08-021 (45) SITE VISIT/OBSERVATION FORM JOB NUMBER: 1352 SITE OF VISIT:9/23/14
DIV#8-DOORS&WINDOWS:
Glazing to be installed. Doors are hung with hardware needing ENT confirmation of hardware function
and security,if any.
DIV#9-FINISHES:
Minor work remains, predominately punch list in nature.
DIV#10-SPECIALTIES:
No work at this time.
DIV#11-EQUIPMENT:The tenant is coordinating all equipment for this project.
DIV#12-FURNISHINGS:The tenant is coordinating all furnishings for this project.
DIV#13-SPECIAL CONSTRUCTION:NA
DIV#14-CONVEYING SYSTEMS: NA
DIV#15-MECHANICAL:
Final trim and system operations to be certified. HVAC to be balanced.
DIV#16-ELECTRICAL:
Final trim requires installation in isolated areas receiving finish touch ups. Light fixtures primarily in place
with a few exceptions. Confirm all devices are clean and operational.
Observed conditions establish that the project has reached substantial completion and is subject to final
inspection scheduling and anticipated certification for occupancy. Any questions or clarifications needed
to supplement the construction reports g erated from this office should be requested in writing.
Lawrence Tuttle,AIA, NCARB,CSI
3 Converse Street Suite 201 Palmer,MA 01069 PH 413-283-2553 FX 413-289-8993
A r c h i t e c t u r a l
Architects Planners Interiors
9/23/14
Inspector Chuck Miller
Assistant Building Commissioner
212 Main Street
Northampton, MA 01060
Inspector Miller,
As a part of'controlled construction'this office was on site to review project progress at the ENT Group
Practice Offices. While there I could observe work that has taken place meets levels of substantial
completion and has prompted this request for final inspection and certification for occupancy on the open
permit for the renovations and expansion of the professional offices.
SITE VISIT/OBSERVATION FORM
JOB NUMBER: 1385 DATE OF VISIT:9/23/14
JOB TITLE/ADDRESS: ENT Surgeons DATE OF REPORT:9/23/14
766 King Street
Northampton, MA VISIT/REPORT # 5
Permit#BP 2014-0985 TIME:8:30 AM
Project#JS-2014-001706
WEATHER: ptly/sunny/60's
NEXT SCHEDULED VISIT:9/31/14
REPORT ISSUED TO: Chuck Miller REPORT COPIED TO:
Assistant Building Commissioner Maureen Gallo, ENT Surgeons
Rick Leno
General Contractor
GENERAL COMMENTS:
The presence of the office staff on site was called for by the GC for the expressed purpose to verify the
reaching of substantial completion of the referenced project. Observed conditions confirm that finish
work and punch list items which are the responsibility of the GC are all that remains of the contracted
scope of work.
DIV#2-DEMOLITION:
Completed as documented
DIV#3-CONCRETE:
Completed as documented.
DIV#4-MASONRY: NA
DIV#5-METALS:
Completed as documented
DIV#6-WOOD&PLASTIC:
All blocking has been established per direction of the ENT representative and has been completed.
DIV#7-THERMAL&MOISTURE:
Completed as documented
3 Converse Street Suite 201 Palmer,MA 01069 PH 413-283-2553 FX 413-289-8993
DESIGN PROFESSIONAL IN RESPONSIBLE CHARGE
FINAL CONSTRUCTION APPROVAL DOCUMENT
(submit at completion of construction project)
780 CMR—Massachusetts State Building Code
Project Title: FY 1 Date:
Project Location: '766 14 Permit#
Scope of Project: T3,1Wt16AJ o IF
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to �l S
In accordance with 780 CMR,8`edition,Section 107.0,most specifically 107.3.4 "Design
Professional in Responsible Charge" :
I, �W Q-1'007 ll� Mass.Registration Number Expiration fJ C
being a registered professional Engineer/Architect hereby certify that:
I am the Design Professional in Responsible Charge and I have been responsible for
reviewing and coordinating submittal documents prepared by others,including phased or
deferred submittal items,for compatability with the design of the building and for
compliance with the requirements of 780 CMR(Massachusetts State Building Code). I
have submitted:
1.) all phased and deferred submittal documents to the Building Official.
2.) Attached the"Final Construction Approval Document"submitted by all
Massachusetts Registered Design Professionals responsible for controlled portions
of the project(including my own—when applicable)attesting to the satisfactory
completion and readiness of the project for occupancy.
3.) The Contractors certification that the construction has been done in substantial
accord with section 107 and with all pertinent deviations specifically noted.
4.) Any and all code related punchlist items generated by the Registered Design
Professionals for work that remains to be performed.
x7V1N A�L�
I believe the work authorized under permit# � 'U`� to be complete.
(All building life safety systems must be completed prior to submitting this document.)
Signature and Seal of registered professional:
BED A# f�
g
®� MASS a.
Version—March 12,2012 h �{Ti1 pF t�PSgr
CONSTRUCTION CONTROL DOCUMENT
Massachusetts Registered Design Professional
• (for Professional Engineers/Architects responsible for portions of a controlled project)
Final Report/Approval Document
780 CMR 8th edition—Massachusetts State Building Code
Project Title: tt-' 'Y Date:
Project Location: ! Permit# Zit`r� 09�
"�
Scope of Project: U —TNT Z ^'(
IXZAAM S>Wi `Z A CAL S tJ1 ';W 4A-
In accordance with 780 CMR,Section 107.0,most specifically 107.6"Co ction Control"of the 8th edition of
the Massachusetts State Building Code:
I, p �(J{� l y Mass.Registration Number l Expiration t'
being a registered professional Engineer/Architect hereby certify that I have prepared or directly supervised
preparation of all design plans,computations and specifications concerning
[ ] Entire Project [Architectural [ ] Structural [ ] Mechanical
[ ] Fire Protection [ ] Electrical [ ] Other(specify)
I certify that I,or my designee,have performed the necessary professional services and was present on the
construction site on a regular and periodic basis to determine that the work proceeded in accordance with the
requirements of 780 CMR and the design documents prepared by me and approved as part of the building permit.
I was responsible for the following as specified in 780 CMR section 107,most specifically section 107.6.2.2:
1.) Reviewed,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 applicable
to my design.
2.) Reviewed and approved quality control procedures for all code required controlled materials applicable to
my design.
3.) 1,or my designee,were present at intervals appropriate to the stage of construction to become generally
familiar with the progress and quality of the work and to determine that the work was performed in a
manner consistent with the construction documents,this code,and my design,for the work completed.
I hereby certify that the work performed meets the applicable provisions of 780 CMR(8a'edition of the
Massachusetts State Building Code),all accepted engineering practices,and all applicable laws for the proposed
project.
I believe the above mentioned portion of the work to be complete and I am submitting to the building official,via the
Design Professional in Responsible Charge,this "Final ReportlApnroval Document"as to the satisfactory
completion of the above mentioned portion of the work along with any associated code punch list items remaining to
be completed(see attached–if any).
Signature and Seat of registered professional:
r
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No.7141 r- 9
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Version—March 12, 2012 , MASS. .�
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ham..
The Commonwealth of Massachusetts , z
City of Northampton
-
Certificate of Occupancy
In accordance with 780 CMR, Section 120.3 (The Eight Edition of the Massachusetts State Building Code)
this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified.
Identify Name of Building of Space Within Certificate No.
Issued to Tadeus Bukowski BP-2014-0985
Identify property address including street number, name, city or town and county Certificate
Located at Expiration
766 North King Street- First Floor Ear, Nose &Throat
Northampton, Hampshire County, Massachusetts
Use Group Allowable
Classification(s) Occupant Lads
B use (Business) to be determined:
max one occupant
per 100 s .ft.
This Certificate of Occupancy is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for
general fire and life safety features. This certificate shall allow for the temporary use as herein described and in conformance with any and all conditions as identified
below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or,
tampering with the contents of the certificate is strictly prohibited.
Conditions of Use All exits and safety systems must be maintained
Name of Municipal Charles Miller Date of Map/Plot:
Building Official Inspection 9/23/2014
Signature of Municipal Date of Issuance
02
O 08-
Building Official Issuance 9/23/2014 G
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V,-
766 NORTH KING ST- 1ST FLR EAR,NOSE&THROAT BP-2014-0985
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 08-021 CITY OF NORTHAMPTON
Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category
renovation BUILDING PERMIT
Permit# BP-2014-0985
Proiect# JS-2014-001706
Est.Cost: $190000.00
Fee:$1140.00 PERMISSION IS HEREB Y GRANTED TO:
Const. Class: Contractor: License:
Use Group: TADEUS BUKOWSKI 074299
Lot Size(sq. ft.): Owner: PARADISE REALTY PARTNERS LLC
Zoning: HB(100)/RI(100)/ Applicant: TADEUS BUKOWSKI-
AT: 766 NORTH KING ST - 1ST FLR EAR NOSE & THROAT
Applicant Address: Phone: Insurance:
1307 TINKHAM RD (413) 374-0521 WC
WILBRAHAMMA01095 ISSUED ON:41712014 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONVERT 2 UNITS TO ONE DOCTOR'S OFFICE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground:— Service: Meter:
� L�nr-�� V Footings:
Rough: �j/..3` Rough: �— r�-/L'j House# Foundation:
Driveway Final:
Final: Final: �� �i
'2�! � Rough Fram : ��(�"
6,0"•
Gas: Y Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: ma �� �d
THIS PERMIT MAY BE REVOKE
THE Y OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND RE A O S.
Certificate of Ocru anc Si nature:
Date Paid: Amount: TCO 7-°�8-lq C �✓t^-
FeeType• (�(Z /, 113,4/
4/7/2014 0:00:00 $1140.00 ( a"Tll R.--, I ece 'rtp !
Building D0 c eGE 1k-
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
Cn