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{
10. Do any signs ebst on the property? YES NO__
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO >C
IF YES,describe size,type and location:
i1. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colmm to bs filled in
by the Ba3.2ding Department
Required
Existing Proposed By Zoning
Lot size
79Q/ /
Frontage 011 5
Setbacks ►�` IS
side L,35 R: 11-�,_ L: R:
Ky
- rear
Building height Z 5UVLA�- S L J
Bldg Square footage sb �� ��� 26 �U /c G
%Open Space:
(Lot area minus bldg SDN
&paved parking) 7, S �
# of -Parking Spaces
f of Loading Docks I N
Fill: I /
vol-ume--& location) /� /V -
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my kno ledge.
DATE: P `/L['`� � APPLICANT's SIGNATURE
NOTE: hamunnoe of a zoning permit does not relieve an applioant's burden to oomply with 4xv
zoning requirements and obtain all required permits f m the Board of Health, Conservatio
Commission, Department of Publio Works and other pplionble permit granting authorities.
FILE #
NOV 1 6 1999
File No.
DEPT OF BUII_MNG INSPECTIONS
NORT€-fA_ NIPTON. MA OiMR
Z" PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: J A—AJEFS 76'S5 D gfi- 'j-D 1z 9 u 1 Lp C re-S
Address: ? L- '^J U-e/ti . 0 /�` 3 Telephone: 413- Z4 7- 7e,3-ld-
2. Owner of Property: T)A1j1EL 13v410E 1/ C--P(F-
Address: 4 r0A'D)-'-o.j AuE Telephone: �S-8q'— 717-1�-
3. Status of Applicant: Owner >- Contract Purchaser Lessee
Other(explain):
4. Job Location: '? 2 /LQlJ�C T/
Parcel Id: Zoning Map# 5 Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property.
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessa-1-
&SAD Pb(Lc o tj A K ohs- Cop) Form 100 G 140u Si✓, u 5 E ao C S
NOT` MFG COi-eEA-rF S�Tl�/���c REt,��►RCM�.13'r�
7. Attached Plans: _ Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PeermiWariance/Finding ever been issued for/on the site?}
NO DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO C DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO�_ DON'T KNOW YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
mow, Needs to be obtained Obtained -,date issued:
(FORM CONTINUES ON OTHER SIDE)
File#MP-2000-0067
APPLICANT/CONTACT PERSON JDR BUILDERS
ADDRESS/PHONE 236 HAYDENVILLE RD (413)665-7587
PROPERTY LOCATION 4 MADISON AVE
MAP 38B PARCEL 156 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING F F LED OUT
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 12 X 4 PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § —w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation C issiioonJ�f
Signature of Building 91fricial 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.
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rte ' DEPARTMENT OF BUILDING INSPECTIo1JS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
'WORKER'S COMPENSATION INSURANCE A + AVIT
(]i�scc�permi tt�)
VVIth a principal place of bUSlnessJresldencc --I
LL
-- --- — (st ��<fisza�Gfnp)
do hereby ccrtiiy, under the pam f- p perjury, th2t
( ) I am an employer providing the followlms wori;c[s cornnen�.auon coverage for Il)),
�nlplovccs wor���in on this job_( ) l assi a sole promietor, general contractor or homeov""Ic- !c-cie one) aid have hired
the contSacToSS hstecd below who have the i011Ow.n workef S GO DeIlS2i]Of1 pChCieS:
(Na]I]C Of Coll ic-,o) (11LRmjlcc COT IC.' Nuol'-r—) (.-?:;)171:n0 Datc)
(N<me of Cots rzcor) (In�ranc Company/Police Nurnccr) (Ewirt on Date)
(Name of Coarracto,) (Lnsuranc Compare}li'oh N,»r.!,r) �prtion Date}
------- --- ---- —
(Nallic of Contractor) aftSI 3IlC (D,plMnon Date)
(euxc�uidt:i octal ch.-r.t if nccrzary to�ndv LRfORnlaoatzic:n.�w all ocxlra dog)
I am a sole proprietor and have no one working for me.
O I am a home owner performing all the viork myself-
NOTE:plc_sc be a rl t t ,r i w-Ljc hoar-o mc,wbo�tlay pcwm W d r.r• a r�o z rc a wori:m.:c d.ell ne of
not¢rode th^n u-r =su in wL-C-1u tax bc-,M&owncr resdea or oa ft�p-ounr'�z{�;,vtecLS.1 thc�.o�T r�x -rsnliy o-trJ:dcr_,j to be
c�ployca un z trµo it 1 cn Ad(GL152-s 1(5)�a{Vlic�riar,by a hone fci e U=,0c«Ponca s-y
Icgal ruau of an csr loyct uod-d:, Wockda Compoas.Lzon net
l—iersi�d d-t>copy of thv clatcnan a-.ay bo forwnnied to tbo Detx raven:of IrxL�YJi:.I P.en'u�xt�Off ua of lr .-c>;o for ek�n
covcrx�-c vcriGcatioo aad that L•ilt.5c to scout covcr�gc tu�dcr:.oction 2SA of 1`tvL I S2�Ic�.'to tx�7z�a;i:ioa nl�.^itnal pcailtin
mau lag oC a fiDC of up to S 1 500.00 anNCK-c ttizoanx-lit of up to one}Tar oriel ci�i1 pcunllia is dx form of a Stop W o:�On'�'I'd'
fro oCSI(?0.00 a c;�y c��.iti:l tx
�---� • � I S `ZC�C.1 Pcrinit Nt>mt� �__--_
— ----------
--------- -
--------- ----
Sig3ra c of Licc7tlPcrmitt ? f'
r
SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: Cpl V T (ok�5 d P�� �O JZ_Ck1 GK) 5J+J&L0 F MIRY
1:'oELL�uf�l
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes 7C No
Plans Attached Roll 0 - Sheet 0
6a If`Newtioiseantloatl"clitiontoezisirigtiousing;'complete tl'"e foll'owin :
a. Use of building: One Family X Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? �') U G
d. Proposed Square footage of new construction. 1 o Dimensions
e. Number of stories? 2-
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
h. Type of construction 59
i. Is construction within 100 ft. of wetlands? Yes P
No. Is construction within 100 yr. floodplain Yes No
I. Depth of basement or cellar floor below finished grade (r t
k. Will building conform to the Building and Zoning regulations? X Yes No .
I. Septic Tank City Sewer—)(— Private well City water Supply X
SECTION 7a -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,
Tr Co f 1J� 12� !� , as Owner of the subject property
her authorize �{ l'Y11 5 u �SS ��/ + �� � bf-_ ) -_S to act on
my beha in all m s relative to work authorized by this building permit application.
VOIAL 6- _(:o
Signature of Own Jr Date
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 penalties of perjury.
Print Na
Signature of ne)Agent Date
j
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Buildiing Department
Lot Size 7 q '71 '4
Frontage
Setbacks Front +♦
a�
Side L: 36 R: 15 L: 30 R: 19- /S--
Rear
1Z 12 �6)
Building Height
Z J?S
Bldg. Square Footage &Z5 % Q
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
A
1
(volume&Location) l � � A
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO — )< _ DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO _ )< _ DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
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
No
IF YES, describe size, type and location:
Pity of Northampton
gilding Department D ..
I 1 620 12 Main Street
Room 100
DEPT Of BU1i LNG INSPECT7191�r t mpton, MA 01062tssf'
NflR�i-�i.,�,� i8 7-1240 Fax 413-587.1272 aitelan
Other Specs � � �
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 cpnipleted'Tby office
Ma Lot y
p Urnt
Zone Overlay,DistrECt 3.
Elm St.District .CBLDistricf
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
DA> IC L ?EAj-CCdE 609X E 4 MADIs� of-j6 0E
Name r' t) Current Mailing Address:
,584- -71 ZS-
Telephone
Sign ture
2.2 Authorized Agent:
Nam C Current Mailing Address: C Icv,
Z4`7 7&3
\__
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
com feted b ermit a licant
1. Building 00 (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) (� L(h, ve Check Number D
This Section For Official Use Onl
Building Permit Number: Date Issued:
I
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2000-0789
0"k APPLICANT/CONTACT PERSON JDR BUILDERS
ADDRESS/PHONE 236 HAYDENVILLE RD (413)665-7587
PROPERTY LOCATION 4 MADISON AVE
MAP 38B PARCEL 156 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 c 317 27,5-0 -
hpeof Construction: CONSTRUCT 6 X 15 OPEN PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 074105
3 sets of Plans/Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Co ' ssion
�oa7
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.
Ier, Asa 2 Pcs of 1.75" x 9.5" 1.9E Microllam® LVL J �S
TJ-Beam T" v5.45 Serial Number:7000002325
BEAMUSA 1111 4/17/00 8:05:08 AM
Page 1 of 1 Build Code:124
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED
Member Slope: 0 Roof Slope: 0
L-�
a- -- - 16'-- ---- - _
All dimensions are horizontal. Product Diagram is Conceptual.
LOADS:
Analysis for Beam Member Supporting SNOW Application. Tributary Load Width: 3'
Loads(psf): 35 Live at 115%duration, 15 Dead
SUPPORTS: INPUT BEARING REACTIONS(lbs.)
WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER
1 Column 3.50" 3.5" Left Face 840/433/1273 Other:
2 Column 3.50" 3.5" Right Face 840/433/1273 Other:
DESIGN CONTROLS:
MAXIMUM DESIGN CONTROL CONTROL LOCATION
Shear(lb) 1247 1101 7265 Passed(15%) Lt. end Span 1 under Snow Roof loading
Moment(ft-lb) 4884 4884 13541 Passed(36%) MID Span 1 under Snow Roof loading
Live Defl.(in) 0.311 0.522 Passed(U604) MID Span 1 under Snow Roof loading
Total Defl.(in) 0.472 0.783 Passed(L/398) MID Span 1 under Snow Roof loading
-Deflection Criteria: STANDARD(LL: U360,TL:U240).
-Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and
positioning of lateral bracing is required to achieve member stability.
-Design assumes adequate continuous lateral support of the compression edge.
ADDITIONAL NOTES:
-IMPORTANT! The analysis presented is output from software developed by Trus Joist. Trus Joist warrants the sizing of its products by
this software will be accomplished in accordance with Trus Joist product design criteria and code accepted design values. The specific
product application, input design loads, and stated dimensions have been provided by the software user. This output has not been
reviewed by a Trus Joist Associate.
-Not all products are readily available. Check with your supplier or Trus Joist technical representative for product availability.
-THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.
-Allowable Stress Design methodology was used for Code BOCA analyzing the Trus Joist Residential product listed above.
-Note: See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. 6ElqM
l'D R q H,4v�
PROJECT INFORMATION OPERATOR INFORMATION:
No Project Information available Rugg Lumber Co., Inc.
Todd M. Czernich
24 West St.,
West Hatfield, MA 01088
(413)247-8314
(413)247-8338
Copyright m 2000 by Trus Joist,A Weyerhaeuser Business. TJ-BeamT"is a trademark of Trus Joist.
Microllam®is a registered trademark of Trus Joist.
4 MADISON AVE BP-2000-0789
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38B- 156 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: ADDITION BUILDING PERMIT
Permit# BP-2000-0789
Project# JS-2000-1481
Est. Cost: $6520.00_
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JDR BUILDERS 074105
Lot Size(ss .ft.): 8015.04 Owner: BURKE DANIEL&PENELOPE K SARB
Zoning L F�F3 Applicant. J L r7 BUILDE133
AT: 4 MADISON AVE
Applicant Address: Phone: Insurance:
23 6 14AYDENVILLE RD (413) 665-7587
WHATELYMA01093-0066 ISSUED ON:3116100 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 6 X 15 OPEN PORCH
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings: o l 4vS Qu rho
Rough: Rough: House# Foundation: r V
Final: Final:
Rough Frame:
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: e K
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL ION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc Siapaiure:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 3/16/00 0:00:00 312 $50.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo