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DEPARTMENT OP BUILDZXG INSPECTIONS r.
INSPECTOR 212 Main Street & Municipal Building Y /F
Northamptt>ti,MA 01060 y'
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(for Professional Engineers/Architects responsible for only portion of a controlled project)
Project Title: h t trs-r H 2 TF Date: 3/2 o/o i
Project Location:305 K,u!;-, S-r - Map: Parcel: Zonc:
Scope of Project: \
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In accordance widr the sixth edition Massachusetts State Building Code,780 CMR SECTION 116.0:
I, A LEo hu-,� _ t��(2.D 1 Mass.Registration Number
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: ;
[I Fire protection. XArchiteAural []Structural []Mechanical [J Electrical
[)Other(specify)
for the above named project and that to the best of my knowledge,such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,all acceptable
engineering practices and all applicable laws for the proposed project.
Furthermore,I understand and AGREE that I shall perform the necessary professional services to
determine that the above mentioned portions of the work proceed in accordance with the documents
approved for the building permit.
Upon completion of the work,I shalt submit a final report as to the satisfactory completion of the above-
mentioned portion of the work.
Signature and al of registered pro inal: `�
r�-
No.4943 0
W gt: BOSTON
MASS
IN OF
Fax 413-587-1272 -phone 413-587-1240
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14at' 28 01 09: 10a RDRMS&RUXTON (413) 734-8138 P. 4
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P. 1
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DEPAR7btEN7 ON BUILD= INSPECTIONS
212 ltilaui Street Municipal Building
/ Northampton, Mass. 01060
i
WOR>aR'-S OOAPENSATfON JWSURANCE AbTII? I BAR 2 8 2001
(liccnscrlpem,;nt� — - - - DEPT OF-BUILDING INSPECTIONS
with a principal place ofbmincssfresideuce at: NORTHAMPTON,MA 01060
HA Ol "t
- ---�-`'S��C,i� t7 honer) �
(6�zlllrity/statelrip)
do hereby certify, under the pains and penalties of pefj n, that:
( } I am an employer providing the fs>ifowirig vroricer S eom}),nsaaon coverage for Inv
eujpioyees working on this job:
(t=tr�c=camay) (Polio*Number) (Expiranon Date)
(- ) T aat_a sale-prop.,ictor,geaeraf 00mT2ctor or homeow>?er(circle one) and have hired
the contractors-listed below who have the folTowiljgwo[kees comp=sa6on policies:
(Name o(contracwr) aumance company/Foucy NUML-cl) (Expiration Date)
(Name ofCoutractor) Ruu=cr Cnnpauy/Policy\.Twmlyer) (Expiration Daic)
(Name of Con[ractor) amit noc-ampazy/P6ky iNu= r) (Expia6u Dale)
(Name of Contractor) _aaSU=Ce£empany/Policy?lvrnller) (Expir�aon Date)
(attach add,tiooal God ifnoomwy to ro� infotmatiou p«trtiaiOg to Jt
( } I am a sole proprietor and haave�nQ one worming for me.
( ) I am a home owner perfonning aU 11m.W0&jW
NOTE,phase b,as arc tit whijc borne,w wbo�pnytoY S�wm m d�rq�_ ��ln�cYlaa artc�ait wvck�adaclliag of
Oot tttote Iban IJntw=ruin tvtzieh(Le bamoowner tcsidts a an tb�VOUa appttttcoant theccto uc rat
�+pt°YmuAet+LeyWt{�gY t+oeAct GLtS2.ss1 S 6t-orp& dmpyc i L.be
C 1k atq+ieatioo•'by s hortwpvrni�fec-q Geeate a permit oaey cvilcooc the
lcgar stacw of aa.t»to}vF under the Watirda Ceespop.40n AaL
Fwd d�Cawpy°f aetgnmt osay ba farmmudod b*6o
OO D offio arfp Cart*aaUM10
S4Q='WVtn V uft S0009a 2SAaf*fGL 1n m i odto tgpinq arol aiaoioai tKwla3
Of t fine of up W S 000.00 moor orup W ooe yw sad„ Vd praaltio in the farm of stop Wak Or&-and a
EM 43CUW.00 a dgy tplett MC.
Far 6Vnftomd use onry
} '
kusu Ntimbe
—Lot/ Y —
" Version 1.7 Commercial Building Permit May 15,2000
'^ECG ION 10,, STRUCTURAL -EER,.REVl EW(780 CMR,.110 11)
independent Structural Engineering Structural Peer Review Required Yes......❑ No......
SECTION11 OWNER 14UTH )RIZATION ,T03BE COMPLETED. HEN
8WN£RS AGENT OR COaNTRACTOR APPLIES EO'R BUILDING PERMIT
3
��,� ��,,�� -�� ►yu1.�� �(`t)ZT -(a�.s Z3AS`,1� as Owner of the subject property
hereby authorize AbA►,-S -#- (-P)-� to act on
my behalf, in all matters relative to work authorized by this building permit application.
Si re 70f wner Date
.- "-3 T - - i<T Cam. as Owner/Authorized Agent
hereby declare that the statements and i formation on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
P ' qame
0
,ign re of Owner/Agent Date
SECTION 12--'CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : Ax aed ) ^iovcA-tits U71 9S- r
License Number
Address Expiration Date
�l38
nature Telephone
SECTION,IS WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c.152,§25C(6))
r
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavi
will result in the denial of the issuanc of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9 PROFESSIONAL DESIGN,AND CONSTRUCTION SERVICES FOR,;BUILDINGS;AND STRUCTURES SUBJECT TO
CQ(�IST�UGTIOIV CQNTFtQI PURSUANT 1`0 780.;CMR]16,{CONTAINING MODE THAN 35;000 C F.Ol ENCLOS,ED.SPACE)
1 Registered Architect:
Not Applicable ❑
Name(Registrant): 4943
Registration Number
Vim,at-r ST LJesT
Address
Expiration Date
See Ar-F-&Rv1T 734 'Z(30
Signature Telephone
92 Registered Professional Engineer(s):
ti /A
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
gnature 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
AbA)AJ iw x? E;( t i�.a"c G. Not Applicable ❑
C moC pany Name:
Xk"4r,rot II o-,CtgtfTf h.
Responsible In Charge of Construction
h o 30`
Jdress
Signd re Telephone
,Mar ;�8 01 09: 10a ADAMS&RUXTON (413) 734-8138
Mart, 2Q 01 02:33Fz P- 3
P-2
Version 1.7 Commercial Building Permit May 15,2000 Q
Water Supply(M.G.I,c.40,g 54) 7.1 Flood Zone Information: 7.3 Scwa 0 sal V 4,,,? 8 2 01
iblic O Private R Zone:_ _ Outside Flood Zone ❑ Municipal 00n iti disposal system ❑
8. NORTHAMPTON ZONING
Existing Prnpased Required by ZoningDEPT BUILDING INSPECTIONS
B is column be tilted in MOR HAMPTON,MA 01060
/Y DepaluncM
Lot Size O_+3A1. (_I 14 03oae p_�3
Frontage `05 r--r 9S F /p70
Setbacks Front 15 t {- r /o
Side L: f S' lt:_tv!A L:15 _W --4' /b
Rear
O
Building Height
Bldg.Square Footage
zg �v,
Open Space Footage % - F
(Loi area mim bldg&paved
arkinl '94�sC i I�';
#of Parking S aces
FoS:
volume&Location
A_ Has a Special.Permit/VarianQe/Finding ever been issuea for/on the site?
h1Q 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 9
B_ Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
W YESi has a permit been or need to De obtained from the Gonservat-*A Commission?
Needs to be obtained___________Obtained____ , Date lssued:—
C. Do any signs exist on the property? YES NO
IF YES, describe size,-type and iocation:- 6- -A- '�,srL ---
D. Are there any proposed changes to or additions of signs intended for 2he,propeKty?YI S
No
IF YES, describe size, type and ioration:_
"f Versionl.7 Commercial Building Permit May 15,2000
EGTIO'N 4 CONSTRUCTION". ERVICEV.FOR�PRO ECTS SS?HAN 35"000
�t�
;rl z .
-" ti,ar"i, l x,.«.:11` 'k=k&-s
'.z
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
❑ ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building[ ] Repairs [ ]
DES(' Piz ..1: Rccps i' Asa t�T� 1 f s 1•�S
SfOT10N° ' US EwGROUPAND GONST]2UCTION �,
�fYPEl'
bw
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly Io A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B I ❑
B Business ' 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 313 ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
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/bR CHANGE 11?I USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6'13UILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
Floor Area per Floor(sf)
St
1
t st 1
2nd
—2- 5
3rd
2nd
3rd 4th .,
4th 9 W
To to (sf)I Area
t Total Proposed New Construction(sf)
5 k G �w
_ ----------------------
Total Height(ft) 1'Z
Total Height ft ...
Version 1.7 Commercial Building Permit May 15,2000
City of Northampton
Building Department
212 Main Street
Room 100
r pton, MA 01060
D 240 Fax 413-587.1272
Alf TIVAROPON!MVCT. WAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
DEPT OF BUILDING INSPECTIONS
NORTHAMPTON,MA 01060
SECTION 1'wSITE INFORMATION
1.1 Property Address: A 9 Thrb4sectio #o be coinple#reii by offftc+e
1�1 O:LT H<, biJ 0 � Ore yq ` pct
CS�D�strict -
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT,
2.1 Owner of Record:
F t IZS T r"t P,z 13 A>v<< X 4A Q S i SYki k4kJ f,-,�,
Name(Print) Current Mailing Address:
—LAdiama C" �(4130 7$Y3 - 7
Si Tele—phone
2.2 Authorized Agent:
AbA,v-Aa -4- R xm�� Ct K-s-s'1 - Lo' P.O. L,4es7 SPF.� c;��F� b.Atr,. bit�`�7:
Name(Print) Current Mailing Address:
/ r4 i-i 73 4 `Z.i 3
nature Telephone
(� .S"EC7lON 3=ESTIIiAA TED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be 'Official'°Use Only
completed by ermit applicant
1. Building �� Q Q O (a) Building Permit Fee
2. Electrical 3Q�b
(b) Estimated Total Costof
Construction from 6
3. Plumbing Building,Permit Fee
4. Mechanical (HVAC) _
5. Fire Protection
6. Total =(1 + 2 + 3 +4+ 5) 1 Q 0 O Check Number
"This.Section>For Official Use:.Oni
Bulling Permit N M.6, - �""" � Date Issued:
Sjgnatu re:
�
Buildirlg,Cornm"issioner/inspector of Buildings Date
Mar 28 01 09: 09a RDRMS&RUXTON (413) 734-8138 p,2
U-1111 r
AGrymC &K UXt(M Cuailty Construction and Service Since 1W9
CONSTRUCTION COMPANY
600 UNION STREET, P. 0. BOX 390 • WEST SPRINGFIELD, MASSACHUSETTS 01089 o, 7R;City of Narthampton wilding Department R 2 8 2001
212 Main St.Room 100
Northampton, MA 01060-3189 DEPT OF BUILDING INSPECTIONS
NORTHPADTON,MA 01060
Attn.: Linda LaPointe
Re: 304 King St.
Dear Ms_ LaPointe,
In an effort to clarify the proposed work at 304 King St, I amAvriting this letter.
FirstMass. Bank mast relocate their Remote Transaction Facility(RTl~) from its existing
location at the former Price Chopper on King St.They are negotiating a lease with F.L.
Roberts for spice at 304 King St.
So.pending.approval from the Building Dept, and the lease agreement, FirstMass. Bank
will relocate the RTF to 3.04-K* St. This building is a prefabricated structure and will
be rived as-one piece to a new foundation. The site plan we previously submitted shows
the site layout and setbacks.
The existing structure already has signage as part of the existing4milding and the Bank
wauld,like to keeRthis signage as is_ They are also negotiating-with F.L. Roberts to
include a logo sign within the existing Sunoco sign at 304 King St.
If you have any questions, please call ale at(413) 734-213 :`1wmk you in advance for
your assistance in this matter.
Very truly yours,
Adams&z.RuxtorLect nstruction Company
Andrew Touchette
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