35-106 (7) BP-2024-0988
80 DREWSEN DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-106-001 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-2024-0988 PERMISSION IS HEREBY GRANTED TO:
Project# 2024 SOLAR Contractor: License:
Est. Cost: 15000 VALLEY SOLAR LLC CSL1 15680
Const.Class: Exp.Date: 04/09/2025
Use Group: Owner: M LEYDEN PATRICK
Lot Size (sq.ft.)
Zoning: WSP Applicant: VALLEY SOLAR LLC
Applicant Address hone• Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840102
EASTHAMPTON, MA 01027
ISSUED ON: 08/07/2024
TO PERFORM THE FOLLOWING WORK:
INSTALL 10 PANEL 4.25 KW ROOF MOUNT SOLAR SYSTEM WITH 13.5 KW BATTERY ON NW EXTERIOR WALL OF
HOUSE (NO STRUCTURAL UPGRADES, DECK ATTACHED)
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. j
Signature: e/
Fees Paid: $150.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
/
d----ss.''''',.. ........../
The Commonwealth of Massachusetts FOR
��` Board of Building Regulations and Standards MUNICIPALITY
achusetts State Building Code,780 CMR
USE
1
b lding ermit pplication To Construct,Repair,Renovate Or Demolish a Revised Mar
r oc One-or Two-Family Dwelling 2011
•ON n gsOPC� This Section For Official Use Only
ny_ tt
Building
�Permit Number: 6 tD� Date Applied:
get)I,J,/25.5 ilk 8.7-202ti
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Numbers
80 DREWSEN DR RFD FLORENCE MA 01062
1.1a 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 Prop ided 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 Zone:_ Outside Flood Zone? Municipal On site disposal system
Check if yes
SECTION 2: PROPERTY OWNERSHIP
2.1 Ownerl of Record:
Patrick Leyden Northampton MA 01062
Name(Print) City,State,ZIP
80 Drewsen Drive (413)858-5132 patrickleyden@hotmail.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction Existing Building Owner-Occupied Repairs(s) Alteration(s)i Addition
Demolition Accessory Bldg. Number of Units 10 Other I Specify:Solar
Brief Description of Proposed Work2: Installation of 10 panel roof mounted solar array.System size 4.25 kW DC.
Includes installation of Testa 13.5 kWh ESS.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 10500 1.Building Permit Fee:$ Indicate how fee is determined:
2.Electrical S 4500 Standard City/Town Application Fee
Total Project Cost3(Item 6)x multiplier x
3.Plumbing S 2.Other Fees:.$
List:
4.Mechanical(HVAC) $
5.Mechanical(Fire Suppression) $ Ch Ail r ,A) )Uji
Check 1` '�� Check Amount: I ..ash Amount:
6.Total Project Cost $15000.00 Paid in Full Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
CS-115680 4/9/2025
License Number Expiration Date
5.1 Construction Supervisor License(CSL) List CSL Type(see bellow) U
Patrick Rondeau
Name of CSL Holder Type Description
•
53 Fox Farms Rd.,Florence,MA 01062 U Unrestricted(Buildings up to 35,000 cu.ft.)
No.and Street
R Restricted I AND 2 Family Dwelling
Florence,MA 01062
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
413-584-8844 Info@valleysolar.solar SF j Solid Fuel Burning Appliances
Telephone Email address
I Insulation
D Demolition
5.2 Registered Home Improvement Contractor(HIC)
Valley Solar LLC
HIC Company Name or HIC Registrant Name 186338 10/27/2024
HIC Registration Number Expiration Date
116 Pleasant St,Suit 321
No.and Street info@valleysolar.solar
• 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 gRmyy behalf, all matters relative to work authorized by this building permit application
P trick Leyden(Jun 28.20241]28 ELM 06/28/24
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER1 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�D Aigehde.4 06/28/24
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 nit have access to the arbitrationprogram or guaranty fund under
M.G.L.c. 142A.Other important information on the HIC Program can be found at WAN,w.mass.guv/oca Information on the
Construction Supervisor License can be found at www.mass.govkdps
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
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be disposed of in
a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A.
The debris ;::1 he disposed of in:
Valley Recycling - 234 Easthampton Rd, Northampton, MA 01060
LOCATION OF FACILITY
PG.tiw Z7 /26.h;i2az 8/2/24
Signature of Applicant Date
AFFIDAVIT
As a result of the provisions of MGL c 40, S 54, I acknowledge that as a condition of
Building Permit Number _ all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly licensed solid
waste disposal.facility, as defined by MGL c 111, S 150A.
_.__I_certify. that_L will,notify the Building Official by (two months
maximum)of the location of the solid waste disposal facility where the debris resulting from
the said construction activity shall be disposed of,and I shall submit the appropriate form for
attachment to the Building Permit.
8/2/24 /-7a cj P /2.6)n:czcacc
Date Signature of Permit Applicant
(PRINT OR TYPE THE FOLLOWING INFORMATION)
Patrick D Rondeau
Name of Permit Applicant
Valley Solar LLC
Firm Name, if any
The Commonwealth of Massachusetts
1 = = / Department of Industrial Accidents
_ c,
1 Congress Street,Suite 100
:eti_ Boston, MA 02114-2017
=t www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):Valley Solar LLC
Address: 116 Pleasant Street Suite 321
City/State/Zip: Easthampton, MA 01027 Phone#:(413)584-8844
Are you an employer?Check the appropriate box: Type of project(required):
LID I am a employer with 40 employees(full and/or part-time).* 7. 0 New construction
2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling
any capacity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]
9. ❑Demolition
4.0 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will
10 El Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs
These sub-contractors have employees and have workers'comp.insurance.'
h.❑We are a corporation and its officers have exercised their right of exemption per MGL c.
14.❑✓ Other Solar
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t I lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:Continental Indemnity/AUW
Policy#or Self-ins.Lic.#:376140840103 Expiration Date:09/01/2024
Job Site Address: 80 DREWSEN DR City/State/Zip: FLORENCE MA 01062
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 fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator. A copy of this statement 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 true and correct.
Sittnature: /"erG I P A?Bi,t, Date: 8/2/24
Phone#:(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):
1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. 8 617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia