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24D-185 (12) i r� i ��ie rpam�rrz�uuec��t�i a��aaaac�uaetGl 'i Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR Type. egistration: 118041 xpiration 1I2Q/2015; Private Corporatic INTEGRITY DEVELOP& NST.INC PETER JESSOP 1 ti 110 PULPIT HILL RD g i u AMHERST,MA 01002 Undersecretary jI I, r a g s I: L p f 1VMassachusetts - Department of Public Safety uu Board of Building Regulations and Standards Construction Super-isor License: CS-059672 PETER W JESSOP= F 110 PULPIT MLL RD Amherst MA 01002 _ Expiration F 06/0712014 commissioner 1 � Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS-090514 ANNA R NOW y 38A SUGARL04ST ' South Deerfield MA 013 Expiration Commissioner --------'----- 09/12/2014 - Information inn ustruct ims Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, exptess or implied,oral or written." An eneployeY is defined as"an individual,partnership,association,corporation or other legal-entity,or any two or more of the foregoing engaged in.a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employee's. However the owner of a.dwelling house having not more than three apartments and who resides therein,or the.occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealthfor any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address,(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance: If an LLC or LLP does'have. employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be•sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom .of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitJlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in • (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where'a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of-Investigations,would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone arid.fax number: The Commonwealth of Massachusetts Department of Tndwtrial Accidents. Mee of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-977-NUSSAFE. Revised 4-24-07 Fax#-.617=727-7749 www.mass.govldia ;K;�� dhe Commonwealth ofMassachusetts . 1 ;:° _ - Department of Industrial Accidents W. Offzce of Investigations ..ti. :600 Washin on Street ` ;• ' .-= Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Lleetricians/Plumbers Applicant Information Please Print Legibly 1V aT118(BusinesslOrganizati on/Individual): �t 1 V` �' �•� "f 2� J �j f/s�L�, , 11 Address: t 1� P� City/State/Zip: 4.p �� Phone#: V6 ( � �I.�C I.M. Are you an employer?Check the/app opriate'boa: Type of project(required): 1. I am a employer with �d' 4. El I am a general contractor and I employees(full and/or part time). have hired the sub-contractors 6. Q New construction 2.Q I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working forme in any capacity. employees and have workers' 9. ❑Building addition [No workers''comp.insurance comp.insurance.• required.] 5. F1 We are a corporation and its 10_.0 Electrical repairs o=additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. o workers comp. right p Y � ' ht of exemption MGL P 12.0 Roof repairs insurance required.]t c: 152,§1(4),and we have no 13.0 Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees.If the sub-contractors have.employees,they must provide their workers'comp.policy number. I am ah employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance CompanyName: :�, M. (f�(�. A4 Policy##or Self-ins.Lic.#.'-W h-U Lo?, 9 A Expiration Date: / Job Site Address: 2 City/State/Zip: Attach a copy of the workers' pensatibn pokey declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of-up to$250.00 a day against the violator. Be advised that a copy of this statement may be.forwatded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi nder a in and penalties ofperjury that the information provided above 's true and correct Sim afore: Date: 2 Phone#: Official use only. Do not write in this area,to be'completed by city or town official City or Town: Permit/License# . Issuing Authority(circle one).: .1.Board of Health. 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector- 6.Other Contact Person: Phone#: '4`°R°® CERTIFICATE OF LIABILITY INSURANCE 4/10/2014 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) 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 lieu of such endorsement(s). PRODUCER CONTAME:CT Cynthia Henderson, CISR NA Webber & Grinnell PHONE (413)586-0111 FAX 413)586-6481 ac No l: 8 North King Street ADORess:chenderson @webberandgrinnell.com INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA:Selective Ins Co of S Carolina INSURED INSURERBA.I.M. Mutual/A.I.M. Integrity Development and Construction, Inc. INSURER C: 110 Pulpit Hill Road INSURER D: INSURER E: Amherst MA 01002 INSURER F: COVERAGES CERTIFICATE NUMBER:Haster Exp 2015 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. INSR TYPE OF INSURANCE A L S BR POLICY NUMBER MMIDDIIYYYY MMIDDYIYYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED rk M ERCIAL GENERAL LIABILITY PREM SES Ea occurrrrence $ 500,000 A CLAIMS-MADE a OCCUR 2067286 /10/2014 /10/2015 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY PRO--7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 9099096 /10/2014 /10/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS }( n NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Underinsured motorist $ 100,000 X UMBRELLA LIAB X CCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB C OLAIMS-MADE AGGREGATE $ 1,000,000 DED I X RETENTION$ 2067286 /10/2014 /10/2015 $ B WORKERS COMPENSATION X WC STATU- X OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? Fli-I N/A (Mandatory in NH) 80080062242014A /10/2014 /10/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES M CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Insurance AUTHORIZED REPRESENTATIVE C Henderson, CISR/CIN ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgmnnst m Tha Ar f1Rr1 noma­1 lnnn*ra ranic4ararl-ke of Arnon 709.3 Local exhaust.All newly introduced devices,equipment,or operations that produce airborne particulate matter,odors,fumes, vapor,combustion products,gaseous contaminants,pathogenic and allergenic organisms,and microbial contaminants in such quantities as to affect adversely or impair. SECTION 710 PLUMBING 710.1 Minimum fixtures.Where the occupant load of the story is No increase in occupant count proposed; increased by more than 20 percent,plumbing fixtures for the story proposed project meets all requirements of shall be provided in quantities specified in the Intemational CMR 248 for fixture count. Plumbing Code based on the increased occupant load. Page 5 of 5 SECTION 703 BLDG ELEMENTS&MATERIALS- N/A SECTION 704 FIRE PROTECTION 704.2.2 Groups A,B,E,F-1,H,1,M,R-1,R-2,R4,S-1 and S-2.In buildings with occupancies in Groups A,B,E,F-1,H,I, The proposed work area is a single M,R-1,R-2,R-4,S-1 and S-2,work areas that have exits or occupancy. corridors shared by more than one tenant or that have exits or corridors serving an occupant load greater than 30 shall be Existing sprinkler system will be altered as provided with automatic sprinkler protection where all of the per proposed new layout as required. following conditions occur: 1.The work area is required to be provided with automatic sprinkler protection in accordance with the International Building Code as applicable to new construction; 2.The work area exceeds 50 percent of the floor area;and 3.The building has sufficient municipal water supply for design of a fire sprinkler system available to the floor without installation of a new fire pump. SECTION 704.4 FIRE ALARM AND DETECTION No requirement for Business Use Building has fire alarm system SECTION 705 MEANS OF EGRESS 705.6 Dead-end corridors.Dead-end corridors in any work area Proposed renovation eliminates one of two shall not exceed 35 feet(10 670 mm). public lobby egress doors and replaces it Exceptions: with a rated corridor to existing egress door 1. Where dead-end corridors of greater length are permitted on first floor. by the International Building Code. 50'w/sprinklers Dr. Clayton has (4) doors from space IBC 2009 Section 1014 Exit Access directly to outside and (1) egress door 1014.3 Common path of egress travel:defined as that portion through common lobby. of exit access which occupants are required to traverse before two separate and distinct paths...are available. The length...in Group B and R shall not be more than 100 feet...with sprinklers SECTION 706 ACCESSIBILITY - N/A Complies with Section 605 SECTION 707 STRUCTURAL— N/A No proposed changes to existing structural elements SECTION 708 ELECTRICAL 708.1 New installations.All newly installed electrical equipment Proposed project will comply. Scope of and wiring relating to work done in any work area shall comply electrical work to include re-configured with the materials and methods requirements of Chapter 5. existing lighting, new emergency egress Exception:Electrical equipment and wiring in newly lighting as required, new exits signs as installed partitions and ceilings shall comply with all applicable required, and general power and tel/corn as requirements of NFPA 70. required. SECTION 709 MECHANICAL 709.1 Reconfigured or converted spaces.All reconfigured spaces intended for occupancy and all spaces converted to Proposed project will comply. habitable or occupiable space in any work area shall be provided with natural or mechanical ventilation in accordance with the International Mechanical Code. Exception:Existing mechanical ventilation systems shall comply with the requirements of Section 709.2. 709.2 Altered existing systems.In mechanically ventilated spaces,existing mechanical ventilation systems that are altered,reconfigured,or extended shall provide not less than 5 cubic feet per minute(cfm)(0.0024m3)'s)per person of outdoor air and not less'than 15 efm(0.0071 m3/s)of ventilation air per person;or not less than the amount of ventilation air determined by the Indoor Air Quality Procedure of ASHRAE 62. Page 4 of 5 WORK CLASSIFICATION ALTERATION—LEVEL 2 as per 2009 International Existing Building Code(IEBC) 2009 International Building Code (IBC)w/ 780 CMR Eighth Edition Amendments to 2009 IBC CODE REFERENCE THIS PROPOSAL SECTION 404 ALTERATION-LEVEL 2 Project involves removing existing and 404.1 Scope.Level 2 alterations include the reconfiguration of adding new non-load bearing partitions space,the addition or elimination of any door or window,the within tenant space, alterations to existing reconfiguration or extension of any system,or the installation toilet rooms,required associated changes to of any additional equipment. existing lighting and electrical systems,new 404.2 Application.Level 2 alterations shall comply with the finishes and new equipment.Proposed work provisions of Chapter 6 for Level 1 alterations as well as the <50%of building square footage. provisions of Chapter 7. SECTION 602 BUILDING ELEMENTS&MATERIALS 602.1 Interior finishes.All newly installed interior wall and ceiling finishes shall comply with Chapter 8 of the International Proposed project will comply Building Code. 602.2 interior floor finish.New interior floor finish,including new carpeting used as an interior floor finish material,shall comply with Section 804 of the International Building Code. 602.3 Interior trim.All newly installed interior trim materials shall comply with Section 806 of the International Building Code. 602.4 Materials and methods.All new work shall comply with materials and methods requirements in the International Building Code,International Energy Conservation Code, International Mechanical Code,and International Plumbing Code,as applicable,that specify material standards,detail of installation and connection,joints,penetrations,and continuity of any element,component,or system in the building. SECTION 605 ACCESSIBILITY Existing layout is already fully accessible, 605.1 General.A building,facility or element that is altered including entrances and toilet rooms. All shall comply with the applicable provisions in Sections 605.1.1 proposed alterations will maintain this through 605.1.14,Chapter 11 of the International Building accessibility and/or upgrade as required to Code and ICC A117.1 unless it is technically infeasible. meet current code. CHAPTER 7 ALTERATIONS—LEVEL 2 701.3 Compliance.All new construction elements,components, systems,and spaces shall comply with the requirements of the International Building Code. Exceptions: 1.Windows may be added without requiring compliance with the light and ventilation requirements of the International Building Code. 2.Newly installed electrical equipment shall comply with the requirements of Section 708. 3.The length of dead-end corridors in newly constructed spaces shall only be required to comply with the provisions of Section 705.6. 4.The minimum ceiling height of the newly created habitable and occupiable spaces and corridors shall be 7 feet(2134 mm). Page 3 of 5 SUMMARY Purpose of Study The purpose of this analysis is to determine if upgrades to life safety,plumbing,and access items are required for alteration of existing offices at 243 King Street,Potpourri Plaza,for Dr.James Clayton. There are no additions to the existing square footage proposed under this building permit application. No alterations to the existing structure are proposed. This study is not all-inclusive. It is based on visual observations and educated assumptions regarding existing conditions. Indication of "code compliance"within this study does not represent a guarantee on the part of the architect that the existing conditions meet all aspects of the code(or that alterations will be constructed exactly as specified)but rather that the conditions appear to meet the critical life safety, plumbing and access aspects of relevance to the proposed use. Resources: The information included in this study was gathered from the following sources: • Base drawing of existing conditions of tenant space. • Observations taken from site visits. • 2009 International Existing Building Code(IEBC)and relevant portions of 2009 International Building Code(IBC)&MA 81'Edition Amendments • Architectural Access Board Regulations: CMR 521 Executive Summary See more detailed analysis following this summary for backup information and code excerpts. The two story portion of Potpourri Plaza that is 243 King Street is separated from the older building of 241 King Street by an 8"cmu firewall and fire doors equipped with fire doors. Total GSF of 243 King Street is 15,300,divided evenly between two floors,7,560 sf each floor. Building is B occupancy,office use. All existing office occupancies are currently separated by one hour construction. The project of expanding Dr. Clayton's offices takes place fully within 243 King street. Construction classification is 513,unprotected wood frame for exterior second floor on masonry bearing wall exterior first floor,with unprotected steel bar joist roof framing. The building is fully sprinklered and has a fully maintained fire alarm system. Dr. Clayton currently occupies 2,045 sf on the first floor. No changes are proposed to existing space. Permit application is for addition of 2,030 sf tenant space configured for new dental office use.A new egress passageway will be provided on first floor to an existing exterior door to replace one of two existing lobby doorways from first floor. Alterations include minor addition of non-loadbearing partitions and associated electrical and mechanical revisions. Proposed work area 2,480 sf is less than 50%of total building area(of 15,300). The proposed scope of work for renovation will utilize the Work Classification Method for code compliance,as described in the following review: Page 2 of 5 NEW Building Code Analysis for Renovation of Offices for Dr. James Clayton Potpourri Plaza 243 King Street Northampton, Massachusetts 01060 Prepared by: N 4: n �o Kathleen Ford,Architect No.10193 A MERST 22 Eames Avenue , Amherst,MA 01002 9FG/ A� 413-374-3601 OF kford @fordgillen.com May 22, 2014 SUMMARY Purpose of Review 2 Resources Executive Summary WORK AREA METHOD — LEVEL 2 ALTERATION 3-5 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 (D No 0 SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT lA*0_5 G 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 ner J � , 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 and the pa' s and penalties of perjury. Print Name Signature of Own r/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: lica Not Applicable ❑ Name of License Holder: License Number Z(ZC)y Addres Expiration Date i( d'uAn Signat 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 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): -, � oioe Registration Number ddre 10 .( Expiration gat e gn ture Telephone / (At 9.2 Registered Professional Engineer(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 t Name Area of Responsibility Address Registration Number i Signature g Telephone Expiration Date 9.3 General Contractor r-I. c Not Applicable ❑ Company Nam : Responsible In Charge of Construction �} Addre _ Iq Signa ure Telephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be tilled 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 i parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Find i ever been issued for/on the site? NO DON'T KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 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 (D YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued. C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: 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,exc vation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 1 Version 1.7 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❑ Brief Descriptior)<Enter a brief description here. Of Proposed Work: ('p 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 ❑ 213 I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 0 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A S Storage ❑ S-1 ❑ S-2 ❑ ' ~ r:' M `.14 U Utility ❑ Specify: M Mixed Use ❑ Specify: r 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) m —7 1 St '.._. l.�,t✓�� .. 1 ..y, _... _ . .., .1 nd 2nd; C 3 rd 3rd 4 t . 4« Total Area(sf) Total Proposed New Construction(so Total Height(ft) c Total Height ft 7.Water upply(M.G.L.C.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ) Private ❑ Zone ? Outside Flood Zone[( Municipal ❑ On site disposal system❑ t Versionl.7 Commercial Building Permit May 15,2000 Department use only ty of Northampton Status of Permit: ilding Department Curb Cut/Driveway Permit JUN 2 02o 'j. 212 Main Street Sewer/Septic Availability L_y Room 100 Water/Well Availability Clectric. n�9 -__J N hampton, MA 01060 Two Sets of Structural Plans �s lnspectI am 587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify 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 1.1 Property Address: This section to be completed by office 2CA T. % Map Lot Unit I�Z Atlk 6m o Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Name(Pri Current Mailing Addr s: LA Signature Telephone 2.2 A horize ent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building ��26U (a) Building Permit Fee 2. Electrical Il (b) Estimated Total Cost of 1 ob v Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection A (o 93,0. P1 9 6. Total=(1 +2+3+4+5) to O Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1385 APPLICANT/CONTACT PERSON INTEGRITY DEVELOPMENT&CONSTRUCTION INC ADDRESS/PHONE 110 PULPIT HILL RD AMHERST (413)549-7919 PROPERTY LOCATION 243 KING ST-SUITE#112 MAP 24D PARCEL 185 001 ZONE HB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 9 211111°)17 J -n, Fee Paid Typeof Construction: EXPAND TO ADJACENT OFFICE SPACE New Construction Non Structural interior renovations Addition to Existing- Accessory Structure Building Plans Included: Owner/Statement or License 90514 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION PRESENTED: proved 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. 243 KING ST-SUITE#112 BP-2014-1385 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24D- 185 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-2014-1385 Project# JS-2014-002335 Est. Cost: $105000.00 Fee: $630.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: INTEGRITY DEVELOPMENT & CONSTRUCTION INC 90514 Lot Size(sq. ft.): 86248.80 Owner: COOLIDGE NORTHAMPTON LLC Zoning: HB Applicant. INTEGRITY DEVELOPMENT & CONSTRUCTION INC AT. 243 KING ST - SUITE #112 Applicant Address: Phone: Insurance: 110 PULPIT HILL RD (413) 549-7919 Workers Compensation AMHERSTMA01002 ISSUED ON.71212014 0:00:00 TO PERFORM THE FOLLOWING WORK.EXPAND TO ADJACENT OFFICE SPACE 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 Siiznature: FeeType: Date Paid: Amount: Building 7/2/2014 0:00:00 $630.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner