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06-055 (11)
349 HAYDENVILLE RD-Route 9 BP-2017-0353 GIS#: _ COMMONWEALTH OF MASSACHUSETTS Map:Block:06.055 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-2017-0353 Project# JS-2017-000580 Est,Cost:$38000.00 FS: $266,00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor License: use Group_ SAGE ENGINEERING & CONSTRACTING INC_ Lot Size(sg.Ea: 617245.20 Owner: LINDA MANOR LLC Zoning:SR(IOpy Applicant: SAGE ENGINEERING & CONSTRACTING INC AT: 349 HAYDENVILLE RD - Route 9 Applicant Address: Phone: Insurance: 199 SERVISTAR INDUSTRIAL WAY, SUITE 2 (413) 562-4884 W ESTF IELDMA01085 ISSUED ON:10/7/2016 0:00:00 TO PERFORM THE FOLLOWING WOR%CLOSING IN AN EXISTING PORCH TO BE A YEAR ROUND USABLE 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: Qft 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: FeeTvpe: Date Paid: Amount: Building 10/7/2016 0:00:00 $266.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0353 APPLICANT/CONTACT PERSON SAGE ENGINEERING&CONSTRACTING INC ADDRESS/PHONE 199 SERVISTAR INDUSTRIAL WAY,SUITE 2 WESTFIELD (413)562-4884 PROPERTY LOCATION 349 HAYDENVILLE RD-Route 9 MAP 06 PARCEL 055 001 ZONE S,R(109)/ THIS SECTION FOR OFFICIAL USE ONLY' PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT �`� ! ] FeePaid Ct * t&'1 j33 { a(21! Building Permit Filled out 1 P .J VV.��// Fee Paid Tvpeof Conftruetion; CLOSING IN AN EXISTING PORCQI JO BE A YEAR ROUND USABLE SPACE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Plans ent/Port License / f,.. ; 3 sets of Plans/Plot Plan Fr) f C rtIed(Lr/eg THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 Demolition toy Date Signa o m mg ffieial 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. SAGE ENGINEERING AND CONTRACTING, INC, DESIGN-5UILD DEVCLOFMENT, ARCMITCCTURAL EVGINee !NG,AND CONSTRUCTION MANAGEMENT August 0, 201 G Lours Hasbrouck Tek 413-587-1240 Budding Commissioner Fax: 4 i 3-587 272 Chuck Miller, Asslstart Commissioner 2 12 Main Street Northampton, MA 01 060 RE: building Permit Application for Renovations of Linda Maror Extended Care at 349 Haydenville Road, Leeds Massachusetts SAGE No. 0558 Dear Mr. Hasbrouck a Mr. Miller On behalf of Linda Manor LLC, Sage Engineenng and Contracting Inc. is submitting the enclosed City of Northampton Budding Permit Application and Fee for a minor renovation to the existing Linda Manor Extended Care Facility at 345 Haydenvil!e Road. The following documents are included: - City of Northampton Budding Permit Application - Constriction Control Affidavit - Worker's Compensation Insurance Affidavit - Certificate of Liability Insurance - Building Permit Fee - Construction Plans, CI Copy) We are available at your earliest convenience to review the plans and supporting documents and look forward to working with the Town of Stoneham Inspectional Services throughout the permitting and construction process. Please feel free to contact me directly with any questions that you may have. Sincerely, /1,67 Bryan hcki, P.E. — reMannis, P.E. Sr. igineer President SAGE ENGINEF_RING 4 CONTRACTING, INC. 199 SERVISTAR INDUSTRIAL WAY-SUrre 2 WSTFIE1D, MASSACIUSE TS 01085 TF1 413-562-1oe4 a FAX: 413-562-:599 w.Wtszae-Ilccom .! _ _ VeisionI.7 Commercial Buddin• ParanaMav 1'. 2000 `L.:c 1 .v€x p -yam; - 1 City of Northampton _,,,ri I Building Department ';aite 4 `' '-•- 're '-'7.-Wee.- .� .. �!2G a 212 Main Street `=- "',Jr:cc ze. *� ; ' � Room 700 g",,,,.."; :,."' ,„, "`� r }* onusesruo .mpton. MA01060 s � '*.,�, *' y: $-587-1240 Fax 413-587-1272 ;� .2?, _; i“....; APPUCATION TO CONSTRUCT,REPAIR.RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SEDT'W N 1 SITE INFORMATION 1.1 Prmertr Address: .-...... Tbisaettlon to becgnpletedt byd>iIce-; : `'^ X349 Haydenville Road Map:06_ tot 055 unit 001 Zone`.SR _ Orerlay District- -' -- = Bram Okada CBPist tct . SECTION 2=PROPERTY OWNERSHIPIAUTNORIZED AGENT 2.1 Owaer of Record: Linda Manor,LLC A_�._.__�-� ,349 Haydenville Road,Leeds,Ma _,__ — Name(Pint) maw e,,,0 �yy�,�,� (413)586-7700 _ signature ��^^"�� Tokpnune 2,2 Authorized Amortb Bryan Baiicki,Sage Engineering&Contracting 199 Setvistar Industrial Way,Westfield,Ma __CI Name(int) Current Mailing Address: `(413)562-4884 — - sfgnswre`-` / re'zpfmne '�_ __.—.__„.— SEC ESTIMAT CONSTRUCTION COSTS Item _.,.. . ...EstimatedCoat(Dollars)labe OKidialUse Only completedby pem&tappbcant - 1. Buik&g $24,200.00, (a)Shading Pemat- pea --` --- '62 2. Electrical — ,— --$1,700.001 @ Estimated cons iTotal n(6) 6, .._. 3. Plumbing ._v'—...___ $0.00 Building..Permit Fee. 4. Mechanical(HVAC) ri._._ 5.Fire Protection $7,100 CO' 6. Total=(1+2+3+4+5) $38,000.00 CbedcNumber (,rt 6(Yl This Section For Official Use Only Snarling Permit Number Date Issued Signature. au)Hing.Crnunissinnamnspec'tnrarsuikittiga Date' Version]7 Commetaai 3uiittiegPermit;Vey 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 I CUBIC FEET OF ENCLOSED SPACE interior Alterations 0 Existing Wall Signs 0 Demolition❑ Repairs Additions 0 Accessory Building Exterior Alteration 0 Existing Ground Sign 0 New Signs❑ Roofing Change of Use❑ Other 0 Brief Description 'Closing in of an existing porch to be a year round usable space. Of Proposed Work: SECTION S O USE GROUP AND CgNSTT2UCTiOttT'YPE I USE GROUP{Check as applicable) I CONSTRUCTION TYPE A Assembly IA-1 0 A-2 0 A-3 0 1A I 0 ❑ 'A-4 0 A-5 0 1B ! 0 IB Business 0 I 2n" 0 E Educational 0 I 28 ❑ F Factory ❑ 1 FA 0 F-2 0 20 0 H High Hazard ❑ I 3A 0 I institutional CI 1I ❑ 1-2 0 1-3 ❑ 35 u M Mercantile ❑ 4 ❑ R Residential 0 RA 0 R-2 0 R-3 0 5A 0 S Storage ❑ S-1 0 S-2 0 58 I 0 U Way ❑ Specify:, M Mixed Use ❑ Specify: S Special Use G Specify: , I COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGEiIN USE Existing Use Group: ,,._ Proposed Use Group: No Change _ Existing Hazard Index 780 CMR 34):I .,__-�,.... .�._—., ,Proposed Hazard index 780 OMR 34} i_O Change_, _. SECTION S BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFSCE USE ONLY i Floor Area per Floor(st) No Change 3d footprint or height v__. Total Area(s£) 7otai Propase3 New Crnstru n(s@ Total Height(ft) ___ 1 7.Water Supply(M.G.L. c 40,§54) 7.1 Flwx}_Zone information: 7,3 Sewage Disposal System: Public 71 Private >, Zone_ Outside Flood Zones Municipal a On site disposal system❑ Version!.?Com*nerca!Building Permit May 15,"009 ' 8: NWOVIIA•1PrONpcp c I Existing ProposedRequired by Zoning I , �Tar/oh=to be Sited in by Building Department Lot Size Frontage -.... Setbacks Front ° NA - m - side, 1 L:NA_i itNA f I—i gear tNi'i , t__? Building xelghr N1 .__. i __..t Bldg.Square Footage NA I : ,__�__. i____, Open Space Footage I _. % _... y (Lorena minusbidg&pavat N'A_: ' _ pia) 1 #ot'Padmtg Scares :NA: ti._.._.. ....._.. Fill:i (volume&Location) None p A. Has a Special Permit/Variance/Finding ever been issued�fory/on the site? L'./ NO 0 DONT KNOW 0 YES IF YES, date issued: 0110111989 Approximately. And 3-13-12 IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Unmown it 1989 decision filet IF YES: enter Book ! 10844 Pagen.._175 ._7 and/or Document#i - �- � - B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained () Obtained Q , Date Issued: . � p'^� NO exterior wor=k-e be compile C. Do any signs exist on the property? YES �:/ NO V IF YES, describe size, type and locator: ;:.ExisLcg wand mounted at street No cnnage T D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 IF YES, describe size, type and location: E. Wiii 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 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required, Version.'.1 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERI/ICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 OMR 116(CONTAINING MORE THAN 35;000 C.F.OF ENCLOSED SPACE,., 9.1 Registered Architect: ' - l Not Applicable r-- Name (Regiatant); I___._..,_._....____._.._...._._..._ .. Reg»tration Number Address __ Explraticn Date Signature Telephone 9.2 Registered Professional Engineer(s); Franc DeMarinis 3 �Architectural Name Area of Responsibility 1199 Servistar Industrial Way ..__--_._____......_._._.__._._._,...._...—...___._. 41640 Address Regetration Number ; F8130/2018 { Signature Telephone S iration Date Name Area of Responsboility Address Signature Telephone Expiration Date Name l Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area or Responsb9ity Address Registration Number Signature Telephone Expwation Date 9.3 General Contractor Sane Engineering&Contracting,Inc _ Not Applicable 0 Company Name: ,Bryan Balicki&Frank DeMarnis Resoonsibe In Charge of Construction -199 Servistar IndustrialWay, Suite 2 Westfield,Ma Address '(413) 562-4884 Signature Telephone Version] 7 Commercial Buil&g Permit May 15,2000 SECTION TO*STRUCTURAL-PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION DI-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES?OR BUILDING PERMIT . as Ovmer of the subject property hereby authorize jto act on my behalf,in all matters relative to work authorized by this budding pemiit appecalion. Signature of Owier Date , as Ommer/Authorecl Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. ---- Print Name /4•10--- de2 1440eir N41 44. ithh Signature of CromertAged214.-- Date SECTION 12-CONSTRUCTION SERVICES 50.1 Licensed Construction Supervisor: Not Applicable Q 'Frank Delviarnils CS-105714 Riatiglis„„slipisigt License Number 199 Sentistar Inrial Way,Westfield,Ma 01085 . 112/11/2017 Expiration Date IL4.1.3)562-4884 Signature Tereptione S 'r N 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAI-c.152,§25C(69 Workers Compensation Insurance affidavit must be completed and submitted with this applicabon Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes 0 No 0 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Wastte Disposaa Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit a!I 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 150k Address of the work: 349 Havdencille Road The debris will be transported by: Duseau Trucking The debris will be received by: Duseau Tracxia9 Building permit number Tap Name of Permit Applicant Sage Engineering E Contracting - Linda Manor LLC Date ! ig = ire o Permit Applicant City of Northampton Ifr `erne-% Massachusetts i t Atk ot f es{ r�'>i y^Y` DEPAa'gT Oil' Wit WitDme xusescn isat, 212 Nava Street n :funic pal a¢tldiag .c c � Northam-ton, 1.1A 01060 INSPECTOR Louis Hasbrouck Fax:413-587-1272 Chuck Miller Building Commissioner Phone:413-587-1240 Assistant Commissioner CONSTRUCTION CONTROL DOCUMENT (For professional Engineers/Architects responsible for Entire Project) Projecniitie:Linda Manor Porch Renovation Date: -1O-16 359 Haydenville Road 6 55 SR Project Location: Map: Parcel: Zone:` Scope of Project: Enclose existing 3 season porch for year round use. In accordance with the Eighth edition Massachusetts State Building Code, 780 CMR Section 107.6: Franc DeMarinis Mass. Registration# 41640 Being a registered professional Engineer/Architect hereby CERTIFIES 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, ail acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that I 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 10.7.6.2.2: 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction documents as submitted 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 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 matter 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 satisfactory completion and readiness of the project for occupancy. ;' Signature and Seal of Registered Professional 1 t j3 Day of cer 20g sso a.� / (seat) The Commonwealth of Massachusetts Department of Industrial Accidents ,Air— Office of Investtations '_ $_-s� 1 Congress Stree4 Suite 100 - — b Boston,ILIA 02114-2017 ste,� ` www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leolbly Name(nainess/OrganizatiopMdividnal): Sage hgineerng & Cont acting. Inc Address: 199 Servistar industriel Way,Suite 2, City/State/Zip:Westfield,Ma 01085 Phone#:413-562-4884 Are you an employer?Check the appropriate box: j ): Type of project(required,. 1. I am a employer with 20 4. 0 I am a general compactor and I + employees(full and/or rsaY.-tints). a have hired the sub-contractors '' 6. New ceaEavc7on 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling ship and have no employees These subcontractors have $. 0 Demolition working for me in any capacity, employees and have workers' 9. 0 Builth v addition [No workers' comp.insurance comp.insurancet required] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their ILO Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp insurance required] 'Any epolicawa that deoks box ill must also fin out the section below showing their workers'annpensadan policy information. t Homorwocn who submit this affidavit indicating they are doing all work and then him outside contactors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name ofbe cob-contactors and sta, whether or not those entities have employees. If the sub-eontators have employees,they must provide their wvskes'comp.policy number. I am an employer that is providing workers'compensation insurance formy employees. Below is the policy and job site information. Insurance Company Name:AIM Mutual Policy#or Self-ins,Lic. tk:ECC-600-400610-2016A Expiration mate:3-23-17 Job Site Address: 349 Haydenville Road City/state/Zip:Leeds, Ma Attach a copy of the workers'compensation polity declaration page(shaming the policy number and expiration date). Failure to secure coverage as required tinder Section 25A of MOL o. 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. Ido hereby certify under the pains and penalties o Jury that the information provided above is true and correct Simiatare: pate: 840-16 Phone Ir 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 P. .'""141i SAGEE-1 OP ID: P. A4 CERTIFICATE OF LIABILITY INSURANCE i opo20 6' This CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS . 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 MD THE CERTIFICATE HOLDER. IMPORTANT: S the certificate holder is an ADD17tONAL INSURED,the policy les)must be endorsed. if SUBROGATION IS WANED,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 eT mem(s). 'PHHILLLIPS INSURANCE AGENCY INC tUCERip E`er Chrystal Greenleaf 97 CENTER STREET r No ON:413.594-5984 I""("tAAAHAS 413-592.8499 (CHICOPEE,MA01013 44lasp.chrystat©philiipsinsurance.com Chris Rivers _ *auR-`SSIAFPDRDmG COVERAGE HNC Pr I INSURERRA:ONTO Security insurance Co DISURED Sage Engineering and i HI-CURER E:A.I.M.Mutual Ins. Co. 33758 Co11,Ye,vist,Inc- INmreSc:Ohio Casualty 199 S Westfield, MA Industrial01085 Way 01085 INSIRERD: �. j tNunE: INSURERS: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER' i THIS IS TO CERTIFY THAT 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 S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ) HEDCP LTR TYPE Of INSURANCE ADDL SUR; —� IDONyrn MMIDD/WTY1. IRI NSD MW POLICY NUMBER Lens A X COMNEROALosHERALUASIUfl EACH OCCURRENCE s 1,000,0( 1 CLAIMS-MADE IT OCCUR 8K557120120 05/04/2016 05/04/20/7 ARD.ES Ws 2an^e^Cdt_ s 100,0( MEOEXP Any olepeacn),- s 15,0( PERSONAL a ADY INJURY r s 1,0000( GENII AGGREGATE UMIT APPLIES PER GENE4atAGGREGAE IS 2,040,0( POLICE rijCT n LOC PRODUCTS-COMP/OP AGG I s 2,000,0( OTHER I Is AinOMOSLEvaSarty ,,COMBIN &SAGAS LAST $ 1,000,0( A III ANY AUTO 3AS67120120 05/04/2016 05/04/2017 BODILY INJURY(Per person) s AALIOWNED I X SCHEDULED sootyJuRY(Por jt t) 5 .E. SUSS'S AUTOS X WIRED AUTOS X NON-OWNS I PROPERTY DAMAGE $ AUTOS (Peracddeno I IS X UPSPELLtWa X I OCCUR EACH OCCURRENCE Is 1,000,0( C SOFAS LIPS CLSIMSANDE VS067120120 05/04/2016 05(04/2017 ADGaEGAr- .__ 3 1,000,0C DED I X lasirsmons 10090 $ YORKERS COMPENSATION MERE 11TE S I Er" S iA&WEMPLOYERS'LW8e1R' $6I ANTPRommeLRaRT*ontecenunvE YIN ECC-400-400010-2016A 031232018 0323/2017 Et EACH ACCIDENT $ 1,000,00 OFFICERMEMBERPxrJ UDED? N ( NIA Wpm In NH) Et DIanSF-EA EMPLOYED$ ( 000,06 be under r„wa$CRFFT�Y.�MOFO.m'RaTKxi$Geb.: I EL OISFa¢- PalcvLnnlT S 1,000,00 1 1 DEUTON OP OPFAAYONe/LOCATORS(VEHICLES(ACORD101,Additional Remarks Schedle,mry0¢aneuMNx rtprtspace M;DRA ) CERTIFICATE HOLDER CANCELLATION ATION EVIDENC 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE MIS BE DELNERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Insurance ACP-TREED REPRESENTATME ,CH-EEiI'. SD A ' Bo a I Si 1988)2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD COftricheck Software Version 4O28 l iii j Envelope Compliance Certificate Proleet information Ererg?Care: 2092 TECO Project:71e: _ccaem: Ncr_ha-ioton, Massachusetts Ci:rosteZore: Ea Penjeciype: New Constructor, Ye'.icaIGNOng+rt.+sl:Area: 27% cnncecn Site: pv/ner/Agent: Designer/Contractor Bonding Aces Floor Area I-Forth(Health care ciinicj:Nonresidential 309 Additional Efficiency Package High £dercy HVAC S,ste"ns cat do rd neet the pram-loose rcirennt'Mil ie €ertned in The tr.echa^.sl relic;remeats Ceeckisf tepee. Envelope.Assemblies Assembly Gross Area Cavity Cent. Proposed dudcet U- or R-Yalce 'a'ekue It-Fabler Fectcrci Perimeter Roof1:Attic Roc?with Steel Voists„31cg.Use 1-Torch: 30e 38.0 38.0 —..... 0.015 0.027 Fico^bConcrete roci(over tnct:Neldgned space),93nor Use I- 309 — 30.0 0-0b 0.074 Pom",j tenorWs-31:Soed Ccncrete:4"Thickness,Normal::ansPortrot= t8 — 3,0 0 a•0 0079 None,!dkdy.Use I-Porch] Exterior Wall 2:Stee4Fratred, 15"c.o.,.'Edg.Use -.Porch) 509 7,5 132 0.05; 0.354 Window I:Y:rrGFiberelass Frme:Faed.Pert Specs.:Product ILO TS — — 0.210 0.380 Pareogm,SNGC 0.25,PF 0.50„Seg.Use I-Porch (b) Window 2:VnyWberglass Prene:Ocerab4.Pec.Specs.:Pro;ret it 70 — — 0.230 0.450 aradigm.SHGC 028,PF 0.50.7HICF. Use F-Perch)(b) (a)aucget G-z„ors are used for software baselinecalculations ONLY.and are not code requirements. (b)Fenestration productperfcmerm must be cenfffed in accordance wtNFRC and requires supporting dooumentaUon. EnvelOCe Compliance Statement Compliance c_Statement The proposeC envy oee design represented in this document Is consratent Ann the bu id cg plans, specifications,ant other calculations submitted wish this permit application.The proposed eenvelope systems have been designed to meet the 2012 GCC re jirements in CCMch?ck Version 23 4 nd tc comply Min Me Tenders,requirements listed the ins ecm E @ kistt. .f c Ci 13(. % Z _ ✓, Haire .Isle /5:Fi-e c&era / Date . .- Project Tate: Ashore date: 09130/16 Data'-ilenere: S RQ.E3TS 0551-0900,99558-0S-1,4 BERKSHIRE PORCH CH LINDA I4A3103O,PerrnitalidingI,Pcntri Page I of o Altera`.en.cck CoMgh+ec k SOt nor. Version 4M,2,3 b EE1 Inspection Checklist Energy Code: 20:12 IECC R equine^+encs: 0.0% Were addressed directly in the CCMcheck set were in the "CemmentsiAs5Lflprons` coiumn is provided by the user it the CCMcheck Requirements screen._en. For each remirement the user certifies that a code requirement will be met and how that is documented, or at an exception is tieing claimed Where compliance is itemized :n a separate:able, e reference to that table Is provided. artier., I - ?tarn Revaew Cor-pacts' Comntntshzsvunpt,cns} 031 Plans endicr sped`c bons provide 3i nom :Iles }tp. p information with which compliance 'DOoes Not tan be determined for the building on,o- mer./ G i :envelope and eocurnent where exceptions to the standard ere Nm_ Applicable 1claimed. I,C4C5�.. :Plans SpeCifications,angler !-.0 rogues ' ftia :calculations provide all information woes Not I r-,th which compliance can be -.DNa Ohsa.^vac e :determined nee Or the additional energy .. r / package opti - :Not A pplicaE e C40i. :Vertical fenestration area 30 Dcopf+.es i ifPRr0'1 c m P :.percent of the cross above-grade wail Dp es Not :area. :[Not Observable • • 11Not Applicable 04033.1 'Sk4ight area a=3 per^^`of the iEcomplies�.` EP'rt3Til 'gross roof area. :Cooe5 NOt :DNot Observable i IDNot Applicable • . . 12482.32 an enclosed spaces> 10,000 ft2 •Dcompiies : i(PR141= .directly under a roof with ceiling Dcoes Not heiyghts>i5 ft.and used as en office, [Tlot Obseraab:e. `lobby, atrium, concourse, corridor, storage, g mnesium/e' - 'secenter, 'Lido': "ppliaole convention center,automotive i service,manufacturing,non- refrigerated warehouse, retail store. distribution/sorting area. 'transportation, or workshop,the 1 :hollowing requirements apply: (a)the ' daylight zone under skylights is>_ half the floor area; (b)the skylight =area to deyiyht zone is >=3 percent :with a skylight VT>=0.40; ora I I minimum skylight effective aperture percent 1C402.3.2. :Areas with obstruicions that Mock D_ ^: op! e5 12 `direct beam sunlight on>=1/2 of the Does Not 'EPF13'il roof over the enclosed area for more Man 1,500 daytime hours per year 'm N'-N Observable • 1 -between 5 am arid 4 pm. IDNot applicable_ Addltiona! Comments/Assumptions: !High lrnoact itis 1) .2I.:Medium Impact ?ier 2; i.3 Low Impact mer 3) 'Project Tse: Report date: 05/30/18 Cat hi_. m_'. S °O?:C'S 0531-06001.0538-05-14 a-RKSHIRE PORCH LINDA diAliedhiPernilt-BuiSingrirorch Pace 2 of 2 Aiterat on.cck I = rcoatlrIgt'n J ce or lrisr ctic-r t Cc3, res? commentsbgasamperords-- Extedcr Msulatenn protected against Ecornp.les:C4Cl .;adagesunlight. ru is wird.wird. nodes Noe ;C404.5 a-5 3 Cdequipment if 4 air erar e iviti_s ' Not OBsarvaolr. Erect Applicable 1dottom surface er door structures Csmcres ,See r=_6-v tie Asse.mb'i_s tade k l" JL3 incorvor3 rg ac art eating CCc sNot valued I insulated -3.5. :ENot Observable __1Not Applicable Ai`dit:ena' Comnen s/Assunat€ons: High Impact mer_) <i Medium Impact cher 2) 13.(mow impact(Ter 3) Project Tien: Report date: 09/30/16 "" i' - - APPOjErS _=0 0 58-C5--_4 2_-.LH.RE PORCH eTelDA MANOP1 r : oui di:_r_tioc.cd< C - ': „c- -_e 3p' 8 ,plans ire fieri ierd\tr;?led 7t F =arC n�a .oa,;.h-in s_zr` ioni .wkie ._= vadu=` �'!Q" =, ?t „s;rtcrn.:- • } lbUtipti C4z4 "rho au it e.v_opec ran _ - ;' .t,. C o^cies to ,;r ucus r - net k noes.tcr 123R)63: sealed in aboltylldmz r wt' xa^= tic bseriac= ' aad either constroctedre e y it an approved manner.Air ' + L-tv ..p:C cte ;barrier n 2lonsa seal r k �t t :an_ap roved mariner. e - 'C&CL43, !Factory -=ii2 tenessat rar0 LC{mpiieg t4Q 4.4 ;doors are labeled as^re ng ^' n _ =Dooes Not [FR8 leakage requirements. # - �V6xO=sey be C403. 'J_.- fenestration U a_._a Eccmplies icesrne Enos/ma Arserneises zQ 3.a -EDoes Not Eaves. �i-8.11 ENot Observable L:Not Applicable iC4W 3 3 Venice]fenestration C value. SHGC:_,_ ">F;GC:_ rh.aes s tee ,r .,ss.. ._ s �- n G,' • �tCEa Mot aofefor x. ❑Net Observable IJNot Applicable i'!363 Y 3 •"'"'Fenestration products rated n [:pR72' 'acmr,ar with VFRC. 4 rt *>CCoe<Nct fl — €GNCt Observable huh' o- rx t• aJNC'.APPiiCaoe !CAi7.3 •Fetlearraron or_d_nd5 are GcornpNes !Wars]: :cal-gibed as o-^Iry c acs '` _ It -`i DoesNot • certiticates provided. u ❑No?Cib52csc E :Gut.A.cphCSr`.e Additional Ccn1 nentslAssumptions: jj ich Impact i-ier 1) 2 isedium, impacts(Ter?) 3 Lot+impact mer 3) Project Title' Retort daze': 29,30;16 rate bleier c: S:,FROjEcTS Obit-2-062C 2558-05-14 B.. .KHiPE PORCH btliDA M NO I _rmit-&.ddl, g:oor•h Page 4 of Aiteraticn.crk cy"'Cti r'e IC4D 5 S n evar r shaft vents h1e LiCorr.piies . .ar:zed dentoera'. z _ .call .Cones Not .ESHn !close. CNo`Cbse^.a'oie 4o;Aso9cable )C4024 cOurdcat aOr and exhaust systems have CComolies 2 -lotoize dampers that auto. ca):r '-0055 Nct Igv SZ7a shut when not in use and meet n'zxS u^i- k_ce rates.Check. ❑Nct Observable !gravity dampers where Ldot Appficecle rn Additional Cor merts(Ass mption5: I fHigh rnpect(Ter 1 < iMed)um impact(Tier 2) 3 low Impact(Tier 3) Project Recent date C9/30/16 Data z me SOPROF5CTS 0551-Can _8-05-14 BERKSHIRE KS IRE POR_ L NDA i.RNCP r _'cildi v, a-h Page 5 o' 8 Aiteraton cck 2CY:orr . % nsula8(an i pmC?.,c <Pf s4 n7se.:R e s k erii( f " c.Heg,P6 _ . Y'a,.as Yaeue* r Cam1 e '"csm slas�m _s_.r, i cC e AI!sourced o r leakage in the - >r- is LCo ares IC bugailPg thermos).env:ale:de ate Nr. :seal a caulked..jasR d ,i # 'e S Net area r s GG d err t dpP c i 4ct OCs manure Yeller-permeable lta 7 a: i • 'ot ApP.c__Ie feakag ma na tominimize h ' „a 7 feapag_. i^pia t .1 x 1C432.4.1. 'Poo` t For some ere _ rq ' empties See .. v ta:Pekes 11 systems reit ica:ion may need,o� ' iN2. occur during Framing rspect:co. Above'ec3 ❑ deck ❑ .es Na - r=�-a C Meta' !n Me Metal N._t Ob= - a'. ._ Attic —' At4.'c ❑No' / ,Applicable 'C303.2 Roo'insulallen installed p _ "'-.nu ' ❑Cc G II s1 manufacturer'sinstructionst ' s NotBlown or poured loose-fill :insulation Installed v where t Js u ^ t \o� Obse ,vabe Gra roof slope in 22. = „ d -n :▪ CUotAppiiicnae C303.2 r_v S.2Ce wail insula Jr r N .nstal ed ,e manLSact - ❑ s e s J Dees ces Not ;instructions. srtn ° ❑Na'Observable lii!CIPPlitkitiici:P. 'Mir-Para Ci :Apoiicabie ! KC402<.. iocr n t a.or R-vah!e. 3 P.-- complies pNBje 0 Mass D Mass JDces Not, t +-' +.es. 0 Steel C Steel Calot Observable i Wood Wood Edict Applicable TC36s.2 Eoor/radiation installed per 2 C modes lN9" manufacturer's instrucrS _ v -CDoe Not f ` i " r DNo'Appi!cable ir.3O3 t Building dir envelope_insulation. r s fied d'aN3013 lac lee with Pvac o it u2 on 1 JDee_Not certificate providing R va ue arc t y � 'F ^ ❑Not ObSe rVOe_ harrelevant data. Yi ;qru[ f—:nl p. A 'p{cable +C333 2 f .EX-ic rswa v/s protected ` F s; -Cempiies �EtN3'r<rz 42nf damage with a prat c'sve �' %Ic pecticr. Fy' tJ Y: ! ^ esNotmaterial { . _ahon for exposed . se rz bletfeunda or nsu,aton may need t i . ,, e.occur curingFoundaden = ^ ▪ r. C\ot adg ,e i C442 1 'rsu e:tor ne r e- Y " lies CEN t -roof insulation er 15t4'( 2annc' n �ie� on- oc '" D3 ce5 es Np; 'sespen _d„e) ng Mark Ppm - t1 a f ;C•No Qbservat e r yus_-entcompliant if C ak "N Pgairca®ie ii!!Insidiatior, is Installed accordingly. acord na y of _'w ^d aditicnal Camanei E Tfissurpf;afs: I 1 l`Fgh in, ac (Tier Si medium trnpat frier 2, 3.I Low impact 3) Project Ojec Report dare: 09/30116 data erne. 1PRCJE C7a 0551-0630)0553-C6-14 3E KSHtRE PORCM LINDA MANOR _ms--Hudd _a e Pape E o !cera;on.d k 2 3e ro `:S s_�.P� - a`Prnec cn _ s t�r�;ees> Cent +s t sslnri^^s ic.4112.43 .;Recessed is irares in thermal IrFF612As ienve.cee to limit infiltration a'o=e':C icces Not _tln oefed.Sez between ,iot CEservade is and cr na usinc. _.dot Acpncabie 'CCE 'Efficient.HVAC performance,efficient DComalies .f i - ;:'ghtins sr tem, or on-site sccciy of Popes Not renewable ene CV sors S ewith uhaz s shown the approved clans_ ❑Not Cioservaile ENct AFpiicatie Adlitionai Comments/Assumptions: • ;High impact;Tier l) i2.1Pfediurn'mpact mer 2i 131 Co.m irnoect mer 3) Prna_.Tide: Repot date: 09/32u` Data finar. 'PRG C— 0551-26120‘0558-06-24 tdEK_HIRE PORCH _NDA ?ANCPP mt-6ui!d -ny Porch Pa of 8 Ater i n c,3 _ —, UI . ., RA, DT' Fittria .,.. // P In 76 �E . C9wBOARD 1 , _ _ pou _PR..,_ / / usunrn'o ICH VAPOR E � �� x HARRIER /e C ac. v:St 226 """° �� n - R..ewm ago 901NE m pI MIK / DECK FULL MEI BLOWY FOG ow. ' 4 1. 1-. . 1, Y II I I Q•m " Li 4.4 I� n3 i. I 741 SM cue .lo C PROPOSED\ '/ rrSECTION11I 1411 scour IR- o o g. ' , I�'� I : , 1 11 I I,,fllc 'RAN 'FY.EPI4 PAPP 09b-1/ /6 141:1119 51:r 1 A2 . I PROPOSED SECTION PLANS A2 .