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24B-038 (61)
325B KING ST BP-2021-1509 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24B-038 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-2021-1509 Protect# JS-2021-002507 Est.Cost: $4500.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Windsor Construction Management Services 026330 Lot Size(sq. ft.): Owner: COLVEST/NORTHAMPTON LLC Zoning: Applicant: Windsor Construction Management Services AT: 325B KING ST Applicant Address: Phone: Insurance: 1259 E COLUMBUS AVE SUITE 201 (413) 363-9793 (213) WC SPRINGFIELDMA01105 ISSUED ON:6/30/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR DEMO 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. 53- Certificate of Occupancy Signature: 1 - / . FeeType: Date Paid: Amount: Building 6/30/2021 0:00:00 $100.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner '1 • bLLED -Pros The Commonwealth of Massachusetts q Office of Public Safety and Inspections E a Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number:6P'../"ISV'Date Applied: Building Official: SECTION 1:LOCATION 325-B King St Northampton, MA 01060 Baystate -NEOS No.and Street City/Town Zip Code Name of Building(if applicable) 24B 038/039 Assessors Map# Block#and/or Lot # SECTION 2 PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration N Addition 0 Demolition N (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes la No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No$C Brief Description of Proposed Work:Constructing a temp wall,removal of interior non load bearing walls, doors ceiling grid&carpet. Minor MEP Work,disconnecting&caping of plumbing supply&waste lines. Temp relocation of HVAC supply&return diffusers. Remove&relocate lighting. 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): B Proposed Use Group(s): B SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) 1 1 N/A Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4❑ A-5 0 B: Business N E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA 0 IIB in IIIA ❑ IIIB ❑ IV 0 VA 0 VB 0 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: Public IN Check if outside Flood Zone Indicate municipal ta A trench will not be Licensed Disposal Site 0 Private Elor indentify Zone: or on site system 0 required e or trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes 0 or No❑ Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): 13 Type of Construction: IIB Does the building contain an Sprinkler System?: X Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Colvest/Northampton LLC 1259 East Columbus Ave#201 Springfield, MA 01105 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Peter LaPointe 413.-363 -9793 860-983-3129 plapointe@thecolvestgroup.cam 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 and 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 0 Otherwise provide conshuction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Windsor Construction Management Services LLC Company Name Frank Colaccino CS-026330 Name of Person Responsible for Construction License No. and Type if Applicable 1259 East Columbus Ave#201 Springfield,MA 01105 Street Address City/Town State Zip 413-363 9793 - - folaccino@thecolvestgroup.com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVI"I (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 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor . and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ $4,500 Bu ding Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 75.00 3.Plumbing $ 4.Mechanical (HVA ) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other $ , nclose check payable to City of Northampton 6.Total Cost $ (contact municipality)and write check number here 50822 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 accura to the best of my knowledge and understanding. Peter LaPointe VP of Real Estate 413.363 _9793 6/16/21 Please print and sign name Title Telephone No. Date 1259 East Columbus Ave#201 Springfield,MA 01105 plapointe@thecolvestgroup.com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: Name Date 1MA City of Northampton as Massachusetts k DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building w " a Northampton, MA 01060 fr .gy" 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: a construction dumpster Location of Facility: Enfield, CT The debris will be transported by: Name of Hauler: USA Hualing&Recycling Signature of Applicant: Date: 6/16/21 The Commonwealth of Massachusetts }, J. Department of Industrial Accidents 1 Congress Street, Suite 100 t' Boston,MA 02114-2017 www.mass.gov/dia w Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Windsor Construction Management Services, LLC Address: 1259 East Columbus Ave Suite 201 City/State/Zip:Springfield, MA 01105 Phone //:413-363-9793 Are you an employer?Check the appropriate box: Type of project(required): LID ID I am a employer with 6 employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ✓❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ✓❑Demolition 3.0I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑ Building addition 4.11I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 1 I.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.CI I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§1(4),and we have no employees.[No workers'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. If the 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:Associated Employers Ins. Co. Policy#or Self-ins.Lic.#:WCC50050117072021A Expiration Date:6/16/2021 Job Site Address:303 King St Northampton, MA 01060 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 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. SignatureC -- Date: 6/16/2021 Phone#:413-363-9793 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#: 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 X 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC X 7 Electrical X 8 Plumbing(include local connections) X 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 are 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 Richard Pizzi 603.622.5450 evan.hickey@lbpa.com 31497 Name(Registrant) Telephone No. e-mail address Registration Number 155 Dow St Manchester NH 03101 Architect 8/31/21 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 - - 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. --"`1 COLVEI7 OP ID: JA ,acoRO CERTIFICATE OF LIABILITY INSURANCE DATE 1V) �•.---� 06/16/2021 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). PRODUCER 413-788-4531 CONTACT Jackie Smith Chase Clarke Stewart&Fontana PHONE FAX 101 State Street, P.O Box 9031 (A/c,No,Ext►:413-788-4531 I(A/C,No):413-214-6160 Springfield,MA 01102 E-MAIL jsmith@chaseins.com Chase Clarke Stewart&Fontana ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Liberty Mutual Ins .IJOURED INSURER B:Safety Insurance Company 33618 Windsor Construction Management Services LLC CIO The Associated Employers Ins.Co. CIO Colvest Group INSURER C: 1259 East Columbus Ave#201 Springfield,MA 01105 INSURER D: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBERPOLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR BKS 22 58501083 01/04I2021 01/04/2022 DAMAGE TO RENTED 300,000 ( ) PREMISES(Ea occurrence) $ 15,000 MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 78, LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ _ ANY AUTO 6225377 10/01/2020 10/01/2021 BODILY INJURY(Per person) $ OWNED RTU EONS ONLY X SCHEDULEDUyy� BODILYO INJURYp (Per accident) $ X AUTOS ONLY X AUTOO ONLY (Parr accident)AMAGE UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION STATUTEPER ERH AND EMPLOYERS'uABILITY WCC50050117072021A 01/28/2021 01/28/2022 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ FFI(MandatoMry R EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE $ (Mandatory In NH) 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE Chase Clarke Stewart&Fontana ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THE OLVEST GROUP LETTER OF TRANSMITTAL 1259 East Columbus Avenue - Suite 201 Springfield, Massachusetts 01105 P. 413.363.9793 - F.413.363.2643 TO: City of Northampton Date: 6/16/21 PROJ. NO.: Building Department Re: Baystate - NEOS Demo permit 212 Main St Application Northampton, MA Attention: Jonathan Flagg WE ARE SENDING YOU: ✓ APPLICATION ❑ ATTACHED ✓ PLANS a REPORTS ✓ CHECK a INVOICES ❑ OTHER COPIES DATE NO. DESCRIPTION 3 6/1 1/21 SET Baystate-NEOS Renovation Demo Plans (Arch & MEP) 1 6/16/21 Demo Building Permit Application 1 6/16/21 Construction Debris Affidavit 1 6/16/21 Workers Compensation Insurance Affidavit 1 6/16/21 Certificate of Liability Insurance 1 6/15/21 50822 Demo permit application fee THESE ARE TRANSMITTED AS CHECKED BELOW: ✓ FOR APPROVAL ❑ APPROVED AS SUBMITTED ✓ FOR YOUR USE ❑ APPROVED AS NOTED ❑ AS REQUESTED ❑ RETURN FOR CORRECTIONS ✓ FOR REVIEW ❑ SIGN & RETURN a BIDS DUE COMMENTS: Attached is an application for an interior demo for interior non load bearing walls, construction of a temp wall & minor MEP demo. If you have any question please give us a call. COPIES TO: Peter LaPointe VP of Real Estate 7,1 ' rya g_ y