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10. Do any signs exist on the property? YES )( NO
IF YES, describe size, type and location: Y svYr zSIGk-c tArn t Stq YZbn, .. Sign 6VYY
c Y Acr.., 4-e.n a, c3 (e c 7 c . iv uevct,-k ko side. a crtrr
Are there any proposed changes to or additions of signs intended for the property? YES NO X.
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size 2.5 a C -V)
. Z FJ CxUt eJ�
Frontage
5 i 4- ?kV ' SCX.
Setbacks Front
Side L: R: L: R: S&w?c, L: R:
Rear
Building Height
Spk.VyK
Building Square Footage
Sc'.vw ..
% Open Space: (lot area
minus building a paved
parking
# of Parking Spaces
N /is.
# of Loading Docks
N /A,
Fill:
(volume & location) N /,A41/4
13. Certification: I hereby certify that the information contained herein is true and accur. a to the best of
my knowledge.
Date: Co 1 (o - 1 0 Applicant's Signature _
NOTE: Issuance of a zoning permit does not reliev • n applicant's burden to comp \ with all zoning
requirements and obtain all required permits from the Board of Health, Cons • rvation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
W: \Documents \FORMS \original \Building - Inspector\ Zoning - Permit - Application - passive.doc 8/4/2004
File No. / P 9'
ZONING PERMIT APPLICATION 010.2)
Please type or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City ofNorthampton
1. Name of Applicant: y 1 1 S i�til 4 � 1 L L L
co Koh r � ( ,.�ns k ruc k-t or
Address: 31 r- o�.wv> piA.A �'ttXL& 1°d ) (eel 0 (D35 Telephone: 2 — 03 1
2. Owner of Property: Tr t d,:wv1- C -or"
150 1..A, ottv., St . ,Swig -e. # 310
Address: f'O. ?Ay, c Flo g ) Nmr.} - 11ori O1 OG) I Telephone: 2 5(0 - 0324
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) n.l d-E{
4. Job Location: D q M O.1L., , arP,rk
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property: CUM. yvICw"f l.ek,l L.14' .v1. �A✓�tt4 -k s
6. Description of Proposed Use /Work /Project /occupation: (Use additional sheets if necessary):
• ►l ! .a /.. e 4 i.A . u i • • 11 {, r• I rs_. da
i re eovcss dour rn p1 (A.v, pis l 11\.) I V) a ou.s ct.h .44w. 1 ax►d
SE,UN\ 1 ours rtar 1 -c �xtii l r�l �n em � Side �a �,, Ftr&t
C c)e e.5 c so 0. - rift e S CAre.. ' o v cLvj + S A i rS .
7. Attached Plans: Sketch Plan Site Plan J Engineered /Surveyed Plans
‘*C (hropostl) \ oi
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DON'T KNOW X YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page V and /or Document #
X
9.Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
W:\ Documents \FORMS \original \Building - Inspector\ Zoning - Permit - Application- passive.doc 8/4/2004
File # MP- 2010 -0095
APPLICANT /CONTACT PERSON KOHL CONSTRUCTION
ADDRESS/PHONE 31 Campus Plaza Rd (413) 256 -0321
PROPERTY LOCATION 109 MAIN ST
f 001. ONE,CB(i0011
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO FILLED OUT _
)~' Pa L2 Z 49 �/.7
Building Permit Filled out
Fee Paid
Tvpeof Construction: ZPA - EGRESS DOOR LANDING & STAIRS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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
//7//0
Signature of Buil. ' g 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 the Office of
Planning & Development for more information.
10. Do any signs exist on the property? r YES X NO 1
IF YES, describe size, type and location: --Pt 04 -F o Sidf aoo( Sic)nS re-rw�� SigYI Cs y(
- rcnrk dour A ev� aAnk A.iv e. y �Av I p,y. � stilt co � J
Are there any proposed changes to or additions of signs intended for the property? YES NO X
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO / X_
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING ,
Lot Size
(2,r' GtUrto- , 1. &CiVv) .
Frontage
j 4 &X, r Srkirri
Setbacks Front
Side L: R: L• SoLyvvt R: 3o..Wv .— 1 R:
Rear
Building Height
Building Square Footage
S OLA10.4-
% Open Space: (lot area
minus building Ft paved
parking
# of Parking Spaces
/Q
# of Loading Docks
Fill: N fr,
(volume ti location)
13. Certification: I hereby certify that the information contained herein is true and accurat: to the best of
my knowledge.
Date: 6-1Z-7,010 Applicant's Signature ' •
NOTE: Issuance of a zoning permit does not relieve % applicant's burden to comply with all zoning
requirements and obtain all required permi from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
W:\ Documents\ FORMS \original \Building - Inspector\Zoning - Permit- Application - passive.doc 8/4/2004
i
n ,,,.
MAY 1 7 2010 ,'n,;i
'ile No. � ___ � �
MZUJ �'E T AFPLIC1 ' ION(i02j
Plea type or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: N I S Otnad-tvt
o (o 1 Cc tS ruC . U
Address: ( �WI, S l tau,. ) Ara le MAi)10 ?Telephone: `t - Z5(o - 6321
2. Owner of Property: Tr i d e.v1*- iZtiAt (. w pcw& 4-i ovr.
iso Mct;�� S�Su�k #310
Address: V's 0 , I P ) t » c g l o R 1 M by A-til MA. lei b (c., ) Telephone: 4 V - t 2-
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) ., J r� ✓
4. Job Location: 1 09 P. &.&,i S+1" e_e
Parcel Id� Zorin Ma Parcel# District s
In Eim:Street District = In aCentra usin ss District
(T0`BE FILLED iN BY: THE` BUILDING DEPART vtENT) rr _ 11,, __
5. Existing Use of Structure /Property: C,ohnrvitYCk,� -° Or1 nj �U�i�t�t�r S
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
IASE r Wt(.4.k Ans (U1Cliio..m 3 a i C ti.v`k rro - try 4- U P rlrtAJ-
U∎'tivt k0 S 1)A. end - 1 4-1711 r e aLV P Lve, O 1 Silt ca C
nr C LADY[ ke-,c, . 111e bJC. U o� 4AA.aa -E rot- `°"� o AAA, �. l�a�, is U
\
Gu r v e v44 y 6Y � r.►c � W � Y> o 1J..6 .'14101.0S 0►dt)S 1 is VVM VU ViA l ly v 1st (D it_ - rrann Nlct .w
7. Attached Plans :: Sketch Plan Site Plan Engineered/Surveyed Plans
'F3eC + a-P4 -e lr (0 ph
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DONT KNOW )( YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and /or Document #
9.Does the site contain a brook, body of water or wetlands? NO x DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
W:\ Documents\ FORMS\ original \Building - Inspector\Zoning - Permit- Application - passive.doc 8/4/2004
File # MP- 2010 -0082
APPLICANT /CONTACT PERSON KOHL CONSTRUCTION
ADDRESS/PHONE 31 Campus Plaza Rd (413) 256 -0321
':PERTY' LOCATION 109 . ST ,.
1 tJ 1,1 f t a t
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONIN FORM ILLED OUT f
Fee Paid / ( 4f
Building Permit Filled out
Fee Paid
Tvpeof Construction: ZPA - INSTALL WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRES CTED:
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 Wa otability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
C /2.0l rd
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 the Office of
Planning & Development for more information.
Bk: 09709 Pg: 298
Planning - Decision City of Northampton
Hearing No.: PLN- 2009 -0024 Date: January 27, 2009
January 27, 2009.
1 certify that this decisio has been mailed t the Owner and Applicant
4 a i 4 ,— /,o? ?.
Any issusance or denial of a permit by the Committee may be appealed to the Northampton Planning Board, by an applicant or other
aggrieved party, provided such appeal has been filed within 21 days of the fling of said decision with the City Clerk. The Planning board
shall limit Its consideration of such an appeal to considering errors of the Committee and shall need a two- thirds vote of its members to
overturn the action of the Committee.
, -QECEIWE,---1
....ti JAN 2 7 2009 -J
CITY CLERKS OFFICE
NORTHAMPTON, MA 01060
February 18, 2009
I, Wendy Mazza, City Clerk of Northampton, hereby certi that the above Dec of the
Cetral Jannuary 16, A 9, that Onemdaysehave City
no appeal
Jauary lb, 20 t twenty
has been filed in this matter.
Attest: (11" (
ty C er -C ty o Nort ampton
GeoTMS® 2009 Des Lauriers Municipal Solutions, Inc. , .
i -
Bk: 09709 Pg: 297
-ion City of Northam pton { ' , � i�,{ i I ;I l�, � 1!f
I� u�i I {�� it{ �' 1 1 it {
PLN -2009 0024 , .
Date: January 27, 2009 , •,._ � • -
TYPE: SUBMISSION DATE: Bk: 9709Pg: 297 Page: i of 2
lusiness Arch. District Perm 12/1812008
Recorded: 02/19/2009 11:00 AM
Name: .Owner's Name:
NAME:
'EALTY CORP TRIDENT REALTY CORP C/O HAMPSIRE PR •
1 Construction A Construction
is Plaza Road 31 Campus Plaza Road
STATE: ZIP CODE: TOWN: STATE: ZIP CODE:
MA 01035 Hadley MA 01035
FAX NO.: PHONE NO.: FAX NO.:
EMAIL ADDRESS:
cation: Surveyor's Name:
SITE ZONING: COMPANY NAME:
T . CB (100)/
ACTION TAKEN: ADDRESS:
pton -
)CK: LOT: MAP DATE: SECTION OF BYLAW:
0 001 TOWN: STATE: ZIP CODE:
Page:
PHONE NO.: FAX NO.:
EMAIL ADDRESS:
1POSED WORK
door on side of building facing Gothic Street
PPROVAL:
1) Return to the Committee for review , with specification drawings and materials denoted, if proposal
does not meet building code regulations.
)GATE BECAUSE:
APPEAL DAtff'.
1`��Gp�M NEAFIMVniMIED OEC\S10P10RPF� et:
TIMMS APPEI4 - ktse'
inn F \\yp1 SIGNINGS 1 '• 2/171
A IA �
uteA \MCI.OSEOAZE• 'IAl2009 -
nee „4 _
NOWI/ ,,tYVw
�/ r HEARING DA VOrwo DATE: • ---- ._
ll�lh �I� DEC lsivn�.,,..
p 1/21/2009 1/27/2009
ERrigINv Y. Ifin Of /�� /� VOTINGOEAOLINE: DE CISION DEADLINE:
HEA RING T 3 ,72049 3fl'2oo9
zesENT:
Vote U favor IIIIIIIIIIIIIIIIII
votes to Vote I favor
;rneY votes to
votes to Vote in Fay
in Vote In Favor
;riviskey votes to DECISION:
'liter votes to Approved
VOTE COUNT:
1 Blumenthal q
SECONDED BY:
MADE BY: Rick Klein close as possible.
Walker t stone on either side as ode by the'
S OF MEETING: & gevelapmen c olor to match grey t decision m Clerk on
Office of Planning Flu metal door; true an accurate Board and the City
[fable in the resented certify that this is a with the
voted "to approve asp Architecture District, all plans have been tiled
Committe (Business fy t hite of this and
agent to the Centro that a copy
Aargaret Keller, as a9 Committee and certify
meal Business Architectu inc.
ao CMS® 2009 Des t_aurt
ers Municipal Solutions,
_ 1000,0000000000..
d
File # MP- 2009 -0054
APPLICANT /CONTACT PERSON KOHL CONSTRUCTION
ADDRESS/PHONE 31 Campus Plaza Rd (413) 256 -0321
. PROPERTY:t0CATION 109 MAIN ST
MAP 32A PARCEL 140 001 Z $; /
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO • ILLED OUT Age
ee ' ai d i i- r
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - EXTERIOR SIDE DOOR
New Construction
Non Structural interior renovations
Addition to Existing_
Accessory Structure
Building Plans Included:
Own or License
3 sets of Plans / Plot Plan
THE F LLOW / ING 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 Co sion Permit DPW Storm Water Management
r
Signature of Building Officia Date
Notc: Issuance of a Zoning permit does not relieve a applicant's harden 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 the Office of
Planning & Development for more information.
Pioneer Contractors
Pi Con, Inc.
1'1't'tiitt Nor Box 1
Northampton,
MA. 01061
Voice 413 - 586 -5491
Fax 413 - 527 -5099
E -mail pioneercontraceNahoo.com
Cell 413.626.7267
To: Anthony Patillo, Commissioner From: David Claxton
Northampton Building Department
Fax: 413- 587 -1272 Pages:
Phone: 413- 587 -1240 Date: 5/21/2009
Re: 109 Main Street CC:
❑ Urgent X For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
• Comments:
Attached please find the following for the installation of the basement service door.
- Building Permit Application w/Workman's Comp. Ins. Affidavit
-Photo of Building exterior showing location
-Copy of Central Business District Decision recorded In BK. 09709 PG. 297
-Check # 13370 for $55.00
Please call w /questions.
Thanks.
•
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4
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-.,,,_-: '.: ; 41 =,,,.,,,,,-,,,„„:,
,,, ,..==„=-=,==„=„=„2,,===:=„=,,,,,,,=;-,*,,.,=„ 4.: •.4i ,,,,,..',`''', ,,,,,,,,k, ,;,,i,f6f1.=:!,,f.14,','-"NZ'IT''',=4', -; '-, i
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DEPARTMENT OF BUILDING INSPECTIONS + °Lt-
•
212 Main Street Municipal Building
Northampton, Mass. 01060 r'
WORKER'S COMPENSATION INSURANCE AIt'F'uMVIT
I, Pioneer Contractors
(liccnseepermittec)
with a principal place of business/residence at:
P Box 1145 Nnrt hamptnn MA ni.ntit (phone) 5 86` 5491
(bit /city /state zip)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
Wcc 500595701200q 6/30/14
Associated Employers Insurance —Co -- --
(Insurance: Company) (Policy Number) (Expiration Date.)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expirntion Date)
,
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(anach additional shod if noxasry to inchs& infocwstioa petaiai.ng to all ooairodon)
( ) 1 am a sole proprietor and have no one working for me.
( ) 1 am a home owner performing all the work myself.
•
NOTE: please be aware that while boenerawiere who employ persons to do amirrf•*+ - ooamuctioa or repair work on a dvrclliog of
not tnac c then throe units in which the homoowacr rclidcs or on the grounds appurtenant thereto ate not gmcrally considered to be
employers under the worker's. compensation Act (GL152,ss 1(5)), application by a homeowner fora license or paned may cviden c the
legal coitus of an employer under the Worker's Compomation Act.
1 understand that a. Dopy of this cta.temeat may ter forwarded to tiro Departsomi of Industrial Accidents' Offioo of la;:uanco for the
coverage vcrifiaiioo and that failure to scout covcrago under section 2SA of MOL 152 can lad to the imposition of criminal penalties
consisting of a fine of up to $1,300.00 an isxquiscatineat of up to one year nod civil pens1tia in toe form of a Stop W oric Ord. and a - ” _
fine of 5100.00 a day signing toe.
For dcputtat use caly
/ /2 ( A 7 Pcrmit Number
_ /t / y ' 3 ,T 1 Maps Lot #
lwt��
Siy Lure of LiecaseelPertni IS
cr --
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 0 No 0
SECTION 11 - OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Trident Realty Corp. , as Owner of the subject property
Pioneer Contractors - -David Claxton
hereby authorize to
act on my behalf, in all matters relative to w• k authorized by this building permit application.
Za� V ' 05/20/2009
Signature of Owner Date
Pioneer Contractors
I, , 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.
David Claxton
Print Name 1 /I
J 05/20/2009
Signatur- of O' er /Agen Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : David Claxton 017890
License Number
P.O. Box 1145 Northampton, MA. 01061 0 01/19/2010
Address Expiration Date
lam, / ,(413) 586 -5491
Signa re 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
Version1.7 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):
Registration Number
Address
Expiration Date
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
Pioneer Contractors Not Applicable ❑
Company Name:
David Claxton
Responsible In Charge of Construction
P.O. Box 1145 Northampton, MA. 01061 gs
Address
,1 f f,A111/ 586 -5491
Signature ' Telephone
Version1.7 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 _ i R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO C) DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 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 0 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 0 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Version1.7 Commercial Building Permit May 15, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑
Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other IS
Brief Description Enter a brief description here. Cut granite fascia& install new steel door in existing service door!
Of Proposed Work: opening.
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A I El
A -4 ❑ A -5 ❑ 1B ❑
B Business GI 2A ❑
E Educational ❑ 2B 1 ❑
F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑
S Storage El S -1 ❑ S -2 ❑ 5B
I. ❑
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: Business Proposed Use Group: Business
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
Floor Area per Floor (sf)
1 st
1 st
2nd 2nd
3�d 3rd
4 m
4
Total Area (sf) Total Proposed New Construction (sf)
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 p Private ❑ Zone Outside Flood Zone p Municipal 12 On site disposal system ❑
Versionl.7 Commercial Building Permit May 15, 2000
Department use only
City of Northampton Status Of Permit:
Building Department Curb Cut/Drivevvay Permit
�cUg 212\Main Street Sewer/Septic Availability
Rpom 100 WaterJWell A railabili
Nortbaff pton, MA 01060 Two Sets of Structural Plans �':
phone 413- 587 -1240 Fax 413 - 587 -1272 Plot/ Site Plans
Other Specify
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
109 Main Street Map Lot Unit
Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Trident Realty Corp 0 150 Main Street Northampton, MA. 01060 la
Name (Print) Current Mailing Address:
(L ° - t (413) 584 -9970
Signature.. �✓�- Telephone
2.2 Authorized Agent:
Pioneer Contractors 0 P.O. Box 1145 Northampton, MA 01061 mi
Name (Print) Current Mailing Address:
(413) 586 -5491
Signature „ � Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building $2,000.00', (a) Building Permit Fee
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) Check Number / ,gJ/ 9 l,t/A5
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2009 -0986
APPLICANT /CONTACT PERSON PIONEER CONTRACTORS
ADDRESS /PHONE PO Box 1145 NORTHAMPTON (413) 586 -5491
PROPERTY LOCATION 109 MAIN ST
MAP 32A PARCEL 140 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 4 �
Fee Paid /396 5 s
Typeof Construction: CONSTRUCT EXTERIOR SIDE DOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 017890
3 sets of Plans / Plot Plan
THE FOL WING 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 Buildin 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.
BP- 2009 -0986
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: Non structural interior renovations BUILDING PERMIT
Permit # BP- 2009 -0986
Project # JS- 2009 - 000787
Est. Cost: $2000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PIONEER CONTRACTORS 017890
Lot Size(sq. ft.): 11325.60 Owner: TRIDENT REALTY CORP C/O HAMPSIRE PROP MANAGEMENT
Zoning: CB(100)/ Applicant: PIONEER CONTRACTORS
AT: 109 MAIN ST
Applicant Address: Phone: Insurance:
PO Box 1145 (413) 586 -5491 Workers
Compensation
NORTHAMPTONMAO1061 ISSUED ON:6/1/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT EXTERIOR SIDE DOOR
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 6/1/2009 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo