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32A-121 (8) V ' o I e�A OeC,/<7 r Z7) CL_ Os p ( N � 4 a � n 7 ris a Y 1 i p r 4 t i � n 15� x 'Fr, Ve, ci { 41 V cPeA c-L .n C' I./op✓h PA k. f _ ^ I T _TF I I City of Northampton Building Department 71 ks�itli 54, _ r Plan Review . tjL� � ` r, 212 Main Street N= hampton, MA 01060 i Z )CS LJ 17 411 z M j r(- 4.- 0 do Id e� 6 is . - ,7611 �G17 T O�LIfje 6-111711-, E 1 7 any f t d J Gerard Stordeur Finishing CS-108497 Commissioner Hasbrouck 4/29/15 Subject: Request for Waiver I request that you grant a modification to waive the requirement for control construction for the rebuilding of steps and handrails on south side of building at 71 King Street, in Northampton 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. All Work will be completed within the prescriptive requirements of 780 CMR. Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Gerard Stordeur Gerard Stordeur Finishing 61 Nonotuck Street,Northampton, MA, 01062 Cellphone: 1-323-363-0659 GERASTO-01 VCASTERLIN ACORCJ� CERTIFICATE OF LIABILITY INSURANCE DAT D/YYYY) `--� 4//30/230/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Valerie Casterline Whalen Insurance Agency PHONE (413 FAX 71 King Street (A/C,No,EXg: )586-1000 (A/C,No): (4 13)585-0401 Northampton,MA 01060 E'ADDRESS:info@-Whaleninsurance.com P INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Utica First Insurance Company INSURED INSURER B; Gerard Stordeur DBA Gerard Stordeur Finishing INSURER C: 61 Nonotuck Road INSURER D: Florence,MA 01062 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR IN SD WVD POLICY NUMBER (MM1DDlYYYY) (MMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE X OCCUR ART-5056866-00 07130/2014 07/3012015 PRREMIEMIETORENTED 5000 PSES(Ea occurrence) _ $ ME EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 X POLICY PRO- JECT LOC PRODUCTS-COMPlOPAGG $ 2,000,00 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED - PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETORlPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED NIA (Mandatory in NH) - E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate issued as evidence of coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton City Street ACCORDANCE WITH THE POLICY PROVISIONS. 210 Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD a ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street x -, Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Leaibl Name (Business/Organization/Individual): /� A dress: d✓l o a k �k(f� / F�O re4C. G /Z Phone#: ��b — 06/57 Clty/State/Z>p &6 Are you an employer?Check The appropriate box: Type of project(required): 1.❑ I am a employer with 4. EJ I am a general contractor and I 6. ❑New construction m tn ployees (full and/or part-time).* have hired the sub-contractors _ 2. I am a sole proprietor or par listed on the attached sheet. 7. ❑Remodeling -- er- These Th sub-contractors'have ship and have no employees 8. Demolition working for me in any capacity. employees and have workers' 9 E] Building addition [No workers' comp.insurance comp. insurance. D. F-1 We are a corporation and its 10.0 Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL myself. [No workers' comp. 12.0,1 oofrep it insurance required.]t c. 152, §1(4), and we have no IJ( e `( employees. [No workers' 13. Other C' l%ate 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 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 certify er the pains a pen es ofperjury that the information provided above is true and rcorrect. Signature: Date: L` �� r Phone#• _37 3— 3 K_3— ® O S Official Ilse onhI. 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 S.Plumbing Inspector 6.Other Contact Person: Phone#: Versionl.7 Commercial Building Permit May 15,2000 J f SECTION 10-STRUCTURAL,PEER REVIEW 1780.CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes No SECTION 11 OWNER AUTHORIZATION-TO::BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property. . __._ ._ __... .[.v � _ to hereby authorize ...__. _. .. ._..._ - _ _ �.- -- ._ �. �.._. act on my b a m rs ela' e to work authorized by this building permit application. Signat of caner r ate as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed_._u der the pains and penalties of penury ..0 _.- w . Print Na ignature of O er/Agent Date SECTION 12-CONSTRUCTION:SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:' _ .er p _ O� �L�1�.., ... ._.. �._.... T ` ..C License Number Address Expiration Date 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 No 0 1 Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR.116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): _ _.___._ _.._. _.. _._._.__...,.....__..____. . Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date ... Name Area of Responsibility Address Registration Number ,.,._m ,.— ._K.. . . ._ .... _._..... Signature Telephone I Expiration Date 9.3 General Contractor of Applicable ❑y Company Name Res onsible In Charge of Construction Ad/re_ s Signa Telephone Version 1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON:ZONING Existing Proposed Required by Zoning This column to Se filled in by Building Department Lot Size Frontage _M.,,,..,_._.. . .._ _._. ._.., ,.,..._. _. . ...... __ ., _...:.... .. ....__. Setbacks Front Side L.' ._.__ R.'. _µ Rear Building Height Bldg. Square Footage % Open Space Footage _ % . _ -_- - - (Lot area minus bldg&paved #of Parking Spaces . Fill: (volume&Location) A. Has a Special Permit/Variance/Finding er been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0µ NYES 0^ NVw IF YES: enter Book Page and/or Document#:i B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 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? YESrr NO IF YES, describe size, type and location ( -�._. .C.0 L.l.. Ind s.. Nr, -h +W mss ... �'�_`... D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO _ IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading, excav ion, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version 1.7 Commercial Building Permit May 15,2000 .0 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter brief description here. �[.lI �C I YLC r Of Proposed Work �� i<15 Lip �o Scc.,A,4 5j--l6ry �f?G1� O'l �Ol�� �i �P of SECTION 5-USE GROUP AND CONSTRUCTION TYPE' USE GROUP(Check as applicable) CONST UCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business 2A ❑ I, E Educational ❑ 28 E] F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ -- -- 3A ❑ Institutional ❑ I-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ Z 4 ❑ R Residential R-1 ❑ R-2 R-3 ❑ 5A S Storage ❑ S-1 ❑ S-2 ❑ 5B U Utility ❑ Specify f M Mixed Use Specify � ��I>1PSf�'S S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING.UNDERGOING:RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group ....... .___._.. __. Proposed Use Group: Existing Hazard Index 780 CMR 34):: . . .... .......___-----.._ Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so St 1 St 2nd 2nd 3rd 3rd th 4 t " Total Area (sf) Total Proposed New Construction(sfl Total Height(ft) --- -_-- _- Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone,Information: 7.3 Sewage Disposal System: Public E] Private E] Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑ C3 il< -f6 ST0'A C Version 1.7 Commercial Building Permit May 15,2000 _ :Department use,only f Northampton Status of Per \ B' I g Department Curb"-Cut/Driveway.Permit w ' aln Street Se�ver/SeptrcAvatlability om 100 WaterM/ellAvailability No m on, MA 01060 Two Sets of Structural Plans _ Purr ���p�0 .1 0 Fax 413-587-1272 Plot/Site Plans Electric. 10 , Northa�r.p Otlae�Specify - APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: Map Lot Unit t, " U ►�0.M� .� m cZ, Q 1 b U Zone Overlay District ElmSt:'District ' cB District` SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owne of Record: G Ck Name(Print) �. Current Mailing Address..._._ _.._._ _... ., Signature Telephone 2.2 Autfa6rized Agent: L°���dvr � . .._ _.. UiLotG � �a/Price(/'I��d160 Name(Print) Current Mailing Address Signature Telephone SECTION 3 ESTI ATED CONSTRUCTION COSTS" Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee 0oo 2. Electrical (b) Estimated Total'.Cost of Construction from- 6 _..__._ __...... 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection - --.... _. ,.._......: o. Total=(1 +2+3+4+5) 6 U U Check Number This Section Foe Official Use Only. Building Permit Number Date Issued Si nature: Building Commissioner/Inspector.of Buildings Date File#BP-2015-1041 APPLICANT/CONTACT PERSON GEORGE STORDEUR ADDRESS/PHONE 61 NONOTUCK ST FLORENCE01062(323)363-0659 PROPERTY LOCATION 71 KING ST MAP 32A PARCEL 121 000 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 za� 150 Fee Paid Typeof Construction: REBUILD 2ND STORY SOUTH SIDE STEPS/HANDRAILS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 108497 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: pproved 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 D I' ' la /-/5 Sign o u din icia 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. 71 KING ST BP-2015-1041 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 121 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2015-1041 Project# JS-2015-001987 Est. Cost: $7000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GEORGE STORDEUR 108497 Lot Size(sq. ft.): Owner: J W INC C/O WHALEN INSURANCE Zoning: CB(100)/ Applicant. GEORGE STORDEUR AT. 71 KING ST Applicant Address: Phone: Insurance: 61 NONOTUCK ST (323) 363-0659 FLORENCEMA01062 ISSUED ON.51112015 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD 2ND STORY SOUTH SIDE STEPS/HANDRAILS 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 SiEnature: FeeType: Date Paid: Amount: Building 5/1/2015 0:00:00 $55.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner