Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
31A-076 (9)
6/20/2014 City of Northampton Mail-Re:Plan for 264 Elm St Re: Plan for 264 Elm St Sarah LaValley <slavalley @northamptonma.gov> Fri, Jun 20, 2014 at 2:15 PM To: Louis Hasbrouck < has brouck @northamptonma.go\(> Hi Louis- Attached-give me a call if you have any questions. I finally have Geo, and it seems to be working, so I'm trying to issue the permit now. -Sarah Sarah I. LaV alley Conservation, Preservation and Land Use Planner City of Northampton Office of Planning and Sustainability 210 Main Street, Room 11 Northampton MA, o 1 o 6 o 413-587-1263 lilt ■i On Fri, Jun 20, 2014 at 2:07 PM, Louis Hasbrouck <Iasbrouck @northamptonma.gov> wrote: Sarah, Can we get formal approval or a copy of the approved plan for 264 Elm St duct work and layout? I'm pretty much ready to issue the permit and I really want to make sure the plans match. Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413) 587-1240 office (413) 587-1272 fax (City of Northampton E-mail is a public record except when it falls under one of the specific statutory exemptions.) (City of Northampton E-mail is a public record except when it falls under one of the specific statutory exemptions.) 31A-076 264 Elm Street.tif https://niai l.g oog l e.com/mai I/ca/u/0/?ui=2&i I-ec5fl9a57e&Ni evs pt&search=i nboy&th=146ba7d6Oe2b7l fi 1/2 6w/204 CKycfNorthmmtm Mail'264 Elm Ex medical building 264 Elm S* medical building Louis Hasbrouck <|hambn»uuk@nmthamnptonmna.Oov> VVmd. Jun 4. 2014 at 5:40 PIVI Draft To: Sarah LaVaUmy <m|avo|by/@northonnptonma.gov^ Sarah, I think you told me that a plan for the AC unit at 264 Elm St. was approved, but I can't find a copy of the appro\ral. Could you send it? The permit application came in and | want to aaa it before | approve it. Thanks. Louis Hasbrouck Building Cornnniaoiun*r City of Northampton ' Town of Williamsburg (413) 587-1240 offioo - (413} 58�-1272 fax ` ' ~ - 0 ' The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Hanle (Business/Organization/Individual): Raymond R. Houle Construction,Inc Address:5 Miller Street City/State/Zip:Ludlow, MA 01056 Phone#:413-547-2500 Are you an employer?Check the appropriate box: Type of project(required): 1.❑� I am a employer with 30 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I 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. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152,§l(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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:A.I.M. Mutual Insurance Company _ I w Policy#or Self-ins. Lic. #:WMZ-800-800 Expiration 12/31/2014 Policy Job Site Address:o2 oq C— , `5579-2013A JVr-c� City/State/Zip: 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 D1A for insurance coverage verification. I do hereb certify under the pains and penalties of perjury that the information provided above is true and correct. Sign `11� %l� "C 05/06/2014 Date: Phone#: 4135472500 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#: Version 1.7 Commercial Building Permit May 15,2000 SECIM 10-STRUCTURAL PEER RENEW(7=CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No O SECT=41-OWNER AUTHORIZATION-TO BE COI WLMD WHEN OIAHr1ERS AtIIIINT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property Robert Langevin Jr.� ._.._.�......_._] hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of owner Date tin I Robert Langevin Jr. 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 durv. Robert Langevin Jr. Print Name -noWfie of Owner/Agent Date SECIIIC N U' CONNI1tUM M SERVICES 10.1 Ucsnsed Construction SMEMIgor. Not Applicable p ice.of Lhxmu Hold : Robert evin Jr _ j CS-066195 License Number 69 Moreau Drive Chicopee,Ma 61020 12/08/2015 Address Expiration Date lure Telephone SECTK y-13 4NIORKERS'COMPENSATION USURANCE A"MW(M.G.L a 161% =(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 E) No O L - Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-pROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR'SU L.DIINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 790 CM 119 CONTAINING &WRE THAN 39,000 C.F.OF ENCLOSED SPACE 9.1 Regieftrod Amhitsct: Not Applicable ❑ Name Registrant): kr'—'� I Registration Number Address I -1 Expiration Date Signature Telephone 9.2 Ragleftmd Professional En inssris): Mark E. Kent Mechanical Name Area of Responsibility 6 East Colonial Road, Wilb aham, MA 010 5 31511 Address Registration Number L413-732-314 L 06 30 2014 sigma Telephone Expiration Date Name Area of Responsibility Address �� Re�gletration Number i � Telephone Expiration Date Name -- Area of Responsibility Address Registration Number � � I Signature Telephone Expiration Date -- _1 Name _ ___._.._..____.... .... .. Area of ResponsitsiNty Address Registration Number (_..._..... ..._._....- -----..J Signature Telephone Expiration Date 9.3 General Contractor ymond R Houle Construction --- � Not Applicable ❑ Company Name: Robert Lanevin Jr j Responsible In Charge of Construction_ _ 5 Miller Street Ludlow,Ma.01056 ; Address Telephone I L Version 1.7 Commercial Building Permit May 15,2000 N 7�Niiti!G Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front f 1A L:= R:= L:= R:= Building Height Bldg.Square Footage Open Space Footage % l ( of awa minus bldg&.paved #of Parkinit Spaces Fill: volume&Location *#*A. Has S at Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW O YES O *0`1IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book ; Page- and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DON'f KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size,type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW 13 required. Version l.7 Commercial Building Permit May 15,2000 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration 23-Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. Of Proposed Work: c1e(,7"z C)vcT wof* 4f__� 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 ❑ A-5 ❑ 113 ❑ B Business 2A ❑ E Educational ❑ 213 I ❑ F Facto ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ 1 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: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADOITIONS ANOWOR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): _� Proposed Hazard Index 780 CMR 34): SECTION#lllAJ iNGMGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION , Floor Area per Floor(so 7t .: lot AA F �� 2� .e 1 2 b I--- _____ t m 3 a # 3 ____ __ _� ,� th Total Area(sf) r�--� Total Proposed New Construction sc Total Height(ft) Total Height ft y� F 7.Water Supply(M.G.L.c.40,154) 7.1 FIp.9 t1.Zgne Information: 7.3 Sewage Disposal System: Public Private ❑ Zone,,,,, .,,_,,,, ,, Outside Flood Zoned Municipal El On site disposal system[3 Version 1.7 Commercial Building Permit Me 15 2000 City of Northampton _ Building Department 212 Main Street Room 100 MAY orthampton, MA 01060 bin Gay, 3-587-1240 Fax 413-587-1272 ectric,pium ' 1060 orthamptcn,N�� APPUCATION 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 This,11160601116 ww ON o 1.1 Property Address: 264 Elm Street tl;Nn ti�,lDlsirtR �� :� SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 11 Owner of Reconl: j 264 Elm Street Northampton,Ma.01060 Name(Print) Current MalfngAddress: V/ iM2 ✓Iji _ same -� nature V 2.2 Authort and AaeM Robert Langevin Jr. �:5 Miller St. Ludlow Ma.01020 Name(PAM) Current MaiNress: _ 1(413)547-2500 Signatu Telephone SEdj�1!1163- CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be ONIcial Use Only completed by rmit applicant 1. Building C (a)Building Permit Fee 2. Electrical (b)Estimated Total Cast of Construction from j 3. Plumbing ! SWIding Permit Fee 4. Mechanical(HVAC) .....___.._... ..... ....�.� $6,557 5.Fire Protection 6. Total=(1 +2+3+4+5) '] 7= Check Number This Ssctton For OfMcisl Use Only Building Permit Number Date Issued Signature: 'cgmrtriseaonsrn ropeclor of Building& Date I, File#BP-2014-1271 APPLICANT/CONTACT PERSON RAYMOND R HOULE CONST INC ADDRESS/PHONE 5 MILLER ST LUDLOW (413)547-2500 Q PROPERTY LOCATION 264 ELM ST MAP 31A PARCEL 076 000 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out -► n X17 L �+ �� Fee Paid ( �y Typeof Construction: RELOCATE DUCTWORK New Construction Non Structural interior renovations Addition to Existing - Accessory Structure Building Plans Included• - Owner/Statement or License 066195 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION 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 _ _6 q i , _ 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. 264 ELM ST BP-2014-1271 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A-076 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2014-1271 Project# JS-2014-002135 Est. Cost: $7957.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RAYMOND R HOULE CONST INC 066195 Lot Size(sq. ft.): Owner: MILLER ALEXANDER RON&DEBORAH JEAN MARKS Zoning: URB(100)/ Applicant: RAYMOND R HOULE CONST INC AT: 264 ELM ST Applicant Address: Phone: Insurance: 5 MILLER ST (413) 547-2500 () WC LUDLOWMA01056 ISSUED ON.612312014 0:00:00 TO PERFORM THE FOLLOWING WORK:RELOCATE DUCTWORK 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 6/23/2014 0:00:00 $55.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner