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32A-147 (2) -J7 S dwr� System Notes EF1 - 24" Centrifugal Upblast Fan, 1.5 HP, 12011160, 4800 CFM, 1665 FPM @ 0.86" SP WC. City of Northampton Fan will be hinged and equipped with a removable grease pan. Building Dec)artment _ Duct - 16 GA galvanized duct, welded seams, welded joints with Clean Plan Review 212 Main Street outs at direction changes and at each floor Northampton, MA 01060 V EF1 �` Clean Out ,s` f Door 3 Masonry Wall Clean out Doors i ��s 1 1116„ P �. Existing portion of duct to be reused t a yi s� i .JOB LOCATION �� SCALE ��"� � s As Noted _ SEID A w Local Burger t MA CAL RN BY --•�•��. 16 Main Street w� ack Seidman 25 SIXTH STEE A-ry Northampton MA 01 60 �' .mow °ATE CHELSEA MA � � Jul 31 , 2015 25 Sixth St. SALES ORDER 1 BROS. INC. Chelsea, MA 02150 Sales Order Number: S02015-217 USA Sales Order Date: Jul 24, 2015 Food Service F,yuipment Dealers, Sttl B Aug 2,2015 Design,Fabric-arion.&I n.srallationrf Kitchen Ethou.st,Swems Voice: 617-884-8110 P y 9 & Page: 2 cu.vonr Srainless Steel Fabrication Fax: 617-884-4284 To: Ship To: Local Burger Local Burger 16 Main Street 16 Main Street Northampton, MA 01060 Northampton, MA 01060 Voice 413-586-5857 R Fax Customer ID PO Number Sales Rep Name Local Burger Jack P. Seidman Customer Contact Shipping Method Payment Terms Joe or Jeff Our Truck C.O.D. Quantity Item Description Unit Price Amount We believe this will take a maximum of two days and may possibly happen in one day.You will need an electrician to run his wire to the roof and connect the new fan. Subtotal 10,150.00 Sales Tax Freight 0.00 TOTAL ORDER AMOUNT 10,634.38 Finance Charge is computed at 2% monthly(24%APR) on all balance: over 30 days old. 25 Sixth St. SALES ORDER BROS. INC. Chelsea, MA 02150 Sales Order Number: S02015-217 USA Sales Order Date: Jul 24, 2015 Fa,MWSerme F.qu;pme Ship B Aug 2,2015 Design,Fnhrication.&ln.sra(latinn of Kitchen Exhaust S)•ems Voice: 617-884-8110 P y 9 Cu.crorn.Stain(es:c&.Steel Fabrication Page: 1 Fax: 617-884-4284 To: Ship To: Local Burger Local Burger 16 Main Street 16 Main Street Northampton, MA 01060 Northampton, MA 01060 Voice 413-586-5857 R Fax Customer ID PO Number Sales Rep Name Local Burger Jack P. Seidman Customer Contact Shipping Method Payment Terms Joe or Jeff Our Truck C.O.D. Quantity Item Description Unit Price Amount 1.00 Job-Labor Labor to remove and dispose of existing duct and fan 1,200.00 1,200.00 1.00 se exsys Exhaust System with 24", 1.5 HP, 1 spd, 120v. 7,000.00 7,000.00 upblast Fan, hinged mount, grease trap, and welded 16" x 18"duct. Duct will run to roof then in 10'from property line. 4800 CFM @ 1665 FPM 0.65"WC SP infab 999 Zero Clearance Duct Wrap by the square Foot 9.50 1.00 Job-Labor Crane service from Local Company. If you can 1,200.00 1,200.00 arraign adequate crane we will waive this fee. 1.00 Job-engdrw Stamped engineered drawing of the exhaust system 750.00 750.00 for the Building Dept. (If required by the town) Job-Prmt cnslt Consulting with Inspectional Services in your town. 550.00 Includes permit fee. Job-Prmt cnslt Hot work Permit from FD 550.00 Job-Labor Fire watch detail, If required by FD, One full day 250.00 Job-Labor Hourly Travel charge will be billed at our standard 250.00 rate of$250.00. (Discount to$150) Price includes delivery and setup of listed equipment. Unless specified, NO plumbing,electrical, carpentry, fire suppression, welding permit,fire watch detail,or subcontracted work is included in price. Subtotal Continued Sales Tax C on rnue Freight Continued TOTAL ORDER AMOUNT Continued Finance Charge is computed at 2% monthly(24%APR)on all balance: over 30 days old. �1 aOC40R° CERTIFICATE OF LIABILITY INSURANCE D IDD201/Y5 TYPE OF INSURANCE 13/ r4/13/ 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy((es)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER MHA Insurance Agency Inc. 5 New England Executive Park NAME Debra Steeves PH HE . (781)262-6250 FAX 0.(781)262-6138 L ADDRESS:dateevez@mhainsurance.com INSURER(S) AFFORDING COVERAGE NAIC ak Burlington MA 01803 INSURERA:Travelers Insurance Company /31/2015 INSURED INSURER B:Commerce Insurance Company $ 500,000 Seidman Brothers Inc. INSURER C:Chubb Group MED EXP M one person 25 Sixth St INSURER D: S 1,000,000 INSURER E: GENERAL AGGREGATE Chelsea MA 02150 INSURER F: PRODUCTS-COMPIOPAGG COVERAGES CERTIFICATE NUMBER:CL1541300087 REVISION NUMBER• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY NUMBER 0 Y M POLICY XP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE EI OCCUR BWEC CS9539 /31/2015 /31/2016 EACH OCCURRENCE $ 500,000 ru ne c 1,000,000 MED EXP M one person $$ 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 1,000,000 GENLAGGREOATEL1 IT APPLIES PER: POLICY PRO- LOC PRODUCTS-COMPIOPAGG S 1,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OVMD AUTOS X AUTOS X HIRED AUTOS X ALIT SWNED GKSLZ 0/8/2014 0/8/2015 fNED IN IT eni 11000,000 BODILY INJURY(Per person) S BODILY BODILYINJURY(Peraccident) S ROP scold R uiD AGE (Per $ a C X UMBRELLA UAB EXCESS LIAS OCCUR CLAIMS-MADE 79892380 0/8/2014 0/8/2015 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED I I RETENTIONli $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER FXCLUDED7 E-1 (Mandatory In NH) It yes,describe under DESCRIPTION OF OPERATIONS below NIA BWEC C89539 /31/2015 /31/2016 WC STATU- I OTH- FR E.L EACH ACCIDENT $ 500.000 E.L.DISEASE-EA EMPLOYEd S 500,000 E.L.DISEASE-POLICY LIMIT 1 S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space Is required) ACORD 25(2010105) INS025(2o)o0s).oi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ®1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 < Boston, MA 02114-2017 www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Seidman Bros. Inc. Address:25 Sixth Street City/State/Zip:Chelsea, MA. 02150 Phone#:617-884-8110 Are you an employer?Check the appropriate box: Type Of project(required): 1.E]I am a employer with 15 employees(full and/or part-time).* 7. E]New construction 2.F1 I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. F1 Demolition 3.[]l am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E] Building addition 4.n I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 14.❑Other Kitchen Exhaust Syst 6.R We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Travelers Insurance Company Policy#or Self-ins.Lic.#:08WEC CS9539 Expiration Date:3/31/16 Job Site Address: 10 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Q,Gd Date: August 7, 2015 Phone#:617-884-8,40 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#: To: Seidman Bros. Page 1 of 2 2015-08-07 18:43:12 (GMT) From: Chris Allard FAX COVER SHEET TO Seidman Bros . COMPANY Seidman Bros . Inc. FAX NUMBER 16178844284 FROM Chris Allard DATE 2015-08-07 18 : 42 :27 GMT RE From Local Burger COVER MESSAGE See attached scan www.efax.com Received Time Aug. 7. 2015 2:43PM No. 6027 To: Seidman Bros. Page 2 of 2 2015-08-07 18:43:12(GMT) From: Chris Allard `�'�:t5a�r9-t.7 r'i�i�t.s9ar^ae9N1 tfuulda�t�i?.c9��if htt.3y t5�2fl(}p _. S 1C)tJ t�<STt tt 79 �I Eta tv F'EEFt E "Jt 'IN(7q CEV49�9 i tt 71 kid pendent StiuCtur 9H�rr4G.i4r Gig St uctural Feer Rev,16t, OU rw Yas eta . . . _ .w SMI, Ii f WRIER'plUTE{ORI ATFt7tr1 Tt�'F3�C�CF�Af"�i�TE;l3 i�Wll�i�. OVItNttS Axt�kT CI Gf?3VTdiAr:�7CFR 1#FE?LESS'Fi 8lJI E_E]IN PFtltET .�::;d.._s.......:a .,....,. .. . .�. ,... ,zias Ownor of the su a mperky T�pt k Sct 3ctt tt r `� idrn��t rras In herety eutt9nrlFc t ._ « - tx� act on:mv J aE'I,rnattmrs•rrvlatiue to�im,rk AtttrlsJl rimed 14 this hukWing permit applic„ano! Sig sfu€c: 0Wner .:..., D ate. . Tttclz 4etdinan,I Seidarnsi"Bro ln� A ent hereby d'.eclare l:hat tt'+e 6tatemen S and information on the foregoing appii0at.an arx,t9�,a andoo-curate,t+�the 3aest of my knuhledge arid.. .0, r, .... . S,e�rrscl,k9r�d r tEae qi s and penaffies r��e9kuiJ°. . yJ3ck. Sold[1743E1. - rnil r _ EyiakfacMridaas Vtz Cg n � � i)tScFn lyk�e9drnano1Izirraa+FrM 9ne. i�l81031/20. � �4E��il!•6si 1a`+Ve4 isCl'zxseuieI-Dn'hrcom.e,«.LS ..... _:: ------------ ..... ............. .............. w.,«. sauri<tu rat f rJ mt rJAy9er. Date : �1<tir� r��x . E�PfS'T�tE1CYEp6�9E:k�;II��S - 1Ci.1 Lie en o�tgirtte<#tan.Sup�sn+tsor Not.Appticatale 171 # 9. �4+�titt .rt5 U�?17 ' h[arxra Carr E_ir.nnse t'is�tdea: _. Lkanse Number 1.,;b 1 0 t C X44 0215Ct ;lI�4l ':C31 ,Andres c,vkUN>srgpd.4y A,dg 1c�nan ExOr!,9aC>rsl?a1r.' Jack,. ,.Siic}tr3f�rsaJl v�`IS�nc',t�dr47 �a+,s 24rSCti41]SiS�+,7„:s•ait9 t`R:d4..F.lay>rtc. n.• . >Et:T E+ EV t3 {Vl( tEiJERS ct�rE3E+tVSirii�t�a Etvt^-l tlAfttfw EiFrE=ivlTIM 0 ,§zs (s} Wa.k?rs t arnperrsekion Insura�ce affidavit ntust;E�a eorr9�tete�i a,n�subnt ttad vrith this ap lica*ion;Failure to prpvtde this.ff�ia�r�twill result in the d 3 vial of the.is uance of the bu�dir'+g pormit SIgne/ �tfl suit AttaehG-d Yes X o Received Time Aug. 7, 2015 2:43PM No- 6027 ` 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 O No O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I Wai Lam as Owner of the subject property Jack Seidman/ Seidman Bros. Inc. hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Jack Seidman/ Seidman Bros. Inc. I, ,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. Jack Seidman Print Nam Digitally signed by Jack Seidman Jack Seidman DN:cn=Jack Seidman,o=Seidman Bros.Inc., 08/03/2015 ou=Sales,email=jack @seidmanbros.com,c=US Signature of Owner/Agent ate: Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Jack Seidman CS-072179 License Number 25 Sixth Street, Chelsea, MA. 02150 11/02/2015 Address Digitally signed by Jack Seidman Expiration Date Jack Seidman inc cn=Jack Seidman,o=Seidman Bros. Inc.,ou=Sales, (617) 884-8110 _ il l rkap—id—nh—rnm r=I I[ Signature Date:2015.08.03 15:47:05-04'00' 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 e No Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Lawrence Roy P.E., F.P.E. Name Area of Responsibility 88 Foundry Street, Wakefield, MA. 01880 34505 Address Registration Number (781) 245-9888 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 Seidman Bros. Inc. Not Applicable ❑ Company Name: Jack Seidman Responsible In Charge of Construction 25 Sixth Street, Chelsea, MA. 02150 Address Digitally signed by Jack Seidman Jack Seidman ou cn=Jack Seidman,o=Seidman Bros.Inc., (617) 884-8110 ou=Sales,email=jack @seidmanbros.com,c=US Signature a 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 40 40 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 C) DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW ® 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 (�) YES C) 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 ® NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO e IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versiont.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 Remove existing upright kitchen exhaust duct and replace it with new welded duct with Of Proposed Work: clean-outs. New fan will be located at top in place of wall mount blower. SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: 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 St 1 St 2nd 2nd 3rd 3rd 4th 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 ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: L.' II Building Department Curb Cut/Driveway Permit - AUG 14 2015 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Elect`.i r,;&"Ga'; i,spJtiorlq rthampton, MA 01060 Two Sets of Structural Plans "'A -587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Local Burger Map Lot Unit 16 Main Street Northampton, MA. 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Wai Lam 4721 243rd Street p Name(Print) Current Mailing Address: (917) 930-3288 Signature Telephone 2.2 Authorized Agent: Jack Seidman 25 Sixth Street p Name(Print) Current Mailing Address: (617) 884-8110 Signature Telephone SECTION 3- TIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee 2. Electrical $650.00 (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection $9,400.00 6. Total =0 +2+3+4+5) $10 500.00 Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0185 APPLICANT/CONTACT PERSON SEIDMAN BROS INC ADDRESS/PHONE 25 SIXTH ST CHELSEA02150(617)884-8110 PROPERTY LOCATION 16 MAIN ST MAP 32A PARCEL 147 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid p Building Permit Filled out Fee Paid Typeof Construction: REPLACE KITCHEN EXHAUST DUCT&NEW FAN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: 1 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 e zrg Si ur of Buil ' g 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. 16 MAIN ST BP-2016-0185 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 147 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-2016-0185 Project# JS-2016-000314 Est. Cost: $10500.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEIDMAN BROS INC Lot Size(sq. ft.): 3005.64 Owner: 16-18 MAIN STREET REALTY TRUST C/O WAI LAM Zoning: CB(100) Applicant: SEIDMAN BROS INC AT: 16 MAIN ST Applicant Address: Phone: Insurance: 25 SIXTH ST (617) 884-8110 WC CHELSEAMA02150 ISSUED ON.811412015 0:00:00 TO PERFORM THE FOLLOWING WORK.REPLACE KITCHEN EXHAUST DUCT & NEW FAN 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 8/14/2015 0:00:00 $100.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner ° �� - ��,, <,.�,;:, .�'. �¢` .,. ,� 'ti` :`.. - ,, ;y System Notes EF1 - 24" Centrifugal Upblast Fan, 1.5 HP, 120/1/60, 4800 CFM, 1665 FPM @ 0.86" SP WC. Fan will be hinged and equipped with a removable grease pan. City of Northampton Building Department Duct - 16 GA galvanized duct, welded seams., welded joints with Clean Plan Review outs at direction changes and at each floor 212 Main Street Northampton, MA 01060 I , EF1 Clean Out � Door i f, F� Masonry Wall Clean out Doors ,S 1 • i c1 t4 , 1 18" 16" t i � r t \� Existing portion of duct to be reused 1 ti t b s a 3 JOB LOCATION �, SCALE z As Noted SUDWA Man Local Burger , Ha �A� , RN BY 16 Main Streeto ack Seidman 25 SIXTH STREET Northampton MA 01 60 M �� DATE CHELSEA 9 MA 02150 �� July 31 , 2015