32A-138 (88) 25 MAIN ST-3RD FLR 332 BP-2002-1053
GIS#: COMMONWEALTH OF MASSACHUSETTS ',
Map:Block:32A- 138 CITY OF NORTHAMPTON
Lot: -006
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2002.1053
Project# JS-2002-1688
Est.Cost:$5000.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Kohl Construction 078992
Lot Size(sq. ft.): 0.00 Owner: CHAMISA CORPORATION
Zoning:CB Applicant: Kohl Construction
AT: 25 MAIN SI - 3RD FLR 332
Applicant Address: Phone: Insurance:
31 Campus Plaza Rd (413) 256-0321 Workers
Compensation
HADLEYMA01035 ISSUED ON:6/4/02 0:00:00
TO PERFORM THE FOLLOWING WORK:3RD FLR RENOVATION (SHEETROCK, SOUND
INSULATION WIRING & FINISH)
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:G/ 1014 in House# Foundation:
Driveway Final:
Final: Final: 6/2242_"p
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:,
Final: Smoke: Final:
S3AL eh9r
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATION' .
Certificate of Occupancy Signature:
p Y
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/4/02 0:00:00 22176 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
.
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File#BP-2002-1053
APPLICANT/CONTACT PERSON Kohl Construction
ADDRESS/PHONE 31 Campus Plaza Rd (413)256-0321
PROPERTY LOCATION 25 MAIN ST-3RD FLR 332
MAP 32A PARCEL 138 006 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 91 / �1
Fee Paid o� V
Typeof Construction: 3RD FLR RENOVATION(SHEETROCK,SOUND INSULATION WIRING&FINISH)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 078992
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 Commission
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.
Version!.7 Commercial Building Permit May 15,2000
I
�e d tUse4only
6i4y-e€Alecinampton `i" r0 4 C l f �il�n mrtment - ,qqStreet S .,,+iMAY 2 aoMampiAMA 01060 A„§itL phone 413 587 1240 Fax 4135871272 o fi ° P tits' . ;z .i
C - - °'t;,,a; 0 e.Spec lit.,...9-i. ;1`, ;d. , '.
r ar
APPLICA ` OVATE, 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: ( 9 '?,a7/9 if?
to be completedJby office
m/5- Ohv I�'1".. 3a)3 . Map </7�p717 .Lot p ,7 Unit OO�: .
i -O Arnt`Y-d'V /—f01 Zone Overlay Overlay District
Elm St.District CBDistrict:.
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
__ GLAm'S�l �rP .
Name(Print) (, A\ \\\ Current Mailing Address:
1.
Signature Telephone
2.2 Authorized
^/Agent: A /r e--
E\Or ta ` -s din I 31 �m pen PIAS at t�lrry ,
Name(Print) J j Current Mailing Ad ress:
Gt a<Ci= 03.21
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars)to be Official Use Only
completed by permit applicant
1. Buildingilt Sdo (a) Building Permit Fee
2. electrical (b) Estimated Total Cost of
SOd • Construction from (6)
3. Plumbing --_ Building Permit Fee
4. Mechanical(HVAC)
.----------
5. Fire Protection q //
6. Total = (1 + 2 + 3 + 4 + 5) ,}1 GOO . Check Number ?o2/?la 1s
This Section�., For Official Use Only w
Building Permit Number: /nh "l Date Issued:
Signature: /'��
Building Commissioner/Inspector of Buildings Date
" ' Version)7 Commercial Building Permit May 15,2000
$E,CTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior ARerptions Existing Wall Signs Existing Ground Signs Additions 0 Roofing ❑
❑ 0
Exterior Alterations ( Demolition❑ New Signs [ I Change of Use [ ] Other [ ]
'�/�,.�. '{�❑�-�C33,-1 j Da, i Accessory Building[ ]/ Repairs [ ] 4
f.�64- V.- fro...);—feria..); I1env' 101•'`Oil -- SyNncl -1'iSu�Atbcw t Cif f-l3I Ske t+tt-L I G;V,.`5{..
SECTION5- USE GROUP AND CONSTRUCTION TYPE [
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly (❑ A-1 ❑ A-2 0 A3 0 IA 0
A.4 0 A-5 ❑ 1B 0
B Business [d' 2A 0
E Educational 0 2B ❑
F Factory 0 F-I ❑ F-2 0 2C ❑
H High Hazard 0 3A 0
I Institutional 0 I-1 0 1.2 0 13 ❑ 38 0
M Mercantile / 4 0
R Residential ❑ R 0 R-2 0 R3 @' BA ❑
S Storage ❑ S-1 ❑ S-2 0 5B Hr
U Utility 0 Specify:
M Mixed Use Td' Specify: iQ � g - 3IJ CiS.-n BSS r He,-ct ,,A oa.
$ Special Use 0 Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: /�i Proposed Use Group: 0 , �n a ..'F.
Existing Hazard Index 780 CMR 34): . . Proposed Hazard index 780 CMR 34): XC c-kcie+i3 a.
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION �j =OFFICE USE ONLY
Floor Area per Floor(sf) _ I /vc7 GI'x0,nie `n J^.._/P'r
iso_ ,/J <3/ ' __— 2"____ `J "7`
2„a fG1T - _ .3tl
4'h
3rd ♦ S
4,n /0 .2L`�/�}
Tr1 L-I/ _ -
otal Area (st) ”] I a„c Total Proposed New Construction (sf)
44 o 'I
Total Height(tt) 33
Total Height ft
• Versionl.7 Commercial Building Permit May 15,2000
7. Water Supply(M.G.L. c. 40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone 0 Municipal 0 On site disposal system 0
S. 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:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW Y/ 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 #
VA
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 be obtained from the Conservation Commission?
Needs to be obtained Obtained / Date Issued:
C. Do any signs exist on the property? YES ✓ NOo
IF YES, describe size, type and location: Sfare * .ck n ) t/Qf" ei Ge S _.
D. Are re any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
Version!.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 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable D
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 Areaot 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 ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
Version1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑
SECTION 11-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR 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
1, bcc c `, . k0✓t I , as Owner/Authorized Agent
hereby declare at 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 perjury.11
On G+ ,�} kdGrl
Print Name
L_
Slgnatu of Owner/Agent Date
SECTION 12•CONSTRUCTION SERVICES
1O.1 Licensed Construction Supervisor: sot,
Not
Applicable ❑ qp
Name of License Holder : -_ be tsc IaS 4-. YJY, I CC S 0 ' / !.Z
I-I n ` g ' License Number
: 1 ecimt3GL k2a R . I Pt, , s-ch •
Address I Expiration Date
55( C-\ 02 tC6'03.a I
Signature Telephone
SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.I. c. 152, §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 building permit.
Signed Affidavit Attached Yes 0 No 0
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(lag of dorfliampfnit;410,0-
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W"'r '�1� DEPARTMENT OP ➢UIIDING INSPECTIONS yc� E
212 Main Street ' Municipal Building `eA
Northampton, Mass. 01060 "Q?tom'
WORTQ',R'S COMPENSATION INSURANCE AFFIDAVIT
(licensee/pc:mince)
with a principal place of business/residence A at:II ''
3I Kampc,5 PICh2PteALA , CG
.. AI l i .(phone/: