32C-001 (7) Exhibit A
Lease Outline Drawing
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Metcalfe Associates Architecture
a 142 Main St. Northampton, MA, 01060 Tristram W. Metcalfe Ill, Ma. Reg. 5393
Phone number > 413 586 5775
Cell number > 413 695 8200
Email > twm3' rcn.com
NCARB, NYS, MA, CT
registrations
WMAIA
A IA
July 27, 2012
Louis Hasbrouck,
Building Commissioner City of Northampton
Puchalski Municipal Building,
212 Main Street, Northampton, MA 01060
RE: Renovations to; Old Flower shop @ the first floor of Thorne's Mkt.
150 Main St Northampton, Ma
Dear Louis,
This is a letter of some Code Review issues and the impacts of the project described here and shown
on a sketch over their lease plan.
Project Description:
The current project is to add a new sliding glass door 6ft wide between two existing commonly
rented rooms of this small space. They will be combing two existing rooms with no doors yet retain
the existing open portal between the rooms thus not altering any egress issues on the existing main
common access & egress corridor of the building.
There are no other code issues I see compromised to the existing conditions since no fire separations
exist between all of the buildings existing units.
I have not explored nor found what if any fire separations or egress pathways nor exit doors to grade
from anywhere in the building may or may not exist according to the new codes.
If there is any other information you seek to allow a permit to add this one door only please let me
know and I will try to provide it.
Sincerely,
BRED Art,
Tris Metcalfe 'f w' 44F
.......
#41.3
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`y , The Commonwealth of Massachusetts
Department of Industrial Accidents .,
a•--,—,.t.-1.--:--;,(7'
:� a Office of Investigations ,
=.r
r - rte::• z -, 600 Washington Street
Boston, MA 02111
Y M www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): ° /ti-► c S m a ) � `
Address: SS 7'4 1 fl. S ZA D P1 .
City /State /Zip: ,AU, r 1? is .0 v) 0 � hone # : ��5 le y
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
6. ❑ New construction
mployees (full and/or part- time).* have hired the sub - contractors
2. I am a sole proprietor or partner- ors have listed on the attached sheet. 7. ❑ Remodeling
These suh- contract h
ship and have no employees 8. ❑Demolition
for me in any capacity. employees and have workers'
working Y 9. ❑Building addition
[No workers' comp. insurance comp. insurance.$
required.] - 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have their repairs or additions
3. E] I am a homeowner doing all work ave exerc r 11. ❑ Plumbing P.
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, § 1(4), and we have no
employees. [No workers'
13.❑ Other
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 him 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 co py of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify , e ? e , at an penalties of perjury that the information provided above is true and correct.
S i • nature: 4-4 Date: i • jL
Phone #: or
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 #:
Version1.7 Commercial Building Permit May 15, 2000
S
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
z- i1 \ as Owner of the subject property
I, Clk -.b- �. d. .
hereby authorize 3 ..... Mad lo ..._ee.u._. '
ac on y .ehalf, in all m A ers relative to work authorized by this building permit application.
,t, - ', // , — Ara ,- 4 ....) , q[i 2■
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 e pains and penalties of�erj�_
.7Re e.e44-... rit . ' dA... ,
int / . ..._.__ __
t/ / ? / 1
Signature of Owner /A.e / / � /2 Date
SECTION 12 - CONSTRUCTION: SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
.1 r.5..i o , ,:!).lid vL�
Name of License Holder : �� m .. . d.. _ r_ .a�.r. .. - ,_..., .,...... :
License Number
Address Expiration Date
/'' S . � 5` -gi ._�_ /2///z.'/3
Signatur- Telephone
SECTION 13 - WORKERS' COMPENSATION INSURANCE AFFIDAVIT (MG.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
•
Version1.7 Commercial Building Permit May 15, 2000
SECTION 9- PROFESSIONAL DESIGNAND CONSTRUCTION! SERVICES - FOR BUILDINGS. AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR (CONTAINING MORE THAN 35,000 -C.F. OF EI LOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
A, TCALf. - 6. . _ ___ _ __ Applicable
Name (Registrant):
1 Li "L MA k N SZ No t ,1 H A M PT 0.N Mkt Registration Number
Address
5 A TA C- ke p Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Ristration 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
ti E.:
_ fv14 1. ( .UL4_\ _.. Not Applicable ❑
Company Name: .. ._.. .__.__....�..._.._,.
Responsible In Charge of Construction
u
Address
Signature Telephone
Version1.7 Commercial Building Permit May 15, 2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column tore filled in by
Building Department
Lot Size
F rontage ,.._._-
Setbacks Front
Side L w R.'. _ _ L.`:_._v_. ; R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces _.. t
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0
IF, YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book ' Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO
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, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
•
Version1.7 Commercial Building Permit May 15, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 t
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑
Exterior Alteration Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑
Brief Descriptio , Enter a( brief description here. Pf i -S c ®p,e ,-, 1-, e , i., „to, # � w try l
Of Prop Wor �`�t ry a t• St I v oi,rS __ _ _ __ .... _._ __. .m _.
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑
A4 ❑ A -5 El 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F -1 0 F -2 ❑ 2C 0
H High Hazard ❑ 3A ❑
I Institutional ❑ I -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 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)
1st 1St
2n d i
2 "d
..._.,...._.............._._ _._..__..._.,,,...�..., ._ _..
491 4
Total Area (sf) Total Proposed New Construction y Lsf)
Total Height (ft) ____ .___..__ _____ .._ ____
Total Height ft _._ _ _,, __ ... _ ._.... . �..
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood, Zone, Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone __,_ ,,, Outside Flood Zone❑ Municipal ❑ On site disposal system
< 1
Version1.7 Commercial Buildin& Permit May 15, 2000
- A�, S I ' Departmelt u
tiL� (.,, .
r" _ City of Northampton St a � P err n %. 4,i 4 10'701' ,.
�R ;u "'¢. °',�^'`?.3..h,�' S "" � '3
Et Building Department G ,rtrC f./Dnyeway Perrttrt --1
AUG 2012 212 Main Street Sewer /sept,cAva,tabtl,ty
Room 100 Wate Nell Avai[abilityi I,, y `
i3J� r_�ii N MA 01060 T wo A i tr e uu Ha .Pl a i x v-p N ,
D
E ". � f t,. ,�
NORTHN F AA oios phone 413- 587 -1240 Fax 413 - 587 -1272 Plat/S,te Plans,
Other Spec
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SE ION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
! , /hit 14 te M ap Lot Unit
CSC l`2�l C� � ; Zone Overlay District
• Flower stop
• -
_ -- -- _ -.—..... - .--r_ _.— -- aR �-----..........._ ,..—. F..A,— , Elm St: District`. ' CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Ow of Record
ss
N ame (Print) Current Mailing Address: �Q�
__... yr s'rg ...__M____ m .
i
Signature t . ' t / �iL�. , i _ Telephone
2.2 Authorized Agent:
JAvv� C S
Name (Print) Current Mailing Address:
T y r = S t 0 a 1 9.3
Signature Telephone
SECTION 3 'ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
/ completed by permit applicant
�i. Building �' ry (a) Building Permit Fee
2. Electrical ? (b) Estimated Total Cost of
Construction from 6 _,.___...,_._ ., . _,,...
3. Plumbing Building Permit Fee •
4. Mechanical (HVAC) .._...._w._.__._.__ .._..� _m.__.., _____..__ !'7 9 'tsS 6 ..__ .,....._
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signatur '- / �
il`- `' /i 9 Buildin Commissioner /Inspector of Buildings Date
150 MAN ST - SUITE 130 BP- 2013 -0167
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C - 001 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP-2013-0167
Project # JS- 2013- 000277
Est. Cost: $5000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JIM MAILLOUX 081694
Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG
Zoning: CB(100)/ Applicant: JIM MAILLOUX
AT: 150 MAIN ST - SUITE 130
Applicant Address: Phone: Insurance:
55 MAIN ST - 2ND FLR (413) 563 -4654 () Workers
Compensation
FLORENCEMA01062 ISSUED ON:8/14/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT DOOR IN NON - LOADING WALL
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 8/14/2012 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner