23D-066 (13) BP- 022-1391
4 WARNER ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23D-066-001 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-2022-1391 PERMISSION IS HEREBY GRANTED TO:
Project# 2022 SOLAR Contractor: License:
PIONEER VALLEY
Est. Cost: 23750 PHOTOVOLTAICS CS106329
Const.Class: Exp.Date: 03/14/2024
Use Group: Owner: THACKER,EMMA K. &BLOCH, ELI .
Lot Size (sq.ft.)
Zoning: URB Applicant: PIONEER VALLEY PHOTOVOLTAICS
Applicant Address Pone: Insurance:
311 WELLS ST - SUITE B (413)772-8788 375928710105
GREENFIELD, MA 01301
ISSUED ON:10/26/2022
TO PERFORM THE FOLLOWING WORK:
INSTALL 16 PANEL 6.4 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 VIO ATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Ti
ut 1 l L s
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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C�/
S . The Commonwealth of Massachus s OCl
Board of Building Regulations and S S . ,
-.
tV ) Massachusetts State Building Code, 78 1' O� s 4 IP E TY
oq' p <9Q�? USE
Building Permit Application To Construct, Repair,Renovate S1. gyp: 'sh a Re sed 'r 2011
One-or Two-Family Dwelling T04, 4<T_
This Section For Official Use Only o TkoN9
Building Permit Number: �P y.—`"/ 4'/ Date A lied:
411,E `1�655 // /0'25- ZdZZ
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2Assessors Map&Parcel Number c
4 WARNER ST,FLORENCE MA 01062
u.
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(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 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
BLOCH,ELI FLORENCE MA 01062
Name(Print) City,State,ZIP
4 WARNER ST (617)599-3377 elibloch0@gmail.com
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 O Specify:Solar PV
Brief Description of Proposed Work2: __
ROOFTOP SOLAR PV ON SOUTH AND EAST ROOF PLANES;(16)PANELS,6.4 KW-DC,6.0 KW-AC INVERTER IN BASEMENT
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $8312 I. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical S 15438 ❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing S 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. 1 aJ3 I Qheck Amount rf Cash Amount:
6.Total Project Cost: $23750 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-106329 03/14/2024
MAYA FULFORD License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
159 CLARK DRIVE
No.and Street Type Description
GUILFORD VT 05301 U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-772-8788 BUILDINGPERMITS@PVSOUARED.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,SUITE B 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 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 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 is true and accurate to the best of my knowledge and understanding.
" r"-)4".... { -e-�. 10/18/2022
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"