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VD a DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE
rn Rainbow Home KOWALSKI 21 GILRAIN
I-1 o rn Improvement SECTIONALS AND
w 128 Ryan Rd TERR FLORENCE MA ELEVATIONS
Florence,MA D1062
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 @northamptonma.gov
Thank you for your cooperation on the a matters.
Chuck Miller
City of Northampton
Assistant Commissioner and Zoning Enforcement
26. Dryer duct maximum equivalent length is 25' less 5' per 90°elbow 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 and airtight doors. 2009 IECC
402.4.3
29. Fire and draft stopping shall be completed before rough inspection.Typical locations,top (ceiling) and
bottom (floor) plates, soffits, and every 10' within enclosed cavities. 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 1/2" 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. Lateral attachment is required for each deck
per section 502.2.2.3.
36. Smoke and CO detectors as required. 780 CMR R314 and R315.
a. Smokes in each bedroom,within 10' of a bedroom door,and at the bottom of a stair leading to
a finished floor above.
b. CO within 10' of bedroom doors, at each level,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.
13. All framing materials which are not code prescriptive must have stamped engineering.
a. LVLs
b. I-joist and or Floor Truss
c. Roof truss
14. A braced wall plan identifying appropriate braced wall areas 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. NOT PNEUMATIC NAILS
15. When nailing sheathing make sure your pneumatic nailers' pressure is properly set. Nails set too deep
perforate the sheathing weakening it and contribute to building damage in high wind events.
16. 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
17. 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
18. 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
19. 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
20. Stairs have critical standards, make sure you know the floor finishes when planning. Minimum tread 9",
maximum riser 8'4", 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. Rails
must be continuous and returned to the wall if not to newel post. 780 CMR R311.7.
21. 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.
22. 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.
23. 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
24. Dryer ducts must terminate outside of the building, have a backdraft damper, cannot include a screen,
and require 3'clearance from windows.780 CMR M1502.3
25. Dryer duct transition is limited to 8' of aluminum flex, must be exposed, and the proper UL listing. 780
CMR M1502.4.3
City of Northampton
7,-;-.04 M ON. NS S'^
Massachusetts �$s; ,cfr
, ms's
( - 1-:-.A, :, )
y ' 4,- 41., DEPARTMENT OF BUILDING INSPECTIONS T g,
212 Main Street • Municipal Building Jys,, ;�a
>, , ! ter/ Northampton, MA 01060 �s�jyµ j�
INSPECTOR
Thomas Malone August 09,2013
128 Ryan Road
Florence, MA 01062
Subject Location: 21 Gilrain Terrace
Map Block: 29-065
Mr. Malone,
Your building permit application and plans dated 8-9-13 have been approved as drawn, noted, and per this
memo.All work must meet all applicable codes whether noted or not included within this memo. _
Please pay particular attention to the following items:
1. Must meet the 2009 IECC, and at final submit a signed Thermal Bypass Checklist.
2. The floor,walls,and ceiling must be air sealed and insulated.
3. Window must be energy star.
4. Proper egress heights must be maintained.
5. Fire separation must be continuous to the roof deck.
6. The door between the conditioned and unconditioned spaces must meet the energy code.
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
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. CMU foundations require 3/8" parging before damp proofing.780 CMR R406.1 see exceptions.
8. Emergency escape is required out of every basement whether habitable or not. 780 CMR R310.1
9. Ceiling joist are intended to prevent spread,once raised above the wall plate they become rafters ties
and may require up sizing of rafters and increased nailing for example with a 4" slope 8-16nd common
are required at each connection. 780 CMR R802.3.1. When there is neither of these a structural ridge is
required with a load path to the foundation.
10. Steel straps over the ridge or 1x4 minimum collar ties are required 4' OC in the upper 1/3rd 780 CMR
R802.3.1
11. Ridge boards must be the full depth of the cut. 780 CMR R802.3.
12. A complete window and header schedule is required.780 CMR Table R502.5 for header sizing and
number of jack studs required.
A R•RE1Ip ��
inham Estimate
128 Ryan Road
�Iy1P pM Florence, MA 01062 Date Estimate#
7/31/2013 1324
Name/Address
Barbara and Paul Kowalski
21 Gilrain Terrace
Florence,MA 01062
Terms Project
On receipt Kowalski Patio Rev2
Description
4 Ea
Project material, labor,subcontract
Material,per job
Labor,per job
Subcontract,per job
Total $19,739.00
We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total. Payments to be made
as follows:half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion. All
material is guaranteed to be as specified.All work to be completed in a manner according to standard practices. Any alterations or deviations from
above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.
All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire, tornado,and other necessary insurance.
Acceptance of Proposal will commence with the home owners signature. Prices,specifications and conditions are satisfactory and are hereby
accepted upon signature. Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified.
Phone# E-mail
Signature � / l
413 885-9038 tom@rainhome.net
Page 5
ow RE,to„,�9 Estimate
Rainham 128 Ryan Road
%7,lov Florence, MA 01062 Date Estimate#
7/31/2013 1324
Name/Address
Barbara and Paul Kowalski
21 Gilrain Terrace
Florence,MA 01062
Terms Project
On receipt Kowalski Patio Rev2
Description
264 SF
Engineered Floating hardwood flooring Everseal adhesive
264 SF
Engineered Floating hardwood flooring 1/2 in.tongue and groove hardwood flooring,various colors$5.00 per square foot allowance.
264 SF
Engineered shoe molding for flooring at doors
12 LF
Priming Painting
803
Storage cabinets for Television components. Paint grade,basic constriction,four doors.
5 LF
Dump fees
1 Ea
Building Permit
19.6
Bi-fold door hardware Bi-fold hinge
6 Ea
Bi-fold door hardware Hardware set
2 Ea
Bi-fold door hardware 72 in.track
1 Ea
Single Casement Sash,8 Lite, 1'4 in.X 4'0 in.
Total
We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total.Payments to be made
as follows: half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All
material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from
above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.
All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.
Acceptance of Proposal will commence with the home owners signature. Prices,specifications and conditions are satisfactory and are hereby
accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified.
Phone# E-mail
Signature
-
413 885-9038 tom @rainhome.net
Page 4
\,\3" YF9 Estimate
128 Ryan Road
1 PROVE' Florence, MA 01062 Date Estimate#
7/31/2013 1324
Name/Address
Barbara and Paul Kowalski
21 Gilrain Terrace
Florence. MA 01062
Terms Project
On receipt Kowalski Patio Rev2
Description
I Ea
Re-use existing rear exterior door for new exterior garage door.
1 Ea
Double cylinder high security lockset for French door
1 Ea
re-use Deadbolt and lockset combo
I Ea
Butt type self closing hinges for Garage fire door
1 Pr
Softwood moulding,casing
250 LF
Softwood moulding,base
52 LF
6-panel colonial prehung interior wood doors 24 in.x 80 in. for closet
1 Ea
Lockset installation Standard 2-1/8 in. bore,site bored
1 Ea
Closet shelves
1 Ea
Damp proof floor
264 SF
Engineered Floating hardwood flooring membrane
Total
We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total. Payments to be made
as follows: half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All
material is guaranteed to he as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from
above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.
All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insurance.
Acceptance of Proposal will commence with the home owners signature. Prices,specifications and conditions are satisfactory and are hereby
accepted upon signature. Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified.
Phone# E-mail
Signature Q�
413 885-9038 tom @rainhome.net
Page 3
•REM*
�9
Estimate
128 Ryan Road
� VE�` Florence, MA 01062 Date Estimate#
-/MPRO
7/31/2013 1324
Name/Address
Barbara and Paul Kowalski
21 Gilrain Terrace
Florence,MA 01062
Terms Project
On receipt Kowalski Patio Rev2
Description
2 Ea
Kraft-faced fiberglass insulation, 16 in.OC framing members 5-1/2 in.(R-21)
99 SF
Kraft-faced fiberglass insulation, 16 in.OC framing members 9-1/2 in.(R-30)
264 SF
Plywood wall sheathing
64 SF
Vinyl siding remove and re-install
I SQ
Stud walls 2 in.x 4 in.
64 SF
Stud walls repair from rot
50 SF
Pad out exterior walls to accept Insulation at R21
216 SF
1 X 6 Tongue and Groove Pattern Board primed finger joint boards.
264 SF
Gypsum wallboard screwed 1/2 in.
528 SF
Gypsum wallboard screwed Add for taping and finishing joints
528 SF
Marvin Integrity French Swinging Double Door with Grills between glass, Inswing doors outswing screens 6'-0 in.x 6'-8 in.
Total
We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total. Payments to be made
as follows:half of hill total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All
material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from
above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.
All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.
Acceptance of Proposal will commence with the home owners signature. Prices,specifications and conditions are satisfactory and are hereby
accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified.
Phone# E-mail
Signature
413 885-9038 tom @rainhome.net
Page 2
pER•RE.4fOD
Riiinhciwo
% �9 Estimate
128 Ryan Road
°'rE�hovTys
Florence, MA 01062 Date Estimate#
7/31/2013 1324
Name/Address
Barbara and Paul Kowalski
21 Gilrain Terrace
Florence,MA 01062
Terms Project
On receipt Kowalski Patio Rev2
Description
The following estimate is based on removal of the double window at kitchen.Custom Bifold window system installed at opening. Installing stairs
riser and tread at concrete step. Construct a paint grade four door cabinet at wall-stair location for TV components. Removal of existing side
entrance door and create a doorway at existing rough opening width. Construct a closet in Patio corner at front exterior wall with 24 in.door.
Remove door and window at rear exterior wall and construct opening to accept six foot Marvin Integrity Wooden French door. Pad out exterior
walls at front and rear to accept Building Code required R21 Insulation. Increase insulation level to R38 code in ceiling. Sheetrock walls and
install bead board on ceiling for finish. Prime and Paint walls,ceiling,doors and trim stain new exterior door. Damp-proof floor,install
Engineered wooden Flooring.Home owner will contract directly with plumber. The plumbing work and electrical would need to be completed
before we could start.
Removal of wood siding on interior wall
45 SF
Removal of stud walls
36 SF
Removal of windows
45 SF
Removal of door,flame and hardware
2 Ea
Door framing, 2"x 4"Over 3'to 4'wide
I Ea
Door framing,2"x 4"Over 6'to 8'wide
I Ea
Factory tread and riser stairs to match flooring as closely as possible
Total
We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total. Payments to be made
as follows:half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All
material is guaranteed to be as specified.All work to be completed in a manner according to standard practices. Any alterations or deviations from
above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.
All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry tire,tornado,and other necessary insurance.
Acceptance of Proposal will commence with the home owners signature. Prices,specifications and conditions are satisfactory and are hereby
accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified.
Phone# E-mail
Signature be.
413 885-9038 tom @rainhome.net
Page 1
• •
City of Northampton
S C
c Massachusetts �,' - ��o
� � * x.
t ' � F ' DEPARTMENT OF BUILDING INSPECTIONS r 4it
212 Main Street • Municipal Building J,4,1;,,.
h ♦ '
ar Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
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 any 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 permits 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
Department of Industrial Accidents
Office of Investigations
_^1=01-'— 600 Washington Street
c r l Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
Address:
City/State/Zip: Phone #:
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees (full and/or part-time).* have hired the sub-contractors
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. e ployees and have workers'
g y P r5' 9. ❑ Building addition
[No workers' comp. insurance omp. insurance.t
required.] 5. We are a corporation and its 10.n Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 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.
1 Ho meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and .enalties of perjury that the information provided above is true and correct.
Signature: Date: r-'1 13
Phone#: ‘A\75 ��3
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 Construction Supervisor: Not Apppplicabblle.£
Name of License Holder:
License Number
"'MAP( Ciy ‘y
Address Expiration Date
Signature Telephone
-mss'-ccs3f
,9 Registered Home Improvement Contractor ; _,,..._ Not Applicable £
l b� S
Company Name Registration Number
\\"-- S ci4-C.1" 0 1— ZON
Address ```` Expiration Date
`�U &Grp O.- S C Telephone k0itS= (131'
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 £
11. ome Owner.:EXernptiori
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) Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [I] Siding[CI] Other[ID]
Brief Description of Proposed /
Work: .■ b� • . �►. �Sa�� 40
Alteration of existing bedroom Yes ✓ No Adding new bedroom Yes t' No
Attached Narrative Renovating unfinished basement Yes ✓ No
Plans Attached Roll -Sheet
6a If New house andor:addition to`existirzc.'housing, complete;the fo lowinpc
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? 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
I, QG"(ACA (Gds <16.,y,VAk% ,as Owner of the subject
property
hereby authorize -�C
�,'I`C.m*S Me
to a on my behalf, in all ma s relativ to k authorized by this building permit application.
a t `A. ` a ,, 0- 7- J3
Signature of Owner Date
I, - ` 0^cj M .\c , 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.
"- Jlnr■c.A, (Y .VA 'e-
Print Name
i
Signature of Owner/Agent Date
I
k
f
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 i _i
1 '
Frontage °._...._..._______.__._......_.__..__._...____-. ;___.._._..__...._...__.._.._... __._..-.__ ...._..._..._.._-_.......__.___..____._._....__....g
Setbacks Front r 1 I_.__—j
Side L:1 I R:E—.- L:1 i R:= Ti
i
Rear i "'' I j
Building Height 1.
Bldg. Square Footage 17 1 /o i i W I,i .......
Open Space Footage __. % 1
I
(Lot area minus bldg&paved __.............:_i ,..__._....,.I i_.._..___..�,
parking)
#of Parking Spaces I I
_ ......_ _...m _..._ _...
Fill: i f4
,
(volume&Location) �"°"""" "4
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW Q YES 0
IF YES, date issued:; j
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW Q YES 0
1.
IF YES: enter Book Page 1 and/or Document#1 +
B. Does the site contain-a brook, body of water or wetlands? NO Q DONT 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: 1
C. Do any signs exist on the property? YES Q NO Q
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 Q
IF YES, describe size, type and location: 1
-..°
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 Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
s
}�L � ,"Department use bnl r
rn i'. e.2 �``t a-- 4. f ��, x yid i'- r
L C_=__.__ --- Ii City of Northampton status i Pecmrt `` � F
Building Department Ct rk Cutlr r� eway errst# ° ' �' 7
AUG ; 2013 212 Main Street Sewer/Sep cAvaita�bg,�yiyfrty ` i
Room 100 WaterMfe�l Avallablhty
-- Northampton, MA 01060 Two Sets of structural Plans
DEF r.OF Eau∎LD J i ;„c:0.6,,,
NORTHAMPTON,MA01060 413-587-1240 Fax 413-587-1272 PIof/Slte Plans : '”
E
Other Specif1 } ,i.r
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by offi
1.1 Property Address: ce:
l` 64`ca`1\— - CC- Map Lot
Unit
T`at n\-\- 6`o6 !. Zone Overay Dstrct
.Elm St.District: CB District.:
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT -
2.1 Owner of Record:
-A 4.•2_ .4ki\ Kpt.,JeiX Z\ Er\(t%∎(. • .- --eCtetcC-
Na ,e(Pri ) I Cur cling e LI jir ALL,e,.A4 6 . 1_.A41 Tele hone
Signature
2.2 Authorized Agent:
(1\.CA Of C- \Z ZS— 0_:-..‘qn ( Z- r1G CC. ANA—
Name -
Name(Print) Current Mailing Addres
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
2. Electrical (b) Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) ?�000 .O Check Number /O g 0 /ate`_
This Section For Official Use Only
. Date
Building Permit Number: • Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2014-0149 `�"� g' 'iVe
APPLICANT/CONTACT PERSON THOMAS MALONE
ADDRESS/PHONE 128 RYAN RD FLORENCE (413)885-9038 L C
PROPERTY LOCATION 21 GILRAIN TER
MAP 29 PARCEL 065 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out Q QC
Fee Paid / �} </ 6?-■
Typeof Construction: CONVERT BREEZEWAY TO LIVING ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 055236
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN✓QATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
diorD�. Delay
, , I 7--f-/
Signa eofBuil.ing I fficial 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.
21 GILRAIN TER BP-2014-0149
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29-065 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2014-0149
Project# JS-2014-000277
Est. Cost: $20000.00
Fee: $120.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THOMAS MALONE 055236
Lot Size(sq. ft.): 18513.00 Owner: KOWALSKI PAUL E&BARBARA K
Zoning: Applicant: THOMAS MALONE
AT: 21 GILRAIN TER
Applicant Address: Phone: Insurance:
128 RYAN RD (413) 885-9038 WC
FLORENCEMA01062 ISSUED ON:8/12/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:CONVERT BREEZEWAY TO LIVING ROOM
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 8/12/2013 0:00:00 $120.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner