18D-061 BP-2022-0257
135 INDUSTRIAL DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
I8D-061-001 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-2022-0257 PERMISSION IS HEREBY GRANTED TO:
Project# RENO SHOWROOM Contractor: License:
Est. Cost: 219026 GREEN LEAF CONSTRUCTION 115823
Const.Class: Exp.Date: 10/09/2024
Use Group: Owner: LLC NOT FADE AWAY,
Lot Size(sq.ft.)
Zoning: GI Applicant: GREEN LEAF CONSTRUCTION
Applicant Address Phone: Insurance:
98 ADAMS ST SUITE 105 (978)401-2053 WBN A91386805
LEOMINSTER, MA 01453
ISSUED ON:03/23/2022
TO PERFORM THE FOLLOWING WORK:
RENO SHOWROOM
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
c A ♦
it
Fees Paid: $1,533.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
��C�� , "s \1 cf' p p Plan l cu n, r-u t ct�L
L, MAR 1 6 2022 'he Commonwealth of Massachusetts
f Office of Public Safety and Inspections
'��yp Massachusetts State Building Code(780 CMR)
•"Y 7�F'un DIBdI]i it lication for anyBuildingother than a One-or Two-FamilyDwelling
(_-�—_ NORTHAMprO r • PP
�l M�0108�
Rite
(This Section For Official Use Only)
Building Permit Number: 8P•id)--,P Dote Applied: Building Official:
SECTION 1:LOCATION
135 Industrial Drive Northampton, MA 01060 F.W. Webb Northampton
No.and Street City/Town Zip Code Name of Building(if applicable)
18D-061-001
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® Repair 0 Alteration ® 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 ® No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No El
Brief Description of Proposed Work:Renovation of the existing 2, 100 +/- square foot
Showroom and expand it 1, 000+/- square foot into unused office
space. New display fixtures, vignette walls, and lighting. A furnace
will he added and some plumbing will he reworked .
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): M, B & S—1 Proposed Use Group(s):M, B & S—1 (no Change)
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
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 0 A-5 0 B: Business 0 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 0 I-3 0 I-4 0 M: Mercantile® R: Residential R-10 R-2 0 R-3 0 R-4 0
S: Storage S-1 ® S-2 0 U: Utility 0 ' Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA CI IB ❑ HA IIB ❑ IIIA ❑ IIIB 0 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:
El
Trench Permit: Debris Removal:
Public CaCheck if outside Flood Zone 0 Indicate municipal
A trench will not be Licensed Disposal Site
Private 0 or indentify Zone: or on site system 0 required®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 0 Yes 0 or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: 2015 Use Group(s):M, B&S—1 Type of Construction: III B
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
HESTER DIANNE M TRUSTEE/
F.W. Webb Company 160 Middlesex Turnpike Bedford, MA 01730
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Bob Mucciarone 781-272_6600 - Dram@fwwebb.com
Title Chief Operating Officer Telephone No.(business) Telephone No. (cell). e-mail address
If applicable,the property owner hereby authorizes:
Green Leaf Construction 98 Adams Street; Suite 105 Leominster MA 01453
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 D.
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)
Damon McQuaid AIA, NCARB 972-340-5922 dm@dmcquaidarchitect.com 951377
Name(Registrant) Telephone No. e-mail address Registration Number
49 Brookview Terr. Lunenburg MA 01462 Arch
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Green Leaf Construction
Company Name
Zachary Victor CS-115823
Name of Person Responsible for Construction License No. and Type if Applicable
98 Adams Street; Suite 105 Leominster MA 01453
Street Address City/Town State Zip
97R-401-2053 cruth@greenleafcm.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® No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs: (Labor
Item and Materials) Total Construction Cost(from Item 6)=$ 219, 026
1.Building $ 9 0, 12 6 Building Permit Fee=Total Construction Cost x•0 0 7(Insert here
2.Electrical $ 94, 000 appropriate municipal factor)=$ 1,533,
3.Plumbing $ 18, 0 0 0 1 ,156
4.Mechanical (HVAC) $ 16, 9 0 0 Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 219, 026 (contact municipality)and write check number here 1 60 'V
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 e t of m knowledge and understanding.
Chris Ruth Project Manager 978-401-2053 3/7/22
Please print and sign name Title Telephone No. Date
98 Adams Street; Suite 105 Leominster MA 01453 cruth@greenleafcm.com
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: na .5 Pas
Name Dale
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
wwmmass.gowilin
'ft.:kers trompensation Insurance Affidavit:Buildersit:ontractorstElectricians/Plumbers.
TO RE FILED WITII THE PERMITTING
timlicant Information Please Print
Name citusmcs,org,our..mon Individuali: Green Leaf Construction
Address: 98 Adams St. Suite 105
Leominster, MA 01453 Phone#: 978-401-2053
Are yam In employer?(leek ib.appropthite Type of project(required):
lover with enwt'venffldtanrnrit.natt 7. El New COnatrUCti011
20 nte a stile posisimor enfat/Ince-Alp and hate tat employees working fear me in 8,C3 Remodeling
any carom*Ibio workers'cam*.mintrance regained j
Q. El Demolition
30 I am a holes,"net daring atwork myself.IN.,workers'eon*.innurance requited r
o CI Building addition
i an.a horneowniin and will be hiring min:tractors to oisiduct all taurk property. I anal
emote that all contractors rather have workere comportmon insurance an err teal, I I a Electrical repairs or Addittute
proprietors with no employees..
i 2.0 Plumbing repairs or additions
am a pelmet contractor and Iboce hired the riabwoith actors hated on the attached sheet
I 3.0Roofiepairs
fhese ambsioritractoric hate employees tad Moe workers'comp.ittantance.;
6.0 r We am a emporation and its officers hate en then right of etemom 14. lOtherm per c.
132.. 10i.and we hove no eniployees.[No workers'comp.Misname artek)
'Any sprhente that checks KA tat ewe at....fill out the atiARIVAIbek9V4 AP%nig thin nerkee'coint101.ditTIKIll rultcy nitnettation
Menem nee what witnnei this affidavit indicate*they ate doing all work and then hire outside coatrooms mien submit a new Wide.it tealteolatg each.
tt ontractots that cheek the hie owe attached an sixisnorrai sheet nEttnannt the nnatte at the Sten-tanntracturaand mate Whet.,"tat tam fhtl.e entitles ha.e
crania,.m If oalseontramois Mac Crtlnec chK!.tacit pretheta peen,'canp polk rcrIfvt
I am an employer that is providing orunters'compensation insurance Or Orly ern/dr/vet &km it the polity and lob site
information.
imordnce c„mpany Name, Citizens Insurance Company of America
Policy at anrSelf-ing.tic.g: WBN A9138 68 05 Expiration Date: 5/2/22
Job Site Address: 135 Industrial Drive caystate.zip: Northampton, MA 01060
Attach a copy of the vim-kers*compensation policy declaration page()dinning the policy number and expiration date).
Failure to secure coverage as required under istGL c I52.II25A is a criminal violation punishable by a tine up to SI.500.00
attiVot one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the violator,A copy of this statement may be fore,aided to the Office of Inkestmations of the DIA for insurance
Con eiage s el ilicatiott
I do hereby certi ttul• the p 115.11 penalties of perjury that the Information provided above is true and correct.
Siena tine. pate, 3/7/22
pi„,„„.. 978-401-2053
4111111.11111111111111011110
Official use only. Do not write in this urea.111 be completed bv city or town offiriat
Cits or Iona: Permititicense Is
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.f:try/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
b.(Mier
tontart Person: Phone 4:
City of Northampton
c Massachusetts
`
� DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 Mr,.„ ,,,,,,-;
'�
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:
The debris will be transported by:
Name of Hauler: Waste Management
Signature of Applicant: ei i2"At` Date: 3/7/22
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
NESTER DIANNE M TRUSTEE/
F.W. Webb Company 160 Middlesex Turnpike Bedford, MA 01730
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information
Bob Mucciarone 7R1-272-6600 ram@fwwebb.com
Title chief operating Officer Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Green Leaf Construction 98 Adams Street; Suite 105 Leominster MA 01453
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 D
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)
Damon McQuaid AIA, NCARB 978-340-5922 dm@dmcquaidarchitect.com 951377
Name(Registrant) Telephone No. e-mail address Registration Number
49 Brookview Terr. Lunenburg MA 01462 Arch
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Green Leaf Construction
Company Name
Zachary Victor CS-115823
Name of Person Responsible for Construction License No. and Type if Applicable
98 Adams Street; Suite 105 Leominster MA 01453
Street Address City/Town State Zip
978-401-7053 - cruth@greenleafcm.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® No O
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs:(Labor
Item and Materials) Total Construction Cost(from Item 6)=$ 219,026
1.Building $ 90,12 6 BuildingPermit Fee=Total Construction Cost x•007
(Insert here
2.Electrical $ 94,000 appropriate municipal factor)=
3.Plumbing $ 18,000
4.Mechanical (HVAC) $ 16,900 Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 219,026 (contact municipality)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 ie t of m knowledge and understanding.
Chris Ruth Project Manager 978-401-2053 3/7/22
Please print and sign name Title Telephone No. Date
98 Adams Street; Suite 105 Leominster MA 01453 cruth@greenleafcm.com
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval:
Name Date
The Commonwealth of Massachusetts
,11W 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
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION
135 Industrial Drive Northampton, MA 01060 F.W. Webb Northampton
No.and Street City/Town Zip Code Name of Building(if applicable)
18D-061-001
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® Repair 0 Alteration El Addition❑ Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy ❑ Other ❑Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No El
Brief Description of ProposedWorlcRenovation of the ex;sti_ng 2.100 +/— square foot
Showroom and expand it 1,000+/— square foot into unused office
space. New display fixtures, vignette walls, and lighting. A furnace
will he added and some plumbing will be reworked.
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 UseGroup(s): M,B & S—1 Proposed Use Group(s):M,B & S-1 (no Change)
• SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 0 A-4❑ A-5❑ B: Business 0 I E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1❑ H-2❑ H-3 0 H-4❑ H-5 0
I: Institutional I-1 0 I-2 O I-3❑ I-4❑ M: Mercantile® R Residential R-10 R-2 0 R-3❑ R-4❑
S: Storage S-1 0 S-2❑ U: Utility❑ Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IB ❑ IIA ❑ IIB IIIA ❑ IIIB 0 IV 0 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:
RI
Public 0 Check if outside Flood Zone❑ Indicate municipal MIA trench will not be Licensed Disposal Site
required®or trench or specify:
Private 0 or indentify Zone: or on site system 0
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Prnces,:
Not Applicable® Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No CI
SECTION&CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code:2015 Use Group(s):M,B&S—1 Type of Construction: III B
Does the building contain an Sprinkler System?: Yes Special Stipulations:
Design Occupant Load per Floor and Assembly space:
Green Leaf Construction Project:21-059 F.W.Webb Northampton
lt GREEN LEAF 98 Adams Street,Suite 105 Showroom
li
411 CONSTRUCTION Leominster,Massachusetts 01453 135 Industrial Dr.
P:978 401 2053 Northampton,Massachusetts 01060
Transmittal #1 - Permit Check
To Kim Carson(City of Northampton) From Chris Ruth(Green Leaf Construction)
212 Main St. 98 Adams Street,Suite 105
Northampton,MA 01060, Massachusetts 01060 Leominster,Massachusetts 01453
Date Created Mar 10,2022
Copies To
Transmit Attached Sent Via Attached
Submitted For As Requested Action As Noted
Transmittal Items
Comments
Attached is the permit check for the F.W.Webb Showroom Project located at 135 Industrial Drive Northampton,MA 01060
Green Leaf Construction Page 1 of 1 Printed On:Mar 10,2022 01:56 PM EST