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37-125 • 26. Unvented attic assemblies. Hot roofs are allowed, but have specific requirements 780 CMR R806.4. 27. Deck ledgers and post must be appropriately attached, bolts or lags. 780 CMR R502.2.2.1 Note: ThruLoks are engineered for post attachment supporting a railing. 28. Smoke and CO detectors as required. 780 CMR R314 and R315. 29. Closets beneath stair which have doors must be drywalled with % ". 780 CMR R302.7 Relevant items must be submitted to the building department for approvals before inspections and or CO can be signed. Other items are intended to avoid costly issues at inspections. Feel free to call if you have any questions. My telephone number is 587 -1240 and office hours are Monday through Friday, 8:30 am to 4:30 pm, excepting we close for walk -ins at 12:00 noon on Wednesdays. My email address is: cmiller(a�northamptonma.gov Thank you f. our cooperation on these matters. uck Miller City of Northampton Assistant Commissioner and Zoning Enforcement • 13. Windows over 72" above grade with the opening less than 24 above the finished floor shall meet the 4" sphere rule. Order restrictors. 780 CMR R612.2 14. Egress and emergency escape requirements shall be strictly met. a. Basements, habitable attics, and all sleeping rooms require emergency escape. 780 CMR R310 b. Windows within 44" of floor, DH 3.3 sqft min window size, Casement 20 "x41" exception 5 sqft at 1 floor. Minimum clear opening 20 "x24" or 24 "x20 ". 780 CMR R310.1.1 c. Two doors remote as possible at the normal level of travel, opening measured from the face of the slab to the stop with door at 90 degrees, one 32" and one 28" minimum 78" high. 780 CMR R311.2 d. Landing at each door 36" out and the width of the door minimum 36 ", maximum step 7 3/4" from the top of the threshold and only in- swinging doors. 780 CMR R311.3 15. Stairs have critical standards, make sure you know the floor finishes when planning. Minimum tread 9 ", maximum riser 83/4", maximum overall variance for the run is 3/8 ", 4" sphere rule on risers except where the total rise is 30" or less 780 CMR R311.7.4.3 Exception, 4 3/8" on balustrade, 6" in the triangle. Graspable_ rail _1 'A" minimum and 2" maximum rail, height minimum 34" maximum 38 ", required for 4 or more risers. Landing to landing constitutes a new run. Minimum 6'8" ceiling height from nosing. 780 CMR R311.7. 16. Guards 36" minimum height above walking surface, a bench is a walking surface, required for more than 30" above floor or grade within 36 ", 4" sphere rule. 780 CMR R312.1. 17. Educate the plumber and electrician about maximum notch and hole sizes, and placement. 780 CMR R502.8 and R602.6. In bearing studs holes not larger than 40% of a stud no closer than 5/8 to the edge, In interior non- bearing studs holes not larger than 60% of a stud no closer than 5/8 to the edge, in bearing walls if more than 50% of a plate is cut or notched a 1 %2 16ga. strap must extend a minimum of 6" past the cut both directions and be nailed with 8 -10d per side, or holes in joist are a maximum 1/3 the depth not closer than 2" from the top or bottom. Notches are different. 18. Dryer duct transition is limited to 8' of aluminum flex and must be exposed. 780 CMR M1502.4.3 19. Dryer duct maximum equivalent length is 25' or per manufacturer's specs. 780 CMR M1502.4.4.1, no screwed connections. 20. Markup air is required for any exhaust hood of 400 CFM or more. 780 CMR M1503.4 21. Fireplaces require all combustion air be provided from the exterior and below the firebox, duct work maintaining 1" clearance for 5' from the duct outlet for all fireplaces 22. Fire and draft stopping shall be completed before rough inspection. 780 CMR R302. 23. Ignition barriers in place before final. 780 CMR R316. 24. Energy aspects shall comply with the stretch energy code. 780 CMR Appendix 115AA or 2009 IECC. a. An initial HERS evaluation is required including insulation levels anticipated. b. A final HERS evaluation confirming code requirements have been met including duct testing. c. Energy information including mechanical equipment posted on the electric panel. d. Remodeling and Additions can be completed in accordance with IECC 2009 with Energy Star Building Option Package. 25. Vapor retarders. Although these are still in the code have exceptions, one must understand that there is a difference between a vapor retarder or barrier and an air barrier. An air barrier is intended to stop air flow (convection) a vapor retarder or barrier is intended to stop molecular moisture transfer (diffusion). A vapor retarder or barrier is effective even if there are some holes or gaps, however an air barrier has to be absolute and complete. If air can leak through an electrical device or through a crack it follows the path of least resistance and carries 99% of the moisture in a structure. This is evident every time one exposes fiberglass insulation and finds black insulation, which is dirt filter out of the air moving through the insulation. 780 CMR R601.2 for vapor retarders and Table N1102.4.2 for air sealing requirements. City of Northampton ' sus• t Massachusetts s .: c''�° 4 DEPARTMENT OF BUILDING INSPECTIONS , 5 212 Main Street • Municipal Building - ' T `b Northampton, MA 01060 41:;17-3;5'‘'‘ � '" INSPECTOR Gregory Quill April 20, 2012 23E Hadley Road Hadley, MA 01035 Subject Location: 20 Black Birch Trail Map Block: 37 -125 Mr. Quill, These are a few items which will need to be included; 1. HERS rating required: initial, final and air sealing checklist must be submitted. 2. 5/8 drywall on all garage walls and ceiling with a UL approved 1hr separation between units. 3. 2 floor window openings must be 24" AFF or have restrictors to meet the 4" sphere rule. 4. Windows within 60" of the stair nosing must be tempered. 5. Heat detectors in the garage connected to each unit. As of August 4 2011 the 8 Edition MA code is the 2009 IRC with MA amendments. In the following are some generic requirements which seem to be problematic. This is not a substitute for purchasing and reading the MA codes. 1. Structures shall conform to 780 CMR 8 Edition 1 and 2 family building codes with MA amendments. 2. Grading plan for structures being constructed required. 780 CMR R401.3 for drainage requirements. 3. A basement drainage system is required in all basements 780 CMR R405.2.3. except those in group I soils (table R405.1) 4. Foundations that retain earth and enclose interior space require damp proofing 780 CMR R406.1. 5. Ceiling joist are intended to prevent spread, once raised above the wall plate they become rafters ties and may require up sizing of rafters and increased nailing for example with a 4" slope 8 -16nd common are required at each connection. 780 CMR R802.3.1. 6. Steel straps over the ridge or 1x4 minimum collar ties are required 4' OC in the upper 1/ 1 780 CMR R802.3.1 7. Ridge boards must be the full depth of the cut. 780 CMR R802.3. 8. A complete window and header schedule is required. 780 CMR Table R502.5 for header sizing and number of jack studs required. 9. All framing materials which are not code prescriptive must have stamped engineering. a. LVLs b. I -joist and or Floor Truss c. Roof truss 10. A braced wall plan identifying appropriate braced wall areas and braced wall method being used. 780 CMR 602.10. a. Garage corners and large corner window /door layout may require special solutions. b. All corners must be appropriately attached to the foundation. 11. Ceiling heights minimum 7' for habitable spaces, 6'8" for bathrooms includes tub /shower area if a shower head is used, 6'8" for basements, 6'4" at beams /ducts. 780 CMR R305.1. MA amended 12. Hazardous glazing locations, within 24" of a door, or within 60" of a stair, or across from hot tubs, spas, bathtubs within 60" if not 60' above the Walking r and other 1. CMR R30Q 4 a Ouic� locations. . 0 .,M.. ��.,..... Louis Hasbrouck From: Louis Hasbrouck Sent: Thursday, April 12, 2012 2:38 PM To: 'rosemund @charter.net' Cc: Charles Miller Subject: 20 Black Birch Trail Attachments: Accessory Apt Zoning 10.10 2008- 11- 19.doc Greg, I got approval of the easement layout from the DPW Water Department, so that's all set. Chuck did the plan review and has a few comments. I'll send them along. One thing that I didn't realize is that the garage includes an accessory apartment. The room over the garage has cooking and bathing facilities and separate means of egress. That constitutes an accessory apartment. Zoning allows accessory apartments in a single family home but there are a number of restrictions. I've attached a copy of the relevant zoning section. There are a number of building code requirements that apply, including fire separation, smoke, carbon monoxide and heat detector requirements, access to a separate electrical panel and common area requirements. Fire separation requires a 1 hour rating (which is not just 5/8" sheetrock) and will likely include the walls of the mudroom (IRC section R302). An accessory apartment is treated as a completely separate dwelling unit so the floor area is considered first floor for permit fee calculations. Look over the zoning info and let me know if you have any questions. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg 212 Main Street Northampton, MA 01060 (413) 587 -1240 1 Louis Hasbrouck From: David Sparks [dsparks @nohodpw.org] Sent: Tuesday, April 10, 2012 1:59 PM To: Louis Hasbrouck Cc: James Laurila, DPW Subject: Re: 20 Black Birch Trail easement Categories: Dealt with Louie, the City Water Departments concern is that we can get a machine in to the location to excavate if needed. Looking at the proposed relocation of the easement it appears that it will be reduced to about 4' to the east and stay the same to the west, 10'. This distance will be sufficient to do any emergency maintenance that we may need to do and is acceptable to Northampton Water Department. David W. Sparks, Superintendent Water Division, Public Works 237 Prospect St Northampton, MA 01060 413 - 587 -1097, dsparks@nohodpw.org On 4/10/2012 1:05 PM, Louis Hasbrouck wrote: > Dave, > There is an easement on the lot at 20 Black Birch Trail (originally > lot > 2) for water and sewer lines that serve 660 Florence Rd (originally > lot 6). The water and sewer lines are private but it is city water. > Both lots have houses on them now. The original layout (2003) shows a 20' > easement on the west side of lot 2. The as -built layout (2007) shows > the water line for lot 6 outside the easement. The easement was > amended in 2011, widening it in one area to include the water line and > narrowing in another area to allow an addition to the house on lot 2. > That amendment has been recorded. I've attached all 3 drawings. Let me > know if you think the amended easement protects the city's interest > and would be acceptable to the DPW. Perhaps you could call me this > afternoon; I'll be in the office. > Louis Hasbrouck > Building Commissioner > City of Northampton > Town of Williamsburg > 212 Main Street > Northampton, MA 01060 > (413) 587 -1240 > City of Northampton email messages are public records except when they 1 JEFFREY S. MARLIN ADMITTED IN VT, NH & MA jmarlin@ppeclaw.com PR JM v [E R TEL: (802) 223 -2102 PRIMMER PIPER EGGLESTON & CRAMER Pc FAX:(802)223 -2628 100 E. STATE STREET, P.O. Box 1309 MONTPELIER, VT 05601 April 10, 2012 Louis Hasbrouck Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 Re: Susan and Wilson Molano, 20 Black Birch Trail, Florence, MA 01062 Utility Easement Amendment Dear Mr. Hasbrouck: I represent the Molanos in connection with the above - referenced matter. I am writing in response to your request for an explanation as to the reasons for the 2011 amendment of the utility easement encumbering the Molanos' property on Black Birch Trail. As you know, the easement benefits Lot 6 on Florence Road. The easement was amended for two reasons: 1) to accommodate the Molanos' desire to build a garage on their lot by narrowing the width of the easement (from 20 feet to approximately 15 feet, subject to some variation based on the as built location of utility lines); and 2) to conform the location of the easement to the location of the as built utility lines. The new easement is angled so that the water line is fully within the easement boundaries. The owners of Lot 6 and the Board of Trustees at the Rocky Hill Condominium Association have approved these changes. If you need any further information, please let me know. i cerely, ...` , iv` Jef u ey S. . in VERMONT: BURLINGTON • MONTPELIER • ST. JOHNSBURY I NEW HAMPSHIRE: MANCHESTER • LITTLETON WWW.PRIMMER.COM f .N NOTE: UTILITY LINES SHOWN AS FIELD LOCATED ON 05 -26 -2011. 4 ' s6>>>.. // ;Ai ry 97 6 F /•4� 6i. EXISTING 20' 0 .h UTILITY `N EASEMENT h q SUSAN M. MOLANO & WILSON E. MOLANO Bk 8688 Pg 148 Q O ' 0 PROPOSED �' pl f,,01 DG 0 `"' UTILITY �" 1) Z3 j EASEMENT ' c f o �� N LINE ifs NEW GAS LINE w EASEMENT R= _ la 0 I Zs) 1529 S.F.± L 94.81' — _ _ i� EXISTING 30 ' cAS o i 1 GAS UNE o LINE a � \ c;) o y 1 EASEMENT mo o' Z °' cr _ to z t` t\ R 29 .00' _ , L 88.: ' — 1� w — ___ L 25 37 • ' f R= 2 93 . 00 ►�i ACCESS EXISTING z-00 �► EASEMENT AND UTILITY 2 -1 IT /, .- -� 1 ' L= 80.27' t `, _ % R= 250.00' • i 'BLAC BIRC- TRAIL r NI , PLAN OF REVISED EASEMENT IN The FLORENCE, MA _- Design PREPARFD FOR Mil Group, Inc. ` DATE: JUNE 14, 2011 ` SUSAN M. MOLANO & WILSON E. MOLANO l ` 4 ,= wor ' u`oa�r�oeoseaooe REST: HAMPB , c�Ytart 11.A_RIANNE L. DONOHUE QUICK ANALYSIS REPORT Date: March 26, 2012 Rating No.: 016 -12 Building Name: Molano apartment Rating Org.: Power House Energy Consulting Owner's Name: Molano Phone No.: 413 - 835 -5162 Property: 20 Black Birch Trail Rater's Name: Matt Turcotte Address: Northampton, MA01062 Rater's No.: 1497133 Builder's Name: Rosemund LLC Weather Site: Worcester, MA Rating Type: Based On Plans File Name: 016 -12 20 Black Birch Trail.blg Rating Date: 3/21/12 Codes Programs IECC 2009 Performance: Fails EPA ENERGY STAR 2.0 Fails IECC 2006 Performance: Passes EPA ENERGY STAR 2.5 Passes IECC 2004 Performance: Passes ! EPA ENERGY STAR 3.0 Fails IECC 2003 Performance: Passes Tax Credit Fails IECC 2001 Performance: Passes HERS Index 65 IECC 2000 Performance: Passes IECC 1998 Performance: Passes ECC of NY Performance: Passes ECC of NV Performance: Fails MEC 1995 Performance: Passes MEC 1993 Performance: Passes MEC 1992 Performance: Passes ASHRAE 90.2 Performance: Passes REM /Rate - Residential Energy Analysis and Rating Software v12.96 This information does not constitute any warranty of energy cost or savings. © 1985-2011 Architectural Energy Corporation, Boulder, Colorado. PERFORMANCE FACTORS - C:\.. . \JMC 2011 UDRH vQ4 for REM 12 9.udr Date: March 26, 2012 Rating No.: 016 -12 Building Name: Molano apartment Rating Org.: Power House Energy Consulting Owner's Name: Molano Phone No.: 413 - 835 -5162 Property: 20 Black Birch Trail Rater's Name: Matt Turcotte Address: Northampton, MA01062 Rater's No.: 1497133 Builder's Name: Rosemund LLC Weather Site: Worcester, MA Rating Type: Based On Plans File Name: 016 -12 20 Black Birch Trail.blg Rating Date: 3/21/12 UDRH Molano apartment DIFF % DIFF Normalized Loads (Btu /sf shell area /DD) Heating: 1.53 1.32 0.21 13.7% Cooling: 0.00 0.00 Normalized Consumption (kBtu /sf floor area /yr) Heating: 46.2 39.9 6.3 13.7% Cooling: 0.0 0.0 Water Heating: 28.5 16.3 12.2 42.7% Lighting: 2.9 2.9 Appliances: 14.3 14.4 -0.1 -0.6% Photovoltaics: -0.0 -0.0 Total w/o PV: 92.0 73.5 18.4 20.0% Total: 92.0 73.5 18.4 20.0% Normalized Consumption (Btu/sf floor area /DD) Heating: 6.6 5.7 0.9 13.7% Cooling: 0.0 0.0 Normalized Costs ($ /sf floor area/yr) Heating: $ 0.302 $ 0.261 $ 0.041 13.7% Cooling: $ 0.000 $ 0.000 $ Water Heating: $ 0.187 $ 0.107 $ 0.080 42.7% Lighting: $ 0.148 $ 0.148 $ Appliances $ 0.731 $ 0.735 $ -0.005 -0.6% Photovoltaics $ -0.000 $ -0.000 $ Total: $ 1.367 $ 1.251 $ 0.117 8.5% Normalized Design Loads (Btuh /sf shell area /DD) Heating: 0.0008 0.0007 0.0001 12.3% Cooling: 0.0000 0.0000 Normalization Factors Floor Area: 603 603 Shell Area: 2119 2119 Heating Degree Days (B65): 6951 6951 Cooling Degree Days (B74): 63 63 REM /Rate - Residential Energy Analysis and Rating Software v12.96 This information does not constitute any warranty of energy cost or savings. © 1985-2011 Architectural Energy Corporation, Boulder, Colorado. x ;; ROSEMUND, LLC Rocky Hill Rd - Building Permit Fees 1ST FLOOR (mudroom) 144 $0.50 $ 72.00 2ND FLOOR 603 $0.30 $ 180.90 basement $0.30 $ - GARAGE 672 $0.20 $ 134.40 mudroom $0.30 $ - FRONT PORCH $0.20 $ - REAR DECK 48 $0.20 $ 9.60 Total SF Usuable 747 Total Fee: $396.90 1 Molano Estimate 3/28/2012 ro BY : Name: 17S Title: Trustee Duly Authorized Commonwealth of Massachusetts Hampshire County, SS On this day June a %, 2011, before me the undersigned notary public, personally appeared fl6 &14 gence< Ac/Isu.h -JDn , and T. S- iephe., , proved to me through satisfactory identification (which was my personal knowledge as to his/her identity or photographic identification) to be the persons whose name is signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose. Notary Public Stephen Hammerschmith 0 7 My Commission expires: 1Jotle be/ �saol L Notary Publi My Commission Expires November 26 2016 Commonwealth of 4 whose name is signed on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose. Stephen P a erschmith My Commission Expires November 25, 2016 Notary Public Commonwealth of Massachusetts My Commission expires: 'N.lo.,E ^11 {r )S r d o L Wilson E. Molano Commonwealth of Massachusetts Hampshire County, SS On this day, June 30, 2011, before me the undersigned notary public, personally appeared Wilson E. Molano, proved to me through satisfactory identification (which was my personal knowledge as to his identity or photographic identification) to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. Stephen Hamrnerschmith Notary Public Notary ublic My Commission Expires November 25, 2016 My Commission expires: Nove►nbQf aS t N)16 Commonwealth of Massachusetts Rocky Hill Condominium Association By: 2 Name: /4405/ L Leavy 1t Title: Trustee Duly Authorized Name: �ok,ctl a P /«►1 i C Title: Trustee Duly Authorized Name: Kose.w-t 1 tn- iJauskw Title: Trustee Duly Authorized 3 IN WITNESS WHEREOF, Gregory M. Grason, Lindsay Koshgarian, Susan M. Molano Wilson E. Molano and Rocky Hill Cohousing, LLC have executed this instrument under seal this S 0 day of June, 2011. , 4 -4 Vic mo . .11 Commonwealth of Massachusetts Hampshire County, SS On this day, June 3o, 2011, before me the undersigned notary public, personally appeared Gregory M. Grason, proved to me through satisfactory identification (which was my personal knowledge as to his identity or photographic identification) to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. Stephen Harn mersc i Notary Public 11 Notary Pub is My Commission expires: ).Jou&.be( S , o 1 b COMOOSSAII el fikeit§Wet 4 tb i 7 Lin say Koshrian j Commonwealth of Massachusetts Hampshire County, SS On this day, June So, 2011, before me the undersigned notary public, personally appeared Lindsay Koshgarian, proved to me through satisfactory identification (which was my personal knowledge as to her identity or photographic identification) to be the person whose name is signed on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose. / Stephen `,Tim/ — � y9 � Notary ublic M Commission X16 My Commission expires: Po 't ASS, �o I 6 / �:. •� 1p Sus. ? M. Molano Commonwealth of Massachusetts Hampshire County, SS On this day, June a ? b, 2011, before me the undersigned notary public, personally appeared Susan M. Molano, proved to me through satisfactory identification (which was my personal knowledge as to her identity or photographic identification) to be the person 2 Bk: 10588Pg: 36 Page: 1 of 5 Recorded: 06/30/2011 12:41 PM AMENDMENT TO UTILITY EASEMENT This Amendment to Utility Easement is hereby agreed to as of June 30 , 2011 by and among 1) Gregory M. Grason ( "Grason ") and Lindsay Koshgarian ( "Koshgarian "); 2) Susan M. Molano and Wilson E. Molano (collectively the "Molanos "); and 3) Rocky Hill Condominium Association ( "Rocky Hill "). WHEREAS, Grason and Koshgarian are the record owners of a certain parcel of land with buildings thereon located at 660 Florence Road, Florence, MA, having acquired title thereto pursuant to a quitclaim deed dated March 12, 2009 and recorded in the Hampshire County Registry of Deeds Book 09734 Page 170 ( "Parcel A ") ; WHEREAS, Parcel A was conveyed to Grason and Koshgarian with the benefit of a certain 20 Foot Wide Utility Easement (the "Original Easement "), as described in Paragraph No. 2 of a certain Declaration of Covenants and Restrictions, Easements, and Maintenance Agreements dated September 1, 2004 and recorded in the Hampshire County Registry of Deeds Book 7976, Page 159, as amended by an Addendum thereto dated April 13, 2006 and recorded as aforesaid in Book 08222, Page 285 (the • ! "Declaration "); WHEREAS, the Molanos are the record owr rs of a certain parcel of land with buildings thereon located at 20 Black Birch`Trail',' Plorence, MA, having acquired title thereto pursuant to a quitclaim deed dated April 20, 2006 and recorded in the Hampshire County Registry of Deeds Book 08688, Page 148 ( "Parcel B "), and Parcel B is subject to the Original Easement, as described in the Declaration; WHEREAS, Rocky Hill, as the unit owner's organization for Rocky Hill Condominium under a Master Deed dated April 2, 2005 and recorded in the Hampshire County Registry of Deeds Book 8252, Page 318 as amended, is responsible for the inspection, maintenance, repair and/or reconstruction of the sewer and water lines that run through the Original Easement pursuant to Paragraph 18 of the Declaration; WHEREAS, Grason, Koshgarian, the Molanos and Rocky Hill desire to amend the boundaries and location of the Original Easement; NOW THEREFORE, in consideration of one dollar and other good and valuable consideration, the receipt and sufficiency thereof is hereby acknowledged, the undersigned parties hereto hereby agree that the location and boundaries of the Original Easement shall be amended, and the Original Easement shall be replaced with a certain "New Easement ", as reflected on a plan entitled Plan of Revised Easement in Florence, MA, dated June 14, 2011 (the "Plan "), attached hereto and recorded herewith. Specifically, the New Easement shall run from the southwesterly corner of the Original Easement N 00 °37'19 "E 95.05 feet; thence N 22 °59'04 "E 19.33 feet; thence S 05 °15'52 "E 72.38 feet; thence S 14° 36'59 "E 38.59 feet; thence 25.37 feet to the point of beginning, containing 1529 S.F. +, as shown on the Plan. 2) Z PG f I e 79 76 - 153 p4 £ 7 9 76 — I S� ''. The Commonwealth of Massachusetts _ � Department of Industrial Accidents p. • j ,,, Office of Investigations - 1 600 Washington Street M, _;' Boston, MA 02111 r - Y 5=; www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): � / �'C r -e G V i \ \ 1 �(�Q' -� v, v, �L . c_. Address: c - E, l CA.ck ` I kirk A1.-(z),„ v)t 0(03 City /State /Zip: Phone #: 1 b a `j ol 0 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ [ am a employer with 4. ❑ I am a general contractor and I gpfployees (full and/or part- time).* have hired the sub - contractors 6. El New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ workin for me in an aci employees and have workers' g y ca p 9. ng addition [No workers' comp. insurance comp. insurance .t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 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 12.0 Roof repairs insurance required.] t 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 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 the policy and job site information. Insurance Company Name: _ 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 of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone #: 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 #: SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : � -e \1 ( �5 5 J License Numb r - 7 3 c� I - td.AIsQ I clA Loi 1M7'\ t-\\act �3 Address Expiration Date I C coq - tct Signature Telephone 9-Reeistere . ome 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 bung 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, SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House n Addition Replacement Windows Alteration(s) n Roofing n Or Doors 0 Accessory Bldg. ❑ Demolition El New Signs [D] Decks [Q Siding [0] Other [D] Brief Description of Prorxsed Work: u_ca 'rU h -h , W V - (aver C , rc q. \kJ Ch \ '5 O d \ C�OV / Alteration of existing bedroom Yes No Adding new bedroom t/ Yes No Attached Narrative Renovating unfinished basement Yes No 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 Bathrooms V c. Is there a garage attached? G v \ Q D- X `a` d. Proposed Square footage of new construction. t (p Dimensions O YOC)'rv- X [ (p e. Number of stories? f. Method of heating? t' \ OE Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 'W 00 k - E Y"(9, VYt - i. Is construction within 100 ft. of wetlands? Yes V No. Is construction within 100 yr. floodplain Yes V./NO j. Depth of basement or cellar floor below finished grade b'1 C)._ k. Will building conform to the Building and Zoning regulations? ✓ Yes No . I. Septic Tank City Sewer \/ Private well City water Supply V SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT f C( I, � t S 0 v\ Y v t c j n a, 0 , as Owner of the subject property II j (� hereby authorize C Y Q v t 1 P----OS to act on my behalf, �yiinn all matte relative to work a (ithorized y this building permit application. / zi,,,_ At — e t — Signature of Owner Date I, C�1 Y ` iJ -e \/v\. U∎ v\ 1 _ L.C. , as Owner /Authorized Agent hereby decl re that t e statemen 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 perj ry. Print Na i - pip, P Sign . e of • Tr • gent — 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 10, t l(,, 66`-+ Frontage ; ' 7 Setbacks Front CS' 6 �' Side L: �5 R: 1 < L: I) R: Rear '5 Building Height 2-C / Bldg. Square Footage 7V0 7 % 621. Open Space Footage (Lot area minus bldg & paved 1 �. 17) parking) # of Parking Spaces Z Fill: �� QOM' (volume & Location) A. Has a Spe • l Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW I YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW O YES C IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW ® YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , 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 ® NO, IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, exc ation, 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 Storm Water Management Permit from the DPW is required. r -- ' Department use only ',Cit of Northampton Status of Permit: 2 ,1.0- We 'rig Department Curb Cut/Driveway Permit ,,�t . Main Street Sewer /Septic Availability 01 - OOm 100 Water/Well Availability a o "°'t w' I orthampton, MA 01060 Two Sets of Structural tural 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 2,0 ( MC>.t rL� � �� 1 rC.>L.l V � Map 7 Lot J2 Unit G {A 0.\1.ti.te 4- Gy^ ) �` Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: ( ) k 0.0C. C ■ v - C \ T 0. \ \ t k, 5 0 v, Ct L u h . c) 034 0 In o r'' f vk o. v.,e't o v-‘ , 1M l' Name (Print) Current Mailing Address: L /�+ q(•3 - Cofi a - to z7 %� 4 i �.c,�Y�,rl^ ,,,, , if , , - Telephone Signature V�'� ,• (� - 2.2 Authorized Agent: 2, (:- 0.S+ 0..k -Q 1 Ro e. V\ LI- c G, (4 ov, \ . �o,�,\ $ 'A d { ,o 3 Name (Print) Current Mailing Address:1 c,---- %.----..„ I - ( 3) Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building [ v o (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of i 0 0 0 Construction from (6) 3. Plumbing ' o O U Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection i 00 0 6. Total = (1 + 2 + 3 + 4 + 5) (9l C) 06 Check Number 015-9 _ a9‘ 4q This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0838 APPLICANT /CONTACT PERSON GREGORY QUILL . ��S � ADDRESS/PHONE 23 E HADLEY RD HADLEY (413) 695 -4195 �� \\� vk PROPERTY LOCATION 20 BLACK BIRCH TRL Yom'" P l c„ t> MAP 37 PARCEL 125 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: Co ' PERMIT APPLICATION CHECKLIST 1 ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid l t0\ 12- Building Permit Filled out 5 0i '.� Fee Paid day ,} `� c5 9 •� - Typeof Construction: CONSTRUCT MUDROOM, 2 CAR ATT GARAGE WITH STUDIO /DECK LAIAA New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 105857 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN 6RMATION PRESENTED: 1 - 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 Peen lts 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 67#/ta /5/-1-J "71'/Z— 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. 20 BLACK BIRCH TRL BP- 2012 -0838 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37 - 125 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- 2012 -0838 Project # JS- 2012- 001485 Est. Cost: $86000.00 Fee: $396.90 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GREGORY QUILL 105857 Lot Size(sq. ft.): 18338.76 Owner: MOLANO SUSAN M & WILSON E Zoning: Applicant: GREGORY QUILL AT: 20 BLACK BIRCH TRL Applicant Address: Phone: Insurance: 23 E HADLEY RD (413) 695 -4195 HADLEYMA01035 ISSUED ON:4/23/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT MUDROOM, 2 CAR ATT GARAGE WITH STUDIO /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 4/23/2012 0:00:00 $396.90 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner