11C-024 JUL 1 1 20M
MA check COMPL CE+ REPORT
,Ma ' 4 .Isetmv[( 6}r Code Permit #
�1ASch rsion 2 . 0
Checked by/Date
CITY: Amherst
STATE: Massachusetts
HDD: 6614
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE : Other (Non-Electric Resistance)
DATE: 7-9-2000
DATE OF PLANS : 7/8/2000
TITLE : JASON PROUDY
PROJECT INFORMATION:
14 ' x 16 ' ADDITION
8 STOWELL AVENUE
LEEDS, MA 01053
COMPANY INFORMATION:
David Fortier Builders
32 Laurel Street
Northampton, MA 01060
COMPLIANCE : PASSES
Required UA = 98
Your Home = 83
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
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CEILINGS 256 30 . 0 0 . 0 9
WALLS : Wood Frame, 16" O.C. 480 19 . 0 0 . 0 29
GLAZING: Windows or Doors 79 0 .340 27
GLAZING: Skylights 17 0 .410 7
FLOORS : Over Unconditioned Space 224 19 . 0 11
HVAC EFFICIENCY: Furnace, 90 . 0 AFUE
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COMPLIANCE STATEMENT: The proposed building design represented in these
documentg is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code .
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125 of the design load as specified in
sections 780CMR 1310 and J4 .4 .
Builder/Designer Date
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DEPnRT1 Uri- OP BUILDING INSPECTIONS
212 Alain Strect * Municipal Building
Norlhnmpton, Mass. 01060
NorORICER'S CONUENSATION INSURANCE AITIDAV1T
I,
(1 i ccus<.rJpc>7n i ttcc)
2 principal place of business residence at
- ` y - S77- --(p lone- )
(srm-ct/a r r in2 tc-fn P)
do hereby certify, under the pains and penalties of perjury, t11a1
( ) ) ,-m aii employer provJdiJl- the rollov',i P V1,01-nCr-'s co(m)cnsc cll cove—' iOr Illy
employees wo1-,,],][ , on uwi job
Date)-
( ) I
am a sole propri(:tor, general contiacTor or homeo,,v= (curie one) end have hired
the cones actors listed below who the foUo%, P ,vorker s policies
(Nom-, of Co_-':Icaor)
(Nainc of CoarTacror) (lns.Iranc Comoa l�fPohcr Numcrr) (L�1 it rion Dale)
(Nalne of Cowncio;) (Insuranc: Compan}•/POIJq NumF r) (Expir,•tio� Date)
-- (Nalnc of Connactc,)- - (I-Aran Come n}'/I'olic� Nulnb�) (T.rl�inrion Dam)
(euad: Via;a.a c'xct if nc�r.a.r;to ak,wc-iafcrt-�aiiec �:nf,t,
( am a sole proprietor and have no one working for rne.
O I am-a home owner perforrnilig all the work myself.
NOTt_plc b twat .a:�LJc t CQYA 4 YT7 ,J�czr,loy pc oa:to d) C r< u•Icrx m.
ON nxxe Ll'—^--L`.7cr_ u m l,ryr•wer raider a oa Lsc��:v'� z .:rict>;rt then r✓-c ox to be
e r loyc t ua cr t k . xkc t a ,yam _:im Act(G L152-�1(5)),:(pt tior by e hc:, CO,rot t C.C=,_u pernvt rr_y—,676 x Lbc
Ic�l n,^�oCcn�loyx under tiro Worlo�,Com�caivt5oa�i
f u<>dc:Tt��d the a—py of thi, auy tx f«-�..v<S.od w t}w D,K—to—! for tlx
eovmsc vc iGci oo nod t}Lt LiJ sc w sc�uc cov Tam unGct SoO ti fl)5A of MGL 152 on l d to tlx:urwsd o0 of n n,l p n�li a
00o1is:-; of a floc o(up to S I}00.00 and/or enpriwn;i oCup to cxr_yc:r t—1 ci tiJ pav-IUO io ff�frxm of a Stop Work 01,1�end a
fun of S 100.00 t d--y tgAurt ay_
For dqy,:trn�==1 ur_onl�.
Pcrnu
Sir,na(trt of Liarr:cc�Yct�itittcc --
CTION.8-CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : OAV't n FOX_-r (tea. &O$O XG
License Number
U A h,a 7,.4 A✓ '31 a o 0 2
Addre T Expiration D to
& 5gG- 6
SignaturY Telephone
�n1 G Not Applicable ❑
Company//Name Registration Number
Tk.Address Expir tion Date
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.
ned Affidavit Attached Yes....... M/ 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
SCR1P 1 ° - ; ;,,
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[
Brief Description of Proposed Work: Ann 1,11 Xl,.,l Sur- ko&,N To I&Isrt,, 40-15(
Alteration of existing bedroom Yes__IZNo Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet Cie'
a. Use of building : One Family t Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
� l
d. Proposed Square footage of new construction. Dimensions �`'� X ((6
e. Number of stories? I
f. Method of heating? 1F^ou—(Zo 4o i A(�L Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? )OZS
roll, Type of construction W000 r2A-it-
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes L-/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
S'ECTi"ON 7a ,.QWNER AUTHORIZATION TO BE COMPLETED I WH N
C tNI*RS,AGENT`OR CONTRACTOR AP"PL!', STt'�1'(,AVI'.D1,NG PERMIT
I �, A001 as Owner of the subject property
hereby authorize to act on
my behalf, in a I at rs r lative to work authorized by this building permit application.
Si n ture of Owner Date
l An 3N.&/z;I F,/L air/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.
ned under the pains and penalties of perjury.
EAU(O M.
Print Name
2 oGu
Signature of Own r/Agent Date
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
Building Department
Lot Size -I(O o SQ r 1 �6.j 0
-1
Frontage ct Q+ &o
Setbacks Front ax, 3 o
Side L: 9, R: % 01( L: 1-1 r R: j
Rear g1t n1 /D
Building Height a( 1&1
Bldg. Square Footage
Sit.
Open Space Footage q % ZVO(a
(Lot area minus bldg&paved 1 Oct 7o
parking)
#of Parking Spaces
Fill:
volume&Location
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:
E -of Northampton
Q Btj,I Ing Department
2 Main Street
Room 10,0
N r mpton, MA 01060
�FPT OF BUIL 158 -1240 Fax 413-587-1272
i` ?{'ili•tii�q'�
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECT[ON,1-51,.1 E INFORMATION
' =x
x �A `
1.1 Property Address: fi
S
To W 17« �
r y M �. a > �
SECT IQ .- PROPERTY'.OWNERSHI,PlAUTHORIZED AGENT
2.1 Owner of Record:
�-JASolv � l3us � �TauraEit_.
me Print) Current Mailing Address:
sg1f _
Telephone
Signat e
2.2 A horized Agent:
tJ l ,�✓ ,2'' 2 AcX2t�� .
Name( i t) Currentc^Mailing Address:
l� b(o
Signature Telephone
71011 ' ESTIMATED GONSTRUCTIOIV COSTS
Item Estimated Cost(Dollars)to be Official,Use Only
completed by ermit applicant
1. Building o2�ySv (a)Building Permit Fee.
2. Electrical (b)Eistrtiated Total Cost of
A !700,o u Construction f�prrt .�
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) Coo. u v
5. Fire Protection
6. Total =0 + 2 + 3 +4 + 5) ay � , oo Chegk,Ntjinber 40
This Sectlbof ;official Use 4sii "
IJdin Permit.Number: /"� Date Issued
Building Corrrmissionon'spector,crf u"ditig5 p""ate
File#BP-2001-0034
APPLICANT/CONTACT PERSON David Fortier
ADDRESS/PHONE 32 Laurel St (413)586-8965
PROPERTY LOCATION 8 STOWELL ST
MAP 11 C PARCEL 024 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid_
Tvpeof Construction: CONSTRUCT 14 X 16 HEATED SUNROOM
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 F LOWING 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 Commission Permit from CB Architecture Committee
14n z4q��,Z__ -/-/ '/ -00
Signature of Building O cial 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.
�4_. �,�.,�_:.
,.
,� _ "`_ �-
,, _ �..
8 STOWELL ST BP-2001-0034
GIs#: It OMMONWEALTH OF MASSACHUSETTS
Map:Block: I IC-024 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
CattegM:ADDITION BUILDING PERMIT
Permit# BP-2001-0034
Project# JS-2001-0061
Est.Cost:$24650.00
Fee: $89.60 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: David Fortier 008026
Lot Size(sq.8.Z 9975.24 Owner: PROUTY JASON L&KAREN L JACOB
Zoning:URA Applicant: David Fortier
AT: 8 STOWELL ST
Applicant Address: Phone: Insurance:
32 Laurel St (4131586-8965
NORTHAMPTONMA01060 ISSUED ON.7113100 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 14 X 16 HEATED SUNROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: y Meter:
Footings:
Rough: Rough:`? House# Foundation: : - s
Final: Final: It I I 10 tom' ,f —
Rough Frame:
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:) 9-/-60
Final: Smoke: Final: U' K (_i _ ✓� ''
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
. r
Certificate of Occu anc Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 7/13/00 0:00:00 3283 $89.60
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo