31B-191 (2) 90 KING ST BP-2016-1054
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma :Block: 3 1 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: renovation BUILDING PERMIT
Permit# BP-2016-1054
Project# JS-2016-001793
Est. Cost: $4000.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: AARON PUNSKA 105542
Lot Size(sq. 1): 7405.20 Owner: NORMA LEE REALTY TRUST
Zoning: CB(100) Applicant: AARON PUNSKA
AT. 90 KING ST
Applicant Address: Phone: Insurance:
111 KINGS HIGHWAY (413) 626-6033 (�
WESTHAMPTONMA01027 ISSUED ON:3/8/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.BRICK INSIDE OF BUILDING
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 3/8/2016 0:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
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File#BP-2016-1054
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APPLICANT/CONTACT PERSON AARON PUNSKA
ADDRESS/PHONE 111 KINGS HIGHWAY WESTHA14PTON01027(413)626-6033 Q
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 _
Buildine Permit Filled out
Fee Paid
Typeof Construction: BRICK IN SIDE OF BUILDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 105542
3 sets of Plans/Plot Plan
THE y6LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN,FYFRMATION 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
=Z- / �� _ 31tiW
SignkeKe 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.
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Versionl.7 Commercial Building Permit May 15,2000
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/SepticAvailability
Room 100 WaterA/Vell Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site 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
This section to be completed by office
1.1 Property Address:
Map Lot Unit
Zone Overlay District
.......... _.._. __...... _...._. __. Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
Name(Print) Current Mailing Address
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building ) g
,u Buildin Permit Fee
y�09, (a
_._.
2. Electrical (b) Estimated Total Cost of
Construction from 6 - -'
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total=0 +2+3+4+5) ���' Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
Version I.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE I
Interior Alterations E-1 Existing Wall Signs El Demolition El Repairs El Additions F1 Accessory Building El
Exterior Alteration El Existing Ground Sign El New Signs❑ Roofing❑ Change of Use❑ Other D"
Brief Description Inter a brief description here.
Of Proposed Work.. 5 i
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 n A-2 El A-3 El 1A ❑
A-4 ❑ A-5 E] 113 ❑
B Business 2A ❑
E Educational ❑ 2B
F Factory ❑ F-1 ❑ F-2 El 2C El
H High Hazard ❑ 3A ❑
I Institutional ❑ 1-1 ❑ 1-2 E] 1-3 0 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage n S-1 ❑ S-2 El 56 ❑
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):1
Proposed Hazard Index 780 CMR 34)- 1
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
St
St
2nd
2nd2 2 ................ ........
rd 3rd d
3
h 7
th 4
4
................ ......................
Total Area(sf) Total Proposed New Construction
Total Height ft
Total Height ft
7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone
e' Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone' Outside Flood Zoneo
Municipal Ej On site disposal systernE]
Version 1.7 Commercial Building Permit May 15,2000
S. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side 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 DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book Page and/or Document#.
B. Does the site contain a brook, body of water or wetlands? NO e�DONT KNOW 0 YES
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: ✓tr-
._.......... . ..._...
D. Are there any proposed changes to or additions of signs intended for the property? YES NOS
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 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 I Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
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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 No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMfT
as Owner of the subject property
hereby authorize' _ . __._.. _ _. __... ____ _ to
act on my behalf, in all matters relative to work authorized by this building permit application
Signature of Owner Date
lc+'�✓( y�`�� 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.. _ _...
Print Name
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor; Not Applicable ❑
Name of License Holder
License Number
41
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 No 0
_` The Commonwealth of Massachusetts
x Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.tnass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information / Please Print Legibly
Name (Business/Organization/Individual): ,Kri't POO- z j2 W
Address: lei
City/State/Zip: �J(7) /Al c.ir.,,?Phone
Areyou an employer?Check the a propriate box: Type of project(repaired):
1.❑ I am a employer with 4. (] I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors ❑ New construction
2. am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have $. Fj Demolition
working for me in any capacity. employees and have workers' Building addition
[No workers' comp.insurance comp.insurance.1
required.] 5. R We are a corporation and its 101-1 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 eiiiployer t/iat isproviding workers'co►npensation iiisurance for my employees. Below is thepolicy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic.#: Expiration Date: !
Job Site Address: City/State/Zip:
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 certify under tl ains and penalties of perjury that the information provided above is true and correct.
Si nature: Date: le
t
Phone#: Yj E C 6/,'o
Official use only. Do not lvrite in this area,to be completed by cio,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 S.Plumbing Inspector
6.Other
Contact Person: Phone#:
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Aaron Punska Construction&Painting
Commissioner Hasbrouck Feb. 29, 2016
Subject: Request for Waiver
I request that you grant a modification to waive the requirement for control construction for the
bricking in of wood area on side of the building at 90-91 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.All work will be completed within the prescriptive requirements of 780 CMR.
Thank you for your consideration.
"Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project"
Respectfully,
Aaron Punska
Aaron Punska Construction & Painting
111 Kings Hwy, Westhampton Ma