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24A-144 solar" alte t rural (�� S T M \ \\ RENEWABLES uv x November 20, 2009 City of Northampton Building Department Louis Hasbrouck, Building Official 212 Main Street Northampton, MA 01060 RE: Building Permit Application Dorothea Von Goeler, 21 Roe Avenue, Northampton, MA Dear Mr. Hasbrouck, Attached please find a building permit application for Mr. Dorothea Von Goeler, Northampton MA. The following documentation is attached. 1. Original building permit application 2. Building permit application fee of $114 ($6 / $1,000) 3. MA CSL License 4. MA HIC License 5. Worker's Compensation Insurance Affidavit 6. Certificate of Liability Insurance 7. Site Plan 8. Specification sheets for equipment to be installed at the Von Goeler residence 9. Dorothea Von Goeler authorization for work to be performed. In addition to the above the following is true. The total project costs for this project is $18,571.37. Adams Power Services will be the electrician on this project and will submit a separate electrical permit for the project. Please mail the approved permit in the self addressed stamped envelope provided. Please contact our office should you have questions or require further documentation. Thank you in advance for your assistance in this project. Sincere) , ,„, . l II -� Michell Everett Operat ons Manager 34 Front Street Suite 321 1 P.O. Box 51924 1 Springfield, MA 01151 1 t: 413.734.1456 1 f: 440.445.4054 1 www.alterisinc.com solar • #� J S.i1�, rt'r21 �w/ a lt er i s T M RENEWABLES vvir i Owner Consent Form Owner: Dorothea Von Goeler Address: 21 Roe Avenue Town: Northampton State: MA Zip: 01060 Phone: 413.584.4551 I hereby give permission to Alteris Renewables, Inc. and their representatives to pull the required permits for a solar installation on my property. Signed, ( 0 � 6 0 Homeo ewe Date 34 Front Street Suite 321 1 P.O. Box 51924 1 Springfield, MA 01151 1 t: 413.734.1456 1 f: 440.445.4054 1 www.alterisinc.com t s' '� r p�r8. s q bb q ` L.� r 4 +, tl L V.4 ��[� k • FRONIUS IG FRONIUS IG 4000 / 5100 / 4500 -LV - Specifications DC Input Data FRONIUS IG 4000 FRONIUS IG 5100 FRONIUS IG 4500 -LV Recommended PV power 3000 - 5000 Wp 4000 - 6300 Wp 3600 - 5500 Wp Max. DC input voltage 500 V 500 V 500 V Operating DC voltage range 150 - 450 V 150 - 450 V 150 - 450 V Max. usable DC input current 26.1 A 33.2 A 29.3 A AC Output Data FRONIUS 1G 4000 FRONIUS IG 5100 FRONIUS IG 4500 - LV Maximum output power @40° C 4000 W 5100 W 4500 W Nominal AC output voltage 240 V 208 V Utility AC voltage range 212 - 264 V (240 V +10% / -12 %) 183 - 227 V Maximum AC current 16.7 A 21.3 A 21.6 A Maximum utility back feed current 0.0 A 0.0 A 0.0 A Operating frequency range 59.3 - 60.5 Hz (60 Hz nom) Total harmonic distortion < 5 % s Power Factor (cos phi) 1 General Data FRONIUS IG 4000 FRONIUS IG 5100 FRONIUS IG 4500 - LV - Max. efficiency 95.2 % 95.2 % 94.4 % - Consumption in stand -by < 0.15 W (night) Consumption during operation 15 W - Enclosure NEMA 3R Size (I x w x h) 28.4 x 16.5 x 8.8 in (720 x 418 x 223 mm) Weight 42 lbs. (19 kg) Ambient temperature range -5 to 122 °F ( -20 to +50 °C) Cooling controlled forced ventilation Integrated DC and AC disconnects standard UL approved DC & AC disconnects 3 Protections Ground fault protection Internal GFDI, in accordance with UL 1741 DC reverse polarity protection Internal diode Islanding protection Internal, in accordance with UL 1741, IEEE 1547 _ Over temperature Output power derating E L Surge Protection Internal DC & AC protection, Tested to 6 kV ^' 3 Compliance E a Safety UL 1741 EMI FCC Part 15; Class A & B Anti - Islanding protection UL 1741, IEEE 1547 s Ground fault detector and interrupter Compliant with NEC Art. 690 requirements, UL 1741 ` a Miscellaneous Maximum AC over current protection Two -pole, 30 A circuit breaker AC wire sizing Use maximum AWG 6 194 °F (90 °C) copper wire ° 3 DC wire sizing Use maximum AWG 6 194 °F (90 °C) copper wire AC disconnect 32 A DC disconnect 40 A ° E H Warranty 10 year Premium Warranty is Standard • Distributed by 1r0/7iL is oA E E Fronius USA LLC A Solar Electronic Division , , 10421 Citation Drive Suite 1100 Brighton, Mi 48116 Phone: 810-220-4414 Fax: 810-220-4424 R. E -Mail: pv- us @fronius.com www.fronius - usa.com Ln N O O O O V - ` i y � . r „, ' ;' ,, ,1 :!" ,,,,,,,,,,, ,, : I., IP,,,,:', ,, .....,...,,,,,,,,,,,,,, , ,,m ,, .. , ,, .. , 0„ . per x ) 1 *1 M 5 k. ,,, a d + ., a y." �' � i aM :: c1 �� r * 4k4 ea w ? 3 \ fie `. ."' i � k w M aR x ..: E -----;: ' .- ttt -,:4, FRONIUS 1G FRONIUS IG GRID -TIED INVERTERS FOR PHOTOVOLTAIC SYSTEMS Light Weight At 42 Ibs, the FRONIUS IG inverters are the lightest grid- connected inverters making them both easy and cost - effective to install. More Energy MIXT" Concept allows your system to output more energy under part -load conditions. Lower Cost Integrated UL approved DC & AC disconnects which reduce installation time and complexity - often eliminating the need for additional disconnects. LCD Display User - friendly and comes standard with every FRONIUS IG; tracks more than 20 critical system performance parameters. Powerful At 4000, 4500 and 5100 watts, these inverters deliver more power output for higher performance installations. Reliable Fronius has been in business for over 60 years and has more than 200,000 FRONIUS IG inverters installed worldwide. Warranty 10 year Premium Warranty. 4D fl/LLS ' POWERING YOUR FUTURE S- 5 ! TM suggestions for spacing of S- 5 ! TM clamps for PV assemblies The following suggestions assume that determination has been made that the roof to which the S -5!TM clamps will be attached is structurally adequate. Any loads imposed on the S -5!TM clamps will be transferred to the panels. Panel seams must have sufficient flexural strength to carry these loads. Panels must also be adequately attached to the building structure, and the structure must be sufficient to carry these loads. The makers of S -5!TM clamps make no representations with respect to these variables. It is the responsibility of the user to verify this information, or seek assistance from a qualified design professional, if necessary. The key to frequency and spacing of attachment points for PV is to distribute loads to the metal standing seam panels in a manner that is consistent with the intended distribution of loads from the roof panels into the building structure. With very few exceptions, the attachment of a single S -5!TM clamp to the seam will be stronger than a single point of attachment of the seam to the building structure. Hence the "weak link" is not the S -5!TM clamp, but the attachment clips that hold the metal panels to the building structure, or the beam strength of the roof panel seam itself. The most conservative approach to the spacing /frequency of PV attachment to the roof is to determine the spacing/ frequency of the roof's attachment to the building structure; then duplicate it at minimum. Determining panel attachment spacing in one axis is very simple: Standing seam panels' attachment will be made using concealed hold -down clips within the seam area of the panel. So, in that axis, the clip spacing is the same as the seam spacing. The location of the clips along the seam (in the other axis) can be determined by a) consultation with the roof system manufacturer or installer, b) checking from the underside or, c) close examination from the topside along the seam. There will usually be P g Y Note: Cl ' ps and k die on ev•, se a slight, but detectable, deformation of the seam at the clip location visible that the frame tr ,erses. from the roof's topside. Many standing seam roofing systems are installed on "pre- engineered steel" buildings. The attachment spacing in that industry is icall 5' -0" and is readily apparent by inspecting the structural purlins tYP Y Y PP Y P g P 4, to which the panel clips are attached from the roof underside (interior of the `� building). t� If the panel clips are spaced, for instance, 5' -0" on center along the seam, then use the 5' -0" dimension as a maximum spacing for the S -5!TM clamps. (S -5!TM clamps may also be spaced at closer centers, but not wider.) When modules are direct attached (without racking) in the landscape orientation, this spacing p t' dimension is dictated by the smallest dimension of the PV frame. Using the x roof panel clip spacing as a maximum spacing template for S -5!TM clamps is a sound practice, whether the PV modules are attached direct to S -5!TM, or to a racking system, which is in turn attached to the S -5!TM clamp (and panel seams). To evenly distribute loads, it is also necessary that each seam be involved in the finished assembly. Thus, every time a seam is traversed, it ,f should be attached. Such an attachment scheme should evenly distribute wind 4 _' loads into the building structure through the panels and their attachment, as was intended in the original roof construction assembly. Please note these are only suggestions. Wind dynamics are complex, and S -5!TM advises review by a qualified licensed professional who understands -.7 M . wind effects and metal roof design and construction. 1a R ev Attach almost anything to standing seam metal roofs without piercing the panel! version 080808 888-825-3432 www ■S- 5 ■coiii S-51.Tm p Un recedented Innovation Unmatched Quality tn Unbelievable Price 'o C Installation Instructions Ti S -5!TM Warning! Please use these products responsibly! Visit our website or contact your S -5!TM distributor for detailed installation instructions and available load test results. The user and /or the installer of these parts is responsible for all necessary PIL engineering and design for the intended use of these parts in an assembly or application. Install clamp. See clamp installation instructions. 1) Place 3" Mounting Disc on the S -5!TM Clamp. Secure Universal PV Stud through the aluminum Mounting Disc (Stainless disc for brass) into the S -5!TM Clamp. 2) -3) Mount frames on top of the Mounting disc. Install the Universal PV Anchor to the Universal PV Stud. Securing the two PV frames (see diagram B). 4) Tighten M8 Hex Flange Nut. Flange Nut tension should be —!`- verified using a calibrated torque wrench between 70 and 100 inch pounds. 5) For end /edge conditions install 1 M8 Hex Flange nut (sold separately), flange side up underneath grab to desired thickness. Break off flange with pliers by bending in to stud then back out. See diagram A. Use the PV Kit -30 for frames with a depth of 1.2" (30mm) to 1.9" (48mm). Use the PV Kit -41 for frames with a depth of 1.6" a �.' (41mm) to 2.4" (60mm). Copyright 2007, Metal Roof Innovations, Ltd. S -5!TM products are patented by Metal Roof Innovations, Ltd. - EndlEdge Condition [diagram A] Field Condition [diagram B] Universal PA Stud _- PV Grab Break an amp o[r-""" ,..': Flange Nuts �,a aaa a n�Re siinin, srrp �� wr toy eaRe hfounting ' 24;" S -S1 Mini Attach almost anything to standing seam metal roofs without piercing the panel! 888-825-3432 www.S -5.com eY "',9IY/' ry evergreens c 1 , Electrical Characteristics Mechanical Specifications Standard Test Conditions (STC)1 PANEL ID LABEL ES -A -200 ES -A -205 ES -A -210 I H 1 1 -fat* fat* -fat* H-- 22 4.9 Pmp 200 205 210 W \° ° pt.... -01 +4.99 -0/ +4.99 -0/ +4.99 W � JUNCTION BOX -. (IP65) �-' 8 0.16 4. - PANEL GROUNDING Prop, max 204.99 209.99 214.99 W SERIAL NUMBER HOLE 0 0 Pmp, min 200.00 205.00 210.00 W r1m;n 12.7 13.1 13.4 % 0 0 Pptc 180.6 185.2 189.8 W (10 AWG. UL47 0 Vmp 18.1 18.4 18.7 V PV -WIRE) Imp 11.05 11.15 11.23 A V °e 22.5 22.8 23.1 V a ° •■ -10x 0.26 Isc 12.00 12.10 12.20 A ID LABEL OR MOUNTING BOLT HOLE Nominal Operating Cell Temperature Conditions (NOCT) } MCm LOCKABLE TNOCT 44.8 44.8 44.8 °C ° CONNECTORS _ ° (TYPE 4) Pmax 146.4 150.1 153.7 W t 0. (-) ( +) ° Vmp 16.7 16.8 17.0 V d CLEAR ANODIZED 4 12x FRAME Imp 8.76 8.93 9.04 A o ALUMINUM FRAME °DRAINAGE HOLE V °c 20.5 20.7 21.0 V - '" % ° 35.9 Isc 9.60 9.68 9.76 A �1.a(+00V0) � 37.5( + / -0.1) ' 1000 W /m', 25 °C cell temperature, AM 1.5 spectrum; All dimensions in inches; panel weight 41 Ibs ' Maximum power point or rated power ' At PV -USA Test Conditions: 1000 W /m', 20 °C ambient temperature, Product constructed with 114 of c stalline silicon solar cells, anti - reflective 1 m/s wind speed p y rY ° 800 W /m', 20 °C ambient temperature, 1 m/s wind speed, AM 1.5 spectrum tempered solar glass, EVA encapsulant, polymer back -skin and a double - walled 'f-framed, a -low voltage, 2 -matt blue (textured) cells anodized aluminum frame. Product packaging tested to International Safe Transit Association (ISTA) Standard 2B. All specifications in this product information sheet Low Irradiance conform to EN50380. See the Evergreen Solar Safety, Installation and Operation The typical relative reduction of module efficiency at an Manual and Mounting Design Guide for further information on approved installa- irradiance of 200W /m' both at 25 °C cell temperature and tion and use of this product. spectrum AM 1.5 is 0 %. Due to continuous innovation, research and product improvement, the specifica- tions in this product information sheet are subject to change without notice. No rights can be derived from this product information sheet and Evergreen Solar Temperature Coefficients assumes no liability whatsoever connected to or resulting from the use of any a Pmp 0.45 %/ °C information contained herein. a Vmp -0.43 %/ °C Partner: a Imp -0.02 %/ °C a V °c -0.32 %/ °C a Isc - 0.003 %/ °C System Design Series Fuse Ratings 20 A Maximum System Voltage (UL) 600 V s Also known as Maximum Reverse Current. Q ELECTRICAL EQUIPMENT ES -A 200 205 210 US 010908; effective September 1st 2008 CHECK WITH YOUR INSTALLER Worldwide Headquarters Customer Service - Americas and Asia 138 Bartlett Street, Marlboro, MA 01752 USA 138 Bartlett Street, Marlboro, MA 01752 USA Evergreen Solar, Inc. T: +1 508.357.2221 F: +1 508.229.0747 T: +1 508.357.2221 F: +1 508.229.0747 www.evergreensolar.com . info @evergreensolar.com sales ®evergreensolar.com evergreensoiar Think Beyond. ES -A SERIES 200,205 &210W photovoltaic panels Best power tolerance available A range of high quality String Ribbon' solar panels offering exceptional performance, cost effective installation and industry- leading environmental credentials made with our revolutionary wafer technology. • No power below nameplate Never pay for power you're not getting • Get up to 5W more than nameplate* ( For enhanced field performance • Industry's lowest voltage per watt rating Delivers the most cost - effective installs • UL4703 certified cables For use with the highest efficiency transformer -less inverters • New extended length cables Eliminates home -run wiring • New MC® Type 4 lockable connectors ** Complies with the latest codes for accessible arrays • Most extensive range of mounting options Allows installs virtually anywhere and anyhow • Smallest carbon footprint of any manufacturer For the greenest of the green • 100% cardboard -free packaging Minimizes job site waste and disposal costs • 5 year workmanship and 25 year power warranty* ** *Maximum power up to 4.99 W above nameplate rating; * *Locking sleeve not supplied with the panel. ** *For full details see the Evergreen Solar Limited Warranty available on request or online. This product is designed to meet UL 1703, UL 4703, UL Fire Safety Class C , IEC 61215 Ed.2 and IEC 61730 Class As standards. String Ribbon is a trademark of Evergreen Solar, Inc. Evergreen Solar's wafer manufacturing techn is patented in the United States and other countries. PERPENDICULAR VIEW OF THE EASTERN ROOF 1 32' - 0" r r 26-0" SKYLIGHTS . // / i N Ch / / / ' ' / " ' - . A 0 1 j [1 19'-7" 1 22' -3" SYSTEM SUMMARY DRAWNG TRLE SunRun Photovoltaic Array Lay out C 5.04 kW (DC) at Standard Testing Conditions a to ri s 24 Evergreen ES -A -210 PV Modules CUSTOMER DRAW" 1 Fronius IG- 5100 Inverter CAR RENEWABLES UniRac SolarMount Racking System THE VON GOELER RESIDENCE SCAL 3/18- = r o" (LETTER) 21 Roe Avenue DATE DRIDNAL Roof Pitch (Module Tilt) = 18° Northampton, MA 01060 9/8/09 ALTERIS RENEWABLES, INC. 17 Burnside St., Bristol, RI 02809 Module Azimuth = 215° Magnetic DATE REVR�or� 9/9/09 P (400 ase-eso' - F: MOD Sae -reo2 • ACORD CERTIFICATE OF LIABILITY INSURANCE 2 /16 /2o 9 PRODUCER (860) 928 -7771 FAX: (860) 928 -7144 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Gerardi Insurance Services Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 16 Pomfret St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Putnam CT 06260 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A.ACadi.a Insurance Co 31325 Alteris Renewables Inc INSURER B: aka Solarwrights Inc & Solar Works Inc INSURER C: 17 Burnside Street INSURER D: Bristol RI 02809 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. IPOLICY POLICY EXPIRATION R JNSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YY) DATE (MM /DD/YY) LT R INSRD LIMITS LT GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISE occu ED $ 100,000 A CLAIMS MADE X OCCUR CPP0241356 2/1/2009 2/1/2010 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE _ $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY JEC LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X 1 ANY AUTO (Ea accident) $ 1,000,000 A ALL OWNEDAUTOS CAP0241357 (CT & RI) 2/1/2009 2/1/2010 BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS MAA0249941 (MA Auto) 2/1/2009 2/1/2010 BODILY INJURY (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 X OCCUR CLAIMS MADE AGGREGATE $ A DEDUCTIBLE CUA0241359 2/1/2009 2/1/2010 $ RETENTION $ $ A WORKERS COMPENSATION AND TORY LIMITS O ER EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICER /MEMBER EXCLUDED? WCA0241358 2/1/2009 2/1/2010 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Alteris Renewables Inc EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AKA Solarwrights & Solar Works Inc 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 17 Burnside St FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Bristol, RI 02809 INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE � p Matthew Desaulnier i'/ J .�/( ACORD 25(2001/08) © ACORD CORPORATION 1988 ItdCfl E ,ninog no., Pnno 1 of9 4. The Commonwealth of Massachusetts Department of Industrial Accidents ' iri Office of Investigations 600 Washington Street Boston, Mass. 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual) : //( `ii` 1 ( f-E /1/6 l;' / � ' t .. `� i 14' f % • 1 f 11 - »' Address: 1C t,, c, / (/ .) y City /State /Zip: -- > i f (_ I- / /1 l /F c ` i I ,' / Phone #: ' / / .. t / / c i s_) i' Are you an employer? Check the appropriate box: Type of project (required): 1. I am an employer with -/ 1 , 4. 1 1 am a general contractor and 1 6. New construction employees (full and /or part time).* have hired the sub - contractors 7. Remodeling 2. J 1 am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub - contractors have 8. 1 Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance. $ required] 5. 1 We are a corporation and its 10. l Electrical repairs or additions 3. 1 I am a homeowner doing all work officers have exercised their 11. 1 Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4), and we have no 12. 1 Roof repairs employees. [no workers' 13.y, Other •`" Cs r ' F ,, «/ c. comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contactors that check this box must attach 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: /k ( '' rl <I ik', , c ,. /i , ;t'' C' Policy # or Self -ins. Lic. #: r( '('/+ t ,•.. / / ( ' '. Expiration Date: ? Ji k)(' ( % ( Job Site Address: .2/ t i E /-f L c / City /State /Zip: 0 , /` /7/.0 ti » ' r Ci ' , A 1 / (7 ( ( `' 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 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 $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby ce ' under the pains and penalties of perjury that the information provided above is true and correct. C_ Signature: , `, ti ) Date: c j Print Name: A I r C 1 u • / (C ( i t.. ,, ;, i Phone #: ;/ ' 1 ' / i `,, I,. 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 Heath 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact person: Phone #: c N al O O O O Co • m Z z 'giQ / • '/ 1I • 4'f m I m 1 ntl Board of : uild • egula ons and Standar+ s ! m u - One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 163252 Type: Individual Expiration: 5/27/2011 Tr# 284599 ROBERT N. JENEN _____ _ _ __ __ _ ROBERT JENEN P.O. BOX 158 HOUSATONIC, MA 01236 - Update Address and return card. Mark reason for change. Address 1 Renewal 1-- Employment E Lost Card DPS -CA1 0 40M- 08108- DBSLIFORMCA108212008 ✓2e Commo r Jf /Cris !Ck ee& Board of Building Regulations and Standards A _ License or registrat valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Iv I 0 u Registration: 163252 Board of Building Regulations and Standards One Ashburton Place Rm 1301 °O Expiration: 5127/2011 Tr# 284599 Boston, Ma. 02108 N Type: Individual ROBERT N. JENEN ROBERT JENEN 1066 MAIN ST C,._ ! HOUSATONIC, MA 01236 Administrator Not valid without signature j Boar of $uYlding `EeguYii anc Stpmier■s • Construction Supervisor License License: CS 81308 Expiration: 2/4 /2010 ty "72J7 Restriction: 00 ROBERT M JENEN PO BOX 158 _" HOUSATONIC MA 01236 Commiss■onrr SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ f ) a J ' ' ._ 11.-, '.'/V 7 (- ( / Name of License Holder : ( iL _ � ;-, t`f %� - s� C /3 / i � /, � /�� , /1 NV i , License Number /)1" c : - , - - , - e-,K , ( =' (f rr , / / r ) /tr/ ' 1 - / - �) / < ` ///2 C' / Address f `` / � Expiration Date Signature L ' Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ i � r� , / rt/c /v , r / <'/rY/ /r ii. /,_ /` Iii /- ;'r «!t , (1 / C/' :: -4 Company Name / Registration Number Address / Expiration Date if _. ��.� Tele ' / / ` ,° 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. I Signed Affidavit Attached Yes3, 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 • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [p Siding [0] Other] -. /i z (..f? r )(; v t' . t i- t_' / : /a/L� i F, \i S � Brief Description of Proposed Work: / A . - " ;/ / t j t C / ' ✓) it. 11,- £'iL °: (["f - • Alteration of existing bedroom Yes No Adding new bedroom Yes ,. No � Attached Narrative Renovating unfinished basement Yes 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 'c /) /t 1 `K , as Owner of the subject property hereby authorize Ail ( 7,. /;'C - t ' / f t, /fi to act on my behalf, in all matters relative to work authorized by this building permit application. 1 -ye ��'J- 14L,.l�r ( 4 G', Signature of of Owner Date I, C`t /(1 Z it f c 'c' i� (1 t / , i /Ci t. A. t 37"\ / / /: k /UL- /z4 /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. Print Narpe , 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 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 Special Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? ! I r NO 0 DON'T KNOW 0 YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW O YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained © , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES © NO XD' IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, x vation, 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. Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability Room 100 WaterNVell 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, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: tt / s 1i; A 6 "':,! t" J ^E /i f f� ` /t /// 111x -i`ti ( Name (Print) Current Mailing Addres : . : _ - Telephone e Sign ure 2.2 Authorized Agent: -1( Fr �;' /' -/ �i , F - ; ! P r, f-- - >'v`� i � h i ' t C `� Y t" ! :':ac . r '%! ': / � f'`r "C... / j 1 /l Name (Print) / Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building , (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 +3 +4 +5) /, *;. ;! , , j' Check Number // J ter Itfi -- This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2010 -0558 APPLICANT /CONTACT PERSON ALTERIS RENEWABLES INC ADDRESS /PHONE P O BOX 51924 SPRINGFIELD (413) 734 -1456 PROPERTY LOCATION 21 ROE AVE MAP 24A PARCEL 144 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out / /�j - ) / // - Fee Paid d / �j / � Typeof Construction: INSTALL SOLAR PANELS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 81308 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: l` Approved 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 Demolition Delay 2 ?o Signature of Building 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. a en RENEWABLES BUILDING INSPECTION APPROVAL FORM Permit #: Name: Dorothea Von Goeler Address: 21 Roe Ave. Town /State: Northampton, MA Description of Project: Installation of roof mounted, grid -tied 20kW photovoltaic system. Date of Inspection: a-/ /0 Inspector Signature: 2-121 0 Name Date Please fax signed form back to Alteris Renewables Inc. at 440 - 445 -4054 Thank you! Alteris enew=abtes Inc. Western Massachusetts Regional Office: P.O. Box 51924 Springfield, P44. 01151 Tel: (413) 754 -14 56 Fax (440) 445 -4054 www.aiterisinc.com 2L AYE BP- 2010 -0558 GIS #: COMMONWEALTH OF MASSACHUSETTS =`; • �: �}` "` CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -0558 Project # JS- 2010- 000784 Est. Cost: $18571.00 Fee: $114.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALT.ERIS RENEWABLES INC 81308 Lot Size(su. ft.): 15420.24 Owner: LINDENAUER PETER K & DOROTHEA S VON GOELER Zoning: URA(100)/ Applicant: AL'I`ERIS RENEWABLES INC AT: 21 ROE AVE Applicant Address: Phone: Insurance: P O BOX 51924 (413) 734 -1456 WC SPRINGFIELDMA01151 ISSUED ON:12/10/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SOLAR PANELS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: f% 7/ o p Meter: / �`�' Footings: Rough: Rough: House # Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: _, Final: Smoke: Final: 40K 2-1 (c 4 i5 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 12/10/2009 0:00:00 $114.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo