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36-169 2009 IECC Energy Efficiency Certificate Insulation Rating R -Value Ceiling I Roof 42.00 Wall 21.00 Floor / Foundation 20.00 Ductwork (unconditioned spaces): Glass & Door Rating U- Factor SHGC Window Skylight 0.44 Door 0.35 NA Heating & Cooling Equipment Efficiency Heating System: Cooling System: Water Heater: Name: Date: Comments: Where pumps operate within solar- and /or waste - heat - recovery systems. ❑ Heated swimming pools have a cover on or at the water surface. For pools heated over 90 degrees F (32 degrees C) the cover has a minimum insulation value of R -12. Exceptions: Covers are not required when 60% of the heating energy is from site - recovered energy or solar energy source. Lighting Requirements: • A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a) Compact fluorescent (b) T -8 or smaller diameter linear fluorescent (c) 40 lumens per watt for lamp wattage <= 15 (d) 50 lumens per watt for lamp wattage > 15 and <= 40 (e) 60 lumens per watt for lamp wattage > 40 Other Requirements: U Snow- and ice - melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a) the pavement temperature is above 50 degrees F, b) no precipitation is falling, and c) the outdoor temperature is above 40 degrees F (a manual shutoff control is also permitted to satisfy requirement 'c'). Certificate: Li A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R- values; window U- factors; type and efficiency of space- conditioning and water heating equipment. The certificate does not cover or obstruct the visibility of the circuit directory label, service disconnect label or other required labels. NOTES TO FIELD: (Building Department Use Only) Project Title: PEPIN RESIDENCE ADDITION Report date: 08/22/12 Data filename: C: \Users \Peter \Desktop \CURRENT DATA \PFRA \PROJECTS \1205PRA \ResCHECK Certificate.rck Page 4 of 4 (d) Floors: Air barrier is installed at any exposed edge of insulation. (e) Plumbing and wiring: Insulation is placed between outside and pipes. Batt insulation is cut to fit around wiring and plumbing, or sprayed /blown insulation extends behind piping and wiring. (f) Corners, headers, narrow framing cavities, and rim joists are insulated. (9) Shower /tub on exterior wall: Insulation exists between showers /tubs and exterior wall. Sunrooms: • Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U- factor of 0.50 and the maximum skylight U- factor of 0.75. New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: Li Materials and equipment are installed in accordance with the manufacturer's installation instructions. • Materials and equipment are identified so that compliance can be determined. u Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Li Insulation R- values and glazing U- factors are clearly marked on the building plans or specifications. Duct Insulation: u Supply ducts in attics are insulated to a minimum of R -8. All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R -6. Duct Construction and Testing: Li Building framing cavities are not used as supply ducts. • All joints and seams of air ducts, air handlers, filter boxes, and building cavities used as return ducts are substantially airtight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Tapes, mastics, and fasteners are rated UL 181A or UL 181B and are labeled according to the duct construction. Metal duct connections with equipment and /or fittings are mechanically fastened. Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet -metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists, mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking -type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). Li All ducts and air handlers are located within conditioned space. Temperature Controls: Li Where the primary heating system is a forced air - furnace, at least one programmable thermostat is installed to control the primary heating system and has set - points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. Lj Heat pumps having supplementary electric- resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: Li Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. p For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and /or Service Water Heating (Sections 503 and 504). Circulating Service Hot Water Systems: Li Circulating service hot water pipes are insulated to R -2. ii Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: • HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R - 3. Swimming Pools: • Heated swimming pools have an on /off heater switch. Li Pool heaters operating on natural gas or LPG have an electronic pilot light. Li Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Project Title: PEPIN RESIDENCE ADDITION W_NA- Report date: 08/22/12 Data filename: C: \Users \Peter \Desktop \CURRENT DATA \PFRA \PROJECTS \1205PRA \ResCHECK Certificate.rck Page 3 of 4 CI REScheck Software Version 4.4.2.3 Inspection Checklist Ceilings: ❑ Ceiling 1: Cathedral Ceiling, R -42.0 cavity insulation Comments: Above - Grade Walls: ❑ Wall 1: Wood Frame, 16" o.c., R -21.0 cavity insulation Comments: ❑ Wall 2: Wood Frame, 16" o.c., R -21.0 cavity insulation Comments: Skylights: ❑ Skylight 1: Vinyl Frame:Double Pane with Low -E, U- factor: 0.440 For skylights without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1: Glass, U- factor: 0.350 Comments: ❑ Door 2: Solid, U- factor: 0.260 Comments: Floors: ❑ Floor 1: Slab -On- Grade:Unheated, 6.0' insulation depth, R -20.0 continuous insulation Comments: Slab insulation extends down from the top of the slab to at least 6.0 ft. OR down to at least the bottom of the slab then horizontally for a total distance of 6.0 ft. Air Leakage: ❑ Joints (including rim joist junctions), attic access openings, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed with caulk, gasketed, weatherstripped or otherwise sealed with an air barrier material, suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units, on exterior walls behind tubs /showers, and in openings between window /door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1) type IC rated and ASTM E283 labeled and 2) sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather - stripped and insulated (without insulation compression or damage) to at least the level of insulation on the surrounding surfaces. Where loose fill insulation exists, a baffle or retainer is installed to maintain insulation application. ❑ Wood- burning fireplaces have gasketed doors and outdoor combustion air. ❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1) a post rough -in blower door test result of less than 7 ACH at 50 pascals OR 2) the following items have been satisfied: (a) Air barriers and thermal barrier: Installed on outside of air - permeable insulation and breaks or joints in the air barrier are filled or repaired. (b) Ceiling /attic: Air barrier in any dropped ceiling /soffit is substantially aligned with insulation and any gaps are sealed. (c) Above -grade walls: Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. Project Title: PEPIN RESIDENCE ADDITION Report date: 08/22/12 Data filename: C: \Users \Peter \Desktop \CURRENT DATA \PFRA \PROJECTS \1205PRA \ResCHECK Certificate.rck Page 2 of 4 Cil REScheck Software Version 4i.4.2.3 Comp Cert Project Title: PEPIN RESIDENCE ADDITION 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: Designer /Contractor: 747 Florence Road Daniel Pepin Peter Frothingham Florence, MA 01062 747 Florence Road Office of Peter Frothingham RA Florence, MA 01062 181 Main Street Suite One Northampton, MA 01060 413 585 5910 pf @pfra.us Compliance: Passes Compliance: 11.8% Better Than Code Maximum UA: 102 Your UA: 90 The % Better or Worse Than Code index reflects how close to compliance the house is based on code trade -off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum -code home. Gross Cavity Cont. Glazing UA Assembly Area or R -Value R -Value or Door Perimeter U- Factor Ceiling 1: Cathedral Ceiling 275 42.0 0.0 7 Skylight 1: Vinyl Frame:Double Pane with Low -E 8 0.440 4 Wall 1: Wood Frame, 16" o.c. 276 21.0 0.0 11 Door 1: Glass 48 0.350 17 Door 2: Solid 40 0.260 10 Wall 2: Wood Frame, 16" o.c. 156 21.0 0.0 9 Floor 1: Slab -On- Grade:Unheated 50 20.0 32 Insulation depth: 6.0' Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other i calculations submitted with the permit application. The proposed bui .' g has designed to meet the 2009 IECC requirements in REScheck Version 4.4.2.3 and to comply with the mandatory r : ire •nts sted in t•e REScheck Inspection Checklist. INI/ tom I ( �.) V r 4. 01 r ame - Titl - ' `ignature Date Project Title: PEPIN RESIDENCE ADDITION Report date: 08/22/12 Data filename: C: \Users \Peter \Desktop \CURRENT DATA \PFRA \PROJECTS \1205PRA \ResCHECK Certificate.rck Page 1 of 4 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, ° act as their own constr action 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 I, �Z2 L � understand the above. ome owner /residen s si ature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to' me. Date 9/11//,; . Address of work location 7Y7 / <� �'2''r Zez( / /qd 0/(.)6 . ■ • ■ , . .\ The Commonwealth of Massachusetts Department of Industrial Accidents VI .... ,...:1■1.77.= Afy Office of Investigation:s . . 600 Washington Street • Boston, MA 02111 . . . 1-,....„„ . . , www.mass crov/dia • . -e, ..,.. -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name pusineseOrgatuialionfindividuaD: D a 1, tit i R 1 efi e- L. . • , . . • Address: 7 ‘-( 7 ic /o , re i, v .e - /Z c ce d___ City/State/Zip: r k r ti( c it- . / 0 6 2.Pb:one .#: Are you an employer? Check the appropriatehox: ' -Type of project (required): ../ 1.0 I am a employer with 4. D I am a general contractor and I 6. 0 New construction have hired the sub-contra.ctors employees (full ancVor part-time).* 2.0 lath a Sole proprietor or partner- listed on the attached sheet. 7. 0 E,emOdeling - - . . ship and have no )loyees These sub-contractors have. .8 0 Demolition working for -me m any capacity emiloyees-_andhave workers' pliratit 114°. w'rice7s' camp insurance * aiance . 5 0 '- aie corporation . - - 0n and it 10. --- Ejectr -" ia - f require repairs or additions d.] •• . . 3. [5 I am a homeowner dOing all work officers hairetx.eraisecl their • 11.pi Plumbing repairs or additions : i myself No workers' comp. • right of exemption per MGL r--I .— 12.0 .moof repairs - . • insurance required.] t - p. 152, §1(4), and we have na • , ' • 0 Other employees: [No workers' • 13. 1 - " . • . comp. insurance reqiiired.j. - • - • . • . *My applicant-that checks -box til must also fill out the section beloWshowing their -compensation policy informatiCat; t Homeowner* who submit thii i4—.ii they .--re doing all work and then hire outside contractors must submit a newaffidavit indicating such. 1- (7,..--tna,. tois that check this box tattached an motional sheet showing tile name of me sub-contractors and state witetherornotthose-entities have employees.. If the sub-contractors have employees; they must provide their workers ' comp policy number. • lam am an employer that is providing workers' compersation insurance for my employees Below is the policya.nd job site information. . . • . Insurance Company Name: - . • • . . • . - Policy # or Self-ins. Lic. #: . Expiration Date: . . . .. • . r • Job Site Address: . • . - City/Sinte/Zip:' • " . .. - • , - .• Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverikelit Seetibt 25A 1526iii. lead to the ii:a'i5cisiiiiii of ainiiHill penalties of a fine up to S1,500.00 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 zlaY against the violator Be advised that a copy of this statement may be forwarded to the•OEce'of_ itivestialiarns cif thi c.iiiiiiii4ViiIt'ariiiii. - . . . _... 1 :: - -....::'..f.•::,.-......•-- .fito"heret. niter the p •and enah)7fperlary that infornsati.onprovidedithort.e_titrueurrirt / .._ Signature: el,-72re 6( 7 ___ -, fr ' - ' . 13 . 94 7/ --- • . • , Phone 4 - --->. ...--- : X/5 , . - Official use only. Do nth write liz 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 , f- . • . . Contact Person: Phone fi: • - SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor ,� Not Applicable ❑ 1 J Name of License Holder : ,a k7€ ( t /29/1 `. (S - 0 C / lP 78 License Number - 76/ 7 rio-ett(t Te c), Via /52/co/3 Addres Expiration Date ( o ff l l . ti. Q C Q 6 ``) Signatur T hone / ja __,JZ c/(3 —5's : eais;gie l ome lr nproti miifii r itraict iw. 3 E ,z .k , ;b z ,17 : -` i q .w Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10 COMPENSATION'! INSURANCE AFFIDAVIT (M,G.L. c. 452, § 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 ❑ vivimoinoilawneimlempuon 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" cert es and umes re nsib ' for compliance with the State Building Code, City of North pton Ordinances, Stat Local ing Lev n4'S of Massachusetts General Laws Annotated. omeowner Signature / '/ i' ti:// /� SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House [l Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. 0 Demolition ❑ New Signs [O] Decks [0 Siding [O] Other [p] Brief Description of Proposed / ^ Work: �D G��' Cv�G.Ctv�t�r' `� VIZ �/c� YJa �� / Ca I- e/' Gf fr,"— Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roil 3- Sheet 04 3 #* a fii � l� i ` // °e cx #ifigfiuusln , iii tfi., , iii)Wiii : a. Use of building : One Family J Two Family Other b. Number of rooms in each family unit: ,3 Number of Bathrooms / Wd(l`"' c. Is there a garage attached? /lJof yel--- -g d. Proposed Square footage of new construction. /j /c 0 Dimensions /a' X / ` r" c l �/ // J6 e. Number of stories? 0/1 .._ / / U'`1 f. Method of heating? /�G � / C ,loUSC 7L) j ll ,-- Fireplatces or Woodstoves Number of each g. Energy Conservation Compliance. , P S / Masscheck Energy Compliance form attached? t`'S h. Type of construction K )Ode 7 /rt. C. ��// i. Is construction within 100 ft. of wetlands? Yes X._ No. Is construction within 100 yr. oodplain Yes x No j. Depth of basement or cellar floor below finished grade 7 r _cvi& 2 a S C/rrs i ! l k. Will:.building conform to the Building and Zoning regulations? K Yes No . I. Septic Tank City Sewer Private well City water Supply X _ SECTION 7a - OWNER AUTHORIZATION TO BE COMPLETED WHEN , OWNERS GENT OR ONTRACTOR APPLIES FOR BUILDING I '(,L - . . .r j 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 I, , 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 Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To IncompleteInformatfn Existing Proposed Required by Zoning This column to be;filled in b ° --- Building Department Lot Size / 1 C l 0 # t Frontage /3 b 1 .`.. (U l _._._ Setbacks Front 1 o l Side L j R: 7 :: L:L7 J R:'.Y 8 Rear ` FS Building Height l Bldg. Square Footage '�l % i Open Space Footage ✓��' % /{ (Lot area minus bldg & paved ; `=W l a (� 0 ? 5e _ parking) # of Parking Spaces V "- - ` 16clik 5< IC Fill: i 1 dr/(20.0ee 02 d ` 1 (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO OD DONT KNOW 0 YES 0 IF YFS, date issued: j IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page l and /or Document #, B. Does the site contain a brook, body of water or wetlands? NO * 4 DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained Q , Date Issued: C. Do any signs exist on the property? YES (3 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 ve IF YES, describe size, type and location: `. E. Will the construction activity disturb (clearing, grading, ex avation, 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. RECEIVED City of Northampton Building Department �' , ,1 ; SEP ( 212 Main Street P $ m 7 Room 100 N orthampton, MA 01060 i� ti�* , -�' DE NORTHAMPTON OF BUILDING INSPECTIOS � � NORTHAMPTON MAGI I . • • - 3- 587 -1240 Fax 413- 587 -1272 `" t '4.4 £ ' ',AID° 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 ' 7 Y 7 Flo revi6e eo,d Map :' , Lot - Unit A 1--/ y 't U c ti /4- A Zone` , ° ' Overlay District 0/ ' Elm St. District CB.District SECTION 2 PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: / DM/f t l 4- S a 0 e r) / 1/ 71 7 , ( relit t r ��Clc.� Nam nnt) / f � �- L Current Mailing Address: -_ 4 - , 'L L, -. . 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 Fe °I e6� v . / 7 C f ( , (a) Building permit Fee 2. Electrical / J / l � , (b) Estimated Total Cost of , - a Q r Construction from (6) 3. Plumbing Building Permit Fee goo 4. Mechanical (HVAC) 5. Fire Protection ,�/ ()' 6. Total = (1 + 2 + 3 + 4 + 5) 4C 7. 7 7V, Check Number c ) 2 / 3 r o Th Section For Official Use Only n (�n ,, I / `I i , /' . h n'� Date :wilding °erit Number. Issued: Signature: Building Commissioner /Inspector of Bu Date File # BP- 2013 -0305 C APPLICANT /CONTACT PERSON PEPIN DANIEL & SAUTHI ADDRESS/PHONE 747 FLORENCE RD FLORENCE (413) 335 -5813 0 PROPERTY LOCATION 747 FLORENCE RD MAP 36 PARCEL 169 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � `D! Fee Paid O(�f Typeof Construction: CONSTRUCT 24 X 26 ATT GARAGE 16 X 16 FOYER W /LAUNDRY/MUDROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License Q� 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INATION 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 Commissio I _ Permit DPW Storm Water Management ,0 01/ /2, Signature of Building • ficial 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. 747 FLORENCE RD BP- 2013 -0305 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 169 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- 2013 -0305 Project # JS- 2013- 000505 Est. Cost: $77780.00 Fee: $300.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 18905.04 Owner: PEPIN DANIEL & SAUTHI Zoning: Applicant: PEPIN DANIEL & SAUTHI AT: 747 FLORENCE RD Applicant Address: Phone: Insurance: 747 FLORENCE RD (413) 335 -5813 0 FLORENCEMA01062 ISSUED ON: 9/25/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT 24 X36 ATT GARAGE & 16 X 16 FOYER W /LAUNDRY /MUDROOM 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 9/25/2012 0:00:00 $300.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner