Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
38B-009 (8)
h Q r BP-2003-1110' 777 COMMO ALTH OF MASSACHUSETTS C TY OF NORTHAMPTON -Lot-001 Permit: Building CategM:ALTERATION BUILDING PERMIT Permit# OP-2003-1110 Project# JS-2003-1731 Est.Cost-$10000:00 Fee:$50.00 PERMISSION IS f3EREBYGRANTED TO: ' Const.Class: Contractor: License: - Use Group: B THOMAS I KORYTOStKI 070047 Lot Size(sq.ft.):-5 .6540.88 Owner: NORTHAMPLgN PROPERTIES INC Zoning:SI Applicant: NORTHAMhTON PROPERTIES INC AT. 136 WEST ST-Q(BERLORE (BASEMENT Applicant Address: Phone: Insurance: P 0 BOX 6840 (413) 552-0776 () HOLYOKEMA01040 ISSUED ON:614103 0100:00 TO PERFORM THE FOLLOWING WORK.-DEMO AND MOVE INTERIOR NON BEARING PARTITION WALLS POUR NEW FLOOR 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:,&/�fp 3 House,:# Foundation: Driveway Final: Final: Final: /Ae n t-/ �/�G/p� � 1 Rough Frame: 0/r 1V rel Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: 0K G -. '?7-CO,3 THIS PERMIT BY THE CI Y OF NORTHAMPTON UPON VIOLA"N OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu an , Si ature: FeeType: Receipt Ni;. Date Paid: Check No: Amount: Building 6/4/03 0:40:00 2186 $50.00 212 Main Street,Phone(40)587-1240,Fax:(413)587-1272 Building ConunisSioner-Anthony Patillo MR- -141 G fxG/u3 r �� f ST-CYBERLORE S133MENT) BP-2003-1110 GIs#: COMMOJ WEALTH OF MASSACHUSETTS 38B-00 CITY OF NORTHAMPTON Lot: -001 Permit: Bu d ft Category:ALTERATION BUILDING PERMIT Permit# BP-2003-1110 Project# JS-2003-1731 Est.Cost: $10000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: B THOMAS J KORYTOSKI 070047 Lot Size(sq.ft,): 56540.88 Owner: NORTHAMPTON PROPERTIES INC zoning: SI Applicant. NORTHAMPTON PROPERTIES INC AT. 136 WEST ST-CYBERLORE (BASEMENT) Applicant Address: Phone: Insurance: P 0 BOX 6840 ( 13) 552-02L6-0 HOLYOKEMA01040 ISSUED ON.6/4/03 Q:00:00 TO PERFORM THE FOLLOWING WORK.IDEMO AND MOVE INTERIOR NON BEARING PARTITION WALLS POUR NEW FLOOR 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 6/4/03 0:00:00 2186 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo t Versionl.7 Commercial Building Permit May 15,2000 e' 8tttla . . 0 ,, - — -fit #_Northampton S ' hLg diing Department 212-Main Street Room 100 VVaterl e� v ab ` SUN -ArWnpton, MA 01060 phone 413.587-1240 Fax 413-587-1212 PIotISI r 4 Ot erS pctf - ya APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1- SITE INFORMATION 7 1.1 Property Address: This section to be completed by office ap Lot " Unit'_: one Overlay District Im St.District CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT The Hempshfie Management Group, ana 2.1 Owner of Record: $ P•Inc.Inc P.O.Box 686 ��4J'lrt ✓LAOraeNorthampton,MA 1061-0686 Name(Print) U —� , Curr nt Mailing Address: *Z zWa C c 70 x l Signature telephone 2.2 Authorized Agent: 4109_x-mw .� �� ©y � li ame(Pr If urrent Ma ink Address: v Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only com feted by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from b 3. Plumbing BuilgingPermit`Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4 + 5) Check Number - � This Section For fficial Use Only Building Permit Number: Date Issued: Signature: Building Co mi over nspector of Buildings Date' Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTIONSERVICES FOR PROJECTS;LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ K ❑ ❑ Exterior Alterations Demolitioryf New Signs [ ] Change of Use-[ ] Other [ ] ❑ Acle"Ury Bilding [ ] Repairs [ ] A c X10 C4- � ;�pa-�A,T,CNA ub q-LC S elco �C SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ lA �— ❑ 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 ❑ 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) St C,9 1//10 w ' 1st2nd �� n r s 2nd / Y 7 Q�L 3�d 4th " f� • Ky )g�k f � t 4v '� � kvq,, 4th Total Area (sf) q 7 1/ (O Total Proposed New Construction (sf) � 4 _ .... .....---..------------- Total Height(ft) Total Height ft .......... ......... �� yx Version 1.7 Conunercial Building Permit May 15,2000 7.Water SupF�y(M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage D' osal System: Public O, Private ❑ Zone: Outside Flood Zone ❑ Municipal On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to b'yflled in by Building DepantInent Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Fi ng ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded t the Registry f Deeds? NO DON'T NOW YES IF YES: enter Book Page and/or Document # B. Does the site contain brook, body of water or wetland NO DON'T KNOW YES IF YES, has a ermit been or need to be obtained from t Conservation CoMmission? -t4eeds to be tained• Obtained' Date Issued: C. 'Do any sign exist on the property? YES NO IF YES, escribe size, type and location: D. Are 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 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SE, VICES - FOR'BUILDINGS AND STRUCTURES SUBJECT T4 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 Dat Signature Telephone 92 Registered Professiona ngineer(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 Tel hone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Company Name: Not Applicable ❑ Responsible In Charge of Con truction Address Signature Tele'hone Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110,11) Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ SECTION 11 - OWNER AUTHORIZATION -'TO BE,COMPLETEDHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PE MIT as Owner of the subject 1 property hereby authorize _ to act on my behalf, in all matters elati e to work authorized by t building p mit application. 1 3v G Signatur of Owner Date as Owner/Authorized Agent hereby declare that the statements and information on the foregoing ap ication are e and accurate, to the best of my kno:•riedge and belief. Signed under the pains and penaltiesf perjury. /'`D/Z 1-0s k Print Nam Signature of Owner/Ag Date SECTION 12 -CONSTRUCTION"SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder � n 9 Jl License Numb �-V',UCnlr/ Address I ( � J o� Expiration Date Signature Telephone SECTION 13 -WORKE ' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152,§,25C(6)) Workers Compensation Insurance affidavit rp4st be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance o e building permit. Signed Affidavit Attached Yes.......` No...... ❑ s.. s e C�izf r Nmrt1jailtpfait ', �a56AChttSC11E Q• m DEPARTMENT OF BUILDWG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORICE,R'S COAITENSATION INSURANCE AFFTDANTr n4IM- 1�4zWVV-110 .c�ns.^xJ ttee} ,.with a principal place of business/`�ide�nce at: C'T �t (phone r) �vx� (st-f�t/ci ty/st�lzi p) do hereby certify, under the pFins and penalties of per' that. I am an employer pre•,•iding the foljo,,N' g worker's compens tion coverage nor mti employees worrang on t}lis ieb: Ae OS (Insu-rauce Co ) (Policy Number) (Expiradon Datc) ( ) 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) (Insuranoc Company/Policy Numbcr) (ExTiraaon Date) (Name of Contractor) (lnsuran,�_- Company/Policy Number) (Expiration Date) (Name of Contractor) Umsuranc_- Comparry/Policy Number) (Hxpiraaon Dale) (Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date) (anach additional sbtcl if neocszsry to ii c, u inform�oc pcj&ining to au 000lr'd ") O I am a sole proprietor and have no one working for me. ( ) I am ` ahome owner performing all;the work myself. NOTE:please be�awarn the while homeoxvcts who craploy p=om to do=i,.tca& o Wastucuoa or rcpair work on a dwcllL"&of not mote thaw throe units is winch the homeowner resider or on the goundt appurtenant thereto are not Ct0=11y,000siderrd to be employers under the tvoriccr`s compc=sstion Act(GL1S2 ss 1(5)�application by a homeowner for a decrier or permit may vvidcaoc the legal rtaUrs of an employer under the Workeea Compemation Act. I understand th,d a copy of this statemeat may be fes warded to the Dopwta col of Inch, al Ao=den&ofBoe of lnsur am for the oovctsgc verificstioo and that failure to verago cruder section 25A of MGL 152 can lead to the imposition of crin i pc &W- ootnisling of a fine o up to S1,500-00 or tune tt of up to one year and civil petnities io the form of a Stop Work Order and a firm 0175100.00 a agaitsst ttx For dial user only Pcrmit Number Signa of ccn, Lbte Map.4 I of#t + 7kr,,.; •..r,.._... :..-Axa.... .