42-141 (3) BP-2022-0474
763 WESTHAMPTON RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
42-141-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0474 PERMISSION IS HEREBY GRANTED TO:
Project# KITCH RENO Contractor: License:
Est. Cost: 27000 CORBIN CHICOINE 113093
Const.Class: Exp.Date:02/16/2023
Use Group: Owner: BUZZEE BLISS DAVID K&TODD H
Lot Size (sq.ft.)
Zoning: WSP Applicant: CORBIN CHICOINE
Applicant Address Phone: Insurance:
24 PRINCETON AVE (413)214-4659
EASTHAMPTON, MA 01027
ISSUED ON:05/02/2022
TO PERFORM THE FOLLOWING WORK:
KITCHEN RENO
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: •
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: (�
x . i
I
Fees Paid: S 176.00
212 Main Street,Phone(413)5 87-1240,Fax:(413)587-1272
Office of the Building Commissioner
.i C r=;
The Commonwealth of Massachusetts ,1s'� :----
Board of Building Regulations and Standard; 6 ` L" QR
1W Massachusetts State Building Code, 780 CMR 4/�/� MUNICIPALITY
G�$ ' USL
Building Permit Application To Construct,Repair,Renov, Or Demolisla�pa ReGised Mar 2011
One-or Two-Family Dwelling , ^14,);/-���
Tr, Cn�n'^_
This Section For Official Use Only `nti/;`);-':
Buildin
Permit Number: (3 p— a 1-•el 7 di
Dae Applied:
2
vi� Z 6.2-ZOZ// -Z
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Number
Zs G+,es riA/WT� Xo . ,), /-.
1.1a Is this an accepted street?yes x no Map umber Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public,Er Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
21�1 Owner'of Record:
i jP4j &i55> TOGA ,8dZZ� 1%A67 Ce //),#)
Name ) City,State,ZIP
7G3 1Jes7-7/4/' o iQ 9/3 5 722/ ,BLS sziz.0&veeSf.tt/
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building l' Owner-Occupied 0 Repairs(s) 18f Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units / Other 0 Specify:
Brief Description of Proposed Work': F
N
•
Ij o '/ a front 36 7Z 8y'
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
�D/DDO 0 Standard City/Town Application Fee
2.Electrical $
6/ 000 0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 021 O 00 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $ /,
Check No Check Amount: ( 1O ash Amount:
6.Total Project Cost: $ oZ
iQDo 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) (S- i?093 -/6.2.�
�,PB/� 4/ License Numberl Expiration Date
Name of CSL Holder
,Q/yC,�2,-
� v� List CSL Type(see below)
No.and Street /` / Type Description
7 U Unrestricted(Buildings up to 35,000 cu.ft.)
01��/-7 Restricted 1&2 Family Dwellini
City/Town,State,ZIP M Masonry
RC Roofing Covering
6rb/n CAi'La//1 e 9�I7Q;l eiwt WS Window and Siding
3 _�/�_��� �/ SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
("d/O/A CA HIC Registration Number E irate n Date
HIC Company Name or HIC Registrant Name
•
No.and Street Email addres
City/Town,State,ZIP Telephone
SECTION 6: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 .0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize r6,jf
to act on my behalf,in all matters relative to work authorized by this building permit application.
1J 't Ba-cs' ,4P.eit 42.5— a0,22
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNERI OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding. ^�
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
°aY Oti .: . sic
Massachusetts 4? <
I (C,1 4 7 DEPARTMENT OF BUILDING INSPECTIONS y;
i. 212 Main Street • Municipal Building O, �a
y: ), Northampton, MA 01060 xt; . ....x,1
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: #//:9t 42/(11
The debris will be transported by:
Name of Hauler: ilk A 1 S U4/.-S -5-
Signature of Applicant: Date: y��S' '-2Z
.I FORTE'ISMMEMBER REPORT PASSED
Level, Floor:Drop Beam
2 piece(s)1 3/4"x 7 1/4" 2.0E Microllam®LVL
Overall Length:7'7"
0 0
7
All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal.
Design Results Actual I Location Allowed Result LOP Load:Combination(Pattern) System:Floor
Member Reaction(Ibs) 2258 @ 2" 5206(3.50") Passed(43%) -- 1.0 D+ 1.0 L(All Spans) Member Type:Drop Beam
Building Use:Residential
Shear(Ibs) 1724 @ 10 3/4" 4821 Passed(36%) 1.00 1.0 D+1.0 L(All Spans) Building Code:IBC 2015
Moment(Ft-Ibs) 3912 @ 3'9 1/2" 7115 Passed(55%) 1.00 1.0 D+1.0 L(All Spans) Design Methodology:ASD
Live Load Defl.(in) 0.130 @ 3'9 1/2" 0.242 Passed(L/669) -- 1.0 D+1.0 L(All Spans)
Total Load Defl.(in) 0.184 @ 3'9 1/2" i 0.363 Passed(L/472) -- 1.0 D+1.0 L(All Spans)
•Deflection criteria:LL(L/360)and TL(L/240).
•Allowed moment does not reflect the adjustment for the beam stability factor,
Bearing Length Loads to Supports(Ibs)
Supports Total Available Required Dead Floor Live Total Accessories
1-Stud wall-SPF 3.50" 3.50" 1.52" 665 1593 2258 Blocking
2-Stud wall-SPF 3.50" 3.50" 1.52" 665 1593 2258 Blocking
•Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed.
Lateral Bracing Bracing Intervals Comments
Top Edge(Lu) 7'7"o/c
Bottom Edge(Lu) T 7"o/c
•Maximum allowable bracing intervals based on applied load.
Dead Floor Live
Vertical Loads Location(Side) Tributary Width (0.90) (1.00) Comments
0-Self Weight(PLF) 0 to 7'7" N/A 7.4 —
1-Uniform(PSF) 0 to 7'7"(Front) 14' 12.0 30.0 Residential Sleeping
Areas
Weyerhaeuser Notes
Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values.Weyerhaeuser expressly disclaims any other warranties
related to the software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is
responsible to assure that this calculation is compatible with the overall project.Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Products manufactured at
Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC-ES under evaluation reports ESR-1153 and ESR-1387
and/or tested in accordance with applicable ASTM standards.For current code evaluation reports,Weyerhaeuser product literature and installation details refer to
www.weyerhaeuser.com/woodproducts/docurnent-library.
The product application,input design loads,dimensions and support information have been provided by ForteWEB Software Operator
•
ForteWEB Software Operator lob Notes 4/25/2022 2:31:40 PM UTC
David Fagnand
Fleury Lumber Co.,Inc. ForteWEB v3.2,Engine:V8.2.0.17,Data:V8.1.0.16
(413)527-2693
fleurylumbercompany@charter.net Weyerhaeuser File Name:Corbin Chicoine Bliss
Page 1/ 1
�'" The Commonwealth of Massachusetts
4 1.4;+ Deportment of Industrial Accidents
i. '�, 1 Congress Street,Suite 100
' Boston, M A 02114-2017
�. www mass.gov/dia
. a
1%cat ers'('ompensatdin Insurance Affidavit:Builders./Contractors/EkctrlcilansiPlum hers.
•10 Ht. FILED%flit THE PERMITTING AUTHORITY.
Antillean!Information Please Print l.eeiblh
Name(Business Organizationflndnddual"1: (, /,5 //4/ ( 'to/%(/7:—
Address: Q2 //'/4/ 72r,t/ i9ve _ %1�--5.�/. /_inn/ Q,/g'
. City/State/Zip: / /0/777j�it// 1A2 Phone#: 'AT a./4-9‘5
Art yea as employer'Chest the appropriate hoax Type of project(required):
1.Q I am a employer with employees(full&idiot part-tirne'l.• 7. 0 New construction
2 am a sole proprietor or paronership and have nu employees working for me in 11. Remodeling
any capacity.[Nu workers'cutup.insurance required.]
9. Demolition
301 am a humewwilex doing all work myself.[No workers'comp_unuranoe regwed]'
4.0 I am a homeowner and will he:hiring vuaunucurs to conduct all work on my property_ I will 10 Q Building addition
enure that all contruturs either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
50 I am a general contractor and I have hired the sub-contractors listed un the attached sheet- 130 Roolrepairs
These sub-contractors have employees and have workers'comp.insurance.;
6.D We are a corporation and its officers have exercised their right..f M c exemption per GL 14. Other
152.y II.41.and we hese no employees.[No workers'comp.insurance required.]
*Army applicant that chocks box=1 must also till out the section below show ing their workers'compensation policy information.
+Homeowners who submit this attiwls4it indicating.they are doing all work and then hire outside contractors aunt submit a new affidavit indicating sock
!Contractors that check this box must attached an additional sheet show mg the name of the sub-contractors and stale whether or not those e ntrties have
employees. li the sub-contractors base cropluyees.they must pros ids their wvrkcn'comp.policy number.
I am an employer that is providing ovorkers'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 MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
andror one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby cert."ent r the s nd penalties ofpery'ary that the information provided above is true and correct
Signature: / >_.. Date: _G/ 7 ��
) ?hone :
i
t
Official Ilse only. Do not write in this area.to be completed by city or town official
tit, or I own: Permitil.icense#
Issuirt�,.kuthority (circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#: