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B UILDING INSTR UCTIONS
LAY DOWN 4 BLOCKS, PUT 2X6 FLOOR JOISTS ON BLOCKS, NAIL, JOISTS
FOGETHER, 2' ON CF NTER.SQUARE THE FRAME. PUT FLOOR BOARDS DOWN ON
FLOOR .JOISTS, LF,ASF 1/2"' IN ON ALI_ SIDES (ENDS) OF 2X6'S. LEVEL THE'FLOOR.
'CAKE LONG 2X4 PUT IN FRONT EVEN WITH FLOOR. TAKE 4X4 POST PUT AT
RIGHT ANGLE, NAIL THROUGH 2X4 INTO 4X4, STAND UP POST ON FLOOR. NAIL
LONG 2X4 EVEN WITH FLOOR BOARDS. NOW DO THE SAME WITH BACK.
(see page 2 & 3)
PUT LONG 4X6 ON TOP OF POST. NOTCH PART UP, PUT 1 NAIL INTO 4X6. DO T1-IE
SAME WITH BACK. PUT UP NOTCHED 4X6 ON ENDS WITH CUT PART DOWN INTO
POST. PLUMB ALL 4X4 POSTS AND BRACE. PUT KNEE BRACES, 4X4 OR 3X4 ON
ALL CORNERS (seepage 3) 2 PER. POST. PUT 2X4 BETWF_.FN POSTS, 3' OFF FLOOR.
FRAME IN DOOR. PUT ALL WALL BOARDS ON TOP OF FLOOR JOISTS LEDGE, WITH
8'BOARDS ON GABLE END AND 6'BOARDS ON FRONT AND BACK OF BUILDING,
USE GALVANIZED NAILS. (see page 3)
ON NOTCHED 4X6 MARK THE CENTER, PLUMB PLIT A LINE ON THF, WALL TO TOP
OF WALLBOARD. PLACE RAFTER ON WALL BOARD UP TO MAARK AND TIIF,N
PLUMB. NAIL. THE RAFTER THROUGH THE WALL, INTO SAME RAFTER DO THE
SAME ATIOTHER END OF SHFD. PUT UP RIDGE POLE TO 1X6 ON MARK AND
NAIL RIDGE POLE INTO RAFTER. NOW PUT UP REST OF RAFTERS. NAIL
BOTTOM OF RAFTERS INTO 4X6, USE I X10 PUT 4" OVER END OF RAFTER ON
FRONT AND BACK. 1X10 HAS TO BE CUT AND PUT ON OUTSIDE OF WALL
BOARDS. (see page 4)
PUT ROOT' BOARDS ON, BE SURI: TO Kl-J,P EVFl"N WH11 OUTSIDE OF FRAME. CUT
OTHER END IF NEEDED. CUT WALL 130ARDS ON GABLE END KI,;EPING EVEN
WITH ROOF BOARDS. (see page 5)
PUT UP IX4 RAKE BOARD, GABLE END CUT EVEN WITH 1X10 IF NEEDED, PUT UP
IX6 FACIA BOARDS. EVE SIDES, FRONT TO BACK. 1X6 FACIA BOARD HAS TO FLT
INSIDE OF 1 X4 RAKE BOARD. (see page 6) NOW YOLI ARE READY TO SHINGLE THE
ROOF.
WHEN SHINGLES ARE. ON, PU1T ON CORNER BOARDS, THE BATTON STRIPS IF A
"ROUGH FINISH" SHED. CUT BO'T'TOM OF BATTONS EVEN WITH WALL BOARDS.
(see page 6)
CUT OUT WINDOW, EVEN WITH TOP OF 2X4 WINDOW IS 20" WIDE BY 24" HIGH.
THEN PUT 2X4 INSIDE., EVEN WITH WAIL, BOARDS, 24" LONG. ONE ON EACH SIDE
AND ON TOP. PUT I-TINGES ON 2X4 AND ON WINDOW. PUT IX4 TRIM ON
OUTSIDE OF WINDOW ON ALL 4 SIDES. ATTACH FLOWER BOX EVEN WLTH
BOTTOM OF WINDOW. ATTACH SHUTTERS. HANG DOOR (S). IF DOUBLE DOOR
CUT IN HALF.
ANY QUESTIONS CALL LAMORE LUMBER kU� 413-773-8385
9. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
This column to be filled in by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage N/A N/A N/A
Front:
Setbacks:
Side: ' L: R: L: R:
Rear:
Height
% Open Space:
(Lot area minus bldg and
Paved parking)
10. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: APPLICANT'S SIGNATURE
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.
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City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work:
The debris will be transported by:
The debris will be received by:
Building permit number:
Name of Permit Applicant
Date Signature of Permit Applicant
Uity of Nortnampton
Massachusetts
�� P
DEPARTMENT OF BUILDING INSPECTIONS Y :
212 Main Street • Municipal Building vl
Northampton, MA 01060 rsl'yVaiti�
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEI:)GEMENT
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
A,/I, ��Err y pfeA( S" understand the above.
v (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 ) G �11 1 1
Address of work location ( °I C-le". dC�J° �l _
pf ev, C e G,, b 0 la.�
1 he Uommonwealth of iviassacnuseus
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
4 www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/OrganizatiorOndividual):
Address:
City/State/Zip: Phone #:
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 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 8. E] Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.t 9. ❑ Building addition
required.] 5. E] We are a corporation and its 10.❑ Electrical repairs or additions
3.t�a I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] 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:
Policy#or Self-ins. Lie. #: 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.
ig—nature: f%'.a.,— Date: l �
Phone#: 017 - 2-11)• j L 5-
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:
License Number
Address Expiration Date
Signature Telephone
9.Registered Home Improvement Contractor ,,... Not Applicable £
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... £ No...... £
11. Hame Owrier 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 buildins 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.
VHorneowner Signature. ___
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [[] Siding [O] Other(0]
Brief Description of Proposed ,/
Work: r h q l�So�—a2 7 c7 v��i ��,e
Alteration of existing bedroom Yes ✓' No Adding new bedroom Yes G, No
Attached Narrative Renovating unfinished basement Yes ✓ No
Plans Attached Roll -Sheet
sa, lf`New house andoi'add'ition to'existing hous'ing 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?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? 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 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? 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
l 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 staterfients and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Tic
Print Name
Signature of 0 e r Date
'
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Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
Tliis column to be filled in by
Building Department
- '
Frontage
Setbacks Front
Rear 1771
Bldg.Square Footage 0110
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volume&Location)
A. Has a Special Permit/Variance/Rnding ever been issued for/on the site?
NO 0 DONTKNOW 0 YES 0
IF YES, date issued:| �
IF YES: Was the permit recorded at the Registry ofDeeds?
NO K > DON7KMO YES
�� YY
IF YES: enter Book Page and/or Document#1
�� ��
B. Does the site contain a brook. body of water orwetlands? NO �~��� DON7KNO\� «�� YES �_�
IF YES, has a permit been or need tobe obtained from the Conservation Commission?
Needs tobeobtained «~� Obtained �-\ Date
\~/ �~/ ' �
C. Do any signs m �� ��d�t 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 0 NO 0
IF YES, describe size, type and location: ! �
��������������������� ...�........����-----���� .....
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E. Will the construction activity disturb(clearing, gradingexcavation,or filling)over 1 acre orisit part ofa common plan
' that will disturb over 1acre? YES NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
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n ty of Northampton
ilding Departmenturla Cut/pri�ieway Ferrrtt# s
212 Main Street
OCT 2 0 20I4 k
� sewer/SepticAvaifabtl�ty
Room 100 Weter/VlteiiAvailabitify
No hampton, MA 01060 l Pfans
Electric Piumning R i� - 4ax 413-587-12
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APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
jefT..his section to be completed py office
Property Address:
-
a
+
Zone Overlay[�istnct
.
EIm St District CBM istnct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: �}
f E'c ! Sor �1 (� G�cr. �r� '� ores.a . Me, r/0
Name(Print) Current Mailing Address:
Signature Telephone
2.2 Authorized Aaent:
Name(Print) Current Mailing Address:
Signature Telephone
ECTION 3-ESTIMATED CONSTRUCTION COSTS.
Item Estimated Cost(Dollars)to be Official Use Only
com I ted by ermit applicant
1. Building (a)Building Permit Fee
nD
2. Electrical (b)Estimated Total'Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.
6. Total=(1 +2+3+4+ ) Ob Check Number
This Section For Official Use'Onl
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File# BP-2015-0448
APPLICANT/CONTACT PERSON PEARSON JEFFREY&MARLENE
ADDRESS/PHONE 186 GLENDALE RD FLORENCE (978)210-8125 Q
PROPERTY LOCATION 196 GLENDALE RD
MAP 42 PARCEL 178 001 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
T_ypeof Construction: CONSTRUCT 240 SO FT SHED
New Construction
Non Structural interior renovations
Addition to Existin¢
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
INY90MATION PRESENTED:
VApproved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received& Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
196 GLENDALE RD BP-2015-0448
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:42- 178 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: shed BUILDING PERMIT
Permit# BP-2015-0448
Project# JS-2015-000828
Est.Cost: $4600.00
Fee: $48.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 81021.60 Owner: PEARSON JEFFREY&MARLENE
Zoning: Applicant: PEARSON JEFFREY & MARLENE
AT. 196 GLENDALE RD
Applicant Address: Phone: Insurance:
186 GLENDALE RD (978) 210-8125 O
FLORENCEMA01062 ISSUED ON:1012412014 0:00:00
TO PERFORM THE FOLLOWING WORK.CONSTRUCT 240 SQ FT SHED
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 10/24/2014 0:00:00 $48.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner