24D-185 (27) 243 KING ST- 105- HAMPSHIRE HEARING BP-2017-1298
cis#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block: 24D- 185 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2017-1298
Project# JS-2017-002155
Est. Cost:$5600.00
Fee:S1oo:oo PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group. RICHARD LAVALLEY 054203
Lot Size(sq.ft): 86248.80 Owner: C.00LIDGE NORTHAMPTON LLC
Zoning: HB Applicant: RICHARD LAVALLEY
AT: 243 KING ST- 105 - HAMPSHIRE HEARING
Applicant Address: Phone: Insurance:
27 NORWOOD ST (411)326-19500 Workers Compensation
GREENFIELDMA01301 ISSUED ON:8/10/2077 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL NON BEARING LOAD PARTION
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 5110/20170:00:00 3100.00
212 Main Street.Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
w
Version) '7 Commercial Building Permit May 15,20.00 ea
Department use only
City of Northampton Status of Permit:
Building Department Curb Cul/Driveway Permit
212 Main Street Sewer/Sephc Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Twc Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify (_
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE, CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
(Lara! Pia*S
SECTION 1-SITE INFORMATION
1.1 Property Address. t, •r- l This section to be completednby office
c)(/3 - 1A- S1 . Se :3e /JS. : Map d'-1 V Lot 1{i5 Unit
N�fa r�'1 a..r p to..„e/ Fritts ) 3/o 4. e Zone Overlay District
-- --- - -- --- - Elm St.District ce District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
(-60// � IcanrJI✓N t vvh114, Aviv' N/
Name(Print)
Current Mailing Address )04p 5 - 3 33 )0
( �) / 9tv 4'37- RSGG
Signature 1 ._ �'^ 4/ Telephone
2..2 Authorized Agent
R Sinter al leteW OA GI
Name levet) Current taming//�.-\ Addresss� I41").77 Rio,-tee ST
^/�/ 6- rift-R.449`� , ..17/(5413o/-_.a
Signature V /l/"'�'r ` �/ Telephone y/ 'tj • '1)C. - Jt) 5
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building ) JO (a)Building Permit Fee
2. Electecal $( ett } (b)Estimated Total Cost of
c7 J«+ Construction from (6) . -
3, Plumbing ._ V _ Building Permit Fee
4. Mechanical(I iVAC)
S. Fire Protection D L.) S _
6, Total 4 -5 c JD.. Check Number o3 �0
f This Section For Official Use Only
Building Permit Number Dale
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
Vermont Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations CJ Existing Wall Signs 0 Demolition 0 Repairs 0 Additions 0 Accessory Building 0
Exterior Alteration 0 Existing Ground Sign❑ New Signs 0 Roofing Change of Use❑ Other 0
Brief Description Enter a brief description here. /
Of Proposed Work: :51v).--.4/ N.dr. %cid ftr•r..-j /r/je,v
SECTION 5 -USE GROUP AND CONSTRUCTION`TYPE . .,
USE GRO '- reheck as a•pfica• -)• CONSTRUCTION TYPE
A Assembly A-1 10A-2 10A-3 10 IA 0
A-4 0 A-5 El
0
B Business 2A ❑
E Educational 0 2B 1 ❑
F Factory 0 F-1 ❑ F-2 0 2C 0
H High Hazard 0 3A 4 I
I Institutional 0 1-1 0 1-2 0 1-3 0 3B
M Mercantile 0 4 0
R Residential 0 R-1 0 R-2 0 R-3 ❑ 5A
S Storage 0 Si- 0 S-2 ❑ I 5B •
U Utility 0 Specify_.
M Mixed Use Yv. Spenry
S Special Use "'"'❑"""111 Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS.ADDITIONS AND/OR CHANGE IN USE
Existing Use Group p�(ONs ° (/$//YY.r TI
Proposed Use Group. 1.5
Existing Hazard Index 780 CMR 34) _. f _ Proposed Hazard Index 780 CMR 34): t .' _.
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
_._. _.. in ... -._
2" _.
3re .
4th
Total Area (sf) Total Proposed New Construction(sf)._
Total Height(ft) -
Total Height ft _.
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewzge Disposal System:
Public Private 10 Zone _ Outside Flood Zone❑ Municipal' On site disposal system❑
•
Version1.7 Commercial Building Permit May 15, 2000
8. NORTHAMPTON ZONING
NI'n' Existing Proposed Required by Zoning
This column to be filled m 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 _
parking)
#of Parking Spaces —
----
Fill:
(VU Lime&Location) _ .. _.... _ .__.
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 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 0
IF YES: enter Book Page. ., and/or Document#
8. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained , Dale Issued: j
C. Do any signs exist on the property? YES 3 NO O
IF YES, describe size, type and location: U.•
D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO
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 O NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
F /J
� '
Vcrston1.7 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 THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable
Name(Registrant): -- - --- -
-- - - - - ---- - - Registration Number
Address .. _ .. ...
- - -- - Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address - -- - -- Registration Number -- - -
Signature Telephone Expiration Date
Name Area of Responsibility
Address __. . .-.. -..... Registration Number .. -
Signature Telephone Expiration Date
NameArea of Responsibility
. ... ...__.. __.._._. I
Address Registration Number
Signature Teleplone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Exmration Date
9.3 General Contractor
Not Applicable
Company Name:
Responsible In Charge of Construction
•
Address . ..... __. _. ... _..
Signature Telephone
Version I.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Enoineenng Structural Peer Review Required Yes l p'�/ No C
SECTION 11-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize _.. _... _... to
act on my behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I l I PIRA a.v-.*� hiA �lr�.J Ie/ __ -- _._ _. ,as Owner/Authorzed
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and bebet
Stoned under the pains and penalties of Penn`
�< tC c-+'rrI.. 1—)A ?lc, _.
, vi -.me
• VI ti - .P1Cbt { 9 t7
ature of• nor/Agent �� Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction)Sunervisor. Its
\\ 1 I Not AppIicabie 0
Name atLcenseHolder \t r.�La 4"4.4� kt..\)e..114.' OS / ao3
License Number
N '01c�
Address EXpliation Date
X113 - 3a1E - 195x._ .
Sig e n Telephone
SECTION 13-WORKERS'COMPENS ON 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 No 0
The Commonwealth of.Massachusetts
Department of Industrial Accidents
'e -k Office of Investigations
%.--a-P.Ptcyr.7lfa600 Washington Street
Boston, MA 02111
www.inass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information
p /.a
PleasePrint Print Legibly
Name (Business/Organization/Individual): /dD1s� /14,../Le ;Aar' /_C
Address: C43..x 310 "17
City/State/AIL " 03i.aPbone#: i
re you an employer? Check the appropriate la; Type of project(required):
I. I am a employer with 4. D I am a general contractor and I
y 6. Li New construction
employees(fail and/or pan-rimed* have hired the sub-contractors
listed on the attached sheet. 7. J Remodeling
2,El I am a sole proprietor or partner-
ship and have no employees These sub-contractors have g r" Demolition
working for me in any capacity. employees and have workers' 9. n Building addition
[No workers' comp.insurance temp.insurance./
required.) 5. l We are a corporation and its 10.0 Electscal repairs or additions
3.�] q ( officers have exercised their 11 Plumbing repairs or additions
I am a homeowner doing all work -C Y:
myself. [No workers' comp. right of exemption per MGL 12.E Roof repairs
insurance required.]t c. 152, §1(4), and we have no
employees.[No workers' 13.E Other
comp. insurance required.]
'Any applicant that checks box#1 roust also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such.
-Contractors that check this box must attached an additional sheer showing the nave of the sub-contractors and state whether or not those entities have
employees. If the subsonneetos have employees,they martpro'nde their workers'comp.policy number.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. J�
Insurance Company Name: 54) //67.040 g�)cu./ G /-74-vo l./d✓ ,27-4,‘,
Fahey#or Self-ins.f Tic.ft: 2 AN-Ca J a,3 7z c/OD Expiration Data / "j.1/2 ,,y�
Job Site Address). /(JJ y3 u.t.v x S7 ' City/State/Zip:/'4.1/ i rf"v/aid Af n5 0/40
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 ynder,he pains an pen ties of perjmy that the information provided above is true and correct
��
,ajananue: C.-- �� c"/ 0.75 Date:s)..7/2/7
Phone#: INS — _ — I.'
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permft/License#_
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical,inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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 by MGL c 111 , S 150A.
Address of the work: Nor4A/,Mpf-0°--
The debris will be transported by: N -Fe r c F, e 1(57 c . , fQ
The debris will be received by:
Building permit number:
Name of Permit Applicant Coo 10_, v o r f �� a C '
'M ," g 1 7 K � ' 1
Date Signature of Permit Applicant
ACORn® CERTIFICATE OF LIABILITY INSURANCE s/3t2o1iYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy{iee)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER NAME:
N : Christina Barrett
NAME
Aquadro 6orsement(s) EeF,II. (413)586-7373 FAX Ho.1413)se4-0e53
355 Bridge St. , P. 4. Boa 357 AD ESS:
INSURERSI AFFORDING COVERAGE NWCA
Northampton MA 01061 INSURER A:Hanover Insurance 29939
INSURED INSURER a:
COOLIDGE NORTHAMPTON LLC INSURER c:
PO BOX 310 INSURERD:
INSURERE:
FR
WHITE PLAINS NY 10605-0310 INsuRERF:
COVERAGES CERTIFICATE NUMBER:CL1441405466 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE*-INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT PATH RESPECT TO MMICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS ADDL RIMPOLICVEFF POLICY EXP LIMNS
TYPE OF INSURANCE IN4R YND POLICY NUMBER IMMIDDNYYYI IMMNDVYYYI
GENERAL WORMY EACH OCCURRENCE $ 2,000,000
APOMO
X COMMERCIAL GENERAL LIABILITY PREMISESO(£R acct once) 3 500,000
A CLAIMS-MADE XI OCCUR 21411612374400 12/21/201612/21/2017 MED EXP(Anpme person) S 10,000
PERSONAL&ADV INJURY 5 2,000,000
GENERAL AGGREGATE _ 1 4,000,000
GENT AGGREGATE LIMO APPLIES PER, PRODUCTS-COMPRP AGG 1 4,000,000_
1POLICY I 1PFO ( ILOC S
AUTOMOBILECOMBINED$WILE LIMIT
LIABILITY
fEa arudeml 9
ANY AUTO BODILY INJURY(Per penml $
—
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
HIRED AUTOS �. AUTOS COREDPROPERTY$bMt4GE
9
X UMBRELLA JAB _ OCCUR EACH OCCURRENCE 9 3,000,000
A EXCESS UAO CLAIMS-MADE AGGREGATE $ 3,000,000
GEC X RETENTIONS 10,000 UNNb123809 12/21/201612/21/2017 $
A WORKERS COMPENSATION NC STArU- X OTH-
AND EMPLOYERS'LIABILITY TORY IKNtS FR
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E L EACH ACCIDENT 9 500,000
OFFICER/MEMBER
ory in NHI EXCLUDED? n NIA XBND123407 12/21/201612/21/2017
E.L.DISEASE-FA EMPLOYEES BOO,OOO
H yes,tleunM'Anger
DESRIPTION OF OPERATIONS below — E DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPEM9ONS I LOCATIONS I VEHICLES (ANSO ACORD 101,Additional RemaN$Schedule,II more aqua is required)
241 6 243 KING ST. NORTHAMPTON
225 S 225R KING ST. NORTHAMPTON
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
THE CITY OF NORTHAMPTON ACCORDANCE WITH THE POLICY PROVISIONS.
BUILDING DEPT
210 MAIN ST. AUTHORIZED REPRESENTATIVE 1
NORTHAMPTON, MA 01060 � //� �
�llL�
ACORD 26(2040/05) C 1988-2010 ACORD CORPORATION. Alt rights reserved.
INS025(201005)o1 The ACORD name and logo are registered marks of ACORD
.<Rs
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060 5/9/17
RE: Potpourri Plaza Suite 105 Interior Renovations
Dear Mr. Hasbrouck
I am writing to kindly request that you grant a modification to waive the
requirement for control construction for the above referenced project for Edmond
DeLaurentis Jr.
I have toured the project and believe the work is of a minor nature, will not
affect health, accessibility, or structural requirements and is impractical in that the
cost of control construction is considerable when compared to the cost of the
proposed work. I have also attached a code narrative explaining my findings.
Please except this stamped letter as consent that we allow for the City of
Northampton to oversee the construction and implementation of this project.
Thank you for your consideration.
Respectfully,
Tom Douglas
Thomas Douglas Architects
yawn' " '
196 Pleasant Street
Northampton, MA 01060 , N'S d�
F
196 Pleasant Street.Northampton.MA 01060 141158506411 � tdwglasarch4ectemm
Code Review Thomas Douglas Architects, Inc.
Alterations to Potpourri Plaza,Suite 105 196 Pleasant Street, Suite 202
249 King Street Northampton, MA 01060
Northampton, MA 413-585-0641
CODE REVIEW May 9, 2017
Potpourri Plaza, Suite 105
Northampton, MA
Applicable Building Code: MA 780 CMR Eighth Addition
IBC, IEBC International EXISTING Building Code, 2009
ZONING DISTRICT: HB
PROPOSED RENOVATIONS:
PROJECT DESCRIPTION:
• Install a new one-hour rated fire partition per Section 709 of the IBC, 2009, within
an existing tenant space to create a smaller tenant space. This work includes
removing one door from an existing wall and covering existing metal-framed fixed
glazing within an existing wall. All existing walls along the new tenant separation
line will be a fire partition per Section 709 and code compliant.
Use Groups
• This is a B Use
• There is no change of use
• The existing Suite 105 occupies 4375 square feet
• The proposed Suite 105 occupies 1930 square feet
Construction Type
• SB
General
• Existing separation of uses within the overall building: All existing separations
will be maintained.
• The new fire partition and framing will be built with materials matching the
existing.
• The current level of safety or sanitation will NOT be reduced and the portions
altered shall conform to the requirements of the IBC.
• The existing path of egress shall not be altered.
• Existing emergency lighting for the path of egress shall not be altered.
• All new elements will conform to the accessibility code.
• This alteration will not affect the height and area limitations.
Sprinkler System
I of 2
Code Review Thomas Douglas Architects, Inc.
• Alterations to Potpourri Plaza,Suite 105 196 Pleasant Street, Suite 202
249 King Street Northampton, MA 01060
Northampton, MA 413-585-0641
• The building has sprinklers throughout.
• The existing fire alarm system and sprinkler system will be altered due to new
wall locations. Sprinkler and sprinkler locations will be code compliant.
Occupancy
• The occupancy for the new Suite 105 is 19 people.
• Per Tables 1004.1 and 2902.1, one toilet room is required.
• There are two existing water fountains that will remain in the suite.
End of Document
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