38B-197 •
•
ACORQ, CERTIFICATE OF LIABILITY INSURANCE DATjzM1D a
o$
PRODUCER (413)586 -0111 FAX (413) 586 -6481 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Webber & Grinnell Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
8 North King Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Northampton, MA 01060
INSURERS AFFORDING COVERAGE NAIC #
INSURED Pioneer Valley Photovoltaics Cooperative, Inc. INSURER A: Peerless/Peerless 24198
324 Wells Street INSURER B: Excelsior /Peerless 11045
Greenfield, MA 01301 INSURER C:
INSURER 0:
INSURER F:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRL ,DATI INFIIDDIYY1 DATE IMM/DDIWI LIMITS
GENERAL LIABILITY CBP8373623 01/01/2009 01/01/2010 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000
PRFMIRFR (Fa nrraramw)
I CLAMS MADE I X I OCCUR MED EXP (My one person) _ $ 5 , 000
A PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,Q00,000
GERI AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 2,000,000
— 1 POLICY I ^ I !Na n LOC
AUTOMOBILE LIABILITY AQS8372626 01/01/2009 01/01/2010 COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident) 1,000 r 000
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULED AUTOS (Per person)
B X HIRED AUTOS
BODILY INJURY $
X NON -OWNED AUTOS (Per accident)
PROPERTY DAMAGE S
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGO $
EXCESSRIMBRELLALIABILITY CU8377126 01/01/2009 01/01/2010 EACH OCCURRENCE S 2,000,000
71 OCCUR n CLAIMS MADE AGGREGATE 5 2,000,000
A $
DEDUCTIBLE $
X RETENTION 5 10,000 000 5
WORKERS COMPENSATION AND WC8376525 01/01/2009 01/01/2010 X ITnRYi MITSI IOER
EMPLOYERS' LIABILJTY
6 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,00
OFFICERMIEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500,000
S EdLAL RP OVISIIONS below E.L. DISEASE • POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
Massachusetts Technology Park Corp. and The Rebate Recipient are listed as additional insured
with respects General Liability coverage and as required by written contract. Coverage is on a
primary and non - contributory basis. General Liability and Umbrella policies include coverage for
independent or sub - contractors and "residential" work.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Massachusetts Technology Park Corp. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
75 North Drive OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
Westboro, MA 01581 AUTHORIZED REPRESENTATIVE - , �_��
J enna Rodrigue, CISR /JER �
ACORD 25 (2001108) CACORD CORPORATION 1988
The Commonwealth of Massachusetts
Department of Industrial Accidents
=f111= Office of Investigations
sz ,I=.....,
, 600 Washington Street
`. Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/ l):" 1tJYt � Y 1/, - ,
I �; - ` I;in, , �� �.i ��:a er - �: - t --- , „
Address: ,_ 1) Jts
City /State /Zip: 1�c_z . ;tir c M J I Phone #: � �
Are you an employer? Chec the appropriate box:
{{
1. [ I am a employer with 12) 4. ❑ I am a general contractor and I Type of project (required):
employees (full and/or part- time).* have hired the sub - contractors 6. ❑New construction
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have 8. ❑ Demolition
working for me in aci employees and have workers'
g any capacity. 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. ❑ We are a corporation and its 10. ❑ Electrical repairs or additions
3. n I am a homeowner doing all work officers have exercised their 11. ❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. ❑Roof repairs
insurance required.] t c. 152, §1(4), and we have no f
employees. [No workers' 13.ErOther_vo a. Ilu ftuc, t•, ,';/ t.7tn.vu44 --
comp. insurance required.] /A la Cv'i t ✓�,/ / 0 — ! 414_ . AL-
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy inform
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suck 1t2t ' ” " j
:Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: . Ck�.x i v- ?t''er
Policy # or Self -ins. Lic. #: �V L,, 2 , `) A Expiration Date: via 34
0
��
Job Site Address: c 5o Kn. ittf ,'4( r ^, Y& t ; ; k i� tr� ( G, �'r C 7Z'1p:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and /or one -year imprisonment, as ell as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advi i that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage; rificaf.In.
I do hereby certify under the pains and pen t : o, p ry that the information provided above is true and correct.
=
Si. nature: .0 ' Date: ') . o d il
Phone #: t'i,3 ' )1 b 6
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 #:
1
Massachusetts - Department of Public Safety
le Board of Building Regulations and Standards
Construction Supervisor License
License: CS 102513
Restricted to 00,
JONATHAN PARROTT
49A VERNON ST
GREENFIELD, MA 01301
Expiration: 4/16/2013
( ommissioner Tr#: 102513
Restricted to: 00
00 - Unrestricted
1G - 1 2 Family Homes
Failure to possess a current edition of the
Massachusetts State Building Code
is cause for revocation of this license.
Refer to: WWW. Mass. Gov/DPS
lie . a» maniveal alp. idaliacAucieffd
Board of Building Regulations and Standards License or registration valid for individul use only
=`� = HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
� �' Registration: 140077 One Ashburton Place Rm 1301
No- Expiration: 9/16/2009 Tr# 13215
Boston, Ma. 02108 ,.,-
Type: Private Corporation zi
i%
PIONEER VALLEY PHOTOVOLTAICS COOP �.� ..
PHILIPPE RIGOLLAUD
Z 1
324 WELLS ST r/ =
GREENFIELD, MA 01301 Administrator Not vat': thogt signature
SECTION 8 - CONSTRUCTION SERVICES
. h
8.1 Licensed Construction Supervisor: Not z
Name of License Holder : 'V�* G a I I J
License Number
4/
Address Expiration Date
Signature Telephone
9. Registered Home Improvement'Contractor: Not Applicable ❑
I cliNk ev" YES ltX 'of.4 iAGS L i, V2,41' ,-0 41-
Company Name Registration Number
Address , Expiration Date
&r M 0 /3v / 9 1 - � 'Ic '
—
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 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 II) No ❑
11, - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
ROOF - MOUNTED SOLAR ARRAY DEAD WEIGHT LOADING CALCULATION
Project Name Eric Kaye
Address 206 South Street Northampton
The flushed to the roof solar array being installed on the southernly roof of the building, consists of sub- array#1 of eight
photovoltaic modules, sub -array #2 of sixteen photovoltaic modules and a roof mounting system.
The mounting system includes a series of supports that represent discrete points of contact with the roof structure. Each
support is anchored to the rafters via 3 "stand -offs ith stain) steel lag bolts designed with a minimum 3.5 inch thread
depth allowing for a minimum pull -out capacity 513 pound
3,r CKY STRUCTO :w 4 ' , 4° ' I
COMMENTS { ,
Height 10 inches 1.Roofing Construction
Width 2 inches Light: YES Heavy:
Rafter spacing 12 inches on center 2.Roof pitch: 40 degrees
g } SOL:AR.MODULE:A WEIG ± A CUL ATION
Photovoltaic modules Units Unit Wt. Total Wt. Comments
Solar module(s) I 16 I 35.3 565 Sanyo 210W
Subtotal 565 5(1 apy # Z
Mounting System Units Unit Wt. Total Wt.
Rails 1048 0.048 50 Lbs /inch
Shared rail with cap strip 0 0.12 0 Lbs /inch
L feet 24 0.25 6 supports include all hardware
L feet on S5! Clamp 0 0.64 0 supports include all hardware
Stand -off with roof boot (single support) 12 1.28 15 supports include all hardware
Stand -off with roof boot (double support) 6 1.7 10 and roof boots
Stand -off with hanger bolt (single support) 0 0.4321 0
Splice bar kits 4 0.5 2
Module and rail grounding 1 3 3
Module mounting clips 36 0.16 6
Subtotal 93
ITotal solar module array weight 657. Pounds
. . ro : 4 'yPOINT L,
Number of support stand -off 18
Total solar module array weight 657
(Point load �; 36`a Pounds „
DIS BUTED, :OA - $., , .LCULAT[ON h r ` ^ . J V
Photovoltaic module array area
Module width (horizontal) 0 inches 31.4 inches 0 inches
Module length (vertical) 0 inches 62.2 inches 0 inches
Intermodule spacing 0 inches 1 inches 0 inches
Number of module columns 0 2 0
Number of module rows 0 8 0
Array area 0 square feet'„wry wsquare feet ... 0 . (square feet
Total array area 224 square feet
JDistributed load i sf , '
•
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A TM' 1
ROOF - MOUNTED SOLAR ARRAY DEAD WEIGHT LOADING CALCULATION
e ^ ;OVERVIE "," . °"* . .... . ,..
Project Name Eric Kaye
Address 206 South Street Northampton
The flushed to the roof solar array being installed on the southernly roof of the building, consists of sub- array#1 of eight
photovoltaic modules, sub-array #2 of sixteen photovoltaic modules and a roof mounting system.
The mounting system includes a series of supports that represent discrete points of contact with the roof str ach
support is anchored to the rafters via 3 "stand -offs with stai -s steel lag bolts designed with a minimum .5 inch t ad
depth allowing for a minimum pull -out capacity o 3 pounds.
STRUCTURE'! M , ° = ...
COMMENTS,
Height 6 inches 1.Roofing Construction
Width 2 inches Light: YES Heavy:
Rafter spacing 24 inches on center 2.Roof pitch: 40 degrees
4711
SOLAR MODULARRAY CALCULATION :
Photovoltaic modules Units Unit Wt. Total ) Comments
Solar modules) I 8 35.3 Sanyo 210W
Subtotal 282 Sub -Array #1
Mounting System Units Unit Wt. Total Wt. /
Rails 528 0.048 25 V/ Lbs /inch
Shared rail with cap strip 0 0.12 0 Lbs /inch
L feet 16 0.25 4 supports include all hardware
L feet on S5! Clamp 0 0.64 0 supports include all hardware
Stand -off with roof boot (single support) 8 1.28 10 supports include all hardware
Stand -off with roof boot (double support) 4 1.7 7 and roof boots
Stand -off with hanger bolt (single support) 0 0.4321 0
Splice bar kits 0 0.5 0
Module and rail grounding 1 3 3
Module mounting clips 20 0.16 3 f
Subtotal et Total solar module array weight ounds I
` , . ROINTIOAP .. ..,
Number of support stand -off 12
Total solar module array weight 335
Point load I:..;: 27.9 Pounds
DIST Bt1 �rLOAD'CALC.1 1 AT1+UN. �. .. .' ., ., ..:. .. ; . .
Photovoltaic module array area
Module width (horizontal) 31.4 inches 0 inches 0 inches
Module length (vertical) 62.2 inches 0 inches 0 inches
Intermodule spacing 1 inches 0 inches 0 inches
Number of module columns 2 0 _ 0
Number of module rows 4 0 0
Array area x;, "11 , square feet :'t ,,0 s :: square feet ., 0 square feet
Total array area 112 square feet
Distributed load I ;:•. 3.0 Ibs 1 sf
132" 262"
• _ I I I I I I I I 4 I I II I I I I I I I I r i
g M g U •
53" 53"
t t I I
� u u u 1 it
u u n I g 1I 1 II II a II a II II ti
so° 50"
V
V n n ra n rt rl� 11
I It t 11 1' \, v t I
'L ∎�� 1 I �I O I I
r,� 0 0 0 0
l4
48 24„ . 4 8,. 8 .. 48" 4 8 „
■
3.5"
I [44-7 " - 1111 1, "
t
j, tl�t
aslr.aOa�� Fla Wash* :r !'
■
� TherenwwMe fast Jack post fvoht g !n1,
agowaUte Installer to gently nett ,4154 /f F
slip the fleshing over the base t
Standoff with double support brac lit and delicate
i c , , 7 -1 moue io limes j g
....d... L.. ' olostae boa � � � e4 ,
n *on e if t ,,,/"" orw novelly' rsn 1 - -- ...._
} ' "ow
Sanyo 210W
End ufrnp_ .1,.. Llomp'. RAFTER
,,.H.,. . t _,- : 62.2" x 31.4"
+:- I r I
. ;� Notes: Title: Kaye Residence
206 South Street, Northampton Massachusetts
Em s, 1. The standoffs brackets are secured to the rafters via stainless
��; ' W «� steel 3.5" lag bolts. Author: P R
M"...` 2. The standoffs are secured every 48" into the rafters.
°` °""" D a te: 6/11/2009 Sheet: 1/1
3. All supports are installed with OATEY solar flashing.
f . ' , '... -: t :... Revision: not to scale- rot for oonshucticn
(PV ) is committed to providing a high quality product and service and we look forward to working fitiA C/L'LX
() P g g 4 YP g with
you on your renewable energy project. Please contact Jon Child at 413 - 772 -8788 with questions or
comments regarding this proposal.
Sincerely,
Pioneer Valley Phot V ltaics Cooperative
(. %' l
/ Jonathan Child
Project Manager
Attachments: General Terms and Conditions
AUTHORIZATION TO PROCEED
I hereby agree to the Project as set out above, and I agree to pay the contract price according to the
Terms of Payment. I further agree to the Terms and Conditions attached hereto as a part of this
Proposal and Agreement. I hereby authorize Pioneer Valley PhotoVoltaics Cooperative to proceed with
the above - referenced Project in accordance with this Agreement. A check for the First Payment is
enclosed and I am returning this Agreement within 21 days of the Proposal date.
L. r` -- 5 2 4 . o �
Printed Name Date
Si nature Title
APPROVAL TO SERVE AS AUTHORIZED AGENT
I hereby authorize Pioneer Valley PhotoVoltaics Cooperative, or its designated representative, to
obtain required permits for this project on behalf of the owner and to begin work of obtaining a CS
grant on my behalf.
"r94 P, VA . 2.4. 0I
Printed Name Date
a ir
Signature Title
Proposal and Agreement Page 6 of 6
Eric and Nancy Kaye, May 12, 2009
ATTACHMENT 5 -C
PANORAMIC VIEW
(KAY - NORTHAMPTON)
ROOF- MOUNTED PV ARRAY INSTALLATION AREA
il ot;•::" , 7 " r t$ s}.' �� # , -A! '!,,!,:iii;--al 4 � ' �: te a'%`,.;
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PV array to be installed on the southwest - facing r o o f of the existing residence
and new addition with remaining critical com (e.g., inverter) to be
installed within the residence. Note that the new two story addition will be
constru in the location of the existing on story extension at the rear of
t h e residence.
ATTACHMENT 5 -A
SITE PLAN
N)
(KAYE - NORTHAMPTO
' :, :°,4,'.,:iri;:t..14'4,:ta:$1,::,
f f F �; L v' } i,'S X �g,yVp
'0i,,,',-.=';',-:,. 3 .biS ' �i- d y R . 1 C ^
A rs t s ;7,1:1' b ra ,, 6n a � ;x-: F
a
` r . � to t � �° �> � ,, t .
t
. `�� Pv Array Sit
. - " � ,
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y
0 ,
g / fit • ,,,' '_,;,7f.--;.,- '
' ' j ,-, "Rte' ' x i , y :% ;' .„‘„;-77,0:,:',* ? ' " :e ° 4:-',,,,; : '� = . ,, '„,i,A.1441%,,4-,..* A!,
, gyp .� .. i [ 0 p °t '€ S
Utz ...
' e �� t�200B _ s � '"
1851 , t�'�" U S.'Geological Survey x s a lc
42 1998 . 7 . ._ 729808. e lan 16711 � ° ;? � Apn2 02� r�_. - Eyeali>._y805It =" •
PV array to be installed on the southwes - f acing roof o f the ex residence
,H7litie: ' ,,,,!,,,,,,, and new addition with remaining critical components (e. inverter) to be
insta within the residence. Note that trees to the sout of the r esidence
have been removed in prepara for t solar elec sy stem installation.
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all aDnlicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [0 Siding [D] Other [D]
Brief Descriptiqn of Propos d y ( � q
WorIc: I M.li g t`1vh, 6 iti, Fk,�}� ^i �+1 ^� ! t , n., t ', t /J) A i, t,, ,IL, ' , t L ;v :ti —r al ,....._'
Alt ration of existing bedroom Yes if No Adding new bedroom _ Yes ✓ No
Attached Narrative Renovating unfinished basement Yes ,/ No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade _
k. Will building conform to the Building and Zoning regulations? Yes _ No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, 4 t+; r.._ k.c,.q,e -- , as Owner of the subject
property % 7 / ( , !
hereby authorize � 4 ,U7 - Ei.ttt- ) i1 1 , t, ‹w 1 Ve,vi ti k--
act on my behalf, in all matters la ive to work authori�ed)by this building permit application.
Signature of Owner Date
.17 ii (' c � , as Gwner /Authorized
Agent hereby declare thal�the statements and information c� ,the foregoing application are true and accurate, to the best of my knowledge
and belief. s
Signed under the pains and penaltie per . ` , ie.
Print Nam t I
Signature of Owner /Agent Date
•
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size :..._ .
Frontage
Setbacks Front
Side L:°.. R: L: _ ._ w. s R: . .
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DON'T KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 't! DON'T KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C. Do any signs exist on the property? YES Q NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO
IF YES, describe size, type and location: •
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? • YES ® NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
- Department use OnIY
City of Northampton Status of Permit:
Building Department Curb CuttDriveway
212 Main Street
1272 W ribalti7
Room 100 4:1'
Northampton, 24o Fax 0411036-5087-
phone 413-587-1 PletiSitAPrl
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
--- 1 7
,, ,_ ■ 1 /
SECTION 1 - SITE INFORMATION
-. Tills sec(ion to be completed by office
1.1 Property Address:
----------J Lot Unit
Map --
Zone Overlay District
Elm St. District_ CB District
, , 1
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
, / ' .° 3 1/4) 1-f,,,,, 5 tire-er - 1 14—Viv ,
A;
:o (o.
Name (Print) ) Current Mailing Address: _ 5 ,.,
—I I , /
,,,-
( 16.5.;". Telephone
Signature /
2.2 Authorized Agent:
‘k'd
--); k14
Name Pt) urrent
rin ill il )11V 16r'x -- -
Mailing Address:
5 ,..., N) ,,,,
--)
Signature
/, '
Telephone
SECTION 3- ESTIMATED CONSTRUCT! N CO TS
Item completed Cost (Dollars) to be Official Use Only
m
leted by permit applican t
1. Building --1 31 ,z, (a) Building Permit Fee
2. Electrical ...----- (b) Estimated Total Cost of
Construction from (6)
Building Permit Fee
3. Plumbing _,---
4. Mechanical (HVAC)
...----
5. Fire Protection _ ,_ c t.
6. Total=(1+2+3+4+5) -2)1,2('-) Check Number _____iv,_v________y/:_ _. I
‘ This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
•
File # BP- 2010 -0305
/
APPLICANT /CONTACT PERSON PIONEER VALLEY PHOTOVOLTAICS
ADDRESS /PHONE 324 WELLS ST GREENFIELD (413) 772 -8788
PROPERTY LOCATION 206 SOUTH ST
MAP 38B PARCEL 197 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 31t9 , ® A.(5 Fee Paid Y
Typeof Construction: INSTALL SUPPORT STRUCTURE FOR SOLAR ELECTRIC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 017890
3 sets of Plans / Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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
Demoli, P elay
"00,11111Ir 7--
Signature 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.
3 w a ST BP- 2010 -0305
GIS #: COMMONWEALTH OF MASSACHUSETTS
:18B -197 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0305
Project # JS- 2010- 000405
Est. Cost: $3206.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PIONEER VALLEY PHOTOVOLTAICS
Lot Size(sq. ft.): 11 194.92 Owner: KAYE ERIC R & NANCY G
Zoning: URB(100)/ Applicant: PIONEER VALLEY PHOTOVOLTAICS
AT: 206 SOUTH ST
Applicant Address: Phone: Insurance:
324 WELLS ST (413) 772 -8788 WC
GREENFIELDMA01301 ISSUED ON:9/24/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL SUPPORT STRUCTURE FOR SOLAR
ELECTRIC
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 9/24/2009 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo