39-063 (6) Initial Construction Control Document
W To be submitted with the building permit application by a
Registered Design Professional
r
for work per the 8t' edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Cooley Dickinson Hospital Date: April 9,2014
Property Address: 8 Atwood Drive,Northampton,MA 01060
Project: Check(x)one or both as applicable: ® New Construction ® Existing Construction
Project description: Tennant fit-out for medical offices
I,Robert F.Griffiths, MA Registration Number: 33161 Expiration date: June 30,2014, am a registered design
professional, and I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerning':
Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information,and belief such plans, computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
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 if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
sn of t,�
Enter in the space to the right a"wet"or ".
electronic signature and seal: R0PrP`F
'r','.:>ri;tis n
o.33161 ft
Phone number: 413.789.0960 Email: rriffths @rwhall.com + TF, ® i
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an `x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen,
provide a description.
Version 06 11 2013
Initial Construction Control Document
F To be submitted with the building permit application by a
Registered Design Professional
for work per the 8th edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Cooley Dickinson Hospital Date: April 9,2014
Property Address: 8 Atwood Drive,Northampton,MA 01060
Project: Check(x)one or both as applicable: ® New Construction ® Existing Construction
Project description: Tennant fit-out for medical offices
I, Robert F. Griffiths, MA Registration Number: 33161 Expiration date: June 30,2014, am a registered design
professional, and I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerningt:
Architectural Structural X❑ Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
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 if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
Enter in the space to the right a"wet"or to of 4 ��
r.,
electronic signature and seal: ROPFR7 s
.33161
Phone number: 413.789.0960 Email: rriffths@rwhall.com sTe °
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an `x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen,
provide a description.
Version 06 11 2013
Initial Construction Control Document
Z To be submitted with the building permit application by a
Registered Design Professional
for work per the 8th edition of the
5 Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Cooley Dickinson Hospital Date: April 9, 2014
Property Address: 8 Atwood Drive,Northampton,MA 01060
Project: Check(x)one or both as applicable: ® New Construction ® Existing Construction
Project description: Tennant fit-out for medical offices
I, Robert F.Griffiths,MA Registration Number: 33161 Expiration date: June 30,2014, am a registered design
professional, and I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerningl:
Architectural Structural El Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information,and belief such plans, computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
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 if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
Enter in the space to the right a"wet"or -tJA OF 04 &
r,
electronic signature and seal: tt0,-1( F,
�i<'HS
No,33161
Phone number: 413.789.0960 Email:rriffiths @rwhall.com °IST ¢�
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen,
provide a description.
Version 06 11 2013
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 8'*edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Cooley Dickinson Hospital _ Date: 04/07/2014
Property Address: __8 Atwood Drive - Northampton,MA _ µ
Project: Check one or both as applicable: x New construction i Existing Construction
Project description: This project included a 7,850 SF first floor tenant build-out including exam rooms,waiting
areas,therapy and accessory spaces for the hospital use.
1 John A Ferrera Jr. MA Registration Number: 20364 Expiration date: 08/31/2014 , am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
[x] Architectural [ ] Structural [ Mechanical
[ ] Fire Protection [ j Electrical [ ] Other____
for the above named project and that to the best of my knowledge, information,and beliefsuch plans; computations and
specifications meet the applicable provisions of the Massachusetts State building Code,(780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept,shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
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 if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, 1 shall submit fieldiprogress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work, I shall submit t I a `Final Construction Control Document'.
Enter in the space to the right a '-wef'or
electronic signature and seal: No.20304
FITCHBURG,, .�
Phone number: 978-407-8848 OF Email: jaferrera @comcast.net
Building CfT`icial Use Only i
Building Official Name; _ __ f emit No.: Date:
Building Element Fire Resistance Rating (Hrs)
Structural Frame 0
Exterior Bearing Walls 0
Interior Bearing Walls 0
Floor Construction 0
Roof Construction 0
Mechanical/Elevator Shafts<4 stones 1
Stair Enclosures<4 Stories 1
4. Interior Finish:
All newly installed wall and ceiling finishes, floor finishes including carpet, and interior trim materials must comply
with 780 CMR Table 803.9. See summarized requirements below:
Exit Stair Class B
Exit Access Corridors Class C
Rooms &Enclosed Spaces Class C
5. Means of Egress:
The means of egress including the number of exists and egress capacity must be sufficient for the number of
occupants on all floors.
Floor Occupant Load Number of Exits Exit Capacity
1 CDH Area 79 4 640
General Egress Requirements
5.1 Maximum exit access travel distance must be less than 300 feet.
5.2 Maximum dead end corridor length to be less than 50 feet(780 CMR 1018.4 Exception 2)
5.3 Egress doors must swing in the direction of egress travel where serving an occupant load of 50 or more
people.
5.4 All means of egress lighting and exit signs throughout the building must be provided with an emergency
power supply to assure continuous illumination for not less than 1.5 hours in case of primary power loss.
6. Fire Protection Systems:
- Automatic sprinkler system throughout entire building: MGL Chapter 148 Section 26G
- Fire alarm and detection system (780 CMR 907.2.2)
- Fire Extinguishers (780 CMR 906.1)
7. Accessibility(ADA)
The tenant fit out shall comply with the requirements of the Massachusetts Architectural Access Board
Regulations (521 CMR)
527 Rollstone Road—Fitchburg,MA 01420—Tel:978407-8848—Email:jaferrera @comcast.net
J Ferrera,
Associates Inc.
Code Review
For compliance with the Massachusetts State Building Code(780 CMR)8m Edition
IBC—Intemational Building Code 2009 w/Mass Amendments
Cooley Dickinson Hospital
8 Atwood Drive
Northampton,Massachusetts
Date: April, 2014
Prepared By: John A Ferrera Jr.,AIA
J Ferrera Associates Inc.
Project Description
The project consists of a tenant area build out of about 7,850 SF on the first floor. This space will consist of waiting
rooms, exam room, administration,finance and accessory spaces(Use Group B).
Evaluation
The renovation must comply with the requirements of 780 CMR Eight Addition and IBC 2009. No structural changes are
proposed as part of this tenant fit out project.
1. Construction Type:
Type IIB construction
2. Height and Area Limitations:
Code Reference Height Area (per floor)
780 CMR Table 503: 3 Stories 23,000 SF
Tabular Values
780 CMR Section 506.3: + 1 Stories +46,000 SF
Sprinkler Area Increase
Total Height and Area Allowed 4 Storied 69,000 SF
3. Fire Resistance Ratings:
The following summarizes the required fire resistance ratings based on 780 CMR table 601:
527 Rollstone Road—Fitchburg,MA 01420—Tel:978407-8848—Email:jaferrera @comcast.net
04/11/2014 14:59 4137862450 DEVASSOC PAGE 02/02
ACGIIR CERTIFICATE OF LIABILITY INSURANCE 4/11/°"1/201°"'""'
2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder I5 an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement On this certificate does trot confer rights to the
certificate holder In lieu of such endorsement(a).
PRODUCER N ME: Debbie Mgg Neal
James J. Dowd and Song Insurance agency Inc. PHONE a
14 Bobala Road .E ): -5311-7444
Holyoke MA 01040 nDORIL , dmaene a7.@dowd.com
T.OMER
CK& ID•:KENNPV I-0�
,. INSURER(S)AFFORDING COVERAGE NAIC d
INSURED - —
INSURERA:TraVt?12r$- Indemnity Corapdri of Conn 25682
Kenneth P. Vincunas & E. J. O'Leary, DBA Develo
P. O. sox 528 wsURtgr3;
Agawam MA 01001 INSURER C:
INSURER D;
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER:59706496 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD INDICATED.NOTWITHSTANDING ANY RRQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH 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 POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POL
LTR TYPE OFINSURANCE POUCYNUMBER MMrDD/YY A=MyPyl LIMITS
GENERAL LIABILITY EACH OCCURRENCE S
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR l�ES..(Ea occurrence)
MED EXP(Any one ersen) $
PERSONAL RADVINJURY b
GENERAL AGGREGATE 5
OEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $
POLICY PRO- I.00 S
AUTOMOBILE LIAUJUTY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY(Per person)
SCHEDULED AUTOS BODILY INJURY(Per accident) 9
HIREDAUTOS PROPERTY DAMAGE _$
(Per sccidani)
NON•C WNE❑AUTOS 5
$
UMBRELLA LIAB OCCUR
EACH OCCURRENCE ¢,
EXCESS LIAR CLAIMS-MADE AGGREGATE 3
DEDUCTIBLE
S
RETENTION
$
A WORKERSCOMPENSATION UB8771MB37 4/121204 4/13/2015 X WCSTATU- OTH-
AND EMPLOYERS'LIABILITY WIN A.I Y ER
ANY PROPRIETOR/PARTNERMKECUTIVE E.L.EACH ACCIDENT $500,440
OFFICEWMEMBER EXCLUDE09 E N/A _
(Mantl4sory In NH) F.L.OISEASE-EA EMPLOYE $5 D0,000
Ii yyas,dt&tfte tmtler ----
DESCRIPTI OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $500,000
DESCRIPTION OFOPERATIONS I LOCATIONS/VEHICLES(Anoch ACORD 101,Additional Remarks Sehadulo,R mum apace)a required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCROED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROViSIONS-
The City of Northampton
210 Main Street
Northampton MA 01060 ALMHORIZED REPRESENTATrvE
fta�rt!v•9"'��''
9)1988,2009 ACORD CORPORATION. All rights reserved.
ACORD 25(2009M9) The ACORD name and logo are registered marks of ACORD
.4co CERTIFICATE OF LIABILITY 4/10/INSURANCE D/10/IO201D/Y4
4
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy()es)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In Ileu of such endorsement(s).
NT OT
PRODUCER NAME: RimbArly Cloutier CISR
Ross Insurance Agency, Inc. PHONE . (413)536-8380 (413)536-8386
150 Lower Westfield Road .kcloutier @roasinsuranco.com
INSURER(S) AFFORDING COVERAGE NAIC d
Holyoke MA 01040 INSURER A:CitiZQns 'Ins. Co. of America 31534
INSURED INSURER 8:
Oxbow Professional Park LLC INSURERC:
c/o Development Associates INSURER D:
P. 0. BOX 528 INSURER E:
Agawam MA 01001 1 INSURER F:
COVERAGES CERTIFICATE NUMBER:City of Northampton REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY �AAGLSES(Eeaccunence) $ 300,000
A CLAIMSauIADE OCCUR BN97649301 0/5/2013 0/5/2014 MEDEXP one person) S 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S 2,000,000
X POLICY PRO LOC $ri
AUTOMOBILE LIABILITY Ea accident)
ANY AUTO
BODILY INJURY(Per parson) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS N ON PR PERTY DAMAGE $
HIRED AUTOS AUTOS (Per accident)
$
UMBRELLA LIAR HOCC6R EACH OCCURRENCE $
EXCESS LAB CLAIMS40,DE AGGREGATE $
DIED RETENTION$ $
WORKERS COMPENSATION TATU- OTH-
AND EMPLOYERS'LIABILITY Y./N ITORY
ANY PROPRIETORIPARTNERIEXECUTIVE❑ N7A E.L.EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH) E.L.DISEASE-EA EMPLOYE $
If yyeeaa describe under
DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Addltlonall Remarks Schedule,if mom space Is required)
8, ATWOOD DRIVE, NORTHAMPTON MA 01060
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE D IVERED IN
City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS,
Office of• the Building Commissioner
Puchalskl Municipal Building AUTHORIZED REPRESENTATiV
212 Main Street
Northampton, MA, 01060
puthmte gn
ACORD 26(2010106) ®1988-2010 fCORD C RP RATION. All rights reserved.
INS026(2moo5).ot The ACORD name and logo are registered marks of ACORD
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
I, , as Owner of the subject property
hereby authorize to
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
Travis P. Ward as Owne Authorized
Agent ereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
an belief.
Signed under the pains and penalties of perjury.
Travis P. Ward
Print Name
S P {n w 2/18/14
Signature wner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisorpnl\_\l Not Applicable ❑
Name of License Holder: `r ,Y � C S� �-7 S7 Sa
License Number
Address Expiration Dat
LLD
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 W 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:
Not Applicable ❑
Name(Registrant): 2 0 3��
Registration Number
Address , ;�- ' S1. )A,
Expiration Date
Signature Telephone
9. Registered Professional Englneer(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 Gepere{Contractor
t 4 �(�, , :S�C-\h e S Not Applicable ❑
Comp—anTy Name: I
c
_ AV'N �� V�I'A cG
Responsible In Charge of Construction
C30
Address
Signatu e�-- Telephone
Version 1.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZORiTG—]
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
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 Q DON'T KNOW 0 YES G
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained ® , Date Issued:
C. Do any signs exist on the property? YES X® NO 0
IF YES, describe size, type and location: existing/approved
D. Are there any proposed changes to or additions of signs intended for the property? YES 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❑ Change of Use❑ Other ❑
Enter a brief description here.
Brief Description New construction Buildout of Physical Therapy Suite +/- 7, 500 sf
Of Proposed Work:
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 ❑
I 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 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
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
15 1 St
2nd 2nd
3rd 3rd
4cn
4cn
Total Area (sf) Total Proposed New Construction (so
Total Height(ft)
Total Height ft
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information:
F 3 Sewage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone❑ unicipal ❑ On site disposal system❑
Version l.7 Commercial Building Permit Ma 15,2000
City of Northampton Iwilll
I
� lil
Building Department " r Rill l
APR 1 1 2014 212 Main Street 'w"
Room 100
�DeC:. rthampton, MA 01060 p l �I:III' I X 14
587-1240 Fax 413-587-12721 I'
I" u
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 7
This section to be completed by c►ifice
1.1 Property Address:
8 Atwood Drive Map Lot Unit
Northampton, MA 01060 Zone Overlay.NOW 1dtl
Elm St.'DI 616,I3 District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Oxbow Professional Park, LLC Current Mailing Address: P. O. Box 528
Agawam, MA 01001
Signature Telephone ( 41 3) 789-3720
2.2 Authorized Agent:
Name(Print) Travis Ward Current Mailing Address: P. 0. Box 528
Agawam, MA 01001
Signature Telephone ( 41 3) 789-3720
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building $ 332, 000.00 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
100, 000.00 Construction from 6
3. Plumbing Building Permit Fee
70 000 . 00
4. Mechanical (HVAC) 98, 000.00
5. Fire Protection
6. Total = (1 + 2+3+4+5) 600, 000.00 Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector'of Buildings Date
File#BP-2014-1046
APPLICANT/CONTACT PERSON DEVELOPMENT ASSOCIATES
ADDRESS/PHONE P O BOX 528 AGAWAM (413)789-3720
PROPERTY LOCATION 8 ATWOOD DR-CDH 1 ST FLOOR FIT OUT
MAP 39 PARCEL 063 001 ZONE
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: FIT-UP TO THE 13,000 SQ FT 1 ST FLOOR FOR NEW TENANT-CDH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 075752
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOJRMATION 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 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.
8 ATWOOD DR-CDH I ST FLOOR FIT OUT BP-2014-1046
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 39-063 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2014-1046
Project# JS-2014-001597
Est. Cost: $600000.00
Fee: $400.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: DEVELOPMENT ASSOCIATES 075752
Lot Size(sq. 1): 64381.68 Owner: ATWOOD DRIVE LLC
Zoning: Applicant: DEVELOPMENT ASSOCIATES
AT. 8 ATWOOD DR - CDH 1 ST FLOOR FIT OUT
Applicant Address: Phone: Insurance:
P O BOX 528 (413) 789-3720 WC
AGAWAMMA01001 ISSUED ON:51112014 0:00:00
TO PERFORM THE FOLLOWING WORK.FIT - UP TO THE 13,000 SQ FT 1 ST FLOOR FOR
NEW TENANT - CDH
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: Date Paid: Amount:
Building 5/1/2014 0:00:00 $400.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner