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23B-035 (3) 61 LOCUST ST BP-2017-0722 cls#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23B-035 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THEGUARANTY FUND (MGL Lcc.1144/2�A)) Category:renovation BUILDING PERMIT 1 I Permit# BP-2017-0722 Project it JS-2017-000886 Est.Cost:$15000.00 Fee:$2555.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALL-TEK BUILDERS INC 76435 Lot Size(sq.ft.): 27007.20 Owner: WOHL CARINA Zoning:NW 100)NRB(0)/ Applicant: ALL-TEK BUILDERS INC AT: 61 LOCUST ST Applicant Address: Phone: Insurance: 88G INDUSTRY AVE (413) 736-0099 O WC SPRI NG FI ELDMA01104 ISSUED ON:I/4/2017 0:00:00 TO PERFORM THE FOLLOWING WORK NON STRUCTUAL INTERIOR DENTAL OFFICE - 5100 SF **INTERIOR ONLY** 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: FeeTvpe: Date Paid: Amount: Building 1/4/20170:00:00 $2555.00 212 Math Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-20I7-0722 APPLICANT/CONTACT PERSON ALL-TEK BUILDERS INC ADDRESS/PHONE 88(3 INDUSTRY AVE SPRINGFIELD (413)736-0099 0 PROPERTY LOCATION 61 LOCUST ST MAP 23B PARCEL 035 001 ZONE NB(100)/URB(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT • __LL_•TION CHECKLIST NCLOSED REQUIRED DATE / ZONING FORM FILLED OUT // Fee Paid !J Building Permit Filled outft I Fee Paid Tvpeof Construction: NON STRUCT AL INTERIOR DENTAL OFFICE-5100 SF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 76435 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON II1191MATION 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 a-ye. Delay e /� � / 5 /7 [ure ofBuil Ii g 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. Version Commercial Building Permit May 15.7000 Department use only I City of Northampton Status of Permit. Building Department Curb Cut(Driveway Permit - t tili r bb 2 V 212 Main Street Seer/Septic Availability Room 100 Weter/Well Availability - Northampton, MA 01060 Two Sets of Structural Plans _--- ----"phune 413-587-1240 Fax 413-587-1272 Pict?Site Plans Other Specl(y 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 ez/ ...Le C-cSr .1 Z-' -.-. .... Map Lot Unit ' 2one Overlay District - - -- - — -- Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 1 2.1 Owner of Record: CARINA L . woyc O2 s7,-- No(Locust S� t/+MPTAMt7 Name(Enid/ Current., Mating Address ae /// 4.3,-Telephone (o - 180 Signature ,_ ! Telephone 2,2 Authorize: nt: f}U ,t K- 4301.-oesJ LZ"C . __ 1-r5^ SU4U1 Z47 f7-L'E SPF'o, i A Manic(Prnt) eg,n-j? 5--Ami. Current Mailing Address / f 06504 5i3 4/2i/ 49/4' r Signature _, _�i ..... Telephone - SECTION 3-ESTIMATED CONSTRUCTION COSTS uem Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 2„h) WV (a) Building Permit Fee 2 Electrical r,,;.zl ti (b)Estimated Total Cost of 36 ^ vt tO a J "/ / Construction from (6) `Sv 3, Plumbing 761 tit, Building Permit Fee 4. Mechanic:ai(HV'AC) - +� ' - ' W 5. Fire Pratecton 6+� z _ 6. Total=(1 +2 +3 +4+5) Check Number L w 4 This Section For Official Use Only Building Permit Number Date Issued Signature I Building Commissioner/Inspector of Buildings I Date Version)-7 Commercial Building Permit May 15 2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35000 CUBIC FEET OF ENCLOSED SPACE Interior AlterationsExisting Wall Signs Ly'Demolitlon!!d' RepaIrs❑ Additions E Accessory Building Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. Of t4 Of Proposed Work: �!N S+Ml Cra,6,d-C,, f1 OF— 0r- 2$'t Si cm 174 SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP{Check as applicable) CONSTRUCTION TYPE A Asssmbly (0A.1 ❑ A-2 0 A-3 ❑ 1A 0 A-4 ❑ A-5 ❑ 18 ❑ B Business K 2A ❑ E Educational 0 28 0 F Factory 0 F-I 0 F-2 0 2C 0 H Huh Hazard 0 3A 0 I Institutional ❑ LI 0 1-2 0 I-3 ❑ 3B 0 M Mercantile 0 4 ❑ R Residential 0 R$i 0 R-2 0 R-3 0 5A ❑ 5 Storage 0 5-1 ❑ S-2 0 5B X U Utility ❑ ._... Santry, 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) - - -.._ Proposed Hazard Index 780 CMR 34)- SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY =100r Area per Floor{sf} 1 " A-146821 _.SF- _. 1" 2°d etb in) 5�.. 3 ;n . _ . .... 41" _ _ Total,Area mf) 9,2_4,40 6r- Total Proposed New Construction{5t} _,„_ Total Height(ft) 'y 0 Total Heieht ft 7. Water Su ply(M,G.L.c.40,§ 54) 71 Flood Zone Information: 7.3 Sewage DI/spas&System: Publicrr, Private 0 Zone -, Outside Flood Zone Municipal pr On site disposal system Version 1 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 _. . Frontage _. . Setbacks Front Side L R:._ L R. Rear _..... _._._._ Building Height - - Bldg. Square Footage - - °n Open Space Footage (Lo:area minus bldg&paved padcog) of Parking Spaces '- -- Fill: _... _.. . I (volume&location) I A. Has a Spec I Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES Q IF YES: enter Book Page and/or Document it B. Does the site contain a brook, body of water or wetlands? NODONT 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 w NO Q IF YES, describe size, type and Location: ,,L,,-€t-S/6yl/ JAI Sia .e'ar / D. Are there any proposed changes to or additions of signs intended for the property? YES % NO Q IF YES, describe size, type and Location: 02/S7"AjAILtE aF 1:017,197„.., p ;e E All the construction activity disturb(clearing, grading, excava` ,or filing)over I acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version l.7 Commercial Building Permit May U.2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 38,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect S ige mild 'Dila L° N51-1 At A Not Applicable 0 Name(Reaistram)'. to Ii to.„tor_ SFPOlfoj Registration Number 1 / a0 -72i.D n. 4.13741 y-35- Expiration Date/ h Signature Telephone 3131 ( f { 9.2 Registered Professional Engineer(s}: fff Name Ares ofP sponsib lily Address Reglstranon Number Signature Telephone Expiration Date Name Area of Responsibility Address Regstraton?lumber Signature — Telephone Expiration Date Name Area of Responsibilig- address _.... Registration Number _.. Signature Telephone Expiration Date Name Ares of Resabnsibl:iry —.... . . :. Address Regrstrabon Number Signature Telephone Expiration Date 9.3yGeneral Contractor / ine'L �yraC` .84/[4-406)I-9796)r.97? &- Nnt Applicable 0 Company Name: _St009-7 S1'1-64t-- Responsible In Charge of Construction gra _Zeus) del-li 7441E1 Adorers - f -- Ill Z.L.t OI'fk Signs.ure Telephone Versionl.7 Commercial Building Permit May N,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 t AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT C/eI• inlg / Weil r_ ,as Owner of the subject property hereby authorize /4“— Z AU/L9 en CjLA-6 G- i-3 Et- to act onmyb a Inall r ativwor ut rued by this building permit application stenata� for /l4aa//r� 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 C2-- Punt Name 2.3 Atev /b Signatur of wner'Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor:pvipV s� Not Applicable El Name of License Holder roe- 9. �a'f/'4ti "fes Q 7 6 y3 CS Number umper e .2 rf —r ty ,-itq oeay /8-L273-11/ Address Expiration Date g �i3 zL/ o/ jr Signature / � Telephone SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be comp) ted 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 CU////i y� t�0 • The Commonwealth of YLassaehu.setts --meetµ Department of Industrial Accidents a- -= Office offnvesrigations 600 Washington Street • Boston, .12A 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractorsrriectricians/Ptambers Aoohheant Information Please Print Legibiv Name (3usiness/Organization/Individual):S'( eX- e44/7tEX.e? ,V1 Address._, :• 1%1�T,LG.a /we. sp4). .o. A /2//A9 City/State/Zip: Phone n: ‘,1/3 736 06 1 I I_Are)o n employer?Check the appropriate boa: - Type of project(required)' m a general contractor and i. amae^vloyer withb. ❑ Nen•construction employees[full and/or pan-time)." have hired the sub-contractor 2.❑ 1.a sole proprietor or partner- listed on the attached sheet. 7. odeling ship and have no employees These sub-contractors have g, klcmolition working for me in any capacity. employees and have workers' 9 r- insurance.]rance.t i Building addition [No workers'comp.insured-ice comp. required,] 5. ❑ We are a corporation and its 10.1 j Elecneal repairs or additions 3.❑ I am a homeowner doing all work officer have exercised their 11.7 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance recused. ' C. 152, 61(4), and we have no ] employees. o workers' L'_n Other camp.insurance required.] *Any applicant that checks box NI mus:also 511 out the sec]on below showing their workers'compensation policy informan on. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. eCbntraawors that check this box must attacked an adiitiona:sheer showing the pant o(:he sub-contractors and state whether or nor those entities have employees. If Cs.sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Name: Policy#or Self-ins.Li:. #: Expiration Date: Job Site Address: City/State/Zip: 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 ofa fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the flier of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification, l do hereby certify under he pains and penalties of perjury that the Deformation provided above is true and correct .r NOV- Phone OV / Si Dare: [ram �..i- cDate: 2-3 6 Phone#: '7 /3 " .3e ' et t 1 C W3 7-2-1 0/qc 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 S:_, City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined b/y MGL c 111, S 150A. Address of the work: & / l—D CCS T Ci t. The debris will be transported by: 3,A., I pdsft't_ The debris will be received by: Building permit number: Name of Permit Applicant C 0 / its / Date Signature of Permit Applicant Initial Construction Control Document *41 To To be submitted with the building permit application by a Registered Design Professional S for work per the 8th edition of the "'���� Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Whol Family Dentistry Date:Nov 22,2016 Property Address: 61 Locust St.,Northampton, MA Project: Check(x)one or both as applicable: ()New construction (X)Existing Construction Project description: Interior Renovation of Level 2 to create new dental office. New plumbing,electric and new Fire Sprinkler system. 17 I Stephen Jablonski MA Registration Number: 6078AR Expiration date: 08-3124 am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': (X)Architectural ( ) Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: I. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 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 if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the buildine official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. -E✓"g.Ep pryy �s•N d_4 .�Qv Enter in the space to the right a"wet"or QrSasE� sic}�� Sts r.signature and seal: _`.\ s /• Ea. ema wSPRING:3ED, g M, ri (( Z/ II Phone number: (413)747-5285 Email: steve@jdarchitects.com telk I 2 Building Official Use Only Building Official Name: Permit No.: Date: Note I.Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised.if`other'is chosen, provide a description. Version 06_11_2013 JABLONSKI I DEVRIESE ARCHITECTS www.jdarchitects.com steve@jdarchitects.com MEMORANDUM Nov 22, 2016 To: City of Northampton Building Official Re: Whol Family Dentistry, 61 Locust St, Northampton, MA Renovation to an existing building, Level 3 Alterations. No Structural Alterations are proposed. Levell & @ + Basement, each floor is 4400 sf. Total Building Size= 13,200 Construction type: 5B unprotected All new walls will be non bearing and any openings used by the public will be a minimum of 32" clear, all new doors shall be 3'-0" wide and have lever handles. Fire protection: because the proposed alterations exceed 33% of the building and the total cost of the project exceeds 33% of the assessed value of the building a fire sprinkler system will be installed for the entire building. Fire sprinkler plans will be submitted separately. Means of Egress: Both existing enclosed fire stairs will be maintained. New public corridors shall be a minimum of 42" wide. Accessibility: the existing accessible entrance and elevator shall be maintained as is. The new accessible toilet added to level 2 shall be accessible. Staff toilets on Levell and level 2 need not be accessible. Energy Conservation: new insulation shall be added to the second floor roof and windows, however the entire building does not need to comply with current energy code. Stephen Jablonski AIA 29 Elliot Street Springfield, MA 01105 I T: 413.747.5285