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23C-063 (2) 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(cD-northamptonma.gov Thank you for your cooperation on thes atters. uck Miller City of Northampton Assistant Commissioner and Zoning Enforcement 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. Floorjoist systems that are not equal to 1%Z" 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%Z" 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%2" drywall on the garage side of the separation wall and if there is a finished space above the garage all walls must have%2" drywall and the ceiling 5/8" drywall. 780 CMR R302.6 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 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 maybe used or plates maybe 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. I-joist and or Floor Truss c. Roof truss 16. All I-Joist need to be protected from fire with % 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 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 1St 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%" minimum and 2" maximum rail, height minimum 34" maximum 38", required for 4 or City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS Z ` 212 Main Street • Municipal Building Northampton, MA 01060 INSPECTOR John Gutowski October 9, 2015 44 North Elm Street Northampton, MA 01060 Subject Location: 115 Willow Street Map Block: 23C-063 Mr. Gutowski, Your building permit application with plans dated 9-7-15 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. Final duct blast results, and a signed Thermal Bypass Checklist. 2. Smoke, Heat and CO detectors throughout the structure to current building codes. 3. An emergency escape window is required within every bedroom, basement and walk-in attic. 4. An air barrier is required between the tub and the wall cavity. 5. 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. 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. 5. 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%" 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 cs Beam 4.21.0.1 Gutowski 10-2-15 kmBeamEngine 4.13.8.1 Materials Database 1530 11:06am 1 of I Member Data Description: r ° Member Type: Beam Application:Floor Top Lateral Bracing:Continuous Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:SBC Live Load: 40 PLF Deflection Criteria: L/360 live,L/240 total Dead Load: 10 PLF Deck Connection:Nailed Member Weight: 23.7 PLF Filename:Beam3 Other Loads Type Trill Other Dead (Description) Side Begin End Width Start End Start End Category Point(LBS) Top 26' 6.00" 1224 360 Live Replacement Uniform(PSF) Top 0' 0.00" 26' 6.00" 5' 6.00" 40 10 Snow Additional Uniform(PSF) Top 0' 0.00" 26' 6.00" 7' 0.00" 50 10 Snow Additional Uniform PSF Top 0' 0.00" 26' 6.00" 7' 0.00" 40 10 Live 8 8 0 21 10 0 Q � 3060 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 1.500" 2275# -3358# 2 8' 8.000" Wall SPF#2 Timbers End-Grain(715psi) 6.000" 5.075" 19051W - 3 30' 6.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 1.572" 589 - Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Live Snow Dead 1 -1510# -2661# -228# 2 6560# 12317# 4892# 3 2617# 3153# 1572# Design spans 8' 5.375" 21' 7.375" Product: 1-3/4x16 VERSA-LAM 2.0 3100 SP 3 ply PASSES DESIGN CHECKS Connect members with 3 rows of 16d common nails at 12.0"oc NOTE:Nails must be applied from both sides Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Review gravity uplift reaction force of 3358lbs at bearing 1 and ensure that the structure can resist appropriately. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 33030.'# 67031.'# 49% 21.64' Even Spans D+0.75(L+S) Negative Moment 37775.'# 67031.'# 56% 8.67' Total Load D+0.75(L+S) Shear 9821.# 18354.# 53% 8.68' Total Load D+0.75(L+S) Max. Reaction 19050.# 22522.# 84% 8.67' Total Load D+0.75(L+S) TL Deflection 0.6585" 1.0807" U393 20.55' Even Spans D+0.75(L+S) LL Deflection 0.4935" 0.7205" U525 20.55' Even Spans 0.75(L+S Control: Max. Reaction DOLS: Live=100% Snow--115% Roof=125% Wind=160% Design assumes a repetitive member use increase in bending stress: 4% All product names am trademarks of their respective owners Copyright(C)2015 by Simpson Slrong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing is defined aswhen the member,floorjoist,beam orgirde[shown on this drawing meets applicable design aitena for Loads,Loading Conditions,and Spans listed on this sheet. The design must be reviewed by a qualified designer or design professional as required for approval.This design assumes product installation according to the manufacturer's specifications. cs Beam 4.21.0.1 Gutowski 10-2-15 1(mBeamEngine 4.13.8.1 Materials Database 1530 10:26am loft Member Data Description: Member Type: Beam Application:Floor 5,�. f " y) Top Lateral Bracing:Continuous T.``� t y Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:SBC Live Load: 40 PLF Deflection Criteria: L/360 live,L/240 total Dead Load: 10 PLF Deck Connection:Nailed Member Weight: 17.6 PLF Filename:Beam1 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 36' 0.00" 12' 0.00" 40 15 Snow Additional Uniform(PSF) Top 0' 0.00" 36' 0.00" 12' 0.00" 0 10 Live 15 O O 9 0 0 © 12 O 0 9 36 O 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 1.500" 4977# -- 2 15' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 3.195" 11993# -- 3 24' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 2.531" 9502# 4 36' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 1.500" 4164# Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Snow Dead 1 3036# 1941# 2 7502# 4491# 3 6238# 3264# 4 2566# 1598# Design spans 14' 9.375" 9' 0.000" 11' 9.375" Product: 1-3/4x11-7/8 VERSA-LAM 2.0 3100 SP 3 ply PASSES DESIGN CHECKS Connect members with 2 rows of 16d common nails at 12.0"oc NOTE:Nails must be applied from both sides Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 15486.'# 38167.'# 40% 6.13' Odd Spans D+S Negative Moment 15991 38167.'# 41% 15' Adjacent 1 D+S Shear 6188.# 13622.# 45%tl 14.26' Adjacent 1 D+S Max. Reaction 119931 14546.# 82% 15' Adjacent 1 D+S TL Deflection 0.3686" 0.7391" LJ481 6.87' Odd Spans D+S LL Deflection 0.2311" 0.4927" U767 6.87' Odd Spans S Control: Max. Reaction DOLS: Live=100% Snow=115% Roof=125% Wind=160% Design assumes a repetitive member use increase in bending stress: 4% All product names are trademarks of their respective owners Copyright(C)2015 by Simpson Strong-Tie Company Inc ALL RIGHTS RESERVED. "Passing is deft ned as when the member,fioorioisl,beam or ginier,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet. The design must be reviewed by a qualified designer or design professional as required for approval.This design assumes product installation according to the manufacturer's s e ifications. cs Beam 421.0.1 Gutowski 10-2-15 kmBeamEngine 4.13.8.1 Materials Database 1530 1 0:51 BIT] IofI Member Data Description: Member Type:Beam Application:Floor Top Lateral Bracing:Continuous Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:SBC Live Load: 40 PLF Deflection Criteria: L/360 live,L/240 total Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 10.7 PLF Filename:Beam2 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Point(LBS) Top 10' 6.00" 1283 799 Snow Point(LBS) Top 13' 6.00" 1283 799 Snow Additional Uniform(PSF) Top 0' 0.00" 24' 0.00" 4' 6.00" 40 10 Snow Additional Uniform PLF Top 0' 0.00" 24' 0.00" 0 10 Live 12 0 0 12 0 O q o 24 O 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 or 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 1.500" 1377# -- 2 12' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 2.087" 7833# -- 3 24' 0.000" Wall SPF#2 Timbers End-Grain(715psi) 3.500" 1.500" 1377# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Live Snow Dead 1 206# 1024# 353# 2 589# 5157# 2676# 3 206# 1024# 353# Design spans 11' 9.375" 11' 9.375" Product: 1-3/4x7-1/4 VERSA-LAM 2.0 3100 SP 3 ply PASSES DESIGN CHECKS Connect members with 2 rows of 16d common nails at 12.0"oc NOTE:Nails must be applied from both sides Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 3709.'# 15028.'# 24% 5.52' Odd Spans D+S Negative Moment 6988.'# 15028.'# 46% 12' Total Load D+S Shear 37624 8317.# 45% 11.41' Total Load D+S Max. Reaction 7833.# 145461 53% 12' Total Load D+S TL Deflection 0.2611" 0.5891" U541 6.11' Odd Spans D+S LL Deflection 0.2131" 0.3927" U663 6.11' Odd Spans S Control: LL Deflection DOLs: Live=100% Snow=115% Roof=125% Wind=160% Design assumes a repetitive member use increase in bending stress: 4% All product namesare tnmemarksof theirmspective owners Copyright(C)2015 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. —Passing is defined aswhen the member,floorjoist,beam or girder,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet. The design must be reviewed by a qualified designer or design professional as required for approval.This design assumes product installation according to the manufacturers s ecificetions. X 5- 17-2 2-v 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: '� The debris will be received by: Building permit number: Name of Permit Applicant v e f Date Signature of Permit Applicant City of Northampton �s r,f k' Massachusetts tis DEPARTMENT OF BUILDING INSPECTIONS . 212 Main Street • Municipal Building 0' 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 inspection are m ,F I, �", �, , � ',. understand the above. (Hom ner/resident's signature requesting exemption) I will call to hchedule all required building inspections necessary for the building permit issued to me. Date J ✓�` r 2, %l Address of work location .������'"??��*`�t l►fir�7�''r1,.� r`�°Y' - �''/�� 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: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4• ❑ 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 8. F-1 Demolition working for me in any capacity. employees and have workers' [N workers' comp. insurance comp. insurance. $ 9. F-1 Building addition quired.] 5. ❑ We area corporation and its 10.❑Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their I I.E] 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' 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 isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: 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 rdfy der th ain and pen Z 'es ofperjury that the information provided above is true and correct. Si ature: Date: LT�fS� Phone#: 0, 6&13 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/Tovvn Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: License Number Address Expiration Date Signature Telephone _ 9 Registered Homeamprovemen__ t Contractors M Not Applicable £ Company Name 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....... £ No...... £ 11 . .Ho-me 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 a umes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State anf ocai.Zoi #g Ljws and State of Massachusetts General Laws Annotated. Homeowner Signature. r t a a � SECTION S-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition lz' Replacement Windows Iteration(s) Roofing Or Doors )ZI Accessory Bldg. ❑ Demolition New Signs (0] Decks [[7 Siding�4 Other[p] Brief Descriptiw of Proposed Work:_ Am j 5,f f kop- / +i7tT1 t Am> 2014 FitVaL 6 /A.,-,' � Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.`If New:house and oraddi.iod. o:exisf'in h"ousm comI"ete ttie foif iii'r a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: { Number of Bathrooms c. Is there a garage attached? 3 1IV,., d. Proposed Square footage of new construction. J Dimensions e. Number of stories? f. Method of heating? f?A D i AIQ r Af-17 Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. H7 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 'Ry No j. Depth of basement or cellar floor below finished grade -1- k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer V _ Private well City water Supply v SECTION 7a-OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT !, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date G?!' 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 underthe pains and penalties of perjury. Print Name . Signature of Own r/A nt Date 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 4 _ t S4� S� t i ___10 VIP q , Frontage .J Setbacks Front FZ 3' Side L: R: Rear Building Height ^-1 Bldg.Square Footage [— % Open Space Footage % (Lot area minus bldg&paved parking) , #of Parking Spaces (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ,@� DONT KNOW Q YES Q IF YES, date issued:r� IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book � Page and/or Document#��� _ B. Does the site contain a brook, body of water or wetlands? NO ATL DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: . C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: f D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading exravation, 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. Ji ' I of Northampton Status of Perrritt 3 4,r I'F i iA�IJ i i. dir (ding Department {CihYr>j Cut/Driyeuvay Perm{t t rJ � P Q �( 12 Main Street Sewer/SepticAvaifabl►tty' "" I " T: Room 100 Water/1Afe E l€Avatla6{I{ty E ' 4y Elect I r - -_ o ampton, MA 01060 Two Sefs of S#liict�fal Piaris' y j NO l??•`7a :� �:- �:.IIIS�pP_ {� n� �°3'- 87-1240 Fax 413-587-1272 sPlo/S{t Plans 3 J, ili l tx APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION Thts sect{on to be completed'by off{ce 1.1 Property Address: 4 r W L QJC - Map , Lot pit U Zone Overlay D►sfrict r / r n. Elm St District CB District SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT: 2.1 Owner of Record: _ L] NO �~4-AA C Name(Print) Current Mailing Address: A_ Telephone l C� Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION 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 Construction'from 6 3. Plumbing 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+ +5) Check Number This Section For Officiaf Use Onl IN Building rmit Number: Date /O 9 Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0285 APPLICANT/CONTACT PERSON GUTOWSKI JOHN i ADDRESS/PHONE 44 NORTH ELM ST NORTHAMPTON01060(413)695-6893 () PROPERTY LOCATION 115 WILLOW ST �✓ MAP 23C PARCEL 063 001 ZONE URA(100)/WSP(100)/ ND `('A0 } 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 729 SQ FT ADDITION &2ND FLR BATH New Construction Non Structural interior renovations o 10 2 Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License eG� jG 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 emoliti Delay Signature of Iluifiling 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. `—. 115 WILLOW ST BP-2016-0285 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-063 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-2016-0285 Project# JS-2016-000467 Est. Cost: $168000.00 Fee: $1122.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 20865.24 Owner: GUTOWSKI JOHN Zoning:URA(100)/WSP(100)/ Applicant: GUTOWSKI JOHN AT: 115 WILLOW ST Applicant Address: Phone: Insurance: 44 NORTH ELM ST (413) 695-6893 () NORTHAMPTONMA01060 ISSUED ON.•1011312015 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 729 SQ FT ADDITION & 2ND FLR BATH 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 10/13/2015 0:00:00 $1122.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner