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32C-001 (72) 150 MAIN ST-THORNES BP-2019-0742 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: Antenna radio heads BUILDING PERMIT Permit# BP-2019-0742 Proiect# JS-2019-001223 Est. Cost: $15000.00 Fee: $105.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GREGORY SCHNOPP 043706 Lot Size(sa.ft.): 16683.48 Owner: THORNES MARKETPLACE LLC C/O HPMG Zoning: CB(100)/ Applicant. GREGORY SCHNOPP AT. 150 MAIN ST - THORNES Applicant Address: Phone: Insurance: 831 SOUTH ST (413) 446-2479 DALTONMA01226 ISSUED ON:12/27/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-SWAPPING 3 ANTENNA, SWAPPING 3 RRU'S, ADDING 6 COAXIAL CABLES, REMOVING 3 AISG CABLES 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 12/27/2018 0:00:00 $105.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0742 APPLICANT/CONTACT PERSON GREGORY SCHNOPP ADDRESS/PHONE 831 SOUTH ST DALTON (413)446-2479 PROPERTY LOCATION 150 MAIN ST-THORNES 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 Buildina Permit Filled out Fee Paid Typeof Construction: SWAPPING 3 ANTENNA, SWAPPING ADDING 6 COAXIAL CABLES, REMOVING 3 AISG CABLES New Construction Non Structural interior renovations Addition to Existingt Accessory Structure Building Plans Included: Owner/Statement or License 043706 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INRMATION 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 l I z 27 h 03 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. Versionl.7 Commercial Building Permit May 15,2000 w w � t City of Northampton Building Department ' k 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,REPAIR,RENO IATE, PAN Y OF,OR DEMOLISH ANY BUILDING OTHER T1 IANA NE OR TWO FAMILY DWE LING SECTION 1-SITE INFORMATION DEC 2 1 2018 d c-- 00/ 1.1 Property Address: This#ectloi i to be completed by offlos DFPT OF SU W��1C,INS PFCTIONS Ufflt 150 Main Street Northampton,MA 01060 NORTHAI9IPRC)N.MA 0 06u Iot Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: Airosmith Development/Andrea Armstrong 355 State Street,Ste 1 East Albany,NY 12210 Name(Print) Current Mailing Address: (518)527-0011 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $15,000.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee i- 4. Mechanical(HVAC) 5.Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Version 1.7 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 0 Brief Description swapping(3)three antenna,swapping(3)three RRUs,adding(6)six coaxial cables,removing Of Proposed Work: (3)three AISG cables SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ Awl ❑ A-5 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3g 11 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 0 Specify: Modification to equipment at existing cell site 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 let 2"d 2nd 3rd 3rd 4m 4th Total Area(so Total Proposed New Construction(sl) 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 0 Zone Outside Flood Zone❑ Municipal ❑ On site disposal system[:] Versionl.7 Commercial Building Permit May 15,2000 & NORTRAMPTON 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 © DONT KNOW O YES O IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW © YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW 0 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , Date Issued: C. Do any signs exist on the property? YES O 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 O 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 Q NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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 © DONT KNOW Q YES O IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES © 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 O 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 O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 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 ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): NameArea 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 Name Area of Responsibility Address Registration Number Signature Telephone I Expiration Date 9.3 General Contractor Prescott Tower Service Ltd Not Applicable❑ Company Name: Eli Pitts Responsible In Charge of Construction 809 Post Road Rutland,VT 05701 Address ff (802)353-0082 Signature Telephone Version 1.7 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 I, 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 I. /7`/�C.��-GZ-- � C� �d7`1rL�Si7'J�' � YCa� ,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. V Print Na IC Signatureof owner/ Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Gregory Schnopp CS-043706 License Number 831 South Street Dalton,MA 01226 06/03/2019 Address Expiration Date (413)446-2479 Signature Telephone SECTION 13-WON't ZS'COMPENSATION IN CE AFFIDAVIT(M.G.L.c.152,§25C(8)) L' 11 0.-' 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 O No O The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anplicaut Information Please Print Les ibly Name(Business/Organization/Individual):Prescott Tower Service Ltd Address:809 Post Road City/State/Zip:Rutland,VT 05701 Phone#:802 773 8844 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 12 employees(full and/or part-time).' 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp,insurance requited.] 9. ❑Demolition 3.O I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10 Building addition 4.[:]l am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.Q 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.�✓ Other RRH replacements 6.n We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no 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. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Acadia Insurance Company Policy#or Self-ins.Lic.#:VTARP302170 Expiration Date:10-23-18 Job Site Address:150 Main Street City/State/Zip:Northampton,MA0106 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un ns and penalties of perjury that the information provided above is true and correct Signature: :3 Date: Phone#:802 353 0082 Offwial 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#: \ The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia «-orkers'Compensation Insurance Affidavit:Buflders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anulicant Information Please Print Leeibly Name(Business/Organization/Individual):Prescott Tower Service Ltd Address:809 Post Road City/State/Zip:Rutland,VT 05701 Phone#:802 773 8844 Are you an employer?Check the appropriate box: Type of project(required): l.a I am a employer with 2 employees(full and/or part-time).' 7. ❑New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.O I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10[]Building addition 40 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ repairs irs These sub-contractors have employees and have workers'comp.insurance.* 14.E]other RRH replacements 6.[:]We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no 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. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors 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:Acadia Insurance Company Policy#or Self-ins.Lic.#:VTARP302170 Expiration Date:10-23-18 Job Site Address:150 Main Street City/State/Zip:Northampton,MA0106 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un airs and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#:802 353 0082 Official use only. Do not write in this area,to be completed by city or town oj,)'iciaL 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#: 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: /SO '� S „• rnp d Io6O The debris will be transported by: 1?rtsc,A+ '('�,� r_<-rrjnee The debris will be received by: N,,6,j lIZr�Qr-' Building permit number: Name of Permit Applicant Date Signature of Permit Applicant AI R©SMITH DEVELOPMENT - We do 8 right the first December 20,2018 City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 Attn: Mr. Louis Hasbrouck RE. Verizon Wireless Modification to Existing Configuration located at 150 North Main Street Northampton,MA Dear Mr. Hasbrouck: Electronic copies of the CDs and SA were sent to you on 12/12/18. Per additional communication you indicated to please forward payment to the City of Northampton. Enclosed please find a copy of the BP application along with the requested fee of$105.00 as well as a self-addressed stamped envelope for you to send a copy of the BP upon issuance. Please also send an electronic copy of the permit to; aarmstrone@airosmithdevelopment.com Please reach out to me with any questions or additional requirements. Thank you in advance for your assistance. 13ei7 Regards Andrea m ong Site Acquisition Specialist Airosmith Development, Inc. (518)527-0011Cell (518)306-1755 Fax aarmstrong@airosmithdevelopment.com 32 Clinton Street,Saratoga Springs, NY 12866 Certified �SRAWOSB Office 518-306-1733—Fax 518-306-1711 1. w�a,Mesnwieu..e www.airosmithdevelopment.com