38D-016 (2) BP-2022-1496
8 CHARLES ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38D-016-001 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-2022-1496 PERMISSION IS HEREBY GRANTED TO:
Project# 2022 SOLAR Contractor: License:
Est. Cost: 32000 SKYLINE SOLAR LLC 027047
Const.Class: Exp.Date: 11/09/2023
Use Group: Owner: W. NIMS,DAWN E. &JONATHAN
Lot Size (sq.ft.)
Zoning: URB Applicant: SKYLINE SOLAR LLC
Applicant Address Phone: Insurance:
95 RYAN DRIVE SUITE 3 (732)354-3111 BNUWC0156055
RAYNHAM, MA 02767
ISSUED ON:11/16/2022
TO PERFORM THE FOLLOWING WORK:
INSTALL 25 PANEL 9.12 KW ROOF MOUNT SOLAR SYSTEM
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: 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
ij
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
}. Department use only
Oa«!A •o. City of Northantpto : '/ Status of Permit
/�- +� Building Departme t 4�/Ov :curb Cut/Driveway Permit
: t I ,t 212 Main Street 7 r Sewer/Septic Availability _
t 4ro.t Room 100 °r � :hnj<, Wat$NWell Availability
'1-*,. /4 Northampton, MA 0f0+�0i Two Sets,of Structural Plans
��� phone 413-587-1240 Fax 413-58��1v 7�:� PIot/Site Plans
1Dther Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address. This section to be completed by office
Map Lot Unit
4g CA-kLS - \ Zone Overlay District
0\06-0 Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Dawn Nims Q�
Name riot) ` ' ��
a 1.4i�ad Current Mailing Address:
t
Signature Tel
2.2 Authorized Agent:
V-7-7,V(KiSrOA i 5k11106 /.6,\C, 4 Crossroads Dr. #116 Hamilton NJ 08691
e(PrinV Current Mailing Address:
7323543111
' nature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 4 .O*CDC:t (a)Building Permit Fee
2. Electrical aLko0o (b)Estimated Total Cost of
Construction from(6)
3. Plumbing it Building Permit Fee
''-764. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) 2000 Check Number .73057
/� This Section For Official Use Only
Building Permit Number: �J//�'07� �'. Q0/' Date
Issued:
Signature: 7
/'�-- f 1 S ZOZ Z
Building Commissioner/inspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing 1 Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: ....._._... R ....._
Rear
Building Height
Bldg Square Footage %
Open Space Footage r,r
Lot area minus bIdg&pa%ed
parking;
#of Parking Spaces
Fill:
'solume&Locatiun
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
7NO DONT KNOW 0 YES 0
IF YE , date issued:
IF YES: as the permit recorded at the Registry of Deeds?
NO 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)F(--DONT KNOW O YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO )Q-.)
IF YES, describe size, type and location:
ti
D. Are there any proposed changes to or additions of signs intended for the property? YES NO '
LJ
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading, -xca •tion,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO co'
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alterations) n Roofing El
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks [❑ Siding[lam] Other[tZ>]
Brief Description of Proposed Installations of a safe and code compliant,grid tied,PV solar system on a residential rooftop 38 Modules 1 14 kw
Work:
Alteration of existing bedroom Yes 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 >C9 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.
1. 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
f\ \OT (`~\S , as Owner of the subject
property
Skyline Solar
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
0Cv•4'• &mil L\ oQ •Q a
Signature of Owner Date
I I f " 06 6 , as Owner/Authorized
Age hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
S' ned un er the pains ant penalties of perjury.
P tN 0
8/9/2022
Si nature o Own gent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable
Name of t icen2e Holder: Phil Chouinard CS-027047
License Number
79 Oak St Unit#101 Ashland MA 01721
A dies !I/64Expiration Date
7313543111
S Sure Telephone
9.Registered Home Improvement Contractor: Not Applicable
Skyline Solar/ Bill Dailey 172284
Company Name Registration Number
4 �Crossroads Dr. #116 Hamilton NJ 08691
Ad 1�l Expiration Date
Telephone_ 7323543111
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 issuan ilding permit.
Signed Affidavit Attac d Yes . No
City of Northampton
,��" �
Massachusetts
1 , DEPARTMENT OF BUILDING INSPECTIONS : i
212 Main Street . Municipal Building
.x--+ Northampton, MA 01060 4:r Ph, }'?•,�
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation ("OCABR") regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes. Prior to
performing work on such homes,a contractor must be registered as a Home Improvement Contractor CHIC").
M.G.L. Chapter 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be
done by registered contractors.
Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered
Installation of a safe and code compliant,grid-tier PV solar system
Type of Work on an existing residential roof.25 Panels 9.l kW Est. Cost: 32000
Address of Work: C- k l S�
Date of Permit Application: �� ( Ott 'a-leer .
1 hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law(explain):
Job under$1,000.00
Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALS S ME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDIN IT.S N XT P GE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit age of e er.
1109/2022 Skylin S tar LLC-Phil Chouinard 172284
Date Contr or Name HIC Registration No.
OR:
Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
City of Northampton
t Massachusetts Sir_'
W y.
{ •t t` DEPARTMENT OF BUILDING INSPECTIONS �I E
� le 212 Main Street •Municipal Building
Northampton, MA 01060 sr� �tti
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building
permit all debris resulting from the construction activity governed by this Building Permit shall be disposed
of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
\e- CK fie. �-�-
(Please print house number and street name)
Is to be disposed of at:
E \c\c- VOH
(Please print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from.
EOMS 318 Manley St. West Bridgewater, MA 02379
(Company Name ar�d Add ess)
I a iko
I
(
11
Sig ature of Permit A licant or Owner at 1 6-6-
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.