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18-013 (14) <C*-N Initial Construction Control Document 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: Walmart Store a290 I Date:OV21/15 Property Address: 18I3 North King Street, Northampton, MA 01060 Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:(jeneral Rentodel of store. paint finish clean exicrior and interfor, repair-'replace misc.doors. floor tile, refurbish misc. spaces. Replace drinking fiomitains and restroom sink,. like tor like.replace and add reach-111 refirigeration cases it) sales I'loor with aswciated equirment 4)n r(tat I Joarinc K. I loban MIA Registration Number-. S 1430 Expiration date:W10,10 ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning'- Architectural Structural X Mechanical X 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: 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 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'. �ft�OFklq Enter in the space to the right a"wet"or electronic signature and seal: HOBAN 0 Phone number: l'WI 865-2332 Email: lhoban a upvIvassoclaICS.0)111 MECHANICAL C'n No.51430 qJAL cra 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 8th edition of the Massachusetts State Building Code,790 CMR, Section 107 Project Title:Walmart Store#2901 Date:04121115 Property Address: 180 North King Street,Northampton, MA 01060 Project: Cbeck(x)one or both as applicable: New construction X Existing Construction Project description: General Remodel of store,paint finish clean exterior and interior,repair/replace misc. doors, floor tile, refurbish misc.spaces. Replace drinking fountains and restroom sinks like for like, replace and add reach-in refrigeration cases to sales floor with associated equipment on roof. I Paul T. McManus,Architect MA Registration Number: 32031 Expiration date:8/31/15 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 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: 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 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 . A - Enter in the space to the right a"wet"or electronic signature and seal: Phone number:918-587-8600 Email: pau]mCasgadesigngroup.com a} Duce -i".to Building Official Use Only Building Official Name.- Permit No.- Date: Note 1.Indicate with an*N'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen, provide a description. Version 06112013 Initial Construction Control Document Tobe submitted with the building permit application by Registered Design Professional � � per g~edition ofthe Massachusetts State Building Code, 780 <`MR, Section 107 Project TidcWu(nart Store 42901 [ate: 04/21/15 Property Address: |8Q North King Street, Northampton, MA0lO8O Project: Check(x)one ur both unapplicable: New construction X Existing Construction Project description: General Remodel of'store,paint finish clean exterior and interior, rcpair/replace misc.doors, floor tile,refurbish misc. spaces. Replace drinking fountains and cemrromm sinks\ikm for like, replace and add reach-in refrigeration cases to sales floor with associated equipment onroof !]mcohA Hamilton MA Registration Number: 5|348 Expiration date: 06/30/|6 ,annungiueru//uesigii ionu1 and lhave repared mrdirecdyuupen'imcdthcpnzpuoatiunoful| 6euignp|anm,computatiomoundmpwciGcationm concerning - Architectural Structural Mechanical Fire Protection ){ Electrical Other: for the above named p 'c�tandtbutn/zhebum oymy knowledge, inhonootkm,and belief such p\uos computations and specifications ozecrthe applicable- prowiuionsofdam��msouchuoe�sS�trBoUding/�ode,(7D0(�&0|�),��dauccoted engineering practices for pn/puwed p 'xcL l understand and agree that I (or my designee)o6uJl perform the necessary professional services and he present on the construction site ona regular and periodic basis to: |. 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 dub registered 3. Be present at intervals appropriate to the stage u[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 of780CMR |07. When required 6y the building official. U shall submit field/progress reports(see item 3.)together with pertinent comments, ina form acceptable to the building official. Upon completion of the work, I shall submit to the building official a 'Final Construction Co V., ment VA Enter in the space to the right a"wet"or :4. HAWILTON electronic signature and sea]: 0 ELE_CJR!CX 0 No.5 1348 Phone number:(785) 865-2332 Email: hamiltom' gpwassociates.com f s - Building Official Cw Only Build ing Official Name. Permit No.� Date: Note 1.Indicate with an 'x'prqject design plans,computations and specifications that you prepared or directly supervised. lf"other'is chosen. provide a description. Version 06112013 Ac' CERTIFICATE OF LIABILITY INSURANCE DATE(IlMDOlYYYYI sr7�201 s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS I 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 poticy(ios)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 ondorsemen a. PRODUCER C NAME Reagan insurance arc°_N�a.-E11t:3,1..: Z ,- 04.__. _..___. ic �a0.1_ -073-.ti2? g Malnstreet E-MAIL P 0 Box 191 ADDRESS; Marcelius NY 13108 INSURER(S)AFFORDING COVERAGE NAIL 4 INSURERA.Cincinnati Insurance Company 10677 INSURED RLSPE INSURER 8:WeSCO 25011 R L Spencer Inc.- iNSURERC:AGCS Marine Insurance Cc 22837 4.500 Pewter Lane, Bldg#7 INSURER 0-ACE American Ins Cc(WHG) 22667 Manlius NY'3104 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:1972869887 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 NO-WITHSTANDING ANY REQUIREMENT-TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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 A{'sDL sueR POLICY EFi- POLICY EXP LTR TYPE OF INSURANCE 1N R POLICY Ni;MBER _ Mra1D©!YY'/Y MMtDD1YYYY� L:MPT$ A GENERALLLA89CITY Y Y CAPS 182866 .4111?:O1S 4/112016 EACH OCCURRENCE :$1,404.000 X. COMMERCIAL GENERAL L1AL�LITY DAMAGE T4 RENTED PREMISES(EBnmurtErce) S5CO,000 CLAIMS-MADE X OCCUR - !. MEUEXP(Anyonern_rsan) 510.000 X Primary& PERSONAL&FLV iNjURY 51,400,000 X Nan 6oRiri @uteEy GENERA:LAGGREGATE 52.100.000 CEN`L AGGREGATE UWT APPLIES PER PR`DLI,,115-COMPiOPAGG 52,000.470 POLICY X PRGi- .X LOC S A AUTOMOBILE LIABILITY, Y Y EBA0175876 41112015 411!2016 ?UU Jr4tt U � L, S1,004,040 X ANY AUTO !BODIL Y INJURY iPar pelrWrr. _S ALL OIANEC SCHEDULED AUTOS AUTOS Bdfi>'ILY 4N13JKY 3Per accrarrsy=5 _ X x NON 3VdNEL PROPERTY DAMAGE S HIRED AUTOS AN jTpy !iFor aL:adR.'{I Hired Phys DTI9 5540,004 D X UMBRELLA L1AB X OCCUR III, Y '410641304 401120115 41112016 EACHOCCURRENCE $8,000,000 EXCESS LJA8 __..'.•:CLAIMS-MADE, AGt.*REvATE. 5°;444;744 M DEL -RETENTION S R WORKERS COMPENSATION Y 1r1MIC3O8642.9 4111'20115 :4/112016 X U C.;TAIL• C3Tfi•. AND EMPLOYERS'LIABILITY YIN: DRY klMI75 ER ANY PROPRIETORiPARTMEAWEXECUTIVE r— E. EACH ACCIDENT $1.,040,00 CIFF-ICERIMEMBP EXCLUDED'> NIA (Mandatory in NH) �""-'"° E L DISEASE-EA EMPLOYEE 51,440;0411 It-es-desaElAe urtidsr SCRIPTiON C.IP OPERATIONS beiaww E L rISEAS;;•P;)LICY LIMIT', $1.000,000 A Leased&Rented Equip CAPS182866 4/V 2415 4012016 S75.030 1500 Ded. C Builders Risk Y Y MZI93057407 3/612015 31612016 51,000,000 $1,000 Ded DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES!Attach ACDRD I C1,Additiawal Remarks Schedule,if mar¢space is required) Additional Insured and Waiver of Subrogation are applicable only if required by contract/General Liability policy includes completed operations coverage/Umbrella policy is on a primary&non-contributory basis&follows form/Auto Hired Physical Damage Deds$100 Comp/$500 Collision Project_Wal-Mart Store#2901-207, Northampton,MA Wal-Mart Store Inc.,its subsidiaires&affiliates,GBR North King Limited Liability Company,Northampton Holdings L,P, OILR Northampton A, LLC,Gibraltar Management Co., Inc.and all other parties as required by contract are listed as additional Insured on the General Liability See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Wal-Mart Store Inc, ACCORDANCE WITH THE POLICY PROVISIONS, its subsidiaries&affiliates 2001 S..E. 10th St., AAVTHORQED REPRESENTATIVE Bentonville AR 7,7716 @ 1988-2010 ACORD CORPORATION. All rights reserved. ACDRD 25(2010 105) The ACDRD name and logo are registered marks of ACDRD Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 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 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 under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Mark Ingraham- RL Spencer, Inc. CS - 080775 T ' License Number 4500 Pewter Lane,BLDG#7, Manlius,NY 13104 07/18/2017 Address Expiration Date �- (315)682-7734 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 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: Paul T. McManus Not Applicable [3 Name(Registrant): 32031 Paul T. McManus Registration Number Address 08/3 1/2015 ' r - (918) 587-8600 Expiration Date Signature Telephone 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 Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor RL Spencer, Inc. Not Applicable ❑ Company Name: Kevin Joslin Responsible In Charge of Construction 4500 Pewter Lane,BLDG#7, Manlius.NY 13104 Address (315)682-7734 Signature Telephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHANIPTON',ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ETR Frontage ETR s.. Setbacks Front ETR Side L:" R: ETR' L:, R:! . . ., Rear ETR Building Height ETR' Bldg. Square Footage ETR % Open Space Footage % (Lot area minus bldg&paved ETR parking) #of Parking Spaces ETR' Fill: ETR (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW • YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 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 DON'T KNOW 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: Size ETR, North King Street 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 NO 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 El Change of Use Other❑ Brief Description Reface & Minor Structural Repairs to Adjacent Tenant Space. 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 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 213 I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 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 11 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: M Proposed Use Group: M Existing Hazard Index 780 CMR 34): 3 , , Proposed Hazard Index 780 CMR 34): 3 SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 5c .. . . 1S 1 ,. .,.::,... 5,700 c 2nd 2nd 3rci 3rd 4th Total Area(sf) 5,700' Total Proposed New Construction (sf) Total Height(ft) 17 Total Height ft 7.Water Supply(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[] ± j - --- Versionl.7 Commercial Building Permit Nlay 15,2000 LJAN 19 2018 City of Northampton Status of Permit: Department use only Building Department Curb CuttDriveway Permit jg§a2MU0!j MA 01060 -— I Room 100 Water/Well Availability, Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 PlottSite Plans ,Other Specify Lt[CATION TO CONSTRUCT, REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDD:INIG OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address' This section to be completed by office 180 North King Street Map Lot Unit Northampton, MA 01060 Zone Overlay District Elm St.District CB District 2.1 Owner of Record: Name(Print) Current,Mailing Address,: Signature Telephone 2.2 Authorized Aaent* /-11�4 Name(Print) Current Mailing Address: SECTION 3-ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building P46,1 00 (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 This Section For Official Use Only Building Permit Number Date Issued Signature: CZ, Building Commissioner/inspector of Buildings Date 180 NORTH KING ST-WALMART BP-2016-0916 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18-013 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-2016-0916 Project# JS-2016-001556 Est. Cost: $46100.00 Fee: $322.70 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: R L SPENCER INC 080775 Lot Size(sq. ft.): 452152.80 Owner: NORTHAMPTON HOLDINGS LP C/O GIBRALTAR MANAGEMENT CO Zoning: Applicant: R L SPENCER INC AT. 180 NORTH KING ST - WALMART Applicant Address: Phone: Insurance: 4500 PENTEL LANE BLDG 47 (315) 682-7734 WC MANLIUSNY13104 ISSUED ON:111912016 0:00:00 TO PERFORM THE FOLLOWING WORK.-REFACE & MINOR STRUCTURAL REPAIRS TO ADJACENT TENANT 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 Signature: FeeType: Date Paid: Amount: Building 1/19/2016 0:00:00 $322.70 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner