29-382 BP-2024-0592
16 BROOKWOOD DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-382-001 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-2024-0592 PERMISSION IS HEREBY GRANTED TO:
Project# 2024 SOLAR Contractor: License:
Est.Cost: 45340 SUMMIT ENERGY 114858
Const.Class: Exp.Date:07/31/2024
Use Group: Owner: GOODENOUGH, STEPHEN M. &JUDITH E.
Lot Size(sq.ft.)
Zoning: WSP Applicant: SUMMIT ENERGY
Applicant Address Phone: Insurance:
15 BERKSHIRE RD (339)201-7769 WCC334918A
MANSFIELD, MA 02048
ISSUED ON: 05/14/2024
TO PERFORM THE FOLLOWING WORK:
INSTALL 30 PANEL 9.45 KW ROOF MOUNT SOLAR SYSTEM (NO STRUTURAL OR BATTERY). REPLACE MAIN
SERVICE PANEL WITH 200 AMP PANEL
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 lriNoray 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: 7P
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
The Commonwealth of Massachusetts
Board of Building Regulations and Standar&4' 1 3 2024 FOR
Massachusetts State Building Code, 780 CMR MUNICIPALITY
USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a,-„sRevised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: ela. 9.-6-9 2_, Date Applied:
/56)jN< 2Y5 6-Ai- ZoZ'
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assess rs Map& Parcel Numb rs
16 Brookwood Dr .� �Z
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❑ 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:
Stephen Goodenough North Hampton, MA 01062
Name(Print) City.State,ZIP
16 Brookwood Dr 413-374-8126 izzygood(agmail.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: Instalation of 30 roof mounted solar panels-9.45 KW AC-
12.600 KW DC- No ESS
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ 40698.00 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2. Electrical $ 4642.00 ❑Total Project Cost3 (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire
Suppression) Total All Fees: t
Check No. 15 Check Amount:/' Cash Amount:
6. Total Project Cost: $ 45340.00 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
114858 7/31/2024
Justin Krnpue License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
15 Berkshire Rd
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
Mansfield, MA 02048 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
339-201-7769 Justin@summit.solar I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
24
Summit EnergyJustin Kroque 193649 11/06/20Da
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
15 Berkshire Rd _.lustin@siimmit solar
No.and Street Email address
Mansfield, MA 02048 339-201-7769
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 .lugtin KrndiIA
to act on my behalf,in all matters relative to work authorized by this building permit application.
Stephen Goodenough Staphe iGeodenoug 5/1/2024
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.
Justin Krogue Juistt vt.KYo 5/1/2024
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 halilbaths
Type of heating system Number of decks/porches
Type of cooling system Endosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
oa,
9„,. Massachusetts �w _
Q DEPARTMENT OF BUILDING INSPECTIONS y
,✓ j n>
` .= y 212 Main Street • Municipal Building �ti �
Northampton, MA 01060 -54 'C'
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: 15 Berkshire RD Mansfield, MA 02048
The debris will be transported by:
Name of Hauler: Summit Energy
Signature of Applicant: ,jwsavvKroga& Date: 5/1/2024
The('ommonwed h of Massachusetts
ri Department of Industrial Accidents
1 Congress Street,Suite 100
'T t•' Boston, MA 02114-2017
as wis mass govldia
- Workers'Compensation Insurance Aftidas it:Builders/Contractors/Electrici atnsfPlumbers.
'10 BE FILED w i t n"r11E t'u i i t"riM::1t rt101tl rl'.
Applicant Infer mat ion Please Print Leiiblh
Name tl3usinesi OrBanizati ondlndivulual):
Address:
City/State/Zip: Phone#:
Are you an employer Check the appropriate boa: Type of project(required):
1.01 am a employer with __...con 1 oyecs(cult and or part-timer_• 7. New construction
2.01 am a su1r:proprietor or Form Whip and have me employees working for me in K. Q Remodeling
arty capacity.[Nu workers'cutup.insurance required.]
30 I am a honscovincr doing all work myself. No wc7rkrns'comp.insurance nqutrcd.]
9. El Demolition
4.Q 1 am a lannortwaw and will be hiring contractors to conduct all work on my property_ I will IQ Q Building addition
ensure that all contractors either have milkers'compensation insurance:or are sole i la Electrical repairs or additions
pnlpnetor,wi[b no crupluvees. 12.0 Plumbing repairs or additions
5 I am a general contsactor and 1 have bled the sub-contractors hatwd on the aitadied sheet
These sub-contractor,(use employees and like worker'courp.insurance. 131-1 Roof repairs
6.0 V1'r are a Lanporation and its officers have exercised thou right of exemption pet MCiL c_ l+l.El Other
officers
'_.:Ir•it.and we love no employees.[No worker'comp.insurance rrquir d.[
'Any applicant that duals bus.n I roust also till out the section hcluw showing then a utkia. cuntpens:Awn policy ralixrnutmvn.
' Horneowu n who,tahtnit thus atl'rda4 it urdiwaing they are doing all work and then hue outside,r ntraa:Wrs mast submit a 0e44'afiida.,it walk:sting such.
t'untracton.that check this lsax must auachcd an additional sheet show ulg the name of the subcontractor,and state w hetber LIT not tti n Kromers have
onployeca. lithe sub-contractors base envies aes.they must pm.idc their workers'comp.policy number.
am an employer that is providing workers'compensation insurance for my employees: Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie,#: Expiration Date:
Job Site Address: CityState:'Zip:
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 violation punishable by a tine up to$1,500.00
and.or one-year imprisonment.as well as civil penalties in the form ofa STOP WORK ORDER and a fine of up to S250.00 a
day against the violator.A.copy of this_,t itenient may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is trite and correct,
Signature: Date:
Phone r:
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):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#: