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32C-003 (4) Initial Construction Control Document To be submitted with the building permit application by a dRegistered Design Professional for work per the 8a'edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Bank of America - Sliding Glass Door Replacement Date: 01/14/2016 Property Address: 144 Main St. Northampton MA Project: Check one or both as applicable: ❑ New construction X Existing Construction Project description: Minor interior renovations. I Douglas Gensler, AIA MA Registration Number: 10938 Expiration date: 08.31.2016 ,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: 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. uav Upon completion of the work,I shall submit to the building official a `Final Cons current'. C. Enter in the space to the right a"wet"or , electronic signature and seal: 0 8 , n � T o MA V� Phone number: 617 619-5700 Email: dougl ler.com Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: � -A-� 1 The debris will be transported by: -�OM-L.5 1� t�- TIZ J TQOC< The debris will be received by: A l` j-L-Y w A--i.,V Building permit number: Name of Permit Applicant - -t� �) T 1 Date Signature of Permit Applicant M ■ r Date: 1/8/16 To: James Winston, 142 Main St. Northampton, Ma. 01060 From: Ed Griffin /CBRE Subject: Bank of America Banking Center 144 Main St. Northampton, Ma. James Winston, To whom it may concern. I give Andy Touchette of"Adam and Ruxton"authorization to apply for permits for the property noted above that we own. Please let us know if there are any questions. erely, m Winston 4584.11 00 Thank you E3 GPiFFin Ed Griffin Project Manager CBRE Bank of America Account 774-242-9156-C The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address:_ U ON S T- City/State/Zip: W- 4 1 kk--,,T-71 Y1 1�©hone #: L� Are ygu an employer? Check t�"ppropriate box: Type of project(required): 1. 1 am a employer with �� 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [Wemodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 131-1 Other 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 an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: P VZLz I`i S U F n �A 6JGE Lc)' Policy#or Self-ins. Lic. #: WC_ 01�- - 2A Z Expiration Date: (2 6 Job Site Address: I AA 1 City/State/Zip: /4 U9_FH M-4 0_E7)t"r Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)X060 Failure to secure coverage as required under Section 25A of MGL c. 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 up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der thepairl andpe ties ofperjury that the information provided above is true and correct. Si gnat Date: Phone#: ---734'--2 (3 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#: 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 ® 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. S -d-tf A Gw EP L E7 J-E< Signature of Owner Date (AOAP6�fN(T(114 CO jEFP 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. � +� Prlpt•N'ame - C/ I 0 Signat e o wner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:A N OkEW QCs CJC F-E t7tE License Number 'bo volo6/ 5-J-) W, sep- ►, &J6F!�-Q ' 13- 1�1_ Address Expiration Date 13_ � -�-2i 3 5 ture Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§26C(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 buil ong permit. Signed Affidavit Attached Yes 0, No 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 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Oj ,__ t e*1 A Registration Number Address _ ] —lJ / 7/y 566 ATT AQ4UI� I��c'�U,�i\ti��"�S Pie f I/ �l ! IC_I Ilrts 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 �/-t- 7, f p ` A,Q&k5 U/` l (✓ '�1 (r� �iF- �I�/ � � Not Applicable ❑ Company Name: lk�j QCtto 04-�rre- Responsible sible In Charge of Construction Address nature Telephone Versionl.7 Commercial Building Permit May 15,2000 S. NORTHAMPTON ZONING _ ' V_) i(� J � (+� 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 Q DON'T KNOW YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW O YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO © DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained O , Date Issued: C. Do any signs exist on the property? YES 0 NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0 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[I Change of Use❑ Other❑ Brief Description Enter a brief description here. Lr\C� X 15`� j J �a�-ASS Of Proposed Work: PTA"� � I-_r.. I C) �j 4 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 Hi h Hazard ❑ 3A ❑ Institutional ❑ I-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 ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE c ,p Existing Use Group: S I 1 Jk 5S 6 e--�-=1 Proposed Use Group: . ikm 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) FA I 1 St 1 S` 2nd 2nd 3`d 3`d 4 t 4m Total Area(so Total Proposed New Construction(so Total Height(ft) Total Height ft 7.Water S,ppply(M.G.L.c.40,§54) [7.1 Flood Zone Information: 7.3 Sewage sposal System: Public Private ❑ Zone Outside Flood Zone❑ Municipal [ On site disposal system❑ Version 1.7 Commercial Building Permit May 15,2000 R Department use only City of Northampton Status of Permit: ,JAN 2 2 `�Ot6 Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability �pEG�oNS Room 100 WaterMell Availability pF BU11I3';SeCy 1S 01 Q60 ocR�,A. N.^"" Northampton, MA 01060 Two Sets of Structural Plans 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 This section to be completed by office 1.1 Property Address: 1-4� tvI A"1�i Map �� Lot Unit 1 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: - �9ev4�;BuKyj��YS 1. ( �� Pie �- � It- iI�l ) sG N/l� cad Name(Print) 7- `� ,� Current M-aiil�ing Address: Signature � C1/ L-E 11� Telephone t �^ 2.2 Authorized Aaent: MS U X TV N 4/-6 \�l , CT toy U 1\1 N 5Tj ill. SPP,I N&C-1t -p Name(Print) �. �1 PL C Current Mailing Address:A 00 Signatures., Telephone SECTION 3 ASTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee 2. Electrical - (b)Estimated Total Cost of O Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection N 6. Total=0 +2+3+4+5) `� �) Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File 4 BP-2016-0934 APPLICANT/CONTACT PERSON ADAMS&RUXTON CONSTRUCTION CO., INC. ADDRESS/PHONE 600 UNION ST WEST SPRINGFIELD01089(617)734-2138 Q PROPERTY LOCATION 144 MAIN ST-BANK OF AMERICA MAP 32C PARCEL 003 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction REPLACE GLASS PARTITIONS W/NEW New Construction Non Structural interior renovations Addition to Existing - Accessoa Structure - Building Plans Included: Owner/Statement or License 071951 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ION PRESENTED: pproved 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 e Si re of Buildi g fficial 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. 144 MAIN ST- BANK OF AMERICA BP-2016-0934 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-003 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category: renovation BUILDING PERMIT Permit# BP-2016-0934 Project# JS-2016-001577 Est.Cost: $35800.00 Fee: $251.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAMS & RUXTON CONSTRUCTION CO., INC. 071951 Lot Size(sq. ft.): 4835.16 Owner: WINSTON BENNETT LLC Zoning: CB(100)/ Applicant: ADAMS & RUXTON CONSTRUCTION CO., INC. AT. 144 MAIN ST - BANK OF AMERICA Applicant Address: Phone: Insurance: 600 UNION ST (617) 734-2138 O Workers Compensation WEST SPRINGFIELDMA01089 ISSUED ON:112612016 0:00:00 TO PERFORM THE FOLLOWING WORK.REPLACE GLASS PARTITIONS W/NEW 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 1/26/2016 0:00:00 $251.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner