18-013 WALL MART (2) 04/26/2007 23: 12 4046561649 LIGHT IND PAGE 01/01
1-
Vans 1.7 CCIt Mweial Building Permit May 157 2048
S£CTXM 9- ESSIQNAL DROWN JtiNb CONSTRUI;TION SERVICES-MR ML,LIIN"AMD STRUCTURES SUBJECT TO
CONSTRUCTliMI COWMOL PURSUANT TO 7110 CMR 116 0 KTAIr M WRE THAN 36,000 C.F.OF ENCLMSEO SPACE)
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Letter of Transmittal
Chris M. Rhea -Architect
To: Attn: Louis Hasbrouck, Building Inspector From: Beth Mullaly, Permit Coordinator
Address: City of Northampton Date: November 16, 2006
Building Department
212 Main Street, Room 100 Re: Wal-Mart Store #2901
Northampton, MA 01060 Restroom Remodel
Northampton, MA
Phone: (413) 587-1240 Project #: 96503146
Fax: (413) 587-1272 Via: Fedex 2nd day
We transmit the following:
Please find enclosed the following for the Restroom Remodel for Wal-Mart Store #2901, located at 180 North King Street:
3 - full size sets of signed/sealed construction documents
1 - Letter of Authorization from the owner
1 - Application for Building Permit
1 - Construction Control Affidavit, signed by Architect of Record
1 - Construction Control Affidavit, signed by Mechanical Engineer of Record
1 - Construction Control Affidavit, signed by Electrical Engineer of Record
1 - Lighting Compliance Certificate
The above documents are being submitted for plan review. The project will be going out to bid once all plan reviews have been
approved. The scope of work is an interior remodel of the existing customer restrooms, 660 s.f. Per my conversation with you
regarding the submittal requirements, you had informed me that plans would be routed to the fire department for review. I have
also submitted a set of plans to Richard Meczywor at the Office of the Board of Health for his review.
If you have any questions, please feel free to contact me at(913) 262-9095.
Sincerely,
Beth Mullaly
Permit Coordinator
Beth Mullaly
CC:
www.brrarch.com
6700 Antioch Plaza,Suite 300,Merriam,KS 66204 MAIN 913-262-9095 FAX 913-262-9044
kansas city I bentonville I phoenix I tampa i miami
04/25/2007 05:05 4046561649 LIGHT IND PAGE 01/02
SNSM
SkanskaUS,A,Building Inc.
70 Ellis Street
Atlanta,Georgia 30332
more 444.9467539
Fax 866 31$2$45
wed www,skanskausa.eom
To: Linda LaPointe
Company: Building Department,Northampton, MA
From.: Kevin Conte
Subject: Certificate of Liability Insurance
Date: 4/25/07
Linda,
Attached is a copy of our Liability Insurance.
Please contact me if this is not the proper document you need-
Tlian.k you,
Kevin Conte
SkauskaUSA
Direct: 404 946-7428
Tel: 404 557-2245 (cell)
Fax: 866 852-5513
Kevin.Contc @skanskausa_com
(R
G 8 A X T
Real Estate & Development
September 22, 2006
VIA FEDERAL EXPRESS
Nick Goodner
Wal-Mart Stores, Inc.
2001 SE 10th Street
Bentonville, AR 72716-0550
Re: Lease dated July 2, 1965 between GBR North King Limited Liability
Company, et al., as Landlord, and Wal-Mart Real Estate Business Trust,
as Tenant, as same may have been amended, modified and/or assigned,
covering premises located in Northampton, MA
Dear Mr. Goodner:
Pursuant to your letter dated September 7, 2006, enclosed herewith please find
an original Building Permit Application which has been executed by Landlord.
Please forward copies of all documents (including floor plans), which are required
and that will be submitted to the Building Department, to me.
Please let this letter serve as Landlord's authorization to commence the work set
forth on said Building Permit Application.
Very try)y yours,
C,an Wechsler
DW:Ic
Enc.
Tel 914 631 6200 Fax 914 631 6243
www.gibraItarmgt.com
150 White Plain-s Rd., Suite 400
Gi bral tar Management Co., Inc. Tarrytown, NY 10591 - 5535
Permit It
Permit Date
COMcheck Software Version 3.2.0
Lighting Application Worksheet
Standard 90.1-1999
Report Date.
Data filename: 1:1Stores10250oT-1102901--1 106 80 6 2-110001EIec\Supp12901NO-1.CCK
Section 1: Allowed Lighting Power Calculation
A B C D
Area Category Floor Area Allowed Allowed Watts
(ft2) Watts/ft2 (B x C)
Common Space Types:Restrooms 670 1 670
Total Allowed Watts= 670
Section 2: Actual Lighting Power Calculation
A B C D E
Fixture ID:Description 1 Lamp I Wattage Per Lamp 1 Ballast Lamps/ #of Fixture (C X D)
Fixture Fixtures Watt,
Linear Fluorescent 4:RC:8'Enlcosed Corner Mt./48"T8 32W!Electronic 2 10 58 580
Linear Fluorescent 5:RD:4'Enclosed Corner Mt./48"T8 32W/Electronic 1 2 42 84
Total Actual Watts= 664
Section 3: Compliance Calculation
If the Total Allowed Watts minus the Total Actual Watts is greater than or equal to zero,the building complies.
Total Allowed Watts= 670
Total Actual Watts= 664
Project Compliance= 6
MR- • ••
page 3 of 3
Exceptions:
24 hour operation lighting.
❑ 7. Master switch at entry to hotel/motel guest room.
❑ 8. Separate control device for displaylaccent lighting,case lighting,task lighting,nonvisual lighting,lighting for sale,and
demonstration lighting.
❑ 9. Photoceliiastronomical time switch on exterior lights.
Exceptions:
Covered vehicle entrance/exit areas requiring lighting for safety,security and eye adaptation.
❑ 10. Tandem wired one-lamp and three-lamp ballasted luminaires(No single-lamp ballasts).
Exceptions:
Electronic high-frequency ballasts;
Luminaires not on same switch;
Recessed luminaires 10 ft.apart or surface/pendant not continuous;
Luminaires on emergency circuits.
Voltage Drop:
❑ 11. Feeder conductors have been designed for a maximum voltage drop of 2 percent.
❑ 12. Branch circuit conductors have been designed for a maximum voltage drop of 3 percent.
Section 4: Compliance Statement
Compliance Statement:The proposed lighting design represented in this document is consistent with the building plans,
specifications and other calculations submitted with this permit application.The proposed lighting system has been designed to
meet the Standard 90.1-1999 requirements in COMcheck Version 3.2.0 and to comply with the mandatory requirements in the
Requirements Checklist.
tit(:L. S ��. C)�:iLf, �'� t 1 n O 6
Principal Lighting Designer-Name Signature Date
Section 5: Post Construction Compliance Statement
Record Drawings and Operating and Maintenance Manuals
Construction documents with record drawings and operating and maintenance manuals provided to the owner.
Page 2 of 3
Permit#
Permit Date
COMcheck Software Version 3.2.0
Lighting and Power Compliance
Certificate
Standard 90.1-1999
Report Date: 11110/06
Data filename:1:1Stores102500T-1102901--11068062-110001EleclSupp12901NO-1.CCK
Section 1: Project Information
Project Title:#0680622901 Wal-Mart Restroom Remodel Northampton, MA
Construction Site: Owner/Agent: Designer/Contractor:
160 North King St. Douglas Peters
Northampton,MA 01060 Henderson Engineers INC
8325 Lenexa Dr.
Lenexa,KS 66214
913-307-5300
doug.petersPhendersonengi neers.com
Section 2: General Information
Building Use Description by: Activity Type
Project Type: New Construction
Activity Tyoefsl Floor Area
Common Space Types:Restrooms 670
Section 3: Requirements Checklist
Interior Lighting:
❑ 1. Total actual watts must be less than or equal to total allowed watts.
Allowed Watts Actual Watts Complies
670 664 YES
Exterior Lighting:
❑ 2. Minimum efficacy of 60 lumen/watt for lamps greater than 100W.
❑ 3. Lighting power for canopies,entrances,and exits meets the following criteria(trade-offs allowed among these applications):
(i) Lighting power for free-standing canopy areas or building entrances with canopies is less than or equal to 3 watts
per square foot.
(ii) Lighting power for building entrances without a canopy is less than or equal to 33 watts per linear foot of door width.
(iii) Lighting power for building exits is less than or equal to 20 watts per linear foot of exit door width.
❑ 4. Lighting power for building facades is less than or equal to 0.25 watts per square foot of the illuminated area.
Exceptions:
Controlled by motion sensor,signal or advertising signage,highlighting features of historic monuments and buildings,or
required for safety or security.
Controls,Switching,and Wiring:
❑ 5. Independent manual or occupancy sensing controls for each space(remote switch with indicator allowed for safety or
security).
❑ 6. Automatic shutoff control for lighting in>5000 sq.ft buildings by time-of-day device,occupant sensor,or other automatic
control.
Page 1 of 3
City of Northampton
Building Department
212 Main Street,Room 210
Northampton,MA 01060
CONSTRUCTION CONTROL AFFIDAVIT
PROJECT TITLE:Wkj-NcLe 4- 'A e�f rr t, ';len,ah PI DATE:
PROJECT LOCATION: i o n N n r+h I-r e a`F
NAME OF BUILDING: w a t- 0.t,+ -J 4-o r a Apo I
SCOPE OF PROJECT: ', jj{-co Q r,a A n I Fax :3 4- : 13 C' (`es f-r n o r17 s
IN ACCORDANCE WITH THE MASSACHUSETTS STATE BUILDINGtODE,780 CMR,CHAPTER 1,
SECTION 116,1 L��AtC ),gtJWAtY) MASS.REG.NO. -3 M15 C, BEING A REGISTERED
PROFESSIONAL ARCHITECT/ENGINEER,HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY
SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS AND SPECIFICATION
CONCERNING:
ENTIRE PROJECT ARCHITECTURAL STRUCTURAL
FIRE PROTECTION <'~ELE CALF MECHANICAL
OTHER(specify)
FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE,SUCH PLANS,
COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE
MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL
APPLICABLE LAWS FOR THE PROPOSED PROJECT.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE
PRESENT ON THE CONSTRUCTION SITE ON A REGULAR BASIS TO DETERMINE THAT THE WORK IS
PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT.
1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by
the contractor in accordance with the requirements of the construction documents.
2. Review and approval of the quality control procedures for all code required controlled materials.
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,in general,if the work is being performed in a manner consistent with the
construction documents.
I SHALL SUBMIT PERIODICALLY,A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS
TO THE BUILDING INSPECTOR. UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL
REPORT AND A CERTIFICATE OF COMPLETION AS TO THE SATISFACTORY COMPLETION AND
READINESS OF THE PROJECT FOR OCCUPANCY.
RR ^IA4t
ORIGIN G _.,._" SEAL
fiTEVN
City of Northampton
Building Department
212 Main Street,Room 210
Northampton,MA 01060
CONSTRUCTION CONTROL AFFIDAVIT
PROJECT TITLE:tJc-I-NeLe 4- .:A eS+me r,eoAen,ah A DATE:
PROJECT LOCATION: i j n N a r+r, k',n A 5+r e P+
NAME OF BUILDING: Loa I- Jul ctl,+ 34-0-9'^q
SCOPE OF PROJECT: ',A+p, ; ny C Q ri 2 4 a l p1p p k ;.5 4- : nc, (`e3+r c o r, s
IN ACCORDANCE WITH THE SSACHUSETTS STATE BUILDIN ODE,780 CMR,CHAPTER 1,
SECTION 116,I DL/,gQ9- f .NAQe—SGr-► MASS.REG.NO. 7,9324 BEING A REGISTERED
PROFESSIONAL ARCHITECT/ENGINEER,HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY
SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS AND SPECIFICATION
CONCERNING:
ENTIRE PROJECT ARCHITECTURAL STRUCTURAL
FIRE PROTECTION ELECTRICAL �__ECHAN_�,CAh—�
OTHER(specify)
FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE,SUCH PLANS,
COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE
MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL
APPLICABLE LAWS FOR THE PROPOSED PROJECT.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE
PRESENT ON THE CONSTRUCTION SITE ON A REGULAR BASIS TO DETERMINE THAT THE WORK IS
PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT.
1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by
the contractor in accordance with the requirements of the construction documents.
2. Review and approval of the quality control procedures for all code required controlled materials.
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,in general,if the work is being performed in a manner consistent with the
construction documents.
I SHALL SUBMIT PERIODICALLY,A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS
TO THE BUILDING INSPECTOR. UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL
REPORT AND A CERTIFICATE OF COMPLETION AS TO THE SATISFACTORY COMPLETION AND
READINESS OF THE PROJECT FOR OCCUPANCY.
ORIG SIQNAT FD 11 SEAL
k nT,
F �J
City of Northampton
Building Department
212 Main Street,Room 210
Northampton,MA 01060
CONSTRUCTION CONTROL AFFIDAVIT
PROJECT TITLE: �.,.c,1=t`+�e . E.s fi r r t r, '�e!'i d o f DATE: 1 j u I 'CL,
PROJECT LOCATION: i c c 19,, h e ti;,��; 54 i'n c F
NAME OF BUILDING:ter.i- i`i r,f S -t,;e '3�q c; i
SCOPE OF PROJECT. ; ,y t e r , E r. t'e M n j r I c F p z _S+ n f e_l+, r,
IN ACCORDANCE WITH THE MASSACHUSETTS STATE BUILDa ING CODE, 780 CMR,CHAPTER 1,
SECTION 116,1 C rt c s h ,'-t�'I E:a MASS.REG.NO. 5 ei q ,,) BEING A REGISTERED
PROFESSIONAL ARCHITECT/ENGINEER,HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY
SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS AND SPECIFICATION
CONCERNING:
ENTIRE PROJECT ARCHITECTURAL STRUCTURAL
FIRE PROTECTION ELECTRICAL MECHANICAL
OTHER(specify)
FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE, SUCH PLANS,
COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE
MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL
APPLICABLE LAWS FOR THE PROPOSED PROJECT.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE
PRESENT ON THE CONSTRUCTION SITE ON A REGULAR BASIS TO DETERMINE THAT THE WORK IS
PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT.
1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by
the contractor in accordance with the requirements of the construction documents.
2. Review and approval of the quality control procedures for all code required controlled materials.
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,in general,if the work is being performed in a manner consistent with the
construction documents.
I SHALL SUBMIT PERIODICALLY,A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS
TO THE BUILDING INSPECTOR. UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL
REPORT AND A CERTIFICATE OF COMPLETION AS TO THE SATISFACTORY COMPLETION AND
READINESS OF THE PROJECT FOR OCCUPANCY.
ORIGINAL SIGNATURE AND SEAL
✓a�
1(S. .=�
OF
LIGHT IND , PAGE 02/62
04/25/2007 05 @5 4046561649 �i6l �SO^-'1W
ACORQ. CERTIFICATE OF LIABILITY INSURANCE YYYY►
PRODUCOR Phnna: 404-S42-9530 Fax: 404-942-1411 THN9 CERI'IRI6M IS ISSUED AS A MAMR Or- INPORMATION
Allied Noxth America Ins. Brokerage Qf GA, LLC ONLY AND CONFERS NO RJOWS LWON THE -CER'TFICATF-
Ele�rl=r. Piedmont Center Ste 7(?0 HOLD- THIS OERTMATE DOES NOT AMEND, EXTEND OR
3495 Piedmont t Road, NR ALTER IM COVERAGE AFFORDED BY THE POLICIES BELOW.
'Atlanta CA 30305-1530 INSURMSAFFMING COVERAGE NAIL9
CMVJRED INSLIRERA' r ._._
Skanska e3SA Building Inc. INaMERS:
70 Ellis street NE
Atlanta GA 30302 '
lN9WRat0;
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COVERAGES
THB Pa iziEs or INSTJRANcs LISTEV GELCW HXVE 9SW ISSM TO TPM IffStMW NAMED ABOVE MR THE POLICY PWtICD TIMICATED.
NMWITR%TA=I.-G A14Y RMUTREKKNT, TW1 OR CMMITION Otr ANY COVIRACT OR OTHER VOCCIMENT IRITR RESPECT TO KRICH THIS
CERTIFICATE MAY BE ISSUED OR MAY P&RTA.IA, THS TMMRANC$ ArFDRM BY 7l:d7i PORKIES rMSCRIKED HMV9 IS SURag= TO ALL THR
TERMS, EXCLUSIONS AND CONDITIONS OF SgCF> POLIC78S. AGC ,' TS LIMITS SMW MAY RAVE BEER REDVCEID By PAID CLAIMS.
INOR AWL PDIJCYNIANREit iN71.ICY CTNII PONG1f ON LItAf1S
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,ERTIFICA fE BOLDER CM.LATIONja
SNO= ANY OF THE AROvs ZIEWRIBIM POLICIR9 88 CAMC1ari,I,BA
BEFORE M 9"7]tATXCW DATE TRUR15OF, TFM ISSUING INSVRBR
City of xOr4thampton WILL MAIL 30 GAYS VMTTTW NOTICE TO TEE CERT'TF101ITS 1ElOFAM
Suilding OrpBXtment NAMED TO THE T4$8T.
212 Main street, Room 140
Worthamptn,x MA 01060
AVII160ROM FA34MSNTATNE
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GORD 25(2D01108) - OA90WROIPKI ON 1988
Version 1.7 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
as Owner of the subject property
hereby authorize
act on my behalf, in all matters relative to work authorized by this building permit application.
n -�
Signature of Owner Date
� i �LY1Ci �
I,° G �M_l • ? 11 1 .<J. .._...___. _..... _. as 9wnwTAuthorized
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 underthe pains and penalties of,perlury.
Print N e _.
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
{
Name of License Holder:! .-�-a- a� - -- -- ----
License Number
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 0
f
Version 1.7 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 36,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
I C f) r `S -,-;)h&CL- -- Not Applicable El
(Registrant):
Registration Number
Amass Expiration Date
Signature Telephone I3 Q
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
!ZS2-5 Lk d-&-XA [ .3 9 3 2-
Addres Registration Number
s
Signature Telephone Expiration Date
"14 F .c i�l CA
Name Area of Responsibility
-3 S ZC-; Yk kT 621 _1 -7,kgs6
Address Registration Number
��-367-5'3av I6,2 130/ZOoX
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
Not Applicable ❑
Company Name:
r
RResponsible In Charge of Construction
Address _
Signature Telephone
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
L_ __j I _i
Side
F_
Rear
Building Heighti
Bldg. Square Footage % mm
Open Space Footage _
(Lot area minus bldg&paved
parking)
#of Parking Spaces -- -- - --i
Fill: ?E
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DON'T KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW 0 YES Q
IF YES: enter Book 1 l Page= and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW ® YES f
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , 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 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 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
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❑ Repairsj5d 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: 1 1 g f e r c r' r e M c��a I Z f ex 15-F r'rj C OJT C,'17 L,F �e s ►
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 ❑ 26 I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ I-1 ❑ 1-2 ❑ 1-3 ❑ 38 ❑
M Mercantile 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 513
U Utility ❑ Specify:
M Mixed Use ❑ Specify: f
S Special Use El Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: M�.�..0 _ .• u m__.__ .. _ Proposed Use Group: „k_.n C- hl P_V 11 C e
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 —__. .. L...
1stOL
_..M 2na _.
2nd& _.._. w __..__.._. . ._.._..
B
rd
3 rd I
th
4
th 4
Total Area(so a Total Proposed New Construction(so
Total Height(ft) I
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 E]
f l
n ,
Version 1.7 Commercial Building Permit May 15,2000
� -. DrpartmePt use ar31y `
r . � r ° u 1 & ar wi
City Of Northampton Stattl3lOfPQ.ftltt (ifi5pq xn �11jr�iHw p�h�i
Building Department Curb Cut/Rftvewa Permtt
212 Main Street S4 f),8epticAvallabtlitr ��i
iI I- Mii, rorawro
Room 100 Watei;liN6l�u w flAbtlik
��cm �r
Northampton, MA 01060 Two Sets o 5tr ct rat Plans.�
Wm
hone 413-587-1240 Fax 413-587-1272 t 'MU
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 completedlb goffice
. . .__ _.....
.� ... ... _ .. .._ P
r / .,` �v ` La7t
(—;tom- Mca,- + �+ r. , F .� ; i Map �3 1 ;; Unit
i �}r. +Yi . n r r + Zone Overlay Distract
NC -+rt c�n, � + o .�
Elm St.District: C$. trici
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) j Current Mailing Address:f __ _.
Signature l ' j Telep�
g one
2.2 Authorized Agent _
Name(Print) urrent Mailing Address.
Signature Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (a)Building Permit Fee
14!
2. Electrical s... (b)Estimated Total Cost of
Construction from 6 __.___-- _-- - -
3. Plumbing Building Permit Fee
o ct) k-)is
4. Media�C)
5. Fire44(94 s n C;1 h
6. Total=(1 +2+3+4+5) 03 or,v. o tj Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
16-" fj4�
I I r �D
File#BP-2007-0581
APPLICANT/CONTACT PERSON NORTHAMPTON HOLDINGS LP
ADDRESS/PHONE NORTHAMPTON
PROPERTY LOCATION 180 NORTH KING ST
MAP 18 PARCEL 013 001 ZONE HB r�
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT �
Fee Paid
Building Permit Filled out
Fee Paid
T_ypeof Construction: Remodel existing customer rest rooms
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure -
Building Plans Included:
Owner/Statement or License � .
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF0,KMATION 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 Co on
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.
BP-2007-0581
Is#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2007-0581
Project# JS-2007-000854
Est. Cost: $54000.00
Fee: $270.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SKANSKAUSA BUILDING INC
Lot Size(sq.ft.): 452588.40 Owner: NORTHAMPTON HOLDINGS LP
Zoning:HB Applicant. NORTHAMPTON HOLDINGS LP
AT. 180 NORTH KING ST
Applicant Address: Phone: Insurance:
WC
NORTHAMPTON MAO 1060 ISSUED ON:412612007 0:00:00
TO PERFORM THE FOLLOWING WORK.-Remodel existing customer rest rooms
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 4/26/2007 0:00:00 $270.0027493
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo
<< .: BP-2007-0581
GIs#: COMMONWEALTH OF MASSACHUSETTS
N 1$--oi CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2007-0581
Proiect# JS-2007-000854
Est.Cost:$54000.00
Fee: $270.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin: SKANSKAUSA BUILDING INC
Lot Size(sq.ft.): 452588.40 Owner: NORTHAMPTON HOLDINGS LP
Zoning: HB Applicant: NORTHAMPTOV,'HOLDINGS LP
AT: 180 NORTH KING ST
Applicant Address: Phone: Insurance:
WC
NORTHAMPTON MAO 1060 ISSUED ON:4 12612007 0:00:00
TO PERFORM THE FOLLOWING WORK.-Remodel existing customer rest rooms
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
a , ��C�'—S y_� Footings:
Rough: 9W Y'2i�t Rough: -A House# Foundation:
Driveway Final:
�L Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: �0 R6oti a/VL Y
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATION
Certificate of•ccu anc nature:
FeeType: Date Paid: Amount:
S ROOM ONLY
4/26/2007 0:00:00 $270.0027493
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
. ; 1
180 NORTH KING ST BP-2007-0581
GIs#: COMMONWEALTH OF MASSACHUSETTS
MW: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: BUILDING PERMIT
Permit# BP-2007-0581
Project# JS-2007-000854
Est. Cost: $54000.00
Fee: $270.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: SKANSKAUSA BUILDING INC
Lot Size(sq. £t.): 452588.40 Owner: NORTHAMPTON HOLDINGS LP
Zoning:HB Applicant: NORTHAMPTON HOLDINGS LP
AT. 180 NORTH KING ST WOA')Aa,,4
Applicant Address: Phone: Insurance:
WC
NORTHAMPTONMA01060 ISSUED ON:412612007 0:00:00
TO PERFORM THE FOLLOWING WORK.-Remodel existing customer rest rooms
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring 2 p D.P.W. Building Inspector
Underground: er 'cc: ,��p "`r �eter:
? 3- ,(= Footings:
Rough:�0 JG4 A61v Rough:/zl&—/ 5�y_- House# Foundation:
D Alm 4C Driveway Final:
Final-�-� to inal:
5 1 9/d 7 Rough Frame:
l� �7 WOM&k -�-;17,0
P PJ-1W
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation: Eli 1$ 0D* 'L
Final: Smoke: Final: ��
z-A plus RM K
G -a7-a7
THIS PERMIT MAY BE REVOKED BY THE C Y OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULA'r S.
Certificate of Occu an
Si nature:
FeeType• Date Paid: Amount:
Building 4/26/2007 0:00:00 $270.0027493
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo
F�