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The Commonwealth of Massachusetts
Department of Industrial Accidents
• 3 — Office of Investigations
. ,47 -; ' ° 600 Washington Street
Boston, MA 02111
_ = www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information • Please Print Legibly
Name ( Business /Organization/Individual):
Address:
City /State /Zip: Phone #:
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
.eKiployees (full and/or part- time).* have hired the sub - contractors
6. ❑ New construction
2. I am a sole proprietor or partner- listed on the attached sheet. 7. ;modeling
ship and have no employees These sub- contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Bnildinc addition
[No workers' comp. insurance comp. uisurance.t
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11. Plumbing repairs or additions
re a
3. ❑ I am a homeowner doing all work � P.
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, § 1(4), and we have no
employees. [No workers' 13. ❑ Other
comp. insurance required.]
*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 must submit a new affidavit indicating such.
1 Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors 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 job site
information.
Insurance Company Name:
Policy # or'Self -ins. Lic. #: 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 WORK 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 DIA for insurance coverage verification.
I do hereby ce i under the pains and penalties of perjury that the information provided above is true and correct.
S ignature: Date: 12 /So /d
Phone #: 4 t 566 'l 4 W
Official use only. Do not write in this area, to be completed by city or town official
City or '1 own: Penult/License #
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 #:
Version1.7 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 0
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
,?c1 rl t3 .1 _ �'t L24, _..e . , as Owner of the subject property
hereby authorize `' �� � .
act on my behalf, in all matters relative to work authorized by this building permit application.
:6 nom ... , 4: /t _..C?
Signatu� o Owner V Date
fA r 1 v i tt yy�
y'`...__. ..... .... __. _.. 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.
Signe,i under the pains nd penalties of perjury.
Z.A nil 0v"1 ? I
Print Name
Signat a of Owner /Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable 0
�1 e r �j
�r _ ..
License Number
•
Address Expiration Date
•
Signat e 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 buil "rig permit.
Signed Affidavit Attached Yes No 0
4
Version1.7 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 0
Name (Registrant):
Registration Number
Address
-, . Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Teleplione Expiration Datc
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable 0
Company Name:
Responsible In Charge of Construction
Aririrpsc
Signature Telephone
Version1.7 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
Rear _.
Building Height
Bldg. Square Footage
Open Space Footage % -
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding e r been issued for /on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Regist of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 9 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued:
C. Do any signs exist on the property? YES 0 NO ( . 1? /----
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES (3 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, exc ation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES (3 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.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 0 Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other 0
Brief Description Enter a brief description here. i TypN 4u
tiZIMa � . ,pv� i , '"
Of Proposed Work: 4 � l'ZST .(,2 3 1.5 Verb b ,e vwi i 1} 0 1417
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' . Ill
F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑.
H High Hazard ❑ 3A ❑
I Institutional ❑ I -1 ❑ I -2 ❑ I -3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R -1 ❑ R -2 ❑ R -3 0 5A ❑
S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify
S Special Use ❑ Specify: . _, ,� ,,.��..�_ _.,.__ ....a m ... _ , __ , , , _ a v _� . __. _.,
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 (sf) v
st
sr ,
1 r , .
1 q zo $ _...
2nd
2 nd
3 �d
3rd J ,
4
Total Area (sf) ' .oif Total Proposed New Construction (sf)
Total Height (ft) t
Tnf i I-1 i ft
7. Water � tipply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage ' posal System:
Public (7� Private ❑ Zone Outside Flood Zone Municipal On site disposal system
•
Versionl.7 Commercial Building Permit May 15, 2000
Department use only„
City of Northampton StatuofPemiit ,
- -- Building Department Curb Cut/Driveway Penmt
212 Main Street Sewer/Septio Availability
p EC 7 0 Room 100 WaterikiVell-vilabilitY
Northampton, MA 01060 Two Sets of Structural
phor)e Rax.413-587-1272 plat/S4e Plans -
, Ottiergpedify
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR 711/0 FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This section to be completed by office
1.1 Property Address:
tit C. 1) tAX11/4(.t---•*67C. Map Lot Unit
01 ();.7.-. Zone Overlay District
- Elm St. District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
, ) ( " :, -,"p ?: )1'1 • ('"
• = ., ‘■ 11. 1 a • `-
Name (Print) t
pn Current Mailing Address:
1 ,) -4 1,1c i /Ail A
Signature 1 t (. (,)/ Telephone e cf
2.2 Authorize A Agent:
n I ( 7011 , 1 )
Name (Print) Current Mailing Address:
(;;:
Signature\.._ Telephone
SECTION 3- R CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
4
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. T (1 + 2 +3 +4+ 5) 5'1 o'
Check Number di90 —
This Section For Official Use Only
Duilding Permit Number Dote •
Issued
Signature'
Building Commissioner/Inspector of Buildings Date
File # BP- 2010 -0633
APPLICANT /CONTACT PERSON JOHN FERRITER
ADDRESS /PHONE 274 Bridge St NORTHAMPTON (413) 586 -9680 0
PROPERTY LOCATION 16 NORTH MAPLE ST - UNIT C
MAP 17C PARCEL 227 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ^' �
Fee Paid 09* 1►4 .3v
Typeof Construction: REPOSITION DOOR, REMOVE SHOWER,INSTALL 2 TOILETS & PRIVACY
PARTITIONS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 061398
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9.RMATION PRESENTED:
1/' 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
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.
. .
Ofai
Ti" '' BP- 2010 -0633
GIS #: COMMONWEALTH OF MASSACHUSETTS
1 ' ` tit n ` 1 ; CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0633
Project # JS- 2010- 000924
Est. Cost: $5704.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN FERRITER 061398
Lot Size(sq. ft.): 6838.92 Owner: VALLEY COMMUNITY DEVELOPMENT CORPORATION C/O HOME
CITY HOUSING DEV
Zoning: GB(100)/ Applicant: JOHN FERRITER
AT: 16 NORTH MAPLE ST - UNIT C
Applicant Address: Phone: Insurance:
274 Bridge St (413) 586 -9680 0
NORTHAMPTONMA01060 ISSUED ON:1/4/2010 0:00:00
TO PERFORM THE FOLLOWING WORK: REPOSITION DOOR, REMOVE
SHOWER,INSTALL 2 TOILETS & PRIVACY PARTITIONS
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 1/4/2010 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
3.0 Test Criteria:
All features, devices, components, and modes of operation shall be tested for acceptance
in accordance with the code and NFPA 72. Smoke detectors shall be activated using
simulated smoke per the manufacturer's recommendations and all pull stations shall be
activated by opening and upon activation of each device the proper operation of the Fire
Alarm System shall be checked for proper operation including annunciation at the Fire
Alarm Control Panel and transmission of an alarm signal. Proper operation in the
emergency power mode shall be demonstrated as well as a check of supervision circuits
for opens and shorts. A test certificate shall be issued verifying said test.
* * * End of Basis of Design Narrative
L &S 1849 Page 6
SECTION 5 - FIRE ALARM SYSTEMS
1.0 Fire Alarm Systems and Components
A. This project includes a new addressable fire alarm system with addressable
devices, re -using the existing wiring system. The alarm system is based upon an
Notifier "Fire Warden 50" system. The new control panel is located in the main
vestibule.
B. All new notification devices are "Temporal 3" audio pattern, plus strobe.
C. All new initiating devices are addressable.
D. Individual address modules (IAM) are used to interface non - addressable initiation
devices such as tamper switch and flow switches.
E. All smoke detectors & heat detectors installed are addressable devices.
F. Carbon monoxide detector located basement boiler room is system connected;
those in hallways outside bedrooms are local alarm.
2.0. Sequence of Operation:
This new fire alarm system is designed to detect fires normally associated with this type
of facility. The Activation of any manual pull station, heat, smoke, carbon monoxide or
flow switch will immediately and simultaneously activate all system audio /visual units,
and send a signal via the Fire Alarm Panel to a radio masterbox.
System connected smoke detectors will be programmed for "Alarm Verification"
operation, otherwise operating as described above.
The system will be constantly monitored as part of the alarm system. Removal of any
fire alarm device or any system wiring fault such as opens or grounds will initiate a
trouble alarm at the Fire Alarm Control Panel and send a trouble signal to the radio
masterbox.
The Fire Alarm Control Panel reset button returns the system to its normal state. Display
messages shall provide operator assurance of the sequential steps as they occur. The Fire
Alarm Control Panel is equipped with battery back up giving 60 hours of standby
operation followed by 15 minutes of alarm. The Fire Alarm Control Panel is also
equipped with visible and audible signals to indicate alarm and trouble conditions.
L &S 1849 Page 5
.
4.0 Design Criteria
A. All residential /dwelling spaces are designed for residential /light hazard
occupancy. The density is .10/900 square feet with a 100 gpm hose allowance.
B. The storage and mechanical areas throughout the building that are ordinary
hazard, the system will be designed with a density of .15/900 sq.ft., density with
250 gpm added for hose stream.
5.0 Test Criteria
A. All sprinklers and standpipe systems shall be tested in accordance with NFPA 13R
and NFPA 25. Complete system flow test will be conducted and test and flow
certificates issued.
1. (WET PIPE SYSTEM) An alarm test connection not less than 1 in. in
diameter, terminating in a smooth bore corrosion- resistant orifice, giving a
flow equivalent to one sprinkler of a type having the smallest orifice
installed on the particular system, shall be provided to test each water flow
alarm device for each system .
2. (WET PIPE SYSTEM) The test connection valve shall be readily
accessible.
3. (WET PIPE SYSTEM) The discharge shall be to the outside, to drain
connection capable of accepting full flow under system pressure, or to
another location where water damage will not result.
B. Hydrostatic Test
1. Hydrostatically test the entire interior piping system at not less than 200
psi (13.6 bars) for 2 hours and provide a test certificate for said test.
C. Flow Test
1. A system flow test shall be performed and the operation of all flow
switches, tamper switches, and alarm devices verified. A test certificate
shall be issued verifying said test.
L &S 1849 Page 4
SECTION 2 - APPLICABLE LAWS, REGULATIONS & STANDARDS
Systems were designed in compliance with the following:
1. 780 CMR 9, "Fire Protection Systems" Section 917, 918, 919, & 923.
2. NFPA 13R — 2007, "Installation of Sprinkler Systems ".
3. NFPA 72 — 2007, "National Fire Alarm Code ".
4. 521 CMR 40, "Architectural Access Board ".
SECTION 3 - DESIGN RESPONSIBILITY
The designs for the fire protection sprinkler system and fire detection and alarm systems
were prepared by:
Lindgren & Sharples, P.C.
435 Cottage Street
Springfield, MA 01104 -4005
SECTION 4 - FIRE PROTECTION
1.0 Basis of Design
The building is served by a wet pipe fire protection system consisting of sprinklers
located in all occupied spaces. These sprinklers are connected to a wet pipe sprinkler
riser and are protected by a backflow preventor.
2.0 Installation
A. The fire sprinkler system is designed in accordance with NFPA 13R, 2007.
B. All spaces are provided with sprinklers specifically listed for the specific
applications in accordance with NFPA 13R, 2007.
3.0 Equipment
A. Pipe is to be schedule 40 Black Steel Pipes for 1" through 3" or Blaze Master
PVC pipe.
C. A main flow switch is provided in the main sprinkler entrance which is also fitted
with an approved backflow preventer.
L &S 1849 Page 3
V
16 NORTH MAPLE REHAB
16 NORTH MAPLE STREET
FLORENCE, MASSACHUSETTS
SPRINKLER AND FIRE ALARM SYSTEM UPGRADE
BASIS OF DESIGN NARRATIVE
June 18, 2010
Information required pursuant to the Massachusetts State Building Code 780 CMR, 903.0.
Owner: Valley Community Development Corp.
30 Market Street
Northampton, MA 01060
Designers of Record: Lindgren & Sharples, P.C.
Consulting Engineers
Date of Submittal: June 18, 2010
SECTION 1— BUILDING DESCRIPTION
PROJECT SCOPE:
This project consists of installation of minor renovations to the existing wet pipe sprinkler
system and installation of a new addressable Fire Alarm System to serve the existing property at
16 North Maple Street, Northampton, Massachusetts. This project includes replacing the
existing sprinkler heads in all areas with new quick response heads and installation of a new fire
alarm system to allow monitoring and supervision of the new sprinkler equipment. This project
also includes the installation of a new addressable fire alarm system installed throughout the
building to meet current code standards.
The property at 16 North Maple Street consists of an existing three story masonry and wood
frame building. The building is classified as R -2.
The total building is comprised of approximately 3,342 square feet of floor space on three levels
with a non - accessible attic.
Fire Department personnel and rescue vehicles can access the site on Maple Street.
L &S 1849 Page 2
NARRATIVE REPORT
FOR
FIRE PROTECTION & ALARM SYSTEMS
AT
16 NORTH MAPLE REHAB
16 NORTH MAPLE STREET
FLORENCE MASSACHUSETTS
PREPARED BY:
LINDGREN & SHARPLES, P.C.
CONSULTING ENGINEERS
435 COTTAGE STREET
SPRINGFIELD, MA 01104 -4005
TEL. 413 - 732 -4336
JUNE 18, 2010
Northampton Fire Dept.
Fees
Job: Valley CDC / 16 North Maple Street Rehab
16C North Maple Street
Florence, MA 01062
Commercial Bldg
Floor Squ. Ft. x 0.04 Fee
SF Gross bldg area 828 x 0.04 $33.12
TOTAL: 828 x 0.04 $33.12
Scope of fire protection per "Fire Protection Narrative" dated 06/18/10 and
drawings submitted to Northampton Building Dept on 06/23/10.
Wright Builders will mail $34.00 check (and copy of FPN) directly to Asst. Chief
Duane Nichols, NFD.
Marney Electric to pull the Fire Alarm Work permit and pay
the associated $80 permit fee.
(Both checks are made out to the City of Northampton.)
cc: Louis Hasbrouck, Northampton Building Commissioner
Asst. Chief Duane Nichols
Jeff Marney, Marney Electric, Fax: 587 -0737 (fire alarm contractor)
Prepared by Wright Builders, Inc. 6/23/2010
v
y �
elk
- new storefront entrance to front commercial space
- upgrades /fixture & finishes replacement in first floor
residential bathroom.
- upgrades, counter /cabinet/& appliance replacement in
existing kitchen.
-first floor laundry
3404.19 Energy conservation Verify existing insulation if possible for evaluating wall R-
I values, but no proposed change or upgrade is proposed at
this time. New insulating windows to be installed.
Insulation of commercial building proposed where roof is
being replaced. All replacement plumbing fixtures to be
water saving . All replacement lighting fixtures to meet
energy star standards. All replacement HVAC equipment to
meet energy star standards.
lb ,
VIT
Kathleen E. Ford
[
fK
� �
3404.1 General Hazard index is ZERO
3404.2 Requirements exceeding those required for N/A
new construction
3404.3 New building systems: Any new building Existing wood HC accessible ramp will be replaced in kind
system or portion thereof shall conform to 780 with a concrete ramp. Existing heating system to be
CMR for new construction to the fullest extent removed and replaced with new. Components of the
practical. However, individual components of an existing plumbing system to be replaced. Componenets of
existing building system may be repaired or the existing electrical system to be upgraded and replaced.
replaced without requiring that system to comply
fully with the code for new construction unless
specifically required by 780 CMR 3408.
3404.4 Alterations and repairs: Alterations or New resident room doors and hardware to be replaced.
repairs to existing buildings which remain or
improve the performance of the building may be
made with the same or like materials, unless
required otherwise by 780 CMR 3408.0.
Alterations or repairs which have the effect of
replacing a building system as a whole shall
comply with 780 CMR 3404.3. _
3405.5 Means of egress: Every floor or story of There is no proposed change to the existing means of
any existing building shall provide at least the egress.
number of means of egress as required by 780
CMR 3400.4 and which are acceptable to the
building official.
3404.6 Capacity of exits Total occupancy for first floor (R2, accessory) use is 1
person. Total occupancy for second floor (R2) use is 5
persons. Total occupancy for third floor (R2) use is 5
persons
3404.7 Exit signs and lights Need to verify compliance (as per 780 CMR 1023.0)
3404.8 Means of egress lighting Need to verify compliance (as per 780 CMR 1024.0)
3404.9 Height & area limitations _ There is no proposed change to height and area.
3404.10 Existing fire & party walls N/A
3404.11 Fire protection systems There is an existing sprinkler system plans to replace
existing heads in kind.
3404.12 Fire protection systems required for the N/A
following cases:
2. For existing buildings modified by addition
and/or change of use where required by 780- CMR
504.0 or 506.0 to satisfy height and area -
requirements.
3404.13 Enclosure of stairways: Open stairways No changes proposed for stairways or stairway enclosures.
are prohibited except in one & two family
dwellings or unless otherwise permitted by 780
CMR 10.00. There shall be no minimum fire
resistance rating for an existing enclosure of a
stairway. Partitions or other new construction
which is added in order to fully and solidly enclose
a stairway shall provide a minimum fire resistance
rating of one hour. All doors in the enclosure shall
be self - closing and tight -fitting with approved
hardware. All doors in those portions of the
stairway which are fire resistance rated shall
comply with the applicable provisions of 780 CMR
9.00.
3404.17 Fire hazard to adjacent buildings N/A
3404.18 Accessibility for persons with disabilities Existing components to be upgraded that will conform to
in accordance with 521 CMR applicable provisions of 521 CMR are:
-ramp and entry to first level of residential building
-path to back entry of commercial building, including
entrance to back commercial space.
d
Ford
Gillen
Architects, Inc.
409 Main Street
Amherst, MA 01002
Tel 413-253-2528
ARTICLE 34 REVIEW Fax 413 -256-1553
fgaoffice @fordgillen.com
Kathleen E. Ford, AIA
William V. Gillen, AIA
RE: 16 North Maples Florence MA
DATE: May 1, 2010
JOB NO.: 2810
780 CMR 3404 Seventh Edition
Requirements for continuation of the same use group or change to a
use group resulting in a change in hazard index of one or less
CODE REFERENCE THIS PROPOSAL
3400.3 Applicability Project is to make capital upgrades to an existing 11 unit
SRO and ground floor commercial, including sitework,
porch & ramp repair /re- build, new heating, plumbing
fixtures, light fixtures, and kitchen counters & appliances.
3400.3.1 Continuation of the same use group, or a Table 3403
change in use group which results in a change in This is a continuation of R -2 Use Group with a change of
hazard index on one or less as determined by CMR hazard index of ZERO.
3403 shall comply with 780 CMR 3404.0
3400.3.4 Additions: Additions to existing No new square footage /addition is proposed.
buildings shall comply with all code requirements
for new construction, except as otherwise provided
in 780 CMR34. The combined height and area of
the existing building and the addition shall not
exceed that allowed by 780 CMR503.0 and Table
503 as modified by 780 CMR 504 and 506.
3400.3.8 Residential Use Groups: A change from This is a continuation of R-2 Use Group.
any other use group to a residential use group or
any alteration or change in occupancy within a
residential use group shall comply with
requirements of the code for new construction,
except that earthquake requirements need only
conform to 780 CMR 3408.
3402.1.1 Investigation and evaluation A structural evaluation will be submitted in sufficient detail
to describe the existing building structure and the effects of
the proposed work on the existing structural system where
the rams and .orch is bein. replace in the front.
3402.1.3 Non Conformities and See attached proposed Compliance Alternatives:
Compliance Alternatives , TBD, none known at this time
•
Ford
Gillen
Architects Inc.
ZONING & CODE REVIEW
409 Main Street
June 15,2009 Amherst, MA 01002
Tel 413-253-2528
Fax 413 - 256 -1553
fgaoffice@fordgillen.com
Kathleen E. Ford, AlA
William V. Gillen, AIA
Mr. Patrick McCarthy
Valley Community Develpoment Corp.
30 Market Street
Northampton, MA 01060
RE: AS OF RIGHT RENOVATION
16 North Maple Street Florence MA
16 North Maple is on a 6838 s.f. lot (zoning map sheet #17C, parcel #227) in GB zoning district. A
primary building is currently utilized in a residential capacity and is licensed to operate as a boarding
house with eleven single room occupancy's (SRO's), with common kitchen, bathrooms, and
community space. A secondary building is utilized as commercial use.
The primary residential structure consists of a primary structure of 3,132 square feet of gross living
area (1,032 square feet of finished basement space, 1,260 s.f. of first floor space, & 840 s.f. of
second floor space). The secondary commercial structure consists of a total of 828 square feet gross
building area, accessible to the public at grade.
An appraisal prepared in 2003 values the property's value at $300,000. For purposes of planning, it
is assumed that the cost of construction will exceed 30% of this value ($90,000), and the project will
maintain it's current compliance with CMR 521 Architectural Access Board requirements (section
3.3.1). The proposed project has been reviewed with both Carolyn Misch of the Northampton
Planning Department and Tony Patillo of the Building Depattment for interpretations relating to both
zoning and building codes and what is allowable AS OF RIGHT.
Improvements to the residential building cannot include reconfiguration of any walls or rooms
without triggering a zoning finding process. Therefore, the proposal is to maintain the existing
boarding house as existing non - conforming use exactly as is. Improvements may include renovation
of common kitchen and bathrooms, and all items of deferred maintenance and general building
improvents such as new windows etc... and general site improvements including improved drainage
and fencing. Proposed replacement and upgrade of the existing handicap accessible ramp is
allowable as per MA General Law 40A.
Improvemen s o he commercial-huildipg_are allowed as of right, and include the additio -
second floor mezzanine for private office use only whic - - :..m1r4 as such in a restrictive
covenant attached to the deed fv-i-tzT o
()T r
P r c .6CA,
/r kec
ll
czo“( )i a f
Kathleen E. Ford
4
City of Northampton
444.-.4.-14 t 1 PAR PT Or7' B El2ZD3A1G I NSPECTIONS Ai:- \- 212 2t 1n Str0a: s l4L'ni nui1 i g r Q 1�
A 4 ' ° '" iror-tbaz tan, ]l1 01060 1 s!' y1 ' E'ti
$ `nob
INS£-ECTOR
Louis Hasbrouck tl Fax: 4-13- 587 -1272 .
Building Commissioner Phone: 413- 587 -1240 Assistant Commissioner
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(For professional Englneers/Architects responsible for a portion of a controlled project)
Project Title: 11 f-10 12-n-4 fr) t/iL 4t-f7 c 7 Date: ' � A ` 1 7 7 I
Project Location:1(o Is-10 e Yh / 19 IA 1tk ' t. Map: Ile- Parcel: '7 Zone: A.
Scope of Project: 17-L. 1 .4: UP4t -Pt. J ) 0 r -ik_ Ie'I -f,
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR Section 116.0:
I , � . V ' C. r T £ 2 L / h e l l r e n Jr. Mass. Registration # 2 2. 4A 5,
being a registered professional Engineerhiteehitcct hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans, computations and specifications concerning:
[ 1 Fire Protection [ ] Architectural [ ] Structural [ 3 Mechanical , Electrical
[ ,I Other (specify)
for the above named project and that to the best of my knowledge, such plans, computations and specifications
meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices
and all applicable Laws for the proposed project
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that
the above mentioned portions of the work proceed in accordance with the documents approved for the building
permit.
Upon completion of the work, I shall submit to the building official a final report as to the satisfactory
Completion of the above mentioned work.
P� �N °F M gs sq
Signature and Seal of Registered Professional oy
EVERT ( CA /
U
f JF., P.E.
. \,,• No. 22425 O)
/6' Day of JU n -P. 20 1 b .0 s L A `a .
(seal)
t
City of Northampton
/ i' * ` : :, Sd a9sac3111setts "� ,: S -Sty,
T §P� -L� DEPAR' QT OF ETJIIDI G INSPECTIONS ; ;
. 212 wt 212 1 is 8trOCt 4 MURic pal Itti 1dios � s `
Nort ton, MA 01060 ESN l h
c7SFECTOR
Louis Hasbrouck Fax: 413 -587 -1272
Building Commissioner Phone: 413- 587 -1240 Assistant Commissioner
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(For professional Enilneers/Archltects responsible for a portion of a controlled project)
Project Title: Ito f [ 4 6/'L,t i - {l't ' Date: I ' (6' lb
Project Location:16 00 MI- fy1 (A g "GfG Map: 17 G Parcei: Zone: f7
Scope of Project: i T7 N` —*4' (44g-rcpt. •) ) iJ r14 - 12--t A--4A-1. '
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR Section 116.0:
I, Mass, Registration # ,
being a registered professional Engineer /Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans, computations and specifications concerning:
[ ] Fire Protection [ ] Architectural [ 3 Structural Mechanical [ 1 Electrical
[ 3 Other (specify)
for the above named project and that to the best of my knowledge, such plans, computations and specifications
meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices
and all applicable Laws for the proposed project.
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that
the above mentioned portions of the work proceed in accordance with the documents approved for the building
permit.
Upon completion of the work, I shall submit to the building official a final report as to the satisfactory
Completion of the above mentioned work. .
Sign ure and S e •f eyed Professional (* * c HARL )
(I irill°
8940
/6 Day of !� (J rJ 20
(seal)
If
1
' City ot Nortnampton
Nasaachusetbe
%.47
13
OF BUZLI)MG 22TSPECTIONS
• ° ;ON
sAW 212 rzia% etrome
Nth Ma 01060
INSPECTOR
Louis Hasbrouck Fax: 413-587-1272
Building Commissioner Phone: 413-587-1240 Assistant Commissioner
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(For professional Enolneers/Arobitects responsible for a portion of a controlled project)
Project Title: I (a 1,10 PM 611921AG r4 Date: ' 1 6
Project Location: • / 7 -4-6 176- Parcel: 7 Zone: 6 i;
Scope of Project: 917 I TIM. f\rie4M7 '-'h1tZPeP
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR Section 116.0:
64f2A E ey) P8 ez-c_ Mass. Registration # '331 q 1
being a registered professional Engineer/Architect hereby CERTIFY that 1 have prepared or directly supervised
the preparation of all design plans, computations and specifications concerning:
[ I Fire Protection I ] Architectural [ Structural [ 3 Mechanical j j Electrical
A)ther (specify) 61 V IL. pi-41
for the above named project and that to the best of my knowledge, such plans, computations and specifications
meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices
and all applicable Laws for the proposed project_
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that
the above mentioned portions of the work proceed in accordance with the documents approved for the building
permit.
Upon completion of the work, I shall submit to the building official a final report as to the satisfactory
Completion of the above mentioned work.
Signature an al o gis d Professional -4%
a CAMPBELL - 0
CIVIL
g(Day of 106/ fe) 20 (a No. 33197
istom it 1
(seal)
•
4
i
414.----'',04 City of Northampton
S S ''
5
EPAR ' OF Br=1:NG SNSPECTIO&S _ a
t I, p. 212 21sin etsat=ic? pal Building Z t:
•
*" r � r + M
Noxt tcn , mak 01060 J et - , J� ',
INSPECTOR
Louis Hasbrouck Fax: 413 -587 -1272
Building Commissioner Phone: 413- 587 -1240 Assistant Commissioner
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(For professional EngineersIArchltects responsible for a portion of a controlled project)
Project Title: I 001 YY)/ 44-i - Pc. Date: & ' (6 ' 1 b
Project Location :1(o 00e41, - f Yh PT I. F " Map: (1 G Parcel : 0 Zone: 61
Scope of Project: l 17`t'i, Ht4e/7 UP4I t. j ) 0 F ig- I24
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR Section 116.0:
I, •-4 ) pp Mass. Registration # I d L t p�
,
being a registered professional Engineer /Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans, computations and specifications concerning:
[ j Fire Protection )(Architectural [ ] Structural [ 3 Mechanical [ ] Electrical
[ ] Other (specify)
for the above named project and that to the best of my knowledge, such plans, computations and specifications
meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices
and all applicable Laws for the proposed project.
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that
the above mentioned portions of the work proceed in accordance with the documents approved for the building
permit.
Upon completion of the work, I shall submit to the building official a final report as to the satisfactory
Completion of the above mentioned work. .
i
Op re and Seal of 'egi erect Professional � E '�p �'�
► / n Z No .10193 " a <n
A.∎/ AMHERST
r �G. MASS. P
2- Day of ,� 20 I. 0 G 4'�
(seal) I
1
.
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 4 6
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
A-141W eA t•- t' i' iro p ■, as Owner of the subject property
Wright Builders, Inc.! Art Pichette
hereby authorize to
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature -ti p Date
@
Wright Builders Inc.! Art Pichette
I, , as Owner uthorized
gent ereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
an. belief.
Signed under the pains and penalties of perjury.
Wright Builders, Inc./ Art Pichette
Print Name
Signature of Owner /Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : Art Pichette CS 68185
License Number
48 Bates St., Northampton, Ma 01060 04/14/2012
Address O , Expiration Date
„t' e c i � �- - (413) 586 -8287
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
Versionl.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): --- - - - - --
L.j — al. L Registration Number
dress --
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
kVA 1./(
Name Area of Responsibility — —
Address
Registration Number
SS gn ture Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
:Wright Builders, Inc. Not Applicable Cl
Company Name:
. :Art Pichette Reg. # 101536
Responsible In Charge of Construction
48 Bates St., Northampton, Ma
Address Exp: 6/26/10
1586 -8287
Signature Telephone •
1
.
•
•
s
Version1.7 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): \ _
1 1 1 Q(
— Registration Number
" ._
ress
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
PLES 1 btff'1r14- (UP‘"
Name Area of Responsibility
4_3S'- Czrr:
Addre s Registration Number
6 4€,L 222— V.I3 p - ��. - -
Signature Telephone Expiration Date
& e a zipl-d re.tife.vr
Name Area of Responsibility
433 _Co 7 e .Sfr�vf S;or 7 elol / 0110 22 4 _.25
Address Registration Number
it'fj f 4/Y 73 d /30/10
Signature Telephone Expiration Date
Name Area of Responsibility Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
—
Signature Telephone Expiration Date
9.3 General Contractor •
Wright Builders, Inc. Not Applicable ❑
Company Name:
Art Pichette Reg. # 101536
Responsible In Charge of Construction
48 Bates St., Northampton, Ma
Address Exp: 6/26/10
586 -8287
Signature Telephone
•
4
Versionl.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:
r Not Applicable ❑
Name (Registrant):
`/0G `r\ �- t rtm • l L� U , t �� Registration Number
Ad�dr ` J` /� 0 �� 3
e J 2.610 2 t Q Expiration Date
Signature i Telephone 07g Via
9.2 Registered Profes i - nal Engineer(s): / / J ,/
C c r-4
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Wright Builders, Inc. Not Applicable ❑
Company Name:
Art Pichette Reg. # 101536
Responsible In Charge of Construction
48 Bates St., Northampton, Ma Exp: 6/26/10
Address
4- 1 ti' &4 j- (- 586 -8287
Signature Telephone
i
• p -s set t, "?.Quilt* 4 CAn< pG'lifew I ' 'A) WSlot
f ,p Iy tevi 1 e /I/Io - 6 D II erwi, Ps / jo4 (ri ik
Versionl.7 Commercial Building Permit May 15, 2000 d "� ,"rw'�� ` s� t j��
8. NORTHAMPTON ZONING �
Existing Proposed Required by Zoning
This column to be fillet ' .y
Building Departme.
Lot Size
Frontage
Setbacks Front
Side L: R: L: •
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking S..ces
Fill
flume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DON'T KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DON'T KNOW ® YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T 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 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, -xc.vation, 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.
Versionl.7 Commercial Building Permit May 15, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 1&Existing Wall Signs ❑ Demolition El Repairs ❑ Additions El Accessory Building ❑
Exterior Alteration X Existing Ground Sign El New Signs ❑ Roofing' Change of Use El Other El
Description Wel ti $1t44 14- y1-, i w, .I p F S (b l 11/�r^ - / �rl if- j •
Of Proposed Work: tieZ NOW ikG' Me( C �.( i n�
r
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE w,' G _, W.
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly A -1 El A-2 ID A-3 El 1A I El
A -4 El A -5 El 1B ❑
B Business O 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑
H High Hazard 0 3A El
I Institutional ❑ I-1 ❑ k2 ❑ 1 -3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R -1 El R -2 ❑ R -3 El 5A ❑
S Storage ❑ S -1 ❑ S -2 ❑ 5B
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
P
Existing Use Group: " A'`vi ,p'v1 Proposed Use Group: IC 04 /t4 I "el li'
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 (sf)
1st 1st
2nd 2 nd
3rd 3rd
4 th
4th
Total Area (sf) O n Total Proposed New Construction (sf)
gag
Total Height (ft)
Total Height ft An "i 1 44
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewa a D isposal System:
Public' Private El Zone Outside Flood Zone Municipal On site disposal system
r
y
t
Version1.7 Commercial Building Permit May 15, 2000
Department use e
— City of Northampton Statue of Permit:
� -
-- - Y , _- --, Building Department Curb Cut/Di ay Perm
�-� ? 212 Main Street Sewe,HiticA�bIr ; ,�
Z OIQ :, Room 100 ater/We Availability' . °
\\A 2 3 Nort�iampton, MA 01060 Two Sets of Studumi Plans
.) p r S 13 -5�7 -1240 Fax 413 - 587 1272 Plot/Sit pl
Other Specify
APPLICATION.T6tCSNSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
I OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
1( C , / A,,, p \� St Map Lot Unit
Zone Overlay District
4-1 U r.e (1C e i A-A_ C\
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT pp,,��,�
2.1 Owner of Record: K C � � � i �Gt. �t 1 i ef` VA4A1C1 ` 'V G
\«Q -{\\ , ‘,.e L. L..C. _ 3 0 M A- 11 1' Si" M i4,1�►P9 (�
Name (Print) Current Mailing Address.
M ) / / / / 113- 5� x,
-sc '
Signature._ _ 11— Telephone
2.2 Authori d Agent:
Wright Builders, Inc./ Art Pichette 48 Bates St., Northampton, Ma
Name (Print) Current Mailing Address:
� (413) 586 -8287
Signature _ Q� r /� S` C t - $ `� �{', `- Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS e t Yo V-- x i 6 /�i a a , — 0 .
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building if It ( etc.-- (a) Building Permit Fee
2. Electrical Q 0 b .. (b Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) t ? 3, Os.
5. Fire Protection t
6. Total = (1 + + 3 + 4 + 5) # '� l � • Check Number ,SC—/476? 0 6 L
)1,54b4°_ This Section For Official Use Only
Building Permit Nu ber Date
Issued
Signature:
Building Commissioner /Inspector of Buildings Date
� R
File # BP- 2010 -1183
APPLICANT /CONTACT PERSON WRIGHT BUILDERS
ADDRESS/PHONE 48 Bates St NORTHAMPTON (413) 586 -8287
PROPERTY LOCATION 16 NORTH MAPLE ST
MAP 17C PARCEL 227 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid 35/60 4' 4 ( 0
Typeof Construction: NEW STOREFRONT DOOR /WINDOW,ROOFING,SIDING,MINOR INT,ELEC,NEW
HVAC & GAS SERVICE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included: )0,
Owner/ Statement or License 068185
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN. FQRMATION 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
'Mos
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.
• •
WL F f BP- 2010 -1183
GIS #: COMMONWEALTH OF MASSACHUSETTS
I7C 227 .;I CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -1183
Project # JS- 2010- 001719
Est. Cost: $39270.00
Fee: $240.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WRIGHT BUILDERS 068185
Lot Size(sq. ft.): 6838.92 Owner: VALLEY COMMUNITY DEVELOPMENT CORPORATION C/O HOME
CITY HOUSING DEV
Zoning: GB(100)/ Applicant: WRIGHT BUILDERS
AT: 16 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
48 Bates St (413) 586 -8287 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON: 7/2/2010 0:00:00
TO PERFORM THE FOLLOWING WORK: NEW STOREFRONT
DOOR /WINDOW,ROOFING,SIDING,MINOR INT,ELEC,NEW HVAC & GAS SERVICE
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 7/2/2010 0:00:00 $240.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
16 NORTH MAPLE ST - UNIT C BP- 2010 -0633
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C - 227 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0633
Project # JS- 2010 - 000924
Est. Cost: $5704.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN FERRITER 061398
Lot Size(sq. ft.): 6838.92 Owner: VALLEY COMMUNITY DEVELOPMENT CORPORATION C/O HOME
?'1 s 440 -DF
Zoning: GB(100)/ Applicant: JOHN FERRITER
AT: 16 NORTH MAPLE ST - UNIT C
Applicant Address: Phone: Insurance:
274 Bridge St (413) 586 -9680 0
N O RTHAM PTO N MA01060 ISSUED ON:1/4/2010 0:00:00
TO PERFORM THE FOLLOWING WORK:REPOSITION DOOR, REMOVE
SHOWER,INSTALL 2 TOILETS & PRIVACY PARTITIONS
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: /- 45-4064) Rough: House # Foundation:
Driveway Final:
_ Final: Uj -a_ /0 , Z Final:
Rough Frame: �'= a
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: 6t< 213 (t0 LoAA-b
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupanc /"" S ignature: ,OASe.":"{C-
FeeType: Date Paid: Amount:
Building 1/4/2010 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo