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18D-055 (3) r PUBLIC WAY 1 (�' E T MECH EXIT LAV 1 LAV I LAV STORAGE /OFFICE SHELVES - 11 cw L - MECH o 1 (24' -4 ") , " -- (23' -4 ") . I. 4 1/2" " -� RELOCATE OUTLET VACANT STOREFRONT M TO BE ADDED TO N en STORE EXISTING CURVES EXISTING CURVES STORE 1 THIS WALL MAY HAVE ACOUSTIC TREA MENT 1. ADD ONE LAYER 1/2" GYPSUM WALLS ARD 2. ADD SURFACE LAYER ACOUSTIC ABSORPTION BOA (MAY DO 1 OR 2 OR BOTH) ALL NEW FINISHES CLASS C FLAME SP AD OPEN THREE NEW 6'x7' OPENINGS / (MAY BE GYPSUM RETURN WITH CORNER BED OR TRIMMED) / RECEPTION ., MAIN ENTRY SIDEWALK PARKING, f tv_elikEY 8. Fyn 8 No. 9525 FIRST I , H toNG7bN CURVES BUSINESS / �� G NORTHAMPTON, D MA RENOVATION DOCUMENTS ARE FLOOR PLAN 4. • _�' SCALE 1 JUN PR E 7 5230 DURATION D M SCOPE U O N A l li / DATE - 21 JUNE; 11 TEL413S675230,AND MAY BE USED ONLY FOR TEE I ARCHITECT J E F F R E Y S C O T T P E N N 77 Worthington Road, Huntington, MA 01050 tel. 413- 667 -5230 fax. 413- 667 -3082 hpsed vverizon.net Proposed Expansion Curves 141 Damon Road Northampton, MA J 21 June 2011 Louis Hasbrouck, Building Commissioner Northampton City Hall 212 Main Street Northampton, MA 01060 Mr. Hasbrouck: I have walked thru the Curves franchise on Damon Road and the adjacent space and find the space and the adjacent space suitable for combining into one large Curves. The retail building (use group B) was constructed for this purpose and maintains many safety features including proper Exit locations and signage, proper battery- backup emergency egress lighting, and proper Accessible features. The building is CMU exterior and wood framed separation walls (type III B construction). The non - structural wall separating the spaces will be opened by installation of three 6 foot wide openings. One other alteration is being considered which is to address sound attenuation to the left adjacent tenant. My recommendation is to add one layer 1 /2" Gypsum wallboard (for sound transfer deadening) and/or one layer acoustical board (for in space sound absorption) and relocate any features properly. The surface treatment for any finish materials shall meet class C fire spread (class A at Exit enclosure and passage). This work proposed is of a non - structural and minor nature, and will not diminish the health or safety of the public. This work will not require construction control. Sincerely , Jeffrey Scott Penn 4( 4/ OF PySP A CERTIFICATE OF LIABILITY INSURANCE 5/25/20 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jeanne Deneault CISR NAME: i Blackmer Insurance Agency Inc. (A//C No. Ext): (413) 625 -6527 FAX No): (413)625 -8210 1147 Mohawk Trail ga ss jeanne@blackmers.com PRODUCER 00001781 CUSTOMER ID #: Shelburne MA 01370 -9707 INSURER(S) AFFORDING COVERAGE NAIC INSURED INSURER A :NGM 14788 INSURER B : Thomas P. Kehoe INSURER C : 34 Severance Street INSURERD: INSURER E : Shelburne Falls MA 01370 INSURER F: COVERAGES CERTIFICATE NUMBER:Master 10 /11 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1N ADDL TR TYPE OF INSURANCE N W SR S VD POLICY NUMBER POLICY EFF POLICY EXP L LIMITS (MM /DD/YYYY) (MM /DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 5O 000 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ A CLAIMS -MADE OCCUR MSP9074B 6/1/2010 6/1/2011 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY PRO LOC $ IFf:T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON -OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Operations usual to a residential contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bonnie Cueman ACCORDANCE WITH THE POLICY PROVISIONS. 28 Fifth Avenue Northampton, MA 01060 AUTHORIZED REPRESENTATIVE J Deneault, CISR /BLAJ '' ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD I ne',ulumouweattu 01 lvlassacuusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): _ , I r _ iI _ ♦ t .. . . . ar ... Address: 3 if c it/o,w: E S i ,, City /State /Zip: 4l- &27 (4CCs ma Phone #: W3. <,?.? - ? ( Fe( Are you an employer? Check the appropriate box: Type of project (required): 1. — I am an employer with 4. — I am a general contractor and I 6. -- New Construction 2. l mployees (full and /or part- time)* have hired the sub contractors am a sole proprietor or partner listed on the attached sheet. I 7. pc-Remodeling Ship and have no employees These sub - contractors have 8. — Demolition Working for me in any capacity. workers' comp. insurance. 9. . Building Addition [No workers' comp. insurance 5. — We are a corporation and its 10. — Electrical repairs or additions required.] officers have exercised their 3. — I am a homeowner doing all work right of exemption per MGL 11. Plumbing repairs or additions myself. [No workers' comp. C. 152, ' 1(4), and we have no 12. — Roof repairs insurance required.] H employees. [No workers' 13. — Other comp. insurance required.1 * Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. H Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. I Contractors that check this box must attach an additional sheet showing the name of the sub - contractors and their workers' 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: For all FCCIP towns 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 certify under the pains and penalties of perjury that the information provided above is true and correct Signature: I. ..,, c _L Date: s //7 /l Phone #: ` / i ' 3 - ,5Q2C2 - 7 FP Official use only. Do not write in this area, to be completed by city of 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 #: 5 . . 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 1 I , C hctrc.1 it e_ , as Owner of the subject property hereby authorize Me 1 ( - ' �Q- to act o • vriehalf, in all matters rel • e to work authorized by this building permit application. e.,4b IA- i-/ S'e nature of Owner D ate I, M ((,"Th (_, d lam- - , 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 und the pains and of p rjury. u t 6 Print Nam - / I Signature of swner /Agent Da e SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ i.h j,4 Name of License Holder : / S KK/In1- y 7 ! 1 7 License Number S Aol io0 /.7 o r l Address /; Expiration Dath `(- .. ¢ Wit._, t / /' ,i 2 - 77 F / 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 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 — l.z - /1 4 -3/A Q • 14 !-/ 4.4„ic 9t45OgLtx(C -t l'c�N.�i �Icll�roN( Not Applicable ❑ Company Name: s int4 As Ki E Responsible In Charge of Construction 7� t /t. ; F( ,k S% Si- Ta t %r . c 4 CA 0 Addr ss , 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 l I w Setbacks Front Side L: R: L: R: Rear Building Height j Bldg. Square Footage 1 Q `MO Open Space Footage % (Lot area minus bldg & paved 2 r Q/ El 0 parking) J I 1 D # of Parking Spaces 5 C) Fill: (volume & Location) A. Has . Special Permit /Variance /Finding ever been issued for /on the site? NO 4„:4 DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW C YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO IV DON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES ■ NO Q IF YES, describe size, type and location: ` re nan c r i - S D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, ex - vation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 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 Er Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Enter a brief description here. Brief Description ( Of Proposed Work: 0 f)Xnt(1c1 d€-m1sinc tl 1, ui +-1 CkofL CNS A 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 A. 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 L ❑ 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: d. 6 Proposed Use Group: G' e , 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 3rd 3 rd 4 4 Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water upply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewa a Disposal System: Public Private ❑ Zone Outside Flood ZoneD Municipal On site disposal system❑ Versionl.7 Commercial Building Permit May 15, 2000 Department use only City of Northampton Status of Permit: RECE V _ ! : uilding Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability - , 2011 Room 100 Water/Well Availability hampton, MA 01060 Two Sets of Structural Plans _ . v87 -1240 Fax 413 - 587 -1272 Plot/Site Plans .�,• ��• 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 .. s: n </ I l ' -.Jarn° n Rocka Cs- Map / 1/ 17 Lot S7 Unit N a c -0 c&m p +on , M V't U 1Oto Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: Po ) K �i kctnpfon , iY1A• Signature Telephone 1 1 ( 5(4%9 1 5FrO 2.2 Authorized Agent: ? 9 S f= 6/6 Z at-(C - Name (Print) Current Mailing Address: �� C� ( ?0 Signature - t-e-'L Telephone (- 1 1 3 - 5,2.2 - 77 c SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item ; 0fl� 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 6. Total = (1 + 2 + 3 + 4 + 5) 1 5D • c'hx Check Number 3/ _ 1r 0 — This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date C KA File # BP- 2011 -0990 I_ V ' APPLICANT /CONTACT PERSON THOMAS KEHOE I ¶� r A F1 ADDRESS/PHONE 34 SEVERENCE ST SHELBURNE FALLS (413) 522 -7981 (� PROPERTY LOCATION 141 DAMON RD - UNIT G / 1 0 MAP 18D PARCEL 055 001 ZONE GB(100)/URA/ i E c (_ toRr THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ° ENCLOSED REQUIRED DATE aa � LE ZONING FORM FILLED OUT I Fee Paid { i Building Permit Filled out �j 05-0 �l� l Fee Paid llid . ✓ Typeof Construction: OPEN DEMISING WALL W /DOORWAY TO EXPAND CURVES ,��V- New Construction V Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 77597 3 sets of Plans / Plot Plan o THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON (2:1( INFORMATION PRESENTED: 6 (/ 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 } 6P- 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. 141 DAMON RD - UNIT G BP- 2011 -0990 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D - 055 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-2011-0990 Project# JS- 2011 - 001616 Est. Cost: $2500.00 Fee: $60.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS KEHOE 77597 Lot Size(sq. ft.): 131551.20 Owner: BOYLE RICHARD R Zoning: GB(100)/URA/ Applicant: THOMAS KEHOE AT: 141 DAMON RD - UNIT G Applicant Address: Phone: Insurance: 34 SEVERENCE ST (413) 522 -7981 SHELBURNE FALLSMA01370ISSUED ON:6/22/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:OPEN DEMISING WALL W /DOORWAY TO EXPAND CURVES 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 6/22/2011 0:00:00 $60.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner