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32A-162 (9) 33 HAWLEY ST BP-2019-1237 GIS a: COMMONWEALTH OF MASSACHUSETTS Mag-.Block: 32A- 162 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-2019-1237 Proiect s JS-2019-001995 Est Cost,$80000.0 Fee:$560.00 PERMISSION IS HEREBY GRANTED TO: Cones Class Contractor: License: Use Group: D A SULLIVAN & SONS INC 053667 Lot Size(sa. ft.): 20211 64 Owner. NORTHAMPTON ARTS TRUST Zoning:CB Applicant: D A SULLIVAN & SONS INC AT: 33 HAWLEY ST Applicant Address: Phone: Insurance: 82 NORTH ST (413)584-0310 Workers Compensation NORTHAM PTONMA01 060 ISSUED ON.51812019 0.00:00 TO PERFORM THE FOLLOWING WORKSITE IMPROVEMENTS, CONCRETE SIDEWALK, PAVING, BENCH POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring U.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House q 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 5/820190:00:00 $560.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019.1237 APPLICANT/CONTACT PERSON D A SULLIVAN&SONS INC ADDRESS!PHONE 82 NORTH ST NORTHAMPTON (413)584-0310 PROPERTY LOCATION 33 HAWLEY ST MAP 32A PARCEL 162 001 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY, PERMIT APPLICATION CHECKLIST ED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid TypeofConstruction: SITE IMPROVEMENTS CO R 'I EWALK PAVINQ,BENCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 053667 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: V 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 v 7 ( Signature o Building Official — `Dae 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. Version 1.7 Commercial Building Permit May 15,2000 Department use only ity of Northampton Slain of Fanelli B 'Iding Department Curb CuUOrkwavyPemlt 2Main Street Sisawl8aptlre AvsltabDly day 3 of olds oom 100 WatodWd Avalleg ly _,asap, ampton, MA 01060 Tato Sib ofStructural Plans <-�oo; ' 413-587-1240 Fax 413-587-1272 PIotBUe Plarw Other Speciry AP IC N 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 33 Hawley St. Map 3aA Lot (, 2- Zone Zone Overlay District Elm SL District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Northampton Community Arts Trust 33 Hawley St. Name(Print) Current Mailing Address: (413) 559-9155 Signature Telephone 2.2 Authorized Anent: D. A. Sullivan& Sons 82-84 North St. Northampton, MA 01060 Name(Print) Current Meiling Address: (413) 584-0310 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed bpermit applicant 1. Building $80,000.00 (a)Building Permit Fee $560.00 2. Electrical (b)Estimated Total Cost of $80,000.00 Construction from 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) ��o 5.Fire Protection 6. Total=(1 +2+3+4+5) 1 Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building CommissionerMspector of Buildings Date 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 Site improvements,new concrete sidewalk, paving, bench. Of Proposed Work: See attached plans SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 11A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hiah 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 13S-2 ❑ SB ❑ 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(so 1.11a 2n° 2n° 3 P i° 0 4e Total Area(so Total Proposed New Construction(sp Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public Private ❑ Zone Outside Flood ZoneE) Municipal ❑� On sae disposal system[] Version 1.7 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 (Int 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 O DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T 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 O , 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 O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(Gearing,grading,excavation,or filling)over 1 am or is it part of a common plan that will disturb over 1 acre? YES O NO IO 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 Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Data Name Area of Responsibility Address Registration Number Signature Telephone Expiration Data Name Area of Responsibility Address Registration Number Signature Telephone Expiration Dale 9.3 General Contractor D. A. Sullivan& Sons Not Applicable ❑ Company Name: Mark Sullivan Responsible In Charge of Construction 82-84 North St. Northampton, MA 01060 Address (413) 584-0310 Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(760 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes © No O SECTION 11 -OWNER AUTHORIZATION -TO BECOMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Richard Wagner - , as Owner of the subject property hereby authorize John Fleming to act on my behalf, in all matters relative to work authorized by this building permit application. 05/02/2019 Signature of Owner Date John Fleming _.. ,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 penury.. John Fleming Print Name - 05/02/2019 Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: John Fleming '',CS 054080 License Number 82-84 North rth ptor A 01060_ _ '..03/05/2020 Address < Expiration Date fvf (413) 575-6035 Signature Telephone SECTION 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 building permit. Signed Affidavit Attached Yes 0 No 0 \ -tlnwneea..I R111Id...J PC..."I \I." I a `11111, SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.111 Independent Structural Engineeri Sirvctural Pear Review Required Yes O No Q SECTION I/ -OWNER AUTHORINTION-TO SE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authonze l by this budding permit application. Signmure of iTxnP Dale I. �y �— as OwnerfAuthonxed Agent hereby declare that the statements and information on the foregoing application are true and accurateto the best of my knovitedge and belief. S' ntler the yams and penagie penury. P. Name 1 Sgnewm o /A i Date SECTION 12-CONSTRU TION SERVICES 10.1 Licensed Contruction Supervisor: Not Applicable ❑ Name of License Holder Leense Number Address Eapratmn Data S gnalum Telephone SECTION 17-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G,L.c 152.§25Ci6)) Workers Compensation Insurance affdant must be completed and submitted with this application. Failure to provide this affidavit vird result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes (�) No Q 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 / b�y1MGL c 111, S 150A. Address of the work: /IVV l/G l -57 The debris will be transported by: tq� The debris will be received by: Building permit number: (� /� Name of Permit Applicant lam', 1 • sua w 6- z-zPl Date ignature f Permit p licant The Commonwealth of Massachusetts Department ss InduStreet, Su Accidents 1 Congress Street,Suite 100 Boston, MA 01114-2017 www.mass.Sov/dia Vix.,kers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Informntion Please Print Legibly Name(Business/organiaaboWIndividuap:D.A. Sullivan R Sons Address:82-84 North St. City/State/Zip:Northampton, MA 01060 Phone #:413-575-6035 Are you m employer?Cheek the appropriate box: Type of project(required): Ioma employer with 32 employees(full and/or part-time).' 7. ❑New construction 2❑1 am a sole proprietor or paanership and have no employees working for me w g, ❑ Remodeling any capacity.Mo workers'comp insurance required.) I an a homeowner doing all work myself [No workers'ema,insurance required.` q. El Demolition T1 4.❑I am a homeowner and will be hiring w rtractors to conduct all work on my property. I will 10 C]Building addition ensure that all contractors either have workers'compensation insurance or are sole I I.❑Electrical repairs or additions proprietors with no employees_ 12.[]Plumbing repairs or additions 5 1 am a general contractor and I have hired the sub-contractors listed on the stmched sheet. These subcontractors hiew employees and have workers'mmp.insurance I 13.❑Othe repairs Site I 6❑We area),and we and its employees have exercised their right o insurance i uun per MGL c. 14.❑Other Site Improvements 152,41(4).and we have no employees[No workers'comp.insurance requ'ved. 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such. :Contractors that check this box most atrached an additional sheet showing the mark,of the subcontractors and state whether or not Nose entities have employees. Ifthe subcontractors 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 the policy and jab site information Insurance Company Name:AIM Mutual Policy#or Self-ins.Lie.N:MCC20020000932018A Expiration Date: Job Site Address:33 Hawley St. City/State/Zip:Northampton,MA 0106 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. Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sismature Date' Phan #' Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/License N Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. Cityrf own Ckrk A Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: 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 written." 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 subcontractor(s)name(s),address(es)and phone numbers)along with their certificate(s)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 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 pennidlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or town):'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 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, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia MMOMMEEMEEMMEMMOMEMME ■ILII■11 =____----==�■■I■��_ ■ ■ �■ I 1 I -- __ - - __ C Arts Trust 33 Hawley ev • 9 fi-tom 4.9 -0 Y•T•+ 6wm .4vr l�llllllllllll�lillllllllllllllllllll::�...�-:=:•:•-•••�� � �'' III-111�II 11-1III-11-111-111-111111.11.•-40-:@-O•o• 1�••:•:��❖:��•�•••:•:•:•:0• •• 00 0 0 00 so ENLARGE 41V"��IYI��yIVYI ANDELEVATONSa PT FRAMING 1X10 LED STRIP LIGHT IPE&4M y } 1'-118' } S F ASPHALT PAVER COMPACTED GRAVEL BASE IIIA=IIIA=IIIA ("DENSm a'PROCESSED GRAVEL 1111= 111= COMPACTED GRAVEL BASE (B5%DENS" B'TYPEBGMVEL BORROW SETCTION �11HARU EXTERIORSTNRG UNDISTURBEDO `f COMPACTED SUBGRADE 10.CONCRETE SONO TUBE WITH REBAR •.�� '�•(Y'A( �1 WOOD DELI(NO PAVERS 6 NOTE: SEE PLAN FOR LOCATIONSAND PIAN Nertlumpton DIMENSIONS AM� 33 Hawley GABXXM BASKET wAu so-e1. SEE PHOTO OF INTENDED NpMplai.IM BEE PHOTO OF INTENDED DES GN.VANIZED14M' AM DIETER PIPE RAIL, VERTS a Sr O.C. RML HAS INTEGRATED _ LED DOWNLIGHT §� $14'WASHED STONE BASE CORE DRILL BASE&FIX WITH ANCHORING CEMENT II IIIA-1111=1111=IIIA -%.mm_ I , z J O K -- ---------------- �n NOMampinn Communlry Arts Tu�l 33 Hawley nomungon. FOUNDATION SITE PLAN