39-041 (20) , 9 ,ovl
Final Construction Control Document
II� To be submitted at completion of construction by a
Registered Design Professional
v
for work per the 9`b edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: 15 Atwood—Staffier Assoc./Assurance Behay.Health Space Date: 02/19/20
Permit No.
Property Address:
Project: Check(x)one or both as applicable: X New construction Existing Construction
Project description: This project is a 1,840 SF fit-out of existing open space on the third floor of a recently constructed
and occupied building. The project will include new doors and partition walls as well as new floor,wall,and ceiling
finishes. New HVAC work,as well as modifications to the existing sprinkler system will be part of this work. (MEP/FP
drawings,specifications,and code compliance documents are to be submitted under separate cover). The new office
space,and the entire building,will be fully sprinklered.
I,Charles W.Roberts, MA Registration Number: 10107 Expiration date: 08/31/20,am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning:
X Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project. I certify that I,or my designee,have performed the necessary professional services,in
accordance with the Professional standard of Care,and was present at the construction site on a regular and periodic basis.
To the best of my knowledge,information,and belief the work proceeded in accordance with the requirements of 780
CMR and the design documents approved as part of the building permit and that I or my designee:
1. Have reviewed, 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. Such review shall not
diminish or relieve the contractor of its submittal and other responsibilities.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been 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 was performed in a manner consistent with the
construction documents and this code.The contractor is responsible for the performance of the work in
accordance with the contract documents and shall be exclusively responsible for its construction means,methods,
sequences and procedures,and for construction safety.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Enter in the space to the right a"wet"orR1:D
electronic signature and seal: ¢�45 W-4
140A010, 7
7
Phone number:(413)259-1630 Email: croberts wkuhnriddle.com MASS
Building Official Use Only `��� OF
Building Official Name: Permit No.: Date: