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32C-171 (28) BP-2021-2316 256 PLEASANT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-171-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-2316 PERMISSIONIS HEREBY GRANTED TO: Project# OFFICE RENO Contractor: License: Est. Cost: 139456 WESTERN BUILDERS INC 073697 Const.Class: Exp.Date:07/18/2022 Use Group: Owner: LUMBER YARD NORTHAMPTON LIMITED PART Lot Size (sq.ft.) Zoning: CB Applicant: WESTERN BUILDERS INC Applicant Address Phone: Insurance: 73 PLEASANT ST (413)467-9171 CO-7F914719 GRANBY, MA 01033 ISSUED ON:12/17/2021 TO PERFORM THE FOLLOWING WORK: DEMO EXISTING LAYOUT TO ACCOMMODATE NEW OFFICE SPACE 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. Signature: • �' yQ 'I • it Fees Paid: $980.00 212Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ri C i t I V E D P,b��us, RLLE> DEC 1 6 2021 T e ommonwealth of Massachusetts il).1; f" 1 DEPT.OF BUILDING�s. INSPECTIONS ffice of Public Safety and Inspections 1° I NORTHAMPTON.MA 01060 assachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (6 9 (This Section For Official Use Only) Building Permit Number: / 'a 1(4 Date Applied: Building Official: SECTION 1:LOCATION Street - Northampton 01060 The Lumberyard No.and Street City/Town Zip Code Name of Building(if applicable) r7,? C ^ / 7/ Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used 9 If New Construction check here 0 or check all that apply in the two rows below Existing Building■ Repair 0 Alteration ■ Addition 0 Demolition ■ (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 • No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No ■ Brief Description of Proposed Work Demolition of existing layout to accommodate new office space.New gypsum board assemblies,wood doors,aluminum entrances/storefront,flooring, painting,ACT ceilings. 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) 0 Existing Use Group(s): Group B(Office) Proposed Use Group(s):SAME SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 1 1530 1 1530 Total Area(sq.ft.)and Total Height(ft.) 1530 10'-6" 1530 8'-6" SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business ■ E: Educational ❑ 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 0 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 ❑ HA IIB 0 IIIA ❑ IIIB ❑ IV 0 VA 0 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: A trench will not be Licensed Disposal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal ❑ required 0 or trench or specify: Private 0 or indentify Zone: or on site system❑ 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 ❑ Yes❑ or No❑ Yes 0 No 0 SECTION 8: CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: 9 Use Group(s): B Type of Construction: I A Does the building contain an Sprinkler System?: YES Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Way Finders, Inc. 1780 Main St. Springfield 01103 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Linda Ciarcia(Facilities Manager) 413-233 J 705 413- _ Iciarcia@wayfinders.org Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Western Builders, Inc. 73 Pleasant Street Granby MA 01033 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❑. 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) Karen Michalowski 413-522-0165 kmichalowski@kuhnriddle.com 9527 Name(Registrant) Telephone No. e-mail address Registration Number 28 Amity Street,Suite 2B Amherst MA 01002 Architect XXXX Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Western Builders, Inc. Company Name Lance Berneche CS-073697(Construction Supervisor) Name of Person Responsible for Construction License No. and Type if Applicable 73 Pleasant Street Granby MA 01033 Street Address City/Town State Zip 413-467-9171 413 265-5600 lberneche@westernbuilders,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 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor = 139,456.00 and Materials) Total Construction Cost(from Item 6) $ 1.Building $ 96,672.00 Building Permit Fee=Total Construction Cost x 7 (Insert here 2.Electrical $ 25,464.00 appropriate municipal factor)=$' • . �P�8a 1� 3.Plumbing $ o 4.Mechanical (HVAC) $ 9,870.00 Note:Minimum fee=$ 100.00 (contact mu ;.;._ •. 5.Mechanical (Other) $ 7,480.00 Enclose check payable to 6.Total Cost $ 139,456.00 (contact municipality)and write check number here /.4 7/ S e y 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 best of my knowledge and understanding. Richard Dobrowski Project Manager 413-265-8793 Please print and sign name Title Telephone No. Date 73 Pleasant Street Granby MA 01033 rdobrowski@westernbuilders,com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: ; 1'rJFA '1 o'�+l' Name Date City of Northampton Massachusetts ki _ ''e y 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: Casella Waste Systems, Holyoke, MA The debris will be transported by: Name of Hauler: Associated Building Wreckers Signature of Applicant: Date: _ - The Commonwealth of Massachusetts .7 756011:12"e . IIMIN 14 • ''' 4,1 Department of Industrial Accidents I Congress Street,Suite 100 -- Boston, MA 02114-2017 ....11 www.mass.govidia Workers'Compensation Insurance A Hi d:i v it: Buil dcrs/Contractors/Electriciansfl'Iumhers. TO HE EILED WITH'I HE I,ERMI'llING AUTHORITY. Applicant Information Please Print Legibly Name ousincsb/Orpuizationandividual : Western Builders, Inc. Address: 73 Pleasant St. City/State/Zip: Granby, MA 01033 phone#: 413.467.9171 Are)tio an cot ployer?Check the appropriate wit: rype of project(required): I El lam a employer with 45 employees Oen and`or part-timey. 7. 0 New construction 201am a sok proprietor or partnership and have no employees working tor me in 8. 0 Remodeling arty capacity..[No workers'ct.'szip.insurance rCt/lired.j 43 I am a homeowner doing all work myself.(No workirs'eump_insurance'Ismail- 9. III Demolitionvs]]* ID 0 Building addition .4./3 I am a litnikviwner and will be hiring contractors to conduct all work on my property.. 1 will ensure that an contractors either have Maras-eorttpczi.sahort insurance or are role II.0 Electrical repairs or additi. proprietors with no erapkvetit.. 12.0 Plumbing repairs or addition:, I am a genera/contractor and I have hired the tub-contractors hated on the attached short. These sub-cuntratetura have employeet and love workers'comp. uran 13 LIRoof repairsce.: 14.1gother Window 6.0 We are a eorporation and its Officers have eterciaed their right of exemption per h4GL.t., 152.,§11.4),and we have no employees.[No winters'coup.inattentive required.] Replacement 'Any applicant that cheeks box#1 moat also fill not the section below show ine their worker.' eraation policy information. t tiontoowners who submit this affidavit nwheating they are doing all work and then hire outside coritractors moat submit a new affidav it indimilrig sta.:11. tiCoritructots that check this box must an.wheil an additional aheet show ins the name of the atili-cienractras anal state 4 tvii-ther or not those emitter have etnployetts. It the sob-citratractors have crmplop•ces.Arco MUNI prl,,,ide their skorkers"comp.policy nurikvr I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job sue information, Insurance Company Name: Charter Oak Fire Insurance Company Policy#or Self-ins.Lic.#:_CO-7F91 4719 Expiration Date: 06/01/2022 Job Site Address: 256 Pleasant Street city/stateizip:,Northamptoni_MA 01060 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 amVor one-year imprisonment,as well as civil penalties in the fonrn of a STOP WORK ORDER and a line 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 ond penalties of perjury that the information provided allure is true and correct Sipature: 1.),,/,_ 01/XX/2022 Phony ..413-265-8793 Official use only. Do not write in arts ilitql.to be onnitleteil by city or town of/it-Ulf City or Town: PermitiLicense 4 _ Issuing Authority (circle one): I. Board of Health 2.Building Department 3.('ityrfown Clerk 4.Electrical Inspector 5. Plumbiii2 I 11Spetilif ().Other ('ontact Person: Phone#: WESTBUI-01 AADAMS ACOR[Y DATE(MM/DD/YYYY) �,�- CERTIFICATE OF LIABILITY INSURANCE 12/14/2021 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 CONTACT Christine Campbell NAME: Watts Group LLC 65 LaSalle Road#209 �a"c°O,"r o,Ext):(860)231-7250 238 FAX No): West Hartford,CT 06107 a DRlEss:christinecampbell@worldinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Charter Oak Fire Insurance Company 25615 INSURED INSURER B:Starr Indemnity&Liability Company 38318 Western Builders,Inc. INSURER C:American Guarantee and Liability Insurance Company 26247 73 Pleasant Street INSURER D: Granby, MA 01033 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER 4MM/DD/YYYYI IMM/DD/YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CO-7F914719 6/1/2021 6/1/2022 DAMAGETORENTED 800,000 PREMISES(Ea occurrence) $ X XCU INCLUDED MED EXP(Any one person) $ 10,000 X NO DEDUCTIBLE PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ MBINED AUTOMOBILE LIABILITY (Ea accident)SINGLE LIMIT $ X ANY AUTO 810-0N700762 6/1/2021 6/1/2022 BODILYINJURY(Perperson) $ OWNED SCHEDULED 1,000,000 — AUTOS ONLY — AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY _ NON-OWNEDUTO (ROP idea DAMAGE $ Per accident) $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE 1000585032211 4/1/2021 4/1/2022 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION X PERTUTE ERH AND EMPLOYERS'LIABILITY Y/N UB-6K239300 6/1/2021 6/1/2022 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? N NIA 1,000,000 (Mandatory m NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Umbrella-Commercial AEC9242691 4/1/2021 4/1/2022 2nd layer umbrella 15,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:The Lumber Yard project located at 256 Pleasant St., Northampton,MA 01060 With respects to work performed by Named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE finders,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Wayfinders, ACCORDANCE WITH THE POLICY PROVISIONS. 1780 Main St. Springfield, MA 01103 AUTHORIZED REPRESENTATIVE EP I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts gi Division of Professional Licensure Board of Building Regulations and Standards Consii0•66441 4S rvisor CS-073697 ii I clpires:07/18/2022 LANCE NBERNECHE•;_1., �; 48 FLETCHER CIRCLE e CHICOPEE MA,01020 ' '1'O/Ss1,30�` Commissioner djaia /'. BFy,LJ, Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl From: Richard Dobrowski, Project Manager Western Builders, Inc. 73 Pleasant St., Granby. MA 01033 rdobrowski@westernbuilders.com 413.265.8793 To: Jonathan Flagg Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at 256 Pleasant Street, Northampton, MA 01060 (the Lumberyard) because the work is of a minor nature,will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, Ol ,\ Digitally signed by Richard A.Dobrowski DN:C=US, Richard A. Dobrowski£-rdobrowski@westernbuilders.com, O=Western Builders,OU=Project ( j 7/) l Manager,CN=Richard A.Dobrowski I 1 C/J Date:2021.12.15 10:38:31-05'00' From: Richard Dobrowski, Project Manager Western Builders, Inc. 73 Pleasant St., Granby. MA 01033 rdobrowski@westernbuilders.com 413.265.8793 To: Jonathan Flagg Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at 256 Pleasant Street, Northampton, MA 01060 (the Lumberyard) because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, Digitally signed by Richard A.Dobrowski DN:C=US, Richard A. DOL.. I I E=rdobrowski@westernbuilders.com, O=Western Builders,OU=Project Manager,CN=Richard A.Dobrowski Date:2021.12.15 10:38:31-05'00'