31D-165 (8) 240 MAIN ST-MEMORIAL HALL BP-2019-0043
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-.Block: 31D- 165 CITY OF NORTHAMPTON
Lot: -00 1 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv�renovation BUILDING PERMIT
Permit# BP-2019-0043
Proiect4 JS-2019-000058
Est.Cost: $850.00
Fee: $0.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Group: CITY OF NORTHAMPTON CENTRAL SERVICES 054510
Lot Size(sg.ft.): 26876.52 Owner: NORTHAMPTON CITY OF MEMORIAL HALL
Zoning:CB(100)/ Applicant CITY OF NORTHAMPTON CENTRAL SERVICES
AP 240 MAIN ST - MEMORIAL HALL
Applicant Address: Phone: Insurance.
Memorial Hall (413) 587-1260 0
NORTHAMPTONMA01060 ISSUED ON:711012018 0.00:00
TO PERFORM THE FOLLOWING WORK:INSTALL 2 - 2X6 WALLS WITH DOORS,
DRYWALL FOR OFFICE SPACE
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:
FeeTvpe: Date Paid: Amount:
Building 7/10/20180:00:00 50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-0043
APPLICANT/CONTACT PERSON CITY OF NORTHAMPTON CENTRAL SERVICES
ADDRESS/PHONE Memorial Hall NORTHAMPTO14 (413)587-1260 O L,
PROPERTY LOCATION 240 MAIN ST-MEMORIAL HALL
MAP 3 1 D PARCEL 165 001 ZONE CB(I00y
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT_APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstruction- INSTALL 2-2X6 WALLS WI ORS DRYWALL FOR OFFICE SPACE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans IncludecE
Owner/Statement or License 054510
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
USE RMATION 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 Pemnit DPW Storm Water Management
e volition Delay
of Buil ing OFS Data
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.
- -Je,ie=_ JCcur,al.cu!dinz Pe.-.;:.r Mev i`."15010
- - DepandnEn;cse Orly
City of NOrtha^t, o-. Status of Pant
Building Depa 7111.: Curb OurrDnveway P-e�r-c
212 Main 5' t Sewer/Seplc A✓ellabiury
Room 100 Water-Well AiauaMlity
Northampton, M .Ci 060 _Two Sets o`Structur_I Plans
phone 413-587-1240 Fax 413587-'272 'PIoH5:le Plans
Ou Sped"
APPLICATION TO CONSTRUCT, REPAIR,RENO'vA T , CH ANG OF,OR DEMOLISH ANY BUILDING
OTHER THAN ON ING
SECTION t - SITE INFORMATION JUL - 9 2018
1,1 procert,Addresss'. py+� This s tion o be completed by office
�� ^� y�t✓py� ---- -
DEP0.'IATI DIVA INSPECT IONS L t L,t
L O
ATHArIAAOID60
Zone Overlay District
Elm SL District Oa Dctrml
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 3 I L) — �UO
2.1 Owner of P.ecord
---�i�C *{Olid _ r� Nal�fltnvpCM�wk
�q I
� Mar",�deres�1j"e. _
arse r.
2.2 Authoriz_ Aa t
Nam=_;Ptlnq r valine Addreas:
Signature _ berhore -- - -
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(,Dollars)io beZ)mcial Use Only
I
completed b permit aoolicant
� , Bulld�n -- —
9 � (a)Building Pennit Fee
2 Elecvical Estimated Toll Cost of
35a Constructor f-ch, (5) _
?
C. lu nSarn -
Iucal (HVAC)
5 Fir=_ProLcdon A -
6- 7otal=(1 +2 -3 5) _ Cheri Numbs: -
This Section For Off.term Use Only
i Eu ld'ng Permit Number Date
Issuec
miss:oner/:n c Buildmc
Vesico:-?�ca.e-a:Builc�.e P.re-dee., ',=. 'GL
SECTION a-CONSTRUCTION SERVICES FOR PROJECTS !ESS THAN 25,000
CUSIC P_ET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Well Signs ❑ Demolition❑ Repairs❑ Additions Accessory Building_Li
m-taoor Alteration ❑ Existing Ground Sign❑ New Signs ❑ Roofing❑ Chance o Us 1
Brief Description Eater a beefdescription here. J-klj%� ,gyp (LS (A)07_\Otlrlif-
OfProposed Work: kwOWVJE' JPAM.
SECTION 5 USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as
applicable) CDNSTR'JC TION TYPE
A Aaaeri.tl,r ❑ A-I ❑ A-2 ❑ A-3 ❑ I ❑
Al ❑ A-5 ❑ I ❑
B sadness ❑ ❑
E Edcc9fimal ❑ _ 25 - �-
F rzc:ory ❑ F-t ❑ F-2 ❑ 2C ❑
H Hi.oh Hazard ❑
1 Irs'i:uticnalI-2❑ -1 13 F'
❑ ❑ ❑ .,�. I ❑
32
M MercznHe ❑ 4 ❑
R Reedental ❑ R-t ❑ R-z ❑ Ra ❑
5 Slcrege ❑ S1 ❑ S-2Ll❑
� s� it ❑
M Mixed Use ❑ I P ny
5 BPecizl Use ❑ Spec(y
COMPLETPTHISSEGTION FEXISTING BUILDING J,ti D-,-GOING RENGVhTIGNS ADDITIONS AN=-,CHANGE INUSE
Existln Use 'P- Popcs-G Use Gmuc
Exlstin Hazard l ndsx TAO CMR 341 _
5 -._. 'macse 4aZaY bdez'SO CLh 3')
SECTION 6 BUILDING HEIGHT AND AREA
BUI777
CONSTRUCTION O nDE USE ONLY
[3331,
oor Aqa p
}I
4n .. _. 4u
Tc el Ara (a Tota Prcpased New CcnOr-cucr 5
TOta, HeicntL;di
oal .Ieig.,tP
7, Water Supfcly KC p.40, § 54) 7A Flood Zone In IOn 7,3 Se,cce Olsoos s._s
Pu .l'c ❑ ie '.a❑ mre G 9e Fin _❑ r — -- _-�
SK TION' S-PROFESSIONAL DESIGN AND CONS TRUCTICN SERVICES FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO]80 CMR 115(CONTFINING MORE irIAN 35.000CF.OF ENCLOSEC] eFA.CE) i
9.1 Registered Architect:
AVO A]9icae- ❑
Pane (d st art)
F
re T F ogistered Professional Engineer(s):
L,r ofF s nsolty
Aft-ea
S"y9a Nr° epapne � tXn :ICm Cah
Nane Area ol Ras sn }
Abd,ed y Edon P ee -
si5nawre Talaphone ,iacon Late
Name ea oT ooasaois,ij,
Add,,, Pegvra5on Nt^mer
Slgna[cre - - al h nepra-aticr,Cete
:Z�dra,
of R_sao so a s a n P--_ anion-art
9.3 General Contractor
q
Not 4npiicati-
Comaa,Name.
R p noble in L re ofCon t ron
UJtu�o� SBt�'
a C 5
_ T��ep�ne I _
1)aL4 ,rvt - 05L sr2 ZAP
��- /
Ver_ior, rrre:cat _?ser. I
8- IN ORTEi4h4PTON 2 ONING I -
Exsria, '-arcs'+ p _ o
I-
I
Fontaae
Serback, Frcnt
Side L - R r ., R _
6.Ildivg Height
B:d,. Square Forage
Op n Space Foorage -
el m
Lnus-lam&pieL
R o:Parking Spzces
- _
FII:
tvowrne&lawo.r � - �
A. -Las a SneCal Perm;c/Variance'nndin e ever he=_n issue^_ far,e-. -.he si_e?
NO O DONT KNOW 0 YES O
IF YES, det_= ;sued:
IF YES: Was the permit recorded at the P.ecis;ry of Deeds-
NO 0 DONT KNOW YES 0
:F YES enter Book Pig=_ and/or DooTent-.
IS Does the site contain a brook, body of water cr wetlands? NO 0 DONT KNOW 0 Y 0
IF YES, has a permit been or need to be obtained from the Conserv=ion Cemmissor'
Needs to be obtained 0 Obtained O Date Issued: -
C. Do any s's-s exist on the property? YES C NO 0
IF YES, describe size, type and toca_icr: - -- -
D. Are there any proposed changes to or aedl acs o- s s ,tented o' tie property ? YES O NO O
IF YES, describe size, type and location:
E ' 411 the cor t�2cton acv.' di b (Clea.i a,:'nar �: - ___ =a�—c- cian
'that wil l disturb over l acre? YES 0 no O
- Zlz_= Cc n.m_or.weals% o`tif¢ssacixuseas -
- —_ Geperz.r�'zt aJ'Ina s, accid�nrs -
_� - QrTtce of lrvesrogatZOns
600 Ti asis,ug,ar. Smear
Boson, 31c 02111
xxx.tn.¢ss.gos/tlaa
�M1 orkers' Compensation Insurance Affidavit: Bellders'Coni-actor s,"Eleetricians PiusSers
ADOIicant Information Please Print Leoibic
Name (Busincss.0raarizaoaNlnd.ndoal):
Addressr
City/StatJZID Phone
Are you an eanployer° Check the appropriate box.
- Type f project
I am a cmoio i c 4. ❑ lrepm-
red}.
tmoloyees 'ful au or part timzi.` a sed th sub o nactors
6_ ❑ \ onsC mo=
r_❑ I a a scle prcpri M7 or2a7eter- s oa the a ac sheer '- ❑
s b anj to,e no m Ie r..es TI' ' o _oa a o ce S_ L'J -io 0
o k t or me on any caoao,ry, c-an!-Iees and h -o k=a' 9. ❑ B c._a�:,ion
:No w o-k_rs' come raurance 'arnp. rns.7aEac _ _
c kir n l ; ❑ !c a. a cpm¢ r n G I0.❑E '-i al r a� nous
3.❑ m a nomco a r dol, works n c c e d near 11 El ° 3 >t r y;:. r :,:ons
myself 140 w0-kc7s comns. t_o setup-o p 11GL 12_❑Roo-._,aL,
asmmeer=uired]y c 1 U.), and -ave no
pl ! s. I_Ao c r ' I_=_❑One._
r ,n.I.aa r =ole 1
ya I
- [ w^ticv s NAY-5,rr ,s. . .. -_
-,�rnlo� s 'S con 'z' '� rel:. v-rS=r
1 am n enrp[ayer that is prm.iding workers'compensation uesevmse for my employees Eelow a the paIIcy and jab size
informaean_
I`suraro, CcrnpavY Nave=
Policy`or Soli-ins. L,,. E:ct.adoa Da:e:
Job Site Adduces_ Ct , S' aca'Zia
Attach a cop} of the workers' compensation policy declaration page (showing the policy number and expiration date).
Fedure to secure coveraae as requnred under Secron 25B ofMGL a lit ran Lad to the uanac idon cf eroroaal pcnalds of a
:me up to b1,500,0C=d or one-year imprisauuneat, as well as civil pena'tics an the form of a STOP u'OILK G?-DER and z r ne
of an to 1250.00 a day aga:.st the violator. Be advised that a copy of this sa¢mext racy be fotu'zrded to dc 0f5ce of
Iu'+sigafions of the DLA for insuuaaee coverage vcnfiadoa.
1 do herebyceaijy under the pains and penalties afperj,,) that the information provided above is vue and correct
Sisnatur=' Da=e'
Photo
itOffeia<tree only. Da rmc o b,in this area, m be completed by c-D or tome ofJlciaL Cin-or Tonin Permit?iceeser
-Issuln Author tp(circle one):
1.Hoard o dealt- 2, Brildiug Department 3 C e _ Clerk j Ejeetr ca Jaspecta- n ao epinsr �m
6. Other
Costa t Person. pitcae= i�
v_m,
SECTION 10-STRUCTURAL PEER REVEW(]8C CMR
iudependem S^_Cural Eoaineenng Saumlrs1 P_=s Pevlew Rej, lee_ o
SECTION 11 -OWNERAUTHORIZATION -TUBE COMPLETED WHEN
OWNERS AGENTOR CONTRACTOR APPLIES FOR 3WLDIN3 PERMIT
I. \D�OVcl, li��1C$G�4i�C'€�xCW�..S' (L� r_
/��•� �y1/� .zs Owner o-' ujeu prcpery
_y a�thorzE
c
ac y bel a> 7 21a:i b work autbr z d ^s bua rO p_ apple o lc^ _
Slg ure o Owne D>> _
Or -.horized
Agent heteb9 informer cr i.ne -cc,e t_ .re b s I ry knew!=_dge
and belief.
Signer under the m@irs and penaties ofpe�ury.
. `runt Na,
SigraEure of Owner/A5e^t met=
SECTION 12- CONSTRUCTION SERVICES
10.1 Licensed Ce nstru ctian Suoervisoc Not Appllc2Ne
Name ofLicense Holde ._... _
Accts � cx:P J to
Signature Telephone
SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§ 25C(6))I 'Wprkers Compena. eanon rsora ice affidavit must.be cronFet and st, mute_ ri:h tris_..v..a:o- -a! re Cncvidetns Levit will cult
In the tlen' . von
suan.e o,Che building permit
Signed ARldavit Attached Vas No o
City of Northampton, Massachusetts
Central Services
Memorial Hall, 240 Main Street
Northampton, MA 01060
David Pomerantz (413)587-1238 Fax: (413) 587-1248
DIIWIII If(-f-I Sl,,,,,
To: Louis Hasbrouck, Building Commissioner
From: David Pomerantz
Date: July 3, 2018
Re: Construction Control- Waiver
I request that you grant a modification to waive the requirement for control construction for
the project at 240 Main Street,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. Thank you for your consideration.
EVACUATION PLAN
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MEMORIAL HALL SECOND F
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SERVICE