Loading...
22B-041 REIF 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I I 1 I 1 I 1 I r 1 1 1 I 1 I I 111 1 1 1 1 1 1 11 I f l l l l l l i l- i f i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 ( 1 1 1 i 1 i 1 1 1 1 1 1 1 i I 1 1 1 1 1 1 1 1 1 1 1.1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ,1 1 1 1 I 11 1 1 1 1 1 1 1 1 1 1 1 111111.1111111.111111 11111.1111111111111.1111111111111111111111111 1 1 IIIMENNIMINUM 1111111111111NININIIIIIMINININININI 1 1 ■NIIIIIIIIIIIIINI INIIIIIIMININIMINNIMINIMINIIIIIM 1 1 ,���il �-iir��iili��i1 1 1 1 1 1 1 11 -.1111a1=1 SEALED AND 'CLOSED 1111111111111111111.111111.1111.111111111.11111 IIIIIIIIIMMMMIIMIIIUIIIIMIIIMIIIMIMMII 1 .111111111111111111111 IIIIIIINIIMIIMIIIIIIIIIIIIIIIIMIIIIIIIMIIIIIII 1 1 1 �� 1 111111111111111111111111.1111111111.11111111111111111111 1 1 1 1 1 1 11111.111111111111.1 1111.111.111.1111111111111111111111111111.11111111 1 1 1 \111•111111111•■ MNMIMIIIIIIIIIIIIIUIIIMIIMIIIIIIMIIIII 1 1 111111•111111rl 1•11111111101111111111110111111111111111•111111111 1 1 1 1 111111•1111•1111 IIIIMIN1111111111111111111111111111111111111=111 1 1 I 1 ■1101111111111111I 11111111111111111111111111111•1111111•1111111111M 1 1 1 1 ■���1 111111111111111111111111111111111111111111111•11111111 � f 1 I I 1 I 1 1 1 1 �- = = --'. MuaFa I I I 1 1.111111111.1111.1111111111.1111.11111111111111111111 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 IIIIIIMIMIIIIIMIMIIIMIIIIIMIIIIIEIIIIMIIIIIMII I I 1 1 1 1 1 1 11 1 1 1 1 1 1 IIIIIIIIINIMINIIIIIIMININNINUMN 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 11 1 1 1 1 1 1 1 1 1_ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4' - 0" T 1 1 1 1 1 1 1 1 1 1 ► 11 1 1 1 1 1 1 1 1 1 1 1 1 111111 1 1 1 1 1 1 1 1 1 1 1 1 l 1 1 1 1 1 1 1 1 1 11 1 J l 1 1 1 1 1 F_ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ( I 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 . 1 i I 11 1 1 1 1 1 1 I I I I I I I I I I I I I I I I 1 1 1 1 1 1 1 1 1 EQUIP. & INSTALLATION MEETS ❑UTSIDE VIEW N.F.P. . 96 CODES & IMC 2003 CODES °N °TM° sFEaFlED: Al WELDING HVAC Fronk Ww (413) ss7-OOS9 C MENSpNS ARE IN NCNES Jerr Gown (413) S34 -SMB 800D AC IN31 . In c . TOLERANCES: nNr SWI GWdrq frh».allhoodehvac0yohoo.com %at% TRLE a * 176 Pine St iwanAR:... Micheal Kaynes Florence, MA THOD S DRAGING a THE Pa eERn of Family Restaurant GO AC NNST MLFRS NIC. DISSEL . RESSE IN ANY FORM E710EPf s� ce+rwrl OWG N0. ichael Kaynes AS E7(PRESSED ZTION er THE D M AGREE IT FRE T . AUTHORI TAHE 0JI&N AGREES TO RERAN THIS DOCUMENT TO THE OWNER ON DEMAND. 3r131 I" I Isar 3 a 3 -■.../\ MIRE RATED METAL STUDS ,L_ 3' STANDOFF ri / / I / / / 4' HOOD / It i / / �`_ / / -"�� / / 10. / / / / / -•12' TO 010' REDUCER / / / / / / / / / / OUTSIDE 14'xX14' CRS DUST / / WELDED LIQUID TIGHT 1 1 / �/ GAL ANIZ GALVANIZED SHEET METAL - v / / Z_ m J / / . / / --) EXHAUST BLOWERS MUA FA TOP VIEW EQUIP. & INSTALLATION MEETS N.F.P.A. 96 CODES & IMC 2003 CODES ''..-7.\ UNLESS OTHERWISE SPECIFIED: Al WELDING/HVAC Fronk 14144 (413) 337 -9o39 DIMENSIONS ARE IN NICHES Jerry GINIn (413) 334 -3408 HOOD AC INSr , Inc. TOLERANCES: Stainless Steel Wsldng frios.allhoodehvacOyahoo,co 1 DOWNS TITLE .00 *' 178 Pine St zoo *.001) .s Micheal Kaynes Florence, MA THIS DRAWING IS THE PROPERTY OF Family Restaurant NOOD /INAC INS AL ERS INC. REPRODUCTION OR DISSEMINA110N IN ANY FORK EXCEPT sal DMeM MG 110. Idry AS EXPRESSED FORBIDDEN WTION INC D OWNER n FORBIDDEN. THE R GIP' Michael Kaynes AGREES To RETURN THIS DOCUMENT TO THE O*MFR ON DEMAND. eau 1408 / Irm 2 of 3 BEAM CLAMPS \--/-\ \--/-\ \ 14'x14' CRS DUCT ) WELDED LIQUID TIGHT (? ...N J... (\ J 012' 24gn GALVANIZED SHEET METAL y, r "` LEANOUT DOORS - - -PYRE INSULATION R- ( \ -----------... EXHAUST BLOWE NFPA APPROVED • 1 %-'\ It [ o ' 3/8 SS THREADED ROD 3/8 ss THREADED ROD --" �. r 3/8 SS THREADED ROD ANGER BRACKETS n - t n ~ �- HANGER BRACKETS MUA FA \ -, '-SS FILTER BAFFLES _ ■ - HOOD--I 4' HOOD 9' 7 CEILING '—SS WALL PANELS I � \ 6' -6" 6' -6" UNT I 1 C 11 `�� - ' 1 WALL MO ANGLE BRACKETS O O O O O O O O O 1 KING EQUDPMENT COOKING EQUIPMENT COOKING EQUIPMENT /� /8' FIRE RATED COOKING BY OTHERS BY OTHERS BY OTHERS / LUROCK / ... WALL STUDS f / \ /E\ / 1 \ / - FR ❑NT VIEW SS WALL PANEL SHOWN WITHOUT ROOF - FOR CLARITY FRONT VIEW EQUIP. & INSTALLATION MEETS N.F.P.A. 96 CODES & IMC 2003 CODES 'M SrECIFIEM Al WELDING VAC r,,,; K'°' (413) 55'-9606 DMEN6 OL RA N II :C11ES HDOD�HVAC INST Inc. ' ' 0ode (413) 534 -3406 TOLERANCES: Slainlea Stets m filoe.al6yp4N1A5 hoo.com .00 *AZ ' 176 Pine St .006 *•060 ANf.IA/iR3 .S Kaynes Mi Ka .^ es ( Florence, MA ' THIS oRwv16 is Tic PRopErm of Family Restaurant - -- oR A& 06 rNN710N IN 417( FORK EXCEPT Yl< NNW oeW 110 111V „, AS 16 PoRBIDOE THE E D Michael Kaynes 1101 To THE OWNER 04 00446). NYC I Joe # IsEET 1 of 3 ■ fOOO OPTIONS HOOD OPTION 1 OPTIONS ONLY. LEFT SIDESPLASH 8000' High X 413.00' Lora 430 SS OPTIONS ONLY BACKSPLASH - INSIDE CORNER 80.00' Hah X 4.00' Lana 430 SS girl/UST FAN INFORMATION _ FAN UNIT FAN UNIT MODEL M MODEL TAG CFM SP. RPM HP. 0 VILT FLA WEIGHT (LBS.> NO. 1 DU85HFA DU851*A Kane Ex 2750 1.000 1554 0.750 1 115 13.0 94.63 XE. TER/MUA FAN INFORMATION FAN UNIT FAN UNIT MODEL * BLOWER NOISING TAG CFN SP. RPM HP, 0 VOLT FLA WEIGHT (LBS.) NO 2 NSAU1 -G1OD G10D NSAU.1 Kane NUA 1900 0.300 829 0.500 1 US 6.8 17964 FAN _OPTIONS FAN I UNIT OPTION (aty. - Descr.) N6 1 1 - Grease Box 1 - Wollrount 24.25' sq, x 2' 1 1 - Wall Mount Construction for Fan 2 1 - Gravity Backdroft Damper for Size 1 Housing FAN ,4CCFSSOR47S EXHAUST SLPPLY FAN UNIT FAN UNIT TAG • NO' GREASE GRAVITY WALL SIDE GRAVITY MOTORIZED WALL CUP DAMPER MOUNT DISCHARGE DAMPER DAMPER MOUNT 1 Kane Ex YES YES 2 Kane 140A YES YES CUSTOMER APPROVAL TO MANUFACTURE. Approval es Noted ❑ Approved elth ND Exception Token ❑ JOB Kanes Produce Revise end Resubmit ❑ SIGNATURE A=1 se s� � — r.�� - LOCATION Southwick, MA ■■ ` DATE 7/6/2010 JOB # 1176158 ur Yo Title Data ,_■' DWG if 1 DRAWN BY SAC REV. SCALE 1/32 FAN #1 DURSHFA - EXHAUST FAN (KANE EX) WAI L MOUNT BRACKET FFATURE4 WALL MOUNT BRACKET WALL - ROPY MINTED FNGS 18 GAUGE STEEL CONTINUOUSLY • �' 123 L /4' 31 7/D - RESTAURANT ICpp. I �' j - UL705 AND UL702 21 MEM VARIABLE SPEED - RITEMML MING COTR0. UNIT I24 \4 l' '' - WEATHERPROOF DISCOMECT I:LI 1 21 I ` - TNERNG OVER OAD PROTECT= MINGLE PHASE) �. / Ira - NW NEAT OPERATION SOOT aH'C) D% - GREASE 0.AStaIUTOl1 TESTDG \� ' 24 l /4' . . (®SAL T..le.4n.F 7TSr \1 f 30 V2 % _ • - -- _ EXHAUST FAN MUST WRAP I 'I 3/4 ` I WHILE EXHAUSTING AIR AT SOOT nN'G / �� \ill WALL OPENING T)ER ALL FAN PARTS NAVE REAPED TICJT ��' THERMAL EOU AEC! AND VETIWT ANY �-/ RN CENTER CUT DETER[OUATDG EFFECTS TO TIE FAN V14CN r VOWS CAUSE UNSAFE OPERATODL ,I�I, GREASE DRAM - WALL BRACKET FITS INTO BASE OF FAN s�8 n 7car - SELF °PILLING SCREWS SHOULD BE USED sR>. EXHAUST FAN MIST OPERATE CONTINUOUSLY MR UNIT ATTACHMENT TO WALL MOUNT BRACKET 2 Manill......11� AT WHILE DWG= DAND43 wean • DMENSIII • 5' WHEN USED WITH DAMPER 1 / 14 7/N \ u IGNITES VITIOJT THE FAN ECONING ee CENTERED IN WALL NOWT ' ., DAMAGED TO MY EXTENT THAT COULD CAUSE / 17 7/8 \ NI UNSAFE CONDITIDN 35 3/4 Mn ‘ OPTIONS GREASE BOX / 24 �' - \ WALLMOUNT 24.25' SO, X 2' WALL MOUNT CONSTRUCTION FOR FAN DUCTWORK BETWEEN EXHAUST RISER ON HOOD AND FAN (BY OTHERS) X CUSTOMER APPROVAL TO MANUFACTURE ■ Approved es Noted ❑ Approved .Mtn NG Exception Talmo ❑ JOB Kanes Produce Revise end ResUoit ❑ SIGNATURE � � LOCATION Southwick, MA Your nae Hate _ ,mot'. - 1 '� - - -1 DATE 7/6/2010 JOB # 1176158 MM� - •-- DWG i f 1 DRAWN BY SAC REV. SCALE 1/32 FAN k2 NSAU1 -GIOD - SUPPLY FAN (KANE MUA) 1. DIRECT DRIVE SUPPLY UNIT WITH 10' BLOWER IN SIZE *1 HOUSING WITH SPEED CONTROL, DISCONNECT SWITCH. 2. INTAKE HOOD WITH EZ FILTERS 3. SIDE DISCHARGE - AIR FLOW RIGHT -> LEFT 4. GRAVITY BACK DRAFT DAMPER, 16' WIDE X 18' HIGH, STANDARD GALVANIZED CONSTRUCTION, 1 1/4' REAR FLANGE, FOR SIZE 1 UNTEMPERED FAN HOUSING (5181) E1� 26' 57 7/8' 6 3/8' 1/4' 32' —�{ SERVICE DISCR'EC SV1T H — 11 1/2' = �'^ Andtov - 10 1/4 MM. 28' BLOWER _l___ • CUSTOMER APPROVAL TO MANUFACTURE' Approved as Noted [I Approved den PC E' cape ' TaW.n Naval and Resubmit 0 JOB Kanes Produce SIGNATURE AM •_�� MI �� LOCATION Southwick, MA ,: Year Me uDate " i ,j : A DATE 7/6/2010 JOB � /' 1176158 DWG }r 1 I DRAWN BY SAC xrv. SCALE 1/32 .,`' The Commonwealth of Massachusetts • : :-x R-- _ Department of Industrial Accidents a : _ Office of Investigations _ a 600 Washington Street • — w'' Boston, MA 02111 www. mass.gov /dia ? Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information 7� Please Print Legibly Name ( Business /Organization/Individual) :j5 t , a1 �° �• , Address: l 04-1 c di- cL Q . S 7a in : C ( --- City /State /Zip: t C.k, t AJl 5- a 011 Phone #: q((3 57, - D' f �j� 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 employees (full and/or part- time).* have hired the sub - contractors 6. ❑New construction 2.. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling 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 3. ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Ro M repairs insurance required.] t c. 152, §1(4), and we have no S employees. [No workers' 13. Other y s +-( w, comp. insurance required.] I *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. ontractors 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 $1,500.00 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 c under t pains and penalties of perjury that the information provided above is true and correct. J Signature: +01A -0.A Date: 07' ;0 —( 0 Phone #: yi' 3 — 5 ( 9 2 4 V 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 #: . , . Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property to act on my behalf, in all matters relative to work authorized by this building permit application Signature of Owner _____. _ �_ _ _ ..w _ . Date v._. __ ._. . , . ,_. , 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 the pains and penalties of perjury,. Print Name Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 1 Licensed Construction Supervisor Not Applicable El Name of License Holder : _ r �� (fl Q .��� 1 License Number Address Expiration Date &I.4,411-t_ 4112--C4-42-4---" V(3' 5/ 1 a y 0 / 7/10 Signature Telephone 3/ SECTION 13 - WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 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 0 No Version1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name ( Registrant): Registration Number Address_.._. Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): } Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date General Contractor T ur i �� C ,..., �J ren f t,-, ..,.. Not Applicable ❑ Company Name: In Charge of Construction q t b ��. \ 50 , U (ck Address Signature Telephone Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ... _ _.__..._ _,....__.. Frontage ._ Setbacks Front Side L. ..._•. R :. _.._,__ L.._____ R._.._. ____ _ Rear Building Height Bldg. Square Footage „_` .. % Open Space Footage _ _ (Lot area minus bldg & paved_ parking) # of Parking Spaces "' ""a' Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES Q IF YES: enter Book ` Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES ) NO 0 IF YES, describe size, type and location: e 46/5/ #LA`S -s 5 /0 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: 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 Q NO (( IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Version1.7 Commercial Building Permit May 15, 2000 , SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE f Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions L1 Accessory Building ❑ Exterior Alteration 0 Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicabl CONSTRUCTION TYPE A Assembly E / A -1 ❑ A -2 A -3 ❑ 1A 1 ❑ LL; A -4 ❑ A -5 ❑ 1B LE B Business ❑ 2A ❑ E Educational ❑ 2B - r ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: ______ _ _ __ ..._ __. _._._..______._. ____ ___ __.__ ........ .....„ __, . _ ___ S Special Use ❑ Specify: . .. ___ _,__ .. ...,. . ..,.__�.__..., ____. � _ , COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: ._.. ... . ._.__. .,. ___ Proposed Use Group ._......_ Existing Hazard Index 780 CMR 34): _ _ ..„ _...___._ Proposed Hazard Index 780 CMR 34): „_:..._ . __ ., _.. ... __,._._:.._ .... SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) a 1s1 2nd 2 nd 3 ro 3rd______ _.___- . ____._ 4` Total Area (sf) 17do Total Proposed New Construction fsf)_ . Total Height (ft) / Total Height ft 7. Water dppiy (M.G.L. c. 40, § 54) 7.1 Flood ne Information: 7.3 Sewage sposal System: Public Private 0 Zone / „__ Outside Flood ZoneD Municipal On site disposal system D Versionl.7 Commercial Building Permit May 15, 2000 u r y .� $ De artlnent Use € ri ; ai, City of Northampton t o 0 re Building Department ',...„----w---,,,- iu ; - -r . 212 Main Street S ev . _ e ` rait a blli . t . Room 100 i7 ira 4 : . Northampton, MA 01060 T, o S ' tr" c s 44!_-,:!.;:' `� phone 413- 587 -1240 Fax 413- 587 -1272 Plot/St e.Fla " y OthP r Yclfyt. �l k '.� ? t e ii Lam+ e 2 2,, fi . �•Rn r. �. 1 r .ax,i a: \ 4`1r� N4 J ' APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR ObCUPANCY OF, OR DEMOLISH'AN'tBUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office X76 �i,(� . Map Lot Unit ,� ,f 1 L ` /� ' Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: S Signature e 'f( - (ir , . Telephone C,/ / JU /47 g 94,9e 2.2 Authori ed Agent Name (Print) Current Mailing Address A , Signature ,t Ll Telephone [ j L ry Si 9 l P '7 �J f t � (/ u SECTION 3 - ESTIMATE C ONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) _...__ . 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) (� 5. Fire Protection 4 `'', ��r � 'I 6. Total = (1 + 2 + 3 + 4 + 5) � b ` � Check ,Number � Thi4 Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2011 -0057 APPLICANT /CONTACT PERSON BRIAN E DRENEN ADDRESS /PHONE 104 FRED JACKSON RD SOUTHWICK (413) 519 -2640 PROPERTY LOCATION 176 PINE ST MAP 22B PARCEL 041 001 ZONE NB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out f! Fee Paid / 7' l�� ' i Type of Construction: INSTALL COMMERCIAL KITCHEN EXHAUST HOOD SYSTEM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 68985 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF I MATION 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 Permit DPW Storm Water Management Demolition Delay 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. 176 PINE ST BP- 2011 -0057 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 22B - 041 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Non structural interior renovations BUILDING PERMIT Permit # BP-2011-0057 Project # JS- 2010- 000917 Est. Cost: $9800.00 Fee: $70.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BRIAN E DRENEN 68985 Lot Size(sq. ft.): 64904.40 Owner: PUN FAMILY LLC Zoning: NB(100)/ Applicant: BRIAN E DRENEN AT: 176 PINE ST Applicant Address: Phone: Insurance: 104 FRED JACKSON RD (413) 519 - 2640 S O UTHW I CKMA01077 ISSUED ON :1/31/2011 0:00:00 TO PERFORM THE FOLLOWING WORK :INSTALL COMMERCIAL KITCHEN EXHAUST HOOD SYSTEM 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: i /// Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: 0i1:7 _, " ? ; Insulation: Final: Smoke: Final: L/_ 1147 Cis'---- - THIS PERMIT MAY BE REVOKED BY THE CITY OF NO' THAMPTON UPON VIOLATION OF ANY OF ITS RULES AND ' IONS. j 4 A vo t z. Certificate of Occupan i" ° Si. nature: FeeType: Date Paid: Amount: Building 1/31/2011 0:00:00 $70.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner