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39A-76 (65)
492 PLEASANT ST-COMMUNITY CORRECTIONS BP-2006-1186 UIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 39A-076 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category BUILDING PERMIT Permit# BP-2006-1186 Project# JS-2006-1751 Est.Cost: S2500.00 Fee: S50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ANDREW O'BRIEN_ 047357 Lot Size(sq. ft.): 66211.20 Owner: QUICKBEAM REALTY TRUST Zoning: GB Applicant: ANDREW O'BRIEN 4J2 r'i..t_HJr''..•: . J '. - v:�lvii' uNi r Y (;OI- r L i IONS Applicant Address: Phone: Insurance: 75 Clayton Rd. (413) 563-1902 () Workers Compensation HOLYOKEMA01040-1543 ISSUED ON:5/8/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:POUR CONCRETE FLOOR TO LEVEL & ADD (1 ) WALL POST THIS CARD SO IT IS VISIBLE FROM THE STREET inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: g g A Footings: Rough: Rough: y/2.6 House# Foundation: Driveway Final: Final: Final: •i �o?.f Oj, J Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Finales 02C'''.4()(124) moke: Final: K 7 30-06 THIS PERMIT MAY BE REVOKED BY THE CJTY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGUL TIONS./7 �� Si nature: Certificate of•ccuNanc r, FeeTvpe: Date Paid: Amount: Building 5/8/2006 0:00:00 550.002218 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo File#BP-2006-1186 APPLICANT/CONTACT PERSON ANDREW O'BRIEN ADDRESS/PHONE 75 Clayton Rd. HOLYOKE (413)563-1902 0 PROPERTY LOCATION 492 PLEASANT ST-COMMUNITY CORRECTIONS MAP 39A PARCEL 076 001 ZONE GB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid p14/2 GS5O — Typeof Construction: POUR CONCRETE FLOOR TO LEVEL&ADD(1)WALL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 047357 3 sets of Plans/Plot Plan THE FOLLOWING 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 Co *on /L/6Z ,gri 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. Versiont.7 Commercial BurMin:Permit Ma 15,2006 � rlpflfiampton aF , i g paitment - rfil _L------212 treet 3 , Imo! MAY t,o nppRocioo 01060 �J ` phone 413-587-121'0 Fax 413-587-1272 l +.!. - '' .S-____ . tc.S3IE'42FORSfAIiO�F. . .- ii-corii .- 171-ti�t�r.mtrllddress:--...... _. _. • .�' :' � tArnft irctpl }w cQ z Pls,Hur sneer . ( oatMairy CoLREcrfo s} Y£ ^� IGET' 'g TIO22ROP.Ell idntRi4WAtilli0O ,SEGP 2.1 Ownneer of Record: R d ' Name(Pu nt) C // M• PONT 4 fT ''',jr(�,(� ismo Cu`rr`rent •Mailing Addresss. tik a^f'L� P�)EllTt4r h'r '� Sgnature L ''i/. al - wejs` 1'ti` + 'e�ephane I{LI-�+ 7 P �•rJ 4 c 2.2 AuthortQd Agent: ri—gr-'rtka_:t a ht• Pi rm w.-,t }7 p� ] Name(PNNN CurreN Mai5ng F21dress: J —Yft CATJR+Q7 17�R`�� l' ma� Signature �' if ' ,"4 Telephone vt) - „I Q�y// a - S-r() r -SEC- 144.•EST1MATEOCONSTRUGTIONCOSTS Item Estimated Cost(Dollars)to ire „ CfficiaF Use Only corn/pIeted by permit aPPlinM 1. Building f �1 eeq.n La�ArnldTg'PermtFee ' OC�VV a Electrical . .. WL) ..- l (b'k Es6 FtfrOM ON o1 Co.�1 aC z.. 3. Plumping 1 ____,, 1 'Building pemitt'fee . 4. Mechanical(HVAC) l �-. _` 5.Fre Protection i 6. Total=(1 +2+3+q+5) 127c 0.,. Check Number t4'I L 5"‘C•1*---- hiaerection'Fok ciat ttse Orily. reuiMi j.Partit3 amtie'E` .. - ed la t7ata' . - .3: Signature: Binding CommissianeUWspedOrct Buildings Date Version1.7 Commercial Building Permit May 1$,2000 r.. $6C-T3f$SInP-L"y_ Eaiklead 14-It D*THAN 35 000 C>tiflLC'€.EET UCii Interior Alterations pi Existing Wall Signs ❑ :Demolition❑ Repairs 0 Additions Accessory Building Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing Change of Use❑ Other❑ Brief Description !Enter a1'brief description,heere. tot cows RE.Tt. Pi 004 m 4evtl, /114s Of Proposed Work:i 4(4 auQ skae .rt,CKx w4tf i SECTION'S tisE-cRSUF-AHa 0MSTRDOCM -= USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly _ A-1 0 4-2 0 A-3 ❑ 1A I ❑ A-4 0 A-5 0 1B 0 S Business 0 2A 0 E Educational 0 2B ❑ F Factory 0 - F-1 0 F-2 0 2C 0 H High Hazard 0 3A 0 I Institutional 0 I-1 0 0 1-3 ❑ as n M Mercantile 0 4 0 R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S storage 0 5-1 0 S2 0 5B J 0 . U Utility , ❑ Specify. ______I______I M Mixed Use 0 Specify:r S Special Use o Speedy e m s _'e C: ine, 3 -est 8(imagapWGG33EtiOcatiaS,.ATI2iELIt}N$,`5b7BtOR ffANGE1N USE Existing Use Group: I Proposed Use Group: Existing Hazard Index 780 CMR 34):i I Proposed Hazard Index 780 CMR 34):F.^ -.. I BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION - � ' '1r'� '" T.'-`- �' Floor Area per Floor(sf) - "'-- T2 ta iaE124000 _ 1r E I .� 3 II) -1.J-4 3ra 3i0 ' r-" 4v' / _. i 4th i - - Total Area(sf) A J20,00 I Total Proposed New Construction{sf) -t"47,78-/°-/74a w,Cgs:".a4.�''a�' € r- � 4u. c. Total Height(ft) [ .10 I _ ! '^1 ' ' ' - .' ti Total Height ft ! �I .=^ls 7.Water apply(M.G.L.c.40,§54) 7.1 Flood Zone Information: ( 7.3 Sew a isposal System: Public 81 Private 0 Zone/., Outside Flood Zone Municipal On see disposal system Version1.7 Commercial Building Permit May 15,2000 Existing Proposed a Required by Zoning MI 5,404Q.. Buu8 iis caiman to be Aped fn by filled Lot Size 1----6- , jOQ I I— I I_ Frontage ___30*P; C. — Setbacks Front t 61( Ir---1 , L:— R:I aidEI....: I I I 1 .._. _. 'Building H_ g1t iA)t _ r— —__, Bldg.Square Footage 4,ith.if I 1 V° I r--'"i Open Space Footage % dot a=miuusbien&paved I_ I I ( 1 I parking) if of Parking Spaces I4) 1 Ii_ __I ' r jvolumd&waio) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0. DONT KNOW 0 YES 0 ' IF YES, date Issued: i I IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES Q IF YES: enter Book i Page ' and/or Document if B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES C} IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained © , Date Issued: f 1 C. Do any signs exist on the property? YES EV NO © IF YES, describe size, type and location: 7 Pole s Tit,u t- s1 a€F(ot sf i'U.4caP l D, Are there any proposed changes to or additions of signs intended for the property? YES ® NO a) IF YES, describe size, type and location: j 1 E. Will the construction activity disturb(clearing,grading,excavation,or Ring)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO 4 IF YES,then a Northampton Storm Water Management Permitfrom the DPW is required. Version1.7 Commercial Building Permit May 15,2000 SEC71oN 9 PRPFE55toNA14Esidti db7bzeitatNC310NSElt1HGEs-mit/oLDINGS.AN11011tUl�idd'7 R'3t189EG7ITO CONSTRUCTION ceN IT;oLfspAN {o 790--GNIR 116 Cth_TN$fNG eMORE iLix3S.d99C F .of Ektth$EDSPACE) 9.1 Registered Architect ._ _ .. I Not Applicable ❑ Name(Registrant): Registration Number Address I Expiration Date.. Signature Telephone 92 Registered Professional Engineer(s): Name Area of Responsibility —J Address Registration Number Signature Telephone Expiration Date j I Name Area of Respa isibifrty I I Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address m u Registration Number Signature Telephone ExpNatian Date L _.. _....._ _ Name Area of Responsibility Address Registration Number I Signature Telephone Expiration Date 9.3 General Contractor 1 Not Applicable ❑ Company Name: Respmaiale In Charge of Construction i Address __ _... ._.. - Signature .. Telephone • Version1.7 Commercial Building Permit May 15,2000 SECTION It.STROCTORA1.,PEERREVIEW"(784Pia 110_11}" _ - - Wdependent Shucturai Engineering Structural Peer Review Required Yes 0 No i4 SECTION-14 I,OWNERAIf[NORIZA7ION-TO-BECOMPLETEU-WHEN OWNERS AGENT OR CONTRACTOR APPLIESF'OR MilivNoPERMfT ,as Owner of the subject property hereby authorize .......—._. —...-._.._ 'to act on my behalf,in all matters relative to work authorized by this building permit application. . Signature of Owner —.. Date Quick 64r$' R€Agy Tatar By: rid4-7114w0M .AnuaLki ,aerMutnorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Si•ned rider e •.ins .•• of•- u _ //J,sQj1L�le Punt Name A Alkinsuo 11, Signature of Owner/Agent Date -- SEC-4101412-CONSTBUCTIOWAERVICR,S 10.1 Licensed ConstryctionS��u//p��eOOr�v.isor. (� � Not Applicable 0 Name of License Holder:' Y4�Y J.1..) � ._()St!£N L.. License Number 75 laS _f oYL /t1a . OtoLiu (v 2b Ad Eryira5on Date ! 'yf3 " 63-1g0Zf Signature Telephone SECTION 13-WORKERS'COMPENSAnONINSURANCEA IDAVM(Met,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 buujlding permit. Signed Affidavit Attached Yes 4!'J No • • Rztwrrr F^,wyp�`c Ur.rf� of �inLflji;))t}�ton A +tii'Slf 3i....rM1«.u.. • . T: . { t= DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street Municipal Building Northampton, Mass. 01060 r WOR1c.I2'S COINCPENSATION GNSURANCE. AFELDAyIT • Ei€wt- 2f311-4. .,61 h-s-p.ianal:A. 1a_a _ - _ ed-at: 75C1t1 fatri aiteKrt-�J� <,, MA 00.10 (phoncU) do hereby certify, under the pains and penalties of perjury, that () I am an employer providing the following ti•orker-s compensation coverage for my employees working on this job: Crva 08 765-`)43c/5— 5 /5 ob (astr =Coopcay) (Policy Nu r) ( I and a sole proortetor1 eneral contractor or homeowner(circle one) and have hired the coniractors listed below who hive the following worker's scope_adon policies: (pane or Cont^coq (Insurance- Company/Pciic; Num[c:) (Exnrsuon Datc)' (Name of Coo tracor) (In urenec Comoaay!Polie: Nuntcr) (Eroinnion Dale) • Mame of Coon-actor) (Madwanc` Company/Poti Number) (Evir ' q' p ago Date) (Name of Contractor) (lnnuanct Company/Policy Numb-.r) _ (Exyilados Dale) (.oid:dStoc,J.Yoea..,-u xuN 1.1:110LCIC p nainien t .11 Ca--cu:a) ) I am a sole proprietor and have no one working for me. () I ama home owner performing all the work myself. NOTE:pI j Fc•, Si WJ<hcmmxan who cow lay o=eooz to.0 i- c-- C n :cur co.a,..JLe of act cone t&n ISa juin wbich the w raid=or on the 6ouoa wufac Neeu..1t ox c r.IN OXntda fah pIo)n uo 'hc' 1cn,,,.,-p-..'m Ao(G L1 2v I(5)).=cabmen q•boomor re::6e.,Cr pa,of zr<.;1Oc m< I<wJ au=of.22 excIoy.r tuedce EU W o&d. 'feu. a_ I uo4 a.nd tins a copy or Wi,maim cry M rte..W.4 to Wa D of bS.u;d needecid om0 of lm.noz ler t6 mome wiGaim ed nu('I"c to&La tt tucciace=Get am+oo 25A of MOL 112 cn lad to the impTufice or aminal pu4tio acaatateg of Ga of up la Sl)00.00 uvYor rmpuo,,me or up to cue year—day p=,..tie,. [cf ora Sep Week Olt W. f of SI 00.00.thy.pime me. Far dep..tv.��t ux Ny 0ypg/ • Permit Numb= 5/x'= Map= Int. - 1 Signature of Li /pc rmi ucc ce hoc _.\\_______\__ , \ \ \ ____ .__ __ ,,, . ,_______ - rmtvA, , , . , .,,,,„ ._ ,,, ), , 4,„, ,,,_, 1----,,,,„, 6_, „______r .,i, ,,,,,,, ,. 7, c� & a,,,�'7 6r°may zP . i6K'k� _ _ __ ___ ._. 1, __ _ 1 . 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