17C-191 Simmons 3- 5 -12
Key a Florence 10:46am
J 1 of 1
KeyBeam® 4.507f
kmBeamEngine 4.509v
Matenals Database 1334
Member Data
Description: Member Type: Beam Application: Floor
Top Lateral Bracing: Continuous
Bottom Lateral Bracing: None
Standard Load: Moisture Condition: Dry Building Code: IBC / IRC
Dead Load: 10 PLF Deflection Criteria: L/360 live, L/240 total
Live Load: 40 PLF Deck Connection: Nailed Member Weight: 9.4 PLF
Filename: KYB1
Other Loads
Type Trib. Dead Other
(Description) Side Begin End Width Start End Start End Category
Replacement Uniform (PSF) Top 0' 0.00" 12' 0.00" 11' 6.00" 10 30 Live
a - .�, »s_x x-; ,� _ a ......:.a..3 .� .., �. �w. _ ssa�s`s � i �rn a ' LS ���i w,. ,; > _,�. , ,,,!: . 'a ji
12 0 0
0
12 0 0
Bearings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
1 0' 0.000" Wall N/A N/A 1.500" 2851# --
2 12' 1.750" Wall N/A N/A 1.500" 2851# --
Maximum Load Case Reactions
Used for applying point loads (or line loads) to carrying members .
Dead Live
1 755# 2095#
2 755## r- -` 205#
Design spans `
42' 1.750"
\
Product: 1- 314x9 -112 VERSA -LAM 2.0 3100 SP 2 ply
Component Member Design has Passed Design Checks:"
Connect members with 2 rows of 16d common nails at 12.0" oc
Minimum 1.50" bearing required at bearing # 1
Minimum 1.50" bearing required at bearing # 2
‘N., Design assumes continuous lateral bracing along the top chord.
'Design assumes no lateral bracing along the bottom chord. ,,e
Allowable Stress a rgn- ---.__.... ...._, --'
Actual Allowable Capacity Location Loading
Positive Moment 8656.'# 13958.'# 62% 6.07' Total load D +L
Shear 2479.# 6317.# 39% 0.01' Total load D +L
TL Deflection 0.4596" 0.6073" 1J317 6.07' Total load D +L
LL Deflection 0.3378" 0.4049" L/431 6.07' Total load L
Control: LL Deflection
DOLs: Live = 100% Snow= 115% Roof =125% Wind= 160%
II
All product names are trademarks of their respective owners
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"( F+ l' Copyright (C)1987 -2011 by Keymadc Enterprises, LLC, ALL RIGHTS RESERVED.
., :reuruisrc'a.c
"Passing is defined as when the member, floor joist, beam or girder, shown on this drawing meets applicable design criteria for Loads, Loading Conditions, and Spans listed on this sheet.
The design must be reviewed by a qualified designer or design professional as required for approval. This design assumes product installation according to the manufacturers specifications.
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N91-r2D 'D N11..9.3
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends 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
home owner."
The building department for the City of Northampton wants person(s) who seek to use
the home owner exemption, to act as their own construction supervisor, to be aware that
by doing so you become responsible for compliance with state building codes and
regulations. The inspection process requires that the building department be called to
inspect work at various stages, which include foundation /footines (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
Permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
,
, .
The Commonwealth of Massachusetts
=.-*.m-.....=- Department of Industrial Accidents
=1*-------- - Office of Investigations '
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/Indivirhi21):de r
Address: 91 At" foglir -ci . r"(ore--(4 a I A il - „ -
City/State/Zip: F/0 reu c-e - Phone.#: 1 f 1 2 7 cwt./ ztoo
• 'I
Are you an employer? Check the appropriate box: Type of project (required): /
1. 0 I am a employer with 4• 0 I am a general contractor and I
6. 0 New construction
have hired the sub-contractors
employees (full and/or part-time).*
listed on the attached sheet. 7. 0 Remoclelins
2. :7.4 I am a sole proprietor or partner-
ship and have no :tloyees These sub-contractors have . 8. 0 Demolition
working for me in any capacity. employees and have Workers'
9. -Er Building addition
[No workers' comp. insurance _ comp.in.sro-xocP...
10.0 Electrical repairs or additions
5. 0 We are a corpoiation and its
required]
3. 0 I am a homeowner doing all work officers have4xercised their 11.0 Plumbing repairs or additions
t
myself. [No workers' comp. right of exemption per MGL
12.0 Roof repairs
insurance required.] t c. 152, §1(4), and we have no
eniployees. [No workers' • 13.0 Other
.
comp- =maw e recluired-i .
-
*Any applicant -that checks box #1 must also fill out the section below showing thew woricers' compensation policy infonnation. - .
1. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
1 Ccartractcas that check this box =1st 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. —
l am an employer that & providing workers' compensation insurance for mr...empleiyees. Below is the policy and job site
information. . __---
-.---
....
Insurance Company Name:
Po ....„„.......„........,______ :„............„------
Policy or Selfns Lic #
# -i. . : Expiration Date:
. ,
Job Site Address: City/State./Zip:' • - .
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
. - -
Failure to secure coverage. as requited taidet Section 25A 'Of MGL c. 152 can lead to the inipositiott of Criminil 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 t.his statement may be forwarded to the Office of
Investigations the DIA for insurance cOvera VeiifiCaliOn.
Ida Irerebycertifil under, p • an penalties ofpetjury that the information providedTabav .e_zit7
,
Signature: Fli ' . Date: . 2 - ...Z 1 — / ''r---
Phone #: 1 1/ 2 2 cr - 74 0 0
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. ElectricalInspector 5. Plumbing Inspector
6. Other , E.
Contact Person: Phone #:
4111111111111111111111111110111ININMINONimi
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑ a
Name of License Holder : 044,1110 3 0
License Number
57 f7ore#tc' / �� . 2 -3 -I
Address Expiration Date
Signature Telephone
11.14.!'t:„ 'm• 9 2 . <, f lm' , . = ri • ; r a Not Applicable ❑
al 0 Zs
Company Name Registration Number
`77 Ploreuce IC- 201
Address / [[�� 2 � Expiration Date
W 3
Telephone Zia)
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 6A No ❑
IIK • ' R r 1
The current exemption for "homeowners" was extended to include Owner - occupied Dwellin • • one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a lic - e, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 1083.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which h- e resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or deta structures accessory to such use and/ or farm
structures. A person who constructs more than one home in o-vear period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, . ; form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under t • uildine permit. •'• ` • • . • ;
As acting Construction Supervisor your pre = e,on the job site will be required from time to time, during and upon
completion of the work for which this . - - t is issued. +
Also be advised that with referen o Clopter 152 (Workers' Compensation) ancJ Chapter'f53 (Liability of Employers to
Employees for injuries not r'. tins in Death).ofllw Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform w• or ydu under tliiis permit. -
The undersi y, - omeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
No , . - . on Ordinances State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
•
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alterations) , , Roofing ❑
Or Doors C3
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E] . .
Siding [p'] ; , Other [DJ •
Brief Description of Proposed
Work C� I - 'e , ) RE/AD DE
Alteration of existing bedroom Yes o Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
61444tiiiiiii4iikihictielhatikiiiiilikiiiiiiiiiiiaNCEiiiii6iiiiiiihiiii46464 • .
a. Use of building % One Family' Two Family '= Other
b. Number of rooms in ea « amily unit: Number of Bathrooms ''
c. Is there a garage attached?
d. Proposed Square footage of new constru • • Dimen §ions
e. Number of stories?
f. Method of heating? Fir aces. or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck ergy Compliance form attached?
\
h. Type of construction
i. Is construction within 10 wetlands? Yes No. Is construction within 1b13-Xr, floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will bujlding conform to the Building and Zoning regulations? Yes No .
1. 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, "p -bt ') StiMiv., oN 5 , as Owner of the subject
property j�
hereby authorize 'Eb iv IN 01,. PCJJ. {i
to a on alf, in all matters relative to work authorized by this building permit application.
zA z e t 1 t .
Signa re o _�` _ -- . V .� � � Date
I, E J 0 (ah1er 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 undclif.fai nd penalyes of perjury.
Print Name
F/1) L - o DE/ 'SR_ zlZf, / z--
Signature of Owner /Agent Date
• .,
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information i
Existing Proposed Required by Zoning 7 1
This column to be filled in by s{{
Building Department
Lot Size L c ()190.4421 { Zc o t
Frontage Rift i I 6 ` i ! - .
Setbacks Front rS r = i
Side L: £ R:�_ L: 1 R: 6 is G
Rear alt 1
k 1 b ��..-
Building Height e__ € ` , ' , , , *,' , . i • • .
Bldg. Square Footage % K ' , �,
Open Space Footage
(Lot area minus bldg & paved / f a .' ` 61.1 _
parking) 3 ff77 //
# of Parking Spaces
Fill: i f '._..:; . r :1 �... _ € : - �..�.d.b,.�..._,..
(volume & Location) { •
A. Has a Special Permit /Variance /Find ng ever been issued for /on the site?
NO Q DONT KNOW YES 0
•
IF YES, date issued:! 1
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW I. YES Q
IF YES: enter Book 1 I Page 1 and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 6 DONT KNOW 0 YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , bate Issued: ,
C. Do any signs exist on the property? YES 0 NO !`
IF YES, describe size, type and location: t I . '
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO 0
IF YES, describe size, type and location: I
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 + 1 4
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
= R �1 City of Northampto §
Building Department ffi x t
212 Main Street =� g �~ 3
1 2. 2412
,
- ; ', , � Room 100 = �� r �� #4.0 p
orthampton, MA 0Q60 R
oo moo,,.° • ne i 587 -1240 Fax 413 -587 -1272 "�
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
S ►Tt 1. ? SITE INFORMATION
This section to be completed by office
1.1 Property Address: //
bt W1L1).cia.. 'pLtcG Map Lot Unit
V Lp CPC '6 ,i , zone lrerlay District
Elm St. Distr cf CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZE ENT '• > r
2.1 Owner of Record:
N e � � -- Curr�n N�ailintA ireg q 10
Telep one
Sign ure
2.2 Authorized Agent:
El O(Ccudel e 7 awshk4.4.1 St'
Na mi (Plipt),X) 2 , Current Mailing Address:
( L > i( 415 j�� f Z(Oo
Signature i Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by,permit applicant
1. Building ,I t o D 0 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
` ) 0 f Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) � n
5. Fire Protection NA
6. Total = (1 + 2 + 3 + 4 + 5) p r i 1� n Check Number 6r-1 4 10 l 90
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Comm /Inspector of Bu Date
File # BP- 2012 -0790
APPLICANT /CONTACT PERSON EDWIN OLANDER
ADDRESS /PHONE 97 CHESTNUT ST FLORENCE (413) 584 -2100 ()
' PROPERTY LOCATION 11 WILDER PL
MAP 17C PARCEL 191 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out l� � fo
Fee Paid Sal
Typeof Construction: REMODEL KITCHEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 049348
3 sets of Plans / Plot Plan
T H FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I ORMATION PRESENTED:
A pproved 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
Demoli on Delay
�/ re ( 1
Signature of Building Official 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.
11 WILDER PL BP- 2012 -0790
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C - 191 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP- 2012 -0790
Project # JS- 2012- 001382
Est. Cost: $15000.00
Fee: $90.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: EDWIN OLANDER 049348
Lot Size(sq. ft.): 5096.52 Owner: SIMMONS KATHLEEN E
Zoning: URB(100)/ Applicant: EDWIN OLANDER
AT: 11 WILDER PL
Applicant Address: Phone: Insurance:
97 CHESTNUT ST (413) 584 -2100 ()
FLORENCEMA01062 ISSUED ON:3/16/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: REMODEL KITCHEN
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 3/16/2012 0:00:00 $90.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner