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23B-035 (15) 61L000STST BP-2019-1091 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:Block: 23B-035 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeory: renovation BUILDING PERMIT Permit# BP-2019-1091 Project# JS-2019-001776 Es[ Cost,$124462.0 Fee $871.00 PERMISSIONIS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SALOOMEY CONSTRUCTION 018780 Lot Size(sg.B.): 27007.20 Owner. WOHL CARINA zoni=NBO 00)/URB(0)/ ApiVicant. SALOOMEY CONSTRUCTION AT: 61 LOCUST ST ADuticantAddress: Phone: Insurance: P O BOX 1203 (413) 269-4360 WC WESTFIELDMA01086 ISSUED ON:4/3/2019 0:00:00 TO PERFORM THE FOLLOWING WORKJNTERIOR OFFICE 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 Occuoancv Signature: FeeTvue: Date Paid: Amount: Building 4/3/2019 0:00:00 5871.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-1091 APPLICANT/CONTACT PERSON SALOOMEY CONSTRUCTION ADDRESS/PHONE P O BOX 1203 WESTFIELD (413)269-4360 PROPERTY LOCATION 61 LOCUST ST MAP 23B PARCEL 035 001 ZONE NB(100)/IJRB(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST EN LOS EQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildine Permit Filled out Fee Paid 3 Tvoeof Construction: INTERIOR OFFICE RENO fV tpASPE � New Construction C Et1c WiTh pt.uM81N4 Non Structural interior renovations Addition to Existing Accessory Structure Building Plans included: Owner/Statement or License 018780 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: 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 (2]'J'Dee'molition'J�Delay ` Signature of Building Official Date 3 ( cI 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. GHCct� (N TcbE MfalL VO =1.7 COmm sl Building Permit May 15 2600 4. ampton RECEIVED Idm9 Department 12 Main Street k Roan 100 - '- APR 3 2019 N mpton, MA 01050 Phone 13 7-1240 Fax 413587-1272 `• '� OFpT OF GUILmC+INcpECr10N$ APPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUAONG OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1•SITE INPORMFORMATION 1.1Lot _.. eae110rI b M eYdab .__ _ _. _ 1�/�joelrll_� �_� . Mop D1�/tj , b 1LQ D/0 GO zan. oe.raYa.ea Eft IL taeale COO NI SECTION 2-PROPERTY OWNERBHIAMMORMD AGENT 2-1 sr -- - -sit Nertxr(PM6 CumM N,MqAdAnr: 8 Wro T Nemer�.,A.-t�.Ad/fK1�z _ ._. .... 1�[G �X.11q 1.41�._!n!.4" �.f1 1.' lit.461,0[ G (PMC Cumrd Llery_Ad4%4e. SlenNuro Ta COSTS Rem EWmeted Cost(Oollrs)to be Oftel Uee 0* �clsftd by rar2 spOicord 1. Buildnp (a)Build.0 Pend Foe i 2. Fledr"l �/ •GU '.. (D)FAlmebd Tom cat of L_ from 3. PNmbinq i.../( a0 _. . BWWke P~Fee .. 4. Medmmcsl(HVAC) - - -711 o 5.Fire Protecuon 6. TOM.(1 +2.3.4 r 5 -_ _- -I CMek Number For Offidifil Un Or* BuilAnB Perm2 Number Date Issued Mquaxe: Bulooft Coamm0000nstfiriopmWat MoWiis Data Versionl.7 Commercial Building Permit May 15,2000 BECTON 4 CONSTRUCTION OE WWU FOR PROJECTS LESS THAN a8.000 CUBLC FEET OF ENGLOBED SPACE InMbr Assawfons ❑ Exisi ngwallsegns ❑ DemoNkmO Rspalra❑ Additions ❑ AOWserry BuNdinp❑ Expiator Alienation ❑ Existing Ground Sign❑ New slprs❑ Roclirq❑ ChsnfM of Use❑ POW/ BddDeearlption ;Enter a brief �description /here. .�/Q t1 j��Q.(i 0'Q--A'�j0�✓JJat Of Proposed Work:: SECTION S-USE GROUP AIS)CONSTRUCTION TYPE UBE OR0UP Clrscltn CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 [3A3 ❑ 1A ❑ A-4 ❑ A-3 O 1B ❑ S Bowness ❑ 2A ❑ E Educational ❑ 2B ❑ FFa ❑ F-1 ❑ F-2 ❑ 2C ❑ H N Heard ❑ 3A ❑ 1Institutional 01-1 ❑ 1-2 ❑ 13 O 12§ N Mercantile O 4 ❑ R Rewderdial ❑ R-1 ❑ R-2 ❑ R3 ❑ 'A ❑ S Storage O 8.1 ❑ S-2 ❑ 5B ❑ U Utlay ❑ Specify. M Mixed Use ❑ Specify. 8 Special Use O Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group' EZNtl Hazard kMex 780 CMR 34:- ..__ _. Proposed Hazard Index 780 CMR 34 _ . .._- SECTION S SUIL N A HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sp 4a Total Area(ift) Total Proposed New CpmtrueApn(Or). ....._ Total HOW Ill) .._. _. Total Heigetit 7.wstr Supply(M.G.L.e.40.It 84) 7.1 FION Zoo inform~: 73 sew OMeal poSystem: Pudic Private 13 �Zone;_.___. Outside Flood Zane Municipal On eft dsPoW sysUM13 Veraimi.7 Commercial Building Permit May 15,2000 8. NOHTHAMPfON ZONAYG Existing Proposed Required by Zoning ]bb mrmm W be fiow m by Buldmg Degrmml Lot Size _ .. , r."_ _ . ... .. . Frontage Setbacks Eypi ,gide L_R:_ L:;A i Building Height *__...._ .." -_. . .. Bldg.Square Footage r-- % Open Space Footage Rol um mmm bids _ . . i....._.. __._ .' a of Parking Spaces Fill: - - soboea[oratim _._ _—._ L_._._ – - . L L ... . .._.._.____ A. Has a Special Permit/Variance/Finding ever been Issued for/on the site? NO Q DONT KNOW © YES Q IF YES,date issued: ._. ..._. .. IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOWO.. .YES'O._ -. IF YES: enter Book Page:. and/or Document F B. Does the site contain a brook, body of water or wetlands? NO © DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obrairad O . Daae Issued: : _. C. Do any signs exist on the property? YES O NO O IF YES, describe sis, type and location: 0. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe sins, type "Iocatlon: E. MI the construction activity disturb(dearinp,grading,excavation,orfiNing)aver 1 sue otie It part of a common plan that will disanb aver 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management permit from the OM is required. Versionl.7 Commercial Building Permit Mq 15,2000 SECTION 10-STRUCTURAL PEER REWEW(M CMR 170.11) Intle ntleM StmcWrel En neean Structural Peer Raviaw R "red Yee No N 11-OTYNlR AUIlIORQA710M•TO SE COMPL.EpED WNpe OWNERS AGENT OR CONTRACTOR APPIJES FOR WILDING PERMIT _ ______:,as Ownerofthewbjedpmpsdy hereby authorize to act on my behalf, ae man hs roletive to*wk author zed by this building permit application Stpol m of Cwrwr t)aes/ as OwnerrAuthonzed nt hereby re that She statements antl"Won on the foregoing application are Ira and acaurrta,to the best of my knowledge and belief. Signed-under the pitro andpenSlgee c(perjury... . . . . ._-..-. Print Nam 36112 13 331_-O.o� Slanstum of 00oer/ m SECTION 12-CONSTRUCTION SERVICES _ IWOdi ' : _ NotApplicable 0 tllmuauoFgrnNtrc — Lk eme N bK bar coz Add ase Exiftll DOW Sigmmre T*phone SECTION 13•WORKERS•COMPENSATION INSURANCE AFFIDAVIT(MA.I m 1SE•1 S9M) Workers Compensation Irwuranca efkdevit must be ampleted and submitted vdth this application. Failure to provide See allldevg rill result in the denial of the iwuerwe ar Win rmiL Si ANdevit Attached Yee 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 govemed 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: The debris will be transported by: The debris will be received by: Building permit number: Name of Permit Applicant Date Signature of Permit Applicant Versonl.T Commercial Building Permit May 15,2000 9WMN 9•PROFESSIONAL DE N AND CONSTRUCTION SERVIM•FOR SIILDMOS AND S1IIUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 760 CMR 116 MOWARWQ MOTE THIN UAW C.F.OF ENCLOSED SP 9.1 Realstered AmIdlect• Nat ApplbableNo"IRMWIM). O Addms w,(� B nen TN 9.2 Flogisteml ProfeaMaW e Nam Am of RewonsUly Adtlnlw Rsdatratbn Nunhr g T, hone ntbn DMe .._ Am of RerponYWay slvwun Tab n9on Date i Nem AM Of RMPomblly Aednw Re9lmaticn Nunley swatum Tebph" Eq*wbon Deb Nam Ana of RealmdAlly Admw ROOMMOn Numel skratum EVAFW Date 9.8 OeMfe1 Convaeror .. ._<._ Not ApOiMbbE3 Company Nam: INe In CMge m COMrutlen me "12 TO nM T �\ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Sleet,Suite 100 Boston,MA 0I114-2017 www.a arsgov/dia Wxl orkers'CompensatioInsurance Affidavit:Builden/Contractors/EEkclricims/Plumbem TO BE FILED WITH THE PERAUrMG AUTHORITY. Analicamt Information qq P 'm 1 Name(BudnesWOrganizationAndwidual): Address: �0 zex zy-5 City/State/Zip: � " i O f hone q: 1 m yov.d empbyerT rnaea Nr wprwebox: Type of project(required): ':fit—a=emPloycrwl_employees(full mdlor pan4ime).' 7we0nLtIN000n 2❑ta=n=k pmpritoor pvlmrshiP aril nave no empbYem working f.rmein 8. maideling my capacity.INo wotksri mmp.iom=nce regasedl 3.01 am a h.meownm doing all woN=yulf[No work='cownp.int me gaired.lr ❑Deilding n 4.❑I am a hmsownm m cl will be Fining cmammm w 000dun all work on my property. Twill 10❑Building addition .re Nt At eonaaiorsedhmli.e. kers'ooinomaim ilwu<tt.eor are.ole 11.❑Electrical repairs or additions popino=wnM1 no employees. 12.❑Plumbing repairs or additions 5.[31 mna lmor mnaamormd 1hive Mimi Ne mb<onaaclon lined on the iaidM aM1et. There subronaactors have mWloyma act have woken'con,i=nn .1 13.❑Roof repairs 6.❑We area mMoraion not is oVicmha exeiviimlhcirnghtofexempion MMOL, 14.❑0ther 152,§I(4),andwelovem m,loye..INowo 'row.imiminx mluired.l 'Anyapplicat Ntchs Fox lel mon also filloutthe aectimbelow showmgdieirwohers'cooper on polity=Nona=. I Homeowners who sl=it this affidant indicting Nay are do'mg m wank and tam hive.wide ron�mut vubmit a mw aii;lmil iMiming such. IC.watars tlut ch.k Nin box mut Inched m a illifi iul N<a aM1owing no,same of tae nub .uwton mot Ate wheNer or nal None man.have e�loye.. VNe sulr.eoteem,rs have employe.,Nay vmp povWe dev workm'comp.policy=mlbcr. I am an employer that is proving lwrkm'compmsadon inma mfw my emldoym. Belowis the policy and job site ultormadon. Insuancc Company Name: 1-�y i L- ,L.. - Policy#or Self-ins.Lic.#: C I late: C rn Job Site Address: � G d-UC is`�� 1 � � City/State/zip: I � LL// Attach a copy of the workers'compensation policy declaration page(showing the policy number aid ex ration ate). C j f O,6 Q 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 violamr.A copy of this statement may be forwarded m the Office of investigations of the DIA for insurance coverage verificatkln ldoh under the m perakiesofperjury duathe information jarinidedafioveiv 9ueandrorced C/Ip Y ,� i � Phone#: _ Offmial use only. Do not write,in this area,to be completed by city or gain official City or Town: PermitILicense# 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#: 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. ✓ i Address of the work: The debris will be transported by: The debris will be received by Building permit number: T Name of Permit Applicant 'Ji, iiri< G" Date l Signature di Permit Applicant ❑ i e F DD F� pppp �� FP � Ff e e i 4 fill OFFICE RENOVATIONS PHILIP D. BURDICK 01 FLOOR PLANMq n=RE-UNOSC WHREMRE-P NWG —� 61 LOCUST STREET ! Mgi U-S~Wd, M mins-iia-zn-em NORTHAMPTON, MA