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23C-012 (2) d(3e --/ c3.1. ■ Forte MEMBER REPORT Level, Floor: Drop Beam g---- PASSED Software 3 piece(s) 1 3/4" x 9 1/2" 1.9E Microllam® LVL - /` r / j Overall Length 12 1" RE El ED 0 0 %JUN ? g ail 1 T 6' DEPT. of Bo ...fN(; MSPE 1 IIiAMPTO MA Ott U All Dimensions Are Horizontal; Drawing is Conceptual Design Results Actual 0 Location Allowed Result LDF Load Combination(Load Pattern) System : Floor Member Reaction (Ibs) 3113 @ 2" 7809 Passed (40 %) -- 1.0 D + 1.0 S (All Spans) Member Type : Drop Beam Shear (Ibs) 2555 @ 1' 1" 10898 Passed (23 %) 1.15 1.0 D + 1.0 S (All Spans) Building Use : Residential Moment (Ft -Ibs) 8893 @ 6' 1/2" 20312 Passed (44 %) 1.15 1.0 D + 1.0 S (All Spans) Building Code : IBC Live Load Defl. (in) 0.129 @ 6' 1/2" 0.392 Passed (1/999 +) -- 1.0 D + 1.0 5 (All Spans) Design Methodology : ASD Total Load Defl. (in) 0.332 @ 6' 1/2" 0.587 Passed (L/425) -- 1.0 D + 1.0 5 (All Spans) • Deflection criteria: LL (L/360) and TL (L/240). • Bracing (Lu): All compression edges (top and bottom) must be braced at 12' 1" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing Support Reactions (Ibs) Supports Total Available Required Dead floor Live Roof Live Snow Wind Seismic Accessories 1 - Stud wall - Spruce Pine Fir 3.50" 3.50" 1.50" 1905 121 0 1208 0 0 Blocking 2 - Stud wall - Spruce Pine Fir 3.50" 3.50" 1.50" 1905 121 0 1208 0 0 Blocking . Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Tributary Dead Floor Live , Roof Live Snow Wind Seismic Loads Location Width (0.90) (1.00) (non -snow: 1.26) (1.15) (1.60) ` (1.60) Comments 1 - Uniform(PSF) 0 to 12' 1" 5' 18.7 0.0 0.0 40.0 0.0 0.0 ROOF LOAD 2 - Uniform(PLF) 0 to 12' 1" N/A 200.0 0.0 0.0 0.0 0.0 0.0 DEAD LOAD FROM WALL ABOVE 3 - Uniform(PSF) 0 to 12' 1" 8" 12.0 30.0 0.0 0.0 0.0 0.0 8" TRIB FROM UNIFORM JOISTS iLEVEL® Notes 0 SUSTAINABLE FORESTRY INITIATIVE iLevel® warrants that the sizing of its products will be in accordance with iLevel® product design criteria and published design values. iLevel® expressly disclaims any other warranties related to the software. Refer to current iLevel® literature for installation details. (www.iLevel.com) Accessories (Rim Board, Blocking Panels and Squash Blocks) are not designed by this software. Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction. The designer of record, builder or framer is responsible to assure that this calculation is compatible with the overall project. iLevel® products manufactured at Weyerhaeuser facilities are third -party certified to sustainable forestry standards. The product application, input design loads, dimensions and support information have been provided by KB /MR /JB ■ I I I i-v' -.) i ) lo0,/,';? ,,,;..,..,,,,,),,, . ,, -, 3 1 i 0 ., , . „... 9 y ] + Fj �..w. - /`` - s .� - 1 x `i 1 1 ) ,v 1 - . ,, -4- , ,f,/ , ..,p, / . -A. ' ' * ' 4 , ,,, , , _ . ,,,,,, , 1 , , - - - , , . i ,_.,,,,, /..- - -- i i 1 I I ab r)-6 °2 n , y' c0 .--6 ,,° - %6 4d 4 ° -b N , 4 ri? `1 0 N -6 )r e 's 2 , 1 1 a,_,.., ,, ,,r, , z5 , . I . , r V-- • t 0 A 1 \\ 1( Vt i 1 , i . ) fil r ---- 4 . • /< 1/4..... A 1 ■CI i 1 ,L) i 1 n) 1 d• '''' I 1—'• CS.) . i L . ...................r.***Fl -.........-' -' ?) (7 I d' 1 1 -H 74 I 1 1 1 .3.7 0 °/,:. FileNo 072403-2 398 Page #9 ;: .•'-''. SUBJECT PHOTOGRAPH ADDENDUM Borrower/Client: Michael E. Ale.o_ Address. 589-593 Riverside Drive City: Nathampton COJ rty. Hampshire State MA Zip Code. 01060 Lender/Client: Florence Savings Bank . ;:..„--. Front View • . .. e ,*- - • '- --! ,, . ‘*" i• ''. ' ' '' ' ,-...... jr ''' .... :_e ..- ; 1.1t - , ..-- - _. •, .... - . - — . , ' ,-.. ,.••• ..: . 4,„.1?': •: . ,' .,-.. ', 7 *';',' .:, , : .../. 4. ... t 1 f) /.■ 2 I tIC 1 fC ) C Y flop, cl ... . ,..;,A.....,,,,•..-:,.,, ,........„ ; . .1 r' •-, ' . 5 8 g Z (-)° .. ,.,, ,.... . . ...,.. _ ... - IMO ' . ' t. t I 44444 ■ k ' ,' 1.411Milf, II ' air - , e7. : - .1,m, ,_ . `• L., - ':..,... ; ,,e.t.,,,, ,, 3t-.., '.. -.. „,, _,,t ,,,,,,, ft ' ' ' .' • ' . - ' Rear View )c .. . .-. 41 - . 1) .., ..,: ....., ...,, 2...- ......- .... .,...., - ...., . • a " ---- :,- t (Ai C\ t:t......ti i■tc..' .,.. . , N , .. fRee: €1 ' 'QeOra.... ,..• ' A; ir I PE X rP ■k ' .. "'--.....` 1111., ,. . -.. - .. ...... - , FM" j J ,,. i j)-7, , - • .. .. ------„, - . - „-4.. ....., 10, —!! f l sim ..... . •.,. A i I i INN - A (1\\ . mu . . . 0 li .. +1480 1 i '.....,..7 _ ,-MIV ,.. Fee ; c ,k-k•'.-- .... . ..r.t.„\:, , - ' \ ' " . .-timiftdt 1 r ...77 i - j - x 5 --?- ; k I (..70,1 ' • i f , ,-- . . A i -.: - ,_ Street View ftr A WIP if.- - -__1 • (1€ 1- ... :. : ' !.. ,. . . . • . ( r ' . . - ...... 44- b i e.) NV , 1111110 . ,..., .. • - .., . - i,- . : • ..V1 ... - • ' ' ' . _ . ,. .. - - This lour) was reproduced by Untied Systems Software Company (8001 969-6727 ' eve Forte MEMBER REPORT Level, Kitchen Girder PASSED software 2 piece(s) 1 3/4" x 11 7/8" 1.9E Microllam® LVL Overall Length: 12' 1" + + fl - 0 1 41 6 ..I, © 13 All Dimensions Are Horizontal; Drawing is Conceptual Des ge Results Actual Location Allowed .. Result LOF Load Combinabon(i oad Pattern) System : Floor Member Reaction (Ibs) 4400 @ 2" 5206 Passed (85 %) -- 1.0 D + 0.75 L + 0.75 S (All Spans) Member Type : Drop Beam Shear (Ibs) 3467 @ 1' 3 3/8" 9081 Passed (38 %) 1.15 1.0 D + 0.75 L + 0.75 S (All Spans) Building Use : Residential Moment (Ft -Ibs) 12568 @ 6' 1/2" 20525 Passed (61 %) 1.15 1.0 D + 0.75 L + 0.75 S (All Spans) Building Code : IBC Live Load Defl. (in) 0.158 @ 6' 1/2" 0.392 Passed (L/895) -- 1.0 D + 0.75 L + 0.75 S (All Spans) Design Methodology : ASD Total Load Defl. (in) 0.373 @ 6' 1/2" 0.587 Passed (L/378) -- 1.0 D + 0.75 L + 0.75 5 (All Spans) • Deflection criteria: LL (L/360) and TL (L/240). • Bracing (Lu): All compression edges (top and bottom) must be braced at 11' 4 5/8" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing pportRea�ns ) SUPP0i12 Tai Available Required Dead - . Floor Live Roof Live Snow , Mimi', Seismic Amt 1 - Stud wall - Spruce Pine Fir 3.50" 3.50" 2.96" 2542 1269 0 1208 0 0 Blocking 2 - Stud wall - Spruce Pine Fir 3.50" r 3.50" i 2.96" i 2542 1269 0 1208 0 0 Blocking i . Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Tributary Dead ; Floor Live Roof Live Snow Wind Seismic lids Location . ` , . Width (DSO) (1.00) toen.snorr: 1.25) (1.15) (1.60)' (1.80) cam , 1 - Unifonn(PSF) 0 to 12' 1" 5' 18.7 0.0 0.0 40.0 0.0 0.0 Roof load 2 - Uniform(PLF) 0 to 12' 1" N/A 200.0 0.0 0.0 0.0 0.0 0.0 dead load from wall above ...- 3 - Uniform(PSF) 0 to 12' 1" 5' 3" 12.0 30.0 0.0 0.0 0.0 0.0 5'3 trib from uniform joists -_. 4 4 - Uniform(PSF) 0 to 12' 1" 5' 3" 10.0 10.0 0.0 0.0 0.0 0.0 / � Ceiling joist load from porch --- I EV I Note S (I ) SUSTAINABLE FORESTRY INITIATIVE iLevel® warrants that the sizing of its products will be in accordance with iLevel® product design criteria and published design values. iLevel® expressly �� disclaims any other warranties related to the software. Refer to current iLevel® literature for installation details. (www.iLevel.com) Accessories (Rim Board, Blocking Panels and Squash Blocks) are not designed by this software. Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction. The designer of record, builder or framer is responsible to assure that this calculation is compatible with the overall project. iLevel® products manufactured at Weyerhaeuser facilities are third -party certified to sustainable forestry standards. The product application, input design loads, dimensions and support information have been provided by Meritt Richmond • Forte Software Operator Job Notes 7/7/2011 1:25:43 PM _ .........................................._........................_ ........_...................... __......................___.................................._............................_..._.........................._.........._.............._. .............................., Joe Level Forte v2.2, Design Engine: V5.3. .1 r, 2, l Sin Tlilargean P•.>€wr f<ichfrond Cowls Guiding Supply Fbversido rok;. Riverside.4te 1413) 649-CI ;C` I. Nortnompion, Ma loo@ owls Corn Page 1 of I F.. -2:3: -y z.8 SKETCH File No. 072403-2.398 c ^cae7C,!ent Michael E. Aleo Address 589 -593 Riverside Drive Cay Northampton County Hampshire State MA Zip Coe 01060 Lende /Client Florence Savings Banj • . i I 1 Apartment 2 17.0' 6.0' 12.0' Kitchen o Bedroom o cc ' ivingR o • . co Bedroom Satn''T 17.0' 4.0' 4.0' r P f Kitchen Er sus NM IMP MI Bedroom ME 0 0 0 v N N N N Living B Kitchen Room Bedroom 1St Floor 20.0' L;. re Room Apartment 3 2nd Floor 18.0' Luartment 1 Comments A +� I I AREA CALCULATIONS SJS".14kRY LIVING AREA BREAKDOWN Code D•scripbon Size Totals Breakdown Subtotals GLA1 Apartment I 616.03 ' Apartment 1 Apartment 2 366.00 1 10.0 x 18.0 180.00 Apartment 3 42.30 1028.00 10.0 x 20.0 200.00 GLA2 Apartment 3 67 672.00 14.0 x 17.0 238.00 Apartment 2 16.0 x 23.0 368.00 Apartment 3 3.0 x 14.0 42.00 12.0 x 16.0 0:1,00 20.0 x 24.0 4110,00 TOTAL LIVABLE (rounded) 1700 7 Areas Total (rounded) 1700 Designed by UrIed Systems Software Company (B00) 969 -8727 Cabinetmaker - Carpenter 14 Rattlesnake Gutter Rd. Leverett, Massachusetts 01054 rAt d (413) 548 -9288 Meritt Richmond m edt P (6n - -{; 9 eia Dr ficor 1 6' irt onckned ovir5 kePPP - - - _ new ce. be?sm tnyouect 1�►n 0 1 5' 2 v f ! cor" 12 1( Bedroom 1 6 Os 1 .13 X11 zod 47 4 /0 comb I' ' gad bear ;q weNli Zoo Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." • - An employer is defined as "an indivirhiai, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the. dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." .4 Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirement:sof this chapter have_ been_presentedlo_the contracting authority." - -- Applicants • Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub- contiactor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited LiaailityPartnerships (LLP) with no employees other than the members or•partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of inrinstrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' • compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self- insurance license number on the appropriate line: City or Town Officials • Please be sure that the affidavit is complete and printed legibly. The Departement has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. • Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write ."all locations in (city}or town)." A copy pf the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is . obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to brim leaves etc.) said person is NOT required to complete this affidavit . . , _ . • The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address, telephone.and fax number: :The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street • Boston, MA 02111 Tel. # 617- -727 -4900 ext 406 or I -a77-MASSAFE Revised 11 -22 -06 Fax # 617- 727 -7749 - www.mass.gov /dia The Commonwealth of Massachusetts Department of Industrial Accidents • l Office of Investigations E . 600 Washington Street 7.7=111g—= Boston, Mel 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name Organ ation/lndividual): r r /F'%r7 jQ) (')" v Address: d P ' t (e t lC City /State/Zip: C.e).)7',t j 11 1 0 10 5 Phone. #: ' l 3 it A Are you an employer? Check the appropriate box:... Type of project (required):, 1.0 I am a employer with 4.. 0 I am a general contractor and I 6 Ej New co nstru c tion employees (full - and/or part - trig):* -_ — have hired the sub=contractors— — 2_ [ I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling ship pzIri have no employees These sub - contractors have . g. Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance cony. insurance. re ed: 5. 0 We are a corporation and its 10 Electrical repairs or additions officers have :exercised their . 1 Plumbing repairs [] I am a homeowner doing all work ffi hid hi � g eai s or additions P myself [No workers' comp. right of exemption per MGL 12.0 goof 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 OfEce of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains.and penakies of perjury that the information provided above is true and correct ;tore: y y_� Date. J11C t a91/ . Phone #: < 7 3 5* - 9 t e - • 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 a Contact Person: Phone #: I� SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : M 1 i-4' C (� C ro , j i G S Z565? License Number l Ieiv):e� 60+6- ?sa . L. - 11, 4/6/e 20 2 Address / Expiratio ate 13- 5-g--9 2 v g ' nature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ 1 Yf I enN,rrc,nL1 eZ 155 8 Company Name Registration Number 5/00/20f 2- A , }�,.� / Expiration/Date ' V � 57o 6 d 7 ?c' � LrI C. ij Telephone 599 Bg 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 ":1 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. 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 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) h nt New House ❑ Addition ❑ Replaceme endows Alteration(s) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition New Signs [0] Decks [C] Siding [D] Other [O] Brief Description of Proposed I { a Work: ' )) IC. �°/) rt rem Lkii c�r� , boor �o fr i� cc u 1 I in �14t 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:, 1i - . 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 j , P , as Owner of the subject property hereby authorize M ['�? i TT ] [ CC to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, O'er ! I ch r , ( , 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. M.-r[ k;Charld Print Name Si ture of Owner /Agent Dale 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 a Building Department Lot Size a , 35 A Frontage F — I Setbacks Front 21 Side L: 1 t R: 30 L: R: Rear Building Height Z 2� Bldg. Square Footage 4 700 Open Space Footage ��+, (Lot area minus bldg & paved 3 (3 00 parking) # of Parking Spaces Fill: ti -A . (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry 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 I►11 DON'T KNOW O YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained o , Date Issued: C. Do any signs exist on the property? YES ® NO .0 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: 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 O NO G IF YES, then a Northampton Storm Water Management Permit from the DPW is required. r ' ' Department use only RE - City of Northampton Status of Permit : uilding Department Curb Cut/Driveway Permit JUL + a 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability �� .._ - • N • hampton, MA 01060 Two Sets of Structural Plans °. - ''•. - • -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 sgq „ 3 93 Map Lot Unit P I - y d e J) f Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: KATYj€YLr E - (c &L-4 a �, 5` I� AA Ebb r,7A, -( A Name (Print) Current Mailing Address: (fat 1 — — 110'7 —) Telephone Signature 2.2 Authorized Agent: Name (Print) Current Mailing Address: 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 lq, 008 . 2. Electrical n 5o g • (b) Estimated Total Cost of 7 Construction from (6) 3. Plumbing 4 , ` Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection rPC 1 - I fl el ec 6. Total = (1 + 2 + 3 + 4 + 5) Check Number to (/-L:, t This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0026 Set APPLICANT /CONTACT PERSON MERITT RICHMOND 5 � �- s ADDRESS/PHONE 14 RATTLESNAKE GUTTER RD LEVERETT (413) 548 -9288 �� ,‘ PROPERTY LOCATION 589 RIVERSIDE DR G G `` MAP 23C PARCEL 012 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: ��� PERMIT APPLICATION CHECKLIST S ENCLOSED REQUIRED DATE 21 \ ) ZONING FORM FILLED OUT Fee Paid \ / Building Permit Filled out Fee Paid � J � �� i ‘.1) d -� `` ` Typeof Construction:_CONVERT 3 FAMILY TO 2, RENO KITCHEN /BATH,REPLACE BEAM '�` New Construction Non Structural interior renovations Addition to Existing Accessory Structure .- t`'{ + Building Plans Included: C Owner/ Statement or License 25639 3 sets of Plans / Plot Plan VA THE FALLOWING 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 - 7// 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. Grade level windows allowed as second means of egress for 1st floor rear one room apartment 07/14/11 Louis Hasbrouck 589 RIVERSIDE DR BP- 2012 -0026 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23C - 012 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 -0026 Project # JS- 2012- 000048 Est. Cost: $40975.00 Fee: $245.80 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MERITT RICHMOND 25639 Lot Size(sq. ft.): 15289.56 Owner: ALEO MICHAEL Zoning: URB(100)/ Applicant: MERITT RICHMOND AT: 589 RIVERSIDE DR Applicant Address: Phone: Insurance: 14 RATTLESNAKE GUTTER RD (413) 548 -9288 LEVERETTMA01054 ISSUED ON: :7/14/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:CONVERT 3 FAMILY TO 2, RENO KITCHEN /BATH,REPLACE BEAM 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 7/14/2011 0:00:00 $245.80 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner