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16B-003 (14) i 100 A BRIDGE RD-REC DEPT BP-2020-0288 GIs#: COMMONWEALTH OF ASSACHUSETTS Map:Block: 16B-003 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTYFUND (MGL c.142A) category:renovation BUILDING PERMIT Permit# BP-2020-0288 Project# JS-2020-00048 Est.Cost: $1760.00 Fee: $0.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: CITY OF NORTHAMPTON CENTRAL SERVICES 054510 Lot Size(sq. ft.): 963547.20 Owner: NORTHAMPTON CITY OF J F KENNEDY SCHOOL Zoning_URA(100)/RI(81)/WSP(44)/Sk(0)/ Applicant: CITY OF NORTHAMPTON CENTRAL SERVICES ' AT: 100 A BRIDGE RD - REC DEPT Applicant Address: Phone: Insurance: Memorial Hall (413) 587-1260 0 j NORTHAMPTONMA01060 ISSUED ON:9/4/2019 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: I 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 9/4/2019 0:00:00 $0.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272- Louis 87-1272Louis Hasbrouck—Building Commissioner File#BP-2020-0288 APPLICANT/CONTACT PERSyl N CITY OF NORTHAMPTON CENTRAL SERVICES ADDRESS/PHONE Memorial Hall NORTHAMPTON (413)587-1260 0 PROPERTY LOCATION 100 A BRIDGE RD-REC DEPT MAP 16B PARCEL 003 001 ZONE URA(100)/RI(81)/WSP(44)/SR(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out I' Fee Paid kpeof Construction: INTERIOR RENO New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 054510 3 sets of Plans/Plot Plan I THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BAS1D 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: § I Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability . Sewer lAvailability I Septic Approval oard of Health Well Water Potability Board of Health i Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay I Signature of Buimg 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. I Versionl.7 Co=ercial_Bsildirid Permit Max 15: 2000 Gj Departrncnt use only ity of Northampton status of Permit Bildin De artment 9 P Curb CuflDnv��rvay Permit 212 Main Street Sewer/Septic Avai(ablhty. -- Room 100 1N3terJUVelI Avarlablllty No harr(pton, MA 011060 Two Setsor Structural Flans phone 413.-587'.1,240 Fax 413-587-1272- . Plfltlsrte'Plans t -- APPLICATION TO CONSTRUCT, EP�`IR,RENOVATE, CHA GE t OF, R.DEMOLISH ANY BUILDING OTHER.THAN A ONE OR 0 FAMILY DWELLING SECTION 1 -SITE INFORSEP 4 2019MATION 1 - DEPT.OF BUILDING INSPECTI section o be om. 1.1 ProDertvAddres�s: This /pllle.tedbyoff©ice "'1' — -----._.+....----- - RTHAMPTON.M.A 01 TON l� 0Uni - - - r- — - CG.` � 610(o0 Zone Overlay District I Elm`St District CB:Districl' SECTION 2-:PROPER-TY OWN ERS�IPIA.UTHORiZED AGENT 2.1 Owner of Record: Name( Current Mailing_Address. Sionatur Telephone 2.2 Auth rize A t: Name (Print) Currant Mailinc Address: Signature Telephone SECTION -ESTIMATED-:CONS:TRU.GTION.COSTS" .. Item Estimated Cost(Dollars)to be Dollars ( Otncial:Use Only- ompleted by permit applicant 1. Building I 5� (a)'Bwlding Peri Fee _....._____.._...-- 2. Electrical. _.y _ (6)Estimated ToLal:Gost of Consf�ricfion from (6) 3. Plumbing Bdilding Permit;Fee 4. Mechanical (HVAC)- S. Fire Protection u 1 a .ti, _.._._..�.._...._ 7e., +3.+4+5) •.Ch.eck dumber This Sectidn:.Fof Official Use Ori! Number .`Date:. Issued . � .ioner/Inspector of Buildings) DZte i1:9. I Version l.7 Cosunercial Building Permit May 15;2000 ' SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,00.0 .CUBIC FEET OF ENC:LOS.ED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change o Use❑ Other❑ Brief Description p Enter a beef d- t'on here:{ StTApLL Of Proposed Work: !may �1 'S •W• %5AW Ll) W AM SECTION 5-USE'GROUP ANf�,CONSTRUCTION TYPE' USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1% ❑ A-2 ❑ A-3 ❑ I 1A ❑ B Business ❑ ;;. 2A E Educational El ❑ F Factory ❑ F-1 ❑ F-2 - 2B �- ❑ ❑ i• 2C j. ❑ H High Hazard E3 I. Institutional El 1-1 I-3 1-1 ❑ 1-2 3A i El i. M Mercantile ❑ ❑ 38 ❑ I � ❑ R Residential ElR-1 ❑ R-2 El R-3 R-3 ❑ I ❑ S Storage El S-1, El - S-2 - ❑ �, 5A 58 ❑ U Utility ❑ Specify: - _._ ___.. ._w__ ..______,_,. __ _ .I M Mixed Use _......._.___.._.__..___ ....__-.---.._......_.__. _. ❑ Specify: , _ . ..._.___..._.,.__._. S Special Use ❑ Specify: COMPLETETH:IS SECTLON IF:FfSTING Bl11LD.ING.UN'DEPGOING RENOVATIONS ADDITIONS ANDIOR CHFNGE IN USE .. Existing Use Group: _..._...__....__...__,......_..,_._.__..,.._.__._:.__..._.. ._..._.,...__. Proposed Use Group: Existing Hazard Index 780 CMR 34)::...,_..__,._,._�. Proposed Hazard Index 780 CHIP.3^-.): '__, ,,,_,__,. ,_•„ - ,_ r SECTION.6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Q.FFICE'USE=:ONLY Floor Area per Floor(sf) - 15f _....... ............._.._...._._..__...._............ 1 St 3rd ......._--'—_•,...._,,._•_-_..,...,_._._,..,..,___.._�...._..::...........�......._ 3`d _...._..._.. Ih ..._.�_.._...,__._..-.._-.,.....__._.,.-.._.r._.,,.,.,.:._...._._..,___,.. 4th .._^____.,_.._,._.__._.........._. �. _ � _.. Total Area (sf, Total Proposed New Construction(sf) Total Height(ft) Total Height ft 7.(Nater Supply(M.G:L.'c.40, § 54) 7.1 Flood Zone Information: 7.3 Sewage.Disposal Sys4. . Public ❑ Private ❑ I Zone Outside Flood 7one(] Municipal ❑ On site disposal system f Version 1-7 Comrnercial Building Perirnit May 15, 2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SErZViCES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 1.16.(CONTAINING.MORE THAN 35,000 C.F..OF EN.C:L.OSEE)SPACE) 9.1 Registered Architect: Not Applicable ❑ Name (Regis._.trant); _..-..._...._..._.____. .........._.._..__ .._---....................._._.__-...... " Registration Number Address Expiration Date Signature j Telephone 9.2 Registered Professional Engineer(s): - Name ._....__-..._:_..__.._..-._-_._„ ...._...._...,..............._. Area of Responsibility ... ..._._..._........._..._.__._.......__._. Address _._.._.__...._.._.__...___....-----__--- Registration Number Sig _..,................_.._:..._._.._....._._..._.__. natureTelephone Expiration Date Name Area of!P.esponsibility __ Address —..—_.__,_._._.._.._._.__._..._._.._...__.._._ _,-•._.,_ P,egistration Number Signature j Telephone. Expiration Date Name .........-........ _....._._..._...__..___.,...._.:__,_ -„ _ Area of Responsibility Address -- _- — Registration Number Signature j Telephone Expiration Date _.._.__.......... __._...-- .._.-_,._.._... Name __.,____ _ r_ __._ _ __.___-__---.---=---------.___.._.__..__.-___._--.--•--._.: ___ ._.. .—.__ __----._._____.__._. __-__.--. Area of P,esponsibifity I Address -`-----------------• Registration Number -_......__....._._..__...__-....__. ----- _..... __....._..._...._.._..,- Signature j Telephone Expiration;Date 9.3 General Contractor �U _.___.._.._______..._----.---__..-.---�--. Not Applicable ❑ Company Name. I esponsible In Charge of Construction _._......_..._.._....._-__._._.._._-......__..._._...... --........._..........._. _......._...._........................_..._ _.._..__.-_.........._._.__.._...... _...._ LAd sat e' ........... .. j. Telephone .. 3 - � Version 1.7 Commercial Building Permit May 15, 2000' . S. I`ORT I �.IvIPTOIv...ZCy' :L`a? ' ExistingProposed Required by Zoning This column to be idled in by Building Department Lot Size >. _� ___ .. ,..•.,.. _....,.... _ _ ..._ _..:.... r ' Frontage Setbacks Front Side L:..-_m__: R::– --w L:_,._,.:.:..,..:. R:..:._._......_. Rear Building Height Bldg. Square Footage - –`— ---- % Open Space Footage + u/o (Lot area minus bldg&paved I — parking) #of Parkins Spaces _...�_.._. ..._.. ....._ I ...._ Fill: _........................................_ (volume&Location) __ _..... „...... ,..._. ......_ _ _ —__ _ _ - .. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book . Pace and/or Document B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: - ___�.._._...K_._.._,.,..._...__–.__.__._�.__.___.,._.___.__,_.__..•__.� D. Are there any proposed chanes to or additions of signs intended for the.,property ? YES NO 0 IF YES, describe size, type and location: E. WII the construction activity disturb (clearing, grading,excavation, or filling)over 1 acre or is it part of a'common pla'n that will disturb over 1 acre? YES 0 NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. _ Ilk _ ^" Tile cOrnmon'weayltj3 Of^Massae'lizCsetts a Dep ar1tnenn ofInditstr-ial Acciderus..- Office of 11:11estigations 600 TT d Iii _ s ria ori Street Boston, MA 0.2111 www.m ass.a o v1dia. NN orkers' Compensation Insurance AffldaNlt: BLilders/Contractors/EIectricians/Plurnbers Applicant Information Please Print Leaibly Name (Business/Organization/Inciit-dual): Address: City/State/Zip: - phone Are you an employer? Check the appropriate box: 1.❑ I am a employer with 4. ❑ I am a generalType of project(required}: contractor and I employees (full and/or part-time). have hired the sub-contractors 6.'❑New construction 2.❑ I am a sole proprietor or partn r- listed on the attached sheet. 7.1❑Remodeling ship and have no employees These sub-contractors have � 8. '❑Demolition working forme in any capaci employees-and have workers' 9. ❑Building addition [No workers' comp.msurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10:0 Electrical repairs or additions. ' officers have exercised their 3.❑ I am a homeowner doing all work 11:E]Plumbing repairs ar additions myself. NNo workers' comp. right of exemption per MGL 12 f❑Roof repairs insurance required.] c. 152, §1(4), and w e have no 13.❑ Other employees. NNo workers' comp.insurance required_] `Any applicant that checks box-1 must also fil�out the section below,showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hitt:outside contractors must submit a new an davit indicanns such. tContractors that check this box must attached an additional sheet showing the narne of the sub-conCzctors and state whether or not those entities have employes. If the sub-contractors have employes,they must provide their workers'tomo.policy number. j I am an employer that is providing work-ers'compensation insurance for my-employees. ;Below is the policyand job site information. Insurance Company Name: Policy"or Self-ins..Lic:.T Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of 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 WORD 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 DLA for insurance'coverage verification_ I do hereby certify under the pains an penalties of perjur),that the information provided above is true and correct- Signature:' Date: �I Phone=`• ✓✓^ffrcial use on1_h. Do not write in this area, to be completed by city or town officiaL City or-Town: Permit/License r "Issuing Authority (circle one): 1.Board of E4ealth 2—Building.Depl rtment. 3,.C1:_b:/T,o,Frr_ Clerk ?.Electrical Inspector S. P?urnbinQ Inspector. 6.Other Contact Person: _ Phone r: 'Version 1.7 Commercial Building Permit May 15;2000 SECTION 10-STRUCTURAL.PEEP'-"REVIEW(780.CMR,11:0.11) Independent Structural Enaineering�Structural Peer Review Required Yes O SECTION'11 -OWNER AUTHORIZATION_TQ 13E r r)mDLET'D ;WHEN No O OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ................................_._._..._.................._........ as Owner of the subject property herebyauthorize...---_.-_..__-._.._..____..._._..�.._.._____._...__._._.___..._..__.._._._._.—___...___.._..__....._._.._..._...__...____ .__._..__.......__._......._.___._..___..___._._...._...:_..._.._..........._.____ to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner, Date igg t� u 49an— ,`why �✓ _.__..... �Owner/Athorized ent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge a belief. g_, he p2ins and,penalties of perjury!. � - T " Pnt Na _..._...._.._. ._.............._ _ .. Signature of Owner/Agent Data - SECTION 12- CONSTRUCTION.SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑" _ - _ ..._____..____..___...._._..._..... me of License Holder:` . _ ._.�.. ' License Number A res — s _ Expiration Date Sig aturJ, Telephone `� • SECTION 13 WOR 77777777777 RS.':`. ,OMPENSATIOII„Ilv'SURANCE AFFIDAV7F IT :....: 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 O No n crry OF NORTHAWTON, 1d1ASS k USETTS 3 ' F Central Services Memorial Hall, 240 Main Street Northampton, MA 01060 David Pomerantz (413)587-1238 Fax: (413)587-1248 Director of Central services To:, Louis Hasbrouck, Building Commissioner From: David Pomerantz i Date: September 3, 2019 Re: Construction Control Waiver I I request that you grant a modification to waive the requirement for construction control for the project at 100 A Bridge Road,Northampton, MA (Recreation Department). Because the work is of a minor nature,will not affect health; accessibility, life and fire safety, or structural requirements, and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work I am requesting a waiver,. i . Thank you for your consideration. i i i QCLOS l I +'�� �-�' I ; / 11�11 � a S `i } CLEAR CLEAR R1F B 4 9 cLounIID ARS Fula 7 HOT LED STAFF " 5 - r } i 1 P. 7'-9' I i - f i 2'-3• L'-3' ( � 1 � I o CL .a N i� w ; BACKER DETAIL (JH � �+ p N p. m SCALE, 1/2'=11-0' - �N N lti M H I MANSARD 24' OJ{ UH -(LM) - 357- - -- \---- ------ -------------- ---------------- 00 -- --------------- - - - - I❑ 1 1 1•-0' � ❑A I �•' i ! I 2 1 3'LD 1/2 �'� — 10'-D• B49 I ti j gi I R I 1 O o �p i I'-0. A I " CLASSROOM-TESTINI-i N I Y MIM. _ 670 I N AR 1 I w C 2x6's I s I MIN. 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