23B-035 (3) 61 LOCUST ST BP-2017-0722
cls#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23B-035 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THEGUARANTY FUND (MGL
Lcc.1144/2�A))
Category:renovation BUILDING PERMIT
1 I
Permit# BP-2017-0722
Project it JS-2017-000886
Est.Cost:$15000.00
Fee:$2555.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ALL-TEK BUILDERS INC 76435
Lot Size(sq.ft.): 27007.20 Owner: WOHL CARINA
Zoning:NW 100)NRB(0)/ Applicant: ALL-TEK BUILDERS INC
AT: 61 LOCUST ST
Applicant Address: Phone: Insurance:
88G INDUSTRY AVE (413) 736-0099 O WC
SPRI NG FI ELDMA01104 ISSUED ON:I/4/2017 0:00:00
TO PERFORM THE FOLLOWING WORK NON STRUCTUAL INTERIOR DENTAL OFFICE -
5100 SF **INTERIOR ONLY**
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:
FeeTvpe: Date Paid: Amount:
Building 1/4/20170:00:00 $2555.00
212 Math Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-20I7-0722
APPLICANT/CONTACT PERSON ALL-TEK BUILDERS INC
ADDRESS/PHONE 88(3 INDUSTRY AVE SPRINGFIELD (413)736-0099 0
PROPERTY LOCATION 61 LOCUST ST
MAP 23B PARCEL 035 001 ZONE NB(100)/URB(0)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT • __LL_•TION CHECKLIST
NCLOSED REQUIRED DATE
/
ZONING FORM FILLED OUT //
Fee Paid !J
Building Permit Filled outft I
Fee Paid
Tvpeof Construction: NON STRUCT AL INTERIOR DENTAL OFFICE-5100 SF
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 76435
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
II1191MATION 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 Commission Permit DPW Storm Water Management
a-ye. Delay e
/� � / 5 /7
[ure ofBuil Ii g 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.
Version Commercial Building Permit May 15.7000
Department use only
I
City of Northampton Status of Permit.
Building Department Curb Cut(Driveway Permit -
t tili r bb 2 V 212 Main Street Seer/Septic Availability
Room 100 Weter/Well Availability
- Northampton, MA 01060 Two Sets of Structural Plans
_--- ----"phune 413-587-1240 Fax 413-587-1272 Pict?Site Plans
Other Specl(y
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 completed by office
ez/ ...Le C-cSr .1 Z-' -.-. .... Map Lot Unit
' 2one Overlay District
- - -- - — -- Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 1
2.1 Owner of Record:
CARINA L . woyc O2 s7,-- No(Locust S� t/+MPTAMt7
Name(Enid/ Current., Mating Address
ae /// 4.3,-Telephone (o - 180
Signature ,_ ! Telephone
2,2 Authorize: nt:
f}U ,t K- 4301.-oesJ LZ"C . __ 1-r5^ SU4U1 Z47 f7-L'E SPF'o, i A
Manic(Prnt) eg,n-j? 5--Ami. Current Mailing Address / f 06504
5i3 4/2i/ 49/4' r
Signature _, _�i ..... Telephone -
SECTION 3-ESTIMATED CONSTRUCTION COSTS
uem Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 2„h) WV (a) Building Permit Fee
2 Electrical r,,;.zl ti (b)Estimated Total Cost of 36 ^ vt tO a
J "/ / Construction from (6) `Sv
3, Plumbing 761 tit, Building Permit Fee
4. Mechanic:ai(HV'AC) - +� ' - ' W
5. Fire Pratecton 6+� z _
6. Total=(1 +2 +3 +4+5) Check Number L w
4
This Section For Official Use Only
Building Permit Number Date
Issued
Signature I
Building Commissioner/Inspector of Buildings I Date
Version)-7 Commercial Building Permit May 15 2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35000
CUBIC FEET OF ENCLOSED SPACE
Interior AlterationsExisting Wall Signs Ly'Demolitlon!!d' RepaIrs❑ Additions E Accessory Building
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑
Brief Description Enter a brief description here. Of t4
Of Proposed Work: �!N S+Ml Cra,6,d-C,, f1 OF— 0r- 2$'t Si cm 174
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP{Check as applicable) CONSTRUCTION TYPE
A Asssmbly (0A.1 ❑ A-2 0 A-3 ❑ 1A 0
A-4 ❑ A-5 ❑ 18 ❑
B Business K 2A ❑
E Educational 0 28 0
F Factory 0 F-I 0 F-2 0 2C 0
H Huh Hazard 0 3A 0
I Institutional ❑ LI 0 1-2 0 I-3 ❑ 3B 0
M Mercantile 0 4 ❑
R Residential 0 R$i 0 R-2 0 R-3 0 5A ❑
5 Storage 0 5-1 ❑ S-2 0 5B X
U Utility ❑ ._... Santry,
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
=100r Area per Floor{sf}
1 " A-146821 _.SF- _. 1"
2°d etb in) 5�..
3
;n . _ . ....
41"
_ _
Total,Area mf) 9,2_4,40 6r- Total Proposed New Construction{5t} _,„_
Total Height(ft) 'y 0
Total Heieht ft
7. Water Su ply(M,G.L.c.40,§ 54) 71 Flood Zone Information: 7.3 Sewage DI/spas&System:
Publicrr, Private 0 Zone -, Outside Flood Zone Municipal pr On site disposal system
Version 1 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
Side L R:._ L R.
Rear _..... _._._._
Building Height - -
Bldg. Square Footage - - °n
Open Space Footage
(Lo:area minus bldg&paved
padcog)
of Parking Spaces '- --
Fill: _... _.. .
I (volume&location) I
A. Has a Spec I Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW Q YES Q
IF YES: enter Book Page and/or Document it
B. Does the site contain a brook, body of water or wetlands? NODONT KNOW Q YES Q
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 w NO Q
IF YES, describe size, type and Location: ,,L,,-€t-S/6yl/ JAI Sia .e'ar /
D. Are there any proposed changes to or additions of signs intended for the property? YES % NO Q
IF YES, describe size, type and Location: 02/S7"AjAILtE aF 1:017,197„.., p ;e
E All the construction activity disturb(clearing, grading, excava` ,or filing)over I acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version l.7 Commercial Building Permit May U.2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 38,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect
S ige mild 'Dila L° N51-1 At A Not Applicable 0
Name(Reaistram)'.
to Ii to.„tor_ SFPOlfoj Registration Number
1 / a0 -72i.D n.
4.13741 y-35- Expiration Date/ h
Signature Telephone 3131 ( f {
9.2 Registered Professional Engineer(s}: fff
Name Ares ofP sponsib lily
Address Reglstranon Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Regstraton?lumber
Signature — Telephone Expiration Date
Name Area of Responsibilig-
address _.... Registration Number _..
Signature Telephone Expiration Date
Name Ares of Resabnsibl:iry
—.... . . :.
Address Regrstrabon Number
Signature Telephone Expiration Date
9.3yGeneral Contractor
/ ine'L �yraC` .84/[4-406)I-9796)r.97?
&- Nnt Applicable 0
Company Name:
_St009-7 S1'1-64t--
Responsible In Charge of Construction
gra _Zeus) del-li 7441E1
Adorers
- f -- Ill Z.L.t OI'fk
Signs.ure Telephone
Versionl.7 Commercial Building Permit May N,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS
t AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
C/eI• inlg / Weil r_ ,as Owner of the subject property
hereby authorize /4“— Z AU/L9 en CjLA-6 G- i-3 Et- to
act onmyb a Inall r ativwor ut rued by this building permit application
stenata� for /l4aa//r�
Date
as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury
C2--
Punt Name
2.3 Atev /b
Signatur of wner'Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor:pvipV s� Not
Applicable El
Name of License Holder roe- 9. �a'f/'4ti "fes Q
7 6 y3 CS
Number
umper
e .2 rf —r ty ,-itq oeay /8-L273-11/
Address Expiration Date
g �i3 zL/ o/ jr
Signature / � Telephone
SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be comp) ted 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 CU////i y� t�0
•
The Commonwealth of YLassaehu.setts
--meetµ Department of Industrial Accidents
a- -= Office offnvesrigations
600 Washington Street
• Boston, .12A 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractorsrriectricians/Ptambers
Aoohheant Information Please Print Legibiv
Name (3usiness/Organization/Individual):S'( eX- e44/7tEX.e? ,V1
Address._, :• 1%1�T,LG.a /we. sp4). .o. A /2//A9
City/State/Zip: Phone n: ‘,1/3 736 06 1 I
I_Are)o n employer?Check the appropriate boa: - Type of project(required)'
m a general contractor and
i. amae^vloyer withb. ❑ Nen•construction
employees[full and/or pan-time)." have hired the sub-contractor
2.❑ 1.a sole proprietor or partner- listed on the attached sheet. 7. odeling
ship and have no employees These sub-contractors have g, klcmolition
working for me in any capacity. employees and have workers' 9 r-
insurance.]rance.t i Building addition
[No workers'comp.insured-ice comp.
required,] 5. ❑ We are a corporation and its 10.1 j Elecneal repairs or additions
3.❑ I am a homeowner doing all work officer have exercised their 11.7 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance recused. ' C. 152, 61(4), and we have no
] employees. o workers' L'_n Other
camp.insurance required.]
*Any applicant that checks box NI mus:also 511 out the sec]on below showing their workers'compensation policy informan on.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
eCbntraawors that check this box must attacked an adiitiona:sheer showing the pant o(:he sub-contractors and state whether or nor those entities have
employees. If Cs.sub-contractors have employees,they must provide their workers'comp.policy number.
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.Li:. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration 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 ofa
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the flier of a STOP WORK ORDER and a fine
of up to 5250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification,
l do hereby certify under he pains and penalties of perjury that the Deformation provided above is true and correct
.r NOV-
Phone
OV /
Si Dare:
[ram �..i- cDate: 2-3 6
Phone#: '7 /3 " .3e ' et t 1 C W3 7-2-1 0/qc
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 S:_,
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 b/y MGL c 111, S 150A.
Address of the work: & / l—D CCS T Ci t.
The debris will be transported by: 3,A., I pdsft't_
The debris will be received by:
Building permit number:
Name of Permit Applicant C
0 / its /
Date Signature of Permit Applicant
Initial Construction Control Document
*41 To To be submitted with the building permit application by a
Registered Design Professional
S for work per the 8th edition of the
"'���� Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Whol Family Dentistry Date:Nov 22,2016
Property Address: 61 Locust St.,Northampton, MA
Project: Check(x)one or both as applicable: ()New construction (X)Existing Construction
Project description: Interior Renovation of Level 2 to create new dental office. New plumbing,electric and new Fire
Sprinkler system.
17
I Stephen Jablonski MA Registration Number: 6078AR Expiration date: 08-3124 am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans,computations and specifications
concerning':
(X)Architectural ( ) Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
I. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the buildine official, I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
-E✓"g.Ep pryy
�s•N d_4 .�Qv
Enter in the space to the right a"wet"or QrSasE� sic}�� Sts
r.signature and seal: _`.\ s /•
Ea. ema
wSPRING:3ED, g
M,
ri (( Z/
II
Phone number: (413)747-5285 Email: steve@jdarchitects.com
telk
I 2
Building Official Use Only
Building Official Name: Permit No.: Date:
Note I.Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised.if`other'is chosen,
provide a description.
Version 06_11_2013
JABLONSKI I DEVRIESE
ARCHITECTS
www.jdarchitects.com steve@jdarchitects.com
MEMORANDUM
Nov 22, 2016
To: City of Northampton Building Official
Re: Whol Family Dentistry, 61 Locust St, Northampton, MA
Renovation to an existing building, Level 3 Alterations. No Structural
Alterations are proposed.
Levell & @ + Basement, each floor is 4400 sf.
Total Building Size= 13,200
Construction type: 5B unprotected
All new walls will be non bearing and any openings used by the public will be a
minimum of 32" clear, all new doors shall be 3'-0" wide and have lever handles.
Fire protection: because the proposed alterations exceed 33% of the building
and the total cost of the project exceeds 33% of the assessed value of the
building a fire sprinkler system will be installed for the entire building. Fire
sprinkler plans will be submitted separately.
Means of Egress: Both existing enclosed fire stairs will be maintained.
New public corridors shall be a minimum of 42" wide.
Accessibility: the existing accessible entrance and elevator shall be maintained
as is. The new accessible toilet added to level 2 shall be accessible. Staff
toilets on Levell and level 2 need not be accessible.
Energy Conservation: new insulation shall be added to the second floor roof
and windows, however the entire building does not need to comply with current
energy code.
Stephen Jablonski AIA
29 Elliot Street Springfield, MA 01105 I T: 413.747.5285