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32C-045 (7) 86 PLEASANT ST-2ND RIGHT BP-2005-0268 GIs#: COMMONWEALTH OF MASSACHUSETTS Man:alock: 32C-045 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildlna DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A) Cateaorv: BUILDING PERMIT Permit# BP-2005-0268 Pro ject# JS-2005-0341 Est.Cost:$5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Grow: THOMAS KORYTOSKI 070047 Lot Sizelsa. fo: 7013.16 Owner: SUHER F,RIC Zoning:CB Applicant: THOMAS KORYTOSKI AT. 86 PLEASANT ST - 2ND RIGHT Applicant Address: Phone: Insurance: 39 LAUREL MOUNTAIN RD (413) 665-2106 0 HAYDENVILLEMA01039 ISSUED ON.•9114104 0:00:00 TO PERFORM THE FOLLOWING WORK:REMODEL 2ND FLR RIGHT BATHROOM 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: House p Foundation: Driveway Final: Final: CjA%/et Rough Frame: Gas: Fire Department Fireplace/Chimuey: Rough: Oil: Insulation; Final: Srtwke: Final: CK -a0'0 THIS PERMIT MAYBE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATIOF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy FeeTvpe: Receipt No: Date Paid: Check No: Amount: Building 91141040:00:00 1978 $50.00 212 Main Speer,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 96 PLEASANT ST-2ND RIGHT BP-2005-0268 GIS u: COMMONWEALTH OF MASSACHUSETTS 32G-045 CITY OF NORTHAMPTON L_nt: -00I PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS ren r Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate or BUILDING PERMIT Permit# BP-2005-Q268 Pmiea# 75-2005-0341 Est Cust $500(00 Fee:S50 00 PERMISSION IS HEREBY GRANTED TO: c nst. lass: Contractor: License: Use Groin THOMAS KORYTOSKI 07 U4747 Lot Su e(so.fr.): 7013.16 Owner: SUHER ERIC zoning_cB Applicant: THOMAS KORYTOSKI AT: 86 PLEASANT ST - 2ND RIGHT Applicant Address: Phone: Insurance: 39 LAUREL MOUNTAIN RD41( 31665-2106 (l HAYDENVILLEMA01039 ISSUED ON:9114104 0:00:00 TO PERFORM THE FOLLOWING WORK REMODEL 2ND FLR RIGHT BATHROOM 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 Dooartment FireplacelChinmey: 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 OccupanU Signature: FeeTvpe: Receipt No: Date Paid: Check No: Amount: Building 9/141040:00:00 1978 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2005-0268 APPLICANT/CONTACT PERSON THOMAS KORYTOSKI ADDRESS/PHONE 39 LAUREL MOUNTAIN RD HAYDENVILLE (413)665-2106 Q PROPERTY LOCATION 86 PLEASANT ST -2ND RIGHT MAP 32C PARCEL 045 001 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Perout Filled out Fee Paid Tyreof Constracti n' REMO L 2ND FLR RIGHT BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owned Statement or License 070047 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFEQTWIAUON 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 ofDeeds 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 Pernut from Elm Sheet Commission Signatureof 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. -Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. Versionl.7 Commercial Building Permit May 15,2000 City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANG�, P DEMOLISH ANY BUILDING OTHER THAN A ONE OR .FAMILY D i SECUOM3 SITE'_.su � /1TIOf'f':_ - I z 1.1 Pmmrty Address; 76 SEC110142 PROPERTYOWNERSHIP,JAUI}IORIIFD,AGENI„e^ 2.1 Owner of Record: yr Name(Riot) Cument Mailing Ad Signature Tele e 2.2 Authorized Agent: N�a'me(Print) / Z_ S CLrtHlt Mailing Atltlress: Telephone SECUON 3-ESTIMATED CONSTRUCRON COSTS Item Estimated Cost(Dollars)to be Offidal Use Only - com leted tyy pernilt applimnt 1. Building 3OdG) (a)Building Permit Fee 2. Electriml �'O>l %Estimated Total Cost or s. Constructiori from:. 3. Plumbing SOO Balding'Perlild°fee - 4. Mechaniml (HVAC) 5. Fre Protection - 6. Total = (1+ 2+ 3 +4 + 5) I ODd ,,Che"umber- S.- .. 7disSectidofar••,Offida7-Use'On Building PenndNrnn6er:.: ---- Signature: .. . - Building Comniisidr:er/Inspecm—of:Buildings Date Versionl.7 Commercial Building Permit May 15,2000 SECRON4£ONSIJUICIIOp CFSzFQR�l 0EEQ5m 07;Ooo �`� �'�,•� Interior Alterations Existing Wall Signs Existing Ground Signs Additions❑ Roofing ❑ ❑ ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] ❑ Accessory Building[ ] /Repairs 1 11 1 1 BRIEF DESCRIPTION: SECTION 5. USEGROUP ANDCONSTRUCTION USE GROUP(Check as applimble) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Burnes ❑ 2A ❑ E Educational ❑ 213 I ❑ F Factory ❑ F-1 ❑ F-2 02 ❑ H High Hazard ❑ A 3A ❑ 1 ImUtuUonal ❑ I-1 ❑ I-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential 10 R-1 ❑ R-2 ❑ R-3 ❑ SA ❑ S Storage ❑ S-1 ❑ S-2 ❑ 513 ❑ U Utility ❑ Specify: M Mired Use '01 Specify: S Special Use ❑ Specify: {pF1P,1ETET)iLSSEC[1pN'EF E)o571NG BUILDINCr-IINDERGOINGRENOVATiON51DDIfiONSA??D,�OR"CHANGE IN USE Exisbng Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6'BUILDINGNEiGNEANDAREA' BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION _ �6 s- Roor Area per Floor(so 2m m 3'a 41° ;l 4' q "' Total Area(so Total Proposed New Construction(sf) "x Total Height(ft) Total Height It Versionl.7 Commercial Building Permit May 15,2000 7.Water Supply(M.G.L c 40,§54) 17.1 Flood Zone Information: 17.3 Sewage Disposal System: Public ❑ Pmate ❑ Zone: Outside Flood Zone ❑ Munidpal ❑On site disposal system ❑ g. NORTHAMPTON ZONING Existing Proposed Required by Zoning This colo m to be filled in by Building Deparennt Lot Size Frontage Setbacks Front Side L: R: L: R. Rem Building Height Bldg.Square Footage Open Space Footage % (Lot area nunua bldg&paved #of Puking Spaces Fill: (volume&ImaHon A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 'X 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 X. DONT 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 Commercial Building Permit May T5,2000 ' SECTION 9-PRgdSSIOIjAL DESIGN j2ND CONSTRUCT{ON SERVICES -FOR BUILDINGS.4.ND SSRUdTURES SUBJECTTO CONSTRUCTFOI{CONTROL PUR517ANT TO780`CMR 116(CONTAINING MORE THAN':35,00�O Of'."OF,ENCL°OSEDSP�tCE) 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 �� ON Si -,7l'"' LC Not Applicable ❑ Com�pajny Name: �tO�tS ��0/'YtOS�Ir Responsible In Charge/of Construction '3 coir Ind Addre U(o 3`J $I nature � Telephone Version 1.7 Commercial Building Permit May 15,2000 SECTfONrL'q STRUCTURACPEER:REVIfW p i7R 110.1,1)__ Independent Structural Engineering Structural Peer Review Required Yes......❑ No__..❑ SECTIDN 11-OWNER AUTHORIZATION-TO SECOMPLETED.WHEN OWNERS AGENT,'ORCONTRACTOR APPLIESfOR BUILDING PERMIT I, 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, d//2A`r� % r)✓�ii✓ , as Owne[[-/Authorized Agent 1 hereby declare that the s ate ents and information on the foregoing application are true and accurate, tNfi;ZagV my knowledge and belief. Signed under the pains and penalties of perjury. Print Na Signature of Orifer/AgSdi, ate SECTION 12-C0NSTRUCTIQN1SERVI6ES, 101 Licensed gonstruction 5upervisor: Not Applicable ❑ m Nae of License Holder YJf GC i G ' S r� 7�yy? / L,6,n,e Nllniber tfaXle'l 411_ Addressp 103 9 Expiration Date 61. 4 00,/ 411, (v 6 57 Gam' Si; e Telephone SECTION 13 -WORKERS COM,¢ENSA}TIONYINS URANCE{4FFIDAVIT k .. _ 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....._ No ..... 0 r� of Qrit� of rz-tlq�nt}i ton A E - � .— ,o OEPNITMEI i OP DVIGDrNC INSPeC DONS 212 Mnia Strcct ' D3uaicipa[ IIai?dog tdorthamptoo, M.", 01060 R'ORI<1:R'S C01,TENSATION MSURANCE ^.PTMAVI-T (i-;ccvscl}xnxuttce; with a principal place of business/residencc al. 'a9 �a na✓� 2 v X ✓ /Y /H/ (phone) .— do hereby certify', under Lhc Pura and penalties of perjury, Ju! ( ) I ;.m ,.n employer providing the following .vori;cr-5 comocnsaoa covc:ac for Im etuployecs wor`dng on L:ws job. {(osurac Conc;sy)Conc;sy) . (Pelle:Nu.�ur) - .. (G"pir_uor, Dv:;) O(f I.zm a sole prooneror, general Coorrzc[or or homeowner (circit one) and bzve hired the coon anors listed below who have the follor worker's=Dt sz-oon policies: Lf 757 (Name a(Caa�-ic.o-) (In2rancc CnlnoanSlPcGc; Nucntul �3.prucoc Dnld - ("t:.mc ai Conmaor} (tunuznc G=ocmaaylPetie; NuLittr? (tceviuon Dvc) (Name or Ceeeamo ) (Lns,traa¢ Compwo/Po4c)- N'.urty) (EvDiruoo Dalc) {Name of Con¢aaor) (Insuraac Comc:oytPati:y Numtr:;} E�pir'tion Dat,) (.�,a,atrau.kc;rux�..�-w��er«n.3m rMw�ab.0 mcra�:.) Yx I am a sole proprieror and have no one woridog for me S ) I am a home oivoer performing all the work myself. NOTES en mm+L�v4c<�w��Nc Swnmaa Ruda«mtY-pvua.SVW+.'ec.beca a+az Cmc'.vv ave4-•e�u tc ®plays. ,w..Jsc..at��n�,u-z,-mna(GL1529I(5)?^wgrwwq.e�,aam rce:6e-=«wa^m_r�•:dms LLc IwMowad l6aampy Nya�a.YalwrWW bJv D.pvwaA nlbAY++J M1mhmY OQim olLwmlu�b � p"sa6Y+mGaum.aaUU Liluc b.muc mva>y +�u»vwISA NMOL 53�cw bdu�h.�,+wWm arawu.l pc�l�c vmas2y n(.(.oce(W�a SISW.Oow+M egsvrgry�o(vpbaryev eod o.Jp�a.�C,cf o(.Stet'w..t antr wtl. of SIOJ.nO.day.piuII me __ PMIDII Numur'+ —te, : SiDnaauc of crnilucc e' _.- A IF-- - s �� __ I, ', -__ _____ ___ _ � 0 . '' � .� -� '�� ;' � h � � � � / � � __ � Q' � 'I e �� � �' , � - _ _ _ � � � stiou�3�on�o_ muuna�,�� �;, b00? 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