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51-010 (4)
550 EASTHAMPTON RD BP-2021-0298 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 51 -010 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:NEW COMMERCIAL BUILDING BUILDING PERMIT Permit# BP-2021-0298 Project# JS-2021-000508 Est.Cost: $233600.00 Fee: $600.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: KURTZ INCORPORATED 036505 Lot Size(sq. ft.): 365904.00 Owner: INVESTMENT REAL ESTATE Zoning: Applicant: KURTZ INCORPORATED AT: 550 EASTHAMPTON RD Applicant Address: Phone: Insurance: 810 SOUTHAMPTON RD (413) 896-0602 () Workers Compensation WESTFIELDMA01085 ISSUED ON:3/22/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:SINGLE STORY SLAB ON GRADE FOR OFFICE 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. 1 I Certificate of Occupancy Signatu, } • 1' A , •it I � FeeType: Date Paid: Amount: Building 3/22/2021 0:00:00 $600.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner MAR 2 2 2021 Co C' r dU� fo— DEPT.OF BUILDING INSPECTIONS t NORTHAMPT(N MA mow) J r- The Commonwealth of Massachusetts i ;Yt � , t Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling n �('� ('I'his Section For Official Use Only) Building Permit Number (�' / ate Applied: Building Official: SECTION 1:LOCATION No.and Street City/Town Zip Code Name of Building(if applicable) 550 easthampton rd. Northampton 01062 Moove In Self Storage-Office Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used yes If New Construction check here la or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 12 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No la Brief Description of Proposed Work: New 750 sf office building SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): _ Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Single story Total Area(sq.ft.)and.Total Height(ft.) 750 sf Approx. 15-8" SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub ❑ A-3 0 A-4❑ A-5 0 J B: Business 0 E: Educational 0 F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 li-4 0 H-5 0 I: Institutional I-1 ❑ I-2❑ 1-3❑ 1-4 0 M: Mercantile 0 R: Residential R-1❑ R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA El Ili ❑ TIIA ❑ IIBD IIIA ❑ IIIB ❑ IV � VA ❑ VB0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: A trench will not be Licensed Disposal Site 0 Public Cd Check if outside Flood Zone la Indicate municipal❑ required❑Or trench or specify:On site dumpster Private 0 or indentify Zone: or on site system 0 permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable la Is Structure within airport approach area? is their review completed? or Consent to Build enclosed 0 Yes 0 or No la Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code:____..._._........,... Use Group(s): 08fcenndustriarType of Construction: 58 Does the building contain an Sprinkler System?: No __ _Special Stipulations:_ Design Occupant Load per Floor and Assembly space: Slab on grade SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner ,�+�._1 ...t-.._ 1�/ {..... Y'E./J�t � ...3 5— C"�tit-/✓t�"i G tZ+6j 12-9 is 4 +its r O +v n) [ • Name(Print) No.and Street . City/Town Zip t q 0 4,6. Property Owner Contact Information: .Z‘ - 6-74-c,2.4 b f>i~u pt.t4 cit. 3 e --r-O-. f r l4 a r..)at.tiat - — ...zZ 5- go f o _G►NI Alt,-__, e. .,, Title Telephone No.(business) Telephone No. (cell) e-mail address If'applicable,the property owner hereby authorizes: Name Street Address City Town State Zip to apply for aria act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control the .rofessional coordinatin: document submittals) . tee. vl 4 tom. A.t 3 ' B,2 a 44 t A sz4 44 -1 t LCO." la 5 6 3 4- Name(Registrant) Telephone No. e-mail address Registration Number 1 4 l.e PL‘44yp ru7''5-r t.l ot2-rta.A-/►jio,.i !n 4 o t 0 ' _..._. Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Kurtz, Inc. Company Name Gene Pelkey CS-036505 12/8/21 —-- — Name of Person Responsible for Construction License No. and Type if Applicable 810 Southampton Road Westfield MA 01085 Street Address City/Town State Zip (41.3) - 568-0636 (413) - 297-1151 genep@kurtzinc.com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152. ' 25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes 0 No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 254,159.19 1.Building $217,630.15 Building Permit Fee=Total Construction Cost x,.__.___(Insert here 2.Electrical $19,525.00 appropriate municipal factor)=$...__.___,____,___. 3.Plumbing $12,319.04 4.Mechanical (I1VAC) ....$4,685.00 mm No#e Minimum fee=$ _(contact municipality) 5.Mechanical (Other $ Enclose check payable to City of Northampton 6.Total Cost $ (contact munici•ality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the of my knowledge and understanding. Gene Pelkey e "— Project Manager 413-297 -1151 3/17/2021 Please print and sign name Title Telephone No. Date 810 Southampton Rd. Westfield MA 01085 genep@kurtzinc.com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: ___ — , d, Name Da • City of Northampton fs� '' Massachusetts Os:i DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 15 Mullen Rd, Enfield, CT 06082 The debris will be transported by: Name of Hauler: USA Hauling Signature of Applicant: Date: 3/17/2021 Ac R 1 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIOD2YYY) L-� 3/17/2021 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(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). CONTA PRODUCER NAME:CT Jenna Duval,CISR Elite Webber 8 Grinnell PHO N.Exa; (413)586-0111 FAX No): (413)586-6481 8 North King Street EMAILRESS: jduval@webberandgrinnell.com duval webberand rinnell.com ADD INSURER(S)AFFORDING COVERAGE NAIC/ Northampton MA 01060 INSURER A: Selective Ins Co of America 12572 INSURED INSURER e: Selective Ins Co of S Carolina 19259 Kurtz,Inc. m MA E to INSURER C: P yCrS/A.I.M. 12888 Marvon Construction&Development,Inc. INSURER D: Admiral Ins Cc/BRECK PO Box 1597 INSURER E Westfield MA 0108E INSURER F COVERAGES CERTIFICATE NUMBER: Master 2022 PDF REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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. INSR TYPE OF INSURANCE INSO wv` POLICY NUMBER POLICY EFF POLICY EXP (MMIDDIYYYYI_(MMIDD/YYYY) LIMITS — X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 IDAMAGE TO RENTED CLAIMS-MADE XI OCCUR PREMISES(Ea Occurrence) S• 500,000 Incl.$150,000 Rented/Leased MED EXP(Any one person) S 15,000 A — Equipment-$500 Deducible S2332899 01/28/2021 01/28/2022 PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3 2,000,000 X POLICY ri PRO- JECT E1 LOC PRODUCTS-CDMP/OP AGG S 2,000,000 I OTHER: Employee Benefits S 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) S B OWNED v SCHEDULED A9105537 01/28/2021 01/28/2022 BODILYINJURY(PerS __AUTOS ONLY _AUTOSaccident) X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY /� AUTOS ONLY (Per accident) S PIP-Basic S 8,000 X UMBRELLALIAB X OCCUR EACH OCCURRENCE s 5,000,000 A EXCESS LIAR CLAIMS-MADE S2332899 01/28/2021 01/28/2022 AGGREGATE S 5,000,000 DED RETENTION S S WORKERS COMPENSATION PER OTII- AND EMPLOYERS'LIABILITY Y 1 N STATUTE _ ER C ANYPROPRIETOWPACLUDEDXECUTIVE l� NIA MCC20020005322021A 01/28/2021 01/28/2022 E.L.EACH ACCIDENT S 500,000 OFFICERlMEMBER EXCLUDED? I 1 I (Mandatory In NH) 500,000 If yes,describe under E.L.DISEASE-EA EMPLOYEE S DESCRIPTION OF OPERATIONS below _ _ E.L.DISEASE-POLICY LIMIT S 500,000 Pollution Liability D FEIECC1762306 01/28/2021 01/28/2022 Occurrence S1,000,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACQRP 101,Additional Remarks Schedule,may be attached if mere space is required) New 750 sf office building, 550 Southampton Rd. Northampton MA. CERTIFICATE HOLDER CANCELLATION Moove In Self Storage 10 Bentzel Mill Road SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE York P.A. 17404 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Investment Additional insureds: Realestate, LLC J.L.M Group Inc. AUTHORIZED REPRESENTATIVE 10 Bentzel Mill Road 335 Holmecrest Rd. York, PA. 117404 Jenkintown, PA. 19046 �✓!��_ 7r / ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ri-7--- The Comrnots•vealth of Alas,sachusetts Department of Industrial Accidents I Congress Street,Suite 100 144 ,.......: Boston, 31.402114-2017 wule.tnass.gasvilia • 1Vorkers'funiptrisation Insurance AMdasit:Buildetv't'tiiitractors/Electrician.sePluiribers. 10 BE i'll_FID Willi I tlf.l'ERNII II ING.tt I littRI I 1 Applicant Information Please Prini I.egibls Kurtz Name i Business•tkgrattlatioa Individuall. : Inc. , .....,-..— ... Address: 810 Southampton Rd. City/Stale/7.i lc Westfield Ma, 01085 phone. : 413. 568.0636 Ate)011 aill ellidp1+1!,,, ' 1,,,1.thr Appruptisitc thi.: Type of project(required). 1.p IWO a crropl,..,,,,,.T ,,,', 18 ,,rivioye,,1 f rtku snrfur poirt-iim,v, 2E31 Ain a ii,,ok protnt,- ,, ilt)d Isle.c no employees winking for MC tit g. CI Remodeling au.eapauty,(Nu vorraers'clamp.Unarm:we ruistatall 9. 0 Delooliturit .1.[21 I atn a tiunieunner dung all 14Utt racyt.elf.Ner, vcsrlits'i*comp onunnktk neutered r to C]Builtiing addition ,0 I ant a 1$onteowbCf had will Iv hiring toutattora ti)eutlauft ell',.ot k on ray peropeity., 1 NW efKlite That ali cillittlCitmli either Nike wtraelli.convent:awn irminsio:or Ire.4.1c II 0 Electrical repairs or additions prupticion*ids nu emplures. 12.0 Plumbing repairs or additions 0 I 4in a wncral con ttnii.,Or almi I have hired the Aub-cutunrctorsr tied iaa the attachod Iheet I have I 3.0Roof repairs se sub-cut islietOra tweet ernployeta and hew workers'eurnp.inawaric-e; I4.E.:1 Other Vie Ite n uncinxmit on and its officer.have cut-tilted their right of email:Kroft pet/.461.e. III,t 1(4i.and..--e hate nu employee*.!No*utters'CLIITIp,tn,armee requited, "Any applicant dui cheeks lot ttl muo alio rill uut the iertitnt beton.boising their veLrtters'eureprination pulley'ulfurins&kart. tioaguweers who Alit du.iillulas a endientrug they at 41.oul all..ulk and then hire outside osatraetrws mat sobnut si be*allidai it IWO:41MA...eh I.'minx tens that thedi this box roust attached an additional sheet al**,ng the name of the mitreontrirtur.aul state whether or nut those L.:init...have cmplvytt-s, It the mll--......0111-2n:tvto,ltr.r curio,ec,,they attAA rriP,dr 111Cit wurkcm iantlp polio auntie!. I am an employer that is proriding workers'compensation insuronee for my(Implorers. Below is the policy and job site information. Insurance Company Nam. Webber Grinnell _ Policy 4 or Se11-ins.Lie:.4. MCC20020005322021A Expiretto,- a Date,: 1/28/2022 Job Site Address: 550 Easthampton Rd. cifyisttite(zip:Northampton Ma 01062 Attach a copy of the%scoters'coniprnsation polky declaration page ishosting the policy number and expiration date). Failurt to ieeure Love rage aN required tinder Nrit.il_.c. I 52, ';.25 A is a criminal Violation puttiltable by a fine up to SI.50()Ofl andiur onu-ycar imprisonment.,lb',A ell uy ci il pcttattl,: III Ili Iona kii'a SI tiP WORK t_tRDER and i line or till to 250,4,g r,. Alay liffaint,,t Lite titillator.A cupy of till's,htateAuent ickiy lit:foisk,ndvd to Int:Office,4 In\,-,41g....1114HIN Of 114C DIA fi,i ilt,tifdrit e , ciret.rage verttleation .. . . _. I do hereby certify u; er the, ins nti rehalties of perjury that the i0lotentetim4 pro rider.,uhpue is trite and I.torrei L ,„--* 3/17/2021 sivnature: ......,e.... Date: Phone X: 413.568.0636 . . , „ . • Official Mt only. Do not write in this urea,to be conopleted by ekr or tini-n official I ( ity or loon: Perruilfl.irense 4 Issuing Authority (circle one}: I. Board of Health 2.Building Department 3.('Its!Town Clerk -4. 1,.lectrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phime 11: ... Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107.The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 Architectural Access Review(521 CMR) 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) 'Areas of Design or Construction for which plans pre not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expitatioii Date - Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date - - Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals. City of Northampton Massachusetts ?S� :_ �'e 6 ,, DEPARTMENT OF BUILDING INSPECTIONS x` 4 212 Main Street • Municipal Building ,..)% Northampton, MA 01060 si4;i 913-5F? - VrOb ,xi' /2-LID h / �r PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR COMMERCIAL& MULTI-FAMILY NEW CONSTRUCTION/ADDITIONS/ALTERATIONS 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. ® One set of plans and specification of proposed work(digital and hard copy). Q Site Plan with location of proposed structure(s)and setbacks. 4. Construction Debris Affidavit filled out and signed by applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy CSL and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate(if applicable). 8. Note any Conservation and/or Special Permit requirements (if applicable). 9. Driveway Permit(if applicable). (0. Proof of Water and Sewer entry fees paid(if applicable). 11. Trench Permit(if applicable). 40 Initial Construction Control Documents filled out and signed by the Registered Design Professional in responsible charge. (0,/ 7- 23 0-2- 7Z cloi