signed - Deaconess_3-19_Initial
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 9th edition of the
Massachusetts State Building Code, 780 CMR, Section 107.6.2
Project Title: Deaconess Rockridge Date:3/19/2024
Property Address: 25-37 Coles Meadow Dr
Northampton, Ma 01060
Project: Check (x) one or both as applicable: New construction X Existing Construction
Project description: Installation of automatic sprinklers to suit new tenant layout.
I Scott Henderson MA Registration Number: 46553 Expiration date: 6/30/24 , am a registered design professional, and
hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerning1:
Entire Project Architectural Structural Mechanical
X Fire Protection Electrical Other:
for the above named project and that 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.
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
electronic signature and seal:
Impact Fire
Phone number: (413) 589-0672 Email: scott_henderson@charter.net
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. If ‘other’ is chosen,
provide a description.