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25C-153 (3) File#BP-2020-1137 APPLICANT/CONTACT PERSON BRAMUCCI CONSTRUCTION ADDRESS/PHONE 17 MT WARNER RD HADLEY (413)221-3942 PROPERTY LOCATION I 1 ORCHARD ST MAP 25C PARCEL 153 001 ZONE URBO00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tyneof Construction:_ADD 2ND FLOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 110834 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION,*RESENTED: 'lpproved V 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: § 3 (A�> T 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 ol /�Lo so Sig ature of Building Official V0 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. Department use only cyn��i. City of Northampton `� Status of Permit: rl � Building Department Curb Cut/Driveway Permit 212 Main Street 41Kq� Sewer/Septic Availability Room 100 �, J Water/Well Availability Northampton, MA 010610 Two Sets of Structural Plans phone 413-587-1240 Fax 41 � --127 Plgt/Site Plans ether Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, R1 OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office l_ ll _ Map J Lot ` � Unit f f� l P7 o4 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 11 - +,•.,�.� Z t z ,t/ �.- 4 k-j Name(Print) / Current Mailing Address: /i:�- : Telephone l Signature 2.2 Authorized Agent: 11�Ih<.X7- 4/- P2 9 9 Name(Print) Current Mailing Address: LJ Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by permit applicant 1. Building / (a) Building Permit Fee cp 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing r Building Permit Fee 4. Mechanical (HVAC) I a o G, • 0o 5. Fire Protection 6. Total = (1 +2 +3+4+ 5) m o o Check Number This Section For Official Use Only Building Permit Number: f7`' ' �L� Date Issued: Signature: Building Commissioner/Inspector of Buildings Date 4U a r C I-r �— Jc t�lTl «t��� @ 6—, 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: R:' L: R:L, Rear Building Height 2 L� Bldg. Square Footage % Open Space Footage % r-- --� (Lot area minus bldg&paved parking) #of Parking Spaces Fill volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW YES IF YES, date issued:' IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW a YES Q IF YES: enter Book i Page and/or Document#� B. Does the site contain a brook, body of water or wetlands? NO Ef DONT KNOW 0 YES 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 O NO 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, ex vation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © 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 ❑ ReplacementWi dows Alteration(s) Roofing E Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding [r] Other[p] Brief Description of Pro ose) Work: 1 �-rt -c o r, :r"F-T (/ �^f� Sctr'/ t�/os�, ✓®�.a�c� c.�.. 1•',S eQ C`,'(,L' Alteration of existing bedroom `f Yes No Adding new bedroom r Yes No Attached Narrative �� Renov9png unfinished basement Yes No Plans Attached Roll - Sheet PL-410 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other f b. Number of rooms in each family unit: > Number of Bathrooms I f } c. Is there a garage attached?_ /4/- d. Proposed Square footage of new construction. 6 31, Dimensions 6X 3S e. Number of stories? f. Method of heating? {7/'-I S /- r Fireplaces or Woodstoves ►�/� Number of each _ g. Energy Conservation Compliance. e- Masscheck Energy Compliance form attached? � f h. Type of construction Vo'./ lc� �•^+� i. Is construction within 100 ft. of wetlands? Yes ✓r No. Is construction within 100 yr. floodplain Yes Y No j. Depth of basement or cellar floor below finished grade 7 k. Will building conform to the Building and Zoning regulations? y 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, AV H �oye� as Owner of the subject property hereby authorize A,ch' to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I /C`4 e-;— L/ as Owner/Authorized h 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 elief. Sig jn�ed funder the pains and penalties of perjury. 1 b ar7- J--/ Print Name yo S� IS 12, 2> Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: 2i f.1-lA2U BRAyw i r GI C o — I o JQ 34 License Number iw rA 1 o3s, 9 - 3 - 2020 AddressExpiration Date ,/� /,� -,�? 12 I - 2 qZ ignatu Telephone 9.Reciistereu Home Improvement Contractor: Not Applicable ❑ c oN s•-r ieo rT 10 n/ /7;,(:1 41 O J2 Company Name Registration Number V-7 iAAT• i,.14 21 6/Z 12 Z %-1 q 3&G ma 01 O-3 S ! 7 " 7.0, Address Expiration Date T Telephone 41 221 -3`e4 z 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....... No...... ❑ City of Northampton S ' ' s; Massachusetts f� A o N y, DEPARTMENT OF BUILDING INSPECTIONS Z ,x ' 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 has.contracted with.a corporation or LLC,that.entity must be registered Type of Work: l2E ry o HnuS F Est. Cost: ,�91 , 600 Address of Work: ii o2 C 4J?b ST. Ne)/TtlArnpToc,/ Date of Permit Application: r- i8 - 2 20 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: / 5 - If3 - bozo SRQmJCC/ oAJS-reoCT/o 4v /SDR 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: 5711612, 2-,, �obt� A/.,,P. �iC'lit1�� Bate Owner Name and Signature� City of Northampton yf►Cti. rte;: Massachusetts ' DEPARTMENT OF BUILDING INSPECTIONS •; 212 Main Street • Municipal Building a� * ,LV --"•�.� Northampton, MA 01060 Jr, 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.wtmg Construction Superyisor 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 Ciener-al Laws Annotated,you may be liable for person(,$)you hire to perform work for you under this permit. City of Northampton w Z Massachusetts DEPARTMENT OF BUILDING INSPECTIONS ^a_ c 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: 1 1 4- . t. �F.-�/ jr-7- < (Please print house number and street name) Is to be disposed of at: L _ !tcy 12scycl, Z3�� L—�� �n��� /1� �y/ws-7� �-rti(' �� , (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: ? �- 2 3 1 ��s 7 ..®?.n ,y, 74 ►�J'- (Company Name and Address) 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 a I 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. Urticant Information Please Print Leiribiv Name (Business/Organization/Individual): 13,egNjc_C1 co`yc:2UC_r_1 0 A Address: -7 M:I. WA Qh1 t-,iL Zz, City/State/Zip: a t.Gy JaO4 a I�t3'E� Phone#: ql 3 -2z 1 - 394 Z Are you an employer?Check the appropriate boa: Type of project(required): 1.PI am a employer with Z employees(full and/or part-time).' 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. Pff Remodeling any capacity.[No workers'comp.insurance required.] 9. IMemolition 3,01 am a homeowner doing all work myself[No workers'comp.insurance required.]r 10E]Building addition 4131 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.1 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.E]Other 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: LlAR7-F012 a u nl D c21"2 rr c4S /V_5 Co . _ Policy#or Self-ins.Lic.#: Io4t. ;j t�, - I le 7O f 74 - 3 _/e>, Expiration Date: i/- /L ?_y Job Site Address: l/ aCd4/LD S7• City/State/Zip:,&k,4zWAm/raN H94 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 un aims anIc-d penalties of perjury that the information provided above is true and correct. !�7 Signature: Date: �o a Phone#: Iq 13 - 221 - 3 F4 2- 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#: Home Energy Rating Certificate Rating Date: 2020-05-05 HIS Registry ID: HERS Projected Report Ekotrope ID: 6LABkGnd • S'9 Index Score: Annual Savings Orchard11 St Your home's HERS score is a relative performance score.The lower the number, ' Northampton, 1 1060 the more energy efficient the home.To $ 2,43Builder: 50learn more,visit www.hersindex.com *Relative to an average U.S.home Austen 1glehard Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtul Annual Cost criteria of the following: Heating 11.6 $609 2015 International Energy Conservation Code Cooling 0.5 $27 Hot Water 2.5 $132 Lights/Appliances 17.3 $829 Service Charges $60 Generation (e.g.Solar) 0.0 $0 Total: 31.8 $1,656 HERSInclex Home Feature Summary: Rating Completed by: No,•c�• Home Type: Single family detached Model: N/A Energy Rater.Adin Maynard Existing Community: N/A RESNET ID:9463452 Homes • Conditioned Floor Area: 1,244 ft2 Rating Company:HIS&HERS Energy Efficiency Number of Bedrooms: 3 Mailing:12 Perkins Ave.Northampton MA 01060 4136588784 Window Type: U-Value:0.29,SHGC:0.29ioo Primary Heating System: Air Source Heat Pump•Electric•2.87 COP Primary Cooling System: Air Source Heat Pump•Electric•19 SEER Rating Provider:Energy Raters of Massachusetts Primary Water Heating: Water Heater•Electric•3.55 Energy Factor 2 Woodlawn Street Amesbury,MA 01913 House Tightness: 3 ACH50 978-270-3911 �•w�,� Ventilation: 63 CFM•11 Watts = a0 This woos. Duct Leakage to Outside: Untested A Ms 1.4•IM 1020 Above Grade Walls: R-21 $ �''• to Ceiling: Attic,R-54 Zero Energye o Hom �...u�.,n foundation Walls: R-13 Adin Maynard,Certified Energy Rater Digitally signed:5/7/20 at 7:36 AM ekotrope Ekotrope RATER-Version:3.2.3.2430 reportThe Energy Rating Disclosure for this home is available from the Approved Rating Provider. This does not constituteor guarantee. Building Specification Summary HIS Property Organization Inspection Status HERS 11 Orchard St HIS & HERS Energy Effici. Results are projected Northampton, MA 01060 Adin Maynard 4136588784 11 Orchard St Builder Austen Iglehard Building Information Rating Conditioned Area [ft,] 1.244.00 HERS Index 50 Conditioned Volume [W] 14,147.00 HERS Index w/o PV 50 Thermal Boundary Area [ft'] 3.826.60 Number Of Bedrooms 3 Housing Type Single family detached Building Shell Ceiling w/Attic I R53 mmnl ,CE15",4-24 bttmchrd U-0.02 Windows(largest)I U-Value: 0.29. SHGC: 0.29 Vaulted Ceiling I None Window/Wall Ratio 10.12 Above Grade Walls I R21, 4!-16 Y PSF U-0.05 Infiltration 13 ACH50 Found. Walls 12" PSF R-13 Duct Lkg to Outside I Untested Framed Floors I None Total Duct Leakage I Untested Slabs I Uninsulated slab R-0 Mechanical Systems Heating Air Source Heat Pump • Electric•2.87 COP Cooling Air Source Heat Pump • Electric• 19 SEER Water Heating Water Heater• Electric • 3.55 Energy Factor Programmable Thermostat Yes Ventilation System 63 CFM • 11 Watts Lights and Appliances Percent Interior LED 100% Clothes Dryer Fuel Electric Percent Exterior LED 100% Clothes Dryer CEF 2.6 Refrigerator(kWh/yr) 691.0 Clothes Washer LER (kWh/yr) 704.0 Dishwasher Efficiency 270 kWh Clothes Washer Capacity 2.9 Ceiling Fan None Range/Oven Fuel Propane Ekotrope RATER-Version 3.2.3.2430 All results are based on data entered by LKotrope users LKotrope discia ms all liability for the information shown on this report. End Use Energy Costs HIS Property Organization Inspection Status HERS 11 Orchard St HIS & HERS Energy Effici, Results are projected Northampton, MA 01060 Adin Maynard 4136588784 11 Orchard St Builder Austen Iglehard Annual Energy Cost $800 $700 $600 $500 to T $400 $300 $200 $100 r $0 Heating Cooling Water Heater Lights &Appliances Service Charges Ekotrope RATER-Version 3.2.3.2430 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shown on this report. Component Loads HIS Property Organization Inspection Status HERS 11 Orchard St HIS & HERS Energy Efci. Results are projected Northampton, MA 01060 Adin Maynard 4136588784 11 Orchard St Builder Austen Iglehard Heating & Cooling Loads 14 12 10 8 6 4 m 2 0 _..__. ■ -2 -4 -6 -8 Above-Grade Infiltration & Slabs & Roofs Ducts Windows & Foundation Internal Walls Ventilation Floors Doors Walls Gains Heating ■ Cooling 0 Ekotrope RATER-Version 3.2.3.2430 All results are based on data entered by Ekotrope users Lkotrope disclaims all liability for the information shown on this report