31A-143 BP-2023-0753
34 FORBES AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-143-001 CITY OF NORTHAMPTON
Permit: Solar Build
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0753 PERMISSION IS HEREBY GRANTED TO:
Project# 2023 SOLAR Contractor: License:
Est. Cost: 58585 VALLEY SOLAR L CSL115680
Const.Class: Exp.Date: 04/09/202
Use Group: Owner:
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLE. SOLAR LLC
Applicant Address Phone: Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101
EASTHAMPTON, MA 01027
ISSUED ON: 06/08/2023
TO PERFORM THE FOLLOWING WORK:
INSTALL 17 PANEL 6.88 KW ROOF MOUNT SOLAR SYSTEM ON HOUSE : GARAGE WITH 19.4 KW BATTERY IN
BASEMENT
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: Q
. a yrJ . I
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax (413)587-1272
Office of the Building Commissioner
\,
The Commonwealth of Massachusetts (40 ��
5! Board of Building Regulations and Sta ds
B ICI ALITY
(:•»' `_ Massachusetts State Building Code, 0 °9 c E
44
Building Permit Application To Construct,Repair,Renov rtiVON� lish a Revis d Mar 2011
One-or Two-Family Dwelling ° .MSAF
AoCT�
This Section For Official Use Only �0so NS
Building Permit Number: 'J(7—,)'lj- -75-. Date Applied:
WWI A-.7.47c 77*.: 6-620Zz
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
34 Forbes Avenue, Northampton, MA 01060 4-
30
1.1a Is this an accepted street yes no Map Number Parcel umber
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:
Zone: _ Outside Flood Zone?
Public 0 Private 0 Check if yes❑ Municipal 0 On site disposal system 0
SECTION 2: PROPERTY OWNERSIIP' •
2.1 Owner'of Record:
David Erickson Northampton, MA 01 60
Name(Print) City,State,ZIP
34 Forbes Avenue (828)335-8402 derickson805@gmail.com
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 Work2: Installation of 17 panel roof mounted solar array,system size 6.885kW DC
Includes install of Solar Edge 19.4kWh Energy Bank solar battery
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $28,685 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $29'900 ❑ Standard City/Town Application Fee
❑Total Project Cost3(Iteti 6)x multiplier x
3.Plumbing $ 2. Other Fees: $ 1
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Feesa$�n
Check No 7 ' heck Amount: Cash Amount:
6.Total Project Cost: $58,585 0 Paid in Full' 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
C5-115680 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 m behalf,in all matters relative to work authorized by this building permit application.
05/13/2023
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.
P� /ee ttiz 2/16/23
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"
,x, i_i,..111,,W14:'.,,,1,, City of Northampton
1� , '� Massachusetts
C
�t ; �-'
t '' DEPARTMENT OF BUILDING INSPECTIONS l
j212 Main Street • Municipal Building ,,b cb,
-- Northampton, MA 01060 4'y°<< P'Q
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
i)
Signature of Applicant: ` �` Date: 5/15/23
The Commonwealth of Massachusetts
,..,,,,..
Department of Industrial.4ceidents
I Congress Street,Suite 100
1 , Boston, MA 02114-2017
www.mrzss.govidia
\s orkers'Compensation Insurance Affidavit:Buiklers/ContractorsiElectriciansfPluinbers.
to BE I I I II). W 1111'1'11E PERAIllrl'INC Atcl'Ilt)RITY.
.1nnlicant hifornia lion Please Print Legiblv
Name 4 BUSinCi&t)rgantztliunAnkitildual I: Valley Solar LLC
Addrcss: 116 Pleasant St Suite 321
......... , _ .
City/staterzip: Easthampton, MA 01027 Phone#:413-584-8844
Are liar an emplos ler?Check the appropriatt.but:
Type of project(required}
1>1 I am a 4:mptay a with 30 ,cmirti.v.vech ifs&and:or part-fora:0 7. []New construction
sal ii sole pruprietis or Firinership ant!have rui employek:s veurking for me in R. 0 Remodeling
day cap .(No workers'comp.insurance n.Ntun:d.)
9. Ili Demolition
30 I sin a hurnoowner itins rill%WA myseli.iNsi workers'comp.irtkirarket rcigliztvd.r
NC] Building addition
4.C:1 i am a Ito fnc.Nra 11..7 and will tic houin ixsaractors ill Ctititkiki:t all work on my pmpony.. I will
ensom that al/evatractiirs cithcr hake sissiters*curnpensation iresurance or are sole II a Electrical repairs or additions
proprietors with no ensplu:kees,
12.0 Plumbing ix-pairs or additions
51:3 I am a serieral contractor and I hake hired the stils-euntractors lixtod on the altadieil.sheet.
These sub-cialtractors lute erraployees and hat e wutktoa i.v.linfo,LitSliturlec,Z I 3.0 Root repairs
6.E1 Vs't•ate ti corporalson and ea officers hiree exia-vised then right of ei.criamurt per Mt.c. I 4.07f4 Odle/Solar
i 5'1 ti WO.and ice have rib employees.(No worker. comp.insurance required]
'Any applicant that chisiis boa a I most also fill out the wction below show ins their°A tickers'conmensation policy information
Homeuwnen.who submit this afraid%it ieating they are&sing ail a mk and then inn:oub:idc 4.-untractor-3-must submit a new Wilda.,it iniiik.vtinit such.
..Curthwton,that Area this box must attached an aidatiuriai abort%boa trig the matte of tilt,,uh-,:untractors and btak*tether tar not diu*c crititis.-1 haw
knriployees If the suls-ccintractors have employees.they muA provide their workers'comp puticy nustrilser
.. . .._ .. •.
1 U111 on employer that is prarhfing Pre,ilk er.%'cottspenNat rem itrsttrititee for on eMployeeA. Below is the policy and job iiie
information.
Insurance company Nam Continental Indemnity/AUW
Policy#or Self-ins.Lic. #. 376140840101 Expiration Date. 09/01/2023
Job site Address.: 34 Forbes Ave CityistatozipNorthempton, MA 01060
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required iindier NIGL c. 152, §25A is a criminal violation punishable by a tine up to$1,300.00
ant one-year irnprisoninent,as well as civil penalties in the form of at STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement niay be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
. ,
1 do hereby certify under the pains and penalties of perjury that the information pro ritle.,I above is true and correct.
Siviarure: f)d-t-4,‘ . ' 4,frs,: 2az4 II:t1,.. 5/15/23
Phone t: 413-584-8844
'' Official use only. Do not write in this area,to be completed by city or town offaciaL
( its or Town: Permitflicense#
Issuing Authority (circle one):
I. Board of Health 2.Building Department 3.('Ity/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
(.Other
('ontact Persi ii,- P li one