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17C-197 (9) v T w-1 u1..aa-w rt •w-a« f v. .'p '. . yp ' EGS FtD�,®F`RUI [ rCo F EGULATI�QNS- ic �iseo, fis OW.'r'r N 1P ursaR A PC,,#rya'Qfiapl i I - .. Rdrn�nisYratot :( i G-tf ewosetl space I.�p (MC1r. ':112 S,60L) 1t1 IWaspn y onty h I 1 8 2 Family fdomes FOlu€e VWpossess a cureent edifidn of the iN�ssachus�tts 5tafet•Building Gods is Caus61 O ltevoEatlon of this IldbMe. a. " •DIG.SAFE CALL CENTER: (S$8)344-7233 CUMBERLAND FARMS,INC. Cumbe; • 348 ALLENS AVENUE,PROVIDENCE,RHODE ISLAND 02905 Farms PHONE:401-781-1730 TELEFAX:401.781-0620 January 03, 2000 To Whom It May Concern: Please be advised that Lucien Couture has the authorization to sign, as an owner of the company for permit applications only. Sincerely, Brian Tremblay Director of Store Engineering BT/jgm s ysr�e a tan . RECEIVED APR 17 2000 CUMBERIAtMD FARMS C0 ISTRUICT10"I CE:PA X? NT Server;gye - ,? s t vw r 4 R i 777 � I .� • . . Fro Cryii3 of �nz A 36Achnr(I16 — cn DEPAR T ME1r7 OP 13UILDING INSPECTIONS Version 1.7 Commercial Building Permit May 15,2000 SECTION 107 STRUCTURAL;PEERAEVIEW.(780,CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ SECTION 11i='OWNER AUTHORIZATION i-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT l 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, LL)C1 CO (2- -J 60 0� Q t as Owner AuthoriZof ent hereby declare that the statements and information on the foregoing application are true and accurate, to e est my knowledge and belief. Signed under the pains and penalties of perjury. I-L)C l ' �rJ C"y—. 0 (L Print N me Signature of Owner/Agent Date SECTION 12 -CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: ,�i Not Applicable ❑ Name of License Holder : h L)"� � /�--u C fk1 f 'Jr'L &-011 o -J" 7 License Number I& �2��1�� cL� l SCtc D Ad ess Expiration Date ,Lee,, A(i 15U4-�2- 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 affidavir will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 SECTION;,9-,PROF.ESSION,AL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CO.NSTRU&401N,CONTROL;PURSUANTITO 780 CMR 116(CONTAINING MORE THAN'35 000 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 Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature 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 ❑ Private ❑ Zone: Outside Flood Zone ❑ Municipal ❑ On 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 parking) #of Parking Spaces Fill: 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 Page 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: D. Are there any proposed changes to or additions of signs intended for the property ?YES No ✓ IF YES, describe size, type and location: Version 1.7 Commercial Building Permit May 15,2000 SECTION -,CONSTRUC7IdN SERVICES'FOR PROJECTS LESS THAN',35,000 CUI31,CIi= 7'OF ENCI_OSD SPACE Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ ❑ ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] 4 Accessory Building[ ] Repairs [ ] r z -s2v,,^r6'c e- f-4e �?9 v �4�� ', �l�� c — cu iitf �C�.av��✓ 01 c� SECTION 5,1 USE GROUP AND CONSTRUCTION TYPE • USE GROUP(Check as applicable) CONSTRUCTION TYPE_ A Assembly Io 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 ❑ 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: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE Existing Use Group: il°1 Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6,BUILD,ING`HIEIGHT.:AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION k1� ELSE©N1Y i / X `^' " Floor Area per Floor(sf) 1s1 �- 1st 2nd 3� A e � Z d 2r,d 3 � >` 4th : 3rd , f� 4th ia ti Total Area (sf) Total Proposed New Construction (sf) ` & s "g � s Total Height(ft) Total Height ft ------------------- lox F ^n 2, t CE Versionl.7 Commercial Building Permit May 15,2000 City of Northampton R Department d t5 W 2 Main Street om 100 rt ton, MA 01060 phone 41 5 240 Fax 413-587-1272 DEPT OF SUII-DING IN e APPLICTTO'N"'TOtklC ;' JR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION This.section o be comp�e#ed by office , 1.1 Property Address: �3 172,41A) S f�l`Lc�/e h1 Ce= IJ14 Map �'' Lot Un- 3� Zone Ovewlay,D�strict Elm St. District C13-District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 377 Hm i NWR A( M 20�/ Name(Print) Current Mailing Address: 22.S--'7-/r6 Signature Telephone 2.2 Authorized Agent: 3 N� J=;;1121ns Na e(Print) Current Mailing Address: w21 Ole ZTI Signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building c-,?--7ty (a) Building Permit Fee 2. Electrical _ (b) Estimated Total Cost of v Construction from_ 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3 + 4 + 5) Check'Number 1 This Section For Official Use Only' Building Permit Number: 61 Date Issued: Signature: Building Commissioner/Inspector of Buildings Date r File#BP-2001-0041 APPLICANT/CONTACT PERSON LUCIEN COUTURE ADDRESS/PHONE 348 ALLENS AVE (800)524-1701 PROPERTY LOCATION 53 MAIN ST-CUMBERLAND FARMS MAP 17C PARCEL 197 ZONE GB 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 HAND SPLIT SHINGLE FROM MANSARD&REPLACE W/ALUMINUM METAL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 057200 3 sets of Plans/Plot Plan THE eLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § _w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 AM _,4 qmmi `7- � � _0i Signature of Build Offici 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. 53 MAIN ST-CUMBERLAND FARMS BP-2001-0041 G1S#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C- 197 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category'Non structural interior renovations BUILDING PERMIT Permit# BP-2001-0041 Project# JS-2001-0069 Est. Cost: $3000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: LUCIEN COUTURE 057200 Lot Size(.ft.): 21387.96 Owner: VSH REALTY INC zoning: GB Applicant. LUCIEN COUTURE AT. 53 MAIN ST - CUMBERLAND FARMS Applicant Address: Phone: Insurance: 348 ALLENS AVE (800) 524-1701 Workers Compensation PROVIDENCER102905 ISSUED ON.7113100 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMOVE HAND SPLIT SHINGLE FROM MANSARD & REPLACE W/ALUMINUM METAL POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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 7/13/00 0:00:00 M030792 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo