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' ''.. !* ' ' • 0110110111PIIMpetrprivit pr-tzromon L: Niels a A 1 . 70/70 3DVd COI CritriDH3 Mai 1MO2 069T.SSSZO 6E 1T 600J/12T/60 Version1.7 Commercial Building Permit May 15, 2000 8 oR oL�4A1YINa " , .. r Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 1 Frontage i i Setbacks Front 77 i Side L: 1 R:E f L: R:' 1 i Rear Butlaltig Height = i i j i _ - _ ._ Bldg. Square Footage I i % 1 ! i Open Space Footage % (Lot area minus bldg & paved i i 1 i i I I i , I parking) # of Parking Spaces i Fill: ' '{ (volume & Location) j A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO Q DON'T KNOW 0 YES 0 ' IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book ; Page, and /or Document # B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO Q - IF YES, describe size, type and location: ; i D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q IF YES, describe size, type and location: j 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 Q ` NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. y i Version1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR. BUILDINGS AND STi2UCTURESSUBJECf TO CONSTRUCTION CONTROL PURSUANT'TO 780; CMR 11& (CONTAINING MORE THAN;35,000°C:F. OF ENCLOSED SPACE) 9.1 Registered Architect • Not Applicable ❑ Name (Registrant): 1 Registration Number Address I j Expiration Date I Signature Telephone 9.2 Registered Professional Engineer(s): 1 Name Area of Responsibility 1 I Address Registration Number I I Signature Telephone Expiration Date t _ I Name Area of Responsibility ' Address Registration Number Signature Telephone Expiration Date j 3 Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date . Name Area of Responsibility Address Registration Number I 1 1 1 Signature Telephone Expiration Date 9.3 General Contractor 1 Z 1 - 0 0 1. AN) be vveil&tj -- W ICI.* 1L14(jj T Not Applicable ❑ Company Name: i Responsible In Charge of Construction (?.0 , 3 DA drl C,h.e6 re ka yvtal. 0 o I -- ; • Address F'`-- 1- I I ? -1 4 ,C ) , " bL/ Signature Telephone 9-ot1,-,9 pr t - - F� ��ti� (rii rrfllnrfl�al)? 1 � t A� f ?asanchncrlln' _ 1_ - DEPARTMENT 01' BUILDING INSPECTIONS • — 212 Main Street • Municipal Building et ,-; Northampton, Mass. 01060 r A WORKER'S CO 'CENSA'I'ION, LNSU AI'FDDAV1 . I, — _ , 0 1Y:. -- . ? -_3Z ),_r4 I A) G vven, alp to_6 4- R1►•L't? 11— (licens d permittcc) wida_2_.pl- as -pace of busino -s rsidenG -at:— s'. O. --- go g, •9 D ftii-1_iP Oa - (phoney=) Li (3 -2 - 51 G (s wJcity /st. ictap) do hereby certify, under the pains and penalties of perjury, dial (JI am an employer providing the following \i•orkcr's compensation coverage for my • employees working on this job: - ,1I) u4• nitAUG 1- 10 L2 31s- 36a (51,-o,'7 5- 217-go) 0 (I.0.5U toocznv) (Policy Nu.nr_r) (E ;piration Dale) • ( ) I- am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors Listed below who have the following worker's coopentadon policies: flame of Contractor) (1n5.tlrancc Colnoa-1v?oUc Nunt -- (!'_XptlJtIo Date)- (Name of Contractor) (Insurance Com p aa oLi cy Nuacer) (Expiration Date) • (Name of Contractor) (Insurance Company /Policy Narnlu) (Expiration Date) (Name of Contractor) (Insurance Compaay/Policy Numb:.) - (Expiration Pate). ( math ad.: it:ccal rbcot if ooa=z. r to mcud= iafond oa pciaiaing to •11 �r_) ■ ( ) I am a sole proprietor and have no one worid.ng for me. ( ) I am.a home owner performing all the work myself. NOTE: pica be c'' 1-t..‘ • ' t _I bemcoWvcn woo clay pezoai tow • ;a•- •,• c=:ac-I c rc- r •wort oa a d.•cll nz of cot moot tb_.a L tmf,.r is which the botoo ovwocr r c ido or cc the [70 =41 a appurtea.z toed .. we cox -41y war:,d=- d to be cmplaycs une'," the w : o Lion Act (GLI $f2„n 1(5)). . ppticstioa by n bomeoa -oa for c Gem_ or permit r>:y cvidcocc the legal ct.•au of ea cl;Aoyor uadcr c ho Wo&Sccla Cooapom•lioa. Act 1 underhand the a copy of (hi. ml.emoa t m.y bo fot- aeorded to too Dwartmce i of 1nh acrid Ascdocrta' Oltroo of Irahmooa for tho coveisc vrtif cYioa And the Giltzt to saauc Lovcrase undror suction 25A of MOL 152 eo led to the ia9^ **rioo of ei kui pcaeltir=- comisiag of • fhac of up to S1.300.00 and/or im:pri -.oa of up to ooc year and c tit pm uhia io he form of n Stop Wort Orda nod a an 01SI00.00 a thy ,pain.. (pc. For dcp.ruzs= ?1 u.c only Pct -mit Numbcr Map:: __ Lot Unalu of Lice c 1Pcrmiticc v?Ce .. - t Version1.7 Commercial Buildin f ,. SECTION 10- STRUCTURAL - PEER REVIEW - (780 CMR 110;113 Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION -TO COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING - PERMIT I, ', as Owner of the subject property hereby authorize ' w• ` JC7 L. i4 iq to act on my behalf, in all matters relative to work authorized by this building permit application. — i 0 Signature of Owner Date � 7 I, i 1 O Y� � � , 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. -- "TDr . Print Name C It r✓l a (if ppoi 1 &,00 Signature of Owner /Agent YDate SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder �UYVN-1-)a>, w v0 65 35 Q ? License Number 0, -0.( ca5 esiwa 1(10.010 z - g- ao Address Expiration Date '7_ Svv e� - 51 6t/ Signature �`d' // Pi /i �' f/l d or Telephone SECTION 13 - WORKERS' COMPENSATION INSIJRANCE 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 0 1 r Version1.7 Commlrcial Building Permit May 15, 2000 SEC •CON , S ERVI C E S _ .. THAN[ 35, 000 CUBICFEETOF ENCLOSED SPACE" ` - Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. e 1Q. Fn on t e tA 4 v . c'e tc.D i }=Iraw� Pw -D___0,00,,- 0,,- 4. Of Proposed Work: Do1V i b, 1 '(lVc-lc- a, Prow , rr v t1HV U*' 5; IS n aFI= blt h li �lr i i b� 1L G fa SECTION 5 - USE GROUP =AND CONSTRUCTION USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A-4 ❑ A-5 ❑ 1B I ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ( ❑ 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 A' ❑ Specify: I 1 M Mixed Use 0 Specify: 1 1 S Special Use ❑ Specify: I I i CO MPLETE TI 1f& SECTION tF EXISTING BU ILDING UNDERGO11�7G R 0V ATI '0NV DONS`ANR.0 D /OHANGE IN USE Existing Use Group: I I Proposed Use Group: Existing Hazard Index 780 CMR 34): I Proposed Hazard Index 780 CMR 34): I 1 SECTION'S BUILDING HEIGHTAND AREA- F BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION �� ,_..�, f ' Floor Area per Floor (sf) '- - �-, �" Y 1 st , -i 1 ` -*: 1 st 1 � � w Vi`µ , 2 ' 2 A A = ^e � t Vfi r- k rd ' 3 rd ir a 4u' 4th I - Total Area (sf) Total Proposed New Construction (sf) ' p Total Height (ft) i r ° ' x Total Height ft :- � .. _° Y { 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 El - . 1 1 Version1.7 Commercial BuildinlilimiiiiimiSPOINO ,,,,_ _ t _ ,,,_, - '''"4-:.-40.4ii*4---i-'Pi'Ait-b._ilt,4Ati'e, City of Northampton W.,, -ng.MK.OtIftlitifil-441:tg.N41,434 lE3uilding Department 212 Main Street r ._,..,..; 4.,,I Room 100 :- ''VX i SEP 11 200klorthampton, MA 01060 ` phone 413-587:1240 Fax 413-587 -1272 I. . Afg* 7,- - ---, -,,--'4,4, 24,-,--- , ----- - - .4 - tzfk_9: ,- ;- 7 14.---:. , --',7 ., •=7 ' L ' r r - , --,--- 4 1 ie. o e rSp APPLICATION TO tateiSTWVT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING ---- 15THER THAN A ONE OR TWO FAMILY DWELLING • • ; - -- - ---------- - ---- - L • ----- -'77 - :-• , ; - - : " - SECIION - 1--=SITEINFORI4ATIOINC. --- -' ----'•:::-'-. - - ..—___ -_ _...,,...._, Thit office - -11-Propertv-Adtiress: . 1 1.1 i S'ect" e - n r.. - 00 ,....‘2 L ?1 e cc 1 .e.A.-E "--- . i Wo g 4-1, c )0 M 01 0 0 . 4 , .F.--2:a..:a , ;:,;', - -:44 . 1...'4,72::e 1 *_iki i ---- - - --- i :A.,.00 .1.4.-- '4 62-5 Unit 1 Ft. .... _.,.. - . - .., tn;-:'n-,:j;a.t.f..'t.'_.,r:"V;,,V.f,i=;:.i:S'::,: ta;.',,:: 5_, --- ---- Agig 1 i - t.---4,„',44 ......:`,4.:1■?-11%,..7,,,,,,. . ;:=1:44.1* .f,,tfil;MV:W*'"4111;;EI3IC4:WAVelW24.41'' U*1.5jeti" I 1 ib ---''=--- dititirstrral . :----...-,-..,--,- SEC TION -i,RciPtiii-Y4541HINAVI-1.0T4E 1$.A5EAT:-.-Ail:s.,-,- -.:. ,,, _ -- : - ..- ---, - ,--- :;- -, .., - .?::.- - .: , . -- -. - .L ., :- -, s:s.--- -- 4:'= -, ;:il'--.-.5-::: , f;L:.: . 4:-.% , ;( , -,,' , . - .: , ..;-' - ,._,7 , 2 , 7;:: ,, ,• - - - ---f-_-..:::-i' 2.1 Owner of Record: i LIN Da_ n (Oekey Name (Print) Current Mailing Address: 0 ' . Signature , -- ! .00 .4 i-kePc_k) 1-es - 24. Co L c h (,/ 1 , S I, I 1 - 5ov - 655 - 8 I 0 0 A tt( Telephone 2.2 Authorized Agent: 1 1O nkMLgAJ__(,±ALC,QAM 1 '--- O. -- f) IDA. Name (Print) Current Mailing Address: e gif, ._ I cill ot..4 WI a . Signature MI f,/ 6 Telephone I-1 13 7 -,.5 ) 6' _ ..: - SECT10 1+3-- ESTIMATED CONSTRUCTION COSTS . ... - Item Estimated Cost (Dollars) to be -- -0ffi.cial-Use'Oply completed by permit applicant l'3:::: . - . - . - . - 1 , 1. Building I i 1 ijayBUilding:Pannit Fee 1 o f -1 2. Electrical i - . ( b) o 1 1 -•'--- Construction from (6) • 3. Plumbing i 1 ililingPerinit7Fee 1-- i 4. Mechanical (HVAC) 1 5. Fire Protection i 6. Total=(1+2+3+4+5) li 6 d'o o • -Check Number tt,1 3 ' ' - ' Thi; OffiCialbse Only - Building',,perinit NtiMbeit-: ...„,_ , -Issue od . - . r ' Signature: Building Commissioner/Inspector of Buildings - - Date • 1 File # BP- 2010 -0281 APPLICANT /CONTACT PERSON THOMAS DOLAN ADDRESS /PHONE P 0 BOX 297 CHESTERFIELD (413) 585 -0612 0 PROPERTY LOCATION 525 PLEASANT ST MAP 39A PARCEL 037 001 ZONE GB(100)/URC/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 03 6S Typeof Construction: REPAIR FRONT ENTRANCE & CHANGE STUCCO FINISH TO BLOCK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 039281 3 sets of Plans / Plot Plan THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: proved 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 ...........,......<7:V"..........7/ --71---/-(1-12-7— 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. +h E r q _ ' BP- 2010 -0281 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 -0281 Project # JS- 2010- 000361 Est. Cost: $6800.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS DOLAN 039281 Lot Size(sq. ft.): 120225.60 Owner: CORLEY LINDA J Zoning: GB(100)/URC/ Applicant: THOMAS DOLAN AT: 525 PLEASANT ST Applicant Address: Phone: Insurance: P O BOX 297 (413) 585 -0612 0 Workers Compensation CHESTERFIELDMA01012 ISSUED ON:9/17/2009 0:00:00 TO PERFORM THE FOLLOWING WORK: REPAIR FRONT ENTRANCE & CHANGE STUCCO FINISH TO BLOCK 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 9/17/2009 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo