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DATE REVISIONS IIII�I_nn_m__ 4 T m m n m n ➢ SITE NAM 790 FLOREIYCB ROAD 0 12/20/13 ISSUED FOR CONSTRUCTION m v b Z m x S1TB NUJM& 53333 a ° ADDRESS: 790 FLORENCE ROAD °z z NORP9AMMN. MA 01088 3's Z zm 3 APPLICANT' O m b z W :� NSV CIMM AR YIACI sS p q >> M W'•2F�q s1136P��a� ,w M . L.rdr&r) o at&t °%aX'lIrI TF, Lw -� .. ,' KAiSBUA,aNH 033082 m u^ p 0) n m n o D C n D U D D = O OZA j` y� D D A i CDr. m y O D 9 m D m A U A W r v U W ZA mnpc l �rl� Kr j 0 0 0 C o LO O p y y >,-. m z Z ,^ n0 6.. AU 00 AAf rr y Nm w N O r m 2-1 m\ D A n p ZU Cm 9k i. f*1 ODNO mZ .. C Oc, nr �� On C) ZD D om0 { O O y r - x 0 A A D.S r C U n 2 rn C n° No mIn y v '� o� @k zm m m m m Z m m m O Oy nn nA nom, yA \ \ \ k D O AO ZD p5 it o W m Ii to O m Z A° A O 0 Z v Z r N Z C yo n "m z v OA n Zn-lG Om Zr x A(.� y`G j m m m �Z➢ v O AN z mN n0" k\ .� N 0 0 0 'i0 M �< zo moo �n >°a, Zzu Inn 3' MIN. y o 0 �Z N Q ;p n m . 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DATE REVISIONS O SITE NAKr 790 FLORRAYCS ROAD m SIPS MA®Blt ssus 0 12/20/13 ISSUED FOR CONSTRUCTION J y ADDRRSS: 790 FLORRDICB ROAD o Z !rA m w m NORTHAMPTON, MA 01062 V w o Na ��m _. z 3 APPLICANT AIN cricuufi IIPIMS o o � �g � CD PM, MC("ATdr) o o at&t °,"dra Ir,RSCSSS, XASNIA,M 00=2 `m o u" 0 }� A t, ti p =0 Oti m z-1 z N \ z >N m z j 0 m ; v0>{ A A Z y D Z S C p V D O O Z O A N Z T N z c U >C Z $ O f�l zza m m A N g M m M M m jzzz \ n Tip I N l U m \ N 50 OA$, Z m<0 0 �D m 0 pm \� m aN 0o x r gm N m%0 mZ O ' o 0 ( Z V D m 0 z I p0M 02� mc> mP� mD N O O Z C C D O N n01 OD m _ m m oS^N zm c D z m ��•Ni� N zm 0 ~W� Dzm O(Dj N mC A m O z]A ,T� ;m D 1 ZCyi I O A m �A D ODm p Vlu { x nc o z mn 00m N O { W � W (O A re O VI =O ti S A N A y0 W i > N m Dm o a �� m Z Z O z z m c� C � D 0 w N r Z p_ z �t > m wl W � •1, ^jl N m N O O D < X V o A Z O N m cam m on i 0 � AA ND.TOI�< x U O D D m 0 �O z.c{O m c00 y� m r0 m� D r <O A o K_N!,�1 0 z m. 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Omf*I m O0 0 zM° o m r A z Z Z 9 O m 0 Z m m O O m n A N Z m N D z O O N °M Z A O C A > D 0 01 m Ui> z D m N A OI C D 0 N m A r Z A m 0 T N N m 0 O z Om O 0 A m film p r A A n� y y Z Zmm 0 D> Om D�-I { pD y y 5 y I 00 ZO z '1 O Zm Z r ° (m/lo0 O D D o0 m �m C m y�x y AZ N 0 n z0 0 °A j o .IA/1 O m m fT•I A O y N 0 O0 z '0 A N m D m N m p N m y Z. O n T C m O° O M m m m.A A Dz Jn Am n o D 0M OyOm mm0 OO AA G A� c z z T O A O .°A W O ()O 000 Z yA M Tlc 2�m pDA �A -( Ol or N m K O A m Z Z A > m ° f*1 � z O a N .lml O z y p D M ° O RAi y M m .0 1 ° (�? A A z A r m ➢ D A z n C { m O y D m n O N N cl o o IT TLE: NO. DATE REVISIONS O SITS'NAIM 790 FLORRAWN ROAD --6-12/20/13 m m m 1 > „"{ n ISSUED FOR CONSTRUCTION m f o m x SITS' NIIII k 59333 Q � ADDRESS: 790 FLONJOr ROAD o 3 Z NORTHAMPTON: HA 01092 3 < \ m c z5 Z U 2 c w N= a`- o f APPLICANT: m p 7 ° J �FFq 0°ah 9 p Pwl LZC(Werar) °° w u bN at&t a129 Na 1GlR IIREL6SS.LLC p q l ROAD ^' Ed :` NASRUA, NN 0906E m K, r ?+� n m � o A W N fTl O 2�AxI Z�O-DODf X00 � C O m Z 0 o�z(nm<myrS+FoFzm z D _ D n cn \�2I xoF1.�z°i�ommn O N O I Z li m xn mw°F A n <°F�Ay1� Z W N N m DZ Za �m�mA it ° -7 ��Z-miWOC>zcnC mrAn r�Ni W W N Z O D Z N OmND�DQ\O� A? p< �\ m 0 m n -u M D n ° 0- r9 Amr ysz il/ r9 A '� M K O N mC Z r U1 v �yz�..v°x� ;mcziF� m -I n D D m m n D O v Z A A D rmo��zo zo-F O C N C r O - D � cs �< (noCO� z D .�J OZ Z D r m K;g (nF Z_om vm�isa ni0L.> � r � ° z O r O 1 Z Dumi�°inczzz zmveyN ° D 0 Z r�T Z �zo���m�uDi k oz° O D Z Z D"^ZmmO NIX Z C (n (A n x l D 6 0 mm< O O - Z D A 0 0 D O z n N N 2 A a Z' N ° CZ•: DK o I A D7,:. D o D zO Tv�N�o � n�> w 0 �`m"s Ao�m z SAO rA*t Emu I'xF AO o 0 0 0 0 0 0 0 0 0 � N oy z 0 N Z N N m�P f Z v ma . a Pb m m 000 > N 750 z O D soo 25° PIZ f RO a n II AD Z Ma 00 O m w ic Z07v0 o w Cm /�+ rn cu o"I r > z W N� o n CA) PAZ] orn CA) m z N Ro- 0 o m � n � v v (n m D m u r r N D 0 (n N :E(n cA c: 0 -u O x D O D O to 74 -; -{ O n 74 < Z r m -0 C 0 �-i Z M fTl fTl fTl 7 O m A f- C N Z7 '� z Z { m o m f!1 O N Fri m O Z O aj D m x O a L -I ITI UI�z �Z-'� Zen az '.W 0 °v0 z �I A z V In N r*,n� n ^ mDC�O ms DN\�fTl ;'a -_i Rm 00 D N N D XOA O \J/ r N-10A rZ7=O U1JO o � Z Z O A .ZIO W O 5<)oz=m'1)-� --� S .�D Z>fTl G CO 00 A n L -*7 -i-(� r ?D W mm .p D Rm;,, yC7��Z r W O0 r.,xOz W O M, a':r r ZDO O _ DO O 0 c n V O y v D Z m C Z O N- n SI D tD W C v -u m m n 0 m ° 2 M I K r K - O U r A Oo CO -Z z C T I O � 0 O m N OymCp.Z7 O 00-M O N D N v W O Om m m S Z TT -IG ?��Z N co Z D �'� '� rfnT1 N pD m< DN0 N <m J m z O DOD OD 0Om° O mn OuOC X m co N f�l O OO O *X0 O O Om0 n (n O Vl O J Z o, C N Z cl) O N 0 O W- IT, -ri •tnn o n o z n D n z m v° Z z r 0 �m n Z x co 0 = � D IZ o0 z0 °z z CONSTRUCTION n m n a SITS VAMP 790 FLORBACB ROAD N0. DATE REVISIONS n m T C l0 O v m m y 0 12/20/13 ISSUED FOR CONSTRUCTION N y y o m a SlTa hujm : Mis 0 d ` ADDRESS: 790 FLORMI ROAD ,o z m NORTHAIMN. MA 01068 3 E o N ° tVr Sri'^ o Sm v 3I i z� o u o i St APPLICANT: NCI CIAWUR IIRRIMS ba W �FF9 51139(���-i`' ICS, MC("eras-) °° NeSRUA. NN 0 + + &t tzr Rrnca Roes /�� 3088 o m °u" a ?++ ------_--..---------------------------------- -s Official Receipt for Recording in: Hampshire County Registry of Deeds 33 King St_ Northampton, Massachusetts 01060 Issued To: BRIAN ALLEN SITE ACQUISITION CONS KX WIRELESS (508) 868-0927 12 OLD TAVERN LANE SUTTON NA 01590 Recording Fees :--------------------------------------------- * Document Recording Description Number Book/Page Amount *--------------------------------------------* DECIS 00000024 1156014$ s75.OD CONTINENTAL CABLEVISION 0 $75.00 Collected Amounts -------------------------------------------- Payment Type Amount 0_ __________________________________________ _* Check 43859 $75.00 $75.00 Total Received : $75.00 Less Total Recordings: $75.00 Change Due $.00 Thank You NARY OLBERDIN6 - Register of Deeds By. Linda N Receiptii Date Time 0270926 01106/2014 09:55a Reprinted By: Linda N Reprinted On: 01/06/2014 09:55a Planning-Decision City of Northampton Hearing No.: PLN-2014-0022 Date: December 13, 2013 FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY: APPEAL DATE 11121/2013 121512013 1212612013 REFERRALS IN DATE HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY: APPEAL DEADLINE: 11/28/2013 112412014 12/12/2013 12126/2013 1/2/2014 FIRST ADVERTISING DATE i HEARING DATE: VOTING DATE: DECISION DATE: 11/28/2013 12/12/2013 12/12/2013 12/13/2013 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 121512013 7:00 PM 3/12/2014 3/12/2014 MEMBERS PRESENT: VOTE: Dan Felten votes to Grant Debin Bruce votes to Grant Ann DeWitt Brooks votes to Grant Jennifer Diennger votes to Grant Mark Sullivan votes to Grant Francis Johnson votes to Grant MOTION MADE BY: SECONDED BY: VOTE COUNT: DECISION: Debin Bruce Francis Johnson 6 Approved MINUTES OF MEETING: Available in the Office of Planning b Development. 1,Carolyn Misch,as agent to the Planning Board,certify that this is a true and accurate decision made by Me Planning Board and certify that a copy of this and all plans have been Hied with the Board and the City Clerk on the date shown above. l certify that a copy this decisk!p has been mailed to the Owner and Applicant Notice of Appeal An appeal from the decision of the Planning Board may be made by any person aggrieved pursuant to MGL Chapt.40A,Section 17 as amended within twenty(20)days after the date of the filing of the notice of the decision with the City Clerk.The date is listed above. Such appeal maybe made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. uFn I _: ,I January 3, 2014 I, Wendy Mazza, City Clerk of the City of Northampton, hereby certify that the above Decision of the Northampton Planning Board was filed in the Office of the City Clerk on December 13, 2013, and that twenty days have elapsed since such filing and that no such appeal has been filed in this matter. - Attest: Wendy Ma#a City Clerk City of Northampton GeoTMSV 2013 Des Lauriers Municipal Solutions,Inc. REGISTER AST: :A!IPSIRRE, ..._.__...........__... Planning-Decision City of Northampton Hearing No.: PLN-2094-0022 Date: December 13, 2013 IIIf iilllf IIHIfiIIHifIfi IJf APPLICATION TYPE: 1SSIONDATE PB Intermediate Site Plan 212013; fllff i ilf f I ilf f III,f Iil�f I IIf f IiII,�II flfllffl 2014 00200074 Bk: 11560Pg: 148 Page: 1 of 2 Applicant's Name: Owner's Name: Recorded: 01106/2014 09:55 AM NAME: NAME New Cingular Wireless PCS,LLC CONTINENTAL CABLEV1S10N OF WESTERN ADDRESS: ADDRESS: 12 Old Tavern Lane C/o CTI Towers 38 Pond St,Suite 305 TOWN: STATE ZIP CODE TOWN: STATE: ZIP CODE SUTTON YA—J 01580 FRANKLIN MA 02038 PHONE NO.*. FAX NO.: PHONE NO.: FAX NO.: EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO.: SiM ZONING: COMPANY NAME: 790 FLORENCE RD TOWN: ACTION TAKEN: ADDRESS: FLOREN CE MA 01062 Approved MAP: BLOCK LOT: MAP DATE: SECTION OF BYLAW: 37 077 001 Chpt.350-11:Site Plan Approval TOWN: STATE: ZIP CODE: Book: Page: 2189 028 PHONE NO.. FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK ADD ANTENNAS&EQUIP BLDG HARDSHIP: CONDMON OF APPROVAL: FINDINGS: The Planning Board voted unanimously to approve the antennas for AT&T to be placed on an existing tower based on the plans submitted with the application: AT&T Permitting Set By ProTerra,Dated 10118113. The Board found that the provisions within the Zoning Ordinance had been met: (1)The requested use protects adjoining premises against seriously detrimental uses.if applicable,this shall include provision for surface water drainage,sound and sight buffers and preservation of views,light and air;This site already contains a tower (2)The requested use will change the convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets,there are no changes to access or function of the site that would warrant the need to address this criteria. and (3)The requested use will promote a harmonious relationship of structures and open spaces to the natural landscape,existing buildings and other community assets In the area; (4) The requested use will not overload,and will mitigate adverse impacts on,the City's resources including the effect on the City`s water supply and distribution system,sanitary and storm sewage collection and treatment systems,fire protection,streets and schools;and (5)The requested use meets any special regulations set forth in this chapter-most relate to construction of new towers and are not applicable; (6)The requested use bears a positive relationship to the public convenience or welfare.The use will not unduly Impair the integrity of character of the district or adjoining zones,nor be detrimental to the health,morals,or general welfare. The use shall be in harmony with the general purpose and intent of the ordinance;and (7)ff applicable,the requested use will promote City planning objectives to the extent possible and will not adversely affect those objectives,as defined in City master or study plans adopted under MGL c.41,§81C and 81D. COULD NOT DEROGATE BECAUSE GeoTMS®2013 Des Lauriers Municipal Solutions,Inc. .._._.._ 1/2/14 City of Northampton Mail-790 Florence Rd antennas 790 Florence Rd antennas Louis Hasbrouck <Hasbrouck @northamptonma.gov> Thu, Jan 2, 2014 at 11:34 AM To: Brian Allen <bdan @kjkwireless.com> Brian, I looked over the permit application for the new antennas on Florence Rd. The plan disk didn't come with the application, the hard copy plans didn't ha\e wind load calcs, the engineer's letter excludes responsibility for some of the structural analysis on the tower, and it doesn't seem like the site plan approval has been recorded at the registry of deeds yet. I'll hold the application. Let me know if you have questions. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413) 587-1240 office (413) 587-1272 fax https:#niai1.goog Ie.corTVniaiI/ca/u/0/?ui=2&ilrec5flga57e&\ie\&=pt&search=sent&msg=14353cea8Oa46120 1/1 Titij of Nart4ampten +�Rassttrllusrtts '`c DEPARTMENT OF BUILDINC INSPECTIONS 212 Main Street • Municipal Building r t� Northampton, MA 01060 Lp�(iq ;� }ack Fax: 413-587-1272 Chuck Miller Building Commissioner Phone: 413-587-1240 Assistant Commissioner CONSTRUCTION CONTROL DOCUMENT (For professional EngineerslArchitects responsible for Entire Project) Project Title AT&T 790 Florence Road (53333) Date: December 20 2013 Project Location: 790 Florence Road Map: 37 Parcel:77-1 Zone: SR Scope of Project: Proposed AT&T equipment at existing telecom facility In accordance with the sixth edition Massachusetts State Building Code, 780 CMR Section 116.0: I, Jesse Moreno, PE Mass. Registration# 47315 Being a registered professional Engineer/Architect hereby CERTIFIES that 1 have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Excluding structural modification D] ENTIRE PROJECT to tower foundation (if necessary) 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 and shall be responsible for the following as specified in Section 116.22 1, Review of shop drawings, samples and other submittals of the contractor as required by the construction documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 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, in general, if the work is being performed In a matter consistent with the construction documents. I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent comments. Upon completion of the work, I shall submit to the building official a final report as to the satisfactory completion and readiness of the project for occupancy. Sin and Seal a e istered Professional 0iy Sign JESSE M. mOREND — L to . Tit 5 Day of (�� 20-13 0. (seal) f?N i- CTI { TOWERS LETTER OF AUTHORIZATION Northampton,MA Site/CTI Towers Assets I,LLC The undersigned, as Chief Financial Officer of CTI TOWERS ASSETS I, LLC, a Delaware limited liability company and subsidiary of Comcast Cable Communications, LLC ("CTI") and affiliate of Comcast of Massachusetts II,Inc. ("Comcast"), manages the tower facility on Comcast's behalf located at 790 Florence Road, Northampton, MA 01062, and identified as Parcel Number 37-077-001 (the "Property") in the Town of Northampton, does hereby authorize New Cingular Wireless PCS, LLC and its agent, KJK Wireless, with the authority to file applications and act as an agent for the sole purpose of gaining any and all building permit(s) to install telecommunications equipment on an existing guyed tower on the Property. CTI Towers Assets I, LLC ! Signature: Print Name: Andrew Sloe- " Title: Chief Finan, Officer COMMONWEALTH OF MASSACHUSETTS COUNTY OF NORFOLK,to wit: On this 5 day of �' 1i , 2013,before me,the undersigned notary public,personally appeared Andrew Sloey, proved to me through satisfactory evidence of identification,which was personal knowledge of the identity of the principal,to be the person whose name is signed on the preceding or attached document, as Chief Financial Officer of CTI Towers Assets 1, LLC,a Delaware limited liability company, and acknowledged to me that he signed i 'voluntarily for its stated purpose. DANIELLE L. LAMBERT Notary Public Notary Public Printed Name:i JJf�Ko L`L't Commonwealth of Massachusetts My Commission Expires My Commission Expires: C c: August 29, 2019 The Commonwealth of Massachusetts Print For �� Department of Industrial Accidents µ = i' Office of Investigations . I Congress Street,Suite 100 '- Boston,MA 02114-2017 wmv.nurss.govAlia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information Please Print Lezibly New England Electrical Contracting Corporation Name(Busincssl C3rganization.+'Individual): 0 9 p Address:21 Marion Drive City/State/Zip:Kingston MA 02364 Plfone#:781-585-0040 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 40 4. ❑ I am a general contractor and [ employees(full and/or part-time).* have hired the sub-contractors b. ❑ Nev'`construction 2.❑ 1 am a sole proprietor or partner- listed oil the attached sheet. 7. ❑ Remodeling These sub-contractors have ship and have no employees These ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp.insurance." required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers`coo right of exemption per MGL p• 12.❑ Roof repairs insurance required.] c. 152.§1(4),and we have no employees.[No workers' 13.❑Other comp. insurance required.] Tiny applicant that checks box#I trust also fill otrt the section below sirowing their workers'compensation policy intonnation. i lanteowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating srtch. 'C'ontractors 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 nmst provide their workers'comp,polio number. J ant an employer drat is providing ivorA-ers•'e(lniperrstrtlon lnsrtrarrce f{rr my employees. Below is thepolicy and job site information. Insurance Company Name:Liberty Mutual Insurance Co_ Policy#or Self-ins.Lic.#:WC531S370327013 Expiration Date:11/13/14 Job Site Address: City,/State/Zip:_�.. 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 herehtx certij under fire aims ant! enalties o er'urp that t/re injarrnatian provided above is true and correct. Signature: Date Phone#: OJjicial use ontp. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person; Phone#: Version 1.7 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 I; as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date as Owner/ orized ereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed u h_ p d penalties of perjury. Print Nam Z jZ3 � 3 Signature of O er/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction��Supervisor: yy Not Applicable ❑ y ` Name of License Holder: � F i.rr-e 1 U r-1 C L License Number Addre �� Expiration Date Tl i S" "� C%c`i c Sig ure 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 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 CHAR 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): 3f 511-t Name Area of Responsibility G'6 Co `(T3 I S- Address Registration Number 413 32"; Signature 9 Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature g Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Not Ap cable ❑ Company Name: Responsible In Charge of Construction ve Add Pture�� Si Telephone Version 1.7 Commercial Building Permit May 15,2000 S. 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 DON'T KNOW 0 YES IF YES, date issued: 11117,115 IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: On f2MCt- G5 gQf,,vt D. Are there any proposed changes to or additions of signs intended for the property ? YES ,> NO Q IF YES, describe size, type and location: 0,,. Nc.l I&e dftf o,y," 2 r ssl- 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. Versionl.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❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Enter a brief description Isere. A da 12 av'�vwl', 4 L -}v �xlSki� 4d't—r Of Proposed Work: tv.G�aS� � l=o"C'" -Q� cpX+t., -' (2lt C. R p(Ox 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 ❑ 1 B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 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: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: 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) ., _ St - 1 St 2nd 2nd 3rd 3rd 4 t 4th Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft fC i 7.Water Supply(M.G.L.c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system E3 533`3 Version 1.7 Commercial Building Permit May 15,2000 Department use only D ity of Northampton Status of Permit: ` wilding Department Curb Cut/Driveway Permit - ��� L!�3 0 2013 212 Main Street Sewer/Septic Availability `�� Room 100 Water/Well Availability --_-- - .N rthampton, MA 01060 Two Sets of Structural Plans Electric.F on r Rorie 413587-1240 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 7 9 CJ FIortv-,cL (La*J Map Lot Unit WAN"1--o%- l ev--A 0 10 6 Z Zone. Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: (0%JI1-&-Fal cal kVic"'. u 110-d S� SUIk 30S Ffar4Q0A ` ov), 0103 Name(Print) G/o C T T 10 VA4-S -TG y.y %70,0,j o Current Mailing Address: o 5o 1B "ot0 67EG Signature 1 �puy— s -e Lo A Telephone 2.2 Authorized Agent: ftow. , Pr1(Qp �-S1c Wkrcle5S a 01r) -Tokvz" lam 5U14 " GiSyo Name(Print) Current Mailing Address: ��8 • ��8 ,Oy 2? Signature Telephone SECTION 3-ESTIMAT CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit appli cant 1. Building (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) d 060 Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Please let me know if there is any additional information that you need in order to process our building permit request. If everything is in order can you please return the permit to me in the enclosed envelope? Thank you in advance for your help, Brian J. Allen KJK Wireless 12 Old Tavern Lane Sutton, MA 01590 508.868.0927 briangkjkwireless.com ff tt 12.23.13 Louis Hasbrouck Building Commissioner Department of Building Inspections 212 Main Street Northampton, MA 01060 RE: 53333 790 Florence Road Louis, New Cingular Wireless/ ATT Mobility would like to expand the compound at the base of the existing tower, add a prefab equipment shelter within the expanded compound, and add antennas, cables and associated equipment to the tower as shown on the included plans. Enclosed please find: • Completed Building Permit Application • from the Tower Manager • Planning board approval • Contractors License • Workmen's Comp insurance • General Liability insurance • Construction Control Affidavit • set of 11x17 plans the f�es • Che • Disk with pertinent info including plans File#BP-2014-0756 APPLICANT/CONTACT PERSON NEW ENGLAND ELECTRICAL CONTRACTING CORP ADDRESS/PHONE 21 MARION DR KINGSTON (781)585-0040 PROPERTY LOCATION 790 FLORENCE RD , MAP 37 PARCEL 077 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T_ypeof Construction: ADD ANTENNAS&EQUIP BLDG New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 096560 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Demolition Delay 14,Z J -31:4iq Sig ature 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. 790 FLORENCE RD BP-2014-0756 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37-077 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-2014-0756 Project# JS-2014-000966 Est.Cost: $72000.00 Fee: $432.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NEW ENGLAND ELECTRICAL CONTRACTING CORP 096560 Lot Size(sq. ft.): 243500.40 Owner: CONTINENTAL CABLEVISION OF WESTERN NEW ENGLAND INC C/O PROPERTY TAX DEPT Zoning: Applicant: NEW ENGLAND ELECTRICAL CONTRACTING CORP AT. 790 FLORENCE RD Applicant Address: Phone: Insurance: 21 MARION DR (781) 585-0040 WC KINGSTONMA02364 ISSUED ON:31312014 0:00:00 TO PERFORM THE FOLLOWING WORK.-ADD ANTENNAS & EQUIP BLDG 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 3/3/2014 0:00:00 $432.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner 790 FLORENCE RD BP-2014-0756 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37-077 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-2014-0756 Project# JS-2014-000966 Est. Cost: $72000.00 Fee: $432.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NEW ENGLAND ELECTRICAL CONTRACTING CORP 096560 Lot Size(sq. ft.): 243500.40 Owner: CONTINENTAL CABLEVISION OF WESTERN NEW ENGLAND INC C/O PROPERTY TAX DEPT Zoning: Applicant: NEW ENGLAND ELECTRICAL CONTRACTING CORP AT. 790 FLORENCE RD Applicant Address: Phone: Insurance: 21 MARION DR (781) 585-0040 WC KINGSTONMA02364 ISSUED ON:31312014 0:00:00 TO PERFORM THE FOLLOWING WORK.-ADD ANTENNAS & EQUIP BLDG 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 3/3/2014 0:00:00 $432.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner