25A-182 (41) 94 INDUSTRIAL DR BP-2017-1357
• GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25A- 182 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Ramp BUILDING PERMIT
Permit# BP-2017-1357
Project# JS-2017-002255
Est.Cost: $29500.00
Fee: $210.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PIONEER CONTRACTORS 017890
Lot Size(sq.ft.): 170319.60 Owner: 94 INDUSTRIAL DRIVE LLC
Zoning:GI(100)/ Applicant: PIONEER CONTRACTORS
AT: 94 INDUSTRIAL DR
Applicant Address: Phone: Insurance:
PO Box 1145 (413) 586-5491 Workers Compensation
NORTHAMPTONMA01061 ISSUED ON:5/25/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL TRUCK RAMP WITH RETAINING WALL
@ OVER HEAD DOOR AND INSTALL NEW OVERHEAD 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 5/25/2017 0:00:00 $210.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File N BP-2017-1357
APPLICANT/CONTACT PERSON PIONEER CONTRACTORS
ADDRESS/PHONE PO Box 1145 NORTHAMPTON (413)586-5491
PROPERTY LOCATION 94 INDUSTRIAL DR
MAP 25A PARCEL 182 001 ZONE GI(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid f, (n
Building Permit Filled out �(d,��/
Fee Paid
Typeof Construction: INSTALL TRUCK H RETAINING WALL(a7 OVER HEAD DOOR AND
INSTALL NEW OVERHEAD DOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 017890
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF MATION 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
• of ' n •elay
`
S ?MIT.114.1 • ding official 4-
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.
Version] 7 Commercial Buldin_ Permit Ma 15,2000
2 J 'nit/ Department use only
City of Northampton Status of Permit.
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Avalabiiity
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PIot+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
4 I '. This section to be completed by office
/r ... \\
*dus;Y0,rW�1 1A.' Map Lot Unit
CL cri+ Wt Zone Overlay District
- - - --- --- - = Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
kAattetAN t 1 p t
t ` ^omC $19 u2tW+6 _F4 r^4t45-� iwl
Name(Print) L��(„ Current Mailing Address:
Signature G L_.....__ Telephone
2.2 Authorized Agent: ✓
RV;ter 6v- _ PLl arc 1141' 1't6rIl av14 C+cxoi
Name.(Print) Current Mar mg Address'
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
L BuildingS{ (a)Building Permit Fee
"
2. Electrical " - (b)Estimated Total Cost of
2{I )VY 'DU i Construction from (6) _
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) --
. 5. Fire Protection -
6. Total=(1 +2+3+4+5) '74, Check Number /Kat' 6,7131
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
Version 1.7 Commercial Building Permit May 15, 2000
NON 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
IC FEET OF ENCLOSED SPACE
for Alterations 0 Existing Wall Signs 0 Demolition 0 Repairs 0 Additions 0 Accessory Building
for Alteration gf Existing Ground Sign 0 Now Signs 0 Roofing❑ Change of Use Other 0
IDescription Fete:a brief description here rv,stait Ttt I Dr. 'YC..a XI(tw+ra�..vy� ti,zk@ P/h Dan.,
Work: N9M1nl "O+C ti� r
.. on ... 1?Hr-t
PION 5 •USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
sembiy ❑ A-1 0 4-2 0 A-3 0 IA ( ❑
A-4 0 A-5 ❑ 18 0
siness d 2A 0
ucetional 0 _ 26 0
:tory [i
❑ F4 0 F-2 0 2C /
h Hazard 0 [ 3A 0
iwtional 0 1-1 0 32 0 1-a 0 3B 0
=.rcanti{e 0 4 ❑
sidentiai 0 R-I 0 R2 ❑ R-3 0 5A 0
,rage IP/ S-1 0 S-2 0 58 I 0
IitY ❑ Specify '
red Use 0 Specify:... _. ..
Baal Use 0 Specify: _. _.... ..
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS ANDIOR CHANGE IN USE
ig Use Group 13r^S"'iima`'e /SQ-' _. Proposed Use Group
ig Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34)
now 0 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE 115E ONLY
Area per Floor(at)
_ _ .. ...._ 211° ,
_. ___ ___
Area fsf) Total Proposed Neu Construction{sfl
Height(ft) _.___..
. Total Height ft
iter pply(M.G.L.c,40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Private 0 Zone -, Outside Flood Zone[97 Municipal ( On site disposal system❑
Version 1.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size -. ... . . . .. _. . _ _.
Frontage _ ... ._
Setbacks Front -- - '"- "---
Side
Rear _.. ., ._..
Building Height - --
Bldg. Square Footage -- - % -
Open Space Footage % _
(Lot area minus bldg&paved -_ -
parking)
#of Parking Spaces --- --
(volume&Location) _ .. _... __.. _.
A. Has a Special Permit/Variance/Fin�dtinn( ever been issued for/on the site?
NO Q DONT KNOW YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW 0 YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0/ YES 0
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 0.7
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading.excav tion, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 Commercial Building Permit May 15,2000
PION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
STRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
egistered Architect:
_. ..._. _. _.. .._.. Not Applicable 0
(Registrant): __....___ .. ._. .... .
Registration Number
ss
Expiration Date
ure Telephone
egistered Professional Engineer(s):
Area of Responsrbility
as Registration Number
ure Telephone Expiration Date
Area of Responsibility '.
s Registration Number
rre Telephone Expiration Date
Area of Responsibility
Registration Number
ire Telephone Expiration Date
Area of Responsibility
Registration Number
ire Telephone Expiration Date
neral Contractor
DILMP.P.t.�._ �4VP�1�-� - ----- --.___ _.._.__ Not APPlicable ❑
ay Name /
sible In Charge of Construction
P o . P)fl l ly( H@, at)a-- (slab !
/eR,-i 1s -'T v 513- -stir
re Telephone
Versionl.7 Commercial Building Permit May IS,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) �/
Independent Structural Engineering Structural Peer Review Required Yes 0 No CO
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
e__ p
t, a i.. sa a. - i.6. y 4 mi _____ .-j - I.as Owner of the subject proerty
hereby authorize . _...r tanO f DewL `�X(�^ to
act on my/penal!,in all matters relative to worn authorized by this building permit application,
J� (. S/Z3 h>
Signature of Owner Date
- +y n< ._. , as C ilio/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.
(
Is Clic%
Print Name
signature o Owner/Agent Data
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor Not Applicable 0
Name of License Holder AV/lad__6(9X _ C>° ,61729a
]1t
AALicense License Number
es.. C.3A:- Ii''{'.}J .tu6eut2uC•..d`kNn, ,(Y12' ..Qber l 1...tst
Address yj rr '' Expiration Dare
1113- 674-7u7
Signatur t L/ Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c.152,§250(6))
Workers Compensation Insurance affidavit must he completed and submitted with this application. Failure to provide this affidavit will result
In the denial of the issuance of the hu Ing permit.
Signed Affidavit Attached Yes No 0
The Consmmn wealth of Massachusetts
Department of Industrial Accidents
. .� Office of Investigations
ustiderfairi'17=
. 600 Washington Street
Boston, MA 02111
www.tnass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (0usiness/Organizatior✓Individual):
Address:
City/State/Zip:_„ . Phone #: _
Are you an employer?Check the appropriate box: Type of project(required):
•❑ I am a employer with 4. -) I am a general contractor and I
employees(full and/or part-dme)* have hired the sub-contractor 60 New rt;nstmcaon
listed on the attached sheet 7. ❑Remodeling
❑ I am a sole proprietor or partner-
ship and have no employees These sub-contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers' q Building addition
[No workers'cotng,insurance comp.insurance,'
required.] 5. f] We are a corporation and its 10.0 Electrical repairs or additions
❑ I am a homeowner doing all work ' officers have exercised their ILO plumbing repairs or additions
myself. [No workers' comp, right of exemption per MGL 12.❑ Roof repairs
insurance required.]t e. 152, §I(4), and we have no
employees. No workers' 13.❑ Other
comp. insurance required.]
ay applicant that checks box 51 must also#11 out the section below showing their workers'compensation policy information.
meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
,nn-actors that check this box must attached an additional sheet showing the none of the subroueactors and state whether or not those entities have
pinyees. If the sub-contractors have engkyees,they must provide their workers'corm.policy number.
m an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
'ormation.
:urance Company Name:
/icy#or Self-ins.Lie.//: Expiration Date:
Site Address: City/State/Zip:
tach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
.lure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a
e 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
✓p to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
estigations of the DIA for insurance coverage verification.
o hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
n ature: Pate:
me n:
Official use only. Do not l'rite in this area, to be completed by city or town official
Circ or Town: Permit/License
ssuing Authority(circle one):
L Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
i.Other
:ontact Person: - Phone it: •
iti1.
a Crim of Nartilalaptan 1
;51.4w��,..'
DEPARTMENT ON BUILDING INSPECTIONS . cE -
212 Main Street ' Municipal Building
Northampton, Mass. 01060 No
WORKER'S COMPENSATION IN'SDRANCE. Alt b!DAVIT
Pioneer Contractors
(licensaipermibes)
with a principal place of bneiness/residence at.
_. _P.O Box_ r t . . • u . . • un . I . _(phoned:) 586 5991
(s�a/city/sruhip)
do hereby certify, under the pains and penalties of perjury, Mtg.
(V I aw an employer providing the following workers compensation coverage for my
employees working on this job:
Wcc 500595701200
Assnri ated Employers TRS trance Co __ __,_ _ST
(1/T
(Insur_ncr Combe eat) (Policy Number) (l xp adon D:et/
() I am a sole proprietor, general conu actor or homeowner (citric one) and have hired
the conuactors listed below who have the following workers compen<ndon policies:
(Name of Contractor) (lnsurenot Company/Policy Number) (Fxpwaoe Date)
(Name of Conmctor) (insurance Company/Policy Number) (Emvaoon Dale)
(Name of Connaclnr) (Insurance Company/Policy Numle0 (icpiroon Date)
(Name of Contractor) (Insurance Company/Policy Numh-r) (Eapiauon Date)
(gram.,.tenial t.bact;rn..ary to cn e=:ofrta,o on pat-taint to sit amt,.,n)
() I am a sole proprietor and have no one worinng for me_
( ) I am a home owner performing all the work myself.
NOTE:please be aware Uvt vital°bccocovererra`Wo asploy paa"e w da 11.1131altaCC.anCUCIOC a roma-war on 1 demand of
ea more than Limon,.crit is which the bomncwocr rmda or on(Sc g'wnh appstrinnacr tem yr not 6orarfy coarisiatd to b.:
asploym user ale wMeh n.ttpe-tr.ina An(0LL5],n 1.(5)).alViec oo by a bomawm for e li es pamatvy'WI' c
lett/ante of an employee under.Ear.Wohdr COCOpaa:14110a An_
Isn&Qeand to a copy of this m r......'1 may b faword.d to Na Depute:wat ofloAamel Am. .O&w of Imuaam for¢a
web.vtnfiaiim Mthat L'J,ec 10"4"“aaerto unda sccdon 25.A of MOL 152 can lad toI&unp moa ofmrimmil penalties
cvmisvng oft[ma of up w Sl)OO.Oo to/or impriso®vl of up to oz ymr nod civil pcpatnict in the foam of..Sap Wok Ont:and
fano o(SIOo On•day*g=tmt me
a For ran ex my
A
PermitSLi ermi.. state j
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: Q>4 _L,—At,.s+riot A._•
The debris will be transported by: /Ay
C C. C. Qol,e. a
The debris will be received by: VerRic), y
Building permit number:
Name of Permit Applicant Pwy‘w, 61.44✓r-yr
Date Signature of Permit Applicant
,
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Pioneer Contractors
NP1 Con,Inc.
agleSt
P.O Box 1145
Northampton, MA 01061
Voice 413-586-5491
Fax 413-527-5099
E-Mail pioneercontracroyahoo.com
Cell 413.626.7267
To: Louis Hasbrouck/Bldg.Comm. From: David Claxton
Fax: Pages: 1
Phone: 413.587.1240 Date: 23 May,2017
Re: 94 Industrial Dr. CC:
❑ Urgent X For Review ❑Please Comment ❑Please Reply 0 Please Recycle
•Comments:
I request that you grant a modification to waive the requirement for control construction for the
installation of truck ramp @ overhead door 8 replacement of the overhead door at the above building in
existing space, 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.
Please see sketch attached to permit application.
Thank you for your consideration.
Respectfully
David Claxton
Pioneer Contractors
( STORAGE
UNITS
NORTHAMPTON
CI-86 MA
a ELECTRIC BOXES
RAMP 112 SLOPE /Q`
HEATER 11'OFF FLOOR q L 1 r
rFIRE EXTINGUISHER
F -
revision date
3/17/17
drawing date
PHASE 1
SCALE: 3/32" = 1'-0"
A- 1
STORAGE
UNITS
t
'',. - 9�"9'__- f_ _. . . .. .. 27'2" 1 B, A 91 .__.9" B'.6" ._ 1'.8'Y y.... ._ Ir6• __ _ _10'P, _ _ _ __ _ _ _ _ _ _ _
NORTHAMPTON
111111
1 ' 1
SECTION 1
SCALE: 1/8" = 1'-0"
4 zv_
iii� revision date
I I
s -+- 3/17/17
drawing date
RAMP 112 SLOPE
A-2
SECTION 2
SCALE: 1/8" = 1'-0"