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36-325 Car rier's Carpentry and Drywall 1 16 David Street Southampton MA 01073 sal -0333 84s -e t I , - I .3/ 13' De .or - l'■-- /ate i S*ocr p Fi•CQ n rel. 5 e.- €"' /7 ) F 1/' 3` a"A,or v f - 1/ ' > - f �, s IN 3 it sg. F +. 1 . _ s: ctiAMp i , alZetKA 1- � �_ �_�� ._ (City of �VV "ar setts turn • _ —_ ,, �I . 1� . T / � ti iii rI aasxch3csetfa _t= _ DEPARTMENT OF BUILDING INSPECTIONS = ! I _ INSPECTOR 212 Main Street • Municipal Building > Northampton, MA 01060 ,,.•� HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction supc:.•isor. 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 fortlle 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 1, 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 Date Address of work location r i • { r P r .. - (rii of a ril dm33fo11 '� A v...4 � E .51c,cwcFntrtte- _ • ._ - DEPARTMENT OP DUILDfG INSPECTIONS 212 Main Street ' Municipal Building, Northampton, Macs. 01060 r' WORKER'S COMQ'ENSATION LYSURA-.NL)✓ AFFIDAVIT 1--, _e6L.A.4..c..._,...,- .___ (iiccvs- Jpermittcc) v.ritb a principal place of at: / 1 0 Q t, 1� _- t-la [a w 1.... (U Y G 1 3 (p hone ') 5 (stici ry /Stai.cla p) do hereby certify, under the pains and penalties of perjury:, that { ( ) I am an employer providing the follo.vin2, v.'orkcr's compensation coverage for in'' • employees worldng on this job: (Lasun - c Comp y) • (Policy Nt.rnrcr) -- (Exoiratior. Dal...) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the conractors listed below wbo have the follo•vine worker's compel policies: • • - (Name of Contractor) (Insuranc„ Cornparryi ?olio Num c Oxpiriu n Date) (Dame of Contactor) (Irsurancc CompanviPotic Ntunc_f) (Ex :lion Date) (Name of Coonaetor) Qnsuranca Co mpany/PoUcy Numb-r) (Expiration Date) (Name of Contractor) (Insuran= Company/Policy Numbz.r) (Expiration Datt) (nn th d i oc51 rile if a <7 to ',o 1 s& inform+ioa petr.ini.nc to .Il eocc-1'..ora) .... 1 1 a-- a sole _proprietor and have no one working for me. ( ) I am..a home owner performing all the work myself. NOTE: pl.-.. be cwzr du: ..-Iii. o bcoxot.xra ..to employ pc-onx to ci r +�••- -. , cs.: =+0o a rgau urork oa • dwrrt^t or not more ib= t1 turfs in Leh the bomoow•oor maid= or oo the n-oua a xppvttea_= theto z : Do( C — _ny oe:. id. --od to he eitpleye: ua:- the w 0 ....t. ioa Aa (GL!152.= 1(5)). -.ppii.^ation by . bommaaa fn c lice or T e""6.- the legs r _ or to r ,Ioyor under the Woricoet C.o1=1:70ma4i0a Act I undassand tut. a copy of this mt xsas may be forLearded to the Dcpectaax¢ of 7.. Aoodcate office of In-.umoo. for the oavce waif Ilion and act Lilt= to sm ut'covcrap +* ^e a•tr-r tociion 25 A of Mal- 152 an th 1=4 to the imy- or ciminal P'r' Jt �^ o comi:.i. or. fix of up to S 1)00 -00 .rldlor itorprioncton o(up to ooc y-.-r r.od d vii pau7 in ' � form of • Stop Work Ortic sod . _ fam or ;100.00 a day tpicst �c For 6.P.,1.7=1-.I. u,c only '- -- - -- � ,r � Pcr -mit Nttmlcr K Y �..-411. • /-(A)'°4, Amp _- LoL sigmauuc of Lir-rsaJPcrmitic:. Date _ - 1 • SECTION 8 - CONSTRUCTION SERVICES t 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : � �1 Q F� C, it ,- e ® - 5 / 6 1 L/ License Number 00 A 64, 504,4 L o k (- 01 0 3 9- a /- 6 Addres (t% Expiration Date Si ature Telephone i9e • is'rfere omen ® "'- ' " vemen�ontrac#a Not Applicable ❑ � � �� Company Name CJ Registration Number C G ba, ; ivbts. ©t o7 3 a s o C Address Expiration Date Telephone Sd 7 - 0 3 33 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 ❑ 4 0111 ,Whew 1 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 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 Ma.huse w 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 I. • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House El Addition n ; Replacement Windows Alteration(s) la Roofing EJ Or Doors 0 • Accessory Bldg. ❑ Demolition ❑ New Signs [0] , Decks [p Siding [0] Other [El] Brief Des iptiop of yropptsed c / ] �^ 1 5 f Work: l w t ,S h r'Cc l 3q ,y, :v, vn. f' �O r - t ( (4 0'+-A 4.,,/ R V 4 Alteration of existing bedroom Yes „.) / , No Adding new bedroom Yes )< No ' Attached Narrative Renovating unfinished basement _ A( Yes No Plans Attached Roll - Sheet V e S - 4 I - o ddi a toy ex�stinc aotysrEnq r:�cornp1ete t oiIa in q. 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 FOR BUILDING: PERMIT I, /'i< (4 ,A e 4 3 -o , as Owner of the subject property ( ,[� (� hereby authorize C h � ,2rJ f l u" e l %Q--U' to act on my behalf, in all matters relative to work authorized by this building permit application. c .�/ LE' d / 01.57- 0 (, Signature of Owner -� Date 1, P-a C; ,/^ , as Owner /Author Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best o my knowledge a rdbelief. Signed un er the pains and penalties of perjury. 4 et 1' ✓'tr �' v Print ,- 5 U 4 Sign- of Owner /Agent Date . Section 4. ZONING All Informati6h 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 Setbacks Front i i j f Side L: I R: L:i R:i Rear I Building Height , . _ - 3 i Bldg. Square Footage i i % 1 i Open Space Footage % (Lot area minus bldg & paved i i t 1 ? i i i parking) # of Parking Spaces Fill: I; !3 i (volume& Location) ` s A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 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 0 DON'T KNOW 0 YES 0 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 0 NO 0 IF YES, describe size, type and location: 's 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: 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 i IF YES, then a Northampton Storm Water Management Permit from the DPW is required. r % µ Department tue only , '` City of Northampton tu�s : � �'`��� i`. g���"'` �� � � � Building D €u. e Q x A 212 Main Street a «r � ;�� Room 100 ,, ,. 4 Northampton; MA 01060 `� P,' 1. ne 413- 587 -1240 Fax 413 -587 -1272 to 7 ` '� - " � APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORM 1.1 Property Address: M This secpon to be completed bpi offi O �s _ j • Map #�o Unit C_-C4 i'Q r r V G W Gt tjS Zone OO Di '' Im Drstnct =' _r0. 66; Drstnct SECTION 2 - PROPERTY °W ENT AG ENT 2.1 Owner of Record: A , d r eel o Hr-r a a � r� r ! w� f 40-4 � ?° CI 6‘0 Name (Print) Current Mailing Address J ,7 /-t ..3 - 3 6 3 Telephone Signature 2.2 Authorized Agent: Q r,) ter- C rv't e G � a . ► Si- „fi�a,,.p � o.v /go-- 6 !C 73 Nam rint Current Mailing Address: ,��t S'7-C3 s Sig ature 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 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. iviechanicai (H AC) 5. Fire Protection 6. Total = (1 + 2 + 3.+ 4 + 5) Sit?' O b Check Number a/v Y� 9 — This Section For Official Use Only Building Permit Number. • Date Issued. Signature: Building Commissioner /Inspector of Buildings Date t File # BP- 2006 -0750 APPLICANT /CONTACT PERSON ROBERT CARRIER JR ADDRESS /PHONE 16 David St SOUTHAMPTON (413) 527 -0333 PROPERTY LOCATION 228 CARDINAL WAY MAP 36 PARCEL 325 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ii 09 Fee Paid U/ Typeof Construction: FIINISH PARTIAL BASEMENT (OFFICE /STORAGE) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 059154 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF (1RMATION 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: § CA/re.-1 p L ST4 c C._ ri Finding Special Permit Variance* C 0 ZcLJy`c / A 4 --P a= -vJ 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 S et Commission � // ,V 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. 228 CARDINAL WAY BP- 2006 -0750 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 325 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2006 -0750 Protect # JS- 2006 -1149 Est. Cost: $19000.00 Fee: $95.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT CARRIER JR 059154 Lot Size(sq. ft.): Owner: STONE ANDREA B Zoning: SR Applicant: ROBERT CARRIER JR AT: 228 CARDINAL WAY Applicant Address: Phone: Insurance: 16 David St (413) 527 -0333 SOUTHAMPTONMA01073 ISSUED ON :1/26/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:FIINISH PARTIAL BASEMENT (OFFICE /STORAGE) 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 ' ` ll2ough: house # Foundation: ? c -1 Driveway Final: Final: Final: 3/4 Rough Frame: t ? c 21 0 6 ( � Gas: Fire Department Fireplace /Chimney; Rough: Oil: Insulation: o'/( 0 LIZ; «1 5 • Final: Smoke: Final: OK C 3(L � 10 6 ` °C0D(t�51 - - i.K -t►�t G THIS PERMIT MAY BE REVOKED BY THE ITY OF NORTHAMPTON UPON VIOLATION OF ° I`- ANY OF ITS RULES AND REGULATION Certificate of Occu anc Signature: FeeType: Date Paid: Amount: Building 1/26/2006 0:00:00 $95.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 • Building Commissioner - Anthony Patillo - �Q l ' ' 1. ' , ' . . .. , ..:f i*WF:'• r-- , .,. . . • • ....... tAAR 3 1 2003 . .5Z .5 HAM p ...0 er 0 . ., . . . -- - - • . , , • . .. =.= -- --*---- 4 1 . ' , ..'; • '' '::. I ' ' ., , ..01,rt of Nortfikmptort ...., - :i m-.-- _....._ ,Lilissxchttsetts i; Mtf.' - fr ct .0,,, ....f... , • , v ...... 4.45 ,„ DEPARTMENT OF BUILDING INSPECTIONS ,d1 --- - SPECTOR 212 Main Street ' Municipal Building IN _ Northampton, Mass. 01060 - Square Footage Amount Basement @ .10 /e-2 g cif ia g Lio 1st Floor @ .40 /a El ,51.3 , 6020 2nd Floor " @ .20 c kp,5 /93. Ob _ 1/2 Floors, Attic, Garage .10 - ziY.sb Deck, Porches .1(D /6 P ietbgb . . .. .. ., TOTAL 96 '50 2. . . _76'6./d_.4-;-4. • 4,X ? ( 0.-4 C/) (C) t ()a 1 , 01 , , -- „ , 1 7 e 71,, r.‘,:x_ .. . . . F-e-e 1 k. 1 G I V ____ , 0£ ,OZ 3 01 0 , OZ = . 1 4, ,,- NV1d aiis H180 NV1d / / / / / , 0 ,�, / .+ - -............. / •• _ ______ _ I nn • • - - _ - - ----t g l -- • ■...-..... . L ' - - -- -- t ----- — . ..._ . , _ . _____ . . _ .......„..._ . _ . ___ _, . ---,, ,. i ______ _ ___ _____._ __ . ,.. ____ , _ . ______ , ___ ______ . , - y _ _, - -TAf-,--', /.... I Ss S \ .00 =d y 83AVd 3A 11V80330 301M ,ti / \ \ k j i J3N803 d01 G3833YYVH3 ' \ B4OI 8.01 w 1 iOd (MOW dVO 33Y1 NI i ,� �a P AVM3A180 Q3AVd 'ON00 '118 S 3SV8 TIM 'OS ,1 \ s'• frt �� 4t 05 '1313 �\ �v ' '� / .30 d01 '310d ydon OOOM 4 \ vb._ z1 381138033SV8'OS,Z/M 1 1 13018 '31`103 3N1V80330 x. , 11 N % f\ I �•'--'� T ' n ► H080. _ y.. 1 1 ,1Z :x {{ W �7:t x y .l \ N I N 1 � o 1 I 1 4 Q. \ \ ` � ti \ - - —� , lZ 311 � __ --� �. q d, d `6 � ' � � ' � L \ 2 a r CITY OF NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS !� ) 125 Locust Street Northampton, MA 01060 413 -587 -1570 • Samuel B. Brindle, P.E. Fax 413 - 587 -1576 Director, City Engineer Guilford B. Mooring, P.E. Assistant Director of Public Works BOARD OF PUBLIC WORKS DRIVEWAY PERMIT GENERAL INSTRUCTIONS AND REGULATIONS • 1. A "Driveway Permit" is required in all cases where a new curb cut or an alteration to an existing curb cut is proposed on a City public way. 2. Driveway permits issued by the Board of Public Works (BPW) shall be attached to and become part of the "Building Permit" issued by the Building Inspector. 3. Prior to the issuance of a "Building Permit" the owner of any lot to be serviced by a new driveway shall apply to the BPW for a "Driveway Permit" by completing the pertinent portions of the permit (see attached). Once the location of the driveway is approved by the BPW, a building permit may be issued. 4. The Building Inspector shall not issue an "Occupancy Permit" unless the driveway to the lot has been approved by the BPW. 5. By the issuance of a driveway permit for the stated location, neither the City of Northampton nor the Department of Public Works imply that no drainage problems will result with the driveway when constructed. Properties situated or driveways installed in low lying areas in the path of the natural drainage will be subject to water problems. These problems may include water sheeting across roadways adjacent to the driveway. The City and the DPW assume no responsibility for any such drainage problems. The owner of the property is responsible for constructing and maintaining the driveway with adequate provision for natural water runoff situations. c muel B Brindis, P.E. Director of Public Works C:1MyFiles\Lyn\Driveway Permit General Instructions Permit No. 31 -03 Conditions: Driveway Permit In lieu of plan approved by City Engineer I agree to the following added conditions: 1. I will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. I further agree that if in the inspections any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. By: ✓ Petitioner Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. cc: Building Inspector 36 Permit No D31 -03 r ti 2 0 2x03 {' LL CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: February 13, 2003 FEE: $25.00 CHECK #: 1481 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 228 Cardinal Way Lot 21 Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. Driveway surface to be paved as soon as possible if the grade of the proposed driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City of Northampton in the event of a washout of this driveway. B y : / ec_A .t' Me issa Boyle, Autumn Properties P.O. Box 628, Easthampton, MA 01027 Telephone #: 413 -527 -1580 Proposed Location Inspected By: ( — 2 .Y o Gravel Base Grade Inspected By: Final Approval THE BOARD OF PUBLIC WORKS voted that petition be granted. George Andrikidis Director of Public Works (SUBJECT TO ATTACHED CONDITION 1 & 2) cc: Building Inspector - 3a s MUNICIPAL SEWER AVAILABILITY (1 Northampton Streets Department 125 Locust Street Northampton, MA 01060 587 -1570 Location: 228 Cardinal Way Lot # 21 Inquiry Made By: Melissa Boyle, Autumn Properties Construction P.O. Box 628 Easthampton, MA 01027 Date of Inquiry: February 13, 2003 Municipal Sewer Main in Front of Location: Yes g No Size of Sewer Main: 2 " Material: PVC Age: 2002 Depth of Sewer Main: 5 Size of Service Connection: 1 -1 PVC Comments: The City of Northampton has not accepted responsibility for the maintenance of the sewer main and service connections as of this date of inquiry_ A corresponding "sewer entrance fee" shall be paid prior to making any connection to the municipal sewer system. Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. 2 /• /D� f Joseph Thomas, Superintendent Streets Department cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector 35 MUNICIPAL WATER AVAILABILITY } Northampton Water Department 237 Prospect St. Northampton, MA 01060 587 -1098 Location: 228 Cardinal Way Lot # 21 Inquiry Made By: Melissa Boyle, Autumn Properties Construction P.O. Box 628 Easthampton, MA 01027 Date of Inquiry: February 13, 2003 Municipal Water Main in Front of Location: Yes x No Size of Water Main: 12" Material: DI Age: 2002 Approximate Street Pressure: 72 PSI Size of Service Connection: 1" copper Comments: The Water Department cannot guarantee adequate water pressure during peak demand tunes at elevations above 320 feet. The City of Northampton has not accepted responsibility for the maintenance of the water main and service connections as of this date of inquiry. A corresponding "water entrance fee" shall be paid prior to making any connection to the municipal water system. Arrangements of such installation shall be made with the Northampton Water Department with a minimum of 5 working days notification. All work shall conform to Northampton Water Department specifications. h ., 4 1, , Charles Borowski, Superintendent of Water cc: Ned Huntley, Asst_ City Engineer Anthony Patillo, Building Inspector i • Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Checked By /Date TITLE: 228 Cardinal Way CITY: Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 03/28/03 PROJECT INFORMATION: Lot #21 @ the Plantation COMPANY INFORMATION: Autumn Builders COMPLIANCE: Passes Maximum UA = 355 Your Home = 342 3.7% Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U- Factor UA Ceiling 3: Flat Ceiling or Scissor Truss 1150 38.0 0.0 35 Wall 1: Wood Frame, 16" o.c. 1856 15.0 3.0 98 Window 2: Wood Frame, Double Pane with Low -E 300 0.400 120 Door 1: Solid 100 0.350 35 Floor 3: All -Wood Joist/Truss, Over Unconditioned Space 1150 19.0 0.0 54 Furnace 1: Forced Hot Air, 88 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release 1a. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% o / he design Load as specified in Sections 780CMR 1310 and J4.4. (� f r Builder/Designer "if ../._ - I Dates 6 /'L hllui� r I O 1flLU tC' 9, l;, I I , C(v o.n Iv�uvlr.c I I Arp v ().o uJ jo 11."0.) (�_:: ; �{ �_:_, (1 ));; )u ;.;.:�.r :.r.rn!:::, �r; Do 0.3. 1 S o7 l JO:Kill v Jo P,¢lntOC) - „c.n) )o Crolpsc i :c, Lit').) Lc I " IDi'i ) > V S ::_ �: r � c au�o� :);; o am11:} t. ll (n v oorl:Dtgc - )A a 3Q ono 0: {1 1,, trs]o :n1z13 1c971 - I. v 1 1 5». _ - 7.; .h, I'�'.l �` 1 1,1::11 )>1)5: {7 C:::i d iUti::_ . :u,' ( ) (:.11:(1 _ l.�: - , 1 , :111';(1T , ? (101.E (1:O_) 10 �O;�l aliC')j() i± 11; I Oi1E) I ,., ( _ _ 0 "'�{� ,7�Jj� 11,r' C ,`.:7�;;L ) JiIF1R5::L) �C Il? :) .s1 -L ce(V ULU' C ;201)bll}. g ucAcikkil)kir-WN _cL) D c; �► � i _, «�� ac`1 � \,;(1121,1V r,rlO [U l'in1 .'i 1, 7 )\r 1 I ? " t SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder : 1 � -1 15 — LQL,. �, e - - W 4"'14 r t License Number 69 0 0110,iier ,rnci 0613 Address Expiration Date I �l, 00`7..110 Si: ature Telephone 9Re'giste "red Homeylmprovemen't Contractor R �, ;�, 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 ❑ 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 building permit. As acting Construction Supervisor your presence on the job site will he required from time to time, during and upon completion of the work fe 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 ucneral i,a 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 X Addition El Replacement Windows Alteration(s) El Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ] f� � Brief Description of Proposed Work: / _ _ _ ,4 . ,..t .' .i 4!`� 0 / / / Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes No Plans Attached Roil ❑ - Sheet ❑ 6a.lf New` ho:us alnd o Ktddition`to '6xisting= housing,.complete the following: a. Use of building : One Family X Two Family _ Other b. Number of rooms in each family unit: 9 Number of Bathrooms 3 c. Is there a garage attached? LIF` Y ' e �/ d. Proposed Square footage of new construction. r Dimensions 1I?L ) 2 � i e. Number of stories? CSC f. Method of heating? G as Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction V a R afy\e_. i. Is construction within 100 ft. of wetlands? Yes V No. Is construction within 100 yr. floodplain Yes ` No j. Depth of basement or cellar floor below finished grade 1 k. Will building conform to the Building and Zoning regulations? t( Yes No I. Septic Tank City Sewer K Private well City water Supply SECTION 7a "OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT' OR: CONTRACTOR APPLIES FOR BUILDING PERMIT I, i ) 'f b1e" j CORS11 OC:4I0 1 , as Owner of the subject property hereby authorize 1 _ c . I _ to act on my b alt in all matters r lative to work auth. • zed by this building permit application. ' ii (--- i e IL-- Signature of Owner Date I, r4) e , as Owner /Authorized Agent hereby declare that the state ents and j ormation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. r- liA OM( - Print - e /1 .,_ (3' ' -613 Sig ature of Owner /Ag. - Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size _ (8,6)13 SF (6 tgjl Frontage L (} O Setbacks Front Side L: R: 2 ! L: R: Rear Building Height (9 P Bldg. Square Footage t4 /; Open Space Footage (Lot area minus bldg & paved j .� i ,H 0 4' parking) `V `'1 O # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO V DON'T KNOW YES IF YES, date issued: /I IF YES: Was the permit recorded at the Registry of Deeds? /O/' NO DON'T KNOW YES IF YES: enter Book Page _ and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 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 No IF YES, describe size, type and location: z y� City of Northampton S a s": ti 1 ' err - .0 Building Department 212 Main Street N ® fov`l�!i a �;1 R 3 1y133 Room 100 a = Northampton, MA 01060 7• Sete` phone 413587 - ''1240 Fax 413 - 587.1272 Ot her APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 • SITE INFORMATION 1.1 Property Address: This se to be rtplet by office )11a( ; Cardinal IOC Map Lo � � Unit J A / (� ` • a Zone r Overlay District ICI) x,. Elm St. District CB'District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ` e 0. X(023 Nam• • tint) rent M il�ng Address: t 1CAg 1�1�J 1 1 61 ()Za,- , 4 Tel ephonne Signature 2.2 Authorized Agent: "- A °Vila -S Beq ?J)_ 223 Nam 'Tint) Current Mailing Address: 1 i t 4' S J res hamp1on1mn 010 3:1 Signature Telephoney13, 53-1 • 1580 SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 120100() 2. Electrical (b) Estimated Total Cost of 7/S S Construction from (6) 3. Plumbing 1 560 Building Permit Fee 4. Mechanical (HVAC) / // // 5 0 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number /j-a This Section For Official Use Only Building Permit Number: - ,° '3" -- ' e 17 Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2003 -0817 • APPLICANT /CONTACT PERSON AUTUMN PROPERTIES LLC ADDRESS/PHONE P 0 Box 628 (413) 527 -1580 PROPERTY LOCATION LOT # 21 - 228 CARDINAL WAY MAP 36 PARCEL 325 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out `� Fee Paid ���d 994ve3 Tvpeof Construction: CONSTRUCT 2 STORY SFH ATT GARAGE/PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 044431 3 sets of Plans / Plot Plan THE FOLLOWING 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 Co • •'on 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.