23B-046 (31) Win-
� � 2� � � cif �J��%� .i �i .'I C�lTI� ��l I�J�1G '1fiC' ( -_•�1 C_iil l .,_JJ"i onvcm3c Qd II-iA
(1SLru1=C�� �rOL';_G,'1 (�3r,[j 7 :,r;�r�uor,
�_u7i C SOIL_ PFDPMM P(°UUaj CW d TOF Or hrjELcO`. "of,.' �CliC:� Ont) 0 have fll n
CODMWars b9tj_' GeIO"I�Wo SM LA iGUM'IM `lOiz:NS GOm°Ilumn pchcies
7C'-0 w".w ofl Doo
JLICV
NOT E 17W, Lni
-: �:: •..�it r` _ c;.•> �-.. --_
__ - l_r�- u� u� -a �_.:.= b-^mac'•... __. Cc C,
Ve,s1onl.7 Continercial Building Permit 1�, 2002
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
ccndent Structural Engineering Structural Peer Review Required s_. . ❑
', SECTION.11 - OWNER ALTHOPIZATION -TO BE COMPLETED WHEN
i OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1
DO C DiC 1 Solp I�OS � Tr�_L t
J n
- i '
�' c s u b;e C r oper
;ertby authorize �Q
m,� be n all matters rely ork authorized by this building permit application.
Signature of Owner Date
as O: ne �,thc,,e�
hereby dec are that the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
I
Signed under the pains and penalties of perjury.
----
?ri•nt Name
Signature of Ow en Date
SECTION 12 -CONSTRUCTIONSERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of _ 1License Holder : 71 066 ,22 / ---
License Number
Address.
ExFiration Date
�03 4//3- 15 722- oo _
S!grat_re Telephone
SECTION 13 -WORKERS COMPENSATION INSURANCE AFFIDAVIT (M-,G , c. 152,§ 25C(6)) '
Compensation Insurance affidavit must be completed and submitted wit n:s application. Failure to p-c cet ;.S E!"'i
vriil result in the denial of the issuance of the building permit.
i
Signed Affidavit Attached Yes....... W No...... ❑
' �`el'srvr;l., Ci, Gler:I 113li!IUII; Per 11; �.'ii�' >, ?L�?0
5 ECTI,b N §--PROFESSIONAL DESIGN AND CONSTRUCTION`.SERVICES FOR BUILDINGS AND STRUCTURES SUFIJECT TO
CONSTRUCT10N'CONTROL PUP SUANT TO 780 CNIP 116 (CONTAINING MORE 51000 C.F OF ENCLOSED SPACE)
9.1 Registered Architect:
I tJ i ✓ ,r, --- --- — - -
txoiration D�'.t I
Signature Telephone
92 Registered Professional Engineer(s):
flame---- ------ -- - Area of Pespons.'oiiity ---- - i
i
F.ddress --�� - - F.c a o Number
i
Signature Telephone Expiration Date — -
I � I
me Area of Responsibility
I
Address Registration Number
S!gnature Telephone Expiration Date
' ---- ---- -�-- —. --I
Name Area of Responsibility
l I
Address Registration Number
i
�I
Signature Telephone Exp ration Date —
Nan-e Area of Responsibiiity
I
Hd
,�dress------------------- --- -------- -- --- I R e gi s t r a t i o n Number i
i
Signature - _- -- -- Tlephone
9.3 General Contractor
Nct P.pplirab!e ❑
Company Name:
Responsible In Charge of Construction
�� ow�/ /0 -
A( JresS l �i
_ 7o1 none
Version I.7 Commercial Building Ycrmit May 1S, 7000
SE610N 4=CONSTRUCTION SERVICESTOR_:R0JECTS LESS THAN 35,000
CUBIC.FEET OF N,CLOSED SPADE
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roo ing Cl
❑ ❑
Exterior Alterations Demolition New Signs [ ] Change of Use [ ] Other [
❑ Accessory Building [ ] Repairs [ ]
BRIEF DESCRIP'T'ION: Reloov` II✓T—P1CSR R&1111 1e lU,e.4L (r, NwS %&;�'� /li/,G����1111,416 0 AGe •;!�>
SECT-ION 5 --USE ROUP:AND_CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly ID A-1 ❑ A-2 ❑ A-3 ❑ 1A
A-4 ❑ A-S ❑ 18 ❑ _
B Business ❑ _ __ zA ❑
E Educational ❑ ZB I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A. ❑
I Institutional ❑ I-1 ❑ I2 I-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ SA ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE:TtlISECIION;IF513NG�UILDINGUNDERGOING2ENOVA33ONS DDITIONSAND/ORCHANGEIN USE
Existing Use Group: I-2 Proposed Use Group: '2
Existing Hazard Index 780 CMR 34): y _ Proposed Hazard Index 780 CMR 34): y
SECTION 6'BUILD.ING HEIGHTANDAREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
-
w.. l axe r
r x ^'s
Floor Area per Floor(sf) �G�,�� 1st k t
7_ S
I
2nd h hk Sr T
yr•i>x
— g
3 rd
4th -
L �
Total Proposed New Construction (so
Ton! Area ,sf ---- -- r:
Total Height (ft) -- — 1v/4 _
z
Total Height ft----------------
Versionl.7 Commercial Building Permit itilay 15, 2000
I
VV:'ter Supply(M.G.L. c. 40, § 54) 7.I Flood Zone Information: { 7.3 Sewage Disposal System;
Public ❑ Pr+vate ❑ Zoned Outside Flood Zone Municipal Xl On site disposal syKem
S. NORTIL,01PTON ZONING
Existng Proposed Required by Zoning
This column to be filled in by
Buildir,�Department
Lot Size 96 9, y�7 S 96 9 VD 7 8
—�
Frontage 59 2 6 50 , _
Setbacks Front 102
Side I.: 88 R: IY2 L: 99 ' R:
Rear
Building Height y 5 611,5
Bldg. Square Footage %
yo2 86�. y021,96 .
Open Space Footage %
(Lot area rtinus bldg&paved
arl�na} / 77 v
of Parking Spaces 761 761
Fill: NIA N�A
(volume&Location)
A, Has a Special Permit/Variance/Finding ever been issued for,/on the site?
NO DONT KNOW YES X
IF YES, date issued: De-r-, /-3.
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book CSDy Page Z39 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 1r NO
IF YES, describe size, type and location: UQ r i o vs
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No --V�
IF YES, describe size, type and location;__ _
v vi JlVLll./ �,V1Wlll.1 x.141-u-UL;1 l Il UL ividy" 1J, L.VVV
_ S
City of Northampton - °h
Bui dirg Department,,'
epartment ( a ,
212 Main Street uv r gel a7 � ,ti� �
Room 100 w � -
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-127.2 :tj , as
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE c_C_HArjGE THE USE OR OCCUPANCY OF, 0 DEMOLISH. NY BUILDING
,
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE INFORMATION
E&RVER,- 3; ThisAecfion�toe�grnpleetl b�+office
1.1 Property Address s
ggj
C00% �- o,cxbnsoh f/osol fial 3f a u h r Urllt
44gR'/+'4°
SECTION 2 PROPERTYOWNERSHIP/AUTtiQRIZED]AGENT
2.1 Owner of Record:
Coo/e y Dicklr).SO/? HO Z; C4 30ioc'61st St. po. 13ox Soo/
Name (Pi Current Mailing Address:
1,113- 58,� - z3/3
Signature Telephone
2.2 Authorized Agent:
T�othy 5. f'e Ile f%er 5/YI,'l/eh Sf. <udlou/, /1I�9 O/056
Name (Pent) Current Mailing Address:
5113- 5y7- 2 500
Signature Telephone
,.__
SECTION 3:— @STIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Offical-Use Only
completed by ermit applicant
1. Building (a) Building`Permit Fee
2. Electrical : bi Estimated Total Cost of
= Construction"frnm 6
3. Plumbing Bwlding Permit Fee:`
4. Mechanical (HVAC)
5. Fire Protection
5, Total = (1 + 2 + 3 + 4 + 5) `Check Number D
This7Sectio6 For.Official Use Only _
Building Permit Number Date Issued:
signature: --
Building Commissioner%Inspector of Buildings Date
File#BP-2008-0559
APPLICANT/CONTACT PERSON Raymond R. Houle Construction Inc
ADDRESS/PHONE 5 MILLER ST LUDLOW (413) 547-2500 Q
PROPERTY LOCATION 30 LOCUST ST- 1ST FLR OLD LAB
MAP 23B PARCEL 046 001 ZONE M
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: REMOVE INTERIOR ARCHITECHTURAL ITEMS(CEILING,WALLS&FLOOR
COVERING(1ST FLR OLD LAB)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 066227
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
V 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 Commission Permit DPW Storm Water Management
Demalition Delay
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.
30 LOCUST ST- 1ST FLR OLD LAB BP-2008-0559
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map.Block: 2313 -046 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-2008-0559
Protect# JS-2008-000851_
Est. Cost:
Fee: $50.00 PERMISSIONISTIERI *BY GRZ1NTED TO:
Consi. Cl;i.ss: Contractor: License:
Raymond R. Houle Construction Inc 066227
Lot_size(s(I,_ rt.): 667077.84 Owner: COOLEI_n1CKINSON HOSPITAL INC'
Zoning: ,M Applicant: Raymond R. Houle Construction Inc_
is
Applicant Address: Phone: Insurance:
5 MILLER ST _ (413 54) 7-2500 Workers
Cgr l'_s_tion
LUDLOWMA01056 ISSUED ON.12/I2/20070:00:00
:rO PFJ?FO1?M T11E- FOLLOWING WORK.REMOVE INTERIOR ARCHITF_CHTURAL ITEMS
(CEILING, WALLS & FLOOR COVERING (1ST FLR OLD LAB)
PO`T TATS ,CARD SO IT IS VISIBLE. FROM THE STRF,ET
I :st t s,t t'iuinbii:;T Inspector of Wiring D.P.'V. i Building Inspector
Untic�-ground: Service: Meter
Footings:
Rouvii: Rough: House# Foundation:
Urivewav Fiu:il:
Fin:,t: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
i
Final:
1�inal: Smnl:e: _
'PHIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Cellificate Of_OCC_UR-gncy ` �� siEtnature: ---- —� --
hee"i Date Paid: Amount:
Building 12/12/2007 0:00:00 $50.0014390
212 Main Street,Phone(413) 587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo