31C-071 BP-2023-0283
67 HIGGINS WAY COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31C-071-001 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-2023-0283 PERMISSION IS HEREBY GRAN ED TO:
Project# 2023 SOLAR Contractor: License
Est. Cost: 37752 VALLEY SOLAR LLC CSL1156:0
Const.Class: Exp.Date: 04/09/2025
Use Group: Owner: LLC NOVA REALTY HOLDINGS,
Lot Size (sq.ft.)
Zoning: PV Applicant: VALLEY SOLAR LLC
Applicant Address Phone: Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840101
EASTHAMPTON, MA 01027
ISSUED ON: 03/07/2023
TO PERFORM THE FOLLOWING WORK:
INSTALL 30 PANEL 10.8 KW ROOF MOUNT 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 VI I LATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
, yo . I
i Q
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
, n
The Commonwealth of Massachusetts ife9� ;
Board of Building Regulations and,Standards FOR
Massachusetts State Building Code, 780 CMR (70 MU.�TICIPALITY
US
Building Permit Application To Construct,Repair,Renovate Orilish as Revised Mar 2011
One- or Two-Family Dwelling <
This Section For Official Use Only ". c�'
Building
Permit Number: 3 � Date Ap lied:
Kc-vi .'�SS � -20Z
0 3
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
67 Higgins Way, Northampton, MA 01060
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 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Luong Nguyen Northampton, MA 01060
Name(Print) City,State,ZIP
67 Higgins Way (508)615-7792 luong.nguyen.pharm@gmail.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addit on ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other ® Specify:solar
Brief Description of Proposed Work2: Installation of 30 panel roof mounted solar array. System size 10.8kW DC.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $26,426 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $11'326 ❑ Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) Total All Fees: $ 14 ['
Check No.764cCheck Amount: �`� Cash Amount:
6. Total Project Cost: $37,752 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-115680 04/09/2025
Patrick Rondeau License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
53 Fox Farm Rd
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft
Florence,MA 01062 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-584-8844 permits@valleysolar.solar I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
Solar LLC 186338 10/27/24
Valley HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
116 Pleasant Street,Suite 321 permits@valleysolar.solar
No.and Street 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 .0
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.
T ret rt- 03/01/2023
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER1 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 of my knowledge and understanding.
/Gi ffli ,e6.g. 2aca 1/23/23
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 con tractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/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
iT Ifq�. ,: ff
A` Massachusetts �, v
[ � � DEPARTMENT OF BUILDING INSPECTIONS ,p4 a''
b . 4 4,,,, 212 Main Street 40 Municipal Building 13
,a
Northampton, MA 01060 Wii=aVO{t
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 dis osed 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: Pa-tu P /een4'a�u� Date: 1/23/23
The Commonwealth of Massachusetts
Department of Industrial Accidents
Ammo
I Congress Street,Suite 100
•
Boston. MA 02114-2017
wwwinass.govidia
t--5W
' otters Compensation Insurance A(Tidos it:Builders/C:ontractors/ElectriciansfPlumbers.
1-11.[I)%Ill! I III PF.RAIIITING At FIR)RITV.
Annlitant Informally!! Plea.se. Print i.elLilds
Name t Business,Organtza Lion.Individual r Valley Solar LLC
Addres,: 116 Pleasant St Suite 321
city,:state,.zip• Easthampton, MA 01027 Phone#:413-584-8844
Are you an employer?Cheek the a pprupriate pe of project(required):
i>1 I am a employ,rs with 30citsrloycvs troll airatot port-titna• 7. CI New construe on
2C3 am a sole proprietor or partnership and tune no employees%lankily fur me in 8. [] Remodeling
any capacity.(No siva-kers°comp.insuranc
e n.s.pural.)
9. 0 Demolition
1[31 am a hotIRENIWILLI doing an wodk myself.[No*arias'comp_IIISUrdlltA:nNuxrcd. °
109 Building addi an
4.9 I am a liiimeolvner and will he hiring contractors to conduct all work on my property_ I will
=sure that all coatrooms either have workors*compensation insurance or are sole 11E3 Electrical r a irs or additions
proprietors with co employees_
12.0 Plumbing or additions
I am a stencral cuntractor and I have hired the sub-cotanietors listed on the attached sheet
3C1Roofrepairs
These soh-contractors fuse employees and have workers'ouirip,..unutionco.:
14. °diet Solar
6.0W are a 4.-011ydratIon and as officers have caraviscd their right ofesemption pet SAGE.c.
)52.t.ti4i.and we ltase no employees.[No workers'WITT,insurance requin:d.I
An applicant thut cheeks lox ti I must oho till out the reetitm below showing then workers'compensation policy information
litmeoworrs.who strinna this affidavit indicating they are doing all work and then hire outside cuaturctors must submit a new affidavit".•hating streli.
:Contractors that check this box must tinached an nddjtiunal .lutxt stow.mg the name of the soh-contractors and state A haler or not thaw team have
empkiyecs If the sids-contractors have omployoes,they must provide their workers"comp policy number
1 am an employer that 1 pre, ierarLers'compensation insurunce for my employees. Below is the policy utol job site
information.
Indemnity/AUW
Insurance company ContinentalNatne:
Policy At or Self-ins. Lie.#: 376140840101 Expiration Date. 09/01/2023
Job Site Address: 67 Higgins Way citystateizip: Northampton, MA 01060
Attach a copy of the workers'compensation pulley 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 line up o S1,500.00
and,or one-year imprisonment,as well as civil penalties in the fat/it of a STOP WORK ORDER and a tine of us to S250.00 a
day against the%101itor.A copy of this statement may he forwarded to the Office of Ins estigations of the DIA t r insurance
coverage
1 do hereby certili under the pains and penalties of perjury that the in f ormation lyre)tided above is true and t orret t.
Signature: 2ti /26W-W tv,..1, 1/23/23
phor, 413-584-8844
Official use only. Do not write in this area,to be completed
by or town official
City or Town: Permit/License
Issuing Authority (circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
Other
t'untart Person: Phone#: