North Commons Building Permit App 8-1-2020DocuSign Envelope ID: E2E56795-C618-43FA-82DD-A8E999557671
~ The Commonwealth of Massachusetts @} Office of Public Safety and Inspections
Massachusetts State Building Code (780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: I Date Applied: I Building Official:
SECTION 1: LOCATION
Lot 13A Village Hill Northameton 01060 North Commons (1il Village Hill
No. and Street City /Town Zip Code Name of Building (if applicable)
Mae 31C, Lot 17
Assessors Mao # Block# and/ or Lot #
SECTION 2: PROPOSED WORK
Edition of MA State Code used --H New Construction check here l!J or check all that apply in the two rows below
Existing Building D Repair D I Alteration D I Addition D I Demolition D (Please fill out and submit Appendix 2)
Change of Use D Change of Occupancy D I Other D Specify:
Are building plans and/ or construction documents being supplied as part of this permit application? Yes Dll No D
Is an Independent Structural Engineering Peer Review required? Yes D No JO
Brief Description of Pro~sed Work:
Construction of new 3 unit passive house apartment building
SECTION 3: COMPLETE TlilS SECilON IF EXISTING BUILDING UNDERGOING RENOVATION, ADDffiON, OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed (See 780 CMR 34) D
Existing Use Group(s): I Proposed Use Group(s):
SECTION 4: BUILDING HEIGHT AND AREA
Existing Proposed
No. of Floors/Stories (include basement levels) & Area Per Floor (sq. ft.) 3 +attic varies
Total Area (sq. ft.) and Total Height (ft.) 61,323 40'
SECTION 5: USE GROUP (Check as applicable)
A: Assembly A-1 D A-20 Nightclub D A-3 D A-40 A-5 D I B: Business D E: Educational D
F: Factory F-1 D F20 H: Hil!:h Hazard H-1 D H-20 H-3 D H-40 H-50
I: Institutional 1-1 D 1-2 D 1-3 D l-4 D M: Mercantile D I R: Residential R-10 R-2 JO R-30 R-40
S: Storage S-1 D S-20 U: Utility D I Special Use D and please describe below:
Special Use Description:
SECTION 6: CONSTRUCTION TYPE (Check as applicable)
IA D 1s a f nA D IIB D I llIA D llIB D I IV C I VA Ill VB D
SECTION 7: SITE INFORMATION (refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal:
Public llll Check if outside Flood Zone IXJ Indicate municipal ml A trench will not be Licensed Disposal Site [!
Private D or indentify Zone: or on site system D required D or trench or specify:
permit is enclosed D
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable llll Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed D Yes D or No lil Yes Dll No D
SECTION 8: CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: 9th Use Group(s): R-2 Type of Construction: VA
Does the building contain an Sprinkler System?: Yes Special Stipulations: none
Design Occupant Load per Floor and Assembly space: n/a
---082
DocuSign Envelope ID: E2E56795-C618-43FA-82DD-A8E999557671
SECilON 9: PROPERTY OWNER AUTHORIZATION
N arne and Address of Property Owner
Future Owner
North Commons at Village Hill, LLC 185 Dartmouth Street Boston 02216
Name (Print) No. and Street City/Town Zip
Property Owner Contact Information:
Rachana Crowley 413 .923 .9022 rcrowley@tcbinc.org ---------
Title Telephone No. (business) Telephone No. (cell) e-mail address
If applicable, the property owner hereby authorizes:
Ziter Saloomey PO Box 1203 Westfield MA 01086
Name Street Address City/Town State Zip
to annlv for and act on the orooertv owner's behalf, in all matters relative to work authorized by this building permit aonlication.
SEcnON 10: CONSTRUCilON CONTROL (Please fill out Appendix 1)
If a building is less than 35,000 cu. ft. of enclosed space and/ or not under Construction Control then check here [J .
Otherwise orovide construction control forms (see section 107 in the code) as reauired.
10.1 Revistered Professional Resoonsible for Construction Control (the professional coordinating document submittals)
Ziter Saloomey 413.531 .0062 ziters@saloomey-construction.com 018780 -----
Name (Registrant) Telephone No. e-mail address Registration Number
PO Box 1203 Westfield MA 01086 cs 11131121 ---
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Saloomey Construction
Company Name
Ziter Saloomey 100978 6124/2022
Name of Person Responsible for Construction LlcenseNo. and Type if Applicable
62R School Street PO Box 1203 Westfield MA 01086 ---
Street Address City/Town State Zip
413 .269.4360 413-531 .0062 ziters@saloomey-construction.com --------
Telephone No. (business) Telenhone No. (cell) e-mail address
SECilON 11: WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L c. 152. § 25C(6))
A Workers' Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a siO'T'led Affidavit submitted with this annlication? Yes II No C
SECilON 12: CONSTRUCilON COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost (from Item 6) = $
1. Building $ 8,119,659.00 Building Permit Fee= Total Construction Cost x __ (Insert here
2. Electrical $ 964,674.00 appropriate municipal factor) = $
3. Plumbing $ 576,000.00
4. Mechanical (HV AC) $ 1,079,447.00 Note: Minimum fee = $ ( contact municipality)
5. Mechanical (Other) $ 266,500.00 Enclose check payable to
6. Total Cost $ 11,006,280.00 (contact municipality) and write check number here
SECilON 13: SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below6 I heri attest under the pains and penalties of perjury that all of the information contained m this
application is true and q~i°a°fJ~ ~~st of my knowledge and understanding. ~~e...o ... ,
413 923 9022 7/30/2020 Rachana Crowley Authorized Agent ------
Please print and sign name Title Telephone No. Date
165 Dartmouth Street Boston MA 02116 rcrowley@tcbinc.org ---
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval:
Name Date
DocuSign Envelope ID: E2E56795-C61S-43FA-82DD-A8E999557671
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: __ _ LOT:. __ _
LOT SIZE: ____ _
REAR LOT DIMENSION: __________ _
REAR YARD ___ _
SIDE YARD ____ _ SIDE YARD ____ _
FRONT SETBACK ____ _
FRONTAGE _______ _
DocuSign Envelope ID: E2E56795-C618-43FA-82DD-ABE999557671
City of Northampton
Massachusetts
DEPARTNEN'l' OF BUILDING INSPECTIONS
212 Main Street• Municipal Building
Northampton, MA 01060
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, 554, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: ~ it'. C-4<: f u c7 /1 I) q J J
The debris will be transported by:
/ _/7
Na me of Hauler: -"'-U ..... S"""!l-'-'--d/o.,_,_.......,1..,,.(_l ___ ,;'-'J-'ir(J-'l ....,,A ...... ft..._0,_(?j'+/_._'(_,_/;......,J"""-.:,,.ct--____ _
Initial Construction Control Document
To be submitted with the building pennit application by a
Registered Design Professional
for work per the 9'h edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: North Commons Date:07 /06/2020
Property Address: Olander Drive, Lot 13A, Northampton, MA 01060
Project: Check (x) one or both as applicable: X New construction Existing Construction
Project description: New construction of(53) unit residential building and associated common spaces.
I , Clifford J. Boehmer, MA Registration Number: I 0697 Expiration date: 8-31-20 , am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans, computations and specifications
concerning':
X Architectural
Fire Protection
Structural
Electrical
Mechanical
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 of780 CMR 107.
When required by the building 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'.
Enter in the space to the right a "wet" or
electronic signature and seal:
Phone number: (617) 283-7878
Building Official Name: Permit No.:
Email: cboehmer@davissquare.com
Building Official Use Only
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
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 9 1• edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: North Commons Date:07 /06/2020
Property Address: Olander Drive, Lot 13A Northampton, MA 01060
Project: Check (x) one or both as appucao1e: X New construction Enstlng Construction
Project description: New construction of 53 unit residential building and associated common spaces.
Christopher Chamberland
I MA Registration Number: 51074 Expiration date: 6/30/22 , am a registered design professional, and I have
prepared or directly supervised the preparation of all design plans, computations and specifications concerning':
Architectural
Fire Protection
Structural
Electrical
Mechanical
Other: Civil
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 building 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'.
Enter in the space to the right a "wet" or
electronic signature and seal:
Phone number: (413) 582-7000 Email: chri,c@berkshiredesign.com
Building Official Uoe Only
Building Official Name: Permit No.: Date:
Nole 1. Indicate with an 'x' project design plans, computations end specifications that you prepared or directly supervised. If 'other' ii chosen,
provide a description.
Vmion 06_11_2013
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: ~N=o=rt=h~C=o=mm==o=ns~ ___________ Date: 07/06/2020
Property Address: Olander Drive, Lot 13A, Northampton, MA 01060
Project: Check (x) one or both as applicable: New constructio~ Existing Construction
Project description: New construction of 53 unit residential building and associated common spaces.
I, Terry A. Louderback, MA Registration Number: 28641 Expiration date: 6/30/2022, am a registered
structural engineer, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
Architectural
Fire Protection
l~S_tr_u_ctu_r_al _____ ~!Mechanical
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:
1. 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 building 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'.
Enter in the space to the right a "wet" or
electronic signature and seal:
Phone number: ~16=1~7)~92=6~-~61=0=0~ _____ Email: tlouderback@souzatrue.co
Building Official Name:
Version 01_01_2018
Building Official Use Only
Permit No.: Date:
DocuSign Envelope ID: E2E56795-C618-43FA-82DD-A8E999557671
Tire Co••onWfflltli of Masmcliusem
Dq,amnent of lndMstrial Accidents
I Congrt!SS Street, Suite JOO
Boswn, MA 02114-2017
WWW..lffllSS.gm,/dia
Wo,i<en' Compeeutloa IMuranc,, Affidavit: Bullden/Conlrttlon/Elfftririani/Plumben.
TO BE FIL[D WITH TH[. Pt:RMITTING AUTHORIT\'.
Applic,al lnforaulioa Ple~al L<gibly
Name (11uai"°'"'°'P"izatioo11..iivi<1ua11: 0'aJo Q azy f'o 61 S;tp If( t;z<1 o=:'
Address: ?o M X /,lo 3 .
City/State/Zip: !UtSfh/' /al /714 o;o}(., Phone#: /-/A:l-o?/2 'i-'le{{,()
An,-_ _..,.o,! Cludl .............. '-'
l.riJ I am a empk,,jes-widl _____ emplo)'l:!ei (fitll amdlor pan-tim:).• 10 ) am a sok p,::ipridur or pm1il!M.hip and haw nD employ em worli:ing hr rm in
any capacity. [No worttn' comp. imwana: n,quirai.J
JO I am a ho~ ooins all \lturk m)Vlf. (No ,1.-od.cn' coqi. utloUrani.~ requittd.) '
4.0 I am a homeuwnl!'r 1111d wiU be bina WlllraCIOB IO r..-.idlk.1: all work un In!,' pn:,pert). I •·i.11
l!'lllillh't' 11w all conlrai:10n rtilbt:r ha'tr WOfkcn.• r..~ iMu:ruicr « ~ llOk
rwoptitturs ,_.,ith no emplCl)'t"CII..
'CJ I am a genrral caab111:10r and l la'te b.irt'd lbe S11b-t:ontnc10l"li li!ilrd un lhc 1111ar..iiiod ~
Tbnt S11~0Dbac10n; la'o'l! employus and la'o·e wmt.~· iCCnip. ins~..:-.:
6.o Wrt are a i.."Ofplnlion. and iu. otTIICffll ha'llrtcx.en.'Ued lbcir rigbl of eJi~ pt:r MGL L".
1 'Sl f I( 4). and Wit haw DO emplO)'fti. [No wOl'Urll' !Xlmp. iti'llUl'6dert r-equ:ind. 1
Typt of projett ( required):
7 _ ~ New construction
S. O Remodeling
9_ D Demolition
IO O Building addition
11 O Electrical repairs or additions
12-0 Plumbing repairs or additions
110 Roof repairs
14_Q01her ______ _
•An)' applie:Ml thai cll«:lu box #I mllll •ho fill out thr RCIKlll lwlcw d1ov111n1 lheir workas' OOJnP'.'ll!UWCl'l pohcy infOffllll.lllXI.
t Homeo'al-·mtni who !litnmit t:hi.!r. 11.tfida\,it mdacating dw)' an: doiay all work 1:1..nd Ihm hire ollb:idr emtntun mllll submit a 111."W a.trtd:a\li1 indi~i!: illl:b.
:.Coattacao01, !hat check this. boJc. mlblt ana::bed an additiuaal sbett !libov.·ina lhc came of~ ~ton and~ ~ or no1 ~ mtitio ha\~
eanplO)Wll. l(lh.!: !lillb-i:Olllraek:lri la\~ cqi,IU)'l!U. dw)' mwa gro"'·idiediffl workmi' Ol:llnp. poliic)' 111i.nber.
I aa 1111 -pll,~r tlurt /$ prow,11111 .. ortun' co,yt1IIStlliot1 l1UM"'11tt for •1 -ro1tts. BtltN Is tilt polity tu1tl Job 11N ,_,.___ .
ln<uranceCompanyName I.!) t.4± Om(') J,L.Lu1 L WLtJQ/?{'J!
Policy # or Self-ins. Lie. #: 8,f!I p £ / O<p Zf J Expiration Date: / {) -/ J-cl /
JobSiteAddre .. : /d/t Y/-~~j' /w// City/State!Zip:~~~~,-7?;11'.Z 0/))&,,
Atta<II I ropy ortt,e worktts' comp<~ polit)' -.tloto I'll• (lhowlng tbe pollcy nlllb ... ~ .~ radon dii'te).
Fllilw., to secure coverage as required under MGL c. 152. §25A i• a criminal violation punishable by a tine up to Sl.500.00
andlor one-year imprisonment. as well a. civil penalties in the form of a STOP WORK ORDER and a tine of up to ill0.00 o
day against the violator. A copy of d>is statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Si
S 111111 pnrllitla of pnj,uy INI lilt lttf--prtnidtt/ II
p
Date: d
Ofll<IIII 11.U only. 0., IIOl ""1tt /11 111/s IIIWI, to M ~ltUd "1 dty or -ojJkllll
City°'" T.,.., ______________ Permil/Llttnse # ____________ _
1 ... 111g Aatllorily (drcle ene):
I. Board of He•IIII 2. BuJldln« Depari-nt 3. Chyffowa Clerk 4. Elttlrital IMpeclor 5. Pllunblng huptttor
6. Otber ___________ _
Con!MI Penon: Plloae #: