23B-046 (93) Remove counters
Install new
door and frame
r - - - - - - - - - - - - - - - - - - - - - - -
+ Outline of new wall set on top
± - - - - - - - - - - - - - - - - - - - - - - - - - ; of existing casework.
General Notes:
1) Remove existing carpet inside
the new room and replace with new.
New drywall partition 2) Remove existing recessed lighting
extend to deck above. and install 2 new 2x2 light fixtures.
3) Install a new supply and return
diffuser tapped into the existing system.
4) Paint the inside of the new room, and
the exterior of the new wall where
EIL_ 11 disturbed by new construction.
Date: 03/24/04
Project: Maternity Reception
Desk Area Office Conversion
Raymond R. Houle Construction Inc.
187 East Street
South Hadley, MA 01075
Phone: 1-413-532-9243 Fax: 1-413-532-0413
e-mail: mail @rayhoule.com
Remove counters
Install new
door and frame
Outline of new wall set on top
- - - - - - - - - - - - - - - - - - - - - - - - - - of existing casework.
General Notes:
1) Remove existing carpet inside
the new room and replace with new.
New drywall partition 2) Remove existing recessed lighting
extend to deck above. and install 2 new 2x2 light fixtures.
3) Install a new supply and return
diffuser tapped into the existing system.
4) Paint the inside of the new room, and
the exterior of the new wall where
disturbed by new construction.
Date: 03/24/04
Project: Maternity Reception
Desk Area Office Conversion
Raymond R. Houle Construction Inc.
187 East Street
South Hadley, MA 01075
Phone: 1-413-532-9243 Fax: 1-413-532-0413
e-mail: mail @rayhoule.com
O
1 Crif3 Of l�crt(lalll}ltoll _ --
_. _
\ E $ta-3anchnrtIIs* _
o DEPART)VENT OP DUILWNG INSPECTIO).'S —
212 Train Strcct ' Municipal 13odding
Northampton, Mass. 01000
«'ORICCR'S COOIYOENSATTON L`ISU ZA-N a ArI�:�Z'17
(liccnscclpermittcc) -- -
kvl h a principal place of business/residence at:
ty/zt uc/a P)
do hereby certify, under the p?_iris and penalties of pCg'ury, ill?.I
.}= I am an employer providing die following workcr-'s comocns-rt;on cove.=c for my
elnptcyccs %vorUng on'diis job:
(L^sur--.n= Corer ) (Polk: ?vt- r) (r_:pirtior, Dzcc)
O I.am a sole propretor, general conc-actor or homeow-oef (c cie one) and hFvt hired
the coc actors listed below rqbo have the following workers cac3en_-a6on policies:
(�flIDC O1 CO^!::?Ci0') (I(1Rt3Ilt:_ Colnpan}'rt�GtSC'i ?�t11II1�G:) (r?:Jt;dG^i? I�IIC)
(Name of Cootraezor) (Insufa= Compaavt?a ic}• Nu t,:r) (Exp r.6on Due)
(Name of Conuaetor) Rasuraoc: Compare}'/Pouch- Nasbc.r) (txoira6on Date)
(Name of Contractor) (Insurance Comcalry/PoLcy Numbci) (Etpirtioo Dau).
{a¢iLll 161.OC31 dca tf ococury Lo c-,�ud_inforM Moo pertaiains to.11 wcre.ccn)
O I am a sole proprietor and bave no one woridng for me.
( } I am.a home owDer perfor umo all the work myself.
NOTE:plesc be ev.'irt tbx..•fie bcmcrrwvcn.vyo emVl%Dc`LOns eo c: .ra,=�c-zcjoo e•rcpzir work on.d..cil_�or
ant moc-_tl:.e L'r :—,,J in"-i-cb the bocnoo+ane rcado or oo the Vo o b zq:n the-cw c.•c ox i!!y occ=&cd to be
eizplor--untie a---vr crm •t'm Act(GLI52:=1(S)�zppU=.iou by a homaow-o=far a PaTah r=y e.ideace the
Icpl«aax of ea =: IoyW wader tlio Wortief,Co@poos,Lioo.A&_
I uodcizand rho a oopy of thi,aatc�a may be f..—urdad to Lt.pop� CXM.or tra—ror tS.
co—c vcif csioo and ai L L•Lr-_to Lonlrc bovcrxcc trade so oo 23 A of MOL 132 Caa,ad to the imition of ciminil K-Aia
oo=i:r of a&x or up to S I}00.00 ww r or up to ooc yczr end aril penatia ie be fora or a Slop Work Order and a
rim o(S100.00 a day cpiazz me
f tx only
Pcrmlt Number
Mzp:1 Lot
Sig'-Wrc of Lict z=/Pcrm Ucc Date
Versionl.7 Commercial Building Permit May 15,2000
SECTION 1Q STRUCTURAL PI=ER REVIEW(780 CMR:110.1
Independent Structural Engineering Structural Peer Review Required Yes......❑ No...�
SECTION 11, .OWNER AUTHORIZATION; 70 BE COMPLETED WHEN
s.
OWNERS AGENT OR CONTRACTOR APPLIES fOR BUfLDING PERMIT
I, as Owner of the subject property
hereby authorize ;7—,C)/ -S/ mil` E-TrL to act on
my behalf, in all matters relative t work authorized by this building permit application.
3 --2-�
Signature of Owner Date
I 77-,z-'z a I-* S �� 1�� %<�G� 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.
/-�roT� S�
Print Name
Signature of Owner/Agent Date
SECTION.I'2 CONSTRUCTIONSERVICES
10.1 Licensed Construction Supervisor: f Not Applicable ❑
Name of License Holder : / t��'� 1� d" 2 /�� /< d 6Ur e Z
License Number
ZCS
Address Expiration Date
Signature Telephone
SECTION 13 WORKERS'C OMPENSATION INSURANCE AFFIRAVIT(M G t .. 152,; 25C(5)) n
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....... No...... ❑
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9 ;PROFESSIONAL DESIGN AND CON STRUC,T4ON SERV10ES FOR BUILDINGS AND STRUCTURES U:B-'J,E:CT TO
CONSTRUCTION CQNTROL PllRS.UANT TO7,80.`CMR lib{CO;NTAINING MORE THAN,35 OOO�,F OF ENCLOSED"SPA'CE)
9.1 Registered Architect:
Not Applicable O
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
92 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
Not Applicable 0
Company Name:
Responsible In Charge of Construction
7_S
Address
�0 S 2-
Signature Telephone
x Versionl.7 Commercial Building Permit May 15,2000
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ 1 Zone: Outside Flood Zone ❑ Municipal ❑On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size 7 ® 7 p ��Z •Ei
r7
Frontage �<S t�T
Setbacks Front /o- ' /G ,?
Side L: R: `7 2 L: R:—Y
Rear
Buildin g Height
Bldg.Square Footage 3,y3 � % 3 73 eM' —/
Open Space Footage %
(L.ot area minus bldg&paved C ,1.
arldn )
#of Parking Spaces & 12
Fill: }�
volume&Location) [ ^
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW YES
IF YES, date issued:��?G'�r
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book G l e�l Page l and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW
YES _ `L l i"( 6—/
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 _ NO
IF YES, describe size, type and location: ac7 op S,4%-S
D. Arg there any proposed changes to or additions of signs intended for the property ?YES_
N
IF YES, describe size, type and location:
Versionl.7 Commercial Building Permit May 15,2000
{
46h6N 4 ONSTRUCIION R IICfS AR R07ECIS IESS THAN 35;000
Gl]B CI�FEET IMCLaO!SEWSPAClE5W, s �
Interior Alterations Existing Wall Signs Existing Ground Signs Additions❑ Roofing ❑
x ❑ ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [
❑ Accessory Building [ ] Repairs [ ]
BRIEF DESCRIPTION: —
SECTIONS=.USE GROUP AND CONSTRUCTION;�
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ I-1 A I-2 ❑ I-3 ❑ 3B ❑
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:
t COMPLE?E TRIS ECTION IFEXiS73iVG BUILDING JIVDERGOINGRENOVATIONS, ,DDITIONS AND%OR`CHANGE 3N-USE
t �, ... _ -
Existing Use Group: Proposed Use Group: Z
Existing Hazard Index 780 CMR 34): 7 Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING.HEIGHT AWAREA : �� v.4 /-
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION kCSENLI '
Floor Area per Floor(st)
ist -2 / X 4�ou
15t 2"d
2nd 3rd
3b - `
4m 4 °'� � s
HIN
Total Area (sf) Total Proposed uNew/Construction (si) �
Total Height(ft)
Total Height ft-- ------- Y
• Versionl.7 Commercial Building Permit May 15,2000
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-1272
-
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF,°QR DEMOLJ$19 NY"BUI'LDING
OTHER THAN A ONE OR TWO FAMILY DWELLIN � "" ; ,
= ..�$ MA R 2 L004
�SECTION1s .S1TE°INFORMATION � i= +-
1.1 Properly Address: h�sectionti be eompl ft'lp M
x venay't ct �
�.� / ,sect
SECTION 2 PROPERTY OWNERSHIPjAUTHORIZEDRGENT
2.1 Owner of Record:
CC.Y .b<cl�e A,-,C>,_,-- sP'✓)',4 c 30 lc psi sT yc spa
Name(Prin) 1 Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
LAa
Name(Print) Current Mailing Address:
4
Signature Telephone
SECTION 3 r'ESTIMATED CONSTRl7CTION COSTS ,
Item Estimated Cost(Dollars)to be Official-°lase 0ny
completed by rmit applicant
1. Building d �_ o {a)"Building Perrriit Fee
2. Electrical �� (b� stimatedTotal Costnf
�Construction'"frflm;.6 _-
3. Plumbing Buldmgermit'fee =. -
4. Mechanical (HVAC)
5. Fire Protection PQ O-
6. Total = (1 + 2 + 3 +4+ 5) / 2c1 66_ -'0 Check Number D D
LL -This Sec did for'Official Use Onl
Building�Perrnit Number Date Issued:
Signature:
Building Commissioner/Inspectorof Buildings Date
File#BP-2004-0916
APPLICANT/CONTACT PERSON Raymond R.Houle Construction Inc
ADDRESS/PHONE 187 East St SOUTH HADLEY (413)532-9243
PROPERTY LOCATION 30 LOCUST ST
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
Buildinp,Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT WALL TO CREATE OFFICE(2ND FLR MATERNITY AREA)
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
INFOIjIVYATION 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
Signature of tkBuildinggf ial 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.
� 1'
r I
s � � � d '�',r �;�
`� '�'
30 LOCUST ST BP-2004-0916
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B-046 CITE' 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-2004-0916
Project# JS-2004-1366
Est. Cost: $12000.00
Fee: $60.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Raymond R. Houle Construction Inc 066227
Lot Size(sq. ft.): 667077.84 Owner: COOLEY DICKINSON HOSPITAL INC
zoning>:M Applicant: Raymond R. Houle Construction Inc
AT. 30 LOCUST 51
Applicant Address: Phone: Insurance:
187 East St (413) 532-9243 Workers Compensation
SOUTH HADLEYMA01075 ISSUED ON:3130104 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT WALL TO CREATE OFFICE (2ND FLR
MATERNITY AREA)
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: � ;�� n7 House# Foundation:
ems'
fir; t si! Driveway Final:
Final: Final: yla 7`Uy
Rough Frame: eyk Z� --7 3_
Gas: Fire Department Fireplace/Chimney:
Roij-:: ()fl- a;�c�E,iiin l:
Final: Smoke: Final: Q r
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupanc Signature:
FeeType: Receipt No: Date Paid: Check No: Amount:
Building 3/30/04 0:00:00 9030 $60.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo