30D-010 (3) 326 BURTS PIT RD BP-2021-0129
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:30D-010 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:demolition BUILDING PERMIT
Permit# BP-2021-0129
Proiect# JS-2021-000207
Est.Cost:
Fee:$30.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 257004.00 Owner: NUTTELMAN MELISSA A
Zoning,_SR(100)/WP(26)/ Applicant: NUTTELMAN MELISSA A
AT. 326 BURTS PIT RD
Applicant Address: Phone: Insurance:
326 BURTS PIT RD (413) 584-5544 (�
FLORENCEMA01062 ISSUED ON.81312020 0:00.00
TO PERFORM THE FOLLOWING WORK.-GARAGE/BARN DEMO
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.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 8/3/2020 0:00:00 $30.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
MUNICIPALITY
Massachusetts State Building Code, 780 CMR
USE
Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011
One- or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: — ' 2 Date Applied:
L.oUls 06 �r c Ut C 1 112,0
Building Official(Print Name) Signature }a e I o 0
SECTION 1: SITE INFORMATION1-U 2
0
Proper Address- 1.2 Assessors Ma Parcel NumbCZ
er oN a-
1.1 s
LO
1.1 a Is this an accepted street?yes no Map Number Parcel Number M o
�_
1.3 Zoning Information: 1.4 Property Dimensions: J LL
J� act f• ��S W o0
Zon ng District Proposed Use Lot Area(sq ft) Frontage(ft) w
0
1.5 Building Setbacks(ft) I
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 H Private❑ Zone: Outside Flood Z,pne? Municipal I//On site disposal system ❑
Check if yes
SECTION 2: PROPERTY OWNERS�H�pI�P'
2.1 Owners of Record-
Name(Print) City,State,ZIP
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ o,Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ld Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
SECTION 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 $
Suppression) Total All Fees: $
City of Northampton
s' Massachusetts
DEPAR2WNT OF BUILDING INSPECTIONS y.
212 blain Street • Municipal Building ve• cD�
Northampton, MA 01060 ssrjy••3;j��o
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS,POOLS, DECKS,ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
1. Building Permit Application signed by legal owner and filled out by owner or authorized agent.
2. One set of plans and specification of proposed work(digital and hard copy).
3. Site Plan with location of proposed structure(s)and setbacks.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new/replacement windows).
8. Home Owner's License Exemption Form filled out and signed by homeowner(if applicable).
9. Note any Conservation and/or Special Permit requirements (if applicable).
10. Driveway Permit(if applicable).
11. Proof of Water and Sewer entry fees paid(if applicable).
12. Trench Permit-public land by DPW/Private land by Building Dept.
13. Stretch Energy Code—all new construction will require a HERS Rater Affidavit to be submitted with
permit application before issuance of permit.
IT
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ ❑ Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Mason
ry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
H
HIC Company Name or HIC Registrant Name IC Registration Number Expiration Date
No.and Street Email address
Cit /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
contained-'n this ap lic 'on is true and accurate to the best of my knowledge and understanding/
e
Print Owner's or Authorized Agent's Name(Electronic Signa re) Date
NOTES:
I. 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"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP 36 1D LOT: 1
LOT SIZE: aG r00�
REAR LOT DIMENSION:
REAR YARD.
J �
SIDE YARD SIDE YARD
FRONT SETBACK
J
FRONTAGE
City of Northampton
S
Massachusetts --' s,��``
`G
=1, DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 rsVjy <��
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:
The debris will be transported by:
Name of Hauler:
3 �
Signature of Applicant: Date:
r
The Comnson wraith of Massachusetts
_ ( Department of Industrial Accidents
-- I Congress Street,Suite 100
- Boston, AIA 02114-2017
www mass.govldia
I$wkers'Compensation Insurance Allidavit:BuiWersiContraeterstEkctrician&/Plumbers.
TO OF FILED W1111 TIM I IEWMITTING AUTHORITY.
Apolicant Information Please Print Le ibly
Natne(Business,'Orgatimationrindividual):
Address: �/` �f
/ 1,111&e--19 --
�oZ � ��r�
City/State/Zip: 6 l O Phone#: y�S ���✓ Q �S/
Are sur an employer'Check the approprhte Har:
Type of project(required):
1.❑1 am a employer with cm>Qltiyeitit(full and or pan-time).• 7. New construction
2{n 1 am a sole pruprietca or pannerahip and have no employers working for nn.in $. emodeling
any capacity_[No wurlim'camp,imurmcr required.]
9. 13t"tllUiltlOfl
3�1 a hunuiowr a doing all work myself.[No v orkcrs'comp.inxrrmwx rrgwmd.J-
0 i. 1 am a huttncownrr and will be[tiring uowr[tselun to conduct all work on my praipe.-r[y. t x ill 10 Building addition
emum that all coutruetors ritber]wvr wariters'crtrnperuatirm imurame a are yule 1 I a Electrical repairs or additions
pwprickm with no empluvm_
12.0 Plumbing repairs or additic►tns
5(3 l ami a Sawral cumrractor mid 1 have hired the sub-curitracwn listed on dsc suaacd shce t- 130 Roof repairs
There sub-cuntraciom have employees and have wurken'comp.imurance.•
6.❑We are a c<npor&1iuri ora!its officen have exercised[heir right of c%cnV6 m per N46L c. 14.[3 Other —
I3 @I(a).and we have no empluyees.[No women'camp.inyuramcereyuinvl.]
*Any applicant that diecks brut a merit also fill out the wctiort below Aiming their wurkcrs'c•vntpcn%atton puticy utfurinati m
+Humeowncn what sul"nit this affidavit utdicatine dwy are doing all work and then hire outside c•tnttra.•tor>intra�ubnu[a rices afftda4 it indicating such.
'C'untractors that check thi,box must arta•Ixd an %J btiunal shtel showing the name of dtc sulr.cmtr-a..tun and,talc u hohe:r or not dto-w attitic�ha�c
cinpluvecs. If[Ix sulrcvntr ictcvs have enrplu}ucs.du y must prvt idc their uorkcn-.xnnp,puliti}.monger
I am aro entplo}err that is protulding n-orkers'compensation insurance for my empl(trees. Below is the lWicy and job site
information.
Insurance Company Name:
Policy#or Self-ms.Lic.M Expiration Date:
Job Site Address: City/State zip:
Attach a copy of the workers'compensation polio'declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a tine up to S1,500.00
andr'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.40 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do h�cdfiyer th ire nd pen es of lreriur►'that the Information provided a re is me and correct
�,
Si at llatti: _
Phone#: �� S�� ��' �✓�
Official rose only. Do not write in ebb area,to be completed b)'city or town offtciat
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health Z. Building;Department 3.City/Town.Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Conlact Person: Phone#:
City of Northampton
' Massachusetts
G
DEPARTMENT OF BUILDING INSPECTIONS ti
212 Main Street • Municipal Building
\ Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, L (insert full legal name), born nsert month,
day, year),hereby depose and state the following:
1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a
parcel of land to which 1 hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption,
does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 1IO.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.85.1.2:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which thE,re is, or
is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use
and/or farm structures. A person who constructs more than one home in a two-year period shall not be
considered a home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for
and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work
on my parcel, I am not engaged in construction supervision in connection with any project or work involving
construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any
provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my
parcel, I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this--2Z day of� �120,-2e.
(Signature)
326 BURTS PIT RD BP-2002-0528
GIs=: COMMONWEALTH OF MASSACHUSETTS
Map:Biock: 00D 010 CITY OF NORTHAMPTON
Lot: -001
Permit: i3l i I I C?
Cateaon: demolition BUILDING PERMIT
Permit 3P-2002-0528
Project= JS-2002-0805
Est. Cost:
Fee: S 10.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
LotSize( ft.): : 57004.00 Oa'tier: NUTTELMAN'' MELISSA A
zoning: SR Applicant: NUTTELMAN MELISSA A
6 BURTS P
Applicant Address: P/tot Lisuratice:
326 BURTS PIT RD 413 5544
FLORENCEVIAO10 ISSUED OV.11127/010:0 0:0 0
TO PERFORM T LLOWING WORK:DEMO BARN
POST-THIS-CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of«firing D.P. V. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimnex:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATI T OF
ANY OF ITS RULES AND REGULATION'S. '
Certificate or Occupancy Signature:
Fee Tape: Receipt No: Date Paid: Check No: Amount:
Building 11'27 01 0:00:00 ;201 S10.00
212 Main Street, Phone(413) 587-1240, Fax:(413)587-1272
Building Commissioner- Anthon% Patillo
IRON PIPE FOUND
'po
q2 STORY8�� 7 O
WOOD FRAME
HOUSE
t'ARAGE/
BARN
,Ap SHED,*FENCE
A� NATIVE
STONE
Lj i��� FOUND
N/F
NUTTELMAN
G
AREA =
6. 160 ACRES {
OVERHEAD ELECTRIC LINES
CROSS PROPERTY IN THIS AREA
y� N/F
WARNER
TRUSTEE OF THE -
^� �� DAY ESTATE
�,,,-
�� .
• � ,�`�
*�' ;�
� �a�. � ,at vim' � �.ifv" .
: -, 'a- '�
"•�
�,. ,,
,,�.
4:
-�W,.,'C�1,. ..t._
�"'� `+�#
._
r,
J� '+ � '�»
:.� Sr
,. y. , k� r
e�+' P'q
.1, y �' 7 .i �e
��{
`.. _i' R r
tv"
� 9.c
��
4;
;� ,.� ��e
r
,�.t,
t�i�.% �. �'...
sS a
v
t
�w
i,
l 4 �Yv1 a:.� r i'���• S� -R�9 �. r �1Y..,K;y .� ri `�. t. C
Y
1
I .
.n
\ F I
.!y
`� k
July 31, 2020
Hi Kim —
Thank you for your help with the barn demolition building permit to
start the process so my mom can move in later this year.
have attached the permit application, a copy of the prior permit,
photos of the barn, a marked property map and the check for $30.
Please let me know if you need anything else.
Randy Baker has contacted digsafe and tentatively scheduled -the job
for next week if the permit is okay.
Stay safe and have a good weekend.
Melissa Nuttelma
326 Burts Pit Rd
Florence, MA 01062
(413) 584-5544
mnuttelman@comcast.net