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BM 0-2
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24" x24" x12"
CONCRETE FOOTING
TYPICAL FOUR FOOTINGS
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ATTACH EXISTING BEAMS TO SHAVED COLUMNS
w/ 3x3x1/4" x 4" LONG ANGLES
& 4 1/2" x 3" LAGS PER ANGLE
NOTE:
1) ATTACH WLHDR 2-1, 2-2, 2-3 & 2-4 TO WALL STUDS w/ SIMPSON SRONG TIE SIDS 1/4 x 6 SCREWS Z:
2) ATTACH WLHDR 1-1, 1-2, 1-3 & 1-4 TO SUPPORTED BEAMS w/ (2) SIMPSON STRONG—TIE A44 CLIP
PER BEAM
C:\—Whetstone Engineering\Projects\Current\05005miriam.thayer\Miriam.dwg, 1/26/2005 4:27:48 PM, Whetstone Engineering
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BM1-1
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NOTE:
1) ATTACH WLHDR 1-1, 1-2, 1-3 & 1-4 TO WALL STUDS w/ SIMPSON SRONG TIE SDS 1/4 x 6 SCREWS
2) ATTACH WLHDR 1-1, 1-2, 1-3 & 1-4 TO SUPPORTED BEAMS w/ (2) SIMPSON STRONG—TIE A44 CLIPS
PER BEAM a-
C:\—Whetstone Engineering\Projects\Current\05005miriam.thayer\Miriam.dwg, 1/26/2005 4:27:34 PM, Whetstone Engineering
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s*` DEPARTMENT OF BUILDI]IG INSPECTIONS /
INSPECTOR '212 Main Street • Municipal Building S
Northampton, MA 01060 ,
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction sup,.:_• sor. T he state defines "Homeowner" as, " Person(s)
'who owns a parcel on which he/she resides or intends to be, a one or-two fanuI
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 any 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 iegulations. 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 pour), a rough building inspection(before work is
concealed). insulation inspection (if required) and a final building inspection.Jhe
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
/1, �! ' understand the above.
( me own /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
l l
Date
Address of work
location
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(riff JQf \Tot fljaliiptoll - __-
4 y f �lcsawrflnsrtta'
DEPARTMEIJT OP BUILDING INSPECTION'S - -
212 Main Strcet ' hTunicipal DwIding
Northampton, Mass_ 0106Q
I i ,
WORICLIZ'S CONOENSA`IION IDNSU"RA�CF AI, AAIrlT
i
I
O1 CMI&=f pCTMj tLCC)
%VILh a principal place of business residence at: ------
U hone=)
i (sv-�.t/c,ty/stalcr�p)
j do hereby certify, under thc.ppdris and penal Lies of pcgury, :hat
1 -
( ) I am an employer providing the following�workerjs comocnsado, covemsc for 1ny
eiupioyces worUng on this job:
('anuan=Come,-v) (Fclic:l:,L r)
i
( ) I am a sole proprietor, general contractor or homeowner (ci:cie one) and have hired
the contras,ors listed below rybo have the folio%wing worker's comoealsadon pokies-
(NL ZMC O- CO:,r^CiOr) Gnsur-ancc CotAo11}•flloUc eats)
(N:me of COOITc10r) R swaccr- C-omoan}v-PoIjm, Num6cr) (ix-Ex -bon Date)
i
(Name of Conn-aaor) On urane-, Compu)-/PoUq• Nt,mber) (Expim6on Daic)
1 -
(Name of Contractor) (Iasuraa� CompzaylPolicy Numb`r) (Expi-,6oa Darr).
(au�.c+J� ocil t'ud,if nct�f..1-to mc!uc�tnrortni'ioa pc'ta.iaias to.11 ooa�-sv:a) .
( ) I am'a sole proprietor and bave no one wor-L ng for me-
I am..a home owner performing all the work myself.
1
NOT€:plea be&w-VC"'I--:3e beer=O,vcn..to ca�ploy pcsam eo do c.,raoe c repair work cn.d..<tt:.,`of
j oo(more than throe tmrs in-�cb the bom,'DCr rCida or oo the p-ou_xr,appurjr==th=en�- ooc C==Ily oo=.daai to be
cixploy=I, the wAj O=M r_- oa Au GL152 a 1 5
t ( )�applin0oo by a 6omooRaa f=:lid__or pcma ray cvidm«LL-
I-1 n-^..of an—:Ployor-odor din Work ce.Compom.tioa Act
I uo,- d tb-a ooyy of tbia r y b.for rd=d io Lb.pop..nmeo¢ ,,-dam ofL-or u- �ra tb-
oova-.sc. SC3uoa a_nd th1 L IL-=to sours tov�,�,ndcr iocGoa 25A of MOL 152 c a Icd to tlx iamsaioo of cim;=1 pcailtio
coozi_.iz of a rmc orup to S 1-�oo.00 for mzraisoumcn Orup to ooc yc=and 6%-l pmahia in tx rorm of.Stop Work Ord=nod.
rim of S 100.00 s day�Cxjazt tnc
PcTmtt NttIDb--
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S turn of tCCn--( Pcnniucc e J
SECTION 8-CONSTRUCTION SERVICES +
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
9:Regis e`r`e Dome_mvroveme'Contractor. , ., Not Applicable ❑
Company Name Registration Num er - _-
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE-AFFIDAVIT(M.GL-6.152,§-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...... ❑
1 BM MIR A
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
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i
SECTION 5-DESCRIPTION OF PROPOSED WORK(check alt applicable)
New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors CI
Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [M Siding[01 Other[❑]
Brief Description of Proposed)� n� / _ f_� S1 L `
Work: 2 v�0 v c �t�.-t!_(,�.i2ti�, c� !:'� D
Work:
of existing bedroom Yes No Adding new bedroom Yes � No ✓ �
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
a' .,;t,.� 'F`�^tiM�"✓
sa'If I ew-hoDSeanc#�ardttan fo ex�s#ina:tioras�ng'competethe.fotlow�ng:
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? lyJ
d. Proposed Square footage of new construction. No C,JycD,/i,-24 Dimensions
e. Number of stories? 3
(�
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.
1. 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, G as Owner/Authorized
Agent hereb clare that t e 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.
p � r
LY J f�`(0 OL Vh
Print Name
4)
Signature of Own Agent Date
R A
Section 4. ZONING All Informatioh 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
l li s
Lot Size
Frontage f i
Setbacks Front
Side L, L: R:
Rear
Building Height ' —�
Bldg.Square Footage I I 011'0 ---1
Open Space Footage %
(Lot area minus bldg&paved ��
-kin
#of Parking Spaces
Fill:
(volume,&Location)'
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO G DON'T KNOW YES 0
IF YES, date issue&
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page- and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO (a DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained
ki Obtained Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location: i
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 r NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton e °=
�- ;----Bugding Department
212 Main Street ��
Room 100 e u
Northampton MA 01060
r-n 1
u 1 5 R&e 413'_5$7-1240 Fax 413-587-1272
APPLICATI16N TQ C�NSTR CT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to he completed by office -
1.1 Property Address:
3
UnFt
:Zone Overlay District
�•iElm S�pistrict . CB.,Disfrict -
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address: .—$ U a
V Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-:ESTIMATED CONSTRUCTION.COSTS
Item - Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building r,/� C�� n'1 ( (a)Building Permit Fee 11 1
2. Electrical '� � (b)Estimated Total Cost of
Constructim ftom 6
3. Plumbing Building Permit-Fee.
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) ? /0 1 CZ Check Number
This Section For Official';Use Only
Date
Building Permit Number. Issued:
Signature:
i
Building Commissioner/Inspector of Buildings Date
File#BP-2005-0784
APPLICANT/CONTACT PERSON HEIN JENNY MIRIAN
ADDRESS/PHONE 35 CLARK ST FLORENCE (413)582-7022 Q
PROPERTY LOCATION 35 -37 HIGHLAND AVE
MAP 25C PARCEL 190 001 ZONE URC
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: RENOVATE KITCHENS&ADD 1/2 BATHS
New Construction
Non Structural interior renovations
Addition to Existing
Accesso_ry Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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 mmission
Z/,-V/
Signature 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.
35-37 HIGHLAND AVE BP-2005-0784
GIs#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:25C- 190 CITY OF NORTHAMPTON
Lot: -001
Pernut: Building
Category: BUILDING PERMIT
Permit# BP-2005-0784
Project# JS-2005-1095
Est.Cost: $10000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 6490.44 Owner: HEIN JENNY MIRIAN
Zoning.URC Applicant: HEIN JENNY MIRIAN
AT. 35 - 37 HIGHLAND AVE
Applicant Address: Phone: Insurance:
35 CLARK ST (413) 582-7022 O
FLORENCEMA01062 ISSUED ON:2116105 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENOVATE KITCHENS &ADD 1/2 BATHS
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 2/16/05 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
BP-2005-0784
GIs#: COMMONWEALTH OF MASSACHUSETTS
.` CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2005-0784
Project# JS-2005-1095
Est.Cost: $10000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License.
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 6490.44 Owner., HEIN JENNY MIRIAN
Zoning:URC Applicant: HEIN JENNY MIRIAN
A?': 35 - 37 H GHLAND AVE
Applicant Address: Phone: Insurance:
35 CLARK ST (413) 582-70220
FLORENCEMA01062 ISSUED ON.2116105 0.00.00
TO PERFORM THE FOLLOWING WORK.-RENOVATE KITCHENS &ADD 1/2 BATHS
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: /0- j,2 -0 Rough: - G{�F==f llr� House# Foundation:
„Driveway Final:
Final:
Rough Frame. 0 i` ( cc
Gas: Fire Department Sle,ij C�9Z 0U =it-6 Fireplace/Chimney:
ORou h `��
g Oil: Insulation:
C4/iVe, i`% z3
Final: Smoke: Final:-*,57 0(C oS(C)q jo 6 L—o4l5
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLArTVbN OF
ANY OF ITS RULES AND REGULATIONS. .. �,�',
Certificate of Occu an Si nature:
Feel e: Date Paid: Amount:
.' g-
Building 2/16/05 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo