22B-008 (17) 130 SPRING ST BP-2002-0934
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:22B-008 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2002-0934
Project# JS-2002-1511
Est.Cost: $2800.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KENNETH LYNDS 0013668
Lot Size(sg. ft.): 65775.60 Owner: PEASE THOMAS R&PEGGY-ELLEN
Zoning: GI Applicant: KENNETH LYNDS
AT. 130 SPRING ST
Applicant Address: Phone: Insurance:
P O BOX 448 (413) 584-9282
LEEDSMA01053 ISSUED ON:4/29/02 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 22 X 10 ADDITION FOR OFFICE
SPACE
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 4/29/02 0:00:00 2053 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
y
File#BP-2002-0934
APPLICANT/CONTACT PERSON KENNETH LYNDS
ADDRESS/PHONE P O BOX 448 (413)584-9282
PROPERTY LOCATION 130 SPRING ST
MAP 22B PARCEL 008 001 ZONE GI
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid 149 iF3
Typeof Construction: CONSTRUCT 22 X 10 ADDITION FOR OFFICE SPACE
New Construction
Non Structural interior renovations
Addition to Existin4
Accessory Structure
Building Plans Included:
Owner/Statement or License 0013668
3 sets of Plans/Plot Plan
S
FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
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 Commissio
LCie
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.
Versionl.7 Commercial Building Permit May 15,2000
Department use only --
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability _
Room 100 Water/Well Availability
-- Nor-thampton, MA 01060 Two Sets of Structural Plans
f �% �� ;pholi� 40-§87-1240 Fax 413.587-1272 Ptot/Site Plans
1—, r _ Other Specify—__-
APPLICATI�TO O,O"UCT,REPAIR, RE OVANE, CHANONE G TTHE WO USE OFAMR DWELLING OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHESECTION 1 --SITE INFORMATION
1.1 Property Address: This section to be completed by office
YE
Map Lot Unit
n _ Aa f I
0 6 a 6 Z' Zone -� —Overlay District
Elm St. District____ _____ CB District_
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 j2bwner of Rec rd:
r 6. oX Z(/ fi/&P1 ACe— _ A p(06 Z
Na a Print) Current Mailing Address:
_ 4L/3 — Sb'CI, .:Y39L
signaturoDO 0 Telephone
2.2 Auth rized A e
Z W �J 13o S<l'
jamoit) Current Mailing Address:
Zs-1,44 Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building ,.l6 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from 6 _
3. Plumbing , )b � Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number 6
This Section For Official Use Only
Building Permit Number: o�1? Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
Version 1.7 Commercial Building Permit May 15,2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations Existing Wall Signs Existing Ground Signs AdditionsA Roofing ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building [ ] Repairs [ ]
6/l- tt - o-- / cc ✓Af%,t.jo
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business 1i 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High 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 ��C r
M Mixed Use ❑ Specify:
r `'�•GtY
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
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf) St /O� x LLQ
1st____
D 2nd
2nd
3'd
3rd 4th —
4th
Total Area (sf) � Total Proposed New Construction (sf)
Total Height(ft) l
Total Height ft ------ �� fl
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 Private ❑ Zone: Outside Flood Zone ❑ I Municipal ;<On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size t•7 GJrA0
r
Frontage '03 f� r 6J� Fr
Setbacks Front ,."6 $8
Side L:/A0 • R: (Zo L:/p°r R: !Lo
Rear ZZo ZZo
Building Height l V fT D z
Bldg. Square Footage �p6 p T % ZZd
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces t7 SA WA-
Fill:
6
volume&Location ._ V
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued: L – G - 1W
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 r � — NO
IF YES, describe size, type and location: (lAc, d� D� -Z"'6
D. Are here any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
Version 1.7 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:
W4Not Applicable ❑
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 1
Aqchxr,&,/1
- z 6K4h-Gfa#e:oo Not Applicable ❑
Company ame:
Al A dJ
Respo ible In Charge of Constructi n
qj
t✓va ;c /Go �.c v o s"3
Address
C nugyW—Pg4i7 l-s?Y-Li SQL
Sigre Telephone
Version 1.7 Commercial Building Permit May 15,2000
SECTION 10- STRUCTURAL PEER REVIEW(780 CMR 110.11) 7
Independent Structural Engineering Structural Peer Review Required Yes......❑ No......
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
0ht" -r I as Owner of the subject property
hereby authorize to act on
behalf, ' all matters re a i tem orize by this build—ing perm application.
.� .Z �0
Signa f Owner Date
I, -h k L wl1 as o /Authorized Agent
hereby decl re that the statements an information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed and r the pains d penalties of perjury.
Print Name
Signat f Qwaer/Agent Date
SECTION 12 -CONSTRUCTION SERVICES
10.1 Licensed Construction Su ervisor: ,�r Not Applicable ❑ /
Name of License Holder: h K - ✓l"� ed — 13(1CY
License Number
71 WWwuo�`� . °,Jeor sus// L e t C(--r a.t'1 _7. Z4- ?") 3
Address Expiration Date
a ure 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....... No...... 0
its!PCO
a� 49 Crzt laf 'Wa t1jam tail
B6asaachnsrtts'
m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building 'o
Northampton, Mass. 01060 ,~
WORKE,R'S COMPENSATION' NSURAN\CE AFMI AVIT
Z J
(Iicensee/permittee)
with a principal place of
business/residence at:
.Crvo12 /�, L,c-C.d.! �1- -44J, d/6f3 (phonell) YIJ -J7Y-ZXX
(street/ci ty/stale/a p)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this)ob:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Numbcr) (Expiration Date)
(Name of Contractor) (Insurance Company/Poky Number) (Expiration Date)
(Name of Contractor) (Insurance Compary/Policy Number) (Fapiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach a.d&6oml sheet if naxnuy to indorse information pcscaiui.ng to all ooatradots)
am a sole proprietor and have no one working for me.
I am a home owner performing all the work myself.
NOTE:please be aware that while homeowne s who employ persons w do mxii tc ,,cc�eoostn=oe or rcpaz worse on a dwelling of
not more than throe units in which the homeowr resides or on the grounds appurtenant thereto arc not gc=ally ooandertd to be
employers under the w-ka s onmptus4oa Act(GL152,ss 1(5)),application by a homeowner far a Game cc permit may evidence tho
legal su- of an employer under tho Workeeg Compomaiion Ad
I understand that a Copy of this s2 t-A may bo forwarded to tbo Dtpartn c of Dial Acadca&Off oa of 1n=Anoe for the
coverage vaificatioo and that failure to secure covaago under section 25A of MGL 152 can Icad to tba inspos On of criminal pcn W-
ooasisticng of it fine of up to S1,500.00 anNor imprisonment of tip to one ytar and civil pcnaltia in the form of a Stop Work Order and a
fins of 5100.00 a day against me
For&Pntmartal use only
Permit Number
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CITY OF NORTHAMPTON APRIL 29, 2002
BUILDING INSPECTOR
212 MAIN STREET
NORTHAMPTON,MA. 01060
TO OFFICE OF BUILDING INSPECTOR,
THIS IS TO CONFIRM THAT THE ADDITION TO OUR
EXISTING BUSINESS IS FOR THE PURPOSE OF OFFICE SPACE. IF THERE
ARE ANY FURTHER QUESTIONS FEEL FREE TO CONTACT ME. sh/Q
THANK YOU,
SINCERELY,
THOMAS&PEGGY PEASE
130 SPRING STREET
FLORENCE,MA. 01062
TEL.- 3-584-839
a. MAY — 2 2002 '..�..e