41-007 (4) Daniel Hewins
1504 Westhampton Rd.
Florence, MA 01062
FRAMING & INSULATION SCHEDULE
STRUCTURALBEAM
Double 2 x 10 LVL
11'6" span
BEARING POSTS
Double 2 x 6
RAFTERS
2x616" OC
9'6" span
ROOF INSULATION
4" polyisocianurate board, R 26
WALL INSULATION
6" cellulose, R 23
Daniel Hewins
1504 Westhampton Rd.
Florence, MA 01062
South Elevation,
Existing house w/ dormer addition
19'
11'2"
,iii„/ ,
O
6'3”
IF
MINE 11111111
7'4"
Daniel Hewins
1504 Westhampton Rd.
Florence, MA 01062
2nd Floor floor plan,
dormer addition
Lzty of Warthaniptan
. z
$ � �Iassac3�usrtts
DEPARTMENT OF BUILDDTG INSPECTIONS
INSPECTOR '212 Main Street • Municipal Building
Nortliwnpton,MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as i:is/her construction sup,:-visor. The state defines"Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a one or two fami -
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 �j
I, L#, / �� S 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
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v~ DEPARTMENT OP BUILD0\IC INSPECTIOIJS
212 Main Strcet Dfunicipal Building
j Northampton, Mass. 01060
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_ _ «'ORJ:CTR'S COIATENSATIO.N GYSU-RACE Al=, AVIT
I ArJ HfA✓I tJ�
(li crnsxJperm�ttcx)
% nth a principaj place of businessfresidence at:
Wk T N A�,`A P 'O >1 P-b . (phone:') 2 ,
— (st�t/ci t,J/sZatrfri p)
do hereby cerdfy, under dic.pains and penalties of penury, hz(
( ) I am an employer providing the iollowinc,ivorker's comocnsZno, cove age for Iny
emplovees NvorUng on Ulis job:
i
- Clams':n=Coorz-Z-0 (Polio:Nu--;ter) -- (r:-pir<tioa Dzt`)
I -
O I am a sole propr,eror, general contractor or homeowner (c cie one) and have hued
the consactor's listed below wbo hzve the `obo%vino worker's co=1tasadon policies:
(Namc O. Contrncior) (In urancc Coinpan)-Pi obc; N111II1*C:) (-I--`.--)Ma on Dltc)
j
-- (Namzc of Concrzcior) (lnsurane;.COmDa1','f•PO1C1' Nttmcrr) (Ekpi bon Date)
(Name of Coa=L-10.) (Lsurancc Company[PoGcy Numbu) (Exair000 Date)
(Name of Contractor) (Insurance CompacylPolicy Numbs) (Expiration Daac).
(atv.d:d1i;;od r'xct,i(acocza•,v to c,c!uc=;MFvrM :ioo pctaiain6 w.11 oca7-to:3)
(4am a sole proprietor and bane no one working for me.
( ) I am.,a home oiwer perforin.ing all the Nvork myself.
NOTE:plea be evrim th I wL-jc bem=o�vcri ubo aaploy pes.om eo do = ,r,ca r rcpac work on a d.•<ii:^a of
jo.ot mote then tl=--tmrj in which the born a,-- r r=.idc«oa the Vvv.,s+ appurtcu==tbce-.L- oo( oacr:d=d>a Uc
SPICY—und-the"-kcr'z c=cp�oa Art(G Lt 52.n 1(5)x,:ppUca.eoo by a bommaaa for c 6—_cc pamh rz=r n'id� the
1c- rt,^„of nn erployec uoder dre Wa,+4et Compomlt.ioa AcL
I uod--t d due a oopy of tbi.-nI=o-n o].ay be foexnrded to the for tbe
coves ab-c vcif eaioo and aw L'd=to sa=tavR-nse under soa6oa 25 A or).(GL 151 caa ie_d to the imposition of c-+rn:...i p-W-
of a floc of to 51}00.00=%Noe p yur pm,r �p
o�u'�8 � �ruomncnt oCu Lo ooc aad aril �o in tSc(ortn o(a Word Or'dc►ad 1
fun 0(5I00.W t day L pica C
F«d.K.- 1.r u.c only -
Lo[K R
Signature of Licvis=fPcrm ucc 135te
e•,
SECTION 8,CONSTRUCTION SERVICES +
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: tj H fJ 4 7 I
License Number
Address ��� � �� / E , fn A O 6 /
Expiration Date
Signature C• Telephone
e ere mec,�� o n �.
Not Applicable ❑
Company Name A
Registration um er ---
�� !x
Address Expiration Date
Telephone
SECTION 10-WORKERS'G(j V OENSATION-INSURA CE WF1DAVtT(M
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...... ❑
M
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 buildine 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"c es and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State an L al Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature ,
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i
SECTION 5-DESCRIPTION°OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑:;, Replacement Windows Alteration(s) Roofing
Or Doors E3
Accessory Bldg. ❑ Demolition ❑ New Signs [C]] Decks [p Siding[o] Other[dj
Brief Description of Proposed
Work: !) e X%S } r•} i pOr
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll eet
saa I ev li4� O an r i2c u�xr a eacistrnc oz�:s ng., or it3 ef+ #fie o Ia Ing:
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: S Number of Bathrooms
c. Is there a garage attached? 40
d. Proposed Square footage of new construction. 91A Dimensions
e. Number of stories? 9 1 h
f. Method of heating? e'x i S++ h Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction 510, F ra"h e
I. Is construction within 100 ft.of wetlands? Yes '� Nrro. Is construction within 100 yr. floodplain Yes V00" 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 Ta OWNERAUTHORIZATION-TO BE COMPLETED;WHEN
OWNERS AGEN T OR CONTRAEi`OR APPLIES FOR BUIL.pNG 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
Il fOc L k{ CIV, J
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.
1� ►jfEL �}r;yJIIJS
Print Name TX `
Signature of er/ ent Date
Section 4. ZONING All Informatioh Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage 4 S
Setbacks Front o SA"1 F i .
Side L:� R:''a` ' I 'L:i R:F --i
Rearm
Building Height
Bldg.Square Footage
Open Space Footage % ---
(Lot area minus bldg&paved
kin
#of Parking Spaces
3 �
Fill: j J
volume I&Location
A. Has a Sp cial Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES 0
IF YES, date issued: j
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DON'f KNOW ® YES 0
IF YES: enter Book Page{ and/or Document#j
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0
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 0 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
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,a vation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES ,. NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
a W
City of Northampton
Building Department
212 Main Street
Room 100
Northampton;'MA 01 060
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 INFQRMATION
Thrs?secbon to bye completed b�once re
1.1 Property{Address* s r
n-
O✓2 n 2 �l /"` o 6.Z Zoae$ OverlajrDrs ncf
SECTION 2-PR,OPERTY'OWNERSHIPfAUTHORIZED AGENT'
2.1 Owner of Record: I
&1 ) ,,j e"' ' 5 p W�s•-Y Y�a
Name(PrinrN Current Mailing Address: -4 , C p Z q q Zl
Telephone > t3
Signatur
2.2 Authorized Agent:
Name(Print) d Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED3C0NSTRUCTION COSTS
Item - Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 0 ' 0 (a)BuildingPermit Fee
2. Electrical ' P P ,(b)Estimated Total Cost of I
_Construction from'6
3. Plumbing o Q Building Permit Fee
$ 7S:
®o
4. Mechanical(HVAC) ( Q 90
5.Fire Protection a
6. Total=0 +2+3+4_+5) 0 9 Check Number 6 2 D 75 U(�
This,°Section�For'Offcial Use Only
Date-
Building Permit Number. 7ssueda
Signature: ` r
Building Commissioner/Inspector of Building§ Date
MAR 2 2 20,616
1
• File#BP-2006-0976
APPLICANT/CONTACT PERSON HEWINS DANIEL E
ADDRESS/PHONE 1504 WESTHAMPTON RD FLORENCE (413) 582-9929 Q
PROPERTY LOCATION 1504 WESTHAMPTON RD
MAP 41 PARCEL 007 001 ZONE RR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
,1$uildin Permit Filled out
i/Fee Paid 6 1�1Z,d
Tvneof Construction: Add dormer and bath to 2nd floor
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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
1/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
Signa a of Building 6fficial 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.
1. ,
BP-2006-0976
GIs#: COMMONWEALTH OF MASSACHUSETTS
IyM :Block:41-0071,"' CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0976
Project# JS-2006-1454
Est.Cost: $15000.00
Fee: $75.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: DANIEL HEWINS
Lot Size(sq. £t.): 43560.00 Owner: HEWINS DANIEL E
Zoning: RR Applicant: HEWINS DANIEL E
AT. 1504 WESTHAMPTON RD
Applicant Address: Phone: Insurance:
1504 WESTHAMPTON RD (413) 582-9929 O
FLORENCEMA01062 ISSUED ON:312212006 0:00:00 T
TO PERFORM THE FOLLOWING WORK.-Add dormer and bath to 2nd floor
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 3/22/2006 0:00:00 $75.006928
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo