12C-013 (2) 91 MOUNTAIN ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1825
Map:Block:Lot: 12C-013-
001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
00 NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1825 PERMISSION IS HEREBY GRANTED TO:
Project# 2021 ROOF Contractor: License:
INSIGHT VENTURES LLC DBA
Est.Cost: 19600 INSIGHT SOLAR 114618
Const.Class: Exp.Date: 10/31/2023
COLA KRISTIN & SYLVIA CLEMIENS-CO1A &
Use Group: Owner: ROBERT H CLEMENS
Lot Size (sq.ft.)
Zoning: RI/WSP Applicant: INSIGHT VENTURES LLC DBA INSIGHT SOLAR
Applicant Address Phone: Insurance:
59C NORTH ST (413)338-7555 WC-03837-1355
NORTHAMPTON, MA 01060
ISSUED ON:09/02/2021
TO PERFORM THE FOLLOWING WORK:
RE-ROOF
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 / I
• j4 1 •
r /
Fees Paid: $40.00
212Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
ram.
�/V
SEi° The ommonwealth of Massachusetts
/'/ t ` 2 202/ oard f Building Regulations and Standards FOR
I. T ass husetts State Building Code, 780 CMR USE
H19p•
MUNICIPALITY
,1
.,I mail. t Ap lication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
Mq ono NS One-or Two-Family Dwelling
nn� _ This Section For Official Use Only
Buildin Permit Number: ram'd� i`y /g Date 'ed:
v)N� ,Ca 55 9 Z ZoZ
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
91 MOUNTAIN ST,FLORENCE,MA 01062
1.la Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone? Municipal❑ On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
KRISTIN COLA FLORENCE,MA 01062
Name(Print) City, State,ZIP
91 MOUNTAIN STREET (413)210-9343 elegantfowlakomcast.net
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other ® Specify: RE-ROOF
Brief Description of Proposed Work2: REMOVE EXISTING SHINGLES AND REPLACE ROOF.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 19,600 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical _ $ — 0 Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ !,
Suppression) Total All;eel^:..$ 11 1'
4' Lai
Check Noll IV Check Amoun . Cash Amount:
6.Total Project Cost: $ 19,600 0 Paid in Full 0 Outstanding Balance Due:
City of Northampton
Jy a
� gg{ Massachusetts A_ 'r J
E - *"
tE DEPARTMENT OF BUILDING INSPECTIONS
14 Al
212 Main Street • Municipal Building C '
Northampton, MA 01060 J,
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 &2 FAMILY DWELLING,ADDITIONS,POOLS,DECKS,ACCESSORY STRUCTURES,
FENCES,GROUND MOUNTED SOLAR,ETC.
1. Building Permit Application signed by legal owner and filled out by owner or authorized agent.
2. One set of plans and specification of proposed work(digital and hard copy).
3. Site Plan with location of proposed structure(s)and setbacks.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new/replacement windows).
8. Home Owner's License Exemption Form filled out and signed by homeowner(if applicable).
9. Note any Conservation and/or Special Permit requirements (if applicable).
10. Driveway Permit(if applicable).
11. Proof of Water and Sewer entry fees paid(if applicable).
12. Trench Permit-public land by DPW/Private land by Building Dept.
13. Stretch Energy Code—all new construction will require a HERS Rater Affidavit to be submitted with
permit application before issuance of permit.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-114618 10/31/2023
EDMUND SEPANSKI License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
59C NORTH STREET
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
HATFIELD,MA 01038 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-338-7555 Edc getinsightsolar.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
/2022
INSIGHT VENTURES LLC DBA INSIGHT SOLAR 192102str Exp06/iration
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
59C NORTH STREET Applcations@getinsightsolar.com
No.and Street Email address
HATFIELD,MA 01038 413-338-7555
City/Town,State,ZIP Telephone
SECTION 6: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 . No 0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize INSIGHT SOLAR
to act on my behalf,in all matters relative to work authorized by this building permit application.
KRISTIN COLA 8/31/21
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
EDMUND SEPANSKI 8/31/21
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
Massachusetts ..
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
--x Northampton, MA 01060 #t,fy l%fi`.
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 59C NORTH STREET, HATFIELD, MA 01038
The debris will be transported by:
Name of Hauler: INSIGHT SOLAR
Signature of Applicant: F ,,, 1"f Date: 8/31/21