25C-147 (5) 27 ORCHARD ST BP-2021-1123
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C- 147 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit# BP-2021-1123
Project# JS-2021-001887
Est.Cost:$6500.00
Fee: $43.20 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BELISARIO BURI 100030
Lot Size(sq. ft.): 4007.52 Owner: ZEMELSKY RYE
Zoning: URB(100)/ Applicant: BELISARIO BURI
AT: 27 ORCHARD ST
Applicant Address: Phone: Insurance:
31 EXETER ST (413) 222-2914
EASTHAM PTO N MA01027 ISSUED ON:4/12/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:ADD 18X12 DECK
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.
'i •
Certificate of Occupancy Signature I
FeeType: Date Paid: Amount:
Building 4/12/2021 0:00:00 $43.20
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2021-1123
APPLICANT/CONTACT PERSON BELISARIO BURL
ADDRESS/PHONE 31 EXETER ST EASTHAMPTON (413)222-2914
PROPERTY LOCATION 27 ORCHARD ST
MAP 25C PARCEL 147 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
:
PERMIT APPLICATION C- - . ST
E� LOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid ,` n
Building Permit Filled out 1�i\'{7 t
Fee Paid
Typeof Construction: ADD 18X 12 DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 100030
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INJORMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
Ve/2,1
Sig 1ature of Building Official I Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
RE- "-
_The Commonwealth of Massachusetts A�pp
14 ) Board of Building Regulations and Stlindarr - 5 FOR
� Massachusetts State Building Code, 7 CMR 2021 CIPALITY
r USE
Building Permit Application To Construct,Repair,Rehovr�� ;(7+ " a R ised Mar 2011
One-or Two-Family Dwelling - '.-=toenONs
This Section For Official Use Only
Building Permit Number: 6P'03/-i/d3 Date Appli :
I�, . � � ► ' V 6 be I-I/ iRi
Building Official(Print Name) I Signature /i Datt
SECTION 1:SITE INFORMATION
1.1 PrApeyrty trssottai_ri ST 1.2.2,skrs Map&Parcel N 7bey1 1• Ti ept I/ no Map Number Parcel Number
. a Is this an accepted street?yes
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
Owner-'rof Record5_ ivoirfiatiljiteQnr{ 1-QUreh &fl n t 1M
1 31 C C
t(a4efprintme159 City,State,ZIP
/` - ()) C63/r4 5t ' 'dd 463 /-724 h2erne15kV Clizal (.cow
o.and Street Telephone Email A ess
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied Eld Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2: /S )4 12 Dec if b u I I Ci �D/ a ci S o file
k&cot .
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building /$ Ca Q 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 0 J ❑Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$ )
Check No.I�Jl q Check Amount: Cash Amount:
6.Total Project Cost: $ 6j 50 0 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supe /00 . 03 0 ,p/2 3l2/
c a 0-1,-1 r c� �r License(CSL)
License Number Expiration Date
ame �
of CSL Holder I 9
1 ci e tar 97 List CSL Type(see below) V
.and t �f Type Description
/ f0Y) /ii 0/O G O I I Unrestricted(Buildings up to 35,000 cu.II.)
'/ ( R Restricted 18c2 Family Dwelling
City/Town,State,' M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
Telephone -2Tl/ eI/So ►,-to l I _ Insulation _
Email address C cry-s-) D Demolition
Registered
j Im ovement Contractor(HIC) /d � //9 03/°l/ 7/?
bur('5 l t a 6 C HIC Registration Number Expiration Date
C Com•• y N�p e or HIC Reant Name f)et,
I y t er J/ 5or1 oYXI Kl e Q h ov. c 0%1
o., d `3' t YY1 T t /2 cy06v /1/3-Z 22-z y, Emai mess
City/Town,State/LIP 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 Is ce of the building permit.
Signed Affidavit Attached? Yes ......... ❑ No .❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRAC R APPLIES FOR BUILDING PERMIT
(...,..
I,as Owner of the subject property,hereby authorize V 0,(/sor'(,o 6(A y' (
to act on my behalf;in all matters relative to work authorized by this building permit application.
Roe ?elyietK Li L(pure/l 60YI✓1 1(/572 /
Print Owner's Name(Ele�onic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under ' s and penalties of perjury that all of the information
stained in this applicati is true and occur e of my knowledge and understanding.
1iac ur( __ . 7/5 /2 I
Print Owner s or Authorized Agent's N ignature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
41k.
'"Wir_,---±-.7:1!:.!.. .
'�` The Commonwealth of iIuw,t•husetts
Department of Industrial Accidents
y1 Congress Street,Suite 100
„.,,,,,,..,,,,
Buxton, 11.-102114-2017
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titerj. . ..
ts'wtc:ntcrs.s.'o►•/ttia
S)u leers'('onytensation Insurance.11Tdas it: Iluik rrsi("ontractor.d'Eleetrician )'lumbers.
1l)BE 1114.1)1%I 1 It I Ill,I't:NNI'I-I Its(:AI l 11(1N11 i.
Applicant Information Please Print I_et_ibhName hiiu,ime.s+trsuntrattwr lndividtralj: u,� S i' J'0itcm.._ �,� ( 6
Address:_ _3 __L 7
City/Statc,�Zip:_1 ' . P4 7 4 f'P- Phony : Z/�5 _ 2 Z Z Z /L/
Arc sun an cumin,re'4 heck the appropriate him: T,pr of project(required)_
J 7 1 .i i a.ng1101,01 a otti com,lar,ec.doh:aurae pat-tee t.' 7. D New construction
Jilt a...h.prvprwtan or dwlri.r.Jup and hasc no w-uipk,stt',isot♦itts for one In S. Q Remodeling
.uv..ap:Kil...I`o..otk.r..'catsup.uaurante ruputerti
9_ 71 Ikntolition
0 it sal a IMlail o.ma doing all iitnl rnssdf.INto r amass"comp_m.urur.rtyuir.d_I
•
1.0 i aura Irniwti.w u.l and lr ill hit hiring�.>uluiradt.n i to conduct all wawk*In ut1 reupt-rtt,.. I rt ill
IA 0 Building addition
emote that all emit actor,either Loc.mocktr. ce.trth•t'Ir.antl u tt.11tanst of arc soh: 11 t__1 Electrical rc stirs or additions
propriela.n..Mt t no cmplo,.cs..
12.a Plumbing rtrpairs or additions
1 l am a general comtrj.tau and I his.hind the sub-contractors h.ocd on the:titr.lt.al.Jeer..
I Item:m -c.Kllr"a.tots h.t....nupte ce u and base fnter,'comp. iit.uran ce. 13.0 Roof repairsl'
h.a 11,an a corporation and Its officer,Lis c cacti .td then nip lit a.t c acnud*trint per\K id... 1 ()the,
lS'_.t1 Wilt and os c Moe no cruld t%ccs.IN,outgo.'comp.mom:MCC 1-CqualCtl.
*:UP:applicant Ilia'ana'k.l,i.t 41 Inas!atur till out fh..aciuv.n lo...ti1,m.1n tltcir..ork.r. .a'In' i..ition policy irftuuvuiluu.
' Romano tier.New,ud.init this attoal4.11 nttlic lltW the,aIc doling ail...:1..and then hire otat.id.-conhactois Imb1'skulk IS m.m.air da,le nrttl.:flnni'such.
.d mitt:soots that check ttiis ls... must attached an additional.Its+.)shim oir III.manor.01 Inc.mid*..otttias'l.Ars anal'Jak wlLL1htt um not ttu.•.c.!il9tlt.'.lla.c
.niplur,c.... It Ilw.uh-c,.Intrastaw.hum,:cart lo.cc..the,trtnst pia„4ut.1li.in ,t.+atkcn.'.r.ntip.rn.dw..irrund,ci..
I am an employer that is providing norlkers'compensation insurance for my employees:. Behar is the policy and job site
inlirrntution.
1117,ttt:tnt:c(ompanv Name: _
Policy#ur Self-iris.t.ic. ::: Expiration[gels:
Job Site Address: Cily..''Stale:Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under IIitGL c. 152.§25A is a criminal violation ptmtshable by a line up to S I.5(N)_(MI
and or one-year imprisonment"as as civil penalties in the thin of a STOP WORK ORDER and a line of up to S250.(K)a
di against the violator.A cope'of I is statement may be torssarded to the Office of)nester alions of the DIA for insurance
co%crage‘enlicatitm.
I do hereby cerlify wider •pain. and penalties ofperjury that the information provided above is true and caned.
Signalure e/ l Date: 'y/ /i/
Plum,: -. I/73 "9 ? Z 24/e,/
(If iriul use.only. Do nut write in this area.to be t-omlilete tl by city or lawn ofJFcial.
('its or I-tutu: Perntih'I.icense It
Issuing.►ulhoritl (circle one):
I. Board of Ileallh 2.Building I)eparlmerit 3.0 its I ussn(leek 4.Electrical Inspector '5.Plumbing Inspector
6.Other
( nnlact Person: Phone#:
ri .VIt UIUUI iwCOIt11 VI moDDot.1 wxttJ "- "- - ,.
Division of Professional Licensure
Board of Building Regulations and Standards Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
Construction Supervisor TYPE:Individual
Registration Expiration
3-100030 Expires: 10'23/2021 165619 03/09/2022
BELISARIO BURI _ BELISARIO BURI
31 EXETER ST D/B/A BURPS GENERATION HI&GC
EASTHAMPTON MA 01027
.0 - BELISARIO BURI
31 EXTETER ST �..��L ‘'i/�s�
EASTHAMPTON,MA 01027 Undersecretary
Commissioner 7tL.,%1/. —
J
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
h
C\-)
r,;F
12'
12
SIDE YARD M SIDE YARD
;vY
I !
I i
FRONT SETBACK
FRONTAGE ,.
City of Northampton
QY_im
A• SAS SAC�.
Massachusetts '<<
-� •ir
DEPARTMENT OF BUILDING INSPECTIONS y ,„
212 Main Street • Municipal Building OD
Northampton, MA 01060 5Sfr
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: I/2 to , p
1
The debris will be transported by:
Name of Hauler: /-72- 67C-
Signature of Applicant: %' Date: / 5 /2-
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