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25A-115 cl o 14C - } 13ge\ M _ �G <3 A (z- FSCFioor Span Connector As an alternative to coil strap,our new FSC-Floor Span Connector, connects upper floors to lower floors from the inside of the wall.The ► 13/a°Ir -_ convenient obround holes make installation in narrow wall cavities easy. Installs with a 3/a"all thread rod,nut and washer(not included). 0 MATERIAL:See table FINISH:Galvanized o �—Nut and INSTALLATION: washer •Can be used on a single 2x stud. = required a o. •Threaded rod,washers and nuts are not supplied with the FSC. •Use 3/a"threaded rod grade A307 or better,with matching nuts p Max and cut washers. 18 •FSC may be installed a maximum of 18"from the sill or top plates. 151/4" •Drill 1/2"to 3/4"diameter hole through the plates for threaded rod access,hole should be located approximately 1'/2"away from the face of stud used for FSC attachment. •Nails can be installed up to 30 degree angle with no reduction in load capacity. CODES:See page 12 for Code Reference Key Chart. . ,F f � o Fasteners Allowable Tension Load ! Model Code 1 Ga DF/SP SPF(HF i No. Stud Anchor Ref. FSC Max d (133) (160) (133) (160) Patent Pending 18 FSC 12 1510dx1Y2 3/8"AT R 1830 1830 1570 1570 146 1.The allowable loads have been increased 33%and 60%for earthquake or wind loading with no further increase allowed;reduce where other loads govern. Nut and 2.Load values are based on a minimum lumber thickness of 11/2'. washer 3.Standard cut washer is required with the 3/3"all thread rod. ;: °; required 4.The FSC can be used on offset studs provided the horizontal offset is no greater than 3".Refer to flier F-FSC for more information (see page 187 for details). 5.NAILS:10dx11/2=0.148"dia.x 11/2"long. See page 16-17 for other nail sizes and information. Typical FSC Installation MSTC48MMSTUMPre-Bent Straps The MSTC48B3 and MSTC66133 are pre-bent straps designed Min.2-2x or to transfer tension load from an upper story shearwa(l to a beam on •j 3" Min.2-2x or 4x the story below. -m cl) MATERIAL:14 gauge FINISH:Galvanized 38 N yCODES:See page 12 for Code Reference Key Chart. :m"; Le Mt C s Start nails g �c 1%2'up from .`. 38 Nails end of stud y Dimensions Fasteners Allowable '' 441/e 1 IT up from Length 21" Model Beam Beam Tension Loads Code 621"for end of stud _' MSTC66B3 * k k No N No. Width Depth Studs/ DF/SP ' SPF/HF Ref. 1' Rec Face Bottom Post No Nails Req'd Rim 1 — (min) (min) (133/160)(1331160) —� Joist a Face Nails " Face I MSTC48B3 3 91/a 12-10d 3930 3380 " � "," 4-10d 38-10d 128 MSTC66B3 31/2 111/4 14-10d 4440 3820 Beam Beam 1. Using fewer than 38 nails in the studs/post will reduce the capacity of m MSTC66B3 the connection.To calculate a reduced capacity use 129 Ib.per nail for ,^w. Installation DFL/SYP or 112 lb.per nail for HF/SPF ' with Rim Joist 2.Nails in studs/post shall be installed symmetrically.Nails may be installed over the entire length of the strap over the studs/post. 3.The 3"wide beam may be double 2x members. MSTC48B3 4. MSTC48B3 and MSTC6683 installed over wood structural panel sheathing 211e Pre bent up to 1/2"thick achieve 0.85 of table loads. 5. Loads govern by the lower of.125"deflection from static tests on wood Bottom Nails members,steel ultimate divided by 2,or the calculated nail values. MSTC48B3 6.NAILS:16d=0.162"dia.x 31/2"long,10d=0.148"dia.x 3"long. See page 16-17 for other nail sizes and information. Installation with no Rim Joist 152 HDAMHoldowns . These products are available with additional corrosion protection.Additional products on this page may also be available with this option,check with Simpson for details. Material Dimensions Fasteners = Model Stud No Base Body HBI SB W H B SO Anchor Machine Bolts o Ga Ga Diap Qty. Dia. y 1-1132A 7 12 49/16 2'/2 23/4 B 29/16 3/8 1'/16 5/8 2 6/8 ® HD5A 3 10 51/4 3 3'/e 97/,6 39/16 1/2 23/,6 5/6 2 3/4 '('� HD6A 3/8 7 63/16 3'/2 31/4.. 11'/16 3'/,6 9/16 2'/16 7/8 2 7/8 HD8A 3/6 7 63/6 31/2 3'/4 149/6 3Yii6 9/6 2'/6 7/8 3 7/6 HD10A 3/9 7 6M6 31/2 3'/a 18'/16 37/16 9/6 2'/16 7/6 4 7/8 �1 HD14A 3/e 3 7 4 31/2 209/16 35/8 5/8 23/16 1 4 1 y HD15 3/6 3 7 4 31/2 241/2 4 1 s 35/e 2Ye 1'/4 5 1 See notes below. Allowable Tension Loads Allowable Tension Loads Holdown9 Holdown914 tSFiSP(133/160) SPF/HF(133/160) Deflection Deflection Model at Highest at Highest Code No. WoodMemberthickness Wood Member Thickness Allowable Allowable ' Ref. Design Load Design Load 13oz 2 '234 3 `334 4% 5Y2 134 2 234 3_ 33'2 434 5% Flush Raised ® HD2A 1555 2055 2565 2775 2775 2775 2760 1320 1740 2165 2570 2565 2565 2550 0.058 0.077 HD5A 1870 2485 3095 3705 4010 4010 3980 1585 2110 2625 3130 3645 3700 3680 0.067 0.117 HD6A 2275 2980 3685 4405 5105 5460 5510 1870 2470 3065 3680 4280 5055 5020 0.041 0.125 N14 3220 4350 5415 6465 7460 8065 7910' 2710 3655 4530 5480 6350 7470 7330 0.111 0.121 40 105, 122 3945 5540 �6935 8310 `9540 9900 9900 3275 4600 5745 7045 8160 9500 9195 0.269 0.269 — — 11080 13380 13380 — — — — 9495 11950 12485 0.215 0.282 — — — — — 15305 — — — — — — 13810 0.082 0.082 1.Allowable loads have been increased for earthquake or wind load durations with 9.Deflection at Highest Allowable Tension Load includes holdown elongation no further increase allowed;reduce where other load durations govern. and anchor bolt elongation(L=5").Additional elongation of anchor bolts A 2.HD15 requires a minimum 48(in a 3Y2"wide shearwall)or a 6x6 nominal post longer than 5'shall be added to hDldown deflection. to ensure the tension load carrying capacity of the critical net section meets the 10.Structural composite lumber columns have sides that show either the wide ( holdown capacity. face or the edges of the lumber strands/veneers.Values in the tables reflect 3.Use a minimum 46 nominal post for the HD14A.Minimum post size is installation into the wide face. required to ensure the tension load carrying capacity of the critical net section 11.To achieve published loads,machine bolts shall be installed with the nut on the meets the holdown capacity. opposite side of the holdown(see picture below).If reversed,the Designer shall 4.HB is the required minimum distance from the end of the stud to the center of the reduce the allowable loads shown per NOS requirements when bolt threads are in first stud bolt hole.End distance may be increased as necessary for installation. the shear plane. 5.The designer must specify anchor bolt type,length and embedment. 12.HDA and HD allowable loads are based on the lower of the 2005 NOS fastener See SB and SSTB Anchor Bolts(page 25-27). values or the ultimate load on a steel test jig divided by 2.5. 6.Refer to technical bulletin T-ANCHORSPEC for retrofit anchor solutions 13.Post design shall be by Designer. (see page 187 for details). 14.Holdowns may be raised off sill plate.Refer to table for increased B 7.Lag bolts will not develop the listed loads. deflection values(if applicable).Refer to note q,page 14 for installation 8.See page 13-15 for testing and other important information. instructions of raised holdowns: SOURCES OF 0 z o DEFLECTION AT 1 1 z r z 1. Bolt slip can occur at holdown stud bolts. W 2. Increased bolt slip can occur if oversized holes are drilled through the 9 stud for holdown stud bolts(oversized holes are when the hole diameter o is greater than the bolt diameter plus'/16"per 2005 NDS 11.1.2). 1 2 N 3. When a holdown is installed on only one side of the stud,an eccentricity BP's are required by o exists during loading which can cause more movement in the shearwall 3 E the City of Los Angeles. system. Bearing Check with your local y 4. Unrestrained anchor bolt nuts can spin loose during cyclic loading; 4 5 Plates building code on usage. using steel nylon locking nuts or thread adhesive may prevent nut spin. (NOS Section 11.1.2.3 6 7 a 5. Movement can occur when nuts are not tightened g htened enou h. Stud requires a metal plate, metal strap,or minimum Retightening bolts before covering wall may prevent this. 8 10 of standard cut washer.) 6. Deflection can occur in the holdown under load caused by stresses due to earthquake or high wind. 7. Lateral displacement at the top of the wall rotates the stud around its Sill Plate base causing the holdown base plate to displace vertically. ° 8. Wood shrinkage can occur due to drying of the sill plate,rim joist, ° and/or top plate;nuts may require retightening. ° Foundation 9. Uplift forces on the bolts can cause localized wood crushing at bolt bearing locations.Using larger bearing plates may prevent this. Holdown 10.Wood at the end of the studs (sill plates, rim joists,etc.)may crush ° Anchor under normal dead and live loading;additional compressive forces due to overturning during earthquake and high wind loads add to the deflection. (1)(Z and©do not apply to the PHD and HDQ. 41 }i�iti sj(3f1 t!.tti �,,A! 1A#Alf.i} s.,}a'�ta it i A�{31}iP3 ��%Ivry+it1 f' i � i '� EIE' t !` ►` ;I ,E ( I. f �. � �-1 � � " I - 11�- ` 1 ► i° +- � l � 11t� � i � =1 p Q'I , _ c _ t s — - J-* - 9699Z#JOPA008 ..... v...,,,, EUOJA .. ....... �! t•;[J 1 � I � Z1 1 _ 1 1 + , ; ! # .i,°:� 1��i'ZM�� I�!{7�K1�x'!E�!� �f ! i�i' I q 1114 1 t .t r Orp I �;1tI pp,t 1'. 1 I �Y f _ x 5695Z#aepao9a O WOJA YiF,II,f ,Jt#3/ fil(� I x i� n4 E ri x(V .t I '� N, N '� 1 '� '1 '! I '� '� 4 � , e — _ _ y _ , . S y ,g — " . .,,........,a=ems... �-:...._,..,.-..�,_...:�..... p-r.._:�,. — " _ E T ; zz= 9699Z#aapaoaa _ _...,, .......... ;+to oi4o aom o+ eta woo n� t ' ,gar F`r+am t1�e h work l t ; �Out i" #i�t .cord 6� '��186 Reorder#25695=2.' it fo jj ..;. ri•Ya:a.�w'aus=,,,:aY���w.a-»��r.+.•ie.usr, 5•'y - f a., a _ j _ t ' e is 4' "-. ..M�._......,_...._......._,.. ._.«..«.. ....., .. ... _. _. ,- ,.....s.,ate. ''� - Y . _. t 5 *.,...•.�„��•„s. ?!»� .-„ �* a r.. . 3. "E I Jo,l S"I"t,d,k,1,t1td,iiLf.L1,ki,l',,7a.( dJ 111J&I�,t,lO'ld.h 'a-3-4. f | � : : } � . <# <\ ' ? war ' ~ � �& � § G&& . . . | /. . . . .. . �. ( ! . : . . . ! .k � | . . .. . . : . . . . . . . : | . y. \ . NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIA-L ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 sfquired by Massachusetts General Law, Chapter .152. Sections 21, 22) & 30. this NAA11 give you ' I Of I' e) have provided for payi-new, to ovir injured employees under the above mentioned 'Alce trio, �w chaptu by insuring with: ASSOCIATED iNDUSTRIES OF MASSACHUSETTS PAUTUAL iNSU RAW'E COMPANY NAME OF INSURA CE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0 V0 ADDRESS OF INSURANCE CONIPANV \,NVC 6 0 1109-70 12007 10J0312007 - 10,'031'2008 POLICY NUMBER EFFECTIVE DATES 6 Campus Lai7e P,nck & Parras IrSUrance Eastharvton, ,M.A 01027 "N',kNIE Of INSURANCE AGENT ADDRESS PHONE David Fortier dba David Ferrier Bu'iders 32 Laurel Street Northampton, %1A 01060 U-14PLOYM y ADDRESS 09,111;2007 ENIPLO)"ER'S WORKERS COMPENSATION OFFICER(IF ANY) DATF MIL,-Vic-AIL.-TRE-AT NINUENLY The aboN e named insurer is required in cases of personal injuries arising out of jr;1 in tits course of employment to furrish adequate and reasonable hwipital and medical services in accordance tis ith the provWons of the Workers CompensaflonAct. r=opy of the First Report of Injury must be given to the injured employee. The employee may selezzt his or her ovtn physician. The reasonable cost of the services ;provided by the treating physician will he paid by the insurer. it the treatment is nec'�-ssary and reasonably connceted to the work related injury. in cases rf quiring hospital attention,employees are hereby notified 'hat the insurer h,,is arranged for such attention at the NEAREST AND BEST MEDICAL Ff'VCHLITY NAME 01F HOSPITAL ADDRESS TO 0 BE POSTED BY EI)VIPLOYER .0 RN CERT1FIC'AT OF LIABILITY INSURANCE paaWAR (4'i3)5 6-0111 FAX (41W46-6431 TWIS CORTIFIGATE.!S ISSUED AS A MAMR OF INFORMATION Webber rinl 11 Ins, h�lar+cy, Inc, ONLY AND CONF&R°S NO RIGHTS UPON THE CERTIFICATE }IOLDER.TK)B CERTIFICATE�S NOT AMEND;ElCl'END OR � I; North XaNg Street LTER NE COVERAGE_! dolela U�'wIe P.O.UCMa BE3.OW - _1 Nontiavpton, CIA 01060 NAiC a Ii&sitED�Lear,ar SIC i!Nst.r:nA pear ess Insurance _ _��,��_ DBA: Buck Bruthfars rbncret+a �us�ArNa kola or/Peer ass _ il€t�,5 — –__. _f PO Box 416 NaM ey, Ra 0303 5 ,N6 6RE.N D7 fti,,,P OF VNISURANCE LISTE;.SELO€U NE 6IMN l3& :C TO THR I�d:URF.SAM:0 ABGVE FOR 7HF POLI'f PEit€OD€NVOATED,NOT'4'IYHSTANDi VG i ANY R.ECUIF imam T raFw QR,couvi`,oh uF ANY i;OMRACT Ok CT;iER Z004I4ENT VhiTH 91SPE.1 TC;if N1014 THit C19 €FVTE MAY aE ISS�,IS.D QP. i MAY?WTAIty.THE iNSURANCE APPQPMEC 4Y 7KE PO ICES ZESCP?ISEC 41REIS I£SUBJECT 70 Af.i.Ttit TERMS,1XCLUSICNE AND CONDITIONS Of SXH ! PGLIVES.AGGREZAT£LSW76 SHOWN MAY F AV!SEEN REOUr EV SY PAID CLA?M°. yf Of WCUAAfNE 'di.►Ct 14JUResr 1 v � R ul ! ( aENRRAL"Jury CaPEi357$04� 11/17/2007 11i1T/2005 SAct�oec�wR�. �i 110001_00 j CLAtA2S FLl9$ f�6CDi:r,, i MD w(My DIV perfiyi } Fe PiR� 4LiNhl a APV INJURY God 1 I r 4E1,2 tt3 VIE bA7E L:1 aPM"fw PER; fI aRO09JCrs cake 4PaGG 1 Di ! i i�AJ'"pi�WMUASSdTY� 80145061 11!17/2007 { X1,/'17/2008 ;coNwi�Easswr��EMY 's ~ 1 tiYYru;a ! ! 46aYCCfe.rK: ''f!1,��f�.�Q4 } ! A'.l OW 40 Moe 1111 ; 8 QC i y1 URY t $ � i X E�HEOUl.fiOAUTp4 4 � i� F ? ...�.-.....�L._.�.�..._......,......... I #Rd0 ALTOS 1I1fj 64GN.Y INJURY j E rC,t-:�WIr�J AtJT65 , �1964m FXCPLRTY DAMAGE f m RAGC UASILfC1 � �� � AUTO ONLY AuCiiX'Nt C, i I AfaY AU'C VNER THAN EA ACr. 6 j i Ai To ONLY - (,7taiiiiUr�19RS{.LA WMIII.M I _ LAOM OGOURKCNOE a OCCUR � 1 CLA 4 kkkM I i j AGQRQGATE I tiTON i _—,, .C1-3r 38�9 U /24/23�8 a3,24fx10 WcAms0010PSWATNANC � L i1P OYeR@'f.WILITY i AkY ORO?RIETQR'PAATVSRA VUI VC ) I G L:fV�'MACOfDEKT P �V-L-0 IUD' OFF iCCRAAEMS EXCL:;DLD� ' $•L.C(SE4S6•EACaNPIJ� L � j P er aed ,Ydor 6€MEC€AL J Crtr�VcEICNd fi 1 013E0E-f+E s.GY Li►MT 1£ S00,60 -�f OTfiEll I � E ON:ICRIpTIOW OF a!'III1A3'4Gklf/Ll)GATICiNS!VS tiCLE BRGLUSIONffi ALC'FZ DY 1N:+O1tffbVEW't iFAC9Ai.PRO i i 4 i 4 EAOULD ANY of(H6 AsOVE 095CAM90 fS?LF U 8E CAWCKLID S@ ONS"4Ik f 9%l4nAr4k WE Thfi%WP,rkE4"6WNa wBURER WRL tMAY0%56ft DRYS WArrm Ylt?wcc To nii affJi!mATs HoLow mAman fa THR+:.F.FP 1 DAvt Fortier %jr F4 URE TO NAL W10"WICE INALL INPO'W NO OirUUTION OR U41twrY � 32 Laurel OF ANY 1UNe Uteri TH&IWEUtiroll,M5"EK*Eat WNWIKToiTIV~S. - - Narthmptan, KA 02060 r jl Holum RErweNtA4tvR' ACOftio 3b(206110p FAX: (413)136.995S "CORD CORPORATION iose v 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 backfill), sonotube holes (before your). 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 I The Commonwealth of Massachusetts r ° . 1?eparttnent of Industrial Accidents r Office of Investigations _ 600 Washington Street Boston, MA 02111 www.lnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le6Jbly Name (Business iOreanization/Individual): V to X), Folz�t(a L _ ?address: tau/-q t- S7. fUt)kL t A �i'o - 010 Q City/State/Zip: Phone#: q/_3 -`a5ot fob Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ZJ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodelinc, ship and have no employees These sub-contractors have g. ❑ Demolition working for me in an capacity. employees and have workers' .� Y P tY• 9. f� Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.7 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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. ? 0 1 9 0 G)`7 Expiration Date: 10 13 a S Job Site Address:-_3 2 ��(aj-ti AA) City/State/Zip:� Aar.. 34.Gib o) 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 Iead 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 cel undert a pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 2 G Phone#• L( 1 3— �Ti( — iT Official 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Pj (� ' " ��/� (�� ('Ej S,o y.0 v0 License Number 31 [Auos-1 �T. k01,-TUAVr0,V MolbLo Is I 1 1,0 Addp6ts, ( Expiration Pate�—Y',,-* i.1 57b--�Cl CT Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number 3U LAU114t !°rW Itq- D(Or1U ' j(o '(v Address Expiration Uate 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'Egempiion 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 N SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition IN Replacement Windows Alteration(s) Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding[O] Other[O] Brief Description of Proposed Work: 1`( X �� niCLOSIi�J d�GE{ Alteration of existing bedroom Yes No Adding new bedroom Yes �L No Attached Narrative Renovating unfinished basement Yes �J _No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building :One Family k 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. cl G 6 Ci. Dimensions e. Number of stories? 1 f. Method of heating? i Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? CwczQ1 h. Type of construction STICK F2Rht i. Is construction within 100 ft. of wetlands? Yes 1C 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 1 .1 —9 W)/1t/Ly � as Owner of the subject property / - hereby authorize k ./.�/yfi(� Jp4) to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Y Date p� r/Authorized Agent hereby declare fhat1he 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. Print Name U r °I G Date Signature of Owner/Agent w Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size .(aQ_..� .r . . .. Frontage Setbacks Front Side L: R:,,,-, L 3P R a..�._ r Rear 2 0 _���-' _._ _ _. Building Height c r Bldg.Square Footage f �- % 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 YES 0 IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT 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 0 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 0 NO 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 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. w Department use only. City of Northampton Status'of Permit: Building Department Curb Permit 212 Main Street SewerfSeptic.Availability Room 100 Waterftell Availability Northampton, MAO 1060 Two'Sets`ofStructural Plans phone 413-587-1240 Fax 413-587-1272 Plott t&Plans" Other Specify LL.w APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This$e�tion to be completed by office , S F a Ma 3 2108 Lot Unit Zone - °— ! Overlay District n r� — EIm St Dis€►as€ CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing A es Telephone Signature 2.2 Authorized Agent: v ,a to vet Name( nt) �— Current Mailing Address: .e 3— 5171e 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. Total=(1 +2+3+4+5) ILI, 600 o o Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2009-0228 APPLICANT/CONTACT PERSON DAVID FORTIER ADDRESS/PHONE 32 Laurel St NORTHAMPTON (413)586-8965 PROPERTY LOCATION 32 SHERMAN AVE MAP 25A PARCEL 115 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 14 X 14 ENCLOSED PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 008026 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INIfOKMATION 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 Demoliti Delay Signature of Building Off. ial 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-2009-0228 GIs#: COMMONWEALTH OF MASSACHUSETTS Aw�� CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category: BUILDING PERMIT Permit# BP-2009-0228 Project# JS-2009-000294 Est.Cost: $14000.00 Fee: $98.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVID FORTIER 008026 Lot Size(sg. ft.): 9278.28 Owner: METZGER WILLIAM JR&DORIS M Zoning:URB Applicant: DAVID FORTIER AT. 32 SHERMAN AVE Applicant Address: Phone: Insurance: 32 Laurel St (413) 586-8965 NORTHAMPTONMA01060 ISSUED ON:911512008 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 14 X 14 ENCLOSED PORCH 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 9/15/2008 0:00:00 $98.005354 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 32 SHERMAN AVE BP-2009-0228 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25A- 115 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH LTNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateq�ory: BUILDING PERMIT Permit# BP-2009-0228 Project# JS-2009-000294 Est.Cost: $14000.00 Fee: $98.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: DAVID FORTIER 008026 Lot Size(sq. ft.): 9278.28 Owner: METZGER WILLIAM JR&DORIS M Zoning. URB Applicant: DAVID FORTIER AT.• 32 SHERMAN AVE Applicant Address: Phone: Insurance: 32 Laurel St (413)586-8965 NORTHAM PTONMA01 060 ISSUED ON:911512008 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 14 X 14 ENCLOSED PORCH 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: _ ,`' 'Y' House# Foundation: Driveway Final: Final: Final: ) _c Rough Frame: ,�w Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: � Final: Smoke: Final: OK ©t/i 6 l 0 Ltrt 1( S THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy 6 Signature: 'm" �� 1✓ "'� �- FeeTy Date Paid: Amount: Building 9/15/2008 0:00:00 $98.005354 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo