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18D-001 (22) 122 NORTH KING ST-PLANET FITNESS BP-2019-0964 GIS#: COMMONWEALTH OF MASSACHUSETTS MeigaBlik: 18D-001 CITY OF NORTHAMPTON Intl:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category:renovation BUILDING PERMIT Permit BP-2019-0964 Project# JS-2019-001596 Est.Cost:8623700.00 Fee:84368.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: STEPHEN LANDRY 099316 Lot Size(su.e.): 532738.80 Owner: RONDEAU STEPHEN Zoning:HB(100VWP(16V Applicant. STEPHEN LANDRY AT: 122 NORTH KING ST- PLANET FITNESS Applicant Address: Phone: Insurance: 12 SPRING ST WC SOUTHBRIDGEMA01550 ISSUED ON:34/2019 0:00:00 TO PERFORM THE FOLLOWING WORIGTENANT INTERIOR FIT OUT- PLANET FITNESS "APPROVED WITH NOTES" 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: 2i1: 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 Occuoancv Signature: FeeTvne: Date Paid: Amount: Building 3/820190:00:00 54368.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File M BP-2019-0964 APPLICANT/CONTACT PERSON NATIONWIDE PERMIT CONSULTANTS ADDRESS(PHONE PROPERTY LOCATION 122 NORTH KING ST-PLANET FITNESS MAPISDPARCEL001 001 ZONE HB(100)/WP(16V THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLTCA'MON CHECKLIST E LOSED REQUIRED DATE ZONING FORM FILLEDOUT Fee Paid Building Permit Filled out Fee Paid Tvneof Construction: TENANT INTERIOX FIT -PLANET FITNESS New Construction _Non Structural interior renovations U7sTN NOTES Addition to Existing Accessory Structure Building Plans Included' Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATI0N 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 Leeds Proof Enclosed _Other Permits Required: _Curb Cm from DPW Water Availability Sewer Availability _Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee _Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay /11 Signature ,,,—Official Date 3 5 Nom: 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. s Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. - - Versionl.7 Commercial Buildin Peanut May 15,2000 .C=l�— Department use only -" City of Northampton stews of Parma: I MARBui Ing Department Cum a Cul/Driveway Parm 6 2019 2 2 Main Street Sewer/Septic Availability. Room 100 Water/W.11 Aveilabairy mpton, MA 01060 Two Sets of Structural Plans nFFT or nun rnNo nowt nnvnroaAWi#V166 -1240 Fax 413-587-1272 Plol/Site Plans Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION I -SITE INFORMATION 1.1 Properly Address This section to be completed by office FHam pPlazaMap Lot Curn North King St zone Overlay Districtthhampton, MA 01060 Elm SL District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Stephen Rondeau_ 1183 Memorial Dr Chicopee,MA 01020 Name(Print) Currem Mi Address: _(830)928-9077 _-_- Signature 2.2 Authorized t' Nationwide Permit Consultants 3725 Vinton Ave. Suite 8, Los Angeles, Ca Name(Print) Cument MalWp Address: (310) 876-1141 Signature Telepnone n Item Estimated Coal(Dopers)to be Official Use Only com Iated by Dentilt applicant 1. Building _ -_Z- rJ C- �. (a)Building Penna Fee _ 2. Electrical -- -- — -- / (b)Estimated Total Cost of - -- Z (,l y 50Construction from(6) — ----- 3. Plumbing i Building Permit Fee 4. Mechanical(HVAC) n 5.Fire Protection 6. Total=(1 +2+3+4+5) )C7 Check Number TItN For Official Use Onl Building Permit Number Date Issued Signature: BuiWinp Commis•brwranspector d BuiHkgs Date / Versionl.7 Commercial Building Permit May 15.2000 .ION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO ,NSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE 9.1 Registered Architect __ _ ._..--— - --- _.. Not Applicable ❑ Name(Registrant): yo, i Registration Number Address _. . __ -.- 1 Expiration Data Signature Telephone 9.2 Registered Professional Engineer(s): Don Penn Consulting Engineer Electrical Name Area of Responsibility, 1Don Penn, P .E. 39742E Addre111301ASo1ana Blvd. Bldg.l Suite 1420,westlake, TX 76262 Registration Number .(817)374.0922_ 06/3U/20 Signature Telephone Expiration Date Don Penn Consulting Engineer Mechanical Name Area of Responsibility Don_ Penn, P .E . 39939-M Addr 1301 Solana nlvd. Bldg.1 Suite 1420,Westla ke, TX 16262 Registration Number ; (817)374.0922 _D-WO120 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: Responsible In Charge of Construction Address Signature Telephone Versionl.7 Commercial Building Permit May 15,2000 .rWN 4 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 75,000 ,JBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ DemolAlon❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ Naw Signs❑ Roo0ng❑ Change of Use V,Other ❑ Brief Description Enter a brief description here. j'FLJ I`rLn 1u' MDIZ Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 1A ❑ A4 ❑ A-5 ❑ IS ❑ B Business gr 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ SA ❑ S Storage ❑ S-1 ❑ S-2 ❑ 58 ❑ U Utility ❑ Specify: _ M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF FROSTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: 1111:7 Proposed Use Group: i A 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(so 1r ( fit �'I�SIQ>�r 1,. 2- — 2m 3`° 30 4 4e Total Area(so ( �- C —#*. Total Proposed New Construction(so Total Height(0) Total Height 0 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone, Outside Flood Zone Municipal ❑ On site disposal system❑ 1 a NATIONWIDE PERMIT CONSULTANTS 3725 Vinton Ave., Suite q8,Los Angeles CA 310.876.1141 fax 310.876.0149 City Transmittal Date vermes Contact: Address: 210 Main Street City: North Hampton State: MA Zip: 01060 Ph. : 413-587-4900 Re: T.l submittal for retail space at Hampton Plaza We previousley sent PDF of plans into Louis-GC also dropped off construction control affidavit and his information as well. Kindly find the following enclosed items for your review., 1 Set of fun size plans for fire z sets of full size plans for building 1 Check for$4368 for review I application 1 zoe wm1 or pt_Ar.15 Call John at 310-880-7859 for any Issues. Please contact us should there be any problems with this submittal. Thank you for all your assistance in this matter. Thank You, Mary Ann Artavia John Ranous onnOrnaliomvmenermns com Nationwide Permit Consultants Phone: 310.876.1141 Cell: 310-880-7859 Fax: 310.876.0149 COMcheck Software Version 4.1.1.0 Interior Lighting Compliance Certificate Project Information Energy Code: 780 CMR Massachusetts State Building Code,9th Edition,Energy Efficiency Protect Tme: Planet Fitness Project Type: Alteration Construction Site: Owner/Agent: DespnenContractan Hamp Plaza DON PENN CONSULTING ENGINEER Northampton, MA 1301 Solana Blvd Bldg 1 Suite 1420 Westlake,TX 76262 817.410.2858 Allowed Interior Lighting Power A B C D Area Category Floor Area Allowed Allowing!Watts (ff2) Watts/ff2 (B X C) 1-Gymnasiurn'Fxness CerxeCExercise Area 18413 0.72 13257 Total Allowed Wan. 13267 Proposed Interior Lighting Power A B C D E Fixture ID : Description/Lamp I Wattage Per Lamp/Ballast Lampsl #of Fixture (C X D) Fixture Fixtures Watt. Gxymnasium/Fitness Center Exercise Area(18413 Multi LED F1:F1:6'Recessed Downlight:Other: 1 69 14 966 LED F2:F2:V Recessed Downlight:Other: 1 45 100 4500 LED F3:F3:6'Recessed Downlight:Other: 1 108 8 864 LED F4:F4:6'Recessed Downlight:Other: 1 36 8 288 Track lighting F6:F6:Track lighting: Wattage based an 26 feel of track 0 0 780 780 Fluorescent Strip F7:F7:Fluorescent Strip:"'T12 40W:Electronic: 2 7 38 265 LED F8:F8:Oval Mirror:Other: 1 6 26 156 Surface Mounted 2X2 F9:F9:2X2:LED Parel 33W: 1 2 32 64 Mission Statement:Flo:Lightbox:46'T5 28W:Electronic: 4 1 112 112 PE@PF:F11:Lightbox:48'T5 28W:Electronic: 3 1 84 84 Wall Sconce:F12:Kichler Wall Sconce:Other: 1 12 100 1200 Compact Fluorescent 1:F13:Other:Electronic: 2 12 32 384 Total Proposed Wafts 9663 Interior Lighting PASSES Interior Lighting Compliance Statement Compliance Statement: The proposed interior lighting alteration project represented in this document Is consistent with the building plans,specifications,and other calculations submitted with this permit application.The proposed intedor lighting systems have been designed to meet the 780 CMR Massachusetts State Building Code.9th Edition,Energy Hficiency requirements in COMcheck Version 4.1.1.0 and to comply with any applicable mandatory requirements listed in the Inspection Checklist. Protect Tme: Planet Fitness Report date: 02/27/19 Data filename: RAPlanet FanesslSargenbA2018118-4030.Northampton.MA\Design\COMCHECK.Sargenti.cck Page 1 of 9 DON PENN,. P.E. 02/27/19 Name-Title Signature.yD.Y.e VANOF OJ. PENN ELECTRICAL a q No.99712 TL OI SSIONAL ENS Project Title: Planet Fltness Report date: 0227/19 Data filename: R:\Planet Fitness\SargentR2019N19-/030.Northampton.MA\Design%COMCHECK.Sargenti.cck Page 2 of 9 i YW 3B1f5 �6 EfECItlICYf ': bEM �« D1' COMcheck Software Version 4.1.1.0 Mechanical Compliance Certificate Project Information Energy Cade: 780 CMR Massachusetts State Building Code,9th Edition, Energy Efficiency Project Title: Planet Fitness Location: Northampton, Massachusetts Climate Zone: 5a Project Type: Alteration Construction Site: Owner/Agent: Designer/Contractor. Hamp Plaza DON PENN CONSULTING ENGINEER Northampton,MA 1301 Solana Blvd Bldg 1 Suite 1420 Westlake,TX 76262 817.410.2858 Mechanical Systems List Quantity System Type 6 Description 4 Water Heater l: Gas Instantaneous Water Heater,Capacity.1 gallons,Input Rating:199 Wtum w/Circulation Pump Proposed Efficiency:0.67 EF,Required Efficiency:0.62 EF Mechanical Compliance Statement Compliance Statement: The proposed mechanical alteration project represented in this document Is consistent with the building plans,specifications,and other calculations submitted with this permit application.The proposed mechanical systems have been designed to meet the 780 CMR Massachusetts State Building Code,9thjdition,Energy Efficiency requirements in COMcheck Version 4.1.1.0 and to comply with any applicable mandatory r irem is listed in the Inspection Checklist. DON PENN P.E. 02/27/19 Name-Title Slgnature Date �110F D.J. PENN MECHANICAL w No.39M IsT SSIONAL ENO Project Tide: Planet Fitness Report date: 0227/19 Data filename: R:tPlanet Fltnessl.5argenti12018118-4030.Northampton.MA%Design%COMCHECK.Sargenti.cck Page 3 of 9 ��En,�d1[d...�N'F d b N�' 7SMJ! ' wec�rwxcrr ^' �� C ?r O'1' r c ;�'(M Ok.1M� COMcheck Software Version 4.1.1.0 Inspection Checklist Energy Code: 780 CMR Massachusetts State Building Code, 9th Edition, Requirements: 100.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column Is provided by the user in the COMcheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that Is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. SecRon M Plan Review Complies? Comments/Assumptions d Re .ID C103.2 '..Plans,specifications, and/or OComplles Requirement will be met. [PR3p calculations provide all information ODoes Not with which compliance can be ONot Observable determined for the service water heating systems and equipment and ONot Applicable document where exceptions to the standard are claimed. Hot water system sized per manufacturer's sizing guide.Completed COMcheck Mechanical certificate and Plan Review Checklist will be submitted with application. C303.2 Plans,specifications, and/or OComplies Requirement will be met. [PR41r calculations provide all Information ODoes Not with which compliance can be ONot Observable determined for the interior lighting and electrical systems and equipment ONot Applicable and document where exceptions to the standard are claimed. Information provided should include interior lighting power calculations,wattage of bulbs and ballasts,transformers and control devices.Completed COMcheck Intemor Lighting certificate and Plan Review Checklist will be submitted with application. Additional Comments/Assumptions: 111 High Impact(Tier 1) 12 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Planet Fitness Report date: 0227/19 Data filename: R:\Planet FRness45argentR2018\38-4030.Northampton.MA\DesigmCOMCHECK.Sargenti.cck Page 4 of 9 Section O Plumbing Rough-In Inspection Complies? Comments/Assumptions 6 R .11) _ / C404.5, Heated water supply piping conforms OComplies Requirement will be met. C404.5.1, to pipe length and volume ODoes Not 0404.5.2 requirements. Refer to section details. Nat Observable'. [PL6V ONot Applicable C404.6.1, Automatic time switches Installed to OComplies Requirement will be met. C404.6.2 automatically switch off the ODoes Not [PL3]1 recirculating hot-water system or heat ONot Observable trace. ONot Applicable 0104.6.3 Pumps that circulate water between a ElComplies Requirement will be met. [PL713 heater and storage tank have controls ODoes Not that limit operation from startup to <=5 minutes after end of heating ❑Nat Observable cycle. Not Applicable C404.7 Water distrbution system that pumps OComplies Requirement will be met. [PLsp water from a heated-water supply ODoes Not pipe back to the heated-water source through a cold-water supply pipe is a []Not Observable demand recirculation water system. ONot Applicable Pumps within this system have controls that start the pump upon receiving a signal from the action of a user of a fixture or appliance and limits the temperature of the water entering the cold-water piping to 104-F. Additional Comments/Assumptions: 1 I High Impact(Tier 1) 12 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Planet Fitness Report date: 02/27/19 Data filename: RVIanet Fltness�Sargenbl20181184030.Northampton.MA\c sign\COMCHECK.Sargenti.cck Page Sof 9 Section # Mechanical Rough-In Inspection Complies? Comments/Assumptions & R .ID C402.2.6 Thermally ineffective panel surfaces of OComplies Requirement will be met. (ME41)a sensible heating panels have ODoes Not insulation >= R-3.5. ONot Observable ONot Applicable C403.2.6. Enclosed parking garage ventilation OComplies Exception:Requirement does not apply. 2 has automatic contaminant detection 1ODoes Not [ME115]3 and capacity to stage or modulate ''ONot Observable fans to 50%or less of design capacity. :ONot Applicable C403.2.8 .Kitchen exhaust systems comply with OComplies Exception:Requirement does not apply. [ME116]3 replacement air and conditioned ODoes Not supply air limitations.and satisfy hood ONot Observable rating requirements and maximum exhaust rate criteria. ONot Applicable C408.2.2. Air outlets and mine terminal devices OComplies Requirement will be met. 1 have means for air balancing. ODoes Not (ME53]s ONot Observable ONot Applicable Additional Comments/Assumptions: 111 High Impact Wier 1) 12 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Planet Fitness Report date: 02/27/19 Data filename: R:1Planet FRness[Sargenti12018\18-4030.Northampton.MA\Deslgn�COMCHECK.Sargenti.cck Page 6 of 9 I� Sactlon A Rough-In Electrical Inspection Complles7 Comments/Assumptions h 1 h' [405.2.1 Lighting controls installed to uniformly OCoNRequirement will be met. [EL15p reduce the lighting load by at least ❑Does,es Not 50%. ]]Not Observable ONot Applicable C405.2.1 '.Occupancy sensors installed in OComplies Requirement will be met. [EL18p required spaces. []Does Not ONot Observable'. ONot Applicable [405.2.1, iIndependent lighting controls installed OComplias Requirement will be met. C405.2.2. :per approved lighting plans and all ODoes Not 3 manual controls readily accessible and ONot Observable:. [EL231� visible to occupants. ONot Applicable C405.2.2. Automatic controls to shut off all 'OComplles (Requirement will be met. 1 :building lighting installed in all ODoes Not [EL22]2 :buildings. ',ONot Observable 'ONot Applicable C405.2.3 Daylight zones provided with :[Complies Requirement will be met. [EL16]2 individual controls that control the []Does Not lights independent of general area ''[]Not Observable lighting. '�ONot Applicable C405.2.3, Primary sidelighted areas are OComplies Requirement will be met. C405.2.3. equipped with required lighting :,ODoes Not 1, controls. [Not Observable [405.2.3. 2 ONot Applicable [EL20]c I. 0405.2.3. Enclosed spaces with daylight area OComplies Requirement will be met. C405.2.3. under skylights and rooftop monitors '[]Does Not 1. are equipped with required lighting ![]Not Observable C405.2.3. controls. 3 [Not Applicable [EL21]r C405.2.4 Separate lighting control devices for [Complies Requirement will be met. [EL41° specific uses installed per approved []Does Not lighting plans. ❑Not Observable ❑Not Applicable C405.3 Exit signs do not exceed 5 watts per [Complies Requirement will be met. [EL6]' face. []Does Not ONot Observable'.. [Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier i)--T2 I Medium Impact(Tier 2) 3 Low Impact(Tler 3) Project Title: Planet Fitness Report date: 02/27/19 Data filename: RAPlanet Fitness\SargentR3018\18-4030.Northampton.MA\Design\COMCHECK.Sa rgenti.cck Page 7 o 9 sacNon # Final Inspection Complies? Comments/Assumptiens d Ra .ID C3033, Furnished O&M instructions for OComplles Requirement will be met. C408.2.5. systems and equipment to the ODoes Not 2 building owner or designated [FI17)3 representative. ONot Observable ONot Applicable C404.3 Heat traps installed on supply and OComplies Requirement will be met. [Fill]' discharge piping of non-circulating ODoes Not systems. ONot Observable ONot Applicable C404.4 All piping insulated in accordance with OComplies Requirement will be met. [FI25]3 section details and Table C403.2.30. ODoes Not []Not Observable ONot Applicable 1404.6.1 Controls are installed that limit the OComplies Requirement will be met. [F112]' operation of a recirculation pump ODoes Not installed to maintain temperature of a []Not Observable storage tank.System return pipe Is a dedicated return pipe or a cold water ONot Applicable supply pipe. C405.4.1 Interior installed lamp and fixture OComplies See Me lnni Lighting fixture schedule nor values. [FI1813 lighting power is consistent with what ODoes Not is shown on the approved lighting ONO Observable plans,demonstrating proposed watts are less than or aqua l to a lowed ONot Applicable watts. 1408.2.5. Famished built drawings for OCooRequirement will be me[. 1 electric power O r systems within 90 days Daes es Not [FI16)3 of system acceptance. ONot Observable ONot Applicable C408.3 Lighting systems have been tested to OComplies Requirement will be met. [FI33)1 ensure proper calibration,adjustment, ODoes;Not programming,and operation. []Nat Observable []Not Applicable Additional Comments/Assumptions: 111 High Impact(Tier 1) 12 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Planet Fitness Report date: 02/27/19 Data filename: R:\Planet Fitness\Sargentl\3018\18-4030.Northampton.MA\Design\COMCHECK.Sargenti.cck Page 8 of 9 Projec Title: Planet Fitness Report date: 07,27119 Data fllename: RAPlanet Fltness45argenti\7018\18.4030.Northampton.MA\Deslgn\COMCHECK.Sargenti.cck Page 9 of 9 V�r( Sfepn57`os�e ,�u.•�c>r•�. cow ion 1.7 Commercial Building Permit Mav 15,2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit - 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availabiliry Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Plocerty Address: This section to be completed by office Hams Plaza Mop Lot ung 122 North King St Northli mpton,MA 01060 Zone, Overlay District - - - Elm St.D1alrict Ca District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record; '':Big Y Foods Inc 2145 Roosevelt Avenue Springfield MA Nam(Pdm) 17� �HY Cunent Mailing Address: _ (413) 218-1243 Signature iiia - Telephone 2.2 Authorized Agent: Real Estate MGR- Dwight Miraman 2145 Roosevelt Avenue Springfield MA Name(Print) 9w -(rlt7 mt/Y �q ` Current Mailing Address: 1/ (413) 218-1243 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $350,000.00 (a)Building Permit Fee 2. Electrical $95,000.00 (b)Estimated Total Cost of $634,000.00 Construction from 6 3. Plumbing $85,000.00 Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection $104,000.00 S. Total=(1 +2+3+4+5) 1 1 Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commieaioner/lnepedor of Buildings Date It i 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 0 Existing Wall Signs ❑ Demolition +❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs +❑ Rooting❑ Change of Use❑ Other❑ Brief Description Tenant fit-up: interior non-structural walls and finishes for a Planet Fitness Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-1 ❑ A-2 ❑ A-3 ❑� 1A 11 A< ❑ A-5 ❑ IS ❑ B Business ❑ 2A ❑ E Educational ❑ 2B D F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1.2 ❑ 1.3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify. S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: A-3 Proposed Use Group: A-3 Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1" 18,187 1 � 18,187 2nO 2" 3' 3m qm Total Area(sf) 18,187 Total Proposed New_Construction(s0 18,187 Total Height(6) 17 Total Height fl 17 7.Water Supply(M.G.L.c.40,154) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑r Private ❑ Zone Outside Flood ZoneO Municipal ❑! On site disposal system[] Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning ais column to be filled in by Building Depanmmnt Lot Size Fronts e Setbacks Front Side L.---� R:= L:= It= Rear Building Height Bldg.Square Image - % Open Space Footage % (Lot men minus bldg&paved parking) k of Parking Spaces Fill: volume&Igcmion 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 Page. and/or Document N, j IF YES: enter Book �,, B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 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 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it pan of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Stem Water Management Permit from the DPW is required. Versionl.7 Commemial Building Permit May 15,2000 eCTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 CONTAINING MORE THAN 36,000 C.F.OF ENCLOSED SPACE 9.1 Registered Architect: 461 From Rd Paramus. NJ 07652 Not Applicable ❑ Name(Registrant): 10765 .461 From Rd Paramus, NJ 07652 RplsWllon Number Address - - -- 08/31/_2019 (973)253-9393 Expa"non Dale Signature Telephone 9.2 Registered Professional Engineer(s): Don Perm Consulting Engineer MEP NanN Area of Responsibility 1301 Solana Blvd. Bldg. 1 I Suite 1420 1301 Solana Blvd. Bldg. I I Suit 39939, 39742,N939 Address Registration Number (817) 328-5924 Signature Telphone Expiration Date Name Area of Responsibility Address, Registration Number Signature Tebphone Expiration Dale Name Area of Responsibility l Address Registration Number Signature Telephone (Expiration Date L__— Name Am of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Ltep N Stone Building Concepts Inc. Not Applicable ❑ Company Name: EMichael Landry Responsible In Charge of Construction X99 Leland Drive Charlton, MA 01507 Address (774) 230-0328 S" tura Telephone Versionl.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 O SECTION II -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Big Y Foods Inc - Dwight Miran as Owner of the subject property hereby authorize Step N Stone Building Concepts Inc - Michael Landry _. ---]to act on my behalf, in all matters relative to work authorized by this building permit application. 02/27/2019 -� Sign lure of Owner Date Michael Landry ,as OwnedAuthorized 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. Michael J Landry Print Name 02/27/2019 Signatu of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ ..._..._ ... .. Name of License Holder Stephen Landry CS-099316 License Number 12 Spring Street Southbridge, MA 01550 09/22/2019 _ Address Expiration Date (508) 410-6853 Signature Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,1 25C(8)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes Q No Q 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: /tea 4k,M A4 ,S4ree f The debris will be transported by: I'L5k- a*rutll- The debris will be received by: 4X Ter 14ia s` die Building permit number: / p Name of Permit Applicant 0 Date a�iy Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dila WIV'rkers' Compensation Insurance Affidavit:Builders/Contractors/Eimtricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. _Applicant Information Please Print Lembly Name(Business/Organiestion/Individual):Step N Stone Building Concepts Inc. Address: 99 Leland Drive City/State/Zip: Chalton, MA 01507 Phone#: 774-230-0328 Are you an employer?Check the appropriate bar: Type of project(required): LQ I am a employer with 5 employees(full and/or pert-time)• 7. ❑New construction 2.❑I am a sole prcpriemr or pm mbip and have no employees working terrain 8. Q Remodeling any capacity.[No workers'comp.insurance requved.l 3.F1I am a homeowner doing ell work myself. kers [No wor 'comp,insurance required.]1 9. ❑Demolition ❑ 4.❑I e,homeowner and will he hiring contractors rr conduct at work my property. I will Building addition 10 move,omove,thin crove all comrers either haworkers'compensarion insurance or ere sole 11. Electrical repairs or additions proprietors with no employees. 12. Plumbing repays or additions 5.0 1 am a genual emmactor and I have hired the sub-cut u sixom listed on the wanted shat The13.DRoof rep evs se sub-contractors have employees and have workers'comp insurmce? fi.❑We mea cerpore ism end its officers have exercised thew right of exemption per MGL o 14.❑Othef 152,¢I(4),end we have no employees.[No workers'comp insurance ne tired.] 'Any applicant thin checks box 0 must also fill out the notion below showing their workers'compensation polity information.'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such. Contractors thot check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employes. If the sub-convectors have employees,they must provide their workers'comp.policy number Intel an employer that is providing workers'compensmion Imuran¢for my employees. Below is the policy andjob she information. Insurance Company Name: Travelers Property& Can Policy#or Self-ins.Lic.#: 7PJUB2E58874118 Expiration Date:4-21-2019 Job Site Address: 122 North King Street City/State/Zip:Northampton 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under tthhepains andpen (ties offyeerjury that the information provided above is true and correct. Simature: Date: ,x -27/9 Phone#: 774-230-0328 Offtedal use only. Donor write in this area,to be completed by city or town offudaL City or Town: PerminLicense# 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#: omE B NTR RBpuNlion HOME IMPROVEMENT CONTRACTOR TYPO:Ca HgD E,, 0 161006 11MM02 0 STEP 71 STONE BUILDING INC STEPHEN \21L13.o-- BB ISLAND DR.DR. C� CHARLTON,MA 01507 UDtleraeaetery Dm Buil of Regu ,oml &W Sts Of eutlang RequNtwns Antl stanYrr Con EtruCtlon Supsrvuor .5.099318 lJlpin�r STEPHEN J LANDRY = 12 SPRING STREET SOUTHBRIDGE M/I1� O(7/N0 Commuuoner 1/�" 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 ajoint 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 home 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 cerificate(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/liceme 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 twn)."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 bum leaves etc.)said person is NOT required to complete this affidavit. The Departnent's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-7274900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02.23.15 www.mass.gov/dia '1*1N - City of Northampton r Massachusetts - � e DEPARlYb&NT OF BUILDING INSPECTIONS 212 Nein Sbtut • eu—cipal Building a Bostl,e6ptm, . 01060 1!d Se6.^TOR Louis Hasbrouck Fax:413-587-1272 Chuck Miller Building Commissioner Phone:413-587-1240 Assistant Commissioner CONSTRUCTION CONTROL DOCUMENT (For professimal Engine"Architects responsible for EMire Project) Project Title: ^PLdIIi )VO4etN b,� l4 p, Date: 2,2'�k\ lq. Project Location: t2?_ V�ioQC1k lGk ft f TO ~ap: Panel: Zone:_ Scope of Project: -1 EK*MU 1Ut tot ¢ct Ck5T ' In accordance with the Eighth edition Massachusetts State Building Code,780 CMR Section 107.6: I, '-A9-16► Yk-N Mass. Registration# _ 6l Being a registered professional EngineeriArchitect hereby CERTIFIES that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: M ENTIRE PROJECT For the above named project and that to the best of my knowledge, such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that 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 projecl for occupancy. D Aq'y om`g Signature and Seal red Professional r ¢ 9 i No. 10765 NEW JERSEY -7,J-Day lagtw 20 hipFM c6aag City of Northampton l" Massachusetts � > i DSPARTME'NT OF BUILDING INSPECTIONS 212 Iain St eet • eunicipal auilainq Norio tcn, M 01060 Louis Hasbrouck Fax: 413-587-1272 Chuck Miller Building Commissioner Phone:413-587-1240 Assistant Commissioner SECONDARY CONSTRUCTION CONTROL DOCUMENT (For proaWonal Engin..Wxmhitects raeponeibi.for s 12adtaa of a oaMrolle4 proiec) Project Title:^D�W� tic TtrLVAS Y"1N Date: 2I E-21 I LI Project Location: IS A.161YIa St• J\0g2 WIgpJ W& Map:_ParceC_Zone:_ Scope of Project -t6tTN7i %LAMV1 m QTc oJT • _ In accordance with the Eighth edition Massachusetts State Building Code.780 CMR Section 107.6: I, L9LT .�p�p1 a'�1.JT I, Mass. Registration# v being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning:[ ] Fire Protection WArchitectural [ ]Structural [''Tlnechanical [4-electrical I ]Other(specify) for the above named project and that to the best of my knowledge.such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that I shall perforin 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. Upon completion of the work, I shall submit to the building official a final report as to the satisfactory Completion of the above mentioned work. DA Signature and Sealof ;�fer�Professional a - s No.10]65 New J9BEY � Day of JZ0Cft ¢V 2014 (soap City of Northampton Massachusetts t' � j �\ DEPANTNENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 �..✓�qa I've reviewed the plans for Planet Fitness buildout at 122 North King St: Mass plumbing code is exclusively 248 CMR; the IPC is not applicable. Fixture count is OK but there may be differences in methods or materials between the codes. Columbia Gas is limiting existing natural gas services to current capacity and is not providing new services. It would be prudent to find out whether the existing service can meet the anticipated demand. You'll need to contact the Northampton DPW water department if the water meter needs to be changed. The code review(T-101)indicates that 2 exits are required and 3 are provided. The plans only seem to show 2. Beyond that, when 2 exits are required the IBC 1005.5 requires that each exit be sized to serve 50%of the occupant load. The rear exit(EX. 2, type 108), at 32"clear opening, is slightly undersized. A slight reduction in occupancy or a larger rear door could resolve that problem. We will need fire protection drawings (shop drawings and narratives)for changes to the sprinkler and alarm systems (Mass code 107 and 901). The Fire Department also reviews those drawings. Louis Hasbrouck Building Commissioner City of Northampton (413)587-1240 I hasbrouck0northamoton ma.aov