07-018 (7) 332 NORTH FARMS RD BP-2019-1257
GIs#: COMMONWEALTH OF MASSACHUSETTS
a : t ck: 07-018 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category INSULATION BUILDING PERMIT
Permit# BP-2019-1257
Proiect9 JS-2019-002029
Est.Cost$4473.00
Fee:$65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use Group: BEYOND GREEN CONSTRUCTION 074539
Lot Size(sp I): owner: MURDUCK KENNETH
Zoni= RR(100)/WSP(100)(WP(12)/ Applicant: BEYOND GREEN CONSTRUCTION
AT: 332 NORTH FARMS RD
Applicant Address: Phone: Insurance:
13 TERRACE VIEW (413) 529-0544 0 WC
EASTHAMPTONMA01027 ISSUED ON.5171'2019 0:00:00
TO PERFORM THE FOLLOWING WORK:WETHERIZATION - BLOWER DOOR
TEST,WALLS
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: QZ 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 5/7/2019 0:00:00 $65.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
-- The Commonwealth of Massachusetts
S r q,� Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR MUNICIPALITY
yo USE
zn m Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2017
N One-or Two-Fanidy Dwelling
This Section For Official Use Only
Buil ' ,/t Number: 1�J �DDaaApAppJlied:
4vo.) /Z� // �// 5 - zo)3
cial(Print Name) �gvauve Dane
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 A���y�=pgap&Parcel Numbe
33;1 N Fnrry s(Zd N�r� haMetvrNg-
1. CL 1���
Is is this an accepted street?yes noQOlp Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(R)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,4 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public D Private o Zone: _ Outside Flood Zone?
Check if yes,, Municipal m On site disposal system o
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'ofRecord:
V,mf\f kVl mkmdocr- _NOtkYlyrDn,1tiA
Name(Print) City,State,ZIP
33d, N Fclrrns Rd
No.and Sonet Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction D Existing Building,, Owner-Occupied n Repairs(s) I Alteration(s) o I Addition c
Demolition o Accessory Bldg.c Number of Units_ Other Spxfl)' /Q, f I " (\
Brief Descrtption of Proposed Wod2: - - I m
)
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs' Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ D Standard City/Town Application Fee
ii Total Project Cost'(Item 6)x multiplier_x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) $ Total All Fees:$ 5
6.Total Project Cost: $ ��?J p Check No. Check Amount Cash Amount:_
Paid in Full ❑Outstamdin Balance Due:
SECTION 5: CONSTRUCTION SERVICES
SECTIONS: CONSTRUCTION SERVICES
5.1 SEAN R 3EFFO Construction SSupervisor License(CSL) CC— W I 1 JJ 57 Q I a$f IS
License Number I Expiration Date
Name of CSL Holder
Gs[CSL Type(see below)
13 TERRACE VIEW
Type Description
No.and Street U Unrestricted(Buildings up to 35,000 on.ft.
EASTHAIvfPTON MA 01027 R Restricted 1&2 Family Dwellin
Citylro,n,Stere,ZIP M -Meso
RC Roofing Covering
WS Windowand Sidin
SF Solid Fuel Burning Appliances
413-529-0544 SEANQBEYONDGREENBIZ I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 101
f .7/on, l, 5/IC'
Seim SeR/effod -B dG Co t HIC Registration Numry
Number Etration Date
HIC Company Name or HIC Registrant Name
13 Terrace Vic, sean(dbevondmeen biz
No.and Street Email address
EastharoyWn.MA 01027 413-529-0544
Ci /Town,State,ZIP Telephone
SECTION 6:WORIMRS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.S 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..........X No...........0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize P1PAn Y)A C-7/t°.G/l CO)t,t5'YRJC 1l'(1!�
to act on my behalf,in all matters relative on work authorized by this building permit application
a cSied io i 9
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARAT[ N
By entering my name below,I hereby attest 029ho pains and penalties of perjury that all of the information
contained in this application is true the best of my knowledge and underslandin&IJ
Seanleffords TI I Ic
La—
Print Owner's or Authorized Agent's Name(Electronic Signature) Dale
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guawnry fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass ov/oca Information on the Construction Supervisor License can be found at www mass.eov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room court
Number of fireplaces Number of bedrooms
Number of bathrooms Number ofhalPhaths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost'
r,
The Commonwealth of Massachusetts
Department of lndustrial Acciden is
1 Congress Street,Suite 100
Boston,MA 0211 4-2 01 7
www.massgov/dia
V11firkers'Compecisation Insurance Affidavit:BuHders/Contractors/Elm&icims/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Aoolicaot Information ,Q ^' Please Print Legibly
Nanne (Businms/OrgwuuadmAwHvidua0:PTCI AO n j C� f PC� C n.S` 1GflO t1
Address: 7uraco V , 6)p
City/State/Zip-ZCJG- G Y-ko,. Phone#:
Are"it an mployed cbak me wpropaate box: Type of project(required):
LE3lmaempbyawoh—Ap—se"I'.s(follows.pe n-taro)" 7. ❑New construction
2.❑Imamlepopneroror mershipaMMyemcmploymworUq formcin g. ❑Remodeling
any mracity.Ma worken'emp.insutenre mquiwd.)
3.❑I m e homeowner doing on work myself[No warkersmmpimawne requirial9. ❑Demolition
4.❑lam a lv a na and will be hiring connectors m oodum dl wA on my Poway. Iwill 10 CD Building addition
uo Metall comae iffloer have workers'compaceniuniwmce or art sole ll.❑Electrical repairs or additions
pmpremrs was re amix,em. 12.❑Plumbing repairs or additions
5.❑I an a commit eenowtor and l nave hued We wbcomncura lead on the attached sheet 13.❑Roof repairs
These sub•corawtors have employers ed lave workers'comp.i..I I '�
6.E]We ma coryomtiw d W
and is offcas have exaciscir right of mansion per MGL c. 14, Otherlll✓vrk4+) , ' 16(11 n
I5;41(6),erd we have m mployem.[No workers'comp.immerserryuired.]
*Any epplicm Wet checksbax a1 most also fill ora the emaon bclmv aMwmg Weir workers'colmxnmion policy infomatim.
"Hmneownm wed submit this affidavit indicating they m doing as work and Wm hire ouske conaenms men submu a,aw amdavit indicating such.
:Co.."thaehe<k this baa men auched en edWtiond A.showing the mans of Wn subconnectms end was wheWa or nor those mtitio have
mployess. If Wv subeonuacmn have"ll any,most provide Weir workers'comp policy number.
I am an employer matisprovidingworkers'compenouion fnsurancefm my employees Below is thepntcy,andjob site
information. /n 1 n`J``
Insurance Company Name: NO��0_u irk IUj CI,(-� C -Q _
Policy#or Self-ins.Lic.#: &M ec 7 L��Qo��0 S l Expiration Da�te:I ' 1—�l� r. OU-"r� y�
Job Site Address:-33d, N �Q(fY15 Rd City/State(Zip:IJD( I'V' lkMOII)n ) o
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 l.J
and/or one-year imprisonment,as well as civil penalties in the forth of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.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 the pains an Jury that the information provided above is nue and correct
S'enatute: Date:
Phone#:
Oficial use only. Do not write in this area,in be completed by city or town oBkiat
City or Town: PermltLiceme#
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#:
i
{
e
I
y ConerlunwealtA of Massachusetts t
Division of Professional Licensure I
Board of Building Regulations and Standards
ConsttMC�?ri uw}rviwr I
CS-074539 Eypires: 1112812020 y
r
i —_
SEAN R JEEFdRDe
13 TERRACE IW
EASTRAMPrONx,1AVy
Commissioner C'4 `� !
1
�T<ie pdrr✓nzaizuJaz�t a CJ/�/ cu�iu�eeZ
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Type: Corporator,
BEYOND GREEN CONSTRUCTION INC. Registration: 191748
13 TERRACE VIEW EStpitaton. /OB20m
EASTHAMPTON.MA 01027
VptlelCMErtsavnY RotuT GCN.
SCA1 v 2�May1]
r��ry�ex,uiOxxTn�7���"�tOVOe'�ini!'//'
NOME MPROVEMENTCONTRACTOR Regtelmtlonvalitl fa lntllWual uss only
WM-Comodstor,
! togg Exassidw
191146 05MO20 �� + bOOentslocmAaeobhf OeCuoarxrlarcpnduamPtlieaorcnttl-aSuits
sIfnfdauBruWefrneealum Rteog:
,Neton
1301
BEYOND GREEN CONSTRUCTION INC. Boston,MA 02108
SEAN 13 RACE E \2.11fa.P--
EASTHAACEVIEW C� Not valid Wlthout Wgitah e
EASTNAMPrON,MA 01027 Under�cfetl�.
1{Otne IniDTOJ'aID�'1i?.,6D.traC•.ar i::a.
Supplement t;,Pc:nit Aponcac,�..
Fcr Olen use Oni'
A'o-:
stay': t1- ;wratiou, renovation, r-pa.r. modevimtimt a1 r
H.rn oaem t,removal or demo t' an or the coas`ruattonai of an addition to arty pre--misting weer occupied
t.x.tumE 'n.oux.ng a ieaat on out oo mor_tuna tow dwelling unit,or to strnet�s which are admcon ro a_ry
e, :r DuijWI-L4 u_none re,asterrd conm cos,:t it certain exechtions;a.ong..;�i.r.ntne. pxlm.�mwts-
`,a 0.-Werk: iNeal iherizaflo.7 _ Est. Cost: _
i4'ars.
ae Nama _--
Date of Pme,I Application:
-�ru,y tbat
gisrma 1M- 1's^...-.:v:;^_irl-i fl-fciI 01'C1m?g C,a on(a):
-,tori excluded Sy law
�.ob under S 5;A.^:)
.� .:.....-cccnaied
_.ctice s'a.Ahv gi'a�,that: �
OWNERS PULLING THEIR OWN FEiiPv1 OR
�i
FORAPPLICABLE HO'i/tE 'Y)NOT HAV'+Air°SS 10 THF
-RSI-R.eTrON PROG_RL Al vR Crt-.R N7s PIING UNDER MC.L.C. 142A. Ii
pznai^es of pe*ju y:
t`emby apply fora permit as the agent oftbe oNaer:
let
Data: Conyactor: s@:vCNT--_Rees CON'siRuC710'ti Reg.ti:_=1<79
__ .._�_.__±ng'�-e icace uc++tica.[heraby�po]g Sr a;emnirLL '-:n a-.e-ur. afffie mope.t}'- �
BEYOND G EEN
CONSTRU C T '. 0
DEBRIS DISPOSAL AFFIDAVIT
TN A .CORDANCE Wl .Ji'.-IMOIAVE .L?'-: .'
MASSAC VSErB =3FiS ___.. 1--1 - PRO`%-S z.D'!S
MASSACHUSETTS GENERAL '-AW C-APTER 40. SEC civ?:
54: A CONDITION OF BUILD:NG PEM-7
FOR DENOL=TTON '+MO;� K 1= '. 'KAT T=!E DEBR?:
RESULTING FiaQN; TH' SY,F': m BE `r'.ENIOIEP FR.e.
SITE AND DTSPOSEC OF 1% A PROPER'..'! '.1C:ENSED SOLID
WASii DISPOSAL FAC-'_'-?' AS DEFINED BY G5 C_.
�iJUA.
i:LTERNATIVE RECYCLING, NORTHAMPTON, MA
°.UrMrkl SIFE ADDRES_...
N Rarms Rd N o r h �fion
3E DISPOSED AND TRANSPORTED BY- G I OU'D
3EYOND GREEN CONSTRUCTION •3r
--_TERNATIVE RECYCLING
SIGNATURE _
45v—yl-7
-
City of Northampton
s _*
Massachusetts '
212 Hein 9[xreet m ibn 010 auildiog
He 010 r
__ HmxNm�tm,, 60
Property Address: �3a Cj -'�afiy)� V c9 �Vor-w)rtrnofog &w olot,, o
Contractor
Name: Vf iianrA O QCYI COn5tt c tion
Address:
City, State: S 141 Gt ynnn Y\ i A 010,11
Phone: �� cJarl- �SLL4
Property Owner ��11n UAMC160,K-
Name:
Address:
City, State: \N(�(
I, J e C n <)P t'T" TW (contractor) attest and affirm that the building I intend to
insulate does not have any open air(lmob and tube)wiring in the spaces to be insulated and that I have
provided the property owner with a copy of this affidavit.
Contractor signature
IA Y
Date
DacuSign EnveI10 BB25A-FiDBA96D-9HF&EF12533c03D8
Permit Authorization
friass saves Form
Site ID: 3750629 Customer: KENNETH MURDOCK
Ryan Murdock
owner of the property located at:
(Ornsr's Neme,polrted)
332 N Farms Rd Northampton, MA 01062
(Property R.d Address) (City)
hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed
below to act on my behalf and obtain a building permit to perform insulation and/or weatherization
work on my property.
oowapnw W:
Owner's Signature: �Av- Muxh&
esexxwee_.
Date; 3/13/2019 18:15 AM EDT
eesmmemgmmgemiaamaaauaaamaeueq m•gem•aagaaammammeagmmqqmeqeaa•mmamon
FOR OFFICE USE ONLY
We have assigned the following Mass Save Home Energy Services Participating Contractor to the
above referenced project:
Participating Contractor Date
Name: CLEAResult
Phone: 800-480-7472
Email:
Page 1 of 1 For Office Ux Only
Rev.102015
AON
BEYOND GREEN
C O N S T R U C T I O N
Dear Building Department,
Please send permit back to Beyond Green Construction by mail or via email
when it is issued. If you have any questions regarding this building permit please
call my cell @ 413-539-1728. See details below.
Address: Beyond Green Construction
13 Terrace View
Easthampton,MA,01027
Email Address: nicole@beyondgreen.biz
Thank you!
Mcolc je}}ords
Beyond Green Construction i project Coordinator
Cell:413.539.1728 1 Office;413.529.0544
13 Terrace View,Easthampton i www.beyondgreen.biz
Beyond Green Construction "Leaders in Energy Efficiency" Phone:413-529-0544
13 Terrace View Established 1998 www.BeyondGreen.biz
Easthampton, MA 01027 CSL#74539