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23A-036
CERTIFICATE OF LIABILITY INSURANCE OP ID SF DATE (MMIDDIYYYI) CONSA50 07/15/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IRM Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Barry M. Stephens, CPCU HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 75 North Main St . -P 0 Box 564 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Longmeadow MA 01028 Phone: 413 -759 -0010 Fax: 413- 759 -0017 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER k central Insurance Companies 20230 INSURER B: Construct Associates, Inc. INSURER C: Center 36 Servlce NorthamptonMA 01060 Road INSURER D: INSURER E: COVERAGES THE POUCIES OF INSURANCE USTED 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INER ADOT. POLICY EFFEC POLICY EXPRATION LTR MERE TYPE OF INSURANCE POLICY NUMBER DATE (MWDDlYYYYI DATE (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500000 A X COMMERCIAL GENERAL LIABILITY CLP7834317 07/01/09 07/01/10 P`R MISE Eao urence) $ 100000 CLAIMS MADE X OCCUR MED EXP (My one person) $ 5000 PERSONAL & ADV INJURY $ 500000 GENERAL AGGREGATE $ 1000000 _ GEM. AGGREGATE LIMIT APPUES PER: PRODUCTS - COMP/OP AGG $ 1000000 POLICY JECT LOC AUTOMOBI.El LIABILITY COMBINED SINGLE LIMIT A ANY AUTO BAP8614614 07/01/09 07/01/10 (Eaacddent) $ 1000000 ALL OWNED AUTOS BODILY INJURY rson X SCHEDULED AUTOS (Per pe) X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE S 1000000 A X I OCCUR CLAIMS MADE CXS7834319 07/01/09 07/01/10 AGGREGATE $1000000 _ S DEDUCTIBLE $ X RETENTION $ 0 $ WORKERS COMPENSATION WC STATU- 0111- AND EMPLOYERS LIABILITY TORY LIMITS ER A ANYPROPRIETOR/PARTNER)EXECUT Y/ WC783431819 07/01/09 07/01/10 E.L. EACH ACCIDENT $ 500000 OFFICER/MEMBER EXCLUDED? (Mandatory M NH) E.L. DISEASE - EA EMPLOYEE $ 500000 I yyes, A PRO under SPECIL PROVISIONSbalav E.L. DISEASE - POLICY UMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION PROOFOO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FALURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABRITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Proof of Coverage REPRESENTATIVES. AUTHORQED REPRESENTATIVE IRM Insurance Agency Inc. ACORD 26 (2009101) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SERVER ROOM move air duct If possible to make room for wall half wall 0 v 0 0 0 L o. a electrical outlet in center of room c mounted in ceiling for "pull down" o power use N 0 G t 01 J half wall half wall ' 4 a y. .+,, o , {I t ) a Q ,i z a f Z a �� = I 'We , J o O i ,.? Y J a U Y c Q v o ,Vs Z N f I CC 03 1,4,,,,, I- C p , s i w TRACK LIGHTING 41r WINDOW a Z O I TRACK LIGHTING . INTEtRIOR WALLS a s c 0 • N J II PERIMETER WALLS a Y c O FLOOR AREA t a: I- DESKTOPS es half wall I _ SERVER ROOM move air duct if possible to make room for wall half wall 0 a 2 a 0 0 t a a electrical outlet in center of room c o mounted In ceiling for "Pull down" N 01 c t of -J half wall half wall CO 0 I a : O * `l t? a. z 0 a O F. z a NC, x F G O ,•^ J 1µ Y c 4 U o � eL a - ' N WV. l — c Via.k ha s W< a. ' N. TRACK LIGHTING , ` lea 0 k 5 t, WINDOW a z O I TRACK LIGHTING ■ INTEtRIOR WALLS a x c 0 • N -.I II PERIMETER WALLS c Y c u FLOOR AREA Z. A r z a F DESKTOPS J halt wall • 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 /� n 5T �'- `` D - S G 9�4`'�'�s�C (OV( 7 /" e r91v -r/ Not Applicable ❑ Compan Name: 5 7 1.x.4.0 s S Responsi I n Charge of Construction 3 4 $.. ,r- v ► C--e 61 h. 71 R rvGt "4,lo,4A w 4 4 Address 1�/ %�" 0, f Y/3 s y - / Z Y atu; / 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 (:,/ SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I ct,m.. S ‘?C... , as Owner of the subject property hereby authorize ..574-4(-- /4' b. �2,<sS to act • • -- •-half, in all matters relative to work authorized by this building permit application. of O Date I 5./.. . 1 $' , 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. S7•c.. �1. --c. D, Ras S Print Name / Signs re of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable 1:1 Name of License Holder : 5 L —� . -(- P. (2c►5 s 7 f /(r!> License Number 3Ce 5-, ,r . C-,_ c.. (24. / ✓hti.. 4.. 44 4 4 /1 Z /t Address Expiration ate _ / 4 (/3 � '(- t2Z•-( Sign re 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 bui 'ng permit. Signed Affidavit Attached Yes No A) 4-- 4 11 / 14 , 41 , vi er v- - e ) . ,yki - Version l.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 a er been issued for /on the site? NO 0 DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Regist Deeds? NO 0 DON'T KNOW YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES e NO 0 IF YES, describe size, type and location: 3 ') 3 10 c4. )LA-- $ ,;.1.4.- J- D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excav on, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • 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 2<emolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: / N4 ! /did ir..r_ti/ J ` p.00lf 404.v--4 ge. 1 41 /41c.......) /41c.......) o- SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) I CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1 1A I ❑ A -4 ❑ r A -5 ❑ 18 ❑ B Business P"i . /u S� d 1 ; ✓ 1 2A ❑ E Educational CI 2B I ❑ F Factory ❑ F -1 El F -2 ❑ I 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I -1 ❑ 1 -2 El 1 -3 ❑ 3B ❑ M Mercantile ❑ 1 4 ❑ R Residential ❑ R -1 El R -2 El R -3 El 5A ❑ S Storage ❑ S -1 El S-2 ❑ 5B [ ❑ 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: auSi I'1 -tf., Proposed Use Group: /Jail ' h - e - S S Existing Hazard Index 780 CMR 34): Z Proposed Hazard Index 780 CMR 34): Z SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1st /? �V 1st / 3 sJ 2nd �/ 2 nd 3rd 3rd 4 4 4 th Total Area (sf) / 5 5?2 Total Proposed New Construction (sf) _ d Total Height (ft) 2_4, ` t Total Height ft 2- V 7. Water Sspply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 3 Sewage D' posal System: Public Private ID Zone Outside Flood Zone[vr On site disposal system 0 . -. Version1.7 Commercial Building Permit May 15, 2000 n l \t j - Department use only II I' - - - -' --- -- — City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit NOV 2 2009 2 2 Main Street Sewer /Septic Availability , i Room 100 Water/Well Availability - Ndrthar pton, MA 01060 Two Sets of Structural Plans h p hone 451-587- 240 Fax 413- 587 -1272 Plot/Site Plans 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 / G /yt �PIG4_ 5,,- ,,/- c...J_ Map Lot Unit //�-tia C--L Mot d/ Zone Overlay District 4 Z Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: "'s Al. Cd'/ 4- 3 C 1M l l\. St Name (Print) , ,..- Current Mailing Address: Signature 4_ Telephone q 35--7--- ' -- Si 2 C 2.2 Autho ed A. e . 1( /2 S7 .01 S 36 5:e. e 'r .4- C .f.-6- '1 4 V - / 2 4 Name (Print) Current Mailing Address: ll/ct✓ d.,. / ,G i ti /-1,•‘9 0/ o G d Signature 53, Telephone _5 ".6 - / 2 Z y SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building Z 8) wv- (a) Building Permit Fee 2. Electrical co-c• (b) Estimated Total Cost of 3 ?ay. Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) .,-) 5. Fire Protection, Z-c) 6. Total = (1 + 2 + 3 + 4 + 5) 3 sr. led, Check k Number 29a )c2// This Section For Official Use Only 111fff"' Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP -2010 -0526 APPLICANT /CONTACT PERSON STEPHEN D ROSS ADDRESS /PHONE 36 SERVICE CENTER RD NORTHAMPTON (413) 584 -1224 Q PROPERTY LOCATION 70 MAPLE ST MAP 23A PARCEL 036 001 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � 401// Fee Paid Typeof Construction: CONSTRUCT NON -LOAD BEARING PARAMETER 1/2 KNEE WALLS & NEW FLOOR 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 FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 1NR0 AT1ON 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 7:4 / 2 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. 71) MAPLE ST BP- 2010 -0526 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A - 036 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit # BP- 2010 -0526 Proiect # JS- 2010 - 000740 Est. Cost: $35000.00 Fee: $211.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 6577.56 Owner: GIPE JAMES Zoning: GB(100)/ Applicant: 5 rEF'HEN D ROSS — :.ay. AT: 70 MAPLE ST Applicant Address: Phone: Insurance: 36 SERVICE CENTER RD (413) 584 - 1224 0 NORTHAMPTONMA01060 ISSUED ON :11/16/2009 0 :00 :00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT NON -LOAD BEARING PARAMETER 1/2 KNEE WALLS & NEW FLOOR POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring _ D.Y.W. Building Inspector Underground: St..rvice: Meter: Footings: Rough: Rough :` � House # Foundation: 'JY/ Driveway Final: Final: Final: / �/ 1 `� 0 Rough Frame: O / 2/ O 0 9 tom'' l � Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: © K 0 r c) J Final: Smoke: Final: o K 1 1 6 1 i o iptji 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 11/16/2009 0:00:00 $211.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo