24A-202 (3) Energy
t . 2009 1ECC , -- Efficiency Certificate
$ .._ ." '`' ms;
Ceiling / Roof 46.00
Wall 15.00
Floor / Foundation 34.50
Ductwork (unconditioned spaces):
C'; F, i a t.'...-;,',..::,..! - F t
Window 0.31 0.27
Skylight 0.42 0.22
Door 0.30 0.18
Heating System: _
Cooling System:
Water Heater:
Name: Date:
Comments:
• HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R -3.
Swimming Pools:
D Heated swimming pools have an on /off heater switch.
❑ 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.
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:
D 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:
❑ 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:
• 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: Mc grath Report date: 10/22/12
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� 1
(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.
(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:
D Materials and equipment are installed in accordance with the manufacturer's installation instructions.
• 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.
Y .
Duct Insulation:
❑ 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:
❑ Building framing cavities are not used as supply ducts.
D 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).
❑ Duct tightness test has been performed and meets one of the following test criteria:
(1) Postconstruction leakage to outdoors test: Less than or equal to 8 cfm per 100 ft2 of conditioned floor area.
(2) Postconstruction total leakage test (including air handler enclosure): Less than or equal to 12 cfm per 100 ft2.
(3) Rough -in total leakage test with air handler installed: Less than or equal to 6 cfm per 100 ft2 of conditioned floor area.
(4) Rough -in total leakage test without air handler installed: Less than or equal to 4 cfm per 100 ft2 of conditioned floor area.
Temperature Controls:
• 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.
LI 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:
D Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code.
• 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:
D Circulating service hot water pipes are insulated to R -2.
D 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:
Project Title: Mc grath Report date: 10/22/12
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� A
Comments: rear bed
❑ Window: 05: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments: m bedroom egress
❑ Window: 04: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310
For windows without labeled U- factors, describe features:
#Panes Frame Type ,Thermal Break? Yes No
Comments: awning
❑ Window: 02: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments: kitchen
❑ Window: 07: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments: qew bath shower
Skylights:
❑ Skylight: vellux: Wood Frame, Double Pane with Low -E, U- factor: 0.420
For skylights without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Doors:
❑ double french door: Glass, U- factor: 0.300
Comments: full lite double, french
❑ Door: single: Solid, U- factor: 0.270
Comments: 1/4 lite entry
Floors:
❑ Floor 1: Steel Frame, 16" o.c., 2x10, Over Unconditioned Space, R -30.0 cavity + R -4.5 continuous insulation
Comments: existing floors( 4" rigid under slab)
Floor insulation is installed in permanent contact with the underside of the subfloor decking.
❑ Floor 2: Slab- On- Grade:Heated, 4.0' insulation depth, R -20.0 continuous insulation
Comments: rear garage addition 4" rigid
Slab insulation extends down from the top of the slab to at least 4.0 ft. OR down to at least the bottom of the slab then horizontally for a
total distance of 4.0 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 /doorjambs 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:
_ ,
Project Title: Mc grath s W � �� � Report date: 10/22/12
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REScheck Software Version 4.4.3
Inspection Checklist
_-- f
Energy Code: 2009 IECC
Location: Northampton, Massachusetts
Construction Type: Single Family
Project Type: Addition /Alteration
Heating Degree Days: 6404
Climate Zone: 5
Ceilings:
❑ Ceiling 1: Steel Joist/Rafter, 16" o.c., 2x6, R -23.0 cavity + R -23.0 continuous insulation
Comments: kitchen ceiling existing
❑ Ceiling 2: Steel Joist/Rafter, 16" o.c., 2x6, R -23.0 cavity + R -23.0 continuous insulation
Comments: bath/ bedrooms /dining room existing
❑ Ceiling 3: Steel Joist /Rafter, 16" o.c., 2x12, R -46.0 cavity insulation
Comments: valuted living area ceiling
❑ Ceiling 4: Steel Joist/Rafter, 16" o.c., 2x6, R -23.0 cavity + R -23.0 continuous insulation
Comments: new construction rear garage addition
Above - Grade Walls:
❑ Wall 1: Wood Frame, 16" o.c., R -15.0 cavity insulation
Comments: east wall existing ( modified)
❑ Wall 2: Wood Frame, 16" o.c., R -15.0 cavity insulation
Comments: short wall existing ( modified)
❑ Wall 3: Wood Frame, 16" o.c., R -15.0 cavity insulation
Comments: east wall existing
❑ Wall 4: Wood Frame, 16" o.c., R -15.0 cavity insulation
Comments: north wall existing
❑ Wall 5: Wood Frame, 16" o.c., R -15.0 cavity insulation
Comments: west wall existing
❑ Wall 6: Wood Frame, 16" o.c., R -15.0 cavity insulation
Comments: garage wall (1hr)
❑ Wall 7: Wood Frame, 16" o.c., R -23.0 cavity insulation
Comments: new construction 2 x 6 garage wall (1 hr)
❑ Wall 8: Wood Frame, 16" o.c., R -23.0 cavity insulation
Comments: new construction south wall 2 x 6
❑ Wall 9: Wood Frame, 16" o.c., R -23.0 cavity insulation
Comments: new construction east wall 2 x 6
Windows:
❑ Window: 06: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments: fixed w/ awning below
❑ Window: 01: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Project Title: Mc grath Report date: 10/22/12
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Name - Title Signature Date
A •
Project Title: Mc grath Report date: 10/22/12
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REScheck Software Version € 4. 4.3
l ki ‘. .( 1,: Compliance Certificate
Project Title: Mc grath
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:
49 Murphy Terrace John Landry John Landry
Northampton, MA 01060 Route 9 Design and Build Route 9 Design and Build
104 North Elm Street 104 north Elm Street
Northampton, MA 01060 Northampton, MA 01060
(413) 587 3050 (413) 587 3050
john @route9designbuild.com john @route9designbuild.com
m k � r'�"i�'t��ea 4'.�3.;�°�,"� ��, ��� ��•} ,�"....a3. e ag'�i ,dy�� �� w . . 2 fit �.�.. Y ... �., �. ae .. .
Compliance: 4.5% Better Than Code Maximum UA: 449 Your UA: 429
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.
Assembly Area tale " R k Door
Ceiling 1: Steel Joist/Rafter, 16" o.c., 2x6 182 23.0 23.0 4
Ceiling 2: Steel Joist/Rafter, 16" o.c., 2x6 527 23.0 23.0 13
Ceiling 3: Steel Joist/Rafter, 16" o.c., 2x12 187 46.0 0.0 6
Skylight: vellux: Wood Frame, Double Pane with Low -E 15 0.420 6
Ceiling 4: Steel Joist/Rafter, 16" o.c., 2x6 307 23.0 23.0 7
Wall 1: Wood Frame, 16" o.c. 148 15.0 0.0 1
Window: 06: Vinyl Frame, Double Pane with Low -E 99 0.310 31
double french door: Glass 40 0.300 12
Wall 2: Wood Frame, 16" o.c. 16 15.0 0.0 1
Wall 3: Wood Frame, 16" o.c. 188 15.0 0.0 13
Window: 01: Vinyl Frame, Double Pane with Low -E 13 0.310 4
Wall 4: Wood Frame, 16" o.c. 189 15.0 0.0 14
Window: 05: Vinyl Frame, Double Pane with Low -E 6 0.310 2
Wall 5: Wood Frame, 16" o.c. 304 15.0 0.0 19
Window: 04: Vinyl Frame, Double Pane with Low -E 16 0.310 5
Window: 02: Vinyl Frame, Double Pane with Low -E 20 0.310 6
Door: single: Solid 20 0.270 5
Wall 6: Wood Frame, 16" o.c. 133 15.0 0.0 10
Wall 7: Wood Frame, 16" o.c. 123 23.0 0.0 7
Wall 8: Wood Frame, 16" o.c. 160 23.0 0.0 9
Window: 07: Vinyl Frame, Double Pane with Low -E 5 0.310 1
Wall 9: Wood Frame, 16" o.c. 123 23.0 0.0 7
Floor 1: Steel Frame, 16" o.c., 2x10, Over Unconditioned Space 918 30.0 4.5 55
Floor 2: Slab -On- Grade:Heated 300 20.0 191
Insulation depth: 4.0'
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 4.4.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Project Title: Mc grath Report date: 10/22/12
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The Commonwealth of Massachusetts
. Department of Industrial Accidents
rs , Office of Investigations
_= 600 Washington Street
4 i!
. , :. Boston, MA 02111
;1'" www.mass gov /dia
Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers
Applicant Information Please Print Legibly
Name (Business /Organization/Individual): L.,'4 q . F ' - r E. K. _
Address: /D t( Dl.4741,... 6f 0, Ore F F
City /State /Zip: p , i N 0/0k Phone #: W3 - 7 -j i sd
Are u an employer? Check the a'iol propriate box: Type of project (required):
I. j I am a employer with ti 4. ❑ I am a general contractor and I 6. ❑ New construction
employees (full and/or part- time).* have hired the sub contractors
listed on the attached sheet. 7. IRK
2. ❑ I am a sole proprietor or partner
ship and have no employees These sub- contractors have g. 111 Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3. ❑ 1 am a homeowner doing all work officers have exercised their 11. ❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13. ❑ 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: ! �t 7`t° r C¢, '( I-Y'(
Policy # or Self -ins. Lic. #: 7 t»')C =5/ VO Expiration Date: i3/0 / /gyp/ 3
Job Site Address: City/State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify and r the p ins and penalties of perjury that the information provided above is true and correct
Signature: 4/'-. Date:
Phone #: C 13 5 Y! 7 31Q 6 &
I` O i Do_,� . Il
j�C.nl ,, se only. nt- wrrfn- rs� -4l+rc area, to be completed by �'�h� or t/�j?��71 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
Contact Person: Phone #:
J
SECTION 8- .CON SERVICES
t.
8.1 Licensed Construction Supervisor: . Not Applicable ❑ Cr
Name of License Holder : I off w K . I, A'N D R Y C5 ?
License Number
o 4 Y. 4i--. 3/ /
Address Expiration ate
Signature . Telephone
(413) . 0 97.3 0 50
.`Ren rs ere - o ▪ m °I -6- 'etnen ont ,. ctc ,�" -titt ; , ,r , : Not Applicable ❑
n v
4 9 A -1 I .Yu E (1 /�- c /./ /t9 3
Comp Name , Registration Number
A ddress , Expiration a te
/pop{
:__•T _ ,gyp / _)
9 "u� �0 / PM .. (e‘(J Telephone yl?- -- g 3).6
- & • wu fro �"K,w ys, i .i`' w - `i- 4 h ;6U, -its h g t a ,c..
S CTION . WORT ERS - S, TTI INSURANCE AFFIDAVIT Nf G1 c ,152, 2.50{6)) t ,. , ..
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 byg permit.
Signed Affidavit Attached Yes No ❑
ag `;
The current exemption for ". , eowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to • gage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth ' . ition Section 108.3.5.1.
Definition of Homeowner: Person (s ho 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 farm , dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more an one home in a two -vear period shall not be considered a homeowner.
Such "homeowner" shall submit to the Bunch.: Official, on a form ac eptable to the Building Official, that he /she shall be
responsible for all such work performed unde the buildint perm'
As acting Construction Supervisor yo -presen -_ • the job site ' - quired from time to time, during and upon
completion of the work for which this p:, s. it is sue.
Also be advised that with reference to C w ter 52` (Wo ers' Comp sat' • n) and Chapter 153 (Liability of Employers ( P'' ) P ( Y to P Y
Employees for injuries not resulting in D ea ) • , the Mass. usetts 'eneral Laws Annotated, you may be liable for person(s)
you hire to perform work for you under 's p s't_
The undersigned "homeowner" certifies :nd assumes responsibi • % for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State • Massachusetts General Laws Annotated.
Homeowner Signature
•
[tf,(0't
c`f t15-4A-c. i0N`. ) - 0 do6, 011,1et)s 1 4oial aii W (2.i i,..- e(utrs^, H (AT iPl
fLi0.04 hi
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ® Roofing E
Or Doors ,
Accessory Bldg. ❑ Demolition air New Signs [D] Decks [Lj Siding [D] Other [D]
Brief Description of Proposed ` � ��kiMtilh � /
Work: • . . ) , ► / . ► l * . 4 t , A. , 1 , •■
Alteration of existing bedroom ?( Yes No Adding new bedroom Yes No CLCCk1I ) (/p' e
Attached Narrative Renovating unfinished basement Yes No � h , sp L-1►o hr.W
Plans Attached Roll - Sheet •
him +erg syiefroi
sa. 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: 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? i4 w ' as Y , ' Fireplaces r Woodstoves Number of each
g. Energy Conservation Complianc:. M. check Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is constru on within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor belo finished grade
k. Will building conform to the Buildi and oning regulations? Yes N.
I. Septic Tank City Sew Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, J f 1r1( A. Mc 4 ve f /+ , as Owner of the•subject •
property
hereby authorize J b 141.1 X . 1, AN C z N(
to act • my b -half in all matters relative to work authorized by this building permit application.
1 ' / �' . __ 101 - - 9(NA
Sign .1 re of Owne f ate
I, Jo L- La. , as Owner /Authorized
Agent hereby declare that the stat ments 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.
,111\0.. 1. A. J
Print Name
Signature of Owned/sent / 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
t
Lot Size. ..., , _. .. .. "� a" ". "_.
1
Frontage " _._ ". _.
Setbacks Front
...- P .._..... .._
Side 1_,:i.----: L.. ".0 ....a ..,,._ ,,...3 _......I
Rear 1:
1 \ NI '
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & .. ed ......_i „__ l
parking)
# of Pa ng Spaces ..._. _.
Fill: :.._ . ;
(volume & Location) _. ,,._ _.,,,...,_ _ _. _ .,r..._
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW It YES 0
IF YES, date issued:£
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW ® YES
IF YES: enter Book Page: Document #
v.
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES ±,40
IF YES, has a permit been or need to be obtained from the Conservation Commission? — NO • INTE'ir-tort.
Needs to be obtained Obtained 0 , Date Issued: RrNO V A +1 914‘
04 t.Y.
C. Do any signs exist on the property? YES NO '4`A
IF YES, describe size, type and location: k
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO *11t
IF YES, describe size, type and location: Y
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 0 NO e r
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
r rtrn u se ,r1i
REC��' -� City of Nort hampton status of Patt
Building Departmen � ��
eGT — 9 21 Room 00 et e t � ( e t It r � ,
} 1t
.OFBUILDNNSPNS o - 587 -12rthampton, M 0 1060 Iw � �r � � pTOG�N Mik 0Et ECTIO 340 Fax 41 3- 587- 127
R l
APPLICATION TO CONSTRUCT, A REPAIR, RENOVATE OR D EM O LIS H A ONE OR TW FAMILY DWE LLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: T his section to be Completed by office
a M N R Y TER-. Map Lot unit
Nor 4 M P 47N M iD J 6 6 Zone Overlay District
Elm St. Distric CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: �a p $ 13
ti�� % 1 � � cam L W ec - S � r i N 1 �i eL/1 i MA 0104D
Name (Print) Current Mailing A dress
ip._:. _ �Ka 4/� • 4 3 3 • !6 2
Telephone Sign J jy f - (
e
1 ,4 34 t4
2.2 Authorized Agent:
�p�F�l L �wp� Y / a. ELM 4r.
WO Y #h�14 r --
Name (Print) Current Mailing Address:
•
i° '1 I3• td 7 3 0 6' p
Signatur:. Telephone
SECTI 3 - ESTIMAT D CONSTRUCTION TS
Item Estimated COS Cost (Dollars) to be Off Use Only
completed by Hermit applicant
0
1. Building
�
zj T/ (a) Building Permit Fee
2. Electrical ll r � (b) Estimated Total Cost of
Construction from (6)
3. Plumbing / ov0 Building Pe rmit Fee 4j' (y or()
4 Mechanical (HVAC) oKlG. V 5 . 0 -
5 Fire Protection i�v ,- t J ( �,v
6. Total = (1 + 2 + 3 + 4 + 5) ( �O � Check Number 1.571'1‘
This Section For Officia
I Use Only
Date
Building Permit Number: Issued
A
Signature:
Building Commissioner /Inspector of Buildings Date
r
File # BP- 2013 -0422
APPLICANT /CONTACT PERSON JOHN LANDRY
ADDRESS/PHONE 104 NORTH ELM ST NORTHAMPTON (413) 204 -9880
PROPERTY LOCATION 49 MURPHY TER
MAP 24A PARCEL 202 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin. Permit Filled out , i , rAall O i iW ►r't ir/f •
Fee Paid , r '
Typeof Construction: . - 0 OWS,DOORz .
New Construction ,
Non Structural interior renovations li / .I/VII. _ G , ;f/ 1 "�
Addition to Existin!. - .
Accesso Structure "V74T� ,,, . ��'f"�I'T1'�. d k, A _, ,
Building Plans Included: ' ' i / - - / /
Owner/ Statement or License 093450 ` i�7■44 .4 ,4 0L �
3 sets of Plans / Plot Plan
TH OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF RMATION PRESENTED:
o
A pproved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission _Permit DPW Storm Water Management
Demolition Delay
/ / 0 z / ?,,
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.
49 MURPHY TER BP- 2013 -0422
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24A - 202 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 -0422
Project # JS- 2013- 000493
Est. Cost: $60000.00
Fee: $360.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN LANDRY 093450
Lot Size(sq. ft.): 8886.24 Owner: MCGRATH NORICE
Zoning: URB(100)/ Applicant: JOHN LANDRY
AT: 49 MURPHY TER
Applicant Address: Phone: Insurance:
104 NORTH ELM ST (413) 204 -9880 WC
NORTHAMPTONMA01060 ISSUED ON:10/23/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:INTERIOR RENOVATIONS DOORS WINDOWS
WIRING PLUMBING HEATING ROOFING INSULATION
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 10/23/2012 0:00:00 $360.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner