37-065 (83) B P-2021-2153
108 BLACK BIRCH COMMONWEALTH OF MASSACHUSETTS
TRAIL
Map:Block:Lot: CITY OF NORTHAMPTON
37-065-008
Permit: Solar Build
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2153 PERMISSIONIS HEREBY GRANTED TO:
Project# 2021 SOLAR SYSTEM Contractor: License:
Est. Cost: 14832 VALLEY SOLAR LLC CSL115680
Const.Class: Exp. Date:04/09/2025
Use Group: Owner: LUTZ JOANN C TRUSTEE
Lot Size (sq.ft.)'
Zoning: SR Applicant: VALLEY SOLAR LLC
Applicant Address Phone: Insurance:
PO BOX 60627 (413)584-8844 WC531 S62064701 I
FLORENCE, MA 01062
ISSUED ON:11/08/2021
TO PERFORM THE FOLLOWING WORK:
INSTALL 12 PANEL 3.48 KW ROOF MOUNTED SOLAR SYSTEM
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:
>9 '
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
/,-- Department use only
-r t)-4. City of Northampt Status of Permit:
I. Building Departme CE7 Cu+b.Sut/Driveway Permit
.i(, g;>` 212 Main Street V�iSQwer/S ptic Availability
X Room '100 / NOV ater/V lell Availability
= " Northampto , M 01060 8 2021 o S�s of Structural Plans
-``4= phone 413-587-124 Fax_ - 87-1272 lot/Site Plans
OF
—`_NpgT�1ILI)lr;lniS Other,.Specify
1 u
APPLICATION TO CONSTRUCT,ALTER, REPAIR, REN R DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address. This section to be completed by office
108 Black Birch Trail Map Lot Unit
Florence, MA 01062 Zone Overlay District
Elm St. District CB District
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Joann Lutz 108 Black Birch Trail, Florence, MA 01062
Name(Print) (��1 . Current Mailing Address:
Y/} . (413)320-1494
r��r� Telephone
Signature J -)
2.2 Authorized Agent:
Valley Solar LLC PO Box 60627, Florence, MA 01062
Name(Print) Current Mailing Address:
POJ A C k b- Z'.crati.ea..a., 413-584-8844
Signature Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars)to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) C
5. Fire Protection
6. Total = (1 + 2 + 3 +4 + 5) $14,832 Check Number Li''ci/
This Section For Official Use Only
Building Permit Number: g .-- 'Z' ' i C-3 Date
Issued:
Signature: / /g 1/' uc • ZUr_I
Building Commissioner/Inspector of Buildings Date
lhasbrouck @ northamptonma.gov
info@valley solar.solar
EMAIL ADDRESS (REQUIRED; CONTRACTOR)
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: __ R: ____ _ L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW O YES C
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Q , Date Issued:
C. Do any signs exist on the property? YES O NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 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 plan
that will disturb over 1 acre? YES O NO Q
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House n Addition ❑ Replacement Windows Alteration(s) Roofing n
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [1= Siding [0] Other[X solar
Brief Description of Proposed
Work: Installation of a 12 panel roof mounted solar array. System Size 3.480kW DC
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes 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
Joann Lutz , as Owner of the subject
property
hereby authorize Valley Solar LLC
to act on my behalf,(iYY���� ''letters relative to work authorized by this building permit application.
c�l 11/02/2021
Signature of Owner V Date
Valley Solar LLC , as Owaor/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.
Patrick D. Rondeau
Print Name Paiy i,c k ..crn,t1 .Lt.,
11/02/2021
Signature of Owner/Agent Date
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Patrick D. Rondeau CS-115680
Address Expiration Date
340 Riverside Drive PO BOX 60627 4/9/2025
Signature Telephone
413-584-8844
9. Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Valley Solar LLC 186338
Address Expiration Date
PO Box 60627, Florence, MA 01062 Telephone 413-584-8844 10/27/22
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 No ❑