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38B-009 (9) i BP-2001-0087 136 WEST ST IS I. COMMONWEALTH OF MASSACHUSETTS ,�Iap:Black;38B-409 iCITY OF NORTHAMPTON Lot:-001 Permit: Building Category:Non structural interior renovations 1J ILDING PERMIT Permit# BP-2001-0087 Proiect# JS-2001-0138 Est.Cost:$4500.00 ` Fee:$50.00 PERMISSIONI� HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALAN HOUGHTON.. .-... 073925 Lot Size(sq.I): 56540.8$ Owner: NORTHAMP ON PROPERTIES INC Zoning: SI Applicant:-ALAN H UGHTON AT. 136 WEST S Applicant Address: Phone: Insurance: 18 SUMMER ST 413 586-9524 NORTHAMPTONMA01060 ISSUED ON:7/27/0 0:00:00 TO PERFORM THE FOLLOWING WOO.REPLACE CONCRETE SLAB W/WOOD DECKING 00' _POST THIS CARD SO IT IS VISIBLE FROM THk STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Rough Frame: i Gas Fire Department Fireplace/Chimney: j 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: Fee Type: Receipt No: Date P id: Check No: Amount: Building 7/27/00 p:00:00 318064207 $50.00 212 Main Street,Phone(41 3)587-1240,Fax:(413)587-1272 Building;Commissioner-Anthony Patillo i File#BP-2001-0087 APPLICANT/CONTACT PERSON ALAN HOUGHTON ADDRESS/PHONE 18 SUMMER ST (413)586-9524 PROPERTY LOCATION 136 WEST ST MAP 38B PARCEL 009 ZONE SI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildina Permit Filled out Fee Paid a" T eof Construction: REPLACE CONCRETE SLAB W/W OD DECKING New Construction Non Structural interior renovations Addition to Existing AccessoU Structure Buildinp,Plans Included: Owner/Statement or License 073925 3 sets of Plans/Plot Plan THE Fj SLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: !/Approved as presentedibased on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § —*/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 Conservatio ission _Permit from CB Architecture Comm ee Signature of Building Official Date 21 Note:Issuance of a Zoning permit does not relieve a appI�cant'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. Versionl.7 Commercial Building Permit May 15,2000 "�4 CJt of Northampton ding Department !� 12 Main Street Room 100 Dth mpton, MA 01060 QPM k'°" �-- &&J4613-5E7-1240 Fax 413.587. 272 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE CHANG THE USE OR OCCUPANCY OF OR DEMOLISH ANY BUILDING OTHER THAN A ONE 0 TWO FAMILY DWELLING SECTION 1-:SATE°INFORMATION 1.1 Property Address: SECTIiON 2 PR0.Pt12TY OW1EEtSHIPIAU `HD AGENT 2,1 Owner of Record: Name(Print) Current Mailing Address: say . 634/ Signat&re Telephone 2.2 Authorized Agent: / oma hte� b--v / h rint) Current Mailing Address: Signature Telephone SECTION 3-EST C©NSTRUCTiON COST'S Item Estimated Cost(Dollars)to b Qfficial Use'Unl, ;. completed by permit applicant 1. Building �/ 1�'O1� , 62 O O BulidrnOermjt def: l 2. Electrical (b) Estm,ated Taal Cost of Construction from"t, 3. Plumbing 'Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 + 3 +4 + 5) 0Check,NVmber 'f s ;ec#inn Fo Official Use Orrll Btdin' Permit Nurraben 'JWZ-77 ate Issued: Signature: �bornmissl'orier/inspector of Bulldings abate Versionl.7 Commerclial Building Permit May 15,2000 SE4-CONSTRUCTION SERVI ES F'O 0, PROSE CTS I:ES THAN 35,000 SIG�EI*T OI"ENCI:OSEQ SPACE Interior Alterations Existing Wall Signs Existing Grf ound Signs Additions Or" Roofing ❑ ❑ L$7 Exterior Alterations Demolition❑ New Signs'', [ ] Change of Use [ ] Other [ ] o .4 PP Co'� � - Accessor uildi g[ Repairs [ ] Sin ae�l�-tip �� jC000�y I SECTION 5- USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as.applicabl ) CONSTRUCTION TYPE A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business 16 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1.1 ❑ 1.2 ❑ 1.3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING.UNDER OING RENOVATIONS,ADDITION$ANDlORCHANGE INLUSE Existing Use Group: _ Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION€s BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NE CONSTRUCTION i y x r lex r Floor Area per Floor(sf) � St u yrr 2nd 1st 3 yy 3rd fflo m/ 2ndWN 4th 3rdF ' 4th Total Area (sf) Total Proposed Newj Construction (sf) �.. Total Height(ft) - b Total Height ft -•-- ! ---•-•--• �� ' • I Version 1.7 Commercial Building Permit May 15,2000 7.'Nater Supply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: �Pukjblic ❑ Private ❑ Zone: Outside Flood Zone ❑ 1 Municipal ❑ On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department �� sir •� � Lot Size y c l oo V--" ' Frontage / ' 7 Setbacks Front v u c=,a-rx j fes' ? r-f �•� Side L: l R: U Lii �'w R:C ,AOSC i 5 Rear Building Height (. 6-T c;� fi=r h•�1��1c Bldg. Square Footage r; 75-c % Open Space Footage % (Lot area minus bldg&paved parking) f #of Parking Spaces 2 Fill: volume&Location) � ' a A. Has a Special Permit/Variance/Finding Over been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registrar of Deeds? I NO DON'T KNOW _ YES IF YES: enter Book f age and/or Document # B. Does the site contain a brook, body of wateror wetlands? NO DON'T KNOW YES i 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? IES NO IF YES, describe size, type and location: . Are ere any proposed changes to or additions of signs intended for the property?YES No LI IF YES, describe size, type and location: j i i " Version 1.7 Commercial Building Permit May 15,2000 SECTION 9 PROFESSIONAL DESIGN ANI)GQNST,RUCTIQN S RV'ICES FOR BUILDINGS AND STRUCTURES >CT TQ CCiV1IUCIr1.N.CGNTRO,L:PUIZS'UAN" "F41CIIR 315:{GQ, TAINING . [CIRE THIN SS, 1 CF CIF SC #5 $I*A . .1 Registered Architect: Not Applicable 121"' I i 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 I Address Registration Number i 'gnature Telephone Expiration Date i Name Area of Responsibility Address Registration Number Signature elephone Expiration Date I Name Area of Responsibility I I Address Registration Number Signature elephone Expiration Date 9.3 General Contractor Not Applicable ❑ om any Name: n � Responsible In Charge of Construction ddre Signature telephone ' i Version l.7 Commercijal Building Permit May 15,2000 I LAII ECT1ON 10-STRUCTURAL PEER REVIEW 43A dependent Structural Engineering Structural Peer Review Req fired Yes......❑ No......❑ SECTION 11 -"OWNER AUTHORIZAT;IaN-TO I3E%CQMPLETED' WHEN OWNERS AGENT•OR'CONTRACTOR APPLIES FOR BUILDING P RMIT as Owner of the subject property hereby authorize to act on my beha a tlgi&Wtive#ork-bathorizid by this building permit ap icatio gnature ner Da as Owner/Authorized Agent hereby declare that the state nts and information on the fore oing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. ,PAAName Signature of Owner/Agent Date SECTION 1.2 4ONSTRUCTION SERVICES, 10.1 Licensed Construction Supervisor: ( -�- Not Applicable ❑ Name of License Holder i License Number zoa -t> AWcess Expiration Date Signature Telephone SEC`-ION 13;-W0RI(ERS'GOIV PENSAtIt7N INISURANCE AFFIp VIT(M.G.L. x.152, ?vC(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....... No...... ❑ i i i r .,,� � a3". �, � }. � .,� `',, ,, � a(ttA1 f/>�. �� G may �,nf "Tnz-fljaill}.~:toil C r�X S I R c II n r.rtt t _ OEPARTMEN* OP BUILDING INSPECTIONS I 212 Main �trcct ' Municipal Building NorLf*ipton, Afnss. 010GO I WORIa, WS CONITENSATION INSU t"CE Ar>MnVIT l r (ii cdus:,>v/lx:rrni ttcc) \vith a principal place of business/residetjc- at: Y6 3 (str�/ci tylstalc�z�p} do hereby certify, under the pains and pc;t}alties ofperjury, 0121 I ( ) I am an employer providing the follywintt Nu,KCr's cotnncns-i✓ion covetfor Illy etuplovecs wor�ang Oil Otis job- i i (P0UC-, Nu_nirr) ---- (T�,Dit tiofr Dn2) i I ( ) I am a sole proprietor, general cont>}actor or homeowner (cir:.ie one) and hive hired the contractors listed below vti,ho hzve t�e io0owi.ng worker's cop-- ensanon policies: (Name of Con.rMcto-) -W - (Insuranc. Cod inoa.ty(Potic; Num!Y,) CEvPirot:on Datc) I (Name of COnCraclor) (tasurancl Comoaav/Poticv Nummcrr) (-Exnif tion Date) l � - (Name of Contractor) Gastu-anc4 Compan)-/Pobq Number) (Expirtion Date) (Name of Conn-actor) (Insurau4 Comrany/PoLicy Numbs) (L=xj)ira ion Date) (anal:.d{i::oca1 t'xd ifa<,r-s:n to uic?u.c�uafoccxi_i ootzinan�to all (.,�I am a sole proprietor ai)d have Ilone worlang for Die. { } I. ain a home owner performing all the work myself. NOTE:plc tK t,,c ttv:w- t,, >Ioy V,,om to di m,;:--vxz,co z r x}c c a sack m.d..tt1 &of ON MOM th n Lroc t U in a{ic$the txaman'111 rrida or oo tSScpv to a zppurtcn ry tbcro 2 D G, x zAv ooas:dacd to lc �zvloy-3 t-C the •moi c i err ACI(GLI 52=11(5)},-pptica000 try a bomooavcr for c LCzr-=a r zs >Ly o`T6mocc tL-c IcSad m-,x"of to =ply"under dx Worto,-, Act iI I tu:,da d tbxt a oopy of Chia crztrmcxst auy ba for�to tbo of lad,,txicl Acodca ofbc o of[—,r, for ttm oavvr•Sc-ai6c---jioo&ad thaA f-ihmr to Iaurc coverage -c6.o 25A of MOL 152 can Ic d to the iaxpoSi603 of crimiCA pCa&Wa ocxnir.ing of a fine of up to S 1.500.06 ,Ocx zzr;a yo�saci f up to one ye-.r Od affil p.s.t'3a in CS<form ora Slop Work O dcr cad I fim of S 160.00 1 day tg;a t Oy- i Lot For dcp�rtrt,-�..al u.c ody / Permit t�timbct Signatlim of t icxr5scrlPc utter �e 100)