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N! _99"OEZ h 2 W p O O I J Z u V p 254.87— X11 ao 2 h - q . Z2�, �, \ k 1 2-t S^� w MM Cl OW 892.57'— N s o O a CO En sy W \ o m m 1z 4 x 10 tw. x N C > ^^►' > z 4J C 0 a • ITT. Deep . . . . . . . . . . . . . . . . . . . ul MO IA r M0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI- TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plot Plans and Plans,-n"wtbe-filed with this application before a permit be granted. M27@M 'r Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE Application for a Dwelling Permit a Northampton,Mass. . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . Telephone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b the Supt.of Buildings: Application for a permit to build is hereby made according to the following:- 1. Location,Street and No. !/W/i/.). .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . Lot No. . . .J�. . . . 2. Nearest cross street . . . . . . . . . . . . Size of lot . . .. 3%.1. .!`�Ee �. . . . . . . . . . . . . . . . 3. Owner's name . � �W.!✓�-s Lf i. .-IIV. . . . . . . . Address jplo-�-4. Architect's name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Builder's name �O4.CE?��' �!.l!1�G: . . . . . . . Address Mass.Construction Supervisor's License No. .4?Coq-&3,6. ... . . . . . . . . . . Expiration Date . . . 5119. .. . .. . . . . . 6. Use of Building:One-family . . . . . . .X. . . . . . . . . . . Two-family . . . . . . . . . . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . . . . . . . . . . . . . . . . . . . . Number of Bathrooms . . . . c . . . . . . . . . . . . . . 8. Is there a garage attached? . . . . . . . ..YES. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of building . . . . . . .l; .X.51C .. . . . . . . . . . . .. . . . . . . Square footage . . . . . . .3 a p. . . . . . . . . . . . . . . . . . . . . 10. Number of stories . . . . . . !'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Distance from finished grade to high point of roof . . . . . .3.7.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Type of construction . . . . . . . . . . . . . o4�0G1O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . 13. Distance from building to street line in feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . 14. Distance from building to side lot lines in feet:Left . . . . . . . ..e�,�D. . . . . . . . . . . . Right . . . . ./90 . . . . . . . . . . . . . . 5 15. Distance from building to rear lot line in feet . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Is a plot plan being filed with this application? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Species of framing lumber:DF . . . . .. . . . . . . . . . . . . . . Spruce . . . . . . . . . . . . . . . . . . .. Other . . . .�< . . . . 18. Are all structural conditions noted on drawings? . . . . . 1��r'S. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Nature of land upon which the structure will be erected:Natural . . . . . .x. . . . . . . . . . . Filled . . . . . . . . . . . . . . . . . . . c 20. Depth of basement or cellar floor below finished grade . . . . . . .� . . . . .?7. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . r 21. Material of foundation walls . !°G �� . . -d 1�� -. . . . . . . . . . . Thickness in inches . . .e_ . . . . . . . . . . . . . 22. Type of roof: Flat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitched . . K. . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . v 23. Material or roof covering . . . . • 24. Method of heating . . . . . . . . . !°' ! !�'' � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Will the building conform to the Building and Zoning Ordinances? . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . 26. Septic Tank? . . . . . . . . ..!K . . . . . .. . . . . . . . . . . . . . . . . . City Sewer? . . . . . .-**/U.. . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Construction within 100 ft.of wetlands? . . . . . . . . . .W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 28. Construction within 100 year flood plain? . . . . . . . .!-Vo . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Estimated cost: Total $ . . .o7�r��. . . . . . . . . . . . . . . . . . . . . . . . . No building or structure which is erected or altered,shall be used,in whole or in part,for any purpose until a certificate of occupancy is issued by the Building Inspector. The undersigned certifies that the above statements are true to the best of his knowledge and belief. C) . . . . . . . . . . . Sign ure o Contractor Si atur f responsib applicant WRITTEN DESCRIPTION OF WORK TO BE DONE w ! 4�... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . COPPER: This element can be found in some natural waters. Excessive amounts of copper can occur in corrosive water that passes through copper pipes. Copper in small amounts is not detrimental to health; however, higher amounts will impart an undesirable taste to drinking water. For this reason the reommended limit is 1.3 milligrams per liter. SULFATE: Sulfate is widely distributed in nature and may be present in natural waters in concentrations ranging from a few to several thousand milligrams per liter. Because of the laxative effects of magnesium sulfate and/or sodium sulfate, sulfate content should not exceed 250 milligrams per liter. CHLORIDE: Most waters contain some chloride in solution. Chloride concentrations in excess of 250 mg/l usually impart a salty taste and are not recommended. An abrupt increase in chloride content may indicate possible pollution from sewerage or from road salting. CHLORINE: Chlorine is used to disinfect waters which contain bacteria. Residual chlorine present car, cause taste and odor problems along with forming chlorinated by- products. Carbon filtration can remove residual chlorine. HARDNESS: Hard waters and soft waters are relative terms. Hard water retards the cleaning action of soaps and detergents. Hardness is caused chiefly by calcium and magnesium ions, and it is expressed as milligrams of calcium carbonate (CaCO3) per liter of water. Hardness may vary from 0 to several hundred mg/I. Small concentrations of hardness help combat.corrosion of metalic pipes by forming a protective coating. Appreciable amounts of hardness break down on heating to form scale in boilers and on cooking utensils. Water showing a hardness of less than 50 mg/l are relatively soft; 50- 100 mg/l are medium hard, and over 100 mg/l are exceedingly hard. Very soft water, usually less than 30 mg/1 of hardness, is likely to be corrosive. CONDUCTIVITY: Water will conduct electricity when ions such as sodium, iron and manganese are present. This test confirms high levels of ions (minerals). TOTAL DISSOLVED SOLIDS: The amount of dissolved materials present. High levels may affect the corrosiveness of the water. Remove by filtration. The standard allows for 500 mg/l TURBIDITY: A suspension of fine particles floating in water. Usually caused by bacterial contamination, organic matter, iron, manganese or silt. Obviously it is very important to have drinking water free of foreign matter. May cause sediment. The standard allows for 0-5 tu. SODIUM: Sodium is commonly found in table salt, rock salt and in soils. High levels of sodium are found in wells that are near roads that are salted during the winter months. People on low sodium diets need to be aware of the sodium content of water they drink. Reverse osmosis systems are available for removal of sodium. The standard allows for 20.0 mg/l. QUABBIN ANALYTICAL LABORATORY P.O. Box 1192, 4 Stadler Street, Belchertown, MA 01007 413-323-7134 INTERPRETATION OF RESULTS OF CHEMICAL EXANUNATION OF WATER BY THE MASS. DEPT. OF ENVIRONMENTAL QUALITY ENGINEERING. AS PRESENTED BY THE QUABBIN ANALYTICAL LABORATORY COLIFORM BACTERIA: Coliform bacteria are widely distributed in nature. Contamination from surface waters, septic systems and direct contamination from animal feces can contribute to the growth of coliform bacteria in wells. Chlorine is used to disinfect well water that contains any coliform bacteria per 100 ml of water. If you have a problem with coliform bacteria in your well it is a good idea to check for bacteria every six months. NITRITE: Part of the nitrogen cycle. Can be correlated to high levels of nitrate. The standard allows for 1.0 milligrams of nitrite per liter. NITRATE: In drinking water above the standard poses an immediate threat to children under three months of age. In some infants, excessive levels of nitrate have been known to react with the hemoglobin in blood to produce an anemic condition commonly known as "blue.baby." If the drinking water contains an excessive amount of nitrate it should not be given to infants under three months of age and not used to prepare formula. The standard allows for 10.0 milligrams of nitrate per liter. pH: A measure of hydrogen ion concentration in water. Values range from 0-14. A value of 7 indicates neutral water; values less than 7, increasing acidity; and values greater than 7 indicates increasing alkalinity. The pH of water often varies from 4 to 9. Determination of pH assists in the control of disenfection and corrosion. ALKALINITY: The alkalinity of water is a measure of it's ability to neutralize a strong acid. Alkalinity is imparted to water by bicarbonate (HCO3), carbonate (CO3), and/or hydroxide (OH). The presence of these compounds is determined by standard methods involving titration with a strong acid u.ing various indicator solutions. The results are reported as mg/l of calcium carbonate (CaCO3) per liter of water. A water with low pH and low alkalinity might be considered to be corrosive. An alkalinity of less than 100 mg/l is desirable for domestic purposes. IRON: Small amounts of iron are frequently present in water because of the large amount of iron present in soil and because corrosive water will pick up iron from cast iron pipes. The presence of high levels is considered objectionable because it stains laundry and porcelain, and it also affects the taste of beverages. The recommended limit for iron is .30 milligrams per liter. MANGANESE: Although rarely present in excess of one milligram per liter, manganese imparts tenacious stains to laundry and to plumbing fixtures. A limit of.05 mg/l is recommended. Qua atory Box 1192 Stadler Street, Belchertown, MA 007 413-323-7134 5 3 098 J,{ Name: Doug Kohl Sample Date: 5-'�0 98, Address: 31 Campus Plaza Road Report Date: 6-01-98 Hadley, MA 01035 Collected By: Mt. Springs Sample Location: Type Supply: Well Turkey Hill Sample No.: # QAL 5443 Northampton, MA 01060 Mass. Lab. # 02454 TESTED FOR RESULTS MAX. RECOMMENDED LEVELS Ta4al Coliform Bacteria Neg Pos or Neg Nitrite 0 1 . 0 mg/l Nitrate .46 10. 0 mg/l pH 7 . 98 6. 5-8 . 5 Alkalinity 26.0 No Limit Iron . 16 . 30 mg/l Manganese 0 .05 mg/l Copper 0 1 . 3 mg/l Sulfate 14.0 250 mg/l Chloride 2 .73 250 mg/l Hardness 22 .0 No Limit Conductivity 86 . 8 No Limit Total Dissolved Solids 57 . 3 500 mg/l Turbidity 4. 5 5 NTU Chlorine 0 No Limit Sodium 3. 60 20.0 mg/l Fecal Coliform Bacteria Neg Pos or Neg Results are only for those items listed above and on the above collected date. Except for the following ---------------;-the sample was found to be within acceptable levels for D.E.P. Drinking Water Standards. If there are any questions on this report, please do not hesitate to call this office. David Fredenburgh, Director a C vn yak M � o�cr (O ct) vw !v o� '` O CA N to O � W A ..zl,lo.ol A ,zo-009. .6Z'r9& .Zx'Glfi - i N � 1E l cA. 1p Ch co - ,2 Co ` W CO (zi co co co a y y J` 00*o0s x ..ES 60.90 x ` 3 ..9,9,6Z.90 S J Co co ION co CO v � O M U1 1U a v y v d 70. C40 (40 3 �V4 8 N o o ���� '� b Ll U - 214.89' *4: ►,L 696 O2',27'42" E 210.91 �� y 1 �z 4 g .lS.srso s '� Z17.35' g ; u, o S 02'27'4, v � N 02'27'12-' E 76 3.11' w 223.79' ► .�_ - v 1957" ' 3 ..LS.6,-SO S �� r � 30,9.90. ' S 05.07•�'.. �, ti, vt 5 3 .GS.6r.S0 Ste\ 321. m -69Z (31 g© 1'�• 3 ..LS.6f.S0'S - S 05•07'44•• ). m 313-26- ° - - - - - - - - - - - - - - - - - _ - - -' - - - - - - • ��t•� [ - - .89 8ZZ N/F IOMN D & PATRICIA Jr o -0' RILEY BA".'j9, PG 312 tD 6 R' BA'PG 1-'9 PC 40 n n o•a+ , ED •- � ,8Z �Et � a• ,6l ZSZ 3 ..Ol,Z x.10 S .8S BZZ � 3 ,SZ,L1.O� S It ..EZ,LE.ZO X z co w x � A �' •, ° CA) W T 2-v � V ZO O ' W j c� o w r' .� r• �\ � Q � �� jJ��a FEE—Z�> COMMONWEALTH OF MASSACHUSETTS Board of Health, , MA. DISPOSAL SYSTEM C®NSTR CTI®N PERMIT Permission is hereby granted to; Construct ) epair( ) pgrade( ) Abandon( ) an individual sewage disposal system at /L as described in the application for Disposal System Construction Permit dated Provided: Construction shall be completed/wi in three years of the date of this m' . All local n ust be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date l Board of Health J '. JUN d 1998 DEPT , ss Conditions: Driveway Permit In lieu of plan approved by City Engineer I agree to the following added condi.Ci.nns; 1) I will contact the Department of Public Works and have an inspector check and approve: t. w graded gravel base prior to paving to insure compliaiice with slope and location; 2) I further agree that if in the in:;prctions any of the permit conditions are not met: that- L will at no expense to the City remove and replace th,; driveway as directed - t by the City Engineer. > By fFet ;NOTE. The Public Works Department=reconnuetccl>: that you provide a plan showing the proposed driveway uil.h grades and location in the :future to avoid possible exp%?nsc: which you will incur by not ;-getting appioval of ;accual' pJan.- in advance. M1 � 36-98 J041 C I T Y OF N O R T H A M P T O N, M A S ,S. � ��9- ..., . ,. 2.Z 19 � THE BOARD OF PUBLIC WORKS The undersigned respectfully peciition your honorob1c. body for common driveway Permission to install driveway at 11,26 T�� b�/LL �� (Lot 5) Fifteen (15) foot maximum width at the street 3Iiie Cutter drainage not to be disturbed. All drainage shall be directed off chm driveway surface to adjacent land and not on the existing roadway. Driv,�way surface to be paved .if the grade of the proposed driveway exceea:; 3Z or more. Kohl onstruction, Inc. 256-0321 31 Campus Plaza Road Hadley, MA 01035 Proposed Location Inspected by: Gravel Base Grade (/ Inspected by: Final Approval: THE BOARD OF PUBLIC WORKS Voted that petition be granted. 125.00 Fee Paid Ck No 14794 Samuel B- Brirtci.l5, P.E. Director of Public Work£ (SUBJECT TO ATTACRFM CONDITION 1 & 2) �Q m��' T ? Y��� �`� III > D> ° a Lli Q) w I _ i 3 1 01 co O Q � LU o o � 2F- 0MN �N�N(h�NN Q r I - Irt� J O . m a p QQQ aO ND NNO C � Y O t0 0 m it i III m ZO m y J to E? J E c II I II I } r F j IOU' OOm NmNN rn n �w v 8 x i jS � N to N N I I Cl) Cl) M m co Q m F- tll ~ I z ° V ZZ U m O I I I I F �rL l.- .a mm mw= m mom c I I � Eat m °-m Nm` III _mw� t m Na 3cm me N fh�fh C? N Ch C?N - O 0 m C 3 f0 aqD-O O m� _m j M M0nm�MC")0mI U W X xc 0 0 wi thrrthm�nthv��nmQ:nm �' w 4 �md b R °10 mLE w W M m M M N Nth t'1M N NChN c �.. th O J N �C �O x3 M m m N MIh Nth � ° L3L O °°°°°U°°°°U°° x p o om xac me m !- F F � � 3 U o m90 m aF ��LLUa��aUha c f th c� M n� 9- aaa a as as v < may x a o� C) w� v 1 W `x '�`� No `h env v E W 'm o8m ° UX LL°ra 0 W m II I NOQvi I I I - a rw r.e mc'm c 0 m c m c 0 m c 0 c 0 0 ac am c 0 am , _ - , N _ w a m v°m o j m m m m c rn m�a p U O o o ~ 0 0 0 0 0 N (L 0 a mmAmmmmmmmmmm O x m `o ami ami mm CO x l l im LL mmdmmmmmmmromm p ! LL a �,aa mo m IQt d� EL (L I C o O iw aaaa as av ° o.' y > f 7> X } N to I �Z INj W QmU°,W ILL U' S-7Y Jf W I3 "'m O N(h Q v)(O r m(➢O N M Q N 0 r 00 Cn O N M Q N 0 r Op m O Nth Q N t0 r OD m o�-N(h Q N t0 r w m 0 N (h Q V1 l0 r (h fh M th(h M[h(h Q tO h l2 t0<O(D l2 tD N 0 l2 t0 r r r r r r r r � � w 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: [ j 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 and cooling 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: [ ] 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 1251 of the design load as specified in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS: [ 1 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 maschk3 DATE: 5-16-1998 Bldg. Dept. Use CEILINGS: [ ] 1. R-38 Comments/Location [ ] 2. R-10 Comments/Location WALLS: [ ] 1. Wood Frame, 24" O.C., R-19 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.35 For windows without labeled U-values, describe features: # Panes_ Frame Type _ Thermal Break? [ ] Yes [ 1 No Comments/Location [ ] 2. U-value: 0.35 For windows without labeled U-values, describe features: # Panes_ Frame Type Thermal Break? ( ] Yes [ ] No Comments/Location SKYLIGHTS: [ ] 1. U-value: 0.24 For skylights without labeled U-values, describe features: # Panes_ Frame Type Thermal Break? [ ] Yes ( ] No Comments/Location DOORS: [ ] 1. U-value: 0.40 Comments./Location ( 1 2. U-value: 0.56 Comments/Location l ] 3. U-value: 0.18 Comments/Location ( ] 4. U-value: 0.39 Comments/Location FLOORS: ( 1 1. over Unconditioned Space, R-19 Comments/Location ( ] 2. Over Unconditioned Space, R-38 Comments/Location ( 1 3. Over Outside Air, R-38 Comments/Location HVAC EQUIPMENT EFFICIENCY: ( ] 1. Furnace, 97.0 AFUE or higher Make and Model Number ( ] 2. Air Conditioner, 10.0 SEER or higher Make and Model Number 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 1310 and J4.4. Builder/Designer Date 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: 5-16-1998 DATE OF PLANS: 5/16/98 TITLE: maschk3 PROJECT INFORMATION: Bell Richards COMPANY INFORMATION: kci NOTES: 97% eff. gas furn doors listed in order are: to porch(V), front(Y), garage(W), to basmnt(2868solid) . Slider(X) is in Glazing total COMPLIANCE: PASSES Required UA = 655 Your Home = 528 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------ CEILINGS 1993 38.0 0.0 60 CEILINGS 5 10.0 0.0 0 WALLS: Wood Frame, 24" O.C. 2466 19.0 0.0 144 GLAZING: Windows or Doors 487 0.350 170 GLAZING: Windows or Doors 72 0.350 25 GLAZING: Skylights 10 0.240 2 DOORS 18 0.400 7 DOORS 46 0.560 26 DOORS 18 0.180 3 DOORS 18 0.390 7 FLOORS: Over Unconditioned Space 1567 19.0 74 FLOORS: Over Unconditioned Space 372 38.0 10 FLOORS: Over Outside Air 8 38.0 0 HVAC EFFICIENCY: Furnace, 97.0 AFUE HVAC EFFICIENCY: Air Conditioner, 10.0 SEER ------------------------------------------------------------------------------- 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 ENERGY CONSERVATION APPLICATION FORM MAY 2 i 1998 FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION Applicant Name: .rG�fl ,ItC Site Address: /av Applicant Address: L—s/ (.g-, V,(j IR�A�i3 .tea City/Town: i /�,O.lz Y W4 Cal035- Use Group: - Date of Application: Applicant Phone: Applicant Signature: Compliance Path (check one): E] Prescriptive Package(for 1-or 2-family residential buildings not heated by electric resistance) Fill in all values that apply from Table J5.2.I b: Package Number(A through KK): a. Gross Wall Area sq.ft f. Wall R-value R- b. Glazing R.O. Area sq.ft. g. Floor R-value R- e. Glazing% (b_a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE n Component Performance (Manual Trade-Off) Climate Zone(from Figure J6.2.2) [:] Zone 12 Zone 13 E] Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable] �M4&heck Software Attach Compliance Report and Inspection Checklist printouts. M Systems Analysis n Renewable Energy Sources Attach approved Analysis Official's Name: Official's Signature: Application Approved Date of Approval: Application Denied ❑ Date of Denial: Reason(s)for Denial: (over for more) asRS 12/007 MAY 2 ; 1998 CITY OF NORTHAMPTON BUILDING PERMIT CHECKLIST All 1&2 Family Proj ectS The following items are to be considered MINIMUM information to be submitted with ALL permit applications A Scaled drawings & details shall be submitted with each application proposing construction, reconstruction,addition,alteration,or repair. The building official may waive the requirements for filing plans when work is of a minor nature.- B. Scaled drawings&details shall indicate&describe all proposed work, including location, size,grade of materials&equipment to be used. C. PLOT PLAN,property address;map &lot number,zoning district&overlays (such as wetlands)-- Show well and septic locations(if applicable)- Location of lot lines,dimensions of lot, frontage Location&dimensions of public easements,public utility easements, railroad right of ways , and established zoning setback requirements. Locations&dimensions of primary and accessory buildings&structures. ' D. FLOOR PLANS,floor plan of each floor and intermediate levels including basements, crawlspaces,terraces,porches garages,carports,and decks, showing existing condition and proposed construction. Dimensions, locations&materials of foundations,footings, columns &piers (including reinforcing when required) Direction, dimensions,spacing&grade of all framing (floors, roofs,walls,partitions) Location of all walls,partitions,windows, stairs &doors,: Location&description of all electrical equipment and alarm devices=- Location&type of all heating and air conditioning(HVAC)equipment. HVAC schematics(where required check with building inspector) EXTERIOR ELEVATIONS, Front, rear&side elevations including foundation and finish grades.,- Location&dimensions of windows &doors. Description of exterior cladding or siding material." Show exterior stair locations &dimensions. Show chimney and vent locations DETAILS &SECTIONS, Sections through exterior walls showing details of construction from footing to the highest point of the building. Sections through fireplaces &chimneys(show clearances)— Location&details of any roof trusses,glue-lam, or engineered lumber (include connection details and Massachusetts professionals stamp on specification sheet) Exterior envelope energy requirements :Uo-of walls, roof-ceiling&floors..OR-.R value of walls/roof/floor,also percent of window area to wall area. ? ;;' Q-�t�M PT =� •�0 0 g _e Critp of �Norfljaiii toli 1 - i B B sssnc bits etta MAY 2 f" 1 1998 DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 , Square Footage Amount Basement @ .10 1st Floor @ .40 2nd Floor @ .20 9 y� 1/2 Floors, Attic, Garage .10 Deck -Porches .10 TOTAL Bev , ¢! 4C 11AMp�, \ �o �oy a ,a (rff� >txf �nx#1fttrlt�r�arl aB �asaacbnrrtta m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building yy Northampton, Mass. 01060 ' WORKER'S COMPENSATION INSURANCE AFFIDAVIT (IicensccJpermiaee) with a principal place of business/residence at: (street/city/statrJa p) do hereby certify, under the pains and penalties of pegury, that goI am an employer providing the following worker's compensation coverage for my employees working on this job: 05# e-& gyve_-98-Gaon -WA/a/0? (Innrrance Company) (Policy Number) (Expir 6 n Dale) ( ) 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: (Name of Contractor) (lnsuran(—_Company/Policy Number) (Expiration Date) (Name of Contractor) R sumcc Company/Policy Number) (Expiration Date) (Name of Contractor) ansurant~Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Coapany/Policy Number) (E)piration Date) (&Mach additioail shod 1fno0ess1ry to rochide mformatioo pert,=,a m all ooaftad4cs) ( ) 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 whits bomcotir who employ perww to do mainimance,coastruction or repair work on a dwclliag of not mom than throe units is which tba homeowner midi or oa tb,grounds V urteaaat iheccto arc oot gcncratty oomidcrcd to be employaa under the—&cel occapcasation Ad(GL152,s31(5)j applintioa by a homeowner for a lion=a permid may cvidenoe the legal ctatu of an amployar under the wo&ces Compooaaiioa Act. I understand that a copy of tlria atatcmmi may bo focwerded to tba ti"rmocn2 of Ind a]A Dadm&Ofoo of Imur+non for tbo coverage verification and that failure to tcatro coverago under soctim 23A of MOL 152 uq lead to tbo impmition of criminal penalties co—tiag of a fine of up to S 1,500.00 and/or*riso� of up to one year and civil penalties in the form of a Stop Work Order and a fins of S100.00 a day tpinA M For 67utur�al uao oily Permit Number Maps--Lot 4 .x:.;;;:.. Sigriahire ia�sccypermittcc �/ --- Do any signs exist on the property YES NO IF YES, describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: 11. ALL `INFORMATION MUST BE COMPLE'T'ED, or PERMIT CAN BE DENIED DOE TO LACK OF INFORMATION. This column to b, filled is by the Building Department Required Existing Proposed By Zoning Lot size zj�, �, Frontage g` Setbacks - - side L: R: L:-/-5-0' R: /BO - rear Building height 37 — Bldg Square footage %Open Space: (Lot area minus bldg &paned parking) f Parking Spaces ht rof Loading Docks d U Fill: Avol-ume--& location) 13 . Certification: I hereby certify that the information contai d herein G is true and accurate to the best of my knowled e. DATE: - APPLICANT's SIGNATURE NOTE: lanuanoe of a zoning permit does not relieve an appli ant's burde to 0o pty wltta all zoning requlrements t and obtain all required permits from e Board of Health. Conservation Commission. Department of Publto Works and other applicable permit granting authorities. FILE # re MAY 2 7 1998 File No. l, Cl I ZONING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: /�04;K Address: Telephone: —113 ash C->3--2 2. Owner of Property: �� D ��/�'17�5 e✓✓(, _ __ Address: <S/ 1i91WPA45 Telephone: .-?6-G 08'Z/ 3. Status of Applicant: Owner Contract Purchaser Lessee ___,T Other(explain): 0-511 ,(2z--Z� �G 4. Job Location: ,/a?D �'// � r �� Parcel Id: Zoning Map#�_ Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Propertv c3T 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 4C 7- �/6F 7. Attached Plans: _�Sketch Plan Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES eO IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? ' ' '� P-.71&9 NO DON'T KNOW YES IF YES: enter Book 5W7,4 Page aV-6 9 and/or Document# 9. Does the site contain a brook, body of water or wetlands? NO__L�- 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: (FORM CONTINUES ON OTHER SIDE) .r FILE 16jq 4 .i MAY 271 10 APPLICANT/CONTACT PERSON: ADDRESS/PHONE: PROPERTY LOCATION: Mo 12z4. -�L 94� " /4-t)P�5 MAP j PARCEL: ,5 ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION_CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FTT,T,FT) OIT Fee Pnid Ridldin2 Permit Fill Eee Paid 7 4V , ✓ - Addition to Existing .�- J c.. THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APF LICATION- Z'Approved as presented/based on information presented Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received& Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval-Bd of Health Well Water Potability-Bd Health Permit from Conservat' n mission A V I Signature of Building Inspector oOr Date NOTE:lssuanoo of is zoning permit does not relieve an applioant's burden to oompty with all zoning requirements and obtain ail required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applicable permit granting authoritles. ca Z o ^ti as �.•r•,i''ti y b CL CD Job a. o Cs1 °ri c�D r: ~' w Ln CD y O vi In L= CAD CD ro X, CD C. 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