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32-029 I 4 s f � t f I N i �� zz I 6 -` < h b —' 0 9z c)'a s C: 7Q i • v 1 � f f N r � 1 � 1 { r t , , f i t Ev f i ci �a .70 a ��9�,� �n%� �� v � �, �C �� ,.�' r7v `'�,� ,�,,� �, �� {f, �� --� �C, i { � � � � S �� J G�l.� =� � _ r c4 4 -��1"'� �, � ;1 �. i ` `, I �� I I � i i ` t � � � '� i =o i � `� S �� i � I S � 1 � r i -�� i J j i ti r\ � i 1 �_. i ,_ i �., � �` � J �. � _ h�Z- _ �5 no '� ��,� � _ �'"°�� `� -2 .� _..,, 1 __ E S p i ,_ � , s s ,,� ,� � �,^ 5.�, � 14T �J'1 V a � � N M r� ; lJ + l 1 r -C-11 L Lk { j J 3 4' 1 ' C 1 W �z E vo v� , X "0' SA� -kb A ............ i �I ' U �, O C� I } i I r I i \ CC' 04 Cs- � C'U l` C'lS r \.J 14 i I W f I i r C, I I i J I 1 � i 40 Henry Street, Northampton, MA 01060 2 Recommendations: 1- The 2x6 wall, presumably framed with either SPF, SP, DFL wood species, shall be laterally braced at 1/3 and 2/3 height with full 6" width blocking in each stud bay. Blocking is not needed above or below the large window location. Blocking shall be installed above the smaller window at the 2/3 height. Wall studs shall be 16" on center. 2- A double top plate shall be used along the top of the wall. 3- Exterior sheathing shall consist of 5 ply 5/8" type X exterior grade sheathing fastened at 12" on center minimum. Sheathing joints shall be staggered at minimum 2' on center. 4- Contractor/Others are responsible for any and all required fasteners and connections. (i.e. Hurricane clips). 5- Contractor/Others are responsible for any and all frame out of all headers and windows/doors/jack studs/posts. 6- Contractor/Others are responsible for any and all structural framing above (roof, rafters, etc) and below (sub floor, floor framing, foundation, etc). 7- The wall shall be positively connected/fastened to the roof framing and floor framing (by others). Should you have any questions or comments, please do not hesitate to contact the undersigned. This report and information contained herein can be revised and changed should any new information become available. Best regards: tN of THOMAS A. tiG MIEFiZWA 0 CIVIL ti No.47ssa _ -14 A Fat TEP� S Thomas A. Mierzwa, P.E THOMAS A. MiERZWA, P.E. 888 FRANK SMITH ROAD LONGMEADOW,MA 01106 THOMAS @TAMENGINEER.COM 413-775-3429 Project: 14-111 Client: Mrs. Kathy Ewall Date of Report: May 14, 2014 Re: 40 Henry Street, Northampton, MA 01060 Rear Wall Recommendations. As requested, you had asked the undersigned to perform a plan review for the proposed real wall and provide framing recommendations. The sketch that was supplied for review is noted below. i . -I� I i o i Diagram 1. Owner supplied sketch. According to the owner, the rear wall will be nearly 20' long. The height of this wall will be reportedly near 14' high and constructed of 2x6 studs. A 94"X113" window will be installed as shown. Ewall 4-26-14 Key'Beam Northampton 1:36pm 1 of I KeyBeam®4.600d kmBeamEngine 4.6026 Materials Database 1472 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Live Load. 40 PLF Deflection Criteria: U360 live, U240 total 1.250" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 3.2 PLF Filename: 64 in hdr.KY Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform (PSF) Top 0' 0.00" 3' 2.00" 7' 6.00" 35 17 Snow T T 3 2 O i 3 2 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" 651# -- 2 3' 2.000" Wall N/A N/A 1.500" 651# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Snow Dead 1 435# 216# 2 435# 216# Design spans 3' 3.750" Product: SPF#2 2 x 4 3 ply PASSES DESIGN CHECKS Connect members with 2 rows of 16d common nails at 12.0"oc NOTE:Nails must be applied from both sides Minimum 1.50"bearing required at bearing#1 Minimum 1.50"bearing required at bearing#2 Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 539.'# 1329.'# 40% 1.58' Total Load D+S Shear 5374 1630.# 32% 3.07' Total Load D+S LL Deflection 0.0316" 0.1104" L/999+ 1.58' Total Load S TL Deflection 0.0473" 0.1656" U840 1.58' Total Load D+S Control: Positive Moment DOLS: Live=100% Snow--115% Roof=125% Wind=160% Design assumes a repetitive member use increase in bending stress:15% This member has been designed in accordance with NDS 2005 All product names are trademarks of their respective owners Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing is defined as when the member,floor joist,beam or girder,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,antl Spans listed on this sheet. The deli n must be reviewed b a ualified desi ner or desi n rofessional as re uiretl fora royal.This des'n assumes roduct installation accordin to the manufacturer's s ecifications. Ewall 4-26-14 ]Key-Beam Northampton 1:34pm lofl KeyBeam®4.600d knnBeamEngine 4.6026 Materials Database 1472 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Live Load: 40 PLF Deflection Criteria: L/360 live, U240 total 1.250"max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 6.8 PLF Filename: 64 in hdrXY Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 9' 5.00" 5' 6.00" 35 17 Snow Additional Uniform PLF Top 0' 0.00" 9' 5.00" 0 40 Live 9 5 O r / 9 5 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" 1591# -- 2 9' 5.000" Wall N/A N/A 1.500" 1591# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Snow Dead 1 920# 671# 2 920# 671# Design spans 9' 6.750° Product: SPF#2 2 x 12 2 ply PASSES 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 Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 3804.'# 5306.'# 71% 4.71' Total Load D+S Shear 1279.# 3493.# 36% -0.06' Total Load D+S LL Deflection 0.0727" 0.3188" U999+ 4.71' Total Load S TL Deflection 0.1256" 0.4781" U913 4.71' Total Load D+S Control: Positive Moment DOLs: Live=100% Snow--115% Roof=125% Wind=160% This member has been designed in accordance with NDS 2005 All product names are trademarks of their respective owners Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing is defined as when the member,floor joist,beam or girtler,shown on this drawing meets applicable design criteria for Loads,Loading Conditions,antl Spans h "or this sheet. The design must be reviewed b a ualifietl tlesi ner or desi n rotessional as re uiretl fora royal.This desi n assumes rodua installation accortlin to the manufacturer's s ecifications. Ewall 4-26-14 XeyBeam Northampton 1:31pm 1 of 1 KeyBeam®4.600d kmBear Engine 4.6026 Materials Database 1472 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Live Load: 40 PLF Deflection Criteria: U360 live, L/240 total 1.250" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 4.4 PLF Filename: 6 ft header Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 6' 0.00" 7' 6.00" 35 17 Snow T T 5 4 O 5 4 O 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" 1081# - 2 5' 4.000" Wall N/A N/A 1.500" 1109# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Snow Dead 1 719# 361# 2 738# 371# Design spans 5' 5.750" Product: SPF #2 2 x 8 2 ply PASSES 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 Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 1481.'# 2645.'# 55% 2.67' Total Load D+S Shear 842.# 2251.# 37% -0.06' Total Load D+S LL Deflection 0.0399" 0.1826" U999+ 2.67' Total Load S TL Deflection 0.0600" 0.2740" U999+ 2.67' Total Load D+S Control: Positive Moment DOLs: Live=100% Snow--115% Roof=125% Wind=160% This member has been designed in accordance with NDS 2005 All product names are trademarks of their respective owners Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. L ed as when the member,floor joist,beam or girder,shown on this Irawing meets applicable design criteria for Loatls,Loa"'Coonted be reviewetl b a ualified desi ner or des,n rofess,onal as re wired fora royal.This de n assumes rotluct installation accordin to the manufacturer s s ectfications. Ewall 4-26-14 Key-Beam Northampton 1:25pm loft KeyBeam®4.600d kmBeamEngine 4.6026 Materials Database 1472 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Live Load: 40 PLF Deflection Criteria: L/360 live, U240 total 1.250" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 13.8 PLF Filename: KYB1 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 24' 0.00" 11' 0.00" 35 17 Snow 3, ' , O 15 6 0 ® 8 6 0 2400 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 5.500" 1.613" 3669# -- 2 15' 6.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 5.500" 4.037" 9184# -- 3 24' 0.000" Wall SPF#3/Stud 2x or 4x End-Grain(650psi) 5.500" 1.500" 1709# -597# Maximum Load Case Reactions Used for applying point loads(or line toads)to carrying members Snow Dead 1 2436# 1232# 2 6036# 3148# 3 1426# 284# Design spans 15' 1.375" 8' 1.375" Product: 1-3/4x14 VERSA-LAM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS Connect members with 3 rows of 16d common nails at 12.0"oc Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Review gravity uplift reaction force of 597lbs at bearing 3 and ensure that the structure can resist appropriately. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 11474.'# 33390.'# 34% 6.43' Odd Spans D+S Negative Moment 12569.'# 33390.'# 37% 15.5' Total Load D+S Shear 4575.# 10706.# 42% 14.74' Total Load D+S Max. Reaction 91841 133661 68% 15.5' Total Load D+S TL Deflection 0.2555" 0.7557" L/709 7.19' Odd Spans D+S LL Deflection 0.1735" 0.5038" L/999+ 7.19' Odd Spans S Control: Max.Reaction DOLs: Live=100% Snow--115% Roof=125% Wind=160% All product names are trademarks of their respective owners Copyright(C)2M by Simpson Slrong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing is defined as when the member,floor joist,beam or girder,shown on this Irawing meets applicable design criteria for Loads,Loatling Conditions,and Spans listed on this sheet. T he'a n must be reviewed b a ualified desi ner or tlesi n rofessional as re wired fora royal.This desi r assumes roduct installation accortlin to the manufacturer's s ecifications. 04/14/2014 14:46 6177313761 BILL EWALL PAGE 08/08 City of Northampton 212 Main Street, Northampton., MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. f Address of the work: The debris will be transported by: f1cl V, The debris will be received by: "- ''N' Building permit number: Name of Permit Applicant ��O'Ut M J �t�► Date Signature of Permit Applicant Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express.or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 7_2n 1 n Fax# 617-727-7749 www.mass.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,AM 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: rui City/State/Zip: Phone Are you an employer?Check the appropriat 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. Q 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 g, ❑ Demolition working for mein any ca P aci tY• employees and have workers' 9."Building addition [No workers' comp.insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their I I. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *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. :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 and r the pains and penalties ofperjury tha the information provided above is true and correct. r Si nature: - Date '56( .. Phone#: 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#: 04/14/2014 15:07 6177313761 BILL EWALL PAGE 01/01 City of Northampton Massachusetts N AEPAR=WT OF B=ZDXNO TNE-PZ TIONS s Y 212 Main Street • Muniaipai Bui.l.ding 'ryF� t � Northmpton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner ROME OWNER EXENTTION ACKNOWLEDGEMEN) 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 fff required) and a final buildmq 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 perrorm 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, �A) • (&--o 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. Address of work location T 1 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: License Number Address Expiration Date Signature Telephone 9 .Re4istered Home Imai`ovement Contractor Not Applicable £ Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§2SC(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....... £ No...... £ 11. Ho.>rne Owner Exemption 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 Zo 'ng Laws and State of Massachusetts Ge eral Laws Annotated. Homeowner Signature. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ` ] Replacement Windows Alteration(s) ❑ Roofing Or Doors I] Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [M Siding[❑] Other[❑] Brief Description of Proposed Work: tS /! Alteration of existing bedroom Yes�T No Adding new bedroom_Z�,Yes No Attached Narrative Renovating unfinished basement Yes _Y,,_No Plans Attached Roll -Sheet 6a, If New=t ouse and or�-addition to"ezist ng.hotastng, cornllilete the followlna: a. Use of building:One Family ^ Two Family Other b. Number of rooms in each family unit: J Number of Bathrooms c. Is there a garage attached?�_ d. Proposed Square footage of new construction. �i�� Dimensions�z7i0 e. Number of stories? f. Method of heating? t��lA'� ]A M-� Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. -Q' C Masscheck Energy Compliance form attached? h. Type of construction \..J Q10—"D r'Q�,f,�� 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 CONTRACTOR APPLIES FOR BUILDING PERMIT I as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date 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. — i cC, �I Print v � 1 Signa ure of Owner/Agent Date Exw� 1 - ' YL^ Section 4. ZONING Ail Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zo Tin-g� Tlais column to be filled in by Building Department Lot Size Frontage Setbacks Front Rear ITV Building Height E Bldg.Square Footage ---- VC Open Space Footage % Lq (Lot area minus bldg Zpaved -�3- #of Parking Spaces (volume&Location) A A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONTKNOW v�� YES �� IF YES, date issued: > IF YES: Was the permit recorded at the Registry of Deeds? NO DONTKNOW 0 YES IF YES: enter Book Page'- ag and/or Document# �� B. Does the site contain a brook' body ofvvaterorwetlands? NO K�� DON7 KNOW «�� YES �=� «�=\ IF YES, has a permit been or need tobe obtained from the Conservation Commission? Needs tobeobtained �-\ Obtained »�� Date v~� �~� ' ' �� C. Do any signs e� �� (ston the YES �,� NO |F YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,gradingexcavation,nrfi|Ung)over 1 acre orisb part ufo common plan , that will disturb over 1acre? YES NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ^ • L..-, _ � 1 ,�^ ? ` :t ~u� � i� ��r T �' �De att �hx Useronl�y ,z�.x,_ �, i,:P :'. r ai xl i k> �I4 RD D City of Northampton �,tatus�ofPermlt�µ 1�1� l'11.¢k{a �x� }.:k r� es�t♦a)+'4'S�v^��'�,?hl�F U k? ik. ,11, ilding Department �trr� g-v jiiyevvayPerml x,c Lek G r �rcrer�� 1v i°'s IF trt �� 12 Main Street Seyver/Septle,4valta'b�llty x n P ,a A u i i t kn x r x }1 i $ Room 100 Water/UlteitAvatla�lllty I'' '4 T Plumbing ;IG Inspe�1lOf1 kn f rlorthampton010601V0 ampton, MA 01060 TWo,$efsCfStr{r�tural Pfans Lp+: i I ne 413-587-1240 Fax 413-587-1272 PIof/Slt Plan's' ��x } . , 'u�p her,, t rk isy�i L a� Other peCl hi 4 h i L n y Lp% s r , 4 a 'Ii add u:..::..x:.::rr-:..:.r_::.:....:.... . .t.e APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION d y ff 1.1 Property Address: This secfion fo be complete b oice in rr 1 r G N ?-3 ST. Map Lot Unit. 3 1 A G YL-V Tl AM �-�� (1/� A Zone' Overlay Distrrct ' Elm St iQlstnct CB District r t.: SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: W �LL. H Name(Print) Cur en1Mailing Addrreess: +/ i-_ Telephone Signature 2.2 Authorized Agent: '63 Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 0 � � (a)Building Permit Fee 2. Electrical ��— (b)Estimated Total Cost of Construction from 6 3. Plumbing 0(3 Building Permit Fee 4. Mechanical(HVAC) 5, Fire Protection 6. Total=(1 +2+3+4+5) ad Check Number Q This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1134 da �XA- � APPLICANT/CONTACT PERSON EWALL WILLIAM 61 ADDRESS/PHONE 87 HENRY ST NORTHAMPTON (617)731-3761 PROPERTY LOCATION 87 HENRY ST MAP 32 PARCEL 029 001 ZONE PAI THIS SECTION FOR OFFICIAL USE ONLY: �v.1 PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT �4 Fee Paid Buildiny,Permit Filled out Fee Paid X sue" 1 Q Typeof Construction: CONSTRUCT 24 X 20 SINGLE STORY BEDRM/BATH ADDITION New Construction Q ^ Non Structural interior renovations , � �J Addition to ExistingS� Accessory Structure Building Plans Included: ^' Owner/Statement or License 3 sets of Plans/Plot Plan THE F OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF MATIO WSENTED: Approved dditional 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: § i 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 Demolit' Delay i e of uil 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. 87 HENRY ST BP-2014-1134 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32-029 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2014-1134 Project# JS-2014-001927 Est.Cost: $47500.00 Fee: $240.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sa.ft.): 25134.12 Owner: EWALL WILLIAM Zoning: Applicant: EWALL WILLIAM AT: 87 HENRY ST Applicant Address: Phone: Insurance: 87 HENRY ST (617) 731-3761 O NORTHAMPTON MAO 1060 ISSUED ON.511612014 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 24 X 20 SINGLE STORY BEDRM/BATH ADDITION 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 5/16/2014 0:00:00 $240.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner