31A-127 BP-2023-0328
25 FORBES AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-127-001 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-2023-0328 PERMISSION IS HEREBY GRANTED TO:
Project# 2023 SOLAR Contractor: License:
Est. Cost: 19852 VALLEY SOLAR LLC CSL115680
Const.Class: Exp.Date: 04/09/2025
Use Group: Owner: BOND HOWARD E&SYDNA G BUDNICK
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY SOLAR LLC
Applicant Address Phone: Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101
EASTHAMPTON, MA 01027
ISSUED ON: 03/15/2023
TO PERFORM THE FOLLOWING WORK:
INSTALL 13 PANEL 5.2 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:
ii 1
i 11 . o '1 •
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
t,,, P`Girls 111 L , i--,,
The Commonwealth of Massachusetts i
W Board of Building Regulations and StandarI. FOR
Massachusetts State Building Code, 7801C BAR 1 3 2023 IMUPALITY
US
Building Permit Application To Construct,Repair;Renovateh a Rev4ed Mar 2011
of rl1,1-grt,INC i�: :r
One-or Two-Family Dwelling n,r,arMn�,, ,,,. R,�sPF�
This Section For Official Use Only
Building P it Na)55
mber: ,P A v�.�--9 Date Applied:
evr,i /12 3-)6 7023
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
25 Forbes Avenue, Northampton, MA 01060
1.1 a 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(sq ft) Frontage(ft)
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 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Howard Bond Northampton, MA 01060
Name(Print) City,State,ZIP
25 Forbes Avenue (413)538-0371 howard.bond@comcast.net
No. and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other El Specify:solar
Brief Description of Proposed Work': Installation of 13 panel roof mounted solar array. System size 5.2kW DC.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $13,896 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2. Electrical $5,956 ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:
Check No.
6.Total Project Cost: $19 852 ' Check Amount: I Cash Amount:
0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-115680 04/09/2025
Patrick Rondeau License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
53 Fox Farm Rd
No. and Street Type Description
Florence,MA 01062 U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-584-8844 permits@valleysolar.solar I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
186338 10/27/24
Valley Solar LLC HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
116 Pleasant Street,Suite 321 permits@valleysolar.solar
No.and Street Email address
Easthampton, MA 01027 413-584-8844
City/Town,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 with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes ® No .0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize Valley Solar LLC
to act on my behalf,in all matters relative to work authorized by this building permit application.
[640 03/09/2023
Print 0 wner'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 istrue and accurate to the best of my knowledge and understanding.
P� Aw. 3/9/23
Print Owner's or Authorized Agent's Name(Electronic 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 fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov,/oca Information on the Construction Supervisor License can be found at www.mass.gov/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"
City of Northampton
i. ,, Massachusetts .
„s DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street Municipal Building��
Northampton, MA 01060 ��$ 4,�'
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: Valley Recycling, 234 Easthampton Rd, Northampton, MA 01060
The debris will be transported by:
Name of Hauler: Valley Solar LLC
�Signature of Applicant: � T� � Date: 3/9/23
The Commonwealth of Massachusetts
r4aWie=a' Department of Industrial Accidents
1 Congress Street,Suite 100
=It Boston, ALI 02114-2017
www.mass.govirlia
i;akers'Compensation Insurance Affidavit:Buiklers/ContractorsfEkctricians/Plumbers.
to BE FILED\\ III1 I lIE PERNIITI'ESC AUTIIORJITY.,
Annlicatit Information Please Print
Name 11131J-1:.t. ss.Orga.naz tioninehrt gins! Valley Solar LLC
Address:116 Pleasant St Suite 321
city/state:zip: Easthampton, MA 01027 Phone :413-584-8844
Are y an employer?Cheek the appropriate bin: 1'.1,pc of project(required):
i)Ecl I am a employer with 30 ernpio..ivesifafl arid part-ti 7. 9 New construction
".2.0 I am a ok proprietor or purincrstop and Iwo,4:no crriployces working for me m it 0 Reincideling
any C..sp.ttlly,(Nu workers.'comp.iltS111:21/34:e
[1] Demolition
30 I am a lannuawnet doing all wuti myself.(No worku-s*comp_insurance roomed.)s
10 El Building additibn
40 I am a horisetiwilea and will be hiring tordractors to conduct all wink on ne,property, Iwill
imaure that all exult:at:sus either hare workers coregiensation iftSurancr or are II I: Electrical repairs or additions
propnetori with no ployeCa..
12.E]Plunibmg wpairs or additions
5 tarn a aerial contractor and I hart hued the sub-contra:tom liskxl on the attached rhea
Thcaa 31:
aub-contractors hare cariployeta and lue r workers's‘earrp,insuntnee..1 Root repairs
14. °the,Solar
6.0 wc are a eorporation and its oliteers hare citarised then right or exemption liar
152_ It4t.and we lure fluargrilityces.[No worker.'camp insurance rtaltainidl
'Any applicant that chicks bow=I must also till out the sectom below shoo in g then takers'compensation iniorrrwtioo
f Itumirwrier.who submit this atrukarit Militating the2i&redoing all work and then hire outside euntraetor mut submit a new atlidar it indicating such.
!Contractors that check this boic fluor attached rut adilitional slioct stay-wing the name of the sub.contracturs and gate whether or not thaw ernitier have
employees lithe sub-CanirdiCtOrA}save tit-01,1w*.they must rirPtidr their 'it takers'comp policy'number.
I am an employer that is providing workers'compensation insurance for my employees. Behoe iS the policy unit job site
informadon.
Insurance Company Name: Continental Indemnity/AUW
Policy#or Self-m . Lic. 376140840101 Expiration Date. 09/01/2023
Job Site Address:25 Forbes Avenue ctryistatc,:zip:Northampton. MA 01060
Attach a copy of the workers'compensation policydeclaration page(showing the polk number and expiration date).
Failure to secure coverage as required wider MCiL c. 152, :§25A is a criminal violation punishable by a lint up to 51,5I/0.0t)
antlior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00
day against the violator.A copy of this statement may be forwarded to the Office of Insestigations of the DIA tbr insurance
coverage verification.
1 do hereby certifu under the pain",and oenoltieti perjury that the information provided enrol (1 lie ilnd twrer t.
P AW-tZa•CaL 3/9/2 3
31211.111.17,
413-584-8844
officio/use only. Do not write in this OIL'it.to be completed b city or town official
('its or Town: PerniittLicense#
Issuing Authority(circle one):
I.Board of Health 2. Building Department 3.CItyfrown Clerk 4.Electrical Inspector 5, Plumbing Inspector
4.Other
Contact Persun: Phone#: