23B-035 (7) 61 LOCUST ST BP-2017-1487
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:elock: 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_
Pennit# BP-2017-1487
Project# JS-2017-002481
Est.Cost: 515000.00
Fee: $105.00 PERMISSION IS HEREBY GRANTED TO:
Const. class: Contractor: License:
Use Group: ALL-TEK BUILDERS INC 76435
Lot Size(sq. ft.): 27007.20 Owner: WOHL FAMILY DENTISTRY LLC
Zoning: N13000)/URB(0)/ Applicant: ALL-TEK BUILDERS INC
AT: 61 LOCUST ST
Applicant Address: Phone: Insurance:
88G INDUSTRY AVE (413) 736-0099 O
SPRI NGFI ELDMA01104 ISSUED ON:7/7/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:FLOORING, RE-ARRANGE LIGHTS 1ST FLOOR,
SECTION OFF 5 SMALL OFFICES
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: OI: 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 7/7/2017 0:00:00 $105.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-1487
APPLICANT/CONTACT PERSON ALL-TEK BUILDERS INC
ADDRESS/PHONE 88G INDUSTRY AVE SPRINGFIELD (413)736-0099 Q
0(
PROPERTY LOCATION 61 LOCUST ST 1(-7
MAP 238 PARCEL 035 001 ZONE NB(100)NRB(0)/
THIS SECTION FOR OFFICIAL USE ONLY: fIs.cJ
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid l0 j
Building Permit Filled out
Fee Paid
Typeof Construction: FLOORING,RE-ARRAIST FLOOR,SECTION OFF 5 SMALL OFFICES
New Construction
Non Structural interior renovations
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
INFO,RMATION 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
P em/o%tel/%/iti/i• Delay
Deela2-/7
•
Sia . ure of Budd g ffi al 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.
• t'l
- --"-"—� Versionl.7 Cornmercial Building Permit May 15,2000
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
-- Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PloVSite 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 L-Property �4 Address
6 : h y/�
/ s V Map A"✓// Lot 00 Unit
Net ifi gj47l1-VA- Zone Overlay District
-- - --- --- ----- Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: ��rr
WO/ft--- mIL1&-t e(vi'h— b /... 4,0 CCSr- sT, _.... . ...-.
Name(Print) ( Current Mailing Address / !r'
57- 49
Signature - _� Telephone
2.2 Authorized Agent:
.2814� c ft/ e-44-12C -7 fr�E. Iasi k(Sea
Name(Print) Current Mailing Address)
/.s `123 2d,i O/Y
Signature / '� Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building /0 on , (a)Building Permit Fee
2. Electrical (b) Estimated Total Cost of
3 Construction from (6) -
3. Plumbing i Building Permit Fee
4. Mechanical(HVAC)
SFire Protection / n
6. Total= (1 +2+3+q+5) n�t Check Number0 7 '?
This Section For Official Use Only
Building Permit Number Date
Issued
Signature'.
Building Commissioner/Inspector of Buildings Date
Versionl.7 Commercial Building Pemrit May 15,2000
ECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
USC FEET OF ENCLOSED SPACE
tenor Alterations ❑ Existing Wall Signs 0 Demolition Repairs 0 Additions 0 Accessory Building 0
donor Alteration ❑ Existing Ground Sign 0 New Signs 0 Roofing D Change of Use❑ Other 0
irret Description Enter a brief description here. ,G�.AQ,-/A , ,2,+<y, rC 2.-ie-Ar-f-
..0
if Proposed Work. /5rs in p sI y- y0iy D ce:..c
ECTION 5-USE GROUP AND CONSTRUCTION TYPE 1_
USE GROUP(Check as applicable) CONSTRUCTION TYPE
Assembly ❑ A-1 0 A-2 0 A-3 0 1A I 0
_ / A-4 0 A-5 0 113 0
Business ID 2A ❑
Educational 02S 0
Factory 0 F 0 F-2 0 •-- 2C ❑
High Hazard 0 3A 1i 0
nstiRtlional 0 I-1 0 12 0 1-3 0 38 0 i
Mercantile 0 4 0
Residential 0 R-1 ❑ R-2 0 R4 0 5A
Storage ❑ S-1 ❑ S-2 0 58 Ifs
Utility ❑ Specify
Mixed Use ❑ Specify'
Special Use 0 Specify
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
isting Use Group -. .. __.._ ._.. . . . Proposed Use Group: r ti-40-2G._.
isting Hazard Index 780 CMR 34) . : Proposed Hazard Index 780 CMR 34) .._. ..
ECTION b BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Dor,Area per Floor(sf)
1st /die-Per /4E7/Operfixe
.. .. _._ -_
3" ...
ital Area GO Total Proposed New wa4trustion{pf).__.
pa!Height{ft) .._..
Total Height ft
Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage DI osal System:
,tic Private❑ Zone_ Outside Flood ZoneD ( Municipal tf' On site disposal system❑
Version l.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 L -.: R .__. L R
Rear _ _..
Building Height _-- -- - -"-
Bldg. Square Footage - t % ---
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 Q DONT KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO CD DONT KNOW Q YES
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 Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained , Date Issued
C. Do any signs exist on the property? YES 0 NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES :0 NO 0
IF YES, describe size, type and location:
E. will the construction activity disturb(clearing,grading,excavation,or filling)over I acre or is it part M a common plan
that will disturb over 1 acre? YES 0 NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version! 7 Commercial Building Permit May 15,2000
ECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
ONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
1 Registered Architect:
- -- Not Applicable 0
�eLozd,%I Dc-ale�rse- HRzr�rl���
ame(Registrant): -__ - ----- - -
---- Registration Number
1 Q ELLIOrr cT jOan 7 .
idress _ _..... . . _.. ... .. .
-- -- - - Expiration Date
mature Telephone
2 Registered Professional Engineer(s):
ame Area of Responsibility
(dress Registration Number
gnature Telephone Expiration Date
Area of Responsibility
(dress Registraton Number
3nabre Telephone Expiration Date
•
me Area of Responsibility
dress Registration Number
;nature Telephone Expiration Date
me Area of Responsibility
dress Registration Number
•
nature Telephone Expiration Date
General Contractor
&feet.-...L,t? zc tL(ALP_t ., _ Not Applicable 0
mpany Name:
sponsible In Charge of Construction
1 .
tress L
� ij Lit 051e
nature Telephone
Version l-7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize, . . .
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
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 penelbes of Petery..
Print Name
Signature et OwierlAgent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Nut Applicable 0
Name of License Haider & -- 5%tc 61929t2.--- °/ .T3+-V-
License Number
,%141a °rte i ,;c tom? /CEA- /4F
Address Expiration Date
/i. tf�3 a/ k
Sign. ,�' Televbone
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 0 No 0
The Commonwealth of Massachusetts
tet.
Department of Industrial Accidents
Office of Investigations
600 j ashtna on Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Busin;ssiOrganizatior'Individua:):
Address:
City/State/Zip: Phone#:
•
Are you an employer?Check the appropriate box:
Type nfew sect(required):
1.❑ I am a employer with 4. [� I am a general contractor and I
employees (full and/or part-time).*
have fired the sub-contractors 6. ❑ New onsauction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. ". ❑ Remodeling
ship and have no employees These sub-contractors have S. Demolition
working for me in any capacity. employees and have workers'
o workers'com coma. insurances 9. ❑ Building addition
(IS p. insurance i
required.] 5. ❑ We are a corporation and its 10.0 Electrical repass or additions
3.❑ lam a homeowner doinc all work ' officers have exercised their 11.0 Plumbing repairs or additions •
myself. o workers' com right of exemption per MGL
12.D Roof repairs
insurance P required.] [ c. 152, §1(A), and we have no
employees. jNo workers' 13.7 Other ..
comp.insurance required.]
'Aoy applicant teat checks box#i mut also fill out the se-.5on below showing their workers'compensation policy information.
T Homeowners who submit this affidavit indicating they are doing all work and then hue outside contactors must submit a new affidavit indicating such.
TContactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entitles have
employees. 3f the sob-contractors have enryloyees,they must provide their workers'comp.policy number.
1 am 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/Zi
•
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 and penalties of perjury that the information provided above is true and correct
Sienature: Date;
Phone m:
Official use only. 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. CityiTown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.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/ 08 S T
The debris will be transported by: CO3--/PC--erg ,Z)/S-Pll 7 -
The debris will be received by:
Building permit number:
Name of Permit Applicante-M73 64.5
Date Signature of Permit Applicant
Initial Construction Control Document
t
Q To be submitted with the building permit application by a
Registered Design Professional
for work per the 8th edition of the
yy Massachusetts State Building Code, 780 CMR, Section 107
Project Title:Commercial Office Space Renovation Date: June 20, 2017
Property Address: 61 Locust St,Northampton, MA
Project: Check(x)one or both as applicable: ()New construction (X) Existing Construction
Project description: Interior Renovation sub dividing some existingoffice space.
I Stephen Jablonski MA Registration Number: 6078AR Expiration date: 08-31-17 ,am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans,computations and specifications
concerningl:
(X)Architectural ( Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge,information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
I. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
"--7 450>
Enter in the space to the right a"wet"or -�
�¢
kN J. JAee cri
electronic signature and seal: s No. 8078vc '
VRW6flNj " �
Phone number: (413)747-5285 Email: steve@jdarchitects.com N Ora / 612-0 f?
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1. Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised. If'other'is chosen,
provide a description.
Version 06_11_2013
&30/2017 City of Northampton Mad-61 Locust
Nn Louis Hasbrouck <Ihasbrouck@northam ptonma.gov>
61 Locust
1 message
Jablonski, Stephen <steve@jdarchitects.com> Thu, Jun 15, 2017 at 4:07 PM
To: 'tows Hasbrouck (Ihasbrouck@northamptonma.govy <Ihasbrouck@northamptonma.gov>
Louis: for your records. I have discussed the Level 1 plan with Brad Gable of Altek, the GC. We will produce a level 1
construction plan next week for your review and approval.
Steve J
Stephen Jablonski AIA
Jablonski DeVriese Architects
29 Elliot St
Springfield, MA 01105 phone: 413 747 5285
http lijdarchitects.sem
"Takin care of business!"that's what Elvis used to say
61 Locust Lev 2 , partial lev 1 Completion Affidavitpdf
171K
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