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32A-177 (6)
1 MAIN HOUSE SIDING&TRIM ACCENTS : JAMES HARDIE,SMOOTH LAP 4"EXPOSURE EVENING BLUE REAR ADDITION SIDING&BUILDING FOUNDATION: 2 JAMES HARDIE, SMOOTH LAP 6"EXPOSURE BOOTH BAY BLUE 1 ' 1 1 I` �I HISTORIC EXTERIOR Architects, Inc. COLLEGEC+O�L]OR 19 6 Pleasant St Northampton,MA INN P_1�0 ( S C H E M E phone (413) 565-0641 l ..wx�w ee aexw ux xmw a�uv..a .n.a xw ]4 BRIDGE ST. ammon.x.iurwyna oMx aM'mwumx L . m...ermnnp.wew��x �..w am. NORTHAMPTON,MA JAl wa n t �14a I �SCALE:—--- _.I i J 'Nartilamp tall � � �sssschnsctta' DEPARTMENT OF BUILDD�,,C INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 ' WORICER'S COMPENSATION INSURANCE AFFIDAVIT I, Pioneer Contractors (lio scr/permitree) with a principal place of business/residence av P-0. Box 1145 Hnrthampfnn MAni-061 (phone" 556 5491 (s&=Uci 64Aatrinp) - do hereby certif)1, under the pains and penalties of perjury, that: ( I am an employer providing the following worker's compensation coverage for my employees woriting on this job: Wcc 5005957012.0012 AG_nr•;ater1 FmIloTezrG Tnsuran^a�Cn art.ntance Company) (Policy Number) -- (Expiration t; t) . ( } I am a sole proprietor, general conrmctor or homeowcer (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Lnszuance Company/Poticy Number) (Fxpirmtion Date) CName of Contractor) (Insumce Company/Policy Number) (Expiradon Date) (Name of Contractor) (Imuraace Compauy/PoLcy Number) (Expiration Date) (Name of Contractor) (Ianuance Company/Policy Number) (Eiradon Date) (anarh additional dwct ifna==wy to inch%.&infoecnadon peraairnng wall watrnrxora) ( } I am a sole proprietor and have no one wwor�dng for me. ( ) I am a home owner performing all the work myself. NOTE:plcmse be aware that white homoowvcn who c mploy pcxsonx to do mmiateoxner,comuuaioa or rc;xiv work on a dwetiiog of ant more than three traits is which the homeowner resides or oa the gvunrh appurtenant[barn arc not gcnaally comidand to be employcm uod r tba wortkcs'x oaaxpcasation Act(GL152,=1(5)1 appticmdon by a homeowvcr for a liens&or permit nay,%idcox the Ieprctaws of an omployw under the Workoes Cooapomatioa.Act 1 undcrstand tlasi i copy of thin—1—may be foevmrdod to rho Depart..[of tnduu,j Arad--&offioo of lauraac»for dw eovmgc vctifiestioa and that f ilurc to secure coverago render socUoa 25A of h(GL 152 can lrsd to the irapoub-of mm-31 p—W- owiLving of a fine of up to S 1,500.00 uo&or hmprisonmcni.of up to one year and civil peuattia in the form of a Stop Work Order mW a fins of s 100.00 a day aping me Fa dcpr=Ljtst use oaty Permit Numb=- l ( p Lot# Si laze of Licr�'rmi 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 Q No O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Unique Lodging LLC/Todd Marchefka I,_________________ -_,as Owner of the subject property Pioneer Contractors hereby authorize---------------------------------------------------------------------to act on my behalf, in all matters relative to work authorized by this building permit application. -------------- -- ------- Signature of Owner Date David Claxton/Pioneer Contractors I,_______— ______—___,as4)wFWWAuthorized 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 pains and penalties of perjury. ------------------------------- Print Name ------------------ -- - - ------------------- �!1/ - ?2-67-- - ------ Signat4 of Owner/Agent ate SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable C3 Name of License Holder: David A. Claxton CS-017890 --------------- -- ---------- --------------------- License Number P.O. Box 1145 Norhtampton, MA 01061' 1/19/2016 --------------------------------------------------------- ----- ---- Address Expiration Date 413.626.7267 Signature Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes G) No 0 Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ ---------------------------------------------- Name(Registrant): 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 ------------------------------------------------------- ------------------------- Address Registration Number ----------------------------------------- ------------ --------------------- Signature Telephone Expiration Date --------- ------------------------------------------ ------------------------- Name Area of Responsibility --------------------------------------------------------- --- Address Registration Number ---------------------------------------- ------------- ---------- ------- Signature Telephone Expiration Date 9.3 General Contractor Pioneer Contractors ---------------------------------------------------------------- Not Applicable ❑ Company Name: David Claxton ----------------------------------------------------- Responsible In Charge of Construction P.O. Box 1145 Northampton, MA 01061 ------------------------------------------------- Address 413.586.5491 Signature Telephone Versionl.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 Q DONT KNOW e YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO o DONT KNOW ® YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO e DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , Date Issued: C. Do any signs exist on the property? YES 0 NO e IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO e 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 e 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 0 Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. Of Proposed Work: • Remove exisitng siding re-side w/Hardie lan siding- 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 ❑ 18 I ❑ B Business ❑ 2A —I}— ❑ E Educational ❑ 2B I ❑ 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 ❑ 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: R- Proposed Use Group: Same Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1 St 1 St 2nd 2nd 3rd 3rd 4 4 m tn 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 0 Private ❑ Zone Outside Flood Zone[E] Municipal El On site disposal system❑ \ Versionl.7 Commercial Buildin Permit May 15,2000 - Department use only. j orthampton Status of Permit: Department Curb Cut/Driveway Permit ain Street Sewer/SepticAvailability l m 100 WatertWeii Avaiiabiiity on, MA 01060 TWO sets of spvctural Plans Exec` orti" ne 410 Fax 413-587-1272 Plot/Sits Plans- Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit 74 Bridge Street Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Unique Lodging LLC Name(Print) Current Mailing Address: 74 Bridge St.,Northampton,MA. 01060 Signature ----- ______ _________ Telephone 2.2 Authorized Agent: Pioneer Contractors Name(Print) Current Mailing Address: P.O. Box 1145 Northampton,MA 01061 Signature —__ Telephone 3 — SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 31,500.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number o This Section For Official Use Only Building Permit Number Date Issued Signature: ---------------------------------------------- Building Commissioner/Inspector of Buildings Date File#BP-2015-1115 APPLICANT/CONTACT PERSON PIONEER CONTRACTORS ADDRESS/PHONE PO Box 1145 NORTHAMPTON01061 (413)586-5491 PROPERTY LOCATION 74 BRIDGE ST MAP 32A PARCEL 177 001 ZONE URC(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out LW Fee Paid Typeof Construction:_REPLACE SIDING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 017890 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 ;;z' ' la Signailar6f Building f icial 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. 74 BRIDGE ST BP-2015-1115 GIS#: COMMONWEALTH OF MASSACHUSETTS MW:Block: 32A- 177 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: vinyl g BUILDING PERMIT Permit# BP-2015-1115 Project# JS-2015-002106 Est. Cost: $31500.00 Fee: $192.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PIONEER CONTRACTORS 017890 Lot Size(sq. ft.): 22999.68 Owner: UNIQUE LODGING LLC Zoning: URC(100)/ Applicant. PIONEER CONTRACTORS AT. 74 BRIDGE ST Applicant Address: Phone: Insurance: PO Box 1145 (413) 586-5491 Workers Compensation NORTHAMPTON MAO 1061 ISSUED ON.511812015 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE S I D I N 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 Siznature: FeeType: Date Paid: Amount: Building 5/18/2015 0:00:00 $192.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner