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23A-069 Northeast July 18, 2013 ATTN: Building inspector, I request that you grant a modification to waive the requirement for control construction for the project at 92 Main St. Florence in Northampton because the work is of a minor nature,will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. ((I have provided a stamped letter from Chris Vreeland P.E. in support of this request.))Thank you for your consideration. Respectfully, Phillip M Baunsgard Jr. MA-CSL#CS-106113 Installation Supervisor Northeast Solar Design (413)247-6045 136 Elm St. Hatfield, Ma 01038 Northeast Solar Design • 136 Elm Street,Hatfield MA 01038 •413-247-6045 "a ' 4x ;' y 1/ l it l r Pitt,kt! �1 i 4 M ,y �a Si, y 'F, li t I t llt g c k ) n Y t r f e f O y s 41 - .v r ta / \ i x ° i r I'a w t � : l� 'r ^ r 1 i n � rf � E a i 1 r p2 44 y 5 €' , E m m . �'�»' x1 ry: � 1 01 x;.f , € m,- �r , 1oJ. x 00 s. 'v k �� � �� R , p t ,rte -„ A a . MINI � ig.t r r S 5 i (A a r e.: 'zl v t K z . - xa 012 i n 1 7 ”- t' k t I P I 3 � �, ^M M ��' r�II �{ 8 �9d ' s �'N w E'P^ Irtf`ut a u r a al Mechanical Properties 0 Electrical Properties(STC") Cells e x 10 LG260S1C-G3 Cell vendor I.C:1 Maximum power at SIC(Pmpp) Cell type 740110c1‘,/stIII1ne MPP voltage(Vmpp) Cell dimensions 156 x 1156 cc or /6 x Er in MPP current(Impp) 'r H of busbar 3 Open circuit voltage(Voc) 38,6 Dimensions(L x W x H) 1640 x 111)00 x 35 mm Short circuit current(Isc) +8:82 6,1 57 x 41117 x 1 38 in Module efficiency(%) 15.9 Static snow load 5400 Pa /113 psf Operating temperature(°C) •40 +.1;10 Static wind load 1400 Pa/50 psf Maximum system voltage(V) P00 tII) 100.)(lrC'___ Weight 16 8±0 5 1<g/36 96±11 lb Maximum series fuse rating(A) 15 Connector type 0C4 connector 14 67 Power tolerance(/) r-= Junction box IP 67 with 3 bypass diodes Length of cables 2 x 1000 mm/2 x 39 37 it Frame Anodized aluminum Certifications and Warranty 0 Electrical Properties(NOCT') Certifications ICC(r1215 IE C 61703 1/ 2,If C 61701, LG260S1C-G3 0I G [Dacus rest"A,r ,, q Rev.lance" Maximum power(Pmpp) 11 _. UI_1703,ISO 9001 MPP voltage(Vmpp) 22 2 Product warranty 10 years MPP current(ImpP) a(e1 Output warranty of Pmax Open circuit voltage(Voc) 3')U Li 1 nmonrT re m 1 ......_...... 'ear warranty" Short circuit current(Isc) 71 Efficiency reduction rt(from 1000 whn'+ 200 Wit,'I 45'/0 Temperature Coefficients NOCT 44.9±2'C Pmpp -0459%/K ro/oao 10030 - Voc 0 343'I/K Dimensions (mm/in) .J I 1. Isc 0.054 /K 'i3 i" 0 Characteristic Curves � ) 28/110 1 z e 10 1000/3,.37 1000 W , n.:la.sa\ [s'e .,r e;b.l i or-id,ka.a Short r4 frame q `y 8 xr,r r ole:la.al .. to _..F ) ...... LI 800 W 18/U 71 - — /1.89 2.1"--L-1 600 W J k . 12.0 F — • e,.n,n n9 Dale I Z�1 I.11 I+! Al 400 N/ �. ;np boin,fa.�l N./ ad IT 200 W %'/ ��Qw S.Sip 22 1 il ooU/39.37 t . it - �.� —. -_.. O 5 10 1 20 25 30 35 40 Voltage{V) n rl V u J// P a o R1.5/0 o5 140 y r m o ' __ ‘` o.,rl x 120 -- E E aU/o,5 0 [L. I c s-1) n y - j fill i . / 1 i 08/0 31 co _ Pmax 1 I� z i . :1 20,_ -..... ......-. ......... .- _ ...._.... rf1111 1 111.11_!_1111'I ---� rt. 0 -_ _... ---_. .._.._ ____. ____ 35/1 39 40 -25 it 25 50 75 90 Temperature CC) \,.. i! E -,- I Ins 1 _ CI CI L� N,1 f/ry .,ifa ^.* k?ss : oo _ / I '' r it le/o:n t LG Life's Good ...'..;... Mono ...... .../... TM LG260S1C-G3 -'1 ' 14 . 11, , fi,„,, ,. I.,., 4i:,,,,., , -4 . , I • .---+-i--- IIII''III IIII' hi'iilk: hil'ilt1"1 i Iitrit',IIII' ii 1 Ell i i 'III( liril III4IIII`Vill,fit Int ,ii'''illiqljr,,i iriiiiiiisiii,liii,Ii • 1 ' . — ii no _ _ _. ... ,-- _._ , , .)1)f I r f,r r,t■1,i t)1, ,111,,I) 11•-0 1 1: 1., 1 1 1, I f , I 1'', [■,,r,..: . w f,n t 1 y,r,-,1,l,,,r', 1 1 1■11,,i I 1,m,'1,' ('I 1 1,,..,11.,I • ■ 1 1 i . t , — . . . 'T. , . . . . i ■ -4 ---f .- -t - -- - I ( , 1 , I I I i 4. ,11 1 i t 1 1,,,1,r I■' I..I 1 0 t.14'', f I 0 I r.., t■;,1.1 I\''. ..Nil i'!1 i i I i■i 1 i t" I', ' I i, i II: i i 1 . I i 1 I iiiiiiiiiiiillit'Il Iiiiili Ilifliii,.01, ■I'I41,1' Iiiiti'V ' I , ------- '!"-t-!! 4 4 , 1 ' !1! --' , #!!! -4 4 : , II I ,,,,,I,,,i ,,,,,I, 1,,, 1,,,I,,,,,,,,., ,,,,,,,,lit.1 ,0 <I,I), ,h114,,.rulqii, I , ,'., Hi<ili,I,1 illly ,,Iro nr,H,i, I . .11, 1,Evy: w„wtil..“ I■11,-d in I r,',. 1,, ,11,,,11,H0,1, 11,,pi',,g :Th' .,4 •. + ill iii, IIIt V,iii,I 1 - ... .4 _!!!!‘!„!!!!, -i..... 1. 1 , ! - 1 -t -- -4- ;It . /3v el . , c , ,„ . : .. , , I 564 564573 55 EN 61215 ,,,,-- -- Light and Robust Convenient Installation , < 1 1 ..., .,...-,‘ , 100% EL Test Completed Extra Power : ! Reliable Warranties Positive Power Tolerance III I - PP A °® CERTIFICATE OF LIABILITY INSURANCE 7/11/2013"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jessica Jica Reid Rep e P Encharter-MA fAf C.NNo.EaR: (800)675-6695 (AFAX /C.No): (800)754-1602 Encharter Insurance LLC E-MAIL ADDRESS: 25 University Drive INSURER(S)AFFORDING COVERAGE NAIC# Amherst MA 01002 INSURER A:Hanover Ins. Companies 22292 INSURED INSURER B Allmerica Financial Benefit 41840 NORTHEAST SOLAR DESIGN NORTHEAST SOLAR DESIGN INSURERC: ASSOC, LLC. INSURERD: 136 ELM STREET, INSURERE: HATFIELD MA 01038 INSURERF: COVERAGES CERTIFICATE NUMBER:13-14 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,OOO X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR 0HN2873803 4/8/2013 4/8/2014 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- ti LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT fEaaccident) $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AWN9512837 4/8/2013 4/8/2014 AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUUTOSWNED (Pe accident)DAMAGE $ Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ OHN2873803 4/8/2013 4/8/2014 $ A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS FR ANY PROPRIETOR/PARTNER/EXECUTIVE NN N/A E.L.EACH ACCIDENT $ 500,000 (Mandatory OFFICER/MEMBER H)EXCLUDED? WHN5715134 4/8/2013 4/8/2014 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept. 210 Main St AUTHORIZED REPRESENTATIVE Northampton, MA 01060 William Dowd/NO1JR1 f 1 LQLtL n. s _CDC 8. -- ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD '. I I I i .} """' R. .y IP t i. •...1..141..;. j orik. I r ,: ¢ cn f o 4'.' O O O N s` N 4) CO 0 mac t O - s iiir ca co O C a. CO - +.. Q) N ,_ c c U — — — — N c CD : x:, N N a; ''',%. .. . . y = �• . : ` 7 6) a) LL. x Cry ;:,, :i aa»,. ft y: i # , d' 41t s 1110 1 sp zik .. a) .:. Ca a) ,,,, › ..• , .... . • ,....„_,." .,„ .. r".•• '-..,;' *,'''r • , 0 rill lai V $1 400 Li 1 0 T3 N -,,, C z N O ors J d O O "I' W ?, k GC Roof System Technical Datasheet Ir rst ken snap-toaethc.r cornponent s I - lest install timr 51 ,�less than c.ompetilors f our men install 3110 panels, racks and ballast per day: 1500 per week f ; � W 5/1(1/15' tilt options ` .. Inch JSIry's k swast ballast requirements due to integrated windscreen de- gn 5 rri otJel with pane Is anF I hallast as low as 1.9 psf rillg '111 t . `^ lis . a All(ill arnanurn and l unless steel �� . r,n l st snow load rated 1'a ii strips make wire mar ugernent fast and easy 120 mph wind to ted and rated for 5/10°, 120rnph rated for 15` llni luo ac,sidil innovations with patents pending �, �A fill sir rirnamding ;trips included approved by ETI_to UI.467 . fileeill1r, and ASfv1F standards for sirur tural Ion( ing I „gas; Tull layoa ai and engineering analysis for every p101W I , y Warranty 20 years-the best in the industry �,, ; Made in the U.S.A. [ <. 4 7 ; 0 I�taterlgl, y Pan.50521-i32 ulairlint rut oundinc Strip: ;14 sta inless inle s steel ', anal clip Mid:airlrninurn A-6005 T5A Wire MtnFalarnent Strip 5051 aluminurrl Iiardwarc. -'/4-20 x 2-1/2 inch bolts, lock washers,stainless steelya Construction: (-on lie rrustrillod on EPDM,TPC,t oncrete,Tar anr I torch down roofs 5rfi : I'r dormant e optimized tilt configtnrations for space availability �S Calculations: . . 1001Y,c ode c omplirrat designs for any locality qtr �� <• thlr party to ciur il PE, stamped drawings and calculations rr .. Inc inns tacit system stir lour l calculations e� , Inc taut(ira tl systrArn design r olculcaiions basod on regional load value I`esi,In ItiFads according to IBC 2006 or 2009 . Patent pending profile geometries with optiml_un material utilization Distribution Load: ly plo1 n rof loading 1.9 4.8 Ibs/sg ft r Par)Row Spacing: 5/1u/15 tilt option; 8.48/16.50/24,75 inches Shade Angles: ,T . b/10/15'lilt options with 21.5/22.2/22.0 degree shade angles Grounding: rrcacrkind system h u integrated grounding utilizing grounding strips to end of �� I,, 'ri ing must ie dame by s=lot'trlciar)at row ends t, "a GAMECHANGE'TM RACKING STRONG. SIMPLE. GC Roof System Technical Datasheet _ _. _ j •vim R ! • „ _-- -•,. � ...._.. ,: -' ... � ,.rat."` - �+�f�..L. x *� a \rte GC Roof System designed based on the need for a cost-effective, simple-to-assemble racking system for PV solar panel Installations. fual anal sic b a ic f ssir , ii I_ngi- Gam r hrnge Rai ins x cicf 5 Design Criterlo and Performance PcgUlrements: near Iin n ed in the apK I<Y]bl otatz to r nSUre that fire �_I. tr rr �' In 4 and the foundations have been designed to satisfy the local structural code requirements. Qtii.rlity ASstlrar 00 1. Installation shall he performed by experienced r:r,vs having a mu-imrn of five(5)years experience erecting similar structures. 2 The structure shall be erectr3d in accordance with GameChange Rai:I, Instructions and at pr .ved clrai✓Ings, 1.GameC:hauge shall r rovcle set of enarneering submittal it:iwina Submissions: 2. No fob icoti n r_af materials by GameChango Racking shall cortinnuct until submittal drawings are arrr'raved by the purr.ii aser, Submittal drawings typically Include: ca.Stir.tuu l Pions cmd Elevations 5,Ballasting Details c.Framing Details d.Racking I c-.tark Strac Ir_rre De Sign and Corisicrjnent Details: 1. The structure shall be designed rand `?etaileri cacocrdin,i to grid engi- nearing practice: 2. Typical roof mount structures shall he specified by itre client and have a nominal slope ranging between 5, 10 and 15 degrees unless otherwise specified. Material Delivery `�trarage and Handling 1. Materials shall be delivered r to the job site by ameChange Racking FOB origin. 2. Access from ',wrack—ling area to construction site shall be clear amti unre- stricted, 3. Materials shall be doted in a clean, dry and covered area that is secure and protected from weather. 4. Upon delivery, inspect and report any freight or handling damage to tl e manufacturer imrdredlately. Manufacturer cannot he held respcn,lble for damages occurring during story rge prier to construction. Notes: 1. WIren required, all special inst:rectors shall Inc retained by the cri'ti'mer. The extent of the inspe,iior;shall �:omply with tire contrast docurnents, alp plicable cod ,reruirements and the local jurisdiction. 2. Ali materials shall be new, of good quality and rwitli ui defc,cts which would lessen quality of work. 3.Customer shall be responsible for installation of the roof mount strut iur s. 4. Inshallation of the 'I r i aural system and all components shall be in strict accoracm,ct'with rrron ufac tracer _;ornmend ations. Site Preparation anti Inspection: Site preparation shall the resf-Fonsibillty of Customer. Installation Slops: Three simple steps are done in the field as the installation manual pry✓ ided by(_.1,iorneChange Racking: Placement of the panel,racks and ballast Placement of panels GAMECHANGE' Graundir"g Al, RACKING ' STRONG. SIMPLE. 0 U m 1 w _ El W E_ - o ' ' ILo a Q'\ o N cab) j ' p - „1 N o o o o = v) N \ ' * .5I .8 0 0 o o EV O H CD I V 3 1 U° '3 1 _ a dU � a 0 U tv ° RO my N O \*1 r'?a C di a 1- 4 , = 0 31 = ° ° � Y P 0-z E ° N U N- N -O C O N i'Op ..N ' Q X h O a. g E a ° O :.,2 7) O 0 " N z) U p us o 4 '0 � 3 O - N p / o a <a 0°6 o O 4oa Z O w z d n o> Z ? oa0pw w P o U U z \I te 0 000 ° 0 o J j O g o Z Y v E I,, ,O LA V- CO N elit; ' —1-1_1 U W — z p M O N I� -0 - -0 f . .1 04 N. CO "0 00 I� Os I� E <0 2 0 8`2 O . owe°iu 0 N < o�a�� N n L ! HH C Q Q Q O L S3Q00 o N CO CO n V O 00 •O 4) Q ,au�� d J ° QJ 2 N .0 0, Q �- w Q• oc.) 12 C Q O II Q / C 3 ' - p V CO V O CO N Iu ' U D C p O o Ol E t 0 m p P M cc?) V' CO) V Cn) V M m C 0_6 66 .6 _6 .6 _6 _6 ICI M' �' • Q 0 4 ac O. V' N •O 'V N 00 o N N ch CV CO N CO CO 9InP0 Ad aP° Ad o in c a .a o) � � � 0 � �INI co' r•-•14.Lii_LILLILLI o , U, a) arpotAl Ad aIfPoW Ad o� m U m U u '_I I X W CI ICI 1 ! ! oo _N— —N- Tu C d U�X U-o X o CI?: O po N 00 0 U m 4 f lat,R AIViEC1ANGE ACKING STR(TNG. . INARL,F. GC Roof System Ballast Tray Loading-72 Cell Module(40x77) GC Roof System Ballast Tray Loading-60 Cell Module(40x65) Design Wind Speed-EXPOSURE'B° Design Wind Speed-EXPOSURE B' 90 95 100 110 120 90 95 100 110 120 F EDGE 5° 22 24 28 33 39 = 5° 18 21 23 27 31 1 ZONE 10° 34 43 53 64 86 EDGE 10° 29 37 44 52 73 15° 54 96 83 97 139 0 , 15° 46 59 70 83 118 0 5° 18 20 22 26 30 0 5° 15 17 19 22 25 ZONE 10° 28 35 42 50 71 MID 10° 24 30 36 43 60 15° 44 57 68 80 114 15° 38 48 58 68 97 Design Wind Speed-EXPOSURE'C' Design Wind Speed-EXPOSURE'C' 90 95 100 110 120 90 95 100 110 120 5° 24 27 30 36 45 5° 20 23 26 31 36 �' EDGE 10° 38 48 57 68 96 EDGE 10° 32 41 48 58 82 % 15° 60 77 92 108 154 15° 51 65 78 92 131 0 5° 20 22 25 29 33 0 5° 17 19 21 24 28 2 MID 10° 31 39 47 56 79 2 MID 10° 26 33 40 47 67 15° 49 63 75 89 126 . 15° 42 54 64 75 107 EDGE ZONE SHALL BE DEFINED AS ANY MODULE WITHIN 10-FT OF ANY ROOF/ARRAY EDGE EDGE ZONE BALLASTING SHALL APPLY TO FIRST 3 BALLAST TRAYS FROM ANY ARRAY EDGE(FRONT,REAR,OR SIDE) EDGE ZONE BALLASTING SHALL APLY TO FIRST 3 BALLAST TRAYS ALONG ANY ARRAY AISLE WIDER THAN 8-FT. MODULES INSTALLED IN AN ISLAND CONDITION(SUBARRAY OF 4-12 MODULES,NO LESS THAN 4 MODULES SHALL BE INSTALLED AS AN ISLAND) OR FINGER(SINGLE MODULE IN ROW OR COLUMN)SHALL UTILIZE BALLAST FROM NEXT HIGHER WINDLOAD Inspection Report Precision Decisions LLC PO Box 179 West Stockbridge,MA 01266 413-269-4965 vreeland67@msn.com To: Greg Garrison,Northeast Solar CC: Jody Nishman From: Chris Vreeland Date: December 19,2011 Re: Inspection and Analysis for Potential Solar PV System—92 Main Street,Florence,MA This letter summarized the analysis of the structure for the structure at 92 Main Street in Florence,MA.The building owner plans to have a solar photovoltaics(PV)system installed by Northeast Solar.The added loading from the solar PV system triggers the need for a review of the supporting structure per the 8th Edition of the Massachusetts Building Code.Chris Vreeland of Precision Decisions inspected the structure. Activities Performed and Site Observations - The roof's supporting structure was measured for further analysis to determine the loads and stresses on the structural members. - The roof is comprised of metal decking by insulation and a rubber membrane.The decking is supported by 18"steel joists on 4'-6"centers spanning 30 feet. - There are four HVAC units on the roof close to load bearing walls;however a portion of their load is transferred to the adjacent roof joists.These joists that support that HVAC loads cannot be used to support any additional loads from a solar PV system. - The remaining roof area(not supporting HVAC loads)was analyzed and has an apparent collateral load of 50 pounds per square foot. Conclusion Based on my observations and analysis,it is my opinion that the structure can support the loads of a solar PV system and meet the requirements of the 8t Edition of the Massachusetts Building Code.The total loading from the array cannot exceed 5 pounds per square foot average load.The final design of the solar system will need to be reviewed for the total load as well as concentrated loading on the roof. No portion of the solar array can exceed 21"above the roof as it would result in a driftin• condition. Sincerely, 0 Vnr s Y reefaner ��� /am- 0 ER y,�''1! Chris Vreeland,PE . 1700 % 5 Ors Q/$7E09�'4� The Commonwealth of Massachusetts _ Department of Industrial Accidents IT,, 1 if i � . �� Office of Investigations 600 Washington Street ./ Boston, MA 02111 '''',3'q f,4 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): NorthEast Solar Design Address: 136 Elm St . City/State/Zip: Hatfield, Ma . 01038 Phone #: 413 -247-6045 Are you an employer? Check the appropriate box: Type of project(required): 1. © i am a employer with 9 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub contractors 6. ❑ New construction 2.El am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. n Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. n We are a corporation and its 10.0 Electrical repairs or additions 3.n I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152. §1(4), and we have no Solar employees. [No workers' 13.E1 Other 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. Below is the policy and job site information. Insurance Company Name: Hanover Insurance Policy # or Self-ins. Lic. #: WHN 5715134-02 Expiration Date: 4/8/15 92 Main St . Florence, Ma 01062 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation 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 that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do hereby certif. r tl 'p I •, and penalties of perjury that the information provided above is true and correct. Si'nature: 4grAlp .1 , Date: 7/9/13 Phone#: 413-247-6045 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#: Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes ® No Q SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Jody Nishman as Owner of the subject property Northeast Solar hereby authorize to act on my,I�ehalf, • II matters rel ive to work authorized by this building permit application. (/�(� 06/27/2013 Signature of Owner c_ Date Northeast Solar, Ann Bronner as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed der the • • s and penalties of perjury. I 4411 /' •finP.1� Print - , /1 06/27/2013 ignature o : er a gent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Phillip Baunsgard CS-106113 License Number 11 Edward Ave Southampton, Ma 0 S" 06/07/2015 7rirci / Expiration Date j � ,(413) 247-6045 -it, . ure Telephone SECTION 13-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 0 No 0 Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Northeast Solar Not Applicable ❑ Company Name: Phillip Baunsgard Responsible In Charge of Construction 136 Elm St. Hatfield, Ma 01038 Ade. , (413) 247-6045 .nature 4/,'" Telephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING 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 parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW YES C IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES l 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 l NO l 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 0 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 (1/4) NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other 0 Brief Description Enter a brief description here. Install 44 solar panels on roof Of Proposed Work: SECTION 5 -USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 0 1A I ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 26 I ❑ F Factory ❑ F-1 0 F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ I-1 ❑ 1-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1St 1st 2nd 2nd 3 d 3rd 4th 4th Total Area (sf) Total Proposed New Construction (sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system 0 Versionl.7 Commercial BuildingPermit May 15,2000 Department use only ty of Northampton Status of Permit:�. B ilding Department Curb Cut/Driveway Permit - 212 Main Street Sewer/Septic'Availability ':,ii ' a�� Room 100 Water/Well Availability No hampton, MA 01060 Two Sets of Structural Plans phone 13 587-1240 Fax 413-587-1272 Plot/Site Plans DEPT OF BUILDING INSPECTIONS Other Specify MA 01060 pecify APPLICATION TO CONSTRUCT,REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 92 Main St. Florence Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jody Nishman 92 Main St. Partners LLP 92 Main St Florence, Ma 01062 Name(Print) Current Mailing Address: %�'�'L - (413) 586-8105 Signature (2 Telephone 2.2 Authorized Agent: Northeast Solar 136 Elm St. Hatfield, Ma. 01038 Name(Print) Current Mailing Address: (413) 247-6045 Sign 6 Telephone i (�i V RLPfer-z, SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit 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 $51 068.00 6. Total= (1 +2+3+4+5) Check Number //95' 0306 t /' D This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0007 APPLICANT/CONTACT PERSON NORTHEAST SOLAR DESIGN ASSOCIATES LLC ADDRESS/PHONE 136 ELM ST HATFIELD (413)247-6045 0 PROPERTY LOCATION 92 MAIN ST MAP 23A PARCEL 069 000 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �j l Fee Paid 3 x`76— b' 1+0 Typeof Construction:_INSTALL 44 ROOFTOP SOLAR PANELS 1 /r 7 //VI New Construction j it/VI Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 106113 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ION 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 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. 92 MAIN ST BP-2014-0007 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A-069 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SOLAR PANELS BUILDING PERMIT Permit# BP-2014-0007 Project# JS-2014-000059 Est.Cost: $51068.00 Fee: $306.40 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NORTHEAST SOLAR DESIGN ASSOCIATES LLC 106113 Lot Size(sq. ft.): Owner: 92 MAIN ST PROPERTIES LLP Zoning: GB(100)/ Applicant: NORTHEAST SOLAR DESIGN ASSOCIATES LLC AT: 92 MAIN ST Applicant Address: Phone: Insurance: 136 ELM ST (413) 247-6045 () Workers Compensation HATFIELDMA01038 ISSUED ON:7/19/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 44 ROOFTOP SOLAR PANELS 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 7/19/2013 0:00:00 $306.40 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner