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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 2 of 2