17C-218 �� fie �oawmanaear!b! o�✓��i,�uu,�ur�u,C�a
Board of Building Regulations and Standards License or registration valid for individui use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 149288 Board of Building Regulations and Standards
Expiration: 12115/2009 Tr# 263459 One Ashburton Place Rm 1301 Boston,Ma.02108
Type: Individual
TIMOTHY J LUCE .-1�_.• j
TIMOTHY LUCE
122 AUDBON RD. ----
LEEDS MA 01053 Administrator `rrot< id without signature
lta�r:tihu,ctt.- Drpa+•tntrnt Fit'Pul►lir`�:tfet`
8(►ard Of Building Res:ui:ttions and Stan(lar•d%
Construction Supervisor License
License: CS 100515
Restricted to: 00
TIMOTHY LUCE
PO BOX 14
LEEDS, MA 01053
Expiration: 7/15/2012
( nmri��i ncr Tr#: 100515
F ° ': oy5 lJ7f�7 of �QTO1;fljc1111pf011
•' 4 �I LJ LRCiI fIGCII6 � -
DEPARTME11T OP DUTLDrnG INSPECTIONS
212 Main Strcct ' Municipal Dodding
Northampton, Mass. 01060
1t71,1ORICEIZ'S COi1 TENSATION MSURA-NCF AI'MAVIT
(phone.!
--- (sur�.tic�tylsia>_c�n p)
do hereby cerwy, under Lhe p?_ins and penalties of perjury, '--ha.l
( ) I am an employer providing the Following \",orher's comncnsa�on cove:-ale for Iny
eiuplovccs wor-.,ing on this job.
(Lri-r Conn: v) (PoUc-, Nu_-arr'r)
(' ) I am a sole proprietor, general contractor or horrieovY-ner (citcie one) and l?cve h1led
the coop actors bsied below who hive the foiloW2ng WOrf.ef s Gomne;lt2hon policies:
(i'ra!1)C 0i C0a'^CiOr) (in'umnc: Coinoan)"/PVL)Ci N1LLML--:)
(Name of CootT2cmr) -- Ojisuancc. ComDa n-i?o!ie Numccr) (-Lxpimiion Date)
(?`amt of Co=cItof1 tssr c CGmy auyirtrGLCj i :llL�'r'1 L:<VTull Daic)
I
(T`amc of Contractor) (Las-u=c-- Comcauy/Policy Numb`f) (Expo-.600 Da-Lc) .
(an�Gi]�;;�!s_'uC if oocci=.r} to a1GU�inforcv..'i on p�'txia.as w.1J 000s-.rn�)
( "1 ! a sole proprietor and have no out work--ing for me.
( ) I a-ma home owner performing all the work myself.
NOTE:plesc be ew-arc tti.•tit:Jc bemcov.v�J�-bo clzplay p�—z w w r--xs+•--,•-„'�r~--`•;.e�oo c-rrnu work cc r d--ll-�of
cot mxc t;_:.L'.so-_tmrj in wbn h Lb,bormowncr,a d,or as the Q-ouar!J z-rp.:rtra:r_tbec'.n t:;Doc�ocatty o_�c:,dcv�to be
e�tployc-�urY.e the..o.-S`er:a ,�c_.im Att(GL152=1(5)x=.ppid=i6on b-f a bomeoa-ocr fm c bt=v_«Ixsmi rr_y c id=ce tre
I,PJ n:.nai or—--?I-y.<under dw World.Co.V--j�o A,,x.
I undQn_Lad tb->Dopy of(hu cat.---,d—y ba forxnrctcd to Lb,Doport—, l°
cover s vai6=600-nd the L•_iha-c t.o caurc F.avoce-se rmdC s-1 6on 2 SA of MGL 151 oz ted to Lb, Qioa o!cim.inil p:a.lii
ooaai oft SDC of UP to S 1,500.00 and/or iMvri of rrp to 01,c ycs Lod 6%iJ pcnttac to�form of>Stop Work Ord--and e
stb oC S 100.06 L d_y L pir=1 to
Permit Number
Si�Zturt- f LiccnscrlPct7niucc —� _._ __ .J
Versionl.7 Commercial Building Permit May 15,2000
t..
SECTION 10-STRUCTURAL PEER"'REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Require! Yes Q No 0
SECTION 1'1 -OWNER AUTHORIZATION -TO BE=COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDINGPERMIT
I Ar � � �tiCL as Owner of the subject property
hereby authorize' , l`^" J �''J - —to
act on my behalf,in all matters relative to work authorized by this building permit application. _
2
Signature of Owner Date
I, )- nO 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 peri�� �
Print Name
Signatur6 of Owner/A Date
SECTION 12-CONSTRUCT.ION SERVICES:
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
ZC
Addre Expiration Date
Signature Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE-AFFIDAVIT(MIG.L.-c.- 1[52,§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 buildin ermit.
Signed Affidavit Attached Yes No 4
r
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT70 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
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
I
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
2
Name Area of Responsibility
� I
Address Registration Number
I
I
Signature Telephone Expiration Date
i
Name Area of Responsibility
Address Registration Number
E
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In C arge of Construction
Address
ature Telephone
Versionl.7 Commercial Building Permit May 15,2000
NORTFIAMPTOlY ZONING, r,.
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R:' L:L-1 R:i
Rear
i
BIdg.Square Footage %
Open Space Footage %
(L.ot area minus bldg&paved I
azlan )
#of Parking,Spaces
Fill: ---- -- —
(volume&Location) — - IL
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DON'T KNOW 0 YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page, and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES 0
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 0 NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES N0
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 0 , NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version 1.7 Commercial Building Permit May 15,2000
f..
SECTION 4 CONSTRUCTION SERVICES FO R-.PROJECTS:LESS THAN 35,000
GUB,IC FEET'OF ENCLOSED.SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ RoofingLy' Change of Use❑ Other❑
Brief Description :Enter a brief description here.
Of Proposed Work:
zlL
SECTION 5-USE GROUP AND CONSTRUCTIQN,TYP
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 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 ❑
1 Institutional ❑ I-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 TF EXISTING BUILD ING.ilh1DERG01NG RENOVA fIONDDITtONS-AND/OR CHANGE IN USE
i .
Existing Use Group: ! Proposed Use Group:
Existing Hazard Index 780 CMR 34): 1 Proposed Hazard index 780 CMR 34):1
SECTION-6 BUILDING HEIGHT AND AREA
OFFiGE,7SE ONLY
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION NvM¢ x
x - x
Floor Area per Floor(sf) -
�� � '�
Z R
1st -
1 St
2nd
nd
2
3rd '� �
rd
3F F
to
m
r x —� s
Total Area(sf) Total Proposed New Construction�(sf) s
nr
a °
Total Height(ft) 2s kx
Total Height It t
� x
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
[3p8r Cner3t tISBR-! fir s
Gi of Northampton Stoma s ' Q
" mss^ .- ..�
8ta lding Department Coln eway rrn�t�
n 25
292 Main Street SewerlSepcuarfabl{rt
cI
Foom'100 alUaterJ Neilialabt( �
Northam ton, MA 01060 T�no SesoS ucturalab sue `
ptiane 41-31! -11 40 Fax 413-587-1272 P1ofiSi e tars �
APPLiEATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
_SEG2tON 1=--SITE-INFORMATION'
—- -- t-Property Addr/es : T,Ytrs sectron to be compCeted byoffice
;Zone a{Oarertay Dis�nct
` •b Etm St?Dlstr�ct � C8 D�sirrct �-
SECTION 2-:PROPERTY OWNERSHIP/AUTHORi2ED AGENT
2.1 Owner of Record:
Name(Print) ,�//J Ci4�/� ��tG Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
t'T►► Low 90 3o� �� �,-- A
Name(Print ` Current Mailing,Address:
Signal: r Telephone
SECTION 3--'ESTIMA D CONSTRUCTION<GOSTS
Item Estimated Cost(Dollars)to be Of tcial Use-Only
completed by ermit applicant
1. Building I _(a)Building,--Permit-Fee
2. Electrical ; .(ti)Estimated Total-Cost of
! ; Construction from 6
3. Plumbing y I Building PennifFee
4. Mechanical(HVAC) i a
5. Fire-Protection I —
& Total=(t +2+3+4+5) I A 1; Check Number o?4 97W 7-77
_
-This-Secfion For.Officiii"else Ohl
Building Permit Numlie�
Issued
t
Signature:
Building Commissionertlnspector of Buildings Date
B P-2009-0338
G
Is#:
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: BUILDING PERMIT
Permit# BP-2009-0338
Project# JS-2009-000461
Est. Cost: $10000.00
Fee: $60.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: TIMOTHY J LUCE
Lot Size(sa.ft.): 6490.44 Owner: LAFRANCE GERALD D& SANDRA K
Zoning: GB Applicant: TIMOTHY J LUCE
AT: 29 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
P O BOX 14 (413) 387-9800
LEEDSMA01053 ISSUED ON.912512008 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
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 9/25/2008 0:00:00 $60.001057
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo