23A-040 (9) SECTION IV— CHAPTER 34 ANALYSIS ALTERATIONS—LEVEL I
WORK AREA#3
GENERAL: 601: The work shall not reduce the level of conformance to building, fire,
plumbing,mechanical or electrical codes in effect at the time that the affected areas of the
building were constructed.
BUILDING ELEMENTS AND MATERIALS: 602: All new work shall comply with
materials and methods requirements in the International Building Code,International Energy
Conservation Code, and International Mechanical Code, as applicable.
FIRE PROTECTION: 603: Automatic Sprinkler Systems will not be required as a result of
the reconfiguration of space as this work does not rise to the level of"major alterations"as
defined by The Commonwealth of Massachusetts, Fire Safety Commissioner's Automatic
Sprinkler Appeals Board, (see Memorandum and Advisory Guidance Document,dated October
14, 2009),and therefore do not trigger the requirements set forth in M.G.L. c. 148, § 26G.
MEANS OF EGRESS: 604.1: Alterations shall be done in a manner that maintains the level of
protection provided for the means of egress, and in accordance with section 102.2.2.1.
There is a sufficient number of exits serving every story. The exit component widths are
sufficient to provide adequate exit capacity. The existing exit stairways shall comply with 780
CMR 10.00 for door closing, handrails, exit signage and emergency lighting.
ACCESSIBILITY: 605.1 Accessibility requirements shall be in accordance with 521 CMR.
There are no additional requirements beyond those identified in Section 706 above.
STRUCTURAL: 606: No additional requirements beyond those identified in Section 707
above.
ENERGY CONSERVATION: 607:No additional requirements beyond those identified in
Section 71.1 above
11
N/A,the Work Area is not shared by more than one tenant, and does not include corridors or
exits that affect others. Therefore,the tenant space undergoing this alteration need only comply
with the means of egress requirements of section 604, (see below.)
SECTION 706 ACCESSIBILITY: Accessibility requirements shall be in accordance with 521
CMR.
Only the work being performed in the work area, (Unit B),is required to comply with 521 CMR
because the cost for the work being performed in this work area is less than$100,000 and is less
than 30%of the full and fair cash value of the first floor of building, (Business Use Group).
Since the work being performed in this areas only involves removal of a single interior partitions
no changes to the existing accessibility of the work area is required.
SECTION 707 STRUCTURAL: Structural elements and systems within buildings undergoing
Level 2 alterations shall comply with this section. 707.2 New structural elements.New
structural elements in alterations, including connections and anchorage, shall comply with the
International Building Code.
N/A,the proposed alteration involves the removal of a single non-bearing interiorpartition, and
the cosmetic repair of the effected ceiling drywall and finish flooring surfaces.
SECTION 709 MECHANICAL: All reconfigured spaces intended for occupancy and all
spaces converted to habitable or occupiable space in any work area shall be provided with
natural or mechanical ventilation in accordance with the International Mechanical Code.
Exception: Existing mechanical ventilation systems shall comply with the requirements of
Section 709.2.
N/A,the proposed removal of a single interior partition does not involve the mechanical system
of the work area.
SECTION 711 ENERGY CONSERVATION: Minimum requirements. Level 2 alterations
to existing buildings or structures are permitted without requiring the entire building or structure
to comply with the energy requirements of the International Energy Conservation Code or
International Residential Code.
N/A,the new elements within the work areas do not affect any the applicable energy provisions
of the International Energy Conservation Code.
10
SECTION 704 FIRE PROTECTION Automatic Sprinkler Systems will not be required
because they do not trigger the requirements set forth in M.G.L. c. 148, § 26G. The
reconfigurations in the work area does not rise to the level of"major alterations"as defined by
The Commonwealth of Massachusetts,Fire Safety Commissioner's Automatic Sprinkler Appeals
Board.
704.2 Automatic sprinkler systems.N/A, Automatic Sprinkler Systems will not be required
because they do not trigger the requirements set forth below.
704.2.1 High-rise buildings. N/A.
704.2.2 Groups In buildings with occupancies in Group A, B, E, F-1,H, I, M, R-1, R-2, R-4,
S-1 and S-2,work areas that have exits or corridors shared by more than one tenant or that
have exits or corridors serving an occupant load greater than 30 shall be provided with
automatic sprinkler protection where all of the following conditions occur:
1. The work area is required to be provided with automatic sprinkler protection in
accordance with the International Building Code as applicable to new construction;
2. The work area exceeds 50 percent of the floor area; and
3. The building has sufficient water supply for design of a fire sprinkler system
available to the floor without installation of a new fire pump.
N/A,The work area is less than 50%of the floor area for this Group B use and the occupant
load is less than 30, (17).
704.3 Standpipes.N/A,The work area does not include exits or corridors shared by more than
one tenant nor is it located more than 50 feet above the lowest level of Fire Department Access.
704.4 Fire alarm and detection.An approved fire alarm system shall be installed in accordance
with Sections 704.4.1 through 704.4.3.
N/A,The combined Group B occupant load of the first floor is 17.
704.4.2 Supplemental fire alarm system requirements. N/A,The work area is less than 50%
of that floor area.
704.4.3 Smoke alarms.N/A,this is a Group B work area.
SECTION 705 MEANS OF EGRESS The requirements of this section shall be limited to work
areas that include exits or corridors shared by more than one tenant within the work area in
which Level 2 alterations are being performed, and where specified they shall apply throughout •
the floor on which the work areas are located or otherwise beyond the work area.
9
SECTION IV—CHAPTER 34 ANALYSIS - RECONFIGURATION OF SPACE
WORK AREA#3
GENERAL Level II Alterations include the reconfiguration of space,the addition or
elimination of any door or window,the reconfiguration or extension of any system,or the
installation of any additional equipment.
701.3 Compliance.All new construction elements, components, systems, and spaces shall
comply with the requirements of the International Building Code.
BUILDING ELEMENTS AND MATERIALS 703.1 Scope The requirements of this section
are limited to work areas in which Level 2 alterations are being performed, and shall apply
beyond the work area where specified.
703.2 Vertical openings N/A, There are no vertical openings in the work area.
703.3 Smoke barriers, N/A in this Group B Work Area.
703.4 Interior finish. The interior finish of walls and ceilings in exits and corridors in any work
area shall comply with the requirements of the International Building Code.
Exception: Existing interior finish materials that do not comply with the interior finish
requirements of the International Building Code shall be permitted to be treated with an
approved fire-retardant coating in accordance with the manufacturer's instructions to achieve
the required rating.
This Requirement shall be met.
TABLE 803.9
INTERIOR WALL AND CEILING FINISH REQUIREMENTS BY OCCUPANCY
NONSPRINKLERED
Exit •
enclosures and Rooms and
exit enclosed
GROUP passagewayeb Corridors spaces'
B, E, M, R-1 A B C
7033 Guards N/A in this work area.
8
521 CMR 3.3.1 If the work being performed amounts to less than 30% of the full and fair
cash value of the building and
a. if the work costs less than $100,000,then only the work being performed is required to
comply with 521 CMR
3.6 MULTIPLE USES When a building is occupied by two or more uses, the
Regulations which apply to each use shall apply to such parts of the building within that use.
3.6.1 521 CMR 3.3, Existing Buildings shall apply based upon each use and not on the
entire building.
3.7 PARTIAL APPLICATION When only a portion of a building is subject to 521 CMR,
the full and fair cash value shall be prorated by the ratio of the square footage of that portion
to the square footage of the whole building.
Only the work being performed in the work areas, (units A and C), are required to comply with
521 CMR because the costs for the work being performed in this work area is less than$100,000
and is less than 30%of the full and fair cash value of the first floor of building, (Business Use
Group). Since the work being performed in these areas only involves repair of the interior
partitions,no changes to the existing accessibility of the work areas are required.
SECTION 506 STRUCTURAL Structural repairs shall be in compliance with this section and
Section 501.2. Regardless of the extent of structural or nonstructural damage, dangerous
conditions shall be eliminated. Regardless of the scope of repair,new structural members and
connections used for repair or rehabilitation shall comply with the detailing provisions of the
International Building Code for new buildings of similar structure,purpose and location.
506.2.1 Repairs for less than substantial structural damage. For damage less than substantial
structural damage,the damaged elements shall be permitted to be restored to their predamage
condition.
The interior partitions undergoing repair in Work Areas#1 and#2 have less than substantial
structural damage, and will be restored to their predamage condition.
SECTION 508 MECHANICAL Existing mechanical systems undergoing repair shall not
make the building less conforming than it was before the repair was undertaken.
7
It was the conclusion of the board that if the nature of the work is the type of work
described in Part A and also meets at least one of the two presumptions described in Part
B,then it can reasonable to conclude that the alterations or modifications are"major",
thus requiring sprinklers throughout the building.
If the specific permitted alterations or modifications are not considered"Major"as
described,but appear to be one phase of a series of modifications being conducted over a
reasonably short period(i.e. five years or less), it may be reasonable to conclude that such
work could be part of a long range project resulting in"major alterations"to the entire
building, or a substantial portion of it,thus triggering the sprinkler requirements.
Consideration should be given to determine if there is a series of future and recent past
planned projects that,taken together,would be amount to"major"alterations.
SECTION 504 MEANS OF EGRESS Repairs shall be done in a manner that maintains the
level of protection provided for the means of egress, and in accordance with section 102.2.2.1.
102.2.2.1 Existing Non-Conforming Means of Egress: The following conditions shall be
corrected in all existing buildings:
1. Less than the number of means of egress serving every space and/or story, required
by Chapter 10 of the International Building Code 2009 with Massachusetts
Amendments(780 CMR 10.00);
There are a sufficient number of exits serving the building.
2. Any required means of egress component which is not of sufficient width to provide
adequate exit capacity in accordance with section 1005.1 of the International
Building Code 2009 with Massachusetts Amendments(780 CMR 1005.1);
The exit component widths are sufficient to provide adequate exit capacity
3. Any means of egress which is not so arranged as to provide safe and adequate means
of egress, including exit signage and emergency lighting in accordance with Chapter
10 of the International Building Code 2009 with Massachusetts Amendments(780
CMR 10.00); or
The existing exit stairways shall comply with 780 CMR 10.00 for door closing,handrails,exit
signage and emergency lighting.
SECTION 505 ACCESSIBILITY Accessibility requirements shall be in accordance with 521
CMR. 521 CMR 3.3 EXISTING BUILDINGS: All additions to,reconstruction, remodeling,and
alterations or repairs of existing public buildings or facilities,which require a building permit or
which are so defined by a state or local inspector,shall be governed by all applicable subsections in
521 CMR 3.00.
6
The Commonwealth of Massachusetts, Fire Safety Commissioner's Automatic Sprinkler
Appeals Board, (hereinafter the"Board"),has defined the term"Major Alterations" in its
Memorandum and Advisory Guidance Document, dated October 14,2009. The Board
established a two pronged test to determine if the proposed work is rises to the level
sufficient to be considered "major alteration"and thereby triggering the requirements of
M.G.L. c. 148, § 26G
Part A-Nature of the Actual Work.
• Is the planned physical work the type of work that would make the effort to install
sprinklers substantially less than it would have been if the building were intact?
• Is the work merely minor repair or cosmetic vs. major alterations? Examples of
"major"alterations or modifications include,but may not be limited to:
o The demolition or reconstruction of existing ceilings or installation of suspended
ceilings;
o The removal and/or installation of sub flooring, not merely the installation or
replacement of carpeting or finished flooring;
o The demolition and/or reconstruction or repositioning of walls or stairways or
doorways; or
o The removal or relocation of a significant portion of the building's HVAC,plumbing •
or electrical systems involving the penetration of walls, floors or ceilings.
Part B-Scope of the Work or Cost/benefit of Sprinkler Installation.
This involves a review of the scope of the major alterations or modifications to see if they
affect a substantial portion of the building. This requires a review to determine how
much of the building is being affected by the work; or a determination that the cost of
installing sprinklers is moderate in comparison to the total cost of the work.
"To assist fire officials,building owners and construction project managers in making
decisions,the Board has established the following two presumptions that may be used to
determine if the scope or the costs of the planned alterations or modifications are"major"
thus requiring sprinklers to be installed throughout the building.
1.) Major alterations or modifications are reasonably considered major in scope
when such work affects thirty-three(33)%or more of the "total gross square
footage"of the building, calculated in accordance with section 26G.
2.) Major alterations or modifications are reasonably considered major in scope
or expenditure,when the total cost of the work(excluding costs relating to •
sprinkler installation) is equal to or greater then thirty-three (33)%of the
assessed value of the subject building, as of the date of permit application.
5
UNSAFE: Buildings, structures or equipment that are unsanitary, or that are deficient
due to inadequate means of egress facilities, inadequate light and ventilation,or that
constitute a fire hazard, or in which the structure or individual structural members meet
the definition of"Dangerous," or that are otherwise dangerous to human life or the
public welfare, or that involve illegal or improper occupancy or inadequate maintenance
shall be deemed unsafe. A vacant structure that is not secured against entry shall be
deemed unsafe.
DANGEROUS: Any building, structure or portion thereof that meets any of the
conditions described below shall be deemed dangerous:
1. The building or structure has collapsed,partially collapsed,moved off its
foundation or lacks the support of ground necessary to support it.
2. There exists a significant risk of collapse, detachment or dislodgment of any
portion,member, appurtenance or ornamentation of the building or structure
under service loads.
The buildingand work areas are"safe"and are not"dangerous"as defined above. New and
replacement materials shall comply with this section.
502.2 New and replacement materials. Except as otherwise required or permitted by this code,
materials permitted by the applicable code for new construction shall be used. Like materials
shall be permitted for repairs and alterations,provided no dangerous or unsafe condition, as
defined in Chapter 2, is created. Hazardous materials,such as asbestos and lead-based paint,
shall not be used where the code for new construction would not permit their use in buildings of
similar occupancy, purpose and location.
502.3 Glazing in hazardous locations. Replacement glazing in hazardous locations shall
comply with the safety glazing requirements of the International Building Code or International
Residential Code as applicable. Exception: Glass block walls, louvered windows,and jalousies
repaired with like materials.
SECTION 503 FIRE PROTECTION Repairs shall be done in a manner that maintains the
level of fire protection provided. 503.2 Major Alterations. Automatic sprinkler systems may be
required in buildings undergoing major alterations per section 102.2.1.1
Automatic Sprinkler Systems will not be required as a result of the proposed repairs because
these repairs do not rise to the level of"major alterations"and therefore do not trigger the
requirements of M.G.L. c. 148, § 26G.
102.2.1.1 Major Alterations.When existing buildings or portions thereof undergo
additions or alterations, M.G.L. c. 148, § 26G may apply with respect to automatic sprinkler
requirements.
4
SECTION III— CHAPTER 34 ANALYSIS-REPAIRS -WORK AREAS#1 AND#2
SECTION 501 GENERAL Repairs as described in Section 402 shall comply with the
requirements of this chapter.
402.1 Repairs, as defined in Chapter 2,include the patching or restoration or replacement of
damaged materials,elements, equipment or fixtures for the purpose of maintaining such
components in good or sound condition with respect to existing loads or performance
requirements. Chapter 2 Defines"Repair"as the restoration to good or sound condition of
any part of an existing building for the purpose of its maintenance.
The proposed work in areas#1 and#2 meet the definition of repairs.
402.3 Related work. Work on nondamaged components that is necessary for the required
repair of damaged components shall be considered part of the repair and shall not be subject
to the provisions of Chapter 6,7, 8, 9 or 10.
501.2 Conformance. The work shall not make the building less conforming than it was before
the repair was undertaken
501.3 Flood hazard areas. In flood hazard areas,repairs that constitute substantial improvement
shall require that the building comply with Section 1612 of the International Building Code.
Substantial Improvement For the purpose of determining compliance with the flood
provisions of this code, any repair,alteration, addition,or improvement of a building or
structure,the cost of which equals or exceeds 50 percent of the market value of the structure,
before the improvement or repair is started. If the structure has sustained substantial
damage,any repairs are considered substantial improvement regardless of the actual repair
work performed. The term does not,however,include either:
1. Any project for improvement of a building required to correct existing health, sanitary,
or safety code violations identified by the code official and that is the minimum necessary
to assure safe living conditions,or
2. Any alteration of a historic structure provided that the alteration will not preclude the
structure's continued designation as a historic structure.
The proposed repairs in work areas#1 and#2 meet the definition of repairs pursuant to section
501 and the costa of the proposed repairs do not eguals or exceeds 50 percent of the market value
of the structure.
SECTION 502 BUILDING ELEMENTS AND MATERIALS
Materials already in use in a building in conformance with requirements or approvals in effect at
the time of their erection or installation shall be permitted to remain in use unless determined by
the code official to render the building or structure unsafe or dangerous as defined in Chapter 2.
3
SECTION 1 —HISTORY/SCOPE OF WORK
The Work Area Compliance Method is utilized for the compliance analysis for the work
performed pursuant to this building permit application. There are three distinct work areas within
the building located at 52 Maple Street,Northampton,MA. Work areas#1  are Repairs,
and work area#3 is an Alteration—Level II.
Work Area#1 is located in Unit A,(316 ft2), at the wall adjoining Units A and B"the work
involves non-structural repairs to holes and other damage of the interior partition wall.
Work Area#2 is located in Unit C,(564 ft2), and involves non-structural repairs to holes and
other damage of several interior partition walls.
Work Area#3 is located in Unit B, (399 ft2). This work involves an alteration/reconfiguration of
the space by removal of a non-nearing, interior partition in order to create a larger open space.
There is no change in use in any of the work areas.
SECTION II—BUILDING DESCRIPTION—EXISTING
The existing building is two stories,24 feet in height, currently being used as a Mixed Use Non-
Separated Structure. The Construction Type is VB, (wood framed, non-protected). The building
is constructed as follows:
Foundation: Stone below grade, with Masonry above grade.
Walls: Wood framing
Floors: 2 x 8"Joists/Wood decking/ Carpet and sheet vinyl
Roof: Wood Rafters/Wood decking/Asphalt Shingles
Total basement area: 993 Sq. Ft.
Total first floor area interior: 1,693 Sq. Ft.
Total second floor area interior: 1,654 Sq. Ft.
Total aggregate area: 4,340 sq. Ft.
The Existing Use Groups:
First Floor B
Second Floor: R-3
2
INVESTIGATION AND EVALUATION REPORT
Pursuant to
Massachusetts State Building Code (780 CMR),
Eighth Edition, Base Volume
Chapter 34 — The Existing Building Code of Massachusetts
OCTOBER 11, 2011
DAVID TEECE
52 MAPLE STREET
NORTHAMPTON, MA 01060
REPAIR&RECONFIGURATION OF BUSINESS SAC y
-
4 9 poi/ I
+
SIEGFRIED PORTH,A.I.A.
MICHAEL J. DUVAL
116 PLEASANT STREET,
EASTHAMPTON,MA 01027
(413)-529-9434
1
City of Northampton
Massachusetts xtvti'v'
t DEPARTMENT OF BUILDING INSPECTIONS -y_
212 Hain Street • Municipal Building 0% to
r = Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Fax:413-587-1272 Chuck Miller
Building Commissioner Phone:413-587-1240 Assistant Commissioner
CONSTRUCTION CONTROL DOCUMENT
(For professional Engineers/Architects responsible for Entire Project)
Project Title: Date: i//i 02
Project Location: 52. Map: Parcel: Zone:
Scope of Project: / 4/A
In accordance with the Eighth edition Massachusetts State Building Code, 780 CMR Section 107.6:
I, i "AP. .41 Zr Mass.Registration# ,
Being a registered professional Engineer/Architect he by CERTIFIES that I have prepared or directly supervised
the preparation of all design plans,computations an specifications concerning:
NTIRE PROJECT
For the above named project and that to the best of my knowledge,such plans,computations and specifications
meet the applicable provisions of the Massachusetts State Building Code,all acceptable engineering practices
and all applicable Laws for the proposed project.
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that
the above mentioned portions of the work proceed in accordance with the documents approved for the building
permit and shall be responsible for the following as specified in Section 10.7.6.2.2:
1. Review of shop drawings,samples and other submittals of the contractor as required by the
construction documents as submitted for the building permit,and approval for the conformance
to the design concept.
2. Review and approval of the quality control procedures for all code-required controlled materials.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine, in general,if the work is being performed
In a matter consistent with the construction documents.
I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent
comments. Upon completion of the work,I shall submit to the building official a final report as to the satisfactory
completion and readiness of the project for occupancy.
Sign. = and Seal; '-gi ' � �{, F '' .
b Oro,
` � ffi,lain r 'r-�.., �1,�.. 11
_Day of A1 20 / tp ,
o y T (sea[).A
'\ The Commonwealth of Massachusetts
-r---' Department of Industrial Accidents
� �f-- Office of Investigations
_• 600 Washington Street
r Boston,MA 02111
_ y
`".".� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers
Applicant Information / J Please Print Legibly
Name(Business/Organization/Individual):_ '€ka,,.I /� A , /7L
Address: 4 8 Al
-►v, k-e ry-f if
City/State/Zip: g,b 0�010_3 3 Phone#: `Yt`/3 5-3-.31 7Y
Are you an employer?Check the aEropriate box: Type of project(required): I
1.2'I am a employer with 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'
Y P ty 9. 0 Building addition
[No workers'comp. insurance - comp.insurance.t
required.] . 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.CI
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 12.0 Roof repairs
insurance required.]t c. 152,§1(4),and we have no
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 anew 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.
Insurance Company Name: ,4- _
Policy#or Self-ins.Lic.#: V Ui C. (,ties' O?O/ O/3 Expiration Date: 5 /eo-- /3
Job Site Address: 3Ti (C ._, City/State/Zip: A� ,�, O/.OG d
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 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to 5250.00 a day against the violator. Be advised that a co py of this statement may be forwarded to the Office of
Investigations of the DU for insurance coverage verification.
I do hereby certify under the pains and'en'Ities of perjury that the information provided above is true and correct.
1 — ' d
i''ature: I_ .�1 , /_/.� Date: v`-C/ — -
Phone#: 913 c fT . 7i-//0
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 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
PAII d 7:;‘ 4 /1[4;gea_ _ .. as Owner of the subject property
Li-- 6 /citt.i
hereby authorize
_mai.. my b: all matters relative to work authorized by t ' building permit application. if
Witir Ar °- /11,••i
Signature of Owner ate
I. ,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 p_ain .enalties of•-1-ju .
if/ /
Print Nam7
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable
Name of License Holder:
_
License Number
IM I
5_ _LT: c _ °LQJ 3
.•
Addre Expiration Date
/12611%- 1_712. ...-5-_rezi"
Signa ure 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 (27 No 0
Version1.7 Commercial Building Permit May 15,2000
f
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 ENISLOSED SPACE)
9.1 Registered Architect:
`_,e— . ____ � /J :64 ' Not Applicable ❑ _ _
Name(Registrant): �/!/ /� �! ; .
I�0< ,. rtz7- c .�►��27.•i 1 %._za _ i 't_i Registration Number _. ----_._._ ..
Address -� T ± _a .
4-4 Expiration Date
./ :Or. ...Li. ../Afr...44%,
Signature ," Telephone
9.2 Registe == rofessional Engineer(s):
Name Area of Responsibility
Address Registration Number
,
Signature Telephone Expiration Date �'~ __y
f 4
Name Area of Responsibility —`
Address R,ge istration Number ______
Signature Telephone Expiration Date
Name __..- ��'— �� — Area of Responsibility _.._.___ ___W.____. __
___.______-_-__.__-_...�-_ I
Address �'� Registration Number —^
3
Signature Telephone Expiration Date
i
•
Name Area of Responsibility
i
s Y Registration Number ___ �__._.__.
Address
Signature Telephone Expiration Date
9.3 General Contractor
----— Not Applicable❑
Company Name:
Responsible In Charge of Construction �� __
• 6E1644% . .5i_ 6 A A__ .6. 1 I
Address
i I i-5) . -7`1/0
Signatur Telephone
Version1.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
' .
Existing Proposed Required by Zoning .
• This column tote filled in by
Building Department
:----- , - ----
■ _.....—______
Lot Size ,
Frontage
Setbacks Front
7----- ,'-----1 ---- __-_
_ . ---
Side L:" ' R: , L:i.._ _.: R:'______,
Building Height r- 1 ---
1 -
Bldg. Square Footage -
ootage ---- ' --— % ,--' -- -------,
Open Space Footage __., %
__. .
(Lot area minus bldg&paved , - , -------
-- —.......-...
parking)
#of Parking Spaces r---1 -I - i
'
Fill: .! .
(volume&Location) ' i ---.--------- .
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 (3 DONT KNOW 0 YES 0
Page
IF YES: enter Book f
' and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 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 0 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 n
• IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
•
Version 1.7 Commercial Building Permit May 15,2000
J
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition] Repairs® Additions ❑ Accessory Buildinan S
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing 0 Change of Use❑ Other❑
Brief Description Ent r a brief description here. ei'Ul-new 6 S PX1. °�d I,�c 1-
Of Proposed Work:R 9 rizt-/l� er;,)v- G t-cywa,�1 t�n1..' I't t t3 'u.ce C . 11- gtiei4.ri
s
f ^Ye+f t 3 .•.- • /, ..... owl I/, • � 71 .• _• ./ ^.... ..4.........
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) I CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 0 1A 1 ❑
A-4 ❑ A-5 ❑ . 1B ❑
B Business I 2A ❑
E Educational ❑ 2B r ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ ___ - - 3A f1 ❑
I Institutional ❑ i-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 lij R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:r w �.
M Mixed Use Specify:1
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING.RENOVATIONS;ADDITIONS AND/OR CHANGEIN USE
Existing Use Group: --v� Proposed Use Group: ____ -- w
Existing Hazard Index 780 CMR 34):'_.._._4Gt/. 7/77-L.4.e__ Proposed Hazard Index 780 CMR 34): AO . e i-e--
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
_. st
_ 6-
151 _ 54E-, 1 ,d
2n° /6,6.477-i 2n
_ ---_____—_...._.____------^"
e C 4� _l7,. -" 3rd r.v_ __
4th 4th __
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 ❑ Zone __, ____ : Outside Flood ZoneO Municipal ❑ On site disposal system
.4
Version1.7 Commercial Building Permit Ma 15,2000
;,,,,,s11.4.1t-4:40-Aw-g,',--44,-74t.q,_14„Prcltv,zts . lz
-. e", a 0--y. ,equiv,_,,,,,,,„._,,,..,,,,,,„„.a..i,,,,,d,...,:z4.4-! ,,,- •,,e',..7-T-,T
se,,,,,,,,,-oat • .. -bt , ";4%1"•" '4. , * ‘`• '•%'''' ,4' :'''..f...7.:
---•• ' Room 100
Northampton, MA 01060
DEPT OF BUILDING INsemino-i t kt**, ,n ''n', ,"4,1t1"3'141.,#,Z4. :o 4,,V,jA,%,...-:■VV,.1.. '',,,..;' , ;
NORTHAMPTON MA oss-- 41 -587-1240 Fax 413-587-1272
.9.,,WP5,01.1', 7-,!!''..•"-: J57-4:411 = 111:7: 2 -i',7.
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
This section to be completed by office
1.1 Property Address:
Sa Aft(6S- rirt. -4 -J2 Map------ Lot Unit
,
; Zone Overlay District
, .
---- — Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
.
2.1 Owner of Record: /
---Sne.,/----Aiacr-p- ________ - ------- ----------4-??
Name.(Print) ------d F : fe g_co., ilt--7,c_4/1--- Current Maiiling Address:7 ...:_riersz
C-C---
Signature Telephone
2.2 Authorized Agent:
'-----1--)e1S-,CT - ------
----7 _
Name(Print) Cu rr iiigAdress _..
Signature ,...) ejva 411 4/66- Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed py permit applicant .
1. Building s An-NO i (a)Building Permit Fee
i -
2. Electrical ---1 (b)Estimated Total Cost of
, ■ Construction from(6)
• _________ ___________
3. Plumbing I Building Permit Fee
4. Mechanical(HVAC)
----7
5. Fire Protection .. _______
6. Total=(1 +2+3+4+5) Check Number 02.. $
7/ .,0--
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Cornmissioner/Inspector of Buildings Date
52 MAPLE ST BP-2013-0580
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23A-040 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-2013-0580
Project# JS-2013-000933
Est. Cost:$6000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: GERALD ARCHAMBAULT 010788
Lot Size(sq.ft.): 20603.88 Owner: SEAWINK LTD
Zoning: GB(100)/ Applicant: GERALD ARCHAMBAULT
AT: 52 MAPLE ST
Applicant Address: Phone: Insurance:
68 AMHERST ST (413)552-7410 0 Workers Compensation
GRANBYMA01033 ISSUED ON:11/26/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT REAR STEPS, REPAIR DRYWALL,
BRACE CELLAR BEAMS, REMOVE 3 PARTITIONS (UNIT C)
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 11/26/2012 0:00:00 $55.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2013-0580
APPLICANT/CONTACT PERSON GERALD ARCHAMBAULT
ADDRESS/PHONE 68 AMHERST ST GRANBY (413)552-7410 0
PROPERTY LOCATION 52 MAPLE ST
MAP 23A PARCEL 040 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid �
Building Permit Filled out ( 5
Fee Paid
Typeof Construction: CONSTRUCT REAR STEPS,REPAIR DRYWALL,BRACE CELLAR BEAMS,
REMOVE 3 PARTITIONS(UNIT C)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 010788
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO AATION 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
Demolition Delay
Q ■ L tlZA1,
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.
Initial Construction Control Document
/, To be submitted with the building permit application by a
Registered Design Professional
rr for work per the 8th edition of the
I wor p
l's54 Massachusetts State Building Code, 780 CMR, Section 107.6.2
imp s
Project Title: 52 MAPLE STREET Renovations_ Date: 12 ULY 2013
Property Address: 52 MAPLE STREET, FLORENCE, MA
Project: Check one or both as applicable[New constructionrIxisting Construction
Project description: Install new interior finishes and electrical wiring to two commercial units.
Reinforce existing wood structure as required.
Thomas uql S MA Registration Number: _ Expiration date: 8100113, , am a
registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design
plans, computations and specifications concerning:
[ ] Entire Project Architectural [ ] Structural [ ] Mechanical
[ ] Fire Protection [ ] Electrical [ ] Other
for the above named project and that such plans, computations and specifications meet the applicable provisions of the
Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I
understand and agree that I (or my designee) shall perform the necessary professional services and be present on the
construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
When required by the building official, I shall submit field/progress reports (see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work,I shall submit to the buil' 'al a 'Final Construction Control Document'.
, VI!414-
r.
"wet" 44, t4
Enter in the space to the right a wet or 1
electronic signature and seal: '`°"talltedirM y
413-585-081n ; r
Phone number: ail: r-dOurliaSgtd0041aSarChiteCtS.COM
Building Official Use Only
Building Official Name: Permit No.: Date:
Trial Version 10_09 2012
The Commonwealth of Massachusetts
Department of Industrial Accidents
— -- Office of Investigations
600 Washington 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): ( e X 5 rl I S ECh _
Address: 1,62(4 Q k2 jZ-‹ 1 017—.
City/State/Zip: HA Otc Phone#: 5� -I y
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. 12] I am a general contractor and I
6. ❑New construction
employees (full and/or part-time).* have hired the sub-contractors
2.g I am a sole proprietor or-partner- listed on the attached sheet. 7. ❑Remodeling
These sub-contractors have
ship and have no employees 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 10.0 Electrical repairs or additions
officers have their Plumbing repairs or additions
3.❑ I am a homeowner doing all work ave exerc r 11.❑
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 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 narne 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 co py of this state ment may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and pe aloes of perjury that the information provided above is true and correct.
Signature: At" GL. , Date: / / It,
Phone#: tir3 - S I to —' �l ).
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
•
SECTION 10-,STRUCTURALpEER REVIEW(780 CMR 110 11)
Independent Structural Engineering Structural Peer Review Required • Yes C No 0
SECTION 11 -OWNER AUTHORIZATION'1'0 13E:COMPLETED,:WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, j,as Owner of the subject property
act on my behalf, in all matters relative to work authorized by this building permit application.
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 undertne_pains
Print Name
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTIORSERVICES .
10.1 Licensed Construction Supervisor: Not Applicable El
Name of License Holder Alrg-AAn=c-2- GtkIsEL
License Number
4,4 Q..V.I .C2.6 T)D- —Otoqa A
Address Expiration Date
d \t'7 it4
Signature Telephone
SECTION.13-WORKERS COMPENSATION INSURANCE AFFIDAVIT(M G L c 152,§.25C(S))
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 C 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 EIJlc:LOSEDSPACE)
9.1 Registered Architect:
__.,_ _ _ Not Applicable ❑ __ __ .. ___.
`'_.,"'."'
fr. 4 EiT:oar■i a w• • rte rill•_.a -
Name(Registrant):
Registration Number
__ _ _ _
Address , ____ _ ._. _ __ _..._,_...._.._,.,..'
Expiration Date
i
Signature Telephone
9:2 Registered Professional Engineer(s):
7
€ , _
Name Area of Responsibility _
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address . Registration Number
Signature Telephone Expiration Date
i
Name Area of Responsibility
J f
Address . Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
I
Address ._ �_ __________. — Registration Number_,_.._.. .. _ _______.
i
Signature Telephone Expiration Date
9.3 General Contractor
� _ ..,_,_.._.._.._ _._._..__._..._....,_ --- _,__._._,.__._._ _ __,...._ Not Applicable ❑
Company Name:
____
Responsible In Charge of Construction ��� � ____.
_Address__ _
I
Signature Telephone
•
, .
Version1.7 Commercial Building Permit May 15,2000
4 ,
8. NORTHAMPTONZONING
. . .
Existing Proposed• Required by Zoning .
This column 6 re filled in by
Building Department
Lot Size L__ _ L.. ... , . .., I L , _
,--- ' ', ......_
Frontage
..*
Setbacks Front T1 1 ,
;"---1 ---' —7 I
Side L:.? = R:,1. I L:: I R:I J
,..., ..
f €
Rear ----4
Building Height
Bldg. Square Footage ri
Open Space Footage ; %
,-,----
r......____I
=
(Lot area minus bldg&paved - I I . 1 ! -.7 3— L____;
parking)
#of Parking Spaces —1
Fill:
(volume&Location) 1
--- —
....
— ----
•
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 0
IF YES: enter Book '
? Page ' and/or Document#t
,
B. Does the site contain a brook, body of water or wetlands? NO 0 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
(3 , Date Issued: ! I
C. Do any signs exist on the property? YES 0 NO 0
...... .....„
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 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.
Version1.7 Commercial Building Permit May 15,2000
J
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 h
CUBIC FEET OF ENCLOSED SPACE '
Interior Alterations ❑ Existing Wall Signs i[1 Demolition IN. Repairs If Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑
Brief Description ;Enter a brief description here. _ /kV'P '.1"'"A C WOR V : Tksfe.«i VP-AL4 JC
Of Proposed Work: W 1.kw4+ - NC+' lkFch..4.w AcL Qc'^�+•vc I' t .A:I-cArlt (CAIN'Ttcx.1
low..4a p*°erg J CCI(-4' , QsilAcce wee, l�►eyu►iAL� __ _ ,
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE 0
A Assembly A-1 ❑ A-2 ❑ A-3 ❑ 1 AA I❑
A-4 ❑ A-5 ID
B Business RI 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 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify: 1 _ . _W _. _ _.
M Mixed Use ® Specify:I i
I
_____—_— ______ ____
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: ___________ ___ € Proposed Use Group: _ ..Y_.
Existing Hazard Index 780 CMR 34):_„ __ ,__ Proposed Hazard Index 780 CMR 34): < _._ w_.___._w. _..._.,
SECTION.6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
i
1St , ;
1St _.._..__.._.._�__ _._. _ - _ .
__ ____ _.__ 2nd
2nd'
..._............ _.._._._...._____...._.._.........,.._, 3rd �.. _.-.� _ ,
,____._.,,_._._.__.. _ 4th
4th .__..-_--.--____......_—_.._...—..
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 ❑ Zone ,,,,._ __ , Outside Flood ZoneD Municipal ❑ On site disposal system❑
-co A A 6
Version1.7 Commercial Building Permit May 15,2000
City of Northampton s'tittfsF.ofPe'thiiigVi*tW4: 1,14.iV4;:iw,z51,i**'..3t;'ki:
,,,,,,,A,00,444•444M0AVAIWRIbffyit-Yapliti:65W40-4ko,2
Building Department
•
212 Main Street '
Room 100 watkthxteirAVaii0bilitkot.,,,i,m,e,q,,,w.v%41,51-1- ?!,,,,,,:,:;,,f:,',..,-,--.
Northampton, MA 01060 TwrurafPfais
phone 413-587-1240 Fax 413-587-1272
Other Spec 1,L'
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
Map c?S A -0;4 0 Lot 001
502 HAP
Unit
r•-4 67r
F c, ••■•• r•••••••• • Zonp, Overlay District
Eim*--gletriCt CB District
SECTION 2-.PROPERTY OWNERSHIP/AUTHORIZEDAppg.,...-
2.1 Owner of Record:
G.4 atuEits %
Name(Print) AK.,c„. Gt.it 6fJ.D Current Mailing Address:
i %Ay 01U-Ag (64 2.
Signature Pted— 41.L. Telephond#35-g G. -- te 9
2.2 Authorized Agent: _
RiI_Name(Print) Current Mailing Address:
Signature if:)L Telephone
SECTION a-ESTIMATED.CONSTRUCTION.COSTS".--• •••
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building • (a)Buildirig Permit Fee
I •!!:
2. Electrical
---- (b)Estimated Total Cost of
• COnattUdibn-from(6)
- •
3. Plumbing Building.Permit.Fee
4. Mechanical(HVAC)
5. Fire Protection ,
. _
6. Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Building Permit Number pate:.
issued
Signature:
Building Commissioner/Inspector of Buildings Date
NEW G3 s75 T 136
A14)1( ° gifetEvc)
Pektkt I. it
58 0 DCTC .Axtl,K
9/9/03
Louis Hasbrouck SEP - 9 2013 1';:'
Commissioner _ s: y,,
Building Northampton -- ' le St.
N Electric, Purbir r F rfs.,.:<.f 52 Maple City Of North rr . . u.-,,l-; One
airs ,-s installing
Hi Lewis the repairs This inc u
of addional costs to 11/26/12. latjon for sound' new
estimate 0130580 issued ceiling This
new sink and
This is framing pa nijt#BP-2 wall,replacing
to amend lighting,installing one
in Florence anew interior
new window,fram addional outlets and
5/S" fire code drywall,floors.
installing hardwood
$5000
1 Electrical.......•.. ........$2000
2, Plumbing. .. 1000
3. Insulation..• .. $9000
4. Flooring..•••.• .$5000
5. Drywall..•..•.�,indaw... 2�..! final
6. Framing/new $24,000 in the orig
Total....•• . of the rear stags included
ction art of a new permit.
include reconstruction does not next month as p
please note this addressed
permit.These will be
Thanks for your help
Alex Ghiselin,
164-Riverside Drive
Bay State Tillage 01062
File#BP-2013-0580
APPLICANT/CONTACT PERSON ALEX GHISELIN
ADDRESS/PHONE 164 Riverside Drive FLORENCE (413)586-1849
PROPERTY LOCATION 52 MAPLE ST
MAP 23A PARCEL 040 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building 0 3'4 I g J
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT REAR STEPS,REPAIR DRYWALL,BRACE CELLAR BEAMS,
REMOVE 3 PARTITIONS(UNIT C)-AMENDED 7/23/13 INSTALL WINDOW,&WALL,REMOVE
PARTIION&DROP CEILING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 010902
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
C/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
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
52 MAPLE ST BP-2013-0580
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23A-040 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-2013-0580
Project# JS-2013-000933
Est.Cost: $6000.00
Fee: $180.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALEX GHISELIN 010902
Lot Size(sq. ft.): 20603.88 Owner: SEAWINK LTD
Zoning: GB(100)/ Applicant: ALEX GHISELIN
AT: 52 MAPLE ST
Applicant Address: Phone: Insurance:
164 Riverside Drive (413) 586-1849
FLORENCEMA01062 ISSUED ON:11/26/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT REAR STEPS, REPAIR DRYWALL,
BRACE CELLAR BEAMS, REMOVE 3 PARTITIONS (UNIT C)-AMENDED 7/23/13 INSTALL
WINDOW, & WALL,REMOVE PARTIION & DROP CEILING
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 9/23/2012 0:00:00 $180.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner