25C-085 (6) J JAM
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Metcalfe Associates
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142 Mo!n Sveet
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01060
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Ant,;r«,,,ro
Ann - Marie M o g g i o
STi4EET COO/ID1/✓ATE'.SJJTEM
CONDOMINIUMS
X — ,3G 700. 77S
/Y led. 23 8 Bridge Street
Northampton , Ma. 01060
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' AD O/VG//NG TO _
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$ 6 �asartr(Ttrscttr'
DEPARTMENT OF BUILDING INSPECTIONS -
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 `
WORTER'S COMPENSATION INSURANCE AFF'IDAVTT
(licensee/pernlitzee)
with a principal place of business/residence at:
f1
l' '`Ci �tr►r
C. t hie q (phone#)
(stT=Ucity/stald2�p)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insu a'- Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
'~ (Name of Contractor) (Insurance Com /Poli Ntunbcr iration Date)
Pang c7 ) ( P
r.
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additioml thoct ifnoo=vy to irwl informalioa pertaining to all oxrtx otz)
I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeowncn who employ pasom w do mx i �coasfruciioa or repair work on a d mtdag of
not more than throe units is winch the howeowner resides oc oa the g<ourxfa gTurtena ih=to arc not wally oo=ukred to be
employers under the Worker`s oompcnsaiica Act(GL152,,s 1(5)�application by a homcownrr for a licc a or pcmit may cvidcnoe the
legit statue of an employer uoder the Wockeet Oompcosation Ad.
I undast=d that a ooPY ofthia ttatemeEd maybe forwarded to the DcputmY of lad,x as Aoddmts'O>hoo of Insuttanoa for the
coverage venficatioo and that failure to scenes covaago under suction 25A of MGL 152 can lead to the impoudOa of aimmal pcaaltics
oomisting of a fine of up to S1,500.00 andlor imprisonmerd of up to one year and civil pen&1 ies in the form of it stop Work Ord--and a
farm of 5100.00 a day against me.
gPermit tmcaul arse only
Ntunber
('.�. Lot#
s F Sign ature of Licensee/Permittee Late
Version 1.7 Commercial Building Permit May 15,2000
, r
SECT10N�0 S Rl CTU,RAI-PEER',EVIEW6{780C>{IR �i011)
.b.�,... .. .. .
Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑
SECS#ON 11 OWNER AtiTHORIZATION TO�BE C011APLE7ED WHEN
OWN£RS AGENT Oil CONTi2ACTR APPLIES=FOR I3UILDIIG PERMIT
z
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
I, !1'l 11 /c` /1'10T Cato 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.
111,11#0_1 'd Alar7(516
,P -Ngme
Signature of Owner/Agent Date
SECTION CONSTRt1CTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
SECTION 13 WORKERS"COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c 152,§'325G(f))
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...... ❑
' Versionl.7 Commercial Building Permit May 15,2000
3 33?�f 3 r3 1 3 a3 a,3, ,�»'fx
ECTiO�V ,,¢x FESSIknAL DES GN 3 ND CQNSRUCTlU SER1/ICES FOl2 UILDINGS/1ND S R CTIIi� UBJ G7 Tp-70,+ a7 ,ar X33 1� 3 w ?z` e I s 3 3 'W iH lY � r'w ,�
CONS`CRUIT CO'NTR� PUR511N 1'T�'780' l�f1�2116.(COtVTA�1I1VG ,MORE THAN 3500 .`.F QI:,E E{ #�ACE)
9.1 Registered Architect:
t 17 14e�"Ga� � Not Applicable ❑
Name(Registrant): !i
2-- Hot t u. 1",4 �v14,�`� rt"` Registration Number
Address-
r. 5 77 f Expiration Date
r�
Sign ure 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
`J n Id" C 0?,r,4 Not Applicable ❑
Company Name:
1/ME,
Responsible In Charge of Construction
Address
S-34- `� S
Sig ure Telephone
Version 1.7 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 91- Private ❑ 1 Zone: Outside Flood Zone ff" Municipal OrOn site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size 13 t 76, r 1' (1
Frontage
Setbacks Front
Side L: la R: L: R:
Rear 1511� I ( � r7� r
Building Height 14 , 14 r
Bldg. Square Footage �00 % ( ,00 �D
Open Space Footage %
(Lot area minus bldg&paved `o tg 0 h goo hF
parking)
#of Parking Spaces 7 '
Fill: D
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book 1� tip` Page b0�� and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T 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: f(GL 12A
D. Are there any proposed changes to or additions of signs intended for the property?YES
No 11'
IF YES, describe size, type and location:
Version 1.7 Commercial Building Permit May 15,2000
SECTION CONSTRUCTMIN SERVICES F
P-
A'k.0 JECTS+�.ESSATHAN 35;00D `
. g ��mENCLOEC}SPC
7 p
Interior Alterations Existing Wall Signs Existing Ground Signs .Additions ❑ Roofing ❑
C3' G]-- [ice
Exterior Alterations Demolition]3�' New Signs [ ] Change of Use [-] Other [ ]
[v Accessory Building[ ] Repairs [ ]
Vp,me
2 per P02 t'ttor�s 1�0 � r � Ur-+1T', CN,' t NtW LN(MV00
SECTIONS' USE GROUP AND CONST#3131"IEO�7YE :;
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 113 ❑
B Business UK, 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H Hi Rh Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 313 Cg's
M Mercantile BI- 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility 0 Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECT ION IF;EXISTiNG BUILDING UNDERGOING'RENOVATIONS,ADDITIONS+AND/OR CHANGE IIV USE
Existing Use Group: M Proposed Use Group: ,
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): 1
SECT01V,6 E3U�LD[NG HEIGHT AND AREA
{
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
Xf
Floor Area per Floor(sf) 15t �
1st t P 2nd x , �
�s
nd E' 3 rd
4th � s
3rd r t�;
r.
4th 0 LI y
Total Area (sf) Total Proposed New Construction (sf) 7:
-------------------------------
Total Height(ft)
m
Total Height ft .................... ' v
_ Version 1.7 Commercial Building Permit May 15,2000
i of Northampton
r�! 2x02 I ing Department
2 Main Street
Room 100
1'1'"1u71uNNorth mpton, MA 01060
Aw 5 -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
N
S 1 ECTIO `��SITE INFORMAT10N'
„�����������Th�s sec ion t e=c PI.,.ed` cer
1.1 Property Address: � �� � � �/�j
2 V Y CX-F. uS-T, I
a
y: y. B�lstr c
111 q,
Elm St Dastrlct
S.ECTION:2-PROPERTY OWNERSHIP%AUTHORIZED AGENT
2.1 Owner of Record:
Name Print < Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
iN e(Print), } Current Mailing Address:
_"'j
Signature Telephone
SEC'�ION,3=`'ESTIMATED CbNSTRUCt10N3ed T5
Item, . v.:_ . .. . _ ... .,. x.,.
Estimated Cost(Dollars)to be °Offica,� Use 'nfy,
completed by ermit applicant � -
1. Building (a) Building Permit Fee. ;
2. Electrical NA (b)Estimated Total Cost of
Construction frorn' :6 , '
3. Plumbing _Buildirg Permit Fee
4. Mechanical (HVAC) �A
5. Fire Protection
6. Total =(1 + 2 + 3 +4+ 5) 000� ,check Nurnber
7�is,5ectionor Official Uge Onl
IM„ ....
Buildrrig Perrnit Number
Date Issued:
3 z
Signature '
Date
°,Duilding Commissioner/lnspe°tor of` ,ufldin s
f,:
File#BP-2002-0636
APPLICANT/CONTACT PERSON JOHN SCALIA
ADDRESS/PHONE 66 BEACON AVE (413)532-4856
PROPERTY LOCATION 238 BRIDGE ST
MAP 25C PARCEL 085 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinjz Permit Filled out
Fee Paid
Typeof Construction: DA TIDE INTO SEPARATE UNITS WITH PARTITIONS&INSTALL NEW WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 068554
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
/-/`/-off
Signature of Building Off c 1 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.
. P BP-2002-0636
COMMONWEALTH OF MASSACHUSETTS
` CITY OF NORTHAMPTON
Lot:-001
Permit: B u i I d i ng
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2002.0636
Project# JS-2002-0999
Est.Cost: $8000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: 3B Contractor: License:
Use Group: B,M JOHN SCALIA 068554
Lot Size(sq. ft.): 13764.96 Owner: MOGGIO MARK A
Zoning:URB Applicant: JOHN SCALIA
AT: 238 BRIDGE ST
Applicant Address: Phone: Insurance:
66 BEACON AVE (413) 532-4856
HOLYOKEMA01040 ISSUED ON:1114102 0:00:00
TO PERFORM THE FOLLOWING WORK.-DIVIDE INTO SEPARATE UNITS WITH
PARTITIONS & INSTALL NEW WINDOWS
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 1/14/02 0:00:00 1360 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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238 BRIDGE ST BP-2002-0636
GIS#: COMMONWEALTH OF MASSACHUSETTS
MV:Block:25C-085 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2002-0636
Project# JS-2002-0999
Est. Cost: $8000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class:3B Contractor: License:
Use Group: B,M JOHN SCALIA 068554
Lot Size(ss .f1j: 13764.96 Owner: MOGGIO MARK A
zonin :URB Applicant: JOHN S CA L I A
AT: 238 BRIDGE ST
Applicant Address: Phone: Insurance:
66 BEACON AVE (413) 532-4856
HOLYOKEMA01040 ISSUED ON.1114102 0:00:00
TO PERFORM THE FOLLOWING WORK:D I V I D E INTO SEPARATE UNITS WITH
PARTITIONS & INSTALL NEW WINDOWS
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:Q#,(' 6 -7-00-
THIS PERMIT MAY BE REVOKED BY THE C17 OF NORTHAMPTON UPON VI LATION OF p
ANY OF ITS RULES AND REGULATIONS.
4
Certificate of Occ anc ���Sfiznature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 1/14/02 0:00:00 1360 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo