32A-138 25 MAIN ST #444 25 MAIN ST#444 BP-2021-0960
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:32A- 138 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: UPDATE WIRING BUILDING PERMIT
Permit# BP-2021-0960
Project# JS-2021-001643
Est.Cost: $10600.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KOHL CONSTRUCTION 064539
Lot Size(sq. ft.): Owner: CHAMISA CORPORATION TO: HAMPSHIRE PROPERTY GROUP
Zoning: CB(100)/ Applicant: KOHL CONSTRUCTION
AT: 25 MAIN ST#444
Applicant Address: Phone: Insurance:
31 Campus Plaza Rd (413)256-0321 Workers Compensation
HADLEYMA01035 ISSUED ON:3/2/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVE DRYWALL TO UPDATE WIRING,
INSTALL NEW DRYWALL
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. i
I r I •
Certificate of Occupancy Signature: I
FeeType: Date Paid: Amount:
Building 3/2/2021 0:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
4
•
jr�AR 2 2021 ! The Commonwealth of Massachusetts
I�w4 I Office of Public Safety and Inspections
1 Massachusetts State Building Code(780 CMR)
of sun r) inldliig rlit Application for any Building other than a One-or Two-Family Dwelling
r;r%n71-in'.al,
(This Section For Official Use Only)
Building Permit Nurnberg"4--9 14 ate Applied: Building Official:
SECTION 1:LOCATION
25 Main Street #444 Northampton 01060 Masonic Building
No.and Street City/Town Zip Code Name of Building(if applicable)
32A 138-006
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used 9th If New Construction check here❑or check all that apply in the two rows below
Existing Building 0 Repair 0 Alteration ❑ Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No 0
Brief Description of Proposed Work: Remove interior finishes including drywall and trim. Remove all knob 8 tube wiring. Install code compliant
outlets and lighting. Insulate for sound. Install new drywall,trim and paint.
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): B Proposed Use Group(s):B
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 I-2❑ I-3 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4❑
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA El IB ❑ IIA ❑ IIB 0 IIIA ❑ IIIB ❑ IV El VA CI VB0
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public 0 Check if outside Flood Zone 0 Indicate municipal 0
A trench will not be Licensed Disposal Site 0
required 0 or trench or specify:
Private❑ or indentify Zone: or on site system 0
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA I listoric Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): _ Type of Construction:
Does the building contain an Sprinkler System?: _ Special Stipulations:
Design Occupant Load per Floor and Assembly space:
City of Northampton
pRS " DA. �j `.. S
11 114
h4 Massachusetts �Q:SN .i._ °'ef
u. *.
E DEPARTMENT OF BUILDING INSPECTIONS �:
'' 212 Main Street • Municipal Building x'J �a�
v~,�.a +"-,art Northampton, MA 01060 r'i'fr1 a
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR COMMERCIAL &
MULTI-FAMILY NEW CONSTRUCTION/ADDITIONS/ALTERATIONS
1. Building Permit Application signed by legal owner and filled oil{by owner or authorized
agent. Ji
2. One set of plans and specification of proposed work(digital and hard copy).
3. Site Plan with location of proposed structure(s)and setbacks.
4. Construction Debris Affidavit filled out and signed by applicant
5. Worker's Compensation Insurance Affidavit filled out and sign d by applicant.
6. Contractors must supply a copy CSL and proof of Liability Insu nce.
7. Energy Conservation Compliance Certificate(if applicable). 1.1
8. Note any Conservation and/or Special Permit requirements (if applicable).
9. Driveway Permit(if applicable).
10. Proof of Water and Sewer entry fees paid(if applicable).
11. Trench Permit(if applicable).
12. Initial Construction Control Documents filled out and signed by the Registered Design
Professional in responsible charge.
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Chamisa Corporation 31 Campus Plaza Road Hadley 01035
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Ted Parker 413-25.6-0321 413 695 0333 tparker@kohiconstruction.com
Tide Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Kohl Construction
Company Name ,,,
Theodore Parker CS-064539 6 VGG ZV�
Name of Person Responsible for Construction License No. and Type if Applicable
31 Campus Plaza Road Hadley MA 01035
Street Address City/Town State Zip
413_256_0321 413 695 _0333 tparker@kohlconstruction.com
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes El No Cl
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs:(Labor
Item and Materials) Total Construction Cost(from Item 6)=$10,600
1.Building $8,500 Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $2,100 appropriate municipal factor)=$ .
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$100 (contact municipality)
5.Mechanical (Other) $ Enclose check payable to '
6.Total Cost $10,600 (contact municipality)and write check number here l 1 `I
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to e be of my knowledge and understanding.
Theodore Parker De President 413 256 _ 0321
Please print and sign name Title Telephone No. Date
31 Campus Plaza Road Hadley MA 01035 tparker@kohlconstruction.com
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: 4\I:&.; ' U 3
4 Name UV ate
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
The Commonwealth of Massachusetts
Department of Industrial Accidents
zt ; I Congress Street,Suite 100
Boston,MA 02114-2017
_.. �
w'ww Inass.gav/Shea
11„pkers' ('utnpettsation Insurance Affidavit:BuiidersiContractorsfEkctricians/Plumbers.
to Bt. t"II.F:D NS I111 TILE:t'i Ft%I1'Il'INC At 1140/11l'l.
Applicant Information Please Print l.et:illy
Name(Hush .Orpntrititin lad actual : Kohl Construction Inc.
Address: 31 Campus Plaza Road
City/State/Zip: Hadley MA 01035 phone#: 413.256.0321
Are yeti ma e+aployer't'heck the appraprate box: Type of project(required):
i.®lam a employer with 5._... etnp4oyees(felt and oe pan•tiak}.•
7. Q New construction
20 I am a auk proprietor or partnership and have no employee:working for me in
8. Remodeling
any capacity_[No workers'comp.rn5utanCe teiltund.l
❑3rJ 1 am a homeowner doing all work myself.(No workers'tamp.insurance required.)' 9. Demolition
El
4.0 I a a homeowner and will be hiring to eondurt all week on my property. I will 10 Building addition
m
ensure that all contraturs either hive makers'onmpt-nxttiun inaurancx or are sole 1 I a Electrical repairs or additions
pruprwton with no employes.
12.❑Plumbing repairs or additions
SO 1 am a general contractor and I lava hired the aub..contraetors listed on the attached street
These sub.contractore have eamloyees arid lave workers'comp.insurance. I ❑Roo repairs
6.0 we are a corporation and its offucers have exercised their right of exemption per MOIL e. 14. Other
352,31I ),and we have no enyslo}eea.[No workers'comp.insurance required.]
"An}applicant that Awls box al must also fill out the section below stowing their workers.'compensation polcy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hat outside contractors most submit a new affidavit initialing SLICK
Contractor that cheek this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employee . If the snub-curtractors have employees.they must provide their workers'eo+np.policy number.
I am an employer that is providing workers'compensation insurance for my employes. Below is the Indic),and job site
information.
Insurance company Name: AIM Mutual Insurance Company
Policy#or Self-ins.Lic.#: WMZ 8008002872-2020A Expiration Date: 2/10/2022
Job Site Address: 25 Main Street #444 City/StatelZip: Northampton MA 01060
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 the Ins and penalties of perjury that the information provided above is true and correct.,-1 7-, ( C
Date: j
Phone413-256-0321
Of ficio/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):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
( ontact Person: Phone#:
City of Northampton
S
Massachusetts ?S :_ •
ti .(. w1
SI
DEPARTMENT OF BUILDING INSPECTIONS ;
212 Main Street • Municipal Building J• �L_-'
Northampton, MA 01060
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: Valley Recycling, Northampton MA
The debris will be transported by:
Name of Hauler: Kohl Construction
Signature of Applicant: Date: 210 r a -24
CONSTRUCTION CONTROL WAIVER
From: Theodore Parker, Kohl Construction
31 Campus Plaza Road, Hadley MA 01035
413.256. 0321 413.695.0333 c tparker@kohlconstruction.com
To:
Jonathan Flagg
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code,section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
25 Main Street, #444 Masonic Building, Northampton MA
because the work is of a minor nature,will not affect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,
74A
4 air
O \2 i
lien= IrAlrf/
/ /7/
_ ,.
'- " r
444
1
44:istwa, , 0"'
in
E , w it.,
.►--
, ,
x
co
i
g .„...,...i. i ss
E0 i/ 1 \ ,
Kohl Construction
31 campusP13Za Road
Had'3y, MA 01035
MASONIC
11,-3'
CI
_
I<_ a�II IIII \\\\\\\\\\\\\... �\\\x �II N
`��-
II I
I l - I
re
lel 1'-3
111
± N
y4
III el.H 63'-S'
III
J
�' u.......,,,....z_lIl
III ..,N - III
y:
,..,
I�
..,.--..., ......_. .: \,.....„..„,..\\„\s„,,,.. ,,,,,
16•-2 1 ` 1
hi
nt N
111
III - UN
I I. {
III
li o
NI. J .k VI& Vialeles,L IILWIL "li----.20. . ''-'\ 10111Ndi - "1114
-T
'- 1
II NH
LJ '
IIII «l �� J
III N
III I. ' k •
m 15'8'
_�
III `� °,_ > 19-tY
Iail
I r 8-3 1/28
III A s a ��
m I
III ,4_2
IIII —14,-2 ' R
IIII 10.-10• 1;
III
, I
v SCALE JOBNAME 1
m 1/8"= 1'0" MASONIC BUILDING
KOHL
ISSUE DATE LOCATION CONSTRUCTION, INC.
° 11.30.06 21-31 MAIN STREET - - 111 T 31 CAMPUS PLAZA ROAD
HADLEY,MA 01035
DWN BY PHASE TITLE NO. Revision/Issue NIT Date (413)256 0321 Fax(413)2580130
JRL 4TH FLOOR PLAN PLOT FILE CREATED 7/3/2008 9:43:07 AM
COPYRIGHT 0 KOHL CONSTRUCTION,INC