22B-008 (5) 130 SPRING ST- 1812 PAINT&BODY BP-2017-0098
cos#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 228-008 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category demolition BUILDING PERMIT
Permit BP-2017-0098
Project# JS-2017.000165
Est. Cost: $1600.00
Fee:$100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use Group: JOHN FERRITER 061398
Lot Size(sq.ft.): 65775.60 Owner: PEASE THOMAS R&PEGGY-ELLEN
Zanina:GIOOOYWSK Hiftft. Applicant: JOHN FERRITER
AT: 130 SPRING ST - 1812 PAINT& BODY
Applicant Address: Phone: Insurance:
274 Bridge St (413) 586-968QD
NORTHAMPTONMA01080 ISSUED ON:8/II2016 0:00:00
TO PERFORM THE FOLLOWING WORK DEMOLISH PORTION OF OFFICE BUILDING
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 8JI/20160:00:00 $100.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Pa
� � rry
File#BP-2017-0098
APPLICANT/CONTACT PERSON JOHN FERRITER u �611114S
ADDRESS/PHONE 274 Bridge St NORTHAMPTON01060(413)586-9680 0 ,,,(
PROPERTY LOCATION 130 SPRING ST• 1812 PAINT&BODY '9 C ?°
MAP 22B PARCEL 008 001 ZONE GI(I00)/WSP(I001/ Ce FA—/
THIS SECTION FOR OffjCIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT '// !/
Fee Paid 701- Y{J'
Buildine Permii Pilled out
Fee Paid
TvpeoPConstruction: DEMOLISH PORTION OF OFFICE BUILDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 061398
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
t 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
1712,,g1 (;
Signature uilding 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 MOL 40A.Contact Office of
Planning&Development for more information.
Version!.7 Commercial Building Permit May IS,2000
Department use only
City of Northampton Status of Permit
�l'1,l� I :uilding Department Curb CutDfivetay Permit
iiS
�l y 212 Main Street Sewer/Septic Availability
.yam Room 100 Water/Well Availability
JI 2 5 20 N rthampton, MA 01060 Two Sets of Structural Plans
phon: 41 587-1240 Fax 413-587-1272 PlouSIte Plans
Orr OF ELNLN& . •, Other Specify
rAPPCE- 1NosSoTRUCT,
REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION 1812paintandbody@gmail,com
1.1 Property Address: This section to be completed by office
130 Spring Street Map 2213 Lot 008 Unit
Florence, MA 01062 Zone GI Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Pease 1812 Auto 130 Spring St 01062
Name(Prim) /t Current Mailing Address: ,L p
ellraltirt a ns,�^'y}-d8.c.� Telephone IPJ I..�SiI 'S39'
2.2 Authorized Age`teA]nC • .—.
•btlt.3 fe:ce,' - 2i4 't•s . . t'l � 00 Mk.otao
Name(Print) Current Mailing Address:
L,1 —srka-Ctta
Signature _ „_ Telephone _
S_ s- . ' JMA1..oCt S - .s t COT.
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $1-000 oo (a) Building Permit Fee
2. Electrical , (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4 Mechanical(HVAC) 2-(00— $100.00 )
5. Fire Protection ^- �/{
6. Total=(1 +2+3+4+5) 4 t1C,c Check Number /6416
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Bub:i igs Date
Versions.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs ❑ Demolition Repairs 0 Additions 0 Accessory Building
Extertor Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use❑ Other❑
Brief Description Enter a brief description here. e"'?A fyis R' pg�t8 et +, building
Of Proposed Work: tt''
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 0 A-3 0 1A I hJ —
A-4 0 A-5 0 18 0
B Business ❑ 2A ❑
E Educational 0 2B ❑
F Factory 0 PA ❑ F-2 0 2C ❑
H High Hazard 0 3A 0
I Institutional ❑ I-1 ❑ 1-2 ❑ 1-3 0 3B ❑ _
M Mercantile 0 4 ❑ _
R Residential ❑ R-1 0 R-2 ❑ R-3 0 5A ❑
S Storage C� S-1 (l 3-2 0 58 0
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(sf)
1s`
2na
2nd
3b 3.a
4h 4�
Total Area(sf) Total Proposed New Construction(st)
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 0 Private 0 Zone Outside Flood Zone❑ Municipal 0 On site disposal system❑
Versionl.7 Commercial Building Permit May 15,2000
S. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be fined in by
Building Department
Lot Si {
Frontage
Setbacks k •nt I/
Side L: R: L: R: 1/
Rear
Building Height
Bldg.Square Footage %
Open Space Footage—
B&B area minus bldg&paved
parking)
q of Parking Spaces _
Fill:
(volume&Location) -
A. Has a Special Permit/Variance/Finding eve b-- issued for/on the site?
NO O DONT KNOW 0 YES 0
IF YES,date issued:
IF YES: Was the permit recorded at the R.•istry of Dee: ?
NO 0 DONT KNOW • . 0
IF YES: enter Book Page \ and/or Document#
B. Does the site contain a brook, b.•y of water or wetlands? NO DONT KNOW O YES O
IF YES, has a permit been • need to be obtained from the Consery 'on Commission?
Needs to be obtained O Obtained O , Date ued:
C. Do any signs exist o he property? YES t✓ NO O
IF YES, desert• size, type and location: \\
D. Are there an proposed changes to or additions of signs intended for the property? YEx(} NO O
IF YES .escribe size,type and location: \1
E. Wilt construction activity disturb(dewing,grading,excavation,or filling)over 1 acre or is it part of a comm plan
t will disturb over 1 acre? YES O NO O
IF YES, then a Northampton Storm Water Management Permit from the DPW is required
Version1.7 Commercial Building Permit May IS,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 38,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
\ Not Applicable 0
Name(R strant): /
N.
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Profess( nginecr(s):
Name A)Iof Responsibility
Address Registration Number
ze.
Signature Telep ne Expiration Date
Name Area of Responsibility ._
Address Registration Number
N.
Sgnxtrse Telephone\ Expiration Date
Name 7 \a of Responsibility
Address / ReyisiraiN1/4•Number
Signature Telephone Expiration Date
N.
Name Area of Responsibility
/ \\
Address Registration Number
S' nature Telephone Expiration Date
9.3 General Contractora _
`jc 14w-tail_ Not Applicable 0
Company Name:
_.�
Responsible MGM?of Construction
274'55 LL tSI. °lobo
Address
i -i7 eo
Signatu Telephone
Versionl.7 Commercial Building Permit May IS,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes Q No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT
nOR�/CONTRACTOR APPLIES FOR(' BUILDINNGGG/(IIPERMIT
}t� '
I, D �`- —}O''''r`� F >�'"`�' '. ;-L-t r.«"' ,as Owner of the subject property
hereby authorize J�lOtki i --�-�� t10a to
act on my behalf, in all matters relative to work authorized by this building permit application.
r
Signature of Owner / Date ry y,^,A0/6
I,_ , 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.
Print Name
Signature of OwnentAgent Date
SECTION 12-CONSTRUCTION SERVICES
10,1 Licensed Construction$uoervisor. ,I�,�.� Not Applicable 0
Name of License Hotaer: Ln ' e ttr'g_ C+5—06i 31?,
License Number
z7` t t'5. Kol AtAtTI I„3 !AMY 0106° lojrz111 -_
Address Expiration iC
,-,��_ `ii,3'S�"SBO
Signatur Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,0 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 budding permit.
Signed Affidavit Attached Yes 0 No 0 __.,,
The Commonwealth of Massachusetts
lam_ /
Department of Industrial Accidents
_liar—91 Office of Investigations
;; i_ 1 Congress Street,Suite 100
'`�:�—
Boston,MA 02/14-2017
%•• --cr.o www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Cy-- Please Print Legibly
Name (Business/Organization/Individual): J( (-)J `( Qtr(
Address: 2 (4A (�-lvU , s'• �(J ,C,
City/State/Zip: I DtA, ' rrt a i ' 1% Phone e#: 4t3 — 1(-) v
Are you an employer?Check the appri i Hate box: Type of project(required):
I.❑ I am a employer with 4. ❑ I am a general contractor and 1
ployees (full and/or part-time)." have hired the sub-contractors 6. ❑ New construction i am a sole proprietor or partner- listed on the attached sheet 7. ❑ Re odeling
ship and have no employees These sub-contractors have g, Demolition
working for me in any capacity. employees and have workers'
[No workers' comp.insurance comp.insurance. 9. ❑ Building addition
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I L❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required.] t c. 152,§1(4),and we have no
employees. [No workers' 13.0 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 arc doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors list check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. Kum 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:
Policy#or Self-ins. Lic.#: Expiration Date:
lob 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 certi nder the pains and penalties of perjury that the information provided above is true and correct.
Signature: 1/ ' Date: 7/25116
Phone#: 7:5-%-e2C
Official use only. Do not write in this area,to he completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone It;
DATE 7/25—A
To City of Northampton
Building Department
Subject: Request for Waiver
I request that your department grant a modification to waive the requirement for control
construction 30 1 r,,�
for the fA5�[, project at kt S } i
in �l.a.a.1_1r r • Ot 062 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,
SIGNATURE /n] •
�5. /�
NAME 03 {/(, testi.
COMPANY p,
ADDRESS 2�7 4 gyiYt C21.
CITY,STATE,ZIP kVtrktAIAAFIJ OkAy1/4. QOM