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23B-046 (20) 9 O. Response to 903.1.1-16 —Fire Protection System Equipment Room: 1. The existing wet sprinkler service entrance and alarm valve assemblies are located in the basement level. 2. The existing dry sprinkler service entrance and alarm valve assemblies are located in Mechanical Room B-34D. P. Response to 903.1.1-17—Fire Protection System Equipment Identification and Signs: 1. The sprinkler system shall incorporate all signage as required by NFPA, as well as indicated in the specification. Q. Response to 903.1.1-18—Fire Protection System Alarm Supervisory Transmission Method and Locations: 1. The System monitors and reports all flow and trouble supervisory signals from the building fire suppression system. Any trouble or alarms that are activated shall send a signal to the 24/7 on- site security office for action by staff.. Should you have any questions regarding this project,please feel free to call. Sincerely yours, CONSULTING ENGINEERING SERVICES, INCORPORATED Steven R. Collins Principal p:\28507.00\narratives\fpnarrative.doc Cc: FILE 3 F. Response to 903.1.1-4—Sprinkler System Info: 1. The sprinkler system consists of a wet pipe type with sprinklers attached to piping system containing water under constant pressure, building alarm valve, zone control valves and backflow preventer. 2. The sprinkler system consists of a dry pipe type with sprinklers attached to piping system containing compressed air,water under constant pressure behind dry system zone control valves,building alarm valve, and backflow preventer. G. Response to 903.1.1-5—Sprinkler System Control Location: 1. The entire fire protection system is equipped with isolation valves at the backflow preventor, each building alarm valve and zone control valve. Each isolation valve is equipped with a supervised tamper switch. In addition, the alarm valve and zone control valve stations are equipped with flow switch. H. Response to 903.1.1-6 & 7—Standpipe System Info: 1. The existing standpipe system designed to NFPA 14 is installed through the building and shall remain, I. Response to 903.1.1-8—Fire Department Connection: 1. The Fire Department connection consists of an existing two port Siamese with two (2) 2-1/2" connections to match Fire Department hose threads. The location of the siamese is at the entrance into the building, this device&location shall remain. J. Response to 903.1.1-9& 10—Fire Protection Signaling System: 1. The existing sprinkler system alarms and trouble signals are wired to the existing building fire alarm system control panel. The signals are sent to the central fire alarm annunciator panel and to on-site 24/7 security office for action by staff. K. Response to 903.1.1-11& 12—Smoke Control System: 1. The renovated portion of this building has smoke detectors being installed within corridors and patient areas. L. Response to 903.1.1-13—Life Safes Features: 1. The building is equipped with horns, strobes and pull stations. Upon activation of any duct smoke detector or pull station the building will go into alarm with all strobes flashing and horns sounding. A signal will be sent thru the fire alarm control panel to the Fire Department. Existing area smoke detectors while not required, shall be maintained in service as supplemental equipment. M. Response to 903.1.1-14—Fire Extinguishing System: 1. There are local fire extinguishers located at periodic intervals throughout the corridors on all floor levels. N. Response to 903.1.1-15—Fire Extinguishing Control: 1. The local fire extinguishers (hand held) are manual. 2 Consulting Engineering Services , I. L. C . — -�- — i August 18, 2008 Mr. Duane Nichols Assistant Chief City of Northampton 26 Carlon Dr Northampton,Ma 01060 Re: Cooley Dickinson Hospital- 28507.00 Dear Mr. Nichols, A. Response to 903.1.1-1a—Basis of Design: 1. The design is based on a building Use Group I-2,consisting of a 6,820 sq. ft interior renovation and modification to the existing wet and dry pipe sprinkler system. 2. The entire building is protected by an existing wet pipe sprinkler system,in accordance with NFPA-13 2002 edition. B. Response to 903.1.1-1b—Sequence of Operation: 1. The wet pipe sprinkler system is attached to a piping system,which is always charged with water. Upon the opening of a sprinkler head or hose valve, the water will flow to suppress the fire,which in turn will activate alarm system caused by the sprinkler flow. 2. The dry pipe sprinkler system is attached to a piping system, which is filled with compressed air and controlled by a dry system control panel. Upon the opening of a sprinkler head or hose valve, the air pressure in the line will drop, causing the control panel to open the valve to allow water flow to suppress the fire and activate the alarm system. 3. The space is equipped with existing alarm valves, and existing zone control valves. Upon activation of any sprinkler, an alarm is sent to the central fire alarm annunciator panel and to on-site 24/7 security office for action by staff. C. Response to 903.1.1-1c—Testing Criteri a: 1. Along with review of shop drawings, hydraulic calculations, etc., acceptance shall be confirmed through routine project inspection,punch list inspections, system pressure test, flow test, for compliance with all related NFPA codes will be performed. D. Response to 903.1.1-2—Building and Site Access: 1. The building is accessible from the Locust St. and Hospital Rd.; the building is also accessible from the paved parking lots,which will accommodate the fire fighting equipment. E. Response to 903.1.1-3 Fire Hydrant Data: 1. The flow test at the site resulted in a static'of 120 psi and a residual of 110 psi with a flow of 1100 gpm. The results of the flow test indicated that the existing city main shall support the required system flow.. '163 81 1 ^ !ddk" SIP"Ft, „t.i'' h(L< 6t� CITY OF NORTHAMPTON, MASSACHUSETTS CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: HAI-07-77 DATE: August 14,2008 PROJECT TITLE: Renovations and Addition for new Linear Accelerator PROJECT LOCATION: 30 Locust Street, Ground Floor NAME OF BUILDING: Cooley Dickinson Hospital SCOPE OF PROJECT: Addition and Interior Renovations IN ACCORDANCE WITH THE MASSACHUSETTS STATE BUILDING CODE, 780 CMR, CHAPTER, SECTION 116, I, RICHARD E. KATSANOS , MASS. REG. NO. 8355 , BEING A REGISTERED PROFESSIONAL ARCHITECT/ENGINEER, HERBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL FIRE PROTECTION ELECTRICAL MECHANICAL OTHER(specify) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICE AND ALL APPLICABLE LAWS FOR THE PROPOSED PROJECT. 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 116.2.2: 1. Review of shop drawings, samples, and other submittals of the Contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required controlled materials. 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in appendix B. PURSUANT TO SECTIONS 116.2.3, 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 DINESS OF THE PROJECT FOR OCCUPANCY. RED Aft Subs&4-led andsworn to b fore me this_day o 2 M. 0, a loo.X355 P �ioys� 3 EASTHAMrTON, �o MA Nota Public atsanos' AIA My Commission expires on ��jH 0 F t� •• � asSA 0 The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington Street } , 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):1-yr10 IYtS tPy L Address: 52, I— OL v, 14P f, City/State/Zip:y N) t•J 6 719 OF ekU Phone#: (40 Sq ' 7 `{ Are you an employer?Check the appropriate box: Type of project(required): 1. ❑ I am a employer with 4. am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working or me in an capacity. employees and have workers' g y p �'• 9. E]Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other 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. tContractors 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: V ��-E'`f 1N�J 2P"A GCS Policy#or Self-ins.Lic. #: W C, 60-7 Z?9 Expiration Date: to ` t ' 2-co q Job Site Address: 317 [—t7(us T &, a2c City/State/Zip:pt4rglI M%O-%-Dt a AN- 0101,0 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 ce ' de he ins and penalt' perjury that the information provided above is true and correct. Signature: Date: 1 Phone#: G(ob 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#: 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 Norm Welch as Owner of the subject property hereby authorize Steven Glanzrock to act on my b alf, in all matters rel wor authorized by this building permit application. f z/—O c1 Sign ure of Owner Date Steven Glanzrock 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 the pains and penalties of perjury. Print Name X09 Signature of 0 er Date-7—SECTION 12 -CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicablleee El Name of License Holder: �J �F-�–(7 C.5 105 License Number 0,- �l\ �tis.11� a o G/// 10 zo t o Address Expiration Date Signature Telephone SECTION 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 kv No 0 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: QILK ��� � �`�� ',�_�� Not Applicable ❑ Name(Registrant): ►f�/� ('4 AIL ���T S �I K )M"(On> W Ar Registration Number Address ` L 7, Expiration Date Signature Telephone , 9.2 Registered Professional Engineer(s): i�lC� sey&iCES Name Area of Responsibility 8/l MiQOc,6:sbk1.j Cr'� 06,YS-7 Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility /,7 ntltJrl o1 z-L- S7; 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 Signature Telephone Expiration Date 9.3 General Contractor 1 5Tft-,3b 2Z-- �.)I a:,,eyC. IN L Not Applicable ❑ Company Name: Responsible In Charge of Construction 52 Al PCA� 4,4� V0611,16T44 G� 061t ) Address (Tir Signature Telephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONNZ7 Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Fromm e Setbacks Front Side L: R: L: R: Rear Building Height Bldg, Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (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 Q DON"r KNOW 0 YES 0 IF YES: enter Book Page and/or Document#i B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q 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 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 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 Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version].7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑✓ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing[I Change of Use❑ Other❑ Brief Description's Enter a brief description here. 1.*j&ejc e-� m-? S� ,J�wc✓�►��,� nHi��f � Of Proposed Work: r� f�'h�73�Gl Lx!/?uC�/II{Lltt. C, '��51�2� ►?Y H✓i" -�/1���rs�Sr� 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 ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional 0 1-1 ❑ 1-2 19 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: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA OFFICE USE ONLY BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) 1 St 1 St 2nd 2nd 3rd 3rd 4 t 4th Total Area (sf) Total Proposed New Construction(sf) 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 ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system E] Versionl.7 Commercial Building Permit Ma 15,2000 Department use only City of Northampton Status of Permit Building Department Curb Cut/Driveway Permit - %U� 212 Main Street Sewer/Septic Availability. R' om 100 WaterNVelt;Availabitity NWham�ton, MA 01060 Two Sets of Structural Plans phone 4t3 W7= 240 Fax 413-587-1272 Plot/Site Plans Other Specify 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 Cooley Dickinson Hospital Map Lot Unit 30 Locust Street !� Ground Floor — l�.f00 A'1 (3 ,3� Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Cooley Dickinson Hospital p Name(Print) Current Mailing Address:30 LUCu�� dG-T Signature Telephone P _ 2.2 Authori ed Agent: Steve Glanzrock © 52 Holmes Road, Newington, CT 06111 p Name(Print) Current Mailing Address: (860) 594-7143 Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building $20,000.00 (a) Building Permit Fee 2. Electrical $5,500.00 (b)Estimated Total Cost of $36,000.00 Construction from 6 3. Plumbing $3,500,00 Building Permit Fee 4. Mechanical (HVAC) $216.00 5. Fire Protection $7,000.00 ))LL 6. Total = (1 +2 +3+4+5 Check Number d Td This Section For Official Use Only Building Permit Number /� Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-0652 APPLICANT/CONTACT PERSON STANDARD BUILDERS ADDRESS/PHONE 52 HOLMES RD NEWINGTON (860) 594-7143 PROPERTY LOCATION 30 LOCUST ST-LINEAR ACC B-51 &B34H MAP 23B PARCEL 046 001 ZONE M(99)/URB(1)//WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid -51484 T eof Construction: INTERIOR WALLS FINISHES LIGHTING MILLWORK HVAC&SUPPRESSION✓X2,00 yn $''� New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 051113 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I=Approved ATION PRESENTED: Got'►nP�`{ W 1 Additional permits required(see below) F�Q'E P�TEC�tcN �'� F(" DEP4P—ThlENT /L.E4`LI1ZEME)')'CS 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. 30 LOCUST ST-Rooms B-51 &B34H BP-2009-0652 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23B-046 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: B lJ 1LDING PERMIT Permit# BP-2009-0652 Project# JS-2009-000949 Est. Cost: $36000.00 Fee: $216.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: + Use Group: STANDARD BUILDERS 051113 r- 1) Lot Size(sq. £t.): 1325051.64 Owner: COOLEY DICKINSON HOSPITAL INC. AN " i90':{ zonin,g:M(99)/URB(1)//WP Applicant: STANDARD BUILDERS AT- fir; n^i ic-- .r_s�. ...,,-. ^_,• st. '�'_i! At�t �'.L:3, '(. Applicant Address: Phone: Insurunce: 52 HOLMES RD (860) 594-7143 - WC NEWINGTONCT06111-1708 ISSUED OIV:112212009 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR WALLS,FIN ISHES,LIGHTING,MILLWORK. HVAC & SUPPRESSION(MUST COMPLY WIFIRE DEPT REQUIREMENTS) 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: C, Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough Oil: lnJL'lat:iltl. Final: Smoke: Final: O y = j 09 1 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. �� Certificate of Dest ^t;ey s; natured _ FeeType: Date Paid: Amount: Building 1/22/2009 0:00:00 $216.0050840 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo