37-031 283 ROCKY HILL RD COMMONWEALTH OF MASSACHUSETTS BP-2021-1768
Map:Block:Lot:37-031-001
Permit: Solar Build CITY OF NORTHAMPTON
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1768 PERMISSION IS HEREBY GRANTED TO:
Project# Contractor: License:
Est.Cost: $16000 MICHAEL WHITE 098295
Const.Class: Exp.Date:09/29/2021
Use Group: Owner: KUON KIM K
Lot Size(sq.ft.)
TRINITY HEATING @AIR INC DBA TRINITY
Zoning: SR Applicant: SOLAR
Applicant Address Phone:, Insurance:
20 PATTERSON BROOK RD-UNIT 10 (413)203-9088 0 GL201900013378
WEST WAREHAM, MA 02576
TO PERFORM THE FOLLOWING WORK: ISSUED ON:08/23/2021
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.
Signature: I
• r
3)17
Fees Paid: $75.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Department use only
City of Nort mpt►.n �C Status of Permit:
Building D part rent �� 11. rb Cut/Driveway Permit
212 M in Str-et eptic Availability
R Am @ C <DQ -ter/W Availability
Northampto , A R :.0 ?D497 Vo Se. of Structural Plans
phone 413-587-1240 Fa• . .4457. 1272 Plot/S'a Plans
'04,/'1'sic, Oth'r Specify
• Tpp,,�
APPLICATION TO CONSTRUCT,ALTER, REPAIR, REN• ►*/E'OR D r OLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
Map 37 Lot D 3/ Unit
283 Rocky Hill Rd, Northampton, MA
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Dianmante Kuon 283 Rocky Hill Rd,Northampton, MA
Name(Print) Current Mailing Address (413)275-6761
Please sec attached Telephone
Signature
2.2 Authorized Agent:
Michael A White 4 Open Square Way- Suite 410,Holyoke,MA 01040
Name(Print) / 1 (�' 1 \ I �� Current Mailing Address:
yy 1
" 1',
X ` ' 413-203-9088
Signature 1 Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 5000 (a)Building Permit Fee
2. Electrical 11000 (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee 4
4. Mechanical (HVAC)
5. Fire Protection
6. Total= (1 +2+3+4+5) 16000 Check Number g gel
This Section For Official Use Only
6 N .R1' '7u '
Building Permit Number: 77 DateIssued:
Signature: /& zo-Z0Z
Building Commissioner/Inspector of Buildings Date
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing n
Or Doors El
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [E Siding [tl] Other[0]
Brief Description of Proposed
Work: Install 4.02 kW DC'solar on roof(12 panels).Will not exceed building footprint but will add 6"to roof height.Structural upgrade.
Alteration of existing bedroom Yes X No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes x 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
Please see attached ,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
Trinity Solar , 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 penalties of perjury.
Michael A White
Print Name t ! 1
Signature of Owner/Agent Date 8/17/2021
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: Michael A White CS-098295
License Number
48 Moore S reet, E{p t 4tongmeadow, MA 01028 9/29/2021
Address I f " Expiration Date
X t ; rJ) 413-203-9088
Signature r4,4,./k
Telephone
9. Registered Home Improvement Contractor: Not Applicable 0
Trinity Heating&Air Inc.DBA Trinity Solar 170355
Company Name Registration Number
20 Patterson Bro Road- iit 0,West Wareham,MA 02576 10/11/2021
Address Expiration Date
; }} t
X 11 �`�. r Telephone 413-203-9088
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.
Signed Affidavit Attached Yes 0 No 0
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