23B-046 (96) Northampton
Department
Memorandum
To: Tony Patlllo
From: Duane Nichols
Date: October 17, 2003
CC: Brian Duggan
Re: CDH MRI stairwell renovations
In conversations with the maintenance department at CDH in regards to this project I
have been informed that no changes or alterations will happen to the alarm or
suppression systems during the renovations for this project. I concur with the
issuance of a building permit for this project.
_ t �
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Jul 28 03 11: 41a . NCRC/BCB NYC 212-825-8952 p• 2
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Thomas Dyer
9 Alien Place
Northampton,MA 01060
July 28,2003
ATTN-. Linda LaPointe:
i currently have a building permit for improvements at my residence at the above address. Since
the permit was issued,my architect and builder have suggested two(2)changes that I understand
may require an amendment to the permit and an additional fee.
The changes are as follow.
I. The addition will be 3 stories with a gable roof(rather than 2 stories with a shed roof)to
provide a bathroom that will serve the third floor bedroom;and
2. The addition will extend I foot further to the rear,but will still be within the 20-foot rear
setback. (In place of a 22-foot setback in the rear,the addition will have a 21-foot
setback)
The total net increase in square feet and corresponding fee is as follows:
ts'floor 14 sq.ft. $.40 = $5.60 �'
2nd floor 18 sq. ft. @ $.20 = $3.60
3rd floor 175 sq ft. (a; $.10 = $17.50 0
TOTAL 182 sq. ft. $28.70 0�q t "
I have attached a floor plan and framing plan for the third floor work. Please let me know if I
have interpreted the fee correctly and I will drop off a check.
Regards,
ee'16W P-1
1
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street 0 Municipal Building '
Northampton, MA 01060
CONSTRUCTION CONTROL DOCUMENT
(for professional Engineers/Architects responsible for Entire Project)
Renovations to
Project Title: MRI Stairtower Date: June 18, 2003
Cooley Dickinson
Project Location: Hospital Map: Parcel: Zone:
Scope of Project: New finishes, ceilings, and lighting
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR SECTION 116.0:
I Edward L. Jendry Mass. Registration Number 4105
Being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly
supervised the preparation of all design plans,computations and specifications concerning:
DJ Entire Project
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 practices and all applicable laws for the proposed project.
Furthermore,I understand and AGREE that I shall perform the necessary professional services to
determine that the above mentioned portions of the work proceed 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 documents as submitted for the building permit,and approval for the
conformance to the design concept.
2. Review and approval of the quality control procedures for all code-required controlled
materials.
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, in general, if the work is being
performed in a manner consistent with the construction documents.
I shall submit periodically, in a form acceptable to the building official,a progress report together with
pertinent comments. Upon completion of the work, I shall submit to the building official a final report as
to the satisfactory completion and readiness of the project for occupancy.
Si gua a nd Seal of registered professional:
p�CHITFCT
DR), n
f ry
p iii y ,n
t
Fax 413-587-1272 -phone 413-587-1240
4•�tW!PT
fl
_ � B .�t1i RC(i abftt6 y
wart Iluily flail
m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORICER'S COIg'ENSA7TON INSURANCE AFFIDAVIT
with a principal place of business/resideace at:
/ 2 1 X T S T So�/Tiyit.1�G c� , 0/D?(Phone#) lrl3S�Z1 ZY
(stTce-uci ty/statrlrip)
do hereby certify, under the pains and penalties of perJury, that:
/ I am an employer providing the following worker's compensation coverage for my
employees worming on this job:
(Insurance Company) (Policy Number) iration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
rt;t (Name of Contractor) (Insura >�
nce Copa>zy/Policy Number) (Expiration Date)
(blame of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compairy/Policy Number) (Expiradon Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Aft sdditieail thee(if noo=wy to inehide iaforma ioa pertaining to.rl ooa.on)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:pleasc be aw-am CE4 wt lc hca=wocn wino c=p lcy pazocs to do= i-�o=5tmz1oa cr repair work a a d—Uiag of
W ancc thsa bxt c uIIf1 is wf=ch the bocxOSV=remidcs or cc t5C grvio6 TNpllftCCya1 tb=to L'C oot Caocr%lly ooaxidc L to be
c=ploy=under the was. 4ca Act(GL152,sr 1(5)}•ar^+pl=E=by a hoatc W=far a Gozase a permit may eMrax the
legal rtabu of an acptoy*r uader the Woricaee Coa:poma:ioa Ad
I uoda-stand dija a copy of ibis etat=5eat auy bo forww4ad to tbo Dcpartxx-ai of Iak�al Aoa&c&Of§oe of lasuraooe for the
oovci 6C Vtrifiatioe e d that fiiltae to saute m�rnges uodcx section 25A of MaL I52 as tmd m tbd iazQassfioa of erimiail peaslties
00=iring of a tax of tip to S1,500.00&ON- of up to ore y and civil pc=N cz is the fora of a Stop Work r Md a
fire of 5100.00 a dny Lpinst or-
i� For dqWtMats1 UX oaty
i'
Pcrm.it Number
Niap# Lot# —
Signature of LioensceRcrmittee e
__
Version 1.7 Commercial Building Permit May 15,2000
,�+ v-r' 4�aY
SECTIONf O�STRUCTURAL PEER REVIEW�(780 CMR--1011)A�
Independent Structural Engineering Structural Peer Review Required Yes......❑ No......El
SECTION 11 OWNER AUTHORIZATION"TO;BE COMPLETED.WHEN ',''
OWNERS'AGENTwOR CONTRACTOR APPLIES�FOR�BUIL`DING'PERMITS-y-'
.,.•_.-a...:, s__.:.F,u-,.•a .. ::i�evu; -!:_. R�'E
.s
as Owner of the subject property
hereby authorize //� �`���� Tr r- to act on
my beha , ' alf rrlatters rel iv to work �qthorized by this building permit pppli cation.
Signatu a of dwner bate
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 Na
j
Sign nature of Ow er/Agent !° Date
SECTION 12 CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor:
/ p Not Applicable O
Name of License Holder: /��rn"Y �S/ L/l ��� L'� D667 2 z
License Number
Address Expiration Date
t2gn�
ature Telephone
SECTION 13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M G L ;.152,§,25q6
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....... No...... 0
Version 1.7 Commercial Building Permit May 15,2000
SECTION=9-",PROFESS IONAL-DIES IGN AND`CONSTRUCTION SERVICES ;TOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 7B0 CMR 116,(CONTAINING MORE:THAN 35;000;C F OF;ENCLOSED SPACEj'
91 Registered Architect:
• Not Applicable ❑
Name(Registrant):
0 4_ ,, �G O,6 O Registration Number
Ad �CJ �� 1G,_L �
4,�yJ y Expiration to T
Si na re Telephone
92 Registered Profes ion ngi r(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
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration-Number
Signature Telephone Expiration Date
9.3 General Contractor
K,( ,� _ ---,
n4 I � t!I > C '�� ✓ �(,�c-/�G` �- �� C' Not Applicable ❑
Company ivsme:
Responsible In Charge of Construction
-� — e 7
Address
Signature Telephone
• Versionl.7 Commercial Building Permit May 15,2000
7.Water Supply(M.G.L. c.40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Pubiic D Private ❑ Zone: - Outside Flood Zone ❑ Municipal ❑On site disposal system ❑
S. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage 2-(°S� 2 l•�
Setbacks Front
Side L: R: W 2- L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved / —
parking)
#of Parkin°S aces 2-
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO— DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book �4' ! Page 7 and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES X 1511.,1 S/-
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: krzar �4r ns i^n7Y�- S�9N
D. Are there any proposed changes to or additions of signs intended for the property?YES
No --L
IF YES, describe size, type and location:
Versionl.7 Commercial Building Permit May 15,2000
-:: .+ ti•a, a r� a<t.'\ x.. t..r:...1_ -.8 .t�,Z�J �..:.,:.":.=`. �,yy_.' - •�r..-.. l;t?:
SECTION 4 --CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35`000 ".
t r .4 ,.y`.. .i�:1.,_,-y.
CUBIC FEETOFAE(VCLOSED�SPAC�� a+' a = "axe" �a;:::....c2*:r�,..as
.� ...<-.: C. �,.�.:.trK.ac�•a.,:,K..a_i2�.';,rl'. .>:ti�'::..�K,•79+.F S.TJ.-^aGe;vCC...�-:�C-'RSt ar.::....:,wAtiT--:+u.'aV..'.�'Z:;..:.
....: .:. .1...:;.w.:-..,.5'.-x.YU,_♦ S:a�?� .. r='-:S'. .n.i[5.�••:.:R'YA":1.7i'^I.L:!S%!'.Nt�`1Y:R.4«,.k;.� ..a:.(v...r.y �:�q:f.fXAR-a�:Y-
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
❑ ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑
Accessory Building[ ] / Repairs [ ]
�,���L' (��'r• ref"%l C_ i 1,�' _t�,-,/.1�� ��> ,7// �- :�.r �_y_-r��,���' a(`�1�:
S EC TION '5 M`SJ E GROUP AND CONSTRUCTION'TYPE;�yt ` .
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A llg-
A-4 ❑ A-5 ❑ 1B ❑
-B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1.1 A- 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:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION l,F EXISTING BUILDING UNDERGOING RENOVATIONS ADDITIONS AND/OR.CHANGE IN USE
Existing Use Group: �-'Z Proposed Use Group: �-
Existing Hazard Index 780 CMR 34): 7 Proposed Hazard Index 780 CMR 34): _> .
SECTION 6 UILDING HEIGHT AND AREA V /O �'O �`` :: (
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION .. :`0 FICEzUSEiONL'`
-mss.•.:�Y4 � � -
Floor Area per Floor(so i st
nd
lsf 2 kiE i� t yyS 4�A t t+as*s;r '
3`d �t rn -Y k, y s yla�t t r1
2nd '�
th
3rdJ
K n Y Y rrr4 Csy
4th
,r
XY ti'
Total Area (so Total Proposed New Construction (sf)
Total Height(ft) - -
Total Height ft .../�1.. .......
r _
' Versionl.7 Commercial Building Permit May 15,2000
`" Oepa` rrme t se o`ly
City of Northampton Stat s o .e ,
�n ing Department Garb • p.
Q �1 2 Main Street See is vaila t
Room 100 a e el a iab h
;
N pton, MA 01060 Two e s f,S c a a
I n
JUL 2pf�oQ A1 -1240 Fax 413-587.1272 Plot/Sit•e laps
or er Specify
A PLICA # , RE IR, RENOVATE, CHANGE THE USE OR OCCUPANCY Of, OR DEMOLISH ANY BUILDING
"`'"} t' OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 ' SITE INFORMATION !'
__..._ M
t' ;f This"section'to be completed by office
1.1 Property Address:
L ,
Lo nit
` � Unit
Y 1 S
v ( i dr }� `R
s / Zone - Overlay 0tstnct
9v7 7-1 �� O/QE / Elm St District CB District
SECTION 2 w:PROPERTY OWNERS HI0 AUTHORIZED AGENT
2.1 Owner of Record:
vsdti /�s�.'rc 30 Loc,/s7 s i
Name(Ps' Current Mailing Address:
Signature 00 Telephone
2.2 Authorized Agent:
Name Pr nt Current Mailing Address:
Signature Telephone
SECTION 3 "ESTIMATEbtCONSTRUCTy(ON COSTS
Item Estimated Cost(Dollars)to be Official UseOnly
completed by ermit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
`> Construction from 6
3. Plumbing " _ Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) �' .� E_ 7 Check Number
This Section For Official Use Only
Building Permit Number. = i " Date Issued:
Signature ,z.
Building Commissioner/inspector of.Buildings .` „r Date
File#BP-2004-0118
APPLICANT/CONTACT PERSON Raymond R.Houle Construction Inc
ADDRESS/PHONE 187 East St (413)532-9243
PROPERTY LOCATION 30 LOCUST ST-MRI STAIRTOWER
MAP 23B PARCEL 046 001 ZONE M
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:_COSMETIC UPGRAbff TO MRI STA TOWER
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 0662
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFSyR112ATION PRESENTED:
A/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 ssion
L Lc
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.
Raymond R. Houle SOO EAST STREET
UTH HADLEY,MA 01075
}�
T,11,, 413-532-9243 FAX 413-532-0413
Construction 10. E-Mail ncc@valinet.com
November 3,2003
City Of Northampton -
212 Main Street
Northampton,MA 01060
Dear Tony Patillo,
Enclosed please find the building permit for the MRI Stairtower project. Unfortunately, the
Hospital has chosen not to complete this project with my company at this time. I am returning
the building permit to you, so I can be removed as the Contractor of record for this project.
Thank you for your assistance in this matter.
Sincerely,
Timothy S.Pelletier
Vice President
.50 LOCJST ST-MRI STAIRTOWER BP-2004-0118
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B-046 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category BUILDING PERMIT,
Permit# BP-2004-0118
Project# IS-2004-0186
Est. Cost: $50000.00
Fee: $233.00 PERMISSION IS HEREBY GRANTED O: �, v
Const. Class: Contractor: License:
Use Group: Raymond R. Houle Construction Inc 066227
Lot Size(sq. ft.): 667077.84 Owner: COOLEY DICKINSON HOSPITAL INC 11
Zoning: M Aolicant: Raymond R. Houle Construction Ihlc
AT- JU J 1-I°II\i i i1!K S('�lVVCtt
Applicant Address: Phone: Insurance:
187 East St 413 532-9243 Workers Compensation
SOUTH HADLEYMA01075 ISSUED ON.10130103 0:00:00
TO PERFORM THE FOLLOWING WORK.-COSMETIC UPGRADE-TO MRI STAIRTOWER
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• Receipt No: Date Paid: Check No: Amount:
Building 10/30/03 0:00:00 7804 $233.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo