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32C-133 (2)
u, 'i To be Initial submitted with Construction the buildiControl ng permit appliDoccatment ion by a 1 Il in- § Registered Design Professional for work per the 8th edition of the ';,., „-C'? Massachusetts State Building Code, 780 CMR, Section 107 Project Title: . ' _ i Ali l.'r[ • .I- (sate: r/`f 13 Property Address: / / .if: ,e /2Q, Project: Check one or both as applicable: q New construction 6Existing Construction Project description: 7J/' << ? A.' I .5 1 j 'ifs 4,e91-c-/ MA Registration Number: ,6. Expiration date:0 am a register(' design professional, and I have prepared or directly supervised the preparation of all design p ans computations and specifications concerning: 0 Architectural [ ] Structural [ ] Mechanical [ ] Fire Protection [ ] Electrical [ ] Other for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a`Fins •, ite t Control Document'. Enter in the space to the right a"wet"or _ ;' \ y ' t ,.''',-',,,t electronic signature and seal: / *NM 2 E. Phone number 4/3—.zp 1131' Emai e ,fs Building Official Use Only 'b, Building Official Name: Permit No.: Date: Version 06_11_2013 General Lighting and Ventilation The furnace is gas fired forced warm air and a/c with ventilation to be provided. The interior has adequate coverage by overhead lighting (not calculated), augmented by natural light. Light levels shall be verified and recommendations of additional light considered. Accessibility Two compliant entries are shown. The doors will be equipped with compliant closers and panic hardware at the rear (west). An accessible path exists throughout the public area leading to the new accessible lavatories and the two exits. Two new Accessible lavatories will have compliant grab bars, sinks, turning space and acoutrements. New floor drains and battery backup emergency egress lighting (shower/locker rooms) and silent strobe smoke alarm alerts (lavatories, Reiki room) will be installed. A baby changing station shall be added, most likely to the women's lay. Health, Safety and Welfare No manual fire alarm has been provided (required over 300 occupancy). At 121 people occupancy, the number of toilets is insufficient for women (at 121 people/65 women/toilet = 2 toilets; propose 1) but is requested to be accepted as a Compliance Alternative. There will be a drinking fountain. Electrical The only recommended change (other than compliant outlets and lighting for new spaces, egress lighting and signs as noted) is the addition of a Carbon Monoxide detector in the largest room. Plumbing The plumbing and gas connection shall be verified by the Plumbing Inspector. Simple Fire Narrative The building has smoke detectors throughout. In the event of a smoke or fire event, the detectors will sound alarm throughout the building and battery-backup emergency egress lighting will assist occupants in accessing the two clearly marked Exits (front and rear of the building). Exits access the front and rear of the building and occupants at the rear are within view of Service Center Road and may easily return to the front of the building. Inside the lavatories, strobe lights shall alert occupants rather than audio. An occupant of the building noticing a fire or smoke event will also have access to 2 fire extinguishers (near rear and main entry). . T c) nor 100 sq. ft. and at the rear may be max. 25 sq. ft. and 10 ft. High (350-7.5.a, b, c — abuts parking). Offstreet parking will continue as on site (350-8.1.B (1)) due to no change in floor area (existing parking for 43 cars). IBC 2009 Addition (3401.4.1) No additional floor area will be constructed Alteration (3404) The alterations proposed include addition of non-bearing interior walls to create lavatories, shower/locker rooms and separate function areas. Existing exterior and support walls seem to be UL Design U905; 2 hour fire protected CMU walls. Two former openings to the adjacent rental space shall be sealed and 2 hour fire protected (either CMU infill Design U905 or wood studs, UL Design U301; 2x4 studs and 2 layers 5/8" type X gypsum wallboard) to increase building safety. The floors are slab on grade. No changes are proposed which will alter the seismic or wind performance of the building, except that new walls will slightly increase the lateral bracing. We are aware of no water issues or flood hazard at the site. Egress Based on gross square footage 6074sf(50sf/person Table 1004.1.1) indicates accommodating 121 people. Thus passageways shall be min. 25" wide (36" minimum overrides - 1005.1). All existing and proposed doors and passages are min. 36" wide. An accessible path connects all parts and the lavatories and shower/locker rooms shall be accessible. Battery-backup emergency lighting is present at the front and rear Exit signs at the egresses as well as centered along the north wall in the large space. We will add battery-backup emergency lighting to each new shower/locker room and silent strobe alert devices in the lavatories and Reiki room (small spaces). There are lights present outside at each egress. There is no intention of adding a fire suppression system. Thus two exits are proposed which are ADA compliant and remote from one another with proper paths, signage and illumination. Panic hardware shall be installed on the rear (west) egress; the main door shall have proper locking but not panic hardware (1008.1.10 and 1008.1.9.3(2)). Repairs No damaged or dangerous conditions have been noted by the Architect. Emergency Lighting and Signage Proper illuminated Exit signs are installed as well as Battery Backup Emergency Egress Lighting accessing two remote exit points. Additional battery backup illumination, strobe smoke annunciators and a new Exit sign (at Aerobics Studio) will protect the new spaces. These features shall be reviewed for acceptance by the Fire Marshall. r ARCHITECT J E F F R E Y S C O T T P E N N 77 Worthington Road,Huntington,MA 01050 tel.413-667-5230 fax.413-667-3082 j spsed(a1verizon.net 15 August 2013 Investigation and Evaluation Client: Construct Associates New location for: Universal Health and Fitness 59 Service Center Road Northampton, MA 01060 To: Louis Hasbrouk, Building Commissioner Town Hall Pulchaski Building,Northampton, MA 01060 General Construct, Associates has asked me to review the building at 59 Service Center Road which will be occupied by Universal Health and Fitness as their new workout facility. This building was formerly a rental center and thus continues business use but by IBC 2009 will now by use group A-3 (formerly B). No modifications to structure are proposed, but new walls will be constructed to furnish lavatories, shower facilities, mechanical and supply separation and function separation. The building is assumed construction Type IB (CMU walls, acoustic tile ceiling hung on open-web steel trusses). The site is located on map 32c, lot 133. The building is single story without basement. I have reviewed the building, 2009 IBC and the Northampton Zoning Ordinance. The purpose of this investigation is to identify the status and proposed remedies for continued use to the existing building. Site The existing building is 6074 square feet and has approx. 15 foot front setback, zero clearance north side, 12 foot south side setback and 60 foot rear setback; no change proposed and request continued use. The site is relatively flat and fully paved. The building is on town water and sewer. Existing parking for 13 cars at front and 40 cars at the north side are provided and no change is proposed. Northampton Zoning (chapter 350) the site is located in GB zoning, map 32c, parcel 133. The building was occupied as a rental business and business activity will continue with public access fitness facilities. We request that the Building Commissioner issue an occupancy permit for the intended use. New signs shall not exceed 10% of the area of the building front (350-7.4.B.3.a, b, Stephen Camp Construction 46 East St. Easthampton, Ma 01027 (41 3)527-7124 Submitted To : Liz Cole Phone-413 531-7858 Address : 59 Service Center Rd. Date- 8-28-2013 Northampton,Ma 01060 Universal health&fitness We hereby submit this estimate for- Remodeling To start the reception desk will be re-located near the front door. I will remove existing boards mounted to the block wall and holes will be plugged. The shelving will be removed and relocated on the back wall or were desired. For the aerobics room I will frame walls to the ceiling. (top 2 feet) The bathroom work will be done as the prints show. All plumbing and electrical work will be done by my subcontractor's. I will cut out all the concrete floor needed and remove. Once the plumbing is inspected I will pour new concrete for the floor. I will frame the walls to the ceiling,but frame ceilings for sheetrock at 8 feet. (The sheetrock and painting will be done by others) (Also all flooring will be done by others) All plumbing and electric work will be finished and I will install All finish trim doors etc. Price=$ 31,800.00 1/3 to start and 1/3 after rough inspection 1/3 at final inspection. Contractor Supervisors License number 082531 Home Improvement contractor Registration number 135204 I propose to supply materials and labor-in accordance with above specifications. This proposal may be withdrawn By us if not accepted within 30 days Authorized Signature _4 Acceptance of proposal Signature 6 The Commonwealth of Massachusetts 111 Department of Industrial Accidents C=y�, =�� , 1�_ Office of Investigations y 600 Washington Street =. ;I: — Boston,MA 02111 ' :.r„vav www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / PIease Print Legibly Name(Business/Organization/Individual): `-)''z' 2 h.e.iv CA-1,4,9 P Address: FA S- j 1-1K 1— • � City/State,/Zip:jA j ,/// � C5� C 2 7 Phone.#: S2 " 2/ 27 Are you an employer?Check the appropriate box: Type of project(required):. 1.,0 I am a employer with 2- 4. ❑ 1 am a general contractor and I employees full and/or • have hired the subcontractors b. ❑New construction . (full part-time). 2.❑"I am a sole proprietor or partner- listed on t c'attached shed: 7.gRemodeling ship and have no employees These subcontractors have 8. 0 Demolition . working for me in any capacity. employees and have workers' [No workers'comp.insurance comp•insurance t 9. (]Buis�dV addition required.] S. 0 We are a corporation.aad its 10.0 Electrical repairs or additions 3.0 I am a homeowacr doing all work officers have exercised their . 11.0 Plumbing repairs or additions myself[No workers'comp. right Of exemption per MGL I2.[]Roof repairs i n s u r a n c e r e q u i r e d,]t ,c.152,f 1(4),and we have no 13.0 Other ,2 employees.[No'workers' comp,insurance.required.] _ de..- a'�`4- �415 -., Any applicant that checks box•t must also 51l oat the section below showing their workers'compensation policy information. - t Homeowners who suit lids affidavit inificatipg they are doing all wait and than hire outside contractors must submit a new affidavit indicating such. *Contractors dat check this box must attached as additional sheet showing the neat of the subeooaacto s and state whether or not those entities have employees. If the subcontractors have employees.they must provide their workers'conv.poky number. . • I am an employer that is providing workers'compensation Insurance for ray employees. Below is the policy and job site information. Insurance Company Name: 14C AM eke. (c A t.-.1 S, t G., , - Policy#or Self ins.I.ic.#: ‘S 2 0/? --Th 1 1 2 .Expiration Data: 7/07. Job Sits; ddness: re/ �-'V' C( Keil*i'-'7/cl i -(tate/ZIp: d4c%9 j,t';Y,o4 it�it e'ere 4 0 Attach a copy of the workers'compensation policy declaration page(sho ing the policy number and expiration date). Failu e.to seal=coverage as required under Section 25A of MOL e.152 tanlead to the imposition of usminalpenalties of a fine:tp to$1,500.00 S ndlarone goers aswelt as civil penalties lathe form of a SLOP WORK ORDER and a fine . • of up to$250.00 a day against tlrr violator.-Betidvised that a copy�ofthis s ynaybe forwarded to the Office of __Tnvestittations ofthe DIA far insaranoe covetaa�e vtxifisa on. _ Ido hereby ea t&fy ; , the , andp�efperjtay that the lr�oaoaailoa provided abo is true and correct. • s _ , z1/j nom I • 122_ 7/Z1- . Official use onjy. Do not write In this area 0 be c npleled by.cl(y or towns q/j?clal City.or Town: Paaitakense if Issuing Authority(circle one): ' :1.Board of Health 2.Building Department 3.Cltytrown Clerk 4.Electric l Inspector S.Plumbing Inspector 6.Other • Contact Persons• • t • Phone#: �- 4, T Version!.?Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Cf 1 ( 7/t Ut, C(' 1<- ,as Owner of the subject property hereby authorize -e'�✓ CAIV to act on my behalf, in all ma relative to work authorized by this building permit application. Signature of Owner T) D e I, �T�J�' Lt/ �� as Owner/Authorized Anent 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. -57/Vk/4 (i f' Print Name / i ' S( Signature of Ow"r/Agent 9 Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction�Supervisor: /� Not Applicable ❑/ Name of License Holder: ✓�tJ?'.•G� eit e2 5 3 v License Number i'S71— 5/vee7" C4-51)7,7444/ ham, //-.2-3 -/J Address Expiration Date 52 7- 7/z/ 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 ej) No O SECTION 9 PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner �?O. 13aC 6 t)39 Di° e/ s'o,t/ HHsr G f/n c ) 09 d/042 Name(Print) No.and Street City/Towb Zip Property Owner Contact Information: ,fees/e,C.'r -5$? 7'6o7 t113.z�� CAS Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes 3 9 //qejp f f3577- 11)4P'—i ` Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) (If building is less than 35,000 cu,ft.of enclosed space and/or not under Construction Control then check here C and skip Section 10.1) 10.1 Registered Professional Responsible for Construction Control i# tl - - �! Na gistrant) Name Telephone No. e-mail address Re anon N tuber Street Address City/Town State Zip Discipline F ra on Date 102 General Contractor Company Name Name of Person Responsible for Construction License No. and Type if Applicable Street Address City/Town State Zip Telephone No.(business) Telephone No.(cell) e-mail address SECITON'11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes❑ No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date Version!.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`e Cr 6/� c � l/ 9/4//J fif L� ry /6 Not Applicable ❑ Company Name:e47` ,, ,,, Responsible In Charge of Construction 9' g'74-s1 Z-J, J , a go 2-2 Address rz 7- 7/2/ Sign ure 1 Telephone Version!.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 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 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT 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 DONT KNOW O YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained fO Obtained © , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: �� L✓,4 l j ltit oJ��-- � D. Are there any proposed changes to or additions of signs intended for the property? YES ee NO IF YES, describe size, type and location: j-05-f— ®,le14±- 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. Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations If Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ 74-KC Brief Description Enter a brief description here. Ai/diet) 4 A€415 L' kw 44 e 4 S ,-c,z.z...S Of Proposed Work: (,, C(/ f 1 L'®.a4Vt-#-L r/vsr 3 A Y l-,,4-iet 5 Lef,I�C J2 ,X o/ �. ra v,44S / ( , 0/,,46,n, 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 ❑ 1B ❑ B Business IR 2A ❑ E Educational ❑ 2B ❑ 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 0 S Storage ❑ S-1 ❑ 5-2 ❑ 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 T/ Existing Use Group: -3 Proposed Use Group: ,4 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) 1st 1st 2nd 2nd 3 3rd `d 4 4th 4th Total Area(sf) 6u 7 Gj � fr Total Proposed New Construction(sf) Total Height(ft) /V / ` Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public,i Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system U U 1 The Commonwealth of Massachusetts I`1{ Department of Public Safety Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number Date Applied: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) 04W No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code uses If New Construction check here❑or check all that apply in the two rows below Existing Building NI Repair❑ Alteration 01 Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use 03 Change of Occupancy ill Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes El No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No-011 Brief Description of Proposed Work: ..o/a . - _ aria f _ �r 7 All( SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): lei Proposed Use Group(s): 4 - `5 SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) / 600 G leb Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ® A-4❑ A-5❑ B: Business ❑ E: Educational ❑ F: Factory F-1 ❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1❑ I-2❑ I-3❑ 1-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB II IV ❑ VA ❑ VB ❑ SECTION 7:SITE'INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: El Public 43 Check if outside Flood Zone a Indicate municipalal A trench will not be Licensed Disposal Site Private❑ or indentify Zone: or on site system❑ required or trench or specify: permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Pi Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Use Group(s): /4-5 Type of Construction:Z1112 _ Occupant Load per Floor: /7_2.. Does the building contain an Sprinkler System?: Ai Special Stipulations: Version1.7 Commercial Building Permit May 15,2000 DU Department use only 'tty of Northampton Status of Permit: wilding Department Curb Cut/Driveway Permit - i ?9 2013 X212 Main Street Sewer/Septic Availability 'v Room 100 Water/Well Availability Electric Plumb i ort ampton, MA 01060 Two Sets of Structural Plans Northamptn on4 Gas i Y ' 04P020 e, y;7-1240 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 c( Se e e Cegt D1/4✓ led- Map Lot Unit 4,4;2nd ✓ ti ®/ 049 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: P za: -t- Ca t e. 34-k Mo ■ V-0.w 0011 Name(Print) Current Mailing Address: E.,-',Q1- a2 sat • -1%sSignature Telephone 2,2 Authorized Agent: 54 A 0 CAA ' �.fr- . ; ZJ,Ifiet4i,/114 Name(Print) Current Mailing Address: i_% .S"z7-7i2, �(,ir Of 3-F: o e>yy Signature �`I�i._ Telephone SECTION 3-ESTIMATED CONSTRUC ION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building f /A/00. ib (a)Building Permit Fee 2. Electrical Sr/g- C%(7 (b)Estimated Total Cost of Construction from(6) 3. Plumbing I',7 ,CJ. Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection r� n b- 6. Total=(1 +2+3+4+5) �3 i �u^G2• e,� Check Number Q�1�t iq This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0251 APPLICANT/CONTACT PERSON STEPHEN CAMP ADDRESS/PHONE 46 EAST ST EASTHAMPTON (413)527-7124() PROPERTY LOCATION 59 SERVICE CTR RD MAP 32C PARCEL 133 001 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out /#9/ O /961 Fee Paid � � I Typeof Construction: CONSTRUCT HANDICAP BATHROOMS FOR HEALTH FITNESS FACILITY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 082531 3 sets of Plans/Plot Plan THE FOLL G ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO TION PRESENTED: pproved 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 942—/ ignature of Buil s ing 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. 59 SERVICE CTR RD BP-2014-0251 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C- 133 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2014-0251 Project# JS-2014-000414 Est.Cost: $31800.00 Fee: $190.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN CAMP 082531 Lot Size(sq. ft.): 21170.16 Owner: COLE ELIZABETH J Zoning: GB(100)/ Applicant: STEPHEN CAMP AT: 59 SERVICE CTR RD Applicant Address: Phone: Insurance: 46 EAST ST (413) 527-7124 () WC EASTHAM PTO N MA01027 ISSUED ON:9/10/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT HANDICAP BATHROOMS FOR HEALTH FITNESS FACILITY 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 9/10/2013 0:00:00 $190.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner