32A-075 41 MARKET ST BP-2017-0999
GIs Pc COMMONWEALTH OF MASSACHUSETTS
Man:Block:32A-075 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:Stair BUILDING PERMIT
Permit# BP-2017-0999
Protect a JS-2017-001728
Est. Cost: $4100.00
Fee:$65.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: EDWARD RICKEY 96159
Lot Size((sq. t,);): 3659.04 Owner: SHEA MICHAEL R 4r DENISE L
Zoning: URC(100)+, Applicant: EDWARD RICKEY
AT: 41 MARKET ST
Applicant Address: Phone: Insurance:
P O BOX 62 (413) 695-7059
W ILLIAMSBURGMA01096 ISSUED ON:3/9/2077 0:00:00
TO PERFORM THE FOLLOWING WORK REBUILD EXTERIOR EGRESS STAIRS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector or Wiring U.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: Douse k Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: OB: 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:
6uildins. 3/9/2017 0:00:00 $65.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File It BP-20 t 7-0999X65 E' , �{', acO
ADDRESS/PHONAPPLICANT/CONE O BOX 62CT )N WEDWARD ?WILLIAMSBURG
-
(413)695-7059 l Bv ��t
��1 >��, - SyDA
PROPERTY LOCATION 41 MARKET ST (fD6 �� & pRr
MAP 32A PARCEL 075 001 ZONE URC(I0D�1 ��po
THIS SECUSE ONFOR AL APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE p(y�y..
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofCo�trgction: REBUILD XTER( t` RESS STAIRS
New Construction
Non Structural interior renovat .
Addition to Existing
Acceasory SITOcture
Buildi Plans Included:
Owner/Statement or License 96159
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
v(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 front Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
. m. ti ,; 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.
• 3e4 - c '7s
1/eternal Commercial Buildil- Permit May 15,2000
Department use only
- ' City of Northampton Status of Permit:WRb tGlj i Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability_
' i Northampton, MA 01060 Two Sets of Structural Plans_,_
- . . - 0513587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOUSH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION t-SITE INFORMATION J
1.1 Property Address. Tills section to be completed by office
yl 'rniml(.r t. ---.. - Map Lot Unit
Zone Overlay District
Ca District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
M,ke b Denise 5f,co. Y 7 /. pr-,1V1 aw led F�%��re Ocliz-
Name(Print) Current Making Address "1 A); 011,1 a
Signature )C (C /dL�— /", '141'-"H/irir telephone _
2.2 Authorized Agent:
Name(Print) +r Current Marling Address 4
y/3 4TS•7oS t
Signature . _ . �.:, Telephone
SECTION 3-ESTI.11ie'ED CON -UCTION COSTS �—
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building r//OG 54 (a)Building Permit Fee
2, Etectricai (b)Estimated Total Cost of
Construction from(8)
3. Plumbing Building Permit Fee
4 Mechanical(HVAC)
5 Fire Protection
6. Total= (1 +2+3+4+5) ✓to°.pe Check Number 4 `5Q
—� This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
VersionI 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 0 Demolition 0 Repairs 0 Additions 0 Accessory Building❑
Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing❑ Change of Use 0 Other
Brief Description Enter a brief description here. pp..��..
Of Proposed Work: ,fejazi.__</ a't. .^r a44.4
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 ❑ A-3 0 1A �� ❑ ....—
A-4 0 A-5 0 18 0
B Business 0 2A ❑
E Educational 0 i B 0
F Factory ❑ F-1 0 F-2 0 2C_ ❑
H High Hazard 0 3A 0
Inslitutonal ❑ I-1 .... 0 1-2 0 1-3 0 38
M Mercantile 0 4 0
R Residential R-1 ❑ R-2 0 R-3 ❑ gA ❑
S storage 0 S-1 0 S-2 0 -.-.. 58 1 ❑
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
roup 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)
_...... _ tai _. _.
2"
Total Area(sr) Total Proposed New Construction{sfj
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 K. Private 0 Zone Outside Flood Zone❑ Municipal CK On site disposal system❑
Versionl.7 Commercial Building Permit May 15, 2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be fined in by
Building Department
Lot Size _.
Frontage
Setbacks Front V,ye.. LNC,;
Side L bub. R £NG. L:LAC RUN':.
Bear UNG' ,UNC.. ......
Building Height —. _..
Bldg.Square Footage
Open Space Footage — %n
(Lot area minus bldg&paved
r
parking)
#of Parking Spaces % --- - .-
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued forton the site?
NO g DONT KNOW Q YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO (3 DONT KNOW Q YES Q
IF YES: enter Book Page and/or Document
B. Does the site contain a brook, body of water or wetlands? NO ei DONT KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C, Do any signs exist on the property? YES Q NO
IE YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO efii
IF YES, describe size, type and location:
E. NMI the construction activity disturb(clearing,grading,exo &tion,or filling)over 1 acre oris it part of a common plan
that wilt disturb over 1 acre? YES Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version 17 Conunercial 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 Applicab'e ❑
Name(Registrant).... . _ --_
Registration Number
Address
-- -- - - - Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name _.. _. _ Area of Responsibility
Address Regishafiun Number
Signature Telephone Expiration Date
Name -.- ... ,.. Area of Respons!blfity
Address Registration Number
Signature Telephone Expiration Date
Name _.- . __. -_. . -_.. - Area of Responsld6ty -_- --
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name ��• _. ...._. ___
Responsibler�� �In Charge of Construction
C
Address
471/3 475-7x47
Signature / Telephone
Versioni.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) 1 /^�
Independent Structural Engineering Structural Peer Review Required Yes 0i No 0
SECTION 11 -OWNER AUTHORIZATION'TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,I ,•(i(.N.A.lC {n/�� as Owner;.it the subject property
hereby authorize c y tell 3 a• -_ _ to
act on my behalf,in all matters relativeelto w k authorized by this building permit application.
X_-a2< o e . '�r1»:�L -- i - x �3 y 7 ..
Signature of Owner Date
,as Owner/Authorized
Agent here *ectare thhe 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 pegury.
_eYw4ROd R[ct«yi Co. _i
Print
Name
6ignatureonet/ -rt.
i Dffie
SECTION 12-CONSTRUCTION SERVICES 1
10.1 Licensed Construction Supervisor: Not Applicable Q
Name of Licgnse Homer: ems.-gtest e_. . . J.� _. ...
License Number
44
P-Bax 6t -o/096 _ 646159
Address �I r Expiration Date
f/,,, / elt6P57C57 7fiVie
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 et the building permit.
Signed Affidavit Attached Yes ce3/ No 0
•
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
YT6A-itTarit 600 Washington Street
Boston, AM 02111
www.rnass.gov/iia
Workers' Compensation Insurance Affidavit: Builders/Coutractors/Electricians/Plumbers
Applicant Information ��` Please Print Legibly
Name (Business/Organizatior/lndividual): pe(u igi_j.(,�'�ed ' Co, V __
Address: Pet gout (>2
City/State/Zip: y; /(i 0/074 Phone#: r-705-
Are
'-7aSAre you an employer?Check t appropriate box: Type of project(required):
1. I am a employer with 4, C I am a general contractor and 1
employees(full and/or parttime)* have hired the sub-contractors 6, ❑New construction
2.S I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g, hi Demolition
working far me in any capacity. employees and have workers' 9. ]Building addition
[No workers'comp. insurance comp. insurance]
required] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised then i i-L Plumbing repairs or additions
myself [No workers'comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c- 152, §1(4), and we have no
- employees. [No workers' 13.® Other_fS
_
comp. insurance required]
*Any applicant that checks box#1 must also fill out the section below showing their workera'compensation policy information,
Homeowners who sol rmt 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. tf 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 andfob 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 eemit&under the pains and penalties ofpeijmy that the information provided above is true and correct
Sienatme:10 Date: S�.SY/7
Phone ft: 52,7-17.17- 7c$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):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:_ ,,,,
•
City of Northampton 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: yl yhhAld &T St
The debris will be transported by: SELF
The debris will be received by: Vaigy TeariL.q y/,,,/�,tay 744
Building permit number: `/
Name of Permit Applicant �.
Date Si nature of Permit Applicant
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Edward Rickey & Co.
PO Box 62
Williamsburg, MA 01096
413.695.7059
request that you grant a modification to waive the requirement for control construction for the Egress
stairs at41 Market 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 an exclusion from control construction for
this project"
Respectfully,
Edward Rickey
Edward Rickey&Co.
PO Box 62
Williamsburg,MA 01096
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