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06-064 (12) 1,001" uck Miller City of Northampton Assistant Commissioner and Zoning Enforcement 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 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%2" drywall on the garage side of the separation wall and if there is a finished space above the garage all walls must have%2" 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 1/2". 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(p�northamptonma.gov Thank you for your cooperation on these matters. 13. A complete window and header schedule is required.780 CMR Table R502.5 for header sizing and number of jack studs required. 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 less 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 15t 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 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 for 4 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 %"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 City of Northampton a��aF a -ri Massachusetts a. f ' }4 I DEPARTMENT OF BUILDING INSPECTIONS ' 7 Iv 212 Main Street • Municipal Building , r �, Northampton, MA 01060 Integrity Development&Construction Inc. May 7,2013 110 Pulpit Hill Road Amherst, MA 01002 Subject Location: 71 Chestnut Avenue Ext—lot 26 Map Block: 06-064 Ms. Novey, Your building permit application and plans dated 3-25-13 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. Stamped engineering for all non prescriptive materials and or systems. 2. HERS initial and final ratings, duct blast results, and a signed Thermal Bypass Checklist. 3. A thermal covering or ignition barrier as required over the exposed basement insulation. As of August 4th 2011 the 8th 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 8th 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%2' 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. MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton,MA 01060 587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 71 Chestnut Ave.Ext—Lot 26(New Construction) 5•�c te..n f W K a f�Inquiry Made By: Anna Novey,Integrity—413-549-7919 t Date of Inquiry: 03/26/13 Number of Type of Single Family X Type of Private X Units: 1 Unit(s): Apart. Comm. Ownership: Condo Multi-family Rental (Annlicant to fill out the above) Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: X No Size of Water Main: $" Material: Ductile Iron Age: 2006 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 40 psi If done attach results Size of Service Connection 1" 3/4!7 Suggested Meter Size: t Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • Arrangements of such in . ion shall he made with the Northampton Water Department with a minimum of 5 working days -. on. A work shall•a. ..r to Northampton Water Department specifications. • [ d 4) A . David W. Sparks, Superintendent of Water Dept. Water Entry$200.00 Meter$100.00 Radio$100.00 cc: Ned Huntley,Director cc: Louis Hasbrouck,Building Commissioner Lfl, Note: If this availability is for a new construction,it must be hand delivered to the Building Inspector. , 1I smbi adn)if';PeTnii�sWater Appiicatiou'-AVatcr A�°ailabili:: dot 0 '')000 MUNICIPAL SEWER/AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton, MA 01060 587-1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 71 Chestnut Avenue Ext.—Lot#26, New Construction QQAZ. Ji-c5Okr��5 Inquiry Made By: Anna Novey, Integrity 413-549-7919 03/27/13 Date of Inquiry: Reason for Enter Into City Sewer System Request: Municipal Sewer Main in Front of Location: Yes X No Municipal Storm Drain Available: 51,4 deep Yes No Size of Sewer Main: R r( Material: 7 V Age: A/61.0 Depth of Sewer Main: Size of Service Connection: U N Type of Service Connection: Tie-in to Sanitary Main Tie-in to Sanitary Stub Comments: Note: If this avallibility is for new construction,this form must be hand delivered to Building Inspector. A corresponding`sewer entrance fee"shall be paid prior to making any connection to the municipal sewer system.Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. .lt ) [} ohn Hall ewer Department cc: Ned Huntley,Director DPW Louis Hasbrouck, Building Commissioner \ or 113\u To: Jim Lawence Subject: new home in Leeds Hi Jim, Attached are plans for the new home in Leeds we will be building. Single story, trussed roof, unfinished basement. The standard exposed heads are fine for the basement, but we'd like concealed heads in the living space. Let me know if you have any questions. Thanks, --Anna Anna Novey Project Manager Integrity Development and Construction, Inc 110 Pulpit Hill Road Amherst, MA 01002 413-549-7919 voice 413-549-7918 fax vvm/m/./ntegbuJdconn (City of Northampton E-mail is a public record except when it falls under one of the specific statutory exemptions. ) (City of Northampton E-mail is a public record except when it falls under one of the specific statutory exemptions. ) 2 Louis Hasbrouck From: Duane Nichols Sent: Thursday, March 28, 2013 1:19 PM To: Louis Hasbrouck; Fire Prevention Cc: novey @integbuild.com Subject: RE: lot 26 Chestnut Ave Extension, Leeds Lou, I am fine with issuing a permit with those conditions. Duane From: Louis Hasbrouck [mailto:lhasbrouck @northamptonma.gov] Sent: Thursday, March 28, 2013 12:48 PM To: Fire Prevention; Duane Nichols Cc: novey @integbuild.com Subject: FW: lot 26 Chestnut Ave Extension, Leeds Larry, Duane, We've received a permit for a new single family house on Chestnut Ave Ext in Leeds (Beaver Brook).The contractor has a quote from Warehouse Mechanical for a sprinkler system (attached).They won't have the system drawings for a while. Can I issue the permit with the condition that the FD permit and sprinkler plans are approved prior to the rough framing inspection? Let me know. Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413) 587-1240 From: Anna Novey [mailto:Novey @integbuild.com] Sent: Thursday, March 28, 2013 12:19 PM To: lhasbrouck @northamptonma.gov Subject: lot 26 Chestnut Ave Extension, Leeds Hi Louis, The sprinkler estimate & specifications for lot 26 Chestnut Ave Extension are attached. I hope this will be sufficient for permitting. Warehouse Mechanical will produce a drawing once we've started and I can forward that to you as soon as I receive it. Any questions, let me know! Thanks again, --Anna From: Jim Lawrence [mailto:jim @warehousemechanical.com] Sent: Tuesday, February 19, 2013 8:28 AM To: Anna Novey Subject: RE: new home in Leeds Anna, attached is our proposal. Call or e-mail me if you have any questions. Thanks From: Anna Novey [mailto:Novey @integbuild.com] Sent: Monday, February 11, 2013 3:34 PM 1 4.-) . Pi. i C!ixt of Norf1ia �tp t n =7 — t, $ -1 `�"1� _ „Sassachusetts —_ r�wa�''�?'7 DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building s,,. ° Northampton,MA 01060 LOCATION Jo)" ,..,.2 k #'l / `'5 A k 1'L9,%/-1 /110'112e7 'fi LL SQUARE FOOTAGE AMOUNT BASEMENT @ .20 ,,2376' L .CO 1ST FLOOR @.50 J 0 / • 2ND FLR @.30 -- mr 'h FLOORS, FINISH ATTIC,GARAGE @.20 / C DECK/PORCHES @ :20 4 7 6J 7'-26 TOTAL / /76-2 ) ACORD. CERTIFICATE 0 C DATE(MMIDDIYYYI) OF LIABILITY INSURANCE 04/09/2012 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED i REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). E PRODUCER CONTACT NAME: Webber & Grinnell Ins. Agency, Inc. {vHONo,Ext): 413.586.0111 (AfC,No):413. 586.6481 8 North King Street ADDRESS: Northampton, MA 01060 PRODUCER 00019640 CUSTOMER ID*: I INSURER(S)AFFORDING COVERAGE NAIC# I INSURED INSURERA: A.I.M. Mutual/A.I.M. Integrity Development and Construction, Inc. INSURERS: 110' Pul pit Hi l l Road INSURER C: Amherst, MA 01002 • INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: Master Exp 04/13 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDDF 'Y1 (MMIDDryYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES PREMISES(Ea occurrence) CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ POLICY PRO- I LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY Per person) $ • ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ i RETENTION $ $ WORKERS COMPENSATION WMZ8006224012012 04/10/2012 04/10/2013 X TORT'TA ITS X OTH AND EMPLOYERS'LIABILITY Y IN ANY PROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT $ 500 000 A OFFICER/MEMBER EXCLUDED? I N I NIA (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500,000 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,QOQI DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) • I CERTIFICATE HOLDER CANCELLATION ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /;.r.y 1�uetttde-..1 I For Information Purposes Only Cynthia Henderson, CISR/CINDY ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ' 7ze V non,wecdth cia(amlachuaeGta Office of Consumer Affairs&Busi ess Regulation *_= OME IMPROVEMENT CONTRACTOR 't'- egistration 118041 Type: �� �xpi ration: 1I2012Qt5, Private Corporatic INTEGRITY DEVELOP&CONST INC PETER JESSOP 110 PULPIT HILL RD g� AMHERST,MA 01002 Undersecretary a:: 1 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supersisor License: CS-059672 PETER W JESSOP 110 PULPIT HILL RD Amherst MA 01012 4.7-2, Expiration \1 Commissioner 06/07/2014 1 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-090514 Alk C- ANNA R NOVEY_-= -- ' 38A SUGARLOAF sr, , f South Deerfield MA 0� j , `..may,. J,•Ir-,. S - ) \ Expiration Commissioner 09/12/2014 L -- --- —" HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner." The building department for the City of Northampton wants person(s)who seek to use the home owner exemption,to act as their own construction supervisor;to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection(if required)and a final building inspection. The building department requires these inspections before the work is concealed,failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical,plumbing&gas)the homeowner will be responsible to make sure that the trades hired secure their proper hermits in conjunction to the building permit issued, and that they get their required inspections.Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location . .. . . • . , \ The Commonwealth of Massachusetts =2.--r.-- Department of Industrial Accidents Alk Wartriu=.■"1_0, Office of Investigations • 2......:--...;=,...2 600 Washington Street Boston,MA 02111 www.mass.gov/dia . . N. . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LegiblY Name(Business/Organizationandividual): \14(KV_\--) pC v....C.6p ilitf.vul 1- C(1-A54-ekt lfIC • in i U Address: it 0 p„41, ,1- i-i i I( ( / City/State/Zip: P-V1A.V1 \1)4 itit( r 6(r)c I -2_ ) ? Phone.#: (t _) ` iel . - Are you an employer?Check the appropriate box: - Type of project(required): ij I am a 4. p I am a general contractor and I 1p loyer with 1'2-- 6.ZNew construction have hired the sub-contractors employees(full and/or part-time).* th listed on the attached sheet. 7. 0 R.emodeling 2.0 I am a sole proprietor or partner- These sub-contractors have. •8. 0 DemoMon - ship and have no. :›Ioyer....s employees and have workers' - working for me in any c..apacity. 9. Ei Building additiOn _ comp..insurance.f_.: _ ,_____ _ ___ [No workers' - comp.insurance . 10.11 lectcal repairs or additions required] 5. 0 We are a corporation and its Eri 3 0 I am a homeowner doing ill work officers havelexercised their 11.0 Plumbing repairs or additions . right of exemption per MGL myself[No workers'comp. 12.0 Roof repairs . • insurance required.]t ' C. 152,§1(4),and we have no employees.[No workers' 13.1=1 Other cot3:m insurance required} *Any applicant-that checks box#1 must also fill out the section belawshowing their woricers'compensation policy information. • t Homeowners who submit this affidaidt indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 mb-contractors have employetx,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: 711 iii4 ktAkialA-12.-- • ' . . . . . Policy#or Self-ins.Lic.#: . )IL ?. (iS°C)(° 7--Z--9 c)/z.(:)(2--- Expiration Date:- V//.2-j/3 j „J__ -7 t i A_ —•1 r Job Slim Address: t (--`.1 4---(-0 C. ‘KO-c5-t1A-LU r‘1"-Q-- (.---- Se -/— City/State/Zip:. I 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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and-a frne of up to$25000 a day against the violator Be advised that a copy of this statement may be forwarded to the Office of •Iiiii-e-sliiitiOns Of the DIA for instirince cOverii-e'Ve-rification. I d-ci hereby ce • under the pains and pen allies of perjury that the information provided above Litnce_and correct. _ Signature: . L.,..,•• ti • . • ' Date: 3/Z-S-1 1 3 • • r, . Phone#: Li I -)'--- 9-/A -- i ie., - . • Official use only. Do not write in this area,to be co-in-plated by city iir town Official . . City or Town: "- Permit/License# • Issuing Authority(circle one): •1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other , • Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ ira_�, C Name of License Holder: 1.1-�-� CS j License Number Address Expiration Date al Li I C a Y ,\-- �l�i� l , / 1A A5 - ,- 1/i z �r y (,U/L, 110 iii�jG( 1 lcj Signature Telephone 9.Registered Home lmDrovement Contractor,w R ,, ,,, y, ; „_h., w, _`, ,,g.. :.',.= Not Applicable ❑ v `.-"Y\ rt. C' r v�k v■, 1- C - u..�c.f c. i/S t 4 I Company N&e Registration Number it o P p di- 4- t . A 6 4- 1 /Z. ‘,// 5--- Address q-11:1 Expiration Date Telephon13' I t 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 X.) No ❑ 11. Home`Uw ter 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. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition ❑ Replacement Windows Alteration(s) n Roofing ❑ Or Doors E Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding[El] Other[D] Brief Descrip iorl of Propo ed Work: hLA YY . Wa/2-'5 kitiln i' SC./LE )r1 cc. (il +,0'0A6C-. Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.;If+.Neir house'-and or addition to existing housmq,`complete`the.followina: a. Use of building:One Family � Two Family Other/ b. Number of rooms in each family unit: l 0 Number of Bathrooms 2,5 c. Is there a garage attached?_ ___ d. Proposed Square footage of new construction. 25-e--:=c) Dimensions e. Number of stories? 1 i f. Method of heating? 2Ct,� (4.1- / k A.i Fireplaces or Woodstoves L >.S Number of each 1 L ` g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 51-1.0.,k---bganv t +17'5, (1 i. Is construction within 100 ft.of wetlands? Yes X. No. Is construction within 100 yr. floodplain Yes ��No �.. 1 j. Depth of basement or cellar floor below finished grade, F., 0 e_ k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer X Private well City water Supply SECTION 7a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT i f1k5(,1i -10 .t..{,j ,as Owner of the subject property \ �,��, hereby authorize t V A�, e ii v il, fl wo. - (-.-::lf -v-C,IC `1 CSC Y\_... to act on my behalf,in all matters elative work authorized y this building permit application. ii...41 evi Signature of Owner Date I at-/0/1 , as Owner uthorized Agent hereby declare that the state ents and information on the foregoing application are true and accurate,to the best of my e and belief. Signed under the pains and penalties of perjury. Print Name 3 Signature rOwner/Agent Date Section 4. ZONING All Informatit rii,Mastee Coed.J"erm Can Be Denied Due To Incomplete Information Existing ; Pr posed Required by Zoning .;if This column to be filled in by Building Department Lot Size I J � o I ,3r(:� -, } . � _.� — j Frontage .:A 1 t_ a`'lc.1._J . __._ °Zt Setbacks Front .'; Side L: tS R.L .J_-_ L:_!- .; R:ri __.. ..__ Rear = "" s Building Height ! I f i i Bldg. Square Footage, j I % 31`00 r - ° Open Space Footage % (Lot area minus bldg 8c paved t I I 31]7 1 L parking) #of Parking Spaces _ ._. Fill: (volume&Location) - -- __ _ _ A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued:. i IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book I Page! ! and/or Document#, � B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Gir YES C IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO i'!"� IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO .N 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 0 NO Gc IF YES,then a Northampton Storm Water Management Permit from the DPW is required. RE t use only City of Northampton tatti,vbrPs � Building Department , � ff ��€� !fiv vv#�Permit z 212 Main Street vattabllit Room 100 Ilia erllrell aPfli ' Northampton, MA 01060 DEPT.RTNAM 4 rptaris` � ' phone 413-587-1240 Fax 413-58-- ; tithgApeati= r- APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Addr This section to be completed by office Map Lot Unit 2 , Ave— Eke, tcecct,s - " n Zone Overlay District Elm St District CB District SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 6t .tfl-Ae-�a ,J0erAc(. 1t-1 P 1-key s i de( Name(Print) Current Mailing Address :\J l 3 -2-91- 5 Y2. / Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item I Estimated Cost(Dollars)to be Official Use Only it completed by permit applicant 1. Building (a)Building Permit Fee 2. Electrical J°C--) (b)Estimated Total Cost of Construction from(6) 3. Plumbing /4 6)6)e2 Building Permit Fee 4. Mechanical(HVAC) /3cZ.:3-0�� ; ZXJ 5. Fire Protection Qo 6. Total= (1 +2+3+4+5) 'raj ewe Check Number ap7/D $1 ! /7. ? This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date • .ptAti File#BP-2013-0867 6ik APPLICANT/CONTACT PERSON INTEGRITY DEVELOPMENT&CONSTRUCTION INC ADDRESS/PHONE 110 PULPIT HILL RD AMHERST (413)549-7919 OP k. G � � �f PROPERTY LOCATION UNIT 26-71 CHESTNUT AV EXT-28 EVERGREEN 6� �J7 MAP 06 PARCEL 064 000 ZONE / A x K- ,_xtp THIS SECTION FOR OFFICIAL USE ONLY: f PERMIT APPLICATION CHECKLIST / ENCLOSED REQUIRED DATE l'4-'c-' ZONING FORM FILLED OUT P140 0( Fee Paid p' Building Permit Filled out * ) !?/?.. ? r'� J �i, r Fee Paid ��f�� /� l Typeof Construction: CONSTURCT SFH W/ATT GARAGE/PORCH �' New Construction Non Structural interior renovations t'0 �� ��� Addition to Existing to 1 �, 4 / Accessory Structure U Building Plans Included: �, (' 3 Owner/Statement or License 90514 b 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON ,00,.• ,nn.�■ INF ATION PRESENTED: �.���� �a�,u Approved Additional permits required(see below) /sa PLANNING BOARD PERMIT REQUIRED UNDER:§ QK Tu Intermediate Project: Site Plan AND/OR Special Permit With Site Plan 4 teA, OA" Major Project: Site Plan AND/OR Special Permit With Site Plan /0";LeA13 LIA ZONING BOARD PERMIT REQUIRED UNDER: § (z91 1.3 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 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. UNIT 26-71 CHESTNUT AV EXT-28 EVERGREEN BP-2013-0867 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 06-064 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2013-0867 Project# JS-2013-001483 Est. Cost: $308000.00 Fee: $1917.20 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: INTEGRITY DEVELOPMENT & CONSTRUCTION INC 90514 Lot Size(sq. ft.): Owner: TORREY SUSAN&NORMA ADLER Zoning: Applicant: INTEGRITY DEVELOPMENT & CONSTRUCTION INC AT: UNIT 26 - 71 CHESTNUT AV EXT - 28 EVERGREEN Applicant Address: Phone: Insurance: 110 PULPIT HILL RD (413) 549-7919 Workers Compensation AM H E RSTMA01002 ISSUED ON:5/7/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTURCT SFH W/ATT GARAGE/PORCH 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 5/7/2013 0:00:00 $1917.20 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner