17A-220 (11) 172 NORTH MAPLE ST BP-2019-1118
GIs 0; COMMONWEALTH OF MASSACHUSETTS
Mao:Block: 17A-220 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Perinit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Catmorrv, she BUILDING PERMIT
Peter Ra BP-2019-1118
Project# JS-2019-001817
Est.cost:$25750.00
Fee:$168.00 PERMISSION IS HEREBY GRANTED TO.
Const.Class: Contractor. License:
Use Group: RICHARD DENNO 066189
Lot size(so.8.): 21692.66 OWner. MCALLISTER JOHN
Zoning: URB000V Applicant: RICHARD DENNO
AT: 172 NORTH MAPLE ST
ApplicantAddress: Phone. Insurance:
551 FLORENCE RD (413) 584-0852
FLORENCEMA01062 ISSUED ON.51312019 0:00:00
TO PERFORM THE FOLLOWING WORK:MODIFY EXISTING SHED
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 At Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplaee/Chimnay:
Rough: 411.1 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 stimulate:
FeeType: Date Paid: Amount:
Building 5/320190:00:00 $168.00
212 Main Street,Phone(413)587-1240,Fu:(413)587-1272
Louis Hasbrouck—Building Commissioner
q 000 :5 00
File#BP-2019.1118 V A3
APPLICANT/CONTACT PERSON RICHARD DENNOA r7
ADDRESS/PHONE 551 FLORENCE RD FLORENCE (413)584-0852 —r-iql,K e0 W I KtLy
PROPERTY LOCATION 172 NORTH MAPLE ST y-i2_,q
MAP 17A PARCEL 220 001 ZONE URBf 1001/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building iFilled out
Fee Paid
T f Constructiow MODIFY EXISTING
New Construction
Non Somummi interim avati ns
Addition m Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 066189
3 sets of Plans/Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN 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 Dads Proof Enclosed
_Other Permits Required:
_Curb Cm 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 Stora Water Management
emolition Delay
25-3-w
Signa fBuilding 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.
partment use only
City of Northampton n:
Building Department Cum Cut/Dri way ermit
212 Main street APO 440aptio '.11. ulty
Room 100 WalerlWell A ilabi
Northampton. MA 01 0 ructu I Plans
phone 413-567-1240 Fax 413 5e -TUTH°MDtom '
at
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
TIO
SECTION 1 -SITE INFORMATION 6,,,;?,, tf- I// f
1.1 Property Address: ^�7Thhiiss section to be completed by office
�7 L Npr-q' -S� Map 1-7-f Lot "I� Unit
Zone Overlay District
Elm SL District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record; ' �1
0-641, MA. r Slv/ nL �INl 41.." ✓z
Name(Print) Address I
�K Curmm MM ilin?leepone
rz4 - S9zo
Signature
2.2 Authorized Aaent
�r c1 h h a If Fl...lill ez Ran/
Name(Print) Current Mailing Address
��� of S31 • D8rf7
Sgriditure Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
comp4etted bvoormstapolicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee f�s
4. Mechanical(HVAC) f Vk
5. Fire Protection
6. Total=(1 +2.3*4«5) 7.5 C. did Gheck Number
This Section For Official Use Only
Date
Building Permit Numr' Is
Number! suetl'.
Signature S'.3-w•-L,r7
Building Commnssionerllnspector of Buildings Date
'�:v R��
1
Section 4. ZONING All Information Must Be Completed. Permit Can Be denied Cue To Incomplete Information
Fxiuinp Pr,trmcd Required by Zoning
n'in im m to ii Iledm to
13.04 lhpanmem
Lot Size
Frontage
Setbacks Front
Side I.: K: I.: R:
Rear
Building Height
Bldg.Square Footage
Open Space Footage °o
(W nm.nnua bide&nnN
pukinnn
N of Parking Spacer
Fill:
(volume a 1 xauom
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O . Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and location:
E. Nil the construction activity disturb(clearing.grading excavationor filling)over 1 acre or Is it part of a Common plan
that will disturb over 1 acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION S.DESCRIPTION OF PROPOSED WORK(check II applicable)
New House ❑ Addition ❑ Replacement wntlows Alterationts) Roofing
Or Doore
Accessory Bldg. Demolition ❑ Naw Signs 101 Decks [E:] Siding i01 Otherl0i
Brief Description of Pio e
Work: /'/l}(J
Alteration of existing bedroom_Yes X No Adding new bedroom_Yes X No
Attached Narrative Renovating unfinished basement _Yes7<1,10
Plans Attached Rall -Sheet
sa. If New house and or addition to existing housing, complete the following:
a. Use of building One Family two Family Other
b. Number of rooms m each family unit Number of Bathrooms
o. Is there a garage attached
d. Proposed Square footage of new construction. Dimensions
e. Number of stones?
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 ftof 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=
OMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, —T;3.4 6, C as Owner of the subject
property
hereby authorize —7�`l a4 ?c.-)-h h d
to act on my behalf, in all matters relative tow k authorized by this building permit application.
�Dft
natured-- ) Date
I, // 0 _ as6wWAlMorized
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.
!!0Z1_7-.)�hA,A
Print Name /)
Signa re otewasr/Agent to
SECTION 6-CONSTRUCTION SERVICES
6.1 Licensed Construction Suparvlaor: Not Applicable Cl
Nem,of License Holder a� _. ha`��r /-3,"16 9
License Numher
,..fs/ Fla•.n v. �� FLsivnc� Marr
012 IAP
Address J p Expiration Date
'yly lf�t6� hone BO r�7
Sgneture Telephone
9.Registered Home Improvement Contractor Not Applicable ❑
i .cfy 2�hnd /Zil
Company Name Registrabon Number
SJ'/ �erelnra«Z',-Z 2�d��t cf
Address Expiration Data
FLeirr r,s hayr Telephone S /-el SL7
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..._.. ❑ No.. Cl
11. - Home Owner Exemption
The current exemption for"homeowners-was extended to include Owner-occupied Dwellings atone(1) or two(2)families
and to allow such homeowner to engage an indis idual for hire who does not possess a license.provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 198.3.5.1.
Definition of Homeowner: Person is)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 personh constructs than one home in a t period shall not b considered houneu%rx, .
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 huildine permit.
As acting Construction Supervisor your presence on thejob site will be required from time to time.during and upon
completion ofthe work for which this permit is issued.
Also be advised that with reference to Chapter 152(V orkersCompensationi and Chapter 153 (Liability ofEmployers to
Employees for injuries not resulting in Death)ufthe Massachusetts General Laws Annotated,you may be liabk for person(s)
you hire to perform work for you under this permit.
The undersigned"humeownef'certifies and assumes responsibility for compliance with the State Building Code.City of
Northampton Ordinances.State and Local Zonine Laws and State of%Iassachusens General Laws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
Department ofIndustrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dla
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Bnsinass/OrgmnatioMndividusl): !2u
Z4 7:46,04,j -1 A P
Address: S's/ fza ne;6cle :�Zz
City/State/Zip,?57 /rte 0/067 Phone#: S'_71 - o B 6 7
FMY
n employer? Check the appropriate box: Type of project(required):
a employer with 4. ❑ 1 am a general contractor and I
oyees(full and/or pan-time).•
have hued the mbcontracton 6. ❑New comtrucdon
a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
nd have no employees These subcontractors have g, ❑Demolition
ng for me in my capacity. employees and have workers' 9. F]Building addition
orkers' comp. insurance comp. insurance.:
ed] 5.We as a corporation and its 10.❑Electrical repairs or additions
homeowner doing all work officer;have exercised their 11.❑Plumbing repairs or additions
MY clf. [No workers' comp. right of exemption per MGL 12❑Roofrapahs
insurance required.]t c. 152,§](4),and we m—nv
employees. [No workers' 13.❑ Other
comp.imunnce required.]
•Anyapplicant datdveksbox#I erunaero fill out the secdon blowahow gtheir wmkart compmaam pilicy anomium.
t Honsmwnvs whnaubmit Nis affidavit mdiadna airy ac doing al work and Nen hire auuidc 1.vaven must submit a newatfdavitindiating auch.
rC,Mactol thatehaek Nuboa mariatucholn•ddidoml sheet showing dm arraoffs msconnacmmaid sum w0eu,a ornor IhoaeanUda have
enryloyeex If the rvb<ontrsetoa have rnplvyea,Wry man provide d,or workers'comp.policy numha.
I am an employer!/noir is providing worken'mmpensation insurance for my employees Below is the po0cy and job ske
information
Insurance Company Name:
Policy#in Self-im. Lic.#: Expiration Date:
Job Site Address: City/Stws Mp:
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 53,500.00 and/or oue•year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of try to 5250.00 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 verihcatioa -
I do hereby certt o under thheepains and penalties ofperjury that the information provided above is true and correct
e:smat": Date e!vbir
Phone# 9:3/�0 006 7
Ofaal use only. Do not write in this area,to be completed by city or(Own 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#:
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Member Data
Description: Member Type:Beam Application:Floor
Top Lateral Bracing:Continuous
Bottom Lateral Bracing: 0.00
Standard Load: Moisture Condition:Dry Building Code:IBCARC
Live Load: 40 PLF Deflection Criteria: L/360 live,L240 total
Dead Load: 10 PLF Deck Connection:Nailed Member Weight 20.3 PLF
Filename:Beaml
Other Loads
Typo 11111b. Otlrr Dead
(Desaiglon) Side Begin End NM sun End sun Eno Ceugory
Replaaamenl Uniloml(PSF) Top 0' 0.00' 23' 0.00' 11' G.W. 35 15 Snow
Additional Uniform PLF To 0' 000' 23' 0.00' 0 e0 Live
lr
3300
2300
Bearings and Reactions
Input Min Gravity Gravity
Lacation Type Material Length Required Reaction Uplift
1 0' 0.000' Wal SPF#3ISwd 2x a4x End-Gain(65Dpsi) 3.500' 3349' 7393# -
2 23' D000' Wal SPF#31Stud 2xor4x End-Gen 3.500' 3.249' 73030
Maximum Load Casa Reactions
Iha1b
Snow ae#gYNry{anIaead lalitibYlbfDman[ss
1 0501# x.52#
2 4501p 2A52#
Design spans
22 6.750'
Product: 1-3/4x20 VERSA-LAM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS
Cwmre members wid14 rows of 164 cameo oails at 12.0'ac
design assumas cordirexms laural lwacirlp alae the top cler#.
Design assumes maximum unbraced length of 0.00'alae the batian cMr#.
Allowable Stress Design
Actual Allowable Capaeilir location Loading
Postw Moment 41899.'# 65494.'# 63% 11.5' Total Load D*S
Shear 6300.# 152954 41% 21.65' Total Load D*S
Max.Reason 73934 7982.# 92% 0' Total Load D*S
TL DehoDon 0.6608' 1.1281' U409 11.5' Total Load O.SD.S
LL Deflection 0.5029' 0.752V 0538 11.5' Total Load
C 0: Max,Reach.
DOta'. 1 113714 S -115% RmF-1F.5 Wi�S160%
NI poLn�wnawextlsneMdMrrap[tlwwrrr
Lgf/ndY(LI Brie b/ampm®upTie Larywry R.NL R[it16 RE6FA`�Fa.
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Hodge City Plumbing, Inc. Lic#9452 Estimate
60 North Maple Street
Florence,MA. 01062 Date Estimate Is
Phone# J Fax# E-mail 5/2/2019 672
413-586-1150 413-'fli-5]4] scouahomoxit..net
Name/Address
John McAllister
172 North Maple Street
Florence.MA 01062
Customer Phone
I Project/Job Site
172 No. Maple S0626-5215
Description Total
HEAT
Price to furnish&instal I one,Forced hot water zone from main house boiler to rear studio.
Price includes all materials&labor to provide sufficient hear on a separate zone.
Price DOES NOT include digging of trench between house&studio.
Price includes(2)large panel hunters wild thermostats&controls. (approximate size each 24 high x 48 wide x 4"deep)
I oml Installed Price................. ....—.11EAL ......................................................_......._..___.._...... 5,550.10
PLUMBING
Price to run water&sewer fur one set tub,lot washing brushes(mainly). To be connected to pump in main house&
discharged into existing 4"cast iron sewer line.
Price includes water&sewer lines with all connections.
NO ferns includes in this price
All permits included
Total Installed Price.... ..._....._.__.......__.....PLUMBING_........._..._..........__......._.._.._.........._._......_....... 3.450.00
'•NOTEO*A 120 volt outlet will be needed at the pump location in main house and is NOT included in this price.
PAYMENTS&SCHEDULINQ Job will bescheduled upon receipt of signed estimate and
50°/e deposit of total price. 50%balance is due immediately upon completion.
Estimate valid for 30 days.
Customer Signature
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