32C-017 (24) BP-2008-1043
GIS #: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2008-1043
Project# JS-2008-001545
Est. Cost: $7997.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ORCHARD GLASS AND MIRROR INC 073684
Lot Size(sq. ft.): 4094.64 Owner: TRIDENT REALTY CORP
Zoning: CB Applicant: ORCHARD GLASS AND MIRROR INC
AT: 78 MAIN ST
Applicant Address: Phone: Insurance:
32 OAK ST (413) 543-5979 Workers
Compensation
INDIAN ORCHARDMA01151 ISSUED ON:5/23/2008 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE ENTRANCE DOORS
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 5/23/2008 0:00:00 $50.00MO
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2008-1043
APPLICANT/CONTACT PERSON ORCHARD GLASS AND MIRROR INC
ADDRESS/PHONE 32 OAK ST INDIAN ORCHARD (413)543-5979
PROPERTY LOCATION 78 MAIN ST
MAP 32C PARCEL 017 001 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out fi3O iC z�� �
Fee Paid —
��
Typeof Construction: REPLACE ENTRANCE DOORS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 073684
3 sets of Plans/Plot Plan
THE F LOWING 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 Commission _ Permit DPW Storm Water Management
Demolition Delay
S ZZ Zoo
,Vte..//----
Signature o uilding fficial 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.
Version1.7 Commercial Building Permit Mav 15, 2000
Department use only
-1' ity of Northampton Status of Permit:
yOding Department Curb Cut/Driveway Permit
_ 12 Main Street Sewer/Septic Availability
M A`( 1 9 200 Room 100 Water/Well Availability
N4rtha pton, MA 01060 Two Sets of Structural Plans
rp�aar t114 -587- 240 Fax 413-587-1272 Plot/Site Plans
Ot�, ' 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
/ S Map Lot Unit
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
1-r de .-- fy cam;p
Name(Print) Currenten Mailing Address:
f' O _�ox 6 ._...,moo.'±/ .-_,.,,x to .i"► 0/060
Signature Telephone
2.2 Authorized Accent:
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 75?6 (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=(1 +2+3+4+5) Check Number /120 sez 5-o "-
This Section For Official Use Only
Building Permit Number 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 Alterations ❑ Existing Wall Signs 0 Demolition❑ Repairs 0 Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other 0
Brief Description Enter a brief description here.
Of Proposed Work: o V �S ,hs _ /tom"-c'e. OO C)f S
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 0 A-3 El1A I 0
A-4 0 A-5 0 1 B ❑
B Business IJ 2A ❑
E Educational 0 • 2B I ❑
F Factory 0 F-1 0 F-2 0 2C 0
H High Hazard ❑ 3A 0
I Institutional 0 I-1 0 1-2 0 1-3 ❑ 3B 0
M Mercantile 0 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A 0
S Storage 0 S-1 0 S-2 0 5B L 0
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)
1st ; i
1 St
l
______ 2nd t
I
2nd '
3rd
3rd i
._. Ott, i
4th i f
Total Area(sf) Total Proposed New Construction(sf) m
Total Height(ft) _...._,__._.�.....__._...__.....
Total Height ft ._,_
7.Water pply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage D' posal System:
Public ( S Private 0 Zone Outside Flood ZoneEr Municipal al- site disposal system
Version].?Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size _ ._._ ,._ .__......._.._._
Frontage
Setbacks Front
Side L _ Ra ' L:.._.._. R
Rear
Building Height
Bldg. Square Footage
Open Space Footage °o
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO (DZ-DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q Date Issued:
C. Do any signs exist on the property? YES NO ei
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing, grading, exca tion, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
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
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
..._....... ..........E
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
0/ C Not Applicable ❑
Company Name:
Responsible In Charge of Construction
3 c(A(< Sr _ �EJ �-r U Iel&r _.AA,,aii.47
Address
t3) S S+3 - C5 71
Sig ure Telephone
Version].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 0
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
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
,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.
Print Name
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable El
23C/
Name of License Holder: Ag4 OD3‘
0-1 0 /vIAR -
License Number
OAk ST D /AA t. _77_
Addres Expiration Date
Si ature 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 0/ No 0
`•, The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Aw Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): C) ( C /./c� c 1 (�/� - -/v,irrc: -a- C
Address: 3 (3 P ST
City/State/Zip: :, ,0_ Phone#: q 13 ST/3— -S-S 7 S
Are you an employer?Check the appropriate box: Type of project(required):
1.I�i am a emplo er with 4 4. ❑ I am a general contractor and I 6. New construction
employees 4:.d/or part-time).* have hired the sub-contractors
2.❑ I am a sole . ..netor 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' 9 Building addition
[No workers'comp.insurance comp.insurance.:
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152, §1(4),and we have no 13.0 Other
employees. [No workers'
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:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
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.
I do hereby certi under the pains and penalties of perjury that the information provided above is true and correct
Signature: �„ Date:
s _ f3 C) '
Phone#:
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#:
•
FROM :ORCHARD GLASS a MIRROR INC.
FAX NO. :1 413 439 0149
May. 19 2008 02:46PM P2
„ r«rOvisl0ns: WC 00 00 00 A,)
ORMATtON PAGE
• ..:„' WORKERS COMPENSATION AND EMI'LOYER3 LIAoIUTY POUCY
" *ISURER: HARTFORD FIRE INSURANCE COMPANY
HARTFORD PLAZA, HARTFORD, CONNECTICUT 06115
NCC1 Company Number: ( 13269
company Code: 1
,THE �'
ARTFORD
i
H
Suffix
LARS RENEWAL
POLICY NUMBER: 08 NEC a1J3192 �� � 03
Previoua Policy Number: 08 WEC NJ3192
ry
HOUSING CODE: SE
1, Named Insured and Mailing Address: ORCHARD GLASS AND MIRROR, INC.
xi> (No., Street,Town, :state, 7ip Cads)
32 OA1C STR.sie
u-s FEN Number: 043509041 INDIAN OECIIhRD, MA 01151
en
State ldentc;ation Number(sy:
UIN:
The Named Insured is: CORPORATION
1 mom
Business of Named insured: Glass Store - Window, Plate &
Other workplaces not shown above: 32 OAR STREET
._.. INDIAN OR-CHARD MA 01151
mir 2. Policy Period: From 10,03/e 7 Tv 1 n/03/08
ii 12:01 a.m.,Standard time at the insured's mailing address_
Producer's Name: IDEAL INSURANCE AGENCY, INC
mise 187 EAST STREET
LUDLOW, MA 01056
N Producer's Code: 087356
maw
Zim issuing Office: THE HARTFORD
maw
tem 4401 MIDDLE SETTLEMENT RD.
NEW HARTFORD NY 13413
(000) 962.-6170 — — —
Total Estimated Annual Premium: ,t9. 727
Deposit Premium:
Policy Minimum Premium: 1335 MA E INCLUDES INCREASED LIMIT MIN. PREM.)
-
auttit Period: ANNUAL Installment Term:
maw
awss The policy is not binding unless courttersogneu by u,u►-euthorizod ropressontative.
mom
Countersigned by
Authorized Representative Date
Form WC 00 00 01 A (1) Printed in U.S.A. Page 1 (Continued on next page)
Prr,cess Date: 0 8/2 8107 Policy Expiration Date: 10/03/08
•
FROM :ORCHARD GLASS & MIRROR INC. FAX NO. :1 413 439 0148 May. 19 2008 02:47PM P3
f 7�J Agent • • • DECLARATIONs - MASSACHUSETTS
A I,D. No.: •. 3 • . i .:. BUSINESS AUTO COVERAGE FORM Q"
i Policy Hunt• : `'086'400001 MAIM tilt MM 00 97 09 98 •"•�."''""�•`"'•..,
ITEM ONE-NA .'. INSURED AND ADDRESS Producer Name and Address 3626
ORCHARD GLASS AND MIRROR INC IDEAL INS AOC1E; INC
32 OAX ST 187 EAST ST
INDIAN ORCRARD, NA 01151 LUDLOW, MA 01056
POLICY PERIOD: Policy Covers FROM 03-25-2008 TO 03-25-2009 12:01 A M Standard Time at the Namned
Reason for Declaration; RENEWAL, Insured's Address stated above
Named Insured's Business:CORPORATION DIRECT BILL
Effective a Date: 03-25-2008
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUDJECT TO ALL TERMS or THIS
POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
ITEM TWO-ACNEDULE OF COVERAGES AND COVERED Au•ron
This policy provides only those coverage where a barge Is shown in the pre niisn column below, Each of these coverages will apply only to those'Autos"she
as Covered"Atutns"fnt w rstriiry star r..-.+mra do by the entry si Iry*r re.***as the y,...ir.d.r.vttr lime oovcricu MU i Ilin oforrann AT ma hYmwrmace Atttra rbwrerspn Co.
..... A.............d ISM wvc.IOW.
LIABILITY INSURANCE
COVERAGES COINED Amos LIMIT PREMIUM
(Psymbols f from themom of tho
COVER[} The most we will pay for any one accident or loss
AUTOS Section of thn R11fina44
Auto Coverage Form show which
autos are covered autos-) r
Compulsory Bodily Injury 7 20,000 6 Each Bo Accident
864
4Q,OQQ -
a .•-.. e.y .eury is..r. er, '-7 0,000 Each
or .d Person 30
ior►at Bodily Injury 7, E, t,u,uu0 Each Person 1,146
_ 500.000 F' 'Am-idea-it
I
Property Damage 7, 8, 9 100,000 Each Accident 1,203
(GGMPULSORY LIMIT S5.000)
Auto Medical Payrrrent8 tnsuranca 5000 Ear h Person 13
Uninsured Motorists(COMPULSORY zoo,000 tech rerson 23
t-1M1T6 icv.we/ ►v.LW) 300,000 Each ant w
t}rxierinstued Motorists 7 100,000 Each Person 113
300.000 Each Apcid
PHYSICAL DAMAGE INSURANCE
Actual Cash Value or cost of repair,whichever is less, minus the deductible for each Covered Auto.
Comprehensive Coverage 7 _BEE �- tieductIble T- 312
Specified Perils Coverage beduCgtl e
Collision Coverage 7 ass SCHEDULE 1:166°C.'tl> . 481
Limited Collision Coverage Oeducletle
•_-Luse or uae^Refltal fiCImbut
'fovring and Labor $25 for each disablement or a private passenger
auto.
Forms and Endorsements
dorseents attached to Otte Coverage Form: ' PREMIU
1L0017(11-85) rL0021(11-85) CA000I(07-97) FOR ENDORSEMENTS
CA182(02-91) m19911(09.98) CA2386(01-06) r *ESTIMATED TOTAL --'
26AP1071(01-06) P019917(09-98) 1.19913(09-9R} PREMIUM - 4.185
P059954(09-98) *This policy may be subiect to final audit.
Fvoamia e•Uodi aa4vr+.r Li-Oity t;ompre►lenslve _, Collision yrg
AB Other Modifications: enatve f. Collision Rating ID
!PO WS*COgy11g19ed - y • V .. ,* 2t• ---" '¢�!Rep,eron>tedvo •.._.
,-11 INSURED COPY
02101/2008
*0036260380
FROM :ORCHARD GLASS & MIRROR INC. FAX NO. :1 413 439 0148 Mar. 18 2008 02:60FM P2
ORCHARD GLASS & MIRROR INC. PROPOSAL
P. O. Box 51051
32 Oak St. Date Proposal #
Indian Orchard,MA 01151 -
P: 413-543-5979 " 2/4/2008 8022
F: 413-439-0148 .'
,
Name/Address
Hampshire Property Management
150 Main St.,3rd floor
P. O.Box 686
Northampton,MA 41060 Project
78 Main St,northampton,...
item r Description Total
The removal of existing entrance doors and frame to be replaced with new doors
with frame and sidelite.
Doors to be bronze anodized aluminum wide stile double doors by Kawneer
complete with 1 1/2 butt hinges,door closers,glazed with l/4"clear safety glass
and to have factory supplied PANELINE EL panics, Von Duprin power transfer
and a power supply.
Electrical and buzzer system to be done by others.
Material 6,930.00T
Labor 720.00
.... .1„..._, Cfikitio., ---(7 .„___,67
aP-e0S1
• 3c/ 9q , a5
Terms: A 1/2 deposit will be required,balance upon completion of job. Subtotal
$7,650.00
..All material is guaranteed to be as specified.All work to be complete in a woridike manner .
accordance to standard practices any alterations or diviation from above specifications involving extra
costs will he executed only upon written orders and will become an extra charge over and above the Sales Tax (5.0%) $346.50
proposal.All a&eemcnla c:onlongenl upon strikes,accidents or delays beyond our control.Owner to carry
fire,tornado and other meeeSary insurance.
****Acceptance of this proposal—The above prices,specifications and conditions are satisfactory and Total $7,9
art 96.5 0 {
are hereby accepted,you t anthori sd to do the work as Teethed.payment as outlined above. ��l
PROPOSAL V ID ONLY OR DAY"
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Signature \, l ! t/ Date: - �' C 1
/1/ f; .
AUGUST,2006 190/350/500 STANDARD ENTRANCES 19
EC-97903-05 PANELINE®/PANIC GUARD®EXIT DEVICE
The Paneline concealed rod exit device for Panic Guard Entrances will accommodate variations in stile width and door width as shown in the
following illustrations.Sidelites adjacent to Paneline equipped doors not requiring exit devices may be fitted with fixed panels as detailed below to
match the general appearance of the Paneline cross rail. NOTE: PANELINE®EL IS NOT AVAILABLE ON PANIC GUARD.
See Hardware Section for complete description of Paneline hardware, including finish of units.
o ; Paneline uses mortise cylinder in lieu of the normal rim-,ripe.
o 1 Dummy Paneline units should not use any type of lock. . 1.23/32' 1-1/8' CAD DETAIL EA107
v c m. (aas) (z79) va
H o, INTERIOR ELEVATION (az)
a NOTE:Sides must be stop glazed above and below rail.
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(Without Exit Device or Lock) AND PULL (FIXED LOCATION) FIXED PANEL
LOCK STILE TRIM FILLER WIDTH
VARIES WITH STILE WIDTH
DOGGING LOCK
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8'-0"(2438.4)MAX.-6-0'(1828.8)MIN.
6'-0'(1828.8)ADA MIN.
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