30D-018 (3) The Commonwealth of Massachusetts
r )4, City of Northampton <;.;e126 ,
of Certificate Occupancy
In accordance with 780 CMR, (The Ninth Edition of the Massachusetts Residential Building Code)
this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified.
Identify Na111e of Building of Space Within, Building Owner, or Permit Holder Certificate No.
Issued to BP-2023-0522
Pioneer Valley Habitat for Humaninty Inc.
Identify property address including street number, name, city or town and county
Located at
286 Burts Pit Road HERS Rating
Florence, Hampshire, Massachusetts - -4
Use Group
Classification(s) Single Family Dwelling Unit
This Certificate of Occupancy is hereby issued by the undersigned to certi that the premise,structure or portion thereof as herein specified has been inspected
for general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified
below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with
conditions or,tampering with the contents of the certificate is strictly prohibited
Conditions of Use Single Family Dwelling Unit
All fire protection and life safety systems must be maintained, and all means of egress must be kept clear
Name of Municipal Date of Final Map/Plot:
Building Official Kevin Ross Inspection 9/16/2024
Signature of Municipal ' Date of
Building Official /C Issuance 9/16/2024 30D-018
�" BP-2023-0522
PIT",� COMMONWEALTH OF MASSACHUSETTS
ck:Lot:
3 =, 8-001 CITY OF NORTHAMPTON
Pena:New Build
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
.. -:,:i # BP-2023-0522 PERMISSION IS HEREBY GRANTED TO:
Ficiect# NEW HOUSE 2023 Contractor: License:
PIONEER VALLEY HABITAT FOR
Est.Cost: 187850 'HUMANITY INC 046013
Const.Class: etxp.Date: 04/14/2025
PIONEER VALLEY.HABITAT FOR HUMANITY INC
Use Group:` Owner: C/O RACHEL BORSON
.Lot Size (NA.)
Zoning: ' '••. Applicant: PIONEER VALLEY HABITAT FOR HUMANITY INC
Applicant Address Phone: Insurance:
140 PINE ST 413-5k6-5430 C69323595
FLORENCE, MA 01062
ISSUED ON:05/01/2023 0
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: /c Service: ' Meter: Footings:
Hong a. Rough:`),` m_.al House# Foundation: rl ,v S 2-
t.- ,
Final:6--/3— Final: Final: Rough Frame:0,I€ 2-I S•2ti K"0
g(Le etc.ww4.
Gas - Fire Department Driveway Final: Fireplace/Chicnnrv":
`'.* Rough: Oil: Insulation: '`, f
C K Z-gPi 2,4 ,✓� 1
Smoke: Finel y.99-3-24 5SA' x"MO)
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY JF ITS RULES AND REGULATIONS.
Signature: r
i
Fees Paid: $708.60
*r. 1
.
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212 Main Street,Pl.one(413)587-1240,Fax:(413)587-1272
Office of the B..ilding Commissioner • ai
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z86 6u?fi5 f aT eb
Commonwealth of Massachusetts Official Use Only
m �� 1,111 Ft Permit No. P-2O2y— 00 '7
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Department of Fire Services
1 E ,q" Occupancy and Fee Checke I3.C)
' BOARD OF FIRE PREVENTION REGULATIONS' [Rev.9/05] (leave blank) '2�D `=
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),537 CMR 12.00
(PLEASE PRiNTININK.OR TYPE ALL INFORMATION) Date: 2 / / /2 D 2,y
City or Town of: fi 0,./h )lovl To the Inspector of Wires:
By this application the undersigned gives notice of his o her intention to perform the electrical work described below.
Location(Street&Number) a , / a u r is I ,•' le/)
Owner or Tenant f j u n 4„-e r �g i)e 4 4-14 r jilt Al Sri i Telephone No.`in J?d i-rje
Owner's Address ) y# P i r� $- o a Ct Flo 1//1,n e c ifl'" Q Jo`p 2
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box)
Purpose of Building Ho hi L Utility Authorization No.Se9 30 7 7C
Existing Service Amps / Volts Overhead 0 Undgrd D No. of Meters
New Service 7 I a Amps PO / ,Z Y'Volts Overhead Or Undgrd ElNo.of Meters
Number of Feeders and Ampacity 3- 7/G A/
Location and Nature of Proposed Electrical Work: (A) ►\ ✓l S 0 AQw ,I7 m i e i n ,,,
o o Awl, Se i-v;e-_
Completion of the followingtable may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf Total
Transformers KVA
No. of Luminaire Outlets No.of Hot Tubs Generators KVA
No. of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grid. grnd. Battery Units
No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
and
No.of Switches No.of Gas Burners No.IfDetec
Initiating Detection on Devices
No.of Ranges No.of Air Cond. Taal No.of Alerting Devices
No. of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained '
Totals: Detection/Alerting Devices .
No. of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No. of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total HP 'TelecommunicationsofDeiceor Wiring:
No.of Devices Equivalent
O IHER: •
Attach additional detail if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:)
I certify,under the pains andReenalties perjruryff thatthe information on this application is true and complete.
FIRM NAME: .i1 i rt J l)L ;be.. t�(eG N i L 1 q in • LIC.NO.: l e—2 9/7/3
Licensee: 111.1v )n .1 W k.4'-c. • Signature 7/..../ �l% LIC.NO.: 5S- rOb (�t
(If applicable,An er "e�pt"i the li ense nu ber �nee.) 0 Bus.Tel.No.: Nt Y f30 S,—
Address: "/72 /`-ron7 s"iv-et (2 to fd 44,4 0/D7Alt.Tel.No.:
*Security System Contractor License required for this work;if applicable,enter the license number here:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $'
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cL4- �S73111
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUM RING WORK
, � - - -
__ CITY/TOWN /l�Of'- cl/9 o_ MA DATE slit/a; PERMIT# /P2 Zo23.-Q2/
- pp 1
JOBSITE ADDRESS a Sh Burt.) R ltL OWNER'S NAME i 6•I1< ( r" /4/7741/7,:fy
POWNER ADDRESS 1 Yo PA's}- Fl rcyce, /"1 P TEL 9/3- SrP 4"sy3O FAX -
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIALA
PRINT
CLEARLY NEW:ik RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO
`
FIXTURES 1 FLOOR-' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB t _ _ - _
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM - r
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER r
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY I t
ROOF DRAIN _
SHOWER STALL 9
SERVICE/MOP SINK PLUMBING & GAS l.S
TOILET f t NOR P-TG N _
URINAL APPROVED f1O'T APPROVED—
WASHING MACHINE CONNECTION d�A
WATER HEATER ALL TYPES
WATER PIPING X X
OTHER
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES k NO 0
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY ❑ BOND ❑
OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER ❑ AGENT ❑
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this appication will be in complianceall Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME ArMntnp1 L4 frincir LICENSE# I S 076 SIGNATURE
MP, ' JP❑ CORPORATION/ El# PARTNERSHIP❑# - LLC❑#
COMPANY NAME Sm;t {�0��1� R4/ /)';-A Sc.Acel ADDRESS (PO LOCvS71 S/
CITY /VP(f'/arf/7/14 STATE/I!/ ZIP 0/6(0 TEL //J-5d7-/'//y
FAX CELL y/3-2/0-o730 EMAIL /7LG1Me))=-r0S�iV/de,Qrr/
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