23D-052 (9) 63 RIVERSIDE DR BP-2006-1046
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D-052 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-1046
Project# JS-2006-1548
Est. Cost: $3000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: William Mazuch 010936
Lot Size(sq. ft.): 10410.84 Owner: AMERICAN LEGION POST#28 HOME INC
Zonine:URB Applicant: William Mazuch
AT: 63 RIVERSR.) :.R
Applicant Address: Phone: Insurance:
69 OLD STAGE RD (413) 247-3242 0
WEST HATFIELDMA01088 ISSUED ON:4/19/2006 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 8 X 8 ENCLOSED PORCH & 4 X 4
LANDING
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:
., nu- I,.,:,a:+ti n:
Final: Smoke: Final: �/ g
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATI I,'''S.
Certificate of Occupancy AO Si_nature:
-yam.
,� .:c.-�'`..
FeeType: . ePaid: Amount:
Building 4/14/2006 0:00:00 $50.009700
212 Main Street,Phone(413)587-1240,Fax:(413) 587-1272
Building Commissioner-Anthony Patillo
File#BP-2006-1046
APPLICANT/CONTACT PERSON William Mazuch
ADDRESS/PHONE 69 OLD STAGE RD WEST HATFIELD (413)247-3242()
PROPERTY LOCATION 63 RIVERSIDE DR
MAP 23D PARCEL 052 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid !�
Typeof Construction: CONSTRUCT 8 X 8 ENCLOSED PORCH&4 X 4 LANDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 010936
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9IMATION 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 C 'ssion
00
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 Offico of
Planning&Development for more information.
4 �.
Versionl.7 Commercial Buildinc Permit May 15,2000
i.. - - "Department use only ;"
�zi fi
of Northampton status of P r n�t. - � '-r--. .'" C'"..--": �
a killing Department GUrb Cu •C:iti way Permit�"- 12 Main Street Sewer/S:,pt,c Avallabifity�_ _
1 Room'100 WaterfVVell a arlabiuty_
n 2CCo
Q°(� — -1. Northampton, MA 01060 Two Sets of St-r;;tural.Plans
phone 41- I-587-1240 Fax 413-587-1272 Plot/Site Plans
r'',r'\(1` .O_ ` Ofh Specify. _._ s-4.i §.
,,,. ►. p1000
APPLICATIOONI,,`i'Cfi CONS-•fRt7C�f,_RE-PAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
_SECTION 1--SITEIINFORMATION
------1 1-Property-Address: •
This section to be completed by office
1 R %h f o C n Map 3 0 Lot `1 '2 Unit
E
1 �,4 Y S j,ca7� Zone 4, R 1 Overlay District
Elm St.Dist-lot CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
AM. I-EO, ION Pelt; f 23 lNC I _
Name(Print) --^y/d(• 00)Aft// Current Mailing Address:
/c
_ (4,k__Gf
; 4%3 rat ti R:e 10�'DR P/ H1A
Signature, Telephone fi'Af 17 f
2.2 Authorized Agent:
//M/7 /`I A20c!'H
Name(Print) W MA Al /v1A2.v6 Current Mailing Address:
�� �` / / } ��q t��lo 5741E 1?D i�,L /JA47- / /o
Signature . 1.L11i-i,y /Z'�7. Telephone 1-1
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 3-e)e) (a)Building Permit Fee
i
2. Electrical 5-eib (b)Estimated Total Cost of
Construction from(6)
3. Plumbing ---% Building Permit Fee
4. Mechanical(HVAC) i i
5.Fire Protection ; !
6. Total=(1 +2+3+4+5) 3 A-)r) Check Number 9-1V 05:0 —
This Section For Official Use Only
Building-Permit Nuniiber- Date
.. Issued
r
Signature:
Building Commissioner/Inspector of Buildings Date
Version1.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations El Existing Wall Signs ❑ Demolition El Repairs❑ Additions El Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use El Other❑
Brief Description Enter a brief description here. PAeLr i, /,4iR ,C pe,+C - P,I)GJ1 271-- 2 No
�l
Of Proposed Work: vl E o.—'Nc t x% 1 /
[-Rom' MA,N `-A// c g,
SECTION 5-USE GROUP AND CONSTRUCTION TYPE t
USE GROUP(Check as applicable) CONSTRUCTION TY
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ iA ❑I
A-4 ❑ A-5 ❑ 1 B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1-1 ❑ I-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 El R-2 ❑ R-3 El 5A ❑
S Storage ❑ S-i ❑ S-2 El 5B [ ❑
U Utility ❑ Specify: :
M Mixed Use fEt
Specify: Cii,,N -. P, ', -rE .+n'-/PARTEJ"16NTC) F',`a7 v i &'fi'.1G
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): i
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
1st Ai 047(.1 1
1st 1
54/'(t '. " " - .'� t
2r�d i /v1 0t� L- I ;S/-Ft'fC ' — 7,.. ha i._ f t.
3rd t I
3`d 1 j
4th , 1 4h
Total Area(sf) 5-j 47 6' f Total Proposed New Construction(sf) r
r ,P'-'r^�. .r „�„, + ,yam. `�'-'�,,
Total Height(ft) 5/ §`r' 444 �-
Total Height ft -SAM G' ,- moo"
.
-.;o.4,.k *�.t "hey, _<
7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public jEl Private 0 Zone Outside Flood Zone❑ Municipal tl On site disposal system
Versionl.7 Commercial Building Permit May 15,2000
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size ;73 co d i 1 .`s,ME ,
Frontage A/< ' 1 `5.4 H C
Setbacks Front 7 1 1)171 E z'.1
Side L:' V-11 R:' L:?1 R•• 1
Rear
-Building Het t 3 j i I ge,i i
Bldg.Square Footage 15,474 % 1 j •y1 rF
Open Space Footage % �„�
(Lot area minus bldg&paved I infer 1 -3 3j I%0 Li 1
parking)
#of Parking Spaces = t 1
Fill: ' i 4"1 /2/7
°
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO lt DONT KNOW 0 YES 0
IF YES, date issued: 1
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book 1 Page;, and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO !„S` DONT KNOW 0 YES 0
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 0
IF YES, describe size, type and location: j ;3x 4. 17f'C,i1 Kit f
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
IF YES, describe size, type and location: j I
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 0 ' NO ,®
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
ti
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL:DESIGN AND CONSTRUCTION-SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT.TO
CONSTRUCTION CONTROL PURSUANTTO 780:CMR 116{CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED-SPACE)
9.1 Registered Architect
Not Applicable ❑
Name(Registrant):
Registration Number
I I
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
I i �
Address Registration Number
I I
Signature Telephone Expiration Date
? I f
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
� 1
Address Registration Number
i I
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
ii
Signature Telephone I Expiration Date
9.3 General Contractor
/I1 f/l/A rl HA z 11/ I Not Applicable❑
Company Name:
j.
Responsible In Charge of Construction
()I') STAUc-: .
Address
11(44-,f4r, j'i#7 -3.91)-1
Signature � ( Telephone
a' -,
Versionl.7 Commercial Building Permit May 15,2000
f
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
''OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, 1 TNolv1 N S a/i M ET as Owner of the subject property
hereby authorize' &2i/`/AM • - —i'-4-1 to
act on my behalf,in all matters relative to work authorized by this building permit application.
'.,
Signature of Owner Date
} i ,as Owner/Authorized
I,I ail MA it/IA 2 ifr��!
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.
1i.'11l/Are. MA 2
Print N me
o� �7 V
*(gnature of Owner/Agent 1/f Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: C (5" 0 /0 4-7U, Not
Applicable 0
Name of License Holder; i(�//1�M ! 1/�/j A7 ile� i 1 O Si (V() `'j 6
License Number
Z-F l0117 STALE Rr) ud( �A7 F/f-jn MA 6 - 9- 0
Address c
Expiration Date
Signature j�/� 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 wiii resuk
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes 0 No 0
=oat ttn>•r�To-Y r..
M-St- (rii of ortl a ii toll
•� AP
� �taaanrhncc((n'
gliganr
- DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street - Municipal Building
Northampton, Mass. 01060
WORIGR'S CONCl'ENSATION, MSURANC:E AFFIDAVIT .'
I, -42(//m-1-1.- 1/A7Cez_g-
• (licet s Jperinittec)
t�nflt� nnnr nor' nlon� n�}�i ci rj side(l -t:
,hone:'
(sarUc-ty/statda p)
do hereby certify, under the pains and penalties of perjury, that
•
( ) I am an employer providing the following \i'orkcr's comncnsauon coverage for my
employees worljng on this job:
(In-ntr- Company) (Polio; Number) --._. (r.-pirtion Date)
( ) I am a sole proprietor, general contractor or homeowner (ccie one) and have hired
the contractors listed below who have the following worker's compensadon policies:
(Name of Contractor) (Insurance CoinpanyiPoUc Number) (Y_-':7trai on Date)_
(Name of Coorraaor) -- (Insurance Coman�iPolic— N1lmcrr) (Ekpir.:tion Date)
(Name of Connaczol) (Insurance Compan}'/Po(;c} tvutekr) (Expiration Date)
•
(Name of Contractor) (L.nsurance Company/Policy Number) - (Expiration Date).
•
(a[t.ach At::oal r_'toc if noccu l'to eadu&taforevaoo pertaining to all 000;rt•_.c•.nn)
( ) I am a sole proprietor and have no one woridng for me.
( ) I am.a home owner performing all the work myself.
NOTE:plesc be await thy!w WC u mWVaLCra woo CTcapIQy pc-tom to do[" a repair work oo a dss'J1i g of
not morn tbno t'.raw LM.i',in which the bomeowver resi4ez oo the crotne.3 a,ports*.+-+tbeeo,_.•c oo(coo-ally w'rs;d >a be
cstployc-o untie the w -kse:c_..•x,Act(GL1 S2.a 1(5))•epplie oo ley a hoe o. for c Gczx or luauit m.ry evidence the
• legal cta-•ui of as cmloyor uode,-dap Worker'.Compom.aGon,Act_
I uodco-Ind[Lc(a copy of thi•mtcmcot aaay b<for'.avded to too Dopertmm¢of 1.>'t..rrial AcOdcma'Out oo of(raur•ooa for tho
oovesg-c vcriLmiioo and tht Eiltam to aaauc eoterase under section 25A of MOL 152 no led to the ;lion of cimiaal pentfl s
norm io of a floc of up to S 1_100.00 and/or imprisocnon=r1 of up to ooc year and a tit penahia in the form of a Stop Wort Ord=and a
lira of S1 o0A0 a llay LF,a.la=me
For dcp.rUT .aJ u.e only
Permit Number
p:: Lotn
Sipnatum of Lioenscoipct-Irt.iucc Date
MORTGAGE LOAN INSPECTION
LOCUS REFERENCE
Book 2079 Page 224
Book 432 Page 30
DO'' o
i�rr
0
`- Lots 1 P»0 8
r N >
k- . 67"_ .i
„..uw c
a
`U BIT PARKING LOT GRAVEL PARKING LOT o
''•
Na
'4., 2 STORY
1/41,, LOT 9
W/F j
1 . .__ •
m L- r
go" _ II.S'-
glv6,esia6 LatvE
TO: Florence Savings Bank
OWNER:
AND: Lawyers Title Insurance Corp_ American Legion Post 28 Home, Inc.
•
hereby maxi that the prmmist*shown on leis plan am LOCATION: 63 Riverside Drive
not loomed withiaaFloodWandAreaasiaremthn Northampton, Massachusetts
?chiral Eatorg tcy Hurt rna t Agoeolh Flood
n.raeoe Ride Map,
;omomity No.250167 - 0002A E. B. HOLMBERG &Associates
IftctiveDete April 3, 1978 LAND SURVEYORS
87 UNION STREET,EASTHAMPTON MA 01027-0943
also repo;to the beat od m3 knosviedsa,igamet on 37 DAMON POND ROAD,ClU3STERIMILD MA 01012-0176
ad bdiat that this impaction Out Mows the
xrptovemeot or im rvYanom as located en the premises
eaaibod,that the improvements am entirely within lot SCALE:
f1�OF i.•.e,
mar,and that them o no encroachment upon the a l" 4 0
nmiaaa dsarLd by the imprvvammt or impruvamaata /'r�Etatly �\�
lazy adjoining pramiasa,astmpt.r noted I Anther // t D. •,\
that dicta are no aasomaus oteaoord the 1=` e DATE.
r aL HOIr �E(LG
act ahem 6aaogo:ocptaanoted. K., C343Jo /,,e November 2, 1999
0^C��1 t JOB NUMBER:
-,---<7 „Ez J 99-074
THIS PLAN IS FOR IDENTIFICATION PURPOSES ONLY AND DOES NOT CONS'ITIViB A PROPERTY SURVEY.
AND IS NOT TO BE USED POR CONSTRUCTION PLANNING OR LAYOUT.
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