23B-046 (90) v U
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s" DEPARTMENT OF BUILDING INSPECTIONS F'
INSPECTOR 212 Main Street • Municipal Building '
Northampton,MA 01060
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(for Professional Engineers/Architects responsible for only portion of a controlled project)
Project Title:
Laboratory Renovation Project Date: May 19, 2005
Project Location:Cooley Dickinson MapN8D83 Parcel: Zone: M
Hospital 2313-046
Scope of Project:
Chemistry relocation and miscellaneous lab space refurbishments.
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR SECTION 116.0:
L, Jeffrey W. Struble Mass. Registration Number 32141
Being a registered professional Engineer/APCkb Vhereby CERTIFY that I have prepared or directly
supervised the preparation of all design plans, computations and specifications concerning:
[ ] Fire protection (J Architectural )t:XStructural [J Mechanical [] 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 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.
Signatu►•e and Seal of registered professional: `. OF MA
JEFFREY �G
W. STRUBLE
W STRUCTURAL N
No.32141
�O
'090 FGIsTE�
0
SSIONA%-�a
Fax 413-587-1272 -phone 413-587-1240
LCD
A4Ct1AMJPU
Of Xod4anipton
s" I r DEPART) OF BUII,DI7�G INSPECTIONS
L'v� ii i
INSPECTOR 12 street * Municipal Building '
_. Northampton,MA 01060
CON r�J MENT
Lai a.,�-r o/✓�
(for professional, n�/10� Entire Project)
Project Title: Laboratory Rer. D� vlay 19, 2004
$J1Vb1NU l
Project Location:Cooley Dickin: varcel: Zone: M
Hospital 23B-046
Scope of Proiect:MP_mj rAl rnaiton and miseellar}ee s lab space
In accordance .vitiFt%ti&l •ei 3 assacliusetts State Building Code,780 CMR SECTION 116.0:
I, P/��✓ Mass.Registration Number
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:
M/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 tl�e 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 with 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.
v�5ttaEo
Signature and Seal of registered rofessi
n �
s No,-1;033
�roN
MA
*ray or
Fax 413-587-1272 -phone 413-587-1240
R��tnl-c nT
O O =
ar "E (rihl of kTorfljalliptofi
X30 itch nrc If$'
DEPAR7X4E1JT OP BUfLOD,\:C INSPECTIONS
212 RIain Street • Municipal Bmidin�
Northampton, Mass. 01060
W O Rla, R'S C O)I'EN S A TT O N Gq S UR.A-N CE A-!'FLI?A VIT
(l;crnscclpCttn;ttcc)
Vvith a principal place of bus;oess/residence 2t:
41(00 VJ2S-t .344+—" -";-!-, 16t,"f'loo<, geuU `�ofk N`j(jhone=:)(Z1Z)SID 233C)
(sar--t/ta ty/stalc12j P)
do hereby certify, under Lhe pasns and penalties of pcdury, h:)
( ) I an an employer providing the Following workers coinoensz non covCM-C ',or im
Ctuplovccs worming on tii;s job.
sue. Pv L-
T2AV�LE5aS G?MP,+NIBS g:T(2�3--V e,23g I�7�a.•- 145
(irsu r�� Conr u.) (Pciic: ?•:u--Lbcr)TI"-04f (_'pif<tion D"--)
( ) I am a sole proprietor, genera! contactor or homeowner (ci:cie ogle) aid have hired
the coauactors liste-d below who have the `oilo%ving Worker's comneraaon policies:
(Nam-, Of Co_'.lnc.0") Coinoai)YPOUCi NUM!'C:)
-- (N=e of Coacacctor) _ (Inslrznc;- CoMOaaNvPo1jc-, Nu.tnccr) (Expiraon Dale)
(Name of Coasraao,) (1-asurane: Compan)•/PoUq- N.unlu) (E\pirdon Datc)
(Name of Coatraeior) ansuran(-- Company/Policy Numbr) (E pp-,doa Date)
(aax3 ocal ch.0 Lrncoc ry to me'uc�ulfW1=LA joo pcstaiasng to.11
( ) I am a sole proprietor and bave no one wor4dng for me.
( ) I am a home owner performing all the %work myself.
NOTE:pl=.=tx ewzrr f>-wt;Je bCC=,-om vrbo carploy pcnotn w a rtpzc work on a d-,e -;of
act more ib_-t_4v_List is ubicb tvc boraoowoc rrsdo oc oa the gounCt spp mun=tbeao c.-c ax oa,-may oeered=cd to be
csrraloyc-1 uaG^ the v -i; -=P--.•;m Act(GL152.^I CS)l =Ppl+ca.6Oo by•boamoova fm c 6c-v oc pvmit rr-,y nideffx the
1epJ Ma-'lc of ea-=Moyer under dto Wockce,(:.aK malioa Ad-
I undcrn,aod dia a copy of tb:a mac as y be foc riled to the Doputmca¢of L;,d rid A=dca&OM"of 4aur+oon for Lt"
covc7.b;c va'if-u-and th1[=Jum to sonar bovrnt ix . soe oa 25 A of I,toL 152 na tad to the iapoaitioa of cimiail peaaltics
000sis of a Get of tg to S 1-500.00 andfor ix� or up to one yvr sad civil pmal.ia in ts-form or.Stop Wort Order and.
fttn o(S 100.00 a day.wn�l me
For dca.rta+: w, onry
PCrmtl)qumbs:J% heap° Lot tf +�
'Siva of L; 1Pcrmittc Ce ,
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
-OW NERSAGENT.OR CONTRACTOR APPLIES FOR BUILDING PERMIT
11G�-� 1� as Owner of the subject property
hereby author' iZ�X� ru� v�J r tc ac; or
my behalf,,K all m tte s rel ti e tow rk authorized by this building permit application.
C
Signature o 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
b
SigrrCture7of Ow r/Agent Date
SECTION 12.2-CONSTRUCTION SERVICES
101 Licensed Construction Supervisor: Not Applicable ❑ p
Name of License Holder : Qi GTf�VV ► C �5yC'C�
Licens Numb r
M78 01/03
Addr Expi ation to
�l 3 73a -(��-S- 1
Signat re 9 Telephone
SECTION 1 3-WORKERS' COMPENSATION'INSURANCEAFFlDAVIT(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....... ❑ No...... ❑
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9= PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES -FOR BUILDINGS AND.STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO,780 CMR 116(CONTAINING MORE.THAN3'5;000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
�j-H-� ITC /r✓ 044E0N12-AFI Q Not Applicable ❑
Name(Registrant):
0 e4 p Registration Number
Address l�'E�3
Expiration Date
Signature Telephone
92 Registered Professional Engineer(s):
- + 1E5 ZAT_C�it l!F- oCu�AN l zr4T�o�i
Name Area of Responsibility
So R."PC41EF S-r, N�EyVToN, A* bdy5'8- 1 (3Lf
Address Registration Number
Signature Telephone Expiration Date
Name
Area of Responsibility
D+ mAt N S_T .
Address Registration Number
W ��sf Y2_116yj_ 06/3v/off
Signatu 0 Telephone Expiration Date
I
I
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
Company Name: Not Applicable ❑
Responsible In Charge of Construction
Address
Signature Telephone
Version 1.7 Commercial Building Permit May 15,2000
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone: Outside Flood Zone ❑ Municipal ❑On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
azldn )
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW x 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
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 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
Version 1.7 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 [ J Change of Use [ ] Other [ ]
❑ Accessory Building ( ] Repairs [ ]
BRIEF DESCRIPTION: LA o�'Tb9-V RZNbVATlONS -.0 Tars ',-100(-,+ gvlld(✓�S C_+D'
SECTIONS-.:USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business 2A ❑
E Educational ❑ 2B , ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 36
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ 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: =Proposed Use Group:
Existing Hazard Index 780 CMR 34): Hazard Index 780 CMR 34):
SECTION'&BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION ~ OFCEUSE ONLY
Floor Area per Floor(sf) ist
NSA-
ist �J •-�/'� 2nd 7 1 I�' x y? :;*yk
2"d I `l0 s +'r�
3 ha�rh t• t
3 rd
4th
th
Total Area (sf) 4% 51, 31 g Total Proposed New Construction (sf)
Total Height(ft)
Total Height ft----- -- p.
Versionl.7 Commercial Building Permit May 15,2000 L-104 EQ10
_ only $ :.
City of Northampton
tia 4
Building Department
212 Main Streeter ►t �
Room 100
t e r V
Northampton, MA 01060 x _o
phone 413-587-1240 Fax 413-587-1272 R r a ,
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
L� t.
D lc�161f SOIJ 4U (T-A(, Map ' _ Lot` Unit
O LOc(l5`T' ST'(Z�Eu"r
Zone Distract
Noel fiPrMPTON, MA 0100 1
Elm St.Distract CB`District
SECTION 2=PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: 30 L—O G VS7- S
1 c.,=t7w-z) Co(LDi�?-- Noi?-q-1+AMPTON, Mfg o 1 OG TOP I
Name(P nt) // JJ Current Mailing Address:
E� L44t3, SgZ - ZZtS
Signature Telephone
2.2 Authorized Agent: 32- " P ,UCH N ST
SrrEP+4En/ KILL i-4r� SPF-fNC5-F—lr✓L-D, MA 01103
Name(Pnn 01 Current Mailing Address:
13 73 2 S-j
nature feleplZne
SECTION 3`-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building X 0-1, 0q 3 (a) Building Permit Fee
2. Electrical r Z '� (b)Estimated Total Cost of
O, OQ
Construction from 6
3. Plumbing Z4 O, O O C) Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection 1 1 6 O O
6. Total (1 + 2 + 3 +4+ 5) (po7 ay3 Check Number �aa 031p o2
T is Section For Officiai Use Only
`Building Permit.Number: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2004-1145
APPLICANT/CONTACT PERSON BARR&BARR BUILDERS INC
ADDRESS/PHONE 32 HAMPDEN ST SPRINGFIELD (413)739-6257
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 oZ 3 75 A 7, s 77-07
Typeof Construction: RENO LAB-1 ST FLR BLDGS C&D
New Construction
Non Structural interior renovations
Addition to Existiniz
Accessory Structure
Building Plans Included: ,
Owner/Statement or License 053 �FFZ�.��t!�4
3 sets of Plans/Plot Plan
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 Stree ommission
::7//�//Zo 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-2004-1145
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-2004-1145
Project# IS-2004-1729
Est.Cost: $607243.00
Fee: $3036.22 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 313 Contractor: License:
Use Group: B BARR & BARR BUILDERS INC 053608
Lot Size(sq. ft.): 667077.84 Owner: COOLEY DICKINSON HOSPITAL INC
Zoning:M Applicant: BARR & BARR BUILDERS INC
AT. 30 LOCUST ST
Applicant Address: Phone: Insurance:
32 HAMPDEN ST (413) 739-6257 WC
SPRINGFIELDMA01103 ISSUED ON.6114104 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENO LAB 1ST FLR BLDGS C & D
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• Receipt No: Date Paid: Check No: Amount:
Building 6/14/04 0:00:00 20022 $3036.22
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo