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19-012 (3) JDR Builders PO Box 4 North Hatfield, Ma. 01066 CSL#074105 HIC# 130397 June 25, 2014 Client: GE Healthcare Jobsite: 22 Industrial Drive East Northampton, Ma. 01060 Dear Sir: I request that you grant a modification to waive the requirement for control construction for the project at 22 Industrial Drive East in 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. Respectfully, Jame D. Ross JDR uilders VERSIGARD (Black) .045 INCH a .060 CH THICK NON-REINFORCED EPDM MEMBRANE NDARD AND FIRE RETARDANT(FR) .045 inch(1.1 mm)thick Wadc non-reinforced EPDM membrane is used for: 1. VersiGard Ballasted Roofing Systems .060 inch(1.5 mm)thldc Wack non-reinforced FR(Fire Retardant) EPDM membrane is used primarily for the VersiGard Adhered Roofing System. This membrane can also be used for the VersiGard Ballasted and Mechanically Attached systems. Note: Although.060 inch Non-Reinforced EPDM Is recommended for Adhered Roofing Systems,.045 inch FR Non-Reinforced EPDM may be utilized If specified. Test ASTM l Physical Property Method SPECAPass) •045 Standard 9.060" Tolerance on Nominal Thickness,% ASTM D 412 ±10 ±10 ±10 Tensile Strength,min MPa ASTM D 412 1305(9) 1550 10.7 1550 10.7 Elongation,Ultimate min % ASTM D 412 300 480 480 Tear Resistance,min,Ibf/in(kN/m) ASTM D 624 150(26.3) 200(35.0) 200(35-0) Die Factory Seam Strength,min. Modified Membrane Membrane Membrane ASTM D 816 Rupture Rupture Rupture Resistance to Heat Aging* ASTM D 573 Properties after 4 weeks @ 240°F(1160Q Tensile Strength, min,psi(MPa) ASTM D 412 1205 (8.3) 1500(10.3) 1500(10.3) Elongation, Ultimate,min,% ASTM D 412 200 225 225 Tear Resistance,min,ibf/in(kN/m) ASTM D 624 125(21.9) 215 (37.6) 215(37.6) Linear Dimensional Chan max % ASTM D 1204 t1.0 -0.4 -0.4 Ozone Resistance* Condition after exposure to 100 pphm ASTM D 1149 No Cracks No Cracks No Cracks Ozone in air for 168 hours @ 104°F(40°C) SDecimen is at 50%strain Brittleness Temp.,max deg. F . C)* ASTM D 746 -49(-45) -67 (-55) -67(-55) Resistance to Water Absorption* After 7 days Immersion @ 158°F(70°C) ASTM D 471 +8.0,-2.0 +2.0 +2.0 Change in mass max % - Water Vapor Permeance* ASTM E 96 max,perm (Proc.B or 0.1 .05 .05 BW Resistance to Outdoor(Ultraviolet) Weathering* No Cracks No Cracks No Cracks Xenon-Arc,7560 kJ/mz total radiant exposure ASTM G 155 No Crazing No Crazing No Crazing at.70 W/m? irradiance, 176°F(800 C)black panel temp. * Not a Quality Control Test due to the time required for the test or the complexity of the test. However,all tests are run on a statistical basis to ensure overall to term performance of the sheeting. VerslGard Tech Manual Update 12/2003 Vers!Gard EPDM Products 2003 - 3 VersiGard EPDM Roofing Systems Products This section lists and describes products manufactured or marketed by Versico. Refer to the"General Design and Planning"and/or respective"Installation"sections in this manual for their use and applicability. The components of Versico's Roofing Systems are to be products of Versico or accepted by Versico as compatible. The installation,performance or integrity of products by others,when selected by the specifier and act as compatible by Versico,is not the responsibility of Versico and is expressly disclaimed by the Versico Warranty. Consult the Versico Technical Data Bulletins for the shelf life limitation,coverage ral es and appNcration procedures of each product Refer to the manufacture's Material Safety Data sheets for applicable precautions and warnings prior to the use of any product. A. VERSIGARD EPDM MEMBRANES 1. Cured non-reinforced or reinforced EPDM (Ethylene, Propylene, Diene Terpolymer) compounded elastomer. Non-Reinforced EPDM membrane is available In(black)or(white-on-black). White membrane must be installed with the white surface facing up. Reinforced EPDM is available in(black)only. ' 2. VersiGard No-Dust(black)EPDM Membrane(mica dust has been removed during manufacturing) is available for sheets maximum 10'(3 m)wide.Refer to applicable"Installation"sections for installation procedures. 3. Membrane is available in various sizes as outlined below. a. Non-Reinforced EPDM Membrane Vers!Gard (black) .045" (1.1 mm) or .060" (1.5 mm) trick non-reinforced EPDM membrane - maximum 50' (15.24 m) wide, maximum 100' (30.49 m) long (.045" thick membrane is also available in 200'lengths)which meets ASTM D4637 and ANSI/RMA IPR-1. VerstGard(white-on-black).060"thick non-reinforced EPDM membrane-maximum 10' (3.05 m)wide,maximum 100'long which meets ASTM D4637 and ANSI/RMA RP-5. b. Reinforced EPDM Membrane(black only) VersiGard(black).045°and.060"thick reinforced EPDM membrane-4-1/2' (1.37 m),7' (2.1 m)or 10'wide,maximum 100'long;10'wide.045"thick membrane is also available in lengths of 200'(60.98 m). Reinforced with polyester fabric which meets ASTM D4637 and ANSI/RMA IPR- 2 - Refer to the physical properties listed on the following pages. VerslGard Tech Manual Update 1212003 VersiGard EPDM Products 2003 2 Reols SYSTBMS il�PPldcA'r91ol�S R�col�l�> las'eroNs Single-Ply,Mechanically Attached Modified Bitumen Cold BUR Hybrid Single-Ply, Fully Adhered Modified Bitumen Mopped Seff-Adhered Single-Ply,Ballasted BUR Ply Sheets Spray Foam(SPUR) 4.. Standard UL Class A/FM 1-90 Mechanically Attached Single-Ply System & 1. Metal deck 2. 11/2"rigid foam insulation 3. i/V STRUCTODEK HD fiberboard roof board $• 4. Mechanically attached EPDM,TPO, PVC, CSPE single-ply membrane 1. Q Standard UL Class A/FM 1-90 Fully Adhered Single-Ply System S. 1. Metal deck 2. 1 1/2" rigid foam insulation 3. 1/2"STRUCTODEK HD fiberboard roof board $. 4. Fully adhered EPDM PO )PVC,CSPE single-ply membrane 1, (solvent and water-based adhesive) j 4• ' Standard UL Class A/FM 1-90 Single-Ply Ballasted System $' 1. Metal deck 2. 11/2" rigid foam insulation $, 3. 1/2"STRUCTODEK HD fiberboard roof board 4. Ballasted EPDM,TPO, PVC, CSPE 4. Standard UL Class A/FM 1-90 Modified Bitumen System Cold/Hot Mopped S $. 1. Metal deck 2. 1 1/2"rigid foam insulation 3. 112"STRUCTODEK HD fiberboard roof board (. 4. SBS,APP cold or hot mopped g, Standard UL Class A/FM 1-90 Re-roof,Single-Ply $, 1. Metal deck 4. $• 2. Existing insulation 3. Existing roofing assembly 4. '/2"STRUCTODEK HD fiberboard roof board t. 5. Mechanically attached, fully adhered,or ballasted single-ply roofing membrane *Contact Manufacturer for Technical Information/Wamings/Warranty Information For further information on STRUCTODEK, including guide specs, - LEED information, and MSDS, visit www.blueddgefiberboard,com. info®blueridgefiberboard.com s 866-850-8834 3/10-1 OM STRUMOREK AM Lean STRUCTODEK is an environmentally friendly product that can help a design team earn LEED credits. The use of STRUCTODEK may contribute to the following LEED credits: • MR Credit 2: Construction Waste Management • MR Credit 4: Recycled Content • MR Credit 5: Regional Materials • MR Credit 6: Rapidly Renewable Materials • IEQ 4.4: Low-Emitting Materials-Composite Wood and Agrifiber Products FAWMING Pam R=1111111111ME s For fastening patterns, refer to FM RoofNav and/or membrane manufacturer for specific assembly requirements. U6 "P" AssemLy Rgoo�aeMa lrs STRUCTODEK is classified by Underwriters Laboratories Inc. Consult UL listing or system manufacturer for more information about specific systems. SYMMS MANO Aymaw AP nowAL I Additional joint listings from these manufacturers can be found in the current versions of the UL Roofing Materials and Systems Directory and FM Approvals/RoofNay. AFM Corp. Garland Co.Inc. Sarnafil Inc. Atlas Roofing Corp. GenFlex Roofing Systems Seaman Corp.Building Systems Bitec Inc. Haartz-Mason Inc. Siplast Inc. Bondcote Corp. Henry Co. Soprema Inc. Burkeline Roofing Systems Hydro Stop Inc. SPI Inc. Carlisle SynTec Inc. Hyload Inc. Stafast Roofing Products Centimark Corp. IB Roof Systems Stevens Roofing Systems Conklin Co. Inc. Imperial Adhesives Stymo Chem Int.Inc. Cooley Roofing Systems Intec/Permaglas Tamko Roofing Duro-Last Roofing Inc. Johns Manville The Garland Co. Ecology Roof Systems Lexcan Industrial Supply Ltd. Tremco Inc. Environmental Roofing Systems Liquid Plastic TH Ply ER Systems Malarkey Roofing Co. US Intec Inc. Firestone Building Products Co. Mule-Hide Products Us Flex Membrane International Performance Roof Systems Versico Inc. Flexible Products Polye#hane Systems Inc. '1�lP Systems Inc. GAF Materials Corp. Poiyglass USA `Check with specific membrane manufacturer for system warranty approval and required fastening pattern. THE S016U TION FOR A WIDE VARIETY OF LOW SLOPE APPLICATIONS AND SYSTEMS. Applications . • Insulation board • Cover board • Re-roof/re-cover board STRUMBEN F►mn Water absorption value of<7% (7% max per ASTM C 208) • UL Class A Systems approved as components (consult UL guide for approvals) • 1-60 and 1-90 systems approval per FMCR Standard 4450/4470 (see FM RoofNav for approvals) • Reduce asphalt bitumen absorption in coated one-side product • Maximum protection on all exposed surfaces with coated-six-side Thickness (nominal) Board Sizes 4'x 4' 4'x 4' 2'x 4' 2'x 4' 2'x 4' 4'x8' 4'x8' 4'x4' 4'x4' 4'x4' 4'x 8' Boards/Unit 4'x 4'=90 4'x 4'=60 2'x 4'=90 2'x 4'=60 2'x 4'=46 4'x8' = 90 4'x8'=60 4'x4'=45 4'x4' =30 4'x4'=23 4'x8'=45 Squares/Unit 4'x 4'=14.40 4'x 4'=9.60 2'x 4'=7.20 2'x 4'=4.80 2'x 4'=3.68 4'x8' =28.80 4'x8'=19.20 4'x4'=7.20 4'x4'=4.80 4'x4' =3.68 4'x8'=14.40 Deflection at specified x0.75'(09mm) No ASTM Data X0.42"(s11mm) No ASTM Data <0.21"(s5mm) min. load,max inches Flute Span 1 5/8'(40mm) 2 5/8"(67mm) 2 5/8"(67mm) 4 3/8"(111 mm) 4 3/8'(111 mm) CompunHcla • ASTM C 208 C �� US • ASTM C 209 • Factory Mutual Class 1 Approved=FMRC Standard 4450/4470 • CAN/CSA-A247-M86 Insulating Fiberboard Type 1 <S> • Canadian Evaluation CCMC #13186-L . • UL 790 tested and classified as a component in Class A Rated Systems APPROVED • UL Classified, reference TGFU,R20803 • UL Classified to Canadian Standard CAN/ULC-S107, reference TGFU7.R20803 BLUE RIDGE. FIBERBOARD CELOTEXTM STRUCTODEK. BLUE RIDGE. HIGH DENSITY ROOFING FIBERBOARD Fl B E R S 0 A R D s� PNODW1QIBW For more than 85 years.,the name CELOTEX has.been a standard bearer for quality fiberboard roof insulation. CELOTEX STRUCTODEK is now manufactured by BLUE RIDGE FIBERBOARD,INC.,a subsidiary of W.R.MEADOWS. Be assured that BLUE RIDGE will continue the longstanding CELOTEX tradition of delivering a quality product and providing superior service to the low-slope roofing market at a competitive:_pdce. STRUCTODEK high density roofing fiberboard _ has been tested and approved by major systems manufacturers who create today's roofing Systems. STRUCTODEK is available in various thicknesses;coating,and panel sizes to meet your needs. The product offers many benefits,including: • Approved in UL Class`A rated roof systems. Structurally riglol and"dimensionally stable board,easily handles heavy `foot traffic and wheeled'load . • Superior adhesion With LXCessabsoeption. • °Insulation properties with R ualues ranging from 1 3 to 5 0 laghtW@ight anti easy to Install without ttie irritating fibetlass dint of G < LaSSg fact tdypaUna liCtard a . �� s '' -ra - � r.�5-a� •eat: „ {� �, The Commonwealth of Massachusetts Department of1fidustrial Accidents r Office of Investigations N 600 Washington Street ' Boston, MA 02111 ,77 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): - Address: `Po City/State/Zip: Vta •�' . [)1or17 Phone#: V4 -7f k-� Are you an employer? Check t e appropriate box: Type of project(required): 1.�I am a employer with 4. � I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or_partner- listed on the attached sheet. 7: ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 E]Building addition [No workers' comp. insurance comp. insurance.$ 5. 7 We are a corporation and its 10.F-1 Electrical repairs or additions required.] �.❑ I am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12YR Roof repairs insurance required.] t c. 152, §I(4),and we have no 13.F1 Other 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. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. alaJt'r Insurance Company Name: ft i� L Ins, Co " Policy#or Self-ins.Lic.#: Expiration Date: — 7[— Job Site Address: Z 7 City/State/Zip: AtNo 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 un a the pains pen ies of perjury that the information provided above is true and correct. Signature: Date: Phone#: Of use only. Do not write in this area, to be completed by city or town offcciaL tty or own: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: } Version 1.7 Commercial Building Permit May 15,2000 J 4 SECTION 10-,STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes No SECTION 11 -OWNER AUTHQRIZATION-TO BE COMPLETED.WHEN. OWNERS AGENT OR CONTRACTOR APPLIES FOR`BUILDING PERMIT (� as Owner of the subject property hereby authorize` ...... �_!._cl�....._ .- ... -�_:.�, ___L� � ._., U. _ ,. _... . ........._ .-----to act on m ehalf, in all matters relative to work authorized by this building permit application. Signati.ee of Owner _Date 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 o ._........... Print Name \ m. Signature of O#r/Agent Date SECTION 12f CONSTRUCTION SERVI C ES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:,--.. .,A License Number Address Expiration Date Signature Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G L. 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 thebtoilding permit. Signed Affidavit Attached Yes No Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTIORSERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION,CONTROL.PURSUANT TO 780 G I MRJ16(CONTAINING. I ,MORE THAN 35,600 C.F.OF qN.SLO'5ED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): ................... Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility ........................—.-............ ................ .......... ......... ...... .............. ............ ............... Address Registration Number Signature Telephone Expiration Date ............................... ........ Name Area of Responsibility Address R�istration Number .--.----,, Signature Telephone Expiration Date .......... Name Area of Responsibility Address Registration Number ................... ............. Signature Telephone Expiration Date ............ Name Area of Responsibility Address Registration Number Signature Telephone I Expiration Date 9.3 General Contractor < Not Applicable ❑ Company Name: C 17VI Responsible In Charge of Construction e-Y, ............ ------ p )47 c 3 7y- 13t Signature Telephone 2 Version 1.7 Commercial Building Permit May 15,2000 S. NORTHAMPTON:ZONING s Existing Proposed Required by Zoning This column tore filled in by Building Department Lot Size Frontage Setbacks Front _..._ µ Side L-'_ R."L—J, L-1 R'--J' Rear Building Height Bldg. Square Footage Open Space Footage _ w % -- --• - (Lot area minus bldg&paved --- •_rude..... ....-..«...«,... t,.:..... sm...,»_. parking) #of Parking Spaces _... .,..- _.._.,.._ .._.....__._ _ .....__._ _ Fill: (volume&Location) -- — - A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW Q� YES 0 IF.YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES 0 IF YES: enter Book Page. and/or Document#i B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued On, Alb i F(72 k66FI,kJ& C. Do any signs exist on the property? YES � NO IF YES, describe size, type and location: $i jail L?�l3 ,J 77lY A,f /NG tt't14L7�+ ... .._ . N'v C i4-A1t,l cs - '0 N�16 S.. D. Are there any proposed changes to or additions of signs intended for the property? YES NO - 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 0 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 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 , r CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs CEk Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. Of Proposed Work i N,j TA—L& P V Us i C M(�-TAL' SECTION 5-USE GROUP AND'CONS.TRUCTION TYPE N O. U a— —n�y rx ( 5 T. ,U N74 A� '' USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 28 f ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ - . , 3A ❑ H'High Hazard El -- -_ _ _ _ = I.- -- -. Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 38 ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ UUtility ❑ Specify:3 _:�__ �._..�___._....._,_._._._..._........_. _._....__.�._...__......, ,.__.,..._._.-.�.-. __.._._._. .... M Mixed Use ❑ Specify S Special Use F-1 Specify: COMPLETETHIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONSAND/OR,CHANGE IN USE Existing Use Group. _M___. , __ _...__.__ __ ... _ Proposed Use Group. _ _,._ _.,. _ _,_, ___._- Existing Hazard Index 780 CMR 34):' _ 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) q: _. ist St __. __.. ,.�.._....._,......_...._.,_..____._.__, , 2nd 2 ° 3rd 3 rd 4tn 4m - Total Area (sf) Total Proposed New Construction(sf) w Total Height(ft) ! __....._ _. - - --- - Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood,Zonelnformation: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone[] Municipal ❑ On site disposal system E] t , Versionl.7 Commercial Building Permit May 15,2000 Departure t use,onfy f \°/ r ity of Northampton Status of Permit l` uilding Department Curb C�ut(Dntreway I?erm�: , JUN 3 Q 2014 212 Main Street SewedSepttcAvallafrftty - Room 100 Water/1Ne11 Rvaifabilify j Noi thampton, MA 01060 Twa'SeYs of 5tructu�af Plans Electr F:ur G roc h pbore4i 87-1240 Fax 413-587-1272 Plof%Srte Plans 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 This section to be completed by office 1.1 Property Address: _._._..._...._......_.......__._.. _.._..._..w._.......__: Ma Lot Unit o f/U lj 5?'{�1/#a` Tj�'i U Fr`fST� p t Zone Overlay District ----- - Elm St:District- CB District' SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: _ Name(Print) Current Mailing Address: Signature � G� Telephone 2.2 Authorized Agent: Name(Print) Current Madmg Address: _ 1 _ . Signature Telephone SECTION 3-ESTI ATED CONSTRUCTION i COSTS: Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 50 o�t� (a)Building'Permit Fee I 2. Electrical (b):Estimated TotalCost of Construction from(6) _...._ _ .,._..._,..._ 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection _:..., __.... 6. Total=(1 +2+3+4+5) Check Number I This_Section.For Official Use Only Building Permit Number Date Issued -Signature:__ Building Commissionedinspector.of Buildings Date File#BP-2014-1409 APPLICANT/CONTACT PERSON JDR BUILDERS ADDRESS/PHONE P O BOX 4 NORTH HATFIELD (413)665-7587 PROPERTY LOCATION 22 INDUSTRIAL DR EAST MAP 19 PARCEL 012 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: INSTALL VERSICO METAL RETROFIT TPO ROOF OVER EXISTING New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Buildine Plans Included: Owner/Statement or License 074105 3 sets of Plans/Plot Plan THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management of ' e Si ure of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 22 INDUSTRIAL DR EAST BP-2014-1409 GIS#: COMMONWEALTH OF MASSACHUSETTS MU:Block: 19-012 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categorv: ROOF BUILDING PERMIT Permit# BP-2014-1409 Project# JS-2014-002381 Est.Cost: $50000.00 Fee: $300.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JDR BUILDERS 074105 Lot Size(sg. ft.): 101930.40 Owner: GE Healthcare Zoning: Applicant: JDR BUILDERS AT. 22 INDUSTRIAL DR EAST Applicant Address: Phone: Insurance: P O BOX 4 (413) 665-7587 WC NORTH HATFIELDMA01066 ISSUED ON.•613012014 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL VERSICO METAL RETROFIT TPO ROOF OVER EXISTING 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 6/30/2014 0:00:00 $300.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner