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38B-216 54 Fort St demo 2016-08-18File # BP-2017-0203 APPLICANT/CONTACT PERSON BRANCH DIANNE E ADDRESSJPHONE 161 northampton st apt f EASTHAMPTON01027 (413) 313-26850 PROPERTY LOCATION 54 FORT ST MAP 38B PARCEL 216 001 ZONE URB(85)/SC06)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid BuikLirlg Permit Filled"-o",,u~t_~_~________________~____~_ FeePaid~___~______________________________________________~_===== Typeof Construction: DEMO SFH NewConstructw~n~_________________________________________-=_______ Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Includ=e",d...: __~__~_~________~_____________ Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWIN=AC,ION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PR ENTED: __Approved _~ dditional 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: u _______•__________ Finding'--__ Special Permit ____ Variance*---­ __._~Received & Recorded at Registry of Deeds ProofEnclosed____ ___Other Permits Required: ___Curb Cut from DPW ___Water Availability _~_Sewer Availability __~Septic Approval Board ofHealth ____Well Water Potability Board ofHealth ___Permit from Conservation Commission ___Permit from CB Architecture Committee ___....Permit DPW Sto:m Water Management t:..JiJ .IV\-ft.-I\tI S&\1:)'N ermit from Elm Street Commission 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 ofMGL 40A. Contact Office of Planning & Development for more information. RECEIVED IlK1 , 620tS of Northampton ing Department 2 Main Street Room 100 pIon, MA 01060 gEPT. OF BU1tD\wp'IPI~ENORTHAMprt:;N'.lWIJ'I~ 1240 Fax 4'13-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONe OR TWO FAMILY DWELLING / SECTION 1 -SITE INFORMATION 1.1 Propertv Address: ;-, ~ra.T' 3r }\Ib~"'~~'M . SECTION 2 -PROPERTY OWNERSHIPJAUT/:-IORIZED AGENT Current Mailing Address: O/OZ.tN'~ ~ 113,.3l.O.. ,Y1lSi9~, Telephone . SECTION 3 -ESTIMATED CONSTRUCTION COSTS 2.1 Owner of Record: 2.2 Authorized Agent: }(e.1SrEh I3flH1c.H Telephone ~ S1 west .It "r 2.,E'"Mfa~ Item 1. Building 2. Electrical 3. Plumbing 4. Mechanical (HVAC) 5. Fire Protection Official Use Only ,(a) Buildin~ Permit Fee (D) Estimated Total Cost of Construction from 6 Building Permit Fee 6. Total =(1 +2 + 3+ 4 + 5)_-'-____~--'-,_6_~_O________:..,'_C.::...he_c_k_N_u_m_b_er_____I'_--~-~__"-_"______-j This Section For Official Use' On_'Y_~.'_____________--I Building Permit Date Signature: ____ Building Commissionerllnspecio['of Buildings Dale SECTION 5-DESCRIPTIOi'll OF PROPOSED WORK (check all aplPlicable) New House o Addition D Rep~acarnei1i Windows o Roofing 0 GrOoors 0 Accessory Bldlg. 0 ! Demolition D New Signs [0] Dec!(s [0 Siding [0] Other [0] Brief Description of Proposed I"" Work: t>f;4ut(llbl\ C~ ZOJc'O S'AJl.c. f'AMIL'I Alteration of existing bedroom No Adding new bedroom Yes _-:-;-_ No Attached Narrative Renovating unfinished basement _'--_ Yes ___No Plans Attached Roll -Sheet a. Use of building: One FaFf.lily ____ Two Family ____ Other ____ b. Number of rooms in each family unit______ Number of Bathrooms.______ c. Is there a garage attached? ____ d. Proposed Square footage of new construction. _____.____ Dimensions __--'--___________ e. Number of stories? _____________ f. Method of heating? ______________ Firepla,c!3s or Woodstoves _____ Number of each v6. Energy Q(ilnservat[on Compliance. ______-'-__ Masscheck Energy Compliance form attached? ______ h. Type of construction ______ i. Is construction within 100 ft. of wetlands? ___ Yes ___ No. Is construction within 100 yr.f1oodplain ___Yes __No j. Depth of basement or cellar floor below finished grade ___________ k. Will building conform to the Building and Zoning regulations? ___Yes ___No. J. Septic Tank __ City Sewer ___ Private wef! ___ City water Supply ___ SECTION 7a • OWNER AUTHORIZATION· TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , as Owner of the subject I, \>ttH1I\E property I, KB\~-EV\ t?Mt\tkt " , .. ;" ' .. ' ,~: Owner/Authorized Agent hereby declare that the statements and informatiowbi\'rthe:~oregoij.')g apP'lication are, tqJe.lI1i!wL~~ra'te; to the best of my knowledge and belief. '" c""" The Cl/Jmml/JTJ1].welfllltlfrt I/Jfllilfllssadnuseits Dept1J1V'tmeni oflil1J1riUBrffrilf!J! Accidlemuts Office I/Jf][TJ1].vestiglflitions 6tH) Waslfrtingil:l/Jn Srffreeil: ]EI/JSl!I/JTJ1]., MA OJ111 / www.massogovldiidll. J W <1JJJr'lkeJr§' C<1JJllIilljpltellll§211biollll Kllll§1l1lJr21Jmce Mlliicllillvll1l:: IB1Jluilldien/OolIDl1tJr'Iillc1i:!lJJJr:§lflEKe<Cli:Jri<CJililllllt§/JPll1l1lllIilllOeinl . AplPllIiclilllllt1l: ]:llltif<1JJrrllIilllill1tft<1JJlllt JPKtelillse JPrrmt Leg;ftlOHy Name City/State/Zip: Phone Are you an employer? Check the appropJriate box: 1. 0 I am a employer with 4. employees (full and/or part-time).* 2. I am a sole proprietor or partner­ ship and have no employees working for me in any capacity. . [No workers' compo insurance 5.i flequired.] 3.0' I am a homeowner doing all work myself [No workers' compo insurance required.] t I am a general contractor and I . have hired the sub-contractors listed on the attached sheet, These sub-contractors have employees and have workers' compo insurance.t We are a corporation and its officers have exercised their right ofexemption per MGL c. 152, §1(4), and we have no employees. (No workers' compo insurance required.] Type of project (required): 6. 0 New construction 7. Remodeling 8. 0 Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions . 12.0 Roofrepairs 13.0 *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. tHo meowners who submit this affidavit indicating they are doing all work and then bire outside contractors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and state whether or not those entities have employees. Ifthe sub-contractors have employees, they must provide their workers' compo policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy andjoh site information. Insurance Company Policy # or Self-ins. Lic. .________~______--'-__ Expiration Date: _________ Job Site Address: Citr/8,J£lte/Zip:{c'.. ii" Attach a copy ofthe workers' compensation policy declaration paget5hoWi:B:gtJ1epo1icY<nlllmber"ana ~a!it1n date): Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal penalti;s 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 fme ofup to $250.00 a day against the violator. B.e advised that a copy of this statement may be forwarded to the Qffice:6f: ... Investigati~n.i ofthe :mA for insurance covera everification.' "; '...'~'. ,.i erjury that the infoi1:nationproJ!ide'd aQd~e~is t'rue and correct . . \ fi,/' )I;; ,... ',' Phone#: 113 .. 313-~ Official use only. Do not write in this area, to he completed hy city or town official City or TOffil: _______________PermitiLicense Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Citytfown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.0ilier ______________________ Contact City ofNorthampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, 854, I acknowledge that as . a condition of the building petmitall debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c iii! 8 150A. Address of the work: .5:"\ .fQ(2..T 57 The debris will be transported by: A"",heJl$T ~tNr- The dE?bris will be received by: 1J~\t.y ttc.YG I~ Building permit number: _____________ Name of Permit Applicant K,.\)re~ BjZ...~ .~~ Date Signature of Permit Applicant 8/]2/20]6 Print Subject: From: To: Date: Fwd: Fwd: 54 Fort St -Sewer Pipe Cap David Veleta (dveleta@northamptonma.gov) branchstudio@yahoo,com; Friday, July 8, 2016 1 :01 PM --------Forwarded Message -------­ Subject:Fwd: 54 Fort St -Sewer Pipe Cap Date:Thu, 30 lun 2016 15:32:41 -0400 From:David Veleta <dveleta(q:northamptonma,gov> To:Louis Hasbrouck <Ihasbrouck@northamptonrna.gov> CC:Charies Miller <cmiller@northamptonma,gov>, Rich Parasiliti <rparasiliti@)northamptonma.gov>, bra nchstudi o@'yahoo.com Louis, Please see the email and photo below and attached photo. The sewer department was not on site to inspect the cap shown below but verified the stake in the field today and discussed the future connection with the contractor as noted below, Based on the information provided, the DPW confirms that the sewer was capped off on 6/29/2016, David David veleta, P.E. Department of Public Works 125 Locust Street Northampton, MA 01060 T: 413-587-1570 ext.4310 C: 413-320-0198 F: 413-587-1576 E: dve1eta@northamptonma.gov W: www.northamptonma.gov/dpw --------Forwarded Message -------­ SUbject:54 Fort St -Sewer Pipe Cap Date:Thu, 30 lun 2016 14:49:25 +0000 (UTC) From:kristen branch <branchstudio@yuhoo.com> Reply-To:kristen branch <branchstudio@yuhoo.com> To:dveleta@'northamptonma.gov <dveleta@northamptonma.gov> Hi, Attached please find photo taken yesterday by Matt Gilmore, excavation contractor. As you can see it is staked and this stake is now about 18" out of the dirt, it was covered after capping. Chuck Miller in the bid. dept. is requesting a letter from 1/2 C"Dlulnbia (~as of Massachusetts A NiSource Company 995 Belmont Street Brockton, MA 02301 August 4, 2016 To Whom It May Concern: Our records indicate that the address below does not have gas service from Colulubia Gas of Massachusetts. 54 FOli St Northampton, MA 01060 Thank you, Heather Meunier (508)580-0100 Ext 1342 Integration Center Columbia Gas of Massachusetts nationalgrid 40 Sylvan Road. Waltham MA 02451 5/23/2016 54 Fort St. Northampton, MA 01060 RE: Service Removal for Building Demolition. To Whom It May Concern, This letter is to confirm that, per your request National Grid has confirmed electrical service has been removed from 54 Fort St. Northampton, MA 01060. If you have any questions or need further assistance, please feel free to contact me at (508)357-4778. Sincerely, C){) , t,... \. LL.>l';C.,:;t.·;LA ~.a>¢"·r .~~) (' (,! , e .er \.....Q.A~Y·~) ().'(-" Elisabeth Coleman Customer Order Fultlllment nationalgrid