23B-014 (3) August 5, 2013
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
Mr. Hasbrouck,
I request that you grant a modification to waive the requirement for construction control
of the window and siding repair project at the DPW Mechanics Barn at 125 Locust Street
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($1,500). Thank you for your consideration.
Respectfully,
CarAt_71:?!:0 ,
David Veleta, P.E.
Senior Civil Engineer
Northampton DPW
Version!.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
_.
RA r NAJZ.,6 pA re__,hs7 ,&rt
hereby authorize 5 _ _ _
act on my behalf, in all matters rel. ive to work authorized by this building permit application.
Lt°
•
Signature of Owner Date
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 thesalmanclootesolokkoL___
- —
Print Name
- 1
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable
1),A 6
Name of License Holder:I VI, _ Fle2 6
_ _
License Number
cAJ24
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 0 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:
1 Not Applicable ❑
Name(Registrant): i-.�. .._ .
1 Registration Number
Add ress 1
E.
Expiration.
Date
Signature Telephone
9.2 Registered Professional Engineer(s): .
I ,
Name Area of Responsibility
—._. u
Address Registration Number ' ��
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
1
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date . _ __ ,
,___________ ___ _
_..
L . . .., __ .._ __ .,
_ _ . _ .
. Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
1 �_ _. Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE �,/
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs L Additions 121 Accessory Building I=1 Exterior Alteration 1:1 Existing Ground Sign❑ New Signs❑ Roofing Change of Use❑ Other CI
Brief Description E r a brief description here. i
Of Proposed Work:
6.1)ii_.... ..CCX—.2-1&-0-442.11..110....CAQVR/S.P 64(g_Vb(ni A itIA:AP16Thi–rfet."11
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 CI A-2 CI A-3 CI 1A 1:1
A-4 ❑ A-5 ❑ 1 B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1-1 ❑ 1-2 ❑ I-3 ❑ 38 0
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
-
U Utility Cl 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: I _.. ._ _.. _. . Proposed Use Group: .._ r _ I
Existing Hazard Index 780 CMR 34): __ ._::_ 7 Proposed Hazard Index 780 CMR 34): i _.,,
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
15t __ _ _ .M ._ lst 9
2nd 1 2nd '
— x
3rd 3rd
__..
4m
4 � _
m
Total Area(sf) I_ Total Proposed New Construction(sf)
Total Height(ft)
Total Height ft I— _.I
7.Wa a Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sew a Disposal System:
Public Private ❑ Zone r I Outside Flood Zone Municipal On site disposal system❑
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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 n.__ 7 1--..._ _._ _a.
Frontage �_..,___ I J __ _ .
_ _ __
Setbacks Front 1 --._..,] I.,
Side L:_� _. R:i _! _ .., _
F•-- t --I
Rear a __
Building Height — L
Bldg.Square Footage i ET-1 % r---i
Open Space Footage -
(Lot area minus bldg&paved 1 ) ...-1
parking)
#of Parking Spaces I I I.......L1
Fill: 1
(volume&Location) 1 i I
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW it YES 0
IF YES, date issued: ' '
IF YES: Was the permit recorded at the istry of Deeds?
NO 0 DON'T KNOW YES 0
_ __
IF YES: enter Book 1 _I Paget i and/or Document it l
1
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES I
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued:
. - C. Do any signs exist on the property? YES . 0 NO 301
IF YES, describe size, type and location
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
IF YES, describe size, type and location r
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.
-- - '_. Version1.7 Commercial Building Permit May 15,2000
",\ `).-1 Department-u6e only
RE ' "" C ty o Northampton Status of Permit: -
Bt ildi • Department Curb CutlDrlveway Permit
AUG - 5 2013 12 ain Street Sewer/Septic-Availability _
R4 om 100 Water/Well Availability,
pEpT.CF 13,3E-0,N IG' am y on, MA 01060 Two Sets of Structural Plans
" M -1240 Fax 413-587-1272 Plot/She Plans
NORTH•�C+ - - - �
Other Specify _
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:
I This section to be completed by office
a( C.4-0 A c( 5 r Map' Lot Unit
1 N ORS I— ` Uri /'n t 010!0 0 ;, Zone: ; Overlay District;
i ____. i Elm St.District: , — -
CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
] r Fluot LL�fi4 '. va6,i_ocvsr stfi t! - `
Name(Print) Current Mailing Address: t 0 Co 0
ii-eti__. __..e 7-i 5.�..
A s _ 3 -S 7Qkf_' 3�'7
Signatures ,' /
q Telephone
2.2Aut1�•rize• • •ent: — _
1- vai'v-- t--7-# 1 ncii ve. .._ ri_-,01-
71-kr— v CAS( -- -/ frXj'"(dniv-r4 0
Mail
Name(Print) Current in Address: 1/"414-e.)10
Z . ee—/S70 ;
Signature I Telephone EX r '/-&f7
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building -up g .C a (a) Building Permit Fee
2. Electrical 1 -------1 (b)Estimated Total Cost of s
Construction from (6) i
3. Plumbing Building Permit Fee
9, ._�-__
4. Mechanical(HVAC) i
5. Fire Protection {: ____ --_ __--._.'
6. Total=(1 +2+3+4+5) Check Number
This Sectiorf For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
bl3
125 LOCUST ST BP-2014-0131
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B-014 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2014-0131
Project# JS-2014-000250
Est.Cost: $1500.00
Fee: $0.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: DAVID VELETA 61352
Lot Size(sq.ft.): 730501.20 Owner: NORTHAMPTON CITY OF BOARD OF PUBLIC WORKS
Zoning: SI(100)/ Applicant: DAVID VELETA
AT: 125 LOCUST ST
Applicant Address: Phone: Insurance:
42 CAROLYN ST (413) 326-0649 0
FLORENCEMA01062 ISSUED ON:8/6/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE 2 WINDOWS,SIDING & MAIN TRIM
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 8/6/2013 0:00:00 $0.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner