06-038 (3) 319 HAYDENVILLE RD BP-2008-0812
GIS#: COMMON\ 'ALTH OF MASSACHUSETTS
Map:Block:06-038 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2008-0812
Proiect:I JS-2008-001252
Est. Cost: 52450.00
Fee: 550.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Grua Homeowner as Contractor
Lot SizeLq. ft.): 11238.48 Owner: HAFFMANS GREG
Z.onirw: SR Applicant: HAFFFMANS GREG
,l pplicaret Address: Phone: Insurance:
237 CHESTNUT ST (413) 575-8488 ()
FLORENCEMA01062 ISSUED ON:3/27/2008 0:00:00
TO PERFORM THE FOLLOWING' WORK:CONSTRUCT KITCHEN CATHEDRAL CEILING
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: /78480.4 House# Foundation:
Driveway Final:
Final: t
J< Q(JB '*IV Rough Frame: 0 k
Gas: Fire Department Fireplace/Chimney:
Rough: _ Insulation: OK 0 41/(o/a'Q tout;5
Final: Smoke: rinat: dkc C,4,t,�C`�y ,44)
THIS PERMIT MAY BE REVOKED BY THE CIT )F NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy / Siature:
Fee"fvpe: Date Pai : Arnottttt:
Building 3/27/2008 0:00:00 3.50.001130
2I2 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File€ BP-2008-0812
APPLICANT/CONTACT PERSON HAFFMANS GREG
ADDRESS/PHONE 237 CHESTNUT ST FLORENCE (413)575-8488 O
PROPERTY LOCATION 319 HAYDENVILLE RD
MAP 06 PARCEL 038 001 ZONE SR
.HIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE.
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Ice Paid //850 456
1 spool Construction: CONSTRUCT KITCHEN CATHEDRAL CEILING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/ Plot Platt
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF .IATION PRESENTED:
Approved_Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Imermediate 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
dam'! laZ �O
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.
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Department use only
City of Northampton Status of Permit:
Building Department Curb Cut'Dnveway Permit
212 Main Street Sewer/Septic Availability
Room 100WafebWe4Avaaabacty
Northampton, MA 01060 Two Setsl "Val {t71 L":""phone 413-587-1240 Fax 413-587-1272 Plousuew 44��'' lei . L'1
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISHJA'ONE CP4Asd QTlaWEI.LTNG
ewe `- a 1
SECTION 1 -SITE INFORMATION W` I Pc s'YS
1.1 Property Address'. �.._ ��� This'S�tti....Mbee ' 'tN":
A---'-'--
5191 6UYy01er?n/ro kW Map Lot Unit
ee /l/J 40 (2//o/-5-..?.. Zone Overlay District
Elm St restrict CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
re w . ,;4 . c„sitz f t 1i p
Name(Print Current Mailing Address:
I' ,U.f/iji Telephone
Signature
2.2 Authorized Agent:
.44/C cat- 5:6116,PP
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COST$ `..
Item Estimated Cost(Dollars)to be - Official Use Only
completed by permit apolicant
1. Building •)/�O�/ n0 'ra)`Building Permit Fee
2. Electncal d {b)Estimated Total Cost of
� �- O((] Construction from(6)
3. Plumbing BuildingPermitFeef
4. Mechanical(HVAC) w Soo" tril4
5. Fire Protection
6 Total=(t +2+3+4+5I Check Number 113 �7 1 ca _J
This Section For Official Use.Only
Building Permit NumberDate
Signature
Building Commissianei/Inspect55 YOulydmgs ". Date
w
ISection 4, ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be tilled in by
Building DTanse,u
Lot Size ... _ ._ ....
Frontage _ ,_____ ___.. _ ..._ _..__._ __.:
Setbacks Front --- -i` _—""--
_ .. —.__.
Side L .. R.._—: L _. R.
Rear
Building Height ,, _
Bldg.Square Footage
Open Space Footage _ % ..._.., --.-
(Lot ora mine Bldg&paved _ _ ._ ..._—_
k of Parking Spaces
(ve cone&Locations
A. Has a Special Permit/Variance/Finding ever been icnned for/on the site?
NO Q DONT KNOW (D YES Q
IF YES, date issued:
W YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES Q
IF YES: enter Book Page and/or Documente#txy
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW YES Q
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 Q NO G
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 f4
IF YES, describe size, type and location: � — •— __ ,._. _..__._...._____v��/
E. Will the construction activity disturb(pc�learing,grading,excavation,or filling)over I acre or is it part of a common plan
that will disturb over I acre? YES V NO
IF YES,prep a Northampton Slam,Water Adanagernent Permit from the DPW is required.
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SECTIQN 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Atteradon(s) vi Roofing
Or Doors Ci +�
Accessory Bldg. L. Demolition El New Signs IO] Decks [CJ Siding[O] Other[D]
Brief Description of Proposed r.'EM.onE a:n.4NCr fait CATHenI L us) Kt-Mt-1eF}
Work. `/
Alteration of existing bedroom Yes •----/No Adding new bedroom yes k./No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roil -Sheet
Ba. If New house and or addition to existing housing, completethe 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
a Number of stones?
f. Method of heating?
A 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 or basement or cellar floor below finished grade
k. Witt 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_
Signature of Owner 97y hate
I, - Al rAtaI.?///121 ' as owner/Authorized
Agent hereby declare,at the state -or is and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Signed under the pains and penalties f penury.
lr
,i //
: 'tf at.
Pent Print Name
fl
I '--e ( " IT✓ t ` f��f�8
ISignature of Owner/Agent / Date
a
SECTION 8.CONSTRUCTION SERVICES
f_
$.1 Licensed Construction Supervisor: 3 Not Applicable 0
Name of License Holder
License Number
Address - Expiration Date
Signature Telephone
8.Registered Home Improvement Centragtmr , Not Applicable 0
Company Name Registration Number
Address Expiration Date
Telephone
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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 0 No 0 ___ _J
ii.-font ® er:Eiemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 1083.5.1.
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
stmrnues.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 buildin°permit
As acting Construction Supervisor your presence on the job site will he required from time to time,during and upon
completion of the work for which this permit is issued.
Also he 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 mai,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_ /yqn iHrt,iLAY/4f.
/j 11
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,;_ ,4 Office of Investigations
600 itasitingten Street
- ---_-
Boston, .11-1 02111
=.T - www.massger/V7i'a
%Workers' Compensation Insurance Affidavit: Builders/Contractors lleetricianciPlumbers
Aoo;icant Information Please Print LesibI%
Mame !. us:r=_ss.Orgy:czaacn:'Ind:rid'-alt(
�1^� � �//�L%
duns : sly �1p �� x'.11 ��
CihYSta;te/Zip: lr"e--t ' �'" y of/et "_ Phone '4: � ? C' _ er
Are you as employer? Check the appropriate box: Type of project(required):
1 ' _U St nio er a i,L 1 i am a genera/contractor and 1
pi
ca _ (F E and'orpan-time) '
have/tired the sub-convacto, 6_ C New ws !ctiuc
2.[] I am a sole proprietor or partner- listed on the attached sheet. Z IPT Remodeling
ship and have no employees These sub-contractors have g. 7 Demolition
wor'r 8yemployees and have workers'for me in any capacity. 9_ , I Buildhig addition
[No workers'compirs•.rnce comp.insurance
eq '.j 5. ❑ :-s We are a torpor ion and 10 D Eiect cal repass or additions
I.X I aro homeowner doing all work lr esed repairs or additions
I m. e l[ No workers' comp. tiorsnt cess of exehampm exercised pa M6eL IL11 PlumbingL Roof repairs
insurance regw.ed.Jt c 152, 51( ),and we have no
employees. [No workers' 13.❑ Ocher
I conn. insurance required.]
"Ary applicant that checks box CI must also ell aur the section below showing their worked compensation policy information.
i.
Ho .- wcct who s:icmic pas a._tda- t irdicaring they are doing ail work and then hire onside contractors midst submit a new av5davit thdicating such_
: ..,_--.
.. -
..,v arse check this :,
bemust:^ached an additional shoot snowing thename of to sub-cocvattots and state whether or not those entities have
env ioYees if do soh-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:
Poi.cy a or Self-ins_Lic. K: .Expiration Dare:
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Job Site Address: _City/State'Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Fatiure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a
tore up to SI,500.01 andior one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up no 5250 00 a day aeninav the violator. Be advised that a copy of this statement may be forwarded to the Office of
Gmesegarons of the DLA for insurance Coverage verification.
I do hereby certii:azdrrhr ',Losnot/pendties-ef pe jur.ntkebthe information provided above is true and correct
c
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' one=' l "� ♦ ° . . ....
:afteeiar. c'._-r -12e, r Iry fvlhis.area.._w_b., 1 m.feted by cify town a pial 1
J1 11
Cir. or Town: Per nitLicense p _ .— )1
111 los:Jinx Au:rorty (circle one):
o
11 j. Board of are_.: Building Dena.._ent 5. Dry Tow_ Clerk 4.Elear:eal Inspector 5. Plumh = Inspector
.I b. Oche.
r ,o.,>c P sen: Phone-: I
.Ja _
. n`
-- wi _
Ca
W. Sam • :4(f_._t l
.a _—: is._
f Nr:tr.a!zpur. M-. C:Gcc
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HOME C'r'Y. r_R i _i: ru TIO .%if_. it'OW f7DGEMIr' r
Me Stere of3,t._:sacbtsecs allows ee hom eow.:ei t-e rich:rider i€OCMR iO& 4 to I
cc az me" cr cohsmoczon gap The "fu"< "Homeowner- ".'J>on-Is)
o owns a camel on which hashe e resides or intends to be a age Or IWOf61rwy
cee c2±ed or ecacized stmommes. ac-erne;to such use andlor arra stmacithes. A I
iper son Fac const uaz more-bez ore home m a:c-year ere:od c . .S no:be cccsda .:a 77Z
home a t ." J
Thebelie detc'c egn for the Cloy of Ncrlicantozor'Cyr--n err pe:sci:(s) who seek to
use "eno."..sGana exemption to anas their owe c:..r..S-.?thous_- 'iscr to be eare
that by doing so jou become responsible for compliance with state building codes
and ret=ailers.The inspection proce reemaires that the build ng dep an ent be celled
to inc ect work m vim:-us sages, which iochude foundafonlfoott is Coefore baci+*Ill.
sorozabe bels(before your). a rough banldinsinsaelca(before work is
canetelern.iasatilos-i:saecti.en-Cif reaufrS)sada..fin el brit;^n;ealertiec.The
_ -.
betide.."2 de„e u.,elt requires these isvec^'i.'ocs before the work is cora-Mat ure to
secare tsese-inwectionsinn result in failure to abtei•' a cert) cate of ocevpaicv
lithe hoteetiamer hires other trades to perform work helech:c>,plumbing So:ergs) the
homeowner will be respoasible zo make sure that the Lades hired se.cure their proper
per—._lits in c„}urc oc to the turn=^C permit issued, and that they get their required
inspecriots.Fat e of-the individual trades to sae the pa-mitts and ince ;as as
re;nirw an DELAY the proiec until suck lima as the proper pe it'r and inspections are
Jnr. _
(7.7 rf
' 1r" 0 inigpi.0 ___._. ,_der nn¢the abort
(acme c.- ere fresid ars signature requeeJa_ecerapuon)
I will aai to schedule all recur ed buildingi spe ion`nece:sa:y for the bu ng permit
issued to me.
Daze s =J is 4,9®®- '/A, P /
leaner. 7r`cch -"fel /.- __
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KeyBeam n v1n
BOLLARD
,B,..,64.50;{91BGmrne 4.503h
•mmsleayslce ]g>
Member Data _—... ------
DesOdptian: rrlmnerT Ta PearlPnlAlt •m' +
I ,tqr Bq ent:nuouS Top Slopet
Standard Load. 'tun- t +: Dry 6 0,: -ICC.1i C 1
Dead Load: lb Pl.- + tIe l a ill.,t : 6r hv+;. S240 total 1 000"m r l,
I Snow Load: 30 r:! : Sr.:c4 ii- rrMier: P-1,21pti Membp..i 2,1e toht 1 S.6 FLc
t Ftrn n [ P „Li1
Other Loads
Type TSttart iter 11
(Description) P n hap Wrdth dth Sian but Start End Calegory
il
nt
1 AdditionUndo ntor t , n -.. 23ii _._ 1_.... ' " 1'
Additional Unitonr:{1- � r'I �! '7_' O.UO"
---- 5' O 12' 0.00' p , !
,5c, "
I
Lt, ,
IBearings and Reactions
Location p•, rt enrnh M Redoe'� ort',Rea,non C awn Up!ar
1 1 0 0000' nrr. ., ,..- n -
Maximum LoadC so N I 1.6.1 toE.r 1'.
I 2 14 6
ad agow
2 _r...a r .._.!,
IV
Design spans
14' 6,5G'
Product:2 0 R'1idI 4 A I iti n-p
Component Men tx n - 1 A D v '*F I
Design.sarmr t ,, I on,y hroctr,ri:Hi.cry l'hn ton rheru.
I Allowable Stress design
rte—: A!ioucbie Sposcrty Loatmn Leading, I
Positive Momen[ r odd L - I
Shear ';�'II V,P2 1a Iota'L._o rt . _
Max.Reaction I
q
LL ODtieflectten t b." +./F lt i.n' "'Pt!,• ... F
TL Deflecon
_ _.. ._.. 045-'- 4eb )<b_ IrG-ta I, I. t+S+ _ _ _1
Control TL C flect a.
DOL L ono
Design une rr ^,-t
II
ManNadulera ror,ta. + Ir r r� r nrerrII e.
II
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II
II
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