16C-002 (2) 3 BP- 2011 -0626
GIs #: COMMONWEALTH OF MASSACHUSETTS
" CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: SOLAR ELECTRIC SYSTEM BUILDING PERMIT
Permit# BP- 2011 -0626
Project# JS- 2011 - 000709
Est. Cost: $5826.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor. License:
Use Group: PIONEER VALLEY PHOTOVOLTAICS 102513
Lot Size(sq. ft.): 212659.92 Owner: FORD EMORY A & SUSAN R
Zoning: URA(100) //WSP Applicant: PIONEER VALLEY PHOTOVOLTAICS
AT. 364 SPRING ST
Applicant Address: Phone: Insurance:
311 WELLS ST - SUITE B (413) 772 -8788 WC
GREENFIELDMA01301 ISSUED ON :1/13/2011 0:00:00
TO PERFORM THE FOLLOWING WORK.- INSTALL SUPPORT SYS FOR SOLAR ELEC
SYS
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 1/13/20110:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner
File # BP- 2011 -0626 I
APPLICANT /CONTACT PERSON PIONEER VALLEY PHOTOVOLTAICS
ADDRESS /PHONE 311 WELLS ST - SUITE B GREENFIELD (413) 772 -8788
PROPERTY LOCATION 364 SPRING ST
MAP 16C PARCEL 002 001 ZONE URA(100) //WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: INSTALL SUPPORT SYS FOR SOLAR ELEC SYS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 102513
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
/ 0 A
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
Department use only
City of Northampton Status of Permit:
BNilding Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address This section to be completed by office
Map Lot Unit
�.Yi� �r'G1�tt�. ��-- Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record
EMmo m cGl►d. Susafn, Ti�r+�- t �flvi,V�r fa'1 - "!►erGv�Ge 1�J ' O�Ofo�i
Name (pint) Current Mailind Addre
Telephone
Signature
2.2 Authorized Agent:
&-r6 3u In�llt ST MO G��ert C��,td �l.4 o k5o i
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building , -� , (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Onl
Building Permit Number: Date
Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
�Cj •� '��'t `a�3M� � , • ' S���, �-, ' .al1t� �a i =- •� ' � j ... .M��.K.. /'ZJJ�. '�11e �l
Wei Y''•' �
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Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
p arking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:'
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES
IF YES: enter Book Page and /or Document #'
B. Does the site contain a brook, body of water or wetlands? NO Is DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable
New House ❑ Addition ❑ Replacement Windows Alteration(s) EA Roofing ❑
Or Doors ED
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding [0] Other [0]
Brief Description of Prop sed> � ,{ � �;''r ++� �`> {
Work: Jt : 4r !i : 4k . & _tU III^ I�''Vt A ✓V,r 1 � . 1i A Y ms s✓
Alteration of existing beWoom Yes No Adding new bedroom Yes
Attached Narrative Renovating unfinished basement Yes T No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, 5elnt _ dryr/L as Owner of the subject
property
hereby authorized;:° ' -
to act on my behalf, in all matters rell ative to work authorized by this building permit application.
Signature of Owner Date
I, t J} �I asL�wwer /Authorized
Agent h'drebV declare t the statement nd information on the foregoing application fe true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
fi b
Print Name
Signature of GwReffAgent Date
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supe �}- Not Applicable ❑
Name of License Holder q,'n, S aL_ G 1 lo -
U -n /-3
{— J' /� License Number Z Z
Addres Expirat 3 02
Signature Telephone
9. Reg istered Home Im rovement Contractor: Not Applicable ❑
1K c
Company Name Registration Number
e u }� ►i� �� t' VIA,
Address �j Expiratio D T -
Telephone
SECTION 10- 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...... ❑
11. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
Department of Industrial Accidents
!' Office of Investigations
I 600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers
Applicant Information Please Print Legibly
II f
Name ( Business /Organization /Individual): '- l�;�i�xr :� c` a �, (�-'ll 1
Address:
City /State /Zip: (::�-(t,t, ,. ' b 0i 3 -, Phone #:
Are you an employer? Ch 4k the appropriate box: Type of project (required):
1. [ , I am a employer with I t 4. ❑ I am a general contractor and I
employees (full and /or part- time).* have hired the sub - contractors 6. E] New construction
2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers' 9. E] Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3. ❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required.] c. 152, § 1(4), and we have no JJ
employees. [No workers' 13. El Other (►t,d u Jla
comp. insurance required.] S e
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation poli y 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. Below is the policy and job site
information. �� j l)
Insurance Company Name: t C I rto� 4� f.v tk
Policy # or Self -ins. Lic. #: ;( 7; � Expiration Date: ck o t oll
Job Site Address: zj,
q 5. i,Sf " City /State /Zip: :&0rCn6& 1'i " G fU ` ,
Attach a copy of the workers c ` pensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised th copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verifi on.
I do hereby certify under the pains and penaltie er)t r t e information provided above is true and correct.
�o J
Si nature: Date:
r f
Phone #:
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 #:
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i Y
ROOF- MOUNTED SOLAR ARRAY DEAD WEIGHT LOADING CALCULATION
OVERVIEW
Project Name Ford Residence
Address 364 Spring Street Florence, MA 01062
The flushed to the roof solar array being installed on the southwesterly roof of the building, consists of three sub - arrays of
five, six and seven photovoltaic modules and a roof mounting system.
The mounting system includes a series of supports that represent discrete points of contact with the roof structure. Each
support is anchored to the rafters via 3 "stand -offs with stainless steel lag bolts designed with a minimum 3.5 inch thread
depth allowing for a minimum pull -out capacity of 513 pounds.
ROOF STRUCTURE
Engineered trusses COMMENTS
Height 4 inches 1.Roofin Construction
Width 2 inches Light: YES Heavy:
Rafter spacing 24 inches on center 2.Roof pitch: 23 degrees
SOLAR MODULE ARRAY WEIGHT CALCULATION
Photovoltaic modules Units Unit Wt. Total Wt. Comments
Solar module(s) 18 44.1 794 Canadian Solar 230w
Subtotal 794
Mounting System Units Unit Wt. Total Wt.
Rails 1442 0.048 69 Lbs /inch
Shared rail with cap strip 0 0.12 0 Lbs /inch
L feet 34 0.25 9 supports include all hardware
L feet on S51 Clamp 0 0.64 0 supports include all hardware
Stand -off with roof boot (single support) 34 1.28 44 supports include all hardware
Stand -off with roof boot (double support) 0 1.7 0 and roof boots
Stand -off with hanger bolt (single support) 0 0.4321 0
Splice bar kits 4 0.5 2
Module and rail grounding 2 3 6
Module mounting clips 42 0.16 7
Subtotal 136
Total solar module array weight 930 Pounds
POINT LOAD CALCULATION'
Number of support stand -off 34
Total solar module array weight 930
Point load 27.3 Pounds
DISTRIBUTED LOAD CALCULATION'
Photovoltaic module array area Array 1 Array 2 Array 3
Module width (horizontal) 38.7 inches 38.7 inches 38.7 inches
Module length (vertical) 64.5 inches 64.5 inches 64.5 inches
Intermodule spacing 1 inches 1 inches 1 inches
Number of module columns 1 1 1
Number of module rows 5 6:: 7
Array area 88 square feet 105 Isquare feet 123 square feet
Total array area 316 Isquare feet
Distributed load 2.9 Ibs f sf
SITE PLAN
(FORD - FLORENCE) p
PV array
installation area g
3
:r
PV array to be installed on the southwest facing roof of the residence with
remaining critical components in the basement.
ATTACHMENT A
APPROXIMATE PV MODULE INSTALLATION AREA
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(PV) is committed to providing a high quality product and service and we look forward to working with
you on your renewable energy project. Please contact Jon Child at 413 - 772 -8788 with questions or
comments regarding this proposal.
Sincerely,
Pio er V ley MPhotoltaics Cooperative
Jonathan Child
Project Manager
Attachments: A - PV Array Sketch
General Terms and Conditions
AUTHORIZATION TO PROCEED
I hereby agree to the Project as set out above, and I agree to pay the contract price according to the
Terms of Payment. I further agree to the Terms and Conditions attached hereto as a part of this
Proposal and Agreement. I hereby authorize Pioneer Valley PhotoVoltaics Cooperative to proceed with
the above - referenced Project in accordance with this Agreement. A check for the First Payment is
enclosed and I am returning this Agreement within 21 days of the Proposal date.
S� 5 ct A.t 4�. I – ' cl /D/
�v
Printed Name Date
6 to K9
`Signature Title
APPROVAL TO SERVE AS AUTHORIZED AGENT
I hereby authorize Pioneer Valley PhotoVoltaics Cooperative, or its designated representative, to
obtain required permits for this project on behalf of the owner and to begin work of obtaining a grant
on my behalf.
Printed Name Date
'�' 6 &Wa
Signature Title
Proposal and Agreement Page 7 of 8
Emory and Susan Ford, October 4, 2010
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