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18D-040 (12) 375 KING ST w. BP-2003-0934 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Bl000k:ISD-040 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-0934 Project# JS-2003-1500 Est. Cost: $3500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Pride Convenience Inc 038811 Lot Size(sq.ft.): 42209.64 Owner: Pride Convenience Inc Zoning:HB Applicant: PRIDE CONVENIENCE INC. AT: 375 KING ST Applicant Address: Phone: Insurance: 246 COTTAGE STREET (413) 737-6992 () Workers Compensation SPRINGFIELDMA01104 ISSUED ON:5/12/03 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE COUNTER, INSTALL WALKIN COOLER, MOVE 2 INTERIOR NON-BEARING WALLS 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: Receipt No: Date Paid: Check No: Amount: Building 5/12/03 0:00:00 10029602 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo File#BP-2003-0934 APPLICANT/CONTACT PERSON PRIDE CONVENIENCE INC. ADDRESS/PHONE 246 COTTAGE STREET n '737-4,99 a— PROPERTY LOCATION 375 KING ST MAP 18D PARCEL 040 001 ZONE HB Z21 — il z 3li ct`'`'— THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid J00o9 J''6O 46.5e3— Typeof Construction: REPLACE COUNTER,INSTALL WALKIN COOLER,MOVE 2 INTERIOR NON- BEARING WALLS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 038811 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 Co sion sue- s 1073 Signature o 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. • 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 Sewer/Septic Availability Room 100 Water/Well Availability "' 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 32r !� M::e , / er) Lot Unit / �r .,' Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ff cvrar Name(Print) Current Mailing Address: 737 �9 Signature Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by permit applicant 1. Building J (a) Building Permit Fee of 2. Electrical (b) Estimated Total Cost of /(/?JJ , Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection ____ 6. Total = (1 + 2 + 3 +4 + 5) 3 Coo Check Number/O Q p/ 4,O?.4 —This Section For Official Use Only Building Permit Number: (>f 3-9 q Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Versionl.7 Commercial Building Permit May 15,2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE interior Alteration Existing Wall Signs Existing Ground Signs Additions 0 Roofing 0 Exterior Alterations Demolition❑ New Signs [ ] Change"bf Use [ ] Other [ ] 0 Accessory Building[ ] Repairs [ ] " -ve,sf'2W+-P-7rb,3: '€k r •.-<.- ,- '-, ,,�.. -e- Q 4,,,et? ,�, �,17€41_, ��r,,y,._ W s,_ SECTION 5 - USE GROUP AND CONSTRUCTION TYPE cr. --A,e—e. 4:.y .,,.rey�, USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly I ❑ A-1 ❑ A-2 0 A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business 1A- 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard 0 3A ❑ I Institutional 0 I 1 ❑ 1.2 ❑ 1-3 El 3B ❑ M Mercantile 0 4 ❑ R Residential ❑ R-1 0 R-2 El R-3 ❑ 5A ❑ S Storage El 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: 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) lsc 1st f / G'D 2nd 3rd 2nd ilex,----- 4th 3rd 4th Total Area (sf) �(y0.2 Total Proposed New Construction (sf) Total Height(ft) /c Total Height ft Versionl.7 Commercial Building Permit May 15,2000 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 Zone 0 Municipal 0 On site disposal system 0 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by , Building Department r Lot Size 10 ,,)-OL Frontage �� Setbacks Front .2-P Side L: 3a" R: L: R: Rear #7 1'1) Building Height Bldg. Square Footage Y % r o?p Open Space Footage % (Lot area minus bldg&paved 17 c-,0) parking) #of Parking Spaces o2 0 Fill: (volume&Location) A. 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 DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? DON'T KNOW YES Cr\10) IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: te 4- vvz--t'--( D. there any proposed changes to or additions of signs intended for the property ?YES 0 IF YES, describe size, type and location: 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 92 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 Not Applicable ❑ Company Name: Responsible In Charge of Construction Address g-- _ 73 2- Signature Telephone • 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.... t SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN ,r 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 � Y �c:Lbc '� , 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. A 46 �C Print Name 03 Signature of Owner/Agent Date SECTION 12 -CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable X Name of License Holder : 3? (P// License Number 147 e_/G1)._,, g' ©//oC (o -Jv 0 7 Address / / Expiration Date 2 3 7 O. 91� 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 >k( No 0 ACORD CERTIFICATE OF LIABILITY INSURANCc OP ID sM DATE(MM/DD/YY) RIDE-1 12/31/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chase Clarke Stewart & Fontana ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mutual Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 101 State Street, P.0 Box 9031 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Springfield MA 01102 Phone: 413-788-4531 Fax:413-731-9234 INSURERS AFFORDING COVERAGE INSURED INSURER A: Graphic Arts Mutual INSURER B: American International Group Pride Convenience Inc - INSURER C: Fleet Operations Inc 246 Cottage Street INSURERD: Springfield MA 01104-4002 I 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 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI I POLICY EFFECTIVE POLICY EXPIRATION 1 LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DONY) DATE(MM/DDNY) LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1000000 A X' COMMERCIAL GENERAL LIABILITY 3280247 03/01/02 03/01/03 FIREDAMAGE(Anyonefire) $ 500000 $5000 CLAIMS MADE Xi OCCUR MED EXP(My one person) PERSONAL&ADVINJURY $ 1000000 I GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY PRO- r LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A 1 ANY AUTO BAC3280253 ' 03/01/02 ! 03/01/03 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) I X I HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) X MCS 90 included PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT I $ r I ANY AUTO ! OTHER THAN EA ACC !. $ AUTO ONLY: AGO j $ EXCESS LIABILITY EACH OCCURRENCE j $ 7000000 A X OCCUR I CLAIMS MADE CULP3280242 03/01/02 03/01/03 AGGREGATE $ H I DEDUCTIBLE $ j X ' RETENTION $ 10000 i $ TH- WORKERS COMPENSATION AND X TORY LIMITS! OER EMPLOYERS'LIABILITY B PENDING 01/01/03 01/01/04 E.L.EACH ACCIDENT $ 500000 E.L.DISEASE-EAEMPLOYEEI $ 500000 E.L.DISEASE-POLICY LIMIT $ 500000 I OTHER I I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Fax: 732-750-6475 CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,�� /•'1 / ' I Y) c: b Timothy J Rooke -�Y �zkyl li ✓ .L%-/�.vL.- ACORD 25-S(7197) CY*CQAD CORPORATION 1988 -t�[P24. =o • °• Grit i xf Naz#I?am14ntt —=b % �,-,e m • n ;►•tllaSSAChnSttla' _• erieif ,r.„ } DEPARTMENT OF BUILDDZG INSPECTIONS _._!1= 212 Main Street • Municiilal Building Northampton, Mass. 01060 r'�•y WORYER'S COMPENSATION INSURANCE AFFIDAVIT I, ,4 ,D' 42kbex-- (licenseepermittee) with a principal place of business/residence at: cl y� �;/-, e, `. J �/,-,e' . , //a3 . (phone#) ) 77-6J''1' (Stnzt/ccity/state/rip) do hereby certify, under the pains and penalties of perjury, that: JO am an employer providing the following worker's compensation coverage for my employees working on this job: t(C 3(717''.41.'Wg' (211, ,q '..-Pin °p°11° 3-3/--e3 (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) .r. (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) ' (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioxal Most if monetary to include information pertaining to all coofactors) is ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that while homeowners who employ person to do maintenance,coastuctio°or repair work on a dwelling of not more than throe units in which the homeowner resides of on the grounds appurtenant thereto are oat generally ooaridcred to be employers under the worker's compassation Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the legal clans of an employer under the Worker's Compensation Act. I understand that a copy of this etaremcnt may be forwarded to the Depertaxnt of Industrial Accidents'Olhoo of Insurance for the coverage verifiatioo and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of 5100.00 a day against tee. For d1 use only Ag 4//ed—e ) �J Permit Number /' �''�—�3 map ti _Lot ti Siortahrr,nfT :,............m___..r Date ✓�e f im,n,inwviz4A of `/a ac/ruaeiZt BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR 'it Number: CS 038811 , Birthdate: 10/31/1943 „a,,. •iff. Expires: 10/31/2003 Tr. no: 9023 Restricted: 00 ROBERTL BOLDUC 49 WOODSLEY RD LONGMEADOW, MA 01106 Administrator - A/?F L2}12 yyL�PLC �'C;.'Gt G' /6jacAe i Board of Building Regulations One Ashburton Place, Rm 1301 Boston, Ma 02'108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 10/31/1943 Number: CS 038811 Expires: 10/31/2003 Restricted To: 00 IZ�i13[R 1 L BOLDUC l() WOODSLEY RD I ONGMIEADO\V, NIA 01106 Tr. no: 9023 Keep top for receipt and change of address notification. • Pride 246 Cottage St., Springfield, MA 01104-4002 Tel. 413-737-6992 • Fax 413-731-5852 Proposed Renovations Pride Convenience 375 King St, Northampton 1. Remodel sales counter. 2. Install additional glass panels in center of store. 3. Install additional walk-in cooler. 4. Relocate 2 non-bearing interior walls. 5. Install red strobe lite to with activate with fire alarm. 6. Install fire alarm panel per code. eoyi_6i,v A-WY e,4q /LZ a - L'fm ,rannoyr_rm, (M,s tz)L51- c5n47 iti y lE r VfirlA V I Fit pR IR ppyls IIIMA-INa[cR !COOLER wINE BEES&WC STOWE • COUNTER SOCA GOOIER DONOR DORMS STOWE PAcKAGED PACKAGED REVS/SHEBANG t SHELVING IS SMLS COUMEA TO BE RELOCATED PRIDE STORAGE YEH WOMEN L. p P : 1/16" = 1'-0° S,s�3 Koury -- O/ 4S DRAY: INGRAM FLOOR PLAN ALTERATIONS DATE: 11-21-02 de CHECKED OT: EIOLOUC 375 KING STREET SCALE: NONE REVISIONS: 246 COTTAGE STREET NORTHAMPTON, MA 01060 SPRINGFIELD,MA 01104 TEL (413) 737-6992 FAX (413) 731-5E152 . • /2P-Li 0 Northampton Fire 2 Department Memorandum - =� 1 k1'/ (� �l V! �� F. To: Tony Patillo MAY - 7 2003 From: Duane Nichols',4 Date: May 6, 2003 CC: Brian Duggan Re: Pride Convenience, 375 King St. Secondary to a review of the plans and fire protection narrative that was submitted to me for review, I concur with the issuance of a building permit for this property subject to the following conditions: • A Knox Box is required on the exterior of the structure near the main entrance; the red 120-candela strobe light that actuates upon an alarm condition is required above the Knox Box. • The suppression system needs to be monitored by a direct connection to the Northampton Public Safety Dispatch as a condition of permit. • A pull station behind service counter to activate an alarm to the fire department that is clearly labeled. • Fire alarm control panel needs to be marked with a red engraved sign with one- inch white lettering on red background "Fire Alarm Control Panel". • Signage clearly labeling pull station for suppression system • Horn/strobe installed in store to alert occupants. • Page 1 -710M -241Y ay/ c -01!73+ F/ — n—%--.pen A/-]ZGe ��1-•vnn7 $�14/.f oor z = as x 01 Sr U-z, /f' r // — _ ,hiX ,8 yr/1.6raS Cry-z l ' �N 3ers,vi , I L AutoCAD File: F: \JIM\NHAMP\NHASBILT.DWG 2)-C "h' ,/ >""L-&s A"as.^'�� ,��U -7-Z J ,iI,, /J ,2 ry oars ,�- — d3�l5no OE ''2 L-r7> 7C�7 '°I — 7,6 , _ ---------IA 71 Z./b / _ ,L C x , tL = s -get S/v/ ic-,A o Vic)/..1^v7 30 I : iv./yn- 9vai./.4f7,9 ,, ONIld3S 03WHS N3WOM N3W (--- 3011801S 30INd — z 0 U ' 31` (� I 11YM ATM tai -Al ONIA 13HS / S N311 0396710dd ,: -g%-6 g 3ON/8O1S '0'0 7 ; 1- - - - - - - , 13-1000 Nl—N1VM 334j03 vacs 30V2:101S AVM8fS7 AYM8f1S . ,,/ 7 N3Z113d M J 7 L669-L£L (£L IF) siO3ro21d 1VI73dS 210103211Q �— ���/SN/ / ^� ZOOP-VOL LO VVV"a13139NIJdS 3ONVH3V1 "0"NVAA 133d1S 39dll03 917Z aPlsid „7.,, ,zs >,v „L , - - ,,