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11A-026 (5) Truss I yi'e Qty wv Fc�,7,ei U r e ��.� -, Job Reference o tiona_li P L c_r.,u amore r .,dads 10 s Jac 25 2015 MiTeK Inous,res.Inc Cat Oct C 8 6__2 C 15 rdoe 1 ID EZh6GoU1vV3eWHoLbibkLFyXW6q-4ZpesKK514DMyWPQjuE2a1?Caip_wR_UNKxdHYyXBrS t-0-0 11-6-0 13-0-014-6-0 22-8-9 32-0-0 33-0-0 11-6-0 1-6-b'1-6-0 8-2-9 9-3-7 1-0-0 Scale=1 66.5 4x6 ` 80012 9 \, t0 8x8 7� `_ 11 x4, 42 38 39 12 ����- 43 5 o `-T�., 3 c W1 ° W.1 4 ST5 0�l ST5 ��\� 14 46 o � V 15 4.00 Cl O I -- ST4 T - W4 16 a'.2x4=ST4 3 N 40 1`37rt4T �� - ST3 ST3 '2�4 STV ST2 .SP6 S,TZ - 18 ST1 2x4 S T-7 - 18 -�ST1 - SL7 _� v 1 2 2x4=�i X14 Q 3x4 -- _ " S7 :: y-} Y'1'- ---- ----� ----- - 1920',co � •-- - - I-XX-.X_Y.X.X�CILSL]LXXYX-X-XXYX_X-X_-JLX_�LX SX�LX��..gB.B7Z_ZL.�YY Y]Z g�CYYT�YY-YY-X-Y.r - -� -O � 36 35 34 33 32 31 30 29 28 26 25 24 23 22 21 3x4 3x4--= 6,6 2x4 1 79.12_ 11-6-0 14-6-0 25-0-0 32-0-0 11-6-0 3-0-0 10-6-0 7-0-0 Plate Offs�__ [6 0-4-0,0 4-81,-C9_0-3-14,0-2-01,[22.0-3-0 0-1-4] LOADING (psf) SPACING- 2-0-0 CSI. DEFL. in (lac) I/deft Lid PLATES GRIP TCLL 40 0 Plate Grip COL 1 15 TC 0 21 Vert(LL) 0 01 20 n/r 180 MT20 197/144 (Roof Snow=40 0) Lumber DOL 1.15 BC 0.09 Vert(TL) 0 02 20 n/r 80 TCDL 10 0 Rep Stress Incr YES WB 0 23 Horz(TL) 0 01 19 n/a nia BCLL 0 0 Coce IRC2009/TP12007 (Matrix) Weight 193 lb FT=4% BCDL 10 0 LUMBER- BRACING- TOP CHORD 2x6 SPF No 2 TOP CHORD Structural wood sheathing directly applied or 6-0-0 oc pudins. BOT CHORD 2x4 SPF No 2'Except` BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing B3 2x6 SPF No 2 JOINTS 1 Brace at Jt(s):40 WEBS 2x4 SPF No 2'Except` -MiTek recommends that Stabilizers and required cross bracing W2 2x4 SPF No 2 or 2x4 SPF Stud be installed during truss erection,in accordance with Stabilizer OTHERS 2x4 SPF No.2 or 2x4 SPF Stud*Except` nstallatio�uide__ ST5 2x4 SPF No.2 - - - REACTIONS. All bearings 32-0-0 (Ib)- Max Harz 2=-221(LC 6) Max Uplift All uplift 100 lb or less at joint(s)2,22, 19,32,33,34,35,36,28,26,25,24,23.21,41 Max Grav All reactions 250 lb or less at joint(s)22,30,32,35,28,31,29 except 2=308(LC 2), 19=467(LC 16), 33=348(LC 2),34=296(LC 2),36=332(LC 1),26=294(LC 15),25=287(LC 13).24=280(LC 13),23=275(LC 1), 21=756(LC 16),39=357(LC 3) FORCES. (Ib)-Max. Comp/Max Ten -All forces 250(lb)or less except when shown. WEBS 6-33=-307/107, 5-34=-254/78,3-36=-271/113,12-26=-253/109, 18-21=-619/172, 10-39=-357/0 NOTES- 1)Wind.ASCE 7-05, 100mph;TCDL=5.Opsf;BCDL=5 Opsf;h=24ft;Cat 11; Exp B;enclosed,MWFRS(low-rise)and C-C Exterior(2) zone,cantilever left and right exposed;C-C for members and forces&MWFRS for reactions shown; Lumber DOL=1.60 plate grip DOL=1 33 2) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind(normal to the face),see Standard Industry Gable End Details as applicable,or consult qualified building designer as per ANSI/TPI 1 3)TCLL.ASCE 7-05; Pf=40.0 psf(flat roof snow),Category 11,Exp B, Partially Exp;Ct=1.1 4) Unbalanced snow loads have been considered for this design. 5)This truss has been designed for greater of min roof live load of 16.0 psf or 2.00 times flat roof load of 40 0 psf on overhangs non-concurrent with other live loads. 6)All plates are 1.5x3 MT20 unless otherwise indicated. 7)Gable requires continuous bottom chord bearing 8)Gable studs spaced at 2-0-0 oc. 9)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads 10)`This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 2-D-0 wide will fit between the bottom chord and any other members 11)Bearing at joint(s)39,41 considers parallel to grain value using ANSI/TPI 1 angle to grain formula Building designer should verify capacity of bearing surface. 12)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 100 lb uplift at joint(s)2,22, 19,32,33, 34,35,36,28,26,25,24,23,21,41. 13)Beveled plate or shim required to provide full bearing surface with truss chord at joint(s)2,22.30,32,33,34,35,36,28,26,25,24, 23,21,31,29,39,41_ 14)This truss is designed in accordance with the 2009 International Residential Code sections R502 11 1 and R802.10 2 and referenced standard ANSI/TPI 1 15)"Semi-rigid pitchbreaks including heels"Member end fixity model was used in the analysis and design of this truss. _LOADCASE(S-y StanUard --- --- - - -- - - ---- - -- --- - Jqb cuss truss 1`ype ty ly Fortier/Upland Avenue Garage 151001678 SOt ROOF SPECIAL 11 1 Job Reference(optional) Universal Forest Products 7.610 s Jan 29 2015 MiTek Industries,Inc. Sat Oct 03 08:16:37 2015 Page 1 I D:EZh6GoU 1 vV3eWHoLbibkLFyXW6q-zK29ih N bpJjoR7iCyIJ_ktAxaJ_3s254HxvgQJyXBrO -1-0-0 6-6-10 13-070--- 22-8-9 25-0-0 32-0-0 �3l 1-0 0 6-6-10 � 6-5-6 9-8-9 2-3-7 7-0-0 1-0-0 Scale=1:62.3 8x8 8.00 u 5 5x6 / �� 22 2 4 � 23 2x4 V� Q 3 ai 2 �\ 6 5x10 4.00 Ll 2 1.5x3 I1 r 14 24 25 13 12 11 10 1 4x4= 3x6--= 3x8 -- MT18HS=- 5x8 1.5x 5x12 3 5x12= 1.79 Ll2 9-0-0 17-0_0 __ 22-8-9 25-0-0 32-0-0 _ 9-0-0 8-0-0 5-8-9 2-3-7 7-0-0 Plate Offsets -- [2:0-8-0,0-0-14] [6:0-4-4 8,0 2-12,L8:0 0-9,0-1-10] [10:0-6-4,0-3-41 LOADING (Ps40.D - ---- -- _. -- .-. — -- SPACING- 2-0-0 CSI. DEFL. in (loc) I/deft L/d PLATES GRIP (Roof Snow=40.0 Plate Grip DOL 1.15 TC 0.79 Vert(LL) -0.48 12-14 >808 240 MT20 197/144 TCDL 10.0 Lumber DOL 1.15 BC 0.91 Vert(TL) -0.77 12-14 >500 180 MT18HS 197/144 Rep Stress Incr YES WB 1.00 Horz(TL) 0.25 8 n/a n/a BC LL 0.0 Code IRC2009/TP12007 (Matrix-M) Wind(LL) 0.14 11 >999 360 Weight: 154 lb FT=4% BC D L 10.0 --- -- ---- - —�----- --- LUMBER- BRACING- TOP CHORD 2x6 SPF No.2'Except* TOP CHORD Structural wood sheathing directly applied or 2-2-0 oc purlins. T3:2x6 SPF 2100E 1.8E BOT CHORD Rigid ceiling directly applied or 9-3-2 oc bracing. BOT CHORD 2x6 SPF 2100E 1.8E*Excel WEBS 1 Row at midpt 6-12 B1:2x4 SPF No.2,B2:2x4 SPF 210OF 1.8E MiTek recommends that Stabilizers and required cross bracing WEBS 2x4 SPF No.2 or 2x4 SPF Stud'Except' 11 be installed during truss erection,in accordance with Stabilizer W2:2x4 SPF No.2 Installation guide. REACTIONS. (lb/size) 2=2124/0-3-8 (min.0-3-5),8=2090/0-3-8 (min.0-3-4) Max Horz 2=-217(LC 6) Max Uplift2=-70(LC 8),8=-100(LC 9) FORCES. (lb)-Max.ComplMax.Ten.-All forces 250(11 or less except when shown. TOP CHORD 2-3=-3072/424,3-21=-2770/442,4-21=-2636/451,4-5=-2443/474,5-22=-2933/484, 22-23=-3056/459,6-23=-3339/457,6-7=-6771/1014,7-8=-6979/986 BOT CHORD 2-14=-186/2421, 14-24=-28/1841,24-25=-28/1841, 13-25=-28/1841,12-13=-28/1841, 11-12=-724/5701,10-11=-726/5699,8-10=-853/6549 WEBS 3-14=-709/220,5-14=-116/962,5-12=-203/1752,6-12=-3419/662,6-1183/1576, 7-10=-367/364 NOTES- 1)Wind:ASCE 7-05, 100mph;TCDL=5.Opsf;BCDL=5.Opsf,h=24ft,Cat.11;Exp B;enclosed,MWFRS(low-rise)and C-C Exterior(2) zone;cantilever left and right exposed;C-C for members and forces&MWFRS for reactions shown;Lumber DOL=1.60 plate grip DOL=1.33 2)TCLL ASCE 7-05,Pf=40.0 psf(flat roof snow),Category Il;Exp B,Partially Exp.;Ct=1.1 3)Unbalanced snow loads have been considered for this design. 14)This truss has been designed for greater of min roof live load of 16.0 psf or 2.00 times flat roof load of 40.0 psf on overhangs non-concurrent with other live loads. 5)All plates are MT20 plates unless otherwise indicated. 6)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 7)'This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 2-0-0 wide will fit between the bottom chord and any other members,with BCDL=10.0psf. 8)Bearing at joints)8 considers parallel to grain value using ANSI/TPI 1 angle to grain formula. Building designer should verify capacity of bearing surface. 9)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 100 lb uplift at joints)2,8. 10)This truss is designed in accordance with the 2009 International Residential Code sections 11.1 and R802.10.2 and referenced standard Al 1. 11)"Semi-rigid pitchbreaks including heels"Member end fixity model was used in the analysis and design of this truss. LOAD CASE(S) Standard II S 3 J 1� t s a � t Ip✓S Fi.,� i PtiCL ion; 1 � !, o v— cz IV . C. 5 as 1 � F �,�� �.fit-_•. Azn 12 12 _ City of Northampton 36"w x 42h Building Department window Plan Review 12 212 Main Street Pointed lap eldng 4 - Northampton, MA 01060 OH OH 1O"OH 10"OH 36"w.x 42h. qawnirg wkxiow XQ 9�w.xx 6'h Gage l �9 a'h Gage 3'x6•-8, -- door 24-0" 32-0" ------^—�-- -^--- -- - STREET SIDE ELEVATION FRONT ELEVATION west south -- -- --- CHEEVERS RESIDENCE -- GARAGE 23 Upland Road Leeds. Ma. 01053 \ 36"w.x 42h- ab n whdo„s YARD SIDE ELEVATION east 4 ACCOR" CERTIFICATE OF LIABILITY INSURANCE DATE`M'�DDI 10/9/2015 15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT HOIISe NAME: King & Cushman Inc. (413)584-5610 � No:(413)584-9322 P.O. Box 447 E-MAIL aD ESS: 176 King Street INSURE AFFORDING COVERAGE NAtC# Northampton MA 01061 INSURERA:Ohio Security Insurance Co. 24082 INSURED INSURERS; David Fortier Builders INSURER C. 32 Laurel St INSAIRERD: INSURER E Northampton MA 01060 [INSURER F: COVERAGES CERTIFICATE NUMBER:CL1510901148 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTTR TYPE OF INSURANCE POLICY NUMBER POLICY£FF POLICY E1CP lJMti3 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE p, CLAIMS•MADE OCCUR PREAMSES Ea oxurrerx e $ 300,000 EKS55722835 12/2/2015 12/2/2016 MED FXp JAM one person) $ 15,000 PERSONAL&ADV INJURY s 1,000,000 GEML AGGREGATE LWT APPLES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECTT LOC PRODUCTS-COMPIOP AGG S 2,000,000 OTHER: Expense Mod Fedor 1 S AUTOMOBILE LIABILITY Ea accident) S ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per aoddent) $ ^ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident S UMBRELLA LIAS OCCUR EACH OCCURRENCE $u EXCESS LIAS CtAIMS4AADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOPJPARTNERIFXECUTIVE E.L.EACH ACCIDENT $_ 100,000 OFFICERIMEMBER EXCLUDEM- N I A A (Mandatory in NH) XNS55722835 9/4/2015 9/4/2016 E.L DISEASE-EA EMPLOYEE $ _ 100 000 B yes,descrbe under DESCRIPTION OF OPERATIONS below E.L-DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 141,Additional Remarks Schedule,may be attached A more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Roger ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street Northampton, MA 01060 AUTHOWZEDREPRESENT� m 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks Of ACORD 1NS025(201401) 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: -3 �!'t�N;� �vfz Lff4,, - The debris will be transported by: 1)4urn -o.�TCa� The debris will be received by: VA 41-Z,!/ Building permit number: Name of Permit Applicant In boiz- Ca-t- Date Signature of Permit Applicant City of Northampton Massachusetts Lj F; y { � DEPARTMENT OF BUILDING INSPECTIONS � :z 212 Main Street • Municipal Building Northampton, MA 01060 ss� S�1Lb INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two- year period shall not be considered a home owner." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made 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 I The Commonwealth of Massachusetts department of Industrial Accidents - Office of Investigations x 600 Washington Street . . ...... :. :. - t Boston,MA 02111 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Con trs-ctor.s/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): DAU 1,3 J- 0 Alf I RIOL (3 ►gn t Address: T;! ` q Uk-4 9-C' City/State/Zip: ko n TT)iU A 10 L-, 0 Phone#: °'(f 3 a Z0 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 6. V New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. 7 Demolition working for mein any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. 7 We are:a corporation and its 10.❑ Electrical repairs or additions 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.❑ 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. �" �/ l- Insurance Company Name: V�(D C U / �!"y s cc)' — Policy#or Self-ins.Lic.#: g U/!S s- 10 Q Expiration Date: Job Site Address: FLAAjo A y City/State/Zip: 1,iQ A` 0(013 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 cerft under a pains and penalties ofperjury that the information provided above is true and correct. Signature: Date: /a 9 Phone# LI? — O6d_ q5 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: e a ! SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: �/�cJid1 N. aS ~ 0 0 C License Number L Sf AJ,2ta k mPix, dn' - 01 V b 0 ') i(6 I lb Add Expirati D e 09&— A2 �� - 33`� SignatuYe 14 Telephone 9 Redistered:Homeimaiovement Contractor;... Not Applicable £ Company Name Registration Number -)I~ o 1 + U Address {�� Expir— a io ate L-� L �e 1 &4:L A 1_'b1J N 01 b 1) Telephoned " 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..V— £ No...... £ 11 .. Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature, i i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House [] Addition [] Replacement Windows Alteration(s) Roofing Or Doors C� 1 0 Accessory Bldg. ®. Demolition ❑ New Signs [O] Decks M Siding [[3] Other[p] Brief Description of Proposed /� a 1 Work:_ �® 6L'il,-) Pt �� v1.4 F;4,t(Z > Oil U ou'g --- 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 andor.adtlltlon.:to existlng hous>Ing -corndfete fhe following: 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? d. Proposed Square footage of new construction. Dimensions e. Number of stories? IF. Method of heating? Fireplaces or Woodstoves 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 j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES'FOR BUILDING PERMIT I, �# 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. Sign ture of Ow er Date 1 r I, AcJt/J -f-v2ilC/Z aver/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. R y to po&T-IRS Print Na e h /I © q Signature Yf Owner gent Date s Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Inforrifation Existing Proposed Required by Zoning This column to be filled in by —fig- Building Department Lot Size p3:3 (. S Frontage ---- —� Setbacks Front Elul Side L: > -- R: - L: R:r� { Rear Building Height "—( y Bldg.Square FootageF % ai ;I Open Space Footage % (Lot area minus bldg&paved M.K parking) 11 � #of Parking Spaces Fill: _..._.....�.._..,.,._.-,...,��.....-,i, .. _,.,...�......�_..�..�,..� , _.w_,.._._.,....-..._.k.......�_. (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 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES Q NO 0 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 Q IF YES, describe size, type and location: I 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 O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. i i ED r Y � Department use only City of Northampton StatusafPermd ' _�..r.... Building Department clip CutlDrtue3ntay Permtl s } OCT W 9 M5 212 Main Street SewerlSepGefkualla611ity Room 100 1Nater/U�et�A ji �a�la6ility Tyr i pi °'' '�` r;^" c�aN Northampton, MA 01060 TwaiSefsol5#r�cturalPra�ts � " 1Jt�RTI A G rh $ T .. 413-587-1240 Fax 413-587-1272 P[of/Site Plans. " 4 .� ._. - -__ - _-^.:nay_. Other Specify r APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION r_ This section to Me completed by office 1.1 Property Address: I ..:Zone --_ Overlay D�stnct s= , - SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT' 2.1 Owner of Record: pp Current Mailin AressNam (Print) ,eCr� Telephone Z y& A4 .��11-t/ C /a te Tel Signature 2.2 Authorized Agent: Nam Print) Current Mailing Address: i MA6 J 0 ^ g -() 93 2 C1 Signature Telephone _T_ SECTION 3 -ESTIMATED CONSTRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 066 00 (a)Building Permit Fee 2. Electrical (b)Estimated Total'Cost of 13 106 60 Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) ciiel Pr,6. 61) CheckNumbe.r This Section For Official`Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector`of Buildings Date File#BP-2016-0487 0 APPLICANT/CONTACT PERSON DAVID FORTIER r ADDRESS/PHONE 32 Laurel St NORTHAMPTON01060(413)586-8965 I J "" PROPERTY LOCATION 23 UPLAND RD MAP 11A PARCEL 026 001 ZONE URA000)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid J Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 32 X 24 DET GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 008026 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9,RMATION 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 /!) ig re of Buildirg 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. 23 UPLAND RD BP-2016-0487 GIS#: COMMONWEALTH OF MASSACHUSETTS Ma:Block: I IA-026 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:GARAGE BUILDING PERMIT Permit# BP-2016-0487 Project# JS-2016-000823 Est.Cost: $57160.00 Fee: $154.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVID FORTIER 008026 Lot Size(sq. ft.): 18861.48 Owner: CHEEVERS NANCY Zoning. URA(100)// Applicant: DAVID FORTIER AT. 23 UPLAND RD Applicant Address: Phone: Insurance: 32 Laurel St (413) 586-8965 NORTHAMPTON MAO 1060 ISSUED ON:1011912015 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 32 X 24 DET GARAGE 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 10/19/2015 0:00:00 $154.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner