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32C-024 (12) 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 CTMR, Section 107 Project Title: Repair and Preventive Maintenance of the Whidden Hospital Parking Garage—Phase 1 Date: September 15,2014 Property Address: Kirkland Avenue,Northampton,MAO 1060 Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Concrete repair and waterproofing I Wesley J.Wilson MA Registration Number:42802 Expiration date: June 30,2016 ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Architectural X 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 constriction site on a regular and periodic basis to: I. 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 t 7,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 electronic signature and seal: Phone number: 617-778-4882 Email:wwilson @desznan.com /WCSLEY J. 'G WfLSON STRUCTURAL `^ 9No. 42802 0. Building Official Use Only �J)�I r'�1 7 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 ewe, 4—H '$G'N 9RYaS. 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P-e scPIS.NT.S -- 0.-e SCAIS:M.T& V 5 ti N 4 � C W R C4 z d z R w FllgT O CONDITION AND DENDt-M 1' sl' I aa, rrnoxs uw�c�unou: M/xm no�nP'sx�ary� roxrcm� msuw^ �1 V�x'maiumn x, wiw.00 ue sw.w, f�'�•°.`�''O�F 'O'x"�rrnuoO50em SBCTION AT TLH ,uwC wa sa lei L I� /�` _ �n-n•° owe 1 +' °xxwn6„W°-.ca vw,:c:wow 4:-1 p ���� � ry RFPRtRFn_CON13MON :q•`��®s`a� �n e ix»u r ar+wmu c.xr a eeuwe u wn w un•a-a-.tea u,Px � UM on. eP>a c-°ao w y:atR eWn es wnuurmx n xDr PL IN AT SEMA CONNICrOM x aws o°ssp nm nP.«emcrnw -a SAND AND EPO7[Y REPAIR AT TEE CONNECTION Q NEW SHEAR CONNECTOR AT D Mt,.NSION 7q-tNT /e-\REMOVE AND REPLACE SEALANT AT PRECAST MINTS P `"P116"P�u R-e SCe18:M.T.S. P-e 6rx„-Ni.6. -e 55.1LC N.T.S. EETA[[ES- e Re_6 °Ym,nn.or .wx.lne —1. :�a mn a" r, M"".� :xe xo x xs.ro d ~ c k { IVx,xsc n e[Pr]oee i =STING CONDITION 610VA1. FR1FT[N-CONDITTDN ND RPVnV i �.w�w�imm ro,dax ISOMETRIC a W oxx Z b H • '. � • • R xr x me xlird¢v me ne Nm:Ixo .[e:e xnx[rP v PNYa..d mca A �F a.a xY.i� 0 m x� �� rl� W.[m W F PULL DEPTH REPAIR ON PRECAST CONCRETE TEES A � RZEA MV Fn r= REP, IREI �gNylTroN d a — fir. DP.RTH RRP m AT At[1ACENT TR. �N.gy Pmf,DDPTfi REPAIR AT OTf11'!'RR_f+1,�NGF Q: [� CO { r f wu boa �pnui x`•ncYrtn)p�—v /��ro� x:ffi s¢;i� uo.c in caxami�f*r-)� Dees cw m'"0.:nm xw a, m fern oomuro: ILI, grCITING CO NUM AND DEMOL ON '\r'a ,el. MOSTDPG CQMMON AND REMOVAL REPAIRED C07I,�I1T[0N f .. xddxx[mcr uc. o�ouc mxn.souxde mnYC x [ar ne uv.ea. REPAD3ED CONDTI7DN nYx¢A"o®d�[ur.e.e,nvm:v yx,.rtY ] rYrmJ.[Yeti cax«wnc wmxYC xwups 1]e xaa. Wx[,[mia xnxm.oi a :JdY"O""'"` ..w n[a Y ovm v e AEYN� [ M uxeeul�ve4tn oo:SiFiF K x,gl[e n tx[woxml 4 c C[Pm v ::a^e.e[ w ,wx Y rw�NN s^�ue rw w.c[wr Yx mv:u or mue mites.epos-[¢nox ��dines Uwe wvw x.wurs u[uxaun afw nea[m[RSC m�6 r xrtS usr.e.e n.w axe wu d:e v me.vlcwPMYAg ° Prru x v Mi�YrxiemrvR�[�wre,Y;Ixax_ue rt wvxow.s rd eK iu m'q Rsra Yv)"m"�i w[i"m I]ws. M+�v ec rroaxe w FAT[P CAL M9SP� OLIA[fb- u.r"`Y"ermA r`ie ri.`ix�e�iw�iw0�"10wuxr, ee v+w,e.YO w.c me r¢xr wo YrYY wn� ] M iwn[o�+mvuai�"annm wxe¢rt z�ans[sw:e[rmn.:eul tp"`R LEE,,. R-5 PARTIAL DEPTH PRECAST CONCRETE �1 AND OVERHEAD TEE tT.ANGE REPAIR �\OVERHEAD_CONCRETE REPAY SnJld:H.S.S - SCAB:N.T.6. _ lu 52 wn 1-7-1--1 1 Zj 0 > T-7-- 7 r7 t JI Z.J. GARE PARKING GARAGE ROOF LEVEL FRAMING PLAN T-4 (D- --- a--- f 9 " 1 a 4 i --s WE REPAIR AND PREVENTIVE MAINTENANCE DESMAN w � E.J. GARE PARKING GARAGE ;� NORTHAMPTON,MASSACHUSETTS 0 r ? 0 4 b 4 4 b 4 ,E) ---8 REPAIR AND PREVENTIVE MAINTENANCE DESMAN E.J. CARE PARKING GARAGE NORTHAMPTON, MASSACHUSETM MID rl r 41"t.- ...... .... 171 > 11 lID g 6 5 b4 b3 E.J. GARE 41. CL PARKING UVEL 2 FRAMING PLAN LEcEND - - REPAIR ITLMB UNIT, OEM QuorTy m PLAN ...... PARLNz Lffgl It. Initial Construction Control Document W To be submitted with the building permit application by a d Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Repair and Preventive Maintenance of the Whidden Hospital Parking Garage—Phase 1 Date: September 15, 2014 Property Address: Kirkland Avenue,Northampton, MAO 1060 Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Concrete repair and waterproofing I Wesley J. Wilson MA Registration Number: 42802 Expiration date: June 30,2016 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: Architectural X 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'. OF IdAS�4 Enter in the space to the right a"wet"or � ES LEY J. 6� electronic signature and seal: -� WILSON STRUCTURAL. No. 42802 Phone number: 617-778-9882 Email: wwilsongdesman.com 09-. - 1 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kv 600 Washington Street Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Marois Construction Co. , Inc. Address: 262 OLd Lyman Road City/State/Zip: South Hadley, MA 01075 Phone#: (413) 433-1320 Are you an employer?Check the appropriate box: Type of project(required): 1. 'L4 I am an employer with 25-35 4. L I am a general contractor and I 6. Ll New construction employees(full and/or part time).* have hired the sub-contractors 7. i 1 Remodeling 2. i '. I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. 1 I Demolition working for me in any capacity. employees and have workers' 9. F Building addition [No workers' comp. insurance comp. insurance.I required] 5J We are a corporation and its 10. Electrical repairs or additions 3. i_i I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no 12. Roof repairs employees.[no workers' 13. L Other comp. insurance required.] *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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 an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Policy#or Self-ins.Lic.#: MCC200033601 _ Expiration Date: 1/1/2015 Job Site Address: ��t�Q ✓4 _ City/State/Zip: Ne': 6 O /"'A Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up 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 $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DI for coverage verifi n. I do herby certi nde a a' and enalties of perjury that the information rovided above is true and correct. Sign ture: Date: 1 y Print Name: Cr-c Phone#: I I S i 132c, 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): I.Board of Heath 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#• II i 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-3500 C.F.OF,0 ENCLOSED SPACE)- 9.1 Registered Architect: - - 1 ] Not Applicable ❑ Name(Registrant) Registration Number i Address Fxpiration Date T Signalure Telephone 9.2 Registered Professional Engineer(s): ...-...... t>J Name �- rea of Res onsibiliry 42802p It Address `Registration Number f fv -__. -- _ z t OF, 617-778-9882 June 30,'2"016 WESLEY 1. Signature WESLEY Telephone Expiration Date g G WILSON � STRUCTURAL ' Area ofResponslbiltty 1 Name No. 428C)2 _ _. .o�a9�G S T E Address :S y Registration Number e-. __�_ __m, 1 Signature Telephone Expiration Date i 1 i Name Area of Responsibility L.. Address Registration Number .._.. - f l k Signature Telephone I Expiration Date (_ i Name Area of Responsibility i Address Registration umber t Signature Telephone Expiration-Date 9.3 General Contractor ?N(,01S Not Applicable El Compan e. �G I 1 Responsible In Charge of struction • G Address r i Signature Telephone c u - i Version1.7 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, "_ i� __ „��"_►� w,. -_ as Owner of the subject property - --------- he by authorrze` tto act h a f, in I ma ers relative to work authorized by this building permit application 017-i ; l Sign r Date --- .................... as Owner uthorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to th of my knowledge and belief. Signed under the pains and penalties of perjury _ _ _ -- _ WION _f CSTUCTION Date _ SERV ICES 10.1 Licensed ConstrtlIction Su or Not Applicable ❑ Name of License Holder-!___ License Number 1 � Address Expiration Date 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 0 No C Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING 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 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW YES Q 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 Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: C. Do any signs exist on the property? YES ® NO O IF YES, describe size, type and location: ��' G D. Are there any proposed changes to or additions of signs intended for the property? YES 0 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 ® NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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 Description Enter a brief description here. Of Proposed Work: (crock jZcPA%RS i wAkr PrYxC'-"a 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 ❑ 113 ❑ 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 ❑ 313 ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage S-1 ❑ S-2 ,Ej 513 ❑ 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: /�© C� ff- 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(so 1 St 1St C� 2nd SO O 2nd 3rd / �0 3rd l 4 m 4th o r Total Area(so A, Q0 o Total Proposed New Construction (so Total Height(ft) l/`f Total Height ft 7.Water upply(M.G.L.c.40,§54) 7.1 Flood Zone Information: [7T3 Sewag Disposal System: Public Private ❑ Zone Outside Flood Zone Municipal On site disposal system❑ c� �'. �hh>_ '7i! ," r' -"`"' t�jf `,.� ''�;4' :.T Versionl.7 Commercial Building Permit May 15,2000 f Department use only City of Northampton Status of Permit: ilding Department Curb CuttDriveway Permit - �'-5���0 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans pn phone 413-587-1240 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 E„S, GAi.G 'PArteov9 6'4zAaX Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: DAV,p Po., eeAN y Z 1'10 S—k 3. r MA 0060 Name(Print) Current Mailing Address: `113 - 561- /goo Signature Telephone 2.2 Authorized Agent: CAKE Me-rc1er, '206 61D 1-yra4,,j 14a04.el, f-A Name(Print) Current Mailing Address: yl3- 533 - t3-z,- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building a p 5 550 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+ 5) z o 5, Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Bull in issirneroKp6ictor of Buildings Date 85 HAMPDEN AVE-PARKING GARAGE-ARMORY ST BP-2015-0342 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-024 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-2015-0342 Project# JS-2015-000629 Est. Cost: $205550.00 Fee: $0.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MAROIS CONSTRUCTION CO INC 060872 Lot Size(sq. ft.): 127195.20 Owner: NORTHAMPTON CITY OF PARKING GARAGE Zoning: CB(100) Applicant: MAROIS CONSTRUCTION CO INC AT: 85 HAMPDEN AVE - PARKING GARAGE - ARMORY ST Applicant Address: Phone: Insurance: 262 OLD LYMAN RD (413) 533-1320 Workers Compensation SOUTH HADLEYMA01075-2653 ISSUED ON.912412014 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONCRETE REPAIRS &WQATERPROOFING 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 9/24/2014 0:00:00 $0.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner