32C-016 (4) 84 MAIN ST-NORTHAMPTON BP-2018-1226
GIS#: COMMONWEALTH OF MASSACHUSETTS
MamBlock:32C-016 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category,windows replaced BUILDING PERMIT
Permit# BP-2018-1226
Proiect# JS-2018-002189
Est.Cost:$25000.00
Fee: $175.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CHASE GLASS & ALLIED PRODUCTS INC_
Lot Size(sp.ft.): 4965.84 Owner: CGI MANAGEMENT
Zonin%CB(1001/ Applicant. CHASE GLASS &ALLIED PRODUCTS INC
AT: 84 MAIN ST- NORTHAMPTON
ApplicantAddress: Phone: Insurance:
123 HANCOCK ST (413) 732-1115 WC
SPRINGFIELDMA01101 ISSUED ON:5/24/2078 0:00:00
TO PERFORM THE FOLLOWING WORK INSTALL NEW 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 Occuoancv Signature:
FeeTvpe: Date Paid: Amount:
Building 5/24/20180:00:00 $175.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File q BP-2018-1226
APPLICANT/CONTACT PERSON CHASE GLASS&ALLIPD PRODUCTS INC
ADDRESS/PHONE P O BOX 1311 SPRINGFIELD (413)132-1115
PROPERTY LOCATION 84 MAIN ST-NORTHAMPTON
MAP 32C PARCEL 016 001 ZONE CB00a/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
E OSE REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
T eofConstmction: INSTALL NEW WINDOWS
New Construction
Non Stmctoral interior renovations
Addition to Existine
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
INFCIRMATION PRESENTED:
_IZApproved_Additional permits required(see below)
i
PLANNING BOARD PERMIT REQUIRED UNDER§
Intermediate Project Site Plad AND/OR Special Permit With Site Plan
Major Project: Site Ptah 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
Pemut from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
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.
uJ y IvOtrCICS
Versionl.7 Commercial Building Permit May 15,2000
C'y of Northampton iikPr �
MAY 18 2018 BL ilding Department CkGD1haWMp¢ )d[
12 Main Street SBeMEBepSitAvelfebw
Room 100 weenlWagAvstie8ltiy , -
DEPT.oreuaowciNsaecnoNSJo ampton, MA01060 T4vdoetsoE a }
NORTHAMPTON.M 01060 7-1240 Fax413-587-1272 Pwat v r
OY1ePSpw'
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 Pmuerty Address: This section to M completed by office
84 Main Street. . ..... . Map �d Cj Lot 0169 Unit
Northampton MA Zone Overlay District
. Eau St District CB DkWa
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Ovmer of Record:
.CGI Management
Name(Print) Current Mailing Address:
Signature Telephone
2 2 Authorized Abem:
Chase Glass&Allied Produ 123 Hancock St. Springfield MA
Name(Pnon Current Mailing Address: _
(413)732-1115
Signature Telephone
]ON C
Item Estimated Cost(Dollars)to be Official Use Only
completed by Pend applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from S
3. Plumbing Building Peri Fee �}
4. Mechanical(HVAC) (
5. Fire Protection
6. Total=(1 +2+3+4+5) iJ Check Number J16
This Section For ORiclal Use Only
Building Permit Number Data
Issued
Signature:
BuAding Cmmissionerllnslredor a Buildings Data
5/1812016 scan1475.jpg
- Versiont.7 Commercial Building Permit May 15,2000
SECTION 10.STRUCTURAL PEER REVIEW(TSO CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes Q No Q
SECTION 11.OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I ',as Owner of the subject property
hereby authorize
act on my behalf,in all matters relative to work authorized by this building permit application. _
Signature ar
Data
as
i _.... ,as Owner/Authonzed
Agent hereby deckers that the statements and information on the foregoing applirgion are true and accurate,to the best of my knowledge
and belief.
Signedunder the pains and.penaihes of perjury. _.... ..
Prim Name
Signature of QwnerlAgenl Data
SECTION 12-CONSTRUCTION SERVICES
101 Licensed ConsVuction Supervisor: Not Applicable ❑
Name of Unnam Hader Robert W Tongue_ CS-0859!3
License Number
44 Lyndale Street Springfield MA 01108 01/22/2019
Atl s E pin afion Dare
(413)732-1115
�ignature TgePmone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT Ill e.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result
in ne denial of the issuance of the building permit.
Signed Affidavit Attached Yes (F) No 0
hftps:l/mail.google.comlmaillcal?shva=l#inbox1163T47ddl7b2ebf0?projector=l&messagePartld=0.1 112
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering StmctiJI Peer Review Required Yes O No O
SECTION 11 .OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, - — as Ovmer 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
1 John Lanucha as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knovvedge
and belief.
Signed under the pains and penalties of perju.
Pint Name
Signature of Omer/Agent Date
SECTION 12-CONSTRUCTION SE ES
10.1 Licensed Construction Not Applicable ❑
Name of Liceri Holds: RobertW.Tongue
License Number
44 Lyndale St Springfield MA 01108 o g 5 9'(j
Morass 6ylration Date
(413) 732-1115
Signature Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§25C(SII
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 Q
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 150A.
Address of the work: Aq rna;n 5�. 44'-MO�Nq
The debris will be transported by: lhgSe A?11 (6)LZS
The debris will be received by: ('k-5e ��455 r ���f / urxt
Building permit number:
Name of Permit Applicant -+ 1: ilx1�(�s
Date Sign uof Permit Applicant
Builders Letterhead
I request that you grant a modification to waive the requirement for control construction for the
Northampton Project at 94 Main Street in Northampton because the work is of a minor nature,will not
affect health,accessibility,life and fire safety,or structural requirements and is impractical in that the
cost of control construction is considerable when compared to the cost of the proposed work.Thank
you for your consideration. "Mass Amendments,sections 107.1 allows for an exclusion from control
construction for this project"
Respectfully,
John Lanucha
Chase Glass&Allieducts
123 Hancock Street/
Springfield MA 01109
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Date:
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Version 1.7 Commercial Building Permit May 15,2000
SECTION4-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❑ Naw Signs❑ Roo0ng❑ Change of Use❑ Omer❑
Brief Description Install of All Windows - S7ort Fr0ot'
Of Proposed Work:
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly1:1A-1 11A-2 ElA-3 ❑ 1A ❑
A4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
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 ❑ 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(si)
1°
3e , 3b
4°' ..
Total Area(sf) Total Proposed New Construction(sf)
Total Height(0)
Total Height It
7.Water Supply(M.G.L.c.40,§64) 7.1 Flood Zome Information: 7.3 Sewage Disposal System:
Public ❑ Private 0 Zone'.- Outside Flood Zone❑ Munidpal ❑ On site disposal system[]
Versionl.7 Commercial Building Permit May 15,2000
g. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Sin
Frontage _
Setbacks Front
Side L:- R:.. . LP_ R:'.
Rear
Building Height _
Bldg. Square Footage %
Open Space Footage % -
(Lot area minus bldg&paved
Ul
of Puking Spaces
Fill: ._. . . .
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O 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 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 construct ion actwity disturb(Gearing,grading,excavation, or filling)over 1 arse or is it part of a common plan
that will disturb over 1 sae? YES O NO O
IF YES,then a Northampton Stoml 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 56,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registran0:
Registration Number...
Address
Expiration Date
Signature Telephone
9.2 Registered Professional EngineeHs):
Name Area of Responsibilily
Address Registration Number
Signature Telephone FViretien Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Eviration Data
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Adder Registration Number
Signature Telephone Eviration Dale
9.3 General Contractor
CGI Management Not Applicable ❑
Company Name.
Paul Berg. .
Responsible In Charge of Construction
Address
,(617)417-6381
Signature Telephone
�\ The Conmeonwealth of Massachusetts
Department of IndustrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Tm orkers'
Compensation Insurance Affidavit: Builders/Contractors/Elmtricions/Plumbem
7'0 BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Inf1� �t 411.p/ /
l Please PriL e'bly
Name(Business/OrgmiimlioM ((,rndividual): )QSQ Gia55 t !'YIDP ffl7(lt(J�"�S
Address: /d,� dari({jcv, 5)r.
i
City/State/Zip: Dllo Phone
Are you an employer?Check t]hhe appropriate box: Type of project(required):
1.Edl am a employer wit Igvamwees(fol and/or port-time).' 7. ❑New construction
2MIamasoleproprietmorpartnershipand havenoemployces working forme to S. Remodeling
any rapacity.[No workers'comp. insurance required)
3Fa homeo.,doing all work mysrlf lNo workrsecomp.imuranee requiredi l 9. ❑Demnhtinn
lam
6.❑I am a homeowner and will be hiring coimaztms to conduct all work on my pmpeny. I will 10 Q Building addition
ensure shat ell contraztrseithm have worters'comperaation ismame or are sole I L[]Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5. 1 am a general contractor and I have hired to sub-cotnractom listed on the ahached sheet 13❑Roof repairs
niew sub-contranoms have employees and have workers'comp.mournme t
6We are a corporation aides omcers have exercised their right of exemption per MGL c 14.00ther
151,§I(4i and we have no employees(No wpkers com, insurance nammedl
'Any aMlinent tat clacks,box NI must also fill out the section below showing their workers'compensation policy information.
I Bomeowmen who submit this atHdevit indicating they are doing all work and then hire outside wntractors must submit a new affidavit iMicating such,
:Commons,tet check this box most atmched an additional sheet showing ate time ofthe sub-contractors and We whether or not those entities have
employees. Ifthe subcontractors have employers,they must provide their workers'comp.fichey number.
I am an employer that is providing workers'compensadon insurance for my employees. Below is the policy andjob site
infornmtion. (
Insurance Company Name:��S t YV 11U -
Policy#or Self-ins.L..i/Ic.#:WM Z bcV8ODS3(a(a 017 A Expiration Date: f�- L-z6
Job Site Address: BY fY1Q1.k 5y. _ City/Smte/Zip: Of YID
Attach a copy of the workers'rnmpeusatbnpolicy ddeeclaration page(showing the policy number and exgn 'on date}
Failure be 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,is well as civilp nalt 'n the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this systema m b forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby cerdfy underthe pains and n of rjury that the information provided above is true and correct
Si aNre: Date: U
Phone#: yl -
Ojj'7cial use only. Do not write i this area,to be completed by city or town ojrciaL
City or Town: Permit/Lieense#
Issuing Authority(circle one):
1.Board at Health 2.Building Department 3.Cityrfown Clerk 4.Electrical Inspector 5.Plumbing Inspector
G Other
Contact Person: Phone#:
a
123 Hancock Skeet
Springfield, MA 01109
Phone 413-732-1115
Fax 413-736-8705
If there are any issues you can email John Lanucha at iohnianuchaCcDchaseaiass ora
Or kimmartn(dkhasealass.ora
Thank you so much for your help S
Kim Martin
413-732-1115 l c
5/24/2018 smnl485.]pg
PAGE FOUR
IN WITNESS THEREFORE,the parties have caused this Agreement to be executed as of the date first above
written.
THE CLIENT: BERMOR LIMITED PARTNERSHIP
Go CGI Management, Inc.
651 Washington Street, Suite 200
Brookline,MA 02446-4579
By Ber o n
It's Ge r P e
D. Cohen
Its President
Its Treasurer
THE CONTRACTOR. Chase Glass &Allied Products, Inc.
123 Hancock Street
Springfield, MA 01109
By: Sa h n u cl
Name j
i
Signature
2S ' r
Title
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