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30B-101 (3) 04/10/14 04 : 20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pg 8/16 OUN!i`> ATT i.SOLOTION Property Owner Consent Form Owner: James Stokes-Buckles Address: 101 Milton Street Town: NorthaKnpton State: MA Zip: 01062 Phone: 413-230-7977 I hereby give permission to Megawatt: Energy Solutions and their representatives to pull the required permits for a solar installation on my property, rotperty Owner Dat Megawatt Energy Solutions, LLC P,O.$ox 23437 Providence, RI 02903 04/10/14 04:20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pgl6/16 c wN N w i �i�im 4y0j 1 I III II I I u { yJ � W IQf U2 t2 A . W O t I^ x Z I I I ryII � i0 $i'4id �� mx�gr SS E ' �Im. li iZ i o�U is I 2�!©iR Zii(� I tl O e( ! ;-al.Q r ai � III III II�� II I I i pp !F 7i j C!! t m x i ,7iy ix x�� I' '�I LLLLLLS55!llFtt N N �i c Diu Q f i i t i�i i i = j Nijii� 3i 1 71>i>1 ij�i• eo-aorlaz uuoul ao•{Ixppu�M4�IIN 19NV oo[wl 04/10/14 04:20PM EDT Megawatt Energy Solutions Town of Northampton 413587127 2 Pgl5/16 x I af (Do J§-8 , 0 C) BA WWI/, LU. aFFFM Si aL.LL fn 151 id z II li ------------------------- § d2 nw, g .1 NO- x A 1 011 Inn'! gill Vail � m d ,gig v 04/10/14 04:20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pg14/16 J Q Job�; ®e W p a d �� 'I�� I I '��IBINx:�.III,'iPRII3A94�SIiRI -,�hl��^ I� 18{8i8IN«88� I INiF I � ��-�- i I ( I , I I ( I I i .,Z li9go� k,.f12 �oCll li�iffi � i� '' � � ��� I ���• ,�; ��,��� �{ ��'��' ����! �'� `��'��� �'��'�� ISC iii i rn psi iii I I $'. 2S ja •. 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L � � .0 nm ©" 'r t.e.evv vvveve•••:•a-•-vev 1 Q 014Pt19L lMI 00'L{x OT14)90.g9Ill IRW ULM 04/10/14 04:20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pg13/16 c o N p® vnp.. 8 � � �� � LU, m> 4 m � A � o go � �?� r LL 40 �S � �Lq CL �N v UZ Z a Z W T b g O U �2 r b ® W b "c �m C7 Z „ F $ EA s 04/10/14 04:20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pg12/16 W 8 -� L.LI g�_ r : R CL � m � a �y o alip ; LL t N \ � d � � x z n ao-luar •wwi aoz x oc«a w•ie ud ierry ooro 04/10/14 04:20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pgll/16 C ICY a � ton c ff wj LU o y z t - r T1717.11 N N W z C/) = . fill I isA u A � ch �, � -,fit �� ��b , � r cJ v,ri W n ec of d N of '^ ri W C EEL ag ^ A tl7 2 eao•r�oc wwooaixoor�avwonn�ioK+ ooaro 04/10/14 04 : 20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pg 3/16 Department of Industrial Accidents Offitce of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractolrs/Electrlcians/Plumbers Applicant Information Please Print Legibly Name (Business/organizatioivindividual): Address: gg P�ti City/State/zip: 2 D U iv e c"ce Phone#: f$g' 6 3`/ 4 9(3,6 Are you an employer? Check the appropriate boar: Type of project(required): 1.El I am a employer with 4. E) I am a general contractor and I employees(full and/or part time).* have hired the sub-contractors 6. []New construction 2.❑ I am a sole proprietor oxpartner - listed on the attached sheet. 7. El Remodeling ship and have no employees These sub-contractors have g, E]Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insuranee.t s• Building addition required.) 5. 0 We are o corporation and its 10.0 Electrical repairs or additions, 3.Q I am a homeowner doing all work officers have exercised their 11.L)Plumbing repairs or additions myself. [No workers' camp. right of exemption per MGL 12.[J Roof repairs insurance required.]t c. 152, §1(4),and we have no l 3 Offer (� employees.[No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t90 meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must subunit 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. It 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: 13,E,4 ca iv M.Jr09 6 _'AJ502,4MGc_ C0 Policy#or Self-ins.Lic,#: 0000 d 90,576�e� Expiration Date: © % /p/ �"d,v S Ci /State/Zip: 10455 01C7G;Z J'°b Site Address: � ty 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 imprisorunent,as well as,civil penalties in the forrm of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify under the pains and,penaltim ofperju y that the information provided above is true and correct. Signature' f y' 'i^�` - f-t Date: t � ?° r Phone#' 8 �' 2 9 a S' - Official use only. Do not write in this area, to be completed by city or town official City or Town:_ Permit/License# Issuing Authority(circle one): [I. of Health 2,Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector Person' ___ Phone#: - _ 04/10/14 04 :20PM EDT Megawatt Energy Solutions —> Town of Northampton 413587127 2 Pg 7/16 SECTION 8-CONSTRUCTION SERVICES Licensed Construction Su Not Applicable £ Name of Lictnaaliatdar License Number `oZ ac t l [A - 7-' C$Plq-OS'2/8 9 Address Expiration Date, Fa,"�� ��'.� AMSS d 2c931' Signature Telephone oc,R�,. m :o - 4�f M Not Applicable £ Company ame Registration Number 9 q ov0mIVi D/Z- pitoV f (2)29 (!):3 Address Expiration Date 62,§26C(6SECTION 10-WOtKEt S'COMPENSATION INSURANCE A F,IDgO4 �) Workers Compensation Insur'ance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result In the denial of the Issuance of the building permit. Signed Affidavit Attached Yes. ... £ No...... £ l£ � �• C V 2 'H The current exemption for"homeowners"was extended to include Owner-occu led Dwellines of one(1) or two(2)families and to allow such homeowner to engage in individual for hire who does not possess a license,provided that the er act as supervisor.CMR 780._,Sixth Edition Section 100-3-5-1. Definition of Homeowner:person(s)who own it 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 Deis who constructs more than a home Ina o-year period she e c nsidered s ho wne . Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shill be Us p qnsipJA fQr all such work VerLormodjugdcr the building a t. As acting Construction Sugervi your presence one 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 m AXke na a 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 ofMaseachusetts General Laws Annotate d. Homeowner Signature, 04/10/14 04 :20PM EDT Megawatt Energy Solutions —> Town of Northampton 413587127 2 Pg 6/16 SECTION 5-DE OE;[0ROPOSED WORK'(check 81l aygllcable)' New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Poors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [q] Decks [Q Siding[d] Other[9 Brief Description of Proposed r dl�� Work: O' Alteration of exieting bedroom Yes No Adding new bedroom_ Yes No Attached Narrative Renovating unfinished basement _Yes �}�j No Plans Attached Roll -Sheet teks hhoiilc�"m ems' ,+ fBYi ' `r�i"c: a. Use of building:One f=amily_� 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 constr ion, menslons e. Number of stories? f. Method of heating? ireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of canetructlon I. Is construction within 10 of wetlands? Ye No, Is construction within 100 yr, floodplain Yes_-___,No j. Depth of basem or cellar floor below finished grade k. Will bull ' conform to the Building and Zoning regulations? _ Yes No. I. S c Yank City Sewer Private well City water Supply SECTION 7a�OWNER A0TKORI7ATION:-;TO,BE COMPLETED:WHEN' .0 WNES AGENT,OR CONT"CIOR-APOOtS"FOR.BUILDING PERMIT .,T I ,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 i as Own er/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 Name Signature of Owner/Agent Date 04/10/14 04 :20PM EDT Megawatt Energy Solutions —> Town of Northampton 413587127 2 Pg 5/16 Section 4, ZONING Alt Information Must Be Completed,Permit Can Be Dented Due To incomplete Information Existing Proposed Required by Zoning lliis oolurnn to be filled in by Building Department Lot Size Fronts o �� Setbacks &qnt rr�-'�-�� � Side L:1_...�1 Rftj LE R:[Zl 1, , Building Height Bldg.Square Footage �'� % Open Space Footage (Lot ar°a minus bldg&paved akin 0 o Parking Spaces }1 Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON7 KNOW 0 YES 0 IF YES, date Issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON-r KNOW 0 YES i 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 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 obtained 0 , Date issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size,'type and location: D. Are there any proposed changes to or additions of signs intended for the property 7 YES C) NO 0 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 pion that will disturb over 1 acre? Y1;S 0 NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW Is required. 04/10/14 04 :20PM EDT Megawatt Energy Solutions -> Town of Northampton 413587127 2 Pg 4/16 Clty of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 7 -SITE,INFORMATIQN 1.1 Property Address: IVDiP_774,4 vN prbry As IISS i SECTION 2.'-PROPERTY'QWNI_ jly ZEO i4GENT;••.•;!. 2.1 OHrner Q Records k pgn�PS S' r�lCE' I?ye-lei e5 Name(Print) Current Mailing Addrese: Telephone Signature 2.2 Authorizad Aaant: Q Name(Print) Current Mailing Address; e,� 11 k�� — Signature Telephone .SECTION 3.--ESTIMATED CONSTRUC 1* COSTS. Item Estimated Cost(Dollars)to be Official Use,Only completed by ermit applicant 1. Building `(a)Bullding"Pegnit Feb' , 2. Electrical (b)'EStimatedTotal'Cos�'ot' -Cbnstruct(on`from' 3. Plumbing Building Permit Fee 4. Mechanical(HVAQ 5.f=ire Protection 6, Total m(1 +2+3+4+5) NumbOr' '• ' �. 7h1s:�Sectlon�oh0`fflcla;lUse Onl , . Data . Building Permlt•N'umber: les�fed: ; Signature: - ' eulldingCommis�fai�erllrtapecior.`ofButldin�s;�'.,,, ', ' . -Date 101 MILTON ST BP-2014-0893 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30B- 101 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-2014-0893 Project# JS-2014-001551 Est. Cost: $19000.00 Fee: $114.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MEGAWATT ENERGY SOLUTIONS LLC 57187 Lot Size(sg. ft.): 16509.24 Owner: BIRCH HILL LLC C/O JAMES A CABRAL MANAGER Zoning. URB(100)/ Applicant. MEGAWATT ENERGY SOLUTIONS LLC AT. 101 MILTON ST Applicant Address: Phone: Insurance: PO BOX 282 (781) 935-8480 WC PROVIDENCER102903 ISSUED ON:212112014 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 4.5KW ROOF MOUNTED SOLAR ARRAY 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 Sisnature: FeeType: Date Paid: Amount: Building 2/21/2014 0:00:00 $114.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner