43-175 BP-2023-0816
422 PARK HILL RD COMMONWEALTH OF M SSACHUSETTS
Map:Block:Lot:
43-175-001 CITY OF NORTH PTON
Permit: Solar Build
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0816 PERMISSION IS HEREBY GRANTED TO:
Project# 2023 SOLAR Contractor: License:
Est. Cost: 56388 VALLEY SOLAR LLC CSL115680
Const.Class: Exp.Date: 04/09/2025
Use Group: Owner:
Lot Size (sq.ft.)
Zoning: WSP Applicant: VALLEY SOLAR LLC
Applicant Address Phone: Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101
EASTHAMPTON, MA 01027
ISSUED ON: 06/23/2023
TO PERFORM THE FOLLOWING WORK:
INSTALL 37 PANEL 14.8 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: 1, ,I , a .
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: 413)587-1272
Office of the Building Commissio, er
The Commonwealth of Massach
Board of Building Regulations and Sta ® FOR
Massachusetts State Building Code, 780 y �O CIPALITY
o� E
Building Permit Application To Construct,Repair, Renovat: o �.: olish . Rev"•'d Mar 2011
One-or Two-Family Dwelling 90 `,
Th' e s
ion For Official Use Only % .
Building Permit Number: l2'01-1j— J Date Applied:
4Z-1 14/2 2S-2015
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
422 PARK HILL RD POLE 21-01 NORTHAMPTON MA 01062
1.1 a Is this an accepted street?yes x 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 T 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:
Scott Cooper Northampton,MA 01062
Name(Print) City,State,ZIP
422 Park Hill Road (413)575-3002 scoop3@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) ❑ Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:Solar
Brief Description of Proposed Work':
Installation of 37 panel roof mounted solar array.System size 14.800kW DC.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $39,472 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $16 916 0 Standard City/Town A'plication Fee
❑Total Project Cost3 (Ite> 6)x multiplier _x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) Total All Fee-s:4,
Check Nog 717 Check Amount: Cash Amount:
6.Total Project Cost: $56,388 ❑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
U Unrestricted(Buildings up to 35,000 cu.ft.)
Florence,MA 01062 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 beh46,41,1y,larnors r tive to work authorized by this building permit application.
06/14/2023
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.
�GZZj2 Z7 /c 19 fl 6/14/23
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
Massachusetts
--: t: ' '''''',-
I(
DEPARTMENT OF BUILDING INSPECTIONS k,,,,t5 ....
212 Main Street • Municipal Building
5: ,, Northampton, MA 01060 ;..
s ,
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: � c� Date: 6/14/23
The Commonwealth of 31assachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston, AfA 0114-2017
WISIRmass.govidia
1%takers"Compensation Insurance Affidas it: Builders/C:ontractorsiElectricians/Plumbers.
10 BE FILED SI LID I DE PERMITTING AtiTlIORI'IV,
Applicant Information Please Print Legibls
Nan le t 0 us Mess:Or:gang=1 iorC Individual): Valley Solar LLC .. , ..
Addres : 116 Pleasant St Suite 321
cityistatc,zip: Easthampton, MA 01027 Phone#:413-584-8844
Axe yini Mtn titkplireltt?t luck the iippropriate but: Type of project(required):
i)Eli 2M a crarilo a with 30 .,,,pits tfiell anifor part-lima:1' 7. 0 New construction
2171 I am a sole proprietor or purtnership and have no xmpkryerrit winking fur MC t13 A. 0 Remodeling
an capatity.„(Nu 54 fakers:comp.insuiranee AN-tared"
9. D Demolition
1 am a humor:wrier doing all work myself.(No vemkers"comp.itrItArdlie,C COOLtit'd1'
I 0 0 Building addition
4.0)am a Intrisecnanc7 and VA 0)ti hiring contrail:ors to cuinina all work on my property_ 1%sill
ensure:that 411 eistaracturs either have YOJSkerIg compensation insurance Ce 3.1ti%Ole I 1.0 Electrical repairs or addition,
proprietors with no crupluyees,
11E3 Plumbing repairs or additions
..1:3 I am a gencild contractor mai I base hired the sub-contractor,listed on the attached thca
I 3.0 Roof repairs
These sub-contractors have aripluytva and hese wutkers'antip.ISISIMIDC.C.2.
14.Pt...4 Other Solar
6.E1'We ate a coiporatiun end it:.utlfri...ers Nov cacteists.1 their right of exemption Ni Nitri I:,
152_*too.and we ha..e no vmpluyees.(No workers'camp.insurance requirod.1
'Any appticiart lila 1.-6.vilo.boa.1.)moat also fill out the W.I.:6011 hall*Siltrif Irv:T.F1 A 01 i.,:i.,',:inlIp4.TINUTIOCI policy information
f Homeowners who sulinfa this affidavit indicating they are doing all work and Own hirc:Aa:21•1:...I:4111'60AX"),R11/4 5.31bInil a new affidavit indicating such.
Contactors that ehevi:this box must a:biased an a•dditiorial alaa.i show inl.,ris.:21il Illt:Of Ih. 411f,—.:aritractora antl iiim:0 hmber or riot ritow auitic).haki.e
...-ripko cc, 1 f the 5,41,-;omracton.have viriplo ecs.they rnuat vivo..id, ::,t: .,.,:kc:,"...‘nip riuhc,..:.num
I am on employer that is providing'corkers'compensation insurance for nay employees. Below is the policy and job site
information,
Insurance C(im Continental Indemnity/AUW
pany Name. _
Policy#or Self-ins.Lie. t 376140840101 Expiration Date. 09/01/2023
Job Site Address: 422 PARK HILL RD POLE 21-01 cstatezip: NORTHAMPTON MA 01062
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expination date).
Failure to secure coverage as requirod under MGL e, 152, §25A is a criminal violation punishable by a tine up to SI,500.00
atidior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 a
day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurtmce
e(.,s.k:T.1.1„!::\CtIlkar.VP
I do hereby cerriti•el rr.I r the pains and pen ethics of perjury that the information provided abort is true and correct.
f3a-t-4- g Z) A5`11-GZCCc-a• a.te. 6/14/23
Sit-na ture:
413-584-8844
Official use only. Do noi write in this area,to be completed by city or Mum official
City or Town: Permit/License#
Issuing Authority(circle one):
I. Board or Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#: