31A-049 r%/T X009 1ECC Energy
Efficiency r ificate
Insulation Rating R-Value
Ceiling/Roof 48.50
Wall 25.50
Floor/Foundation 12.00
Ductwork(unconditioned spaces):
Glass&Door Rating U-Factor SHGC
Window 0.28
Skylight 0.05
Door
Heating&Cooling Equipment Efficiency
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments:
Exceptions:
Where public health standards require continuous pump operation.
Where pumps operate within solar-and/or waste-heat-recovery systems.
Li Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a
minimum insulation value of R-12.
Exceptions:
Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source.
Lighting Requirements:
u A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following:
(a)Compact fluorescent
(b)T-8 or smaller diameter linear fluorescent
(c)40 lumens per watt for lamp wattage<=15
(d)50 lumens per watt for lamp wattage>15 and<=40
(e)60 lumens per watt for lamp wattage>40
Other Requirements:
Li Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting
off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is
above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement'e).
Certificate:
L] A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window
U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility
of the circuit directory label,service disconnect label or other required labels.
NOTES TO FIELD:(Building Department Use Only)
Project Title: CAPLAN RESIDENCE ADDITION Report date: 04/02/13
Data filename:C:\Users\Peter\Desktop\CURRENT DATA\PFRA\PROJECTS11301CR3\rescheck0l.rck Page 3 of 3
/Pikblif
0/1,
i arethSto//ed' a eor
dance:tht�eman�fa
;nt are Identified so thatcomplianCe can cfura�s�nstallation inst
3 for all installed heatin be determined; �ctt°ns,
dazing IJ-factors,and heating aand cooling equipment and
equipment effi cienc Service water heatin
Y are dead the equipment have bee
Y marked on the buifdin n provided.
S are insulated to a minimum of 9 plans or s
t R-6, R-8,All peC+fcations.
other ducts in unconditioned spaCeS or outside the bull
i and Testing:
sullies are not building
envel°Pe are
of used as supply ducts.
ims of air ducts,
s,liquid sealants,air handlers,filter
9asketin boxes,and building
e!abated accordin g or other approved cavities used as retu
P joints for
sealants,
according to the duct Other closure systems Ta rn ducts are substantial)
s
g heet_ round metal ducts h ruction.Metal duct connections es,mastics,and fasteners substantially a� cht b
metals ave a contact la with are rated by means
crews, p of at least 1 1/2 inenes and arefas equipment and/or fittings UL�8 t or
are fastened 9s are mechanically
seams covered with s with a minimum
pray pplvurethane foam. of three
partially inaccessible duct connection exists,
as to prevent a hinge effect.
mechanical fasteners can be equally spaced o
uously welded and locking-type longitudinal'
and air handlers are located within on the exposed
)Dints and seams on Portion of the
conditioned s ducts operating at less than an 2 in.w.g•(500 Pa).
lure Controls:
the primary heating system is a forced air-furnace,at least one programmable thermostat
19 system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the installed to control the primary
It pumps having Supplementary electric-resistance heat have controls that prevent supplemental Doling cycle.
lnpressor can meet the heating iDad, ppiementai heat o
peration when the
sting and Cooling Equipment Sizing:
an inspection for compliance with the International Residential Code requirements for equipment sizing are included by
Additional
For Systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial
Building Mechanical and Sections 503 and 504),
ior service Water Heating
Circulating Service Hot Water Systems:
Service hot water pipes are insulated to R-2.
Circulating 9 pump when the
• ulating service hot water systems include an automatic or accessible manual switch to turn off the circulating
Du Circulating
system is not in use.
Heating and Cooling
lns
ng
piping ulatlon:
onveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R 3.
HVAC piping c
Swimming Pools:
Dols have an onioft heater switch. pilot li ht.
Heated swimming P on natural gas or LPG
have an electronic p 9
LJ
Pool heaters operating resent.
Li Timer switches on pool he
and pumps are p
ar� _. Report date:04102113
Page 2 of 3
��NCE ADDITIO N
-n\CURRENT DATA\PFRA\PRQ�ECT5i1301CR3\rescheck01.rc
(b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned wit
h insulator)and any gaps are sealed.
(c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier.
(d)Floors:Air barrier is installed at any exposed edge of insulation.
(e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or
sprayed/blown insulation extends behind piping and wiring.
(f) Corners,headers,narrow framing cavities,and rim joists are insulated.
(9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall.
Sunrooms:
• Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum
skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope
requirements.
Materials Identification and Installation:
• Materials and equipment are installed in accordance with the manufacturer's installation instructions.
• Materials and equipment are identified so that compliance can be determined.
ci Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided.
j Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications.
Duct Insulation:
• Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are
insulated to at least R-6.
• Duct Construction and Testing:
• Building framing cavities are not used as supply ducts.
All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means
of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or
UL 181B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically
fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three
equally spaced sheet-metal screws.
Exceptions:
Joint and seams covered with spray polyurethane foam.
Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the
joint so as to prevent a hinge effect.
Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa).
• All ducts and air handlers are located within conditioned space.
Temperature Controls:
❑ Where the primary heating system is a forced air-furnace,at least one programmable thermostat is installed to control the primary
heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle.
• Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the
compressor can meet the heating load.
Heating and Cooling Equipment Sizing:
• Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code.
• For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial
Building Mechanical and/or Service Water Heating(Sections 503 and 504).
Circulating Service Hot Water Systems:
• Circulating service hot water pipes are insulated to R-2.
• Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the
system is not in use.
Heating and Cooling Piping Insulation:
• HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3.
Swimming Pools:
• Heated swimming pools have an on/off heater switch.
p Pool heaters operating on natural gas or LPG have an electronic pilot light.
• Timer switches on pool heaters and pumps are present.
Project Title: CAPLAN RESIDENCE ADDITION Report date:04/02/13
Data filename:C:\Users\Peter\Desktop\CURRENT DATA\PFRA\PROJECTS\1301CR3\rescheck0l.rck Page 2 of 3
ciREScheck Software Version 4,4.3
Inspection Checklist
Energy Code: 2009 IECC
Location: Northampton, Massachusetts
Construction Type: Single Family
Glazing Area Percentage: 13%
Heating Degree Days: 6404
Climate Zone: 5
Ceilings:
❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.5 cavity+R-10.0 continuous insulation
Comments:
Above-Grade Walls:
❑ Wall 1:Wood Frame,24"o.c.,R-25.5 cavity insulation
Comments:
Windows:
❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.280
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Skylights:
❑ Skylight 1:Other,U-factor:0.050
For skylights without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Crawl Space Walls:
❑ Crawl 1:Solid Concrete or Masonry,5.6'ht/4.0'bg/6.0'ext.insul/1.5'inside bg depth,R-12.0 continuous insulation
Comments:
Exposed earth in unvented crawl space foundations is covered with a continuous vapor retarder(less than or equal to 0.1 perm).All joints
of the vapor retarder are overlapped by 6 inches and are sealed or taped with edges extending at least 6 inches up the stem wall and
securely attached.
Air Leakage:
❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are
sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or
solid material.
❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between
window/door jambs and framing.
❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk
between the housing and the interior wall or ceiling covering.
❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or
damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed
to maintain insulation application.
❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air.
❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts.
Air Sealing and Insulation:
❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7
ACH at 50 pascals OR 2)the following items have been satisfied:
(a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or
repaired.
Project Title: CAPLAN RESIDENCE ADDITION Report date: 04/02/13
Data filename:C:\Users\Peter\Desktop\CURRENT DATA\PFRA\PROJECTS\1301CR3\rescheck0l.rck Page 1 of 3
REScheck Software Version 4.4.3
is( Compliance Certificate
Project Title: CAPLAN RESIDENCE ADDITION
Energy Code: 2009 IECC
Location: Northampton,Massachusetts
Construction Type: Single Family
Project Type: Addition/Alteration
Heating Degree Days: 6404
Climate Zone: _ 5
Construction Site: Owner/Agent: Designer/Contractor:
235 Crescent Street Jeffrey Caplan Peter Frothingham
Northampton,MA 01060 235 Crescent Street Office of Peter Frothingham RA
Northampton,MA 01060 181 Main Street
Suite One
Northampton,MA 01060
413 585 5910
pf @pfra.us
Compliance:Passes
Compliance:33.7%Better Than Code Maximum UA:98 Your UA:65
The%Better or Worse Than Code index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code horns.
Gross Cavity Cont. Glazing UA
Assembly Area or R-Value R-Value or Door
Perimeter U-Factor
Ceiling 1:Flat Ceiling or Scissor Truss 563 38.5 10.0 12
Skylight 1:Other 36 0.050 2
Wall 1:Wood Frame,24"o.c. 606 25.5 0.0 27
Window 1:Wood Frame:Double Pane with Low-E 76 0.280 21
Crawl 1:Solid Concrete or Masonry 77 0.0 12.0 3
Wall height:5.6'
Depth below grade:4.0'
Insulation depth:6.0'
Inside below-grade depth: 1.5'
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 bu' g sdesigned to meet the 2009 IECC requirements in
check Ver • n 4.4.3 and to comply with the mandatory requi merit ist n the ESchecl Inspection Checklist.
% �A .4. ' btu!' GAM' 2' .-1 I
Name-Title SI nature Date
Project Title:CAPLAN RESIDENCE ADDITION Report date:04/02/13
Data filename:C:\Users\Peter\Desktop\CURRENT DATA\PFRA\PROJECTS11301CR31rescheck0l.rck Page 1 of 1
The Office of
PF PETER FROTHINGHAM
L J
Registered Architect
181 Main Street,Suite One
Northampton MA 01060
USA
413 585 5910
TRANSMITTAL
2 April 2013
Chris Kellogg
15 Fairway Drive
Florence MA 01062
Re: 1301 —Caplan Residence Addition
4 copies of Building Permit Application documents:
A1.1,A2.1,A3.1,&S-1
1 copy of REScheck Compliance Certificate
1 copy of REScheck Inspection Checklist and Panel Card
1 CD with PDFs of the above
FOR YOUR USE AND DISTRIBUTION
Peter
L ,„
,gyp
+0 .0, __.. __._..___
$ ig-/ # , lassaclpnsrtts l_
14.-tkw _l1' ..
DEPARTMENT OF BUILDING INSPECTIONS _ `
■S
INSPECTOR 212 Main Street • Municipal Building 'a,,, _=s,.'
Northampton,MA 01060
ri f Ci/
LOCATION 55 (/ 1
- /
•
SQUARE FOOTAGE AMOUNT
•
BASEMENT @ :20
Isl.FLOOR @.50 J i-� oq"
2ND FLR @.30 •
FLOORS, FINISH ATTIC,GARAGE @.20
DECK/PORCHES @ :20
TOTAL d V.. 5
City of Northampton
h 4, J -W
"� Massachusetts ° ra,
,: * .-
DEPARTMENT OF BUILDING INSPECTIONS r - �''
212 Main Street •• Municipal Building rte $
v •: +'' Northampton, MA 01060 Sti .� �'4..
a_
INSPECTOR
Louis Hasbrouck Chuck Miller
' Building Commissioner Assistant Commissioner '
. HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her
construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel op which t
'he/she resides or intends 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 home owner."
The building department for the City of Northampton wants any person(s)who seek to use the home
owner exemption, to act as their own construction supervisor, to be aware that by doing so you
become responsible for compliance with state building codes and regulations. The inspection
process requires that the building department be called to inspect work at various stages, which include
foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection
(before work is concealed), insulation inspection (if required) and a final building inspection.
The building department requires these inspections before the work is concealed, failure to secure
these inspections can result in failure to obtain a certificate of occupancy until the work can be
inspected.
If the homeowner hires other trades to perform work(electrical, plumbing & gas)the homeowner will be
responsible to make sure that the trades hired secure their proper permits in conjunction to the building
permit issued, and that they get their required inspections. Failure of the individual trades to secure
the permits and inspections as required can DELAY the project until such time as the proper permits
and inspections are made
I, understand the above.
(Home owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit issued to me.
Date
Address of work location
•
The Commonwealth of Massachusetts
Department of Industrial Accidents
3 �` , ` Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): r/ Xei/le "
Address: / 5 feu/r✓ ' ///iVf 1�
City/State/Zip:/.-7° Yx' -"a�0� Z,._ Phone #( /3�) u X 1 5
Are you an employer?Check(he appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
ployees(full and/or part-time).* have hired the sub-contractors 6. [ New construction
2. am a sole proprietor or partner- listed on the attached,sheet. 7. n Remodeling
ship and have no employees '� These sub contractors have' 8. Etemolition
working for me in any capacity. employees and have workers' 9. Building addition
[No workers' comp. insurance comp.insurance.
required.] 5. n We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 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' 13.11 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 certiA under the pains and penalties of perjury that the information provided above is true and correct.
Signature:
�_ Date: — Z — '20/
/ rr
Phone#: Zit/3.
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
b
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: CAK-,5+/-ex-- C Air tc. -D D
License Number
/4/?-1- y. /r0/ /Ck& e /4,9 7p ,3/00/
Addrp.s l ' :, , Expiratio(i Date? "
A (' 3) $"�`
Sign211 Telephone
9:Registered Home Improvement Contractor ..� Not Applicable ❑
•
?`•% C . hVe-1 ce 'l f 71/
Company Name Registration Number
��� (7 ,bra -e /W/ 67g 2-
*dress
• • / + Expi tion ate •
•
Telephon4 _? C
V 2 5
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 buildin permit.
Signed Affidavit Attached Yes No ❑
11.- :Home OwnerzExemption
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 ❑ Addition 2 Replacement Windows Alteration(s) n Roofing pi
Or Doors D
Accessory Bldg. ❑ Demolition ® New Signs [p] Decks [p Siding[q] Other[p] 4
, 1 , 4 i 4 t
Brief Descriptio of oposed _� /� ,./ _ /
Work: / /LGtr/ /�� �C: `�' ? ad j� � �'
Alteration of existing bedroom Yes (/ No Adding new bedroom �r Yes No
Attached Narrative Renovating unfinished basement Yes %I No
Plans Attached Roll -Sheet
sa.{f.New house andto'r.addition to..,existinq housing,completethe foliowing:
a. Use of building: One Family V Two Family Other
e
b. Number of,rooms in each family unit: 4 Number of Bathrooms 3 L - 4+ ,
C. Is there a garage attached? i!) / e P
d. Proposed Square footage of new construction. .S"--U/3 Dimensions 3 7 x /44
e. Number of stories?
f. Method of heating? az-5YZuot,"d' le/74 - 4'4 Fireplaces or Woodstoves Number of each '
g. Energy Conservation Compliance. !/ Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes 1,--- No. Is construction within 100 yr. floodplain Yes `'- No
(/
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? /7" 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, \ C 7 7 (cT iaJ7 , as Owner of the subject
property
hereby authorize -
��S K.-.
to ct on my beh If, in all relative to wor authori y this building permit application.
L
Signature of er Date /�' ��/
1 .�� S' , as Owner/Authorized
Agent h declare that the stater€ and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed un er th pains and penalties)of perjury.
Ke(797 _
Print Na
i
Signat $ er/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 filled in by
Building Department
Lot Size Ela
r .
.. . t ,
Frontage '' ' iL.1' _____ ,7L, _________: '_ .• . _
...
' „n
Setbacks Front i ,t-'),.,
_ --
Side L:..72 I • R: .iP 2". L:ItFiT eiR: 62/
Rear
4 I
Building Height /
o' .---
- -
Bldg.Square Footage
•If_2___4 _. % 3 '' 7 _
--- #
r 4 4 r
Opn Space Footage I /0 . --- 4
(Lot area minus bldg&paved ,r..-?--54 -Er-4-5- 4t7T7
- ;---i.
_......_
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO CE5 DON'T KNOW 0 YES 0
IF YES, date issued:.
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
, .
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 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 0 NO (221
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 0-
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
. . .
Department use only
City of Northampton Status of Perrr it , E r
Building Department Curb CuttDrlyeway Permit
�'L!Vt 212 Main Street SewerISepticAuaiJabiity t
Room 100 Water/Wetl Availability
illill - t, • hampton, MA 01060 Twa Set Hof StructuralPlans :' �
• •ne 4,N1* 587-1240 Fax 41,3-587-1272 Ply ofi�lSit�erans _ t � �
,. "•oFSUuniNetru Other Specify a ,# .� r
�1 4 R 2 , ��•
APPLICA • = - ' RUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address: r ,
3� e .
Map Lot Unit
Zone ' Overlay District
` , • s Elm St.District � CB C�istrict•
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
(14 PLiiii‘) Telephone - ( 7 r Cii Signature (----- L/1-5" 3
2.2 Authorized Agent:
Name(Print) i Current Mailing Addres 7,.,
Si Telephone
9
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 6 z� 3 (a) Budding Permit Fee
2. Electrical ,. (b) Estimated Total Cost of
Construction from j6) .
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total= 1 +2 3+4"+5) Check Number 'J� ? hi` C
This Section For Official Use Only
��� � Date
Building Permit Number: . Issued:
Signature:
Building Commissionerllnspector of Buildings Date
File#BP-2013-0903
APPLICANT/CONTACT PERSON C&T CONSTRUCTION
ADDRESS/PHONE 15 Fairway Drive FLORENCE (413)586-4965
PROPERTY LOCATION 235 CRESCENT ST
MAP 31A PARCEL 049 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out l�5/ aZd�/. p T�� 'U
Fee Paid SI
Typeof Construction: CONSTRUCT 37 X 14 MSTR BEDROOM&BATH pci
New Construction a To
Non Structural interior renovations .
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 062884
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
r- ,, .- ay p!
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.
235 CRESCENT ST BP-2013-0903
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A-049 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-2013-0903
Project# JS-2013-001547
Est.Cost: $62500.00
Fee: $281.50 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: C & T CONSTRUCTION 062884
Lot Size(sq.ft.): 8929.80 Owner: CAPLAN JEFFREY&ANN
Zoning:URB(100)/ Applicant: C & T CONSTRUCTION
AT: 235 CRESCENT ST
Applicant Address: Phone: Insurance:
15 Fairway Drive (413) 586-4965
FLORENCEMA01062 ISSUED ON:4/18/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 37 X 14 MSTR BEDROOM & BATH
Smoke and CO detectors must be to current building code throughout the structure!
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 $281.50 11/a/3
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner