Loading...
02-020 ^ o 7,Q I � S - - ' IPA ( UI iL, - I i � ; t-��� _•mac_ .. j- y.. C 1. �1 y ' S7 f of i:r t w { 71 A Neil Homstead 408 North Farms Rd Florence, MA 0106`'2 413-584-045& 1 ENERGY CONSERVATION APPLICATIO44 FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS r 780 AMR Appendix J etfective 3/1/98) tzppti sr,t;hiam : 06fL- f•aw Site AtSdrESS: j�o� I�IorzTZ+ FsF2NtS �� k.ppt r�rrn� f ddrrt,s s: 4!7$ �lJ(LThF FAgeS Cltyf own. �-Lp12G7UClf�.,--MA- ,. 2C?7UC L _ Use Group. Date of pool cation,: Annlirrnt P'fwr: ,���—a�- ^ �NI;C-�iiv� Sji�,iotiiio: COilt.�{.3i4GX° �t}'S(C�lt^Ck >Jt1lSx 1.1 Prascriptis.-e Pack--g-t (!_invitee to 1- or 2- family Wood 'r-me Uuddings tledted w t1n fassil (uel; only) Packare (A throug;i KK from Table J5.2 (b)' — Heaii.ng Degree Days (HDD,) from Taole J5.2 la: (For items d. throun; i., fill in all values t`tat apply from Tab)e J5.2) a. Gross Wfzii izrep '700 sq. fi f. Wa,t R-Yahlr- g _ t. Glaine t.re�l � � + �. +.•! � FIC;: R Yal.:� FL � 1 c. Giezing%(3 D0 x b+a) h. Easement wall >q - NA o d, GlaZino 11-rr1 r !_ Q. 31 t _ C;eb Forimeier E. AIA e. co,ling R-value R 3 i. Heating AFIJE n �npc, n, PeFforrnarice 'isanuil Trade d L c (Li.^n ted io woo or metal framed buildings only) Gima-t---20-e(from F-i , J6.2.2) Zone 12 ❑ gone 13 ❑ 7nra ',G At>rch r rade-0;T -orn Appendix i, [and ii VAC Ttape-Urn by ti�neet, if applicable] [j tAAScheck Softrrart Attach CWrpifance f?apolt 2nd 1nspeti7iQn Ctlecklist printouis. ED Sysicns Analysis OR (J Renewable Energy Se rces Attach Mass Registered Arthitvt,-t or Engitwwr Analysis ALTERNATIVE FOR ADDITIONS OW Y: a. Gross Wall t !'iiiino A,fe-A400 D c f ti n 1 _ � lazing Area �2� Sq.Y c. C;Ia2�ng T"(IC)'J x b+a} � ❑ ADDITION with Glazing % (c.)up to 4jDc,,' may use 780 CMR Table J1 1 .2.3.1 below: MAXIMUM U'4a:(F Minim, Urn, R vaSucs Fene rat n Coilirg Wali Floor 8astrnnt Wall Slab Perimeier• Dept 13.39 R-37 R-13 R-19 R-10 I ?.10•a ri. ❑ -SUNPOOM" addition (�:reater-than 4Cr)�glazing to wail and cc-;i+np gro>S are-b) Attach 'Consumer lnft- maIion Form" from ?K GI-1-R Appcnd-ix B. Grncial`s hkame: /,9TW-eCj Crficial'S Signature: Apphczb-an Approved [&- Denied ❑ Date of App—ova!/Den ai_ 20 n�oaSL.(S) ivi t^rciiidi; (prayiCit adQlilonaf de'4Ldi1S aS necxded On back SitlA) Qa`T- .Area_=ay bc.ck bu: -dponing cc una Dim iiabes. 1, iJ�RAIAY.MAP s� AF 2 G CS � ��. oa Na z N8g"� P � y h y9s NOR_,, s g$e a ll • SSSE ° r + n fJ R oWn Z'1 v fl� New tr N M� off ow « m Z / c 14: 1P 88 /�o' / / Ng a W .740' . rl S°• N� rr J1 -�z8' s z9,rE 476 Il /o" is 3° �P W° ip NORTHAMPTON, MA Property of Jonathan and Suzanne Kurtis 569 North Farms Road Northampton, MA 01060 Prepared by: Lincoln C. Fish 3/93 from Huntley Deed Study 12/79 - and Huntley Survey 11/88 , 1/82 For Chapter 61 proposes only SCALE: 1" = 400' f , �I 83Dli C}t1lStttE ' �z DEPARTMENT OF BUILDD1,TG INSPECTIONS /= INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as has/her construction sup,,.--z sor. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or twoftrnity- dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-yeas 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 Ogulations. 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.: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. Daze Address of work location r I a E Crrf pf 'N;azfljalliptoll stay:hchnsrtle• — a DEPARTMENT OP BUILDING INSPECTIONS 212 Main Strcet Municipal Dudding Northampton, Mass. 01060 I i WORCiR'S CON TENSA`IION ONSURANCE AFFMA.Vj-j' I, !�E (L (I1 CCI1S--CJpCrMj ttCC) %Inch a pruicipal place of businessfresidence at: ---- 40Y tilde' Pews R-o FLO,26-V-C& AM etO6 ;hone'Y¢(3) (stT�.tici rr/sta.tcfa p) do hereby ceriify, under thc.pamns and penalties of perjury:, :hat ( ) I am an employer providing the followim-7%vorkcr's comocnsado, cove age for lily eluplovees lvor�3119 on this job: (In»xan=Comr zv) (POUC Nu_�DCr) --- (r:piratiorr. D2=) ' ( am a sole proprietor, general contractor or homeowner (ccie one) and have hired the coati actors listed below who have the following worker S COMDt Saaon acbcies U6.757DRRt�, -A-00 jA kI e-5 /1/A r c.i-aUK '2 (�c Ix .S (o -6 2-c7dS ('Name Of Co.,^Ci0') (lnsuranc:; CoInpaS1)./Pouc- NU-ML::) ( XP'IF'J":On bate) © to CCrG7-f-7 S-) t3ot3 Scc�,y�� %�A "7-rvP�i� 39 4 `� it o r 105- - -- —(Namc of Contractor) (Lasarznc: ComoaawPolic; `t rncrT) (ExpiM60a 21c) (Name of Coammo;) (LDsw an= Comnan)•/PoUq- N-umber) (Expirdoa Dam) (Nzmc of Contractor) (Insuran(-- Company/Policy Nt1mb r) kxpimdoo Da1L). (1¢atjz ddi�oca!rte. if aCcQ..V w Q,c!vc�=info—i .pc�Wins w.11 cc -_co�j am'a sole proprietor and have no one worldDg for me- am-a home owupr performing all the work myself, NOTE_pl=.se be to rc L1 4•. c 4ca r0-Mta caxpIQy P=-i- �in c--c:joo c rePaa work m a d–xj1*--g of CD(m«t t!`a c:str.tint r in u3itb the bomoowac raid-a oa the pct,zppur+--„ them a-c ouc Cc�.r�;y aea'd=vd to bC cizocy,=urxd the w�ekdz� -- m Ace(Gl!152.=1(5)).=Pptinooa by.bomeo-=far_lice=or pamis mzy n-idmce EL-c Icg�!et�Aic of en er�loy.r under dze Workda C.ompamat;ep Act I uadesaaad tha a copy of thin mtm m,y b.foev.urd.d to tb<Departmcoa th. coverase vc'if ezlioa+ud tlz:1 C11tac to soyrs`aovRy�tmd`s soeiioa 23A of}.taL 1 S2 an led to the i�ositioa ara;...:.,.I peatliio oo0.i,,rsg of rae ar up>a s t po,00.ne,ar or"p w o�-)-, r=e a.;l pm,j-,;a s 6c rorw or a Skzp Work Order and rim of S 100.001 day 1piaA me For dcputa+�+!ux agty . PcrmJt Numl;— Si ziurZOfLi crmittct Uate -- -� ¢' SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: — CS o:3 1 ZT 9 License Number Address Expiration Date poop e--)L)e- 0I0 6,, Z Signature Telephone SF4 - C�4S� K e�H _ ., � R .a ; .� , 9� eu[sf-erec'�Hom��mpramec��ont�t n �„�, Not Applicable ❑ k)6 fL P Hdrtils ►— 7 13 -Z Z<; Z Company Name Registration INum er ----- A)e-/L C t7rr>�S 7'-.cFl i� 12 / /V /zc7 o 6 Address FLOQe-VCE i 44 A` Expiration Date 9©� Voe %4- FA-2W1.S RU. Telephone J�O'�'0���1 SECTION 1'0-WORKERS'COMPENSAT.ION`INSURANCE AFFIDAVIT"(M.G.L.c.'152,•:§=25CE6jj 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......� 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 r , s SECTION 5-DESCRIPTION OF PROPOSED WORK(check�alk applicable) New House ❑ Addition .. Replacement Windows Alteration(s) Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[[3] Other[�] Brief Description of Proposed Work: A7�i�" BL 1�2D19►/Vt AL-Tt� �Xrs i��J4 VC EEA) PaRCk T0 AT(fQ00A l Alteration of existing bedroom Yes No Adding new bedroom k— Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet (3 ..� 1 s .�`�?".-'" xri�t'q?-�S�' a,at`i `es�`"`�"�'.- ,;.�.,f[ �% � � .�.;•i=ar' ,. "�+�;,... _: sa �€New �ro�se�`a�d� dct�t>nk, to ex t� - or�sl�lcr cor�ate��fh a tOUr�k>atck: 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? r d. Proposed Square footage of new construction. 3 q 3 / Dimensions 20 X 17 e. Number of stories? f. Method of heating? o-r O.Arr E jZ - 0 r L Fireplaces or Woodstoves Nei Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 1769 12kw 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 NA 2—r E 125 k. Will building conform to the Building and Zoning regulations? _ Yes No. I. Septic Tank _ City Sewer Private well�_ City water Supply SECTION Ta-OWNERAUTHORIZATION-TQ BECOMPLtTED';WHEN1 OWNERS'AGENTOR CQNtRAGTOF2 APPLIES'.FOR BUILUINCPERMIT as Owner of the subject property ll � hereby authorize N I L t1 o 04 S ?' '4-TD to a my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date I, V0 L 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. ' lV EEL 6(0 M—S 7-E AL7 Print Name .¢-26 - O.5' Signatur of Owner/A nt Date ^ ` � Section 4. ZONING All Informat-i6n 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 �C> Setbacks Front Rear Building Height Bldg. Square Footage 0,10 *Z-2 1 Open Space Footage (Lot area minus bldg&paved #of Parking Spaces (voluine&Location) A. Has Special Perm�/Vuhunoo/Findi ever been �suedfor/on the o�e? NO' DON7KNOVV 0 YES 0 � IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON7KNOVo 0 ,Ex IF YES: enter Book Page end/or Document# ' �� B. Does the site contain a brook, body of water urwet|ands �� VV �_�NO �~� DO0TKNO YES IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained x�� Obtained �-v Date |ysma�' v�� «�� ' ' wt—A C. Do any signs exist on the property?� YES *�� NO |F YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,gradingexcavation,or filling)over 1 acre oriod part ufo common plan that will disturb over 1 acre? YEG K ] NO K�J -�� � �� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ' r City of Northampton e 6 Building Department Y n z 212 Main Street S. • . . .� Room 100 a kaa `tiE a Northampton; MA 01060 phone 413-587-1240 Fax 413-587-1272 laf�S atts� O4ierpee�tf APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1.-SITE INFORMATION �-- ` This section to be completed by office 1.1 Property Address: ,5-&cl k)oR 4 F1+RM-S dC . ��> �`n Ahapr L`ot Unit L O r2 C C M s `Overlay Drsfcrct r � 2 PP SECTION 2-PROPERTY'OWNER$HIPIAUTHbIZIZECA F.� ��� 2.1 Owner of Record: °' S�v C/ VoRT4 F4eo -s ,TQ14bL*-hAA '4- S laah ke V S i-Lo j2 evc E MA 4106 Z Nam nt) Current Mailing Address: Telephone �' s t r& U Signature (3 2.2 Authorized Agent: 40g V0277-f FAPAII S IVErL. r-Lo2 tZ0C0 , MA . D(06 2 Name(Print) Current Mailing Address: Sig ture Telephone SECTION"3.-ESTIMATEDCONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building �' S�O� (a)Building Permit Fee 2. Electrical 3 �� (b}Estimated Total Cost of Construction from 6 3. Plumbing 4,0co — Building,Permit Fee 4. Mechanical(HVAC) 31000 5. Fire Protection "- 6. Total=(1 +2+3+4+5) 0 , Q O Q r Check Number 'b This SectiomForOfficial'Use Only Date Building Permit Number. L Issued: Signature: !' i Building Commissioner/Inspector of Buildings Date J File#BP-2005-1047 APPLICANT/CONTACT PERSON NEIL HOMSTEAD ADDRESS/PHONE 408 NORTH FARMS RD FLORENCE (413)584-0458 PROPERTY LOCATION 569 NORTH FARMS RD MAP 02 PARCEL 020 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out IL Fee Paid 1049-Y XD1711 T_ypeof Construction: CONSTRUCT 20 X 17 BEDROOM ADDITION&CONVERT SCREEN PORCH TO BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 031249 3 sets of Plans/Plot Plan THEYOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I F RMATION 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 Co sion S' 200, 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. BP-2005-1047 569 NORTH FARMS RD COMMONWEALTH OF MASSACHUSETTS GIS#: CITY OF NORTHAMPTON Map:Block:02-020 Lot:-001 Permit: Billding BUILDING PENT Cates_ Permit# BP-2005-1047 Project# IS-2005-1434 Fier Cost: $60000.00 Fee: 00 PERMISSION IS HEREBY GRANTED T Contractor: License: Cons— NEIL HOMSTEAD 031249 Use Group: Lot Sizersa f ) 174240.00 Owner:n l'cant NEIL HOMSTEAD&SUZANNE 1 Zoning:RR A AT: 569 NORTH FARMS RD Phone: Insurance: APP cant Address: 413 584-0458 408 NORTH FARMS RD FLORENCEMA01062-4513 ISSUED ON:5/310 0:0000 TO PERFORM THE FOLLOWING WORK"CO 20 X 17 BEDROOM ADDITION & CONVERT SCREEN PORCH TO BATHROOM POST THIS CARD SO IT IS VISIBLE FROM D H W STREET Building Inspector Inspector of Plumbing Inspector of Wiring Service: Meter: Underground: Footings: Foundation: �✓ f 0 h Rough: Rough:�0 f 11IC h/�� House y \/ ,1 Driveway Final: Final: h Frame:}!�L T Final:�""�� �� �L 31,�T76 � Rough V,l 1���p�^dil 4., Fireplace/Chimney: Gas: Fire Department _ Insulation:(� k 1 ✓ 8' Rough: Oil: Final: 43C �"','1.5 -O 41 Final: Smoke: Gl— OF NORTHAMPTON UPON VIOLATION OF THIS PERMIT MAY BE REVOKED BY THE C1 Y ANY OF ITS RULES AND REGUL ONS. ,� � Si nature• Certificate of Occu anc Date Paid: Amount: Feel e• Building 5/3/05 0:00:00 $177.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo