19-011 (2) iWesstofi ld,MA01085-4269
MA CSL#092267 Phone:413563-2534
MA HIC#154022 Fax:413-566-3245
EPA RRP Certified Renovator
February 20,2014
Charles Miller
City of Northampton
Building Department
212 Main Street Room 100
Northampton,MA 01060
Dear Mr.Miller.
I request that you grant a modification to waive the requirements for control construction for the project
at 32 Industrial Drive East in Northampton because the work is of minor nature,will not affect health,
accessibility, life and fire safety, or structural requirements, Also it is impractical in that the cost of
control construction is considerable when compared to the cost of the proposed work. Thank you for
your consideration in this matter.
Sincerely,
J ph M Muto
Proprietor
JAN Woodworks&Renovations
Ch
to
VIP
kJ
o
44
kA
2-i
Unrestricted-Buildings.of anY use group which
contain less than 35,000 cubic feet(99 1 M)of
CS-092287
enclosed space.
JOSEPH M MUTO-
61 BOVVDOIN ST-'
WESTFIELD Mk 01085
Failure to Possess a current edition of the Massachusetts
0712212015 State Building Code is cause for revocation of this license.
For DPS Licensing information visit: www-mass.Gov/DPS
office of Consumer Affairs&Business Regulation License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 154022 Type: office of Consumer Affairs and Business Regu lation
Expiration: 1/31/2015 DBA 10 Park plaza-Suite 5170
Boston,MA 02116
JAN WOODWORKS&RENOVATION
JOSEPH MUTO
61 BOWDOIN ST. 4 L
WESTFIELD,MA 01085 Undersecretary Not valid without signature
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington,Street
Boston, MA 02111
www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): ---1 2 IC S IZ C k/o y.9 77"D
S
Address: 6 1 a o L-) o v X ✓ S ; L E T"
City/State/Zip: lAJES i r i� O v 6, Phone #: q IS -S G - Z S7_7 C/
Are you an employer?Check the appropriate box: Type of project(required):
1.® I am a employer with 2 4. [:] I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g• Demolition
working for me in any capacity. employees and have workers'
9. Building addition
[No workers' comp. insurance comp. insurance.+
required.] 5. E] We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] c. 152, §1(4),and we have no
employees. [No workers' 13.[:1 Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: /95Soci.9,- O ���oLGYE�tS %�f���tic�
Policy#or Self-ins. Lic. #. SC)o S S 7 0 0 / Z o f Z Expiration Date: vim—/G f'12 r✓i
Job Site Address: 3 Z ZT7IV0 vS 7Ytu,/ L t__�l r v4r— fW_r i City/State/Zip: �Y���✓�•�/�'i2�`!�1if oiU�a
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify th ins and penalties of perjury that the information provided above is true and correct
Si ature: Date: O 2 i
Phone# 7/..)
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
Versionl.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 9 Telephone Expiration Date
9.3 General Contractor
J.A.N Woodworks & Renovations Not Applicable ❑
Company Name:
Joseph M Muto
Responsible In Charge of Construction
61 Bowdoi reet Westfield, MA 01085
Addre
(413) 563-2534
Si atu Telephone
l
Versionl.7 Commercial Building Permit May 15,2000
S. 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 Permit/Variance/Finding ever been issued for/on the site?
NO ® DONT KNOW 4) YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DONT KNOW ® YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO � DONT KNOW 0 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 ® NO Q
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 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 ® NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version].7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes ® No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, kle u CN-N PA C /I I (,-f 41' as Owner of the subject property
hereby authorize TO,/C',I-, q 1,q 4,k0 to
act on my behalf, in all matters relative to work authorized by this building permit application.
Sigrfature of er Date
l Joseph M Muto , 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.
Joseph M Muto
;natur t Nam
ILI
of Own Agent Date
SECTION 12-CONST UCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Joseph M Muto 092287
License Number
61 Bowdoin Street Westfield,MA 01085 07/22/2015
Address Expiration Date
(413) 563-2534
Sign6 ure Telephone
i
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 G) No
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations El Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing El Change of Use❑ Other❑
Brief Description Converting utility closet into a kitchenette for coffee and lunch use
Of Proposed Work:
f'
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 El A-5 El B ❑
B Business _E9_
2A ❑
E Educational El 2B ( El F Factory El F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑
3A ❑
Institutional ❑ I-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A
S Storage ❑ S-1 ❑ S-2 ❑
56 ❑
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(so
1 St 1 St
2nd 2nd
3rd 3rd
4th 4th
Total Area(so Total Proposed New Construction(so
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]
f
Version 1.7 Commercial Building Permit May 15,2000
Department use only
J City of Northampton Status of Permit:
wilding Department Curb Cut/Driveway Permit -
C'`�� 12 Main Street Sewer/Septic Availability
�, Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
hone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
�G
Other Specify
APPL\WXfION 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
32 Industrial Drive East Map Lot Unit
Northampton, MA 01060 Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
Signature Telephone / f e 7 -
2.2 Authorized Age :
Joseph M Muto 61 Bowdoin St Westfield,MA 01085
Name(Print) Current Mailing Address:
(413) 563-2534
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building $2,240.99 (a)Building Permit Fee
2. Electrical (b) Estimated Total Cost of
$625.00 Construction from 6
3. Plumbing $2,125.00 Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) `-{ jC1 Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2014-0880
APPLICANT/CONTACT PERSON JOSEPH M MUTO
ADDRESS/PHONE 61 BOWDOIN ST WESTFIELD (413)563-2534
PROPERTY LOCATION 32 INDUSTRIAL DR
MAP 19 PARCEL 011 001 ZONE
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: CONVERT UTILITY CLOSET TO KITCHENETTE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 92287
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN ON PRESENTED:
proved 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
SignatuAoff t m g 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.
32 INDUSTRIAL DR BP-2014-0880
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 19-011 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2014-0880
Project# JS-2014-001534
Est. Cost: $4990.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOSEPH M MUTO 92287
Lot Size(sq. ft.): 106722.00 Owner: FUGU THE GROUP LLC
Zoning: Applicant: JOSEPH M MUTO
AT: 32 INDUSTRIAL DR
Applicant Address: Phone: Insurance:
61 BOWDOIN ST (413) 563-2534 WC
WESTFIELDMA01085 ISSUED ON:212012014 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONVERT UTILITY CLOSET TO KITCHENETTE
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 2/20/2014 0:00:00 $55.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner