23B-022 BP-2024-1422
204 NORTH ELM ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23B-022-001 CITY OF NORTHAMPTON
Permit: Solar Build
PERSONS CONTRACTING WITH UNRI GISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2024-1422 PERMISSION IS HEREBY GRANTED TO:
Project# 2024 SOLAR Contractor: License:
Est.Cost: 29756 VALLEY SOLAR LLC CSL115680
Const.Class: Exp.Date: 04/09/2025
Use Group: Owner: CO-TRUSTEES WEST, STEVEN A& AMY S. WEST
Lot Size(sq.ft.)
Zoning: URB Applicant: VALLEY SOLAR LLC
Applicant Address Pon • Insurance:
116 PLEASANT ST, SUITE 321 (413)584-8844 EXT 217 376140840103
EASTHAMPTON, MA 01027
ISSUED ON:10/28/2024
TO PERFORM THE FOLLOWING WORK:
INSTALL 20 PANEL 8.6 KW ROOF MOUNT SOLAR SYSTEM (RAFTER ATTACHED, NO STRUCTURAL UPGRADES OR
BATTERY)
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:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: S125.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
�:. a¢�C -/ The Commonwealth of Massachusetts FOR
i * /m / Board of Building Regulations and Standards MUNICIPALITY
i p i ��, 'Massachusetts State Building Code,780 CMR
' 7-* i 00 ?'� USE
CT Building Pcrmit/Application To Construct,Repair.Renovate Or Demolish a Revised Mar
<024 One-or Two-Family Dwelling 2011
I.
_+NDATyq!1D�NG iN I This Section For Official Use Only
Building Permit Num TV41'r h• /4422-- Date Applied:
cif • $5 I � /a.a 2--
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Numbers
204 N ELM ST NORTHAMPTON MA 01060
1.1a Is this an accepted street?yes I no_ Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required I'ru.idrd
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private Zone: Outside Flood Zone? Municipal On site disposal system
Check if yes
SECI ION 2: PROPERTY OWNERSHIP
2.1 Ownerl of Record:
Amy West Northampton MA 01060
Name(Print) City,State,ZIP
204 North Elm Street 6162915935 steve.west@e3svnergy.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK?.(check all that apply)
New Construction Existing Building Owner-Occupied Rrh:ur:,1,) Alteration(s) Addition
Demolition Accessory Bldg. Number of Units 30 ()titer ✓ Specify:Solar
Brief Description of Proposed Work2: Installation of a 20 panel roof-mounted solar arras,.
System size 8.60 kW DC.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building S 20829 1.Building Permit Fee:$ Indicate how fee is determined:
2.Electrical S 8926 Standard City/Town Application Fee
Total Project Cost3(Item 6)x multiplier x
3.Plumbing S 2.Other Fees:$
List:
4.Mechanical(HVAC) S
5.Mechanical(Fire Suppression) S Total All Fees.
Check No. A I Check Amount' VIA Cash Amount:
6.Total Project Cost S 29756 Paid in Full Outstanding Balance Due:
SECTION 5:CONSTRUCTION SERVICES
____. CS-115680 4/9/2025
License Number Expiration Date
5.1 Construction Supervisor License(CSL) List CSL Type(see bellow) U
Patrick Rondeau --
Name of CSL Holder Type ` Description
53 Fox Farms Rd.,Florence,MA 01062 NEll Unrestricted(Buildings up to 35,000 cu.ft.)
No.and Street _. ,
R Restricted 1 AND 2 Family Dwelling
Florence,MA 01062
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
413-584-8844 Info@valleysolar.solar SF Solid Fuel Burning Appliances
Telephone Email address
I Insulation
D Demolition
5.2 Registered Home Improvement Contractor(HIC)
Valley Solar LLC
HIC Company Name or HIC Registrant Name 186338 10/27/2024
• HIC Registration Number Expiration Date
116 Pleasant St,Suit 321
No.and Street info@valleysolar.solar
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 f No
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 aA)�l�/�(�n�lf,in all matters relative to work authorized by this building permit application
Amy VI ioct.s.2024 i6:17 ear: Oct 5,2024
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNERI 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 knowledgen/ and understanding.
PG.t2LCA 17/Cn BJG�2Qf4 10/04/24
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I._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 Da have access to the arbitrationprogram 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
oµt HAM,)p
? F, x �� S�5 .• SAC
Massachusetts ? :._
(141 .11. .`.
. E " x' DEPARTMENT OF BUILDING INSPECTIONS a I
212 Main Street • Municipal Buildingr
Northampton, MA 01060 ...
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 disposed 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: An‘4cu4 Date: 10/23/2024
k.,r 1 ne c,ommonweatrn of.viassacnuserrs
Department of Industrial Accidents
,9 ---1( Office of Investigations
— Lafayette City Center
1� 2 Avenue de Lafayette, Boston, MA 02111-1750
. /.
� �; = www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Valley Solar LLC
Address: 116 Pleasant St, Suite 321
City/State/Zip: Easthampton, MA 01027 Phone #:413-584-8844
Are you an employer? Check the appropriate box: Type of project(required):
1. ■❑ I am a employer with 30 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6 El New construction
listed on the attached sheet. 7. ❑ Remodeling
2.❑ I am a sole proprietor or partner-
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. 0 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.❑ 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.❑■ 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: Applied Underwriters
Policy#or Self-ins. Lic. #: 37614 034 0103 Expiration Date: 09/01/2025
Job Site Address: 204 N Elm St City/State/Zip: Northampton, MA 01060
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 under the pains and penalties of perjury that the information provided above is true and correct.
Signature: i)G.t�i ,e9,t,"2. Date: 10/23/2024
Phone#: 413-584-8844
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority (check one):
10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5Elumbing
Inspector 6.0Other
Contact Person: Phone#: