32C-090 BP-2024-1510
140 WILLIAMS ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32C-290-001 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-2024-1510 PERMISSION IS HEREBY GRANTED TO:
Project# 2024 SOLAR Contractor: License:
TRINITY HEATING&AIR INC DBA
Est. Cost: 27000 TRINITY SOLAR 088684
Const.Class: Exp.Date:07/06/2026
Use Group: Owner: GOFF GOLDBLAT DANA L&GREGORY
Lot Size (sq.ft.)
TRINITY HEATING&AIR INC DBA TRINITY
Zoning: URC Applicant: SOLAR
Applicant Address Phone: Insurance:
4 OPEN SQUARE WAY, SUITE 410 (413)203-9088(1522) WC 13588107
HOLYOKE, MA 01040
ISSUED ON: 11/12/2024
TO PERFORM THE FOLLOWING WORK:
INSTALL 15 PANEL 6.15 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: 6/0
Fees Paid: $125.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
j1
`thccom nwealth of Massachusetts
N�✓ 1 ( :oard o Buil ing Regulations and Standards FOR
L sacpiuse State Building Code, 780 CMR MUNICIPUSALITY
.
44: �( 2r> it App cati To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
'ON.r�q"Ecr� On,-or Two-Family Dwelling
,/ so,v
This Section For Official Use Only
Building Permit Number: 8A. - /67 0 Date Applied:
572, G/G/ t /r-/i zy
Building Official(Print Name) ign lure Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
140 Williams Street,Northampton,MA 01060
1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
Residential
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:
Dana Goldblat Northampton MA 01060
Name(Print) City,State.ZIP
140 Williams Street (413)652-1643 note2selfmusic@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 Addition 0
Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify: Solar
Brief Description of Proposed Work2: Install 6.15 kW DC solar on roof(15 panels).Will not exceed building
footprint,but will add 6"to roof height.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $8,000 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $19,000 ❑Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) Total All Fees:
$ Check Not1al� heck Amount 1+A Cash Amount:
6.Total Project Cost: 27,000 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES 1
5.1 Construction Supervisor License(CSL)
CS-088684 7/6/2026
Michael S Blanchard License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
142 Nelson Street
No.and Street Type Description
West Springfield,MA 01089 U Unrestricted(Buildings up to 35,000 Cu.ft.)
R ' Restricted I&2 Family Dwelling
City/Town,State,Z M Masonry
X 11 Vf G t° � t I'� RC Roofing Covering
vl f/( V' (� WS Window and Siding
SF Solid Fuel Burning Appliances
413-203-9088 x 1521 applications.westma@trinity-solar.com I Insulation 1
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
TrinitySolar Inc DBA TrinitySolar17035510/11/2025
HIC Registration Numb Expiration Date
HIC Company Name or HIC Registrant Name
20 Patterson Brook Road-Unit 10 applications.westma trinity-solar.com
No.and Street Email ddress
West Wareham MA 02576 413-203-9088 x 1521
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 El 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 Please See Attached
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) 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 appliiccatio is t e and accurate to the best of my knowledge and understanding.
x I�it VJG<' b L L/#J-,U/ 11/11/2024
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 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.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/des
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"
,,i.,I.,f
City of Northampton
F``ti� ,' Massachusetts ��t7:i:_ s'C�t,,
�� i � w; M ,
L . S i DEPARTMENT OF BUILDING INSPECTIONS
.;' -iw 212 Main Street • Municipal Building wy.ti -'4�
{ Northampton, MA 01060 r:N ,,‘�
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: Casella- 295 Forest Street, Peabody, MA 01960 _
The debris will be transported by:
Name of Hauler: Trinity Solar
pp Mk
Si nature of A licant: ti6e: (34-1 L lid"-"c/ Date: 1 u11/2024
g
NJ,Electrical Contractor business permit number 34E800839200
NJ,HIC reg.t113VH12957000
For other jurisdictions,please visit:http://www.trinity-solar.com/about-us/locations-and-licenses
SOLAR
HOMEOWNER AUTHORIZATION FORM
I, Dana Goldblat
(print name)
am the owner of the property located at address:
140 Williams Street Northampton,Massachusetts 01060 United States
(print address)
I hereby authorize Trinity Solar, LLC ("Trinity Solar") and its employees, agents, and
subcontractors, including without limitation, , to act as my Agent for the limited
purpose of applying for and obtaining local building and other permits from the Authority Having
Jurisdiction as required for the installation of a Photovoltaic System, Battery System, roofing or other
Trinity Solar offerings located on my property, applying and obtaining permission and approval for
interconnection with the electric utility company, and registration with any state and/or local incentive
program(s).
This authorization includes the transfer/re-administering, and/or cancellation of any existing
permits on file for the purpose of updating/applying with an alternate subcontractor.
Without limitation to the generality of the foregoing I specifically authorize Trinity Solar et al. to
populate technical details, fill-in, edit, compile, attach drawings, plans, data sheets and other
documentation to, date, submit, re-submit, revise, amend, and modify application, submission and
certification documents ("Approvals Paperwork"),including those for which signature pages are included
herewith for my signature, in furtherance of the related transaction, and I am providing any signatures to
Approvals Paperwork for purposes of the foregoing. Trinity Solar will provide copies of Approvals
Paperwork upon request by the homeowner. My authorizations memorialized herein shall remain in full
force and effect until revoked. I acknowledge that these authorizations are not required to proceed with
the transaction and are not a condition of the related agreement included herewith but are being given
for my own convenience and benefit in order to expedite the approvals processes.
Electric Utility Company: National Grid
Electric Utility Account No.: 25233-86032
Electric Meter No.: 87996725
Name on Electric Utility Account: Greg°fYGof
Customer Signature
Dana Goldblat
Print Name
October 11, 2024
Date
Corporate Headquarters 1-877-SUN-SAVES
2211 Allenwood Road Ph: 732-780-3779
Wall, New Jersey 07719 Fax: 732-780-6671
www.Trinity-Solar.com
FOR INFORMATION ABOUT CONTRACTORS AND THE CONTRACTORS' REGISTRATION ACT,
CONTACT THE NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY,
DIVISION OF CONSUMERS AFFAIRS AT 1-888-656-6225.
Version 2,effective 03-26-2024