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31C-032 (2) r M w , CV 13 LOT A15 N LOT A17 LOT ," A1'9 FF FF N FF 5 221 .5 222.25 %,-223. 75 .' ^ _VI Al } :h } Lo o Lo a N N N N N r N S N N ^ N City of Northampton Massachusetts r, DEPARTMENT OF BUILDING INSPECTIONS f 212 Main Street • Municipal Building S> Northampton, MA 01060 ssNy ��` Fee Calculator for Residential Properties Location : ! ' '! Mosc--g- S Square Footage Amount Basement @ .20 ) c Z b O 1 ST Floor @ .50 Oz- 2 nd Floor @ .50 '/ Floors, Finish Attic, Garage @ .20 1 1 0 74 Deck / Porches @ .20 Z Total : 7'2 Registry ID: Rating Number: HERS-528 Certified Energy Rater: Matt Turcotte Rating Date: 12/22/15 119 Moser St Rating Ordered For: Northampton,MA 01060 Estimated Annual Energy Cost Projected Rating 5 Stars Plus Use MMBtu Cost Percent Projected Rating: Based on Plans, Field Confirmation Required Heating 28.9 $420 31% Uniform Energy Rating System Energy Eff icient Cooling 1.4 $71 5% Hot Water 9.4 $132 10% 1 Star 1 Star Plus 2 Stars 2 Stars Plus 3 Stars 3 Stars Plus 4 Stars 4 Stars Ptus 5 Stars P70",rLs, Lights/Appliances 14.3 $729 54% 500-401 400-301 300-251 250-201 200-151 150-101 - - Photovoltaics -0.0 $-0 -0% HERS Index: 559 Service Charges $0 0% General Information Total 54.0 $1352 100% Conditioned Area: 985 sq.ft. HouseType: Single-family detached Conditioned Volume: 16245 cubic ft. Foundation: Unconditioned basement This home meets or exceeds the minimum Bedrooms: 1 criteria for all of the following: Mechanical Systems Features Heating: Fuel-fired air distribution,Natural gas,97.0 AFUE. Cooling: Air conditioner,Electric,16.0 SEER. Water Heating: Instant water heater,Natural gas,0.95 EF,0.0 Gal. Duct Leakage to Outside: 10.00 CFM25. Ventilation System: Balanced:ERV,35 cfm,24.0 watts. Programmable Thermostat: Heating:Yes Cooling:Yes Building Shell Features Ceiling Flat: R-59.2 Slab: None Sealed Attic: NA Exposed Floor: R-0.0 Vaulted Ceiling: NA Window Type: U-Value:0.300,SHGC:0.250 Above Grade Walls: R-26.0 Infiltration Rate: Htg:2.00 Cig:2.00 ACH50 Foundation Walls: R-10.1 Method: Blower door test Lights and Appliance Features TITLE Percent Interior Lighting: 80.00 Range/Oven Fuel: Electric Company Percent Garage Lighting: 80.00 Clothes Dryer Fuel: Electric Address Refrigerator(kWh/yr): 0.00 Clothes Dryer EF: 3.01 City,State,Zip Dishwasher Energy Factor: 0.00 Ceiling Fan(cfm/Watt): 0.00 Phone# The Home Energy Rating Standard Disclosure for this home is available from the rating provider. Fax# REM/Rate-Residential Energy Analysis and Rating Software v14.6.1 This information does not constitute any warranty of energy cost or savings. ©1985-2015 Noresco,Boulder,Colorado. 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: I II M O'S EP- R-z(--T The debris will be transported by: Assuc,ir-'N-c- �> r�v� -�;+�� �► �-t-��RS The debris will be received by: Building permit number: Name of Permit Applicant Ktfl►�r PeCOY AND sons , 1tiL. GG/ Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents w Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): K E r,�i P E r oy t<nj u so N f c ;n ,c 1 nt,J F t N (- Address: zti i�At_A i tJ ;T W Shi�c iJLryF tE� ,t`P 6� C� 1 4 `j City/State/Zip:u­ t-Ary ow t,3 Phone #: 3 ?, I —7 UC t, Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 3 U 4. ❑ I am a general contractor and I 6. 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 g, ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.E] 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. t Homeowners 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: PS p Q vow S tL i t VN,_,c-( Policy#or Self-ins. Lic. #: y.;M-z- 'd co P u C'10�,,23 -,;t r� 1-4,q Expiration Date: Job Site Address: 1101 O u`,ee- ST City/State/Zip: W or iii Pt o rt Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and r the pains and hies of perjury that the information provided above is true and correct Signature: Date: �- Z Phone#• C`��'�� 7 U- 7 00 e, Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: (<EN 1 PECc)/ (" - 052-5 A License Number 215i1)k\i-7WiM ST- \rl.SPt?1 61=ir=L-6 MA 6Ii1�•`1 9 — Ib- 1z Address Expiration Date 913 Signature Telephone 9.Registered Home improvement Contractor: Not Applicable ❑ KecrIT P'6:(or At�lb soNS CGNJsTP-,'4:T10JJ Jr'JCr 10-7-N,,� Company Name Registration Number 2.15 t-tZ�,,I K7 �T. ��! "d'P- i j(�7,F 1 k�L-0 MA (:10 J -7-31 - 1 to Address � Expiration Date TelephonWJ 1 3)-? C1 --7 GC 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....... N 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 El Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding[01 Other[O] Brief De nppti n of Proposed L i_ ` L. Work: (��"�S�YU(_1 Y\f� I bL `s� In16 e 1L�6t`ll��f o'n - il-b r1Lia, y.%iik a e�e1ld W Ot1C Ci i- a�uge. Alteration existing bedroom Yes-,X—No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes K,No Plans Attached Roll -Sheet 6a. If New house and or additii . on to existing housing, complete the followin a. Use of building : One Family x Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? N U i i i1 d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating?�1 � FCI�L�t� f1R Fireplaces or Woodstoves d Number of each g. Energy Conservation Compliance. y .S Masscheck Energy Compliance form attached? C h. Type of construction W DO t7 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 -7 k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer_x Private well City water Supply _ SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, XU-NI P EC 0' as Owner of the subject property hereby authorize BPS Ret JNJ to act on my If in all matters a to work authorized by this building permit application. Signature of Owner A// Date I, ��F4M IZ�tJi�Ul'� 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. N),NM 1' F NhiJ f� Print Name Signature of Owner/Agent Date F r-,TTI',(—"- -t SIT iplJ�h 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 Setbacks Front IUD Side L: R: _ L'< 16 R:'_ `1 Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) 2 #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW Q YES 0 IF YES, date issued:' IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES IF YES: enter Book Page, and/or Document# B. Does the site contain a brook, body of water or wetlands? NO � DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES Q NO t 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 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 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Peirntt Building Department Cu rb , 212 Main Street SrtJSept�Ayeitt�bl�r � i Room 100 1IVetu�ell A�vll>ttity ;, Northampton, MA 01060 Tw ?8tsatctufer � phone 413-587-1240 Fax 413-587-1272 #rk7 'lefi ": w APPLICATION TO CONSTRUCT,ALTER,REPAIR RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION A- 1.1 Property Address: This section to be completed by office 01 GSP r Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUT ORIZED AGENT 2.1 Owner of Record: I<eNT na-(Oy NwN SCE!s S- 2-15 I3AupWih� S-T 4'V.SPP_\fJGPl(;_ j .'MA, 01061 Name(Prin Current Mailing Address: (gin -7?,,1-_7CQ8 Telephone Signature 2.2 Authorized Agent: Mann ke+nak� 7-15 BaL-©yj,(v si W .s P�t�LFtc�p � r'lA C31t� � Name(Print) Current Mailing Address: S4peirure Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building bs -� 50 (a)Building Permit Fee / 2. Electrical (b)Estimated Total Cost of 1 Construction from 6 3. Plumbing L S C✓ Building Permit Fee f r '� 4. Mechanical(HVAC) 1 5. Fire Protection 6. Total=(1 +2+3-+4+5) 2( 3 6c0 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File# BP-2015-0943 APPLICANT/CONTACT PERSON KENT PECOY&SONS CONSTRUCTION INC ADDRESS/PHONE 215 BALDWIN ST WEST SPRINGFIELD01089(413)781-7008 PROPERTY LOCATION 119 MOSER ST-LOT A17 MAP 31C PARCEL 032 ZONE PV 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 SFH W/DET GARAGE/PORCH New Construction Non Structural interior renovations Addition to Existing- Accessory Structure Building Plans Included: Owner/Statement or License 052589 3 sets of Plans/Plot Plan THE FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* --Received& Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demoli Si re 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. 119 MOSER ST-LOT A17 BP-2015-0943 G1S #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31C-032 CITY OF NORTHAMPTON Lot: - 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-2015-0943 Project 4 JS-2015-001823 Est. Cost: $290000.00 Fee: $1055.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KENT PECOY & SONS CONSTRUCTION INC 052589 Lot Size(sq. ft.): 4378.00 Owner: KENT PECOY& SONS CONSTRUCTION INC Zoning: PV Applicant: KENT PECOY & SONS CONSTRUCTION INC AT. 119 MOSER ST - LOT Al Applicant Address: Phone: Insurance: 215 BALDWIN ST (413) 781-7008 WC WEST SPRINGFIELDMA01089 ISSUED ON.•11612 01 6 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT SFH W/DET GARAGE/PORCH 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 1/6/2016 0:00:00 $1055.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner