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23A-063 (2) 69 MAPLE ST-FLORENCE FIRE STATION BP-2019-0072 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A-063 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ALTERATION BUILDING PERMIT Permit ft BP-2019-0072 Project# JS-2019-000113 Est.Cost: $1250.00 Fee:$0.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CITY OF NORTHAMPTON CENTRAL SERVICES Lot Size(sp.It.): 26484.48 Owner: NORTHAMPTON CITY OF FLORENCE FIRE STATION zoning: GB(100)/ Applicant: CITY OF NORTHAMPTON CENTRAL SERVICES AT. 69 MAPLE ST- FLORENCE FIRE STATION ApplicantAddress: Phone., Insurance: Memorial Hall (413) 587-1260 0 NORTHAMPTONMA01060 ISSUED ON.7123/1018 0:00:00 TO PERFORM THE FOLLOWING WORK BUILD GEAR STORAGE ROOM AT FLORENCE FIRE STATION 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 7/232018 0:00:00 $0.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File p BP-2019-0072 APPLICANT/CONTACT PERSON CITY OF NORTHAMPTON CENTRAL SERVICES ADDRESS/PHONE Memorial Hall NORTHAMPTON (413)587-1260 O PROPERTY LOCATION 69 MAPLE ST-FLORENCE FIRE STATION MAP 23A PARCEL 063 001 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST LOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: BUILD GEAR STORAGUOQW FLORENCE FIRE STATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: V 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 / 4.L� -7/Z-1 15 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. VersSo_!.l Comnert al --d.:2 Pec^ br _9Vp Depart-nort Use only City of NorthaTp .,D Status of Parrrt Building Depa Hent Kuru CctrDnveway Parrrt 212 Main StCet Sewer Sepnc AvailaNfty. Room 100 Wit rMlell Ava11251lty Norhampton, NIA S'C50 TVJo saa o struau-=_I Planr phone413-587=1240 Pax413 871272 _tP vi sn Pans r SF 'city APPJCATION TO CONSTRUCT, REPAIR,RE OV F,CHANGE THE USE OFfOCCPPANCY OF, OR DEMOLISH ANY BUILDING OTH2F THA A GNE OR TWO FAMILY DWE LING D SEC ON t -SITE INFORMATION r I �� i I 1.1 P,.DdrtV Address: DEPT OF BUILDNG I NSPFCTION his ection to be completed by office NONTHAW1 ON.( MA01050 C��9 r�p`1�1�ClsS-',�• 3_4 Unit Zone a? Lot Overlay D'stnct Elm SC District CBDistrict SECTION 2 -PROPERTY OWNERSHIPiAUTHORIZED AGENT 2.1 Owner of Record boa Aut�w 1A rb Nva-140. N ma rPrC,W ba ry P..er°ss 22 anam� Telsphera Authori tl A nT Name(2.nq G .M1a oc P:Er=s'. 3"btuz O,hore SECTION 3-ESTIMATED CONSTRUCTIONCOSTS Item Estimated Cost(Dollars)to be OTICIaI Use Only completed by permit ao,theam 1. Building (��_ (a);Euilding Petit Fee 2. Electrical ('b) Estimated Total Cast of 7 r+ Cons!r,ction From 3. P.umbinc I Building Permit Fee T C. Mechanical (H'JAC) 5. Fre Pro. Ction 7C.'tck Number This Section For Official Use Onl Badding Permit Number Date T LIssued ' o er/Ins R , VarsionlJLo-L-reu-al Buildios eer-ntB{aitS_ODI S'cCTIC 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 32,G00 CU91C FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demoll:ion❑ Pspairs❑ Additions A¢e_sory Building❑ Exterior Alteration ❑ Ex sting Ground Sign❑ New Slgr•s❑ Roofn_e❑ Chance or Jsa❑ Other ,❑ _. Brier Description Ea'er zbrief description here '�,XAU.t) (�gptis't{�LAe(fs Oi Proposed Work: f. ane�� FZ SECTION 5 -USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ A ❑ A-4 ❑ A-5 ❑ - ❑ B easiness ❑ I I 2A I ❑ E Educational ❑ - 2B F Factory ❑ F-1 ❑ F-2 ❑ 22 I ❑ H Hi2[, Hazard ❑ 3A li ❑ I Instituticral ❑ -1 ❑ I-2 ❑ 1-3 ❑ II�3EM MercantileR Residential ❑ R-1 ❑ R-2 ❑ ❑ S Smrage ❑ S-1 ❑ S-2 ❑ .... . oo _ U Uellty ❑ Spec ty M Mixed Use ❑ Specry 5 Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING L'NDEP.G_OING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Gmup. _ _. _ Pmpos_d Usn S o T Existing Hazard Index 7K CMR 3")' _ PmooseC Hazard Index 733 CIVIR 3"r SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXIST,NG PROPOSED NEW CONSTRUCTION OFFICE LSU ONLY Floor Area per Floor(sf) 3m 3 _ .... —_. 4. Total A-a (s) Total Proposed New ConsL-9ctlon GN Tota Haaht(R) _ Total Heicht N - 7. WaL=r Supply IM G L. c 4g, § 511 T1 Flood Z,,rre f,rra-i,_ I t 3 _ 5 oDlsps:os I o _r, L7 � Puellc r 3e ❑ c_ne O -c ^eR rl C ' - mac' r __ _� V e-sioc1; Vitae li__BOr SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR 3UILDINGS AND STRUCTURES SUSJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAIN I NO MORE THAN 35.000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: _. .. _._ Nit Appllcacle ❑ ._. _. . i Name IF ,start for v tuber Adrr=s; . _. , -tion Date Scnatur- one I( 9.2 RegisteredProfessional EnSineer(s): Neer _ Ara of'esoorsblt, Address - R s,,st, N_moer Signature T.epr _ on= E p aioo oat= No, A Resporshlty Adtl Is Fccarat.n Nunbxr S'gnffiure Ephpne EX]la[I0, Gate A aof Responsbli1 Adders �.._ —._._ —. I Rr,srr2t on. Number 5g ztf, Telepbonx p orCate Nanx fFon.fasponebltty Atldress Ra,stratan Nunoor S'gnaure Tae-hon, E,rr.on Da:e 9.3 General Contractor ��<< (109 ' , Not APPIIcable ❑ C moanv Name spprsible In Cn ge ofCon t .te o A5 `/a onl 7 a!Bci.dl c?==Ntavti_2^.00 8. NORTFLAMPTON ZONLNG - j EXlsitna Proposed Rf,rtrrtj r, Zen,g Serhecks Front _- '-- - Side L R:_.-_.. r . R I Boildme Heieht Bldg. Squaa Foote_' Orev STace Foot age t ,nus b'dg&pap yea d o el of Pa-idn�Sozces � — � -- /volur�<s Loruloa) _ A Has a Special Permio/Variance/r;nd'ng ever Deern ' soee `:r/on th=_ site, NO DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Regissry of Deeds' NO 0 DONT KNOW (5 YS 0 IF YES: enter Book Pace and/or Document e. Does the site contain a brook, body of water or we Rands? NO 0 DON7 KNOW O YcS O IF YES, has a permit been or need to be obtained frcm the Cooser,adim, Commission? Needs to be obtained 0 Obtained 'J Date Issued: C Do any signs exist on the property? YES 0 NO 0 IF YS, describe size, type and location: D. Are there any proposed changes to or additions of signs intended or the p-coer`? YS 0 NO O IF YES, describe size, type and loc=_tion: E. Willa= nstmction aotiii/ s,rr (dea y. ra.:in, e orftlln to _c- :r 5- C..rawv c - - thatwilldisurboverlaca7 YFS O X90 O IFYES,Nen a Nonharrmoo Story_We M r- 5a,en -"om t,= c. r qJr C. Pte CotnmonweaLtle Of Vassachusees Depar..rr.9rt ofZna s m!deciderxas _ Qjice of 7r.t.�stiga:ons - 500 irasMngton Street Boston, AL4 02111 xoww.mass.gor/dia iForkers' Compensation Insurance Affidavit: Builders,sConrractors T itctrieiansr?Iumbers Applicant Information Please Print Lesib!v -'prams Buateess/Oresnizz:io nadridual : Ac?r255' Cil/State/Zip: Phony Are you an employer? Check the appropriate bps: Type of project (required): I.❑ am a orraloyor or--h 4. ❑ I atn a central cont tar an..I nuloae s (firll and'ot Parr-time)." have Prone to sup o�¢aa oa 7. ❑R a omni .on i, ?.❑ Iam asole proem romorparecen Is d ache acocle } her ❑ '� o Th-'e so,h-cot a 0 'ti.. snn and have no mn�overs I x. LI D mo on o.!L=.a for one in any mpacrry. p-o '_es and ba-- wo-k-.- 9. ❑ u gad'tor [No vort,=' comp_insurance comp. insurance? J ELc¢tcal tenons or addijons .squired.] 5. ❑ We ec a corm,or �0.on and its - -- 3❑ L am a homzown . doing all work off cera have e s a .Sri 1 L.❑ Plarnbroo rmznzor add,,c-n myself. o wo Lza'comp. arzht of onempnon a 6-GL y �" 13.❑Roo_r_pams imrrrance requird]T c 1"2' I(^), and we have no emplovices_ Ffd. oo--e,3 IJ 0uher cow. i^sutaace regiirad.j __ 'f;Pesubwnea:ors hap-.-,r r �,[bEy nu5i JNVIaP CKI[ wOi,�-$'mplp.pC ' enDca I am on empla}ger that is providing workers'compensation insurance for m}:employees Selaw is rhe policy arzdjob site informadorc Insurance Compane Name: Policy d or Self-ins.Lic Expinric,Date:_ Sob Site Address: City.'Staoc,Zip: Attach a cop} of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Semen 25A ofMOE c lit can Lead to the imposition of caminal penalties of a five up to 51,500 00 and/or ane year hnprisonment, as well as civil penalces in Inc form of a STOP WOIZR ORDER and a fine o`up to 52+0.00 a day aze n n no.violator Be advised that a copy of tins sm:zment may be fornardzd'_o c¢e Of9ce of In,estigarlons of the DLa.for insurance coverage verification. I do hereby cerrif}'under the pains and penalties ofperjup dvat the informatiors provided above is ri a and cot,act. Signature: D-t Phone i Offrc,ol use only. Do ,or n the to dais area, ro be completed by cig or tavo ojrclaL City or Town: Permit'Li cense= _ l5sirrig Authorit'p(circle one): I. Bo-rd ofHealth 1.€t:.Mia,Department 3. C n Clerk .. ct- —I irooec or 6. 0th r �� Contact Person t4 ue- • _. �'erioel.%Co.,ne.cia!B_Sit,Penn-Mat 1,.'_000 SECTION 10-STRUCTURAL PEER REVIEW(780 CM—R-110.11) Independent St--mural Engineering SVuctura_I Peer Revie,m Reouir-c = SECTION 11 -OWNER AUTHORIZATION -TO.B'c COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT = I ^e rebyajthcrze a 1 on Ty behalf in all mzRers rzla[:be Ec v�nrk auihchz=_c 'o c^Is _cllcinc p5nmi'apciioa5or. 8lgnawre of Owner Da, At�ebef. ent tereby de^_laretpatthe sta!amenlsperd lnfornaton cn'he fo�=_gol a apoli2bo re,ue and ac....rzle to the best of my'tnoWledge thz Zino and eral-ne la_ ntC NS UC T ION SERVICESCon bon Suoervlsor Nct Acpl cable ❑ Name of L' a Holde _. 'c>_nse NiTGer Address Exoir:ion Dat=_ Slsnature Telephoce SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G L o. 152 § 250(6)) Workers of[he Compensaissuance of thebuiidmintion lnauranceuictmus:be comple'e�a'd wbmitedwim this iiatlan. Falun to orov deNsa7TCavh m [he dental g permit. I Signed A6ica+itAffi ch�L yes � No 0 City of Northampton, Massachusetts ` Central Services Memorial Hall, 240 Main Street Northampton, MA 01060 David Pomerantz (413)587-1238 Fax: (413)587-1248 Dirsmv ofCrntnl Services July 16, 2018 GEAR STORAGE ROOM FLORENCE FIRE STATION • Storage room for gear- 14'x 16'x10'. • 2"x6" PT plates. • 2"x6" KD framing. • Yz"plywood finished one side for walls both sides. • Ceiling to be 2"x12" KD framing with %'plywood finished one side for room side. • ''/a" CDX plywood for top of ceiling- to be used for storage. • Lighting- fluorescent lighting. • Door- 3068 solid core, flush with lever lockset. City of Northampton, Massachusetts Central Services Memorial Hall, 240 Main Street Northampton, MA 01060 David Pomerantz (413)587-1238 Fax: (413)587-1248 DLrenor or(,m.I Scrvims To: Louis Hasbrouck, Building Commissioner From: David Pomerantz Date: July 16,2018 Re: Waiver- Florence Fire Station Central Services will be building a 14'x I6'x 10' room in the apparatus bay area to be used for gear storage. I request that you grant a modification to waive the requirement for control construction for the project because the work is of a minor nature and will not affect health, accessibility, life and fire safety, or structural requirements. Construction control 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. ,n J 2' 2 x 11'-2' TnCK BAYS GONGRETE PLR GTp. 0D.GEiL. m l4'-O' AFF. IS'-Tq' x la'.o' ❑ F.D. '`�.Q�N"` F.D. -41 4 3, 4�, �' a M.O. MVN Q .O. afl EXISTING FIRST -4. _ ry5 - FLOOR PL,4N 55 744 SQ . FT . _ _.