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31A-011 (3) 259 ELM ST-AUTUMN INN BP-2019-0439 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.Block: 3 1 A-011 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 Permit# BP-2019-0439 Proiect# JS-2019-000714 Est.Cost: $1028618.00 Fee: $7200.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group_ GARRETT FLYNN 098554 Lot Size(sq.ft.): 34935.12 Owner: THOMAS ROBERT S Zoning:URB(100)/ Applicant: GARRETT FLYNN AT. 259 ELM ST -AUTUMN INN Applicant Address: Phone: Insurance: 89 DUFF ST (617) 592-2726 WC WATERTOWNMA02472 ISSUED ON.1012912018 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RENO 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 10/29/2018 0:00:00 $7200.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0439 �( 0!<� ��1 L APPLICANT/CONTACT PERSON GARRI'''T FLYNN 1 ADDRESS/PHONE 89 DUFF ST WATEI_TOWN (61'7' 592.2726 PROPERTY LOCATION 259 ELM ST-AL UMN DIN MAP 31A PARCEL 011 001 ZONE URB(_00)/ THIS SECTION FOR i)y L.'IAL USI 'ONLY: PERMITAPPLICA f101 l CHEC ENCLREQUI D DATE ZONING FORM FILLED OUT Fee Paid IF 64 V to 7 Building Permit Filled out _ Fee Paid Tvneof Construction:_INTERIOR RENO New Construction Non Structural interior renovations Addition to Existina Accessory Structure Building Plans Included: Owner/Statement or License 098554 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO!"ATION PRESENTED: p:roved Additional permits required(see below) FLANNING BOARD PERMIT REQUIRED UNDLR:§ itermediate Project: Site PIan1AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDLR: §` 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 Demolition Delay 042�_ 1 101, 61, 8 Signature of Building Official 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. ;�Mpotr5-f to 7-o 100r"46- r-w Version 1.7 t'omrncrcial Buildin,Pcrmil Mav 15,2000 Mdwz Department use only City of Northampton Status of Pemtit: Building Department Curb CuVDrNeway Permit - 212 Main Street So%w/S icAv ry Room 100 WaberiV"Avaitabitityr Northampton, MA 01060 Two Sets of St u Lural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Sits Plans APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCt IPAN4VBUI DING OTHER THAN A ONE OR TWO FAMILY DWELLING OCT 1 1 2018 SECTION 1 -SITE INFORMATION This do to be com feted by offs 1.1 Property Address: DEPT OF BUILDING INSPECTIONS Autumn Inn Map ?//q- ORTH NIA CTI 11t 259 Elm Street Northampton, MA 01060 Zone Overlay District Elm SL District co District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Robert "Thomas 283 Washington Street, Gloucester, MA Name(Print) Current Mailing Address: 617-513-2704 Signature Telephone 2.2 Authorized Agent. Jeff Sulkin 16 Rebecca Road. Newton, MA 02465 Name(Print) // Current Mailing Address' 617-719-3507 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 726979 (a)Building Permit Fee 2. Electrical 79,409 (b)Estimated Total Cost of Construction from 6 3. Plumbing 66.100 Building Permit Fee 4. Mechanical(HVAC) 4-7, 5. Fire Protection 156,130 6. Total=0 + 2+3+4 +5) 1,028,618 Check Number This Section For Official Use Only Building Permit Number Date Issued Signature. Building Commissionertinspector of Buildings Date C 1 J���s0 l �r'1 fviti ��r C 0� Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: �hO ,h Jgeeoe SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B M Mercantile ❑ 4 ❑ R Residential [] R-1 ❑ R-2 El 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 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1s 1sc 2nd 2nd 3rd ul 3rd 4 m 4m Total Area(sf) Total Proposed New Construction s Total Height(ft) Total Height ft ul 7.W rSupply(M.G.L c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public El Private 11 1 Zone Outside Flood Zone[D Municipal E] On site disposal system❑ Versionl.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 % 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 © YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO () 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 Q DONT KNOW © YES 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 O NO IF YES, describe size, type and location: x t y tg s,a ron o prope y D. Are there any proposed changes to or additions of signs intended for the property? YES o NO 0 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 © NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version 1.7 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(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration hate 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 orest Hill Builclers Not Applicable ❑ Company Name: e alkin Responsible In Charge of Construction 16 Kebecca R—o—aU, Newton, Address � ,,V r` - - Signature ,�IIU/f�'/� Telephone Version 1.7 Commercial Building Permit Via-, 15,20(H) SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes © No e SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Robert Thomas I, as Owner of the subject property hereby authorize •teff Sulkin to act on my behalf, in all matteryotive to work authorized by this building permit application. 10/10/18 Signature of Owner Date 1 Jeff Sulkin 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. Jeff Sulkin Print Name 444&& 10/10/18 Signature of Owner/A6ent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: !Jarrett Flynn License Number 89 Duff Street, Watertown, MA 02472 CS-098554 Exp. 11/13/19 Address Expiration Date 617-592-2726 Signatu a Telephone 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 G 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: 259 Elm street, Northampton, MA 01060 The debris will be transported by: Skinner Demo, 155 Bodwell Street,Avon, MA 02322 The debris will be received by: Skinner Demo, 155 Bodwell Street,Avon, MA 02322 Building permit number: Name of Permit Applicant Jeff Sulkin 10-10-18 Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 wwx.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Forest Hill Builders Address: 16 Rebecca Road City/State/Zip:Newton, MA 02465 Phone k 617-719-3507 Are you an employer?Check the appropriate box: 8 Type of project(required): I.E]I am a employer with employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.[:]l am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.[]l am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ repairs re airs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information American Zurich Insurance Company Name: Policy#or Self-ins.Lic. #:6ZZUB6B07312318 Expiration Date:06/26/19 Job Site Address: 259 Elm Street City/State/Zip:Northhampton, MA 010, Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 th)IJ& nssdpena&L-s ofperjury that the information provided above is true and correct Si ature: Date: WA048 Phone#: 617-719-350 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.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t M1R s r3: s 1�1 4 x ' tz ..... ... a F -MinvoWN MA W&,W12 -oe COMMIS -45I' oner Cft Of 4 N� Louis Hasbrouck<Iasbrouck@northamptonma.gov> Fwd: Autumn Inn 1 message Louis Hasbrouck<Iasbrouck@northamptonma.gov> Thu, Oct 11,2018 at 12:18 PM To:Jeff Sulkin <jeffsulkin@gmail.com> Jeff, I got the building permit application for the Autumn Inn. I asked for more information in my last email; see below.As I said,the plumber needs to get in touch with the plumbing inspector„we need information about the HVAC units and a better scope of work(maybe a copy of the contract). Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax ------Forwarded message--- From: Louis Hasbrouck<Iasbrouck@northamptonma.gov> Date:Wed, Sep 26, 2018 at 11:49 AM Subject: Re:Autumn Inn To: Jeff Sulkin <jeffsulkin@gmail.com> Cc: Kim Carson<kcarson@northamptonma.gov>,Andy Pelis<apelis@northamptonma.gov>, Larry Eldridge <leldridge@northamptonma.gov>, Duane Nichols<dnichols@northamptonma.gov> Jeff, Based on the work you've described,we'd be willing to waive the requirements for construction control if you submit a formal request. See attached sample wording. A few things; The fire department will need to review and sign off on the permit.They may have some concerns. The plumbing contractor should talk to our inspector sooner rather than later. The rooms in the basement have been used for storage for years;we'd want an architect's code review if they are going to be renovated. There may be some exit signage/emergency lighting that needs to be replaced or improved. The building is in the Elm St district; HVAC equipment is regulated.The historic commission needs to approve outside equipment like compressors(not on the front of the building,adequately screened).They'll want details and drawings. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax On Wed,Sep 26,2018 at 10:28 AM,Jeff Sulkin<jeffsulkin@gmail.com>wrote: Hi Louis: We are a general contractor and are going to be doing a renovation to the Autumn Inn at 259 Elm Street. We have basic existing floor plans that are attached to this email. The work in general consists of: • New tile,paint and fixtures in the bathrooms(fixtures remain in the same location) • Carpet and paint in the hotel rooms and common areas • Installation of heat pumps for HVAC in the hotel rooms and common areas • Updating some common area lighting • Cosmetic update to the reception desk The owner has not hired an architect to do construction drawings. We are getting ready to file for the building permit and I have two questions. 1. Based on the scope of work above will you require construction drawings? 2.Will this fall into construction control and therefore we would have to have an architect provide that documentation? Thank you in advance for your response. The existing conditions floor plans are attached below. Best,Jeff Sulkin Jeff Sulkin President jeffsulkin@gmail.com 617.719.3507 Dm %% Nton Control Construct Waiver 2018-09-25.doc 24K Auturm Inn ------------------------------------------------------------------------------, quwr.r. 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