25A-188 (26) File X BP-2019-0842
APPLICANT/CONTACT PERSON SANDRI CO
ADDRESS/PHONE 400 CHAPMAN ST GREENFIELD (413)772-2121
PROPERTY LOCATION 99 INDUSTRIAL DR-HERITAGE HEMP
MAP 25A PARCEL 188001 ZONE GI(IOD/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid ^ V
Building Permit Filled out �.
Fee Paid t
Tvmaof Construction, NEW CEILING AND I WALL IN EXISITNG ROOM&INSTALL EXTRACTION
MACHINE ON 3/12/19 ADDED 4 MINI SPLITS TO PERMIT APPLICATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 111260
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFnRRMATION PRESENTED:
_VApproved_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 Ehn Street Commission Permit DPW Storm Water Management
_Demolition Delay n
�/-- � J`�-/� ly 1
Signature o uil— ding 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.
RECEIVED eanG.i.com
G DReprtGn 3
MAR 1 2 2019 GreenReN.MA M302 2
P 800.828.1800
F413.T13.SW8
Building Commissioner's Office DEP, o=mn1D;
99 INDUSTRIAL DR-HERITAGE HEMP BP-2019-0642
GIS4: COMMONWEALTH OF MASSACHUSETTS
Mw:Block:25A- 188 CITY OF NORTHAMPTON
Lor-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category•Zoning Permit BUILDING PERMIT
Permit k BP-2019-0842
Project a JS-2019-000947
Ls[ Cost,$28900.00
Fee:$202.00 PERMISSION IS HEREBY GRANTED TO:
Court Class, Contractor: License:
Use Group: SANDRI CO 111260
Lot Simian.ft.): 172497.60 Owner: CONZ STREET REALTY INC
Zoning;G1001)/ Applicant. SANDRI CO
AT: 99 INDUSTRIAL DR - HERITAGE HEMP
Applicant Address: Phone: Insurance:
400 CHAPMAN ST (413)772-2121 WC
GREENFIELDMA01301 ISSUED 5N:3/4/2079 0:00:00
TO PERFORM THE FOLLOWING WORK.NEW CEILING AND 1 WALL IN EXISITNG ROOM
& INSTALL EXTRACTION MACHINE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspectorof Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Melon
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. y�
Certificate of Occupancy Signature: (/
FeeTvi)e: Date Paid: Amount:
Building 3/420190;00;00 $202.00
212 Main Street,Phone(413)587.1240, Fax;(413)587-1272
Louis Hasbrouck-Building Commissioner
COMMONWEALTH OF MASSACHUSETTS
SHEET METALWORKERS
ISSUES THE FOLLOWING LICENSE
MASTER-UNRESTRICTED
FLOYD M DUNNELL \..,
400 CHAPMAN ST
A R INC
GREENFIELD, MA 01301-1736
11606 0812812020 527256
CONTROL# J 10 9 2 9 0 9
IMPORTANT
If your license is lost,damaged or destmysd;Is inaccurate;or
needs to be corrected,visit our web site at meca.gov/dpl for
instructions to ensure the proper mailing of your Renewal
APPIICatIOo and any other coneepondence.
This license Is subject to Massachusetts General Laws and
regulations.Your license is a pnvilege,and cannot be lent or
assigned to any person or entity under penalty of law:Keep this
license on Your person of posted as required by law and/or
regulations.
The CommonweaA'h of Massachusetts
Department oflndustrialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass gov/dia
WW'rkers'Compermation Insurance Affidavit:BuilderstContractors/Electricians/Plumbers.
TO BE PILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Leeibly
Nagle(Business/OrgmimdonTndividual):Sandri Energy, LLC
Address:400 Chapman Street
City/Stete2ip:Greenfield, MA 01301 Phoae#:(413)772-2121
Are you an employe Check the appropriate hoc Type of project(required):
l.p i am a evgbyer with 750 employees(fou mdlm Pat-fiae)' 7. ❑New construction
2.❑Icmawkproprietororpmtoashipm Mvememployeeswo gformeic 8. []Remodeling
ary capacity.[No workers'comp.immwce rcqui ]
Derran
non
3.❑lamahome .ding all kmyself.[No workem'wmp.fteerecerequrIG alt 9. ❑BuddingadditionBudding
ensure thaz aU wntmcfom eiurerhav<wakas'wmpmsetiw msmmceor ve cola I I.❑Electrical repairs or additions
proprietors with no eugloyees.
12.E]Plumbing repairs or additions
d4—]lava gmeal ctarc hwampavehheddle bwr a'wa6.aanthe ttbched abet 13. Roof airs
these eubcomvcton have employees and heveworkem'comp.iosvmec<.t ❑ �
6.❑We are amrpoupon and uta officer tam crmdaedtheir right efexempfien per MGL c. 14.❑Other
152,41(a),anawe harem euPloyees.[No wmken'comp.inammcemquimd.l
•Any appucavtmatcheeks box#1 mrft ileo fill out the aecfioabelow ebowiug theirwmkas'rompeeeaianpolioy iofolmtiw.
t Honxo n who nbmitthis affidavit mdicahag Hwy aredoingaUl crkand Hwnhhe ouuldc comacmn mastsubmit anew affidavit mdicativg 911[11.
tContxtorsthatebeckthis boxmustatmchedenadditionalsheetsbowasgtl a%uc ofthe robaoauactorsandsmwwhetherornotthroe erneshave
employees. Ifthe mbcwtncton have employees,they mart provide their workers'comp.policy vmnber.
Zan,anemployerthatisprovidingworkm'compmsationinsunmceformyemployees. Below is thepoliry andjob she
information
Insurance Company Name:Llberty Mutual Fire Insurance Company
Policy#or Self-ins.Lie.#:WC2-Z11-B8863T-018 Expiration Date:07/31/2019
Job Site Address: City/Stanump:'
Attach a copy of the workers'compea mflon policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby cerd s n p n o erjurythatthe infaM, copy ob a and correct.
Signature: Dat.-09. Oa is
Phone 0:(413)223-112i
OJreial use only. Do not write in Ms area,to be completed by pry or fawn official
City or Town: Permit/I.iceme#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/To"Clerk 4.Electrical Inspector 5.Plumbing Tnspector
6.Other
Contact Person: Phone M