31D-156 (2) 12 CRAFTS AVE COMMONWEALTH OF MASSACHUSETTS BP-2021-1869
Map:Block:Lot:31D-156-
001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2021-1869 PERMISSIONISHEREBYGRANTED TO:
Project# roof Contractor: License:
Est. Cost: 22000 BURIS GENERATION HI&GC 100030
Const.Class: Exp.Date: 10/23/2021
Use Group: Owner: GUERRA CLAUDIO
Lot Size(sq.ft.)
Zoning: CB Applicant: BURLS GENERATION HI&GC
Applicant Address Phone; Insurance:
31 EXETER ST (413)222-2914
EASTHAMPTON, MA 01027
ISSUED ON:09/14/2021
TO PERFORM THE FOLLOWING WORK:
ROOF REPLACEMENT
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:
• '' 9:57)•
ri
Fees Paid: $154.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
s
The Commonwealth of Mas - o etts 1.1
Office of Public Safety and Inspecti• ., mG
Massachusetts State Building Code(780 CM -vy��
��i'�� �•7
Building Permit Application for any Building other than a One-o "ly lling
(This Section For Official Use Only) e410%T
Building Permit Number& ' iIf Date Applied: Building Official:
SECTION 1:LOCATION
No.and S t 4VQ City/T wn i Zip Code c��G6o Name of Building(if applicable)
j 3i D — /�Co
Assessor Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building❑ Repair ral Alteration 0 Addition❑ Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No l -
Is an Independent Structural Engineering P er Revie req ' d? Yes 0 No m�
Brief Description of Proposed Work
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft)
Total Area(sq.ft.)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 1-2❑ 1-3❑ I-4❑ M: Mercantile 0 R Residential R-ID R-2 0 R-3 0 R-4 0
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use❑and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA IBD IIAD IIBD IIIAD IMBD ND VA D VBD
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
Public CICheck if outside Flood Zone 0 Indicate municipal 0
A trench will not be Licensed Disposal Site 0
Private 0 or indentify Zone: or on site system❑ required 0 or trench or specify:
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes❑ or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
e
N�e an Address of Property Owner
CIquo10 duerrq 61-S/Var C1r0ls� f-(w-e'ilee n .. .PI /G >�
Name(Print) No.and Street City/Town Zip
Pro rty Owner Contact Information
1.vryieY' - — - Cfau�lcv o5 ,�ler`� �Jyr► ��
Title Telephone No.(business) Telephone No. (cell) e-mail address C/
If applicable,the property owner hereby authorizes:
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0.
Otherwise provide corlstrurtion rontrol forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
I
Compan Name
(6.e1(50rto BO ri
Name of Person R ponsible for C nstruction License No. and Type if Applicable
Meet Address City/T State Zip
P
- - 46-. - Zq 1 u beii r-y, ur-; 6. emh c. c olt
Telephone No.(business) Telephone No.(cell) e-mail addiess
SECTION 11 WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes @'No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ a`2 0 C 67 Building Permit Fee=Total Construction Cost x (Insert here
2 Electrical $ appropriate municipal factor)=$ .
3.Plumbing $ oe
4.Mechanical (HVAC) $ Note:Minimum fee=$�. (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 2 1 (9 (contact municipality)and write check number here
SECTION 13: G RE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby a t nd the p ins and penalties of perjury that all of the information contained in this
• lion is true an accurate to the f my know ge and understan ' g.
, _.._ ( ' .or' till_ 222__lit/ V/0/2/
ea ' t sign natrl Title 2 7 T Iephone o. • pate/
gao#,A,„Tepy, z7w l ho/94. uc(r, joe.cZ)1Street Address City/ n State 'p Email Address
Municipal Inspector to fill out this section upon application approval: ✓ /��� / .13 Zv 2
Name Date
The Commonwealth of Massachusetts
c.�
ii. I_Ill Department of industrial Artie/eats
t ie/ents
-:i I Congress Street.Suite 100
:11_ ,,"1
Boston. �1f i 02 11�1-?(ll"
111‘....,
wrutw:mass.gor/dia
11 eskers'('timprnsation Insurance.Allidas it: ItuildersI("untractors+lectririaus l'Iu Miters.
It)B1: I li i )%%1111 Illl•:PIERMMI I I ING Al fltok11L
on PleasePrint 1. Agibh
NameApplicant Information
( - t•
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Address: 3 ( xe_ e�Y. __ 4>
citylsiatorZip:_, �r1.� r1 U! mom II: '�1. 2 2 2 -'2 g r L
Are iau an employee?Cheek rrc box: Type of y' project I req uiredl:
I.0 1 AIR a et1 a idi a .tie,OVA and mi nrne t..
4� �_ t�t1• 7. 0 New cunatrurtiwi
_` . a.Ktle iwu1$11i►tu ur ikkoanetmhip awl hate no cuyfitw.x,wutkuuc tit nw ill S. 0 Remodeling
airy.'alutity..I?'U wIj LIt ctt107p.Iltti trtn4X nxywnd_l
10(sell a Iruw luv. m net tkone all work yselt.l;\at workers"comp..iiuuralce r .c uitu.l"
9. ❑ Demolition
I00 Building addition
-1.0 I ant a lnwuatw,uir will he honor:VIAIIIla1:1itr:,tU conduct all wtrk mu tut pwperty_ I will
tmUtn that all conkitiesscithur hate winker,'.Ytnp+tasmathat si crane art ate mill. 110Electrical repairs or additions
prt1I f.dtwr.U1111 nt► t1}_
12.❑Plunihiiu repairs or additions
50 I Jul a pausal I hate hoed the a1tt.-camtra.lurs lt+t.J on 11w atta.hctt theta..
them:% -t mince Uri hare tout do:ices and hate wirier.'camp.lnalrance. I Z.n KtK1�rti Ir:ur+
60 Ike an a evaporation and its officer.hat a etereiwt'd then nt ht itt exemption per%U 1l_C.
14. ()tltt:t
152.w 1(-1).and we hate nu bolt((u u...I No winker.'cttunp.(name(:..itspo r f.l*Any a iphe-ln that cheeks hoe*I roam al,.lilt.rut ddn_ .tltvt 16,-,6%.6a itlnr th.rr tt..rk41• coniperoutnta policy 111lY mt.town
$11+t1ttaY.whK'IS what,ttlwnit 11110 tlllltl t4 At 17Ltll.:tt1111•tlleF MC doing all atilt(,and then hoe outmule cuttiraetx.t-mutt.aill.rtut a Iww.atl*katat ltdtt'atlnt:ouch.
:C'ontlact os that cheek this Iwtr alum(:ttta'Ih,l all attahtliwtal shed,Ihtwlno Itw theirs.01 ail',ill+-ct UR:I.tui,JUII SIM.:attwihcr 411 nut dllttx moth^.Hate
ellldlli.ye.^s.. it the,Lit,ctrnlra.Itws tut.cltg'ltrs..,.they must ptutrde their wttrl..t,'aticlp.pint.}tutnutwt.
s-
I am an employer that is providing worhe rs'compensation insurance for m!y entplay ees. Below is Ike policy and job site
in/armatian.
Instilattt r(`otupant NAllI:.
110111cy 4 or Sclt-HIS.Lic. ::. 1 ti;puatturt 1)atc: —
Job Site Address: t at Stine tip: _-
Attach a copy of the workers'compensation policy declaration page(showing;the Indic} number and aspiration date).
Failure to secure coverage as r• red under MGL c. 152.§25A is a crnnwil violation punishable by a tine up to$1,500.00
and or tilt.-ytar imprisonment. • well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250A0 a
il:iv against llic t ttilatur.A c ,of 1 statement may be forwarded to the Officx of Investigations of the DIA for insurance
coterattc teritication. _,
,
I do hereby certify urn r e pains an Penalties o f perjury that the in/irrnrrrlian provided sib /
sty is in e and correct.
9 /3 /
SibiiatllrC_��_ -- IDale. /
Phone#: ` l 13 2 2 (n •i 61 I
Lii
Official use only. Do not write in this area,to be completed h) city or town of/icial
(it, or Town: Prrntit,'l.icrnse#
Issuing.‘uthurith (circle one):
1. Board of Health 2.Building;Department 3.('il'it'd—fosse Clerk 4.Electrical Inspector 5. Pluuibiii Inspector
tl.Other
Contact Person: Phone#:
City of Northampton
H M
?oa Massachusetts ��45
DEPARTMENT OF BUILDING INSPECTIONS
. /' 212 Main Street • Municipal Building yvL CDC
Northampton, MA 01060 rsdh ,`^�
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:
1/4t
Location of Facility: (Q Q 6 d7 /�
The debris will be transported by:
Nam (6e 0/4 of CU) I
a e of Hauler. CLrI � � 11.2-
Signature of Applicant: Date: 7M/2/
\.VI 111 IIVI IwCOILI l UI IpaDDW.11UDetL. 14 (WInlc)1rn!!7�/l! n��'_'/�p.FJ�/P11ll.:P�;
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 BURL BELISARIO BURI
31 EXETER ST D/B/A BURI'S GENERATION HI&GC
EASTHAMPTON MA 01027
BELISARIO BURI
31 EXTETER ST flu,,- -;. ' for
EASTHAMPTON,MA 01027 Undersecretary
Commissioner •u.�..24f •-- .*�