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24A-214 Bob Bak 6- 8 -09 . tfii'eY13ea"Ati 35 adare pl. 1:59pm l of 1 KeyBeam® 4.504e lamBeamEngine 4.506u ■ Materials Database 1024 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing: Continuous Top ' Standard Load: Moisture Condition: Dry Building Code: SBC Dead Load: t 10 PLF Deflection Criteria: U360 live, U240 total Live Load: 40 PLF Deck Connection: Nailed Member Weight: 7.1 PLF Filename: KYB2 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Replacement Uniform (PSF) 0' 0.00" 7' 6.00" 12' 6.00" 10 30 Live , Additional Uniform (PSF) 0' 0.00" 7' 6.00" 12' 6.00" 10 20 Live t' ................. :{.; 11 :i t. I .. : : I• ......... ......... ;.. :::: 1::.Ca:. :. ......... . . i, ;;; .,.. :: : :.:1.... ... .. ::.... . Y :: ��:; �i: y:;: vij;: i::: i:!: is�: �: t �: ii$ jiijiiiiiiii: :;:j }':'f::T +j .. .. .... .................. ............................... ..... .. . . ................... ' ft / / 7 6 0 / 0 0 / 7 6 0 Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 3.500" 1.500" 3115# -- 2 7' 0.750" Wall 3.500" 1.500" 3115# -- Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Live 1 908# 2207# 2 908# 2207# Design spans 7' 0.750' Product: 1 3/4x7 1/4 Versa -Lam 2.0-3100 SP 2 ply Component Member Design has Passed Design Checks.** Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 5500.'# 8377.'# 65% 3.53' Total load D +L Shear 2582.# 4821.# 53% 0.01' Total load D +L Max. Reaction 3115.# 9188.# 33% 0' Total load D +L TL Deflection 0.2221" 0.3531" L/381 3.53' Total load D +L LL Deflection 0.1574" 0.2354" L1538 3.53' Total load L Control: LL Deflection DOLs: Live = 100% Snow= 115% Roof = 125% Wind= 133% Manufacturer's installation guide MUST be consulted for multi -ply connection details and alternatives All product names are trademarks of their respective owners . , ikiii:::,' ''y f •': �y;;g,* ::.. Copyright (C)1989-2005 by Keymark Enterprises, LLC. ALL RIGHTS RESERVED. "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. 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. —.11111■•■■•ii! gym.. . Bob Bak 6- 8 -09 ik: `' `Y g earn 35 adare pl. . 55pn Y 1 of 1 KeyBeam® 4.504e ` 1m 4.506u , Materials Database 1024 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing: Continuous Top Standard Load: Moisture Condition: Dry Building Code: SBC Dead Load: 10 PLF Deflection Criteria: U360 live, L/240 total Live Load: 40 PLF Deck Connection: Nailed Member Weight: 9.4 PLF Filename: KYB1 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Replacement Uniform (PSF) 0' 0.00" 9' 6.00" 14' 0.00" 10 50 Live Additional Uniform (PLF) 0' 0.00" 9' 6.00" 10 0 Live / / 9 6 0 9 6 0 1 Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 3.500" 1.500" 3894# -- 2 9' 0.750" Wall 3.500" 1.500" 3894# -- Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Live 1 722# 3172# 2 722# 3172# Design spans 9' 0.750" Product: , 1 314x9 1/2 Versa -Lam 2.0 -3100 SP 2 ply Component Member Design has Passed Design Checks.** Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 8823.'# 13958.'# 63% 4.53' Total load D +L Shear 3214.# 6318.# 50% 8.61' Total load D +L Max. Reaction 3894.# 9188.# 42% 0' Total load D +L TL Deflection 0.2608" 0.4531" L/417 4.53' Total load D +L LL Deflection 0.2124" 0.3021" L/511 4.53' Total load L Control: LL Deflection DOLs: Live =100% Snow= 115% Roof = 125% Wind= 133% Manufacturer's installation guide MUST be consulted for multi -ply connection details and alternatives All product names are trademarks of their respective owners L `''`'fi"""''''`''' "`'' "' fi +"''�"' Copyright C 1989 -2005 b Ke ses, LLC. ALL RIGHTS RESERVED. :" O by Key mark Ente ri rP L 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. The design must be reviewed by a qualified designer or de 9 ofessional as required for approval. This design assumes product installation according to the manufacturer's specifications. P ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO - FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) ' ;, 5 Applicant Name: Site be, .} 1a y._-- Site Address: /3 5 - 14G/ ?z___ \, print Town: v0 l l ik r)1 >IL )4,k to Applicant Phone: - g6 - 5 ' ) , 0 ... Date of Application: Applicant Signature C. _' A / pp NEW CONSTRUCTION: ` (choose ONE of the .Mowing two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE - AND TWO - FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement Fenestration exposed Wall Floor Perimeter Wall AFUE HSPF SEER U- factor floors R -Value R -Value R -Value R -Value R -Value and Depth National Appliance Energy R -10, Conservation Act (NAECA) of 35 R -38 R -19 R -19 R -10 4 ft 1987 as amended, minimums or greater as applicable Note: This f o r m is not required if you choose e i t h e r of t h e T w o v e r s i o n s o T R E S c h r e c k as Iisted below_ ❑ Option 2: q REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck —Web which can be accessed at http://www.enerzvcodes.g.ovirescheck/ ADDITIONS OR ALTERATIONS TO EXISTING BUILDINGS OVER 5 YEARS OLD* ' a *Buildings under 5 years old must use option 41 or #2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b - a) 5.q SF J�� 100 x /1(2‘2, ÷- _ , = — ,5-% of glazing (b) Glazing area equals 537 SF a If glazing; is < 40% use the chart below_ - If glazing`. is ` "> 40 % proceed to. "SUNROOM''": section . ,. 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW -RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM ❑ Fenestration Ceilin and Wall Floor Basement Wall Slab Perimeter U- factor Exposed floors R -Value R -value R -Value R -Value R -Value and Depth , .39 , R -37 a R -13 R -19 R -I0 R -10, 4 feet a R -30 ceiling insulation may be used in place of R -37 if the insulation achieves the full R -value over the entire ceiling area (i.e. not com•ressed over exterior walls, and including any access openings). SUNROOM — An addition or alteration to an existing building/dwelling unit where the total ❑ glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) 50.E 45 3 35 ..,. '' 75 91 24A -212 y ' I 25 170.73 90 94.5 181 80 '5 \ x9 6 2 -210 18 � �� 24A -213 24A -211 � 80 180 J 80 f 78.30 70 / \ �� 74.90 F 24A -214 :� X4.90 70.00 _ �� r l 79.39 70 190 / 70 ' 24A -209 24A -215 , 70 70 .-.84 190 70 l � r 4I s +'* . ! f , , x 24, -,. ..._ , 7,---7-.-'.,-,.,T,- -....' - ,..,,,,i, It �0' � �.- ,, �: . 9b / �� : 70 ..-..,„. ,', ,-..-7.,--..,,i,/- , .,..--. �� - 1.. 24D 01 92- - - - 43` 06 07 08 )2.=.I 11 13 1 m ap sh ,,,,, )D 11C 12C C iB 16A 16B 17A 17B 18 ....... 16C16D17C17D18C118D ,..1,., � 1 71(.' / Mgt. ( ZZt95) tits. t 1'i fir, 3? 1 it 1 _ .. -_._ _ _ _.. e_ I I i_wT- 1Z r— -1 ) $ . T L ii 2h ar W. F. 1 vi f 7[? 11.,i • 1 hereby report that the preemies shown on this plan is rot located within a Tluod Nsrard Area as shown on Department of N.U.D. Fedora' ds,N,�ltsattoa Maps. Community Number 250167 00026 tdenttilcati to � _ ___ _..�..._.._ byt ..74 TO TOE 'Loma! SAVINGS RANK OWNER ' JOIN C. QUA JR . L P.1.I1* S. QpA RWO THE FIRST AsRRICAN MLR INS. Co. -ONLY LOCATION, a to the best of my knowledge. Inform- 33 ADARR PLACE NOiTNAMPTON lion and belief. I hereby report that t ' have examined the premises and that this ALFA HUPATLEVR. • ASSOCIATES, INC inspection plat show the Improvement or S1.$VETONS • £NO1NCERS • LANDSCAPE MCNITECT$ improvements as located on the premises de- SO $NOUSTNIAL ORIVE CAST P.O. ROK SM scribed. that the improvement or *prove- NORTINMPTON,MAISACNUS[T?S ONO wants are entirely within lot lines. and that there are no encroachments two the SCALE premises described by the improvement or ,. t I improvement% of any adjoining premises. 05\ - , ) except as indicated. 1 further report that QATE, there are no easements of record affecting the tract shorn hereon. a pt as noted. 1 ,. • 1 1 ` 1 ,i`/ JOB NQ. t,$c 1 c:' e 4 06/04/09 10:22:13 AM RESIDENTIAL PROPERTY RECORD CARD CITY OF NORTHAMPTON, MASSACHUSETTS EFFECTIVE DATE OF VALUE: JANUARY 1, 1998 PARCEL ID: 24A- 214 -001 35 ADARE PL PLOT: LIVING UNITS: 1 CLASS: R - 101 CARD #: 1 OF 1 CURRENT OWNER /ADDRESS NEIGHBORHOOD ID: 9.00 FINAL VALUE FLAG: COST BAK ROBERT E & DEBRA J LAND DATA - ASSESSMENT INFORMATION - 35 ADARE PL TYPE SIZE INFLUENCE FACTORS LAND VALUE PRIME SITE 13500 174,600 PRIOR COST CURRENT NORTHAMPTON MA 01060 LAND 174,600 174,600 174,600 BLDG 173,500 169,400 169,400 TOTAL 348,100 344,000 344,000 DEED BOOK: 3415 DEED PAGE: 253 SALES INFORMATION DEED DATE: TOTAL ACREAGE: 0.310 TOTAL LAND VALUE: 174,600 LAST UPDATE /COST: 20080707 DATE TYPE PRICE VALIDITY 19890701 LAND + BLD 205,000 0 LAST UPDATE /COST: 20080707 ADDITION DATA X DATE: Lower Level First Floor Second Floor Third Floor Area DATA COLLECTION INFORMATION A EFP 192 ENTRANCE CODE: UNOCCUPIED B OFP 40 INFORMATION SOURCE: C FrBay 16 DATA COLLECTOR: MC D FrBay 16 I DATE: 19991015 E F DWELLING INFORMATION G H STYLE: CONVENTIONAL YEAR BUILT: 1928 , ° " ` STORY HEIGHT: 2.00 ATTIC: UNFIN Basement: FULL TOTAL ROOMS: 6 TOTAL BEDROOMS: 3 FULL BATHS: 1 ADDITIONAL DWELLING INFORMATION Half Baths: BASEMENT GARAGE( #CARS) ADDITIONAL FIXTURES: i 5 OFP EXTERIOR WALLS: FRAME BRICK TRIM: X UNFINISHED AREA: STONE TRIM: X 26 GROUND FLOOR AREA: 728 TOTAL LIVING AREA: 1488 REMODELING DATA FINISHED BASEMENT LIVING AREA: X BASEMENT RECREATION AREA: X 328 YEAR REMODELED: MASONARY FIREPLACE STACKS /OPENINGS: 1 / 1 METAL FIREPLACES: KITCHEN REMOD(Y /N) HEAT /CENTRAL A /C: BASIC BATH REMODEL (Y /N) HEATING SYSTEM: STEAM — FUEL TYPE: OIL QUALITY GRADE: C+ PHYSICAL CONDITION AVERAGE COND /DESIRABILITY /UTILITY VG INTERIOR /EXTERIOR SAME Frs 8 2$ A /2Fr /B OUTBUILDINGS & YARD ITEMS PERMIT DATA 2 — TYPE QTY YR SIZE1 SIZE2 GRD COND DATE PURPOSE PRICE RG1 1 1928 1 240 C A NOTES: 21 Fri' 8 12 16 8 8 8 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 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 /13 e C understand the above. (Home er /resident's sig ature requesting exemption) g q g P ) I will call to schedule all require, •uilding inspections necessary for the building permit issued to me. Date 2 jg — d? Address of work location - w • "` ' The Commonwealth of Massachusetts Department of Industrial Accidents ° - , - ,), -- ---.,:r.;, �, Office of Investigations _ Ir- 6 00 Washington Street w - h , ,,, w _ Boston, MA 02111 -., ,., ° www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information Please Print Legibly • Name ( Business /Organization/Individual): Address: City /State /Zip: Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1. Q 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. Q New construction listed on the attached sheet. 7. Q Remodeling 2. [I] I am a sole proprietor or partner- ship and have no employees These sub - contractors have 8. Q Demolition working for me in any capacity. employees and have workers' 9. Q Building addition [No workers' comp. insurance comp. insurance.$ re uired. 5. Q We are a corporation and its 10. Electrical repairs or additions X q ] officers have exercised their 11. Plumbing re airs or additions I am a homeowner doing all work ❑ p myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.0 Other comp. 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 der the pains and enalties I , erj tat the information provided above is true and correct. X Sisnatur- : �'� U - ` �� f Date: '5U .—, 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 : License Number Address Expiration Date Signature Telephone 9: Registered Home Improvement Contractor ;- �;` -= 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 ❑ 11. — Home, 0*r er: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, e and L cal Zoning Laws and State o assachusetts General Laws Annotated. Homeowner Signat • re SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition Replacement Windows Alteration(s) n Roofing n Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C] Siding [0] Other [0] Brief Description of Proposed r 5Z 6 . Q r Ais� ` (kitchen) Work: (�_J � 6��1 7- GtCK �Gj , Alteration of existing bedroom Yes k. 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 Y Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? l "b / d. Proposed Square footage of new construction. 2.,A / /� Dimensions Xie. e. Number of stories? l f. Method of heating? 64f4, 5 AttA)4 ier Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? YES h. Type of construction W[31D(,f Compliance. 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 rrOC i /paC 5 k. Will building conform to the Building and Zo . g regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner /Agent Date , or 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 L._ .__� _ ._ .. ��/Ct�..._...... ......... _ ,. ,,...._ ".,_.,.,... . Frontage __ . _ .. _... _. _. „ _ _ _....... Setbacks Front Side L: „ R: _ L. R :,, .5' ,5 Rear T' 1�'Y Building Height Bldg. Square Footage ?( % Open Space Footage / / / _ p 0 (Lot area minus bldg & paved `l 3 3,5' i °ro5 parking) � r # of Parking Spaces Fill: bAlr (volume &Location) 14 ' ._. __. .. A. Has a Special Permit /Variance /Finding ever been issued for/on the site? NO DONT KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book ?- Page 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 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: E. WiII the construction activity disturb (clearing, grading, exc ion, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. v.. .. , De pa r t mer 4!**,i:' City of Northampton estuarlD'itif:9616!-ItifPF);7"1:.; Y/,!e"11' 11,.':',--::-::;,:';',:':::::;:,,,:i,": \ \puilding Department , $'''.6.'we'''rl-S 0.6.:IViafla.„..,,blitY:::„;;,:: ' Main Street ROOM 100 Wat e r N V O I L A Y. 4 1, 1 3, 1 - 1 11ti! , 'i, , „ ., 7 , ' " ' ' fStrite"kirarflan ... 2,0 NOtranipton, MA 01060 -i ,,--':'-_-,-, phone 413i587-4 Fax 413-587-1 272 Pii Other Spep,if ''- ''"'- - - , APPLICATION' TO C Dit ST ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 3 Address: 4 1 .., 1.1 Property 7./4KE PL.. Map 2 _ 4 4. Lot 7—l3 This section to be completed by office t Unit i ro)q M4' Zone R -- /0 1_ Overlay District • t Im St. District CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record:(3 P ..... T /371., 7 c urrent mailing Address:zi/.3 ,/ .3‘ 4E - z—. Name (Print).„---";), e --, „....„ , Sign ature ,---- . c _>, 7 Teiephone 2.2 Authorized Agent: Name (Print) Current Mailing Address: Telephone elephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)tob 1. Building Official Use Only completed by permit applicant (a) Building Permit Fee 3 .119° 2. Electrical 5— 470 066 7( Cr° Construction from Cnio(s6t of (6) t _ .. (b) E C s o ti n m st a r t u e ct d i o 3. Plumbing / 0 / C 66 Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 3591- f/26 .- 6. Total = (1 + 2 + 3 + 4 + 5) Check Number '1171 This Section For Official Use Only Date Building Permit Number: .__._ Issued: Signature: Building Commissioner/Inspector of Buildings Date File # BP- 2010 -0003 • APPLICANT /CONTACT PERSON BAK ROBERT E & DEBRA J ADDRESS /PHONE 35 ADARE PL NORTHAMPTON (413) 256 -5301 0 PROPERTY LOCATION 35 ADARE PL MAP 24A PARCEL 214 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out o cif Fee Paid 33 / `1 4 Construction: CONSTRUCT 14 X 18 KITCHEN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION PRESENTED: pproved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay • ♦i 2 60 e ' Signature of Building Of cial 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. 35 .4 * -': BP- 2010 -0003 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -0003 Project # JS- 2010- 000004 Est. Cost: $47500.00 Fee: $126.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 13503.60 Owner: BAK ROBERT E & DEBRA J Zoning: URB(100)/ Applicant: BAK ROBERT E & DEBRA J AT: 35 ADARE PL Applicant Address: Phone: Insurance: 35 ADARE PL (413) 256 -5301 () NORTHAMPTON MAO 1060 ISSUED ON: 7/9/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 14 X 18 KITCHEN 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 7/9/2009 0:00:00 $126.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo