Loading...
31A-067 (55) BP-2024-0534 186 ELM ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-067-001 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-2024-0534 PERMISSION IS HEREBY GRANTED TO: 2024 QUADRANGLE NEW Project# ENERGY PLANT Contractor: License: BOND BUILDING CONSTRUCTION Est. Cost: 21953262 INC CS-102479 Const.Class: Exp.Date: 01/07/2025 Use Group: Owner: COLLEGE SMITH Lot Size(sq.ft.) Zoning: EU/URC Applicant: BOND BUILDING CONSTRUCTION INC Applicant Address Pjane: Insurance: 10 CABOT RD SUITE 300 (617)387-3400 wa7-61d-b9p93b-010 MEDFORD, MA 02155 ISSUED ON: 05/30/2024 TO PERFORM THE FOLLOWING WORK: QUADRANGLE DORMS -INSTALL NEW ENERGY PLANT AND ADD PANELS &POWER FAN CEILING UNITS -8 BUILDINGS, 31 FLOORS -PHASE 1 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: S153,678.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED The Commonwealth of Massachusetts MAY - 1 2024 Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or'I v` M T'o Ns (This Section For Official Use Only) Building Permit Number. of/*43'1 Date Applied: Building Official: SECTION 1:LOCATION 10 Elm St, Northampton, MA 01060 Emerson,Jordan,Cushing,Morrow,Wilson,Gardiner,Comstock, No.and Street City/Town Zip Code wilder Name of Building(if applicable) 31A #067, #066, #065, #252, #253, #254, #255 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 0 Repair 0 Alteration 011 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use ❑ Change of Occupancy ❑ Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ® No ❑ Is an Independent Structural Engineering Peer Review required? Yes 0 No DB Brief Description of Proposed Work: The work will take place in all of the Smith Quadrangle Dorm buildings.The work will be split up between two summers:Summer 2024 and Summer 2025.During this summer 2024 we will be working on the Basements,Attics,Fourth and Third floors of all buildings.The work consists of installing all new Fan Coil Units and their associated infrastructure(electrical,controls,HVAC.)New mechanical pipes and connections getting installed in preparation for the buildings being converted with the rest of the campus to a geothermal system.The premit being divided between the two summers was discussed with the building commissioner prior to this submission. 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): See section 5 Proposed Use Group(s): Not changing SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Varies Varies Not Changing Total Area(sq.ft.)and Total Height(ft) Varies Varies Not Changing SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2® Nightclub 0 A-3 Di A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1❑ F2 0 H: High Hazard H-1 0 H-2 0 H-3 ❑ H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-ID R-2® R-3❑ R-4 0 S: Storage S-1® S-2❑ U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ HA CI IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA 0 VB SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit: Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Dis sal Site CR Public® Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Po Private 0 or indentify Zone: or on site system 0 reg i ®cl trench or specify: permiti s enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable® Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes❑ or No IS Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: 9th edition Use Group(s):R-2,A-2,A-3,Si Type of Construction: 3A Does the building contain an Sprinkler System?: Yes Special Stipulations: Design Occupant Load per Floor and Assembly space: Varies SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Smith College Board of Trustees 10 Elm Street Northampton, MA 01060 Name(Print) No.and Street City/Town Zip Property Owner Contact Information:Gary Hartwell Project Manager - - 413 -320- 9763 ghartwell@smith.edu Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Bond Building Inc. 10 Cabot Road. Suite 300 Medford MA 02155 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❑. 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) Jim Keay 617- 908- 4902 jkeayRbond-building.co CS-102479 Name(Registrant) Telephone No. m e-mail address Registration Number 7 Loudville Road Easthampton MA 01027 Construction 01-07-2025 Street Address City/Town State Zip Discipline Expiration Date Supervisor 10.2 General Contractor Bond Building Construction Inc. Company Name Mike Spodek / Jim Keay Name of Person Responsible for Construction License No. and Type if Applicable 10 Cabot Road, Suite 300 Medford MA— 02155 Street Address City/Town State Zip 617-394-0694 mspodekQibond-building.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 CI No Cl SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE trm Estimated Costs:(Labor Iand Materials) Total Construction Cost(from Item 6)=$21,953,262 1.Building $ 964,741 Building Permit Fee=Total Construction Cost x$Z() Insert here 2.Electrical $ 1,690,023 appropriate municipal factor)=$ 153.678.00 3.Plumbing $ 4.Mechanical (HVAC) $ 19,298,498 Note:Minimum fee= 100.00(contact municipality) 5.Mechanical (Other) $ Enclose check payable to City of Northampton 6.Total Cost $ 21,953,262 (contact municipality)and write check number here 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. Ximena Cruz de Brown Project Manager 857-321-9983 4/22/2024 Please print and sign name Title Telephone No. Date 10 Cabot Road. Suite 300 Medford MA 02155 xcruz@bond-building.com bond-building.com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: /` �� � 5 3O- z 1 Name Date CITY OF NORTHAMPTON SETBACK PLAN MAP: 31A LOT: #067, #066, #065, #252, #253, #254, #255 LOT SIZE:460,788 ft' REAR LOT DIMENSION: 522 ft Rear set back REAR YARD requirement=0' According to EU (Educational Use) overlay zoning district `°�P 4. •y°cP ` ' C.) • cps , �_ �� t if S 4 fpi: ,,attz. .,. 1 � °,e e. Ho ,` Elm Stree ° P } n • F �e Morrow;House i:,' °% , Smith College ' � .. 41 ,, a 1 e r . . Sr;�h Ccl(e e r- a�� r Rear set back :x r" q f Rear set back s t `• -A.D requirement= 0' Q.u,... =i lc slimyARD requirement=0' ice -" Smrt Co e. Wilder•Hous= 0' OddS C,. • Hashimy House o P®.._, j. Rear set back FRONT SETBACK requirement=0' FRONTAGE 535 ft w City of Northampton Massachusetts �+ � r c V �� � DEPARTMENT OF BUILDING INSPECTIONS • . 1F i .." K-r'� �! 212 Main Street • Municipal Building vti P� Northampton, MA 01060 Ss'Nw . \1° 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 Rd, Northampton MA 01060 The debris will be transported by: Name of Hauler: USA Waste & Recycling ! ) / Signature of Applicant: Date: 4.23.2024 Commonwealth of Massachusetts 111 Division of Occupational Licensure Board of Building Regulations and Standards Const( l LS ervisor ., :f CS-102479 . . E ires: 01/07/202 JAMES D KEAY 7 LOUDVILLE ROAD 10-4,,,,, 1,9 EASTHAMPTON MA 01027 ._ , :4 Commissioner 'a� K. b' c��. • ,Is y ` i .! Construction Supervisor Unrestricted - Buildings of any use group which contain •ss thaa 35,000 cubic feet (991 cubic meters) of enclosed space. • atoto possess a current edition of the Massachusetts ilding Code is cause for revocation of this license. t # For information about this license ! 4•Cat m 7) 727-3200 or visit www. ass.gov/dpl The Commonwealth of Massachusetts _*.�'1 ►= z Department of Industrial Accidents 'el_ 1 Congress Street,Suite 100 • _;111_ ' Boston, MA 02114-2017 -1,.t. wwx.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LegiIAN Name (Business/Organization/Individual): Bond Building Construction, Inc. Address: 10 Cabot Rd City/State/Zip: Medford, MA 02155 Phone#: 617-387-3400 Are you an employer?Check the appropriate box: Type of project(required): 1. 4 I am a employer with 800+employees(full and/or part-time).* 7. New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t El Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurance? 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,*I(4),and we have no 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. 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 the policy and job site information. Insurance Company Name:Travelers Indemnity Company of Connecticut Policy#or Self-ins.Lic.#: UB- 1 X684452-23-25-D Expiration Date: 10/31/2024 Job Site Address: 10 Elm St, City/State/Zip: Northampton,MA 01060 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c flunder t ainsland penalties of perjury that the information provided above is true and correct. Signature: ' a Date: 4.23.2024 Phone#:857 1-9983 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.Cite/Tow,n Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural X 2 Foundation 3 Structural X 4 Fire Suppression X 5 Fire Alarm(may require repeaters) 6 HVAC X 7 Electrical X 8 Plumbing(include local connections) X 9 Gas(Natural,Propane,Medical or other) X 10 Surveyed Site Plan(Utilities,Wetland,etc.) X 11 Specifications X 12 Structural Peer Review X 13 Structural Tests&Inspections Program X 14 Fire Protection Narrative Report X 15 Existing Building Survey/Investigation X 16 Energy Conservation Report X 17 Architectural Access Review(521 CMR) X 18 Workers Compensation Insurance X 19 Hazardous Material Mitigation Documentation X 20 Other(Specify) X 21 Other(Specify) X 22 Other(Specify) X *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information Charles W.Roberts 413-259- 1630 croberts@kuhnriddle.com No. 10107 Name(Registrant) Telephone No. e-mail address Registration Number Kuhn Riddle Architects,28 Amity Street,Suite 2B.Amherst, MA 01002 Architect R/31/9094 Street Address City/Town State Zip Discipline Expiration Date Jeff Urlaub 715--832--5680 No. 53643 Name(Registrant) Telephone No. e-mail address Registration Number Mechanical 6/30/2024 Salas O'brien.One Gateway Ctr.#701. Newton, _MA_ 02458 Street Address City/Town State Zip Discipline Expiration Date Darren Dickenson 651 -4007 darren.dickensonfasalasobrien.com No.56592 Name(Registrant) Telephone No. e-mail address Registration Number Salas O'brien,One Gateway Ctr,#701, Newton, MA 02458 Electrical 6/30/2024 Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals. Initial Construction Control Document P.I / To be submitted with the building permit application by a Registered Design Professional • for work per the ninth edition of the is Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Smith College Quad District-Building Conversions Date:12/21/2023 Property Address: Northampton,MA 01063 Project: Check (x) one or both as applicable: New construction (X) Existing Construction Project description:Hot water building conversions,replacement of existing steam heating systems with hydronic dual temperature(heating&cooling)systems I Jeff Urlaub MA Registration Number:53643 Expiration date:06/30/2024,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningl: () Architectural ()Structural (X) Mechanical (X) 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 OF^'AS; electronic signature and seal: (640 stir,►\ O ' C ANICAL Phone number: 715-832-5680 Email:jeff.urlaub@salasobrien.com 0 0 53E430 yo Building Official Use Only o �sioNA�-� 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. }} Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional c{ for work per the ninth edition of the -i.a Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Smith College Quad District-Building Conversions Date:12/21/2023 Property Address: Northampton, MA 01063 Project: Check(x)one or both as applicable: New construction (X) Existing Construction Project description:Hot water building conversions,replacement of existing steam heating systems with hydronic dual temperature(heating&cooling)systems I,Darren Dickenson(MA Registration Number:56592,Expiration date: 06/30/2024),am a registered design professional,and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning1: () Architectural () Structural () Mechanical () Fire Protection (X) 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'. 1443 Enter in the space to the right a"wet" or *"Or electronic signature and seal: • NO 51,2 AFC�SiE �C Phone number:651.379.9120 x 1300 Email:darren.dickenson @salasobrien.com ss 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. Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the ninth edition of the N _ ,. Massachusetts State Building Code, 780 CMR, Section 107 Project Title:Smith College Quad District-Building Conversions Date:12/21/2023 Property Address:Northampton,MA 01063 Project: Check(x)one or both as applicable: New construction (X) Existing Construction Project description:Hot water building conversions,replacement of existing steam heating systems with hydronic dual temperature(heating&cooling)systems I,Charles Roberts(MA Registration Number:10107,Expiration date:08/31/2024),am a registered design professional,and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningl: (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 RED AR0 electronic signature and seal: Q``�`. W.Ap y"i1� szt J ,41oia7 .is Phone number: 413.259.1630 Email: croberts@kuhnriddle.com j R4As T4.1 Building Official Use Only 4�J 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.