29-135 [ ] All ducts must be sealed with mastic and fibrous backing tape.
Pressure—sensitive tape may be used for fibrous ducts . The HVAC
system must provide a means for balancing air and water systems .
TEMPERATURE CONTROLS:
( ] Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
and/or cooling input to each zone or floor shall be provided.
HVAC EQUIPMENT SIZING:
[ ] Rated output capacity of the heating/cooling system is
not greater than 125% of the design load as specified
in sections 780CMR 1310 and J4 . 4 .
MISC REQUIREMENTS :
[ ] Refer to 780 CMR, Appendix J for requirements relating to swimming
pools, HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F, and circulating hot water systems .
----NOTES TO FIELD (Building Department Use Only)-------------------------
MAScheck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2 . 0
MOFFIT
DATE: 7-1-2001
Bldg.
Dept.
Use
CEILINGS :
[ ] 1 . R-30
Comments/Location
WALLS:
[ ] 1 . Wood Frame, 16" O.C. , R-19
Comments/Location
WINDOWS AND GLASS DOORS:
[ ] 1 . U—value: 0 . 31
For windows without labeled U—values, describe features :
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
FLOORS:
[ ] 1 . Over Outside Air, R-30
Comments/Location
HVAC EQUIPMENT EFFICIENCY:
[ ] 1 . Furnace, 87 . 0 AFUE or higher
Make and Model Number
THERMOSTATS:
[ ] Adjustable thermostats required for each HVAC system.
AIR LEAKAGE:
[ ] Joints, penetrations, and all other such openings in the building
envelope that are sources of air leakage must be sealed. Recessed
lights must be type IC rated and installed with no penetrations
or installed inside an appropriate air—tight assembly with a 0.5"
clearance from combustible materials and 3" clearance from insulation.
VAPOR RETARDER:
[ ] Required on the warm—in—winter side of all non—vented framed
ceilings, walls, and floors .
MATERIALS IDENTIFICATION:
[ ] Materials and equipment must be identified so that compliance can
be determined. Manufacturer manuals for all installed heating
and cooling equipment and service water heating equipment must be
provided. Insulation R—values, glazing U—values, and heating
equipment efficiency must be clearly marked on the building plans
or specifications .
DUCT INSULATION:
[ ] Ducts in unconditioned spaces must be insulated to R-5 .
Ducts outside the building must be insulated to R-8 . 0 .
DUCT CONSTRUCTION:
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code Permit #
MAScheck Software Version 2 . 0
Checked by/Date
CITY: Amherst
STATE: Massachusetts
HDD: 6614
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non—Electric Resistance)
DATE: 7-1-2001
DATE OF PLANS: 7/1/01
TITLE: MOFFIT
PROJECT INFORMATION:
341 RYAN RD.
COMPANY INFORMATION:
DAVID FORTIER BUILDERS
COMPLIANCE: PASSES
Required UA = 77
Your Home = 55
Area or Insul Sheath Glazing/Door
Perimeter R—Value R—Value U—Value UA
-----------------------------------------------------------------------------
CEILINGS 192 30 . 0 0. 0 7
WALLS: Wood Frame, 16" O.C. 448 19 . 0 0. 0 27
GLAZING: Windows or Doors 49 0 . 310 15
FLOORS: Over Outside Air 192 30 . 0 6
HVAC EFFICIENCY: Furnace, 87 . 0 AFUE
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
sections 780CMR
v
Builder/Designer Date 4l e%
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m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFM' AVIT
I, O �!J;z,T!!�2
(li ceusee/peTmi flee)
with a principal place of business/residence at:
32 `r9u�2r�t. ST, /)&� aAl�%a]zw DSO(,u (phone#)
(st=Ucity/staW2i2i )
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Nome of Contractor) (Insurance Company/Policy Numbcr) (Expiration Date)
(Name of Contractor) (Insurance Compairy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(aaadi additioe3d slxet if nootniry to include infornvtioo pertaining to all ooatradors)
( I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homcowom who employ pasom to do m&ir�consti;aioo or repair work on a dwelling of
not more than throe units is which the homoowncr resides a oa the gcouads appurtenant th=w arc Dot generally cowidacd to be
employers undo the wotket's oca4>=mr4cn Act(GL152 a 1(5)�application by a homconvcr for a liccase cc permit may evidence the
legal stains of an omployor under the Worker's C.ompematiou Act
I understand that a copy of this cta2emmt may bo forwarded to tho Deparwxrd of Indr tdd AccidtatY Oflioo of luwrsDOO for tho
coverage ver Mcatioa and that failure to soot=eovcrago uudcr s ctioa 25A of MOIL 152 can lead to the imposition of"i-i W pcnaitia
eomisting of 1 fine'of up to SI,500.00 andlor imprison of tip to one year and civil pcn&t6cs in the form of at Stop Work Or --and a
firm of 3100.00 1 day against tae
For d '1 uto Daly
permit Number
a/ Wpb Lot#
Si of Liccn,,Jpermittce Daffe
s
SECTION 8 �CbiNSTR17CT10N SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:_'�/��! �• �d 2'l trz/- d®yU 2 4
License Number
3'2- / ,,
Address r Expiration Date
Signature Telephone
"t-,.e.»'. «, m ..v�a�n,a • _«.,.m .Y-.ss e �.a. .. ,wr a` :� #"w f 13;� a x
Re (t H. a=ern r. .vetnen n rac or *�aae a, ..�__ ���`w Not Applicable ❑
tJ Ulc rO142< 10 3cic of
Company Name Registration Number
G �,— e�,
Address Expiration Oate
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 the building permit.
Signed Affidavit Attached Yes....... No...... ❑
r� a —N
1�1 � ome.Owner.E`Xempt>!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--DESCR OPROPOSEDiWORK(c'heck all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [*I'- Siding [ ] Other [ ]
I Brief Description of Proposed Work:b"'O f ixj DiN%Nu ��,y I'- �;��X "2� CdUv(Z4 Q(,�C�L
Alteration of existing bedroom Yes�No Adding new bedroom Yes V"' No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0- Sheet C-
6a If°New=house and or addition to eitisting.lion`sing;-c _m_P eteAhe following:
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? f'i 2 S4 9f 0i—,NG'2"".1, �i�vlNi. /?,y, /'I(.<
d. Proposed Square footage of new construction. P`iN 6&i1_- 04z4k Dimensions ooze N / 2'x 1 .
e. Number of stories?
f. Method of heating? /-1 c(z-) 14et LVlT-a'- Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? Vecs
h. Type of construction W&A F/L4,SEZ
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes_ l No
j. Depth of basement or cellar floor below finished grade A114
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
as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to wok authorized by this building permit application.
q az&c
�v
Signature of Owner ate
� y
I, A✓!� �—Q�� �I�� as Owner Auth;es ized nt
hereby declare that the statements and information on the foregoing application are true and accurate, to e of my
knowledge and belief.
Signed under the pains and penalties of perjury.
Print Na!:Si
? � o
Signature of Owner/Agent Date
i
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
R"•
Lot Size "`),
^ -
Frontage -75
Setbacks Front G 2 rT, ?
I �
J O
Side L: R: L: a R: 3 s
Rear
Building Height
Bldg. Square Footage '"? 0 ScFt -3-1 % IoY( s
Open Space Footage 610101 p� %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
• i
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060 e o
phone 413-587-1240 Fax 413-587-1272 loop e� k
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION! 1 -SITE INFORMATION'
Thjs sec tion to be completed by office
1.1 Property Address:
1
Nh{ Map Lot
a� `� �
Zone O�ertay DastrIct �
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing A dress:
_ J Telephone
Signature
2.2 Authorized Agent:
Uc 0 A), �'0�2.T i ft/?—
Name(P ) ,, �- Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars)to be Official Use Only
completed by ermit applicant
1. Building -2` v (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
7 0 0 . ad Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection pin
6. Total = (1 + 2 + 3 + 4 + 5) # /S 06. oG Check Number 'A93
This Section For Official Use Only
Building Permit Number: P ZO "' I Date Issued:
Signature
Date
'Buildipg Cbmmis tuner%insocto:�o Butldir gs '
File#BP-2002-0010
APPLICANT/CONTACT PERSON MOFFETT JAMES&DEBORAH
ADDRESS/PHONE 341 RYAN RD (413)585-5844 Q
PROPERTY LOCATION 341 RYAN RD
MAP 29 PARCEL 135 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tvneof Construction•_BUILD 12 X 16 FOOT DINING ROOM AND 12 X 12 COVERED DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOI! AMATION PRESENTED:
pproved Denied
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan OR Special Permit and Site Plan
Major Project: Site Plan OR Special Permit and 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 Comissio
m
Signature of Building Offi 'al 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.
w f.
o- BP-2002-0010
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: ADDITION BUILDING PERMIT
Permit# BP-2002-0010
Project# JS-2001-0523
Est.Cost:
Fee: $80.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: David Fortier 008026
Lot Size(sq.ft.): 21 780.00 Owner: MOFFETT JAMES&DEBORAH
Zoning.URA Applicant. David Fortier
AT: 341 RYAN RD
Applicant Address: Phone: Insurance:
32 Laurel St (413) 586-8965
NORTHAM PTO NMA01060 ISSUED ON:715101 0:00:00
TO PERFORM THE FOLLOWING WORK.-BUILD 12 X 16 FOOT DINING ROOM AND 12
X 12 COVERED DECK
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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 Silznature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 7/5/010:00:00 3683 $80.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo