The URL can be used to link to this page

31D-143 (3) ,a N w Bench Seating.3 seats Sink I g 3 0 Employee bar area 1 EF 1 — 0 2 3 : O I CD 1 F, N n I 1 38' ----- Trash closet I I smoke detects \. Fire extinguisher N y ---- -36'------- - Fpor to noor 12QS.. 'tese 7.5'1 Run 9.5" Pth.29"Me1ght:34• — - i � � N Fire exting)isher I a -Second means of e 1 Curia t —48 5. 9ra3s One Amber Lane °'Bxris � First Floor Overhead Layout New window Exterior Door Window Plug Seating Tables HVAC Fire Pull StatlonlStrobe Ramp C Bar Equipment Underfloor Plumbing Internal Wall Staircase G Exterior Brick Aboveground plumbing ■ Internal Brick Wall Interior Door S N Mi «&i +� TV jw 1� to �_ ;�� y ie �" � a4`A. •? • ••• � �� .r-r �s ,� ? �� ,€i 'k -err e� �, � �� a� a .� ,��,. � E! I i��,a+� "�e�.t� ,}��,�,,^� "�s �,•+i�r y'�t '�+qa�s�„ *� �,,'a^ V , •a' (� i ��y'^�"�,.krM Y'..�,�"�i '+►"'��'•k'R'„dRa�"�rF �y4�R"F-,yl!"�'+'� g'..+ J.k ra.. '-'16 Curio: - - ' " Overview � _�� m ,�� ` �-�� &�=�J�ew � Amber Lane �� d�� proposed Espresso Bar) * Removal nfnon-structural internal walls as marked on ~ Removal of exterior vvaU covering (drywall)to bring walls tostuds as marked , `"r%'"t * Removal of brick and partial window on southern exterior wall as marked on ��/�e� ��e ThiyisinpreparatonfnronewphmaryrneansofeOress. 8hcktobe /emoved:40" |ongby35' hi8hbe|owexishnQvxindoxv. VVinduwtobenemoved:4O" |on8by6O^ hiDh. Reytofvvindovvwi|| be reframed and kept. The existing 10' long window has structural support from an existing lintel above window in brick. Demolition will not extend beyond existing lintel. ° Removal of non-structural door inexisting second means of egress as marked on �^��u,' �cc�uc This i» in preparation for installation of new window. (pnmpmsed Gallery) * Removal of non-structural internal walls as marked on `��,rao� ��,�ac � Removal of wall covering (drywall)to reveal internal brick wall (running E-W along centerline of building)as marked on .,°—,,' "`. ^.r*�^� w Removal of non-structural faux garage door wall and window on east wall as marked onfo�rr,� Wall to be removed: 112" long by96" high, includes removal of window.This is in preparation for installation of glass/aluminum garage door in same position. ~ Removal of current staircase to prepare for new staircase in same footprint. H@3f^ (proposed Private Meeting Space) * No demolition. (proposed Kitchen,Employee Bathroom, Office) * No demolition. • First floor: Gallery • Walls: Painted drywall, painted brick(new paint on existing materials). • Floors: Sealed concrete (new sealant on existing materials). o Ceiling:Sealed and painted wood (new paint on existing materials). • First floor: Men's and Women's bathrooms c Walls: Finished mold-resistant drywall with sealed wallpaper. o Floors: Copper tiles. o Ceiling: Finished, sealed drywall. • First floor: Utility room • Walls: 1-hour fire-rated drywall. • Floors:Sealed concrete(not being changed). • Ceiling: Sealed wood (not being changed). • Staircase o Iron with closed metal tread. • Second floor: Private meeting space • Walls: Wood paneling over existing drywall. • Floors: Sealed hardwood(not being changed). o Ceiling: Wood paneling over existing drywall. • Second floor: Kitchen o Walls: Porcelain tiles 2/3 of height. Sealed, painted drywall for final 1/3 of height(final 1/3 not being changed). Accent wall: Painted and sealed over existing drywall. o Floors: Porcelain tiles. o Ceiling:Sealed drywall (not being changed). • Second floor: Employee bathroom • Walls: Ceramic tiles 213 of height. Sealed painted drywall for final 1/3 of height(final 1/3 not being changed). • Floors: Onyx tiles. • Ceiling: Sealed, painted drywall (not being changed). • Second floor: Office • Walls:Wallpaper over existing drywall. • Floors: Sealed hardwood (not being changed). • Ceiling: Sealed drywall (not being changed). ��0�� m � ^��uuN ��m � Amber Lane �� J� �� , ^ ~ • Overall square footage: l796sq[t (898sqft per floor; 2 floors total) • Ceiling height: First floor at 9.5' and Second floor at average 7.5' (sloped ceiling) • Occupiable space(uncmncentratedseating) • First floor: 206.4sqft/ lS net= l3people • Second floor: IOOuqft/ l5 net= l3people • Occupiable space(standinQ) o First floor:58.6sq ft/S net= 11 people • Fixed seating: o First floor: l fixed bench: l side S3" (Zpeople); 1 side 32'' (1 person)=3people • Commercial kitchen(ennp|myee'mn|V) o Second floor: IOOsqft/2OO gross= 1person • Espresso bar(eonp|myee-on|y) o First floor:5D.7Ssqft/ 1D0 gross= .Sperson • Office(employee-only) o Second floor: 1SOsqM/ 10O gross= 1.Spersons • Unoccupiable space:corridors, bathrooms, utility closet,staircase, trash closet,footprint of espresso bar and attached equipment ~ Use Group: B (place ofAssembly with an occupancy under SOpeople) * Customer-facing space: First Floor(ordering/receiving drinks at espresso bar,seating (fixed and furniture), bathrooms). Second Floor(private meeting space—not open to public). * Employee-only space: First Floor(behind espresso bar,trash closet, utility closet). Second Floor (kitchen, bathroom, utility room,of0ce). * First floor: Espresso Bar • Walls:Taken to studs. Insulation complies with minimum R20. Finish: sealed concrete board. • Floors:Sealed hardwood for customer traffic(new sealant on existing materials); Porcelain tile behind employee espresso bar. • Ceiling: Sealed wood (new sealant nn existing materials). Possible sheet metal between exposed joists. • Espresso bar: Sealed wood for bar top; zinc sheet metal for bar face. See Ceti o for list of finishes for walls,floors,ceiling for each space. Because of the building's small size and proposed use as commercial throughout,the life safety requirements are minimal. We will install fire extinguishers at each means of egress (new primary and existing secondary)as well as at the top of the stairs on the second floor -within easy travel distance of the private meeting space and the kitchen. Additionally,the building's size does not require exit signs by code. However, if the Building Inspector requires exit signs, we will install 4 as shown on 0verhv-.,,,(1 3 on the First Floor:at primary means of egress, at secondary means of egress, and at the hallway between Gallery and Espresso Bar. 1 on the Second Floor:at top of stairs. Existing 4 Smoke detectors will remain in place, 1 each in Espresso Bar,Gallery,top of stairs, and Office. Hallways and walk ways inside the building maintain a minimum 36" width at all times. The path of travel in case of emergency is as follows: - Espresso Bar: toward primary and secondary means of egress,whichever is closer. -Gallery and 2 customer bathrooms:through open hallway to Espresso Bar and follow above. - Private meeting space: down stairs to Espresso Bar and follow above. - Kitchen, Employee Bathroom, and Office: down stairs to Espresso Bar and follow above OR out fire escape in Office. See%Dwerneac, Lmtic; for additional information. The existing rise/run and footprint of the staircase to the second floor will be maintained. A new staircase will be installed in its place with cosmetic upgrades.The new staircase will be iron with a closed metal tread. The kitchen will be used for ware washing, baking pastries and desserts (examples: scones, muffins, pies) and making juice(with fruits and vegetables). Produce will be washed in 1 bay of the ware washing sink, designated for produce and sanitized before/after use.This has been approved by the Northampton Health Department. Curio will not have a range and our menu does not include cooked items. All baked goods will be made in a KitchenAid Superba double oven, wall mounted.This model vents into the room and has been approved by the Northampton Health Department. -New South Entrance this will be the new primary means of egress for the building.This south wall is 16' wide with a 10'wide window inset.The proposed change will use the existing window's lintel for structural support, cutting in 40" on the"left side" of the window (as looking from the outside of the building) and removing bricks beneath.The new door will be framed in here and the remaining 80" of window will be preserved. - New East Window:this is currently a door used as a secondary means of egress but was previously a window. We propose to take out the door and put back a window. -New East Garage Door:this is currently a faux "garage door" style wooden wall. We propose to take out this non-structural wall (112" wide and 96" high) and replace with a glass and black painted aluminum garage door. This door will remain in a fixed position,treated as a window to let in additional light, and not be operable by the public. -New exterior lighting: we propose to add 8 lights to the building on the south and east. All 4 of these changes have been submitted to the Central Business Architecture Committee in detail for review. We acknowledge that,while these facade changes are included in this building permit application,we will need to wait for their approval to begin that portion of the build out. See copy of our (narrative, mock ups) attached to this application for more detail. The new primary means of egress will be handicap accessible with a 38"out-swinging door.The path from the public sidewalk to the door is about 20' with a slight arc toward the door. The rise from ground level to the floor of the cafe is between 8" and 10". This rise will be portioned out over the 20' ramp,creating a maximum gentle slope of 1:24 (1 inch of rise per 24 inches of run —or less than 5%). As such,this ramp is not required to comply with AAB ramp regulations and will not include handrails.The incline will be made out of pressure-treated lumber. Path of travel along incline will be perpendicular to grain of wood to ensure non-slip surface. AAB clear floor space is provided on both sides of the door. An existing means of egress will be used as our secondary means of egress with a 36" door (existing). Because our occupancy load is over 20 people,we will install 2 handicap accessible bathrooms in our Gallery: either both unisex or one for men and one for women, as required.These measure 88" long by 60" wide with the hand sinks recessed into adjoining walls by 2".The bathrooms are mirror images of each other. Both include the 60" turning clear floor space inside the room, clear floor space access into the room itself and at a front approach to the sink;grab bars at the toilets;and fixtures (toilets and sinks) installed to AAB requirements. Handicap accessible seating will be provided in the Gallery at the tables along the east wall that faces Amber Lane. See for additional information. Curio: 1 Amber Lane My business partner and I are planning to open a new business called Curio at 1 Amber Lane in Northampton.To prepare for Curio,we are submitting an application for a building permit to build out the business. Curio will be a food service establishment, specifically an arts cafe. Our menu will include espresso, coffee and tea beverages;cold pressed fruit and vegetable juices; baked pastries; and baked desserts. All juices, pastries and desserts will be made on premise in the employee-only kitchen. All beverages will be made on premise in our customer-facing espresso bar. Curio will consume the entirety of 1 Amber Lane, 1796 square feet split on 2 levels(898 square feet per floor). The building is naturally divided into 4 sections named and referred to throughout this application as follows: -Espresso Bar: "bottom left"space on plans, oriented toward Masonic Street Parking Lot to the south.This space will include the proposed new primary means of egress (the handicap means of egress);the secondary means of egress;the proposed new east window;a staircase to the second floor; sparse customer seating, and the espresso bar itself. -Gallery: "bottom right" space on plans,oriented toward Amber Lane and the privately owned parking lot behind our building.This space will include 2 ADA-accessible bathrooms;the majority of customer seating;the utility room; and the proposed garage door. -Private Meeting Space: "top left" space on plans, above Espresso Bar.This space will be reserved for private meetings. -Kitchen, Office, Employee Bathroom:"top right"space on plans,above Gallery.This space will include the kitchen with ware washing sink, oven, and hand sink;employee bathroom with mop sink; and office. The occupant load for Curio is 43 and it is use group B. Please see for detail. The current use of 1.Amber Lane is law offices open to the public. Building out Curio will require the demolition of several non-structural walls currently used as office partitions on the first floor. No demolition is required on the second floor. Please see for detail. The build out of Curio will include 3 facade changes and the addition of exterior lighting.These changes are as follows: SHIPMENT ROUTING INSTRUCTION ZONE:NorthE Ship From Ship To Bill to Inf ation SomerTile 7726 Multi-Mode Logistics, LLC Wayfair LLC 217 County Roa 522 295 Ella Grasso Turnpike 4 Copley Place, Floor 7 Manalapan Towns , NJ Windsor Locks, CT Boston, MA- 02116 07726 06096 United States United States United States Po#: C S 3042 5 6 of 25 Item Carton Information Overpack Additional Notes Arabesque 2-3/4" x 1-7/8" Porcelain Mosaic cal livery Tile in Glossy White FDXARGW NOT FOR ROUTING PURP ES - CARRIERS SEE T OF FORM FOR ORIGIN AND DESTINATION Origin estination SomerTile NJ 07726 Emily Withenbury c/o hris Thornton 217 County Road 522 108 West Morris Road Manalapan Township J Bantam, CT 07726 06750 United States United States 8 yV l x Y:d ti id kcr'd Alt, a�° i"t•`"°� i �..s 6.�"��-.� �#"d:"�I'4 r^t .. �i� � `� } warac k „ j IB ,#'t�lp sP2# 4 F `w sr waaE an } qg t {{ } tT zyJ 211 2 Vlwj if h t � N q a � t q 'r { a ,3# JU )[I lt4j t, i } f , r.t � � v e. b # xV az Ift 7.,ON IF t ily opgg 4 fit . h Y 4h $fiRYY ✓C-, �w°F ,y IF, L i 8`8: { ai,` F idi � i• s s.x .� � ,. 5.�sge�,g w t r #3: New South Entrance The current entrance to 1 Amber Lane exists on the east side of the property. It is not possible to install a proper handicap accessible ramp on this sidewalk because of lack of space.The Architectural Access Board (AAB)of Massachusetts requires 48" between the handrails on a handicap accessible ramp, plus the distance beyond the handrails. This width does not exist on the east sidewalk along Amber Lane and, even if it did, the ramp would be right next to the street,with no buffer for car traffic. I am proposing to create a handicap accessible entrance on the south side of the property—the side that faces the municipal parking lot off Main/Masonic and points at Cracker Barrel Alley. There is currently a 10'long window on the south side of the property. I will use the existing lintel above the window as the structural support for the new entrance, cutting a 40" wide opening out of the left side of the window (as you're looking at the building)and preserving the remaining 80"of window.The 40"wide opening will extend to the bricks beneath the window and will be framed in for a new door. The intent with this new entrance is to present a handicap accessible, public-facing entrance to ensure ease of access and visual recognition. I aim to create continuity and aesthetic cohesion across 1 Amber Lane's facade by keeping this new entrance in the property's signature black palate.The door, window,and trim will be painted black.The trim (above window and door; below window;and around door) will be wood with carved accents in a Victorian-style detailing. As required by AAB regulations,this new entrance will open onto a wheelchair accessible route. My business partner and I are working closely with Department of Public Works and the City Planning Department to design a functional, aesthetically-pleasing, and public-facing Parklet off this new main entrance.This new space will contain our business' handicap accessible route (on a gentle incline),flanked by 2 sets of built-in bench seating open to the general public. The public Parklet concept has gained sizable foothold in several municipalities across the country. My partner and I were able to watch the success of these Parklets unfold firsthand in San Francisco. San Francisco currently boasts over 40 Parklets,each a small public park inside a former street parking spot-granted by the City to a business or individual for development. Parklets beautify the area and create a functional space for the public to relax within a City's central business district. My partner and I look forward to developing a Northampton Parklet in conjunction with the installation of the New South Entrance on 1 Amber Lane. #4 Exterior Lighting I propose to modify the existing exterior lighting on 1 Amber Lane with the installation of 8 lights spanning 2 sides of the property:the eastern and southern. Currently,there is 1 light above our secondary door and no city lighting on Amber Lane. Amber Lane exists in a unique location—as a city street that ends abruptly when it changes to a private parking lot with a Dead End, all in the middle of downtown Northampton and at the end of a municipal parking lot! As such, the lighting in this area is minimal and doesn't account for much foot traffic on Amber Lane itself. Our property's current primary East entrance will continue to be used by the public as a secondary means of egress. Increased exterior lighting will mitigate public safety issues on Amber Lane.There is current, frequent foot traffic through Haymarket's back entrance; residential access to apartments; and safety concerns at my own property. In December 2013, 1 reported an incident of vandalism to the Northampton Police Department after my building manager discovered what he believed to be a break-in attempt to the second entrance. In addition to increasing accessibility and safety on Amber Lane,exterior lighting will encourage safe use of our proposed public Parklet. I chose black anodized aluminum caged down lights.These are in keeping with the black exterior accents on my property and introduce a touch of industrial to the design,thus linking the industrial garage door with the Victorian detailing on the new South entrance. I am taking the city's Dark Skies policy into consideration by installing Philips 8-watt dimmable LED Lamps with a 25 degree beam spread,450 lumens,in warm white (2700k).These fixtures will not exceed 5 foot candles of illumination on the ground. 1 Amber Lane, Northampton Facade Changes for Central Business Architecture Review I am proposing 3 changes to the facade and the addition of exterior lighting to my property: 1 Amber Lane in Northampton, MA.These changes reflect an emphasis on accessibility, public safety, and the vibrant architectural detail of the Central Business District. #1: New East Window There are currently 2 doors on the east side of the building—the side that faces Amber Lane and toward Main Street. I would like to take out the secondary door and replace it with a window, in keeping with the building's original facade. One can tell this used to be a window from the newer brick work that frames the top of the current door. Additionally, above this brickwork sits arched brick that matches the other windows on 1 Amber Lane. The new window will be in keeping with the size, material, and color of the other windows on 1 Amber Lane. Most likely, the window from the faux garage door wall will be repurposed for the New East Window. #2: New East Garage Door There is currently a faux "garage door" style wall made of wood (with an inset window)on the east side of the building— the side that faces Amber Lane and toward Main Street. I would like to take out this wooden wall and replace it with a glass and black aluminum garage door. Originally this cut out was for sliding carriage doors to access the barn,to let in the carriage and horses. The new garage door will be 112"long and 96" high,the same dimensions as the wooden wall. It will be glass panels framed with black painted aluminum, manually operated to slide up into the property and rest in the ceiling when not in a fixed down position.The intent with the garage door is less one of function (load in/load out)and more to bring visual appeal to that focal point and let in natural light.The current faux"garage door" style wall gives nice treatment to the black accents on the property's exterior but falls short of highlighting the full unique historic character of the property. Additionally,the property does not have any windows on the north and west walls. A window of this size would let in a sizeable amount of natural light. 1 Amber Lane is a commercial space with public access.The public will not operate the door as it will remain in a fixed position. I considered both garage door and carriage door style options and chose my proposed door because of price,space constraints,and aesthetic preference.Traditional carriage doors are about four times as expensive as the garage door I earmarked.Additionally, carriage doors would be out-swinging (into Amber Lane, an active street); in-swinging (into our narrow building); or sliding(not energy efficient or a functional use of that wall inside the building). And,finally, I enjoy the intersection of industrial and Victorian aesthetics and find this style of door a pleasant option that is in keeping with the quirky, unique character of 1 Amber Lane. City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: AM OVC L� e- � The debris will be transported by: A The debris will be received by: /f u -- �q-,s w`-6 r-gu Building permit number: Name of Permit Applicant �m�� lNi-tlb �1�1 �5 Gth Date Signature of Permit Applicant Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more of the.foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,associationn or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another'who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or gown that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 7-2010 Fax# 617-727-7749 www.mass.gov/dia The Commonwealth of Massachusetts fK1 . Department of IndustrialAccidents - Office of Investigations Jig - 1 Congress Street, Suite 100 + Boston, MA 02114-2017 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Con tractors/Electricians/Plumbers Applicant Informat on C Please Print LeQibl Name (Business/Organization/Individual): J\�/ Address: City/State/Zip: L-2. Phone F1.Are you an employer? Check th ppropriate boa: Type of project(required): .❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Zemodeling ship and have no employees These sub-contractors have g. F_j Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance co .insurance.$ required.] 5. are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 131-1 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 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. Uthe sub-contractors have employees,they must provide their workers'comp.policy number. I ani an employer that is providin-workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: J , ��&,o J' -0 I �� Policy#or Self-ins.Lic. CA Expiration Date: Job Site Address:_1 Q 3 y�)e-f- Lg1Je City/State/Zip: 0 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der the p ins and pe�zalties of erjury that the information provided above is true and correct. Si,nature: I _ .- Date Phone#: Al ea- Official use only. Do not write in this area, to be completed by city or town official City or Town: Perm itfLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ' The Commonwealth of Massachusetts Department of Ltdttstrial Accidents Office of Investigations m 6 00 Washington Street Boston, MA 02111 www.snass.,,ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _ Address: City/State/Zip: _ Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full an orpart-time). * have hired the sub-contractors 6. New construction cL _2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions g J.❑ I am a homeowner doin all work officers have exercised their I L Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]+ c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fil]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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:, Policy#or Self--ins.Lic.#: 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 die 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Sienature: Date: Phone#. 4f flcial use onhl. 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 S. Plumbing Inspector 6.Other Contact Person: Phone#: Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-,STRUCTURAL;,PEER REVIEW(780 CM R 110.11!) Independent Structural Engineering Structural Peer Review Required Yes Q No 0 SECTION 11 -OWNERAUTHORIZATION-TO:BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR`BUILD ING PERMIT . r+... ,p j, - Ip (�'� w' `� l.. as Owner of the subject property hereby authorize J�\. ._.... .... act on my behalf, in all matters relative to work authorized by this building permit application 21_'+I 15 Signature of Omtp Date I,. . ...... _- 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 ❑ CS.-_ a Name of License Holder 1I�_,_J License Number Add res Expiration Date Signature Telephone SECTION 13 WORKERS COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c 152x.§-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 bu' ng permit. Signed Affidavit Attached Yes No Version 1.7 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 ENLOSEDSPACE) 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 Name _ .. Area of Responsibility Address Registration Number I i Signature Telephone Expiration Date i 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 Si f (,e��Sul .._� LU Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature Telephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to 5e filled in by Building Department Lot Size Frontage Setbacks Front SideL. .... ._m R. ..,. .__. L ......__... R ..,....._... Rear Building Height f' Bldg. Square Footage / OX Open Space Footage __ % . (Lot area minus bldg&paved pe parking) #of Parking Spaces Fill: ... , (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO µDONT 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 ._ IF YES: enter Book Page:, and/or Document#: B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: u C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: ................ .. D. Are there any proposed changes to or additions of signs intended for the property? YES NO 0 IF YES, describe size, type and location: " r' r > !�!0 ,....1i) bVJC )t "'I'F.x�,� E. Will the construction activity disturb(clearing, grading, xcavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version L7 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 K Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief descn tion here. Of Proposed Work1! SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business 2A ❑ E Educational ❑ 2B �a ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ ___ 3A ❑ Institutional ❑ I-1 ❑ 1-2 ❑ 1-3 ❑ 313 ❑ M Mercantile ❑ 4 R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ 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 .., G QQ ._.,... ...., _.._. __._.....,. nd _. 2n0 2 _,..... .. _.._._, 3° _. _. ........ ._ ..,... 3T° th - w,._.,_._......,,.._..,_,._......�._. 4 h 4 Total Area(sf) (� Total Proposed New Construction(sf) „ Total Height(ft) ,1f Total Height ft 7.Wate Supply(M.G.L. c.40,§54) 7.1 Flood Zone 7.3 Sewage Disposal System: Public Private ❑ Zone Outside Flood ZoneA Municipal On site disposal system E] Versionl.7 Commercial Building Permit May 15,2000 Departme',t use only City of Northampton StaCus of Per�Ttrt Building Department Curb Gut/Dnueway Permit: `1 212 Maid Street :Sews/Septic, lvailab(tty Room 100 Watei•/Well Availablhfy Q r' Northampton, MA 01060 Two Sets of Structural Plans mbin phpne 13-587-1240 Fax 413-5$7-1272 Pl&(8 to Plans o$M-'s tr'�v�ions Other Specify APPLICATION TO CON TRUCT, 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 _. _... _..... ......._.... ..,.. Map Lot Unit 1 1tl�t.rti T�t�i 1116 CIJUl.! i. Zone Overlay District - - Elm St.District CB District` SECTION 2-.PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ?lt J C Name(Print) _ Current Mailing Address: Signature 4ll xA/ 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 ermit applicant 1. Building rp , (a)Building Permit Fee 3, OX 2. Electrical ' (b)Estimated Total.Costof ✓ 1 t/ �'c Construction from 6 _..., ., .. ...._... 3. Plumbing .., . ,^ Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection . .. ..:. . _... w..._ 6. Total=0 +2+3+4+5) - / SJ- v Check Number This Section For Official Use 0nl Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-0775 or for,''(-A O PC �V' `A APPLICANT/CONTACT PERSON ALEXANDER M SIV -��Nf 1 1 (►JP �' ,� " ADDRESS/PHONE 205 PINE ST HOLYOKE01040(413)219-5987 J PROPERTY LOCATION 1 AMBER LN r/,P.-fL MAP 3 1 D PARCEL 143 001 ZONE CB(100V THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APP_LICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Roo Fee Paid CR UNTIL CQAC. Typeof Construction: BUILDOUT&FACADE CHANGES FOR CAFE New Construction A PP UV A L Non Structural interior renovations O F RCA Fie Addition to Existing 1 Accessory Structure Building Plans Included• Owner/Statement or License 106994 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION PRESENTED: T!x-r ��0 W o�,� sP�c N p tN6r �C- AfPervv�ts,, 1, Approved Additional permits required(see below) G 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 Signature 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. I AMBER LN BP-2015-0775 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 3 1 D- 143 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-2015-0775 Project# JS-2015-001514 Est. Cost: $18000.00 Fee: $108.00 PERMISSION IS HEREBY GRANTED TO Const. Class: Contractor: License: Use Group: ALEXANDER M SIV. 106994 Lot Size(sq. ft.): 1219.68 Owner: WITHENBURY EMILY Zoning-: CB(100)/ Applicant: ALEXANDER M SIV AT. 1 AMBER LN Applicant Address: Phone: Insurance: 205 PINE ST (413) 219-5987 HOLYOKEMA01040 ISSUED ON:211012015 0:00:00 TO PERFORM THE FOLLOWING WORK:BUILDOUT & FACADE CHANGES FOR CAFE: interior work only until CB approval of fagade 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 2/10/2015 0:00:00 $108.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner - Furnace lk Utility Room smoke detector o Sink Bathroom toilet ,LUti 1, R. ctor eal?a of" W'ndoW smoke date SS Se cond leans Of curio one Amber Lane,Existing First Floor Wmdow door wall Window Mon-Structural Wall is removed Wall covering is removed,studs remain i I Fire Enca�oe j �a a•q Fi,e edoyryisbor Sink � nrrwka detector TaAet Utility roam Mop sink Employee bathroom .!aokedeteato, I 7 I I FI—to floor 120.5' I Frte e.ua°I'ne Triple Warewashmg sink Hand wash sink Private meeting space Rise LS°r Run 9.5" I � I i Back Office i i I Refrigerator Kitchen Closet Ciurld D«,be W.0 One Amber Lane aen Second Floor Overhead Layout Exterior Door Wmdow Piu9 Seating Tables HVAC F7re Pull Station/Strobe Ramp Bar Equipment Underfloor Plumbing Internal Wail Staircase Exterior Brick �? Aboveground plumbing ® Internal Brick Wall Interior Door N --- - ---rW -- -- ti Bench Seating:3 esnte Sink Sink 29"x18.5° 29"x18,5" .ter--i s•.r• Furnace Toilet Toilet Utility Room Ll—01 T -n aEmployee bar area Women's W�w k< �IpY1's Bathroom 3 m _ I S - I tin l 3 ,a O � CIZ v Z N m I N { -- w I ' ! - -- "-- Trash closet \#4f I aa� smoke detector Fire extinguisher ---- "-- - ` ,ro nom 1 zos" �a\ A i ltlse 7.5*/Run 9.5- i Y DeAth:29 Height:34^ y o Fire extinguisher a Second 01 13. Curio of egress One Amber Lane j First Floor Overhead Layout s New window y Exterior Door Window Ptug Seating Tables HVAC Fire Puff StationiSVobe Ramp C Bar Equipment Underfloor Plumbing Internal Wall Staircase G Non Entrance Garage Door Style Window Exterior Brick Aboveground plumbing S Internal Brick Wall Interior Door S N Fire Escape 3 toilet Sink 0 M Utility closet C, Second floor landing Bathtub Bathroom -3z,- or Office F Office o Kitchen Vt Closet curio wh-4uw One Amber Lane,Existing Second Floor 1------1=1.