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18C-155 BP-2023-1641 30 WARBURTON WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-155-001 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-2023-1641 PERMISSION IS HEREBY GRANTED TO: Project# 2023 SOLAR Contractor: License: Est. Cost: 23184 VALLEY SOLAR LLC CSL115680 Const.Class: Exp.Date: 04/09/2025 Use Group: Owner: E FISHER-KATZ DIANE Lot Size (sq.ft.) Zoning: URB Applicant: VALLEY SOLAR LLC Applicant Address Phone: Insurance: 116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840102 EASTHAMPTON, MA 01027 ISSUED ON: 11/20/2023 TO PERFORM THE FOLLOWING WORK: INSTALL 16 PANEL 6.72 KW ROOF MOUNT SOLAR SYSTEM ON DETACHED GARAGE & HOUSE (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: n X �y i j �"' I . . Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner � r, ` The Commonwealth of Massachusetts FOR �t� y _� oazd of Building Regulations and Standards MUNICIPALITY mm — A r assachusetts State Building Code,780 CMR \+ �r�, USE O 2 O gilding 'ermit pplication To Construct,Repair,Renovate Or Demolish a Revised Mar � N One-or Two-Family Dwelling 2011 pNS GT/ pLoT OR Bun q.O' CrN1A0) Flits Section For Official Use Only BuildiJn�'ennit N le- - 404 3 /0 y/ f Date A lied: Z�j -zz3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Ass�sw s..Map and Parcel Numbers / 6, �7 30 WARBURTON WAY NORTHAMPTON MA 01060 L- 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: i 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 Private Zone:_ Outside Flood Zone? Municipal On site disposal system Check if yes f SECTION 2:PROPERTY OWNERSHIP 2.1 Ownerl of Record: Diane Fisher-Katz Northampton MA 01060 Name(Print) City,State,ZIP 30 Warburton Way L413)320-9614 dkatz1961@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Existing Building Owner-Occupied Repairs(s) Alteration(s)` Addition Demolition Accessory Bldg. Number of Units 16 Other I. Specify:Solar Brief Description of Proposed Work2: Installation of a 16 panel,roof mounted solar array.System Size:6.72 kW DC SECTION 4:ESTIMATED CONSTRUCTION COSTS ItemEstimated Costs: Official Use Only (Labor and Materials) 1.Building $16228 I.Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $6955 Standard City/Town Application Fee Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2.Other Fees:$ List: 416 4.Mechanical(HVAC) 5.Mechanical(Fire Suppression) $ Total All Fge Check No.inheck Amount: Cash Amount: 6.Total Project Cost $23184 Paid in Full Outstanding Balance Due: SECTION 5:CONSTRUCTION SERVICES CS-115680 4/9/2025 License Number , Expiration Date 5.1 Construction Supervisor License(CSL) List CSL Type(see bellow) U Patrick Rondeau Name of CSL Holder Type I Description 53 Fox Farms Rd.,Florence,MA 01062 U Unrestricted(Buildings up to 35,000 cu.ft.) No.and Street R Restricted 1 AND 2 Family Dwelling Florence,MA 01062 City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding 413-584-8844 Info@valleysolar.solar SF Solid Fuel Burning Appliances Telephone Email address I Insulation D Demolition 5.2 Registered Home Improvement Contractor(HIC) Valley Solar LLC HIC Company Name or HIC Registrant Name 186338 413-584-8844 HIC Registration Number Expiration Date 116 Pleasant St,Suit 321 No.and Street info@valleysolar.solar 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 '✓ 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 ',C.-4 ; A 41S 11/07/2023 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNERI 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�tothebest of my knowledge and understanding. 19az /P Ameztaa 11/07/23 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 na have access to the arbitrationprogram or guaranty fund under M.G.L.c.142A.Other important information on the HIC Program can be found at www.mass.gow'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 "e, * . w4 pt DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building c)tib Northampton, MA 01060 ' Nti 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: pc i frtcle. Date: 11/09/2023 _ The Commonwealth of Massachusetts Department of Industrial Accidents �=il�* 1; 1 Congress Street, Suite 100 Boston, MA 02114-2017 WWW.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Valley Solar LLC Address: 116 Pleasant Street Suite 321 City/State/Zip: Easthampton, MA 01027 Phone #: (413)584-8844 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 40 employees(full and/or part-time).* 7. ❑ New construction 2.1:I I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.] 9. ❑Demolition 10 ❑ Building addition 4.11I I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.p Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ]3 ❑ROOf repairs These sub-contractors have employees and have workers'comp.insurance? 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other Solar 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Continental Indemnity/AUW Policy#or Self-ins.Lic. #:376140840103 Expiration Date:09/01/2024 Job Site Address:30 Warburton Way City/State/Zip:Northampton, MA 01060 Attach a copy of the workers' compensation policy 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 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 fine 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 coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: /61ct2 ,77 /e6fls Date: 11/09/2023 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#: