18D-001 (5) •
.
File # BP- 2011 -0415
APPLICANT /CONTACT PERSON GARDNER CONSTRUCTION & INDUSTRIAL SERVICES INC
ADDRESS/PHONE 47 OLIVINE ST CHICOPEE (413) 535 -1500
PROPERTY LOCATION 158 NORTH KING ST
MAP 18D PARCEL 001 001 ZONE HB(100) //WP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out & , 3 � j ! al 4164, a 0
Fee Paid b
Typeof Construction: CONSTRUCT INTERIOR WALLS FOR BATHROOMS & OFFICE SPACE (WIRELESS
ZONE)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included: � ,� ��y
Owner/ Statement or License 84078 ��/471'_'" �"-Q
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
Ci ' /8/6
i
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.
2010-10-28 09:30 413 536 0242 P 1/5
Version 1.7 Commercial Build ink Permit May 15 2000
- - Department use only
City of Northampton Stus of Permit • t'
Building Department Curb Cut/Dnveway Pennit -)
,‘•-\
212 Main Street SeweiSeptic Availability .•:,
Room 100 Wale
Northampton, MA 01060 ;t7i0:0,ets . •
phone 413-587-1240 Fax 413-587-1272 PJoVIS,te Plans •
•
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOUSH 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:
1 6r C r /"t Map Lot Unit
B not Kin9 ST"
Overlay District
°Mir:Imp 0100 ; Zone
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT
2,1 Owner of Record:
- Thus - r
. .
Name (Print) mfr mou r Current Meiling Address: r.
La145 goositiZg (VIC.- •
signature Telephone 4E3 184 Otp00
2.2 Authorized Agent:
._G L
. . ....._.:
Name (Print) ism Curtooty4ing Address: _
Signature
/ LS1 .... CH;copu,..111c,..
Telephone 413 FAs
■
SECTION3 - STIMA D CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 70 0 (a) Building Permit Fee
.o
,
2. Electrical ? a ad . a° (b) Estimated Total Cost of • Construction from (6)
3. Plumbing Building Permit Fee
Od,.
4. Mechanical (hIVAC)
5, Fire Pro ecti
•
, Jo
6, Total i „. 1 3 4 + Check Number a JP
This Section For Official Use Only
- •
Buildi g rmlt Num.. Date
Issued
Signature:
Bung Commissioner/Inspector of Buildings Date
2010-10-28 09:30 >> 413 536 0242 P 2/5
Version1.7 Commercial Building Permit May 15, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs 0 Demolition 0 Repairs 0 Additions 0 Accessory Building 0
Exterior Alteration CI Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use 0 Other lia
Brief Description Enter a brief description here. Consfroe'f7on of 7.4 f(' 414 1/
Of Proposed Work:
F b lh /s4_5 a n a 0 I‘ C/c (... 5 f., tm I aptss Ze N 6
...___Pf. .. _a__...r.:(2.0. .____..... ________ . ....____ .. . ...._ ._... ._......... . . ............. .
. _....._....... ..____....
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly 0 r- A-1 0 A-2 0 A-3 ID 171 El
A-4 0 A-5 D 18 0
B Business 0 2A 0
E Educational Li 28 J El
F Factory 0 F-1 0 F-2 0 2C 0
H High Hazard 0 3A 0
I Institutional 0 1-1 0 1-2 0 1-3 0 313 0
M Mercantile RI 4 0
R Residential 0 R-1 0 R-2 0 R-3 0 5A 0
S Storage 0 S-1 0 S-2 0 513L 0
U Utility
Specify: i ---.- - • •••---••• • • ------ - - • ---i-.--•••• • ------ - • • .---- -• • -------- ... ------ .
1:3 .___....... _______ .........._______... ...___,.. ..........___... . ... ._._...... ...__.... .._. _
M Mixed Use 0 Specify.
- _ .......
S Special Use 0 Specify:
•
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
•-- 1
Existing Use Group: i . .
Existing Hazard Index 780 CMR 34): ...._____ Proposed Hazard Index 780 CMR 34): •
..;
,----..—..A
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (0)
__ .. _ _____ ....
1' •
_
2"
2" ' ' .
..ardi
3 1 ' 1 _....i
. •
.......—...... ._._..._ . ......_____... . .
4
4 i
th ' :—..---... ,....______.-
Total Area (sf) : • Total Proposed New Construction (Op . ......__,, .
Total Height (ft) i
Total Height ft
7, Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public co Private 0 — Zone l ..._. _.. Outside Flood Zone0 Municipal 0 On site disposal systemn
2010-10-28 09:30 >> 413 536 0242 P 3/5
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
Frontage ;
Setbacks Front
;
Side P» .
.....
Ltat
Building Height
Bldg. Square Footage " F - 777 7 % '
Open Space Footage
(Lot arca minus bldg & Travcd .
parking)
#ofParkingSpaces
• • •
Fill: 5 -
(volume & Location) . . • •
—
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW ( YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
• ;
IF YES: enter Book Page
• and/or Document it!
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained
Obtained
0 , Date Issued: •
C. Do any signs exist on the property? YES
NO 0
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 0
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,
2010-10-28 09:31 >p 413 536 0242 P 4/5
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 TOO CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)
9.1 Registered Architect:
,--- ---- -------' — ---` Not Applicable C%
Name (Registrant): • - -' -� � --- -- -----�
Number
Addre �_-__----'__-----_--__--_---___---_-_-_'-_�_--___---__---_-_� �- _--
Auovmss L—_---___--'_----_----_ •• •
'--'--� - Expiration Date
Signature Telephone
9.2 Registered Profemsimnm|Engineer(s):
-'_--- ---_--_ - '---�
Name ���n� Responsibility
, _ _ __ ___ ________
� _-'-'_-____--_-__�_ - — 7
—' — --- ' — —'-'' ---_-'__ _____-___'--__�'� �
Address Registration Number
Signature Telephone Expiration Dale
Name Area of ResponsibilIty
• ---� F -�--------------'--------'--�
--------------------------------------- ---� L--__-� -- � _ _ �
Address
-'-----| - ----�----- ----- -----------�
( -
Signature Telephone Expiration Date
•
• . •
Name Area
• ' ' - ' - - � '' - ----- '--- ` �- ' •- ---'-- 7 •
�---------------- ----------- --' ---------------� L-- -- --_'----�
Address Registration Number
| i i --------'' ' ---
Signature Telephone Expiration Date
_'�-- — —'`—_'__''
mamm Aream Responsibility
r --- ---------'--'-------'-------------------------� -�----'-'-�--------------
1
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
• • • ', '_�.^~�.-
'----------'� ----------- Not Applicable 0
Company Name:
Responsible In Charge of Construction ._'____________�__�________
______________________________________
Address
Signature Telephone
2010 -10 -28 09:31 >> 413 536 0242 P 5/5
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 0
SECTION 11 -OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
BMW -- - -- - - - -...- - - ........_ ........ .. ..... :. i as Owner of the subject property
•
hereby authorize '• -_.GFIROQ i __C V 1 1.6.0121 &ia l .
act on my behalf, in all matters relative to work authorized by this building permit application_ __ — .._ ______ _ - ._____.. - ._ ........
Signature of Owner Date
--- -- - - --
I, -- - - - - -1 Gt�'!..__.�f ....���. -------------- - -• -_: , 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 thepains.and penalties . of perjury ................ . ..._....-.-.-.-.----.--------------.-- •--- ._.._....._..__...... -. -- - ...._..--- •__ -_ --
L _
Print Name
Signs of Owner/ . ent Date
SECTION 12 - CONSTRUCTION SERVICES
101 Licensed Construction Supervisor: Not Applicable ❑
I•
•
•
Name of License Holder ::--- _.._. __�tsl . S� t2_- __- __ .- ----- .-- .-- _ - ---- -.. -
License Number
Fin
Addre Expiration Date
/ar ✓ d / �� ... y/3 5,4/20,._
Signature Telephone
SECTION WORK S' 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 'CJ No 0
The Commonwealth of Massachusetts
Department of Industrial Accidents
"
V Office of Investigations
1 600 Washington Street
1 , , Boston, MA 02111
" r www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information ) Please Print Legibly
Name (Business/Organization/Individual): 1ded4 fr Cn't't Ck 7'O4e`�/1d1J5/pir / , i,# tK.
Address: 1- 17 Qi, vin e S7Llf 6f
City /State /Zip: 4 ' A. // ; Phone #: y/j — 5I5-/ Sao
Are you an employer? Check the appropriate box:
general contractor and 1
Type of project (required):
1. I I am a employer with ,� 4 . I am a Q n g
employees (full and /or part-time).* have hired the sub - contractors 6. n New construction
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7.E�odeling
ship and have no employees These sub - contractors have 8. n Demolition
working for me in any capacity. employees and have workers'
9. n Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. _ We are a corporation and its 10.0 Electrical repairs or additions
3. [ I I am a homeowner doing all work officers have exercised their 11.F Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.11 Roof repairs
insurance required.] t c. 152, §1(4), and we have no 13. n 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 the policy and job site
information. /9/4 'T s /_
Insurance Company Name: //6 c .L /� uranG L U7r ei,
Policy # or Self -ins. Lic. #: 9//y3 90110 Expiration Date: //////
�� c
Job Site Address: / Si /(/,r/. k,, r� S7 t / City /State /Zip:Arf / �a / 4n Ag. O J 0
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 under the pains and penalties ofper'ury that the information provided above is tru and correct.
Signature: ' Date: / 0 /�r /d
Phone #: 1 1/c..? 5, 3J - / 5 0
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 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
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HFP Corporation
A (ITC Fire and Security Company
32 Char Drive
Ww{ficld. MA DI(R1
"lel: (811(1) 888 -5197 10: (4111 - 4709 Fax: (413) 562.7293
November 3, 2010
Gardner Construction & industrial Services
47 Olivine Street
Chicopee, MA. 01013
(413) 536 -0242
Subject: Automatic Fire Sprinkler Quotation
Re: Tenant Fit -Out - Northampton Plaza
Northampton, MA.
Gentlemen:
T-TFP Fire Sprinkler, Inc. is a wholly owned subsidiary of HFP Corporation. Incorporated in 1972, HFP has
become known as one of the largest and most credible sprinkler contractors in the Northeast United States.
With a bonding capacity of 10 million dollars and an annual volume of 20 million dollars, HFP has never
failed to complete any job in its 37 year history.
We are pleased to offer
to modify the existing automatic fire sprinkler system at the above referenced project.
A. Our quotation is based on the following scope of work:
1. Sketch as prepared by Gardner Construction it industrial Services
2. Specifications design build
3. Starting our work at the existing fire sprinkler system
4. Adequate water supply
5, Wct sprinkler systcru is designed in accordance with VFPA. 0l3 "Installation of Sprinkler Systems"
6. Seismic bracing will be installed in accordance with NFPA Standards and the Building Code,
HFP Fire Sprinkler, Inc. / HFP Fire Protection Services, Inc. / HFP Residential Fire Sprinkler
u 1jI -Ileu - Ir€? Si pprpcslon & Lorrrol JyStems
Offices Located at
!nn0 old CA,At CW.1e I t t I , w , d,o, lxb. Cr 0606 A ••••••F 41••71 M •7Cn Jr*... MA 01047
,8001 83.?.., 413 / L Rio") 07. <400 ; 9e0113i�457Fa.. uwj)113•e5Z r 1.:(111ITMruq I I30el ::uruFo,
MA Lk - -rl,. A' li{I CT Llc.Nn I • I I .A4 DI l{Car:o I: I00000f3 VI q 4;076
.V• F A. I lrenAn I; 11 747 ) _ Cr FA. Ucor.e w FI.0 OIJD kl 1.T. Llca.•.,n 0: AF17.4 464
vrAnv.hrpsprtntler. com
Louis Hasbrouck
From: Duane Nichols
Sent: Thursday, November 04, 2010 11:13 AM
To: Louis Hasbrouck
Subject: RE: Big Y plaza
Lou,
I am good with shop drawings and FD approval as a condition of occupancy.
Duane
From: Louis Hasbrouck
Sent: Wednesday, November 03, 2010 3:43 PM
To: Duane Nichols
Cc: Fire Prevention
Subject: Big Y plaza
Duane,
Big Y is fitting out a space in the Big Y Plaza (between Delap Realty and the old Bickford's space). The space is
35x60; they're putting up a couple partition walls for offices at the back. It is fully sprinkle red and alarmed now. They
may need to move a couple of heads; they have contracted with HFP for the sprinkler work. Are you OK with shop
drawings and FD approval as a condition of occupancy or do you need drawings before I issue the permit? Let me know.
Thanks.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
Phone: (413) 587 -1240
Fax: (413) 587 -1272
1