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C P - +i /-'.° \,,,, 5ca l e 1 _ 1 io vf • . . 1 eve ' Forte MEMBER REPORT Level, CEILING JOIST PASSED software 1 piece(s) 16" TJI® 230 @ 16" OC Overall Length: 25' 6" 0 0 1 25' 6" I lin El All Dimensions are Horizontal; Drawing Is Conceptual Design Results Actual o Location Allowed Result LDF Load Combination (Load Pattern) System : Floor Member Reaction (lbs) 708 @ 11" 1485 Passed (48%) 1.00 1.0 D + 1.0 L (All Spans) Member Type : Joist Shear (Ibs) 658 @ 1' 2190 Passed (30%) 1.00 1.0 D + 1.0 L (All Spans) Building Use : Residential Moment (Ft-lbs) 3921 @ 12' 9" 5710 Passed (69%) 1.00 1.0 D + 1.0 L (All Spans) Building Code : IBC Live Load Defl. (in) 0.380 @ 12' 9" 0.592 Passed (1./748) - - 1.0 D + 1.0 L (All Spans) Design Methodology : ASD Total Load Defl. (in) 0.532 @ 12' 9" 1.183 Passed (L/534) - - 1.0 D + 1.0 L (All Spans) T) Pro Rating 37 Any Passed - - - - • Deflection criteria: LL (L/480) and TL (1/240). • Bracing (Lu): All compression edges (top and bottom) must be braced at 4' 5" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. • Support 1 exceeds the allowed maximum bearing length of 3 1/2" for this product. The maximum bearing length was used for analysis. • Support 2 exceeds the allowed maximum bearing length of 3 1/2" for this product. The maximum bearing length was used for analysis. • A structural analysis of the deck has not been performed. • Deflection analysis is based on composite action with a single layer of 23/32" ILevel® Edge Panel (24" Span Rating) that is glued and nailed down. • Additional considerations for theTJ -Pro"" Rating Include: 1/2" Gypsum ceiling. Bearing Support Reactions(ibs) SuppOrtS Total ,° Available Required Dead Floor live„ `. Roof .live Snow Wind ' Seismic Accessories 1 - Stud wall - Spruce Pine Fir 12.00" 10.75" - - 204 510 0 0 0 0 1 1/4" Rim Board 2 - Stud wall - Spruce Pine Fir 12.00" 10.75" - - 204 510 0 0 0 0 1 1/4" Rim Board . Rim Board is assumed to carry all loads applied directly above It, bypassing the member being designed. Dead " Floor Live Roof Live . Snow Wind Seismic Loads Location Spacing (0.90) (1.00) (non-snowt125); 0.15) ( (1.60) Comments 1 - Uniform(PSF) 0 to 25' 6" 16" 12.0 30.0 0.0 0.0 0.0 0.0 Residential - living Areas iLEVELOR Notes , _ , SUSTAINABLE FORESTRY INITIATIVE ilevel® warrants that the sizing of its products will be in accordance with (Level® product design criteria and published design values. (Level® expressly disclaims any other warranties related to the software. Refer to current (Level® 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 Forte Software Operator Forte "" Software Operator Job Notes 7/5/2011 2:34:06 PM Joe Haillargeon Jamie Hasbrouck- Norfolk ave iLe v2.1, Design Engine Ver: V5.2.1.1 Cowls Building Supply NORFOLK AVE.4te (41 1) 549 -0001 joe0lcowlsco"' Page 1 of 1 1 eve Forte MEMBER REPORT Level, BEAM 4 PASSED software 3 piece(s) 1 3/4" x 11 7/8" 1.9E Microllam® LVL o eq,, L Overall Length: 14' 0 0 14' ,Y All Dimensions are Horizontal; Drawing is Conceptual Design Results Actual 0 Location Allowed Result ', LDP Load Combination (Load Pattern) System : Wall Member Reaction (lbs) 4671 @ 1 1/2" 10238 Passed (46 %) - - 1.0 D + 1.0 L (All Spans) Member Type : Header Shear (lbs) 3843 @ 1' 2 7/8" 11845 Passed (32 %) 1.00 1.0 D + 1.0 L (All Spans) Building Use : Residential Moment (Ft-lbs) 15768 @ 7' 26772 Passed (59 %) 1.00 1.0 D + 1.0 L (All Spans) Building Code : IBC Live Load Dell. (in) 0.312 @ 7' 0.458 Passed (L/529) - - 1.0 D + 1.0 L (All Spans) Design Methodology : ASD Total Load Defl. (In) 0.416 @ 7' 0.688 Passed (L/396) - - 1.0 D + 1.0 L (All Spans) • Deflection criteria: LL (L/360) and TL (1/240). • Bracing (Lu): All compression edges (top and bottom) must be braced at 14' 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; - Moor five Roo(' live Snow Wind Seismic Accessories 1 - Trimmer - Spruce Pine Fir 3.00" 3.00" 1.50" 1171 3500 0 0 0 0 None 2 - Trimmer - Spruce Pine Fir 3.00" 3.00" 1.50" 1171 3500 0 0 0 0 None Tributary Dead Floor Live ' Roof Live i Snow Wind Seismic Loads Location Width (0.90) (1.00) . (rwe -snGwi 1.25) (1.15) , " (1.60) j (1.60) Comments 1 - Uniform(PSF) 0 to 14' 12' 6" 12.0 40.0 0.0 0.0 0.0 0.0 Residential - Uving Areas iLEVEL® Notes SUSTAINABLE FORESTRY INITIATIVE iLevel® warrants that the sizing of Its products will be in accordance with iLevel® product design criteria and published design values. (Level® expressly disclaims any other warranties related to the software. Refer to current (Level® 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 Forte Software Operator Forte" Software Operator Job Notes 7/6/2011 8:14:38 AM Joy Fsaulargeon Jamie Hasbrni¢:k- Norfolk aye iLevel© ForteTM v2.1, Design Engine Ver: V5.2.1.1 Cowl, Building Supply NORFOLK AVE.4te (411540 -0001 joe com Page 1 of 1 1 eye ' Forte' MEMBER REPORT Level, BEAM 3 R , ( PASSED � software 1 piece(s) 1 3/4" x 11 1/4" 1.9E Microllam® LVL # 3 Overall Length: 6' 6" 0 0 6 6" X 0 All Dimensions are Horizontal; Drawing Is Conceptual Design Results Actual Cf0 Location Allowed Result! Lb! Load Combination (Load Pattern) System : Wall Member Reaction (lbs) 2130 @ 1 1/2" 3413 Passed (62 %) - - 1.0 D + 1.0 L (All Spans) Member Type : Header Shear (lbs) 1352 @ 1' 2 1/4" 3741 Passed (36 %) 1.00 1.0 D + 1.0 L (All Spans) Building Use : Residential Moment (Ft -Ibs) 3200 @ 3' 3" 8069 Passed (40 %) 1.00 1.0 D + 1.0 L (A0 Spans) Building Code : IBC Live Load Defl. (in) 0.059 @ 3' 3" 0.208 Passed (L/999 +) - - 1.0 D + 1.0 L (All Spans) Design Methodology : ASD Total Load Defl. (In) 0.077 @ 3' 3" 0.313 Passed (1/977) - - 1.0 D + 1.0 L (All Spans) • Deflection criteria: LL (L/360) and TL (11240). • Bracing (Lu): All compression edges (top and bottom) must be braced at 6' 6" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing J' Support Reactions (Ibs) Supports Total Available Required Dead . Floor Ilvn Roof live Snow Wind Seismic' Accessories 1 - Trimmer - Spruce Pine Fir 3.00" 3.00" 1.67" 505 1625 0 0 0 0 None 2 - Trimmer - Spruce Pine Fir 3.00" 3.00" 1.87" 505 1625 0 0 0 0 None Tributary Dead Floor Live ROOT thee Snow Wind !- Seismic Loads Location Width (0.90) (L00) (non-SnaW 1.x5) (145) (1.60) (1.60) Comments 1 - Uniform(PSF) 0 to 6' 6" 12' 6" 12.0 40.0 0.0 0.0 0.0 0.0 Residential - Living Areas (LEVEL® Notes 4 SUSTAINABLE FORESTRY INITIATIVE iLevel® warrants that the sizing of Its products will be In accordance with iLevel® product design criteria and published design values. (Level® 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 Forte Software Operator Forte Software Operator Job Notes 7/6/2011 8:13:49 AM )o.., Baiu�rgean Jamie Hasbrouck-Norfolk ave . iLevel® ForteIM v2.1, Design Engine Ver: V5.2.1.1 Cowls Building Supply NORFOLK A VE.4te (413) :;4y..0001 ioe@ }cowls. corn Page 1 of 1 • 1 ly 'Forte' MEMBER REPORT Level, BEAM 2 PASSED software 2 piece(s) 1 3/4" x 14" 1.9E Microllam® LVL Overall Length: 14' 0 0 I 14 11 All Dimensions are Horizontal; Drawing Is Conceptual DeSign Results Actual Location Allowed Result LDS ' Load Combination (Load Pattern) System : Floor Member Reaction (Ibs) 3638 @ 13' 10" 5206 Passed (70 %) - - 1.0 D + 1.0 L (All Spans) Member Type : Flush Beam Shear (Ibs) 2871 @ 1' 7 1/2" 9310 Passed (31 %) 1.00 1.0 D + 1.0 L (All Spans) Building Use : Residential Moment (Ft -Ibs) 11984 © 7' 1" 24258 Passed (49 %) 1.00 1.0 D + 1.0 L (All Spans) Building Code : IBC Live Load Defl. (In) 0.153 © 7' 1" 0.338 Passed (L/999 +) - - 1.0 D + 1.0 L (All Spans) Design Methodology : ASD Total Load Defl. (In) 0.288 @ 7' 1" 0.675 Passed (L/562) _ - - 1.0 D + 1.0 L (All Spans) • Deflection criteria: LL (11480) and TL (1/240). • Bracing (Lu): All compression edges (top and bottom) must be braced at 14' 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 Fltk)rllve „ Sootily.) ' Snow Wind Seismic Accessories 1 - Stud wall - Spruce Pine Fir 5.50" 5.50" 2.50" 1743 1983 0 0 0 0 Blocking 2 - Stud wall - Spruce Pine Fir 3.50" 3.50" 2.45" 1702 1937 0 0 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) (ion-snow :1,25) (1.15) (1.60) (1.60) Comments 1 - Uniform(PSF) 0 to 14' 7' 21.2 0.0 0.0 0.0 0.0 0.0 ROOF LOAD 2 - Uniform(PSF) 0 to 14' 7' 12.0 40.0 0.0 0.0 0.0 0.0 FLOOR LOAD (LEVEL() Notes (Z ) SUSTAINABLE FORESTRY INITIATIVE iLevel® warrants that the sizing of Its products will be In accordance with ILevel® product design criteria and published design values. (Level® 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 Forte Software Operator Forte r" Software Operator Job Notes 7/7/2011 7:43:55 AM Jon Baiilaryeon Jamie Hasbrouck-Norfolk ave. iLevel® Forte IM v2.1, Design Engine Ver: V5,2.1.1 Cowls Building Supply NORFOLK AVE.4te (413' 549 -0001 joe(uiccw!s corn Page 1 of 1 Beg, ((im j°e,5r 1 eve * Forte MEMBER REPORT Level, Wall: Header PA )SED software 1 piece(s) 1 3/4" x 14" 1.9E Microllam® LVL /VL4 t SP,„ (5 1 Overall Length: 8' 0 0 von 8 0 ®� All Dimensions are Horizontal; Drawing is Conceptual Design Results Actual I@ Location Allowed ! Result LPF load COmbinatiort (Load pattern) System : Wall Member Reaction (lbs) 1483 @ 1 1/2" 3413 Passed (43 %) - - 1.0 D + 1.0 L (All Spans) Member Type : Header Shear (lbs) 958 @ 1' 5" 4655 Passed (21 %) 1.00 1.0 D + 1.0 L (All Spans) Building Use : Residential Moment (Ft-lbs) 2784 @ 4' 12129 Passed (23 %) 1.00 1.0 D + 1.0 L (All Spans) Building Code : IBC Live Load Defl. (in) 0.040 @ 4' 0.258 Passed (L/999 +) - - 1.0 D + 1.0 L (All Spans) Design Methodology : Aso Total Load Defl. (in) 0.053 @ 4' _ 0.387 Passed (L/999 +) - - 1.0 D + 1.0 L (Ali Spans) • Deflection criteria: LL (11360) and 11 (L/240). • Bracing (Lu): AN compression edges (top and bottom) must be braced at 8' o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing . SupportReactions(Ibs) Supports Total Available Required Dead Ploo live Roof live Snow Wind Seismic 'Accessories 1 - Trimmer - Spruce Pine Fir 3.00" 3.00" 1.50" 363 1120 0 0 0 0 None 2 - Trimmer - Spruce Pine Fir 3.00" 3.00" 1.50" 363 1120 0 0 0 0 None Tributary Dead Floor. Live Roof Live , . Snow . Wind Seismic Loads Location '� Width (0.90) (1,00) ; (nOn-3nowr 1.29) (1.15) (1.60) (1.60) Comments 1 - Uniform(PSF) 0 to 8' 7' 12.0 40.0 0.0 0.0 0.0 0.0 Residential - Living Areas iLEVEL® Notes i `i" SUSTAINABLE FORESTRY INITIATIVE 'Level® warrants that the sizing of its products will be in accordance with (Level® product design criteria and published design values. 'Level® 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 Forte Software Operator Forte'* Software Operator Job Notes 7/5/2011 2:14;31 PM lue Baillargenn Jamie tl,asbrouck- Norfolk ave . (Level® Forte rr't v2.1, Design Engine Ver: V5.2.1.1 Cowls Building Supply NORFOLK AVE.4te (413) 54g -0OO I ,.e( ;ccvr s.co Page 1 of 1 James E. Hasbrouck Custom Building/Remodeling 125 Gold Street Belchertown, MA 01007 413 374 -0375 July 6, 2011 Northampton Building Department To Whom It May Concern: I am applying for a Building Permit to build a second floor on the house at 25 Norfolk Ave. Northampton. In order to complete this project I plan to address the structural details as follows: J1. To carry the new floor and roof loads on the exterior wall I will use a single 14" L.V.L. beam over the existing top plate. The new floor joists will be attached with metal joist hangers. The span of this beam is 7'6 "and it is labeled #1 on the plans V 2. To carry the new floor and roof load over bedroom 1, I will install a double 14" L.V.L. beam. The span of this beam is l'tand it is labeled #2 on the plans. , ,, 3. To carry the new floor load over the kitchen doorway I will use a single 12" L.V.L. ( beam. The span of this beam is 7'6" and it is labeled #3 on the plans. 4. To carry the new floor load over bedroom #2 I will use a triple 12" L.V.L. The span of this beam is 13'6" and it is labeled #4 on the plans 5. The second floor ceiling /attic floor will be framed with 16" TJI joists, 16" on center. These joists will span 23'6" and are rated for a live load of 30 psf. All of these beams and joists have been load calculated and designed by Cowls Building Supply. I have included an "I level Forte" member report for each structural detail. All point loads created by adding these beams will be traced to and supported by suitable posts and footings in the cellar I am looking forward to working with you on this building project. Thank you, James Hasbrouck. El REScheck Software Version 4.4.1 Compliance Certificate Project Title: Biddle Residence Energy Code: 2009 IECC • Location: Northampton, Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6404 Climate Zone: 5 Construction Site: Owner /Agent: esig r /Contractor: 25 Norfolk Ave T I Hartman Northampton, MA • Coldham & Hartman Architects 155 Pine Street Amherst, MA Compliance: Passes Compliance: 44.8% Better Than Code Maximum UA: 270 Your UA: 149 The % Better or Worse Than Code incx reflects how close to compliance the house is based on code trade -off rules. It DOES NOT provide an estimate of energy use or oast relative to a minimum-code home. • Gross Cavity Cont. Glazing UA Assembly Area or R -Value R -Value or Door Perimeter U- Factor Basement Wall 1: Solid Concrete or Masonry 952 0.0 30.0 30 Wall height: 8.0' Depth below grade: 7.0' Insulation depth: 7.0' Door 1: Solid 41 0.300 12 Wall 1: Wood Frame, 16' o.c. - -- - -- - -- - -- - -- Exemption: Framing cavity not exposed. Window 1: Vinyl Frame:Triple Pane with Low -E 237 0.200 47 Wall 2: Other Wall 1224 0.025 31 Ceiling 1: Cathedral Ceiling (no attic) 1618 60.0 0.0 29 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 2009 IECC requirements in REScheck Version 4.4.1 and to comply with the mandatory requi - - is teda e R . S hec Inspection Checklist. D ' ' Si'ture Date / ' I dt i/ Project Title: Biddle Residence . Report date: 07/02/11 • Data filename: \ \.psf\ Home\ Desktop \11 -01- Rescheck- 110702.rck Page 1 of 1 • 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 contraction 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 ermits 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 I, 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 tome: Date Address of work location S v The Commonwealth of Massachusetts Department of Industrial Accidents - Office of Investigations _fame 600 Washington Street , r Boston, MA 02111 • %� www..mass.gov /din -Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual) : jaile_5 Z 7%3,'o 4 .(4 Address: IZ 12 Sfi City /State /Zip: , ? /chtu' # ` , ,"t. (, /ai) Phone. #: y/ 3 `/ r 0 Are y(}0- an employer? Check the appropriate box:... Type of project (required): • 1. I am a employer with y 4.. 0 I am a general contractor and I 6 ❑_N w constriction____ employees (full and/or part-time).* * have hired the subcontractors — 2. ❑ I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling ship and have no erxTloyees These sub- contractors- have- .8. Iceeraolidon working for mein any capacity. act tY employees and have workers' 9. Q Building addition [No workers' comp. insurance comp. rns,rrance t required:] _ 5. 0 We are a corporation and its 10. 1 Electrical repairs or additions ff officers havexercised their . 11. in r 3.0 I am a homeowner doing all work g repairs or additions myself [No workers' co right of exemption per MGL Y 12. Roof repairs . c 1 52, §1(4) ,and we have no insurance required:] t 13. Other employees. [No workers' comp. insurance requited.} *Any applicant that checla 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. Coritractors 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. lithe sub - contractors have employees, they must provide their workers' comp. policy number. Iam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: 6 ,' 4 d. . 5 t 47 ., . 5-'M •'le IL- (C's, . Policy # or Self-ins. Lic. #: IA) L 0O `) " Yl 0 7 Ex pirationDate: 7/ 07/ / Job Site Address: No k" 5f . . . City /Stafe/Zip:' ri hp i /in I3(O D 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 crimin41 penalties of a fine up to $1,500.00 and/or one -year imprisonment; as well as civil penalties in the form of g 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 Investieations of the DIA for insurance coverage verification. I do hereby ce , 1 under the pains and p ° of perjury that the information provided above is true and correct • / Sine . tore: -dor f. t , Date: \v j ` 8 0/1 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other I Contact Person: Phone ii: I SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable; ❑ ' L Name of License Holder : JG;'r/l�' S uJtJ ��h at-A S License Number J2_5 6 Sf .13 kiierkU) /f Dl0U) c /201 Z Addr s Expiratio Date CTh � - 3f /5 • 'nature Telephone -;:_' Not Applicable ❑ �es�is#erpcFortre% rq " c€C�«, � ,z.,& �.�,,, � . F. ;-• E< x� PP ' c?/ .c.Cc ! O4,9 j 1/ 5 t . 1 4- . a e - o Company Name Registration Number � 2 5 c v/i 57 � /c /,r i.7 A, 4. 000 - Itig /dOi L Address Expiration ate Telephone y�3 / / -03 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 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 . 1 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) K 4 New House ❑ Addition ❑ Replacement Windows Alteration(s) pq Roofing ❑ Or Doors O Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [D Siding [❑] Other [EJ] Brief Description of Proposed ( (, f' J r, -_, -.� ti : Q Work: A& . =Floor G ��l er L-ry , ,i5: j e c k v � �f� 3 Alteration of existing bedroom Yes ✓ No Adding new bedroom /Yes No Attached Narrative ,j Renovating unfinished basement Yes . No Plans Attached Roll Sheet q (7rgrgtN`1���Q �t'1'(ilCllici: 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 I, - SC_.:` - j f N _.L - as Owner of the subject property hereby authorize J E r., I- 44 � p__, U cg_ to act on my behalf, in all matters relative to work authorized by this building pe 1 appli tion. 7 /1 7 nat a of Owne Dat I, L, t . - / J,■4 : - 0 `t C- k , 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. , L _5...1 4,LL. Print Name Signature of Owner /Agent Date .i i Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zori ng This column to be filled in by Building Department r Ii R( i I Lot Size E2Z 1 LliataLo i 1 4' / ` 11 1 7 . - 1 Frontage - • Setbacks Front [ J 51-7 i Side L: V2 R:R L: J R:r. i 1 I Rear I -30 . ' 1 i Building Height i l Bldg. Square Footage g&91 ( I% 4'P f cti t 0 3 I I i I � _Open Space Footage % ( j - - -- (Lot area minus bldg & paved I ! C c 1 parking) # of Parking Spaces l I Fill: 1 , 1 (volume & Location) I if I t A. Has a Special Permit /Variance /Findin ever been issued for / on the site? NO 0 DONT KNOW YES 0 IF YES, date issued:; I IF YES: Was the permit recorded at the Regi of Deeds? NO 0 DONT KNOW YES 0 IF YES: enter Book l Page I 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 0 Obtained ,Date Issued C. Do any signs exist on the property? YES NO ei IF YES, describe size, type and location: l 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, ex vation, 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. , e Ci of Northamptont " � i - R # C E V E Building Department t � _ �� � = 212 Main Street =m ='It t �" ! L i 1 2011 Room 100 = '`I-$ � ;4 Northampton, MA 01060 �_ - = r , - . ,1 4 • one 413- 587 -1240 Fax 413- 587 -1272 = i DEPT r F BUILDING INSPEC710N8 N �THAMPTON MA01060 6 i _ . , fr f - ' ,..m 3 ; 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 d 5 N -�,IA ,4'L. Map - _ Lot Unit Ai:: e t..rtp 4- Zone ->'-, OverlayDistnct Eini St District .. , . _ • ,CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Own of of Record: ' / / / Sco 6714 /✓1 f 3, (i (e. / f; 1 ✓1 5 e l Name (Print I Current Mailing Address: y,.3 -(5- Sty �z- Telephone ignature ...e".::°=:r.'ee"):g7 , 2.2 Authorized Agent: iiJJ �9 J0 i44 , 3 .. �T , f LI C" /' i &- / / - 3 e / iw! J � M o,c ' Na a (Print) Current Mailing Address: , � y/ 3 - 3 Y - G) 3 - 5 j/3 3Z-3 ,° ,� gnature 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 >i iUf Llf iC► 2. Electrical 0 � L 0 i -, (b) Estimated Total Cost of 7 - Construction from (6) 3. Plumbing *-fl. L. 5 cv oc , Building Permit Fee 4. Mechanical (HVAC) g 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) /;3 000 00 Check Number' ) This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date • ............... . s r File # BP- 2012 -0028 c APPLICANT /CONTACT PERSON JAMES HASBROUCK L..O N t �\ ADDRESS/PHONE 125 Gold Street BELCHERTOWN (413) 323 -8837 � PROPERTY LOCATION 25 NORFOLK AVE 24A PARCEL 255 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � � � Fee Paid 6 Typeof Construction: CONSTRUCT 2ND FLR ADDITION(3 BEDRMS/BATH) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 53135 / J 3 sets of Plans / Plot Plan THE FO LOWING 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 Demoli D el y e of Building Official Date 7 - , 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. 25 NORFOLK AVE BP- 2012 -0028 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24A - 255 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit # BP- 2012 -0028 Project # JS- 2012- 000050 Est. Cost: $123000.00 Fee: $738.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JAMES HASBROUCK 53135 Lot Size(sq. ft.): 14984.64 Owner: BIDDLE MARY B & JOHN S JR Zoning: URA(100)/ Applicant: JAMES HASBROUCK AT: 25 NORFOLK AVE Applicant Address: Phone: Insurance: 125 Gold Street (413) 323 -8837 Workers Compensation BELCHERTOWNMA01007 ISSUED ON:7/26/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2ND FLR ADDITION(3 BEDRMS /BATH) 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 7/26/20110:00:00 $738.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner