30D-019 (3) The Commonwealth of Massachusetts
City of Northampton
tl ACertificate of 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 Name of Building of Space Within, Building Owner, or Permit Holder Certificate No.
Issued to
Pioneer Valley Habitat for Humaninty Inc. BP-2023-0523
Identify property address including street number, name, city or town and county
Located at
278 Surts Pit Road HERS Rating
Florence, Hampshire, Massachusetts -10
Use Group
Classification(s) Single Family Dwelling Unit
This Certificate of Occupancy is hereby issued by the undersigned to certify that the premise,structure or portion thereof us 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 30D-019
Building Official /( Issuance 9/16/2024
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
� 3/— 3 ;55 T'u 54-'5 O:a. 8-8'23 k.i e
Underground Service: Meter: Footings:,1Z si,'/43 1 4 Iv
Rough:/-3/ Rough , ///- .2l( House # Foundation:0,v 5 222-�3 g.e
1—\
Final:6 r'Z... Final:g)241 ggdynci Final: Rough Frame: Y 77Zc sc:'SO4G 1Z6 13x,e
Gas: n ________Fire Department Driveway Final: Fireplace/Chimney:
,.-.o.t2> '" 0.‹ -7.3 25Ki1Z
Rough: Oil: Insulation:re 2-2'1- 2,1 lc, I
Smoke: Final: FAIL 9•?•VI git Co )
Olt- 4-!(d--Z1l 5 p
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: $708.60
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
27' / W2T6 PO- /1
Common wealth of Massachusetts Official Use Only
I� t Permit No. C- t ZO2-(— O o 2
Department of Fire Services
T y Occupancy and Fee Checked
.,,,.� � BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank)4.2,0D—
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
* . All work to be performed in accordance with the Massachusetts Electrical Code(1qC), 27 CMR 12.00
(PLEASE PRLVT DI INK OR 7YP�L� ORMA Old) Date: Z- // / 2 de--I/
City or Town of: //O/7 rl 44r pro`'/ To the Inspector of Wires:
By this application the undersigned gives notice of hisl or her intenti to perform the electrical work described below.
Location(Street&Number) a7' /1 .s PI,/ x�
Owner or Tenant �;o 'e" /V4 6,44`( 4 r 4lr,tt �y.1,�L/ Telephone No.y/3 5& S'Y3D
Owner's Address /yD ! 1 n t S r -I- ,/du��iy6c /14 /4.) e' ' Z
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building i-A.tt G Utility Authorization No.3o9 30 7-13
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters
New Service D I Amps /2 0 / Z V o Volts Over ead Undgrd El No. of Meters /
Number of Feeders and Ampacity 2 L/D
Location and Nature of roposed Electrical Work: L./ r tp,„ ` l pa 4..e `i O .G , pe- /
am0 thy. , Pir0l'i
Completion of the following table may be waived by the Ingoector of Wires.
—NoNo.of Recessed Luminaires No.of Ceil.-Susp. Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No. of Luminaires Swimming Pool Above In- No.of Emergency Lighting
g grnd. Li grnd. Battery Units
No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.ofn Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Tons 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 ❑ 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 Telecommunications Wiring:al
No.of Devices or Equivalent
O1'BJ R: '
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 ❑ OTHER 0 (Specify:)
I certify,under the ains and ze_naliieseV-perjury/th the information on this application is true and complete.
FIRM NAME: .11 i el J LA'1LL E(tG-N i G rot • LIC.NO.: i e-2 pljrj
Licensee: �.ev j n I t J .�-t. `' • Signature 9.(., ?../.w i LIC.NO.: 31 ' t7b i
(If applicable, n er "em�pt"i the li ense nu ber i .) Bus.Tel.No.: Nit 5-3 0 AJ-
Address: /72 r-rorT -ee C, ,,to/-'d 14# t /Oz u Alt.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 ❑owner's agent.
Owner/Agent
Signature Telephone No. 1 PERMIT FEE: $
irktm tw- h f /
Ck-4q'.67z 4t19S.�
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUM BING WORK
tt,..itCITY/TOWN /VQ. i 4e1111-00 MA DATE S- C PERMIT# lie2U23-0_, r D D / 1�— JOBSITE ADDRESS .27o Dvrts P f RA OWNER'S NAME ,Mt_p; ti Fr" gilei iiil
P OWNER ADDRESS 1 YO Pine' . F/Ore/Cey /'?A TEL y/3'" $8 "Sy3O FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL4
PRINT �{
CLEARLY NEW:�l 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 I
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIUSAND SYSTEM
DEDICATED GREASE SYSTEM _ _
DEDICATED GRAY WATER SYSTEM — _
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER I
DRINKING FOUNTAIN
FOOD DISPOSER r
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
.4 _ _ _ _
..
LAVATORY
ROOF DRAIN ,
SHOWER STALL I'LUr 1BING & GAS NSPECTOR
SERVICE I MOP SINK NOR"'HAIy1 PTON
TOILET , a APPitaILED NOT APL LOVED
URINAL
WASHING MACHINE CONNECTION f
WATER HEATER ALL TYPES / .
WATER PIPING 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
LIABI_ITY INSURANCE PO,.ICsi AI 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 0
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this applicat on are true and accurate to the best of my knowledge
and that at plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General�aws.
PLUMBER'S NAME r'/nM41/1d -ArnoUr LICENSE# IS074 SIGNATURE
MP,f JP❑ CORPORATION❑# PARTNERSHIP❑# LLC❑#
COMPANY NAME 5m;t1/ l 'h."At/f.c,:^4/ l?',�h SdO,4 ADDRESS CFO L&cji _51-
CITY /VQ(1'h0,7kk/1 STATE/IE ZIP 0/60 TEL 'fr3'SLP7-/y/y
FAX CELL 1#3`aI04730 EMAIL R/L4/,.,v./�S/'2ith teC flit
. ,,o/ //940