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22D-103 (2) BP-2024-1459 46 CLARK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 22D-103-001 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-2024-1459 PERMISSION IS HEREBY GRANTED TO: Project# 2024 SOLAR Contractor: License: Est.Cost: 35088 VALLEY SOLAR LLC CSL 1 15680 Const.Class: Exp.Date:04/09/2025 Use Group: Owner: H BUSCEMI PETER M& ANN Lot Size(sq.ft.) Zoning WSP Applicant: VALLEY SOLAR LLC Applicant Address Phone: Insurance: 116 PLEASANT ST,SUITE 321 (413)584-8844 EXT 217 376140840103 EASTHAMPTON, MA 01027 ISSUED ON: 11/01/2024 TO PERFORM THE FOLLOWING WORK: INSTALL 24 PANEL 10.32 KW ROOF MOUNT SOLAR SYSTEM (DECK ATTACHED, NO STRUCTURAL UPGRADES OR 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: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: lP Fees Paid: $175.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner i i i i The Commonwealth of Massachusetts FOR i=yr ___N'0i Board of Building Regulations and Standards MUNICIPALITY 2�24 Massachusetts State BuildingCode,780 CMR .s 1 CT 1 8 USE et:'L VI`_ Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar -'_ 1 One-or Two-Family Dwelling 2011 i L .. ,F,r ';' , This Section For Official Use Only Building Permit Number: 8P 7-mil- 141S1 Date pplied: GAR /i / •2V Building Official(Print Nate Signature • Dat SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Numbers hCU 48 CLARK ST POLE 6 NORTHAMPTON,MA 01062 ,Adt 0 /03 I.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 I 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 Zone:_ Outside Flood Zone? Municipal On site disposal system Check if yes SECTION 2:PROPERTY OWNERSHIP 2.1 Ownerl of Record: Ann Buscemi Florence MA 01062 Name(Print) City,State,ZIP 46 Clark Street (413)519-5947 annbuscemi53Caol.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Existing Building Owner-Occupied Rcpairs(s) Alteration(s) Addition Demolition Accessory Bldg. Number of Units 24 Other ✓ Specify:Solar Brief Description of Proposed Work2: Installation of a 24 panel roof-mounted solar array. System size 10.32 kW DC. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) l.Building $24561 1.Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $10526 Standard City/Town Application Fee Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2.Other Fees:$ List: 4.Mechanical(HVAC) S / S.Mechanical(Fire Suppression) $ Total All Feed:t 4 '-j J/ Check No. Check Amount: / Cash Amount: 6.Total Project Cost S 35088 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 M 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 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 on my behalf,in all matters relative to work authorized by this building permit application lawiratbaii(Oct 7,202.4152E EDT) Oct 7,2024 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNERI 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 offn my knowledge and understanding. /C P WL/4 a 10/07/24 _ 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 tug 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 www.mass.gov/oea 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 /�MAM, "•.''' Massachusetts 4, 'e �` c s1':: I • DEPARTMENT OF BUILDING INSPECTIONS �t Y I. ' .:., 212 Main Street • Municipal Building v Northampton, MA 01060 r ' -.•. `.� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, 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: PaticA 22 /26.if Date: 10/15/2024 1 ne uommonweatrn of iriassacnuserrs Department of Industrial Accidents c Office of Investigations c _ , I Lafayette City Center 2 Avenue de Lafayette, Boston, MA 02111-1750 _ www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Valley Solar LLC Address: 116 Pleasant St, Suite 321 City/State/Zip: Easthampton, MA 01027 Phone #:413-584-8844 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 30 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6 ❑ New construction listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' $ 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other solar comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners 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: Applied Underwriters Policy#or Self-ins. Lic. #: 37614 034 0103 Expiration Date: 09/01/2025 Job Site Address: 48 Clark St Pole 6 City/State/Zip: Northampton, 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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. Signature: /1)Gti, /C6`rt Date: 10/15/2024 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 (check one): 11:1Board of Health 20 Building Department 3fCity/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.DOther Contact Person: Phone#: