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23B-011 (7) , BORDER. SEGE.. Ver11,00 --.- - .,,,V;T7J, ga / _ _ i ;-„,:,,-.„„___ = V , , _ _ --- PROPOSED 5 X 8' - 5" CuST00/4/4 CLOSET - - ---__ 1-, \ 12: ' ' ' ' , i • -„ ',A.A.,. • (8,13') ,.., \ . „,A-,,, , .. \ \ r • , \ ,- \ aoor 0.6' r pooF OR66--.._1, \-\:\ -74--- 1L-7—aL— ,, .. ,I;;,;:,A \ , ...r....•5, ;:,-; 1 , ‘, • f ‘)'. ' 1 \ k ,'(DJ , \ , ,,;,:,,,,,,,,,,,.,:,,,, 2001 . ':°''''' ''‘‘' i , 5= e .1 I IIIE 1 i d..... . \ E Y.M ; 1,:, '471 ;, !1---- ,. 'TC„ . 114:- — ,-.... . 1 N \ .... ' ;„/„,',/, N.' /://,),'))/; 'ol,'I;it EXISnl, IN r .l..r , III, r i 1 - ill di . 1'57,1Y Ve.,'ODS-WLE OFFCE Rua.. 6 • ;II 1 ',CA 28,0.--1 001 M v T \ L 1 '"X&T , ''' BUNC-COr z :•,.11 , /RI" ----*--. . T I , _ i • 1,, I \ \ 11 ENLARGED VIEW O e F NEW OFFICE ADDITION & NEW OFFICE BUMP -OUT , s A BA., hs"r 4 urp ; ,, , ., PLAN ROOK 31. PACES 76-77 14ARE a BERENS SCALE, 1" = 10' I 11 \ 1 BOOK 4615, PAIGE 73 II \ tI, \ • .,,, ' I 1 \ \ c, r A 1 ■ ,.....",5. ,, , ' . Nt - F- , ,s, , I 1- 1 , , . 1, ,''„, 'f'', E-?, , 1 ' ‘ I I \ VI I i \ I \ ' r I I , Ix ..., le, \ . , ;'.. , 0 1 [ 1 I \ i , ., , , , , , . , , , , o , , ■ \ . I -- , 4° T ----- ' --5 - v _ , , , ,, ,,...-- _ _ __ __ ___ __ ---- '7 ,,, =.-' '• t, , 2 '7- — =,, — — — _'-,__ _ ._,_ _L__ _-=-7!•-•-" — — — . I / , I LOCUST ') STREET ) , • ‘, , i , , , , 1 ' , I , , ( If SCALE, 1" - 20' --- A% ---/ .........................„4. — SITE PLAN FOR PROPOSED BUILDING ADDITIONS NORTHAMPTON AREA PEDIATRICS ,I,TNn NORTHAMPTON, MASSACHUSETTS IRON PIPE FOUND 0 PREPARED FOR RCN BAR FOUND • ,NOTES• NORTHAMPTON AREA PEDIATRICS, LLP 193 LOCUST STREET ROUND FOUNT a I.) FOR REFERENCE TO ENCLOSED PERIMETER, SEE ROOK 4969, NORTHAMPTON. MASSACHUSETTS SATE NOVEMBER 23, 2009 I' GONDOLA INTERVAL 231 - PAGES 335 & 339 5' CONTC INTERVAL ---- 2-35 - __ _ _ SPC,T ELEV. DON •..,, 7 ) UNDERCROUND UTIUT7 LOCATIONS SH HEREON ARE BASED UPON HERITAGE SURVEYS, INC. SUP AC FEATURES AS LOCATED ET SuRVE•' AND AVAILABLE RECORD DRAIN MANHOLE 0 DATA, AND ARE APPROXIMATE ACTUAL LOCATIONS SHOULD BE VERIFIED REGISTERED PROFESSIONAL LAND SURVEYORS SEWER MANHOLE 0 WITH THE APPROPRIATE UTILITY COMPANY AND/OR MUNICIPAL DEPARTMENT COLLEGE HIGHWAY & CLARK STREET OATOK .5. 111 PRIOR TO PAN, DESIGN AND/OH CONSTRUCTION POST OFFICE BOX I UTILITY POLE , SOUTHAMPTON, MASSACHUSETTS WETLAND DELINEATION FLAG -K. (413) 527-3600 xe , 3960-040301 kt, 3950,,,,,,), 11ss. , 39SO-091123 r i r - - 1 1::9 ; i iJ I 1 1 , 0 l i / I U=1 II 1 . ism - - - . 1t _ 1 34 N _� � �It . � 1 1 : 1 I 1 1 1 .F•alir=;:l I 1 1 1 I - 1 1 - r ; VIII Yl� L. L_ J _ J L J i I I t \EW OFFICE ADDITO\ 1— 2C5 sf new, 12C sf renovate JJ �p �. � STAIR /fri � c2 s /v o T — T //t — rot 16' -0" i j/// ///%//////////// / /AMMON. / / / / / / / / / / / / / / / / / / / / /% —J - New Office °-' Lab Area Eye Te ing 14 -6 x 7 -7 ` Windows match /�� — — —� existing • 4 00 I I Q� r • l De 2 -4 x 6 -0 �. / t I fldOW li � (, lit ,' New 24" w. I New 36 ` indow i door 1 1 -T i TT h--> w EX T 1 •• Eo New 36" 36" w glass door panel door — Secretary I 4 9 -3 x 9 -0 Sxg Windo . match New (offic i/ 11-- ----II II 1 I existing 9 -4 9 -0 Doc's phone Area 14 co x 9'- (j A 7 -4 x 3 -0 Desk 2 -4 x 6 -0 file file / file f / t �_ _ . x i Su ur lu )I UL) Ill vn wail I JL . _ : i a, 7 ' -1 - TOILET j BATHROOM 0 007 ( 7-4 X 6 -3 1/2 Kitchenette EXT ,� 0 1 I .. I10/aDN)I1 /n C. I.. 4 4 D I 4 ti Mark 0. Gelotte Architect. 70 Elm Street Hatfield, Massachusetts 01038 413 247- 9624 Fax 247- 3092 August 30, 2011 Mr. Louis Hasbrouck Building Commissioner City of Northampton 212 Main Street Northampton, Ma. 01060 RE: 193 Locust Street, Northampton Area Pediatrics Dear Mr. Hasbrouck, We would request that the Building Commissioner grant a modification to waive the requirement for Sec. 107.6, Construction Control for the project at Northampton Area Pediatrics on Locust Street in Northampton because the work is of a minor nature that will not affect health or accessibility, and is impractical in that the cost of Construction Control services is considerable when compared to the cost of the proposed work. Thank you for your consideration. Sincerely, ✓ fr, q1✓ f' , Mark Gelotte 'Co / ; tio.793* - mew ,,� Omasta Builders, Inc. General Contracting 21 North St Hatfield, MA 01038 Phone /Fax (413) 247 -5666 Mr. Louis Hasbrouck Building Commissioner City of Northampton 212 Main St Northampton, MA 01060 RE: Northampton Area Pediatrics 193 Locust St, Northampton, MA. August 30, 2011 Dear Mr. Hasbrouck, I am writing to you as the building contractor for The Northampton Area Pediatrics. I am requesting that a deviation from the requirement for Section 107.6 be granted based on the minimal construction cost for a 205 square foot addition to existing office space. Granting this deviation will not affect accessibility or health for said project. Thank you for taking this under advisement. Sincerely, Roy L. Omasta President — Omasta Builders, Inc. Permit Listing Report by Permit Type Date Range: Submitted after Sep-01 -2010 Printed On: Mon Aug 22, 2011 SQL Statement: Street No. like "193" AND Street like "LOCUST ST" and ([Type of Permit] = "ZONING PERMIT APPLICATION ") Permit Type Address (Work Location) District Zoning Owner Work Category Est. Cost Proposed Use Details Map /Block/Lot Permit No Online Permit No Permit Status Date Issued Contractor (Phone #) Work Description Fees Paid Check # ZONING PERMIT 193 LOCUST ST 30500 SI(100) 193 LOCUST ST ASSOCIATES LLP Zoning Permit $0.00 APPLICATION 23B1011/001 MP- 2011 -0044 APPROVED Oct -25 -2010 193 LOCUST ST ASSOCIATES LLP ZPA - ADDITION .�� $15.00 2603 Permit Type ( ZONING PERMIT APPLICATION ) TOTALS: ESTIMATED COST: $.00 NUMBER OF PERMITS: 1 FEES INVOICED: $15.00 FEES PAID: $15.00 BALANCE: $.00 . GRAND TOTALS: ESTIMATED COST: $.00 NUMBER OF PERMITS: 1 FEES INVOICED: $15.00 FEES PAID: $15.00 BALANCE: $.00 GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investioations ' f w_ '= 600 Washington Street -.w - t Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information jj Please Print Legibly Name ( Business /Organization/Individual): ' AStf!' / - /L "'� t �- �- Address: 0 1, City /State /Zip: 7�I AL 0/4 3.E Phone #: ? - 5.- Are you an employer? Check the appropriate box: Type of project (required): 1. I am a employer with 11 4. ❑ I am a general contractor and I employees (full and/or part- time).* have hired the sub - contractors 6. New construction 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3. El am a homeowner doing all work ❑ 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 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 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. 7— X Insurance Company Name: a/f /5 --T 5 Policy # or Self-ins. Lic. #: 5 3 673 f Expiration Date: ' M ///:t Job Site Address: / ? 3 � � '- >- .Sr City/State /Zip: /° /t i <4cy, h' a/ 6 " 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 co py 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 Siznature: 1. G 4 ' 5f' Date: /, 7/ Phone #: a1 41 7 -5.6 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): 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 CMR110.11)' Independent Structural Engineering Structural Peer Review Required • Yes 0 No SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN I, OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT C �- r2 (� � �j;v hereby authorize _ .. ___ . V _ act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner / G Date z . z t,4_ I, ..__.. �: `� l.c. __.�� ......: _. �..____ _._.._....._,._ .__..._ , 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 arcs andpenalties of perjury. ___ _ Print Name __,_________ _ __ _ . ......... Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : ? , .._ _ .._... ..._..w�.._ — —.w.w- .• „- 6 License Number __ .._ . � .� m..__ z ' . _m 5 � fi _ ' ! ..�.. ` �_ Y... _..._.. _._.. _.w._ ._ . _ a l i a // / ._._.. Address Expiration Date ( .7-7 —I.-- ------ Signature Telephone SECTION 13 - WORKERS' COMPENSATION INSURANCE AFFIDAVIT (MG.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 ® No Version1.7 Commercial Building Permit May 15, 2000 r J SECTION 9- PROFESSIONAL DESIGN CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENSLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name (Registrant): i _._ _ •-- ---- _ _ �_w Registration Number Address -' `" i Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): _ _ Name Area of Responsibility Address Re istration Number Signature Telephone Expiration Date Name Area of Responsibility Address _ .... "_ _ Registration Number Signature Telephone Expiration Date Name Area of Responsibility 1 Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor j ' c 0 � � ____. /3` ` f ` R ..... �. _' v im __.. _._ _ __ _ . __ .____ Not Applicable ❑ Company Name: a�( MR5�1`r Responsible In Charge of Construction r) / .... , "' 2 f A ._ 5r/4,1;4 , _;' c 07 "'- Address _ „ , , 6--e o 7-1— ,. _____,„_ Signature Telephone Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON.ZONING Existing Proposed Required by honing This column to 'be filled in by Building Department Lot Size 7111Trii Frontage _5e10..._ Ale .,:: G Setbacks Front Side L:46 R• T Rear Building Height ri AO Jo( slut/ t utivi c Bldg. Square Footage yal .. % T Open Space Footage % (Lot area minus bldg & paved ; 37 parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO (3 DONT KNOW Gr YES 0 IF.YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW t� / YES _.._....___ _ . IF YES: enter Book ! Page ? and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ef 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 Qr NO 0 IF YES, describe size, type and location: ,tr}4 "r 3)(5 ,,, 1 e79`lz��t D. Are there any proposed changes to or additions of signs intended for the property ? YES (3 NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, 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 Management Permit from the DPW is required. Version 1.7 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 ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work , SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ j 1A I ❑ ❑ A-4 ❑ A -5 ❑ 1B ❑ B Business l 2A ❑ E Educational ❑ 2B r ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ :- 3A ❑ I Institutional ❑ I -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 0 R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ___ U Utility ❑ Specify: ....._-___.. .___ __ M Mixed Use ❑ Specify: I S Special Use ❑ Specify: €����- COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING!. RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: 11 .__._. 1�:5 ►.l_ S _ S _, Proposed Use Group: e u5iN�'S,rj._ ° - �^ ,_.___W_. 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) P • 151 '?' ___ ____ 1 c 2ntl 2 nd 4 h _ __ _ 4th _._.____ ___ ___ ..._ Total Area (sf) c Total Proposed New Construction (sf 6 54- Total Height (ft) /e t Total Height ft _ __�. ', ... 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 le' On site disposal system r Version1.7 Commercial Building Permit May 15, 2000 :g D darf efit txse dityl `" kt . ), City of Northampton ® A, s� w} l Building Department 6t/D ,''.' e � erttt 212 Main Streets ep ltaflatbia � Room 100 ate aw- M w. s p a a u i ?1an ,. ` 0 Northampton, MA 01060 phone 413- 587 -1240 Fax 413- 587 -1272 P�/ s -m..:.z. �" s 4 a i t,i-s_ft., , ... . `..rte 04 04; ^, 0 4... �� izl- A,I > .^� °" APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION ' 1.1 Property Address: This section to be completed by office 1q3 k0(1)5 <>1-- Map Lot Unit i d p 4„9 - 1 o ✓ O/ ' C ; Zone Overlay District .._...w._.o._. ,M... _ -.- : — ff Elm.St." District ' CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: Signature i Telephone 2.2 Authorized Aqe x_ . , : DT 0 /z 1 457,4 ( / oRi /i ? W/9 Name (Print) Current Mailing Address -A ( k- Telephone ..._.._. _ .� Signature SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building g � � (a) Building Permit Fee ' 2. Electrical _ __. (b) Estimated Total Cost of ' " 0O ` Construction from (6) ..._._.�_�._. ..._µ_ ."�... _..... 3. Plumbing i Building Permit Fee 4. Mechanical (HVAC) d(� Ca M^ 5. Fire Protection _ 6. Total = (1 + 2 + 3 + 4 + 5) 3 5, pow 'i Check Number 51‘?6 This Section For Official Use Only Building Permit Number Date . Issued Signature: Building Commissioner /Inspector of Buildings Date / 4 ( • /0 MI File # BP-2012-0227 ' % %3 p APPLICANT/CONTACT PERSON Omasta Builders, Inc. o f ADDRESS/PHONE 21 North Street HATFIELD ?(tipt tif PROPERTY LOCATION 193 LOCUST ST MAP 23B PARCEL 011 001 ZONE SI(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Peimit Filled out Fee Paid Typeof Construction: ADDITION 205 SQFT offices New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 6763 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9FAIATION 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 , . 'o :' -lay 77( i_nature o ui . 0 ficial 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. 193 LOCUST ST BP- 2012 -0227 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23B - 011 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit # BP- 2012 -0227 Project # JS- 2011- 000538 Est. Cost: Fee: $102.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Omasta Builders, Inc. 6763 Lot Size(sq. ft.): 39465.36 Owner: 193 LOCUST ST ASSOCIATES LLP Zoning: SI(100)/ Applicant: Omasta Builders, Inc. AT: 193 LOCUST ST Applicant Address: Phone: Insurance: 21 North Street HATFIELDMA01038 ISSUED ON: TO PERFORM THE FOLLOWING WORK: ADDITION 205 SQFT offices 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 9/9/2011 0:00:00 $102.50 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner