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23B-046 (22) o i t W R6 f 14 ' 7E 13'X14' 25'X13' B e 37'X13' FM 70 ::!7E tl 110SQ.FT. B 120 - - - - 14 Reswing door opposite hand y J 32'X13' E Li m 0 - � ! _ � ! ' I . ! . ! � ! ! . JA EMIIEI ! z ! ! �� ■ _ ; ! g ! ! | ! � E� ! ! ! � ! ! ! � ! � ! ' , . , | � � | ! , ! . ! ! | o4�ItA!/p�0 - ° 6aJ1RCt�naftta DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 ' WOMCEER'S COMPENSATION INSURANCE AI'I+IDA.VIT (li censerlper>nl flee) with a principal place of busin ess/residenc : e at S/yI,/�Pd' S7 4iGff�ow, BIOS (phone#) %/3'S;'I-ZSD� (street/ci ty/stale/zip) do hereby certify, under the pains and penalties of pcgwy, that: ( I am an employer providing the following worker's compensation coverage for my employees wort ng on this job: %T/V A111a S,4 s , A-,W z B©D5S790/ 2007 / 2 -3)-00 (Lnvrance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Lnsurance Coi pauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Ccmpany/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attuh additional:beet ifnaoeuuy to incftsde inform�tzoa to all watrncton} O I am a sole proprietor and have no one worming for me. ( } I am a home owner performing all the work myself. NOTE:plena=be awuc that V610 hoaxrowncn who cmplay pcnonz to do ma..fr,.�cu=7trctioa or repair work oo a dwelling of not tuorn than thrco unit+in wtrich the}wt�oswcr resides or on the Erounc}s apptutcnaot therdo me one emcrzlly ccaridcrcd to be employers under tho wozil r «mpcm&tioa Act(GL152,ss 1(5)),zWdcapon by a homeovvma for a Gocasc oc period may evidcoa the 1cgxl ttahta of an amployer under tho wo'koee conv o. tioa Act. I un&ra nd that a oopy of thin datcmcat m.y be forw=,c. d to tho Dtgarta co of Iodu_strial Aocidcat>'Ofiioo of Lmur oe fa ti- coverage va ifieatioo nad that failure to&=cure eovcntgo under section 25A of MOL 152 can Ic d to the imposition of-m¢ul penalties oo¢sistatg of a fmc of up to S 1,500.00 and/or inrprisoaaxrit of tip to oac ycer ud civil pcmttia is the focm of it Stop Work Ordtr and a fino of 5100.00 a day ap.inst tw- Fcr dcputmc�1 u10 only Permit Number Nfap�t Lot# . ;Yr� .., Stgnahtrc o iccnseelPcrmit#.ce e on!.7 Conunerciai BuiidinR Pel7nit May ! , '-DC I SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.17) _ -- -- --- --- — ------- -- - iCeoende.nt Structurai Engineering Structural Peer Revier,� Required SECTION 11 --OWNER AUTHORIZATION-TO BECOMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT __--- Do C _ DiCS/p 0, � or ;uDIE hereby authorize Q �f lC laou I e C 012 S rl UG�LZ. -----------------t act my beh in all matters rel ork authorized by this building permit application. Signature of Owner Date I, _ 6(Z/91 )� �� 17D11�� COhS T�UCT/O/� -�/7C . as Ovmr uthorized Agee` hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knov.,ledge and belief. Signed under the pains and penalties of perjury. � Print Name Signature of Ow �- en Date — SECTION 12 -CONSTRUCTIOt1SERVhCES 10.1 Licensed Construction Supervisor: Not Applicable E, Name of License Holder / � S. - e /e 7�/ems' — 066 ,227 -- License dumber Address Expiration Da,e Signature Telephone SECTION 13 -WORKERS.COMPENSATION INSURAN.CEAFFIDAVIT;{M G1 c.-152, Vdoi'F;eid submitted with this application. Failure to prop --'e t:��s r . s Compensation Insurance affidavit must be completed an o_ esult in the denial of the issuance of the building permit. i �Ssgned Affidavit Attached Yes....... No...... 11 �'ersior,l.7 Co;nmcrci�l R,uildir 1% 1 ,211 n SECTIOtq 9- PROFESSIONAL DESIGN AND CONSTRICTION SERVICES FOR BUILDINGS AND STRUCTURES SUEJEC.T TO CONSTRUCTION CONTROL PURSUANT TO 780 CG1R 116 (CONTAINING FACRE THAN 35 000 C.F.'OF ENCLOSED;SPACE) q.1 R:eg,stered Architect: -,,rat c �J.r`-;:� res. Expiration Date S!„na`i re Telephone i 92 Registered Protessional Engineer(s): fVzme Area 3f Pesponsibiktv i P,ddress Registration Number Signature - ---_- Telephone Expiration Date -- i game Area of Responsibility I Address ---- - --- --- ---- � Registration Number ---- --- _ I Signature Telephone Expiration Date Name Area of Responsibility � I A ddress -- -_-- — - -- Registration Number - — I I Signature Telephone Expiration Date Name Area or Responsibility I ---------- ---- -- ---- -- ---- Address Registration Number --- -- —— `' ---------I- - r a -- -- - -- ----' Jib^alure _ I PeF/I�pnP Y.FJlra L 11or1 .�_,� 9.3 General Contractor APoi r✓aD'e o j Company Name: biro�` Responsible In harge of Construction —s 122, 2/-e/' ---- --- 26, � Versionl.7 Commercial Building Permit May 15, 2000 S Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone: _ Outside Flood Zone Municipal p On site disposal sy tem ❑ S. NORTELAMPTON ZO'N ING --- Existing Proposed Required by Zoning Phis column to be fillcd in by Building Department _ I _ Lot size I 96 4, �/c,7 8 96 9, y279 Frontage 59 2 6 5 0, _ Setbacks Front 102 ' p 2 ' Side L: $8 R: y2 L: 88 R: Sit Rear Building Height Bldg. Square Footage % Open Space Footage / % (Lot area minus bldg&paved !o• {� �Q• 6 arki n o) of Parking S aces 761 Fill: NIA MIA (volume&Location) A, Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW YES X IF YES, date issued: Der l3, 20U) IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES V IF YES: enter Book 6 SOy Page 239 and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T 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 1-r NO _ IF YES, describe size, type and location: VG -1 o vs D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location;_ _. Versionl.7 Commercial Buildrng Permit May 15,ZUUU ;EClION 4--CONSTRUCT-IONSER'VICES-FOR-ROJ.ECT8 LESS T iA_N 35,.000 ti :UBIC`.FEET:OFNCLOSED SPACE ' anterior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ � ❑ ❑ — -- cf eriorAlterations Demolition[] New Signs [ ] Change of Use [ ] Other [ ] ❑ I Access )I�or-y Building [ ] Repairs [ ] R 80wets BRIEF DESCRIPTION: Al��/' /.>CIS/�tS S cJ'7►'f'Ce %D ('f e•Ve /yto Pe v5 46m .S?QC& >EMON 5 -:-USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A A-4 ❑ A-5 ❑ 1B I ❑ Business ❑ El Educational ❑ _ ZB I ❑ Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ 1 High Hazard ❑ 3A ❑ Institutional ❑ I-1 ❑ I-2 I-3 ❑ 3B ❑ _ I Mercantile ❑ 4 ❑ Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ Storage El S-1 ❑ S-2 El 5B ❑ I Utility ❑ Specify: I Mixed Use ❑ Specify: Special Use ❑ Specily: COMPLETE THISS UNDERGOING RENOVATLON.,MDMC)-NS ANDbR CHANGE IN USE xisting Use Group: 1-2 Proposed Use Group: Z -2 Xisting Hazard Index 780 CMR 34): y Proposed Hazard Index 780 CMR 34): y SECTION 6:BUILDING HEIGHTAND�REA' __ 3`��- s�",�'KOFF�CEUSEONLY cY BUILDING AREA EXISTING PROPOSED NEVI CONSTRUCTION =loor Area per Roar (sf) 1, Y 2nd rd 3 t{ n ~ ,z 3 rd tiu rt 1 - 4m _ .w� - U F - - rl Total Area (sf� Total Proposed New Corstmcton (sf) oral Height (ft)-- — F Total Height ft—N� -------- ivui.i viuui l lci Luau 5 I IuuL iYjdy I-) ZUUU City of Northampton �Ixg� Nom . Building Department a 'e AN 212 Main Street uv rail : Room 100 a ai_ :i � , Northampton, MA 01060 ets as phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE,CHANGE THE USE OR-OCCUPANCY-OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMIL-Y D'l EIILiN OCT 16 2008 SECTION SITE LN]FORMATION 1.1 Property Address: � ecio tole corn �ted b office sy �00% �;ckihsoh f/os.oi tca( a URN 30 / ! S !�-•s'"f 85 r„�, x Wk ;k, �`�,y 1 K.s�.4H a'S a v 5t -has - SECTION Z PROPERTY OWNERSHIPJAULHORREDAGENT __. Z.1 Owner of Record: Coo/e v Dic ihsoh /Vas,oi7"al 30 o061s7` S t. PO. Go/ SOO/ Vame(P t) Current Mailing Address: y/3- 582 - P-31 ')ignature Telephone �,2 Authorized Agent: 7i 7-/6 V 5. `'e//e 7-et 6- Z ll el- St. 4 u d/a u/, /1919 210,66 Jame (Print) Current Mailing Address: 5'i3- by7 2 500 >ignature Telephone >ECTION 3�,ESTIMATED CONSTRUCTION COSTS tem Estimated Cost(Dollars) to be = Official°Use Only completed by ermit applicant Building r� (Z) Budding Permit Fee Electrical J 6 04 {b)estimated Totai Cost of -mn tructionfrom 6 Plumbing Building";Permit'Fee Mechanical (HVAC) J 3 Zd oo _ Fire Protection / 3 Z D. °O Total = (1 + 2 + 3 + 4 + 5) e/, 5.0 2 Check Number This Section For`Official Use'.Onl wilding PermltNurriber - = DateZssued: _ ig nature: — Building Commissioner JInspectorbf.Buildings Date File#BP-2009-0425 APPLICANT/CONTACT C PERSON RAYMOND R HOULE CONST INC ADDRESSIPHONE 5 MILLER ST LUDLOW (413)547-2500() PROPERTY LOCATION 30 LOCUST ST- 1 ST FLR DR BOWERS MAP 23B PARCEL 046 001 ZONE M(99)/IJRB(1)//WP 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: ALTER BUSINESS OFFICE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 066227 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Commission Permit DPW Storm Water Management Demolition Delay /,O00000r d/'�� t15 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. 30 LOCUST ST- 1ST FLR DR BOWERS BP-2009-0425 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23B-046 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category_ BUILDING PERMIT Permit# BP-2009-0425 Project# JS-2009-000573 Est. Cost: $65021.00 Fee: $390.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group RAYMOND R HOULE CONST INC 066227 Lot Size(sg. t: 1325051.64 Owner: COOLEY DICKINSON HOSPITAL INC rRWIV/MVP AMlie!Zut: RAYMOND R HOULE CONST INC Applicant Address: Phone: Insurance: 5 MILLER ST (413) 547-2500 O Workers Compensation LUDLOWMA01056 ISSUED ON.1012712008 0:00:00 TO PERFORM THE FOLLOWING WORK.-ALTER BUSINESS OFFICE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meier: Footings: Rough: Rough-r � House# Foundation: Driveway Final: Final: Final: / ,`' � � U - y Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oii: as-"'A'ue :.... Final: Smoke: Final: Ot THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. } Y Certificate of Occupancy,, f:f r��`� Signature: 'Yy' A FeeType: Date Paid: Amount: Building 10/27/2008 0:00:00 $390.0015560 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Conunissioner-Anthony Patillo