32A-138 (113) •
BP-2007-1153
GIs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Pe m t: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2007-1153
Project# JS-2007-001844
Est. Cost:$45000.00
Fee: S 190.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CHRISTOPHER KEYS 070650
Lot q.ft.): Owner: CHAMISA CORPORATION PNB" iK racier
zoning:ing: Applicant: CHRISTOPHER KEYS
AT: 25 MAIN ST - #439
Applicant Address: Phone: Insurance:
9 MIDDLE ST (413) 586-4528
HAD L EYMA01035-9592 ISSUED ON:6/18/2007 0:00:00
TO PERFORM THE FOLLOWING WORK:RECONFIGURE OFFICE SPACE & PROPOSED
STAIRWAY - UNIT #439
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: Date Paid: Amount:
Building 6/18/2007 0:00:00 $190.00455
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2007-1153
APPLICANT/CONTACT PERSON CHRISTOPHER KEYS
ADDRESS/PHONE 9 MIDDLE ST HADLEY (413)586-4528
PROPERTY LOCATION 25 MAIN ST-#439
MAP 32A PARCEL 138 006 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out /��J J.�` -y96�
Fee Paid `Y�J
Typeof Construction: RECONFIGURE OFFICE SPACE&PROPOSED STAIRWAY-UNIT#439
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owned Statement or License 070650
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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 Commi ' n
-407
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.
' Version L7 Commercial Building Permit May 15,2000
aIota;
f
r ti City of Northampton A 'f ,�rt -,4 tt�s s t t ,
:. Budding Department iiip*��, �� .>? 1 7
.2;42 Main Street c p '�' `"7 A -�
0 a Room 100
Northampton, MA 01060 `
° 3'W aeft'...
phone . „--T-1240 Fax 413-587-1272 Re
4'
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
1.1 Property Address: This section to be completed by office
-... f/ nAd-!A/ 4/re-4V- Map Lot Unit
to;4 //� 0 1M4 OtOSd zone Overlay District
I1v,y ---- Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: ��17 �^yy
_D _ K.01-0,,. -- 31 Ch,+., ?Q. . .„ , I%.lky
Name(Print) W c h ' et^11+-i 4 • Current Mailing Addre s': G to31-
/� `j13..2 x(2 .0321
Signature sir Sect.. I( Telephone
rn
2.2 Authorized Agent:
Jcrp p? E--lam 2 MAIN_ 5Fr` STG11-371 006 o
Name(Print) Current Momp Address
x -, 0(7 }
Signature l"- Telephone
SECTIO - CONSTRUCTION COST*
Item Estimated Cost(Donors)to be Official Use Only
completed by permit applicant
1 Building L-Z 3 G 00 tad (a)Building Permit Fee
2. Electrical ✓' '`, ,O GU (b)Estimated Total Cost of
1 r ti'V c Construction from(6)
3. Plumbing GG G toil Building Permit Fee
4. Mechanical(HVAC) 1/ V c,l
S.Fire Protection .3.__U r` _ .. ,f ..-
6. Total=(t +2+3+4+5) Lys;Lys; cc/I, — Check Number ./Qt. . X7/90 --
This Section For Official Use Only
Building Permit Number Date
Issued
Signature;
Building Commbsionerflnspedor of Buildings Date
•
Version! 7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alteratlons4XExisting Wall Signa X Demolitions Repairs 0 Additions ❑ Accessory Building❑
Exterior Alteration Existing Ground Sign❑ New Signs❑ Roofing Change of Use Other❑
Brief Description Enter a brief description here.
Of Proposed Work: �^ r ( r J/I �`/`/
1-J sq l Ut�L�q_L'X(i/_7,j. 4l l / g._ Spicer_$f rofCCPt/ /r^ /
SECTION 5-USE GROUP AND CONSTRUCTION TYPE / /
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly A-1 ❑ A-2 ❑ A-3 ❑ 1A I ❑
}�/ A-4 ❑ A-5 ❑ 1B ❑
B Business yq 2A 0
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C
0
H High Hazard ❑ 3A ❑
I Institutional ❑ IA ❑ 1-2 ❑ 1-3 ❑ 36 0
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A 0
S Storage ❑ S-1 ❑ S-2 ❑ 5B `I�(
f"�
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
T-mwr Men
Floor Area per Floor(sf)
1.. _.___ _.. . . ___ 1"
2a, 2�a _. _ __ .
4e id 300 _ 4e
Total Area(sf) _/y ��r.. Total Proposed New Construct'. (sf)
Total Height(ft)
Total Height ft __.. .
7.Wa r upply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewa e !spout'System:
Public Private 0 Zone Outside Flood Zone MunicipaOn site disposal system
Versionl.7 Commercial Building Permit May 15,2000
S. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to he filled in by
Building Department
Lot Size
Frontage
Setbacks Front ----'
Side L R: L: . R:
Rear
Building Height
Bldg.Square Footage ., __. % _ —.. -
Open Space Footage %
(Int area minus bldg&paved ,
parking)
#of Parking Spaces -
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Findin ever been issued for/on the site?
NO DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Re istry of Deeds?
NO DONT KNOW X YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NOl JC DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained yy, Date Issued:
C. Do any signs exist on the property? YES NO x
IF YES, describe size, type and location: / `
D. Are there any proposed changes to or additions of signs intended for the property? YES NOX
IF YES, describe size, type and location: '
E. Will the construction activity disturb(clearing,gradin e, xyvaliien,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES I NO 1 X
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
rRei Not Appl3icab�lle ❑
Name(Registrant): 76 54-
155 - y L } A, _14t VA o oot Registration Numb
er
Address/2
. 8 /
b7
413 Pit 34s! Expiation
Date
Signare Telephone
9.2 Registered Professional Engineer(s):
- - - - - --- - �, /n/GrAr neIle-
1Kt/
Name Area of Responsibility
z& AIatth S No-1101W Mk_ OIooO 37300
Address Registration Numb
e
403.184'444 G/s o
Signature Telephone Expiation Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address _ - - - Registration Number
Signature Telepplration Date
Name Area esponsibility
Address Registration Number
J
Signature Telephone Expiration Date
9.3 General Contractorc/
! "rPr 6 k9�S Not Applicable ❑
Company me /
War—
Respons ble In Charge of Construct o
t 9 /d S 4 /VA- 6/03c
Address
Se‘ Ysz
Signature telephone
Versionl7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) l�l
Independent Structural Engineering Structural Peer Review Required Yes ❑ No I I
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FORUBUILDING PERMIT,
-- y�.� �' 1L OVNLAS z">. D `' as Owner of the subject property
/.Y/ Q '1Ja4) C-4 .s,ps, fury,
hereby authorize._.. _. _ ._ to
act on my behalf all matters relative work authorized by this building permit application.
•
Signature ofn{ er Date
as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Name 1t
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Su rvisor: / Not Applicable 0
Name of License Helder• /f9^
/✓L�,e.51> License Number
�y. � 4 6 3s 7e:‘,5-0
Atltlress Expiration Date
5 =ysz±3 3 z/-zoo9
Signature Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.152,§25C(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 Er No❑
r
�1
I tl'i'
Ste�,� . ... _ n
eaflIC 6ifur of Nnrtijantptan •=:=it- /C{
=-
i.
kvt .ifltlu aAS/ }
5=�T��t
v DEPARTMENT OF Bt)21DD;0 INSPECTIONS _ Fl_
INSPECTOR 212 Main Saar • Municipal Building —_F 4/
Nardumpwoo,MA 01060
' CONSTRUCTION CONTROL DOCUMENT
(fpr professional Engineeg/ArChitees responsible xforr Entire Project)
Project Tide �PA40 Date: /yolk t/1 07
Project Location:,25 WT 9Map: privet !! Zone: �(""''''
Scope et/Podium. Xemoc./e - ,4'inncy PC v// LY�0 .tYv f
Lv/Gs�'frr�dr/G/4,04 p,6 iisa'o "on .4C -
In accordance with the sixth edition Massacburn•State Building C e,780 CMR SECTION 116.0:
I, gRVZ. C C(_-L?fhAM Mass. Registration Number_76 cif
Being a registered professional En wrJAaddua hereby CERTIFY that t have prepared`or directly
supervised the preparation of aft design plans,computations and specifications concerting
)(East Project
for the above named project
e
and that to the best of aw imowiedge,such plans,computations and
Verifications moa the applicable provisions of the Mamch¢ndts State Building Code,all acceptable
engr>ering practices and all applkable laws for the proposed project
Furthermore I understand and AGREE that t shall perform the qty Fractional=Mims to
determine that the above mentioned portions of the work proceed in accordance with the documents
approved for the building permit and shall be responabkfur the following as ape ified in section 116.2.2:
1. Review of shop drawings,samples and other submittals of the mmactnr as required by the
construction doaiments as ssbraiued for the bolding penult,and approval for the
contu®ams to the design concept
2. Review and approval of the quality control procedures for all code-regaled controlled
materials.
3. Be present at intervals appropriate to the stage of construction to become generally familiar
•
with the progress and quality office work and to determine,in gcraaat,tithe work is being
performed in a manner consistent with the construction documents.
I shall submit periodically,in a form nip • to the building official,a progress report together with
pertinent comments,Upon completion of the work,I shag submit to the building official a filial report as
to the sathiaaory completion and readiness ofthe project for occupancy,
Signature and Sal otrcgismed professional: st'ED AR&
WCe'4�a 00: CA
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�bH OF MPr+SP '
Fax 40-517-1272 -phone#13-587-1 r
TOOfe % Natter) Ted Ot 9O LOO2/LOis0