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25C-251 (44) Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional • W for,work per the 8 edition of the \ s ve I Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: Date: Three County Fair Rooftop Solar 1 -16 -2013 • Property Address: 54 Fair St., ( P.O. Box- 305) , Northampton, MA 01 Project: Check (x) one or both as applicable: Renovation to Existing Construction Project description; Installation of Photovoltaic Rooftop Solar System I, Allison Kimball, MA Registration Number: 49826 Expiration date: June 30, 2014, am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': Entire Project Architectural Structural Mechanical Fire Protection X Electrical Other: for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. , OF ,g gss Enter in the space to the right a "wet" or 4 �` electronic signature and seal: .a ALLISON D. 0 No. 4982£ oo F Phone number: (732) 894 -5061 Email: AKimball @kmbdg.com S SioNALe\ t; Building Official Use Only Building Official Name: Permit No.: Date: Note 1. Indicate with an `x' project design plans, computations and specifications that you prepared or directly supervised. If `other' is chosen, provide a description. Trial Version 10 09 2012 R.J. Farah Engineering STRUCTURAL DESIGN AND CONSTRUCTION CONTROL AFFIDAVIT To the Building Commissioner: • I hereby certify that, to the best of my knowledge, information and belief, the design plans, specifications, and computations concerning the project: Inverter Platform Three County Fair North Hampton, MA 01060 are in accordance with the requirem nts of the Massachusetts State Building Code. • in addition, I hereby certify that I, or my authorized representative, in accordance • with the requirements of the Massachusetts State Building Code, will perform construction observation of the work associated with the above referenced project. . y 4 Y Rachid J. Farah PE - 45180 Engineer - Reg. No. R J Farah Engineering Inc. Company n- 80 Montvale Ave, Suite 201 Stoneham, MA 02180 r `• Address f Chet _ 617- 645 -0901 _._.- Telephone n.w Commonwealth of Massachusetts County of On this the 5th day of February, 2013, before me, Kerry Aquino, the undersigned Notary Public Name of Notary Public Personally appeared Rachid J. Farah Name(s) of Signer (s) Proved to me through satisfactory evidence of identity, which was /were Personals Known to me , Description of Evidence of Identity Signature of Notary Public ,, "`'�I('4 Kerry Aquino, °` Printed Name of Notary # : r `• v My Commission Expires 1 /3/2014. ! 11t:4.914l ;�Ftil ;:p�t'� *,‘;i � ^ , L etter of ' �~��K.K~�~n �*� � n ��n n~on n n � K.K.��� Date: Jonuary 16, 3013 � � ~ Re: Three County Fair- Northampton, NW` ��nQ���~��~������� Rooftop Solar Project i S/nor/So�/�� � on �anA�erno�ves r ���� From: Bob Ricked Attn. Louis Hasbrouck Commercial Project Manager Building Commissioner GeoPeak Energy LLC Cool /0 0 285 Davidson Ave., Suite 101 hampton, MA 01060 Somerset, NJ 08873 (413) 587'1240 Phone: (732) 377-3700 Fax: (732) 377-8832 ____ Description Pages WE ARE PROVIDING YOU: 1) Check for Permit AppLication Fees #281 25 PV'1.0,3.0 Z'1.0 E4.0,3'0,3.0 (1) Set of GeoPeak Energy Permit Plans 7.0,9.0,11.0,12.0,13.0,13.1,13.2 Drawing (19-Pages) S' 1.0L1.1 ( Application for Commercial RuidngPermit Dated 1/18/3013 5 pages (1) Workers' Comp Insurance Affidavit ! 1 page (1) GeoPeak Energy Certificate of Insurance 1 page (1) Sub-Contractor List 1 page ( Certificate of Insurance State Electric Corp. 1 page • ' , . | COPY TO: SIGNED: + ^ _ — GeoPeak Energy • 285 Davidson Ave., Suite 101 • Somerset, NJ 08873 • Phone (732) 377'3700 Sub — Contractor for Three County Fair Rooftop Solar Project State Electric Corporation 24 Torrice Drive Woburn, MA 01801 '4` °R0 CERTIFICATE OF LIABILITY INSURANCE iii6i2ols ) 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 Julie Routhier NAME: HONE Cleary Insurance, Inc. (A /C. No. Ext) (617)723 -0700 FAX No): (617)723 -7275 226 Causeway Street ADDRESS: PRODUCER 00016091 CUSTOMER ID #. Boston MA 02114 -2155 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A :Insurance Co. of Pennsylvania 13889 !mums BNational Union Fire Insurance 19445 State Electric Corporation INSURER C : 24 Torrice Drive INSURERD INSURER E : Woburn MA 01801 INSURER F : COVERAGES CERTIFICATE NUMBER:2012 -13 , Liability 9/09 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 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500 000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ A CLAIMS -MADE X OCCUR GL 650 - - 4/1/2012 4/1/2013 MED EXP (Anyone person) $ 25,000 PERSONAL B ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 1,000,000 X ANY AUTO A ALL OWNED AUTOS CA - 650 - - 4/1/2012 4/1/2013 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) X NON -OWNED AUTOS $ _ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 10,000,000 DEDUCTIBLE $ B RETENTION $ BE 020701830 4/1/2012 4/1/2013 $ A WORKERS COMPENSATION X TORY LIMITS T ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y / N E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N / A 4/1/2012 4/1/2013 (Mandatory In NH) WC 003 - - 6821 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) SEC Job# 13005. 3 Country Fair project. CERTIFICATE HOLDER CANCELLATION (732) 377 - 8832 rrickerl @geopeakenergy. com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN GeoPeak Energy, LLC ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Bob Ricker/ 285 Davidson Ave. AUTHORIZED REPRESENTATIVE Somerset, NJ 08873 Julie Routhier /JAR L� — ACORD 25 (2009/09) ©1988 -2009 ACORD CORPORATION. All rights reserved. INS025 (2oogog) The ACORD name and logo are registered marks of ACORD • • � GEOPE -1 OP ID: JK • A °R CERTIFICATE OF LIABILITY INSURANCE DA 0 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 POUCIES 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 poiicy(ies) must be endorsed. If SUBROGATION 15 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). T.E. A PRODUCER Agency, Inc. P hone: 732 - 246.1330 KE 13 Roa Su 202 Fax: 732- 248 -3715 az Ex : I FAX No): House Account INSURER(S) AFFORDING COVERAGE NAIC t INSURER A: Peerless Insurance Company 24198 INSURED GeoPeak Energy, LLC memo :New Jersey Casualty Comp 285 Davidson Ave, Ste 101 Somerset, NJ 08873 INSURER C: INSURER!) : INSURER E : ---- -- -- _ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL BUM POUCY EFF POLICY EXP LTR TYPE OF INSURANCE PER WVD POLICY NUMBER IMMIDDIyYYy) IkaUDINTYYY) LIMITS GENERAL LUIBIJTY EACH OCCURRENCE f 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP4633800 09/30/12 09/30/13 DAMAGE TO RENTED PREMISES . , s 1 00,000 CLAIMS -MADE I X OCCUR MED EXP (My one person) $ 5,000 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM AGGREGATE UNIT APPUES PER PRODUCTS - COMP/OP AGG 1 2,000,000 7 POLICY J I] LOC Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY CEOMBaccid ; INGLELIMIT $ 1,000,000 A ANY AUTO BA4650025 09/30/12 09130/13 BODILY INJURY (Per person) 8 ALL OWNED Al1T SCHEDULED BODILY INJURY (Per acddsnt) S X HIRED AUTOS AUTOS NON-CWNED (P aceldent) s $ tRreRELLA LIAB X occuR EACH OCCURRENCE _ $ 10,000,000 A 1 EXCESS LAB CUUMS -MADE CU8806346 09/30/12 09/30/13 AGGREGATE = 10,000,000 DED 1 X 1 RETENTION $ 10,000 $ WORKERS COMPENSATION I AND EMPLOYERS' MOSEY Y / N ITORY L WI IMITS J 13 B ANY PROPRIETOR/PARTNER/EXECUTIVE ( N 1 A M50014 -0-12 01/15/12 01/15/13 EL EACH ACCIDENr s 1,000,000 OFFICERAYEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 DESCRI OPERATIONS below EL DISEASE - POUCY UNIT $ 1,000,000 C Equpment Breakdown MAC 0311239 09/01/12 11/01 /12 3,916,920 Deductibl 5,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Sefiadula, I mere spans Is ,squired) CERTIFICATE HOLDER CANCELLATION LOREAL3 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE n C 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD • The Commonwealth of Massachusetts �- �� Department of Industrial Accidents 1r =, i Office of Investigations ii. -' , 1 Congress Street, Suite 100 ' Boston, MA 02114 -2017 .'-•��•�' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information Please Print Legibly / } Name ( Business /Organization/Individual): C.. t ?Z) f E� t C .-- Ai 6 r1 6> L L Address: S'.3 yg j/ / 11,$ 4 I / t/ g' City /State /Zip: S' 0 h� c= /7 S e r'/11 Phone #: 7 2 — 3 7 7— 3 7e) 6 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. Nam a general contractor and I employees (full and/or part- time).* ave hired the sub - contractors 6. 0 New construction 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.$ 9. ❑ Building addition [No workers' comp. insurance p 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 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no 13 Other 04 yO employees. [No workers' comp. insurance required.] S Q 4 -14 iz- *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. tContractors 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: t 14 7 4 C r i e ( 7 f , / C i4 '% Policy # or Self -ins. Lic. #: C /" J/ts ti /? 4 .4 oA-Hate: ,3 C o 0 A., T 7 - e4 ' 1L. / .� f / Job Site Address: )4 17 e "i /1 EL 0 A — 61 4 len /Or ?/ ity /State /Zip: %/a / / /M, 'Orr a/D 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 hereb certify under th ' . ' s a �; pe , ties o per'ury that the information provided above is true and correct. Signature: r ... IDate r Phone #: 7 .. g ' 7 7 7 O 1) k : 3 ®/ V Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Version1.7 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 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, [ .T _1' V-C Ti.. 5 W _ (. t, L ,1 ` ___.__ _.. __- ____ I, as Owner of the subject property hereby authorize L.____ _._ ___C 0 _ __ - -_ 111:f __.. _.. i _ e_. - � .__. _._ _Jto T act on my behalf, in all matters relative to work authorized by this building permit application. /14.4.1-11(41,--e-444--rie 1 Signat e of Owner Date I, ._____ �� _� i ._f .' / _._�_ __C , asOwner /Authorized o/ — 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 ' • znalties of ry. 1 i i Print Name ,�j &. i L., 4..' - e i" i L /— /‘ -' /.. 1 Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES I 10.1 Licensed Construction Supervisor: Not Applicably N _ Name of License Holder : L ...— _______— _ _ .i L I __ _ ___ ..__._____ ___ __ - ._ _ w____ __. -._._. License Number Address Expiration Date Signature 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 o t e b 'Iding permit. Signed Affidavit Attached Yes No 0 • Version1.7 Commercial Building Permit May 15, 2000 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 SPACE) 9.1 Registered Architect: (( _ Not Applicabl Name (Registrant): L_ _..__.._ Registration Number Address .__ __ i Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility ._. ',l C = H_%. j ) . C . _ _ _ _ r 1 1 ! . r ? c ' 61 c . - ) 4 _ ? C. ---. Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility r _ Address Registration Numbe Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor L' C i Not Applicable ❑ Company Name r! - fc'Il C.r T: "1 x [ Responsible In Charge of Construction i __ E . 5-.DA_l. l till_i4'1/e Sr c"4. L' �- Address i / D 7 r Al Signature Telephone Si 2 /7 'y Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs 0 Demolition 0 Repairs 0 Additions 0 Accessory Building 0 Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use 0 Other 0 Brief Description 'Enter a brief description here. I Of Proposed Work: , goo F "tocuJwi) c60412, kg Rikel A ketA Ba) ct, L._ j SECTION 5- USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A-1 0 A-2 0 A-3 0 1A 1 0 0 A-4 0 A-5 0 1 B 0 B Business 0 2A 0 E Educational 0 2B 0 F Factory 0 F-1 0 F-2 0 2C 0 H High Hazard 0 3A 0 1 Institutional 0 1-1 0 1-2 0 1-3 0 3B 0 M Mercantile 0 4 0 R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S Storage 0 S-1 0 S-2 0 5B [ 0 U Utility 0 Specify: M Mixed Use 0 Specify: — ---- S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE Existing Use Group: L --- 1 Proposed Use Group: I I L Existing Hazard Index 780 CMR 34): L___ _ __. _ _ ___ Proposed Hazard Index 780 CMR 34): L SECTION 6 BUILDING HEIGHT AND AREA I BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 3 8 9i Cerri k P- e P f ---rt) S 0 1-4 A, f e / ii 0eto 4 'Z oft...effo co r . 1 St , 4 St ' 2nd 1 2nd 1 r 3 3 4 1 1 4th[ Total Area (sf) 8 9, ity a k Total Proposed New Constru4prilsi) i rA) ed 0 q#44 ... Total Height (ft) i ..5 6 : Total Height ft 2,..i i 0 ' ( 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone information: 7.3 Sewage Disposal System: Public 0 Private 0 Zone r_ _ Outside Flood Zonetk Municipal 0 On site disposal system0 ' --z-- - — Versionl.7 Commercial Building Permit May 15, 2000 . \ \ JAN 2 2 2013 City of Northampton , ,..' 4° 17 4 4 4 , 1°", 444 , 1 4 414 2 1 ' '''' '''` ' ' ' t , ' - ' Pl ° "; ;:r - ' A, .4 ',', '' : ) -440:47TO , Building Department 212 Main Street DEPT CF Lu, ,, TH 'VPTON mA 01060 Room 100 4;4- 0,.. 4 '4 . 14 1' ,-,..*,. , ' , "0*,` Northampton, MA 01060 L: 'r :' - F „ ''.. '1,4 7:0441#4 --ww.tovi.!ikki• phone 413-587-1240 Fax 413-587-1272 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 r) .---4 1.::4 , 77 This section to be completed by office 1.1 Property Address: - 1 H 12 &-"&" k et 1 1 . r r , , I PI Fii 7 ( / /7 s' - 7 et, 2 IA 3 As I Map Lot Unit 1 , 0 rzr Overlay District 1 A- - ff yl mgren -) AA 12 / 06 0 l 1 i i Elm St. DIsaict CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 1 d kir/ s H 1 p t; /Iztov e ti iti - r )4 om timAit , 1 Name (Print) 1 4 6 2' ii.,,1 40(itce7-7( Current Mailing Address: Signature a ■ .. _ Alli."..- --..... Telephone if 3 —$7 1 2 07_, 2.2 Authorized Aaent: ' i --., [ C.._c r ,-. £ (Gie6- 6* x ti-e- C -2 eFs) ',I.! j4kie--Sai 1 /di Name (Print) ,62 12 it , fr, , C_ — r /ter Current_Mailin Address: PAme / d P g *7 1/ ,... ..-- Signature 0 1111111111 11■. / , Telephone 7I --- z./ 70-- .5 r 4 2_ milf -- --, f SECTION 3- ESTIMA v 1 CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building / 6 6 z , 60 .._----- (a) Building Permit Fee I I — --r— — - - — - — 2. Electrical --- (b) Estimated Total Cost of jrJ 1) " . Construction from (6) _ 3. Plumbing ; / 0 1 Building Permit Fee [ 4. Mechanical (HVAC) 1 5. Fire Protection C) , _J 6. Total (1 +2 + 3 +4 +5) oy i 9 t" ,0,0 0 , --- Check Number 90 / Of C.) cif cQjq 9y /This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date r J � 1 Q �, �"�.o O File # BP-2013-0710 p,J• 1 NSZ P- 10 APPLICANT /CONTACT PERSON GEOPEAK ENERGY LLC ADDRESS/PHONE 285 DAVIDSON AVE STE 101 SOMERSET (215) 470 -5362 j 0 kW: :-- PROPERTY LOCATION FAIR ST - FAIRGROUNDS MAP 25C PARCEL 251 001 ZONE SC(100)/URB(1)/ ( ! 1- 3t3 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid �/ �2� hia , 2- Building Permit Filled out t d Fee Paid Typeof Construction: INSTALL ROOF MOUNTED SOLAR ARRAY ON ARENA BLDG New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: A 414e4- Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOR ATION PRESENTED: pproved 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 - 2A/3 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. FAIR ST - FAIRGROUNDS BP- 2013 -0710 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C - 251 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- 2013 -0710 Project # JS- 2013- 001176 Est. Cost: $488000.00 Fee: $2928.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GEOPEAK ENERGY LLC Lot Size(sq. ft.): Owner: HAMPSHIRE FRANKLIN & HAMPDEN AGRICULTURAL SOCIETY Zoning: SC(100)/URB(1)/ Applicant: GEOPEAK ENERGY LLC AT: FAIR ST - FAIRGROUNDS Applicant Address: Phone: Insurance: 285 DAVIDSON AVE STE 101 (215) 470 -5362 SOMERSETNJ08873 ISSUED ON:2/6/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL ROOF MOUNTED SOLAR ARRAY ON ARENA BLDG 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 2/6/2013 0:00:00 $2928.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner