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17C-219 (6) i PIPE SIZES (in. ) NON-CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-1" 0-1.25" 1 .5-2. 0" 2 . 0+" I 170-180 0.5 1. 0 1 .5 2. 0 140-160 0.5 0.5 1 . 0 1 .5 100-130 0.5 0. 5 0 . 5 1. 0 ----NOTES TO FIELD (Building Department Use Only) ------------------------- VAPOR RETARDER: Required on the warm-in-winter side of all non vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating j and cooling equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts shall be insulated per Table J4 .4 .7 . 1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer' s installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 1250 of the design load as specified in Sections 780CMR 1310 and J4 .4 . [ ] SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 200 of the heating energy is from I non-depletable sources. Pool pumps require a time clock. [ ] HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in. ) : PIPE SIZES (in. ) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1 .25-2" 2 . 5-4" Low pressure/temp. 201-250 1.0 1 . 5 1.5 2 .0 Low temperature 120-200 0. 5 1 . 0 1 . 0 1 . 5 Steam condensate any 1.0 1 . 0 1. 5 2 . 0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0. 5 0 .75 1.0 refrigerant below 40 1.0 1 . 0 1 .5 1. 5 I i [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in. ) : MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2. 01 DATE: 2-27-2003 Bldg. Dept . Use j j CEILINGS: I. R-38 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-19 Comments/Location BASEMENT WALLS: _ . Conc. 9. 0' ht/5 . 0' bg/9 .0' insul, R-19 interior cavity Comments/Location WINDOWS AND GLASS DOORS: _. U-value: 0.32 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I DOORS: 1 . U-value: 0.28 j Comments/Location I SLAB-ON-GRADE FLOORS: [ ] j 1. Unheated, 2 .0" insul. , R-7.2 Comments/Location Slab insulation to extend down from the top of the slab to at least 2" OR down to at least the bottom of the slab then horizontally for a total distance of 211 . I HVAC EQUIPMENT: [ ) j 1 . Furnace, 80. 0 AFUE or higher i Make and Model Number I AIR LEAKAGE: [ ; Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: j 1. Type IC rated, manufactured with no penetrations between the j inside of the recessed fixture and ceiling cavity and sealed or j gasketed to prevent air leakage into the unconditioned space. 2 . Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0. 944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. MAScheck COMPLIANCE REPORT —— -- Massachusetts Energy Code i Permit # MAScheck Software Version 2 .01 Checked by/Date CITY: Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached �IEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 2-27-2003 COMPLIANCE: PASSES :required UA - 198 Your Home = 195 Area or Cavity Cont . Glazing/Door Perimeter R-Value R-Value U-Value UA ----- --------------------------------------------------------------- CEILINGS 400 38 .0 0 .0 12 WALLS : Wood Frame, 16" O.C. 684 19 . 0 0 . 0 41 BSMT: C=c. ° . " ht/5 .0' b9/9.0' insul 285 19. 0 0. 0 15 GLAZING: Windows or Doors 120 0 .320 38 DOORS 21 0 .280 6 SLAB FLOORS: Unheated, 2 .0" insul. 82 7 .2 83 IIVAC EQUIPMENT: Furnace, 80.0 AFUE ---------------------------------------------------------------------- - COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet Lhe 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 L. Date / —�y 1 r3 � y may. 1 91i ; r1 -C ttA�11'T g��� o°e of �17� �Ij�111�7�II1i �i3ERCE�ttSt{{E c DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 W0RICER'S COMPENSATION INSURANCE AFMAVFT (licenscrlpermittee) with a principal place of busi1CS-'J1 sidence at: (phone#) y/ 70 (sti�{lci ty/stat.elzi p) do hereby certify, under the pains and penalties of peguly, that. O I am an employer providing the following worker's compensation coverage for my employees worcing on this)ob: (Insurance Company) (Policy Number) (Expiration Dale) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Nome of Contractor ) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Poticy Number) (Expiration Dale) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (anach additiooil abort if neaauy to inc}ude information pertaining to all ooatx er ) (✓) i am a sole proprietor and have no one working for me. ( ) T am a home owner performing all the work myself. NOTE:please be aware that wfrile hancowncra who cmpfay pawns to do rnai tca ^n omsb 00 or repair work on a dwelling of not mom than tbroo units in whicfr the homeowner r=dcs or oo the grounds vvarteaani therd arc Dot genaady Ww6crrd to be etnployera under the worker`s comp==tim Act(GL152,m 1(5)),application by a homeowoa for a Haase a P=Mif=Y cvidc=the ItsA ctatua of an employer under the Workoea Compamation Ad - I uadastsnd the z ocpy of thia rtatcmcd may bo forwarded to tho Departax:at of Industrial A=dea&Ofoo of Inxuwoa for 0- covmge verMostioa and that failure to secure ooverago uudcr section 25 A of MGL 152 can lead to tba"impost -of cumin penalties oomisting of a fine of up to S 1,500.00 aadlor hnpcisoamart of up to o=year end civil penatlia in the form of a Stop Work Ord--and a fim o(5100.00 a day ag&hA me For dgMtmd--'uao ooty Permit Number Q`�/7 0 3 Lot# Late Signature of LicenseelPertnitlee R Version 1.7 Commercial Building Permit May 15,2000 SECTION10 STRUCTURAL PEER REVIEW(780 CMR 11011) .... ., , Independent Structural Engineering Structural Peer Review Required Yes......❑ No......(Z -SECTION,11 OWNER AUTHORIZATION ,:TO,B....-E COMPLETED WHEN ,01NNERS'AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT :. 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 as Owner/ hereby declare t at 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. Print Name Signature of Ow er Date •°SECTION 12 CONSTRUCTION SERVICES : .,.. . 10.1 Licensed Construction Supervisor: k Not Applicable ❑ Name of License Holder: �—1Gi I` D ZA) '3/ 0 License Number Lees 0`/-�) 3— :?-ooy Address Expiration Date L113 51 Y Sign Telephone SECTION 13�1NORER S' COIyIPENSATlON1NSURANCEA�FIDAVIT(MG L c X52 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....... 0 No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 'SECTION 9 "R&ESSIONALA ESIGN AND CONSTRUCTION;SERVICES - FOR BUILDINGS AND STRUCT,URES,SUBJECT TOM g CONSTR"UCTION'CONTROL"PURSUANT TO"780 CMR 116`(CONTAINING "MORE THAN 35,000 C F ,OF.,,ENCLOSED`SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 92 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature Telephone Version 1.7 Commercial Building Permit May 15,2000 7. Water Supply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public EO Private ❑ Zone: Outside Flood Zone 12 Municipal 0 On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ��a�• ? -� Cir. ✓ Frontage Sa rK �- Setbacks Front Side L: ,�3G"R: 30 , L: R:_ e_ Rear Building Height D Saws �_ Bldg. Square Footage % r Open Space Footage % (Lot area minus bldg&paved 79, a7 parking)_ #of Parkin S aces ) S- 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: Version 1.7 Commercial Building Permit May 15,2000 SECT "' 4 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC`FEETOFENCL0�5EbSPACE � 3 ' ,k Interior Alterations Existing Wall Signs Existing Ground Signs Additions fib Roofing ❑ ❑ ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] ❑ Accessory Building [ ] Repairs [ ]l ✓►—�1 F��'1`�r 1J i �Cf'V t o L f' f jC'i S t•n C 4,c IN 4 c tOU S ti r Pc m S,ECTION'$ USE`GROUPAgND CONSTRUCTIONgTYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ lA ❑ A-4 ❑ A-5 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 2B F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential 0 R-1 ❑ R-2 0 R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 513 G3 U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION (F EXiSTING'BUILDING UNDERGOING RENOVATIONS,ADD1Ti0NSiNDIOR CHANGE IN.USE Existing Use Group: Proposed Use Group: eA e Existing Hazard Index 780 CMR 34): `� Proposed Hazard Index 780 CMR 34): �4✓n F' SECTION 6$U1t.DIIG�HEIGHTANDAREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) 15t �4 ?� 1 St CZ ,4��� 2nd �/c •��_ - �+ 2nd s D s4 0 3rd 3 rd 4th 141e,r1 e2 4th �a n E Total Area (sf) 3 �5� � Total Proposed New Construction (sf) �... Total Height(ft) j f , H.e Total Height ft - `' — '� Versionl.7 Commercial Building Permit May 15,2000 City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413.587-1272 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SEC?ION`1 SITE INFORMA710N, , 1.1 Property Address: h1s " irton{to`'be completed b�dffiee'' P Y TM ��Zone "' � ."� Overday D1strlct�� � f EIm�S �lstrict_ CB Distr►ct °air z 3 SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: t Name( int) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION.3.''E3STIlVIATE[)`CONSTRUGTI0 COSTS; Item Estimated Cost(Dollars)to be ;Official�UseOn =�mr � � com pleted _ 1. Building (a)BUlldirig v' Permit f ee A 3 . �� � 3 v 0 o 2. Electrical (b)�1~stama#ed�fit {:oStiof ' ��` .Constiuctlonrom 6 '" ".,,, ER, 3. Plumbing Bul1#41 Per mit F 4 „h 4. Mechanical (HVAC) PE /00° �w 5. Fire Protection s a' d's. . - �,. 6. Total =(1 + 2 +3 +4 +5) 3 '?00I�ecklumb„e,; 33 d , ”'p Mi.;' a �. Seet1'0wF6KO,(f1G111 5e 1]nl i d)r1gPei'{I11M Um ber 4 � y i .� InIT S1 atllr2 f3UIldIQ t✓ORlrY115SI0fler✓In$peCtOCO � ..,- 8 :Buildipgs File#BP-2003-0903 APPLICANT/CONTACT PERSON Roger Clark ADDRESS/PHONE P O Box 34 (413) 584-1170 PROPERTY LOCATION.2A,,,,ORT9*b T MAP 17C R Rte CEL 21 I ZONE GB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid O —' Typeof Construction: REMOVE ATT/GARAGE, CONSTRUCT 25X 16 ADDITION (1ST- 1NGROUND POOL 2ND ADD(2)BEDROOMS) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 02 13 10 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION DRFSENTED: Approved__y 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: § Z Finding Special Permit Variance* '' Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from Di'\%J _ 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 Stree mission 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.