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32A-145 (8) 26-28 MAIN ST-NORTHAMPTON BP-2020-1064 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 145 CITY OF NORTHAMPTON Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: renovation BUILDING PERMIT Permit# BP-2020-1064 Project# JS-2020-001806 Est.Cost: $414650.00 Fee: $2902.55 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: DAVID A HARDY CONTRACTOR 043898 Lot Size(sc. ft.): Owner: SINGH AMRIK C/O INDIA PALACE RESTAURA Zoning:CB(1001/ Applicant. DAVID A HARDY CONTRACTOR AT. 26 - 28 MAIN ST - NORTHAMPTON Applicant Address: Phone: lizsnraiiee: PO BOX 1468 (413) 527-2655 WC EASTHAMPTONMA01027 ISSUED ON:6/22/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENO &ADDITION OF SINGLE RESIDENTIAL UNIT 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 si�natnre: FeeType: Date Paid: Amount: Building 6/22/2020 0:00:00 $2902.55 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Versionl.7 Commercial Building Permit May 15,2000 Department use only ��--�� City of Northampton Status of Permit: rBuilding Department Curb Cut/Driveway Permit - 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability APR 2 0 2020 Northampton, MA 01060 Two Sets of Structural Plans —phone 413*587-1240 Fax 413-587-1272 Plot/Site Plans i Other Specify 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 T 26 - 28 Main Street, Map :3 /4 Lot ( q J unit Northampton MA, 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Singh Amrik 28 Main St. Northampton, MA 01060 Name(Print) Current Mailing Address: Signature //:r�I/ Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: `l/ 3 5r�7—oZ�S� Signature Telephone SECTION 3 -ESTIMATED CONST ION 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 JI-2) 3 Ob 00 Building Permit Fee 4. Mechanical (HVAC) i 0-'5'0, oUL/Q��,s� 5. Fire Protection /? & oa C19 6. Total=(1 +2+3+4+5) %f`y 65-0 Check Number d?1 � This Section For Official Use Only Building Permit Number Date 2) 19. 100 00 C1 Issued Sign lure: Buil ing Commissioner/Inspector of Buillhings Date t '�l� S62-75&7 Version 1.7 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 ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing F-1 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 applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑✓ 2A ❑ E Educational ❑ 2B I ❑ 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: B & R Proposed Use Group: B & R Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA OFFICE USE ONLY BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(so �45���� ! 7 N� `✓,`7C 1St 1 '7 -I'v 1St 2nd 2nd t J0 '5' 3rd 1 U S 3`d !._....__.. .____� —,"_f— s l 7` 4th V`10 S f 4th 11j & sf- i Total Area (so 7 cj Y � Total Proposed New Construction (so i 0 (7 Total Height(ft) 51 Total Height ft 51 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑i Private ❑ Zone Outside Flood Zoned Municipal E] On site disposal system E] 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 1950 1950 Frontage 26 26 Setbacks Front 0 0 Side L:N/A R:N/A L:N/A R:N/A Rear 0 0 Building Height 51' 51' Bldg.Square Footage 1950 100 °�° 1950 100 Open Space Footage % (Lot area minus bldg&paved 0 0 0 0 parking) #of Parking Spaces 0 0 Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DONT KNOW Q YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW ® YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO IF) DONT KNOW © YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained ® , Date Issued: C. Do any signs exist on the property? YES e NO 0 IF YES, describe size, type and location: FRONT OF BUILDING - PAINTED D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO O 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 O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 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: SIEGFRIED PORTH Not Applicable ❑ Name(Registrant): 6634 SIEGFRIED PORT Registration Number Address 08/31/2020 (413) 529-9434 Expiration Date Sig ure Telephone 9.2 Register 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 cL nn 1J`� i ft .4y,Z,Wy ��� � LLL Not Applicable ❑ Company Name: 04010 0�� Responsible In Charge of Construction t?U, lvox i i-i t, 050 Addr s 5�)-d(C;5-5 Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT r 'm r t L as Owner of the subject property hereby authorize b f-'io h tfK4UY Co llte-,c-t c.4' LLC to act on my b half, in all matters relative to work uthorized by this building permit application. Signature of Owner Date t� I, 0 a U 10 (+ 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 N 7 Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: �J p Not Applicable ❑ Name of License Holder: 1J (0 ,! 1 i ' I ko y a —6 1[3 x� License Number Y ccz) 7foal Ad res Expiration Date bie� �fi3-563 -757 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 No City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 26-28 MAIN ST, NORTHAMPTON MA r The debris will be transported by: �no io The debris will be received by: Oa�T(�y"ch nc Caw IV-ivn Building permit number: Name of Permit Applicant 1�Ul 6 f4 ffW-P-0y Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents �^ I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Corkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aaulicant Information Please Print Legibly Name(Business/Organization/Individual):DAVID A. HARDY, CONTRACTOR, LLC Address: F.O. Box 1468 City/State/Zip: Easthampton, MA 01027 Phone#:413-527-2655 Are you an employer?Check the appropriate box: Type of project(required): 1.�✓ I am a employer with 4 emplovees(full and/or part-time)-* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, Remodeling any capacity.[No workers'comp.insurance required.] ❑ 3.®I am a homeowner doing all work myself[No workers'comp.insurance required.]' 9. Demolition Q4_❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.R Plumbing repairs or additions 5.r7 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repairs These sub-contractors have employees and have workers'comp.insurance.• 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c- 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer t/tat is providing workers'compettsatiott insurance for,tty employees. Below is the policy and job site information. Insurance Company Name: Farm Family Casualty Insurance Company Policy#or Self-ins.Lic.#: 2001W8463 Expiration Date: ��0--7/02/20--20 Job Site Address: din— � V ft l f1 �� City/State/Zip:Nom /;f f��106,0 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce un r thep, 'ns and enalties of perjury that the information provided above is true and correct. Sisinature: �` `/ Date: —� Phone#• 'L/i 6Z2 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#: 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 permiti'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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel.# 617-727-4900 ext. 7406 or 1-877-NIASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia �� i��� � r Farm Family Casualty AMERICAN Insurance Company An American National Company NATIONAL 344 ROUTE 9W I GLENMONT,NY 12077-2910 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE NCCI COMPANY NO. 16721 JOSHUA E NADEAU POLICY NO. 2001W8463 186 NORTHAMPTON ST STE E EFFECTIVE 07/02/2019 EASTHAMPTON MA,01027-1050 TRANSACTION TYPE Renew FEIN# 20-8235541 413-203-5180 IT£M 1.INSURED INSURED AND MAILING ADDRESS: DAVID A HARDY CONTRACTOR LLC PO Box 1468 EASTHAMPTON,MA 01027-5468 THE INSURED IS LLC Workplaces covered by this policy: ST WP NO. ADDRESS OF WORKPLACE RTG.BUR NO. INTRASTATE NO. MA 1 116 PLEASANT ST STE 332 EASTHAMPTON MA ITEM 2.POLICY PERIOD - The policy period is from 07-02-2019 to 07-02-202012:01 A.M.Standard Time at the insured's mailing address. ITEM 3.COVERAGE A. Workers Compensation Insurance:Part One of the policy applies to the Workers Compensation Law of the state listed here: MA B. Employers Liability Insurance:Part Two of the policy applies to work in each state listed in item 3.A.The limits of our liability under Part Two are: Bodily Injury By Accident Bodily Injury By Disease Bodily Injury By Disease $500,000 each accident $500,000 policy limit $500,000 each employee C. Other States Insurance:Part Three of the policy applies to the states,if any,listed here: All states except the states designated in item 3.A.of the information page and ND,OH,WA,and WY D. This policy includes these endorsements and schedules: WCOOOOOlA0319 WCOOOOO000115 WC0003150985 WC0004040484 WC0004140790 WC000422B0115 WC2003010484 WC200302A0908 WC200303D0810 WC2004011190 WC2004030191 WC2004050601 WC200601A0708 WC2006041102 Copyright 1987 National Council on Compensation Insurance PROCESSED 2019-05-28 WC000001A Edition 03-19 2001 W6463 Commonwealth of Massachusetts �. Division of Professional Licensure Board of Buiidirig Regulations and Standards s t CS-043898 6cpires: 1111212021 DAVID-A HARDY 4 COOK ROAD SOUTHAMPTC* MA 01073 , h4..•la/Lj.� Commissioner `�-'- /�� UUU Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.govidpl r , City of Northampton Massachusetts ��:• �- ' << DEPARDIENT OF BUILDING INSPECTIONS �'• 212 Main Street • Municipal Building yvs•., �.D Northampton, MA 01060 Ss67q 'y j<�O INSPECTOR Louis Hasbrouck Fax: 413-587-1272 Chuck Miller Building Commissioner Phone: 413-587-1240 Assistant Commissioner CONSTRUCTION CONTROL DOCUMENT (For professional Engineers/Architects responsible for Entire Project) Project Title: India Palace-Renovation&Addition Date: 02-25-2020 Project Location: 26-28 Main Street,Northampton,MA 01060 Map: 32A Parcel:145 Zone: Scope of Project: Renovation&addition of a single(2)bedroom residential unit. In accordance with the Eighth edition Massachusetts State Building Code, 780 CMR Section 107.6: Siegfried Porth Mass. Registration # 6634 Being a registered professional Engineer/Architect hereby CERTIFIES that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: pc] ENTIRE PROJECT For the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 10.7.6.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed In a matter consistent with the construction documents. I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent comments. Upon completion of the work, I shall submit to the building official a final report as to the satisfactory completion and readiness of the project for occupancy. O\�1 SRED,qq �FRIED,o c'SiJ Signat a and Seal Regis Professional Q��� 0 �n CD No.6634 NORT �PION, Day of N1IZCV-(� 202 F o qt ly Of M NSSAG� q H C FINISH FLOOR Lu TBD BY OWNER 3/4"T&G SUBFLOOR (� (GLUED) Q ��a � 1-3/4"X 11-718"LVL FLOOR JOISTS �4 (FIRE CUT ENDS PER DETAIL 4 ON A-103) �\ M \ \ _� ACOUSTICAL INSULATION �� �� o „�a-a FIBERGLASS OR MINERAL WOOL(FILL CAVITY) \ \ A E co r o x 1/2"RESILIENT CHANNEL Q w (2)LAYERS 5/8"TYPE C FIRECORE GYPSUM CEILING � � A� �� LL- (� z > 0 F- W > o v) s a z Lu o Lu N0 u- NOTES: ALL PENETRATIONS TO BE SEALED WITH FIRE CAULKING OR APPROVED SEALANT W m = < FIRE CAULKING AT PERIMETER OF CEILING N o z Q o FLOORICEILING ASSEMBLY SHALL HAVE A MINIMUM STC RATING OF 50. a- o FIRE BLOCKING AT 10'-0"O.C. VED ��. WO BY; ATA CAM 617E 06-19-2020 C' N 604 ; N9R APA ' DRAWING N0. tlF �' SK-1. 1-HR RATED FLOOR_/ CEILING ASSEMBLY SK-01 (BETWEEN EXISTING DWELLING UNIT AND NEW DWELLING UNIT)