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17C-231 (28) IT Co Airg4C7o CM'i el- BP-2023-1189 34 NORTH MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-231-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1189 PERMISSION IS HEREBY GRANTED TO: Project# CANNIBUS RENO 2023 Contractor: License: Est. Cost: 260000 LUKE PAULL Const.Class: Exp.Date: Use Group: Owner: LHIC INC Lot Size (sq.ft.) Zoning: 01 Applicant: LUKE PAULL Applicant Address Phone: Insurance: 51 WARREN RD (413)883-7531 NPP8876888 BRIMFIELD, MA 01010 ISSUED ON: 09/06/2023 TO PERFORM THE FOLLOWING WORK: INTERIOR RENO FOR CANNIBUS CULTIVATION FACILITY 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I 11, Fees Paid: $30.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner cal/ Piz' /2/06 P Co ATIM-C io/L The Commonwealth of Massachusetts Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) / Building Permit Application for anyBuildingother than a One-or Two-FamilyDwelling (This Section For Official Use Only) Building Permit Number: D3- 11g9 Date Applied: Building Official: SECTION 1:LOCATION Ater-)* P\W/t_ S f- Pe r r1t a n/&/) 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 0 Repair❑ Alteration 0 Addition❑ Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy ❑ Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No ❑ Is art Independent Structural Engineeriin,S Peer Revie w required? Yes 0 No 0 Brief Description of Proposed Work: I(An3'1 i P Q�26 �6)23 $IU.la bud ex;s ,)y V6►Can-t' s fa&v. to houy4_ a c-onn al' C UI NfaliDel Riedi-ly 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) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AkEA 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❑ Nightclub 0 A-3 0 A-4❑ A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2❑ H-3 ❑ H-4 0 H-5 0 I: Institutional I-1 0 I-2 0 I-3 0 I-4❑ M: Mercantile 0 R: Residential R-ID R-2 0 R-3 0 R-4❑ S: Storage S-1❑ S-2 0 U: Utility❑ Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ rIA ❑ IIB ❑ MA ❑ rIIB ❑ IV ❑ 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 ElCheck if outside Flood Zone❑ Indicate municipal❑ 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❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ 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: f_ 4 77 -- �2 7 -//3l l SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner ErFC Sulu- 3L1 Narl'1, Kyle- s 1- Nord a meal Name(Print) No.and Street City/Town Zip Property Owner Contact Information: (5ah Y- - _ yl3 -5l - e5u/ter@ ees/orb:co,' Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,hi all matters relative to work authorized by this building permit 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 D. 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) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Lvk.t fay Company Name Gr,1t Paull C.5 - 166 G Z Name of Person Responsible for Construction License No. and Type if Applicable �1 la/a rim R.& fr)"-F,it id- MA- QJOID Street Address City/Town State Zip ql3 - IV.. 0531 /lrke)roll&t ntiaIl,co.I Telephone No.(business) Telephone No.(cell) e-` hail 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 $ (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. LuL4. fcwI� y� 7/ 6-erltral Cbn'4racfP- 11 -8K3 -r753/ /3O/z3 Please print and sign nameS7 4/wren Q /� Title 0161 6 /c_el Telephone No;g nDQ.1 Street Address City/Town State Zip EmailAddress`J Municipal Inspector to fill out this section upon application approval: 1 �/ 6 wea* 9 2.3 Name ate offal;� The City of Northampton 4..,. . ''' ) 4 4,- = . Building Department P§0):44,E 212 Main Street 1@y. %TED stool Northampton, Massachusetts 01060 Phone (413) 587-1240 Fax (413) 587-1272 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVAT ION PROJECTS) In accordance with the provisions of MGL c40, 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, s150A. The debris will be disposed of in: G5COre U OS--e Location of Facility l t1 f1S`k- S Ware) 1\ P 1 01 0 61- The debris will be transported by: Name of Hauler 14 42 'au11 Signature of Applicant: ` - "1, - Date: /3O/2) The Commonwealth of Massachusetts 41 t' ( ; Department of Industrial Accidents =„ i'=w 1 Congress Street, Suite 100 It•— " Boston, MA 02114-2017 -- www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Lu Iu, V(� i i Address: 51 idr1 rt.n City/State/Zip: BC i r‘+;l 1d 1n Pi- OJD 10 Phone#: (4l3 i 3 -i)')3/ Are you an employer?Check the appropriate box: Type of project(required): 1. am a employer with employees(full and/or part-time).* 7. ❑ ew construction 2.'II am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'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. ',! 1 Insurance Company Name: W W$ er'n /�OI 1- /I15' Co Policy#or Self-ins.Lic.#: TV i V �7IO D / r6 O Expiration Date: /2/g/2 3 Job Site Address: 3 ( 41dt A Mgt_ S.F City/State/Zip: Writ.AOrt TCih 111 it Attach a copy of the workers' compensatio policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce rtify under the pains and penalties of perjury that the information provided above is true and correct Signature: �I! �"'"" 1� Date: 0`Y)/2 3 / Phone#: `l • - 883- 9571 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#: From: / U 00Vl ) • Pin -rSt idf (Y\ A OibID To: Jonathan Flagg Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at l Nor-h M y ple 5) j ea,r---z Q tr07` 1 /; because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, c J�� 9/6/23,8:50 AM City of Northampton Mail-34 NORTH MAPLE BP-2023-0123 ' . City of Northampton�- Kim Carson <kcarson@northamptonma.gov> 1 34 NORTH MAPLE BP-2023-0123 2 messages Kim Carson <kcarson@northamptonma.gov> Wed,Aug 30, 2023 at 3:16 PM To: "mcquaidkuel@gmail.com" <mcquaidkuel@gmail.com> Hi, Did you ever send me a withdrawal on this job? I remember you telling me but I need something in writing....can you email it to me? Kim Carson Northampton Building Department 212 Main St 413-587-1240 Kuel McQuaid <mcquaid.kuel@gmail.com> Tue, Sep 5, 2023 at 9:53 AM To: Kim Carson <kcarson@northamptonma.gov> Good morning Kim I never sent you a withdrawal, but could you please withdraw my name from that permit for 34 North Maple St. in Florence. Thank you [Quoted text hidden] Kuel McQuaid KAM Construction m: (413) 537-6063 e: mcquaid.kuel@gmail.com https://mail.google.com/mail/u/0/?ik=28605c8627&view=pt&search=all&permthid=thread-a:r8918670549982261130&simpl=msg-a:r-55698821550515... 1/1