18C-056 51 1/2 HATFIELD ST UNIT 24 BP-2019-0045
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C-056 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-2019-0045
Project# JS-2019-000060
Est.Cost:$1792.00
Fee:$65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BEYOND GREEN CONSTRUCTION 074539
Lot Size(sq.ft.): 12153.24 Owner: Eswen Fava
Zoning,URBn001/ Applicant: BEYOND GREEN CONSTRUCTION
AT. 51 1/2 HATFIELD ST UNIT 24
ApplicantAddress: Phone: Insurance:
13 TERRACE VIEW (413) 529-0544 0 WC
EASTHAMPTONMA01027 ISSUED ON.7/70/2078 0:00:00
TO PERFORM THE FOLLOWING WORKAIR SEALING, DAMMING, BATH FAN VENT,
BATH FAN HOSE, HATCH, WEATHER STRIPPING, DOOR SWEEP, ATTIC FLOOR
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.
Certificate of Occupancy signature:
FeeType: Date Paid: Amount:
Building 7/10/20180:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
RThe Commonwealth of Massachusetts
>�i Board of Building Regulations and Standards FOR
GJi7r/. 2018 Massachusetts State Building Code, 780 CMR MUNICIPALITY
Buildi ig P it Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
oePTs One-or Two-Family Dwelling
No ITHANIPTON.MA 01060 This Section For Official Use Only
Building Permit r. - 1 Date Applied:
Bu mial(Print ame) ignamro Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assesso p&Parcel Numbe
--�� -
1.1 a Is this an accepted street?yes l`4W no 0\Oce o Map Numher Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposal llse Lot Arox(sq II) Pornlagc(ft)
1.5 Building Setbacks(D)
Form Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (MG I.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Ione: —_ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check ifyes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of R ord:
Eswe -- 4vo. --- N 01 � 11�m��rl n (4 b 16 L,0
Namc(Print) City,sure,ZIP
t�4 a19- 73°i_g9—__
No.and Smel Telephone Email Add.
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ AlteaIt�io�n(s)1'�❑ Addition E3Demolition ❑ Accessory Bldg.[I Number of Units Other �.Speeify: WPQT,IGr, Zaj, ovet
Brief Description of Proposed Work': i fS P fP1 Sr7
M' c�n.kt s} I.( a-
VMkMAC12e nna4 Fen 4 e
SN .\ kLrrirvrxr�
ewtE-mL G � r-- am
01 OU-) _
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building $ 1. Building Permit Fee:$_.,L95 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 $
Su ression) Total All Fees:,$i.-_,-„-S,p�—
n Check No. Check Amount:-Cash Amount:_
6.Total Project Coal: $ i -I a ❑Paid in Full C3Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C S�`V—II ,S�q
SEAN R JEFTORDS ` ' 1
_e
Iauemse Number Pxpiration Date �L .
Namcof CSl.11oldcr ( j
List CSI.Type(see below)___ �/1
13 TERRACE VIEW _
'Iype Description . .
No,and Street IJ Unrestricted(Huddin n ro 35.0110 cu. Il.
EAS I'HAMPI ON MA 01027 R Restricted 1A2 Family Dwelling
Cily/Town.State,ZIP M M ...nry --
RC Roofin Covcrm
WS Window and Siding
SF Solid Fuel Burning Appliances
413-529-0544 __ _S['.F N(rid3EYONUGREEN HI% I Insulation
'I clephome Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 6
Ses.R Beyond C Construction HIsCcaRegistration
�etgRegistrationulniudnenNumber Expiration Date
DICCmp.yNameoHIC Registrant Nems
133 nraccView
No,and Street
Email address
Easthamolun MA 01027 _ 413-529-0544
Cit /Town,Stale,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 192.6 2SC(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 7e:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDIN/G1 PERMIT
I,as Owner of the subject property,hereby authorize C
1�U._ &yf-c
to act on my behalf, in all matters relative to work authorize y this building permit application.
see 0-o chrr�--_
Prins Owner's Name(Electronic Signature) Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby a pains and penalties of perjury that all of the information
contained in this application is true a best of my knowledge and understanding.
Sean JetTords
Print Owner's or Authorized Agent's Name(EleGromc Signature) Date
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 guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
Www.mass.gov/oc Information on the Construction Supervisor License can be found at www.mass.eow'dos
2. When substantial work is planned,provide the information below:
Total Floor area(sq. IL) (including garage,finished basemen/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system_ Number o(decks/porches
I ype of cooling system Enclosed __Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
The Commonwealth of Massachusetts
Department offitdustrial Accidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.massgowslia
Ulkirlairs'Compenstation Insurance Affidavit:Builders/Contractors/Eleetricians/Plumben.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Auolicem Information r� �rPlease Print Legibly
Name lBuimmsrOrganizadoNmdividua0: &9 And C^IPff'Ii Cdr115fnf a/1
Address: 1 ,6 Tf,'(lr 0 (e \f N eyj
Cityistate/Zip:FCA5 -ho-wyiQ,\ )'MIFF Phone#: X113- 5ac1-025L "
Are you as Man nver'Check the"MPdn,how: 0) 0'D-� Typeof project(required):
9 )
re aired
I.0lamamoployerwith 3 emrLryees(Pol,oumrmmmm).' 7. ❑New colutruction
2.❑lama mkerorerwarpne—maiparehavermen,loyccs working formeim 8. E]Remodeling
any celmnty.INowotkeW camp.insumnce r mrad.]
3.❑ mmc,
iaaM1ownmdme,alloeakmycom
self lNoworkers'' m.morarahi,re eedl' 1 ❑Demolition
a.❑lama hmmeowmr and will be hear,nonreactors to condwt all wady on my mram,, Iwill B❑Building addition
emure that all moil tor:elmer love workerswrr,emaion irnamsen—,.In 11.0 Elearical repairs or additions
P'opireroo wiN no employes. 12.L]Plumbing repairs or additions
5.❑lren a yerrenl coarmcmrand l lave hired mesubuoaecara'leaedon the miefweheet. j3.❑Roof repaia
Theuaii, minae,haveemPkyeea and Imen workers'eamp.nommree: 'l,,
e❑We are a mmonvion and in offimrt M1eve cxcrcisd Ntir right afexemPtian par MCL c. 14.�O[herQ.T I Je I(l
152,00),andwehavenoereploymslNoworkers camp inner c,as ircdl
"Any applkmt that decks box at must els.fill out a,,action III showing their warkers'compensation feslicy infomution.
'Hmeammen who solei Nis andavit nadhCaung they art Jame all work and then him outside wnerara ilmn submit.new aR&va induarin8 such.
lConmcmn amt chttk Nis Mx man emched nn additioml.Met sbrwna the mate of rhe subcuntramrsaM.smm wMhrr m rim rknemNies Rare
employees. Vile wabcemannms love re loyms,they must memos,their workers'romppnlwynumber
lam an employer thatisproviding workers'compensation insurancefor my employees Belowisthepolicyan4jobsae
information.
Insurance Company Name: I`�O f GUM.1 U I I fn(Lu u n(/;t (�
Policy 9 or Self-ins.Le,,a: SWC —I LOIY I Expiration Datppe:__/
Job Site Address: C:)\ 1 a H WJJie 1d
Attach a copy of the workers'compersation policy declaration page(showing the potey number and expirafmn date). �p�U
Failure to secure coverage as required under MGL c. 152,G25A is a criminal violation punishable by afire up to$1,500.00
and/or one-year imprisonment,as Well as civil penalties in the form 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 Wepains and mthr information prcarded above a due and correct
Signature:
Phone k:
Official use only. Do not write in this area,to be completed by city or union official.
City or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
b.Other
Contact Person: Phone#:
i
Massachusetts vepartmint tions a d lToSt ndard
Board of Building Regulations and Standards
License: CS-074539
C0I15[r:IC:10h SJ JEfS ISGI
6,EAN R.EFFOROS i
13 TERRACE VIEW
EASTHAMPTON MA 01027
'_xpiratioo
Commissioner tvzaRola
11, i�•v '� SCFJ.. x:'tt'/.1 104`S
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Type: Corporation
BEYOND GREEN CONSTRUCTION INC. Registration: 191746
13 TERRACE VIEW EzPiralion: 05/09)2020
EASTHAMPTON, MA 01027
—._- upam�Aumeas a.,a naraw vow.
M,.of Comumar Affairs i Business Rwelatien2'
HOME Mi PROVEMENT CONTRACTOR Registrationvaild for hWividual use oray
TYPE:Comaation before the expiration date. H fouml return to:
R»n E,,i UM Office of Consumer Allier,and Bustneas Regulation
191746 05/09/2020 One Ashburton Mace-SuEe 1301
BEYOND GREEN CONSTRUCTION ING. Boston.MA 02108
SEAN JEFFORDS
13TERRACEVIEW ..
EASTHAWTON.MA 01 On Undersecretary Not Valid without signature
I
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Permit Authorization
111aSS SaVe. Form
„.,.
Site ID: 3418977 Customer: ESWEN FAVA
I• IF5'W t V1 C1\g b ,owner of the property located at:
IO e.Nam.,PFMO)
51 1/2 HATFIELD ST UNIT 24 NORTHAMPTON, MA 01060
Iv.aaanrvmn aaa,>*1 Icgl
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 weatheri=ation
work on my property.
Owner's Signature: �C.�A,t`Ctil `1(L.LrZI
Date: SJ✓l.'I'1
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'.
For OFrae ma I"
Rev.102015
JON
BEYOND GREEN
CON STRUCTI ON
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: nlcole@beyondgreen.biz
Thank you!
Nicolejeffords
neyond Green Construction I ProleetCoordmator
Cell:413.539.17281Office:413.529.0544
13 Terrace View,Easthampton I www.beyondgreen.blz
Beyond Green Construction "leaders In Energy Efficiency" Phone: 413-529-0544
13 Terrace View Established 1998 www.BeyondGreen.biz
Easthampton, MA 01027 CSLit 74539
City of Northampton
Massachusetts w"9
DSP�T OF HDSLOZSG 2NSFSCTY0NS a3 4 J (1
Y� 212 Mein 9Ci,eet 0 M Ici el e0il W
G-, PucfAmptvn, MA 01060
Property Address: J ` i/�. �1 co A� -
Contractor _
Name: Rijorvi' 2 r c (Dn
Address:
City, State: LuS'�'�'1 (,t_9rn ,ln �I`M1 t4 OI Oa-1
Phone: Lf � ?i� 15aq- osi-1LI
Property Owner
Name: SWQt/1 Nb-V0.
Address: ` I�a ���fi�ie 0 .
City, State: t\)o ('W h'Y�"�`fiD n '�M(A c� ( �� C)
\
I, e Cko c ){ t—tY J'rd3 (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 affidavit.
Contractor signature
rt
Date