Attention all Contractors

Transcription

1 Attention all Contractors The Massachusetts Department of Environmental Protection (D.E.P.) Must Be Notified Prior to Demolition and Construction. All Asbestos Must be Removed Before Demolition and Renovation. For Information and Permit Applications Contact the Springfield D.E.P. Office at: (413) Ext 2210

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3 The Commonwealth of Massachusetts City of Pittsfield Massachusetts State Building Code (780 CMR) Eighth Edition Building Permit Application for any Building other than a One- or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number: Date Applied: Building Inspector: SECTION 1: LOCATION (Please indicate Block # and Lot # for locations for which a street address is not available) No. and Street Map/Block/Lot Zoning District / Use SECTION 2: PROPOSED WORK If New Construction check here or check all that apply in the two rows below Existing Building Repair Alteration Addition Demolition (Please fill out and submit Appendix 1) Change of Use Change of Occupancy Other Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes No Is an Independent Structural Engineering Peer Review required? Yes No Brief Description of Proposed Work: SECTION 3: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION, ADDITION, OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Evaluation is enclosed (See 780 CMR ) Existing Use Group(s): Existing Hazard Index 780 CMR 34: SECTION 4: BUILDING HEIGHT AND AREA No. of Floors/Stories (include basement levels) & Area Per Floor (sq. ft.) Proposed Use Group(s): Proposed Hazard Index 780 CMR 34: Existing Proposed Total Area (sq. ft.) and Total Height (ft.) SECTION 5: USE GROUP (Check as applicable) A: Assembly A-1 A-2r A-2nc A-3 A-4 A-5 B: Business E: Educational F: Factory F-1 F2 H: High Hazard H-1 H-2 H-3 H-4 H-5 I: Institutional I-1 I-2 I-3 I-4 M: Mercantile R: Residential R-1 R-2 R-3 R-4 S: Storage S-1 S-2 U: Utility Special Use and please describe below: Special Use: SECTION 6: CONSTRUCTION TYPE (Check as applicable) IA IB IIA IIB IIIA IIIB IV VA VB Water Supply: Public Private Railroad right-of-way: Not Applicable or Consent to Build enclosed SECTION 7: SITE INFORMATION (refer to 780 CMR for details on each item) Flood Zone Information: Check if outside Flood Zone or indentify Zone: Sewage Disposal: Indicate municipal or on site system Hazards to Air Navigation: Is Structure within airport approach area? Yes or No Trench Permit: A trench will not be required or trench permit is enclosed Debris Removal: Licensed Disposal Site or specify: MA Historic Commission Review Process: Is their review completed? Yes No SECTION 8: CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations:

4 SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Name (Print) No. and Street City/Town Zip Property Owner Contact Information: Title Telephone No. (business) Telephone No. (cell) address If applicable, the property owner hereby authorizes Name Street Address City/Town State Zip to act on the property owner s behalf, in all matters relative to work authorized by this building permit application. SECTION 10: CONSTRUCTION CONTROL (Please fill out Appendix 2) (If building is less than 35,000 cu. ft. of enclosed space and/or not under Construction Control then check here and skip Section 10.1) 10.1 Registered Professional Responsible for Construction Control - - Name (Registrant) Telephone No. address Street Address City/Town State Zip Registration Number Discipline Expiration Date 10.2 General Contractor Company Name: Name of Person Responsible for Construction License No. and Type if Applicable Street Address City/Town State Zip Telephone No. (business) Telephone No. (cell) address SECTION 11: WORKERS COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c C(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 No SECTION 12: CONSTRUCTION COSTS AND PERMIT FEE Item 1. Building $ 2. Electrical $ 3. Plumbing $ 4. Mechanical (HVAC) $ 5. Mechanical (Other) $ 6. Total Cost $ Estimated Costs: (Labor and Materials) Total Construction Cost (from Item 6) = $ Building Permit Fee = Total Construction Cost x (Insert here appropriate municipal factor) = $. Note: Minimum fee = $ (contact municipality) Enclose check payable to (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. - - Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Building Official Approval: Name Date

5 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA Workers Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1. I am a employer with 4. I am a general contractor and I 6. New construction employees (full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partnership and have no employees These sub-contractors have 8. Demolition listed on the attached sheet. 7. Remodeling working for me in any capacity. employees and have workers 9. Building addition [No workers comp. insurance comp. insurance. 10. Electrical repairs or additions required.] 5. We are a corporation and its 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers comp. right of exemption per MGL 12. Roof repairs insurance required.] c. 152, 1(4), and we have no employees. [No workers 13. Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers compensation policy information. 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, and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $ 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 under the pains and penalties of perjury that the information provided above is true and correct. _ Signature: Date: Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: PITTSFIELD Issuing Authority: Building Department Permit/License # Contact Person: Phone #: (413)

6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers compensation for their employees. Pursuant to this statute, an employee is defined as...every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152, 25C(6) also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, MGL chapter 152, 25C(7) states Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under Job Site Address the applicant should write all locations in (city or town). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department s address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA Revised Tel. # ext 406 or MASSAFE Fax #

7 Appendix 1 Building Demolition Checklist For the demolition of structures the building code requires action on service connections. Name of Demolition Contractor: In respect to the demolition of the building / structure located at: Before a building or structure is demolished or removed, the owner or agent shall notify all utilities having service connections within the structure such as water, electric, gas, sewer and other connections. A permit to demolish or remove a building or structure shall not be issued until a release is obtained from the utilities, stating that their respective service connections and appurtenant equipment, such as meters and regulators, have been removed or sealed and plugged in a safe manner: Organization: Telephone Number: Date: Verified by: Telephone (Verizon) (413) Berkshire Gas (800) Northeast Utilities (413) Pittsfield DPW (413) The following agencies have been notified of the proposed demolition of the building / structure: Agency Telephone Number Date: Approved by: Pittsfield Fire Dept. (413) Pittsfield Health Dept. (413) Pittsfield Conservation Commission Pittsfield Dept. of Community Development Pittsfield Historical Commission (413) (413) c/o Dept. of Community Development All debris shall be disposed of in accordance with 780 CMR 111.5: By: To: (Name of licensed hauler) (Location of licensed disposal facility) I AM FAMILIAR WITH THE REQUIREMENTS OF 310 CMR 7.09, AND I HAVE MADE PROPER NOTIFICATION TO ALL FEDERAL, STATE, AND MUNICIPAL AUTHORITIES HAVING JURISDICTION. Signature of Permit Applicant: Date:

8 City of Pittsfield Building Permit Application Appendix 2 Checklist for Construction Documents* Construction Documents are required for structures that must comply with 780 CMR 116. The checklist below is a compilation of the documents that may be required for this. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark x where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm (may require repeaters) 6 HVAC 7 Electrical 8 Plumbing (include local connections) 9 Gas (Natural, Propane, Medical or other) 10 Surveyed Site Plan (Utilities, Wetland, etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests & Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report (ComCheck) 17 Architectural Access Review (521 CMR) 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other (Specify) 21 Other (Specify) 22 Other (Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein. Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Work started prior to approval may be subjected to triple the original permit fee. Registered Professional Contact Information - - Name (Registrant) Telephone No. address Street Address City/Town State Zip Registration Number Discipline Expiration Date - - Name (Registrant) Telephone No. address Street Address City/Town State Zip Registration Number Discipline Expiration Date - - Name (Registrant) Telephone No. address Street Address City/Town State Zip Registration Number Discipline Expiration Date

9 MEMORANDUM To: PITTSFIELD HISTORICAL COMMISSION From: Date: October 16, 2007 Re: Transmittal: In accordance with the City of Pittsfield s Historical Commission and the Community Development Board, I am forwarding for approval the application and all associated paper work to demolish a building. ( Number 1 thru 9 must be completed or application will not be accepted ) 1) Provide a copy of the Assessors street card for this property 2) Provide photos of the building 3) The Building is located at: 4) Assessors Map 5)The Building is located in a: Zoning District 6)Building Owners Telephone # 7)The Building Classification Code is: 8)The current use of the building is: 9) The reason for requesting a demolition permit: 10) A brief description of the proposed reuse, reconstruction or replacement, if the applicant feels such will contribute to the justification for the demolition: Demolition Approved Y / N Date: Signature Comments:

10 DEMOLITION DELAY ORDINANCE FOR THE PRESERVATION OF HISTORICALLY SIGNIFICANT STRUCTURES PURPOSE AND INTENT This ordinance is enacted for the purpose of preserving and protecting historically significant structures within the City of Pittsfield which reflect distinctive features of the architectural, cultural, economic, political or social history of the city, and to encourage owners of such buildings or others to seek out ways to preserve, rehabilitate or restore them rather than demolish or alter them in a detrimental way, thereby promoting the public welfare and preserving the heritage of the City. To achieve these purposes, the Pittsfield Historical Commission ("the Commission") and the Community Development Board (the CDB ) are empowered to advise the Building Inspector with respect to the issuance of permits for the demolition of significant structures, as regulated within this chapter. DEFINITIONS Applicant - Any person or entity who files an application for a demolition permit. If the applicant is not the owner of the premises upon which the structure is situated, the owner must indicate on the application his/her assent to the filing of the application. Application - An application for the demolition of a structure. Building Inspector- The person occupying the position of Building Commissioner or Inspector, or those otherwise authorized to issue demolition permits. Community Development Board (CDB) Members and, or personnel as defined in the Pittsfield City Code, Article XIV. Commission The Pittsfield Historical Commission or its designee. Demolition - Any act of pulling down, destroying, removing, dismantling or razing a structure, or commencing the work of total or substantial destruction with the intent of completing the same. Substantial herein shall mean either half the volume of the structure or half its assessed value, as determined by the Building Inspector. Demolition Permit - The permit issued by the Building Inspector as required by the State Building Code for the demolition, partial demolition or removal of a structure excluding a permit issued solely for the demolition of the interior of a structure. Historic Resources List - A list of Pittsfield buildings which are on the National Register of Historic Places, the State Register of Historic Places or the Local Inventory of Historic Resources. Any structures on the Historic Resources List shall be considered to be a Significant Structure. Preferably Preserved - Any significant structure which the CDB determines by simple majority vote, following a public hearing, that it is in the public interest to be preserved, rehabilitated or restored rather than demolished. A preferably preserved structure is subject to the six (6) month demolition delay period of this ordinance. 1

11 Significant Structure Any structure within the city which is in whole or in part seventy five (75) years or more old, and which has been determined by the Commission to be significant based on one or more of the following criteria: The structure is listed on, or is within an area listed on, or eligible for, the State or National Register of Historic Places the Inventory of the Historic and Prehistoric Assets of the Commonwealth or the Historic Resources List; The structure is importantly associated with one or more historic persons or events, or with the broad architectural, cultural, political, economic or social history of the city, the Commonwealth of Massachusetts or the United States of America; or The structure is historically important by reason of period, style, method of building construction or association with a particular architect or builder, either by itself or in the context of a group of buildings, structure or sites Structure - Any combination of materials assembled at a fixed location to give support or shelter for persons, animals, or property, such as a building, framework, or the like and/or walls, statues, monuments, bridges, or other combinations of building materials. The word structure shall be construed, where the context requires, as though followed by the words, or part or parts therefore. PROCEDURE No demolition permit for a structure which is in whole or in part seventy five (75) years or more old shall be issued without following the provisions of this ordinance. If a structure is of unknown age, it shall be assumed that the structure is over seventy five (75) years old for the purposes of this ordinance. An applicant proposing to demolish a structure subject to this ordinance shall file with the Building Inspector an application containing the following information: The address and City Assessor s Map, Block and Lot designation of the structure to be demolished; The owner's name, address and telephone number; A description of the structure including items such as architectural elements, style and type of construction; The date of structure establishment as determined by the Pittsfield Board of Assessors, deed or other documentation verifying year of construction; The reason for requesting a demolition permit; A brief description of the proposed reuse, reconstruction or replacement, if the applicant feels such will contribute to the justification for the demolition; and A photograph or photograph(s) of the structure. The Building Inspector shall within seven (7) days forward a copy of the application to the Commission and the CDB. Within thirty (30) days after receipt of the application, the Commission shall make a written determination of whether the structure is significant. No demolition permit shall be issued during this time. Should the Commission fail to notify the Building Inspector of its determination within thirty (30) days of receipt of the application, the Building Inspector may issue a demolition permit. Should the Commission deem that the structure is not significant, the Building Inspector may issue the demolition permit upon receipt of the Commission s written determination. 2

12 If the Commission determines that the structure is significant, it shall notify the Building Inspector, the CDB and the applicant in writing that a demolition plan review must be made by the CDB prior to the issuance of a demolition permit. Within sixty (60) days after the determination of significance by the Commission, the applicant shall submit five (5) copies of a demolition plan to the Commission and ten (10) copies to the CDB, which shall include the following information: A map showing the location of any structure to be demolished, with reference to lot lines and abutting structures; Photographs of any street façade elevations; A description of the structure to be demolished; The reason for the proposed demolition and data supporting said reason, including where applicable, data sufficient to establish any economic justification for demolition; and A brief description of the proposed reuse and development of the property, if the applicant feels such will contribute to the justification for the demolition. Not later than thirty (30) days of receipt of such plan, the CDB shall hold a public hearing with respect to the demolition plan. Public notice of the time, place and purpose of the hearing shall be given by the CDB or its designee, at the expense of the applicant, not less than fourteen (14) days before the said hearing. Such notice shall be posted in a conspicuous place in the City Hall, published in a newspaper of general circulation in the city and mailed to the applicant, the legal abutters and to such other persons as the Commission and the CDB shall deem entitled. Within fifteen (15) days of receipt of the demolition plan the Commission shall submit in writing, their recommendation and any comments to the CDB. The CDB shall decide by a simple majority vote at the public hearing whether the structure should be preferably preserved upon finding that the structure is significant as defined above. If agreed to in writing by the applicant, the determination of the CDB may be postponed. Should the CDB fail to notify the Building Inspector in writing within fourteen (14) days of the public hearing, the Building Inspector may issue the demolition permit. If the CDB determines that the structure should not be preferably preserved, the CDB shall so notify the Building Inspector, the Commission and applicant in writing, no later than fourteen (14) days after the close of the public hearing. The Building Inspector may then issue the demolition permit. Should the CDB determine that the proposed demolition would be detrimental to the historical or architectural heritage or resources of the city, such structure shall be considered to be preferably preserved and the CDB shall file with the Building Inspector, the Commission and the applicant within fourteen (14) days after the close of the hearing, a written report on the demolition plan which shall include the following: A description of the age, architectural style, historic association and importance of the structure to be demolished; The determination as to why the structure should be preferably preserved; and An invitation to the owner of record of the structure to participate in an investigation of alternatives to demolition including but not limited to incorporation of the structure into future development of the property, adaptive re-use, seeking a new owner willing to purchase and preserve, restore or rehabilitate the structure or moving the structure. The CDB shall also notify the Massachusetts Historical Commission and any other interested parties in an effort to obtain assistance in preservation funding or in finding an adaptive re-use of the structure which will result in its preservation. 3

13 Once a structure has been designated to a preferably preserved status, the owner shall be responsible for properly securing the structure if vacant, to the satisfaction of the Building Inspector. Should the owner fail to secure the structure at any time during the six (6) month demolition delay period, any subsequent destruction or loss of the structure through fire or other cause, of which destruction could have been prevented by the required security measures, shall be considered a demolition in violation of this ordinance and all non-compliance penalties shall pertain. No demolition permit shall be issued until six (6) months after the date of such determination of significance unless otherwise agreed to by the CDB. All approvals necessary for the issuance of such demolition permit, including without limitation any necessary zoning variances or special permits, must be granted and all appeals from the granting of such approvals must be concluded, prior to the issuance of a demolition permit under this section. Upon application by the owner, the CDB may, after following the same public hearing and recommendation process above for a demolition plan review, determine by a simple majority vote that: (a) the owner has made continuing bona fide and reasonable efforts to locate a purchaser willing and reasonably able to preserve, rehabilitate or restore the subject structure and that such efforts have been unsuccessful. For the purposes of this paragraph, the term "Continuing, bona fide and reasonable efforts to locate a purchaser" shall mean retaining a licensed broker to market the property in the usual manner over a substantial period, obtaining an appraisal from a reputable appraiser and providing evidence of good faith negotiations with potential buyers of the property. These efforts to sell the property shall be deemed unsuccessful only upon a finding that either there were no offers to purchase the property, that no offer from a willing and reasonably able buyer was for at least the reasonable appraised value of the property, or that no agreement to sell the property pursuant to an offer of at least the reasonable appraised value of the property could be reached despite good faith efforts to do so; and (b) there is no reasonable likelihood that any person or group is willing to purchase, preserve, rehabilitate or restore such structure. Such finding shall be issued in writing by the CDB to the Building Inspector and the Commission within seven (7) days of the close of the hearing, at which time the Building Inspector may issue a demolition permit for the preferably preserved structure. ADMINISTRATION The Commission and CDB may adopt such rules and regulations as are necessary to administer the terms of this ordinance. The Commission and CDB are authorized to adopt a schedule of reasonable fees to cover the costs associated with the administration of this ordinance. The Commission may delegate authority to make initial determinations of significance to one or more members of the Commission or to a municipal employee. The Commission may pro-actively develop a list of significant structures (to be known as the Historic Resources List) that will be subject to this ordinance. EMERGENCY DEMOLITION Notwithstanding the above provisions, the Building Inspector may issue a demolition permit at any time in the event of imminent and substantial danger to the health or safety of the public due to deteriorating conditions. The Building Inspector shall document in writing the findings and reasons requiring an emergency demolition 4

14 and shall forward a copy immediately to the Commission and the CDB. No provision of this ordinance is intended to conflict with or abridge any obligations or rights conferred by Massachusetts General Laws, Chapter 143 regarding removal or demolition of dangerous or abandoned structures. In the event of a conflict, the applicable provisions of Chapter 143 shall control. NON-COMPLIANCE Anyone who demolishes a structure determined to be preferably preserved under this Ordinance without first obtaining, and complying fully with the provision of a demolition permit, shall be subject to a fine of three hundred dollars ($300.00). Each day the violation exists shall constitute a separate offense until a faithful restoration of the demolished structure is completed or unless otherwise agreed to by simple majority vote of the CDB following the same public hearing and recommendation process as listed above for a demolition plan review. If a structure subject to this ordinance is demolished without first obtaining a demolition permit, no building permit shall be issued for a period of two (2) years from the date of the demolition on the subject parcel of land or any adjoining parcels of land under common ownership and control unless the building permit is for the faithful restoration of the structure, including but not limited to use of materials, design, dimensions, massing, arrangement of architectural features and execution of decorative details, or as otherwise agreed to by the CDB. ENFORCEMENT AND REMEDIES The Commission, the CDB and/or the Building Inspector are each specifically authorized to institute any and all actions and proceedings, in law or equity including injunctive relief, as they may deem necessary and appropriate to obtain compliance with the requirements of this ordinance or to prevent a violation thereof. HISTORIC DISTRICT ACT Following a determination that the structure is significant and preferably preserved, the Commission may recommend to City Council that the structure be protected through the provisions of Massachusetts General Law, Chapter 40C, The Historic Districts Act. The steps required under M.G.L. Chapter 40C shall be followed prior to the establishment of a local historic district. Nothing in this ordinance shall be deemed to conflict with the provisions of the Historic District Act, Massachusetts General Laws Chapter 40C. If any of the provisions of this ordinance do so conflict, that act shall prevail. PRE-DETERMINATION Any property owner or their designee may submit a pre-determination request directly to the Commission, in order to determine significance of their property prior to initiating a demolition permit application with the Building Inspector. Once a determination is made by the Commission, they shall submit their decision in writing to the Building Inspector s Department, the CDB and the applicant. Such determination shall be attached to the applicant s demolition application with the intent of allowing the application to proceed promptly through the above processes in the case of a determination that the structure is not significant. Such written pre-determinations shall be considered valid for one (1) year, barring any relevant changes to the Acts regarding historic structures, or any new substantial findings on the property in question. 5

15 FORM B BUILDING MASSACHUSETTS HISTORICAL COMMISSION MASSACHUSETTS ARCHIVES BUILDING 220 MORRISSEY BOULEVARD BOSTON, MASSACHUSETTS Photograph Insert here or on a Continuation Sheet a digital photograph (either color or black and white). A paper photographic print (3½x5¼" or 4x6" must also be attached to the form in this space or to a Continuation Sheet. Prints, from a photo-quality inkjet printer, must use brand name paper and inks approved by MHC. Attached photographs should be clearly identified with town name and property address. See MHC's Guidelines for Inventory Form Photographs. Topographic or Assessor's Map Assessor s Number USGS Quad Area(s) Form Number Town: Place: (neighborhood or village) Address: Historic Name: Uses: Present: Original: Date of Construction: Source: Style/Form: Architect/Builder: Exterior Material: Foundation: Wall/Trim: Roof: Outbuildings/Secondary Structures: Insert here or on a Continuation Sheet a map clearly showing the location of the property including the name of the nearest road or street and at least one other intersecting road or feature. Assessor's maps are preferred, but other forms of detailed plans such as an excerpt from a USGS topographic map or an aerial or satellite photo clearly marked are also acceptable. See MHC's Guidelines for Inventory Form Locational Information. Major Alterations (with dates): Condition: Moved: no yes Date Acreage: Setting: Recorded by: Organization: Date (month / year): Follow Massachusetts Historical Commission Survey Manual instructions for completing this form.

16 INVENTORY FORM B CONTINUATION SHEET [TOWN ] [ADDRESS ] MASSACHUSETTS HISTORICAL COMMISSION Area(s) Form No. 220 MORRISSEY BOULEVARD, BOSTON, MASSACHUSETTS Recommended for listing in the National Register of Historic Places. If checked, you must attach a completed National Register Criteria Statement form. Use as much space as necessary to complete the following entries, allowing text to flow onto additional continuation sheets. ARCHITECTURAL DESCRIPTION: Describe architectural features. Evaluate the characteristics of this building in terms of other buildings within the community. HISTORICAL NARRATIVE Discuss the history of the building. Explain its associations with local (or state) history. Include uses of the building, and the role(s) the owners/occupants played within the community. BIBLIOGRAPHY and/or REFERENCES Continuation sheet 1

17 DIRECTORY OF LOCAL HISTORY RESEARCHERS The individuals listed below have indicated a willingness to perform research for a fee. The Pittsfield Historical Commission does not assume responsibility for the accuracy of the work of the individuals listed. Persons wishing to contract work should contact the researchers directly. Researchers are listed alphabetically. Susan Denault 268 Williamstown Road New Ashford, MA Sdenault@capital.net Donna M. Kasuba 11 Hull Avenue, Ste. A Pittsfield, MA DmKasuba@aol.com (413) Norene Roberts 119 Cape Street Williamsburg, MA robertshistory@verizon.net (413) State Consultant List