23B-046 (102) Northampton
4 Department
Memorandum
si
To: Tony Pawn kll�`1 t t _ 1
kit
, ;
From: Duane Nichols
Data June 30, 2003 tY„
CC: Brian Duggan
Re: Pharmacy project at C.D.H.
Secondary to a review of the fire protective narrative and a meeting with the
contractor, our concerns have been answered. l concur with the issuance of a
building permit for this project.
•Page 1
rvk Northampton
Department
1
Memorandum
To: Tony Patillo � '
From: Duane NicholsD I'
Date: June 13, 2003
CC: Brian Duggan
Re: Pharmacy project C.D.H.
Secondary to a review of the plans and fire protection narrative for this project,
disagree with the issuance of building permit as I have significant questions on the
fire alarm system. I would like to request a meeting to clarify these questions with the
contractor.
•Page 1
May 22 03 09: 41a p. 2
C0.yVLkRPTO
,mas%RcE Itor Its r tI
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building �\
Northampton, MA 01060
r
CONSTRUCTION CONTROL DOCUMENT
(for professional Engineers/Architects responsible for Entire Project)
Project Title: N6 w�A_ 4?e EXFA-b1'S?!0 Date: V_AAY Z81 ?_00?j
Project Location: 30 MAGUS+o S+ Map: Parcel Zone:
Scope of Project: ' pC) s� Or t"0\J,4g—M > ftA41t�,
In accordance with the sixth edition Massachusetts State Building Code, 780 CMR SECTION 116.0:
l n � Mass. Registration Number
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.
j 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 MassachuSetlS State Building Code, all acceptable
engineering pracfices 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
perfortzled ir,a manner consistent with the constntction documents.
1 shall submit periodically, in a form acceptable to the building official, a progress report together wth
i
pertinent comments. Upon completion of the work, I shall submit to the building official a final report as
to the satisfactory completion and readi ess of the project for occupancy
Signature and Seal giste pr onal: .C,�S�EA0 4.'t''
tr
R� N0.6033
OF
hax 413-587-1272 - phone 413-587-1240
• o O
g� e9 Gx� x1f wart 1jaillpflail
� 6 �asaacEinsrtta'
s
m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building 'a
Northampton, Mass. 01060
WORKER'S�COMPENSATION INSURANCE AFI'IDAVTT
(/,,s7
Ncz=nscrJpermitiec}
with a principal place of business/residence at:
1 ,F2 fid'S T _5 T Sa cl7l,-. bt {�, '�0l0'7(5p hone#) l�l3S�z?zYS'
(stmef/city/stalrJa p)
do hereby certify, under the pains and penalties of perJury, that:
I am an employer providing the folloWlg worker's compensation coverage for my
employees working on this job:
y iS,�ff.vc�'/Y 'e �/j2 3 3 e Z 0 3
(Insurance Company) (Policy Number) (Expiration 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,
�< (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
•f.
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Daze)
(Name of Contractor) (Insumace Company/Policy Number) (E)piration Date)
(atw+additioml sheet ifneaeauy to inchsde int «Mahon pextaini g to all 0003rndon)
( ) I am a sole proprietor and have no one worming for me.
( ) I am a home owner performing all the work myself.
NOTE:pteaae be awsrn taut while hoamv ncra who employ pazow to do n ;.,r,„a nce c=stx=oa or mpair work on a dvmZmg of
not mote than throe units in which the homoowncr reside oc oa the gouods appurtenant thereto=ax&coaa11y coaridemd to be
employe a under the wozka"s comps matioa Act(GL152,ss l(5)�application by a homcow=for a Geeuse or pamd may cvidrnoe the
legs!dal"¢of an employer under the Woricocla Coapomation Act.
I undaua ad that a oopy of 0au arit—TI may be forwarded to the Dcparta>mi of ID&=triat Aocidw&Ofoc of 1mumooe for the
eovaage vcri&c dioo and that failure to secure rootage under section 25A of MGL 152 can lead to the impositioa of aimilW penaltie
oomi.stiag of a fine of up to S1,500.00 andloe impriso®eat of up too=year and civil peoaltia in the form of a StoP Worts Ordcr and a
fine of 5100.00 a day against me.
per dcp:rt nalw use onty
Permit Number
Map# Lot#
f.
Signatttrc of LiamsecfPetmittce Date
Version 1.7 Commercial Building Permit May 15,2000
r7 0 SECTION0�STRUC7 URAL PEER PREVIEW(780 CMR 101,11)
Independent Structural Engineering Structural Peer Review Required Yes......❑ No......
jul
SECTION 11 OWNER AUTHORIZATIONS TO BE COMPLETED WHEN r
AWNERSA GENT OR CO c NT
,,,,,,,,RA,, BUILDING PERMIT 3
-..-, x- s. w,3
y3 t
tow.-....
6-� pD /yG�.�f as Owner of the subject property
hereby authorize /li! P���� � ' Dom- to act on
my behalf, in a tters relative Wvork/ t horized by this building permit pplication.
d � log
Signature of wner 6ate
7/7 SP� 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.
7 f/£T,'£A
Print Nam
Signature of Owner/Agent Date
SECTION 12 ,CONSTRUCTION SERVICES
10.1 Licensed Construction SSuupervisor:`/ Not Applicable O
Name of License Holder: /� T/7 �f= / ®66 F 0 7
License Number
i sa vT/S�y&!1 04o ?.s 717/2603
Address Expiration Date
ignature Telephone
SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G L c.1521 §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.......s� No...... 0
Versionl.7 Commercial Building Permit May 15,2000
SECTION ,9-,,P OFESSIONAL;bESIGN ANDgCONSTRUCTION SERVICES, OWBUILDING&ANDISTRUCTURES SUBJECT7Q,,.I
s
CONSTR,U,CTIO[ CONTROL PURSUATVT fO,Y780 CMR,116,"(CONTAINII G 'MORE THAN 35 OOQC F,OF ENCLOSED SPAC
9.1 Registered Architect:N A[A Not Applicable ❑
Name(Regist nt): V
s Registration Number
Addr
Expiration Date
Signature Telephone �j t 0
92 Registe Professional Engineer(s):
?c,,-0 (\1
Name Area of Responsibility
Address Registration Number 0 -30 La
Si nature Telephone Expiration at
MAF, K s,�AL)�,AIE F f
Name Area o Res pons ibiity
� /
Ad ess Regis7oNOmber
Signatur Telephone Expirat' n 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 ,J( �
�i9Yendrs� P. //0-1/4 O�lS%�yG7/VX/ Not Applicable ❑
Company Name:
Responsible In Charge of Construction
2 T ST .Sv £ ,i9 0! v 7 5
Address r
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:
Public ❑ Private ❑ 1 Zone: - Outside Flood Zone ❑ Municipal ❑ On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage 2 2 (•S�'
Setbacks Front /b 2 /D_Z
Side L: R: L: R: `/�'
Rear
Building Height
n L% tJ�• J
Bldg. Square Footage
3 9 3 8q`l
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces Z
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: 4"'
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book �f�>'r; Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES X C-:1PA Si
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: r4/-n 41 n s
D. Are there any proposed changes to or additions of signs intended for the property?YES—
No
IF YES, describe size, type and location:
Version 1.7 Commercial Building Permit May 15,2000
SECTION 4 CONSTRUCTION SERVICES IFOR PROJECTS LESS THAN 35 O00
CUBIC�FEET�OFiENCLOSEDSPACE� V<' -
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building[ ] Repairs
v/� i.r/�s 'f�f r �/e Od J� 5--x1a4 71i1eA1
-SECTION 5 FUSE GROUP AND CONSTRUCTION TYPE} ' '
..4r.r ^,
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 I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1.1 OL 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,8ECTION IF.EXISTING BUILOING UNDERGOING RENOVATIONS, ADDITIONS.AND/OR CHANGE IN USE
Existing Use Group: 23 Proposed Use Group: Z—
Existing Hazard Index 780 CMR 34): 7 Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND',AREA �—
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTIONi� i �,
Floor Area per Floor(sf) St �y 2
1 �3 �/d f� K
2 nd
tg4 <
1St
r'
2nd 3rd
rd 4th
4th
�.:
Total Area (sf) Total Proposed New Construction (sf)
SEA mm,.
x
Total Height(ft)
Total Height ft .. -------
� ,.
• Versionl,7 Commercial Building Permit May 15,2000
— .City of-
,Northampton d
7 ;Building Department C° e
---p-12 Main Street
Room 100 a
JUN ' 6 MortHam' pton, MA 01060 _ e
phone 413-587.1240 Fax 413-587.1272 P i
APPLICATION-TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANUY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELL?MG
JUN
i
SECTION 1 SITE INFORMATION '
? s This 9'6,d tarr toad c6'ml ed by office
1.1 Property Address:
iLot Unit.
ZOne Overlay qtstrict.''; � r-
Us S /.
G 7 �� 7;:;;,A-/ /Q6 / . Elm St District CB D�str�ct :
SECTION'2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
e,,)oLCY �)-6-/- CIA-'Ilo-S '7r1c 3 eve- 15 7 -S
Name(P int Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
z-r T YS T S o y 7/0 )C C,; a/075
Name(Print) Current Mailing Address:
%3--.-3 2 -7 2 y3
Signature Telephone
5ECTI6N3 ESTIMATED CONSTRUCTION'C'OSTS:
Item Estimated Cost(Dollars)to be OfficialtJse'Only;
completed by ermit applicant
1. Building (a)Building Permit'Fee
2. Electrical -9,00 00. (b)Estimated Total Cost of
Construction from 6
3. Plumbing 3�d�a - Building Permit Fee
4. Mechanical (HVAC) t
5. Fire Protection /zV ,d c7.
6. Total =(1 + 2+ 3 + 4+ 5) -�era a �I�<>f% Check Number
This Section For Official Use Only
Building Permit Number 'Date Issued:
3
k
Signature:
Building Commissioner/Inspector,of,Buildings Date
File#BP-2003-1119
APPLICANT/CONTACT PERSON Raymond R.Houle Construction Inc
ADDRESS/PHONE 187 East St (413)532-9243
PROPERTY LOCATION 30 LOCUST ST-SECURITY OFFICE
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: PHARMACY EXPANSION-BUILDING"A" 1 ST FLOOR,INTERIOR RENOVATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FO OWING 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 Co ssion
tae
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.
L-5z
j�j
46:0
30 LOCUST ST BP-2003-.1'1'.19
GIS#: COMMONWEALTH OIL MASSACBUSETTS
Man-.Block: 23B-046 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: ALTERATION BUILDING PERMIT
Permit# BP-2003-1119
Project# IS-2003-1755
Est. Cost: $586000.00
Fee: $2930.00 PERMISSION IS HEREBY GRANTED TO:
Const. Crass: Contractor: License:
Use Group: Raymond R. Houle Construction Inc_
Lot Size(sq. ft.): 667077.84 Owner: COOLEY DICKR�ISON HOSPITAL INC
ZoningM AppUcant: Raymond R. Houle Construction Inc
AT. 30 LQC U EST ST
AAWlicant Address: Phone: Insurance:
187 East St (413) 532-9243
SOUTH HADLEYMA01075 ISSUED ON.717103 0:00:00
TO PERFORM TIIE FOLLOWING WORK:PHARMACY EXPANSION - BUILDING "A" 1ST
FLOOR., INTERIOR RENOVATION
POST THIS CARD SO IT IS VISIBLE FROM THE ST REET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: 1 —0 -) /','1KRough: House# Foundation:
Driveway Final:
Final: j, �� v .� Final: Marl f b
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke �:,��L i ^r�i'. Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS _
Certificate of Occu anc Signature:
FeeType' Receipt No: Date Paid: Check No: Amount:
Building 7/7/03 0:00:00 7723 $2930.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo