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30A-032 (101) 320 RIVERSIDE DR BP-2007-0876 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.-Block: 30A-032 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: BUILDING PERMIT Permit# BP-2007-0876 Project# JS-2007-001434 Est. Cost: $550.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: IJse Groin: Harvey Messeck 006919 Lot Size(sQ. ft.): 0.00 Owner: CFP PROPERTIES LLC Zoning: Sl Applicant: Harvey Messeck S20 RIVERSIDE DR Applicant Address: Phone: Insurance: 271 Prospect Street (413) 584-4460 •NORTHAMPTONMA01060 ISSUED ON:3/26/2007 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT BRICK PASSAGE WAY BETWEEN MOTHERWEAR & TAPESTRY 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: p(e,,1010'4 01 t�omt t (�'Wk&Aj U 91AT 6(c) THIS PFRMIT MAY BE REVOKED BY THE ITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS 2zf2 Certificate of Occu an ,G Signature: FeeT - e: Date Paid: Amount: Building 3/26/2007 0:00:00 $50.003966 212 Main Street,Phon•�( , '`7.1240,Fax: (413) 587-1272 Building Cor ._. �::i: - Antl,ony Patillo 320 RIVERSIDE DR BP-2007-0876 GIs#: ` COMMONWEALTH OF MASSACHUSETTS Map:Block: 30A-032 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2007-0876 Project# JS-2007-001434 Est. Cost: $550.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin: Harvey Messeck 006919 Lot Size(sq. ft.): 0.00 Owner: CFP PROPERTIES LLC Zoning: SI Applicant: Harvey Messeck AT. 320 RIVERSIDE DR Applicant Address: Phone: Insurance: 271 Prospect Street (413) 584-4460 NORTHAMPTON MAO 1060 ISSUED ON:3/26/2007 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT BRICK PASSAGE WAY BETWEEN MOTHERWEAR & TAPESTRY 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 Signature: FeeType• Date Paid: Amount: Building 3/26/2007 0:00:00 $50.003966 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2007-0876 APPLICANT/CONTACT PERSON Harvey Messeck ADDRESS/PHONE 271 Prospect Street NORTHAMPTON (413)584-4460 PROPERTY LOCATION 320 RIVERSIDE DR MAP 30A PARCEL 032 001 ZONE SI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid do Typeof Construction: CONSTRUCT BRICK PASSAGE WAY BETWEEN MOTHERWEAR&TAPESTRY New Construction Non Structural interior renovations Addition to Existiniz Accessory Structure Building Plans Included: Owner/Statement or License 006919 3 sets of Plans/Plot Plan TH/FA WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INION PRESENTED: d 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 2 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 fW Department use only', _ r City of Northampton st tus of r n :t �-...-Building Department curb cv T, e Jay Permit _—_ ---_ 212 Main Street lsevre-CSeptic Availability_______ t Room 100 GWaterMlell Avaiiability _ ^� 2 ' Northampton, MA 01060 ;Two Sets of Structural Plzns_ MPFI phone 413-587-1240 Fax 413-587-1272 Plct/Site Pians_______ Other Specify 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 This section to be completed by office_ -1.1 Property-Address: 1u U6 ` / j5k1 E— Map Lot Unit Zone:; Overlay District ' Elm St.Qtsfnct CB District —--- SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: t'U7te1Z`� 1�11/t 01W& /Y1 crc � S Name(Print) Current Mailing Address: i Signature i/ Telephone 2.2 Authorized Agent: i Name(Print) Current Mailing Address: i Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6) --- 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Versionl.7 Commercial Building Permit May 15,2000 f.. SECTION 4-CONSTRUCTION SERVICES F6F2 PROJECTS LESS THAN 35,000 CUBIG:FEET-OF ENCLOSEDSPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing[] Change of Use❑ Other) Brief Description Enter a brief description here. l- I C Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPu USE GROUP(Check as applicable) CONSTRUCTION TYPE A AssemblyA-1 1:1 A-2 A-3 1A E] ❑ A-4 ❑ A-5 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: I M Mixed Use ❑ Specify: S Special Use ❑ Specify:i COMPLETE THIS'SEGTION;JF EXISTING BUILDING UNDERGOING RENOVATIONS;.ADDITIONS AND/OR CHANGE IN USE Existing Use Group: ! 1 Proposed Use Group: Existing Hazard Index 780 CMR J4):' i Proposed Hazard Index 780 CMR 34): SECTION:6 BUILDING HEIGHT;AND AREA_. BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) : 55, ist St 2nd 2nd! s. •kms 3rd i 3rd 4"' i i 4 m Total Area(sf) ir` Total Proposed New Construction(sf) I i -*M� E. Total Height(ft) I Total Height ft "' 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone[] Municipal ❑ On site disposal system❑ Version 1.7 Commercial Building Permit May 15,2000 S,N©R' HA,IVI ''ONZUNIlBG .. u Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front j Side L:= R:= L:, R:i = ''-- Rear BulTding HeiOIT Bldg.Square Footage % Open Space Footage (Lot area minus bldg&paved arldn ) #of Parking Spaces Fill: ' (volume&Location) i A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q IF YES: enter Book Page; and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtainedQ Obtained Q , Date Issued: C. Do any signs exist on the property? YES ® NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO O IF YES, describe size, type and location: 1 E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ` NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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: I Not Applicable ❑ i Name(Registrant): Registration Number i t � Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): i Name Area of Responsibility i i ! Address Registration Number � ' I i Signature Telephone Expiration Date i Name Area of Responsibility I Address Registration Number i Signature Telephone Expiration Date i Name Area of Responsibility Address Registration Number i � I Signature Telephone Expiration Date Name Area of Responsibility I Address Registration Number i Signature Telephone Expiration Date 9.3 General Contractor Not Applicable❑ Company Name: Responsible In Charge of Construction Address Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 t.. SECTION 10-SiRUCTURAL_PEERREVIEW(T8Q CMR 11011) Independent Structural Engineering Structural Peer Review Required Yes O No SECTION 11--OWNER-AUTHOR1ZATtON--TO BECOMPLETED WHEN OWNERS AGENT.ORCONTRACTORAPPLIES.FOR`BUILDING`PERMIT 1, , e�76 y �CIIZ 1911'J0 7#57SSLV,47- S as Owner of the subject property i hereby authorize �` �yP _ `to / act on my behalf,in all mattals relative to work authorized by this building permit application. iZZ D' Signature of Owner 7E Date i I as Owner/Authorized Agent hereby declare that 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. Print Name' SignatuFe of Owner/Agent Date SECTION 12 CONSTRUC7?ON`SERVECES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:' l/ License Number � 7/ 11-o5Pe �S ,o a � v� at i % �D9 aoo7 Address Expiration D to i Signature Telephone -11 -1- -- -7 - - - . -1- 7 7 7F- SECTION 13-WORKERVvCOMPENSATION-INSURA AEF} 7VLG 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 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia ,Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: eC�� _ City/State/Zip:�i'/Z iYr��i ' /000 00 Phone.#: Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.'& I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance.$ 9. ❑Building addition required.] 5. ❑ We are a corporation and its I0.[1 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.Q Other V comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage,as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investisations of the DIA for insurance coverage verification. I do hereby certify under the pains aVen, es of per' that the information provided above is true and correc Si ature: c Date: Q 7� Phone#: i Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: