17C-197 (7) Versionl.7 Commercial Building Permit May 15, 2000
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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 4 Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
CHASE GLASS & ALLIED PRODUCTS, INC Not Applicable ❑
Company Name:
John Lanucha
Responsible In Charg nHa ucti_)n
ock St reet
Address ri field, MA 01109
John Lanucha (413) 732-1115
Signature Telephone
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+ Version 1.7 Commercial Building Permit May 15,2000
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Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑
ECT10 ]x =`0lflit>fER AI�T�iQE IZA7IQN „Tp BE',CQryIP�.ETED" WHEN
oR'coNV*9A'G- OR�QPIp ads{fog, IPIN�q E'lli IIT
1, as Owner of the subject property
hereby authorize to act c
my behalf, in all matters relative to work authorized by this building permit application_
Signature of Owner Date
l 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
SECTIQN 1'2=col Tlk)C`T;�AN, ►�CS
10.2 Licensed Construction Supervisor: Not Applicable ❑
License Number
Address Expiration Date
Signature Telephone
S�GTIQN �3 WQRK'„EFtS” COMP'ENS,ATIO-N INstiFRANCE'AFEkDAVIT(Kol.c. 152,1 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidav
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... ❑ No...... ❑
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Version 1.7 Commercial Building Permit May 15,2000
�TIaN r4 CONSTIZ�JOTIQN ' 1006 FOR PROJECTS LESS'THXN 3!44,60 '
161 'o�a;lact osD's� � ,
r
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
❑ ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] .
❑ Accessory Building[ 1 Repairs [XI EMERGENCY
Masonary Work as well as glass & glazing
�1 I
15E UP AND'CO T160''TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 18 ❑
B Business ❑ 2A ❑
E Educational ❑ 213 ❑
F Factory ❑ F-1 I] F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1.1 ❑ 1-2 ❑ 1.3 ❑ 313 ❑
M Mercantile ❑ 4 Q
R Residential Io R•1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage Q S-1 ❑ S•2 ❑ 5B d
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
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:1, 3CITIfG BUILDINGtlpRC011 REhlp 'ATIO(�S, ADDITIQMS'A�ID�d ;CF�11NOE+1sN;il�S
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34). Proposed Hazard Index 780 CMR 34):
'SFC�Wfi , L',DI"N�G HIEI HT ANP'74Rl A
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
!
Floor Area per Floor(sf) ,, F
21,a
�s7
C 1 11,3 r
3rd
2nd
4th I, 1 h d k III II 1+r
3rd ilihl
4th
I
Total Area (sf) Total Proposed New Construction (sf) 1;�,
"
Total Height(ft)
Total Height ft --------------------
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VersioTkl.7 Commercial Building Permit May 15,2000 ' t�
Q � c �
City of Northampton � a '' ! W „
4`
ilding Departmentu� A '
AN
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\l Main Streetwr`6�pti
Room 100ntrlVf "iIua�Eh�ll `t M ';
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Ir a iiav a. r
ampton, MA 01060 v��y'� v»p �
{vr�AwYW' 1 Ar4 ;Ri 1G'
on 87.1240 Fax 413.587.1272 PLotjSixePi s^ w ^ �<< r t, Wa ,W�
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APPLICATION TO STIR T, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDIN(
OTHER THAN A ONE OR TWO FAMILY DWELLING
SC�1'OrZ }S1`T iIfF4l211hOON
1.1 Property Address: EMERGENCY REPAIRS r This sect►od fwp P i
Cumberland Farms
I `77777: � v t Il ��v v S�iF;�vllr v 9� 1,�uvv iE
zone "
53 Main Street o r^
Florence, MA
S GT ON 2 -;PROPERTY'OW,NEkSHIP/AUTH¢R;i2ED ACENT',
?., 1 Owner of Record:
Name(Print) Current Mailing Address:
Signature Telephone
2,2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTIA ES-1MATE6 OI`1STt UCTION COSTS
Item Estimated Cost(Dollars)to be C�t�!c�al �ls� Orly
Completed by ermit a licant
1_ Building (a) Building P,errnit l=ee
$10,000.00
2. Electrical ;'(b) ESfjmated Total 0Q5t afii
Co, nstruCf P #rQm 6
3. Plumbing Bu�ling'P,eKm�t Fee:
4. Mechanical (HVAC)
5. Fire Protection
6, Tata1 =(1 +2 + 3 + 41- 5) $10,000.00 OhQCIc,Number `►
Tnis S,ection`'For Official Use dn
r ,t a�uilm I sued "
S'ignaturey
Bu�Id�r� issi�lier..finspectp>"Qf Bu;l�tfings ' ' bite ' 'T ,
g Garxtm'
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File#BP-2002-0377
APPLICANT/CONTACT PERSON CHASE GLASS&ALLIED PRODUCTS INC
ADDRESS/PHONE P O BOX 1311 (413)732-1115
PROPERTY LOCATION 53 MAIN ST-CUMBERLAND FARMS
MAP 17C PARCEL 197 001 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid —
Tyneof Construction: MASONRY WORK AS WELL AS GLASS&GLAZING
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
pproved Denied
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan OR Special Permit and Site Plan
Major Project: Site Plan OR Special Permit and Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding I 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 Commissio
Q
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.
53 AI S -44 EPAND- A BP-2002-0377
G1s# COMMONWEALTH OF MASSACHUSETTS
�_. = 197 CITY OF NORTHAMPTON
Lot:-001
Permit: Buildb
Cate o :Non structural interior renovations BUILDING PERMIT
Permit# BP-2002-0377
Project# JS-2001-0069
Est.Cost: $10000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CHASE GLASS & ALLIED PRODUCTS INC
Lot Size(sa.ft.): 21387.96 Owner: VSH REALTY INC
Zoning: GB Applicant: CHASE GLASS & ALLIED PRODUCTS INC
AT. 53 MAIN ST - CUMBERLAND FARMS
Applicant Address: Phone: Insurance:
P 0 BOX 1311 (413) 732-1115
SPRINGFIELDMA01101 ISSUED ON.10 131010:00:00
TO PERFORM THE FOLLOWING WORK.-MASONRY WORK AS WELL AS GLASS &
GLAZING
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/3/010:00:00 8518 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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