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25A-185 (42) . � C RANDALL E. ROBERTS General Contractor MA Lic#042573•HIC Lic#104873 Commercial•Industrial•Residential•Renovations•New Construction 7 -6 . V ., 1/i 7 Yi'`�`5, 4 Construction Drawings by h V44 RMD U ROBERTS { GENERAL CONTRACTOR ; For Our Use Only �t4v4 e <1 cl� . G+°" - ;+w.r�'+* " #'° i 9 �+.,:. �•an.�.q� y{yam + ,y ! �r. e, ? � � _x A �' ■,iF� � �;.4 �N4 i�S.rsrv� � �-.ariy� k,�y:..i �:�� ' a� �Ga ti� (rri f ��cr� ifjalll}�to11 A E �idstr{(i nsrlt's' - DEPARTMENT OP DUILD0\1G INSPPCT101.'S — 212 Alain Street ' Municipal DmIding Northampton, Mass. 01060 ';VOTUCCR'S COJYMENSAT`ION MSURANCE AFFMA1 Tj` -t-AVIN V)- (li cxnsxlncrmi t 1cc) _��-�-�t-i��ci�al-pl-d-E -e-f=b>=t�iz�€ss1r-�-s-ire-t���-t:-����.-�"•� �_ . ` (sTr=.t/ci ty/sl=/z,P) do hereby certify, und7Lc pai nm and penalties of pcgury, h?i ( ) I am an employer providing the followine �,orkcr's coinocns-ndor, covcmgc for 111y emptovecs worjang on Lies job: (=8 IT OZOO 10-20 -5,6 (Folic: ?:u_bcr) --- F::-pirz or,Du_) - - O I am a sole proprietor, geaeral contractor or homeowner (c' cie one) and have hired the coal actors fisted below who hive the follotvinP, Worker's cOMJenSaDion ac!icies: ((+aID: Oi CORr 1Ci0") (lRR mncc- Coinozm)•1PoUc-, Numl--) tExi IF-au-0n Dalc) - (Name of COn(racior) _ (Insurance Comoa.ny/Poi1Cv \u.nc^_r) (Expiration Date) (Name of CCOt1II3C10:) (Insura;aec Compan)•/PoUq- Numb j) (Expi-m6on Date) I I (Name of Counctor) (Insurance Comcaay/PoUcy Numb-.r) - (E?pifil600 Dale), (aa�Gtl •r4i:;;ocz1 L'uct tf aoccr��to mctu�informs;oa pcstainins to d11 ooa�'-...G.o:a) O I am a sole proprietor and have no one working for me. ' ( ) I am.a home owner performing all the work myself. NOTE:plcsc be do-Arc it- tje b.. c -Ocrs�+-bo anploy Pez w W r.:{-i=L z e e� n c rrnir vori .d..c1L.�of an<@OCt iheD l�"fb_1^1rJ la lc.�f.�lb[t'KT[DOOk'DC1 7TSlC j OC O�LbC�D•Ja(,.]2�ryp;Yjrn•rt,b, o-C]:.d.7Ltj Lo be cnploycs u�c the. { arc--,im An(GL152=1(5)).apportion by n bomnoaoc f,=c bc=r-:oc permit a_y n-rkncc(t-c Iegr1 etuau of da-Moyer under do Wortiole Co�oa AeL I unZcmt d the a copy of this ml—ovy bo foe-rnuded w tbo 13.9-tarn¢of four d AecdeMi'Office or t6. oove>�—lc=ioa-rid th_t L-il=c to scan bov &,r 25A cf M01-13'2 ew lrsd to the'=pos*r;oa of ciminsl peaaWczs oomir=)E ofd fine of up to S 1-500.00■ndf r orup to oar ye r d edit p..11io in t'x form or.Stop Work Order dad s r=of 5100.00 a day eFpjtjsj t� For u-only Pcrmi1 Nu mbar Lot Sit* zlum of Lic�ux/Pcrmiucc y r Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL P R PEER REV EW'&66 dM ` 011} r_ Independent Structural Engineering Structural Peer Review Required Yes Q No Q SECTION1 1-OWNER AUTHORIZATION-TOBECOMPLETED.WHEN: OWNERS AGENT OR CONTRACTOR APOLI I&FORBUILDING'PERMIT 1 � j J 42 rY• rJ n ',as Owner of the subject property hereby authorize' to act on my behalf,in all tters relative to work authorized by this building permit application. signature/ f fner Date I,L J 2 m e j L 2 n 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. Si ned under the pains d enalties of Pe" t Print Name / z3/n Signature of Owner/Agent' Date SECTION-12-CONSTRUCtION;SER1/ICES 10,1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date At Signature Telephone SECTION 13-WORKERS''COMP.ENSATIONINSURANCEi4FFIDAV IT 1 -G L..c:"152;°§25C(6)j Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit wiii resuit in the denial of the issuance of the building permit. Signed Affidavit Attached Yes , No 0 r i Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND:CONSTRUCTION SERVICES-FOR BUIIDINOS AND STRUCTURE$S_UBJECT.TO CONSTRUCTION CONTROL'PURSUANT`TO 780'CMR 116(CONTAINING MORE THAN,35,000 C.F_OF ENCLOSED-SPACE) 9.1 Registered Architect Not Applicable i Name(Registrant): Registration Number i Address I Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): r Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility I 1 , Address Registration Number j Signature Telephone Expiration Date # I Name Area of Responsibility Address Registration Number i Signature Telephone Expiration Date Name Area of Responsibility i 1 Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor { i Not Applicable ❑ Company Name: f Responsible In Charge of Construction i I Address S Signature Telephone 3 Version 1.7 Commercial Building Permit May 15,2000 1pR•�'[a�tbtP'c�N�01�TIi�7 ,r- a. Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size i Frontage ` ! Setbacks Front i 3 Side L:' I R:= L: R:'_� I Rear Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved t ? i i I parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Re istry of Deeds? NO 0 DONT KNOW YES 0 IF YES: enter Book Paged and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 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 0 IF YES, describe size, type and location: Q Q c oe ` D. Are there any proposed changes to or additions of signs intended for the property? YES NO IF YES, describe size, type and location: 3 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 O ` NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ► 1 Versionl.7 Commercial Building Permit May 15,2000 t.. SECTION 4=,.COAISTRUP', Tl SERvickS, ROJECTS ZESS THAN 35.0 CUBI,CEEETOF;ENCLOSED SP-ACE Interior Alterations 4)ff 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 here. j Of Proposed Work: ; j v' iYlc rl rti"""TTT SECTION-5=USE GROUP AND CONSTRUC USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly El A 71 ❑ 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 ❑ 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:i S Special Use Specify: { COMPLETE TPIIS;SEC ,I"O[1 TF EXISTINGBUILD'fNG UNI3ERGOII G RE N -S;.ADpMO.NS ANDfOR:CHANGE 1N USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34):i Proposed Hazard Index 780 CMR 34): i SEC7ION`6'BUILDIN0'HEIGI TAND eREA; BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) . St ist nd 3 rd Via. """ at���,ryay.�,.�c.�;•.,, ,��„� ; t 4"' 4cn # Total Area(sf) Total Proposed New Construction(sf) Total Height(ft) �b Total Height ft ^� w 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❑ Versionl.7 Commercial Building Permit May 15,2000 City of Northampton a Building Department 212 Main Street Room,100 Northampton, NSA 01060 phone 413-587-1240 Fax 413-587-1272 -. APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING �._ _.SEC.TtORI::�_ SITE iNFORMATIOt�I` _ :_ �����r ,�'tt��ec#,on to"be cocup[eted��r°ofEi'ce� --- -"-ProPetty Addres / S .-4 I �"*�a'nee �z+eifa�D"rstrrctr �, ! �* 1-M-M � � . a SECTION 2 i'RQPERTY QWNERSHIPiAf3THORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: U 010 D Signature Telephone ���� ' v/ / -S 2.2 Autbuorized Acienj i IAL Name(Print) Current Mailih Address: 7 G v Signature Telephone 0 D o SECTI0FF:3-.ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to beOffi�ial Use Ontq completed by ermit applicant 1. Buildin g > r l ` P0ldlh g Pen� tFee 000 2. Electrical © {ti)Esttrriated Total Cost of ? QU Q _ 00 ! ! Constriction Xrom"-6 n =. 3_ Pli�mbina .--� Butl�ingPeiinitFee 1,X4 is , o0 4. Mechanical(HVAC) ; 5.Fire Protection ~— 3 i 6. Total=0 +2+3+4+5) Check Numbe O s 00 This-See6on'For.DfFiclaftjsaaril Building Permd plumber; uDafe - AsWed 3 Z lao � _ r Signature: eu7ilding•Commissionedl6s6-f of-Widings Date BP-2006-1007 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-1007 Project# JS-2006-1491 Est. Cost: $9000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RANDALL ROBERTS 042573 Lot Size(sq.ft.): 950914.80 Owner: COCA COLA COMPANY THE zoniqg: GI Applicant: RANDALL ROBERTS AT: 45 INDUSTRIAL DR Applicant Address: Phone: Insurance: 41 HEMENWAY RD (413) 367-9385 WC LEVERETTMA01054 ISSUED ON:312812006 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT WALLS IN UPSTAIRS OFFICE 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 3/28/2006 0:00:00 $50.004144 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo