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31A-035 (21) 5 FRANKLIN ST BP-2017-1107 cls#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A-035 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-2017-1107 Project# JS-2017-001888 Est. Cost: $63000.00 Fee: $441.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: MICHAEL L HARRINGTON 102948 Lot Size(sq. It): 14157.00 Owner: COMMUNITY ENTERPRISES INC Zoning: URB(l0oy Applicant: MICHAEL L HARRINGTON AT: 5 FRANKLIN ST Applicant Address: Phone: Insurance: P O BOX 393 (413) 575-8345 NORTHAMPTON ,MA01061 ISSUED ON:4/18/20170:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATION OF EXISTING OFFICE BUILDING FOR THE USE OF COMMUNITY ENTERPRISES. NEW PRIVATE OFFICES & CONFERENCE ROOMS WILL BE CREATED, EXISTING OPEN OFFICES WILL BE REFINISHED 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 Occu•anc Si•nature: FeeType: Date Paid: Amount: Building 4/18/2017 0:00:00 $441.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck-Building Commissioner File# BP-2017-I 107 APPLICANT/CONTACT PERSON MICHAEL L HARRINGTON ADDRESS/PHONE P 0 BOX 393 NORTHAMPTON , (413)575-8345 PROPERTY LOCATION 5 FRANKLIN ST MAP 31A PARCEL 035 001 ZONE URB000)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT I/ Fee Paid 4 ,,,,,,cd l Building Permit Filled out Fee Paid 7 Typeof Construction: RENOVATION OF EXISTING OFFICE BUILDING FOR THE USE OF COMMUNITY ENTERPRISES.NEW PRIVATE OFFICES&CONFERENCE ROOMS WILL,BE CREATED-EXISTING OPEN OFFICES WILL BE REFINISHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 102948 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: oved 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 d • pprmJi 'e elay 0401+ ' itng 0':ci. Date * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. Verson 1.7 Commercial Building Permit May 15.2000 \ Department use only \\\\\\ City of Northampton Status of Permit 20\'� -\ Building Department Curb Cut/Driveway Permit r� \ 212 Main Street Sewer/Septic Availability PQ� ^ 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 Spedfy 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: 5 Franklin Street,Northampton MA 01060 Map Lot Unit Zone Overlay District Elm St.District Ca District SECTION 2-PROPERTY OW NERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: / - 1 %c-1^<. -cf VFr"'L 1 ) rvr t i`6.AJ T&, i ' J,CC- Name(Print) r 1 IJ 1 pt A 5 i Current Mailing Address: �f -ll A; D ( I p ,...Ail /19 r� . 6 /06eph ' I /� y Signature 7%/eJ Telephone 013 - � `( - -I U 2.2 Authorized AO,nt:- Name(Print) i rl ( N i E(,, Hikket IUV-( LSU Current Mailing Address: Signature A Telephone L4 13' -7S 3'IS SECTION ESTIM•TED /ONSTRUCTION COSTS Item \ Estimated Cost(Dollars)to be Official Use Only completed by permit applicant t Building 0 O CO "/ (a) Building Permit Fee 2. Electrical /�[y (�f�,�!( (b)Estimated Total Cost of Q rel ��/,� ; d 00 Construction from(6) 0./ Oc`v /✓,7l' 3. Plumbing U Building Permit Fee H 4. Mechanical(HVAC) I 5. Fire Protection �( 6. Total=(1 +2 +3+4+5) Check Number 7S �K /44— 3 This�on For Official Use On se Only Building Permit Number b7 /o(;t7r Date Issued Signature: Building Commissioner/Inspector of Buildings Date 4oLIJ Foo, JtA6 S oiaf�1C£R � S Cr� h�P hoCD Fop_ cH6cr t1 Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ✓ Existing Wall Signs Demolition Repairs ✓ Additions Accessory Building Exterior Alteration Existing Ground Sign New Signs Roofing Change of Use Other Renovation of an existing office building for the use of Community Enterprises,Inc. New private Brief Description offices and conference rooms will be created. Existing open offices will be refinished. Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 0 A-2 0 A-3 0 1A I 0 A-4 0 A-5 0 iB 0 B Business 2 2A 0 E Educational 0 2B I 0 F Factory 0 F-1 0 F-2 0 2C ❑ H High Hazard 0 3A 0 I Institutional ❑ I-1 0 1-2 0 1-3 0 38 2 M Mercantile 0 4 ❑ R Residential ❑ R-1 0 R-2 0 R-3 0 5A 0 S Storage ❑ S-1 0 S-2 0 5B 0 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) 14 2344 it no change 2°d 2390 2"° no change 2308 3'd no chance e 4" 0 4" 0 Total Area(sf) 7042 Total Proposed New Construction (s0 no change Total Height(ft) 29 Total Height ft no change 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public R Private 0 Zone Outside Flood Zone,e Municipal R On site disposal system Version!.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be tilled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage Open Space Footage °k (Lot arca minus bldg&paved parking/ Si of Parking Spaces Fill: Comm&Location) A. Has a Special Permit/Variance/Finding ever been issue for/on the site? NO O DONT KNOW O YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O 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 O , Date Issued: C. Do any signs exist on the property? YES O NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O 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 O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May IS,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: Jody Barker Not Applicable 0 50885 Name(Re - trent). 32 llo reef Florence,MA01062 Registration Number W August 2017 Address 617-216-5988 Expiration Date Signal 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 Not Applicable ❑ Company Name'. 4/K(0teG • /¢/C/12n06770 Responsible In Charge of Construction Address 7/! Pit �1� i filife '(7-/ f, _rs Signature Telephone Version L 7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) �(/ Independent Structural Engineering Structural Peer Review Required Yes 0 No e SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, R; ln Gc ,- ,- q/ J€_.te /v c , as Owner of the subject property hereby authorize ili -a G P_ A -fie. I I r .A- �� Cn-/ to act on behalf ' all ii r:alive to work authorized by this buildi permit application. / pes : _ fCbo eilto 6b7 azure of Owner/- Date MIIIIIMIIIIMIllr— I. /2]( C ff/ l&L L . /-ff4'U/,t'(i- ( O L , 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 ,.. s and penalties of perjury q ' , 6.. 1 L- l-lelal 4)6 Print Name j 1r y- 3-/ Signa - of Own-r/A.e Date SEC ION 12- ONSTRUCTION SERVICES 10.1 Li - sed Construction Supervisor:f �/� ) /�,- , / Not Applicable Name of License Holder: Al Lt&fc L L. 144-1711-14:6:( CV /C ;291/gr cense Number /' Ni. M 'Q/7/e 57-1157-1166-77f •, S-j7 Address Expiration Date �- 1 (7— 41d ., )lC%1a 6113.. -1. 3K Signature I elephone 4 SECTIO 13-W KERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Co ensation Insurance affidavit ust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the build] emit Signed Affidavit Attached Yes No O 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: .S ['124i) Li Sl. Al•' OniAA The debris will be transported by: _ -PV EQ'C j 2 dC✓i1r- The debris will be received by: tt'77 t Le/ kr ( (z-/ i Building permit number: Name of Permit Ap I' ant ICI44CL L . Nita liv ral Date Signature of Permit Applicant The Commonwealth of Massachusetts a Department of Industrial Accidents �=!� Office of Investigations �'�_� v1_- 1 Congress Street,Suite 100 is/ Boston,MA 02114-2017 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): CL ,I444()ft/l(J &ii1..z2Pal (-- r�C Address: '19l 9/4-fuj GD � City/Scale/Zip:/Jd��l{J�lI1PTU e(�� _(�� Phone #: y� j — ��y— `,1`6G Are you an employer? Check the appropriate bo . Type of project (required): 1.❑ I am a employer with 4. am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ N construction listed on the attached sheet. 7. Remodeling 2.0 I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their II.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 13.0 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. lithe 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: Policy # or Self-ins. Lic. #: 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 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 under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as",„every person in the service of another under any contract of hire, express or implied, oral or written.” An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely. by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under`Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 7406 or I-877-MASSAFE Fax# 617-727-7749 Revised 7-2013 www.mass.gov/dia ACORoe CERTIFICATE OF LIABILITY INSURANCE DAT"""'"d1Ye"' 01/21/2017 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, TFBS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDMONAL INSURED,the policy(fes)must be endorsed, If SUBROGATION IS WAIVED,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 or such endorsement(s). P tOOUOER CONTACT Susan Eeury KING&CUSHMAN, INC. lalal 5e4-5619 /VC ADDDREEss: sfieury@kingcvshmancom P.O BOX 447 M8URERIBIAFPOrOINGCWERAGE PURR NORTHAMPTON MA 01061 NSURERA: AIM MUTUAL INS CO 33758 ' RHODES GENERAL CONTRACTING LLC INSURER D: INSURER O: PO BOX 4022 INSURER s: LEVERETT MA 01054 eisuRERE, —...r. COVERAGES CERTIFICATE NUMBER; 130518 REVISION NUMBER: 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 IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. OtALYSIM LYSR TWE OF INSURANCE •.'Ln W ........... POLICY EFF POLICYEIp i POLICY HUMBER OWmp(YYYY1 MEG CONE£RCLLLOENFMALUASEMY EACHOCCURRENCE DAMAGE TU REMO 'CWMSMADE I I OCCUR - P gMI a(Fi MED EXIT(NAMDI piryu) N/A PERSONAL&A DV INJURY G£NL AGGREGATE LIMIT APPLIES PER: CAMERAL AOGRRWTS IPa POLICY JECT :...jLOC PRmLen-COWIC8AG6 O ER ALHOITOBILE WBlulY C MBBIINpED erO SINGLE LIMIT ANY AUTO BODILY INJURY IPA Penin) ALL OWNED — SCHEDULED AUTOS AUTOS N/A SOL LY WJURY(P,ncOdmQ PROPERTY HPEDAUTOS NON D A ROS I ami. nrt{i' ACE UMBRELLA LAB OCCUR Excess we �......'CLAIMS-MADE EACH OCCURRENCE CLAIMSADE AGGREGATE EEO RETENTIONS �/ •'. ..........� WORKERS COMPENSATION XI Mine E0. MU EMPLOYERS'[MILT" YEN ANYPFOPRIE(ONPAPTMERMSECUIIVE E.L.EACH ACCIDENT 100,000 A MRC„tM;MNEAExcLLCEDI IWAI N/A NA AWC40070349752016A 10/31/2016 10/31/2017 yes,TombIn under HI EL DISEASE•EA EMPLOYEE 100,000 II DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY UM ' 500,000 N/A DESCRIPTION OP OPERATIONS/LOCATIONS/VEHICLA3(ACORD 101,AeAtione Remalka SMtlNN,may MCFachS Nmore spate is rp41MY1 Wolters'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 2003 0813,no authorization is given to pay claims for benefits to employees in slates Other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the(fate that this certificate was issued(unless the expiration date on lie above policy precedes the issue date of he certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govfiwdfworkers-compensallonfimestigatIonst CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBEDPOUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Michael Harrington Community Enterprises Inc. ACCORDANCE WITN THE POLICY PROVISIONS 441 Pleasant St MITITOaSEDREPLI[ESIMAINE Northampton MA 01060 Daniel M.C yCPCU,Vice President–Residual Market WCRIBMA W 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORO name and logo are registered marks of ACORD A ROC ROC p. CERTIFICATE OF LIABILITY INSURANCE DATE DOSOO 17TI 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(Sj, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must De endorsed. If SUBROGATION IS WAIVED, 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 endorsement(s). PrtooucR CONTAlWssiEtt Susan Fiaury, CLC, CISR Xing & Cushman Inc. PHONE iNc, EAB: (413)584-5610 rig i :,Rest 584-9322 P.O. Hex 447 EMAIL sEleu Cushman.coon ADDRESS: r�@kin 9 176 King Street INSUREF4S)AFFORDING COVERAGE NAIC/ Northampton MA 01061 msURERA Main Street America Assurance Co. 29939 DD INSURER a:NFD] Insurance Company 14788 RHODES GENERAL CONTRAC'L^-140 LLC INSURER C: PO BOX 402 NSUHERO: ... INSURER E: LEVERETT MA 01054-0402 /USURER F: ......... ........... COVERAGES CERTIFICATE NUMBERCL1733201954 REVISION NUMBER: THIS IS TO CERTL'Y TEAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 POLICIEgS..I LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTBMR TYPE OF INSURANCE 'AMMON POLICY NUMBER 1MW I IIVEFO M POLICY UMTS X COMMERCIALGENERAL LABILITY EACH OCCURRENCE 1 1,500,000 A __,_ CLAIMS-MADE IA.)OCCUR pRESE5 Ea0ENcennu $ 500,000 MET09258 5/18/2016 5/18/2017 MED EU'(Any coo Poison) S 10,000 I PERSONAL&AIN INJURY '5 1,000,000 GENLAGGREGATE UMRAPPuES PER. GENERAL AGGREGATE s 2,000,000 POLICY PRO- ...;LOC ) PRwLL:Ts-CONNOR AGO S 2,000,000. I OTRER I IM'r+uual Risk mod?rem S AUTOMOMA LIABILITY COMBINED SINULE LIMN $ (Ea accident) I I ANT AUTO BODILY NJURY(P ef person) S ALL ON.NSD —I SCHEDULED BODILY 4LftY(Par accident) 3 ' AUTOS _. AUTOS MIRED AUTOS ___ AVMS NONOux.EC Pet. TY DAMAGE S I © OCCUR UAB EACH OCCURRENCE " $ 1,000.000 H EXCESS LAB Cl/ME-MADE AGGREGATE 3 1,000,000 OEO X RETENTION4 10,090 p DRUMS 6/3/2036 5/18/2011 y WORKERS COMPENSATION PERME O TH ER _ AND EMPLOYERS LIABILITY TAN ANY PROPIETORIP TNEREXECUTNE --, : I Et EACH ACCIDENT S ....- (MOF andatory In ' NIA IMalEaroryln NN) E.L DISEASE EMPLOYEE Ir ye.,m.ote under DESCRIPTOR QF OPERATIONS'CqW EL DISEASE POLICY INTI S I NESCmPnON OF OPERATIONS/LOCATIONS/VEHICLES(Amman,Additional Remvka Scnat4e,may G attached Nmora apaaam,flared) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Michael Harrington THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Enterprises Inc. ACCORDANCE WITH THE PROVI310 441 Pleasant St. 4' Northaapton, l 01060 Arm/Nunn REPRESENTATIVE . " fh: f rI'a- !At ' I fir"' ®TSLDENE _n•• R54rved. /CORD 25(2014781) The ACORD name and logo are registered marks of ACORD INS025 ammo RICHSTR-01 SDEAR ACORO' woe aamorrom CERTIFICATE OF LIABILITY INSURANCE 04/03/e017 THIS CERTIFICATE 15 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,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, 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 endorsement(s), PRODUCER C2NTACT Whalen Insurance Agency IWC, Enl',(413)586-1000 FAX . 613 585-0401 71 King Street lac xoy( ) Northampton,MA 01060 Mies:info@Whalenlnsuranee.eom INSURER(s)AFFORDING COVERAGE NAICU INSURER A;General Casualty Company of WI 24414 INSURED INsuRERB. Rich Strong Air Conditioning LLC&Rich Strong&Sheena INSURER C: Strong 166 Main Street INSURER D Hatfield,MA 01038 INSURER E• : INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE IVSD SUER POLICY NUMBER POUCY EFF POLICY EXP XSR ISD VNO IMMIDONEYH IMMIDDNYYYI LIMITS A X COMMERCIAL GENERAL AeILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE X OCCUR CCX0587605 04/12/2017 04/12/2018 DAMAGE aiq„„„uro ei 100,000 MED EXP(Any.one person) 5,000. PERSONAL a Any INJURY t000,000 GEN L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE 2,000,000 POLICY Tco-r iocPRODUCTS-COMP/OP AGO 2,000,000 OTHER. -. A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 L"w a5Y0e ANY AUTO CCX0587605 04/12/2017 04/12/2018 BODILY INJURY(Per person) OWNED AUTOS ED AUTOS�U� ONLY X ON-O y p BODILY INJURY(Per accident). X AU.OSOray X PUT06WONLV (Pere000e(DAMAGE A X UMBRELLA LAB X CCCCP EACH OCCURRENCE 4,000,000] EXCESS UAB CLAIMS-NAPE CCU 0534319 04/12/2017 04/1212015 AGGREGATE 4,000,000 DED RETENTIONS WORKERS AND EMPLOYERS LIABILION ITYYIN STATUTE ERH ANY/PROP IEMTORPARTNEEI.XELUTIVE NIA EL EACH ACCIDENT IMandatory In NH) p EL.DISEASE-.EA EMPLOYEEDESRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES IACOR0101,Additional RamaMa Schedule.muy be attached it mule RUM Is required) Ili Certificate issued as evidence of coverage. I l CERTIFICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Community Enterprise I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. 441 Pleasant St. Northampton,MA 01060 UTHORIZED REPRESENTATIVE • , - ACORD 25(2016/03) 011988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Initial Construction Control Document l� r To be submitted with the building permit application by a Registered Design Professional t. s/ for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Proposed Renovations for Community Enterprises, Date: 3/29/2017 Property Address: 5 Franklin Street,Northampton,Massachusetts Project: Check one or both as applicable: ❑ New construction w. Existing Construction Project description: Renovations to an existing office building at 5 Franklin Street in Northampton,MA.This project will provide new private offices, conference room space,and renovated open office space for the use of Community Enterprises,Inc..New life safety and alarm systems will be installed as part of this project. Jody Barker MA Registration Number: 50885 Expiration date: August 2017 , 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 I ] 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. 1 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. Upon completion of the work, I shall submit to the buih 'ng-�:�g9% �-a` .._ onstruction Control Document'. 7rF.,... Enter in the space to the right a"wet"or 4- electronic signature and seal: 0:44 No.50885 NORTHASET • Phone number: 817-2165988 1 , '/er.aia@gmaitwm Building Official Use Only Building Official Name: Permit No.: Date: Version 06_11_2013 Jody Barker.A.LA. Architecture+Design,LLC 32 willow Street Oorence.MA 01062 colt 512216,6988 ledybarkecalaegmall.com CODE REVIEW March 29,2017 Community Enterprises,Inc. 5 Franklin Street Northampton, MA Applicable Building Code:MA 780 CMR Eighth Addition IBC, IEBC International EXISTING Building Code,2009 PROPOSED RENOVATIONS; PROJECT DESCRIPTION: • Renovation of an existing office building for the use of Community Enterprises, Inc.for their main office.Existing open office space will be modified to create smaller offices on the basement and 2nd floors of the structure.A new conference room and break room will be built on the basement level. Use Groups 310 • Existing uses -Group B,Business • New use - Group B,Business • There is no change of use group proposed for this project. Construction Type • 38:The building is constructed with concrete block masonry bearing walls.The floor structure is a concrete deck supported with steel trusses.Interior partitions are a mix of concrete block walls and metal stud framed walls with sheet rock finish.The building roof Is wood framed.The north stair is wood framed. Sprinkler System • No sprinkler systems exist in the building.No new systems are proposed. Fire and Smoke Alarm &Detection • A manual fire alarm system and an automatic smoke detection system will be installed throughout the building. • An independent Fire Alarm Vendor will supply the final alarm plans and device specifications. According to the IEBC this renovation is being reviewed as: Compliance with Chapter 6-Alterations Level 1 and Chapter 7-Alterations Level 2. • Level 1changes- new finishes throughout. • Level 2 changes - reconfiguration of open office spaces at the basement and 2nd floor to create private office space. 1 of 4 Jody Barker,A.I.A. Architecture+Design,LLC 32 willow Street Florence.MA01062 cel:617.215.5989 lodybarkecale®gmall.com Fire Resistive Required Types of Building Element Type 36 Construction,Table 601 IBC Primary Structural Frame 0 Bearing walls,Exterior 2 Bearing walls,Interior 0 Nonbearing walls and 0 partitions,exterior Nonbearing walls and 0 partitions,interior �.... Floor construction and 0 secondary members _ Root construction and 0 secondary members Building area calculations The existing building has three(3)floors - basement, 1"floor,and 2i0 floor. There is an existing,accessible elevator lobby level 1/2 floor down from the 1M floor,This space is included as part of the 1"floor for this review. Area Basement- 2,344 SF Area 1°floor including elevator lobby- 2,390 SF Area 2nd floor - 2,308 SF Total area - 7,042 SF Level 1 work requirements: 602.1 Interior finishes: All newly installed wall and ceiling finishes shall comply with the IBC 603 Fire Protection: Alterations shall be done in a manner that maintains the level of fire protection provided. 604 Means of Egress: Repairs shall be made in a manner that maintains the level of protection provided for the means of egress 606 Structural: No structural changes are included In this project. 607 Energy Conservation: See 711 below Level 2 work requirem, rts: 701.3 Compliance Windows may be added without the light and ventilation requirements of the IBC New electrical equipment must comply with section 708 Length of dead end corridors,comply with 705.6 Minimum ceiling height of newly created habitable and occupied spaces shall be 7 feet. 2 of 4 Jody Barker,&LA. Architecture+Design,LLC 32 Wilbw Street Florence.MA 01062 roll',617.216.5988 lodybarker.alaegmail.corn OCCUPANCY Occupant Load Calculation B use "Business" Total (1004.4.1) use max See attached spreadsheet occupant toad Area 7,042 SF 100 gross 70 Total 70 Toilets Required - Required fixture Required Number of Total per sex i Lavatory occupants Women 1 per 20 I 1 per 50 35 2 fixture flay Men 1 per 25 1 per 50 35 2 fixture 1 • There are two(2)existing,accessible restrooms on the 1"and 2"d floors.There is one(1) existing shower room on the basement levet which will remain. • Restroom count - 5 total(2 men,2 women, 1 existing shower room).4 are accessible. 704 Fire Protection: 704.2,91221 Automatic sprinkler systems Automatic sprinkler systems are not required in this project because of the exceptions in 704.2.2 The following conditions are present: The B use area is less than 12,000 square feet(IEBC) The B use area is less than 7500 square feet(MA General Law Ch.148,section 26G) 705 Means of Egress Each floor has two(2)means of egress to grade which will be maintained. 705.4.4 Panic Hardware In level 2 work areas,Panic hardware Is only required for A uses with occupancies over 100. 705.7 Means of Egress lighting All means of egress shalt have compliant egress lighting. 705.7 Exit Signs All means of egress shall have compliant exit signs. 705.9 Guards All stairs, landings, and balconies that are more than 30 inches above the adjacent grade,shalt have compliant guards. 7092 Mechanical,Altered existing systems. The following requirements will be met: 3 of 4 Jody Barker,A.LA. Architecture+Design,LLC 32 Wglowstreet Florence,MA 01062 cele 617.216.5986 od,Darker.alaegmaa.com in mechanically ventilated spaces,existing mechanical ventilation systems that are altered, reconfigured,or extended shall provide no less than 5 cfm per person of outdoor air and not less than 15efm of ventilation air per person. The renovations are designed to work with the existing HVAC layout and distribution. 711 and 607 Energy Conservation: Level 1 and 2 alterations are permitted without requiring the entire building to comply with the International Energy Conservation Code.Alterations(new construction)shall comply with the international Energy Conservation Code. A building that undergoes Levet 2 alterations is required to meet a certain level of energy compliance. Where there are reconfigurations of the space or new doors or windows,any such new element is required to meet the International Energy Conservation Code. Elements within the building that are not being affected do not heed to be evaluated and do not need to comply with the energy provisions.Essentially the entire building is not required to meet the energy provisions;only a degree of possible improvement in the energy performance of the building Is Intended to be achieved by making the new elements meet the IECC. in certain cases where the reconfiguration of the space might have resulted in the creation of new spaces the newly created space should be evaluated as a whole for compliance with the energy provisions even though some of the element within the space might actually not have been altered.Likewise,in a case where an existing mechanical system is being extended to other areas or new duct work Is being installed to reconfigure and reroute the ducts to various spaces,it is only required to have the new elements meet the energy provisions and not the entire system. Any new replacement windows wilt have a maximum U value of 0.4 Any new entrance doors will have a maximum U value of 0.8 All existing ceilings,walls or floor cavities of the building envelope exposed or accessible during construction will be filled with Insulation that meets or exceeds an R-value of R-3.5 per inch. The roof will not be altered In this project 806 Accessibility CMR 521 The existing structure is accessible.There Is an operational elevator in the building which accesses all three floors as welt as an at grade lobby.Accessible restrooms are existing at the office floor levels-1"and 2n°floor. Existing corridors have accessible clearances, New corridors,partitions,and doors will be constructed with the correct clearances. End of Document 4 of 4 < The Commonwealth of Massachusetts 8- Department of Industrial Accidents Office of Investigations Y- k; 1 Congress Street, Suite 100 Boston, MA 021144017 k\. l% www.mass.govidia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r�� Please Print Legibly Name (flusiness/Orgnization/Individuat): Ail, E-/-0(�` 1'7a(p -„L. 1_ _ t/2" Tod_ Address: 9 I fit 1 PD &- 6 .5 rr�{{C f City/State/Zip: LD/jF Ce l i{. (/14 Phone;?: Li.(2_ "./1 .---C?-9 ( j u Are you an employer? Check the appropriate bo . Type of project(required): I.0 I am a employer with 4. I am a general contractor and I s have hired the sub-contractors 6. 0 New construction employees (fill and/or part-Time). 2._ I am a sole proprietor or partner-— listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have S. 0 Demolition working for me in any capacity. employees and have workers' 9. (]Building addition [No workers' comp.insurance comp. insurance.: 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 11.0 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 applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicadng they are doing all work and then hire outside contractors must submit a new affidavit indicating such. t'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-contrac6Ms have employees,they must provide their workers'comp.polity 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: _ Policy#or Self-ins. Lie. #: Expiration Date: Job Site Address: City/StatelZip: 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 of a fine up to $1,500.00 an• crone-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a .: agai i t the violator. Be advised that a copy of this statement may be fonvardecl to the Office of Investigations of th DIA ;r inns o.e coverage verification. I do hereby cer u . r th•pa'. : .penalties of perjury that the information provided abovi e istruetrue and correct. m $igrtare: / , AS,/ .. Date: if f V . l i Li Phone#' j -44-7-44-7% () { v 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#: