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37-060 (4) , 3/ 019 . rte. i rA Q3 FYI d19a 32 CL T9-g rov TS9'T dL 39 Ud -861'i7 X U9 :33s w JIT/ JIjV�7V Cl 3snoN --Jlrn 10. Do any signs ebst on the property's YES NO IF YES,describe size,type and location: D� �T Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. Thia be gillad by the Building Department Required i Existing Proposed By Zoning Lot size Frontage ,e3tl) Setbacks - side L: `eR:�t' / L:, '` R: - rear Building height Bldg Square footage %Open Space: C� (Lot area minus bldg &Paved parking% # of -Parking Spaces ! A / f of Loading Docks / n1 Fill: fit/ {volume -& location) {3 13 . Certification: I hereby certify that the information cqn"pained herein is trupr and accurate to the best of my knowpbdge MITE: APPLICANT's SIGNATURE f'' NOTE: Iss a o® of a zoning permit does not relieve onlappiioanYs u d n to oomply Wit4 4111 zoning requ laments and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other appilomble permit granting authorities. FILE # APB - 8 2003 File No. 1#03® ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Tk'Z eoaltla XeevzzxA06g�- G wfild f t Address: ✓GU �UG2�//) 00 62� Su /CTelephone: V13 0 2. Owner of Property: Address:3& .��G' Telephone: X115' `6 3. Status of Applicant: Owner Contract Purchaser Lessee Otthh�err(explplain): 4. Job Location: �/oC Parcel Id: Zoning Map# 3 7 Parcel# �� District(s): (TO BE FILLED IN BY THE BUILDING DEPARTME 5. Existing Use of Structure/Property-����//�C"/UT/ � � /J 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): /4/X ze 7. Attached Plans: Sketch Plan _Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW y YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW E/ YES IF YES: enter Book Page and/or Document# 9. 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: (FORM CONTINUES ON OTHER SIDE) File#MP-2'003-0146 APPLICANT/CONTACT PERSON MICHAEL RAYMOND ADDRESS/PHONE P O BOX 752 (413)648-9130 PROPERTY LOCATION 272 GROVE ST MAP 37 PARCEL 060 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING ORM FILLED OUT Building Permit Filled out Fee Paid Typeof Construction: ZPA-CONVERT 10 X 20 STORAGE AREA IN DET GARAGE FOR ADDITIONAL OFFICE 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 OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFTION PRESENT ED: ved 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 ssion Z�lJ 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 the Office of Planning&Development for more information. r MP-2003-0146 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON G1S#: 7413 Map: Lot: °— ZONING PERMIT !Block- Lot: 001 1 Permit: _— G PERMITpL7 APPLICATION PERMIT Category: Zonmg Permit Permit# MP-2003-0146 1 PERMISSION IS HEREBY GRANTED TO: Project# JS-2003-1380 — — __-- —- Contractor: License: Est.Cost: $0.0__0 Fee: Homeowner as Contractor $10.00 #of Fixtures: Owner: TRI COUNTY YOUTH PROGRAMS INC Applicant. MICHAEL RAYMOND AT. 272 GROVE ST ISSUED ON. 17-Apr-2003 AMENDED ON: EXPIRES ON. TO PERFORM THE FOLLOWING WORK: ZPA-CONVERT 10 X 20 STORAGE AREA IN DET GARAGE FOR ADDITIONAL OFFICE THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Zoning Permit Application REC-2003-003002 09-Apr-03 1851 $10.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272 GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. APB V �J t\ -J � a 0 i �^ v 1 \ � rte", � ti^ Va) ``� �► 1'tt 0 Q-.�t1A1Np�O 'Wor [ja111pfoil B 6 f�lasattcf[nsctls' a DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building 'o Northampton, Mass. 01060 �y WORIC�R'S CWPENSATION INSURANCE AFFIDAVIT . (l.icenseelpermittee) with a principal place of®business/residence at: � f01� (phone#) ������ ( ty/=&2ip) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (lnsumnce Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expimdon Date) (Name of Contractor) (Insurance Company/Podcy Number) (Expiration Date) (Name of Contractor) (Insurance Compa.ny/PoGcy Number) (Expiration Daze) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach UWdoaal sheet ifnexssary to inhale information pertaining to all ooatroctoa) am a sole proprietor and have no one working for me. ( ) I am a home owner performing al[the work myself. NOTE:please be aware that whilo homeowuera who employ pcaom to do maiatcuaace,coa&uciioa or repair work on a dwelling of not mote than throe units in which the homeowner rcxida or m tree grounds appurtenant tbetcto at oot grnerally comidered to be employes under the worker's compensation Act(GL152 ss 1(5)),application by a homeowner for a Gecase or permit may evidence the legal status of an employer under the Workeet Compensation AaL I understand that a copy of this statrmecd may be forwarded to the Dgwtax of Indushiol Aoddam&Ohio-of Imunnoe for the coverage wri&cation and that fnilrme to secure coverage under section 25A of MOL 152 an lead to the iarpmrtion of criminal penalties of a fine of up to 00.00 and/or impr6o�of up to one year and civil penslties in the form of a Stop Work Ord--and a fine o 100.00 a day For dgmta�wo only Permit Number _Lot# ignature of LiccnseelP ttee Version 1.7 Commercial Building Permit May 15,2000 �iOa�. SECTION 0 TRUCTURAL EERY, Independent Structural Engineering Structural Peer Review Required Yes......❑ No.....26 SECTION 11 �OWN ER1AUTJJORJZAT1PN O BE COMPLFT> D WHEN �; OINNERSGENT'OR;CONTRAC`t OR APPL S�OR Bt11DING'iPERMIT ,93D , amsa��. ��«..hA'nib�U131 G� as Owner of the subject property hereby authorize � �� �� #15 ✓r�G to act on my behalf, i I matter elative ork au horized by this building permit application. ,Z D4 Signatur er Date I � , as Owner/Authorized Agent hereby eclare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed r the pains and a ties of perjury. Print Name , l ' Signature o wner/Agent Date SECTION 12 CAMSTRIJU>i11+1ER1IlCS .,,.r. . �. ,... 10.1 Licensed Construction Supervisor: ��An �1 Not Applicable ❑ Name of License Holder:���{f�G/L 1�"'//1�Ur�/ e 7© �� License Number /5' 1)J2i UZ Ad-JL sa#itln Date k&I i nature V Telephone 4 J CT N W LEM RIM G . 152, 'h ?�.'.v57.",.,6` ,i.,. „ ,•,.>:, s'�,sit�ri# L' .. XA ,dam: F wd,>,,;f�i ,.,4Gn�5"' ,«a� ,?.;'��,x. .kc:d lk':`-, .3 777 17777 ... k4 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...... ❑ Versionl.7 Commercial Building Permit May 15,2000 �Cf�P _��%'• :�3,�'a..,a�.�� 3.3 >.j3• ��' I�..:..._ „� ,«;;y ECTlON 9,P OFESS1OI4AL�DESIGI SAND CONSN"CTION SERVICES „FOR BUILDINGS AND TRUGTU 94 l p OT15 fRUGTiO CQN fj3Q P�URS,UAN (CQNTJIWING`.�VLORE THAN 15;000 PAC' »�..... ?s�.. � 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. General Con Actor Not Applicable ❑ Co any ame•. Re onsi le In harge of nstructio n. 5 � Ad r ss �ISi (V WV ure elep one Version 1.7 Commercial Building Permit May 15,2000 } 7. Wat r upply(M.G.L. c.40, § 54) 7.1 Flood Zone Information: 7.3 Sewa a isposal System: Public`. Private ❑ Zone: Outside Flood Zone Municipal On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required b 'Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front / Side L: R: L: R: Rear f Building Height / Bldg.Square Footage % y�� Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location) A. Has a Special Permit/Variance/Finding r been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registr f Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # V B. 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: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: hUNT�I E5 D. AM there any proposed changes to or additions of signs intended for the property?YES_ No IF YES, describe size, type and location: '{ Version 1.7 Commercial Building Permit May 15,2000 MW sei g IERVIC S ORP C" I` IE " >.,rya' i1'.�•�c+.»,.,»N,, x".�s`;a?HrA' 3»row`!;aell�':?;Iaif o-..,.rin;�.wir, ? ke'?i3�••.,.: t•�:i,'G=.��3 �s13 s. 'll '.�a. 4,.,,..:..h!,.,L�..s;4�k'� n.-,»„�$'H. _ �"'„�I.k�«�,bi•flr�: ,.�: .f.�..,�a. ,I�_13uu�. .,fl'•3�tYW;3 ,,,« >, tm,`.Y..Ju:�';�^t�.at., .� `i.1��3.':;.I .3J3:�d�i. Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ ❑ ❑ Exterior Alter ions Demolition❑ New Signs [ ] Change of Use C-] Other [ ] Accessory Building[ ] Repairs [ ] SECT1OIV 's` SEA ONSTRUC ONyT,YE„ USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ lA ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business D4 4Al 19XIf 2A ❑ E Educational ❑ 26 I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi Rh Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1.2 ❑ 1.3 ❑ 313 ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 513 U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: C0Ml?L� i31 ECTaON 1F EXISTING'BUILDING UNDERGOING REIVOVATIONS, DOITIO,NS ANDS ANGE 1 U8E ,88. x"ems , n... Existing Use Group: _ roposed Use Group: Existing Hazard Index 780 CMR 34): ���� Proposed Hazard Index 780 CMR 34): / SEC ION�6 UILDIN�HEIGIiT I�t D EA"' ;.•. x,» _,+ _._r�,� BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION ��syp,li 4s�f� Floor Area per Floor(sf) St Id� 2nd 1st `4i�V 3 2nd rd li II I” III 3rd 4th 4 th Total Area (sf) Total Proposed ew Construction (sf) _......... ....-. , Total Height(ft) -� ' Total Height ft -----1 -,-------- Versionl.7 Commercial Building Permit May 15,2000 City of Northampton Build log Department 212 Main Street Room 100 Northampton, MA 01060 p pf gnqr,4,13-567-1.240 Fax 413.587.1272 APPLICATION TO CONSTRUCT,`REPA R, RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING THER THAN A ONE OR TWO FAMILY DWELLING iCTIONtt. . NPORMA �(?N V :..., .. ...,,iH,... ..,...� Ifi•s� ect"-F 1.1 Property Address: A4 . SECTION 2� P�i:OPERTY'OWNERSHIP%AUT�1aR�IZEDAGENT 2.1 Owner of Re-cord: Name(Print) Current Maili Address: Signature Telephone 2�2 Au ized Agent: fit 4;1 Name(Pr' Current Mailing Address: , Signa ure Telephone SECTION 3��E5TIM"�i'1`I��CflN5TI�ElClO1��OS�t'S�,�� r Item Estimated Cost(Dollars)to be c_4npleted by ermit applicant 1. Building (a)Bur liag,r Fee � i z M ary<-z v 2. Electrical (b} r ted`T f g � 3. Plumbing 8u ding-'erm�#FeW" 4. Mechanical (HVAC) � 5. Fire Protections 6 Total =(1 + 2 +3 +4+5) a Ghecl�i�imb�r � �.'� Bu t �iri PermltN tier ' � ,� Date Issuuuuuuud��i c i �& �r r 3 >h B40-Mog'I'U'Mmziss�aner/1s1 j5e ofi, i fi,'ling i File#BP-2003-0889 APPLICANT/CONTACT PERSON MICHAEL RAYMOND ADDRESS/PHONE P O BOX 752 (413)648-9130 PROPERTY LOCATION 272 GROVE ST MAP 37 PARCEL 060 001 ZONE URB 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: CONVERT 10 X 20 STORAGE AREA IN DET GARAGE FOR ADDITIONAL OFFICE New Construction Non Structural interior renovations Addition to Existiniz Accesso1y Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION 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 Commis 'on �c ev L Signature of Building Official D AV 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. BP-2003-0889 CIS# COMMONWEALTH OF MASSACHUSETTS ` CITY OF NORTHAMPTON ',4 w. Lot: -001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2003-0889 Project# IS-2003-1380 Est.Cost: $11000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MICHAEL RAYMOND Lot Size(sa. ft.): 71917.56 Owner: TRI COUNTY YOUTH PROGRAMS INC Zoning URB Applicant: MICHAEL RAYMOND AT. 272 GROVE ST Applicant Address: Phone: Insurance: P O BOX 752 (413) 648-9130 BERNARDSTONMA01337 ISSUED ON:4125103 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONVERT 10 X 20 STORAGE AREA IN DET GARAGE FOR ADDITIONAL OFFICE 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 Occuupangy Signature: FeeType• Receipt No: Date Paid: Check No: Amount: Building 4/25/03 0:00:00 1868 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 272 GROVE ST BP-2003-0889 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37-060 CITY OF NORTHAMPTON Lot: -001 Permit: Building Cateiory:Non structural interior renovations BUILDING PERMIT Permit# BP-2003-0889 Project# JS-2003-1380 Est. Cost: $11000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MICHAEL RAYMOND Lot Size(sa. ft.): 71917.56 Owner: TRI COUNTY YOUTH PROGRAMS INC Zoning: URB Applicant: MICHAEL RAYMOND AT.- 272 GROVE ST Applicant Address: Phone: Insurance: P 0 BOY 752 (413) 648-9130 BERNARDSTONMA01337 ISSUED ON:4125103 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONVERT 10 X 20 STORAGE AREA IN DET GARAGE FOR ADDITIONAL OFFICE 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: °`1� `j j1 ✓' House# Foundation: Driveway Final: Final: Final: �� r ✓ �? Rough Frame:ak� 1- $ �3 Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: d ,0 _�� Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOrATIQNFOF ANY OF ITS RULES AND REGULATIO Certificate of Occu anc Si nature: FeeType: Receipt No: Date Paid: Check No: Amount: Building 4/25/03 0:00:00 1868 $50.00 212 Main Street, Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo L L 14a N o a A v Q w _ Q a an •r Co Q a z � 3 0 �0 o�