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31B-254 (4) I .. ,.. f i 1 1 . i . . ■ ; . _. 1 .. 1 I . . . | . ' ^' � ' � window � � � — � D. � . . / Fume��/aus� ' � | s :\?),) � S�uU)uxhxvsJ - -.��' ' // ^ \_ / ,'\\ /`' / \ _ ; \:- O V ' / y � � 30" C/ -`— � i | | V . \ » / ` Ash pit \_/'^ | . Thu ash phcnuNbo�cu�d � � t ' . in any A.8.(�o/D locations. ~`` � 4�_. • c*~ .., --_ .._--- i�' ^~�/ ' �F.'~`'_�� '�__ �.>� �~^ - . � � Data for fumes exhaust ( ' do cioor ` oven ' \ Ash pit / V \ / ,:-_,:-/,,, ' �u , Nolo: Both exhausts should bo 36" above iho roof, 36" away from tho highest ;1111101Inding MIO und covered with vmu(ho/cap. / i -« - --� ���-----�- o A |„),,,..„ � u u 9 � �� I MIL _^.~ e | - |[[ r (^� --- / / /] 6 / | [ � / | I ^^ / i -sic-) . k2 | ' | / / ( ' , | | l V ■ , 11 ____l — :).( T -41 -� �� '1(7 /\3'hphf .511.e5 for L oven To ba1o«orec,l /1.!--3 left . :okmd|ngvinjow. I �� _--' ' - - [ l| - '\/'ilQ V��1(���| / m -�' - � � -' wheel U[ / 7------'-!------�-~--- / — �- ! 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' / (:,\I ) \ / / `v `. / \`~ / \` , / \ / \‘‘,.. ' / �_. -_- CO � • " N (ki ' �� m — : __ i ./ |ry |v» 1 m __'/ _/ / __ VII - Structural Design AERCON Lintels Allowable Superimposed Uniform Loads (plf) Thickness = 8 inches Min Bearing = 8 in at each end Overall Length Max. Opening Length 8" high 12" high 16" high 24" high 4 ft 8 in 56 in 3 ft 4in 840 1355 1965 3835 5 ft 4in 64 in 4 ft 0 in 675 1060 1550 2605 6 ft 0 in 72 in 4 ft 8 in 550 840 1245 1965 7 ft 4in 88 in 6 ft 0 in 385 570 955 1165 8 ft 0 in 96 in 6 ft 8 in 335 480 850 935 9 ft 4in 112 in 8 ft 0 in 255 360 620 1350 11 ft 4in 136 in 10 ft Oin 185 245 415 1015 13 ft 4in 160 in 12 ft O in NR 175 300 805 15 ft 4in 184 in 14 ft Oin NR 135 220 595 17 ft 4in 208 in 16 ft O in NR 100 165 445 19 ft 4in 232 in 18 ft O in NR 75 130 340 NOTES: 1. For lengths not listed, use the allowable load for the next longer length listed. 2. Specify lintels as follows: ttxhhxddd where: tt = thickness in inches (08) hh = height in inches (08, 12, 16, or 24) ddd = overall length in inches (see table above) 3. NR indicates Not Rated 4. When concentrated loads are to be supported, contact AERCON Technical Services for assistance. 5. Self- weight of lintels can be calculated using 42 pcf. 6. Allowable Superimposed Uniform Loads are provided in pounds per linear foot. length ER_ N height A- thicknes s 06/03 / VII -38 VII - Structural Design EXAMPLE: An unreinforced, nominal 8" thick AERCON block wall, Strength ClassAC4, eight feet high, is subjected to an axial load at the top of the wall at an eccentricity of one inch. Determine the maximum axial load, at the one inch of eccentricity, that the wall can carry in pounds per linear foot. Reference the Overview Section for compressive strength, allowable flexural tensile stress, design dead weight and actual thickness. Wall height (h) = 8' - 0 ", including bond beam height of 8 in Superimposed load eccentricity (e) = 1 in Wall thickness (b) = 8 in nominal (actual = 7.874 in) with a design dead weight of 37 pcf Wall area per foot of Length (A) = 7.874 in x 12 in = 94.5 in2 per ft Wall section modulus per foot of length (S) = (7.874 in) x 12 in = 124 in3 per ft 6 Wall moment of inertia per foot of length = (7.874 in) x 12 in = 488 in' per ft 12 Radius of gyration (r)= ( 488 in" / 94.5 in' ) -2.273 in Bond beam dead load = 30 plf (see Bond Beams, later in this subsection) Wall dead load = (8.0 ft - 0.667 ft) (7.874 in / 12) (37 pcf) = 178 plf (excluding bond beam course) Total wall dead load at base of wall (D) = 30 plf + 178 plf = 208 plf Fa = 4 c 1 ( 140 hr )21 = 580 psi [1 \140 (2.273 ft) in) ) =131.8 psi F = [M1 = 580 psi = 193 psi 3 3 P F, F A S - 0 S F„ 131.8 psi (193 psi) 94,5 in (124.0 in - 208 lbs (124.0 in 193 psi S Fb + A F, e 124.0 in (193 psi) + 94.5 in' ; (131.8 psi) 1.0 in P„. 8,059 Ibs per foot of wall length 24 psi = F , = _ -9,533 lbs per foot of wall length e 1 tin 1 S A 124 in 94.5 in' Since P is negative, the compressive stress controls and the maximum axial load at a one inch eccentricity is 8,059 Ibs per foot of wall length. O6'O3 / VI1 -26 IX - Construction Details Plaster Over Chase Furred Gypsum AERCON t Wall Details o O AERCON Block w /3/4" x (t12- 112 ") Tie -Down Chase 1 1 © Cored AERCON 1 Block /. © Threaded Tie -Down Rod 1 1 1 � Q O AERCON Repair Mortar to Fill Chase ° gri Q Mesh Placed Over Chase Q AERCON Interior Wall Plaster Q AERCON Compatible Coating Cored Block Brick Veneer O Pressure Treated t Furring Strips t ` , 0 Gypsum Board CI Clay or Concrete Brick Veneer I• 0 10 O \ 3 ° 2 Note: Reinforcing bar can be used instead of threaded rod. Cores must then be grouted. 06 / IX -46 r AERCON Florida, L.L.C. A 3701 C.R. 544 East AERCON Haines City, FL 33844 FLORIDA OA (800) 830 -3171 fax (863) 422 -6361 SALES QUOTE 11 -13387 Prepared For: Dates Customer: Stephen Yoshen Company: \ D ate Prepared: July 22, 2011 Address: Quote Issued: July 22, 2011 City: State & Zip: MA. 01060 Salesperson: Mike McCormick Quote valid for 15 days from the date Phone: (413) 695 -7801 Fax: issued. Project: Hungry Ghost Bread ,Location: Northhampton, MA E -Mail: stephenyoshen @gmail.com Product/Service Name Quantity Price TOTAL ITEM # DESCRIPTION 4085 AC4 Precision Block - 8 x 8 x 24 (200x200x608) - Plain (60 /Pallel 8 $227.85 $1,822.80 4084 AC4 U - Block - 8 x 8 x 24 (200x200x608) (60 /Pallet) 1 $350.60 $350.60 4083 AC4 Cored Block - 8 x 8 x 24 (200x200x608) - Plain (60 /Pallet) 7 $249.25 $1,744.75 7000 Thinbed Mortar (Bag) 31 $12.10 $375.10 7003 Block Patch Mortar (Bag) 2 $12.65 $25.30 501 AC4 AERCON Lintel 8 x 8 x 4'8" (200x200x1420) (ea) 5 $41.33 $206.65 Sub Total $4,525.20 1 Keep in mind our block quotes are not "fixed price quotes" for a project - they provide our Taxes unit pricing (for a period of time) and provide a best effort estimate for the project as a 1 Trucks @ $ 2,538.00 $ 2,538.00 courtesy, based on the info we are provided. A signed quote by the customer to initiate an order for block is not a commitment to purchase a specific qty either. Customers will be billed $7,063.20 only for what is actually ordered and delivered. J .. Terms — To be determined prior to shipment. All payments shall be due as invoiced and shall not be contingent upon payment to the Buyer from any third party. A deposit of 25% of the Total Quote is due upon signing of this document. If there is a change in the agreed upon delivery date, Seller shall be entitled to reimbursement for any materials produced but not delivered as well as reimbursement for storage of materials if delivery is not made within 10 days of manufacture. Due to volatility in steel and cement costs, quoted prices are subject to change based on actual steel and cement prices at the time of production. Customer may elect to lock -in prices at any time by authorizing and funding AERCON's purchase of the materials prior to production. Also, due to the volatility in fuel costs, transportation charges are subject to change based on actual costs at the time of shipment.ln the event litigation is brought against either party relating to the obligations contained within the contract, the parties agree the exclusive jurisdiction shall be in Polk County, Florida. J Approval ■ To accept this quotation, sign here and return: Name: Delivery Date: Title: Date: i I a 1t€ Lip= i 1 r i 5 ' i i / . I _... _ iii i i ' i ' ti ( _ z1 1 3. 1 *k.. . I 1 1 Fes' 3R ALA\ 1 8" Aercon Block 1 t 11 -1387 x t say, ®, �L��c �i apt P12 OF 2 ,. ... .G� Ft =T i'. S ",Lt" „z el ACCUF -AB IRONWORKS. INC. Po box 328 Goshen Ma, 01032 4 2 68 - 7133 413- 268 -7105 07 -28 -11 TO: Stephan Yoshen FROM: Russell Laroche FAX: 413- 268 -7105 FAX: PHONE: 413 268 - 7133 PHONE: 413 - 695 -7801 Hungry Ghost Bread — 62 State Street — Northampton, MA We are pleased to provide this cost proposal to furnish and install steel bar joist and galvanized metal roof decking. (sized for a 1501b per square ft load) • Steel bar joist with horizontal bridging furnish & install • Bearing plates furnish only • 1 1/2" 20 gage galvanized roof decking furnish & install • One 15' -9" lintel beam furnish only Includes: shop drawings, field measuring, hoisting, standard shop primer, equipment, anchors and hardware for a complete installation Excludes: permits, finish painting, shoring, and engineering Total price $ 10,500.00 + sales tax Option: provide engineer stamped joist and deck drawings Add $ 300.00 Should you have any questions please contact Russell Laroche at 413- 268 -7133. JOIST NOTES I ALL JOISTS PK CAMBERED N 7.0ROMCE WIN SP SPEEPICA7.4 UKISTS MOM. MT. 2 UNLESS OTIONISE 14.23 JOIST OMEN AK NOT DONN. roe CCKEPTINTED LOADS DOER PLACE LOMS AMMO P.M OR FIELD WOO MOM.. IMNERS PO. OF LOM TO NEAREST PM. MOT ON OPPOSITE CITORD AT NO OPENSE TO NORT.N. STEEL CORP. 3 MUM .7.40. ME MT PROM. MUMS 011.1F,W.6 NOTED 4 ALL JOISTS TO RECENE CNE 31401 OW OF DRAT PANES 5. BROOM - I 1 6 NONSONTPL 6 ALL mower. BROOM SOPPED N TO -0 LEN.. STANDARD 6 VP 7 mem TAGGED (PIECE M... END OF .STS 25 SIMON CN PIAN a 6. NOOK ORS ON. AT ONCE IF JOS. CANNOT BE oTrup7D ACCORDING .E LATEST PONS AS NE WILL NOT BE RESPONSIBLE FOR ANT ...ES WOE KNOUT OUR CONT.!. e ROOF DECK NOTES Done TO BE 211 0421 le• 01014 0000 61036 KM A COVERAGE Ci 36 MANUFACTURED BY NOV MILLENNIUM. 1 2. new 70 BE E11.000203. 2 s F111t DECK TO ALL SUPPORTS AT 12 0/C USING A M.UM **? 9 SHEETS 0 21 2 11-J ROOF JOIST & DECK LAYOUT "r ib ia> 2 For Approval Only lYPE BA BRIDGMG CUPS BOLTS BY OTHERS SECTION 1 SECTION 2 5/3/11 FOR *PROM, au ks DATE REVISIONS BY P. SIM 1.5 NM, 0166I la MIKE CRONAN _ i i steel produtts ITOAS 00414 4002 MCA IAJDOf PROTECT MONO WC. BREAD 702116461406 116 cusroure I03138 PROT / ENG. I/CCEIS oaec =UP DRAM ENT Is DATE 6-3-11 ofcLAcD 01: DATE JOB No. 11-134 92001 1404 JEI 01 1 Planning - Decision City of Northampton Hearing No.: PLN- 2011 -0049 Date: July 25, 2011 • FILING DEADLINE: MAILING DATE HEARING CONTINUED DATE: DECISION DRAFT BY: 'APPEAL DATE: 6/23/2011 7/7/2011 7/28/2011 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY: APPEAL DEADLINE: 6/30/2011 8/19/2011 7/14/2011 7/28/2011 • 8/8/2011 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 6/30/2011 7/14/2011 7/14/2011 7/19/2011 SECOND ADVERTISING DATE: HEARING TIME VOTING DEADLINE: DECISION DEADLINE: 7/7/2011 7:05 PM 10/12/2011 10/12/2011 MEMBERS PRESENT: VOTE: Debin Bruce votes to Grant Marilyn Richards votes to Grant Stephen Gilson votes to Grant Jennifer Dieringer votes to Grant Mark Sullivan votes to Grant MOTION MADE BY: SECONDED BY: VOTE COUNT: DECISION: Jennifer Dieringer Marilyn Richards 5 Approved MINUTES OF MEETING: • Available in the Office of Planning & Development. 1, Carolyn Misch, as agent to the Planning Board, certify that this is a true and accurate decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. 1 certify that a copy of this decision has been mailed to the Owner and Applicant. S Mirk_ Notice of Appeal An appeal from the decision of the Planning Board may be made by any person aggrieved pursuant to MGL Chapt. 40A, Section 17 as amended within twenty (20) days after the date of the filing of the notice of the decision with the City Clerk. The date is listed above. Such appeal may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. Planning - Decision City of Northampton Hearing No.: PLN. 2011 - 0049 Date: July 25, 2011 APPLICATION TYPE. SUBMISSION DATE: PB Special Permit with Intermediate 6/15/2011 Applicant's Name: Owner's Name: NAME: NAME: Jonathan Stevens & Cheryl Maffie SMITH COLLEGE OFFICE OF TREASURER ADDRESS: ADDRESS: 62 State St. COLLEGE HALL 4 TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE. NORTHAMPTON MA 01060 NORTHAMPTON MA 01063 PHONE NO.: FAX NO.: PHONE NO.: FAX NO.: EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO.: SITE ZONING COMPANY NAME: 62 STATE ST CB(100) / /EU TOWN: ACTION TAKEN: ADDRESS: NORTHAMPTON MA 01060 Approved MAP: BLOCK: LOT: MAP DATE: SECTION OF BYLAW: 318 254 001 Chpt. 350- 6.2/Attach 2: Table of Dimensional TOWN: STATE: ZIP CODE: Book: Page: Requirements 1940 295 PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK: Expansion retail bakery HARDSHIP: CONDITION OF APPROVAL: FINDINGS: The Planning Board approved the application for a special permit for a one story expansion less than the 30' height and further than 5' back from the street based on the information submitted with the application. The Board also approved the option for the addition to be located on the north side of the building instead of at the front of the building. In granting the permit, the Board found that the following required elements had been met: (1) The requested use protects adjoining premises against seriously detrimental uses. This is a minor addition at the edge of the CB district. (2) The requested use will promote the convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets, minimize traffic impacts on the streets and roads in the area. There will be no additional impact. The site is mostly accessible by foot with on- street parking in various locations. (3) The requested use will promote a harmonious relationship of structures and open spaces to the natural landscape, existing buildings and other community assets in the area. (4) The requested use will not overload, the City's resources including the effect on the City's water supply and distribution system, sanitary and storm sewage collection and treatment systems, fire protection, streets and schools; and (5) This is a minor addition that allows a business to expand its operations at the edge of the CB district adding vibrancy to this end of the district.. (6) The requested use bears a positive relationship to the public convenience or welfare. The use will not unduly impair the integrity of character of the district or adjoining zones, nor be detrimental to the health, morals, or general welfare. The use shall be in harmony with the general purpose and intent of the ordinance; and (7) if applicable, the requested use will promote City planning objectives to the extent possible and will not adversely effect those objectives, as defined in City master or study plans adopted under MGL c. 41, § 81C and 81D. COULD NOT DEROGATE BECAUSE: GeoTMS®2011 Des Lauriers Municipal Solutions, Inc. • Planning - Decision City of Northampton Hearing No.: PLN -2011 -0050 Date: July 27, 2011 Central Business Architecture Committee and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. 1 certif that this dec'. ion has been mailed to the Owner and Applicant. J.1�l. ► l t Any issuance or denial of a permit by the Committee may be appealed to the Northampton Planning Board, by an applicant or other aggrieved party, provided such appeal has been filed within 21 days of the filing of said decision with the City Clerk. The Planning Board shall limit its consideration of such an appeal to considering errors of the Committee and shall need a two- thirds vote of its members to overturn the action of the Committee. GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. Planning - Decision City of Northampton Hearing No.: PLN-2011-0050 Date: July27, 2011 APPLICATION TYPE: SUBMISSION DATE I Central Business Arch. District Permi 6/15/2011 Applicant's Name: Owner's Name: NAME: NAME Jonathan Stevens & Cheryl Maffie SMITH COLLEGE OFFICE OF TREASURER ADDRESS. ADDRESS: 62 State St. COLLEGE HALL 4 TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: NORTHAMPTON MA 01060 NORTHAMPTON MA 01063 PHONE NO.: FAX NO.'. PHONE NO.: FAX NO.: EMAIL ADDRESS EMAIL ADDRESS: Site information: Surveyor's Name: STREET NO SITE ZONING COMPANY NAME: 62 STATE ST CB(100) / /EU TOWN: ACTION TAKEN: ADDRESS. NORTHAMPTON MA 01060 Approved MAP: BLOCK: LOT: MAP DATE SECTION OF BYLAW 31B 254 001 156: CENTRAL BUSINESS ARCHITECTURE TOWN: STATE: ZIP CODE: Book: Page: REVIEW 1940 295 PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK: Expansion of retail bakery HARDSHIP: • CONDITION OF APPROVAL: FINDINGS: The Central Business Architecture Committee approved the application for addition to the right of the existing building including a green roof based on the revised plans provided at the hearing.: 1. Hungry Ghost Bread 62 State Street by Hutchinson Drafting & Design dated 7/21/2011. In granting approval the Committee found the project to meet the standards in Chapter 156 for additions to an anomaly building that will add to the vibrancy at the edge of the Central Business District. COULD NOT DEROGATE BECAUSE: • FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE. DECISION DRAFT BY APPEAL DATE: 8/9/2011 7/7/2011 7/26/2011 8/9/2011 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: _ FINAL SIGNING BY , APPEAL DEADLINE. 6/30/2011 8/19/2011 7/26/2011 8/9/2011 ( 8/17/2011 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE. DECISION DATE. 6/30/2011 7/14/2011 7/26/2011 7/27/2011 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 7/7/2011 7 :00 PM 9/9/2011 9/9/2011 MEMBERS PRESENT. VOTE: Barry Steeves votes to Grant. Aelan Tierney votes to Grant Bruce Kriviskey votes to Grant MOTION MADE BY SECONDED BY VOTE COUNT: DECISION: Barry Steeves Aelan Tierney 3 Approved MINUTES OF MEETING. Available in the Office of Planning & Development 1. Carolyn Misch, as agent to the Central Business Architecture Committee, certify that this is a true and accurate decision made by the GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. Information and Instructions a � Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub - contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self - insured companies should enter their self - insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617- 727 -4900 ext 406 or 1- 877 - MASSAFE Revised 4 -24 -07 Fax # 617 -727 -7749 www.mass.gov /dia The Commonwealth of Massachusetts , Department of Industrial Accidents r O ffice of Investigations = 600 Washington Street "! Boston, MA 02111 ��. `�' `" www.mass gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information ( - k Please Print Legibly Name ( Business /Organization/Individual): ���� V —� C� '�� Address: ? 7 C G\ d c a g C 7 Li 1 City /State /Zip: (U m c�� 'P hone #: L{( 3( 3(7/ c f f 3 I Are you an employer? Check the appropriate ox: / 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. El New construction 2 —I - -am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling ship and have no employees These sub - contractors have 8. ❑ emolition for me in any capacity. employees and have workers' working Y P ty 9. DI Building addition [No workers' comp. insurance comp. insurance.t 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. ❑ Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13. ❑ Other • comp. insurance required.] *My 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 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 certi u der he ! , i + an penalties of perjuty that the information provided above is true and correct Si. ature: .1/W Date: (Z1 / ( Phone #: Li/ 3 s / `g 0 1 Official use only. Do no 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 1, . a it v, S V"W e as Owner of the subject property Cheryl Maffie & Jonathan Stevens hereby authorize to act on my half, in all matters relative to work authorized by this building permit application. rii/Zutr Signal a re of Owner Date ,Cheryl Maffie & Jonathan Stevens , 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 and r t pains an enalties of� r v Print Name 0/200 Signature of Owner /Agent - Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Stephen Yoshen CS 88490 License Number 33 Bryant Rd. P.O. 41 Cummington, MA 01026 10/01/2011 Address Expiration Date (413) 695 -7801 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 0 No 0 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 el 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 Stephen Yoshen Not Applicable ❑ Company Name: Responsible In Charge of Construction 33 Bry. t Roa!'P.O. Box 41 Cummington, MA 01026 Address7)Wil� •••.'' (413) 695 -7801 Signature Telephone Version] .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 3700 3700 Frontage 144.2 144.2 Setbacks Front 50 50 Side L: R: L: 20 R: Rear 25 25 Building Height 20 20 Bldg. Square Footage 676 18 % 1248 33 Open Space Footage % (Lot area minus bldg & paved 2035 55 1463 40 parking) # of Parking Spaces 3 3 Fill: (volume & Location) none Q none Q A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW YES 0 IF YES, date issued: -( furl 1- - 3-11 4 ) e ,1 f �� f �o i `a Et A riAci lr' � r-c, < « .ti25� l IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T 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 0 DON'T KNOW YES 0 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 IF YES, describe size, type and location: painted wood over existing door 3' x 8' 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 NO 0 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 ❑ Demolition ❑ Repairs ❑ Additions CI Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description 25 x 22' addition. Single story w/ flat living roof. 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 1 ❑ A -4 ❑ A -5 ❑ 1 B ❑ B Business II 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C CI H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B p M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 0 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: Business Proposed Use Group: Business 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) 1 S` 676 1 s� 550 2 0 2nd 0 3 0 3rd 0 4th 0 4` Q , Total Area (sf) 676 Total Proposed New Construction (sf) 550 Total Height (ft) 20 '' Total Height ft 16 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public p Private ❑ Zone Outside Flood Zone's' Municipal 12 On site disposal system f-. Versionl.7 Commercial BuildingPermit May 15, 2000 �� Department use only .. r a City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit - 8 201 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability 0110"L BUILDING INSPECTIONS Northampton, MA 01060 Two Sets of Structural Plans i#T►1AMPTON, MA 01060 phone 413 -587 -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 62 State Street Map Lot Unit Northampton, MA 01060 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Smith College _ 24.0 we$ T ST IUonTAsm dvt !Yt VI• . Name (Print) 7 N� S k'M.°eT t Current Mailing Address: cEt Signature "" Telephone 2.2 Authorized Agent: C • Sket, CZ- L (&) S7 rfor rn lk Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $68,000.00 (a) Building Permit Fee 2. Electrical $3,500.00 (b) Estimated Total Cost of Construction from (6) 3. Plumbing $500.00 Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection $2,500.00 6. Total = (1 + 2 + 3 + 4 + 5) Check Number A724/ 4 _ 9 75 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0155 APPLICANT /CONTACT PERSON STEPHEN YOSHEN P E-4 ADDRESS /PHONE P 0 BOX 41 CUMMINGTON (413) 695 -7801 () p� feu') -E \) `' 1 3 PROPERTY LOCATION 62 STATE ST T MAP 31B PARCEL 254 001 ZONE CB(100) / /EU j1/41661: £ ' (NEE r THIS SECTION FOR OFFICIAL USE ONLY: w "� ' PERMIT APPLICATION CHECKLIST (NoT mks 6 1 2 4 F - rig) ENCLOSED REQUI ED DATE ZONING FORM FILLED OUT _ Fee Paid N al 5 PE G 610 Building Permit Filled out Zf Fee Paid /0 T AO 75- �j�, OVEN -� Typeof Construction: CONSTRUCT 25 X 22 ADDITION A New Construction Pert v149 I6C/ Non Structural interior renovations Addition to Existing 1 iv\ Cr Accessory Structure Building Plans Included: Owner/ Statement or License 88490 3 sets of Plans / Plot Plan 5 pt 1° THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 5I F t{f l'.1 ATION PRESENTED: 6 V t �� '• � pproved Additional permits required (see below) N (f tai ` 6 PLANNING BOARD PERMIT REQUIRED UNDER:§ p M fr" Intermediate Project: Site Plan AND /OR Special Permit With Site Plan 1 ) , 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 Peiinut from Elm Street Commission Permit DPW Storm Water Management Des.../ ay oope nature of Buil. ing I cial 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. 62 STATE ST BP- 2012 -0155 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31B - 254 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADD BATH BUILDING PERMIT Permit # BP- 2012 -0155 Project # JS- 2011- 001618 Est. Cost: $74500.00 Fee: $275.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN YOSHEN 88490 Lot Size(sq. ft.): 3702.60 Owner: SMITH COLLEGE OFFICE OF TREASURER Zoning: CB(100) / /EU Applicant: STEPHEN YOSHEN AT: 62 STATE ST Applicant Address: Phone: Insurance: P 0 BOX 41 (413) 695 -7801 0 CUMMINGTONMAO1026 ISSUED ON:9/1/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT 25 X 22 ADDITION 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 9/1/2011 0:00:00 $275.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner