Loading...
24B-038 (62) 325B KING ST BP-2022-0002 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-2022-0002 Project# JS-2021-002507 Est.Cost$93500.00 Fee: $654.50 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:7/13/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RENOVATION - NEW CLINIC &X-RAY ROOM 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. I . . . Til • Certificate of Occupancy Signatur•i FeeType: Date Paid: Amount: Building 7/13/2021 0:00:00 $654.50 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner �0/1 / Jul The Com on ealth of 1'I24,is se s Office of Pbc, and. Inspectio s • - p Massachuse •aitq)?0,48$iixg 1. - 780 C R) Building Permit Application for any Buil i p 1 riA 1Cai,9 f 1 e-or Two-Family Dwelling °Torn (This Section For Official Use Only) Building Permit Number:&- , -A Date Applied: ` Building Official: SECTION1: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 IX Repair 0 Alteration 21 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 Xl No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No 111 Brief Description of Proposed Work:Renovation of existing outpatient clinic area to create new orthopedic specialty clinic, including a new X-Ray room. Selective demolition associated with this project was provided under a separate permit submission. 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-i 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 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 0 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 ❑ IB ❑ IIA ❑ IIB ILIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑ 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 rsi Check if outside Flood ZoneXi Indicate municipal A trench will not be Licensed Disposal Site 0 Private 0 or indentify Zone: or on site system 0 required a or trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable 0 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): B 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 pllapointe@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 bµilding is less than35,000 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 professional coordinating document submittals) Richard Pizzi 603 622-5450 evan.hickey@lbpa.com 31497 Name(Registrant) Telephone No. e-mail address Registration Number 155 Dow St Suite 400 Manchester NH 03101 Architect 8/31/21 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. an Type• Applicable 1259 East Columbus Ave#201 Springfield MA 01105 Street Address City/Town State Zip 413-363 9793 - - fcolaccino@thecolvestgroup.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 ISE No ❑ SECTION 12:CONSTRLJCTIOIV COSTS AND PERMIT FEE � � e ,� Item Estimated Costs:(Labor 93 500 and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ $85,000 Building Permit Fee=Total Construction .st x.007(Ins: there 2.Electrical $ 5,000 appropriate municipal fact. =$ 654.50 3.Plumbing $ 4.Mechanical (HVAC) $ 1,000 Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ 2,500 Enclose check payable to City of Northam 6.Total Cost $ 93,500 (contact municipality)and write check number he 50 .881 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 44ePVP of Real Estate 413.363 -9793 6/30/21 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 Munrcrpal:Inspector to fill out this section upon application approval: 4' `4 '' ✓ (' 'at City of Northampton Massachusetts ` t w ftt 1,4 i,$,g 4140 DEPARTMENT OF BUILDING INSPECTIONS 5 4,'. ,' lil 212 Main Street • Municipal Building t> a 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: a construction dumpster Location of Facility: Enfield, CT The debris will be transported by: Name of Hauler: USA Hualing&Recycling Signature of Applicant: Date: 6/30/21 The Commonwealth of Massachusetts ► �_ Department of Industrial Accidents at rkpea 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia 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): I.0 lam 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.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 10 ❑Building addition 4.❑I 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 11.0 Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ]3.❑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.El 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.#:WCC50050117072021 A Expiration Date:1/28/2022 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. SiQnature Date: 6/30/2021 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.corn 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 Jeffrey Cichonski 864 286-9171 jeffc@bvhis.com 49384 Name(Registrant) Telephone No. e-mail address Registration Number 206 West Newberry Rd Bloomfield CT 06002 Engineer 6/30/22 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. �-�"... COLVEI7 OP ID:JA ACORLY DATE(MM/DDIYYYY) - , CERTIFICATE OF LIABILITY INSURANCE 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 PHON: 101 State Street,P.O Box 9031 (A/C, o,Ext):413-788-4531 FAX 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 WSURED INSURER B:Safety Insurance Company 33618 indsor Construction Management Services LLC Associated Employers Ins.Co. C/O The 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY1 /MM/DD/YYYYI' A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR BKS 22 58501083 01/04/2021 01/04/2022 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 _PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JERCOT- 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) $ AUTOS ONLY X AUTOSSULED BODILY INJURYp (Per accident) $ X AUTOS ONLY X NON-OWNEDOS ON (Per accident)AMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 7 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION PER ERH AND EMPLOYERS'LIABILITY Y/N WCC50050117072021A 01/28/2021 01/28/2022 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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 I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Initial Construction Control Document k To be submitted with the building permit application by a Vrfir1! Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Baystate Health Northampton MOB-NEOS Renovation Date 06/28/2021 Property Address: 325B King Street,Northampton,MA Project: Check(x)one or both as applicable: New construction X Existing Construction Project description:Renovation of existing outpatient clinic area to create new orthopedic specialty clinic,including a new X-Ray room. Selective demolition associated with this project was provided under a separate permit submission. I Richard Pizzi MA Registration Number: 31497 Expiration date:8-31-2021, 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 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: 1. 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"wet"or electronic signature and seal: Qo ARO No.31497 NCH o i /4-' 4zTROFNps Phone number: 603-703-6473 Email: richard.pizzi@lbpa.com Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description. Version 06 11 2013 Initial Construction Control Document To be submitted with the building permit application by a /Al Registered Design Professional I per the 9th edition of the „ for work ,fir �e Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title:Baystate Health Northampton MOB—NEOS Pod Fitout Date: 6/28/2021 Property Address: 325B King Street,Northampton,MA Project: Check(x)one or both as applicable: New construction I X Existing Construction Project description: Renovation of existing outpatient clinic area to create new orthopedic specialty clinic,including a new X-Ray room. Selective demolition associated with this project was provided under a separate permit submission. I,Jeffrey S.Cichonski,MA Registration Number: 49384,Expiration date: 6/30/2022, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural X Mechanical X Fire Protection X 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: 1. 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"wet"or ::,,. electronic signature and seal: �' '!!' Phone number: 860-286-9171 Email:jeffc@bvhis.com w . Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description. Version 06 11 2013 THE t'�LVEST 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: 7/1/21 PROJ. NO.: Building Department Re: Baystate - NEOS Building permit 212 Main St Application Northampton, MA Attention:Jonathan Flagg WE ARE SENDING YOU: ✓ APPLICATION ❑ ATTACHED ✓ PLANS ❑ REPORTS I CHECK ❑ INVOICES ❑ OTHER COPIES DATE NO. DESCRIPTION 3 6/25/21 _ SET Baystate-NEOS Renovation (Arch & MEP) 1 6/30/21 Building Permit Application 1 6/30/21 Construction Debris Affidavit 1 6/30/21 Workers Compensation Insurance Affidavit 1 6/16/21 Certificate of Liability Insurance 1 7/1/21 50884 Demo permit application fee 1 6/28/21 Initial Construction Control Document (Architectural) Initial Construction Control Document (Mech., Fire Protection, Elec.) THESE ARE TRANSMITTED AS CHECKED BELOW: ✓ FOR APPROVAL ❑ APPROVED AS SUBMITTED ✓ FOR YOUR USE ❑ APPROVED AS NOTED a AS REQUESTED ❑ RETURN FOR CORRECTIONS ✓ FOR REVIEW ❑ SIGN & RETURN ❑ BIDS DUE COMMENTS: Attached is an application for an interior Renovation of existing outpatient clinic area to create new orthopedic specialty clinic,including a new X-Ray room. Selective demolition associated with this project was provided under a separate permit. If you have any question please give us a call. COPIES TO: Peter LaPointe VP of Real Estate C , / // 000 / 0 x z