32C-011 (2) 1/6/2016 City of Northampton Mail-114 Main Street building permit
- City Of Louis Hasbrouck <Iasbrouck @northamptonma.gov>
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NorlfharreOM
114 Main Street building permit
1 message
Louis Hasbrouck <Iasbrouck @northamptonma.gov> Wed, Jan 6, 2016 at 11:44 AM
To: Bill Turomsha <wturomsha @gmail.com>
Cc: Charles Miller<cmiller @northamptonma.gov>, Larry Therrien <Itherrien @northamptonma.gov>
Bill,
I've approved your building permit application for minor renovations at 114 Main Street.
We will require Fire Department sign off prior to our final inspection. Please provide a written narrative to the building and fire departments describing
the ro osed work on the fire alarms stem before that work begins.
P P Y 9
Also, ensure that any openings or damage in the first floor hard ceiling are covered or repaired before the new ceiling is installed.
Let me know if you have any questions.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413) 587-1272 fax
https:/Imail.google.com/mail/ca/u/0/?ui=2&ik=ec5fl9a57e&view=pt&search=sent&th=15217d3a5aOf8880&siml=15217d3a5aOf8880 1/1
DESIGN& CONSTRUCTION
5 January 2016
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
Dear Commissioner Hasbrouck:
In regard to the storefront renovation of 114 Main Street, the space is only 820 square
feet. The work that I am performing is all non-structural and has no effect on any entry or egress.
The work consists of removing the existing acoustic suspended ceiling, installing a steel
framed "Chicago Grid" and '/2" drywall, and removing framing plaster and lath to expose a brick
wall.
The work is of a minor nature and therefore I request that you grant a modification to
waive the requirement for architect controlled construction.
Respectfully submitted,
g
William J. Turomsha
WJT/djt
Wm.J. TUROMSHA ♦ P.O. Box 141 ♦Leeds ♦ Massachusetts 01053
DESIGN& CONSTRUCTION
30 December 2015
Building Department
City of Northampton
114 Main Street Storefront Renovation;
Remove existing acoustic suspended ceiling.
Remove existing ceiling lighting.
Install steel Chicago grid.
Install wiring for track lights as shown on plan.
Replace ceiling heat and A/C diffusers.
Hang 1/2" drywall ceiling.
Remove drywall, 2x4 framing, lath and plaster from one wall.
Remove carpet.
Install 3'-0" x 6'-8" solid core door to lower level.
I am performing no work on the lower levels or in either of the two bathrooms.
1-
m �.�--
William J. Turomsha
WJT/djt
Wm. J. TUROMSHA ♦ P.O. Box 141 ♦Leeds ♦ Massachusetts 01053
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/C ontractors/Electricians/Plumbers
Applicant Information I I Please Print Legibly
W
Name (Business/Organization/Individual): t, 3 A r¢.6 M s k b DES 1 g N Go lysmacce- I o 14 _
Address: O $ok 1 Y
City/State/Zip: M0 O /o6S Phone#: 4113 SSL SI as s-
you an employer?Check the appropriate box: Type of project(required):
FAre
.❑ 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_pa=or- listed on the attached sheet. 7. ®Remodeling
ship-and have no employees These sub-contractors have 8. ®Demolition
working or me in an capacity. employees and have workers'
g Y P tY 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 exercised their 11. Plumbing repairs or additions
�.❑ I am a homeowner doing all work ❑
myself ' . right of exemption per MGL
Y [N o workers comp. 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 nacre 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: "rRAU C-LE2S
Policy#or Self-ins.Lic. #: I f Tu R O Io 53 M9 41 Expiration Date: Zo 3uNe Zc/G
Job Site Address:—/I y Ma ;4 S-re-e-mil" City/State/Zip: N6g1 ME1 pM&J 1pb0
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 ce��rtijy under the pains and penalties of perjury that the information provided above is true and correct.
Sienature: 4/,0� _ 1k4 Date: Z Z-swer,,a., ZoIL
Phone#:
Of frcial use 011117. 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#:
Version 1.7 Commercial Building Permit May 15,2000
J
f
SECTION 10-STRUCTURAL.,PEER REVIEW(780 CW110.11)'
Independent Structural Engineering Structural Peer Review Required Yes No
SECTION 11 -OWNER AUTHORIZATION-TOBE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES-FOR BUILDING PERMIT
ST..... .... .. ..:_.. _ _. . ',as Owner of the subject property
hereby authorize' .... W011 AIn S_..7',!,!� t—.%5-P.-A._.:._-._- .-.—_..w v. ..._. __to
tact on my behalf, in all matters relative to work authorized by this building permit application.nature of Owner _Datemv
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 pains and Penalties_of perjury
011AI.1 ..._._�. _ 4_iSi!/Q_._..
Print Name
Signature oflgWo ►WA nt Date
SECTION 12-CONSTRUCTION:SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
l._ f
Name of License Holder: oma
License Number
Address Expiration Date
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 1 No 0
Venionl.7 Commercial Building Pernut May 15,'_000
SECTION 10-STRUCTURAL PEER REVIEW(730 CMR 110.11)
Independent Stn,cduret E.ngineenng Structural Peer Review Require Yes No
SECTION 11-OWNER AUTHORIZATION-TO BE COMPLEtt _o WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1. So ACf.)!� RiW QLItST _ _�.as Owner of tfte suDpct property
hereby authorize W t for N eN T -r,,"--+s;N A . . ...
- - - _ --. - to
aCt on my behalf,in all matters relative to WQrk authorized by this Wkting permit application. _
`
S I Or owner
Date
as OwnerrauthonZed
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.
_ y e o
Print Name - -- -
Z 3..±....r. 701(a _
S' atwe W Qauen' it Date ._--
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor Not Applicable ❑
Nia"M of Lke"se"*1 71 waQn rbAo 000 slS -.
License Number
raoiuT57: nio5 1s J=�+�ekR Zo)(,
Address _ _. Gp ration Da:o
Telephone
SECTION 1S WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152,§2SC(g))
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit wiz result
In the denial of the issuance of the building perms.
-SignW Affidavit Attached Yes ® No Q
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 ENSLOSED 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
f
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
...:.......
Signature Telephone Expiration Date
_._. _...M w_.._ ..M....__:.. . .,...... ..............,,...
_. .. .__...._._ _. ...._..
Name Area of Responsibility
{
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
_Address____
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning .
This column to V-e filled in by
Building Department
Lot Size _.. ...._._._,_.,.._....___._...�
Frontage
Setbacks Front p jN o
Side L. 1 R:I..
Rear
Building Height » 1
Bldg. Square Footage Ooo' ! _ %
Open Space Footage _ %
-- (Lot area minus bldg&paved
parking) ..,,_,.... .....N.
#of Parking Spaces
_...... . .._ _ ...__.,._, . ...,...
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES
;IF',YES, date issued: �..�.....,�..._.,�..
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 »YES 0^ NA
IF YES: enter Book Page^ ! and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO � DONT KNOW 0 YES
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: ��( Zsµ13cm TLpB &ucX Lo
..... .... .. ...t..wG�._. __....
D. Are there any proposed changes to or additions of signs intended for the property? YES 67) NO
IF YES, describe size, type and location: 51z� RQMw4 ' ` °"�' a oiiiy Gii.••t
1PtP1[
RIEpbPac ForIST 41J.
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.
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJ.E:CTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE-
Interior Alterations ❑ Existing Wall Signs C9 DemolitiontX Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑
Brief Description `Enter a brief description here. RF-MOOE Ekist1W.1 Atovsrs� susp �z�ro CeifW1
Of Proposed Work: )A13Ti•ll -419k) Pnitaviall Cmuft7.�0 Per STC;I Ctia, 3TajV �.�PM�1 � nM�� � P�•Pt
oFF Sn,cIL T!._ P.,_o�3 $ !G__11 �!I tl .TQ +►!`l�u+�-,. .1 ± 7�.tR1 Nlc,a_.
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 ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H-Hi h Hazard ❑ - -_- - 3A ❑
I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile 19 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A El
S Storage El S-1 ❑ S-2 ❑ 5B ❑
U Utility F-1 Specify:
.._.&#'_e. ,.,.,_ _._ .........
M Mixed Use ® Specify: ! Pra�'r Fb.erti .arm 1•wi� terser 1�►la'e,` is;u'i;
p �� ?_..t+re.�s�
S Special Use ❑ Specify:
i
COMPLETETHIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,:ADDITIONSAND/ORICHANGE 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
Floor Area per Floor(so t or.►�.� Ge..eL
19 331 5rI9 54s+g I g
st
Ist
Sq
nd
nd 2 2
_...... _....
.._._..__.a
3rd 3rd
4c"
Total Area(so Total Proposed New Construction(sf)
._
SAME
Total Height(ft)1,33, -O- Lo
Total Height ft 'Si°►K _,^
7.Water Supply(M.G.L. c.40,§54) 7.1 Flood_Zone._Information: 7.3 Sewage Disposal System:
Public ® Private E] Zone Outside Flood Zone❑ Municipal ® On site disposal system E]
Versionl.7 Commercial Building Permit May 15,2000
Departure t use,oFtlX
City of Northampton Status of Perrr�t
Building Department curb Cut/Dnrreway Permtt� u
212 Main Street SewerlSepficRvailafiilfy
Room 100 Water7Well Artalfab'ility+ _
Northampton, MA 01060 Two Sets of SfructuraCPlans ;.r
phone 413-587-1240 Fax 413-587-1272 Plat/Site Pfans
Ofher,Speclfy:: 3
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 ProgertV Address:
:This section to be completed by office
l y M l'ty S mr-E T' Map Lot Unit
Illn IN
i one Overlay. District
'Elm.St:District. CS District`
SECTION 2-'PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
€3sl1*t-�
%A&r. . GFANQu1ST ? .MNIN STREET M0MAf;-1111
Name(Print) Current Mailing Address:
ST, .Ct 17.,2.3 z l
Signature TeIep?9nV-%%' 112.10q 9211
2.2 Authorized Agent:
QO IL I t1 P.,F DSj-14- 0140 53...
Name(Print) CuRent Mailing Address _..... __..._.. _._..__..._.,_...__.._................._..._,.
Signature . �/L�O�s'Qr�..�— Telephone
SECTION 3-!ESTIMATED CONSTRUCTION COSTS:.'
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 100 I (a)Building Permit Fee
2. Electrical (b),ELStimated'Total Cost.Of
Construction from 6 _,__._,...._._, __. ..._. ..
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) »
5. Fire Protection
6. Total=0 +2+3+4+5) / , oC Check Number
This Section FocOfficial'.Use Only"
Building Permit Number Date
Issued
Signature:_
Building Commissioner/Inspector.of Buildings Date
Versionl.7 Commcrcial Buildin .Permit May 15,2000
�' _ _____.._ : Depa t lise only • _
' -qty of Northampton Status pf Permit
Building Department C nYeway Pt rrntt '
JA 212 Main Street Sewerl5eptic,Piyailad'nlity
N d 2016 Room 100 VrfaterMVetl Availability
N rt t oloso
p`r,r hamp on, MA T,wo Sets oiStsuefuraf Ptac► `
c.-
N n 41 -587-1240 Fax 413-587-1272 elak/SRe wra„s
euurn - c>
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
1.7 Property Address: -
This section to.be completed by office
It'/ n rf*IM S T B T' Map Lot Unit
' N O+�TH A..►p'lb a3� N1 p I
Zone Overlay District
Elm SCbistriet. - CB District
SECTION 2--PROPERTY OWNERSHIPIAUTHORVEO-AGEIIIT.
2.1 Owner of Record:
:S.'4l ti.Lotf GKMQutST _Miev—�L�j)k .0ort �►??P`1. ��"rp,_.
Name(Print) Current Malum Address:
Signature V�d w'r TeIX ' tstt 'lit 361 &MV
2.2 Authori Agent:
t�!l ,.T. .�u. ,► NA _--�___ _____ .' �o• So Y- i�Li_� xiS M[a_4l453
Name(Print) Current Mai Address:
Signature l kllfeh+� Telephone
SECTION 3-ESTIMATED CON$7RUCTION COSTS:
Item Estimated Cost(Dollars)to be Official:Use Only
completed by ermit applicant
1. Building (Ai)"Building'Permit Fee
2. Electrical _ .._..._ ....
�DO�,oe (§f Estimated'Totaf Cost of
Consfructibn from 6 _.....__._.._......___......_.._...
3. Plumbing -Buildfng!PetmitF-ee
4. Mechanical(HVAC) ...--.—.___..
5. Fire Protection gam•.
. . _ _ . _.._.,.. ... ..
-�- .. . . .. . ........ ---..
6- Total=(1 +2+3+4+5) / ao t;hecic.Number
This.Section F&Official..Use Only.
Building Permit Number Date
Issued
_ Signature:
Building Commissioner/inspector or Buildings Date
File#BP-2016-0853
APPLICANT/CONTACT PERSON WILLIAM TUROMSHA
ADDRESS/PHONE P O Box 141 LEEDS01053 (413)586-4005
PROPERTY LOCATION 114 MAIN ST
MAP 32C PARCEL 011 001 ZONE CB(100)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: INSTALL NEW CEILING EXPOSE BRICK INSTALL NEW LOWER LEVEL DOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Building Plans Included:
Owner/Statement or License 000515
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQRMATION PRESENTED:
b/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
Z'' f C^ f
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.
114 MAIN ST BP-2016-0853
G1S#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-011 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-2016-0853
Project# JS-2016-001443
Est. Cost: $18790.00
Fee: $131.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WILLIAM TUROMSHA 000515
Lot Size(sq. ft.): 1045.44 Owner: P+Q LLC
Zonin4: CB(l00)/ Applicant. WILLIAM TUROMSHA
AT. 114 MAIN ST
Applicant Address: Phone: Insurance:
P O Box 141 (413) 586-4005
LEEDSMA01053 ISSUED ON.11612016 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL NEW CEILING, EXPOSE BRICK,
INSTALL NEW LOWER LEVEL DOOR
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 1/6/2016 0:00:00 $131.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner