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23C-028 (5) BP-' 022-0949 107 BAKER HILL RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23C-028-001 CITY OF NORTHAMPTON Permit: Solar Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0949 PERMISSION ISHEREBYGRANTE 0 TO: Project# 2022 SOLAR Contractor: License: PIONEER VALLEY Est. Cost: 43320 PHOTOVOLTAICS 111266 Const.Class: Exp.Date:03/14/2023 Use Group: Owner: KLEPACKI EDWARD A JR Lot Size (sq.ft.) Zoning: URB Applicant: PIONEER VALLEY PHOTOVOLTAICS Applicant Address Phone: Insurance: 311 WELLS ST - SUITE B (413)772-8788 375928710105 GREENFIELD, MA 01301 ISSUED ON:08/10/2022 TO PERFORM THE FOLLOWING WORK: INSTALL 25 PANEL 9 KW ROOF MOUNT 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: ( , • lo ilk• >2 " 3-1 Fees Paid: $75.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ! � l The Commonwealth of Massachuse s Board of Building Regulations and Sta dard• FO Massachusetts State Buildin Code 78 CM' AUG IC ' ITY \,/ g — 9 20Z► J Building Permit Application To Construct, Repair,R nov - • Demolish a Re ised ar 2011 One-or Two-Family Dwelling .r nFBUito This Section For Official Use Only ''�M` NS Building Permit Number: OP- " g yr Date Applied: �05 /7/7 8'to zozZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 107 BAKER HILL RD,NORTHAMPTON MA 01062 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(11) 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 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: KLEPACKI,EDWARD JR NORTHAMPTON MA 01062 Name(Print) City,State,ZIP 107 BAKER HILL RD (413)575-3817 skipklepacki@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other El Specify:Solar PV Brief Description of Proposed Work2:roof mounted solar PV installation of roof-mounted solar PV;(25)panels,9 kW-DC,7.6 kW-AC SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) _ 1.Building $17572 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $25748 ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fees: -� Check No.!-3 I eck Amount: IS- Cash Amount: .6.Total Project Cost: $43320 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-111266 03/14/2023 Daniel Gomez-Gonzalez License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 43 Hatfield Street No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Northampton MA 01060 R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofmg Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-772-8788 BUILDINGPERMITS@PVSQUARED.000P I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 140077 9/15/2023 PIONEER VALLEY PHOTOVOLTAICS COOP HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 311 WELLS STREET BUILDINGPERMITS@PVSOUARED.COOP No.and Street Email address GREENFIELD MA 01301 413-772-8788 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 p No . ❑ 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 Pioneer Valley Photovoltaics Coopertive to act on my behalf,in all matters relative to work authorized by this building permit application. SEE ATTACHMENT (A) SEE ATTACHMENT(A) 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' true and accurate to the best of my knowledge and understanding. s r / 8/8/2022 Print Owner's or Authori Agent Name(E lectronic 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"