35-142 (5) BP-2021-2314
35 WESTWOOD TERR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-142-001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2314 PERMISSION'S HEREBY GRANTED TO:
Project# ROOF Contractor: License:
Est. Cost: 6500 BURIS GENERATION HI&GC 100030
Const.Class: Exp.Date: 10/23/2023
Use Group: Owner: LORENCO, TERESA M. &PETER A.
Lot Size (sq.ft.)
Zoning: WSP Applicant: BURIS GENERATION HI&GC
Applicant Address Phone: Insurance:
31 EXETER ST (413)222-2914
EASTHAMPTON, MA 01027
ISSUED ON:12/16/2021
TO PERFORM THE FOLLOWING WORK:
ROOF
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.
Signature:
I •
Fees Paid: $40.00
•
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
i RE1----- O--7--, ,_•
The Commonwealth of MassachAsett ......
irxr
�
J. Board of Building Regulations and i;tan.:rds0 OR
�i 1;i:,��a Massachusetts State Building Code'780 MR E� 1 4 2021 CIPALITY
.. , USE
Building Permit Application To Construct,Repa' ,Relovla4- !. s emolish a Revi ed Mar 2011
One-or Two-Family Dwelling--2"2�rf,i nin 3,I��cp�r-r o
This Secfon For Official Use Only � ` `�07___
Buildin Permit Number: �-/ ac3/�7 Date Applied:
LUi�J KpSS �/7 /2-/4'Zd1I
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 P ty d res 1.2 Assens Map&Parcel Numbers
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system ❑
Check if yes❑
ez► SECTION 2: PROPERTY OWNERSHIP'
2`ne-r
e sc rd:i-o)f e0 iToyeøce VIP" 0010 t 2-
Name(Print) City,State,ZIP 1
3 S Laz. u)ooc LerrdCe U13' 30 y63g c,ltimariipDscls y01oo. :cir/
No.and Street Telephone Email`Address /
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building WY. Owner-Occupied I" Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of UnitsOther El Specify: - it. I//.� ,. . 7
Brief Description of Proposed Work2: 54p q ql
e 'p t for a qw.j AI" // / • „V
/wen()vtit) ivy dA yd wN c 1
CTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Suppression)
‘, Check
v /� No. Check Amount: Cash Amount:
6.Total Project Cost: $ (/(•' 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
Co i struction Supe ' or License(CSL) y too.030 0(2 j 2L
1;gV'(13 a V I )License Number Expirati Date
tir
•1 e o CSL Holder � l
fg e � List CSL Type(see below) V
N and� e y/ Type Description
/ �l/ U Unrestricted(Buildings up to 35,000 cu.ft.)
I Q Vl 0 21 R Restricted 1&2 Family Dwelling
6ostt4'l
ty/Town,State, M Masonry
RC Roofing Covering
WS Window and Siding
/'L, SF Solid Fuel Burning Appliances
4I J — � -2 �9/1 14aVa) bur/ ko-econI Insulation
Telephone Email address D Demolition
2 Registered Home I�g(6provemg� of ra/c`Qr JIIC) //S'6 /y 4)3) '1 2
uYY S enert� "� H C HICO Registration Number Expiration Date
IC C pany Dame or egistrant Name be.IartoLw )vahoo. coøi jo.
ICx>°T0,—
. d Street Email address
_I% ,,,,q-,4 nil c/c U �13-122-29/U
ity/To ' ,State,ZIP Telephone
SECTION 6: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 ./../'°---0 No .0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize P.(I S(.1 Y'w BL,( r/
to act on my behalf in all matters relative to work authorized by this building permit application.
/rzire5 0 ) oreJ1co is/ 13 /2 I
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby att under the pains and penalties of perjury that all of the information
contained in this application is true an to to the best of my knowledge and understanding.
0,1i St-11'LO &a"( / /, //3 /9. I
Print Owner's or Authorized Agen' ectronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
)r _ I Department of Industrial Accidents
_= I Congress Street.Suite 100
_ Boston. MA 02114-201
:., .;; www mass.gov/dia
%%taker:Compensation Insurance:%flidas it: Iluitdersl'('ontractorsifElectriciansIPlumbers.
11)III.t ILEI)•5I tit OD. I't.R'111771G At411t)RI I%.
Applicant Information Please Print l.et iblh
Name(Ilu,tti.ss t 1i__J131/atton huh tklua1 : Li J,$ 601 ei-. '6COI /12— V 6'C
Address: 31 X - ,71--
City/StatelZip: N /I l4 �l 017 phone n: (. -. 2Z 2—21 *
t rc y�an en.phai rr7 4 lurk tier app ►glair INtc
Ty pr of project(required):
I I.aft:acuria•yaurth en>pkva.t:,thin tlaorpnrl-ionLI.• 7. 0 New construction
I.flit a...dr pn,pn.taa of puranersiup and lta%c no imph•ye.t *forking lot Inc an $, a Remodeling
a Ia3.a pa.rts.I%.:.V...r l.'h camp.InNUTWICe regain e.l.I
9. ❑Demolition
i..-1 I,Mt a hoinctiv.nor dom:all ux.aL any.eli.(Nx•A4.9t..39 ..H11111-neariga ce acquirrd.l
10 0 Building addition
1.71 I Jfn a laaaneouan.a and c all Inc halm a iiirao.ion.to conduct all modun my pmp aty. I will
carsute that all contfa.iors crdret louse*mart,•conapen,;atN*n iuliuume.a aaelel! i i.1: Electrical repairs or additions
r.g,tictx•t.a ttli tn,one teyana.
12.0 Plumbing,repairs or addition.
la ant a j ent:al runlaaclor mill low hflL'd the Nathi.wintessibo linIhr nrehal
Ihrscwh-c.artrxtot,ha,ral rpcc,and has II:.4.1 alinne maw inianstect 13.'Rootrepairs
14.0 Othet
ti 3 We an aaattpnrata.m and a,oilu..rd have clacie ved tla n filth(ofe venaptAU per M(iL c
152,'1(4),awl achosesass owls*can.Ilia.,u.alcrs'comp.insult an..acqunrat.I
•Amy appliamtailthctik,lxas$1 rout also Idlout the arclNanhelou shouane ihlrt saonL.-i compensation tx.ltcs nmlunioiiva.
1 Ilutn.x,u nctaa obo,.U*'mht tam Arian it nhdacattnr they arc going all u oil*and then here tanbark contr-.a'tsa,must valiant a nen affilarii imitating such.
:C-a.ntractols that check flit,,Nos anus;atta.lied an additional sheet Jeri air the naanl 4.1 the,Ut.-to taar of Mkt+tale uhcitxi..a not those entitles has.
,_rnhb o cc-. II Zhu'NW,0.411r4ctot+.Ivan ccuuxlrio:.cc-..tihcymu-t pro,id.their i,ofLer,•conttr.htlti.'yorogiI--.
I am an employer that is providing workers'compensation insurance for m► employees. Below is the polity and job site
information.
III-iut.Ittr:c t.-~nnpiny Nante: __.
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: ( 11s State Lip:
Attach a copy of the worker's'compensation polies declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MCI c. 152.,s,25A is a criminal sialation punishable by a tine up to SI.500.00
and or one-year imprison t,as well as civil penalties in the barn of STOP WORK ORDER and a tine of up to$250.00 a
tki against the violator-A v of this statement may be forss arded to the Office of Investigations of the DIA for insurance
:us era;e serilieatit.n.i
I do hereby eery• yfe the pains d penalties of perjury that the information provided above is tree and correct.
titsnature: / Date. / /! _/�
Pltttne.r.: -} 1 3 — 'Z,2 Z ._ 2- 7 /L
Official use only. Da not write in this area.to he completed by city or town trflidat
( its or Town: 1'erniiti License Al
I swing.authority (circle one):
I. Board of Health 2.Building Department 3.('its(I own('lerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
( onlart Person: Phone#:
%Ic` ,,,tnriltProid rf/f..:,ne/..; //, Division of Professional Licensure
Office of Consumer Affairs&Business Regulation Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR I�1l
TYPE: Individual ConsOutt$Atprvisor
Registration Expiration
165619 03/09/2022 CS-100030 '�' f tyires: 10/23/
BELISARIO BURI t i
BELISARIO BURI ,
D/B/A BURI'S GENERATION HI&GC 31 EXETER ST
EASTHAMPTON MA 01027 !
BELISARIO BURI
31 EXTETER ST
EASTHAMPTON,MA 01027
Undersecretary
Commissioneriaa /i. tic�ta
City of Northampton
eloc.-4,,�j
-
` Massachusetts
1 *
( f L � ;
,\ DEPARTMENT OF BUILDING INSPECTIONS y M
� 212 Main Street • Municipal Building �j CD�
Northampton, MA 01060 Js l WO‘'‘'
O'`'
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: lig / y 1e CJ iti ? j
The debris will be transported by:
f
Name of Hauler: ��� "� S �6 ro 'IL-04 /1 66
Signature of Applicant: D J2// 3/2/ate: