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25A-129 (11) City of Northampton Mail-69 Day Ave https:Hmail.google.com/mail/u/0/?ui=2&ik=ec5fl9a57e&view=pt&... t �Of Louis Hasbrouck<Iasbrouck @northamptonma.gov> t F 69 Day Ave Louis Hasbrouck<Hasbrouck @northamptonma.gov> Mon,Sep 14,2015 at 11:06 AM Draft To:John Sackrey<sackrey @crocker.com> Cc:Carolyn Misch<cmisch @northamptonma.gov> John, Before we issue the building permits,we need verification from the DPW for water and sewer connections.We also need verification that the water connection will be stubbed at least 4'with copper,and that the proposed HDPE line is sufficient for the service.These conditions from the special permit(attached). Carolyn needs to approve the HOA covenant;I've attached a copy. Also,make sure you deal with the water meters and shutoffs(conditions 4 and 5),and condition 3 before COs. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax ..,................... 2 attachments 69 Day Ave decision.pdf 123K goggins new day condominium master.ded.pdf 103K 1 of 1 9/14/2015 11:06 AM Bk: 11999 Pg:97 Planning-Decision City of Northampton Hearing No.: PLN-2015-0045 Date:June 18, 2015 or intersections affected by the project below the existing conditions The applicant has offered an in-lieu-of payment for the additional two units to address Incremental increase in traffic on the network, C.The site will function harmoniously in relation to other structures and open spaces to the natural landscape,existing buildings and other community assets in the area as It relates to landscaping,drainage,sight lines,building orientation,massing,egress,and setbacks.Rear and/or side wall facades. The front unit will be located in line and oriented similarly to other structures on the blockface. D.The requested use will not overload,and will mitigate adverse impacts on,the Cltys resources,including the effect on the City's water supply and distribution system,sanitary and storm sewage codecdon and treatment systems,fire protection,streets and schools. The construction materials and methods for water lines,sanitary sewers,storm sewers,ffre protection,sidewalks,private roads,and other Infrastructure shall be those set forth in the Northampton Subdivision Regulations[l](even for projects that are not part of a subdivision) unless the Planning Board finds that a different standard is more appropriate.Major projects that do not trigger separate stonnwater permitting shall have conditions that stipulate when Inspections shall be completed and submitted to the City.Annual reports,as necessary depending on the stormwater management system,shall be submitted to the City. E The requested use meets any special regulations set forth in this chapter for URB table of dimensional,density and design. F.Compliance with the following technical performance standards: (1)Curb cuts onto streets shall be minimized. (2)Pedestrian,bicycle and vehicular traffic movement on site must be separated,to the extent possible,and sidewalks must be provided between businesses within a development and from public sidewalks,cycle backs and bike paths. COULD NOT DEROGATE BECAUSE: FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY: APPEAL DATE: 521/2015 61412015 6/2512015 REFERRALS 1N DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY: APPEAL DEADLINE 528/2015 7/24/2015 611112015 61252015 7/9/2015 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 528/2015 611112015 6111/2015 611912015 SECOND ADVERTISING DATE: HEARING TIME OTING DEADLINE DECISION DEADLINE: 6/4/2015 T50 PM 9/9/2015 919/2015 = - i MEMBERS PRESENT: VOTE: - I ` 7 Theresa(Tess)Poe votes to Grant Alan Verson votes to Grant u y ZU 15 John Luft votes to Grant f Karla Youngblood votes to Grant Debin Bruce votes to Grant Mark Sullivan votes to Grant DECISION: MOTION MADE BY: SECONDED BY: VOTE COUNT: Karla Youngblood Mark Sullivan 6 proved with Conditions MINUTES OF MEETING: Available on the city website: www.northamptonma.gov/ 1,Carolyn Misch,as agent to the Planning Board,certify that this is a true and accurate decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. I certify t a copy ofthl islon ha%been mailed to the Owner and Applicant. Notice of Appeal An appeal from the decision of the Planning Board may be made by any person aggrieved pursuant to MGL Chapt.40A,Section 17 as amended within twenty(20)deys after the date of the flting of the notice of the decision with the City Clerk.The date is listed above. Such l appeal may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. ! July 10, 2015 I, Wendy Mazza,City Clerk of the City of Northampton, hereby certify that the above Decision of the Northampton Planning Board was filed in the Office of the City Clerk on June 19, 2015, that twenty days have elapsed since such filing and no appeals have been filed on this matter. L ity'Clkilrk GeoTMSO 2015 Des Lauriers Municipal Solutions,Inc. • AM t REGISTER MARUbLBEILDAM Bk: 11999 Pg:96 i Planning-Decision City of Northampton Hearing No.: LN 2 P - 015-0045 Date: June 18,2015 INll�ulfllliilllllul �INIIINf 5 10 APPLICATION TYPE: SUBMISSION DATE: Sk:11999Pg:96 Page: 1 Of 2 P8 Intermediate Site Plan 020/2015 Recorded: 0711 0/201 5 03:36 PM ApplicanVe Name: Owner's Name: NAME: NAME: Rice Yun Architects Klmberl Goggins ADDRESS: ADDRESS: 6 Crafts Ave. 69 Day Ave. TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: NORTHAMPTON MA 01060 NORTHAMPTON MA 01060 PHONE NO.: FAX NO.: PHONE NO.: FAX NO.: EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO.: SiTE ZONING: COMPANY NAME: i 69 DAYA1/E URB(100)1 TOWN: ACTION TAKEN: ADDRESS: NORTHAMPTON MA 01060 Approved M9tir Conditions MAP: BLOCK LOT: MAP DATE: SECTION OF BYLAW: 25A 129 001 Chpt.350-11:Site Plan Approval TOWN: STATE: ZIP CODE: 1 9uok: age: PHONE NO.: FAX NO.: 3 3 EMAIL ADDRESS: NATURE OF PROPOSED WORK DEMO EXISTING STRUCTURES 6 CONSTRUCT 3 SFH a HARDSHIP: 1 CONDITION OF APPROVAL: 1) Prior to Issuance of a building permit the applicant shall provide the City with draft language for Home Owner's Association Maintenance documents that will be recorded with the property as part of covenants. Maintenance for the rain garden and permeable pavers and dry wells shall be specMed. Language shall specify who is quallfted to make inspections and conduct various maintenance ,j functions. 2.Prior to issuance of a building permit,the applicant shall confine that the HOPE water service line proposed is sufficient. 3.As offered by the applicant and prior to CerNHcate of Occupancy,the applicant shag a.make a payment of$2000 to the city of Northampton for the 2 now units. 4 b.shag replace the entire sidewalk along the frontage If any damage occurs,as determined by staff. K replacement is necessary,the sidewalk shall be reconstructed with cement concrete. I 4.The copper water service shall extend for a minimum of 4 feet beyond the curb stop. 5.Each individually owned unit shall have a separate water shutoff valve and separate meter.A i shutoff shall be installed downstream of the proposed branch tee for the frontage facing unit;on the branch tee for the middle unit;and downstream of the middle unit branch tee for the rear unit. FINDINGS: The Planning Board approved the site plan for Me demolition of the existing house and construction of 3 detached units on the aft based on the information submitted with the application and the following plans: 1).69 Day Avenue Site Plan Review by The Berkshire Design Group for Rice Yun Architects,dated May 12,2015 Sheet L 1.0 to 5.0 2)New Construction Day Avenue Condominiums by Ricy Yun Architects Sheet Al Exterior Elevations,dated May 8,2015. 3)LED Outdoor Sconce Luminalre 4) Stormwater Management Report for 69 Day Avenue,by The Berkshire Design Group,inc. Dated May 14,2015. In approving the site plan for the 3 new units,the Board evaluated the following site plan approval criteria: A.The requested use protects acyolning premises against seriously detrimental uses.if applicable,this shag include provision for surface water drainage,sound and sight buffers and preservation of views,fight,and air,The site improvements Include additional buffering on top of the 151 side yard setbacks and incorporates on site rain gardens to absorb stormwater runoff. B. The requested use will promote the convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets,the location of driveway opening remains the same. The site contains more parking than the minimum required. (2)The project,including any concurrent road Improvements,will not decrease the/eve/of service(LOS)of all area City and state roads GeoTMS®2015 Des Lauriers Municipal Solutions,Inc. i MUNICIPAL SEWER/AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton, MA 01060 587-1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 69 Day Ave, Northampton, MA Inquiry Made By: John Sackery 413-563-6639 Date of Inquiry: 8127115 Reason for Request: 3 new condos existing house lot Municipal Sewer Main in Front of Location: Yes X No Municipal Storm Drain Available: 5 Y2 deep Yes No Size of Sewer Main: g» Material: Vitrified Clay Age: 1894 Depth of Sewer Main: 11' Length of Sewer Main: unknown Size of Service Connection: unknown Type of Service Connection: Tie-in to Sanitary Main X Tie-in to Sanitary Stub Comments: City Requires 6" cleanout installed at Citv Property Line Note: If this availability is for new construction this form must be hand delivered to Building Inspector. A corresponding"sewer entrance fee"shall be paid prior to making any connection to the municipal sewer system.Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. John Ha Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner \ I MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton,MA 01060 587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 69 Day Ave,Northampton,MA Inquiry Made By: John Sackery 413-563-6639 Date of Inquiry: 8/27/15 Number of Type of Single Family Type of Private Units: 3 Units : Ownership:( ) Apart. Comm. p Condo X Multi-family Rental lAnnlicant to fill nut the ahwel - Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: X No Size of Water Main: 12"OR Material: 12"DI Age: 12"2012 6" 6" CI 6111927 Approximate Static Street Flow Test Conducted:Yes: No: Pressure: If done attach results ". Size of Service Connection Existing 3/4" Suggested Meter Size: 5/8"each Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. WILL NEED RECORDED EASEMENT FOR CITY TO ENTER PROPERTY TO SHUT OFF WATER AT CURB BOXES • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • Arrangements of such installation shall be made with the Northampton Water Department with a um of 5 working days notification. ' • All work shall conform to Northampton Water Department specifications. Gregory R.Nuttelman Sup1rintendent of Water Dept. Water Entry$200.00 Meter$390.00($1300)Radio$405.00($1 cc: Ned Huntley,Director \r Note: If this availability is for a new construction,it must be hand delivered to the Building Inspector. — \� \\smbl\admin\Permits\Water Application\Water Availabi.lity.doc ` \ 39. Energy aspects shall comply with the stretch energy code.780 CMR Appendix 115AA or 2009 IECC. a. An initial HERS evaluation is required including insulation levels anticipated. b. A final HERS evaluation confirming code requirements have been met including duct testing. c. A signed copy of the Thermal Bypass Checklist. d. Energy information including mechanical equipment posted on the electric panel. e. Remodeling and Additions can be completed in accordance with IECC 2009 with Energy Star Windows and the Thermal Bypass Checklist. Duct blast testing when practicable. f. All band joist insulation must be enclosed within an air tight cavity, which you must create. 40. Vapor retarders. Although these are still in the code have exceptions, one must understand that there is a difference between a vapor retarder or barrier and an air barrier.An air barrier is intended to stop air flow (convection)a vapor retarder or barrier is intended to stop molecular moisture transfer(diffusion). A vapor retarder or barrier is effective even if there are some holes or gaps, however an air barrier has to be absolute and complete. If air can leak through an electrical device or through a crack it follows the path of least resistance and carries 99%of the moisture in a structure.This is evident every time one exposes fiberglass insulation and finds black insulation,which has filtered dirt out of the air moving through the insulation.780 CMR R601.2 for vapor retarders and Table N1102.4.2 for air sealing requirements. 41. Unvented attic assemblies. Hot roofs are allowed, but have specific requirements 780 CMR R806.4. 42. Deck ledgers and post must be appropriately attached, bolts or lags. 780 CMR R502.2.2.1 Note:Thrul-oks are engineered for post attachment supporting a railing. Lateral attachment is required for each deck per section 502.2.2.3. 43. Smoke and CO detectors as required. 780 CMR R314 and R315. a. Smokes in each bedroom,within 10'of a bedroom door, and at the bottom of a stair leading to a finished floor above. b. CO within 10' of bedroom doors, at each level,for every 1500 sqft, (plumbing code in the mechanical room) Except if there are no fossil burning fuels or attached garage. c. Heat detector in attached garage, and other large unfinished unconditioned spaces. 44. Closets beneath stair which have doors must be drywalled with%". 780 CMR R302.7 45. If there is mechanical equipment or a combustible roof, 30 sqft of space, and 30 measured from top of ceiling joist to bottom of rafters an attic access of minimum RO of 22" x 30" is required to be located in an accessible place. It must be insulated equal to surrounding, gasketed, and secured in place. 46. Clearances above gas stoves and cook tops burners is 24"to non-combustible or 30" to combustibles. Relevant items must be submitted to the building department for approvals before inspections and or Certificates of Occupancy can be issued. Feel free to call if you have any questions. My telephone number is 587-1240 and office hours are Monday through Friday, 8:30 am to 4:30 pm, excepting we close for walk-ins at 12:00 noon on Wednesdays. My email address is: cmiller(Wnorthamptonma.gov Thank yo r r cooperation these matters. Chuck Miller City of Northampton Assistant Commissioner and Zoning Enforcement 22. Egress and emergency escape requirements shall be strictly met. a. Basements, habitable attics, and all sleeping rooms require emergency escape. 780 CMR R310 b. Windows within 44" of floor, DH 3.3 sqft min window size,Casement 20"x41" exception 5 sqft at Vt floor. Minimum clear opening 20"x24" or 24"x20". 780 CMR R310.1.1 c. Two doors remote as possible at the normal level of travel, opening measured from the face of the slab to the stop with door at 90 degrees, one 32" and one 28" minimum 78" high. 780 CMR R311.2 d. Landing at each door 36" out and the width of the door minimum 36", maximum step 7%"from the top of the threshold and only in-swinging doors. 780 CMR R311.3 23. Stairs have critical standards, make sure you know the floor finishes when planning. Minimum tread 9", maximum riser 8%", maximum overall variance for the run is 3/8",4" sphere rule on risers except where the total rise is 30" or less 780 CMR R311.7.4.3 Exception,4 3/8" on balustrade, 6" in the triangle. Graspable rail 1 V minimum and 2" maximum rail, height minimum 34" maximum 38", required for 4 or more risers. Landing to landing constitutes a new run. Minimum 6'8" ceiling height from nosing. Rails must be continuous and returned to the wall if not to newel post.780 CMR R311.7. 24. Guards 36" minimum height above walking surface, a bench is a walking surface, required for more than 30" above floor or grade within 36",4" sphere rule. 780 CMR R312.1. 25. Floor joist systems that are not equal to 1%" nominal dimension must be covered with %" drywall or 5/8" wood structural panel or equivalent with some exceptions. 780 CMR R501.3 26. Educate the plumber and electrician about maximum notch and hole sizes, and placement.780 CMR R502.8 and R602.6. In bearing studs holes not larger than 40%of a stud no closer than 5/8 to the edge, In interior non-bearing studs holes not larger than 60%of a stud no closer than 5/8 to the edge, or holes in joist are a maximum 1/3 the depth not closer than 2" from the top or bottom or to any other hole. Notches are different. 27. Drilling or notching of more than 50%of the wall plate width of an exterior wall or load bearing partition requires a 16 GA 1%" strap across the area and 6" beyond each side with 8-10nd nails.780 CMR R602.6.1 28. Where dryer ducts penetrate the wall they must be sealed with fire caulk. 780 CMR M504.2 29. Dryer ducts must terminate outside of the building, have a backdraft damper, cannot include a screen, and require 3' clearance from windows.780 CMR M504.4 30. Dryer duct transition is limited to 8' of aluminum flex, must be exposed, and the proper UL listing. 780 CMR M504.6.3 31. Dryer duct maximum equivalent length is 35' less 5' per 900 elbow or per manufacturer's specs. 780 CMR M502.6.4, no screwed connections use foil tape appropriate for the use. 32. Dryer ducts when concealed must have a permanent label or tag within 6' of the duct connection 780 CMR M502.6.5 33. Makeup air is required for dryers exhausting more than 200 CFM.780 CMR M504.5 34. Makeup air is required for any exhaust hood over 400 CFM.780 CMR M505.2 35. Fireplaces require all combustion air be provided from the exterior and below the firebox, duct work maintaining 1" clearance for 5'from the duct outlet for all fireplaces and airtight doors.2009 IECC 402.4.3 36. Fire and draft stopping shall be completed before rough inspection.Typical locations,top (ceiling) and bottom (floor) plates, soffits, and every 10' within enclosed cavities.780 CMR R302. 37. Ignition barriers are required over all thermal plastics and must be in place before final.780 CMR R316. 38. Dwelling/Garage fire separation.An attached garage (within 3' of main structure) is required to have%z' drywall on the garage side of the separation wall and if there is a finished space above the garage all walls must have%:" drywall and the ceiling 5/8" drywall. 780 CMR R302.6 3. A basement drainage system is required in all basements 780 CMR R405.2.3.except those in group I soils (table R405.1) 4. Foundations that retain earth and enclose interior space require damp proofing 780 CMR R406.1. or if high water table or severe soils waterproofing 780 CMR R406.2. S. Through wall form ties must be removed from both faces and patched with hydraulic cement. 780 CMR R406.2 of amendments. 6. Foundation anchor bolts must be %2" and be embedded a minimum of 7" into the concrete. 10" bolts! 780 CMR R403.1.6 7. CMU foundations require 3/8" parging before damp proofing. 780 CMR R406.1 see exceptions. 8. Emergency escape is required out of every basement whether habitable or not, each bedroom and walk- in attics. 780 CMR R310.1 9. Crawl spaces can be treated in three different ways,vented (poor idea), exhausted (similar to exhaust only systems), or treating the space with supply and return.See 780 CMR R408 10. Ceiling joist are intended to prevent spread, once raised above the wall plate they become rafters ties and may require up sizing of rafters and increased nailing for example with a 4" slope 8-16nd common are required at each connection. 780 CMR R802.3.1. When there is neither of these a structural ridge is required with a load path to the foundation. 11. Steel straps over the ridge or 1x4 minimum collar ties are required 4' OC in the upper 1/3rd 780 CMR R802.3.1 12. Ridge boards must be the full depth of the cut. 780 CMR R802.3. 13. A complete window and header schedule is required. 780 CMR Table R502.5 for header sizing and number of jack studs required. 14. Wood walls shall be capped with double plates to provide overlapping at corners and intersecting walls with bearing partitions,joints staggered 2' minimum. 780 CMR R602.3.2 a. Exception:A single plate may be used or plates may be excluded over lintels provided the plates/lintels are adequately connected by a 3"x 6" plate .036 galvanized steel nailed to each segment with 6-8d nails 15. All framing materials which are not code prescriptive must have stamped engineering. a. LVLs b. Hoist and or Floor Truss c. Roof truss 16. All I-Joist need to be protected from fire with%2 drywall or 5/8 wood structural panel. (R501.3) 17. A braced wall plan identifying appropriate braced wall areas where required (R301.1) and braced wall method being used. 780 CMR 602.10. a. Garage corners and large corner window/door layout may require special solutions. b. All corners must be appropriately attached to the foundation. c. When using PFH (R602.10.3.3) or PFG (R602.10.3.4)the nailing requirement is 4" and 3" respectively using 8d common nails or galvanized box nails. PNEUMATIC nails must be full headed with the temper and shank sizing meeting the strict code requirement. 18. When nailing sheathing make sure your pneumatic nailers' pressure is properly set. Nails set too deep perforate the sheathing weakening it and contribute to building damage in high wind events. 19. Ceiling heights minimum 7'for habitable spaces, 6'8" for bathrooms includes tub/shower area if a shower head is used, 6'8" for basements, 6'4" at beams/ducts. 780 CMR R305.1. MA amended 20. Hazardous glazing locations, within 24" of a door, or within 60" of a stair, or across from hot tubs, spas, bathtubs within 60" if not 60" above the walking surface, and other locations.780 CMR R308.4 21. Windows over 72" above grade with the opening less than 24 above the finished floor shall meet the 4" sphere rule. Order restrictors. 780 CMR R612.2 !- City of Northampton 7 sf Massachusetts ( G. DEPARTMENT OF BUILDING INSPECTIONS d 212 Main Street • Municipal Building vs �? Northampton, MA 01060 INSPECTOR Sackrey Construction LLC September 4,2015 83 South Main Street Sunderland, MA 01375 Subject Location: 69A, 69B,69C Day Avenue Northampton Map Block: 25A-129 Mr.Sackrey, Your building permit application with plans dated 7-22-2015 has been approved as drawn and per this memo. All work must meet all applicable codes whether noted or not included within this memo. Please follow up on the following items: These items will need to be accomplished as the project moves forward and before rough inspections; 1. Provide a revised electronic copy of plans. 2. Foundation walls to be changed to 8' height with 7' of backfill or increased reinforcement per table R404.1.2(8). 3. A Portal Frame with Hold Downs is required at the right side of the garage door on buildings"A" & "B" or increase the wall length to 24" and use a Portal Frame for Garage. 4. Tempered glazing at each hazardous location, at stairs and shower, minimum, as required by code. 5. Fire stopping at the top of all double walls and vertically at 10' intervals at all double walls. 6. Positive connection at 6 x 6 corner post. 7. Final hot roof detailing. 8. Fixed glazing over the gas fireplace vent. 9. Dryer exhaust that are hidden within a structure require signage at the dryer location per M504.6.4.1. 10. All I-joist must be protected from fire with an approved protection system. 11. Final ratings, duct blast results, and a signed Thermal Bypass Checklist. 12. Smoke, Heat and CO detectors throughout the structure to current building codes. 13. An emergency escape window is required within every bedroom, basement and walk-in attic. 14. An air barrier is required between the tub and the wall cavity. 15. If permeable insulation is used air sealing and an air sealing inspection is required at the exterior and interior skins. Typically the sheathing and drywall. Note:The 2012 IECC with MA amendments is the non-stretch energy code and the new Stretch Code expected to be completed in 2015. As of August 4th 2011 the 8th Edition MA code is the 2009 IRC with MA amendments. In the following are some generic requirements which seem to be problematic. This is not intended to be comprehensive, nor is it a substitute for purchasing and reading the MA codes. Read only international codes are available on line at http://publicecodes.cyberregs.com/icod/one must also consider the MA amendments to these codes which can be found at www.mass.gov/dps/bbrs . The current relevant building codes are: 2009 IBC, 2009 IEBC, 2009 IMC, 2009 IRC, 2009 or 2012 IECC,AA115, MA amendments. 1. Structures shall conform to 780 CMR 8th Edition 1 and 2 family building codes with MA amendments. 2. Grading plan for structures being constructed required. 780 CMR R401.3 for drainage requirements. -c µ 9 � ^ � �fi5$Zi CI(liS[ti3 J c 1 DEPARTMENT OF BUILDI?\'G INSPECTIONS l:NSPECTOR 212 M<un Street ® -Municipal Building Northampton,MA 01060 LOCATION AkIrE SQUARE FOOTAGE AMOUNT BASEMENT @ :20 1 ST FLOOR.@.50, 2N'FLR @. 5� Z 2 -71 1-0 Vz FLOORS, FDZSH ATTIC,GARAGE g.20 i DECK/PORCHES @ .20 ` " S U TOTAL. SU 1 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: C_ D - The debris will be transported by: The debris will be received by: Building permit number. Permit Name of P Applicant A Date Sig -at ure of Permit Ap licant t City of Northampton _ Massachusetts ! DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building 'J'•,, =b�1 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 occupancv 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 I' 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations s 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �^ ' Please Print Legibly Name (Business/Organization/Individual): �C1�°�1-t Z ( r Address: �z (fy . City/State/Zip: c,,/� Phone#: (3 5­(V (fir (v 1 Are you an employer? Check the appropriate box: general contractor and I Type of project(required): 1.[� 4. I am a am a employer with �'i ❑ g employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' comp. insurance.$ 9. ❑ Building addition [No workers comp.insurance p' 10.❑ Electrical repairs or additions required.] 5. [] We are:a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E] 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 anew 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: • Policy#or Self-ins. Liirc. #: Ut.*ki- bcb, &005`7 1 "' zot Expiration Date:,, Job Site Address: City/State/Zip: F ,< Attach a copy of the workers' compensation policy declaration page(showing the policy number and expira 'on 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 cerl under the p 'ns and enalties ofperjury that the information provided above is true and correct. Sigm ature: Date: `6 Phone#• S 10 Of 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: Not Applicable £ Name of License Holder: (5 U Ic 3 License Number Address ExpiratiorfDateT Signa+ej"�q Telephone 9.Registered Home'Improvement.Contractor Not Applicable £ Company Name Registration Number Address Expira on Date L/ �� 3 3 �, Te ephone 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...... £ 11 .. .Rome Owner Egempt><on 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. j SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House 1311*� Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [❑ Siding[0] Other[O) Brief Description of Proposed f Work: Ge^F Sir v T f( ., r Cif Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.lf New house and or�addition to exlstina.housing, complete the followi`nc�: a. ^ Use of building : One Family ✓ Two Family Other X" b. Number of rooms in each family unit: `� Number of Bathrooms Z z- c. Is there a garage attached? ra d. Proposed Square footage of new construction. Z 2- G Dimensions Z- e. Number of stories? 2~ f. Method of heating? Fireplaces or Woodstoves I' Number of each g. Energy Conservation Compliance. Masscheck 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 M j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? ,--,Yes No. 1. 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 i K " e?i�n`� &0 L­ -')' as Owner of the subject property hereby authorize 31 d��'_I y < 4 z to act on my behalf, in all matters relative to work authorized by this building permit application. Sig ature of Owner Date 1 ��i�y` ���£— �Y �-� as Owner/Authorized Agent hereby declare that the statements and i formation on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed unde the pains and nalties of perjury. D Print Name Signature of O t Datif Section 4. ZONING All Information 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 ! ` l Z �(�_—_._� t Ck��� Setbacks Front r TT i Side L:'.._..... I R:= Lf i 5"1 R:. z..a :' Rear f._ __1 38 t.m--- Building Height Bldg. Square Footage —` % Open Space Footage _ % (Lot area minus bldg&payed parking) #of Parking Spaces 1.-- ---m-` Fill: i (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW Q YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q ' IF YES: enter Book N � Pager and/or Document# — B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained O , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: 4 D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES, describe size, type and location: _ E. Will the construction activity disturb(clearing,grading, excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. LA.., n X . .of Northampton Status of Permit "' a ,' 4 a �l �ing Department r r 12 Main Street _h L��(J Room 100 VJatelVrfiGA1blt ° "1 fl,ort ampton, MA 01060 `F& tt�itS 7-1240 Fax 413-587-1272,AAA 01068 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION Thts secfiorr to be completed by office 1.1 Property Address: rG' DA-1 t�- Map Lot Unit VkC, p Zone µOverlay Disfrict EIm.St District CB District SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED.AGENT' 2.1 Owner of Record: A4 o�ob -/any Na a(Print) Current Mailing Addres S. W a s-'75_ is` Telephone Signature 2.2 Authorized A ent: � � Cf �. LLtr �;3 ,5• vim.J�+�.�' . �S� r��,e Name(P ' t) Current Mailing Address: Signature Telephone SECTION 3 ESTIMATED iON STRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only com leted by ermit applicant 1. Building (a) Building'Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing 2 GIO-t? Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) C}Z3-Z> Check Number S This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings :Date File# BP-2016-0293 APPLICANT/CONTACT PERSON SACKREY CONSTRUCTION ADDRESS/PHONE 83 SOUTH MAIN ST SUNDERLAND01375 (413)665-9995 Q PROPERTY LOCATION 69 DAY AVE MAP 25A PARCEL 129 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid off o Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 2 STORY SINGLE FAMILY CONDO ATT GARAGE/DECK-UNIT 69C New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 040714 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION 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 Permit DPW Storm Water Management Demolition Delay /--t, 14", 71/ Signa ure of Building O facial 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. 69 DAY AVE BP-2016-0293 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25A- 129 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A1 Category:New Single Family House BUILDING PERMIT Permit# BP-2016-0293 Project# JS-2015-001711 Est. Cost: $247000.00 Fee: $1217.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SACKREY CONSTRUCTION 040714 Lot Size(sq. ft.): 18992.16 Owner: FINN JOAN B&KIM F GOGGINS&K MALYNOSKI &M F GRYGORCEWICZ Zoning: URB(100)/ Applicant: SACKREY CONSTRUCTION AT. 69 DAY AVE Applicant Address: Phone: Insurance: 83 SOUTH MAIN ST (413) 665-9995 O Workers Compensation SUNDERLANDMA01375 ISSUED ON:911412015 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 2 STORY SINGLE FAMILY CONDO ATT GARAGE/DECK - UNIT 69C 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 Occupant Signature: FeeType• Date Paid: Amount: 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner CTifu �I �13T�3II'iTI 4 � �` � - �85S8th1ib CtiS = P C 7 DEPARTMENT OF BUILDR\IG INSPECTIONS r JNSPECTOR 212 Main Street * ,Municipal BEdiao Northampton,MA 01060 LOCATION tC/ ,P b i SQUARE FOOTAGE AMOUNT BASEMENT @ .20 Z ? C3, IIT FLOOR @.50 2NDFLR @.3� ' FLOORS, FINISH ATTIC, GARAGE g.20 c° DECK/PORCHES @ -20 m TOTAL. City of Northampton 212 Main Street, Northampton, MA 01 060 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: °ft- The debris will be transported by: A-4.kE c , The debris will be received by: Building permit number: Name of Permit Applicant Ceti�` Nam pp Date Sig -ature of Perm Applicant City of Northampton Massachusetts cJl, r 4a DEPARTMENT OF BUILDING INSPECTIONS x� 212 Main Street • Municipal Building r� 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 occupancv until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be i 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 I, 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street i Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �-C Wia-fZ�, Qy f ; c-, IL Address: �6 �, S "�+_f 14 City/State/Zip: �vt-- .Q re*t (.A-"o Phone #: 4 Q - 6 3 te(o `3 7 Are y an employer? Check the appropriate box: Type of project(required): 1, I am a employer with�!^ 4. E] I am a general contractor and I employees (full and/or part-time). * have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• []Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance.$ 9. Building addition required.] 5. We are;a corporation and its 10.❑ 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: . - Policy#or Self-ins. Lic. #: Wkl- - sui>.-bob-5 7 cil 3 " 2L_f Axpiration Date: -2- 12, Job Site Address: (0 DA(4 Ad6iIZ City/State/Zip: 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 cerd nder the mains and penalties ofperjury that the information provided above is true and correct. Sign ature- Date: J' /,- Phone#: r IV Of 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 Su`pery iisor: Not Applicable £ Name of License Holder: —+©(Akk _ _ 5-6-N License Number Address Expirati Date 35 Signatur Telephone 9.:Reoistered HomeamprovementConuactor Not Applicable £ Company Name I Registration Number Address Expira ion Da `�Telep one SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.IL.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...... £ 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, SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks (M Siding[0] Other[o] Brief Description of Proposed Work: L.0-t-A 5'CNL tJ (_-C k ^IJ S/0 L7 L(-"- (:-,^ AV 0 �V j t i ;_)f^� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet use' nd r ad1 ot m olowinc:i`k6 a . o n a. Use of building :One Family / Two Family Other b. Number of rooms in each family unit: Number of Bathrooms Z c. Is there a garage attached? / 5 UYd. Proposed Square footage of new construction. 2- Z O Dimensions J e. Number of stories? Z f. Method of heating? ff L t"` f / ,1 ,1 t ° f t !�S Fireplaces or Woodstoves Ci ) A-S Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction W 45' w ")nl`f",�C-(;, i. Is construction within 100 ft. of wetlands? Yes `''"No. Is construction within 100 yr. floodplain Yes No t j. Depth of basement or cellar floor below finished grade I k. Will building conform to the Building and Zoning regulations? V 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 I, t�i �✓L �d Cy(rt �� > as Owner of the subject property hereby authorize to act on my behalf, in all matters elative to work authorized by this building permit application. 3 A,7 a i s Signature of Owner U0 Dale t I S 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. Print Name/)l 3 Signature of Ow er/Ag Date q � Section 4. ZONING All Information 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 Sized z 3 S 0 O Frontage Setbacks Front Side LJ R:= L:L`at._°_' R:, Rear Building Height Bldg.Square Footage % E LI Open Space Footage % —� t area minus bldg (Lo g&P ave d parking) #of Parking Spaces -- - Z Fill: 6 ! r (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES Q IF YES, date issued:) IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q IF YES: enter Book I Pagel and/or Document# B. Does the site contain a brook, body of water or wetlands? NO a DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Q , Date Issued: i y-7. 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 Q NO e IF YES, describe size, type and location: j E. Will the construction activity disturb(clearing,grading' excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. I r u Department use onlX i i City Of NO amptontatUS,OfP�rmit key �n h1 J it �; rF B'b Rlina ZVilbA-ep, rtment Ct r>,Cut/Drivealuay Permit \, C; 212 eet SewerlSeptic Avalfa6llity I -° { WaterlU�el�Ava�lahtltty ! On, MA 01060 TwO Sets of S#rUCturai Pfa[rs h OR pg -587-1240 Fax 413-587-1272 Ph liter Plans Other Specify` APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE,INFORMATION �Thts section to he completed by office 1.1 Property Address: j B y < 1 J �V i Map Lot Unit �� � ' �� j /� Zone Overlay District ' L _Elm St District QB Distract SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT.:: 2.1 Owner of Record: L6('in6,e4 ( , F G©!�;!� oy� Gf- Name(Print) Current Mailing Address: �a d� �- Telephone Signature I ou 2.2 Authorized Agent: Name(Prin Current Mailing Address: 413 - !> - Cp 31 Signature Telephone SECTION 3-ESTIMATED CON TRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a) Building Permit Feb 2. Electrical (b)Estimated Total Cost of 2-�9 d Zf'27 Construction`from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) Z 1 k Check Number O This Section For off icial`Use Onl Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector`of Buildings Date File#BP-2016-0292 APPLICANT/CONTACT PERSON SACKREY CONSTRUCTION ADDRESSIPHONE 83 SOUTH MAIN ST SUNDERLAND01375 (413)665-9995 Q PROPERTY LOCATION 69 DAY AVE MAP 25A PARCEL 129 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APP_LICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 2 STORY SINGLE FAMILY CONDO ATT GARAGE/DECK-UNIT 69B New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 040714 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF kMATION PRESENTED: V 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 Permit DPW Storm Water Management Demolition Delay /-3� L-,I� y `T-- p I(S 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. 69 DAY AVE BP-2016-0292 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25A- 129 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2016-0292 Project# JS-2015-001711 Est. Cost: $247000.00 Fee: $1217.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SACKREY CONSTRUCTION 040714 Lot Size(sg. ft.): 18992.16 Owner: FINN JOAN B&KIM F GOGGINS&K MALYNOSKI&M F GRYGORCEWICZ Zoning URB(100)/ Applicant. SACKREY CONSTRUCTION AT. 69 DAY AVE Applicant Address: Phone: Insurance: 83 SOUTH MAIN ST (413) 665-9995 O Workers Compensation SUNDERLANDMA01375 ISSUED ON.911412015 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 2 STORY SINGLE FAMILY CONDO ATT GARAGE/DECK - UNIT 69B 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: 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner xnar �o� oy 4 ; $"" � �Iassac�useffs - DEPARTMENT OF BUILDIT;G INSPECTIONS 212 M�un Street 0 -Municipal Building ;fNSPECTOR Nortbampton,MA 01060 LOCATION SQUARE FOOTAGE AMOUNT BASEMENT @ :20 I"FLOOR @.50. 1 J r7 �L D 2 FLR @.-k j b 7 Z Y2 FLOORS, FINISH ATTIC, GARAGE g.20 1 J DECK/PORCHES @ -20 TOTAL. �' I •�� 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: The debris will be transported by: =j The debris will be received by: �A�'L-LAL�j Building permit number: Name of Permit Applicant c Ne ` 3 Date Signature of Permit Applicant City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building �J•. `b�' Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT F e State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her nstruction supervisor. The state defines "Homeowner"as, " Person(s) who owns a parcel on which /she resides or intends to be, a one or two family dwelling, attached or detached structures cessory 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/footinqs (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 the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be i 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 I' 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 8 ?) City/State/Zip: S Phone#: Are ypu an employer?Check the appropriate box: Type of project(required): 1.[ I am a employer with 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2.0 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.] 5. 0 We are.a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11,0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 131-1 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: . 11 . Policy#or Self-ins. Lic. #: w A--z 8 n 8n 5 -]1q3 ZC l S Expiration Date: 7/2 Job Site Address: (o J .A D& V cL City/State/Zip: '� e 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 certi under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: bl.41 h Phone#: ! (k 3 e 3 Official use only. Do not write in t is 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: Applicable £C� G Name of License Holder: JQ�k—IV ft ' License Number 8-1 Ulu..j��,,,.�, ��Jl- � d� - f b I (., Addres Expiratigfi Date Signatu Wr Telephone 9 'Renistered Home:mprovement r7, _ Not Applicable £ Company Name Registration Number fs 3 C, . 1 w � 't 2-Y tr Address // Expiration Date Telephon 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...... £ 11! . .Home Owner_Egemp >lon' 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 i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House [�' Addition [] Replacement Windows Alterations) Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [❑ Siding [O] Other[0] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.`I#New house and._or:additl"on to existi`ng houslng, comalete the follawing: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms Z /z c. Is there a garage attached? 5 s d. Proposed Square footage of new construction. <, ,y A fk Dimensions Z`_ e. Number of stories? Z r /I \ GA-S f. Method of heating? CUGC-tik(L :;yf JP(A T S Fireplaces or Woodstoves -) Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction W r_ W/ Di pj `^'A 1-t- i. Is construction within 100 ft. of wetlands? Yes v/ No. Is construction within 100 yr. floodplain Yes No � N j. Depth of basement or cellar floor below finished grade 6 (c k. Will building conform to the Building and Zoning regulations? 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 M L�Ilkit^l &0 UP-(-r #4 as Owner of the subject property hereby authorize �,- - S A-%V to act on my behalf, in all matters relative t work authorized by this building permit application. Sig ature of Owner Date as Owner/Authorized Agent hereby declare that the statements and infor ation 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 n /Age Date ^ . Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Tbis column to be filled in by Building Department Lot Size Frontage t Setbacks Front E--1 Rear Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume&Location) A. Has a Special Permit/Vahance/Finding ever been issued for/on the site? ' o� NO 0 DONTKNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry ofDeeds? NO � j DOMlKNOYY 'ES �� IF YES: enter Book Page and/or Document# �� � B. Does the�tecontain a brook' body uf water orwed ����wetlands? NO DONTKNO\� «�� YES IF YES, has permit been or need to be obtained from the Conservation Commission? Needs tobeobtained �~� Obtained �� Date |ssued. ' �~� �~/ ' 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 K � NO ( �|/- IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading tion. orfi||ing)over 1 acre orioit part ofa common plan ' that will disturb over 1 acre? YES NO a IF YES,then o Northampton Storm Water Management Permit from the DPW io required. � . � / N O ��, ' TJ � � i3epartmentuse>7nly , 1 City of Northampton Status ofPerrrtt `~ Building Department Curt"CUt/Drir[e�nray Rerrrf�# trrr F T r r^ - 212 Main Street SewerlSepticAva�labllrty } " LJ ch j Room 100 1Naterlel[AvallabUlty� r 1 (� a L Northampton, MA 01060 Twa Se#s o1 S#ritctr�ral Plarfs z phone 413-587-1240 Fax 413-587-1272 P1of/Site Plans r< r �' a � Other 5peoifyr ` �3r r ` '� ' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: _ This sectiorr to be completed by office fk rz, Umt H, Zone s r r m_st'D�strict CB:Distnct_ r SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 1Crfrn � i.- r ��oc��A, r 0, i�,X /�U(�� 464- a'"'el4o AW O/04 ad 01 Name(Print) or Current Mailing Address: 4 3- Telephone Signature 2.2 Authorized Agent: C Name(p, ) Current Mailing Address: Signature Telephone SECTIO 3 -ESTIMATED CONSTRUCTION COSTS. Item Estimated Cost(Dollars)to be Official Use Only com feted by ermit applicant 1. Building (a)Building Permit Feb 2. Electrical (b) Estimated Total,Cost of (3ven> Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) Z y 1 C70-Z✓ Check Number This Section For Official Use Only Date Building Permit Numb . ssued: Signature: Building Commissioner/Inspector.of Buildings Date J File#BP-2016-0291 APPLICANT/CONTACT PERSON SACKREY CONSTRUCTION ADDRESS/PHONE 83 SOUTH MAIN ST SUNDERLAND01375 (413)665-9995 Q PROPERTY LOCATION 69 DAY AVE 0`4-� MAP 25A PARCEL 129 001 ZONE URB000)/ 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 2 STORY SINGLE FAMILY CONDO ATT GARAGE/DECK-UNIT 69A New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 040714 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved Additional permits required(see below) �z PLANNING BOARD PERMIT REQUIRED UNDER:§ I 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* � QK 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 9 f S— 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. 69 DAY AVE BP-2016-0291 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25A- 129 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2016-0291 Project# JS-2015-001711 Est. Cost: $247000.00 Fee: $1217.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SACKREY CONSTRUCTION 040714 Lot Size(sq. ft.): 18992.16 Owner: FINN JOAN B&KIM F GOGGINS&K MALYNOSKI&M F GRYGORCEWICZ Zoning URB(100)/ Applicant: SACKREY CONSTRUCTION AT. 69 DAY AVE Applicant Address: Phone: Insurance: 83 SOUTH MAIN ST (413) 665-9995 O Workers Compensation SUNDERLANDMA01375 ISSUED ON.911412015 0:00:00 TO PERFORM THE FOLLOWING WORK.-CON STRUCT 2 STORY SINGLE FAMILY CONDO ATT GARAGE/DECK- UNIT 69A 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 Occupant Signature: FeeType• Date Paid: Amount: 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner