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23D-183 BP-2023-0993 191 FEDERAL ST COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 23D-183-001 CITY OF NORTHA PTON Permit: Solar Build PERSONS CONTRACTING WITH UNREGIS ERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0993 PERMISSION' S HEREBY GRANTED TO: Project# 2023 SOLAR Contractor: License: Est. Cost: 33696 VALLEY SOLAR LL CSLI 15680 Const.Class: Exp.Date: 04/09/202 Use Group: Owner: DELIS E,MARY E. &GERO, WILLIAM H. Lot Size (sq.ft.) Zoning: URB Applicant: VALLE SOLAR LLC Applicant Address Phone: Insurance: 116 PLEASANT ST,SUITE 321 (413)584-8844 EXT 217 376140840101 EASTHAMPTON, MA 01027 ISSUED ON: 07/27/2023 TO PERFORM THE FOLLOWING WORK: INSTALL 27 PANEL 10.80 KW ROOF MOUNT SOLAR SYSTEM (NO STRUCTURAL NO BATTERY) 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: . Ts, • I Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissi.ner chiki The Commonwealth of Massac• sett Jo W Board of Building Regulations and .n�'... •R Massachusetts State Building Code, 781 40,:1'; :4 ICI':LITY tigQ Q� U• Building Permit Application To Construct, Repair,Renovat- 0-)!~ •lish a 'evise Mar 2011 One- or Two-Family Dwelling *�6''Oc This Section For Official Use Only Df°6o%'1'S Buildin Permit Number: , to ?3-- �J Date Applied: 1 ��� s /62 7-Z7- ZZZ3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 191 Federal Street,Florence,MA 01062 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 Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: .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: Mary Delisle Florence,MA 01062 Name(Print) City,State,ZIP 191 Federal Street (413)586-7904 med191f@yahoo.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction ❑ Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:Solar Brief Description of Proposed Work': Installation of a 27-panel roof-mounted solar array.System size 10.800kW DC. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $23,587 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $10 109 El Standard City/Town Application Fee ' ❑Total Project Costa (Itett 6)x multiplier x 3.Plumbing S 2. Other Fees: $ 1 4. Mechanical (HVAC) S List: 5.Mechanical (Fire $ Suppression) Total All Fees: /' Check Noi$1 Check Amoun :1h Cash Amount: 6.Total Project Cost: $33,696 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSI,.) 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 U Unrestricted(Buildings up to 35,000 cu.ft.) Florence,MA 01062 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 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 . leit 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. 7-na.at he e�,a ee 07i2 i i2o23 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 applicatioonis true and accurate to the best of my knowledge and understanding. PZ�.L(2,/� Z /n 91Lt%e 7/21/23 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 -0: r4:. , SAS . �CG �� Massachusetts �?� �'�� DEPARTMENT OF BUILDING INSPECTIONS t 212 Main Street • Municipal Building J `/, Northampton, MA 01060 sr)4, 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: c�t2`. p ��� Date: 7/21/23 .7\ .„......, The Commonivealth of Massachusetts Department of Industrial.4ccidents 1 Congress Street,Suite 100 .p; Boston, MA 02114-2017 WWIRmass.govidia 11 4,1)kers'(:ompensation Insurance Affidavit: BuiklersiContractorsiEtectriciansfPlumbers. 11)BE I ILED 55 nit I Ilk Pt:1E111111NC Ati'llORITV, Annlicant Information Please Print Legibls Valley Solar LLC 116 Pleasant St Suite 321 City,State:Zip: Easthampton, MA 01027 Phone 413-584-8844 , Are you an employ er?C.hrek the appropriate Nis: Type of project(required): 1)24 I arn a employes with 30 eniplooyecs tfull arul'or part-tirnet.• 7. Ej New construction 2171 1 am a_sole proprietor or partnership and have nu employers working for me in M. 0 Remodeling any came:4_(No workers'cramp.instill:11CW required.) 9. 0 Demolition 3Lj I am a homeowner doing all work myself.iNo workers'comp..insurance requital 100 Building addition .1.E1 I am a horrieowik.7 and stall be hiring mentaalors to conduct all work on my property. I will ensure that all contracuns citt a wr hve viodcess i.-onetcsation insurance ut are sole 113 Elettrica I repairs or additions proprteturs with no employees, 2_[:]Plumbing repairs or additions 50 I am a yenertil contractor and I base hired the sub-contractors fisted on the attailied sheet I 31:Roof repairs These sub-contractors boon erriployees and hoc workers'comp.isisonmee.1 14. Other Solar 6.[:a Nh'e-ate txrrporation and:Ls ottiNTS cstansed their ride of exemption per MGL 352_§1‘44., iid we has e einployees.[No workers'ecanp.insamorx reotrin.J.j •.Nny.,applicant that cItc.a.%bo IX1 most also fill out the section below shoo,ins:their nLcr**compensation policy utforrnation teens who submit this arlidait indicating they&reeking all work and then hire outside contractors mint sadatitit a new allidam it indicating surii. 'Contractors that chd tht,bus roost attached an ndahtional sliest%bowing the name of the ,111,-conttackt.-3 and,tars tie hethcr err not those entities tf r the sub-contr.,czots s I:Xh.the must provide their =,.4 orkerh" I am an employer that is providing workers'compensation insurance Or my employees. Below is the policy and job site information. Insurance Company Name: Continental lndemnity/AUW Policy or selt.,„,. iie. t, 376140840101 Expiration Date. 09/01/2023 191 Federal Street Job Site Address. CityState,Zip:Florence, MA 01062 Attach a copy of the workers' 4:fliiipensation poIk 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 line up to SI.500.00 aratOr one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator.A copy of this statement may be forwarded to the Office of investigations of the DIA for insurance ;sr 1i:cation. I do hereby certi iv under the pains and penalties ofperjury that the information provided above is true and correct. - Signature: 2iP AsviZo—Ce.44 Date. 7/21/23 413-584-8844 Official use only. Do not write in this-area,W be completed by city or town official City or Town: PermitILicense*I Issuing Authority(circle one): I. Board of Health 2.Building Department 3.Cit)11-own Clerk 4.Electrical Inspector 5. Plumbing Inspector i.Other Contact Person: Phone#: