18D-026 (59) 55 DAMON RD BP-2019-0328
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18D-026 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-2019-0328
Proiect# JS-2018-002242
Est.Cost: $44000.00
Fee: $308.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PETER CASEY C/O MARKETING DOCTOR INC 078176
Lot Size(sq. ft.): 61419.60 Owner. SARDINHA EMANUEL
Zoning: GI000) Applicant. PETER CASEY C/O MARKETING DOCTOR INC
AT. 55 DAMON RD
Applicant Address: Phone: Insurance:
30 INDUSTRIAL DRIVE (413) 539-0500 Workers
Compensation
NORTHAM PTONMA01 060 ISSUED ON.9/14/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-UNIT#3 - INTERIOR WALLS, TRIMS, MILLWORK
& ELECTRICAL FOR OFFICE USE
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 9/14/2018 0:00:00 $308.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
Versionl.7 Commercial Building Permit May 15,2000
CEIVEDDepartment use only
JB
f Northampton Status of Permit:
ng Department Curb CutlDriveway Permit Main Street Sewer/Septic AvailabilitySEP 13 2018Room 100 Watern/vell Availability
pton, MA 01060 Two Sets of Structural Plans
[DtRE
OF BUILDING , ION81240 Fax 413-587-1272 Plot/Site Plans
RTHAMPTON,MA 0 0060 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
SECTION 1 -SITE INFORMATION
1.1 Property Address: 2 This section to be completed by office
��� � Gov /T 3 Map ti 'l Lot �� Unit
Zone Overlay District
- Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address: v "
Signature Telephone
2.2 Authorized Ascent:
Name(Print) 1A)C C ent Mailing Address
Signature 21 Tete
SECTION 3-ESTIMATED CO TRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building d•. - (a) Building Permit Fee
2. ElectricalZS�� (b) Estimated Total Cost of
Construction from (6)
3. Plumbing cr Building Permit Fee r
4. Mechanical (HVAC) �� , Cic:'O'ljQ 7i7
5. Fire Protection
6. Total =(1 +2+ 3 +_4+ 5) Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Ll- / 'X 7 1 . 'i I t�
Building Commissioner/Inspector of Buildings Date
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 ❑ Demolition❑ Repairs❑ Additions ;9' Accessory Building❑
Exterior Alteration ❑ ExistingGround Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other E]_._ .,1.._.. ......m.........._.._.
Brief Description 'Enter a brief description here.
Of Proposed Work: > u---GTP kCA-L
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ® 2A P9
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M 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: ' ��f"_`'
Existing Hazard Index 780 CMR 34): i! �' Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
_-
ist
St 3�-'7
2nd .2nd
3 d 3`d f
qth
th 4
Total Area(sf) Total Proposed New Construction s
Total Height(ft)
fi
Total Height ft t L-
7.Water Supply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public [2g Private 0 Zone Outside Flood Zone® Municipal 53, On site disposal system❑
Versionl.7 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
Open Space Footage
(Lot area minus bldg&paved
arkin
#of Parking Spaces
Fill:
volume&Location _
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW Q YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW 0 YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued
C. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO 0
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 ® NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
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 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):
_...._. ......._._ .._ _....._ . ...._.._ ..__..._. . _..e...._.._
Name Area of Responsibility
Address Registration Number
i
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
i
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
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 0 No
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, ............ .... _.. _... . ...___. . . . _�_. . ......_ . _....._ _ 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
E
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
__. ... ............_,... .
Name of License Holder. t� �`��"^ � '� L" NA
License Number
I li,t 4ATF(�-_1..b &kA t i 7� C z $
Address Expiration Date
�r
573 go iTl x. ,
Sign to Telephone
SECTION 13-WORKERS'COMPENSATION 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
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: s-6 O47qo7✓ 4-5
The debris will be transported by: DvSy '722-4&40-�
The debris will be received by:
Building permit number:
Name of Permit Applicant 'PerizW
Date Si rtureof Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
Workers'Compensation Insurance Affidavit: General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Business/Organization Name:
Address: I Z-
City/State/Zip: MA 0(03Y Phone#:
Are you an employer?Check the appropriate box: Business Type(required):
1.® I am a employer with employees(full and/ 5. ❑Retail
or part-time).* 6. ❑Restaurant/Bar/Eating Establishment
'XWI am a sole proprietor or partnership and have no 7. ®Office and/or Sales(incl.real estate,auto,etc.)
employees working for me in any capacity.
[No workers' comp.insurance required] g• E]Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152,§1(4),and we have 10.❑ Manufacturing
no employees. [No workers'comp. insurance required]* 11.❑ Health Care
4.❑ We are a non-profit organization,staffed by volunteers,
with no employees. [No workers'comp. insurance req.] 12.0 Other
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
**If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an
organization should check box#1.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name: �-
Insurer's Address: s'4-90 W04-,14 fi / 6 LJD
City/State/Zip: 64,0 , 'TX 75Z5 l
Policy#or Self-ins.Lic. # 0& V/64 _ CQ1`414P Expiration Date: 7/t`>/740 1 C
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,under the pains_andpenalties ofperjury that the information provided above is true and correct
Si nature: � Date: `7 <
Phone#: 413
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.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
www.mass.gov/dia
- rX/.5 7/1L)(
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply your insurance company's name,address and phone number along with a certificate of insurance.
Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members
or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy
is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of
insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town
that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you
have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the
Department at the number listed below. Self-insured companies should enter their self-insurance license number on the
appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that
must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town
may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit
must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business
or commercial venture(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this
affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street
Boston,MA 02114-2017
0 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
www.mass.gov/dia
Form Revised 02-23-15
r---5'-t�'--- _____ -9'_6�•- ---k'- r--fy -------g'-g'--------*r-- `---- 3'-g'- ---- '-11�" --�''6 '--y
I
I
5TV , I
, I 1
I � �
I I I
I I
I I
--------------g,_Ipj•______--
I I I
1 I 1
I I
1 I
I
_4 1 1
I I I
I
I I
I
i
I
I i
II
I 1
I I
I
I I
I I
I
I I
I I
I tl, I
I 9 I
I I I
I I I
I I I
I I I
I 1
2 --- -7k
I I
,amu �Da
I
I
,_a I 3-_a•_ _____7•_3•____x_ 1
I I
I 1 I
I I I
I � I
I I
I
v 113 1
. A'
�Y Gi
v
____19'_5 ---
r
I I I
I I I 1
I 1
1 �
I I
� I
1 I
� I
I , I
15-8^'
� I I
I p-6•
I
I Y I
1 �
, I I
1 a,_
I I I
I 1 1
y 3-_Z�•_ ______- --- ---------p_gJj------ __3'-10'__ _y-_51•__ _ y_g •__ ___y_p •___ __3'-10'__ ____�'-10•_____y_�,_-`" 6-
Marketing Doctor North
55 Damon Rd, Unit 3
Northampton, MA
09-05-2018
t
4
s
101'-g;'i EXIST MASONRY
•�• W-10' ' S'-IIS' g'-4' 9'-0' 4'40' T-10' 4'-6' 4'-0'
MA. M".
M.O. M.O. MA. .
—___—
-----__---
_ ——' 106 ———_——_ __� ——— —————— ————————— —————-
- 7--- L � I A.GMJ �
'Q'
JZTMEL ELEOT O O2
� FA/EL O
WATER SUB METER I n
� I
O I
I
I
I
I
I
I
I®�i
I
I
I
A
I 4
I I u
I
I
I
I
I
I QQ
la eY
I
4
ETR CMU BEARING WALL A42 r
OPENINGS TO BETE IIATM
�--� At LACR DATE (�
n �
I
:ENTER OF PEMIslN j
LL TO BE OENTEREP
MINPOW FRAME IRB]
I Q
I �
I
1 I
I
I
I
TENANT•3 j m
3)9B sF 6RO66
O SATO sF NET
I
I
I
I
Q v�
I
I
I
I
O -0
RE n
- `I
f cw
® ----- — .EIF
� 1
--___ -- --- ---- --- ----------- --- ----�_—_ --_ _—_---\ B
FS SIM µ'1 61M ! ` LOW NIGH
1'-11•S 4'-4•S ]'-11'S R'-,'� B'-O'S A'•T•S SLO' 4'-6' _ 6'-7,{'S
E'1R MA. BTR MA. GTR MA. MA. O}•
1011**EXIST MASONRY _
I FLOOR PLAN
1 9GALE V4'•I7
iovisions: WCOOOOOOC)
,,ORMATION PAGE
NORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY
6URER: The Hartford Underwriters Insurance Company
ONE HARTFORD PLAZA HARTFORD CT 06155
THE
lf
HARTFORD
NCCI Company Number: 10456
Company Code: 6
Suffix
LARS RENEWAL
POLICY NUMBER: 08 WEC CQ9146 �4
Previous Policy Number: 08 WEC CQ9146
1. Named Insured and Mailing Address: MARKETING DOCTOR INC
(No., Street, Town, State, Zip Code) 30 INDUSTRIAL DR
NORTHAMPTON MA 01060
FEIN Number: 45-5182697
State Identification Number(s):
The Named Insured is: Corporation
Business of Named Insured: Advertising Agencies
Other workplaces not shown above:
2. Policy Period: From 07/10/18 To 07/10/19 ANNUAL
12:01 a.m., Standard time at the insured's mailing address.
Producer's Name: BATES FULLAM INS AGENCY INC/RATS
975 ELM STREET
WEST SPRINGFIELD MA 01089
Producer's Code: 08088509
Issuing Office: THE HARTFORD BUSINESS SERVICE CENTER
3600 WISEMAN BLVD
SAN ANTONIO TX 78251
(877) 853-2582
Total Estimated Annual Premium: $1,145
Deposit Premium:
Policy Minimum Premium: $294 MA (Includes Increased Limit Min. Prem.)
Audit Period: ANNUAL Installment Term: Two Pay (60%Down+1@40%)
The policy is not binding unless countersigned by our authorized representative.
Countersigned by 05/31/18
Authorized Representative Date
et. �
Form WC 00 00 01 A 1 Printed in U.S.A. Pa est' Continued n n A page)
Process Date: 05/31/18 Policy Expiration Date: 07/10/19
s
P
f
,4TION PAGE (Ccr ! --ed) Policy Number: 08 WEC CQ9146
A. Workers Compensatio- -__-ance: Part one of the policy applies to the Workers Compensation Law of the states
listed here: MA
B. Employers Liabiditpinsurance: Part Two of the policy applies to work in each state listed in Item 3.A.
The limits of our' 1 00 ur Part Two are:
An 09 injury by Accident $1,000,000 each accident
Body injury by Disease $1,000,000 policy limit
BocOy injury by Disease $1,000,000 each employee
C. Other Stales hus rance: Part Three of the policy applies to the states, if any , listed here:
ALL STATES D=EPT NORTH DAKOTA, OHIO, WASHINGTON, WYOMING, U.S.TERRITORIES AND STATES
DESFGNATE,Z -EM 3.A. OF THE INFORMATION PAGE.
D.This poicy includes these endorsements and schedule:
SEE F-0 430RSEMENT-WC 99 03 68
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans, All information required below is subject to verification and change by audit.
Premium Basis
C ms cations Total Estimated Rates Per Estimated
Code Number and Annual $100 of Annual
Description Remuneration Remuneration Premium
Tota Standard Premium $766
Excense Constant $250
Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement $87
Estimated Annual Premium (before Surcharges) $1,103
Total Estimated Surcharges $42
"See the attached Schedule(s)of Operations for Location and State Level Premium Information
Total Estimated Annual Premium: $1,145
Deposit Premium:
Policy Minimum Premium: $294 MA(Includes Increased Limit Min. Prem.)
Interstate/Intrastate Identification Number: Refer to Schedule of Operations
NAICS: 541810
Labor Contractors Policy Number: SIC: 7311
Form WC 00 00 01 A (1) Printed in U.S.A. Page 2
Process Date: 05/31/18 Policy Expiration Date: 07/10/19
Versionl.7 Commercial Building Permit Nlay 15.2000
Department use only
City of Northampton Status of Permit.
Building Department Curb CutiDrivewey Permit
212 Main Street SewerlSeptic Avadabili
Room 100 WaterNdetl Availability
Northampton, MA 01060 Two sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plotlsite Plens
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
SECTION 7 -SITE INFORMATION
This section to be completed by office
1.1 Property Address
5 aom�; f &oU 17-
Map Lot Unit
Ak� /'/—&7A)'r en 14 Zone Overlay District
Elm St,District ce District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owns, or f Record:
A/vt+t rC soh' Ptr'641,. R44 ..,5 7.%
Name(Print) Current Mailing Address:
-'
Signature Telephone
2,2 Authorized cent'
r�ldn p�r t 1 /fu t"1 t�
/tA r, !
Name(Print) IA-'_ Current Mailing Address:
Signature � i elcphonc
SECTQN 3-ESTIMATED COTRUCTION_COSTS
Item Estimated Cost(Dollars)to be ONiclal Use Only
cam feted by ermit applicant
1. Building •,t- �, (e)Building Permit Fee
2, Electrical (b)Estimated Total Cost of
r L Construction from(8
3. Plumbingc Building Permit Fee
4. Mechanical(HVAC) !
5.Fire Protection
6. Total=(1 +2+3 +4+5) Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Corn mlaslonerllnspactor of Buildings Date
r,
!ft
s- •
Northampton Building Department
#100, 212 Main St
Northampton, MA 01060
September 13, 2018
Dear Northampton Building Department,
I request that you grant a modification to waive the requirement for control construction for
the interior buildout of Unit 43 located at 55 Damon Rd, Northampton because the work is
of a minor nature, will not affect health, accessibility, life and fire safety, or structural
requirements and is impractical in that the cost of control construction is considerable when`
compared to the cost of the proposed work. Thank you for your consideration. Mass
Amendments, sections 107.1 allows for an exclusion from control construction for this
project.
Warm regards,
e—te Casey
Principal
MA CS#078176
i