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17C-231 (18) 1 License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 i - N valid without signature �ommuildina�uoe�lLz. Board of Bg Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration. 112234 Expiration. 12/1812009 Tr# 264402 i Type: Private Corporation PAUL A.CUSSON CONSTRUCTION,INC JAMES CUSSON 33 CARROLL ST C ..l AUBURN,MA 01501 Administrator 00-35,000 cf enclosed space 1A-Masonry only 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Bo r�of in ing egulahorfs and gtandarus z. Construction Supervisor License r License: CS 59694 Expiration: 3/13/2010 Tr# 19099 Restriction: 00 JAMES A CUSSON 10 GATES COURT AUBURN,MA 01501 Commissioner 20 ` 0 ' 10 ' 10 CREW OFFICE/ LOUNGE 36X80 36x8o OFFICE 36x80 CISt. R.H. L.H. L.H. _ 36 0 R 1-j"Metal Pipe Fencing 10 x CREW RM. DOUGUS E. BEST A0 go MECHAMCAL Into. 29045 3 / - 4 // 1 ---- — certified by: Am-B-Care Ambulance - Northampton Base 34 North Maple St. Florence, MA Dwg.#: OFFICE BUILD LAYOUT OB-1 Date: Drawn by: Scale: 03-24-2008 ROBERT J PHILLIPO None �. C4,_6N 0 10 NEW 17 X 19 1 0 CREW OFFICE OFFICE! GARAGE DOOR LOUNGE Clst. 1 Z' 91-10/1 CREW RM, 201 Wr�'A�H BAY ® �iNS W/. L-WATER T-4 PMATOR ' 3 0' DOUGLAS E. BEST 1 MECHANICAL NO- 29045 { i 30' III Vi::h11t tL PACE a E ISiING DRAIN t { f ................._,..,,.......,,..._..._..1 ..__.................,................ 3 0'- -- certified by: Am-B-Care Ambulance - Northampton BasE 34 North Maple St. Florence, MA Dwg. : BASE LAYOUT BL-1 Date: Drawn by: Scale: 03-24-2008 ROBERT J PHILLIPO None CONNECT TO EXISTING FIRE SPRINKLER SYSTEM Single Head Sprinklers CREW OFFICE-1 OFFICE-2 LOUNGE 36X 8o L136X 80 3 6 X80 R.H. = L.�. L.H. 36X 80 R.H. 1-21"Metal Pipe Fencing -e Total Run Lenth-50' 10 Use of match to exising sprinkler Heads to maintain DOUGLAS E. system integrity. No design flo changes required. BEST MECHANCAL CREW RM. Office 1 - 1 0'x1 0' Room-Oty 1 -Single Head Ne. 2904 _j Office 2- 10'x10' Room-Qty 1 -Single Head Crew Lounge - 10'x20'Room-Qty 2-Single Head 0 CrewRm.- 10'x10' Room-Qty I -Single Head C Layout and Equipment to be design &specified by Bay State Sprinkler, Inc. Holyoke.MA certified by: Am-B-Care Ambulance - Northampton Bass 34 North Maple St. Florence, MA DW A FIRE SPRINKLER LAYOUT FP-1 Dale: Drawn by: Scate: 03-24-2008 ROBERT J PHILLIPO None ACOW CERTIFICATE OF LIABILITY INSURANCE OP ID KG 706/11/08 TE(MMIDD/YYY ) PAULA-1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marsh-Kemp Insurance Agency In HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 28 Park Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01605 Phone: 508-798-8663 Fax:508-753-8267 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: NGM Insurance Company INSURER B: Paul A Cusson Construction Inc Names Cusson INSURER C: 33 Carroll Street INSURER D: Auburn MA 01501 INSURER E: COVERAGES THE POLICIES OF INSURANCE 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER P LI Y EFFE TIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE DATE MMIDD/YY DATE MMIDDIYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY MP187121 01/14/08 01/14/09 PREMISES(Ea occurence) $ 500,000 CLAIMS MADE F OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A ANY AUTO M9187121 01/14/08 01/14/09 (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ 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/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry-residential Evidence of Workers' Compensation Insurance written with Granite State Insurance Company effective 2/3/08 through 2/3/09 will be sent by the carrier directly. CERTIFICATE HOLDER CANCELLATION NORTHAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Northampton NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL City Hall IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 210 Main Street Northampton MA 01060 REPRESENTATIVES. E�:AUTTMPP6 REPRES / y�jC ACORD 25(2001/08) ©AC D CORPORATION 1988 06/18/2008 10:56 4135844700 4MBCARE NOHO PAGE 03/03 Version 1.r Commercial Building 9oT/oh May o' x000 Independent Structural Engineering Structural Peer Review Required Yes 0 No, SECTION 11 -OWNER AUTHORIZATION,;-TO-BEZ-OMPLE TED:-.WHEN:-'- OWNERS AGENT OR CONTRACTOR APPLIES F6R B130-DiO PEAMIT as'�WY ft subject property hereby authori:-Le act on my behaif,in all matters relative to work authorIzed by this building permit application. Signature of Owner Date as OWner/Authorized Agent hereby declare that the statements and information on the foregoing applicatJon are true and accurerte,to the best of my knowedge and belief. of perlqN. PrInt Name Signatufo of OwnerlAgent, Date 10.1 Licensed Construction Lunervisor: Not Applicable [I Licamso Number cl- Address Explration Date Telephone Workers COMPeMS860M Insurance affidavit must be completed and submitted%fith this application. Fallure to provide this affidavlt will result in the denial of the issuance of the building permit, Signed Affidavit Attached Yea No 0 06/10/2008 10:59 4135844700 AMBCARE NOHO PAGE 82/03 Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL-DESIGN AND COMSTPUCTI.ON-SERVICES-.FOR.BUILDINGS-AND STRUCTURES SUBdEC•T TO CONS,TRUCT.ION CONTROL:PWRSI �]T TO 780 CW, ..16;(CONTAINING MORE THAN 3s 000 C.f.OF ENCLOSED SPACE) 9.1 Registered Architect: Not- Applicable - __,.._„..-. Name(RegistrsJnt); ` Registration NumberT" Address " - Expiration Date Signature Telephone 9:2 Registered'Prafessional Engineer(s): Name Area of ResponsibilIty Address ---- -— - - - -- _ Registration Number-_ �• I Signature Telephone Explratlon Date . .......... _ Namo Area of Responsibility .•,r Y - ._-....... _ r � Address —-- _ _ —_ R.tgtstration Number ___._.. ----.----- Signature Telephvne I Expiration Date Name Area of Responslbllity— Atltlress _ _ - - Reglstnetion Number___--__-- µ Signature Telephorm Expiration Date ' Name ....�--- Area of Responsibility ` Address ' Registration Number Signature ^Telephone Expiration Data 9.3 General Contractor L — NM Applicable El Comp'anny�Name- Responsible In'Charge of Construction Address - �1 Signature Telephone 06/10/2008 10:56 4135844700 AMBCARE NOHO PAGE 02/03 Vci-sionl.7 Commercial Building Permit May 15.2000 S. N0kT-H-*M-PT-0N-.Z0N1 -JIR7 Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Sizc Frontage Setbacks Front Side L::--1 R:: Building Height J Bldg. Square Footage OpcnSpaccFootage % (Lot area minus bldg&paved Rarkinz.) 7 r-7 0 of Parking Spaccs Fill: (volume A Location) A. Has a Special Permit/Variance/Fiqd1n%ever been issued for/on the site? NO 0 DON7 KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON7 KNOW 0 YES 0 IF YES: enter Book Page,' and/or Document#' B. Does the site contain a brook, body of water or wetlands? NO DON7 KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 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 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 IF YES,then a Nortn8mpton Storm Water Management Permit-from the DPW is required, 06/10/2008 10:59 4135844700 AMBCARE N01-10 PAGE 03/03 Version 1.7 Commercial Building Permit May 15,2000 SECTION.4-CONSTRUCTION SERVICES FOR PRO:IECYS LESS THAN 35;000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolltlon❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground.Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description.here. -.44eri or r-t dA Ve,>i oel-V, 4iu.Al Of Proposed Work;' Crete Y yyt SECTION 5-USE GROUP AND CONSTRUGTION'TYPE" USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly © A-1 13 A-2 ❑ A-3 ❑ 1A ❑ A-4 0 A-5 ❑ B Business ❑ 2A ❑ E Educational ❑ 28 ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H H h Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storagc ❑ S-1 ❑ S-2 [] 58 ❑ U Utility ❑ Specify: MMixed Use ❑ Specify:�.__..___....w....—.......-._,._._._..�.....,,., -._._..__..__.....,_....---..r.�__�.---�......��.._....`,,..,. S Special Use ❑ Specify: ,.,.._...�.....,._�_..._.�.----------- �_ -_.�,,........,.......,.T__.. .�........._.�) COMPLETE-THIS SECTION IF EXISTING^B.IJQI•t � ( ISJEF?"Gbif�GtZ SNOT[QN.S,;: rt?fciZl( NS'Pi4�1ti1biZ. k6�g1E Il_IJSE Existing Use Group: _—._.,. - —........ Proposed Use Group: ----.M.._- Existin Hazard Index 780 CMR 34):;'--- -i Proposed Hard Index 780 CMR 34); g SECTION 6 BUILDING HrEIGHTAND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) I 2no ' 3 3ro ,u i Total Proposed New Construction fa s Total Area(s ---•----._..w,....._._...,_._I r..,_,.._,—.�.... 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:�_._.. a Outside Flood Zone❑ Municipal ® On site disposal system❑ 06/10/2008 10:56 4135844700 AMBCARE NOHO PAGE 01/03 f Version 1.7 Commercial Buildine Permit:May 15.2000 (?;��.M.'�'=i�M�y��;r u�r��.`"• �. •.�i�,"4�'.'�'gOf7ry' Sy�,Si�I'r'''�,'"°,'`i City of Northamp Sa7xs?d :,.•�ti; ;, � � ary.1. ton :titi1" a 1 J+.�•� ' - •»» �a•',h.. , �w::ln,, - \ It ' w±y.,. •• -FT! Building Department � � ��'���:;-• �� '���; '���'�,�}-��1�-^+,� 212 Main Street t%YaP3 � a Room 100 U� Yom'::.'.... .�.�.•\�N,J_�1 ... �y�,�i. North m ton MA 01060 a h � P � *�b,�t�y'? 'P "',��.a,:f.!t�;+.•,,,t•M•. ni y,•a{C fi�•er�'+•phone 413-5$ -1240 Fax 41 3-587-1272 'l.. '� aa-�;„�'�JL� U+ �}!� 4�' �.)�'C'J�tC���• 1 IF 'Va!' S�,�S .1 AP TiON tQ•CN' CT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING a,, OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address; This section to be'cPimpletetl by o11`•Ice 3 L/ A10 R-lei Mf3 PLC' +� ; IMap Lot Unit Overlay District l SECTION 2-:PROP.ERTY OWNERSHINAUTH0R1iZEDw1kGEIV;F 2.1 Ownerof Record: _ Name Print) Cvrrent Malvin Address: L � x _.c_e_ Signature Telephone 2.2 Authorized Anent: _ Name(Print) Current Mailing Address:_•--_.___ „ Signature Telephone to SECTION'3•_ES L71iedTE'D'G©NSTRtiGTIQN°OO'Si'S '," Item Estimated Cost(Dollars)to be Offici2l lJse.Only' completed oy permit applicant 1. Building ©p U `% -_—? '..(gNildilag�P..err,>'rlt Fee 2. Electrical EstImated•Totaf'Gost 3. Plumbing /�� ;Buiidieg.Pectnit Fbe 4. mechanical(HVAC) ---�--�___ 5. Fire Protection _ _ • .__..„...»..,».�_..__.__.__._...„.___._.' 6. Total=(1 +2+3+4+5) r...._. L?W Eheck:Number Sd This See0dh F'dt'0fficial'.Ube Onl ' Suilding Permit Number Dgte Signature: Building Commisslonedlnttpector of Buildings Date File#BP-2008-1130 APPLICANT/CONTACT PERSON JAMES A CUSSON ADDRESS/PHONE 33 CARROLL ST AUBURN (508) 868-8724 PROPERTY LOCATION 34 NORTH MAPLE ST MAP 17C PARCEL 231 001 ZONE SI 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: INTERIOR RENOVATION,BUILD 2 OFFICES BREAK RM&CRE RM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 59694 3 sets of Plans/Plot Plan THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I F 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 Z /2, 0-7 Signature of Buildin Offi�ciaf 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. 34�QItT BP-200 - GIS#: COMMONWEALTH OF MASSACHUSETTS y s. CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category BUILDING PERMIT Permit# BP-2008-1130 Project# JS-2008-001663 Est. Cost: $16500.00 Fee: $82.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES A CUSSON 59694 Lot Size(sq. ft.): 59241.60 Owner: LHIC INC Zoning: SI Applicant: JAMES A CUSSON AT. 34 NORTH MAPLE ST Applicant Address: Phone: Insurance: 33 CARROLL ST (508) 868-8724 AUBURNMA01501 ISSUED ON.612512008 0:00:00 TO PERFORM THE FOLLOWING WORK.-INTERIOR RENOVATION, BUILD 2 OFFICES, BREAK RM & CREW RM 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 6/25/2008 0:00:00 $82.50227 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo