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17D-012 (43)
-- . . . 4.. - • . • Da■ -:• • --- ) Mee°f Capin:Merl()Park"thrsPlaza-and Regulation Suite.";1170 • • .,-,_. • Boston, ,, , ... . 02116 - _ . - m Rgstrdion . - - . . ___________ ______ Regdsfraget $41140 • . - . ------7-, — f .7., Typer-Individual . '• ) ----.7-=---::-: ..1'=""—7.44- explrarpost. 111812014 1.0. zags - —.1,-- J:L _ KEVIN DAVID OSRIEN - .• KEVIN 013RIEN - ,. V i ----,....---..._1.... =_-...- 1 , ,.. .--- --- t.... - . . - P.O.BOX-8:1126 . •%.,„:--.,..-2.-.s...,... . ',....,- -. ,. .- - ,....:.! ,......m........-:.-.---, ,....., . - . SPRINGFIELD. 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MITE -,--, :•..„r •....1:„...,,...„ ...dreviiitighisdai_ - ' MOFIEUX MA • - 111dancretary fletwidIvilboutalassdire -- .... . _ . - - - . . . - - - - - -. ..„. • . , _.---- -4 St massachusetts-DeParbneet et Public safety 4‘.: -1i Be)ard'at"kftn9 Readations and Standards -.: '' ' 11 Carel:rad"SuPenifor I&2 Fan* Licensee CSFAONBIO .. if .3. .0411's • . li laCMCD=Obr :. • *."..,_ ...2 kronor 'sc. ' c' ...1 .-..7. n srliGnailD - ..? . ... '' i ..."Atee• -"" • • 1-i --.7,-.._ .......„...,....- - .3 , -..., _. :-. Conataissioner .0e= . - -• •. pammummemmumv one of the bedrooms,that framing will be replaced. The work in Unit 221 and Unit 231 is limited to replacement of windows and carpet and patching of holes in the walls and ceiling,as well as repairing the unit entry door to Unit 221.The work in this phase will include replacement of broken windows,as well as roof repairs and repairs to damaged siding and trim. We will prepare drawings that document the scope of the work for Phase Two,a building code review and affidavits and submit to your office for a building permit.Once we have completed the work for Phase Two,we will apply for a permanent Certificate of Occupancy for the building.Per the requirements of 780 CMR Chapter 34 and IEBC 2009,the work for Phase Two falls under the requirements of Section 403:Alteration--Level 1. We can review our all of the above information as well as the progress of the Phase One restoration work at our meeting on site tomorrow. Best Regards, DMS design,llc By: Daniel M.Skols Principal 106 Cummings Center.Suite 4230 nms DMS design, lie Bevaiy.MA 01913 7c1978 Suite 5740 Architectural Design Services Fax M6648 8231 d;miel@dmsdesiyn coo design.11c August 7,2013 Louis Hasbrouck Building Commissioner City of Northampton 210 Main Street Northampton,MA 01060 Dear Mr.Hasbrouck, The purpose of this letter is provide your office with our understanding of the condition of Building 2 at Meadowhrook Apartments at 491 Bridge Road in Northampton after the fire of July 22,2013 and to layout our intended phasing of the restoration work. Building 2 is a three story wood framed slab on grade building that contains twelve two-bedroom apartments.Each apartment is located ofT a central corridor that runs from the front to the back of the building.There are four apartments per floor,one located in each corner of the building.There is a central boiler mom located off the main corridor on the first floor. Building 2 was damaged by a fire on July 22,2013.The origin of the fire was a bedroom in Unit 211 which is located in the left front corner of the building.The most heavily damaged unit in the building is Unit 211,followed in severity of damage by the units above, namely Unit 221 and Unit 231. The remaining nine unit units and the corridors were only damaged by smoke and water.These are Units 212, 213,214 on the first floor,Units 222,223,224 on the second floor and Units 232,233,234 on the third floor. The repairs to the building will be carried out in two phases.Phase One will include the repairs necessary to the nine units that were only damaged by smoke and water as well as repairs to the corridors and exit stairs.These repairs include:replacing damaged carpeting,repainting of walls and ceilings,and the repair or replacement of damaged unit entry doors.All smoke and heat detectors and CO detectors will be made operational.The fire alarm system will be made operational.All emergency lighting and exit signs in the corridors will be made operational and all corridors will have fully charged fire extinguishers. The drywall for a portion of the first floor corridor wall at Unit 211 was damaged and that drywall will be repaired. The plumbing system, gas lines, and electrical systems will be tested and will he made operational.Units 211,221 and 231 will have rated unit entry doors installed and will have operational smoke detectors.Once this work has been completed, we intend to seek a temporary Certificate of Occupancy permit to occupy these nine units.Per the requirements of 780 CMR Chapter 34 and IEBC 2009,the work for Phase One falls under the requirements of Section 402:Repairs. Phase Two will include the repair work for Units 211,221 and 231.Unit 211 was heavily damaged and will require the replacement of all wall,ceiling and floor finishes as well as replacement of kitchen cabinets and counters,bathroom finishes,and replacement of wiring and possibly plumbing lines.Despite all of the damage to the finishes,the exposed structural elements that we have observed are undamaged and may remain in place.There is some damage to limited non-structural framing at the closet door of Rightfax C3-1 8/21/2013 5 : 27: 06 AM PAGE 2/002 Fax Server - 0 CERTIFICATE OF LIABILITY INSURANCE DATEjp(MM/DDJYYYY) T TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: SULLIVAN KEATING MORAN PHONE I FAX 840 LIBERTY STREET (A/C,No,Ext): (A/C,No): E-MAIL SPRINGFIELD,MA 01101 ADDRESS: 28WMM INSURER(S)AFFORDING COVERAGE NAIC# • INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY OBRIEN,KEVIN DBA OBRIEN CONSTRUCTION INSURER B: INSURER C: INSURER D: P.O.BOX 80125 INSURER E: SPRINGFIELD,MA 01 138 INSURER F: ` C OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES- LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDD\YYYY) (MM\DDIYYYY) LINTS GENERAL LIABILITY EACH OCCURRENCE $ - COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR DAMAGE S RENTED $ PREMISES( SES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ . POLICY E PRO.ECT 0 LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ . ANY AUTO LIMIT(Ea accident) . ALL OWNED AUTOS BODILY INJURY $ . SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) . NON-OWNED AUTOS PROPERTY DAMAGE $ - (Per accident) . UMBRELLA LIAR OCCUR EACH OCCURRENCE $ MI EXCESS LIAR F CLAIMS-MADE AGGREGATE $ Ell DEDUCTIBLE $ . RETENTION $ $ A WORKER'S COMPENSATION AND y WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-5B972235-13 05/13/2013 05/13/2014 LIMITS ANY PROPER ITOR/PARTNERIEXE CUT IV E c. N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,descr be under E DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR OBRIEN,KEVIN CERTIFICATE HOLDER CANCELLATION • BUILDING COMMISSIONER CITY OF NORTHAMPTON MA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 212 MAIN ST IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR IQ TAE NORTHAMPTON,NIA 01062 w` = ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. --Aug. 21. 2013 9: 00AM — '-No. 5945' —P. 1 CERTIFICATE OF LIABILITY INSURANCE DATEp(MMIDD/YYYY) T CYloR TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT HOLDER. 1}41§ CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(Ies)mus(be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies May require and endorsement. Astatement on this certificate does not confer rights to he certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: SULLIVAN KEATING MORAN PHONE I FAX 540 LIBBRTY STREET (ANC,No Ed): (NC,No): EMAIL SPRINGFIELD,MA 0110I ADDRESS: 2BWMM INSURER(S)AFFORDING COVERAGE NAIC ft INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY OBRIEN,KEVIN DBA OBRIEN CONSTRUCTION INSURER B: INSURER C: INSURER D: P.O.BOX 80125 INSURER E: SPRINGFIELD,MA 01138 INsURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF(f15URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV OR THE POLICY PERIOD INDtCATED- NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- ptgq ADO SUB POLICY EFT DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MRTDDWYVY) (MMUDDWYYY) LIMITS GENERAL LIABILITY _ACH OCCURRENCE • COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ w CLAIMS MADE E OCCUR. 'REMISES(Ea occurrence) MED EXP(Any one person) $ /PERSONAL&ADV INJURY S GENII_AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ . POLICY 0 PROJECT 0 LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ III ANY AUTO LIMIT (Es accldeul) - ALL OWNED AUTOS BODILY INJURY S - SCHEDULE AUTOS Per person) HIRED AUTOS BODILY INJURY EN $ (Per accident) - NON-OWNED AUTOS PROPERTY DAMAGE S - (Per accident) • UMBRELLA LIME eOCCUR EACH OCCURRENCE LIA $ . EXCESS B CLAIMS-MADE AGGREGATE I. DEDUCTIBLE S . RETENTION S A WORKERS COMPENSATION AND x we STATUTORY OTHER EMPLOYER'S LIABILITY YM U9-58972235.13 05113/2013 05/13/2014 LIMITS ANY PROtrPERITORIPARTNERIEXECUTiVE (7' NIA E L EACH ACCIDENT 5 1,000,000 OFFICERIME4IEER EXCLUDED? (�...( (Mandatory IC NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Nyes,aesaibaunder E.L.DISEASE-POLICY LIMIT 5 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS1LOCATIONSNEHICLE$IRESTR(CTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVER ACE. THE WORKERS'COMPENSATION POLICY ODES NOT PROVIDE COVERAGE FOR ODRCEN,SEVDI. CERTIFICATE HOLDER CANCELLATION BUILDING COMMISSIONER CITY OF NORTHAMPTON MA SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BC CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 212 MAIN ST IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR :• TAE NORTHAMPTON,MA 01062 e„l ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 913B-20 0 ACORD CORPO• 'Ti' . • r g s reserved. . . . Version1.7 Commercial Building Permit May 15,2000 ., .. , . . . ._ . . SECTION 10 STRUCTURAL PEER REVIEW(780 CIVIR.110.1 t) ,.., ,,,„ Independent Structural Engineering Structural Peer Review Required . Yes 0 No C‘_.) SECTION 11 -OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT '.. . / I, ) herebyauthorize! act on my behalf, in all matters relative to work authorized by this building permit application. ( , i 1 Signature of Owner Date _.--„--, ,475Z.-411 : uttCo-ri31 At'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 pains and penalties_of_per ury. . : 6 /&) 0 P<Name , 1 9t> i rcs7II1III Signature/Owner/Agent ate SECTION 12-CONSTRUCTION SERVICES i 10.1 Licensed Construction Supervisor: 7,3— Aitc—i3J--- -- Name of License Holder:' ,........ _................... ,,,,-.._ ,.7 ,Not Applicable 0 _ _____, /WA 71-2-3" License Number 1 i / iyilt , rass-- -- ------- — 'f- — Expiration Date i zi.f3 ...C177337C-7 Signet e Telephone : • . •- •..-. -.- .: ••.,• ....- • •::•.-- - . - - - - • SECTION 13-WORKERS COMPENSATION INSURANCE AFFIDAVIT(M G L c 152,§25C(&)) . .. . . " - ' - . - ' . .-- . - '-'.' -'•. ..' .. -- . ' - 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 ...t,, , ,I The Commonwealth of Massachusetts A Department of Industrial Accidents • 4---1____,...,,z;-0---rt' Office of Investigations 4 , 4 ` 600 Washington Street -.: /:;7 Boston, MA 02111 -<:,-....72-7,..." '=7_,,r,:. www.mass.gov/dig Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ��t11� ©,& 1 / t$�/ a t157�cTL O,, ( Address: (J 6 OA Gr>o l City/State/Zip: S,� M 0/1 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1.❑ I a employer with 6. 0 New construction mployees (full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. N Remodeling = These sub-contractors have g, Demolition ship and have no employees working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.$ required.] • 5. 0 We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.0 Plumbing repairs or additions 3.0 I 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 q ] -- employees. [No workers' 13.0 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 flare 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. Insurance Company Name:, - Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 ertify under the 'Its and penalties of perjury that the information provided a ove i true and correct. c\,.2...,„ Signature: .�"-- Date: O es A Phone#: ep3S3' /SS one#: 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#: Version1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON,ZONING Existing Proposed Required by Zoning This pelmnn to be filled in by Building Department Lot Size'.. Frontage Setbacks Front N. Side L~v: R: ..__. _ ,'` L _. ,_... R .._..__... Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) • A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book ' Page and/or, Document# B. Does the site contain a brook, body of water or`Wetlarids? NO Q DONT KNOW Q YES Q 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 C Nth, 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES (3 NO 0 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 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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): 0 n1> (S J LL Registration Number Address t ,S-. 6 All-A°RED Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): 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 Name Area of Responsibility Address _.._ Registration Number _ Signature Telephone Expiration Date � 9.3 General Contractor _ Q k c � W 57iQ t1�Y� _ Not Applicable❑ Company Name: e ! V ©,g il 7 Responsible In Charge of Construction Add 'ss Signature Telephone . - Version1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE OS Interior Alterations;14 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. R p4 t2 5i, AN 0 W AC6 2 0 p i,.„,'t Of Proposed work: 2 2 2 22.3 -2-2-Li 1 2-3-z 2 33 -3 ti '2-13 L 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 I ❑ B Business ❑ 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 ❑ R-2 50 R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B I ga. U Utility ❑ Specify: M Mixed Use ❑ Specify S Special Use ❑ Specify: _ ___..._,,.n._.,..�.._A. - „_____ -_. COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing 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 sr 1 aI 2�d , __ _.. _. . .... .. ......... 2nd 3rd 3rd - -. _._-.,._-_-.__., .., cn 41h 4- / N Total Area(sf) / Total Proposed New Construction(sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone❑ Municipal ❑ On site disposal system .1 Versionl.7 Commercial Building Permit May 15,2000 Fs L.7 C,d! D ,, wt �, �epattment use otyy City of Northampton Sta gf,Perntt 4 4 ' AUG 2 Q Building Department Cur�✓ut/D�ttrewa�a PetCu t , 'ms, er iiaW r 212 Main Street =Swe/Sepc- asli)ity g %t ".c A Room 100 v Water/Wei Aa4ab 4 ,W MP'N :,01060 NS Northampton, MA 01060 Two;�et`s.'of S aura ieians � - r' __e.__ _.___. phone 413-587-1240 Fax 413-587-1272 k7:Stte,Plans ' Z. Y Y L7ther S,,,,,,,, ,,;;;:;Fig,_ ed '7; ,. 1 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 1L 9, Qi4^ e- ,QO� Map Lot Unit -/--e2-2. ---/%16.&-7 ! `' fli 0/069- Zone Overlay District o.° Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: /14eVb1/411A)/ dO1t ik ())Alkow A.c3 0 '47/°'", Name(Print) , Current Mailing Address: 41 /1 S 7 Signature �. �r Telephone 2.2 Authorize• Agent: Name(Print) Current Mailing Address: --1.--0—g-.- 16419YCLA-**----- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only ` completed by permit applicant 3 1. Building (a)Building Permit Fee 2. Electrical • , � . (b) Estimated Total Cost of 3 vl�� GAD �6) • 0 Construction from(6) __....,<._.. ... ( 3. Plumbing/ A. 41 000 , p U ; Building Permit Fee j 4. Mechanical(HVAC) _� 1 . Fire Protection , . 6. Total=(1 +2+3+4+5) , (.30,700 ' crz) Check Number /// 6A This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date 8' 6t NI ES 5/uvrr` oAvvIAC So;Mf cU71fj& DAv'tAG v t � -, File#BP-2014-0208 APPLICANT/CONTACT PERSON KEVIN D O'BRIEN ADDRESS/PHONE 66 GRALIA DR SPRINGFIELD (413)538-1556 PROPERTY LOCATION 491 BRIDGE RD-MEADOWBROOK APMTS-UNIT 2 MAP 17D PARCEL 012 001 ZONE URB(100)/WP(28)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building ding /ion a ill/f)10 Building Permit Filled out Fee Paid Typeof Construction: REPAIR SMOKE&WATER DAMAGE TO 8 UNITS(222,223,224,232,233,234,213,214) 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 FOLL G ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO TION PRESENTED: pproved 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 . 400 Delac., �0 3 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. 491 BRIDGE RD-MEADOWBROOK APMTS-UNIT 2 BP-2014-0208 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17D-012 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:RENO WIRING BUILDING PERMIT Permit# BP-2014-0208 Project# JS-2014-000178 Est. Cost: $30700.00 Fee: $184.20 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KEVIN D O'BRIEN Lot Size(sq. ft.): 1169150.40 Owner: MEADOWBROOK PRESERVATION ASSOCIATES LTD PARTNERSHIP Zoning:URB(100)/WP(28)/ Applicant: KEVIN D O'BRIEN AT: 491 BRIDGE RD- MEADOWBROOK APMTS-UNIT 2 Applicant Address: Phone: Insurance: 66 GRALIA DR (413) 538-1556 WC SPRINGFIELDMA01128 ISSUED ON:8/22/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:REPAIR SMOKE &WATER DAMAGE TO 8 UNITS (222,223,224,232,233,234,213,214) 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 8/22/2013 0:00:00 $184.20 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner