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23B-046 (109) Northampton � Department Memorandum T To: Tony Patillo P ", 1 3 2J C? From: Duane Nichols Date: March 17, 2003 CC: Brian Duggan Re: Elevator fill-in for new office at CDH Secondary to a review of the plans and fire protection narrative that was submitted to me on March 17, 2003, 1 concur with the issuance of a building permit for this property subject to the following conditions. • All fire alarm devices must interface with any devices in existence in the remainder of the building • A graphic representation of the structure must be installed at the Fire Alarm Control Panel and at the Fire Alarm Annunciator Panel • All fees and permits must be pulled and paid •Page 1 March 3, 2003 HEALTHCARE Fire Protection Narrative ARCHITECTS INC. Elevator Shaft Infill for a New Office CORPORATE DIRECTOR East/South Wing Edward L.Jendry, A.I.A. Cooley Dickinson Hospital Northampton, Massachusetts _ SENIOR PRINCIPAL C.J.Whitham The following existing fire protection systems at the Hospital will be effected by this PRINCIPALS project as follows: Don Hafner Richard E.Katsanos Ann Lawrence Knox Richard PWilk Wet Sprinkler System ENGINEERING ASSOCIATES The East/South Wing of the Hospital is fully sprinklered with a wet sprinkler system. William M.Barry,P.E. Under this project a new lateral sprinkler line with one new sprinkler head will be run Ronald G.Stenlund,P.E. into the new office area that will be created by the filling in of the old elevator shaft. All work will be completed in accordance with N.F.P.A. 13. Fire Alarm System The East/South Wing of the Hospital is protected by a fully function fire alarm system,which is tied into the main fire alarm system for the entire Hospital campus. Under this project,a new smoke detector will be added to the existing fire alarm system. This smoke detector will protect the new office area. HEALTHCARE ARCHITECTS INC. 64 GOTHIC STREET NORTHAMPTON, MASSACHUSETTS 01060 413-585-1512 O O ��r� �Htx of wart 11a11tpfall Bc B ,�t[361{Cl�n5tlla Q' m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE A.N,FIDAVTT l C (licensuJpermittee with a principal place of bu- ness/residence at: ��5 PxQ,, e PO VN, (phone-,#) 'i�3 3 (are--i/city/ sap) do hereby certify, under the pains and penalties of perjury, that: ( I am an employer providing the following workers compensation coverage for my employees worming on this job: q(,.\A,U\ W(F w1� z,—\—) z (Insurance Company) (Pokey Number) (Expiration Date) (A) I am a sole prophet r, general contractor or omeowner circle one and have hired ___ __l— c ) the contractors listed below who have the following worker's compensation policies: 0�A1kA4,:�, M e I4?A a (Name of Contractor) (Insurance Cornpany/Poucy Number) (Expiration Date) (Name of Contractor) (Inszuance Co=anrPolicy Number) (Expiration Date) (Name of Contractor) (Insuran(-- Company/pot cy Number) (Expiration Dale) (Name of Contactor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sfl�ifneoca to mcludc information pertairring to all 0003radoc,) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:pleaao be awuc thai vihile homeoKVaa who mploy pazoat to do=&ia�coasructioa or repair work on a dvmU of not more tL-M throe traits in which the homeowner rreidm cc oa tlx gottorls appurtcnaat therdo arc not gamily oow6crcd to be caT4oyer3 trnrler the wolfs'%coapc=aiioa Act(GL152,n 1(5)�application by a hoa=wncr for a Germ=cc pclmd mey evidcaoc the legs[siahra of an amployer under the Work'Oet C,ompomation Aat I uaderattad that a mpy of thin rtxt=cat may bo focveardnd to tho Dcpart..a of Industrial Ami4=&Offioo of laarsnce for rho coverage verification end that failure to&==coverages tinder socuoa 25A of MOL 152 can lmd to the imposition of a iminsi penaltict ooasisting of a fmc of up to 51,500.00=Nor iraprisooaxttt of up to one yrzr a�civil penalties in the form of a Stop Work Ord-and a firm of 5100.00 a day agni=t ttsc �[ L /t For dcputmal a u only \ / v PcTmit Number Version 1.7 Commercial Building Permit May 15,2000 SECTION 10 STRUCTURAL PE€R REV(E MR 110.11) Independent Structural Engineering Structural Peer Review Required Yes......❑ No...... SECTION 11 �OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGEN IT as Owner of the subject property hereby authorize �'�°`'� R l to act on my b half, in all matte rext �to w b�this building permit application. DIRECTOR OF FACILITIES Si ature of Owne Date 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. ;�6ry fQ Print Name Signat re of 0 ner%Age Date SECTION 2 CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : 0�✓� '� �" ��i� � C CJ��� ?s(, License Number LAf Add„fj�e7 Expiration Date 1-/Yl /,A 9 P) Signat e V Telephone SECTION 13 WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M G 2*�C(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....... No...... ❑ 1 4 y y Versionl.7 Commercial Building Permit May 15,2000 SEGTION,:9 PROfESS10NAL DESIGN AND CONSTRUCTION_SERYICES FOR BUILDINGS AND STRUCTURES:SUBJEGT.TO CONSTRt�CTION,COAITROL PClRSL1ANST0 78Q CMR'I16,(COtTA1NING M'OF2E'fHAN 3 ,000 G:F;OF ENCL©SED:SPACE) 9.1 Registered Architect: CAS^C� L, Not Applicable ❑ Name(Registrant): i-� �6 � Registration Number Addr ZU� ( � j _ , Expiration D? Si Ka Telephone 92 Registered Prof ssion nginee s): Name Area of Responsibility Address Registration Number I 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 OLI-�r 4 ����� ` C Not Applicable ❑ Company Name: J? o 5,70b Responsible In 16 rge of Construction k 3 O�A :ddres S ig natur Telephone Version l.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 X Private ❑ Zone: Outside Flood Zone ❑ Municipal .181 On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Z Setbacks Front I p Z p Side L: 'F7 R: Z L: R: Z Rear c� 1 Building Height lr9. Bldg. Square Footage yo ZZbl 41. 1d Open Space Footage % (Lot area minus bldg&paved -(off 5(� �� S LL 5L ? . parking) # of Parking Spaces ` (o Fill: (volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES x IF YES, date issued:_ Qv IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES X IF YES: enter Book y9 � � Page (-I :) - and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES �( ELM t;�. -15 (�C'o 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: CtujT ZN - QVV)Q�R(-C" LY D. Are there any proposed changes to or additions of signs intended for the property ?YES _ No _X_ IF YES, describe size, type and location: y Versionl.7 Commercial Building Permit May 15,2000 SECTION 4=CONSTRUCT ON SERVICES FOR PROJECTS LESS THAN 35,OQQ; CUBIC FfET OF EfVCLOSED SPACE xv? Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] ❑ /�>f'�9 s or Building[ Repairs [ �:�-7L Gl�v bR ltv,—l�L ��,^ � C (=)CL 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 I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1.1 ❑ 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 IF EXISTING BUILDING;UNDERGOI�NG RENOVATIONS ADDITIONS`ANDIOR.CFIAIVGE . ,. Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BU LDI ING HEIGHT AND AREA R BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION � tfI'I °i#t� � a � ,� ` Floor Area per Floor(sf) St (;�,C,iU L) 2nd 1 St 2nd 3rd _ 4th 3rd 4th Total Area (sf) 962 000 Total Proposed New Construction (sf) Total Height(ft) 41 Total Height ft t✓fc vS 11+.� v � z . ti Version 1.7 Commercial Building Permit May 15, 2000 a City of Northampton Building Department 212 Main Street Room 100 bNo'6ampton, MA 01060 phone 413-587-1240, Fax 413-587.1272 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECT]ON1- SITE INFORMATION Thls sectron=to b+�cornpJete Itil, c� 1.1 Property Address: � * T `> - MapLo 13ns. � �. L (1(Z.t I i4�A'P (1) ti �10(�,Q ot, Over a 3brstrrct _�� E#mom Drstric{ SECTION 2;. PROPERTY OWNERSHIP/AUTHORIZED_AGENT 2.1 Owner of Record: Name rint) GEORGE NOLAN Current Mailing Address: DIRECTOR OF FACILITIES Qj ( � , _ -z�1 -2_ GOOLEY Signature ON HOSP'Ti%ephone 2.2 Authorized Agent: t-Z,S��k T-&l L Name(Print) Current Mailing Address: Signature Telephone SECTION°3 ESTIMATED"CONSTRUC ION COSTS Item Estimated Cost(Dollars)to be ;'Officaal Use Only com feted b ermit a licant u 1. Building Permit Fee i 2. Electrical ': bFst>rnatedATotalGstof ._ Constructionfror . 6 _. 3. Plumbing Bu�tdrng Permit Fee ` 4. Mechanical (HVAC) �f"P r't'Y1 e 5. Fire Protection ro 5 a 6. Total =(1 + 2+ 3 +4 + 5) 1 (�U(J e Checic:Nurnbei 5 InisSection'For.Official Us FOnt 8���i�rgf'�rrrtri��iember ! �'` '. Date issued F 1 >..�- �a3 �`".Bt�i`ldingRCorrtrr��s�oner'JTnspecor of Sui}dregs:`... .e.. .. . _ Date �-� ,f File#BP-2003-0738 APPLICANT/CONTACT PERSON MOWRY&SCHMIDT INC ADDRESS/PHONE P O BOX 135 (413)773-3176 PROPERTY LOCATION 30 LOCUST ST 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 5933 0- Typeof Construction: CONSTRUCT OFFICE ON 1 ST FLR SOUTH WING ELEVATOR INFILL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 07536� ����3 sets of Plans/Plot Plan ��""_"` THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO.,RMATION 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 sion 2 f1 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 BP-2003-0738 GIs#: COMMONWEALTH OF MASSACHUSET'T'S Map:Block: 23B-046 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-0738 Project# IS-2003-1197 Est. Cost: $15600.00 Fee: $70.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MOWRY & SCHMIDT INC 075360 Lot Size(sq. ft.): 667077.84 Owner: COOLEY DICKINSON HOSPITAL INC Zoning:M AA pUcant: MOWRY & SCHMIDT INC <�e 30' LOCUST ST Applicant Address: Phone: Insurance: P O BOX 135 (413) 773-3176 Workers Compensation GREEN FIELDMAO1302 ISSUED ON:411103 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT OFFICE ON 1ST FLR SOUTH WING ELEVATOR INFILL 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: ��-290 3 �'House# Foundation: Driveway Final: Final: Final: (,/,2�103 Ar /�. --A;'—Rough Frame: �/Lj 'aq�� Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: Q THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATION Certificate of Occu anc Si nature: Feel e: Receipt No: Date Paid: Check No: Amount: Building 4/1/03 0:00:00 5933 $70.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo