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32A-148 (13) 34 PLEASANT ST BP-2020-1025 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:32A- 148 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ALTERATION BUILDING PERMIT Permit# BP-2020-1025 Proiect# JS-2020-001731 Est.Cost: $35000.00 Fee: $245.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: RONALD GROGAN 090818 Lot Size(sa.ft.): 7840.80 Owner: YANKEEBIBBA REALTY TRUST Zoning:CB(100)/ Applicant: RONALD GROGAN AT: 34 PLEASANT ST Applicant Address: Phone: Insurance: PO BOX 282 WHATELYMA01093 ISSUED ON.512912020 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCTION OF NEW EXTERIOR SHAFT FROM GARAGE LEVEL TO DECK LEVEL FOR PERSONAL LIFT 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 5/29/2020 0:00:00 $245.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-11272 Louis Hasbrouck—Building Commissioner File#BP-2020-1025 APPLICANT/CONTACT PERSON RONALD GROGAN ADDRESS/PHONE PO BOX 282 WHATELY PROPERTY LOCATION 34 PLEASANT ST MAP 32A PARCEL 148 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST SED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCTION OF NEA EXTE HAFT FROM GARAGE LEVEL TO DECK LEVEL FOR PERSONAL LIFT New Construction Non Structural interior renovations Addition to Existin Accesso1y Structure Building Plans Included: Owner/Statement or License 090818 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN ORMATION PRESENTED: Approved 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 Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* 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 Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 64L T I aen� -- a9 a� Si nature of Building Official 10 Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. Versionl.7 Commercial Buildin Permit May 15,2000 [� Department use only r�&CS/V —City of Northampton Status of Permit: - DBuilding Department Curb Cut/Driveway Permit 42 Main Street Sewer/Septic Availability MAR 132020 / Room 100 Water/Well Availability ort ampton, MA 01060 Two Sets of Structural Plans DEaT OF one 13- 87-1240 Fax 413-587-1272 Plot/Site Plans N�R7'An.I DON INA pECn0fVg Other Specify APPLICATION TO CONSTRUGT; EPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING of SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 30 Pleasant Street Map -4 Lot 1 y� unit Northampton, MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: YankeeBibba Realty Trust (YBRT). P. O. Box 790, Cedar Key, FL 32625-0790 Name(Print) Current Mailing Address: (352) 543-9307 Signature Telephone 2.2 Authorized Aqent: Elizabeth O'Grady, Trustee P. O. Box 790, Cedar Key, FL 32625-0790 Name(Print) Current Mailing Address: (352) 543-9307 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $33,000.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of $2,000.00 Construction from 6 $35,000.00 3. Plumbing $0.00 Building Permit Fee 4. Mechanical (HVAC) $0.00 q � 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date Issued Signture: Build g Commissioner/Inspector of Buildin Date Version].?Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations El Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration 0 Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Construction of new exterior shaft from garage level to deck level above for new personal lift for Of Proposed Work: use by unit owner within their space. SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 El R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: R2 Proposed Use Group: R2 Existing Hazard Index 780 CMR 34): 1 Proposed Hazard Index 780 CMR 34): 1 SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1 St 1 St 2nd 2nd 3rd 3rd 4th 4m Total Area(so Total Proposed New Construction(sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal [Z] On site disposal system[] Version].7 Commercial Building Permit May 15,2000 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 (F) YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO e DONT KNOW O 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 Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: ___.._._..._ .. ._....... Not Applicable El E. Katsanos - HAI Architecture ._ �.�...� Name(Registrant): AR 8355 Richard E. Katsanos - HAI Architecture Registration Number w. - Address 08/31/2020 (413) 585-1512 Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility I Address Registration Number t 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 Ron Grogan Building Renovations Not Applicable ❑ Company Name: Ronald Grogan Responsible In Charge of Construction P.O. BOX 282 WHATELY MA 01093 Address —� 1-413-259-5111 Signa Telephone Commcrcri;il Hiiildint Permit 'c"f,, SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes - No • SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property hereby authorize to l act on my behalf, in all matters relative to work authcrrazecl oy this building permit aoolication. Signature of Owner Date F=lizahc lh O'Gradv.Trn-�tee of YI-InkeeRihha f oadtN-Trilco 3 as Ovmer/Authorized { Agent hereby declare that the statements and information on the foregoing appiicatton are true and accurate. to the best of lily knowledge ! and belief I Signed under the pains and penalties of perjury. Elizabeth O'Grad-, I Print Name I March 12,2020 E yn3f}PO OWn#*''At?e,^? Galt' SECTION 12-CONSTRUCTION SERVICES l 10.1 Licensed ConstructionSuSupervlgor. Not Applicable ❑ Narne of Ucense Molder 12_o,,q-- G/go�6,1,F4 p Lcense N. (1)f/,�_,4 Y h-t ° Address I Expiration mare 2-51 atur Telephone SECTION 13-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152,§25C(6)) Lin orkers Compensation insurance affidavit must be completed and submitted with this appiioavon. Failure to prov!de tnrs affidavitw ' resuit the denial of the issuance of the building permit_ Signed Affidavit Attached Yes 0 No f City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 3 o PT -57- The rThe debris will be transported by: _f,,yyc The debris will be received by: Building permit number: Name of Permit Applicant 12�-�.,k-,D C'G2 c, cTj2 Date Signature of Permit Applicant FEZ The Commonwealth of Massachusetts = Department of Industrial Accidents d 1 Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/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): 'RO N 620 64 AJ QUA/L/>/�(!lr 211+ap,'4> -r-YT Address: R'a. JdX 232 e-W- a/0S3 City/State/Zip: tLl4reeZ joy u/a 73 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. New construction 2.7/ 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 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4. F-11 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.❑Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]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. TContractors 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:CONCORD GROUP INSURANCE Policy#or Self-ins.Lic.#:20026862 Expiration Date:10/31/2020 Job Site Address:30 PLEASANT ST City/State/Zip:NORTHAMPTON MA 01 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. Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: 3 /3 1 LZ e-Z Phone#:1-413-259-5111 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#: Initial Construction Control Document N To be submitted with the building permit application by a R d Registered Design Professional for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Renovations for New Enclosed Vertical Personal Lift Date: 03/1212020 Property Address: 30 Pleasant Street, Unit#6, Northampton,MA 01060 Project: Check (x) one or both as applicable: New construction X Existing Construction Project description: Construction of new exterior shaft from garage level to deck level above for new personal lift for use by unit owner within their space. I Richard E. Katsanos MA Registration Number: AR8355 Expiration date: 08/31/2020 , 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 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 C1,ritr4 Dorcument'. Enter in the space to the right a"wet" or y electronic signature and seal: " 44i Phone number:413-585-1512 Email: Richard.Katsanos@HAIArchitecturP:cot Building Official Use Only Building Official Name: Permit No.: Date: chosen,provide a description. Version 01 01 2018 H I Al Architecture TRANSMITTAL DATE: March 12, 2020 PROJECT: Renovations for New Enclosed Vertical Personal Lift 30 Pleasant Street, Unit#6, Northampton, MA 01060 TO: Jeff Dwyer/General Contractor FROM: Rick Katsanos, Principal HAI Architecture 64 Gothic Street, Suite 1 Northampton, Massachusetts 01060 ITEMS: Copies Date Description 1 03/12/2020 CD with Permit Set Drawings and Construction Control Document 1 03/12/20020 Construction Control Document 1 03/12/2020 Signed Permit Drawing Set REMARKS: To be picked up CC: 64 Gothic Street,Suite 1,Northampton,MA 01060 1 413.585.1512 1 fax 413.586.7945 I www.haiarchitecture.com