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32A-148 (8) T-8 8'-5" wC . � J co N oe ` la 2668 City of Northampton Ong Department Plan Review 212 Main Street Northampton, MA 01060 Skyline Design Commercial , 1Zesu6tial Construction ' —2emovathm 209,CocustStreet, %x60142 Florence,c/Wass.01062 413-586-8491 j,"582-0275 April 12, 2015 Commissioner Hasbrouck City of Northampton Dept of Building Inspections Pulaski Municipal Building 212 Main Street Northampton MA 01060 Re: Sheridan/Meccanello Bathroom and Kitchen Renovation 30 Pleasant Street, Northampton Subject: Request for Waiver I request that you grant a modification to waive the requirement for control construction for the Bathroom and Kitchen Renovation at 30 Pleasant Street in Northampton because the work is of a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. All work will be completed within the prescriptive requirements of 780 CMR. Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Douglas Ferrante 413-695-6373 Skyline Design Commercial• Residential Construction • Renovation 209 Locust Street Doug Ferrante Box 142, Florence 413 586-8491 Mass. 01060-142 Fax 582-0275 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 100705 Type: DBA Expiration: 6/23/2016 Tr# 252336 SKYLINE DESIGN Douglas Ferrante 209 Locust St - Box 60142 Florence, MA 01062 Update Address and return card.Mark reason for change. 20M-05/11 SCA 1 c; Address ❑ Renewal [] Employment F-] Lost Card Q9��panvnzaozcuecci o�6ac�ivaelta Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Wepi st ration: 100705 Type: Office of Consumer Affairs and Business Regulation iration: 6/23/2016 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 SKYLINE DESIGN Douglas Ferrante 209 Locust St Box 60142 Florence,MA 01062 Undersecretary of valid without signature UMassachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor AMM License: CS-002722 MAWRE Ism- DOUGLAS P FERJ'AN 27 S MAIN ST - -4 HAYDENVILLE?" 0 Expiration Commissioner 10/07/2015 N The Commonwealth ofMassachttsetts =T Department of Inditstrial Accidents } - Office of Investigations 600 W ashington Street a Boston, MA 02111 =' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibl Name (Business/Organizadon/Indi vi dual): ��00 1—`li to Z'l Address: -�c( �' �C'U S riot -e 01 u S S City/State/Zip: (9 ©6 �-- Phone#: I Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction _2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑DemoIition 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 0. officers have exercised their 11. Plumbing repairs or additions ❑ I am a homeowner doing all work ❑ myself. o workers'com right of exemption per MGL Y [l`I p• 12.7 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ 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 thepolicy and job site information. Insurance Company Name: Policy#or Self--ins.Lic.#: Expiration Date: Job Site Address: 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 DIA for insurance coverage verification. I do hereby cert' under the pa' s an e alties of p jury that the information provided above is true and correct Sianature: r Date: Phone#: f 4 Of 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): L Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: Version l.7 Commercial Building Permit May 15,2000 .D 4 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR110.11) .a Independent Structural Engineering Structural Peer Review Required Yes No SECTION 11 -OWNER AUTHORIZATION-TO..BE COMPLETED- WHEN' OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT w..._.. _ . as Owner of the subject property h ,e yauthonze'..._. »..1 �� .��._,M_ ,_.L. .� �. .__ ...__. _. ... .. to i a my behalf, in all a rs relative td wo u o ' ad by this building permit application Sign o e Date �.1,A4\..L. }- _.w. ._._._.. _:. _ ,_........... ........ as Owner/Authorized LJ 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 uder t ains and penalte pert l� Print Name let f Signature of Ow6er/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder....��Jr� lrx, ___ if License Number Address 2 v14 0, rj T Expiration Date 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 No 0 Version 1.7 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' 16( ONTAINING MORE THAN 35,000 C.F.OF ENOLOSED SPACE) 9.1 Registered Architect: t•°e_C1 Not Applicable ❑ Name(Registrant): €_.,_. _,._.... ................ ...,. __..,... .. _._ s... _ . ..., ..,., Registration Number Address Expiration Date i Signature Telephone ry 9.2 Registered Professional Engineer(s): Name Area of Responsibility I ...... .......... _....... _.__.._.._,. . ................,.__...._.. .... ..._.... ............_ Address Registration Number Signature Telephone Expiration._ 9 p Date Name Area of Responsibility Address Registration Number _.. . __ .._..._ _..__ _........... .... j i Signature Telephone Expiration Date Name Area of Responsibility i Address Registration Number ..._..... .. ........... Signature Telephone Expiration Date Name Area of Responsibility ...._.,_, Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor „ _......,,. .:.. _ _.. j Not Applicable ❑ Company Name: Responsible In Charge of Construction Addres-s.___ - Signature Telephone Version 1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning . This column to.5e filled in by Building Department Lot Size _... ._.. _.. . _,.__ Frontage Setbacks Front _... Side L.__..._ _ R....._,.w., L L:....,_,,.a R...__..__._ Rear _F Building Height ...... Bldg. Square Footage /° Open Space Footage _ _ (Lot area minus bldg&paved ; ; parking) #of Parking Spaces Fill: (volume&Location) __._.,...:_...._ _.. _....,...._ __.... ._....,:.. _._._._.w A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 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 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued C. Do any signs exist on the property? YES NO 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 _ IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, e cavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ' f Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-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 ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description ;Enter a brief description here. Of Proposed Work i- �ik�'( C(, K �3c{ �,�o�v11 rrt c�J f�Ic�s� I �,1 •G SECTION 5-USE GROUP AND CONSTRUCTION TYPE Jet CA-420) USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ - - 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 38 ❑ 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:F S Special Use ❑ Specify:w� .,....-.M..b�,_..�d.,-..�.m.�,_�..m.� . -.o. _._� ._� .. ,�.�•.. � �.m�.�.._�. __. .w�,v,€ COMPLETE THIS SECTION IF.EXISTING'BUILDING UNDERGOING.RENOVATIONS,ADDITIONSAND/OR CHANGE IN USE Existing Use Group Proposed Use Group: ,...__ .. _,...__ _._. w . Existing Hazard Index 780 CMR 34):, .•.,_• . ...._,. Proposed Hazard Index 780 CMR 34) _.,_„_ _.. ........ ... SECTION.6 BUILDING HEIGHT AND AREA C) GJ Iv 6ml BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) (�0 C� 1 C- V1. q• 1st 1st nd 2nd. 2 ..,:_........ .. ....:... ,_....., , ,, rd 3rd 3 4th ._ .._,..�._.� _,..._......_.._. _._ ...„.. 4th ` Total Area(sf) _ Total Proposed New Constructionsf) Total Height(ft) Total Height ft 7.Water upply(M.G.L. c.40,§54) 7.1 Flood_Zone•Information: 7.3 Sewag Disposal System: Public Private ❑ Zone Outside Flood Zone❑ Municipal On site disposal system[:] o� Version 1.7 Commercial Building.Permit May 15,2000 City of Northampton Status:of PemtEt Departure tuse,only Building Department CurbGut/Dnveway Permit 212 Main Street Sewde/SepttcAvailabtlity Room 100 WaterlWell Avallablllty Northampton, MA 01060 Two'Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot%Site Plans Ot�er,Specify ' LICATION 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 "�� P� Sc( v1rt sue}— ✓ri tT # : Map Lot V Unit 'kck`� ` ( Zone Overlay District 4 --' —_ Elm St:District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name(Print) Current Mailing Address Signature 9 Telephone 2.2 Authoriz Agent: Name Print Current Mailinq Address Signatu / Telephone �'/ �9 (y 3 7-3 SECTION 3-?ESTWAX CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use:Only completed by ermit applicant 1. Building (a)Building Permit Fee 2. Electrical „,.._.... (b)Estimated'Total.Costof I Construction from 6 __ _,...r_... _...,.. . . _.. .,_...._. 3. Plumbing t9� Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection ..a 10 Q - l.. .. 6. Total=(1 +2+3+4+5) Check Number 6 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-0981 APPLICANT/CONTACT PERSON SKYLINE DESIGN ADDRESS/PHONE P O Box 60142 FLORENCE01062(413)586-8491 PROPERTY LOCATION 30 PLEASANT ST-UNIT#4 MAP 32A PARCEL 148 001 ZONE CB(100)/ 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: REMODEL KITCHEN BATHROOM&ADD LAUNDRY New Construction Non Structural interior renovations Addition to Existing Accessory Structure - Building Plans Included• Owner/Statement or License 002722 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO1j14�ATION 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 De lition y Signature of Building ff ial 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. 30 PLEASANT ST-UNIT#4 BP-2015-0981 GIs#: COMMONWEALTH OF MASSACHUSETTS Ma :Block: 32A- 148 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-2015-0981 Project# JS-2015-001888 Est. Cost: $18000.00 Fee: $108.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin SKYLINE DESIGN 002722 Lot Size(sq. ft.): 7840.80 Owner: MECCARIELLO HENRY Zoning: CB(100)/ Applicant: SKYLINE DESIGN AT. 30 PLEASANT ST - UNIT#4 Applicant Address: Phone: Insurance: P O Box 60142 (413) 586-8491 FLORENCEMA01062 ISSUED ON.-411612015 0:00:00 TO PERFORM THE FOLLOWING WORK.REMODEL KITCHEN, BATHROOM &ADD LAUNDRY 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 4/16/2015 0:00:00 $108.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner