24A-022 (3) 83 RIDGEWOOD TER BP-2017-1306
GIS a: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A-022 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-2017-1306
Project# JS-2017-002163
Est.Cost:$2000.00
Fee: $72.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BEYOND GREEN CONSTRUCTION 074539
Lot Size(se. ft.): 10018.80 Owner: LEIBUNDGUTH NANCY S C/O NANCY B SHEEHAN
Zoning:URB(100y Applicant: BEYOND GREEN CONSTRUCTION
AT: 83 RIDGEWOOD TER
Applicant Address: Phone: Insurance:
13 TERRACE VIEW (413) 529-0544 O WC
EASTHAMPTONMA01027 ISSUED ON:5/11/2017 0:00:00
TO PERFORM THE FOLLOWING WORK ATTIC INSULATION
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 if 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:
FeeTvpe: Date Paid: Amount:
Building 5/11/2017 0:00:00 $72.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-1306
APPLICANT/CONTACT PERSON BEYOND GREEN CONSTRUCTION
ADDRESS/PHONE 13 TERRACE VIEW EASTHAMPTON (413)529-0544 0
PROPERTY LOCATION 83 RIDGEWOOD TER
MAP 24A PARCEL 022 001 ZONE URB(1001/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyoeof Construction: ATTIC INSULA ON
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 074539
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INJO$MATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:$
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site 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
%rie
se 5,7
Si: : . - of Buil. ng 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 40k Contact Office of
Planning&Development for more information.
I % The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR MUNICIPALITY
USE
Ca Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
I)'- F Dui g Permit Number. Date Applied:
L_ a
ilding Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Pro rty Address: 1.2 Assess??MMM &Parcel Numbers
83 Kid ekcood�Cr ♦J0A-ham -ton, cf /l
1.1a Is this an'Accepted street?yes tit` -nucr0 Lar_, 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(D)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHOPW
2.1 Owner of Record:
0,u) 51n e-Cincum fjoc mosc9k-c `l`AV\ OvCcat�
Name(Print) City,State,ZIP
R • A. why TeX 1-11.3-5Ro-b(n�l
No.and Street • Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg.0 Number of Units Other fa Specifyilupp,.-hfl iCOfl
Brief Description of Proposed Worl2: (PYl(11C ,-i4 u ,cLAACr, d-R a-'nck
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: acid Use Only
(Labor and Materials)
I.Building $ 1. Building Permit Fee:$ 7 2. Indicate how fee is determined
2.Electrical $ 0 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:,$
6.Total Project Cost: $ QC7
Check No.l )Check Amount: a- Cash Amount:
0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1
RIEruORDSSupervisor License(CSL) /v� ) / ' r 3CI I ' 2?lie
l..J—(7 `-1 �.0 1
License Number Expiration Date
Name of CSL Holder I
List CSL Type(see below) l
13 TERRACE VIEW
Type Description
No.and Street U Unrestricted(Buildings up to 35,000 cu.ft.)
EASTHAMPTON.MA 01027 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-529-0544 SEAJ4 BEYONDGREEN.BIZ I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) / 31979
Sean R Jeffords-Beyond Green Construction HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
13 Terrace View seantthbeyondmeen.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.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...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES fFOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize /;) OcU Orern Cco`SITZ.( G}7 0.n
to act on my behalf,in all matters relative to work authorized by this building permit application.
�e e ct,F-1 acr,ed q I reg/l7
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER"OR AUTHORIZED AGENT DECLARATION
By entering my name below,J hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and ,..sts it the best of my knowledge and understanding. 1
_Sean Jeffords w; `I P3(
(
Print Owner's or Authorized Agent's Name(El. Ironic 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 MC Program can be found at
www.mass.eov/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 count
Number of 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"
City of Northampton
Massachusetts
A •t `j: iaPAR1f®iT OF SNILDINQ INSPECTIONS '..
213 nth Stns • Hunt cipal Boilding
MorthaPtml, ba D1060 C<>
Property Address: \3 Y\\Ckyij3nicdi "fey tOJ(W1 Cten r' \ 4kk (.)1(i QC
Contractor In
Name: bet croft recn COn5i"nVC:fion
Address: I3 `/Trr1rare v\ o )
city, state: Ea&\ hConn(JitY\ MW1 OIoil
Phone: (-f 1 3— 5aq- o541-i
Property Owner
Name: �7 �) Ct-(1 C� hC21-)Oun
Address: O3 �' nC\CrkA3OCr
City, State: IS\C-��yn`Flj1 � U C
l ' e"N C\ 6� 1 `o c�
I, Sear\ t )Q 41Ords (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
Date 513 f -i
The Commonwealth of Massachusetts
T
®. Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-074539
Construction Supervisor
SEAN R JEFFORDS
13 TERRACE VIEW
EASTHAMPTON MA 01027 -
Expiration:
Commissioner 1128/2013
s78 (o-112.7?'ev2?roe t/fp Cf/a/I/ajjackGd£'`�.i
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 131279
Type: Individual
Expiration: 6292018 Tat 288957
SEAN JEFFORDS
SEAN JEFFORDS --
13 TERRACE VIEW ----- — -- - ---- ..__-_..
EASTHAMPTON, MA 01027
Update Address and return card.Mark reason for change.
Address (✓ Renewal ;J Employment [, Lost Card
SCAI a muosm
'f y./// //attic/ ,db
Lice
Oita el Consumer Affairs&a A Regulation or registration valid forindividual use only
.Ar-~" +JHOME IMPROVEMENT CONTRACTOR before the expiration date. If found realm to;
""''It Registration: 131279 Type: Office of Consumer Affairs and Business Regulation
Expiration: 6292018 Intlividual IO Park Placa-Suite Sl]0
Boston,MA 02116
SEAN JEFFORDS
SEAN JEFFORDS
13 TERRACE VIEW -...
EASTHAMPTON,MA 01027 Undersecretary Not valid without signature
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
Suparstd Affidavit For Herne Improvement Contractor Prnoit 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: Weatherization Est. Cost: 20 CO
Address of Work: :3 ?- 1 C\Cy 141C100k I Cr I'A3QC-3A0.tYx c'cO A \.MNA- 61(1)O
Owners Name: If) Ct i'-1 C,P, ,1 <<he en Etn
Date of Permit/Application: _ 1 a 8 I ' l
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
lob 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 I
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE
ARBI I RATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A_
rtt-0' l
Signed under penalties of perjury: C 14,_„7
[hereby apply for a permit as the agent of the owner: i
Date: Contractor: BEYOND GREEN CONSTRUCTION Reg.# : 131270
OR: SEAN R JEFFORDS
Not withstanding the above notice,l hereby apply for a permit as the owner of the property.
Date: Owner: Tel#:
BEYOND GREEN
CONSTRUCTION
DEBRIS DISPOSAL AFFIDAVIT
IN ACCORDANCE WITH THE COMMONWEALTH OF
MASSACHUSEI is 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 TI115 WORK SMALL DE REMOVED FROM
SITE AND DISPOSED OF IN A PROPERLY LICENSED SOLID
WASTE DISPOSAL FACILITY AS DEFINED BY MGL C111,
5150A.
FACILITY-
ALTERNATIVE RECYCLING, NORTHAMPTON, MA
CONSTRUCTION SITE ADDRESS-
2.3jQul;x "rer NJO(-11nOmett_CLIVI A
TO BE DISPOSED AND TRANSPORTED BY- 010(.12b
BEYOND GREEN CONSTRUCTION or
ALTERNATIVE RECYCLING
SIGNATURE CCfY/��J,j[n7
DATE L-c l r7 ell 7
Irt
t Permit Authorization _of I
mass SaVe Form
CONTRACTORSite ID: 2049176 Customer: Nancy Sheehan
I, Nancy Sheehan ,owner of the property located at:
(Owner's Mame,printed)
83 Ridgewood Terrace Northampton
{Property meet Addtass) (Qty)
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.
Owner's Signature: '�f
( a
Date: Lu1111
FOR CLEAResutt OFFICE USE ONLY
CLEAResult has assigned the following Mass Save Home Energy Services Participating Contractor to the
above referenced project:
j',:tWS,,�'. Participating Contractor Date
)
h
t CI,EAResult • 50 Washington Street,Suite 3000 • W1800.480-7412estbaraugh,MA 01581 • O
Par CRice the Only
Rev.102015
BEYOND GREEN
CONSTRUCTION
Dear Building Department,
Please send permit back to Beyond Green Construction by mall or via email
when it is issued If you have any questions regarding this building permit pince
call my cell @ 413478-8631.See details below.
Address: Beyond Green Construction
13 Terrace View
Easthampton,MA,01027
Email Address: nicole@beyondgreen.biz
Thank you!
.: I Prgectcowdlaamr
04 413.478.8631 I Office:413.529.0514
13 Terrace View.r+ufampmo I wwwbeyoo0greembis
Beyond Duan Construction "Leaders in Enemy EBkMney" Phone:413429-0544
13 Terrace View Established 1998 www.BeyondGreen.ba
Easthampton, MA 01027 CSI*74539