36-153 ` Y
Manual Trade-Off Worksheet'
/ Per mit
Builder Name —TD t¢`^� H 2-1 l / "r S / Date 16 3 9
Builder Address i W/G 147 _S T. Checked E
Site Address 1 b' to o 0�DS /2 Zone []12 E)13 g14
Submitted By J• 2 /L�'T** "'S/`'/ Phone_-2-V 7 S o .0 y Date
Ceilings, Skylights, and Floors Over Outside Air
Required
Insulation x Net U-Value
Description R-Value U-Value Area = UA (Table J6.2.2}') x Area = Ui
Ceiling ft C�
(TableJ6.2.2a) 3o
Floor Over Outside Air ft2
(Table J6.2.2a)
ft2
ft2
Total Area �s2
Walls, Windows, and Doors
Insulation x Net Required
Description R-Value U-Value Area = UA U-Value x Area = U.
Walls ft-,
(Table J6.2.2b,c,d) 0&y 357 d�2. L/YG 4
Windows — p r ft2
(NFRC or Table J1.5.3a) • 3 3 { 7 '3�� j
Doors — _ ft
(NFRC or Table J1.5.3b)
Sliding Glass Doors — ft
(NFRC or Table J1.5.3a)
ft
ft2
Total Area [L�ft2
Floors and Foundations 7
Insulation Insulation x Area or Required
Description Depth R-Value U-Value Perimeter = UA U-Value x Area =UP.
Floor Over Unconditioned (Table ft2 �� Q ,.-
Space J6.2.2e) '3 e . 633 3/ - z3 3/o /S'S
Basement Wall (Table ft2
J6.2.2f)
Unheated Slab ft
(Table J6.2.2g) in.
Heated Slab ft
(fable J6.2.2g) in.
ft2
ft2
Total Proposed UA must be less Total 'f Total
than or equal to Total Required UA Proposed UA ` ��"/ Required UA
Statement of Compliance:The proposed building design represented in these documents is consistent with the building plans,
specifications, and other calculations submitted with the permit application?
Build r signer Company Name Date
i �
ENERGY CONSERVATION APPLICATION FORM
FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION
Applicant Name: 2_1o,4J-.5rl Site Address: l w °°Z>,5 ICAD
Applicant Address: G -b �r 5r City[Town:
Ln6!21-f 7w, Use Group:
Date of Application: c5)c l ,.1 -3 _
Applicant Phone: --V7 '30 / y Applicant Signature: --
Compliance Path (check one): -
E] Prescriptive Package (for 1- or 2-family residential buildings not heated by electric resistance)
Fill in all values that apply from Table J5.2.1b: Package Number(A through KK):
a. Gross Wall Area �/��G sq.ft f. Wall R-value R-' 1 7
b. Glazing R.O. Area / 0 sq.ft. g. Floor R-value R- 3
c. Glazing%(b _ a) % h. Basement wall R-
d. Glazing U-value U- 3 3 i. Slab Perimeter R-
e. Ceiling R-value R- O J. Heating AFUE 'f
Component Performance (Manual Trade-Off)
Climate Zone(from Figure J6.2.2) [] Zone, I.2 E] Zone 13 Z Zone 14
Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable)
[] MAScheck Software
Attach Compliance`Report and Inspection Checklist printouts.
[j Systems Analysis Renewable Energy Sources
Attach approved Analysis
Official's Name: Official's Signature:
Application Approved Date of Approval:
Application Denied Date of Denial:
Reason(s) for Denial:
(over for more)
Y`°•:'_. :i . BBt2S 12/08/97
a
• is
MA SUPERVISOR#017899 11OMR IMPROVRMI:NT#100133
JOHN H. ZIEMINSKI
BUILDER & GENERAL CONTRACTOR
16 DWIGHT STREET
HATFIELD,MA. 01038
( 413 ) 247 -9014 -
OCT 3,1999
BUILDING INSPECTORS OFFICE
CITY OF NORTHAMPTON
ATTN: TONY OR STAN
REF: 18 WOODS ROAD, FLORENCE
ONE MORE WINDOW 32"X 64"WILL BE ADDED TO THE EAST WALL.
THE CEILING INSULATION R-VALUE WILL BE INCREASED FROM
R-30 TO R-38 BY STRAPPING THE 2 X12 TO INCREASE HEIGHT TO
PERMIT ADDITIONAL INSULATION AND STILL PERMIT OPEN
AIR SPACE ABOVE FOR VENTALATION.
ATTACHED PLEASE FIND ENERGY SHEETS AND DRAWING CHANGES.
THANK YOU,
JO H ZIEMINSKI
f
MA SUPERVISOR#017899 110ME,TMPROVEWNT 9100133
F; 1, I)HN H. ZIEMINSKI
BUILDER & GENERAL CONTRACTOR
0 Q (o,Pq 16 DWIGHT STREET
HATFIELD,MA. 0103 8 e
(413 ) 247-9014
FAX LEAD SHEET
FROM:
DATE:
THIS TRANSMISSION INCLUDES PAGES INCLUDING THE COVER SHEET,
PLEASE CALL IFYOU DID NOT RECEIVE ALL OF THE PAGES. THE
DOCUMENTS ACCOMPANYING THIS FAX TRANSMISSION ARE INTENDED
ONLY FOR THE USE OF THE ADDRESSED INDIVIDUAL. IF YOU HAVE
RECEIVED THIS TRANSMISSION IN ERROR, PLEASE NOTIFY US
IMMEDIATELY. THANK YOU.
JOHN H. ZIEMINSKI
16 DWIGHT STREET
HATFIELD, MA 01038
PH 413 247 9014
PH 413 584 4002
FAX 413 2479014*
AUTOMATIC RECOGNITION
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Zoning
Miscellaneous Additions, Repairs,Alterations,etc. Tel.No. �`�r Y Alterations
NORTHAMPTON, MASS. � 19 1 Additions
APPLICATION FOR PERMIT TO ALTER Repair
ti r
Garage
1. Location LJ c�nJ ' r{ � �7 Lot No.
2. Owner's name Eby - ti` -t-Pe-YDS /SEMP Address
3. Builder's name ��(�l tt /Eyy/���/ Address
Mass.Construction Supervisor's License No. Cl-)A'J;'� Expiration Date 3V?--C,L`i,
4. Addition X e- 5lz=r�
5. Alteration 9C," txd<^-
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating 1 t 12
11. Distance to lot lines rAPAT Lf—T 51PC' �S' Kl6 T 2' /eU'
12. Type of roof Giml-c
13. Siding house i ti Yt-
14. Estimated cost:-
�v� •---
The undersigned certifies that the above statements are true to the best of his.
knowledge and belief.
,1
Ognature of responsible app,icant
Remarks !`� �L` ►ti 1T c
( �' lh l�G� �J s
Tv Ci�-1 I r, y -
04•�t1A1�f p�,
e Crif-� xaf
S .
m ' DEPARTMENT OF BUILDEgG INSPECTIONS
212 Main Street a Municipal Building
Northampton, Mass.* 01060 `
WORKER'S COiMTENSATION INSURANCE AFTIDAVIT
(lic'n- Permittee)
with a principal place of business/residence at:
7 9 e" y
(str�i/ci ty/st<3.ida p)
do hereby certify, under the pains and penalties of penury, that:
X I am an employer providing the folloVving worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (F-cpiradon Diu)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Cornpauy/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Companv/Policv Number) (Expiration Due)
(Name of Contractor) (Insurance Compwy/Policf Numbu) (Ex-pira6on Date)
(Name of Contractor) (Iosu=cc COmpwy/Poucy Numb--r) (Expiration Date)
(attach sdditiooal zianci if nooaziry to me hic5c v.forra.tioo pcstaiaing to.11 ooctnC gin)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself
NOTE:please be aerate the whilo bomrAUVcra%%too cmplay pasom to do alxiea • oms:rl ioo'or repair work on a dwelling of
not morn than tbeoo units is which the bomoo-. c r=oc.a oa ciao gzou appurtcaaat tS=w art oc(&�ncral1y ooa;idcrcd to be
employers under tba worker`s oompcasjion Act(GL152.33 1(5)),applicaEon by a bomcowniz fora liocax cc permit naay cvidcn c the
legal dxbu of as employee under the Woricoh Cocapemdioa AA;(-
I undarisad ttuat a copy of this chtcmaII may be forward.d to the Dopaxtmc d of A-8&-&OfG—of 1--fa the
covrsage vai&eatioa and that faihuc to scans cova xV under section 25A of MOL 152 an itxd to tbd imps—of aiminal peaaltia
oohs Amg of a-fime bf up to S1,5OO.00 aadlct imprisoa of tip to 000 ycw and civrl peaahio is the form of a Stop Want Order sad a
fiae oCS100.00 a day agsiasi ttaG - - .
\ � For dcyictmrabltiaeonlx '
L
- -- Permit Ntimba
Lb
Si ctmillce
10. Do any signs ebst on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colQam to be filled in
by the Eriild=g Department
Required i
Existing Proposed By Zoning
Lot size
Frontage /6)2 o y �� y
Setbacks - frnnt 2- 0
- side L:39 3 R: '0,i L:,' 66,3 R:a.3.
- rear
i 2sI 125-
�Q
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg n `
paved parking) 93, � �G / ..0 • � � (P�
# of -Parking Spaces
f of Loading Docks
Fill:
vol-Ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of m knowledge.
DWTE: �j APPLICANT's SIGNATU
NOTE: 1 an of a zoning permit does not relieve a a plioanVs b den.to oom wit
zoning requirements and obtain all required Pn ., fw .all
commission, Department of Publio Works and other m onble e i Health. Conservation
P permit granting authorities.
FILE #
>1
L U S
EP 2 8 1999
L�
OF .i File NgB�oG
stir i' GTiONS
- fI TG PERMIT APPLICATION (§Z0 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: -S mil` t4 -
Address: 5 J> Telephone: 2Y 7 '90,'Y
2. Owner of Property: - ��" '� aC' �oE�crf
Address: W Lteor.).� Telephone: �'S `3 0 3 3
3. Status of Applicant: Owner Q Contract Purchaser Lessee
_Other(explain): B"I C 0 E`7"2
4. Job Location: d5
Parcel Id: Zoning Map# (0 Parcel# �r District(s): 1
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property F,t-3 i 0t C t=
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
hl�- ,cyo 4`201 6"rLr c,,,, ALA 7Z) 50zc-171 5lPr
7. Attached Plans: 1%4 Sketch Plan g' Site Plan x Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW r YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
File#BP-2000-0344
APPLICANT/CONTACT PERSON John Zieminski
ADDRESS/PHONE 16 Dwight St (413)247-9014
PROPERTY LOCATION 18 WOODS RD
MAP 36 PARCEL 153 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid '
Typeof Construction: CONSTRUCT 1 STORY 16 X 20 ADDITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 017889
3 sets of Plans/Plot Plan
THE
LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § _w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § _w/ZONING BOARD OF APPEALS
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 Co on
Signature of Building cial 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.
18 WOODS RD BP-2000-0344
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 36- 153 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:ADDITION BUILDING PERMIT
Permit# BP-2000-0344
Project# JS-2000-0563
Est. Cost: $30000.00
Fee: $128.00 PERMISSION IS HEREB Y GRANTED TO:
Const.Class: Contractor: License:
Use Group: John Zieminski 017889
Lot Size(sa ft.): 46260.72 Owner: BOETTCHER ELAINE G&ELAINE G
Zoning:URA Applicant: John Zieminski
AT. 18 WOODS RD
Applicant Address: Phone: Insurance:
16 Dwight St (413) 247-9014 Workers Compensation
HATFIELD 01038 ISSUED ON.0913011999 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 1 STORY 16 X 20 ADDITION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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 Sianature•
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 09/30/1999 0:00:00 $128.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
s�
WOODS RD BP-2000-034
GIs#: COMMONWEALTH OF MASSACHUSETTS
Ma Block: 36- 153 CITY OF NORTHAMPTON
Lot:-001
Permit: Building }
Category:ADDITION BUILDING PERMIT
Permit# BP-2000-0344
Project# JS-2000-0563
Est. Cost:$30000.00
Fee:$128.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Group: John Zieminski 017889
Lot Size sq.fQ: 46260.72 Owner: BOETTCHER ELAINE G&ELAINE G
Zoning:URA Applicant: John Zieminski
AT: 18 WOODS RD
Applicant Address: Phone: Insurance:
16 Dwight St (413) 247-9014 Workers Compensation
HATFIELD 01038 ISSUED ON.•09/30/1999 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 1 STORY 16 X 20 ADDITION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
� p Footings:
Rough: Rough:��j��l/ House# Foundation:
Final: Final: ��•�
Rough Frame-
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation: ®�
1
Final: Smoke: Final: Ol<
THIS PERMIT MAY BE REVOKED BY THE CITY O NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate Si nature:
Fee Tyne: Receipt No: Date Paid: Check No: Amount:
Building 09/30/1999 0:00:00 $128.00
r 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo