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48 PLATINUM CIR BP-2017-0675 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:37-079 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-2017-0675 Project# JS-2017-001103 Est.Cost: S4000.00 Fee:$89.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: use Group BEYOND GREEN CONSTRUCTION 074539 Lot size(sa. ft.): 31842.36 Owner: SCHIPELLITE KAREN MARIE Zoning: Applicant: BEYOND GREEN CONSTRUCTION AT: 48 PLATINUM CIR Applicant Address: Phone: Insurance: 13 TERRACE VIEW (413) 529-0544 O WC EASTHAM PTO N MA01027 ISSUED ON:I1/16/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:IMPROVE ATTIC INSULATION TO CODE AND AIR SEALING MEASURES 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 k 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 11/16/20160:00:00 $89.00 212 Main Sweet,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0675 APPLICANT/CONTACT PERSON BEYOND GREEN CONSTRUCTION ADDRESS/PHONE 13 TERRACE VIEW EASTHAMPTON (413)529-0544 0 PROPERTY LOCATION 48 PLATINUM CIR MAP 37 PARCEL 079 001 TONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid nG Building Permit Filled out k`#'1N� Ege Paid Tvpeof Construction: IMPROV. a ' INSULATION TO CODE AND A1RSEALING MEASURES New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included; Owner/Statement or License 074539 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOR) .ATION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:ys Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: She Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER:§ 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 /•''�oliti � De 'y .lure of Building 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. . - ga - The Commonwealth of Massachusetts r Board of Building Regulations and Standards FOR f: ' MUNICIPALITY �' '� Massachusetts State Building Code,780 CMR USE v uilc ing Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011 ;s One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Building Official(Print Name) Signature Date SECTION I:SITE INFORMATION 1.1 PropertyAddress: 1.2 Assessors Map&Parcel Numbers n 4g litaiUin C( flOiCnCeLMu - 1.1a Is this an accepted street?yes no— U01D'Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq R) Frontage(R) 1.5 Building Setbacks(R) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.Lc.40,454) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: __VSiYtn SCnI i-2 1O(tncC, Or Ol �� Name(Print) City,State,ZIP Le 9iannu-0(\ Ct ( L-413-c47ab-335a No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other ,2 Specify: (h)Q Q-j'( C(,ZC117ui) Brief Description of Proposed Work': IYY1p(OVe DU-4'k Ir\sLA.(O-A" en `(t% (CC"( ___ and Cil ( cSPCAi(C9__. arlf(Likrr& - SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 1. Building Permit Fee:$ 9 Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: q aQ Check No. Check Amoun 01 Cash Amount: 6.Total Project Cost: $ LI 000 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS_O `f_?J9 II a S7 (� SEAN R JEFFORDS _ V `9 .�J 1 License Number Expiration Date Name of CSL Holder List CSI.Type(see below) 13 TERRACE VIEW Type Description No.and Street U Unrestricted(Buildings up to 35,000 cu. ft.) EAS IHAMYTON.MA 01027 R Restricted l&2 Family Dwelling Masonry City/Town,State,ZIP RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-529-0544 SEANItBEYONDGREEN.BIZ I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) _ 13 i /1-7(� /499 (j B Sean R Jeffords-Beyond Green Construction El IC RegistrationatNumber xpimlion Date 111C Company Name or HnC Registrant Name 13 Terrace View sean Zbevondereen.biz No.and Street Email address Easthampton,MA 01027 413-529-0544 City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a 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 ❑ 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 .`_) . 'co Co c _ to act on my behalf, in all matters relative to work authoriz-. by this building permit application. see fetcheq nilA Print Owner's Name(Electronic Signature) Da e SECTION 7b:OWNERW OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and ace . e t. •est of my knowledge and understanding. Sean JeffordsI I/1r//f0 Print Owner's or Authorized Agent's Name(Electron. Signature) Date NOTES: I. 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 guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/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.R.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number cif fireplaces Number of bedrooms Number of bathrooms Number of half/baths 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" .' fr.,, �D� of g esi aL4cci ¢s k -X� 4 6 �/rt�szd? t i setaeo MA tl2& _ •ea.z.0.1 !1onv.s sc.ae-rvkia !dram,COM .-in!z_� n liguntmee alga lagdeL'sjQ.: +86W89iEtlettri - ben arag(Ea66ieiUetgmi ettaingy]pg�: J C: ko-fv tint?e,.'1 to s-ri u,„ .+ 11. T I. } , 'Phone t: ] _ - ' ,vietie -74): ftlaia[ < -Nt1�3C":: lt1* .mss# ui3 - -�.C — L '--'e yea am=player?rbne,.Me app snake i6'et; { `: s,l ..t am amap'myerwint 2 4._ 0 i am agenerai contactor aadi Type (� 'e' Iemployees CAMan and/or have hire the seb pamreetos '� []Ne'wconause[ioa _ { 1 2.0 t p; am a sole odet cr orpma Iter- listed omthe attached*est. 7. 0 Remneieting ship am/l aveso employees These snb-ca_tacte.+silsva & Baanolilion tvoddag ems i�aagcapaeity. eploveesandhaveworkers' P. r- Ruitedaddi'ieu 1 rw v_mitats'comp.insurance comp.ns'sauc regorge.] 5.0 We art a co:pumtioaaad its IND Blectieai=paha oraedi800s 1 3.0 t ai ahomeograertieing mi watt oe letisbrio['misedfSt IUDPlumbingrepels cE additions myself.[No worts'comp des ofw.e puo_per taw, o£Euaics i xmnrere required.] II152,§i(+{),and meleeno -`t,o _ employees.itis wake' 3. U`5tr, Vv` .i' h i 1 i(:�?,. ncomp.beancem mere) Any apalieentthatteclabold=;mostahofrawtt6eseotion elowshorriogi{netrwetlws'vxapwseUanpaaegfafomw4as. I Eomeawaeawho SE* Whaling gap/me daiog al wedcand*wain}alas angtaelormints bmit nanWdmoitImmo/coma I%Conmiat=%attack this baamatz1t nn ddituentgnat shwingete MI=onh0m5canimmoa=I totertviwthar erauttlioseadiil.s lave amrtoynx iftim nb.mmmetotehim emplogees,meg mast providetheir wot&Ws'etts.atmota ober. waai'es iflais aroW€ g=eer=:2scwitat c ejt-eV ez+lcpeaa BefewSISOggaileY=@lotstae ar..s"Jianre Cow1tni • ILS iprni a. rc ' i 3 la"Y !ii r L.. Policy 14 or Seating.iia#k Jka. CI:::, 7' — - t — yob sue!Aaron: La e I C41 NAM C.A Y uty/State/Zip: -V(UYe,/1(f, M v� (�\uca- A=� ch a ea>y ea€be wroeeaan esampemettm paw statatiem pt ge(skov g Ss poi/ova/amber ma Surma fie). Fai?urs to secure coverage as required under Scud 251 of MGT,c. 152 yanked So the impositionofarhninaletelties of a 1-mu0o8450Onsad/ortmo-yearim©rseumen:asell aseSvlll penalties M the Thu oft STOP WORK.ORDM.sad afine of up to$256.66 a day aged tette. Be advised drat a copy offftbis setene_ntmay be/ended to the Oce of tnves.'igations of the Di&fra•iasoraacztowage veedfioakton. Ida eery taealy met:heaois¢aepe.%c? eere?ext.&-relev'berw*rnpmuicr&tmeve .'aseandeone.M. Veer& _ 3m f) Laic° phoaeil: ('1,3 -5 Li — u GLt:4' () .9ffls €assarup. Da era tattSta&sese:y to 9a mragTeadby re ortowz Oretef aty as Test afeeett/E.ie sem (drub ane): 13.Board a1aeeVPi a Balding 83epetkatrrat V.Cat/Tea Off. 4.ateaaekaBBespatter 5.Ethethimpthaseettor 1 Other pp Contact Penns Moues: 11 fes( Massachusetts . e ar n te a 'o. u a oor Bu c t:c . c . Stanss'or 'Jceose CS-074539% SEAN R SEFFORQS �^ 13 TERRACE VIEW 'ir?. ` r rs EASTHAMPfOPFMA itH 7' 11/28/2016 CII 6-'onuitaneven e2 clICT /(,7YI:Jtyct7ctielt Office of Consumer Affairs and Business Regulation i 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration_ 131279 Type: Individual Expiration: 6/29/2018 Tr# 288957 SEAN JEFFORDS SEAN JEFFORDS ---_- - 13TERRACE VIEW __--- - _- EASTHAMPTON, MA 01027 - ---- Update Address and return card.Mark reason for change. SCA 21704-05,1 Address Renewal Employment Lost Card 12, ,,,,,.Lf WI//L,,P//,u>,,be,r/s License or registration valid for individual use only of Consumer Affairs&Business Regulation g V% nef>HOME IMPROVEMENT CONTRACTOR ore the expiration date. If found return to: Registration: 131279 Type: Office of Consumer Affairs and Business Regulation Expiration: 62912018 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 SEAN JEFFORDS SEAN JEFFORDS 13 TERRACE VIEVV EASTHAMPTON,MA 01027 Undersecretary Not valid without signature AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application Suggmted Affidavit For Home Improvement Contractor Permit Application For Office Use Only Permit No.: Date: Note 142 A. requires that the Areconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal or demolition or the constructional of an addition to any pre-existing owner occupied building containing at least one but no more than four dwelling unit,or to structures which are adjacent to such residence or building®be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: WeatherizaatntionLy Est. Cost: Address of Work: `I ? w' t Cl',fl r1Ll.h'l CT' -VID v CflC e) M to Q\CLOD- Owners Name: Y.1 OJ n SChiptA\\1 Date of Permit/Application: k\\`-\\ \ I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$ 500.00 Building not owner occupied Owner pulling own permit Other(specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A. Signed under penalties perjury: I erreby apply for a emut as the agent of the owner: Date: Contractor: BEYOND GREEN CONSTRUCTION Reg.#1 : 131279 OR: SEAN R JEFFORDS Not withstanding the above notice, I hereby apply for a permit as the owner of the property. Date: Owner: Tel.# : ir BEYOND D GREEN CONSTRUCTION DEBRIS DISPOSAL AFFIDAVIT IN ACCORDANCE WITH THE COMMONWEALTH OF MASSACHUSETTS DEBRIS DISPOSAL PROVISIONS OF MASSACHUSETTS GENERAL LAW CHAPTER 40, SECTION 54, A CONDITION OF BUILDING PERMIT NUMBER FOR DEMOLITION WORK IS THAT THE DEBRIS RESULTING FROM THIS WORK SHALL BE REMOVED FROM SITE AND DISPOSED OF IN A PROPERLY LICENSED SOLID WASTE DISPOSAL FACILITY AS DEFINED BY MGL C111, S150A. FACILITY- ALTERNATIVE RECYCLING, NORTHAMPTON, MA CONSTRUCTION SITE ADDRESS- I g ( um Co< -Ntencf) MtA- 00) 0? TO BE DISPOSED AND TRANSPORTED BY- BEYOND GREEN CONSTRUCTION or ALTERNATIVE RECYCLING SIGNATURE DATE "HO C° � Po City of Northampton Massachusetts ffiaRTJ@NT OF WILDING INSPECTIONS +!� 212 Main Street a Nuoiclgl Buildup v, .(� Northampton, Kt 01060 Property Address: {R Q10.+1nu v' Car \nYrrce 'tA\A b\pw -a- Contractor en�, /� Name: Y7@ O f(�t Pi rccn Co n Smit ti on 3 Address: I errare vIol,L) City, State: act Si-ha. nPitY\ MA OIOal Phone: L I 5€ S o 541 Property Owner Name: FGCen 3lil1 pp X\\\ Q Address: Lk8 P1oirtou_ r\ CA( -C-t; eirtep Mt4- n\oL0a City, state: Off()( Q Mfk.... I, Sc an cQ Y'( ,} (contractor) attest and affirm that the building I intend to insulate does not have any open air(knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this��affif�dd�avit. Contractor signature c< Dale // -f/lam RISE60 Shawmut Road, Unit 2 Canton,MA 02021 1339-502-6335 ENGINEERING www.RlSEengineering.corn OWNER AUTHORIZATION FORM two) 5dvellile (Owner's Name owner of the property located at: D Ec EoeEI I Ll , ocr i =oi. (Property Address) _ I Rofelia- Oa_ (Property Address) hereby authorize A/An (S contra or) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property.This form is only valid with a signed contract. ikOX Sig�re (\ / 0 Date [4i c