42-089 (14) 4d 0P !'
Giabal'f �°Ser4`ices
750 Park of Commerce Boulevard
Suite 300
Boca Raton,FL 33487-3612
P: 605.422.1548
F: 605.422.1550
Mount Elev'(ft) C�ty* Antenna Mount Type Lines Carrier
73.0 1 PCTEL GPS-TMG-HR-26N Stand-Off (1)1/2"Coax Sprint Nextel
Removed Equipment
Mount Elev.'(ft) City. Antenna Mount Type Lines Carrier
3 RFSIBC1900HB-2
197.0 6 Alcatel-Lucent 1900MHz RRH Low Profile Platform (6)15/8"Coax Sprint Nextel
6 Andrew DB98OH80E-M
Proposed Equipment
Elevation'(ft)
Mount RAD Qty- Antenna Mount Type Lines Carver
3 RFS APXVTMI4-C-120
197.0 197.0 3 Alcatel-Lucent TD-RRH8x20-25 w/Solar Low Profile Platform (1)7/8"(0.88")Fiber Sprint Nextel
Shield
Mount elevation is defined as height above bottom of steel structure to bottom of mount,RAD elevation is defined as center of antenna
above grade level(AGL).
Install proposed coax inside of the pole shaft.
The existing and proposed loads listed in the tables above are compared to the tower's current design capacity
or previous structural analysis. The tower should be re-evaluated as future loads are added or if actual loads are
found different from those listed in the tables. The subject tower and foundation are adequate to support the
above stated loads in conformance with specified requirements.
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Global T oJ,er Services
750 Park of Commerce Boulevard
Suite 300 AMERM-AN TOWEEt•
<d A�OAwYdF
Boca Raton,FL 33487-3612
P: 605.422.1548
F: 605.422.1550
Eng. Number 55299211
November 24,2013
Page 1 of 2
Structural Evaluation
ATC Site Number&Name 15035,Northampton Landfill MA,MA
Carrier Site Number&Name BS33XC083,N/A
Site Location Westhampton Road
Florence, MA 01062-9806,Hampshire County
42.295569 N/-72.707844 W
Tower Description 198.9 ft Monopole
Basic Wind Speed 100 mph(3-Second Gust)
Basic Wind Speed w/Ice 40 mph(3-Second Gust)w/1"ice
Code ANSI/TIA-222-G/2009 IBC/Massachusetts State Building Code,9' Edition
Existing and Reserved Equipment
Mount Elev'(ft) qty. Antenna Mount Type Lines Carrier
3 Alcatel-Lucent 800 MHz RRH
3 RFS APXVSPPI8-C-A20
3 Alcatel-Lucent 1900MHz RRH (3)11/4"Hybriflex
197.0 Low Profile Platform Sprint Nextel
1 Alcatel-Lucent MPR a (1)0.24"Cat 5
1 RFS SB2-107AMPT
3 Alcatel-Lucent ALU 800MHz External
Notch Filter
6 72"x 12"Panel
186.0 Low Profile Platform (12)15/8"Coax T-Mobile
6 6.7"x 10.7"TTA
12 Kathrein Scala 86010025
2 Powerwave P65-17-XLH-RR
6 Kathrein Scala 80010122 ( 8"Coax
175.0 6 Powerwave TT19-08BP111-001 Low Profile Platform (2))0 0.78'78"'8 AWG 6 AT&T Mobility
(1)3"conduit
1 Raycap DC6-48-60-18-8F (1)0.39"Cable
6 Ericsson RRUS-11800 MHz
1 Andrew SBNH-1D6565C
1 Telewave ANT1501`2 (1)7/8"Coax City Of Northampton
Police Dept
6 RFS FD9R6004/2C-3L
142.0 2 Antel BXA-70063/4CF Low Profile Platform
1 Antel BXA-70063-6CF-EDIN-X (12)15/8"Coax Verizon Wireless
6 AntelLPA-80063/4CF
3 Antel BXA-171085-8BF-EDIN-X
135.0 3 RFS APXV18-206517 Flush (6)15/8"Coax Youghiogheny
120.0 1 4'HP Dish Flush (1)1/2"Coax
116.0 1 2'HP Dish Flush (1)3/8"Coax AT&T Mobility
114.0 1 2'HP Dish Flush (1)3/8"Coax
The Commonwealth of Massachusetts
Department of Industrial Accidents
r W Office of Investigations
I Congress Street,Suite 100
Boston, MA 02114-2017
ivlvrt)mass.gov/dia
Workers' Compensation Insurance Affidavit: Builder-s/Conn-actors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Green Mountain Communications, Inc.
Address:702 Riverwood Dr
City/State/Zip. Pembroke, NH 03275 Phone#:603-717-7117
Are you an employer? Check the appropriate box: Type of project(required):
1.0 I am a employer with 69 4. I am a general contractor and I
employees (full and/or part-time).'"
have hired the sub-contractors 6. El New construction
1❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g. Demolition
working or me in an capacity. employees and have workers'
g Y $ 9. F1 Building addition
[No workers' comp. insurance comp. insurance.
re
required.] 5. We are a corporation and its I0.❑ Electrical repairs or additions
q ]
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself No workers' com right of exemption per MGL
Y [ P• 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.5 Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeo miers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their .vorkers'comp.policy number.
I acre an employer that is providitrg►wrkers'compensation insurance fur n:y employees. Below is the policy and job site
information.
insurance Company Name:Zurich American Insurance Company
Policy#or Self-ins.`Liicc.##:WC 5946539-05 Expiration Date: 12/31/2014
Job Site Addressd g"CA z)J City/State/Zip: Uf �kk 0 1 M, „<
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi,61 tinder t"pains and1penaldes of perjury that the information provided above is true and correct
Signature: Date:01/30/14
Phone#: 603-717-71V e'
official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License #
issuing,authority(circle one):
1. Board of 14caltlr 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing lnspector
6. Other
C, s e? f rso;a;
Versionl.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
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
W as Owner of the subject property�_)\zryt_hereby authorize to
act on my behalf ' II matte lative to work authorized by this building permit application.
Signature of Owner Date
C� 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.
Print Name
Signature of Owner/Agent Date /
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: S e Giz`L t� L c z-S Not Applicable ❑
Name of License Holder: ��� S _7� ("I s
License Number
Address Expiration Date
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 ilding permit.
Signed Affidavit Attached Yes No 0
Version 1.7 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): � AL.
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
61"v A C Not Applicable❑
Company Name: T
Responsible In Charge of Construction
-7U")
Address
Signature Telephone
Version 1.7 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 f\j J
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 O DONT KNOW � YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW ,'/T1% YES O
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 O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO _
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,gradin ex vation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O 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 ❑ Existing Wall Signs ❑ Demolition[--] Repairs❑ AdditionsIRL Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use[:] Other
p
Enter a brief description here. 1^' tit SS , �`
Brief Descri tion �r� �'x, r 1-/ 1 , �'� C1 ) (�
Of Proposed Work: �6\
�-` J C�) t�►�
SECTION 5-USE GROUP AND CONSTRUCTION TYPE J l'
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I 0
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ I-1 ❑ 1-2 ❑ 1-3 ❑ 3B
M Mercantile ❑ 4 El
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 513 ❑
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: �`1��, SS CUMr� ` �' Proposed Use Group: �^/i CG`'vi''t ``� 5
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(st)
St �v
St nl
! _ � 'k 2nd
2nd
��` 3rd
3`d
4 t
4th
Total Area(so 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: `P�" 7.3 Sewage Disposal System:
Public Private❑ �` p<' Zone Outside Flood Zon Municipal❑ On site disposal sy to
Versionl.7 Commercial Building Permit May 15,2000
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
D 212 Main Street Sewer/Septic Availability
In�rFEB � ��} i Room 100 Water/WellAvailability
"! f lorthampton, MA 01060 Two Sets of Structural Plans
phone 4' 3-587-1240 Fax 413-587-1272 Plot/Site Plans
Electric. r'.. ctions
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 do s: This section to be completed by office
1-7 0 �1 t��' �L" �� Map Lot Unit
V �-- Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: v
Name(Print) ( Current Mailing Address:
Signature An Z"r, Telephone
2.2 Authorized Asaent: c c
Name(Print) 1 Current Mailing Address: 6 L` � `�
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by rmit applicant
1. Building i Gv 0 (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) 000 Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
FEB 14 2014
February 4, 11 -.1-1 _j
lectric, Fir-',L:r,c1 �Lrtctions
Office of the Building Commissioner
Pulchalski Municipal Building
ATTN: Louis Hasbrouck
212 Main Street
Northampton, MA 01060
RE.- Sprint upgrade and modification to existing wireless facility at 170 Glendale
Road, Florence
Dear Mr. Hasbrouck:
On behalf of Sprint, I am please to submit the attached building permit application for the
routine upgrade and modification of a wireless facility on the existing
telecommunications monopole located on 170 Glendale Road, Florence.
As described in the enclosed package, Sprint proposes to modify their existing antennas
on the tower and associated radio equipment at the base of the tower.
The following materials are included in this package:
• Building Permit Application
• Construction Supervisor License
• Workers Compensation Insurance Affidavit
• Certificate of Insurance
• Structural Analysis
• Two sets of Drawings
• Check for the Application Fee ($6 per$1000)
Please review the enclosed materials and contact me if you should have any questions
or if you should need any additional information. Once the permit has been issued,
please contact me at (617) 823-7055 and I will arrange for immediate delivery. Thank
you for your attention to this matter.
Regards,
G�
Christopher M. Tracy
160 Center Street
North Easton, MA 02356
(617) 823-7055
Agent to Sprint
File#BP-2014-0875
APPLICANT/CONTACT PERSON GREEN MOUNTAIN COMMUNICATIONS IN LD G ADDRESS/PHONE 702 RIVER WOOD DR PEMBROK (603)717-7117 PROPERTY LOCATION 170 GLENDALE RD MAP 42 PARCEL 089 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUI
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
T_ypeof Construction: MODIFY ANTENNAS&ASSOCIATED EQUIPMENT-SPRINT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 077763
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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
2 12
Signature o 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.
170 GLENDALE RD BP-2014-0875
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map.Block: 42-089 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ANTENNAS BUILDING PERMIT
Permit# BP-2014-0875
Project# JS-2014-001527
Est. Cost: $15000.00
Fee: $90.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: GREEN MOUNTAIN COMMUNICATIONS INC 077763
Lot Size(sq. ft.): 2265120.00 Owner: NORTHAMPTON CITY OF LEACHATE TREATMENT FACILITY
Zoning: Applicant: GREEN MOUNTAIN COMMUNICATIONS INC
AT: 170 GLENDALE RD
Applicant Address: Phone: Insurance:
702 RIVERWOOD DR (603) 717-7117 O WC
PEMBROKNHO3275 ISSUED ON:212712014 0:00:00
TO PERFORM THE FOLLOWING WORK:MODIFY ANTENNAS & ASSOCIATED
EQUIPMENT - SPRINT
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. av r
cry
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 2/27/2014 0:00:00 $90.00
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Louis Hasbrouck—Building Commissioner