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36-060 0 0 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 55201 WALTER L MAREK III° 73 SOUTHAMPTON RD WESTHAMPTON, MA 01027 °%- . _ _ -may — Expiration: 6/23/2012 ('ommissioner Tr#: 30366 1 \ Office of Consumer Affairs & Business Regulation ►, - ''A ME IMPROVEMENT CONTRACTOR __° h .egistration: 159488 Type: ' VIM; xpiration: 4/30/2014 Private Corporatic W. MAREK INC. WALTER MAREK III 73 SOUTHAMPTON RD. -�ti WESTHAMPTON, MA 01027 Undersecretary Massachusetts - Department of Public Safet■ Board of Building Regulations and Standards Construction Supervisor License License: CS 55201 WALTER L MAREK III 73 SOUTHAMPTON RD WESTHAMPTON, MA 01027 �% _ — +e` Expiration: 6/23/2012 ('omm issioner Tr#: 30366 <?Te ` e Owe 'nail woo la r /n - / ;cr,laa /(eJee Office of Consumer Affairs & Business Regulation ) ° — 1•ME IMPROVEMENT CONTRACTOR = i= Aegistration: 159488 Type: Its xp 4/30/2014 Private Corporatic W. MAREK INC. WALTER MAREK III 73 SOUTHAMPTON RD. �a,./.—�_ WESTHAMPTON, MA 01027 Undersecretary Job � Truss Truss Type Qly Pry QUICK REFERENCE PRICE LIST BUDGETPRICEDESIGNS 524C FINK 1 1 Job Reference (Optional) Truss Engineering Corp., Indian Orchard, MA 01151 7.250 s Nov 19 2010 MiTek Industries, Inc. Wed May 09 0629:07 2012 Page 1 ID:BM 4z? IocoBjMmIWCSesV9zt9xQ- Om22VzhpgMzvg8eyLs9SBiTlovQdQIzPLRPQSZzIKO' ' 1 - - 6 -3 -12 5-8-4 ! 5-8-4 6-3-1 31 2 r 1-0 -0 Scale: 3/8".=1 5x6 = 4 111111 5.00112 11 12 1.5x4 \\ 1.5x4 // 3 5 , 4 f 10 13 r; 2 6 Y =1 7 r11 ►5 'C 14 • 9 8 ►5 3x8 = 4x4 = 5x8 = 3x8 = I 8 -0-0 16 -0-0 24 -0-0 8 -0-0 8 -0-0 8 -0-0 Plate Offsets kl,.ra hr . 1 -c 6:0 -4 -4 0-1 -8 8:0.4 -0 0-3.0 _ 1537#/ - 401# LOADING (psi) SPACING 2-0-0 CSI DEFL in (loc) 1/defl Ud PLATES GRIP TCLL 40.0 Plates Increase 1.15 TC 0.59 Vert(LL) -0.16 8-8 >999 240 MT20 197/144 (RoofSnaw =40.0) Lumber Increase 1.15 BC 0.90 Vert(TL) - 0.38 6-8 >784 180 TCDL 10.0 Rep Stress Ina YES WB 0.41 Horz(TL) 0.10 8 n/a n/a BCLL 0.0 Code IRC2009/TPI2007 (Matrix) Weight: 81 Ib FT = 10% BCDL 10.0 LUMBER — -- — - -. _. TOP CHORD 2 X 4 SPF 1650F 1.5E BOT CHORD 2 X 4 SPF No.2 BOT CHORD LOAD CASE(S) WEBS 2 X 4 SPF Stud 2 -9=- 553/2520, 8-9=- 321/1702, 6.8 =- 553/2520 Standard BRACING WEBS TOP CHORD 3 - 9= 261, 4 - 183 /950, 4.8= 183/950, 5 682/261 Structural wood sheathing direly applied or 3-6-3 oc purlins. BOT CHORD NOTES (9) Rigid ceiling directly applied or 7-10-1 oc bracing. 1)1Mnd: ASCE 7 -05;120mph; TCDL=4.2psf; BCDL =5.Opsf; h =25ft; Cat. II; Exp B; enclosed: MINERS (tow -rise) gable end zone and C-C Exterior(2) -1-0-0 to 2 -0 -0, REACTIONS (Ib /size) interior(1) 2-0-0 to 9-0-0, Exterior(2) 9-0-0 to 12-0-0, Interior(1)15.0.0 to 22-0 -0 zone; 6 = 1537/0-3 -8 (min, 0-2 -7) cantilever left and right exposed ;C-C for members and forces & MWFRS for reactions 2 = 1537/0-3-8 (min. 0-2 -7) shown; Lumber DOL =1.33 plate grip DOL =1.33 Max Horz 2) TCLL: ASCE 7 -05; Pf=40.0 psf (flat roof snow); Category 11; Exp B; Partially Exp.; 2 = 81(LC 8) CI =1.1 Max Uplift 3) Unbalanced snow loads have been considered for this design. 6 = - 401(LC 9) 4) This Suss has been designed for greater of min roof live load of 16.0 psf or 1.00 times 2 = - 401(LC 8) flat roof bad of 40.0 psf on overhangs non - concurrent with other live loads. 5) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with FORCES (Ib) - Max. Comp./Max. Ten. - All forces 250 (Ib) or less except when shown. any other live loads. TOP CHORD 6) All bearings are assumed to be SPF No.2 . 2 -10 =- 2855/713, 3-10=- 2746/727, 3-11 = - 2509/691, 7) Provide mechanical connection (by others) of truss to bearing plate capable of 4- 11 =- 2394/700, 4-12=-2394/700, 5- 12=- 2509/691, withstanding 401 Ib uplift at joint 6 and 401 Ib uplift at joint 2. 5.13=- 2748/727, 6-13=- 2855/713 8) This truss is designed in accordance with the 2009 International Residential Code BOT CHORD sections R502.11.1 and R802.10.2 and referenced standard ANSI/7P1 1. 2 -9 =-553/ 2520, 8-9=-321/1702, 6.8-- 553/2520 9) All Plates 20 Gauge Unless Noted GUARD Wo Compensation an(1 Employer's Liability Policy It NorGUARD Insurance C4>mpany - A Stock Company INSURANCE Policy Number WMWC318094 ; Renewal NCCI No [25844] • Policy Information Page [1] Named Insured and Mailing Address Agency W Marek, Inc FINCK & PERRAS INS AGENCY 73 Southampton Road 6 CAMPUS LANE Westhampton, MA 01027 Easthampton, MA 01027 Agency Code: MAI INC1.0 Federal Employer's ID 90 0129473 Insured is Corporation Risk ID Number 000117462 i ! [2] Policy Period From February 10, 2012 to February 10, 2013, 12:01 AM, standard time a the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to wort: in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $100,000 Bodily Injury by Disease - each employee $100,000 Bodily Injury by Disease - policy limit $500,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, and WyDming. D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms [4] Premium Tha Premium Basis and. therefore, the premium will be determined by ou Manual of Rules, City of Northampton . Massachusetts "4 .fr .. c . t DEPARTMENT OF BUILDING INSPECTIONS a S m .' 212 Main Street • Municipal Building � a llorthampton, MA 01060 .yy ti INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner 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 any 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 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 I, 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information N /kw Please Print Legibly Name (Business /Organization/Individual): , ) _ Address: — T3 SiAlkov. City /State /Zip: (AA 6V� "r Phone #: 13 q T J Are you an employer? Check the appropriate box: Type of project (required): 1 iri I am a employer with I 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.g Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13 Other f e193+1 P-grI( - J�'��� comp. insurance required.] 0 *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1 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: V h�S . Policy # or Self -ins. Lic. #: toir,Oc38cigy Expiration Date: ( 0 , I \ t Job Site Address: 2 `�' 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 under t, ' pains and p lties of perjury that the information provide a ove is true and correct. S / - 0. Date: tic)._ Phone #: 11 113 q537 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 Supervisoor: O l Not Appl ❑ Name of License Holder : (A) 041 Y1 c4( + cs SAA1 (Aie.srtitikfri Licensp Nu ber 6./A? IP Addre s Expiratio Date q) q3 Signature Telephone 9 Registe gaRt it iiriiiroii me e fi C ont actor , '} `, k „ 5� , ; Not Applicable ❑ 19 Company Name r -- Regis atio Number Address Expiratio Date 7 41.617. 1?(.9 Telephone B 971 v l F 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 OA No ❑ Owner ome empt on 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 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 • W SECTION 5- DESCRIPTION OF "PROPOSED WORK.(check all applicable) ,, New House ❑ Addition E Replacement Windows Alteration(s) n Roofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Ea Siding [p] Other [a] Brief D7�scriptign o(Prcosed n r p k , z r 1 (_ j_ i , . i3 T rip + e p Work: Kic4E W 61.1‘X. �" Cc ` tt7�` [71 �( Alteration of existing bedroom Yes CX No Adding new bedroom Yes (( No Attached Narrative Renovating unfinished basement Yes ix No Plans Attached Roll - Sheet 6a IL�> ; eWIlousr and <or addiifion to"existmq "housing acomplete thex;:followtng: a. Use of building : One Family e< Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached?CG( 1 d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each ' g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION ,.TO BE COMPLETED WHEN OWNERS:"AGENT OR`C ONTRACToitO LIES.FOR BUILDING PERMIT I, Tah �c-Lt r ump s as Owner of the subject propertyI' v // hereby authorize to c on my b' all matters relative to work authorized by this building ermit application. Signature of Owner D e mil ,, K. f� . , 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 nd r the pain and penalties of perjury. hr (tj Print Name / 530 — Si of Owner /Agent a te • p. . k J Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by'Zonin nk This column to be filled d in i �y Building Department fk ' Lot Size 1 . 3 ` Frontage , Setbacks Front Side L:? R:: L R: i i i Rear 1 1 - Building Height i Bldg. Square Footage r i Open Space Footage % (Lot area minus bldg & paved I I k 1 parking) E ■ i I I # of Parking Spaces Fill: _.__ _ ._ ._ _ _ — __. , � . -._a.._._. _._ -_ ___ . ; (volume & Location) ___ .b. _. _ .. _ -�- _ i I= A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW C® YES IF YES, date issued:, IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW ® YES 0 IF YES: enter Book Page; and /or Document # : B. Does the site contain a brook, body of water or wetlands? NO 3 DON'T KNOW Q YES I IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained I , Date Issued: C. Do any signs exist on the property? YES 0 NO !® 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 g. 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 a IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • 'R y ' y De . artmeat: use in . : 4> ` n r Y x- ; k` ?4,3 +tY, 3.. r, . w + 4,0. *� ' - - -�teG City of Northampton Status of Permit t fl 1 : uilding Department ;6 ? � • If � � a t � 4 212 Main Street • S ewery ep t c �Yallabili x � 114,4 � Room 100 water_ � el l : ia`bi tyi r� - �z �� OF BU\`P j N p10� • orthampton, MA 01060 wo set a�� ct� ns $ N • one 413- 587 -1240 Fax 413- 587 -1272 !moo I e e l'i ns R � � : Other . , a t APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFOR MATION This section to be completed by office 1.1 Pro ert Addr s: i k � i � O{� . Mapr '` , Lot Unit Zone O verlay District FlOiet '1 :' , : :: 7 :CP 2- ," , ,'„ ,,, ,`'," ' i Elm St D;istnct �' CB District r ' SE CTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGE 2.1 Owner of Recor A + rr�—t— u 9 Pe � . Dr, ence N e ( rint) Current Mailing Address: 'IR 5 . ) 130 Telephone Signature , 2.2 Authorized Agen : 3 y I n ( .k,it%,14-„,,i,i--,,, Name Print) Current Mailing Address: ( Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only , completed by permit applicant 1. Building ' S i © or (a) "Building P ermit Fee 2. Electrical [' (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection e 6. Total = (1 + 2 + 3 + 4 + 5) J� -Check Number � , ±' " Th is S ec tion For "Official Use Only' Building Permit Number : - IDssued: Signature." - . Bu ilding Commissioner /Inspector of Buildin " Date File # BP- 2012 -0980 APPLICANT /CONTACT PERSON WALTER MAREK III ADDRESS/PHONE 73 SOUTHAMPTON RD WESTHAMPTON (413) 527 -7667 0 PROPERTY LOCATION 9 REDFORD DR MAP 36 PARCEL 060 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT / Fee Paid a, A Rth L./ Building Permit Filled out J,� ( 987f) IftRY � 1,7 Fee Paid � ( Tvpeof Construction: REPLAC • 1 RUSSES & STRIP & SHINGLE ROOF / � New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 055201 3 sets of Plans / Plot Plan THE FO NG 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 Demolition Delay Sig e o tui dm ffi i 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. 9 REDFORD DR BP -2012 -0980 GIs #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 060 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit # BP- 2012 -0980 Project # JS- 2012- 001698 Est. Cost: $26500.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WALTER MAREK III 055201 Lot Size(sq. ft.): 19602.00 Owner: NORRIS THOMAS R & LINDA M Zoning: Applicant: WALTER MAREK III AT: 9 REDFORD DR Applicant Address: Phone: Insurance: 73 SOUTHAMPTON RD (413) 527 -7667 () Workers Compensation WESTHAMPTONMA01027 ISSUED ON:5/11/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE 4 TRUSSES & STRIP & SHINGLE ROOF - AIR SEAL & INSULATE ATTIC 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 5/11/2012 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner