Loading...
31B-191 All Exteriors Roofing, Flat Roofing, Siding, Windows, Repairs, Snow Plowing 21 Rolf Ave. Chicopee, MA 01020 MA HA.0 Registration#174528 CT HA.0 Registration#0636067 MA Construction Supervisors License#106836 11/6/2014 Dear Northampton Building Inspector„ I request that you grant a modification to waive the requirement for control construction for the project at 90-92 King St. in Northampton because the work is of a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. The new roof system is also lighter than the existing one that is being removed.Thank you for your consideration. Respectfully, Jeremy Sawyer All Exteriors (413)478-1536 Allexteriorsl@gmail.com (413)478-1536 Allexteriorsl @gmailxom The Commonwealth of Massachusetts Department of Iiadustrial 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): Address: / �� ✓-� City/State/Zip:- C'h, c v e 12,71-9 0, Phone#: 7 --57 3 6 Are you an employer?Check the appropriate box: Type of project(required): 1.R I am a employer with 3 4. E] I am a general contractor and I 6. New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. ❑Demolition working for me in an capacity. employees and have workers' 9 b y p ty ❑Building addition [No workers' comp. insurance comp.insurance.t required.] 5. ❑ We are a corporation and its 10.7 Electrical repairs or additions re 3.❑ I qu 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�_<J Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 1-'.7 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 narre 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 isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: y r-{f.r Policy#or Self--ins. Lic.#: / /d — /`{ Expiration Date: i - Job Site Address: ')o -7;t f"^ 4 City/State/Zip: Ala r i h�noe 4, "74 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 certi and penalties ofperjury that the information provided above is true and correct. Signatu • Date: Phone# Of 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): I.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Version 1.7 Commercial Building Permit May 15,2000 J SECTION 1D-,STRUCTURAL.PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes No SECTION 11 -OWNER'AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR'BUILDING PERMIT I, _ n._ v _ .,_ , as Owner of the subject property herebyauthorize __. __..._ ..__.___ _ _.,_. _ . _.w.___r_ , ... �� ,_. _.�.., ....__ ._.__. .,_ _ .__-__. .... _._ . . ._ _.___.._ _ ''to 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 unde..._..... _ ..... ._ d penalties_of perlurY... Tame _ ZJ l—r,—y. S.cam G✓'��°.� //—t7 / _..._...w_ ...:._.:_...._. ........_.__... _._. _..... ..... , Signature of Owne/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder.', PC�' !. .. - ``� � ._..,...._ . .... .. ... . . .. . .. �� .8 3 G License Number Address Expiration Date ure Telephone SECTION 13-WORKERS..COMPENSATION INS''URANCE 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 No 0 Version 1.7 Commercial Building Permit May 15,2000 0 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 EKLOSED SPACE) 9.1 Registered Architect: ...,...._..........._.. , ..._,..__.. .._..._.._...__.�,._._,.,.�_....�._.__.w._.,.._._.,.._.�..__....�......._._..._.,�. ._.._._M Not Applicable ❑ Name(Registrant): Registration Number Address 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 i Address Registration Number Signature TelephoneM Expiration Date Name Area of Responsibility Address Registration Number r Signature Telephone Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Const7tion Address Si e 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.E, _._ L:--J 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 DONT KNOW A-�, YES 0 IF YES: enter Book _ Page _ and/or Document#, B. Does the site contain a brook, body of water or wetlands? NO (D 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 , Date Issued C. Do any signs exist on the property? YES 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 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 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 ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ RoofingR Change of Use❑ Other❑ Brief Description `Enter a brief description here. g e r"c,rL ek,.sl,-,5 6 I+- ado .F Of Proposed Work SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business 2A E Educational ❑ 2B r ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ --- =- 3A ❑ 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 F-1 Specify: ]_,.. _. _. ... ...�_..._.___......�..._..__._._.._._ _._.,.,_ _._._._. .._..._�_.... .___�___ .__ M Mixed Use F-1 Specify S Special Use ❑ Specify: COMPLETETHIS SECTION IF.EXISTING:BUILDING.UNDERGOING RENOVATIONS, ADDITIONSAND/OR;CHANGE IN USE Existing Use Group. _ ._,_..., _ _,....-._._. .___. .._ __ Proposed Use Group. Existing Hazard Index 780 CMR 34):'- _ __.__ m 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) y St ..............,.,.,....._.._ 1 St 2nd 2nd 4 h -___.__. _._.__, __._..__ ___ _ 4m Total Area(so 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❑ Municipal ❑ On site disposal system E] Version 1.7 Commercial Building.Permit May 15,2000 Depart m6ht use,only City of Northampton status of Permit Building Department curb°CuflDrirreway Fermat 212 Main Street 8ewerteptiGAvatlablrty Room 100 Wate`rlWell Availability hampton, MA 01060 Two Sets of Structure[Plans � ecU U n1�g& 4 87-1240 Fax 413-587-1272 Plot/Site Plaris Ede°u�c orth wi7ipk°n' Other's SpeCi., kAPPI (CATION 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 0 I /: ..f S f Map Lot Unit Zone` Overlay District --- - Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ..._Sw.., c; Name(Print) w Current Mailing Address: 33 �3 Signature Telephone 2.2 Authorized Agent: Name(Print) Current Mailing_Address: �.. .__. Signature Telephone SECTION 3-I ESTIMATED.CONSTRUCT ION COSTS. Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building L/l ,.6 eo {a)Building Permit Fee 3 2. Electrical (b)Estimated Total.Cost of Construction from 6 _......_..._... _ ..__.. J 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) _.._.. ._.___. ._m.... 5. Fire Protection _. 6. Total=(1 +2+3+4,;-) 11-1/ 2-8"6- ©d Check Number This Section Foe Official Use Only. Building Permit Number Date Issued Signature:_ Building Commissioner/Inspector of Buildings Date File#BP-2015-0531 APPLICANT/CONTACT PERSON JEREMY SAWYER ADDRESS/PHONE 21 ROLF AVE CHICOPEE (413)478-1536 PROPERTY LOCATION 90 KING ST MAP 3 1 B PARCEL 191 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid Typeof Construction: INSTALL SINGLE PLY TPO ROOF SYSTEM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildiniz Plans Included: Owner/Statement or License 106836 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOR ATION 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 Demolitio el y 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. 90 KING ST BP-2015-0531 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31 B- 191 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2015-0531 Project# JS-2015-001005 Est.Cost: $41386.00 Fee: $248.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JEREMY SAWYER 106836 Lot Size(sq.ft.): 7405.20 Owner: FARRICK ROBERT D&NORMA L zoning: CB(100)/ Applicant: JEREMY SAWYER AT. 90 KING ST Applicant Address: Phone: Insurance: 21 ROLF AVE (413) 478-1536 WC CHICOPEEMA01020 ISSUED ON.11/10/2014 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL SINGLE PLY TPO ROOF SYSTEM 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 Siiinature: FeeType: Date Paid: Amount: Building 11/10/2014 0:00:00 $248.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner