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October 26, 2013 Designer : Owner 1:44 PM Job Number : KOLODZIEJ panel analysis of rafters,pete kolodziej Checked By: Reactions, By Combination, (continued) LC Joint Label X Force Y Force Z Force X Moment Y Moment Z Moment (k) (k) (k) (k-ft) (k-ft) (k-ft) 1 N3 .017 .171 0 0 0 0 1 N7 -.021 .458 0 0 I 0 0 1 N8 .01 .391 0 0 0 0 1 N9 -.021 .458 0 0 0 0 1 Totals: 0 1.649 0 1 COG (ft): X: -6.76 Y: 3.152 Z: 0 LISA-3D Version 4.5 [C:\RISA\SOTH HADLEY SOLAR ROOF ANALYSISOF RAILS.r3d] Page 2 Company : Frederick J. Dzialo &Company Inc. October 26, 2013 Designer : Owner 1:44 PM Job Number : KOLODZIEJ panel analysis of rafters,pete kolodziej Checked By: , Global Steel Code ASD: AISC 9th, AISI 99 Allowable Stress Increase Factor(ASIF) 1.333 Include Shear Deformation Yes Include Warping Yes No. of Sections for Member Calcs 15 Redesign Sections Yes P-Delta Analysis Tolerance 1 0.50% Vertical Axis Y Materials (General) Material Label Young's Modulus Shear Modulus Poisson's Thermal Coef. Weight Density Yield Stress (ksi) (ksi) Ratio (per 10^5 F) (k/ft^3) (ksi) SPF 1200 480 .3 .65 0 0 Sections Section Database Material Area SA(yy) SA(zz) I y-y I z-z J(Torsion) T/C Label Shape Label (in)A2 (inA4) (in^4) (in^4) Only SEC1 SPF1 SPF 8.25 1.2 1.2 1 52.21 1 SEC2 SPFIRNOI 2X8 W1 10.875 1.2 1.2 2.039 47.635 7.093 Joint Coordinates Joint Label X Coordinate Y Coordinate Z Coordinate Joint Temperature Detach from (ft) (ft) (ft) (F) Diaphragm N 1 L -13.52 0 0 0 No N3 0 6.305 0 0 No N7 -10.14 1.57625 1 0 0 No N8 -6.76 I 3.1525 0 0 No N9 -3.38 I 4.72875 I 0 0 No Member Data X-Axis Shape/ Material Phyy.O.M. End Releases End Offsets InactiveMember Member Label I Joint J Joint K Joint Rotate Section Set Memb I-End J-End I-End J-End Code Length Idegrees) Set xyz xyz xyz xyz (in) (in) (ft) M2 NIL N3 I SEC1 SPF Y 14.918 Boundary Conditions Joint Label X Translation Y Translation Z Translation MX Rotation MY Rotation MZ Rotation (Win) (k/in) (k/in) (k-ft/rad) (k-ft/rad) (k-ft/rad) N1L Reaction Reaction Reaction Reaction Reaction N3 Reaction Reaction Reaction Reaction Reaction N7 Reaction Reaction Reaction N8 Reaction Reaction Reaction N9 Reaction Reaction Reaction I Member Direct Distributed Loads, Category: OL1, BLC 1 : sol Member Label Direction Start Magnitude End Magnitude Start Location End Location (k/ft,F) (k/ft, F) (ft or%) (ft or%) M2 V -.122 -.122 j 0 I 0 Reactions, By Combination LC Joint Label X Force Y Force Z Force X Moment Y Moment Z Moment (k) (k) (k) (k-ft) (k-ft) (k-ft) 1 N1L .017 .171 0 0 0 0 RISA-3D Version 4.5 [C:\RISA\SOTH HADLEY SOLAR ROOF ANALYSISOF RAILS.r3d] Page 1 Summary of Results Computer results indicate that for the prescribed panel loads and snow loads the roof framing is capable of sustaining the applied loads. The roof framing consists of 2"x6"wood roof joists spaced at 16inches off centers. The roofing also is covered with 5/8 inch ply wood. The rails supporting the solar panels are spaced horizontally at 48 inches off centers. The rails are supported at 40inches off centers. The loading for the analysis was as follows: Ground snow load=40 pounds per square foot. Dead load of panels= 5 pounds per square foot. Dead load of roofing= 10 pounds per square foot T. 1 OCT 2 8 2013 �) 0 L s Electric, Pi,M;- . ons N°`` L. Frederick J. Dzialo 8z Co., Inc. Roof Analysis Due to Solar Panel Loading Structural Engineers Frederick J. Dzialo &Company Structural Engineers Hatfield, Massachusetts Pete Kolodziej 83 Florence Street Northampton, Massachusetts October, 26,2013 Registration Massachusetts Connecticut "' 'Pt Rhode Island FREDERICK 4'^; Vermont DZIALO New Hampshire No. 17657 .trout.. 0 4. New York 'Stout 04\� / New Jersey A. ' 1 Pennsylvania /0/A b Vi Colorado 19 Pleasant View Drive, Hatfield, MA 01038 • 413-247-5740 LI 1=h... kl •■■',di 0 Physical Characteristics 992mm 942mm Mounting 39.1 in 37.1 in holes 9mm x 14mm i -- -- _-- Q 0.35in x 0 55in 1 ,����������. u a 1...!'11111111111111111 50mm 1111111111P 1111 1 _f 008in ["' 860mm 1000mm I~ n~I [ 1650mm 1 M33.9in Mounting holes • Ground 5 1 38i 65.Oin 1m mm 0.2in 1 36S 1111.1111111111111 Drainage f ° ` ,. holes i f •I [':#i / ' 7. - + 0 Physical Design Properties 0 IV Curve 9 - Weight 43.7 lb[19.8 kg] 8 Maximum Tested Load ±50 psf[2400 Pa]/+113 psf[5400 Pal* --- Q Hailstone Impact Resistance 1"L 50 mph[25 mm @ 80 kph] c Junction Box IP65 rated t 5 = 4 1000 Wtm?,25°C cell 4.0mm'Universal PV Wire, U 3 - 1000 W/m2,60°C cell Output Cables 1000mm[39.4in], -- 800 Wfm2,48'C cell Tyco SOLARLOKO Connectors 2 _. FIefer to module installation instructions far maximum loading configurations. 1 0 0 0 10 15 20 25 30 35 40 CO Electrical Performance Voltage(V) "�, 1 tr �1 r2t°r - ' �"�. �� °t�" *, ; t "E ..w a' i 27�°t . e "��-.. gg i, i, 'ice, .,.4 aJ ,,; Test E Conditions STC NOCT STC NOCT STC NOCT STC NOCT Max.Power Voltage Vmpp(V) 29.1 26.2 29.4 26.6 29.8 27.0 29,9 27.1 Max.Power Current Impp(A) 7.9 6.3 8.0 6.4 8.1 6.5 8.2 6.5 Open Circuit Voltage Voc(V) 36.8 33,8 37.1 34.1 37,3 34.2 37.4 34.3 Short Circuit Current Isc(A) 8,4 6.8 8.5 6.9 8.6 7.0 8.7 7.1 0 Electrical Performance Parameters Isc Temperature Coefficient a(%/`C) +0.07±0.02 Max.Series Fuse 15A Voc Temperature Coefficient [3(%I C) -0.34±0.01 Max.System Voltage 600V, 1000V Pmax Temperature Coefficient r(%/'C) -0.46±0.02 Normal Operating Cell Temp.(NOCT) 48"C±2°C Efficiency Reduction at 200W/m1,25"C <5% Limiting Reverse Current(Ir) 8.7A IV parameters,are rated at Standard rest Conditions(Irradiance of 1000 Mai',AM 1 5 cell temperature 25"t Al me su ements are guaranteed at the laminate leads. NGCT;5 rnE nsured at 800 Wa 1 20`G ambient,ar d 1 m s windspeed.SI e r iheuSens<a e subier t to charge xithaut nonco. �� tlatar.h reserves the rnhts of final interpretation and revision on this datasneE t =�af ,�7 'x 8 r, ::w w i�2 Via:;a "I i"a" `tt all z I[(x ;;a r�'x ?ill O �Ii.tiV�' x`4 1 P t� 'iFfH II'i e s is i�,, 9 I rat" ti" a 1 +na t 6 ,,T -a ' �` ~wt ;u 1+u ti �It •', ; 1� " °iarya.d#�F ra•P a Fti 'ry7 �t�'M. �:� t .w^r E pd I`- '���)t ;;; a 'r AI;+ "'�*wW°,V *" � ,� 'F r��+ G at s x ,* rt- ai d .'` '4'' hp�Ai t;,,," d *�r d t tr ^+ j tl ;' tit is r F�'r Va V4 I 4�1 u k a; .t r �k a+') .�:' .���!��W ; 7 nr ��t: ; ;'c�,It '�'�*�+t` ��33 � �' aRh k �w ��' t� S( a ,4"'°'��' �, } ii x = u r d err it ,; �} 71' aiV7 4�1 ' ��tS . i r '° �� L;i, /a a 1r ' ha 4r t p4� 1 „ 1 �; i a a ��� a a a a W/ taaN t ,7 ; l r i-�rd a Z = ri -w,rr �a ,,�i i _ „,,,.'-' --..-:•,•,, - , 44.7' -1, -,■n= ' EL'',:41.,;%,4,,,,Adr'', 1M60 Series Photovoltaic Modules Peak Power: 230-245Wp .,. 0 Features I - 60 MOTECH multicrystalline solar cells connected in series . i _...._ ..... a Designed for 600V or 1000V applications . For residential, commercial and solar farm grid-tied applications . 1 _ Output power tolerance of-3% +5% Robust, anodized aluminum frame and tempered glass ., . Tyco junction box, easy click SOLARLOK°connectors and 1 , t cables ---- --- ---- — ---1- --- L. ' ------ 1, Manufactured globally with world-class quality standards , ■ - t 1 0 Quality, Reliability, and kWh Yield i t MOTECH modules are powered by industry acknowledged high performance, reliable silicon cells. The modules have . . been designed and engineered with over 20 years of industry t 1 experience. Rigorous durability and performance tests are ii performed to ensure each module's lifetime performance and , maximum kWh yield. . ------------' ---!!!!' ---'!-- :: *"r;;: ; :,-,,Anai-i-c,t;',, italamiii ttain4C-04111A,Sk 41■14. idt.i.,-.30.-16=,.., Ar4,rki ,-,-,„ yolk N..,v 1`10.6111.1111111.110.1 rt;L;rtr,21,_trirrf' ' 14111.11111.rar:4-,31 ,VIVL.N.,riN...I.", (;) Certifications & Standards* 0 25-Year Extended Warranty* EU 10-year warranty at 90%: 25-year warranty at 80% EC (I) ( E Ss -lllt 5-year warranty on materials and workmanship 'Please refer to our website for certification and warranty details. Intertek I ntertek Application Class A IEC 61215 CEC listed{US) Safety Class II IEC 61730 CEO listed(AUS) UL 1703 FSEC listed J-PEC listed ri i i ;,,,1,,:•,,-:..'.„-,..-'',.;,,.,:'„-,,:•--,-,:.::.,o;:',*0\..?,.;i'''r,?.'-:'..P,",-,t.'.-.i`,"I'i,'\,.N',t,:'..'?.','.i',;,, , Developed by Engineers N.i,-,k_0.,,:..,,-..',44..,...1-.,i...y7,i;,-',:ii-..r.,'-,;.v4:,t.7.:,-'7-,i7g"-.=..S'",'N..„-,:'-.,4 T':4„‘..,'O..7:”',-s y..;7,,''„-',..:i'-;''',v..,'•4I- i.,,„'-7,,,,.-',„!..,,,,-.-".(/,''-,7/.1,,.,'.0,',,„,!(-„.-,;.,/1,,.,.r;,......17.,".-*,:;%,k7-.,„k and Installers 7ti The SnapNrack System was developed :„,4 ,'i. in the field by a team of veteran solar .... engineers and installers.Their goal .-”` was overcoming the limitations of conventional racking and ensuring „. - �. a quick, efficient installation.These mounting rails have been tested on r a megawatts of real world residential and / `' commercial installations. - The Ideal Fit for Any Roof The SnapNrack System has been engineered from the ground up to ensure maximum standoff adjustability for a clean, level installation on even the most irregular roof surfaces.And every roof penetration gets a full metal flashing to `I ensure worry free waterproofing for the life of the system. 4 Tilt? Ground mount? w No problem! � � ;` The Sna Nrack S stem allows you to i64 ' easily configure a racking solution for ; 1-: m ",` 1t4 . a any tilt. Or sink pipes in the ground for a w -'.-/... s perfect ground mount. For tall tilt angle , 4 ? requirements the rails double as legs, •• , The Flashed L-Foot for composition Roof top adjustable standoff. simplifying / roof attachment. in-field / ` '`� design. ✓ > : . 0 Pipe-to-rail cannertion for S . ground mount systems ', y See the SnapNrack Ground Mount manual for more details rnf Sna l i roc k,,TM www.snapnrack.com printed with eco-friendly paper and ink +rid Rev.2.0 ©2011 SnapNrack.All rights reserved. ' ,,...-.,- t„.,„, tF Sna i �c rack M Faster Installation, Lower Cost §r�t dw ' �°,+.. "^ >;z ,u 4 t s k 5�, " �q { a47 d.,a i4Me t �` 3 '� a,.. :r.>. A¢'•°v ,r, '^., a � " z .a ., a t IG`a.i 'r ri' NNW' III • lllp•i M11∎11))) rr, Y 8 }} 4` fi ..'''':V+ 9 5'x` *41 ey fix. ,, ,..04 Any►, A'* '". [�'p* Low-profile installation for enhanced aesthetics. The SnapNrack PV Mounting System is a line of solar racking specifically designed to reduce your installation time. The SnapNrack system incorporates major technical and production advances to simplify and reduce the cost of solar installations. SnapNrack is designed to be simple, adaptable and strong: SIMPLE the entire rail section, not just on a I • Sliding module clips install quickly the ends. and easily and ensure precise • Run module leads through the a;� ,� J1,17 alignment. Mid clips are a half-inch SnapNrack rail channels for ` thick to keep the math simple. better aesthetics and improved ' � • One wrench fits every bolt in the wire management. system.And there's no need to drill STRONG the rails to connect standoffs and . SnapNrack is engineered for L-feet, ensuring efficient installation durability and structural integrity and reducing labor time on the roof. in all environments with excellent New Innovative • SnapNrack's compact, efficient seismic,wind, and snow-loadin rail profile reduces material require protection on all components. g Universal End Clamps men and ensures a low profile • One size fits any module with a • Builds integrity into every standard L frame. installation on any roof. installation because SnapNrack's ADAPTABLE simple vertical and horizontal • Provides a cleaner look with the • SnapNrack is compatible with adjustments ensure superior fit new rail end caps modules from virtually any and array alignment. • Quick assembly half inch wrench manufacturer. • SnapNrack's rain-tight metal fits all fasteners! • The SnapNrack's unique''snap-in" flashing ensures absolute water- ■ Less rail required nothing extends channel nuts are installable along proofing at all roof penetrations. beyond the module frames. • The Commonwealth of Massachusetts ;,,, Department of Industrial Accidents .,... Office of Investigations 600 Washington Street t leriiii Boston,MA 02111 ` > ° www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): A i J lA.r I "All n ,,r— Address: ?)- 'FL ( s--ti-, City/State/Zip: .S0 u,kk Haava 641 MA Phone #; /-/13 40..5.-y - y6o 3 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I _ employees(full and/or part-time).* have hired the sub-contractors 6. ['New construction 2. ki I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 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 f /� employees. [No workers' ?V ?V Sc u-r ll" ., 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. tContractors 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: Policy#or Self-ins.Lic.#: Expiration Date: 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 certify u der t .e.icrins and penalties of perjury that the information provided abo e is tr e and correct. Signature: j`a't""1� Date: (� ( r 7j Phone#: 41 13 I (1 S 1?-- (0Cl t5 Official use only. Do not write in this area,to be completed by city or town official City or Town: PITTSFIELD Permit/License# Issuing Authority: Building Department Contact Person: Phone#: (413)499-9440 • , • _ _ _ Massachusetts -Department of Public Safety -Wif :ttT. - .,. . SETTS Board of Building Regulations and Standards l'ott‘tructuin Suer'nor License CS452870 410, ,. z:".J.,,• - :A...x."0 ,-- 8 . ".' + - ,., .r.:,' . .. ;..,.., KERRY A FOURNIER 4. , '""..... V'' ' ' ' i ' ". 72 HADLEY ST .= *1 ; '.-.-. *40'',.• SO HADLEY ma--oiq-, - , 4..... ,,- ,. .., .„ ,i, 0 ” Expiration i In ,,g 01.754047 Commissioner 05/12,2015 l-," t-- _. .. e -6:70 ill ' I' I 41 4 if I ' f I Office of Consumer Affairs and usiness Regulation r'"---,4-7,„.• 10 Park Plaza - Suite 5170 "...,•"`„,.-.,,,. Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171789 Type: Individual Expiration: 4/24/2014 Tr* 224194 KERRY FOURNIER _ KERRY FOURNIER ,s , , _____ _ _ 72 HADLEY ST _ SOUTH HADLEY, MA 01075 . , Update Address and return card.Mark reason for change. Address Renewal r---'1 Employment •-:" Lost Card DPS.CA1 O 50M-04/04-6101216 :7;4 ;,,n,ottrouveriiig ell. Iii,a4fiStiC.44.4.k.A License or registration valid for individul use only ''''\ Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR 1;- Type: Office of Consumer Affairs and Business Regulation -".: Registration: 1:71789 10 Park Plaza-Suite 5170 ''i Expiration: 4/2412014 Individual Boston,MA 02116 KEI:ZKY FouRNIER ' .. 1- KERRY FOURNIER c I 72 HADLEY ST ers-:....."... ..— t , SOUTH HADLEY,MA 01075 Undersecretary I Not valiC)IrfLt 4'Id it ou signature — 1 I Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYYP 1 L_.-.-----• 06/12/2013 ' ' 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 NAME: Metras Insurance Agency, Inc. (A/CC No FM): (413) 536-1491 I ac NQ):(413) 532-8522 2030 Memorial Drive E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Chicopee MA 01020- INSURERA:Travelers Indemnity Insurance INSURED Kerry Fournier dba Fournier Building INSURER B: 72 HADLEY STREET INSURER C: INSURER D: INSURER E: , SOUTH HADLEY MA 01075- _INSURER F: COVERAGES CERTIFICATE NUMBER: 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. NOTVNTHSTANDING 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 IADDL SUER POLICY EFF POLICY EXP • LIMITS LTR 1,N SR WVD POLICY NUMBER (M /Y M/DDYYY) (MM/DD/YYYY) A GENERAL LIABILITY 16800010067701-IND-12 07/11/2013 07/11/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY / / / / PREMISES En occurrence) $ 300,000 CLAIMS-MADE X J OCCUR / / / / MED EXP(My one person) $ 10,000 / / / / PERSONAL&ADV INJURY $ 1,000,000 / / / / GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS-COMP/OP AGG $ 2,000,000 —I POLICY n PROT- [ ]LOC / / / / $ JEC I AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT (Ea accident) ANY AUTO / / / / BODILY INJURY(Per person) $ ALL OWNED SCHEDULED / / / / BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED / / / / PROPERTY DAMAGE $ HIRED AUTOS AUTOS OS (Per accident) / / / / $ UMBRELLA IJAB _ OCCUR / / / / EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE / / / / AGGREGATE _ $ DED I I RETENTION$ / / / / $ WORKERS COMPENSATION / / / / WC STATU- 1 10TH- I 1 AND EMPLOYERS'LIABILITY I TORY LIMITS ER Y/N / / / / ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) / / / / E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below / / / / E.L.DISEASE-POLICY LIMIT $ / / / / / / / / DESCRIPTION OF OPERATIONS/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 ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Insurance AUTHORIZED REPRESENTATIVE - 8rue&P Nuett& I ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD 'SECTION`8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: kkcr RO v r h i f.r —7(J / 0 l / License Num r l S 0-1/1 147A) (tit) 11(0- /07'S— /P.- / Address 7 Expiratio Date 41(^A'14- u[3 6Se d'lo03 Sig ature Telephone , a ..� , Not Applicable ❑ Fern %t- &&tt` Idin ��r ( f irn,.Le— 12/ 7 Company Name V Registration Number Ct LV) Vt V )-Li/) Address Expirat on Dat Telephone SOS' . r - CECTION 1b WORKE 3S'°COMPENSAT1QI I I SIIRANCE AFFIDAVIT(M AL L 182, 5C(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 ❑ 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing 7 Or Doors D Accessory Bldg. ❑ Demolition El New Signs [D] Decks [p Siding[D] Other[p1 ?V .-\01 i.r rR-vr Brief Description/o, Proposed ,9 �+ r. It Work: '1 3 T a S Pa��J�i. c71, ���vu,b C� i`d0 ��, �+ Are. X�p X l3 ( /6 6.1^ G,r-" Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No 0.0 r OU'A - Plans Attached Roll -Sheet pa-od i e-f 6a. If New house and or addition to existing housing, complete the following: p vl� 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 P,o(l-fy h10/0(47i L 1 , as Owner of the subject property °1 hereby authorize Q t`c Li k--1) u, P.{— to act on my behalf, in all matters relati a to work authorized by this building permit a plication. Si nature of r ( 47CQ Date 1°7 AV)3 , 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 under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date 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 parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO tall DON'T KNOW 0 YES 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 44 DON'T KNOW 0 YES 0 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 .4) 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 04. 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 0 NO t®� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ,-,1 I- _ 1,'!' '-„ De art?Aent use only l''—',„'i City of Northampton Status of Permit ', , ° Building Department Curb'Cut/ nveway Permit _ Li ii OCT 2 1 2013 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability yx" Electric, Piumbing&Gas Inspectionilorthampton, MA 01060 Two Sets of Structural.Plans,, Northampton, MA° 9ne 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 g J Fl0r e.n t..e ge • Map Lot Unit _� Zone Overlay District I--e.e4 (7� Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ownerrof Record: P }-to L ) 32 ( °r /� Name ' t) Current Mailing Address:-40, ) i l e J � 7� Telephone gnatu 2.2 Authorized Agent: /-6-4. J e�Lt corArr : 7a S-/. �uA / ft'1 M ?4 Name(Print) Current Mailing Address: r /073- /.u. _ ��• 11/ '3 lJ5-g - Y(oo 0 Signature Telephone 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 �y f SO 6. Total=(1 +2+3+4+ 5) @� g 1 go 0 ,, 0 0 Check Number /o7 This Section For Official Use Only !, Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0496 APPLICANT/CONTACT PERSON KERRY FOURNIER ADDRESS/PHONE 72 HADLEY ST SOUTH HADLEY (413)658-8600 PROPERTY LOCATION 83 FLORENCE ST MAP 11C PARCEL 066 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid /0 $13 Typeof Construction:_NSTALL ROOF MOUNTED SOLAR ARRAY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 52870 3 sets of Plans/Plot Plan THE FOLLO ON HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ION PRESENTED: pproved 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 -' o iti.•. D ela S tune of Bui .in rOffi ate 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. 83 FLORENCE ST BP-2014-0496 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 11C-066 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 PANELS BUILDING PERMIT Permit# BP-2014-0496 Project# JS-2014-000842 Est.Cost: $21800.00 Fee: $130.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KERRY FOURNIER 52870 Lot Size(sq. ft.): 20865.24 Owner: KOLODZIEJ PETER J&MARILYN J Zoning:URA(100)/ Applicant: KERRY FOURNIER AT: 83 FLORENCE ST Applicant Address: Phone: Insurance: 72 HADLEY ST (413) 658-8600 SOUTH HADLEYMA01075 ISSUED ON:11/1/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL ROOF MOUNTED SOLAR ARRAY 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 11/1/2013 0:00:00 $130.00 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Louis Hasbrouck—Building Commissioner