32A-135 1'KING ST q iv, . BP-2003-1027
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map Bloci 32A 35 5 CITY OF NORTHAMPTON
Lot: -001 i
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-1027
Project# JS-2003-1638 1
Est.Cost: $17400.00
Fee: $87.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Young Roofing Co Inc 011878
Lot Size(sq.ft.): 4791.60 Owner: PERLMAN DENIS
Zoning: CB Applicant: Young Roofing Co Inc
AT: 1 KING ST
Applicant Address: Phone: Insurance:
P O Box 56 (413) 584-1367 Workers Compensation,
FLORENCEMA01062 ISSUED ON:5/15/03 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL NEW BALLASTED MEMBRANE ROOF
W/INSULATION
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: II
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: Receipt No: Date Paid: Check No: Amount:
Building 5/15/03 0:00:00 14917 $87.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
•
v Versionl.7 Commercial Building Permit May 15,2000
• City of Northampton .tatso'f*te�rr'il��l5f� ,:'14 '°f /{�!}�
•Building Department ur G'ut 'D i .upP r ° , ,r g �•
1 ra .t ag w,€ r, eyt, x:'� s. rg = t-,or,a%
212 Main Street Set i e 1 ' TAIiti3 i � S, MA , � :.
I' • Room 100 •t erl Vel 4 `�la ►f� �! 'A
Fe P rqf -`�a U' r L> r F 'i
Northampton, MA 01060 xWo 4ets'oi.,,, tt tI a a s 1' •• ` ` ,
phone 4i13-.587-1240 Fax 413.587-1272 P1ot,�5tte' Plbaim r '� I x � ^� � ;.
• tVi,y 2CO3 , -j Other_Speclfy �n a.. - ' ' - _- NAP'
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
1
SECTION 1-.SITE INFORMATION '
i.f Th►ssect►onto beco mpleted by of f►ce `1.1 Property Address: eyr _ s s e�y � e : 2 0t + J0* 3I
3
I Kin ' -- Ma'= �, ti'Lot 4et zi +,furl �:y1Unit r
,l (��/���/�/J JJ ��'//� /{,/f////�� /AJ //���n t :i �hr 4 2 ns'fl(/ ,> ►, r4 5'c�" j`T'�'E,Y,lksp'7{�f p 4444. D
1\1V( )a 1O' / / �i , V l V I.Y U q s.,. .Ft f�;Y t 5. j 4 s .i•t tik.7z3,;* v1, t v, o, ,
.� j ,, v tk it t ,,;3.t a ry
i° �� ,Overlay>D►str►ct �#��} r ,s, _ ,
Zone•c �,
x� ��� z:.: jc F V,IP*1:14 4{V t^NPAV r ail. ,&r t
/ ,wka yua $ TS`a '° A Y d"s,, r 5 r,
,,Elm;St'District ,' '4� t..:CB District"tip'=R ..
SECTION 2= PROPERTY OWNERSHIP/AUTHORIZED..AGENT
2.1 Owner of Record:
SI I,VeYSCti-Pe IeSi l I K.(inc S+�• A)OV4-hah1��i PA-.
Name(Print) U Current Mailing AdlQlress:
See a. ac6 e pvDposr.ci • '413- 5-gLI - 33a4
Signature Telephone
2.2 Authorized Agent:
Young Roof in• Co., Inc. P:O. Box 56 Florence, MA. 01062-0056
Name(Prim 9' Current Mailing Address:
•
/ '/Air . 413-584-1367
Signa ure / f Telephone
SECTION 3 - ESTIMATED CONSTRUCTION-COST•S:: -
Item Estimated Cost(Dollars)to be Official Use'Only,
completed by permit applicant • .. .
1. Building l(y6)
(a) Building Permit Fee
2. Electrical (b) Estimated Total`Cost of
: .coo str:.uction from (6)..:...,.. r:., -
3. Plumbing Building Perm►t Fee
:
4. Mechanical (HVAC)
5. Fire Protection - .
6. Total =(1 + 2 +3 +4 + 5) I 1 H-00 ;Check•Number
... . .. 1:Thus.Sect►on.;For:Off►c►ali.Use Only .... `s
f
Building Permit:Number Date Issued ,
.' e ` r
:. ... .:..:. :. .�;. ..,.. ... .,.: ... :.: .�,s ..�..a '�.�..# ;`�... .fA..4. i LI ... sty S .. I .. -.
:
Signature
.-Building Commissioner/Inspector.of:Btii.ldmgs Date` .
Version1.7 Commercial Building Permit May 1'5,2000
•
SECTION 4 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 • .
CUBIC FEET OF ENCLOSED SPACE `'
Interior Alterations Existing Wall Signs Existing Ground Signs Additions 0 Roofing 1l
0 0
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
0 Accessory Building[ ] Repairs [ ]
E4 IDcseexp-Tre, : �iri34-a,ktiii8 a.n e, b atad—etil wt e ye tviw4—ii su1 M
SECTION 5 -USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly I❑ A-1 El A-2 0 A-3 ❑ 1A I ❑
A-4 El A-5 0 1 B ❑
B Business ❑ • 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C 0
•
H High Hazard El 3A 0
I Institutional ❑ I-1 0 1-2 ❑ 1.3 0 3B ❑
M Mercantile El 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A ❑
S Storage ❑ S-1 ❑ S-2 0 5B 0
U Utility 0 Specify:
M Mixed Use El 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
•
ilkeBUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION �lx �'"o 'rO1FFICE USE�ONL " r� „`.,i,$.
. 3 sE �.e'�' {?a... ee��c'��'�:sS-stH';.w�.?;13., .."v-#���k, P.n �:
ail tv''�.a,.1wiT fi� l.exr i' filykos,. . .'4.
Floor Area per Floor(sf) 15t }� !,¢ �� .f,,, -,( € ,,, 1 s> ,
nd 3¢ fP 4'+ Y 4140041.59A P
th e ,55��a � ��3 r g �t.
3rd 4 q x �t3i.itYk t$a a,,�bt �, '' � � ,§1004 F!.
ax r P � ,�}� xs r 4 7# jj� P 3
Ab igl ti I 1 i -'wile ' l4g,4}�y,l' x=• v.t
IL
111 4FC4� ,O, wi 4d"Exu� �l rAvAt .td6
���x S' assA4£ ��n.�4 27 '� � Y�14.�. .,-�`r�3x't�C�i,34z`2,x.�.
L. a �7 x &ri r j S.z,IVAI t ikV
Total Area (sf) Total Proposed New Construction (sf) �v ,' �r;A�� ; ,,��` ,
n+i y 5 1 . x
y, '^y iy. } ta�sY,i T. tei �xtt .:il41 f"A Y15 v
—
Total Height(ft) y 5i :, 1L,. 4 i. a t m$i ,r,,
Total Height ft 1'°' �i'i;twl{; `� 4 ` 4,, lz,i ,:,
Versionl.7 Commercial Building Permit May 15,2000
'T�Y�....�+,:}`%� ',�:"p§�"Mb:�.1.: ,�°dra„�.r d,�, ,,,'-,�e� �«. .�,r.,:z•�a#ril'a�>�"�x��_.... 7.:.,:,arA . l;IiF.? .a`,
''SECT 4#91 P 0 ESSIUNAI:DESIGN AND =f STRU:C (1. „„ R1/IOES, F `:R BU LD " 9 k,'
��. .-,_..«n� �a,;�,,:����a���,. ��.,.:�,� �. .�,�, .,.:,-1 ...�:.. „�m k �,,..�.,�a. � .��a�Q-� a= ..�..�.,� I�IS',�tD�,5TRU,�, U E�SS� BJ;�L��T'TO
�Co"NS' EV=TVICOTRUL PUR 'U IL 0 91- 1444 CONTAINNG•, 'MO 2E'i;HAN`35 OUO�Cs P:r L " � �
�, � �, � �. �.w_..�r��,�-�, ,��.����,, �,���brr.:..�.(���g.�._�<.���.��.. <.>.�W r��.., .�„u.x,�,x,.a.�.,,,,,�,:x:��.�w.�� �,. .. ���ED„ P��E)1 s
9.1 Registered Architect:
Not 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
Young Roofing Co., Inc. Not Applicable 0
Company Name:
Richard Young President
Responsible In Charge of Construction
P.O. Box 56 Florence, MA. 01062
Address
584-1367
Signature Telephone
Version1.7 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 0 Municipal ❑ On site disposal system 0
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
•
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW- V YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW V 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 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
•
Version1.7 Commercial Building Pennit May 15,2000
SECTION 10 STRUCTURAL PEER REVIEW(780 CMR 110 11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No
SECTION 11=OWNER AUTHORIZATION -;TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, , as Owner of the suhjecl propel lv
hereby authorize to act or
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
, 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
Signature of Owner/Agent Date
SECTION 12 -CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: Richard Young 011878
License Number
P.O. Box 4,Florence, MA. 01062 8/14/03
Address Expiration Date
413-584-1367
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 affidavi-
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes fc] No 0
4-(NAM p�,
Bc ..ts'6 C1.if1r lad >za #If�tin}rfult
gate"/ . Ala5anCliunrtta'
zWDEPARTMENT OP BUILDING INSPECTIONS 4
' 212 Main Street ' Municipal Building .
Northampton, Mass. 01060 ���
174/OI2KER'S (.C()M.I'ENSA'J'JON INSURANCE AFFIDAVIT
I, .
(license&permittec) -
with a principal place of business/residence at:
•
• (phone)
(Ftre t/city/statc'7ip)
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 wolfing on this job: .
• A :err I �r f korke 6. wco07 P5 3N9U3 i 11 Ia y
(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 Number) (Expiration Date)
_' 'I..
n.
.i: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
fit --
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
"
L
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) .
tA "
4 (and]additional sheet ifn tt•ry to include information pertaining to all contractors
)
• tta
a ( ) I am a sole proprietor and have no one working for me.
• ( ) I am a home owner performing all the work myself.
•
•
-1 NOTE:please be aware that while homeowners who t l�•':,� emp oy persons to do maintenance,ceastructioa'ar repair work oo a dwelling of
not more than throe units in which the honwovr ocr resides oc oa the gi-ou d,appurtenant thereto are not t• ally cooiidatd to be
employe under tho workegs compensation Act(GL152,ss 1(5)),application by a homeowner fora License or permit may evidence the
legal ctahre of an employer under the Wodusen Compensation Act
I understand that a copy of this statement may be forwarded to the Department of Industrial Aoeidenti'Offioo of lnsuance for the
• ooverxge vaificatioa and that failure to secure covcraga under section 25A of MCL 152 can lead to the imposition of criminal penalties
eomistiog of a fine of up to S 1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
••
Eno of SI00.00 a day against me.
7-
For dct,artrmtal use ashy
Permit Number 51i51(3 Map lot
:...t.:.. Signature o icease PIT - Date
FROM :CONSTRUCT RSSOCIRTES FAX NO. :4135B47504 May. 14 2003 01:09PM P2
Contr.Lic.No, 1.01723 NOV 2 0 2002
O V NET Tel. 413-584-13 7
Roofing Co., Inc. � 413-586-9167
Fax 413-585-0226
P.O. Box 60056
Florence, MA 01062.0056
Date; 11/19/02
Customer : Construct Associates, Inc.
Address: Service Center Northampton, MA. 01.060
Job Location Silverscape Designs 1 King Si. Northampton, .MA• ..__.
SPECIFICATIONS: •
1. Remove the existing ballast stone and apply 1 inch polyisocyanurate insulation.. .R Value 7.0.
2. Install Carlisle's ballast roofing system and return the existing ballast stone.
3. Flash all walls, edges, and roof penetrations with an approved Carlisle detail.
4. Install 16 oz, lead coated copper edge metal to the parapet walls.
5. Install.2-4 inch retrofit roof drains. •
6. Remove any'unused equipment off the roof and dispose in a legal ls,nd fill,
7. Upon completion of the work Carlisle will inspect the job an issue the owner a Fifteen (15)
year. Golden Seal Total. System warranty.
The General Contractor will install the wood nailer to the parapet walls and have the electrical
conduits and unit on roof disconnected.
•
•
All tltaLat'Iol in gaamnteed to be as opml0ed. Any n$erstinns or drvlaq°n heal nb.'VO
npetdllcntlane Involving txim coats will be twenutrdd nnly ilium written orders,and will boctnae an extrn charge over and Above the estimate. All agreements corltlagent upon 'dal aMites,neeldante or delaye beyond our control. Owner to nnny fire.and other ncn eanty
ineurunue. All neecomts not paid within 96 nays aro aui3Jcct ton late charge of 1 I/2% Authorized ard Yo g resident
per month on the nnlwlel Warm In rho°vent Mal legal adieu 1s Inshore l to en ho%
any lame dim under this agreement,the un t°rdgncd egreeo to pay all costa Inmate(' Signature
Including roaaonahlo ullorney'n fees.
Acceptance of Proposal- The above Witness
Signature
prices,specifications and condltlons are satisfactory and arc
hereby accepted. You are authorized to do the work as
specified. Payment will be made us outlined above.
Date of Acceptance . c j I aCI) Acceptance ? j-1�