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42-021
BP-2023-0965 851 WESTHAMPTON RD COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 42-021-001 CITY OF NORTHA PTON Permit: Solar Build PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0965 PERMISSION IS HEREBY GRANTED TO: Project# 2023 SOLAR Contractor: License: Est. Cost: 19900 VALLEY SOLAR L CSL115680 Const.Class: Exp.Date: 04/09/202 Use Group: Owner: TRUST SZKOTAK MANDANA MARSH Lot Size (sq.ft.) Zoning: WSP Applicant: VALLE SOLAR LLC Applicant Address Phone: Insurance: 116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101 EASTHAMPTON, MA 01027 ISSUED ON: 07/24/2023 TO PERFORM THE FOLLOWING WORK: INSTALL 13 PANEL 5.20 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I +. .> - 13- 1 • i• Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax (413)587-1272 Office of the Building Commissioner .c‘o 0 4./& C<>1_ r do C"� Q The Commonwealth of Massachusetts 9's,t? Board of Building Regulations and Standards �4y ec FO E��/ o?cif ICIP ITY �� Massachusetts State Building Code, 780 CMR s �y A� E Building Permit Application To Construct,Repair,Renovate Or De °� Rev• ed Mar 2011 One-or Two-Family Dwelling s This Section For Official Use Only Building Permit Number: 5 el"..)-3 - P1 G S Date Applied: 1/i!u ) <1Z /74 7.Zy-Z0Z3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 851 Westhampton Road 1.1 a Is this an accepted street?yes x 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 I 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❑ Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ _ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Mandy Szkotak Northampton,MA 01062 Name(Print) City,State,ZIP 851 Westhampton Road (413)270-1376 mandana1028@idoud.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2( heck all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other la Specify:Solar Brief Description of Proposed Work2: Installation of a 13-panel roof-mounted solar array.System size 5.200kW DC. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $13,930 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $5'970 ❑ Standard City/Town Application Fee ❑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.t,,Ul a Check Amount: /S Cash Amount: 6. Total Project Cost: $ 19,900 0 Paid in Full ❑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, 01062 U Unrestricted(Buildings up to 35,000 Cu.ft.) Florence, City/Town,MAt01 ZIP R Restricted 1&2 Family Dwelling 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) 186338 10/27/24 Valley Solar LLC 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 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 2 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 Valley Solar LLC to act on my behalf,in all matters relative to work authorized by this building permit application. M a/La inaita, .,i✓ 07/18/2023 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. / &Lz e‘ Z7 /6&11.,—z 7/18/23 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" City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 7' 212 Main Street • Municipal Building �k --� Northampton, MA 01060 s�bY �kt� 'ors"c-.:::;r-.•;.,. 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: � � T� ��,4 Date: 7/18/23 The Commonwealth of Afassachusetts 7=z0 Department of Industrial.4ecidents 1 Congress Street,Suite 100 , VD, imasi= Boston, MA 02114-2017 vieVY (0" WWW.mass.garldia -t`75f'- SVoskers'Compensation insurance Affidavit:Builder&ContractorsfElectriciansfPlumbers. I1)BE 1-11..ED%11111'IRE PIRMIE-1ESG .1nnlicant Information Please Print Lei!ibls Name - Organization,Indlitiluair. Valley Solar LLC Adtiress: 116 Pleasant St Suite 321 City State/Zip: Easthampton, MA 01027 Phone#:413-584-8844 Ate)Usi AU CPI Chtdo.the a pp rupriaav hat: r),pe of project(required): I ant tatpityps•with 30 empittyces rind anikin part-tr 7. a New construction I am a wie gruptietur or partnership and have no employma wurking for me lb g. C:1 Remodeling any c3pseny,(No workers'comp.insurance rtNurratilj j 9. Cremolition I am a horrsoriitu.o deans all work mysclf.NO workers comp.mica:nice requited.) 0 0 Building addition 4.E:1 I am a Itemeounca and will he hum nOa.t,r to eunduei all work on riry properry_ I will ensure that all contractors either hate workers'conarensation insunince or are sole iI a Electrical repairs or additions pruptwitml ith no=pia:Veen. I 2..C]Plumbing repairs or additions 51:31 am a.h.enionl contractor and I hist hired the......,-cuntractors kited on the attached slice. ' These srits-contraelorshake toriployeres anti have workers'comp.instinincc. 130 ROW repairs 6.0 14.St Other Solar we are corporation und its officers inive exercise-et then right or exemption per iviCit I 52.§lirit,arid hae no employees.No workers'comp insurance requitod.1 applicant that checks bow a I must also fill out the section below show ins their workers*compensation pulley intOrmution fiumeoWnera who submit dot aftickain indicating they are doing all work and then hire outside comm.:tors must submit a new affidavit indicating such. !Contractors that check this Loa must attached an Aldnipanal ahtxi%how mg the name a the sith-coittractois and irate A henna VT tot Aline Itiks hate cmcdo,..ec, If the oh-conuractun. ett oes.,they must provide their A oilier,'ciorip policy nurnlvt I am an employer that is providing workers'compensation insurance for my employees. Below is the policy aniffob she information_ Insurance Company Name: Continental Indemnity/AUW Policy or Self-ins. Lic. 1 376140840101 Expiration Date. 09/01/2023 Job Site Address.851 Westhampton Road cstaierip:Northampton, MA 01062 Attach a copy of the wto Let.tt° cum pensation polky declaration page(showing the policy number and expiration date). Failure to secure coverage A.:, n:quinaci trier MGL r. 152, §25A is a criminal violation punishable by a line up to$1,500.00 a.nikor 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 niay be forwarded to the Office of Investigations of the DIA for insurance I do hereby certift under the pains and penalties ofperjury that the information provided above is true and correct Signature: Date: 7/18/23 413-584-8844 Official use only. Do not write in this area.to be completed kr city or town officiaL City or Town: Permit.rLicense Issuing Authorir.4 (circle one): I. Board of Health 2. Building Department 3.t'lly/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 4: