39A-078 (8) BP.2022-0922
518 PLEASANT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
39A-078-001 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-2022-0922 PERMISSIONISHEREBYGRANT I TO:
Project# INTERIOR DEMO Contractor: License:
Est. Cost: 20000 MATTHEW WAINSCOTT 104496
Const.Class: Exp.Date:08/17/2023
Use Group: Owner: 518 PLEASANT STREET LLC
Lot Size (sq.ft.)
Zoning: GB Applicant: WAINSCOTT BUILDING
Applicant Address Phone: Insurance:
37 STAGE RD (413)559-0825 2001W9052
WILLIAMSBURG, MA 01096
ISSUED ON:08/03/2022
TO PERFORM THE FOLLO WING WORK:
INTERIOR DEMO
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL• TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: I
• r . . 1 .
Fees Paid: $140.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
SEC
The Commonwealth of Massachus sqU�
Office of Public Safety and Inspections �O
• •_ Massachusetts State Building Code(780iCMR f Eot ' (12
Building Permit Application for any Building other than a One-or"TweE# Dwelling
� ,trASp FCn
(This Section For Official Use Only) � h.
Building Permit Number:.2-2 * ?ZZ Date Applied: Building Official: .�h DNS /
I t SECTION 1:LOCATION
5)' Ae ,fur �arNetciJ C)ID6 i
No.and Street City/Town Zip Code Name of Building(if applicable)
'269-018•-dot
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`P, Repair 0 Alteration 0 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 0 No f-
Is art Independent Structural Engineerin�jPeer Review required? / Yes 0 No 0
Brief Description of Proposed Work d�. G t/��r fu bran-- r c//5 4am .tYw- S de
�q 4e G rQA e�ur 17,1?✓re_ r b v, )1d 04 ✓G4 terg a r,c..• G ll..,c` , P/ 1 t1 1-in abz
Srl�jniitie Id„—s ek-rr'a r G Kcrldi.l
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) Cl
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.) arae �/ (� f
Total Area(sq.ft.)and Total Height(ft) �� -/5pw / ' "/S'� ,?
SECTION 5:USE GROUP(Check a applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business IS 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 0 I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3❑ R-4 0
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use❑and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IBO IIA ❑ IIBC IBA CI IIIB0 IV IV VAC VB 0
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 ktf Check if outside Flood Zone 0 Indicate municipal
A trench will not be Licensed Disposal Site''
Private 0 or indentify Zone: or on site system❑ required 0 or trench or specify:
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 0 Yes 0 or No 0 Yes Cl 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
Sl& '91e„.„i 5-LI.(_ 19 Pieaa, S1- L)or ^c p40a 6J 61, i
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information
- i/4 /��C '�C,� - - -
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 0.
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
LChivSe4Ti '&1 IC „ LL L
Company Name
A-J W t.,J st 0-ri- CS i o4 L19 c,
Name of Person Responsible for Construction License No. and Type if Applicable
3 . $4,-re_ al (0,11 a nven.6.1wr l 0101 (.
Street Address City/Town State Zip
`l>3- 519 o cAl-‹ - - ll,..)... ,-r`i.,„Mc.
Cr.rlc,,i.
Telephone No.(business) Telephone No.(cell) e- ddress
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes 0 No 0
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ Building Permit Fee=Total Construction • ert here
i 2.Electrical $ appropriate municipal factor) i*
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (co - - nicipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ a Q f (3 (contact municipality)and write check number here 0,j
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.
Please print and sign name Title Telephone No. Date
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: 173-
)11\1611\1-''
Nam ile
City of Northampton
ASS' ,{,,
�r 2Ss ....sicr
C‘ Massachusetts mat •-:c�
A'r
:G
�, DEPARTMENT OF BUILDING INSPECTIONS F. ;)e
`am 212 Main Street • Municipal Building O' Ca
--•�� Northampton, MA 01060 ry"-•• �1
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: ()die 2 �I,�
S
The debris will be transported by:
Name of Hauler: c,. j vL)_ 3r4,3
Signature of Applicant: ‘--- Date: Z Z Z Z
'\ The (-otrthnornveallh of Massachusetts
.7....--i
:fi t,
r Department c+f Industrial Accidents
el►1=1[p� / Congress Street.Suite 100
Boston. :1L-102114-201
...... .
M'WW.Mtass.gOL/flhl
%S urkerr'('ompensation Insurance Ai idas it:Builderwt'ontraetora/Electricians!Plumbers.
1'0 BE FILED WI fl1'OIL PElttifl l-f1NG A1ITHORITt'.
.applicant l Ian ruratiun PICA PrinI I-r_ihlt
1 ..---
Name —
d211C ikiusinc Uratr► uoalttdrvyduall: '�.,ct t.iscu +1 a, r,c.�
Address: 34 5 _, (2 , > _
City`State:'Zip: li.)tl1►,,,,ms):).r ,VL.. 01oir` Phone#: t/13 6-5-5 6V?gs
Ire gnu.n enrptuWer4 Cheek the appropriate
Type of project(requ i red►:
am a cmploycr with emptuyces(full aod'o:port-titnct-•
7. New cunstrucuun
AM a sole pcupnctur or partncratrrp and have nu crnpluyeca wurkui Iirr me in h. Er Remodeling
an,capacity.[_Nu workers'comp.uu monad.]qunl.j �—/
9.aDemolition
i 1 am a humcnwn r doing all work myself.(No workers."sump.larlialilliX required]'
4.0 1 ant a homeowner and will tic Ming oinurai lor-t to conduct all work on my property_ I will 1(!Q Building addition
cruun that all contru-turs either his waders'compu-na-lion uuuraruc ra are sole 11.0 Electrical repairs or additions
prupnclurs with no employees_ 12.0 Plumbing repairs or additions
3.CI 1 ant a general cowl:min and 1 have hued the anti-euntraeturs Broodd on the mutated.,heet I3.❑Rewf repairs
Theme sob-contactor hate employee,amid hate wurken•cramp utsurancc.•
14_DOther
6.12 We are a corporation and its officer have eaten ta-iced their nght of eaaptwm per MCiL e.
152,$1l41.and we have no employees.[No workers'comp.in lamer iaqurrcdj
•Any applicant that checks but al mutt atw fill out the%c lion below shuniag their workers'compena diun policy rnformatrun-
'tk,ntcuwr:t>Ail')submit this airldiltrt urdreating they arc..Wang all work and then hire uutsimie Contract/an mutt auhnut a new affalat it rrxlmoili►g such.
:Cuntractur that cheek gm box must art-wheal an aikliliunal sheet allow ins the morn of the r ubxcearrracttxs and slate whether or not those minis:,hate
employee, It the sub-cuniracturs hat;employee,.they ritual pn.tidcthen warners'comp polls:).number
I rim an employer that is pratidink ii.urLers'compensation insurance for nit'employees. Below is the policy and joh site
in/irrvirreliun. n
Insurance Company Name: tt Z,n rZ _I,„ —
Policy ti or Self-ins.Lie. 4: 2,. . „_,,,,,_, Expiration Date: I - Z y^ 1
3
tub Site Address:619 P1e43 .4 ge- City/StaterZip:.Ljr"Ie,„i, 14A" Q106t
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 line up to S1,500.00
:truelor 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 tray be forwarded to the Office of Investigations of the DR for insurance
coveraec ten tic ation
I do hereby certify under ins and penalties of perjury that the information provided abate is true and correct.
Sitenaturr: ✓l' Dais D 7—0 z - ZoZ Z.
Phoney: 4/13 SS 5" a -1-5
Official Ilse unit. Du not write in this area,to be completed ht tilt or foci of/iris!
(its or Tos,n: Permit.License a
Issuing,Authority icirelc one):
I. Board of Ileslth 2. Building;Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
('untact Person: Phone*:
EXISTING 2 STORY BUILING WITH RENTAL UNITS
AND A 1 STORY WING WITH 'B' USE TENANT CHANGING
j ' i I ,TO NEW B USE TENANT ALTERATION FOR L -
IMPROVED BUILDING EGRESS.
6." ?.•Ii,�new fire separation wall for exit
with shorter exit path and no
pass thru a separate unit's occupied
private areas
4.-le
-- .,' ' close off exit 1
1
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existing thru unit
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518 Pleasnt St Northmpton Metcalfe 1 4 2 MAIN STREET
"B" Business use with new "B "use NORTHAMPTON. MASSACHUSETTS
6-2-22 Associates 4 I 3 586 5775 & 695 8200
tenant to improve egress safety A R C H I T E C T V R E }wm3Csmetcalfearchitectcre.com
with some minor alterations .
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