31B-179 ►Dpv►s cG- _, BP-2023-1046
25 HENSHAW AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-179-001 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-2023-1046 PERMISSION IS HEREBY GRANTED TO:
Project# ADA RENO 2023 Contractor: License:
Est. Cost: 80512 WRIGHT BUILDERS 065521
Const.Class: Exp.Date: 01/25/2024
Use Group: Owner: COLLEGE SMITH
Lot Size (sq.ft.)
Zoning: EU/URC Applicant: WRIGHT BUILDERS
Applicant Address Phone: Insurance:
48 Bates St 413586-8287 MCC20020005342023A
NORTHAMPTON, MA 01060
ISSUED ON: 08/08/2023
TO PERFORM THE FOLLOWING WORK:
ADA/MAAB IMPROVEMENTS -PHASE 1 RENO BATHROOMS
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: ,
Fees Paid: $564.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
V--
The Commonwealth o Massac'q�'1,:tts
,r'jv ,f, ��
Office of Public Safety d Inspection tiv o
41 Massachusetts State Buildin Code(780 CMR) 2.0 O
Building Permit Application for any Building of r than a One-o Civil ami well •g
0
(This Section For Official Use y) g<p%
Building Permit Number�3•�� Date Applied: Building Official: � I6,
SECTION 1:LOCATION
25 Henshaw Avenue Northampton MA 01060 Smith College-The Davis Cen -r
No.and Street City/Town Zip Code Name of Building(if applicable)
318 179-001
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used 780 CMR If New Construction check here Ei or check all that apply in the two rows below
Existing Building 0 Repair 0 Alteration 0 Addition❑ 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 th.s pennit application? Yes 2 No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No 0
Brief Description of Proposed Work:ADA Improvements-Phase 1 will be Just refinishing bathrooms for accessability.Phase 2 will include ADA improvements
Kitchen space and exterior entrances.New handrails,Signage.Interior Improvements.
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): R-2 Proposed Use Group(s):R-2 -
SECTION 4:BUILDING HEIGHT AND AREA
_
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) 3 1455 SF 3 No Change
Total Area(sq.ft.)and Total Height(ft) 3,200 SF 2 Story No Change No Change
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4❑ A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2 0 R-3 0 R-4 0
S: Storage S-1 0 S-2❑ U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA D IB0 IIA0 IIB0 IIIA0 IIIB0 IV CI VA VB0
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 0 Check if outside Flood Zone 0 Indicate municipal 0
A trench will not be Licensed Disposal Site 0
Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify:
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes 0 or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE O F OCCUPANCY
Edition of Code: 780 CMR Use Group(s): R-2 Type of Construction VB
Does the building contain an Sprinkler System?: No Special Stipulations:.
Design Occupant Load per Floor and Assembly space: Per Code
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Smith College 100 Elm Street _Northampton, MA 01060
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Charlie Conant- Sn. PM 413 _323. 5225 cconant@smith.edu
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Wright Builders Inc 48 Bates Street Northampton MA 01060
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 Eli.
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)
Charles Roberts,Kuhn Riddle Architects
croberts@kuhnriddle.com MA 10107
Name(Registrant) Telephone No. e-mail address Registration Number
28 Amity Street Suite#2B Amherst MA 01002 A 6/31/2024
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Wright Builders Inc
Company Name
Steven Barrett U: CS-065521
Name of Person Responsible for Construction License No. and Type if Applicable
97 Federal Street PO Box 503 Belchertown MA 01007
Street Address City/Town State Zip
413 _586_8287 _ _ sbarrett@wright-builders.com
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE ANr1DAVTT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of In ustrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the enial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes D No 0
80,512/1000=80.512 x 7=$564.00 JON 12 CONSTRUCTION COSTS
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $72,257.00 Building Permit Fee=Total Co n Cost x (Insert here
2.Electrical $0 appropria:e m cipal factor)
3.Plumbing $8,255
4.Mechanical (HVAC) $0 Note:Minimum f = _ conta municipality)
5.Mechanical (Other) $0 Enclose check payab:e
6.Total Cost $80,512.00 (contact municipality)and write check number here 4p at q?
SECTION 13:SIGNATURE OF BUILDING PERMIT, APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my knowledge and understanding.
Nicholas Wright ,f/..c fskzs.G[/,.f,ft Estimating/Sales 413_ 586 _ 8287 7/31/2023
Please print and sign name Title Telephone No. Date
48 Bates Street Northampton MA 01060 nwright@wright-builders.com
Street Address City/Town State 2ip Email Address
Municipal Inspector to fill out this section upon application approval:
Name Date
�YKAM City of Northampton
....".`...SAC/' Massachusetts
• ' K1 DEPARTMENT OF BUILDING INSPECTIONS y; ;
1 '.► ?` `f'v "' 212 Main Street • Municipal Building
\ Northampton, MA 01060 ssyh.. N'10
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 234 Easthampton Road,Northampton MA 01060
The debris will be transported by:
Name of Hauler: J&J Trucking LLC
Signature of Applicant: .i/ u/ Date: 7/31/2023
The Commonwealth of Massachusetts
Department of Industrial.4ecidents
i=° 1 Congress Street,Suite 1
: = �� i Boston,MA02114-201
e4
•N..�. 4. WNhW)k:ma_ss.s or/dta
11 orkers'Compensation Insurance Affiida%it:Builders/C ritEketricims/PIumbers.
10 RV tll.t•:!)VI 1111 1111 PERMITTING I1T110R1TY.
Applicant Information I Please Print l_e_rihlt
Name,iusincsss 3rganir$tion.'Individual): Wright Builders Inc
Address: 48 Bates Street
City/State/Zip: Northampton, MA 01060 Phone#:41�3-586-8287
Art roe at imp kneel('heck the appruprialc Irut:
Type of project(required):
10 I am a employer with 23 curplosecs tiull and or part-tirrw't-' 7. D New construction
2.01 air a wile proprietor or partnership and has+rut einri,n.i-,at..rkutg for nu:on K. 0 Remodeling
our caFt curt'.[Nu workers'comp.immature required"
9. 0 Demolition
AO t am a 11A,nwvtner doing all work myself.(No workers'emir.riwraucc E..vlwrreU.J
4.0 I am a hoevsrur and will be hiring ohnarae&ns to conduct all%oil on pregrcrts.. I'Aill
10 0 Building addition
m
eauure chart all contractors either hate%mie. .ssc1rlh-ut a1ion insurance 19 are scde 112 Electrical repairs or additions
proprietors with no cinployeea.
12.0 Plumbing repairs or additions
50 tam a general contractor and I hays hired the contractors listed on attached sheet
These sub-eunrraetu U.rs have employees and have mien:ovum.uura t, ree_ l 3.n Roof rY'pairs
14.0 Othe!
ti;0 We are acumination and its officers hav eu e etersed their rich,u„t cacnuintuwnt per hkiL e_
132,11(4),and sec hate no employees.[Nei wtnkers'comp_instnanee requiredl.i
'Ain,applicant that checks box u I mum also fill out the section helms showing their w utkers'compensation policy infotn atiun.
'IImmo."rrers Who subrnit this attidatit indieatiiw they.arc doing all stork and than 4ruc eotsidc ee tiractun must submit a metu.affidat it indicating shwh.
:contractor,.that check this hot must attached an additional sheet show inr the name of the swtr-ceaurractcrs and state Nhelher or not those entities have
ernple,secs.. It the sub-euuiraetews have employees.they mug provide their worker..'comp.relic',number.
I ma an employer that is providing workers'compermation insurance for my employees. Below is the policy and job site
information.
Insurance Cotnpan}'Name: Massachusetts Employers Insurance Company/Phillips lnuurance Agency Inc.
Policy#or Self-ins.Lie.#: MCC-200-2000534-2023A Expiration Date: 3/1/2024
lob site Address: 25 Henshaw Avenue-The Davis Center ity/state/zip: Northampton MA 01060
Attach a cope of the workers'compensation polios declaration page(showing the policy number and expiration date).
I adore to secure coverage as required under NIGI.e. 152.§25A is a criminal t iulation punishable by a line up to SI.500.0(1
and or one-year imprisonment,as well as cio it penalties. in the form of a STOP WORK.ORDER and a line of up to S250.O0 a
day against the violator.A copy of this statement titati he firm.arded to the Otlice of Investigations of the I)l.\ fur insurance
coverage verification.
i do hereby certify under the pains and penalties of perjury that the information provided above iss true and correct
Su rntture: ,t2 2oa.G e t- Date: 7/31/2023
Phone#: 413-586-8287
Ofrtial n ue only. Du not write in this area,to he a tnnrplelerl hi cite or town official.
( its or Too n: Perntitil.icensetl
Issuing authority (circle cue):
1. Board of llrtlth 2.Building Department 1 CO Jout"(lerk 4.Electrical Inspector 5, Plumbing Inspector
6.Other
( oohed Person: Phone 4/: