Borawski_Northampton Building and electric Permit App signedDocuSign Envelope ID: 87CB1508-D258-4463-A573-89A80DDDE697
The Commonwealth of Massachusetts
*� Board of Building Regulations and Standards
FOR
Massachusetts State Building Code, 780 CMR
MUNICIPALITY
USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a
Revised Mar 2011
One- or Two -Family Dwelling
This Section For Official Use Only
Building Permit Number:
Date Applied:
Building Official (Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map & Parcel Numbers
10 Pinebrook Curve
Map Number Parcel Number
L l a Is this an accepted street? yes X no
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 ❑
Zone: Outside Flood Zone?
Check if yes
Municipal ❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner' of Record:
KathyBorawski Northampton MA 01060
Name (Print) City, State, ZIP
10 Pinebrook Curve 413-539-4878 kathyborawski@comcast.net
No. and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction ❑
Existing Building ❑
Owner -Occupied ❑
Repairs(s) ❑ 1 Alteration(s) ❑
Addition ❑
Demolition ❑
Accessory Bldg. ❑
Number of Units
Other P Specify: Solar
Brief Description of Proposed Work 2: Install 40 solar panels on Carport a
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building
$
1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2. Electrical
$
❑ Total Project Costa (Item 6) x multiplier x
3. Plumbing
$
2. Other Fees: $
List: _
4. Mechanical (HVAC)
$
5. Mechanical (Fire
$
Su ression)
Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost:
$65,940
F
0 paid in Full 0 Outstanding Balance Due:
DocuSign Envelope ID: 87CB1508-D258-4463-A573-89A80DDDE697
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License (CSL)
C S —10 6113 6/7/25
Phillip Baunsgard
License Number Expiration Date
List CSL Type (see below) U
Name of CSL Holder
41 Heath Rd
Type
Description
No. and Street
Colrain, Ma 01340
U
Unrestricted (Buildings up to 35,000 cu. ft.
R
Restricted 1&2 Family Dwelling
City! 'own, State, Z .`
M
Masonry
I
RC
Roofing Covering
'
WS
Window and Siding
SF
Solid Fuel Burning Appliances
413-247-6045 Phil@ rtheast-solar.co
I
Insulation
Telephone Email address
D
Demolition
5.2 Registered Home Improvement Contractor (HIC)
Northeast Solar
169641 7/13/25
HIC Registration Number Expiration Date
Permitting@northeast-solar.com
HIC Company Name or HIC Registrant Name
136 Elm St.
No. and Street
Hatfield_, Ma. 01038 413-247-6045
Email address
City/Town, State, ZIP Tele hone
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 ..—. .... 9 No ........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES I+Olt BUILDING PERMIT
I, as Owner of the subject property, hereby authorize Northeast Solar
to act on my behalf r 1�I�i&VWs relative to work authorized by this building permit application.
(aDVAWS�cI 2/6/2024
Print Owner's Name e r is i ndture Date
SECTION 7b: OWNER' 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 if my knowledge d understanding.
. 2 2�
Print Owner's or ALitho '. d Agent's Name(Cectronic Signa e] 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 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.itaass.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 Nuinber 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"
Official Use Orly
Commonwealth of Massachusetts Permit No..
Department of Fire Services Occupancy and Fee checked:
BOARD OF FIRE PREVENTION REGULATIONS [Rey-. V2023]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ► ORK
All work to be performed in aocarclance with die Massachusetts Electrical Code (MEQ, 527 C4'IR 12.00
Cite or Town of: Northampton Date:
To dieInspector of )Fires. Tly ibis appEcadm the unders4ped gives noute: ofhis ar her=mdon to peromr the ektnca: wank dezm_ted bdoar.
Location (Street & Number): 10 Pinebrook Curve Unit No_:
Owner or Tenanr. _ _ _ Kathy Borawski Emad: kathyborawski@comcast.net
Owner's Address: 10 Pinebrook Curve phone No_: 413-539-4878
Is this permit in conjunction with a building permit: (Check appropriate boa) Yes ® No ❑ Permit No.:
Purpose of Building: Residence Utility Authorization No.:
Existing Service: Amps Volt Overhead ❑ Underground ❑
New Service: Amps Vohs Overhead ❑ Underground ❑
No. of Metm-
No. of Meters:
Description of Proposed Electrical lwtallatwn: Wiring Of 40 Solar Panels Or Carport 16.2 kW
Completion of the follownrg table way be waived by the Imperior of Mires.
No. ofRec,epsable Outlets: No. of Switches:
Generanar KW Rating:
T}pe:
No. Lumituar s- No. ofRecessed Luminaires:
No.'<4 ind Generatars-
Wind KW Rating:
No. Appliances:: KW: No. Water Heaters: KW:
No.TrarLSIbmers-
Total KVA
Space Heating KW: Heating Equipment KW:
No. Motaas: Total HP: Total KW
No. Heat Puangs. Total KW: Total Tang,:
Fire Alamo System Ll
Noe of Devices:
SgrW==g PooL In-Gmd Aboue-Grad.. Hot-TubLj
No. of Self -Contained Detection Alert Dence :
No. OU B rwr5. No_ Gas Bumm:
Video System Lj
No. ofDevices.
No. Au Conditioners: Total Ions:
Te6ecaut Systere ❑
No_ of Ou*lets:
No. Fhergy Storage Systems: K%H Storage Rating:
Se=ry System ❑
No. of Deuces:
Solar FtV KW DC Rat=:16.2 solar PV KW AC Rating: 11.4
No. of Modules: 40 Foof-Moue, ❑ Ground-L fount ❑
No. ofElectric Vetude Supply Equgm meat-
Le6•el l ❑ Level 2 ❑ Level 3 ❑ Rating-
OTHM
Attcch additional detail rf desired, or as required by the Iaspereor of 9 xres.
Estimated Value of Electrical Work: $65940 ('%hen required by municipal policy)
Date Krone to Start: Inspections to be requested in accordance uith MEC Rmle 10, and upon completion-
FIRMNAhfE: Northeast Solar A-1 ®orC-1 ❑ LIC. No.: 3727 Al
Masterr'Sy-ste= Licensee: David Baird
LIC_ No_: 21918 A
Journeyman Licensee_. LIC. No_:
Security :System Business requires a Division of Occupational Licensure "S" LTC. S-LIC_ No_:
Address: 136 Elm St., Hatfield, MA 01038
Emad: permitting@Wftheast-solar.com TelephoneNo.: 413-247-6045
I ce1 dh-. under ter sins d al es of pe)jKry, that the infarrrrution on this application is true and complete.
Licensee_ pit Name: David Baird Celt_ No_
IN,S1rRA,N-• O'l'ERiG : Unless waived by floe owner, no pe=t liar dnee performance of electrical work may isswe mless. the licensee
provides proof of liability including `:completed openuou" cot,erage or its substantial equivalent. The undersigned certifies that such coverage
is in ENce and has exhibited proof of same to the permit issuing office.
CBECK O'_'1TE: INSURANCE® BOND ❑ OTHER ❑ Specify:
M-NER'S INSUR:k CE W AB ER: I air anraae that the Licensee does not have the liability insurance coverage nonnally
required by law. By my signahtze below, I hereby aaiva this requzz'ewert_ Y am die: (Check ones Owner ❑ Owner's agent ❑
Owner? Agenr. TeL No.:
Signature : Email.-