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18C-133 BP-2022-0101 80 BLACKBERRY LANE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-133-001 CITY OF NORTHAMPTON Permit: Solar Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-010I PERMISSIONISHEREBYGRANTED TO: Project# 2022 SOLAR SYSTEM Contractor: License: Est. Cost: 16000 EMPOWER ENERGY SOLUTIONS 019944 Const.Class: - Exp.Date: 12/01/2023 Use Group: Owner: RUSSELL JOE W JR & MARGARET H Lot Size (sq.ft.) Zoning: URB Applicant: EMPOWER ENERGY SOLUTIONS Applicant Address Phone: Insurance: 39 FERNWOOD DR (475)221-2356 WC533SB2191Q011 ROCKY HILL,CT 06067 ISSUED ON:01/31/2022 TO PERFORM THE FOLLO WING WORK: INSTALL 12 PANEL 4.8 KW ROOF MOUNTED SOLAR SYSTEM WITH 3.8 KW INVERTER 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I y9 • li • J � 5.9111 Fees Paid: $75.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner LI, The Commonwealth ofMassachlsetts d FOR `:,:.. , Board of Building Regulations and Stan 0, ECEIVE Massachusetts State BuildingCode. rSU CMR MUNICIPALITY u SSE Building Permit Application To Construct.Repair.$tenor=ateakaiglia� keuise. Mar?011 One-or Two-Family Dwelling ..! i This Section For Official Use Only.' ::)r nun DING INSPECTIONS -i .� Building Permit Number. - a..).- 1 0) Date Applied: . tartit:>r,1P.f oF,,1A±<rnn60_-..-.. 1 3) a Building Official i Print Name k Signature to SECTION 1:SITE INFORMATION 1.1 Properh Address: 1.2:l �Ma & Parcel Numbers, 80 BLACKBERRY LANE NORTHAMPTON MA 01060 j 1.1 a is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning DLstriet Proposed Use Lot Area i;sq#I) Frontage i fl 1.5 Building Setbacks(ft) Front Yard Side Yards : €t ar Yard Required ['muted Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40.§54) 1,7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 0 Private 0 Check if Ws❑ ' Municipal 0 On site disposal system ❑ {{�� SECTION 2: PROPERTY OWNERSHIP' J.t7` 2.1 trUSfecord: NORTHAMPTON MA 01060 Name i Print i City.State.ZIP 80 BLACKBERRY LANE 413-586-0033 1�`riot.atty{¢gmail.cbrrt No and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 T ii,: t_n, Building 0 Owner-Occupied ❑ Repairs(s) 0 " Alteration(s) 0 Addition 0 Demolition 0 1 . sor'v Bldg. 0 Number of Units Other ® Specify:Pv Sedar Brief Description of Propus.d Work2: Instafation of a safe and code compliant,gnd-tied PV solar system on an existirrr residential roof. 12Paneisl4.80kw SECTION 4:ESTIMATED CONSTRUCTION COSTS item Estimated Costs: Official Use Only (Labor and.Materials) 1. Buildine S 4000 1. Building Permit Fee: $ indicate how fee is determined: -° 0 Standard CityTown Application Fee 2. Electrical S 12000 0 Total Project Cost (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ 16000 Check No.)U U—7 Check Amount: / Cash Amount: b.Total Project Cost: S 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-109944 12101/2023 Lando Bates License Numbs./ Expiration Date Name of CSL Holder 51 Assabet Dr Nartttorough MA 01532-2600 List CSL Type(see below) Na. and Street Type Description Northborough MA 01532-2600 U F Unrestricted(Buildings up to 35.000 cu. ft.) Restricted 1,54.2 Family Dwellinu CitvTown. State,ZIP MMasonry. RC Roofing Covering. Vt'S Window and&dine. SF Solid Fuel Burning Appliances 774-249-1687 Lando.B@eropowerenergy.co a Insulation Telephone Email address Demolition 5.2 Registered Home Improvement Contractor(HIC) 198351 04105/2022 Empower Energy Solutions Inc HIC Registration Number Expiration Date H IC Company Name or HIC Registrant Name 39 Fernwooil Drive operations©erripowerenengy.00 No. and Street Email address Rocky Hill CT;06067 (475)221-2356 CityTown.State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted 1.vith this application. Failure to provide this affidavit will result in the denial of the Issuance of the build:tit:, p.-rtilI Signed Affidavit Attached? Yes 0 No .... SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES 11)R Bt'll.DINC; PERMIT I.as Owner of the subject property,hereby authorize Empower Energy Solutions Inc to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature.) Date . . SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Y1704,047 4.7 1/17/2022 Print Owner's or Authorized Agent's Name(Electron k Signature) Dato NOTES: I. An Owner who obtains a hnTding permto& h isher own wor-,or an owner w o hires an unregisteied contractor (not registered in the Home Improvement Contractor(IBC)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.p..ov;oca Information on the Construction Supervisor License can be found at www.mass.govidps 2. When substantial work is planned provide the information below: Total floor area(sq. ft.) (including garage,finished basementlattics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halrbaths 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"