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12C-028 64 BURNCOLT RD BP-2019-1476 GIS#: COMMONWEALTH OF MASSACHUSETTS Map,Block: 12C-028 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# BP-2019-1476 Project# JS-2019-002391 Est.Cost:$18000.00 Fee:$75.0o PERMISSION IS HEREBY GRANTED TO: Const.class: Contractor: License: Use Group: TOBIN BUILDING AND REMODELING 074317 Lot Size(sp.R.): 17467.56 Owner. SMITH ELIZABETH S Zoning: RI(I00)/URA(100)/WSP(looy Applicant: TOBIN BUILDING AND REMODELING AT: 64 BURNCOLT RD Applicant Address: Phone: Insurance: 306 NORTH MAIN ST ON (508) 525-9878 WC UXBRIDGEMA01538 ISSUED ON.&2512019 0:00:00 TO PERFORM THE FOLLOWING WORK.ROOF MOUNT SOLAR - 15 PANELS, 5.56KW 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 62520190:00:00 $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Sa (�H-ic_ u City of Northampton status of Permit: Deparboent .only Building Department Curb Cut/Ddveway Permit 212 Main Street Sewer/Septic Availability 2 Room 100 Water/Well Availability Northampton, MA 01080 Two Sets of Strum al Plans Phone 413-587-1240 Fax 413-587-1272 PlotlSlte Plans Other pe APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMO SX �LuL NG GEGTION 1 -SITE INFORMATION 8 19!9-iy? p JUN 2 4 2019 /1.1,,P11roperJtyAddress: Is a on to be completed by a Qz er _p lOT I )urn ('7 o4 —00j Map DEP K111 U it d Zone Overlay District Elm at District Ce Dlsmct SECTION 2-PROPERTY OWNER5NIPIAUTXORIZED AGENT 2..1 Owner of Record: Q �y G1 i2ab'eA� SM lA� v`q', 11YY+I co�+ /•�Kr�o r� Neme(PriM) Cunegl`,iRlildr:•tss1-1 ' Tale `Nene V Signature 2,2 Authorized Agent, 9-1chuxiA '5IN N • AAonn5� �3N %hr1i�O.g.MAOI'9'S Name(Print) Current Mailing Addivas, Signature `' Te1aphmv SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cwt(Dollars)to be OiEdal Use Only cpm leted by permit a plicard 1. Building 1 ^ U O 0 , 00 (a)Building Pe"it Fee 1 2. Electrical n�O OO (b)Estimated Total Cost of I Cwstmcfiw frm e 3. Plumbing Building Permit Fee 4. Mechaniwl(HVAC) 5.Fire Protection 6. Total=(1 42+3+4i 5) 0 - 10 1 Check Number This Section For Official Use Onl Date Building Permit Number: Issued:_ Signature: G-Z'l-2019 BuMng Coremiasionwllmpetmr of Buildings Deb EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING NI Warman.Must Be Completed.Permit Can Be Dmied Due To Incomplete Infocom[ion Existing Proposed Required by Zoning This coFuna w be filled in by nuildin6 DcParonmt Lot Size Fronts . Setbacks Front Side L: R: . L. R Rear Building Height Bldg.Square Footage Open Space Footage Ito arm winos bWg&paved An p of Parking Spaces Fill: volume&Lee... A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW IS 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 ', Pageand/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW ® VCS O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O 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 filling)over 1 acre or is it part of a common plan that mIl disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. A SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablel New House ❑ Addition ❑ Replacement Windows Alteration(s) ® Roofing Q Or Doom C3 Accessory Bldg. ❑ Demolition ❑ New Signe (QI Decks IM Siding 10j Other[IM Brief Descri bon of Propos MSUh i[� werk:\n�Dur,#iort If t %QCP and C Odab!32%ian - 9n'dJieAl AlM-fV�L1.JG)M ' Alteration of eodsting bedroom_yes Y, No Adding new bedroom Yes K No Attached Narrative Renovating unfinished basement Yes 1L No Plans Attached Roll -Sheet on.If New house and or addition to existlna housing, complete the following. a. Use of building: One Family ti y Two Family Other b. Number of moms 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 1. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr, floodplain_Yes No j. Depth of basement or cellar door 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 AUTHORWATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMfT I, �l1 sw6J�—1 '7M I-N` as Owner of the subject property hereby authorize Z1 U 1 QKIA T hi n to act on my be in ere relative to work authorized by this building panni[application. �sargr' to/Iq/Iq aa Signxe of eOtle I, L wnxd as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and pamthes of perjury. �Cktorr�f Tobt1'1 Print Name to I signeNre al pwner/ Dale SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction ConsWctionSupervisor. Not Appficb ❑ NameofLicenseHolder: 91N`_ UrU -rOb1n ls —V T ✓ ^1 Ucerpe Nu 30b N. UainSb fj(_t ritL6� MSF 01538 a rJ /a 1 Address Expiration Date S gna areal 9.Registered Home Imprevement Convector. Not Applicable ❑ --'Fobf n 13utI&�oC6 ounce Q P,h'Ipow i 7A 11oq 0 Cl to Combanv Name Registration Number IftN. WafN%- �9 (�I.11'KbridbhkI nAA UIS?�B 1419-1 /20 s / Expiration 0 G.- f/' Telephone(5o 6"s—A874's SECTION 78•WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a 152.125C(8)) Workers Compensation Insurance affidavit must be completed and submitted valh this application.Failure to provide this affidavit will result in the denial of Issuance of the building permit. Signed Affidavit Attached Yes....... No...... ❑ City of Northampton r 1, f/ Massachusetts � x DBPaRlfDdi'1' OF BUILDING INSPSCTIONS 212 Win Strut •Wnleipal Building Borthampten, N 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building peril 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: 44 '�-Affnco4 Zoaal (Please print house number and street name) Is to be disposed of at: 6la,�l Fa1ca-yic �ca3Dwnftos Pd Choi MR (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) n � Signature of Permit Appli 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. ® `�ivlNnonwealth of Massachusetts Divisan Ol PT0lessional Leensure Board Of Builtlinq RegulallOns and Vanda s Construotion Supervisor CS-076317 Eaplrea:0210512021 RICHARD J, JR. _ SOfi N.MAIN S7,P3 _ NORTH UXBRIOCTE MA 01638 a' j( .Ell CO 7�'�W umn.1r.i&v4nw Plruu. PROVEMENT CONTAa Csa YPE'.StatW[+nmlD.Vd WI18 ONlQpioIPbI'g5 W21(IYSCRIC6M 'I WAND REMODELING MW38 Urfda�epfapty The Commonwealth ofMmsachuseds Department oflndastrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers /� Applicant Information Please Print Leeibbr Name: Ridi o (Business/Organizationflndividual)- YZ- owi Address: O 8 Ci /State/Zi : 1 015Y9 Phone#: SSP 0 - 25-- 1. ❑ I am a employer with4.E]I am a general contractor and 1 6. New Construction employees(full and/or part-time).• have hired the sub-contractors listed ,� on the attached sheet.These sub- �' ❑Remodeling 2.0 'am a sole proprietor or contractors have employees and 8. ❑Demolition partnership and have no employees have workers'comp.insurance working for me in any capacity. 9. E)Wilding addition [No workers'comp.insurance 5.❑we are a corporation and Its 10.❑Electrical repairs or additions required.] officers have exerdsed their right of 11.❑Plumbing Repairs exemption per MGL c.SS2,§1(4), 3.❑I 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 required]t 'Any applicat dat cheeks box4l mon also 1111 out the section Mow showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they an:doing all wwk and nun him outside eoammaors mart submit a new affidavit indicating such.-Connectors that check this box must attached an additional sheet showing the name of the sulrconaectan and stab whether or not those en5ves have employees If the sub-conbacmrs have employees,they mustprovide their wcwkers'comp policy number. I am an employer that is provkfing workers'compensation insurance for my employees Below is thepolicy and job site, information. Insurance Company _ Name: Policy#or Self-ins.L'pc,#: Expiation Data: Jab Site Aft t • \t7'-F city/St,te/Zip: � A G1 Attach a copy of the workers'compensation policy dedarafion page(showing the policy number and expiration date).Failure to secure coverage as inquired under Section 25A of MGL c. 152 can lead to the impmition of criminal penalties of a fine up to$1,500.00 and/or ontrycar imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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. Ido hereby certlJ*anndderJthe paiim annddpenables ofperjwy that the informoton provided above is true mrd correct Signature. '% ® - /' Date: /[Cd`�0 Phone#: 5-0 tip OFF/CUL OBEOMZ DONOTWR MJKTHMAREA, TOBECOMFLETFABYCITYORTOWNOFFICGIL. City or Town: PermitfUcense# Issuing Authority(drek me)-- 1. ver1.Board of Health 2.Building Dep unimmt 3.City/rus u Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other ContactPerson. Phone#: aC Ko 0" CERTIFICATE OF LIABILITY INSURANCE """D 0 M512019 THIS CERTIFICATE IS ISSUED AS AMATTER 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 POLICES 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 me ceMl to holder is an ADDITIONAL INSURED,the,ITATIWies)must have ADDITIONAL INSURED Provisions wa endorxtl. N SUBROGATION IS WANED,suGjed 10 the terms and condifiona of Me polry,certain pollees may require an a mforsemem. A alatemard on this certificate does not confer dgh%to the cord icats holder in Neu of such endomement(e). MOxIDFR � TACT NYE. SelamA,a Insurance Canery aAnnncs x1oMe MTy)7FF313sNeir (IFM3Tl13D93 PO.BDX IW25 ADRMaB: servowcanlar®eMactimo,m INM91al AFFR.DaMCOVDMaE Nac• Richmond VA 3]Z15-0OZS xxIREA A: Seh"Funs Inal.lann Go W SC 19258 M9111rE0 NNpaR e. RICHARD TOWN DBA TOWN BUILDING AND REMODELING a®URERC: PO SOX 491 aHIlRew p., ..E N LIMI GE MA 015360/81 soads, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCYPERIOD WDICATED. NOTWITHSTANDING My REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFDRDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJEC TOMLTNE TEAMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PATO CLAIMS. L1X TYPE OF xNRANCE PgICyMNapl IYIa COIxMACMLeE1a!IILLYaBLT' EAM aRIMaBI� F 1.DND.NDD CLASIDAIILE ®OfgM PMENIBEe Es 1 5N%= MEDEW a 15.5W A S 2233905 U1N712019 0V07=0 PERaDMALaAwaMam s 1.000AN 0lNLA0OlEDAIEINRM'LEB TER: GFIIFAMAUDREWIE a %wo-DUD Pouc®°,fir ®Loc PRODIA:TB-CCWKPAp({ a3,000,001, oTerRR e Nis AInaMOralaWaAr a s`AT a ANYABn1 aDDLYNIRr Ter.l t OMTEO eooar NURh'IPi®aeAl i autos orAv AUTo5 A1ROS wu:O ngNaxTeo y Auras ORLv AUTOS MYWar .L s IaaMnurre acaw EAWDDSTIANAI t EI¢9a YAa CWMMNE AOORI F Lm PFIEMCN a E xU1RR8 COVPlIMT0X MIDMROYEI6'LIABILITY Y/M CBt"M ER ANY PRdl11ETaMWRrEIep£ NNF ❑ NIA EA.EACXALCOEM i C£FICERMEMPFR IX¢1Kent {rYgbyN MMI E1.DRFA9E-FA BIRDYEE E ..'TnoN 09AAHOAS aeb ELpRFAR-P0.FY Wr t KeCI1P11aMOPOPLaATpXa/LOGlaNa1VRacLfa PdDaD M1,AaWnM Raner NIT A hWe.Nm.eamx..a.n.reams, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPRATION DATE TIIEREGF NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AVTXOINEDREPRESENTArVE C 1983-2015 AC0RD CORPORATION. Ml rights reserved. ACORD 25(2016183) The ACORD name and logo art registered marks of ACORD The Commonwealth ofMassachusetts Deparbnent of IndustrialAccidents, I Coogrrm Street,Suite 100 Boston,MA 01114-1017 w Bmrssgot✓dia WRockers'Compensation Insurence Affdavlk BWMcrs/ContrutorsAUecuieianWhmben. - TO BE FILED wffH THE PERMITTING AOfHORITY. Applicant Information ` . ,,I r' Please Print Lealbly Name i iramcwOrgam,as araii eidual): , ` yen Co,tAl1s - o A� exAy is i a n Address: 'QF�P D w\(lY('kswy R00A / f� City/State/Zip " r5 Phone 0:(011 B� g�IFJal. - "138 M wa m agbrer'Clue she autoplot,bps: �j Type of protect(required): 1.�lmaaMMyw with ✓ employem(fiJiaMlwput-time).• 7. Q New construction 2.C)Imawkpopicvwpmraahipa Mvem=wWyemwoku games S. 0Remodeling M capacity,(No waiters'Pmnp_imasse a Mgeired.l 3.�Imasmxpwmr doiipali trots rnr��r lino workers comp.irwmrr<rWu'uW.l' 9. El Demolition 4.�1 ma Emwox'ner and well be hinny contractors w emdul ell workan my propmty. twat 10❑Building addition ue rmr au mnaarou eidrm Nuc workma'mmp+mtm irmrmrcewaeade 11.0 Electrical repairs or additions popremn wpm Mo Pioyrm- 12.Q Plumbing repairs or additions 5.[:]I ma gmerel cpnmcrcv end l have hired de aubmrrtacwa Badu de amcMd din. Tlen.bconuacww Mve employeca and sane waren'comp.rruummeI 13. Roofreppe`trs (� � 6.0 we arca:orprratim aosmoffi.love ax—i dreir:islad' nano.per MGL e. 14. Other ` okla)/ 133,41Ia1.nv:ws Nue m vnPkam.INo worbnscomp irwmrcr required.) •Any.Mirna tbul C#w,.bs bps al mut also fill out tM xso.We.stowing rheic workers'comperueuon potter hrfonmtim. 'Horrcownas who wbma tbvaardrvil rvdeatsrg tbey ac rlarrrg ell www ens nwm hire omarne enno-ecrma mwu sumo a nn atfldammhttlreg puce. ernplrxmrsdwelr Yrhiaboamutaonpl ao tldymwt msMwirg rbc kmo psm4r nu mea and atnewMMmrct @osaYgi[e Mve mnPloycm. Iftleatbammcmw Nueempbyeew acv must protide rhea workers rump.pWwy number. lam an enployerMarisprorlding workers'ronrpearadon Insamncefor my anWayen. Bela.Is thepolky andfob site htfonmmfan. bsmsnnce Company None: ..11 , + Policy a or Self-ins.Lie.0: nn .d-l0 5Expiration Date: Job Site Addtca: (f4'&("CCI+ baa City/Statejzip: I^' . \ M)A 0 W O Attach a copy of the workers'compensation policy declaration page(Wowing the policy number and expi tioa dam). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisoamcrt,as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to$250.00 a day against the violator.A copy of this smtement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hent'cerf{fy ander t ins of jury that the informarknproviiied above h oue mad correct Sienat rt: ((''ly �Lp Date 4f �IcI Phoncb: -1CC,, Ojykial ace only. Do not write in Mtr area.to be completed by city or town offreiaL City or Town: PermlttLlcense a Issuing Authority(circle one): 1.Board of Health 2.Buildiug Depart meut 3.Ckyfrowa Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: �1 COLDW-3 CERTIFICATE OF LIABILITY INSURANCED" 78)�' 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(les)must have ADDITIONAL INSURED provisions or 0a 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 endorsements. PRODUCER 978558-3711 kWCT Maria Millikin D Francis Murphy Ina Agcy Inc PHONE _- 978-5685711 FAx 978567-MG 50 Main Street c"4,Enl:. Hudson,MA 01749 4VL Marla Millikin INSURENBaFFONWIeCOVFBAGE__ _ IN .A Maddeachuseft Bay Insurance Co 22306 sOR=" MspRsx s,Norfolk B Durham Mutual Fire 23965 feean Coldwell Elecmlcian Me Insurance Company 34761 Nub ��e ber C.nD&A 0G1D4a52 o: _ MB E: ----___ MaWERF: COVERAGES CERTIFICATE 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.LIM"SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPEOFMMAMLE .xissuc1 POMCY EPF Paamlma @ UNITS, A X COYLIERCIALOFFINIALLMBEIIY EACH OCCURRENCE a 1,000,000 CM. FXJ OCCUR ODMD00214202 08410 18 08103/2019 OAMAGETORENrm 300,000 MED EXP me 5'000 PFRSONPLaAOV114NFY 1,000,000 GEM MieRE TE LIM?FPFl.IE8FER: GENERK AC{aRE iEa 2,000,000 Pglcv Loc PRODUCTS-canProPAGG 2,000,000 C surcoclix UABIIIn- COMNNED Sec.Lmn 1,000,000 AxrAuro BCYJ21 0511=018 06I2312VIi BwILraDIMr(Px - IO 105�ONLY % sums"pp ec0g0a Nuvay Pre. X AUTOSOXLY % �.T '^� �I _... MBREW CVY.'UR FACM OCCURIBNCE a E%C08LW CWNa11ME AGGHEWTE DED RETEMIpIS B leORIRasCprPFNBA X I PER OM �MDENPLOyERe'uAaanr YIN 1706161/ 04112/2019 04/1242020 100,800 PNr PPERWRIET9OEHRPMTNEWEXECUTNE E.L.EAOH .EnW 'En xM Ea, ED, O NA loo,O0D 1 EL NSEASE- EMPLorE '.Dyes,4een,re omx 500,000 Ur OPEMn Is r LIMIT OESCRIPTIMOFOPE MSILOCAT SIVMMLES IACORD 141,Aummmal R—demschedule,maybe macmdII mulrNealia NecWM) Steven J Coidweii is excluded from work comp CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE ACCORDANCE WITH THE POLICY PRTHEREOFOVISIONS. WILL BE DELIVERED IN 210 Main St Northampton,MS 01060 AuTHORu�Fe(�OjR ESEHrATIVE AY-6Y411.1b -,I,. Ihl ACORD 25(2016103) ©1988.2015 ACORD CORPORATION. All rights rase The ACORD name and logo are registered marks of ACORD DATE:April 11, 2019 RE: 64 Bumcolt Rd, Florence, MA 01062, USA 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 February 15, 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 satisfactorily meet the applicable standards included in the Massachusetts State Building Code (Ninth Edition), 2015 IBC/IRC and 20181EBC. Design Criteria: Wind speed = 117 MPH Ground snow load =40 psf Roof dead bad =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 bad of the solar panels and their framework. Acknowledged by: N OFMq�� Digitally signed Chris by Chris Kim Date: CHRIS H. KIM ^' °19.0.11 IVIL H Kim2 524 52430 13:38:03-04'00' CODE INFORMATION SOLAR INDIVIDUAL PERMIT PACKAGE ELIZABETH SMITH Z 5. 56 kWj GRID-TIED PHOTOVOLTAIC SYSTEM SATELLITE IMAGE (508) 257-9079 64 BURNCOLT ROAD FLORENCE, MASSACHUSETTS 01062 AHJ: NORTHAMPTON UTILITY: NATIONAL GRID - MASSACHUSETTS JOB NOTES SHEET INDEX wtoux•ac�nrxAwur�xae 9 a € a Nt01M6f1111CTYRLLd4MllOt � � 3 � F N IoU fl..OMWYn e1 srt Rl Ls�. n�ouaaxs f.FC1.Kµcuau.prl sRCTC nws sopa.W**"pR�O.f C60 samcnxe wea ...�o.a.. MPVA4' Lecexo oe _ - -- - -- ,l�.a 3 _ I 101p1R d _ I O avnxcsan¢raxr N 1 Ie DE4dEDSWC TURF ® a6rvc wury x[T � I — xaoeaR u>E 1 I O xn innoa«mr z`a . a . 1 _ e xos.cr� wsx.xr x rc unun xaexue xerta CNfl18V`NIM meucuc 1 p VEM mce cl y1W1Y GPW o 411 y I ager exe:v xooxu' b hrls H Klm I e I Kim 113 :47 00' y � � Ir+y .m onousmerrs erma a b — I o.srouwunerin� + I J z.uxe sme in.neom BURNCOLT ROAD +es mroaxnw a.'«m. a sroar RPVA L _ 1 TABU I-MMYS INFDRIM'ION ROOF SWIMS ATTAWNIM, W.or F"mi. FGXWO OC MAY. VINRRATLON P— TYPE TYF! 1TOR30 lYH MISXF11aXO pAM MTF 'IN... ITRATION OVIRMANO y1E�ig1FF1 sPAC MI RWF1 ]A COmD BMrge 3-mM L-bt L WxEYM aa6 1.33' 12.35' WN SW9eR 3 1.33' Z RWf3 ROOF e i R ROOfE •• .i, C gAF6 CXECX TABLE 2 MR PENETM ON PAM"GUIDE FW I:ROOF I SIRIN.TMNL P TW DETAIL FIGURE 2:lmV MW W ROOF ATTACIOFEW DETAILS 0 TRMS/RAFTERS ixwam .Jj3R Of w.maul � rvrmuu ` wwuaa �_ CMRI9 H.NIM r" 62AM1 •.. tza TABU 2:PEHEI =k WDFE MR TW TALL FlGURE 3:MOUNTING d3MP ZEE CC MSMONING DETARS ~ S PTT TT TFI RTT-TTt+t T T T T XT Ar^a I I I I I I I I I I I I I I I I I I I I I h+'�i5t2t� �tf�+�� Efttt'k3 I I I I I I I I I I I I I 1 1 1 1 1 1 1 1 Hltyi itl bt1AL31al NaL lfl l-3tl sal'pF TTi FT-T--fiT Sll 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ISy13 Y�iy b1-1-3FS ie1 NCFULmuF z = ii ���� •I I I I I ��I� I ' _ - I I I I �J I II �;-F Imo 's eucra uone MR- PVE-7 eucmtu�wcuunoxs W 3 urunrM umnu L [Mmli Lm[MaT m.r.om �ar,e.+�....rmr m.owxew..vami mu=nNm m m MN kuo-Km m � } s m PVE-Z Z wc.noxs �i; - vwna taH�ousV 004 OT IOLTI"Cil Lk 91iM4E N41B J W [ N � ¢ wan�.sTATMA.z"nnEu rvA ME°! 6 Iwo ars Za 2 i 8 S !M'OOXNPI.. S 2. Olt 314.4E Sxnu HAVE ALL Gvnnt LETEAs wnx MIXpUM 1{'IATA. ox A.BnIXfA4UX4. 3' wr�en'rm w.4sn�ce ona`-----nc�x�'`inox w�aA..w we- e twI.--.A..c ten.rs �IS.Ea'n.l44X ALLrtu RAX amIDA A..ILACTTON VES ED ALEA,ES.RRESFSSEXWEE. avXe ro A�AT ALL DC TT]MBINEI AA. a.rowo.LIT seers w.VLLA4E.,.ALA—LN c .A-xs! 4r.Xa.4X®A4Ham. PVEJ c[/¢xounORM000vo SRIIGLy{E W f� z N •wAcwauie,on.v,:pe nrcmR CAUTION . POWER TO THIS BUILDING IS ALSO SUPPLIED FROM THE FOLLOWING SOURCES WITH DISCONNECT(S) �CMaEuk,un.9mjk(I" LOCATED AS SHOWN: UTILITY METER MAIN SERVICE PANEL B w DISCONNECT a MA SMART UTILITY- REVENUE TILITY REVENUE METER SOLAR LOAD _ _.. CENTER i 9 PHOTOVOLTAIC L g 9 ARRAY ON ROOF 64 BURNCOLT ROAD x PVE-4 �! INSTALLER NAME: W I� BRANCH VOLTAGES: O 5: N 6. LEGEND t SYMBOLS: �. , . ._ tr,rwWviw `- m• rLwiriw ROOF ONE: 17 MODULES T T .-__--- 6:12 L • 7 • ao ws q■$ i k < w � z � R DRNEWAY —� I I m PVEd-