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13-080 CS neam4.605 Rockland Heights 7-8-14 IonneartErigmi 4.G1.0 Materials Database 1492 Northampton 7:33am loft Member Data Description: Member Type: Beam Application: Roof Top Lateral Bracing: Continuous Slope: 0.00/ 12 Bottom Lateral Bracing: 0.00 Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Snow Load: 35 PLF Deflection Criteria: U360 live, U240 total Dead Load: 15 PLF Deck Connection: Nailed Member Weight: 13.8 PLF Filename: Beam1 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 16' 0.00" 13' 0.00" 35 15 Snow 16 0 0 16 0 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall Steel WA 2.041" 5359# -- 2 16' 0.000" Wall Steel N/A 2.041" 5359# Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Snow Dead 1 3673# 1686# 2 3673# 1686# Design spans 16' 1.750" Product: 1-3/4x14 VERSA-LAM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS Connect members with 3 rows of 16d common nails at 12.0"oc Minimum 2.04"bearing required at bearing#1 Minimum 2.04"bearing required at bearing#2 design assumes continuous lateral bracing along the top chord. Design assumes maximum unbraced length of 0.00'along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 21631.'# 333904 64% 8' Total Load D+S Shear 4584.# 107064 42% -0.06' Total Load D+S TL Deflection 0.6341" 0.8073" L/305 8' Total Load D+S LL Deflection 0.4346" 0.5382" L/445 8' Total Load S Control: LL Deflection DOLS: Live=100% Snow=115% Roof=125% Wind=160% All product names are trademarks of their respective owners Doug Hudgins rk Miles Inc. Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing is defined a5 vnen the member,fiowjoist,beam or girdef shown on this drwAng meets applicable design criteria for Loads,Loading Conditions,and Spans listed w this sheet. Thetlesi nmust be reviewetl a ual=.tlesi neror design fessional as uired fora al.This design assurnes uct installation according to the manufacturers ificatione. Job russ Qty Ply Marek/Rockland Heights 14062538B T01GE GABLE 2 1 Job Reference(optional) Universal Forest Products 7.430 s Jul 25 2013 MiTek Industries,Inc. Wed Jun 18 19:51:23 2014 Page 1 ID:_MXUjL Xc?XEoGgWTU42HHrz4yvw-TSnrvN_tkPMmf7hXWHCQ88B41QCY0oeZAoR16Wz4yu2 1-0 Q 12-0-0 24-0-0 25-0 Q 0 0 12-0-0 12-0-0 1-0-0 4x4= Scale=1:56.6 9.00 FIT 9 3x4 i 8 10 3x4 O 7 11 5 12 5 13 4 14 114 114 ,13 ET3 15 3 1 1 0 16 0 X11 2 d 0 3x4= 28 27 26 25 24 23 22 21 20 19 18 3x4= 5x6= 24-0-0 24-0-0 Plate Offsets(X Y)7 [21:0-3-0,0-3-01 LOADING (psf) SPACING 2-0-0 CSI DEFL in (loc) I/deft L/d PLATES GRIP TCLL 40.0 Plates Increase 1.15 TC 0.11 Vert(LL) -0.01 17 n/r 180 MT20 197/144 (Roof Snow=40.0) Lumber Increase 1.15 BC 0.04 Vert(TL) -0.01 17 n/r 80 TCDL 10.0 Rep Stress Incr YES WB 0.32 Horz(TL) 0.01 16 n/a n/a BCLL 0.0 Code IRC20091TPI2007 (Matrix) Weight:124 lb FT=4% BCDL 10.0 -- LUMBER BRACING TOP CHORD 2x4 SPF 210OF 1.8E TOP CHORD Structural wood sheathing directly applied or 6-0-0 oc purlins. BOT CHORD 2x4 SPF 210OF 1.8E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. WEBS 2x4 SPF No.2 or 2x4 SPF Stud WEBS 1 Row at midpt 9-23 OTHERS 2x4 SPF No.2 or 2x4 SPF Stud`Except* MiTek recommends that Stabilizers and required cross bracing ST6,ST5:2x4 SPF No.2 I be installed during truss erection,in accordance with Stabilizer Installation guide. REACTIONS All bearings 24-0-0. (lb)- Max Horz 2=207(LC 7) Max Uplift All uplift 100 lb or less at joint(s)2, 16,24,25,26,27,28,22,21,20,19, 18 Max Grav All reactions 250 lb or less at joint(s)23,26,27,28,20,19,18 except 2=273(LC 12),16=273(LC 12),24=360(LC 2),25=285(LC 2),22=360(L(-3),21=285(LC 3) FORCES (lb)-Max.Comp./Max.Ten.-All forces 250(lb)or less except when shown. WEBS 8-24=-320/83,10-22=-320/83 NOTES 1)Wind:ASCE 7-05;100mph;TCDL=5.Opsf;BCDL=5.Opsf;h=24ft;Cat.Il;Exp B;enclosed;MWFRS(low-rise)and C-C Exterior(2) zone;cantilever left and right exposed;C-C for members and forces&MWFRS for reactions shown;Lumber DOL=1.60 plate grip DOL=1.60 2) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind(normal to the face),see Standard Industry Gable End Details as applicable,or consult qualified building designer as per ANSI TPI 1. 3)TCLL:ASCE 7-05;Pf=40.0 psf(flat roof snow);Category II;Exp B;Partially Exp.;Ct=1.1 4)Unbalanced snow loads have been considered for this design. 5)This truss has been designed for greater of min roof live load of 16.0 psf or 2.00 times flat roof load of 40.0 psf on overhangs non-concurrent with other live loads. 6)As requested,plates have not been designed to provide for placement tolerances or rough handling and erection conditions. It is the responsibility of the fabricator to increase plate sizes to account for these factors. 7)All plates are 2x4 MT20 unless otherwise indicated. 8)Gable requires continuous bottom chord bearing. 9)Gable studs spaced at 2-0-0 oc. 10)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 11)`This truss has been designed for a live load of 35.Opsf on the bottom chord in all areas with a clearance greater than 3-6-0 between the bottom chord and any other members. 12)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 100 lb uplift at joint(s)2,16,24,25,26, 27,28,22,21,20,19,18. 13)This truss is designed in accordance with the 2009 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1. 14)"Semi-rigid pitchbreaks including heels"Member end fixity model was used in the analysis and design of this truss. LOAD CASE(S) Standard Job russ Truss Type Oty y Marek!Rockland Heights 140625388 Tot FINK 11 1 - Job Reference(optional) Universal Forest Products 7.430 s Jul 25 2013 MiTek Industries,Inc. Wed Jun 18 19:51:36 2014 Page 1 ID:_MXUjLXc?XEoGg WrU42HHrz4yvw-by3lep81 gP?wj6B 1 n WxTAuDBEfUhxhtUAJ4U3Gz4ytr 1-0 Q 6-2-3 12-0-0 17-9-13 24-0-0 25-0-Q 1-0-0 6-2-3 5-9-13 5-9-13 6-2-3 1-0-0 4x6= Scale=1:54.3 9.00 12 5 3x8 3x8 4 6 12 13 5�X 2x4 1/ 3 7 rn 2 m 1 1 7-8-2 2 8 0 ;1 9 Ic 3x8-_ 11 35 PSF Load Center Panel 10 3x8= 4x4= 6x8= 8-M 16-0-0 24-0-0 B-0-0 8-0-0 8-0-0 Plate Offsets(X Y)' f2:0-8-0,0-0-101,[5:0-3-0,0-1-81,[8:0-8-0,0-0-101,[10 0-4-0 Edgel LOADING (psf) SPACING 2-0-0 CSI DEFL in (loc) I/defl L/d PLATES GRIP TCLL 40.0 Plates Increase 1.15 TC 0.54 Vert(LL) -0.41 10-11 >690 240 MT20 197/144 (Roof Snow=40.0) Lumber Increase 1.15 BC 0.67 Vert(TL) -0.4910-11 >581 180 TCDL 10.0 Rep Stress Incr YES WB 0.32 Horz(TL) 0.05 8 n/a n/a BCLL 0.13 BCDL 10.0 Code IRC2009/TPI2007 (Matrix) Wind(LL) 0.04 2-11 >999 360 Weight:98 lb FT=4% LUMBER BRACING TOP CHORD 2x4 SPF 210OF 1.8E TOP CHORD Structural wood sheathing directly applied or 4-6-1 oc purlins. BOT CHORD 2x4 SPF 210OF 1.8E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. WEBS 2x4 SPF No.2 or 2x4 SPF Stud'Except* MiTek recommends that Stabilizers and required cross bracing W2:2x4 SPF No.2 I be installed during truss erection,in accordance with Stabilizer Installation guide. _ REACTIONS (lb/size) 2=1817/0-3-8 (min.0-2-14),8=1817/0-3-8 (min.0-2-14) Max Horz 2=207(LC 7) Max Uplift2=-69(LC 8),8=-69(LC 9) FORCES (lb)-Max.Comp./Max.Ten.-All forces 250(lb)or less except when shown. TOP CHORD 2-3=-2466/275,3--12=-2232/344,4-12=-2089/355,4-5=-2036/376,5-6=-2036!376, 6-13=-2089/355.7-13=-2232/344,7-8=-2466/275 BOT CHORD 2-11=-87/1817,10-11=0/1205,8-10=-87/1817 WEBS 3-11=-585/247,5-11=-163/1131,5-10=-163/1131,7-10=-585/247 NOTES 1)Wind:ASCE 7-05;100mph;TCDL=5.Opsf;BCDL=5.Opsf;h=24ft;Cat.II;Exp B;enclosed;MWFRS(low-rise)and C-C Exterior(2) zone;cantilever left and right exposed;C-C for members and forces&MWFRS for reactions shown;Lumber DOL=1.60 plate grip DOL=1.60 2)TCLL:ASCE 7-05;Pf=40.0 psf(flat roof snow);Category II;Exp B;Partially Exp.;Ct=1.1 3)Unbalanced snow loads have been considered for this design. 4)This truss has been designed for greater of min roof live load of 16.0 psf or 2.00 times flat roof load of 40.0 psf on overhangs non-concurrent with other live loads. 5)As requested,plates have not been designed to provide for placement tolerances or rough handling and erection conditions. It is the responsibility of the fabricator to increase plate sizes to account for these factors. 6)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 7)'This truss has been designed for a live load of 35.Opsf on the bottom chord in all areas with a clearance greater than 3-6-0 between the bottom chord and any other members,with BCDL=10.Opsf. 8)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 100 lb uplift atjoint(s)2,& 9)This truss is designed in accordance with the 2009 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSVTPI 1. 10)"Semi-rigid pitchbreaks including heels"Member end fixity model was used in the analysis and design of this truss. LOAD CASE(S) Standard 301r iqyL�' fl,�is CCf�� (Jln � j►�t�� 'C viz `1 )-X , Sill L-)44 �o LA 'I I i . ti s l i } P i i i i i 1 4 I i f I j iN r) �:t I j I-C lil_,TH LABEL LEI I J Cut List for REAR WALL WALLY MAREK 06/18/14 Ref:ROCKLAND Scale: 1/4"= V --FL-] L4BEL —E! 11-,-11 H L i4 P,L-L LEI li-,TH J 4' Cut List for RIGHT WALL WALLY MAREK 06/18/14 Ref-ROCKLAND Scale: 1/4"= I' II A LU- [-�FFL LEEI IF,-[H —LIHCJ H F F oit t,-)],j I'] H -,o Cut List for FRONT WALL WALLY MAREK 06/18/14 Ref-ROCKLAND Scale: 1/4"= V F LAPEL `EriC,TH LABEL LEfli_, I-H rTf q, ,_,1,1T Cut List for LEFT WALL WALLY MAREK 06/18/14 Ref:ROCKLAND [v__1_. 1/AVI - , S x� 5 4 �` aC Vil ` All A N � �+,t4^�V`e t stn 1arA�l.ma ss t t I .I � f 40 t + �, t A4 N z aP6 �'s f Nol g rzt, d bs .$a 1. dd'S � r $'N } + � pg l ("��" q A-1� _ 7-AE � Z Saws a � M �� — — I Custom View WALLY MAREK 06/18/14 Ref:ROCKLAND -- 11 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-055201 WALTER L MAROK �. . 73 Southampton Wadl Westhampton Mai; 0107YI °�,•�..� �11�6l " "' Expiration Commissioner 06/23/2016 &^/X/ V/22�'o-n7�mo�rLLlreCLtfYl a�Ul�GL7DdLLClZ�cJP,� t Office of Consumer Affairs&Business Regulation VME IMPROVEMENT CONTRACTOR - xegistration: 159488 Type: piration: 4/30/2016= Private Corporatic: W. MAREK INC. WALTER MAREK III 73 SOUTHAMPTON RD. WESTHAMPTON, MA 01027 Undersecretary i 1 Commonwealth of Massachusetts Department of Public Safety Hoistint; Engineer License: HE-156708 WALTER L MAREK,H1 73 Southampton-Road "i Westhampton MA 01027 Expi ration: Commissioner 06/23/2015 BERKSHIRE HATHAWAY Workers' ComDnsation and tMp 0g1LL iy�- cy UARDINSURANCE NorGUARD Insurance Company - A Stock Companv +COMPANIES Policy Number WMWt'$27"3 Renewal of WMWt:422910 NCCI No [258441 Policy Information Page [i] Named Insured and Mailing Address Agency W Marek, Inc FINCK & PERRAS INS AGFNCY 73 Southamptor Roar 6 CAMPUS LANE t Westhampton, MA 01027 Easthampton, rv,A LIU2: I Agency Code: t+AFINZ _J # federal Employer's ID 90-0129473 Insured is Corporatio-) i Risk ID Number 0170 1:7462 I t 121 Polity Period From February 10, 2014 tc Febrruary 10, 2015, 12:01 AM, standard time at tt-e WSU;ed's mailing I address Coverage i A Workers` Compensatior Insurance - Part One of this policy applies to tt•e Workers Con•,pensat,ori aw u`the following states. Massachusetts B ernp.ryer's _!ebllfty 1n5L1rarff— - Part Two of this policy applies to work In earn of Vie states i,steo in iterr ,3)A. The i!mlts of our liabii'.ty under Part Two are ! Bodily Injury by Accident - eacn accident 9.10,+.000 Bodily Injury by Disease each employee $100 00S Booiiy 'rjury by Disease polity limit $5010,000 C Other States Insurance - Ra°t Tnree of this pohc a t _, t i k y pp !e: c afi stag:. except any state !�stec :�• + ` item 3;A, and the states r)f Borth L�akota, Ohio, Washington, and W'yorning ! I f D In!5 001iCy MCude., thF�se encl >rSeTlents and sche0ules See E:xtersion of 1rfo,,-a'c;on Page - 5checl jle of Farms 5(41 V Premium 'he Rremi;.'-1 Basis zod, ;nerefcre, the premium will be determ,ned by our Manu?i of Rules, f ir�ss f+cations, Rates, and Rat.ng, P,-n, A;i req"ired inar,rrn.ut!on is sub!act te) ve,+V:atiun a.-td ch nr ae 7y audit {Crsntinue� or another page•'' CO "'y Total E'r1mated Policy Premium r Iota S.trcharges/Assessments $ Total Ectimated Cost 5t 1,t ape lnf0ri7,-9tl,,n npa t vvMWCr ,�R8? I t '.t iiYl-C:. :4 ?ANC't. SO Ir; P,ni ; Street •r n_ Iv)x p r+. r VViikes-Sarre, PA 1 ii'li13 �7) 6 V JV, 199.52'± NOTE: BOOK 7198, PAGE 31 SUBJECT TO AND TOGETHER WITH PLAN BK. 79, PG. 48A EASEMENTS AND RIGHTS OF WAYS j-1 OF RECORD. ") co N o) cV Pf� r pave ;r �`dri ve o t 23.17'± 176.83'± ROCKLAND HEIGHTS *—light , 25. w►oE RIGHT Pole ROAD - — _ of waY__..� City of Northampton Massachusetts wS �?lte DEPARTMENT OF BUILDING INSPECTIONS �= x *� 212 Main Street • Municipal Building Northampton, MA 01060 ssjrn y711� 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 on which 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 1, understand the above. (Home owner/resident's signature requesting exemption) will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location 1 The Commonwealth of Massachusetts 1 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1 1 (' Please Print Legibly Name (Business/Organization/Individual): W4 Address: City/State/Zip: �' �J�� Phone#: C l f cm C 5l Are you an employer? Check the appropriate box: Type of project(required): 1.9 I am a employer with 5 4. E] I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. 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 g. E] Demolition working or me in an capacity. employees and have workers' g y p �'• 9. [__J Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. F� We are a corporation and its 10.E] Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners 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: CfU(J- Policy#or Self-ins. Lic. #: �i�t t1 e 5r 1�� Expiration Dater� Job Site Address: u V rQn s �� C �I �` !'�'J�C � 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 penaltie of perjury that the information provided a ove is true and correct. Si ature: Date: Phone#: LLI 3 CM m 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#: t SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ l Name of License Holder: License tuber ..G�+i_ �l Md v .t (y l Address Expirati n Date Signature Telephone 9 Reoistered:.Home Improvement Contractor:' , ` Not Applicable £ Company Name a Reg istra'on Number Address Ex irat on Date �� S' Telephone/-li L �r 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.o`'. £ 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. 1 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑] Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. Demolition ❑ New Signs [O] Decks [M Siding[0] Other[ED] Brief Description of Proposed (�' �- Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a If.W house and'or,aunt on to eAsfmcf'.housinq complete the following: a. Use of building :One Family ' Two Family Other b. Number of rooms in each family unit: Number of Bathrooms -� c. Is there a garage attached? L d. Proposed Square footage of new construction. V Dimensions �� X � e. Number of stories? >1 f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. ' Masscheck Energy Compliance form attached? h. Type of construction ("10'A 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 —./ k. Will building conform to the Building and Zoning regulations? a Yes No. 1. 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 -'AAA �33t a' as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains a penalties of perjury. Print Name Signature of Owner/Agent Date ow Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information F.xi.onv Proposed Required by Zoning Tbis column n to be filled in by Building Department Lot Size (C Frontage _w- Setbacks Front �� Q Side L:= R:= L: D_. R: �---7 Rear 00 1•--.-1 Building Height Bldg.Square Footage ? "'-} % � !: Open Space Footage % A----, (Lot area minus bldg&paved parking) #of Parking Spaces Fill: / (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW Q YES Q IF YES, date issued:'— — —? IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES 0 IF YES: enter Book T Paged and/or Document#� i B. Does the site contain a brook, body of water or wetlands? NO d& DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: t D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q IF YES, describe size, type and location: �� s, 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 Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton Building Department Curb-GOte i iv—1niay P, ggtir. 212 Main Street SewerlSepGGAvailabllrfy �� , t " Room 100 Water/ulfefAvailablllty Northampton, MA 01060 TwQ sef`s afS#rtrctural PTar}s` 4 phone 413-587-1240 Fax 413-587-1272 Ploflsite Ptans i, a, x 1 1` k ; `` OierSecify � " '' 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 he completed by office. , (� Map Lot Unit Zone Overlay D►strtct EIm St D)stnct :..... k - CB:District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Reco 3 �_ ��<:fc-1�L vas, bow L►� � <I > 4)-t Name(Print Current Mailing Address: Telephone Signa re 2.2 Authorized Agent: PQ Name(Print) _ Current Mailing Pdd,)s,' : Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS. Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building h .�� (a)Building Permit Fee 2. Electrical J (b)Estimated Total'G.ost of oo Construction from 6 3. Plumbing Building Permit Fee , r 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3 +4+5) Check Number This Section For Official'Use'Onl Date Building Permit Number: Issued: Signature: Building Commissioner/(nspector'of Buildings Date File#BP-2015-0036 APPLICANT/CONTACT PERSON WALTER MAREK III 11 0 i 1 ADDRESS/PHONE 73 SOUTHAMPTON RD WESTHAMPTON (413)527-7667 PROPERTY LOCATION 48 ROCKLAND HEIGHTS RD MAP 13 PARCEL 080 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: Garage New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: pproved 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 D oliti la e uilding fi ' 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. 48 ROCKLAND HEIGHTS RD BP-2015-0036 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 13 -080 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Building BUILDING PERMIT Permit# BP-2015-0036 Project# JS-2015-000076 Est. Cost: $21500.00 Fee: $115.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WALTER MAREK III Lot Size(sg. ft.): 38115.00 Owner: JORDA JANEL P&KARLA D YOUNGBLOOD Zoning: Applicant: WALTER MAREK III AT. 48 ROCKLAND HEIGHTS RD Applicant Address: Phone: Insurance: 73 SOUTHAMPTON RD (413) 527-7667 O WESTHAMPTONMA01027 ISSUED ON:711512014 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 24 X 24 DET GARAGE 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 SilInature: FeeType• Date Paid: Amount: Building 7/15/2014 0:00:00 $115.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner