25C-251 (117) 54 FAIR ST-FAIRGROUNDS BP-2019-0902
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-251 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit# BP-2019-0902
Project# JS-2019-001504
Est.Cost: $15000.00
Fee: $105.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOSEPH JASINSKI 057025
Lot Size(sq. ft.): Owner: HAMPSHIRE FRANKLIN&HAMPDEN AGRICULTURAL SOCIETY
Zoning: SC(100)/URB(l) Applicant. JOSEPH JASINSKI
AT. 54 FAIR ST - FAIRGROUNDS
Applicant Address: Phone: Insurance:
43 Fair St (413) 527-7379 O WC
NORTHAMPTONMA01060 ISSUED ON.•2/20/2019 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL METAL ROOF ON FARM MUSEUM
BUILDING ALONG WITH NEW VENTILATION
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 2/20/2019 0:00:00 $105.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-0902
APPLICANT/CONTACT PERSON JOSEPH JASINSKI
ADDRESSIPHONE 43 Fair St NORTHAMPTON (413)527-7379 Q
PROPERTY LOCATION 54 FAIR ST-FAIRGROUNDS
MAP 25C PARCEL 251 001 ZONE SC(100)/URB(1)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOS UIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: INSTALL METAL ROOF ON FARM MUSEU ILDING ALONG WITH NEW
VENTILATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 057025
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
p/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
Demolition Delay
-- 1
a/26
t
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.
Ver�ion1 r C 40 4 W,j_ '4i ,1`ermit M15,2000
City of North mp n
Building De rim nt 660Z c,
83A
212 Main tre
Room 00
Northampton, A OERA130
phone 413-587-1240 Fax 4
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
Cwr a�-OWSZOVA- i( Map ', Lot Unit
LA 9 Fk'Z r9,(-' Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Nyr;-LAAtu� ^C4--] Current Mailing Address:
-'! r7
Signature Telephone
2.2 Authorized Anent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3- STIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee _
/5 Ua2>.
2. Electrical . (b)Estimated Total Cost of
............
Construction from 6
3. Plumbing ,� Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=0 +2+3+-4+5) Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
( ., C ni C. CUA
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION ERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED ,PACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ RoofingChange of Use❑ Other❑
Brief Description ;Enter a brief description here.j.A5t-"A\ W-"rXZ fov-F � FAA- u,Cv v
Of Proposed Work: 1� 0.� it3� n�� 0&-�-. ;
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 I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
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 .... � ._... ._. ..n
--- ----------.-------- _..__..__ _ — - - - _ __--------------
M Mixed Use Specify:
p fy',Fk('1���-'-W� ��L�fl�'�sc�C C f!l�Ct�►urn S'��� E
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: ( ,_._.._ _, _ _.__ a Proposed Use Group:
—__ ------- v.m�....
Existing Hazard Index 780 CMR 34):i 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(so
51i. _ - -
1r�,. ?...__
nd _.
2nd 2
------ .__ _
3rd n
. 3rd a
�. ...... -----.... ....---------------------
... .. .....�_....-, , 41r
4
lh
Total Areas Total Proposed New Co struction s
Total Height(ft) 1 j
Total Height ft _W .....
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Z ne Information: 7.3 Sewage Disposal System: i✓r�
Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal 0 On site disposal system❑
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPT N ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
....
Lot Size
I _ _ _
Frontage L—---_.
Setbacks Front ,"�.. - 1
m„,
Side UL J R:L
Rear i
Building Height
L_.______J
Bldg.Square Footage /, 0,10
_. _.__J
Open Space Footage %
�.� . ............
(Lot area minus
parking)
#of Parking Spaces
Fill: i, _ ..__......_
(volume&Location) __..,. _..... ........ 1
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW R YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O—A YES 0
IF YES: enter Book F Paged and/or Document#i
B. Does the site contain a brook, body of water or wetlands? NO 0> DONT KNOW 0 YES 0
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 i NO
___---
---
--------------
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
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 �.
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:
........._m__-----------------_ ___------------- __...._. —- _ ----------- __ �_ �...._.__.
Not Applicable
Name(Registrant): ...........__.___ --- ----------_--_ _
___------------ __ ..
_...._ .------_-- m___.. _ _
_ . _._ _ �._.. ..._._ _ __.._....__
Registration Number
Address _ ..-----------
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
--_. ..--. -.. - ----
t
Name Area of Responsibility
Address Registration Number
r
i
Signature Telephone Expiration Date
�..�............
_...._ _.---------------..__---�,..____---- _.�...... ........._......... ..,.
��. I
��
Name Area of Responsibility
__,.___-----.._. _ �
--- ------------------._ .._. .. ___._._--------— , .._-----.._ - _.w ___ ...__.------
i
S
i t
Address Registration Number
Signature Telephone Expiration Date
------_- .._.___- __ --- -..__.. ------------------ __.._
a ,
Name Area of Responsibility
-----
Address Registration Number
------------
Signature Telephone Expiration Date
_.. ..
___� .m
Name Area of Responsibility
AddressRegistration Number
�------.. _._----------_
Signature Telephone Expiration Date
9.3 General Contractor
.. .. ! "-- �...__. l�'? ��%L'f C71�� _-- .._. _._ __._ . . ._ ..._ Not Applicable 0
Company Name
Responsible In Charge of Constru tion
Address
Si ature Telephone
Versionl.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.
Signedunder the p ins andpenaltie _ f perjury
I
Pri _
Signature weer/Agent Date
SECTIO 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder ..r? �G
License Num er
Address Expiration Date
Signature Telephone
SEC ON 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 b 'Iding permit.
Signed Affidavit Attached Yes No 4
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: l'� �&� 6��
The debris will be transported by: ��
The debris will be received by:
Building permit number:
Name of Permit Applicant
Date /Signatu�rermit Applicant