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30C-089 BP-2023-0992 569 BURTS PIT RD COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 30C-089-001 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-2023-0992 PERMISSION IS HEREBY GRANTED TO: Project# 2023 SOLAR Contractor: License: Est. Cost: 27100 VALLEY SOLAR LL CSL l 15680 Const.Class: Exp.Date: 04/09/202 Use Group: Owner: S MAR SEK PAUL S&HELEN Lot Size (sq.ft.) Zoning: WSP Applicant: VALLE SOLAR LLC Applicant Address Phone: Insurance: 116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101 EASTHAMPTON, MA 01027 ISSUED ON: 07/27/2023 TO PERFORM THE FOLLOWING WORK: INSTALL 18 PANEL 7.20 KW ROOF MOUNT SOLAR SYSTEM (NO STRUC URAL NO BATTERY) 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: I0 • J, • .2 o''I • Fees Paid: S75.00 212 Main Street,Phone(413)587-1240,Fax (413)587-1272 Office of the Building Commissi.ner V/kThe Commonwealth of Massach ettsa �� ..° Board of Building Regulations and Sta .r'• O� 6+ .. Massachusetts State Building Code, 780 C ,'�`',ti4e, USA• TY Building Permit Application To Construct, Repair, Renovate • i,-, ' a ' ised a ar 2011 One-or Two-Family Dwelling ' o'°F6 This ection For Official Use Only ` tis Building Permit Number: �-"' q /., Date Applied: /L,if—) /2,, i/12 ' Z7-Z3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION, 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 569 BURTS PIT RD FLORENCE MA 01062 1.1a 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 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: l.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: PAUL S MARUSEK FLORENCE MA 01062 Name(Print) City,State,ZIP 569 BURTS PIT RD (413)519-7833 marusek@hotmail.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 0 Specify:solar Brief Description of Proposed Work2: Installation of 18panel roof mounted solar array.System size 7.200kW DC. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $18,970 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $8 130 ❑ Standard City/Town A plication Fee ❑Total Project Costa(Ite 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 1 5.Mechanical (Fire Suppression) $ Total All Fees: $ t l' Check No. Check Amount: �� Cash Amount: 6.Total Project Cost: $27,100 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor LicenseIGSL) ' 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 City/Town,State,ZIP R Restricted 1&2 Family Dwelling 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 ❑ 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. 07/06/2023 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. �GZZJt GC i P /e6W-Gigaz 7/6/23 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 e`�ti;r� r,c,„„ ��s ��c Massachusetts �� !�� w � 4 DEPARTMENT OF BUILDING INSPECTIONS ?, r, 212 Main Street • Municipal Building �+ Northampton, MA 01060 11� 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: � � Z) /�en�� Date: 7/6/23 The Contmottwealth of Massachusetts Deportment of Industrial Accidents =T; = I Congress Street,Suite 100 Boston, 314 02114-2017 www.mass.govIdia 1S 401 kers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumber,. to BE V1LED sii 11 I IlE PERNIIITING AtritIORITY, Applicant Inforiomion Please Print Letfibb, Name Li us intssOrrnziLion1nth du al K Valley Solar LLC Address.: 116 Pleasant St Suite 321 City/State/Zip: Easthampton, MA 01027 Phon ,-413-584-8844 Art,nu an employer?Chtvk the appropriate Nos: Type of project(required): 1)4 .rn a mpLa with 30 etnviuyets t antrum partne)-* 7. 0 New construction zniukpluprician or parim hip and have no erstployo:s wining for me m 8. 0 Remodeling any cariscny(No workers:comp.insurance requirall I am a 9. Demolition 3E] hunitaiwno.doing all imni.myself.[Nu wuckets`corm..imuranoe rex;uircd.. I 0 1:1 Building addition 4,0 1 am u JklrliaAktICI and will be hiring contrakaorsto00111111.1 all wink on tny pupal/. I will =sum that all contractors either base work,c-rs'coirApefmustion intaArrrax 1,t ale&..1.11C 4:3 Electrical repairs or additions proprietors with no employees.. 1 2.E]Plumbing repairs or additions 501 am a emend eunnactor and 1 base hired thc sub-contractors listed on the anadied sheet. I 3.{:Roof repairs Thew sub-conuactom haw cinployce3 and has t watittes'camp,utzurnnec..; fi.Ej Wr art u cation and it..*officers have txari*nd then'risk of exemption per Wit.c, 14. Other Solar 351*10),and sr!Lai enoemployees.[No wakes'comp.inatannec riNuinzd.] An applicant that chtxls PI must also fill out the section below show ing their*mien controcrisalitin pul icy utiormatton Homeowiscrs who submit this aflida%it indicating they are doing all work.and then hire.outside contra:tors must salami a new affidavit indicating such. CunIjat.un.that dud,thia but inual aILl ;ID Asht imna3*bum hbuv.tog the Marti Of Ow,A111-‘.-ontra.:t.ort and hate ttober nut iifuts.v. mos1 proVi,..ir their k2,'1711, I Link"( I am an employer that is providing, woriters'compensation insurance for my employees. Below is the policy and job site information. in,urance company Name: Continental lndemnity/AUW Policy or seif_ins.L,c. 376140840101 Expiration Date. 09/01/2023 Job Site Address: CityStateZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal ‘ielatiOn punishable by a tine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator.A copy of this statement may be forwarded to the Ofhce of investigations of the DIA for insurance coverage vcr:ltion. 1 do hereby certify under the pains and penalties ofperiury that the Information provided above is true and correct, Sismannv: 17 'fri--d-a-64 1)2.1c 7/6/23 phom: 413-584-8844 Official use only. Do not write in this area to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3.(Ilya-own Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other C'ontact Person: Phone#: