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32C-052 (14) 9 PEARL ST BP-2018-1143 GIS n: COMMONWEALTH OF MASSACHUSETTS YW.Block: 32C-052 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: demolition BUILDING PERMIT Permit BP-2018-1143 Proiect# JS-2018-001820 Est.Cost $20000.0 Fee: $140.00 PERMISSION IS HEREBY GRANTED TO: Const.Class Contractor: License: Use Group? TEAGNO CONSTRUCTION INC 082248 Lot Size(sp.ft.): 11194.92 Owner: GLEASON HELEN C&PATRICK T TRUSTEES OF HELDON REALTY Zoning: CB(100)/ Applicant, TEAGNO CONSTRUCTION INC AT. 9 PEARL ST Applicant Address: Phone: Insurance: 228 TRIANGLE ST (413)549-0803 Workers Compensation AMHERSTMA01002 ISSUED ON:5/3/2018 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMO ONLY - PARTITIONS AND STAIRCASE 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 Sl2nature, FeeTvpe: Date Paid: Amount: Building 5/3/2018 0:00:00 5140.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner RECEIVED Versionl.7 Cmnmemlal Holding Permit May 15,2000 Department use only MAY - 3 2018 ity of Northampton Status of Permit: ' wilding Department Cum CuvDrlveway Permit 212 Main Street SewerlSepbc Ayalatelity DEPT OF BUILDING INSPECTIONS Room 100 NONTHAMPTON.MA 01060 Water/Welt AValabllty orthamplon, MA 01060 Two Sets of sbucwrelPlans ! phone 413-587-1240 Fax 413-587-1272 PloUSrtePra€o— I omersp�asy 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 yMap Lot Unit Zone Oyeriay District Elm Sl.District CB Distinct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT _ 2.1 Owner of Record: %te/Don P-pd^ 7r jfi Name(Pro) tlkk E� S �1'P'aOv'7/-'rtL'-�- Current Mailing Address ��y—)� - (�cvKEi3�LCSDi !z,( L£CDS� NA�UlO Signature ` �I Telephone 2J 2.2 Authorized Agent: Name(Print) Current�Mailing Address T"` CQ/! )(�w (9187 Signi Telephone SECTION 3.ESTIMATED CONSTRUCTION COSTB Item Estimated Cost(Dollars)to be Official Use Only completed bpermit applicant 1. Building '- (a)Building Permit Fee ex ,,ri 2. Electrical (b)Estimated Total Coal of Construction from 6 3. Plumbing Building Permit Fee !, 4. Mechanical (HVAC) 5, Fire Protection ----- fi. Total=(1 +2*3+4+5) 01Ue Check Number o! This Section For Official Use Only Building Permit Number Date Issued Signature' 7 k Building Commissioner/Inspector oo\(Bui[ldlnjg�s �{ \ Date % ' Vcrsionl.7 Commercial Bvlding Permit May IS.7000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations E] Existing Wall Signs ❑ Demolition Repairs El Additions ❑ Accessory Building[I Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description F.nter a brief description here DE/ c 0 q .— T ti TSE r-'od— pN�o'd a Aid"' Proposed Work: srrpo 0. CAd SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly1-1A-1 ElA-2 ElA-3 El 1A El A-4 ❑ A-5 ❑ 1B ❑ B Business 2A ❑ E Educational 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 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: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE i Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34) Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA L J-4-r Rl No a' BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area par Fluor(st) 1'• Iss 2,a 2.a 3e 3° ... 4 lh4v. Total Area(sf) Total Proposed New Construction (sh Total Height(R) Total Hi If _... _. 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zane❑ Municipal ❑ On site disposal system E] Version 7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING E i r ua No P I1a-,v Existing Proposed Required by Zoning Thea coluuni to be filler in b, BoilAiny D"srtu'n, Lot Size Fronto�e Setbacks Front Side L._. . R:. L. R Rear Building l leight Bldg.Square hbolage Open Space Footage o (Lo,nim minor bldg&pawl orkln ) g of Paik,.gS aces Pill: nlmnc&LucuGoul A. Has a Special Permit/Variance/Find I ever been issued for/on the site? NO O DONT KNOW YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? p� NO DONT KNOW )& YES O IF YES: enter Book Page and/or Documeri B. Does the site contain a brook, body of water or wetlands? NO C DON'T KNOW O YES O 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 J9 NO IF YES, describe size, type and location: �AI-Teo) 0 N is t 132,Ck D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO J'0 IF YES, describe size, type and location: �'� E. Will the construction activity disturb(Gearing,grading,excavation,or filling)over I acre or is it part of a common plan that will disturb over I acre? YES O NO Q IF YES.then a Northampton Storm Water Management Permit from the DPW is required. Vernon] 7 Compe l Building Permrc 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)' Reglstmtion Number Address Exyiration Date Signature Telephone 9.2 Registered Professional Engireer(sl: 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 Respi,dendpty Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor / �-9/UC -0,C)iCTl OAS �Tk` Not Applicable ❑ Company 1: RUIs Respons rie In Charge of Construction a4 drool_ Addr ss gna�are Telephone Version 1_717rmmorcial Building PermitMay 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes © No SECTION II -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES�FOR BUILDING PERMIT I, / / / / / \�'✓ / � // ,as Owner of the subject property herebyauthorze _ �eaU/.s (.}!¢ Nn-dor— IPBDXCO Cotilt/-�C`tiOrff l//C • to act on my behalf, in all matters relative to work authorized by this building permit application. Signature caner w �fr ,ys��p Dete Sr�� P,,( EJ 1, L..(7 U L (9 A /// J114 t.L) ,as OwneNAethonzed Agent hereby declare that the statements and information on the foregoing application inside and accurate,to the best of my knowbadge and belief. Signed under the pains and penalties of pequry._ -S _ �a /li n a r o Pn Name Slgnalure of OwnerlAgen ale SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ J Name of License Holder � Cy f (T—� /¢" (i1/xf '�-d ff S — License Niudw, aa � rr ;G �% St. Ar /Pr�,f N�4oieo�- IOLY Al Address �� Expiratin Dad4 S�naNre Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§26C(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 © 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: / &4 -S7- The debris will be transported by: ,� vS ecw i foc k'�j The debris will be received by: /A- e ee rtic /n- Building permit number: Name of Permit Applicant �0 U� 151¢ ��i✓b�RO 9z/ Jort' � Date Signature of Permit Applicant The Commonweolth ofMassaehusetts Department olfss Street, Suit cciAents / Congress S(reet,Suite 100 v/ Boston,M4 02114-2017 Vwww.mass.gfroul \lorkers'Compensation Iusera ace Affidavit: Bit ilders/Contractors/F.leclricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lev'bly Name tHarme,:a-org,,,naeemindiviaanp: ray. ,h'0 (�0411-17i�.0i r Sp0 . Address: —Lf /P }tet Ciry/state/Zip: w ell i+ �,/({" O/E��-' Phone #: 2� X73'03 Aoegoo an employer?Cbeek d e uppropri to box: Type of project(required}. I,isIauaemplober.. —_.1✓ arm.....(full wNor parttime)* 7, ❑New construction a.❑lam I eol,,onoa crpaih l told hero.r—re,ln1ee,working Nr m..n 8. E] Remodeling any capablR[No oadas'warp.Nsmvnce warned] 3� ameM1omemenardoin Il workm arty: coworkers'cpm tv.rin. r d 9- ❑Demolition ga )- L v -n � -e require ]' 10 E]Building addition 4.❑I f ro dsllbh' g contractor,roconduct-It k pp.t, to , rsethatall o tt either have k mmpe. ciao ter o .,r a. tae 11.❑Pkc[neul repairs or additions pp' ta.. h al nrylo,he; 1Z E]Plumbing repairs or addition, -.❑I or a ,.arl ono,il andlthus lihodhe. rhraad,hodoilthe hedlat. 13_E]Raofrepalrs lh :ubco i t I are amPl , dh vd Ftrun 6_❑Ni area corporationham exert its officer,hacmmsed their right ofexeragion per stair l4-❑Other 153.¢1(91.and uhavu ao amploym's.INo works,-lixu in—a-rovi red_l "vo,,iphrenithlrh,,ksboxal oloraiso fill our the vactor hdow,ahowing thdrwotkcnconuen oatpollr"renh—tlon 'Hoar tt. »he subminhis amd—,indicating they are doing all wort and than tortuous contracts,must submit anevafYdmnlnd'u,nugoth. 1C.stoly l that ehcek the area 111al a ached an additional cheer dovlvg the name or ulb-conuaewIlard smte whether cr lot rtose.ne"'have emplo}tts. read ob aartalhave<.,loycu,Iheg warp provide their workers crimp po8a real. lam an carp!oyer that is providing workers'compensation insurance fin my employees. Below is the policy wall site information. Insurance Contpanp Name- 24 T /�f . �Clfct�� Tl f l rO Policy#or Self-ins. Lis.#:1y M 78006 L-�J-3"'1,401/d yr Expiration Date: I/ Joh Site Addiehs: 9 ,y eL ST A)ofi �h" /pic' /1j,•P City/StatelZip: CP106C) Attach a copy of the workers' compensation pokey tar Inn lug the policy number and expiration date). Failure to eccum coverage as required under MCL c 152,§25A is a annual violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penahies iv the tor.ofa STOP WORK ORDER and a fine cf up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage cerifrciar l too hereby cettilp under tthhe pain 2penMpes if'Perjury that the information provided abovell. true and correct Sienatme 1 xDare- 15-11 phone b: Official use only. Do not welle in this area,to be completed by city•or town o(ficiat. City'or Town: Per.itiLiceme,# Issuing Authority, (circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk d.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Louis Hasbrouck Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 05/01/2018 RE: 9 Pearl Street, Interior Demolition Dear Mr. Hasbrouck I am writing to kindly request that you grant a modification to waive the requirement for control construction for the above referenced project for Heldon Realty Trust, Dan Gleason Executive Trustee. I have toured the project and believe the demolition work is of a minor nature, will not affect health, accessibility, or structural requirements. Full 2015 IBC review and permit documents are forthcoming & will precede any new construction on site. Please accept this letter as consent that we allow for the City of Northampton to oversee the construction and implementation of this project. Thank you for your consideration. Respectfulrrl//yy/�, Daniel Architect, LEED AP Thomas Douglas Architects 196 Pleasant Street Northampton, MA 01060 196 PIeasan[Sveec NonFampron,MA 01060 14135650M12 1 dou&—h,1ea—