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23A-115 Office of Consumer Affairs & B siness Regulation HOME IMPROVEMENT CONTRACTOR Registration: 162559 Type: Expiration: 3116/2013 Private Corporation FI STAR BUILDING CORP. KEVIN PERRIER 17 EAST STREET EASTHAMPTON, MA 01027 Undersecretary ♦lassaclillsetts - Depai of Public �afet Board of Buildim- Re--mlatiows and standards Construction Supervisor License License: CS 85319 KEVIN A PERRIER 17 EAST ST EASTHAMPTON, MA 01027 IL Expiration: 1/13/2013 Tirt: 8550 ti v e S ta Building Corp. 17 fast Street • Easthampton, MA 01027 • Fax (413) 587 -4061 (413) 587-4060 - 1- 800 -767 -6355 Transmittal Date: 10/13/2011 To: City of Northampton From: Five Star Building Corp. Building Dgpartment Project: Baystate Health Heart & Vascular Drawings as listed below F Specifications 0 Reports 0 Submittals 0 Contracts 0 Other Documents Qty Section No Title / Item / Description Notes / Comments 1 Construction Control Affidavit 1 Existing Conditions Evaluation Report 1 Building Permit Application With required attachments 1 Building Permit Fee Check #6020 for $511.50 3 Stamped Drawings 0 As Requested For Review For File 0 For Signature E::] Approved F Not Approved CC: The existing electrical service for this building is via multiple distribution panels located within discrete electrical rooms. The scope of this project work area modifies existing electrical distribution devices and wiring as well as new devices and wiring and shall fully comply with Massachusetts Electric Code. Section 709 Mechanical The existing HVAC system is a central ducted system providing heating, cooling, and ventilation. The scope for this project work area does not affect the building envelope regarding energy conservation. Minor changes are proposed to the existing mechanical HVAC system serving the project area where required by architectural changes, such changes shall comply with 780 CMR 8 th Edition Section 709. Section 710 Plumbing The minimum number of plumbing fixtures is not applicable as the occupant load will be unchanged within the project work area. Additional toilets and sinks are being added as a response to clinical needs, however. Section 711 Energy Conservation The existing building exterior consists of multiple wythe brick masonry construction. Existing windows are wood framed single pane. The scope of this project does not modify any component of the building envelope. All work within the project work area shall comply with the energy requirements of 780 CMR 8 Edition for new construction. END OF CHAPTER 34 REVIEW REPORT HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton, Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 Section 705 Means of Egress The existing egress requirements within the project work area are compliant with 780 CMR 8 th Edition and Life Safety Code 101. Existing components of the egress corridor system modified under this project shall comply with this section. Occupant load of the project area is less than 50 and the travel distance from the furthest point within the project area to the nearest exit is less than 75 feet. Two exit stairs lead from the basement level at opposite ends of the building. New and existing corridor walls, doors, and other openings are unrated and code compliant based on a fully protected code compliant fire protection system There are no dead end corridors within the work area exceeding 35 feet. Means of egress lighting and exit signs are code compliant and not modified by this project. Internally illuminated exit signs and egress lighting are battery operated. No new or existing guards or handrails are part of the project work area Section 706 Accessibility The building entrance and most public spaces are handicap accessible. The scope of this project does not modify any of those existing accessibility components. All new work within the project work area shall conform to the requirements of 780 CMR 8 "' Edition Section 605. Section 707 Structural The existing structural system consists of concrete slab basement floor, wood beams and wood plank flooring with plywood subfloor on upper floors, masonry columns and masonry bearing walls in the basement with wood columns and some wood framed bearing walls on the upper floors. The scope of this project work area does not affect any existing structural systems. No structural elements shall receive increased stress from this project. Section 708 Electrical HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton, Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 3. ALTERATIONS LEVEL 2 Section 701 General This project work area will comply with all requirements for Alteration Level 1 as specified in Chapter 6. No portion of the proposed project work area alters the existing conditions such that the building will become less safe than its existing condition. Requirements regarding flood hazard areas are not applicable to this project Section 702 Special Use and Occupancy Not applicable. Section 703 Building Elements and Materials No new or existing vertical floor openings are within the project work area. New penetrations within existing smoke and fire rated partitions shall comply with opening requirements for those elements. All new interior finishes, including wall, ceiling, floor, and trim materials to be installed under this project work area will comply with 780 CMR 8" Edition. No new or existing guards are part of the project work area Section 704 Fire Protection A complete dry pipe fire protection sprinkler system exists in the building. Modification of the fire protection system within the project area will be designed and constructed by a certified fire protection vendor and will comply with 780 CMR 8th Edition. A fire alarm system, compliant with the International Fire Code, exists within the project work area. All fire alarm systems which fall within the project work area shall improve or maintain the existing condition of those systems. HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton, Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 2. CLASSIFICATION OF WORK The proposed project work area is classified as Alteration - Level 2 per EIBC Section 404 and therefore complies with the provisions of Chapter 6 and Chapter 7 as reviewed below: HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton, Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 1. GENERAL INFORMATION A. PROPERTY NAME: 10 Main Street Medical Office Building B. ADDRESS: 10 Main Street, Florence, Massachusetts 01062 C. BUILDING USE: The building was originally constructed as a manufacturing facility, and is currently used for B - Business occupancy, encompassing offices and ambulatory patient care serving patients capable of self preservation. D. BUILDING USE GROUP: B - Business as defined by the Massachusetts Building Code. E. CONSTRUCTION CLASSIFICATION: Type 3B (protected) Foundation: concrete slab on grade; brick masonry walls Exterior Walls: multiple wythe brick Int. Load Bearing: unit masonry columns / solid timber columns/ wood framing Roof: pitched wood framing / slate shingle F. HAZARD INDEX: Existing and proposed Hazard Index is 4 as defined by the EIBC Table 912.4. Occupancy classification remains unchanged. HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton. Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 780 CMR 8" Edition International Existing Building Code Chapter 34 Evaluation Renovations for Baystate Heart & Vascular Program Cardiovascular Imaging Basement Level 10 Main Street Florence, Massachusetts 01062 Purpose This Report is in conformance with Massachusetts Building Code 780 CMR Stn Edition and the International Existing Building Code 2009 Chapter 34 regarding alterations (Renovations for Baystate Heart & Vascular Program Cardiovascular Imaging) to an existing building located at 10 Main Street, Florence, Massachusetts. Limitations of review The extent of this review is limited to visual inspection of existing facilities and /or as -built documentation only. No destructive testing was performed as part of this analysis. HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton, Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 Existing Conditions Evaluation Report 780 CMR Stn Edition Chapter 34 International Existing Building Code 2009 Renovations for Baystate Heart & Vascular Program Cardiovascular Imaging Basement Level 10 Main Street Florence, Massachusetts 01062 October 04, 2011 D AR S T F � ? s No. 8355 HAMP U �J SP O S As prepared by Ric ar E. Katsanos, AIA HEALTHCARE ARCHITECTS INC. 64 Gothic Street Northampton, Massachusetts 01060 phone: 413.585.1512 fax: 413.586.7945 CITY OF NORTHAMPTON, MASSACHUSETTS CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: HAI -10 -93 DATE: October 4, 2011 PROJECT TITLE: Renovations for Baystate Heart and Vascular Program PROJECT LOCATION: Basement Level NAME OF BUILDING: 10 Main Street, Florence, Massachusetts 01062 SCOPE OF PROJECT: Interior Renovations In accordance with the Massachusetts State Building Code, 780 CMR 8'" Edition, Chapter 1, Section 107.6 Construction Control, I, Richard E. Katsanos, Massachusetts Registration No. 8355 being a registered professional Architect, hereby certify that I have prepared or directly supervised the preparation of all design plans, computations, and specifications concerning architectural scope for the above named project and that, to the best of my knowledge, such plans, computations and specifications meet applicable provisions of the Massachusetts State Building Code, 8 Edition, all acceptable engineering practices and all applicable laws for the proposed project. ENTIRE PROJECT ARCHITECTURAL STRUCTURAL FIRE PROTECTION ELECTRICAL MECHANICAL OTHER (specify) I further certify that I shall perform the necessary professional services and be present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 107.6.2.2 Construction: 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 Chapter 17. 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 construction documents and this code. Pursuant to Section 107.6, I shall submit periodically, a progress report together with pertinent comments to the Building Inspector. Upon completion of the work, I shall submit a final report and an affidavit of completion as to the satisfactory completion and readiness of the project for D A ancy. gc Subscribed and sworn to before me this �I day of 204\ o No. 8355 EA, 4, , t ` �r0 SLY A STHAMPTON p y� MA Notary Public BER ``glr OF E. atsanos, AIA My Commission expires on + a'9• �� • N 2� . �gSSACN��'' Tg Pv0 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www. mass gov /dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): Five Star Building Corp. Address: 17 East Street City /State /Zip: Easthampton.MA 01027 Phone #: 413.587.4060 Are you an employer? Check the appropriate box: Type of project (required): L ❑ 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. ❑ I am a sole proprietor or partner- listed on the attached sheet. �• Remodeling ship and have no employees These sub - contractors have 8. © Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.© Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.0 Other *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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: General Casualty Policy # or Self -ins. Lic. #: CWC082037310 Expiration Date: 5/9/2012 Job Site Address: 10 Main Street c ity /state /zip florence, MA 01062 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 verific ion. I do hereby certify under the pains and penal ry that the information provided above is true and correct Sig nature: Kevin Perrier, l President Date: 10/12/2011 Phone #: 413.587.4060 Official use only. Do not write in this area, d 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 5. Plumbing Inspector 6. Other Contact Person: Phone #: Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No SECTION 11 -OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I , Ba Christman Project jest Manager for Baystate Health s as Owner of the subject property hereby author ! Five Star Building Corp to act on M be fi in all matters relative to work authorized by this building permit application. a �m,.,.....,. Signatur,. ct O r er Date £Five Star Building Corp I, ...... _ .___.__rt .._ __ _._ _,. ... asOwner /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 undgrthe pains and„pe . . ies,_of perjury ........ .... __...._..._.__ .__ __ . _,,,,. ;Kevin Perrier, Presid Print Name _ Signature of Owner/ ent Date SECTION 12 - CASIRUCTION SERVICES 10.1 Licensed Construction Supervisor Not Applicable ❑ Name of License Holder KeVlri Perrier CS 85319 _. ... _. .. __ _.. License Number �.. 17 East Stree , ..... ampton, MA 01027 �1 01/13/2013 ��� i Address Expiration Date (413) 587 -4060 Signature Telephone SECTIO 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 (D No Versionl.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: Not Applicable ❑ -Richard E. Katsanos �___... �.... -... ..�,,,,,,���- .- .._ . .. ...... ....___. _ .,.,�...._.- ........ ...,, __.......- ?8355 Name (Registrant): a . . ..... .. . ...... _... _ . . -_w_ ....,a...,.. s is Registration Nmber R E Katsano ....... u ....... ... ........� ..,....,_.- ._.�- ......_, Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): ... _. _.. _ ..., - - -- N/A ...., � ....... Name Area of Responsibility ....._,._ Address Registration Number i Signature Telephone Expiration Date m �:. Name Area of Responsibility i Address Reistrapon Number 1 ` Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number aw w _ ....................... i Signature Telephone Expiration Date Name Area of Responsibility _-- -_ ... ...... -. Address Registration Number .. ...__ ._ w_,,. _ _ _.._ ....., ......... Signature Telephone Expiration Date 9.3 General Contractor Fi Star Building Corp. Not Applicable ❑ Company Name: ! Kevi n Perrier Respon In Charge of C o nst ruction X 1 Sire ,Easthampton, MA 01027 7 East Add; 96 ' (413) 587 -4060 Signatur Telephone i I Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ............ a e Setbacks Fron 1, _._ . Side L. ,,, .,.._. R. ... ..... L. R. Rear,,. _.. Building Height Bldg. Square Footage ..,. ; _ � % r Open Space Footage % (Lot area minus bldg & paved _,_,,,,_ ,•••• t p arking) # of Parking Spaces ___- - °° J Fill: volume & Location) _... ,. A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW lQ9 YES 0 IF YES, date issued:��' IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES IF YES: enter Book = _ Page Document # B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q _.. ,_.. 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 Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations El Existing Wall Signs ❑ Demolition 0( Repairs ❑ Additions 0 Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use El Other El __ _m --- -- . ,.., Brief Description Renovation to medical office space. Of Proposed Work: z SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business El 2A ❑ E Educational ❑ 2B I ✓❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify:l M Mixed Use ❑ Specify: _. _._.... _ .. S Special Use El Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: iBm usess Proposed Use Group. smess Existing Hazard Index 780 CMR 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 (so 1st r ; 1st 2 nd 2nd ___. _...._ ... . .. . ..... ..,__ .... _ - 3rd i 3 rd :, 4 Total Area (so 4 474 Total Proposed New Construction (sf� ;.� ... ..... ..... �...... ...._ ....,. 3........ _ ._.. - ., Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ I Zone =_ _, , i Outside Flood Zone[] Municipal ❑ On site disposal system❑ �� ""�! .._ ., ,,, .... s .;.� � EIVED Versionl.7 Commercial Building Permit May 15, 2000 City of Northampton ettlt OCT 132011 Building Department 212 Main Street S�v�retlp A Ir WPE Room 100 W�alerlw w: orthampton, MA 01060 T��tsM`S a phone 413 - 587 -1240 Fax 413 - 587 -1272 P Sitdia� y 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 1.1 Property Address This section to be completed by office 10 Main Street Map Lot ` Unit ,Florence, MA Zone Overlay District Elm St. District CS District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record Baystate Health 759 Chestnut Street, Springfield, MA Name (Print) Current Ma iling Address: 413 322-4060 . . '� � _.. - Signature Telephone 2.2 Authorized Accent: Five Star Building Corp 17 East Street �._ Easthampton, MA _...._ _.... _.. __._...__......_..._,.M _ ..... ..___ Name (Print) Current Mailing Address „ L (413) 587-4060 ._ .... ... Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by ermit applicant 1. Building i (a) Building Permit Fee $66,270.00; 2. Electrical F 1 (b) Estimated Total Cost of $18,980.00 Construction from 6 3. Plumbing $0.004 Building Permit Fee 4. Mechanical (HVAC) $0.001 _.._m.._ ._- ...... 5. Fire Protection _ i 6. Total = + 2 + + 5) $85,250.00 Check Number r This Section For Official Use Onl Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0382 C� APPLICANT /CONTACT PERSON FIVE STAR BUILDING CORP 7 ADDRESS/PHONE 17 EAST ST EASTHAMPTON (413) 587 -4060 Q PROPERTY LOCATION 10 MAIN ST MAP 23A PARCEL 115 001 ZONE GB000)/ 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: RENOVATION TO MEDICAL OFFICE SPACE - BAYSTATE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 085319 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION 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 Demolition Delay Signature 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. 10 MAIN ST BP- 2012 -0382 GIs #: COMMONWEALTH OF MASSACHUSETTS Map:Bloc 23A - 115 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit # BP- 2012 -0382 Project # JS- 2012 - 000605 Est. Cost: $85250.00 Fee: $511.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: FIVE STAR BUILDING CORP 085319 Lot Size(sa. ft.): 21170.16 Owner: TEN MAIN STREET FLORENCE LLC C/O EDWARD L JENDRY Zoning: GB(100)/ Applicant: FIVE STAR BUILDING CORP AT. 10 MAIN ST Applicant Address: Phone: Insurance: 17 EAST ST (413)587 -4060 WC EASTHAMPTONMA01027 ISSUED ON :10125120110 :00 :00 TO PERFORM THE FOLLOWING WORK.- RENOVATION TO MEDICAL OFFICE SPACE - BAYSTATE 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 10/25/20110:00:00 $511.50 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner