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32C-001 (46) �Y" y. �', ���� �`�,; •, :. �,, � . a,� :' � Asa.- , h' m u � y1 A Now / a a NO 3 � as --✓ ,� 4 y __ ---- it ...� '� g � Y �, , a � ,, �.. � y� A g �{x r� 5 .3i Pi- 7 44 Viol-A ,. a-�� *., .. ............. ............ _,,, } ai z Wiva Adhesive Anchor Selector Chart HIT HY 200-A Rs ' #!IT HY 200-Et HIT-Hy 100 E HIT-HY In PLUS NOMMUMNAMM HIT HY 70 WT SSE°:500-995 F i 8 3-it T f-E HVI) [ J( HAS E €'€E"f V Y I < t Yc= , S 290 Hilt . outperform. Outlast. p, i 1,f1woi S i 2:cZ r k miles Inc w,hatt(eld 0:0*14132478338 P,0431003 It P Member Data Dmscrt ran:U r r , r T p to t°aU r ».._:: cvl P' a rsrrttr tv; tip..et are!ufaorr q t'Onflr'L:OL:s 34 e 000/12 4PP,^M LCOn, F1r awv'o ti Onc vLift:"-Y 110d g Coe M-s ' LQ41 MW Dead Load; 0 PLF Ack Can,ado—fuiv ?4annt bw klveiaht, 116 UFF Other Loads eta to other Daad t ; eac€tptcatt} ail 50 an E114 Walh Vxft Lntt dart Ed catogttry tt Rowee n a at Unmet M LY.F s Tan 107 21 u M, >o: 7 B aY I Lv$wm(PLr) U i ON" 24 C " 27 ? Lea Jnh(,TPLM AD 0 6M, 6W 44 Loa Pool i 3"E on z4 6M, �i '83 I ve Me L , qV > € I l3earinip and Rvaotions �p 1°asst ET�dtt Cyt$4`hi'j L"aP�v$� L'04ativri Type z atd* ; Le'gM Aogti'rad Reacttti.n Lbtzttft C C.C3rst3' '41aa FtF ;ur, (4 2 �J' WA,,p R Maxmiurn Load Case Root tia E Da"Ogy"spans H �rodu t; 1-314x14 VERSA-LAM ,0 3100 Sig 2ply BASSES DESIGN HECKS ' ou n wag mt cort9nijaera iato*tux&ta p along vie top cuts, r „oee3gn aeaarmtaa et+r tirwooa tatem!bM,09 zi ung tha i att rrt 'wrd ,allowable$trues Design � A;toaj AjJvwl%b a capacdtj Location LoaWnq k, �Cft'E,r f t,„ C:s;za' '�:C „�a3 •�" T.:ss6a�l cttrl i ;i NEW ZvL (t ?E t [1oni-r*OP4 (z .,. akaarass„arftsn+rr��eou� A+ tvt�x.Aa*r m'4�ac x'c c assv a xa 9,rs uxs�Y Saag s s ,�,�z �� a?>�:ar�s,3asna`�s�v �zva aa xf ��➢ S+«„ �?�'r 9nns�q rslf 6a'Awta�{a a�s�drao�xr.e t➢mgr ms��s�a23eY rova�Y E,€Eh�$ari3E.T �r�q,$ ice, *s,.R>J.n�s saA,ae,a3r,ice a 9,�auPa�a�s�. how Ma;a tin No _ _.9Js 47ac t 1 M812015 12,'01 r K mics tnc w,Matfielt! 141 e1783 P,002141 ld191 13 r5 Member Data is Description:catcW %"artl;,de T+YP8,cwcor A io,t 's.Roof f 4;;QtY IM"6 R?dt5° Top;.,WWI Sra:inq, S;'O e SlurdordLoad', '1oivureConeiton Dry 1ainq-:.cde, b(" f»:'. u load PL R 00& km Cr;tzsnw r 360 tiae ',j 4 s. tai Nal iload�. 0 FLF Deck Connecs €:tug te>x 4A PLC I".kit} Em LLWAV•C' $a Other Loadtt � Type 7nt. ottor 0"d (tl"wiption) W3 S* In Eno Width atmt :r:j Start End eCuvury i � e�rt�rs,�srstti�rarr�rr�,.�j TCN� ° " fsi c rtott s� t( T' # 1 a° xf ? Uvo w } I . J _...... �..,.,,e r h i Bearings and Reactions Input title avv ty 43rov4y L.oc�rf'cn �fPn tAat+criot L�da6th �oqukad I�oaCt4Q^. tlrs3ft VIVO $PF rte; ., M,kx,.:., Maximum Loaf#CAse Ronotione q win,.xdE�q prm �cxa ir:aa�w�lr ssmSY"�KS�'+Dra Deac Product Hem-Fir(N)#2 2 x 14 1 pi ..:° ' #' FAILS DESIGN vHECKS Allowable Stress Design Actual Movable capadry LOCA06n �uxdGntp P'I)p,vs Worno-t !3 23:x 32102# +422% 12' ifa;r,U-44 G+ Pa"') o eR 1628.01 :121.6 i0� 023' TotalUodD+1. 11 1otai toad t Ftt.i 1, 7 � A1F pt3y;{1.T, S�PMa4:'A F .. Dc'-V a s°1t +nr �`s`c Y .iP�d � t 6r T•ud t y�9+1� r A>^.CM1 HdbS "d3 Rfiw� 5a� 3,t B33 1 a4t :tied.°';Sw aB £� Jai ��� €� Pd€W Hiff"!'3"Via, S.LN �^-l" .�.yF""'1 �,..Nns-r}y r�r�ri�,n Ss�xx�� N> d�a:vaS 'av-ti+ s-va-,iv�j gru4xS3-�s� ,,may,.---`�,.•-_°_._ ..u�n�tr��+� fiau� ►v��$ �rv�.�.s,x3 ---°-''�� -v��.��e� ;~tx� �n��.��,�� ._--___ ._ �. _a_ ____-,-.:____."`� .z,,,w. . ,3 kf , -t M.J.a..4(qf� .Y� 4r �7 C•z7 - 'a*�'Df E[./.i 1.�ae�,.3.,,3n •' -iS•.••7 c,�t�Aws a +s.a., y rr s-2 i it -7 � - 46 '7n� i-Av hIx j' 7u,yS x dab 1 nras� nac, -7n A. x fu rl} '1acv ---- 'Yl torn 4"1t M X21'3'D<:L— <v i i i � 3L 3ivN�13n.}� ` � n1, 7,�)t 4't i.��ri S 3�p7J rn 9 N �„•f ---�_ �...- _. - f+ 3 nJV'L D w+3w o,3y �+��d `21 t ca o,j l S �5nt{ ,uaxs°-�4 344sFn� y31sr Oby�o z40`vr�r�t L t 694'ON 71 F 11A13 u� ONY133NA -__._........_ V OIAVO o 9J a? rsSrW-4p H� CIQ Z'11C7 VW ..J,-a 31t.Lu ti a vw 51F 7"9')n.�r `SY-�Q;•r t n� ys2a•��� ',�j�tyGt.;y�y/ �1.�b 2/��i?o�' .t�;7r7+Cr'y�f S�it�2�©,i{� t® ERS CONSTRUCTION NARRA"FIVE ONSINI I.,,.1..m NI.#M. tMI fa'.?ti`t Wool N k7m, 35 M1 sm"r I"0 Oaln1 -, C' 'ii CO11f° 011"1"111", �\'OWK I'l s;a 4i waisd dm",, 1%vo o the existing,We" Il.}trc Ih.' n Cali w wla„I"',paw EIS voicr v,-,:$c, lo crew a i•:.a,1 Dull;'!"n) vicc," I hewe We,,,.l a%I€I'I.vof,1 I,,..mM&I'm Ilil',13f11th"a, (''?tg6alno I�ic�..l j uw �;."��,'iSa?.'Hw h El gme t 'now, s � 4i f°Ctrl I=� 3t,3a,[�"�l=::i� ¢,f lax IV t�tt �t �Juxs°:�rk�,=W'?wi*,$t�t„3tti(U", fllcac,c'ev dic atti l4hcd load walculailki l .}um ho%k.` V dl Y (Iti`-..iacir Cs�dl 4„:uraisiw x 5€!!T'�,i.t'alcl ad i� ul t1CedN b) lit I � ml€tiff±,tft d al f€I`�l;r hl IT cO cum n! I?tl I,iit1„r vt d *� P1 AN buk RUM WWI BtliW as h pnnlu<+uW P, all me IN mv%Mum^elm ..l ON ”Ah W" I VI in lheil' ,ll iiret� 1c,1hQ a laChCd MAI"61g Off SIVA LS i.2:1 US YTis00h. I he i•irll ;3>�G a ;1 IIi De ,acc °,Y to cu lltii'. an xmcli$Tlt;EI'piro18€3ltli V A \ 14' in NiA 4_ &to the mA deck, I OTM Ita,' OW M1 RMO "Wk. W" SWA'tsV 0OU56ML Md I it)11 ',nOUg "ill he its 101 1, Initial Construction Control Document u To be submitted with the building permit application by a w d Registered Design Professional for work per the 8th edition of the ' Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Thornes Market Roof Repair Date:12/11/15 Property Address: 150 Main Street,Northampton, MA Project: Check (x)one or both as applicable: New construction X Existing Construction Project description: Remove two damaged 2x14 rafters and install 14" LVL replacement rafters. 1, David Vreeland, MA Registration Number: 46317, Expiration date: 6/30/16 , am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': Entire Project Architectural X Structural Mechanical Fire Protection Electrical X Other: Construction Control for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a"wet"ort*A OF'�s� electronic signature and seal: o� DAVID A. VREELAND �y CIVIL w No.46317 Phone number: 413-624-0126 Email: dvreeland @verizon.net °y 9��'/STEP � �L Building Official Use Only Building Official Name: Permit No.: Date: Note 1. Indicate with an 'x' project design plans,computations and specifications that you prepared or directly supervised. If'other' is chosen, provide a description. Trial Version 10 09 2012 AC40R"® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDnYYY) 7/10/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NADMP Cynthia Henderson, CISR Webber & Grinnell PHONE (413)586-0111 No):(413)586-6481 8 North King Street ADDRIESS:chenderson @webberandgrinnell.com INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01060 _ INSURER A Arbella Insurance Group17000___ ---------- -- INSURED INSURER B: Keiter Builders, inc. INSURER C: Attn: Scott Keiter INSURER D: 35 Main Street INSURER Florence MA 01062 INSURER F COVERAGES CERTIFICATE NUMBER:Master Exp 2016 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. - --- ADD - - - INSR L SUBR - POLICY EFF POLICY EX(P LTR 1 TYPE OF INSURANCE � I POLICY NUMBER MM/D /YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 '-- - DAMAGE TO RENTED A --, CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 300,000 8500064396 6/1/2015 6/1/2016 MED EXP(Any one person) $ 5,000 j 1,000 000 PERSONAL 8 ADV INJURY $ � GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 1:1 PRO LOC PRODUCTS-COMP/OP AGG $ -- 2,000,000 -- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 _ Ea accident A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED Fy SCHEDULED X j AUTOS AUTOS 1020039381 6/1/2015 6/1/2016 BODILY INJURY(Per accident) $PERT NON-OWNED Pe�accidenlDAMAGE $ I_. HIRED AUTOS K AUTOS --- ----- ----- Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1 .000 000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ ___ _1U0o0,000- DED X I RETENTION$ 10,000 4600064399 6/1/2015 6/1/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE �.Y/N E.L.E_A_CH ACCIDENT _$ 1.00,000. ._ OFFICER/MEMBER EXCLUDED? N N/A I - - A ;(Mandatory in NH) —I 9127440615 6/11/2015 6/11/2016 E.L.DISEASE-EA EMPLOYEO$ __ -1o0,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 C Henderson, CISR/CIN °d `� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD NSn95 igranen1l 'i r, City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 15OA. Address Of the work: 150 Main street The debris will be transported by: Duseau Trucking The debris will be received by: valley Recvicing Building permit number: Name of Permit Applicant Keiter Builders, Inc Date Signature of Permit Applicant i I The Commonwealth of Massachusetts Department of Industrial Accidents N Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Keiter Builders, Inc Address:35 Main Street City/State/Zip: Florence, MA 01062 Phone#:413.586.8600 Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 15 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' [No workers' comp. insurance comp. insurance. $ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers' comp, right of exemption per MGL 12.® Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13,❑ Other comp, insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number, I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Arbella Policy#or Self-ins. Lic. #:9127440615 Expiration Date:6.1 1.16 Job site Address: 150 Main Street city/State/Zip: Northampton, MA 01 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. f do hereby Bert' under th ins and penalties of perjury that the information provided above is true and correct. //,A,-- 11.3.15 Si afore: �� 64it/✓ Date: Phone#: 413.586.8600 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#: h 1 Versionl,7 Commercial Building Permit May 15,2000 i SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) I Independent Structural Engineering Structural Peer Review Required Yes O No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I RICHARD MADOWITZ as Owner of the subject property hereby authorize Keiter Builders,Inc to act on my I eh If,in all atters rel ' e to work authorized by this building permit application. 12/14/15 Signature of Owner Date i Keiter Builders,Inc 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. Scott Keiter Print Na e Si lure of Owner/ Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Scott Keiter CS-102457 License Number 51 A Hatfield, Street Northampton, MA 01060 06.20.16 Addre Expiration Date 413.586.8600 S' ature Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,c.152,§25C(6)) T_ 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 O No O 4 i 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 Please see attached Signature Telephone 9.2 Registered Professional Engineer(s): V rt" V, Name Area of Responsibility Ibji-4 Address Registratio 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 Keiter Builders,Inc Not Applicable ❑ Company Name: Scott Keiter i Responsible In Charge of Construction 35 MA Street Florence,MA 01060 A ; 6413.586.8600 Telephone i ( Version 1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING j 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 narking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW O YES O IF YES: enter Book Page and/or Document#i B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is It part of a common plan that will disturb over 1 acre? YES O NO O I i i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 1 �I 1 1 i Versionl.7 Commercial Building Permit May 15,2000 SE TION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE �/ Interior Alterations ❑ Existing Wall Signs El Demolition El Repairs OF Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description p Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE Please see the attached plans and control documents 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 ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ I-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 OFFICE USE ONLY BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) 1st 1st 2nd 2nd 3rd 3rd 4th 4th i Total Area(sf) Total Proposed New Construction(sf) Total Height(ft) Total Height ft I 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 Buildm Permit May 15,2000 e�artment u'�e ariCy �, - --� City of Northampton status of Pprmft I Building DepartmentCurb Ou#IRrivQwy Permit 212 Main Street �aewirl5etic AVa1)abiilty DEC 15 ; Room 100 WWAW/tr tlAy�; lJlt� ?�I I orthampton, MA 010604 Std ettrugtural1tY {�hnhe 4 3-587-1240 Fax 413-587-1272 P�cstllt tin ' dt �r` pecify z T 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 Thorns Marketplace Map Lot Unit 150 Main Street Northampton,MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Richard Madowitz PO BOX 686 NORTHAMPTON MA 01061 Name(Print) Current Mailing Address: e� o000 � 413 582 9970 Signature Telephone 2.2 Authorized Agent: Keiter Builders, Inc 35 Main Street Florence, MA 01062 Name(Print) Current Mailing Address: 413.586.8600 Signature 1 P ,�i` phone ECTI -ESTIM TED ONST TION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1, Building (o I Q (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=0 +2+3+4+5) 1 O O o0 Check Number (j This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0792 APPLICANT/CONTACT PERSON KEITER BUILDERS ADDRESS/PHONE 35 MAIN ST FLORENCE01062(413)586-8600 Q 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 Tvpeof Construction: REPLACE 2 DAMAGED RAFTERS New Construction _ Non Structural interior renovations _ Addition to Existing _ Accessory Structure Building Plans Included: _ Owner/Statement or License 102457 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOy?hMATION PRESENTED: k_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 Demoliti D ay Sign 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-2016-0792 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:renovation BUILDING PERMIT Permit# BP-2016-0792 Project# JS-2016-001335 Est. Cost: $10000.00 Fee: $70.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KEITER BUILDERS 102457 Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG Zoning: CB(100) Applicant: KEITER BUILDERS AT. 150 MAIN ST Applicant Address: Phone: Insurance: 35 MAIN ST (413) 586-8600 O WC FLORENCEMA01062 ISSUED ON.1211612015 0:00:00 TO PERFORM THE FOLLOWING WORK.REPLACE 2 DAMAGED RAFTERS 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 12/16/2015 0:00:00 $70.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner