32C-047 (24) I
F-
L.N.BERNECHE INC.
665 Prospect St.
Chicopee,MA 01020
Inberneche.com
Cons,ft-
Address
SOUND PROOF WALL Address
Pho
MASSAGE MASSAGE _hail
BREAK&ART ROOM
Con Rant
Address
Address
Phone
e-nl
ail
Consutlant
Atldress
Address
Phone
Fax
o-mail
Consuhant
Atldress
Address
F-
CLOSET -had
TATTOO
STATIONS --- Conau1w't
Address
Address
Phone
4'PARTITION DIVIDERS(IF REQUIRED) H.C.TOILET Faali
SUPPLY ROOM JAN.
CLOSET CLOSET
DISPLAY CASE
� I
I
I
ARCH WAY
I
I
RECEPTION STORAGE
e�
I —
No. Dexription Date
I I
I
LOBBY AREA OFFICE
I
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F.F.100.00' /
LEVEL SPACE
I I 1 I I
I , �
TATTOO
AFTERLIFE
�'$' ------- --------------�
110 PLEASANT ST.NORTHAMPTON,MA
First Floor
1 Level t
1l4"—1'-0" Project nurnb.r
Date 5iM2014 9:14:13 AM
Drawn by NMB
Checked by LNB
C (REVISED)
Soale 1/4'=V-G'
Description of Existing Signs
-3'x 18' aluminum painted sign on building wall facing Pleasant St.
-3'x 10'vinyl sign on building wall facing Pearl St.
Description of Proposed Signs
--3'x 18' aluminum painted sign on building wall facing Pleasant St.to replace existing.
--3'x8' aluminum painted sign on building wall facing Pearl St.to replace existing.
conform to the requirements of 521 CMR. In accordance with
M.G.L. c. 143, § 3, 521 CMR shall be enforced by the building
official or the state inspector, as applicable.
Note: Chapter 11 of the IBC is replaced by 521 CMR. Applies Complies
1209.4 Air Sealing. Doors, trap doors, scuttles, and other openings
separating conditioned form unconditioned space shall be
fitted with gaskets, weather strips, etc. and such openings
shall close tight to minimize air transfer between conditioned
and unconditioned space. Not Applicable
780 CMR: Massachusetts Amendments to the International Energy Conservation Code 2009
502.4.3.1 Air Barrier Penetrations. All penetrations of the air barrier
and paths of air infiltration/exfiltration shall be made air tight.
Not Applicable
248 CMR
Table 1: The total occupant load of 15 requires at least one toilet and one lavatory for each
gender. Currently there are no accessible toilet rooms in the building. One accessible toilet is
provided. One mop sink is also provided.
521 CMR
3,3,1 For work other than handicap access work and excepting roofing according to 3.3.1.b.c
the budget is likely to be on the order of $135,000. Therefore, not only is all that work required
to comply with 521 CMR, but accessible entrance and accessible toilet room are required.
There are no drinking fountains. Bottled water bubblers with paper cups will substitute.
- End of Review-
S
IN,
Page 7 of 7
New Occupancy (all floors): Business "B" — IBC 304
Type of Construction: 3B (IBC Table 601)
Egress Width
Per Occupant: Required: other egress components: 0.20"
(IBC 1005.1) Provided: (2 doors at 36" wide) = 72"/0.20" per
occupant = 360 occupants
Required: stairways: 0.30"
Provided: (2 stairways) =90"/0.30" per
occupant = 300 occupants
Fire Resistance Rating
of Building Elements: Primary structural frame: 0 hr
(IBC Table 601) Exterior bearing walls: 2 hr
Interior bearing walls: 0 hr
Exterior non-bearing
Interior non-bearing
Walls and partitions: 1 hr ( 602.4.6)
Walls and partitions: 0 hr
Floor construction: 0 hr
Roof construction: 0 hr
Dead-End Corridor: Maximum: 20'
(IBC 1018.4) Actual: No corridors
Length of Exit
Access Travel: Maximum: 200' (without sprinkler system)
(IBC Table 1016.1) Actual: 57'
Occupant Load: Business:
(IBC Table 1004.1.1) Tabular: 100 sf (gross) per occupant = 24 occupants
Actual: 15 occupants
Minimum Number of Exits: Required: (2)
(IBC Table 1021.1) Provided: (3)
Interior Finish Requirements: Rooms and
(IBC Table 803.9) Enclosed Spaces: Class C
International Building Code (2009) with Massachusetts 780 CMR 8th Edition
Supplemental Information and Amendments
A code compliance review of the requirements of the International Building Code (2009)
with Massachusetts 780 CMR 8th Edition Supplemental Information and Amendments is
provided on the drawing. Other items are listed below.
780 CMR: Massachusetts Amendments to the International Building Code 2009
1101.1 Scope. In accordance with M.G.L. c. 22, § 13A all public
buildings shall be designed to be accessible to, and functional
and safe for the use by, physically disabled persons, and
Page 6 of 7
1. At least one accessible building entrance. Applies/Complies
2. At least one accessible route from an accessible
building entrance to primary function areas. Applies/Complies
3. Signage complying with Section 1110 of the IBC. Applies/Complies
4. Accessible parking, where parking is being provided. Applies/Complies
5. At least one accessible passenger loading zone, when
loading zones are provided. Applies/Complies
6. At least one accessible route connecting accessible parking
and accessible loading zones to an accessible entrance. Applies/Complies
Where it is technically infeasible to comply with new construction
standards for any of these requirements for a change of group
occupancy, the above items shall conform to the requirements to
the maximum extent technically feasible.
310.5 Additions. Provisions for new construction shall apply to additions.
An addition that affects the accessibility to, or contains an area of,
a primary function shall comply with the requirements of Section
310.7. Not Applicable
310.6 Alterations. A building, facility or element that is altered shall
comply with the applicable provisions of in Chapter 11 of the IBC
and ICC A117.1, unless technically infeasible. Where compliance
with this section is technically infeasible, the alteration shall
provide access to the maximum extent technically feasible. Not Applicable
Mass Amendments indicate that 521:CMR supersedes this chapter.
310.7 Alterations affecting an area containing a primary function. Where
an alteration affects the accessibility to, or contains and area of, a
primary function, the route to the primary function area shall be
accessible. The accessible route to the primary function area shall
include toilet facilities or drinking fountains serving the area of
primary function. Not Applicable
521:CMR supersedes this paragraph.
310.8 Scoping for alterations. The provisions of Sections 310.8.1 through
310.8.14 shall apply to alterations to existing buildings and facilities. Not Applicable
521:CMR supersedes this paragraph.
310.9 Historic buildings. These provisions shall apply to buildings and
facilities designated as historic structures that undergo alterations
or a change of occupancy, unless technically infeasible. Where
compliance with the requirements for accessible routes, entrances
or toilet facilities would threaten or destroy the historic significance
of the building or facility, as determined by the applicable governing
authority, the alternative requirements of Sections
310.9.1 through 310.9.4 for that element shall be permitted. Not Applicable
International Building Code (2009)
Existing Occupancy (all floors): Educational "E" — IBC 305
Page 5 of 7
307.5 Energy. Buildings undergoing a change of occupancy that would
result in an increase in demand for either fossil fuel or electrical
energy shall comply with the IECC. Not Applicable
307.6 Section omitted by MA Amendments 780 CMR.
307.7 Section omitted by MA Amendments 780 CMR.
307.8 Mechanical. It shall be unlawful to make a change in the occupancy
of a structure that will subject the structure to the special provisions
of the IMC applicable to the new occupancy without approval. The
code official shall certify that the structure meets the intent of the
provisions of law governing building construction for the proposed
new occupancy and that such change of occupancy does not result
in any hazard to the public health, safety or welfare. Applies/Complies
307.9 Section omitted by MA Amendments 780 CMR.
Section 308 Historic Buildings Not Applicable
Section 309 Moved Buildings Not Applicable
Section 310 Accessibility for Existing Buildings
310.1 Scope. The provisions of Sections 310.1 through 310.9 apply to
maintenance, change of occupancy, additions and alterations to
existing buildings, including those identified as historic buildings.
This building will have 2 handicap entrances and a toilet room. Applies/Complies
In addition the provisions of 521:CMR Architectural Access Board will govern
310.2 Maintenance of facilities. A building, facility or element that is
constructed or altered to be accessible shall be maintained
accessible during occupancy. Applicable
310.3 Extent of application. An alteration of an existing element, space or
area of building or facility shall not impose a requirement for
greater accessibility than that which would be required for new
construction.
Alterations shall not reduce or have the effect of reducing
accessibility of a building, portion of a building or facility. Applicable
310.4 Change of occupancy. Existing buildings that undergo a change
of group or occupancy shall comply with this section. Applicable
310.4.1 Partial change in occupancy. Where a portion of the building is
changed to anew occupancy classification, any alterations shall
comply with Sections 310.6, 310.7 and 310.8. Not Applicable
310.4.2 Complete change of occupancy. Where an entire building
undergoes a change of occupancy, it shall comply with Section
310.4.1 and shall have all of the following accessible features:
Page 4 of 7
304.1.1 The code official has final jurisdiction regarding the repair of dangerous conditions.
304.2 A building with substantial damage to the vertical elements of its lateral-
force resisting elements is required to be evaluated by a design
professional. Not Applicable
304.2.2 Substantial damage to gravity load carrying components: Not Applicable
304.5 Flood hazard areas. Not Applicable
Section 305 Fire Escapes Not Applicable
Section 306 Glass Replacement Not Applicable
Section 307 Change of Occupancy
307.1 Conformance. No change shall be made in the use or occupancy of
any building that would place the building in a different division of
the same group of occupancy or in a different group of
occupancies, unless such a building is made to comply with the
requirements of this code for such division or group of occupancy.
Subject to the approval of the building official, the use or
occupancy of existing buildings shall be permitted to be changed
and the building is allowed to be occupied for purposes in other
groups without conforming to all of the requirements of this code for
those groups, provided the new or proposed use is less
hazardous, based on life and fire risk, than the existing use. Applies Complies
307.2 Certificate of occupancy. A certificate of occupancy shall be issued
where it has been determined that the requirements for the new
occupancy classification have been met. Applies
307.3 Stairways. Existing stairways in an existing structure shall not be
required to comply with the requirements of a new stairway as
outlined in Section 1009 of the IBC where the existing space and
construction will not allow a reduction in pitch or slope. In this case
one run of stairs needs an additional riser and tread. There is sufficient
space to accommodate these. So the work should be done. Not Applicable
307.4 Seismic. When a change of occupancy results in a structure being
reclassified to a higher occupancy category, the structure shall
conform to the seismic requirements for a new structure of the
higher occupancy category. Where the existing seismic force-
resisting system is a type that can be designated ordinary, values
of R, 00, and Cd for the existing seismic force-resisting system shall
be those specified by the IBC for an ordinary system unless its
demonstrated that the existing system will provide performance
equivalent to that of a detailed, intermediate or special system. Not Applicable
Page 3of7
301.1 Scope. The provisions of this chapter shall control the alteration, repair,
addition, and change of occupancy of existing structures, including
historic and moved structures as referenced in Section 101.5.1. Applies
301.1.1 Compliance with other methods. Alterations, repairs, additions,
and changes of occupancy to existing structures shall comply with
the provisions of this chapter or with one of the methods
provided in Section 101.5. Applies
301.2 Building materials. Building materials shall comply with the
requirements of this section. Applies
301.2.1 Existing materials. Materials already in use in a building in
compliance 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 be dangerous to life, health
or safety. Where such conditions are determined to be dangerous to
life, health or safety, they shall be mitigated or made safe. Applies
301.2.2 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 hazard to life,
health or property is created. Hazardous materials shall not be
used where the code for new construction would not permit their
use in buildings of similar occupancy, purpose and location. Not Applicable
Section 302 Additions Not Applicable
Section 303 Alterations
303.1 Alterations must comply with the requirements of the IBC for new
Construction or at least no less conforming than was the existing building
prior to the alteration. Applicable
303.2 Flood Hazard areas Not Applicable
303.3 Existing Structural Elements carrying gravity load need to be strengthened
if the design gravity load is increased more than 5% Not Applicable
303.3.1 If the design live load is not increased by the alteration, the existing
structure may be evaluated for conformance to IBC 1607. If found to be
nonconforming, the nonconforming area is permitted to be posted with
placards showing the approved load. Not Applicable
303.3.4 Structural lateral loads: The demand-capacity ratio with the alteration is less than 10%
greater than before the alteration. So no further evaluation is required. IEBC 707.5
Not Applicable
313.3.6 Means of Egress Width Capacity Factors Already complies with IBC
Section 304 Repairs Not Applicable
Page 2 of 7
Roy S.Brown Architects
85 Chilson Road -Wilbraham, Massachusetts 01095
Phone 413.596.2360-Fax 413.596.2360
Email: rsba85 @yahoo.com
Code Compliance Review
Tattoo afterlife
110 Pleasant Street
Northampton, Massachusetts 01060
May 12, 2014
Overview:
Tattoo Afterlife has a use group category of B for an business use. The prior use was a
used car dealership, business B, preceded by an auto repair shop, preceded by a
gasoline service station. The owner intends to continue the most recent business B
use group category for the Tattoo business and spend on the order of$155,000 in
construction renovations, including items for handicap access. The current assessed
valuation of the building alone is $520,000.
The gross area is 2442 S.F. and the tabular occupant load is 21 from 2009 IBC, Table
1004.1.1. The building consists of a single level on grade.
Applicable Codes:
IBC - International Building Code (2009)
IEBC - International Existing Building Code (2009)
IECC - International Energy Conservation Code (2009)
Massachusetts State Building Code 780 CMR 8t' Edition Supplemental
Information and Amendments (2010)
Architectural Access Board 521 CMR (2006)
NFPA 101 Life Safety Code (2006)
Massachusetts Plumbing Code 248 CMR (2006)
Massachusetts Fire Prevention Regulations 527 CMR (2007)
NFPA 13 Fire Sprinklers (2007)
NFPA 72 National Fire Alarm Code (2007)
OSHA (current)
NFPA 10 Fire Extinguishers (2002)
International Existing Building Code (2009)
Chapter 1 Scope and Administration
101.5.1 Under the prescriptive compliance method, we will need to comply with the
International Fire Code as regards fire notification systems. Applies
But the code does not require any fire alarm notification system for this use
group and for so few people. IBC 2009, Section 907.
Chapter 3 Prescriptive Compliance Method
Section 301 General
Page 1 of 7
Roy S.Brown Architects
85 Chilson Road —Wilbraham, Massachusetts 01095
ph 413.596.2360— fax 413.596.2360
email rsba85 @yahoo.com
CONSTRUCTION CONTROL AFFIDAVIT
PROJECT NUMBER: 14-05-02 DATE: 5/21/2014
PROJECT TITLE: Renovations
PROJECT LOCATION: 110 Pleasant Street,Northampton, MA 01060
NAME OF BUILDING: Tattoo Afterlife
SCOPE OF PROJECT: Fitout of partitions, doors, floors, ceilings, lighting.
IN ACCORDANCE WITH THE 8th Edition MASSACHUSETTS STATE BUILDING CODE, 780
CMR, CHAPTER 1, SECTION 107.6.1, I Roy S. Brown MASSACHUSETTS
REGISTRATION NO. 4293 BEING A REGISTERED PROFESSIONAL ARCHITECT
HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE
PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS
CONCERNING
X ARCHITECTURAL ❑ STRUCTURAL ❑ MECHANICAL
❑ ELECTRICAL ❑ FIRE PROTECTION ❑ OTHER
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.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL
SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR BASIS TO
DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE
DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE
FOR THE FOLLOWING:
1.Review of shop drawings, samples and other submittals of the contractor as required by the construction
contract documants as submitted for building permit,and approval for conformance to the design concept.
2. Review and approval of the quality control procedures for all code required controlled materials.
3. Special architectural or engineering professional inspection of critical construction components requiring
controlled materials or construction specified in the accepted engineering practice standards listed in
Appendix B.
I SHALL SUBMIT PERIODICALLY, A PROGRESS REPORT TOGETHER WITH PERTINENT
COMMENTS TO THE BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I
SHALL SUBMIT A FINAL REPORT AND AN AFFIDAVIT OF COMPLETION AS TO THE
SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY.
°a% p
('1
n 4,1.
(Signature) "` ',a. 4
;44
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statue, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An emplover defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the forgoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity,employing employees, However the
owner of a dwelling house having not more that three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer".
MGL chapter 152 section §25(6) also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152 section §25(7)states"Neither the commonwealth nor any of its political subdivisions
shall enter into any contract for the performance of public work until acceptable evidence of compliance with the
insurance requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es)and phone number(s) along with their certificates(s) of
insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the
Members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the pen-nit or license is being requested, not the Department of
industrial Accidents. Should you have any questions regarding the"law" or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Towns Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary)and under"Job Site Address"the applicant should write"all locations in
(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to
the applicant as proof that a valid affidavit is on file for future pen-nits or licenses. A new affidavit must be filled out each
year. Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The office of investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
phone#: (617) 727-4900 ext. 406 or 1-877-MASSAFE
fax#: (617) 727-7749
Revised 11-22-06 www.mass.gov/dia
R The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, Mass. 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/organization/Individual):L. N. Berneche Inc.
Address: 665 Prospect Street
City/State/Zip: Chicopee, MA 01020 Phone#: 41:3-5-36-2060
Are you an employer?Check the appropriate box: Type of project(required):
1. X I am an employer with 13 4. '._: I am a general contractor and 1 6. - New construction
employees(full and/or part time).* have hired the sub-contractors 7. iXRemodelinv
2. I am a sole proprietor or partner- listed on the attached sheet. b
ship and have no employees These sub-contractors have 8. a Demolition
working for me in any capacity. employees and have workers' 9. Building addition
[No workers' comp. insurance comp.insurance.+
required] 5_1 are a corporation and its 10. Electrical repairs or additions
3. _ I am a homeowner doing all work officers have exercised their 1 1. ; plumbing repairs or additions
myself [No workers' comp. right of exemption perm MGL
insurance required] t c. 152, § 1(4), and we have no 12. Roof repairs
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.
tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contactors that check this box must attach 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: EMC Insurance Companies
Policy#or Self-ins.Lic.#: 6S60UB-5B85533-2-13 Expiration Date: 3/19/15
Job Site Address: 110 Pleasant Street City/State/Zip: Northampton, MA 01060
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 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
$250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the
DIA for coverage verification.
I do herby certify under the pains penalties of rjury that the information provided above is true and correct.
Signature: Date: 5/22/14
Print 1V-me: Leon LBe7rneche Phone #: 413-536-2060
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):
(.Board of Heath 2. Building Department 3.City/Town Cleric 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact person: Phone#:
Vemionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 C44R 110.11)
Independert Structural Engineering Structural Peer Review Required Yes 0 No
SECTION 111 7UMNEKAUTHORIZATIC)H-TO BE COMPLETED WHEN
OWNERS,A6ENTOR CONTRACTOR.APPLIES FOR BUILDING PERMIT
as Owner of the subject,property
hereby authorize N Ben.=he to
act on VA"Palf,in alJLm&#&ss*W1ve,.to_Work authorized by this building permit applicstion.
Sig t owner
Date
leon N I�erneche
as Owner/Authorized
Agent hereb-, declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
$il% uip the
N .krneche
ftnt Name
_j
Signature of OTedAgent Date
SECTION 12 -CONSTRUCTION SERVICES
10,1 Ucansel CQnsbruptlo!!§yjLrvlpor-
Not Applicable C3
HAM of l.lceni w-14oldar:L1,Sn N Berneche
License Numbs(
F1 8-7 W.9 A hington St.BelcherOpn,MA
Address Expiration Date
7
E
(41:i)'ii3-5909
Si re Telephans
SECTION 13,411ORKSRS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152,§25C(q))
Workers Comronsation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result
in the denial o the issuance of the building permit.
I Signed Affidavit Attached Yes @ No C)
Version 1.7 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:
�kOy S ��\\\\ _ ��s Not Applicable ❑
Name(Regist ant): y l i�-
q1; Registration Number
Address 4Z' `
(413) 596-2360 Expiration Date
Signaturt Telephone
9.2 Re i ered 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
L.N.Berneche, Inc. Not Applicable ❑
Company Name:
Leon N Berneche
Responsible In Charge of Construction
665 Prospect St. Chicopee, MA
A dress
(413) 536-2060
Si of re Telephone
Version l.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW (F) YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW () 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 (�) NO
IF YES, describe size, type and location: See Attachment
D. Are there any proposed changes to or additions of signs intended for the property? YES (i) NO 0
IF YES, describe size, type and location: See Attachment
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 P Roofing❑ Change of Use❑ Other❑
Brief Description Enter a brief description here. New interior fit-out for a tattoo parlor including new light gauge
Of Proposed Work: stud and gypsum walls, new ceilings, flooring, and restroom work.
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ✓❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1-1 ❑ 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:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
--t1 o c.�nan a,a Fconn EX�stin
Floor Area per Floor(sf)
15` 2,264 1 st 2,264
2nd 2nd
3rd 3rd
4m
4m
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 Zone[L—] Municipal [Z] On site disposal system[]
Versionl.7 Commercial Building Permit May 1:5,2000
- City of Northampton a"it*'
Building department Curb;;G.u # wyel' : `...'•:,`
2 3 2014 212 Main Street
MAY �';:.J .Sew�arlia6�p���Y.�ii�bilE't�° • .. '•:;
Room 100 ;
Tic orthampton, MA 01060 '
Plumbing&Gas Inspectio I`BI'r; ► '
Northampton M c 3.5871240 Fax 413-587-1272 RfpttS.�+�
;.
APPI.ICAY10H TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHSR THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -$1 PE INFORMA1101N
1.1 prop 6 Address: rhl�s6Cttan to be compl@ted-by office
110 Pleasant St. slap Lot unit
Northamptoi.,Ma Zone ' Overlay District
_.... -
........... .. = F.lm ,gistrict CB0110iat
SECTION 2-PROPSRTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of 9,mora;
Name(Print) Current AAailing Andress: _ �/7
Signature Telephone
2,2 Authorised ent: '
Feon N 13emcche 66S Prospect St Chicopee MA
_... . .� L_..., ---1
Name(Print) Current Mailing
(413)536-2060
Signature Telephone
SECT, ION 3 _E;a M A_TED G.QNSTRU211 N COSTS
Item Estimated Cost(Dollars)to be Otfioal Use Only
com leted by rmit agplicant
1. Building $85,d92.U0i (a)Building Permit Fee i
2. Electrical (b)Estimated Total Gast of
Construction from 6
3. Plumbing �� + $20,100 0� Building Permit Fee
4, Mechanical(HVAC)
t
i..,.. $26,097.00
5.Fire Protect)n _
f. Total=0 + 2+3+4+S) i Check Number
This Section For Official Use Only
Building Perms:Number Data
Issued
Signature: '
Building Comm ssioner/inspector of gWk}ingi Date
File#BP-2014-1236
APPLICANT/CONTACT PERSON LEON N BERNECHE
ADDRESS/PHONE 665 PROSPECT ST CHICOPEE (413)536-2060 Q
PROPERTY LOCATION 110 PLEASANT ST
MAP 32C PARCEL 047 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiny,Permit Filled out
Fee Paid
Typeof Construction: INTERIOR FIT-OUT FOR TATTOO PARLOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 015446
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF RMATION PRESENTED:
� Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
S
Signature o uilding 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.
110 PLEASANT ST BP-2014-1236
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-047 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-2014-1236
Project# JS-2014-002010
Est. Cost: $157889.00
Fee: $947.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: LEON N BERNECHE 015446
Lot Size(sq. 8.): 9713.88 Owner: OLIVIERI MATTHEW
Zoning: CB(100) Applicant: LEON N BERNECHE
AT: 110 PLEASANT ST
Applicant Address: Phone: Insurance:
665 PROSPECT ST (413) 536-2060 0 WC
CHICOPEEMA01020 ISSUED ON.61212014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INTERIOR FIT-OUT FOR TATTOO PARLOR
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 6/2/2014 0:00:00 $947.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner