09-005 (2) BP- 2010 -0407
GIS #: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
L ot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP- 2010 -0407
Project # JS- 2010 - 000554
Est. Cost: $375.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 131551.20 Owner: STEVENS DANA
Zoning: RR(100 ii) WSP Applicant: STEVENS DANA
AT. 317 KENNEDY RD
Applicant Address: Phone: Insurance:
317 KENNEDY RD (603) 809-92310
LEEDSMA01053 ISSUED ON :1011912009 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMOVE LOAD BEARING WALL, POUR
FOOTING,INSTALL POSTS & HEADER
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 10/19/2009 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
File # BP- 2010 -0407
APPLICANT /CONTACT PERSON STEVENS DANA
44 - f� t
ADDRESS/PHONE 317 KENNEDY RD LEEDS (603) 809 -9231 Q
PROPERTY LOCATION 317 KENNEDY RD / �'?� 7
MAP 09 PARCEL 005 001 ZONE RR(100)//WSP (p �
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: REMOVE LOAD BEARING WALL POUR FOOTING INSTALL POSTS & HEADER
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 FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION 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
Demolition Delay
i
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.
Department,use only;
City of Northampton 'Status of permit
Building Department Curb CUIVDnvewa Pear tt
212 Main Street Sewer /Sep #cAuaabxCit}±
Room 100 Water/Well Avalabtit#y
Northampton, MA 01060 Two fiefs afstrrcturaE
phone 413 587 - 1240 Fax 413 587 - 1272 Plot/Slte pions �C
Qther S}ecEfy'"�' ''
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE-OR TWO DWELLING
C
SECTION 1 - SITE INFORMATION
1.1 Property Address (, This sectionAo be completed by office
517 Z V� �(Jl Map Lot Unit
Zone Overlay District
V (� Elm St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record
Name (P. Current Mailing Address: _ q;—>3
-}- �'A , Telephone
Signature
2.2 Authorized Agent:
V e_t'� z-`{ A A, ova
Name (Print) Current Mailing Address:
C C , 3 S r i -,Ii( Z
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building Zr� S C)U (a) Building Permit Fee
2. Electrical �� (b) Estimated Total Cost of
Construction from 6
3. Plumbing ,, Building Permit Fee
4. Mechanical (HVAC) ^ NV �- CHf� S
5. Fire Piuleulion (�� • 4 00 : oc)
6. Total= (1 +2+3+4+5) Check Number
This Section For Official Use Onl
Building Permit Number: IIsssued:
Signature:
Building Commissioner /Inspector of Buildings Date
1
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
Frontage _m_ _._,. ,_
Setbacks Front
Side L ..... _._. R: _.._. L _.._.._ .
Rear
Building Height
Bldg. Square Footage _ . _ %
Open Space Footage o
(Lot area minus bldg & paved
p arkin g)
# of Parking Spaces _..
Fill: .,_._., _,..,.__ ,.. ..._ .. . .. ...... ...
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES
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' Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued
C. Do any signs exist 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
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.
Section 4 ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column io be filled in bl
Building Department
Lot Size cd/t3�551s� gAn
Frontage �
Setbacks Front ' r7 i;
R�
Side L: Zt R 5�1 L: R:
Rear �j --
Building Height
Bldg. Square Footage t O $� °k l 6 �-
Open Space Footage %
(Lot area minus bldg & paved
p arking)
# of Parking Spaces f
Fill: ii
(volume &Location)
A. Has a Special Permit /Variance /Finding ever been issued for/ the site?
NO 0 DONT KNOW 0 YES
IF YES, date issued: A v (l S , Zv 0 9
IF YES: Was the permit recorded at the Regi ry of Deeds?
NO 0 DON'T KNOW YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO Q/ DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 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 9/
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, gradingev�o
n, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5- DESCRIPTION OF PROPOSED WORK tdwck aB
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E3 Siding [p] Other [Cal
Brief Description of Proposed
Work: FFmovA L_ t:> AC) 3F�V 1.tr, ac. — t4c,: , -ANO \N5T41.L Qc >S-�5 4N� 0_4DE4
Alteration of existing bedroom Yes _ No Adding new bedroom Yes No iJ
Attached Narraby Renovating unfinished basement Yes No
Plans Attached(Roo I,- Sheet s
6a. If 'NOW .h►W 9l� std tom' ? - &:_ - Kill
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
I, D A N A J�CE�! F N ) < -" as Owner of the subject
property
hereby authorize
to act on beh 'n all matters relative to work authorized by this building permit application.
Signature of 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 and penalties of perjury.
Print Name
[ 3 0 `1
Signature o er /Agent Da
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor Not Applicable
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
9. Flleaistered Home lrnmoye merit Contactor: Not Appli
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (1i_O.L. c. M, 48))
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 -oj6w �r A"
jultm
The current exemption for "homeowners" was extended to include Ow>aetL oceutiied DwelihtQS of one (f) 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 constrects more than out home In a two-year period shall not be coudiered 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 aff such work 2r12rnsed under the butkUnQ Hermit
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 Loc# Latins and State of Massachusetts General Laws :annotated.
Homeowner Signature ^` ��
' The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
t ` <: wtvw mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): D 1�, E, &JS
Address: 7 y - Y-
City /State /Zip: Mix- , Phone #: EC.Z> %a
Anyou an employer? Check the appropriate box: Type of project (required):
1. I am a employer with 4. ❑ I am a general contractor and I 6. E] New construction
employees (full and/or part- time).* have hired the sub - contractors
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. ❑ Demolition
world for me in c employees and have workers'
� �' capacity. �' � $ 9. E] Building addition
[No workers' comp. insurance comp. insurance.
qu a homeowner doing all work have exercised r I L Plumbin g repairs ired.] 5. E] We are a corporation and its 10. El Electrical repairs or additions
3. I am
officers hised their 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.
I 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 ce under pains and penalties of perjury that the information provided above is true and correct
Si tures. • \'L C (
Phone #: c 62 q2-2�,
F c�iuw only. Do not write in this area, to be conrleted by city or town of trial
City or Town: PermitlLicense ii
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 *•
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CNM 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 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 n s s reau that the building department be calle 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
-- - - - - -- - - it s -in- conjunction _to_the_buildi.ngTermitissued, 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
l
I, � ^ r 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.
Address of work
location
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office oflnvestigadons
' 600 Washington Street
Boston, MA 02111
www.mass govIdza
-Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/PIumbers
Applicant Information Please Print Le6ibly
Name ( Business /Organi=on/Individual):
Address:
City /State /Zip: Phone.:
Are you an employer? Check the appropriate box: Type of pro7red :
1.
ED am a employer with 4. [] I am a general contractor and I 6. New
employees (full and/or part-time).* have hired the sub- contractors
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remo
shin and have. no 1e,�ees These sub - contractors have. .8. � Demolition
working
Y capacity. for me in an act employees and have workers'
9. Q Buildi workers' comp: insurance comp. - ins required. ] 5. We are a corporation and its 10.0 Electrditions
9_ zs a ve Exercised their
3. I am- a- homeowner- deia�a -all work -- - - -- - -- I— LaPlcmzb ag repairs or additions
myself. f 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' 13.0 Other
comp. insuran 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 aTulivit.indicating they are doing all work and then. hire outride contractors must submit anew affidavit indicating such_
lcont wtors 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
ormation.
Insurance Company Name:
Policy # or Self-ins. Lic. #: Expiration Date:
J Site Address: City /Staie/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. - 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. 13e advised that a copy of this statement may be forwarded to the Office of
Investizations of the DIA for insurance coverage verification
_ I do hgrehl? certify under the pains and penalties of..per, jury.that the information. provided .abase- & &ue-- an&correcL -__
Sii?nature: Date: -
Phone #:
. - 0fcial use only Do not write in this -area, tv be catnpleied by city or town offlclaL
City or Town: PermitUcense #
Issuing Authority (circle one):
- I: -Board of Health 2, Building Department 3. City/Town"CIerk 4 EIetrcal_ 5. Plumbing Inspect "_ "_ ___ __
6. Other y
Contact Person: Phone #:
Building Department
City of Northampton
City Hall
210 Main Street
Northampton, MA 01060
October 6, 2009
Re: Narrative proposal for alterations to residential structure
To Whom it May Concern:
This note is intended to act as a simple written description of work being proposed at 317
Kennedy Rd., Leeds, MA. An existing load - bearing wall supporting ceiling joists only,
on a 26 foot wide home, will be removed. In place, a large "header", or beam, will be
installed. The beam will span nearly 15 feet. On one end, load will be transferred to a
pre- existing masonry foundation footing. On the other, a new spread - footing type pier
will be poured. The footings will support posts that extend up to a primary girder
supporting the first (and only) floor. Above the girder, posts will extend up to the height
of the uppermost surfaces of the ceiling joists. The joists, once supported on top of the
load - bearing wall, will be hung from the beam using Simpson Strong -Tie model TS #tts
(see attached).
Live and dead load calculations were made according the - � h edition of the Massachusetts
State Building Code, as well as Appendix G of the 6 edition, which supplied "Unit Dead
Loads for Design Purposes ". Beam sizing was supplied using engineering software at a
local lumber yard (R.K. Miles). A breakdown of calculations has been attached.
Thank you,
Henry Glick
Authorized agent
603 - 387 -4912
s
TS Twist Straps
Twist straps provide a tension connection between two wood members. An equal
number of right and left hand units are supplied in each carton.
IOalferia 16 gauge
Finish Galvanized. See Corrosion Information
Installation:
• Use all specified fasteners. See General Notes `
nf
• TS should be installed in pairs to reduce eccentricity. "'
. f;ei5 far �,�c°<•„ "�aa:ia
iallery: a top
ro cover 4nages below Io , �;e Y ,s - qer
ye ll 9 5 k Y
D r 4 3 E� f i
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€_curl Table: See d,;,ir. 'e art ;5t n 7 bEftN A. top
Model t fasteners Allowable
tart i(084
olbft ,
1. Install half of the fasteners on each end of the strap to achieve full bads.
2. Loads have been increased 60% for wind or earthquake loading; no further increase allowed; reduce where other loads govern.
1 16d sinkers (0.145" dia. x 3 1/4 ") may be substituted for the specifiers 16d cornrnons at 0.84 of the table loads.
4. Loads are for a single TS.
5. NAILS: 16d = 0.162" dia. x 3 1/2" long. See other nail sees and information
gore Rem} (PDF s): .next .top
l,d'PM0 ES iCC -ES 'ESR CITY OF LOS S AidGELES STATE OF FLORIDA itaC -ES NER :CC-FS ER ICS t1 ES
ER
TS See specific model numbers for code kMww.
TS12 No code lishiig: Please contact us for test data.
TS18 No code listing: Please contact us for test data.
TS22 No code listing: Please contact us for test data.
TS9 No code 'miry P � contact s for test data.
( rawi n s To download drawings, tight- click or Ctt1 -click on the link, then choose "Save Target As... T next Atop
Dovvnioad the Simpson AutoCad Menu which. allows you to insert Ortho vies^ ;s directly into your AutoCAD drawing.
T$ None for this model TS: DWG l DXF
TS12: DWG I BXF
T$12 TS12 con sew I XF None for this model
TS12 nghtview I QCF
TS18 None for this model None for this model
TS22 DWG 'I DXF
TS22 TS22 AM view - -MVG s imne for this model
TS22 right view, CM i
TS9: DWG I DXF
TS9 TSS9 9 fr v� I None for this model
right Catalog Pages (PDFs); A top
C -2009 (Wood Construction Connectors), page 151 Order free 2a12120 by mail
Related Categories' A top
Strap Ties
Technical Bulletins (PDFs); A top
TruespecTm Nail Identification System Applications with Halsteel Fasteners
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