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06-051 (2) r7 pl . 'F fi - � � BP- 2010 -0304 GIS #: COMMONWEALTH OF MASSACHUSETTS 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- 2010 -0304 Project # JS- 2010 - 000402 Est. Cost: $8181.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BUILDERS SYSTEMS INC 49298 Lot Size(sq. ft.): 1344697.20 Owner: MASSACHUSETTS ELECTRIC COMPANY C/O PROPERTY TAX DEPT Zoning: SI(100)// Applicant: BUILDERS SYSTEMS INC AT. 548 HAYDENVILLE RD Applicant Address: Phone: Insurance: P O BOX 635 (508)798 -8797 WC AUBURNMA01501 ISSUED ON :912212009 0:00:00 TO PERFORM THE FOLLOWING WORK :EXTEND ROOFLINE 6' OVER DOCK STAIRS 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 9/22/2009 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo File # BP- 2010 -0304 APPLICANT /CONTACT PERSON BUILDERS SYSTEMS INC ADDRESS /PHONE P O BOX 635 AUBURN (508) 798 -8797 PROPERTY LOCATION 548 HAYDENVILLE RD MAP 06 PARCEL 051 001 ZONE SI(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 1,.2417 KV Typeof Construction: EXTEND ROOFLINE 6' OVER DOCK STAIRS New Construction Non Structural interior renovations Addition to Existin Accessory Structure Building Plans Included: Owner/ Statement or License 49298 3 sets of Plans / Plot Plan THE FOLLOWING 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 Commission Permit DPW Storm Water Management Demolition Delay Signature of Building Officidf 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. Versionl.7 Commercial Building Permit M 15, 2000 Deparbnant use only City of Northampton Status of- Permit: Building Department �UV" "ay;P nrt 212 Main Street SsrepicAv;ilabrlity - Room 100 1arlfel'Auilatl+ Northampton, MA 01060 7#s+truoral phge 413= 587 -1240 Fax 413 - 587 -1272 Ploli6it6.Plans Other Specify APPLICA'T`ION 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 o% N. Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record IuArIWA L Gin S4�r I��AYAtri u.t 1z0 tjw Mw#raN Name (Print) Current Mailing Address: tae.660. 40L (010 Signature Telephone 2.2 Authorized An ent: i U C 1110"40 R. '� �s 3.�, A v&wr%.rA " dr yo Name (Print) Current Address: ,�' Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by ermit applicant 1. Building a (a) Building Permit Fee Q � 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing w ow Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = 0 +2+3+4+5) Check Number This Section For Official Use Onl Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date Versionl .7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOS SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration K Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: GrbNft A .�oo uNti ..�, 0 :.. {fi d�iM"' VA SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A ❑ A -4 ❑ A -5 ❑ 113 ❑ B Business 2A ❑ E Educational ❑ 213 I ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 36 ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 56 ❑ 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): T _ SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) St 1St 1 2 nd 2 nd 3 rd 3rd 4th . . 4 Total Area (so Total Proposed New Construction (so Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone I Outside Flood Zone❑ Municipal ❑ On site disposal system E] Versionl .7 Commercial Building Permit May 15, 2000 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 Arkin # of Parking Spaces Fill: volume & Location A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW � YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES IF YES: enter Book Page; and /or Document #! B. Does the site contain a brook, body of water or wetlands? NO V& DON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: NAT1dhiA1,,. d[RAA D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl .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: Not Applicable Name (Registrant): _ ID 7CON Registration Number C R oroN ' 4 wolutytR 1rwA 0110W Address Expiration Date �.,,t S `�i p RCN yl,�w1j Cfi��� Signature Telephone 9.2 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 oy11111KOf SmUt 1 Not Applicable ❑ Company Name: Responsible I harge of Co ruction Address 3'o .g►$�,�9 Signature Telephone 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 0 No SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I 1 1�AA� as Owner of the subject property hereby authorize %)I64MAIii to act on my behalf, in all matters relative to work authorized by this building permit application. '51ti ArrAeN to L�f !�-� A•t16 Signature of Owner Date as (hoer /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 th ins and,p nalties of perjury. 1114 1�ir ��� Print Name Signature of Owner /Agent Y Date SECTION 12 - CONSTRUCTION SE ICE 10.1 Licensed Construction Supervis Not Applicable � El Name of License Holder : t�•�e�NA1 �1 1 bl V License Number % 10ow5 . Avc�uM•r a , I q • � "� • L or o Address Expiration Date % Signature Telephone SECTION 13 - WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 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 0 No Q - boy C.earonS �� T � � Y BUILSYS -01 MEMA ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (M 6/25 /200YYY) /2009 PRODUCER (508) 852 -8500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Protector Group Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 100 Front Street, Suite 800 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norcester, MA 01608 -1435 j INSURERS AFFORDING COVERAGE NAIC # INSURED Builders Systems, Inci INSURER A: Acadia Insurance ! 135 Southbridge St, PO Box 635 INSURER B: Atlantic Charter Auburn, MA 01501 I NSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. VTR I S.b POLICY EFFECTIVE POLICY EXPIRATION _TR N Rd TYPE F INSURANCE POLICY NUMBER DATE MM /DDlYY DATE (MM1DDfYY1 LIMITS GENERAL LIABILITY j EACH OCCURRENCE S 1,000,00 4 X COMMERCIAL GENERAL LIABILITY CPA0042039 7/1/2009 7/112010 1 PREMISES Ea occurence S 250,00 CLAIMS MADE OCCUR ! MED EXP (Any one pers on) S 5,00 � I PERSONAL & ADV INJURY I ''� $ 1,000,00 GENERAL AGGREGATE S 2,000,00 GEN'L AGGRE LIMIT APPLIES PER:: PRODUCTS - COMP /OP AGG -, S 2,000,00 ! POLICY X PE h! LOC j AUTOMOBILE LIABILITY ! 1,000,00 COMBINED SINGLE LIMIT S a ANY AUTO I MAA130059417 7/1/2009 7/1/2010 (Ea accident) X ALL OWNED AUTOS li $ SCHEDULED AUTOS BODILY INJURY (Per person) X HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) S PROPERTY DAMAGE (Per accident) S GARAGE LIABILITY ! AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG S ! EXCESSIUMBRELLA LIABILITY ! EACH OCCURRENCE !. $ 10,000,00 OCCUR CLAIMS MADE CUA0042041 7/1/2009 7/1/2010 AGGREGATE $ 10.000,00 DEDUCTIBLE $ — RETENTION S ! $ ! WORKERS COMPENSATION AND �(i WC STATU- '.OTH- EMPLOYERS' LIABILITY i1NCAOO514002 7/1 /2009 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE 7/1/201 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If S PECIAL AL PR describe under 1,000,00 SPECIAL PROVISIONS oelow I EL. DISEASE - POLICY LIMIT I S OTHER i k 'Installation Floater 'CPA0042039 7/1/2009 1 7/1/2010 'Per Site $200,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT ! SPECIAL PROVISIONS :ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,CORD 25 (2001/08) © ACORD CORPORATION 1988 CONSTRUCTION CONTROL PROJECT NUMBER: / n PROJECT TITLE: �i9- r, &—,q L 6 '� rp ` X le Gl ' A al c ' �z PROJECT LOCATION: 5��� fI f 1 _ /�/ IlZ'L L DA1� Ale)k n/ MpT�,4-1-i� NAME OF BUILDING: NATURE OF PROJECT: /x/67&1 &O " V6 - In accordance with section 116.0 of the Massachusetts State Building Code, I, P f{ V27D J, A: R Registration No. 7ejn_T being a Registered Professional Engineer /Architect hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL _ MECHANICAL _ FIRE PROTECTION _ ELECTRICAL OTHER (SPECIFY) For the above named project and that to the best of my knowledge, such plans, computations and specifications meet the provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following specified in Section 780 CMR 116.0, 7th edition of the Massachusetts State Building Code. RED A,qc Q �v \y P d` 0 � KRO � SEAL No.07003 K q(TH OF MPSS SIGNATU Subscribed and sworn to before me this 1l day of c Notary public My commission expires �Cwrrl�M�r� mom Mow swasm V , 1 ap"d400SWO4yM 4LOC MAW- national g rid September 17, 2009 Anthony L. Patillo, CBO Building Commissioner Zoning Enforcement Officer 212 Main Street -- Room 1.00 Northampton, MA 01060 -3189 Dear Mr. Patillo: Builders Systems Inc. of Auburn, MA has been authorized by National Grid to apply for a building permit to construct a canopy roof over the stairwell of the loading dock at the National Grid facility at 548 Haydenville Road in Northampton, MA. Sincerely yours, Kris Thebado Supervisor National Grid 939 Southbridge Street Worcester, MA 01610 508.860.6262 939 Southbridge Street, Worcester, MA 01610 -2293 T 508/860 6000 ■ www.nationalgrid.com Massachusetts - Department of P-iblic SafetN _ Board of Building- Romlations and Standards Construction Supervisor License License: CS 49298 Restricted to: 00 RICHARD C RINGGARD 288 SOUTH ST AUBURN, MA 01501 Expiration: 9/17/2010 ('unmiisiunrr Tr#: 3292 i i i