Loading...
43-110 (3) DIG SAFE SYSTEM, INC. - Create New Quick Ticket Page 1 of 2 Request Number: 20153202447 Date 08/03/2015 Time 13:44 Latitude: Longitude: State: MASSACHUSETTS Municipality: NORTHAMPTON Address/Intersection: 107 WHITTIER STREET Nearest Cross Street 1: PARK HILL RD Nearest Cross Street 2: Additional Information: Nature Of Work: DEMOLITION Area Of Work: STREET TO HOUSE Area Is Premarked: Y Start Date: 08/07/2015 Start Time: 09:00 Caller: MICHAEL Title: Return Call: Phone#: 413-732-3179 Fax#: Alt.Phone#: Email Address: Contractor: ASSOCIATED BUILDING WRECKERS,INC. Address: 352 ALBANY STREET City: SPRINGFIELD State: MA Zip: 01105 Excavator Doing Work: Member Utility List Code Abbreviation Name AJ COMCAS COMCAST-SOUTH BURLINGTON MC NGRDEL NATIONAL GRID ELECTRIC-MASS ELEC SP VERIZN VERIZON WG CMAGAS COLUMBIA GAS OF MASSACHUSETTS ON ONTARG ON TARGET LOCATING RJ VERIZN VERIZON • There may be non-member utilities in the area that you need to notify. • Electric and other companies may not mark lines they don't own or maintain. You may want to contact them for more information. • The excavator is responsible to maintain markings placed by member utilities... http://digsafeform.digsafe.com/cgi-bin/dlcgi.exe 08/03/2015 DIG SAFE SYSTEM, INC. - Renew Existing Ticket Page 1 of 2 Request Number: 20153604469 Date 09101/2015 Time 10:29 [Latitude: Longitude: State: MASSACHUSETTS Municipality: NORTHAMPTON Address/Intersection: 107 WHITTIER STREET Nearest Cross Street 1: PARK HILL RD Nearest Cross Street 2: Additional Information: [Nature Of Work: DEMOLITION Area Of Work: STREET TO HOUSE Area Is Premarked: Y Start Date: 09/08/2015 Start Time: 09:00 Caller: MICHAEL Title: Return Call: Phone#: 413-732-3179 Fax#: Alt.Phone#: Email Address: Contractor: ASSOCIATED BUILDING WRECKERS,INC. Address: 352 ALBANY STREET City: SPRINGFIELD State: MA Zip: 01105 Excavator Doing Work: Member Utility List Code Abbreviation F Name AJ COMCAS COMCAST-SOUTH BURLINGTON MC NGRDEL NATIONAL GRID ELECTRIC-MASS ELEC ON ONTARG ON TARGET LOCATING RJ VERIZN VERIZON SP VERIZN VERIZON E:11 CMAGAS COLUMBIA GAS OF MASSACHUSETTS • There may be non-member utilities in the area that you need to notify. • Electric and other companies may not mark lines they don't own or maintain. You may want to contact them for more information. • The excavator is responsible to maintain markings placed by member utilities... http://digsafeform.digsafe.com/cgi-bin/dwcgi.exe 09/01/2015 Northampton, MA Property Detail Page 2 of 2 r Additional Features: Brick Trim: 0 X 225 Stone Trim: 0 X 0 Remodeling Data: Year Remodeled: 0 Kitchen Remodeled (Y/N): Bath Remodeled (Y/N): Land Dat jOutbuilding Info Square Foot Type Utilities Type Feet Value no no information information Type©Year Size 1 Size]Grd Con RPS 1987 �648 ©0 Acreage Type Type Acres Value Street/Road Home Site 1.00 111,750 no information Undeveloped 0.53 5,940 Sales Info IlPermit Info Date Type Price Validity 05/02/2005 Land+Bldg 550,000 —� Date Permit#lRig Purpose 12/30/1999 Land+ Bldg 370,000 L--J no information /9308 Land+ Bldg 258,000 E http://www.northamptonassessor.us/noho/propertydetail.php?map_no=43 -110-001&page... 08/03/2015 Northampton, MA Property Detail Page 1 of 2 City of Northampton, MA: Residential Property Record Card New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 43 -110-001 Zoning: LA307 Assessmen Location: 107 WHITTIER ST Neigborhood: 18 Land: #Living Units: 1 Deed Book: 8244 Building: Class: R-101 Deed Page: 148 Total: Dwelling Information Building Sketch Style: Contemporary Year Built: 1986 Story Height: 2 1 c6 29 10 Attic: None 29 22 18 11 Basement: Full 12 H 12 1212 1Fr/B 121 Total Rooms: 10 12 22 21s Bedrooms: 4 51 Full Baths: 4 2 2s4 22 11 s2 24 21 Half Baths: 1 Exterior Walls: Frame 72 10 2p Unfinished Area: 0 Ground Floor Area: 1162 FG 24 UFP4 Total Living Area: 3068 s22 2aa Finished Basement Living 28 Area: 0 X 1388 Basement Recreation Area: 0 X 0 Woodburning Fireplace Addition Information: Stacks/Openings: 1 /2 Lower 1st Story 2nd Story arc Metal Fireplace 0/ 0 Basement One Story Frame One Story Frame C Stacks/Openings: Basement One Story Frame C Heat/Central A/C: Central Air Basement One Story Frame C Heating System: Warm Air 10ne Story Frame C Fuel Type: Oil lFrame Garage--] C Quality Grade: B+ lopen Frame Porc C Physical Condition: Average lWood Deck C Interior/Exterior: Same lWood Deck C Condition/Desirability/Utility: AV [::::=Wood Deck Vacant/Dwell/Oby Status: Dwelling http://www.northamptonassessor.us/noho/propertydetail.php?map_no=43 -110-001&page... 08/03/2015 Massachusetts Department of Environmental Protection Bureau of Waste Prevention• Air Quality BWP AQ 06 Notification Prior to Construction or Demolition f•This is a revision to an existing form. Project ID for existing form to be revised: • This job is being conducted under a Blanket Permit MassDEP assigned Blanket Authorization ID: • This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: • None of the above conditions apply,generate a new form. Revised: 11/13/2013 Page 1 of 1 Massachusetts Department of Environmental Protection ` eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: BAYSTATE1 Transaction ID: 764050 Document: AQ 06-Construction/Demolition Notification Size of File: 88.91K Status of Transaction: in Process Date and Time Created: 816/2015:6:55:43 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. eDEP - MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System Username:BAYSTATEI Nickname:BAYSTATE CONTRACTING My eDEP Forms KA My Profile La Help' Notifications L Receipt Forms Signature Payment Receipt Summary/Receipt print receipt F. EXIt Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP" to see a list of your transactions. DEP Transaction ID: 764050 Date and Time Submitted: 8/6/2015 6:51:07 AM Other Email : DEP Transaction ID: 764050 Date and Time Submitted: 8/6/2015 6:51:07 AM Other Email : Form Name: AQ 06 -Construction/Demolition Notification Form Name: AQ 06 -Construction/Demolition Notification Payment Information DEP code: 112152 Date: 8/6/2015 6:50:49 AM Amount($): 100 Payment Detail: BEAUDRY JAMES --AccountType --AccountNumber ****2979 Confirmation Number: My eDEP MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System ver.12.17.2.00 2015 MassDEP https:Hedep.dep.mass.gov/Pages/PrintReceipt.aspx 08/06/2015 Massachusetts Department of Environmental Protection Bureau of Waste Prevention• Air Quality BwP AQ 06 100226243 L7, —_� Notification Prior to Construction or Demolition Asbestos Project Number# C.General Construction or Demolition Description(continued) The Asbestos Abatement Notification Number for this address is: This project r- Construction J—o, Demolition is: 8/18/2015 10/31/2015 Project Start Date(MM/DD/YYYY) Project End Date(MM/DD/YYYY) 8.For demolition and construction projects,indicate dust suppression techniques to be used r Seeding r Wetting r Covering r Paving r Shrouding Other-Specify: 9.For Emergency Demolition Operations,who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title Date of Authorization(MM/DDNYYY) MassDEP Waiver Number D. Certification ANDREW MIRKIN "I certify that I have personally examined the foregoing and am Print Name familiar with the information ANDREWMIRKIN contained in this document and Authorized Signature all attachments and that, based PRESIDENT on my inquiry of those Position/Title individuals immediately ASSOCIATED BUILDING WRECKERS responsible for obtaining the information, I believe that the Representing information is true,accurate,and 8/6/2015 complete. I am aware that there Date(MM/DD/YYYY) are significant penalties for N/A submitting false information, including possible fines and P.E.# imprisonment.The undersigned hereby states, under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 of 3 ' Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality BWP AQ 06 100226243 Notification Prior to Construction or Demolition Asbestos Project Number# B.General Project Description(continued) 3.General Contractor: ASSOCIATED BUILDING WRECKERS 352 ALBANY STREET Name Address SPRINGFIELD MA 011050000 4137323179 City/Town State Zip Code Telephone ANDREW MIRKIN 41 37323179 General Contractor's On-site Manager/Foreman Telephone General C. General Construction or Demolition Description Statement:If asbestos is found 1.Construction or demolition contractor: during a Construction or Demolition ASSOCIATED BUILDING WRECKERS 352 ALBANY STREET operation,all Contractor Name Address responsible parties must comply with 310 SPRINGFIELD MA 011050000 4137323179 CM 7.00,7.09,7.15, City/Town State Zip Code Telephone and Chapter 21 E of ANDREW MIRKIN 4137323179 the General Laws of the Commonwealth. Construction and Demolition On-site Manager Telephone This would include, but would not bw 2.Licensed Contractor Supervisor: limited to,filing an asbestos removal ANDREWMIRKIN CS-062382 notification with the Department and/or a Supervisor Name License Number notice of release/threat of 3.Is the entire facility to be demolished? r Yes r No release of a hazardous 4.Describe the area(s)to be demolished: substance to the Department,if COMPLETE DEMOLITION OF FIRE DAMAGED STRUCTURE. applicable. - """ MassDEP Use Only 5. If this a construction project,describe the building(s)or addition(s)to be constructed: Date Received N/A rl� 6.If this is a demolition or renovation project,were the structure(s)surveyed for the presence of Asbestos-Containing Material(ACM)? Yes No 7.Was asbestos containing material(ACM)found? l Yes No If a survey was conducted,who conducted the survey? Name Department of Labor Standards Certification Number Revised:03/17/2014 Page 2 of 3 Massachusetts Department of Environmental Protection 7 Bureau of Waste Prevention • Air Quality L B",T AQ 06 100226243 Notification Prior to Construction or Demolition Asbestos Project Number# A. Applicability A Construction or Demolition operation of an industrial,commercial, or institutional building,or residential building with 20 or more units is regulated by the Department of Environmental Protection(MassDEP), Bureau of Waste Prevention,Air Quality Division, under Regulations 310 CMR 7.09. Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. Is this a fee exempt notification(city, town,district, municipal housing authority,state facility,owneroccupied residential property of four units or less)? Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? 1— Yes F No Type of Notification: [— Revision of an Existing Form r Cancellation of Project Instructions: 1.Blanket Permit Project Approval,if applicable: Approval ID# 1.All sections of th is 2.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: form must be completed in order to Approval ID# comply with the Department of B. General Project Description Environmental 1.Facility Information: Protection notification FIRE DAMAGED RESIDENTIAL STRUCTURE 107 WHITTIER STREET requirements of 310 CMR 7.09. Name of facility Street Address NORTHAMPTON MA 010620000 4135636639 2.Submit Original City/Town State Zip Code Telephone Form To: Commonwealth of JOHN SACKREY PROJECT MANAGER Massachusetts Facility Contact Person Contact Person Title P.O.Box 4062 4135636639 DEMO @BUILDINGWRECKERS.COM Boston,MA 02211 Facility Contact Person Telephone Facility Contact Person Email Facility Size: 3068 2 Square Feet Number of Floors Was the facility built prior to 1980? r Yes FNo Describe the current or prior use of the facility: FIRE DAMAGE RESIDENTIAL STRUCTURE Is the facility a residential facility? F Yes FNo If yes,how many units?1 2.Facility Owner: ADAM HALL 107 WHITTIER STREET Facility Owner Name Address NORTHAMPTON MA 010620000 4133875487 City/Town State Zip Code Telephone JOHN SACKREY 83 SOUTH MAIN STREET On-Site Manager/Owner Representative Address Sunderland MA 01375 4135636639 City/Town State Zip Code Telephone Revised:03/17/2014 Page 1 of 3 demo coordinator From: John Hall <jhall @northamptonma.gov> Sent: August 06, 2015 11:00 AM To: demo @buildingwreckers.com Subject: Building Demolition 8/6/15 10:55a.m. Mike, I sent an E-Mail to Louis Hasbrouck the Building Commissioner for the City Of Northampton, informing him that you would be taking down two buildings in the City. One at 69 Day Avenue and the second at 107 Whittier Street. I explained to him that you would call me for an inspection of the capped Sewer Service when the building had been taken down. John Hall Foreman Sewer Department City of Northampton 1 demo coordinator From: Romito, Jeff<Jeff_Romito @cable.comcast.com> Sent: August 05, 2015 8:17 AM To: demo coordinator Subject: RE: Comcast All Set From: demo coordinator[mailto:demo @buildingwreckers.com] Sent:Tuesday,August 04, 2015 6:05 AM To: Romito,Jeff Subject: Comcast Good Morning Jeff, Attached you will find a request for the disconnection of the cable service at 107 Whittier Street in Northampton. Please let me know if you have any questions, or require any additional information. Thank you, Michael Orr Demolition Coordinator Associated Building Wreckers, Inc. 352 Albany Street Springfield, MA 01105 (413) 732-3179 (0) (413) 734-6224 (F) demo@ buildingwreckers.com 1 RECEIVED 10/02/2013 02:38 Sep. 1. 2015 9: 14AM No. 1156 P. 1 Associated Building Wreckers, Inc. 352 Albany St.,Springfield.MA 01105 Tel: (413)732-31791(800)448-2822 Fax: (413)734-6224 August 4,2015 To;Pam PUchala Email: Pamela.d.puchala('a,verizon.com of: Verizon Phone: (866)686-1195 (508)884-4908 Please cut all services of all buildings at the following location as it is being scheduled for demolition: 107 Whittier Street,Northampton,MA. (Emergency Fire Damaged Structure) Once disconnection has been completed,please either sign below and fax it to(413)734- 6224 or send a notification on your company letterhead. Thank you very much for your assistance in this matter. Sincerely, Associated Building Wreckers,Inc. SERVICE AT: 107 Whittier Street,Northampton,MA (Emergency Fire Damaged Structure) HAVE BEEN DISCONNECTED AS OF /S` PRINT NAME: SIGNATURE;_ REMARKS,IF ANY: nationalgrid 40 Sylvan Rd Waltham MA 02451 August 24, 2015 Associated Building Wreckers ATTN: Michael Orr 352 Albany St. Springfield, MA 01105 EMAIL: demo @buildingwreckers.com RE: Service Removal for Building Demolition. Dear Michael: This letter is to confirm that, per your request,National Grid has removed electrical service and meter(s) from 107 Whittier St., Florence, MA 01062 as of 8/24/15. If you have any questions or need further assistance, please feel free to contact me at (508)357- 4605. Sincerely, Ann?Marie Zstref�a Customer Fulfillment Fax: 315-460-9149 Phone: 508-357-4605 annmarie.estrella@nationalgrid.com Nationalgrid WR#20088319 C-111mbia Gas Of Massachusetts A NiSource Company 995 Belmont Street Brockton,MA 02301 Date: August 27, 2015 To Whom It May Concern: The address listed below has no record of gas service(s) ADDRESS : 107 Whittier St. TOWN : Northampton STATE : Massachusetts Sincerely, Lisa Buckley Integration Center Columbia Gas of Massachusetts 508-580-0100 Ext 1293 a City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: t0'1 Wh�4l�e�S�nr�tt� The debris will be transported by: AsSoc%a "Vw3 %vwct wrecuat'i-T-NC. The debris will be received by: Building permit number: Name of Permit Applicant a e pp Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations d 1 Congress Street, Suite 100 a Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): ASSOCIATED BUILDING WRECKERS, INC Address:352 ALBANY STREET City/State/Zip:SPRINGFIELD, MA 01105 Phone#:413-732-3179 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 32 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, Q Demolition working for me in any capacity. employees and have workers' q ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions 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 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:GREAT DIVIDE INSURANCE COMPANY Policy#or Self-ins. Lie.#:WCA154516513 Expiration Date:02/01/2016 Job Site Address: 107 Whittier Street City/State/Zip:Northampton, MA 01062 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$1,50 0 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. a ay against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigation f t e DIA for insurance coverage verification. I do hereby rt under e p 'ns and penalties of perjury that the information provided above is true and correct Al August 1, 2015 Si nature: Date: Phone# %%' 7 -31'1 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: -I � -5 b License Number S . V"4" S T. 10 /r yzl b Address Expiration Date I - St, � r (o S Signature Telephone 9 Registered HomeImprovementCoptractor � _ LL'' y M Not Applicable £ Company Name c Registration Number Address Expiration tate `ft3- s�3-�c,35 Telephone SECTION 10-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....... £ No...... £ 11 Home Owner.Egemp :ion. The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature. I i i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑7 Addition [] Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition New Signs [01 Decks [❑ Siding [[J) Other[0) Brief Desori tion of Pr posed 1 1 Work: r�s.rwI cs VN rr.� AC."i`)"q_ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.1f New house and or add1: om o exisfin .housin com lete#Fie followin `: a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: 1'- Number of Bathrooms c. Is there a garage attached? _ d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? /A Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. tu Masscheck Energy Compliance form attached? P h. Type of construction_J i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes \/�No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes—�< No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR.BUILDING PERMIT i r trA A-(,,(i as Owner of the subject property l (,� 1 hereby authorize `-� "t ►� hc """�-Zz to act on my beha , i It matters lativ to work authorized by this building permit application. - - d 04- Signature of Own Date I �py¢ U �"informatidn as Owner/Authorized Agent hereby declare that the statements anon t he foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties erjury. Print Name f it Signature of 0 n r/ a Date .! Section 4. ZONING7 All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 3 Frontage — Setbacks Front -- «---- r---- �-~-- Side L:' f R:= L: ___ R:E Rear t—--I Building Height Bldg. Square Footage — Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: ! E t (volume&Location) A. Has a Special Permit/Variance/Findi g ever been issued for/on the site? NO Q DONT KNOW _ YES Q IF YES, date issued:; _"1 IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW YES Q r� IF YES: enter Book Page and/or Document#? B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES, describe size, type and location: j I 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 O NO a IF YES,then a Northampton Storm Water Management Permit from the DPW is required. i ���- `� {3epartment`useypnly k �� City of Northampton Status ofPerrntt y � ` i Building Department 5 Cut/Crclrr��yay Fermlt{ � 1 �� 212 Main Street SewerlSepticA Val lalillrty eotions Room 100 U1later/V�-I Ayatlai�tlttjx El ctric,Plum b+n9&Gas Insp rt Northam ton,MA oloso Northampton, MA 01060 Twa Sets of$tructurai Piaps imam= phone 413-587-1240 Fax 413-587-1272 Plof/s,te Plans °_� ether SpecYfy fi .�, �1 � APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION: 1.1 Property Address: a This section to be completed by office ; } w7 wA thrr > � MaP: _ Lot rtrt U M%.-= 1- ---i. a i� �✓ f�l©�2 Zone 3 Overlay DrstRa � r -' 1 %Elm St:District. CB Distrrct SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT- 2.1 Owner of Record: A f ' 1 ACS A-W, � L Sy k��s w4 y--rip o--p' H y Name(Print) Current Mailing Address: 413-1, Telephone Signature 2.2 Authorized Aoent: Name(Pri J Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Buifding 'may, It'A N� (a)Building*Permit Fee � '�C �� 2. Electrical (b) Estimated Total Cost of Construction'from fi 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) S 5. Fire Protection ` 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use'Only Date Building Permit Number: issued; Signature Building Commissioner/Inspector of Buildings: Date 107 WHITTIER ST BP-2016-0305 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:43 - 110 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: demolition BUILDING PERMIT Permit# BP-2016-0305 Project# JS-2016-000492 Est. Cost: $18950.00 Fee: $75.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SACKREY CONSTRUCTION 040714 Lot Size(sq. ft.): 66646.80 Owner: HALL ADAM C&SUZANNE SMITH Zonin : Applicant: SACKREY CONSTRUCTION AT. 107 WHITTIER ST Applicant Address: Phone: Insurance: 83 SOUTH MAIN ST (413) 665-9995 O Workers Compensation SUNDERLANDMA01375 ISSUED ON.911012015 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMOLISH S F H 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 9/10/2015 0:00:00 $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner