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32A-155 (5) 12 MAIN ST BP-2007-0711 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 155 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) categotyL BUILDING PERMIT Permit# BP-2007-0711 Project# JS-2007-001076 Est. Cost: $20000.00 Fee: $75.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Robert Reckman 009498 Lot Sizcq. ft.): 914.76 Owner: MASTERS TOM Zoning: CB Applicant: Robert Reckrnan Al: -i2 ivikir,i Phone: Insurance: Applicant Address: (413) 584-1224 Workers 36 Service Center - Unit 2 Compensation NORTHAMPTONMA01060 ISSUED ON:1/16/2007 0:00:00 TO PERFORM THE FOLLOWING IF WALGE 1ST FLS.INSTA R NEW BEAMHEAT,INSTALL IN CELLARN AL FIRE ALARM SYS, REMOVE BATHROOM, PATCH POST THIS CARD SO IT IS VISIBLE FROM THE STREET BuildingInspector Insp.ctor of Plumbing Inspector of Wiring D.P.W. p Underground: Service: Meter: Aiglb7 �t'i Footings: Rough: Rough: F 7 e; 7 vim^1 House# Foundation: f;: ,i 1,f — Driveway Final: Final: Final: , -, a.- -� 6K V�7 a 7`4 ,, Rough Frame: `4/,( Fireplace/Chimney: Gas: Fire Department Insulation: Rough: Oil Smoke -r Final: a 3—/ .3•07. -Q� Final: � S/0� ��I�� F�� THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occuranc Si nature: FeeType: D. a aid: Amount: Building 1/16/2007 0:00:00 $75.0012055 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo A ')/ ) L./ j;_-, 9 0/5A Z9/$1?:° %to/SA ,� File#BP-2007-0711 APPLICANT/CONTACT PERSON Robert Recicman ADDRESS/PHONE 36 Service Center-Unit 2 NORTHAMPTON (413)584-1224 PROPERTY LOCATION 12 MAN ST MAP 32A PARCEL 155 001 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 XX(' Typeof Construction: CHANGE 1ST FLR HEA ,INSTALL CENTRAL FIRE ALARM SYS,REMOVE BATHROOM,PATCH WALLS,INSTALL NEW BEAM IN CELLAR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 009498 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFWIATION 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 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. Version1.7 Commercial Building 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 Room 100 WaterNVeil Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 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 IA *In stheef Map Lot Unit /rlar*twrnptan. 114 0106° Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Reek lvhihng> (►a-Y2v 4ea//y Test Si *aerg tree t Nar//ai v fn Name(Print) Current Mailing Address: 413 584 3500 Signature / d a v git/v Telephone 2.2 Authorized Agent: f/ / Bob IQecklrr.j .3 4, .4c-vloe &ter Narthnmpizn Name(Print) Current Mailing Address: 4/3 56/1 ma�l Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 1700 2. Electrical (b)Estimated Total Cost of 2 Sd J Construction from(6) 3. Plumbing Building Permit Fee Z�oJ 4. Mechanical(HVAC) 5. Fire Protection JvJa _ 6. Total=(1 +2+3+4+5) 2 D r oO D Check Number /&Q7 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Version1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations m Existing Wall Signs ❑ Demolition❑ Repairs 71 Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other El Brief Description Enter a brief description here. 1741431 healing in lsry00ndnstall new fenlral Vahan fire c1.<hrm Stem timnve ,daffirxm, Ile denalld al0411s, consolidate ele2k rt, ,eal, Install new !ka Of Proposed Work: in l I SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A I ❑ A-4 ❑ A-5 ❑ 1 B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 El 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 El 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 El R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 El S-2 El 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) 1st 1st 2nd 2nd 3rd 3rd 4th 4th 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 El Municipal El On site disposal system • Version 1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by /�( n{, ems` Building Department Lot Size No e�q G TU Fod-pr,n t or �S� Frontage `J/ 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 Q DONT KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O 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 Q , Date Issued: C. Do any signs exist on the property? YES Q NO Q IF YES, describe size, type and location: Mare wienhhcQhO� D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0 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 G IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version1.7 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 Obi) Rea kman Not Applicable ❑ Company Name: bob Reeky aii Responsible In Charge of Construction 31.e S vwee, Cfr. korikenptui Address alit//ail Signature Telephone Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Be'1 w,//17,g , as Owner of the subject property hereby authorize d 10iinan to act on my behalf, i all matters relati e to ork a orized by this building permit application. Signature of Owner Date I, r bb 41eekVYY.2,d1 , 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. �+JCI L� Print Name J/ 9 (D4 Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: /Q Not Applicable ebbed- ❑ Name of License Holder: d. /(tM n'an Ot'L`/�7 8 License Number di' &r14C Infer Akrth 2mp/ n /I/vg Address Expiration Date -13 ,5-134i sJ Signature Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE 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 0 e•ffhh0/111 Oh RI&