35-022 (2) 64 WEST FARMS RD BP-2019-1304
CIS 0: COMMONWEALTH OF MASSACHUSETTS
M lock: 35-022 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category: INSULATION BUILDING PERMIT
permit BP-2019-1304
Project tt JS-9019-002102
Est Cost:$4712,0
EW-0= PERMISSION IS HEREIN GRANTED TO:
Const.Clnss: Contractor. License:
Use Groan: BEYOND GREEN CONSTRUCTION 074539
Lot Size(Ig It.): 38507.04 Owner: ARONSON CHAYA
Zoning: AS0I£an4, BEMNQ GREEN CONSTRUCTION
AT: 64 WEST FARMS RD
depkantAddress. Phone; Insurance:
13 TERRACE VIEW (41.3) 529-0544 O WC
EASTHAMPTONMA01027 ISSUED ON:5/17/2019 0:00.00
TO PERFORM THE FOLLOWING WORK:INSULATIONNVEATHERIZATION
POST THIS CARD SO IT IS VISIBLE FROM THE SJUFT
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service; Meter;
Footings:
Rough: Ran& Haase# Foundation:
Driveway Final;
Final: Final;
Rough Frame:
Gas: Fire Departlyeyi Fireplace/Chimney:
Rough: Pili 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 OcruDanov Signature:
FggyXirq` ,Date,Paid: An ognt:
Building 3/17/20190:00:00 $65.00
212 Main Street,Phone(413)387-1240,Fax;(413)587-1272
Louis Hasbrouck--Bnilding Commissioner
-rNC/&A 71a/v
OBuflding
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR MUSELILY
Building Permit Application To Construct, Repair,Renovate Or Demolish a RevisedMar101/
One-or Two-Famtl DwellinThis Section For Official Use Onl`ermit Number. r teA lied:
Keu„� ' Koss 5'I�-Zo)9
Building Official(Point Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 sor Map&Parcel Numbeq
�CI( m1.l�Q(f11$ P,� �IOYCdI CQ�MA4 -A 019c)-
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(A R) Frontage(it)
1.5 Building Setbacks(ft)
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 o Private c Zone: _ Outside Flood Zone? Municipal o On site disposal system c
Check if,..
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'ofRecord:
('.Yxu�a V"ri M -VAcK nu, t-%
Name(Print City,State,ZIP
(OLA 4J Fcumt Rd 508- au3 s383
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction. Existing Building o Owner-Occupied . I Repeirs(s) c I Alteration(s) o Addition .
Demolition . Accessory Bldg.o Number of Units_ I Other Spaiiify 14121 Jff4IN
Brief Description of Proposed Work': 'h'1 vo.l Y � ��
f .V nh Q
fi \5
l t\.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
labor and Materials
L Building $ 1. Building Permit Fee:S_LCa Indicate how fee is determined:
2.Electrical $ .Standard City(Fown Application Fee
.Total Project Coal`(Item 6)x multiplier x
3.Plumbing $ 2. Otbm F.s: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression $ Total All Feasp
Check No. Check Amount Cash Amount:_
6.Total Project Cost: $ 1 'd.5� o Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) �1 < _/-."IL1 cJ?Q j a S I IS
SF.ANRJEFFORDS J V i J I
License Number Expiration Date
Name afCSL Holder .
Lin CSL Type(see below) -
13 TERRACE VIEW
I
Type Description
No.and Street U Unrestricted(Buildings up to 35,000 ru.R
EASTHAMPTON MA 01027 R Restricted 1&2 Fatuity Dwelling -
City/t'own,State,ZIP M - Masonry
RC goofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-529-0544 SEANOBEYOFIDGREENBIZ I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 'C1 ) 7`1 4!O a-0
$can R I H rd -Beyond Green Co trttctio HIC Registration Number Expiration Date
MC Company Name or HIC Registrant Name
13 T Viewsean(albevondeaen biz
No.and Street Ell address
EMlhammon.MA 0102] 413-529A544
Ci /Town,State,ZIP Tel hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a.152.5 25C(6H
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 7s:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize�yca0n(� l'7(R01) C?){'LS'1'Yl/GhClrl
to act on my behalf,in all matters relative m work authorized oy this building permit application
,Sf e n E fact ecl 5
Print Owner's Name(Elecnume Signature) Date
SECTION 7b:OWNERt OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all ofth�information
contained in this application is true and accurate to the best of my knowledge and understanding. C
Sean Jeffords S
Print Owner's or Authorized Agenfwwnnic 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 fwd under M.G.L.c. 142A.Other important information on the HIC Program can be found m
ww�v.mass. oR v/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 basementlauics,decks or porch)
Gross living area(sq,ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number ofhalfibaths
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 of Massachusetts
Department of IndustrialAccidersts
1 Congress Street,Suite 100
Boston,AM 02114-1017
www.massgov/dia
V11,irkers'Compensation Insurance Affidavit:Builders/ContraMors/Eleevicims/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
A lican[Information Please Print bl
Name (Busiaesi/Orgenirationllndividual): �b ( 11
Address: A b : Q,((Ua \J'&J �
city/state/zip: CClSA-`�QVY-\eV 1 M� Phone#:
Areyou an employer?Check me appropruse box: O10aJ Type of project(required):
1.01mneeuployawim �n a np.yeu(aul.ad/mpn-rune)- 7. ❑New construction
z.❑Ismaaala poprinm orprmership endluvememployeo wmki� fxonam 8. ❑Remodeling
any mines, [No workeri comp.announce requined.]
3.❑Iemehomeowrordoingallw rayw1f lNowarkers'can,Aaxux=eregnred.l' 9. El Demolition
s.❑Inn.homxwav and win x hmng ronoeclors a condmun wodrov my toxicity. I will l0 E]Building addition
wum meleli wnwew.eimer have Workers'xmpenseti ....na.,.sde Il.❑Electrical repairs or additions
pmprieura wins ro enplxycx.
12.❑Plumbing repairs or additions
5.❑Ian.sexual...and l haw shed me sulMxntacmrs lisaAan the amched mese 13.[—]Roof repairs
These aubconunelme have employees aM w
have orkers'comp.inauumas r�
6.❑W...co,p xllaca and in arcrcas bare earomead mon,eight ofaxnpfi.per MGL c. 14.W OIher 1U P(,�lY\f,Y1 LCk
151.qII«and we have m wnPioyem.INo workers'comp.imu,wce required.]
'Any aMlicmtllut chxks box al mart alas fill out the seclion below showing(heir wohers'compenmtion policy imannessm.
e Nomxw m who subndl mis.mdavit lodimtlog mry art doing ell wmkuA rax hire waidewnuxlors rmor submit a new ama.vil mdkating such.
lConnacwrs mel<bxkmu box mart etmeM1ed en additional rhxt shxwugme mnw ofthe wbconuactma end suawheher orroi max wlilies have
employees. Irene wbwnuacmn M1ave emploYxs,mry mull puvide Meir workers'comp.policy number.
L am an employer that is provlding workers'compensation insurancefor my,employees. Below is thepolley andjob site
informadom
Insurance Company Name: j��r,Yy�
Policy#or Self-ins.Lic.ff#: Lf(nA ),P�_�- �,IJ�pNS Expiration Date: I ' -r2G
Job Site Address: ( 0`-1 W 'r L r 1'U City/State/Zip: :Rbyr'CDQ=a4
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Q O�
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.
I do hereby certify under thepain fperjury that the lnformadon provided above is nue and correct
Signature: Date
Phone M
Official use only. Do notwrite in this area,to becompkmd by dry or w"ofjkiaL
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#:
C...M of MassaoutaeRs
t®t Division of Professional Licensure
l Board of Building Regulations and Standards
. Const4fiY�r{�tlp'rvlsor
1.
CS-074539 Wires: 11/282020 I
SEAN R JEFFORN,Fw "
13TERRACEIM�W.
EASTHAMPrON.41MVO7,, J
Commissioner
`✓ fYJYU//1.O9ZCC/2f000p2. OCL
Office of Consumer Affairs and Business Regulation
One Ashburton Place-Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registtat on
Type: Corporation
Registration: 191746
BEYOND GREEN CONSTRUCTION ING. e0raffon: 05/09/2020
13 TERRACE VIEW
EASTHAMPTON,MA 01027
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BEYOND GREEN CONSTRUCTION INC. Boston,MA 02108
SEAN
' EPR7RO5
isTERANEW
EASTHAMPTON,MA
0107/ Undersecretary Not valid sAftut stgRBWrE
Ar.-FID-a i';
Hum-Imnrov=nt f,,mtractor i a,
Supp;emeui w P it Apvhcauo:.
SOyg51a'..._-ewv_Cv:nvx LW->`.++m C3PS'w:Je,yt Mvieurv:
dor Office Use Oni'
�.�iLit:DEQ:
A, r„quins that the AreconstruCti m, alteration, renovation, repair, modemimbon, convcmioi:,
y ztnprove.,Ment,removal or demouuon or the constructional of an addition to ,lv pra-exisbgg owner occupied
'.. building cnntainiag at imst one but no mozthan four dwelling unit,or to structures which am adjacent m sal+
.-u+aarce crbuileuerbe done,m6stered conir-c_ors,w: =twin exceptions,alongr'ith,Xrier raauiraments. ,.
..:geufR'.,rh� JWeatherization --- Es[.Con;
Date of Permit l ApplicalimE
—_e^y o=rtify that
etrann is nog eq-nma f^_i" F foI%i:':ding rtzm (s):
Work excluded by law
ut,under S 510.00
Oarer occupied
v Amer n17i.*.e wm rc-�,r j
hher;;necin�;
t�se s hereb,given that:
a 0WNERS PIFLL4NG THEIR O'fN PERM I' Uf Dirt, `U' Wl.E t;IREG1STERED C0NT-RACTORS
FOR APPLICAELE HO. p 'A_rFOR ACCESS . THF
4R91TRAT10N PROORAM OR GUARANTY FUND UNDER MG1C- 142A i
°ig3,:d trzider penalties ofpejury:
1 hueby apply f, a permit as the agai of the uwner:
Dain: Cmatactor 9EYOND vl-RF_EiNCONSTRUCTION Reg.#: 7 31279
GR: SEAN' c JE=FOFOS
hast ding}e sbore notice, 1 hereby apply ;or a,,rznit a'"`e awn,ofthe pmpeny.
Date: Owner: Tel.#
BEYOND GREEN
C ON STR U C T '
DEBRIS DISPOSAL AFFIDAVIT
IN ACCORDANCE tn;": --E _2'l1MOMINFALTH
44ASSACN,USE?7; Dl -,Z� ZS?,0SI- PRO_V' TONE G?
MASSACHUSEf - GENERAL ::AW CHAPTER 40: SEC"rC, ,
54. A CONDITION OF BUILDING PEP-MIT NJU?V-E
FOR DEMOL-710N' •,ArORK I , Tl�„A? T';iE DEERT_'.
RESULT NC R-QM Ttiia 4AiORK. SK-'L- 3E RF-MOVED FRO;
SITE AND DISPOSED OF !N A PRnPER_Y LICENSED SO',�=;
WASTE DISPOSAL FALLS-Y AS DZFINED SY MG- C>.._.
,i51A.
iALTERdATIVE RECYCLING, NORTHAMPTON, MA
p1 T'? C-TION SITE AllDRE3: -
�n-LA W F�ACfYI,S �C� �nt�( D Yvi �
BE DISPOSED AND TRANSPORTED BY-
�EYOND GREEN CONSTRUCTION 0r
-:LTERNA.TIVE R.ECVCLT
9.
SIGNAT+JRE _ -
DATE .._. 5 -
city of Northampton
=,.5..
Massachusetts
� 'J
\ D212 R n T a BSIL c l xc!Ruil Ung
212 Hnln Street Nun 010 Building
NocUavq,Wn, DP--11010610�� M' 3�
Property Address: u W Eaf f�'nS R6 `I� I bf C,0 01Q LkA
Contractor �L440A Q YOnS r�
Name: r' �'
Address: (oU w ';�al rr1s Rd
City, State:
Phone:
Property Owner
Name: V v d -f
Address: r 3 1 -f Ck tLO
City, State: lip (���I1'��( AYl( ,\
I, `�Ca n lJ�l �J"0 (contractor) attest and affirm that the building I intend to
insulate does not Rafe—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 5 11 o� I C
AWN
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: nicole@beyondgreen.biz
Thank you!
Mcote)effords
Beyond Green construrtion I Protect Coordinator
Cell:413.539.1728 1 Office:413.529.0544
13 Terrace View,Easthampton I www.beyondgreen.blz
Beyond Green Construction "Leaders in Energy Efficiency" Phone: 413529.0544
13 Terrace View Established 1998 www.BeyondGreen.biz
Easthampton. MA 01027 CSL#74539