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18D-001 (5) • . File # BP- 2011 -0415 APPLICANT /CONTACT PERSON GARDNER CONSTRUCTION & INDUSTRIAL SERVICES INC ADDRESS/PHONE 47 OLIVINE ST CHICOPEE (413) 535 -1500 PROPERTY LOCATION 158 NORTH KING ST MAP 18D PARCEL 001 001 ZONE HB(100) //WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out & , 3 � j ! al 4164, a 0 Fee Paid b Typeof Construction: CONSTRUCT INTERIOR WALLS FOR BATHROOMS & OFFICE SPACE (WIRELESS ZONE) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: � ,� ��y Owner/ Statement or License 84078 ��/471'_'" �"-Q 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 Ci ' /8/6 i 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. 2010-10-28 09:30 413 536 0242 P 1/5 Version 1.7 Commercial Build ink Permit May 15 2000 - - Department use only City of Northampton Stus of Permit • t' Building Department Curb Cut/Dnveway Pennit -) ,‘•-\ 212 Main Street SeweiSeptic Availability .•:, Room 100 Wale Northampton, MA 01060 ;t7i0:0,ets . • phone 413-587-1240 Fax 413-587-1272 PJoVIS,te Plans • • APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOUSH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section to be completed by office 1.1 Property Address: 1 6r C r /"t Map Lot Unit B not Kin9 ST" Overlay District °Mir:Imp 0100 ; Zone Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT 2,1 Owner of Record: - Thus - r . . Name (Print) mfr mou r Current Meiling Address: r. La145 goositiZg (VIC.- • signature Telephone 4E3 184 Otp00 2.2 Authorized Agent: ._G L . . ....._.: Name (Print) ism Curtooty4ing Address: _ Signature / LS1 .... CH;copu,..111c,.. Telephone 413 FAs ■ SECTION3 - STIMA D CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 70 0 (a) Building Permit Fee .o , 2. Electrical ? a ad . a° (b) Estimated Total Cost of • Construction from (6) 3. Plumbing Building Permit Fee Od,. 4. Mechanical (hIVAC) 5, Fire Pro ecti • , Jo 6, Total i „. 1 3 4 + Check Number a JP This Section For Official Use Only - • Buildi g rmlt Num.. Date Issued Signature: Bung Commissioner/Inspector of Buildings Date 2010-10-28 09:30 >> 413 536 0242 P 2/5 Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs 0 Demolition 0 Repairs 0 Additions 0 Accessory Building 0 Exterior Alteration CI Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use 0 Other lia Brief Description Enter a brief description here. Consfroe'f7on of 7.4 f(' 414 1/ Of Proposed Work: F b lh /s4_5 a n a 0 I‘ C/c (... 5 f., tm I aptss Ze N 6 ...___Pf. .. _a__...r.:(2.0. .____..... ________ . ....____ .. . ...._ ._... ._......... . . ............. . . _....._....... ..____.... SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly 0 r- A-1 0 A-2 0 A-3 ID 171 El A-4 0 A-5 D 18 0 B Business 0 2A 0 E Educational Li 28 J El F Factory 0 F-1 0 F-2 0 2C 0 H High Hazard 0 3A 0 I Institutional 0 1-1 0 1-2 0 1-3 0 313 0 M Mercantile RI 4 0 R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S Storage 0 S-1 0 S-2 0 513L 0 U Utility Specify: i ---.- - • •••---••• • • ------ - - • ---i-.--•••• • ------ - • • .---- -• • -------- ... ------ . 1:3 .___....... _______ .........._______... ...___,.. ..........___... . ... ._._...... ...__.... .._. _ M Mixed Use 0 Specify. - _ ....... S Special Use 0 Specify: • COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE •-- 1 Existing Use Group: i . . Existing Hazard Index 780 CMR 34): ...._____ Proposed Hazard Index 780 CMR 34): • ..; ,----..—..A SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (0) __ .. _ _____ .... 1' • _ 2" 2" ' ' . ..ardi 3 1 ' 1 _....i . • .......—...... ._._..._ . ......_____... . . 4 4 i th ' :—..---... ,....______.- Total Area (sf) : • Total Proposed New Construction (Op . ......__,, . Total Height (ft) i Total Height ft 7, Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public co Private 0 — Zone l ..._. _.. Outside Flood Zone0 Municipal 0 On site disposal systemn 2010-10-28 09:30 >> 413 536 0242 P 3/5 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 P» . ..... Ltat Building Height Bldg. Square Footage " F - 777 7 % ' Open Space Footage (Lot arca minus bldg & Travcd . parking) #ofParkingSpaces • • • Fill: 5 - (volume & Location) . . • • — A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT 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 it! B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: • C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading. excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required, 2010-10-28 09:31 >p 413 536 0242 P 4/5 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 TOO CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: ,--- ---- -------' — ---` Not Applicable C% Name (Registrant): • - -' -� � --- -- -----� Number Addre �_-__----'__-----_--__--_---___---_-_-_'-_�_--___---__---_-_� �- _-- Auovmss L—_---___--'_----_----_ •• • '--'--� - Expiration Date Signature Telephone 9.2 Registered Profemsimnm|Engineer(s): -'_--- ---_--_ - '---� Name ���n� Responsibility , _ _ __ ___ ________ � _-'-'_-____--_-__�_ - — 7 —' — --- ' — —'-'' ---_-'__ _____-___'--__�'� � Address Registration Number Signature Telephone Expiration Dale Name Area of ResponsibilIty • ---� F -�--------------'--------'--� --------------------------------------- ---� L--__-� -- � _ _ � Address -'-----| - ----�----- ----- -----------� ( - Signature Telephone Expiration Date • • . • Name Area • ' ' - ' - - � '' - ----- '--- ` �- ' •- ---'-- 7 • �---------------- ----------- --' ---------------� L-- -- --_'----� Address Registration Number | i i --------'' ' --- Signature Telephone Expiration Date _'�-- — —'`—_'__'' mamm Aream Responsibility r --- ---------'--'-------'-------------------------� -�----'-'-�-------------- 1 Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor • • • ', '_�.^~�.- '----------'� ----------- Not Applicable 0 Company Name: Responsible In Charge of Construction ._'____________�__�________ ______________________________________ Address Signature Telephone 2010 -10 -28 09:31 >> 413 536 0242 P 5/5 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 0 No 0 SECTION 11 -OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT BMW -- - -- - - - -...- - - ........_ ........ .. ..... :. i as Owner of the subject property • hereby authorize '• -_.GFIROQ i __C V 1 1.6.0121 &ia l . act on my behalf, in all matters relative to work authorized by this building permit application_ __ — .._ ______ _ - ._____.. - ._ ........ Signature of Owner Date --- -- - - -- I, -- - - - - -1 Gt�'!..__.�f ....���. -------------- - -• -_: , 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 thepains.and penalties . of perjury ................ . ..._....-.-.-.-.----.--------------.-- •--- ._.._....._..__...... -. -- - ...._..--- •__ -_ -- L _ Print Name Signs of Owner/ . ent Date SECTION 12 - CONSTRUCTION SERVICES 101 Licensed Construction Supervisor: Not Applicable ❑ I• • • Name of License Holder ::--- _.._. __�tsl . S� t2_- __- __ .- ----- .-- .-- _ - ---- -.. - License Number Fin Addre Expiration Date /ar ✓ d / �� ... y/3 5,4/20,._ Signature Telephone SECTION WORK S' 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 'CJ No 0 The Commonwealth of Massachusetts Department of Industrial Accidents " V Office of Investigations 1 600 Washington Street 1 , , Boston, MA 02111 " r www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information ) Please Print Legibly Name (Business/Organization/Individual): 1ded4 fr Cn't't Ck 7'O4e`�/1d1J5/pir / , i,# tK. Address: 1- 17 Qi, vin e S7Llf 6f City /State /Zip: 4 ' A. // ; Phone #: y/j — 5I5-/ Sao Are you an employer? Check the appropriate box: general contractor and 1 Type of project (required): 1. I I am a employer with ,� 4 . I am a Q n g employees (full and /or part-time).* have hired the sub - contractors 6. n New construction 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7.E�odeling ship and have no employees These sub - contractors have 8. n Demolition working for me in any capacity. employees and have workers' 9. n Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. _ We are a corporation and its 10.0 Electrical repairs or additions 3. [ I I am a homeowner doing all work officers have exercised their 11.F Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.11 Roof repairs insurance required.] t c. 152, §1(4), and we have no 13. n Other 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. 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 is providing workers' compensation insurance for my employees. Below is the policy and job site information. /9/4 'T s /_ Insurance Company Name: //6 c .L /� uranG L U7r ei, Policy # or Self -ins. Lic. #: 9//y3 90110 Expiration Date: ////// �� c Job Site Address: / Si /(/,r/. k,, r� S7 t / City /State /Zip:Arf / �a / 4n Ag. O J 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 under the pains and penalties ofper'ury that the information provided above is tru and correct. Signature: ' Date: / 0 /�r /d Phone #: 1 1/c..? 5, 3J - / 5 0 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit /License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: _ ., .. .. i , 1 i . i i I 1 1 ; • •Z , — 0 kei LI JO ! / • 1 ; 1 ,,, 5 -- 0 () ,,, k El ...I I - 1 . 1 , i • , , ; 0 . , i . . 1 r L , } i 1 I : 1 i 2" m .. , ..„ . 1-_-_-_----- '- 1 ' , ,, I ' 3in , 513 1 ; EFS . ■ I . ; f i ■ ' ' 1 ' / ' I • 325 k i ':, ' im ... om ' - r _ . 1•.i. --io'laly.-.: -00J6) 3 j ! i i i .... , t '''''' ' al • , . 0, '' ' i .• 1 1 _., *7-7 - - A . _ 9 II - t) --- C L /1 6 / / .96 / ,.., ii 1(--- - A I St 11 /173 /'Lblb 1L:17 1 3d nr iNKL.t.c I ""u V+ CI, • • • HFP Corporation A (ITC Fire and Security Company 32 Char Drive Ww{ficld. MA DI(R1 "lel: (811(1) 888 -5197 10: (4111 - 4709 Fax: (413) 562.7293 November 3, 2010 Gardner Construction & industrial Services 47 Olivine Street Chicopee, MA. 01013 (413) 536 -0242 Subject: Automatic Fire Sprinkler Quotation Re: Tenant Fit -Out - Northampton Plaza Northampton, MA. Gentlemen: T-TFP Fire Sprinkler, Inc. is a wholly owned subsidiary of HFP Corporation. Incorporated in 1972, HFP has become known as one of the largest and most credible sprinkler contractors in the Northeast United States. With a bonding capacity of 10 million dollars and an annual volume of 20 million dollars, HFP has never failed to complete any job in its 37 year history. We are pleased to offer to modify the existing automatic fire sprinkler system at the above referenced project. A. Our quotation is based on the following scope of work: 1. Sketch as prepared by Gardner Construction it industrial Services 2. Specifications design build 3. Starting our work at the existing fire sprinkler system 4. Adequate water supply 5, Wct sprinkler systcru is designed in accordance with VFPA. 0l3 "Installation of Sprinkler Systems" 6. Seismic bracing will be installed in accordance with NFPA Standards and the Building Code, HFP Fire Sprinkler, Inc. / HFP Fire Protection Services, Inc. / HFP Residential Fire Sprinkler u 1jI -Ileu - Ir€? Si pprpcslon & Lorrrol JyStems Offices Located at !nn0 old CA,At CW.1e I t t I , w , d,o, lxb. Cr 0606 A ••••••F 41••71 M •7Cn Jr*... MA 01047 ,8001 83.?.., 413 / L Rio") 07. <400 ; 9e0113i�457Fa.. uwj)113•e5Z r 1.:(111ITMruq I I30el ::uruFo, MA Lk - -rl,. A' li{I CT Llc.Nn I • I I .A4 DI l{Car:o I: I00000f3 VI q 4;076 .V• F A. I lrenAn I; 11 747 ) _ Cr FA. Ucor.e w FI.0 OIJD kl 1.T. Llca.•.,n 0: AF17.4 464 vrAnv.hrpsprtntler. com Louis Hasbrouck From: Duane Nichols Sent: Thursday, November 04, 2010 11:13 AM To: Louis Hasbrouck Subject: RE: Big Y plaza Lou, I am good with shop drawings and FD approval as a condition of occupancy. Duane From: Louis Hasbrouck Sent: Wednesday, November 03, 2010 3:43 PM To: Duane Nichols Cc: Fire Prevention Subject: Big Y plaza Duane, Big Y is fitting out a space in the Big Y Plaza (between Delap Realty and the old Bickford's space). The space is 35x60; they're putting up a couple partition walls for offices at the back. It is fully sprinkle red and alarmed now. They may need to move a couple of heads; they have contracted with HFP for the sprinkler work. Are you OK with shop drawings and FD approval as a condition of occupancy or do you need drawings before I issue the permit? Let me know. Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg Phone: (413) 587 -1240 Fax: (413) 587 -1272 1