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23D-107 (38) 548 ELM y - BP-2006-1323 GIS#: COMMONWEALTH OF MASSACHUSETTS Iap:Bloc C i t' ?7 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-1323 Project# JS-2006-1954 Est. Cost: $16000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 53143.20 Owner: 548 ELM STREET LLC Zoning: URB Applicant: Healthbridge Management AT: 548 ELM ST Applicant Address: Phone: Insurance: 548 Elm Street (413) 586-3150 NORTHAMPTONMA01060-2832 ISSUED ON:6/16/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE 8 X 12 SHED W/ 10 X 16 & 42 X 14 SLAB FOR DUMPSTERS 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 6/16/2006 0:00:00 $25.00MO 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2006-1323 APPLICANT/CONTACT PERSON Healthbridge Management ADDRESS/PHONE 548 Elm Street NORTHAMPTON (413)586-3150 PROPERTY LOCATION 548 ELM ST MAP 23D PARCEL 107 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 41 � Fee Paid Typeof Construction: REPLACE 8 X 12 SHED W/10 X 16&42 X 14 SLAB FOR DUMPSTERS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 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. Version1.7 Commercial Building Permit May 15 2000 - T City of Northampton ,�s T N�',f-" , 1 " '.,, ' ,,F 1 \ Building Department kii .,2r , r �, a �= -S '..- 212 Main Street .a_,,,,e4l,. €3 ii'•i :7 :m , :-_ - ;”se Q — ��t. ^� `. ,., l Room 100 %. .iY •n li I him, A x � F SO6 \ -florthampton, MA 01060 ' i=, ail' a,;..., `;,,,,t,,ii N ry ' r ,. 111�' phone 413-587-1240 Fax 413-587-1272 gym' Ail , e, "'r' ` .W i, r 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 . 1.1 Property Address: 7lfl>s's �o>itaQp�'Cdinpfsbsd by Off co 15 a-L wl s of Unit L8 pert aiptitrkk I. _ Mil%YAYWi 'CS Disb1Ct . .i'J..n ,t SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: (Print) _Name( nt) -�` Current Mailing Address: I Signature Telephone 2.2 Autttnrized A4ent: tJA►)t...`. CP u D ST.: C L( n. _ I LE% 1 rr-N $A- 012_(±ha c2 Name(Print) Current Mailing Address: 1,, 1--)i 3 — 5� 3 `i Signature ' LI..K� .A _ eiephane SECTION 3-ES (MATED ONSTRU TION COSTS — item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 5--fC, (a)Building Permit Fee 2. Electrical r f f' - (b)Estimated Total Cost of I ( � Construction from(B) _,�...� 3. Plumbing I _ i Building Permit Fee " 4. Mechanical(HVAC) 1 �— 5. Fire Protection ;, ( / ' L...__. 6. Total=(1 +2+3+4+5) 1_ OOO - Check Number ai This Section For Official Use Ony �,. _ Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date T0002 ZLZIL85CIb XVd 65:80 900Z!90/90 Version1.7 Commercial Building Permit May 15,2000 '8',:rNO,,RTHAMP1'ON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks .h i i e L:ll Q R S i L:1J,7.(1i E: U s Rear ��. i I n Building Height 2)1 771 Bldg.Square Footage `�() I E- I "° IGO . Open Space Footage (Lotnrea minus bids&paved l I 1 I-_. I parking) a #of Parking Spaces Fill' (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW le YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book { I Page and/or Document#I __ J B. Does the site contain a brook, body of water or wetlands? NO () DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: [ — C. Do any signs exist on the property? YES (4') NO Q IF YES, describe size, type and location: Li- -?)U t\C Yv( ,Inn- ' D. Are there any proposed changes to or additions of signs Intended for the property? YES a NO ;y� IF YES, describe size, type and location: 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 O NO ;i3O\ IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Z000 ZLZTL95ETt XVd 6S:90 900Z/50/90 Versionl.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❑ Repairs LI Additions LI Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign Li New Signs CI Roofing❑ Change of Use CI Other El Brief Description !Enter a brief descn,tion here. �^--(�� /,,Of Proposed Work: S t--(L.D1016 \�• w 1 � \O�'' Aj1^/�-S\'Q��`�"I X �4-I n�SECTION 5-USE GROUP AND CONSTRUCTiON TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 El A-2 El A-3 ❑ 1A ❑ A-4 ❑ A-5 0 1173 0 T B Business LI2A ❑ E Educational ❑ 28 ❑ F Factory LI F-1 0 F-2 El 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 0 1-3 0 3D ❑ M Mercantile ❑ 4 ❑ - R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A El S Storage ❑ S-1 g S-2 0 58 0 U Utility ❑ Specify:! I M Mixed Use ❑ Specify $ Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: IM_ Proposed Use Group: I Existing Hazard Index 780 CMR 34):f I Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA _ .._...._ ::... .,OFFICE'USE ONLY BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION " Floor Area per Floor(sf) sl 1 i_ \0 1, ft,'I 2 2nd( J r 3rd ;- f 3'd 4th �x 4cn Total Area(sf) L_ ct5,: I Total Proposed New Cons ction(sf) Total Height(ft) L_- ` ....... Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood information: 7.3 Sewage Disposal System: Public 0 Private ❑ Zone i J Outside Flood Zane❑ Municipal ❑ On site disposal system[ COO Z ZLZTLBSCTt XV,3 6S:80 900Z/50/90 . . Vemiou17Cnuomverrcial Budding P*o�t May 15,2000 SECT-JON 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND 3TiRu=RE8 SUBJECT TO CONS71WCTION CONTROL PURSUANT TO 180 CUR 118(CONTAINING MORE THAN 35.000 C.F.OF ENCLOSED SPACE) _9.1 Registered Architect �- ---- --- - | Not Applicable/--------' ------' ' [ - ' Name(ReQ���)., _- - � -------- ` i Registration Number /wmreu � | s0raflon Date Signature Telephone 9.2 Registered P,mfemsionmEmgineer(s); Name Am'of nwwpnnelwvty ---- \ '---' _- Addmm Registration Number -- '---i Signature Telephone sxxauonomte Area of r-Name --^- '-- --'' � [------'Responsibility -- ] Address Registration Number | oWnmmm Telephone_ Lm»*mwnow� - ----'- -~ Name Ama of _Responsibility Address Registration Number Siommmm Telephone _s�-irao=,owta ' Name Area of �---- 1 | ------ --1 Address Registration Number --] F ------ ' Signature Telephone Doration Date _ 9.3 General Contractor - - Not Applicable 1] Company Namm | | Responsible In Gliirge of � _-_--'__---Conutruction _-_--_-____-------_-_''_ _ _-SiAddress gnature Telephone Telemmmw too J1%Tl89C7V YVJ 68:80 90OJ/00/90 Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes C) No Q SECTION 11 -OWNER AUTHORIZATION•TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT R.-V t A) Cool (PGe I\Ah s f W a� �- ---• as Owner of the subject property hereby authorize t L w.\ _ !to act on my behalf,In all matters relative to work authorized by this building permit application. - `J- to.t Signature of OQutier pate C Ac-Vt w COOLt G c Noes't,J G- Rw1 "(Z N 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 theiplains and naltles of a jury. I 4 ,;.. Print Name Rl r'1{J f_L\ y�nT���i.2�.l --- ry t n o.)c 1v -5 - Olt, — --- Signature of Owner/Agent // Dgfe SECTION 12-CONSTRUCTION SERVICES 10.1 LIce-psed Cons tfon Supervisor: Not Applicable Q Nam of Llerlte_tiplder: --.- --.. License Number Address Expiration Rate Signature _._. Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,g 25C(8)) 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 0 S00�j ZLZTL8SCTI' k'Fd 62:80 900Z/S0/90 • AYtwrrr - Winl ,, _\ p, ` 45".* (iit rf N. o rtljamptoli a — _,.. «� ' 91.2asrlleartfe' =z: '` , DEPARTMENT OP nuluDostc INSPECTf0NS —' 212 Main Street ' Municipal Building Northampton, Mass. 01060 r.r' WORRI R'S COMPENSATION 'Cs/SURANCE AFFEDAVIT • • (Hausa-/permitter) with a principal place of business/residence at: rji_i$ -\m , �c {np r. inn (phone&') A413'5'6b'3(5D (srr .tJcity1 f ip) do hereby certify, under Chc puns and penalties of perjwy., Dial . ( ) I am an employer providing the following worker's compensa ion coverage for my , employees working on this job: (1asun=Coci ') • Relic-:Number) ('r.pimtioli Dale) . I.am a sole proprietor, seoeral contractor or homeowner(cizc a one) 2.od have hired the cono-actor listed below who hzve the following worker's compe)1_czdon policies: (ovcr Cc\-Otiv‘ (Na ne o.Cancmctol (ln-Turanc Comoasr)•RaliC,Nun-Lne ) (r.,:piracelt Ontc) 6\14 LtVg_C_cC) e.,V _5()\-e- c-c\--A-vt\iTC2 . . awe of Contractor) (lAsuraa ComnaaytPoticti' ,cua,c:r) T K-pis tidn Dale) . (Nape of Contr-acto;) (Lostuanc Company/Policy hwcebcr) (Eninpoo Date) ()Fame of Contractor) . (insurance Comtany/PoUey Nufubrr) (E.-iraiion Dale). . (aer .1d.:ln'oexi ISea if aeoc.tV w ice illitriTOC.pvtii041300 al••'*•-., con) , N I am a sole proprietor and have no oAe working for me. , ( ) I am..a home owner performing all the work myself, NOTE:ple;e be 111,art tts=",.ire bem owo i wbo eaploy pe-zoaf to do r_-..-,s.... 10e.10o G' .wr;e oa► "%11_5¢of oa moat tbeo tb.Ce ami i is u'aida the b4moe,w -ride or ix;the creep s appu t tb-e:o pet j; 4,f7 scoido'ed w be ceploy+,ueeC the••erkax azq=.,:ay Ivy(eGL1 Stu t(S)).sppliar;oo by•eotoose v fa a Gam:or permit tr-iy r idcroe the legal.....m or se ocig,ley.r upder the Worker'.Caerspeepatiee A.. I r►odereAnd thK a.espy of eW wutereit.m.T be ham rd.0 le lb.Dapartmmd at lettuAtiki Medeei OM..er I.......o.for dm Op1'a4t WriGcuioa Lae rho f iJ=1.want ba•e.ce voider reef jop 2S w ar Not.1sa ea rod to tlx tagyZmition arerimmai penallia aoos;uigla of■Goe erg to S 13O0,00.Woe ioriaccoonx otop to one yr r+ad civil pet.ria o ec forth er.Slop Work Order eod. Igo o($tOo.00 a day.. .inst ax. For dw.^a4-n1"+c only Permit Ntuni r ' t '`dip• Lot S'S Wre LiccriscaPcemiuct 900E ZLZTL92CTt XVI 65:80 900Z/50/90 04/03/2006 12:56 4135675211 PAGE 01/01 Peter Casty, Finish Carpenter 47 ! . T/ / 24 Birnie Rd Longmeadow, MA 01106 Date; eV, 3 -p 413-539.0500 FAX i pAte@shedbuilding.cam Snip to: ,/a.- www.sheciroutiding.com Mass iilCfl1 133718 1/`� j '✓56L '7 t -z/ C74603607 ( �T To: C'l Vi tl COOL/06E ili /,cJ4 > 3/Z-i r - - �`/!0,4 4 5 � Irstrriete.on Date: Address: A�7 _ !�f (Mete y 1&x 2 n.iow�_ Ciry,State,tip: /A I/ '- ,0/ /) 4 )/t/&0 Tem 1f/3 • --rs, 9�2-70 Km H heanl of:/*PS *3 ` 5 7 ., -77053 _Description: Unit Prime Total /0 scE6 ,ham..-,0 J ' - '/O 171G 9 je 3 dfz , ,,4'/o hO°' Z:2;inz , Ala A)(UDC i j,/70). 6. ;. ck =k , , SurTetal: Saies Tax: Total S Agreed to: Deposit S Balance COD S A Qevicelt to all work is required. Balance Is required upon completion. Roof toter: 5/12 gable std 'Dj o44__ WiAclaws: -� - 11E.1--j l Storm 165ca4- _-.. . 20(24" / N Vinyl Other _ Ooor width: 36'Ile RO) / 60'(38'RO), #1 Loft: Shutter Sets i F"Bwc Ramp: 36'W x 48"L 60'w x 46"L .t-------` !C� f^'7 Other �A r As per R of attached pages Monet tears: 4 1.AU.permits and zoning comptlanpc relies solely with the customer. ff 2.Site shelf be deer of debrla and marked out prior to ran A lrrgh,ning_ #3.All materials,procedures are as specified In brochure/webslto unless noted above. #4, Photos of sheds con be panted on shedbuilding.com and used fot marketing. , .S.- /V/ ,,,, .' • ,,\///., // . .co.:.., z6Grry :r • .:'••./J..... JAW61A' OCGPO' � _ -�-Mg,o.a......• -- /f 1\ I- - -- - - -Va.,.....• -.�• - - ` \ /Cal a/i.V dual •CI , ,•J .4•• xanr r<•r a•�...../arrr/ •c,:. { •��</,'r'!' ems.►.+r"°° ,a.. Jea.vO.•-v e •yr, j% >a�+1 ^e"' SZ4 /f3of M..A' ..... 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