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23A-176 (2) TI C1ti:-;_, PR I L1ESi 11-11 ?F1- �1r. '14 P.Al '11-1 BOTT ,t §, IcTJ-�edm"' v .55 Segal Numbcc 70010717u 3 Pcs of 1.75" X 11'.875" 1.9E Mlcrollam@ LVL 'y BEAMUSA 1111 06/OSi20Ot 9:36:14AM Psgt 1 of 1 Build Code-146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED � 7 Fil: :C] 15'4" Product Diagram is Conceptual_ TOADS: { Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width: 1' !f' Loads(psf):40 Live at 100%duration; 10 Dead;0 Partition;and: '' TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(plf) Floor(1.00) 150 104 0 to 15'4" Adds to Uniform(pif) Floor(1.00) 280 104 0 to IV 4" Adds to i 1 SUpPQRT$" INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LIVE/DEADITOT. PLY DEPTH DETAIL OTHER illjl 1 2x4 Plate 3.50" 2.396" 3603/1742/5345 1 11.9" Detail A3 1.25"LSL Rim 2 2X4 Plate 3.54" 2.395" 3603/1742/5345 1 11.9" Detail A3 1.25"LSL Rim ai1,I' -See TJ SPECIFIER'S I BUILDER'S GUIDES for detail(s):A3, 1 -Bearing length requirement exceeds input at support(s) 1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS-, MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 5229 4452 11845 Passed(38%) Rt.end Span 1 under Floor loading Moment(ft-lb) 19609 19609 26772 Passed(73%) MID Span 1 under Floor loading Live Defl.(in) 0.410 0.500 Passed(U439) MID Span 1 under Floor loading l4 r Total Defl.(in) 0.809 0.750 Passed(U296) MID Span 1 under Floor loading Deflection Criteria:STANDARD(LL:U360,TL:U240). Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"olc unless detailed otherwise. Proper attachment and ,y positioning of lateral bracing is required to achieve member stability_ 1 ,4DDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(Ti). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ 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 bya TJ Associate. Not all products are readily available. Check with your supplier or TJ 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 NER analyzing the TJ Residential product listed above. Note:See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. .W r fA, (1. ROJECT INFORMATION OPERATOR INFORMATION: rt; ATTN:GINGER PrimeSource RUGG LUMBER TIMOTHY LYNCH 413-247'8338 . 45 Freight Street t Waterbury,CT 06702 203-455-5200 pyright 67 2000 by 7rua Jaiat,a Wcyc&aouaor Bu8in6sb. TJ-p,u—and T4-5camT9 era%)dcr➢drKa of TrUS Joisi. ro11,9me,is a registered trsdcmark of 7rus Joist. e 06-05-01 09 : 37 RECEIVED FROM: 2 03 465 5214 P . 01 J Truss Truss Typo aty Ply _N111"S CA NER QW5023 CIF 1-2 CAMBER 10 1 fo;W-nalL �DF ....... fru s ifctnrig corp Indian Cichard.MA 01151 4-131 SR1 s Nov 16 200O iI Industries,loc- rua Jun0510:29:02 2001 ?age 1 2-10.1 26 CD 23-1-15 23-3-11 V-0-41 Scafo 1:654.1! rt, 4xS U_ oil 1.6x411 3M 3 w 7 314 4 9.50 V2 314 3 4 3M W? 0 60 PSF UV 1 1G 15 '7 17 t4 11111 13 12 Tx" 7�' .5x& 4)L,9 6.00 P-2 rr4 21-3-11 26-0-0 6-3-11 10,0_0 5-3-11 24-5 > H LOADW(psfl SPACING 211-0 C131' DFF1_ rn (Jac) vdzn PLATES G r4p �TCLL 35,0 Pulas Increase 1.15 TC 0.64 Vart(,u) ZA713-15 >56s M1120 1971144 Li TCDL TX LumberIncreari• IIAS BC 0.113 Varign) -0,5611-15 :1529 Z W 13CLL 0,10 Rep$tms c.kc r YES WE 0.95 tfor4nj 0.21 10 I'da BGDL 10.0 Code WCAJANSIms (Matrix) 1111 LC LL Min Lrde n=2d0 Warafft:137 LIJ F-1 =LUMBER T)TUs truss has heca designed with ANSVM 1-1-125 critcrW- WTOPCHORO 2XLSPFfIo_2 15.10 = 2230 15-17 = 1274 14-17 = 1274 14-18 = 12-74 8)AU PI ate s 20 Ga u ge Un Fe ss N oled LOBOTCHORD ZX6SPF1&50F1.5E 13.18 = 1774 12-13 = 2930 110.12 - 211180 fj}WEBS 2 X 4 S PF Stitd'Exzept- VM135 LOAD CAS46) LY W4 2 X 4 SPF No.Z W42 X 4 SP-F Na2 346 = $18 3-16 = -935 545 - -US 6.15 1574 Standard 643 1574 7.13 = 439 943 = -"5 942 = ale RRACR40 TOP CHORD NOTES (3) Sftaatlwdor7-A-5ocipwrilins. 1)This trues has been oftecked fur unbalanced UIa i conditions. ROT CHORD 2)This truss has been desrqntd tar ttkawfud toads gumzLEd by 90 mph windr.at ,clRigfdcei"d6-eetV applied ur7-,%-15 achrac". 25 ttabcrm ground[suet,uskV 5.0 psf Wp chord deed load and 5.0 mtbOttDM E) WE B5 chard de ad load,fn the gable end t u of m In a on aa occupancy c ifteg ory 0,cwtd kin n m I Rna el midipt 6.15,6-1a 11 FafflaRy cnmk"d BuRdrag."ah expa.m C ASCE7-1;5 per 130CATARSKS W.Ad 04 iTt verticals rat cantilevers exist,they are exposed fn wind. III'porches exist,they ars 0 REACTIONS(Usfal exposed to wind. The hunberOOL[lacrease Is 133,and the pliala QrIp WtE-Asets 2 - 176EN-3.1 10 1,33 F1 Max Ho 3)As requested,ptalmIs have not h4en designed to provide foT p4aceflnent. E')2 = -32T(load case 2) tolerances or rough Uncarng and erection candki(wis. It Is the responsibitIty of the i. I.,J Max Uplift fabricator Co fincressR plate sii:ms to account for these factors. ti 2 = -1542(laid case 41 10 = -542(road case 5) 4)•This truss has been designed fora llvoload 0t 60.Opst on th8 bottom[chord In 0 all areas;with a clearance greater than 3-64 batwe-_-n the houtom chord and any I I FCRCE-S(b)•FML Load Cass Only a thar mamhcr%. to 7=TOP CKGRI) 61 Bearing at joliat(s)2,10 corls[dcqs parallel to grain value rising ANSUTPI 1.1935 0 1.2 = S3 .2 3 = -3489 1-4 = -2701 4-5 - .2538 angle(o gran ronnala. Building(Je5ignerstroufdveffy capacity oftreating 5 I -2705 E-? 270S 78 = .2535 9.9 = •ZT61 surface, LO 940 11%83 10.11 = 53 S)Provide mechanical connactiaii(by others)of truss to k z6n9pWiLe capable of 0 EOTCHORO withstanding 642 lb uprrft aLpInt 2 and 542 Jb uplift at joint W. 216 = 31&D 7- PRIf•1ESOI IRCE - �1+, OTT• B 4 � 9.�" T,�1 /PrOTM-.130TS JOIST 16.0"" o/c � f l ' 7J-Beam- v5.55 Serial Number.7007 07 17 8 BEAKW$A 1001 06!0512001 9:37:45 AM It PaBc 1 of 1 Build Godo:146 1; THIS PRODUCT]MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTI-D y1{ry� 11,x, ii a. .o 14'-- l' Product Diagram is Conceptual. LOADS: I� Analysis for Joist Member Supporting FLOOR-RES.Application. Loads(psf):40 Live at 100%duration;10 Dead; 0 Partition SUPPORTS: INPUT BEARING REACTIONS(II)S.) WIDTH LENGTH LIVE/DEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3.50" 2.25" 373/93/467 1 9.5" Detail A3 1.25"LSL Rim '' 2 2x4 Plate 3.50' 2.25" 373/931467 1 9.5" Detail A3 1.25"LSL Rim See TJ SPECIFIER'S I BUILDER'S GUIDES for dstail(s):A3. id' D jIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION I Sri !i' Shear(lb) 453 447 1120 Passed(40%) Lt_end Span 1 under Floor loading Reaction(Ib) 453 453 1120 Passeo(40%) Bearing 1 under Floor loading F,..,,, Moment(ft-Jb) 1538 1538 2787 Passed(55%) MID Span 1 under Floor loading Live Defl.(In) 0.226 0.344 Passed(L720) MID Span 1 under Floor loading Total Defl.(in) 0.283 0.679 Passsd(DS76) MID Span 1 under Floor loading Allowable moment was increased for repetitive member usage. -Deflection Criteria:STANDARD(LL:U480,TL:U240). -Deflection analysis is based on composite action with single layer of the appropriate span-rated.GLUED&NAILED wood decking. Bracing(Lu):All compression edges(top and bottom)must be braced 2t,2'8"01C Unless detailed otherwise. Proper attachment and ti 'It posftioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this wl: software will be accompiished in accordance with TJ 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 TJ Associate. Not all products are readily available. Check with your supplier or TJ technical representative for product avaiiabilAy. J -THIS ANALYSIS FOR TRUS,JOIST PRODUCTS ONLYI PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the TJ Residentla►product listed above. ti Vt 11( I,s 'yr; l PROJECT INFORMATION OPERATOR INFQRMATION: ATTN_GINGER PrimeSource RUGG LUMBER TIMOTHY LYNCH 413-247'8338 45 Freight Street Waterbury, CT 06702 R 203-465-5200 coGyrlgnt C 2000 by True Joist,a Weyerhaeuser Business. Pro'",TJ-Pro1A and TJ-Bppm-are traderrorks of Trus Joist. TJIi:Is a registered trademark of Trus Joist. �r D6-05-01 09 : 38 RECEIVED FROM=203 465 5214 P • 02 t t¢ TLII l t=ic-12t_tt=t1 i t9:58 PR I MESUURCE -10 4r,c "_'14 P.F_1__ 't=W �i BOTT � ' �t t� � `. ialNvM 9.5° TJI@/ProT"'-134TS JOIST @ 16.Q" orc P ,^ 7J-geam'" v3.5� Serial NUrY1t)Er'70070717fi �± ;'!" BEAn9USA 1001 OFrn5r2001 9:38::.?Ann ` M.,4 Page 1 or 1 Build Code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED 9 !I 91r• - - .. Overall Dimension=26' T� �rrl, ie lk o-- 12' I'LOADS: Product Diagram is Conceptual. ti Analysis for Joist Member Supporting FLOOR-RES.Application. Loads(psf):40 Live at 100%duration: 10 Dead-0 Partition ier r SUPPORTS: INPUT BEARING REACTIONS(Ibs.) WIDTH LENGTH LIVEEDEADITOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3-50" 2.25" 289158!347 1 9.5" Detail A3 1.25"LSL Rim 2 2x4 Plate 3.50" 15" 857/214/1071 1 9.5" Detail 83 3 2x4 Plate 3.50" 2.25" 329175 r 404 1 9.5" Detail A3 1.25"LSL Rim 'It" -See TJ SPECIFIER'S/BUILDERS GUIDES for detall(s):A3,83. °r ESIGN C TROLS- N r MAXIMUM DESIGN CONTROL CONTROL LOCATION 1' Shear(ib) 560 525 1232 Passed(43%) Lt.end Span 2 under Floor loading Reaction(lb) 1071 1071 2660 Passed(40%) Bearing 2 under Floor loading Moment(ft-lb) 1339 1389 2787 Passed(50%) Rt.end Span 1 under Floor loading Live Defl.(in) 0.165 0.345 Passed{LJ999+) MID Span 2 under Floor ALTERNATE span loading Total Defl.{in} 0.194 0.690 Passed(L/851) MID Span 2 under Floor ALTERNATE span loading t� t -Allowable moment was increased for repetitive member usage. t -Deflection Criteria_ STANDARD(LL:L/480,TL:Li240). 1'"i Deflection analysis is based on composite action with single layer of the appropriate span-rated, GLUED&NAILED wood decking. Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise: Proper attachment and rt ;, positioning of lateral bracing is required to achieve member stability, ( -The load conditions considered in this design include Alternate member loading. VADDI-TIQN L NOTEST- IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this AAA software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product �7t application, input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. Y Not all products are readily available. Check with your supplier or TJ technical representative for product availability. a +I THIS ANALYSIS FOR TRUS JOiST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOiDS THIS ANALYSIS. r, Allowable Stress Design methodology was used for Code NER analyzing the TJ Residential product listed above. to 1 ;t „I a , lr ROJECT INFORMATION OPERATOR INFORMATION: ATTN:GINGER PrimeSource RUGG LUMBER TIMOTHY LYNCH 413-247'8338 45 Freight Street Waterbury,CT 06702 203-465-5200 ;pyrjght eJ 2000 by This Jocl,a Weyerhaeuser Business. Prol",TJ-Pro T"9nd TJ reemTN arc traderryrks of Trus Jol.,j is a registarea trademark of Tus Jai%. 06-05-01 09 :38 RECEIVED FROM:203 465 5214 P- 03 ►I C "Vjo-ru G(<_ aril JIJId-t=lc-2t_�t�1 L�y:�ti F'RIMESUURCE 't_i^ BOTT TJ•Bcam T'" v5.55 Sarlal Nurnut rc 7001a717a �.�" TJIQ/PraT'�-130TS JOIST @ 16.0" o/c SEAMUSA 1001 06/05/2001 y;39:1 f AM Pay"1 of i Build GOde'.Af6 THIS PRODUCT MEETS OR EXCEED$THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED LOADS: Product Diagram Is Conceptual. i4 Analysis for Joist Member Supporting FLOOR-RES,Application. Loads(psf):40 Live at 100%duration; 10 Dead;0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LIVEIDEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3.50" 2.25" 320 1801 4DO 1 9.5" Detail A3 1.25"LSL Rim 2 2x4 Plate 3.50" 2.25" 3201801400 1 9.5" Detail A3 1.25"LSL Rim y y i,t -See TJ SPECIFIERS I BUILDER'S GUIDES for detail(s):A3_ DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear((b) 386 381 1120 Passed(34%) Lt.and Span 1 under Floor loading t k'y Reaction(lb) 386 3a6 1120 Passed(Z4%) Bearing 1 under Floor loading Moment(ft-lb) 1118 111E 2787 Passad(40%) MID Span 1 under Floor loading Live Defl,(in) 0.125 0.290 Passed(U999-t-) MID Span 1 under Floor loading Total Qefl.(in) 0.156 0.579 Passed(L)880) MID Span 1 under Floor loading Allowable moment was increased for repetitive member usage. ul)(lar1 -Deflection Criteria:STANDARD(LL:0480.TL-U240). Deflection analysis is based on composite action with single layer of the appropriate span-rated,GLUED&NAILED wood decking. -Bracin Lu All compression edges((OP and 001tom must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability, n 11 t ADDITIONAL NOTES- `}' -IMPORTANTI The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ 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 TJ Associate. t �fh Not all products are readily available. Check with your supplier or TJ technical representative for product availability. THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. t Allowable Stress Design methodology was used for Code NER analyzing the TJ Residentlal product listed above. lit f9 Rc�JECT INFORMATION OPERATOR INFORMATION• ATTN:GINGER PrlmeSource ,! RUGG LUMBER TIMOTHY LYNCH 413-247'8338 45 Freight Street Waterbury,CT 06702 203-465-5200 yright w 2000 by Tru;Joiat,a WcyerheruWr Buaines;, PrcT"'.7J-Prorm and Ti,auiRm7"erg trademarks of Trus ucut*c. is n rrVistered trademark of Trus Joist. TOTAL P.04 06-05-01 89 :39 RECEIVED FROM:203 455 5214 I' • ©4 „r • �.�t1AMP�0 Grxb� of Nart4Millpto t B fl � 6 �lassachnsctts` m DEPARTMENT OF BUILDING INSPECTIONS ' 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVTT (IicenserJpermitiee) with a principal place of business/residence at: ag �1n C� S� { 16 rlei-LL C AA,+ 010(o,?- (phone#) � ( city/statrlap) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or omeowner circle one) and have hired the contractors listed below who have the following wor er's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Corapany/Poky Number) (Expiration Date) (Name of Contractor) (Insurance Company/Poky Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sheet if noocniry to inchrde inforautioa pertaining to au ocatradots) ( ) I am a sole proprietor and have no one working for me. I am a home owner performing all the work myself. NOTE:please be aware that wizilo homcown=who employ pazons to do maiatcnance,consuuctioa or repair wort;on a dwc.tling of not mote than throe units in wlrich the homeowner r e=des or on the grounds appurtenant thereto art not generally 000ndered to be employers under the worker's oompeus4oa Act(GL152,ss 1(5))�,application by a homoow=for a Ucense or permit may evict—the Iegal datuo of an employer under the W"kee'a Compemation AcL I undastand that a copy of this riatemeat may be forwarded to the Depwtmcat of Dial Aoddec&Offioc of lmxWsoco for the coverage verification and that failu m to seatre covemp under section 25A of MCIL 152 can lead to the impos oa of aiminal pca&wcs oonihting of a fine of up to 11,500.00 ancYor kprisor of up to one yt w and civil pc'Lwes in the form of a stop Work Order and a firm of 5100.00 a day againA me. For use 001Y Permit Number ul( LS- 5/ �� Map# Lot# Signature of Licensee/Per=ttee F 7 La SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone Not Applicable ❑ Company Name Registration Number Address Expiration 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. 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 O p b1 New House ❑ Addition ❑ Replacerrle t Windows Alteration(s))6 Roofing 0 Or Doors Accessory Bldg. ❑ Demolitions New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: �n0 I non.- u 1 c2novc+ Kr Alteration of existing bedroom Yes No Adding new bedroom Yes J,_No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet❑ a.N 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? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck 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 . I. Septic Tank City Sewer Private well City water Supply SECTION 74:-0WNER AUTHORIZATION ­TO BE COMPLETED WHEN » ? N tS AGENTV +CONT`RA OFf APPLIES:POD»WILDING PN'RMIT 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 wner Date 1, Mawa 1 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. m.j�'t4'r-a pla,ti Print Name Signature of Owner/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 YV 1� CLc� Frontage r15' 75' Setbacks Front a 5 ` 5` Side L: /0 R: U-1 c' R: 5 Rear Cl D 10 t Building Height , Bldg. Square Footage f�,ov % 00 Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces If 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: City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587.1240 Fax 413.587.1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: RIM / g �x s SECTION 2-,PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: IG�►cGut e l (spry w if�h 4 t8 Frne S+ Name(Print) Current Mailing Addr s:` IV 5-101t- 57 R—JJ . Telephone Sign ture 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION'S- ESTIMATED CONSTRUC71aN COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a) Building°Permit Fee 2. Electrical ? Q (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) 0 C'�Z1® cP'j'1 Check Number This Section For Official Use Only' Building Permit Number: Date Issued: Signature': Building Commissioner/inspector of Buildings Date File#BP-2001-0983 A! APPLICANT/CONTACT PERSON PLANTE MAURA E& ADDRESS/PHONE 28 PINE ST (413)584-5694 Q PROPERTY LOCATION 28 PINE ST MAP 23A PARCEL 176 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 l i _ Typeof Construction: REMOVE 2 BEARING WALLS,INSTALL BEAMS, 1 NON BEARING WALL, RENOVATE KITCHEN&BATHROOM 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 ission Permit from CB Architecture Committee 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. BP-2001-0983 14T" T GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:renovation BUILDING PERMIT Permit# BP-2001-0983 Project# JS-2001-1757 Est.Cost: $30000.00 Fee: $105.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Size(sa.ft.): 9670.32 Owner: PLANTE MAURA E& Zoning_URB Applicant: PLANTE MAURA E & AT. 28 PINE ST Applicant Address: Phone: Insurance: 28 PINE ST (413) 584-5694-0 FLORENCEMA01062 ISSUED ON.6151010:00:00 TO PERFORM THE FOLLOWING WORK.-REMOVE 2 BEARING WALLS , INSTALL BEAMS, 1 NON BEARING WALL, RENOVATE KITCHEN & BATHROOM 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: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 6/5/010:00:00 3707 $105.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo