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23A-070 (5) 1 City of Northampton //#< . „.4.,,„ S15 . SfCr v.: Massachusetts 4 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building �kti cb Northampton, MA 01060 Ben Schenkelberg One Monarch Place, Suite 2540 Springfield, MA 01144 Re 70 Main Street Florence 23A-070 August 5, 2013 Dear Mr. Schenkelberg, I have reviewed the building permit application and plans submitted for the addition to Valley Medical at 70 Main Street in Florence. I have approved the foundation plans. I will need more information before I can finish my plan review and issue the full permit. • Your code review for this project does not specify the compliance method you've chosen as a basis for this project (Chapter 34, section 101.5). • The existing and proposed occupancy loads are not listed. • There is no information about energy code requirements. Northampton has adopted the Stretch Energy Code (Appendix 115AA). That section requires an addition that exceeds 30% of the existing conditioned floor area of the existing building meet the requirements for new construction. This includes the requirements for the thermal envelope, and compliance with sections 502-505. • The plans and specifications for the fire alarm system do not provide enough detail to determine whether the system will meet code requirements. It would seem that the alarm system specifications do not include enough pull stations (7 pull stations, 8 exterior doors) or visual alarm notification devices (24 devices, more than 40 exam rooms, 907.5.2.3.1). • The plans and specifications for the sprinkler system also do not provide enough detail to determine whether the system will meet code requirements. I will consider approving the next phase of the project pending full plan approval. Feel free to contact me if you have any questions. Respectfully, Louis Hasbrouck Building Commissioner City of Northampton (413) 587-1240 Iasbrouck(a�citv.northampton.ma.us cc Northampton Fire Department Crocker Builders City of Northampton 04�w2M• a Massachusetts A' (11 44%'Aftil * c DEPARTMENT OF BUILDING INSPECTIONS , 2F svt, - b / 212 Main Street • Municipal Building �r Northampton, MA 01060 ssy . �h`� � Crocker Building Co, Inc. 186 Stafford Street Springfield, MA 01104 Re 70 Main Street Florence Map/Lot 23A-070 October 15, 2013 Dear Mr. Crocker, I have reviewed the building permit application submitted for the addition and renovations to the Northampton Health Center at 70 Main Street in Florence. I have approved the application and issued the full permit. The project must be done under the prescriptive requirements of the 8th edition of the Massachusetts State Building Code, IEBC Chapter 3 with Massachusetts Amendments, Prescriptive Compliance method. As required by GL 148, § 26G, The building must have a sprinkler system installed in accordance with NFPA 13. Feel free to contact me if you have any questions. Respectfully, Louis Hasbrouck Building Commissioner City of Northampton (413) 587-1240 Hasbrouck(a�city.northampton.ma.us Planning - Decision City of Northampton Hearing No.: PLN-2013-0054 Date: May 28, 2013 Stephen Gilson votes to Grant Jennifer Dieringer votes to Grant Mark Sullivan votes to Grant Francis Johnson votes to Grant MOTION MADE BY: SECONDED BY: VOTE COUNT: DECISION: Stephen Gilson Jennifer Dieringer _ 8 Approved with Conditions MINUTES OF MEETING: Available in the Office of Planning&Development. I,Carolyn Misch,as agent to the Planning Board,certify that this is a true and accurate decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. I certify that a copy of this de. ion has been mailed to the Owner and Applicant. / , . .Iii Notice of Appeal An appeal from the decision of the Planning Board maybe made by any person aggrieved pursuant to MGL Chapt.40A,Section 17 as amended within twenty(20)days after the date of the filing of the notice of the decision with the City Clerk. The date is listed above. Such appeal may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. June 19, 2013 I, Wendy Mazza, City Clerk of the City of Northampton, hereby certify that the above Decision of the Northampton Planning Board was filed in the Office of the City Clerk on May 28, 2013, that twenty days have elapsed since such filing and that no appeal has been filed in this matter. Attest: l gbi Aizr City Cl City of Northampton GeoTMS®2013 Des Lauriers Municipal Solutions,Inc. ST: HAMPSHIRE, , REGISTER MARY IaLBERDI Planning -Decision City of Northampton Hearing No.: PLN-2013-0054 Date: May 28, 2013 APPLICATION TYPE: SUBMISSION DATE: IIIIIII PB Major Site Plan 5/1/2013 IIIIIIIIIII IIIIIIIIIII IIIIIillll III IIIIII 1438 . \\\\\\\\\\ \\\\\\\\\ \ \\\000 Applicant's Name: Owner's Name: 2013 e: f 2 AM NAME: NAME: B K: 11354P9:70 Pa9 MIDDLE HAMPSHIRE DEV GROUP MIDDLE HAMPSHIRE DEV GROUP LLC Recorded: 06/191201111o:03 ADDRESS: ADDRESS: 270 EXCHANGE ST 270 EXCHANGE ST RECEIVED TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: CHICOPEE MA 01013 CHICOPEE MA PHONE NO.: FAX NO.: PHONE NO.: FAX NO.: 2 4 2013 (413)537-9109 0 (413)537-9109 0 EMAIL ADDRESS: EMAIL ADDRESS: DEFT OF BUILDING INSPECTf NORTHAMPTON MA 01060°1\18 Site Information: Surveyor's Name: STREET NO.: SITE ZONING: COMPANY NAME: 70 MAIN ST GB(97)/URB(3)/ TOWN: ACTION TAKEN: ADDRESS: NORTHAMPTON MA 01060 Approved With Conditions MAP: BLOCK LOT: MAP DATE: SECTION OF BYLAW: 23A 070 001 Chpt 350-11:Site Plan Approval TOWN: STATE: ZIP CODE: Book: Page: 2245 065 PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK 4800 SQ FT ADDITION HARDSHIP: CONDITION OF APPROVAL: 1) Four additional street shade trees in accordance with required standards in 6.8 shall be planted along the frontage. 2).Exterior lights shall be put on timers to be turned off no later than 9 PM. FINDINGS: The Planning Board voted to approve the site plan for construction of a 4,800+-sf addition to the rear of the building based upon the plans submitted as follows: 1). Expansion and Improvments Northampton Health Center, 70 Main St,Florence,Pg A-1,A-2,A-4. 2). Site Plan Middle Hampshire Development Group,Feb 19,2003. 3).Reflex Lighting Plan Middle Hampshire Development Group,(revision date 5/23/2013) The Board approved the plans upon finding that the criteria in 11.6 had been met.No parking at the site would be changing from existing conditions and revised lighting plan meets the standards. COULD NOT DEROGATE BECAUSE: FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY: APPEAL DATE: 5/2/2013 5/16/2013 6/6/2013 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY: APPEAL DEADLINE: 5/9/2013 7/5/2013 5/23/2013 6/6/2013 6/17/2013 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 5/9/2013 5/23/2013 _ 5/23/2013 5/28/2013 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: 'DECISION DEADLINE: 5/16/2013 7:45 PM 8/21/2013 8/21/2013 MEMBERS PRESENT: VOTE: John Lutz votes to Grant Karla Youngblood votes to Grant Debin Bruce votes to Grant Ann DeWitt Brooks votes to Grant GeoTMS®2013 Des Lauriers Municipal Solutions,Inc. File#MP-2013-0083 APPLICANT/CONTACT PERSON MIDDLE HAMPSHIRE DEV GROUP LLC ADDRESS/PHONE 270 EXCHANGE ST (413)537-9109 0 PROPERTY LOCATION 70 MAIN ST MAP 23A PARCEL 070 001 ZONE GB(97)/URB(3)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT /// V� 0/j' Fee Paid / Building Permit Filled out Fee Paid Typeof Construction: ZPA-4800 SQ FT ADDITION:DENY PB SPR MAJOR PROJECT 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 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 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 the Office of Planning&Development for more information. Industrial Residential Security, LLC 73 Gunn Road Southampton, MA 01073 413-527-3353 Fire Alarm Narrative: 6-17-2013 Location: Valley Medical 70 Main Street Florence MA 01062 Building: Usage Group: B commercial Installing Company: Industrial Residential Security, LLC 73 Gunn Road Southampton,MA 01073 Fire Alarm System: The Fire Alarm System is a Silent Knight addressable control. The SLC Loop is class A. The Notification Loop is a SLC class A or class B. (Key in Knox box to enable-operation). The procedure to reset and or silence the alarm, is to push the silence and or reset button then push in the code (1111). Fire Alarm Monitoring: The Fire Alarm System will be monitored at C.O.P.S. Monitoring in NJ. Irsco shall program all alarms, troubles and supervisory. It shall dial thru the built in digital dialer to the central station. Proper notifications to the Fire Dept. and responsible parties shall be made upon receiving the signals. Fire System: 1 Silent Knight 5808 addressable control with transformer, batteries 1 SK 5860 LCD annuciator 1 Outdoor red Beacon 11 Outdoor Knox Box 1 SK 500AIM module sprinkler water flow 3 SK 500 AIM modules sprinkler tampers 3 SK SD 505 DCTR duct smokes with remotes plates 7 SK SD 500 PSDA dual pull stations 1 SK SD 505 APS photo smoke above control 8 SK SD 505 APS photo smokes 10 System Sensor Strobes SR in bathrooms and Xray room 14 System Sensor P2r Horn strobes through out 4. Conduct system operational and alarm test on the system from the inspector's test connection in accordance with NFPA 13 5. Central station must receive the alarm and trouble signals Warehouse Mechanical is in charge of setting up and conducting the testing. Warehouse Mechanical will provide test certificates Section 2- Equipment and Tools a. Manufacturer's instructions b. Approved narrative report, sequence of operations section c. Flow measuring devices- pitot tube for backflow preventer full forward flow test d. Gauges- main riser for 2" drain and hydrostatic testing e. Fire hose is required to direct backflow flushing Section 3-Approval Requirements a. Certification from Warehouse Mechanical Contractors, Inc. stating that the fire protection sprinkler system has been installed in accordance with the approved fire protection construction documents and that he has reviewed the as-built drawings for conformance to 780 CMR 901.7.4 and has identified deviations if any, from the approved fire protection construction documents. b. Confirmation by the building owner/developer or authorized representative that they have received the as-built sprinkler system shop drawings from the installing contractor c. Material Test, Performance and Completion Certificates,properly executed by the installing contractor in accordance with the applicable NFPA Standards. d. Satisfactory functional test of all fire protection systems witnessed by the Building official and the head of the fire department or their designees. Section 4—Fire Protection Systems to be installed a. Water supply will be taken from the existing 4" water service that is connected to the city main in South Street b. Sprinkler systems and components c. Fire alarm systems and components- audio and visual appliances installed throughout in accordance with NFPA 72. d. Manual suppression systems are not required e. Seismic provided in accordance with NFPA 13 f. Stortz fire department connection provided in accordance with the Northampton Fire Department All of the above items are required by regulations (780 CMR) all systems are new 901.2.1(1.a.ii) Sequence of Operation Section 1 Wet sprinkler system: System operates automatically upon the fusing of a single fire sprinkler. Operational Sequence: a. Wet system operates automatically on water flow from a single sprinkler. Closed contacts on the flow switch will provide alarm contact for the fire control panel and activate the local audible visual panels. 901.2.1(1.a.iii)Testing Criteria Section 1-Testing Criteria in accordance with NFPA 13 System piping: 1. Hydrostatically test wet system piping at a pressure of 200 psi for two hours without a loss of pressure 2. Conduct a full forward flow test of the backflow preventer at a rate of 121 GPM thru the 2" main drain 3. A 2" main drain test shall be conducted. Record static and residual pressures on the test certificates FIRE PROTECTION SYSTEMS NARATIVE REPORT BASIS (METHODOLOGY) OF DESIGN Section 1 —Building Description a. Building "Use Group: The Building use is Business (B) b. Type(s) of occupancies (hazards within the building): Medical Offices c. One story above grade high point of building roof is 14'-0" +/- d. Zero stories below grade e. The existing building is 13,540 SF, the new addition is 4,780 SF for a total of 18,320 sf f. Storage: In accordance with NFPA-13 for miscellaneous storage under 12'-0" in height The highest sprinkler flow requirement is .10 GPM over the most remote 900 square feet which will require approximately 121 GPM @ 41.9 PSI at the base of the riser and 221 GPM @43 PSI at the connection to the city main Water flow test is 66 PSI Static, 57 PSI Residual with 520 GPM flowing Section 2—Applicable Laws, Regulations and Standards a. 780 CMR code sections "Fire Protection System Requirements" 903.2.0 Fire Suppression Systems 903.4.2 Requires audio visual alarm devices 903.4.1 Monitoring b. NFPA Standards and Editions used for the design of each specific fire protection system, NFPA 13, 2007; NFPA 72, 2007; NFPA 24, 2007 Section 3 —Design Responsibility for the Fire Protection Systems Warehouse Mechanical Contractors, Inc. develops a full system layout, design criteria and calculations and certifies the system installation for code compliance at completion. WAREHOUSE MECHANICAL CONTRACTORS, INC. A certified Service Disabled Veteran Owned Small Business Sprinkler Contractors and Designers Established 1980 Fire Sprinkler portion of Narrative Report Northampton Health Center 70 Main Street Florence,MA. By Installing Contractor Warehouse Mechanical Contractors, Inc. MA. Sprinkler Contractors License SC 2254 Expires 11/23/2013 413-536-9222 Phone 413-535-2486 Fax June 12, 2013 342 Britton Street - Chicopee, MA. 01020 Tel. (413) 536-9222 FAX(413) 535-2486 MA. Lic. 2254 & RI. 329 i \!! Massachusetts -Department of Public Safety I �/ Board of Building Regulations and Standards Construction Supervisor License: CS-067805 ■ I WILLIAM D CROt'\4 ti-y° '; ,� 36 SPRINGFIELI7�STS r* 3 WILBRAHAM NFA OI `-2..,. JJ f.. '"" Expiration Commissioner 04/19/2014 BERNARD M. SCHENKELBERG A R C H I T E C T ❑ SUITE 2540, ONE MONARCH PLACE 3309 SPUR LANE ❑ SPRINGFIELD, MASSACHUSETTS 01144 GREEN BAY,WI 54313 OFFICE: 1-413-739-0162 OFFICE: 1-920-434-3277 FAX: 1-413-739-0163 FAX: 1-920-434-3301 CONSTRUCTION CONTROL CERTIFICATION PROJECT NUMBER: DATE: 1.11'I?i PROJECT TITLE: )40pr AMJA 4.04 1/4414 G4lt PROJECT LOCATION: 10 444101 9T' NAME OF BUILDING: SCOPE OF PROJECT: CilpDlJ j141r 121012 Pe4oVAllMI5 In accordance with the Massachusetts state building code,780 CMR,Chapter 1,Section 116, I Mass.Reg.No. ;being a registered professional Architect/Engineer Hereby certify tfiat I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Entire Project Structural Fire Protection Electrical Mechanical Other(Specify) For the above named project and to the best of my knowledge such plans,computations and specifications meet the applicable provisions of Massachusetts State Building Code,IEBC 2009 and Massachusetts Amendments 8th Edition,CMR 780 and meet or accede all applicable codes by the architectural access board 521 CMR,all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular basis to determine that the work is proceeding in accordance with the document approved for the building permit and shall be responsible for the following. 1. Review of the shop drawings,samples and other submittals of the contactor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required controlled materials. 3. Special architectural or engineering professional inspections of critical construction components requiring controlled materials or construction specified in the accepted engineering practices standards listed in appendix b. I shall submit periodically,a progress report together with pertinent comments to the building inspector. Upon completion of the work,I shall submit a final report and a certificate of completion as t vatisfactory completion and readiness of the project for occupancy. �i�"— c Subscribed and sworn to before me 1dQ.6642 r • _� Azi,„„,,,,, z SI'rR1NC: iELD m _ ��� xo a eP MASS � h Signature 1. ! A,_ q s �5� My minission expires,an ,s-ITS Berna d M. Sc -nkelberg A.I.A. -1. irai„ommission 4i ),. 2013 ,4- , Ag -u- _ ui © L _I 1:0 ...fpl COMMERCIAL+INDUSTRIAL+HEALTHCARE+ MUNICIPAL AND EDUCATIONAL FACILITIES WISCONSIN+MASSACHUSETTS• MINNESOTA+CONNECTICUT+ DEC-26-2008 08:44 FROM: TO:14137376861 P.1 BEN SCHENKELBERG A R C H I T E C T U Suite 2540.One Monarch Place 0 3309 Spur Lane Springfield,MA 01144 Green Bay.WI 54313 413.739.01 02 920.434.3277 413.739 0153 FAX bmsarchitectl aaoI.com 920,434.3301 FAX 11 JUNE 2012 - RE; NORTHAMPTON HEALTH CENTER ADDITION 70 MAIN STREET FLORENCE,MA BUILDING CODE REVIEW, MASSACHUSETTS BUILDING CODE, CMR 780 AND TEE IBC CODE DATED 2012 EDITION WORK INCLUDES INTERIOR RENOVATIONS, BUILDING ADDITION AND SITE WORK. THE BUILDING IS A SINGLE STORY STRUCTURE ALONG WITH THE PLANNED NEW ADDITION. THE NEW ARCHITECTURE WILL CONFORM TO THE EXISTING DESIGN_ THE BUILDING WILL BE OCCUPIED DURING CONSTRUCTION AND ALL SAFETY REGULATIONS WILL BE IN PLACE_ BUILDING TYPE: 2B BUILDING USE: B BUSINESS, SINGLE TENANT PARKING: CONFORMS SITE LIGHTING: CONFORMS LANDSCAPING: CONFORMS ALL PHASES OP THE SITE AND BUILDING WILL BE ACCESSIBLE AND CONFORM TO 521 CMR HVAC,ELECTRICAL AND PLUMBING ARE BEING UPGRADED AND CONFORM TO REQUIRED CODES FOR EACH TRADE THE ENTIRE BUILDING IS BEING PROTECTED WITH A NEW SPRINKLER AND FIRE CONTROL SYSTEM EXITS CONFORM AND THERE ARE NO DEADEND CORRIDORS EXISTING WINDOWS... ARE BEING..REPLACED THE EXISTING BUILDING IS; 13,540 SF THE NEW ADDITION IS: 4,780 SF SC T CI' y 5 t, FOR THE ARCHITECTURAL P SE OF THE PROJECT ' LI ^a J ,4 l z \RC8IJT)ECTUflJE COMMERCIAL• HEALTHCARE• INDUSTRIAL• MUNICIPAL& EDUCATIONAL FACILITIES CONNECTICUT• MASSACHUSETTS•WISCONSIN 70 MAIN ST BP-2013-1236 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A-070 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: ADDITION BUILDING PERMIT Permit# BP-2013-1236 Project# JS-2013-001342 Est. Cost: $1475000.00 Fee: $7820.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CROCKER BUILDING CO INC 067805 Lot Size(sq. ft.): 72135.36 Owner: MIDDLE HAMPSHIRE DEV GROUP LLC Zoning: GB(97)/URB(3)/ Applicant: CROCKER BUILDING CO INC AT: 70 MAIN ST Applicant Address: Phone: Insurance: 186 STAFFORD ST (413)737-7803 Workers Compensation SPRINGFIELDMA01104 ISSUED ON:8/5/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 4800 SQ FT ADDITION & RENOVATIONS: FOUNDATION, STEEL 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 7/22/2013 0:00:00 $7820.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck-Building Commissioner City of Northampton Massachusetts A$ e. AT DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building iw CF Northampton, MA 01060 ssE i1` Ben Schenkelberg One Monarch Place, Suite 2540 Springfield, MA 01144 Re 70 Main Street Florence 23A-070 August 5, 2013 Dear Mr. Schenkelberg, I have reviewed the building permit application and plans submitted for the addition to Valley Medical at 70 Main Street in Florence. I have approved the foundation plans. I will need more information before I can finish my plan review and issue the full permit. • Your code review for this project does not specify the compliance method you've chosen as a basis for this project (Chapter 34, section 101.5). • The existing and proposed occupancy loads are not listed. • There is no information about energy code requirements. Northampton has adopted the Stretch Energy Code (Appendix 115AA). That section requires an addition that exceeds 30% of the existing conditioned floor area of the existing building meet the requirements for new construction. This includes the requirements for the thermal envelope, and compliance with sections 502-505. • The plans and specifications for the fire alarm system do not provide enough detail to determine whether the system will meet code requirements. It would seem that the alarm system specifications do not include enough pull stations (7 pull stations, 8 exterior doors) or visual alarm notification devices (24 devices, more than 40 exam rooms, 907.5.2.3.1). • The plans and specifications for the sprinkler system also do not provide enough detail to determine whether the system will meet code requirements. I will consider approving the next phase of the project pending full plan approval. Feel free to contact me if you have any questions. Respectfully, Louis Hasbrouck Building Commissioner City of Northampton (413) 587-1240 Hasbrouck(c�citv.northampton.ma.us The Commonwealth of Massachusetts 'tPipt Form Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 "° ' Boston, MA 02114-2017 , , www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Crocker Building Company.Inc. Address:186 Stafford St. City/State/Zip:Springfield, MA 01104 Phone #:(413)737-7803 Are you an employer? Check the appropriate box: Type of project(required): 1. 4 I am a employer with 15 4. ❑ 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. Is Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' g Y P Y 9. Is Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.n Electrical repairs or additions 3.❑ I 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 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ 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. 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:AIM Mutual Insurance Policy#or Self-ins. Lic.#: C c- 6 0( - yoGO s-io - zoo A- Expiration Date:3/31/14 Job Site Address:70 Main St. City/State/Zip:Florence, MA 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 of perjury that the information provided above is true and correct. Signature:I _._ I= -1.1- .�_ Date:6/18/13 Phone#: 413) 737-7803 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#: 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 Matt McDonough as Owner of the subject property hereby authorize Seth Crocker to act on my behalf, in all matters relative work authorized by this building permit application. 06/18/2013 Signature of Owner Date ,Seth Crocker , 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. Seth Crocker Print Name _44 4,A 06/18/2013 Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:aWilliam Crocker CS-067805 License Number 186 Stafford St., Spnngfield,MA 01104 .._ _.. m. ._. 04/19/2014 Address Expiration Date ,(413)737-7803 Sign re 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 0 No 0 JAN-3-2009 10:49 FROM: TO:14137376861 P.1 20 Jun 2013 8: 17PM CRPCNER BUILDING Co 14137376861 p'2 ` VwrSiom1.7 Commercial Building Pennh May 15,2U00 }^ .` ' ` � ., �*• , ,�A8�a � �� ~ •�� �� �� .� _ ' mI0egtataredArchitect Nana � �ei�0: ___.�~_- �)~ �Ko�uz�� 4�' � MA01144 I _---- --- ��— --� �- _--/ -- --- -----� �- -_ ,_-_�- ',A6 Expiration Date re Telephone , , R.2 Regimoenuf Professional ErtgimSvrl�� ' -----'----------------' ' / [---------'- - ^----.1 Rama Area ����. �u-�. 1 ___ _-_ ` ----______ '-------_____--__-__'___-__-^' Armrests Reolstrssion Number ---'—1 �------'--'---'- ) �___--_-_-___] L-__ -__-_----_._____] Moneta! ___ _____ -_ �-----_~__-�--------------~..~~�-___----_---Telephone--_.-- Expiration Dale -_ ■,. ___1 ( __3 Paine _______ __-� --- 1 r-'----------------- ' '---� �-___--_-__-. ___'-_-_-_�__�~~_^ _�__ _ �--� �----_----___---_-__'_--_-'_- � Address F-- '--�-1 --- �____- � �--___'___------''____--_-� 1 Wears `*ienwn"e Expiration Date Name---'--- --'----- —'---- Ares of Resp.onsibility 1 __------ — ------- - -- -------- — 1 � '—.- Adis Numb-1r � -----1 �-'----------�----'----------� L__. wIgnalum� Tnleph*"e Expiration Ma / __'_-_-_7 Nemo Arse of Rasponstillity ,_--_�___--. --' __ ----___'_____-__- ' _„- . -_- -__-~ Address _____ Signature Tat. ��"m ~ ~ 9.3 Gisnerst mwntnmcwmr ____-__-. ____-_-__-____-____-____'-__--__- '--_, 10n.),~er Building Company,Inc._____ 1 m«naPOlietabieCJ Company Name:__---____-_' - 1/cth LCroc.cer _---___ _ ] F.t...pscubis In Charge oirCensouction [186 Stafford St, Springfield,MA 01104 1 ..._..4gee_emr4______[tt 13)737-78031 al. - tampons ` Version1.7 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 92755 same Frontage 257 same Setbacks Front 35 35 Side L: 110.. R:'7 L:.110 : R:7 Rear 132 82 Building Height 22 14 Bldg. Square Footage 135$ 14.6 % ;,.183it 20 Open Space Footage (Lot area minus bldg&paved 2946 3.1.7 294© 31.7_�[ parking) ................... #of Parking Spaces '103 Fill. +1- 300 c. under (volume 84 Location) �- _ Y_• © A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES t IF YES: enter Book 1/ 3,S L Page 70 and/or Document# q 3r7 B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: Pylon sign near driveway 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 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. . J 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 GI Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions El Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description ;;4780 s.f. addition plus renovation of the existing building Of Proposed Work: SECTION 5 USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly El A-1 El A-2 ❑ A-3 El 1A El A-4 ❑ A-5 ❑ 1B El B Business GI 2A ❑ E Educational ❑ 2B I GI F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional El 1-1 ❑ 1-2 El 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 El R-3 ❑ 5A El S Storage ❑ S-1 El S-2 ❑ 5B El 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: 'Business Proposed Use Group: Business Existing Hazard Index 780 CMR 34):,1.� ._ Proposed Hazard Index 780 CMR 34): .1 SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1 s� 13,540 1st 4,780 2nd .,.. 2nd 3rd �.. 3rd 4th Total Area(sf) 13,5401 Total Proposed New Construction(sf) 4,780 Total Height(ft) ! 22 Total Height ft 14, 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public p Private ID Zone Outside Flood Zone p Municipal is On site disposal system I=1 . . , ____j` Versionl.7 Commercial Building Permit M 15,2000 Department uo a�� / °, City of Northampton Statusn sf Permit �p v a `m uilding Department Cam' t/DrivewayPer it 9 =„,� 1- z� 212 Main Street Se +er/Sepfic'A vailaby �> ,b g . o a� �� Room 100 V�Vater/ lee Avrailabilrty "'0qr p„� orthampton, MA 01060 Tt o Sets of",Structural�Plans :� ,1 l;'r” rO� spkcro ne , 1 3-587-1240 Fax 413-587-1272 Plot/Site Plans �` ; P' i, : r-', o�oso s ,"' ii Ottiei Specfy' a ? t 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 70 Main St. Map' Lot Unit Florence,MA Zone Overlay District E1m St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ;Middle Hampshire Development Group, LLC 270 Exchange St., Chicopee,MA 01013 Name(Print) iii .�., CDU y� Current Mailing Address: �� / '(413) 746-5500 Signature A1! Ad Telephone 2.2 Authorized Agent; ;Seth Crocker 186 Stafford St., Springfield,MA 01104 Name(Print) Current Mailing Address: (413) 737-7803 Signature el P 6 Telephone �. SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Doll !Trot- Official Use Only cQrgfllgigd)by permit applicant ��pp[roott, , 1. Building $640,000.00; (a) Building Permit Fee 4/O,PPP 2. Electrical II" Ooo $100 000.00 (b)Estimated Total Cost of Construction from(6) . _ _. . 3Sr000 $50,000.00, 3. Plumbing = Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection .1 7,froop $115,000.00 1 6. Total=(1 +2+3+4+5) $ I70 Idd t ?O(,ody Check Number 5 0310 $ Z96-0 A•413 m. + fift ''Slefloi, For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date ofcic.k- civ, p (Iv Olds or File#BP-2013-1236 P6k1 a ri ec) APPLICANT/CONTACT PERSON CROCKER BUILDING CO INC ADDRESS/PHONE 186 STAFFORD ST SPRINGFIELD (413)737-7803 ._ PROPERTY LOCATION 70 MAIN ST rilti i �(�,l C) MAP 23A PARCEL 070 001 ZONE GB(97)/URB(3)/ c THIS SECTION FOR OFFICIAL USE ONLY: (-cop PA''' I 4V PERMIT APPLICATION CHECKLIST t-A ENCLOSED REQUIRED DATE (' - ZONING FORM FILLED OUT L f„ ()C--°\1 9 q c) Fee Paid s e� �{r r , Building Permit Filled out f �f t' l P Fee Paid l� 08 Y `✓ra 5N ��\5� Typeof Construction: CONSTRUCT 4800 SO FT ADDITION&RENOVATIONS i.A.d New Construction b E P��\� .) Non Structural interior renovations Xr Addition to Existing - i S I �J (3 Accessory Structure Building Plans Included: ( � Owner/Statement or License 067805 (� I� ( \ 3 sets of Plans/Plot Plan 11 THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON ttOLD -- (N FO INF RMATION PRESENTED: Approved Additional permits required(see below) U is-t i j PLANNING BOARD PERMIT REQUIRED UNDER:§ t> Intermediate Project: Site Plan AND/OR Special Permit With Site Plan _ Major Project: Site Plan AND/OR Special Permit With Site Plan ( E E CI' ) ZONING BOARD PERMIT REQUIRED UNDER: § �P ILMt (N PAR-4, Finding Special Permit Variance* �3��L�`1/4' old/ i Received&Recorded at Registry of Deeds Proof Enclosed ' \c 0 Other Permits Required: \0� 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-ea4 ALA- (A-fIA- -a- /0/01113 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. 70 MAIN ST-Valley Medical-Florence BP-2013-1236 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A-070 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2013-1236 Project# JS-2013-001342 Est. Cost: $1475000.00 Fee: $7820.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CROCKER BUILDING CO INC 067805 Lot Size(sq. ft.): 72135.36 Owner: MIDDLE HAMPSHIRE DEV GROUP LLC Zoning: GB(97)/URB(3)/ Applicant: CROCKER BUILDING CO INC AT: 70 MAIN ST - Valley Medical - Florence Applicant Address: Phone: Insurance: 186 STAFFORD ST (413) 737-7803 Workers Compensation SPRINGFIELDMA01104 ISSUED ON:1 0/1 7/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 4800 SQ FT ADDITION & 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 10/17/2013 0:00:00 $7820.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner •