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31D-166 - City of Northampton ;� . ±- ` , Massachusetts ' k. . , w : ' .. W s . 1 : `` ?: i'l' DEPARTMENT OF WILDING INSPECTIONS � = _ -m L.' 212 !fain Street • Municipal Building JT. �n � V Northampton, Q. 01060 r l�p �r, I NS PECTOR Louis Hasbrouck Fax: 413 -587 -1272 Building Commissioner Phone: 413 - 587 -1240 Assistant Commissioner SECONDARY CONSTRUCTION CONTROL DOCUMENT (For professional Engineers/Architects responsible for a portion of a controlled project) Project Title: 47�ZU 140 � i & Date: 7q23{110 Project Location:Mti �L , �� D ltd, *HUSir: .1 141, reb. k. Map: Parcel: Zone: Scope of Project: WAN l)J .prynt; L14Vt In accordance with the sixth edition Massachusetts State Building Code, 780 CMR Section 116.0: I, 1—a Mass. Registration # 13057 , being a registered professional Engineer /Architect hereby CERTIFY that I Have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Fire Protection [vIrchitectural ( ] Structural ( ] Mechanical [ ] Electrical [ ] Other (specify) for the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for the building permit. . Upon completion of the work, t shall submit to the building official a final report as to the satisfactory Completion of the above mentioned work. S , re and Seat of Registered Professional p_j •.., 1 " t1E0 �4A C `S tE y f r Day of ,4,Cst)'Scj" 20 t O A yQ►�QS S �9 L1/ � O� a CC No. 8039 0 PALMER, w 3 0 ``�lTp al- of` :e Property Address: 2-71- �, Contractor Name: '` `- • ►�- • , Address: 1 . City, State: v • / ,: _ 4 , \ - Ilk 1, : 4 . O a 2'51 / Phone: 1 ' 7Z3 7S4 Property Owner Name: _ _ ..m . - .. - - Address: d X1 2=; _- - - - - -- City, State: ., ,. l i� %• .., .�� 0. \ \_� I, _ . �_ % ,�� � `∎ (contractor) attest and affirm that the building I intend to insulate does not have any open air (knob and tube) wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Cont - ctor : i nature �\ Date \ \ 4 \ l` ,, / \ 1lussachusetts - Department of Public sate Board of Buildinu Re!„ ulations and Standard, ' Construction Supervisor Specialty License License: CS SL 102810 Restricted to: WALTER DROLETTE 7 PENELOPE ROAD ''; BOURNE, MA 02532 � Expiration: 10/27/2012 ( ,urnn,issioner Tr#: 102810 ' ./i 49 ,' 4 �1I �u� I- fling w Office of Consumer Affairs and usiness Regulation 4 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 163873 Type: Private Corporation Expiration: 8/6/2013 Tr# 217096 COLONY INSULATION OF WEST SPRItIGF JOSEPH DROLETTE 103 WAYSIDE AVE. W. SPRINGFIELD, MA 01089 Update Address and return card. Mark reason for change. ill Address rI Renewal LII Employment 11 Lost Card 3 -CA1 Ce 50M- 04/04- G101216 Office 6, Office airs iiii4isalteglaikifiliet4 License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �t� ; Registration: 163873 Type: Office of Consumer Affairs and Business Regulation - Expiration: 8/6/2013 Private Corporation 10 Park Plaza - Suite 5170 Boston, MA 02116 Co` •NY INSULATION OF WEST SPRINGFIELD CAPITAL INSULATION JOSEPH DROLETTE �-- 103 WAYSIDE AVE - ./';..-/---. -.75- W. SPRINGFIELD, MA 01089 Undersecretary Not vali ithout sign ure . . A r c h i t e c t u r a l = == ® Submittal Architects Planners Interiors Reject E B1GYI PROVIESS T PROJECTS Submittal: 11=1 Safe SPFlb rGlass Rowing Insu lion City of Northampton Min 8 -19-10 amebic NA APPROVED FABRICATION /INSTALLATION MAY BE UNDERTAKEN. APPROVAL DOES NOT AUTHORIZE CHANGES IN THE CONTRACT SUM OR CONTRACT TIME UNLESS STATED BY APPROVED AS NOTED CHANGE ORDER OR CONSTRUCTION CHANGE DIRECTIVE. L_J APPROVED PENDING SUBMISSION OF MISSING ITEMS (SEE COAAENTS) REVISE AND RESUBMIT FABRICATION/ INSTALLATION MAY NOT BE UNDERTAKEN. 1..� IN RESUBMITTING, LIMIT CORRECTIONS TO THE ITEMS REJECTED MARKED REVIEW AND APPROVAL ARE ONLY FOR CONFORMANCE WITH THE INFORMATION GIVEN AND THE DESIGN CONCEPT OF THE PROJECT AS EXPRESSED IN THE CONTRACT DOCUMENTS. REVIEW AND APPROVAL OF SUBMITTALS ARE NOT CONDUCTED FOR THE PURPOSE OF DETERMINING THE ACCURACY AND COMPLETENESS OF OTHER DETAILS, SUCH AS DIMENSION AND QUANTITIES, OR, FOR SUBSTANTIATING INSTRUCTIONS FOR INSTALLATION, OR, PERFORMANCE OF EQUIPMENT OR SYSTEMS, ALL OF WHICH REMAIN THE RESPONSIBILITY OF THE CONTRACTOR AS REQUIRED BY THE CONTRACT DOCUMENTS. THE ARCHITECT'S REVIEW AND APPROVAL OF THE CONTRACTOR'S SUBMITTALS SHALL NOT RELIEVE THE CONTRACTOR FROM ANY OBLIGATION CONTAINED IN THE CONTRACT DOCUMENTS. THE ARCHITECT'S REVIEW AND APPROVAL SHALL NOT CONSTITUTE APPROVAL OF ANY CONSTRUCTION MEANS, METHODS, TECHNIQUES, SEQUENCES, OR ANY SAFETY PRECAUTIONS OR PROCEDURES. THE ARCHITECT'S APPROVAL OF A SPECIFIC ITEM SHALL NOT INDICATE APPROVAL OF AN ASSEMBLY OF WHICH THE ITEM 15 A COMPONENT. ARCHILUIUKAL INC. J it S. J&wete6 8 -25 -10 BY: DATE: Review Comments: Sample(s) required? (WO) Supplied? (NA) Certificate(s) required? (NO) Supplied? (NA) Warranty(s) required? (NO) Supplied? (NA) Notes: Please be sure to maintain ventilation pathways from the eave soffit vents. (If there are existing recessed fight fixtures attention should be given to allow for ventilation around light fixture housing unless the fixture is rated and made to allow insrdation placed directly around the fixture,. 3 Converse Street Suite 201 Palmer, Massachusetts 01069 PH 413 -283 -2553 FX 413 -289 -8993 I: \10 \1066 Energy Improvemets - Northampton \ConstrAdmin\Shop Drwgs \Blown Insulation.docx 1 From:Molly Kienzler FaxID: Page 1 of 1 Date:11/4/2011 02:58 PM Page:1 of 1 • 5R CERTIFICATE OF LIABILITY INSURANCE OP ID MK DATE(MM/DD/1NYY) CAPII50 10/31/11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IBM Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Barry 14. Stephens , CPCU HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 75 North Main St . -P 0 Box 564 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Longmeadow MA 01028 Phone:413- 759 -0010 Fax:413- 759 -0017 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A 20230 Central Insurance Companies Colony Insulation of INSURER B A. I. M. Mutual Insurance Co. West Springfield Inc. wsuRERc dba Capital Insulation 103 Wayside Avenue INSURER West Springfield MA 01089 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OP MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSK aUU'L POLICY EFFECTIVE POLICY EXPIRATION LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDfYWY) DATE (MMIDDNI'W) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY CLP8606135 01/01/11 01/01/12 P REM Es (Ea ootence) $ 300000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5000 PERSONAL &ADV INJURY $ 1000000 X GL Plus Endo Appl GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2000000 PRO - X � POLICY JECT LOO AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A ANY AUTO BAP8606134 01 /01 /11 01/01/12 (Ea accident) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 A X 1 OCCUR CLAIMS MADE CXS8626973 01/01/11 01/01/12 AGGREGATE $ 1000000 DEDUCTIBLE $ X RETENTION $ 0 $ WORKERS COMPENSATION - 42—Y 'STATJ- AND EMPLOYERS' LIABILITY X LIMITS ER ___ B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WMZ8006341012011 01/01/11 01/01/12 EL. EACH ACCIDENT $ 500000 OFFICER /MEMBER EXCLUDED'? (Mandatory in NH) E . DISEASE- EA EMPLOYEE $ 500000 If yes, describe under SPECIAL PROVISIONS below E L DISEASE- POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYOFN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Ci ty of Northampton IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Building Dept. 212 Main Street REPRESENTATIVES. Northampton MA 01060 AUTHORIZED REPRESENTATIVE P IBM Insurance Agency Inc. ( ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Asomome- '.A , Version13 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes © No 0 I SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I! . as Owner of the subject property here. authorize to act o 1, • - -If. in all matters relative to work authorized by this building permit application. 11.61.11 Signat i i . Date le) 1 ‘4 I. L • hit , . as Owner /Authorized Agent her. .y d clare at th. 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. AR 1 oio P I kAtOMO. ►. Pnn X .� ' 1 11 Signat - • Own- . • - t ' Date SECTI • - C • RUCTION SERVICES 10.1 Lic- :dC•n do . -rvis, : p, u 9 Not Applicable ❑ Name of License Holder : . r \ MII. • , _ 16 ' `lb._ N License Number -, ! -�- • ..��. ' ii..A CSsL in act boo Addre Expiration Date -56t -g 1,0 \:z..7 1 Signature Telephone c ae 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 • No 0 . PROFESSIONAL . DESIGN AND - CONSTRUCTION CONTROL PURSUANT TO (CONTAINING MORE THAN 35,0om E) Registered - - �'; Not 13 r- � ----- � -- ! • L ___''_—_-�_- � 40 2 Z34116 — 3Expiretlon Dale Registered Professional Engineer(s): � , • � ..� . . . ___ _ � ___._____ ________ _________ / __ ___ _ . _____ . ___.___ Area of - ' 7 l -_ � | Signature Telephone - ' - -- [---- --' - -' -- --'--.'- --- ------ 1 / . '__ _ . | -- __ -__ -_--_. -_ __ �__--_- mddre^ . _ -4 ! __ �m�* e��n ���� � - -_- - - | . �__- __-_� ,-_'-'_-- ._ ________ -_--_--' .. �____' -___- � - - ' ' |'- � '.___- ' wmrms Number i� ` - ` Signature ` Telephone avirmw*n __ _ ' - - . -�� __ .__ __ . -- _-_-_ . '-___ .-_---__--._- `__ . - ____ __- �___ ''— i -'' --- . 41 . --____-� ' ~ Signature Expiration Gate 9. " Company Name; Responsible oho of i '. gn*tureArAMI1111//1 Telephone II V C Version! .7 Commercial Buildup Permit May 15. 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be tilled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: 114 A- 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 DON'T KNOW 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 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES NO O IF YES, describe size, type and location: A.Asw .i 1(AkeL1.- D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO IF YES, describe size, type and location: E. WiII 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 • IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • Version!.7 Commercial Building Permit May 15. 200() SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Buildi g ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs �p ❑ Roofing ❑ Change of Use ❑ Other j Y► Brief Description Enter a brief description here. V Of Proposed Work: 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 ❑ 1 B ❑ B Business ❑ 2A 1 ❑ E Educational ❑ 2B I ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B 0 M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 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: 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) 1" 463o 1st 2 „d 2" 3rd 3 rd 4th 4d Total Area (sf) 6 O Total Proposed New Construction (sf) Total Height (ft) 14 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❑ • wA Set s Version1.7 Commercial Bui1di Permit May 15, 2000 .�, Department use only "'� City of Northampton S ta t us o f Permit: Building Department Curb Cut/Driveway Permit - '• TN 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans ti11 --41 - •, LL . , =p pne 413- 587 -1240 Fax 413 -587 -1272 Plot/Site Plans 1 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 ,. Map Lot Unit Zone Overlay District fISZ&J16.3.444,T4R1\ k \14\AC Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 21 Ow er •f - :c•rd: Name (Print) , Current Mailing Address: Si • natu y' I11� ` 1 . • • le • Tele P5"11■NNijkar4NN. 9 X11 2.2 Author! :d A. Name (Print) /` Telephone Mailing Address: Sign ature 11 O 1 ' `' one SECTION 3 AT s CO STRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant Building ak iel- k S OC (a) Building Permit Fee 2. Electrical ,l VV (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee hh /, 4. Mechanical (HVAC) -U C - 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 File # BP- 2012 -0463 • APPLICANT /CONTACT PERSON CAPITAL INSULATION ADDRESS/PHONE 103 WAYSIDE AVE WEST SPRINGFIELD (781) 203 -2706 PROPERTY LOCATION 274 MAIN ST MAP 31D PARCEL 166 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICA,TION CHECKLIST k ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Q Fee Paid Typeof Construction: INSTALL ATTIC INSULATION New Construction Non Structural interior renovations Addition to Existing, Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION PRESENTED: ' Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay /4 /I WU 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. < 274 MAIN ST • • BP-2012-0463 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31D - 166 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SHEETMETAL BUILDING PERMIT Permit # BP- 2012 -0463 Project # JS- 2012- 000757 Est. Cost: $10800.00 Fee: $0.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CAPITAL INSULATION Lot Size(sq. ft.): 87120.00 Owner: NORTHAMPTON CITY OF ACADEMY OF MUSIC Zoning: CB(100)/ Applicant: CAPITAL INSULATION AT: 274 MAIN ST Applicant Address: Phone: Insurance: 103 WAYSIDE AVE (781) 203 -2706 WC WEST SPRINGFIELDMA01089 ISSUED ON :11/9/2011 0 :00 :00 TO PERFORM THE FOLLOWING WORK :INSTALL ATTIC INSULATION 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 11/9/2011 0:00:00 $0.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner •