38C-044 (2) 26 SOUTH PARK TER BP-2018-1310
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-.Block: 38C-044 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category INSULATION BUILDING PERMIT
Permit# BP-2018-1310
Project# JS-2018-002331
Est.Cost, $7100.00
Fee:$65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BEYOND GREEN CONSTRUCTION 074539
Lot Size(sq.R.): 12283.92 Owner: MARTUNES PETER PAUL&MARY ANN&PETER P MARTUNES JR
TRUSTEE
Zoning: URB(100)/ Applicant. BEYOND GREEN CONSTRUCTION
AT: 26 SOUTH PARK TER
AanlicantAddress: Phone., Insurance:
13 TERRACE VIEW (413) 529-0544 n WC
EASTHAMPTONMA01027 ISSUED ON:6/12/2018 0:00:00
TO PERFORM THE FOLLOWING WORK INSULATIION THROUGHOUT
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:
FeeTvoe: Date Paid: Amount:
Building 6/12/2018 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
RThe Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
luw 2016 Massachusetts State Building Code,780 CMR MUNICIPALITY
USE
Buildi g Pe it Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
DEPT. This Section For Official Use Only
ME,Building
.1Mma60
Building Pe um r. Date Applied:
liluddiag'Off611srguature Date
SECTION L SITE INFORMATION
1 Prope Address: 1.2 Ass sors Map& Parcel Number
(� � . /K.'(er Nor-t-hCuvy�c�) vin 3�C �`f
Lia Is this an accepted street?yes__ no 0100,,0 Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Are.(sq a) Frontage(In
1.5 Building Setbacks(ft)
From Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(MOL a 40,454) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone?
Public❑ Private❑ Check if y.0Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owae sof Record:
Peter �r . Merkunet N�(1�nn ( _T WcT3-Do
Name(Print) Cily,Slate,ZIP
au Z .- ' if U16-58U-Vo I
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Altemtion(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.11 Number of Units_ I Other In Specify:)�p� ' lW}fon
Brief Description of Proposed Work': R-Ill- 2 CSiri —5 :MCA
) l u wbsf }
Ido.da real r '0 lu Jn a,-n '� 1"Th r * t<nren dct + S; i I 'c
ulOt-K- R-1 \ Vc L ,o:' r c ..a,i d.0 In w Iriw.�t
u.rn '�low.rrdcor r us *C IS ca. yw e cn
SECTION 4: ESTIMATED CONSTRUCIFION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee:$ In3 Indicate how fee is determined:
2. Electrical g ❑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:$
Check Na. Ck Amoun�t:Fl 1K 1
Cash Ammunt
6. Total Project Cost: $ 11 0W _
0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C S —o-1 U53� i '( ,a� I�
SEAN R JEFFORDS
License Number ' Expaetiot(i011ift;
Name of CSL Holder
List CSL Type(see below)
13 TERRACE VIEW ..._._
Typetitin"
No.and Strect U Unmstricted Bm'fdin - to 3.5,0p0.cu.fl.
LAS'I'HAMPTON,MA 01027 R `Restricted 1&2 Family Dwell in
City/Town,State,ZIP M Mason
RC Roofin Coverin
WS Window and Siding
SF Solid Fuel Burning Appliances
413-529-0544 SEANnBEYONDGREEN.BIZ I Insulation
telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)m 1 . ,
Sean R Jeffords-Beyond Green Construction HICKRegistration Number Ezpia[ion Date
HIC Company Nae or HIC Registrant Name
13 T—View _ sean(a)beyondereen biz
No.and Street Email address
Easthosaymn,MA 01027 413-529-0544
Cit /Town,State,ZIP telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.G c. 152.4 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 CONTRACTORAPPLIES
1 FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize- &u /
nnd � e eln 0�iuc I Q n
to act on my behalf,in all matters relative to work authorizedby this building permit application.
Re a*-w&,eA
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my time below,l herebyattxswinddopams and penalties of perjury that all of the information
contained in this application is true and best of my knowledge and understanding.
Sean leffords _
Print Owner's or Awomniasd Agent's Name(F.led nic 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(IIIC)Program),will not have access to the arbitration
program or guaranty Pond 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,aov/dps
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"
The Commonwealth ofMassaehusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
ulklwCompensation Insurance Affidavit:Builders/ContractorslElectricians/Plumbers.
TO BE EILED WITH THE PERMITTING AUTHORITY.
Applicant Information (� r{ /µ.Please Print Legibly
fn
Nae dusmass'OoN
rg...iiedwidual): (JNno (�rQ k.l� �Ydl Vllvklill�n
Address: 13 TC( rQ y I Lo C q
City/State/Zip: t'\ I Phri ' ` 0 1 SLi
Ld
Anyouanemplayer'. Cmskpeappwpfiim boa: \U�11
_<J i' Type of project(required):
I.�emeagnlny..wnh cmployea(fun anNor len-thrc).' 7. ❑New construction
2 l an a sale peoprinmor prmerchipand havens employee world, fon re in 8. ❑Remodeling
any capacity.[Nowmkers'comp.moumnoe rtgni ed.]
3.❑l a me homcawnm dietitian work myself[No tsm1mii comp maimmee re,eedd s q. ❑Demolition
4.❑Iamahommwnnandwillbehiringca torsmmMN tallwmkonmy POKn)'. ]will ]0❑Building addition
wisum Nn an ameacmmesher leve workers'compensation immerse m arc sole IL❑Electrical repairs or additions
pmlmnms wits na empbyeea. 12.0 Plumbing repairs or additions
s.❑I am a amemlmrmamm.M 1 have hued um ve wous4acmrs Baud on smaMcncd aitch. 13.❑Roof repairs
These xub-connecmrc have employees end Mve wohers comp.imurence:
¢.❑We arc attenuation and is officers base exemisud stair right ofesemptem per MGL c.
152,pl(4),and we have vie employees.[No workers'comp.immmtae mquiM.I
"Any epplicmt tat checks box MI mint atw fill out the section balms sMwin6 their wrorkees'compensation policy infomution.
'Dmaesem s who submit dais affiunvit aneem,thry ati doing all work ant dais hire estate conumus s must submit a new,affidavit mdzetin,such,
ma,aacmmincl eM1eckthis lax must artecbM an Wditbrel sbcetshowimtlrc6mrs orthm wlic racers eM amts whedam or not daoxensties Mve
nn0loyem. If sm wbeontncmrs Mve employees,mry met provide mete wvrkerc'comp.policy number.
I an,an employer that isproviding workers'compensation insurancefor my employees Below is thepoffry andjob site
information.
Insurance Company Name: C', 5,� I )r r
Policy#or Self-ins 5ue
Lic.4: (( rc.-7QVG I Espimtion Date:(_
Job Site Address: JL U - Park 7"et- City/StateJZip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirradoof
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine 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.
1 do hmeby cerdjy corder the pains and f' erjury that Me information pr ovided abore is true and correct
Signature Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
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
Massachusetts department of Public Safety
Board of Building Regulations and Standards
License: CS-074539Supervisor Construction Supervisor
SEAN R JEFFORDS
13 TERRACE VIEW
EASTHAMPTON MA 01027
/A',. —r.— Expiration:
Commissioner 1112812818
i
Office of Consumer Affairs and Business Regulation
S Al' 10 Park Plaza - Suite 5170
Boston, Massachusetts 03115
Home Lnprovement Contractor Registration
Registmtinrl: 151279
TVPe- Individual
EXPIrahGn: 629/2018 Trp 263957
SEAN JEFFORDS
SEAN JEFFORDS
13 TERRACE VIEW
EAST HAMPTON, MA 01027 - --
Update Address and return card.Mark roman for cha ee.
,Address I Rencwai Employment Lost Card
Afoot,&
. T W,/ License or regi,trrtion.and far indicdudnse only
Orr M IMPROVEMENT
BAsibCRdeyfa[unIf
—!A ROME Iation: VEMENT COCf�ihppC'YQR beta re[he expif rtian date. .,ad uad,sturneg
T#ii Registration: 131279 1'raa4 •,�_,Mr n Pa of l _ cr\fTa . and Rnziness ltegulafion
Ezpimtionn 612912019 Intliv tlu lO Park!'laza Sultc,lTO
Roston,lSiA 02116
SEA'J JEFFORDS
SEAN JEFFORDS
13 TERRACE VIEW
EASTHAMPTON,MA 01027 I:ud rttar: 'Sot ,lial arahouuignaturc
AFfiDAHTT
HI ate
Supplement is i'ormit Appnzativn
ear Office ::se Only
Peat N'r,
Oan:
"dt e t . t quir" _hat thf Arxomtruc inn, alreration, renovation, repair. modcmizati'm not ml I
Ifni'); ve ent rt nwai or demolition or the constructional of an addition to any pre-existing owner oci uniad a
b i mi ,g�!nLiurn- a ast on l ut .o more,fnaL:ow dwetl.n unit,or tai tnict n—s which we adjacent to such i
4bn1U ti pc dOnu 9 r L aTer At n 1 4v'1i3 ^� ..�.,uit cxG'p i S A1png't t ctn:._'IvT61 �l n jl
Pype of Work. Weatherization _ F Tr Cost
„e e Work -'w SIIS� '_,�,an�Kt S� NO(�1 tn—�Y &�
Os tic N.-'me: —..?aa J 1 K
Dfoc SPermi , 4,pplication:
`terei>y cartiRT chat
Registration is not regnrren for the foLro'.viog reason(s):
_ Work e%ci4deu 6y :re
Too tine rv ?;I` .:0
Buildoig n„r owner occupied
0,"C'pu'Jing cvn perrnit
(ither'cprciY4')
-, _ ;rehi 2TVen that.
j
OWNERS 2S PL' LING THEIR JRti PLERhi u% 9a-- ( sJ':_{ ' NKr( rk I FIED CONT%<_A
FOR APPLICABLE HOME IMPROVEN�ENC WORK DONOT HAIL AC CTSS t0 IHE i
ARBITRATION PROGRAM OR GLARANTY 1 CND UNDER MCL C 142A.
v —
s'F—J u;der penalties of perjury:
1 hereby apply for a permit as the agent of the ov,nor:
Date: Contractor: Reg.# :
131,279
OR: SEAN ? JFFFOHDS
N ;nsrarri ig t , shove n>is,,I hereby snp_) for:y r a -s the owner of the property.
Jatc: O n nc:F: Tel ft
AMPS�-
Aw
BEYOND GREEN
CON STRU T : vN
DEBRIS DISPOSAL AFFIDAVIT
IN ACCORDANCE vii-l —,
OF
MASSACHUStT(S- GEiaE ._p.we prCP;- 4i;., SE^TI'O
54, A CONDITION OF D''-LR[niG PERK - 'VUMBEK
RESULTING Ff1VP'i 'y `v,--- pK" 5HA' ':. 5t R.EP10VEL% FR01
SITE AND DISPF!SFiJ OF iN A PROPER;.'( LICENSED SOLID
Vu4ST- DiSN[
S A.
. .
XILTERNATIVE RECYCLING, NORT"HARNPIUN; biz;
No r ,,naxv ,r�sA
TO BE DISPOSED AND TRANSPORTS,. 51'- C��bCe(j
BE"OND GREEN COCISTPUCTIO i r
ALTERNATIVE AEC'ri'4.':`4
City of Northampton
maeza NScas ern�rrnmmrc arsmuldi gMassachsssetta
Rh. 01060
i
Property Address: ��¢ 5• �GrK. It( Wr) (LM� '" A 6to�oD
Contractor
Name: IAArVI P rem COnS-tTLich cir�
Address: _� 3 )�5..�'Vr1r�i"Q V{ 1° U)
City, state: 5-lr- 1 O 9m Pt)(\+.N G 0I00-1
Phone: ( E 13— Sr1Q- 05uu
Property Owner -t�
Name: Y `C 'MCA C�lAi'l4 5
Address:
City, state: ` h)CX VAL± -\ Fy\A O, C)V37,e
I, S e Ol n (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.
vContractor signature
t
Date
Department use only
City of Northampton Statu$"° amll;
Building Department Cur'1" fivexay Permit
212 Main Street Saw/Septc Avall!IWIII y
Room 100 Water/VJgIIA vailability
Northampton, MA 01060 T Q(5imctufal P"" I� crone(
phone 413-587-1240 Fax 413-587-1272 PID ams k
"Mn z
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address'.
26 S Pw1A(7eir0rc MaP Lot unit
,,Vor-,thamli MA ofo&o Zone Overlay District
Elm St DleMet OB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
21 Owner of Record: TT
AP , /Y1Rr fuh PS Ur Z(D
Name(Pont) Conant Mailing Address:
�— 4r3 sB -oGs7 oro
Telephone
Signature
2.2 Authorized Anent:
Name(Pant) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed bpermit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6, Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioneninspeclor of Buildings Date
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: nicoie0heyondgreen,biz
Thank you!
Nicole)efforcls
Beyond Ilrccn Conaruction I Project Coordinator
Cell:413.539.17281 Office:413.529.0544
13 Temce View,Easthampton I wrm.beyondgreen.htz
Beyond Green Construction "Leaders in Energy Efficiency" Phone:413-529-0544
13 Terrace View Established 1998 www.BeyondGreen.biz
Easthampton, MA 01027 CSL#74539