30A-032 (85) 320 RIVERSIDE DR BP-2002-1112
#: COMMONWEALTH OF MASSACHUSETTS
*ff'Block: 30A-032 CITY OF NORTHAMPTON
Lot: -001
Permit: BuiIdIni?
Category BUILDING PERMIT
Permit# BP-2002-1112
Project# JS-2002-1782
Est. Cost: $10876.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BOURKE BUILDERS 035861
Lot Size(sq. ft.): 0.00 Owner: CFP PROPERTIES LLC
Zoning: GI Applicant: BOURKE BUILDERS
AT. 320 RIVERSIDE DR
Applicant Address: Phone: Insurance:
77 LONG HILL RD (413) 548-9214 Workers
Compensation
LEVERETTMA01054 ISSUED ON.6/13/02 0:00:00
TO PERFORM THE FOLLOWING WORK.-DEMO WATER DAMAGED FLR & DRYWALL,
POUR CONCRETE FLR & REPAIR DRYWALL - BASEMENT
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 SiEnature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/13/02 0:00:00 5650 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
a� File#BP-2002-1112
APPLICANT/CONTACT PERSON BOURKE BUILDERS
ADDRESS/PHONE 77 LONG HILL RD (413)548-9214
PROPERTY LOCATION 320 RIVERSIDE DR
MAP 30A PARCEL 032 001 ZONE GI
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid I-rah-0
Typeof Construction: DEMO WATER DAMAGED FLR&DRYWALL POUR CONCRETE FLR&REPAIR
DRYWALL-BASEMENT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included• -
Owner/Statement or License 035861
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 111ATION 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 Commissio
zoo
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 1.7 Commercial Building Permit May 15,2000
* epa merit tlse'onlyl ,�
City of Northamptonx� m a , ��
t ttl o : r
Building Department t a
erlt. m �
212 Main Street
Room 100 & •
Q r pton, MA 01060 1 atl � '
`n
Tw het o t c Ka an ..
8 1240 Fax 413-587-1272 p , a<
/. Other S eCi 5
PPL Y+ATI 0 UCm P. n w. _w
AIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
OFoT 0r RI!I[DING INS?ECTIONS
SECTION 1 -SITE INFORMATION
1.1 Property Address: /� This section to be ccoompleted by office
�—�' /ZI��✓c� StYJ� bRty"� Map Lot J
Unit
(� C, Zone / Overlay District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Elm St. District CB District
2.1 Owner of Record:
Name(Prink) -� !�"� 1�'e�'��`TL`;l`t
Current Mailing Address:
9��
Telephone
Aut prized A ent:
c.kL ,� � �7 L��G lam.t
Nam rent) /� LL_ /COIF; A
a
Current Mailing Address:
4I 3 _
Signature '' Z�
Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be
Completed b permit a licant Official Use Only
I. Building
(a) Building Permit Fee
?. Electrical (�
(b) Estimated Total Cost of
's. Plumbing Construction from 6
JV!A Building Permit Fee
Mechanical (HVAC)
Fire Protection /j Occ , OG3
Total =(1 + 2 + 3 +4 + 5
6 76, 60 Check Number
U —
This Section For
uilding Permit Number: Official Use only
Date Issued:
gnature:
Building Commissioner/Inspector of Buildings
Date
Version 1.7 Commercial Building Permit May 15,2000
4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
FEET OF ENCLOSED SPACE
-----------------
Interior Alterations
Existing Wall Signs
❑ ❑Existing Ground Signs Additions ❑
Roofing ❑
Exterior Alterations Demolitionw-11 New Signs [ ] Change of Use [ ) Other
❑ Accessory Building[ ] Repairs [ ] [ )
— ��p�r �: Df��w� w►aPE�4 AC C1�x►Q a�eywaii ' O�u,e�,v�^.�r��'4�c �2�A Ii
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE L`"
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑
lA ❑
A-4 ❑ A-5 ❑ 1 B
B Business ❑
E Educational ❑ 2A ❑
F Factory ❑ F-1 ❑ 28 I El
F-2 ❑ 2C ❑
H Hi h Hazard ❑
1 Institutional ❑ 3A ❑
I-1 ❑ 1-2 ❑ 1-3 ❑ 38
M Mercantile ❑ ❑
4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑
S Storage S-1 ❑ S-2 ❑ 5A ❑
5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA �j 4—
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
r�C �t{Iq+�L� f tJ S, � C� (NT1�.fUr�.�►�:jej
Floor Area per Floor(sf)
St
]st 2nd
2nd 3rd
3rd 4th
4th
Total Area (sf) Total Proposed New Construction (sf)
.................................. .:
Total Height(ft) —
:1
Total Height ft ....................
Version 1.7 Commercial Building Permit May 15,2000
llpply(M.G.L. C. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Private ❑ Zone: Outside Flood Zone ❑ Municipal 2,tn site disposal system ❑
H, NORTHAMPTON ZONING
Exis ing Proposed Required by Zoning
This column to be filled in by
�V f�>g211C��S Building Department
I,nl Size
I�runta*e
tielbacks Front
Side L: R: L: R:
Rear
1111ilding Height
111,18. Square Footage %
open Space Footage %
(I of arca minus bldg&paved
vul.ui
N ul'Parkin Spaces
I�ill:
(v„lame&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW J 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 #
L3• Does the site contain a brook, body of water or wetlands? NO '� DON'T KNOW
YI_S
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
IF YES, describe size, type and location: NEIL Z jPk+IAJ�TrPJ — v('4- '0C-0'L0., G3 LZ L41 k3(;_
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No ;---
IF
IF YES, describe size, type and location:
-,r.....—mal Ftuildine Permit May 15,2000
Versionl.7 Commercial Building Permit May 15,2000
PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO
4�1!:;,'� GCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)
gistered Architect:
Not Applicable L�
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
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
T7'7 ION C� m LL P<-Y) v a4--r,- Tr' M 4- CI C,54
Add
.5"4e,-Y2/4
Signature Telephone
Version 1.7 Commercial Building Permit May 15,2000
jON 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
,dependent Structural Engineering Structural Peer Review Required Yes......❑ No......M,
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
X I, 0 6g4-1- 1 YL4iNl 1 VV C>S , as Owner of the subject property
hereby authot.�e
L El, J b k �&o;,(1��C� i tI l� N. to act on
my behalf, n II a s r ati/ /tor uthor,zed by t is duilding permit application.
0,-)
Signat re of ne Date
I,
�A L1 t_ k. -E> 0 k�, �{ as Owner uthorized Age�',
hereby declare that the statements and information on the foregoing application are true and accurate, to the est otmmy�
knowledge and belief.
Signe er the pains and penalties of perjury.
Print Na
Signa re of Owner/Agent' Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : �' " �2.C� +J�eS�
License Number
i ►�t w ��T_
I'd+�it r.Ls irlat- G I C->C�- 2—
Address Expiration Date
X13 - 5-4R' 39 C
Signature Telephone
SECTION 13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. 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....... 91,11' No...... 0
�.
•�0 0
af17Z1�&111�JIII1
�' �asarrcflnsctta'
m DEPARTMENT' OP BUILDITNG INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
(�
WORR1,R'S COMPENSATION INSURANCE AVIT
PAIL ►ri- �oi� tt=
(licenser�permittec}
with a principal place of business/residence at:
o , Lim v.>✓N2+STT (phoned) A(-*5
(str>wt/ci ty/stab/rip)
do hereby certify, under the pains and penalties of perjury, that:
('� 1 am an employer providing the following v"Orker's compensation coverage for my
employees working on this job:
-:7_-7pe, . Co . 6 6q- q 4 Z ; C13
Gasur= co
mpany) (Policy Number) cation Date
�P )
am a sol ro rietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
IQCtIIF---
(Name of Contractor) (InsuranceCompany/Pobcy Numbcz) tmtion Date
., (E� )
(Name of Contractor) (Insurance Compam/Policy Number) (Expiration Date)
(Name of Contractor)
(Insurance Company/Policy Number) (Expiration Date)
-------------
(Name of Contactor) (Insurance Co /poli Number
(anadh�oaal sheet ifneoeasry to in,}- n ) (Expiration Date)
mforasIIon pertaining to an oo�nd4„)
( ) I am a sole proprietor and have no one worlang for me.
( ) T am a home owner performing all the work myself.
NOTE:please be aware trot vile hoac
than three uniU' wnm who l
not-aro to which the homeowner rrsidca or m Pte-to do rm rt r, o�n=oa or repair work on a dwr l of
e-players ander the wwka4 dation Aci(GL 152 ss 1 5 � �lherdo arc Oct Caxralty oo =knd to be
legal ctatw of as employer under the Worlrees iceAzL) liratioa by n homoownrr far a licca=a permit may cvi&=the
1 understand thzt a oopy of this rh ttmmi may be forwarded to tbo
-v—gc vaificatioa aad that ad=to satire oo �°`f MG°f 52 cm L d to the i O�oo of l_M. for the
oomistiag of a fine of up to S 1,500.00 and/or im tinder up tion 25A of MOL 152 can teal to the i-pomfi of crimia-a penalba
fim OCS100-00 a day r&&inst me. of up to one year and Civil pcazttica in the fora of a Stop Work Ord—and a
caty
a For dgxrtm=%W usea � Ci/ / Z Permit Numbs "
---- ----- - - - ----------- -- ----- it Lo vo-E N cC� M1%
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P�enPERT1ES k1Ni`IQ
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C O j
BOURKE BUILDERS
77 Long Hill Road
LEVEREIT, MA 01054
(413) 548-9214
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