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31B-079 (4) BP-2022-0731 132 KING ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 3 I B-079-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0731 PERMISSIONIS HEREBY GRANTED TO: Project# RENOVATION DUNKIN Contractor: License: Est. Cost: 82355 T&J CONSTRUCTION 109077 Const.Class: Exp.Date: 12/13/2022 Use Group: Owner: LLC SARDINHA'S & CONSTANTE REALTY, Lot Size (sq.ft.) Zoning: CB Applicant: T&J CONSTRUCTION Applicant Address Phone: Insurance: 223 DON AVE (401)451-7881 WC9084297 EAST PROVIDENCE, RI 02916 ISSUED ON:06/27/2022 TO PERFORM THE FOLLO WING WORK: RENOVATION DUNKIN 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 4 • r • .)41 7-2 . AIT Fees Paid: $576.0( 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2022-0731 APPLICANT/CONTACT PERSON:T &J CONSTRUCTION 223 DON AVE EAST PROVIDENCE, RI 02916(401)451-7881 PROPERTY LOCATION 132 KING ST MAP:LOT 31B-079-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $576.00 Type of Construction: RENOVATION DUNKIN New Construction Non Structural 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 INVORMATION 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 Perm it from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 6A 17/a a Signs re 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. ,mud Mi1 The Commonwealth of Massachusetts 1 JUN 1 7 Office of Public Safety and Inspections �022 ' Massachusetts State Building Code(780 CMR) Building Pe IA plication for any Building other than a One-or Two-Family Dwelling I nT- TOF. UILnING INSPcCTI N� (This Section For Official Use Only) —... _ �ru�tfn�N � Building Permit t7�imbeF: 1 Q6 ate Applied: Building Official: SECTION l:LOCATION No.and Street City/Town Zip Code Name of Building(if applicable) 132 King St— 0.Ditau,1-5 Northampton MA 01060 Dunkin Donuts Assessors Map# Block#and/or Lot # 31 8— 0 9 SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building® Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes El No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No ❑ Brief Description of Proposed Work Remove cabinets wall.ceiling.and grid. Install new cabinets.wall.ceiling.and grid Install wall and floor tiles. Install sheet rock on walls. Exterior-frame new bump-out walls with finishes. as specified by Dunkin. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) D Existing Use Group(s): B Proposed Use Group(s): B SECTION 4 BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 1 1795 1 1795 Total Area(sq.ft.)and Total Height(ft.) 1 1795 1 1795 SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business ® E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 1-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2❑ U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA D IBD IIAD IIBD IRAD IIIB0 IV VA VB3 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information / Sewage Disposal: Trench Permit Debris Removal: / Public Check if outside Flood Zone E Indicate municipal A trench l not be Licensed Disposal Site®I/ Private 0 or indentify Zone: or on site system 0 required or trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Is Structure within airport approach area? Is their review compled? or Consent to Build enclosed 0 Yes 0 or No Yes❑ No Wnot applicable SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction 5.R Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Gill&)u'L SAP ftn/ k. 1 to ah-OGaoo STE" we_c-t-P etc() tvi A • o lO g5_ Name(Print) No.and Street City/Town Zip Property Owner Contact Information: 411' -2*--,2140- 94040, 4R- fr ar'a7(0 F t:Nhc_l6i AMe(4ccuaZettMrn/1h/4fc04a Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: ' COrYl Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) �R�al►I 1 r L1Sgnr`���c°S-r t:43?- .57)10 iv 6i w.ARck.-f Ms ,COM Name(Registrant) Telephone No. r., e-mail address Registration Number Stet reeQlit(ep IA.t.sl.:'l6er Sm)-i-1 etd f,2 ODA117 . . Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor T&J Construction Company Name Tony Fontes CS-109077 Unrestricted Construction Supervisor Name of Person Responsible for Construction License No. and Type if Applicable 223 Don Ave Rumford RI 02916 Street Address City/Town State Zip 401- 451 - 7881 afontes20cox.net Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes Cl No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor 82,355.86 and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 82,355.86 Building Permit Fee=Total Construction Co -rt here 2.Electrical $ 0 appropriate municipal fact. $ 5114 3.Plumbing $ 0 4.Mechanical (HVAC) $ 0 Note:Minimum fee=$ (contact muni.;..lity) 5.Mechanical (Other) $ 0 Enclose check payable to 6.Total Cost $ 82,355.86 (contact municipality)and write check number here 4 0 2-0 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my kn.wledge and understanding. AN 'T Z o . - ! `�' ri 5 1. ► Pee S: [,.4i 1Ct)_L- 1- 10 i 5I/0 Please print and sign name Title Telephone No. Date 0a3 . / ,je • Et P Roo;ebaArL 'Z_ D�,1I(o Street Address City/Town State Zip Email Address kicConn r a-Cs 1 &C t/107-- Municipal Inspector to fill out this section upon application approval: w ` • I1 . b�l I Name Da '\ The Commonwealth of Massachusetts tltad�`k:t Department of Industrial Accidents �� mi 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia 11 makers'('ompeatwtien Insurance Affidavit:BuildersiContritetorsFEkctrkiansfPlumbers. TO BE FILED Willi T11E PERNII'ITING AI1T11UIt1T . Annhicanl Information [� ,gyp Please Print Leeh ib Name(Hu.Incsa Organization Individual): TG J J . �ro.. 40 4...4 � ► aN ! UC Address: a 3 `e l Ak)eet,ju. City/State/Zip: E'ASTf p,, j C 0,44 ip Phone#: 1101 45 1 — 7gg-I . Are t.s am egroycr!(►rrk the appropriate hot: Type of project(required): l.NKmaemployer with 1 employees dull and cm lsmt-Gan).• 7. O NC%construction '.D I am a wk pn,pnctor or partncr.hlp and lfase no cufplowexs working, tier roc m $. aft:modeling. arty capacity.!Nu worker,'comp.IIL.urane requncd.I 9. 0 Demolition i. I am a homeowner dunes all work myself.Ida,»oaks,.'comp.Insurance rcyuircd.i• 10 0Building addition 4.E 1 am a honewwrei and will he banal contractor,to conduct all'AIM It.on my pn pill%. I No ill l7L.nre that all contractor.odic'has weniers compensation insurance an are soli 11.0 Electrical repairs or additions promIctors with no a iployc s. 12.0 Plumbing repairs or additions sin I am a perlual contractcn and I have hired the subcontractors listed on the attached sheet_ rite.:sub-comroctor.ins+canployccs and base workers'comp.insamm�ce I3.0Roofrepa r5 6.0 We as a corpo rim and Its officers have cxcrcaacd then nyht of exemption pet 11(i1.c. E4. Other . 152,I11(4).arid we Itase no ctgrhnec%.[No winters•comp.insurance requited. *Any applicant that cles:ks lux:.,l must also till out the section below show antis there w.Kkczs compensation policy utfiKrnatisln. *ikmieoslex.%Ix,submit tlm attidas.t indicating ties arc doing all work and then his,:Mutst&ccattrac1a*s roust suMmt a new attrdas it Irfdacaiug.mush.. :Contractor.that chick this Ik•s must attached an additional sheet show mg,taw mum of the ant squractiK,and state whether or not tuna ull,ucs Iws c rinplo)ccs. if the sula—conkacta m.love employees.they nest punish:Ihcir worker. .-amp.policy numthc-r. I am an employer that is providing worAers'compensation insurance for par employees. Below is the policy and job site information. Insurance Company it SUt1 i — Policy#or Self-ins.Lie.#:____AACRD gL10 C`'1 Expiration Dale: 03/ iq /6.14..)8 Job Site Address: 13 a K;N S .--r C'ity!Statc.Zip: lJ r ,$AM Proi,i NA-- e 13(v(Q Attach a copy of the w num ber compensation policy declaration page(showing the policy and eapirati6a date). Failure to smite coverage as required under MGL c. 152.125A is a criminal violation punishable by a fine up to 81,500.00 andeor one-year imprisorurtcnt.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 imcstigations of the DIA for insurance coverage verification. I do hereby certifj•under the pains a d penalties of peewee that the information provided above is true and carted. Signature:r��//^/�(/'� ""�i, �� � Date: a-/i (0 p� Phone#: 4 0 I — LI S-I — 7E8 1 Official ase only. Do not write in this area,to be completed by cur or town a fi iat ( it. air I it$1 ii: Permit/license 4 Issuing.luIhuruis It-ircle umri: I. Board of Ilealth 2. Building Department 3.t its'"funn Clerk 4.Elrctrical Inspector 5. Plumbing;Inspector h.Other ('intact Person: Phone#: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional • for work per the ninth edition of the �..�� Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Dunkin Donuts Remodel Date:5/16/22 Property Address: 132 King Street, Northampton,MA 01060 Project: Check(x)one or both as applicable: New construction x Existing Construction Project description:Dunkin Donuts Remodel I John A. Aharonian, RA MA Registration Number: 8551 Expiration date: 8/31/22 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningl: Architectural Structural Mechanical Fire Protection Electrical Other:X(Entire project) for the above named project and that to the best of my knowledge, information, and belief 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. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. 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" or electronic signature and seal: SiEDc iez/T Phone number:401-232-5010 Email:Jaharonian@arch-eng.co ;p CUM RLAND It- RI Building Official Use Only \ Building Official Name: Permit No.: Date: ���TN of ti� ��4 Jry Version 01 01 2018 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDMIYY) `..� 05/16/2022 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 have ADDITIONAL INSURED provisions or 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 NAME: CONTACT Autumn Lee Howe Lezaola Thompson Insurance ucc.No.Exq: (401)434-7203 WC FA)C ,No): 2761 Pawtucket Ave I;EMAIL Autumn@Lezaoia-ina.com East Providence, RI 02914 INSURER(S)AFFORDING COVERAGE NAIL r INSURER A: Selective Insurance 12572 INSURED INSURER B: Selective Insurance 19259 T&J Construction,Inc INSURER C: 223 Don Ave INSURER D: East Providence, RI 02914 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 95965385-0 REVISION NUMBER: 25 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. INSR ADM OF INSURANCE INV AD SUER POUCY EFF POLICY EXP UNITS INSD D POUCY NUMBER (MM/DOIYYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY S 2441887 03/19/2022 03/19/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one Person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PER0. LOC PRODUCTS-COMP/OP AGO $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY S 2441887 03/19/2022 03/19/2023 (&Macciel eDtSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B AND EMPLWORKEROYERSELIABIILITY ON WC 9084297 03119/2022 03/19/2023 X STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUT1VE YIN E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Northampton MA ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ii-, =1C1 1.2t' f.!L'G' (ACH) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by ACH on 05/16/2022 at 08:09AM Commonwealth of Massachusetts Division of Professional Licensure II Board of Building Regulations and Standards ConsVt ,rvisor • 4 CS-109077 .* ires: 12/13/2022 ANTONIO J FONTE :A/ 7. 223 DON AVENUE 1,�;► J 4' EAST PROVIDENCE , • 6 0 3O OIS 4 Commissioner disk Y3`&,ctb, City of Northampton M?/°a H,M. o S,S V,,,.. •'f 4, Massachusetts �Q� '<< L A' At: 3 t DEPARTMENT OF BUILDING INSPECTIONS x. +� ti 212 Main Street • Municipal Building vp �D: �. Northampton, MA 01060 s'I, 3�0�. CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: E( £r S Pn.Cc*- L ,�1c.C1 Gv r Ai 4-In et, S T --C__A-Gtr,PN-0 n! j 14 A ' The debris will be transported by: Name of Hauler: v l S.-� C S\ken.PI 62 (y (�r, A An r' Signature of Applicant: e-"y0 _ Date: f/P2