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32A-107 50 MARKET ST BP-2018-1095 GIS 4: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 107 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeorv:renovation BUILDING PERMIT Permit s BP-2018-1095 Protect# JS-2018-001972 Est.Cost $12135.00 Fee $100.0 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: GENE BOROWSKI 106527 Lot Sizdso ft.): 6490.44 Owner: WISNESKI JOSEPH A zonfne:URcn00)/ Applicant: GENE BOROWSKI AT. 50 MARKET ST Applicant Address: Phone: Insurance: 117 SUNNYMEADE AVE (413) 687-3777 WC CHICOPEEMA01020-1780 ISSUED ON:5/15/2018 0:00:00 TO PERFORM THE FOLLOWING WORIGWINDOWSAND SKYLIGHT 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 5/15/20180:00:00 $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Vernml.7 Commercial Building Permit May 15,2000 Default IV" i City of Northampton W-C Building Department " 7 *1: 'V 212 Main Street sewers so Room 100 Northampton, MA 01060 of Is L---'��II113-587-1240 Fax 413-587-1272 Pig T J11I am 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 Lotl C7 Unit A" &1104"g Zone G Overlay District Elm St.District CIS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address 1 OW-3 ) 9 Signature Telephone 2.2 Authorized Agent 117-�� les - cares Name iPnnt) Current Malin Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost(Dollars)to be Official Use Only ,—cam leted by Pend appfic�ant 1. Building oGae) (a)Building Permit Fee 0- 2. Electrical (b)Estimated Total Cost of Construction from (6) 3. Plumbing 3, Oo Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection e'-0- --- 40n 6, Total= (1 +2+3+4+5) i Check Number This Section For Official Use Only Building Permit Number Date Issued Building Comm/issioner/Inspector of Buildings Dale ! J- 1 -1>, R,EMS60 PLANS - S �6 vJOR"C To --nuuv Version1.7 Commercial Building Permit May 15,2000 1 , SECTION4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs Demolition❑ Repairs Additions ❑ Accessory Buildi g Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing Change of Use❑ Other Brief Description Enter a brief dscription here. Of Proposed Work: e . 2e. zp !. P/ CAac SECTION 5-USE GROUP AND CONSTRUCTION TYPE o¢ / USE GROUP(Check as applicable) UCTION TYPE A Assembly ❑ A-1 11A-2 ❑ A-3 111A ❑ A-4 ❑ A-5 ❑ 18 ❑ B Business 2A ❑ E Educational ❑ 2B I ❑ 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 ❑ SA ❑ S Storage ❑ S-1 ❑ S-2 ❑ 56 ❑ 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 Existing Use Group: Proposed Use Group _ Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34). SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1 in 2n',. 2nd -- --.. 3rtl _. ,.. 3`tl _.. Total Area(sp Total Proposed New Construction Total Height(n) Total Height It _.. 7.Water Supply(M.G.L.c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zane Outside Flood Zone❑ Municipal ❑ On site disposal system❑ 1 Versioul.7 Commercial Building Permit May 15,2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning ibis column a be filled in by S"' Building Department , Lot Size _. +S1 Frontage __ .._. ._ _. ...._... Setbacks Front Sited L: /O R..I L.... R. Rear Building Height 17, --- Bldg. Square Footage /5,,. Open Space Footage L7U % _.. - (Lot area minus bldg&pavedparl'ing) #of Puking Spaces volume&Lacanon _. ..._ A. Has a Special Permit/Variance/Firich'ngy ver been issued for on the site? `Cl NO © DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Re 0 try of Deeds? NO O DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO (V DONT KNOW © YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained O , Date Issued: C. Do any signs exist on the property? YES NO O IF YES, describe size, type and location: `Ja�lstly �f �Q / D. Are there any proposed changes to or additions of signs Intended for the property? YES © NO V IF YES, describe size, type and location: E. Will the construction activity disturb (cl©ng, grading,exca tion,or filling) over 1 acre or is it part of a common plan that will disturb over l acre? YES NO IF YES,then a Northampton Stan Water Management Permit from the DPW is required. T Version1.7 Commercial Building Permit May 15,2000 1• 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 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 Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor - D!'pLu Not Applicable ❑ Company Name Responsible In CChha}r6 f Constru tion Address Signature 0 Telephone / Versionl.7 Commercial Building Permit May 15,2000 SECTION 11 STRUCTURAL PEER REVIEW(TSO CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT ORRCCONTRACTOR /APPLIES FOR BUILDING PERMIT I, as Owner of the subject property hereby authorize —.. .... P �CP 2[/'�cc.! _._ . ..__ – _ to act on my behalf, in all matters relative to work authorized by this building permit application _ Signature of Owner Date 1 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 Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: 9 Not Applicable ❑ Name of Lmense Holder. License Number Address Expiration Date $ii 1_4=1� ureY Telephone SECTION 13-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.it. 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 © 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 IMGL c 111 , S 150A. Address of the work: SOy�/lrrdp� The debris will be transported by G�«�p � z<4Eanc�7 The debris will be received by: Building permit number: Name of Permit Applicant /(1zle.-re �� ? Date Signature of Permit Applicant The Commonwealth of Massachusetts l Department of IndustrialAccidents 1 Congress Street' Suite Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. A ]icon[Information Please Print Legibly Bt>_siness/Organization///Name: Address:—//7 6e City/State/Zip: Phone#: Are you employer?CM1eck the appropriate box: Bust Type(required): 1.2trl am a employer with -'7—cmployees(full and/ 5. E21ketail or part-time).* 6. ❑Resraurant/BadEating Establishment 2.❑ I am a sole proprietor or partnership and have no 7 ❑Office and/or Sales(mcl,real estate,auto,etc.) employees working for me in any capacity. [No workers'comp. insurance required] S. Non-profit 3.0 We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,$1(4),and we have I O.❑Manufacturing no employees. [No workers'comp. insurance required]" 11.❑Health Care 4.Q We are a non-profit organization,staffed by volunteers, with no employees. [No workers'comp.insurance req.] 12.0 Other "Any appbeean that checks box#1 must also LII out the sectiov below showing[heir workers'compwsation polity irdbamat on. ""If the corporate officers have exemprN themselves,but the corpomtiou has other employees,a workers'compensation policy is retuned and such an orxaw-con should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policyinformation. Insurance Company Name: f r Pt"S Insurer's Address: //7 JN- City/State/Lip: i e Policy#or Self-ins.Lia# — —/.g Expiration Date: �3 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure m secure coverage as required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of a fine up to S 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,on r the poi s d penabi of perjury that the informadan provided abov is nue rd correct Signature Date: y/aY ,� Phone#: t�Z97—'K-77-7 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.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: xww.mass.gov/dis Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or wr tten" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confumation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or lawn that the application for the permit or license is being requested,not the Department of industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permulicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filed out each year. Where a home owner or citizen is obtaining a license or permit not related many business or commercial venture(i,e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston,MA 02114-2017 Tel. # 617-727-4900 ext.7406 or 1-877-MASSAFE Fax# 617-727-7749 www.mass.gov/dia Form Revised 02-23-15 5,1512018 Dry of No nlampton Mail-Re: 50 Market Street . Fari Cft Of Louis Hasbrouck<Ihasbrouck@northamptonma.gov> gmunpilm Re: 50 Market Street 1 message Louis Hasbrouck<Ihasbrouck@northamptonma.gov> Tue, May 15 2018 at 11:11 AM To: Gene Borowski <beyondbuilders49@gmail.com> Got it.Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax On Tue, May 15, 2018 at 11:09 AM, Gene Borowski <beyondbuilders49@gmail.com>wrote: Hi louie Yeah we're not doing any plumbing so he's holding off on the renovation part all we're going to do is change out the skylight in one of the windows on the side thank you GENE On Tue, May 15, 2018 at 11:04 AM Louis Hasbrouck<Ihasbrouck@northamptonma.gov>wrote: Gene, Do you want to go forward with the Market Sl project without the new plumbing? Let me know. I'll hold it until I hear from you.Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413) 587-1272 fax On Fri,Apr 27, 2018 at 5:18 PM, Gene Borowski <beyondbuilders49@gmail.com>wrote: Ok,thanks for the update. The plumber is the MGM and I'll get a hold of Nick and let them know what's required otherwise The building permit OK. Regards Gene On Fri, Apr 27, 2018 at 4:46 PM Louis Hasbrouck<Ihasbrouck@northamptonma.gov>wrote: Gene, We've reviewed the plans for renovations at 50 Market Street. The plumbing code requires a floor drain and a gas and oil separator for all commercial garages. Because the project involves new plumbing,the plumbing code will require that the floor drain/separator be installed.The plumber should contact the plumbing inspector to discuss the situation. If no plumbing work is done,the floor drain doesn't need to be installed.You could still proceed with other construction and electrical work. Let me know if you have questions. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax haps://maiLgoogle.comlmaiUu/1/?ui=28ik=ec5r19a5]e8jsver=GAFHaMvsbdw.en.Bcbl=gmail_fe_180506,06_p7&view=pt&search=sent&th=163645b l l6721744&si