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36-358 City of Northampton Massachusetts - , DEPARTMENT OF BUILDING INSPECTIONS 14 ,r} 212 Main Street • Municipal Building �� . Northampton, MA 01060 .1*-46\7. INSPECTOR Donald Besancon December 18,2013 PO Box 520 Belchertown, MA 01007 Subject Location:91 Emerson Way Lot 9 Map Block: 36-358 Mr. Besancon, Your building permit application and plans dated 12-17-12 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. Final HERS rating. 2. Manual "J" calculations and if a warm air heating system is used a sheet metal permit is required and line drawings of the duct system with CFMs of supply and returns. 3. Stamped engineering for all non prescriptive materials and or systems.Truss and LVLs. 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. 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(pnorthamptonma.gov Thank you for your cooperation on these matters. huck Miller City of Northampton Assistant Commissioner and Zoning Enforcement 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: 91 Emerson Way, Lot 9 Inquiry Made By: Benchmark Custom Homes Don 478-9528 Date of Inquiry: 11/12/13 Reason for Request: Hook into City Sewer Municipal Sewer Main in Front of Location: Yes No Municipal Storm Drain Available: 5 %deep Yes No Size of Sewer Main: Material: Age: Depth of Sewer Main: Length of Sewer Main: Size of Service Connection: Type of Service Connection: Tie-in to Sanitary Main Tie-in to Sanitary Stub Comments: A-T- Note:: If this availibility 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. ) )1(.11 3 John all Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner GUMIL- *TO MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department ±A QA-Clk- 2S° 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: 91 Emerson Way, Lot 9 Inquiry Made By: Benchmark Custom Homes, Don 478-9528 Date of Inquiry: Number of Type of Single Family x Type of Private x Units: 1 Unit(s): Apart. Comm Ownership: Condo Multi-family Rental 1 I I 1 • 11 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: 2010 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 45 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 time's at elevations above 320 feet. • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • ements of such ins - at .n shall be made with the Northampton Water Department with a minimum of 5 wor ing days no ' watt',n. • All wo sha f. to orthampton 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 availabili is for a new construction it must be hand delivered to the Buildin V Inspector. smbl`:adrnm Pernmits`•:Water Application'.Water Availability.doe City of Northampton 4~,M ;-S . o ;, , s r� Massachusetts „, ?r� 1 � i "f-. Wei Ild-- '4 DEPARTMENT OF BUILDING INSPECTIONS L I J �fi� ,- § 212 Main Street • Municipal Building �Jj,y 't, \ ° Northampton, MA 01060 ss -��`,s,� ",,,,,, _-5,---- 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 =T ' Office of Investigations �nl 12121:1 - 600 Washington Street m A® Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information a,,,,,,..,%/Vre__S---Oc"Ceiti Please Print Legibly Name (Business/Organization/Individual): Address: 70_5 , City/State/Zip: 4C-z_ Phone #: ir- 9re, Are you an employer? Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1.El I am a employer with ❑ 6. [ ew construction iployees (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. employees and have workers' 9. [:=I Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 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 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo 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: 9/ f /J, t1 L J (.:-e'i 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 t�ndpenalties of perjury that the information provided above is true and correct. Signature: Date: -,W4//// Phone#: -/-s �` 9 78> 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: r(J C,p � 5/9-/U CO iv Not Applicable £ Name of License Holder: •9 F.✓ J; �'�`i°r �r�C�`�`� CS 0 9V License Number Address Expiration Date z 443 V 7t 92 Signature Telephone 9.Registered:Horde lImprovement Contractor: ... ..:_ Not Applicable £ Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes £ No £ 11 :Home Owner=Exempt on 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 El Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors D 1 Accessory Bldg. El Demolition El New Signs [D] Decks ID Siding [DI Other[D] Brief Description of Proposed Work: $ -,G` ,e '..f.- /j /j 4:'— Alteration of existing bedroom Yes "---- ' No Adding new bedroom _Yes No Attached Narrative Renovating unfinished basement Yes :.r-- No Plans Attached Roll -Sheet sa.lf.Newhouse and:or`addition to existinq.houind;„comptete the.folit wmq: a. Use of building:One Family I" Two Family Other r b. Number of rooms in each family unit: D Number of Bathrooms 1 2' c. Is there a garage attached? V 6 � 93-4°d. Proposed Square footage of new construction, 3" V 2 t / V1 0 D Dimensions- 37 7 %7r' e. Number of stories? C22 f. Method of heating? .c1 ) Fireplaces or Woodstoves ./1/ Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? -.1./ h. Type of construction 2')•6, LcftYOA/ 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 6 'oryo rll/ - fi t k. Will building conform to the Building and Zoning regulations? ✓ Yes _No. I. Septic Tank City Sewer (/` Private well City water Supply L SECTION 7a-OWNER AUTHORIZATION TO BE COMPLETED WHEN 4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT : I, oe-Ct ` i f , P J 142h1 , as Owner of the su jec , pro r�y hereby authorize _ 4.,l/J, !il,/J i_ / JIM. /Rill NI _ IDA . .4111 7 o.I.... -.4 to act on my be : I - - : 7 o k a thorized by is . ilding permit a pi' align. �� d �� it/ Signature of•/�,��� Date I, ,-/ /ogi�� 7-,("�-�ree,,,"', , as Owner/Authorized AgenfTie by 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. "Cs.___---�'� i,«-4/ Zref-4.f4e''41 Print Name /i� Signature of Owner/Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by , . Building Department 2:2272 1s /4 4'V2 1 I Lot Size Frontage t—=T -_..- ' C / ..-- 1-_.___._--_. __.■ Setbacks Front 1 1 1 Side L:!-1 R:'`.------1 L:114-7 R: . i 1 Vii_! Rear 1 i �Ge t____-' Building Height r E i ' Bldg. Square Footage —--�s % iii.-i571 [] � = I I - Open Space Footage °%a (Lot area minus bldg&paved [ __,j __�I L__.__i parking) ■ #of Parking Spaces Fill: 1...._._____._.__w__..._._�..._..�._; �....,.�._._._._m.,,.w...._.W..�..-._...._,.. � _...-.�. .__.u.W......_..�.....,-. (volume&Location) ■ A. Has a Special Permit/Variance/Findin ever been issued for/on the site? NO 0 DONT KNOW YES Q IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book 1' ______- Page -1 and/or Document#1 —�� i B. Does the site contain a brook, body of water or wetlands? NO ►AI 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: C. Do any signs exist on the property? YES 0 NO ef IF YES, describe size, type and location: i D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO a- i IF YES, describe size, type and location: 1 E. WiII the construction activity disturb(clearing,grading,exca tion, 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. • :2100MITROSIEPtOttaggeaN4ligitailarnii 1. , ,,.._ _ __ 7=v000-mqoaermeaskoimowvirr4emorimpotitted , City of Northampton AtVeigq8.0111110:04:41AVAPhittfAINRAAWit; Building Department -p..,,-Dr.,..t4,,,,th,,,,..,-,, ,,,, ,,,-4.4,,,,luemerairwomk.magon**-4E-zFIL MormsitmagtmlogrAirgagakkgr.:4,ips;10,::,,,,,,,kwittmlo .L' NOV 2 6 2013 , , No 212 Main Street ._...., Electri ,ri,n-,...-,, ,,-.., k.rtr,,-, , „,, , Room 100 Northampton, MA 01060 .....0j,„,-„g4,:g..,_,,,,,,...,gav="wkvaigies,,,ya,-,ENTemarmisugilimimi g§woristopmg!tOlyty,T :!::- itit,!qli0s;::4 ÷2,F17.11=5"0"f"q:4'1W142Alli**4-1Pre..--:=g43.4i.tina4fr*:1-4:fina,1:2,51iVigN.41:11!,:74.V.4720, ■WaledWil rag I I a 61 I i tYliaMERREPAitinkRagrintiO4A*01&:!:42; %,"-ii.FiiglaulitiOilk5luliffrIggIEMP:kw:iccseggie.rog-WaLt?:ImiNk44i:,mgefig:tei-40103 13NekSatedif ZtiliOilitaiR1atitigiliigakla•2:41::4:1CiabliMatagell; :.NI.i;:;;:1064.014.4**204.0240.4;iiiitliiiiiiiiL:iil,iiiiiti.giia pho n e 413-587-1240 Fax 413-587-1272 iptotipiqpillairibqmogr:61:1::..1!:::...,:,ffolwidesoirmjeighimig • i-•;, :,. .-...forgr-41,,,,g4o-ip,i91E4-avagegiooputaughvatig:,,vgatzitiglia_z vAsksodifylowsiiratorgagma.kgravvlihoaergogf..411Adttil APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION , :-:' :: i9A-16t) PLANS nourvii,7t1,10:100,0ditg:keptiMe*pyry10 :i; :" :";,:,:.; :i.::[!:i:.:: 1.1 Property Address: ell IgglittlallilSgt aki:: :::'k'-::.::;:1;:':4 9) if,verz-s2"-t" 64-1/7 64)- i :Iegiiiiiiiiititilliiiitiot .Aw::::2:: :::f.i' ifi::,i4i.sigigvikeninekiiptifeovpi.orderme..1.r7L,.:::;,.1,6a, ":,.q.::: :::?:: l'M'VF'Ri4V,a'WJIR444tVigggA'Stgfeekggegiii::FPNW.'MT.=ijNtf.' :".;;:'::::i';;,:'!i'':'.C.;;,"'i:::'j:,.!:: Elm SteRtStr#,:i7.::::mem.t:11:10:-9:::F:ii.,4:pi!,,,,:ii. ..caipistrictIL-1::::,:,-',:,,,,:-:..,4:.,e.9.,P,.1,,.,.:,!:: SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT • :.. 2.1 Owner of Record: 'c 1 ' 41 • /Asp / a , yi Altiii, ..•At a . ArAr i„ityy- ,,,2,1 60 4' 4.3 , - - ir re ailing Address" Ind , / _,- AvAr ... , Telephone 171-1? Clire3 67 /(rtitn Signature 2.2 Authorized Agent: / „/ c---71' zie/L 4ei-4 , Ce.-4-49h1 /ti v 4-) ,,, x- - - ,... It Name(Print) ,' '''''' -' ---- • Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS - Item Estimated Cost(Dollars)to be . Official Use Only completed by permit applicant - • .- . 1. Building 2 (a)Building Permit Fee ..., ye' ife7,0 2. Electrical /teer . (b)Estimated Total Cost of Construction from(6)'' 3. Plumbing /leer Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection / 3 Pao, 6. Total=(1 +2+3+4+5) Z-04 OVO Check Number --11-173---1/31t-Sr-C._ • .- . • . • '' . This Section For Official Use Only •• . •.. • , • Date Building Permit Number: • ' . Issued: ' Signature: . _ Building Commissioner/Inspector of Buildings '- . : .. . Date . ,,,,.... Ulf -1. , Ar-6-4,41-4,4 File#BP-2014-0664 APPLICANT/CONTACT PERSON DONALD R BESANCON /)..o N 1 ADDRESS/PHONE P 0 BOX 520 BELCHERTOWN (413)478-9528 PROPERTY LOCATION 91 EMERSON WAY l'' MAP 36 PARCEL 358 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out /c2 4 [4 �a I, l �'j Fee Paid / �7'(J Typeof Construction: CONSTRUCT 2 STORY SFH W/ATT GARAGE/DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 94265 �,� �r o 3 sets of Plans/Plot Plan ¢—!�'C�CC(/,v(/d C / Qf THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 -molition Delay Signature of Bui ding 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. 91 EMERSON WAY BP-2014-0664 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-358 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-2014-0664 Project# JS-2014-001141 Est. Cost: $281000.00 Fee: $1686.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DONALD R BESANCON 94265 Lot Size(sq.ft.): 12414.60 Owner: HAMPSHIRE PROPERTY MANAGEMENT Zoning: Applicant: DONALD R BESANCON AT: 91 EMERSON WAY Applicant Address: Phone: Insurance: P 0 BOX 520 (413) 478-9528 BELCHERTOWNMA01007 ISSUED ON:12/18/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SFH W/ATT GARAGE/DECK 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 12/18/2013 0:00:00 $1686.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner