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31B-170 (2) ] BP-2022-1468 / HENSHAW AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31B-170-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-1468 PERMISSION IS HEREBY GRANTED TO: Project# PARSONS HOUSE RENO Contractor: License: Est. Cost: 130000 FIRE SERVICE GROUP LLC SC145974 Const.Class: Exp.Date: 07/04/2024 Use Group: Owner: SMITH COLLEGE XINH SPANGLER Lot Size (sq.ft.) Zoning: EU/URC Applicant: FIRE SERVICE GROUP LLC Applicant Address Phone: Insurance: 1010 THORNDIKE STREET 14136689100 FIWC290917 PALMER, MA 01069 ISSUED ON: 11/21/2022 TO PERFORM THE FOLLOWING WORK: FIRE SPRINKLER SYSTEM 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Liv IL, • Fees Paid: $910.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner Adl Aipp I Pich,s riL ECG 1EI1'I.,- 1 t The Commonwealth of Massachusetts ZUZZm4)& , Office of Public Safety and Inspections( Massachusetts State Building Code(780 CMR)F;'T.OF BUIL DING NSPECTIONS Building Permit Application for any Building other than a One-orTliiiiiFtirialy t l $ng (This Section For Official Use Only) Building Permit Number. .?.—/'/i2 Date Applied:( Building Official: SECTION 1:LOCATION 24 Henshaw Ave, Northampton, MA 01060 Parsons House No.and Street City/Town • Zip Code Name of Building(if applicable) ,316 /70 J Assessors Map# Block#and/or Lot # SECTION 2 PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building® Repair 0 Alteration LF Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No ❑ Brief Description of Proposed Work: Install new fire sprinkler system within gutted building per NFPA 13 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING 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.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: t3usiness 0 E: Educational 0 F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H-4❑- H-5 0 I: Institutional I-1❑ I-2❑ I-3❑ I-4 0 M: Mercantile O. R!-Residential R-10 R-2 0 R-3 0 R-4❑ S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: ; SECTION 6:CONSTRUCTION TYPE(Check as applicable) • IA 0 IB ❑ IIA ❑ IIB ❑ IIIA ❑ Hilt IV 0 VA El VB 0 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: El Public CB Check if outside Flood Zone® Indicate municipal® A trench will not be Licensed Disposal Site y required!S or trench or specify: FSG Private 0 or indentify Zone: or on site system❑ permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: . MA Historic Commission Review Process: Not Applicable I21 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 • Yes 'prNo.l •:: , Yes❑ No ❑ SECTION 8:CONTEN'1'bF`CERTIF1CATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?:' ` $p&.ial Stipulations: Design Occupant Load per Floor and Assembly space: ,t - SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Keiter Builders 35 Main St Florence, MA Name(Print) No.and Street City/tTown Zip Property Owner Contact Information: Scott Keiter 413-586-8600 _ skeiter@keiterbuilders . com Title Telephone No.(business) t Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Fire Service Group 1010 Thorndike Street, Palmer MA 01069 Name Street Address City/Town State Zip to apply 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 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. a-nail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Fire Service Group, LLC • I Company Name Daniel P Belanger SC-14-5974 Name of Person.Responsible for Construction ., ,.License.No. and Type if Applicable Fire Service Group 1010 Thorndike Street, Palmer MA 01069 Street Address - City/Town' State Zip 4136689100 brenna@fireservicegroup. com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 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 signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ appropriate municipal factor)=$_T_LCL. 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ 13 0, 0 0 0 . 0 0 Enclose check payable to 6.Total Cost $ (contact municipality)and write check number here 5"g'i"7 SECTION 13:SIGNATURE OF BUI]LDING,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 to t •• t of my knowledge and understanding. Brenna K Hanechak -t Assistant Proj . Mgr. 413-6689100 7/1/22 Please print and.sign name Title Telephone No. Date 1010 Thorndike Steet, Palmer, MA 01069 brenna@fireservicegroup . com Street Address City/Town State Zip Email Address • n U I Municipal Inspector to fill out this section upon application approval: p) .✓1 Name � Da e