32C-067 (2) 2 CONZ ST-UNIT#64-MAPLEWOOD SHOPS BP-2009-0113
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-067 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Peiiiut# BP-2009-0113
Project# JS-2009-000149
Est. Cost: $2500.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STEPHEN DROSS 079160
Lot Size(sq. ft.): 30666.24 Owner: MAPLEWOOD SHOPS INC
Zoning: CB Applicant: STEPHEN D ROSS
AT: 2 CONZ ST - UNIT #64 - MAPLEWOOD SHOPS
Applicant Address: Phone: Insurance:
36 SERVICE CENTER RD (413) 584-1224 () WC
NORTHAMPTONMA01060 ISSUED ON:
TO PERFORM THE FOLLOWING WORK:CONSTRUCT NON-LOAD BEARING WALL &
REPLACE FLOORING
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:
Rought? -t/ Rough: q� Ppo House# Foundation:
Driveway Final:
Final: '00 ,���`��Final: 9////6', /��2
0/1 f f> Rough Frame: 0k �.g-14
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: Q K 6 ./b-t g -1Ap
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGUL TIONS
Certificate of Occu anc Si nature: 9`
FeeType: Date aid: Amount:
Building $55.00368
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2009-0113
APPLICANT/CONTACT PERSON STEPHEN D ROSS
ADDRESS/PHONE 36 SERVICE CENTER RD NORTHAMPTON (413)584-1224 Q
PROPERTY LOCATION 2 CONZ ST-UNIT#64-MAPLEWOOD SHOPS
MAP 32C PARCEL 067 001 ZONE CB
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 NON-LOAD BEARING WALL&REPLACE FLOORING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 079160
3 sets of Plans/Plot Plan
THE FOLLOWING 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 Commission Permit DPW Storm Water Management
Demolition Delay
/001r e//2•00'469
Signature of Building Offici• 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.
V. Version].7 Commercial Building,Permit May 15,2000
\ , Department use only
City of Northampton Status of Permit:
O� Building Department Curb Cut/Driveway Permit -
3� ti� 212'Main Street Sewer/Septic Availability
�% ,�� Room 100 Water/Well Availability
�'� Northampton, MA 01060 Two Sets of Structural Plans
��\'' phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
fi,- Other Specify
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: This section to be completed by office
O2 CON 4 5. Map Lot Unit
VV\I H 4 Zone Overlay District
1•10 (1'ii',l hn) hA/ o I e1(/"O Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
If, 2.1 ner of ecor : G IC Z-/V
3esiCec - 0-- 3)( )6(P , wk
Name tint) Y Current Mailing Addres :
I •fry
Signature Telephone
2.2 Au orized en 41.4
tA)\ treS.
Name(P nt) w ON.. OAS 0.,/` JCS c...Current Mailing Address:
Signature Telephone
SECTION 3-ESTI ED CONSTRUCT N COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 4 r5o.0 (a) Building Permit Fee
•
2. Electrical I (b) Estimated Total Cost of
(�� Construction from (6)
3. Plumbing #500 Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) 4?5ittCZ Check Number ,3Y
f- 15-5-. --
This Section For Official Use Only
Building Permit Number 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 NI Existing Wall Signs Demolition Ul Repairs El Additions ❑ Accessory Building 0
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑
Brief Description Enter a brief description here. P4 i r W (l I S r
Of Proposed Work: SU1 �d1�/�r / kLJ �pox;e\ PQ1� 1..).}) e'rurllemciU.a_ of CJ ,itme)rr'?
SECTION 5-USE GROUP AND CONSTRUCTION TYPE UV/ rep.)
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly A-1 El A-2 ❑ A-3 El 1A � ❑
A-4 ❑ A-5 ❑ 1 B ❑
B Business 2A 0
E Educational 0 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B L ❑
U Utility ❑ Specify:
M Mixed Use ❑ 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
1st
2nd
2nd
3rd
3rd
4th
4'
Total Area(sf) Total Proposed New Construction (sf)
Total Height(ft)
Total Height ft
7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public Private El Zone Outside Flood Zone Municipal On site disposal system El
Version1.7 Commercial Building Permit May 15,2000
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 0 DON'T KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO R5 DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained O , Date Issued:
C. Do any signs exist on the property? YES (xg) NO O
IF YES, describe size, type and location: f ts.J l) d 1/e.r .r1 r et
D. Are there any proposed changes to or additions of signs intended for the property? YES NO O
IF YES, describe size, type and location: gep 62_, awn) A( iy/-/.J, 72ew a
o >✓ 54+ — S z.e__ and / �= a-1-.) I1
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 Co
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
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):
Registration Number
Address
Expiration Date
Signature Telephone
9.2 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
:_• -7 E—; IU `�15.7&C/ 1 . /`051 `"—Not Applicable ❑
Company Name:
Responsible In Charge of Construction
r;,; �Q, C<r,+ C.4 • . r-+ha
Addr s
y /L---" >g 9
gnature� 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 0 No O
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
, as Owner of the subject property
hereby authorize 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
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 El
Name of License Holder:
License Number
Address Expiration Date
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 affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes O No O