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23A-060 (6) 59 MAPLE ST BP-2020-0877 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A-060 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTER1.1)CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2020-0877 Project# JS-2020-000156 Est.Cost: $3323500.00 Fee:$1256.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group HANK SILVER 108530 Lot Size(sg.ft.): 17903.16 Owner: TREWORGY JOHN Zoning: URB(100)/ Applicant: HANK SILVER AT. 59 MAPLE ST Applicant Address: Phone: Insurance: 53 Old Stage Rd _(917) 902-2998 Liability MONTAGUEMA01351 ISSUED ON:2/10/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-NEW 2 STORY ADDITION 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 2/10/2020 0:00:00 $1256.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of Northampton Status of Permit: Building Department,/44/ 3, CurbCutJDriveway Permit f- 212 Main She 90 90 Se/Wer/SelStic Availability L Room 100 Opr VyraterNVell Availability Uig ? Northampton, MA 01060�,,,'Al,� wo Sgts of Structural Plans -/0,,, Plot/ to Plans phone 413-587-1240 Fax 413-55 n(, - \` Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION a' r This section to be completed by office 1.1 Property Address: �P' 9 JKAP LC (-'T Map Lot �t.e Unit. -- Zone Overlay District Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: c� Name IPrim ' Current Mailing Address: _ Telephone Signat 2.2 Authorized Agent: AAAW- I�o�ve o ItMB�Lt. t�5 tgL) s3 OLD -s- cgrya'*[) A6kiboll u� Name(Print) Current Mailing Address: 609 - 1496 N 79 3 Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com leted hy nprmit a licant 1. Building 2 76, 00C) (a)Building Permit Fee 2. Electrical 000 (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee / 4. Mechanical (HVAC) �l f : 5dp 5. Fire Protection 6. Total =(1 +2+3+4+5) 30 3 Check Number fJ n This Section For Official Use Only �( '� U` gly Date Building Permit Number: I Issued: —— Signature: JV Building Commissioner/Inspector of Buildings Date 9yK�jSrL.vG-(- @ C m4IL . Cc, \- EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 Side L: (b R: / _5 L:_)I`G R: Rear N 2 Building Height Bldg. Square Footage b j 9 f o Open Space Footage % S (Lot area minus bldg&paved I q 7 ' parking) #of Parking Spaces G 3 Fill: V volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW Q YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 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 0 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(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. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition © Replacement Windows Alteration(s) ❑ Roofing r Or Doors Accessory Bldg. LJ Demolition ❑ New Signs Decks Siding [O] Other[�J Brief Decf iption of Proposed �I n Work: /`� (C,� � " S tCtK 4 D(rY io 1 COan^1 UMIC,e♦-(Wai Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the 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 ? 70�o f r vIti�� e. Number of stories. f. Method of heating? /U 1.0 i " S Q( I r Fireplaces or Woodstoves /v o Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? t h. Type of construction 11,(Ay 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 A 7 WAP-5 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, O4Ln iv r as Owner of the subject property hereby authorize to act on my behalf,.in 4 matteFs-f�fafive to work authorized by this building permit application. Sign Pre of Owner Date 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. AMS Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder t - Srcvt�. ( 1�plJwfx?p �t� r�t,BK� CS' I()8b3G : � License Number Address Expiration Date q �0 q 793 Signature Telephone 9 Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number '53 GLQ S 2� 44(2, /i OUOv ( / �� a ?�I 1 y Oar - �� 1 Add Expiration Date resrs)) {M lC ✓`1.�ti-�-`.'._ Telephone v� T9Ol 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....... 111,/ No...... ❑ I City of Northampton .•yam Massachusetts FFF ' DEPARTMENT OF BUILDING INSPECTIONS y; e 212 Main Street • Municipal Building Northampton, MA 01060 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 owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner d owner has contracted with a corporation or LLC, that entity must be registered. Type of Work: `t PCVItkL (A9 If/ Est. Cost: ,,^,,,�,-e �r ,, � c� , ✓cif G'�C 2 Address of Work: 6-9 '-WA*V, Date of Permit Application: I 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.G.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: I hereby apply for a building permit as the agent of the owner: IR&Aoom 'i 1•4A RC- `:P _16 S (Ak Me- Save,,) 162-C 8 7 Date Contractor Name HIC Registration 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 3: N. DEPARTMENT OF BUILDING INSPECTIONS � r 212 Main Street • Municipal Building Northampton, MA 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 110.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 DEPARTMENT OF BUILDING INSPECTIONS y 212 Main Street •Municipal Building Northampton, MA 01060 Debris 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. The debris from construction work being performed at: (Please print house number and 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 Name and Address) )� ��a ; a�- Signature of Permit Applicant or Owner Date 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 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information 1Please Print LeeiblY .4 e Name(Business/Organization/Individual): 1 ROP TIM wQCCS (Awe– Sf I-V&T— ) Address:—S 3 C'4'9 —e`0 PtA P City/State/Zip: I"16^4(4UG, JMA 013 Cj 1 Phone#: 6W q 9O ' If T 9 77 Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).' 7. [/]New construction 2.0 am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition t.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t I 0 Q'building addition 1.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 1 1.C]Electrical repairs Or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.M I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 1;.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.❑Other 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'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. tContractors 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: b gbYx )14 Lou 4t,— Policy iPolicy#or Self-ins.Lic.#: W(-2 315 - tD I?Q1 "612 Expiration Date: 23 -sc-p- 9020 /"V Job Site Address: 5/ LC S f I ('al)Cr City/State/Zip: ,Icer jjC-C A 0166 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature ti1� St Date Phone#: �G2 - `�9 0 ' 4 793 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#: City of Northampton �.--- ' Massachusetts I` DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 ssN ,�0 Fee Calculator for Residential Properties S_ Location : � � �� ' f � . Lc�Z�Jcz Square Footage Amount Basement @ .20 1 ST Floor @ .50 2nd Floor @ .50 /( 80 '/2 Floors, Finish Attic, Garage @ .20 1660 Deck / Porches @ .20 Total : � �° MEN Generated by REScheck-Web Software HIS C�J( Compliance Certificate HERS Erik v , Project 59 Maple St Addition Energy Code: 2015 IECC Location: Northampton, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6404 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 59 Maple St Northampton, Massachusetts 01060 Compliance: Passes using UA trade-off Compliance: 12.4%Better Than Code Maximum UA: 234 Your UA: 205 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. U-Factor UA Assembly or R-Value R-Value Perimeter Ceiling>Amb SIP: Structural Insulated Panels (SIPS) 2,152 38.0 0.028 60 Wall>Garage: Wood Frame, 16"D.C. 270 23.0 0.0 0.055 14 Door-R5 default fire door: Solid Door(under 50%glazing) 20 0.200 4 Wall>Ambiant sip: Structural Insulated Panels 2,243 23.0 0.047 101 Window- Marvin default U:Vinyl Frame 48 0.290 14 Window-Marvin Elevate french doors U.29 total unit:Vinyl Frame 40 0.290 12 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 IECC requirements in