30D-016 278 BURTS PIT RD COMMONWEALTH OF MASSACHUSETTS BP-2021-1737
Map:Block:Lot:30D-11111,
001 CITY OF NORTHAMPTON
Permit: Demo
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1737 PERMISSION IS HEREBY GRANTED TO:
Project# Contractor: License:
Est. Cost: 50000 Todd CELLURA
Const.Class: Exp.Date:
Use Group: Owner: NORTHAMPTON HOUSING AUTHORITY
Lot Size(sq.ft.)
Zoning: SR Applicant: Todd CELLURA
Applicant Address Phone: Insurance;
135 Southampton Rd. 413-977-6608
WESTHAMPTON, MA 01027
ISSUED ON:08/18/2021
TO PERFORM THE FOLLOWING WORK:
DEMO HOUSE&GARAGE
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.
Signature:
• 52 Tit
If
Fees Paid: $
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
File #BP-2021-1737
APPLICANT/CONTACT PERSON:Todd Cellura
135 Southampton Rd.WESTHAMPTON, MA 01027 413-977-6608
PROPERTY LOCATION 278 BURTS PIT RD
MAP:LOT 30D-016-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $ ijo
Type of Construction: DEMO HOUSE&GARAGE
New Construction
Non Structural Renovations
Addition to Existing
. Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INVORMATION 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 WaterAvailability 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
11 j
Sign ure 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 o
Planning&Development for more information.
The Commonwealth of Massachusetts OR
s,t; . Board of Building Regulations and Standards •
W1114 Massachusetts State Building Code, 780_MR R EC E IV �SE� 1 Y Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 4 011
One-or Two-Family Dwelling AUG 1 6 2021
This Section For Official Use Only
Building Permit Number: Date Applied:
r,tv i.�BWLry 3G.. Fcriabis
I �cir NORTHAMPTON.MA 01060
Building Official(Print Name) Signature I s.t�
SECTION 1:SITE INFORMATION
1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers
7� 3urfps ??1, lZvwt �0 D O / Co
1.1a Is this an accepted street?yes"( no Map Number Parcel Num
bet
1.3 Zoning Information: 1.4 Property Dimensions:
rep.# r�ler
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 I Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Publiejel Private D Zone: _ Outside Flood Zone? Municipal❑ On site disposal system fig
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of
Recor
Name Print to- �1(9r I
i rlt fi Ct✓t-14 k6 M 1 C,/�°
(Print) City,Sae,ZIP
�. i ca /% c,,,ft S ,
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑
Demolition il Accessory Bldg. ❑ Number of Units Other El Specify:
Brief Description of Proposed Work':
1-3,e i z) is A beL1s e - 61 w4 r .s A.1'
N.
err C cle., I i
Li ?� -p e'gyp✓1
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials) .
1.Building $ d 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 00 Standard City/Town Application Fee
0 Total Project Cost (Item 6)x multiplier x
3.Plumbing $ O 2. Other Fees: $_
4.Mechanical (HVAC) $ 0 List:
5.Mechanical (Fire $ 0 —
Suppression) Total All Fees: /6
-' Check No. eck Amount. Cash Amount:
6.Total Project Cost: 0 Paid in Full ❑ Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5,1 f or rtrretign Srncrvi nr i i77n�e (CSL,) I Gs.,. 06 Q 116 0I/19 70 2 3
L� 46 7 Ce 10,c 41 License Number Expiration ate
Name of CSL Holder
ri
�� �s��� j � �u' �� � C � List CSL Type(see below) �y1 (1 5��' I c �
No.and Street (� Type Description
U Unrestricted(Buildings up to 35,000 Cu.ft.)
�.�e �j /� �'� __M_ 0 >� Z R Restricted 1&2 Family Dwelling
City/Town,tate,ZIP / M Masonry
RC Roofing Covering
gosh„re_.` WS , Window and Siding
i 1 cf,.5,0, SF Solid Fuel Burning Appliances
7ji e77 440 ire-)10r9e 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 AleFIDAVIT(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 Yam` No 0
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 and the pains and penalties of perjury that all of the information
contained in this application is true and ace to the best ,. /y knowledge and understanding.
/
7;;D>C . C tIlc Vr`f C. 31/3 7°2/
Print Owner's or Authorized Agent's (Electronic S�i. -) 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/dos
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
N j '. Massachusetts �wr .e
/. G
k'�v` . DEPARTMENT OF BUILDING INSPECTIONS v 1 :;
,:y 3f 212 Main Street • Municipal Building JL �a
Northampton, MA 01060 T'i;:A:-:.i .-
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: ‘ 6 /1 ( E M Alv 70ke 44 4 v. 41
4oc, a tZ of }3c7 i).el, il, I,0''C c IC.P rC s (--) `,S fe h plc v S
The debris will be transported by:
` f
Name of Hauler: s c`;o : hfrff 0 ‘ I4( 1.-)�'2CKCt�5
S
Signature of Applicant: Date: , / 20 z1
The((romionovea!tm of Mttccrtelsti.cetlrs
Department of Indrrstrial,4eeidents
,Im I congres s Sheet,Suite 100
ti I—t tf_ 1
rod �taw" Boston,MA 02114-2017
R www.mass.gov/dia
asc.gci/daft
t
%Lo ers' Compensation Insurance Affidavit:Builders/Contractors/Electric ans/Plunthers.
7'a Ill: ILI i)Willi'IRE PIr R IT1'1 (( All'1'IIOIIJTY.
Name
Information
r Please Print Legibiv
Name(Business,.organizationfindividuali= O • V-C i •c ✓t �0 .i. '' '/-5 .
Address: / '>r $OQ {-1q k� eoi,
P Cyr
(
City/State/Zip: ,k..st-ki cs [i[! / 4 7)o27 Phone/i: Li)3 'r / 77--c
Are van um entptayee awl the 2Jtpraltra box.: � �r ro Type of project(required):
111 It
a 1 ant a employer with_,_,__employees(fail curler part-timcl.'
g ?_ New coustl trt'tiort
2 Lam a suJr pruptietur ur i.sa tauatnp wad have nu employees workin.' for nx lb a. 0 Ret3lttdebrng
any capacity_(Nu tturkeca'camp,insurame reclaim].)
9_ 0 Delnoiitian
301 am a.lianse... .mkt&Jag all Yeark myself.INN welia.M'0u041_1I1.7tIrsiigC EVI IUnCJ.]-
i(J 0 Building addition
4.01 ate a Iutrtteznaner rued will'be hunts eaattraahors to ouricluLi ail murk on my tiroiterty. J dill
answer ihrii all sYuriru'lurz Lith ar luiae tt'4n er5'NWItpl n ATiwI LltsUranll LIT ace si)le l i C Electrical repass or additions
prnprileru a with nu employees.
i 2.0 Plumbing repairs or additions
SO I aai a penrrni ccrmrraetur WWI bate hired the zinc-cuntraetorr limed an the:-line in l abed-
, These nub-caatrmctarr.I have empluyeuand Isa4c warners'comp.utattramee.r 13.0 Roof repairs
ti O we ate a euvraraiuu utua its officers Lem:exercised their right of c2u'a71rlala per(tilt')!L.
14. [her
IS',§11-ll,end we hate no wiroloyees.(Ni %rankers'eencip.ia:huruhee rcyuiraii]
Ana appLie nu that checks lilt 44J lmtiat aliu all uut TJk iettiott below showing their Wurittzs'ontpertsutiun'tuLiew otfina iatioa.
Hoicieuseciers tvba Itabenit this of ed t it i u aline they arc Joing null work and ten tiveeer3itlr cintlranetecs mtvt suhtrtir a Dew of ida4 it tndicakg such.
UCuntraeturs dot etleekthl]1'e]must tatxzlieil an additional sheet sho4Itlfg'Elbe name older call-cuniraz:Ldlri amt.sta4'wia--Ilacr Ur oral[Ruse emtlta:i lla4'e
OtapluVeni. If the slab-euracaetur'a b94..employees.they Ileasi pN4ulc their workers.colap.isahey muckier.
i dine cur employer that is providing(workers'compensation insurance for my employees. Below is the pnlicy Wirt job site
infarmnt/wi. / /� ?
lnsionm a Company Name: A ( ,, /(/J U ei, SV✓/Ce all C.< ID itfGe''i,
Poliey#of Sel€-Etas.Lie..#; ltA) 1,4.Z._.g(!Co TIT Z t f Expiration Dare: 7/1/22.
Job Site Address: 2-7 .7 i( 's f2 flt- act(4 City/State&Zip:ji Lit1 o0v/"IA 01a27
Attateh S copy of the workers:'compensation policy declaration page(showing the policy comber and eYt ipirittion dated.
Failure to secure coverages required under NIGL c.. 152, §25A is a criminal violatiori punishable by a fine up to S1,500.00
and/or one-year.Imprisonment,as well as civil penahies in the firm of a STOP WORK ORDER and o fine of up to S250.O[)a
day against the violator.A copy of this 3tateartent may be forwarded to the Office of liwestigatialis of the.D°IA for insurance
coverage verification.
I da ker' eby certify ashler the . f ,s and penalties a rfitry(brut the err,'armrrtion p-rcn ided a vie is rue and correct
Si2na ure: C / i ( Date: 5( i Z1:72.-/
Pbora #: t�
Official use wily. Do not write in this area,tv be completed by thy or tom official I
City or Town: PermWLkense#
Issuing Authority(circle one):
1.Board of lieaith 2.Building Department 3.City'rrowu Clerk 4.Electrical Inspector 5.Plumbing inspector
b..Other
Contact Persona: Phone#:
EVERS'URGE
August 13, 2021
Sovereign Builders
278 Burts Pit Rd
Northampton, MA 01060
E-Mail: dbailey@sovereignbuilders.com
Re: 278 Burts Put Rd
This is to inform you that there is no Eversource Gas Service at 278 Burts Pit
Rd, Northampton, Ma 01060
Sincerely,
Shcw ii 'Ferri'
Shauna Ferris
Eversource Gas
Office: (508)930-5841