18D-001 162 NORTH KING ST BP-2021-1483
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18D-001 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:Zoning Permit BUILDING PERMIT
Permit# BP-2021-1483
Project# JS-2021-001384
Est.Cost: $19000.00
Fee: $300.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: C E FLOYD 111715
Lot Size(sq. ft.): 532738.80 Owner: D'AMOUR PAUL H ET AL C/O BIG Y TRUST
Zoning: HB(100)/WP(16)/ Applicant: C E FLOYD
AT: 162 NORTH KING ST
Applicant Address: Phone: Insurance:
19 TUTTLE PLACE (508) 934-9425 WC
MIDDLETOWNCT06457 ISSUED ON:6/15/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:DEMO JIFFY LUBE BUILDING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
I
Certificate of Occupancy Signature I; -� • V • yQ 3:ADIT
FeeType: Date Paid: Amount:
Building 6/15/20210:00:00 $300.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
l The Commonwealth of Massachusetts
T � Office of Public Safety and Inspections
�•� � Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
11
yJ (This Section For Official Use Only)
Building Permit Number: b,'a1' �� Date Applied: >t 0:2 0 -- Building Official:
SECTION 1:LOCATION
188 N. Kina St Northampton 0106C Jiffy Lube
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building 13 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Ck
Is an Independent Structural Engineering Peer Review required? Yes 0 No 121
Brief Description of Proposed Work: We will Be demoira the existing Jiffy lube. All Gas, water and Electric
have been cct and capped.
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): N/A Proposed Use Group(s): N/A
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business ❑ E: Educational ❑
F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 I-2❑ I-3 0 I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB 0 IIA ❑ IIB 0 IIIA ❑ IIIB 0 IV 0 VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit Debris Removal:
Public 0 Check if outside Flood Zone 0 Indicate municipal 0
A trench will not be Licensed Disposal Site 0
Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify:
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Big Y Foods, Inc 2145 Roosevelt Ave Springfield, MA 01102
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Project Manager 413 -2_9 - 1588 913-219 - 1588 psmith@bigy.com
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
':T`t^ 2145 Roosevelt Ave. Springfield MA 01102
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this buildingpermit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
James MacFeat 860. 635 7111 jmacfeat@cefloyd.com 111715
Name(Registrant) Telephone No. e-mail address Registration Number
19 Tuttle Place Suite 2 Middletown CT 06457 CSL 8/16/2C21
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
C.E. Floyd Company, Inc.
Company Name James MacFeat "eye
/icei ,
Name of Person Responsible for Construction License No. and Type if Applicable
19 Tuttle Place, Suite 2 Middletown CT 06457
Street Address City/Town State Zip
860-635- 7111 860 _670 _ 3791 jmacfeat@cefloyd.com
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes 0 No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 19,000 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my knowledge and understanding.
James MacFeat Account Executive 860 - 670 _3791 6/10/2021
Please print and sign name Title Telephone No. Date
19 Tuttle Place Suite 2 Middletown CT 06457 jmacfeat@cefloyd.com
Street Address City/Town State Zip Email Address
)' l
Municipal Inspector to fill out this section upon application approval: 2 C P!6y' (p
j, Name if
City of Northampton
ti�r/ .�l
Massachusetts
,
Y
�4 DEPARTMENT OF BUILDING INSPECTIONS
sw
3'--;:.;r 212 Main Street • Municipal Building ,r`
_ '- Northampton, MA 01060
JIM 172p2T
' DFa
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APPLICATION FORA OLITION PERMIT
Attached are the forms required for a Demolition permit. Please fill out all of the attached forms
and submit them to the Building Department with the appropriate fee. Please make checks
out to the City of Northampton. (Cash not accepted)
Please be advised that disconnect signatures from the following departments must be submitted
with the application:
1. Eversource (Gas division)
2. National Grid (Electric division)
3. Northampton Department of Public Works - Water
4. Northampton Department of Public Works — Sewer
5. Northampton Department of Public Works — Storm water Management
6. Northampton Department of Public Works —Tree Warden
7. Northampton Historical Commission Review (if built prior to 1945)
*Proof of extermination is required to be submitted to the Health Department for all Commercial
demolitions and all abandoned residential properties. (Extermination may be required at the
Health Inspector's discretion if evidence of rodents exists).
Other required documents:
• Massachusetts Construction Supervisors License
• Copy of Workers Comp Affidavit
• Asbestos abatement report
A Demolition Permit will not be issued, and no demolition is to commence until ALL required
documents are submitted to the Building Department.
For further questions or information, please contact this department @ (413) 587-1240
EVERSwURCE
„4,
June 10, 2021
Dear Customer
This letter is to inform you that our records indicate the gas formerly supplying
the property described below has been physically cut off at the main in the street
on the date indicated:
188 North King Street Northampton, MA on 06/09/2021
The former Jiffy Lube
Note: State law requires you to notify Dig Safe at least 72 hours in advance
before any excavation — not including weekends and legal holidays. Call 811 to
notify Dig Safe and obtain a ticket number. Please visit www.digsafe.com for
more information.
Project Controls
995 Belmont Street
Brockton, Ma 02301
Eversource Gas of Massachusetts
nationalgrid
40 Sylvan Rd
Waltham MA 02451
March 11, 2021
142 North King St
Northampton MA
RE: Service Removal for Building Demolition.
To Whom It May Concern:
This letter is to confirm that, per your request; National Grid has verified there is no electric service to
the structure located at 142 North King St, Northampton MA. If you have any questions or need further
assistance, please feel free to contact me at (508) 691-6722.
Sincerely,
Dawn/11/44e/s
Order Processing Rep
Electric Order Processing
nationalgrid
az.+ MP, CITY OF NORTHAMPTON, MASSACHUSETTS
DEPARTMENT OF PUBLIC WORKS
125 LOCUST STREET
'� �•��' NORTHAMPTON, MA 01060
413-587-1570
FAX 413-587-1576
Donna LaScaleia
Director
April 27,2021
Jonathan Flagg, Building Inspector
Municipal Office Annex
212 Main Street
Northampton, Ma 01060
Dear Mr. Flagg:
The water service at#188 North King Street has been shut at the curb stop and the water meter has been
removed from the premises as of 4/12/2021.
Please contact me if you hav estions.
Sincerely, U y(.
David Sparks
Superintendent of Water
ASBESTOS REMOVAL
All residential, commercial and institutional buildings are subject to Massachusetts Department of
Environmental Protection (MassDEP) asbestos regulations at 310 CMR 7.15. Therefore, owners
and/or operators (e.g. building owners, renovation and demolition contractors, plumbing and
heating contractors, flooring contractors, etc.) need to determine al asbestos containing materials
(AGMs), both friable and non-friable, that are present at the site, and whether or not those
materials will be impacted by the proposed work, prior to conducting any renovation or
demolition activity.
Examples of commonly found ACMs include, but are not limited to, heating system insulation,
floor tile and vinyl sheet flooring, mastics, wallboard, joint compound, decorative plasters, window
glazing, asbestos containing siding and roofing materials and fireproofing materials.
Failure to identify and remove all ACMs prior to its being impacted by renovation or demolition
activities, can result in significant penalty exposure, and higher clean-up, decontamination,
disposal and monitoring costs.
A DOS certified asbestos consultant must be contracted to determine if asbestos is present and
whether removal/repair is necessary. If the building is a state owned facility, contact DCAM and
DOS. DOS provides a list of licensed asbestos abatement contractors and consultants. You may
wish to inquire if a contractor has any history of violations. Only DoS licensed and DOS certified
asbestos abatement contractors and consultants may be hired to perform asbestos related work
in Massachusetts.
Received by: ✓hcS p(11.,,c/ .cx-I-T— XCGuiV ! EKCCV tV'e.
iz
Print Name Title
----7- - WV7 /
Signature Date
City of Northampton
t� *. Massachusetts
� � u
r DEPARTMEN
T OF BUILDING INSPECTIONS ,';
e�be " 212 Main Street • Municipal Building b
--1 Northampton, MA 01060 �sta•�t ; �xv,‘
•
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: (Otto II,kto,t4 S'P I €V i '4A,17t_.e G i -€•,. , I.A.
®t7LO
The debris will be transported by:
Name of Hauler: Ao-"5c--,1/44,7c. 'C ®�. ti ^‘ OPk - 4 t+I
/
Signature of Applica _ t Date: 5 "• 2-1 " �2J
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
if-
,
roost ittaSS.goy/di°
\I otters'Compensation Insurance ArTidas it:BuildervoContraciorsfEketricianstPlumliers.
TO DE FILED II 1111 THE 11:W411111N t,Al 11401011.
AnDllakIt Infortusgq. Pleaw Print LeEibIN
Name(Business/Or .pnizationfludividual): C.E Floyd Company, Inc
Address: 19 Tuttle Place suite 2
•
City/State/Zip: 2Middletown, CT 06457 Phone 4: (860)635-7111
—
Art a nu an anploa,es?Chock lbe oppreprlaue boa: Type of project(required).
1.3 I am a enrI,P;e:a.oh if: _ L.InTrio*ce*Ural said 07 ran-threl.• 7. 0 New constructum
20 I am a*0Ic proprietor or pionitip and latve no cninioi o...7*%*otian6 tot rra tn 8. 9 Remodeling
caret:It:,[No'0,race.: .iarivp mantas:3.x 11,Nustiald
9. 0 Demolition
30 isas a honk:v*11,a ihrsDE all 1411/t rst. elf,[No*total, ',Attic ovoirantr',Num...11 r
1 o Ej f3uilding addition
4 C3 I am a hooky,*net and 14 311 be hIX111:s"‘Vntractun t V cumlud all,*Oirk.on ni!propan,, I*ill
morn:that all ctuttra-lora 41[6,3 hate o.orken;orrwervuhon artaisramt or Lae*olr: II a Electrical repairs or additions
pruprictor,with..,.nr1.3..., i 2.0 Plumbing repairs or additions
50 I sna a fourral rove:loin anal I havc hard ikan arrh-contr.a.toraltond on the aoatired*hcci
13 0 Roof repairs
now aut-oaturacuisa tome clunk/eel and have%voter;,..iorrp anauronet
14,00thei
ILO Wc arca wirx-ition mail it.t.offaixo.have extre•d then ogla of cu.-arrow:a pet AKtL;.
132..4144).and tar harvc nto cnapir.sycesk.[Nio rautitzts•dump imor.nene tryout-1J
'Arty Imptu:aro!.., :,hozl,bat gi mini.6,,lull mt 6,.ecuiun tvi.aia,”*.ing thew barkas'..-onipensabon p.siu.... infix mation
this 4111411%t tralwahrve the..;art atritsC ail%uric and dim tote baba&commas:tor,nrov olon nest arTaio u tilling such
.:Cutort*.i.on.that,.he,I.lhtl i'vr,roo*1 gill-A.bed an bd.-1141.MA%heel',lurk tnE tlic mom 04 nit ovit•-•,:onrra.son a n-.1+;...11C.heater or n0i abuse erosive*havt
catch'!"nev. IA ria.-stst-i.oninanl or*till C errc,lo'.et'..Chi) 11.11,1 pro.ale their *.mi.,'comp,wit,s, ma/1So
- ..
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Lnurdocc Compaciy Norm: The Rowley Agency _
policy it,or Self-al .Lik,0: SEE ATTACHMENT Elk ptralson Date: 3/24/2022
Job Site Address: 188 N. King St. Cit‘'State Zip: Northampton, MA
Attach a cop) of the workers'compensation policy declaration page(shossing the policy number and expiration date).
Failure to secure coverage as required under NIGE c. 152,*25A is a minimal N iolalion punishable by a fine up to 51.500.00
and or one-year imprisonment.UN'A Cli as cavil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the violator.A copy of this statement asly be forwarded to the Office of Investigations of the DEA for insurance
L-overage‘vrificalion,
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
7, N,,„,---. .,________
s,ma lure. ail. 6/10/2021
Official use only. Di,not wrac in this Oren,10 he completed by city or town official
• City or Town: Permitilicense#
Issuing Authority(circle one):
I. Board of liealth 2.Building Department 3.Cit)frovin Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
i .
1 Contact Person: Phone#:
LINDSAY MACFEAT 1305
JAMES MACFEAT
39 MCCULLOCH DR5t-7s9stzt t t
1// df
SOMERS, CT 06071
Dote
860-810-9702 CMECx�tt1
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