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STREET fLORENCE, G OWNER: DANIEL TKENNER CONTRACTOR: STEPHEN YOSHEN MA 0 1 02 LICffNSE #: C5 85490 • Sloe View- 2no Poor 4 9 , _ 4 „ w Post to oe ourieo in wa<< 15' 62 \dipole St, Contractor: Stephen Yoshen Florence, va, License CS 88490 Danie4 Trenner Y n Sice View First PLoor 4 - 2x12 8 -4 0 ) Post to Joe ouriecl in walk 13' - L" 62 vioale St, Contractors Step -len Yosnen Florence, va, License CS 88490 3aniel Trenner 3 ,---, f ' t i ' r," i ) ' - 1' ' • 1 ' - ( - (:)/ / Ari C:r OC> 1 .P4 g 0 C ) rY\ A '. _ _____----------- ( N `• , ,,, , --,... . .,. -,.., ,. . . * 0 ... ■ I _ / 9L, / `- 1 1 (g . STRUCTURED KNEE 3 . ❑ WALLS R OOF: G" BLOWN IN ❑ 3 SKYLIGHTS IN CELLULOSE; 2" RIGID ,—, ROOF FOAM; 5/8" DRYWALL ❑ i S'4 lg } ` /--- SHED ROOF 3.E4 BELOW 4 0 ; n (yel , J r4 C 2, o,s4-5 d I AN( ' J 2x 12'5 .••.) SISTERED TO i i EXISTING S G 14 2&S - 1 y 6 '*0 SFAN GJ U - .VC�JFbt.. - s ___..\--____ ... 2x 12 5 SISTERED TO EXISTING 2x6 FLOOR I _ JOISTS; 3/4" T *G t PLYWOOD W/ SOLID = WOOD FLOORING OVER L _ , , IcCio "ISPAA1 n( 1 ., ,,, THIRD FLOOR PLAN /JF ,,.) wy.) DoLoS (E6- gc.s,S.:; oA Co‘ 3eea"oo.---- .20' 62 MIDDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE, MA 0 1062 LICENSE #: CS 88490 OWNER: DANIEL TREN N ER - - -- -- 1.7 i - , S-- . 8e,I (.- dt fs • - BATH g ;e ree 1 v� -- ADDITION _ St to s�`{ !: — B ATH w 6( ' 2 ) & i ..2 t O } J., --.... \--......_ \ Y T \ - e e it (d .L4t.. • I ek Lfo i j � i� t g y ° I Y � ___ _ . __ P v vodc r� s r'.,p . O+ek - - -- 7 f _ , „f, r I - (Lee_ : 1:k'c. c'e- L _ ... ) 0 IT. y y y +. e '�j y SAOiKC a14 Co2- it Ot t h S SECOND FLOOR PLAN 62 MIDDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE, MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TREN N ER .' REF. STOVE ""1 11 DINING KITCHEN �„� WALLS TO BE REMOVED NEW MUD �� ° INK — — ROOM SONOTUBE ' _ f= _ PIER I 1 b 111 ! 's- Q j — - 2 LAL'dDR" n ( w !�S / x ` 41 I EXTERIOR WALLS: 2x6 @ 16" OC; BLOWN IN CELLULOSE; �, 1/2" PLYWOOD ShEATI1ING; 2" C� RIGID FOAM INSULATION, s 4� roo } 1 ----. i Ps z t , a R ___I 1 ` rp 1; I1 Chyt A to cl.i , 11 &J i1Z-32 1 / , Coy .1 1 —, ,- I P 6r6 '- ci V : p� r� 0se I t pi, N ifL 4 "; t -►-- -( .1 S ,c c l�� FIRST FLOOR PLAN G2 MIDDLE STREET CONTRACTOR: STEPHEN YO5IEN FLORENCE, MA 01062 LICENSE #: CS 88490 OWNER: DANIEL TREN NER r 1 le y. I I 1 STRUCTURED KNEE ❑ WALLS ROOF: 6" BLOWN IN 3 SKYLIGHTS IN CELLULOSE; 2" RJGID ❑ WEST ROOF FOAM; 5/8" DRYWALL S4 (S i > f I GI�rG/ SHED ROOF ari • I -1)FI+` BELOW ; s t J 2x 12'8 _ SISTERED TO 1 1 EXISTING 2x6'S - 1 SPAN r I a W /5C-r ., - - ' I _ 2x 12'S SISTERED TO E 1 EXISTING 2x6 FLOOR ki j _ JOISTS; 3/4" T4G PLYWOOD W/ SOLID - WOOD FLOORING OVER lq'to' SPAS! { , , . ,.,, THIRD I=LOOR PLAN nic o ws-a Down 5 (€6-iet-5.S.;;. ►+ti o ? 1 .k, .3c. ) Po 0 .-6-- .' .2 0 g( x L /) ) 1 °► et-WA. G2 MIDDLE STREET CONTRACTOR: STEPHEN YOSNEN FLORENCE, MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TRENNER ,,,-,.,, 41 BATH ADDITION / C • -- bATrI r SECOND FLOOR PLAN G2 MIDDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE, MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TREN N ER w t REF 1 STOVE I DINING KITCHEN' I WALLS TO BE { i REMOVED - NEW MUD r IN I ROOM SONOTUBE a v' � PIER Li 1 NEW / -----\F. LAL��DR n L WALLS - 6 x 4 EXTERIOR WALLS: 2x6 @ 1 OC; BLOWN IN CELLULOSE; � N r .- 1 /2" PLYWOOD SHEATHING; 2" ', RIGID FOAM INSULATIO ( ---- _ �,.lk�e...a _...., 1 _____ . 1 ....„ t i - /( �� ._ F � -, 1 - 1 \ 1/ il: i I 1 ( .-:---- I i 1 i FIRST FLOOR PLAN 1 i i I 62 V I DDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TREN N ER I '1" 0 ii i i or < 86. / — ? NEW WATER , GAS SERVIC EXISTING GARAGE I W NEW ADDITION j i I T ,Y. i /1 __I t ' %ice ; / 2 i br > 0 EXISTI t STUDIO /RECREATION ROOM IN GARAGE - ■ t HOUSE NEW ROOF * t ' 4 WINDOWS; REPLACE GARAGE DOOR WITH DOOR AND WINDOW; FRAMED FLOOR W/ PLYWOOD SUBFLOOR; VINYL FLOORING j t > K APPROXIMATE 07 PROPERTY UNE t Q i � I t t S $g/ —> STREET SITE PLAN 62 MIDDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE, MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TRENNER I.! *if a 17' .? 0/ i/- i ■,7 1S ) 1 -1/11D'Di s--- , ) -S--- .--=:-. (.7 0 1 6 • a ) inn z$ - ? ?.3 A IA 1 // ,fi l W 101 0? )1Z 21,00 y 2 21-d r 2'71 An 71 Z►1� 9/ D SLS14t $ X Z �►' 441- 35“ t12ts s79n hXZ — iys 3 21 ,. 2 -pu 7 , 11 p 21 ,g n o j n_q IA) ou?A tin\O . . „pool 99 ob 45 Z9j 01.0) 46-02.(0i+5 - koSi "a - -) � r 2 • s .(5..s+,4(9) s \1^°m 01 )% , �1 44 1 )r°M) z ,ks08. °L5 ° -Z' / ,) • - t. • (5 'Z. -�- ° 14- °1 ) � s 1 M oZ h 8 • (6)/ s' ?+ 5•7 = 4 -*3 )l ^ 1 0 Z o • _ IS c-\r) 0 02 0 2 • _ 001 7 M S 0 0 I iron_ );‘)-A SJ ` 0 • SG? o ff£ = C�g,w��� + 5 • . f 1/4” S 1 ')t SS h —� . $ °0 • -1..r)(1 fo “c_ = 1). -�- 3 9• Z x2 0 _ 2 �. T9 • z t 59 • 0/)42 �rui>e i Sa).00—/ a-b°ss& 2)°)'"is -6)/172"D»V ,i*JAPOQZ rces1 VT. --j'IV1()MIAV5—) &()sai VPS c'YL .410, -2 25S - 1 - -= 0 cenn.c)D4,crvri p i &viol ---1A -4 , A0 „s001.1 o a-40-7 .2A ,41. ri).°'1 )1)2761 01-0 -Tr 009 -2,6).,1k.5, X 5 7,1 Nlicr'Qv5))91 7 )5)b) J‘29) t1.1.°41g6°.\ 1?-acq Ass va-'1111_3. 2gilc , , 1 Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non - Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5" to 2.0" Over 2" Temperature ( °F) 170 -180 0.5 1.0 1.5 2.0 140 -160 0.5 0.5 1.0 1.5 100 -130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range( °F) 2" Runouts 1" and Less 1.25" to 2.0" 2.5" to 4" Heating Systems Low Pressure/Temperature 201 -250 1.0 1.5 1.5 2.0 Low Temperature 120 -200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant and 40 -55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD: (Building Department Use Only) Project Title: Report date: 04/14/08 Data filename: Page 4 of 4 • , • • Duct Insulation: u Ducts are insulated per Table J4.4.7.1. Duct Construction: Li All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. • The HVAC system provides a means for balancing air and water systems. Temperature Controls: u Thermostats exist for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and /or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: Li Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: ❑ Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: O All heated swimming pools have an on /off heater switch and a cover unless over 20% of the heating energy is from non - depletable sources. Pool pumps have a time clock. Heating and Cooling Piping Insulation: ▪ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Project Title: Report date: 04/14/08 Data filename: Page 3 of 4 Generated by REScheck -Web Software Inspe Checklis Date: 04/14/08 Ceilings: ❑ Ceiling 1: Cathedral, R -24.0 cavity + R -10.0 continuous insulation Comments: Above - Grade Walls: ❑ Wall 1: Wood Frame, 16in. o.c., R -16.0 cavity insulation Comments: Basement Walls: ❑ Basement Wall 1: Solid Concrete or Masonry, 7.0' ht / 5.5' bg / 2.0' insul, R -5.0 continuous insulation Comments: Windows: ❑ Window 1: Wood Frame, Double Pane, U- factor: 0.049 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Skylights: ❑ Skylight 1: Wood Frame, 2 Pane w/ Low -E, U- factor: 0.039 #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1: Solid, U- factor: 0.049 Comments: Heating and Cooling Equipment: ❑ Boiler 1: Gas -Fired Steam: 78 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ When installed in the building envelope, recessed lighting fixtures #meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 Vs) air movement from the the conditioned space to the ceiling cavity. The lighting fixture has been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm - in - winter side of all non - vented framed ceilings, walls, and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R- values, glazing U- factors, and heating equipment efficiency are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions, in substantial contact with the surface being insulated, and in a manner that achieves the rated R -value without compressing the insulation. Project Title: Report date: 04/14/08 Data filename: Page 2 of 4 Generated by REScheck- Web Software Compliance Certificate Report Date: 04/14/08 Energy Code: Massachusetts Energy Code Location: Northampton, Massachusetts Construction Type: 1 or 2 Family, Detached Heating Type: Other (Non - Electric Resistance) Glazing Area Percentage: 14% Heating Degree Days: 6404 Construction Site: Owner /Agent: Designer /Contractor: Compliance: Passes Compliance: 14.0% Better Than Code Maximum UA: 615 Your UA: 529 Gross Cavity Cont. Glazing UA Assembly Area or R -Value R -Value or Door Perimeter U- Factor Ceiling 1: Cathedral 2000 24.0 10.0 57 Skylight 1: Wood Frame, 2 Pane w/ Low -E 36 0.039 1 Wall 1: Wood Frame, 16in. o.c. 3600 16.0 0.0 200 Window 1: Wood Frame, Double Pane 500 0.049 25 Door 1: Solid 63 0.049 3 Basement Wall 1: Solid Concrete or Masonry 1500 0.0 5.0 243 Wall height: 7.0' Depth below grade: 5.5' Insulation depth: 2.0' Boiler 1: Gas -Fired Steam78 AFUE Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck -Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. 4 lob VIIK /0 cP Name - Title Si . nature Dat Project Title: Report date: 04/14/08 Data filename: Page 1 of 4 1 t 1 , I i i STRUCTURED KNEE ❑ WALLS ROOF: G" BLOWN IN r 0 3 SKYLIGHTS IN CELLULOSE; 2" RIGID ❑ r WEST ROOF FOAM; 5/8" DRYWALL ? P �S is t .� SHED ROOF , bA BELOW ■ L V _ - i 2x 12'5 _ SISTERED TO i i EXISTING *0 I 2xG'S - I G' 4 SPAN 1 w1 u Q ,L�C ., - — _____ \ 2x 1 25 SISTERI D TO EXISTING 2xG FLOOR JOISTS; 3/4" T *G PLYWOOD W/ SOLID WOOD FLOORING OVER 14)/ . l4 F , THIRD FLOOR PLAN i\J> ,J wy..)ti (Egitet-sS C� m" u� ? 'C ',3e. ,:),FE-14, ' .20 s ik Gt tt) ) ZRT✓\ 62 MIDDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE, MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TREN NER 0 • � F BATH ADDITION - ATH 6/ I \ ( w t SECOND FLOOR PLAN G2 MIDDLE STREET CONTRACTOR: STEPHEN YOSHEN FLORENCE, MA 0 10G2 LICENSE #: CS 88490 OWNER: DANIEL TRENNER (1:-S 1 a4 / J t I REF. 570 E II DINING - K(TCf1ENI I WALLS TO BE REMOVED -- — NEW MUD I IN ROOM ,SONOTUBE ■t►i�_ _ PIER tul NEW i / p / LAG 1DR WALLS R rJJ 1 1 EXTERIOR WALLS: 2x6 @ 16" OC; BLOWN IN CELLULOSE; `� I /2" PLYWOOD SHEATHING; 2" 1 f RIGID FOAM INSULATION I - s4.cA f Ps O k �. ,. — �,.tKl.ei 1 I ,! f I _ •Th i ( /----- \l/ ■ Iv eartii i FIRST FLOOR PLAN i 6 2 MIDDLE STREET CONTRACTOR: STEPHEN YOSIIEN FLORENCE, MA 01062 LICENSE #: CS 88490 OWNER: DANIEL TRENNER p- 1 oZ / i P f 2 ...__. r _______________ 7 , , NEW WATER *. A1 GAS SERVICE EXISTING GARAGE t '` 3 NEW ADDITION j i 1 NJ 1 f.� /// - - � 0 p EXISTING STUDIO /RECREATION ROOM IN GARAGE - ■ HOUSE NEW ROOF 4 WINDOWS; REPLACE i GARAGE DOOR WITH DOOR AND WINDOW; FRAMED FLOOR W/ PLYWOOD SUBFLOOR; VINYL FLOORING j ■ j 1< APPROXIMATE �/ it PROPERTY LINE 1 . f c S8 / -> STREET SITE PLAN 62 MIDDLE STREET CONTRACTOR: STEPHEN YOSIIEN >✓LORENCE, MA 0 1 062 LICENSE #: CS 88490 OWNER: DANIEL TREN N ER ,3 iFF-c - i ' d i ,- I , 0 :;:). ,,;.--:,2:;:) 'N V -...1 '.... 4 1 7 i ..,` 3 , ,,: 1* .,, Q ) 1.- 4.- ''',; ) 1 / I ) 1 J ':-) 11 CO C - ii i' i I e , / e 9 '' ) 01 Q po - 7 1'1/ i f 0 .... .- ---- .0 i ' A/ -) ) ) ) ..V \ SM ,-.... . 0 1 ' i -- ., i ,. ci C ' / 1 ,../ ' ; - - .., / j ' )." /I i / ' (''''.'' ,./ • . . '1/4 VW . ''''''' t '''.:. ?, -1. 4.-__ v 5- ) ) ./...„....„,. , , , ..., . i .# i „ ..., , t ' , .: ' ..)-;' 1 --? 4Thr) -- a-- 4 r . / 1 ) - ) ) ,- c- „› j . 3 r-- ai (....) \ ' i 77745' _1 - J., 4 r • , „ -3., ,.... c ,9 s .,„ -1 1 - 3e'') i) e , 40 - , - 4 , - d' . ;..,,, t . 4. .2 01 7 \ ,,,,...... i • 14 ko -;› (‘, - J - f 1 tz) ,...1 i 1 tsie ( ' 1 n r 1 '''' -c-- „..„0.,,,, 9 41 ?V - -.--i c 2 .. ?/ 1 i t , Z.,,„ .,....„, Cy I n......,.....H.,# tel. ..). (7 ". ( „...... -. 5 i =ICI i, 0 2 a ,, :,,,, . . ( ..... \ 1 t...... ,e,;..„c / iL, , .... • . , . . - _ _ _ _- E= — =� =—=iT OF L�27.2-� G �,ti5r^ "SONS - °.';,c Y N∎Grt rip am, M. QI QE:O ,_ Si HOME O iliNE ' YE \ fTT ',,� c=17\, n ViTT ED -f;.' - r 'NT V_!j� i-7 Y /t i i:1 1:_ l.. � 3.: i ��_ � r3 v - �._ I ire t.aie - of k a it's s allows the homeowner cL' r e; f ' S ! r s c .. the r�L>, t:._� -.. 7 E�C� � 108 -� -� to I I "1-Tom-owner" u aCt as. Li.`..i er corstru'c%cn st:�= ; cr- The .Szz e d omes a , er sons) woo owls a parcel on winch he/she resides or intends to be, a one or tAlofca ily r thv a J an cr dena.cced s ii uc Lres accessory to such use and/or farm structures. A person wilo constructs more than one home in a v c- e r period shall not be considered a home owner." The bu IE_ -Eep z_T :ent fet the City of k- -rpton .s any per oc(s) who seek to a use � pe vi�scr i to be aware the IOri.: owner exemption, to act as their c riu i.+:uS`u �L:�Li .a... that by don` so you become responsible for corpli -'ice with state buidin. codes and re retz The irspeczio process requires that the buiidnv Cep anent be ca. to insper worn z var sees, which include foundation/footinzs (before bac i l). sonotube holes (before Door). a roue building. insuecton (before work is cc = ; . do ...ins-4ecticn.Cif recufr d a fin n 7 baile=r.; insnectian. The b 7i cm= cep..:hen= requires these inspec ons before the errors is coocezIed, failure to - secure the in er-tions can result in failure to obtain a c ertificate of occunancv u tae- or'a be-ix snecte _. . Tithe h.c. eoweer hires other -ales to perform moors (eie ; p1u=bin L.: mss) the hornet, when wfil be respponsible to make sure that the tea ^es hired se^Tre their proper pelnits in conjunction to the buildn, permit is,sued, and that they get their required inspections. Failure of the indi trades to secure the permits and rn. peCticfs as require:. can DELAY the project unfi such time as the proper permits and inspections are rracie - , - - -- — _ enders ad the above. (Irome.OTtwner /resIdent's sI= 'ature regzies`tizig eietptIon) I I=II to schedule all required build` inspections necessary for the bu:ildin permit isst2ed to rne- Date • - Addres._.a= vv of _ ecatia I .._ . `W ' - I Office of Investigations = ,..� 600 Jrasnington Street Boston, MA 02111 =r' www.nzass.gov/dia Workers' Compensation Insurance Affidavit: Builders /Contractors1rElectricians /Plumbers Aoolicant Information Pease Print Leaibiv Name ( Business /Or:anization/IndividuaI): �� PLq- Y Q� k � _ - - f•\ # D r-LLI.,..u...0,,. t al ' ( I 10 C c.v..: It 4 , City /State /Zip: L ,,\q L ) C ( O (DEG Phone #: ( b 3c/ S�(f Are you an employer? Check the appropfiate box: Type of project (required): I. _1 I am a employer with 4. ❑ I am a general contractor and I 6: Q New cons' action � (full and/or part- time).: have hired the sub - contractors , 2. I am a sole proprietor or partner- listed on the attached sheet. 7. 2/Remodeling, ship and have no employees These sub- contractors have 8. ZDe°nolition working for me in any capacity. employees and have workers' 9. (Building addition [No workers' comp. insurance comp. insurance.t f I required.] 5. El We Electrical repairs or ar?riitions We are a corporation and its ❑ p 3. Li I am a homeowner doing all work o leers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' corlp. right of exemption per l IGL 12. Roaf repairs 1.•❑ Other required_] ; c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] - `.='<ny applicant that checks box ml must also fill out the section below showing their workers' compensation policy information. Ho meowaers 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 sub - contractors and state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Nape: Policy # or Self-ins. Lic. #: _Expiration Date: Job Site Address: City /State /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 Section 25A ofiVIGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 andior one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day ag 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. 1 do hereby- cerri, - - -, re-o o ' . - c ties ofpexju zat-the information provided abo e is true and correct C 1 a r , �. _- f atu. e : `-.�� Date: Phone =. /3 3 y._ t 3 -- _. __OfificiaL use_oaL_ _I?u_nur w .ri te.i _thisarea to be completed by city or town o "ciaL - I II —_ City or Town: Permit/License t iI Issuing Authority (circle one): _ 1 1. Board i - rd o? eaitn _ Buiidin' Department .. City/.Town Clerk 4. Electrical Inspector _. Pl TL , .g inspector l 0. (icier �. 1 ■ 1 ;'._ cl n,.., Phone w SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: V / Not Applicable ❑ Name of License Holder : Tce �0 ti //�� V� C5 42/ I/9 v n 111 License Number PtO 66)4 Y( 3 3 e.C ,-:* d . /oh /9.001 Address - Expiration Date CJ w■ v" r 6 l O.6 Sign "re / Telephone Telephone /1► • j � eL — (y/ v j 3 3 / S. Re. istered Home I ®rovemerit Contractor:, >„„:' , Not Applicable ❑ 401-1 Company Nam � S Registration umber 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 building permit. Signed Affidavit Attached Yes ❑ No ❑ 11.. - lame Owner =Eiem tau 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 1083.5.1. 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 v• SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition EzS Replacement [ rows Alteration(s) Roofing EY Or Doors Accessory Bldg. ❑ Demolition New Signs [0] Decks [[] Siding [g;14 Other [01 6. n e l u roo.44. c ) 7 ; r a� 4-- kv . tc �os Brief Description of Proposed / ►) 1 � - 5 s � 4 {� Work: (Qirtb,/ -� V...(1 t`� - r, (&dillic/ 11.0..6../ 11.0..6../ W. ` i „•,5L A i, !fir Y b 0, Pv 4- irt ol Alteration of existing bedroom Yes V No Adding new bedroom 7 Yes No Attached Narrative Renovating unfinished basement Yes V No Plans Attached Roll - Sheet sa. it New house and or addition to existing -housing complete the foii '/ a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: / J Number of Bathrooms c. Is there a garage attached? A 0 / , d. Proposed Square footage of new construction. / 0 Dimensions 6 X 1 e- Number of stories? . f. Method of heating? c" 1nv. Fireplaces or Woodstoves Number of each j g. Energy Conservation Compliance. r' Masscheck Energy Compliance form attached? h. Type of construction LA/ 0 0 O i. Is construction within 100 ft. of wetlands? Yes /No. Is construction within 100 yr. floodplain Yes 'No , j. Depth of basement or cellar floor below finished grade 6 , / k. Will building conform to the Building and Zoning regulations? i Yes No . I. Septic Tank City Sewer V Private well City water Supply V / SECTION 7a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, D n, ( C ■\ €_.--C , as Owner of the subject property hereby authorize . 5+ ., ...,., • s to a • ■ , -half, in ..II ma ryfi` - • - o w• . uthorized by this building pe t application. Sig :ture of Cwaer E /-/- , as Owner /Authorized Agent hereby de are that the st ments and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed u der the pains and enaities of perjury. E' i r h rz/._ D Print i1 ' ,- ►"� �______ _ �� (o Signature of 0 ner /Agent 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 tilled in by Building Department Lot Size Z.. _�...._`.�.�°`_. Frontage ....... _ Setbacks Front --_.. In . __r Side L:`..(... -...- R: .- L ... �_0:_ R .. & Rear / _, -1-51 Building Height 35' 3,' "�„.„. ._ . Bldg. Square Foota e \. % .. ? .__. ._ _ i1�e �ud trt se Ott. _ . __. 7O _ _____ Open Space Footage % _. (Lot area minus bldg & paved a t . _. ��� parkins) Lj� # of Parking Spaces -- * °. ` Fill: (volume & Location) ..__. __ _.__.. . A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW er YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO co DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES (3 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, exc vation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Sform Water Management Permit from the DPW is required. - Department use on . City of Northampton StatusofPerrnit \wilding Department Cur> Cut/Drrvewa Pe€rrut \ ''12 Main Street S ewte r JS e p f r cA v a � t a brlf y ;,,: Room 100 Wa r%1 IetfAva agility r ACC$ Noilfilampton, MA 01060 Twro Sets of Sfructur Pta PA hone 4134587 -1 Fax 413 - A 587 -1272 Ptot/SitePlans �� �� Other At',i;?k;tCATION■ C UCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING s SECTR5N 1 - SITE_INFORMATION This section to be completed by office 1.1 Property Address: l d 1 `� 4 Map Lot Unit �(OfE?v■C,Q Zone Overlay District J Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT I 2.1 Owner of Record: ,, Name (Print) / Current Mailing dres : ��Ilr._ - 33 3 © o - y Telephone Signa re �� 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building is f � I 0 �. (a) Buildi (� ng Permit Fee 2. Electrical 1 ' (/ (b) Estimated Cost of S (,7 49 e Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) r ° 0 0 5. Fire Protection 0 6. Total= (1 +2 +3 +4 +5) , t20 0 Check Number 3 4,5 A `" This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building, Commissioner/Inspector of bindings Date v ` File # BP- 2008 -0901 APPLICANT /CONTACT PERSON STEPHEN YOSHEN ADDRESS /PHONE P 0 BOX 41 CUMMINGTON (413) 634 -5431 PROPERTY LOCATION 62 MIDDLE ST MAP 23A PARCEL 057 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 9713 ,((. Fee Paid y'/ 3 ' Typeof Construction: CONSTRUCT 6 X 9 MUDROOM ADDITION, RENO KITCH /LAUNDRY, FINISH ATTIC W /BATH,ENCLOSE & INSULATE GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 88490 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 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. 62 MIDDLE ST BP -2008 -0901 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A - 057 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit # BP- 2008 -0901 Project # JS -2008- 001360 Est. Cost: $66000.00 Fee: $330.00 PERMISSION IS HEREBY GRANTED TO Const. Class: Contractor: License: Use Group: STEPHEN YOSHEN 88490 Lot Size(sq. ft.): 6795.36 Owner: TRENNER DANIEL & NOREEN Zoning: URB Applicant: STEPHEN YOSHEN AT: 62 MIDDLE ST Applicant Address: Phone: Insurance: P O BOX 41 (413) 634 - 5431 CUMMINGTONMA011026 ISSUED ON :4/22/2008 0 :00 :00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT 6 X 9 MUDROOM ADDITION, RENO KITCH /LAUNDRY, FINISH ATTIC W /BATH,ENCLOSE & INSULATE GARAGE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building'Inspector Underground: Service: 4 / n e el Meter: )' epaoto Footings: Rough: ' ° 1 7 vt Rough: House # Foundation: 10 Driveway Final: Final> C' V 2 Final: C "A Rough Frame: 14 � . L d -� s► ic ivPlo Gas: (Wax 6 J,�.;J` 7Y' Fi Department Fireplace /Chimney: �� al / Roughs 7 q g a Oil: Insulation: j �.( 05-12 tool to +~ l< ' Smoke: Final: f< ((0 Co & (3 O THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occuoanc Signature: '"` FeeTvpe: Date Paid: Amount: Building 4/22/2008 0:00:00 $330.00473 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo