Loading...
23A-040 (5) New England Remodeling General Contractors Inc. 67 Division Street Easthampton, MA 01027 Phone (413)529 -0801 Fax (413)529 -0006 www.neremodeling.net 12/15/09 TO: Northampton Building Dept. The detailed description of 52 Maple Street as an existing business is as follows. The business use was an Acupuncturist, Chiropractor, Hypnotherapy and message therapist. This business had multiple offices within the building for it's current use. On the second floor there are 2 residential apartment units. There are approximately 20+ off street parking spaces for the building. The changes made to the interior of the first floor will consist of the partial removal of non load bearing walls to open up the floor space for a bike repair and retail shop ( Full Circle Bike Owned by Jason Graves). There will be no changes made to the exterior of the structure. All 4 existing exterior doors will remain in the same location. For the fire protection we will use the existing 3 smoke detectors as drawn on the floor plan. In addition, we will add 4 pull stations, 1 at each exterior door location. On the parking lot side there are 3 - 36" egress doors to a covered porch witch have 3 stair cases to grade. On the right side of the building there is 1 — 32" door with stars to grade. In this location there is an existing fenced in area where an access gate will be installed. Tom Bacis, New England Remodeling General Contractors, Inc. New England Remodeling General Contractors Inc. 67 Division Street Easthampton, MA 01027 Phone (413)529 -0801 Fax (413)529 -0006 www.neremodeling.net 12/15/09 TO: Northampton Building Dept. The detailed description of 52 Maple Street as an existing business is as follows. The business use was an Acupuncturist, Chiropractor, Hypnotherapy and message therapist. This business had multiple offices within the building for it's current use. On the second floor there are 2 residential apartment units. There are approximately 20+ off street parking spaces for the building. The changes made to the interior of the first floor will consist of the partial removal of non load bearing walls to open up the floor space for a bike repair and retail shop ( Full Circle Bike Owned by Jason Graves). There will be no changes made to the exterior of the structure. All 4 existing exterior doors will remain in the same location. For the fire protection we will use the existing 3 smoke detectors as drawn on the floor plan. In addition, we will add 4 pull stations, 1 at each exterior door location. On the parking lot side there are 3 - 36" egress doors to a covered porch witch have 3 stair cases to grade. On the right side of the building there is 1 — 32" door with stars to grade. In this location there is an existing fenced in area where an access gate will be installed. Tom Bacis, New England Remodeling General Contractors, Inc. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Inzvestigations 600 Washing ton Street Boston, MA 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly_ Name ( Business /Organization/Individual): ,/"' (4 - ( {i g / i 4r d K +°yh Ode,/ 41_ 6, G, Address: 6 .- 2 b Iv/ 5 City /State /Zip: I a 1 p^ hone #: ) U V Are you an employer? Check the appropriate box: Type of project (required): LT I am a employer with 3 4. ❑ I am a general contractor and I employees (full and/or part- time).* have hired the sub - contractors 6. [I] New construction 2. CD 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' y ap ty 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* 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 11.0 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. ❑ Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the sect :un bek ;w showing then 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. Company Name: .4 a 76-1 C jM Plllt r f �� C eio Policy # or Self -ins. Lic. #: > Q6 (,c f Sal ;pi Expiration Date: Sept 2.6/6 Job Site Address: S 4 p 1 City /State /Zip: /Ur 7'4 cM f 7 14 d ! dGs4 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 under the pains and penalties of perjury that the information provided above is true and correct. Signature: ��- -�� l� Date: I ! ' � " G q Phone #: y enr G Official use only. Do not write in this area, to be completed by city or town official City or Town: PermiuLicense # 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 SECTION 10- STRUCTURAL, PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. _ Signature of Owner Date a U , as Own: /Authorized Agen hereby declare that the statements and information on the foregoing application are true and accurate, to the best of edge belief. Signed under the pains and penalties of perjury, �_ .. .._ ..... am.._. � 0h!l►SC { Gr 5 Print Name .- � it Signatu: of Owne-!Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder . ..m_� ` . C4 License Number Address ' Expiration Date 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 of the building permit. Signed Affidavit Attached Yes 9it No 0 Version1.7 Commercial 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 Applicable Name (Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registratiorl Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date�� 9.3 General Contractor _._.,,_x. ._,..... ......,.._.__..____._ _ ..._._.__.,._.__.._ ._ __. _.. _._.' Not Applicable Company Name: Responsible In Charge of Construction Aririracc Signature Telephone Version1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L...__....,.. _ R:. . . _ . . . L:........ R ..... . Rear Building Height Bldg. Square Footage Open Space Footage ° (Lot area minus bldg & paved parking) # of Parking Spaces m - - - •_M Fill: (volume & Location) A. Has a Special Permit /Variance /Findin ever been issued for /on the site? NO (3 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book ` Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO @ DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 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 0 IF YES, describe size, type and location: E. 'MII the construction activity disturb (clearing, grading, avation, 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 Managem t Permit from the DPW is required. ' Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE nterior Alteratio s ❑ Existing Wall Signs 41h Demoliti„ n 0 Repairs ❑ Additio, sin Accessory Building ❑ x or Al eration 0 Existing Ground Sign ❑ New igns ❑ Roofing❑ Change of Use 0 Other ❑ Brief Description Enter a brief description here. f for 6Ife Of Proposed Work: y..., � Ai1 S / � SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A I ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B rf ❑ F Factory ❑ F -1 ❑ F -2 ❑ i 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B 0 M Mercantile ❑ 4 0 R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 0 5B ❑ 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) 1 st 1 st 2nd 2nd . 3rd ..:,,.. 3 rd 4m 4m Total Area (sf) 1 1J., 5 Total Proposed New Construction (§1)__, Total Height (ft) . .I .... 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❑ Versionl.7 Commercial Building Permit May 15, 2000 Department use only City of Northampton Status of Permit x. Building Department Curb- CutlDnveway Permit 212 Main Street Sewer /SepticAvailaiility Room 100 WaterMfell Availability , Northampton, MA 01060 Two Sets of Structural Plans phone 413- 587 -1240 Fax 413- 587 -1272 PIot7Site Plans Other Specify APPLICATION TO CONSTRUCT, REP �I NpVATF, qH G . THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING �i!!At✓ A N R FkMILY DWELLING SECTION 1 - SITE INFORMATION 7nog 1.1 Property Address: This section to be completed by office frp Lot Unit S ��d Zone Overlay District P ore-A.4,-1 o fO 6 c.. Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) imp ix ( T c g urrent Mailing Address: Signature L� Telephone r 2.2 Authorized Agent: . Name (Print) Current Mailing Address 54; a Fag Signature 7 Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing / Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection ��� ,� f- Total= (1 +2t3 +4 +5)__ _ _ Check Number /0/ T `1:5' This Section For Official Use Only Building Permit Number Date Issued Signature. Building Commissioner /Inspector of Buildings Date File # BP- 2010 -0599 ( t3 " l APPLICANT /CONTACT PERSON THOMAS BACIS ADDRESS /PHONE 67 DIVISION ST EASTHAMPTON (413) 529 -0801 • • • • _ Y LO. TION 52 MAPLE ST )r1 fl P' . r 23A PAR 0 001 ZONE ' GA(100)/ THIS SECTION FOR OFFICIAL USE ONI \ t�l PERMIT APPLICATION CHECKLIST \17') \ 1 L ENCLOSED 1 ZONING FORM FILLED OUT Paid Building Permit Filled out ,2' Fee Paid �� #.! — �' ` Typeof Construction: REMOVE NON- BEARING WALLS & ADD BENCH' SHOP New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 070061 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: 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 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.