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32-004 BP-2023-1725 STRONGS RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32-004-001 CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1725 PERMISSION IS HEREBY GRANTED TO: Project# DEMO BARN Contractor: License: Est.Cost: 1000 Const.Class: Exp.Date: Use Group: Owner: JAESCKE RICHARD E Lot Size (sq.ft.) Zoning: SC Applicant: JAESCKE RICHARD E Applicant Address Phone: Insurance: 774 BRIDGE RD NORTHAMPTON, MA 01060 ISSUED ON: 12/26/2023 TO PERFORM THE FOLLOWING WORK: DEMO BARN 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I. J Fees Paid: $30.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2023-1725 APPLICANT/CONTACT PERSON:JAESCKE RICHARD E 774 BRIDGE RD NORTHAMPTON, MA 01060 PROPERTY LOCATION STRONGS RD MAP:LOT 32-004-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $30.00 Type of Construction: DEMO BARN New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan Driveway Grade% THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON ?th . l INFORMATION PRESENTED: • 1��3 ' $ Approved Additional permits required(see below) g U)LT 161y�f 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 Commission Permit DPW Storm Water Management Demolition Delay ,110 (,,w .4 N. 01)03 ature 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. RECEIVED �y The Commonwealth of Massachuse - 8 2023 Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR� s DEFT�.nF G DING IN�p EC'�pNS Building Permit Application for any Building other than a une-o>rnl xa�ry yj w ing (This Section For Official Use Only) Building Permit Number:073 ' I7a f Date Applied: Building Official: SECTION 1:LOCATION No. and Street_e r "..._City/Town Zip Code Name of Building(if applicable) raSf Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition if(Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Is an Independent Structural Engineering Peer Review required? Yes 0 No Ele Brief Description of Proposed Work: jainolt sk 2 es Is t i 74,-.K b cat/al s au s. Dgfe is 73-' /®� I A i$ (.Pak . TAe of&e' is 20',( 20 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business ❑ E: Educational ❑ F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1❑ S-2 0 U: Utility 0 Special Use grand please describe below: Special Use Description: frGrpc 574Di425t' bw/ol. iy,s SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA ❑ IIB 0 IIIA ❑ IIIB ❑ IV CI VA 0 VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit: Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site 0 Public 0 Check if outside Flood Zone El Indicate municipal 0 A trench will not be P Private 0 or indentify Zone: /110 60r 51 or on site system❑ required 0 or trench or specify: io4 permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Mr Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No e Yes❑ No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner !iGhkid and Stjut, �aescmc 77l di-14c ,d it/ f/*.* /1 Name(Print) No.and Street 7f`,��/City/ w Zip Property Owner Contact Information: -iir7 if rr�"/�� y� -5. o77f 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 IV Otherwise provide construction control forms(see section 107 in the code)as required. 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 • Company Name Name of Person Responsible for Construction License No. and Type if Applicable 7 r'1 Brio A-;- Street Address City/Town State Zip —— 444- 5351 s 775-- Telephone No.(business) Telephone No. 1) 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 if No D 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 $ OO 4.Mechanical (HVAC) $ Note:Minimum fee=$�' (contact municipality) 5.Mechanical (Other) $ Enclose check payable to p� 6.Total Cost /O-�,.pfl contact municipality)and write check number here 9&S SEC E 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 gad pplication is true and accurate to the best of my knowledge and understanding. r'o( /ittc t•act,41trae,Z, OwK[r 0775. i Pleaseprint and signname Title Telephone No. ate P Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: rv►",^'v"' 2 , V975, Name Date r " BUILDING DEPARTMENT DEMOLITION PERMIT SIGN-OFF SHEET Date: Address: Building Use: Owner: Phone: Owner's Address: UTILITY CUT OFF (Signature of Authorized Representative of Utility Department required) As required by the Massachusetts State Building Code (780 CMR), a permit to demolish shall not be issued until a release from the utilities is obtained, stating that their respective service connections and appurtenant equipment have been removed or sealed and plugged in a safe manner. Eversource (Gas) Signa�ur-e Title National Grid (Electric) Signature Title DPW (Water) Sign� . Title DPW (Sewer) Sin Title DPW (Storm water) Signature"- _�1itle DPW (Tree Warden) - ----- Signatur� Title DPW Director Signature- Title Historic Comm. Review Signature Title Health Department Signature • Title 4 • The Commonwealth of Massachusetts .......* Department of Industrial Accidents .. .. , , 1 Congress Street,Suite 100 * ____ Boston,MA 02114-2017 WWIti.mass.govidia %%Others'Compensation Insurance Affidavit:Builders/Contractors/Ekctricians/Plumbers. 10 RE FILED WITH THE rilioniTING At:TilORITY. Applicant Information Please Print Legibls Name(94151InC5s..Orsanizottomindividual): ieth,44 4.-if,/e,Scit‘ , _ Address: I-7 11 4-4 'el. City/State/Zip: Abt rha..of,a iv n 114 Phone #: .03 535- 077C sar!iota on eiriployvr?("hick the a pprnpriate box: Type of project(required): I ii am a erriployia it an A employees.(fall and or part-urnet• 7. CI New construction 1211 ant a*ale propnetur or punnet-Alp and have no etnployeel„o orkino fin roe in 8. El Remodeling fiz- y t.. pacity.t'.0*Littera c wisp.insomnia: requattifi 9. [9/Demolition 3 I ant a huntecrotner dome all WO*myself.[No workers'eurnp.Insurance rialormii,r 1 0 Ei Building addition 4.0 lam a hornouitiner and will be hiring eantrueturs to v.:oviduct all wink it my property_ I will ensure that all contractors tuber ha‘e workers"conmen,abon insurance or WC sole HID Electrical repairs or additions propriehms with no enaplo yeTN_ 12.C]Plumbing repairs or additions 50 I am a ileneralcontractOr and I have hired the alls-reoistracturs listed iin the.attached*led i 3.0 Roof repairs rho.sub-cuntraesurs Kase employees and hame workers'erxrtp.maul:trice.: 14.0 Other_ 60'i't c an.a iOTIVIrS700 and its officers lime exraviaed that risIn of eimptsurt per .IRA c. and w e have no arsploli ism.I.\Ai*or-kers'einnp.insorani.i ii.oiiid.; •Ans applicant that ilio.:Lis but al mind also fill out the termon helot shooting then winks,:dontrensation pulse!, uttacinasion 'Hai:Ineowners*to sof not this atruhmit indicating they are dinng all work and then hire outside CUTLIMCARAI-8 mug Anbnut a new afftala4 it inthezkillng such_ I:Conti-at:sum that check thts box mug attA.-hed an abartionta sheet showing the mune of die sub•tuntractart%and gate whether or not those aggro have cruploy re, It slw suE-euntratetetria haroe employees.they rittoa prin.olc 1.;Iii: 0,oilers'evinp.r.11,::.,[ILI:lb.:I I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: farm c:zirir iji _TR Sie Policy#or Self-ins. Lie.#: 24,2>rig Cif3 Expiration Date: 6/2/2024 Job Site Address: /40 Icglr- 41. 4Lien 5',pg. City'StateiZip: Attach a copy of the ssorkers'conwensatiun polic declaration page(showing the policy number and expiration date). Failure to secure coverage.is required under MGL c. 152.§25A is a criminal violation punishable by a fine up to$1.500.00 ardor one-year imprisonment,as well as civil penalties in the form°fa STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Ins estigations of the DIA for insurance coverage verification. I do hereby certifr icr the pains and penalties ofperjury that the Information provided above is true and correct Si} -1444ze 9g2eize.-4 Date.: /////.20-1 3 Phone;; 41/3 33< 07 7,5. . Official use only. Do not write in this urea.to he completed by city or town official. Cits or l'ostn: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/To/an Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other i Contact Person: Phone#: nationaigrid 55 Bearfoot Rd Northborough, MA 01532 December 5, 2023 RE: Service Removal for Building Demolition 140 CROSS PATH RD NORTHAMPTON,MA 01060 To Whom It May Concern, This letter is to confirm that,per your request,National Grid has removed electric meter #16621823 and the electrical service on 140 CROSS PATH RD,NORTHAMPTON, MA 01060. The work was processed on Work Request#30895197. If you have any questions or need further assistance, please feel free to contact Randi Rivers at 508-691-6595. Sincerely, fTh )e Randi Rivers Standard Connections ESR2 MyConnections NE nationaigrid J „HAM CITY of NORTHAMPTON 9 too ..„ a i DEPARTMENT of HEALTH& HUMAN SERVICES i ,� / - ` Commissioner—Merridith O'Leary, RS 1 :iii ( Municipal Building- 212 Main Street-Northampton,MA 01060 Phone(413)587-1214-Fax(413)587-1221 http://www.northamptonma.gov/245/Health PublicHealth Prevent.Promote.Protect. WITNESS OF EXTERMINATION Date f)eCeMbcr 2 1 , 2e3 Time ' ', /5 4/Y Property Owner: (i�jefra, `j Qe Sc/ Property Address: 7 7c/ .Uyi e e 14 cicl ,14: r 4a`i p.iz: /14 Exterminator: -PA kA 1 ID 0.S c IN Q rl c'.S Company: T I-6n i N Company Address: !1-1 GM1,1 P(,\ W 21,.S 1 r r 710 Rodenticide/Chemicals Applied ( C h-4 r ^-C i IU\ - J 0 1 a g S c.. Reason for Extermination: 5t4,a,,, e,n i' r.a:1 Comments: (No P 6-I v i yj — no 5 l7('t y t-f v✓1 e 4((),i•l E. 1 [e_d . a.I I hereby certify, under the pains and penalties of perjury, that Ito the best of my knowledge and belief, have applied the above noted pesticide in accordance with M.G.L. Chapter 132B and any other applicable law or regulation. ❑City Water . L Well--.--_ ❑ Septic System...__ If applicable ❑ ❑ "�Yes . No t Iql-aa3l a6 1 \A-tAin Board o ealth Representative Signature of Exterminator *Demolition best practices relating to fugitive dust and debris must be adhered to in accordance with MGL Chapter 111, Section 122. -f • } TERMINI ® IA SANDY JAESCKE 32100620 141 Main St 12/21/2023 Next service: • Customer name Sales agreement Northampton, Today's date December/2023 number �1A rr1060 WESTERN NEW Service Address ENGLAND to 148 Thompson Rd Webster,MA 01570 1(800)837-6464 Hi SANDY,Thank you for choosing Termir., '.Here are some notes about today's visit: Employee number:40961 PAUL DESCHENES License/Cert:AL,0027261 Ext Gen Pest Service technician Supervisor:PALUMBO,NICI1-_LAs 7:51 AM-3:21 AM OneTime (413)246-8837 A Control Extra Svc Arrival/departs re time Service frequency paul.de,shenes®rerminix.wm Supervisor License/Cert:CC- Purpose of appointment 0031303 041 TODAY'S CONDITIONS Temp Wind speed Wind direction General conditions 29°F 16.11 MPH N Clear HERE'S WHAT I FOUND: SERVICE VISIT PICTURES No activity found View pictures and notes from your Thank you for choosing Terminix.Your ess is appreciated. service technician with MyAccount at Terminix.com/My-Account. MY TREATMENT NOTES: Your service is now complete.If ye.i r e:ed something before your next service appointment,don't hesitate to let us know.Thank you for letting us protect your home. PRODUCT LABELS&SAFETY DATA SHEETS Product Labels&Safety Data Sheets,pl visit:https://lycensed.com/orgs/terminix/public/chemical_documents For NY customers,please select'NY'as your locale Call 1-800-Terminix or visit Terminix.com I©2021 The Terminix International Company Limited Partnership.All Rights Reserved.37335 , TERMINIX NOT ENROLLED IN AUTOPAY? SUMMARY OF TODAY S CHARGES Paying is easy with MyAccount. Balance due: $0.00 There's no need to track down the check l and stamps.Simply go online to Terminix.con .I 1,,-Account Current charges: $0.00 to pay quickly and easily. Subtotal: $0.00 Billing Address 141 Main St Tax: $0.00 Northampton,01060 Total: $0.00 Customer ', ree-no signature ,ken Customer Signature: Date: SANDY JAE Recommended and Service pi .r ided by: Technician Signature: Date: 12/21/2023 PAUL DESC a H S In case of poisoning call Poison Control Center @1 ai i :'22-1222 Call 1-800-Terminix or visit Terminix.com I©2021 The Terminix International Company Limited Partnership.All Rights Reserved.37335