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17A-253 (4) � . . — ----�8 -------9'Q ----- ��z 9'z 9- cq | | | | � ---�� ---O�O ��G --- .� u = | ! i | � cz -------��8---'--'4^----------------'0�.�� -------�C�----'--�---��\� i / q '' o k-,<— m - k8 Igo � 8 e qx Y� l DescriptoriAraa 11 A:1 .5R/B 7 C 616 sgft 11 7 9:EFP 221 sgft 131 FFIE FP C: EFP' j 77 sgft 8 F D:1 Fr/EFP 91 sgft E:FBAY 38 �1.5F F/ 2B sgft F:'Food Deck 48 sgft 25 5 12 19 19 18EFP 71 Aowl Al9 Co 9yql Ru o OAK t L by � p�n�1 `r r vs..S c /,? 't- . toll . t P I �tea z ' pqi rc Lajl� Call # 1�Ga r Cooiz P�PN of Ents ►r� ROM E W tT{{ A rj 0 1)2A v J (M�sT 6E w`o°) Lo LATI o N o f S m°t<E A a D co n N -9 o N DETECT C w P(-A N S IN t i D d U7 E ttE 5 l N Q KATE Q , n) PEA N S ( At Lb�s► o f IN l C uclk tL. 0 4 — c H6 rFOL ors 6 .oc) BRIDGE (66') RO A D cm 39.8 1 , 100.06' 12.50� ,r 182.58' MEA 8. 182.78 PLAN " JONATHAN D. NORTH AMP r CONGREGAI BK.45, $7, FAG.233 0 .. 8K. 80, RG.54 -,...,.M-_»-- .. ire ID JE HOV (v c W ITN EG8 E4 t*� ! BK.13767PG., FND. IPFM I.PFNl;I; _ , i .. 88 07'18"E 1`5.x'7 MEAS. L,d Zb 175.88 PLAN UJ Of .� to 8 K. 13 10)PG.3 G, fit* I 8 1 9 SET ,.., „ 'fit?: �R��'"'" � •. 8 ,' i,tN L LINE ► 2191 P L t o 1 l a B. 218.9 11 M tyj ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J Applicant Name: Cff PST-0 (�'- Site Address: Applicant Address: City/Town: y OF, �� S t( _ Use Group: Date of Application: Applicant Phone: a L Q— 9 27 Applicant Signature: Compliance Path (check one): ❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil fuels only) Package(A through KK from Table J5.2.1b): Heating Degree Days (HDD65)from Table J5.2.Ia: (For items d. through i.,fill in all values that apply from Table J5.2.Ib:) a. Gross Wall Area sq.ft f. Wall R-value R- b. Glazing Area' sq.ft. g. Floor R-value R- c. Glazing%(loo x b:a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE ❑ Component Performance: "Manual Trade-Off' (Limited to wood or metal framed buildings only) Climate Zone (from Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HUAC Trade-Off Worksheet,if applicable] ❑ MAScheck Software Attach Compliance Report and Inspection Checklist printouts ❑ Home Energy Rating System Evaluation Attach Home Energy Rating Certificate(HERS rating score must be 83 or higher) ❑ Systems Analysis OR ❑ Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wall +Ceiling Area sq.ft. b. Glazing Area' sq.ft. c. Glazing%(100 X b=a) ADDITION with Glazing% (c.) up to 40% may use 780 CMR Table J1.1.2.3.1 below: MAXIMUM U-value MINIMUM R-Values Fenestration' Ceilin ' I Wall Floor Basement Wall Slab Perimeter,Depth 0.39' R-37 R-13 R-19 R-10 R-10,4 ft i Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation maybe used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e.-not compressed over exterior walls,and including any access openings.) ❑ "SUNROOM"addition (greater than 40% glazing-to-wall and ceiling gross area) Attach"Consumer Information Form"from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied ❑ Date of Approval/Denial: Reason(s)for Denial: (provide additional details as needed on back side) Ju IbU O 60 ? ` x cn 103.46 72.42 110 "1 32 109 17A-275 100 219 82.5 17A-2; 104 186.5 17A-253 186.5 21c 151 80 17A-2 f 160 21c w n i r RIDGE (66 ROAD p. 1�g6( S82 49 42 E 0� 40420 MEAS. 182.56 MEA,'S. 182.75 PLAN �W 1 i D. G.. NORTH AMP TO-NER GONGREGAI S "'" j."""'"""` !"'L. SK. 601 PG.54 � CD WITH ESS E'l (� $K.13762PG. I S$ NE .._+.... 17x.77'MEAS. 175.88'PLAN UJ d Z' Lj a STY, w r co RONALD E. READ ci 16 BK. 1$10 )P'G.36` S 7941 9 DRIVE.w.. �, � 1.�' LD l0N o 219 PL 218.91'>m 0) 0 BRAD E. SHIMEL I �1NE 8K. 5749,PG 317' f ;. .ENO- V1ELD LINE N'ID- $p �,lr -1.04` 162.49 04 N 80°02141 11W CD MICHAEL E GOY OA ro N 8K.3214,PSG.296 Tq DEU S 2 STgN,KOWSK 1 BK. 1766,PG. 13 a 1. O¢'SKI+MPlO ` � �Il$SSHth1i8[tf3 DEPARTMENT OF BUILDDIG INSPECTIONS '212 Main Street • Muuicirml Building T' INSPECTOR Northampton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as 'r is/her construction sups r,i sor. The state defines "Homeowner" as, 'IT who owns a parcel on which he/she resides or intends to be, a one or fwo 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 home owner." -The buil_ding departmenf"foi-the City oTNorthampton-warnarty p erson s- lro-seek-tr, (-r- 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 fegulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/foofinzs (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 occupancv until the work can be inspected. If e homeowner hires other trades to pertorm or e e ncal,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 - insgectioYrs 1*ai�ure ofthe-individual-tradesio-seeur-e-the-perfnits-and-inspections as required can DELAY the project until such time as the proper permits and inspections are made L!n f�``S ' ��-��!` � 0 S4 j 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. - Date- Address of work location tor r �C F `E (yii of �\TG fIjUlilvfali �= R ' £ �Z.�.RC3latrtla' w DEPARTMEArT OP BUIL.Dr>\,C INSPP 212 Main Strect DZunieipal Building Norlha?rtpton, TTass- 01060 i I NVO ICEIZ'S CONOENSATIO.N >J ISUTZA-NCE AFF�A-VIT, v-Iit_h a principal plat-- of business/residence at: — -- (strttt/c�rJlsz�c.Ia p) I do hereby cerTil)r, under the p,-ins and penalties of perjury, hal ( ) I am an employer providing die following!V:'orl:cr's cotnocasadon cove-.-- for my etuployces worldog on tills job: 1 . (Lesuranc Corer.v) (PoIie: ?:u=�_r) — ("-pi,�tior. Da=) I i ( ) I am a sole proprictor, general coanacor or homeowner (c cie one) and have hired the contractors listed below wbo have the foilo: p, workers coLnep_tadon policies i ( +ali2c Oi Con nclor) Onsurantx CompaJ,-P, o6q }�I11II1L<:) f1-`:Jt,1IUQ ().ltC) i - - ----- (lame of Conraaor) (Lrssran= Comt)aziw?o6m, Numccr) (Ex-oim6on Date) (Name of Co=ck-.) 0MSW`aa—_ ComP.an;-/P0UC)- N=bcr) (Expiraoo Dam) (N me of Cona-acior) (Insurance Con:Lcaay/Policy Numb,.r) tE_tpirdoa Datc). (aasc3 wool z5ces.iFnccc�_r w irc udc iarorau3oa pc-ticia:nc to.11 we-ca s) I - { ) Iarm_a sale pFflpnetor and have no one woritdDg for me. "I am,a home owner perforTniag w all the work myself. NOTE:pl=.=be ewar;t*c 4.. .0�CmC7v ac7 Vto caplet'pCO=Lo t W C�5^ c==L,00 c rr it crz on a d--1L:t of ooe mote t>:-c d ro•=itJ is wbch the homoo,wc reams oc oa the IIoia6�pvttca�tbe-,——fixity oc:--d--ci to 1r PI-)---11 the pair- -ti-_-,:m Aa(GUI 52=1(5)),=ppG_-?on by.bomra>ac fc_Gov«pe=lt c_y c.-id—d-- ic-,l rt:=of e.a a-p loy°r ualer d>o Wm+or L C.oc=p, , ten Act I und--d it-a oopy of thi.=a=�y be omo.of In---for th. oovctoc va iretioc and 2L-L Lilta-e%D,ea 'Coverae_t:fldc,.c6oa 25 A of M01-152 an l=d to the i=*Os on of eimiail pecalt"= or.GX or Up to S 1 S00-oo.rtdfor isocye3 of up to ooc y-=-e.d civil peo.hio in 6c form of.Slop Wort Ord._.mod. fim of S 100.00 t Cry tpia4 I C PC=, 1(umt� �,� ✓ it�p- t..ot . 04.E ttn}t E,TO z Grim of Yorilluntptoll 9 6 [7Q ACh nrctia V i DEPARTMENT OF BUILDC)\C INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORICER'S COMPENSATION INSURA-NCE A { AM (liccn_SCClpermittcc} --- ------ with a principal place of businesslresidence at: (stn�t/ci ty/stalr-12i P) do hereby certify, under the pains and penalties of pegury, that O I am an employer providing the following worker s compensation cove-age for my employees working on tills job: (Insi=can Comp_aLy) (P0hC-�Number) ---- (Lxpiruon Dare) ( ) I atn a sole proprietor, general contractor or homeowner (circle one) and have 'lured the contractors listed below v,,ho have the following worker's compensation policies: (Name of Contractor) (lnsurancc Company/Poky Numb- ) (Expiration Date) ---- --------- (Name of Contractor) (Lilsalranoc Company/Po!icv Number) (Exprrtion Date) (Name of Contractor) (Insurance CompauylPokcy Nutntx ) (Expiration Date) (Name of Contractor) (Inswaace Company/PoLcy Number) (Expiration Date) (&Mach additional thcct ifnccusary to mdu,3c tafbrm on p stninins w nv o u�nGO s) Aam a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:plr_sc be awzrc that v4n-lo bomcowom who cmpl oy pczom to do ma nt n ox�ruciioo or rryair work oo a d�Abng of Mnt meta th=throo units in wfrich the bomooavcr resides or oa the Uoundr appurtenant the.. &rc ooe grncrnlly oomidcsed to be etaploya-3 under the workrs'a oemp=5aUoa Act(GL152-�s 1(5))�apptication by a bomeoavcr for a license or permit may cvidmce the ItS21 etntue of an employer under dt Worir�a Compomat Act t understand that a copy of thu rtatemc=may bo forwarded to tbo pelxirtmmG of Indus-,d Acridcat Offioo of trrnin000 for the coverage vrriGcsiioa and that f_iltut to&CU=covcrz�,under souion 25A of htOL 152 ctn lead to tho impoution of cnmintl penalties ooalzti of a fine of up to S 1,500.00 andloC impruoomcrd of up to ow-year and civil PCOAhm in the form of a Stop Work ordr_r-d a firm o(:S 100.00 a day agaiwa mr- Foc uac only Permit NumbCT Signature of LiccrtscxJPct�ritiee SECTION 8 -CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable©❑ Name of License Holder [J ®&49 r License Number Address Expiration Date Signature Telephone 9 ftetrMered. lome lr�py%menttoritracfar , ..1 Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone 0 J 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...... ❑ gl . Qme" wnerxemption 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 SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition I/ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: _Ov s /0/ Alteration of existing bedroom Yes k No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ 6a_°If New hou,::9rnd=or additidh,to existing hailsing >complete the followin : a. Use of building : One Family ✓ Two Family Other b. Number of rooms in each family unit: -7 Number of Bathrooms c. Is there a garage attached? N�) d. Proposed Square footage of new construction. `I Dimensions + e. Number of stories? f f. Method of heating? VP S Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction WO-)E) F i. Is construction within 100 ft. of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes ?C No j. Depth of basement or cellar floor below finished grade — C.? k. Will building conform to the Building and Zoning regulations? Yes_> �, No . I. Septic Tank City Sewer X Private well City water Supply SECTION 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 1 S76 Cx �, as Owner of the subject property hereby authorize to act on my be in relative ork a hor ed by this building permit application. Si nature of Owner Date _ � 1�� f r_— �• 170 * #,- as^Owner Authorized Agent hereby declare that the statements and information on the foregoing application are true and accO the best of my knowledge and belief. Signed under the pains and penalties of per ury. Print Nam r Date Sig of Owner/Age r 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 ,TZ /4� Frontage /a '� 151 Setbacks Front "� t '71 Side L / R: L: R: 1 Rear `-CU �tJ Building Height '2_1 1 4 Bldg. Square Footage �� 7 % 1✓ ©�.� Open Space Footage / % (Lot area minus bldg&paved V�Ll V�s parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 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: g �� department use aniy `: City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01062 , s9: 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: This section to be completed by office 1 Ll Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: h►�i '-s-To Ph er Avl 6 lt�j C te ame ,---� Current Mailing Address: Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars) to be Official Use Only completed by ermit applicant 1. Building (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 = (I + 2 + 3 + 4 + 5) '0 4 J Check Number 6 ( 7 r 51v. This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date r= yr �� File#BP-2007-0006 APPLICANT/CONTACT PERSON BOYLE CHRISTOPHER J ADDRESS/PHONE 149 OAK ST FLORENCE (413)247-9708 Q PROPERTY- I THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid r Building Permit Filled out Fee Paid r Tpeof Construction: CONSTRUCT 16 X 24 BEDROOM ADDITION New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan TH FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INRMATION 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.