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25A-162 (2) Message List Vertical Direction Overall Spans Design is OK Positive moment LC: -A2: D + L Negative moment LC: -A1: D Shear LC: -A2: D + L Deflection LC: -TOTAL LOADS Moment shear interaction LC: -A2: D + L Bia>dal moment interaction LC: -A2: D + L Web stiffener required at left support in Span 1 Web stiffener required at right support in Span 1 Span1 Positive moment LC: -A2: D + L Negative moment LC: -A1: D Shear LC: -A2: D + L Deflection LC: -TOTAL LOAD Moment shear interaction LC: - A2: D + L Web crippling interaction LC: -TOTAL LOADS Biaxial moment interaction LC: -A2: D + L Web stiffener required at left support in Span 1 Web stiffener required at right support in Span 1 Lateral Direction Overall Spans Design is OK Positive moment LC: -A1: D Negative moment LC: -A1: D Shear LC: -A1: D Deflection LC: -TOTAL LOADS Moment shear interaction LC: -A1: D Biaxial moment interaction LC: - A2: D + L Spanl Positive moment LC'. -A1: D Negative moment LC: -A1: D Shear LC:-A1: D Deflection LC: -TOTAL LOAD Moment shear interaction LC: -A1: D Biaxial moment interaction LC: - A2: D + L Spanl Span2 Span3 Span4 Span5 LC RC Bending Capacity (lb -ft) 24900 0 0 0 0 0 0 0 Positive Bending Moment (lb-ft) 11162.66 0 0 0 0 0 0 0 Ratio 0.45 0 0 0 0 0 0 0 Critical LC A2 - - - - - - - Bending Capacity (lb -ft) 24900 0 0 0 0 0 0 0 Negative Bending Moment (lb-ft) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - Shear Capacity (lb) 20400 0 0 0 0 0 0 0 Actual Shear (Ib) 2976.9 0 0 0 0 0 0 0 Ratio 0.15 0 0 0 0 0 0 0 Critical LC A2 - - - - - - - Deflection Limit (in.) 0.5 0 0 0 0 0 0 0 Deflection (in.) 0.46 0 0 0 0 0 0 0 Ratio 0.92 0 0 0 0 0 0 0 Critical LC TOTAL - - - - - - - Live Deflection Limit (in.) 0.5 0 0 0 0 0 0 0 Deflection (in.) 0.32 0 0 0 0 0 0 0 Ratio 0.65 0 0 0 0 0 0 0 Critical LC LIVE - - - - - - - Stiffener Capacity (lb) 15000 0 0 0 0 0 0 0 Actual Web Crippling (Ib) 2976.9 0 0 0 0 0 0 0 Ratio 0.2 0 0 0 0 0 0 0 Critical LC TOTAL - - - - - - Moment -Shear Interaction Ratio 0.45 0 0 0 0 0 0 0 Critical LC A2 - - - - - 0 0 Biaxial Moment Interaction Ratio 0,45 0 0 0 0 0 0 0 Critical LC A2 - - - - - 0 0 Lateral Direction Spanl Span2 Span3 Span4 Span5 LC RC Bending Capacity (lb -ft) 3500 0 0 0 0 0 0 0 Positive Bending Moment (Ib -ft) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - Bending Capacity (lb-ft) 3500 0 0 0 0 0 0 0 Negative Bending Moment (Ib -ft) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - ShearCapacity (Ib) 36100 0 0 0 0 0 0 0 Actual Shear (lb) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - Deflection Limit (in.) 0.5 0 0 0 0 0 0 0 Deflection (in.) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - Live Deflection Limit (in) 0.5 0 0 0 0 0 0 0 Deflection (in.) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC LIVE - - - - - - - Moment -Shear Interaction Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - 0 0 Biaxial Moment Interaction Ratio 0.45 0 0 0 0 0 0 0 Critical LC A2 - - - - - 0 0 i CJ Span WSdth Dead Live Wmd Seismic Snow (ft) (psf) (psi) (psi) (psf) (psi) False All Spans 7 15 40 0.0 0.0 0.0 Load Combination Allowable Stress Design (ASD) Al : D A2: +L A3:D +S A4 : D + 0.75L + 0.75S A5 : D + W A6:D +0.7E A7 . D +0.75W +0.75L +0.755 A8: D +0.75E +0.75L +0.755 A9:0.9D +W A10. 0.9D + 0.7E Analysis Detail Vertical Direction Lateral Direction Reactionl = 2977 Ib =0 Ib Reaction2 = 2977 Ib =OIb Stiffener Locations Web Stiffener Required at Location 0 ft = 2 Web Stiffener Required at Location 15 ft =2 Design Check Maximum Overall: Vertical Direction Lateral Direction Bending Capacity = 24900 Ib -ft = 3500 Ib-ft Positive Bending Moment = 11162.66 Ib -ft = 0 lb-ft Ratio = 0.45 = 0 Critical LC = A2 = Al Bending Capacity = 24900 Ib-ft = 3500 Ib -ft Negative Bending Moment = 0 Ib -ft = 0 Ib -ft Ratio = 0 = 0 Critical LC =A1 =A1 Shear Capacity = 20400 Ib = 36100 Ib Actual Shear = 2976.9 Ib =0 lb Ratio = 0.15 = 0 Critical LC = A2 = Al Deflection Limit = 0.5 in. = 0.5 in. Deflection = 0.46 in. =0 in Ratio = 0.92 = 0 Critical LC = TOTAL = TOTAL Live Deflection Limit = 0.5 in = 0 5 in. Deflection = 0.32 in. = 0 in. Ratio = 0.65 = 0 Critical LC = LIVE = LIVE Stiffener Capacity = 15000 Ib = N/A Actual Web Crippling = 2976.9 Ib = N/A Ratio = 0.2 = N/A Critical LC =TOTAL = N/A Moment -Shear Interaction Ratio = 0.45 = 0 Biaxial Moment Interaction Ratio = 0.45 = 0.45 Span Maximum Vertical Direction LSB E4 LiteSteelbeam LSB'• Selector Software Draft contents of report generated by LSB Selector software Version 2.0 Disclaimer The technical data, product specifications and product performance data included as part of the LSB Selector Software are not a substitute for the professional expertise, recommendations and judgment of a certified engineering professional after consideration of important factors like specific project objectives, anticipated structural demands, environmental and climate conditions, and governmental code requirements. The Software and its use under any circumstances are not intended to replace or eliminate the need for the advice of a qualified Professional Engineer. By installing and using tie Licensed Product, Licensee assumes complete responsibility for the selection, Use, efficiency, and suitability of the Licensed Product and for the suitability and performance of any product of Licensor selected and used by Licensee in reliance on the Licensed Product. Licensor shall haw no liability to Licensee or third parties for a failure of the Licensed Product as a design tool or otherwise or for any failure of any product of Licensor to perform or suffice for any purpose. LiteSteel Beam is a trademark, and LSB is a registered trademark of LiteSteel Technologies. Project Data Project Name = Day Ave, Northampton, MA Project Number = Project Location = Description = Date = 01/27/2012 Designer = Program Settings Application version = LSB Selector Software 2.0 Design Method = ASD Units = US (Imperial) Program Mode = Manually Picked Web Stiffener = Yes - Insure the web Stiffener are Installed Allowable Live Deflection = 360 Allowable Total Deflection = 360 Beam Data LSB Beam Size = 800LSB250 -98 Back to Back Number of Spans = 1 Span 1 = 15 ft Span 1 Unbraced Length = 0 ft Section Properties Beam Depth(d) = 7.9 in Beam Wdth(b) = 472 in. Flange Depth(df) = 0.79 in. Beam Web Thickness(t) = 0.098 in. Ro =0.148 in. Riw =0.118 in. Area =3.5 in2 Weight/ft = 11.92 lb Ix = 32.8in4 Sx = 8.32 in. Rx = 3.06 in. l y = 2.4 in. Syl = 3.08 in. Syr = 1.52 in. Ry =0.83 in. m =0.93 in. GJf = 1865kin2 J = 0.332 in. CW = 11.4in6 Loading Data Area Loads : Message List Vertical Direction Overall Spans Design is OK Positive moment LC: -A2: D + L Negative moment LC: -A1: D Shear LC: -A2: D + L Deflection LC: -TOTAL LOADS Moment shear interaction LC: -A2: D + L Biaxial moment interaction LC: -A2: D + L Web stiffener required at left support in Span 1 Web stiffener required at right support in Span 1 Spanl Positive moment LC: -A2: D + L Negative moment LC: -A1: D Shear LC: -A2: D + L Deflection LC: -TOTAL LOAD Moment shear interaction LC: -A2: D + L Web crippling interaction LC: -TOTAL LOADS Biaxial moment interaction LC: -A2: D + L Web stiffener required at left support in Span 1 Web stiffener required at right support in Span 1 Lateral Direction Overall Spans Design is OK Positive moment LC:-A1: D Negative moment LC: -A1: D Shear LC:-A1: D Deflection LC. -TOTAL LOADS Moment shear interaction LC: -A1: D Biaxial moment interaction LC: -A2: D + L Spanl Positive moment LC: -A1: D Negative moment LC: -A1: D Shear LC: -A1.D Deflection LC: -TOTAL LOAD Moment shear interaction LC: -A1: D Biaxial moment interaction LC'. -A2: D + L Spanl Span2 Span3 Span4 Span5 LC RC Bending Capacity (lb -ft) 12400 0 0 0 0 0 0 0 Positive Bending Moment (Ib -ft) 7822.2 0 0 0 0 0 0 0 Ratio 0.63 0 0 0 0 0 0 0 Critical LC A2 - - - - - - - Bending Capacity (Ib-ft) 12400 0 0 0 0 0 0 0 Negative Bending Moment (Ib -ft) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC - - Al - - - - - Shear Capacity (lb) 10200 0 0 0 0 0 0 0 Actual Shear (Ib) 1590.67 0 0 0 0 0 0 0 Ratio 0.16 0 0 0 0 0 0 0 Critical LC A2 - - - - - - Deflection Limit (in.) 0.35 0 0 0 0 0 0 0 Deflection (in.) 0.25 0 0 0 0 0 0 0 Ratio 0.73 0 0 0 0 0 0 0 Critical LC TOTAL - - - - - - - Live Deflection Limit (in.) 0.35 0 0 0 0 0 0 0 Deflection (in.) 0.25 0 0 0 0 0 0 0 Ratio 0.72 0 0 0 0 0 0 0 Critical LC LIVE - - - - - - - Stiffener Capacity (Ib) 5200 0 0 0 0 0 0 0 Actual Web Crippling (Ib) 2977 0 0 0 0 0 0 0 Ratio 0.57 0 0 0 0 0 0 0 Critical LC TOTAL - - - - - - - Moment -Shear Interaction Ratio 0.64 0 0 0 0 0 0 0 Critical LC A2 - - - - - 0 0 Bia,aal Moment Interaction Ratio 0.63 0 0 0 0 0 0 0 Critical LC A2 - - - - - 0 0 Lateral Direction Spanl Span2 Span3 Span4 Span5 LC RC BendingCapacity(Ib -ft) 1800 0 0 0 0 0 0 0 Positive Bending Moment (lb -ft) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - BendingCapacity(Ib -ft) 1800 0 0 0 0 0 0 0 Negative Bending Moment (Ib -ft) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - ShearCapacity (lb) 18000 0 0 0 0 0 0 0 Actual Shear (Ib) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - - - Deflection Limit (in.) 0.35 0 0 0 0 0 0 0 Deflection (in.) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC - - - Al _ - - - Live Deflection Limit (in.) 0.35 0 0 0 0 0 0 0 Deflection (in.) 0 0 0 0 0 0 0 0 Ratio 0 0 0 0 0 0 0 0 Critical LC LIVE - - - - - - Moment -Shear Interaction Ratio 0 0 0 0 0 0 0 0 Critical LC Al - - - - - 0 0 Biabal Moment Interaction Ratio 0.63 0 0 0 0 0 0 0 Critical LC A2 - - - - - 0 0 Location Direction Dead Live Wnd Seismic Snow Span (ft) (Ib) (Ib) (Ib) (Ib) (Ib) 1 5.5 Vertical 2977 Load Combination Allowable Stress Design (ASD) Al : D A2:D +L A3:D +S A4:D +0.75L +0.755 AS:D +W A6:D +0.7E A7: D + 0.75W+ 0.75L + 0.755 A8: D +0.75E +0.75L +0.755 A9:0.9D +W A10: 0.9D + 9.7E Analysis Detail Vertical Direction Lateral Direction Reactionl = 1449 Ib =OIb Reaction2 = 1591 Ib =0 Ib Stiffener Locations Web Stiffener Required at Location 0 ft = 1 Web Stiffener Required at Location 10.5 ft = 1 Design Check Maximum Overall: Vertical Direction Lateral Direction Bending Capacity = 12400 Ib -ft = 1800 Ib -ft Positive Bending Moment = 7822.2 Ib -ft = 0 lb -ft Ratio = 0.63 = 0 Critical LC = A2 = Al Bending Capacity = 12400 lb -ft = 1800 Ib -ft Negative Bending Moment = 0 Ib -ft = 0 lb-ft Ratio = 0 = 0 Critical LC = Al = Al Shear Capacity = 10200 Ib = 18000 Ib Actual Shear = 1590.67 Ib = 0 Ib Ratio = 0.16 = 0 Critical LC = A2 = Al Deflection Limit = 0.35 in. = 0.35 in. Deflection = 0_25 in. = 0 in. Ratio = 0.73 = 0 Critical LC = TOTAL = TOTAL Live Deflection Limit = 0.35 in. = 0.35 in. Deflection = 0.25 in. = 0 in Ratio = 0.72 = 0 Critical LC = LIVE = LIVE Stiffener Capacity = 5200 Ib = N/A Actual Web Crippling = 2977 Ib = N/A Ratio = 0.57 = N/A Critical LC = TOTAL = N/A Moment -Shear Interaction Ratio = 0.64 = 0 Biaxial Moment Interaction Ratio = 0.63 = 0.63 Span Maximum Vertical Direction M LSB _ , LiteSteel beam LSB" Selector Software Draft contents of report generated by LSB Selector software Version 2.0 Disclaimer The technical data, product specifications and product performance data included as part of the LSB Selector Software are not a substitute for the professional expertise, recommendations and judgment of a certified engineering professional after consideration of important factors like specific project objectives, anticipated structural demands, environmental and climate conditions, and governmental code requirements. The Software and its use under any circumstances are not intended to replace or eliminate the need for the advice of a qualified Professional Engineer. By installing and using the Licensed Product, Licensee assumes complete responsibilityfor the selection, Use, efficiency, and suitability of the Licensed Product and for the suitability and performance of any product of Licensor selected and used by Licensee in reliance on the Licensed Product. Licensor shall have no liability to Licensee or third parties for a failure of the Licensed Product as a design tool or otherwise or for any failure of any product of Licensor to perform or suffice for any purpose. LiteSteel Beam is a trademark, and LSB is a registered trademark of LiteSteel Technologies. Project Data Project Name = Day Ave, Northampton, MA Project Number = Project Location = Description = Date = 01/27/2012 Designer = Program Settings Application version = LSB Selector Software 2.0 Design Method = ASD Units = US (Imperial) Program Mode = Manually Picked Web Stiffener = Yes - Insure the web Stiffener are Installed Allowable Live Deflection = 360 Allowable Total Deflection = 360 Beam Data LSB Beam Size = 800LSB250 -98 Number of Spans = 1 Span 1 = 10.5 ft Span 1 Unbraced Length = 0 ft Section Properties Beam Depth(d) = 7.9 in. Beam Vtfidth(b) = 2.36 in. Flange Depth(df) = 0.79 in Beam Web Thickness(t) = 0.098 in. Ro = 0.148 in. Riw = 0.118 in. Area = 1.75 in . Weight/ft = 5.96 lb Ix = 16.4in4 Sx = 4.16 in. Rx =3.06 in. ly = 1.2in4 Syl = 1.54 in. Syr = 0.76 in. R = 0.83 in. m =0.93 in. GJf = 1865kin? = 0.332 in. CW = 11.4in6 Loading Data Points Loads : 31' -1 I/2' - DN COV.PORCH NEW DOOR 3 1 1 H . t i-. 0%{Stlllg iI_ .. �, cNm ney 1 h if7 F 10'4" ' I2 P 13'-8' g I II • 0 \�_ o te LIVING ROOM KITCHEN u2 7 r 7-6 { N . ! TH 9 B I AT ( , f9 L. �' `.,". 3 .�1 { " —� � © C: DOS R �. i I __� . J . LAN INGAND •TEPS 10MEOL :'17F:11CTOR:TOVEF J s ALL DIMEN 3 RUCTIRAL DETAIL :_.. BUILDING C , JD GRADE T , i. O REOUIR`EMI � -8 13'' - : - a ? o tt 11 �lo �/ : in CONTRACTOR SHALL VERIFY ALL 11 N OOM c 0 I KITCHEN • Lo CONDITIONS AND DIMENSIONS AT THE 10 JOB SITE AND NOTIFY THE ARCHITECT OF } ti ANY DIMENSIONAL ERRORS, OMISSIONS T OR DISCREPANCIES BEFORE BEGINNING L."5 ' � T 1 : °' OR FABRICATING ANY WORK. 't 27.6' I { EXISTING FOOT PRINT NO CHANGES N TI N_ ALL INTERIOR WALLS TO REMAIN AS IS ` F LIVING ROOM f u 1v NEW WALLS AND DOORS ADDED TO PROVIDED FOR NEW ACCSESORY ARPT. 1 1 L , LA., o., a COVERED PORCH 1 W Lo tO i II DN .": SUN PORCH m FLOOR PLAN 13' - 7' 13' - 8' I SCALE 1/4" = 1'0" I . — - %` - 1 0., AMY FLEIG 14'-0 1/2' 1¢ 7" '"`• 50 DAY AVE NORTHAMPTON MA 31' -1 1/2' PLANS BY LAURA'S ARCH DRAFTING AND DESIGN LIVING AREA -- 1849 sq It City of Northampton / " Massachusetts{ DEPARTMENT OF BUILDING INSPECTIONS � s i a,�. 212 Main Street • Municipal Building Northampton, MA 01060 Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 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 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 • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street -: Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name (Business / Organization /Individual): .S 00Z-Ck Address: (j 51)()-}-ki Mow/ lvl S+ City /State /Zip: T:4011 c.q 044. Qtt) (oc Phone #: 4 { 13 - 1t/ - 313 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub contractors 6. [11 New construction 2.I am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition for me in an capacity. employees and have workers' working Y p ty. 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. n We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑ 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 employees. [No workers' 13.0 Other 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: 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 certify under the pains and penalties of perjuly that the information provided above is true and correct. Si • a _._ • . Date: 1 -31 •'t a Phone #: 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 #: SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ` ❑ Name of License Holder : r t. 3 �Q1.i�C7t 0 License Number Adc ress Expiration Date 0113) q ^ 3y31 Si ture Telep one 9. RegtStered°l'1onle,Impr.OVement COntractor.A Y ' ��...�mZgf.. 4 , tite M >' Z:57j Not Applicable ❑ b‘eor-4 3 S 6 Lro. (o/37 b3 Company Na1ne Registration Number (off- ` J 4 Mat ct • 1 10r t p 1/0.a. (0 1 13 Address Expiration Date Telephone ( -//, �l� - , SECTION 1O-WORKERS' coinFiENsATioN 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 ❑ 1 - omwnerE-xeinption 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 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 • W SECTION 5= DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) I I Roofing 1 1 Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [I:3] Decks [Q Siding [El] Other Brief Description of Prpp•sed Work: •' _+ . s . f / . .1 .-WA 0 •• _ v644.11 6 )t i ^ a S C.&F Alteration of existing bedroo Yes x No Adding new bedroom Yes k No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa (L.New.house }and or add t on to exlstin'q-housi , acomplete.the. nq: 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 _ OWNERAUTHORI _, TO BE COMPLETED WHEN OWNERS AGENT; OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, t 7- fr ./-e/ , as Owner of the subject property hereby authorize r ^te to act on • • alf, in a ter a ti e to w r authorized by this building permit application. 704t (/.2_ '.nature of 0 er Da 1, AAR tvr J ' ci . , as Owne uthori0 zed Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best o m 4cnowledge and belief. Signed under the pains and penalties of perjury. OrQ kw .1 5C' 1 ,.72-0L. Print Name 1 late 3(1). ture of Owner /Agent Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information ....,.f s , Existing Proposed Required by' Zoning +" This column to be filled in by Building Department i Lot Size 1 ; i j Frontage Setbacks Front 7 Side L: R: i L :, l R: i ' I Rear 4 Building Height { i 3 I i I , Bldg. Square Footage 1 i i 1% 1 I E Open Space Footage ��{ (Lot area minus bldg & paved i J _! I parking) # of Parking Spaces 1 L - - ` Fill: 4 _.____ � € 0 (volume & Location) I i A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO D ONT KNOW ®, YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW ti. YES 0 IF YES: enter Book Page I and /or Document # B. Does the site contain a brook, body of water or wetlands? NO It! DON'T KNOW 0 YES t IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained 0 , Date Issued: i i C. Do any signs exist on the property? YES 0 NO . IF YES, describe size, type and location: 1 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 I 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 i IF YES, then a Northampton Storm Water Management Permit from the DPW is required. � figA De ®a etnt use o,n1 § ° � . ,,......- �ECE�vEp City of Northampton Status ° tae , I , ', r ,1 > Building Department Ctt •�Uutiatiye ra�r 7.-ern-ii,," At 212 Main Street t,t t l Se p I eA a . ±' °1% Room 100 VVeter = e Auallabt � � Northampton, MA 01060 Twvo e lof a a l , t? an : �pT.OF ..„111,11,1G 'Ns . ne 13- 587 -1240 Fax 413 - 587 -127 ® ` 1 s 09� NO RTHAM PTON, NW *` ` �" "" 10V -j�' ^ r . 1 " _ r y vthe Specify ' k _ x s . APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION ,- SITE INFORMATION Thts secti to be completed by office 1.1 Property Address: f �"` 1 `S X L i.. ' .'2 5 ' ^ 1 ! } F - A T . ' £ . � Rl CLAN -1. ap 4 " Lo ' 4 a i Unit Zon Overlay D E '' +, ^ . c S 1 7 a a r� _, h r xt . `Elm st Distric " - ° " '' "CB District SECTION 2 PROPE OWNERSHIP /AUTHORIZED AGENT 2.1 Ownerr of Record: r A VA..y C • {- 1e l ' • � 0 Da c-) l"k�1 o Name (Print) • Current Mailing A dress Telephone Sign l I " • 2.2 Authorized Agent: ,ri " ( 5et, t a kc rig S4- , 7=C ��' t� Na e (Print) Current Mailing Address: Ott 3"—C2't/4 — 3 L(3 t Si ture 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 � coo� co 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) Check Number This Section For Official Use Only!! - Building Permit Number issued: Signature Building Commissioner /Inspector of Buildings "' Cate , File # BP- 2012 -0736 APPLICANT /CONTACT PERSON HENRY J SOUZA ADDRESS /PHONE 62 SOUTH MAIN ST FLORENCE (413) 949 -3431 PROPERTY LOCATION 50 DAY AVE MAP 25A PARCEL 162 001 ZONE URB000)/ 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: OPEN DINING RM CEILING & INSTALL SPIRAL STAIR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 087984 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 2 2. 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. _ Q 50 DAY AVE BP- 2012 -0736 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25A -162 CITY OF NORTHAMPTON Lot: -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- 2012 -0736 Project # JS- 2012- 001290 Est. Cost: $6000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HENRY J SOUZA 087984 Lot Size(sq. ft.): 6577.56 Owner: FLEIG AMY Zoning: URB(100)/ Applicant: HENRY J SOUZA AT: 50 DAY AVE Applicant Address: Phone: Insurance: 62 SOUTH MAIN ST (413) 949 -3431 FLORENCEMA01062 ISSUED ON:2/23/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:OPEN DINING RM CEILING & INSTALL SPIRAL STAIR 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 2/23/2012 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner