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24B-072
80 BARRETT ST BP-2019-0260 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.Block:24B-072 CITY OF NORTHAMPTON Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateamv:ROOF BUILDING PERMIT Permit# BP-2019-0260 Project# JS-2019-000421 Est Cost:$84593.00 Fee:$591.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group CHAD OROURKE Lot Size(sp.ft.): Owner. ASTER ASSOCIATES Zoning, Applicant. CHAD OROURKE AT: 80 BARRETT ST AtrnlicantAddress: Phone: Insurance., 6 UNIVERSITY DR SUITE 206-215 (413) 34741 AMHERSTMA01002 ISSUED N.8130120180.00.00 TO PERFORM THE FOLLOWING WORK:ROOFI NG 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: O01• 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 sienature: FeeTvoe: Date Paid: Amount: Building 8/30/20180:00:00 $591.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Versimal.7 Commercial Building Permit May t5,2000 De ilii" .41 ��P 7111o , F-VE G I of Northampton aws, 8 ildin Department 12 Sin Street AUG 28 2U18 R om 100 w No am ton, MA 13 1060 is X, [CFPT. F GUIL mArnoaa 7-1 40 Fax 413-587-1272 11HIMPTON,MA01050 APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING --————— Duo SECTION I-SITE INFORMATION 1.1 Property Address: This section to be completed by oi Map Les L77L— Unit goZone 01 Distrw ot JVO(4� p+ov� _/'A A - I— --- One at District CS Disarict SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2,rlr I licol, LLC,, Name(Pian) Cursiu M.,I,rg Adore.: si,ri Telephone 2.2 Authorized Agent: Name(Print) Curiefl=d6d ress Signature Telephone SECTION 3-9STIMATED CONSYRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building P, (a)Building Permit Fee 2 Electrical (b)Esbmated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4 Mechanical(HVAC) I fir, 5 Fire Protection 6 Tobal=(1 -2-3+4+5) Check Number This Section For Official Use Only Building Permit Number Date Issued Sigrurtui 1 BuddingCommissionedirepectorofBuildings Date Version l.7 Commercial Building Permit May 15,2000 SECTION 4 CONSTRUCTION SERVICES FOR.PROJECTS LESS THAN 35,660 -„] CUBIC FEET OF ENCLOSED SPACE 1 Interior Alterations ❑ Existing Wall Signs ❑ Demolition[I Repairs El Additions Aet:esenv Building Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofingin Change of se Other❑ Brief Description Enter a brief description here. r\ c Of Proposed Work: _1flJ.rV„„) i SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 11A-2 E] A-3111A ❑ A-1 ❑ A-5 ❑ 1B ❑ B Business 112A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ri M Mercantile ❑ q ❑ 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 Existing Use Group: _ Proposed Use Group Existing Hazard Index 780 CMR 34), Proposed Hazard Index 760 CMR 34) SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 2 e .__.... __. ..__... 2 n 3 rd Total Area(sf) Total Proposed New Construction(sf) Total Height(ft) Total Heightit 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone❑ I Municipal ❑ On site disposal system[] Version L7 Commercial Building Permit May 15,2000 g. NORTHAMPTONZONA'C Existing Proposed Required by Zoning lLis column ro be filled o by Building nepamnco Lot Size --- -- -- Frontage --- -- --- Setbacks Front Side L R. U R_ Rear _. Building Height Bldg.Square Footage % ' Open Space Footage _ o (Int area minus bldg&roved .. rkiv #of Parking Spaces Fill: _.. l._.. ... _ _.. volume&Lncafiov) A. Has a Special Permit/Variance/Finding ever been issued far/on the site? NO O DON'T KNOW O YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O 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 O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit 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(Registrart) ..-.--.. .._._ _._.. Registration Number Address Expiration Date ....... SignatureTelephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Add.. Regisiretion Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telkaphor. Expiration Date 9.3 General Con tractor "F-kW 1-/ - WI-/ :Vi-/ /c AAJ Not Applicable Compnyy Name I d,( ❑ (k� soy�r lC k,_'4� Responsible In Charge of Construction Pr j zF tac tc /L t __ Address ✓�M Signa re Telephone r Version L7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineenng Structural Peer Review Required Yes © No SECTION I.1-OWNER AUTHOF=TION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize to act an 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 hue and accurate,to the best of my knowledge and belief. Signedunder the pains and penalties.ofperjury, Print Name _..._. Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed C nstru tion Su�^"ISO y1/1 r '1 ,�//y y// Not Applicable ❑ Name of License Holder F W... ll_�l! 11 Y"1C __... y, Ncense Numbe C5-210 3� U lVe j 4t Address Expiration DDan�te Signature Telephone 9/V Q SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT N.G.L.c.152,§25C(S)) 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 b ding permit. Signed Affidavit Attached Yes Is No O 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 byMGLc 111, S 150A. Address of the work: - The debris will be transported by: The debris will be received by: & RC J� ,- ty P-0c)(Ct"S V>&C(f Building permit number: Name of Permit Applicant Date Signature of Permit Applicant The Commonwealth of Massachusetts �c Department of Industrial Accidents 1 Congress1 Suite 100 Boston,MAA 0202114-20177 www mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTIMG AUTHORITY. AoDlicant IBforination —f' I L Please Print Legibly Business/Organization n Name: ((�'AIk 1 '�//Q ,'i�64 Address: S4 lq-t J'r - 6e 644ki-,"tel City/State/Zip: Q (OD-7 Phone#: qI Y — A e y u in employer?Check the appropriate box: Business Type(required): 1. am a employer with___�Z,_employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Berfating Establishment 2.0 1 am a sole proprietor or partnership and have no 7, ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers'comp.insurance required] S. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing no employees. [No workers'coml insurance required]* 11 ❑ Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers'comp. insurance req.] 12.❑Other *Any applicant drat checks box#1 must also strut tM section bebw stowing Ihv wokms'compensation policy inG,wsuon. **IfNe corporate officers have exempad themselves,but the cnrpoixuM bas mhcr employees,a workers'compensation policy is rs uaed and such m .,vuutlua should check box#l. I am an employer Ilial is pror ing/wPrk rs'compensation insurance for my employees Below is the policy information. Insurance Company Ntam�e/: YVJ,d� �. y,',r [�,, �A 1� Insurer's Address: J , p1� 4it& eC. ��f*�� / •U City/State/Zip: (do Policy#or Self-ins.Lic.# LrAnjExpiration Date: / Attach a copy of the workers'compensation policy declaration page(showing the policy number nd exp' ation date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition o 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 da hereby cerfi der thepainsand ena[ties ofperj 8t the information provi ed above is true and corse t Si am e: Date: Q7 Phone is: 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 Once d.Other Contact Person: Phone#: www.m gov/du 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 ofanother under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more ofthe foregoing engaged in ajoint enterprise,and including the legal representatives ofa deceased employer,or the receiver.,trustee ofan 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 reuewalvf a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence ofcompliance with the insurance coverage required." Additionally,MGL chapter 152,$25C(7)slates"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence ofcompliance 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 Parmerehips(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 confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town 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 permit/license 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 proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any 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 vv w.mass.gov/dia From R[vlsM 02-23-15 Family Tree and Home PO Box 3699 Amherst, MA 01004 (413)404-4110/(413) 478-8159 Owner/Operator Nicholas Southwick-Hall August 27, 2018 Commissioner Hasbrouck Subject: Request for Waiver I request Shat you grant a modification to waive the requirement for control construction for the reroof (Aster Row)at 80 Barrett Street Northampton, MA because the work is of a minor nature,will not affect health accessibility, life an fire safety,or structural requirements and is impractical in thatthe cost I control construction is considerable when compared to the cost of the proposed work.All work will be completed within the prescriptive requirements of 780 CMR.Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Nicholas Southwick-Hall Family Tree and Home