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23B-046 (130) August 15, 2000 Narrative for Fire Protection Systems for: � New Oncology.Program AUG T goo (Physician practice and hospital services) DEPT of;�R r�T'-!P-SPFrTIONS Cooley Dickinson Hospital gy ces) NUT: . H ",60 30 Locust Street Northampton, MA 01060 Fire Protection Narrative 1. Fire Alarm System This area will have a new fire alarm system that will connect into the hospital's relatively new Notifier Fire Alarm System. New smoke detectors, pull stations, visual alarms, audio alarms and wiring will be installed in this area. 2. Sprinkler System The entire project area is currently protected by a wet sprinkler system in accordance with N.F.P.A. There will be minimal relocation of sprinkler heads in this project to accommodate a few changes in the room layouts. RUB-23-2000 11:52 COOLEY DICKINSON 413 582 2959 P.02i02 of )Iarfhampto» 20,,))'PARTMPNT OF BUILDING INSTE=ONS I INSPECTOR CEP i2'moin Street # Mupkipal Building �f + '' MA 01060 has r` ° - nttl►:tmpittn. "• `'A0lr&0hg CONSTRUCTION CONTROL DOCUMENT {for professional Engineers/Arehitocts responsible for Emirs Project) Project Tide: Date 000 plioj ct ration; Scomof Project: ' In accordance with the sixth edition MassachusettS State Building Code,7110 CMR SECTION 116.0: I, Mass.Regisuation Number A LO Being a registered professional EnginArchitect her, CER'�IFY tfiat f have prepared or directly supervised the preparation of all design plaps,coa►putations and specifications concerning: )(Entire Project for the above named project and that to the best of my knowledge,sveh plttM,computations and specifications ttteet nice applicable provisions of the Massachusetts State Building Code,all acceptable engineering practices and all applicable laws fortltrpfepvsed project. Furthemore,I understand and AGREE Hutt 1 shall perform the Accessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for tha building permit and shall be responsible for-the following as specified in section 116.2.2: L Review of shop drawings,samples and other submittals of the contractor as required by the constmction documents as submitted for the building permit,and approval for the conformance to the design concept. L Review and approval of the quality control procedures for all code-m9uired controlled materials. 3. Be present at intervals appropriate to ft stage of construction to bexomc 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 1 shall submit periodically,in a form acceptable to the building official,.a progress report together with pertinent comments. Uporr completion of the work.I shall submit to the building oS`icial a final repot as to the satisfactory completion and madinesssf the project for oacvpancy. Signature and Seal of tceotcred professional: p, SACyC AAr.,� .A 1tle. 4t tF Lw r Fax 411-5$7-1272 -phone 413-387-1240 TOTAL P.02 AUG-41--00 rFR I 08: 15 AM FAX N0, P. 02 ACORD� CERTIFICATE OF LIABILII Y MUKANl:t w�•��•° -- _ 08/11/2000 PROL((;ER (413)S86-0111 (413)586-6481 - Webber & Grinnell Ins. Agcy. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR A North King Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P,O, Box 538 INSURERS AFFORDING COVERAGE Northampton, MA 01061 INSUReD Pioneer Contractors, Pi Con, Inc INSURERA, Maryland Casualty-Contractors ~ P 0 Box 1145 INSURER 8: Liberty Mutual Northampton, MA 01061 INSURER C: INSURCR D: INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED Of LOW HAVE BEEN ISSUr:D TO THE INSU14FO NAMED ABOVE FOR THE POLICY Pt RIOD INDICAI ED,NOTWITHSTANDING ANY RCOLAREMGNY,I ERM OR CONDITION OF ANY CONTRACT OR OTI ICR DOCUMENT WITH RESPCCT TO WI IICH 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 POLICIF,,S.AGGREGAI E LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. jR TYPE OF INSURANCE POLICY NUMBER -DATE DfYY) DATE(MMIDO/YY) LIMITS GENERAL LIABILITY SCP3164SZ99 06/30/2000 06/30/2001 EACH OCCURRENCE S 1,000,000 X COMMERCIAL rFNCIIIR^^^ALLIABILITY FIRE DAMAGE(Any one(ae) t 300,000 CLAIMS MADE ' .' 1 OCCUR MFD EXP(Any ono psr:,on) $ 10,000 A _M PERSONAL&ADV INJURY 5 11000,000 GENERAL AGGRCGATE S 2,000,000 CEN'L AGGRCGAI E LIMIT API'LIES PER: PRODUCTS-COMPIOP AGG S 2,000,000 VOLICY JCCI LOC AUTOMOBILE LIABILITY ZA90544073 06/30/2000 06/30/2001 COMBINED SINGLE LIMIT S ANY AU'I O (Ea acdOenty ALL OWNCO AUTOS BODILY INJURY 3 A Sr)IEDULEU AUTOS (Por Poison) S 0 0,0 0 0 X HIRFOAUTOS BODILY INJURY 8 X NON-0WNFDAIJT09 (perawrionl) 500,000 PROPERTY DAMAGE S (Per oecf enq 100,000 GARAGE LIAnILITY AUTO ONLY-EA ACCIDENT S ANY AU',O OTHIER THAN EA ACC S AU f 0 ONLY. AGG S EXCESS LIABILITY EACH OCCURRENCE- S OCCUR CI AIMS MADE AGGRCCATE b S DEUUCTIM E $ RETENTION S S WORKERSCOMPENSATIONAND VC13154998220SOO 07/15/2000 07/15/2001 ITORY ITS ER CMPLOYERS'LIADILITY El,EACIIACCIDENY S 100,000 B E.L.DISEASE-EA EMPLOYE S 100,000 E.L,DISEASE.POLICY LIMIT f S00,000 OTHER DESCRIPTION Uh'UvCRATtON5%LOCATIONSlVENICL6SICXCLUSION9 ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCR15ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Cooley Dickinson Hospital —10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Facilities Management Department BUT FAILURE TO MAIL SUCH NOTICE S HALL IMPOSE NO OBLIGATION ORLIABILITY 30 Locust Street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES, Northampton, MA 01060 AUTHOHIZEDREPRESENTATIVE 'P L —' Richard Wtbher/R7W 1 � u o ' cc O rn -• �+ O O Lrl m ov A «-� m R CA o a O `O e � 0 I-S r n m m o m O � o a A Cl) b N o ro O m t, O —mG Q 2 .•� r0 a b N 33 rw ° D z A A rn D z o N A y A tsk n tp ti «'Zi _ m !'1 m C12 ny Z v 1 C ° z � co C1 m N to -4 cp m 3 O :3 O ° (n cn v' z ° to ct °z C: o C'• A- a cn n z b Cl) v n to, o, A 4 ce O' o y Q y A E C�iif� of �,Tod11alliptoil ,Qle-j titchncclle _ DEPARTMENT OP BUILD0\1C INSPECTIONS = 212 Main Street ' Municipal BuildinC Northampton, mass. 01060 «'OMCEIZ'S CONITENSA'nON INSURA-NCE AFFIDAVIT V"Ith a pincipal place of business/reslidencc at. s -- (stmt/ci •/stalcfap) do hereby certify, under tic pains and penalties of perjury, ?hat ( m an employer providin- the followint \t,orkcr's comoens::uon covcmge for Inv e-tuplovecs wor{zing on tills job (Insur-= CoO=y) (POLIO; Nt ter) -- (r :piruor Daic) ( am a sole proonetor, general contractor or homeowner (circie oee) and have hired the coatrac oi-s listed below who have the f-oDoWIoQ %V017ker's compeasadon policies (Name o-Co=c,o-) II1R 13111 CotnpanyiPoki , -) (' ) ( '�um^c. t_x;>i;Icon Dat,. (Name of Contraclor) -- Rasuianc;, CompanNvPo!ic,, Date) (Name of Conaacio;) (Insluancc Compao)./Polin Nambu) (ExpLm000 Date) (Name of Contractor) (I-nsuranc-- Company/Policy Numbs) (ExTL-anon Date) (anac+,adyi::a_�1 caC troc�cs,;� Ln��._��infcxn,;ioo pc�tn-iains to.11 oca'r_t_o-�) ( ) I am a sole propnetor and have no one work ng for me. ( ) I am a home owner perfonuing all the work myself. NOTE:plcsc M ewuc the wt:Jc boar_rn-ms ubo amp lay peons to 63 c^._ • `coo r_ rc^yau •ori oo t d••cll ;Of C0(MccC Lh-,z two'_•L•-Vi Ln l,iLcb Lb�Lwxnc,1,ucr rcz,dc3 O"o(3 th, Q,71n/+ a purtccs:r_•tbce ,o-x L,U,occrid ci to h aU4)loyc-uz-,—Lbc--k&:caa;)—�uco Aci(GL152-"1(5)) r4)pticx6on try e homoowx fcr c hc=:or permit a,•y c idacc Lh IcSxl ctanu of e Moyer uodor dl Works ,,Cocap,,Lgn Ad I undo.-tL�d dii a copy of Lhi.aitemem m..y bo fa-xnrdod t,o Lbo f d AeadaAY Offi oe of Lz..c.noo for the covmsc'at CI Oo e. LJu LiJL7c to scans cOv r&Ec under scctioa 25A of MOL 152 czn lad to Lh:i^;,osGica of criminA pczahcs 00oaisiui8 of a fcnc of up to S 1-300.00 endror ,=of up to ooc yv L'A ciNil pm+.tio in Ltic fore,or a Stop Work Ordcr end s rim of 5100.00 a day tEyinsl Gy- r Or dgwrtn '1 U K tX t Pcnnt NumbCr Lot Si�niturt of LICc])sccA)crmittcr- Version 1.7 Commercial Building Permit May 15,2000 I SE Ur. 10- STRUCTURAL PEER REVIEW(780 CMR 110.11) ent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ S: ION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN O'. ERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT coo ff eci as Owner of the subject property he authorize Fir"f\-C6+W W t \4V',�'M two DtrP_0f yt op [ 1l lye6 to act on rr a in all matters relative to work authcMzed by this building permit application. SiL ur )f Owner t Date l kv\,-L-�, as Owner/Authorized Agent he _,dare that the statements an nformation on the foregoing application are true and accurate, to the best of my ki _ :e and belief. S d der the pains and penalties of perjury. Pri E77-t-,�q' n�I Vic-C) (;ir f Owner/Agent Dat S, IC i 12 -CONSTRUCTION SERVICES 10 ised Construction Supervisor: � �/ Not Applicable ❑ Na _ icense Holder :J�� J—. /'�1 eL 1-eJ1 9S C5 License Number q, Expir tion D to S Telephone SE ::__13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152, § 25C(6)) W ,ompensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit W, n the denial of the issuance of the building permit. S "davit Attached Yes....... 113 No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 SE" '.ON 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CC. rRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) ;istered Architect: A Not Applicable ❑ Ncl el, 4. uG 61060 Registration Number A 7i" fj i 4 '?� Expira io Date S'; Telephone 92 a!Astered Professi al En N Area of Responsibility Ac' ; Registration Number Si; ure Telephone Expiration Date N Area of Responsibility A Registration Number e Telephone Expiration Date N Area of Responsibility A' Registration Number Si Telephone Expiration Date N Area of Responsibility Ac Registration Number SI Telephone Expiration Date 9. eneral Contractor Aro �`ll e rX A Lolf, Not Applicable ❑ C y `Jam ;Fv`%\ 6-t V Y E' a.A- R, e In Charge of Constructio R0 1AK S u Telephone Versionl.7 Commercial Building Permit May 15,2000 7. �r Supply(M.G.L. c. 40, § 54) 17.1 Flood Zone Information: 17.3 Sewage Disposal System: a Private Zone: Outside Flood Zone PY-- Municipal XOn site disposal system 11 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size /-- Frontage r A S 5 Setbacks Front Side L: R: '7 L: R: Rear Building Height A/ 6'1 Bldg. Square Footage I,? q Open Space Footage % (Lot area minus bldg&paved /'R9 hO, parkin ) h hh 4 of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES 1< IF YES, date issued:)/ Vj,, rq9 5 Book J41- 04 � � 2.2.5 5 peci IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES X- IF YES: enter Book Page _ and/or Document # B. Doe he site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? 1V(3 Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES Y NO r r• IF YES, describe size, type and location: Read ala A 4'00-c �`1✓� �� Fri ►2yr 'E` D. Are there any proposed changes to or additions of signs intended for the property ?YES_ No 7— IF YES, describe size, type and location: Versionl.7 Commercial Building Permit May 15,2000 r-E_CTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 )BIC FEET OF ENCLOSED SPACE Inter:ur Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ ❑ ❑ Exte:for Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] ❑ Accessory Building[ ] Repairs [ ] SECTI ION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A A- ;mbly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B B, ness A E E rational ❑ 2B ❑ F F- Dry ❑ F-1 ❑ F-2 ❑ 2C ❑ H H Hazard ❑ 3A ❑ Ir. ..itional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 313 ❑ M �- --antile ❑ 4 ❑ R P dential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S S age ❑ S-1 ❑ S-2 ❑ 5B ❑ U ! 'y ❑ Specify: -d Use ❑ Specify: S ,ial Use ❑ Specify: MPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE Exi_ Use Group: oq�' _ Proposed Use Group: ,LJ Exi; ; Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SEC ON 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Flc ea per Floor(sf) 1st lsi / V 2nd lybi 3'd �� 4th 4`'' N/A T0. rea (sf) 3�g0� Total Propo ed New Construction(sf) Tot !eight (ft) Total Height ft 4tv X7 ow,ri Versionl.7 Commercial Building Permit May 15,2000 art.. C of Northampton t us o k R ding Department 12 Main Street r t Room 100 {° + AUG 1 7 2000 No mpton, MA 01060 g1 ` l phone 413-58T-1240 Fax 413-587-1272 AP LIC-A- iO`N TO CeN8—fRUCT, REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be c ompleted by office 1.1 Property Address: jj /LePGi>IS - �r Map Lot (� Unit /b V f a IA4 Zone�� Overlay District "Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: j / �ff IM �� Ca d 16 1 c Rw q dyi � / ( �� c l?5� V f c k j iwtY. -T y t _Wei, lame (Print) Current Mailing Address: 6-sr d--- a-w 3 Signs _:re Telephone 2.2 P.uthorized Agent: N (Print) V Current Mailing Address: bL,L w 5 - 9,31.3 Signz,lure Telephone SEC'.-ION 3 - ESTIMATED CONSTRUCTION COSTS Iterr, Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 0 UD (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of C� G 0 o Construction from 6 3. F tubing �Gu Building Permit Fee 4. N ,chanical (HVAC) 5. Fi;e Protection 6. Total = (1 + 2 + 3 + 4+ 5) Check Number This Section For Official Use Only Builc::ng Permit Number: C� �J Date Issued: I!!--. tune: Building Commissioner/Inspector of Buildings Date File#BP-2001-0186 APPLICANT/CONTACT PERSON COOLEY DICKINSON HOSPITAL ADDRESS/PHONE 30 LOCUST ST (413)582-2313 PROPERTY LOCATION 30 LOCUST ST MAP 23B PARCEL 046 ZONE M THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid Z7V,3 J 77 75r) Ty_peof Construction: ONCOLOGY INTERIOR RENOVATION New Construction Non Structural interior renovations _ Addition to Existina Accesses Structure Building Plans Included• Owner/Statement or License 074595 3 sets of Plans/Plot Plan A THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: �� Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 Commissi Permit from CB Architecture C ittee 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. � R F a � p' b $r Aa P L4!t, 30 LOCUST ST BP-2001-O T86 COMMONWEALTH OF MASSACHUSETTS Mak:Uk:23B-046 CITY OF NORTHAMPTON Lot:-401 Permit: Build ft Categ©rv:renovation BUILDING PERMIT Permit# BP-2001-0186 P iaw# JS-2001-029$" Est.Cost:$159000.00 Fee:$750.00 P.E"ISSIONIS HEREBY GR,4NTED TO: Cog.Class:2A Contractor: License: Use Crow: B COOLEY DICKINSON HOSPITAL 074595 W Six(s .1}:,§67077.84 QWne CQ IMF l I�?ICKITtSON.f30sPITAL INC zun , M Ait XacgL. COOLEY DICKINSON-HOSPITRL AT. 30 LOCUST ST` jW&antAddress: Phone: &su 30 LOCUST ST (413 582-2313 Workers ComMsation NORTHAMPTONMA011060 ISSi`.�tED(.N.-AaZ1QQ Q:UQ:QQ TOPERFOR. THE FOLLOWING WORK.ONCOLOGY INTERIOR RENOVATION POST THIS CARD SO IT IN 5 IRLE FROM THE STREET inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground:" Service: Me#er; 00 Footings: Rough:ko f w Rough: House# Foundation: Final:40,� Final: q Y O 911 Rough Frame: . Gas F irg IDenartmen# FireplacelChimney: Rough: Oil: Insulation; Final: Smoke: Final: O l C THIS PERMIT MAX BE REVOKED BY CITY OF NORT ON UPON VIO ON OF ANY OF ITS RULES AND REGULATIONS. Cegrtifir,51te of Qgcypa si r : Fee T e: Receipt No: Date id: Check No: ant: Building 8/22/40 0:00:00 493178 $750.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo