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32C-067 (20) 2 CONZ ST-#60 ALL ABOUT YOU SALON-MAPLEWOOD'SHOPS BP-2016-1214 GIs#: COMMQNWEALTH OF MASSACHUSETTS Map:Block: 32C-067 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Catego!y: renovation BUILDING PERMIT Permit# BP-2016-1214 Project# JS-2016-002089 Est. Cost: $900.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 108772 Lot Size(sq. ft.): 30666.24 Owner: MAPLEWOQD SHOPS INC Zoning: CB(100) Applicant: VALLEY HOME IMPROVEMENT INC AT. 2 CONZ ST - #60 ALL ABOUT YOU SALON - MAPLEWOOD SHOPS Applicant Address: Phone: Insurance: P O BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON.4/21/2916 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL CASE OPENING FOR INTERIOR DOOR & WINDOW 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 4/21/2016 0:00:00 $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-1214 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC YA ADDRESS/PHONE P O BOX 60627 FLORENCE01062(413)584-7522 PROPERTY LOCATION 2 CONZ ST-#60 ALL ABOUT YOU SALON-MAPLEWOOD SHOPS MAP 32C PARCEL 067 001 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 CASE OPENING FOR INTERIOR DOOR&WINDOW New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 108772 3 sets of Plans/Plot Plan THE FOLL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN TION 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 �Pen-nit DPW Storm Water Management De ii n De Signatur ilding Of tcial 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 Boardof Health,Conservation Commission,Department of public works and other applicable permit granting aut4orities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. Version 1.7 Commercial Building Permit May 15,2000 Department use only City o€Northampton Status of Permit: Building Department Curb Cut/Driveway Permit PR 19 2016 1 212 Main Street Sewer/Septic Availability orthampton MA 01060 Two Sets of Structural Room 100 WaterlWell Availability lPlans h' ffe 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 1.1 Property Address: This section to be completed by office ,IN L4- ft(3oUT ` OU Map Lot Unit CO uZ Sc` 41 ('0 Zone Overlay District 010 tm�„> .._ ___. _. Eire St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 'iMPJFCL?L.y. ()6*4 t�4M(�Ztitil1 c:io� Name(Print) Current Mailing Address: Signatured Telephone 2.2 Authorized Agent: . Kior►n►e. ..-...../1� (-lrrca � t, t Name(Print) Current Mailing Address ,,r7 SignatureMuC Telephone SECTION 3-EST TED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only ic cam feted by permit applicant 1. Building L4 ,O C (a)Building Permit Fee 2. Electrical (b); (b)Estimated Total Cost of (ic Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) „ 5. Fire Protection 6. Total=(1 +2+3+4+5) to •A heck Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Version l.7 Commercial Building Permit May 15,2000 W"" „ n� SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 X- - / CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. C� I4 )n,5.h ©� �'` L� { �n j� Of Proposed Work: C da01� In nm— load bear l SECTION 5-USE GROUP AND CONSTRUCTION TYPE l( USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ ❑ A-4 ❑ A-5 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ I Institutional ❑ I-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 Resi ck-n+ ai (1!71'15 S Special UseElSpecify. COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: � '�. V$ ?�— Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA OFFICE USE ONLY BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) _.. 1 st .. 1 Sl _. 2nd 2nd. .......... .._ __. .._....... .._. ......_.___.._ ....... 3rd rd3 ,. ., .... . .. ...:.,.. .. ... . .._... m 4`h 4 Total Area(sf) Total Proposed New Construction Total Height(ft) Total Height ft 7.Water pply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewagfptsposal System: Public Private E] Zone Outside Flood Zon4 Municipal On site disposal system[] �I I Versionl.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: ..:..,. L:' R:i , Rear Building Height Bldg. Square Footage °lo Open Space Footage __, % , (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Fi iladin ever been issued for/on the site? NO 0 DON'T KNOW 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 DONT KNOW Q 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: 11� � 1n �-� cx� d�c I rn +. ')J'�' { 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 exca tion,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version1.7 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 Num9.ber 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 Vg—tIeq Porno Tw '. _der ef,Tt ..,... Not Applicable ❑ Company r4A e: Responsible In Charge of Construction fit . Address Signat e Telephone i I Versionl.7 Commercial l!uilding Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 116(1 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize.\WIN act on Ty behalf,in all matters relative to work authorized by this building permit application C� ature Owne Date I, \Ioj "Tl ` 4of) hn L ),ei rr i 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. _ .. ...... . .... Jd),rakl ..... Print Naine l All, SI gnafur4 of Ov I q to SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ ............... Name of License Hofder. O ri._. .i `. � _...... _ . C. ... 1 0 / !a License Number ider5ide r, .liar s- Ct 'I y j 19 Address Expiration Date 41 7-5 Signatur Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MG.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 oft e b 'lding permit. Signed Affidavit Attached Yes No 0 The Commonwealth ofMassachusetts 7 - Department of Industrial Aceiderats Office of Investigations 600 [Vashington Street �..c,. ..,. Boston, AIA 02111 www.mass.govtdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _ Address: City/State/Zip: Phone#: FAre you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and 1 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. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp.insurance comp. insurance.* required.] 5. ❑ We are a corporation and its I0.❑ 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 nam 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 jab 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 the pains andpenalties of perjure that the information provided above is true and correct. Sienature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town officiaC City or Town: Permit/License# l 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#: i ISFL.�ti�hS':'"...al� Depael3nent of;nrdustrial Acci dents _ - 1; we o -�aes�ga do ns � - 600 IVa s ington .Street Boston MA 02111 4 www.Maass.gov1 diaa Workers' Compensation Insurance Aff davit: Builders/Contractors/Electricians/Pluinbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ,� L r �- &w-atr'.6 4- —Tn Address: �QIAU City/State/Zip: I-e.aCC �� 1 Thone 1�)?Z Are you an employer? Check the appropriate box: 'Type of project(required): 1.1% I am a employer with 1 2� 4. Q 1 am a general contractor and I 6 Q New construction employees(full and/or part-time).' have hired the sub-contractors 2.F1 I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These subj-contractors have S. Q Demolition working for me in any capacity. employees and have workers' 9 ❑wilding addition [No workers' comp. insurance comp. insu ance.I required.] 5. Q We are a corporation and its 10.Q Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L 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' l3,❑Cabey 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 ata an employer that is providin workers'compensation h4uraance for nay employees. Below is the policy maid job site inform-ation. Insurance Company l`'darrAe: a.�.� +.;�,r�•'`-• C c .�..y.�r_.yc� �,f�.t,.s Policy##or Self-ins.Lic.#: i_�U J:C.-:: Expiration bate: [ 'a 17 Job Site Address:£��� 3' .Z ? CitylState/ ia: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Faiiajre co secure coverage as-required under Section 2DA os r,4 L c. 1.52 can lead to trte imposmon of ciu sinal penalties of a fine up to$1,500.00 and/or one-year in,prisonment,as well as civil penalties i„the form of a STOP WOMC ORDER and a fine of up to$250.00 a clay against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investic,atiohs of the DIA for insurance coverage Verification. I do hereby certify a the pains ra +d,penrald perjury that tette information provided above is true and correct: Si afore: xC �e 1� -,1, Date: I Official use only. iso not rite in this area,to be comple.W by cit, or town o✓ficial City or Tov�m: Permit/Licenge 4 �I :&g umg Al thaa1 Ay Baca I. Board of!_1Lez!tL 2.null, ng Depzrtme nt 3. CitylTl own Clerk 4s Electekal Ikuspector 5.Flunabing Inspector 6. Other Contact Person: Phone#: I ii r■ a rm ��m wrnnum�r�n�r —_.. Valley Home I provement, Inc. P.O.BOX 60627,NORTHAMPTON,MA 0106 413-584-7522 FAX 413-585-0820 DESIGN / BUILD VALLEYHOMEIMPROVEMENT.0 M ADDITIONS • RENOVATIONS April 14,2016 City of Northampton Building Department 212 Main St. Room 100 Northampton, MA 01060 I request that you grant a modification towaive the requirement for control construction for the All About You A Salon project at 2 Conz St.#60 in Nc rthampton 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. Thank you for your consideration."Mass Amendments,sections 107.1 allows for an exclusion from control construction for this project." Respectfully, n Demerski Valley Home Improvement, Inc. 340 Riverside Drive Northampton, MA 01062 �Ja Sb Af>-)21 6 ?ny Q I