Loading...
24D-070 (41) 238 KING ST-STOP&SHOP BP-2021-0084 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24D-070 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: renovation BUILDING PERMIT Permit# BP-2021-0084 Project# JS-2021-000132 Est. Cost: $800000.00 Fee: $5600.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ROBERT FERS COMPANY 063289 Lot Size(sq. 1): 330184.80 Owner. STOP&SHOP Zoning: HB(100)/URA(0)/ Applicant. ROBERT FERS COMPANY AT. 238 KING ST - STOP & SHOP Applicant Address: Phone: Insurance: 134 MIDDLETOWN (203) 239-1955 U WC NORTH HAVENCT06473 ISSUED ON.7/30/2020 0:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATION OF SALES FLOOR 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 7/30/2020 0:00:00 $5600.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner JUL Z 2 2020 The Common�veafth of Massachuse _rc,�co,,,,�,�,sP rl,II T � i CT,ONS Office of Public Safety and Inspections - °N•rna.oinso � � Massachusetts State Building Code(780 CMR) BuildingPeanut Application for an Building other than a One-or Two-Family Dwelling PP Y g Y g (This Section For Official Use Only) Building Permit Numb •?l � Date Applied: Building Official: SECTION 1:LOCATION 44Z -SAAgo&N No.an�treeet ty/T -7Zip Code ame of Building(if applicable) Assessors Map# Block#and/ Lot # SECTION 2-PROPOSED WORK , Edition of MA State Code used If New Construction check here q or check all that apply in the two rows below Existing Building❑ Repair Cl I Alteration I Addition❑ Demolition ❑ (Please fill out and submit Appendix 2) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes No ❑ Is an Independent Structural Engineering Peer Revim,required? Yes ❑ No Brief ption of Proposed o SECTION 3:COMPLETE THIS SECTION IF EXISTING BUMDING.UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) 1< CS 6 SEC'T'ION 5:USE GROUP(Check...applicable A. Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto , F-1❑ F2❑ H: Hixh Hazard H-1❑ H-2❑ H-3 ❑ H-4 0 H-5❑ I: Institutional I-1❑ I-2❑ I-3❑ 1-4❑ M: Mercantile R: Residential R-10 R-2❑ R-3❑ R-4❑ 5: Storage S-1❑ S-2❑ U: Utility❑ 1 Special Use❑and please describe Below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ IIB [ DIA E3 IIIB ❑ IV 13 1 VA 13 VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on-each item) Water Suppl Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public Check if outside Flood Zoned Indicate municipal A trench will not be Licensed Dispo al ❑ : Private 13 or indentifp Zone or onsite system required❑or trench or specify ❑ permit is enclosed❑ Railroad right-of-w Hazards to Air Navigation: MA Historic Commission Revie A,Process: Not Applicable Is Structure within airport ap oach area? Is their review compl ed? or Consent to Build enclosed El Yes 13 or Nor Yes❑ No SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9:.-PROPERTY OWNER AUTHORIZATION Name andddress of Propertyi-Owner — / ! Q `A ]*am,(P t) I r No.and Streetity/Town Zip Property Owner Contact Information: p itle Telephone No.(business) TeIephone No. (cell) e-mail address If a plicab)e,the property owner hereby authorizes: Name Street Address City/Town State Zip 7 to a 1 for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 3500 cu.it.of enclosed space and/or not under Construction Control then check here 13. Otherwise provide constivction cnntml forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) 041- W6 "6T Rt Tt�hNo. e-mail aJ s Retr�a'on Number Street Address City/Town State Zip Discipline Expiration Date 102 General Contractor- d I . . s yt� Company ame 1V1;CAeA_tA el CS - 463Z82 Name of Person Ren ible for Cons 'on U No. and Type if Applicable ray it �e /!/orfs G��� 57- G�yTj Street Address City/Town State Zip Telephone No.(business) Teie hone No.(cell) e-mail address SECTION 11:WOM,-ERS COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§2SC(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' suance of the building-permit. Is a signed Affidavit submitted with this application? YesX No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT THEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ per � Building Permit Fee=Total Construction Cost x ere 2 Electrical $ QiQQ appropriatte�e..,,m,��uniclual factor) � _ 4.Mechanical AC $ Note:Minimum$ B ntat 6DDC� 3.Plumbing $ O 5.Mechanical (Other) $ Enclose check payable to 6.Total Costaq $ (contact municipality)and write check number here .2 137 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate t est ofy kn dge and understanding. Z3 by7 2/ Pleas print d s' a tle ,.. ee ho e o. Date �'/ Street Address City/Town State Zip Email Address Municipal inspector to fill out this section upon application approval• _k&M 0 Name i Date I �- The City of Northampton 4, Building Department 212 Main Street Northampton,Massachusetts 01060 Phone (413) 529-1402 Fax (413) 529-1433 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance with the provisions of MGL c40, s54, 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__ --- ---- ---- --------- The debris will be transported by: Name of Hauler— _ _ _ _ _ _ _ _ — - -- — _ _ _ — _ _ — Signature of Applicant : _ ____ ___ ___ ___ _Date:__ __ Retail Business Services July 13th, 2020 City of North Hampton Building Department 212 Main Street Northampton, MA 01060 To Whom It May Concern: Robert S Fers Inc. is authorized to act as our agent regarding permits and other matters concerning the Online Pick-up permit work at Stop & Shop #787 located on 228 King Street Northampton, MA 01060. If you have any questions, please do not hesitate to contact me. Sincerely, Korie A. B. Kritzky Manager of Construction Projects The Stop &Shop Supermarket Company, LLC c/o Retail Business Services 1385 Hancock Street Quincy, MA 02169 C: 860-916-1823 ,e The Contrnonwealth of Massachusetts Com` Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia «Yorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED VIgTH THE PERMITTING AUTHORITY. Applicant Information Please Print Le0bly Name(Business/Organization/Indi,.idual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of.project(required): 1.0 I am a employer with employees(full and/or part-time)., 7, []New construction 2.Q I am a sole proprietor or parmership and have no employees working for me in $, 0 Remodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]r 9. 0 Demolition 4.❑1 am a homeowner and ttrill be luring contractors to conduct all work on my property. I will 10[]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.M Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have-workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box most attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. lam 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.Lic.M 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of lnvestigations 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: Phone#: 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 b.Other Contact Person: Phone#: r Client#: 1021709 ROBERS3 ACORDTM CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 12/23/2019 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(ies)must have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCERT NAME: USI Insurance Services LLC PH A/C ONE No, o xt: AIC No g55 874-0123 203 634.5701 E 530 Preston Avenue E-MAIL Meriden,CT 06450 ADDRESS: 855 874-0123 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A•Tmvelem Indemnity Company 25658 INSURED INSURER B:Continemal Insurance Company 35289 Robert Fars,Inc. INSURER C:Farmington Casualty Company 41483 134 Middletown Avenue Charter Oak Fire lnsuranceCompany 25615 North Haven,CT 06473 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH 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. LTRR TYPE OF INSURANCE INR WVD POLICY NUMBER POLICY M DIDY� MM/DDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY DTC04FO13266IND20 1/01/2020 01/01/2021 EACH OCCURRENCE $1,000,000 CLAIMS-MADE a OCCUR PREMISES EaEocccE occurrence) $300 OOO MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑JECOT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY 8103LO126262026G 1/01/2020 01/01/2021 ES Oa.d.nINGLELIMtT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED ONLY X NON-OWNED PROPERTY DAMAGE $ AUTOSAUTOS ONLY Per accident $ B X UMBRELLA UAB X IOCCUR 6056649909 1/01/2020 01/01/2021 EACH OCCURRENCE $10,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $10,000,000 DED I X RETENTION$1 OOOO $ C WORKERS COMPENSATION UB9J51552A2026G 1/01/2020 01/01/2021 X PER OTH- AND EMPLOYERS'LIABILITY Y/N OFfICER/PMREMBER�EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S27478107/M27475215 S9KZP Initial Construction Control Document w 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: Date: Property Address: P Project: Check(x) one or both as applicable: New construction Existing Construction Project description: I MA Registration Number: Expiration date: ,am a registered design professional,and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': 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: 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'. Falter in the space to the right a"wet" or electronic signature and seal: Phone number: Email• Building Official lIse OnZy Building Official Name: Permit No_ Date: Note 1.Indicate with an'x project design plans,computations and specifications that you prepared or directly supervised.If'othei is chosen,provide a description. Version 01012019 City of Northampton r Massachusetts i� l DEPARTMENT OF BUILDING INSPECTIONS �. 212 Main Street • Municipal Building Northampton, MA 01060 INSPECTOR Louis Hasbrouck Fax: 413-587-1272 Chuck Miller Building Commissioner Phone: 413-587-1240 Assistant Commissioner CONSTRUCTION CONTROL DOCUMENT (For professional Engineers/Architects responsible for Entire Project) Project Title: Stop & Shop #787 - Remodel- Date: 07/09/2020 Project Location:228 King Street Map:240 Parcel:070 Zone:001 Scope of Project: Remodel of existing Stop & Shop grocery; includes general conditions, structural, mechanical, electrical and plumbing scope of work. In accordance with the Eighth edition Massachusetts State Building Code, 780 CMR Section 107.6: Christopher K. Doersehlag Mass. Registration# 9467 Being a registered professional Engineer/Architect hereby CERTIFIES that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [A ENTIRE PROJECT For the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 10.7.6.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 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, in general, if the work is being performed In a matter consistent with the construction documents. I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent comments. Upon completion of the work, I shall submit to the building official a final report as to the satisfactory completion and readiness of the project for occupancy. • G\S.IEREO ARc'yi Sign d Professional /Q�oQ�ER K.p�FC+ a n a NO.9467 i I COLUMBUS S Day of , 2030 OH J OF MASS Appendix 1 Construction Documents are required for structures that must comply.with 780 CMR 107.The checklist below is a compilation of the documents that,may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents' Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural K104 y Fire Suppression 5 Fire Alarm ma require repeaters) 6• HVAC 7 Electrical 8 Plumbinginclude local connections 9 Gas(Natural,Propane,Medical or other) Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Ins ections Pro am 14 Fire Protection Narrative Report 15 Existing Building Sun a Investigation 16 Energy Conservation Report - 17 Architectural Access Review(521 CMR) 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify 21 Other(Specify) 22 Other(Specify) 'Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional. Contact Information w� '1,f ti LAS 6d--& 7 f2 Name(Registrant Telephone N : e-mail address Registra�on Number 7M7 s��ay AyeeA Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address ReiistratioLn Number Street Address Ci /Town State zip Dis lute Expiration Date Name(Registrant) Telephone No. e-mail address Re atiioyn�Number Street AddressCi /Town State zipDi Aplin Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals.