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36-400 (3) EmersOn Way, , ----— , .._ ----7--- L=68.83 7-------1._--___ 23.5 T 1 - ----- -- -L. 4 4404 Lr5 0 rn 1 , , v) , : - ... 1 - . , . PORCH 4 I , , , t , , , t , 1 , I I GARAGE 1 5 . 0 ' HOUSE , 1 S ETBACK1 t u) t I (...4 1 "" t (51 1 i I 1 I , 1 I , 1 1 \ 1 f I I I, 1 I L0 1 1 . , 1 co 56 _ _. _ __ . I 57 1 \‘‘ bg 1 12 I ,181 s.f. 11,64P - - 1 1 , , . i I Z sppl'e. ?) V \ N88`2906"W i ..- 79.60' CM -- V s,.0 1" , 6 o,a7,- min Permit No. D 08-11 Conditions: Driveway Permit In lieu of plan approved by the City Engineer I agree to the following added conditions: 1. 1 will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. 1 further agree that if in the inspections, any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. By: , Ai/ Petitioner Signature Name: Kohl Construction/Fred Meyer Address: 31 Campus Plaza Road, Hadley, MA 413-256-0321 Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. For Commercial and Industrial applicants, a plan showing the proposed driveway with grades. location and Planning Board permits are required. Cc: Building Inspector Permit No. D08 I CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: June 6. 2011 Check #: 035895 FEE: $250.00 THE BOARD OF PUBLIC WORKS Driveway must be staked and house & lot number posted The undersigned respectfully petitions your honorable body for: A new driveway installation Per to install a driveway at: 72 Emerson Way, Lot 56 "The Oak's" Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All Drainage shall be directed off the driveway surface to adjacent land and not on the existing Roadway. Driveway surface to be paved as soon as possible if the grade of the proposed Driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City of Northampton in the event of a washout. of this driveway. Code of Ordinances §350-8 8 providing standards for private, individual driveways as amended by the City Council on October 15, 2009, must be followed. By: Kohl Construction/Fred Meyer Telephone: 411-256-0321 Proposed Location Inspection By: Mr /kV:7Z - 4 7- N Gravel Base Grade Inspected By: Final Approval: THE BOARD OF PUBLIC WORKS voted that petition be granted. Edward S. Huntley, P.E. Director of Public Works Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS 1 & 2) J. TA.QAc9 Bk: 10550 Pg: 274 EXECUTED as a sealed instrument this 124" day of May, 2011. � OAK RIDGE ROAD, LLC r By (\ 1 L . ‘ Wi tn s Ric, . d M. Madowi" Its Managing Partne THE HAMPSHIRE PROPERTY MANAGEMENT • GROUP, INC By • . 1, ArphcK -- .1 L Witn • s Richard Madowitz Its Co- President j COMMONWEALTH OF MASSACHUSETTS HAMPSHIRE. COUNTY, SS. ACKNOWLEDGMENT On this day, M cu (2 , 2011, before me, the undersigned notary public, personally appeared Richard M Madowitz, Managing Partner of Oak Ridge Road, LLC, and proved to me through I satisfactory evidence of identification (which was my personal knowledge as to his identity) to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. '''''‘ At✓J& .• • ria McPherson, Notary Public commission expires Sept 9, 2016. . `9 s • t " s ; ` + ' • \\%••• 'Af1 .w ATT•HT: HLMPt9HIRE, v' ,RBGI$TIIIR MARILWU L. D0JOE80I1 `} ! Bk: 10550 Pg: 273 ', ,' , II , 1 l I 1 I 1 i i ,, .. .!* ' COVENANT - Form I Bk: 10550Pg: 273 Page: 1 of 2 Reoorded: 05/18/2011 11:07 AM The undersigned Oak Ridge Road, LLC, of 31 Campus Plaza Road, Hadley, Massachusetts, and the Hampshire Property Management Group, Inc., of 150 Main Street, Northampton, Massachusetts, hereinafter together called the "Covenantor ", having submitted to the Northampton Planning Board the S 1 Definitive Plan of a subdivision, The Oaks Subdivision, dated February 6, 2003, final revision dated i September 29, 2005, and recorded at the Hampshire County Registry of Deeds at Plan Book 209, Page 0 91, do hereby covenant to and agree with said Planning Board and the successors in office of said Board, 2 2 pursuant to Mass. General Laws, Chapter 41, Section 81U, as amended, that: 1 1. The Covenantor is the owner of record of the premises show on said plan; 2. This covenant shall replace /release the covenant on lots number 1 -59, recorded with said Registry of Deeds at Book 10053, Page 135. -Q 3. This covenant shall run with the land on lots number 1, 4/5 and 20-46 as required for tb performance guarantee in accordance with City of Northampton Code of Ordinances Chapter 290- 25D(la) . d .E 4. This covenant shall be binding upon the executors, administrators, heirs, assigns of the 1 0 La Covenantor, and their successors in title to the premises shown on said plan. 5. The construction of ways and the installation of municipal services shall be provided to serve any lot in accordance with the applicable Rules and Regulation of said Planning Board before such lot may be built upon or conveyed, other than by mortgage deed; provided that a mortgagee who acquires title to the mortgaged premises by foreclosure or otherwise and any succeeding owner of the mortgaged premises or part thereof may sell any such lot, subject only to that portion of this Covenant which provides that no lot so sold shall be built upon until such ways and services have been provided to serve such lot; 6. Nothing herein shall be deemed to prohibit a conveyance subject to this covenant by a single deed of the entire parcel of land shown on the subdivision plan or of all lots not previously released by the Planning Board without first providing such ways and services; 7. This covenant shall take effect upon the approval of the Northampton Planning Board; 8. This covenant shall be recorded upon approval by the Planning Board. Approved by the Northampton Planning Board on Mei pe 1 , 2011. 1 Je ife Dieringer, Vice Cha N rth pton Planning Board Kohl Construction www.KohlConstruction.com 31 Campus Plaza Road, Hadley, MA 01035 ph (413) 256 -0321 fx (413) 256 -0130 72 EMERSON WAY WINDOW SCHEDULE Window Specs: Pella Encompass Series 25, 3- 11/16" jambs, low E argon, standard hardware color, screens KEY # MFGR & TYPE MODEL # COUNT Pella Flashing tape $25.16/150' roll MA Pella Encompass DH 2442 1 M, N Pella Encompass DH 2448 2 FA, HA Pella Encompass DH 2848 2 P, AA, BA, Pella Encompass DH 2854 9 CA, DA, EA, JA, KA, LA A, B, C, E, F, Pella Encompass DH 2860 10 G, J, H, K, L GA Pella Encompass DH 2848 -2 1 NA Pella Encompass DH 2854 -2 1 D Pella Encompass CSMT 2442 -2 LR 1 MUNICIPAL SEWER/ AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton, MA 01060 587 -1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 72 Emerson Way, THE OAKS Inquiry Made By: Fred Meyers Kohl Construction 256 -0321 Date of Inquiry: 5/17/11 Reason for Hook into City Sewer System Request: Municipal Sewer Main in Front of Location: Yes No Municipal Storm Drain Available: 5 1 /2 deep Yes No Size of Sewer Main: Material: Age: Depth of Sewer Main: Size of Service Connection: Type of Service Connection: Tie -in to Sanitary Main Tie -in to Sanitary Stub Comments: ?j2 V • _ k �C�1[. <1 Ai 3 ( ?II R Note: If this availibility is for new construction, this form must be hand delivered to Building Inspector. A corresponding "sewer entrance fee" shall be paid prior to making any connection to the municipal sewer system. Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. r44A ) ohn Hall _/ Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton, MA 01060 5871097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 72 Emerson Way, THE OAKS on Oak Ridge Road Inquiry Made By: Kohl Construction, Inc. Fred Meyer 256 -0321 Date of Inquiry: 5/17/11 Number of Type of Single Family Type of Private Units: Unit(s): Accessory Apart. Ownership: Condo Multi - family Rental (Annlicant to fill out the ahovel Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: X No Size of Water Main: 8" Material: Ductile Iron Age: 2004 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 60 If done attach results Size of Service Connection 1" Suggested Meter Size: 5/8" Comments: The Water Department cannot guarantee adequate water pressure during peak demand tines at elevations above 320 feet. • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • angements of such installation shall be made with the Northampton Water Department with a minimum of 5 orkin days n i on. • Al work sha 1 co fo to N jj rthampton Water Department specifications. David W. Sparks, Superintendent of Water Water Entry $200.00 Meter $100.00 Radio $100.00 cc: Ned Huntley, Director cc: Louis Hasbrouck, Building Commissioner Note: If this availability is for a new construction it must be hand delivered to the Building Inspector. RESNET HOME ENERGY RATING Standard Disclosure For home located at: Oak Ridge Rd City: Northampton State: MA 1. ! /The Rater or the Rater's employer is receiving a fee for providing the rating on this home. 2. 1 1/ In addition to the rating, the Rater or Rater's employer has also provided the following consulting services for this home: A. Mechanical system design )B. Moisture control or indoor air quality consulting C. Performance testing and /or commissioning other than required for the rating itself D. Training for sales or construction personnel E. Other (specify below) 3. 11,/The Rater or Rater's employer is: A. The seller of this home or their agent • B. The mortgagor for some portion of the financed payments on this home („„..1. 4. An employee, contractor or consultant of the electric and /or natural gas utility serving this home 4. ! ,f The Rater or Rater's employer is a supplier or installer of products, which may include: Installed in this home by: OR Is in the business of: HVAC systems 1 Rater ( Employer Rater Employer Thermal insulation systems Rater i 1 Employer ter Employer Air sealing of envelope or duct systems Rater Employer er 1,,,.t=mpioyer Windows or window shading systems Rater Employer Rater ' Employer Energy efficient appliances Rater i Employer � Rater Employer Construction (builder, developer, construction Rater Employer Rater Employer contractor, etc.) Other (specify below): Rater Employer Rater Employer I attest that the above information is true and correct to the best of my knowledge. As a Rater or Rating Provider I abide by the rating quality control provisions of the Mortgage Industry National Home Energy Rating Standard as set forth by the Residential Energy Services Network (RESNET). The national rating quality control provisions of the rating standard are contained in Chapter One 4.C.8 of the standard and are posted at http: / /www.natresnet.org /accred /standards.pdf. This home may have been verified under the provisions of Chapter Six, Section 603, "Technical Requirements for Sampling" of the Standard. • Matt Turcotte • Rater's Printed Name Certification # / May 14, 2011 Rater's Signature Date RESNET Form 0300 -2 PERFORMANCE FACTORS - C:\._.WMC 2011 UDRH v2 for REM 12.9.udr Date: May 14, 2011 Rating No.: cet 11 -151 Building Name: The Grange Rating Org.: CET Owner's Name: Phone No.: 413 - 586 -7350 Property: Oak Ridge Rd Raters Name: Matt Turcotte Address: Northampton, MA 01060 Raters No.: Builder's Name: Kohl Construction Weather Site: Northampton, MA Rating Type: Based On Plans File Name: 11 -151 Oak Ridge Rd plans.blg Rating Date: 5/14/11 UDRH The Grange DIFF % DIFF Normalized Loads (Btu /sf shell area /DD) Heating: 2.41 2.01 0.40 16.7% Cooling: 21.04 16.46 4.57 21.7% Normalized Consumption (kBtu /sf floor area/yr) Heating: 40.0 31.3 8.6 21.6% r--- Cooling: 2.8 2.2 0.6 21.1% L-' Water Heating: 9.4 8.6 0.8 8.8% Lighting: 1.9 1.9 Appliances: 8.6 8.6 Photovoltaics: -0,0 -0.0 Total w/o PV: 62.6 52.6 10.0 1670% 1 ,'*?-r Total: 62.6 52.6 10.0 16.0% t Normalized Consumption (Btu /sf floor area /DD) Heating: 6.5 5.1 1.4 21.6% Cooling: 13.7 10.8 2.9 21.1% Normalized Costs ($ /sf floor area /yr) Heating: $ 0.583 $ 0.461 $ 0.122 20.9% Cooling: $ 0.146 $ 0.115 $ 0.031 21.1% Water Heating: $ 0.133 $ 0.122 $ 0.012 8.8% Lighting: $ 0.099 $ 0.099 $ Appliances $ 0.379 $ 0.379 $ Photovoltaics $ -0.000 $ -0.000 $ Total: $ 1.341 $ 1.176 $ 0.165 12.3% Normalized Design Loads (Btuh /sf shell area /DD) Heating: 0.0020 0.0016 0.0005 22.9% Cooling: 0.0315 0.0257 0.0059 18.7% Normalization Factors Floor Area: 2196 2196 Shell Area: 5189 5189 Heating Degree Days (B65): 6179 6179 Cooling Degree Days (B74): 202 202 REM /Rate - Residential Energy Analysis and Rating Software v12.91 This information does not constitute any warranty of energy cost or savings. ©1985 -2010 Architectural Energy Corporation, Boulder, Colorado. QUICK ANALYSIS REPORT Date: May 18, 2011 Rating No.: cet 11 -151 Building Name: The Grange Rating Org.: CET Owner's Name: Phone No.: 413- 586 -7350 Property: Oak Ridge Rd Raters Name: Matt Turcotte Address: • - • on, MA 01060 Raters No.: Builders Name: Kohl Construction Weather Site: Northampton, MA Rating Type: Based On Plans File Name: 11 -151 Oak Ridge Rd plans.blg Rating Date: 5/14/11 Codes Programs IECC 2009 Performance: Fails EPA ENERGY STAR 2.0 Fails IECC 2006 Performance: Fails EPA ENERGY STAR 2.5 Passes IECC 2004 Performance: Fails EPA ENERGY STAR 3.0 Fails IECC 2003 Performance: Passes Tax Credit F IECC 2001 Performance: Passes HERS Index IECC 2000 Performance: Passes IECC 1998 Performance: Passes ECC of NY Performance: Passes ECC of NV Performance: Passes MEC 1995 Performance: Passes MEC 1993 Performance: Passes MEC 1992 Performance: Passes ASHRAE 90.2 Performance: Passes REM /Rate - Residential Energy Analysis and Rating Software v12.91 This information does not constitute any warranty of energy cost or savings. © 1985 -2010 Architectural Energy Corporation, Boulder, Colorado. - » I'm curious about the status of our building permit for 72 Emerson » Way » If there is any information you need from me please do not hesitate » to request it. » Thank you, » Fred Meyer » City of Northampton email messages are public records except when » they fall under one of the specific statutory exemptions. > -- > Visit us online !<http: / /www.cetonline.org> > Matt Turcotte< mailto:mturcotte@cetonline.org> 1 Energy Analyst Center > for EcoTechnology 1 320 Riverside Drive - 1A 1 Northampton MA 01062 > 413 - 586 -7350 ext. 231 1 413 - 259 -5064 (cell) www.cetonline .org<http: / /www.cetonline.org> 1 Sign up for EcoUpdates! > <http: / /www.cetonline.org /Mailist /VR Signup.php> Visit us online! <http: / /www.cetonline.org> Matt Turcotte < mailto :mturcotte(alcetonline.org> 1 Energy Analyst Center for EcoTechnology 1 320 Riverside Drive - 1A 1 Northampton MA 01062 413 - 586 -7350 ext. 231 1 413 - 259 -5064 (cell) www.cetonline.org <http: / /www.cetonline.org> 1 Sign up for EcoUpdates! < http : / /www.cetonline.org /Mailist /VR Signup.php> 3 a A » *From:* Charles Miller f mailto :cmillerOnorthamptonma.gov] » *Sent:* Tuesday, June 21, 2011 4:13 PM » *To:* Fred Meyer » *Subject:* RE: 72 Emerson Way permit Status » Hi Fred, » I need to know what CET is basing the HERS rating on? Tell Matt I » need more detail, what insulation is where. Your wall section on » sheet 12 is not consistent. 2 x 6 plates, 2 x 10 walls. 2" XPS in » header with 2x10 walls? Fiberglass in the basement ceiling. » How are you intending to meet braced wall requirements at the garage » door . If portal frame see R602.10.3.4 for the garage application. » This is not just plywood both sides with nails 4" OC. I don't doubt » that this may work, but will require engineering. Also note wall » steel and double anchors are needed. » Thanks, » Chuck Miller » *From:* Fred Meyer ( mailto :fineyer@kohlconstruction.coml » *Sent:* Friday, June 17, 2011 11:29 AM » *To:* Charles Miller » *Subject:* RE: 72 Emerson Way permit Status » Chuck, » I had heard through the grape vine that local inspectors were down there. » Next week it is. » We do have all of our approvals for water, sewer and driveway from » the DPW. » Thank you, » Fred Meyer » *From:* Charles Miller [ mailto :cmiller(alnorthamptonma.govl » *Sent:* Friday, June 17, 2011 9:43 AM » *To:* Fred Meyer » *Subject:* RE: 72 Emerson Way permit Status » It on my plate, but I've been in W. Springfield helping out so I » haven't gotten through it. Next week. » Chuck Miller » *From:* Fred Meyer ( mailto :fineyerPkohlconstruction.coml » *Sent:* Thursday, June 16, 2011 2:38 PM » *To:* Charles Miller » *Subject:* 72 Emerson Way permit Status » Hi Chuck, 2 � r Charles Miller From: Fred Meyer [fineyer @kohlconstruction.com] Sent: Friday, July 08, 2011 2:42 PM To: Charles Miller Subject: FW: FW: 72 Emerson Way additional info from CET for HERS rating Hi Chuck, Matt finally sent this info. I hope it is what you were looking for. Fred Meyer Original Message From: Matt Turcotte [ mailto :matt.turcotte @cetonline.org] Sent: Wednesday, July 06, 2011 4:35 PM To: Fred Meyer Subject: Re: FW: 72 Emerson Way permit Status Thanks Fred. I had the -Foam in the model, I just forgot to include it in the email. -Matt Fred Meyer wrote: > Matt, > Band joists are insulated with 1" foam on the exterior, depending on joist spacing the interior of the band joist is blown cellulose between joists when there is not enough room for fiberglass or R -19 fiberglass blockers and runners. > Everything else looks good. > Thanks, > Fred > Original Message > From: Matt Turcotte [ mailto :matt.turcotte @cetonline.org] > Sent: Wednesday, July 06, 2011 3:08 PM > To: Fred Meyer > Subject: Re: FW: 72 Emerson Way permit Status > Hi Fred. Here are the specs that I based my analysis on. Please let me know if any of these are incorrect: > basement ceiling: R30 fiberglass batts band joists: 5.5" dense pack > cellulose (R19.25) exterior walls /garage walls /basement stairway > walls: 5.5" dense pack cellulose (R19.25) > windows: U -value = .30, SHGC = .28 > doors: R5 insulated doors > ceilings: 13" loose cellulose (R48) > attic scuttle: 4" XPS (R20) > Let me know if you need any other info. > -Matt > Fred Meyer wrote: PLOT FILE CREATED: 6/24/2011 10:50:11 AM 1 REVISIONS # Revision /Issue Init Date ..,,,„, r j'� _ _ frfr_ -.114.--- J � V r s 3 i , ___ / C ` - / i 68 �� o � w 2 \� 70.2' .. 0 2' I t `� t 4 u� , � , 20 �G • / 0'^ / -h , W Noss , • w / fr./2 1?0, I h4 , , / C / CJ �.,v i 0 Cb / • .` • / / / - / • • • / 56 , / --.`` N88:2, 2 9'0 6 „ / 79 ` .6 �'- / ......... J n n , 0 5' 10' 15 20' 1) , 6 4 40' Kohl Construction J DATE SITE PLAN EMERSON WAY [lot# 56] 06.24.2011 Spy TITLE SCALE 31 Campus Plaza Road, Hadley, MA01035 EMERSON WAY, Northampton, MA 1" - 20' 1 OF 1 ph (413) 256 -0321 fx (413) 256 -0130 COP'RIGHT C: KOHL CCNSTRWTION. INC G July 12, 2011 Kohl Construction 31 Campus Plaza Road Hadley, MA 01035 Subject Property: 72 Emerson Way — Lot #56 Florence, MA 01062 Mr. Parker, The plans for the Single Family Residential Building dated 4 -26 -11 have been approved as noted; 1. Individual items will be reviewed on site for verification of code compliance. 2. Structure must conform to 780 CMR 8 addition 1 and 2 family building codes. 3. Energy components must meet stretch energy code requirements. (appendix 115AA) A copy of the initial HERS rating is required as well as a copy of the final HERS rating with blower door and duct blast testing results. 4. There must be a continuous air barrier behind all fireplaces, tubs, and showers on exterior walls before fixture installation. 5. Note additional anchor bolts may be required to meet braced wall requirements plan ahead. 6. Deck rail post must be bolted through the deck framing. 7. Dampened make up air is required for wood burning fireplaces. 8. Must be a smoke and CO within 10' of bedrooms, at the bottom of stairs leading to a finished level, and for each 1200 SQFT. Smokes in each bedroom and heat detector in attached garages. 9. All engineered products must be provided with stamped engineering and shall be installed per engineering drawings and notes. I- joist, LVLs, and truss stamped drawings required, email format. 10. Manufactures requirements must be followed for all intake and exhaust locations (separation distances). 11. HVAC heat loss calculation per Manual J room by room. 12. HVAC equipment sizing and energy specifications. 13. HVAC contractor must obtain - a sheetmetal permit, the application must include a line drawing of the supplies, returns, damper •cations, and CFM flow at all registers. Charles Miller Assistant Commissioner of Buildings r. , r The Commonwealth of Massachusetts Department of Industrial Accidents ; ='l Office of Investigations .S.1:1101-1-7 y 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name (Business /Organization /Individual): Kohl Construction, Inc. Address: 31 Campus Plaza Road, Suite 3 City /State /Zip: Hadley, MA 01035 Phone #: 256 -0321 Are you an employer? Check the appropriate box: Type of project (required): 1. 0 I am a employer with 14 4. ❑ I am a general contractor and I 6. 0 New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7 ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11. ❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. 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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 800287201 2010 Expiration Date: 02/10/12 Job Site Address: Lot 56 Oak Ridge Rd. City /State /Zip: Northampton, MA 01060 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 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. Be advised that 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 pins and penalties of perjury that the information provided above is true and correct. Signature: �.. ,L.. ' " 1 / 7 / 3 , 4 % ) Date: April 28, 2011 Phone #: 256 -0321 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 #: • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable El Name of License Holder F,.b 5,. n E E . I� 1K O N , [ 63 / License Number 3l CM P1..4hA . ht, LEY CIA 01 63'5 5 Jis/i Address Expi on D Z56 o3z/ Signature Telephone F " S: � Reaistered Home lrriproverreiit• Contractor;`, Not Applicable ❑ 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. Signed Affidavit Attached Yes lid No ❑ 11, - _mine O nerE iiiition 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 -vear 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) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature Aimf SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House E Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ri Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [q Siding [0] Other [0] Brief Description of Proposed Work: Comt-►'iwcr hla tAJN ►rbe -wf trrn\pHe.t GAtLAC S b C.lC' t ceNdettirfi PO ecJ-j Alteration of existing bedroom Yes )( No Adding new bedroom Yes V No Attached Narrative Renovating unfinished basement Yes 11 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: 13 • Number of Bathrooms 2.5 c. Is there a garage attached? y , ', / a / b d. Proposed Square footage of new construction. 2/ Sr Dimensions 21- Y 4' ' 5 ) Z2 x TO -o e. Number of stories? `` 2- cc nn ,, II • f. Method of heating? [1tarNn» 444, TUcedr I A il Fireplaces or Woodstoves A,/b Number of each 0 g. Energy Conservation Compliance. , 7 Masscheck Energy Compliance form attached? /V h. Type of construction i. Is construction within 100 ft. of wetlands? Yes X. No. Is construction within 100 yr. floodplain Yes X No J j. Depth of basement or cellar floor below finished grade _ n k. Will building conform to the Building and Zoning regulations? )X Yes No . I. Septic Tank City Sewer X Private well City water Supply x SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, RI e N laZt (' 1 Ato tN fl'j. , as Owner of the subject property hereby authorize I k;ot E. P Attic Ek. r, to act on my behalf, in all matters r a to work authorized by this building permit application. Signature of Owner Date I, TfrmotolaE E. PAkA ' , 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. TyE.nno -� E. PA - e- Print Name Signature of Owner /Agent Date 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 12. 181 5 F .. Frontage • Setbacks Front ZA Side L:. 1.... R..L2 L: R: .al Building Height r - I Bldg. Square Footage ZeT93 till. lie Open Space Footage (Lot area minus bldg & paved _," parking) # of Parking Spaces , 2-- Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued:'': IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES IF YES: enter Book Page I and /or Document #, B. Does the site contain a brook, body of water or wetlands? NO CIO DON'T 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 NO *4 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 4 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 0 NO *®4 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. f ( / V t 41 r: 1 EIVED tep 4se only ' Cit of Nort h a mpton S tatu s : of Permi ry � �, Bui lding Department Cu rb Cut/Driveway Pe , `` SIN — 3 201 I , � 212 Main Street Sewer/Septi Av a il a b I ilit Y dl 3 � y Room 100 W Availability ice. DEPT. OF BUILDIN No r oKw►o+aeo 'NO ,,A0 MA 01060 , Sets o f� Strud� Plan F phon 413- 587 - 1240 Fax 413- 587 -1272 Piot/Slte ' � .�g ` ,, O t he� Sec, f y ���,�� . �• ,.. �i. APPLICATION TO CONSTRUCT, ALTER, R EPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELL SECTION 1 - SITE INFORMATION 1.1 Propertv Address: �t�•�,. `- } This section to be completed by office 01- 5 ( M ���60 J WAy� Map 4 Lot Un re d AK tQEs � Zon Overlay Dist No tr'>H AM 11-1.1;94 A Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED A GENT 2.1 Owner of Record: �ANl�al�l Pao �r/ GZ' C lt ixrd� 1�tC1#tt M lS0 pith) 14 S Note 4 M�ro�, o ►A6a Na ( Pri t) / Current Mailin Address: ZA `/ 3 58Z - 977 d 1 X/o Telephone Signature t t o - $reS. *Or 2.2 Authorized Agent: '� c 31 C�MAus PL h NAILky, M4 DI1� Name (Print) Current Mailing Address: o3z 1 � �" z// 256 Signature S Telephone SECTION 3 - ESTIMATED CONTRUCTION COSTS Item Estimated Cost (Dollars) to Offic Use Only , 6 co mpleted by permit applicant 1. Building (a) Bu i ld ing Permit Fee / /20, 00 0 2. Electrical / (b) Estima To tal C ost of �/ Q d Constr from (6) 3. Plumbing l 2 O r) C7 Building Permit Fee ry35 i 3 4. Mechanical HVAC 1 "" 5. Fire Protection 0 0 U 0 3149-4 6. Total= (1 +2 +3 +4 +5) �rj ?3 OD b Check Num . This Sec For Officia Use Only Date Building Permit Number: Issued: Signature: Building Co mm issioner /Inspector of Buildings Date /11)16 - P 1.,,A File # BP- 2011 -1016 �� j APPLICANT /CONTACT PERSON KOHL CONSTRUCTION � ]` U , [ d r`�� ADDRESS/PHONE 31 Campus Plaza Rd HADLEY (413) 256 -0321 t 1 Y1A) PROPERTY LOCATION 72 EMERSON WAY - LOT 5C - OAK RIDGE RD MAP 36 PARCEL 400 001 ZONE SR(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Ty �j � 5 _ / . Fee Paid V /(p to Tvpeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE/DECK & PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 064539 n 3 sets of Plans / Plot Plan QtT2atka THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION 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 ems ' '."='a 7 ;e : Signature of Bui ding 0 icial 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. 72 EMERSON WAY - LOT 5C - OAK RIDGE RD BP- 2011 -1016 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 400 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: New Single Family House BUILDING PERMIT Permit# BP- 2011 -1016 Project # JS- 2011- 001647 Est. Cost: $153000.00 Fee: $2513.66 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 064539 Lot Size(sq. ft.): 12196.80 Owner: OAK RIDGE ROAD LLC Zoning: SR(100)/ Applicant: KOHL CONSTRUCTION AT: 72 EMERSON WAY - LOT 5C - OAK RIDGE RD Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 - 0321 Workers Compensation HADLEYMA01035 ISSUED ON:7/12/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT 2 STORY SFH W /ATT GARAGE /DECK & PORCH 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 7/12/2011 0:00:00 $2513.66 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner