29-296 BP-2024-0227
112 BROOKSIDE CIR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-296-001 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-2024-0227 PERMISSION IS HEREBY GRANTED TO:
Project# SOALR 2024 Contractor: License:
Est.Cost: 25326 VALLEY SOLAR LLC CSL115680
Const.Class: Exp.Date: 04/09/2025
Use Group: Owner: M HELDT RAYNA
Lot Size (sq.ft.)
Zoning: WSP Applicant: VALLEY SOLAR LLC
Applicant Address Phone: Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840102
EASTHAMPTON, MA 01027
ISSUED ON: 03/01/2024
TO PERFORM THE FOLLOWING WORK:
INSTALL 10 PANEL 7.56KW ROOF MOUNTED 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:
elkozo. gut teriv.fiL
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
/ --------,.„ 4:-:----.--
` & "'- ..The Commonwealth of Massachusetts Q 2-1 b FOR
17-----:
= Ti/ -„ j•Boardbf Building Regulations and Standards 7.! MUNICIPALITY
F Massahusetts State Building Code,780 CMRr= �829 t` 1 USE
.+=+=r_= ping P it A'plication To Construct,Repair,Renovate Or Demolish a Revised Mar
��=`j= 4.,'` , One-or Two-Family Dwelling 2011
--- m i ' NSPF.
kt4 n-Cjrio . This Section For Official Use Only
Building Permit Number: et a'`a' l-� 7 Date Applied:
I.0t4is 14asbrovck_ (>1 _ 1 /�,..,5� 3 x z
Building Official(Print Name) Signature ate
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Numbers
112 BROOKSIDE CIR*COGEN*FLORENCE MA 01062
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 Private Zonc: Outside Flood Zone? Municipal On site disposal system
Check if yes 1
SECTION 2:PROPERTY OWNERSHIP
2.1 Ownerl of Record:
Rayna Heldt Northampton MA 01062
Name(Print) City,State,ZIP
112 Brookside Circle (978)606-8232 rmheldt(agmail.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 18 Other I Specify:Solar
Brief Description of Proposed Work2: installation or a 18 panel roof mounted solar array.System size:7.560 kWDC
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building $17728 I.Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $7597 Standard City/Town Application Fee
Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2.Other Fees:$
List:
4.Mechanical(HVAC) $
5.Mechanical(Fire Suppression) $ Total All Fee
Check NO i U lCheck AmourTh Cash Amount:
6.Total Project Cost $25326 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 Description
53 Fox Farms Rd.,Florence,MA 01062 Q 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 1 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 t on my behalf,in all matters relative to work authorized by this building permit application
U,,,,.,,"4'0 02/21/2024
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 to the best offn my knowledge and understanding.
p� Leh / 02/21/24
Print 0v,ner'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 zwt 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 ww-w.mass.govioca 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
� J1 41 1C
�, Massachusetts ���` �!e,
4 � DEPARTMENT OF BUILDING INSPECTIONS ' ‘ �`4
e 212 Main Street • Municipal Building ,�4
_ ' , ,r Northampton, MA 01060 x
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: /Oa Lti ?� Date: 02/23/2024
1"\` The Commonwealth of Massachusetts
x 1 Department of Industrial Accidents
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
2.0 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.]t
9. ❑Demolition
10❑ Building addition
4.❑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.❑Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.:
6.❑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.
t 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. Belox'is the policy mul job site
information.
Insurance Company Name:Continental Indemnity/AUW
Policy#or Self-ins.Lic.#:376140840103 Expiration Date:09/01/2024
Job Site Addiess: 112 BROOKSIDE CIR, *COGEN* City/State/Zip:FLORENCE MA 01062
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: Pat-a Z , it h su4 Date: 02/23/2024
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#: