44-134 1006FLORENCE RD COMMONWEALTH OF MASSACHUSETTS BP-2021-1924
Map:Block:Lot:44-134-001
Permit: Solar Build CITY OF NORTHAMPTON
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1924 PERMISSIONISHEREBYGRANTED TO:
Project# 2021 SOLAR Contractor: License:
BEYOND GREEN CONSTRUCTION
Est. Cost: 49000 INC 074539
Const.Class: Exp.Date: 11/28/2022
Use Group: Owner: LEBLANC ANDREW &ADRIENNE
Lot Size (sq.ft.)
Zoning: SR Applicant: BEYOND GREEN CONSTRUCTION INC
Applicant Address Phone: Insurance:
13 TERRACE VIEW 4132039088 BEWC223285
EASTHAMPTON, MA 01027
ISSUED ON:09/23/2021
TO PERFORM THE FOLLOWING WORK:
INSTALL 25 PANEL 10 KW ROOF MOUNTED SOLAR SYTEM
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.
Signature:
I , le
i
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Department use only
City of Nort mp n �C --_� Status of Permit:
Building D7�art ent �/f , -Cirb Cut/Driveway Permit
212 Min Street `SFp \• 'S we)1Septic Availability
Ro,bm 3,141 2,,p ater/Well Availability
Northamp Nt 9 160 (90(9,• wo Sets of Structural Plans
phone 413-587-1240 Fan4 '1��'•, 1272 PlotJSite Plans
>off.fir'1:
` \ Other Specify
rio,v /
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVP E OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
1006 Florence Road, Florence, MA Map Lot Unit
Zone Overlay District
Elm St. District CB District
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Andrew Leblanc 1006 Florence Road, Florence, MA
Name(Print) Current Mailing Address:
(413) 478-3755
Please see attached Telephone
Signature
2.2 Authorized Agent:
Sean R Jeffords 13 Terrace View,Easthampton,MA 01027
Name(Print) Current Mailing Address:
111111111%.
Y „""t 413-203-9088
Signature '� Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 15000 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
34000 Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) #7 .-�
5. Fire Protection
6. Total = (1 +2 +3 +4+ 5) 49000 Check Number 7170
This Section For Official Use Only
Building Permit Number: 6P-- 2 1-I"//� 14 Date
Issued:
Signature: /1Z 9-2Z-ZiZi
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage 04,
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DON'T KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW Q YES Q
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 Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q Date Issued:
C. Do any signs exist on the property? YES Q 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 Q NO Q
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES IQ NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [I] Siding [El] Other[0]
Brief Description of Proposed
Work: Install 10 kW DC solar on roof(25 panels).
Alteration of existing bedroom Yes X No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -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 in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
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 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
Please see attached , 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
I, Beyond Green Construction Inc , 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.
Sean R Jeffords
Print Name
X ' t'
Signature of Owner/Agent Date 9/21/2021
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
Sean R Jeffords CS-074539
License Number
13 Terrace View, Easthampton, MA 01027 11/28/2022
Address Expiration Date
X 413-203-9088
Signature Telephone
9. Registered Home Improvement Contractor: . Not Applicable 0
Beyond Green Construction Inc 191746
Company Name Registration Number
13 Terrace View,Easthampton,MA 01027 5/9/2022
Address ' Expiration Date
X Telephone 413-203-9088
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 0 No 0
11. - Home 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 Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature