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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#: