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32A-143 (7) k,----� BOWLEN-cl M - �A 19 OVERLOOK DRIVE WEST SPRINGFIELD,A- R- PEN MA 01089 `~ OFFICE 483733-0934 CELL 413 348-0537 ~— INSURED LICENSED REGISTERED August 31, 2015 \ request that you grant a modification to waive the requirement for control construction for the Bruno custom stairUft at 38 Main 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. Thank you for your consideration. "Mass Amendments, sections 107'1 allows for aO exclusion from control construction for this project" Respectfully, Thomas Bowten Bovvien's Carpentry 19 Overlook Drive West Springfield, NW\01O8g0 ---4.88 LOWER BACK SIDE OF RAIL TOP VIEW T '7.50 RAIL TO WALL OR OBSTRUCTION FOR OUTSIDE RADIUS 8.00 FOR INSIDE RADIUS v I LOWER LANDING 1 ❑ ❑ —r 18 1/4' SHOWN 2.50 TYPICAL ( 22.0' ADJUSTABLE: --- - EAT HEIGHT 1 I 19.0" RAIL Existin first Floor Level n Existing Second Floor Level �Existing Third Floor Level � i EXTENSION ELEVATION 5 smle: lns•-ro• Usml.: lns•-ra UsP�: lnsra I 233/8"ADJ.' CHAIR EXTENSION'. 45/8"'ADJUSTABLE --_I t FOOT REST HEIGHT d t ! i 221/4'.+STUD WALL 120V DUPLEX OUTLET IN GW.+STUD fROX.12'AU TO IF03DED HT.WALL,APPR0X.17 A7 F.TO G IN BRUNp PLUG IN BRUNO CHARGING STATION. RGNG STATION. POSITION 161/8" NOTCH LOWER uTCFi CORNER !SEAT DEPTH f \ FROM DOOR,APPROX.@'WIDEX19FUGH (VERIFY DIM.WITH S�BCLEAPANCEOF BRUNO CRAR PAIL). • - 25 3/4' 20V DUPLEX OUTLET IN GYP.+STUD ALL.APPROX.12'A F.F.TO PLUG IN FUND CHARGING STATION. ?_ 9 � DItv1ENSIONS ARE BASED ON 7.5"RAIL TO WALL POSITION SIDE VIEWS J Bruno Chair Litt-Standard Details 4 sous: 1IB' ra Chair Sto -Char in Station First Floor Level Chair Sto -Char in Station Second Floor Level Chair Sto -Char in Station @ Third Floor Level sme: 18-ra 2 emu: l8-ro 3 sraa: le-ra City ofNortha.znpton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work. 3 The debris will be transported by: F-;,cA; The debris will be received by: 4:;0+i 4- CgYz 5f- v. Building permit number: Name of Permit Applicant Date Signature of Permit Applicant Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity,or any two or more ofthe.foregoing engaged in a joint enterprise, and including the legalrepreseutatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local Iicensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfoimante of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s) along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confruiation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pennit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of In-festigatimns 1 Congress.Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 7-2010 Fax# 617-727-7749 www.mass.gov/dia The Commonwealth of Massachusetts . ..... Department of IndustrialAccidents Office of Investigations 1 Congress Street, Suite 100 �+ Boston)MA. 02114-2017 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Qtr} rc lA�' ��(1�l Address: may0 MC AM.,i'c,VN it City/State/Zip: (J(6f Phone#: Are ou an employer? Check the appropriate boa: Type of project(required): 1. I am'a employer with 10 4. F� 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 8. Demolition working for me in any capacity. employees and have workers' comp.insurance.$ 9. ❑Building addition [No workers comp.insurance P required.] 5. 7 We are a corporation and its 10.F-1 Electrical repairs or additions i h d i ter h off cers have exercised 3.❑ I am a homeowner doing all work o 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.7 Roof repairs insurance required.] c. 152, §1(4), and we have no L employees. [No workers' 13. 'Other S cki e' 11"1 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'camp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. f Insurance Company Name: Policy#or Self-ins.Lic. 13 0 3)q Expiration Dater Job Site Address: City/State/Zip: CIO 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify undq1thepains nd penalties of erjury that the information provided above is true and correct. Date:':; -- — - ---- --. p 7 Phone Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: t The Commonwealth of Massachusetts :,. _ Department of Industrial Accidents E—� Office of In vestigations 600 Washington Street wr Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibl Name(Business/Organization/Individual): Fo CqV,c C/' Address: S ) � /y'�C'!' City/State/Zip: Cl co hone#: /Are you an employer?Check the appropriate box: Type of project(required): 1.�am a employer with 4. � I am a general contractor and I ` * have hired the sub-contractors 6. E]New construction employees (full and/or part-time). _ 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. F_� We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. o work ' right of exemption per MGL y � workers' comp. 12.0 Roof repairs c. 152, 1(4),and we have no insurance required.]t 13.0 Other employees. [No workers' 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: �ln `� A clvo Policy#or Self-ins.Lic.#: �/ Expiration Date: A ) Job Site Address: "' I i'1 City/State/Zip: �i=i�-- 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 u r the pains d penalties of perjury that the information provided above is true and correct. Si nature: Date: J C Phone 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): 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 J SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) r Independent Structural Engineering Structural Peer Review Required Yes Q No 0 SECTION 11 OWNER AUTHORIZATION-TO'BE COMPLETED WHEN: OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT I, __.._........_. . . _. .. _.__ __..._ ___.. ._...__,..___ __..... .___ as Owner of the subject property herebyauthorize ... _-.. . . . __ . ....... .............__................... _..... _ . __... ___to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner _Date 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 ofperlury Print Name Signature of Owner/Agent Date SECTION 12-CO TRUC ON SER. 10.1 Licensed Co stru ion Supervisor: Not Applicable ❑ Name of License Holder: License m(....� h Li r Address Expiration Date Sign a Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT M. L.:! 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 1 � Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION;'SERVICES-FOR BUILDINGS AND STRUCTURES GUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR;116(CONTAINING MORE THAN 3¢,000 C.F.OF f1JSLOSED SPACE) 9.1 Registered Architect: ,....,._ ...,_.-.�_.,.,__.._._.. ....,_._....._..__._�..__..r._.,.,�..�.._._.._..,_._._.�._�.._.,.._.___.�._,_.__.._...._.,. Not Applicable ❑ Name(Registrant): _..... ...... . .___ _.... .._. ., Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number I__.. _..., _, _ _ _ _ ....:.,._ Signature Telephone Expiration Date Name Area of Responsibility 1 i Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date _._. ..__.... _.__..._... v.._.p .r. _ ..._ _,. .... _.� ..., �..._-.,. _. t Name Area of Responsibility S Address Registration Number Signature Telephone I Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: — e Responsible In Charge of Construction Addre Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON.ZONING Existing Proposed Required by Zoning . This column to.�filled in by Building Department Lot Size Frontage ...... . Setbacks Front Side L __ _ R _j _ (__"-___, Rear Building Height ' M' Bldg. Square Footage % i Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces -_-_ Fill: .._.._ ._-._.. _,. � , (volume&Location) A. Has a Special Permit/Variance/Find'ng ever been issued for/on the site? - NO 0 DONT KNOW YES 0 .IF.YES, date issued: IF YES: Was the permit recorded at the Legistry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book Page, and/or Document#; B. Does the site contain a brook, body of water or wetlands? NO 0 DONT 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 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: 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 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version 1.7 Commercial Building Permit May 15,2000 SEC T1 M&C.ONSMCTION SERVICES FOR PROJECTS LESS THAN 36,000 CUBIC FEET OF ENCLOSED SPACE nt��fteratlon ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Ex ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. INSTALLATION OF A PRIVATE MOTORIZED CHAIR LIFT Of Proposed Work: ITO PROVIDE ACCESS TO TOP FLOOR NECESSITATED BY OCCUPANT'S HEALTH. SECTION S-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 E❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ 1 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 ❑ 5B ❑ U utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS ANDIOR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34):i _ Proposed Hazard Index 780 CMR 34): SECTION 8 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) st St 2 nd�--- _. MM —-- i 3r°I 3 th _ 4th r--- 4 Total Area{ f Total Pro p s osed New Construction f 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❑ Version 1.7 Commercial Bui Win Permit Ma 15,2000 t f v C f Northampton Bu i g Department - 3 ` X12 ain Street om 100 E1EC.r ton, MA 01060 =-----Pfiione 413-5874240 Fax 413-587-1272 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 7.1 Prouertv Address: _ _ _ _ -": be corn~by*Me& DICKINSON BLOCK CONDO — 41nit �38 MAIN STREET,NORTHAMPTON i !UNITS 5 AND 6 IE11rhat0Ntrirt CBDlotrict SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: R.E. CABLE LLC ! 184 NORTH STREET,NORTHAMPTON Name(Print) Current Mailing Address: x(413) 586-2046 Signature Telephone 2.2 Aythorized Agent: ;JOHN F. FORTIER I [84 NORTH STREET,NNORTHAMPTON Name(Print) U G Aie) F- Current Malting Address: - �413) 586-2046 Signature Z4W61relephone SEC 3- G Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building (a)Building Permit Fee V I 2. Electrical j (b)Estimated Total Cost of a I Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection — 1 6. Total=(1 +2+3+4+5) — C� .O� Check Number This Section For Official Use Only Building Permit Number Date issued Sig ft uiiding missloner/ or of B ddi s e Date File#BP-2016-0056 APPLICANT/CONTACT PERSON THOMAS BOWLEN ADDRESS/PHONE 19 OVERLOOK DR WEST SPRINGFIELD01089(413)733-0934 PROPERTY LOCATION 38 MAIN ST-UNIT 5 &6 MAP 32A PARCEL 143 001 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: INSTALL CHAIR LIFT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 58522 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INATION PRESENTED: pproved 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 oll ' n Delay 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. 38 MAIN ST-UNIT 5 &6 BP-2016-0056 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 143 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-2016-0056 Project# JS-2016-000103 Est. Cost: $25820.00 Fee: $182.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS BOWLEN 58522 Lot Size(sq. ft.): Owner: R E CARLE LLC zonine:CB Applicant: THOMAS BOWLEN AT. 38 MAIN ST - UNIT 5 & 6 Applicant Address: Phone: Insurance: 19 OVERLOOK DR (413) 733-0934 WEST SPRINGFIELDMA01089 ISSUED ON.91812015 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL CHAIR LIFT 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 9/8/2015 0:00:00 $182.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner