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32A-172 _~ \ 7 ------ \ ---------D. \ .--".. ---------...\\ e7 --.7. \ n. Metcalfe Associates ARCHITECTVRE a 142 Main St. Northampton, MA, 01060 Tristram W. Metcalfe III, Ma. Reg. 5393 Phone number > 413 586 5775 Cell number > 413 695 8200 Email > twm3 @rcn.com NCARB, NYS, MA, CT registrations WMAIA AIA November 14, 2011 Louis Hasbrouk, [413 587 1239] Building Inspector City of Northampton Puchalski Municipal Building, 212 Main Street, Northampton, MA 01060 RE; 11 -15 Bridge St Roof renovations building permit FOR; Silvia Woicekoski, 57 Bridge St Northampton Ma William Turomisha Construction Manager Dear Louis, This is a letter to back up the drawing A -21 rev 11 -14 -11 submitted with this letter. The structural problems to be repaired from both fire and age are; 1. East West ridge settled 7" on the South El end 2. Low 24" ballooned wall in attic is bowed outward —7" 3. Rafters ends and valley ridge is separated. We will carry all loads both jacking and permanent loads down ridge on the; a. Attic, new posts b. 3rd and 2nd floor frames with existing walls and new reinforcing onto c. the steel posts existing in 1st and Basement floors down to grade. We will use spanning wood &or steel headers to gather single point loads from above down onto the double sets of steel posts existing including existing steel Wide Flange beams. This drawing A -21 will be revised as we do demolition inspection access as we conduct the work verifying our plan with what empirically transpires. The roof structural support will be redundant by means two systems; A, direct bearing ridge support with posts to grade and B. collar tie spread resistance through the attic floor joists and deck using new angled ties. We hope to get a permit to begin this work. If you have questions we will provide answers. Sincerely, Tris Metcalfe digglp I *4w0$ . � November 16, 2011 Report Fo/ Ultimate Abatement. Inc PD Box 51O20 Indian Orchard MA 01151 Project COrnrneno|8| Building 10 Bridge Street NorthGnnp\on, MA Date of Sampling November 16, 2011 Date of Analysis November 16 2011 Scope It was requested that a visual inspection be performed and final air samples be collected and analyzed for fiber content. The inspection and air sampling were performed by Robert Gnev8UeSe. an AHERA accredited and Massachusetts licensed project monitor. Methodology The air samples were collected in accordance with 453 CMR 6.00, The samples were analyzed by the NIOSH 7400 method for Phase Contrast Microscopy, Results i ' - --- humxp|, !h Location ! Start |� Stop lypc Result KA )W ��« , ' - i - - - � | | |«�! | |ohn) � ]x] H., !kW | 2:41 � l�� l`\| |ixu| |U�m}4 1))m3 � .-�- � H | �o H ! l»ixi` �x| U- ||xU 2:41 � ���} I'M |ioz| |oNA `U,0)3 / Comment The containment was visually inspected and found to be free of suspect material The current clearance standard in the State of Massachusetts is 001 fibers/cc of 8o The airborne fiber level in this area was below this level The abatement involved the removal of asbestos containing joint compound (wallboard system) by the full containment. The Commonwealth of Massachusetts „ Department of Industrial Accidents = - + ' Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly • Nance ( Business /Organization/Individual): l S• J LLgt1 m sy,4 _ Address: 58 FizouT STaee- P•o . Box iqi ( 'Fos mp .O?oS3. City /State /Zip: Phone #: `/f 3 5b a yaks 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 employees (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. ® Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions i h d i h ffi ocers have exercised their 11. 3. ❑ I am a homeowner doing all work ❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.2] Roof repairs insurance required.] t c. 152, § 1(4), and we have no • employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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 nP to $1,500 00 and /nr nnn -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains and penalties of perjury that the information provided above is true and correct Signature: /I7 . lG12Aydi►s— Date: /$ J Astroirri 3r . ) O /) Phone #: Official use only. Do not write in this area, to be completed by city or town officiaL City or'I own: PermitfLicense # — — — 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 #: The Commonwealth of Massachusetts Department of Industrial Accidents �-- Office of Investigations 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 employees (full and/or part- time).* have hired the sub - contractors 6. New construction listed on the attached sheet. 7. j=1 Remodeling 2. ❑ I am a sole proprietor or partner- ship and have no employees These sub - contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' Y ca P ac nr 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :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 fin? ,tp to $1, 5(1() 00 and /or nne -yaar imprisa11111CLIt, 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 certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone #: Official 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: ______. s e . A Version1.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CN1R 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 1, SYLI.J./A lAtatz.,z k °ski „,„ as Owner of the subject property hereby authorize 1 act on my behalf, in all matters relative to work authorized". this bLi pe lication. Signatur of Owner c Date ,-eamfamosc/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 andpenalties of_peduly. _ Print Name - /140.72.4s Signature of j r/Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder :LJA/111.ffift:Tt_f_rm&ckm..414A_, L License Number = — . 58 _repp-ir sreEST" gilta91_191_.„LEEns. PIA .414„s...1_ 1 L 2 • 15 • 2012. Address Expiration Date y/i co 6" Signature Telephone SECTION 13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c 152, § 25q 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 r " . 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: t tri444A- M ki .f_..1-._ 44 _ _ Not Applicable l>, Name (Registrant): 1- ,.. 1 Registration Number lit- .___.1441-_i-t�► `? +- __. _' � �' ,.._. — _ ._._._... 3 �t 3 .. _ _ _ __ . Address / �' /' —...0111. 3 5�� s�? Expiration Date j .nature « Telephone v f � 9.2 Re. - ered P • -ssional Engineer(s): 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 I Address Registration Number _ .. , .._.. ______ I _ d Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number f Signature Telephone Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: } Responsible In Charge of Construction WI%I taP'N S Ti.R.S:V ►SK Address SS F RRoVAT br'a`ss - - -_-1.F �e ,.. a --.frt A . pf ,4 Want-ILL.., in sac yeas - - - 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 ,,...,,..1.. u_.._.... _..........._ _.. ________: . ______2 Frontage ..t ,_..13..,4., 5 f _ € _ _,_ w.__._,__,..,_... _ __. '_._.......... ..__ .._ _ ___ Setbacks Front � 0 � "� mm ? I I 1 �-` F I R Side L' S -o R.25 -+o L 3 R: _.:a L , Rear 63'1! Building Height ��.. ., { Bldg. Square Footage 89>i5 % i _.__.—_ ; .___ ., Open Space Footage _ % ---1 (Lot area minus bldg & paved l 2 j parking) # of Parking Spaces - -F S Fill: ,l Y.:_ (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 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 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 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO x® IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 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,ig - ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Grounid Si n ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other 0 _ Brief Description :Enter a brief delcri. ion here. , Of Proposed Work: ? REPAig. F12E hAMAME® Roof S'TRJACIIA RE A s , t SECTION 5 - USE GROUP AND T - ON TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A-4 ❑ A -5 ❑ 1B ❑ B Business E 2A 1 ❑ E Educational ❑ 2B - r , ❑ F Factory ❑ F -1 ❑ F-2 ❑ 2C ! , ,_ .❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1 -2 ❑ 1 -3 ❑ 3B '® M Mercantile ❑ 4 ❑ R Residential R -1 ❑ R -2 [ R -3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 58 ❑ • U Utility 0 Specify: # _ __. , M Mixed Use ❑ Specify: i , S Special Use ❑ Specify: 1 _ COMPLETE TI-HS SECTION IF N' EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE Existing Use Group: ,^1_-.R 2- , . . _ ._�.1 Proposed Use Group: Ne_.... ggiaca_______._,...___�._..,__. _, Existing Hazard Index 780 CMR 34): 2 ± n2 µ __ 1 Proposed Hazard Index 780 CMR 34): 4 SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE,f , .. Y Floor Area per Floor (sf) < 4 , , n d 1 2nd ____.____..__._ __� __.N 3 2 3`d ._ _._ _.. —. _ e 4 2343 _ _J . Total Area (sf) Zi ‘ , 16) __ j Total Proposed New Construction (sfL _ I r Total Height (ft) p- . Total Height ft _.. w_..,.. _ „ 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public Private ❑ Zone _ = Outside Flood Zone❑ Municipal ® On site disposal system E] Version1.7 Commercial Buildin_• Permit May 15, 2000 ` ' City of Northampton 1 „:, - ���� • ° - �` � � 0 � Z . Building Department $ ui 212 Main Street . Y ru _ �0 Room 100 ` . �, Northampton, MA 01060 ,: - ..x Q 4- , phone 413 - 587 -1240 Fax 413 - 587 -1272 ' ; : : ate- APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUP C -- . • o;',. I % ^ 's , It B ILDING OTHER THAN A ONE OR TWO FAMILY DWELL! - • N MA01060 SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office I1 15 ' RIDGE %TitEAT , Map 3LA Lot I42. Unit WRThA.MeTo1 KR i Zone` me, Overlay District ti _ __ r ,._ ,...— .... — ,. ...— _,-. .....__ -- ._.o.,._._. -.a - Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: S _.ul , .14.0.1eE.Kos.k w .,..s `_•, in . es'_S3 Elt14- -E -- T _.40 —c NprcP MA Name (Print) \ Current Mailing Address: 'in .&: 84 ! _10.51,L Signature X - - -C W , i, \ lephone 2.2 Authorized Agent WWIA _S. -17 :4 !tom,. .. _..._,_._— ? -a • 20# ill.1eR..I,_.M..._o_Lo5,.3 ___, . n_. .' Name (Print) Current Mailing Address: __ _y ___ Signature 41/m,_____2 Telephone SECTION 3 - ES MATED CONSTRUCTION COSTS Rem Estimated Cost (Dollars) to be Official Use Only completed by permit applicant __ 1. Building fS � m - 000. eo mm % (a) Building Permit Fee j NJ ' Yw_ _ .. , 2. Electrical "--.._ --- (b) Estimated Total Cost of l Construction from (6) E__.._.._._,_...._._ ._ ..__.__. 3. Plumbing ' Building Permit Fee 4. Mechanical (HVAC) P co 0 gr i � o 5. Fire Protection /54 000 • °O l 6. Total = (1 + 2 +3 + 4 + 5) Check Number A. j” /` � y� � This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector. Buildings Date File # BP- 2012 -0514 APPLICANT /CONTACT PERSON WILLIAM TUROMSHA ADDRESS/PHONE P 0 Box 141 LEEDS (413) 586 -4005 PROPERTY LOCATION 15 BRIDGE ST MAP 32A PARCEL 172 001 ZONE CB(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 Tvpeof Construction:_REPAIR FIRE DAMAGED ROOF STRUCTURE & SIDING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 000515 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management 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.