32A-153 (8) FIRE NARRATIVE FOR 18 STRONG AVENUE
Fire protection will be provided through the existing automatic
sprinkler system; which includes appropriate sprinkler heads, fire
warning strobe lights and signal horns.
R-�tw•rnT / �.
E �I 3 of k1ortijulllpf01l
R - ,t3l caancEJnsrlfs" - l
DEPARTMEIrT OP ➢UILDf7\C INSPecT1O1:'S -- -
212 Alain Street ' Municipal Budding
Northampton, Mass. 01060
'.`ORICCI?'S COiVEPENSATTON. ENSURANCF AFFU A.VIT
itt >
(l-2 S� d � 4!4?5 (ph on oT? £f 3 $
(SC-r--uc� P)
do hereby certify, under the pains and penalties opper'u:ry, . hai
I arm an employer providing die following ��,orkcr's coinmns-nu.of, coverage Cor 111ti
emplovees \vor�Jing on L is job:
(L�sur� CoEI=Y) (Polio Nu-mbcr) -- (T :"pimtion Dar-)
( I am sole proprietor taeral coot racor or homeowner (c cie one) a.nd have hired
the cone aclors listed below who have the follo%irIEQ worker's coCoellsanon policies:
(Name of Co`,.= ior)- _ (1RR!t3llt�. CorIlDa,'1}"/PGUCi'Nu",—)
(Name of Contracor) (ins-,rrzncz Comoa wPolie; Nuracrr) (Lx-Dili Pion Date)
(Name of CO=Cld,) (Lastuane: Compao)"/PoUq- N.dmb,-r) (Espiraoa Dale)
I
(Name of Conn c-Lor) (I.osuranc-- Comca ry/Poucy Numbs) - (Expi—,,ioo Dal-).
(aIIVj]ad��ocxl bcG ifnoc.�czi�"co mc?u�uitccevaoo pcstafaia�to.L oc�-�".o:a)
i
I am a sole proprietor and have no one worlong forme-
( ) I am-a home owner perfor-mma all tine work myself.
NOTE:ple be ew-,c ifi- 6coeo i,w•bo aaploy p-iOm w& C=—.:ems'Q c rc-,-u-ore oa.d,-,U_;of
e.oc¢.rocs thm t'Vroc?_:.ts.in u'yr;+t ttx homoownc raido a oe the p-ou.orta zpputie- tbean L-c ripe�e-.lf-r 0.�erd.--ui to be
CCVIoy,=u 0..a=-,ioa Act(GLI52-=1(S)).:L4V iatioa by a bomco-=rcr c Gc _cc pama t>_y--id—crc
Ic pJ ct,'iu of ea exployx uadrr tt,a Worcoe-Coczp<m.Z on Ad
I undcst.ind dh, >copy of tbi,c tc o y bo for-wdod to tbu poparcmcat or 1ccSiuicl Any •f OM-of U=--m
covca&c v=-!ction zad ax--t L-.-i7czc to sccuxt`covcrasc unc'.cY ua60a 15 A of MGL 152 m Icd to the"^xi Oa of ciminA pcnalt
ooxz:mg of.riot oC ttp to S I S00"00 an&or¢��oC up to ooc yr=r r'd a,il pm,,t'.ic io c`x Corm or a Stop Work Otdc and a
of S 100.00,day a fp,imt me
For dcp.nm=-�uK only
—
1,�p::
Si�acum,of c�scrlPcrmittcc —)S-3Ce -• .�
Version 1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes ® No
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, 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 ❑
r
Name of License Holder:
License Number
0-50". 1 j1
Address Expiration Date
Signature / Telephone
"Z-
SECTION 13-WORK S'COMPENSATION SURANCE 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
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
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
Version 1.7 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 ® DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DONT KNOW ® YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q 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 Q 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 Q
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,vation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES ® NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required. I
Version 1.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations [AL Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑
Brief Description Enter a brief description here. R,6 N 0 V RTE a ATH U6 4,i TO c c is
Of Proposed Work: , / % / � � �� /�`✓�[ 1/ G� //
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 113 ❑
B Business 2A ❑
E Educational ❑ 2B
F Factory ❑ F-1 ❑ F-2 ❑ 2C El
H High Hazard ❑ 3A ❑
I 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 ❑
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)
1 sc
18�
2nd
2nd
3r' 3`d
4m
4`h
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 ❑ Zone Outside Flood Zone[-] MunicipaIX On site disposal system[]
Versionl.7 Commercial Buildin 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
µy' Room 100 Water/Well Availability
J Northampton, MA 01060 Two Sets of Structural Plans _
phone 44-587-1240 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
Map Lot Unit
•� r�i���r avI ✓��
Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
hen A'rr�?Ye)i P 0 , Bey- � r�t lU
Name(Print) Current Mailing Address:
Signature .4 1 4414 Telephone
2.2 Authorized gent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building " l'd �'�' (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing � ���/ Building Permit Fee
4. Mechanical(HVAC)
r •��
5. Fire Protection /iaru - G eel
6. Total=0 +2+3+4+5) (i Ga 0,11 Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
K
File#BP-2007-0453
APPLICANT/CONTACT PERSON WINTHROP GOULDING
ADDRESS/PHONE 11 STEVEN DR SOUTH HADLEY (413)427-6835
PROPERTY LOCATION 18 STRONG AVE
MAP 32A PARCEL 153 007 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
Ttipeof Construction: ADD SHOWER STALL&PRIVACY WALL FOR FITNESS SUITE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 013317
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
io 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
to V2-
Signature of Building fficial 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.
18 STRONG AVE BP-2007-0453
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Black: 32A- 153 CITY OF NORTHAMPTON
Lot: -0107_ PERSONS CONTRACTIIJG WITH UNREGISTERED CONTRACTORS
Permit`_ Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categyry: renovation BUILDING PERMIT
Pernvt# BP-2007-0453
Project# JS-2007-000562
Est.Cost: $7200.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WINTHROP GOULDING 013317
Lot Size(sg. ft.): Owner: FERR�,RONE STEPHEN
Zoning: CB A 2licgnt. WINTHROP GOULDING
AT- 1 A -rpnNl^ -,"!r:
Applicant Address: �+ _Phone: Insurance:
11 STEVEN DR 413 427-6835
SOUTH HADLEYMA01075 ISSUED ON.1012712006 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENOVATE EXISTING SPACE TO ADD
ACCESSIBLE BATHROOM & PRIVACY WALL FOR FITNESS SUITE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET_
Inspector of Plumbing Inspector of Wiring D.P.VV. Building Inspector
Underground: ervice: Meter:
Footings:
Ruugiu� 1 6 Rough. ,���j,r, � House# Foundation:
Ul f Driveway Final:
�? �� /
Final./' �> -0 Final: 0�3�of
1i '� 2
Rough Frame:`1 � 1
Gas: Fire Department Fireplace/Chimney:
"" Insulation:
Final: Smoke: i�� ;;�f^ 7 + �K,� Final: (`f / `07q
THIS PERMIT MAY BE REVOKED BY T CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGU TIO
Certificate of Occupanc Signature:
I'eeTvne: Date Paid: Amount:
Building 10/27'2006 0:00:00 $50.002070
212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272
Building Conuitissioner-Anthony Patillo