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30A-046 (2) • ROOF - MOUNTED SOLAR ARRAY DEAD WEIGHT LOADING CALCULATION OVERVIEW Project Name HERTZ residence Address 37 Lexington Avenue Florence, MA 01062 The flushed to the roof solar array being installed on the south facing roof of the garage, consists of one array of 27 photovoltaic modules and a roof mounting system. The mounting system includes a series of staggered supports that represent discrete points of contact with the roof structure. Each support is anchored to the rafters via 8" stainless steel hanger bolt designed with a minimum 3 inch thread depth allowing for a minimum pull -out capacity of 615 pounds. ROOF STRUCTURE COMMENTS Engineered trusses 1.Roofing Construction Height 6 inches I Light: YES Heavy: Width 2 inches 2.Roof pitch: 7/12 degrees Rafter spacing 24 inches on center SOLAR MODULE ARRAY WEIGHT CALCULATION Photovoltaic modules Units Unit Wt. Total Wt. Comments Solar module(s) ( 27 I 43.6 1177 Canadian Solar 240W Subtotal 1177 Mounting System Units Unit Wt. Total Wt. Rails Standard Unirac 2149.8 0.048 103.2 Lbs /inch Shared rail with cap strip 0 0.12 0.0 Lbs /inch L feet 0 0.25 0.0 supports include all hardware L feet on S5! Clamp 0 0.64 0.0 supports include all hardware L feet on 3/8 hanger bolt 51 0.58 29.6 Eco- fasten with 8 screws and flashing 0 2.69 0.0 supports include all hardware Stand -off with roof boot (single support) 0 1.28 0.0 and roof boots Stand -off with roof boot (double support) 0 1.70 0.0 Stand -off with hanger bolt (single support) 0 0.43 0.0 Quickmount 0 1.00 0.0 with hanger bolt & hardware Quickmount with doubble support 0 1.35 0.0 with hanger bolt & hardware Splice bar kits 6 0.19 1.1 Module and rail grounding 1 1.75 1.8 Module universal end clips 0 0.25 0.0 Module mounting clips 60 0.10 6.0 Subtotal 141.7 'Total solar module array weight 1318.9 'lbs 1 POINT LOAD CALCULATION Number of support stand -off 51 Total solar module array weight 1318.9 Point load ( 25.9 lbs DISTRIBUTED LOAD CALCULATION Photovoltaic module array area Array 1 Array 2 Array 3 Module width (horizontal) 38.7 inches 0 inches 0 inches Module length (vertical) 64.5 inches 0 inches 0 inches Intermodule spacing 1 inches 0 inches 0 inches Number of module columns 9 0 _ 0 Number of module rows 3 0 0 Array area 484 square feet 0 square feet 0 square feet Total array area 484 square feet Distributed load 2.7' lbs / sf 1 • AERIAL SITE PLAN HERTZ - FLORENCE, MA ..,"' ,.■ PV Array Site -_ ,_....4,t, e: ..;,,,,,,„, - 4 1t . 44" ' 'ft* Nooe''' .„, - "' ' , • ill 1 I. -"Ie ,,,-,•., ■-r ''''' '''''' 6 ' ' ' ','' ' , a1 0 fADZ, Gecspatitt-Sqr`"i':11's '''' 'A'''', , I 1, abart - PictorrietrIf Eies Eve - - .„,,..,; .„.,.... PV array to be installed on southeast facing roof of garage. ,.... .1 - ..,,. . . .. , -. .... .. . , SOLAR ARRAY MOUNTING STRUCTURE LOCATION - .---1.--........,......i. ........-- ` lic..... .,.......,.... .............. ......... . 3 It /111111111111•111 • ,„„,... • . a ...,..... ,..„..., e ,,, ..lvvivarvv 1 * — '1 l• ; k ' — t■ '' s um _ _ .fir ICI_ __ III AMID I IIrII�IVV�I�I W_ IlII ,L 1.111110_111 11T JIWIA�I 1 I IIIIIII� - III (IWQ �f [ I I 11 _ I ill/ 11 II I i w � _ III d Iu ,$ u I u I�j 111 I�� � � � �;, 358 I7 F 11 li ® 1 1 ` II Wi : '" J h . IIII II 111 WI t. 111/1 I 11111 l I II IIWJI 1 En 0111 i IlW1 1111111111111111111111 WIIWIII{ YIOIIIIIIWII 1111111111111111.11 11111011111111111 t 4 ' BEEN I BIM 1 vim nun Illt Iw 1 BIM III 11=111111111111 IIIIIIIIINNIIIIII ' 11111h1111111 111111111111111 ° . WWWWI cal III IIIIWW I Wp1W111 1 111 J I II II ` IS L.L _ _� _ = N I _ , _ VIII__ II _ II II _ ' II ` I IIII 11I 1 1 1 F II IMI II 1 I l� { li Iin — Mil ' ii ` 1 1 L ! I l I N I I I I 1 • 1 ■ 11 1 I 1 1 11 I 1 ,, " ® I J I ® I I p1 l l Ann i I IrI�I ®L Va . _..,..,, in m A o Irl IIWIII 111�11I in I IVlll� u� 1 { 11 � W 1 11 n I II I I� _ 111111111111111111111 11111 ���� MO In 111 = IVi 1 11W 11WWWr1 1111 W ��� IW 111111111111 s 1 111101INiii " I 11 91 ff VIII 11n iw1 i1"1rwiiiii 11ii111111 1 1 VISE1 g111Y11 1 1111111!I , Under each module w rl�111 W 1 11 11111111111L in M I I 1 1■I 11W1W1l1 L1II1I MI WI WII IUI IW a dedicated micro L III III 11 III Irl l IIll I III Irl1■'II VI 11 111_ II _ I III _ II III inverter is to be p 1r�II r _ I IIrI�®I 1Ir i s" '1 I I 11 11 O iT1 r 11 ,T 1 j Iw1 111�11111 I I ■N■IIII�I1 IIIIII I Iw11w1 � � I Mil I ■ secured to the mounting rail 711M111-11 I 1 11 ® 1 II I m 1 1 1 1 I I � � i1r1 I� �"' - it 1� 1 VIII 1 I 1 rl 11I � 1211111111111111 W IWII 11111111111111 1W 1M11 111111111111111 I . ...R tl I I : I1'„ ■1 1 1 1 I I I■ I JJOI111 11 I I w I 11111Ai1�1 I■ IwillSil IIIIIIAII A �I 1111 E 11111111111111111111 II 11 I44IIUII111 . =MI MI IMWra111 11111111111111111 1111111111 1 .:. •tLl u 111111 I I , T.I L- unmoor' IINLIIW , lit_ Im L1L - I ' IV d i I - 11 _ III s NOTES: 1. When position of solar modules are finalized, 1/4" - 20 hardware used in conjunction Er . with top down clamps must be installed to 10 ft -lbs of torque. When using UGC -1, UGC -2, WEEB 9.5 and 1 WEEB 6.7, 1/4" - 20 hardware must he installed to 10 ft -lbs of torque. 2. Use Unirac SolarMount light rails. 3. Unirac Hanger Bolts. Using heavy washers and flange nuts, secure the L -foot from your ' ' ' st SolarMount rail kit above roofing material. When all L -feet are aligned, torque the top flange nut to 30 foot - pounds. 4. Overhang beyond array outside supports should not be longer than 12 ". 5. Center the array on the roof. E l - MfNu:,M I ` PV Layout v e 27 Module Array L 1 HERTZ Residence Photovoltaic Project ..... RR Canadian Solar 240w 64.6 X 38.1 X 1.57 in. .. 08/18111 ... vl not for construction � not to scale ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) Tm 01/03/2011 PRODUCER 413. 586.0111 FAX 413. 586.6481 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Webber & Grinnell Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8 North King Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Northampton, MA 01060 INSURERS AFFORDING COVERAGE NAIC # INSURED Pioneer Valley Photovoltaics Cooperative, Inc. INSURER A. Peerless /Peerless 24198 311 Wells Street INSURER E Excel si or /Peerless 11045 Suite B INSURER C Greenfield, MA 01301 INSURER INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR WDD'L DATE MMIDDNYYY( DATE MMIDDIWYY} LTR INSRC TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY CBP8378623 01/01/2011 01/01/2012 EACH OCCURRENCE $ 1,000,000 UAMGE 10 REN FEU X COMMERCIAL GENERAL LIABILITY PREM SES (Ea occurrence) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) _ $ 5,000 A i PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENE AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY jEC7 LOC AUTOMOBILE LIABILITY BA8372626 01 /01 /2011 01/01/2012 COMBINED SINGLE L MIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY B X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS UMBRELLA LIABILITY CU8377126 01/01/2011 01/01/2012 EACH OCCURRENCE $ 2,000,000 X1 OCCUR CLAIMS MADE AGGREGATE $ 2,000,000 A $ DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION WC8376525 01/01/2011 01/01/2012 X oRYUMITS ! ' OTH- ER AND EMPLOYERS' LIABILITY B D FFICE OPRIET ER C EX NER /EXECUTIVE Y f N EL EACH ACCIDENT $ 500, 000 (Mandatory in NH) E . DISEASE - EA EMPLOYEE $ 500, 000 It yes, describe under SPECIAL PROVISIONS below E . DISEASE - POLICY LIMIT $ 500, 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project: 50kW and Less Massachusetts Clean Energy Technology Center, the System Owner, & as applicable the Host Customer as Additional Insured with respects to General Liability as per the terms and conditions of the policy on a primary & non - contributory basis for both commercial and residential work CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Massachusetts Clean Energy Technology Center IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 55 Summer Street, 9th Floor REPRESENTATIVES. Boston, MA 02110 AUTHORIZED REPRESENTATIVE Jenna Rodrigue, CISR /JER ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD . lilt 4uiuuiU11Weu1Ll1 Ul 1V1ussaI iiUheLLs • Department of Industrial Accidents Office of Investigations 600 Washington Street Boston; MA 02111 www.mass.aov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): 1 ;vik;;r ied x:,� I h oo4A ,�. $ • ,1 : 17-k) r� -tv iu� -DA— i t Address: ,, ' °,'Jt,1l5 I1 - t-: ... City /State /Zip: L vset v � c It: L ' Ysa w;, U L ., , Phone #: fig - - 4X - 55 Are you an employer? Check the appropriate box: Type of project (required): 1. - I am an employer with [ 4. - I am a general contractor and I 6. - New Construction . Employees (full and/or part- time)* have hired the sub - contractors 2. - I am a sole proprietor or partner- listed on the attached sheet. I -Remodeling Ship and have no employees These sub - contractors have 8. - Demolition Working for me in any capacity. workers' comp. insurance. 9. - Building Addition [No workers' comp. insurance 5. - We are a corporation and its 10. - Electrical repairs or additions required.] officers have exercised their 3. - I am a homeowner doing all work right of exemption per MGL 11. Plumbing repairs or additions myself. [No workers' comp. C. 152, ' 1(4), and we have no 12. - Roof repairs insurance required.]H employees. [No workers' 13 Ot her }41,, (�;�,_. comp. insurance required.] �, s�� -eh( * Any applicant that checks box #1 must also fill out the section below showing their worked compensation policy info 'on. H Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indica ' such. I Contractors that check this box must attach an additional sheet showing the name of the sub - contractors and their woikers' I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and Job site information. Insurance Company Name: C t :( 1."i/ 1 Policy # or Self -ins. Lic. #: \I ) "1 j ,4 `-) Expiration Date: V 3 I, / X - > 1 2, i Job Site Address:_31 L (i City/State/Zip: `trtnlc_, /41 1 o j p (oz. 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 for one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this s ement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. — I do hereby certify under the pains and penalti ", *perjury 7 ' the information provided above is true and correct. Signature: — Date: 51 3/ Phone #: if`) "?"a,_ t. Official use only. Do not write in this area, to be completed by city of town official. City or Town: Permit/License #: Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: 5 License or registration vsilfd ter itrdividui use owly Office .oi•Eons Consumer Affairs & Business Regulation before the expiration data if found return to: Q : 1 ; y I . HOME 1MP VRMENT CONTRACTOR Office of Consumer Affairs and Bysiness Regulation ‘'- l i ; Regifttr*tiOi(;: . 140077 r 10 Park Plaza - Suite 3170 / Y•_1 J4 � :" ExpirS"i .. =f ^11 Tr,' 289945 Boston, MA 02116 TY 1-€ _ `_, Olen PIONEER VAL{L ^ • -K r � tD.. - `II +, COOP 40 .-,.// 324 WELLS ST / �� GREENFIELD, MA 01301 Undersecretary Not :.1 , •" r r ^ n'�":, store • • 410 ,.t a. ass - nstruction DelSui M Massachusetts - Department oLicense f Public Safet Board of Building Regulations and Standards License: CS 102513 Failure to possess a current edition of the Massachusetts State Building Code " , is cause for revocation of this license. JONATHAN PARROTT AIX111' , 5 BARBER AVE Refer to: WWW.Mass•Gov/DPS GREENFIELD, MA 01301 `� - � - - Expiration: 4/16/2013 ( iii uniss' r Tr#: 12262 SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: (� �� Not Applicable ❑ Name of License Holder : aka.1Vta. �ary"bfl U I$ � 615 License Number S AVIAAA-9-- GVekin f c!. f o i 3D ( 4/ I e /2 1' Addre/ Expiration Date it, ,2,,f_ 6 Signat Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ v Val I C5 lit- I 8U .- - 14 Company Nanly Registration Number 3i( 1,1A .f E., 3 G k l* o 13 3/ 16 /,&o Address / TV- Expiration Date i Telephone 4 �3 81O1c — SECTION 10- 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 )dl No ❑ 11.- Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two - year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature A.1 ci1 — ( (PV)2 is committed to providing a high quality product and service and we look forward to working with you on your renewable energy project. Please contact Jon Child at 413 - 772 -8788 with questions or comments regarding this proposal. S ere , Pioneer V. - Photo f L. Cooperative if Jonath. Child Project Manager Attachments: General Terms and Conditions AUTHORIZATION TO PROCEED • I hereby agree to the Project as set out above, and I agree to pay the contract price according to the Terms of Payment. I further agree to the Terms and Conditions attached hereto as a part of this . . Proposal and Agreement. I hereby authorize Pioneer Valley PhotoVoltaics Cooperative to proceed with the above - referenced Project in accordance with this Agreement. A check for the First Payment is enclosed and I am returning this Agreement within 21 days of the Proposal date. Printed Name nt d a e Date _1_ Yve a ui'yfl�- Signature Title APPROVAL TO SERVE AS AUTHORIZED AGENT I hereby authorize Pioneer Valley PhotoVoltaics Cooperative, or its designated representative, to obtain required permits for this project on behalf of the owner and to begin work of obtaining a grant on my behalf. D (7, PiJ T Z S, ill t Printed Name Date ( D -4N gejC 1 r`e-- /•� Signature Title Proposal and Agreement 6.48 kW Page 7 of 7 Debra and Michael Hertz, August 1, 2011 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) ---; -N ) New House ❑ Addition ❑ Replacement Windows Alteration(s) I I - oofing ❑ Or Doors l] 1 Accessory Bldg. ❑ Demolition ❑ New igns [ cks .l 1 7 • • • u ] Other 1 ( A fs Brief Description of Proposed 1' Work: installation of aluminum support structure for solar or on the south roof of garage. L • ? y' " .. Alteration of existing bedroom Yes X No Adding new bedroom Z s N Attached Narrative Renovating unfinished basement Yes x No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ��/ ►�1ti_ 1/� , as Owner of the subject property hereby authorize ?Atty. i gi'lo<t,� A Cz P n A r ) c- to act on my behalf, in all matters relat to work authorized by this buildin p '1 (,_ ermit application. Atx aik4.141,49t.,t (A) i5-1 3 I ke, i 1 Signature of Owner Date I, 1 M\■: - s . P 0 irT(//Y■1221 . VLt 16 1/1pb�O kQ,LC,j /1)1 ., • , as Comer/Authorized Agent hereb eclare that a statements ainformation on th- f egoing application are true a accurate, to the best of my knowledge and belief. 1 7 Signed under the pains and penalties of perjury. r i . To LL}xU Print Name illprZ Signature of Owner /Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 15,800 Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW C) YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO C) IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. ... , ",....._..._ 1 / .,,"‘ SG11 _ _.._ 4 I 7 . j� • ECEIV (� �J 1� - � j� Department use only j � 1'Idb l fl'i Status of Permit: SEP 20 � � (ding Departmen Cu— CutrDriveway P r Permit j ' ` - cnon Sew erlSeptic Availability (� . =r�. mow Wat erlWell Ava i la bility Elec Plum bing & C;a� In �c . • Norths . n. + _A N. rthampton, MA 0106 Two Sets o f Structural Plans p ho ne 4 13- 587 -1240 Fax A13-587- 1272 PlotlS Pla Other Specify APPLICATION TO CONSTRUCT, ALTER, RE PAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - S ITE INF 1.1 Property Addr This s , ec tion to be completed b y off Map 3)°‘---'- '1 01 Lot Unit 3� L�?�t�l Zone Ove rlay District Elm St. D is t rict CB Distric SECTI 2 - P R OPERTY O THORIZED AGENT 5o I 2.1 Owner of Recor ivut Debra Hertz en Florence MA 01062 Name (Prin Cur rent Ma Address: ll el n (i4) 413 586 5522 WNERSHIP /AU 37 Lexington Av � p u � l , Telephone 2.2 A u tho rized Ag ent: Name ( fllfht) Cur rent Mailing A ddre ss: I UU �j 413 - 772 -8788 Signature Signature y-�' Te lephone SECTION 3 - ESTIMATED CON RUCTION COSTS Item Estimated Cost (Do rs) to be t lla Offic Use Onl co mpleted by permit applican 1. Building 9,15 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Perm Fee 4. Mec hanical (H VAC) 5 Fir Pr ot 6. Total = ( 1 Building + 2 + 3 9, Ch eck Number I II 9 . 11 S� This S ection For Official Use Only Permit Nu mber: Date g Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0256 APPLICANT /CONTACT PERSON PIONEER VALLEY PHOTOVOLTAICS ADDRESS/PHONE 311 WELLS ST - SUITE B GREENFIELD (413) 772 -8788 PROPERTY LOCATION 37 LEXINGTON AVE MAP 30A PARCEL 046 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ,,E�— Fee Paid 7 0145 Typeof Construction: INSTALL SOLAR ARRAY SUPPORTS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 102513 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO N PRESENTED: proved _ Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demo • • P ela �� Ag erAir . -de:Aaa e o B.'lding Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. • 37 LEXINGTON AVE BP- 2012 -0256 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30A - 046 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SOLAR PANELS BUILDING PERMIT Permit # BP- 2012 -0256 Project # JS- 2012- 000401 Est. Cost: $9153.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PIONEER VALLEY PHOTOVOLTAICS 102513 Lot Size(sq. ft.): 15812.28 Owner: SOUTHERLAND MICHAEL & DEBRA HERTZ Zoning: URB(100)/ Applicant: PIONEER VALLEY PHOTOVOLTAICS AT: 37 LEXINGTON AVE Applicant Address: Phone: Insurance: 311 WELLS ST - SUITE B (413) 772 -8788 WC GREENFI ELDMA01301 ISSUED ON: 9/16/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SOLAR ARRAY SUPPORTS 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 9/16/2011 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner