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29-566 (2) BP-2022-0266 87 PIONEER KNOLLS COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-566-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0266 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 10000 TRINITY SOLAR CS098295 Const.Class: Exp.Date:09/29/2023 Use Group: Owner: L KASS FREDERICK D&JENNIFER Lot Size (sq.ft.) TRINITY HEATING @AIR INC DBA TRINITY Zoning: WSP Applicant: SOLAR Applicant Address Phone: Insurance: 4 OPEN SQUARE WAY, SUITE 410 (413)203-9088(1522) WC13588107 HOLYOKE, MA 01040 ISSUED ON:03/21/2022 TO PERFORM THE FOLLOWING WORK: NEW 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ( I I � Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Department use only f RECEIVED City of Northampton Status of Permit: 1/ puilding Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability MAR 1 8 2022 1 Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans .pho1]le 41 3-587-1240 Fax 413-587-1272 Plot/Site Plans -FPT.OF BUILDfNG INSPECTIONS 1 NORTHAMPTON.MA 01060 Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to beZleted by office 87 Pioneer Knolls, Northampton, MA 01062 Map eq9 Lot Unit Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Fred Kass 87 Pioneer Knolls, Northampton, MA 01062 Name(Print) Current Mailing Address: (413) 537-9596 Please see attached Telephone Signature 2.2 Authorized Agent: Michael A White - Trinity Solar 48 Moore Street,East Longmeadow,MA 01028 Name(Print) Current Mailing Address: 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 10000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 6 O 5. Fire Protection G 6. Total= (1 +2+3 +4+5) 10000 Check Number ! 9 b �(� /This Section For Official Use Only Building Permit Number: 60~` oa` �"`� Date Issued: Signature: 7/72 3- 21' ZDZ Z. Building Commissioner/Inspector of Buildings Date 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 O DON'T KNOW 0 YES 0 IF YES, date issued:IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained , Date Issued: C. Do any signs exist on the property? YES Q 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 Q 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 0 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 ❑ Addition ❑ Replacement Windows Alteration(s) Roofing a Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [EJ Siding [O] Other[0] Brief Description of Proposed WorkStrip and rcroof 1200 square feet.Install ice and water shield and new 3/4"plywood.Install 110ft of 5"seamless gutter with 100ft of 2x3 downspouts and gutter guards 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) Trinity Solar Print N ; e R X fi fl. Signature of Owner/Agent Date 3/17/2022 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 Street, East.Longmeadow, MA 01028 9/29/2023 Address j y'1 , , i Ji !. Expiration Date ,f�r;At' l' �‘'! � 413-203-9088 Signature J" 1 1 Telephone 9.Registered Home Improvement Contractor: Not Applicable 0 Trinity Heating&Air Inc. DBA Trinity Solar 170355 Company Name Registration Number 20 Patterson Brook oad-J nitil0,West Wareham,MA 02576 10/1 1/2023 Address i i ' Expiration Date X 1„,4�(�t=' -i . - _,4 t t Telephone 413-203-9088 l 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 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 City of Northampton •' ¢ Massachusetts k~� k- f%, ° DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building �.� Northampton, MA 01060 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: Casella. 295 Forest Street. Peabody. MA 01960 The debris will be transported by: Name of Hauler: Trinity Solar 4 ,, Signature of Applicant: w) iirttAt - f� v 1, Date: 3/17/2022 1 NJ,Electrical Contractor business permit number 34EB01547400 NJ,HIC reg.#13VH01244300 SOLAR For other jurisdictions,please visit:http://www.trinity-solar.com/about-us/locations-and-licenses HOMEOWNERS AUTHORIZATION FORM Frederick Kass (print name) am the owner of the property located at address: 87 Pioneer Knolls Northampton MA. (print address) I hereby authorize Trinity Heating & Air, Inc. DBA Trinity Solar and its employees, agents, and subcontractors, including without limitation, , to act as my Agent for the limited purpose of applying for and obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System located on my property,applying and obtaining permission and approval for interconnection with the electric utility company, and registration with any state and/or local solar incentive program. This authorization includes the transfer/re-administering, and/or cancellation of any existing permits on file for the purpose of updating/applying with an alternate subcontractor. Without limitation to the generality of the foregoing I specifically authorize Trinity Solar et al. to populate technical details, fill-in, edit, compile, attach drawings, plans, data sheets and other documentation to, date, submit, re-submit, revise, amend and modify application, submission and certification documents ("Approvals Paperwork"), including those for which signature pages are included herewith for my signature, in furtherance of the related solar transaction, and I am providing any signatures to Approvals Paperwork for purposes of the foregoing. Trinity Solar will provide copies of Approvals Paperwork when submitted. My authorizations memorialized herein shall remain in full force and effect until revoked. I acknowledge that these authorizations are not required to proceed with the solar transaction and are not a condition of the related solar agreement included herewith but are being given for my own convenience and benefit in order to expedite the approvals processes. Electric Utility Company: Electric Utility Account No.: Name on Electric Utility Account: Frederick Cass R) Customer Signature Frederick Kass Print Name 10/29/21 Date Corporate Headquarters 1-877-SUN-SAVES 2211 Allenwood Road Ph: 732-780-3779 Wall, New Jersey 07719 Fax: 732-780-6671 www.trinity-solar.com FOR INFORMATION ABOUT CONTRACTORS AND THE CONTRACTORS' REGISTRATION ACT, CONTACT THE NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY, DIVISION OF CONSUMERS AFFAIRS AT 1-888-656-6225. ECOFASTEN CLAMP Inn (REFER TO SPEC SHEET FOR DETAILS) E SOLAR MODULE T II MI' ECOFASTEN RAIL S Z25 Si (REFER TO SPEC SHEET FOR DETAILS) 1 1h M S ECOFASTEN FLASHING .S) `� (REFER TO SPEC SHEET FOR DETAILS) 6• T _ = APOC SEALANT s7 R FOR SPECS) SOLAR MODULES SHALL NOT / , EXISTING RAFTER EXCEED PEAK HEIGHT. REFER TO ENGINEERS LETTER FOR SPEC CHMENT ON ASPHALT SHINGLE ROOF ❑HEIGHT FROM GROUND LEVEL TO PEAK OF ROOF SCALE:NOT TO SCALE Issued/Revisions BACK R7 ISSUED TO TOWNSHIP FOR PERMIT 11/29/202] NO. DESCRIPTION DATE R5 R6 Project Title: KASS,FRED- TRINITY ACCT#:2021-08-620487 DC dD AC Project Address: 87 PIONEER KNOLLS NORTHAMPTON,MA 01062 42.320793,-72.685769 R3 S . _ (=1Drawing Title: N' PROPOSED PV SOLAR SYSTEM Drawing Information DRAWING DATE: 11/29/2021 DRAWN BY: MS REVISED BY: R4 System Information: DC SYSTEM SIZE: 12kW R2 AC SYSTEM SIZE: 10kW MODULE COUNT: 30 MODULES USED: HAN W HA 400 p D MODULE SPEC#: Q.PEAK DUO BLK ML-G10+400 �J C M E P UTILITY COMPANY: NAT'L GRID UTILITY ACCT#: 5146217017 UTILITY METER#: 74573308 "'NOTE:PV DISCONNECT 24/7 ccnnlT DEAL TYPE: SUNNOVA Division of Professional Licensure Board of Building Regulations and Standards CS-098295 ? Expires:09/29/202 MICHAEL A WHITE 48 MOORE STREET EAST LONGMEADOW MA O1028 t t Commissioner jdeb ft. Cot i gat,. I THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card TRINITYRegistration 170355 SOLAR INC. Expiration 10/11/2023 D/B/A TRINITY SOLAR 2211 ALLENWOOD ROAD WALL, NJ 07719 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street Suite 710 170355 10/11/2023 Boston,MA 02118 TRINITY SOLAR INC. D/B/A TRINITY SOLAR NEIL GREENE 20 TERSO BROOK 2 Os D UNIT 10 WEST NAM,MA Undersecretary Not valid without signature ACG RDA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 5/20/2021 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(ies) must have ADDITIONAL INSURED provisions or be 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 endorsement(s). PRODUCER CONTACT NAME: Mark Grasela Arthur J. Gallagher Risk Management Services, Inc. PHONEExt): 856-482-9900 FAX (A/C,Ne):856-482-1888 4000 Midlantic Drive Suite 200 (A/C.No.E-MAIL Mount Laurel NJ 08054 ADDRESS: CherryHill.BSD.CertM@AJG.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Gotham Insurance Company 25569 INSURED TRINHEA-03 INSURER B: National Union Fire Insurance Company of Pittsburg 19445 Trinity Solar Inc. 4 Open Square Way, Suite 410 INSURERC:Endurance American Specialty Ins Co 41718 Holyoke, MA 01040 INSURERD:Liberty International Underwriters INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:206332321 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. 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GL202100013378 6/1/2021 6/1/2022 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $100,000 MED EXP(My one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X PE 0. LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY CA 2960145 6/1/2021 6/1/2022 COMBINED SINGLE LIMIT $2,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ A UMBRELLA LIAB X OCCUR EX202100001871 6/1/2021 6/1/2022 EACH OCCURRENCE $5,000,000 D X EXCESS LIAB ELD30006989100 6/1/2021 6/1/2022 CLAIMS-MADE ' 1000231834-05 6/1/2021 6/1/2022 AGGREGATE $5,000,000 DED I I RETENTION$ Limit x of$5,000,000 $19,000,000 g WORKERS COMPENSATION WC 13588107 6/1/2021 6/1/2022 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under 1 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Automobile CA 2960146 6/1/2021 6/1/2022 All Other Units $250/500 Comp/Collusion Ded. Truck-Tractors and Semi-Trailers $250/500 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Insurance AUTHORIZED REPRESENTATIVE —`----Zi (7t—, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts ( _ Department of Industrial Accidents I Congress Street,Suite 100 Boston, MA 02114-2017 wwwmass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Letiibly Name (Business/Organization/Individual): Trinity Heating&Air, Inc. DBA Trinity Solar Address: 2211 Allenwood Road City/Slate/Zip: Wall, New Jersey 07719 Phone#: 413-203-9088 Are you an employer?Check the appropriate box: Type of project(required): .Q I inn a employer with 1,630_employees(full and/or part-time).* 7. ❑New construction 2.0!am a sate pmprietor or partnership and have no employees working forme in 8. El Remodeling any capacity [No workers'comp.insurance required.) 9. ❑Demolition 3.El t am a homeowner doing all work myself[No workers'comp insurance required)f 10 Building addition 4.0 I sin a homeowner and wilt be hiring contractors to conduct all work on my property. t will ensure that all contractors either have workers'compensation insurance or arc suit I 1.0 Electrical repairs or additions proprietors with no employees 12.0 Plumbing repairs or additions 5,0 t am a genets!contractor and!have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'camp insurance 6.[]We arc a corporation and its officers have exercised their ngbn of exemption per MCrL c 14.QOther Solarinstallation 152,a1(4),and we have no employees )No workers'camp insurance required.] 'Any applicant that checks hos al must also till out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must sulunn a new affidavit indicating such. :Contractors that check this hos must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp policy number I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: National Union Fife Insru'ttrt,:e Company of Pitishorti . Policy#or Self-ins.Lic.#: WC13588107 — Expiration Date: 6/1/2022 Job Site Address: 4 Open Square Way city/state/zip: Holyoke, MA 01040 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verific. ion. .....ut-" I do hereby cer1 fy u der the pains r ad pen, res o'ry that the inform, provided above is true and correct Signature: (/ • / Date: t 4" 2-0 d" Phone#: t. a- 7?C 3 fir9.. Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2,Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: