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Z Cl z �'_'° °�^ —� o t - — [wpAri,,,,,Riir o -- p MAIN CA rE - - J _> t _ I +>\ -- *i C , /(N5 r 1 I a A PAcIl1 '-� ' o ______r_ , �� L iOrL_ DGi n R ESr �� \ _ ._. a . _ ..--o TUNN[L , , L 7. _ _ _ _- UR00M5 _. t - - � L 1 031.0 Ji, / / �� ►( a1 -� � 5r 11+0 f l�` �. ` - - a� _n_.. a__�..a __,_a �_ • EUWE /A/ ROL I EO.f A FRANK Al — _i a^ � GR ANOS IA NO jjjLsoN PART uurVEI O I GRE �� M(Y(lqu l� � 1 I F 1 -N " F N�RI)ION — I ._ -. - -- HALL DIN G Q , II S 011 fll out i _ a (AIR STREET JJ 4 O - rlRSr LD I l I EAST GAff -- - - -- - -_ - - - - - -- / REST In o t _ -. (AIR S{RE - THREE COUNTY FAIRGROUNDS , I )/"-", 'E' NORTHAMPTON MASS. f or -t) PARKIN() SCAL DATE. MAY 1981 too so is so g oo .w 1 -- — ` � - K v J ; o ?( J A�uFR MuN TLCtr, JR • ASSOCIAI[S, IHC ((: ^S!O JJ �.f rs .4' • m , Ir � � m „(11AN P h 6 _ v. S. 0 , * • aaDarhnsrtta MAW _ r r DEPARTMENT OF BUILD D' G INSPECTIONS 4 _ =F f 212 Main Street • Municipal Building Northampton, Mass. 01060 No ' WORKER'S COMPENSATION INSURANCE Al I, .c.Cab FjeA bk/k l1l-i N43 ),rmpd 4R' l / 2i9 (liccnseelperm,ittce) S a CI T eirti with a principal place of business/residence, at: P 2 , °2- �,,,^ -�' p hon 9/36/9' ,,.3'”) 0 � 5 honer- (su city /st to /Tip) do hereby certify, under the pains and penalties of peril.tn ;, that. ( 1<farn an employer providing the following worke s colnpensancn coverage for my employees working on this job: /ea a hi 1, NS ACC Ativcc CO WC `J- 0Q3y0 ° ? , .0.3 (Insurance Company) (Policy Number) (Exp ,l)ion tare) ( ) I am a sole proprietor, general onuactor or homeowner (circle one) and have 'aired the contractors listed below who have the following worker's compensation policies: i (Name of Contractor) (Insurance Corn-may/Policy Number) (E.�ir -aeon Date) } (Name of Contractor) (Insurance Company Poticy Number) ( Expiranon Dale) 't i (Name of Contractor) (Insurance Com an um y Number) (Expiration Date) 1. _ (Name of Contractor) (Innuance Company/Policy Number) (Expiration Date) (attach additional shed if necessary to mckudc information pertaining to all co radon) 1 ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. • NOTE: please be aware that while hemeownera who employ paaom to do maintenance, wusrueioa or repair work on a dwelling of not more than throe units in which the bomoowwer resides cc oa the grounds appurtenant thereto are not generally considered to be employera under the worker's compensation Act (GL152,s1 1(5)), application by a homeowner for a license or permit may evidence the legal rtet of an employer under tan Woriac't Compensation Act_ I understand that a Dopy of this aiatcme t may be forwarded to the Dcpertmme of Industrial Accident& Office of Insurance for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1,.500.00 and/cc imprisonment of up to one year and civil penalties in the form of a Stop Wort Order and a _ fine of 51O0.00 a day against uric. For degutnrrtal Use off' Permit Number ' . iC.././—l—ler.A4 NO 2 6 Map# Lot 4 Signature of Liccnsee/Permittee y/ Version1.7 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, COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, 69.0.0E S -' A \\ C..2 O S S , 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. Prin ame j ` - 1 1 / 6 Z--- ignature of Owner /At - Dat SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number 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 ( No ❑ Versionl.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION'CONTROLPURSUANT TO 780 CMR 116 (CONTAINING MORETHAN=35,000 C.F. OF ENCLOSED SPACE) 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 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature Telephone Version1.7 Commercial Building Permit May 15, 2000 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ _ Private ❑ Zone: Outside Flood Zone ❑ Municipal ❑ On site disposal system ❑ 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 parking) # of Parking Spaces Fill: (volume & Location) i I 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 DON'T KNOW YES IF YES:. enter Book Page and /or Document # 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:. 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 SECTION4=` CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC `FEET or ENCLOSED ED SPACE Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing 11 ---- ❑ ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] ❑ Accessory Building [ ] Repairs [ ] • ReRcA,,G. 14s VA Z 4 F N r6 Q AR KS ‘26-1 e/12 $i`'AGjc1 - - DE,Se - Tr4 3 • 0 v e z i , Ail, 'S N, c le Late ( " 4 — SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly I A -1 ❑ A -2 ❑ A -3 ❑ 1A I ❑ A -4 ❑ A -5 ❑ 1 B ❑ B Business ❑ 2A. ❑ E Educational ❑ 2B I ❑ F Factory ❑ F -1 ❑ F•2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1 -1 ❑ 1.2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ I 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): I Proposed Hazard index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA - ,4 p. OFFICE I S 'T.-N-11'44, ' � i BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION , -�. ,, „� !�,,, °, �,x : ,;: � x 1st ,,, � . ; n ;- �; Floor Area per Floor (sf) 1st q� 2nd ' ..,' 4, 3rd 3rd 4th at _; : ;;�, ;, ��� . . . ''.*�, a • 4th 1;i k •t' ' 4 €y. ' Total Area (sf) Total Proposed New Construction (sf) ,, , `' a 9? �� Total Height (ft) ��, Total Height ft ��, Version1.7 Commercial Building Permit May 15, 2000 C.t-y- :off Northampton 7. ;')f ::,Bi ilding Department -- - 212 Main Street �Ftt W ;Room 100 Y r Q'� 1 �� �`''-t‘dortha"mpton, MA 01060 phone 413-5137-1240 Fax 413 - 587.1272 APPLICATIdN3C�..CbNSTRUCT, 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 12 STMT Map t e- L ot Un it: Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: H/1.6,1n s 11.1 Re �A'Li-' "'� 1 ),0 '6D1 1, n'IP) 1 6it�GtLT14/24L ScC �efy Ai 12 J ..- �L o rJ V1/14. C)' > — a3os J Current Mailing Add Name ;Print; Address: ' 13 5F — ?.a-37 } Signature Telephone 2.2 Authorized Agent: / 3 6 S� i2..t,(e � h . S 1-i 9 1 I ere. as s _ /\./ o 12 ✓Y1A D/ 0 6 J— G,?a s� Na 'Print; Current Mailing Adcress. / ignature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item i Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building T (a) Building Permit Fee /0, ob 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) / o, D 0 Check Number This Section For Official Use Only Building Permit Number: Date Issued: , Signature: Building Commissioner /Inspector o Buildings Date itirt BP- 2003 -0503 GIS #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2003 -0503 Project # JS- 2003 -0831 Est. Cost: $10000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor_ Lot Size(sq. ft.): 871200.00 Owner: HAMPSHIRE FRANKLIN & HAMPDEN Zoning: URA Applicant: HAMPSHIRE FRANKLIN & HAMPDEN AT: FAIRGROUNDS - FAIR ST Applicant Address: Phone: Insurance: P.O. BOX 305 (413) 584 -2237 (112) NORTHAMPTONMAO1061 ISSUED ON :11/14/02 0 :00 :00 TO PERFORM THE FOLLOWING WORK :REPAIR & REROOF (2) BARNS OVER EXISTING (1) LAYER 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/14/02 0:00:00 999 $100.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo