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44-014 (8) this Agreement represents and warrants that he or she has full authority to execute this Agreement on behalf of,and to bind to the Agreement,the party on whose behalf he or she is signing. 14. Limitation of Liability. In no event shall any party hereto be liable to any other party hereto for special, incidental, indirect, punitive or consequential damages, Including loss of revenue or profits, In connection with this Agreement. The parties hereto have caused this Agreement to be executed as of the day and year first written above. SBA Network Services,LLC T-Mobile USA,Inc. By: B Name: 1�cy`►a.Q �J/ Dave M Named o Terhonlagy Stfat y, ance& eveiopment Title: ��t��i"t�l�`Gic°� Title: CONFIDENTIAL AND PROPRIETARY TO SBA _ i intent of any of the terms of this Agreement. This Agreement will be interpreted and enforced in accordance with Its provisions and without the aid of any custom or rule of law requiring or suggesting construction against the party drafting or causing the drafting of the provisions in question. S. Notices. Except for purchase orders issued pursuant to Section 1,above,all notices,demands or communications required or permitted under this Agreement will be in writing and delivered by hand or mailed by certified mail,return receipt requested,postage and registration or certification charges prepaid,or by nationally recognized overnight courier service,to the party entitled thereto at the address first set forth above,or such other party(ies)or address(es)as either party specifies by written notice to the other from time to time. A purchase order issued pursuant to Section 1 above shall be deemed to meet the requirement,if any,under the applicable Tenant Lease that the TMUS Affiliate Is to give notice regarding removal of the Equipment from said Tower Site, 6. Attorneys Fees and Costs. In the event of any litigation or arbitration arising out of this Agreement,the prevailing party will be entitled to recover all expenses and costs incurred,including reasonable attorneys'fees and costs,from the non-prevailing party. 7. Assignment. No party to this Agreement shall have the right to assign any of its rights or Interests in this Agreement to any entity or person that is not a party hereto,without the prior written consent of the other party to this Agreement,which may be withheld by such other party In its sole and absolute discretion. 8. Governing Law. This Agreement will be governed by and construed and enforced in accordance with the internal laws of the State of Florida without regard to principles of conflicts of laws. 9. Integration. All prior understandings and agreements between the parties with respect to the removal of Equipment from Tower Sites,as described herein,are merged in this Agreement. Neither party is relying upon any statement,covenant or representation made by the other party with respect to such subject matter which is not embodied in this Agreement. 10. Amendments. No purported amendment to or waiver of any term of this Agreement will be binding upon any party,or have any other force or effect in any respect,unless the same Is in writing and signed by the party to be charged. 11. Further Assurances. Each party will,from time to time,execute,acknowledge and deliver such further Instruments,and perform such additional acts,as the other party may reasonably request In order to effectuate the intent of this Agreement. 12. Third Parties. Nothing in this Agreement,whether express or implied,is intended to confer any rights or remedies to any persons other than the parties hereto and their respective successors and assigns,to the extent permitted pursuant to the terms of this Agreement. 13. Authority,This Agreement constitutes a valid and legally binding obligation of each party executing this Agreement.The execution of this Agreement,and the transactions and performance contemplated hereby,have been duly authorized by the requisite action on the part of each party. Each person signing CONFIDENTIAL AND PROPRIETARY TO SBA of this Section shall in no way be interpreted to(i)create any new termination rights under any Tenant Lease,or(il)amend,modify or repeal any environmental or other indemnity obligation under any Tenant Lease. Ownership of the Equipment shall be transferred to SBA(or its designated other SBA Affiliate)upon SBA's(or its designated other SBA Affiliate's)receipt of the applicable purchase order as described above and payment of the Fee In full to SBA(or its designated other SBA Affiliate)from the applicable TMUS Affiliate.T-Mobile and the applicable TMUS Affiliate represent to the SBA Affiliates that T-Mobile or the applicable TMUS Affiliate is the owner of the Equipment. EXCEPT AS EXPRESSLY PROVIDED HEREIN,ALL WARRANTIES AND REPRESENTATIONS OF ANY KIND WHATSOEVER,EXPRESS OR IMPLIED,FROM OR ON BEHALF OF T-MOBILE AND THE APPLICABLE TMUS AFFILIATE AS TO THE CONDITION,QUALITY,MERCHANTABILITY,AND FITNESS OR SUITABILITY OF THE EQUIPMENT FOR ANY PARTICULAR USE OR PURPOSE ARE HEREBY EXCLUDED AND DISCLAIMED BY T-MOBILE AND THE APPLICABLE TMUS AFFILIATE. SBA(or it designated other SBA Affiliate)and T-Mobile together with the applicable TMUS Affiliate acknowledge and agree that it is their intent to herein convey to SBA(or Its designated other SBA Affiliate)at the time of the payment of the Fee the entire right,title,and Interest in and to the Equipment described herein. Additionally,SSA(or its designated SBA Affiliate)and T- Mobile together with the applicable TMUS Affiliate agree that no individual bill of sale is needed for the transfer of the described Equipment to be effective. Upon transfer of ownership of the Equipment to SBA(or its designated other SBA Affiliate)pursuant to and in full compliance with the terms of this Section 1,the applicable TMUS Affiliate will have no further duties or obligations under the related Tenant Lease with respect to removal of the Equipment from the applicable Tower Site. 2. Default and Remedies;Acknowledgment of Separateness of Existence. If any party to this Agreement is In breach hereof,the non-defaulting party shall be entitled to all remedies,at law or In equity,as a result of such breach,but such cause of action shaft only be against the breaching party. Any default under any Tenant Lease shall be governed by the default and remedies provisions contained in such Tenant lease,and in no event shall any event of default under this Agreement give rise to any right of any party hereto or to any Tenant Lease to terminate or seek any remedies under any Tenant Lease other than as such breach relates to the particular Tower Site and is a breach under such Tenant Lease. The commitments of the parties hereunder shall be the several,and not joint,commitments of the parties hereto and no party shall be liable for any obligation of the other party under this Agreement. In connection with the bankruptcy filing of any party to this Agreement,each party to this Agreement agrees that it will not in any manner use the existence of this Agreement as evidence that any other party to this Agreement should be consolidated with the bankrupt party in such bankruptcy proceeding. 3. Term. The term of this Agreement shall commence as of the effective date set forth above and shall expire two(2)years from such effective date,unless otherwise extended in writing by the parties hereto. 4. Interpretation. The singular includes the plural and the plural Includes the singular. The word"or" is not exclusive and the word"including"is not limiting. References to a law Include any rule or regulation issued under the law and any amendment to the law,rule or regulation. References to a Section mean a Section contained in or attached to this Agreement. The caption headings in this Agreement are for convenience and reference only and do not define,modify or describe the scope or CONFIDENTIAL AND PROPRIETARY TO SBA • E E AGREEMENT FOR REMOVAL OF EQUIPMENT This Agreement for Removal of Equipment("Agreement')is effective the 1 day of\)i 2014, by and between SBA Network Services,LLC,a Florida limited liability company with an ad ress at 5900 Broken Sound Parkway NW,Boca Raton,FL 33487,for itself and on behalf of its tower-owning affiliates ("SBA", and together with its tower-owning affiliates,the"SBA Affiliates",and individually,each a"S Affiliate")and T-Mobile USA, inc.,a Delaware corporation,with an address at 12920 SE 38'h Street, Bellevue,WA 98006,for itself and on behalf of Its affiliates(`T-Mobile",and together with its affiliates, the"TMUS Affiliates",and individually,each a"TMUS Affiliate"). WHEREAS,TMUS Affiliates have entered into tenant leases which were formerly MetroPCS leases pursuant to which they lease or license tower and/or ground space from SBA Affiliates(each such former MetroPCS lease,a"Tenant Lease")with respect to the tower communications facility described therein(in each instance,a'Tower Site"),and WHEREAS,T Mobife has requested that upon expiration or rightful termination of any Tenant Lease,the applicable TMUS Affiliate has the option to leave certain of its Equipment(as defined below)at the Tower Site thereunder for removal and disposal by SBA; and WHEREAS,SBA has agreed to perform such removal and disposal of Equipment upon the terms and conditions set forth in this Agreement. NOW,THEREFORE,in consideration of the foregoing premises and the mutual promises and agreements contained herein,the parties to this Agreement agree as follows: 1. Removal of Equipment. For any Tenant Lease between any TM US Affiliate and any SBA Affiliate with respect to a Tower Site that the applicable TMUS Affiliate terminates in accordance with its terms or does not renew,such TMUS Affiliate shall have the option of(I)removing all of its property located at the applicable Tower Site In accordance with the terms of the applicable Tenant Lease or(ii)paying SBA (or its designated other SBA Affiliate)a fee of Eleven Thousand Five Hundred Dollars($11,500.00)(the 'Egg")and not removing the applicable TMUS Affiliate's coaxial lines,antennas,TMA's,empty shelters or cabinets and any other equipment attached to the applicable tower or adjacent on the ground (collectively,the"Equipment"),provided(a)the applicable TMUS Affiliate timely Issues to SBA(or its designated other SBA Affiliate)a purchase order containing a provision which states that upon SBA's(or its designated other SBA Affiliate's)receipt of such purchase order and payment in full of the Fee to SBA in connection therewith,the Equipment will become owned by SBA(or its designated other SBA Affiliate)and T Mobile and the applicable TMUS Affiliate relinquish all ownership rights to such Equipment,(b)such payment of the Fee is made in full within thirty(30)days following such TMUS Affiliate issuing to SBA(or its designated other SBA Affiliate)such purchase order,and(c)all property of the applicable TMUS Affiliate other than the Equipment(such other property to Include but not be F limited to electronics,batteries,generators,fuel tanks and equipment within a shelter)must be removed by such TMUS Affiliate in accordance with the terms of the applicable Tenant Lease. The terms CONFIDENTIAL AND PROPRIETARY TO SBA DocuSign Envelope ID:213D7395-7E6D-4800-BiB6-822148A341A4 N . . . .M Il � e SQ) SBA Site# T-Mobile Site# Decommission Date NH02249-S BOS0687 8/29/2014 N H47173-A BOS0665 8/29/2014 NH02307-S BOS0661 8/4/2014 MA14297-A BOS0654 7/29/2014 MA12206-A BOS0652 7/25/2014 MA11556-A BOS0639 8/8/2014 MA46692-A BOS0630 8/1/2014 MA12213-A BOS0613 8/28/2014 MA13732-A BOS0571 8/1/2014 MA46701-A BOS0540 8/26/2014 MA46689-A BOS0535 8/3/2014 MA03532-S BOS0522 8/26/2014 MA07276-A BOS0500 7/30/2014 MA41212-T BOSO462 7/24/2014 NH13785-A BOSO404 8/29/2014 NH13778-A BOS0399 8/29/2014 NH2O094-A BOS0397 8/29/2014 MA07717-S BOS0396 8/26/2014 MA13710-A BOS0378 8/6/2014 MA30044-M BOS0353 9/10/2014 MA03056-S BOS0348 8/27/2014 MA46705-A BOS0340 7/31/2014 MA07669-S BOS0304 8/6/2014 MA41206-T BOS0271 7/25/2014 MA41202-T BOS0230 8/25/2014 MA46707-A BOS0211 8/28/2014 MA13734-A BOS0152 8/5/2014 MA06496-A BOS0137 8/26/2014 MA12750-A BOS0131 8/5/2014 MA13736-A BOS0116 8/27/2014 MA41203-T BOS0045 8/25/2014 MA04712-A BOS0040 8/25/2014 MA41200-T BOS0008 8/21/2014 DocuSign Envelope ID:213D7395-7E6D-4800-B1B6-B22148A341A4 WE r SBA Site# T-Mobile Site# Decommission Date CT12219-A NHC0169 7/28/2014 CT02694-8 NHC0153 7/17/2014 CT03538-5 NHC0111 7/28/2014 CT03110-S NHC0052 7/17/2014 NH47174-A MAN0025 8/1/2014 NH47171-A MAN0016 8/1/2014 NH07567-A MAN0013 8/19/2014 MA46695-A HYN0038 7/24/2014 CT46126-A HFC1516 7/21/2014 CT11558-A HFC1502 7/21/2014 CT03801-S HFC1500 7/18/2014 CT46134-A HFC1499 7/18/2014 CT01080-5 HFC1494 7/18/2014 CT01725-A HFC1457 7/17/2014 CT95919-L HFC1394 9/18/2014 CT07824-S HFC1282 7/24/2014 CT04382-S HFC0755 7/18/2014 CT08558-B HFC0754 7/18/2014 CT13062-A HFC0636 7/17/2014 CT13063-A HFC0612 7/21/2014 CT02216-5 HFC0386 7/21/2014 CT46124-A HFC0331 7/24/2014 CT01498-S HFC0025 7/18/2014 MA02260-5 BOS1142 8/6/2014 MA08178-A BOS0771 7/30/2014 MA08179-A BOS0767 7/21/2014 MA46693-A BOS0761 7/31/2014 MA06224-A BOS0749 9/4/2014 MA10710-A BOS0729 7/30/2014 MA07279-A BOS0722 7/30/2014 MA12221-A BOS0717 7/30/2014 DocuSign Envelope 1D:213D7395-7E60-4800-BiB6-B22148A341A4 ■ n ■ ■M bi e ■ SBA Site# T-Mobile Site# Decommission Date MA11629-S PVD0152 7/31/2014 MA12220-A PVD0150 8/4/2014 MA20024-A PVD0120 7/21/2014 MA11606-S PVD0117 7/21/2014 R197704-L PVD0082 7/23/2014 R140272-T PVD0068 7/24/2014 8108737-A PVD0036 7/23/2014 R196062-L PVD0028 8/1/2014 CT13076-A NLD0067 9/22/2014 CT13556-S NLD0044 8/28/2014 CT09680-S NLD0036 8/29/2014 CT13074-A NLD0023 8/29/2014 CT01493-S NLD0022 8/29/2014 CT03241-S NLD0021 8/29/2014 CT00595-S NLD0015 8/29/2014 CT11561-A NLD0003 8/29/2014 CT00235-B NLD0001 8/29/2014 CT46149-A NHCO597 7/17/2014 CT13071-A NHC0594 7/17/2014 CT00252-S NHC0488 7/17/2014 CT33762-M NHC0477 7/17/2014 CT97402-L NHCO462 7/24/2014 CT13070-A NHC0412 7/17/2014 CT02722-S NHC0375 7/18/2014 CT13616-A NHC0322 7/17/2014 CT46138-A NHCO279 7/28/2014 CT46128-A NHCO274 7/17/2014 CT01499-S NHCO170 7/28/2014 DocuSign Envelope ID:213D7395-7E6D-4600-B1B6-B22146A34iA4 ■ ■ ■ ■Mobile SBA Site# T-Mobile Site# Decommission Date MA08741-A WOR0084 7/28/2014 MA95911-L WOR0083 8/19/2014 MA09985-S WOR0064 8/19/2014 MA12209-A WOR0062 7/24/2014 MA13740-A WOR0061 7/24/2014 MA46700-A WOR0059 7/25/2014 MA46681-A WOR0052 8/6/2014 MA08745-A WOR0049 8/5/2014 MA00713-S WOR0044 7/28/2014 MA12229-A WOR0035 8/19/2014 MA04528-B WOR0029 7/24/2014 MA08736-A WOR0028 7/28/2014 MA06223-A WOR0026 8/5/2014 MA08744-A WOR0019 7/24/2014 MA13741-A SPM0232 8/2/2014 MA12216-A SPM0144 8/4/2014 MA09875-5 SPM0103 8/2/2014 MA13720-A SPM0093 8/2/2014 MA13729-A SPM0092 8/2/2014 MA13216-A SPM0089 8/4/2014 MA08544-5 SPM0087 8/2/2014 MA13210-A SPM0085 8/19/2014 MA13208-A SPM0076 8/5/2014 MA13219-A SPM0047 8/2/2014 MA13731-A PVD0280 7/23/2014 MA13742-A PVD0268 7/23/2014 R114814-A PVD0256 7/22/2014 R113847-A PVD0248 7/21/2014 R113381-A PVD0245 7/22/2014 MA06901-5 PVD0241 7/31/2014 R147739-A PVD0233 7/22/2014 R147732-A PVD0227 8/1/2014 MA41201-T PVD0206 7/23/2014 DocuSign Envelope ID:213D7395-7E6D-4800-BiB6-B22148A341A4 M Schedule 1 to Equipment Removal and Transfer Notice SBA Site# T-Mobile Site# Decommission Date NV09869-S VGS056 7/29/2014 NV21299-A VGS228 8/20/2014 NV47300-A VGS224 7/28/2014 NV20207-A VGS208 8/16/2014 NV11758-A VGS206 8/6/2014 NV12842-A VGS184 7/31/2014 N V20346-A VGS179 7/21/2014 NV09981-A VGS178 7/28/2014 NV20345-A VGS177 7/21/2014 NV33728-M VGS167 7/21/2014 NV20347-A VGS161 7/21/2014 NV20201-A VGS160 7/21/2014 NV12841-A VGS157 7/21/2014 NV47339-A VGS156 8/1/2014 NV20185-A VGS155 7/21/2014 NV47323-A VGS144 8/4/2014 NV12290-A VGS112 7/21/2014 NV20057-A VGS105 7/29/2014 NV20102-A VGS095 8/4/2014 NV20862-A VGS093 7/28/2014 NV40196-T VGS089 8/5/2014 NV20045-A VGS079 7/21/2014 NV20051-A VGS077 7/21/2014 NV10075-B VGS071 8/4/2014 NV20040-A VGS065 8/4/2014 NV20046-A VGSO47 7/30/2014 NV47288-A VGS035 8/25/2014 NV20058-A VGS023 7/30/2014 NV47325-A VGS017 7/31/2014 NV47325-A VGS017 7/31/2014 NV11466-A VGS005 7130/2014 NV98088-M VGS004 7/31/2014 MA04372-5 WOR0110 7/30/2014 i Docuftn Envelope ID:213D7395-7E6D-4800-8186-822148A341A4 e . . .M( l e 12920 SE 3e Street Bellevue,WA 98006 Equipment Removal and Transfer Notice SBA Network Services,LLC 5900 Broken Sound Parkway NW Boca Raton,FL 33487 Re: Equipment Removal and Transfer Notice("Notice") This Notice is being provided in connection with that certain Agreement for Removal of Equipment dated July 1, 2014(the"Agreement")by and among SBA Network Services, LLC, a Florida limited liability company, for itself and on behalf of its tower-owning affiliates("SBA",and together with its tower-owning affiliates,the"SBA Affiliates",and individually, each a "SBA Affiliate") and T-Mobile USA, Inc., a Delaware corporation, for itself and on behalf of its affiliates ("T-Mobile", and together with its affiliates, the "TMUS Affiliates",and individually,each a"TMUS Affiliate"). Unless otherwise clear from the context in which they are used,all capitalized terms used herein shall have the meanings given to them in the Agreement. Notice is being provided that: i) At the sites listed on attached Schedule 1, T-Mobile has elected to leave the Equipment as detailed in the Agreement; ii) For each site listed on Schedule 1, T-Mobile shall issue a purchase order for the agreed upon Fee of$11,500.00; iii) Upon SBA's receipt of the purchase order and the Fee, the Equipment shall be transferred to and will become owned by SBA("Transfer Date");and iv) On and after the Transfer Date, the applicable TMUS Affiliate will have no further duties or obligations under the related Tenant Lease with respect to removal of die Equipment. The sites listed on Schedule I were decommissioned during the months of July, August and September of 2014. Please contact Allan Tantilto at 425-383-2413 if you have any questions. Thank you. Sincerely, Fa7eayo Senior Vice President r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' I Congress Street, Suite 100 t Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): SBA Network Services Address: 117 Precourt Street City/State/Zip:Biddeford, ME 04005 Phone #:(207)282-4200 Are you an employer? Check the appropriate box: Type of project(required): 1.0 1 am a employer with 50+ 4. ❑ I am a general contractor and 1 employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working or me in an capacity. employees and have workers' g Y 9. E] Building addition [No workers' comp. insurance comp. insurance.t 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.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no Demolition employees. [No workers' 13.❑■ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors 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 must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Henderson Brothers, Inc. Policy#or Self-ins. Liic.��9:TC20UB475M4437814 Expiration Date:3/15/2015 Job Site Address: Cr `75, Od LQ,J I I C4-1)w V_d City/State/Zip: &IUMOUJ o Iwo 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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 2072824200 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Versionl.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 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. l Signature of Owner Date r 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 s nd I' erlu rr�_ Print Name . _e Signature of wner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License—Number Address Expiration bate Signature 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 builqipg permit. Signed Affidavit Attached Yes No 0 Vomiooi7 Commercial Building Permit May l5,20O0 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: 'I Not Applicable Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address ReRistration 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 Not Applicable 0 Company Name: Responsible In Charge of Construction Address Signature felephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size .. �. Frontage Setbacks Front e _ s Side L. .�eea� R. _�er®- L: ,lm�. � R.[ — Rear .... __ ._. Building Height m Bldg. Square Footage 3 °° % ` Open Space Footage �o % �o (Lot area minus bldg&paved parking) ®� #of Parking Spaces � Fill: 1. (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW a YES 0 IF YES: enter Book 1 Page; and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 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: N C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO 0 IF YES, describe size, type and location: 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 ef 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 [:1 Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration Eff Existing Ground Sign[:1 New Signs❑ Roofing❑ Change of Use[:1 Other —------------ Brief Description Enter a brief description here. —?,en-OV6A C6" P�t,�k tz4.� CM 1 3521:� Of Proposed Work: 1 —__ le— < _ QL6 0A as_J3� pv SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly El 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 ❑ 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 THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE F Existing Use Group: Proposed Use Group: L1___________1_11__ Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):ip SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) St I St 2 nd 2nd rd 3rd 3 to th 4 4 L Total Area(sf) Total Proposed New Construction(se D_ Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) N 7.1 Flood Zone Information: I'SW [T73 Sewage Disposal System: Public ❑ Private ❑ Zone=j Outside Flood Zon e — M unicipal ❑ On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 srtrrtet}tse #1y, , City of Northampton ,� rrtilt Building Department fi� 212 Main Street Sewer ` Il �HMut�nwr 'a � i ' ti9 B Room 100 tetl laE � oi"i� . 20 15 �; Northampton, MA 01060 ph ne 413-587-1240 Fax 413-587-1272 r# Se ads --� ; { � , e i Electrl Pu�[; ,,�Cas Inscec ions 51$� phi M TRUCT, 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 Old Map Lot Unit Zone Overlay District Sim St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: Pi Name(Print) Current Ma.ilin9 Address:. Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing w Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number (✓ This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-0730 APPLICANT/CONTACT PERSON SBA COMMUNICATIONS LLC ADDRESS/PHONE 117 PRECOURT ST Biddeford04005 (207)282-4200 PROPERTY LOCATION 254 OLD WILSON RD MAP 44 PARCEL 014 001 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 Typeof Construction: REMOVE 3 ANTENNAS&ASSOCIATED EQUIPMENT-T MOBILE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 071639 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOPMATION PRESENTED: AOApproved 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 emo ' ' elay Si uild' ffici Date J 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. 254 OLD WILSON RD BP-2015-0730 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:44-014 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2015-0730 Project# JS-2015-001421 Est. Cost: $11500.00 Fee: $69.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SBA COMMUNICATIONS LLC 071639 Lot Size(sq. ft.): Owner: AMERICAN TOWER CORPORATION C/O OMNI POINT Zoning: Applicant: SBA COMMUNICATIONS LLC AT: 254 OLD WILSON RD Applicant Address: Phone: Insurance: 117 PRECOURT ST (207) 282-4200 WC BiddefordME04005 ISSUED ON.1116120-15 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMOVE 3 ANTENNAS & ASSOCIATED EQUIPMENT - T MOBILE 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 1/16/2015 0:00:00 $69.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner