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11C-055 BP-2023-0621 420 NORTH MAIN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 11C-055-001 CITY OF NORTHAMPTON Permit: Addition PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0621 PERMISSION IS HEREBY GRANTED TO: Project# LEAN TO 2023 Contractor: License: Est. Cost: 23465 CHRISTOPHER JACOBS 60475 Const.Class: Exp.Date: 11/10/2024 Use Group: Owner: C JACOBS, CHRISTOPHER R, & MARY Lot Size (sq.ft.) Zoning: HB Applicant: BARRON &JACOBS Applicant Address Phone: Insurance: 420 NORTH MAIN ST 413-586-8998 WMZ80080063652022A LEEDS, MA 01053 ISSUED ON: 05/16/2023 TO PERFORM THE FOLLOWING WORK: LEAN TO ROOF OFF REAR OF BUILDING TO BE USED FOR STORAGE 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: rt.& l►r. Fees Paid: $168.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner / 13.-- --C'-r-- i ' T`� � The Commonwealth o�f Mas�sac usg( 1 1 20 / ; k, Office of Public Safety and Inspectiis / , _._ , +,% Massachusetts State Building Code/(780 'IRbg,''--____4 Building Permit Application for any Building other than a Ong-)d�i Qw lling (This Section For Official Use O.11y) i �N- ��o pvNS Building Permit Number: ?�✓'''' / Date Applied: Building Official: SECTION 1:LOCATION No.and Street City/Town Zip Code Name of Building(if applicable) 1\( '055 Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building til Repair 0 Alteration 0 Addition IR Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes fl No 0 Is an Independent Structural Engin Peer Review required? Yes 0 No Brief Description of Proposed Work:e 11 lI d 't Paw-k'D v'Ooc £ V-Ar li Io \ its) a-()Q,V)c. 2j0 1( I g' DC F %eui a� b:kc�,a.�, ko bc, v 5�d. -far CO vt,rtel. s fio r . \ cAdekgtS LO,P-c,re-kne.-- e.,,,k. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business /if E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 1-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1❑ S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA 0 IIB 0 MA IIIB ❑ IV CI VA 0 VBpil SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information Sewage Disposal: Trench Permit: Debris Removal: Public Ii1 Check if outside Flood Zone!' Indicate municipal IX A trench will not be Licensed Disposal Site VI Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify: permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable j71 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 8 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner (JNC\S 504.--1:01a5 1-‘1,0 N. i\A(A..+,(\ LDS duos) Name(Print) No.and Street City/Town Zip Property Owner Contact Information Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor 15CvYd . kioC-00S Company Name C.V\v 50•1.-ZbS (.S ` UL'DLA Name of Person Responsible for Construction License No. and Type if Applicable `-��� �1 • VV'i'w . �t• LIbenflei 1.-E-L VV )r- D 10S'5 Street Address City/Town State Zip 1-17 g-°1 r yl'5- 7A0- 6 6 Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes PO No El SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 2.3,y5S Building Permit Fee=Total Construction Co -rt here 2.Electrical $ appropriate municipal factor)= 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payale to 6.Total Cost $ '2- '-tCo T (contact municipality)and write check number here of 40 7 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of knowled e and understanding. C ANC.A Qrt.Sia f - stir6-.i. `c Please print and sign name Title Telephone No. Date Lt1A- kn St• LQ, A S tAPI O10-3Th t eibetvrohAvJl olo -a>r-,, Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: Name Date City of Northampton -n,�r it '" �: jti .� Massachusetts 7 ,' ft )ric� DEPARTMENT OF BUILDING INSPECTIONS --: V..) s 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: V (A 3cAti ins}-1,,,,,,.,.- ( l The debris will be transported by: Name of Hauler: b owv A c °6 Signature of Applicant: G Date: c 111 12;5 The Commonwealth of Massachusetts 1 '"'.iii $ Department of Industrial Accidents ' l' 1 Congress Street,Suite 100 ';i 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 Please Print Legibly Name (Business/Organization/Individual): bc,wyOv (AY vv{ SA(,c,b j S)(,vj Address: LA- ) ' �'(kV• air ce . City/State/Zip: L>u S IAA( U\pc)') Phone #: Li 1 ID- L -8'�-1 X Are you an employer?Check the appropriate box: Type of project(required): I. am a employer with_ \O employees(full and/or part-time).' 7. New construction 2 LJ'am a sole propnetor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp_insurance required.] 3.0I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 9. [Q Demolition 10 wilding addition 4.0[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 11. Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c 14.['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. fi Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors 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 nib-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: a \ NA My e`\ Policy#or Self-ins.Lic.#: koV''VVe-'1D)(')(p6j Z01—'2—pr Expiration Date: I t 12-0zt. Job Site Address: r\ a . 'MA\yN Sk - City/State/Zip: l.Qe N\PC O\c 5T 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 d penalties of perjury that the information provided above is true and correct. Signature: ( Date: q I l\ I") /) 1 Phone#: —1 ` Val 411 I' 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#: A�oRGP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 03/03/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Adina Edgett,CISR NAME: Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 (A/C,No,Ext): (A/C,No): 8 North King Street E-MAIL aedgett@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Main StreetAmerica/MSA 29939 INSURED INSURER B: NGM/MSA Barron&Jacobs Assoc.Inc. INSURER C: A.I.M.Mutual/A.I.M. 33758 420 N Main Street INSURER D: INSURER E: _ _ Leeds MA 01053 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 03/24 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL-SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DO/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPT8049D 03/09/2023 03/09/2024 PERSONAL 8ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO 3,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER EPLI $ 10,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S 1,000,000 B OWNED X SCHEDULED M1T8049D 03/09/2023 03/09/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ B EXCESS LIAB CLAIMS-MADE CUT8049D 03/09/2023 03/09/2024 AGGREGATE $ DED X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 500'000 O OFFICER/MEMBER EXCLUDED? W ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA MZ80080063652022A 03/01/2023 03/01/2024 E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE g 500,000 If yes descnbe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standards Consk p TServisor CS-060475 E3pi res: 11/10/2024 CHRISTOPHOR R JA 420 NORTH MAIN S '° LEEDS MA Otp53 CC....nis.sk:nc_ 'Pn.lj_ B/ THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 W a-hington Street - Suite 710 Boston. Massachusetts 02118 Home Improvement Contractor Reg tration Tyoe corporation Regctratioxl 100809 9,AR?ON 3 JACOBS A G4-E INC =>spration 06/22/2024 420 NOR-H MAIN STREET EE Ma 01053 Update Address and Return Card THE COMMONWEALTH Of MASSACHUSETTS Office of Consumer Affairs&BUsin•5 Regulation Regr.tratlon vied fa individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If round return to_ TYPE..50.ryoroon Office of Consumer Affairs and Business Reguratron Regi:tratjon Ezpirabon 100o'Nasninglon -Suixe 710 100609 Boston,MA 02118 BARRON 4 JACOBS ASCCCIATE S.INC. 4.0^ NORTH AWN STREET LEEDS.MA 01053 Undercretarr Not valid wit signature CS Beam 202 15 0 8 420 North St 5-4-23 kmBeamEne 2018 9.0.I Materials Database 1587 420 North St Leeds 10:15tmi Iol'I Member Data Description: Member Type:Beam Application: Floor Top Lateral Bracing:Continuous Bottom Lateral Bracing: 0.00 Standard Load: Moisture Condition:Dry Building Code:IBC/IRC Live Load: 40 PLF Deflection Criteria: L/360 live,11240 total Dead Load: 10 PLF Deck Connection:Nailed Member Weight: 5.9 PLF Filename: 10ft hdr Bea Other Loads Type Trib. Other Dead (Description) Side Begin End Wdth Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 10' 0.00" 10' 0.00" 40 10 Snow 2 6 0 0 5 0 0 © 2 6 0 ® ` , 10 0 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 3.500" 1.500" 469# -240# 2 2' 6.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 3.500" 2.257" 2268# - 3 7' 6.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 3.500" 2.257" 2268# - 4 10' 0.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 3.500" 1.500" 469# -240# Maximum Load Case Reactions Used for appyng part bads(or the bads)to carryng members Snow Dead 1 430# 40# 2 1802# 467# 3 1802# 467# 4 430# 40# Design spans 2'3.375" 5'0.00a' Z 3.375" Product: Spruce-Pine-Fir(S)#2 2 x 12 2 ply PASSES DESIGN CHECKS NOTE:Connection schedule for member requires special design consideration,consult a professional engineer. Design assumes continuous lateral bracing along the top chord. Design assumes maximum unbraced length of 0.00'along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Lowing Positive Moment 757.'# 4700.'# 16% 5' Even Spans D+S Negative Moment 917.'# 4700.'# 19% 2.5' Adjacent 1 D+S Negative Unbrod 917.'# 4700.'# 19% 2.5' Adjacent 1 D+S Shear 815.# 3493.# 23% 2.51' Adjacent 1 D+S Max.Readion 2268.# 3894.# 58% 2.5' Adjacent 1 D+S LL Deflection 0.0056" 0.1667' U999+ 5' Even Spans S TL Deflection 0.0068" 0.2500" U999+ 5' Even Spans D+S Control-Max Readion DOLs: Lis=100%Srx 115%Roof=125%Wnd=160% This member has been designed in accordance Hith N DS 2012 Al product names am trademarks of thef respective owners Copyright(C)2018 by Snpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. -Passng a defned as when the n,ernbe.fborpst,beam or gider shown on the dravwrg meets appicable design crtena for Loads,Loadng Conditions.and Spans Isted on the sheet.The desgn must be reviewed by a quaffed designer a desgn professional as requred for approval.This desgn assumes product nsalatan accaclhg to the manufacturer's specfications CS Bean 20215.0.8 420 North St 4-11-23 kmBeamEngtne 20189.0.1 420 North St Leeds 2:55pm 1587 1.0f Member Data Description: Member Type:Joist App tion:Roof Top Lateral Bracing:Continuous Sb : 2.00/12 Bottom Lateral Bracing:Continuous Standard Load: Moisture Condflon:Dry Bu g Code:IBC/IRC Snow Load: 35 PSF Deflection Criteria: U240 lye,U180 total Dead Load: 15 PSF Deck Connection:Naiad Rename:20ft hdr Bea 17 3 0 at 17 3 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0 000" Wall SPF#3/Stud 2x or 4x End-Grain(650ps1) 3 500" 1 500" 422# - 2 1 T 3.000" Wall SPF#3/Stud 2x or 4x End-Grain(650ps0 3 500" 1 500" 4224 - Maximum Load Case Reactions used tar appy n9 psnt bads,or be bads'.to cart"members Snow Dead 1 294#(29401) 128#(128p1f) 2 294#(294p1f) 128#(128p11) Design spans 1T 0.562" Actual Length 1T7750" Product: Spruce-Pine-Fir(S)#2 2 x 12 12.0"O.C. PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Losdrg Positive Moment 1774'# 2702.'# 65% 8 62' Total Load D+S Shear 370.# 1747# 21% 16.19' Total Load D+S Max Readion 422.# 1759.# 23% 0' Total Load D+S LL Deflection 0.3303' 0 8522" L/619 8 62' Total Load S TL Deflection 0.4738" 1 1363" L/431 8 62' Total Load D+S Control Poslletsarent DLLs Lne=100%SnowF115%Rook125%Wa 160% Desgn assumes a repeltke mmtb&tee inasse in bending mess 15% This member has been desgrled in accordarlcevlt NOS 2012 Al induct raves am 4a1areks of der restxclve°cults Comte I0)2018 IN Snpsar Sbon9-lie Camay Inc ALL RIGHTS RESERVED "Passing a deered ai when use nerroer.flora psi bean or gala Steels on Its braomg meets abatable Cesar Wee for L.lads-oadl9 Canberra and Spas bled an II*sheet The Cesar must be moaned by a spared desgler crates pofessiaa as roused for ataraa Ths craw assures podia Ystabmn aerating ins to the mawacluas sp cictons