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' / C ' - ( 1 C 5 1- A: a f i'' Cr 0 P 172 7 "\--• 7 I ON/ -------- -..- i , „1 1 ! - / O -/5-/) Florence, MA 01062 -„ Rit 413-5.84-045a ,, r - c C 6 c..T ' Is : , ._. -C R L-IO > :> - ---, / d ____------- i , C/ Verb 2 ,( S, 24 O-c, ;) --' 4 , a 0, C, a CLL°'F E - _ , V r NT - - - 4 ._ .... _ t i i . rig Cot -INc t° r, pG , pttr \14.t �6 rt Ili )0 NC( � . ____ ,,,,,,i ji......._ 1- L-- N eµ) C ON C. Fe o r s ( ---- 14" a alt" K 6 Fxts - C roolvBATI nr SLAT?:.,) 1 cL -I q j A R irl C E C Ross - SEc - n o/ -SCALti ,, I /4" _ 1 , -0 t. `1 -2- (2 RoU Sv2.q .) C CH AtAl Z - la, . Neil Homstead 21 a 4OfZI - M FA m RID, North Farms Rd FBc�r , ,, ; 01 Flo E, Ca' /!'' 41�Ei a, 28. Dwelling /Garage fire separation. An attached garage (within 3' of main structure) is required to have %" drywall on the garage side of the separation wall and if there is a finished space above the garage all walls must have %" drywall and the ceiling 5/8" drywall. 780 CMR R302.6 29. Energy aspects shall comply with the stretch energy code. 780 CMR Appendix 115AA or 2009 IECC. a. An initial HERS evaluation is required including insulation levels anticipated. b. A final HERS evaluation confirming code requirements have been met including duct testing. c. A signed copy of the Thermal Bypass Checklist. d. Energy information including mechanical equipment posted on the electric panel. e. Remodeling and Additions can be completed in accordance with IECC 2009 with Energy Star Windows and the Thermal Bypass Checklist. Duct blast testing when practicable. 30. Vapor retarders. Although these are still in the code have exceptions, one must understand that there is a difference between a vapor retarder or barrier and an air barrier. An air barrier is intended to stop air flow (convection) a vapor retarder or barrier is intended to stop molecular moisture transfer (diffusion). A vapor retarder or barrier is effective even if there are some holes or gaps, however an air barrier has to be absolute and complete. If air can leak through an electrical device or through a crack it follows the path of least resistance and carries 99% of the moisture in a structure. This is evident every time one exposes fiberglass insulation and finds black insulation, which is dirt filter out of the air moving through the insulation. 780 CMR R601.2 for vapor retarders and Table N1102.4.2 for air sealing requirements. 31. Unvented attic assemblies. Hot roofs are allowed, but have specific requirements 780 CMR R806.4. 32. Deck ledgers and post must be appropriately attached, bolts or lags. 780 CMR R502.2.2.1 Note: ThruLoks are engineered for post attachment supporting a railing. 33. Smoke and CO detectors as required. 780 CMR R314 and R315. 34. Closets beneath stair which have doors must be drywalled with %2 ". 780 CMR R302.7 35. If there is mechanical equipment or a combustible roof, 30 sqft of space, and 30" measured from top of ceiling joist to bottom of rafters an attic access of minimum RO of 22" x 30" is required to be located in an accessible place. It must be insulated, gasketed, and secured in place. 780 CMR R807 Relevant items must be submitted to the building department for approvals before inspections and or CO can be signed. Other items are intended to avoid costly issues at inspections. Feel free to call if you have any questions. My telephone number is 587 -1240 and office hours are Monday through Friday, 8:30 am to 4:30 pm, excepting we close for walk -ins at 12:00 noon on Wednesdays. My email address is: cmilleranorthamptonma.gov Thank you for our cooperation on these matters. / � v Chuck Miller City of Northampton Assistant Commissioner and Zoning Enforcement 13. All framing materials which are not code prescriptive must have stamped engineering. a. LVLs b. I -joist and or Floor Truss c. Roof truss 14. A braced wall plan identifying appropriate braced wall areas and braced wall method being used. 780 CMR 602.10. a. Garage corners and large corner window /door layout may require special solutions. b. All corners must be appropriately attached to the foundation. 15. Ceiling heights minimum 7' for habitable spaces, 6'8" for bathrooms includes tub /shower area if a shower head is used, 6'8" for basements, 6'4" at beams /ducts. 780 CMR R305.1. MA amended 16. Hazardous glazing locations, within 24" of a door, or within 60" of a stair, or across from hot tubs, spas, bathtubs within 60" if not 60" above the walking surface, and other locations. 780 CMR R308.4 17. Windows over 72" above grade with the opening less than 24 above the finished floor shall meet the 4" sphere rule. Order restrictors. 780 CMR R612.2 18. Egress and emergency escape requirements shall be strictly met. a. Basements, habitable attics, and all sleeping rooms require emergency escape. 780 CMR R310 b. Windows within 44" of floor, DH 3.3 sqft min window size, Casement 20 "x41" exception 5 sqft at ft floor. Minimum clear opening 20 "x24" or 24 "x20 ". 780 CMR R310.1.1 c. Two doors remote as possible at the normal level of travel, opening measured from the face of the slab to the stop with door at 90 degrees, one 32" and one 28" minimum 78" high. 780 CMR R311.2 d. Landing at each door 36" out and the width of the door minimum 36 ", maximum step 7 3/4" from the top of the threshold and only in- swinging doors. 780 CMR R311.3 19. Stairs have critical standards, make sure you know the floor finishes when planning. Minimum tread 9 ", maximum riser 8 % ", maximum overall variance for the run is 3/8 ", 4" sphere rule on risers except where the total rise is 30" or less 780 CMR R311.7.4.3 Exception, 4 3/8" on balustrade, 6" in the triangle. Graspable rail 1 'A" minimum and 2" maximum rail, height minimum 34" maximum 38 ", required for 4 or more risers. Landing to landing constitutes a new run. Minimum 6'8" ceiling height from nosing. 780 CMR R311.7. 20. Guards 36" minimum height above walking surface, a bench is a walking surface, required for more than 30" above floor or grade within 36 ", 4" sphere rule. 780 CMR R312.1. 21. Educate the plumber and electrician about maximum notch and hole sizes, and placement. 780 CMR R502.8 and R602.6. In bearing studs holes not larger than 40% of a stud no closer than 5/8 to the edge, In interior non - bearing studs holes not larger than 60% of a stud no closer than 5/8 to the edge, in bearing walls if more than 50% of a plate is cut or notched a 1 /" 16ga. strap must extend a minimum of 6" past the cut both directions and be nailed with 8 -10d per side, or holes in joist are a maximum 1/3 the depth not closer than 2" from the top or bottom. Notches are different. 22. Dryer duct transition is limited to 8' of aluminum flex and must be exposed. 780 CMR M1502.4.3 23. Dryer duct maximum equivalent length is 25' or per manufacturer's specs. 780 CMR M1502.4.4.1, no screwed connections. 24. Markup air is required for any exhaust hood of 400 CFM or more. 780 CMR M1503.4 25. Fireplaces require all combustion air be provided from the exterior and below the firebox, duct work maintaining 1" clearance for 5' from the duct outlet for all fireplaces 26. Fire and draft stopping shall be completed before rough inspection. 780 CMR R302. 27. Ignition barriers in place before final. 780 CMR R316. City of Northampton 4 Massachusetts * r j T DEPARTMENT OF BUILDING INSPECTIONS ` +P'" 212 Main Street • Municipal Building .mom Northampton, MA 01060 INSPECTOR Robert and Suzanne Chambers October 15, 2012 211 North Farms Road Florence, MA 01062 Subject Location: 211 North Farms Road Map Block: 12 -002 Ms. and Mr. Chambers, Your plans last dated 5 -7 -12 have been approved as noted and per memo. Please follow up on the following items: 1. Northampton is a stretch energy code community therefore a HERS rating is required. a. Any air permeable insulation must be in a sealed cavity, accentually air tight from both sides. The exterior portion is required to be accomplished before rough inspection. b. All penetration in the ceiling must be sealed before attic insulation is installed; an air sealing inspection is required. c. Window must be Energy Star. d. Insulation must be meet current standards, R -38 ceilings, R -20 walls, R -30 floors typical. 2. Two rear and one front window flanking the exit doors must be tempered. 3. A beam is required at the front entry for roof and ceiling loads. 4. All new point loads must have adequate bearing on footings sized to spread the loads. As of August 4 2011 the 8 Edition MA code is the 2009 IRC with MA amendments. In the following are some generic requirements which seem to be problematic. This is not intended to be comprehensive, nor is it a substitute for purchasing and reading the MA codes. 1. Structures shall conform to 780 CMR 8 Edition 1 and 2 family building codes with MA amendments. 2. Grading plan for structures being constructed required. 780 CMR R401.3 for drainage requirements. 3. A basement drainage system is required in all basements 780 CMR R405.2.3. except those in group I soils (table R405.1) 4. Foundations that retain earth and enclose interior space require damp proofing 780 CMR R406.1. 5. Through wall form ties must be removed from both faces and patched with hydraulic cement. 780 CMR R406.2 of amendments. 6. Foundation anchor bolts must be 1/2" and be embedded a minimum of 7" into the concrete. 10" bolts! 780 CMR R403.1.6 7. CMU foundations require 3/8" parging before damp proofing. 780 CMR R406.1 see exceptions. 8. Emergency escape is required out of every basement whether habitable or not. 780 CMR R310.1 9. Ceiling joist are intended to prevent spread, once raised above the wall plate they become rafters ties and may require up sizing of rafters and increased nailing for example with a 4" slope 8 -16nd common are required at each connection. 780 CMR R802.3.1. When there is neither of these a structural ridge is required with a load path to the foundation. 10. Steel straps over the ridge or 1x4 minimum collar ties are required 4' OC in the upper 1/ 1 780 CMR R802.3.1 11. Ridge boards must be the full depth of the cut. 780 CMR R802.3. 12. A complete window and header schedule is required. 780 CMR Table R502.5 for header sizing and number of jack studs required. \\\ teL 1 -cyoia - 1/ 4 e yfrapy 01 3 , )74.5 0-) •Y`87)4V-1-1.0 • 10- 3 -12 Key Be rF 1:42pm loft KeyBeam® 4.600c kmBeamEngine 4.600g Materials Database 1369 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: None Standard Load: Moisture Condition: Dry Building Code: IBC /IRC Dead Load: 10 PLF Deflection Criteria: L/360 live, L/240 total 1.250" max. LL Live Load: 40 PLF Deck Connection: Nailed Member Weight: 14.0 PLF Filename: KYB1 Other Loads Type Trib. Dead Other (Description) Side Begin End Width Start End Start End Category Replacement Uniform (PSF) Top 0' 0.00" 13' 6.00" 12' 0.00" 17 31 Snow 13 6 0 0 13 6 0 Bearings and Reactions Input . Min Gravity Gravity. Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall N/A N/A 1.500" 4026# -- , 2 13' 7.750" Wall N/A N/A . 1.500" 4026# -- Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Snow 1 1487# 2538# 2 1487# 2538# Design spans 13' 7.750" Product: 1- 3/4x9 -1/2 VERSA -LAM 2.0 3100 SP 3 ply PASSES DESIGN CHECKS Connect members with 2 rows of 16d common nails at 12.0" oc NOTE: Nails must be applied from both sides • Minimum 1.50" bearing required at bearing # 1 Minimum 1.50" bearing required at bearing # 2 Design assumes continuous lateral bracing along the top chord. Design assumes no lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 13733.'# 25040.'# 54% 6.82' Total load D +S Shear 3558.# 10898.# 32% 0.01' Total load D +S TL Deflection 0.6136" 0.6823" L/266 6.82' Total load D +S LL Deflection 0.3869" 0.4549" L/423 6.82' Total load S Control: TL Deflection DOLs: Live =100% Snow=115% Roof =125% Wind =160% Design assumes a repetitive member use increase in bending stress: 4 % All product names are trademarks of their respective owners ;;k Copyright (C)1987 -2012 by Keymark Enterprises, LLC. ALL RIGHTS RESERVED. n w Msc.. ui "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. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub - contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self - insured companies should enter their self- insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit /license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Depai talent of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114 -2017 Tel. # 617 -727 -4900 ext 406 or 1- 877- MASSAFE Revised 7 -2010 • , Fax # 617 -727 -7749 www.mass.gov /dia N, The Commonwealth of Massachusetts Print Forrn ' u Department of Industrial Accidents , t - r � = Office of Investigations i ," T 1 Congress Street, Suite 100 ' i , z« `` Boston, MA 02114 -2017 ", ,' - ��... -- www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information // Please Print Le Name ( Business /Organization/Individual): (��o , GYt Address: oZ / N &vf / d City /State /Zip: f 7 e- 01 0c i- Phone #: (-(( S KSS Are you an employer? Check the appropriate box: Type of project (required): 1. n I am a employer with 4. IV I am a general contractor and I employees (full and /or part-time).* hay e hired the sub contractors_ - . _ 6. I I New construction listed on the attached sheet. 7. n Remodeling 2. H I am a sole proprietor or partner- ship and have no employees These sub- contractors have g. I I Demolition working for me in capacity. employees and have workers' g any p y comp. insurance.$ 9 • n Building addition [No workers' comp. insurance p' 10.(n Electrical repairs or additions required.] 5. El We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their 11.n Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.11 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.n 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 foiun 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 under the gains and . 'nalties ofperjufy that the information provided above is true and correct Signature: ' ,A._,' t j Date: ` (a S' -// L Phone #: t ( t 3 -C S S -F Official use only. Do not write in this area, to be completed by city or town official 11 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. ed o iel L • Goa = a • Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone — SECTION 10- WORKERS' COMPENSAT N INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) Workers Compensation Insurance affid vit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buil ing 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-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 Z nin and State of Massachusetts General Laws Annotated. Homeowner Signature Gam'( ,444 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition Replacement Windows Alteration(s) J Roofing Or Doors pa Accessory Bldg. ❑ Demolition El New Signs [D] Decks [D Siding [DI Other [Dj Brief Desc ' tion of Proposed / o ,,. Work: rfi vhouzi �lcV otrtl.v.`f� .vac✓ vuc, �ilriv'c" c[4v a-4-1 t �,+�'' / Alteration of existing bedroom Yes _ No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes .k N6 Plans Attached Roll - heet 6a. If New house and or addition to existing housing. complete the following: a. Use of building : One Family k Two Family Other b. Number of rooms in each family unit: (v Number of Bathrooms c. Is there a garage attached? CZV�pvf d. Proposed Square footage of new construction. 2 O S Dimensions /b X 4 e. Number of stories? f. Method of heating? /ix (:„i o Fireplaces or Woodstoves /.1 Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction (,),fuzi np lS�lchc i. Is construction within 100 ft. of wetlands? Yes A No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade 41,/- k. Will building conform to the Building and Zoning regulations? ,k Yes No . I. Septic Tank .k City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , 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 a are e s atements 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 Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size f . f � cc v . f14/ 4' C(, -c Frontage j 4 S qq Lit Setbacks Front Side L: R: L: R: Rear Building Height I; f/ t Bldg. Square Footage w % Open Space Footage % (Lot area minus bldg & paved ?b> parking) 7 # of Parking Spaces Z 2 Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO e IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. i ._.. uvteu uuwt uaw v {� City of Northampton Status of permit �� i - 5 Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /SepticAvailability L D_ INSP Room 100 Water NVell Avallabtiity, NORTHAMPTON lNgpi Northampton, MA 01060 Two S of Structural Plans phone 413 587 - 1240 Fax 413 - 587 - 1272 PlottSi Plan 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 r r / PO 2, Map Lot Unit Zone Overlay District cam- O[ ao L Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: e u .1 C 642- I- 1-1 / /J � AS 1 4/ei-tee / 0/ 04;2_ Name (Print) Current Mailing Address: /�s 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 3 7 / 75 _ (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of C i7Z Construction from (6) 3. Plumbing �- Building Permit Fee 4. Mechanical (HVAC) 7 3 e 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Cf 3 Check Number ./ , 5"'3 This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2013 -0397 ff6, APPLICANT /CONTACT PERSON CHAMBERS ROBERT A & SUZANNE F kg-A/ "- ADDRESS/PHONE 211 NORTH FARMS RD FLORENCE (413) 584 -5568 0 r PROPERTY LOCATION 211 NORTH FARMS RD MAP 12 PARCEL 002 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out / / i ea- Fee Paid `� O Typeof Construction: DEMO CARPORT,CONSTRUCT SCREEN PORCH,STORAGE,ENTRY & EXTEND DINING RM 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO,RMATION 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 - molitio P - la • .40 Si .re 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. 211 NORTH FARMS RD BP- 2013 -0397 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 12 - 002 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 -0397 Project # JS- 2013 - 000641 Est. Cost: $43050.00 Fee: $258.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 84506.40 Owner: CHAMBERS ROBERT A & SUZANNE F Zoning: Applicant: CHAMBERS ROBERT A & SUZANNE F AT: 211 NORTH FARMS RD Applicant Address: Phone: Insurance: 211 NORTH FARMS RD C413) 584 -5568 0 FLORENCEMA01062 ISSUED ON:10/15/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: DEMO CARPORT,CONSTRUCT SCREEN PORCH,STORAGE,ENTRY & EXTEND DINING RM 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: FeeTvpe: Date Paid: Amount: Building 10/15/2012 0:00:00 $258.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner