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32A-138 (108) 31 MAIN ST BP-2007-0165 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A- 138 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2007-0165 Project# JS-2007-000245 Est.Cost: $5500.0.0 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: use Kohl Construction 078992 t sec Group: *�_.` x.00 Owner: CHAMISA CORPORATION Zonin2:CB Applicant: Kohl Construction AT: 31 MAIN ST Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413256-0321 Workers Compensation HADLEYMA01035 ISSUED ON:8/15/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATE EXISTING 4TH FLR BATHROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: ,aa(--k.ztai Rough1i�3`v4 House# Foundation: "" r��` o Driveway Final: /• Final:11 4 jar/it ' Final://-/C....6 (Q V�n P tY,- Rough Framed i- 4./2_006 ..6/470-----"- Gas: Fire Department Fireplace/Chimney: i 1 Rough: Oil: Insulation: Final: Smoke: Final: O K 1<_ 1I71: L-"t.t,i THIS PERMIT MAY BE REVOKED BY THE Cl/ OF NORTHAMPTON UPON VIOLATI N OF ANY OF ITS RULES AND REGULA .$NS.j .#07.---. Certificate of Occu s anc .011111111" si•nature: -------" :"" FeeTvpe: Date Paid: Amount: Building 8/15/2006 0:00:00 $50.005088 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo f File#BP-2007-0165 APPLICANT/CONTACT PERSON Kohl Construction ADDRESS/PHONE 31 Campus Plaza Rd HADLEY (413)256-0321 PROPERTY LOCATION 31 MAIN ST MAP 32A PARCEL 138 001 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid ,¶071�J ( MI' Typeof Construction: RENOVATE EXISTING 4TH FLA BATHROOM 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 nue or/ WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 Co ::.n Signature o 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. 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 SewertSeptic Availability Room 100 Water/Well Avaiabifity Al1G t ion Northampton, MA 01060 Two Sets of Structural Plans,_„ phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office The Masonic Building Map Lot Unit 21-31 Main Street Northampton,MA, 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Chamisa Corp a 31 Campus Plaza Road, Hadley, MA,01035 p Name(Print) A Current Mailing Address: //� `j ,. l(�j (413) 256-0321 Signature `\. /`� ✓1 Telephone 2,2 Authoriz Agent: Douglas A.Kohl p 31 Campus Plaza Road,Hadley, MA,01035 a Name(Print) Current Mailing Address: (413)256-0321 Signature Telephone SECTION 3- TIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $4,000.00 (a)Building Permit Fee 2. Electrical $500.00 (b) Estimated Total Cost of Construction from (6) 3, Plumbing $11100.00 Building Permit Fee 4. Mechanical(HVAC) $0.00 5, Fire Protection ,.(/�} tY,{/ 6, Total=(1 +2+3+4+5) Check Number 5r/(}/I rel -- This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/inspector of Buildings Date Version I.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 I4 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs 0 Demolition 0 Repairs© Additions 0 Accessory Building 0 Exterior Alteration 0 Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other 0 Brief Description Bathroom renovation on the fourth floor. New tile and fixtures to be installed. No change to size Of Proposed Work: of existing bathroom. SECTION 5-USE GROUP AND CONSTRUCTION TYPE _ USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembl A-1 0 A-2 ❑ A-3 0 1A F 0 A-4 0 A-5 0 113 0 B Business ❑ 2A 0 E Educational ❑ 28 0 F Factory 0 El 0 E2 0 2C 0 H High Hazard ❑ 3A 0 Institutional ❑ I-1 ❑ k2 0 1-3 ❑ 3B ❑ M Mercantile 0 4 a R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S Storage ❑ S-1 0 5-2 0 5B 0 U Utility ❑ Specify: M Mixed Use ❑, Specify: Offices, restaurants, dance and yoga studios. S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Mercantile Proposed Use Group: Mercantile Existing Hazard Index 780 CMR 34): 3 i Proposed Hazard Index 780 CMR 34): 3 SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sO 1" 9,000 1 9,000 2" 9 000 2"d 9,000 3m 9,000. 3rd 9,000 4"' 9,000 4'" 9,000 Total Area(sf) 36,000 Total Proposed New Construction(sf) 0 Total Height(ft) 60 Total Height ft 60 J 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public (] Private 0 Zone Outside Flood zoned Municipal 0 On site disposal system❑ VersiouL7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by BoiWing Department Lot Size 9000 9000 Frontage 130 130 Setbacks From 0 O Side L: 0 R: 0 L:O R: 0 Rear 0 O �..........._ Building Height 60 60 Bldg. Square Footage 3606 % 3606 Open Space Footage (Lot area minus bldg&paved 0 0 parking) —, #of Parking Spaces 0 0 Fill: NA (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW 0 YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW O YES O IF YES: enter Book Page and/or Document d B. Does the site contain a brook, body of water or wetlands? NO 0 DONT 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 3 NO (3 IF YES, describe size, type and location: Fitzwiily's painted on the west side of building. 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 Q NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version L7 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 0 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 75 Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsbitity Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiation Date 9.3 General Contractor Kohl Construction Inc Not Applicable 0 Company Name: Douglas A. Kohl Responsible In Charge of Construction 31 Campus Plaza Road, Hadley, M 01035 p Address r (413) 256-0321 Signature Telephone Versionl.7 Commercial Building Permit May I5,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) 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 Douglas A. Kohl ( Chamisa Corp. ) ___... ,as Owner of the subject property Hereby authorize Douglas A. Kohl , Kohl Construction Inc, to act on my behalf,in all matters relative to work auth ' ed by this building permit application. Q � g 1 C nIa Signature of Owner Dbate Douglas A. 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 A. Kohl Print Name p W-�/ Ei 11 �bb Signature of Own¢rlAge ' Date SECTION 12-CONSTRUCTION SERVICES 10,1 Licensed Construction Supervisor: Not Applicable ❑ /)A Y Name of License Holder_ Douglas A. Kohl 78892 License Number 31 Campus Plaza Road , Hadley, MA,07035 p 10/25/2006 ... 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 e No 0 1150 HUG 01, ?006 TO: ROPRNSKT INSURANCE TR NO: 586-7973 *97505 PH{,,L1 2/3 ACQ$D, CERTIFICATE OF LIABILITY INSURANCE 08/01/22 PROnurrm (413)586-5011 FAX (413)5864973 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Alexander W. Borawski, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 88 KingStreet, Suite B HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Northampton, MA 01060-3257 INSURERS AFFORDING COVERAGE NAM II INSURED Kohl Construction Co. _.. asURPRA, National Grange Mutual 14788" 31 Census P1aza Road INSURER B. AIM Mutual Hadley, MA 01035 INSURER C: INSURERD NSURERE. -.. _.......... 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 BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORD LD DY TILE POLICIES DESCRIBED IIGHEIN IS SUBJECT TO ALT THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAC CJJMS_ '�R ELEY'........ Pn CRY NJN9ER POLICY EFFECTWE POLCT EYPRATAH ..._ UNITS LIR?NSR TYPE OF INSURANCE PATP,MMiDYH DATE flegnYYl GENERALOAETUET M5560902 12/31/2005 12/31/2006 EACH OCCURRENCE 1,000,000 X COMMEROu.GENERAL I AD L TY DAMAGE TO RENTED 50,000 CLAIMS LNPF X OCCUR MED EXP IA"Y=ne wrsoll 5,000 A PEHSCELAL&Auv INAMY 1,000,000 _— 3ENERU AGGHEGAra 2,000 000 O . P _.. X POLIoYEGAr=LM-TA==L Es, PRODUCTS PRooucrs.coMvrtsP AGG 2,000,000 X POLICY JEL I_., AUTOMOBILE LA&LRY 119560902 12/31/2005 12/31/2006 COMBINED SINGLE L.MIT .lANY AUTO 4flaoitlmt s 1,000,000 22 NL OWNED wYtla BODILY MORN' X .SGNmuL FD AUTOS (PCI Person) $ A __ ... X HIRES ATTQS sooty INJURY X NON CwNESAU1I'!s LPN aaTdenS a PROPERTY DAMA,'52. B . (FascoHe N, SWAGE LIABILITY AVID ONLY-EA ACCIDENT E ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESSAMEPFLLA LABILITY CUS6090Z 12/31/2005 12/31/2006 iscwo cussing: s 2,000,000 ._. X eAGGREGATE . .000,000 AOCCURx ` �anr,MADE 2 s DESUCTIBLE $ _ X RETENTION $ 10,000 5 worKERs COMPEMSAtm AND WM280028720120116 02/10/2006 02/10/2007 X Trifle"" a; IRI EMPLOYERS'uaTntm T!T.EACH ACCIDENT a 500,000 3 Lar P8OPR.E1OwPAXTHET_Xtu IV O.PICEP/MEAtER EXCLUDED? k.L DISEASE.EA EMPLOYEE 4 500,000 OTTEa.PRovaIGNs.,No., I eL DISEASE-Palcv L.MIT B 500,000 OTTER DESCRIPTOR Of OPERATIONS!LOCATIONS VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANTOF mEIHOVE MOWED FOUCES BE CANCELLED BEFORE THE E W BATON DOE TtIEBEOF,THE mein e W N€R M.L ENDEAVOR TO MAL City of Northampton 10 DAYS WRIRENNOTCE TOTHE CFATIFICATENG.DFA NAMED TO THE LEFT, Department of Building Inspector 212 Main Street BUT RNLURETO MAIL SUCH NOTICE SHALL&POSE N008LGATION GRLIABLm Room 100 OF ANY KING UPON THE INSURER,RS AGENTS OR REPRESENTATIVES. Northampton, MA 01060 AUTM1Vn2EDREPRESENTAIWE ;7-,4.6630Z. �j_ Robert Borowski(BORIBI `�'/f"&„ ACORD 25(2001/08) CACORD CORPORATION 1988 LREVISIONS • L•7 Rev3icNLSsue mt Dale . ,1);;. Lo m r/ BATH REMODEL: I) LOVER EXISTING FLOOR 6) EXISTING ELECTRIC WRING TO 5E 2) REPLACE EXISTING FIXTURES REMOVED AND REPLACED. WITH ADA COMPLIANT FIXTURES, 1) INSTALL NEW ON-DEMAND 'TANK-LESS' 3) INSTALL ADA COMPLIANT GRAB BARS ELECTRIC WATER HEATER. 4) EXISTING ROOM DIME-SONS TO 8) INSTALL NEW 36' WIDE DOOR WITH REMAIN THE SAME ADA Ca-PLIANT DOOR LEVERS. 5) EXISTING PLUMBING ROUGHS TO BE REMOVED AND REPLACED KOHL CONSTRUCTION, INC. On„"E Fitzwilly's Building GAr08.11.06 SK-1 I GNPUS PLAZA FWD the srpu 1"93` r,N1s1"ssPOD 4TH FLR BATH REMODEL 112" = 1' 0” ion REVISIONS ' • RevlsoNtasue INt Date --"C ki E a II Oo T N W ''4 i ! 4 / BATH REMODEL U LOVER EXISTINS FLOOR 6)EXISTING ELECTRIC WIRING TO BE 2)REPLACE EXISTING FIXTURES REMOVED AND REPLACED. WITH ADA COMPLIANT FIXTURES. 1) INSTALL NEW ON-DEMAND 'TANK-LEG' 3) INSTALL ADA COMPLIANT GRAB BARS ELECTRIC WATER REA I ER. 4) EXISTING ROOM DIMESIONS TO b) INSTALL NEW 3b' WIDE DOOR WITH REMAIN THE SAME ADA COMPLIANT CALOR LEVERS. 5) EXISTING PLUMBING ROUGHS TO BE REMOVED NV REPLACED 1113 L CONSTRUCTION,INC. ,FRAME DATE Building a 08.11.06 SK-1 3,UAINS Pt RA ROAD TITLE SCALP Wan{413)256032/'� Fez(4-3)258Om 4TH FLR BATH REMODEL 112"= 110" 10P 1 CcwVRIc"I©K°",w�,R-Cna" REVISIONS P 1 RewsioMssue inn 1 Dale I. It a a ' N i rr 1 I - -..--V. r e ".. '''- e.— el".,--19' ..e./ BATH REMODEL: I) LOVER EXISTING FLOOR 6) EXISTING ELECTRIC WIRING TO EE 2)REPLACE EXISTING FIXTLRES REMOVED AND REPLACES7. WITH ADA COMPLIANT FIXTURES. T) INSTALL !EW ON-DEMAND 'TANK-LESS' 3) INSTALL ADA COMPLIANT 6RAB BARS ELECTRIC WATER HEATER, 4)EXISTING ROOM DIME5AOIG TO b) INSTAI I NEW 36'WIDE DOOR WITH REMAIN HE SAME ADA COMPLIANT DOOR LEVERS. 5)EX15TING PLUMBING RCVGFE TO BE REMOVED AND REPLACED J03xgME DATE KOHL C.ONSTRUCTION, INC. Fitzwilly's Building 08.11.06 fin/. 31-CAMPUS PLAZA ROAD T.TLE ""E 321 Fa 4TH FLR BATH REMODEL " _ ' " (1131359030 Mss IN3)2580155 4! 1 0 70F1 EOPmIM C OtIL NSTPW9Cw,JM