Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
23B-035 (2)
61 LOCUST ST BP-2017-0722 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23B-035 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-2017-0722 Project# JS-2017-000886 Est.Cost:$15000.00 Fee:$2555.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALL-TEK BUILDERS INC 76435 Lot Size(sq.ft.): 27007.20 Owner: WOHL CARINA Zoning:NB(1001/1RB(0)/ Applicant: ALL-TEK BUILDERS INC AT: 61 LOCUST ST Applicant Address: Phone: Insurance: 88G INDUSTRY AVE (413) 736-0099 O WC SPRINGFIELDMA01104 ISSUED ON::1/4/2017 0:00:00 TO PERFORM THE FOLLOWING WORIGNON STRUCTUAL INTERIOR DENTAL OFFICE - 5100 SF **INTERIOR ONLY** 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 1/4/2017 0:00:00 $2555.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck- Building Commissioner File#BP-2017-0548 APPLICANT/CONTACT PERSON AI.,L-TEK BUILDERS INC ADDRESS/PHONE 880 INDUSTRY AVE SPRINGFIELD (413)736-00990 PROPERTY LOCATION 61 LOCUST ST MAP,23B FARCEL 035 001 ZONE NB(IOO)/URBOKI THIS SECTION FOR OFFICIAL USE ONLY; PERMITAPPLICATION CHECKIAST INCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee eaid Building Permit Filled out Fee Paid +r Tvpecf Construction: NON STRUCTUA I • X New Construction � �� NomStructural interior renovation Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 76435 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS.APPLICATION BASED ON INFORMATION 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: She 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 De , tic. / d.! 2,6 Signatur- . nilding Of 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. Lers!oni.7 Commercial Bu;idin:Permit May 15,2000 Department use only City of Northampton Status of Permit. _ ___ Building Department Curb Cut/Driveway Permit_ REG 212 Main Street Sewcr/Septic Avaliability Room 100 Water/Well Availability_ cT 19 , Northampton, MA 01060 Two Sets of Structural Plans phope 413-587-1240 Fax 413-587-1272 PlottSite Plans _ • Other Specify '' AYtCStTOCONSTRUCT, 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 I („--p Gvs' r CS r , Map Lot Unit Zone Overlay District -- - - -__- -- Elm St.District CB District SECTION 2•PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 2& 694_44mi tic-bre t S/Utc fate L-CGcis"Y_ST, Fa> ,. '5 Name(Fant) Current Mailing Address- (//S Sfv bt_�z/ Signature Telephone 2.2 Authorized Agent: a L-7Dv a'74.od44 et 1 ft if_f -< (tOO&t j -c..(_' IRA ot_s WC Oa” -La Lxs'f t../ pt- SP,F l? ,[,4/ n`>d'71 Name(Print) Current Mailing Address se 6itB Lf13 Lv, L>/ Signature _, ` � '�., ielephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item pc-/..1 Estimated Cost(Dollars)to be Official Use Only '�,,.I.�.� completed by permit applicant 1, Bu4AUir� "y �s' (/1)-2, L'V (a) Budding Permit Fee — 2 Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee d. Mechanical(HVAC) I 5. Fire Protection .. _ 6. Total=(1 +2+3+4+5) Check Number 9c/i. This Section For Official Use Only Building Permit Number Date Issued Signature'. Sung Commissioner/Inspector of Buildings Date Vernon) 7 Commercial Bui(d:ag Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 36.000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs 0 Demolition Repairs Additions 0 Accessory Building Exterior Alteration 0 Existing Ground Sign❑ New Signs❑ Roofing Change of Use❑ Other 0 Brief Description Enter a brief description here. Of Proposed Work: ma./ ^_f 7"`%'-icL74-z 0c"7iz.Fi, SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A-2 0 A-3 0 1A � ❑ A-4 0 A-5 ❑ lB ❑ e Business 2A 0 E Educational 0 2B [ ❑ F Factory 0 FI 0 F-2 0 20 ❑ H fligh Hazard 0 SA 0 I Inslilu!ional 0 I-1 ❑ b2 0 4a 0 3B ❑ NI Mercantile 0 4 ❑ R Residential 0 R-1 p R-2 0 R-3 0 5A 0 S Storage ❑ S-1 ❑ S-2 ❑ SB ❑ - U Utile 0 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 730 CMR 34).'. Proposed Hazard Index 780 CMR 34) SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCION OFFICE USE ONLY T Floor Area per Floor(st) 1.r _.. to .. .._ ... ._. 2nd 3 ... 3b _. .._. Total Area (sf) Total Proposed New Construction(sf) Total Height(R) _.. _.... Total He ght fi _. 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❑ Municipal 0 On site disposal system Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning 3'his cohmm to be filled in by 7:: j : L: - R _. . yL ht -- OSpa % Spume Footage ,1 Open pan Space Footage f °o (Lot area mime bldg&pay padltng) tt of Parking Space (volume&Location) .. .. _. A. Has a Special Permit/Variance/Finding ever been issued for/on the sit:. NO 0 DONT KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 41 IF YES: enter Book Page and/or Document ft B. Does the site contain a brook, body of water or wetland NO 0 DONT KNOW 0 YES 0 tF YES, has a permit been or need to be obtained f •m the Conservation Commission? Needs to be obtained Q Obtaine• 0 , Date Issued: C. Do any signs exist on the property? YES ip NO Q IF YES, describe size, type and Inca ' n' D. Are there any proposed changes • or additions of signs intended for the property? YES V NO Q IF YES, describe size, ty,- and location: E. MI the constructio• .ottety disturb(clearing,grading, excavation,or filling)aver I acre or Is it pad of a common plan that will disturb over I acre, YES 0 NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. • Versienl.?Commercial Building Permit May[5,2000 r 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 O —.... Name(Registrant) Registration Number Address Expiration Date Signature 1'eiepnme 9.2 Registered Professional Engineer(s): Name Area of Responsibility ASdrss Registration Number .... F Sionatu'¢ Ty eFhel%C Exptmtim:Pale Name Area of Responslbiluy 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 lete{thone Expiration Dale 9.9 General Contractor � / 4eLacN' 61/414-406- 1-- ) _ G... Not Applicable ❑ Company Name: 44) 6< St ,— Responsible In Charge of Construction Address g Signature -telephone VersionI.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structure!Peer Review Required Yes 0 No 0 SECTION 11 .OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT i•i... - as Owner f the subject property hereby authorize act on my behalf,in all matters relative to work authorized by this building permit application. Signature or Owner Date L __ ,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 Ownor/Agent Dale ECTION 12-CONSTRUCTION SERVICES /5 10.1 Licensed Construction Supervisor:nn � /.t pot Applicabler9 /- 0 Name of license Holder &t'W 6A'f1EL - V7b 9 35 License Number es--_ -6 tz-/_ SPt2D, A/5. O//r14/ Expir 7S- /1 Address / /3 2'Lf/ /' r 4 Sign. ure G V — Telephone SECTION 13-WORKE-S'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 0 No 0 The Comrnorzwealt'h of Afassaehusetts Deparvnent of Industrial Accidents �-wt ';trirrf Office of Investigations 600 Washington Street Boston, M4 0211] www✓z¢ass.gov/tile Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): / /p'CAL. %(-my_ ...61.4 CO L S Address: efrer .--Tom:-CLs r/U yK S�FZ f� (rfl' ©//2J t7/ City/State/Zip:_, Phone #: 4 /3 2-2,l 12/4/ f Are you an employer?Check the appropriate Type of project(required): Warn 1- a employer with Li 4. t am a general contractor and employees(full and/or part-time)." have hued the sub-contractors 5" j New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. LirlfCaolition 01i ty working for me in any capacity. employeesand have workers' 9. n Building.addition [No workers'comp.insurance comp.insurance.: required.] 5. [] We are a corporation and its 10,0 Electrical repairs or additions 3. lam a homeowner doing all work officers have exercised their 11.D Plumbing repairs or additions myself. [No workers'copY- right of exemption per MOT ILL Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 73-U Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below shovnng their workers'compensation policy info+nation. `Homeowners who submit this affidavit indieating:hey are doing all work and then hire outsidecontracrors mast submit a new affidavit indicating ouch, iContractors that check this box must attached an additional sheet showing the nave of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employes,they must provide their workers'comp.policy number. Iain an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lie.#: 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 thepatnd penalties ofpetjmv that the information provided above is true and correct. —62 Si¢ngNreJ : / l X..-6.�' �/ Date: /k t 0Cr /6 Rhone W: C/t3 7-2-/ 6)/ V cF Official use only, Do not write in this area,to he completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): I.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector G.Other Contact Person: Phone#: 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: 6/ G 1S/2f T' S /, ) t7 /7 4,47 J The debris will be transported by: <)M 0cey 1),,s,)O7c- The debris will be received by: Building permit number: Name of Permit Applicant &77-z ER Date Signature of Permit Applicant