24D-188 ,E 2009 IECC Energy
1( Efficiency Certificate
Insulation Rating R -Value
Ceiling / Roof 50.00
Wall 21.00
Floor I Foundation 30.00
Ductwork (unconditioned spaces):
Glass & Door Rating U Factor SHGC
Window 0.30
Door 0.30 NA
Heating & Cooling Equipment Efficiency
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments:
•
D Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code.
O For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial
Building Mechanical and /or Service Water Heating (Sections 503 and 504).
Circulating Service Hot Water Systems:
O Circulating service hot water pipes are insulated to R -2.
Li Circulating service hot water system's include an automatic or accessible manual switch to turn off the circulating pump when the
system is not in use.
Heating and Cooling Piping Insulation:
O HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R - 3.
Swimming Pools:
▪ Heated swimming pools have an on /off heater switch.
Li Pool heaters operating on natural gas or LPG have an electronic pilot light.
Li Timer switches on pool heaters and,pumps are present.
Exceptions:
Where public health standards require continuous pump operation.
Where pumps operate within solar- and /or waste - heat - recovery systems.
Li Heated swimming pools have a cover on or at the water surface. For pools heated over 90 degrees F (32 degrees C) the cover has a
minimum insulation value of R -12.
Exceptions:
Covers are not required when 60% of the heating energy is from site- recovered energy or solar energy source.
Lighting Requirements:
O A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following:
(a) Compact fluorescent
(b) T -8 or smaller diameter linear fluorescent
(c) 40 lumens per watt for lamp wattage <= 15
(d) 50 lumens per watt for lamp wattage > 15 and <= 40
(e) 60 lumens per watt for lamp wattage > 40
Other Requirements:
O Snow- and ice - melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting
off the system when a) the pavement temperature is above 50 degrees F, b) no precipitation is falling, and c) the outdoor temperature is
above 40 degrees F (a manual shutoff control is also permitted to satisfy requirement 'c').
Certificate:
u A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R- values; window
U- factors; type and efficiency of space- conditioning and water heating equipment. The certificate does not cover or obstruct the visibility
of the circuit directory label, service disconnect label or other required labels.
NOTES TO FIELD: (Building Department Use Only)
Project Title: ALTERATION Report date: 12/06/10
Data filename: C: \Documents and Settings \Sieg \My Documents \REScheck \HANK.rck Page 5 of 5
u Air barrier and sealing exists on common walls between dwelling units, on exterior walls behind tubs /showers, and in openings between
window /doorjambs and framing.
Recessed lights in the building thermal envelope are 1) type IC rated and ASTM E283 labeled and 2) sealed with a gasket or caulk
between the housing and the interior wall or ceiling covering.
u Access doors separating conditioned from unconditioned space are weather - stripped and insulated (without insulation compression or
damage) to at least the level of insulation on the surrounding surfaces. Where loose fill insulation exists, a baffle or retainer is installed
to maintain insulation application.
▪ Wood - burning fireplaces have gasketed doors and outdoor combustion air.
Air Sealing and Insulation:
j Building envelope air tightness and insulation installation complies by either 1) a post rough -in blower door test result of less than 7
ACH at 33.5 psf OR 2) the following items have been satisfied:
(a) Air barriers and thermal barrier: Installed on outside of air - permeable insulation and breaks or joints in the air barrier are filled or
repaired.
(b) Ceiling /attic: Air barrier in any dropped ceiling /soffit is substantially aligned with insulation and any gaps are sealed.
(c) Above -grade walls: Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier.
(d) Floors: Air barrier is installed at any exposed edge of insulation.
(e) Plumbing and wiring: Insulation is placed between outside and pipes. Batt insulation is cut to fit around wiring and plumbing, or
sprayed /blown insulation extends behind piping and wiring.
(f) Corners, headers, narrow framing cavities, and rim joists are insulated.
(9) Shower /tub on exterior wall: Insulation exists between showers/tubs and exterior wall.
Sunrooms:
• Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U- factor of 0.50 and the maximum
skylight U- factor of 0.75. New windows and doors separating the sunroom from conditioned space meet the building thermal envelope
requirements.
Materials Identification and Installation:
• Materials and equipment are installed in accordance with the manufacturer's installation instructions.
Li Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R- value.
D Materials and equipment are identified so that compliance can be determined.
Li Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided.
Li Insulation R- values and glazing U- factors are clearly marked on the building plans or specifications.
Duct Insulation:
zi Supply ducts in attics are insulated to a minimum of R -8. All other ducts in unconditioned spaces or outside the building envelope are
insulated to at least R -6.
Duct Construction and Testing:
u Building framing cavities are not used as supply ducts.
u All joints and seams of air ducts, air handlers, filter boxes, and building cavities used as return ducts are substantially airtight by means
of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Tapes, mastics, and fasteners are rated UL 181A or
UL 181B and are labeled according to the duct construction. Metal duct connections with equipment and /or fittings are mechanically
fastened. Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three
equally spaced sheet -metal screws.
Exceptions:
Joint and seams covered with spray polyurethane foam.
Where a partially inaccessible duct connection exists, mechanical fasteners can be equally spaced on the exposed portion of the
joint so as to prevent a hinge effect.
Continuously welded and locking -type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa).
Li Duct tightness test has been performed and meets one of the following test criteria:
(1) Postconstruction leakage to outdoors test: Less than or equal to 8 cfm per 100 ft2 of conditioned floor area.
(2) Postconstruction total leakage test (including air handler enclosure): Less than or equal to 12 cfm per 100 ft2 pressure differential of
0.1 inches w.g.
(3) Rough -in total leakage test with air handler installed: Less than or equal to 6 cfm per 100 ft2 of conditioned floor area when tested at
a pressure differential of 0.1 inches w.g.
(4) Rough -in total leakage test without air handler installed: Less than or equal to 4 cfm per 100 ft2 of conditioned floor area.
Heating and Cooling Equipment Sizing:
Project Title: ALTERATION Report date: 12/06/10
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Cul REScheck Software Version 4.4.1
Insp Checkl
Ceilings:
❑ Ceiling 1: Flat Ceiling or Scissor Truss, R -50.0 cavity insulation
Comments:
Above - Grade Walls:
❑ Wall 1: Wood Frame, 16" o.c., R -21.0 cavity insulation
Comments:
❑ Wall 2: Wood Frame, 16" o.c., R -21.0 cavity insulation
Comments:
❑ Wall 3: Wood Frame, 16" o.c., R -21.0 cavity insulation
Comments:
❑ Wall 4: Wood Frame, 16" o.c., R -21.0 cavity insulation
Comments:
Windows:
❑ Window 1: Vinyl Frame:Double Pane with Low -E, U- factor: 0.300
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
❑ Window 2: Vinyl Frame:Double Pane with Low -E, U- factor: 0.300
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
❑ Window 3: Vinyl Frame:Double Pane with Low -E, U- factor: 0.300
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
❑ Window 4: Vinyl Frame:Double Pane with Low -E, U- factor: 0.300
For windows without labeled U- factors, describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Doors:
❑ Door 3: Glass, U- factor: 0.300
Comments:
❑ Door 2: Glass, U- factor: 0.300
Comments:
Floors:
❑ Floor 1: All -Wood Joist/Truss:Over Unconditioned Space, R -30.0 cavity insulation
Comments:
Floor insulation is installed in permanent contact with the underside of the subfloor decking.
Air Leakage:
Li Joints (including rim joist junctions), attic access openings, penetrations, and all other such openings in the building envelope that are
sources of air leakage are sealed with caulk, gasketed, weatherstripped or otherwise sealed with an air barrier material, suitable film or
solid material.
Project Title: ALTERATION Report date: 12/06/10
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Name Title i. : ure 17 Date
•
Project Title: ALTERATION Report date: 12/06/10
Data filename: C: \Documents and Settings \Sieg \My Documents \REScheck \HANK.rck Page 2 of 5
r .
CI REScheck Software Version 4.4.1
Comp Cert
Project Title: ALTERATION
Energy Code: 2009 IECC
Location: Northampton, Massachusetts
Construction Type: Single Family
Project Type: Addition /Alteration
Building Orientation: Bldg. orientation unspecified
Heating Degree Days: 6404
Climate Zone: 5
Construction Site: Owner /Agent: Designer /Contractor:
139 PROSPECT HENRY BADNER SIEGFRIED PORTH
NORTHAMPTON, MA 01060 OWNER ARCHITECT
IRELAND ST. 116 PLEASANT ST.
CHESTERFIELD, MA SUITE 331
EASTHAMPTON, MA 01027
529 9434
Compliance: Passes
Compliance: 6.6% Better Than Code Maximum UA: 317 Your UA: 296
The Better or Worse Than Code index reflects how close to compliance the house is based on code trade -off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
Gross Cavity Cont. Glazing UA
Assembly Area or R -Value R -Value or Door
Perimeter U- Factor
Wall 1: Wood Frame, 16" o.c. 661 21.0 0.0 33
Orientation: Front
Window 1: Vinyl Frame:Double Pane with Low -E 36 0.300 11
SHGC: 0.00
Orientation: Unspecified
Door 3: Glass 42 0.300 13
SHGC: 0.00
Orientation: Unspecified
Wall 2: Wood Frame, 16" o.c. 667 21.0 0.0 34
Orientation: Right Side
Window 2: Vinyl Frame:Double Pane with Low -E 78 0.300 23
SHGC: 0.00
Orientation: Unspecified
Wall 3: Wood Frame, 16" o.c. 661 21.0 0.0 33
Orientation: Back
Window 3: Vinyl Frame:Double Pane with Low -E 81 0.300 24
SHGC: 0.00
Orientation: Unspecified
Wall 4: Wood Frame, 16" o.c. 667 21.0 0.0 31
Orientation: Left Side
Window 4: Vinyl Frame:Double Pane with Low -E 80 0.300 24
SHGC: 0.00
Orientation: Unspecified
Door 2: Glass 35 0.300 11
•
SHGC: 0.00
Orientation: Unspecified
Ceiling 1: Flat Ceiling or Scissor Truss 999 50.0 0.0 26
Floor 1: All -Wood Joist/Truss:Over Unconditioned Space 999 30.0 0.0 33
Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building has been designed to meet the 2009 IECC requirements in
REScheck Version 4.4.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Project Title: ALTERATION
Report date: 12/06/10
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,,
Northampton
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139 Prospect Street • $189
Talk about location, right on the edge of downtown Noho and a five minute walk to everything. This
nine room colonial is currently a two- family but could easily be converted to a lovely single family resi-
dence or two high end condos. The interior has been totally gutted by the seller and is ready for your
personal renovation plans. The third floor attic space offers additional sun - filled living space and even
the huge walkout basement has lots of natural light and is bone dry. Bring your architect or builder
and restore this property back to its original glory. You'll have a terrific investment and be part of
Northampton's ongoing renaissance.
ZONING URC SCHOOLS Local BEDROOMS Four ROOMS Nine
GARAGE None HEAT Hot Air BATHS 2 Half FIREPLACE None
PORCH /DECK Yes FUEL Gas FLOORING Wood DISPOSAL None
LOT SIZE .13 Acre RENTAL EQUIP No INSULATION None REFRIG None
FRONTAGE 133 Feet HOT WATER None CBL TV Available RANGE Gas
APPR AGE 1900 H.W. FUEL Gas SEWER Public MICROWAVE None
TAXES $2,542 GLA 2,097 SF WATER Public DISHWASHER None
TYPE Colonial COLOR Gray /Gold CONSTR. Frame OCCUP. Negotiable
1ST Living, kitchen, 3 bedrooms %2 bath WASH CONN Yes
2ND Living, kitchen, 2 bedrooms 1 /2 bath DRY CONN Yes
CELLAR Full- walkout & dry -- House is totally gutted and ready for renovation MLS# 703734146/
(Blizniak) Oil
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44 Conz Street t , ; 76 North Elm Street
Northampton, MA 01060 Northampton, MA 01060
1 1-413- 584 -7500 *�,#1 : 1-413- 584 -5700
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Representation and descriptions of the property contained in this exclusive right to sell listing agreement are those of the owner and
are not to be relied upon by any prospective buyer as being represented or verified by the realtor. Prospective buyers are advised to
verify the accuracy of this information and the realtor and owner invite inspection by any competent specialist prior to making an offer
on this property. Buyer's agents will be compensated only if they are present on the first occasion their buyer client inspects the sub-
ject property.
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CITY OF NORTHAMPTON
Construction Debris Affidavit
In accordance with the provisions of MG.L. c. 40 § 54, all debris resulting from any work
covered by a Building Permit shall be disposed of in a properly licensed disposal facility,
as defined by M.G.L. c. 111 § 150A.
Address of Work:
/37 PA O '?c 5+ -
The debris will be transported by: 1) N.11
The debris will be received at: NC.)CR 1 1(i- , / 627 (
Signature of PerrnitA piicant iL a wax w . P ---
Date
Building Permit Number:
A
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 /footings (before backfdl)
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
Ati u Ara �I - - ■111111111 understand the above.
` (Home owne Ii esident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to
Date 1 W710 t
Address of work
location P_q PR`i M S PE
i411 . i & $■
. '... ..
. - .
The Commonwealth of Massachusetts
Department of Industrial A
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 pusineseorgathiation/individuaD: .:
Address:
City/State/Zip: - Phone.#:
Are you an employer? Check the appropriate box: Type of project (required): /
1.0 I am a employer with 4. n I am a general contractor and I
6. 0 Nevi construction
employees (full and/or part-time).* have hired the sub-contractors
listed on the attached sheet 7. EZReinodeling
2.0 I aria a sole proprietor or partner-
These sub-contractors have
ship and have up e>loyees 8• 0 Demolition
ms d a' • -
working for me in any capacity. eployee anhve workers 9 f Building addition
[No workers' comp. insurance _ comp...insinnacc.T.:
5 0 We are a corpo an d it 10.0 Electrical repairs or additions
,,_..., requirect] • .
3.04 I am a homeowner doing all work officers have4xercised their
t 11.0 Plumbing repairs or additions
myself [No workers' conap. right of exemption per MGL r--, .., .-
12.1_ j ADOr repairs
insurance required.) t . 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.j. '
*Any applicant That checks box #1 must also fill out the section below showing heir workers compensation policy information.
t Homeowneri who submit this affidaVit indicating they are doing all work and then hire outside contraCtors must submit anew affidavit indicating such. .
:Contractors that check this box must attached an additional sheet showing the name of the sub and stain whether or notthose 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 einployees. 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 inkier Sedtibil'25A - C. 152 can lead to the imposition of Cricninal; Penalties of a
fine up to S1,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK-ORDER and a fine
of up to $25000 a day against the violator Be advised that a copy of this statement may be forwarded to the Officeof,
Eiiitibiai "Of the for insurance r coverage --v-iiitCiiiiiit __
: - = - -- '7_' -- 7 - - . - .. -- 77 .- ..7. ,.----- : . ...
filo hereby e 47 antler the p% • , , pert:if : s ofp erjurythal the information provididibitve *_:zit _
...;,,,,,
si... tare : \ Li h. . A A—.410.—._ ..mili - P a:t...... iAtik A..
._ ,
, , ----
N --/ Phone 4: z , 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):
:I. Board of Health 2. Building Department 3. City/Town Clerk 4. ElectricalInspector 5. Plumbing Inspector
6. Other ,
Contact Person: Phone #:
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
,r .. .._ �o IZ�-: ,g gig. K;...... Not Applicable ❑
9. Registered. Ht�rrie ,'Imtirorrement- Oc�n#ractar��.� ��H .
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10= WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L, e. 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 qk No ❑
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two - year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) 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 . sumes responsibility for compliance with the State Building Code, City of
Northampton Ordinance . e and Local Z.4, i . s • d State of Massachusetts General Laws Annotated.
Homeowner Signature � 1/11.4 � s
w
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition [] Replacement Windows Alteration(s) Roofing EZI
Or Doors O
Accessory Bldg. El Demolition El New Signs [0] Decks [ Siding fry] Other [R]
Brief Description of Proposed /
Work: (., i emole/ 7
Alteration of existing bedroom Yes _ No Adding new bedroom Yes i>K No
Attached Narrative Renovating unfinished basement i)( Yes No
Plans Attached Roll - Sheet
1;471 t eVti t i ai wait l SIitt t t o st tik cs�mpt e.t filtiitl ihii:
a. Use of building : One Family Two Family (/ Other
b. Number of rooms in each family unit: y Number of Bathrooms
c. Is there a garage attached? h/6
d. Proposed Square footage of new construction. /(0019 C Dimensions
e. Number of stories? - 7 - 14../ C)
f. Method of heating? 4,7 ,4 R. Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. 7 f S Masscheck Energy Compliance form attached? Y(°S
h. Type of construction woo / eS, ,/e e �i " ,
i. Is construction within 100 ft. of wetlands? , Yes 1,. No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade 6- ( , /
k. Will '. building conform to the Building and Zoning regulations? // Yes No Y //
. /
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN ,
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
i prop t gq.(1
t— _ 15.RDISc , as Owner of the subject
hereby authorize 11t. \ i4 is :Au= a - _ S ,1
to act y behal', in II elative to work a thorized by this •uilding permit app ication. /�
`I lJ
Signature er " �` D ��t� l
I, , 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.
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 Rired ing
This equ column by to be Zon filled in by
Building Department
Lot Size 1 ,5'6'6.� .1 3 .,1
Frontage [ /4 q ' H ' 3 `/
Setbacks Front 4 S-i/ 1715''7,
Side L:°) ' ` R:i / L:I ? __ R:` ( i _
Rear IT 1 I a/
Building Height 3)- 1 ; 3 d. I
Bldg. Square Footage Gt,�` 1 " -7 % .)� $ i e 3
Open Space Footage 4 % A663
(Lot area minus bldg & paved E r ,
parking) _
717 y �
# of Parking Spaces ..
Fill: 1_ Ai 0 /7 e _..._._ ..�.. _._.�., ��� .�,. i d _ ._ I !
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO Q DONT KNOW 0 YES 0
IF YES, date issued:;
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW i 4 YES 0
IF YES: enter Book z I Page I 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 ® Obtained ,Date Issued:
C. Do any signs exist on the property? YES ® NO G
IF YES, describe size, type and location: F
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO a
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 G
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
. 1
City of Northampton ® v , Z ° x� -
Building Department ` s '" 4-' f �f
212 Main Street
�
� Room 100 e 4 .
Northampton, MA 01060 .
v p hone 413- 587 -1240 Fax 413- 587 -1272 m ., , ; _
:1^,: c o- ;'7,:t.": 3;1' A 4 -' �.° az� nom
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
i 3 7 prt;.1S'P f- 57`" Map Lot Unit
6 ;1"h e l" r7? /o'i , i''9 rct C) /Uv 0 Zone, ' Overlay District
Elm St District CB District
SECTION 2 PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
a •
R A, B, DivE�R /0 R , - ,�,,�, �,
N am (P t) / Current Mailingy�cj�rer'ss� q tr `n
3 d 77 p i°
i V 44 MP IL . ■-. l'elephone 9 / .r 0/ `r ,'
Signature ( p
2.2 Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applican
1. Building (a) Building 9._./.S, vat ng "Permit Fee
2. Electrical ',/,_5- (b) Estimated Total Cost of
C% D 0 Construction from (6)
3. Plumbing 07, Building Permit Fee
ali.) COIF
4. Mechanical (HVAC) 6 _
JO
5. Fire Protection S / U
6. Total = (1 + 2 + 3 + 4 + 5) 7 C? f� Check Number�� f GZ 6.°
This Section For Official Use Only
Date
Building P rmit um r: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2011 -0523.
APPLICANT /CONTACT PERSON BADNER HENRY
ADDRESS/PHONE 410 IRELAND ST WEST CHESTERFIELD (413) 296 -4204 0 ' C
PROPERTY LOCATION 139 PROSPECT ST f,k C ��4 1 r'
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64124-
MAP 24D PARCEL 188 001 ZONE URC(100)/ / , oA_ , j a 1 e `
THIS SECTION FOR OFFICIAL USE ONLY: tit-) t /_ R N
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �/
Fee Paid 1P6) /J V
Typeof Construction: COMPLETE RENOVATION OF 2 FAMILY
New Construction � f h a U r
Non Structural interior renovations I' 5 (�e/t-'l
Addition to Existing
Accessory Structure
Building Plans Included: p � t
Owner/ Statement or License pjr� e •
�ji S1 ��� W , — = ice` t / 1� r
3 sets of Plans / Plot Plan
t et Ce' � N C
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON Ft S
INFORMATION 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
Demolition Delay
2iV o 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.
BP- 2011 -0523
GIS #: COMMONWEALTH OF MASSACHUSETTS
i 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- 2011 -0523
Project # JS- 2011- 000471
Est. Cost: $275000.00
Fee: $1650.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: DYLAN BATCHELDER 085139
Lot Size(sq. ft.): 5314.32 Owner: BLIZNIAK WILLIAM J & NANCY J
Zoning: URC(100)/ Applicant: BAD N E R HENRY
AT: 139 PROSPECT ST
Applicant Address: Phone: Insurance:
410 IRELAND ST (413) 296 -4204 ()
WEST CHESTERFIELDMA01084 ISSUED ON:12/16/2010 0:00:00
TO PERFORM THE FOLLOWING WORK:COMPLETE RENOVATION OF 2 FAMILY
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 12/16/2010 0:00:00 $1650.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner