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06-044 (4) l �t i r r� 5 RS f S ta? f- -- „R4 i+`7:✓.;�t?..: -- �\ ' / ( It"C%StWI�!E N, ! --� � J" 7{. y BACK 40 VIEWS ANALYSIS MASTER PLAN / rte\ ,&, JUNE,2001 dho HEADQUARTERS JAY LE,'1NE a,, AARON SCHLECHTER CONWAY SCHOOL OF LANDSCAPE DESIGN 10 O 10 20 30 WIT SHFEf15'OF27 (r i i � .c f � --_- a E � �c�;fljallipjo)1 — �� f �las�r,rhncctta' _ DEP/-R T ME?,T OP DUILDD\IC INSPECT1O1.'S — 212 Main Strect • Municipal Doilding Northampton, Mass. 01060 ��'ORT41Z'S CONQ'ENSA'EON MSURA_NCE 1, -- ��-- �_-��L s°°✓ (Ii ccosrxJpcim�ttce> nth principal place of business/residence at: -/o Lc_,A r,rJ o�u,6 f:¢s ond. S-2 }7-alb (svt~t1c�ty/stab/a p) do hereby ceru.fy, Under Lh.e puns and penzlties of per)ury., i-hai ( } I am an employer providing the followint worker's comoens�Don coverage For Inv eluployccs tvor'.Dng on'uiis job: OM5U -:a= Comp, nv) (Polk; Nuser) ^- (r:-pir-a or Dzt ) O I am a sole propr,etor, general contractor or homeowner (circle one) amd have hued the cones actors listed below who have the following worker's co> oenczdon pc!icies: (N,gMC Of CO-^.t^C-,Or) Ori_—o 3nc^. CotIID17)'/Pobci Mara-'-) i_xpinjuOn Date) (Name of Coocracior) (Wsuranc-- Comoan)•fPoUc}, Nuabcr) (xp r,:tion Date) (Name of Co=mo,) 0-asurancc Compan)•IPoUq- N,lsbtr) (E.xpim600 Daic) (Name of Contractor) (L==C-- CompanyfpoL cy NUMJYZS) (Expiation Dale). (taAcb Addi-iocaj rboC ifnccc,". , =form�7oo pcYttinins w.11 000=ncv:�) (�a sole proprietor and have no one worming for me. ( ) I am.a home owner performing all Lhe work myself. NOTE:pl=c be tw�Lrc +uz•wL�Io bomco,,-r3 w-bo employ pcs=w do r--iri •o= r npair wonk on c d.•cll::Z or ant molt t1Ln L`ro =ru is u-bicb the bomw sae read,.a oo the p-ouo zppurt.co_nt tbeeo r_-c ooc C=�—-aDy w=.dcui to be cmployc-undc the w-kcr'S o=mpc=,ztioa applin600 by t botnnowoc fn:litx.or pcsmh r=y n-idmcc t1=c Ic-¢il M="of en esploye uader dw Wor+oer C.o¢Vomaijoa A. L I undcrrtaod di,a a oopy of tbia ca.t�may be focrardsd to tbo Dcpnrtmcw of 1nmruiJ rl.dmty omoo of lrrw+oon for tb. oovmtsc rcriresioa tad trLt L•.iltac to scauc`covczase uodrs suction 25 A of i.(oL t 52 oa tod a the L-.p iw of aimia l pcoslli,. oomis•iq of a Goc o(up to S 1,500.00■ttdror imgrtyocroc=orup to coc y=end civil peoejcs in the form ora Stop Work Order and a Cim of S 100.00 t dzy t{,-,.l=me For _ r.t u.c only 2 Permit 1(umbcs Map: Lot."_ t of Licaucc/Pcrmiucc :-: i Version 1.7 Commercial Building Permit May 15,2000 SECTdON 1U"S1rRUCT17RAL P £t RE111 f"(780 MR 110 11 Independent Structural Engineering Structural Peer Review Required Yes......0 No...... �-� `'SECTION 11 -OWNER AUTHORIZATIONr2`T�BECOMPLETED WHEN 0WNEf2S AGE NTOR=CONTRAOT0R APPL"IES'FDR BUILDING'`PERMIT' I, (A-Z n n e— n2i 1{,� �rl��.ec.�5 a� 1 z- 1„� (/SI T , as Owner of the subject property hereby authorize Ll�t,r-r-4 N�1 Sc� Y\ to act on m behalf, in all matters re ath to work authorized by this building permit application. a -3 gna re of Owner ate L, Yl h 1. as Owner/Authorized Agent hereby declare that the stateme 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. L( I E' C I 1 Pri t Name ®.� Signatu of Owner/Agent Date SDbT QN 12 Cfl1VSTR 7 ON SER11lCES 10.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder : L �JQti GrLSd / (--�,5 L or, License Number Address Expiratio IJA Kgnature Telephone ECTIQN 13 WORKERS'GOI�!IMNSATIO,N]NSURANCE AFF1 DAV1T{M G L c 152, 25C{ ) 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....... 0 No...... O /7 2 w Version 1.7 Commercial Building Permit May 15,2000 SECTION 9;PROFESSIONAL DESIGN AND CQNST,R66f1 N S`ER1ryCES FOR SUItDINGS� TID STRUCTURES SUBJECT TO C©NSTRUCT;ION CONTROL PLfRS�U"T T,,O'780,CMR'116ICPNTAItJING MORE.THAN 5 r 0 OF.Ei�ICLt3SED SPi10E) 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 Company Name: Not Applicable ❑ Responsible In Charge of Construction Address Signature Telephone t Versionl.7 Commercial Building Permit May 15,2000 7.Water upply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage posal System: Public Private ❑ Zone: Outside Flood Zone ❑ Municipal n 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 �y Side L:_,R:_,&2L L: R:_ Rear ' Building Height Bldg. Square Footage 30,90 % 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 YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ___(7N'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: D. Are th any proposed changes to or additions of signs intended for the property?YES_ No IF YES, describe size, type and location: Versionl.7 Commercial Building Permit May 15,2000 SO gig, �+ � + Interior Alterations Existing Wall Signs Existing Grou igns Additions❑ Roofing ❑ Exterior Alters ' ns Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] Accessory Building [ ] Repairs [ J BRIEF DESCRIPTION: wok Wti�q SEG'n01N!5--': St1'G NE X00 I C tIN�E USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly Io A-1 ❑ A-2 ❑ A-3 ❑ 1A 1 ❑ 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 9--' 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: �)MPI �SEE1EGr r1�16. .. {I ® ? 5, '0NSAQflRt7+fG `.IN°17SE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): S OX EIG1tI �ll � BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION S Floor Area per Floor(sf) 2nd rt� r nd 2 3� � . qg- 3rd th 4 th Total Area (sf) J?of Total Proposed New onstruction (sf) Total Height(ft) �� A Total Height ft�-�------ �� Versionl.7 Commercial Building Permit May 15,2000 City of Northampton ate=- uilding Department 212 Main Street Room 100 c- I rthampton, MA 01060 jpho -587-1240 Fax 413-587-1272 APPLIC ._ TO^CON ,REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING o OTHER THAN A ONE OR TWO FAMILY DWELLING w t" Vi --JFT 1.1 Property Address: � } a > fl �zRO�„Et� I+lERS1I1� 3A Gi1T 2.1 Owner of Record: I .C�, ILK �j Na a(Print) rreu�g Address: Sidnatuly Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone :SECi1113.-��TMAANSTGTZflNCflSI ` Item Estimated Cost(Dollars)to be Off 1c1al lase Orl1y' completed by rmit applicant 1. Building !`�i J J.l�� Bu>ld�r�gPerr �tee 2. Electrical mated TTxatal st�caf �AIStI14t9 i11 3. Plumbing 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 +2 + 3+4+5) 0 ber 15�eCtiOtpp!' CUal` 1se Orel ssUed Birdd�n Perm lumber'' � � to 9 r Signature: Building rComm issio`nerlInspectorof..Butdin s Date File#BP-2004-0087 APPLICANT/CONTACT PERSON LARRY NELSON ADDRESS/PHONE 40 WARD AVE (417)527-0165 PROPERTY LOCATION 241 HAYDENVILLE RD MAP 06 PARCEL 044 001 ZONE SR 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: CONSTRUCT 4 X 4 DECK W/ROOF&NEW ENTRY DOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 061674 3 sets of Plans/Plot Plan THLOWING 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 Commission .,/� "141-,-��lk 7• 3 Signature of Building Gricial 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. r!41 HA Yt t9Vft .`R'RD BP-2004-0087 GIs#: COMMONWEALTH OF MASSACHUSETTS t..,` ode:tib-ca CITY OF NORTHAMPTON Y Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2004-0087 Project# IS-2004-0131 Est.Cost: $14500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: LARRY NELSON 061674 Lot Size(sq. ft.): 1829520.00 Owner: WESTERN MASS GIRL SCOUT COUNCI Zoning: SR Applicant. LARRY NELSON AT. 241 HAYDENVILLE RD Applicant Address: Phone: Insurance: 40 WARD AVE (417) 527-0165 EASTHAMPTON MAO 1027 ISSUED ON.7129103 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 4 X 4 DECK W/ROOF & NEW ENTRY DOOR 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: Receipt No: Date Paid: Check No: Amount: Building 7/29/03 0:00:00 927 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo