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23A-070 (15) BP-2006-1189 s#: _ COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lor-001 Permit: Building BUILDING PERMIT pernma BP-2006-1189 Project# JS-2006-1759 Est Cosy 81161000 Eee. 50 00 PERMISSION IS HEREBY GRANTED TO: const.rh-Class: Contractor: License: LLe G-1Qun' DENNIS R BENZ 036856 t of Size(so ft L 71525.52 wrrerf MIDDLE HAMPSHIRE DEV GROL7P Zoning: GB Applicant: DENNIS R BENZ AT: 70 MAIN ST Applicant Address: Phone: Insurance: 686 LITTLE MOHA WK,RR 7_ (,413) 624-5505 COLRAINMA01340 ISSUED ON:5/812006 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE (2) DIVIDING WALLS TO EXPAND OFFICES & INSTALL COUNTERTOPS 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 BireplacelChimney: 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: FeeTvne: Date Paid: Amount: Building 51812006 0:00:00 550.005916 212 Main Street,Phone(4I3)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Paulin 4 Version1.7 Cnuauercial Building Permit Ma 15,2004 City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01080 phone 413-W-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,REPAIR RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING - 70 Udtt�jr dL{F:YyCL1G. GP6La'� I _ k1 � -' 1 F"�E,vc� Iv1a, �l sEenQNz ''ROPr RnowNeitsRPrADTHowz 2-1 Owner of Recwm- Name(p1m) C.nent Mailing Actress BiggNU(e Teispltom 2.2 Authorize¢Agent ^.... Name(Print) Cumene Mailing Agtlnss: Signature Telephgne .SEgbON 3,ESTIMATED CONSTRUCTION = Item Estimated Cost(Doilais)to be ; , _ OTficiati}se coin leted by mrnitapplicant 1. Building --m Btiltding.Pamut Fees a�T^ I . 2. Elechiml jr 64(0.6(5 (�ZEs4Cois ed ToWtC Sbt ate_ 3. Plumbing ` g,0. 6CS Build�rg.PerinRFee 4. Mechanical(HVAC) I' - 5-Fire Protection — S. Total=(1 +2+3+4+5) -CheckNumber _ ;._:Thr-Section+Eoc6igcial Use_Oni Bwldiitg8art71t15u7ab€[ -'Ongied Signaftrte: 8uitd' Cwnmisiknerngspecld*tff•Budevttn Data Versioal.7 Commercial Building Permit May 15,2900 r r.. A— MESE[LfT t�R3'R[fti~S-Yt, 531iAN33;00 .-.... Intedor AiterationeAR Existing Wall Signs ❑ Dennifftiong Repairs❑ Additions AccessoryBuilding❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing[] Change of Use❑ Other❑ Brief Description Enter a brief desc:riptlon here. ofPreposedwortcl.��rew'E{�J L�ailrvx,(r.7�CS '�EXpx.glp tasarry� q"$~C..��� SEctiSON-s:ttsE�RaDP-%N +3sSRUC�QN�Y2E'_ USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly &1 ❑ A-2 ❑ A-3 ❑ to ❑ __ _ A< ❑ A-5 ❑ 16 ❑ ... 6 Business-__--� 2A ❑ E Educational ❑ 2B ❑ F Factwy ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ i Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 36 M Marcanfilo ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A (� 5 Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Lilly ❑ SpeCity M Mixed Use ❑ Specify. ...... S Special Use Specify GOMPLM]F- TIS<SE,CTt, 9TI1l-DING13N13ERGOIfgGRf,NOVA'YtOtAS,'ADDMONS- D1ORCRANOE.IN USE Existing Use Group: I Proposed Use Group. Existing Hazard Index 780 CMR 34).F--] Proposed Hazani index 780 CMR 34Y. SECI9ON'SSUI[0I)Q01tE)GN.SD_` fE - BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION FkxxArea per Flow(sf) lou I .J P -1 a 4" Total Area(s0 ', i Total Proposed New ConstrucWn(sf) 1 J Total Height(ft) Total Height ft . ' 7.Water Supply(M G.L.e.40,§54) 7.7 F3, on ntormafieir 7.3 Sewage Disposal S}stam: Public ❑ Private ❑ Zone: Outside Flood Zone❑ Municipal ❑ On site disposal system❑ 2 - Versionl.?Commercial DwIding Permit May 15,200 Existing Proposed Required by Zoning Thu..I.w to fillal in by exude,rx� Lot Size Frontage — i Setbacks Fro i_J Side L-=' R"= L=RL= Rear Bldg.Square Footage JJ /a Open Space Footage (r '.rrris-bldg Bc,a i #of Parking Spaces Fill: mLrmf&Lxarion A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW © YES ® " IF YES, date issued: _ IFYES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW © YES IF YES: enter BookPaged and/or Document 8 B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW O 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 O NO O IF YES, describe Size, type and location: F— D. Are there any proposed changes to or additions of signs intended for the property? YES © NO 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 pian that will disturb over l acre? YES O ' NO Q IF YES,then a Northampton Stan Water Management Peanut from the DPW is required. Versionl J Cownercial Badding Permit May 15,2000 { SECTION S•PROFESSSIOpIAL DESEGIiAEIDLON5T711G#k SE[tVlGE6—Rb2$lltt,DtNtiSAND� BIl B,7ECI'f0 CONSfRt1 , ONC6 OLPUIf,$DYINT TO 7b9=C64't 116 jCbt}7A1R7}7G MORE' W- ,3$WOC.RO�� CLOSED-$PACE) 9.1 Registered Architect Not Applicable ❑ Name{Ragiscawt n �j Regisoabon Number Ad . !� Exp rabon Date.. S,onabae Tolapnone 9.2 Registered Professlohal Engineer(s): Name Amo al Resporsa ty _J Address kegatmibn Number 59rabrre Telepeam, E,,cewmn baa, Name Area of Responsbibty J Address ftWsmlon Number Signature Telephone 1 Etyimfion Date Name Area of Res ponslbility �. Atltlress r- Regisbation Number I Signature TelepYeme Ei irafiw Date i Name Area of ResponsU ty Add." Registration Number Sigr2Wre Tekpnone Expindion Date 9.3 General Contractor Nat Applicable Company Name: �ny1'rcr[�oY_r�r�re*� Responsble In Charge of Canstrtrction I S 7 i Add grrahuE _ Telephene I Version 1.7 Co anerciat Bonding Permit May 73,2600 r- SECTTON'I01wUCTURAL.PEERREWEW(TOD CMR910.}iv- _ !nd r�daM Stnrclurat Eqformenng Structural Peer Rewew Requiretl Yes Q No Q SECrTiON 11 OWNER AUTHORIZATION•TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR AUJILDINGPERNIT as Owner of the subject property t hereby authorize'_. 'to act on my behalf,m a0 mailers relative to vara aWlionzed by this building permit app0 anion. _ Signature of tamer Date I, .as OwnerlAuthomiad Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sin under the aims and enalti of e'u Print Name I Signature of Dwner ent' Date " SECTIONt2-.CORSTBUCTION`- £SEIO ES 10.1 Licensed Construction Suoetvisor. Not Applicable O Name of License Holder:' -t.��EU<;isF=�' '3 Ci: �-- txense Numtrer 16 Address Expkaticn Bate SQ.". ( Felaplrme SECTION 13,WORKERS'COMPENSATION INSURAXCEAFPMA)nrf .G.L.c S52,§,?SG(fi}j Workers Compensation Insurance affidavit must be completed and submitted with this appilcation.Failure to provide this atfidavd wilt result in the denial of the issuance of the building permit, Signed Affidavit Attache¢ Yes 0 No a?� uau �?E Criitk rrfl�arfliant} fon DEPI, TIME? OP DVItDrNG INSPECTIONS 212 Main Street ' Mupieipa3 nu lding Northnmpton, Mncs. 0)OGO t'i Or2T¢R'S CONTENSATION. LNSURANCF AT AVM.. . (tittus=1{x:rnicta} —� (s¢rzldtplsyscr2ip} do hereby certify, under thepzuu and penzltie9 or perjury, aha: ( ) I am an employer providing the followine worker's comocnz 0r. cove agc rot Im employees tvordng on this job (InnC�c coo..) (Poco Nv 'r)� �� (_•piruor.Date) ' I am a Sole propr ,oar, general coc r aor or homeowner (C Cle one) and have hired the conu=,Oro tisred belc'.v wbo hive the fo(lowin2 workers Ca*Dtme ennn pctcles: MI z (blame 0' Coccmaoa) Num'scr) -�imoo,'± (N:gc of Coenacoq (Insuzncc CompsnyrPolie; �uaca) t�ipir:ion Dzte) Mam= of conn& ) It cO.p^ Compu).(POlic)' Nvmbcr) (Eapiruea )am) (Name of Co.unctor) {(nyv:an Camp.uyfe^ohcy N=L,,Jl...._ (Exptrariaa Da ). t.o,.e:ascw...i e.�✓ate.:ye ar,.�a:;via�ui�Pam;o:os w.a ma.,-��) Od I am a sole proprietor and have no one woridng for me { ) I am.a home owner performing all the work myself NpTEPlc�bc ewy..u..ti46cvrwoea uboenpivr➢�*+vcawvi� cm,+e wuim.d..clL:a( mrc::ie t_`a a-,la w uSrfltbe bv,�w.ve ravdo or w Se pw�6,�p.:„eaaC'1-ce e'{ax C .ihxro'.d-d u to �igioY�veeclk Wxkrhll�m,w(GI,J%2s1(5)l {y.haavrocx fa:�Qv uPmvn cr�iu�iec - 1.-ql a�iya e!.n wleyw.nA.'grswdcd,Carq,®.tim,>x m.�*rstwo;Gcvmor�w,eamsttcsoo.zoom.awysyw,.d.,mot,>a5lmw1=tld�wrL�.sor>SndP�woxP V—U>o6d- fF.Mo .w . .my.ppi¢a or, r" C Pcrmn Nwnbcr 1 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 036858 Birthdate: 02/2611047 Expires: 0212612008 Tr.no: 15060 Restricted: 00 DENNIS R BENZ 686 LITTLE MOHAWK01340 RD 686 LIT L MA 01340 ComTlaslener Board of Building Reguixdoea and Scundardt HOME IMPROVEMENT CONTRACTOR Registration; 127178 Explraton: 911512006 Type: ORA CARPENTRY CONCEPTS DENNIS BENZ '686 lftfft MOHAWK RDS zL..:., COLRAIN,MA 01340 Administrator ACORD CERTIFICATE OF LIABILITY INSURANCE o ioS a) RD UCEIR 10.13)625-6527 FAX (413)625-8210 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Blackmer Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1000 Mohawk Trail HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Shelburne, MA 01370-9737 Joseph Judd INSURERS AFFORDING COVERAGE NAIC 9 INSURED Dennis R. Benz INSURERA National Grange Mutual (Ni 14788 686 Little Mohawk Road INSURERS. Colrain, MA 01340 INSURER INSUREBD: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBRDOTYPE OF IHSVMXCE POLICY NUMBER POLICY EFFECTVE POLICY EXPIRATIONIndat .,a LIMITS GENERAL LIABILITY MP023629 06/26/2005 06/26/2006 EACH OCCURRENCE $ 500,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 500,00 CLAIMS MADE ❑X occur MEOEXP(Wy, per...) IS 10,00 A IFIERMENAL&AESUNTI $ 500,00 GENERAL AGGREGATE $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS�COMPIOP AGO $ 1,000,00 POLICY F7 PELROT LOC J AUTOMOBILE LIABILITY CFOa a-di SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Pc/parsan HIRED AUTOS BUCILYINJURY $ NON-OWNED AUTOS Ireacnaenp PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTOONLY-EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG S EXCESSIUMBRELLA L ABILITY EACH OCCURRENCE S OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ § WORKERS COMPENSVRON AND WC STATU OTH- EMPLOYERS'LIABILITY ANYPRO PRIETORIPARTNIE ERXECUTIVE EL EACH ACCIDENT S OFF I CERIMEMBER EXCLUDED? EL DISEASERA EIMPILGYEE S if We describe under SPECIAL PROVISIONS Below EL DISEASEPOLICYLIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS perations usual to carpentry 7MainSt. HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL OAYS WRITTEN NDICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ding Inspector BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, 01060 AUTHORIZED REPRESENTATIVE Joseph Judd/BLAJJI ACORD 25(2001108) ©ACORD CORPORATION 1988 rn r �a p � h h s� V ti M \ � � � Fc 3J d t q-0 V