23B-046 (34) General Narrative on scope of Construction Project
Third Floor West Wing
Cooley Dickinson Hospital
In general the scope of the project creates a Medical Day stay unit
from three existing rooms, changes any three bed rooms to two bed rooms
and installs new case work the nurses station.
Each of the existing patient rooms will receive new flooring and paint
to match the North building. Because telemetry will now be located on
this floor a monitor station has been created opposite the nurse
station.
Electrically communications wiring and auditable/ visual fire
indicators will be installed in each patient room. The 2x2 lights in
their existing hall locations will be changed for new style fixtures
that match the north building. There will be some demo and installation
work as we remove the old and install the new.
Structurally and HVAC there are no changes to this space.
Plumbing a tub room that is no longer required because of the patient
load will be removed and turned into a storage area. We will be
relocating five existing fixture and cutting and capping four.
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Ti0t1 10 STRUCTURAL PEER REVIEVr. (72,13 CNIR 110 11)
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c �aent Strccturai E^gir r
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` FCTION 11 O'iNNER AUTHORIZATION - TO BE COMPLETED V�H. N
OIYNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT-,
a i=
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cam__
herebyauthorize Q
p �f l�ov�e C oZs
m�� beh in all matters rel ork authorized by this building permit application:
Signature of Owner Date
—mil�a /J'IDhe1 r/DU�` COhS T�'UGT/O_f� i7C . - -- _-, as Ovrne ho ,eed AUCn
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.
-7-_�t2O_.f�h ---------------------
Print Name
Signature of Ow en __ Date _ __
SECTION 32 - CON S Tf2UC:fIOTlS'El_S
10.1 Licensed Construction Supervisor: vot A I PP Ilcable O
Name of License Holder :__ S, Q /e tiei--- 066227
_icense Number
D 7-o 7- U_
Address � Expiration Date
_Q yr - �y 2
c,;gn?,ure Telephone
SECTION 13 WORKERS' COMPENSATION INSURANCEAFFIDAVIT (M.G.L. c. 152,;§ 25C(5))
Compensation Insurance affidavit must be completed and submitted wit!-: Ynis app i�atic��:_ � lure rc: r
esult in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes.... No.._.. ❑ __----__ _
CTI�hd a- PRO, ESSICP�Ai DES!Gh A CCNSTPCCTICII tiE6T1 L_� � �t BI_Ill�l dG�.��iD- 1 FUC-1 ES n�4 �EC7 10
rr! 1�,
_-�TF;UC1-IJN C,ONTi,DL F��r,�UA?�T T07�0 Gl��rr, lc.��.(J 1, II- I(: i i RE i!lr, 5,000 C � . CFENCLOS t, �r-ACt1
---- --------------
E,= rn-iu❑ 1� e
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i
Stu
I c le p hone
.2 Registered Professional Engineer(s):
Jayne Area cf Responsi)Ihty
i
--- -- --- ----- ---------- ------ -- ------ — -
ddress Registration Number
i
ignature e phon Expiration Date
!ame Area of Responsbility
I
ddress Registration Number
ignature i elephone Expiration Date
amp Area of ReSoonsibility
ddress Registration Number
Telephor-,e— Expiration Date ---_--_—,
arr�e Area of responsibility
I
i
Jdress Registraucn Number
Tel cr re r� `ria �a�s
3 General Cone actor
Co 2002 o
,mpary Name:
onsir le In c or C,onstr� ,ion
l
/ ��� J
Vcrsion1 "i Comn:crc al Blnlding Permit 1%Iay IS, 2000
>:_ipply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal Syste
�ifli __-_—_-P ,�te ❑ -- Loner__--- Outs'de Flood Zone Muni i0r' � On site dlShoS,3 r F;
NORTFL�AITTONZ0NgNG '-
Ezisi-ing Proposed �r t,c.q,�._7 C
� his coh:,:rn; ;, be Ellice ire'c}'
— -- BUildinglJC� Lincnt
Lot Size 9G 9, 5 7 S 96 9, X12 7,S
i
montage ----
Setbacks Front 102 / p2 '
Side L: 88 R: 5Z` L: 88 R y2
Building Height y 5 y 5
Bldg. Square Footage %
yoz S 6 i. yoZ s l_ ---- --�
Open Space Footage %
(Lot area minus bldg&paved
arcing)
#of Parhng Spaces 76 _ 761
Fill: N/A N/�}
(vo)ume k Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES X
IF YES, date issued: De-(-- /3, 200/
IF YES: Was the permit reco,,-ded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book 6 SOy Page 2 3 9 and/or Document
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
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 l� NO
TF YES, describe size, type and location:__—VGa --
D, Are there any proposed changes to cr additions of signs intended for the property ?YES
No 1 f
?F YES, describe size, type and location,_______----- —_ �------__� —-_------._-_--_
Versionl J Commercial Building Permit May 1S, 2000
SECTION 4.CO NS TRIiCTiONSERVI CES'FOR�RO]ECTS:LESSTHAN35,000
CUBIC FEETOF ENCLOSED SPACE
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
❑ ❑ L� — --
Exterior Alterations Demolition[] New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building [ ] Repairs [ ]
r � - XiSTi� Sc�C� 'jv Cl°e rTy 7`��'
BRIEF DESCRIPTION: �G `� d j , f
rctY4,1T �t6lj '[ 6"�" el�in 'caHtS V
SECTION.5 USE GROUPAND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly I ❑ A-1 ❑ A-2 ❑ A-3 ❑ lA
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ ZA ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ I-1 ❑ I-2 I-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1. ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixec Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS�ECTZON IFE)QSiNGBUILDING UNDERGOINGaENOUA330NS,{DDITIONS'ANDOR CHANGE IN USE
Existing Use Group: I-� Proposed Use Group: Z '2
Existing Hazard Index 780 CMR 34): y Proposed Hazard Index 780 CMR 34): y
SECTION 6'.BUILDING HEIGHTATIDAREA
BUILDING AREA EXISTING
PROPOSED NEW CONSTRUCTION
/ d E r
Floor Area per Floor (sf)
1 �
2nd
-
t
2nd 3rd .
3�' – �x
4m L -
4 -
r t?
F .l -
- , ( Total Proposed New Construction (st)
i o�taci Area s� _ i
Total Height(ft)
Total Height n s
Ve-rsionl.7 Commercial Building Permit Niav 15, 2000
City of Northampto
Building Department
212 Main Street wliaYbili . � �
Room 100 e 1 ai iii
Northampton, f IA 01060 w ets -fry "
phone 413-587-1240 Fax 413-587-1272
4PPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPAt 'C� [ M LI i�i kY �UILDING
OTHER THAN A ONE OR TWO FAMILY DWELLINGf -- - -
I AUG 1 5Oi
ECTION 1s $ITEZNFORMATION �` '
4Th�s S on. pl i e
.1 Property Address: �
_ ae`S' ,`
Ma F r l n �fll' U i J✓�l7nrt r
C'00% v U�ckihsoh h'osri fiat ]
ter j r s .«o
1 1' »': `, a S 4
30 // /� veraay,Distnct' E ,
h�C U.S S a ayF tS Sa ti aY
-
�<��wR�N�'.jt?:°i�y`...�r"t.�..ij��'..'.�<..�4{' �.G C_R-+A".+�✓�'"`s',�.h�c�5.1��Yyy.�`���"^�rSai..-.,yy Le �F"�.� s 1 1 :
Il\����JUJI.I�I G . 4 .."�•'3 -a+o�I5�f7 C� .t )4-�!
ECTION Z PROPERTY OWNERS HIPJAUTt�ORIZED AGENT
.1 Owner of Record:
Coo/e v Dickinsoh f/os oiTa l 301 oc'os Po. 13ox Soo/
3me (P' t) ' Current Mailing Address:
1723- 582 - a 3/3
;nature Telephone
2 Authorized Agent:
3me3me(Print, � Current Mailing Address:
0�z do
3y7- 2 5oa
3nature Telephone
_CTION 3 ESTIMATED CONSTRtiCTION COSTS
'm Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
Building {a)`Building Permit:Fee
Electrical {h) -timafed Tota] Cost of
70 DOO ,Construction from,,6
Plumbing Building;Permit-Fee.
/'0 Doo
Mechanical (HVAC) �Di OorJ
Fire Protection
Total = (1 + 2 + 3 + 4 + 5) -5'aj QOo 'Check Number_.
This Sectori For'Oicial Use'Qnl
ilding PernitNurrber - Datelssued:
nature: -
Building Commissioner%Inspectornf:Buildings Date
File#BP-2008-0149
APPLICANT/CONTACT PERSON Raymond R.Houle Construction Inc
ADDRESS/PHONE 5 MILLER ST LUDLOW (413)547-2500 Q
PROPERTY LOCATION 30 LOCUST ST
MAP 23B PARCEL 046 001 ZONE M
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
Typeof Construction: WEST3 RENO-NURSES ST,NOURISHMENT CTR,DAY STAY AREA
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 066227
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO IATION PRESENTED:
pproved 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 ssion
2.0
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.
30 LOCUST ST BP-2008-0149
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B-046 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2008-0149
Project# JS-2008-000228
Est. Cost: $500000.00
Fee: $2500.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Raymond R. Houle Construction Inc 066227
Lot Size(sq. ft.): 667077.84 Owner: COOLEY DICKINSON HOSPITAL INC
Zoning-: M Applicant: Raymond R. Houle Construction Inc
AT: 30 LOCUST ST
Applicant Address: Phone: Insurance:
5 MILLER ST (413) 547-2500 O Workers
Compensation
LUDLOWMA01056 ISSUED ON.8/21/20070:00:00
TO PERFORM THE FOLLOWING WORK:WEST3 RENO - NURSES ST,NOURISHMENT
CTR,DAY STAY AREA
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
�� 4 Footings:
Rough � -'(7 t . Rough: ' House# Foundation:
L)/ �� �_� � (' Driveway Final:
Final: -�.� d f� Fnia1:c�'
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
1 Jk
Final: Smoke: ���� Final: ®K\ o 1112 IC 7
THIS PERMIT MAY BE REVOKED BY THE C_TY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGU 'IONS.
Certificate of Occu anc F nature:
FeeType: Da.*,e Paid: Amount: r.
Building 8/21/2007 0:00:00 $2500.0090452
212 Main Sheet,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo