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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