work authorized by this buildi g permit application. Signature of Owner Date �wner/ uthorized Agent hereby declare that the statements and information on the foregoing application are true and acc the best of my knowledge and belief. Signed under the pains-, and penalties of perjury. in Print Na ye Signature of Owner/Agent Date SECTION:32 CONSTRUITOIaI!,SERI,IC'ES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: J 'Yf �� �1�1 4.3G 7G?-, 7 License Number Address Expira ' n Date Si re Telephone SECTION 13 WORKERS, COMPfNSA710N I�ISOI2ANCE AFFIDAVIT(M G L c 152,; 25C(6)j Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 SECTION 4; PROFESSIONAL DESIGN°AND CON$TRUCTaON SERVJCES - FOR BUILD"INGS AND fRUCTURES.SUBJECT;�p" C©NSTRllCT(ON CONTROL'.PURSUANT TO=780 CMR,116'{GO"NTAINING MORE THAN 35;000 F.OF"Et�ICLOSEfl°:SPADE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 92 Registered Professional Engineer(s): 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 Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor /dI1J��251 feria � 5/ ��� Not Applicable ❑ Company Name: ed2flyg, G Responsible In Charge of Constructi .�-- /0(11"13e)X /�b /J CAL G'/c �!pG�'Y��f� a yey Address Signat r Telephone Versionl.7 Commercial Building Permit May 15,2000 7.Water Su ply(M.G.L.c.40,§54) 17.1 Flood Zone Information: 7.3 Sewage Disposal System: Public Private ❑ Zone: Outside Flood Zone E3�- Municipal Z215n site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved arldn #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW L----"- YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW Z- - YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NOr''� DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO _ 11-� IF YES, describe size, type and location: D. Are the ny proposed changes to or additions of signs intended for the property?YES_ No IF YES, describe size, type and location: Versionl.7 Commercial Building Permit May 15,2000 x is k :SECTION*jCQXMUC77 R-It{3ECIS.U— SS TJfAN 3B,-3&.000i CUBIC EET'OF CI:JOSEWW' C 3 ' » .<,.� v_, a Interior Alterations Existing Wall Signs Existing Ground Signs Additions❑ Roofing ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] ❑ Accessory Building [ ] Repairs [ ] BRIEF DESCRIPTION: 005kv! GeTf 1WTpz SECTION S-"USE ROU1PrANWCONS1rRL CIiiUN 1(�E .USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential V R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: CO1�IP.,LEC1=TSEttNi#GBU1lI1G1D10�3iIGIOVATONS, 13IT1flNS A1D%ORCNA1VGE.IiV USE Existing Use Group: ,e6,s d -4;f1 Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION S:BIrlLDING HEIG ANI AREA'' n xr^ ` ate y S. BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION k 01 , Floor Area per Floor(sf) 1 n it nd 2 rd 3 � 3 r — �` A, " w f 4m '3 s 4m Total Area(sf) 55- Total Proposed New Construction (sf) Total Height(ft) i•'V�- �4 � Total Height ft------------------ r .. ;� a;4"��. k�U ter:�„h"�°^.. •u.s , Versionl.7 Commercial Building Permit May 15,2000 __-----City of Northampton —�� '�"4 B�ilding Department 212 Main Street __- Room 100 0d A Nodf ampton, MA 01060 phone 415$7-1240 Fax 413-587-1272 AP f SttUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING s SECTION.1_.-SITIE,� IFDRMATiON: 1.1 Property Address: ems" x s SECTIOM IPROP...ER?1f}OWIf1fERSH3P�AUTlORI2�© PENT ~ ' ' r 2.1 Owner of Record: �f /�/l - Gcu-vro✓c S �`�z i'�/�i •vS% ��-�i/ �eal�U�/ ��<'! Name(Pri t) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION z3 ESTII�IATED- ONSTRUCiION COSTS Item Estimated Cost(Dollars)to be OfFielal`Use on completed by ermit applicant 1. Building (a Bu�ld�ng Perrnit Fee 35T 000_ — 2. Electrical (t►)l=sfirriated Total CosE of S c��. rstc#ioi fi0m 3. Plumbing tFee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1+ 2 + 3+4+ 5) .5`7 000 urnberV-_ . :_., 'bins Section For Official lUse?Onl Bd ildmg PerrnitNurrtber °= Oate Issued{ Signature: Building Commissioner,/Inspector of Buildings Date File#BP-2004-0882 APPLICANT/CONTACT PERSON Diversified Construction Services ADDRESS/PHONE PO Box 168 BELCHERTOWN (413)253-2798 PROPERTY LOCATION 36 STRONG AVE MAP 32A PARCEL 153 001 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid s Typeof Construction: INTERIOR RESIDENTIAL BUILDOUT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 030787 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFqRMATION 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 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. 36 STRONG AVE BP-2004-0882 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 153 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2004-0882 Project# IS-2004-1317 Est. Cost: $56000.00 Fee: $280.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Diversified Construction Services 030787 Lot Size(sa. ft.): 6054.84 Owner: CONNORS MICHAEL Zoning: CB Applicant: Diversified Construction Services AT: 36 STRONG AVE Applicant Address: Phone: Insurance: PO Box 168 (413) 253-2798 BELCHERTOWNMA010070168 ISSUED ON:3122104 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RESIDENTIAL BUILDOUT 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• Receipt No: Date Paid: Check No: Amount: Building 3/22/04 0:00:00 2435 $280.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo