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38A-116 (9) BP-2008-0741 GIs#: COMMONWEALTH OF MASSACHUSETTS ITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cite, ry BUILDING PERMIT Permit# BP-2008-0741 Project# JS-2008-001156 Est. Cost: $996165.60 Fee: $2761.90 PERMISSIONI&HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R2 WILLIAMS BUILDING COMPANY INC 85270 l.ot Size s(. ft.): Owner: Community Builders, Inc. zoning: PV Applicant: WILLIAMS BUILDING COMPANY INC AT. VILLAGE HILL FAD - BLDG A-3, MOSER ST - LOT#23 Applicant Address: Phone: Insurance: 196 OLD TOWN HOUSE RD (508) 394-3644 WC WEST YARMOUTHMA02673 ISSUED ON:3/27/2004 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 8 UNITS R-2 BLDG 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#i 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 3/27/2008 0:00:00 $2761.9027688 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo i File#BP-2008-0741 APPLICANT/CONTACT PERSON WILLIAMS BUILDING COMPANY INC ADDRESS/PHONE 196 OLD TOWN HOUSE RD WEST ARMOUTH (508)394-3644 PROPERTY LOCATION VILLAGE HILL RD-BLDG A-3,MOSER ST-LOT#23 MAP 38A PARCEL 116 001 ZONE PV THIS SECTION FOR OFFIQAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildin Permit Filled out Fee Paid 1 Ty_peof Construction: CONSTRUCT 8 UNITS R-2 BLDG New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: ---Owner/Statement or License 85270 3 sets of Plans/Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: _Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDERi§ / 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 Demolition Delay 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. i i Versionl.7 Commercial Building Permit May 15,2000 11 Department use only City of Northampton Status of Permit_ Building Department Curb Cut/Driveway Permit - 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability 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 1.1 Property Address: j This section to be completed by office � p Map Lot Unit $v i Iola-r L&+ oZ 3 70-r ua-1 =D 3eA—lll(0— 00 11 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Village at Hospital Hill II, LLC c/o The Community Builders,Inc. Q Name(Print) Thomas P.Kegelman,Authorized Agent Current Mailing Address: C40 (413) 737-0207 Signature Telephone -----------1_-- 2.2 Authorized Agent: Williams Building Co., Inc., Tim Williams,Principal p 1 19(o OIJ Towv) Oou5e, l dl \No,54 flay-M"� Name(Print) Tim Williams .Current Mailing Address: (413) 737-0207 Signature ------------------ Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS tem stimated Cost(Dollars)to be ! Official Use Only completed by permit applicant 1 Building $797,153.60 (a)Building Permit Fee 2 lectrical (b) stimated Total Cost of $80,800.00 Construction from 6 3 Plumbing $47,689.60' Building Permit Fee 4 Mechanical( AC) -- 5 Fire Protection $70,522.40 6 Total (1 2 3 4 5) $996,165.60 Chec Number This Section For Official Use Only Building Permit Number Date saued Signature: Building Commissioner/nspector of Buildings Date i Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS T14AN 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: C0 N k - 2- SECTION — ZSECTION 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 ❑ 2B 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 F-1 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 Existing Use Group: Proposed Use Group: 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) 1 st 151 3,432 2nd 2nd ,. 3,279 3rd 3'd 2,512 m 4n, 4 Total Area(sf) Total Proposed New Construction(sf) 9,223 Total Height(ft) Total Height ft 38 7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public Private E] Zone Outside Flood Zoned Municipal 0 On site disposal system❑ i Versionl.7 Commercia Building Permit May 15,2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size :38,100 Frontage 584.7 Setbacks Front 9.7 _. Side L R: _ L: 121.3 R::69.9 Rear 7,3.7 Building Height 38 Bldg. Square Footage % 923'' Open Space Footage % (Lot area minus bldg&paved 15900 parking) #of Parking Spaces 3�, (Lot 23 total) Fill: (volume&Location150_CY A BLDG A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW 0 YES Q IF YES, date issued: 02/08/2008 IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW © YES IF YES: enter Book 9389 Page; 200 and/or Document# 00002538 B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: C. Do any signs exist on the property? YES O" NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of,signs intended for the property? YESo 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 Q NO 0 IF YES,then a Northampton Storm Water Managemerht Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 9,PROFESSIONAL DESIGN AND CONSTRUCTION*VICES..FOR BUILDINGS AND STRUCTURES SUBJECT TO. CONSTRUC7"iON CONTROL PURSUANT TO 780 CMR 116(CON INING MORE THAN 36,006CAOF ENCLOSED SPACE) 9.1 Registered Architect: .,...._�..m_.�� ...�.�.�..��. V..,.,,,e.�.. �.�.�.�. ...M....� Kerry L.Dietz Not Applicable ❑ Name(Registrant): 5264 �� ,.,..... ..' ._.�_ Dietz&Company Architects,Inc., 17 Hampden St., Springfield,MA Registration Number08/01/2008 Address 413 733-6798 Expiration Date Sig ature Telephone 9.2 Registered Professio ngineer(s): Mark B.Darnold� � � ��� Civil Engineering Name _ Area of Responsibility Berkshir Desi Gro 1 lac ,Northampton,MA 01060 _ 32459 4uredAdRegistration Number 413)582-7000 06/30/2008igTelephone Expiration Date Jay Vinskey � Landscape Architecture Name Area of Responsibility Berkshire Design Gr 4 Allen Place,Northampton,MA 01060_ 1267 _ _ l Ad dressRegistration Number1/3 (413) 582-7000 01/2009 Signature Telephone Expiration Date William B Structural Engineering Name Area of Responsibility B Engineers&Constructors,Inc., 176 Churchill St.,1ittsfield,MA� 30196 Address Registration Number (413)443-6591 106/01/2008 Signature Telephone Expiration Date Delbert BSmith,Jr., CPD,LE AP � Fire Protection Engineering Name Area of Responsibility CE Inc.,811 Middle St.,Middletown,CT 06457 PEN 0018073 Registration Number ;(860)632-168201/31/2009 Sl&ature Telephone Expiration Date 9.3 General Contractor Williams BuildinCompany,Ince Not Applicable ❑ Company Name: ,,._ ,✓//`."...,...%h� if,��-�7/1(.� .X.2r�(/'✓.�,� i,'��f.�✓ t_/y_'���1+�'..0 ,1 ,� S�K_. Responsible in Charge of Construction 196 Old Town House Rd.,West Yarmouth,MA 02673 Address Ut t' „� �l icit 75 0 7 08) 394-3644 Si nature Telephone i Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SE ICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONT INING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Delbert B. Smith, Jr., CPD, LEED AP HVAC Engineering 0 Name Area of Responsibility CES, Inc., 811 Middle St., Middletown, CT 06457 PEN 0018073 Add Registration Number IMF (�60) 632-1682 01/31/2009 Si ture Telephone Expiration Date Delbert B. Smith,Jr., CPD, LEED AP Plumbing Engineering Name Area of Responsibility CE , Inc., 811 M' dle St., Middletown, CT 06457 PEN 0018073 An �V Registration Number 860) 632-1682 01/31/2009 gnatur + Telephone Expiration Date Douglas S. Lajoie, PE, LEED AP Electrical Engineering Name Area of Responsibility CES, Inc., 11 1 t iddletown, CT 06457 PEN 0020909 Address Registration Number 4i ( 60) 632-1682 01/31/2009 Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature 9 Telephone Expiration Date 9.3 General Contractor /�lt��,s zri� •�z Cover• /n6 - Not Applicable ❑ Company Name: Responsible In Charge of Construction 1 &/j Address r' S"' 3Ci4/ S6 Y4 Si re Telephone i Version 1.7 Commercial uilding Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ;Village at Hospital Hill II,LLC, Thomas P Kegelman,Authorized Agent _......... .. ._.._...t . .,.. as Owner of the subject property hereby authorize Williams Building Co.,Inc. to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date -Williams Building Co., Inc., Tim Williams,Principal 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 ;Tim Williams Print Name Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder.. Kevin Letendre CS85270 License Number 4 Bentwood Drive, Sturbridge,MA 01566 p' 01/29/2009 Address Expiration Date (508) 347-0993 Signature Telephone SECTION 13-W RKER- CO PENSATION 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 4 i i i Board of Building Regulations and Standards Construction Supervisor License Uc66W;CS 85270 BiF� .iI'�9I1952 Exp"tlbA' 112 2009 Tr# 8893 Re*W KEVIN LETENDRE 34 CEDAR LAKE DR c;z'G ST RBRIDGE,MA 01566 Commdidoner 1 The Common wealth;of Massachusetts Department of Ind strial Accidents Office oflnv stigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legiblv Name (Business/Organization/Individual): •r Address: I'l(p C 1 A 141dZhQLf LZ Lad- City/State/Zip: Phone #: c50 8'•y?`��/ 3(o y� Are you an employer? Check the appropriate Type of project(required): El1. I am a employer with 4. am a general contractor and I 6. JZNew construction employees(full and/or part-time).* have hired thQ sub-contractors 2.E] I am a sole proprietor or partner- listed on the 4ttached sheet. # ❑ Remodeling ship and have no employees These sub-cobtractors have 8. ❑ Demolition working for me in any capacity. workers' con*. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have bxercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL. I L❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),;and we have no 12.❑ Roof repairs insurance required.] t 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 infom7ation. 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 their workers'comp.policy infonnation. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy# or Self-ins. Lic. #:� �' �Q Expiration Date: SIRc ! 0760 ,y Job Site Address: City/State/Zip: &d /v J7 Attach a copy of the wor rs' compensation policy declaratioB> page(showing the policy number and expiration date). 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 civi]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 under the pains d penalties of perjury that#ie information provided aboveistrue and correct Signature: Date: CO Q Phone#: I d n - s3—?q- c3 lU`1 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#: 02/06/2008 WED-16: 29 FAX 508 790 1677 FAIR INS wms building 0002/003 i ACO-TM CERTIFICATE OF LIABILI Y INSURANCE 7110ATE 06/2009 PRODUCER (508)775-3131 FAX (508)790-1677 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fair Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 430 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 619 Main St. Centerville, MA 02632 INSURERS AFFORDING COVERAGE NAIC# INSURED Williams Building Co Inc INSURERA: Star Insurance Co INSURERS: OneBeacon Ins. Companies OBI001 196 Old Town House Road INSURER C: W Yarmouth MA 02673 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR01 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONLTR r LIMITS GENERAL LIABILITY DATE(MM/ODM) —DATE fMMIDDLYY.) EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE []OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ POTHER THAN AUTO ONLY: AGG 5 EXCESWUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F1 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC0371516 05/25/2007 05/25/2008 wC$TATU- 0TH• EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ SOO,OO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 5001000 OTHER 790003653000 07727/2007 07/27/2008 Limit for Rental $55,900 B 50 Days - $1,000 ded DESCRIPTION OF OPERATIONS/LOCATIONS;VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT)SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Northampton BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 210 Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Northampton, MA AUTHORIZED REPRESENTATIVE >// -11 Kath Silvia/FAI]Sl �() r ACORD 25(2001/08) ©ACORD CORPORATION 1988 i f --------------- ------------------------------• Official Receipt;for Recording in: Hampshire County Registry of Deeds 33 King St. Northampton, Massachusetts 01060 Issued To: VILLAIE AT HOSPITAL HILL II LLC C/0 C MNUNITV BUILDERS 95 BERDELEY ST STE 500 BOSTON MA 02110 Recording Fees D:-------------- ----------------------Recording------ocument ng Description Number Book/Page Amount :---------------------------------------------- DECIS 00002538 9389 200 $75.00 VILLAGE Al HOSPITAL HILL $75.00 collected Amounts ---------------------------------------------- Payment Type Amount ---------------------------------------------- Cash ------------ ------------------------------ -Cash $75.00 $75.00 Total Received : $75.00 Less Total Recordings: $75.00 Change Due $.00 Thank You MARIANNE DONOHUE - Register of Deeds By: Maureen C Recs pt# Date Time 018554 02/08/2008 08:56a Reprinted ly: Maureen C Reprinted On: 02/08/2008 08:56a 4 " I o�'CttAMP�O (� f 'Warf4allyfalt � e yn EEE R[tt 178 tttE DEPARTMENT! OF BUILDIJ,"G INSPECTIONS - INSPECTOR_ 212 Main Street • Municipal Building Northampton,MA 01060 CONSTRUCTION CONTROL DOCUMENT (for professional Engineers/Architects responsible for Entire Project) Project Title: 164� It dSt !1 Date: Project Location:/ 16V A Map: JI G Parcel: w 4-n fTV• ,Std Scope of Project: New W6,041 4nJ1.A r skim t R-� k76VSlh9 1 (4VLS1yV .Hj hpC S—,e> In accordance with thesixthedition Massachu$eetts State Building Code, 780 CMR SECTION 116.0: 1, ex L1/ • l Q,` z— Mass. Registration Number rja{D Being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: []Entire Project 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. Furthermore,I understand and AGREE that t shall perform the necessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for the building permit and shall be responsible for the following as specified in section 116.2.2.- I. 16.2.2:1. Review of shop drawings,samples;and other submittals of the contractor as required by the construction documents as subrnittted for the building permit;and approval for the conformance to the design concept. 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 constniction to becomegenerally 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,in a form acceptable to the building official,a progress report together with pertinent comments. Upon completion of the Work,I shall submit to the building official a final report as to the satisfacto le 'on and readiness oftlie project for occupancy. �D ARS Signa 49 red professional: too. 5264 Springfield, Fax 413-587-1272 -phone 413-587-1240 I i OSS ttn'ip�, ` - a L rif., Elf Xartlially tail RS sachiil,till, DEPAR.TNfENT (}F BUILD r IAC INSPECTIONS f. INSPECTOR 212 Main SLrrret • Municip,,11 Builtling Ncrr[hvnP(lrn, MA Cllflt(l SECONDARY CONSTRUCTION CONTROL DOCUMENT (for Professional Engineers/Archilects responsible for only portion ofa controlled project) Project Title: III � SDIfi � �I Datc; 0o�OK Project Location: �JQV44QAAA tI Map: 316 Parcel; 17 Zone; :'v%A i � '94 Scope of project W661 In accordance with.the sbuh edition l+v+Zassaclius4ts State Building Code, 730 CMR SECTION 116.0: Mass. ;Registration Number_peI4 Ool 8073 Being a registered professional Engineer/Architect hereby CERT)TY that i have prepared or directly supen,iscd the preparation of all design plans, computations and specifications concerning: Fire protection {) Architectural [] Structural Mechanical [) Electrical [) 011ier(specify) for the above named project and that to the best of my knowledge, such plans,computations and speci.ficstions meet the applicable provisions of'the Massachusetts State Building Code,all acceptable engineering practices and all applicable lams for the proposed project. Funherinorc, I understand and AGRZE that I shall perform the necessary professional senticrs to deterlrline that the above mentioned portions of the Nvork proceed in accordance with the documents approved for the building permit. Upon completion of the work, I shall submit a Coral report?s to the sitisfnctory co>.rlpletion of tale above- mentioned portion of the work. 5igna(ure antl Scarl of registered professional: V%OF RT RR. CHANI iZt j A t Fax 413-5$7-1272 -phone 413.587-1240 "001n ZLZTL99CTP XVd 9V:VT SpOZ/90/Z0 Gifu Elf Nartliallyla11 ,� � �Rsaatly:Tsrtta ` DEPARTMENT OF BUILDlN7G INSpECt`ION.S G_- INSPECTOR 212 Main$v=t ! Muntt_iFil Bilil ting Noi,thampmn,MA 01060 SECONDARY CONSTRUCTION CONTROL DOCUMENT (for Professional Engineers/Architects,responsib)c for only portion of controlled project) Project Title: 9, ak WKD144'` PJW 'Datc; 0&' 64d0 Project Location: oy' ap: 31C Parcel; Zone; V w►xtn SCS Scope of Project: In accordance with,the sixth edition Massachusetts State wilding Code, 730 CMR SECTION 116.0: I, Mass, Registration Number TE00,;L0 0l Being a registered professional Engineer/Architect hereby CERTMY that I have prepared or directly supen•ised the preparation of all design plans,computations and specifications concerning. ( j Fire protection [1 Architectural [] 5trUctural [] Mccheinical AElectrical [] 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 lams for the proposed project. Funhermorc, I understand and AGREE that I shall perform the necessary professional services to determine ohnt the above mentioned portions of the work proceed in accordance with the documents approved for the building permit. Upon completion of the work, I shall submit a fital report as to,ilia satisfactory completion of the above- mentioned'portion of the work Sign;lture and Scal of registered professional: Fax 413-5V-127Z -phone 413-587-)240 Z00z ZLZTL99CTV XNd 9V:VT 90OZ/90/ZO (54ftt Elf XCtr#Ilallt?tall C x � a � �sasrac}?�:artta r .i DEPARTMENT" OF BUILDFI\G INSPECTI0Ns ^/ ENSPP-CTOR 212 Main$treet ! Municip, Qtiiitlinb ,Y �` NoAh.unp(on, MA 01060 SECONDARY CONSTRUCTION CONTROL DOCUMENT (for Professional > ngineers/Architects responsible for only portion ora controlled project) Project Title, AAA A Datc;_._��` i10 ddD(� Project Localion:�, DL4uA—TWi A Map:-31(, Parcel: f Zone-, V 4 •5G7 Scope of P101'e / Idfet�ak 7YA t. a v�$ a eh ve vjtY -&" 5"13 In accordance with.the sixth edition Massachusetts State Building Code, 73O CMR SECTION 116.17: I, t-A of-Y , -�E>. -Dax-n o Mass. Registration Numberr-� Being a registered professional Engineer/Architect hereby CERTUZY that I have prepared or directly supe-Msed the preparation of all design plans,computations and specifications concerning: ( ] Fire protection (] Architectural [] Structural [J Mechanical (j Electrical Otfter(specify) C.l Vi II V7Q.dlezei for the above narncd 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 lazes for Ithe proposed project. Furtherworc, I understand and AGREE that I shall perform the necessary professional senlicc.s to deterininc that the above mentioned portions of tete work procced in accordance with the documents approved for the building permit. Upon compaction of the work, I shall submit a final report:is to the satisfactory completion of the above- mentioned'ponion of the work Signature ,rota Scal of registered professional: �� Of 3 l K B. �, Q2NOLD -+ CML ft 324M '��fsKF1t� fpy t� Pax 413-587-227 -phone 4 3-587- 240 7,00[n ZL9TLt39M YU W VT t300Z/90/Z0 O�,T ritiifPT ^�a'�-l � � � � i �Rsnac}t:ractta � •1 ' DEPARTMENT OF BUIL OFNIG INSPECTIQN.S r INSPI-CTOP 212 Main Street 0 Mutticip;tt I3uiltli11g North.unpmn, MA 010X0 i SECONDARY CONSTRUCTION CONTROL DOCUMENT (for Professional Engineers/Architects responsible for only portion of controlled project) Project Title:.Villa4c,_4 gill AY, Il Date;_�(id-j t�D�X Project Location: tdit r APOWP&J�M A Map: 3 G Parccl: 17 Zone- FV Sco of Proiect. Z r►n - In accordancc with.cite sWlt edition Masmchusetts State Building Code,730 CMR SECTION 116.0- 1, ,,:� 41 _�l I!1SK� Mass. Registration Number Being a registered professional Engineer/Architect hereby CERTUZY that I have prepared or directly supeMscd the preparation of all design plans,computations and specifications concerning: [ ) Fire protection () Architectural j] Structural {) Mechanical () Electrical Other(specify) �GtV� tt�?Q, iYtt Uy for the above named project and that to the best of my IcnowledZe, 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. Funherniore. I understand and AGREE that I shall perform the rtcccssarN professional smices to determinc that the above mentioned portions of the ivork proceed in accordancc wi(h the documents approved for the building permit. Upon cotnplctiott of the pork, T shall submit a final report as to ilia satisfactory completion of the ibove- mentioned*ponion of the work ,yaEe�etatuutttrs►rrrrafA, Signaturc and Scat of registered professional: :.a �+�rti 0.1261 INC Fax 413-5$7-1272 -phone 413-587-)240 zoo[ %Z%99CT� YV3 9i VT 900Z/90/ZO ti (rifv of Xorfila plall � � � �saaael?usetSa _ Z i DEPARTMENT OF BUILDI?tiG INSPECTIoNs A• iNSPECTOP 212 Main tLrz et 0 Municipal Building w Noithampttan, MA 01000 SECONDARY CONSTRUCTION CONTROL DOMNIEN T (for Professional Engineers[Areliitects;responsible for only portion of controlled project) Project Title: V t tIT rASbiT l` i Daic; �Id/ Project Location: t4OL&,M„Q�M BA ap: G Parcel; JI Zonc;_W� -S Scope of Project: i NW C12KI)YVC&A 4 hMAS t4 chs In accordance with.the sixth edition Massachusetts State Building Code,730 CMR SECTION H&0: Mass. Registration Number Being a registered professional Ertgt UTArchimct hereby CERTIFY that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: [] Fire protection [] Architectural xs"ctural [) Mechanical [) Electrical [) 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 tans forthe proposed project. Funhermore, T understand and AGREE that I shall perform the necessary professional services to dctermirtc thot the above mentioned portions of the Nvork proceed in accordance with the documents approved for the building permit. Upon completion of tate work,I shalt submit a Casal report as to the satisfatctory completion of the above- mentioned porion of the work Signature and Scal of registered professional: . dY DATUM P mr1 4y r�v Fax 413-587-127.2 -p one 413-587.1240 Z00[n ZLZTL92CTV XVd 9V:VT $OOZ/90%ZO 02/22/08 12:06 FAX zool _ � � u'c?^3.Tu ?r; Qr L'UI,'�:i�G IN�?c�LOI•'S �=_�'�1 2.12 1`iaiM 'S'--catAfur.7 opal B-u:?ding � 1 t::SPC-CT 02 i Sqi a/r ee/ Foo C ag e As�Oun 2nd Floor @ S-30 1/? Floors, Attic. Garages S_jZ Deck.. POCCnes