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17A-068 (2) D� J.C. PRATT FLc, alp- cj, tc6?-- BUILDERS cow.Lic. #06140 1 - REG. # 115419 L Lk-) x LL 0 A c C C LA AJ AIR, y� C) .4-z-- lloc4— ('11AiYL L Z- ,> -C� X12 C/I 4�xv(/U kdl� 43 Montgomery Road - Southampton,MA 01073 - Phone: (413)585-1627 5101-a L� R cc J.C. PRATT C"IJ 4�j BUILDERS CONST.LIC. #061401 • REG. # 115419 L-L Ov LL C k-Lvq 10 r�'j )c 6 /z- C-V kYLC"Az--L /l/k iz- Ls A/ x. tic) — C-x uiazt�)E- - �Z/ AJ cclk,<4 2- i2 C Al' / 6r4 43 Montgomery Road Southampton,MA 01073 Phone: (413)585-1627 ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS 78)0 /GMR Appendix J l-effective 3/1/98) applicant Name: _ 1 _!'s -- — Site fddre-ss: Appl cant Address UseGroun -- ---- - -- -- �7 ----- Date of Appiicat or,: - -- AnNir,ni Pi­: Cv.mpUai►sce Path(cf+eck 6")t , ❑ Prascriptive Package ('J+nitef to ] or 2 family wood !ranee Uuildings heat( l with fassil fuels only) Package (A through KK from Table J5.2. Ib) _ Heating Degree Days (HDD,,) from Table J5.2 la: ('r or items d. throun, i, fill in all valueS that apply from Table J5.2) a. Gross W><I1 AraP � _Q_--- sq. ft t. Wall R-Yatur, j b. Glazing Ar"r ft cot R :`al::.= c_ GiRzing %(100 x b+a) _S __ h. Bas.ament wall d (;fa7ma 1I-vTl __ au �enmett3r e. C:rnfing R-value h -_-__ He-ennE Af UE ❑ r,- ---e,-� Pnri�tniancr `manual Trade Cris (Limited lo wood or metal framed buildings only) Gimate Zone(from Figure X6.2.2) ❑ Zone 12 1 ?one ❑ Zone 1f Attach trade-Off Kbrkhert from Appendix J, (and nVAC 7 raoe-01�14brrsheet, if applicab!c) Fj NtAScheck Software Attach Compliance Report zed inskx-cticke Checkiisi printouts ❑ Systems Analysis OR ❑ Renewable EnerFry Sources Attach Mass Roistered Afchitect or Engines* Analysis ALTERNATIVE FOR ADDITIONS ON!-Y; a. Gross Wall + Cciiing Ares : _ sp ft. b Glazing Area SG.Y c. Glazing "/o (1 x b a) ri AIJDiTiON with Gfazmg (c.)up to 4C% may use 780 CMR Table J1 i.2.3.1 below: MAXIMM- U-461tx Minim,urn R values fenestration _ Ceiling Wa11 Floor Basement Wall Slab Perimeter, Dept 39 J--- R-37 R 13 R-19 j R.lo - — R-10, 4 tt. ❑ -SUNP00m, add,tion (greater than 40%0 glazing-to wall and cc,linp grof.s artx) Attach 'Consumf3r !ntarmation Forrn' from 780 CMR Appendix 83 �_ Official's Sig ature: __-_- Gfnciafs ,-__-- ARplicaton Approved ❑ Denied ❑ Date of °mow is)vi venial: (I(nuyide addiiional details as needed on back side) GlazuP Area=xy be ohher Puiu&(3powng or Unit 1xnn,,—onz ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS 0( 780 QMR Appendix J4-effective 3/1/98) ppplic-znt t4ame: �V�� - __--1 Site Address: Rpptiurnt hddrnss — a.c+1 . ��Y1 * City/To wn: Use Group_ _ ( 1 —7 Date of gpplicat or,. ---- Annlirrnt Gtwv n.._!:__.i on SD F _. Camp•Ei&n0,- Pwtih(check 0")r L1 FIrpscriptive Packag-_ ('_Imiiee to 1 or 2- lamiiy wood irzme Uuildngs heate<j with fossil fuels only) Package (A through KK from Table J5.2. lb): _ Heatinv Degree Days (HDD,,5) (rpm Table J5.2 la: (For items d. through i., fill in all values drat apply from Table J5.2) a. Gross Wail Area A(,12 )_: sq. h t. Wail R-Vaiur t- Glazing Mc+al —sq. H F. `IG3.- R Val::.= iL C- Glazing (100)c b+a) �P_ `y. h. 8:;::(3meat wall -----_--- e. Carling R-value fj__- -- I. Hea:ioF AI UE r l r---m__ n I. Climate-Zone(fromTFtgurt J6.2Mjnual Ir2d1�Zone 121 �ted lo'wood,oe metal framed buildin>zs only} r I`znrnF :e. Attach Trade-Off KMkshee,from Appendix J, (2nd riVAC iraoe-On ttro(isheet, it app!icab!c) [) MAScheck Software Attach Compliance Report and inspection Checklist printouts ❑ Systems Rrktlysis C> Q Renewable EncrF, sources Attach Mass Re-gistered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY.- a. Gross Wall + CeiiinE Area sq t b Glazing Area' __ sg.tt c. GIez,ng %o(1W x b*a) Q ADDITION with Glazing % (c.)up to 40 may use 780 Cti1R Table J1 '1 .23.1 below: M XIM,L,W U-value- Minimurn R VaSue-s Fbrltrsfrabon� Ceiling Wall Floor Basement Wall ;Slab Perimeter. Dept 0.39 R-37 R 13 j R-19 R-10 j R-1 0.a tt._ I ❑ -SUNPOQM- addition (greater than 40% giazing-tawall and c^rlinF gross area) Attach -Consumer Intormation Fofm" from 780 CMP Appendix B. Official's Name: Official's Signature. Applicaton Approved L) Denied (_l Date of A.p;xovat/Denial. t;zs-on(s)—Ivr Denial: _ (prwde additional details as needad on back, sida) Gl.2=z Area a=y be ckh r Pmath Qpaung m Uaa DtnimmDns �C( t A-+4,,- J.C. PRATT F BUILDERS G-cvh'r ;� � r�``A CONST.LIC. #061401 • REG. # 115419 r Jrz`�s cn T c; 43 Montgomery Road Southampton,MA 01073 Phone: (413)585-1627 ©� - A- �- J.C. PRATT BUILDERS � `°'Er ��'� CONST.LIC. #061401 • REG. # 115419 J t ' r c-; 43 Montgomery Road Southampton,MA 01073 Phone: (413)585-1627 AS-k5`-!o AU s S�-4�AC 4C3 J.C. PRATT BUILDERS CONST LIC #061401 • ItEh 115419 Y v Ah t. 43 Montgomery Road Southampton,MA 01073 Phone: (413)585-1627 i MV—�S10/0 S J.C. PRAirr �,�, � � . BUILDERS CONST LIC #061401 • RT 115419 r i 1 tj r JKI ;X1 t 43 Montgomery Road Southampton,MA 01073 • Phone: (413)585-1627 £fQ L F lyBbls 71s�5' 3 j t,� f 1 j� f F � K t ft � 4 ! a s x Y { 4 1 i f � { { tv � 0"V4--- a- o7' Le IL �7 L4 / � 1 r .of d� y F 3 t f I YV " 54 `L �4'` LA ' � E Soil ..>, =� q _.: __.L....__ E.w _..�.._.. .. ., al fR C j i f 't SaiG S�ijC/�' i 3 t � C� �m• � x' �Xt��� .,.fiJl�li -�„«- a-�.... j n ,. o ,� ; � � � � �l � � � �., ._ ---.�- - 1 i+. �� { ;(, r,, `` t� L < t k 6 y e .d r F l i I $' A i 9 5 i 3 7 vUQ V 16— vc 1 4•(1tAMP2. O O Crzf� >af wort[Janlpton B � ,�aSERC1�ITSt(tE . m DEPARTMENT OF BUILDITNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATTON INSURANCE 'MAVIT with a principal place of business/residence at: (phone#) (SOMWcity/statr/ p) blv r� do hereby certify, under the pains and penalties of persury, that: ( ) I am an employer providing the following workers compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hued the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) , (Expimtion Date) (Name of Contractor) (Insurance Compary/Policy Number) (Expiration Date) (Name of Contractor) (Lnsuranc-- Compary/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (atfadt additiotral if ne ceazry to me hl&mforrniti on pertaining to"c•�atrndors) ( am a sole proprietor and have no one to for me. ( ) I am a home owner performing all the work myself. NOTE:please be awatc thzi whim bomoottivcn wbo employ pc=m w do m.;.,e,-axacr,W33truaion or rcpair work on a dwelling of not areca than tbtmo tails in which the bomoov n r=dcn or oo tho grounds appurtenant thcdu arc Dot gCocnlly ooandacd to be employers irrxicz the worku4 ooavcaszfioa Act(GLI52-s 1(5)),application by a homeowner for a liccax or pamia may cvidcaoc the legzl ctstua of an employer under the Workoes Compensation Act I unAau=d thzt x oopy of thu rhf—A cnay be forwarded to the Dcgart of Ix>d<rstzial Anadca&OtSoe of lnwrwoe for dw cov=ge vaifieatioa and that fnilum to somm coverages undcr semoa 2 5 A of MOL 132 can lead to tbd imposition of criminal Pea W- 000sist mg of a-fine bf up to S 1,500.00 andlor imprisc®o of tip to one ynr and eivta pca'W cs in the form of a Stop Work Order and a ' fma of 5100.00 a day against tnC For dq-'*rbr°0W use only C4 c permit Number Mao Lot# Signahtre Licc nsoc Pcrmittcc SCTOt�18 CONSTRUCTION SERVICE'S ` 8.1 Licensed Construction Supervisor, Not Applicable ❑ Name of License Holder : �! C� ,/_�,� r T ` ��° �` y 06l r-/(l / License Number Z/,//,y A-, Address Expirati n Date Signatur Telephone e r :er. ,'orne� : yerraen; recto Q.. Not Applicable ❑ �-Prz Company Name Registration Number LI d Aj`��onn�� �U / i O/07? v? Z 3 Z Oo -- Address Expiration Dat Telephone l`Y<j &--7-16 Z SEGTION 10 WORKERS' COMPENSATION INSURANCE AFFIDAVI,.T(M GL 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...... ❑ A ago Wow, 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 3SEC71:ON S DTS .FXTLON OF PROPOSED (YORK(chec 11 bpi�cabte) ., vn.... .......�'. _... 'ice T_ d`'.�-... �.-s .+:va%` a .A21e'S' ? . . Vn rtR'...'mY^l`.' �.... ,.}• S' ..,4._- ''_-:fit -.,x ;*"�.`,i"F'x v.•�-5`i'r'Y�.." New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg" ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: 3C �2 � �A1C5' Alteration of existing bedroom Yes_j ZNo Adding new bedroom Yes ✓ No Attached Narrative❑ / Renovating unfinished basement Yes br No Plans Attached Roll o- Sheet(Y e o 7adlo—MNi"on/t ears rn hatrsrnQ�p MER''e-44 0 0W a. Use of building: One Family c/ Two Family Other b. Number of rooms in each family unit: __ Number of Bathrooms [_ c. Is there a garage attached?_'4y d. Proposed Square footage of new construction. Dimensions, X e. Number of stories? a I f. Method of heating? r X �Yo� tt3ig� Fireplaces or Woodstoves Number of each -------7 g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction X`7� 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 ✓y Private well City water Supply +ice -SECT101�17a OliVNER;AUEHORIZ/71ON, TO BE,COMPLE7ED YYHEN ;OWNERS F_ GEV I OR CONTRACTOR APPLIES FOR BUILDING P:.ERNlIT 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. (v tZ C 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. � It C' " �1 Print Name Zw Signature of ne ent - 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 �( d S-y 13 1 Building Department Lot Size • v�1J 5 /2 S frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage / f Open Space Footage i % (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 DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO v°f~ DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT 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�„t✓ IF YES, describe size, type and location: Ci of Northampton LN department e `. - Main Street 100 L i 2 %M1!drth on, MA 01060 Tama - phone 413-5& -1240 Fax 413-587-1272 APPLICA'T Q]1LTO-C -AtIER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-S1TE1NFORMATION Opt 1.1 Property Address: Thsecho be complete by office GG R` Mao Lot Unrt r?�,�!r ;Zone Overlay D�str�ct' ©n�Sti D1stnct CB District SECTION,2-PROPERTY-OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Na a(Print) Current Mailing Address: 2� Telephone gnatu �— — p7 2.2 Authorized Agent / / i A-7"T At.C,rlr���? � °y3 /KC'Aj4 11"_x / Name(Print) Current Mailing Address: I Signa Telephone SECTION 3- CONSTRUCTION-COStS71 COSTS Item Estimated Cost(Dollars)to be 'Of_icial Use Only completed by rmit applicant 1. Building (a)'Building Permit.Fee 0 2. Electrical (t);Estimated-Total,Cost Of Construction from. 6` 3. Plumbing 66 i1dtno-Permit-Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 +2+3+4+ 5) $ p Check Number This Section For°Officiall Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date w File#BP-2005-0518 APPLICANT/CONTACT PERSON J C Pratt Builders ADDRESS/PHONE 43 MONTGOMERY RD SOUTHAMPTON (413)585-1627 Q PROPERTY LOCATION 18 MOUNTAIN ST MAP 17A PARCEL 068 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid T_ypeof Construction: ROUGH FRAME 8 X 6 BATH DORMER New Construction Non Structural interior renovations Addition to Existiniz Accessory Structure Building Plans Included• Owner/Statement or License 061401 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION 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 Commission 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. r i ti 18 MOUNTAIN ST BP-2005-0518 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-068 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A) Category: BUILDING PERMIT Permit# BP-2005-0518 Project# JS-2005-0674 Est.Cost: $9500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin: J C Pratt Builders 061401 Lot Size(sq.ft.): 10018.80 Owner: SADLOWSKI JOSEPH J&ELIZABETH Zoning.URA Applicant: J C Pratt Builders AT. 18 MOUNTAIN ST Applicant Address: Phone: Insurance: 43 MONTGOMERY RD (413) 585-1627 () SOUTHAMPTONMA01073 ISSUED ON:1114104 0:00:00 TO PERFORM THE FOLLOWING WORK.-ROUGH FRAME 8 X 6 BATH DORMER 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 Occuoangy Signature: FeeType• Receipt No: Date Paid: Check No: Amount: Building 11/4/04 0:00:00 3868 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo