31B-230 (15) 11111.111111, BP-2008-0658
GIS#: COMMONWEALTH OF MASSACHUSETTS
1.111111111111, CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UN GISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2008-0658
Project# JS-2008-001004
Est. Cost: $10900.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Raymond R. Houle Construction Inc 066195
Lot Size(sq.ft.): Owner: NORTHAMPTON ARCHITECTURAL
Zoning: Applicant: Raymond R. Houle Construction Inc
AT: 64 GOTHIC ST
Applicant Address: Phone: Insurance:
5 MILLER ST (413) 547-2500 () Workers
Compensation
LUDLOWMA01056 ISSUED ON:2/20/2008 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATE OFFICE ARE FOR NEW
EQUIPMENT (HEALTHCARE ARCHITECTS)
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.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 2/20/2008 0:00:00 $50.0014619
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony 'atillo
File#BP-2008-0658
APPLICANT/CONTACT PERSON Raymond R.Houle Construction Inc
ADDRESS/PHONE 5 MILLER ST LUDLOW (413)547-2500 0
PROPERTY LOCATION 64 GOTHIC ST
MAP 31B PARCEL 230 000 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �p
Fee Paid I /! if U
Typeof Construction: RENOVATE OFFICE ARE FOR NEW EQUIPMENT(HEALTHCARE ARCHITECTS)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 066195 Aet-&-al
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
/Apprroved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special P•rmit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Varianc *
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Pota.ility Board of Health •
Permit from Conservation Commission Permit from C: Architecture Committee
Permit from Elm Street Commission Permit DPW ',torm Water Management
Demolition Delay
...,.............. 17,,..:4;04____
Signature of Building Official D:to
Note: Issuance of a Zoning permit does not relieve a applicant's burden to omply with all zoning
requirements and obtain all required permits from Board of Health,Cons rvation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards 'f MGL 40A.Contact Office of
Planning&Development for more information.
- 1 A Versionl.7 Commercial Building Permit May 15. 2000 t +
n - '-' z Department-use only
2QQ$ City of Northampton Status of Permit:.
N 11
Building Department Curb Cut/Dnveway_Permit
212 Main Street -Sewer/Septic Availability
Room 100 I
WaVg Wel Availatnfity
Northampton, MA 01060 T°-q--e.ts`�fStructuralPlans
phone 413-587-1240 Fax 413-587-1272 Plot/SiteTians.:" -
P
Other Spedify____
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property�Address: This section to be completed by office
6 /! Go - L S 7. Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
ton I,-ti, 64 6 rc cf rye . Suit (, I for-f nm ins
Name Print Currentiv
Mailing Address:
L1•¢l 3. �0 4. 7 21-
Signature Telephone
2.2 Authorized Agent:(Ob err L a'' -e vi.v T!, V 1 I/rr' 6Z L./�D//low, /1�IG, O/OS C
Name(Print) Current Mailing Address:
L//3- ,. .y7- a3-o0
Signa Telephone
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by permit applicant
1. Building oo (a) Building Permit Fee
2. Electrical C d (b) Estimated Total Cost of
� Sad. .�. ��fk
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) 0
5. Fire Protection /0I �JOO, -
6. Total = ( + 2 + 3 +4 + 5) Check Number / /9 �j�
4ngThis Section For Official Use Only Permit N ber: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
I` 46 Versionl.7 Commercial Building Permit May 15,2000 '
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Intl erior Alterations 7 Existing Wall Signs Existing Ground Signs Additions 0 Roofing 0
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
Accessory Building [ ] Repairs [ ]
IEF DESCRIPTION:
- — _ ��1, ,, i-Trr c crr et. �or .tie w �yu%�o-11�-47.
SECTION 5 -USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 0 A-1 0 A-2 0 A-3 0 lA I ❑
A-4 0 A-5 0 1 B 0
B Business X 2A 0
E Educational 0 2B 0
F Factory 0 F-1 0 F-2 0 2C 0
H High Hazard 0 3A 0
I Institutional 0 I-1 0 I-2 0 I-3 0 3B 0
M Mercantile 0 4 0
R Residential 0 R-1 0 R-2 0 R-3 0 _ 5A 0
S Storage 0 S-1 0 S-2 0 5BX.
U Utility 0 Specify:
M Mixed Use 0 Specify:
S Special Use 0 Specify:
COMPLL I L THIS SECTION IF EXIS I ING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf) 1st 4LL
n. 'fir �, a �,,, rts0- �s, wr kf
� � - 3> � .:
2
1st dES,,""$$ � 4 d+'.`1 ' `,` s wa
'SiM q„tv2nd
_ • 9 P°�cA �vita}N M
3rd ? ;, d t 1�t`k'€ ' r' "'
4th '41 r: ,
4th s-,
Total Area (sf) Total Proposed New Construction (sf)
7" , . . ; ' .:: S. : " ti"'.
Total Height(ft)
Total Height ft1 � x
r �ti
Versionl.7 Commercial Building Permit May 15,2000 • ri
7.Water Supply(M.G.L.c.40,§ 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone 0 Municipal 0 On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
•
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES—
No
IF YES, describe size, type and location:
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO I
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)
9.1 Registered Architect:
t }}
o �P r AM
Not Applicable 0
Name(Registrant):// {� `/ ► Narihnn0m /�/� / O. 4. vv 1 k £r W �v i / "/� (,Db o R�Ltration Numf� er 31/1-V •
50`•1'2* Expi tion Date
Signature Telephone q
92 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
l 4 yrn p A,0( 03. Nose CoA/67; Not Applicable ❑
Company Name:
&b n I.a..' -cv/4v Jr ,
Responsible In Charge of Construction
,4 iJkr S7, I.vcl/ocvi /1/JG, 0los-6
Address
y/3- br'i7-A5.66
Sig Telephone
...
1
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10- STRUCTURAL PEER REVIEW(780 CMR 110.11) l
•
Independent Structural Engineering Structural Peer Review Required Yes 0 No 11..
SECTION 11 - OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Don 'Jrr "r , as Owner of the subject property
hereby authorize Q3Ob,err Lan. -c v/A) TI'. to act on
my behalf in all mat -r. relative to worn authorized by this building permit application.
CP f 01A001
Signature of Owner .
I, (306<ry La.v t-VI-v Tr, , as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
Ilob-crY J.aAltl/by Tr,
Print Name
00P-
Signature of n Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder : 13ob-err 1.a01.y-eV14. J I. CS (j G/9.5
License Number
a JAckso. i ST. C 'icopr-e, r;4 4, oloaO 472/8lo9
Address Expiration Date
W3-S9'`/- 770 7
Sig Telephone
SECTION 13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit 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.
Signed Affidavit Attached Yes aK No 0
•
I L
roQYtwrrTOY
R+ -L` I�� raf Northampton /
DEPARTMENT OP BUILDING INSPECTIONS 4
�~
212 Main Street • Municipal Building
Northampton, Mass. 01060 r'
WORKER'S COMPENSATION LNSURANCE AFT DAVIT
�ci�tMc"rr�C\. COt��T�c�r�a.`,S'..�c
(li cxnscrJpermi tux
with 2 principal place of-business/residence at:
S ,,, S . 4N_ Q\ (phone )Lk\?j— sk..0-d5OO
(sv /city/statcrap)
do hereby certify, under the paint and penalties of-perjury, that
(A I am an employer providing the following worker's compensation coverage (or my
employees worljng on'this job:
4\1\.Z RC)\_ate IA 3 o�
(Lnsuru Conrzcv) (Polio: Nurnbcr) (rxpiralion Date)
( ) I.am a sole proprietor, general contractor or homeowner (circie one) and have hired
the contractors listed below who h2ve the following worker's comoen_adon policies:
(Name of Conti c.or) (lnsuranc:. ColnpanyfPGUC'i Numb T) (r:pir uoP. Date)
(Name of Coouracior) (lrtsurancc Company/Po!ic}• Nltocrr) 024ir:Lion Date)
(Name of Conrracio,) (Insurane:. Company/Policy Nambar) (Expiroon Date)
•
(Name of Cocoaetor) (Insuranca Compacy/Poticy Number) (E.\-piration Date)
(saw Anneal bcc if ncoct_ary w ccu.de infortzte600 perthaninz to all oc cr.c-,^a)
•
() lama sole proprietor and have no one wor4dng for me.
( ) I am.a home owner performing all the work myself.
NOTE:plcs be oc-ite(Lc'..•�]c bomw,.xn wbo employ pctans to O. r-, rcpon'+•Drier cro.d..c116 of
ant(Doer the t tx,tmrr to uln'ch the bomoowncr revdo or oo the c ouacb tppurtcn'xt the-do oectrid-rcd to be
eutploye-s,,r the v.-ix-tees Y-ram t.,im Act(GL152ss I(S)).o.pplicwoo by.bomcoavc for c l ate:a permit ray cvideoce the
Icg.,J ctaau of en oxployor under the,Wortio Co¢.aom.tion Ad
I underruod th.t a Dopy of chim cca.rrmsn ovy b.for-.corded to tbo Dopanmact of lark ierid Aoodcml Omoo or roman-Doc for th.
Coveratge veriatoioo wad thu toiit.e to t.catre CoverLge utdc uxvoo 25 A of MOL I52 an Iced to the i sitioo of criminal peat ct
oomikmg of a Cox of up to S 1.500.00 and/or imapriz.ocozcat of up to one ycor end civil Copra.hia to the rm ora Stop Wort Order Lod.
ciao of S 100.00 a thy ap,iva Inc.
For d parta+c.�u.c orJy _
,Ray
Permit Number
Z/-OF T.fap:: Lot ."=
tgna t of Licc sccfPcrrniucc L) to :;
V
CITY OF NORTHAMPTON, MASSACHUSETTS
CONSTRUCTION CONTROL AF IDAVIT
PROJECT NUMBER: HAI-07-00 DATE: December 18,2007
PROJECT TITLE: Renovations to Healthcare Architects Inc. Office
PROJECT LOCATION: Suite 01
NAME OF BUILDING: 64 Gothic Street, Northampton
SCOPE OF PROJECT: Limited Interior Renovations
IN ACCORDANCE WITH THE MASSACHUSETTS STATE BUILDING CODE, 780 CMR,
CHAPTER, SECTION 116, I, RICHARD E. KATSANOS , MASS. REG.
NO. 8355 , BEING A REGISTERED PROFESSIONAL ARCHITECT/ENGINEER,
HERBY CERTIFY THAT I HAVE PREPARED OR DIREC I LY SUPERVISED THE
PREPARATION OF ALL DESIGN PLANS, COMPUTATIOI S AND SPECIFICATIONS
CONCERNING:
ENTIRE PROJECT ARCHITECTURAL STRUCTURAL
FIRE PROTECTION ELECTRICAL MECHANICAL
OTHER(specify)
FOR THE ABOVE NAMED PROJECT AND THAT, TO T II BEST OF MY KNOWLEDGE,
SUCH PLANS, COMPUTATIONS AND SPECIFICATION MEET THE APPLICABLE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE
ENGINEERING PRACTICE AND ALL APPLICABLE LA S FOR THE PROPOSED
PROJECT.
I FURTHER CERTIFY THAT I SHALL PERFORM THE N CESSARY PROFESSIONAL
SERVICES AND BE PRESENT ON THE CONSTRUCTIO SITE ON A REGULAR BASIS
TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE
DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE
RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2:
1. Review of shop drawings,samples,and other submittals of the ContractIor as required by the construction contract
documents as submitted for building permit,and approval for conformance to the design concept.
2. Review and approval of the quality control procedures for all code required controlled materials.
3. Special architectural or engineering professional inspection of critical c nstruction components requiring
controlled materials or construction specified in the accepted engineerin practice standards listed in appendix B.
PURSUANT TO SECTIONS 116.2.3, I SHALL SUBMIT P IODICALLY, A PROGRESS
REPORT TOGETHER WITH PERTINENT COMMENTS T THE BUILDING INSPECTOR.
UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AND AN
AFFIDAVIT OF COMPLETION AS TO THE SATISFACT RY COMPLETION AND
pitotniNciNS OF THE PROJECT FOR OCCUPANCY.
7,0*-5;ri:-(?Z71.774ZT
�' ;'�;;� �A ''�e`� Subs i d and sworn to before me + <
t. Q. ;, this ay o C� 20Qp4e.m.�0,4.'-_
1‘..--)( lo.6335 ;-:2 ''
4,6,,,,Q__.n. q. A 4 Ai '. try 4tris,4 -‘:
• ' Notary Public
• 4, fi pie a s, AIA My Commission expires on . • C= . .-+0�,i,�.�'
';wy n Or C >V
RY Pv i'
Northampton Fire
Department
Memorandum
To: Tony Patillo
From: Duane Nichols
Date: February 1, 2008
CC: Brian Duggan
Re: 64 Gothic St. Healthcare Facilities
Secondary to a review of the plans and fire protection narrative submitted to me
for review, I concur with the issuance of a building permit subject to the following
conditions:
• Fire alarm and fire suppression work permits shall be obtained for the project.
The C/O inspection fee needs to be paid prior approval of any fire alarm or
sprinkler plan.
• Engraved key tags are required for the keys in Emergency Access Key Box.
• A graphic representation of the structure must be installed at the Fire Alarm
Control Panel (FACP) and/or Fire Alarm Annunciator and/or Communicator.
• Alarm verification must be active on all smoke detection zones.
• The Fire Alarm Control Panel and Fire Alarm Annunciator must be labeled
with red engraved signage with one-inch white lettering "Fire Alarm Control
Panel" and/or "Fire Alarm Annunciator". Also engraved signage listing all fire
alarm zone locations installed near panels.
• Page 1
• Engraved labels (1"x1") numbering all smoke detectors for identification
purposes installed on smoke detectors on main fire alarm system. Numbering
sequence to be determined by Fire Department. (Only if a zone system)
• 5 lb ABC Fire extinguishers are needed located at exits. This shall be in
compliance with NFPA relative to maximum travel distance. Appropriate
signage in compliance with ADA should be located above.
• Pull stations in renovated area shall be double action type.
• Red engraved signage with white lettering shall be placed on door to
mechanical room indicating "Fire Alarm Control Equipment"
• Page 2