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23A-125 (4) 41 24 MIDDLE ST BP-2019-0913 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A- 125 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 ELECTRIC SYSTEM BUILDING PERMIT Permit a BP-2019-0913 Project N JS-2019.001525 Est Cost: $15000.00 IF= 7 o PERMISSION IS HEREBY GRANTED TO: Const,Class: Contractor: License: Use GMUD: TOBIN BUILDING AND REMODELING 074317 Lot Size(sD.ft.): 7797.24 Owner: SEILER MARGARET L&LEONARD MELNICK Zoning:UM100v Applicant. TOBIN BUILDING AND REMODELING AT. 24 MIDDLE ST Applicant Address: Phone: Insurance. 306 NORTH MAIN ST #3N (508) 525-9878 WC UXBRIDGEMA01538 ISSUED ON .3162019 0:00.00 TO PERFORM THEFOLLOW7NG WOR%ROOF MOUNTED SOLAR, 13 MODULES 4.68 KW 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: Rougb: 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 Siaanture: FeeTvpe: Date Paid: Amount: Building 3/6/20190:00:00 $75.00 212 Main Street,Phone(413)587.1240,Fax:(413)587-1272 Louis Hasbrouck—Building Cotmnissioner /urz Department use only City of Northergpto stews w P it: Building Departure FEB 2 CI( MVg O vewa Permit / 212 Main Street SeweNSept Ava ability Room 100 DEpr oElweOr 1NSPELTI °ail Airy Northampton, MA 01 O NORTHAMPi .ulw521 w ral Plans phone 413.587-1240 Fax 413-587-1272 McAlSite Plans Other Specify APPLICATION TO CONSTRUCT,ALTER REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.11Property/ 11Address:pp C ` _ This sacdon to be completed pi by ecs a4 NA`tack,` kreeA- Map o�'�J LW 1d'T Unit Zone Overlay DlstriN Elm St.131.mct CB DissNO SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Lenna_xa Name(Print) TC. Add!�c1 Signature' 2.2 Authorized Agent: Q ( ck'\eLyd Tn13;r �(llo NnrlhVaYts4 �� .�xhvido�MA Name(Print) Current Meiling Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS hem Estimated Cost(Dollars)to be Official Use Only completed bPermit applicant 1. Building 1 rl 00 0 ox�' (e)Building Permit Fee 2. Electrical V 0 o-C) (b)Estimated Total Cost of 51 Construction from 6 3. Plumbing Building Penult Fee 4. Mechanical(HVAC) 7�-oD 5.Fire Protection 6. Total=(1 +2+3+4+5) ) Check Number This Section For Official Use Only Building Permit Number:Number: / Issued: Signature: Building Ganmissionerlinspeetor of Buidings Date YlarriYlcl � kL�i� \in @ Com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 6U" 1 _.CiYld a� U4 n1 Gv Uf elU:i JItL'[t;:L1�JK8 j LEA a. Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Intwsnation Existing Proposed Required by Zoning This coluna to be filled in by Buudingoepartmmt Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage (Iur area minus bWg At paved parking) #of Parking Spaces Fill: voWme&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW ® YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document M. B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW ® YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , 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 O NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or tilling)over 1 acre or is it part of a common plan that will disturb over l acre? YES NOgo IF YES,then a Northampton Sic"Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK fcheck all applicablel New House ❑ Addition E Replacement Windows Alteration(s) Ll Roofing Or Doom i� Accessory Bldg. ❑ Demolition E] New Signs [O] Decks [O Siding[OI Other[a Brief 4e sort dooliPtoposed r(� � P �" Wmk:1n �Rhr n 90.51418 QfY;I (Oil cowl qfd h <,61(Lviery Si/j` bv,, QT-0.0s Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Nammve Renovating unfinished basement Vey No Plans Attached Roll -Sheet Ga.If New house and or addition to existing housing, complete the folloiNi a. Use of building One Family /\ Two Family Other b. Number of roams 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? I. 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 h.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. SepticTari CitySewer Private well City water Supply SECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Leona rc Y 'IY�1 nI as Owner of the subject property hembyauthorize my to act on my beha5,in all matters relative to work authorized by this ofilding permit application. �_�� a�l 771 l Signature orOmanr v T,.A,, Data 1, 1 tts \V L 1" ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application aro true and accurate,to the best of my knowledge and belief. S' ed under the ins and penalties of perjury. Z Print Nem 01 Signature of Omer/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed ConstrucI! Su arvisor. Not U)-0-145)l A`pplicablle-I/❑121 Name of Lleenee Holder: 1 U )—O 14 J 1 l #5 License Number A)i, sir ��,n�. N .�r�rac� Ma 65Z-4 aI5/ a ii Address Expiration Date 4G,i �1, 5f)r) - 01�61� Signati m n Telephone 9.Re Istered Home Improvement Contract r. Not Applicable ❑ i,ilc4unca (a motS inq I6`1O�ll� Company Name j n �J Re istratn Numper '� N- �lci S . urid� lAq o15-M- Tala o Address E)phaon Data es SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.O.L.c.152,§25C(8(( Workers Compensation Insurance affidavit must be completed and submitted with this applica8on.Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... No...... ❑ City of Northampton Massachusetts W�- Debris DEPAP2f1tT1T OF BUILDING INSPECTIONS"\, 212 Main 8traat •Municipal Building�..... Poxthampton, 1W OlOfiO Disposal Affidavit In accordance of the provisions of MGL c 40, 554, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: (Please print house number and street name) Is to be disposed of at: �lWr "� Wn wMx Qct. �1'� M4 0150-1 ( ease print name and locadon of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) - -a ' � q �) -i �� Signature f Permit p icant or Owner Date If,for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. ®; F7emnonwealth Of Massachusetts DivisionOI professional Licensure Board of Building Regulations no SlnndarEs Constr4Ction Sup¢rvlsor CS-074317 Expires:0210512021 RICHARD J.TOBIN,JR ' 3DE N.MAIN STJI3 "T NORTH U%BRIO(�,F Mp 0"", v gapWCnnwmer Ad. N4iweaPpWM NOYE WMOV{YfIR COMiPl1CTfM TYPE.SIIYYaTP111 Cifl 1®OBE Oa2rRO2p RICHARDIN8 13,q iDBIN BDILOINBAND REMODELING HAW TOBIN 0I WINTER ST. NrcLN.xu czcJB UREEIEBOp1Ely MIIIIIIIIIIIIIIIII i a The Commonwealth of Massachusetts Department ofladustrial Accidents I Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contmetors/Electricians/Plumbers Applicant Information Please Print Legibly Name: R 'c`i ' a (Business/Organiaation/Individual)' A e Address: PC B Ci /State/ • : r i D/ Phom#: o19 — 2-5- 1. ❑ I am a employer With- 1. 4.❑I am a general contractor and 1 6. New Construction employees(full and/or partum').` have hired the sub-contractors listed �-, � on the attached sheet.These sub- 2. ub- �- Remodeling 2.O l am a sole proprietor or contractors have employees and S. ❑Demolition partnership and have no employees have workers'comp.Insurance! working for me in any capacity. 9. Building addition [No workers'comp.insurance 5.❑We area corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their right of 11.❑Plumbing Repairs exemption per MGL c. 152,§3(4), 3.❑1 am a homeowner doing all work and we have no employees.[No 12.❑Roof Repairs Myself, [NO workers'comp.insurance workers'comp.insurance required.] 13 ❑Other requiredl 'Any applicant that checks box 01 must also 611 out the section below showing their workers'compensation policy information. I Bona wners who submit this si idavll indicating they arc doing ell work end then hie outside oconscton must submit a new affidavit indicating such tContractors thin check this bine most atmbed sn sdditinml sheet showing the mane ofthe wbmntrumrs and stem whether or not those cotities have employees. Ifthe sub-conaecmm have employers,they must provide Meir workers'comp.policy number. ]am an employer that is providing workers'compensation insurance for my employees. Below is the pokcy and job site,information Insurance Company Name: Policy#or Self-ina._Lip.#: Expiration Raba: Job Site Addddttaas,sgg :JU City/StetdZip.- NOyA--Y 0U 1�1v� 0IUVU Attach a copy of the workers'eumpeasatim poBcy 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/m one-year imprisonment,as wall as civil penalties in the form ofa STOP WORK ORDER and a fine of up to$250.00 a Clay against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cersify under the paaim anndd penafties of perjury that the information prodded above is true and correct Sign=,, Date: Phone#: soy OFFICLIL USEONLR OO NOT WRITE By TtOSAREA, TO BECOZ"LBTBD BYCITYOR TOWNOFFICIAL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Bealth 2.Building Department 3.City/1'own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other CoatactPetaon• Phone#: ncc]IRd CERTIFICATE OF LIABILITY INSURANCE 9 TEANaDDYrYT W/t9 018 THIS CERTIFICATE 6 ISSUED AS A NATTER OF I FORMATNIN ONLY AND CONFERS NO RIGHTS UPON THE CERTIINCATE HOLDER.THIS CERTIFICATE DOES NOT AFYNIMATIVELY OR REWIIWELY WEND,EICTEND OR ALTER THE COVERAGE AFFORDED BY THE POL MS BELOW- TMS CERW"n OF NSURANCE ODES NOT CONSTTNIE A CONTMCT BETWEEN THE ISSUING WSIAER(S).AUTE1OIEIIED REPRESENTATIVE OR PRO0l10EN AMD THE CERTIMATE HOLDER. IMPORTANT: XONttr1INUHH iSMA001TpMALNSUELED."poicy()I N AOO1TNMALNSMEDpwHbns RrbxtlpaM. X SUBA0CJLINW IS WANED,sub)W W Bra lams a110 M110NbAs b tlN pdiq.caNM pRBws I11aY rapWe E SrmaaIN1L A MMarrNM E NH a fcaM DPH;YIPI calx r',W tlR rer0fcids Ho10er M Nao W Slldl atlws.Ard(S). wmcER ANN, SeR%WC IRHaeFCC CompenYd AmerDF RINE (BI]ARJIIS IBA1J18.1033 P 0.Eoa 13325 AEpLK. savinwpr®1Maclrve wn aNRDgy SETRYI6 CpFRLCE RidmvlP VR 132350325 amA: Sektlrye lmValce Cad SC 19159 wswEP BNIfd B: 1 HARD,T0WN DBA TOWN NNLONG AND REMODELING SyEA c: PO BOX 491 FYINFA*: RN RNN E' N UXBRIDGE AV1 0153Bd91 �®F: COVERAGES CERTNICATE MUIBER: REVKNIM K MP: X515 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE KEN ISSUED TO THE INSURED NALED ABOVE FOR TIE POLICY PERIOD INDNATED. NOIWRNSTANWNG ANY REOUREMENT.TERN ON CONOITION OF ANY COWTA OR OTHER OOCMKNT VAN RESPECT TOWMCH THIS CERTF"TE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE MFORKD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOML 111E TERMS. EXCLUSIONSANDCONp]I SI SLCHNLICIES.LINTSSHOWNMAYHAVEKENKW EDBYPNDCLNMS. L fL'PE 9P FNIMM2 1g1Cr NIMLB WR CSN0IaAL9FA[W LMAAm EAcn a[cuoREHtt L T000.000 flAaGalAp ®o[am WNMsfsIF, s SOROS MfO fRPI L 15.000 A S 2263905 0utamlB 04070019 vfRsaNMaAW NASO L I.00DODD (gLYYSFFJ1FlYTMNN514R FSNRN.AOOEFAIE 3.00MODS RSr 0A�0T ®La RRJUIKn.NNfv/G4 s3.00D.000 OH(R: f AN�EIMIMIY f INV MRO BWILV W1OPV I�pPrm1 f M/IOSOIMY NlfOf 9 ADTasOAY Bl»nv H1URY IPe NrMeLi f INNo N AurosoxLY aAr f ME14LwRGPM EAUIQ . f F1maIW PIMtFLVOE NFAE"TE s OEOI IMTNdf p[NYS>aA AfOMROYFS•LIWIY •IN IAT R M(IPI4TIR TOINMIINREMLCNM ❑ NrA [L EM]I ALLYNNI f CRf4AafMERfY4V0F0' PIA+IL1yYNy FLOHFAYEEAFIROVfP f P 6mRum pEYRW1gNCf pSMICNPpp El P5FA5F.RIXICrIN1 f Nfl'A•I0IR PMRAIUINIL01AE4O1Yg6[F IAtDEM.AaaaHtll As�MN1YYEFYNYRNNXsaalpatltleWrR CERTIFICATE HOLDER CANCELLATION SHOVED ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.HOME ELL BE%LIVERED N ACCOROMICF WITH THE P%ICr MVIS10115. MIIIgIN[FD REPRI lA. e 1N 201S ACORD CORPORATION. All riyNs reums l ACORD 25(20IM3) TNF ACORD AMrM arr9lpye AM"..W marts 0 ACORD i "^ The Commonweahh ofMassaehuseM Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 w ..massgov/dia Workers'Compecum ioo Insurance Affidavit:Beilders/Contracwn/Elecaician✓Plumbom . TO BE FILED lVffH THE PER%trrr[NG AUTHORITY. APolicant Information � /� ,,1 Pleue Print Legibly ` Name lBlginClv'Orgavvmium7mliralud): � 4eyf 1 1.oldutte)\ el r-A'y(r 1 Q Address: ,Q'=50-�p UJnas >X 2MA City/State/Zip0Y1CU&n I MR �iL Pho le a: cQu�) B'15- '� G 3B Antro n empbyeR Clink[he ypropriate ba: 2 Type of project(required): t.�tmmr mw,Mry ori® 3 employee((ua er�dsorpm-rime[." 7. ❑New construction ].❑1®arloc PwpdmworpmmeMip ad Mvcno evrybymn waning fro me car 8. ❑Remodeling any'capacity.INe vowlan'CM,emato a ngwd.) 3 I an a hhemmwerEoi,[t At sorts myself lNo waem'Mm,Imamrcereoubedd' 9. ❑Demolition e.❑IanaAomeowntt ePd wlllMhmngemmemrsbcodun ell wurkop mY popery. [out 10 C3 Building addition swore aa:ail mnttacaveeitiv Mrc wmkma'sampquanmoi�rercc Oren rde 11.0 Electrical repairs or additions 12.❑Plumbing repairs or arMitiom s.❑[®sue-CacmmgtoleemMyma and n have nhgmn de mean Ne atuched ohm. 13. Roof airs Theca wbconuas°rs.'^.ev<cmployas gghrc woregr'rorty.nmee¢er �P res/ 6.❑We mecnrpnrotim and M�Mve gmeud their rumd exc.,ien w MGL, 14. Other__ I5;41faAam we hn<m moploysu.(Ne workers'cmnp ireure�re rpuird.) `Any wgliawe Aat chwla hox MI mua.lm fill scat tM amtion balm':dwwins nmN wprkeR mmmartion policy mfmmaao. n Nomeowm srhosubmit ohm N4,, usdx.n Wry ere dpmg aswink do then hireccntle gmo-.,sand our mdamw aniaa.n uMemma,e tConvxion Nm rhak Nis tax nus:umchvf ev.wWdwM shot shuwma dc n.rc of Ile suAcnnomtars entl sure wtmhq m ubx mtidq Mvc gnPloygs. If Nt subconbaaors Mvc mmloYces,They must provide Meir wwkgs'cmnp.policy numF.. I ane an employer tha f isprmlMa nnrkers'compemation larurance for my empfoyees. Below U rhe polity andjob site informu[lon. Vamncc Insurance Company Name: qq Policy Nor Self-ins.Lic.B: LD.+FJ Expiration Dem: Job Site Address: ? L�\C�C�i�2 t2 - City/smaZip: �)t1r�'hQ.YVI'(>tcn, MA OI Olv`� Attach a copy of the worlran'eampena dam policy declaration page(Wowing the policy amber and expiration dare). Failure to secure coverage as required under MGC c. 152,125A is a criminal violation punishable by a fine up to 51,500.00 aidfor a=year imprisonment,as well as civil penalties in the.form of a STOP WORK ORDER and a Etre of up to$250.00 a day against the violator.A copy of tW statement may be forwarded to the Office of Investigations of the DW for insurance coverage verification. I do hereby eero ander o�f,//gymry that the/nfnnnadon proviArdabove is new and eorrect Signature: --(�s� 1�/(I�R'et'pe Phone a: (ancc,,) 1DL_�"{�D Offmial use only. Do not write in this area,m be cumulated by city or town o fc/aL City ar To": Permit/Licenae ll Issuing Authority(circle one): I.Board of Health 2,Building Department 3.City/Towa Clark 4.Electrical Impactor S.Plumbing Inspector b.Other Contact Person: Phone 4: i1 COLDW-3 OP ID: BT AR� CERTIFICATE OF LIABILITY INSURANCE D"uv17 ' 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: N the certificate holder Is an ADDITIONAL INSURED,due policy(les)must be endorsed. N SUBROGATION IS WAIVED,sub)ect to the terms and conditions of the policy,certain policies may require an Mldomement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRDDOCFA =EEADT Mede Millikin D Francis Murphy Ins Agcy Inc PHONEFez 50 Main ScreenxA W,,978-668-B711 .(Ac. 8783876A38 Hudson MA 01749 JAML - - _ - - _-- Made Mililkin _ WMxRAf9)afip101p fAVEMGE assume A:Maaeadlusetb Bay Insurance Co 22306 P DIMMI D Steven Caldwell Electrician ashati A 9.Norfolk 8 Dedham Mutual Fire . 23965 Steven J ll d0a 85 Chicopee aMURv c:Commerca Insurance Company- 34754 ee Or Dr - - - - Hubbertlston,MA 01452 WsuREa o: IMURER E'__ MUR[R 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 POLICY PERIOD INDICATED. NOTWRHSTANDING 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 SUMECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. usel....._— _._.._ _._. .. _ CY LTR TYPE OF IxaUMHCE WLICYNI n rIDUYD]PYY Ma1rF A IX LaIaERCMLDETEMLLMDLRY IE.¢H IX:CIIR. .S 7.00g.gg �CWMS-MADE [XI OCCUR ODND00214202 08103I2g/a 08/0312019 N 1 .E l ..i .300,00 PREMISEe(Ea pn_F_,lul MED E%PlMy cne plwnl $ 5,000 _ PERSONAL A ADV INJURY $ 1,000,00 GR1l AGDREMIE LIMITMPLIESPER: GENERA—AGGREGATE $ 2.DOO,DO PDLIcr❑JECr FLDD ImmUns.coMPrav Acc 'i 2000,0 .. _ - s AMTgaggRL YAwYryNEDQ SINGLE LIMn a 1,DOD, _._ Ee @GEw _ C MY AUTO YJ21 ON23M2018105/2L2019 toonr INJURY IPm p,eanl s ALLOOSIIED x BODUYNJURYIFinadDmN) f AURNS X HIRED AUTOSX XDXONfED PROPEALYpAYAGE f AUTOS Pm,xtlE_^1_ ..--. SCNEDMAUED s uses" LIA W OCNR FA41aCCIMENCE f __ _ —015LW CWMEYSDE AGGREGATE _TT.. DED ' 'RETENrIDN s NMxEM coreAUTaw x aTA,LIrE �.ER _ AND EYPLOY -uAaYry B ANVPROPRIETDIOPARINEREXECLDIW YIN 178615A gY12=8 OW212019 E,L_.EACHACCIOENT_ � IS 100,00 OFFIOERNEMBEF"MUDEm Y�M/A -- — 11�1W�MFIwIMMe E1.DISEASE EAEMI,OyEIi $ 100,0GO o sCRlm�w OPERATN)xs bdu E.L.DISEASE-POLICY LIMIT Is _ 500,00 DESCRIPTION OF AATIOHB I LOCATIONS I VEHICLES(ALORD IDI,AGGYbnFI AM..amea..,,pY4Fbcab Xmon tpp N,pu4W Steven J Caldwell Is excluded from work comp CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Northampton THE ACCORDPIRATION DAM THEREOF.ANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN 210 Main St Northampton,MS 01060 AVTXIROf � EfO/JR�EP�AE�SE�XTAA�lIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD DATE:January 17, 2019 RE: 24 Middle St, Florence, MA 01062 To Whom It May Concern, As per your request, we have conducted a structural assessment of the building at the above address that included a site inspection on January 9, 2019. This inspection included an examination of the roof structure and condition as well as any structural drawings that were available. PV solar panels are proposed to be installed on roof areas as shown in the submitted plans. The panels are clamped to rails which are attached to the roof with a lagged mounting system, and installed per manufacturer's specifications and recommendations. It was found that the roof structures as noted on PVS-1 can satisfactorily withstand the proposed additional loads and will meet the applicable standards included in the Massachusetts State Building Code (Ninth Edition)and 2015 IRC. Design Criteria: Wind speed = 117 MPH Ground snow load =40 psf Roof dead load = 9 psf Solar system dead load = 3 psf The roof was determined to have asphalt shingles atop half-inch plywood sheathing. Overall the roof area is structurally adequate to support the additional load of the solar panels and their framework. Acknowledged by: ASN OF ? CHRIS H. KIM c�1 CIVIL 52430 Chris Kim, P.E. CODE INFORMATION °C SOLAR INDIVIDUAL PERMIT PACKAGE W AML-011 CODES,—S Pxp 0.EWN MNS 3 zomxrzawnoxA.eNvncxD cone pen � sm[xnu woe U+q d - _ lG4"�ONNA. E Leve cone.rC' LEONARD MELNICK wnDx.L e�rn¢wne,Nec, Z 4. 68 kW GRID TIED PHOTOVOLTAIC SYSTEM SATELLITE IMAGE ;`•' 4135309876 24 MIDDLE STREET NORTHAMPTON, MASSACHUSETTS 01062 AHJ: NORTHAMPTON UTILITY: NATIONAL GRID - MASSACHUSETTS JOB NOTES SHEETINDEX wWIR ARCn MWC LDP Noa u weOLA MWTUMLDMNNGS J L{ L xwenx¢N[eArt: $ ¢ P W wLM eLFmecu Durnuos rvex as .wxoi e.a.w-m.some:ax�. PVA-0 LEGEND pC MIDDLE STREET — SPR z _ p co'.scv.x wua N - l— MEAN —t ® cnx4 Nruty N[rm I I � I YWr9rrY1➢E _ v . I n I © ao�wwar CHR Or ® wAur Vnun wYe .y. .fIR CNPISX NIM ROOF 3: 2 I O vert IDEI o s .ao MODULES Em [Evk° Pox vexr / ` 10'-��� I I ® Gunn For Structural Only G � 0.00E 2:9 MODULES i u • 42'-1t' £ $ ROOF 1:7x • o MODULES i TO ELECTRIC McffnwioPrmoPOMsmexrs u.ma $ F A g L URLIIY GRID r usmox PxwLmeo>xomox.w 3' I I .ewwee.lern. = m.Pxlznmx i I 'SIWs Pro• MIDDLE STREET LEGEND _ _ � D mwuD sa Z Q- 7 - 0 aunxa sans winr h x ® anrao anon nem I ,s sort O sxr ux.oaam . I t �^- p varnrt cmc I I exxxo ® aarrn. For Structural Only .ousr�x. Du $ m 1Eo-`.cruu SM m.omaxAW rX3. i I I g awc n«ny I I ss•.�sr•serc _ _ s:nsss:u w : raelE I-ARRArs IxmRRAnox ROOF ROOIdG aTTaO1MO1I NO.OF flI1Md0 Fx1M11N OD IMX FlMITRaT30N MIY Y[L rRxfrunox FRDX Trfe TYre ommes TERE !!Se aF1aMG S.. URTTRRN ovERN11x0 i warm HOOF LI: 33.75• Come sn6ge $uNlppp L-mot z WupE RFM z%6 36• 8.]r SMWNW a• L.33' = e ROOF3 3A.S Comp Shq SMm LFoo[ 3 Wm6 PeM W W 6.15 BNpevM A' 1.33' y CHECK TI E 2 MR PENETRATION PATTERN GUIDE FIG 1.1:ROOF I R 3 STRUCIIIML FURRING DETAIL FIG 1.2:ROOF 3 STRUC URAU.FRAMING DFIa1L Q".,u,., m.oHa r--N :.tom �r-� I—F L F yyygyyyg FIGURE z:INVISIMOUNT RDOFATICMMENTDEFA1L80 TRUSSI RAFTERS TABLE2:PENFTMTION WIDE MR INBT FIGURES: KINKS umG MR � K MSITIONING OEruLs p V e 0 o r •• -.•.• •�•• P-r T TT TAI PTT7>T-T11 PTT•T�Tl1 a =[ - IIrT{I +I + I I I +�I II y T •T� � FTT � $ I I I I I I I I I I I I II V I I I LFii Af-1-lcl L>,Je 1aL.k lcl (3 aL 1.11111 F.TT•T T T+In,a'• F.;-IT-TT•l < I I I I I I L•11111y b1J4l leJ ..,.,�,.. FE1 —71 .rte• � - �I I I I LL TI - L I I I III I o B , o i3O EIECilIf4YO16 i F Z�� �� ® � W .onomru[anmowm. xrmw.r.pw.[rp _ ® oeeapinivrtc.°px�wmne.caa+e�pnmroep'mw�c ¢c�µi[auev.uri er11 •��cm5rsrtxnpo-ym o. xnxmn�n°.s s ® r W PVE-7 zp \ § [ ) EIERxIGLMT.\STOfIGlb16 W PHOTOVOLTAIC POINT OF INTERCONNECTION wxwuEOEa Am To 4WGE MlF3 Q F � � 2 EIMEOx NE ♦W sum.0 IPI TNN xnEoN TlN ; w ..CEN7 To um..z 1..�Einunox wEvnTen. enaw micouna w�eustieiaesrs sAll ixrews.mews oc es No AND AT A.a Wxeiticc.xn mxmux so.Es. =- - w. --No.oxEsm. ae.+..mxexc vu Cunduatn,s o«:,:i :r� CAUTION ' • • THIS BUILDING IS ALSO 0 SUPPLIED FROM THE FOLLOWING SOURCES WITH DISCONNECT(S) OCF Sizing Based on 60°C(140°F) LOCATED AS • SOLAR LOAD D1 CENTER PHOTOVOLTAIC ARRAY MA SMART UTILITY REVENUE METER ON ROOF• m mUTILITY METER,_ DISCONNECT LL � S . MIDDLEPANEL 24 v mom �u �® INSTALLER NAME: W E— DR6 AY BRANCH VOLTAGES: O i� 1. J ;: 4. H E 5. 6. LEGEND B SYMBOLS: on•,Pwwvuh; _ m�,vwwvwe _---- - b.S.PERPfPFIE/RE�ITPCIF 10',RECFPPP�E/0.E[ - e E',%LG/RKERKIEFP! f0'.PW WRE®�PtlE ' DPLSV CWllN � EN�GYv ROOF3: 2 MODULES p � a a,....�i •i�.-� ROOF 2: 4 3 z MODULES o ;3 , • Oy ROOF 1: 7 MODULESEl • PVE-5�,�•