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25A-068 Fisher Scott 11-6-08 38 hubbard ave 3:52pm k % Northapton 1 of 1 KeyBeamO 4.504a kinBeatnEngine4.505b Materials Database 885 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing:Continuous Top Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Dead Load: 10 PLF Deflection Criteria: L/360 live,L/240 total Live Load: 40 PLF Deck Connection: Nailed Member Weight: 7.1 PLF Filename: KYB4 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Point(LBS) 11 9.001, 1187 5244 Snow Ti r 3 6 0 3 6 O Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 3.500" 1.500" 3242# - 2 3' 0.750" Wall 3.500" 1.500" 3242# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Dead Live Snow 1 620# 61# 2622# 2 620# 61# 2622# Design spans 3' 0.750" Product:1 314x71/4 Versa-Lam SP 2.0-3100 2 ply Component Member Design has Passed Design Checks." Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity location Loading Positive Moment 4944.'# 9634.'# 51% 1.53' Total load D+S Shear 3231.# 5544.# 58% 3.05' Total load D+S Max.Reaction 3242.# 9188.# 35% 3.06' Total load D+S. TL Deflection 0.0300" 0.1531" L/999+ 1.53' Total load D+S LL Deflection 0.0244" 0.1021" U999+ 1.53' Total load S Control: Shear DOLS: Live=100%a Snow--115% Roof=125% Wind=133% Manufacturer's installation guide MUST be consulted for multi-ply connection details and alternatives All product names are trademarks of their respective owners }' Copyright(C)1989-2005 by Ke mark Enterprises,I.I.C.ALL RIGHTS RESERVED. fv. .. —Passing is defined as when the member,floor joist,beam or girder,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,and Spann listed on this sheet.The design must be reviewed by a qualified designer or design professional as r2quired for approval.This desi n assumes product installation accordi to the manufacturer's a ecifications. Fisher Scott 11-6-08 38 hubbard ave 3:52pm Northapton 1 of 1 KeyBeam®4.504a kinBeamFngine 4.5051b Materials Database 885 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing: Continuous Top Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Dead Load: 10 PLF Deflection Criteria: L/360 live, L/240 total Live Load: 40 PLF Deck Connection: Nailed Member Weight: 7.1 PLF Filename: KYB4 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Point(LBS) 1' 9.00" 1187 5244 Snow 3 6 O 0 3 6 0 Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 3.500" 1.500" 3242# — 2 3' 0.750" Wall 3.500" 1.500" 3242# -- Maximum Load Case Reactions Used for applying point loads(or line bads)to carrying members Dead Live Snow 1 620# 61# 2622# 2 620# 61# 2622# Design spans 3' 0.750" Product:1 314x71/4 Versa-Lam SP 2.0-3100 2 ply Component Member Design has Passed Design Checks." Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 4944.'# 9634.'# 51% 1.53' Total load D+S Shear 3231.# 5544.# 58% 3.05' Total load D+S Max.Reaction 3242.# 9188.# 35% 3.06' Total load D+S TL Deflection 0.0300" 0.1531" U999+ 1.53' Total load D+S LL Deflection 0.0244" 0.1021" L/999+ 1.53' Total load S Control: Shear DOLS: Live=100% Snow--115% Roof=125% Wind=133% Manufacturer's installation guide MUST be consulted for multi-ply connection details and alternatives All product names are trademarks of their respective owners �: ,.w„ •ism *,": copyright(C)1989-2005 by Keymark Enterprises,LLC.ALL RIGHTS RESERVED. E f1"€ "Passing is defined as when the member,Floor joist,beam or girder,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet.The design must be reviewed by a qualified designer or design rofesswal as r uired fora meal.This desi n assumes product installation accordinq to the manufacturer's specifications. Fisher Scott 11-6-08 a 38 hubbard ave 3:41pm Northapton 1 of 1 KeyBeafn®4.504a ktnBealmEngine 4.5051b Materials Database 885 Member Data Description: Member Type: Beam Application: Roof Lateral Bracing: Continuous Top Slope: 0.00/12 Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Dead Load: 10 PLF Deflection Criteria: L/240 live, L/180 total Snow Load: 50 PLF Deck Connection: Nailed Member Weight: 15.8 PLF Filename: KYB2 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Replacement Uniform(PSF) 0' 0.00" 18' 0.00" 12' 0.00" 10 50 Snow r r isoo isoo Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 4.000" 2.450" 6431# - 2 17' 5.750" Wall 4.000" 2.450" 6431# — Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Dead Snow 1 1187# 5244# 2 1187# 5244# Design spans 17' 5.750" Product:1 3/4x16 Versa-Lam 2.0-SP 3100 2 ply Component Member Design has Passed Design Checks.'' Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 28100.'# 42969.'# 65% 8.74' Total load D+S Shear 5450.# 12236.# 44% 17.47' Total load D+S Max.Reaction 6431.# 10500.# 61% 17.48' Total load D+S TL Deflection 0.6468" 1.1653" U324 8.74' Total load D+S LL Deflection 0.5274" 0.8740" L/397 8.74' Total load S Control: Positive Moment DOLS: Live=100% Snow=115% Roof=125% Wind=133% Manufacturer's installation guide MUST be consulted for multi-ply connection details and alternatives All product names are trademarks of their respective owners Copyright(C)1989-2005 by Keymark Enterprises,LLC.ALL RIGHTS RESERVED. "Passing is defined as when the member,floor foist,beam or girder,shown on this drawing meets applicable design criteria for Loads,loading Conditions,and Spans listed on this sheet.The design must be reviewed by a qualified designer or design rofessional as required for approval.This design assumes product installation acoordinq to the manufacturer's specifications, X Fisher Scott 11-6-08 38 hubbard ave 3:41prn Northapton 1 of 1 KeyBeam®4.504a lunBeamEngine 4.505b Materials Database 885 Member Data Description: Member Type: Beam Application: Roof Lateral Bracing: Continuous Top Slope: 0.00/12 Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Dead Load: 10 PLF Deflection Criteria: L/240 live,L/180 total Snow Load: 50 PLF Deck Connection: Nailed Member Weight: 15.8 PLF Filename: KYB2 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Replacement Uniform(PSF) or 0.00" 18' 0.00" 12' 0.00" 10 50 Snow lip t u, w?�n 18 0 0 18 O 0 Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 4.000" 2.450" 6431# — 2 17' 5.750" Wall 4.000" 2.450" 6431# — Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Dead Snow 1 1187# 5244# 2 1187# 5244# Design spans 17' 5.750" Product:1 3/4x16 Versa-Lam 2.0-SP 3100 2 ply Component Member Design has Passed Design Checks.'' Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 28100.'# 42969.'# 65% 8.74' Total load D+S Shear 5450.# 12236.# 44% 17.47' Total load D+S Max.Reaction 6431.# 10500.# 61% 17.48' Total load D+S TL Deflection 0.6468" 1.1653" U324 8.74' Total load D+S LL Deflection 0.5274" 0.8740" U397 8.74' Total load S Control: Positive Moment DOLS: Live=100% Snow--115% Roof=125% Wind=133% Manufacturer's installation guide MUST be consulted for multi-ply connection details and alternatives All product names are trademarks of their respective owners Copyright(C)1989-2005 by Keymark Enterprises,LLC.ALL RIGHTS RESERVED. t, "Passing is defined es when the£member,floor joist,beam or girder,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet.The design must be reviewed by a qualified designer or design rofessional as re wired(or a royal.This design assumes product installation according,to the manufacturer's specifications. i 1�T IMPORTANT NOTE: NOTE: THE DIA WILL ACCEPT 1��to Ejj�y This Stop Work Order CERTIFIED CHECKS AND Your company has been imeda remains in effect until All MONEY ORDERS ONLY FOR Stop Work FINE PAYMENT.NO CASH, y fines have been paid. PERSONAL OR COMPANY_.._, InvestigationsoftheDeparhnentof CHECKS WILL BE ACCEPTED.' Industrial Aeddents for fa&reto ILLUSTRATION CERTIFIED CHECKS AND produce evidence of a valid workers' MONEY ORDERS SHOULD BE A STOP WORK ORDER is compensation policy. MADE PAYABLE TO: issued on the 28th,you present DIA SPECIAL FUND In won to the Stop Work Order, evidence of a valid workers you may be subject tocriYninal/evil compensation insurance We also accept VISA, penalfiesofoneyearimprisonment policy and pay all fines on the MASTERCARD and;' and/or a$1,5OO fine asproscnWby 31st. At$100 per day, total DISCOVER MGL 152,Section 25C. fines would accrue to $400.00 (See Illustration) Payment of fines can be arranged b contacting the If your company is required �� g y g to obtain a license or permit ` 2 34 DIA Office of Investigations from a local or state licensing in Boston Sam through 4pm board, i.e. liquor license, 5 6 7 8 9 10 11 at 617-727-4900 x 406 common victualers,building 12 13 14 15 16 17 18 ._..-Fax,;,617-727-7749 -.r r_ permits, etc., the DIA may When paying the I the contact that licensing agency 19 — - Boston-office,you should and request that your license 26 27 28 29 30 31 proceed to the seventh floor of not be renewed until you have 600 Washington Street. Upon obtained valid workers' arrival,you will ask the compensation coverage. information desk to contact STOP WORK ORDER S ISSUED the Office of Investigations at POLICY FFFFCTIVF If your company is involved in FINE PAID extension 406, a DIA Office of any local/state or other public Investigations representative sector funded projects,your will assist you. For failure to carry workers' convenience you may arrange compensation insurance could to pay a fine at any of the result in a three year following regional DIA debarment from all public Please be advised that a fine of offices: funded projects as proscribed Fall River: 1 Father DeValles by MGL 152, Section 25C. g; Blvd. P- 01 Lawrence: 160 Winthrop St. _ 00 per day -APPEALED) (Rt.114�y P.w. Fines T - Worcester: 340"Main.St. Fines accrue daily from the Has been imposed and will accrue from ,/Springfield: 436 Dwight`St. date this STOP WORK this day forward until insurance has ORDER was issued up to and been obtained and all fines have been A ea S including he date evidence of paid. g You may appeal the issuance insurance is presented to the of this STOP WORK ORDER DIA and all fines are paid. within ten (10) days of the Fines accrue over weekends issuance of the Stop Work and holidays. Order if you believe it to be u unwarranted. (revised 6/08) y Commonwealth of Massachusetts o Department of Industrial Accidents STOP WORK ORDER This Stop Work Order is issued pursuant to the provisions of MGL 152,Section 25C., the Commissioner of the Department of Industrial Accidents, or his designee has determined that the following named employer (Company or Corporation) has been found to be in vicRation of MGL Chapter 152; Company name: :t j It. ; '' i- '� ' y ' t Street/Job site. ; i Ciry/Town: ' i,^?� ' State: Zip: '_a The Commissioner hereby orders that any or all of the work sites, work places or places of business of the above named employer located within Massachusetts be closed and that all work cease. Said work sites, work places or places of business shall remain closed until the above named employer pays all civil penalties in accordance with Chapter 152, Section 25C and secures the proper workers'compensation insurance and producing evidence of same to: Department of Industrial Accidents - - -- 600 Washington Street — Boston, Massachusetts 02111 617-727-4900 Extension 406 DATE&TIME WORK MUST BE STOPPED: i Any parry in interest objecting to this order may make an appeal to the Commissioner of the DIA within 10 (ten) days following the service of this order. This order takes effect IMMEDIATELY UPON service of this STOP WORK ORDER, with the date of service considered the first of the;ten days. Issued Bye - on DIA Commissioner or Designee Service Date.-- Accepted By. Person served-Print name Person Served'-Signature Contact phone number �.4 l -I wish to appeal the issuance of this Stop Work Order Signature ^ At the request of the business/employer listed above, a Stop Work Order Appeal Hearing has been scheduled. The Stop Work Order and/or the penalty shall be rescinded if, at the hearing, it is determined that the business has been in compliance with Massachusetts General Laws. If it is determined that the employer was not in compliance with Massachusetts General Law by not providing workers' compensation for their employee(s), the fine shall accrue at a rate of$250.00 per day for each day such employer was not in compliance with this chapter, counting the date of service of the Stop Work Order as the first day and the date of payment of the penalty herein provided and of production of evidence of insurance or self-insurance as the final day, in accordance with Massachusetts General Law, Chapter 152, Section 25C. Hearing Date Hearing Location Department of Industrial Accidents Office use only Hearing Time: 600 Washington St. Boston MA 02111 Ind: �. EEs - . 7`"Floor SWO# Issued By: (Initial) 3/2008 THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES ANU t5 NU i TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. BUILDING LOCATION ACCURACY IS NOT GUARANTEED 66't y' BOOK 8304, PAGE 302 BOOK 535, PAGE 110 r LOT #13 ohs 1 4 tkr k � I ! - c°o co NOTE: SUBJECT TO EASEMENTS AND RIGHTS OF WAYS OF RECORD. a� -3 #38 7 L -i. 66'f HUBBARD STREET TO: MERRIMACK MORTGAGE COMPANY, INC. & LAWYERS TITLE INSURANCE CORPORATION TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY #250167 �arfa� -NOTE- SURVEYOR: lF, THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY . — AND DOES NOT CONSTITUTE A PROPERTY SURVEY s� ASS -MORTGAGE LOAN INSPECTION PLAT- OF NORTHAMPTON, MASSACHUSETTS RAND AL PREPARED FOR EZER y DIANE FISHER KATZ & DIERDRE SCOTT N35032 SCALE: 1"=20' OCTOBER 6, 2008 HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET - HADLEY - MASSACHUSETTS �0 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 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 backfll). 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 oflndustrialAccidents Office of Investigations F' } ` 600 Washington Street ...p,- Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): r r( t✓;` 'A e Address: Oei v: City/State/Zip: + © ,v MGY- GI©73 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 g. Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.E�J_Electrical repairs or additions officers have exercised their I L Plumbing repairs or additions 3.❑ I am a homeowner doing all work � P 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' li.❑ Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my 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 5250.00 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=tunder the pains and penalties of perjury that the information provided above is true and correct. Si�nahrre: Date: ��"D V 0 Phone r• (_Y� ) `d 7 — O 6 0,f cial use only. Do not write in this area, to be completed by city or town official Citv or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector Plumbing Inspector 6. Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: ��� �at L.SiL Ntr i y e- --r License Number Ad Expiration Date es e Signature Telephone 9.Registered Home Improvement G, 66tractor ,„ '', a„ .., ., , „ , Not Applicable ❑ Company Name Registration Number Address J Expiration Date lephone 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. -Hyme Owner Ex` 1n t o` 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-vear 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 - t ' SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) JRoofing Or Doors 0 Accessory Bldg. ❑ Demolition New Signs [0] Decks (M Siding[0] Other[0} Brief Descrip iop of Pro sed, 0�Cum Q��h� S 1 � u l7 F'SC%S +i� CyR54 �t- C'i6^��� 4 F%crt, Work: �i� � l�Tl c e3 �C �c��� 7��rv��s, ��.� } ��v f-jc.'V Alteration of existing bedroom Yes^ No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If Newhouse and or addition to'existl6a"housing,domatete the.foifovvinct: 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, 72�C as Owner of the subject prop y hereby authorize �fa �r 4 V � to act on my behalf, in all matters relative to w9fk authorized by this building permit apZo tion. /oz o#�r+ier Date as Owner/Authorizgd 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 urder thV pains and penalties of perjury. fDr 3A 0A r 1` y Print m 0 9 Sign ture 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 LotSize _.,_._ _...._ . ,._,... _.,.,... _,m ...... Frontage Setbacks Front Side L: ._w......_ R.'m._,_, L � R Rear Building Height w. Bldg. Square Footage _ % Open Space Footage ° (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 0 DONT KNOW 0 YES IF YES, date issued:,. IF YES: Was the permit recorded at the Registry of Deeds? NO DONTF KNOW .,_0 YES 0 ....,_.. IF YES: enter Book - Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: T" C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: 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 0 NO 0 IF YES. then a Northampton Storm Water Management Permit from the DPW is required. ' �t� �� Department�l:tse onCy � � City of Northampton Stas©flerrrtlt Building Department Cut/E7eway per: K 212 Main Street Sewer�sepix'Avertbtli€ Room 100 Wa ereweiCAv4 t66tt0 Northampton, MA 01060 a Sefs AStt,bturarma% S 5 phone 413-587-1240 Fax 413-587-1272 Pigt/S►te f'tans � � � ' ,; � " �4 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Proppeertyj Address: This section to be completed by office 3 L 1'� Ci�' j�IfA�' Map Lot Unit Zone Overlay District A Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGEhIT 2.1 Owner of Record: Ize Name(Print) �� Current Mailing��e� c!r Signa Telephone e 2.2 Authorized A ent: G y� C3 e�+2 r r'✓ t f'r� 1 �i ��C11 Ii ` / v L ft, o1 lei, 1 Name(Ri Current Mailing Address: �r v333 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit 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. Totai=(1 +2+3 +4+5) C , (?�? Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-0516 APPLICANT/CONTACT PERSON ROBERT CARRIER JR ADDRESS/PHONE 16 David St SOUTHAMPTON (413)527-0333 PROPERTY LOCATION 38 HUBBARD AVE MAP 25A PARCEL 068 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvneof Construction: ADD SHED ROOF TO EXPAND AREA(BATHROOM/HOME OFFICE) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 059154 REISTIU s W 3 sets of Plans/Plot Plan No 04cgyANC`{ w 1a WNftf ABASE SiMOK6 f(o WECTO_ a�- THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION 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 Demolition Delay t_,�0_uJ iz a o Signatur of Building 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. BP-2009-0516 GIS#: COMMONWEALTH OF MASSACHUSETTS �-° 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-2009-0516 Proiect# JS-2009-000723 Est. Cost: $48986.00 Fee: $293.40 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT CARRIER JR 059154 Lot Size(sq.ft.): 5270.76 Owner: SCOTT DEIRDRE&DIANE FISHER-KATZ Zoning_URB(100)/ Applicant: ROBERT CARRIER JR AT. 38 HUBBARD AVE Applicant Address: Phone: Insurance: 16 David St (413) 527-0333 SOUTHAMPTONMA01073 ISSUED ON.121812008 0:00:00 TO PERFORM THE FOLLOWING WORK:ADD SHED ROOF TO EXPAND 2nd FLOOR: NO OCCUPANCY W/O WHOLE HOUSE DETECTORS OR RESTRICTIVE COVENANT 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 Sifinature: FeeType• Date Paid: Amount: Building 12/8/2008 0:00:00 $293.402544 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 38 HUBBARD AVE BP-2009-0516 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25A-068 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-2009-0516 Project# JS-2009-000723 Est. Cost: $48986.00 Fee: $293.40 PERMISSION IS HEREBY GRANTED TO: Const.Ciass: Contractor. License: Use Group: ROBERT CARRIER JR 059154 Lot Size(sq. ft.): 5270.7_ Owner: SCOTT DEIRDRE&DIANE FISHER-KATZ Zoning:URB 100 / Applicant: ROBERT CARRIER JR AT: 38 HUBBARD AVE Applicas:_'Aaaress: ^� rnsurgnce: 16 David St SOUTHAMPTONMAO'1073 ISSUED ON:121,912008 0:00:00 TO PERFORM THE FOLLOWING WORK.-ADD SHED ROOF TO EXPAND 2nd FLOOR: NO OCCUPANCY W/O WHOLE HOUSE DETECTORS OR RESTRICTIVE COVENANT 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: —�e 'D '� Rough: }..t(.0 House# Foundation: Rn� Driveway Final: Final: Final c,� Y �- { a 2 0 O Rough Frame: G Gas: Fire Department Fireplace/Chimney: 99 ' awoil: + ) Z Insulation: ��( 0?� 1S Rough: "on l ` G 9 [," Final: q- 5 �? � 'Smoke: OjC 0((j-U/#y �tl= Final:pt< Gq ' 1) COU13 .�� 1 I THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu anc D Si nature: -- FeeType• Date Paid: Amount: Building 12/8!2008 0:00:00 $293.402.544 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo