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17C-227 (31) 4 P z N 4 . v 9911RR F a i r t v . �3ii 4 �•t a� +'�.. yM - s , y w ` C Pe-,7.77 iJ ,F�: 3 3 rr � < ». v, .M • Y �$/��y < �`e.. iii:�.d�. � Y �,�.,� .}. � »-�F" .�yy# � ice^ � ����. •,iY1 s r s MOW t- O��1 VJ•t PLO ;.. - - �> _n L7f a11I:p 0 .l R 8 rlla3aachnjccIIs' u. DEPARTMEAfT OP BUILDrI\,G INSPPCTIOI.'S 212 Main Street ?Municipal Building .e j Northampton, Mass. 01060 WORBT.- Z'S COiYTEMSA'I.ZON MSURA_NCE : 1 FMAA11-I' (li ccusxlperm�ttcc) - \VI h a principal place ofbusiness/residence at: Z-T �r��cx-✓►e� 5 -- -7 (phone.') ��' Z 56 -73 (s�tJci t`r lsZalLt a p) do hereby cerdf,, under dic.pain.s and penalties of pef3ury, h�I ( ) I aIa an employer providing the following!%vorkces colnocns-r�3ior,. coverage for lily 1 employees ivor>Dng on tills job: 7 i Q�sur-anc Conan.•) (Pol . N- unor) — (�:-p i _no r. D2t`) 1 ( ) I am a sole Proprietor, eneral contract or 1lomeowDer (ci c;e one) and have hired i the Coalractprs Used below w)10 ve the '10up vipS worker's coi pen_tabon policies: k-A 0";amc Of con=Ci0r) (Inswznc: CoInpan /hoUci !4unLC) (Y';:)1i-auon D.-itc) / � 1 I — _ (Name of Conirmor) (1ns,uzn ComozzyRoliev NUMccr) (Exp maon Date) (Name 01 Connac lo,-) (insuraac; Company/pOUCY Numbcj) (Expimdon Date) I (Name of Conlractar) (1lZSUIa1Cr Comr,any/Policy N{Imbcr) il=l�irtion DaIL). (aII1L11 .d.'..-^..-OC31 s3cd.irncc.�t•to alc!uc�=-iafbl + oa P=-L .as to'U oc,C_­tv:a) - O I am a sole propnetor ana have no one working for me. I ( ) I zln..a home owner performing all the work myself. NOTE:pl=.=be GVYZre tfi*•Kti�je bCc�OV aC 3 to C.Z Icf p,=--=to dJ - cs r ao a reyar-err.ca. of oac more the a t' oe�i.+in.•mod the bomoo+nc m do or ca the p ouneta z7purt�thee,c c we C� Uy oecrd. d to tic csploycs I, e the K cc=pc...,-c.A=(GLI52sa 1(5)1 a-pplin.Ooo by a bomaoava fc a lid_-or pcmi'try evidmoc trc Icp.I R-•..x of ea c=Ployer uoder d.o Wade.Coc�a Ad ' I uodcsxynd dut a oepy of tbi,c=-*.:d may be r.r- -daa to the Dryertm.�¢of In�.snJ Mcde 0[roe or 4z+u+ooe for for covcrasc�e iretioa aad tlLt Lilta a to senuc)cov�tCc tmdc socion 23 A aC I{QL 152 as led to the i^a?ositioa of eimiaal peasllia coosi aiag or a rise of up to S I}00.00 ILroc"iaqruoczm-.,n of up to ooe yr=r gad civil pc a-huo in Cc form of s Stop Work Orde aad a ri=or S I00-0o z d_y tvLi=me - 1 For - 1 44-tai.. I.f'zn: LO[ St�.—alrc of Li<_—__sc-JPcnniuc:. u3ce -- J A_ 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 �-!®gTYr1t� i'►'pp �.. .seGl�" o V 1L� "�.�� „ , as Owner of the subject property hereby authorize �r .t _ ,�..� I. . ... L� - _ ._..1 .a ,,._.. act on my behalf, in all matters relative to work authorized by this building permit application._ i ( `a to tur"fner Date ... I, .__.. „ n,.+1L°�. .,.. IT !�. 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 ga ms and penalties of per ury .... , Print Name Signature O ner/Agent Date SECTIO •CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ _. Name of License Holder:i_ (ws Q%. ., �Q4•� ,.. License Number d ss Expiration Date Signature Telephone I -T- SECTION'13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G L.c. 162,§26C(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 b ilding permit. Signed Affidavit Attached Yes W No 0 Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 36,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: ...... ....... .._. ...._ ..,.,..,._ Not Applicable El Name(Registrant): ..... .,....... . ... ... ...n. �..�,,, Registration Number Address E Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): i Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility _.... __ .,....., _..__... __._... _.._. __. ............. .......... .r_.. Address Rqq stration Number E Signature Telephone Expiration Date ............. i Name Area of Responsibility Address Registration Number . _.__.._......... , i... _.._. ..._..._....... _....... -- i i .,. ..�.., ......i ...... .......... ........ ..........._�„. Signature Telephone Expiration Date Name Area of Responsibility i Address Registration Number . ...... .... . .. . .. �_._.. �..... ..�,.. . _._ E 3 Signature Telephone I Expiration Date 9.3-General Contractor a , _... ..._ .1 .SIAiYCU( f .f�1....... S....... . , ,,, _.._ Not Applicable ❑ Company Name: �.......E .. .. Responsible In Charge of Constru ion lr l h �_ f Address A13 Z!1.777'3 Signature L Telephone Version 1.7 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 Side L. ........_. R.`.._.... L __ R� __? J .. .. Rear _ r Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved _ _,..., L. __ parking) #of Parking Spaces Fill: (volume&Location) ...... .w.._...,_ ....,,_ A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW Q YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW (g) YES IF YES: enter Book Page and/or Document#' ... ... B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 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 Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q ._....._ 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 Q NO Q 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 ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Otherig description Brief Description Enter a brief .. here. Ia'9WI I.xr• w.WIL;a"tt&4 G�.cl� -/wt�• l�crptc.� eats Of Proposed Work: VUIMc�tJv✓S f�1104k SIC�i. dux •- 1rti7pW �vvAte skdtvw S4vA1. 6xeL t**,oel, SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 113 ❑ 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 ❑ 513 U Utility El Specify: M Mixed Use El Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group. Existing Hazard Index 780 CMR 34):E::­1'1' _ __ _ ._ __..... _ Proposed Hazard Index 780 CMR 34). _- SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so St ....... ...... .... ___.....,..,... 4 1 s� 2nd 2nd . rd (._ 3rd _..,_.._ _a_....... . __.. 4m 4 th Total Area(so Total Proposed New Construction (sf) ._ m_m .... ._.. Total Height(ft) ; �Z Total Height ft 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❑ Version 1.7 Commercial Building Permit May 15,2000 De rrt use© � City of Northampton Status it Building Department Curb tuew @It � 212 Main Street Sews' eptic Miilty ��sn !^ ► — �` Room 100 �, r_ �C eflWeil a bih Northampton, MA 01060 Twq' etsturi�ll�r ' H� -phone 413-587-1240 Fax 413-587-1272 I �otl5tea N ' APPLICATION TO CONSTRUCT, 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 Map 17 Lot 27-7 Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY''OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: Name(Print) ��L ��� Current Mailin Address _ ............... Signature Telephone SECTION 3 E4T61ATED CONSTRUCTION 6STS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee gym....:._ .. ........... 2. Electrical (b)Estimated Total Cost of _ Construction from 6) ...._..... 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) _..._.___.... i 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-2006-0697 APPLICANT/CONTACT PERSON NATURAL SIDING ASSOCIATES / �yQ.Q- — ADDRESS/PHONE 27 IRELAND ST WORTHINGTON (413)238-7773 Cp 7�" / _3 PROPERTY LOCATION 16 NORTH MAPLE ST MAP 17C PARCEL 227 001 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 T_ypeof Construction: INSTALL SIDING&TRIM REPLACE SIDE WINDOWS/DOOR&REPLACE ROTTED BOTTOM PLATE SECTIONS New Construction Non Structural interior renovations Addition to Existing, Accesso1y Structure Building Plans Included• Owner/Statement or License 075119 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Commis Signature of Building Official 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. 16 NORTH MAPLE ST BP-2006-0697 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-227 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0697 Protect# JS-2006-1048 Est.Cost: $20000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NATURAL SIDING ASSOCIATES 075119 Lot Size(sq. ft.): 6838.92 Owner: VALLEY COMMUNITY DEVELOPMENT zoning:.GB Applicant: NATURAL SIDING ASSOCIATES AT. 16 NORTH MAPLE ST Applicant Address: Phone: Insurance: 27 IRELAND ST (413) 238-7773 WC WORTH I NGTONMA01 098 ISSUED ON:11412006 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL SIDING & TRIM, REPLACE SIDE WINDOWS/DOOR & REPLACE ROTTED BOTTOM PLATE SECTIONS 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 1/4/2006 0:00:00 $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo