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32A-255 (23) i i j l '5 i Hotel Northampton-Re-Built Stairs to Cafe , i I 5 { IMAM- Hotel Northampton-Ebsting Entry Stairs i n aISMa ownigrolor r , '"11t1!!/. s. .0 it Gt t �Y It to LOW— y`. , i i r -.� 4-�t1AMP�. �OOo a (rzt�r laf wart[jamptiall $ B �:aaxchttsrtts' m DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORT{ER'S COMPENSATION INSURANCE AFI'IDA.VTT (Li permitiee) with a principal place of bliTness/residence at: ly (S ( ��b 14� t`�k;Yt. (phone#) (strr_ei/ci stalrJzip) do hereby certify, under the pains and penalties of perjury, that: (t4ll am an emplover providing the follo11virlg worker's compensation coverage for my employees wort ng on this job: c4-' Company) (Policy Number) (Expiration Dam) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insm-iicc Company/Pohcy Number) (Expiration Date) (Name of Contractor) (In=zuice Company/Policy Number) (Expiration Date) (AaAdi additioail sheet ifnc-c u to include mfoemstiou pertaining tcl all coGracron) O I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that while homeowners who aaplay pcnom to do ru e.,,,n 00astructioa or repair wort;ou a dwclliag of not more than three units in winch the homeowner residd or on the gourds appurtenant thcccto arc not grncally oocndcrcd to be employcra ands the wwozk oxipussatica Act(GL152,ss1(5)),application by a homeowner for a license cc paniii nsay evidence the legal o-- of an employer under the Workce%CompemWion AcL I undustsnd thst a copy of this rtst—rd may be forwarded to the Dcpartmmi of Indusfrid AC6 Office of Inauznco for the coverage va-if cation and that failure to&t,=covmngo under suction 25A of MGL 152 can lead to the ikon of cr1=1 penalties oomisting of a fine of up to S1,500.00 anNor imprisowneat of up to ow year and civil pcaaltics in the form of it Stop Work Order and a find of 5100.00 a day against mc. For dgmtw4nt l—oaly Permit Number gyp# Lot# S gnature of Licensee/Pernn e Versionl.7 Commercial Building Permit May 15,2000 ECTION 10 STRUCTURAL PEER REVIEW(780 CMR 110.11) dependent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ ECTION 11 -OWNER AUTHORIZATION -TO BE',COMPLETED WHEN WNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property ereby authorize - fpy��i¢.0 �rn� J � to act on iy behalf, in all matters relative to work authorized by this building permit application. �A 66W 1�►,� gnature of Owner Date P1 fmee,4' ( ;, VVJ ' ,er6vmer/Authorized Agent ereby declare that the statements and information on the foregoing application are true and accurate, to the best of my iowledge and belief. igned under the pains and penalties of perjury. r D�V'Q fW' lj ACS ( C� CC�r"i(n int Name gna re o Owner/Agent Date *IECTION 12 -CONSTRUCTION SERVICES 0.1 Licensed Construction Supervisor: Not Applicable ❑ lame of License Holder : �Ga.�� l_/►�"k �� NX I�� License Number ddress Expiration Date r) gn ur Telephone 'ECTION 13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152, §25C(6)) Vorkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit vill result in the denial of the issuance of the building permit. signed Affidavit Attached Yes....... No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 -1ECTION 9- PROFESSIONAL DESI.GN AND CONSTRUCTION SERVICES - FOR BUILDINGS.AND STRUCTURES SUBJECT TO :ONSTRUCTION CONTROL„PURSUANT TO 780'CMR 116(CONTAINING MORE THAN St,,000 C:F OF ENCLOSED SPACE) .1 Registered Architect: Not Applicable ❑ ame(Registrant): Registration Number ddress Expiration Date ignature Telephone +2 Registered Professional Engineer(s): ame Area of Responsibility ddress Registration Number ignature Telephone Expiration Date ame Area of Responsibility ddress Registration Number gnature Telephone Expiration Date ame Area of Responsibility ddress Registration Number ignature Telephone Expiration Date ame Area of Responsibility ddress Registration Number gnature Telephone Expiration Date !.3 General Contractor Not Applicable ❑ ompany Name: ?esponsible In Charge of Construction ddress ignature Telephone Versionl.7 Commercial Building Permit May 15,2000 Water Supply(M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: ublic ❑ Private ❑ I Zone: Outside Flood Zone ❑ I Municipal ❑ On site disposal system ❑ 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 Perm it/Variance/Finding:ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW _ __ YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained / Date Issued: C. Do any signs exist on the property? YES 7i 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 IF YES, describe size, type and location:_ Version 1.7 Commercial Building Permit May 15,2000 'ECTION 4-CONSTRUCTION SERVICES FOR-PROJECTS LESS THAN 35,000 :UBIC FEET OF ENCLOSED SPACE iterior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ ❑ E1 xterior Alterations Demolition❑ , New Signs [ ] Change of Use [ ] Other [ ] X Ry�vr > ccessory Building[ ] Repairs [ ] .ECTION 5-'USE GROUP AND CONSTRUCTION;TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE Assembly A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1 B ❑ Business ❑ 2A ❑ Educational ❑ _ 2B I ❑ Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1.3 ❑ 3B ❑ Mercantile ❑ 4 ❑ Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ Storage ❑ S-1 ❑ S-2 ❑ 513 ❑ Utility ❑ Specify: Mixed Use ❑ Specify: Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE (sting Use Group: Proposed Use Group: .isting Hazard Index 780 CMR 34): _ Proposed Hazard Index 780 CMR 34): ECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USA ONLYa„ Rk- �KY oor Area per Floor(sf) 1st _., 2nd 3,d �� { id ' i w ,a 4th _ a rd A th otal Area (sf) Total Proposed New Construction (sf) � otal Height(ft) /► Total Height ft ...1� j g Fr . ,y Version 1.7 Commercial Building Permit May 15,2000 City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413.587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE SE R(O:66P N Y 0 �-'•OR DEMOLISH ANY BUILDING OTHER THAN A ONE OkTWO FAMILY DWELLING A li 2 -7 ^inn n. SECTION 1-"SITE INFORMATION �� seigrrkto be mpl�ted by�ff�Ge� t 1L.1 Property Address: u Lot' O..verla District K Zone y' EfmSt Dfstiiet C6 Disfrict - ` SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT 1.1 Owner of Record: UmAk- — 36 ��v-- fi Nor ,-��.` N Ow bo ame(Print) Current Mailing Ad ress: signature Telephone -.2 Authorized Agent: 'Jame(PriritA Current Mailing Address: ign r Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS tem Estimated Cost (Dollars) to be Official Use Only completed by ermit applicant Building � (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Z Check Number f '' j This Section For Official Use,Onl Building Permit Number: d7 date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2004-1044 APPLICANT/CONTACT PERSON Pioneer Contractors ADDRESS/PHONE PO Box 1145 NORTHAMPTON (413)586-5491 PROPERTY LOCATION 36 KING ST MAP 32A PARCEL 255 001 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 Typeof Construction: REPAIR FRONT STAIRS New Construction Non Structural interior renovations Addition to Existing Accessory Structure - Building Plans Included• - Owner/Statement or License 017890 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO RMATION PRESENTED: k 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* �tPAiR y- 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 mmission 200 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. �?JO I 21 VA c3�y-ly-L a -77-V j o 5 ��► 7�m��i s _::;(2 0 tv®-. 36 KING ST . BP-2004-1044 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:32A-255 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-2004-1044 Project# JS-2004-1568 Est.Cost: $12000.00 Fee: $60.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Pioneer Contractors 017890 Lot Size(sg.ft.): 72614.52 Owner: STAR NORTHAMPTON INC Zonine:_CB Applicant: Pioneer Contractors AT. 36 KING ST Applicant Address: Phone: Insurance: PO Box 1145 (413) 586-5491 Workers Compensation NORTHAMPTONMA01061 ISSUED ON.514104 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPAIR FRONT STAIRS 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: Final: Smoke: Final: 1,"r THIS PERMIT MAY BE REVOKED BY ThE CITY OF NORTHAMPTON UPON VIOLATIOIN,OF ANY OF ITS RULES AND REGULATIONS. Certificate of of Occupancy 'Shmatin e: FeeType: Receipt No: Date Paid: Check No: Amount: Building 5/4/04 0:00:00 9024 $60.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Conunissioner-Anthony Patillo