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23A-291 (3) February 07, 2012 Stephen Camp 46 East Street Easthampton, MA 01027 Subject Property: 190 Nonotuck Street Florence, MA 01062 Mr. Camp, The plans for the Elder Care Access LLS dated 01 -18 -12 have been approved as noted; 1. Architect shall email a set of electronic plans. (cmiller@northamptonma.gov) 2. All work shall meet requirements of AAB 512 CMR. jr ,0 Charles Miller Assistant Commissioner of Buildings Date: 2/1/2012 Time: 11:52 AE To: 4135871272 Page: 02 , '° CERTIFICATE OF LIABILITY INSURANCE DATE pONIDOtYYYY) 2/1/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AM) CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AM) THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT John Kubacki Cray -Dowd Insurance Agcy.,Inc. PHONE FAX 101 University Drive Suite A6 ma p. El*: 413- 538 -7444 1 WC: N�7 : 413 -536 -6020 Amherst MA 01002 ADDESS$: ikubacki @dowd.corn CUSTOMER TTOMER ID 1: CAMS T 2 INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED MSURERA:Guard Insurance Group Stephen P. Camp 46 East Street INSURER a Easthampton MA 01027 INSURERC: INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 188932608 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, `tHE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. • *SR ADM SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE plait MID POLICY NUMBER (NMIDOIYYYY) (MWDOIYYW) LIMITS GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ I CLAIMS -MADE I IOCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT. AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG S n POLICY n PRO- I LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) S ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE S HIRED AUTOS (Per aooident) NON -OWNED AUTOS S UMBRELLALIAE OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION S S A WORKERS COMPENSATION STHC241459 4/4/2011 4/4/2012 71 STATU- 3 I ER ! - AND EMPLOYERS' LtABILRY TORY LIMIT IOTH Y i N ANY PROPRIETOR/PARTNER/EXECUTIVE E L. EACH ACCIDENT $100,00 0 �M OFFICEREMBER EXCLUDED? Y N I A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $100,000 It yes, describe under DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT 5500,000 DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (Attach ACORD 101, Add dorsal Romarhe SahMuN, S more epaee In required) Workers Compensation policy does not provide coverage for the Sole Proprietor, Stephen P. Camp Re: 190 Nonotuck Street CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton Attn: Building Dept. 212 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo we registered marks of ACORD Massachusetts - Department of Public Safet■ Board of Building, Regulations and Standards Construction Supervisor License License: CS 82531 STEPHEN P CAMP } 46 EAST ST 4 , rt EASTHAMPTON, MA 01027 <': --�- -�- Expiration: 11/23/2013 (' ommissioner Tr#: 7108 s. >✓ c af;.m ' 4- W'esslt� . r efoT � rt C r ; E y �li�xQ V T Ix 2- ,2 111 11 1 ___ _ fife il. 1 4 t 250.11 iitiVrgiikfr*AtiatUt Tr* 29 ,tdut 1714 lF'A'EN ¢A'P T S • _[A lersecretan7 r6kei"'At PTON, f'A4d1G 7 • • • 5. Any means of egress which is not so arranged as to provide safe and adequate means of egress, including exit signage and emergency lighting in accordance with Chapter 10 of the International Building Code 2009 with Massachusetts Amendments (780 CMR 10.00); or The existing building is in full compliance with this requirement. ACCESSIBILITY There are no additional requirements beyond those identified above. STRUCTURAL No additional requirements beyond those identified above. ENERGY CONSERVATION No additional requirements beyond those identified above ENERGY CONSERVATION: Minimum requirements: Level 2 alterations to existing buildings or structures are permitted without requiring the entire building or structure to comply with the energy requirements of the International Energy Conservation Code or International Residential Code. The alterations shall conform to the energy requirements of the International Energy Conservation Code or International Residential Code as they relate to new construction only. LEVEL — I ALTERATIONS GENERAL Level 1 alterations include the removal and replacement or the covering of existing materials, elements, equipment, or fixtures using new materials, elements, equipment, or fixtures that serve the same purpose. BUILDING ELEMENTS AND MATERIALS All new work shall comply with materials and methods requirements in the International Building Code, International Energy Conservation Code, and International Mechanical Code, as applicable. FIRE PROTECTION There are no additional requirements beyond those identified above MEANS OF EGRESS Alterations shall be done in a manner that maintains the level of protection provided for the means of egress, and in accordance with section 102.2.2.1. 102.2.2.1 Existing Non Conforming Means of Egress: The following conditions shall be corrected in all existing buildings: 1. Less than the number of means of egress serving every space and/or story, required by Chapter 10 of the International Building Code 2009 with Massachusetts Amendments (780 CMR 10.00); There are a sufficient number of Means of Egress 4. Any required means of egress component which is not of sufficient width to provide adequate exit capacity in accordance with section 1005.1 of the International Building Code 2009 with Massachusetts Amendments (780 CMR 1005.1); The exit component widths are sufficient to provide adequate exit capacity. ACCESSIBILITY Accessibility requirements shall be in accordance with 521 CMR. Only the reconfigured work areas are required to comply with 521 CMR because the costs for the work being performed in this work area is less than $100,000 and is less than 30% of the full and fair cash value of the building. The condominium unit currently meets the requirements of 521 CMR and the proposed Level II — Alterations shall not reduce that level of accessibility. STRUCTURAL New structural elements: New structural elements in alterations, including connections and anchorage, shall comply with the International Building Code. Minimum design loads: The minimum design loads on existing elements of a structure that do not support additional loads as a result of an alteration shall be the loads applicable at the time the building was constructed. Existing structural elements carrying gravity load: Alterations shall not reduce the capacity of existing gravity load - carrying structural elements. Existing structural elements supporting any additional gravity loads as a result of the alterations, including the effects of snow drift, shall comply with the International Building Code. Existing structural elements resisting lateral loads. N/A Voluntary improvement of the seismic force - resisting system: N/A MECHANICAL All reconfigured spaces intended for occupancy and all spaces converted to habitable or occupiable space in any work area shall be provided with natural or mechanical ventilation in accordance with the International Mechanical Code. Exception: Existing mechanical ventilation systems shall comply with the requirements of Section 709.2. 709.2 Altered existing systems. In mechanically ventilated spaces, existing mechanical ventilation systems that are altered, reconfigured, or extended shall provide not less than 5 cubic feet per minute (cfm) (0.0024 m /s) per person of outdoor air and not less than 15 cfm (0.0071 m /s) of ventilation air per person; or not less than the amount of ventilation air determined by the Indoor Air Quality Procedure of ASHRAE 62. Local exhaust: All newly introduced devices, equipment, or operations that produce airborne particulate matter, odors, fumes, vapor, combustion products, gaseous contaminants, pathogenic and allergenic organisms, and microbial contaminants in such quantities as to affect adversely or impair health or cause discomfort to occupants shall be provided with local exhaust. MEANS OF EGRESS The requirements of this section shall be limited to work areas that include exits or corridors shared by more than one tenant within the work area in which Level 2 alterations are being performed, and where specified they shall apply throughout the floor on which the work areas are located or otherwise beyond the work area. N /A, the Work Area is not shared by more than one tenant, and does not include corridors or exits that affect others. Therefore, the tenant space undergoing this alteration need only comply with the means of egress requirements of section 604. 102.2.2.1 Existing Non Conforming Means of Egress: The following conditions shall be corrected in all existing buildings: 1. Less than the number of means of egress serving every space and/or story, required by Chapter 10 of the International Building Code 2009 with Massachusetts Amendments (780 CMR 10.00); There are a sufficient number of Means of Egress 2. Any required means of egress component which is not of sufficient width to provide adequate exit capacity in accordance with section 1005.1 of the International Building Code 2009 with Massachusetts Amendments (780 CMR 1005.1); The exit component widths are sufficient to provide adequate exit capacity. 3. Any means of egress which is not so arranged as to provide safe and adequate means of egress, including exit signage and emergency lighting in accordance with Chapter 10 of the International Building Code 2009 with Massachusetts Amendments (780 CMR 10.00); or The existingbuilding is in full compliance with this requirement. TABLE 1004.1.1 MAXIMUM FLOOR AREA ALLOWANCES PER OCCUPANT FLOOR AREA IN SQ. FT. PER FUNCTION OF SPACE OCCUPANT Business areas 100 gross Area per Area/Occupant Occupants Floor Use Group per Table 1004.1 Allowed 1 floor: Business Area 1759 ft 100 18 The existing mess capacity meets or exceeds the occupant load as specified in the International Building Code for the new occupancy TABLE 803.9 INTERIOR WALL AND CEILING FINISH REQUIREMENTS BY OCCUPANCY NONSPRINKLERED Exit enclosures and Rooms and exit enclosed GROUP passageways" Corridors spaces` B, E, M, R -1 A B C Guards: N/A in this work area. FIRE PROTECTION The requirements of this section shall be limited to work areas in which Level 2 alterations are being performed, and where specified they shall apply throughout the floor on which the work areas are located or otherwise beyond the work area. Automatic Sprinkler Systems will not be required because they do not trigger the requirements set forth in M.G.L. c. 148, § 26G. The reconfiguration of interior partitions planned in the work areas in total do not rise to the level of "major alterations" as defined by The Commonwealth of Massachusetts, Fire Safety Commissioner's Automatic Sprinkler Appeals Board. Automatic sprinkler systems: Automatic sprinkler systems shall be provided in accordance with the requirements of Sections 704.2.1 through 704.2.5. Installation requirements shall be in accordance with the International Building Code. 704.2.1 High -rise buildings: N/A 704.2.2 Groups In buildings with occupancies in Groups A, B, E, F -1, H, I, M, R -1, R -2, R -4, S -1 and S -2, work areas that have exits or corridors shared by more than one tenant or that have exits or corridors serving an occupant load greater than 30 shall be provided with automatic sprinkler protection where all of the following conditions occur: N/A - The work area does not exceed 50 percent of the floor area of the building. 704.2.3 Windowless stories: N/A 704.2.4 Other required suppression systems. N/A 704.2.5 Supervision. N/A Standpipes: N/A Fire alarm and detection: N/A for this B Use Group; the work area is less than 50 % of the floor area SECTION 1— HISTORY / SCOPE OF WORK The Work Area Compliance Method will be applied for work performed pursuant to this building permit application, The Classification of this Work is Alteration — Level II. The work areas are entirely within one Condominium Unit which is a part of a larger condominium building currently being used for business. Several non -load bearing interior partitions shall be removed to increase the common area within the Condo unit. A storage closet shall be expanded and new doorway created for access to the closet. Two interior partitions shall also be constructed to provide separation between the common areas from the kitchen and staff areas. The handicap bathroom shall be remodeled. There is no change in use for this work space. SECTION II — BUILDING DESCRIPTION — EXISTING The existing building is a one story condominium approximately 14 feet in height, which is currently being used as business offices serving the medical professions, (Occupancy Group B). The Construction Type is IIIB and is constructed as follows: Foundation: Slab on Grade Walls: 12" unreinforced masonry Roof: Flat, Rubber Membrane Total building area: 15,504 sq. Ft. Total area of Condominium Unit: 1,759 sq. Ft. SECTION III — CHAPTER 34 ANALYSIS - RECONFIGURATION OF SPACE Level II Alterations include the reconfiguration of space, the addition or elimination of any door or window, the reconfiguration or extension of any system, or the installation of any additional equipment. All new construction elements, components, systems, and spaces shall comply with the requirements of the International Building Code. BUILDING ELEMENTS AND MATERIALS The requirements of this section are limited to work areas in which Level 2 alterations are being performed, and shall apply beyond the work area where specified. Vertical openings: There are no vertical openings in the work area. Smoke barriers: N/A in this Group B Work Area. Interior finish: The interior finish of walls and ceilings in exits and corridors in any work area shall comply with the requirements of the International Building Code. Exception: Existing interior finish materials that do not comply with the interior finish requirements of the International Building Code shall be permitted to be treated with an approved fire- retardant coating in accordance with the manufacturer's instructions to achieve the required rating. This Requirement shall be met. INVESTIGATION AND EVALUATION REPORT Pursuant to Massachusetts State Building Code (780 CMR), Eighth Edition, Base Volume Chapter 34 — The Existing Building Code of Massachusetts JANUARY 15, 2012 ELDER CARE ACCESS, LLC. 190 NONOTUCK STREET NORTHAMPTON, MA 01060 RECONFIGURATION OF OFFICE SPACE LEVEL II ALTERATION 0ED p � a...34 , SIEGFRIED PORTH, A.I.A. QRT. i .. ° �tl� MICHAEL J. DUVAL � . f , S P 116 PLEASANT STREET, EASTHAMPTON, MA 01027 (413) -529 -9434 Stephen Camp Construction 46 East St. Easthampton, Ma 01027 (413)527 -7124 Submitted To : Sheryl Fappiano Phone- 584 -6950 695 -8233 Address : 190 Nonotuck Street Date 1 -16 -2012 Florence, Ma 01062 We hereby submit this estimate for - Total Renovation To start all demo work will be to remove partitions as planned. I will cut the concrete floor to see the plumbing drains. All new partitions will be framed according to plans. The rough plumbing and electric will be installed and inspected. I will install sheetrock, tape and sand ready for paint. All walls will be painted (color is customers choice.) All cabinets, doors and trim will be installed. New glue down carpet will be installed along with oak flooring In desired areas. Tile will be installed in the bathrooms and the kitchen. New drop ceilings will be installed The finish electric and plumbing will be done at this time. All final inspections will be done to complete the job. Building permit and trash removal is included in my price. Price = $ 56,450.00 1/3 to start 1/3 after rough inspection 1/3 on completion Contractor Supervisors License number 082531 Home Improvement contractor Registration number 135204 I propose to supply materials and labor -in accordance with above specifications. This proposal may be withdrawn r/, By us if not accepted within 30 days Authorized Signature 4 _ Acceptance of proposal Signature i'� :., The Commonwealth ofMassachusetts Department of Industrial Accidents Lri t,- Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): Si /(eYV ( Address: 64 $174»7 City /State /Zip:.. 4Y1c,' J L t CP i T) Phone #: 1 X 7- 7/ 2/' employer? Are you an e r? Chef7c the appropriate box: Y P Y Type of project (required): 1. I am a employer with Z 4. 0 I am a general contractor and I 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub- contractors have g. !a Demolition working for me in any capacity. employees and have workers' g Y P ty 9. El Building addition [No workers' comp. insurance comp. insurance.: ... required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.❑ Plumbing repairs or additions 3. ❑ I am a homeowner doing alI work myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.0 Other,7I t employees. [No workers'. 1 Lei Xv0e44.7ls f comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. /l Insurance Company Name: C ilCc 1/15 /0, g en e'-y Policy # or Self -ins. Lic. #: .� - C2- 7i/ Expiration Date: 7 / / Z Job Site Address: f g0 2 City /State /Zip: /79,,/ / e { M U Lg 2 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unde h p ins an enalties of perjury that the information provided above is true and correct. Signature: Date: / —� Z- Phone #: 7 f2 2 - / 2y (' // fr-e9 " t7 4 / Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Versionl.7 Commercial Building Permit May 15, 2000 , SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 11011) ti Independent Structural Engineering Structural Peer Review Required • Yes 0 No ' SECTION 11 - OWNER: AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING. PERMIT 1, .: _ ' _ .„ � _ _ _ -_ _...,_............__ _, __ , _ .a ,....�......_e....�a, as Owner of the subject property hereby authorizer . _ _.. act on my behalf, in all matters relative to work authorized by this building permit applicationn__________ 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 enelties of a 'u . _r ______ ,,, __ _________ ePk4�✓ Print Name y �.11i01_!. .. __ __.. _____ _ __ Signa re of Owniiiirip / Date SECTION 12 • ' TRUCTION.SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder . '.—. a / a YY License Number ___Q .5,(e,__"/ 6,5 ii ? (2).1.,, rkt 0/0 2 2 ' //--- 3-27 Address Expiration Date 9 .,. 7Z r 7 - ?j. 1' Sig ure !' " } 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 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 ENSLOSE ®:SPACE) 9.1 Registered Architect: r� ® ,i Not Applicable ❑ ?� - -- �' Name (Registrant): - ... l' 3�5 1 441 7 0 j 7 Registration Number } t Address �!L �.r _...._.. ,/ , Expiration Date Sig'.ture Z Telephone 9.2 R- • istered Professional Engineer(s): Name _ _ � w... � � ���� Area of Responsibility Address Registration Number Signature Telephone Expiration Date g 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 C G,We...r (, - a n ' 1 Kr/ 91 �'w� _ __ _._ Not Applicable ❑ Company Name: Responsible In Charge of Construction _ e re...3 cr/-e-e .-.. IVA/ ty/ —7 Address___ Signature Telephone Version1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON. ZONING .. 4 .17 Existing Proposed Required by Zoning , This column to filled in by Building Department Lot Size Frontage ,_ .. _ .. ____,....___.. -_. ___ Setbacks Front Side L: R :. l L:= i R:.. a Rear .__.._.,,i ., Building Height i Bldg. Square Footage % 7---7 i T i ll Open Space Footage % •--- (Lot area minus bldg & paved i _ f ' parking) , q # of Parking Spaces Fill: (volume & Location) - ---. ... .... i - ._.. -- -___ --__ - --- A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book ' . Page ' and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: _ D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 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 0 NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. , - Version 1.7 Commercial Building Permit May 15, 2000 I ... ,.. . SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 1 . CUBIC FEET OF ENCLOSED SPACE .Skis Interior Alterations if' Existing Wall Signs cr Demolition 0 Repairs 0 Additions 0 Accespory Bui i, lding Li Exterior Alteration 1:1 Existing Ground Sign CI New Signs 0 Roofing 0 Change of Use D othe ,, Brief Description ' ',Enter a brief description her In tkfr" d ' i ' / PA Vii: t )- l ' / --- -,---- pi>, Of Proposed Work: 1 f--- li e...i tvi-Ifs A u/icice•-e—r 0 CA - 1 - / 7 *41 y -- ; rne, pi 4 ,,,_ ,,,.. SECTION 5- USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-1 El A-2 0 A-3 0 1A 1 El A-4 0 A-5 El 1 B 0 B Business .in 2A 0 E Educational 0 2B ' r 0 F Factory 0 F-1 Ei F-2 0 2C 0 H High Hazard 0 -. 3A 0 I Institutional I=1 I-1 0 1-2 El 1-3 ID 3B ill M Mercantile CI 4 CI R Residential 0 R-1 El R-2 0 R-3 0 5A 0 S Storage 0 s- 0 S-2 El 5B 1 0 U Utility 0 Specify: - - . M Mixed Use 0 , Specify: 7 S Special Use 0 Specify: 1 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) k... s tfl - 1 2nd i 2 . __ i _ — - 1 ' „......, _.,......_.......__ ,,, 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 0 Private Ei Zone Outside Flood Zone0 Municipal 0 On site disposal system 0 • Version1.7 Commercial Building Permit May 15, 2000 RIVED _ City of Northam pton t- Bu (ding Department FEB - I 7112 L12 Main Street § 5e =mss Room 100 L 7 atl� alter- M „ `erg ortt ampton, MA 01060 °F ` egg 5a 7 -1240 Fax 413 -587 -1272 j* ri : 'V a f pp nTllMm - e o a g � e rSpe �� "g � P mss. , 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 / q 0 4/a4 ; Map Lot Unit je�44.L L. ® / C} le Z Zone Overlay District �`' ( ----- 'Elfin St District`. CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: _ s ✓,;fir✓%c.PP /wA/D Name (Print) Current Mailing Address: Signature ^ Telephone 2.2 Authorized Agent: Name (Print) Current Mailing Address: i/3 52 9 - . : 770/ _ e// .sT %y y Signature 1 ^ Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 2 0 . (a) Building Permit Fee 2. Electrical (b) Estimated` Total Cost of 00 s Construction from (6) _ ._ ...____.._ _..., 3. Plumbing Permit Fee � f 4. Mechanical (HVAC) 5. Fire Protection . _._ 6. Total = (1 + 2 + 3 + 4 + 5) 5 y "+f ©, ev Check Number \ _° 4 g3� This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0684 /1146(0:\i‘k, APPLICANT /CONTACT PERSON STEPHEN CAMP ADDRESS/PHONE 46 EAST ST EASTHAMPTON (413) 527 -7124 0 PROPERTY LOCATION 190 NONOTUCK ST MAP 23A PARCEL 291 000 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 1,� Fee Paid L3U J 2133 l� Typeof Construction: REMOVE PARTITIONS,FRAME NEW WALLS,BLDG 1 HANDICAP BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 082531 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Sire of Building O ' icial 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. 190 NONOTUCK ST BP- 2012 -0684 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A - 291 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Zoning Permit BUILDING PERMIT Permit # BP- 2012 -0684 Project # JS- 2012- 000455 Est. Cost: $56450.00 Fee: $336.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN CAMP 082531 Lot Size(sq. ft.): Owner: HICKS KATHERINE M Zoning: Applicant: STEPHEN CAMP AT: 190 NONOTUCK ST Applicant Address: Phone: Insurance: 46 EAST ST (413) 527 -7124 0 WC EASTHAMPTONMAO1027 ISSUED ON:2/7/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: REMOVE PARTITIONS,FRAME NEW WALLS,BLDG 1 HANDICAP BATHROOM 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 2/7/2012 0:00:00 $336.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner