32A-148-011 #6B & 6G BP-2023-1718
30 PLEASANT ST UNIT 6 COMMONWEALTH OF MASSACHUSETTS
6B& 6G
Map:Block:Lot: CITY OF NORTHAMPTON
32A-I48-01 1
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2023-1718 PERMISSION IS HEREBY GRANTED TO:
Project# BATH RENO UNIT 6 2023 Contractor: License:
Est. Cost: 26000 RONALD GROGAN CSL090818
Const.Class: Exp.Date: 03/30/2024
Use Group: Owner: O'GRADY ELIZABETH TRUSTEE
Lot Size (sy.ft.)
Zoning: CB Applicant: RONALD GROGAN
Applicant Address Phone: Insurance:
PO BOX 282 413-259-51 1 1 20026862
WHATELY, MA 01093
ISSUED ON: 12/06/2023
TO PERFORM THE FOLLOWING WORK:
BATH RENO TO UNIT 6
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 VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: $182.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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`" he ommonwealth of Massachusetts
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RTyq�2nin� Massachusetts State Building Code(780 CMR)
Yd,f er it Ap lication for any Building other than a One-or Two-Family Dwelling
C1'4°'SooNs / (This Section For Official Use Only)
Building Permit Numbers • a.a /Date'Applied: Building Official:
SECTION 1: LOCATION
30 PLEASANT ST. NORTHAMPTON UNIT#6 01060 HAMP CONDOS
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used 9TH If New Construction check here 0 or check all that apply in the two rows below
Existing Building 0 Repair 0 Alteration >g) 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 DII No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No LI
Brief Description of Proposed Work: REMODEL BATHROOM INSIDE UNIT#6 HAMP CONDOS BUILDING
NEW TILE SHOWER INSTALL PLUS OTHER BATHROOM FIXTURES REPLACE, SOME WALL
COVERINGS ETC. REFINISH PAINT TRIM ETC.
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 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 0 R: Residential R-10 R-2(R) 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 ❑ IIA 0 IIB 0 IIIA ❑ IIIB ❑ IV CI VA 0 VBMI
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site
Public gl Check if outside Flood Zone IX Indicate municipal fm A trench will not be p
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 al Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No al Yes 0 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
YANKEEBIBBA REALTY TRUST 30 PLEASANT ST#6, P.O. BOX 267, NORTHAMPTON MA 01060
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
ELIZABETH O'GRADY 413.584.0761
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❑.
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 C GROGAN JR CS-090818
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❑ No D
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$ 26,000
1.Building $ 19,500 Building Permit Fee=Total Construction 'os Inse here
2.Electrical $ 2,850 appropriate municipal factor =$ I Q�,
3.Plumbing $ 3,650
4.Mechanical (HVAC) $ Note:Minimum fee=$ ( tac Is • a ity)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 26,000 (contact municipality)and write check number here / 7&
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.
GENERAL CONTRACTOR 413.259 _5111 12/06/2023
Please print and sign name Title Telephone No. Date
P.O. BOX 282 WHATELY MA 01093 RONGROGAN44@YAHOO.COM
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: //7 Zkk3
Name Date
City of Northampton
Massachusetts t{,,
* c.
DEPARTMENT OF BUILDING INSPECTIONS �.
'yama ` 212 Main Street • Municipal Building yti
%fir Northampton, MA 01060•
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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 HATFIELD MASS 01088
The debris will be transported by:
Name of Hauler: USA WASTE & RECYCLING
Signature of Applicant: Date: 12/06/2023
The Commonwealth of Massachusetts
- ' L Department of Industrial Accidents
=ar l= I Congress Street,Suite 100
p Boston, MA 02114-2017
4.7•d .4..•.w.w'
.,, :t} www.mass.gov/dta
VIuskers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
11)RE:FILED‘‘11'11'I 11E PU Sil E1'1\(:At' llORI
Applicant information Please Print Leaibh
Name(ttusincs!Orgamzition lndisiduti) _ _RON_GROGAN BUILDING & RENOVATIONS
Address: P.O BOX 282
City/State/Zip: WHATELY MA 01093 Phone#: 1-413-259-5111
Are you an employer?chock the appropriate box: Type of project(required):
I I am a entpkwer with ,._ � 5 (ttdl androrpan-►itiai)-' 7. CI New construction
lama sole proprietor or partnership ami have net employees working for me in $. fj Remodeling
any capsc:rty.INo workers'comp.msuranee required.)
30 La a homeowner doing all wink myself.f No workers'roe.insurance ran requirud.j' 9. Demolition❑
m
4.0 l ant a homeowner and will be hiring contractors to conduct all work on my propexty. I will 10 Building addition
ensure that all contractors either have weaken'compensation insurance to are sole 11.0 Electrical repairs or additions
o r"1'
etors with no employees_proprietors 12.0 Plumbing repairs or additions
5E3I am a general contractor and I have hired the sub-contractors listed on the attached sleet.
These sub.contzaeeont have employees and have workers'creep.insurance.: 13.0 Roof repairs
6.0 We are&c'orpttrauan and its offlcera have exercised their right ofexemptitn per MC&c. 14. Outer
152,i 1(4).and we have no employees.[No woriters'comp.manatee required.]
'Any applicant that cheeks box at must also fill out the aeetion below showing their workers'compensation policy information.
homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicting tuth.
CContractona that cheek this box mug attached an additional sheet show ins the mute of the£.111,-oNitmoor,.tnd state whether or not those entities hive
employees. If the sub-contractors have ensployces.they must provide their %otters'comp.policy numb et
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 INS. CO.
Policy#or Self ins.Lic.#: 20026862 _ Y Expiration Date: 10/31/2024
Job Site Address: 30 PLEASANT ST City/State/Zip:NORTHAMPTON MA 01060
Attach a copy of the workers'compensation polio"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 tine 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$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DlA for insurance
coverage verification.
I do hereby certify under the pains and penal/es of perjuty that the information provided above is true and correct.
Siunaturi:: Date: 12/06/2023
Phone 4: 1-413-259-5111
Official use only. Do not write in this area.to be completed by city or town offrciaL
City or Tossn: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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1 UNIT 6
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