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28. 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
29. Fire and draft stopping shall be completed before rough inspection. 780 CMR R302.
30. Ignition barriers in place before final. 780 CMR R316.
31. 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
32. 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.
f. All band joist insulation must be enclosed within an air tight cavity, which you must create.
33. 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.
34. Unvented attic assemblies. Hot roofs are allowed, but have specific requirements 780 CMR R806.4.
35. 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.
36. Smoke and CO detectors as required. 780 CMR R314 and R315.
a. Smokes in each bedroom, within 10' of a bedroom door.
b. CO within 10' of bedroom doors, at each level, at the bottom of a stair leading to a finished floor
above, for every 1500 sqft, (plumbing code in the mechanical room) Except if there are no fossil
burning fuels.
c. Heat detector in attached garage, and other large unfinished unconditioned spaces.
37. Closets beneath stair which have doors must be drywalled with % ". 780 CMR R302.7
38. 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.
Relevant items must be submitted to the building department for approvals before inspections and or
Certificates of Occupancy can be issued.
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: cmiller(c�northamptonma.gov
Thank you fo peration on these matters.
Chuck Mi er
City of Northampton
Assistant Commissioner and Zoning Enforcement
14. All framing materials which are not code prescriptive must have stamped engineering.
a. LVLs
b. I -joist and or Floor Truss
c. Roof truss
15. A braced wall plan identifying appropriate braced wall areas where required (R301.1) 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.
c. When using PFH (R602.10.3.3) or PFG (R602.10.3.4) the nailing requirement is 4" and 3"
respectively using 8d common nails or galvanized box nails.
16. When nailing sheathing make sure your pneumatic nailer's pressure is properly set. Nails set too deep,
essentially perforate the sheathing weakening it and contribute to building damage in high wind events.
17. 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
18. 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
19. Windows over 72" above grade with the opening Tess than 24 above the finished floor shall meet the 4"
sphere rule. Order restrictors. 780 CMR R612.2
20. 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 1 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 /" from
the top of the threshold and only in- swinging doors. 780 CMR R311.3
21. 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 %" minimum and 2" maximum rail, height minimum 34" maximum 38 ", required for4 or
more risers. Landing to landing constitutes a new run. Minimum 6'8" ceiling height from nosing. 780
CMR R311.7.
22. 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.
23. 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, or holes
in joist are a maximum 1/3 the depth not closer than 2" from the top or bottom or to any other hole.
Notches are different.
24. Drilling or notching of more than 50% of the wall plate width of an exterior wall or load bearing partition
requires a 16 GA 1 'A" strap across the area and 6" beyond each side with 8 - 10nd nails. 780 CMR
R602.6.1
25. Dryer duct transition is limited to 8' of aluminum flex and must be exposed. 780 CMR M1502.4.3
26. Dryer duct maximum equivalent length is 25' or per manufacturer's specs. 780 CMR M1502.4.4.1, no
screwed connections.
27. Markup air is required for any exhaust hood of 400 CFM or more. 780 CMR M1503.4
City of Northampton
Massachusetts - `fir
G . ' DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
a Northampton, MA 01060 "J. SeYt
INSPECTOR
Mr. Bushey April 5, 2012
16 Cooke Avenue
Northampton, MA 01060
Subject Location: 16 Cooke Avenue
Map Block: 18C -031
Mr. Bushey,
Your building permit application and plans dated 4 -5 -13 have been approved as drawn and per this memo.
All work must meet all applicable codes whether noted or not included within this memo.
Please follow up on the following items:
These items will need to be accomplished as the project moves forward and before rough inspections;
1. Copy of plans in electronic format.
2. Stamped engineering for all non prescriptive materials and or systems. (LVLs)
3. A structural ridge is required and the load paths must be continuous to bearing points.
As of August 4th 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.
Read only international codes are available on line at http : / /publicecodes.cvberregs.com /icod/ one
must also consider the MA amendments to these codes which can be found at www.mass.gov /dps /bbrs
The current relevant building codes are:
2009 IBC, 2009 IEBC, 2009 IMC, 2009 IRC, 2009 IECC, AA115, MA amendments.
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 %" and be embedded a minimum of 7" into the concrete. 10" bolts!
780 CMR R403.1.6
7. Foundation walls require horizontal reinforcement 2 #4 bars one within 12" of the top and one in the
middle if 8' or less and 3 #4 bars at top and 3rds if over 8'. 780 CMR R404.1.2(1). Also see vertical
reinforcements requirements.
8. CMU foundations require 3/8" parging before damp proofing. 780 CMR R406.1 see exceptions.
9. Emergency escape is required out of every basement whether habitable or not. 780 CMR R310.1
10. 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.
11. Steel straps over the ridge or 1x4 minimum collar ties are required 4' OC in the upper 1 /3rd 780 CMR
R802.3.1
12. Ridge boards must be the full depth of the cut. 780 CMR R802.3.
13. A complete window and header schedule is required. 780 CMR Table R502.5 for header sizing and
number of jack studs required.
Load Short Form Job:
4 wrightsoft Date:
NEW ADDITION By: Dave Lampron
All Seasons Heating & Air Conditioning
31 School Street. Hatfield, Ma Phone: 413 - 247 -9842
■
Project Information
For: BUSHY RESIDENTS
Design Information
Htg Clg Infiltration
Outside db ( °F) 0 87 Method Simplified
Inside db ( °F) 70 75 Construction quality Average
Design 1D ( °F) 70 12 Fireplaces 0
Daily range - M
Inside humidity ( %) 30 50
Moisture difference (gr /Ib) 28 24
HEATING EQUIPMENT COOLING EQUIPMENT
Make n/a Make n/a
Trade n/a Trade n/a
Model n/a Cond n/a
AHRI ref n/a Coil n/a
AHRI ref n/a
Efficiency n/a Efficiency n/a
Heating input Sensible cooling 0 Btuh
Heating output 0 Btuh Latent cooling 0 Btuh
Temperature rise 0 °F Total cooling 0 Btuh
Actual air flow 0 cfm Actual air flow 0 cfm
Air flow factor 0 cfm /Btuh Air flow factor 0 cfm /Btuh
Static pressure 0 in H2O Static pressure 0 in H2O
Space thermostat n/a Load sensible heat ratio 0
ROOM NAME Area Htg load Clg load Htg AVF Clg AVF
(PP) (Btuh) (Btuh) (cfm) (cfm)
NEW MASTER BED 360 19061 5978 268 320
FAMILY ROOM 323 12457 3350 175 179
NEW ADDITION p 683 31518 9328 444 499
Other equip loads 0 0
Equip. @ 0.92 RSM 8582
Latent cooling 1199
TOTALS l 683 I 31518 1 9781 I 444 1 499
Calculations approved by ACCA to meet all requirements of Manual J 7th Ed.
2013 - Mar -23 09:19:04
z-, wrightsoft Right - Suite® Universal 2012 12.0.11 RSU17313 Page3
4. -A ...bean \Documents \Wrightsoft HVAC\All Seasons BUSHY RESIDENTS.rup Calc = MJ7 Front Door faces:
Load Short Form Job:
4 wrightsoft Date:
EXISTING HOME By: Dave Lampron
All Seasons Heating & Air Conditioning
31 School Street, Hatfield, Ma Phone: 413-247 -9842
Project Information
For: BUSHY RESIDENTS
Design Information
Htg Clg Infiltration
Outside db ( °F) 0 87 Method Simplified
Inside db ( °F) 70 75 Construction quality Average
Design TD ( °F) 70 12 Fireplaces 0
Daily range - M
Inside humidity ( %) 30 50
Moisture difference (gr /Ib) 28 24
HEATING EQUIPMENT COOLING EQUIPMENT
Make n/a Make n/a
Trade n/a Trade n/a
Model n/a Cond n/a
AHRI ref n/a Coil n/a
AHRI ref n/a
Efficiency n/a Efficiency n/a
Heating input Sensible cooling 0 Btuh
Heating output 0 Btuh Latent cooling 0 Btuh
Temperature rise 0 °F Total cooling 0 Btuh
Actual air flow 0 cfm Actual air flow 0 cfm
Air flow factor 0 cfm /Btuh Air flow factor 0 cfm /Btuh
Static pressure 0 in H2O Static pressure 0 in H2O
Space thermostat n/a Load sensible heat ratio 0
ROOM NAME Area Htg load Clg load Htg AVF Clg AVF
(ft (Btuh) (Btuh) (cfm) (cfm)
MUDROOM 133 4191 969 59 52
KITCHEN 253 7672 1921 108 103
BATH1 48 957 130 13 7
BATH 2 48 957 130 13 7
HALL 36 565 65 8 3
SITTING ROOM 108 1696 196 24 10
LIVING ROOM 240 8791 2411 124 129
EXISTING HOME p 866 24830 5823 350 311
Other equip loads 0 0
Equip. @ 0.92 RSM 5357
Latent cooling 576
TOTALS I 866 I 24830 I 5933 1 350 I 311
Calculations approved by ACCA to meet all requirements of Manual J 7th Ed.
2013-Mar -23 09:19:04
...., wrightsoft Right - Suite® Universal 2012 12.0.11 RSU17313 Page 2
$. ' ...bean \Documents \wrightsoft HVACNAII Seasons BUSHY RESIDENTS.rup Calc = MJ7 Front Door faces:
4 wrightsoft Load Short Form Da
Entire House By: Dave Lampron
All Seasons Heating & Air Conditioning
31 School Street, Hatfield, Ma Phone: 413 - 247 -9842
Project Information
For: BUSHY RESIDENTS
Design Information
Htg Clg Infiltration
Outside db ( °F) 0 87 Method Simplified
Inside db ( °F) 70 75 Construction quality Average
Design TD ( °F) 70 12 Fireplaces 0
Daily range - M
Inside humidity ( %) 30 50
Moisture difference (gr /Ib) 28 24
HEATING EQUIPMENT COOLING EQUIPMENT
Make Make
Trade Trade
Model Cond
AHRI ref Coil
AHRI ref
Efficiency 80 AFUE Efficiency 0 SEER
Heating input 0 MBtuh Sensible cooling 0 Btuh
Heating output 0 Btuh Latent cooling 0 Btuh
Temperature rise 0 °F Total cooling 0 Btuh
Actual air flow 793 cfm Actual air flow 793 cfm
Air flow factor 0.014 cfm /Btuh Air flow factor 0.053 cfm /Btuh
Static pressure 0 in H2O Static pressure 0 in H2O
Space thermostat Load sensible heat ratio 0.89
ROOM NAME Area Htg load Clg load Htg AVF Clg AVF
(ft (Btuh) (Btuh) (cfm) (cfm)
NEW ADDITION p 683 31518 9328 444 499
EXISTING HOME p 866 24830 5823 350 311
Entire House d 1549 56348 14832 793 793
Other equip loads 0 0
Equip. @ 0.92 RSM 13645
Latent cooling 1775
TOTALS I 1549 I 56348 I 15420 I 793 1 793
Calculations approved by ACCA to meet all requirements of Manual J 7th Ed.
-{`�'. 2013 - Mar -23 09:19:04
wrightsoft Right - Suite® Universal 2012 12.0.11 RSU17313 Page 1
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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 ,
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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 appurtenanX thereto shall not because of such employment be deemed to bean 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 your insurance company's name, address and phone number along with a certificate 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). 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
Department 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
Fax # 617 -727 -7749
www.mass.govidia
Form Revised 7/2010
',. The Commonwealth of Massachusetts
Department of Industrial Accidents
y �. Office of Investigations
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;. ,,,, a , ,� 1 Congress Street, Suite 100
,e Boston, MA 02114 -2017
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: General Businesses
Applicant Information Please Print Legibly
Business /Organization Name: Allt , v , • e
Address: J (p a to Ave
City /State /Zip: No /n4 6Jddhone #: y/3 -sYy-79f
Are you an employer? Check the appropriate box: Business Type (required):
1. ❑ I am a employer with employees (full and/ 5. ❑ Retail
or part- time).* 6. ❑ Restaurant/Bar /Eating Establishment
2.2,,1 I am a sole proprietor or partnership and have no + 7. ❑ Office and/or Sales (incl. real estate, auto, etc.) i
employees working for me in any capacity.
[No workers' comp. insurance required] 8. El Non-profit
3. ❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152, § 1(4), and we have 10. ❑ Manufacturing
no employees. [No workers' comp. insurance required] **
11.0 Health Care
4. ❑ We are a non - profit organization, staffed by volunteers,
with no employees. [No workers' comp. insurance req.] 12.0 Other ANI # OtoWG>e-
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
* *If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an
organization should check box #1.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy information.
Insurance Company Name:
Insurer's Address:
City /State /Zip:
Policy # or Self -ins. Lic. # Expiration Date:
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 certif ,
g under the pain and enaltie of perjury that the information provided above is true and correct.
Signature: 1 oYU,tAQ ( Date: 3 J ( o
1
Phone #: y/ 3 — 587 — MIS , Ce // y/ -55. - ?D
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. Licensing Board 5. Selectmen's Office
6. Other
Contact Person: Phone #:
www.mass.gov /dia
S a
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : _
License Number
Address Expiration Date
Signature ' Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes ❑ No ❑
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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 Local Zoning Laws and State of Massachusetts General Laws Annotated.
111:re,Ai&idiRI
Homeowner Signature
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SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing j
Or Doors a
Accessory Bldg. ❑ Demolition El New Signs [D] Decks [EJ Siding [1811 Other [0]
Brief Description of Proposed •
Work: •Tt2 ADD 1$187 ADD iv ?U emsrt Otr 600V FROs r 2.1%, nnubia Be.D "^
Alteration of existing bedroom Yes ✓ No Adding new bedroom - r Yes No
Attached Narrative Renovating unfinished basement Yes II No
Plans Attached Roll If Sheet
ga. If New house and or addition to existing housing. complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms a�
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c. Is there a garage attached? 7I' • '
d. Proposed Square footage of new construction. (Pcl Dimensions 1$ 1-37
e. Number of stories? AN:3% e
f. Method of heating? 01 Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. 410 s� Aid Masscheck Energy Compliance form attached?
h. Type of construction AMA (AFJCjr*
i. Is construction within 1 ft. of wetlands? Yes '/No. Is construction within 100 yr. floodplain Yes V No
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j. Depth of basement or cellar floor below finished grade ( rs r 7
k. Will building conform to the Building and Zoning regulations? Y Yes No .
I. Septic Tank City Sewer ✓ Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
, 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
1, 71% o \ ,LS lr , as Owner /Authorized
Agent hereby declare that the statements and info ation on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
7 - 6 orv,(4.6 G- g e,?
Print Name
►DV1AMd R1.444 3 - // • ,gyp /. 3 t
Signature of Owner /Agent Date
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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 0 23, L3 y aL, 300
Frontage cX) • l D✓v q?
Setbacks Front a3. a5
Side L: R: 102 L: R: $q
Rear eta a
Building Height oy s a
' Bldg. Square Footage ). % 3 .S
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Open Space Footage (90, 740 % de), Ono
(Lot area minus bldg & paved
parking)
# of Parking Spaces y 7
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 410 DON'T KNOW 0 YES 0 .
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 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 • DONT KNOW Q YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O 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
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.
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SNO11.O3dSNI Department use only
City of Northampton Status of Permit:
EIOZ ? Z II. Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/SepticAvailability
Room 100 Water/Well Availability
G A+3031:1 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
lb C% c a Ave Map Lot Unit
Zone Overlay District
NOg het rn pTo MR 01 0(00
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
T1,omcts G t3v5V‘e -� 1 , R CooVe \ve
Name (Print) Cg Mail tir`ss: 4433
Telephone 5$'-I
Signature
2.2 Authorized Agent:
`rh orricLs G- R 1/4A4N. eil_ i to CA:0I4e Ave
Name (Print) Current Mailing Address:
43-5$ - Mai Jedi 4 //3 , ►-'7085
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
So 000
2. Electrical (b) Estimated Total Cost of
�� (�Q Construction from (6)
3. Plumbing Building Permit Fee , 33 3
a ° 9 62 3.g
4. Mechanical (HVAC) . Ur t ,3
02 0/ 5. Fire Protection ,• g FOOD /-
6. Total = (1 +2 +3 +q +5) #( ,'7/D Check Number 4 Kam,
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2013 -0879 NS C AL
APPLICANT /CONTACT PERSON BUSHEY THOMAS G ,,�
ADDRESS /PHONE NORTHAMPTON (413) 584 -1428 Q fbv
PROPERTY LOCATION 16 COOKE AVE
MAP 18C PARCEL 031 001 ZONE SR(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
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PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out _ a � 1 l lj a-6
Fee Paid l!i/ � �A��
Typeof Construction: CONSTURCT 18 X 37 FAMILY RM, MSTR BEDROOM ADDITION
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
IN FOXVIATION PRESENTED:
j 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 Co _ .: = _ Permit DPW Storm Water Management
Demolition Delay i
A L FAVIL A
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.
16 COOKE AVE BP- 2013 -0879
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C - 031 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 -0879
Project # JS- 2013- 001504
Est. Cost: $65000.00
Fee: $466.20 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 19340.64 Owner: BUSHEY THOMAS G
Zoning: SR(100)/ Applicant: BUSHEY THOMAS G
AT: 16 COOKE AVE
Applicant Address: Phone: Insurance:
(413) 584 -1428 ()
NORTHAMPTONMA01060 ISSUED ON:4/8/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTURCT 18 X 37 FAMILY RM, MSTR
BEDROOM ADDITION
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 4/8/2013 0:00:00 $466.20
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner