31A-072 BP-2023-0026
222 ELM ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-072-001 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-2023-0026 PERMISSION IS HEREBY GRANTED TO:
Project# RENO 2023 Contractor: License:
Est. Cost: 58500 RUSSELL MANZ 81403
Const.Class: Exp.Date: 11/23/2023
Use Group: Owner: J. SALLOOM, SIMON
Lot Size (sq.ft.)
Zoning: URB Applicant: HOME ROOTS CONSTRUCTION
Applicant Address Phone: Insurance:
81 CHAPIN RD (413)775-3126
BERDNARDSTON, MA 01337
ISSUED ON: 01/12/2023
TO PERFORM THE FOLLOWING WORK:
INTERIOR RENO -KITCHEN, BATHS,ADD BATH AND ADD BEROOM ON 2ND FLOOR
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:
,t
Fees Paid: $410.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
lL cif
())11.1 h ricd
The Commonwealth of Massachusetts
I��' Office of Public Safety and Inspections
�' Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number:131,:'1'103-COPDate Applied: Building Official:
,,L SECTION 1:LOCATION
7 2-Os 171-r
(i-hampon.
6
No.and Street City/ own Zipp ode Name of Building(if applicable)
ii
Assessors Map# Block#and/or Lot #O��
SECTION 2 PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building 0 Repair 0 Alteration I( Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify: ,
Are building plans and/or construction documents being supplied as part of this permit application? Yes Er No 0
Is an Independent Structural Engineering P Review r ui ? c Yes No K
Brief Dpesc 'ption of Pro se ork: O O !. 'L
l L 1AV 2g/- 0 c h 41: 1'
G 7 fiC1/‘)74t Z 1
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) D
Existing Use Group(s): Proposed Use Group(s):
SECTION 4 BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft)
Total Area(sq.ft)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5❑ B: Business 0 E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4❑ H-5 0
I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-ID R-2 0 R-3❑ R-4❑
S: Storage S-1❑ S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA IBD IIAD IIBD MAD IIIBD ND VAD VBD
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Suppl . Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: —/
Public Check if outside Flood Zone Indicate municipal' A trench wi not be Licensed Disposal Site II
Private 0 or indentify Zone: or on site system 0 required or trench or specify:
permit is enclosed 0
Railroad right-of-way:/ Hazards to Air Navigation: MA Historic Commission eview Process:
Not Applicable M'' Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No Yes 0 No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
` SECTION 9: PROPERTY OWNER AUTHORIZATION
Name anddAddress of Propgrty Owner
911flo✓1 54/toop 2 07v liii 4 q( Ala9-} I kit Qy4 60
Name(Print) No.and Street City/Tow4 Zip
Property Owner Contact Information:
0 w4 er 3-7y f_SA_ y/ _ os 1
Title Telephone No.(business) Telephone No. (cell) e-mail ad
If applicable,the pro owner hereby authorizes: 1
c 5a.m� o i�>°r i i1 vi 1.-(
sty 5Je )bvrvt e, MA- O,37o
ap/lyeallidleart
��0��tom/ Street Address City/Town State Zip
to e p rty,(wner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Wan /�y �n*iii()/ ion (ItL3(2'1)
Company I ame
el/0 ett fl4sz- C5 -(B I Y63 //it, — /57";
Name of Person Responsible fo Construction Licelse N . and Type if Applicable
6l cia m ge01.4 art AA- .0137
S��gqeet A dress City/Town l Sta Zip
7i� ry �j1?� - ;zi//e *fie(scot'? legit, lo in
Telephone No.(business) Telephone No.(cell) e-mat SF
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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
Is a signed Affidavit submitted with this application? Yes No 0
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor ',/f
and Materials) Total Construction Cost(from Item 6)=$ / Fee
1.Building $ 5000 Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ ro O appropriate municipal factor)_$___V..
3.Plumbing $4 vao p
4.Mechanical (HVAC) $l V_ dv o Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ U c,O Enclose check payable to
6.Total Cost $ .� 5-od (contact municipality)and write check number here Alp #
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
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 accura A .• tie best of my knowledge and understan ' g.
a 6( \ Imo. ilo�e e( Yliias__OekigPl print and sign ,, •- Title •Telephon No.
� NM o
Street Address City/Town State Zip _ Email Address �e k
r will
/ ` j
, _ , , ' ,// -
Municipal Inspector to fill out this section upon application approval: -il— .1
Name Da
City of Northampton
Massachusetts '?r
DEPARTMENT OF BUILDING INSPECTIONS i
212 Main Street • Municipal Building vj C
Northampton, MA 01060 rffrJ 3?‘�t1
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: ✓ lei
The debris will be transported by:
Name of Hauler: �/ !
Signature of Applicant. Date: /9A3
leant LUL e Al 2015 Northampton i 1-b-
iBeamEnane2018.9.0.1
aterials Database 1587 i''"' I�' Lwt 8:28ar
1 of
Member Data
)escription: Member Type:Beam Application:Floor
Top Lateral Bracing:Continuous
Bottom Lateral Bracing: 0.00
>tandard Load: Moisture Condition:Dry Building Code: IBC/IRC
_ive Load: 40 PLF Deflection Criteria: L/360 live,L/240 total
)ead Load: 10 PLF Deck Connection:Nailed Member Weight: 24.3 PLF
Filename:Beam1
)ther Loads
We Trib. Other Dead
Description) Side Begin End Width Start End Start End Categor
teplacement Uniform(PSF) Bads 0' 0.00" 19' 4.00" 7 0.00" 40 10 Liv
kiditional Uniform(PSF) Top 0' 0.00" 19' 4.00" 8' 0.00" 40 10 Liv
19 4 0
19 4 0
3earings and Reactions
Input Nin Gravity Gravity
Location Type Material Length Required Reaction Uplift
I 0' 0.000" Wall SPF#3/Stud 2x or4x End-Grain(650psi) N/A 2.210" 7541# -
'. 19' 4.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) N/A 2.210" 7541# -
rAaldmum Load Case Reactions
sad for apph.,g pot*bads((rtne bads)toca ingiranbutb
Live Dead
5844# 1698#
5844# 1698#
)esign spans
19'5.750"
Product: 1-3/4x16 VERSA-LAM 2.0 3100 SP 3 ply PASSES DESIGN CHECKS
NOTE:Connection schedule for member requires special design consideration,consult a professional engineer.
Minimum 2.21"bearing required at bearing#1
Minimum 2.21"bearing required at bearing#2
Design assumes conttinxmus lateral bracing along the top chord
Design assumes maxinun uribraced length of 0.00'along the bottom chord.
JIlowable Stress Design
Actual Allawable Capacity Location Loadin0
'ositive Moment 36725.'# 58288.'# 63% 9.6T Total Load
>hear 6509.# 15960.# 40% 18.43' Total Load D+L
-L Deflection 0.6999" 0.9740" U333 9.67' Total Load b+L
_L Deflection 0.5423" 0.6493" U431 9.67' Total Load L
;onto':LL Delled ion
DOLs Li'e=100%Sr1(Av=115%Roof=125%Wnd=160%
Desgn assumes repetitive member use increase in bending stress 4%
.2(c,(/--/_ v .iy
kr '' 0 (k ,
e-2\1 ‘6.L, :\‘ ?27
z. 0,C to ,,k 06,. 0 .
Al prodct names are trades ants of thee'respective ovmers
Copyrigt*(C)2018 by Sinpsan Stung-Ye C.arpery Inc.ALL PoGHIS RESERVED.
'assig is Opined as when the member,tborpet,beam or seder statin on ttts dathig meets applicable design crteria tar Loads,Loading Carcleors,and Spars toted on ttrs sheet The
1/12/23, 10:24 AM Image 1-12-23 at 7.37 AM.jpeg
__: The Commonwealth of Afassachusetts
r __yl-r Department of Industrial Accidents
--7 1iF 1 Congress Street,Suite 100
.4 ' Boston,MA 02114-2017
www.mass.gov/dla
_,:i, \\urkers'Compensation Insurance Affidavit:BuildersJCoNtractors/Electriciana/Plumbers.
TO BF.FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
r-
N (Business/Organization/Individual): (
me(Business/Organization/Individual): 1 f'J
Address: 0 G � 7 /
City/State/Zip: ;1r hone#: 4795 L 7 3' Z
Are you an employer?Cheek tie appropriate bur: Type of project(required):
1.0I am a employer with employees Mill andlor part.time)' 7. ew construction
2.01 am a sole proprietor orpartnership and have no employers Nuking for me in t. Rerttodeling
any capacity.[No workers'comp utsuran«required I
9. Demolition
3.1E1 I am a homeowner doing all work myself.(No workers'comp.iruutance required.]'
I 0 Building addition
4.01 am a homeowner and will be hiring contractors to conduct all work on my property.I will
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees 12,0 Plumbing repairs or additions
S 0 I am a general umtmctur and I base hired the sub-coetracton listed on the attached shear. 13.❑Roof repairs
sub-contractors have employees and have workers'comp.insurance
h g/TheseWe we a corporation and its officers have exercised then nght of exemption per MGL e. 14.DOt]ter!_
152,*1(4),and we hare no employees.[No workers'comp insurance requited.]
'Any applicant that checks box w 1 must also fill out the section below slowing 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
t ontractors that check this box most anactmcd an additional shut showing Inc name of the sub-contraciors and suab-whether or mot those entities have
employees If the sub-cant,as ion hew einpiosces.they must provide their workers'cane polies numbs?.
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/Statellip:
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 S1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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 semiPLAL
nder the pal 'and penalties of perjury that the informwtion provided above is true and correct.
coloBIL-.-- _____.____ Date; 1/9/23
signature_-- . --
PhRne#_-_- -------4137-7531 Fi---
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):
I.Hoard of Health 2.Building Department 3.Cityflown Clerk 4.Electrical Inspector 5.Plumbing Inspector
b.Other
Co - Person:
Phone SS:https://mail.google.com/mail/u/0/?shva=1#inbox/FMfcgzGrbvKgxgPGtBrVbNhsGDWwJcZB?projector=1 1/2