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32C-001 (17)
Initial Construction Control Document Ri ** , r To be submitted with the building permit application by a Ali , Registered Design Professional '` � for work per the 8th edition of the .i„�,�.y,• Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Thornes Marketplace Elevator Date: October 10, 2013 Property Address: 150 Main St Northampton, MA Project: Check (x)one or both as applicable: New construction X Existing Construction Project description: Configure existing shaft for new elevator car i. Robert i_ect, MA Registration Number: 38942 Expiration date: 06/30/2014, am a registered design prgfessional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': Entire Project Architectural X Structural Mechanical Fire Protection Electrical Other: for the above named project and that 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. When required by the building official, 1 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 " ttEtFi electronic signature and seal: •, • w LEFT r 4.' STRUCTURAL L 38942 11, dirotirtIO Phone number: 978-544-8000 Email: rleetnwildb • 4_ ., A 0 ' Building Official Use Only Building Official Name: Permit No.: Date: Note 1. Indicate with an 'x' project design plans,computations and specifications that you prepared or directly supervised. If'other' is chosen. provide a description. Trial Version IQ_09_2012 a� s ���° Crzi� of Nazfljampfent ;@t2,1071- DEPARTMENT OF BUILDING INSPECTIONS , ai°t • 212 Main Street • Municipal Building Northampton, Mass. 01060 'V* Vr`ORI'IR'S COMPENSATION INSURANCE AI:+'it'll.)AVIT I, Pioneer Contractors (licenscripermi ttee) with a principal place of business/residence at: • _ P.O. Box 1145 Northampton, MA 01-061 (phoner° 586 5491 (sti t/city/staidrip) do hereby certify, under the pains and penalties of perjury, that: ( I am an employer providing the following worker's compensation coverage for my employees working on this job: • • Wcc 50059570120012 ti��n� 1�ssnc�i at F.m -Pd pl dyers Insurance Co --- - (Insurance Company) (Polidy Nulnlzer) (Expiration Date) ( ) I atn 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) (Lnsu ancx Company/Policy Nu-mbcr) (E.pirntion Date) f (Name of Contractor) (Insurance Company/Policy Number) (Ex-piration Date) • (Name of Contractor) (Insurance Company/Policy Number) (E\-piration Dale) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (ands ad3itioosl sheet ifneaess.ry to include information pertaining to all oxsrndors) ( ) I am a sole proprietor and have no one work ng for me. ( ) I am a home owner performing all the work myself. NOTE:please be awuc that while homeowners who employ persons to do n*e«+,-ci ,000struaioo or repair work on a clw-Ineg of not more than throe waits in which the bomoowacr resides or oo the grounds:ppm-tenant thereto arc not geoeralky coosidcrrd to be employers under the vicckcr s oempnzsatioa Act(GL152,s1 1(5)),application by a bonteowver for a license a permit may cvidmx the tegat status of an employer under the Worker's Compensation Act I understand that a copy of this eatcmmt may bo forwarded to the Doperm,eeat of Industrial Aoeidmti Office of lmurwce for the coverage verification and that Callum to secure eoverago under section 25A of MOL 152 can lead to the imposition of criminal penalties oornisang of a fine of up to S l,500.00 usdlor imprisonment of up to ism year and civil puttics in the form of a Stop Work Order and a find of 5100.00 a day against tnc- Fos-dial use only / �� Pcrmit Number 41 .4 • map __---Lot# Siva lure of Licc>isee/Pcrmi- - qr. e -� • . 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 O No O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Thornes Marketplace LLC--Jon McGee,Manager as Owner of the subject property hereby authorize Pioneer Contractors to act on my behalf, in all matters relative to work a horized by this building permit application. (V.., ,,,1-- Z.6 oLo ZO vc>ijt L .cczti,,5 10/09/2013 Signature of Owner Date j David Claxton/Pioneer Contractors 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. David Claxton Print Name #L Ie / 10/09/2013 Signature of iwner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: David Claxton CS-017890 License Number P.O. Box 1145 Northampton, MA. 01061 01/19/2014 Address Expiration Date (413)586-5491 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 0 No Version1.7 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): Robert Leet/Whetstone Engineering Structure Name Area of Responsibility P.O. Box 881 Wendell,MA. 01379 Address Registration Number (978) 544-8000 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 Pioneer Contractors Not Applicable ❑ Company Name: David Claxton Responsible In Charge of Construction P.O. Box 1145 Northampton, MA. 01061 Address / ,� ____ rff (413) 586-5491 Signature ' Telephone Version1.7 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: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (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 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 Q DON'T KNOW 0 YES o 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 Q 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 ® NO Q 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 © NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 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 ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other El Brief Description Enter a brief description here. Freight elevator replacement per attached drawings Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 El A-3 El 1A I ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business p 1 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A GI I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B L ❑ 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: Business Proposed Use Group: Same 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 2nd 2nd 3rd 3rd 4th 4th Total Area(sf) Total Proposed New Construction(sf) 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 p Private ❑ Zone Outside Flood Zone p Municipal p On site disposal system a "i= `l Version1.7 Commercial Building Permit May 15,2000 Department use only of Northampton Status of Permit: • i '\-- OCT Q 2013 Et (ding Department Curb Cut/Driveway Permit j •12 Main Street Sewer/Septic Availability <„c irons Room 100 Water/Well Availability Electric.Piur-tonrr iq - MA 01060 mpton, Norte, ;,n_ 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 150 Main St.,Northampton Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Thornes Marketplace LLC. 150 Main St. Northampton, MA. 01060 Name(Print) Current Mailing Address: 4C9 � G+Sc-L2 ryev(Z) r- (413) 582-9970 Signature '') 9 Y " � J`�'� Telephone 2.2 Authorized Agent: Pioneer Contractors P.O. Box 1145 Northampton, MA. 01061 Name(Print) Current Mating Address: ff (413) 586-5491 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $230,000.00 (a)Building Permit Fee 2. Electrical $10,000.00 (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 6,3 41, 7L{0 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0432 APPLICANT/CONTACT PERSON PIONEER CONTRACTORS ADDRESS/PHONE PO Box 1145 NORTHAMPTON (413)586-5491 PROPERTY LOCATION 150 MAIN ST MAP 32C PARCEL 001 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out %/1[3 q!� 1 J�,)1 0 Fee Paid Q (�'1 / ) 1 Typeof Construction: REPLACE FREIGHT ELEVATOR /IF' y' t rq(2E'(0 Nl S 4Avt FJCL ).1 t New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 017890 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 Peanuts 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 Cit 0 13 Signature of Building Official Date g g 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. 150 MAIN ST BP-2014-0432 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-2014-0432 Project# JS-2014-000748 Est. Cost: $240000.00 Fee: $1440.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PIONEER CONTRACTORS 017890 Lot Size(sq. ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG Zoning: CB(100)/ Applicant: PIONEER CONTRACTORS AT: 150 MAIN ST Applicant Address: Phone: Insurance: PO Box 1145 (413) 586-5491 Workers Compensation NORTHAMPTONMA01061 ISSUED ON:10/10/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE FREIGHT ELEVATOR - SEE PLAN NOTES CONCERNING SHAFT ENCLOSURE 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 10/10/2013 0:00:00 $1440.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner