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30B-120 (3) Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness In Inches by Pipe Sizes Non - Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5" to 2.0" Over 2" Temperature ( °F) 170 -180 0.5 1.0 1.5 2.0 140 -160 0.5 0.5 1.0 1.5 100 -130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Fluid temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range(°F) 2" Runouts 1" and Less 1.25" to 2.0" 2.5" to 4" Heating Systems Low Pressure/ Temperature 201 -250 1.0 1.5 1.5 2.0 Low Temperature 120 -200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD: (Building Department Use Only) Page 4 of 4 i D The HVAC system provides a means for balancing air and water systems. Temperature Controls: • Thermostats exist for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and /or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: Li Rated output capacity of the heating /cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: u Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: Lj All heated swimming pools have an on/off heater switch and a cover unless over 20% of the heating energy is from non - depletable sources. Pool pumps have a time clock. Heating and Cooling Piping Insulation: • HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Page 3 of 4 CI R EScheck Software Version 4.10 I nspec tio n Check Date: 06/23/10 Ceilings: ❑ Ceiling 1: Flat Ceiling or Scissor Truss, R -50.0 cavity insulation Comments: Above - Grade Walls: ❑ Wali 1: Wood Frame, 24" o .c., R -24.0 cavity insulation Comments: Basement Walls: ❑ Basement Wall 1: Solid Concrete or Masonry, 8.0' ht / 7.5' bg / 8.0' insul, R -10.0 continuous insulation Comments: Windows: ❑ Window 1: Vinyl Frame:Double Pane with Low -E, U- factor. 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1: Glass, U- factor: 0.300 Comments: Air Leakage: ❑ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ When installed in the building envelope, recessed lighting fixtures#meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 Us) air movement from the the conditioned space to the ceiling cavity. The lighting fixture has been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm side of all non - vented framed ceilings, wails, and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R- values and glazing U- factors are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions, in substantial contact with the surface being insulated, and in a manner that achieves the rated R -value without compressing the insulation. Duct Insulation: ❑ Ducts are insulated per Table J4.4.7.1. Duct Construction: ❑ All accessible joints, seams, and connections of supply and retum ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. Page 2 of 4 F n , ci REScheck Software Version 4.1.0 Compliance Certificate Report Date: 06/23/10 Data filename: Untitled.rck Energy Code: Massachusetts Energy Code Location: Northampton, Massachusetts Construction Type: 1 or 2 Family, Detached Heating Type: Other (Non- Electric Resistance) Glazing Area Percentage: 11% Heating Degree Days: 6404 Construction Site: Owner /Agent: Designer /Contractor: Compliance: Passes Maximum UA: 200 Your Home UA: 148 = 26.0% Better Than Code Gross Cavity Cont. Glazing UA Assembly Area or R -Value R -Value or Door Perimeter U- Factor Ceiling 1: Flat Ceiling or Scissor Truss 475 50.0 0.0 12 Wall 1: Wood Frame, 24" o .c. 1276 24.0 0.0 60 Window 1: Vinyl Frame:Double Pane with Low -E 123 0.300 37 Basement Wall 1: Solid Concrete or Masonry 552 0.0 10.0 31 Wall height: 8.0' Depth below grade: 7.5' Insulation depth: 8.0' Door 1: Glass 25 0.300 8 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 4.1.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shal be no greater than 125% of the design f load as s cified in Section 780 MR 1310 and J4.4. ,;(/// fr i / ( .., .. 0 I Z ]--lC � Name - Title ignature Date Page 1 of 4 The Commonwealth of Massachusetts Department of Industrial Accidents ': '— Office of Investigations E �i 600 Washington Street k c . r ,� Boston, MA 02111 ' www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers A # , licant Information Please Print Le q b Name (Business/Organization/Individual): 1 S Address: ie 4 A,,, , -, J / /,7 C Ci /State /Zi.: � Phone #: 73 - Z 91 ®/ Z 3 Are - you an employer? Check the appropriate box: Type of project (required): 1. Ell am a employer with 2, 4. 0 I am a general contractor and I employees (full and/or part- time).* have hired the sub - contractors 6. ❑ New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. uilding addition [No workers' comp. insurance comp. insurance.# required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions 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.] *My 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: -6, i -' /�� < / - , / , / - r Policy # or Self -ins. Lic. #: b✓ Z '2 / 24 / 0 Expiration Date: 9' l2 2 er, C/ Job Site Address: //s Liz -'h ' ? 17/ , City /State /Zip: /tea ' /�- • - �. ef e'er/ 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 un r e pains a penalties of pedury that the information provided above is true and correct. Signature: ,,, // Date:a 2 `— � Phone #: `// ? ` %� _ d / 2.. - 3 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 : 1:7 / 'Cis �j ( / 4 P4x License Number 2 a f i C- 5 - .....4 ion i-``, / - J 2 - Z- .e 2__ Address ` 03- Expiration Date 2 0/2 -3 Sig ature Telephone 9. Registered Homg Improvement C ntractor: Not Applicable ❑ IC f /4 G,.? Z ref i/ Ze_ / Z . s7 f� { t / a /� Registration Number eC/t- J0X 5 `/ i/ /Z/6 5 , /r/ Co m / ,if y - 2f . fi`Z Address ?e-e,/ Expiration Date Telephone z3 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 162, § 26C(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 buildin .permit. Signed Affidavit Attached Yes No ❑ 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-vear 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 6- DESCRIPTION OF PROPOSED WORK (chick all aaalicable) New House ❑ Addition d Replacement Windows Alterations) [ J Roofing D Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks [10" I Siding [0] Other [C1 Brief Description of Proposed /� Q Work: 0 ii. ;/L /(JG t,' f;e... e>„ /4 eA Oc 1 p,„ S Alteration of existing bedroom Yes Lo 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 ✓ Two Family Other b. Number of rooms in each family unit: "y Number of Bathrooms c. Is there a garage attached? ., d. Proposed Square footage of new construction. 6.1 / Dimensions 2 5 .k' 2 2 e. Number of stories? Z / / f. Method of heating? 6 r ti !i o 51 1 w�-,/ 4Sf Fireplaces or Woodstoves <ii/e Number of each g. Energy Conservation Comptia ce. , Masscheck Energy Compliance form attached ? / h. Type of construction ivio re.-- - 1. Is construction within 100 ft. of wetlands? Yes .7 Is construction within 100 yr. floodplain ✓ Yes No j. Depth of basement or cellar floor below finished grade 1 / k. Will building conform to the Building and Zoning regulations? ✓ Yes No . I. Septic Tank City Sewer /— Private well City water Supply v �� . SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, 1N t.Y WA: 4 c, v.'1 1 , as Owner of the subject property X hereby authorize `7 � �Y to act on my behalf, in all matters relative to work authorized by this building permit application. ..i/u� — r.,e.+ 6-. •2) - /Q Signature of Owner Date 1 Xi / .. s , 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 un er the pains an pens ies of perjury. ,4( f - , e S Print Name i Signature of it ner Agent Date Section 4. ZONING All Information Mist 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 /) 47 / fi 7 d 2 ' Frontage t Setbacks Front Side L: R: /'`7 Rear /6-5 75-0 J Building Height 3 ��,� N1 P-r c Bldg. Square Footage (Dc 3 ` C..7 /'.X) Open Space Footage (Lot area minus bldg & paved parking) Y # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Findir NO er 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 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO © DONT KNOW ® YES e IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained i© Obtained V , Date Issued: C. Do any signs exist on the property? YES O NO V 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 er IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, exc or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 1 • Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability ri(,\ Northampton, MA 01060 Two Sets of Structural Plans �� ' phone 413 -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 Map Lot Unit Zone Overlay District l ! �! . /' `Z d, / Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: 4 -1t G121 / G 0, /// f z /5 Dt S,� n API O.b Name (Print) Current Mailing Adtifess: Telephone Signature 2.2 Authorized Argent: / � / r Name Current Mailing Address: Sig 8 ure Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building / 3 � 1'49 (a) Building Permit Fee 2. Electrical ,} (b) Construction from (6)� 3. Plumbing /c2 Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection f /i is 6. Total = (1 + +3+4+5) / A 49040 Check Number /d g This Section For Official Use Only Building Permit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File # BP- 2010 -1185 APPLICANT /CONTACT PERSON KENT HICKS ADDRESS/PHONE P 0 BOX 57 WEST CHESTERFIELD (413) 329 -4788 0 PROPERTY LOCATION 145 VERNON ST MAP 30B PARCEL 120 001 ZONE RR/URA(100) //FFR /WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out /032—{T /- ' Fee Paid 'IP to Typeof Construction: CONSTRUCT 2 STORY ADDITION (FAM RM,BEDRM,BATH) & RENO KITCHEN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 66104 / (� 3 sets of Plans / Plot Plan C ��' 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 7/1/0 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. ON ST BP- 2010 -1185 GIS #: COMMONWEALTH OF MASSACHUSETTS 0A3 �a . c l - 120 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- 2010 -1185 Project # JS- 2010- 001464 Est. Cost: $168000.00 Fee: $637.00 PERMISSIONIS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KENT HICKS 66104 Lot Size(sq. ft.): 16465.68 Owner: WARK HEATHER & WILLIAM WHITCOMB Zoning: RR/URA(100) //FFR/WP Applicant: KENT HICKS AT: 145 VERNON ST Applicant Address: Phone: Insurance: P 0 BOX 57 (413) 329 -4788 () WC WEST CHESTERFIELDMA01084 ISSUED ON:7/2/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY ADDITION (FAM RM,BEDRM,BATH) & RENO 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 7/2/2010 0:00:00 $637.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo