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31A-324 (5) 8 PARADISE RD-PRESIDENT'S HOUSE BP-2016-1092 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 3 1 A-324 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: windows replaced BUILDING PERMIT Permit# BP-2016-1092 Project# JS-2016-001872 Est. Cost: $379486.00 Fee: $2656.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KEITER BUILDERS 102457 Lot Size(sq. ft.): Owner: SMITH COLLEGE OFFICE OF TREASURER Zoning• EU(106)/URC(85)/RR(21)/WP(21)/ Applicant: KEITER BUILDERS AT. 8 PARADISE RD - PRESIDENT'S HOUSE Applicant Address: Phone: Insurance: 35 MAIN ST (413) 586-8600 O WC FLORENCEMA01062 ISSUED ON.•3/17/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL REPLACEMENT WINDOWS & DOORS - bottom sash 219-H requires tempering! 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 3/17/2016 0:00:00 $2656.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File# BP-2016-1092 APPLICANT/CONTACT PERSON KEITER BUILDERS ADDRESS/PHONE 35 MAIN ST FLORENCE01062(413)586-8600 Q PROPERTY LOCATION 8 PARADISE RD-PRESIDENT'S HOUSE MAP 31A PARCEL 324 001 ZONE EU(106)/URC(85)/RR(21)/WP(21)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid BuildinE 'illed out IN Fee Paid Typeof Construction: INSTALL REPLACEMENT WINDOWS&DOORS S p New Construction 'e �eO Non Structural interior renovations Addition to Existing Accesso1y Structure AJA Building Plans Included: Owner/Statement or License 102457 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: *?Cpproved Additional permits required(see below) �J 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 AofBui'1di I ' n Del _ 3 ature ng Off1 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. Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: nL7 Building Department Curb Cut/Driveway Permit 212 Main Street SewedSeptic Availability C Room 100 WaterMell Availability. LTJ Northampton, MA 01060 Two Sets of Structural Plans (� W z phone 413-587-1240 Fax 413-587-1272 Plot/Slte Plaits ° Other Specify N 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: Smith College - Presidents House Map , IA Lot aq Unit 8 Paradise Rd Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Trustees of Smith College C/O Facilities 126 West Street Northampton MA Name(Print) Current Melling Address: 413-584-2700 Signature Telephone 2.2 Authorized Agent: Keller Builders, Inc 35 Main St Florence, MA Name(Print) Current Maitng Address: 4135868600 Signature President,Keiter Builders,Inc. Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $379,486.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) $379,486.00 Check Number 5 ) This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Version 1.7 Commercial Building Permit May 15,2000 S CTS ION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS T#IAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ 'Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ Now Signs❑ Roofing❑ Change of Use❑ Other El Brief Description Window $ Door Replacment Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE meaSe See attaChed Control DOCS USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 36 M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 58 ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION B BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so let 2nd 2nd 3'" 3rd 4r' 4s Total Area(so Total Proposed New Construction(so Total Height(ft) Total Height it 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone❑ Municipal 0 On site disposal system❑ i _ Version].7 Commercial Building Permit May 1S,2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be rolled in by Building Department Lot Size Frontage Setbacks Front iS& L• .—R' L. R. Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking S aces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO = DONT KNOWF-6 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO = DONT KNOW YES= IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NOF—*--� DONT KNOW= YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YENO IF YES, describe size, type and location: E. Will the construction activity disturb clearing,grading,qxcavallan,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO Lg .! IF YES,then a Northampton Storm Water Management Permit from the DPW Is required. Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Laura Fitch Not Applicable O Name(Registrant): 8835 Laura Fitch Registration Number Address 08/1 Please see attached control Docs 4135495799 Expirallon 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 Registration Number Signature g Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone P Expiration Data Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Keiter Builders, Inc. Not applicable 0 Company Name: Scott Keiter Responsible In Charge of Construction 35 Main Street Northampton MA Address k4;z� President,Kciter Builders,Inc. 4135868600 Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(7a0 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes E] No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED EN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I Peter Gagnon-Trustees of Smith College CIO Facilities Management as Owner of the subject property hereby authorize Keiter Builders, Inc. to act on my behAK-,'J? ative to work authorized by this building permit application. r t Signature of Ckwner Date C' /6 i Keiter Builders, Inc. 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 of perjury. Scott Keiter Print N 4�� President,Keiter Builders,Inc. Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Suoervisor: Not Applicable p Name of License Holder: Scott Keiter CS-102457 License Number 51A Hatfield St 06/20/16 ;;s Expiration Date President,Keiter Builders,Inc. 4135868600 Signature Telephone I 7_ SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) 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 the building permit. Signed Affidavit Attached Yes Q No❑ City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: 8 Paradise Rd The debris will be transported by: Duseau Trucking The debris will be received by: Valley Recycling Building permit number: Name of Permit Applicant Keiter Builders, Inc zf- 4e Fresident,Reim-Builden,jnv Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of IhIdustrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,MA.02114-2017 www.mass.govIdia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Keiter Builders, Inc. Address:35 Main St City/State/Zip:Florence, MA 01062 Phone#:413-586-8600 Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 15 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• � 9. []Building addition [No workers' comp.insurance comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ ep 3.❑ I am a homeowner doing all work officers have exercised their 11.171 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12❑Roof repairs insurance required.] t c. 152, §1(4),and we have no Windows/Doors employees. tNo workers' 13.©Other comp. insurance required.] •Any applicant that checks box#1 must also 611 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. 1Contractors 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 the policy and jab site information. Insurance Company Name:Arbeila Insurance Policy#or Self-ins. Lic. #:0127440615 Expiration Date:6/11/2016 .rob site Address:�8 Paradise Rd � � City/state/zip:Northampton, MA � 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 reify u er tip pains and penalties of pedury that the information provided above is true and correct. t na Q . 03/10/2016 ftnc C 4135868600 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 S.Plumbing Inspector 6.Other Contact Person: Phone#: ACORO® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDNYYY) 7/10/2015 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(les) must 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 rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Cynthia Henderson CISR NAME: y r Webber & Grinnell PHONE (413)586-0111 FAX N (413)586-6481 8 North King Street ADORLESS:chenderson@webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC X Northampton MA 01060 INSURER A Arbella Insurance Group 17000 -- 00 INSURED INSURER B Keiter Builders, Inc. INSURERC: Attn: Scott Keiter INSURER D: _ 35 Main Street INSURER E: _ Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER:Master Ex 2016 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 CONTRACT OR 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. IN SR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP IN LTR qn POLICY NUMBER M D/YYYY /YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE XOCCUR DAMAGE TO RENTED 300 PREMISES Ea occurrence $ ,000 8500064396 6/1/2015 6/1/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,0_00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $ 21000,000 OTHER: $ AUTOMOBILE LIABILITY EOMaBIINdEDtSINGLE LIMIT $ 1,000,000 - -_... - __ ANY AUTO ! BODILY INJURY(Per person) $ A ~ ALL OWNED SCHEDULED - ---------- AUTOS X AUTOS 1020039381 6/1/2015 6/1/2016 BODILY INJURY(Per accident) $ PROPERTY DAMAGE 1 X HIRED AUTOS X AUTOS NON-OWNED $ AUTOS Per accident Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,0991000 EXCESS LIAB 1 00 A _ CLAIMS-MADE AGGREGATE $ - 0,000_ DED X RETENTION 10,000 4600064399 6/1/2015 6/1/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STAT TE ___ ER !ANY PROPRIETOR/PARTNER/EXECUTIVE � N/A E L.EACH ACCIDENT $ 1001-000 A OFFICER/MEMBER EXCLUDED? ---- -- - �(Mandatory inNH) 9127440615 6/11/2015 6/11/2016 E.L DISEASE EA EMPLOYE $ 100,000 If yes,describe under —_---- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 C Henderson, CISR/CIN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS095 r9nteml Initial Construction Control Document w To be submitted with the building permit application by a x a Registered Design Professional for work per the 8t" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: President's House Window and Door Replacemnt Date:2/26/2016 Property Address: Smith College, Northampton, MA Project: Check(x)one or both as applicable: New construction x Existing Construction Project description: Office Renovations I, Laura Fitch, MA Registration Number: 8835 Expiration date: 8/16,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: x 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'. Enter in the space to the right a"wet"or electronicN signature and seal• , AMMM r Phone number: 413-549-5799 rte. CF Email: Ifitchgakrausfitch.com Building Official Use Only Building Official Name: Permit No.: Date: Note 1. Indicate with an 'x' project design plans,computations and specifications that you prepared or directly supervised. It'other' is chosen, provide a description. Version 06 11 2013