23D-132 (9) r
73 HINCKLEY ST BP-2001-0207
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D- 132 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:ADDITION BUILDING PERMIT
Permit# BP-2001-0207
Project# JS-2001-0334
Est.Cost:$30000.00
Fee: $205.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sq. ft.): 24480.72 Owner: ROOSA DOUGLAS F&DIANE E FABI
Zoning: URB Applicant: ROOSA DOUGLAS F & DIANE E FABI
AT: 73 HINCKLEY ST
Applicant Address: Phone: Insurance:
73 HINCKLEY ST (413) 586-9384 ()
FLORENCEMA01062 ISSUED ON:8/29/00 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 15 X 28 BEDROOM/BATH
ADDITION W/BASEMENT
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 8/29/00 0:00:00 1177 $205.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2001-0207
APPLICANT/CONTACT PERSON ROOSA DOUGLAS F&DIANE E FABI
ADDRESS/PHONE 73 HINCKLEY ST (413)586-9384 0
PROPERTY LOCATION 73 HINCKLEY ST
MAP 23D PARCEL 132 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid /f 77 c 6 °b
Typeof Construction: CONSTRUCT 15 X 28 BEDROOM/BATH ADDITION W/BASEMENT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THELLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Y Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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
.G � 77-eD
Signature of Building 0 cial t 7 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.
•
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street 1Sewer/Septic Availability
Room 100 EWater/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 (Plot/Site Plans_
!Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
,•09 --
•` I ° Map V Lot i '' Unit
1— I 0, �, -*, Zone Overlay District_____;:
Elm St.District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
:hir3
:::aih ;;
e - J ()
2.2 Authorized Ag t:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars)to be Official Use Only
completed by permit applicant
1. Building a oo \ (a) Building Permit Fee
2. Electrical VV�I (b) Estimated Total Cost of
000 Construction from (6)
3. Plumbing )000 Building Permit Fee
4. Mechanical (HVAC) r.j
5. Fire Protection UVQ
6. Total = (1 + 2 + 3 +4 + 5) 0(Y) Check Number s
15:1()°,5--- -
This Section For Official Use Only
Ruuilding Permit Number: --6PCJI "'-0)67 Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
q Building Department
Lot Size o�-1 Jam)
Frontage i (00
Setbacks Front a co.
Side L: L:IC) R:
Rear C)
Building Height I J J
I � i11
Bldg. Square Footage 50 �O{ % i o 12-7
Open Space Footage
(Lot area minus bldg&paved a)., t \ 9
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?`
NO X DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 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 DON'T KNOW
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 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
f
CTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition D Replacement Windows Alteration(s) 0 Roofing 0
Or Doors 0
Accessory Bldg. 0 Demolition New Sig [ ] ii Dec{ [ ] Siding[ ] Other [ ]
c1
Brief Description of Proposed Work: (�.�. 'k1'
Alteration of existing bedroom Yes No Adding new bedroom X Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Shee ,
641.41NeT ae BD® s® =`;ditionktoAexistinglitititititi,COMP a s 0�_+ � •
a. Use of building : One Family \. Two Family Other
b. Number of rooms in each family unit: .5 Number of Bathrooms
c. Is there a garage attached? •'0 � /
[
d. Proposed Square footage of new construction. 1 t O Dimensions 1 [I x t3
e. Number of stories? I �
f. Method of heating? `'(�l-ACC�'�� c4 ,T Fireplaces d Woodstoves Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
03;� c _. . 'Type of construction a tc �1,�;1 [' (A)I r
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes X, No
j. Depth of basement or cellar floor below finished grade J1 `f •
k. Will building conform to the Building and Zoning regulations? )4 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
, 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 Date
I,
• O(Y'(. , as Owner/Authorized Agent
hereby declare th the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and be ' f.
;ned er the pains an enalties of perjury.
Pr t Name
Uv
Sign wner/Age �'�-- Date
s
I SECTION 8-CONSTRUCTION SERVICES
Licensed Construction Supervisor: Not Applicable 0
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
, , ?'' 'fai Not Applicable 0
Company Name Registration Number
Address Expiration Date
Telephone
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.
c'^ned Affidavit Attached Yes 0 No 0
z
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) , 'I assachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform we for ye. under thi permit.
The u dersigned"ho ,eowner"ce .Ties . I assumes r sponsibility for compliance with the State Building Code,City of
No1 ()?C'e-:
ampton Ordinances State and .1 a. g L- s and State of Massachusetts General Laws Annotated.
Homeowner Signature ���irA
, \\��Iwr�To o (Iit of orthamptonas �`� � ealcssnc ncrtls t
..... 7,_.---7:.
' _. , DEPARTMENT OP BUILDING INSPECTIONS , •
—
212 Main Street ' Municipal Building - .
Northampton, Mass. 01060 r`',
• WORKER'S COMPENSATION INSUTZA_NCE AFFIDAVIT
IT
ZU `(Y)S
(li ccvscc/perwi ttcc)
with a principal place of business/residence at:
c_ --?'6 1-iti\A3( 0\ 4 , \-- \omy\c_e__ kOk obgtoondo (113-O6.- 3 (4
(srrc t/city/siatelzip)
do hereby certify, under the pains and penalties of perjury, that
•
( ) I am an employer providing the following worker's cotnocnsahon coverage for my
employees woddng on this job.
(Las-urn Company) (Potic: Number) (r epiration Date)
I am a sole proprietor, general contractor or h cow-ner rcie one) and have hired
/the contractors listed below who have the following worker's convention policies:
� QcL .
(Name of Contractor) (Insurance Company/Policy Num!Yr) (1:x iration Date)
it
(Name of Contractor) (Insurance ComoanyiPoticy Nwaier) (Epiration Date)
(Name of Conractor) (Insurance Company/Policy Number) (Expi radon Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date).
(ankh additiocaJ t'x,C ifnccn.ry to mead✓iafocma xoa pertaining to.11 oco roc on)
( ) I am a sole proprietor and have no one working for me.
( ) I am.a home owner performing all the work myself.
NOTE:plcsc be ea-arc thv..tnic bemco«om µbe airplay pcioaa w do r-,ir+.-„n, cmr-r.:eioo a rtuu.:ors:oa.d.•ellint of
not ranee th.n t rco grit in ubich the bornoowocr raido oc oo the grounds appurtcava tbccto arc not -aly eecridatd to be
cmpioycs undo the c. 's o=cpcasctioa Act(G1_152 53I(5)),applir,tion by a boa coovrr far a trea..3c or permit r�:y c idcmc the
Ieg:a ctnuu of an oxloyor under rho Woke Coco iux. i.on Ad
1 I uodastond th.e a copy of thi.aztcmmt m.y bo focwordod to tbo pcpertm cat of InAirricl Arodmts'Offioo of traunnco for the
oovcugc vci[tc tioo and th.t I_iltat to sonar covcntsc under section 25A of MOL 152 tin Trod to the ice,orIIioa of criminal pcoallic
of s floc of up to S I.500.00.ndtor imprisoomc,-n of up to ooc year rnd civil pauJuo io cbc form of a Stop Work Order and.
tm of S .00 a d_y t
ro dcp.run�:.�J u.c only
5 �� (/` - PCrIni�ap::t Number
�
Lot ,:w
Signer mart:of Li 3crntittec Date
•
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER
SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE
SURVEY AND IS NOT TO BE RECORDED.
Z«. s '. �1
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I�o.�o Ii
TO: FLORENCE SAVINGS BANK &
LAWYERS TITLE INSURANCE CORPORATION
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # 250167
SURVEYOR: —NOTE—
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
4, of Af —MORTGAGE LOAN INSPECTION PLAT—
oattr
, RANDALL ti�1 NORTHAMPTON, MASSACHUSETTS
E. PREPARED FOR
IZER+35032 : ESTATE OF LEROY V. TACY
L�No
OPESS 'I; SCALE: ! "=40 ' JUNE 18 , 1992
SUIer HAROLD L. EATON AND ASSOCIATES, INC.
�• --�'`l ` REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
ENERGY CONSERVATION APPLICATION FORM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS
7g0cMR` Appendix )*effective 3/1/98) �(
Applicant Name: C24:Yyr— Site Address: '11 ``k�
Applicant Address: 1 �
vs. �AZ ¶k City/Town: ve:\UC''�ncfE�
I‘GC&vcx, v•AN t1 Use Group:
()1 .3 Date of Application: - J`4
Appticsnt Phone: 6- ! JZ��y]y/6- V i Application Signature:
Cetnpiiattce Path(check ene)
O Prescriptive Package(Limited to 1- or 2- family wood frame buildings heated with fossil fuels only)
Package (A through KK from Table J5.2. ib): Heating Degree Days (HOD")from Table J5.2 la:
(For items d. through i., fill in all values that apply from Table J5.2)
a. Gross Walt Area sq. tt f. WaIf RVallee R-
b. Glazing Areal sc. ft E. Floor R•Value R-
c. Glazing/0-(100 x b+a} _ % h. Basement wall $
d. Glazing I1-yati io. Li' i. slab Perimeter Ft
. e. Ceiling R-value R- i. Heating AFIJf.
O Component Performance: 'Manual Trade-Off` (Limited to wood or metal framed buildings only)
Climate Zone(from Figure J6.2.2) ❑ Zone 12 Q Zone l3 0 Zone 14
Attach Trade-Off f4Wksheetfrom Appendix J,[and HVAC Trade-OffWorksheet, it applicable)
❑ tetAScheck Software
Attach Compliance Report and inspection Checklist printouts.
❑ Systems Analysis OR Q Renewable Energy Sources
Attach Mass Registered Architect or Engineer Analysis
ALTERNATIVE FOR ADDITIONS ONLY:
a. Gross Wall +Ceiling Area (Cta�sq. ft. b. Glazing Area'Lf7 f sq.ft. c. Glazing%(100 x b+a) 5 %
i. ADDITION with Glaring%(c.)up to 40%may use 780 CMR'fable J1.1.2.3.1 below:
MAXIMUM U.-value 1 Minimum R•Values
Fenestration Coiling Wall 1 Floor Basement Wall (Slab Perimeter, Dept
0.34- R-37 R-13 R•19 j R-10 R-10,4 It.
❑ -SUNROOM" addition (greater than 40%glazing-to-wail and ceiling gross area)
Attach "Consumer Information Form'from 780 CMR Appendix-B.
Otficial'S tame: Official's Signature:
Appticattan Approved 0 Denied ❑ Date of Ap,xca alJDenial:
Rv.v4„„(s)yr Denial: (provide additional details as needed on back side)
I Glazing Arta may be itkher-Rovagis Opening or Unit ryim nsions.
11-0 N LN II, W_Iin
1111
-i
AUG242000 L.j----
DEPT OF BUILDING INSPECTIONS
NORTHAkIPTON,MA 01060
�1
Zokk-A- (2KOXY�C 4�
MAScheck COMPLIANCE REPORT I 6 I
Massachusetts Energy Code I Permit # I
MAScheck Software Version 2.01 I I 2, 1A`�I ` ,
I I ti� ✓ 1�
I Checked by/Date I
I I
CITY: Northampton
STATE: Massachusetts
HDD: 6404
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 8-24-2000
COMPLIANCE: PASSES
Required UA = 111
Your Home = 90
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value U-Value UA
CEILINGS 365 30.0 0.0 13
WALLS: Wood Frame, 16" O.C. 630 19.0 0.0 38
GLAZING: Windows or Doors 47 0.330 16
DOORS 18 0.330 6
FLOORS: Over Unconditioned Space 365 19.0 0.0 17
HVAC EQUIPMENT: Furnace, 78.0 AFUE
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 requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate,
has been determined using the applicable Standard Design Conditions found
in the Code. T C equipment selected to heat or cool the building
shall be no gr ater th n 125% he design load as specified in
Sections 780CMR 1 10 an 4 �,l
Builder/Designe Date ]V� _`
MAScheck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2.01
DATE: 8-24-2000
Bldg. I
Dept. I
Use I
CEILINGS:
[ ] I 1. R-30
I Comments/Location
-
I WALLS:
[ ] I 1. Wood Frame, 16" O.C., R-19
Comments/Location
WINDOWS AND GLASS DOORS:
[ ] I 1. U-value: 0.33
I For windows without labeled U-values, describe features:
I # Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
DOORS:
[ ] I 1. U-value: 0.33
Comments/Location
FLOORS:
[ ] 1. Over Unconditioned Space, R-19
I Comments/Location
I �
I HVAC EQUIPMENT:
[ ] I 1. Furnace, 78.0 AFUE
AIR LEAKAGE:
[ ] I Joints, penetrations, and all other such openings in the building
I envelope that are sources of air leakage must be sealed. When
installed in the building envelope, recessed lighting fixtures
I shall meet one of the following requirements:
1. Type IC rated, manufactured with no penetrations between the
I inside of the recessed fixture and ceiling cavity and sealed or
I gasketed to prevent air leakage into the unconditioned space.
I 2. Type IC rated, in accordance with Standard ASTM E 283, with no
I more than 2.0 cfm (0.944 L/s) air movement from the the
conditioned space to the ceiling cavity. The lighting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
I difference and shall be labeled.
VAPOR RETARDER:
[ ] I Required on the warm-in-winter side of all non-vented framed
I ceilings, walls, and floors.
MATERIALS IDENTIFICATION:
[ ] I Materials and equipment must be identified so that compliance can
be determined. Manufacturer manuals for all installed heating
I and cooling equipment and service water heating equipment must be
1 provided. Insulation R-values and glazing U-values must be clearly
marked on the building plans or specifications.
I DUCT INSULATION:
[ ] I Ducts shall be insulated per Table J4.4.7.1.
DUCT CONSTRUCTION:
[ ] I All accessible joints, seams, and connections of supply and return
I ductwork located outside conditioned space, including stud bays or
I joist cavities/spaces used to transport air, shall be sealed
I using mastic and fibrous backing tape installed according to the
manufacturer's installation instructions. Mesh tape may be
omitted where gaps are less than 1/8 inch. Duct tape is not
I permitted. The HVAC system must provide a means for balancing
air and water systems.
I I
I TEMPERATURE CONTROLS:
[ ] I Thermostats are required for each separate HVAC system. A manual
I or automatic means to partially restrict or shut off the heating
and/or cooling input to each zone or floor shall be provided.
HVAC EQUIPMENT SIZING:
[ ] I Rated output capacity of the heating/cooling system is
not greater than 125% of the design load as specified
in Sections 780CMR 1310 and J4.4.
[ ] I SWIMMING POOLS:
I All heated swimming pools must have an on/off heater switch and
I require a cover unless over 20% of the heating energy is from
I non-depletable sources. Pool pumps require a time clock.
[ ] I HVAC PIPING INSULATION:
I HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F must be insulated to the following levels (in.) :
I PIPE SIZES (in.)
I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4"
Low pressure/temp. 201-250 1.0 1.5 1.5 2.0
Low temperature 120-200 '0.5 1.0 1.0 1.5
Steam condensate any 1.0 1.0 1.5 2.0
COOLING SYSTEMS:
Chilled water or 40-55 0.5 0.5 0.75 1.0
refrigerant below 40 1.0 1.0 1.5 1.5
[ ] I CIRCULATING HOT WATER SYSTEMS:
I Insulate circulating hot water pipes to the following levels (in.) :
I j
I PIPE SIZES (in.)
I NON-CIRCULATING 1 CIRCULATING MAINS & RUNOUTS
I HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+"
I 170-180 0.5 I 1.0 1.5 2.0
I 140-160 0.5 I 0.5 1.0 1.5
I 100-130 0.5 I 0.5 0.5 1.0
----NOTES TO FIELD (Building Department Use Only)
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