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37-065 Solar Array Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) `.�..i" 3/3/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jessica Reid, Rep e P Amherst office (A/C o. Ext) (413) 549 -4971 p No): (413)549 -4974 Encharter Insurance LLC A DR Drive PRODUCER 00022892 25 University CUSTOMER ID #• Amherst MA 01002 INSURER(S) AFFORDING COVERAGE i NAIC # INSURED INSURER A :Hanover Ins. Companies 22292 _ INSURER B : NorthEast Solar Design Associates, LLC, INSURER C : 136 Elm Street INSURER D : INSURER E : Hatfield MA 01038 INSURER F : COVERAGES CERTIFICATE NUMBER:CL113301753 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYYY) GENERAL LIABILITY I EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ ■ CLAIMS -MADE OCCUR MED EXP (Any one person) $ — PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY I E 1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON -OWNED AUTOS $ UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ _ DEDUCTIBLE RETENTION $ $ A WORKERS COMPENSATION TORY LIMITS I 0T ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICER /MEMBER EXCLUDED? N/A (Mandatory in NH) WHN5715134 4/8/2010 4 / 8 / 2011 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE William Dowd /NO1DS2 w asrYt<„ 4—) - ACORD 25 (2009/09) ©1988 -2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD CONCRETE AND REINFORCEMENT D ASSO I S ARE E ALL DIMENSIONS AND CONDITIONS SHALL BE PROPERTY of STAYER FIELD VERIFIED BY THE CONTRACTOR AND * STREET r ASSOCATES. INC SECTION Concrete shall worm to applicable provisions of t NY WAY WAY NOT YATNOU E# USED T IN A OWNER. ANY ERRORS OR DISCREPANCIES C 2010 SHALL BE REPORTED TO THE ENGINEER ACI -301 and 318. BEFORE COMMENCING WITH ANY WORK. SCALE: = r-0 mum 28 day compressive y compres strength (Pc) as follows: All concrete: 3000 psi 0 ,� * Cement . M M T O 'd Concrete exposed to soil: Type I/II 6" EXTRA STRONG All other I/II P IPE COL. w l * Deformed reinforcement: ASTM A615 grade 60, W except bars specified to be field bent, stirrups, and ties which shall be grade 40. M t , * Reinforcement shall be fabricated and placed per ACI z Manual of Standard Practice (ACI -315). At splices, lap In 6 bars 50 diameters unless noted otherwise. [ * Concrete cover over reinforcement 1 %" for concrete placed against forms; 3" for concrete placed against earth. See also drawings. 'i 1 * In continuous members, splice top bars at mid span k 1 ; j! and bottom bars over supports. o * Keep reinforcement clean and free of dirt, oil, and 8 PAVING \\ f1 scale. Oil forms prior to placing reinforcement. >• �i� P It ., N - - -_._ STRUCTURAL STEEL: Z r i 11 _ , �il * Standard Pipe Columns: ASTM A53, Grade B. 24 "0 CONC. PIER. a -- �' i( I i i 11 I L � � *� * All structural steel shall be fabricated and erected per i I i I } � the current edition of AISC Steel Construction Manual. iv i i ■ i t II � � N lo I (8) #5 VERTICAL BARS I I I I W/ (3) #4 TIES AT TOP AND #4 TIES AT 12" ,I i ,i O.C. BELOW. i I I I I i 7 DRAWN BY: J.F.S. j ogre \_. __.. __._._ ___.__ __. A i 1 JAI ssix is 10/7/10 (4) #5 FOOTING DWLS . m - r - - '-, TIE TO #5 VERTICAL JN $ C .-. L " _ S-0" X 3' -0" X 12" 1 STEEL ABV. 12 t THICK CONC. PAD i _ •-410" FOOTING REINFORCE .� NUNIKR • WI (4) #4 BARS EA. > j WAY. FOOTING SHALL S 1 - - BE PLACED ON 3' UNDISTURBED SOIL. 2" TO 3" THICK LAYER !1C ('DI ICUCfl CT/lk1C 3 , THESE DRAWINGS ARE TNF PROPERTY OF THAYER - - STREET ASSOCIATES. INC � _ t MAY NOT BE USED IN ANY WAY 1WTHWT S ECTION 3" 1' -6" 3" WRITTEN PERMISSION COP MIGHT 2010. SCALE: 1" = 1'-0' UU Z v � ,,,,,:in n ' , ' r, 3' -0' X 3' —O X 12., F� o \• ✓ THICK CONC. PAD , / FOOTING REINFORCE W/ //' ' w � 7— �- — h0 /2 (4) #4 BARS EA. WAY. E a ', � ,. o W I j I fr � o ce O # W V (8) #5 VERTICAL BARS. tj 6" EXTRA STRONG 1 \ ` - y PIPE COL #4 TIES TYP. // �-* (4) #5 FOOTING OWLS. ! ;lc r TIE TO #5 VERTICAL z ; STEEL ABV. 8 ° Q 1- _ GENERAL STRUCTURAL NOTES 0 Z DESIGN LIVE LOADS: Massachusetts Sate Building Code - 7th edition * Snow Pg = 55 psf * Wind 100 mph, exposure C, 3 -Sec gust FOUNDATION: * Foundation are designed without an engineer's soil investigation. Foundation design criteria was assumed for purposes of foundation design and shall be confirmed by a soils engineer, at owner's expense, prior to construction. (This procedure DRAWN BY J.F.S. may require revisions to foundation design, at additional expense to the owner, if soils engineer determines that such , E 'A,E 1 0r,10 ONS design criteria are inappropriate for this building site.) RE� * Footings shall be placed on undisturbed natural soil or compacted fill tested and approved by soils engineer. XS MAME. . * Maximum design soil pressure: 2000 psf * Minimum dead load design soil pressure: no minimum psf S2 APPROX. 1269.5" - 66.34" MODULE I SCT230 MODULE LENGTH .5" NP • POWER RAIL TYP. - TYP. I I 1 39.09" M joil 1 ODULE I ' ( SCT230 WIDTH I I I MODULE TYP. - -- F y - TYP. T - I- + -- ~- ' - - - ~- - H POWER RAIL I IA I 11 I r I STRUT Al B RACKET 160.5" M- - - ± el- - + - -lc ' + 7t�.1 = 1 -, I I I � r - ,„ I I A I 2X 4 "MPM CLAMP STRUT I I I I II --- r- 1-- .,„---r- Lam--- -_ I RAIL BRACKET 4" SCH40 PIPE MID CLAMP } SECTION A - (4.5" O.D.) PIPE CAP ,- III -< (PARTIAL) TOP VIEW W/ U -BOLTS 1 r i POWER RAIL (PARTIAL, NOT TO SCALE) \. -- END CLAMP SCT230 MODULE 34.7" TYP. END CLAMP TYP. 4" SCH40 PIPE M:I MN NE :a iE (4.5" O.D.) IE RR III / II 120" II I END CLAMP 11 PIERS DIRECT POWER AND WATER j SCT230 MODULE RAIL BRACKET 4000 VASSAR DRIVE NE 6" SCH40 PIPE 4" SCH40 PIPE (6.63" O.D.) DPW TITLE: ALBUQUERQUE, NEW MEXICO 87107 t� (4.5" O.D.) PIPE CAP PT# PC -6V4H SOLAR DP- MPM76- SCT230 -19x4 '\ - G. CUSTOMER: US SOLAR DRAWN BY WILL G � DATE: 9 -16 -10 MPM CLAMP DISTRIBUTING ENGINEER: WILL V • POWER RAIL P ROJECT: J.R. SHT. 2 FRONT VIEW ROCKY HILL CO. THIS DRAWING IS THE PROPERTY OF DPW SOLAR, (PARTIAL, NOT TO SCALE) HOUSING AND CANNOT BE USED, COPIED, OR DISCLOSED WITHOUT PERMISSION. DO NOT SCALE DRAWING 4" SCH40 PIPE MID CLAMP (4.5" O.D.) --- 2X 4" MPM CLAMP SCT230 W/ 2X 1/2" FLANGE NUTS, MODULE • 2X 1/2" CARRIAGE BOLTS 39.09" / TYP AND 2X 3/8" SET SCREWS (NOT SHOWN) MODULE WIDTH / O ilt \r„.... TYP. 160.5" ` ` . SCT230 .• MODULE � STRUT TYP. w , - 4" __ -------- \ k„„,,, • / STRUT BRACKET RAIL BRACKET •l: kP.' I / MID CLAMP ‘4 PIPE CAP 3/8" U -BOLT STRUT BRACKET 167.3" W/ HEXNUT, PIPE CAP FLAT WASHER END CLAMP PT# 6V4H AND LOCK WASHER TYP. 2 PLACES STRUT ON EACH PIPE CAP 119.4" POWER RAIL e'er 6" SCH40 PIPE (6.63" O.D.) 30° MANUFACTURER'S RECOMMENDATIONS 2 FOUNDATION RECOMMENDATIONS PER THE IBC2006, ./ 7 V V V V V- .. � / ./ ./ ./ ./ y ./ ASCE 7 -05, AND BASED ON THE FOLLOWING ASSUMPTIONS: • • EXPOSURE B .. °' / • 2,500 PSI CONCRETE /j��������������\ ' / . ���� \� \ • 6" SCH40 AND 4" SCH40 STEEL PIPE / / / / / • Q ' C • / / / / N / / PH MAX • \ \ /j� / /� / / A � / / A /��� � /� \� • SOILnTYPEIMUM WIND SPEEDS • 100 • SOIL IS UNDISTURBED AROUND FOOTINGS • 7. . . • 30° MAXIMUM TILT 7a" • 40 LBS. PER SQ. FT. MAX SNOW LOAD 0% DIRECT POWER AND WATER • 4000 VASSAR DRIVE NE e. . a ° ALBUQUERQUE, NEW MEXICO 87107 • . • DPW TITLE 2 " -3" COARSE GRAVEL ' e -* SOLAR D P -M PM76- SCT230 -19x4 . e CUSTOMER: US SOLAR DRAWN BY: DATE: • WILL G.- 9 -16 -10 L -24" DIA. --I DISTRIBUTING ENGINEER: R. SHT. 1 SIDE VIEW PROJECT: ROCKY HILL CO. THIS DRAWING IS THE PROPERTY OF DPW SOLAR, HOUSING AND CANNOT BE USED, COPIED, OR DISCLOSED WITHOUT PERMISSION. DO NOT SCALE DRAWING /(i„z,z,J,/„ / ,-,, 3 ,4 5 , q.k it/ii/ , .. t:;' ty..7,? -_ ...- — _.. :_— ',_:-..-, • tZ0-44$:i14.,,i •.'„':::,..._, y ..„ . ';' t ,,,,,,,,,,,.,,,,,, - ' v.,..,..-"..- 2,, `,,C,I,:,?),:t,11,'",,V,::::-,--7",:7-1'0,':4‘::„..i.7.1'4-,!-Zn'!:,15,..‘,.'v "', :,,--, lir . ■ 7 . - ., / - — • ' :- . - -.:',:'.• ' ', ''''' i i: - C 4K4 : :: .4 1 116;Sti - ;, 1 2Y .. ' , P - 9.1 , : , 11,P, tz;?, U.': • a ,:,,,,...,- .,-,-„,,, , ..7... .......,..- . . /_,e0f: - - .-:',7i."-7 . \ ,,''.•7: ' --.7....--..`; \ , . , :. , ; . ,..., , ,,i:7;,,f,..7 . : -..X....,, :-N.:.-- . •.., — . : ----- - - - - " •-• -H ','.-... -',' .:?;,..Tr.::.:,...;:,P,' 7 ,.- ,..:' ' ' . -'" 1 '' '-'" . '' --:— ,'::::::.,‘,... :,. ''.'.''' ,-.- •.: ----.,;-,..-_-,..- .. ,... i : .,:,,,,. , . , ...,,,..._ ..... , ____.... • From: Ann Bronner <ann @northeastsolar.bizs Subject: authorization for permit Date: March 1, 2011 2:19:01 PM EST To: Donna Cohn <donnacohn @comcast.net> 2 Attachments, 449 KB Hi Donna, Thank you for getting me the letter(s) so quickly. The last thing I need from you for the permit is your signature on the Work Authorization Form that gives us permission to file for the permit on your behalf. Ann Ann Bronner Operations Manager NorthEast Solar 136 Elm Street Hatfield, MA 01038 413 - 247 -6045 413 - 674 -0006 fax ann@ northeastsolar.biz www northeastsolar biz East Solar pow Gr.en is easy East Solar ..going Green is easy HOMEOWNER WORK AUTHORIZATION FORM By signing this form, I hereby assign NorthEast Solar and its representatives authorization to act on my behalf to file permits and attend to administrative duties associated with my project. CUSTOMER PRINTED NAME DATE Do 4 (0 1-1141._ t CUSTOMER SIGNED NAME ____C- 111.& Sections of the minutes of Rocky Hill Consominium Association community meetings during which installation of photovoltaic panles paid for and owned by some community familes were approved. Sept 11, 2010 Community votes: ■ Pole mounted components 15 in favor, one stand - aside, (in favor of the project overall with concerns about $2.5K and desire to cover entire car) a New shed and move old show 16 in favor no stand asides. a Straw poll followed by consensus approval — wide spread approval that RHC to pay up to $2.5K for the cost of the new shed 15 approve 2 stand asides (would like creative ideas, concern that it does not respect the process for allocating capital funds.). October 9, 2010 Community votes: Money for new shed We have $16,500 available for capital projects. BoT requests that we use $2500 of that money toward the new shed The new shed will house some of new solar panels. Design Review and Buildings and Grounds committees will site the old shed. We have already agreed to spend $2500 toward a new shed; this is a decision to take it out of capital funds. Fourteen households agree. Decision to spend $2500 of capital funds toward new garden /maintenance shed. 2/28/11 To whom it may concern, The Rocky Hill Condominium Association (RHCA) holds community meetings once or twice a month to discuss and vote on topics important to the community. On 9/11/10 the community discussed and approved the installation of • several arrays of solar photovoltaic (PV) panels on poles in a part of the community parking lot and • a new shed designed to accommodate an array of PV panels.. The PV panels and related equipment will be paid for and owned by several families in the community The community also approved the allocation of up to $2,500 for the cost of this new shed. On October 9. 2010, at another community meeting, community members approved using up to $2,500 from the Rocky Hill capital project fund for the up to $2,500 toward the construction and installation of the new shed. The Board of Trustees of RHCA confirms that allocation of funds has been approved and that the community has agreed to allow specific community members to install and own solar arrays on this new shed as well as mounted on poles that will be installed in the parking lot near the new shed. The relevant sections of the community meeting minutes in which the community approvals are recorded are attached. Please contact me Jeff McAuslin (jkmcaus @hotmail.com) if you have any questions about these actions. Sincerely yours, Jeff McAuslin President , Board of Trustees Rocky Hill Condominium Association • Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Authorization Form attached as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Donavin Gratz , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Donavin Gratz Print Name 03/03/2011 Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Donavin Gratz /NorthEast Solar Design 1 04454 License Number 136 Elm St. Hatfield, MA. 01038 04/18/2014 Address Expiration Date 247 -6045 Signatur Telephone SECTION 13 - 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 O No 0 • p.1 Version t .7 Commercial Building Permit May 15, 2DOf.1 SECTION 9. PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACEI 9.1 Registered Architect: Not Applicable • Name (Registrant ): ' Registration Ncimber Address Expiration Dale Si na ure Telephone 9.2 Registered Professional Engineer(s): Jake Smith/Thayer St Assoc, Project engineer Name Area of Responsibility S Coates Ave. So. Derrfeld. MA 01373 47430 Ad &as!, Registration Number �- 41‘./ 665 -401 S 06/01/2012 - •nature Telephone Expiration Date Name Area of Responsibility Address T Registration Number Signature - Telephone Expiration Date Name Area of Responsibility • Address Registradon Number Signature, Telephone Expiration Daw Name Area of Responsibility Aadtass Registration Number -- Signature Telephone i =xpIre /Ion Date 9.3 General Contractor NorthEast Solar Design Assoc. ` Not Applicable ❑ C¢mpany Donavan Gratz — Responsible in Charge of Construction 136 film St- Hatfield . 01038 Address Our 247 -6045 rAlgri7rture Telephone Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 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 12 Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW Q YES Q IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q 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 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • 1 Versionl.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other 0 Brief Description Enter a brief description here. Erect a carport that is a photovoltaic solar array and install a solar Of Proposed Work: array on the adjacent, existing shed. SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A I ❑ A -4 ❑ A -5 ❑ 1 B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use p Specify: A grid tie solar array that will be used as a carport p S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1St 1 st 2nd 2 nd 3 d 3rd 4 th 4 Total Area (sf) Total Proposed New Construction (sf) 1,400 Total Height (ft) Total Height ft 14 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On site disposal systemO Versionl.7 Commercial Building Permit May 15, 2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit 109 Black Birch Trail Florence, MA. 01060 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Donna Cohn 109 Black Birch Trail Florence, MA 01060 Name (Print) Current Mailing Address: / 519 -9873 Signature Atr '10 rt 2.4 .4 1 0 n to rwl 6.1:1 f -chc, ' .. Telephone 2.2 Authorized Agent: NorthEast Solar Design Associates 136 El;m St. Hatfield, MA. 01038 Name (Print) Oha 6- rct 2 Current Mailing Address: 247 -6045 Signature ; CAI Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $183,753.00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 10 2. 0 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number i f 62 This Section For Official Use Only Building Permit Number Date Issued Signature: 1/4"..."{\--e Y/1/1 Building Commissioner /Inspector of Buildings Date 109 BLACK BIRCH TRL BP- 2011 -0714 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37 - 065 CITY OF NORTHAMPTON Lot: -009 PERSONS CONTRACTING WITFI UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SOLAR PANELS BUILDING PERMIT Permit # BP-2011-0714 Project # JS- 2011 - 001173 Est. Cost: $183753.00 Fee: $1102.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NORTHEAST SOLAR DESIGN ASSOCIATES LLC 104454 Lot Size(sq. ft.): Owner: COHN DONNA Zoning: SR Applicant: NORTHEAST SOLAR DESIGN ASSOCIATES LLC AT: 109 BLACK BIRCH TRL Applicant Address: Phone: Insurance: 136 ELM ST (413) 247 -6045 () Workers Compensation HATFIELDMA01038 ISSUED ON:3/7/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: ERECT CARPORT W /PHOTOVOLTAIC SOLAR ARRAY & ARRAY ON SHED 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 3/7/2011 0:00:00 $1102.50 212 Main Street, Phone (413) 587- 1240., Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner