18D-053 80 DAMON RD#6101 BP-2002.0923
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18D-053 CITY OF NORTHAMPTON
Lot: -156
Permit: Building
rCategory: BUILDING PERMIT
Permit# BP-2002-0923
Project# JS-2002-1500
10
Est.Cost: $14800.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: GPS BUILDERS 053457
Lot Size(sq.ft.): Owner: GANDHI CHANDER&ROSY UPMA
Zonme: GI/WP Applicant: GPS BUILDERS
AT: 80 DAMON RD #6101
Applicant Address: Phone: Insurance:
125 FRANK B MURRAY (413) 739-3341
SPRINGFIELDMA01103 ISSUED ON:4/25/02 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAIR FRAMING
DAMAGE,BRICKWORK,SHEETROCK & KITCH CAB
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:
Roug Rough: L y4(,2.A7 House# Foundation:
A4/4 Driveway Final:
Final. Final: 512211C2.T
Rough Frame:
Gas: Fire Department Fireplace/Chimney: ..:, . .
Rough: Oil: Insulation:
Final: Smoke: a.3'dO2
Final:0 K --�'
illTHIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc ��� %'
p Y v Stgnature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/25/02 0:00:00 467 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo
Plumbing
Building 0 Electrical
City of Northampton
rthampton
BUILDING INS
ECTION LABEL
ppP
OV ED
Inspector
(.3 pate
80 DAMON RD#6101 BP-2002-0923
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18D-053 CITY OF NORTHAMPTON
Lot: -156
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2002-0923
Project# JS-2002-1500
Est.Cost: $14800.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: GPS BUILDERS 053457
Lot Size(sq. ft.): Owner: GANDHI CHANDER&ROSY UPMA
Zoning: GI/WP Applicant: GPS BUILDERS
AT: 80 DAMON RD #6101
Applicant Address: Phone: Insurance:
125 FRANK B MURRAY (413) 739-3341
SPRINGFIELDMA01103 ISSUED ON:4/25/02 0:00:00
TO PERFORM THE FOLLOWING WORK:R E PA I R FRAMING
DAMAGE,BRICKWORK,SHEETROCK & KITCH CAB
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/25/02 0:00:00 467 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2002-0923
APPLICANT/CONTACT PERSON GPS BUILDERS
ADDRESS/PHONE 125 FRANK B MURRAY (413)739-3341
PROPERTY LOCATION 80 DAMON RD#6101
MAP 18D PARCEL 053 156 ZONE GI/WP
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: REPAIR FRAMING DAMAGE,BRICKWORK,SHEETROCK&KITCH CAB
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 053457
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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 Co ion
—II./V,el—4
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
w
Department use only
ty of Northampton Status of Permit:
( !; C ',�ibll'ding Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability.,_
5 2002 MA 01060 Two Sets of Structural Plans
APR 2 Nor�lSa'�mpton,
phone 413-581-1240 Fax 413-587-1272 Plot/Site Plans
. Other Specify
APPLICATIQN.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: This section to bemcco leted by office
Map D /" f Lot `-'' Unit 3 lP
D/144eN L'Vlp Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
/e/v672. 44/6 4cJOM L /4//LI47 ,4-rsO GiAi w" )f.'i o /e o4 o ,j/e i4M/4Ta J
Name(Print) fl orx/^/ 4-0-oc,ATES/ /Oiedeoery A.A6e. Current Mailing Address
97'fs-
Signature Telephone
2.2 Authorized Agent:
6;t1i7Z rth-- 6/44- l/AC s1/4-exi2S /2> 1--"s/tJ a MN/eA/1 s , �/`�40/14J6//ELD
Nam((Print) Current Mailing Address:
i 731 33 /
Signature ! Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building ' O'er (a) Building Permit Fee
2. Electrical (b) FTtimated Total Cost of
8�0 Construction from (6)
3. Plumbing �' 7.S0 Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection Zd
6. Total =(1 + 2 + 3 + 4 + 5) $ /f f/(-z Check Number Li(00 l v
A This Section For Official Use Only
Building Permit Number: T3Po / Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
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 Existing Wall Signs Existing Ground Signs Additions ❑ Roofing 0
0 ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building[ ] Repairs [ ]
J - I:f_ste,W-Tr /fpfii, Di- fiPAww,Wt-- 4'14I,G1 Jl ia'ii.oRK1$Ig667 .'tX AND A',TCr -AJ 40/NE15
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly I ❑ A-1 0 A-2 0 A-3 0 lA ❑
A-4 0 A-5 ❑ 1 B ❑
B Business 0 2A 0
E Educational ❑ 2B I ❑
F Factory ❑ F-1 0 F-2 0 2C 0
H High Hazard 0 3A 0
I Institutional 0 1.1 0 1-2 0 1-3 0 3B ❑
M Mercantile 0 4 ❑
R Residential R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage 0 S-1 0 S-2 ❑ 5B I ❑
U Utility 0 Specify:
M Mixed Use 0 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
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf) 1st
nd �3 t;
nd
1st 2 !fit 'r
3rd IC e 4*-4
2 t4i44; tara io1,,z ...
rd �t
4the,I 1-
Total Area (sf) Total Proposed New Construction (sf)
Total Height(ft)
Total Height ft :" (
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 0 Private 0 Zone: Outside Flood Zone ❑ Municipal 0 On site disposal system ❑
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 YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T/KNOW YES
IF YES: enter Book y Page and/or Document #
B. Does the site contai a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a ermit been or need to be obtained from the Conservation Commission?
Needs to be btained Obtained , Date Issued:
C. Do any sign exist on the property? YES NO
IF YES, d scribe size, type and location:
D. Are ere any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
•
Versionl.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:
Not Applicable ❑
Name(Registrant): 1
Registration Number
Address •
/ Expiration Date
Signature Telephone
92 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature / Telephone Expiration Date
J
t'
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
Not Applicable ❑
Company Name:
Responsible In Charge of Constr ction
Address
Signature Telephone
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 ❑ No ❑
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, I((Jet 4c41 r,vji.r..rc J xiAnarx) goliK.J ilS iA7Li.%Mery/Qfi�r , as Owner of the subject property
hereby authorize 6f'f /4c[/Low to act on
-- behalf, in all matters r lative to work authorized by this building permit application.
;L1 ature of 0 r �/CO0 Jh1 lf' /� Date
I, e .44rr zn_. /4st 6�.f�Zf/LDe:�S , as Owner/Authorized Agent
hereby declare a the statements and inmation on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
6,r.e -y P '
Aiz-ram.
Print Na e
Signa ure of 0 r/Agent Date
SECTION 12 -CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: K.P..C'6 / PJ.�2A-rsi✓c=r,1... C S 0.0 5
// License Number
y$ *Wei"! Cr2GLf (2 i( O MA 6vo6'> QY- z./ — o 3.
Addres Expirat on Date
ucyieaftL c_, I/ 3 -
Sign ture 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
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes No 0
VitiAMpTO
aalw`„4 ;it (r r cif Nartl ainp-f on _*
Vtf s,�+^n �E' ffiassaclinselts
m: DEPARTMENT OP BUILDING INSPECTIONS __1)`-
212 Main Street ' Municipal Building
Northampton, Mass. 01060 r'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(Lcenseepermittec)
with a principal place of business siden t:
•
qq RA-244 Clash-� 1d ief i,AK4 Q/OBS' (phones) 1/i3— 5Ci-'/o66
(s u ec t/ci ty/s tatr/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 job:
• (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)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional rhed ifrt - xy to include information pertaining to all scats on)
XI 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 homeowners who employ persons to do v aintm.on corstrurion or repair work on a dwelling of
not more than thine units in which the homeowner resides or ea the grounds appurtenant thereto arc not gen,.ally cmtidcrcd to be
employers under the worker's compensation Act(GL152,s3 1(5)),application by a homeowner for a lie nse or permit may evidence the
legal d at,ce of an employer under the Woricors Compensation Act
I understand that a copy of this rtatcmcat may be forwarded to the Department of Industrial Accidmti OfEoe of Insurance for the
coverage vcrifrcatioa and that failure to secure coverage tinder section 25A of MOL 152 an lead to the imposition of criminal penalties
consisting of a fine of up to S 1,500.00 and/or imprisouneat of up to one year and civil penalties in the form of a Stop Work Order and a
firm of S 100.00 a day against toe.
For depaztnrotal uao only
lam_ Permit Number
-2 -s7i Map# Lot# •
tKa S gnature L etmitfee