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32A-097 (3) ( (\/ iN V7A. . Northampton Fire Department Memorandum To: Louis Hasbrouck From: Duane Nichols Date: August 30, 2010 CC: Brian Duggan, Larry Therrien Re: 1 Market St. Northampton Secondary to a review of the plans submitted to me for review, I concur with the issuance of a building permit subject to the following conditions: • Fire alarm work permits shall be obtained for the project. The CIO inspection fee needs to be paid prior to approval of any fire alarm plan. • The Fire Alarm Control Panel and Fire Alarm Annunciator must be labeled with red engraved signage with one -inch white lettering "Fire Alarm Control Panel" and /or "Fire Alarm Annunciator". Also engraved signage listing all fire alarm zone locations installed near panels. • A graphic representation of the structure must be installed at the Fire Alarm Control Panel (FACP) and /or Fire Alarm Annunciator and /or Communicator. • Pull Stations shall be double action type located by the exits. • Engraved key tags are required for the keys in Emergency Access Key Box. • Page 1 August 18, 2010 { Emergency light only units in Toilets & @ mid point of basement & 1 floor level Fire extinguishers @ three 1 floor exits & bottom of basement stairs 24 hour monitoring by UL Listed Central Station; reporting will be noted as _Bridge St, 1st Floor., * One Hour Fire Separation between adjacent spaces & residential areas above *Street number to be assigned by Post Office • Page 2 Pioneer Contractors Pi Con, Inc. Fire Narrative P.O Box 1145 Northampton, MA. 01061 Voice 413 - 586 -5491 Fax 413 - 527 -5099 E -mail pioneercontracvahoo.com Cell 413.626.7267 To: Louis Hasbrouck, Commissioner From: David Claxton Northampton Building Department Fax: 413- 587 -1272 Pages: 2 Phone: 413- 587 -1240 Date: 8/18/2010 Re: 1 Market St., Northampton CC: ❑ Urgent X For Review ❑ Please Comment ❑ Please Reply 0 Please Recycle • Comments: Following our meeting today w /Assistant Chief Duane Nichols & Capt. Larry Therrien of the Northampton Fire Dept., the above building will comply w /current NFPA code requirements & meet NFD guidelines as follows: Fire Detection /Notification -A new zoned fire detection system w /fire alarm control panel (FACP) to be located @ the existing stair to basement. A remote annunciator to be located inside the Bridge St. entrance visible from street Beacon & relocated Knox box to be @ Bridge St. entrance Pull station devices to be located @ all three (3) 1 floor exits Horn /strobe notification in basement & 1 floor levels of new cafe space Strobe only notification in new handicap accessible toilets Horn /strobe notification on 2 & 3 floor hallways of residential areas @ 82 db Smoke detection in basement & 1 floor per plan; heat detection in service /bakery area Carbon Monoxide detector to be located in basement adjacent to water heaters; activation to signal trouble only Exit/emergency light units w /battery backup @ all 1 floor exits & @ bottom of ea. basement stair tNtrF %` 3 d , assxcliusctts' = fi r . t DEPARTMENT OF BUILDIT(G INSPECTIONS �'_ • 212 Main Street * Municipal Building , Northampton, Mass. 01060 ttttttr" WORKER'S COMPENSATION INSURANCE AEFIDAVTT I, Pioneer Contractors (licenseeJperzni flee) with a principal place of business/residence at: • P.O. Box 1145 Nnrthamptorl, MA 01061 (phone«) 586 5491 (str .deity /statezip) do hereby certify, under the pains and penalties of perjury, that: ( /I am an employer providing the following worker's compensation coverage for my employees working on this job: • Wcc 500595701 200ci aa AL Assnri ated F.nlgl ns ---___ ( I.nsurance Co rapa.ny) (Polic)/ Number) (Expiration Date) ,. ( ) 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Dale) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (mach additional abaci ifneomttary to mctudc infomnation paGa.iniug to all 000trnctara) ( ) 1 am a sole proprietor and have no one working for me. ( ) X am a home owner performing all the work myself NOTE: please bc acnrc that wtrile homeowners who employ pasoac to do maistexiance, coasCUCtioo or repair work on a dwelling of not more than three, units in which the bomoowna rotten roc as the grounds appurtenant thereto arc act generally considered to bc employers under tbo worker's oompea satioa Act (01.152,m 1(5)), application by a botaxovencx for a berme or permit may a1(% ax the I egar status of an employer under thb Woricc F Conspcoaslioo. Act. 1 understand the a Dopy of this nal emm¢ may bo fo wanted to the Depart:rocas of lodustrie l Aoci4.eat ? OfSoo of rmurwoo for tbo coverage vcriftztion sad that failure to rccauc covcrag, trader sec Lion 25A of MOL 152 can lcad to t.hc imposition of criminal Pcnaltia consisting' of a fine of up to S1,500.00 and/or isupaisoemctit of up to ooc year and civil penalties in the farm of a Stop Work Ocdc and a files of 5100.00 a day against mc. /lf, t For dcputtn l tun o nly Permit Number 7A Ai 1 J 2 .Ot0 Maps I.,ol Si.a tore of Lta i sce/Pcrmi . • e • Version1.7 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 :r SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Paul Brown/Adam Dunetz , as Owner of the subject property Pioneer Contractors hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. 07/29/2010 Signature of Owner Ar Ap Date David Claxton/Pioneer Contractors , 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 penalti f ry. David Claxton "V Print Name 07/29/2010 Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ David A. Claxton 17890 Name of License Holder ...... _ .. , .. ! _ .. License Number P.O. Box 1145 Northampton, MA. 01061 01/19/2012 Address Expiration Date (413) 586 -5491 Signature Telephone 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 C) 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 9.3 General Contractor Pioneer Contractors Not Applicable ❑ Company Name: David Claxton Responsible In Charge of Construction P.O. Box 1145 Northampton, MA. 01061 Address (413) 586 -5491 Signature Telephone Version1.7 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: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES IF YES: enter Book Page and /or Document # Does the site contain a brook, body of water or wetlands? NO C) DON'T KNOW 0 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 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 C) 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 (J NO c) IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl .7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs 12 Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing I:1 Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Construction of new handicapped accessible toilets, interior ramp Of Proposed Work: '' connecting existing floor levels, interior partitions etc. SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 IS 1A 1 ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A 0 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: Business Proposed Use Group: A -3 Restaurant 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) 1st. _ . �_ . ,,,� .. _ 1 st 2 nd 2 nd 3 rd , 3rd 4m 4 Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public p Private 0 Zone Outside Flood Zone p Municipal p On site disposal system ❑ Version1.7 Commercial Building Permit May 15, 2000 Department use only City of Northampton Status of Perm)lt: Building Department Curb Cut/Driveway Permit 212 Main Street SewerlSeptic "Avaitab ility Room 100 Watert ekt Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY QF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING '..__ SECTION 1 - SITE INFORMATION AUG 1 9 2010 1.1 Property Address: This section to be completed by office 1 Market St. Map Lot .s Unit Zone Overlay District EIm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Paul Brown/Adam Dunetz (Tenant) 1 Market St., Northampton, MA. 01060 Name (Print) Current Mailing Address: (413) 535-9885 Signature Telephone 2.2 Authorized Agent: Pioneer Contractors P.O. Box 1145 Northampton, MA. 01061 Name (Print) Current Mailing Address: (413) 586 -5491 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $44,350.00 (a) Building Permit Fee 2. Electrical $13,300.00' (b) Estimated Total Cost of Construct from (6) 3. Plumbing $$,840.00' Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection $7,100 6. Total = (1 + 2 + 3 + 4 + 5) - 731 �) d Check Number / ' ( 4 This Section For Official Use Only Building Permit Number Date Issued Signature: Date Building Commissioner /Inspector of Buildings T � File # BP- 2011 -0137 APPLICANT /CONTACT PERSON PIONEER CONTRACTORS ADDRESS /PHONE PO Box 1145 NORTHAMPTON (413) 586 -5491 PROPERTY LOCATION 1 MARKET ST MAP 32A PARCEL 097 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out % ' , di Fee Paid /SD / 5/44 Typeof Construction: Interior Reno for Cafe New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 017890 3 sets of Plans / Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF • '. ATION PRESENTED: o • a ved 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 //ib 6/410 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. cET sT > BP- 2011 -0137 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A - 097 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP- 2011 -0137 Project # JS- 2011- 000190 Est. Cost: $73590.00 Fee: $444.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PIONEER CONTRACTORS 017890 Lot Size(sq. ft.): 3876.84 Owner: BROWN E PAUL TRUSTEE Zoning: CB(100)/ Applicant: PIONEER CONTRACTORS AT: 1 MARKET ST Applicant Address: Phone: Insurance: PO Box 1145 (413) 586 -5491 Workers Compensation NORTHAMPTONMAO1061 ISSUED ON:8/31/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: Interior Reno for Cafe 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 8/31/2010 0:00:00 $444.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner Page 2 of 3 11. ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. 12. This column to be filled in by the Building Department. Existing Proposed Required by Zoning Lot Size Frontage Front: Setbacks: Side: L: R: L: R: Rear: Building Height Bldg Square Footage % Open Space: (Lot area minus bldg and Paved parking) # of Parking Spaces # of Loading Docks Fill: (volume & location) 13. Certification: 1 hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: APPLICANT'S SIGNATURE NOTE: Issuance of a zoning permit does not relieve an applicants burden to comply with all zoning Requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. FILE # Page 3 of 3 6 Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION Rio No. ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION TI 11/V_ (tAf O 1 1. Name of Applicant: e ��' t e Address: \ / `PA k- 9 it-C Telephone: S ' - 26 2. Owner of Property: Pik \A 1 � � ,p * P c_ t Address: t -f A t' c iG t 111/4 t " Telephone: 4t3 — = '"" J!t. e ?q 3. Status of Applicant: _Owner Contract Purchaser Lessee _Other(explain): 4. Job Location: 11 1 4 AC., - SA \e,t'k Parcel ID: Zoning Map # Parcel # District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: L./ At 6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary) 4 7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans LE u 8. Has a Special PermitNarian 1e /Finding ever been issued for /on the site? NO DON'T KNOW , YES IF YES, date issued: IF YES: Was the permit recor d at the Registry of Deeds? NO DON'T KNOW t YES IF YES: Enter: Book Page and /or Docu nt # 9. Does the site contain a brook, body of water or wetlands? NO ` DON'T KNOW YES IF YES: Has a permit been, or need to be, obtained from the Conservation Commission? Needs to be obtained Obtained , Date issued 10. Do any signs exist on the property? YES NO IF YES: Describe the size, type and location: r r r Are there any proposed changes to, or additions of, signs intended for the property? YES NO IF YES: Describe the size, type and location: % ( ? ,\ C (-), II 1611 *0 11 rCM1 k i oQ �H ne o , ccit a Marti Ituntrtan ggggpp �iFIzsari11$PttB h t C \ � ( ''�. m: .# N : @@ B f '3d 2, f, 1 i ,� t Z DEPARTMENT OF BUILDING INSPECTIONS �� b u #' 212 Main Street • Municipal Building � v ` "' ,° Northampton, MA 01060 (NspEcTOR Application for a Permit to Place or Maintain a Sign °clop"":°. • - �" Or other Advertising Device, or Marquee ,fit„ - J (Application to be filled out in ink or typewritten) Number Plans must be filed with the Building Inspector Erection ( ) before apermit will be granted. Alteration ( ) Repair ( ) Repainting ( ) Removal ( ) FEE PAGE PLOT Northampton, Mass. 20.1 /. To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME ..........T \.4' ../t?► {1 1. Location, Street and No. 1 11/ G' 2. Owner's name 44014/\ Ous\ 7_, 3. Owner's address SA ' ' e C.` 4. Maker's name I4',��` �. i Z(v�f71� � ,- ) +�' V cri, qs ( . t�. 'A � c . 5. Maker's address " 11 / \k � f,\ AIL 5 — ∎ :: / 9:) ..v..... � � Q Ai\ ti -1I r ) 6. Erector's name L, l r ' .i,' : vr, .X '1,,,.1°!'l 7. Erector's address ° ` -- Zk ( \ i- ' C C$ [ SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ' Non-illurRihated 2. Will sign obstruct a fir,g escape, window or door? iv d Marquee 3. Lower edge will be ....ft .... 'tins above the public way. Projecting 4. Upper edge will be .. j.t.ft...iu ..ins above the public way. Roof 445/VII j 5. Height ..:�j .ft. t...ins Width I ft ins Temporary 6. Face area .3..sq. ft. Wall / 7. Inner edge will be ins from the building or pole. Ground 8. Outer edge will be ins from the building or pole. L. Other 9. Face of building or pole is ins back from the street line. S) J ill*. 10. Sign will project ins beyond the street line. 11. Sign will extend ft ins above the building or p I . t t ` `,'` 12. Of what material will sign be constructed? Frame ....V1'ui Face...3\ ........... �, M� 13. Estimated cost $ 4 3..0.00. 'Q ' J The undersigned certifies that the above statements are true to the best of his knowledge and belief. (zit-A/ (Signature of Owner or Agent) File # BP- 2011 -0827 APPLICANT /CONTACT PERSON DMETZ ADAM ADDRESS /PHONE 1 MARKET ST NORTHAMPTON (413) 587 -2625 0 PROPERTY LOCATION 1 MARKET ST MAP 32A PARCEL 097 001 ZONE CB(100)/ 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: ERECT ILLUM SIDE WALL SIGN - THE ROOST New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 (> /p4-4_,K ) 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. File # BP- 2011 -0826 APPLICANT /CONTACT PERSON DMETZ ADAM ADDRESS/PHONE 1 MARKET ST NORTHAMPTON (413) 587 -2625 0 PROPERTY LOCATION 1 MARKET ST MAP 32A PARCEL 097 001 ZONE CB(100)/ 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: ERECT ILLUM FRONT WALL SIGN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN,FOOIATION PRESENTED: L./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 1/ 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. -_ . /e a. F3 thvt (r x I £ f x t 1 aIII�I QIT p = * 0 11 T I Tasaachttsctlii • DEPARTMENT OF BUILDING INSPECTIONS 4 • 212 Main Street Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFI+I_DAVTT I, Pioneer Contractors (licensedpermittee) with a principal place of business/residence at: P.O. • _ $ox 1145 Northampton, MA 01061 (phone 586 5491 (str Ucity /stare do hereby certify, under the pains and penalties of perjuy, that: (VII am an employer providing the following worker's compensation coverage for my employees worming on this job: • Wcc 5005957012000 Assnr• Fmployer.-s_-Insurance Co ---- 6/30/1'L (Insurance: Company) (Policy Number) (Expiration Date) ( ) 1 am a sole proprietor, general conuactor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) sr (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company /Policy Nu zibe.r) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Wash sdditioosl -beet to Mehl& information pertaining' to all co dractors) ( ) 1 am a sole proprietor and have no one working for me. ( ) lam a home owner performing all the work myself. • NOTE: plc be atrarc that while homeowners who employ persons to do maitrtrnsnct, suction or repair work oa s dwelling of not mote than throe units in which the homeowner resides oc on the grounds appttrtenaat thereto arc not g-enerally considered to be employers under the worker's cemp aasation Act (GL15ass 1(5)), application by a homeowner for a license oc permit may evidence the legs!' &tams of an employer under tho Worker's Compomation Act. 1 understand that a Dopy of this rutcmcat may be foawarded to the Department of Industrial Aeadeass' Offioo of Insurance for the coverage vcriicAioa ao4 that failure to accurc covcragv under section 25A of MOL 152 can lead to the imposition of criminal posalt cs oomisting of a fuse of up to S 1,500.00 rnd/oc in>pxisoamxzit of up to one your and civil patuttics is the form of a Stop Work Otdc and a Sac 0(5 100.00 a day against aYX I r For et l use only Pcrmit Number '. if J'""� p S �It7 Maps ___—____ Lo1 # Si.s t of LioensC .i e/perm - e >_ _ 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 Paul Brown/Adam Dunetz I, as Owner of the subject property Pioneer Contractors hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. 07/29/2010 Signature of Owner Date David Claxton/Pioneer Contractors , 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. David Claxton Print Name 07/29/2010 „„, • Signature of 0 J r gent ���ftt ��� Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ David A. Claxton 17890 Name of License Holder • . License Number P.O. Box 1145 Northampton, MA. 01061 01/19/2012 Address Expiration Date (413) 586 -5491 Signat e Telephone 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 Versionl.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 9.3 General Contractor Pioneer Contractors Not Applicable ❑ Company Name: David Claxton Responsible In Charge of Construction P.O. Box 1145 Northampton, MA. 01061 Address /?� (413) 586 -5491 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 Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 0 YES IF YES: enter Book Page. and /or Document #' B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained ,Date Issued: C. Do any signs exist on the property? YES NO 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: !' 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 Interior Alterations ❑ Existing Wall Signs p Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Remval of non -load bearing partitions, ceilings & flooring etc. Of Proposed Work: SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 IN 1A 1 ❑ A -4 ❑ A -5 ❑ 1B ❑ - B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A El 1 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 I ❑ 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: Business Proposed Use Group: A -3 Restaurant Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTIONS BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1 1 s 2 nd . 2 3r 3 r d 4 4 Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone., Information: 7.3 Sewage Disposal System: Public is Private ❑ Zone Outside Flood Zone p Municipal p On site disposal system❑ Version1.7 Commercial Building Permit May 15, 2000 City of Northampton Status of Perm ` Ft5 Building Department Curb CutIOrive i 212 Main Street Sewerlseptic4 t1 ' I ty l Room 100 V\faterJVftell Av i ,.. ' ' i 0 . 1' Northampton, MA 01060 Two Sets of St ctur -Plans phone 413 -587 -1240 Fax 413 -587 -1272 ?lotISite Plans- o or 1 ;f~ , r APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 1 Market St. Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: - `''� F Paul Brown /Adam Dunetz (Tenant) 1 tiA r ` b M Name (Print) '' Current Mailing Address: D I Dim Signature 1 Telephone 2.2 Authori ent: `Pioneer Contractors P.O. Box 1145 Northampton, MA. 01061 Name (Print) Current Mailing Address: (413) 586 -5491 Signature V4 Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $5,000.00 (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 6. Total = (1 + 2 + 3 + 4 + 5) $ � n9'' Ch eck Number 1 — 1 �� 5 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2011 -0106 APPLICANT /CONTACT PERSON PIONEER CONTRACTORS ADDRESS/PHONE PO Box 1145 NORTHAMPTON (413) 586 -5491 PROPERTY LOCATION 1 MARKET ST MAP 32A PARCEL 097 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid mg Permit Fi e 4 * Fee �� t 56.0-0 Typeof Construction: Interior Reno for Cafe New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 /1"---21j 110 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. _. _ r : ST ' TM BP- 2011 -0106 GIs #: COMMONWEALTH OF MASSACHUSETTS 732A - 091 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- 2011 -0106 Project # JS- 2011- 000190 Est. Cost: $5000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PIONEER CONTRACTORS_ Lot Size(sq. ft.): 3876.84 Owner: BROWN E PAUL TRUSTEE Zoning: CB(100)/ Applicant: PIONEER CONTRACTORS AT: 1 MARKET ST Applicant Address: Phone: Insurance: PO Box 1145 (413) 586 -5491 NORTHAMPTONMA01061 ISSUED ON :8/17/2010 0:00 :00 TO PERFORM THE FOLLOWING WORK:Interior Reno for Cafe 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 8/17/2010 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner