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32C-001 (11) 150 MAIN ST BP -2009 -0975 GIs #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C - 001 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- 2009 -0975 Project # JS- 2009 - 001408 ---- ( ...e._ ., 4 ; , u Est. Cost: $1250.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 078992 Lot Size(so. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG Zoning: CB(100Z Applicant: KOHL CONSTRUCTION _4 T. 1 cn l:! L,' N ST Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 -0321 W orkers Compensation HADLEYMA01035 ISSUED ON:5/22/2009 0:00:00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT INTERIOR WALL FOR ADDITIONAL OFFICE - HPMG OFFICE 3RD FLR 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: C''K 9 : -0 f -/k THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. ,7 Certificate of Occupancy - 7--- Signature: FeeType: Date Paid: Amount: ` Building 5/22/2009 0:00 :00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo I PLOT FILE CREATED 2/8/2010 1:11:25 PM Cr) o. ReWdon/lasue INIT Data V a ( ry 7 F . Z 22'-0;' GL ice"! IT d GL L9'-* GL ---1 . i 4 CI- 4 GL I — � -4'3y' GL-- r - -4' -0' LLB - -4'-0' GL • 4'-4' GL 1111.1111.1 L I 1 aPE11 i it III I ff B'O _ c 0 I I I d SU 00 0115 L ,:: • FNiX .� • y Z b O O CD o 1 , 1 — 0 : W J O w ELEVATION #1 z CO 2 rn o 1 lI NLN A W H i I L 10' T,1l . 1 MATCH NCT Or BACK B NNL) • / b' -0' FIN OPENING 8 T.O. D05TBG Q O O W w BACK WALL �\ 1r J 1 II MGM BRIG( �� W I \ CV i cc � SANO DOOR ENTRY i_ PAGE AUGI FACES 2 ELEVATION #2 ENTRY REDESIGN Yz "= 1'0" 2 OF 2 i e 2 SUITE 050 i. m 2 F, LIMIT OF WOIRI( �'^�^ " LIMIT OF WORK""'°"°°"°'{ y R @ � @@ • • • \ \\ 1 S ; °t { • 'C, \ - i O .- ^ TAI -I 1 t.l Y� P y I _ L _, 1 , :., „ , 4{H it )IMOM dO iIV I1 - i 15-0. �� yfr 111 :a • ,_ e # .C) . ■ ■ r = 1 7 � -r'''c .\: l',4+ I 4 k_1— ,� II 54 ■ ■1111 r r 1 I'i . 0 ) .. 2. dO 11• 111 D O , l`4 1i mZ m ! ie DO m Z T r TT I T SCALE JOBNAME PI 3/16"=1'0" ° ISSUE DATE 02.08.10 LOCATION 109 MAIN, NORTHAMPTON MA THORNES N DWN BY PHASE TITLE JRL PERMIT SUITE 050 PLAN MARKET PLACE . The Commonwealth of Massachusetts Department of Industrial Accidents ;,�� ►�= Office of Investigations 14114 600 Washington Street Boston, MA 02111 .Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print LeEibly Name ( Business /Organization/Individual): Kohl Construction, Inc. Address: 31 Campus Plaza Road, Suite 3 City /State /Zip: Hadley, MA 01035 Phone #: 256 -0321 Are you an employer? Check the appropriate box: Type of project (required): 1. Si I am a employer with 11 4. ❑ I am a general contractor and I 6. New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. I 7 . M Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g Y P h'• 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.0 Other *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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 800287201 2010 Expiration Date: 02/10/11 Job Site Address: -,S t�l 7t . `i 4 rte_ w) City/State /Zip: N SA 0tOCa( 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 S ignature: t • ?. i Date: L I Phone #: 256 -0321 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I I, as Owner of the subject property 1 hereby authorize ... ___ -to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date ;Douglas Kohl , 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. Douglas Kohl Print Name ( .....„ L \ ._,k e.... e . to } Signature of Owner/ t Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder . Douglas Kohl 078992 License Number 31 Campus Plaza Road, Hadley MA 01035 1 110/25/2010 Address Expiration Date (413) 256 -0321 Signature 1 Telephone SECTION 13 - 0 ERS' 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 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 Kohl Construction, Inc Not Applicable ❑ Company Name: Douglas Kohl Responsible In Charge of Construction 31 Campus Plaza Road, Hadley, MA 01035 Address a_P (413) 256-0321 Sign e Telephone Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L. , , ., ._ R: ,,, L :'_ R: Rear Building Height Bldg. Square Footage % ...... Open Space Footage ° (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES 0 IF YES: enter Book 1 Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT 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 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO Q IF YES, describe size, type and location: Several existing retail / mercantile signs D. Are there any proposed changes to or additions of signs intended for the property ? YES i NO 0 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 O 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 ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Grou Sign ❑ Neyv Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description ", Improvements to store facade & entrance door, addition of 12 If of interior wall with door 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 I ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C I ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile 0 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: Mixed „ _ Proposed Use Group: Mixed Existing Hazard Index 780 CMR 34): 5 Proposed Hazard Index 780 CMR 34).5. .__ .... J SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1 s t 1 st z ...,.....,..._.�. .,�_.,.. _. € 2 2nd 3rd l .. 3r d 4 m 4 Total Area (sf) Total Proposed New Construction (sf) Y 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 ❑ Zone Outside Flood Zone El Municipal p On site disposal system Versionl.7 Commercial Building_Permit May 15, 2000 Department use only City of Northampton Stasisi rm 20' 1 Building Department 212 Main Street Curb GuVDrlve y Derr tt Sewer /SepticAva ility Room 100 WaterWettA a abitit � � �� Northampton, MA 01060 Tvio SeM4 Structurat Flans phone 413- 587 -1240 Fax 413- 587 -1272 lito " " 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: f This section to be completed by office Thornes Marketplace y - �c� t'i Map 32C -001 Lot 001 Unit 150 Main Street, Suit 050,,. . " Zone Overlay District 'Northampton, MA 01060 Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: L .." IThornes Marketplace, LLC =150 Main Street, PO 686, Northampton 01061 Name (Print) Current Mailing Address: (413) 256-0321 Signature C Hvii4oAr.;.-rz_ Telephone 2.2 Authori d Agent ,Doug Kohl, Kohl Construction, Inc. 31 Campus Plaza Rd., Hadley, MA 01035 Name (Print) Current Mailing Address: (413) 256-0321 Signature Telephone SECTION 3 -STIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 3300 (70 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of 2-50 • QC Construction from (6) 3. Plumbing c)c) ? Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection , • 6. Total= (1 +2 +3 +4 +5) 00 Check Number 3 1 /� s, _ This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File # BP- 2010 -0714 APPLICANT /CONTACT PERSON KOHL CONSTRUCTION ADDRESS /PHONE 31 Campus Plaza Rd HADLEY (413) 256 -0321 PROPERTY LOCATION 150 MAIN ST - LEFT CLICK - LOWER LEVEL MAP 32C PARCEL 001 001 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 64 f6 Fee Paid Tvpeof Construction: INTERIOR RENO TO STORE FACADE & ENTRANCE DOOR & ADDITION OF INTERIOR WALL & DOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 078992 3 sets of Plans / Plot Plan THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN MATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management Demolition Delay /4:7 /6 /2 c.? ea Signature of Bui ding 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. 150 MAIN ST - LEFT CLICK - LOWER LEVEL' BP-2010-0714 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C - 001 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- 2010 -0714 Project # JS- 2010- 001064 Est. Cost: $3800.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 078992 Lot Size(sq. ft.): 16683.48 Owner: THORNE'S MARKETPLACE LLC Zoning: CB(100)/ Applicant: KOHL CONSTRUCTION AT: 150 MAIN ST - LEFT CLICK - LOWER LEVEL Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 -0321 Workers Compensation HADLEYMA01035 ISSUED ON:2/11/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: INTERIOR RENO TO STORE FACADE & ENTRANCE DOOR & ADDITION OF INTERIOR WALL & DOOR 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 2/11/2010 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo (REN REPLACEMENT AND Standard Frame Expander System fillA ) SYSTE NOTE: Details shown are representative of typical residential applications. Other consideration may be required for D , - FRAME !� _L,F P TG T R. EXPANDER .NFJD - commercial applications depending upon building height, , �-q �,� un and location and application. cnv F (,-I", The Pella Precision Fit" replacement window is another option for this condition. See the Precision Fit product sections in Volume 2 for more information. '3'.; s u1 �� f / WI a u_ 0 , EY k q ; pi I (2 \ l t- <, V . re, A ,,,t +6 & i . , ---- i k-c i R L Pti1_A ERAME EXPENDER /ND REC.EPTOR- F. Cr nsiru and 1,':1' ,. frame Remove existing sash and parting stop Blocking as a. required by others. ▪ L 'I-51---u---°L,, , j ` } , ) Li''' '' '' Wood blocking, trim, sealant, and insulation by others. Cal ▪ 2 L. L ,AMN w 7 7 I ..: , ,,, „.„. _ 1 w • z , , , PELA RAM E EXPANDLR z. i Xi. t,og Cc, - slJC_Tl;n a 'ALUMINUM SILL , n dew F a1 C ? tLEtE ILL Pella 2010 Architectural Design Manual • Division 08- Openings • Windows and Doors • www.PellaADM.com H-4 _ k " ( ARCHITECT SERIES i HUNG ) Aluminum Endure Clad® Exterior SE Double-Hung Unit Sections - ft* ) _ Scale 3" = 10 VENT FI i I [ 34] ON _I ■',._,j - UPPER JAMB PP Iffill `—', , ■ C) ' '--- : ■:;.' ip 1 __ , IP 4====. HEAD w i ■ III _ -,-; 7t- I - • O ' :1 ', in ' ' - ' ' ILEFAir .1 .... .. , ,,, iti-- 1 (..... c 4 .....) _ , . CHECKRAIL LI 7.` I ti" 1 1 D I - ', - ',48," [371 i2, IFFIVFME JVIDTH , 1 Cs1 tli Vat* 11: P PP . low II r2 , er'• ' IPA _ 1 wo' ,, _ ..._. . _ ,._... , 11 .1 ci Ithinol 11% 1P (M.' , frrliis-.11_4014 Il k 6 ,o Ill .. 2 7 (" I 1 , 2 - , [271 — /---, S) SILL Q_)i LOWER JAMB * FJ:inenjo■ required for faF l(1,:nr,c; .Fruts wv,t1P ,ash All dimensions are approximate. Rev. 02/28/2010 Pella 2010 Architectural Design Manual • Division 08- Openings • Windows and Doors • www.PellaADM.com 5-45 ARCHITECT SERIES 1 _, 1 HUNG ) Grille Types Typical Grille Patterns 0 Grille Profiles Integral Light Technology® with Clad Exteriors (1) Available in Pine, Mahogany, Alder or Douglas Fir to match complete unit. f i i 1 114" l 7/8" Regular 1 1/4" Regular 2 ReGu• Integral Light Technology with Wood Exterior (2) Available in Pine or Mahogany to match complete unit. V n/- �I I 7;8" 1 1 1/4" ,,/ 4 7/8" Regular 1 1/4" Regular 2" trza;�.;lar Removable Interior Pine Bars 0 3/4" 1 t l4" 2,. e J" " 1 3/4" Regular 1 1/4" Regular 2" Regular 1 1i4" Colonial 2" Colonial 3/4" Grilles- Between- the -Glass CI I 3) 1 A 3/4" Contoured Pella 2010 Architectural Design Manual • Division 08 - Openings • Windows and Doors • www.PellaADM.com 5 -27 Customer Approval Form: Signature: Date: 1.-- 30.5 Viewed from the Exterior Quote Number: 1573292 Line Number: 15 Scaling: 1/2" = 1' Description: Architect, Double Hung, 39.5 X 41.25, Hartford Green, 3- 11/16" Rough Opening: 3' 4 1/4" X 3' 6" These drawings are based on our interpretation of the information provided to us. They are submitted for final approval of the individual** responsible for the project and are not intended to create any warranty or other liability. The user** is responsible for compliance with applicable building codes or other regulations and determining the suitability of the suggestions for the particular application, including the final design of reinforcement, flashing, and sealant systems for all window and door installations. ** building owner, architect, contractor, installer andlor consumer Quote Name: Prec Fit with Wrap Project Name: Thorne's Market, 150 Mair A Jobsite Location: NORTHAMPTON, MA Room Location: Units 1- 2- 4 -7 -10 Sales Branch Location: 18400 PELLA PRODUCTS INC esiiii414 tAl. f*ci"ii . . ,,, fo$,. ,i4 ',. '',)0i. '', .Pi I • ''' 1 ., ',' .'''', 4 1 - ',',,,' ' -','''', -' ',. '-',:iii it' , ` , ..i,:. :.' - ::,,.,-:,T `� 'ia 1 0 gr € !. 1 it S :, } <'a a l',.. m ... F:f .& in a a . , '�' >; " x ? .. " p ,q ` ,s I d v ( s A3 �" .f+. ' ` ` tx' ,�iaa ' v v s K , i r- '4 "ups .� ° J 4# Yh -'.'.,^'';-!:'''.''''' J� 3 f`t _ C . f � { �d I i f 9 �w IPIPPIPOO a c:: i. 2 3 _ .> t t . 1" iti;w44t vflgyiAgro J 3 , .,,, _....„ _. ..„ . ._ ., N .n. ,,,,,,, .. .-4 , .. ,. . , .... :,.. -,-..- , ., ... - . ,, ,- 4:111 * X 40 , „..,,„•,.:,.._,......:.,.,,.„.i„„rio,,,e,i.,...,.,,,,._,:.,_,::_:,:„.„,,,,,,.„,;:...,:„.5. 1 7..„274,,,,„L__.,,,_„:,__...,„:„.i. : ,,:....,_:„.., ; ,...,,,, i ,_:.,..:„.„,,.. : ;:_:,,...._•,, ,-,,.. , .. .. . . ,_. ,, ..., .. . _. ...., , • , ._.....„..„, .... . .,. _,...... £; t ... ' a ' ' ' l' ''' , . a . ....., . . ,,........ . . .. ,::::::_:,... .. .-- ---- - - y 11 z.,,.....,-„ , _ „„... .,...... .. _ n o r -•�_ - ,,.2.: ,._.... , �m Ir.,,.iu. yea �,±' .#, u _.,". ?-=,' _.-- ...•... „,,,,-,4.‘:..--1:-,--- �- -,.�ya .��*, � _. e " xw,+;. . _.�. .« - - a.xs :„. to awJirus. ..r• e I A MARKETP LAC ; - - . x a ` .�i a a te ,,e:, s.` a +x Building Department Town of Northampton Thank you for reviewing our building permit request for Doug Kohl of Kohl Construction located at Thornes Market (Cornucopia) 150 Main St. Please direct any questions or concerns, you may have to me, Diane Lemieux, at the Pella Products Inc., West Springfield, MA retail showroom. All customer and project information is located in this particular office, therefore I will be able to answer any question or address any concerns there may be more efficiently. I have included a self addressed stamp envelope for the return of the permit. Thank you for your anticipated cooperation. Sincerely, Diane Lemieux Pella Products, Inc. 69 Ashley Ave. West Springfield, Ma. 01089 (413)736 -9239 Phone (413)736 -3390 Fax From:413 447 1977 06/01/2010 08 :52 #312 P.002/009 A CORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDIYYYY)- 6/1/2010 PRODUCER (413) 773 -9913 FAX: (413) 774 -3872 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MassOne Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4 y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 117 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 638 - Greenf ield MA. 01302-0638 INSURERS AFFORDING COVERAGE _ NAIC # INSURED INSURER A: Continental Western ' - Pella Products, Inc. INSURER B: ATTN: John Benjamin INSURER C. 155 Main Street INSURER D. Greenfield MA 01301 --3258 INSURER E: COVERAGES 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 DE ISSUED OR MAY PERTAIN; THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADM- TYPE OF INSURANCE POLICY NUMBER POLICY ATE (MMIDDIYY P DATE MMIDDIY' EXPIRATION LIMITS LTR INSRD ( ) ( ! 'GENERAL LIABILITY EACH OCCURRENCE. $ 1, 000 00 DAMAGE TO RENTED 300 000 X COMMERCIAL GENERAL LIABILITY PREMISES IFa occurrence) $ A CLAIMS MADE X OCCUR CPA020470113 1/1/2010 1/1/2011 MED EXP (Any one person) $ 15,000 PERSONALS ADV INJURY $ 1,000,060 GENERAL AGGREGATE $ 2,000,000 - - G�EN'L AGGREGATELIMITAPPLIESPER' PRODUCTS - COMP/OP AGG $ 2,000,000 J POLICY ri JEC n LOC - - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident} $ 1, OOQi, O'00 A' . . ALL OWNED AUTOS MAA020470213 1/1/2010 1/1/2011 BODILY INJURY - X- SCHEDULED AUTOS (Per person) - $... X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) - I - PROPERTY DAMAGE $ 1 )Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ - - -" AUTO ONLY i' i i EXCESSIUMBRELLA LIABILITY EACH OCCI IRRENCF $ . T, I OCCUR CLAIMS MADE AGGREGATE - $ $ . - DEDUCTIBLE $ RETENTION $ 1°R- $ RY - .. A WORKERS COMPENSATION AND X TO T ZIT'S I ` EMPLOYERS' LIABILITY ANY PROPR :ETOR /PARTNERIEXECUTIVE E EACH ACCIDENT $ 500 ' %000 OFFICER /MEMBER EXCLUDED? WCA020470513 1/1/2010 1/1/2011 500, E.L. DISEASE -EA EMPLOYE $ O9 It yes, - describe under 0 5 0 0, 0 0 0 � SPECIAL PROVISIONS below E L. DISEASE - POLICY LIMIT $ OTHER DESCRIP110N OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - Job Thorne's Market , 150 Main St Hadley -M1 01035 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ' ' ,Kohl Construction EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 31 Campus Plaza 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT ' Hadley, MA 01035 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE .err Robin Sargent /RMS ° ACORD25 (2001/08) ©ACORD CORPORATION INS025 (01 08).088 Page 1 of 2 The Commonwealth of Massachusetts o Department of Industrial Accidents Ario 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): // /PO u c /3 � ` rI G. _ Address: /55 /f % cv/0 S lre� City /State /Zip: 6 r «o - E id f fy? U /3o / Phone #: 1 7 / /i ' 770 . U / J J Are you an employer? Check the appropriate box: Type of project (required): 1. [g] I am a employer with 7() 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub - contractors 6. ❑ New construction 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.[ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.[K Otheri� /c'cc- G/ dew) comp. insurance required.] eVbc/ . )ao r S 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. tContractors 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: / (c7 / n5 u r Ce / n Policy # or Self -ins. Lic. #: G (1.2 O 705? -j Expiration Date: l • l € O // Job Site Address: 150 M - City /State /Zip: rte,* ekq , CA(00 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 thg pains and penalties oofperjury that the information provided above is true and correct Signature: Date: CO 1 2- l Phone # (((,-;) 77 2 `U l 5,3 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 #: , .7=4 --_ .-_''...•:, gite 6 # " , ,.9 f 4 4 , = -----...,. ------- .16 - -:-.-....---irfiliv-- - ----=- 1_.---- Office of Consumer Affairs and 'B usiness Regulation -migilli_ , .. ---..-....., . 10 Park Plaza - Suite 5170 ,_....." r, . --•., ..e. — N Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 142279 Type: Private Corporation Expiration: 3/24/2012 Tr# 294515 PELLA PRODUCTS, INC. GARY SHERMAN 155 MAIN STREET GREENFIELD, MA 01301 Update Address and return card. Mark reason for change. , I I Address 1 Renewal ri Employment 0 Lost Card " DPS-CA1 0 50M-04/04-0101216 to ectormckrutieaat al License or registration valid for individul use only Office of Consumer Affairs & Business Regulation .........--.. ._,,,---- ,: t- before the expiration date. If found return to t : ‘ 1, 14 442279 Registration ra HOME IMPROVEMENT CONTRACTOR ,..--. .. Office of Consumer Affairs and Business Regulation ....„_-_-. . ..4 ', : . 40 3 Expiration: 3/24/2012 Tr# 294515 10 Park Plaza-Suite 5170 0 Type: Private Corporation Boston, MA 2116 PELLA PRODUCTS INC GARY SHERMAN ,0 / 155 MAIN STREET . Arillf . ....,.. Aii. GREENFIELD, MA 01301 Undersecretary ..e vt Ad 4: 4 A ot vali I itho 1 signature Pella Products, Inc. 155 Main Street Greenfield, MA 01301 Phone: 413 - 772 -0153 Cell: 413- 834 -8799 To: Building Inspector From: David White — Installation Manager Date: January 19, 2009 SUBJECT: Building Permit Applications & Designees Pella Products Incorporated is in the business of replacing windows and doors for our customers. Our process includes providing a building permit for each and every project. I am a licensed Construction Supervisor. Building permits will be applied for using my CSL #091496 and our HIC, # 142279. Please find a copy of my licenses below. 1 ` B aedt Bn![ t i 0$ a .ice } ,yam tier* Worwlusionoores c1:; Ggiat? T - 9441 - Customer: Kohl Construction Project Name: Thorne's Market, 150 Main St., N'ton, MA Order Number: 184 Quote Number: 1573292 [❑ Project Checklist has been reviewed Order Totals Taxable Subtotal $3,553.25 Credit Card Approval Signature Sales Tax @ 6.25% $222.08 V _ Non- taxable Subtotal $1811.70 Total Customer Name (Please print) Pella Sales Rep Name (Please pnatt $5.587.03 f r Deposit Received ,„ J / tJ er ; !' (. _ .--- -...._ __._____ Amount Due Customer Signature Pella Sales Rep Signature $5,587.03 4, c5 1Ll IC_. Date t Date For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.pella.com Printed on 5(14(2010 Contract - Detailed Page 4 of 4 Customer: Kohl Construction Project Name: Thorne's Market, 150 Main St., N'ton, MA Order Number: 184 Quote Number: 1573292 Thank You For Purchasing Pella® Products PELLA WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product warranties are incorporated into and become a part of this contract. Please see the warranties for complete details, taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system. Neither Pella Corporation nor PELLA WINDOWS INC will be bound by any other warranty unless specifically set out in this contract. However, Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. Clear opening (egress) information does not take into consideration the addition of a Rolscreen [or any other accessory] to the product. You should consult your local building code to ensure your Pella products meet local egress requirements. Per the manufacturer's limited warranty, unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually, thereafter. Variations in wood grain, color, texture or natural characteristics are not covered under the limited warranty. Refer to Pella Corporate Warranty This form constitutes a contract between Buyer and Seller. Prices are subject to change anytime after 30 days following date of estimate and does not guarantee availability of any product listed. Pella Products Inc. management has final authority on acceptance of this order. Your signature confirms the accuracy of the product(s) chosen. Pella Products assumes no responsibility for accuracy of take offs from drawings or blueprints or that the products listed will be sufficient to complete customer's intended project. The Buyer agrees that the product(s) listed herein are correct, final and cannot be changed, returned or canceled. Deposits are partial payment of the contract and are not refundable. The Buyer agrees that if paying by credit card that authorization is granted to the seller to debit the Buyers credit card by signing this contract. The Buyer agrees that payment discounts do not apply when paying with a credit card. A 1 -1/2% SERVICE CHARGE per month (18% PER ANNUM) will be added to all outstanding balance past our stated terms, plus lawyer and account fees for collecting outstanding accounts. The Buyer agrees that the customer delivery date is a realistic estimate of when the product is to be delivered. Items remaining in our warehouse for more than 30 days beyond the agreed to delivery time will be subject to a storage and handling fee of 1% of the net amount of the order ($25.00 minimum charge). The Buyer agrees that the product can be delivered without the Buyer present and agrees to accept the shipping documents as proof of delivery. The Buyer agrees not to hold the Seller responsible for any damage to driveways, sidewalks, trees and overhead wires caused by the Seller's delivery vehicles. The Buyer agrees to examine the product(s) upon delivery and within 7 DAYS OF DELIVERY provide the Seller notice of any discrepancy between the product(s) ordered and the products(s) delivered, including hardware. If the Buyer does not provide notice within 7 days the Buyer accepts the product(s) as is. For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella website at www.pella.com Printed on 5/14/2010 Contract - Detailed Page 3 of 4 Customer: Kohl Construction Project Name: Thorne's Market, 150 Main St., N'ton, MA Order Number: 184 Quote Number: 1573292 Line # Location: Attributes 10 Units 1-2-4-7-10 Architect, Precision Hung Double Hung, 40 . • : - - - Item Price Qty Ext'd Price 11111 11111 $1,072.99 5 $5,364.95 1: Non - Standard Size Double Hung, Equal 'lit / r, / i Frame Size. 40 X 43 1 ` 3 J / ii1 General Information: Style Edition, Clad III ��"" ` 666 II III /III Exterior Color / Finish: EnduraClad Plus, Ha • d Green `�, Interior Color / Finish: Primed Interior -- 11 --- -- Glass: Insulated Low E Advanced Argon Gas Hardware Options: Standard Lock, Champagne, Order Sas' ' . Viewed From Exterior Screen: Full Screen, InView Grille: ILT, No, 7/8 ", Traditional (2W1 H / 2W1 H) Wrapping Information: Perimeter Length = 166 ", Glazing Pressure = 85 Exterior Paint Seacoast Warranty: Yes Rough Opening: 3' 4 1/2" X 3' 7 1/2" Sd 1(0 x 11/ 5/V e V s Customer Notes: Cost per unit includes removal and disposal of old window, new interior stops, Exterior Coil Stock wrap of existing Casings and Sill EAC - - Exterior Aluminum Capping (Coil Stock) Over 110 UI Qty 1 PF -2 - Exterior Pocket Installation for Precision Fit Qty 1 4 / raOcia /OA_ /7„ / 3 . kr 7 t 3 6 e-g- 6 oc r' �t `, Bo c. IFQArv.- a C rW 9 N° 1 �•w � �l �i. For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.pella.com Printed on 5/14/2010 Contract - Detailed Page 2 of 4 Contract - Detailed ' 0 14 Pella Windows &Doors Sales Rep Name: Schabacker, Don 69 Ashley Ave Sales Rep Phone: (413) 736 -9239 West Springfield, MA 01089 Sales Rep Fax: 413 - 527 -3620 Phone: (413)736 -9239 Fax: (413)736 -3390 Sales Rep E -Mail: dschab @184.pellapdsn.com Customer Information Project/Delivery Address Order information Kohl Construction Thorne's Market, 150 Main St., N'ton, MA Quote Name: Prec Fit with Wrap 31 Campus Plaza Order Number: 184 HADLEY, MA 01035 Lot # Quote Number: 1573292 Day Phone: (413) 256 -0321 , Order Type: Installed Sales Mobile Phone: County: Wall Depth: Fax Number: (413) 256 -0130 Owner Name: Payment Terms: 2% 10th /Net 11th E -Mail: Tax Code: MASS Contact Name: Owner Phone: Cust Delivery Date: None Jon McGee Quoted Date: 5/14/2010 Great Plains #: 53C107340 Contracted Date: Booked Date: Customer PO #: Customer Notes: 5/14/10: Pella products Inc. will honor the 11/9/09 pricing per unit of for the 5 windows selected for the Cornucopia space. See notes at line item #10 ,. '.)20 ; c e(20'62-3 ' YY1a.Q ct Al b 4 VAc P&i L a ak' Ai (A iv. 4/1)%/6 1 h ji A 6.;.,.I 4- Fi ) 6 4 A-0.4 c01‘ / Alau,a • "� --•�� , "`' 1 , �, Pr 2,1t & `�� pbas,1 L°'2LT+ "P "g- a t m om... Rol( - Z' 2)i.. PAO DIY " >^' 4 1 0 . to to . . e LAIlz BAs P4/6 For more information regarding the finishing, maintenance, service and warranty of all Pellae products, visit the Pella® website at www.pella.com Printed on 5/14/2010 Contract- Detailed Page 1 of 4 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 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, �V \ ` A, a`\0 \1 `r `�� 2> as Owner of the subject property r hereby authorize 1JC \a- �� to act on my behalf, in all matters relative to work authorized by this building permit application. wee S\ctno A CCrn -; 2os5 \, -A,1, Signature of Owner Date I, ?e1, `Q ,* ''nL • , 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. Day' , o \ kkg..._ Print Name ! •.....J (O 2 1 Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: \ Not Applicable El Name of License Holder : Oct \ Lt ` License Number MCuun b c - (J`03\ of \3 Address Expiration Date } c C. ) hti. r12 - ()\3 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 bui ing permit. Signed Affidavit Attached Yes No 0 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 (P>Z \, Q ?co. C 6 • Not Applicable ❑ Company Name: Responsible In Charge of Construction 155 K ' LA S A G_n ' 11 ��301 Address � Q 4; C 1 J h- Q 6) -772:615 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: 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 /Findin ever been issued for /nn the site? NO O DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW (3 YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ec 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 Q Obtained , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: r f'prlt ►J- L01 } S Ul(G Si D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, exc ation, 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. 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 2 Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration [Existing Ground Sign El New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. — � \ p�Ck..C. v %A. ca r\ e) S LV`R W c b _ S • �S si Of Proposed Work: ci (?en i`f`f, %A.1\.) ("�\ i f \Ckn S - SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 1E1 A-3 El 1A 1 ❑ 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 El 5A ❑ S Storage ❑ S -1 El 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: (1\a— Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1 1 st 2 nd 2 " 3rd 3d 4 th 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 10 Private ❑ Zone Outside Flood ZoneD Municipal ❑ On site disposal system ❑ • Version 1.7 Commercial Building Permit May 15, 2000 Department use only City of Northampton ,y atuu of I ermit: Building Department n Curb Cut(Driveway Permit 212 Main Street ,verISec vailability Room 100 - Water 11 Ava ability Northampton, MA 01060 T o : of Stru ural Plans phone 413- 587 -1240 Fax 413 -587 -1272 ' P .S� pecify APPLICATION TO CONSTRUCT, REPAIR, RENOVAT C HANQ E E THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A`QNf''OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office TNT( tA,C4 V.- ± Cc r'1 v cD f kc.) Map Lot Unit 1St) M'OL • Zone Overlay District Norm P�a'r) r.G • b \b(o. I Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: CD ov do h\ �bhn G 31 Cc - Pos Name (Print) Current Mailing Address: /' rQc C�n�� ZSC0 - C321 M • o \ 2.2 Authorized Agent: Signature ITel ephone ►fi 1, I ct, ` rDcLU n C C 55 M cc i n - 6 r n-' 11 [ 013d Name (Print) Curren aili g Address: - // � -, rt[� 413) � Z D 153 Signature t`J C V� ►' W�+ Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 5 f (_co c(:) (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) 5 ( , Q Q Check Number ,. / (3 This Section For Official Use Only /}}�� Building Permit Number Date 5 'J j S Issued 11zel 0 �a Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2010 -1102 APPLICANT /CONTACT PERSON PELLA PRODUCTS, INC ADDRESS/PHONE 155 MAIN ST GREENFIELD (413) 772 -0153 PROPERTY LOCATION 150 MAIN ST MAP 32C PARCEL 001 001 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 '3 ?O 6 �i Typeof Construction: INSTALL 5 REPLACEMENT WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 091496 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON H oL I' n-f i ► J ( INF9RMATION PRESENTED: f ` IV Additional permits required (see below) CAt (,60 19 '-1 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 c = 6/10110 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. 150 MAIN ST ' BP - 2010 - 1102 GIS #: COMMONWEALTH OF MASSACHUSETTS 'ap :Black: 32C-001 : 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- 2010 -1102 Project # JS- 2010- 001620 Est. Cost: $5600.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 091496 Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC CIO HPMG Zoning: CB(100)/ Applicant: PELLA PRODUCTS, INC AT: 150 MAIN ST Applicant Address: Phone: Insurance: 155 MAIN ST (413) 772 -0153 WC GREENFIELDMA01301 ISSUED ON :6/10/2010 0 :00 :00 TO PERFORM THE FOLLOWING WORK :INSTALL 5 REPLACEMENT WINDOWS 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 6/10/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo j The Commonwealth of Massachusetts City of Northampton Certificate of Occupancy In accordance with 780 CMR, Section 5120.3 (The Seventh Edition of the Massachusetts State Building Code) this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified. Identify Name of Building of Space Within Certificate No. Issued to RAO s BP- 2011 -0128 Identify property address including street number, name, city or town and county Located at 150 Main Street (1st fl) Northampton, Hampshire, Massachusetts Use Group Classification(s) (B) Business Use This Certificate of Occupancy is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate, failure to comply with conditions or, tampering with the contents of the certificate is strictly prohibited. Conditions of Use Coffee Bar Name of Municipal Date of Map /Plot: Building Official _— ■ Charles M∎ er Inspection 08/17/2010 Signature of Municipal V Date of 32C -001 Building Official �. Issuance 08/18/2010 L • , REVISIONS # Revision /Issue 'nit Date ILL /,1-- L NOM �O lWl NOM �O lWl u L. I I / b 3.1" ` 1 12 �� Q SUITE 130 I 258 S.F. ° DEMOLISH EXISTING WALI q _ TO CREATE CASED OPENING ace = wI CC o? m 0 00 N0 1. p _ _• ____ N 44CMFN ■ m I ry _ - Nona 1' 6" DEEP S COUNTER ‘ RELOCATE LIMIT OF t •RK EXISTING SINK TO BACK ROOM N CONSTRUCTION 0 1" 2" . 0 2' 4' 6' 8' JOBNAME SUITE 130 [PERMIT] DAT0 1.12.10 T H O ,i R <1 N F 'TITLE SCALE MARKET PLACE 1ST FLOOR 114" =1'0" 2 OF 2 COPYRIGHT © KOHL CONSTRUCTION, INC /L I' • The Commonwealth of Massachusetts rar*=. Department of Industrial Accidents !! ` ij�i� CG Office of Investigations 1_. =life= 600 Washington Street • "•' =- Boston, MA 02111 Y � `' •:. www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information Please Print Legibly Name (Business /Organization /Individual): Kohl Construction, Inc. Address: 31 Campus Plaza Road, Suite 3 City /State /Zip: Hadley, MA 01035 Phone #: 256 -0321 Are you an employer? Check the appropriate box: Type of project (required): 1. Si I am a employer with 12 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ' • Fi 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 required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other 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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 800287201 2009 Expiration Date: 02/10/10 Job Site Address: 150 Main Street City/State /Zip: Northampton MA 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 par s and penalties of perjury that the information provided above is true and correct. Signature: 0 (� � Date: 1 3/9-As ( 0 Phone #: 256 -0321 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 #: .mw Versionl.7 Commercial Building Permit May 15, 2000 SEITION 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Douglas Kohl , 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 thepains and ,,.penalties of perjury ........ Print Nam= Signa Owner /Agent Date SECTI o N 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Douglas Kohl !078992 License Number 31 Campus P laza Road, Hadle MA 10/25/2010 Address Expiration Date (413) 2560321 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 Version1.7 Commercial Building Permit May 15, 2000 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) ered Architect: Not Applicable ❑ istrant): Registration Number Expiration Date Telephone istered Professional Engineer(s): Area of Responsibility Registration Number Telephone Expiration Date Area of Responsibility Registration Number » _ ..... . ..... ....... .......... Telephone Expiration Date nature Area of Responsibility _.._.. . «_ . ,.,,. ..._w..__- Registration Number ress Telephone Expiration Date lature Area of Responsibility ne „ Registration Number dress Telephone Expiration Date ;nature 3 General Contractor Not Applicable ohl Construction nc >mpany Name: D ouglas Kohl �sponsible in Charge of Construction , ..01035 1 Cam us Plaza Road, Hadley ;dress 413 256-0321 Telephone ignature a 15, 2000 ee�tM � Zoning • B� 1,d�1g lobe filled cnby ,at V eo‘,111+1` attcnevv Yrop s3A.11 ng 1S tti1 � i Version1.7 Commercial in al Build. Perm May 15, 2000 ' Department use only . u1 II 111111' +'I 11 ° 1 11111 ,, ill) ,,,' 111 1111 1 II I 1 i 1 III I II I whi Illlni i 11 1 f 1 ui i i 1I1 i Il , I II 11 I III I II �I � i( �{ III III III I I � 11I:,, 11 II II I I 1 � 11 I I I ( I I I I I 11 ` I II II i ,, h, 1 II I II I 1 1 f 1 Il I II !: I II I1 1 1111 I II ,. '„ 111 1 " I I 1 f t 'I 1: �� 1 1 I ( II 111 Il 1I III 1 1 1 i II 1 1� , it , 11 Il J 1 11 li , 111 �, I o I 1 1 I 1 1 111 Il` 1 1 1 I � I d i 111 i, ', , I 111 1 �I 11. I r 1 1 1 l 11 11 l 1 I 1 Il l i I 1 II 1� 1 h I1 1 1 , 1 1 1 l h 11 j �I I II 1 ( 1 11 I' '1 I 1 1j� 1 m 1 I 1i 1 1 1 I1', I 11 11 I �f ll I !, I I 1, ' I ;I i I i I� I 1 I ,:. 11 1' 111 1 I. I . ' 11 �1 I 1 1 .1 I :dm I I 11 11 I I 11 11 1 II 1 1 1 i 1 1 li II I ,, 1 ,' ;I 1 ( u 1 j I 1 I 111 II I 111 I I i 11 II 1 I,'.... ,,, I ( IIII I 1 1 ,II ` I 1 I I 11 I I I1, I ! ', 1 I I 1 I I i I. ! 1 3;1 I 1 1 111 I 11 it 1 1 II 1 . "1 1 I ,I I I 1,," lls i I i I ,1 I 1l 1 I I Ill 1 i I '! I 11 �1j. ;I, I I ;,1 I 1 , 1 1; 1' 11 11 , 1 it ` 1 (1 I I ' 11 1,1 11 1 I, [I I I II I I l 1 I h 1 1 I 1 1 I I, 1 , 1 1 i 1 II II II I I1 11 I I i \\, °c oment # D ON'T KN ' e Con:4 0 YEs 0 • 0 erVa tiOn C oMmission? i 1 1)- s : 1.1c1 t° . y 0 SeVer eXi t NO (3 ' D4 t e Issu d e : 1 Z% , A °°Sed CrI4 ,les '%es to or aciA,41.c.ms ot %ms.‘11,1ntenrc:tdaiilion: t Es 0 NO , 0 NV. vi , vA d part of a commo Plan gra bxcavat ion, or filling) over 1 acre or is it \ IZS, %ell a Northampton Storm Water Management Permit from t D' \s'ce*eci. 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: L: .............. R: 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 Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES 0 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 0 YES 0 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 Q NO 0 IF YES, describe size, type and location: ';Several existing retail/mercantile signs. D. Are there any proposed changes to or additions of signs intended for the property ? YES f NO Q 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 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 ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Rearrange cabinetry, install sink in Petals and Bloom flower shop. 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 I ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C I ❑ H High Hazard ❑ 3A I f ❑ I Institutional ❑ I -1 ❑ 1 -2 0 1 -3 ❑ 3B ❑ M Mercantile 151 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. Mixed ', Proposed Use Group: ,Mixed Existing Hazard Index 780 CMR 34): .5 _ _„ _ _ ..............' Proposed Hazard Index 780 CMR 34):. SECTION 6 BUILDING HEIGHT AND AREA I BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) St 1 2nd . . 2 nd 3 r d 3rd „. _. ,.,_ .,, .._ . .... _.. . 4 m 4th 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 ❑ Zone Outside Flood Zone p Municipal 0 On site disposal system❑ .+ Versionl.7 Commercial Building, Permit May 15, 2000 Department use only City of Northampton ,. Status of Permit Building Department Curb Cut/Driveway Permit ° ,:.. ,, 212 Main Street � t': Sewer/Septic bit��ty r I Room 100 Wate e i Aailab vii ty N . Northampton, MA 01060 Tuiro Set��truc ans ,, "pone 413- 587y1240 Fax 413- 587 -1272 P'lot/Site fns R - I Other Spec 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 Thornes Marketplace . 1 F3 C..) i Map 32C -001 Lot 001 Unit ` , 150 Main Street Northampton, MA S1P677 Zone Overlay District EIm St.' District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Thornes Marketplace, LLC 1 150 Main Street, POB 686, Northampton 01061 Name (Print) Current Mailing Address: - � 413 256 0321 Signature ` G ' 'P` Telephone 2.2 Authorize &gent: t Dou ohl Kohl Construction 31 Campus Plaza Road, Hadley MA 01035 Name (Print) Current Mailing Address _ / 256-0321 Signature Telephone SECTION 3 - TIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $2,500.00: (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of , -7 b U ..a _ .._ I Construction from (6) ��_ w.,, _ , ..,.,�� 3. Plumbing - Building Permit Fee .� v cJ I 4. Mechanical (HVAC) �� 5. Fire Protection "`"._' ,__. _.. _ .__.... ,,,,,,.. 6. Total = (1 + 2 + 3 + 4 + 5) i t 2 o ( Check Number 3 4'f p.-9 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2010 -0665 APPLICANT /CONTACT PERSON KOHL CONSTRUCTION ADDRESS /PHONE 31 Campus Plaza Rd HADLEY (413) 256 -0321 PROPERTY LOCATION 150 MAIN ST -SUITE 130 - FLOWER SHOP MAP 32C PARCEL 001 001 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 �/y Fee Paid 3Y d o2-7 t Typeof Construction: REARRANGE CABINETRY,INSTALL SINK IN 1ST FLR FLOWER SHOP New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 078992 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION 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 O� � / L , / 0 Signature of uilding 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. A. 150 h1AIN ST -SUITE 130- FLOWER SHOT BP-2010-0665 GIS #: COMMONWEALTH OF MASSACHUSETTS apBlock: 32C - 001 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- 2010 -0665 Project # JS- 2010 - 000963 Est. Cost: $2800.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 078992 Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG Zoning: CB(100)/ Applicant: KOHL CONSTRUCTION AT: 150 MAIN ST -SUITE 130 - FLOWER SHOP Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 -0321 Workers Compensation HADLEYMA01035 ISSUED ON:1/19/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:REARRANGE CABINETRY,INSTALL SINK IN 1ST FLR FLOWER SHOP 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 1/19/2010 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo (7(3 5 IN /71' • The Commonwealth of Massachusetts Department of Industrial Accidents -WIMP Office of Investigations Y;- 600 Washington Street _ - X Boston, MA 02111 www. mass. gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): Kohl Construction, Inc. Address: 31 Campus Plaza Road, Suite 3 City /State /Zip: Hadley, MA 01035 Phone #: 256 -0321 Are you an employer? Check the appropriate box: Type of project (required): 1. l0 I am a employer with 15 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7 . 12 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 required.] officers have exercised their 10.0 Electrical repairs or additions 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 12.0 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.0 Other *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. tContractors that check this box must attached an additional sheet showing the name of the sub - contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 800287201 2009 Expiration Date: 02/10/10 Job Site Address: 150 Main Street City/State /Zip: Northampton MA 01060 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 nal • s of perjury that the information provided above is true and correct. 1 Signature: - Date: Phone #: 256- 21 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 #: t ' Versionl.7 Commercial Building Permit May 15, 2000 SECTJON 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 as Owner of the subject property to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date ;Douglas Kohl _......, ., _ ..... .. .. ..... , 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_pams and penalties of perjury. i Print Nang — 09/10/2009 Signature Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder . : Douglas Kohl 078992 License Number °31 Campus Plaza Road, Hadley MA 10/25/2010 Address Expiration Date + (413) 256-0321 Signatur _ 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 COt4'3TRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable all 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 1 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 Kohl Construction Inc Not Applicable ❑ Company Name: Douglas Kohl Responsible In Charge of Construction 31 Campus Plaza Road, Hadley MA Address (413) 695-2200 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�aa _....... z . _.._, :.._.._ �_ ...... Setbacks Front L. 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 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 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 DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: Several existing mercantile signs 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, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 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 J Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing I:3 Change of Use ❑ Other ❑ Brief Description Construction of interior partitions and wiring 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 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C I ❑ H High Hazard ❑ 3A ❑ 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 ❑ U Utility ❑ Specify M Mixed Use p Specify: :Mercantile within mixed S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group. ,Mixed Proposed Use Group. Mixed Existing Hazard Index 780 CMR 34): 5....__, a Proposed Hazard Index 780 CMR 34): L. ..v_ Y._ .. SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1 s 1 2 2 nd nd 3rd ... 3 ._,_.. ,, .. ... ,..._......__ ...__ ..,. 4 m Total Area (sf) = Total Proposed New Construction (sf) Total Height (ft) i ......... Total Height ft �. 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public 12 Private ❑ Zone Outside Flood Zone p Municipal p On site disposal system El . Versionl .7 Commercial Building Permit May 15, 2000 Department u ©nty • City of Northampton Status mit: r Building Department Curb G ut�Oriy Permit 4 A � 212 Main Street Sewer /peptic Availability i.,:,,:;;,,,,.„*„.,,,„ Room 100 WaterJV Aua�labitity „A a�� w c Northampton, MA 01060 Two e� %f Structural l ian , phone 413- 587 -1240 Fax 413- 587 -12 1 . v i . u APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMIL1Y Dy IN �r ? 0 2009 SECTION 1 - SITE INFORMATION L......___ .. _, 1 . , i This secti9n to 0 e cofpleted by office 1.1 Property Address: - --. __ _ � d 1Thornes Marketplace �! M ap 32 -001 Lot 001 Unit 150 Main Street 5,,,,,, ' /070 1 Zone ' Ov erlay District =Northampton, MA 01060 L trim St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Thornes Marketplace, LLC 150 Main Street, POB 686_ , Northampton 01061 Name (Print) Current Mailing Address -- '° (413) 582 9970 Signature (� 3 Telephone 2.2 Authorized 1st ent: Kohl 1Fstructio f '31 Campus Plaza Road, Hadley MA Name (Print) Current Mailing Address L( 41 3) 2 5 6-0321 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $800 00 (a) Building Permit Fee 2. Electrical $ (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee r 4. Mechanical (HVAC) -. ._ .__.... _. _,.... _a... .� ., .. .. $55.09j 5. Fire Protection �/' 6. Total = (1 + 2 + 3 + 4 + 5) Check Number �1V //� 04.5-5-- This Section For Official Use Only /( Building Permit Number D ate I ssued Signature: Building missioner /Inspector of Buildings --- Date 6 File # BP- 2010 -0280 ' APPLICANT /CONTACT PERSON KOHL CONSTRUCTION ADDRESS /PHONE 31 Campus Plaza Rd HADLEY (413) 256 -0321 PROPERTY LOCATION 150 MAIN ST MAP 32C PARCEL 001 001 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 4.3 1 1b l r it 5-5 Typeof Construction: CONSTRUCT INTERIOR PARTITIONS & WIRING - SUITE 120 New Construction Non Structural interior renovations Addition to Existing, Accessory Structure Building Plans Included: Owner/ Statement or License 078992 3 sets of Plans / Plot Plan THE FOL WING 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 �' % L Q Signature of'I uilding Official Dat! 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. 15014AAT40,80111 00. BP-2010-0280 GIS #: COMMONWEALTH OF MASSACHUSETTS 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- 2010 -0280 Project # JS- 2010- 000360 Est. Cost: $1100.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 078992 Lot Size(sq. ft.): 16683.48 Owner: THORNE'S MARKETPLACE LLC Zoning: CB(100)7 Applicant: KOHL CONSTRUCTION AT: 150 MAIN ST -SUITE 120 Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 -0321 Workers Compensation HADLEYMA01035 ISSUED ON:9/22/2009 0:00:00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT INTERIOR PARTITIONS & WIRING - SUITE 120 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 9/22/2009 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo 150 MAIN ST - LEFT CLICK - LOWER LEVEL BP-2010-0714 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C - 001 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL cA42N) ' Category: .4VILDING PERMIT Permit # BP-2010-0714 Project # JS-2010-001064 Est. Cost: $3800.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 078992 Lot Size(sq. ft): 16683.48 Owner: THORNE'S MARKETPLACE LLC Zonina: CB(100)i Applicant: KOHL CONSTRUCTION A 7: - C ' Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256-0321 Workers Compensation HADLEYMA01035 ISSUED ON:2/11/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RENO TO STORE FAQADE & ENTRANCE DOOR & ADDITION OF INTERIOR WALL & DOOR 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: 4-1 AO House # Foundation: Driveway Final: Final: Final: OA p" Rough Frame: DK )_ 2 Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: O 3(f5/10 E .4 1 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. ,P _740e1( Certificate of Occupanc, k, signature: FeeType: Date Paid: Amount: Building 2/11/2010 0:00:00 555.00 212 Main Street, Phone (413) 587-1240, Fax: (413) 587-1272 Building Commissioner - Anthony Patillo • ..,......---.---- ' 40, .,0,,,,071".1-'— ., ,..'. ; .„:ir,Kf" "W7 +SIB d ,p A< u ry. > e . , • o p 'T 0 . \ i ' '' ill IV , 7 /' A'. t'il ' . fi',- i'` i,_ r ` � ' , 5 il I ' 1, I`! ' IAN . ) 111,, 1 li.. � . �� . • ti R ,E,s -. � - \ , l ' i ' ma y,: \ \ \ E 1 rl• ( fi " � � tt /1 ' \, / {, \ I 3I. - - • M .L , ,, `i,. ,. / nI ; , t 1 .a u , .. , , , A It -; ,,,,, -..'i : .,1 or: ..., ,, ,, 1 ...__,...,...... ...i.. , i„ . r ,., , : tii . , , 44 y rtm ........,, r ya;: �^ , � .' . .. _ =�� - ' s a 1 • 10. Do any signs exist on the property? YES V NO IF YES, describe size, type and location: i( (?- eC"0 i- ex 16 /vt (4 iur t /W {6U4 Are there any proposed changes to or additions of signs intended for the property? YES NO IF YES, describe size, type and location: 11. Will the construction activity disturb (clearing, grading, excavation, or filling) ov 'r 1 acre or is it part of a common plan of development that will disturb over 1 acre? YES NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION This column reserved !v VJ\ for use by the Building Department EXISTING PROPOSED REQUIRED BY ZONING Lot Size Frontage Setbacks Front Side L: R: L: R: L: R: Rear Building Height Building Square Footage % Open Space: (lot area minus building a paved parking # of Parking Spaces # of Loading Docks Fill: (volume 8 location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: 1 ( Applicant's Signature NOTE: Issuance of a zoning permit does not relieve : app . is burden to comply with all zoning requirements and obtain all required permits om the Board of Health, Conservation Commission, Historic and Architectural Boards, Department of Public Works and other applicable permit granting authorities. W: \Documents \FORMS\ original\ Building - lnspector\Zoning - Permit- Application- passive.doc 8/4/2004 ' RECEIVED JUN 2 8ZOtl ioct+r or�►....scrnN! File No. �/0 N°R " Arm " . "" a 2tiffING PERMIT APPLICATION ( §10.2) J Please type or print all information and return this form to the Building Inspector's Office with the $15 filing fee (check or money order) payable to the City of Northampton n n t 1. Name of Applicant: 0 1 7\ / 170 ' " of 1 tiles 1" 6t( pt aC c- Address: M ul, ( 0 (ii F%LWI p9/1 Telephone: f 413 2. Owner of Property: R t Crt4 M Qt)1 +' ` '€ c Po u6444- le-444 L Address: 1 120 MU.(/l 4 +. ) 0 Q A 1 4 1 1 A 4 1 / 1 A Telephone: + - 5 2- gel - 7D X I C 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) 0W4 l 01 4. Job Location: 114414 tqU IUeG- i L ✓O (. Glly'1 �1 Parcel Id: Zoning Map# Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) ji 5. Existing Use of Structure/Property: 2C7a-1 4.. IvLGLI 6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary): VI. Q+ vt�rr 00(ti o1 (4 €5 ' MG 1 in S$r.e - LC4I C ft, F res, 244 +(owl.a'o -s Vfi I -1f StAimitI(A outer ttinvias + 1 . Tv►. alb QA440v4 t M - e(l1Lls as weal.( ei6 p pirdu.c41(er o f WtAi` idt-t s ti Cvvn -e4( 1 111 fA II y 1 10,14 4' In sal rte( 4.1A vt (O w112d -w�/ 7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans / 8. Has a Special Permit/Variance/Finding ever been issued for /on the site? / NO DON'T KNOW " 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 # 9.Does the site contain a brook, body of water or wetlands? NO J DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , date issued: (Form Continues On Other Side) W: \Documents\ FORMS\ original \Building- Inspector\Zoning- Permit - Application- passive.doc 8/4/2004 File # MP- 2012 -0014 APPLICANT /CONTACT PERSON THORNES MARKETPLACE LLC C/O HPMG ADDRESS/PHONE P 0 BOX 686 (413) 584 -5582 (5) PROPERTY LOCATION 150 MAIN ST MAP 32C PARCEL 001 001 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: ZPA - ERECT BANNERS 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 ACTI HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRES TED: 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 V 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 ' •�: • m Elm Street Commis • n Permit DPW Storm Water Management � ' 7- Signature of Buil• mg 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 the Office of Planning & Development for more information. REVISIONS # Revision /Issue !nit Date SUITE 160 203 S.F. O D\ — UPo Ca d\ - n005 JOBNAME DATE SUITE 160 11.17.09 160 THORNEQ , TITLE SCALE MARKET PLACE 1ST FLOOR 114" =1'0" 10 COPYRIGHT 0 KOHL CONSTRUCTION, INC The Commonwealth of Massachusetts � Department of Industrial Accidents P7, � t� / , � i= .; Office of Investigations 600 Washington Street ° .1,= Boston, MA 02111 r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name (Business /Organization /individual): Kohl Construction, Inc. Address: 31 Campus Plaza Road, Suite 3 City /State /Zip: Hadley, MA 01035 Phone #: 256 -0321 Are you an employer? Check the appropriate box: Type of project (required): 1. Si I am a employer with 14 4. ❑ I am a general contractor and I 6. New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7 . 0 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 required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other *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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 800287201 2010 Expiration Date: 02/10/11 Job Site Address: Thornes Marketplace, 150 Main Street city/state /zip: Northampton, MA 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 painsjndpenalties of perjury that the information provided above is true and correct. Signature: 9 e- \ �---- Date: 08/18/2010 Phone #: 256 -0321 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit /License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Theodore Parker , 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. Theodore Parker Print Name G 1 08/18/2010 Signature of Q r /Agent 1 Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Theodore Parker License Number 31 Campus Plaza Road, Hadley MA 01035 5`I j, )r / ) 2- Address ) Expiration Date (413) 256 -0321 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 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 Kohl Construction, Inc. Not Applicable ❑ Company Name: Theodore Parker Responsible In Charge of Construction 31 Campus Plaza Road, Hadley MA 01035 Address 3 6. (413) 256 -0321 Signature Telephone 4 j Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L. R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW C) YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT 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 DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: ': Several existing retail /mercantile signs D. Are there any proposed changes to or additions of signs intended for the property ? YES (D NO 0 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 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. r 5 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 ❑ Demolition❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Remodel of existing cafe space (Suite 160). 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 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 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 ❑ U Utility ❑ Specify: M Mixed Use GI Specify: Mercantile within mixed S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Mixed Proposed Use Group: Mixed 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) brie 14 ete" : 5130 _ s, 2 nd 3rd X 7514 3 f X i 4 Total Area (sf) 40 W4 Total Proposed New Construction (sf) I 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 ❑ Zone Outside Flood Zone p Municipal 1151 On site disposal system 0 � r Versionl.7 Commercial Buildin• Permit May 15, 2000 Department use only City of Northampton Status of Permit: ' Building Department Curb Cut/Oriveway Permit $ PLV 212 Main Street Sewer /Septic Availability 1\� '! Room 100 Water/Well Availability: \Northa pton, MA 01060 Two Sets of Structural Plans phone.4 - 87 -1240 Fax 413- 587 -1272 PIot/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 Thomes Marketplace Map 32C -001 Lot 001 Unit 150 Main Street, Suite 160 (old Marketplace Cafe) Zone Overlay District Northampton, MA Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Thomes Marketplace, LLC 150 Main Street, POB 686, Northampton 01061 Name (Print) Current Mailing Address: (413) 256 -0321 Signature Telephone 2.2 Authorized Agent: Theodore Parker, Kohl Construction 31 Campus Plaza Road, Hadley MA 01035 Name (Print) Current Mailing Address: (413) 256 -0321 Signature C/ C Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $15,000.00 (a) Building Permit Fee 2. Electrical $4 000.00' (b) Estimated Total Cost of $21,500.00 Construction from (6) 3. Plumbing $2,500.00 Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= (1 +2 +3 +4 +5) $2 9 Check Number 3 l '11 1a-ct This Section For Official Use Only Building Permit Number Date Issued Signature g of Fl //d Building Commissioner /Inspector of Buildings Date PS WIN ST- .RAG'S coFFVE ° < BP- 2011 -0128 GIS #: COMMONWEALTH OF MASSACHUSETTS L ° , 4apLBlock: 32C - 001 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 -0128 Project # JS- 2011- 000182 Est. Cost: $21500.00 Fee: $129.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 064539 Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC CIO HPMG Zoning: CB(100)/ Applicant: KOHL CONSTRUCTION AT: 150 MAIN ST -RAO'S COFFEE Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 -0321 Workers Compensation HADLEYMA01035 ISSUED ON:8/18/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: RENOVATE COFFEE SHOP 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 8/18/2010 0:00:00 $129.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck— Building Commissioner 150 MAIN ST -RAO'S COFFEE BP -2011 -0128 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C - 001 CITY OF NORTHAMPTON Lot: -001 PERSONS C )NTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PEI IT Permit # BP- 2011 -0128 Project # JS -2011- 000182 Est. Cost: $21500.00 Fee: $129.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 064539 Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG Zoning: CB(100)! Applicant: KOHL CONSTRUCTION AT: 150 MAIN ST -RAO'S COFFEE Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 -0321 Workers Compensation HADLEYMA01035 ISSUED ON:8/18/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: RENOVATE COFFEE SHOP 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:6 `) f, - II) I, \ ,Rough: House # Foundation: Driveway Final: Final: C ?'' 1'`)., /p 4 9 inai: n ,y� /6 ,// G G Rough Frame: CI gr_/g--/O cups.. Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: i K 8 - r) — /U C k. THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. (1 440 Certificate of Occupancy ' gnature: FeeType: Date Paid: Amount: Building 8/18/2010 0:00:00 $129.00 212 Main Stree Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner