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31B-199 (6) 109 ELM ST-SESSIONS HOUSE BP-2018-1123 GIS 4: COMMONWEALTH OF MASSACHUSETTS Mau:Block:31 B- 199 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeorv:REPAIR BUILDING PERMIT Permit# BP-2018-1123 ProiectS JS-2018-002025 Est.Cost:$85000.00 Fee:$595.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: KEITER BUILDERS 102457 Lot Sizc(sg.R.): 11717.64 Owner: SMITH COLLEGE z c� EUn00)/uRC(100)/ Applicant: KEITER BUILDERS AT. 109 ELM ST - SESSIONS HOUSE Applicant Address: Phone: Insurance: 35 MAIN ST (413) 586-8600 O WC FLORENCEMA01062 ISSUED ON:5/4/2018 0:00:00 TO PERFORM THE FOLLOWING WORK:MISC INTERIOR ENVELOPE REPAIRS 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 N Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy signature: FeeType: Date Paid: Amount: Building 5/4/2018 0:00:00 $595.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2018-1123 APPLICANT/CONTACT PERSON KEITER BUILDERS ADDRESSTHONE 35 MAIN ST FLORENCE (413)586-8600 O PROPERTY LOCATION 109 ELM ST-SESSIONS HOUSE MAP 31B PARCEL 199 001 ZONE EU(100)/URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �—pv Fee Paid r� Typeof Construction: MISC INTERIOR ENVELOPE RPRAIRZ;" New Construction Non Structuml interior renovations Addition to Existing Accessory Structure Building Plans Included' Owner/Statement or License 102457 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION 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 emolition Delay Sloature of Build VIfficial 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 MOL 40A.Contact Office of Planning&Development for more information. RECEIVED Versionl.7 Commercial Building Permit May 15,2000 APA 2 7 2018Department uss only ity of Northampton Stews of Pemeb Wing Department Curb Cut/Ihivewey Panmt DEPT OF BUILDING INSPECTIONS 212 Main Street Samer/SepticAvasabMHy NORTHAMPTON.MA01W Room 100 Weler/Wall AnlabNty Northampton, MA 01060 TM Sets of Structural Plane phone 413587-1240 Fm413587-1272 PbVSite Plena OlherSpedfy 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§12 Sess1 P Thisppsection to be eompletatl by ones rons ouse- 09 Elm Street Map 3( p Lot / 99 Unit Zara Overlay District Nm SL DIahM OB DMtrk1 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ovmar of Ramrd: T-fName(Print) � Cvrmt MNling Adtlau: t O tic IkAll ?�l, 5w L CaUa�e Hat Slpnaue TaepMlle 10 t.4.4 drier 2 u ers,Inc. 35 Main Street Florence,MA 01062 Neme(PMI) Curenl Mall Addw: 413-58 -9600 Slgstee Taephone SECTION 3-ESTIMATED CONSTRUCTION COSTA Item Estimated Cost(Collins)to be OfMal Use Only comedeted Im,summitapplicant 1. Building Q S (a)Building Permit Fee 2. Electrical (b)Estimated TORI Cost of Construction horn 8 3. Plumbing Building PermIt Fes r 4. Mechanical(HVAC) _..... v 5. Fire Pmtectim S. Totel-(1+2+3+4+5) W Check Number This Section For Olfldel Use Only Building Permit Number Dale Issued SlgraW � 1 e n Buldllas~ Date / �� Vcnicnt.7 Commeroiel Building Pcnnit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations Existing Well Signs Cj DemolitionSO Repairs d Additions O Accessory Building❑ Exlerbr Alteration Existing Ground Sign El Now Signs[] Roofing❑ Change of Use E] Other El Brief Description KA � �, 1�n�L�J� R.w✓c-i- C._ 1c� i � Of Proposed Work: SECTION S-USE GROUP AND CONSTRUCTION TYPE USE GROUP lCheck as applicable) CONSTRUCTION TYPE A Assembly ® A-1 0 A-2 ® A-3 1A 03 A-4 ® A-5 ® 1B 13 8 Business ® 2A 03 E Educational 28 03 F Factory ® F-1 ® F-2 ® 2C 13 H HIM Hazard ® 3A 03 1 Institutional ® 1.1 1.2 ® 1.3 ® 3B 03 M Mercamas ® a 03 R Residential ® R-1 ® R-2 ® R-3 5A 93 S Storage 12 S-1 ® S-2 ® 58 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 760 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(SQ 1e 1e 2n° 2� 3i° 3- 4- 4n Total Area iso Total Proposed New Construction(st) Total Height(it) Total Height It 7.Water Supply(M.G.L.c.40,g S4) 7.1 Flood Zane Information: 7.3 Sewage Disposal System: PnMic ® Private Q I Zone Outside Flood Zane[] Municipal Q On site disposal System[] Verdool.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This mkmn m be a11M in by Building Depumamt Lot Size Fronts e Setbacks Front Side L: R: LR:_._.___ ]test Building Height Bldg.Square Footage % Open Space Footage % (Ict area minor bks At paved pn,king) #of Parking Spaces Fill: vnlame a taariam A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook,body of water or wettands? 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 O 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. WIN the construction activity disturb(Gearing,grading,excavation,or filing)over t acre oris It pan of a common plan that vnll disturb over 1 acre? YES O NO O IF YES,then a Northampton Sharon Water Management Permit from the DPW is required. Vendoal.7 Comteembl Building Prmh May 75,2000 SECTION S.PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND BTRUam aSmECTTO CONSTRUCTION CONTROLPURSUANTTO 780 CMR 116(CONTAINING MORE THAN 76,000 C.F.OF"MGM SPACE) 8.1 Archlbet NoIA ImMsO Aaa,m 413.�'� BPa.rn Dar Ta1M�Rr 03 RegilUmd Prolepin l E noa e: xrr Maa of 1leaprWbON Aad,em r� Reyatragon Number I� rens i E*mwn iZ Nana AnaafMKnnaOBb' pdyer ft Imallan Number 81pnWne T e EyAilbn Drr Nero A dnm mlbmy Reyowlbn Nu Swakm TeIvIMp P+4lrelbn Oele Arror Rea UIV Miro Reyoba0on NumMr L� S4rbae TelpbR E'4k+tlm,Dela 0.7 General Contractor Keller Ruildm,lnc — ---_ __� Not ApolcoWe0 CM rbms: Scott KeZ RagwBb bChrpeof ConatucOm _____ _l JS Main St Florence,MA 01062 _J Adfto Q- Gc 41J-656-7600 bue Td-oi Vetsiont.7 Cammendal Building Permit May 15,2000 SECTION 10•STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No SECTION 11.OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, FGl ew- �-1 t��'a� J .as Omar of the subject property herabyeuthonze !-. �l 1 Lf �.ul �QQt�S to ed on my ��att Krey�a to vrork authadzed by this building permit application. sgaaz a Date Keller Builders,Inc I, .as Omer/Authorized Agent hereby declare that the statements and Information on the foregoing applkabon are We and accurate,to the best of my knowledge and belief. Sgrred under the pains and penalties of perjury. Scott Keifer Pdni / P—,..&* Gr 4.24.18 Signirlars ofOam/Agenl owe SECTION 12-CONSTRUCTION SERVICES 10.1 Lleansad Construction Sueeruleor: Not Applicable C] Kei Scott ter CS-102457 Name of 1.1".Holder: Ucarue Numbm 51A Hatfield Street 620/18 �J 413-586-8600 Expiration Dab �C 2.- _` r. - nebis ' Ttlephans SECTION 19-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,$2SC(6)) Workers Compensation Insurance affidavit must be wmpleted and submitted with this application.Failure to provide this affidavit will result In the dental of the Issuance of the building peffrdt. Signed Affidavit Attached Yes O 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 property licensed solid waste disposal facility, as defined by MGL,yc� 111, S 150A. Address of the work: lo � '�& ( . S -� A,* /��� The debris will be transported by: Kefter Builders, Inc. The debris will be received by: valley Recycling Building permit number: Name of Permit Applicant Keiter Builder, Inc 4MIS xo-,F� P.W.4 KNI Date Signature of Permit Applicant The Commonwealth ofMassaehusetts Department of IndustrinfAccidents Office of Investigations 7 Congress Street,Suite 100 Boston,MA 02114-2017 If www.mass.govldia Workers'Compensation Insurance Affidavit: BuOders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Busioers/orgamratioMKeifer Builders, Inc. naiviaasl): _ Address:35 Main Street City/State/Zip: Florence, MA 01062 Phone#:413-586-8600 Are you an employer?Check the appropriate box: Type or project(required): 1.19 I am a employer with 20 4. ❑ 1 am a general contractor and I employees(full and/or part-time).• have hived the subcontractors 6. ❑New concoction 2.❑ I am a sole proprietor or partner. listed on the attached shit 7. Remodeling ship and have no employees These sub-connactors have g ®Demolition workingfor me in m ci employees and have workers' y b = 9. ❑Building addition rworkers' comp,insurance comp.insance. required.] ur5. ❑ We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised thew 11.0 Plumbing repairs or additions myself (No workers' comp. right of exemption per MGL 12 Roof r ass insurance required.]t c. 152,§l(4),and we have no ❑ employees.[No workcrs' 13.❑Other _ comp,insurance required] *Any applicant Waz checks box al meet also fill as the action ow belebowing th6rwmkm'compaua6mpolicy mfortmtion. 1 Hamm.who submit dis aradsAl indicating Ony art doing A wok and Wen him outride cmhectm mim submit•taw alFdsivit i,diWftu;such. 1cotamcmn net check this bas muss wedwd asec1difiood sheet showing the Dame ofthe sub< mxton andsore whetheranat those entities have employees. if the sobemaadm have mployea,they soon provide Wds workers'carp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name:AIM MUTUAL Policy#or Self-ins. Lic.#:WMZ80080071392017A Expiration Date:6111/118 1 Job Site Address: CI /iC-LL .) City/State/Zip�:_�' MA -,y cc�J�"1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to seems,coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 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 5250.D0 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 berets nyy under the paha andpenalties of perjury that the information provided above is brie and correct. (/A, Presldeor,KBI 4.20.18 Sigl>!tt!ve Date: Phone#• 413586-8600 Official use only. Do not write in the area,to be completed by city or town offreial. City or Town: Permit/f.icease# 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#: .. .. ...... ...........o ,,.....,.,..... .,I Department of IndustrialAccidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02 11 4-201 7 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Keller Builders, Inc. Name (BusinessiorganizatioNtndividuaq: _ --- Address:35 Main Street Cit /State/Zip' Florence, MA 01062 Phone #: 413-586-8600 Are you an employer? Check the appropriate box: Type of project (required): i.© I am a em to er with 20 4. ® I am a general contractor and I p y have;hired the sub-contractors 6. ®New construction employees (full and/or part-(ime)., 7. • 10 1 am a sole proprietor or partner- listed on the attached sheet. ® Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers comp. insurance comp. insurance. required.] 5. ® We are a corporation and its 10.0 Electrical repairs or additions 3.® 1 am a homeowner doing all work officers have exercised their i LZ Plumbing repairs or additions right of e.eemption per MGL. myseit: [No workers' camp. 12.0 Roof repairs insurance required.] c. 152, §1(4), and we have no employees. IN(, workers' i® Other_,,,,__ comp. insurance required.] _ °Any applicant that checksbou 41 mustelse till Out the section ecknY shmving their,o,wo*compensation polis,information- `H,a »,mars who soman this affidavit indiounigfncy are doing ail crone and then hireoutside wnvaaors must sabno a ne,c affidavit indicating ouch. k mitmetors that check this hox must attached an additional sheet showing the name of the sub-contractors and state Mather a not those entities have umpld,o,$ n1b,sub.vmoedxs have employees,they most powide their wmker+ cunp-pulicg number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policv and Joh site information. AIM MUTUAL Insurance Company Name: —...... Policy N or Self-ins. Lic. R: P — WMZ80080071392017A Expiration .lob Site Address: _City/State/Zip: Florence, MA 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 tine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of Inc DIA for insurance coverage verification. I do hereby ' rtify user the pains and penatties of perjury that tire information provided above is true and correct. 4.20.18 President, Kill Date' Swat re: _..._ .—.... 413586-8600 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/To"a Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: ._.. Phone #: ACORO® CERTIFICATE OF LIABILITY INSURANCE °6/29/20/ 9/20 7 61] 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,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) 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 of such endOmement(s). PRODUCER CONT Cynthia Henderson/ BIER Webber S Grinnell PHONEq13 586-0111 FAxFAx EW. ( ) Al N ) IalJ lsez-6aex 8 North Kin Street EMAIL - _-- -- 9 DRESS-chenderson@webberandgrinnell.com _ INSURERi AFFORDING COVERAGE BeHAI Northampton MA 01060 Efl IxsuRA:Selective 19259 INSURED - — ER INSURERBA.I.M. Mutual Reiter Builders, Inc. INSURER C: Attn: Scott Reiter INSURER D'. 35 Main Street - - - INSURER E. Florence MA 01062 THE"I COVERAGES CERTIFICATE NUMBER9laster exp 2018 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 INS. TR TYPE OF INSURANCE AODL SVBR POLICY EFF POLFY EIP P LICY HUMBER LIMITS R j COMMERCIAL GENERAL LABILITYEAOCCURRENCE g 1,000,000 DAMAGEMAGCTO RENTED -- - A _ j CLNMSMME X OCCUR PREMISE$(E wmn I $ 300,000 - S2265567 6/1/2017 '', 6/1/2018 MED E%P IPny One person) $ 51000 PERSONAL fl ADV INJURY $ 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER. " GENERAL AGGREGATE $ 2,000,000 X POLICY -J PRO, rI LOC PRODUCTS-OOMP/OPGGr$ 2,000,000 MITER _— $ .AUTOMOBILE LgBILRY COMBINED SINGLE LIMIT $ 1E.K ,000,000 `1daRp — _ A ANY AUTO I I BODILY INJURY(Per pers ) E ALL OWNED SCHEDULED hi - -- ---- _ AUTOS K IpLTOS A9105217 fi/1/201] II, 6/1/2018 BODILY JUR )P roma nI S _X NON-OWNED PROPERTY DAMAGE HIRED AUTOS K_ AUTO$ LLP e-orl_ $ MNdeal-emen, ..S.__ _- 5.000 R !, UM..ELLA LAS i� OCCUR !I EACH OCCVRRENLE _ T$ 5,000,000 � EXCESS LMB I CLAMS-MALU A !.._ � AGGREGATE I$ �, RRETENTIONI 522655fi] 6/1/201] 6/1/2018 - -- ---- RED E 10 000 $ AND KERS EMPLOYERS COMPENSATION PER '0TH AND EMPLOYERS'LNBILT Y/N1 (_'4 STATUTE R_ ER _ ANY PROPRIETONPARTNER/E%ECVTIVE EL EACH ACCIDENT $ 1,000,D00 OF CERIMEM BER EXCLUDED? IN .!N/A T _._. B 'IMM o"m NN) NN%8008007I392030A 6/11/2017 fi/11/2018 _L DISEASE EA EMPLDYER$ _ 1,°0°a 000 NYae BiRDESCRIPTIO under E1015EPSE-POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS below DESCRIPTIONOFOPERATgNS/LOCATIONS/VEHICLES (ACORD101,Additional Remarks Seraftle,may benteeNd II morearmc Ie racum,) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORISED REPHESENTATNE C HCnderson, CISR/CIN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS19B/Omenn Initial Construction Control Document t To be submitted with the building permit application by a / Registered Design Professional for work per the 8" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title. Smith Sessions House Renovations Date:4/23/2018 Property Address: 109 Elm Street, Smith College,Northampton, MA Project: Check(x)one or both as applicable: -New construction x Existing Construction Project description: Exterior painting roofing replacement, window restoration I, Laura Fitch, MA Registration Number: 8835 Expiration dale: 8/I8, am a regislereddesign 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 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 building official a `Final Construction Control Document. Enter in the space to the right a "wetor electronic 7To s, signature and seal: `Q4p.aFT, Nae Phone number: 413-549-5799 Email: Ifitch@krausfitcheom new i, Building Official UscOri Building Official Name: permit No Dale: M1ote I. Indicate w ith an x project design plans.computations and specifications that you prepared or direeik supervised. It othcr' is chosen. provide a description. Version 06 1 12013