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32A-152 (8) �. R E (�it-�) of �,Tc tlluiliptoil - _- 9 � f �tasaRrhntrtta' - — Q DEPARTI ,BENT OP DUILDrNC INSPECTION'S 212 Main Strcct ' Municipal Building, ?Northampton, Mass. 01060 WOMCCR'S CO`UENSATION LNSURA.-NCE AI'I'IDAVI-T (li ccnsa'J i tt�) %VILb a principal place of business/residence at: (phone-') str�.Uci ty/sutcfa p) do hereby cetTify, under th.e pains and penalties of perjury•., -.hat am an employer providing the following worker's comncns-nZion covera-c for Intl' etuplovccs worlong on'tins job: JC 7'1!f)/6s-110/ Z©o (Insures Corer �) (Folic: Nt>_ r_r) (�.-pit tor, D2tc} O I a:n-1 a sole propnetor, general contractor or homeowner (ci cie ont) and have hired the coon aciors listed below cgho have the following workers cocptn-anon pckies: (IvQIII: Oi CO.^.'_^Ci0") COIADITI}'Pf GUC{ n bale) (Name of Contractor) -- (lnsuranc-- Companyi?obm, Numcrr) (Ex-piraiion Date) (Name of Contractor) (Iastu-ane; Compare}-[Poke}- Nambu) (Exaimrioo Date) (Name of Conaactor) 9zSuranc-- Compaoy/Pobcy N=b i) (Ea�itation Date). (aaacb:dts;:oc�r'�cC cfcooct.r}'to mcuc>=inforasaoc pcaxinins to all ( ) I am a sole proprietor and bave no one worling for me. ( ) I am.a home owner performing all the work myself. NOTE:pl=.c be aw'7rt r_he.tt jc homcowacr�µ-bo cmplcy pesos w Jo repair-oric ca,d-ctt of ont treat t1-n i ro tmrj in wt=b the bor oow ,=,dee or oo the Qoupccs zppu�th,!.t:r ooc G=�.-,Gy oc-=.& rd to be employ-unc'.e L-kui:.erm 0=aP •,'m Act(G LI 5L=i(S)�.appli=6=by a homeo-=fer_btu or permit r=y n-r6r the legal crave of an<r*loyer uodor dare Wor4.olc Coeapoav-t.ioa Ad (trader-L-d d-a copy of thii ml—m„y be r,,-,,id to the Dcq.n of lomir-ricl Acndcaa'Office or Gavnoou rot th. oovexsc vairesim and ttset L•ittsc w acetate`eot•ery�toodrX soetioa 25 A n!MoL l S2 oa led to the i�itim o(aimiasl pco+ltics eomisimg of a Goe of up to S 1300.00 and/or of up to one year sad avi)peaahie in 6c form o(a Slop Work Order and a Gm of S 100.00 a CLy tpj=me •,...�' Foe 6,*r +col u. only Pcrmlt Number _ �� d Map" Lot K ` t of Li ccmittcc e -- Version 1.7 Commercial Building Permit May 15,2000 -7771 -2 SEC7lON ID STRUCTURAL PEER REVIEW"X780,'CMR'11041, Independent Structural Engineering Structural Peer Review Required Yes......0 No...�-- SECTON it OWNER AUTHORIZATION-"=T,O BE,-,COMPLET:EDj WHEN OWNERS AGENT lRCONTRACTOR APPLIES FOR BUILDING:PERMIT ij �o114- ✓ as Owner of the subject property hereby authorize IJ%f ' l�' to act on my behalf, in al atte relative to work authorized by this buil ng permit application. r�� "�----- /0 / 3 Signature of O ner Date as Owner Authorized A hereby declare that the statements and info r ation on the foregoing application are true and accurate, to e es o my knowledge and belief. Signed under the pains and penalties of perjury. Print Name /znzv 3 Sig e of Owner/Agent Date SECTION 12.-CONSTRUC'fIOTI SERVICES '} 10.1 Licensed Construction Supervisor: Not Applicable O Name of License Holder : �'�~� �° 0'?o 70� License Number d S x 4! Address Expira n D e $ig re Telephone SECTION I3_.WORKERS' ti, NSA TI ON A?dS RANCEAFFIDAVIT,{.lyl G L c I52,§25Cj6J) :-I A 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....... [Y No...... 0 Version 1.7 Commercial Building Permit May 15,2000 SECTION 9; PR©FESSIONAL DESIGN AND CONSTRUCTION;"SE-RVICES -FO ,_l3UILDINGSAN D STRUCTURES SUBJECT TO" CONSTRUCTION CONTROL PURSUANT TO 780 CMR"116 CONTAINING MORE THAN"35",Pqp C"F OF"ENCLOSED SPACE) " 9.1 Registered Architect: Not Applicable ❑ 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 �llJ .t�/4zr� v� /2c°� lc.�� SrO�c r ceps �L Not Applicable ❑ Company Name: Responsible In Charge of C structi/on y n Address S ture Telephone Versionl.7 Commercial Building Permit May 15,2000 7.Water Supply(M.G.L.c.40,§54) 17.1 Flood Zone Information: / 7.3 Sewage Disposal System: P--"Public Private ❑ Zone: Outside Flood Zone g/ Municipal 91-Oh site disposal system ❑ 8. 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 arldn #of Parking Spaces 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: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW L,' YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT 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 _�� NO IF YES, describe size, type and location: -2 �'X/Z ff-15Oc.-e /;�&-Z—AoG r� D. Are there any proposed changes to or additions of signs intended for the property?YES No IF YES, describe size, type and location: /�.tf _5 Z5 ' le Ct a�U . 5rerle'-171" Versionl.7 Commercial Building Permit May 15,2000 ,,SEC,SEC,TTON4--Z0XSV1W, flN l�i� R RO EC I£SS T#iAN :�;II�B OIIBICEEIOFNCISEI� AL"f � µ c Interior Alterations Existing Wall Signs Existing Ground Signs Additions❑ Roofing ❑ Q-11 ❑ ❑. Exterior Alterations Demolition❑ New Signs [1l Change of Use [ ] Other [ ] ❑ Accessory Building [ ] Repairs [ ] BRIEF DESCRIPTION. vlr. SIX 57&,-- V yl�/ Y,, SECTION S-,USE GROUP ANi3�STiZ1�C�DN: E 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 ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I-1 ❑ 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 Speafy:�G�.��. 15 r l L. O F- l-fr-;-- S Special Use ❑ Specify: G C© lP.fL E IS It J i '1�QsTING )ERGOIN 011 T OA15; 1TIONS A111DJ CHANGE I1V IJSE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): 1SEC71ON=6 BUIItING,IIEb AND 1e1REA �� r BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION M ' Floor Area per Floor(sf) 1sr y � � G ��{1 211d :.:v„� 1st \ dx3y x� 2nd `� / — rd 3 rd th th a »w Total Area (sf) Total Proposed New Construction (sf) Total Height(ft) 010 Total Height ft- ------- µ Versionl.7 Commercial Building Permit May 15,2000 - - --- pity of Northampton ilding Department { 212 Main Street i Room 100 OCT 1 6 20-03 1hampton, MA 01060 phone 13- 87-1240 Fax 413-587-1272 oT t j giliLDINGINS,'fGii0n3 RUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECiIfl�l� �ITE� �fORiN1ATION�'R ' , . R&��s 1.1 Property Address: Y f 4;54 Y{pSt�iWC � f�'x� is � SECT3aN ,PROPERTY 01NNERSI3PUT#�OiEDJ1f ENT 2.1 Own r of Record: 3 N Current Mailing Address: X -Z/C3 1--19S3 SikaWF4 Telephone 2.2 Authorized Agent: 23 7vxl6 s Name(Print) Current Mailing Address: 2-S' Signa Telephone SECTIiDN 3.=ESTIIN1iTEDONSTitIICTION COSTS Item Estimated Cost(Dollars)to be Official se Onl completed by ermit applicant 1. Building -*�'o Cam_ Perm t f;=!e r 2. Electricaltim Total Cost� f 3. Plumbing Si>tld�ngPem�tee 4. Mechanical (HVAC) Fire Protection 5 6. Total = (1 + 2+ 3 +4+ 5) .3 U _5�b MCheck Nurntier.. 7'Sv Budding=;PernaitNumber t3ate issued Signature: Building�Commissioner/Inspector of:Buildings, Date r File#BP-2004-0437 APPLICANT/CONTACT PERSON Diversified Construction Services ADDRESS/PHONE PO Box 168 (413)253-2798 PROPERTY LOCATION 7 STRONG AVE MAP 32A PARCEL 152 001 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid OU30 2M / ,S-0 Typeof Construction: INSTALL PANELING,LIGHTING,ANSUL SYSTEM RECONNECT APPLIANCES New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 030787 3 sets of Plans/Plot Plan THE F9LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 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 mmission 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. y 11[ 7 STRONG AVE BP-2004-0437 GIs#: COMMONWEALTH OF MASSACHUSETTS MU Block:32A- 152 j CITY OF NORTHAMPTON Lot:-001 Permit: Building Category Non structural interior renovations BUILDING PERMIT Permit# BP-2004-0437 Project# JS-2004-0501 Est.Cost: $30500.00 Fee: $117.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: A3 Diversified Construction Services 030787 Lot Size(sq. ft.): 3746.16 Owner: TRIDENT REALTY CORP Zoning: CB Applicant: Diversified Construction Services AT. 7 STRONG AVE Applicant Address: Phone: Insurance: PO Box 168 (413) 253-2798 BELCH ERTOWN MAO 10070168 ISSUED ON:10123103 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL PANELING, LIGHTING, ANSUL SYSTEM, RECONNECT APPLIANCES 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 si nature: Feel e: Receipt No: Date Paid: Check No: Amount: Building 10/23/03 0:00:00 2330 $117.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo