32A-148 BP-2022-0247
30 PLEASANT ST UNIT 5 COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32A-148-010 CITY OF NORTHAMPTON
Permit: Demo
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2022-0247 PERMISSIONIS HEREBY GRANTED TO:
Project# DEMO Contractor: License:
Est. Cost: RONALD GROGAN CSL090818
Const.Class: Exp.Date:03/30/2022
Use Group: Owner: FLA 77 UNIT LLC
Lot Size (sq.ft.)
Zoning: CB Applicant: RONALD GROGAN
Applicant Address Phone: Insurance:
PO BOX 282 413-259-51 1 1 20026862
WHATELY, MA 01093
ISSUED ON:03/16/2022
TO PERFORM THE FOLLOWING WORK:
INTERIOR DEMO WORK FOR FURTHER ASSESSMENT
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: I � �)
• 1 I. yg . 'I •
Fees Paid: $100.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVEi
1 I
A- HI' 0/0 MAR 1 s
2D22 r
The Commonwealth of Massachusetts I
Office of Public Safety and Inspections
I�I1 j Massachusetts State Building Code(780 CIf4R) , 'Tne.of et tl o!nu;INSPECTIONS
ni v� ,
Building Permit Application for any Building other than a One-br Ywo
(This Section For Official Use Only)
Building Permit Number:ZL• 2#7 Date Applied: Building Official:
SECTION 1:LOCATION
No.and Street City/Town Zip Code Name of Building(if applicable)
30 PLEASANT ST#5 NORTHAMPTON 01060 HAMP CONDOS
Assessors Map# 32A- 148 Block#and/or Lot # -001
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 0 Repair 0 Alteration 0 Addition 0 Demolition 181 (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 El
Is an Independent Structural Engineering Peer Review required? Yes 0 No
Brief Description of Proposed Work REMOVE AREAS OF DRYWALL AND WALL COVERINGS FOR FURTHER ASSESSMENT BY
AN ARCHITECT OR FNGINFFR FOR FUTURF PROPOSAL OF BFDROOM FSCAPF HATCHWAYS FTC ALSO FOR AN
ADJUSTMENT OF LOFT AREA NEAR SPIRAL STAIRCASE IN ADDITION TO DRYWALL REMOVAL IN VARIOUS AREAS
FOR KITCHEN AND BATHROOM UPDATING
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): Proposed Use Group(s):
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❑ B: Business 0 E: Educational 0
F: Factory F-1❑ 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❑ M: Mercantile 0 R: Residential R-10 R-2® 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 0 IIA0 IIB0 IIIA0 MB0 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:
Public M Check if outside Flood Zone CM Indicate municipal ElA trench will not be Licensed Disposal Site
Private CA or indentify Zone: or on site system❑ required®or trench or specify
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable M Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No M Yes M No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
CAITLIN JEMISON 30 PLEASANT ST UNIT#5 NORTHAMPTON 01060
Name(Print) No.and Street City/Town lip
Property Owner Contact Information:
OWNER 718 687- 3608 _ - FORTANACHPROPERTIESAGMAIL.COM
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 building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here(iil.
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)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
RON GROGAN BUILDING & RENOVATIONS
Company Name
RONALD GROGAN CS-090818 , /307z2_
Name of Person Responsible for Construction License No. and Type if Applicable
P.O. BOX 282 WHATELY MA 01093
Street Address City/Town State Zip
413-259- 5111 - - RONGROGAN44@YAHOO.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 rii No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ Building Permit Fee=Total Construction Cost x_(Insert here
2.Electrical $ appropriate municipal factor)=$ .
3.Plumbing $ I do
4.Mechanical (HVAC) $ Note:Minimum fee=$ 6 (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ (contact municipality)and write check number here 0 3 4/
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.
RONALD C GROGAN JR GC 413-259 -5111
Please print and sign name Title Telephone Not Date
P.O. BOX 282 WHATELY MA 01093 RONGROGAN44(aYAHOO.COM
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: ____//€ J 1 6-ZQZZ
Name Date
CITY OF NORTHAMPTON
SETBACK PLAN
MAP:32A-148 LOT: -001
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
„�' Massachusetts �k .1... 'e
• f , DEPARTMENT OF BUILDING INSPECTIONS y` to
ap' 9' 212 Main Street • Municipal Building vti -:',
s"; Northampton, MA 01060 4'4. ���
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: 77 WEST ST. WEST HATFIELD MA, 01088
The debris will be transported by:
Name of Hauler: USA RECYCLING
Signature of Applicant: Date:
� \ The Commonwealth of Massachusetts
Department of Industrial Accidents
Tan ii=I
I Congress Street.Suite 100
s r•_-1 Boston. MA 02114-2017
•., www.mass.gor</dia
11 inters'Compensation Insurance Aflidas it:Builders/( ontractors[Llectricians/Plumbers.
TO 13E FILED IA WI TIIh:f EKs1fI"fIMt:At'I lIORI I .
:tonneau!Information Please Print Ettihls
Name tf3uain ( ganization'Individuaf): RON GROGAN BUILDING & RENOVATIONS
Address: P.O. BOX 282
City,State/Zip: WHATELY MA, 01093 Phone:-: 1-413-259-5111
Are you an employer?l'hrck the appropriate Iron:
Type of project(required):
1.D l ant a enpbyci With employees(full and ot part-time).* 7. 0 Ness construction
2.2 1 am a sole prc.pra:tor tit twrtners,hrp and hate no employees working for nee in 8. Q Remodeling
am capxtty.[Nu'thinkers'comp.insurance niyuinxf_]
9. M Demolition
1.0 I am a lrunxo%nr doing all work m»self.'No wotki s'comp.insurance regained.]"
4.0 I am a ottom% et and will be Ming contractors to conduit all sort on my property. l will
l0❑ Building addition
I
cvswe that all contractors either base workers'conilwmrsuti n insurance or are sole I 1.0 Electrical repairs or additions
proprietors with no ci ploycv.
12.0 Plumbing repairs or additions
50 I am a gc-rx-ral cuntnactor and i Ince hired the slab-contractors listed on the attached sheet 13.Q Roof repairs
Theme sub-contractors have employees and lime workers'comp.Insurance.-
6.0 V.c are a corporation and its officers have exercised their right of exempiicn per!1t(:L c. 14. Other_ —
152.fi 1(4)_and we base no employees. No workers'comp.insurance required.]
'Any applicant that checks box aI must also fill out the section below dousing rhea wurlers'compensation p.dmes oil.cnution.
+ikntwowner..who submit this atlydas it indicating they are doing all w oil and then hue outside contractors court submit a uni attidat it milie.c mg such.
Contractors that cheek this bx must attached an additional sheet slowing the name of the sob-contractors and cute%better o,not tlaome entities has."
etiployers. It the sub-onuracttrs base etpk)sx .they must ptu.ide then' workers'comp.policy numfet
I am an employer that is providing wortiers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Nance: CONCORD GROUP
Policy#or Self-ins.Lie.#: 20026862 Expiration Date:_ 10/31/2022
Job Site Address: 30 PLEASANT ST city'State.Zap: NORTHAMPTON MA 01060
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration daft).
Failure to secure coverage as required under M(IL c. 152,*25A is a criminal s iolation punishable by a fine up to S1,500.00
and or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Ins estigations of the[MA for insurance
cos crags:verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone,v: 1-413-259-5111
Ojjcial use only. Do not write in this area,to be completed by city or town ofcial
('ih or Town: Permit/License#
Issuing:Authority (circle one):
I. Board of Ilealth 2.Building Department 3.('it iTown Clerk 4.Electrical Inspector S. Plumbing Inspector
6.Other
Contact Person: Phone#:
Initial Construction Control Document
ill; To be submitted with the building permit application by a
l# ` ; , Registered Design Professional
1 for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Date:
Property Address:
Project: Check(x)one or both as applicable: New construction Existing Construction
Project description:
I MA Registration Number: Expiration date: ,am a registered design professional,and I have
prepared or directly supervised the preparation of all design plans,computations and specifications concerning_
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:
Phone number: Email:
Building Official Use Only
Building Official Name: Permit No.: Date:
Note L Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is
chosen,provide a description.
Version 01 01 2013
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
2 Foundation
3 Structural
4 Fire Suppression
5 Fire Alarm(may require repeaters)
6 HVAC
7 Electrical
8 Plumbing(include local connections)
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
Name(Registrant) Telephone No. e-mail address Registration Number
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
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.