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36-147 (2) LI-le -Y 4?// ki v a-15 n r 4 i I ti t. r „`` f V ( 3 113 f L \ .......... IJ- Cal 11'2 lo N ti � � 7 l 1 Q cu U d Q SSA J� m City of Northampton Building Department V'QW R Plan Review �7�a�( I�e 212 Main Street Northampton, MA 01060a ��'K� sJW Syr;44 I 12 UWi L 14X yy, � Job Truss Truss Type --*—Ply 'FLORENCE M_A. Q1607M T1 GE 'GABLE 2 1 Job Reference optional) Truss Engineering Corp.,Indian Orchard,MA 01151 7.500 s Nov 26 2013 MiTek Industries,Inc. Mon Jul 2012:33:37 2015 Page 1 ID:-309F4kp34aqmiedt08ziEywBEb-TQZxOwOloArOilcyPH5517PD6U7hB4Q811PQH3ywBC5 14-0 0_041 "_0 10-0.0 20-0-0 21- 1 10-M Scale 1:26.9 4x4 7 8 4.00 27 9 �Ta 25 10 4 T, ST4 ST4 _T1 3 STJ S T3 11 III 2X4 1! ST; ST2 2x4 I —is 2 12 20 5x5 is STII: W W STi 13 1 17 81 21 9 1x4: ------ 22 16 9 ------------- X)(YYYYYYXXXX 24 23 is IN4 1x4 0-0-0 10-" -0-0 204-0 10-0-0 10 LOADING(psf) SPACING 2-0-0 CSI DEFIL in (loc) Well Ud PLATES GRIP TCLL(roo� 30.0 Vert(LL) -0.01 13 n/r 120 MT20 197/144 Snow(Pf/Pg)38-5155 0 Plates Increase 1.15 TC 0.12 TCDL 10.0 Lumber Increase 1.15 BC 0.03 Vert(TL) -0.00 13 n/r 90 Rep Stress Incr YES WB 0.06 Horz(TL) 0.00 14 n/a rVa BOLL 0.0 i BCDL 10.0 Code IRC2009ITP12007 (Matrix) Weight:66 lb FT=10% LUMBER TOP CHORD 2x4 SPF No.2 BOT CHORD 2x4 SPF No.2 FORCES Ob)-Max.CompJMax.Ten.-All forces 250(lb)or less except when shown. 10)Truss to be fully sheathed from one face or securely braced against lateral WEBS 2x4 SPF No.2 WEBS movement(i.e.diagonal web). OTHERS 2x4 SPF Stud 6-20=-274/157,8-18-274/157 11)Gable studs spaced at 2-M oc. BRACING 12)This truss has been designed for a 10.0 psf bottom chord live load nonconcuffent i TOP CHORD NOTES (18) with any other live loads. Structural wood sheathing directly applied or 6-"oc puriins, except end verticals. 1)This truss has been ched(ed for uniform roof live load only,except as noted. 13)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all BOT CHORD 2)Wind:ASCE 7-05;120mph;TCDL=42psf,,BCDL=5.Opsf,h=19ft;Cat.11;Exp B; areas where a rectangle 3-6-0 tall by 14)-0 wide will fit between the bottom chord and Rigid ceiling directly applied or 6-0-0 oc bracing. partially;MWFRS(low-rise)gable end zone and C-C Exterior(2)-1-"to 2 any other members. MiTek recommends that Stabilizers and required cross bracing be installed during -0-0, 14)Provide mechanical connection(by others)of truss to bearing plate capable of interior(1)2-M to 7-0-0,Exterion(2)7-0-0 to 10-0-0,Interior(l)13-"to 18-0-0 zone; withstanding 116 lb uplift at joint 24,130 lb uplift at joint 14,127 th uplift at joint 20,121 lb!: Lm accordance withStabilizer Installation guide. uplift at joint 21,122 lb uplift at joint 22,138 Ito uplift at joint 23,127 lb uplift at joint 18, a�efection,in erection, cantilever left and right exposed;C-C for members and forces&MWFRS for reactions shown;Lumber DOL=1.60 plate gdp DOL=1.60 121 lb uplift at joint 17.123 lb uplift at joint 16 and 131 lb uplift at joint 15. REACTIONS All bearings 20-0-0. 3)Truss designed for wind loads in the plane of the truss only. For studs exposed to 15)Beveled plate or shim required to provide full bearing surface with truss chord at (lb)-Max Horz wind(normal to the face),see Standard Industry Gable End Details as applicable,or joint(s)19.20,21,22,23,18,17,16,15. 24---75(LC 10) consult qualified building designer as per ANSVTPI 1. 16)This truss is designed in accordance with line 2009 International Residential Code I Max Uplift 4)TCLL ASCE 7-05;Pr-30.0 psf(roof live load:Lumber DOL=1.1 5 Plate DOL=1.15); All uplift 100 lb or less at joint(s)except 24=-1 16(LC 11), Pg=55.0 psf(ground snow);Pf--38.5 psf(flat roof snow:Lumber DOL=1.15 Plate sections R502.11.1 and R802.10.2 arid referenced standard ANSl/TPI 1. 14--130(LC 12),20=-127(LC 9),21=-121(LC 9),22---122(LC 11), DOL=1.15);Category It;Exp,B;Partially Exp.;Ct--1 17)"Semi-rigid pitchbreaks with fixed heels"Member end fixity model was used in the 23=.138(LC 9),18---127(LC 10),17=-121(LC 10),16=-123(LC 12), 5)Unbalanced snow bads have been considered for this design. analysis and design of this truss. 15-131(i-C 10) 6)This truss has been designed for greater of min roof live load of 12.0 ps f or 1.00 times 18)All Plates 20 Gauge Unless Noted Max Grav fiat roof load of 38.5 psf an overhangs non-concurrent with other Ave loads. LOAD CASE(S) All reactions 250 lb or I-.$at joint(s)24,19,14,23,15 7)This truss has been designed for basic load combinations,which include cases with Standard except 20=316(LC 16),21=289(LC 16),22=260(LC 16), reductions for multiple concurrent live loads. 8)AJI plates are 1.5x4 MT20 unless otherwise indicated. 18=316(LC 17),17=289(LC 17),16--260(LC 17) 9)Gable requires continuous bottom chord bearing. - -- --- Job Truss Truss Type '.,Qty Ply- --''FLORENCE MA. Q1507240 T1 SCISSORS Truss Engineering Corp.,Indian Orchard,MA 01151 ID:13o9F4kp34agtmiedtO8zEywBEb p6rPVpFD UK5GvvhheimtHGbvoD sgNX�N?tvnsl Page wBCe' -0-0-0 1-0-0_D--0 5-1-12 5.142 4-10-4 104)-0 4104 14-10-4 5.142 __— _._2D- 21-0-0 Scale-1:26.4 4x6=? 4 4.00 12 18 \.. 17 '. 3x4; 15 _ t8 3x4 WS \ 5 14 79 T1 ---W4 ____ -1�- _-W4 13 �/ -- -�- ___ 20 5x6; // / � - -- W3. �� Sxe 7 -- � -_- ��- �✓ 4x6= 4x6 2.00 12 72 3x4 1: 9 3x4 II 048(0.2-0) x48(0.2-0) o-a5 5.1-1z 5-1-12 4-104 to." 4.104 14-10-4 5-142 20-0-0 Plate Offsets(X Y): r2:0-2-1 z 0-2-41 (6:0-2-1 z o-z-4t(9:0-2-0 0-z-01 f 11:0-2-00-2-0L _ `LOADING(psf) SPACING 2-0-0 CSI DEFL in (loc) Vdefl Ud PLATES --GRIP -_ TCLL(roof) 30.0 Snow(PI/Pig)38.5/55.0 Plates Increase 1.15 TC 0.69 Vert(LL) -0.20 9-10 >999 240 MT20 197/144 TCDL 10.0 Lumber Increase 1.15 BC 0.74 Vert(TL) -0.37 10-11 >640 180 SCLL 0.0• Rep Stress Incr YES WB 0.58 Horz(TL) 0.18 8 rVa rUa BCDL 10.0 Code IRC2009/TPI2007 (Matrix) Weight:78 lb FT=10% LUMBER -- --- - - -- - TOP CHORD 2x4 SPF No.2 BOT CHORD 2x4 SPF No.2 TOP CHORD 5)This truss has been designed for greater of min roof live bad of 12.0 psf or 1.00 times ! WEBS 2x4 SPF Stud-Except- 2-13---2906/1156,13-14=-2823/1161,3-14=-2767/1168, flat roof load of 38.5 psf on overhangs non-concurrent with other live loads. W1,W2:2x4 SPF No.2 3.15=-2561/1064,15-16=-2504/1068,4-16=-2484!1076, 6)This truss has been designed for basic load combinations,which include cases with BRACING 4-17=-248411076,17-18---2504/1068,5-18=-2561/1064, reductions for multiple concurrent live loads. TOP CHORD 5-19=-2767/1168,19-20=-282311161,6-20=-2905/1156, 7)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with' Structural wood sheathing direly applied or 2-9-3 oc purlins, except end verticals. 2-12=1247/619,6-8=-1247/619 any other he loads. BOT CHORD BOT CHORD 8)'This truss has been designed for a live bad of 20.0psf on the bottom chord in all Rigid ceiling directly applied or 5-7-3 oc bracing. 11-12-2081308,10-11=-1102/2725,9-10---1025/2725, areas where a rectangle 3-"tall by 1-0-0 wide wig fit between the bottom chord and MiTek recommends that Stabilizers and required cross bracng be instaNed tlunng -:i 8-9=-1 3 713 0 8 any other members. thus erection,,r accordance with Stabilizer Installation guide. WEBS 9)Bearing atjoint(s)12,8 considers parallel to grain value using ANSVTPI 1 angle to 4-10=-372/1117,5-10=-577/316,5-9=3081215,3-1(i=-577/302, Stain formula. Building designer should verify capacity of bearing surface. REACTIONS (Ib/size) 3-11=-308/215,2-11=-898/2378,6-9=-898/2378 10)Provide mechanical connection(by others)of truss to bearing plate capable of 12 = 1264/0-5-8 (min.0-2-0) withstanding 549 th uplift at joint 12 and 549 lb uplift at joint 8. 8 = 126410-5-8 (min.0-2-0) NOTES (13) 11)This truss Is designed in accordance with the 2009 International Residential Code Max Horz 1)This truss has been checked for uniform roof live bad ony,except as noted. sections R502.11.1 and R802.10.2 and referenced standard ANSI/fPI 1. 12 ;BCDL=5.Opsf;h= 19R;Cat.Ii;F�rp B; 12)"Semi-rigid pitchbreaks with fixed heels"Member end fixity model was used in the 75(LC 10) 2)Wnd:ASGE 7-05;120mph;TCDL=4.2psf, analysis and d Max Uplift partially;MWFRS(low-rise)gable end zone and C-C Exterior(2)-1-0-0 to 2-0-0, design 13)AD Plates 20 Gauge Unless Noted of this thus. 12 = -549(LC 9) Interior(1)2-0-0 to 7-M,Exterior(2)7-0.0 to 10-0-0,Interior(1)13-0-0 to 18-0-0 zone; 0 _ -549(LC 10) cantilever left and right exposed;C-C for members and forces&MWFRS for reactions LOAD CASE(S) shown;Lumber DOL=1.60 plate grip DOL=1.60 FORCES pb)-Max.CompJMax.Ten.-All forces 250(lb)or less except when shown. 3)TCLL:ASCE 7-05;Pr-30.0 psf(roof live load:Lumber DOL=1.15 Plate DOL=1.15); Standard TOP CHORD Pg=55.0 psf(ground snow);Pf=-38.5 psf(flat roof snow:Lumber DOL=1.15 Plate 2-13=-2905/1156,13-14-2823/1161,3-14=-276711168, DOL=1.15);Category 11;Exp B;Partially Exp.;Ct--1 4)Unbalanced snow loads have been considered for this design. CONTRACTOR QUOTE PRINTED ON! 07/20/15 PAGE 1 QUOTE # Q1507240 DATE QUOTED:07/20/15 EN .NEE 1111G 181 GOODWIN ST VALID UNTIL: 08117115 C RP RATION PO BOX 51027 Job: CAMP INDIAN ORCHARD, MA 01151 MANUFACTURERS OF ROOF& FLOOR TRUSSES Phone(413)543-1298 Fax(413)543-1847 Toll Free(800)456-0187 FLORENCE, MA Quote To:Fleury Lumber Company Inc. Requested B : REBECCA 231 Main Street q Y' Easthampton, MA 01027 Quoted B Mike Heaton Attn:REBECCA Y� Phone:(413) 527-2693 LOADING TCLL-TCDL-BCLL-eCDL STRESS INCR. ROOF TRUSSES INFORMATION 60.0110.0,0.0,10.0 1.1b _ ROOF TRUSS SPACING:24.0 IN.O.C.(TYP.) LAYOUT PROFILE QTY PITCH TYPE BASE O/A LUMBER OVRHG/CANT SHIPPING UNIT PLY TOP BOT TRUSS ID SPAN SPAN TOP BOT LEFT I RIGHT HEIGHT WEIGHT SCISSORS 01-00-00 01-00-00 *! 12 4.00 2.00 T1 20-00-00 20-00-00 2 X 4 2 X 4 040400 78 1 - ' 1 4.00 2.00 T1GE 1 20-00-00 20-00-00 121 X 4 2 X 4 o GABLE 01-00-00 1-oaoo 04-0400 I 66 Truss Engineering Corporation(TEC)strictly adheres to the'Standard Responsibilities in the Design of Metal Plate Connected Wood Trusses'as defined by TPI Chapter 2(available upon request)regardless of any job specific SUBTOTAL specifications unless clearly defined otherwise in writing by TEC. This product list is Truss Engineering Corporation's INTERPRETATION of plans and drawings as supplied to us. No responsibility Is taken or intuited by TEC for the structural integrity of the structure below the trusses or the affects of � - - - TEC's product on the structure as a whole. The building ownerlownees agent Is solely responsible for verifying all dimensions,geometry,loads and load requirements for accuracy and full compliance to construction documents and shall be responsible for notifying TEC immediately of any discrepancies. Truss Engineering Corporation Is NOT responsible for Held verification of dimensions or special conditions. The building owner/owner's agent is responsible for coordinating all construction details between trades. The truss /� Installer shall follow all BCSI recommendations,construction document specifications as well as any she specific GRA ND TOTAL requirements to ensure safe and proper installation. No loading shall be applied to trusses until properly and fatly ' Installed,including all sheathing,hangers,wall anchors,lateral web bracing(as shown on Individual shop drawings),and permanent bracing(as required by the construction documents). Installation contractor shall refer to the individual truss - ----- - --------- - ---- - shop drawings for all structural requirements of trusses,including but not limited to bearing locations and requirements, ply to ply nailing,lateral web bracing,and truss spacing. No trusses supplied by Truss Engineering Corporation may be cut,drilled,or altered in any way without first contacting TEC and receiving engineering documents allowing such. *** THESE DRAWINGS HAVE BEEN REVIEWED AND ARE APPROVED AS AN ORDER *** Approved By;- Approval Date;_-______- PO#: __ __ _ Requested Delivery Date: _- .lnh 'Truss LFLIDOR ePly '415=40F 2124 g 1 Jan ttelerence foytiondl) O .- - _._ — Truss Cnglnernn0 Corp.,Indian Grchard h 01767 7.500 s Nov—2e2 013 MiTek Industries,me Fn Ju124 1-5-5-6-47 2015 Pege 1 � IO:mn2feT8D15DJe1(7W16LmgyurR_SmyBftKzSFEaGxBIVSXT7AMNNbB7nrQFhwRUhyupsl� 0-1-8 1 >v H 2-6-0 0--� 0.010 ro-1:28.' m c 1< 15x4 11 1.5.4 11 ac3= 402=_ 3.9 FP- 1,5.4 J 4.4= 1.5x4 11 3x6= 1.5x4 I:. 4.12, 293 `� 1 2 a 4 5 8 7 _8 -9 _ 10 SIB - �- --` `\ { 19 j '1 18 15 id 13 72 i 4x9= 3x6 M165H3 FP- 1.50 11 44= 40= 4x9= 4x4= i 8.0 0 8-9-0.9.6-0 204-0 r` B-0-0 +0-9-0 0-9 0 10-6-o I - — Plafe Oksets{J;_11:EUge,0.l?121(5:0-1-8,Edge1,(1 tEdge 0.1 ],[12:0-2-12,Edge1 L�3:0-13,Edpe],[16:04-4 Edgej -U.Edgfi 0-1-8j LOADING(pst) SPACING 2-0-0 GSI OE>=L in (10c) Wall Lrtl PLATES GRIP TCLL 40.0 Plates Increase 1.00 TC 0.48 Vert(LL) -0.31 12-13 1764 Ud MT20 1971144 TCDL 10.0 Lurnberincrease 1.00 BC 0.54 Ved(TL) -0.6012-13 >393 240 M18SHS 2201195 BCLL 0.0 Rep Stress Inu YES M 0.51 Hor2(TL) 0.08 11 n/a i' BCOL __100 Code IRG2LX)9/TP12007 (Matrix) —1 Weight 85 lb FT=010,10%F LUMBER —_- ,.. W TOP CHORD 2x4 Dr 2850F 2.3E(flal) NOTES (7) I N SOT CHORI? 20 OF 28502 2.3E(flat) 1)Unbalanced flaor live loads have been considered for this desf n. VYLBS 2x4 SPF No2j8at) 0 v BRACING 2)This}toss has been designed for basic load Crombhalions,which include cases with � TOP CHORD reductions for multiple concurrent live loads. Sheathed of 6x0-0 oc purrins, except end verticals. 3)All plates are MT20 plates unless otherWSe indicated. BOT CHORn 4)This buss is designed in accordance vAth hie 2009 tntemational Residential Code O Rigid ceiling directly applied or 10.40 oc bracing. sections R502-11.1 and R802.10.2 and referenced standard ANSUI-PI 1. i 5)"Semi-rigid pdchbreaks wi(h fixed heels"Member end fixity model was used in the REACTIONS (16 1s1ze) analysis and design of this irvss, j 17 = 117910.5.8 (min.0-1-8) 5)Recommend 2x6 strongbacks,on edge,spaced at 10-M cc and fastened to each i 11 z 1}7910-5-8 (min.0-1.8) truss with 3-10d(0.131"X Y)nits. Strunobacks to be attached to walls at their outer ends or restrained by other means, j FORCES (lb)-Max.CompJMax.Ten.-All forces 25a(lb)or less except when shovm. 7)Ali Plates 20 Gauge Unless Noted JI TOP CHORD LOAD CASE(S) 2-3=-379710,3 4=37 9 716,4-5=379710.5-6=476110 Standard (3-7=-478110,7.8=382810,8-9--3 8 2 810 130T CHORD C,J 16-17=0/2243,15-16=014761,14-15=014761,13-14=014761, 12-13=014634,11-12=012254 WEBS 0.11=2476/0,2-17=246W,9-12=0f`1740,2 1 6=011 7 1 8, 4-16=-274MR,7-12--091/0,510-125810,7.13=-2431559 Jul 25 15 07:47a Fleury Lumber Co., Inc. 413-527-9110 p.2 CONTRACTOR /\1 O TE PRINTED ON:07/24/15 PAGE t Q UO TyEC # Q 1507240F DATE QUOTED:07124115 181 GOODWIN ST VALID UNTIL; 08121115 ENGINEERING PO BOX 51027 CORPORATION NZ_ INDIAN ORCHARD,MA 01151 Job: CAMP -FLOOR TRUSS MANUFACTURERS OF ROOF&FLOOR TRUSSES Phone 1413)343-1298 Fax(413)543-1947 Toll Free{800)456-0187 MA Quote To:Ffeury Lumber Company Inc. Requested By: REBECCA 231 Main Street Easthampton, MA 01027 Quoted By: Mike Heaton Attn:REBECCA Phone:(413) 527-2693 FLOOR TRUSSES LOADING lCLL--CDL-BCLL-BODE STRESS INCR I FLOOR TRUSS SPACING:24.0 IN,O.C.(TYP.) LAYOUT / INFORMATION 4D.D,1Q0.0.Q10.76 -1 o6 FLOOR CITY TRUSS ID DEPTH BASE O!A END TYPE CANTILEVER STUB UNIT PROFILE PLY SPAN SPAN LEFT RIGHT LEFT RIGHT LEFT RIGHT WEIGHT 9 F124 i D1-04-00 120-DO-00 20-DD-DD 85 Truss Engineering Corporatlon Inc)strictly adheres to%he*Standard Responsloliltles in the Qesign of Metal Plate Connected Wood Trusses'as defined by TPI Chapter Z(available upon request)regardless of any job specific ! T/1 specifications unless cleady defined otherwise in xelfl"by TEC. SUB-TOTAL AL This product list is Truss Engineering Gorpotatinn s INTERPRETATION of plans and drawings as supplied to us.No responsibility is taken or implied by TEC for the structural integrity ofthe structure below the trusses orthe affects of TECs product on the structure as a whole.The building ownerlownees agent is solely responsible for verifying all dimensions,geometry,loads and lead requirements for accuracy and full compliance to construction documents and shall be responsible for nolitying TEC immedlately of any discrepancies.Truss Engineering Corporation is NOT responsible for Field verification of dimensions or special conditions. The building ownerfovmefs agent is responsible for coordinating all construction details between trades.The truss installer shall follow all 6051 recommendations,construction document specifications as well as any site specific GRAND TOTAL requlrernents to ensure safe and proper installation.No loading shall be applied to trusses until properly and fully installed,including all sheathing,hangers,wad anchors,lateral web bracing{as shown on individual shop drawings),and permanent bracing(as required by the construction documents). Installation contractor shall refer to tine individual truss shop drawings for all aim chiral requirements of trusses,Including but not limited to bearing locations and requirements, ply to ply nailing,lateral web bracing,and truss spacing. No trusses supplied by Truss Engineering Cerporatloo may be cut,drilled,or altered in any way without first contacting TEC and receiving engineering documents allowing such. *"* THESE DRAWINGS HAVE BEEN REVIEWED AND ARE APPROVED AS AN ORDER pproved 8y: Approval Date: Pa#: Requested Delivery Date- ✓ � s ' suoyc,a t-" SIOZ p % 21W— � 6-d dweo ueyde;S Stephen Camp Construction 46 East St. Easthampton, Ma 01027 (413)527-7124 Submitted To : Bob Davis Phone- 584-8936 Address : 37 Longview Drive Date - 6-29-2015 Florence, Ma 01062 We hereby submit this estimate for- 16'x 20' Addition This estimate is for me supplying building materials& labor to build a 16'x 20' addition. The floor will be framed to match existing floor height. The walls will be 2x6 construction with roof trusses/cathedral style. I will install 4 windows and 1 door. Vinyl siding will be installed on the whole addition and back of the house. I will install new shingles on the addition and have aluminum valleys to tie into existing roofing. New gutters will be installed to finish the exterior. The inside I will insulate with fiberglass insulation. The walls will be sheetrock and the ceiling will be v-groove pine. The floors will be oak to match the existing house floors. All windows and door will be trimmed along with baseboard. (Customer will do all painting and electrical work.) (All excavation and concrete work will be done by others.) Estimated price for materials= $ 23,000.00 Price for labor= $ 18,600.00 Total Cost= $41,600.00 Contractor Supervisors License number 082531 Home Improvement contractor Registration number 135204 I propose to supply materials and labor-in accordance with above specifications. This proposal may be withdrawn By us if not accepted within 30 days Authorized Signature / r Acceptance of proposal Signature City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: 3 l�wy !�i"J The debris will be transported by: The debris will be received by: Building permit number: Name of Permit Applicant z2 s� Date Signature of Permit Applicant Ulty of Northampton Massachusetts OF fr1. F. DEPARTMENT OF BUILDING INSPECTIONS ✓ ? i 212 Main Street • Municipal Building yvl•, b,.j Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s) who seek to 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 regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (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 occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, 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 inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made 1, 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 The Commonweattn of wtassacnusetis ► Department of Industrial Accidents Office of Investigations 600 Washington Street y< Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name (Business/Organization/Individual): •��.✓/ 64` Address: `7 t,/ JA-5 r City/State/Zip: aZ-'� Phone #: 5 7 Are you an employer? Check t e appropriate box: Type of project(required): 1.FM I am a employ er with 4. E] I am a general contractor and I p Y 6. New construction employees (full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working or me in an capacity. employees and have workers' , g Y p ty• 9. �Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.F-1 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. " Insurance Company Name: C� � �''� y7 �;57AI Policy#or Self-ins. Lie. #: 2 2 Expiration Date: Job Site Address: , 72 10 !0 ✓r eL ) /9 y k-e_ City/State/Zip: �Cle✓tli i e e, l c>h Z Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Signature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: 1tl Not Applic^aable £ Name of License Holder: ) 7W N� 09 5-,3/ --� License Number Address Expiration Date Signature Telephone 9.'12eaistered Home Imarovemenf Contractor Not Applicable £ Company Name T 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..X Yes.. £ No...... £ 11. - Home Owner.Exemption 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. i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) file New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding[0] Other[0] Brief Description of Proposed X 2o /C'/ ,.P; Work: 1 Alteration of existing bedroom Yes_ No Adding new bedroom Yes iIC No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ' omplete the> olwind:6a f New house and ot'addition to existing hoLising, c a. Use of building:One Family x Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached?_ )V d. Proposed Square footage of new construction. fq Dimensions �' 2 e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction k v4P 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 �y � S P GC- k. Will building conform to the Building and Zoning regulations? —k Yes No. I. Septic Tank City Sewer_� Private well City water Supply _ SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT l 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/Authorized' Agent hereby declarefthat 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 per Print Name Signature of O er/Agent 6Z Date , , -- Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning TMs column to be filltA in by Building Department Lot Size j Frontage Setbacks Front r--- ' Rear Building Height Bldg.Square Footage 0110 Open Space Footage % #of Parking Spaces A. Has a Special Permit/Vahance/Fimding ever been issued for/on the site? x,� �~� NO �_�~�/ DONTKNOYY «�� YES x�� |F YES, date iouedd } IF YES: Was the permit recorded ut the Registry ofDeeds? �� YY NO �� DONTKNU 'ES _ 0 IF YES: enter Book L Page and/or Document# 1VK �� B. Does the site contain a brook, body ofvvaterorwetlands? NO W DON7KNOY� «�� YES ��' IF YES, has a permit been or need tobe obtained from the Conservation Commission? Needs to be obtained x—\ Obtained �~� Date �_� �~� ' . 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 0 NO 0 IF YES, describe size' type and location: ' ! E. Will the construction activity disturb(clearing, gradingexcavation,nr filling)over 1 acre urioit part ofa common plan ' that will disturb over 1acre? YES NO ) |F YES,then a Northampton Storm Water Management Permit from the DPW iarequired. epa nt k ity of Northampton Status ofPermttF I �, ^,k �I�; f -�� ilding Department Garb Cut/Driyeuuay Perrrti# 015 irk rt k + I b I{ I I + f >e ti 22 2 i+ 12 Main Street Sewer/SepticAvairabi[tty L7 r n � Room 100 uVater/U�e1lA�ailablhty 1 I a In`-pe $nr ampton, MA 01060 Twa Sefs of Structural Pjans Piutnb ng Ft r Etect( ton. Northamp h 01060 -587-1240 Fax 413-587-1272 I?lof/Slte Plans `' v y t>w li F I APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: ' Lot ✓�� Map Unit /0 h.9 i/I � i Jv _ S Zone Overlay District Elm St Dtstract CB Distract � - ,; SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Recor i Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: C QJ ��4 �lC Via) Name(Print) Current Mailing Address: �J Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS, Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 60 Q 6 (a)Building Permit Fee 2. Electrical !3 (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) Check Number s This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0086 APPLICANT/CONTACT PERSON STEPHEN CAMP ADDRESS/PHONE 46 EAST ST EASTHAMPTON01027(413)527-7124 Q PROPERTY LOCATION 37 LONGVIEW DR MAP 36 PARCEL 147 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 16 X 20 FAMILY ROOM ADDITION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildine Plans Included: Owner/Statement or License 082531 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOJRMATION PRESENTED: pproved 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 Permit DPW Storm Water Management Demolition Delay 0;11'715 ture of Auildi �dfficial 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. 37 LONGVIEW DR BP-2016-0086 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36- 147 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2016-0086 Project# JS-2016-000159 Est. Cost: $41600.00 Fee: $160.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN CAMP 082531 Lot Size(sq. ft.): 16291.44 Owner: DAVIS ROBERT E&LORI J Zoning: Applicant: STEPHEN CAMP AT. 37 LONGVIEW DR Applicant Address: Phone: Insurance: 46 EAST ST (413) 527-7124 () WC EASTHAMPTONMA01027 ISSUED ON.712812015 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 16 X 20 FAMILY ROOM ADDITION 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 Occupancy Signature: FeeType: Date Paid: Amount: Building 7/28/2015 0:00:00 $160.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner