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32C-145 (4) • �ztw+vr (rite of Nort4amptan $ � 6 �TlaesxcE<usrtts �' I' wa Z DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building 'o Northampton,MA 010W SECONDARY CONSTRUCTION CONTROL DOCUMENT (for Professional Engineers/Architects responsible for only portion of a controlled projcct) Millbank Affordable Housing 18 Michelman Avenue 9/26/02 Project Title: Date:u Project l..ocation: 18 Michelman Avplap: Parcel: Zone: Scope of Project: Renovations and improvements to the six existing apartments. In accordance mth the sixth edition Massachusetts State Building Code,780 CMR SECTION 116.0: 1 Robert W. Hall, P.E. Mass.Registration Number 85017 Being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly superviscd the preparation of all design plans,computations and specifications concerning: - [J Fire protection [) Architectural (] Structural (]Mechanical ( ( Electrical ( Other(specify) HVAC 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 Iaws 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,I shall submit a final report as to the satisfactory completion of the above- mentioned portion of the work Signature and Seal of registered professional 1�k OF ®� ROBERT W ` 1 11 HALL v No• v, s E �A l E C� Fax 413-587-1272 -phone 413-587-1240 Z'd diO =ZO Z0 GO IBC �T 11^H PT t11a»iptell _ a � � ,{�iasaxdtusrtts �� K` dam' DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ! Municipal Building ' North,unpton, MA 01060 - SECONDARY CONSTRUCTION CONTROL DOCUh1ENT (for Professional Engineers/Architects responsible for only portion of a controlled project) Millbank Affordable Housing Project'title: 18 Michelman Avenue Date: 9/26/02 18 Mih Project Loeauion: celman Av EMap: Parcel: -Zone: _ Scope of Project: Renovations and improvements to the six existing apartments. In accordance with the sixth edition Massachusetts State Building Code, 780 CMR SECTION 116.0: I, Robert W. Hall, P.E. Mass. Registration Number 34985 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 (] Architectural (] Structural (] Mechanical Pq 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 sen?ices 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, I shall submit a final report as to the satisfactory completion of the above- mentioned portion of the work. Signature nd Seal of registered professional: NN 0 F ROBER W. HALL o NO.34 v L 6, Fax 413-587-1272 -phone 413-587-1240 2 -d d10 =20 20 60 Inc Q St1iU7 PT •\ 0 e Crit of Warthaiiiptan _ A � d j�asaccltics,tfs �� '' Kai ' sue' DEPARTMENT OF BUILDING INSPECTIONS ' INSPECTOR 212 Main Street ! Municipal Duilding ' Nnrth,unpion, MA 0106() SECONDARY CONSTRUCTION CONTROL DOCUMENT (for Professional Engineers/Architects responsible for only portion of a controlled project) Millbank Affordable Housing 18 Michelman Avenue 9/26/02 Project Title: Date:_ Project Location: 18 Michelman Avplap. Parccl: Zone: Scopc of Project: Renovations and improvements to the six existing apartments. In accordance with the sixth edition Massachusetts State Building Code,780 CMR SECTION 116.0: 1, Robert W. Hall, P.E. Mass.Registration Number 19 2 8 3 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: [ J Fire protection [J Architectural [] Structural Mechanical [ J Electrical [J 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,I shall submit a final report as to the satisfactory completion of the above- mentioned portion of the work. Sign C of registered professional: % OF 0 0 0 r -< v cc No.1 ea - t ek Fax 413-587-1272 -phone 413-587-1240 ��`� d10 =Z0 ZD so IBC OQ`SHA1rpTO GritR of 'Narf lamp#an m DEPARTMENT OP BUILDING INSPECTIONS INSPECTOR 212 Main Street t Municipal Building Nord,ampton,MA 01060 CONSTRUCTION CONTROL DOCUMENT (for professional Engineers/Architects responsible for Entire Project) Millbank Affordable Housing Project Title: 18 Miehelman Avenue Date: 9/26/02 Project Location: 18 Miehelman Av16Iap: Parcel: Zone: ScopeofProject: Renovations and improvements to the six existing apartments. In accordance with the sixth edition Massachusetts State Building Code,780 CMR SECTION 116.0: I Kevin Rothschild—Shea Mass. Registration Number 9618 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: N Entire Project 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 and shall be responsible for the following as specified in section 116.2.2: 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction documents as submitted for the building permit,and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent%-6th the construction documents. I shall submit periodically, in a form acceptable to the building official,a progress report together with pertinent comments.Upon completion of the work, I shall submit to the building official a final report as to the satisfactory completion and readiness of the project for occupancy. Signature and Seal of registered professional: t D ARC 1H 0 F� a Ito. 9618 > WILBRAHA yFq��f 411 Fax 413-587-1272 -phone 413-587-1240 T •d d10 =20 20 60 Inr U%_ o uC_ a u: cur r 0.SttMfp�, Crit� of Naz#llanip an 4 8 Al ass achnscfill DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT Desrosiers & Son Inc. / Robert A. Desrosiers (li censer/pezmi tree) with a principal place of business/residence at: 32 Champion Drive, Chicopee., MA 01020 (phone#) 413/593-5451 (Strr_-l/city/Sta2e/2ip) do hereby certify, under the pains and penalties of pegury, that. (X) I am an employer providing the following worker's compensation coverage for my employees working on this job: Travelers Indemnity Co -AMD 886X576902 06/01/03 (ass nce Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors listed below wbo have the following worker's compensation policies_ (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Poficy Number) (Expiration Date) (Marne of Contractor) (Insurance Compahry/Policy Number) (Expiration Date) (affuh additiarnl thee ifneocn ry to:xludc infor=mdon permiai.&to.lt oo=newn) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that wbilo homeowners who employ pasom to do maintinaacS wasuuction or repair work oa a dwelliag of not worn than throe traits is which the bonuxmner resider or on the grounds appurteaaaltbwto act not geoeraJly oomidurd to be employees under the vvorlcu`s matpms4on Act(GLl52,n 1(5)�appliratioa try a homeowner far a bccwc or permit may evidence the 1cg3I rums of an employer under the Wodda Compemdion Ad 1 ttadecsntad that a copy of this ahtemmt may be forwarded to the Departma t of Iadtutriat AoeiderIIs'OhSoe of lmumooe for the coverage vmficxtioo aid that failure to sown:coverage,under section 25A of MOL 152 cau lead to tho impositioa of C it i pcaaldcn 00a listing of a Sae of trp to S 1,500-00 rmdfor of up to are year nod civil pcmttia in the form of a Stop Work order and a fine of S 100.00 a day against M!'_ For dgmtuse3t'1—only d •• L�,'-�i Permit Number Mai Lot# Std of LiatmseeTetmittce ` e — Millbank Affordable Housing 18 Michelman Avenue Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes......❑ No...... SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT - — — Joanne Campbell — -- --- —_,asOwnerofthesubjectproperty Kevin P. Rothschild-Shea hereby authorize__-- --- ----to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of O e ----- - Date I V. ----- - --- K in P. Rothschild-Shea ------- — -------__—__—_, 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. _ Kevin P. Rothschild-Shea Print Name ---- -- ----- -- — -- Signature o Owner/Ag t Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Robert A. Desrosiers Name of License Holder: 018881 Desrosiers & Son Inc. License Number 32 Champion Drive, Chicopee, MA 01020 02/10/2004 Address —(413) 593-5451 Expiration Date ---- ---------- ----- -------- Signature elephone 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....... IN No...... ❑ Millbank Affordable Housing 18. Michelman Avenue 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 GMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Kevin P. Rothschild-Shea Not Applicable ❑ Name(Registrant): 9 618 614 Main St. Wilbraham, MA 01095-1604 Registration Number Address — — 08/31/03 413/786-5556 Expiration Date Signa ure Telephone 9.2 Registered Professional Engineer(s): Robert W. Hall, P.E. Mechanical Name Area of Responsibility Robert W. Hall Consulting Engineers, Inc. 540 Meadow St - F.xt. , Agawam, MA ni nni 19283 Address Registration Number i I 413/789-0960 06/30/03 Signature Telephone Expiration Date Robert W. Hall, P.E. HVAC Name Robert W. Hall Consulting Engineers, Inc. Area of Responsibility _ 540 Meadow St. Ext. , Agawam, MA 01001 _ 85017 Address % Registration Number 413/789-0960 06/30/03 Signature Telephone Expiration Date Robert W. Hall, P.E. Electrical Name Robert W Hall Consulting Engineers, Inc. Area of Responsibility 540 Meadow St. Ext. , Agawam, MA 01001 34985 Address Registration Number - 413/789-0960 06/30/03 Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Desrosiers & Son, Inc. Not Applicable ❑ Company Name: Robert Desrosiers Responsible In Charge of Construction 32 Champion Drive, Chicopee, MA 01020 Address) �� ` ✓� t 413/593-5451 - Signature Telephone Killbank Affordable Housing 18 Michelman Avenue Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON 7.ANING. Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 141 , 143 s . f. No change 171 .4 Michelm n No change Frontage 40 , Kingsley Setbacks Front Side L: 20 R: 233 L: 20 R: 233 Rear 29 ft 21 ft Building Height 321 -61, No change Bldg.Square Footage 6, 328 % 282 s f Open Space Footage % (Lot area minus bldg&paved 74.7 6 2 . 5 parking) #t of Parking Spaces 48 56 Fill: N/A N/A volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO X DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES X IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained X , Date Issued: January 18 , 2001 C. Do any signs exist on the property? YES X NO IF YES, describe size, type and location: Vehicular Parking and Directional D. Are there any proposed changes to or additions of signs intended for the property?YES X No IF YES, describe size, type and location: Vehicular — see plans Millbank Affordable Housing 1,8 Michelman Avenue 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 Existing Wall Signs Existing Ground Signs Additions❑ Roofing ❑ ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] 7 Accessory Building[ ] Repairs [ ] A?'t o /ire, `l'. Irv'V -t, u ffAM b f G r f r,j,A z 7- 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 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential W R-1 ❑ R-2 IN R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ 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: - R-2 ------ Proposed Use Group:-- R-2 — —_—_ Existing Hazard Index 780 CMR 34): 2— -- Proposed Hazard Index 780 CMR 34): 2 SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION (3FFiCE`USE ONLY Floor Area per Floor(so 3 , 16 4 ------ 15�--- —14 2 --- oti 2"d 3, 16 4 2nd----- 142 —————— 3rd 3rd ---- — 4'h 4� --- — — Total Area(sf)` 6, 328 — Total Proposed New Construction(sf) 284 Total Height(ft)— 32 ' -6" - Total Height ft—?5 =8�- 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public KI Private ❑ Zone:—�—_ Outside Flood Zone ❑ Municipal jo On site disposal system ❑ Millbank Affordable Housing Versionl.7 Commercial Building Permit May 15,2000 eat use City 6f Northampton St s o P r . -guifciingeartment ��v� rt 4 212 Maintreet Roor`660 Northampton, MA 01060 Tvu� ets � tt ral�lan � .` �; 1 l phgne..413 5�7=12#0 F�X 413-587-1272 PI 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 This section to be com leted by office 1.1 Property Address: Map Lot /.Y v Unit 18 Michelman Avenue Northampton, Massachusetts Zone __OverlayDistrict _ Elm St-.District- CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: c/o Valley Community Development Co p. Valley Millbank LLC 16 Armory Street, Northampton, MA N e(Print) Current Mailing Address: �r 55 _(413) 586-5855 __ Sig ture Telephone 2.2 Authorized Agent: Joanne Campbell Valley Community Development Corp. Na e(Print) Current Mailing Address: 16 Armory Street, Northa pton 4131 586-5855 -- --- — Sigolure Telephone SE 66N 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building $ 251 ,698 -00 (a)Building Permit Fee 2. Electrical 12, 530 .00 (b)Estimated Total Cost of Construction from 6 3. Plumbing 34,400 . 00 Building Permit Fee 4. Mechanical(HVAC) * 26,445 -00 5. Fire Protection N/A �( 6. Total =(1 +2+3+4+5) 325, 073 . 00 Check Number V 13 V0,5-0 This Section For Official Use Only Building Permit Number:_ Date sued: --- —_ Signature: Building Commissioner/Inspector of Buildings Date: File#BP-2003-0436 APPLICANT/CONTACT PERSON DESROSIERS&SON INC ADDRESS/PHONE 32 CHAMPION DR (413)593-5451 PROPERTY LOCATION 18 MICHELMAN AVE MAP 32C PARCEL 145 005 ZONE URC THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 7VO �a Typeof Construction: INTERIOR RENOVATIONS PORCH REPLACEMENT&ROOF REPLACEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 0188 3 sets of Plans/Plot Plan GO THE FO LOWING 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 Co ssion Z o0 Signature of Building Official Dat 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. BP-2003.0436 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -005 Permit: Building Category. BUILDING PERMIT Permit# BP-2003-0436 Project# JS-2003-0736 Est. Cost: $325073.00 Fee: $1390.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: R3 DESROSI ERS & SON INC 018881 Lot Size(sq. ft.): Owner: VALLEY MILLBANK LTD PARTNERSHI Zoning.URC Applicant: DESROSIERS & SON INC AT. 18 MICHELMAN AVE Applicant Address: Phone: Insurance: 32 CHAMPION DR (413) 593-5451 CHICOPEEMA01020 ISSUED ON:11127102 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RENOVATIONS, PORCH REPLACEMENT & ROOF REPLACEMENT 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 Si nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building //k'7/0 1 1920 $1390.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo