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36-211 (1) JDR Builders August 5, 2011 PO Box 4 North Hatfield, Mass. 01066 CSL: 074105 HIC: 130397 Paul and Ann Lenkowski 21 Birch Lane Northampton, Mass. 01060 Lenkowski Deck Project Scope: Build a 13' -6" square deck off of the dining room to support a new hot tub The deck will connect to the existing deck and will step down 1 -2 steps. The deck surface will be mediera trex with a blind fastening system to minimize screws. Cedar rails are included but post cap are not. Staining or painting is by others. Materials: 6 precast concrete piers delivered $ 780.00 Framing lumber $ 550.00 Hardware $ 180.00 Trex Decking $ 1,925.00 Hidden fasteners $ 250.00 subtotal: $ 3,685.00 Subs: Tim Jaescke to dig and install the piers $ 500.00 Note: Tim said he figures about 1 hour per pier for digging If he encounters boulders or has to bring in some sand to backfill with, he'll have to add the additional machine time and! or material costs to his bill. Labor: Layout, excavate, install piers and grade soils $ 800.00 Set posts, build girders and install joists - complete framing $ 800.00 Install decking $ 800.00 Build rails in shop and install on jobsite, build step $ 800.00 Cleanup and punchlist $ 200.00 Disposal: 1 trip to the landfill $ 50.00 Permit: City of Northampton Building Permit Fee $ 50.00 Total: $ 7,685.00 . KeyBuild structure �TM2.309t RossJDLenkowskiDeck - Level 6 9- 9 -11 , kmBeamEngine 4.509s Materials Database 1307 • 3:37pm 2 of 2 C cNZ Member Data Description: CalCB4 Member Typ . Bea_ r3 Application: Floor Comments: Top Lateral Bracing: Continuous Bottom Lateral Bracing: (See Below) Standard Load: Moisture Condition: Dry Building Code: IBC / IRC Dead Load: 0 PLF Deflection Criteria: L/360 live, L/240 total 1.500" max. LL Live Load: 0 PLF Deck Connection: Nailed Member Weight: 8.8 PLF Filename: Q: \RossJDLen Other Loads Type Trib. Dead Other (Description) Side Begin End Width Start End Start End Category Replacement Uniform (PLF) Top 0' 0.00" 13' 11.50" 79 952 Live Point (LBS) Top 0' 4.63" 110 0 Live Point (LBS) Top 13' 6.88" 110 0 Live Mg ell 6 11 12 6 11 12 ® © 1311 8 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall N/A N/A 1.812" 3071# -65# 2 6' 7.125" Wall N/A N/A 5.053" 8564# -- 3 13' 2.250" Wall N/A N/A 1.812" 3071# -65# Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Live 1 326# 2746# 2 720# 7844# 3 326# 2746# Design spans 6' 7.125" 6' 7.125" Product: SP PT #1 2 x 12 2 ply Component Member Design has Passed Design Checks.** ** Design assumes continuous lateral bracing along the top chord. No lateral bracing required along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 4213.'# 6592.'# 63% 2.97' Odd Spans D +L Negative Moment 5647.'# 6592.'# 85% 6.59' Total load D +L Negative Unbrcd 5647.'# 6592.'# 85% 6.59' Total load D +L Shear 3308.# 3938.# 84% 5.93' Total load D +L LL Deflection 0.0469" 0.2198" 11999+ 2.97' Odd Spans L TL Deflection 0.0494" 0.3297" U999+ 2.97' Odd Spans D +L Control. Negative Moment DOLs: Live =100% Snow =115% Roof =125% Wind =160% This member has been designed in accordance with NDS 2005 All product names are trademarks of their respective owners Your Company Name Your Company Address T' .- =. Copy ri ght (C)1887 -2011 by Keymark Enterprises, LLC. ALL RIGHTS RESERVED. Your Company Address "Passing is defined as when the member, floor joist, beam or girder, shown on this drawing meets applicable design criteria for Loads, Loading Conditions, and Spans listed on this sheet. Your Company Phone The design must be reviewed by a qualified designer or design professional as required for approval. This design assumes product installation according to the manufacturer's specifications. KeyBuild slrnctlffeTM2.309t RossJDLenkowskiDeck - Level 6 9- 9 -11 kmBeamEngine 4.509s Materials Database 1307 3:37pm 1 of 2 (L) Member Data Description: CaIcB3 Member Typ . Beam . Application: Floor Comments: Top Lateral Bra ' g Continuous Bottom Lateral Bracing: (See Below) Standard Load: Moisture Condition: Dry Building Code: IBC / IRC Dead Load: 0 PLF Deflection Criteria: L/360 live, 0240 total 1.500" max. LL Live Load: 0 PLF Deck Connection: Nailed Member Weight: 8.8 PLF Filename: Q: \RossJDLen Other Loads Type Trib. Dead Other (Description) Side Begin End Width Start End Start End Category Replacement Uniform (PLF) Top 0' 0.00" 13' 11.50" 33 442 Live Point (LBS) Top 0' 4.63" 46 0 Live Point (LBS) Top 13' 6.88" 46 0 Live F PM /O 6 11 12 ® 6 11 12 ©/ 13 11 8 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall N/A N/A 1.500" 1427# -31# 2 6' 7.125" Wall N/A N/A 2.355" 3993# -- 3 13' 2.250" Wall N/A N/A 1.500" 1427# -31# Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Live 1 150# 1276# 2 346# 3647# 3 150# 1276# Design spans 6' 7.125" 6' 7.125" Product: SP PT #1 2 x 12 2 ply Component Member Design has Passed Design Checks.**** Design assumes continuous lateral bracing along the top chord. No lateral bracing required along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 1963.'# 6592.'# 29% 2.97' Odd Spans D +L Negative Moment 2633.'# 6592.'# 39% 6.59' Total load D +L Negative Unbrcd 2633.'# 6592.'# 39% 6.59' Total load D +L Shear 1542.# 3938.# 39% 5.93' Total load D +L LL Deflection 0.0218" 0.2198" U999+ 2.97' Odd Spans L TL Deflection 0.0230" 0.3297" L/999+ 2.97' Odd Spans D +L Control: Negative Moment DOLs: Live = 100% Snow =115% Roof = 125% Wind = 160% This member has been designed in accordance with NDS 2005 All product names are trademarks of their respective owners Your Company Name s 3 Your Company Address ^4 ` 4'''-'' ' <@ � l h Copyright (C)1987 -2011 by Keymark Enterprises, LLC. ALL RIGHTS RESERVED. Your Company Address "Passing is defined as when the member, floor joist, beam or girder, shown on this drawing meets applicable design criteria for Loads, Loading Conditions, and Spans listed on this sheet. YOU- Company Phone The design must be reviewed by a qualified designer or design professional as required for approval. This design assumes product installation according to the manufacturers specifications. KeyBuild structure""'2.309t RossJDLenkowskiDeck - Level 6 9- 9 -11 kmBeamEngine 4.509s Materials Database 1307 • 3:37pm I of 1 Member Data Description: CalcA1 Member Typ:. Joist Application: Floor Comments: Top Lateral B ._.• .. ontinuous Bottom Lateral Bracing: (See Below) Standard Load: Moisture Condition: Dry Building Code: IBC / IRC Dead Load: 10 PSF Deflection Criteria: L1360 live, U240 total 1.500" max. LL Live Load: 40 PSF Deck Connection: Glued & Nailed Filename: Q: \RossJDLen Other Loads Type Dead Other (Description) Side Begin End Start End Start End Category Replacement Uniform (PSF) Top 0' 0.00" 13' 5.13" 10 120 Live / , ( / / 6 2 2 6 5 4 O 912 9 0 ° / 13 5 2 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall N/A N/A 1.500" 463# -38# 2 6' 1.500" Wall N/A N/A 1.605" 1361# -- 3 12' 6.750" Wall N/A N/A 1.500" 634# -- Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Live 1 30#(23p1f) 432#(324p1f) 2 104#(78p1f) 1257 #(943p1f) 3 44#(33p1f) 589#(442p1f) Design spans 6' 1.500" 6' 5.250" 0' 9.750" (right cant) Product:SP PT #1 2 x 8 16.0" O.C. Component Member Design has Passed Design Checks.**"* Design assumes continuous lateral bracing along the top chord. No lateral bracing required along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 666.'# 1889.'# 35% 9.67' Even Spans D +L Negative Moment 855.'# 1889.'# 45% 6.12' Adjacent 1 D +L Negative Unbrcd 855.'# 1889.'# 45% 6.12' Adjacent 1 D +L Shear 585.# 1269.# 46% 6.45' Adjacent 1 D +L LL Deflection 0.0530" 0.2146" L/999+ 9.67' Even Spans L TL Deflection 0.0556" 0.3219" U999+ 9.67' Even Spans D +L LL Defl., Rt. - 0.0229" 0.2000" 2U850 13.38' Even Spans L TL Defl., Rt. - 0.0241" 0.2000" 2U808 13.38' Even Spans D +L Control: Shear DOLs: Live = 100% Snow =115% Roof =125% Wind = 160% Design assumes a repetitive member use increase in bending stress: 15 % This member has been designed in accordance with NDS 2005 All product names are trademarks of their respective owners Your Company Name 4, Your Company Address ` `" ; Copyright (C)1987 -2011 by Keymark Enterprises, LLC. ALL RIGHTS RESERVED. Your Company Address „, iiiiikiiiii,ii iii. "Passing is defined as when the member, floor Joist, beam or girder, shown on this drawing meets applicable design criteria for Loads, Loading Conditions, and Spans listed on this sheet. Your Company Phone The design most be reviewed by a qualified designer or design professional as required for approval. This design assumes product installation according to the manufacturers specifications. Northampton, MA Property Detail Page 1 of 2 City of Northampton, MA: Residential Property Record ■ New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map -Block -Lot: 36 - 211 -001 Zoning: Assessment: Location: 21 BIRCH LANE Neigborhood: 17 Land: #Living Units: 1 Deed Book: 4956 Building: Class: R -101 Deed Page: 08 Total: Dwelling Information Building Sketch Style: Contemporary Year Built: 1986 t Story Height: 1 29 Attic: None 22 Basement: Full 26 Total Rooms: 8 ---- 1 Fr /B 4 N Bedrooms: 3 1472 14 \3 56 Full Baths: 2 1 _ Half Baths: 1 4 4 Irma Exterior Walls: Frame 20 141 CC s if , Unfinished Area: 0 _ - Ct Ground Floor Area: 1472 29 �'"�+ �� 4 21 Total Living Area: 2052 .�� 1FrlFG 20 Finished Basement Living 0 X 0 Area: Basement Recreation Area: 0 X 0 4 Woodburning Fireplace 1 / 1 Stacks/Openings: Addition Information: Metal Fireplace Stacks /Openings: 0 / 0 Lower I 1st Story 2nd Story 3rd Heat/Central A /C: Basic 'Basement 'One Story Frame' Heating System: Hot Water I 'Frame Garage One Story Frame Fuel Type: Gas I 'Wood Deck I Quality Grade: B+ .I One Story Frame Physical Condition: Good I I One Story Frame http: / /www.northamptonassessor.us/ noho /propertydetail.php ?map_no =36 - 211- 001 &pagec... 9/11/2011 • I _, The Commonwealth of Massachusetts Department of Industrial Accidents ,i =fr Office of Investigations 1 600 Washington Street �= = ` ^ Boston, MA 02111 _ _ www. mass gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Printl,egibly Name (Business /Organization/Individual): V5 /J 1 2) SS �13f9 ,6/Z- 6 Li /lb S Address: (d l City /State /Zip: �Ee_6, /nA - I /O 6 Phone #: 2 7/3 3 7 II- 79 Are ou an employer? Check the appropriate box: Type of project (required): 1. rili I am a employer with 1 4. n I am a general contractor and I 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors listed on the attached sheet. 7. ID Remodeling 2. [1 I am a sole proprietor or partner- ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ill Building addition [No workers' comp. insurance comp. insurarice.$ required] 5. ❑ We are a corporation and its 10.111 Electrical repairs or additions 3. Li I am a homeowner doing all work officers have exercised their 11.0 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 n employees. [No workers' 13. CS Other N eUJ A e_ comp. insurance 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 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: l o/ -1> //v s, . CO. Policy # or Self -ins. Lic. #: TA vJ C ).), ( -1 (-1 3 S Expiration Date: 1 2 9 - ,, ® /-)— Job Site Address: 0 / R/1 / 1 City /State /Zip: F402 iC € /2 9- o )- 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 IA for insurance coverage verification. I do hereby certi u er t e pains ndd nalties of perjury that the information provided above is true and correct I ` Date: 9 ^ `� ' / / Signature: Phone #: 6 1/ / 3- 57 (" -7 ? Y 3 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 #: • GUARD Workers' Compensation and Employer's Liability Policy NorGUARD Insurance Company - A Stock Company INSURANCE Policy Number JAWC224435 G R OU Renewal of NEW N CCI No.[25844] Policy Information Page [1] Named Insured and Mailing Address Agency James D Ross FINCK & PERRAS INS AGENCY PO Box 66 6 CAMPUS LANE Whately, MA 01093 Easthampton, MA 01027 Agency Code: MAFINC10 Federal Employer's ID 061 -55 -9981 Insured is Individual Additional Names of Insured (N2) JDR Builders Locations on Policy (L2) 177 State Road , South Deerfield, MA 01373 (01/29/2011 - 01/29/2012) [2] Policy Period From January 29, 2011 to January 29, 2012, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $100,000 Bodily Injury by Disease - each employee $100,000 Bodily Injury by Disease - policy limit $500,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming. D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms [4] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium $ 3,126 Total Surcharges /Assessments $ 189 Total Estimated Cost $ 3,315 INTERNAL USE GT Page - 1 - I Formation P_.e MGA : JAWC224435 !(tC .001014 Date : 01/28/2011 MANOTE .� 4, • 16 South River Street • P.O. Box A -H • Wilkes- Barre, PA 18703 -0020 • www.guard.com SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor. Not Applicable 0 Name of License Holder : *- i "— AtYY1 S 72‘...)S S big 10.- License Number q - g- Z /z Add s s, Expiration Date 4 3 Signatu a Telephone S. Registered Home knpraverrrent Contractor Not Applicable 0 I t..aE1 3v 3'1' 7 Company Name Registration Number Address Expiration Date Telephone' 1 t. f 7q g 3 SECTION ICY 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 1 No 0 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. ChM 788, Sixth Edition Section 1 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 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs (CO Decks flNt Siding [Dl Other [Dl Brief Description of Proposed Work: `BUILD N e>a 11 3( ' 11 b£cY Ta Sc-' .iP;' )4z,T v cf=: LE Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, 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? 5 Jr p� d. Proposed Square footage of new construction. ' J5 Z. ' Z C ' Dimensions [ 3 - 6, X i 3 " L' 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 'Y 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? u Yes No . I. Septic Tank ' City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TOBE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Pig 01, /( 7 Y as Owner of the subject property � � hereby authorize �J4 E ,) • ZS S to on my behalf, in all tters relative to work authorized by this building permit application. ignature of Owner Date I, � ' = „ , 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 Signature of rfAgent Date 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 I' r I- Frontage Setbacks Front Side L: R: IC 0 L:5 d R: Rear 's Building Height Bldg. Square Footage Open Space Footage (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 0 DONT KNOW YES 0 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 and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained C) Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO e 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 3 IF YES, describe size, type and location: E. M:It the construction activity disturb (clearing, grading, e x vation, or filling) over 1 acre or is it part of a common plan that will disturb over I acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. . . r..........'' , 1 01 S . , . ECEIVED Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit i ll 1 2111 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability ;::1 girt coreutroxi wamcnoms Northampton, MA 01060 Two Sets of Structural Plans 13- 587 -1240 Fax 413- 587 -1272 Plot/Site Plans Other Specify 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 be completed by office ,, c � L e n Map Lot Unit t / Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: p U L Eiv k ) {) 1 �c�i /sex N f1� -e /rte me • rint) Cu M. • ing Address: . � � a *fi— T hone Si! a ure 2.2 Authorized Agent: 1 � J J _ y b i 3ib Bulk" �"b a j 4/ j ,t) ) ! 7 L L.. //, v,1 /9 • Name (P ' - Current Mailing Address: /OG t. ( 1 / 3 7 1 - / — 7 Signature / Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee -7, DC©. 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 +3+4 + 5) 7 Dip , z•� Check Number 3 11'So This Section For Official Use Only Building Permit Number: I Date Issued: Signature: Building Commissioner /Inspector of Buildings Date 4 • File # BP- 2012 -0239 ' , 0 t1 ` ?-60k APPLICANT /CONTACT PERSON JDR BUILDERS Gtr CP' T d c N) ) 6 V ADDRESS/PHONE P 0 BOX 4 NORTH HATFIELD (413) 665 -7587 N 60 �r PROPERTY LOCATION 21 BIRCH LN �� (- ° C ` l� MAP 36 PARCEL 211 001 ZONE SR(100)/ f ©� THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST t F W' 1 . N ��e (Z ENCLOSED REQUIRED DATE C.� ZONING FORM FILLED OUT A4/ ,., (L Fee Paid � � (� N � J Building Permit Filled out / i 50 n Fee Paid (P Typeof Construction: CONSTRUCT DECK TO SUPPORT HOTTUB OFF EXISTING DECK f e 6 I W �t New Construction '' Non Structural interior renovations j ` Addition to Existing L 1, Z' Accessory Structure Building Plans Included: � �'" 0 Owner/ Statement or License 074105 SEE- P 3 sets of Plans / Plot Plan -ti - THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION PRESENTED: Pie C ' Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER: § 611 S 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 2 l ay a . . - - -/- — - - 7/ Sign. ii e 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. t 21 BIRCH LN 1 BP- 2012 -0239 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 211 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit # BP- 2012 -0239 Project # JS- 2012- 000372 Est. Cost: $7000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JDR BUILDERS 074105 Lot Size(sq. ft.): 77972.40 Owner: LENKOWSKI PAUL & ANN Zoning: SR(100)/ Applicant: JDR BUILDERS AT: 21 BIRCH LN Applicant Address: Phone: Insurance: P 0 BOX 4 (413) 665 -7587 WC NORTH HATFI ELDMA01066 ISSUED ON:9/20/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT DECK TO SUPPORT HOTTUB OFF EXISTING DECK 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 9/20/2011 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner