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17C-229 (14) rO�(IVJt p�•Oy 4 \ A c (riff ofLirr� fl� ill}�fan A E MW _ �l-3$aChnrc(Ia' = DEPARi2,IEIrT OP BUIL )rN.0 INSPecT1o7.'s — 212 Alain Street ' Municipal Building Northampton, Mass. 010GO %-YORICER'S COI UENSATION LNSURANCE AI' A�T`I'. . I, (li cens.^C/PCTmi(tcc) -- (phone;') (sta t/c�ty/natrJa p) do hereby certify, under Lt1e.pa_m' s and penalties of perjury:, :hat ( ) I am an employer providing the following %�orl:crs compensZLI'ofi coverage Cof lnti e(upCovices wor'0*119 on Oils job. `»w-�n= Con=,) (Policy Number) ---- (r:-pirrtion Date.) .. O I am a sole proprietor, geaera3 contractor or homeowner(curie one) and have hired the coon actors Listed below wbo have the following workers cocpei sabon po!icies: (Namc of Co.^.lmcwr) (IRR r311t COlnp m)-il"ouc NLLmrC;) Date) (Name of Conrraaor) -- Gnsu=cc Company/Policy `um cr) (E Dir-,uon Dale) (Name of Conn-acto,) (Imuranez Compan)•/Poke}• Number) (Expumi600 Date) 1 i (Name of Contraclor) (Insurance Comca.0y/Policy Numb•:r) - (Expim6on Datc). (ana.cb�:i:;occ!Ica ifncc �co aic?uc�inloc'cu�oo PcIn=ins to.E oo=mj--o.�) am a sole pro netor and haven L P o Oct one ori�ng for me. ( ) I am.a home owner perforrnilig all the work myself. NOTE:pl=x be'M wtrJo bcmcolmcn w-bo employ pa-z [o cc,-.;rya Cr rcpau work oa.d,�-z of pot tnor_'l: ' _tars in u-ich the bon=,zc raicyo cc oa the Vio, c+ zqpurtrn.an tbe-en,oa C=ea11y ooerd-r d to be '0:00)'undc tbc.. :­P =tic-Acl(GL152-sa 1(5)�apptintioo by a bomcowme fm a ties._or permit r>_y cvidmec the leg cL-L'of an ez?Joyx under db Wl+tiel Co, ai MI- (unda-x d th4 a copy of thi.—'—ov.y be t«-�.erd>d to Lb-pcpnctmcat or 1.6=nd Mode OM-or Lm-v�ooa f--Lb- - cOlcr�v-iGe ioa and t1Lt UL=to scctiuc`covera�undcz zoetion 2 S A o!)(OL 1 S2 m Ic d b the im IIiw of cimina!pca+ltic3 oomiriztg oCa riot oCtrp to S 1}00.00 and/or orup to one year end C VU pmaJtio a Lye for or.$lap Wort Order and a fl=0(5100.00 a dsy apinit ax- For dcq.r -,�J u,c only Pc-r=t Numbcr -- Lot jSign-IL'urc o Lic=zec/Pcm Tact � J Version 1.7 Commercial Building Permit May 15,2000 SECTION 10=SRIJCTURAL PEER.R It"VIEW(78Q CMR 1101 IJ Independent Structural Engineering Structural Peer Review Required Yes No Q SECTION-Ill" OWNERAUTHORI7ATIO,N:-T0 BE COMPLETED WHEU OWNERS AGENT OR CONTRACTOR APPLIESFOR BUILDING"PERMIT 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. { ftr9lre of Owner Date I 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 i Print Name E Signature of Owner/Agent Date J ,SECTION 12:-;CONSTRUCTION SER[ICES, , . .. . . .. ... . 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:' License Number r Address s Expiration Date Signature Telephone SECTION 1`3-WORKERS'COMPENSATION.INSURANCE"AFFIDAV 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 0 r { Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL 4 jGN:•AND CONSTRUCTtOPk SERVICES EQR BUItDWGS AND STRUC�TI7RESSU6:IECT;tO CONSTRUCTION CONTROL PURSUANT'TO 78U CMR116(CONTAINING _M,ORE THAN 35,00 C:Fs OE ENCCL�SE SPACE) 9.1 Registered Architect: Not Applicable ❑ i Name(Registrant): s Registration Number Address Expirati on Date Signature Telephone 9.2 Registered Professional Engineer(s): Name t Area of Responsibility t Address Registration Number Signature Telephone Expiration Date i Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date € F I I I 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 t Not Applicable ❑ Company Name: Responsible In Charge of Construction r Address Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size { ? ? k y Frontage Setbacks Front p= j Side Li I R= L:—_! R:" Rear u�irdmg Heigir-- Bldg.Square Footage % - r— Open Space Footage % (Lot area minus bldg&paved arlan ) 7­7 f #of Parking Spaces Fill: volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO "0 DONT KNOW Q YES Q IF YES: enter Book Paged and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 i IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q 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 Q ` NO a IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 1 ; Version 1.7 Commercial Building Permit May 15,2000 t.. SECTION 4 .CO)`ISTRCTCTLON SERVICES.FORPROJECTS CESSTHAN 35,000 CUBIC FEErOFENCttlSED SIACE Interior Alterations ❑ 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. N l CX� CoN, /�/�'(��'!✓ Of Proposed Work: u p c3 A , �c),A/ 'SECTION 5-USE GROUP AND_CONSTRUCTION�TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A 71 ❑ A-2 ❑ A-3 ❑ 1A A-4 ❑ A-5 ❑ B Business - ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 2C ❑ H Hi h Hazard ❑ 3A ❑ 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:I i COMPLETE-THIS-,,S 1=XISTINzG BU1LD[�!G UNDEf2G'011+1G°REtYQ�AT[Ot<IS ADDITIONSfMDIQ CKAN661N USE Existing Use Group. 1 ( Proposed Use Group. Existing Hazard Index 780 CMR 34): ; Proposed Hazard Index 780 CMR 34): `• -SECTION"SBUILDING:NEIGH Ek BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION a . y`3 Floor Area per Floor(sf) st ,. st 2nd 2nd _.._ ., ♦. E w. 3rd i 1 3 ro th a 4'" i 4 Total Area(so i 3 t Din Total Proposed New Construction(sf) y ~ 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❑ Municipal ❑ On site disposal system E] °.'.t'a�- J 'F4 V '-, ;TM� v„ �':; i':.',°+fie,. ��:> .a,`: T I'"..,m"1'�s T'1 „s—•n.`�v��' $ ,.. �. w — jP...+�„�k,.� ,.�',rP �6� j •„� �',.�A w ,, Version 1.7 Commercial Building Permit May 15,2000 -Rorthampton - --°r�—F it iF4 pepartment 4 , C ----�"'2��,Main Street _ Fi;9c1 m; 00 tha rb, MA 01060 phone 413-587,1240, Fax 413-587-1272 Plc APPLICATIOW'T&CONSTRftf,'E"s NOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECUON ==SITE INFORMATION"� 4 --"-PropertyAddressTU�s sectrockfabe cornpCefed offices 2� rLt�y vti P �C Lai ° vo- O l ® (A`�— ; o� k Cly F�D ► 5 � ��' �"x 'e��''xw� ..ay�i. "(+."jy'"` ^�*� v �•�• �+',as- ,�rre�tF^r 'i—< ���qIR:S'.St":'D1StrIGt �CB Disiric SECTION 2-;PROPERTY O1tVNERSf1PtACtTNORIZED°AGENT r F 'k 2.1 Owner of Record: .1 �Q z E oio z Name(Print) Current Mailing Address: Signatur - Telephone 2.2 Authorized Agent: L Name(Pri Current Mailing Address: r Signature Telephone -.SECT10N.3--ESTIMATED CONSTRUGTI'ON COSTS Item Estimated Cost(Dollars)to be Official Usp-Ork[y, completed by ermit applicant 1. Building , S ��f7 i (a);Bulding Permit Ees i 1 f 2. Electrical i K (b)•Estimated Totai'-'Cost of Construction from 6), s. 3. Plumbing Buldmg PermiLFee 4. Mechanical(HVAC) l 5.Fire Protection E4 ,600 , 6. Total 0 +2,+3+4+5) Check Number �- Tfii�Secti©n:For,:Ofcfaf[7seOnl'=. Bu'I'd PerriiitC umber Dafe� fissued r Signature: Building Commissionertinsoed6r6f.Buildings Date File#BP-2006-0315 APPLICANT/CONTACT PERSON TIMOTHY STOKES ADDRESS/PHONE 20 TURKEY HILL RD WESTHAMPTON (413)587-9470 PROPERTY LOCATION 28 NORTH MAPLE ST MAP 17C PARCEL 229 001 ZONE SI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ZONING FORM FILLED OUT ENCLOSED REQUIRED DATE Fee Paid Buildiniz Permit Filled out Fee Paid Typeof Construction: INTERIOR CONSTRUCTION OF NON.-BEARING WALLS New Construction Non Structural interior renovations Addition to Existiniz Accesso1y Structure Building Plans Included: Owner/Statement or License 083602 3 sets of Plans/Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INYFWMATION 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 Signature of uilding 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. 28 NORTH MAPLE ST BP-2006-0315 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-229 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0315 Proiect# JS-2006-0462 Est.Cost: $126500.00 Fee: $505.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: TIMOTHY STOKES_ 083602 Lot Size(sq. 8.1: 16422.12 Owner., TREASURE TOWERS LLC Zoning: SI Applicant: TIMOTHY STOKES AT: 28 NORTH MAPLE ST Applicant Address: Phone: Insurance: 20 TURKEY HILL RD (413) 587-9470 WESTHAMPTONMA01027 ISSUED ON.9/28/2005 0:00:00 TO PERFORM THE FOLLOWING WORK.-INTERIOR CONSTRUCTION OF NON-BEARING WALLS 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 9/28/2005 0:00:00 $505.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo CD BP-2006-0315 28 NORTH MAPLE ST COMMONWEALTH OF MASSACHUSETTS GIs O CITY OF NORTHAMPTON Map:Block: 17C-229 Lot: -001 Permit: BUlldlnq BUILDING PERMIT Category: Permit# BP-2006-0315 Pro'e�t# IS-2006-0462 Est.Cost: $126500.00 Fee:$505.00 PERMISSION IS HERE-ft GRANTED TO: Contractor: License: Const. Class_ 083602 Use Group: TIMOTHY STOKES Lot Sizes . ft.): 16422.12 Owner: TREASURE TOWERS LLC 7on,na. 4t Applicant TIMOTHY_STOKES - - — — AT: 28 NQ _ iV;t:-L- SE Lisurance: Applicant Address: Phone: 20 TURKEY HILL RD (413) 587-9470 WESTHAMPTONMA01027 ISSUED ON:912812005 0.00.00 TO PERFORM THE FOLLOWING WORK.-INTERIOR CONSTRUCTION OF NON-BEARING WALLS POST_TH'IS CARD SO IT IS VISIBLE FROM THE STREET Building inspector Inspector of Plumbing Inspector of Wiring �n,),, D.P.W. Underground: Service:G1/��Iof ,t; Meter: IITT""""__ Footings: Rough:l/ p House# Foundation: Rough: g /�/DS P }��I Driveway Final: OJetL Final: Final: U Rough Frame: K �3�6 Fire Department Fireplace/Chimney: Gas: -,cnl7tinn: , Rouge: Oil: 0K PIMA(- Ot/2,3/06 touts Final: Smoke: 0�4, P Final: o t< 06,rq ir-1 F/A4 <.A s V-20-0;` 0V19/ uf, Louis THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPO ;V;IOLA ION OF ANY OF ITS RULES AND RE,GULATIONS, Signature: — Certn ccu lrate �f • n anc FeeT e: Date Paid: Amount: Building 9/28/2005 0:00:00 $505.00 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Comrn:ssioner-Anthony Patillo