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23C-011 (2) 1 c ' ' I LVL' b'` p�; e u New R�0 Z-Z -1ZK TRAPAN I-LEW IS 5ATHROO r/DOR1" ER PROJECT 2'-(o 3'-2V2" i o 0 X m q + N N O _1 440" Ed' ri STAI 20'-S" INSULATION - WALLS = DENSE PAK CELLULOSE R 21 - CEILING = LOOSE FILL CELLULOSE R 30 + tI C 2-106,1 alp wa 11 Keiter547RiversideDr060514-I.: 6-5-14 l:m$eatnEn��ne 4.6.L0 :Materials Database.1489 3:48pn1 Iofl Member data Description:CaJCB2 Member Type:Beam Application:Roof Comments: Top Lateral Bracing:Continuous Slope: 0.00/12 Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code: IBC/IRC Live Load: 0 PLF Deflection Criteria: 0360 live,L/240 total Dead Load: 0 PLF Deck Connection:Nailed Member Weight: 4.4 PLF Filename:QA1Keiter597 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PLF) Top 0' 0.00" 5' 3.00" 1 67 Live Replacement Uniform PLF Top 0' 0.00" 5' 3.00" 218 0 Snow © 5 3 O 5 3 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall N/A N/A 1.500" 744# - 2 5' 3.000" Wall N/A NIA 1.500" 744# Maximum Load Case Reactions Used for applying point ioadsiorlim loads)to carrying members Live Snow Dead 1 2# 560# 185# 2 24 560# 185# Design spans 5' 1.750" Product: Spruce-Pine-Fir#2 2X 8 2 ply PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 958.1# 2645.'# 36%b 2.62' Total Load D+S Shear 570.# 2251.# 25% 0.06' Total Load D+S LL Deflection 0.0257" 0.1715" 0999+ 2.62' Total Load S TL Deflection 0.0342" 0.2573" 0999+ 2.62' Total Load D+S Control: Positive Moment DOLS: Live=1001% Snow--115% Roof=125% Wind=160% This member has been designed in accordance with NDS 2005 All probed names are lrademaft of their respective oymers Doug HOdgIt1S Copynght(C)2013 by Slmpsen Slm'g T e Company In L RIGHTS RESERVE- "Pasaing is defined as When the member,d"a'Jo sl beam Orilint",,show'On t t'stl-wing eI5 applicable besgn aite-pia for Loads...acing Conditions.and Spans Iisa.or.th's sheet. -he Design must to rev.awed by a qualified das,gnerordesig t pru(.v."al as rergoi.-d In,„rp oval.'his deign assumes Prnoud installations !ding to the ma-fa+YUr9r s sPgtiilcat:Gns. cs Stuctum1112.06 13[Bidd 11 Keiter597'Riversidel}h{)60514 1, 6-5-14 kmBe.amFtione 4:6.1.0 Nfatcria6DataWse 1491) 3:�17pm lofl Member Data Description:CaIcG1 Member Type:Girder Application:Roof Comments: Top Lateral Bracing:Continuous Slope: 4.68/12 Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:IBCARC Live Load: 0 PLF Deflection Criteria: L/240 live,L 1180 total Dead Load: 0 PLF Deck Connection:Nailed Member Weight: 4.4 PLF Filename:QAKeiter597 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PLF) Top 0' 0.00" 10' 5.75" 23 7 Snow Replacement Uniform PLF Top 0' 0.00" 10' 5.75" 23 7 Snow MN 10 512 10 512 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.009, Wall N/A N/A 1.500" 324# 2 10' 5.750" Wall N/A N/A 1.500" 324# - Maximum Load Case Reactions used for applying point loads(or line loads)to carrying members Snow Dead 1 230# 94# 2 2301# 94# Design spans 10' 7.188" Product: Spruce-Pine-Fir#2 2 x 8 2 ply PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 801.1# 2645.'# 30% 5.32' Total Load D+S Shear 265# 2251.# 11% 0.39' Total LoadD+S LL Deflection 0.0862" 0.5300" 0999+ 5.32' Total Load S TI-Deflection 0.1214" 0.7066" U999+ 5.32' Total LoadD+S control: Positive Moment DOL& Live=100% Snow=1150.% Roof=125% Wind=160% This member has been designed in accordance with NDS 2005 All proAua rames ate Iademaks of(heir re pest—oan-a, Doug Hudgins Copynghi(C)2013 by Siripson St no Tie Company I nc.A!-L RIGHTS P.ESERV D. "passing is Jef neo asivhen the member,tloorta,5t beam r g,rcet sho n this dm g metl5 pplir<Ve d,,sign mtena to!LoaCS LUac in,7 Co:n'lio^s,an<I Spans Ilaleo cn this ih'el. The L¢Slgn InuS,be n?rIQWEC try 2 r,Uelifi¢fl design Z(of sign pmffSSlO.ldl d5!L(tnifeli(n(nppmvel This ttesign assumes pmoucl insla,lation Z colmng to the hn—Of Cura!5 spe6Gcahrn', w aru.tcue,'L.W.t:iltsadd 11 Keiter597R.iverside-Dr060514-I, 6-5-14 lan.r3eamineine 9.6.1.0 MawrialsDaiabase 1489 3:47prn 1of1 Member Data Description:CalcB3 Member Type:Beam Application:Roof Comments: Top Lateral Bracing:Continuous Slope: 0.00112 Bottom Lateral Bracing:(See Below) Standard Load: Moisture Condition:Dry Building Code:IBC/IRC Live Load: 0 PLF Deflection Criteria: L/360 live,L/240 total Dead Load: 0 PLF Deck Connection:Nailed Member Weight: 11.7 PLF Filename:Q:\Keiter597 Other Loads Type Trib, Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PLF) Top 0' 0.00" 4' 1.75" 1 160 Live Replacement Uniform(PLF) Top 0' 0.00" 4' 1.75" 447 0 Snow Replacement Uniform(PLF) Top 4' 1.75" 7' 5.00" 1 55 Live Replacement Uniform(PLF) Top 4' 1.75" 7' 5.00" 180 0 Snow Replacement Uniform(PLF) Top 4' 1.75" 16' 1.75" 1 64 Live Replacement Uniform(PLF) Top 4' 1.75" 16' 1.75" 180 0 Snow Replacement Uniform(PLF) Top 7' 5.00" 12' 5.00" 1 55 Live Replacement Uniform(PLF) Top 7' 5.00" 12' 5.00" 180 0 Snow Replacement Uniform(PLF) Top 12' 5.00" 16' 175" 1 55 Live Replacement Uniform(PLF) Top 12' 5.00" 16' 1.75" 180 0 Snow Point(LBS) To 4' 3.25" 0 72 Live n 16 1 12 Y 16 1 12 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall NIA NIA 1.641" 4306# 2 16' 1.750" Wall NIA NIA 1.500" 3898# Maximum Load Case Reactions Used for applying Point loads(or line loads)to caning members Live Snow Dead 1 9# 3096# 1211# 2 8# 2840# 10589 Design spans 15 6.5w, Product: 1-314x11-7/8 VERSA-1_AM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. No lateral bracing required along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Pcsitive Moment 15466.'# 24466.'# 63% 7.99' Total Load D+S Shear 3695# 9081.# 40% 0.23' Total Load D+S TI-Deflection 0.6922" 0.7771" U269 7.99' Total Load D+S LLDeflection 0.5009" 0.5181" U372 7.99' Total Load S Control. LL Deflection DOLs: live=100% Snova=115%, Roof=1251/. Wind=160% Manufacturer's installation guide MUST be consulted for multi-ply connection details and altematives All pmdu names am trademarks of their respective owners Doug Hodgins Copyright(C)2013 Ly Simpson Stfong-Tie Campaoytnc.,at.L RIG=.TS RESERVED. "Pasting is defined as when tna member.floor foist,beam orgndec shoWn on ihlsdrawing meets applicable design oilena for Loads,Loading Conditions,and Spans ks!ed on this cheat. ='."T 5 be re—wed bya qualified designer ordesign professional as fequimd'or aoproval.This design assumes product inslallatiur atta ding to the manufaouf�r's 07. THERMAL& MOISTURE Install netw rooftop guard, drip edge, ice and water,and 30Year architectural shingles at S.E. Elevation All ntisc.air sealing • Install blown-in cellulose in new walls and affected ceiling areas Install baffles to promote attic veni,ilatiott All wall flashingS, weather barrier;;,and membranes Install new 4"duct and roof-jack to exhaust bathroom fan/vent nnit O8. OPENINGS • Install new, pre-hung solid core dour(See"Allowance"below) • Install privacy lockset • Relocate existing master bedroom door to north side of hallway • Install(1)new construction window unit. This includes pan flashing,tapes,etc. 09. FINISHES • Install new vinyl siding,j-channel,outside corners,under-sill,and perforated sof7it • Wrap fascia with aluntinutm • Install new gutters and downspouts at new dormer location • Install drywall at all affected areas • (I)coat of primer and(2)coats ol'paint at all affected areas • Install new, pre-finished 2 '/"red oak flooring in hallway Install new ceramic the in balbroom area. 11. EQUIPMENT • Supply,transport,set-up/break-down OSHA compliant staging at southeast elevation • All ladders and other equipmnen1 22. PLUMBING • All plumbing to install second (poor bathroom. This includes labor, piping, tax,and permit 26. ELECTRICAL ' Relocate/remove misc,cxisling outlets and/or switches • Install dedicated circuit for new(iPCI Provide and install new exhaust fan/light • Please see 'Allowances" liar light futures ALLOWANCES • New bathroom window............................................... $?00.00 .............. • New bathroom door& Inardcvarc........••• ........................... 522 ,00 ............ • Electrical fixtures........................... $300.00 Plumbing fixtures(toilet,shower pan!surround,vanity, vanity top, sink, faucetaet,shower valves& brad,shower door,toilet paper holder, towel racks,med cabinet, etc...................................................... $2.0000.00 — Initial Hoio .;V=., & S"I B U I L D E R. 0;�`4; SCOPE OF WORK JUNE 03,2014 CUSTOMER: Clover Lewis& -Jeff Trapani,597 Riverside Drive, Florence,MA ESTIMATED START DATE.: June 09,2014 ESTIMATED PROJECT RUN TIME: 6-8 Weeks DORMER ADDITION AND NEW BA'rHRO0M 01. GENERAL CONDITIONS ■ Permit application, fees, and inspea:-on 9 Dumpsterind debris removal(15 YARD) • Demolition • Existing 13' length of exterior wall • Existing rafiers,ceiling,and roof sheathing • Existing shingles on pitched section roof. Southeast elevation • All flooring in existing hallway area • Temporarily remove exisli')L.bedroom door 0 Portable toile( 9 Site set-tip and breakdown ■ Project isolation, lent enclosures, floor protection,cleaning,etc. 04. MASONRY ■ Demolish chimney below roofliae • Cap and seal chimney with non-combustible material 06. WOOD & PLASTICS u All rough framing to construct new shed root'dornieraddition. This includes: • Mise.subnoor • New 2 x 6 exterior wall and sheathing • Skier existing ceiling Joists to extend to new wall plate • New interior wall for bathroo:in • New rafters from ridge to nev,wall plate r, Frame new wall to conceal pLimbing on first Iloor area beneath baffiToorn • All finish carpentry., This ifICILides: • Baseboard trim • Window and door casing c, Set vanity,in isc. Initial By signing this Agreement,you acknowledge that you have received a complete and original signed copy of the entire Agreement and attached Fxhibit!;. Keiter Builders, Inc. may not start work until atier this Agreement has been signed. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. THIS IS A LEGALLY BINDING AGREEMENT. IF THERE ARE ANY PROVISIONS WHICH YOU DO NOT UNDERSTAND, YOU SHOULD CONSULT 11''ITH ArY ATTORNEY BEFORE SIGNING. ICrITER BUILDERS, INC. OWNM I Scott ICeite , President Date f Date Date Initial I lore 6 ;' of conservation commissions, are required to be obtained beibre Kciter Builders, Ittc. can obtain their pertttits, it is your obligation to satisfy such requirements and you shall meet those requirements at your cost. ST�18TING A!\'D.ENDING DA TES, Keiter Builders, Inc. will apply for the permits within 7 day(s)of signing this Agreement or your satisfying any conditions required to be met prior to the permits being used, whichever date is later. Keifer Builders, Inc. will start work within ,30 day(s) of obtaining the necessary permits and expects to have the work substantially completed-within 45 day (s)of starting.. II'Keiter Builders, inc. is delayed at any tinge, in the progress of completing the work, clue to acts ol'God, %var, civil commotion, accident, governnlerd regulations or policies, any act or neglect of yours, or by any separate contractor, or by change orders, or by labor disputes, fire, delay in transportation, unavailability of materials, adverse weather conditions, unavoidable casualties, difficulty in obtaining fuel, electricity, services or supplies front the sources from which they are normally obtained, or other causes reasonably beyond my control, then Keiter Builders, Inc. may reasonably extend the date for substantial completion. ifthe work is not substantially complete by the ending date, as extended, Keiter Builders, hie. will not be liable to you for any incidental or consequential damages you may incur duc to such delay. 11'you are supplying any materials or equipment to be used in the work. you shall have such materials and equipment delivered to the work site not less than 5 days before they are needed for the work. If they are not delivered on a timely basis. Keiler Builders,Inc. will not be able to schedule work dependent upon them and the date of substantial completion will be extended duc to such delay. TO TALL 4R10E it 'D Pit 1ADJe_f\'7'.SC1aEDULE: The total price for performing the work and supplying the materials under this Agreement is 1?orty Nine Thousand, Nine }_.lundred and Twenty Dollars (S49,920.00) DOLLARS. Payments against work completed and materials delivered will be made within 2 days from when Keiter Builders, Inc. notifies you that they have reached different completion stages. Payments will be made in the amounts as set forth in the attached payment schedule. 1/3 of total price due with signed contract (516,640,00) 1/3 of total price due at rough framing inspection (S 16,640.00) progress payment at appro.ximately SO,% completion (7,488.00) Final payment due art Substantial Completion. ($9,152,00) All sums not paid before substantial completion of the Nvork will be due and payable upon substantial completion. Payments due and unpaid under this Agreement sliall bear interest from the date payulcnt is due at the annual rate of Eighteen (18%) percent or at the maximum legal rate whichever is less. in the event that Keiter Builders, Inc. incurs costs or expenses in collecting any payments due and unpaid under this Agreement. you shall pay such costs and expenses including reasonable attorney's fees. If you fail to make any payments when they are due, then Keiter Builders, inc. may immediately stop work. Keiter Builders, Inc. may choose to not start work again until you are current with the payments and Keiter Builders, Inc. feels secure in obtaining the remaining payments. I1'thcre is any stoppage in work due to your 2 _.. Inili�,l I l�iFa CONSTIZUCTTION_AGREEMENT Keiter Builders, Inc., of Northampton, MA whose federal Tax Identification Number is 27 2518846, Contractor's Registration Number 175168 (Exp. 04-29-2015), and License 11102457 (Exp. 06-20-2014), is entering into this Agreement with yot.;Jeff'l'r_�ti &Cl9ver Lewis of 597 Riverside Drivc, Florence, i�lA. ALI, RESIDEN'T'IAL CONTRACTORS AND SUBCONTRACTORS ARE REQUIRED TO BE REGISTERED WITH TIDE MASSACHUSETTS BOARD OF BUILDING REGULATIONS AND STANDARDS, UNLESS SPECIFICALLY EXEINIM' FRONT REGISTRA'T'ION. INQUIRIES CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HomE INIPROVENIENT CONTRACTOR REGISTRATION, ONE ASHBURTOiN PLACE, ROOtNI 1301, BOSTON, MA 02018 (617) 727-8598. SCO.PG OF JKOJ?K: Keiter Builders, Inc, will perform the work set forth in the attached Scope of Work on your home, or the property located at 597.Riverside Drive,._Florence, MA. If you would like to change any work to be performed or materials used, we will have to make such changes through a Change Work Order, which may also change the total price and extend the date for completion. Change Orders will be handled on a time and material basis. Keiter Builders, Inc. reserves the right to make minor changes in any plans and to substitute materials of equal or better quality. Should Keitcr Builders, Inc. encounter any unknown conditions below the surface of the ground, or concealed or unknown conditions in any existing stricture, you will agree to make an equitable adjustment with Keiter Builders, Inc. under a Change Work Order, which shall increase the total price and extend the date for substantial completion of the work. PERA17TS: To perform this work, Keiter Builders, Inc., or subcontractors hired by Keiter Builders, Inc., will obtain, on your behalf, the following permits(if required): _x__ Building Permit _x_ Electrical Permit Smoke Certificate ax _ Plumbing Permit _ Demolition Permit Certificate of Occupancy 11' IS THE OBLIGATION OF K1;I ER BUILDERS, INC, TO OB'T'AIN THESE PERMITS AS YOUR AGENT. I`"THE EVENT THAT K:EITER BUILDERS, INC. DOES NO"T OBTAIN THESE PERNIITS, AND YOU OBTAIN THEtNI, OR It' K.EITER BUILDERS, INC. IS NOT REGISTERED WITH "11IE BOARD OF BUILDING I'll EGULA.TIONS, YOU WILL. NOT BE ENTITLED TO OBTAIN ANY BENEFITS FRONT THE GUARANTEE FUND ESTABLISHED UNDER ti,lASSACIIUSETTS GENERAL LAWS CHAP"f I?R 142A, Keiter Builders, file. obligation to obtain permits is limited to those permits directly related to performing the work Kciter Builders, file. agrees to do. To the extent that other permits or governmental or regulatory agency approvals,such as, but not limited to, zone changes, variances, special permits,site plan approvals, or approvals Initial Hera PITY OF NORTHAMPTON Construction Debris Affidavft In accordance with the provisions of MG.L. c. 40 § 54, all debris resulting from any work crvered by-a-Birilr�in�:Permitt shalt be disposed-of.in a�ropedy licensed.disposal facility, as de&ii it by M.G- L c. 111' § 150A.. . Address of Work: %7 P—I V-e l-'5 t d P?- �lae.-ci�bris_Ml.be-transported by The debris.will be.recerved at .-Wltv,4, --- - - -° Signature of Permit-A�O cant Building Permit Number: . T The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly dame? lzsi �;ss(pgatzYztio>IIndt� clualj;; e l� l/S - Ci MA- ol4o Aijgj$ii'911xeinpl6 CChieck°thefappidpriatebox: Type�o�?pr j�ec�e��iiirgd) I. I am an employer with e> 4. ❑ I am a general contractor and I 6. ❑ New construction . employees(full and/or part-time).* have hired the sub-contractors 7. ❑ Remodeling listed on the attached sheet. 2. ❑ I am a sole proprietor or partner- These sub-contractors have 8. 0 Demolition ship and have no employees employees and have wor4rrs' ❑ Building addition working for me in any capacity. comp. insurance.$ [No workers' comp. insurance 10.❑ Electrical repairs or additions required.] 5. ❑ We are a corporation and its ` officers have exercised their 11.❑ Plumbing repairs or additions 3. ❑ I am a homeownerSeattle8 doing right of exemption per MGL c. 12.❑ Roof repairs all work myself. [No workers' 152, §1(4), and we have no comp. insurance required.] f employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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. Belo►v is the policy and job site information _F Q Insurance'Gomp j��f5ame l{tea V�-e r� `�/1 V_�yl C-C- Polipy,#or Self uis u6.#. 3 2 j�'J��OJ`7�a IOC Expuatiori Dafe' �O " �� — �� /ZJ_ , +' 1 fob Site Adzirr�ss: All Locations G}tyfState%Zt S"p:1 59-7 RI'vQr5 ids Dr. NCOV-P.vtc-� MA- o to G z_ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a Fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby rti under the pains and penalties of perjury that the information provided above is true and correct._ `-t Sigiatixre Date: , Ph"one,#: -11519 -K_OD Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License#: Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other: Contact Person: Phone#: ZAWorkers Comp Aff-Highlited.doc SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: L� �-Qi! �-� I� C S / ' (. a q,5-7 License Number & Addrest Expiration Date bf- ly&r Sin r e V Telephone 9.A291stered Home lingr9yement Contractor: Not Applicable ❑ -fit - r / 75 / (119 Company Nam Registration Number ,,9t A- 34 /-/ - �;k e-), - /-,5 LA dlesss �n n 1� _,n /� -� Expiration Date 1 O 1 � !(�L��l�/ U / , M4- o/6 (P 6 Tel phone � C>b©� SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,g 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 Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition,Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition `4 Replacement Windows Alteration(s) E—JRoofilng El `� Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding[O] Other[0] Brief Description of Proposed Work: A.�L -Z I— 6 4(i L ry mj d 0-4 \-e-zr Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a, If New house and or addition to existing housing. complete the followina: 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, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, Cil Ir' � f0t->°it1T -�1 T'eI� FW Id'e,✓5 A� � as Owner/Authorized 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 under the pains and pena ies of perjury. SGD-f� Print me Si ure of 0 r/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 Lot Size Frontage Setbacks Front Side L: R:_. L R:' Rear Building Height 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 Q DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW eY YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained I , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: JO 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 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use onty i x: —=' City of Northampton Status of Permit: _ Building Department Curb Cut�Drlveway Permit JUN ' 6 2014 �' 212 Main Street Sewer/Septic Availability Room 100 WaterMiell Availability '. Elec ric,Piumbing&Gas inspections Northampton, MA 01060 Two Sets of Structural Plans Northampton, MA oio6ophon 413-587-1240 Fax 413-587-1272 PlotlSlt Plans Other Specify APPLICATION TO(CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 597 j21V�f)Idt_ Uf'1 ✓2— Map Lot Unit r w Ye vi C�2 b(D tv-z— Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Ac ient: ,e,i -Ie A- PQ- l"J'0C 9+ �,lovjht vt A- Na (P- t) Current Mailing Address: IT /�/5- 5�(P - 46-D 4��Si nature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building , /q pa (a)Building Permit Fee 2. Electrical �/ (b) Estimated Total'Cost of 4C t9�� Construction from 6 3. Plumbing Building ermit Fee 9 l �G 1po�-� 9 4. Mechanical(HVAC) 5. Fire Protection 6. Total= 0 +2+3+4+5) 9 6-0 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1302 APPLICANT/CONTACT PERSON SCOTT KEITER ADDRESS/PHONE 51A HATFIELD ST NORTHAMPTON (413)320-9035 PROPERTY LOCATION 597 RIVERSIDE DR MAP 23C PARCEL 011 001 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 Typeof Construction: CONSTRUCT DORMER BATHROOM ADDITION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 102457 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: roved 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 ion Delay Signature of lkiiiII60fficTal 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. 597 RIVERSIDE DR BP-2014-1302 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23C-011 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2014-1302 Project# JS-2014-002190 Est. Cost: $49920.00 Fee: $299.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SCOTT KEITER 102457 Lot Size(sq. ft.): 11891.88 Owner: TRAPANI JEFFREY J&CLOVER A LEWIS ZoninaURB(100)/ Applicant: SCOTT KEITER AT. 597 RIVERSIDE DR Applicant Address: Phone: Insurance: 5 1 A HATFIELD ST (413) 320-9035 WC NORTHAMPTONMA01060 ISSUED ON:61612014 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT DORMER BATHROOM ADDITION 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 6/6/2014 0:00:00 $299.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner