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24D-090 BP-2023-0088 68 NORTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-090-001 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-2023-0088 PERMISSION IS HEREBY GRAN ED TO: Project# 2023 SOLAR Contractor: . License: Est. Cost: 38772 VALLEY SOLAR LLC CSL1156 0 Const.Class: Exp.Date: 04/09/2025 Use Group: Owner: EVERETT DEVILBISS JONATHAN Lot Size (sq.ft.) Zoning: URC Applicant: VALLEY SOLAR LLC Applicant Address Phone: Insurance: 116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101 EASTHAMPTON, MA 01027 ISSUED ON: 01/26/2023 TO PERFORM THE FOLLOWING WORK: INSTALL 27 PANEL 10.8 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 VI LATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I , 1 Gr, V Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner IZA The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY _ A r USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 8/-,- 3 Date Applied: Wev l� Coss 1- Z -ZoZ3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 68 North Street,Northampton,MA 01060 1.la 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: Jonathan DeVilbiss Northampton,MA 01060 Name(Print) City,State,ZIP 68 North Street (301)602-7864 jdevilbiss3(dgmall.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units Other X Specify:solar Brief Description of Proposed Work2: Installation of 27 panel roof mounted solar array,system size 10.8kW DC. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $27,140 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 11 632 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ — Suppression) Total All Fe 11 Check No.7 A Check Amount: 'Pi Amount: 6.Total Project Cost: $38,772 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-115680 04/09/2025 Patrick Rondeau License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 53 Fox Farm Rd No.and Street Type Description Florence,MA 01062 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-584-8844 permits©valleysolar.solar I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) Solar LLC 186338 10/27/24 Valley HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 116 Pleasant Street,Suite 321 permits@valleysolar.solar No.and Street Email address Easthampton, MA 01027 413-584-8844 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AP'i'ZDAVIT(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 .❑ 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 Valley Solar LLC to act on my behalf,in all matters relative to work authorized by this building permit application. %gnat a.rL 01/22/2023 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. P e&ti 1/20/23 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" The Commonwealth of Massachusetts l'iglu,_ Department of Industrial Accidents �,: tt� I 1 Congress Street,Suite 100 +.'4r 1 Boston,MA 02114-2017 -:,. .�-Au �'' www.mass.govrdia IS otkers'Compensation Insurance Affidas it: Builders/ContractoraiEkrtricians,Plumbers. 10 BE: f 11_E:D w1T11 t-IIE:PE:RNifi"tlN(:At it1ORJTl. .lnnlicant Information Please Print Leeihh Name(Businessurgantzation'IndividualY: Valley Solar LLC Address: 116 Pleasant St Suite 321 City/State/Zip: Easthampton, MA 01027 Phone#:413-584-8844 Are yea an eimployer7 Cheeps die appropriate but: Type of project(regt�). la tam a empioyei wvtir 30 employees[full and or Part-ume1.• 7. D New constructicn I am a sok proprietor ur partnership and lave no employees working for me m R. o Remodeling any capacity.(Nu weepers comp.insurance required.' 30 I am a home Yw1rer Joni all work myaelt.No workers'coup.rnsurorrce n�cinced.)' 9. Demolition 4.0 I am a hurraeown tt er and will be hums conas'lon to anrduct all work on my property_ 1 wall 10 Building addition ensure that all contractor either have workers"cenarprn rgnne insurance or are wile I ICI I Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 50 tam a general contractor and I have hired thr sub-connectors listed on the=ached abort name sob-contractors lave employes,and have workers'camp.ernurance. 1��Roof repairs 1 4./giOthet SolarEEOWe are a eotpuratiun and its ot'lken have exercised then nen of etenption per M(iL a:. 152.p 1441.and we have no employees.(No workers'corny.insurance required.) *Any applicant that checks boa R 1 musi also fall out the aectwn below slowing their Workers'compensation PA ICY rnformatrRin i Homeowners who submit this affidavit indicating they are eking all words and then hire outside eantraotors must submit a new affidav it rndisaatrng such. 1Conlracturs that cheep this hot muss attached an additional shed shooing the name of the sob-coritracton and state u hrlber or not those entities have cmployeea If the sub-contractor,have crrgrio:t ees.they must prvv ids their workers'comp.pulu'y mnnher l am an employer that!s providing ieormers'rotnpensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Continental Indemnity/AUW Policy.#or Self-ins.Lic.#: 376140840101 Expiration Date: 09/01/2023 Job Site Address: 68 North Street cityrstatc zip:Northampton, MA 01060 Attach a copy of the workers'compensation policy declaration page(showing the polio number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine 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 tine 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 titrstrace verification. l do hereby certify under the pains and penalties ot perjury that the information provided above Is true and correct signature: � � /�� Date: 1/20/23 Phone#: 413-584-8844 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): 1. Board of Health 2. Building Department 3.City Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton a H it ,s...." s, ' Massachusetts A. e:- �! 'I , -'• '''" , G� DEPARTMENT OF BUILDING INSPECTIONS y rr /'^t e x _r`'.�� t 212 Main Street • Municipal Building vit;. �a r'r ,..;�.� Northampton, MA 01060 '�sH 3���, 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: Valley Recycling, 234 Easthampton Rd, Northampton, MA 01060 The debris will be transported by: Name of Hauler: Valley Solar LLC �Signature of Applicant: � ��'� Date: 1/20/23