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23B-044 (15) ACORD % CERTIFICATE OF LIABILITY INSURANCE DATE 03/02/2010 PRODUCER 413. 586.0111 FAX. 413. 586.6481 ` THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Webber & Grinnel 1 Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE • 8 North Kin Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR King ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Northampton, MA 01060 INSURERS AFFORDING COVERAGE NAIC # INSURED Wright Builders Inc AT 'R 2 3 20tu INSURERA Excel sior /Peerless _ 11045 48 Bates Street INSURERS[ Peerless /Peerless 24198 Northampton, MA Q1060. INSURER C: Netherlands /Peerl 24171 INSURER D: ....... -_ _ INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LT R RD TYPE OF INSURANCE - POLICY NUMBER POLICY ATE (M DATE (MEXPIRATION IY1 N LIMITS GENERAL LIABILITY CBP8616138 03/01/2010 03/01/2011 EACH OCCURRENCE $ 1,000,000 PR ES (Ea a COMMERCIAL GENERAL LIABILITY occurrence) (Ea occurrence) $ 250, 000 I CLAIMS MADE I X OCCUR MED EXP (Any one person) $ 5, 000 A X Blanket Add't Insu PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG . $ 2,000,000 7 POLICY n FCr X LOC AUTOMOBILE LIABILITY BA8615140 03/01/2010 03/01/2011 ANY AUTO COMBINED SINGLE LIMIT 1,000,000 (Ea accident) ALL OWNED AUTOS S BODILY INJURY • A X SCHEDULED AUTOS (Per person) X HIRED Autos BODILY INJURY $ • • X . NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE _ $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ • ANY AUTO OTHER THAN EA ACC $ • AUTO ONLY: AGG $ EXCESSIUMBRELLAL.IABILITY CU8618241 03/01/2010 03/01/2011 EACH OCCURRENCE $ 5,000,000 X OCCUR I I CLAIMS MADE AGGREGATE $ 5,000,000 B $ DEDUCTIBLE $ X RETENTION $ 10, 000 $ WORKERS COMPENSATION WC8612741 03/01/2010 03/01/2011 X I TORY L M S I _ ER AND EMPLOYERS' LIABILITY C AANYYIPROPRIErOR/EARTNEf� ?DIVE I Y f N E.L. EACH ACCIDENT $ 500, 000 (MandatorylnNH) E.L. DISEASE - EAEMPLOYEE $ 500,000 If yes. describe under SPECIAL PROVISIONS below • E.L. DISEASE- POLICY LIMIT $ 500, 000 OTHER - DESCRIPTION OF OPERATIONS! LOCATIONS /VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION D • ATE 'THEREOF, THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. • • • Evidence of Insurance AUIHORIZEDREPRESENTATIVE - Jenna Rodrique, CISR /JER ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • i •- NIassachu set ts - Department of Public Safety „ y Board of Buil(lin�. Regulations and Stztndai s + Construction Supervisor License APR 2 , License: CS 84280 Restricted to: 00 C j / ROGER S BUZZELL 277 SOUTH ST BERNARDSTON, MA 01337 ' 4 Expiration: 3/6/2011 ( 1umniissioner Tr#: 15306 • • Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 68185 Restricted to: 00 ' ARTHUR L.PICHETTE,� -'�; 174 LAUREL HILL RD WESTHAMPTON, MA 01027 Expiration: 4/14/2012 Comnnlissioner Tr#: 21579 • WRIGHT BUILDERS, INC. 034701 DATE INVOICE NO. JOB NO. COMMITMENT NO. AMOUNT DISCOUNT NET AMOUNT 4 -21 -10 042110 -101 10-10? 69.00 OO 69.00 CHECK DATE CHECK NO. TOTAL GROSS TOTAL DISCOUNT CHECK AMOUNT 4 -22-10 34701 69.00 .00 69.00 3',11.1,a.M121=====iital2,11=1 INHITEWAKEP vq - WRIGHT BUILDERS, INC. FLORENCE SAVINGS BANK 034701 FLORENCE, MA 01062 48 BATES STREET 53 NORTHAMPTON, MA 01060 413-586-8287 p ay; ttt***ttttkItttf-7*.ktfkti:ff*k57- dc:i an d no cents DATE CHECK NO. CHECK AMOUNT Aryr“ 22, 201n 34701 . 1:-.4.-A-Arttfr;ttg . rin NOT VALID AFTER 90 DAYS 7 ez A'/:;-T .L - NATURES REQUIRED ON • E S OVER 55000.00 AUTHORIZED IGNATURE NP AUTHORIZED SIGNATURE MIV.14172",1=ZM 2] SECURITY FEATURES INCLUDED. DETAILS CN BACK. [21 LMIA, 003470 Iv 1:2 L LEI 7 L6EiEil: 0 L 25 0056060 • Northampton Fire Dept. Fees Job: Cancer Connection: 41 Locust St., Suite 1.1 Northampton, MA 01060 Floor Squ. Ft. x 0.04 Fee 1st Floor 1724 x 0.04 $68.96 TOTAL: 1724 x 0.04 $68.96 Scope of fire protection per "Fire Protection Narrative" forwarded to NFD via the Northampton Building Dept. Wright Builders mailed $69 check directly to Asst. Chief Duane Nichols, NFD. Graham Electric to pull the Fire Alarm Work permit and pay the associated $80 permit fee. (Both checks are made out to the City of Northampton.) cc: Tony Patillo, Northampton Building Commissioner Asst. Chief Duane Nichols Graham Electric Prepared by Wright Builders, Inc. 4/21/2010 WRIGHT BUILDERS Fire Protection Narrative To: Louis Hasbrouck, Building Inspector Date: April 23, 2010 Project: Cancer Connection - Remodeling 41 Locust Street Florence, MA Contact: Betsy Neisner Work Tel: 586 -1642 Existing Conditions: There is no existing fire alarm system in the building. Area of work: Floor Level Use 1 Floor (Street Level) Cancer Connection — Offices (not medical) Scope of Fire Protection work: 1 Floor: Exit signs at each exit. Installation of (1) one new Secutron, Model #MR2306 micro processor based fire alarm panel with built -in communicator, a two line udact. Also to include: (3) three hardwired photo - electric smoke detectors (1) one new hardwired strobe in ea Bathroom (total of (2) two) (1) one horn strobe and dual action pull station w /key reset located at ea exterior door (total of (2) two) (1) one beacon on exterior of bldg above (1) one new knox box Work to be done by: Graham Electric, Bill Graham Cell: 413 -575 -0700 _; • Versionl.7 Commercial Building Permit May 15, 2000 1 • 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 ❑ ... Name (Registrant):- ' -- Registration Number Address `____ ___ Expiration 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 Telephone Expiration Date - Name Area of Responsibility Address Registration Number i Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number , Signature Telephone Expiration Date 9.3 General Contractor - V P 1 e' `1 ► 1g'v 1 1* F t � G 1m t Not Applicable Cl Company Name: kh . C b ( 5 3 to Responsible In Charge of Construction (Fr ' S Affith . 0 1' 41 erw , i t Pr' P • a-41 J a • dress,, - • �3 ... 9 Sign. • r Telephone . , . , A/tc, nyv toice pie. -to ,9 1 >b 14 (Ai rntiri elc 1>-t) ti6- 4* 6 T Pk r t Version1.7 Commercial Building Permit May 15, 2000 • 8. NORTHAMPTON ZONING - .: • . Existing Proposed Required by Zoning This column to be fil in by Building Depa nt _ .... - Lot Size - ' . - I _ _. ____ - - - " - Frontage 1 Setbacks Front I Side L: — — .... . R: — - — 1,- Rear ------ Building Height rT ---- Bldg. Square Footage 1 . % Open Space Footage - -- 1 , 1 (Lot area minus bldg & paved , parking) • # of Parking S es _ _ Fill- I ume & Location) • i A. Has a Spe • l Permit/Variance/Finding ever been issued for/on the site? • . . . DONT KNOW 0 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 L 1 Page and/or Document # ...! „.. • B. Does the site contain a brook, body of water or wetlands? NO ec 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 0 , Date Issued: • C. Do any signs exist on the property? YES 0 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 e- IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, exca ation, 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. .,!,,,....,z 3...- : , <0 31, 71 • ■,- 7.: .. ( , .:ST, ...,.. .., , ..,.. :3 ,,..e .,..., ..._ , ' . --:' ■ ' , - '..-, • , . . _ . . Version1.7 Commercial Building Permit May 15, 2000 ' - ... .---. v- - SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOS SpACEit=3:47 , .. Interior Alterations' 0 Existing Wall Signs - ;_gr :Demolition EIRepairs 0 Additions 0 Accessory Building 0 ..• - - ,. - - - „72„-., : - ..,,, - .._=., - : ,_. , . . .. .-; Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use 0 Other 0 - ---: 7:- :-:i.. ..; ._ - -! . Brief 44440 7 -t - Al - c -4 -" f - f -T oT.`j -,--------1 •r ifi: tt 0 e5 -- -- 6-- (f - 4 fi t.. - .; - r - z' ''. . -. :' -- 4 1 1 :Of Prc)13 -1 ' -°. *7f -- 4 - i-.. ---7-" ' 'h-e-c_ --4-r t - trc - -t.k. fN,IVVr ' k,q pt . 1 ' ruek ih— • SECTION 5 7 USE GROUP AND CONSTRUCTION TYPE - - USE GROUP (Check as applicable) CONSTRUCTION TYPE : - A Assembly - 1 ' A-1 . 0 . - A-2 0 A-3 0 - ' - - 1A A-4 0 A-5 0 1B 0 B Business ; ' Er - 2A 0 • E Educational 0 — 2B 0 F Factory 0 F-1 0 F-2 0 • 2C 0 H High Hazard 0 -- ' 3A 0 ... 1 InstitutiOnal i -. 0 . 1-1 0 1-2 0 1 _ 0 3B ' 0 M Mercantile : - 0 •- 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 5B 0 :- - - U Utility ,.-., - 0 i - Specify: r , L . - --- . - M Mixed Use 0 Specify: _ _____ S Special Use - : ti-,:::::-.: ., _ Specify r . . . . , -.L.-. - , - 1 ... ..• COMPLETE ill 1S SECTION IP EXISTINGBUILDINGONDERGOING RENOVATIONS , ADDITIONS AND/OR CHANGE IN USE ..-- Existing Use Group --' I?') l'i ccf .ct - — I Proposed Use Group: .1 - OR i': - - J. = -- - . : . . . Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): I____:__ i — r, SECTION 6 BUILDING HEIGHT AND AREA ::::::,n y-< -t kv,...(torl ,A1,-thly) 9,y4`\--f,y\cl • .- USE- 1- .--,---,,---- ; BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION _ '''',_,,i"-.'.:.Tift: "OFFICE ONLY .: ".j.::: ... ....• . "= .... Floor Area Floor (sf) ''S.::::: ..•.' .=::::,.. =., , ==.' 2 . :-.. :..?. ...;.: . ::.-,i:".:: ;."....E..,..:........:';.:_.: .. ,.:,::.:.,:, .. 2. ' '..::'',. ' ;' , ■: : • : - .7,: ,• 17 4'1 ', H- .. i . :'.'i • *. . ''.... ::::---: ..; : : ' ' :: :: - - - .. 1 ------------------------ 1 11 7 - .- i -- - .-----7 i 1 ::: ......, . :::..-:.:„._.•::-:..,„ . - A — 2 n. ' ' S '.-;'..' i'':':.': --..':: . : 2 nd ---- — — ---- _ _ — r4 - 3 _ r ,th . 4th , . ..-----__ _____----- Total Area (sf) i Total Proposed NewConstruction (si) ..•• ,_ .. - .- .. .: .: • . ' . Total Height (ft) • Total Height ft . - 7. Water ;upply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: . Public DI Private 0 Zone 2. Outside Flood ZoneEK Municipal Ig On site disposal system El ) 'JI,..< - ::f'i;:' -4 X- , .... - " 7 4.4' 7 •'7.::!... - : , :' - , , , -- =;- . ..- - ' - ;:::5.-'_ , ,.--- i . . • . . •-• .; ',-;.--.:;'"-.. . . . - , Version1.7 Commercial Building Permit May 15, 2000 , : ,, ,..:,•. , :•.',.. - ..‘-:: , .%T.A - i - rn;liDepartment use only '1`;.W,V . - Z.: City of Northampton Status of permit: _, ,-- ' - Building Department Curio'L;ut/IJnyeway terrnit .' . - ' •- '. - r'-' - --'--, --• :- 212 Main Street • .. Sewer 41- v -:- - '''---:- 't --- • - • - ‘ # . - :i_- - , JAL- . in^ Room 100 in. • .- - ' .:- Nomnamptori MA 01060 - ------- - tti - ''--,..-- . -- • -• - '----- ---,----; ' - 7 - phone . 413-587:1240 Fax 413-587-1272..:::. PioyilieIlrs ya. t :' -. ..g. ,.. - - ,,,......,, P.,,,P!.: ., ' •" .- '' ...,..-5.-, ..Vs f .,f` A ,9,-,„ -- :.------: 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 !-:--;;;,--:k:'::::::,>.:F.- •: . :"':-:".:;::::Y:::- , This section to be completed by office :, •-: .:•,::',..„ 1.1 Property Address: ........ -- .: • • ' ' • • ' - 4I Li) cvs - 7 - sr ,zvi i-i a , Map .... Lot AJnit .F.-. .,, • . :.::.•....,, . _.., ,il04-TI P70 Af, M A , 1 •,:. Overlay District _ .. . ___:_____ , __ ..g../ett . . .._EImSt. District . ., - ,.. ,:.-. ,. CB District SECTION 2 .PROPERTY OWNERSHIP/AUTHORIZED AGENT . :-?:^:". '-' ':. . , : '; :" ' .. :' ' - , 2.1 Owner of Record: • H It 7 r=i EL i) or 0 iik : - t 4 ____.: Name (Print) 1 Current Mailing Address: givi..41"....e."...., . 14)_h■ i 6 i f 4. ceb-7000 i _ • X Signature - - Telephone -- 2 2 Authorized Agent: I i , • • • Name (Print ,..0 zi k.e. . Current Mailing Address: litg 5 st- i ve-i„ri ti ,, 1 04 1-1 A --- orti - Va ::::. - . _ . Signature *A, ) "--- - • Telephone ( 41 ,.) SECTION 3 -iSTIMATEDObt■ifkUctioN COSTS - Item - .T.. -..: '..-.---...--..- Estimated Cost (Dollars) to be ‘',- • - -.-- --- .---.--,-. -.0fficial Use Only: • - completed by permit applicant , .. 1 1. Building ' I (a) Building Permit Fee i ------1 (b` Estimated Tof= Cost of ' - . --- - " -!---- : 2. EIectric,a l .. 1 ( ( a si i (b) "' ."" ''''. ..--' B.Eu;CdOinng Permit () 6 _,... " - , 3. Plumbing 9 . , - - .•_,. -. . • ) .• .: 4. Mechanical (HVAC) : C (c - , L : - - . • . , -.- .. • , 5. Fire Protection . 5 _..- 6. Total = (1 +2 + 3 + 4 + 5) (C a 1 3,4. Check Number 3 y ? 037 2—.. This Section For Official Use Only Building Permit Number Date Issued Signature: • Building Commissioner/Inspector of Buildings Date - — - ,,------------,:--;' - ," - " ': t- .- ..: :,-•, 7. ., - - .i'-':' ' , ‘' . ''''''''''''''''''''"0l!CM-tiV.t.:::':"t.*.i'S''",:'-s-'="-r-':1 ,-• ,‘ , NNNN., File # BP-2010-0936' APPLICANT /CONTACT PERSON WRIGHT BUILDERS ADDRESS /PHONE 48 Bates St NORTHAMPTON (413) 586 -8287 PROPERTY LOCATION 41 LOCUST ST MAP 23B PARCEL 044 001 ZONE NB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid ,/ n o? czy 37OZ Typeof Construction: INTERIOR TENANT FIT OUT - CANCER - CONNECTION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 068185 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION 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. 41 LOCUST ST BP- 2010 -0936 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23B - 044 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -0936 Project # JS- 2010- 001393 Est. Cost: $62121.00 Fee: $372.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WRIGHT BUILDERS 068185 Lot Size(sq. ft.): 23435.28 Owner: OMASTA ALBERT M & BERNICE E C/O EDWARD MALINOWSKI Zoning: NB(100)/ Applicant: WRIGHT BUILDERS AT: 41 LOCUST ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586 -8287 Workers Compensation NORTHAMPTONMA01060 ISSUED ON:4/29/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: INTERIOR TENANT FIT OUT - CANCER - CONNECTION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: S"j / 7 I 'Se vice: Meter: j Footings: Rough: ,2;_, �-a? °a � ... Rough: _r_2. ` 1 `� , House # Foundation: alp Driveway Final: Final: . 7-1 3 - /'? -- Final: NO s J J,t', F- / ~(6 V t Rough Frame: 5 (� 1 f U 1 $- Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation:pC giY0 C/i//Li Final: Smoke: e f r , , , / Final: Ok /7 F— /U Q R/,,.-L iq 74V/4) THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REG LATION A•1• 007 OP' dL. et44,4 Certificate of Occupanc enature: FeeType: Date Paid: Amount: Building 4/29/2010 0:00:00 $372.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo