32C-067 (31) Mow BP-2008-0376
GIS#: COMMONWEALTH OF MASSACHUSETTS
ViDEMEN CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2008-0376
Project# JS-2008-000547
Est. Cost: $6500.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOSEPH TYPROWICZ 093516
Lot Size(sq. ft.): 30666.24 Owner: MAPLEWOOD SHOPS INC
Zoning: CB Applicant: JOSEPH TYPROWICZ
AT: 2 CONZ ST
Applicant Address: Phone: Insurance:
417 SPRINGFIELD ST SUITE 210 WC
AGAWAMMA01001 ISSUED ON:10/9/2007 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE STAIRS & CAT WALK TO 3RD FLR
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:
FeeType: Date Paid: Amount:
Building 10/9/2007 0:00:00 $50.001571
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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File#BP-2008-0376
APPLICANT/CONTACT PERSON JOSEPH TYPROWICZ
ADDRESS/PHONE 417 SPRINGFIELD ST SUITE 210 AGAWAM
PROPERTY LOCATION 2 CONZ ST
MAP 32C PARCEL 067 001 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ���/
Fee Paid
Typeof Construction: REPLACE STAIRS&CAT WALK TO 3RD FLR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 093516 in
3 sets of Plans/Plot Plan T hOTa j U/'/ 4 1
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INATION PRESENTED:
LLLL✓✓////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
ZW2 /a b9 a7 .
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.
Versionl.7 Commercial Building Permit May 15,2000
y Department use only --
-� City of Northampton status of Permit-
S �� Building Department curb Cu�Dr, way Permit,_
i 212 Main Street Sewer/Septic availability
Room 100 Water/Well Availability _
OC-\ - L ��Northampton, MA 01060 Plans____
phone 413-5 7-12,40 Fax 413-587-1272 Plot/Site Plans
1 Other Specify _ _
APPLICATJON TO CONS..T fel-,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 ;.:S`
------11 Property Addresc:
0/1&014 Wood $i i10(J5 T�WC. Map 3 a Lot
a. can i_ 51172-0-+- w :_
1 � � '•".��Y�'�b'srw-rv��kd"aA3crL"'.��w ss��.rra.iYY�..`
1 Y o�"'�'�'1etlM,pk , YTh'- ;-. .-tie.' OverlayD�stncY
5 � __ — CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT I
2.1 Owner of Record:
016z ok,,,:_, S V1oP5 ii h c./(.vay AL. cuLci i i Po boy i x9 i C.(..or8rneadoe ,►r tl- o ioLii
Name(Print)enCi .,+h geet,V Current Mailing Address:
UU
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Signature P ‘.5 Telephone .
2.2 Authorized Agent:
` El p a�,LA c z L}( S Q,,,, t .. ..r,.,.y, i piA 0166 i
Name(Print) Current Mailing Address:
M1,1- jPici - plc} i
Signature 44 -di, Abit Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant J
1. Building dif (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from (6)
3. Plumbing ? Building Permit Fee
4. Mechanical(HVAC) I
5. Fire Protection
6. Total=(1 +2+3+4+5) (.31 i Sda — Check Number 1 7 f Q
This Section For Official Use Only
Building Permit Number . Date ,
Issued
,-
Signature:
Building Commissioner/Inspector of Buildings Date
t - ,
Version1.7 Commercial Building Permit May 15,2000
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SECTION-A-CONSTRUCTI:ON SERVICES_FORPROJECTSLES.S;THAN 35,000
CUBIC FEET OF ENCLOSED SPACE ' ;9
Interior Alterations 0 Existing Wall Signs 0 Demolition❑ Repairs 0 Additions 0 Accessory Building❑
Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use❑ Other R1
i
Brief Description 'Enter a brief description here. Ic4�- •1hct5-4-iv a 5�r ; C 'i1/44 . c-,a*450-2C
Of Proposed Work: i > i—LjAp( U urn ,
i
SECTION 5-USE GROUP-AND CONSTRUGTJON TYPE- _ _ '
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ElA-1 0 A-2 0 A-3 ❑ 1A I 0
-- — A-4 0 A-5 0 18 0
B Business J 2A 0
E Educational 0 2B I ❑
F Factory 0 F-1 0 F-2 0 2C I 0
H High Hazard El 3A +f ❑
I Institutional ❑ 1-1 ❑ 1-2 0 1-3 ❑ 3B 0
M Mercantile 0 4 0
R Residential 0 R-1 0 R-2 ❑ R-3 0 5A 0
S Storage 0 S-1 0 S-2 ❑ 5B [ 0
U Utility ❑ Specify:I
•
M Mixed Use ❑ Specify:I
S Special Use 0 Specify:
II
. COMPLEI I_THIS SECTION TF EXISTING BUILDING UNDERGOING RENOVATIONS;.A'DDITtONS�AND/OR CHANGE-IN USE
i
Existing Use Group: 1 1 Proposed Use Group:
Existing Hazard Index 780 CMR 34):I 1 Proposed Hazard Index 780 CMR 34): 1
SECTION 6 BUILDING HEIGHT-AN IDAREA.
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION �r A.4
�� - r
Floor Area per Floor(sf) _ 'w
1st ' Li
71 1st `oC.t/vf,A
nd 1 2nd { Co OVY)LA. it t ta"p.Je^' `v '�cAy,^ o a �.
3rd2
tf
�` Si Z 3`d I a/✓ i - t *� m T
`s
4m t 4 I aair -�...-- �
th n,�
1 • ,, c�
alimimIki
Total Area(sf) 37 t „go 1 i Total Proposed New Construction(sf) V ~ 3 r` ;,.
ems. kS�
Total Height(ft) 1 i t„ �� .
ram. .."-.�:
Total Height ft - 4Ti a
y'yi.>, 1, ta"" 4At fix.._s i+` ;"
,--- d.t a ig- ':,._,,.�._ '-i
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private 0 Zone' Outside Flood ZoneD Municipal 0 On site disposal system 0
Version1.7 Commercial Building Permit May 15,2000
1ORt OPI ZO.NiN ,.i,.
,.�'L.-4. 4E'"Y�ftwoif.M.%I1*-7rt f1s.'-.-5.
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
I •'1 vy 1 i :l O't
3gLi .S 89q. S
Frontage '
Setbacks Front i j
Side L:' 1 R:1---1 L:1 1 R:1 1 i
Rear 1 1 i i i
.
-1KtTding Height _-
I
Bldg.Square Footage 1 1 ; % i i I-1
Open Space Footage %
(Lot area minus bldg&paved i i 1---- 1 1 I i f
parking)
#of Parking Spaces
Fill: ' iI' 1
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW G 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 i Page; and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO e DONT KNOW 0 YES Q
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 Q 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
IF YES, describe size, type and location: 1
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 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version!.7 Commercial Building Permit May 15,2000
.- .:. _
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUI3JECTTO
CONSTRUCTION CONTROL PURSUANTTO 780.CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED-SPACE)
9.1 Registered Architect
Not Applicable 0
I
Name(Registrant):
i I Registration Number
' I I
Address L
i Expiration Date
l i
Signature Telephone
9.2 Registered Professional Engineer(s):
{
Name Area of Responsibility
I i I
l
Address Registration Number
Signature Telephone Expiration Date
I I
I
Name Area of Responsibility
1
I
Address Registration Number
I I I
Signature Telephone Expiration Date -
i
I
Name Area of Responsibility
1 I
I
Address j Registration Number
I I 1
E
Signature Telephone Expiration Date
j
i
Name • Area of Responsibility
I
Address Registration Number
f I l
l i I
Signature Telephone Expiration Date
9.3 General Contractor t 1
I
l y p1roGJ1 C.Z. 445 VYl e.Z im prOt1�VYl 4t+ I -L • I Not Applicable❑
Company Name:
1.O .e.Qh ' N Prow►C.Z I
Responsible In Charge of Construction
411 Si) l(�. S I--+�.u.k. 51 . 1 a , Ar6otioaryt, ni 4Q- Oi Off) I
Address 1 I
di,
Sig ature Telephone
Version1.7 Commercial Building Permit May 15,2000
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SECTION 10-SiRUCTURAL:PEER REVIEW-(780 CMR 110.11) _
Independent Structural Engineering Structural Peer Review Required Yes Q No 0
SECTION 11-OWNER AUTHORIZATION-TO BE COMPLETED-WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
l ) /11 tram/aC Z.,K Z as Owner of the subject property
t I ' I
hereby authorize' N t Tii .elc 7 / CJ /NSod/L ( s1 `i14411•c.:. ;to
act on my half,in all tters relative to work authorized by this building permit application.
—- { /mil P/G).
nature of Own Date
i `
1,; ,,r, 4,..-ti i'^� h vl ,44 �J .A C-. k'�0 I ' ,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 under ains and enalties of a 'u .
Print Name cS
� I
i
Signatu of Owner/Agent Date
SECTION.12.; CONSTRtfCT1ON SERVICES• ;
10.1 Licensed Construction Supervisor:'�" Not Applicable El
IName of License Holder:'QVS"e wk I Qi'066 i (..2.. I V�t3S� j
License Number
1 Lltl SPifi.&8-i'.IcQ Sbir.4. ,5F'-e--1-10 , A(c:anm .Irn4. c>icoi 1 4 CS) ().(C Jc0
q
Ad ess _ Expiration Date
4-411A. 41/{04; 1 Li t '13C('(0/02.- 1
Si re Telephone
9
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT`(M:G.L".e.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 97 No 0
f
4 . .
The Commonwealth of Massachusetts
Department of Industrial Accidents
11 ==„.1,
Office of Investigations
�lol= 600 Washington Street
• Boston,MA 02111
�s� ` www.mass.gov/dia
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual):.y pecg.,_%i(.,Z 4C)r ie J--VYlp o venial* .LYK. .
Address: y I) Spli( 54.4_1d 1 v' .r a Si-e c Its
City/State/Zip: 14qu CAX4ley1 1 al O 100l Phone#: Li 13.v ci •6 i Oa.
Are you an employer? Check the appropriate box: Type of project(required):
1.Ff I am a employer with 3 4. ❑ I am a general contractor and I
have hired the sub-contractors 6. ❑New construction
employees(full and/or part-time).*
listed on the attached sheet. 7. ❑ 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' 9 ❑Building addition
[No workers' comp.insurance comp. insurance.$
required] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11. Plumbingrepairs or additions
3.❑ I am a homeowner doing all work
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' 13.2 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: (i(Cx to 1 rL S+CI Q Z� U 1(C Y C,.C CA M PC4 A V
Policy#or Self-ins. Lic. #: �C ,gp1 L{ 8S Expiration Date:- 3/ Z O/O '
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Job Site Address:a.0...0n Z S#"1(.e.e,f— City/State/Zip:I apipfon t Yn4 o wb
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, rtify r the pains and penalties of perjury that the information provided above is true and correct
Signature: e V l OC '. 3 , d f�c)�y� � ' Date:
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Phone#: 13 • Q •.Cp )0 a
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#:
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