11-002 (20) BP-2021-1894
0 HAYDENVILLE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
11-002-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2021-1894 PERMISSION IS HEREBY GRANTED TO:
Project# ANTENNA Contractor: License:
Est. Cost: 1500 EASTERN COMMUNICATIONS INC 79697
Const.Class: Exp.Date:02/20/2023
Use Group: Owner: NORTHAMPTON CITY OF SMITH SCHOOL
Lot Size (sq.ft.)
Zoning: Rl/RR/WSP Applicant: EASTERN COMMUNICATIONS INC
Applicant Address Phone: Insurance:
103R OLD WINDSOR RD 8960-242-8100 X 229 5101800727
BLOOMFIELD ,CT 06002
ISSUED ON:09/20/2021
TO PERFORM THE FOLLOWING WORK:
80KW GENERATOR
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.
Signature:
)2 CP •
•Fees Paid: $105.00
212 Main Street, Phone 413 587-1240 Fax: 413 587-1272
Office of the Buildine Commissioner
I
00 /U�w CP1 i f�lr
SECTION 4: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
American Tower Corp. 10 Presidential Way Woburn, MA 01801
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Project Mgr. 646.669.4302 - - Martin Gumbs
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑.
Otherwise provide construction control forms(see section 107 in the code)as required.
1 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Eastern Communications, Inc.
Company Name
Michael Heath / Joseph Gagnon CS-079697 /20731 A & 11237 B
Name of Person Responsible for Construction License No. and Type if Applicable
103R Old Windsor Rd Rloomfield CT 06002
Street Address City/Town State Zip
86Q 242 8100, x229 860.307. 9715 cmorton@eastemcomm.com
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes a No CI
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$ .
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
appl ation is true and accurate to the best of my knowledge and understanding.
1 ,, f U► UV��� �1 Ul �� Project Manager $60. 307 9715 111501
Please print d sign name Title Telephone No. Date
103R Old Windsor Rd. Bloomfield CT 06002 cmortoneasterncomm.com
Street Address City/Town State Zip Email Address
1 Municipal Inspector to fill out this section upon application approval:
Name Date