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32C-067 (6) 64 MAPLEWOOD SHOPS-COOKING SCHOOL -2 CONZ ST BP-2004-0578 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-067 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: Non structural interior renovations BUILDING PERMIT Permit# BP-2004-0578 Project# JS-2004-0050 Est. Cost: $1000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOODTECH INC Lot Size(sq. ft.): 30666.24 Owner: MAPLEWOOD SHOPS INC Zoning: NB Applicant: HOODTECH INC AT: 64 MAPLEWOOD SHOPS - COOKING SCHOOL - 2 CONZ ST Applicant Address: Phone: Insurance: 20 CONNECTICUT AVE (413) 783-9664 WEST SPRINGFIELDMA01089-1106 ISSUED ON:11/10/03 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL HOOD SYSTEM 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: Receipt No: Date Paid: Check No: Amount: Building 11/10/03 0:00:00 8442 $50.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2004-0578 APPLICANT/CONTACT PERSON HOODTECH INC ADDRESS/PHONE 20 CONNECTICUT AVE (413)783-9664 PROPERTY LOCATION 64 MAPLEWOOD SHOPS-COOKING SCHOOL -2 CONZ ST MAP 32C PARCEL 067 001 ZONE NB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � ��jj fi�rr,, Fee Paid �f' `— SD Typeof Construction: INSTALL HOOD SYSTEM 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 LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN17411, ATION PRESENTED: pproved 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 Commi n /ry//o©� 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. ♦ Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: . • Building Department Curb Cut/Driveway Permit 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 ' ` Other Specify _ APPLICATION TO CONSTRUCT, REPAIR, RENOVATE,tikAN E tHE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING NOV - 6 ZOOS SECTION 1-SITE INFORMATION 4, litplKG INSP 11 S �/„� /, ' `�� This section to be completed by office 1.1 Property Address: / � i i/_ / /7 L n �*�—• Nlap ''�i Lot' tG' ` Unit �� � Zone Overlay District 004/4i 'rj/irt/ir_ Elm St.District CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 04973 PCB f etc)6 co,4 � pi )4 k-l4 N Name(P t) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: a/G/ lc)q coin $�. C-1•e•564/flied a Name Pri Current Mailing Address: YctS signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building /v 006 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4 + 5) Check Number ,FW C65o _ n This Section For Official Use Only pY Building Permit Number: r� o,/ `.s-�1 Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Versionl.7 Commercial Building Permit May 15, 2000 4 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations Existing Wall Signs Existing Ground Signs Additions 0 Roofing 0 0 0 Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] 0 Accessory Building [ ] Repairs [ ] )(BRIEF DESCRIPTION: /-ka 4.-5 S 4--•^1 pc-4-- p i L J- _ 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 1A I 0 A-4 0 A-5 0 1B 0 B Business lIg' 2A 0 E Educational 0 2B I 0 F Factory 0 F-1 0 F-2 0 2C 0 H High Hazard 0 3A 0 I Institutional 0 I-1 0 I-2 0 I-3 0 3B 0 M Mercantile 0 4 ❑ R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S Storage 0 S-1 0 S-2 0 5B 0 U Utility 0 Specify: M Mixed Use 0 Specify: S Special Use 0 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 2nd 1st 2nd 3rd 3rd 4th 4th Total Area (sf) Total Proposed New Construction (sf) Total Height(ft) Total Height ft Version1.7 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 0 Municipal 0 On site disposal system 0 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 DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO / DONT KNOW YES 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 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: Version 1.7 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 92 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 fr v6 /LC� Not Applicable ❑ Company Name: Jet Responsible In Charge of Construction 20 n t,G'/rc(.ton 4Lve J. t t_3 G Mi5111707e, Address di / Signature Telephone a Versionl.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 0 SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , 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 1, / ��� 1�4 , as Owner/Authorized Agent Xhereby d's'clare 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. /4 3, 5- az t 7-6014 : ere nt Date / �j/1,03SECTION_12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder : O L1(.4i1/61, i -es O 6 a/6 'S e License Number 2-7 ? 5 ik)14 0._. Wed- 1cL 7/1,4 6/o cS Z 2-2/-0 c-/ Address Expiration Date mo t' ......., 7 3 &fie 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 0 No 0 a • oaIttntrp),04, A+ �`- 1E (it- of 3cirtljalllkltoll 1 AQ t-yM�� E filasa.rhnsrlla' - _— . rw1 •- — E�`���- DEPARTMENT OP BUILDING INSPECTIONS di • 212 Main Street_ Municipal Building Northampton, Mass. 01060 as • WORKER'S COMIFENSATION NSURANCE AFFD)AVFT L, —�%' a -CDC-- -- - — -- (li ccascdperwi ttcc) with a principal place of business/residence at: 50 Cc►ievic.. zd , StpTA,,5 4fLAI " (phone#) 3 q G G q (srrc lJdtyfaa.trhip) do hereby certify, under the pains and penalties of perjury, that ( ) I am an employer providing the following worker's comocnsz;ion coverage for my employees wor ng on'this job'. 4C61-- — jc?q 3`7,g20o3 's/29/0y (Instr�a=Conr-rr5') (Policy Nu- cr) (r;-pirtion Dace) ( ) I.am a sole proprietor, general contractor or homeowner (circle one) and have hired the conu-actors listed below who have the following worker's compensation policies: (Name of Contrtcior) (InR!ranc^ Company/Polk—J. Numlx7) (E.Xp1;J'uon Datc) (Name of Contractor) (lnsa.rancc Compan}vPolie}' Ntlrlc-cr) (Lkpintion Date) (Name of Contractor) ansurancz CompanyfPolio• Number) (Expiration Date) • (Name of Contractor) (Insurance Company/Policy Numb:r) (Ex-pi/anon Da.t.e) (.nsch:ddi:.cc31 dSoct if ococul•to incucc infor u.6to perm.ining in.11 oom•ncors) • ( ) I am a sole proprietor and have no one wori;3ng for me. ( ) I am.a home owner performing all the work myself. NOTE:plea be ew-are th.c..• -k bccocowocn wbo cmplay pears to So c.a7,-•wv cos c,00 c rcpait work on.ds•c lidz of oot most thra lb-oe tmi's in t kith the boohoo+oc rr ido or co tau p•ouocb zppuiteo.un tbeca.o err oot -'-ally oo rdcod to be e¢lployc-3 uoda the wacS;c{s r - -+im Act(GI-1 S2=I(S)),applithdoo by.b000° C far c lit• ce p..,uit rXy c.idcuoc the Icg31 m.o.of.a odoployer under tbo Workala Cocap,, ...ion Act- 1 underieod tha a copy of this mtczocm m.y be forwarded to tbo Degenmcca of t...:.,r,iel AtodeacY Office of!,)auras+for tb. oovcagc vc•ir•CItioa artd the f lltae to spoon bovcrnge uador socioa 25 A of MOL 152 can Iced to the imnrxeioo of criminal pcnalticts ooastaing of a floc of op to S 1.500.00.rtd/or idqx-isoctoacP1 of up to ono ytar cod civil pca..l io is SSc form or.Slop Work Ordc.nd a ram o(5l00.00 a thy&Ttipst me For dcp.na+�-il use only PcTt Numbct ' m Loth Signaotrc of Liccascc/Pccmittcc ISte . -.-..._ .l