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12C-130 • .// QUICK ANALYSIS REPORT ate: February 11,2013 Rating No.: 12-487 Building Name: Stiebel Residence Rating Org.: Center for EcoTechnology Owner's Name: Frank Stiebel Phone No.: 413-586-7350 Property: Cloverdale Extension Rater's Name: Evan Dick Address: Northampton,MA Rater's No.: 7633799 Builder's Name: Weather Site: Northampton,MA Rating Type: Projected Rating File Name: 12-487 Cloverdale Extension Stiebel Plans Tier I Rating Date: 12-12-12 Codes Programs IECC 2012 Performance: Fails EPA ENERGY STAR 2.0 Fails j IECC 2009 Performance: Passes ! EPA ENERGY STAR 2.5 Passes IECC 2006 Performance: Passes EPA ENERGY STAR 3.0 Fails IECC 2004 Performance: Passes Tax Credit Fails IECC 2003 Performance: Passes HERS Index 64 IECC 2001 Performance: Passes IECC 2000 Performance: Passes IECC 1998 Performance: Passes ECC of NY Performance: Fails ECC of NV Performance: Passes MEC 1995 Performance: Passes MEC 1993 Performance: Passes MEC 1992 Performance: Passes ASHRAE 90.2 Performance: Passes REM/Rate-Residential Energy Analysis and Rating Software v13.0 This information does not constitute any warranty of energy cost or savings. ©1985-2012 Architectural Energy Corporation,Boulder,Colorado. ENERGY EFFICIENCY PLAN 2. Preliminary Home Energy Rating Results Based on the assumptions described above, we have calculated the following Preliminary Home Energy Rating results. Preliminary HERS Index: 64 Preliminary Improvement Over 2011-4Q Massachusetts Reference Home: 49.3 Note that Confirmed Home Energy Rating results may vary from the Preliminary Home Energy Rating results due to changes in building plans, energy features installed in the home, RESNET standards, software changes, and other factors. 3. Services Requested CET will provide a Confirmed Home Energy Rating for the purpose(s) indicated below. CET will charge fees for these activities based on the Price List attached to your Home Energy Rating Services Agreement. ® Stretch Energy Code compliance Z Utility company incentives for the Massachusetts New Homes with ENERGY STAR program-Tier Ill As part of these services, CET will verify that your home meets all the requirements listed in the attached Program Description. I have reviewed and u derstand this Energy Efficiency Plan. I have reviewed the assumptions in part 1 and confirm that the assumptions are co ect. Signature: 4/q/ Date: / lD'Zo/? / Printed Name. - re&IA% ff!e 64 Company: • CET Internal Use Only HERS Rater: Evan Dick Date of Preliminary Rating: 12-19-2012 REM/Rate File Name: 12-487 Cloverdale Extension Stiebel Plans Tier 1// Form v2012-02-13 Page 2 of 2-Please send signed form to the Center for EcoTechnology Tel(413)586-7350 ext.242-Fax(413)586-7351 -oreenhome(a.cetonline.orq / Uo-Y-e4-104' • CENTER Fa2 411 - 9 2013 VEPT.OF BuiLDiNo INRa EcoTechnology- NoRTHAmpron, ....EcTioNs we make green make sense- � --------------- ---- -- --- -----------_ -----1 ENERGY EFFICIENCY PLAN ---------- _____ Project Address: Cloverdale Extension Northampton, MA ----- -- - ----' ------------- --- - - Conditioned F|oor A rea 3737 _______ Bui|dingLTy[�� ---- ___________ S�g|eFami|yj]o�aohod Bedrooms 5 -��� '—�-�-----�--- ---------- �����---- --��-----�� ---------�----'-----��������-�'��� 1. Assumptions for Preliminary Home Energy Rating CET has completed a Preliminary Home Energy Rating with the following assumptions: a) The construction plans you have provided are accurate including window dimensions and locations. b) Energy features not listed below in part c will meet the prescriptive requirements of the IECC 2000. c) The home will be built to incorporate the following energy features: -- Building Envelope Specifications Used in Analysis Basement Condition --------- Insulated, U fi i h d NOT f U heated --- -- Foundation VVall Insulation Type = Insulated Concrete Form R-Value= 20 Slab Edge Insulation T_.y..pe = Rigid Foam R-Value= 20 Rim & Band Joist Insulation Type = Cellulose '12" min R-Value= 42 i_ Above Grqde & Walkout Walls Insulation T_ype = Cellulose 12" min R-Value= 42 Grade=1 ' Windows U-value = 0.30 (typical, varies) SHGC = 0.30 (typical, variesj 1 Glass Doors U-value = 0.30 ttypical, varies). SHGC = 0.30 (typical, varies Exterior Doors Insulated, R75 or better , Ceilin_gs Insulation Type = Cellulose -1- " min. R-Value= 63 -; Blower Door Test* 3 ACH50 or better* 1 i i Meet ALL Checklist Requirements as verified by a HERS rater at pre- I I Thermal Enclosure Checklist Sections 3 5 I ; • The 2009 IECC requires a b/owe, door test result oil ACH5O orlowe/ The number listed here requires sigirilicant impl'ovemen(S ni air seal/fig beyond the base energy code. [- - -------- - -- -- -- 1 Specifications Used inAnalysis Mechanical Systems Heating_Equipment Type: Solar hot water with electric backuR Efficiency: N/A Cooling Equipment Type: Ductless Minisplit Heat_Pump. Efficiency:_23 SE_ER...______....._ Water Heating Equipment rype: Solar hot water with electric backup Efficiency: N/A Energy or heat recovery ventilator that consumes less than 100 watts i Whole House Ventilation (ASHRAE 62.2) I and exhausts 82 cfm continuously. --- ------�--� -- -'----�--------------------'------------ ---�-| �- 8pnci�no1ionoUsed inAnalysis , Lighting & App|iancam L Lighting 80% or 1 Dishwasher Energy Star Labeled _____; Page 1 of 2 , CD CD 1•17-4 ; X CD o c� i1 i 0 0 0 o0 CD 0 . (I > 2 a m E . r-f O '-i m ai 0 b. CO within 10' of bedroom doors, at each level, at the bottom of a stair leading todffloor above,for every 3.5p0-sgft, (plumbing code in the mechanical room) Except if the re are no 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%z".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 d secured O of place. x 30" is required to be located in an accessible place. It must be insulated,g Relevant items must be submitted to the building department for approvals before inspections and or CO can be signed. Other items are intended to avoid costly issues at inspections. Feel free to call if you havd any questipns. 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(a�northamptonma.ciov Thank you for your cooperation on these matters. Chuck Miller City of Northampton Assistant Commissioner and Zoning Enforcement the total rise is 30" or less 780 CMR R311.7.4.3 Exception,4 3/8" on balustrade, 6" in the triangle. a , • . 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 viall plate width of an exterior wall or load bearing partition requires a 16 GA 1Y2" 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 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 1/2' 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. 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 reinforcement 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 1/31d 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. 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 1st 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 City O NoruricUUY�,uLi - s;,{ y - Massachusetts -,4, $ DEPARTMENT OF BUILDING INSPECTIONS r 3 0+ x , 212 Main Street • Municipal Building 'a. Northampton, MA 01060 `�,I" , ' INSPECTOR . ,February 8, 2013 Mr. Daniel Jackman , 242 Suffolk Street i �/ / c)-t- _Imqf'te Holyoke, MA 01040 Q Subject Location: 37 Cloverdale Street Lot#4 Map Block: 12C-130-001 Mr.Jackman, Your building permit application and plans dated 10-5-12,have been reviewed. All work must meet all applicable'codes whether noted or not presented below. ' , Please follow up on the following: Item#1, 2, and 3 must be addressed before a permit will be issued, other items need to be accomplished as the project moves forward. ,/'I/1. There are several areas of the building that do not meet the braced wall requirements of 780CMR 0 �/ R602.10,you are required to submit a braced wall plan.These can be engineered solutions or a code prescriptive solutions.780CMR R602.10.3.3 is a prescriptive solution which could be used with slight modifications to the plan.You'll need to understand and follow the requirements of this section. Steel reinforcement,embedded tie down anchors, an anchor bolt, continuous header, 1000 lb straps, nailing and blocking. this is a ()V/2. I would like additional detailing on the sill for the Master Bedroom balcony doors, nonstandard wall depth and conventional jamb/sill often will not function properly.This particular door is not protected by a roof above making it susceptible to leakage/rot. or 3. Submit a copy of plans in electronic format. 4. Double wall systems provide some unique fire blocking requirements 780CMR R302.11 Fire blocking.Along with fire blocking at every ceiling and floor one must fire block every 10' horizontally, meaning you must fire block from the exterior stud to the interior stud every 10' 5. There are several windows that will need to be tempered based on 780CRM R308.4 Hazardous locations. 6. Stamped engineering for all non prescriptive materials and or systems.Truss, LVLs, and I-Joist. 7. HERS initial and final ratings, duct blast results, and a signed Thermal Bypass Checklist. 8. Smokes and CO detectors per code. See item 36. Locations are marked on plans. 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.cyberregs.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. STIEBEL PROPERTIES, INC. 242 SUFFOLK STREET HOLYOKE MASSACHUSETTS 01040 Tel. 413 / 535-1734 2/5/13 37 Cloverdale Building Permit Fee Schedule 1 Ryq Basement 2000 Sq Ft. @.20 $400.00 YT 1St Floor 2000 Sq Ft. @.50 $1000.00 hr73€7 2Nd Floor1738 Sq Ft. @.30 $521 .40 © .Attic 1738 Sq Ft. @.20 $347.60 / g` Porches 502 SqFt. @.20 $100.40 J09,0 cye_ 60) 91?c9?Lotal Permit Fee $2369.40 Daniel F. Jackman Property Manager Cloverdale Street Homeowners' Association 38 Cloverdale Street Florence, MA 01062 December 14, 2012 City of Northampton Assessor's Office 212 Main Street, # 306 Northampton, MA 01060 Re: Lot 4 of the Cloverdale Street Extension Subdivision To whom it may concern, As current president of the Cloverdale Street Homeowners' Association I hereby wish to communicate the assent of the Association to the proposed building plans of Mr. Frank Stiebel with regard to lot 4. Mr. Stiebel has been the owner of lot 4 since a time prior to my purchase of lot 1. Although the lot was undeveloped he has participated in the maintenance of the cul-de- sac by payment of Association dues on a regular basis. Prior to beginning the clearing of the lot he met with adjacent neighbors to explain his plans. Although the Association bylaws do not require that we have the opportunity to review the proposed construction, Mr. Stiebel contacted me as a courtesy to provide me the opportunity to review the plans. I have no objection to the size, location or style of structure that Mr. Stiebel plans to build and I am not aware of any objection from either of the other two members of the Association. The home that Mr. Stiebel plans to build has a square footage comparable to the other three houses on the cul-de-sac and the plan will set the house back at a distance from the road that is greater than that of the existing three houses. He has plans to landscape the area in a manner consistent with the surrounding area including the addition of trees. The house will not be readily visible to the owners of Lots 1 and 2 and Mr. Stiebel has met privately with the owners of lot 3. It is my understanding that there are no objections and I gladly provide this note at Mr. Stiebel's request. Please feel free to contact me with any questions. We look forward to Mr. Stiebel and his family joining our neighborhood. Very truly yours, • John P. DiBartolo, Jr. H: 586-1585 W: 529-2955 C: 519-2931 38 Cloverdale Street, Florence, MA 01062 r 1[i Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS 1 & 2) Permit No. D19-13 Conditions: Driveway Permit In lieu of plan approved by the City Engineer I agree to the following added conditions: 1. I will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. I further agree that if in the inspections, any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. B a I 1.etitioner Signature Name: D. 'ackman/Stiebel Pro serties Address: 242 uffolk Street, Holyoke, MA 413-315-0797 Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. For Commercial and Industrial applicants, a plan showing the proposed driveway with grades, location and Planning Board permits are required. Cc: Building Inspector C. Permit No. D19-13 CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: 1/11/13 Check#: 3142 FEE: $250.00 THE BOARD OF PUBLIC WORKS Driveway must be staked and house & lot number posted The undersigned respectfully petitions your honorable body for: a New Driveway Permission to install a driveway at: 37 Cloverdale Street Fifteen (15) foot maximum width from street line to property line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. The first one hundred (100)feet of the driveway surface shall be paved as soon as possible if the grade of the proposed driveway exceeds 3%at any point in the first one hundred (100) feet. Homeowners will be held responsible for any costs to the City of Northampton in the event of a washout of this driveway. City is not responsible for culverts installed under driveways in City layout. Code of Ordinances §350-8.8 providing standards for private, individual driveways as most recently amended,must be followed. By: Dan Jackman/Stiebel Properties Telepho -• ; 13-315-0797 _ :nature: Apt,\_ 14,AjL,..._ . • , Proposed Location Inspection By.t./ �,. ��_;� Aff OC• — c i.S � 0/3 Gravel Base Grade Inspected By: Final Approval: a THE BOARD OF PUBLIC WORKS voted that petition be granted. Edward S. Huntley, P.E. Director of Public Works j 'DUB,, WU,I.84 EjcC.o,,,,od'or 1 �ro,n k w UAa��I sr r k 20 13 �-f,QV 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: 37 Cloverdale Street Inquiry Made By: Dan Jackman Stiebel Properties, Inc. 413-315-0797 Date of Inquiry: 1/11/13 Reason for ( Needed for Building Permit) New Construction Hook into in spring of Request: 2013 Municipal Sewer Main in Front of Location: Yes .) No Municipal Storm Drain Available: 51/2 deep Yes No 1 Size of Sewer Main: A /1 Material: C. L A. �` Age: Depth of Sewer Main: Size of Service Connection: ( // ?V Type of Service Connection: Tie-in to Sanitary Main Tie-in to Sanitary Stub Comments: Note: If this availibilitv 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. o-► ) ) C John Hall Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner �v_ 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: 37 Cloverdale Street Inquiry Made By: Dan Jackman/Stiebel Properties 413-315-0797 Date of Inquiry: 1/11/13 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: 8" Material: Ductile Iron Age: 2002 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 65 psi. If done attach results Size of Service Connection 1" Suggested Meter Size: 5/8" 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 installatio shall be made with the Northampton Water Department with a minimum of working days notifi • n • work shall on to rthampton Water Department specifications. 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 Note: If this availability is for a new construction,it must be hand delivered to the Building Inspector. 60/ .:J J_:: 1 : AM FAX No. ACORD CERTIFICATE OF LIABILITY INSURANCE DATE,MM DD YY Y,1D,z5,zo12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS •1:ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES cELOtiV THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. MPORTANT: 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). PRODUCER CONTACT NAME: Webber & Grinnell Ins. Agency, Inc. INC,No,Exr): 413. 586 0111 1 FAX No): 413. 586.6481 8 North King Street E-MAIL ADDRESS: Northampton, MA 01060 PRODUCER 00005763 CUSTOMER ID Y: INSURER(S)AFFORDING COVERAGE NAIC A 1NSORED INSURERA: WCAR- A.I.M. Mutual St1ebel Properties, Inc. INSURERS 242 Suffolk Street INSURER Holyoke, MA 01040-4456 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 2013 REVISION NUMBER: THIS .S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INTICATED 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. ACLJSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. v,SR ADDL SUM—..--- ---- —POLICY EFF I—POLICY EXP rR TYPE OF INSURANCE INSR `KVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYY Y-) LIMITS GENERA_LIABILITY EACH OCCURRENCE $ i Prrr.;E TO RFriTECi _J:1...1, 1Er EP Any 5na pn r ,ER/ACS E a'F p+UU;CI I n!vWrOr $ ..,,"JJAGBILE J LIAEILTY I T r IE'dNED J'.NO_E Lllvl' iI -- t R.■ Par- s.c -- -- ICEF-SILhTt' ,E ;Ps"di::1,70nII 1 _ UTABRELLA LIAB R k, b OCCURRENCE E'LESS LAB ANC EMPLOYERS'CO VWC6009898012012 10102/2012:10/02/2013 ANC EMPL YERS LIAB COMPENSATION YIN X O�_'="1-1'7.--L!t4 rv�lLrl�i I ET � R.�e:r�E N r A E EACh AC IDErr' 500,000 c; SEASE E;.EM LC r', 500,000 rtA ry anoato In NH) E_ _ LEr.;E-FVLr 500,000 C_SCRIP'Cr,OF OPERATIONS I L .CAT1ONS I VEHICLES (Attach ACORO 101,Addldonal Remarks Schedule,If more space Is required) ?o provide evidence of workers' compensation coverage CERTIFICATE HOLDER CANCELLATION SHOULD 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 ( 1 Q • For Insurance Verification Purposes Janet Sanuita, CISR/BARBG O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Print Form Department of Industrial Accidents 1.1 Office of Investigations m. i� 1 Congress Street,Suite 100 Boston,MA 02114-2017 t,.. --..1* ','' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): _ A 0 10 .. 1 Address: 2)42— F� ) St- City/State/Zip: `„ 111,■ e-- Iii a Phone#: � r r7 ` re you an employer?Check le appropriate box: T of project(required): 1.��J I am a employer with ( ® 4. El I am a general contractor and I ` \employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. El Building addition [No workers'comp.insurance comp.insurance.# required] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.0 !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 employee& Below is the policy and job site information. --Insurance Company Name: r\ (V\ MC--A‘XO . _ Policy#or Self-ins.Lic.#: ti,_ WC.(00oci 1 co ( 2.611.-- Expiration Date: %O l21- a:J Job Site Address: (A c c l37 City/State/Zip: i' 10 'cSZ C,Q 1)-Y;� 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 h ■ -r ft;1. 1 under ' e i�,, and ,- allies of perjury that the information provided above• true and correct � cc 1 ice., .i. Date: I-1 1 O 12— Al , Phone#: 57S— I 7'C•y 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.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Constru `Supervlsor: Not A'pplicable ❑ name of License Holder: \ h k e \ --,S Cf-e�J k rINCk.C\ —7� .5 License Number 21\ le_6(6e8tecrecas-Itr\ C\- 013-31 1 CI \ 13 ddress E on Date tun: Telephone 8.Rea lstered Nome Inwrovement 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 X No ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certi and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State , oc., oning Laws and State of Massachusetts General Laws Annotated. / i I Homeowner Signature KI/1f;E,111► 4 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aoolicabie) New House p Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [❑ Siding[D) Other[q] Work:Description of Proposed ' -'C Work: �. S� CI°1A e_ ./ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.if New house and or addition tQ existinsl housing.complete the followinsl: a. Use of building: One Family 4 Two Family_ _Other b. Number of rooms in each family unit Number of Bathrooms c. Is there a garage attached? \ (rCr� N USQ 31 443 t ` _ ( v- . d. Proposed Square footage of new constructioCc 9_CitQ- ‘b2.—C) Dimensions 1 SV,512-- -37 xS LI ?cI-X--1 e. Number of stories? Z f. Method of heating?_ _„Firepleeeeior oodstoves! t Number of each t g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction__L&OCOCL___ / i. Is construction within 100 ft.of wetlands? Yes f/ No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade (t "- ~'"� k. Will building conform to the Building and Zoning regulations? i;/ Yes No. I. Septic Tank City Sewer i/ Private well City water Supply tr SECTION 7a-O ER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGE, OR ONTRACTOR APPLIES FOR BUILDING PERMIT I, Ili Vial._,1 , as Owner of the subject property s hereby authorize t C.. $ P V A r\ to act on my behalf,in a matters relative to work authorized by this building permit application. Signature of Owner Date I, Fve ft 4 S�l e6eL ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. S1-1e e( Print Name �,rs: ; l /2 - 14- . 2,07z_ Signature of Owner/Agent 1 Date • Sect'ibn 4. ZONING Alt Information Must Be Compteted.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size t i c Frontage c c • $® 5 Setbacks Front ' f I Side SL: 1 R: 2.1CD L: R: Rear Building Height `-�1 i V .4-.m.. Bldg.Square Footage % t'kisy eiraZ Open Space Footage (Lot area minus bldg&paved a- I ping) ! • #of Parking Spaces Fill: (volume&Location) 00 A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 1:40 DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES I® NO 4. IF YES, describe size, type and location: E. WiII the construction activity disturb(clearing,grading e avation, 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. & ifeo( '7ec Department use only i . City of Northampton Status of Permit Building Department Curb Cut/Driveviey Permit i . 212 Main Street Sewer/SepticAvaiab�y I_ y Room 100 Water/well Availability FEB Q 2013 Northampton, MA 01060 Two Sets of Structural Plans i phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans I_ . Other Specify L —A—PPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: C✓,.� This section to be completed by office '31 C.J6 J C{t ,l LI Map Lot Unit " 1 reo� - m P •• b Zone Overlay District A-- l Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ica _ °l e \ 2-73 C efc Aid, YS ^e. 1-- Nam- (Print) C ent Ma ui d dress4 • 71( lIdi t -= Telephone Signature I Authorized Agent: ntc,1 6..JLCr, 2)47—SW Mc. if. \NitAid4 e_ %A .6%N ame(Print) , Current Mailing Address: 1 ' 41 6�3C ^-7' `1 . iS O1G) Signature / Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building .ego; 000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Tr( ( 2O Construction from(6) 3. Plumbing o n � Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection /S----,: Da) 6. Total=(1 +2+3+4+5) it 84 two Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2013-0741 APPLICANT/CONTACT PERSON DANIEL JACKMAN ADDRESS/PHONE BE 13)315-0797 0 PROPERTY LOCATION 37 CLOVERDALE ST ! • MAP 12C PARCEL 130 001 ZONE RI(100)/URA(100)/WSP(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ' / Fee Paid W�y�'�j v!��{��' Tom' Typeof Construction: CONSTRUCT SFH W/ATT GARAGE/PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: R/ ,1- 04' Owner/Statement or License 88226 �/ // //` 3 sets of Plans/Plot Plan A*"Orwb� c b f �C� THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON JN 0 INFO ATION PRESENTED: Approved Additional permits required(see below) � � r,,a„”') 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 - •-lay / Sig ruilding • fi :1 ' 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. Daut6 ST/e 4e( eirgew , iv(r 37 CLOVERDALE ST BP-2013-0741 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 12C- 130 CITY OF NORTHAMPTON Lot: -001 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-2013-0741 Project# JS-2013-001276 Est. Cost: $480000.00 Fee: $2369.40 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DANIEL JACKMAN 88226 Lot Size(sq.ft.): 80063.28 Owner: STIEBEL FRANK Zoning:RI(100)/URA(100)/WSP(100)/ Applicant: DANIEL JACKMAN AT: 37 CLOVERDALE ST Applicant Address: Phone: Insurance: 242 Suffolk St (413) 535-1734 0 WC HOLYOKEMA01040 ISSUED ON:4/10/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 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 4/10/2013 0:00:00 $2369.40 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner