06-055 (15) •
BP-20030199
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit Building
Category:renovation BUILDING PERMIT
Permit# BP-2003-0199
Project# JS-2003-0215
Est. Cost: $14700.00
Fee: $173.50 PERMISSION IS HEREBY GRANTED TO:
Coast. Class: Contractor: License:
Use Group: MACDONALD SECOR ASSOC INC 069244
Lot Size(so.ft.): 617245.20 Owner: LINDA MANOR LLC
Zoning: SR Applicant: MACDONALD SECOR ASSOC INC
AT: 349 HAYDENVILLE RD
Applicant Address: Phone: Insurance:
P 0 BOX 168 (802) 447-3340 Workers
Compensation
BENN INGTONVT05201 ISSUED ON:8/28/02 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATION OF 3 DAY ROOMS
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Buildy,ig _ 8/28/020:00:00 116607 $173.50
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
FROM : LINDA MANOR FAX NO. : 14135827906 Aug. 08 2002 02:28PM P6
Versionl.7 Connncrclal Building Permit May 15,2000
Cityf}'Northampton Vl, .i }$ y ,*�t .
V ing Department
, •
Y -•ifdan Street 't*s ,yrt ' ~. ath a:arp',y�
yy.�((�� ., m 100 » 7ir `Ilf�� „' ,
t 0 irth.mp .n, MA 01060 -+"ee4� h '-t R'{ v,+S+ CF
Nig R
phone 4 ' 12`0 Fax 413-5871272 d: n4:
f
1NG3HSPECIe, i.".: .�..s . 4A. of 0',3-.' 's.�,',.?; Jrr,,L
AP +11.i,.x'T 0=i4 ,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
1.1Prog„e Address
ue l . aer ACV et 1•
9�R Prige�%�'+ �2r
� I �
349 Haydenville Road Ur4Ci 1"btU01� ' '" a�' '
k A L
Leeds, MA 01053 °a+ ^"' 7i 5d k ,
x fi� l r rr
-51310 7703 ,. IDOWC 1- n M ig , i �' v , . .
$EetIOFs :PRDI;+ERTY< Qh!FER51Yll*XAII1HOTi[ ED AGEbIT
2.1 Owner of Record:
John Chakalos 52 Overlook Drive, Windsor, CT
Name(Print) Current Mailing Address:
860-688-5994
Signature Telephone
2.2 Authorized Aeent:
Noc. .- et.n Management Systems, Tnr 7 L. . . - I . • ` 01201
Name(P 4 Current Mailing Address
413-447-2157
Signature •r 1, 5• - , . Telephone
SECT(ON9o.ESTIMATED'CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be i _ Official Use Only.. :.
completed by permit applicant
1- Building (a)Building Permit Fed
i 2. Electrical (b)Estimated Total Cost of
Constructionfrom(Gj_
3. Plumbing Building Permit Pee
4. Mechanical(HVAC)
5 re Protection
6 Total-(1 +2+ 3+4+ 5) { 14,700 Chock Number /�(✓/,6 9 /73.5
'' - Hi's Sectiorf F'or Official Use Only
-Ebdifdlq Perrot.Number.,,., '1 y Date Issued:_._.
"s..r.aMidingeOMMT4loWegrarshANr bj'lu{)dulgs :: -_ Date
FROM : LINDA MANOR _ FRH NC. : 14135827906 Rug. 013 2002 02:29PM P7
VersionI.7 Commercial Building Permit May 15,2000
I
SECTION 4CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC;FEETOF ENCLOSED SPACE
Interior Alterations Evisting Wall Signs Existing Ground Signs Additions❑ Roofing ❑
O ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of User, ] Other I ]
❑ Accessory Building[ ] Repairs [ ] t<c!'�
ferff W£ TP rtc h3. . u�4PnOC�iReho L rud0. hlcatioc" - "Oa`{ "h'` C CI')
$Sc.Q.St`v",iUSE GRgUR C*N4,ta,ON&TRU4`.T,Ntfnli�_., ,
USE GROUP(Chock as applicable) CONSTRUCTION TYPE
A Assembly I❑ A 1 C A2 ❑ A3 ❑ IA ❑
A4 ❑ A5 ❑ 1B 0
B Business _ ❑ _T 2A a
E Educational ❑ 2B ❑
F Factory ❑ F4 ❑ F-2 G 2C ❑
H High Hazard ❑ 3A 0
I Institutional ❑ 61 ❑ 1.2 ❑ 13 0 39 ❑
M Mercantile ❑ 4 0
R Residential _ ❑ R-1 ❑ R.2 ❑ R-3 ❑ 5A ❑'
S Storage 0 Si ❑ S-2 ❑ 5B ❑
,U Utility 0 Specify:
M Mixed Use 0 Specify:
S Speciat Use ❑ Specify:
CO.MPLETE THIS SEG`TION(F EXI$TINaliut 3lj1G 1119:2 ERGOING RENOVATIONS,AODIFEbwS'ANDIRR"EFW1GEJPY t1SE
Existing Use Group: Proposed Use Group.
Existing Hazard Index 780 CMR 34): _ Proposed Hazard Index 780 CMR_. 34): _
SECTION,$BUILDING NEIGNT AND AREA .
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCT+IDN a w., 1Gy;'tQt % al 3 '-f ii
floor Area per Floor(st) is Aattt f - s jo k b .;
x y,r
ra _ __ _ 2n? _ •I1II1I3 !
cli
3r7 ,, _ etrxt7444;177-441F7547S- 'll 'P.-AAP-5774
4,_ i7-41' 11G41itelrelbgg q
Total Area(sf)_. Total Proposed New Construction(sit Blinn5 µ �n st s'�yl
-Gawp. $c r>t :;11,5-4,1x.'Tf in i,
Total Height(tt)....- -
5 •, J tXll p r. a
Total Het ht ft rpAn. *tIl : �,3, 11" .p�
;71-Ar... $ aw.+4 a Hp 6 ,e,i.
FRGMLINDP MANOR FRY, h17, : 141-tmeD27
ggib
Aug. 08 21112 02:31P1 Prt
Version'.7 Commercial Building Permit May IS,2000
7-Water Supply OLDS.c.40,§54) 71 Flood Zone Information: 7-3 Sewage Disposal System:
Public ID Private I7 ) Zone: _ Outside Flood Zane ❑ Municipal p On site disposal system 6
ft NORTHAMPTON ZONING _
Existing Proposed Required by Zoning
This Deem to tie(Med in+h
Building Department
Lot Size
Frontage
Setbacks Front
aide Li R: L:
Rear
Building Height
Bldg Square footage
Open Space Footage ?b
(lot area minor bldg&paved
parkmgl
a 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 4
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 he 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:
FROM : LINDA MANOR FAX C. : 14135027905 Aug. 08 2002 02:31PM P9
Version I J Commercial Building Permit Nlay 15,2(100
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION'CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect: _
Not Applicable ❑
' David J. Westall,. R.A. S tJ ,
Name(Registrant): .-
P.O. Box 606, Williamstown, MA 01267 Registration NumberNu
Address % ' 01 — --
__/}421
, / A . u /1'add
'ft 155 .
5 $ , f ( i Expiration Date
Signature xJa// Telephone l
92 Registe d 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 0
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
FROM : LINDA MANOR FAX NO. : 1413582790E Aug. 9B 2002 02:22PM PB
Version) 7 Commercial Building Forpth May 13,2000
SECTION 9—PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO I
CONSTRUCTION CONTROL PURSUANT TO 7$O CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable 0
Name(Registrant)'
Registration Number
Adaress
Expiration Date
Signature Telephone
92 Registered Professional Engineers):
Name Area o'Responsibility
.._. ...... �.i....._
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
NameArea of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
vny_..bOi� eo...i �SrCCi V�. r ( _ Not Applicable 0
Company Name:
' C3`c a P ly MR c,
Responsible In Charge of Construction
aaeress '. �GX l�8 li NIN6 Ci. VCC52Q1
PCS
one
Sign.tore � Telephone
FROM : LINDR MANOR FAX NO. : 14135827906 Puy. 08 2002 02:22PM P9
Version 1.7 Commercial Building Penni)May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) l
Indepenaent Structural Engineering Structural Peer Review Required Ycs,.,._❑ No d7
SECTION 11,-OWNET AAT,NQfIZATION-TQ BE COMPLETED WHEN.
OWNERS AGENt'OR CONTRACTOR APPLIES FOR BUILDING PERMIT
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
L Northampton Management systems. Inc. , as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing epolicabon are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
Northampton Management Systems, Inc. By Paul Sinopoli, Associate Vice President
Print Nam-
AtIL Anonch 1Co, 7007
Signe lire of Orf/A-.#" Date
.SECTiO1,44-cot4TRUCTTAO,N,SERVICESr
10.1 Licensed Construction Supervisor: Not Applicable 0
Name9J1is4 ' der•. s_ i k, Se, SCHLCA . CSCCcit17.2ek'k
License Number
?6b4i/ `, .vim 'KS( . ccj' Ui051C1 __- tC
Addres Expiration Cate
iG 44Z 34C
Si:nzture .." Telephone
S,ECTI• ,7,a-WORKERS`COMPENSATION INSURANCE Ain DAVIT(M G.L.'c.152,§250(6)),.
Workers Compensation Insurance affidavit must be completed and submitted w'th this application Failure to provide this affidavit
wi.l result in the denial of the issuance of th ilding permit.
Signed Affidavit Attached Yes No 0
FROM : LINDR MANOR FAX N0. : 14135827906 Hub. 0B 2002 02:23PM P10
a4S oa.L _
gk }44 (riff of :ax:f(FItlnpfntt
era C
r DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Mtmicipal Bidding
Northampton, Maas. 01060
WORKERS COMPENSATION INSURANCE Albll)AVTT
M2,5 ',( r` t4fvL FSF�('ty� LaS X , iR
plc stcipernvace)
with a principal place of business/residence at:
AP:5 t " '- a ( 1. 3 w. t (,'Jpe11 (phone ) J:k_461/44- 753�t.l
(a(rceticity/statdzip)
do hereby certify, under the pains and penalties of perjury, than.
( ) I am an employer providing the following worker's compensation tion coverage for my
employees 'working on this job:
€C \2&\ . _
i(1nn:nac4 Compo y) (Foam Number) (=/mitanee Dam)
() I am a sole proprietor, general contractor o, homeowner(circle one) and have hired
the coatractors Listed below who have the following workers compensation policies:
itt
(Nome of Counaoar) (?nsumnec Company/Fficy Number) (Expitadon Darr)
(Nzmc ofContncor) (Inrarnuce Company/Policy Num&r).. (Expiration Date).
(Nam of Cocnactor) (Iamrance Conipacy/Poliry Nmrlwr (Erp[ ndcn Date)
(Name of Courractoi) dusmmice Co: y/Policy Number) (hepiranon Date)
(utast aMi1%W t C,t j v..-..ryfo'cohda wfama4'M pau,mngu ail mvnuon)
( ) lam a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:pl^mm lir aware that wtie hennax4+mplgpen=m do mail•.M, mcervnionwrpmsvec at t dw Liog at
mu maetb a three tett in Wank trio bazmxmrnadm or an We yamh yn,ut.es�tbaNi u. oniglaft,sto t4.
elScday=Lea the Warktel teR4XmallaaalA(6LI52ala.5)%ry i tin by•s,m, axa Pr a livam paw ty tvt of tla
}gar bum.eras 4070105qt uairte NnkahCwgamY+aaM
undastaed Ma fWia-, _. wAYb WaWJd to the M ktauctoaa tha
ma'?aE vc',9evlW'sod trt•. Navuem naiale 157 c kta dto i Cw,ort&tfumi
^mtcirba fpf,uta St 4*()O aku ubNmraofvecou]Sot ed tsZcnl•uitouf e'n. Wctt uruu t
lmatsi�,iRa dsy 4�ac ' 'otupmvcny end avif Rm^.i.,s�Cci fume'n.SMp Vfw[OaYr a;.ta
ForhPaumrt+l
Pgmjl Number
YJ
hfakF( ._..__
vgaaym - _
08/01/2002 16:06 8024421131 WILLS INSURANCE PACE 01
M` CQR ,t7 .;X"' c_m '.dl�14 fi µ d _ " "g ogre mo/23m0
w
5A.1.." .rE�1 ". errnwn e*^n a" ? x±3.' +mx4P;:a'rvM ?-? - ' � e (2002
Pmnu tRTHIS CERT ATE IS ISSUED AS A MATTER OF INFORMATION
WILLS INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE ODES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE- '
COMPANY
A Cincinnati Inscranee Ccrpaaiee
INSURED
COMPANY
MacDonald Secor AssoC. . Inc. B
PO SOX 168 COMPANY
Sea-Lingtan, UT Oa2011 C
COMPANY
D
c iv ek^ ,� -.;zsf .amu Ysl. -`, @'Tw ex.�s�15 ,", .. ..,,,,4:4--...' t" ,' °'}", q..w
VALI St AT x D NAE 3 POLICR °"Ober„ 'p'
THIS INDICATED,IS TD CN TWI HSTA DIN PANYIEB OF INSURANCE ee R0 S NDW HAVE ANY CONTR T T THE THERED CUMEN WITH ES TIE O WW PERIOD
CRTIFICT NOTWITHSTANDING ANY PERTAIN,TH?Mee OR C E AFFORDED
OF ANY CONTRACT OR DCII{DOCUMENT SUB RESPECT TO THE
MSS
CERTIFICATE MAY DITION OR MAC PERTAIN, THE INSSRAWOE A V HAVE
EO BY THE POINTER PACLI HEREIN 5 SUBJECT TO ALL THE TERe15.
CIUSiDN6 AND CONDITIONS OP SUCH POLICIES LOANS SHOWN MAY HAVE BEEti REDUCED 8Y PAID CLAIMS.
CO TEN DP INWMNCe IPLCY IMMSO TOM/EFFECTIVE PONCE EXPIRATION LIMOS
LTA oAl IMM201WI DAR PM100MI
OEa9wl LAMM" CENIMALAGGREGATE e
in CPP 073 TB 60 08/02/2002 08/02/200y-
SRa COMMPAOULDENEu4 UA&uPt ICOOLT3 CceAPMP ACC a 2 SO0,000
. CLAIMS MADE a OCCUR YE%ONat&AW INJURY 4 1 000 000
OWNERS&CON'RACTORE NOY SACH OCCUPRENCR P 1,000,000
MAE?AMASS Miry one firm S .100.000
MEC IMPAmos INNEN 4 5,000
AVTDMOSS :AaTW
'CAF 546 36 13 08/02/2002 08/02/2002 come1NEDSMaa UMIr R
ANY AUTO 1,000 000 .
ALL OwNPO AUTOS BODILY INANIN
SCP ttRO 4003 INK PNNOTI P
HIRED ANEW SOCAY I?ytURT
NovowNED 0141-08 NNE icIOMG e
PROPERTY DAMAGE I
WAGE LIABILITY ATO ONLY.SA ACCIDENT 0
ANYAUtO crus IVAN ADVO ONLY' EIMMIln
EACH ACCIDENT IIIIIIMEMI
AGOnrGATE Mallillin
RCESSLIASARY - 6 cooccu.RQICe N 4 000 000'
A CCC 998 BS 83 08(02/2002 06/02/2002
is UMRREIAA sum AMCAm4rp E 4,000,000
OYNETI THAN UWPRIA PORN . 5t .(
4
WgIXSNSODMRflWATiON AND - X4`aruMITS' DN ' ' ...• •_;.
A EMPLOYERS'LMNRRT WC 1515640-00 08/02/2002 08/02/20 OS E,EACHACCOBNr R 100,000
TNEPRVRtETON INCL t.Otb-ASE.TOUcY LIMIT a 500,000
ARTENRS MMOTITIVE
VIEWS ARE X Got _ $.%same.a IMPIMat S 100,.000
oTMal
DESCRIPTION OF OfEMTLONS4OCATNNSAISHIOL'ERPECOM RIMS
for Charlene Manor and Linda Manor
.sa
.ES 6a.
Berkshire t(saltk Care Systems STIMULI AIN OT TEM u°vs oesomm ACMES BE &Amuse. TO NE
amnesties eve TNARmf, TRE OBVING COMET AMA WDuvoR TD MA..
10 DAYS WRMEN Nora TO THE CEIITIMAYN MOWER NAMED TO THF LER.
MR FAILURE TD MAIL SUCK ACTNR SN4L IMPOSf NO O.YSARON OP LM ILFrV
OF 4NY • UbN TNM •EDP Y NE APIYTS OP PEPNSSSETATNES.
NRNOP2ED T
.., i ,i.-s3L':.::d:IiAt «..A'AS 51. P. -.n 4. .,�:«.� :• ee �:Ec,.^ . ""R,.E`.�`..F iaI:I:�•R '#;.;"x : "