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39A-041 • (`' .'\ 10'-4 314 "_ ,- - x'7 F UTURE FOUR PARKING SPACES :D 64' x 24' TWO -UNIT . -6 , WNHOUSE BUILDING 0 EXISTING EXISTING 10' -0" BARN BARN \,. % , FU ► -E DRIVEWAY % 0," , e 7 1, 192-0" 6 OPEN YAR OR Q 5 10' -0" 4 EXISTING 116' -6' 7 TWO -CAR 3 EXIST' PARKING GARAGE (FOUR - ACES) liilh• 8 N•-FAMILY BUILDING 'ED A •FFICE BELOW Ni°' , ID - ESID CE ABOVE. y 20.-0" O G 4 , ibio - \ *4114., 'd 260' -0" 'ROPOSED • oDITIONAL 2 PARKING 'ACES 14 4 17'-4 1/2" \ 15' -0" J / . _ - _ _ _ .., _ _ giiid/ce_ rivelooR..c., . L r „, x RooF R e R tick M" , 61\5 R""1" Sert.,1c..f. 12 1 7 y _c v (i3 GieLlits& 0 $ 7 p ? 1 Dooh)e 02 1.), Loi'/), p 1 e aLL Piki.t.,5 /4 cc, 13 — ily tipi pT - 110.- ......_ PT 51,1por 1L5 /1 *--------) # L i 4/— ..--... Ill l • . It P T 6) c, 1.....i/ 6 ,„ 4 1 we.._ S 1.,f tt r 7 S I IR ri .1e. FT A7■A„ r ,Qc.., i ( — , r 1 11 (..- ) v 2X1 . 1 3- f r 1 1 1 I\ Li ( — o f I i --1- L.---- ' I I I 11 b / - • 6 . 5 e> K.9 Ca_ ru e— Li �� � XS T u�.r°� ,5 ee , 1 Le &i /o b 4/ fr)f ___ T ......_...... _____________ ,, ce i 1 1 l .� a x 8 r' r . : J -6 r 5 I N I 1 1 1"1/ PA:* -Jr,- e c' S ' H 1 i i N ' I 1 4 . L-•*---- 7 — / / Y/7/ prt. co ? / / / i I�u 5� Nod ! �' E'er a i iii , "6 b-- h - s , \ ) i fi 1 - - r ,oe 0 \ ___-- it \ _ds"ai _h \ a A___ , \ -‘) ) h lc I w \ __ -1, -Q -7 ....A..., _c --- ,, , . \________.A--- ) ." k 4 .) , , , ":",--1- \--- 44 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations r : 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): Yet,tt,> �l e l C. t- coo t1� t 80/ f �i Address: fff City /State /Zip: Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and /or part-time).* have hired the sub - contractors 6. ❑New construction 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. employees and have workers 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] ' c. 152, §1(4), and we have no employees. [No workers' 13. ❑ Other comp. insurance required.] *An% 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 state whether or not those entities have employees. If the sub - contractors have employees. they must provide their workers comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: 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 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 unde the pai r , an ' penalties of perjury that the information provided above is true and correct. �. Signatur I Date: Y// 3 !/ Phone #: G[ LL' Z'(7 ?AC-9 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 #: .04/13/2011 WED 11:17 FAX LOj0U1/OUZ Client #: 15160 WILLI47 ACORO„ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/ Ym PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION King & Cushman, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE King & Finn Streets HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 447 Northampton, MA 01061 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Peerless Insurance William R. Childs INSURER B: The Travelers Insurance Company 229 Wisdom Way INSURER C: Greenfield, MA 01301 INSURER 0: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !NSA ADD'L TYPE OF I NSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS :NSRC DATE IMM/DO/YY) DATE (MIIIOD/YY) A GENERAL LIABILITY CCP8248131 03/09/11 03/09/12 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY p3FMI RENTED t .x,000 CLAIMS MADE in OCCUR MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 1 POLICY 1 JECT n LOC AUTOMOBILE LIABILITY _ ANY AUTO ( COMBIINEEM? ANGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ — SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) --- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 5 _ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG 5 EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ — I OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND 7PJU84266P06110 06/16/10 06/16/11 i WC STATU- 1 1 oTH- TORY LIMITS FR EMPLOYERS' LIABILITY E.L. EACH ACCIDENT 5100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFlCERlMEMBEfl EXCLUDED? E.L DISEASE - EA EMPLOYEE $100,000 it yes, descnbe under SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Northampton DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 111 DAYS WRITTEN Building Inspector, Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Northampton, MA 01060 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TTiE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTH RAZED REPRESS T ry ATIVE ACORD 25 (2001/08) 1 of 2 #S10029/M10028 O,[ � c_s SAK 0 ACORD CORPORATION 1988 • APR -7 -2811 86:58 FROM: RYAN S HELLWIG, PE 1 413 584 4593 TO:14137759269 P.1/1 • • RYAN S. HELLWIG, PE • STRUCTURAL ENGINEER • ��,tiH OF te a`` RYAN S. 4 MELLWIG 3 STRUCTURAL. { No. 37300 � .- April 7, 2011 / Bill Childs, Building Contractor Yankee Millwork & Building 132 Elm Street Hatfield, MA 01038 Fax: 413- 775 -9269 Re: Beam for New Deck Albert Mosley Residence 88C Hockanum Road Northampton, MA Design Criteria Live Load = 60 psi Tributary width = 10 ft (half of 20 ft wide deck) Beam Span = 16' -0" Beam Deflection = L/240 maximum for live load L /180 maximum for Total Load including Creep Factor = 1,5 on Dead Load Use W 10 x 49 (beam is oversized to provide adequate space for attaching wood deck framing) Steel Specification: Fy 36,000 psi (Yield Stress - minimum) • 28 ALDRICH STREET • NORTHAMPTON, MA 01060 • M VOICE 413 - 584 -HLWG (4594) • FAX 413 - 584 - HLWFax (4593) • . . -=.- N1.1.achu■ctts - Department of Public Board of Buildin2 Reuulation and Standard - Construction Supervisor License License: CS 14572 Restricted to 00 WILLIAM R CHILDS s f ,2 229 WISDOM WAY , .. GREENFIELD, MA 01301 ---5 Expiration: 10/31/2011 ( , .■11f11 k‘i. Tr 5013 -, i_o.../..ea Office of Consumer Affairs & B siness Regulation HOME IMPROVEMENT CONTRACTOR Registration: 100320 Type: Expiration: 611612012 DBA Yierkee Millwork & Bldg William Childs 229 Wisdom Way Greenfield, MA 01301 Undersecretary Versionl .7 Commercial Building Permit May 15. 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, G S er T ` rri 5 LE y , as Owner of the subject property hereby authorize h (LL / ay✓. / / C_ 77 S to act on my b al , in all matters 7 .tive to work a crize by this building permit application. / /f7 / (1' Signature f er Date I `.. I I �` l L ( 3 , 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. W tG.t . wt R ehr LcLS Print Name Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ S (-1 s 7 �_ Name of License Holder : Li- a_ G � � C ce License Number wCS o w 6''�°' occ.. /0 /3i/ � 1 Address Expiration ate � aCP 9 Signature Telephone SECTION 13 - 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 f No 0 Version1.7 Commercial Building Permit May 15. 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not ApplicabIgk Name (Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Pp. tt7 h L4) Name Area of Responsibility OZ /T L fJ C C IpL 5 T C /J // c 3 7 v Address Registration Number 9ec 546y '15,y Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor .y1 Y IP-A ) C( e - c � ° • "`°1 Not Applicable ❑ Company Name: e i? ( Responsible In Charge of Construction w t 5 p (A) e1/4.y 6P( /;l4_ Address / L ,?Y7 9�6 Signature Telephone Version 1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW Mj YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO "DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO I1 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 �RC 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 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other 0 Brief Description Enter a brief description here. Rem c r a, d p r m.c e w ! `F Of Proposed Work: TaG4s e. O e - c SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 0 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1 St 15t 2nd 2nd 3 rd 3 4 th 4 Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone0 Municipal ❑ On site disposal system C r"; I. ' '/ Versionl.7 Commercial Building Permit May 15. 2000 Department use only City of Northampton status of Permit: LU Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability L OFBUNGSPEON$ Room 100 Water Nell Availability NORTHAMPTON. MA 01000 Northampton, MA 01060 Two Sets of Structural Plans phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office B` ? / C. i 4 OM RL Map Lot Unit 1 )0 (2,ACt/141% c 11 C Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: p p- Name (Print) /¢L b�-r ' t v in o $ Le. O o C' / C a ' ' " I J? ' C u rrent Mailing Address / t! Signature r1��� p • Telephone 60 J P 7 4 ' ` 2.2 Authorized Agent: Name (Print) !tip i & I-- I a ` k C Current Mailing Address: o2 d 9 S f, ()Ng (AA-5/ /��// > Q evn t 9 3 /e )C . ('oe Stec Signature ` - -- , �' ✓ n Telephone oG� /- / r /.z co / SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building / D C ) O ©-- (a) Building Permit Fee 2. Electrical (� (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection �i 6. Total = (1 + 2 + 3 + 4 + 5) 6pOo0 a -- Check Number 1r/ � , ? 5 v . This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date ■ File # BP- 2011 -0834 ge`Pli'6 cyK: APPLICANT /CONTACT PERSON YANKEE HOME IMPROVEMENT INC ADDRESS/PHONE 82 INDUSTRIAL DR, UNIT 2 NORTHAMPTON (413) 584 -8318 Q � , h 6 PROPERTY LOCATION 88 HOCKANUM RD RA 1�' V MAP 39A PARCEL 041 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT A e Paid . 1dinl Permit Filled out a ee Paid 1 I u _ T A• eof Construction: Re .lace deck with lamer New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE F : LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ' ' 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 em•1' ': rDelay VS)) . ture 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. f 88 HOCKANUM RD BP- 2011 -0834 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 39A - 041 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit # BP-2011-0834 Project # JS- 2011- 001378 Est. Cost: Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Yankee Millwork and Building 14572 Lot Size(sq. ft.): 34935.12 Owner: MOSLEY ALBERT Zoning: URC(100)/ Applicant: Yankee Millwork and Building AT: 88 HOCKANUM RD Applicant Address: Phone: Insurance: 229 Wisdom Way (413) 247 -9269 WC GREENFIELDMA01301 ISSUED ON:4/22/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: Replace deck with larger 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 4/25/2011 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner