23A-181 16 PINE ST BP-2018-1103
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23A- 181 CITY OF NORTHAMPTON
Lot -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2018-1103
Project# JS-2018-001984
Est Cost$40000.00
Fee: 5260.00 PERMISSION IS HEREBY GRANTED TO:
Const Class: Contractor: License:
Use Group: HANS DALHANS 101628
Lot Size(so.It.): 20298.96 Owner: PYLE WILSON
Zoning: URB(I00)/ Applicant: HANS DALHANS
AT. 16 PINE ST
ApplicantAddress: Phone: Insurance:
11 CHERRY ST (413) 977-6094
EASTHAMPTONMA01027 ISSUED ON.412712018 0:00:00
TO PERFORM THE FOLLOWING WORK MOVING A BATHROOM TO MAKE A 1/2 BATH
AND RENOVATE BACK PORCH TO MAKE DINING SPACE
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:
FeeTvpe: Date Paid: Amount:
Building 4/27/2018 0:00:00 $260.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File 4 BP-2018-1103
APPLICANT/CONTACT PERSON HANS DALHANS
ADDRESS/PHONE 11 CHERRY ST EASTHAMPTON (413)977-6094
PROPERTY LOCATION 16 PINE ST
MAP 23A PARCEL 181 001 ZONE URB(l00)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
NCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstruction: MOVING A BATHRO MAKE A 1/2 BATH AND RENOVATE BACK PORCH
TO MAKE DINING SPACE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 101628
3 sets of Plans/Plot Plan
THE FgELOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INJF9KMATION 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
emolition Delay
gnamre ofBuildiq official Date
Note: Issuance of as 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.
i Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
—'--. City of Northampton Status of Permit Department use only
Building Department Curb CuVDdwway Permit
212 Main Street Sewer/Septic Availability
G Room 100 Water/Well Availability
Northampton, MA 01060 Twd Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PloVSite Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTON 1 -SITE INFORMATION R
This section to
1. I' w'4 r now 3iA LM � ' y �etl by office
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
i�kk r JL. e i�—
2- Authorized A M:
me(P- Current ling resx
x(13 - i 77 —60ti�1
Sgnaturs Tekvhone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 0 OO (a)Building Permit Fee
2 Electrical (b)Estimated Total Cost of
I WJ Construction from 6
3. Plumbing S— OUO Building Permit Fee
4. Mechanical(HVAC)
��
5. Fire Protection
6. Total=(1 +2+3+4+5) W. Check Number TO
This Sectloo For Official Use Only
Building Permit Number: Date
l Issued
Data
Signature: .r
Building Com i ioneninspeclor of Buildings Date
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4.:FZ71 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 Demomme
Lot Siac
Frontage
Setbacks Fmnt
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
I1ct mem mini.bid,&w.w
km.,
p if Parking Spaces
Fill
(,vinme&LaLiinn)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and location:
E Will the construction activity disturb(deanng,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will diatom over 1 acre? YE-0 NO O
IF YES,then a Nothampton Storm Water Management Permit from the OM is required.
SECTION S DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows AN Minnie) ® Roofing ❑
Or Doors in I
Accessory Bldg. ❑ Demolition ® New Signs ED] Decks ® Siding ERI Other EM
Brief ppgqscri tion of P o 0
Work1"I P'r�] 7?,V, L4 aj
Alteration of eAs ing bedroom Yes No Adding new bedroom Yes X No 1� �1i0/`� �y
Attached Narrative ` ' Renovating unfinished basement Yes No T
Plans Attached Roll -Sheet yQS
Be.If New house and or addition to existing housing, complete the following:
a. Use of building One Family Two Family Other
It, 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?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheda Energy Compliance form attached?
h. Type of construction
Is construction within 100 N.of wetlands? Yes Na. Is construction within 100 yr Floodplain_Yes No
j. Depth of basement or cellar Noor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No
I. Septic Tank_ CitySewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
a.: r
I, ,as Avner o/the subject
property I
\ T
hereby authorize 1 /21 GVH fns(\(}�,�1'�`(U . I.Y\C
to ad on my be alk all mattem relative to wont Authorized by 11fits building permit applica ion.
as Owner/Authorized
A nt ereby deda at the statements and information on the foregoing application are true and accurate,to Ne best of my knowledge
antl ie/
Sig ed under the pains and penalties of perjury.
G
Pn t Name
'V lfa/ b
-Signature of Ownen Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Su rvisor: Not Applicable ❑
Name of Ucense Haider: ) v (S—It, 6,1 G
License Number
Address Ex irati Date
ure Tillepwna
9.Re Iatered llcaras roverrlem Contractor: Not Applicable ❑
Chs i0149
Calm n Name 1 Regi tration Number
I Jc, � e-v:n cif '0P4 p1�1 Z 11g
Address G / Exprabo Date
�) L _ Telephone` I 1 i6 01,
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and saturated with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes.__. b No__.. ❑
City of Northampton
14assachusetts
L DEPARR OF BUILDING INSPECTIONS - /1
212 Mein Strcet • Mu,icipal Building r V s+
Nottt,empWn, Mn 01060 rry x
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR") regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes. Prior to
performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconstruction, alteration,renovation, repair,modernization, conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing ownerbccupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence w building"be
done by registered contractors.
Nate:If the homeowner has contracted with a corporation or LLC,that entity mast be registered
Type of Work: yRp A \) Est.Cost: b Qu )
Address of Work:
Date of Permit Application:
1 hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law(explain):
Job under$1,000.00
Owner obtaining own permit(explain):_ _
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.C.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
1 hereby apply for a building permit as the agent of the owner:
Date Contractor Name T HIC Registratr No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
City of Northampton
$� Massachusetts
t: c
LEPARTMENT OF BUILDING INSPEOTIONS
y 212 Nein Street • Mu,—P.1 Hniltlinq V \'i
NorNa ton, ! 01060
Massachusetts Residential Building Code
Section 110.R5.1.2
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.
Section I I O R5.1.3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s)
for hire to do such work, then such homeowner shall act as supervisor.
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.
City of Northampton
Massachusetts rs
DEPAItTMElIT OF BOILDING INSPECTIONS
212 Nein Street @l ieipal Building
No:Kempton, w, 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c40, 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.
The debris from construction work being performed at:
�� �
9
(7a (
n
(Please p' int house
number an street name)
Is to be disposed of at:
(Please print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company a and Address)
7
Ignature of Permit licant o ate
If, for any reason,the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston,MA 02114-2077
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:General Businesses.
TO BE FILED WITH THE PERMIFIING At rHORITI'.
ADDlicant Information Please Print Legibly
Business/Organization Name: " C C.JS
Address: (, PVW `71'k
l
City/State/Zip: � � A olaone#: Vif> T11 605xl
Are you an employer?Check the appropriate box: Business Type(required):
11-1 1 am a employer with employees(full and/ 5. ❑Retail
or part-time).' 6. ❑Reslaurmt/Bar/Eating Establishment
2.❑ I am a sole proprietor or partnership and have no y. ❑Office and/or Sales(incl,real estate-auto,etc.)
employees working for me in any capacity.
)No workers' comp.insurance required] g. ❑Non-profit
1EM We are a corporation and its officers have exercised 9. ❑Entertainment
their right of exemption per c. 152,§I(4),and we have 10❑Manufacturing
no employees [No workers'comp.insurance rcquiadj'
q.❑ We are a non-profit organieation,staffed by volunteers, 110 healthCere 7
with no employees. (No workers comp.insurance req.] 12.®Other �Of)4yj tk�
•Anyy,cosrttM1a�checksave exempted
.v eprkoepolicyinfet,Io�.
",,m coryora.ldeho,kM1ave exempad themselves but the m,q,a�ion has otberemployee;awoAers wmpensanon policy is required nml sucM1 an
organirs�ion should cM1cck box.I.
I am an employer that is providing workers'compensation insure neefor my employees. Be/ow is the policy information.
Insurance Company Name:
Insurer's Address:
City/Slale/Lip.
Policy#or Self-ins.Lic.# Expiration Date:
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
fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine
of up to$250.00 a day against e violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA!]�Ilrxhmhrec verification.
l do hereby carol u r they I s o ties oftwetury that the information provided above is true and correct
Si oatua Date:
Phone#: 6 0G
OOfcial use only. Do not write in this area,to be completed by city or town ofciaL
City or Town: Permit/Licemse#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Tomo Clerk 4.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
w ve nvsssgov/dia
Information and Instructions
Massachusetts General Laws chaplet 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as'L..every person in the service ofanolher under any contract ofhire,
express or implied,oral or written"
An employer is defined as-'ad individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in ajoint enterprise,and including the legal representatives ofa deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the
owner ofa dwelling house having not more than three apartments and who resides therein,or the occupant ofthe
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence ofcomplimme with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence ofcompliance with the insurance
requirements oflhis chapter have been presented to the contracting authority."
Applicants
Please fill out the workerscompensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply your insurance company's name,address and phone number along with a certificate of insurance.
Limited Liability Companies(LI,C)or Limited Liability Partnerships(LLP)with no employees other than the members
or partners,are not required to carry workers'compensation insurance. Item LLC or LLP does have employees,a policy
is required.Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of
insurance coverage. Also be sum to sign and date the affidavit The affidavit should be returned to the city or town
that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you
have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the
Department at the number listed below. Sal Finsured companies should enter their self-insurance license number on the
appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
ofthe affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/Iicense number which will be used as a reference number.In addition,an applicant that
must submit multiple permit/icense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary). A copy ofthe affidavit that has been officially stamped or marked by the city or town
may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit
most be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business
or commercial venture(i.e.a dog license or permit to bum leaves etc.)said person is NO'I required to complete this
affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street
Boston, MA 02114-2017
Tel. #617-727-4900 ext 7406 or 1-877-MASSAFE
Fax#617-727-7749
www.mass.gov/dia
Pam R—s i 02-21-15
B—m1611010 16 Pine st 4 9-1
R` F,mWwna Florwce 910a
mnoewmmti im
1 of
Member Data
)escription: Member Type: Beam Application: Floor
Top Lateral Bracing: Continuous
Bottom Lateral Bracing: 0.00
itandard Load: Moisture Condition: Dry Building Code: IBC/IRC
ive Load: 40 PLF Deflection Critena: U360 live, U240 total
)ead Load: 10 PLF Deck Connection: Nailed Member Weight: 7.3 PLF
Filename: Beaml
)cher Loads
'ype Trib. Other Dead
Description) Side Begin End Width start End Sart End Categor
ieplacemem Uniform(PSF) Tap 0' 0.00" 8' 0.00" 6 0.00' 30 10 Lim
idditional Uniform(PLF) Top 0' 0.00" T 6.00" 0 80 Liv,
\dditional Uniform(PSF) Tap 0' 0.00" 8' 0.00" 7 0.00" 35 15 Sna.
T
Boo
O 0
Boo
3earings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
0' 0.000" Wall SPF#K3/Stutl2x or4x End-Graim(650si) WA 1.500" 2324# -
8' 0.000" Wall SPF#3/SWda a 4.En6Grain(650psi) WA 1.500" 2282#
Aaximurn Load Case Reactions
isM brgpylrg pa LoMsrw��rai ybcaMTB^g^bws
Live Brow Dead
]33x Se&t 1025IX
]:f SN 939p SFW
)esign spans
F1]
Product: 1-3/4x7-1/4 VERSA-LAM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS
Connect members with 2 rows of 16d common nails at 120"oc
Minimum 1.50'bearing required at bearing#1
Minimum 1.50'bearing required at bearing#2
Design assumes continuous lateral bracing along the top chord.
Design assumes maximum unbmced length of 0.00 a"the bottom chord.
Ulowable Stress Design
Actual Allowable capacity Location Loading
'ositive Moment 4730.'# 9634.'# 4W. 4' Total Load D+0.75(L+S)
,hear 19624 55441 35% 7.49' Total Load D+0.75(1-+S)
L Deflection 0.1981" 0.4073" 1-/493 4' Total Load 0.5D+0.75(L+S)
L Deflection 0.1421" 0.2715" U688 4' Total Load 0.75(L+S)
:oMrd: LLDMleclbn
DOLS: Lva10p'/e Snvv-115 a Raol=125'k Wirvl-ilia'/
1-,L - � 1 _1� e�