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31B-201 (3) AGENCY CUSTOMER ID: 570000036474 LOC#: A=°R°. ADDITIONAL REMARKS SCHEDULE Page of _ AGENCY NAMEDF&SUREO Aon Risk services Northeast, Inc. Consigli Construction Co., Inc. POLICY NUMBER See Certificate Number: 570048604257 CARRIER NAIL CODE See Certificate Number: 570048604257 EFFECTIYEDATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE:Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY LTR TYPE OF INSURANCE AINSR SVIVO POLICY NUMBER EFFECTIVE EXPIRATION LIMITS DATE DATE (MM/DDIYYYY) (MM!DIWYYYY1 EXCESS LIABILITY C NY12EXC7698992V 12/30/2012 12/30/2013 Aggregate 55,000,000 Each $5,000,000 occurrence ACORO 101(2008/01) V 2008 ACORD CORPORATION.A!1 rights reserved. The ACORD name and logo are registered marks of ACORD A °i CERTIFICATE OF LIABILITY INSURANCE ` 2'N"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATIO f It WAIVED,subject to :: the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the 9 certificate holder in lieu of such endorsement(s). zs PRODUCER CONTACT Aon Risk Services Northeast, inc. PIWNe (565) 283-7122 (PAx C847} g53-5390 Boston MA office tom•Na EmB rAI N,N One Federal Street sAIAR.58, z Boston MA 02110 USA INSURERS►AFFOIWSIt3 COVERAGE NAIL a INSURED INSURER A. Old Republic General Ins Corp 24139 Consigli Construction co., Inc. pia: Starr Indemnity & Liability Company 38318 72 Sumner Street Milford MA 01757 usA BMW C: Navigators Insurance Co 42307 MOOR D: POURER E: POURER R COVERAGES CERTIFICATE NUMBER:570048604257 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limns shown are as requested TYPE OP INEURANCe 1 POLICY NUMBER QpP�t��OrI��I C4�Y EEPr y-� HMO EXP LASTS A A20096831203 1X/30/2012 1ZMO EACH OCCURRENCE $1,000,000 © COAaERCtAL GENERAL UABlUTY FREM DAMAGE-TO RENT idd $100,000 PREAe$Et+cEs PocurrPnul ■ CLAIMs.aAoE a OCCUR tow EXPyarPPnm) $10,000 ■ PERSONAL a ADV INJURY $1,000,000 N III GENERAL AGGREGATE $2,000,000 GENti AGGREGATE UtXt APPUES PER PRODUCTS-COMPIOP AGG $2,000,000 MCI POLICY n I^I LOC A AUTOMOea.ELIABR,TY A2CA96841203 96841203 12/30/201212/30/2013 COMB SINGLE Lair $1,000,000(Ea accident' A ANY AUTO A2CA96831203 12/30/2012 12/30/2013 BOOLY ENJURY(Par pawn) O © ■ALL OWNED `""SCHEDULED MA BODILY MAY per accident) AUTOS _ AUTOS PROPERTY DAMAGE C III IeRPDAUTOS _AUTOS WNED (Pasocddaa) e II UNOR$LLALIAa JX OccuR sXscCCL01697212 12/30/201(12/30/2013 EACHOCCURRENCE S5,000,000 tI Excess u a CLAMNS.AMDE AGGREGATE S5,000,000 owl f RETENTION A -WORNxERE COMPENSATION AND A2DN9683120-3 12/30/201212/30/2011 Xiwc sTATU-` 100TH. EMPLOYERS'UABIL rr 1 TORY U) T3 R ANY PROPRIETOR/PARTNER!EXECUTIVE TAM E.L.EACH ACCIDENT $1.000,000 �EREcwCeD7 N NIA ((Manwmoy In NH) EL DISEASEEA EMPLOYEE 51,000,000 DESCtIPTION OF OPERATIONS below EL DISEASE-POLICY UMIT 51.000,000_. Am a DESCRIPTION Of OPERATIONS I LOCATIONS 1 VEIECLES(Attach ACORD 101,Additional Remark.$otrduto.a mon span Is tmgvind) 4,1 For Evidence of Insurance 0_ a MI CERTIFICATE HOLDER CANCELLATION w' ii SHOULD ANY OP THE ABOVE DESCRIBED POUCIBs BE CANCELLED BEFORE THE li EXPIRATION DATE THEREOF. NOTICE See/BE DELIVERED IN ACCORDANCE WttH THE POLICY PROVEION$. ill!Consigli Construction Co., Inc. AUTHORIZEDREPR.ESE NTATWE 72 Sumner Street Milford MA 01757 USA MI IN 01958.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010!05) The ACORD name and logo are registered marks of ACORD • • JA ? IT=AS=TO:ViiQITk3':!G�'�iiPtSA1`I Ot�i:1i;S. z±i '•,a.,._an ' :( 0 Wirlii `c#tcnzod:s ozyi 'the -:y: • ;thcg#rne:Cvittc etor .• 0.a! £of a produCi'.C.-` 'the'L3 1 r.r'?t: :1••••i,4 - •.• • 11"ALl autitili zi4.10.104''o�•'•• :::••••- •.,,tb8:Sul,Contract�11:faiv1na Of. "•t'pmduc:-:::::-:;;;?!..-.:.;,".•-.,t ftie Iiii.Wy! �' ::l;g: or iis-.*If4inzutred . • `• ' �'t :'r'?l_' 120i2<:-1 :1 .:.:. airy d�►.iecb' 't #{eftei ,:....., ,.- . � 1:? teixm�i � ..:. - ,f.. : :L,. ! 't 'l;. ..tJ••",�}i,:-`� - ,Old Republic c Ge a�; _ t°3 a ani i tv#tr ai h sc�"aeaaral ws�`" 1.52, >Subss l �7 O5 0.- p/ j ' i tetts S wtsf0}1 dBridges ot eighwabiyson of Massa 'd •• , . c r tat ' •.•• :...':".":::'''......:':..'•:.•7 7. •.7 '' ' .: . '.. .•". 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Brae a i iizS >ii” cOn> of ices 6t`•,t.e Prime, tht SuOrCdntraci.': r 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,association 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 town 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 burn 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 ( Print Form Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 µ := Boston,MA 02114-2017 'i www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Consigli Construction Co.Inc. Address:72 Sumner Street City/State/Zip:Milford MA 01757 Phone#:508 458 0543 Are you an employer?Check the appropriate box: Type of project(required): 1. 0 I am a employer with 350 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. 0 Remodeling ship and have no employees These sub-contractors have 8. Fl Demolition working for me in any capacity. employees and have workers' g y p 9. 0 Building addition [No workers' comp.insurance comp. insurance.t required.] 5. 0 We are a corporation and its 10.11 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.S Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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. Insurance Company Name:Old Republic General Policy#or Self-ins.Lic.#:A2DW96831203 Expiration Date:12/30/2013 Job Site Address: St Elm Street City/State/Zip:Northampton, MA 01603 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 c i under he p • and penalties of perjury that the information provided above is true and correct. Signature:I L p Date O I Phone#: s-b i C/ 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#: Version].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 Q 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 .. . ..... . .. .. .. ,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 ❑ Name of License Holder; Michael Caputo '4 2. License Number 72 Sumner Street Milford MA 01757 411° 1.2-0 t Address pi4 Sq. Expiration Date (508)458- 3 Signatur Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes Q No O Versionl.7 Commercial Building Permit Mav 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): Mark Walsh-Cooke Mechanical Name Area of Responsibility 955 Massachusetts Avenue, Cambridge MA 02139 49296 Address Registration Number (617) 864-2987 i06/30/2014 Signature Telephone Expiration Date Andrew Woodward Fire Protection Name Area of Responsibility 955 Massachusetts Avenue, Cambridge MA 02139 47842 Address Registration Number `i0 i (617)864-2987 06/30/2014 Signature Telephone Expiration Date 'Julian Astbury Electrical Name Area of Responsibility 955 Massachusetts Avenue,Cambridge MA 02139 45455 Address Registration Number / (617) 864-2987 06/30/2014 Signature i) Telephone Expiration Date Jimmy Su Strutcural Name Area of Responsibility 955 Massachusetts Avenue, Cambridge MA 02139 41770 Address Registration Number (617) 864-2987 06/30/2013 Signature ��'w Telephone Expiration Date -"""" Grp- 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature Telephone Versionl.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: �1hc�ic�t `��4`;T l C ' 'SI'YI.�.� 51\4 Not Applicable 0 Name(Registrant): 30$78 /22S p7 li V Sr Su t t G W M as-o to 02110 Registration Number 08/31/2013 Address 617-406-3420 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 Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Consigli Construction Co. Inc. Not Applicable❑ Company Name: Michael Caputo Responsible In Charge of Construction 72 Sumner Street Milford MA 01757 Addre 0404- � � (508)458 Signature Telephone 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 100650 100650 Frontage 280' +1- 280' +/- Setbacks Front 40 40 Side L: 52 R:96 L: 52 R: 96 Rear 70 70 Building Height 39.5 39.5 Bldg. Square Footage (ctic 2 % Open Space Footage LLr' � - % (Lot area minus bldg&paved 47.1 44.8 parking) #of Parking Spaces 50 51 Fill: 0 (volume&Location) © 0 A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DON'T KNOW Q YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW Q YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW Q 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 0 NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q 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 O NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs 0 Demolition❑ Repairs❑ Additions ❑ Accessory Building 0 Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. P/t.. u2 > J� / ArAP1/17 SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly U A-1 ❑ A-2 p A-3 ❑ 1A I ❑ A-4 0 A-5 0 1 B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I SI F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential 0 R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage 12 S-1 ❑ S-2 U 5B I ❑ U Utility ❑ Specify: M Mixed Use GI Specify: Non-separated CI 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 T 11,003 1st 'iwzma\ty11,003 2nd 19,401 2nd 19,939 3rd 17,274 3rd 17,274 4'h 17,274 4th 17,274 Total Area(sf) 64,952 Total Proposed New Construction(sf) 65,490 Total Height(ft) 40 Total Height ft 40 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public p Private 0 Zone Outside Flood Zone p Municipal 12 On site disposal system❑ phase IB Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability RECEIVED • -mpton, MA 01060 Two Sets of Structural Plans phone • 3- ;7-1240 Fax 413-587-1272 Plot/Site Plans Other Specify PP CATION TO CON n R 'EPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING DEPT.OFB OTHER THAN A ONE OR TWO FAMILY DWELLING '9' HAMPTO - CTIONS SECTION 1 -SITE INFOR MA• 1.1 Property Address: This section to be completed by office 79 Elm Street ablZeA Map 3 ,I-S3 Lot 00 ( Unit Northampton, MA 01063 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Smith College 126 West Street p Name(Print) Current Mailing Address: (413) 585-2424 Signature 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 permit applicant 1. Building $7,616,603.00 (a)Building Permit Fee 2. Electrical $671,112.00 (b)E of Construction stimated Total from Cost(6) 3. Plumbing $346,899.00 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection $1,116,808.00 i Check Number i► / o 6. Total=(1 +2+ 3+4+ 5) I „ 111E.1.- -7.,7:.:.�-.ern � . I This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2013-1253 APPLICANT/CONTACT PERSON CONSIGLI CONSTRUCTION CO INC ADDRESS/PHONE 72 SUMMER ST MILFORD (508)458-0487 PROPERTY LOCATION 79 ELM ST-ZISKIND/CUTTER MAP 31B PARCEL 201 001 ZONE EU(100)/URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out / Fee Paid d a yPp a Old J 6 Typeof Construction: PHASE 1B-INTERIOR RENOVATIONS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 91762 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 6/ /i3 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. 79 ELM ST-ZISKIND/CUTTER BP-2013-1253 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31B-201 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: renovation BUILDING PERMIT Permit# BP-2013-1253 Project# JS-2013-001320 Est. Cost: $11005249.00 Fee: $66019.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CONSIGLI CONSTRUCTION CO INC 91762 Lot Size(sq. ft.): Owner: Smith College Zoning: EU(100)/URC(100)/ Applicant: CONSIGLI CONSTRUCTION CO INC AT: 79 ELM ST- ZISKIND/CUTTER Applicant Address: Phone: Insurance: 72 SUMMER ST (508) 458-0487 WC MILFORDCT01757 ISSUED ON:7/3/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:PHASE 1B - INTERIOR RENOVATIONS 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 7/1/2013 0:00:00 $66019.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck-Building Commissioner