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30D-019
BP-2023-0523 278 BURTS PIT RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30D-019-001 CITY OF NORTHAMPTON Permit: New Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0523 PERMISSION IS HEREBY GRANTED TO: NEW SINGLE FAMILY HOUSE Project# 2023 Contractor: License: PIONEER VALLEY HABITAT FOR Est. Cost: 187850 HUMANITY INC 046013 Const.Class: Exp.Date: 04/14/2025 PIONEER VALLEY HABITAT FOR HUMANITY INC Use Group: Owner: C/O RACHEL BORSON Lot Size (sq.ft.) Zoning: Applicant: PIONEER VALLEY HABITAT FOR HUMANITY INC Applicant Address Phone: Insurance: 140 PINE ST 413-586-5430 C69323595 FLORENCE, MA 01062 ISSUED ON: 05/01/2023 TO PERFORM THE FOLLOWING WORK: NEW SINGLE FAMILY HOUSE 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: litk., Fees Paid: $708.60 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner t. t 1 gL, The Commonwealth of Massachusetts , Board of Building Regulations and Standards h ' F43R L- IrOt Massachusetts State Building Code,780 CMR MUNI ZIPALfI'Y SE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revi d Mat 2011 One-or Two-Family Dwelling rf11���� This Section For Official Use Only Building Permit Number: �'i'JI 3 64 3 Date Applied: S . 1. I t i 5 ) 3 Building Official(Print Name) Signature I ate SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 278 Burts Pit rd. 30-D 019 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: SR _ Residential 14,693 80 Zoning District Proposed Use Lot Area(sq ft) I Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 30' 40'2" 15' 15'+ 30' 30'+ 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public El Private 0 Zone: Outside Flood Zone? Municipal® On site disposal system ❑ Check if yes® SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Pioneer Valley Habitat for Humanity Northampton,MA 01062 Name(Print) City,State,ZIP 140 Pine St. (413)586-5430 Megan@PVHabitat.org No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction® Existing Building 0 Owner-Occupied El Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units 1 Other I 0 Specify: Brief Description of Proposed Work': Construction of a Single Family House. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 135,350 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 22,500 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 13,000 2. Other Fees: $ t 4.Mechanical (HVAC) $ 17,000 List: 5.Mechanical (Fire Suppression) $ None Total All Fees $ I Ot .GO Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 187,850 0 Paid in Full ❑Outstanding Balance Due: 1 f SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSFA-046013 4/14/25 Michael F Broad License Number Expiration Date Name of CSL Holder PO Box 94 List CSL Type(see below) R No.and Street Type Description Shutesbury, MA 01072 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-636-6747 mfbroad@gmail.com I Insulation Telephone Email address D _ Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address City/Town,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 ® No .❑ 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 to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information co tai I ed in this application is true and accurate to the best of my knowledge and understanding. V -_4Ae aki /W' a �25 3 Print 0 , •• uthorized Agent's N (Electronic Signature) Xe �r 6- Date NOTES: 1. An ► -r 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.aov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 1,527 (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) 1.344 Habitable room count 4 Number of fireplaces 0 Number of bedrooms 3 Number of bathrooms 1.5 Number of half/baths 1 Type of heating system Air Source Heat Pump Number of decks/porches Type of cooling system Air Source Heat Pump Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" � x City of Northampton ,s • • s, " Massachusetts '�� �? '• c tim DEPARTMENT OF BUILDING INSPECTIONS Z ,x 212 Main Street • Municipal Building OD Northampton, MA 01060 st-,, ~ 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: Valley Recycling or USA Recycling The debris will be transported by: Name of Hauler: Self Haul or Dumpster from USA Recycling Signature of Applicant: Date: Z� II13 i '--- The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 •44) ; Boston,Ma 02114-2017 —'% www.mass.gov/dia .0% lluskers'Compensation Insurance Amdas it:Builders1(ontractors/Eketrician, Plum 11 TO 8E FILED WITH THE PERMITTING Al'THORITY. Applicant Information I'Ic;,,t I'm tnt I c_thls Name IHustncssr►r_antztionIndavtdual►: Pioneer Valley Habitat for Humanity, Inc. Address: 140 Pine Street/ PO Box 60642 City/State/Zip: Florence, MA 01062 phot,: 413-586-5430 Are"'NI an employer?('leek tie appropriate bus: I pe of project(required): 1.123 I am a employer with 6, employees(full and or part-time 1• 721 1e w construction 21J 1 am a sole prupnctor or partnership and base no enq►lwsrs working for me an S. Remodeling any capacity (Nu worker.'comp.tnsuranex mount.) 30 I am a homeowner doing all work myself.[No workers'coop insurance required.] 9. ❑ Demolition 4.0 I am a homeowner and w ill be hiring contractors to conduct all Murk on my property I will 10 o Building addition ensure that all contractors either have worker.eunfprnsabum insurance or are sole 11.0 Electrical repairs or additions prupneton with no employees 12.Q Plumbing repairs or additions 50 I am a tamers!contractor:end I has c hued the subcontractor.listed on the attached sheet. 131:Roof-repairs These subcontractors base employees and hoe workers'sump.uuurance.• 6.0 wofficers e an:a corporation and its ocers has a ,L exercised thee nglu of exemption per Mt 1 O 0thet 152.i I141.and we have no employees.[No workers'comp insurance required.] *Any applicant that chucks but al must also till out the section below showing then workers'cottrp ensation policy uefurnwtio n. *Homeowners who submit this attidasit indicating they an:doing all work and then hue outside contractor,must subnut a new atftda%tt indicating such ICunt:actors that check this hulk must attached an additional sheet showing the name of the suts•contract,r,and state whether or not those rttng:a hale torch..:,, It the sub-contractors base rttrplos ices.they must pros ad,th.it .s .1-1.en'eunrp.polies ntunt-kr /am an employer that is providing worker.•compensation insurance for rn; employees. Belo►,is the polio; and job site information. Insurance C'ompanv Name Lockton Affinity LLC Policy#or Solt-toss Lie. # C69323595 Expiration Date: 4/1/24 Job Site Address: 278, 286 and 298 Burts Pit Rd "ity;State Zip, Northampton, MA 01062 Attach a copy of the workers'compensation policy declaration page(showing the policy number and r.pIt at ion date). Failure to secure coverage as required under N1GL c. 152.§25A is a criminal violation punishable by a tine up to S1.5O0.00 and or one-year impnsonment.as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the s tolator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cis%erage.erttication. /do hereby cer 'jr under the pains and penalties of perjury that the information provided above is true and correct. Signature: ( !)erne 4/24/23 phone 413-58 -5 06 Official use only. Do not write in this urea.to be completed by city or town official (its or 1 own: Permit/Licease Issuing.luthurit 'circle one): I. Board of Health 2.Building Department 3.( ity t own Clerk 4.Electrical Inspector S. Plumbing Inspector b.Other ('ontact Person: Phone0: 1 � AtGc RO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 04/07/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lockton Affinity, LLC Lockton Affinity, LLC )aC, o.ertk888-553-9002 (m,Ne):913-652-3967 E-MAIL P. O. Box 873401 ADDRESS: Kansas City, MO 64187-3401 INSURER(S)AFFORDING COVERAGE NAIL* INSURER A:Ace American Insurance Co. 22667 INSURED INSURER B:Bankers Standard Insurance Company 16279 Pioneer Valley Habitat for Humanity, Inc INSURER C: PO Box 60642 INSURERD: Florence, MA 01062-0642 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR - - --- POLICYEFF POUCY EXP _ LTR TYPE OF INSURANCE INSD WVD POUCY NUMBER (MMIDCYYYYY) (MMIDEVYYYY) IJMTS A x COMMERCIAL GENERAL LIABILJTY GL1064964-23 04/01/2023 04/01/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE ES occurrence) $1,000,000 MED EXP(Any one person) $0 PERSONAL 8 ADV INJURY $1,000,000 GENT AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- X POLICY JEG'i LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accidejj§ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OVVNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) S UNBRB.LAUAB _OCCUR EACH OCCURRENCE S _ EXCESS LIAR CLAIMS-MADE AGGREGATE DED RETENTION$ $ B WORKERS COMPENSATION C69323595 04/01/2023 04/01/2024 z AST ME OTH- AND EMPLOYERS LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ( 7 N/A EL EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ' (Mandatory in NH) EL nistFasF-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POUCY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 1064964 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Coverage THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZ RSENTATI� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 44596869 1064964 M Commonwealth of Massachusetts IMF Onitsion of Occupational Licensure Board^,:t Budding Re ulations and Standards £wes Q A.- m I & 2 Fatty -SFA--046013 _ E,pires 04/14/2025 1+EL.f 85 OAD - PO BOX 94 Stt17ESEWRY MA 01012 i F *. ff .t ti`s %i t1.1 'ii/NA.%• ordrirntsiarirrpr •/,rt„4 f' ,,vrti ja,, "FI ;lt�hlM CITY OF NORTHAMPTON PERMIT DECISION DATES PROJECT INFORMATION Submitted 4/25/2022 Owner Name/Address City of 210 Main St MA 01060 Northampton Northampton Hearing 5/26/22 Applicant Name/ Office of Address(if different) Planning& Sustainability Extension Applicant Contact Wayne Feiden 413-587-1265 wfeiden@northamptonma.gov Hearing 5/26/22 Site Address 278 Burts Pit Rd Florence MA 01062 Closed Decision 5/26/22 Site Assessor Map ID 30D-16 Zoning District Suburban Residential Filed with 5/27/22 Permit Type Planning Board Site Plan for dimensional reductions for the Clerk purposes of creating affordable housing. Appeal 6/16/22 Project Description Divide lot into three building lots all designated as affordable Deadline housing. An appeal of this decision by the Planning Board may be made by any person within 20 days after the date of the filing of this decision with the City Clerk,as shown.Appeals by any aggrieved party must be pursuant to MGL Chapter 40A,Section 17 as amended and may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. Plan Sheets/Supporting Documents by Map ID: 1. Pioneer Habitat for Humanity Proposed Housing Permit Set by the Berkshire Design Group Dated April 25,2022 Addendum May 4, 2022. P LC100-700. BOARD MEMBER PRESENT FAVOR OPPOSED ABSTAIN/NO COUNT VOTE TALLY (Favor-Opposed) George Kohout,Chair ✓ ✓ ❑ ❑ Janna White,Vice Chair ✓ ✓ ❑ ❑ Chris Tate ✓ ❑ ❑ ✓ David Whitehill ❑✓ ✓ ❑ ❑ Christa Grenat ✓ ✓ ❑ ❑ Sam Taylor ❑ ❑ ❑ ❑ Melissa Fowler ✓ ✓ ❑ ❑ ,Assoc. ❑• ❑ ❑ ❑ Corinne Coryat,Assoc ✓ ✓ ❑ ❑ 7-0 pg. 1 r � �+.mr # `• CITY OF NORTHAMPTON PERMIT DECISION APPLICABLE APPROVAL CRITERIA/BOARD FINDINGS ZONING 350 SR Table of The Planning Board approved the site plan to create three lots,2 of which are smaller than the Use standard lots allowed in the SR for the purposes of creating permanently protected affordable 6.12;11.6 housing. The Board determined that the criteria in 350-6.12&11.6 had been met. A.The requested use protects adjoining premises against seriously detrimental uses. Single Family homes are allowed in the district. B. The requested use will promote the convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets. No changes to the site access are proposed. The project,including any concurrent road improvements,will not decrease the level of service(LOS) of all area City and state roads or intersections affected by the project below the existing conditions when the project is proposed and shall consider the incremental nature of development and cumulative impacts on the LOS. This parcel was originally a part of the redevelopment plans for the former State Hospital,which included a traffic mitigation for all the reuse. C.The site will function harmoniously in relation to other structures and open spaces to the natural landscape,existing buildings and other community assets in the area as it relates to landscaping, drainage,sight lines,building orientation,massing,egress,and setbacks. The lots are clustered to have the least impact on the wetland buffer zone. D.The requested use will not overload,and will mitigate adverse impacts on,the City's resources, including the effect on the City's water supply and distribution system,sanitary and storm sewage collection and treatment systems,fire protection,streets and schools.The lots will be accessed from existing road with ample capacity. E.The requested use meets any special regulations set forth in this chapter.(350-6.12)-The applicant shall obtain a)DHCD approval as Local Initiative Program(LIP)units,so that all affordable units created under this section can be listed by DHCD on their Subsidized Housing Inventory;or b)show evidence of commonwealth funding that requires units to be counted on the DHCD State Housing Inventory.Additionally:All permanent energy sources(thermal loads,hot water,and electric loads) shall be from grid-supplied electricity or otherwise not use fossil fuels(natural gas,propane,oil).This shall not apply to emergency generators,outdoor grilling,or mobile energy uses. F. Compliance with the following technical performance standards: (1)Curb cuts onto streets shall be minimized. One driveway will serve each lot. (2)Pedestrian,bicycle and vehicular traffic movement on site must be separated,consistent with single family homes. CONDITIONS Prior to Site Work Prior to Certificate of Occupancy 1. Tree protection shall be installed along the work limit line to 2. The applicant shall plant 3 trees on the ensure that trees intended to remain are protected in accordance north side of the lots. with an arborist's recommendation. A letter from an arborist shall be submitted indicating completion of this condition. Minutes Available at WWW.NorthamptonMa.Gov I,Carolyn Misch,as agent to the Planning Board certify that this is an accurate and true decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk and that a copy of this decision has been mailed to the Owner,Applicant 4C& pg. 2 • . Olf) ( CITY OF NORTHAMPTON PERMIT DECISION pg. 3 a CITY OF NORTHAMPTON PERMIT DECISION DATES PROJECT INFORMATION Submitted 2/27/2023 Owner Name/Address PV Habitat For POB 60642 MA 01062 Humanity Florence Hearing 3/23/23 Applicant Name/ Address(if different) Extension Applicant Contact Megan 413-586-5430 megan@pvhabitat.org McDonough Hearing 3/23/2023 Site Address 278 Burts Pit Rd Florence MA 01062 Closed Decision 3/23/2023 Site Assessor Map ID 30D-16 B 14598 P 228 Zoning District Suburban Residential Filed with 4/3/2023 Permit Type Planning Board Site Plan Amendment. Clerk Appeal 4/23/2023 Project Description Amend original permit to remove more trees. Deadline An appeal of this decision by the Planning Board may be made by any person within 20 days after the date of the filing of this decision with the City Clerk,as shown.Appeals by any aggrieved party must be pursuant to MGL Chapter 40A,Section 17 as amended and may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. Plan Sheets/Supporting Documents by Map ID: 1. Tree Removal Plans and Arborist Statement BOARD MEMBER PRESENT FAVOR OPPOSED ABSTAIN/NO COUNT VOTE TALLY (Favor-Opposed) George Kohout,Chair ✓ ✓ ❑ ❑ Janna White,Vice Chair ✓ I ❑ ❑ Chris Tate ❑ ❑ ❑ ❑ David Whitehill ❑ ❑ ❑ ❑ ❑ ❑ ❑ Sam Taylor v ❑ ❑ Melissa Fowler ✓ ✓ ❑ ❑ Stacey Dakai,Assoc. w v ❑ ❑ ,Assoc ❑ ❑ ❑ ❑ 5-0 pg. 1 CITY OF NORTHAMPTON PERMIT DECISION APPLICABLE APPROVAL CRITERIA/BOARD FINDINGS ZONING 350 SR Table of The Planning Board approved the site plan amendment to allow additional trees to be removed for Use the purposes of providing solar access to the net zero homes. 6.12;11.6 CONDITIONS For Amendment(all other conditions from original permit remain) Prior to Certificate of Occupancy 1. A total of 6 new trees shall be planted on site along the frontages. 2. If solar is not installed on the homes,tree replacement in accordance with 12.3 shall be completed. Minutes Available at WWW.NorthamptonMa.Gov I,Carolyn Misch,as agent to the Planning Board certify that this is an accurate and true decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk and that a copy of this decision has been mailed to the Owner,Applicant pg. 2 Massachusetts Department of Environmental Protection , . Bureau of Resource Protection -Wetlands L WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out From: forms on the Northampton computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Northampton Office of Planning &Sustainability City of Northampton return key. Name Name y� City Hall, 210 Main Street m Mailing Address Mailing Address Northampton MA 01060 City/Town State Zip Code City/Town State Zip Code /fon X\ 1. Title and Date(or Revised Date if applicable) of Final Plans and Other Documents: Pioneer Valley Habitat for Humanity Proposed Housing Permit Set, 4/25/22, addendum 1 Berkshire Design Group Date Wetland Delineation Report,Wendell Wetland Services 3/17/22 Title Date Title Date 2. Date Request Filed: May 2, 2022 B. Determination Pursuant to the authority of M.G.L. c. 131, §40,the Conservation Commission considered your Request for Determination of Applicability,with its supporting documentation, and made the following Determination. Project Description (if applicable): Construction of three affordable single family homes within the outer 50-100 foot buffer zone to bordering vegetated wetlands. Project Location: 278 Burts Pit Road Northampton Street Address City/Town 30D 016 Assessors Map/Plat Number Parcel/Lot Number wpafonn2.doc•Determination of Applicability•rev.4/22/2020 Page 1 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands L WPA Form 2 — Determination of1 Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act. Removing,filling, dredging, or altering of the area requires the filing of a Notice of Intent. ® 2a. The boundary delineations of the following resource areas described on the referenced plan(s) are confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. All boundaries shown on the planset are confirmed ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ® 5. The area and/or work described on referenced plan(s) and document(s) is subject to review and approval by: Northampton Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Northampton Wetlands Ordinance C 337 Name Ordinance or Bylaw Citation wpaform2.doc•Determination of Applicability•rev.4/22/2020 Page 2 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department.Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ❑ 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions(if any). Please see attachment A ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. Page 3 of 5 wpaform2 doc•Determination of Applicability•rev 4/22/2020 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands L WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on ❑ by certified mail, return receipt requested on May 27, 2022 Date Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office (see https://www.mass.gov/service-details/massdep-reqional-offices- by-community) and the property owner(if different from the applicant). Signatures are made in accordance with M.G.L. c.110G and pursuant to the board's electronic signature authorization vote recorded on June 5, 2020 in Book 13653, page 165 at the Hampshire Registry of Deeds. Signatures: Paul Foster-Moore Jen Smith C. Mason Maronn Alec Bernstein Randy Krotowski Jason Perry wpaform2.doc•Determination of Applicability•rev.4/22/2020 Page 4 of 5 . .. L1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 May 27, 2022 Date D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see https://www.mass.gov/service-details/massdep-regional-offices-bv- community) to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. Page 5 of 5 wpaform2 doc•Detenninaeon of Applicability•rev.4/22/2020 � 1 "ATTACHMENT A" 1. Prior to the initiation of any work,the applicant/owner shall submit a letter of understanding to the Commission stating that he/she has received, read, understands and shall comply with these conditions. The applicant, and, his or her contractor, foreman and/or construction manager shall sign the letter of understanding. 2. Prior to the initiation of any work,the applicant shall submit to the Commission a sequencing plan for construction, and erosion and sedimentation control installation. 3. Prior to the start of any site work,excavation or construction, a pre-construction conference shall be held on the site, between the contractor conducting the work,the site/project engineer,the applicant, and a member or agent of the Conservation Commission, in order to ensure that the requirements of this Determination are understood by all parties. Prior to the pre-construction meeting, all erosion control devices must be installed. 4. All required permits must be obtained from applicable federal, state and local agencies and departments prior to the start of any project. 5. A copy of these conditions and associated plans shall remain on site during all construction and/or building activities. The project manager and all equipment operators shall be familiar with the approved plans, and shall be informed of their location on the site. This location shall be accessible to all contractors whenever work is occurring on site. 6. All revised plans shall be approved by the Conservation Commission and incorporated into the permit by reference and shall be followed during the course of construction. 7. The areas of construction shall remain in a stable condition at the close of each construction day. Erosion control measures shall be inspected at this time, and maintained or reinforced as necessary. All such devices shall be inspected, cleaned or replaced during construction and shall remain in place until such time as stabilization of all areas that may impact resource areas is permanent. These devices shall also be inspected to assure that the maximum control has been provided. Any entrapped silt shall be removed to an area outside the buffer zone and resource areas, and maintained or reinforced as necessary. Erosion controls shall be inspected after every rainfall to assure that maximum control has been provided. 8. An adequate stockpile of erosion control materials shall be on site at all times for emergency or routine replacement and shall include materials to repair or replace silt fences, straw bales, erosion control blankets, riprap, filter berms or other devices planned for use during construction. 9. Soils exposed for periods greater than two months shall be stabilized with erosion control blankets and netting, a covering of straw mulch, or a temporary cover of rye or other grass to prevent erosion and sedimentation. Drainage ditches shall be stabilized and seeded with a native perennial grass mixture. Any stabilization materials such as jute netting shall be firmly anchored to prevent them from being washed from slopes by rain or flooding. Preference should be given to biodegradable materials. 10.All disturbed areas shall be graded, loamed and seeded,c3or stabilized with erosion control blankets or netting, and a covering of straw mulch prior to November 30, of each year. No disturbed areas or stockpiled materials will be left unprotected or without erosion control after this date. 11.No disposal of soils or other materials shall be allowed within: a 100-year floodplain; 40 feet of the 100-year floodplain elevation;any wetland;or any area within 100-feet of a wetland, or 200 feet of a vernal pool unless such areas are specifically approved by the Commission, in accordance with 310 CMR 10.00, and City of Northampton Ordinances- Chapter 337. Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability L Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out From: forms on the Northampton computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Pioneer Valley Habitat for Humanity Inc return key. Name Name PO Box 60642 4m Mailing Address Mailing Address X Florence MA 01062 City/Town State Zip Code City/Town State Zip Code 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents: RDA Packet 3/27/23 Title Tree Removal Request Memo 2/14/23 Title Date Title Date 2. Date Request Filed: March 27, 2023 B. Determination Pursuant to the authority of M.G.L. c. 131, §40,the Conservation Commission considered your Request for Determination of Applicability,with its supporting documentation, and made the following Determination. Project Description (if applicable): Removal of 12 trees within the 50-100 foot buffer zone. Trees to be cut above grade, stumps to remain. Project Location: 278 Burts Pit Road Northampton Street Address City/Town 30D 016 Assessors Map/Plat Number Parcel/Lot Number wpafonn2.doc•Determination of Applicability•rev.4/22/2020 Page 1 of 5 Massachusetts Department of Environmental Protection LBureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation(issued following submittal of Simplified Review ANRAD) has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act. Removing,filling, dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a. The boundary delineations of the following resource areas described on the referenced plan(s) are confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ® 5. The area and/or work described on referenced plan(s) and document(s) is subject to review and approval by: Northampton Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Northampton Wetlands Ordinance _ C 337 Name Ordinance or Bylaw Citation wpaforrn2.doc•Determination of Applicability•rev.4/22/2020 Page 2 of 5 . . L1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions(if any). The applicant shall install replacement plantings of a mix of shrubs and low-hright trees within the buffer zone. ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•Determination of Applicability•rev.4/22/2020 Page 3 of 5 . . Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) El 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on ❑ by certified mail, return receipt requested on April 20, 2023 Date Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office (see https://www.mass.gov/service-details/massdep-regional-offices- by-community) and the property owner(if different from the applicant). Signatures are made in accordance with M.G.L. c.110G and pursuant to the board's electronic signature authorization vote recorded on June 5, 2020 in Book 13653, page 165 at the Hampshire Registry of Deeds. Signatures: Jen Smith C. Mason Maronn Paul Foster-Moore Randy Krotowski David Reckhow wpaform2.doc•Determination of Applicability-rev 4/22/2020 Page 4 of 5 • LIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 April 20, 2023 Date D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see https://www.mass.gov/service-details/massdep-regional-offices-by- community) to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wpaform2.doc•Determination of Applicability•rev.4/22/2020 Page 5 of 5 . . . -1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: Request for Departmental Action Fee Transmittal Form Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information 1. Location of Project a.Street Address b.City/Town,Zip c.Check number d.Fee amount Important: 2. Person or party making request(if appropriate, name the citizengroups representative): When filling out forms on the computer, Name use only the tab key to Mailing Address move your cursor-do City/Town State Zip Code not use the return key. Phone Number Fax Number(if applicable) �� 1 3. Applicant(as shown on Determination of Applicability(Form 2), Order of Resource Area Delineation (Form 4B), Order of Conditions(Form 5), Restoration Order of Conditions(Form 5A), or Notice of Non-Significance(Form 6)): , Name Mailing Address City/Town State Zip Code Phone Number Fax Number(if applicable) 4. DEP File Number: B. Instructions 1. When the Departmental action request is for(check one): ❑ Superseding Order of Conditions—Fee: $120.00(single family house projects)or$245(all other projects) ❑ Superseding Determination of Applicability—Fee: $120 ❑ Superseding Order of Resource Area Delineation—Fee: $120 Send this form and check or money order, payable to the Commonwealth of Massachusetts,to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.4/222020 Page 1 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number Provided by DEP Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office(see https://www.mass.gov/service-details/massdep-regional-offices-by-community). 4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. wpaform2.doc•Request for Departmental Action Fee Transmittal Forn•rev.4/22/2020 Page 2 of 2 9-1 tP ��THA . -4. CITY OF NORTHAMPTON,MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS 6 "'n. 1' 125 Locust Street Northampton,MA 01060 413-587-1570 Donna LaScaleia Fax 413-587-1576 Director Permit No. D08-23 DRIVEWAY PERMIT Date: 2/16/2023 Check#: 9570 FEE: $250.00 Proposed driveway must be staked and address and/or lot number posted. Public Shade Trees are protected by MGL Chapter 87. Do not cut, trim or remove any trees on City property without the expressed written permission of the Tree Warden. The undersigned respectfully petitions The Department of Public Works for: A new Curb Cut Permission to install a driveway at: 278 BURTS PIT ROAD Fifteen (15) foot maximum width from street line to property line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. The first one hundred (100) feet of the driveway surface shall be paved as soon as possible if the grade of the proposed driveway exceeds 3%at any point in the first one hundred (100) feet. Homeowners will be held responsible for any costs to the City of Northampton in the event of a washout of this driveway. City is not responsible for culverts installed under driveways in City layout. Code of Ordinances §350-8.8 providing standards for private, individual driveways as most recently amended, must be followed. No excavation is authorized without a valid trench permit in addition to this permit. By: PIONEER HABITAT FOR HUMANITY Telephone: MEGAN 586-5430 Signature: (1 ....--- Superintendent—Tree Warden Highway Superintendent Date Forestry,Parks&Cemetery Date Proposed Location&Tree Mike Antosz 3/8/2023 Richard Parasiliti 2/28/2023 Protection Inspections Gravel Base Grade Inspected Final Approval Director of Public Works Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS I &2) 10 Permit No. D08-23 Conditions: Driveway Permit In lieu of plan approved by the City Engineer I agree to the following added conditions: 1. 1 will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. I further agree that if in the inspections, any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. By: MEGAN MCDONOUGH Name: PV HABITAT FOR HUMANITY Address: 140 PINE STREET, FLORENCE, MA 01062 413-348-6706 Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. For Commercial and Industrial applicants, a plan showing the proposed driveway with grades, locatio and Planning Board permits are required. Cc: Building Inspector i a Permit No. S16-23 Date Approved: '/- I i 1j Exp. Date: 1 t 2) CITY OF NORTHAMPTON,MA RESIDENTIAL OR COMMERCIAL BUILDING SEWER ENTRY PERMIT A Department of Public Works Trench Permit Shall he required prior to any construction or connection activity associated with this application. To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the OWNER of the property (Owner, Owner's Agent) located at 278 BURTS PIT RD , does hereby request a permit to install and (Number and Street) connect a building sewer to serve the RESIDENCE at said location. (Residence, Commercial Bldg.,etc.) 1. The applicant and or owner shall furnish upon request of the Superintendent the estimated quantity and characteristics of waste to be discharged to the public sewer. 2. "Owner" shall mean the person holding title to the property served or to be served by the building sewer. 3. The person or firm who will perform the proposed work is: SVAHS ARMAND LAMOUR , of 80 LOCUST ST, NORTHAMPTON (Name) (Address) 4. Plan and specifications for the proposed building sewer are attached hereunto as Exhibit "A". In Consideration of the granting of this permit, the undersigned agrees: I. To accept and abide by all provisions of the City's sewer use regulations,as established by the Northampton Department of Public Works,and all other pertinent ordinances and regulations. 2. To maintain the building sewer at no expense to the City. 3. To notify the Supertintendent when the building sewer is ready for inspection and connection to the public sewer,but before any portion of the work is covered. 22-2 3 - D-o a 3 - 3 SEE ATTACHED UTILITY CONNECTION REQUIREMENTS • Permit No. S16-23 4. The City shall not be held liable for any open plumbing fixtures below street level. 5. The applicant and or owner herby agrees to pay the City any sewer use assessments or charges as may be established under city ordinance. 6. City requires 6" cleanout installed at City Property Line. DATE: 4 3 2023 SIGNED: SVAHS ARMAND LAMOUR (Name of Applicant) 80 LOCUST ST, NORTHAMPTON, MA (Address of Applicant) 413-587-1414 T lephone No. of Applicant) Application approved and permit issued: �- i DATE: c1 I SIGNED: (Director of e Department of Public Works) The City's Sewer Use Regulations are available on the City's website. Tie-in to sanitary service at street line $1,250.00 X *** CHIMNEY REQUIRED SEE ATTACHED UTILITY CONNECTION REQUIREMENTS 'ermit No. S16-23 SEWER CONNECTION INSPECTION REPORT Northampton Sewer Department 125 Locust St Northampton, MA 01060 (413) 587-1570 Date: 4 3 2023 Type of Service: New X Renewal Repair Existing Sewer Entry Fee Paid: Yes X No Checks 9579 Cash Money Order# Pipe: Size 8" Length 300' Material PVC Age 1977 Location of Installation: 278 BURTS PIT RD,FLORENCE (Number and Street) Contractor Developer Installing Service Connection SVAHS ARMAND LAMOUR CHIMNEY REQUIRED (Name) 413-587-1414 (Telephone Number) This service connection at this location was inspected by the undersigned on (Date) at and approved by: (Time) (Sewer Foreman) I have instructed of that the installation can be backfilled. Sewer Foreman *City requires 6" cleanout installed at city Property Line. Measurements for all installation shall be listed on the back of this form. The information shall be attached to the permit on file at the Public Works Department office. Copy to Supervisor: Date: Copy to Utility Billing: Date: Copy to WWTP Date: Dale Small Copy to WWTP Date: Kevin Gillette SEE ATTACHED UTILITY CONNECTION REQUIREMENTS VARIES 1 . W W 6`PVC.PIPE. -"x-"x6"WYE REDUCER OR INCREASER w Z If NEEDED ri 6`x6"x6 -9O PVC. TEE WYE FERNCO COUPLING B'BEND (SIZE VARIES) EXIST SEWER SERVICE CO (SIZE VARIES) 2 X MIN. SLOPE I } PLAN �Z 6-CAP EXIST GROUND NOTE: FOR CLEANOUTS WHICH TERMINATE , I WITHIN PAVEMENT AREAS CONTRACTOR TO SUPPLY THE TOP OF A STANDARD WATER GATE BOX TO PROVIDE ACCESS AND TO PROTECT THE PIPE. REDUCE CLEANOUT PIPE SIZE FROM 6" TO 4" WITHIN THE GATE BOX TOP. W R V a N 6"PVC.PIP E, VARIES i° w DUCER OR a NCREASER IF NEEDED SEWER MAIN (SIZE VARIES) FERNCO COUPLING -"x-"x6"WYE , (SIZE VARIES) I ' I fr: 2 f MIN. SLOPE\6.BEND 6"x6`x6` 90 PVC. TEE WYE PROFILE EXIST SEWER SERVICE (SIZE VARIES) TYPICAL 6"PVC. SEWER SERVICE NOT TO SCALE SEE ATTACHED UTILITY CONNECTION REQUIREMENTS • Permit No. W22-23 Date Approved: ?./( �} Exp. Date: c-I( t 3 CITY OF NORTHAMPTON,MA RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY PERMIT A Department of Public Works Trench Permit Shall be required prior to any construction or connection activity associated with this application. To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the OWNER of the property (Owner, Owner's Agent) located a 278 BURTS PIT RD , does hereby request a permit to install and (Number and Street) connect: I" Water Service to the RESIDENCE at said location. (Size) (Residence,Commercial Bldg.,etc.) 1. "Owner"shall mean the person holding title to the property served or to be served by the water service. 2. The person or firm who will perform the proposed work is: SVAHS ARMAND LAMOURR ,of 80 LOCUST ST,NORTHAMPTON, MA (Name) (Address) 3. Plan/sketch and specifications for the proposed water service shall be attached to permit. In Consideration of the granting of this permit,the undersigned agrees: The Water Department shall make all taps to the water main of 2" or less,unless approved by the Water Superintendent. 2. WATER ENTRY PERMIT FEE IS$1250.00 3. Additional work performed by City forces from the water main to street line shall be paid at the prevailing labor rates and cost of material. Water Meters 5/8" $450.00 Water Meters 3/4" $450.00 Water Meters I" $550.00 Radio Read N/A $150.00 **** Water Meters>1" will be purchased by the City and charged to the customer. **** 4. A Radio Read Fee is charged with the purchase of a new meter. 5. The Water Superintendent shall be notified for water line inspection prior to backfill of trench. S (- '23 T4 - O3 -30p. SEE ATTACHED UTILITY CONNECTION REQUIREMENTS 4 4 Permit No. W22-23 CITY OF NORTHAMPTON, MA RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY APPLICATION DATE: 4/3/2023 SIGNED: HABITAT FOR HUMANITY (Name of Applicant) PO BOX 60642, FLORENCE, MASS (Address of Applicant) 586-5430 (Telephone No.of Applicant) $ 1250 Entry fee paid Check No. 9579 $ 450 Meter fee paid Check No. 9579 $ 150 Radio Read fee paid Check No. 9579 Application approved and permit issued: - DATE: -/( Z SIGNED: (Director of the Department of Public Works) Fee Schedule: Fire Line Fee included in Water Entry Fee Water Entry Permit Fee $1,250.00 5 8" Meter Fee: $450.00 3 4" Meter Fee: $450.00 I" Meter Fee: $550.00 Radio Read Fee: $150.00 SEE ATTACHED UTILITY CONNECTION REQUIREMENTS Permit No. W22-23 WATER CONNECTION INSPECTION REPORT Northampton Water Department 125 Locust St Northampton, MA 01060 (413)587-1570 Date: 4 3 2023 Domestic: X Fire Line: Irrigation: Type of Service: New X Renewal Repair Pip Size 12" Material AC Age 1978 Water Entry Fee Paid: Yes X No Meter Fee Paid: Yes X No Meter Size: 5/8" Radio Read Fee Paid: Yes X No Checks 9579 Cash Money Order* Location of Installation: 278 HURTS PIT ROAD (Number and Street) (Parcel ID) Contractor Developer Installing Service Connection SVAHS ARMAND LAMOUR (Name) 587-1414 (Telephone Number) — - This service connection at this location was inspected by the undersigned on (Date) at and approved by: (Time) (Water Superintendent) I have instructed of that the installation can be backfilled. Measurements for all installation shall be documented by the Water Department. The information shall be on file at the Public Works Department office. Copy to Supervisor: Date: Copy to Utility Billing: Date: Copy to Water Dept: Date: SEE ATTACHED UTILITY CONNECTION REQUIREMENTS e A Requirements for Utility Connection Permits The following requirements shall apply to and be incorporated into any Utility Connection permit, as defined below,issued by the City of Northampton Department of Public Works(DPW)for interconnection to City owned utilities including the Water,Sewer and Storm Water systems. 1. Utility connection Permits and Trench Permits will be good for a period of thirty days,unless extended. Please contact the DPW at 413 587 1570 seven days prior to permit expiration for an extension,if needed. 2. The DPW will be strictly enforcing the following inspection requirements for all Utility Connections: a. No Utility Connection shall be back filled before the utility connections have been inspected on site by a DPW representative and determined to be in accordance with City standards. b. Any trench that is backfilled prior to inspection will be required to be re excavated to expose the new work in its entirety to satisfactorily close the permit. c. To request an inspection,please contact the DPW at 413 587 1570. Every effort will made to accommodate same day requests if made before 1 PM,but the DPW cannot guarantee same day inspection. There will be a$100 fee for same day requests made after 1 PM on business days,and all same day requests made on weekends or on legal holidays d. PHOTGRAPHS ARE NOT ALLOWED IN LIEU OF ON-SITE INSPECTION. 3. For purposes of this Policy Order,a 'Utility Connection'shall be a connection to the City water system in accordance with the Code of City Ordinances§325 3,a connection to the City sanitary sewer system in accordance with the Code of City Ordinances§260 5 et seq.,or a connection to a drain within the City stormwater system in accordance with the Code of City Ordinances§256 10. A"Utility Connection Permit"shall be any permit issued by the DPW,regardless of its title or form, necessary to make a Utility Connection. SEE ATTACHED UTILITY CONNECTION REQUIREMENTS t , :�?' '7":". . CITY OF NORTHAMPTON,MASSACHUSETTS PENDING APPROVAL 7 DEPARTMENT OF PUBLIC WORKS 278 BURTS PIT RD ll .� 125 Locust Street i����hmf Northampton, MA 01060 Trench Permit Number: 2023-298 .p . :- _',: 413-587-1570 " Fax 413-587-1576 Date Approved: 11 -( I L. Expiration Date: S - I I i 7j - (for City Use Only) EXCAVATION/TRENCH PERMIT Pursuant to G.L. c. 82A and 520 CMR 14.00 et seq.(as amended) This permit must be fully completed prior to consideration.Submit completed form with permit fee to Northampton Department of Public Works, 125 Locust Street,Northampton, MA 01060. This permit is issued under the provisions of M.G.L.c. 82A, 520 CMR 14.00 and applicable sections of the Revised Ordinances of the City of Northampton, including, but not limited to,Section 285-21. Fee: $250 Check#:9578 Date Issued:3/30/2023 Name of Applicant Primary Phone# THEROUX BROTHERS 374-1488 Street Address Emergency Phone# 622 GRANBY RD City/Town State Zip Email SOUTH HADLEY MA 01075 theroux29@comcast.net Name of Excavator Primary Phone# SAME Street Address Emergency Phone# City/Town State Zip Email Name of Property Owner(s) Primary Phone# PIONEER VALLEY HABITAT Street Address Emergency Phone# 278 BURTS PIT RD City/Town State Zip Email FLORENCE MA 01062 Insurance Certificate# Policy Expiration Date ON FILE Name&Contact Information of Insurer ON FILE Dig Safe#& Start Date from Dig Safe Ticket: 2023-090-6182 5/6 -a3 (w ag a3 a i . Project Description/Location of Work. Provide the following: ® Description of purpose and exact location of proposed work including description of what is to be laid or repaired in the proposed trench (e.g. water pipe,sewer pipe, drain pipe, gas line, power line, communication lines, etc.) ® Sketch or drawing showing all proposed work. ®Anticipated Start of Work Date. Description: 278 BURTS PIT RD TRENCH FOR ONE SEWER AND WATER LINE FROM STREET MAIN TO HOUSE PERMITS ASSOC WITH THIS TRENCH W22-23 S16-23 *** CHIMNEY REQUIRED Check if applicable: ❑ Emergency ® Work on Private Property ® Work in Public Right of Way ❑ Work within State Layout(attach State Permit) ❑ Work within 50' of a Public Shade Tree(see attached Public Shade Tree Regulations) ❑ Tree removal required(see attached Public Shade Tree Regulations) ❑ Tree protection,trimming,or root pruning required(see attached Public Shade Tree Regulations) ❑ Work within 100' of a wetland or 200 Ft. of a stream or river (attach Permit) ❑ Work within floodplain (attach permit) ❑ Public Water/Sewer/Drain Entry Permit(attach permit. if available) ❑ Driveway Permit(attach permit, if available) ❑ Pole and Wire Petition (attach approval) Pg.214 • ti , By signing this form,the applicant, owner and excavator all acknowledge and certify that they are familiar with, or, before commencement of the work, will become familiar with, all laws and regulations applicable to work proposed, including OSHA regulations, M.G.L.c.82a,520 CMR 14.00 et seq.,and any applicable municipal ordinances, by-laws and regulations, and they covenant and agree that all work done under the permit issued for such work will comply therewith in all respects and with the conditions set forth below. The undersigned owner authorizes the applicant to apply for the permit and authorizes persons duly appointed by the municipality to enter upon the property to monitor and inspect the work for conformity with the conditions attached hereto and the laws and regulations governing such work for the duration of the construction. The undersigned applicant, owner and excavator agree jointly and severally to reimburse the municipality for any costs and expenses incurred by the municipality in connection with this permit and the work conducted thereunder, including but not limited to enforcing the requirements of state law and conditions of this permit, inspections made to assure compliance therewith,and measures taken by the municipality to protect the public where the applicant, owner or excavator has failed to comply therewith, including police details and other remedial measures deemed necessary by the municipality. The undersigned applicant,owner and excavator agree jointly and severally to defend,indemnify, and hold harmless the municipality and all of its agents and employees from any and all liability, causes or action,costs and expenses resulting from or arising out of any injury, death, loss or damage to any person or property during the work conducted under this permit. By signing this form, the applicant,owner and excavator acknowledge that they have read and understand all the information set forth in and referenced within this application package and that they agree to comply in all respects with the requirements therein. Applicant Date Excavator Signature(if different) Date Owner Signature(if different) Date Pg 3'4 To be completed when approved permit is picked up. By signing below,the applicant acknowledges and agrees to all the conditions of approval stated below and validates this permit. Applicant Date For City Use—Do not write in this section Department Approvals/Comment Water: 3/31/2023 Sewer/Storm Drain: 4/7/2023 FPC: 4/7/2023 Streets: 4/3/2023 Traffic Signals: 3/31/2023 2019 ❑ Subject to 5-yr. pavement moratorium Road last paved: /1 Special Conditions: C MfYlAel 1 t h _ Agar„ L .2c _1. c4- Fee ® $250 Permit Application received(Check payable to the City of Northampton) ❑ Waived. Reason: ❑Tree mitigation: Permit Ap al __ _ 7 -I I 1 Director of Public Works Date Pg 4 4 >< .n 2 A ‘ II* • Home Energy Rating Certificate Rating Date: 2023-02-24 \fi U Projected Report Registry ID: LH. , Based on Plans Ekotrope ID: LMkk6Yry HERS® Index Score: Annual Savings Home: Your home's HERS score is a relative Lot 2&3 VB Farm Burts Pitt Rd 3 performance score.The lower the number, 4 1 46Northampton, MA 01060 the more energy efficient the home.To Builder: learn more, visit www.hersindex.com *Relative to an average U.S.home Pioneer Valley Habitat Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtu] Annual Cost criteria of the following: Heating 8.6 $565 ENERGY STAR v3.2 Cooling 0.5 S32 ENERGY STAR v3.1 Hot Water 1.7 $113 ENERGY STAR v3 Lights/Appliances 14.4 $940 2021 International Energy Conservation Code Service Charges $180 2018 International Energy Conservation Code Generation(e.g.Solar) 0.0 $0 Total: 25.2 $1,831 HERS Index Home Feature Summary: Rating Completed by: ww.town Home Type: Single family detached so Model: N/AEnergy Rater: Mark Bashista Exis oo Community: N/A" RESNETla 7580975 Homes 0 Conditioned Floor Area: 1,412 ft2 Rating Company: New England Energy Raters 1ONumber of Bedrooms: 3 198 Sylvester Rd Florence MA 01062 03 ReferenceIl0 Primary Heating System: Air Source Heat Pump•Electric•13.5 HSPF 43 570 5750 Home0 Primary Cooling System: Air Source Heat Pump•Electric•30.5 SEER Rating Provider: Performance Systems Development 0 Primary Water Heating: Residential Water Heater•Electric•4.3 Energy Factor 950 Danby Rd,Ste 201P,Ithaca NY 14850 0House Tightness: 1 ACH50 607-277-6240 0Ventilation: 64 CFM•32 Wattsso 0 Duct Leakage to Outside: Forced Air Ductless irk Above Grade Walls: R-30 0 This Home Ceiling: Attic,R-60 1‘) / a so Zero Energy Window Type: U-Value:0.27,SHGC:0.27 Foundation Walls: N/A Mark Bashista,Certified Energy Rater et uttve ' `eon Framed Floor: N/A Digitally signed:2/28/23 at 6:03 AM ekotrope The Energy Rating Disclosure for this home is available from the Approved Rating Provider. This report does not constitute any warranty or guarantee.