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32A-138 (89) 25 MAIN ST BP-2003-1065 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:32A- 138 CITY OF NORTHAMPTON Lot:-006 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-1065 Project# JS-2003-1690 Est. Cost: $3000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Kohl Construction Lot Size(sq. ft.): 0.00 Owner: CHAMISA CORPORATION Zoning:CB Applicant: Kohl Construction AT: 25 MAIN ST Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256-0321 Workers Compensation HADLEYMA01035 ISSUED ON:5/29/03 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 3RD FLR EGRESS 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: o k le - a7C3 -AI THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOL . .- ANY OF ITS RULES AND REGULATIONS. .-- x-eir , 9 Certificate of Occupanc Signature: FeeTvpe: Receipt No: Date Paid: Check No: Amount: Building 5/29/03 0:00:00 23858 $50.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2003-1065 APPLICANT/CONTACT PERSON Kohl Construction � ADDRESS/PHONE 3I Campus Plaza Rd (413)256-0321 7-0 m PROPERTY LOCATION 25 MAIN ST MAP 32A PARCEL 138 006 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �7 Fee Paid r''�7&Oi bU� Typeof Construction: INSTALL 3RD FLR EGRESS New Construction Non Structural interior renovations Addition to Existing. Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO$MATION PRESENTED: a/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 Conuniss' Signaling 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 40K Contact Office of Planning&Development for more information. Versionl.7 Commercial Building Permit May I5,2000 { fp1 1, i� Citj/"df Northampton . _ .gtildngDepartment v .. 212 Main Street ' MAY 2 3 2003 Room 100 � NorthAmpton, MA 01060 i+ �. .. __ phone 4133587-1240 Fax 413-5874272 peri ¢, + u I 3elr of T 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 7.7 Property Address. ;+g his se to be co :I C ib� Nice; •(c �0(:n -J Map / / w 'Ori�t Car 1�s -I-on . Zone *s Ove : e .�' cr;;CA"::+li Elm Si�bish�ict �+= SCB nstrrtt - SECTION 2• PROPERTY OWNERSHIP/AUTHORIZED:AGENT 2.1 Owner of Record: /}( atteilikSca Gcs..-ti. ,3 lra "/ sL Y)A2Cn Rd Name(Print) Current Mailing Address: 256..'G32. I 7T Signature Telephone 2.2 Authorized Aeent: I� 'To,-rt Fie -c.tiPr.^"." .3 ) Cc,rnrcts Pig Name(Print) � ' Current Mailing Address.. ,2 S."6" o3 ,z I Signature Telephone SECTION 3`•ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 00 (a) Building Permit Fee 2. Electrical (b)Estimated Total Costof Construction from(6) 3. Plumbing Building Permit File.: 4. Mechanical(HVAC) 5, Fire crotection 6. Total =(1 +2 + 3+4+ 5) -of 31 000 Check.Number 42(3 ,f� *� This Section,For Official Use Only Building Permit Number iS/84 Date issued. Sigittsture: _" ..sr "' Building Commissioner/lnspector of Buildings Date. 4. ' Versionl.7 Commercial Building Permit May 15,2000 (Interior Alterations) Existing Wall Signs Existing Ground Signs Additions 0 Roofing ❑ ❑ ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] 0 Accessory Building[ ] Repairs [ ] /B(j}' r 'DESCKwP-s t ,y s10 J/ /Yew �creSS o), ,arc, R/cry(- SECTIOt'3 AtSF,'rlp&ND CONST[}UCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly I A-1 0 A-2 El A-3 ❑ IA I ❑ A-4 0 A-5 0 1B 0 B Business 2Z 2A 0 E Educational 0 2B IA F Factory ❑ F-1 ❑ F.2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional 0 I-1 0 1-2 0 1-3 ❑ 3B ❑ M Mercantile 0 4 ❑ R Residential 0 R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ _ S Storage ❑ 61 ❑ 5-2 0 5B Eir-- " U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use 0 Specify: COMPL!TETHIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE IS Existing Use Group: 1 , Proposed Use Group: 6 Existing Hazard Index 780 CMR 34): 2 Proposed Hazard Index 780 CMR 34): 2- SECTIO*6 BUILDING HEIGHT•AND AREA ' BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION „ i® ra D " a :: jf FloorArea per Foor(s1) 1114 t1, 1N 2m 2nd 3rd 'r," a,VE 3 d 4th b„ . ,c.. IT. , 4th :$47 ','Pi . 'T-".T1a , Total Area(sf) Total Proposed New Construction (sf) Total Height(ft) ' g:. Total Height ft e t 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 ❑ 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: 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 DON'T KNOW V 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# 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 NO t../---- IF /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: • Version1.7 Commercial Building Permit May 1 S,2000 r ' Lp NbdP, $TRUCtiOniR}!d�,CESrt abiTRUC' RESSU �-CTtO ;CP < }A in . „ t e ,Pt7R$Q NJ TO /8;D MR 116 bNTAffi, G MOE IVA°� r.,+ c ,OF ENCLOSED A¢,E 9.1 Registered Architect: Not Applicable (J� 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 koIn I (. o,'s4yz.4C t fliCAyl _ NotARPiicable Company Name: Torn P1C4c)1e-r' Responsible In Charge of Construction 3/ Ga ht 4 S Ala,.zt A Address 7, de/ , s6 .03zi Signature Telephone 05!28/2003 12;30 4133-256-0130 KOHL CJNSTRUCTICN PATE 01 VefHam1.7 Commetdal 9uilding Pemut,May ls,2000 p.," - -{3 L iy ri r i<, ua 14151 F , Independent Sbriretural Engineering Structural Par Review Raqulred Yes 0 Ne..,...0 5 r i;1 t it :''''f6;1717:47:7". I i i I,p ,'.lp i r» 14 a Deity)GS tA-t A. `lJ7 ilk 7 as Owner of tine subject property hereby authorize tie; f 0 irlr-Ca - i P.4(t'tor- to act on my be g,in all ma s rata ve work authorized oy this building permit application. J)' V ©A 5 of Oma' Date as Owner/Authorized Agent herebydentate that the StIterreants and information on the e:tagoing eppeeatkn are true and accurate,to the best of my knowledge utdbeilet, Signed under the pains and penalties of perjury. Print Name Signature of Owner/Agent j Date JO 1 Licensed coustructloI Jgpervfsot. / Not AOPiicebe C1 Hams ofl Joanne pegs, ((i-tt t-' f?-t-'�� L��✓°i-GA Err License Number /76 (7;r - diC1 ;/ 0NICLnt1I(e 7b 06.3990 Address ! expiration Date Ess 9 :3 � Signature Telephone 0 S 1 9 • U iy ares e -sjelfiesrATI9k4-igfirurvce t'kRS.. .. . . Workers Compensation insurance affidavit must be completed and Submitted with this applkatlon, Falun to biocide tris atgoavlt will result in the denial of the issuance of the bandinR,pemat. Signed Affidavit Attached Yes 4 'No...... €5?2 2aaa 1230 412-25S-Pi130 kCFL cCHE FL OT1 k PAG*. 22 e J/ jfJ c�} '�q -I, of ceedbtlj kAlllb hall IG t) lc / E.:14,ekSji Y oEPAATMENT OF avanmc ,NSPaCTIONS dl 21S Main Street * Municipal Building Northampton, Mass. C:060 '-a4 WOSUaR'S COKE',EN$ATlON INSURANCE Al•I*i))AVlT l. fn„yins_. a. • L A A d 'ink( aM Inc NCalrwRrn;ms) with s prrftricipat piece of businesstresideace at: ?it t q W puS Nemo._ e4 (phone) t3 am-a311 (mtWci '/stsWtp) do hereby eemdy, under the pains and peaaides of penny" :hai. evil am an employer providing the following worker's compcnsiuoc coverage for Iny employees working on thusjpb: - A.1. M , 1/.44tth rh',7 snit ,2na (barman=Comoxal) (PoemsNumbe€) non ass) ( ) I em a sole proprietor,general contactor or homeowner{dick one)tea bake hued the contractors listed beo,v who have the fot1pwing worker's compeceadon potties: (Name of Contractor) °arum=Compam!Pohc)_NUFjbc ) A ,"OG,tritupo Date) {t+ax of y"'oprraaor) assort=CcmpYny+po)icyN+.*-.rtf "is'anvaUac DaaY (Name of Contractor) Onnuapoe.Cowpanyl .0key Nuetb r) (E.dpuadoo Datc) (Nam=of Contractor) (fame ace Company/Polley Nutoaer) (tun r+doo Dam; taertwdfetieutpussies ukiabm,ia ra iwr to vminkOUV ( } I as Boit proprietor and not no oat working for,.nee ; . { ) t am a home owwer performing all the work myself Wink yseacia ama+LaWa namavaam.+Ya gYrr yam.m bcaiyugsa$ .adbo a;fair wink m amwfas a( m may 1Ym'1hee•Wer/aahkatla$pitilM.m nide Of Mel av"mid t 6}m tY eb[till wawwoes amlym amara names cemp S itq ang1415ealcasio6mt®3t` k✓nmwm/W homed m.Y awamm uu 6.01 seas(as awkywtwist t W Vka4eraw.ties A<' I sada, M Ae a et*•(S_Wstm .m ear M 4aa.04 to t.pK_mit'of)ayaY)r NWlma'06ar of male fa us a•mmaaai4miaa oretWtYsat mumsaxyagaatlRmeea2SA.(Ma413fmabdmpaiatt. eta-ebd#a•t+a• .aWaa.re as en.m SIXco.00 mat lmRtmm,m of W m em)v'us.ira p4aM era a'ma .am wmk o.m and im orstmat•der leap me - ozual -Mf3 Map, bot Si. 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I 'z No. 2,?6" T IND .TORY T7?AMING PLAN MASONIC 7.G'M7>L: T NO. AY OCALZ UN-4r77 NORTHAMPTON,M,4 3.: . ..- - Par/VANS ZIAYL2Y, ANON%rr"c r f As- Mar ri SA• .