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42-157 rAp"INOWW'"141 BP- 2010 -1026 GIS #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PEt:SONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate orb BUILDING PERMIT Permit # BP- 2010 -1026 Project # JS- 2010 - 001515 Est. Cost: $222000.00 Fee: $1622.40 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 MATT WILCOX 075440 Lot Size(sq. ft.): 57107.16 Owner. ROSEMUND LLC Zoning SR(100) //WSP II Applicant: MATT WILCOX AT. 57 WOODLAND DR Applicant Address: Phone: Insurance: 7 PORTER ST (413) 665 -8269 WC SOUTH DEERFIELDMA01373 ON: 71212010 0:00:00 TO PERFORM THE FOLLOWING WORK.- CONSTRUCT 2 STORY SFH W /ATT GARAGE /PORCH /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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 7/2/2010 0:00:00 $1622.40 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo File # BP- 2010 -1026 APPLICANT /CONTACT PERSON NfATT WILCOX ADDRESS/PHONE 7 PORTER ST SOUTH DEERFIELD (413) 665 -8269 PROPERTY LOCATION 57 WOODLAND DR MAP 42 PARCEL 157 001 ZONE SR(100)//WSP II THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid T_ypeof Construction:_ CONSTRUCT 2 STORY SFH W /ATT GARAGE /PORCH/DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 075440 3 sets of Plans / Plot Plan THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON P f �r1/✓vL �l1N CP M) INF ATION PRESENTED: Approved Additional permits required (see below) Pei 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 - / Signature of Building Official 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. Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability. Northampton, MA 01060 Two Sets of Structural Plans phone 413- 587 -1240 Fax 413 -587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address This section to be completed by office Map / Lot � Unit Zone J K w5/ -4vertay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record KUS , e v , /\\_Ky AA LL c- QlU � Name (Print) Current Mailing Address: Telephone Signature 2.2 Authorized Ascent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by ermit applicant 1. Building 8v Ut)o (a) Building Permit Fee 2. Electrical ( Q Q o (b) Estimated Total Cost of 1 Construction from 6 3. Plumbing 1 5l Q Q Q Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection St U U C) it 4o 6. Total = (1 + + 3 + 4 + 5) a, (�Q (} Check Number '} This Section For Official Use Onl wilding Permit Number: Date Issued: Signature: Building Comm issionedlnspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 3l t exep-8 i 1�� t (o Frontage 15 � Setbacks Front �j (o Side L: SO4 R: I `t8 < 9 L: R: Rear Building Height 3 Bl g. Square Footage 4 i bb % OpeA 8pace F tage % (Lot area minus bldg & paved I • `� -kin # of Parking Spaces 3 Fill: volume & Location A. Has a Spe lal Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW ® YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW ® YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO G/ DONT KNOW © YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained a , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, ex tion, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © NO &4 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors 171 Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [p Siding [[3] Other [p] Brief Description of Pr Q j� posed Work: f I1 p 1� a P O i y a — \4 r,iC.�' TI T_�� w c�G d( ��uln��1� C1Til� v� C-Gr GC�1�c�4 2 r YQA ck Alteration of existing bedroom Yes No Adding new bedroom Yes No a r 1°CU� Attached Narrative Renovating unfinished basement Yes No h0i'wS roc, Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building: One Family � Two Family Other b. Number of rooms in each family unit: Number of Bathroom c. Is there a garage attached? d. Proposed Square footage of new construction. a9 Dimensions ��P k s e. Number of stories? f. Method of heating? L( A Fireplac s or Woodstoves a Ca jPWA3e Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction MCCA i. Is construction within 100 ft. of wetlands? Yes __ZNo. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade �n / k. Will building confo to the Building and Zoning regulations? V Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS 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 woh authorized by this building permit application. Signature of Owner Date -f _ Q A ,l �1 as Owner /Authorized Agent hereby declare that a stat ments and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. c0 -,,P VV\ �_k V-\J LLC' b. a i,- ii _V 1 � V I Print Name Signature of Owner /Agen Date SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction / Supervisor 1 p Not Applicable ❑ Name of License Holder W it 1 t Co R a � \ (� � rS —) S ( 4 c) ( G), QQ i,�,� n Y\A License Number V d,3 -1 (0 i 3 �I 11 Address Expiration Date 4t3 (0 a(09 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10- 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 buildi g permit. Signed Affidavit Attached Yes....... No...... ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there 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 homeowner Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature b Truss Tr T Qty ,Ply 57 Woodland Drive Northampton, MA 123372R ',500 !MOD. QUEEN 16 ; 1 Job Reference (optional) rfti- ABLE TRUSS CO., NEW BEDFORD MA, 02745 7.220 s Dec 29 2009 MiTek Industries, Inc. Fri Aug 20 13:57:312010 Page 1 6 -7- 12 -9 -10 19 -M 2 -2 6 31 -1-12 6- 4 6 -2-6 6-2 - 6-2-0 6- 6 -7-4 8x8 II /�� W= 1:79.3 9.081;2 t �� 1 5 ... . ..... 34 ,5- 'a.6 3x8 i 5 7 / j 7 3x8 Q 4 e I 2x4 V� \� 9 2x4 G 3 / \W3 �j w3 2 \W 5x6 5x6 O 17 �.� 5x6 %� 2 �! �� 10 5x6 Q I / exe = 18 75 14 13 72 6.8 _ 3x8 = 44 = 3x6 = 34 = 04 = 3x6 = 8x8 = 1 -0-0 9-8 -7 19 -0-0 _ 28-3 -9 37 -0-0 -0-0 _ 1 -" 8$ -7 9 -3 -9 9 -3-9 8-8-7 1-0 Plate Offsets (X,Y): 1:0- 2- 9,0- 3-01,[1:0 -1- 2.0.0 -2], [11:0 -2- 9,0-3. 01,(11:0 -11- 15,0.0 -21 LOADING (psi) — TCLL 50.0 SPACING 2-0-0 CSI DEFL in (hoc) Ildefl Ud i PLATES GRIP (Roof Snow =50.0) Plates Increase 1.15 TC 0.93 Vert(LL) -0.24 14 >999 240 1 MT20 197/144 TCDL 10.0 Lumber Increase 1.15 BC 0.99 Vert(TL) -0.55 11 -12 >827 180 TCLL 10.0 ' Rep Stress Incr YES WB 0.69 Horz(TL) 0.21 11 n/a Na BCDL 10.0 Code IRC20031TP12002 i (Matrix) Weight: 175 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 2100F 1.8E `Except* TOP CHORD Structural wood sheathing directly applied or 2 -2 -0 oc purtins. T1: 2 X 4 SPF 165OF 1.5E BOT CHORD Rigid calling directly applied or 2 -2-0 oc bracing. BOT CHORD 2 X 4 SPF No.2 WEBS 1 Raw at midpt 5-14,7-14 WEBS 2 X 3 SPF No.2 *Except` W3:2 X 4 SPF No.2 SLIDER Left 2 X 8 SYP No.1 3-8 -1, Right 2 X 8 SYP No.1 3-8-1 REACTIONS (size) 1 =0-4 -2 (input: 0-3-8),11--0-4-2 (input: 0-3-8) Max Horz 1=- 216(LC 8) Max Grav 1 =2640(LC 1), 11 =2640(LC 1) FORCES (lb) - Max. Comp. /Max. Ten. - All forces 250 (lb) or less except when shown. TOP CHORD 1-2=-4077f78,2-17=3893180, 3- 17= 3859/101, 3-4=-3664/100,4-5= 3288/138,5-18=2611/163, 6.18 =- 2385/188,6 -19= 23851188,7 -19= 2611/163,7$ =- 3288/138,8.9 =- 36641100,9 -20 =- 3859/101, 10 -20 =- 3893180,10 -11=- 4077178 BOT CHORD 1 -16 =- 4/3239, 15- 16= 0/2631, 14 -15= 012631, 13-14= 012631, 12- 13= 0/2631, 11 -12= 413239 WEBS 3 -16= 609/129, 5-16= 01739, 5-14=13311123,6-14=-9211973,7-14=-1331/123,7-12=0, 9- 12=- 6091129 NOTES 1) Wind: ASCE 7 -05: 90mph; TCDL= 6.Opsf; BCDL= 6.Opsf; h =25fL B =48ft; L =38ft; eave =5ft; Cat. It: Ecp T; enclosed; MWFRS (all heights) and C -C Exterior(2) 0-1 -12 to 3 -11-6, Interior(1) 3-11.6 to 15 -2-6, Exterior(2) 15-2 -6 to 19 -0-0, Interior(1) 22 -9-10 to 34-0-10 zone; cantilever left and right exposed ; end vertical left and right exposed;C -C for members and forces 8 MWFRS for reactions shown; Lumber DOL =1.60 plate grip DOL =1.60 2) TCLL: ASCE 7-05; Pf =50.0 psf (flat roof snow); Category 11; Exp B; Fully Exp.; 6t =1.1 3) Unbalanced snow loads have been considered for this design. 4) 'This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 5) WARNING: Required bearing size at joint(s) 1. 11 greater than input bearing size. 6) This truss is designed in accordance with the 2003 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1. 7) "Semi -rigid pitchbreaks including heels" Member end fixity model was used in the analysis and design of this truss. LOAD CASE(S) Standard 9 C TIMOTHY L. LaCHAPELLE '� GI f)L c ; 0.30 0 20/10 Warnings — Verify design parameters and READ NOTES ON THIS AND INCLUDED RELIABLE TRUSS REFERENCE PAGE RT -2 - RELIABLE TRUSS 4ND CCMPONFNT-E Ind•;:. _ - - - RT -90, 3 -13-07 ob 1 Truss '�.TrussType QtY ] PlY 57 Woodland Drive Northampton, MA M72R 501 1GABLE 2 1� I J ob Reference (2Lbonal) RELIABLE TRUSS CO., NEW BEDFORD MA, 02745 7.220 s Dec 29 2009 MTek Industries, Inc. Fri Aug 20 13:57:34 20102010 Page 11 19 -0-0 38-M 19-0 -0 -� 19-M 5.6 _ Scab = 1:86.9 13 14 I 8.00 112 12� 11 / 15 10 16 { 40 j 9 48 17 I: s 47 �� ; �, li 50 is 3.6o t 20 ST10 3'610 21 g a19 � i j 4 S66 I S i� 8 j' j\ 22 17 I e i &` 3 I I S�t4 55 I (• I i I' 5 4 3 23 2 ST7 f 3 (( I SY'IJ(II 87124 ! 1 S�f2 25 \ } o 34! 46 45 44 43 42 41 40 39 38 37 36 35 M 33 32 31 30 29 26 27 26 5x6 = 5x6 1 -0-0 { 0 0 3 7-0 -0 _ Plate Offsets (X,11: [1:0- 3- 9,0 -1-8i [25:0.3- 90 -1 -83 (31:0 - 3-0,039] [41:0- 3- 0,0 -3-01 LOADING (ps 5 0.0 SPACING 2-" CSI DEFL in (loc) I /deft Ud PLATES GRIP TCLL 5 Plates Increase 1.15 TC 025 Vert(LL) n/a nla 999 MT20 197/144 (Roof Snow =50.0) ' Lumber Increase 1.15 BC 0.16 Vert(TL) rda n!a 999 TCDL 10.0 Rep Stress Incr YES WB 0.44 Horz(TL) -0.01 26 n11a n1a 1 BCUL 10.0 BCDL 10.0 ' Code (RC2003/TP12002 (Matrix) ! Weight: 219 lb LUMBER BRACING TOP CHORD 2 X 4 SPF No.2 TOP CHORD Structural wood sheathing directly applied or 10-0-0 oc purfins. BOT CHORD 2 X 4 SPF No.2 BOT CHORD Rigid ceiling directly applied or 64)-0 oc bracing. OTHERS 2 X 3 SPF No.2 WEBS 1 Row at micipt 13-36, 12 -37, 11 -38, 10-39, 9-40, 14 -35, 15-34, 16.33. 17 -32 REACTIONS All bearings 36 -0-0. (lb) - Max Horz 46= 216(LC 9) Max Uplift All uplift 100 lb or less at joint(s) 38, 39, 40, 41, 42, 43, 44, 45, 46, 34, 33, 32. 31, 30, 29, 28.27. 26 Max Grav All reactions 250 lb or less at joint(s) 36, 37, 38, 45, 35, 34, 27 except 39= 328(LC 2), 40= 443(LC 2), 41= 317(LC 2), 42=280(LC 1), 43= 277(LC 1), 44= 302(LC 2), 46- 2), 33 =328(LC 3), 32= 443(LC 3)• 31= 317(LC 3), 30= 280(LC 1), 29= 277(LC 1), 26= 302(LC 3), 26= 435(LC 3) FORCES (lb) - Max. Comp./Max. Ten. - All forces 250 (tb) or less except when shown. TOP CHORD 10.11 =- 13'274, 11- 12=- 51302, 12- 13=- 1/283. 13.14 = 0,'283, 14- 15=0/302, 15- 16= -31274 WEBS 10.39 = - 296/51, 9.40 =- 400/49, 8-41= -27T45 246=•316/64. 16- 33=- 296!51, 17 -32= 400/49, 18- 31=- 277145, 24- 26=- 316138 NOTES 1) Wind: ASCE 7 -05: 90mph: TCDL= 6.Opsf; BCDL= 6.Opsf: h=25ft 8=48ft; L =38ft; eave =5ft; Cat. ll; Exp B; enclosed; MWFRS (all heights) and C -C Exterior(2) 0-0-0 to 4-M, Interior(1) 4-0-0 to 15 -2 -6, Exterron 2i 15 -2.6 to 19-0, Interior(1) 22 -9-10 to 34-0 -0 zone: cantilever left and right exposed: end vertical left and right exposed;C -C for members and forces & MWFRS for reactions shown; Lumber DOL =1.60 plate grip DOL =1.60 2) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind (normal to the face), see MiTek "Standard Gable End Detail' 3) TCLL: ASCE 7 -05; Pf =50 -0 psf (flat roof snowl. Category IF. Exp B Fully Exp.; Ct=1.1 4) Unbalanced snow loads have been considered for this design. 5) All plates are 2x4 MT20 unless otherwise indicated. 6) Gable studs spaced at 140.0 oc. 7) 'This truss has been designed for a 10.0 psf bottom chord live load nlonconcurrent with any other live loads. 8) One H2.5A Simpson Strong -Tie connectors recommended to connect truss to hearing walls due to uplift at jt(s) 38, 39, 40, 42, 43, 44, 45.46. 34, 33, 32, 30, 29, 28,27,26, ,and . 9) H16 Simpson Strong -Tie connectors recommended to connect truss to bearing walls due to uplift at jt(s) 41. 10) H16 Simpson Strong -Tie connectors recommended to connect truss to bearing walls due to uplift at ft(s) 31. 11) Non Standard bearing condition. Review required. 12) This truss is designed in accordance with the 2003 international Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSVTPI 1. 13) "Semi -rigid pitchbreaks including heels" Member end fixity model was used in the analysis and design of this truss. 14) H16 Hurricane tie must wraparound the underside of the wall plates. For trusses between 3:12 and 7:12 slope. LOADCASE(S) Standard O� TIMUTHY L, y 11 LaGHAPELLE -4 C'VIL 0.30 J 20110 Warning! — Verify design parameters and READ NOTES ON THIS AND INCLUDED RELIABLE TRUSS REFERENCE PAGE RT -2 _ I rula X-711-111 R• ! 3 -13-07 The Commonwealth of Massachusetts Department of Industrial Accidents .. Office of Investigations tl y t , 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information l Please Print Legibly Name (Business/Organization/Individual),' Address: City/State/Zip: C A Phone #: � A I SL S,�& r Are yo an employer`! Check the appropriate box: Ty;7 roject (required): 6. 1. ;I am a employer with 4 ❑ I a general contractor and I construction employees (full and/or part-time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have g ❑ Demolition working or me in c a p acity. employees and have workers' g a P ty 9. [] Building addition [No workers' comp. insurance comp' insurance.: 10. [] Electrical repairs or additions required.] 5. C] We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[] Roof repairs insurance required.] c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the suns- contractors and state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and jab site information. r, Insurance Company Name: tt= r.. Policy # or Self-ins. Lic. #: w c_ i," , , ci::,) i )_-0a`l Expiration Date: Job Site Address: i City / State /Zip: Attach a copy of the workers' compensation policy deciaratio page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under thepains,andpevallies ofperjury that the information provided above is true and correct. l C7, z Si r D Phone #: = t Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Complete this form if you are interested in applying for incentives as part of the 2008 -2009 Program. This information will be used by a HERS rating company to help you select the building specifications to qualify your home as ENERGY STAR" and determine the incentive(s) your home(s) can achieve. Once completed, you can submit an Application and Agreement Form or incentives based on your homes energy performance. Complete information Mu ,� be submitted with full -sized copies of the building plans, including: • Plans: foundation, floor, and site plan indicating building compass orientation. • Elevations indicating grade level for all sides of the building. • Sections to clarify any cathedral /vaulted ceiling, floor level, and wall assembly details. • Complete window schedule with rough opening dimensions. • Indicate on plans all window sizes or Include reference labels from window schedule. Important Note: For homes over 5,000 square feet, a fee of $10 for each 100 square feet over 5,000 will be charged to the Applicant, (Example: a 6,600 s.f. home exceeds 5,000 by 1,600 s.f. Therefore, the fee is 1600/100 x $10 = $160.) F�' �A�Y�#nrt>i�"'fi.��a��,�, off'.;+,. 3 , ,,, .,,. � a r .....» W; s, . ,. 3 :r w ... _ .,..a riµaaxe.• . . „ 4�d ADDlicant Company Nam Primary Contact:: Contact Phone: Email: V\ C" 4 ) C' Y� uk VA L. L-r_ - 1 r t " t; � t3 (n�. S � � , S rce`��i a v -+uv h Project Name & Address: Project City: Electric Service Provid : i�_) W04a4- 16 C no enxk "�-c)^ n,,.+ i c----,, Number of Market Rate Units: Number of Low - income Estimated Completion Date: k Units: --- W C� f n r Insulation Location Insulation insulation R- Insulation Stud /Joist Spacing Thickness Value Type* (O.C.) Flat ceilings (w/ attic above) i Q Sloped/cathedral ceilings Exterior frame walls 9 d r y . cct C 11U10 Z Rim /Band joists Floor over unconditioned basement � 9 �GI Q�S Floor over garage € l Cantilevered floor Foundation walls Basement frame/walkout walls Under -slab insulation Ins, width (feet) Slab perimeter insulation Ins. depth (inches) If foam insulation is used, specify type, such as: isocyanurate, expanded or extruded polystyrene, etc. a' � ��� �' +§ a^"t ¢;hLa5��dF "'an � �,a s''�`,�"Y�.'�.G�✓�s�"a� .�. Mu w 7�'; .� . . `'.�Q ,�"p �> �, i Exterior Doors C�Insulated Steel fiberglass OWood OOther ❑Storm Windows OClear NLow E OJArgon filled C] Wood frame i�/inyl frame OOther M n icturer NFRC whole -unit U -Value NFRC w hole -unit SHGC 13 i �{ WIN Heatin E N� g q pment Gas 000 OGeoExchange ❑Other OHydro Air DOpen Loop V OClosed Loop - t__'\ ^ N* arm Air oHot Water ORadiant Floor IjOther Gas CWented CUnvented Rated output capacity (Btulhr or tons),3�) ;N AFUE or COP rating. ' ,� r C oolin Equipment °tentral A/C OGeoExchange r v\ X Rated output capacity (Btu/hr or tons) � � {)C) SEER Domestic Hot Water YGas ON OElectric OGeoExchange L_,Desuperheater OOthe ODedicated r OStand alone Olndirect rstant- Jankless Coil OOther fired aneous Rated output capacity (Btu/hr or tons) Energy Factor (EF) Ventilation System Exhaust -only (rated for continuous ,-,Heat Recovery Ventilator operation) Mail an entire set of plans and the Home Specification Form and Analysis Fee, if applicable to: Center for Ecological Technology ♦ 26 Market Street ♦ Northampton, MA 01060 Please call 800 - 369 -3333 ext.21 or email meganm c@cetonline.org with any questions or for additional assistance. No. - lu FEE 1 COMMONWEALTH OF MASSACHUSETTS `�,' Board of Health, '1� Wlovr 1 , MA. T DISP®SAL SYSTEM CONSTRUCTI ®N PERMIT Permission is hereby granted to; Construct Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at Vi' as described in the application for Disposal System Construction Permit No. 3D L_ ` , dated. Provided: Construction shall be completed within three years of the date o JPcal conditions must be met. Form 1255 Rev. 5196 A.M. Sulkin CO. Charkst0+m MA Date 4 Board of Health 1 MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton, MA 01060 587 -1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 57 Woodland Dp,., Northampton New Building Inquiry Made By: Marie Quill 695 -8795 Date of Inquiry: Number of Type of Single Family X Type of Private X Units: 1 Unit(s): Accessory Apart. Ownership: Condo Multi - family Rental IAnnlicant to fill out the ahovel Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: No Size of Water Main: 8 Material: D.J. Age: 1996 Approximate Static Street Flow Test Conducted: Yes: X No: Pressure: 65 psi If done attach results Size of Service Connection 1 Suggested Meter Size: 5/8" Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. New tap required on main. • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • ments of such instal . shall be made with the Northampton Water Department with a minimum of 5 w king day ti ation • All rk s all n to N rt pton Water Department specifications. r e David W. Sparks, Superintendent of Water Water Entry $200.00 Meter $100.00 Radio $100.00 cc: Ned Huntley, Director cc: Tony Patillo, Building Inspector Note: If this availability is for a new construction it must be hand delivered to the Building Inspector x;,60 Permit No. D09 -10 CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: 5/5/10 Check #: 2080 FEE: $250.00 THE BOARD OF PUBLIC WORKS Driveway must be staked and house & lot number posted The undersigned respectfully petitions your honorable body for: A Driveway Permit Permission to install a driveway at: 57 WOODLAND DRIVE Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All Drainage shall be directed off the driveway surface to adjacent land and not on the existing Roadway. Driveway surface to be paved as soon as possible if the grade of the proposed Driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City of Northampton in the event of a washout of this driveway. Code of Ordinances §350 -8 8 providing standards for private, individual driveways as amended by the City Council on October 15, 2009, must be followed. By: Marie Quill/Rosemund LLC Telephone: 413 -586 -0520 Signature: Proposed Location Inspection By: " �G�' • �z 'Z�lO Gravel Base Grade Inspected By: Final Approval: THE BOARD OF PUBLIC WORKS voted that petition be granted. Edward S. Huntley, P.E. Director of Public Works Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS 1 & 2) Permit No. D09 -10 Conditions: Driveway Permit In lieu of plan approved by the City Engineer I agree to the following added conditions: 1. 1 will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. 1 further agree that if in the inspections, any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. A Petit ner Signature Name: Marie Quill/Rosemund LLC Address: 23 E. Hadley Road Hadley, MA 01035 Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. For Commercial and Industrial applicants, a plan showing the proposed driveway with grades, location and Planning Board permits are required. Cc: Building Inspector L nnnn -- - — - -- --- – -- - 1ST FLOOR $ 1,372.00 $0.50 $ 686.00 2ND FLOOR $ 1,576.00 $0.30 $ 472.80 GARAGE $ 540.00 $0.20 $ 108.00 BASEMENT $ 1,360.00 $0.20 $ 272.00 FRONT PORCH $ 204.00 $0.20 $ 40.80 REAR DECK $ 214.00 $0.20 $ 42.80 PERMIT FEE $1,622.40 1 HEYWOOD 2485.XLS 5/12/2010 O N w a y Y vo r cq N � � u u U to o v o r CN Q) CD ��~ C J w o cu V v Q o� ts cz O O o tj u O 0 O l.` y • ry v -� �+ +v •� ° o •� ed U N cu u v Q, 3 w O a •� �' y O •i6.i U � m V U U Q) 0 'b u O v . 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