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HomeMy WebLinkAboutBuilding Permit # 4/26/2016 FORTH �DILDIN PERMIT '1„�%o o TOWN OF NORTHA DOVE 0 APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �9 ArgD AC” d , Date Issued: IM ORTANT:Applicant must complete all items on this page /r / � i t { i fl ✓ , Y � ,,t ' {ir ir, l� - + X}v rrry�rr r ✓"' r 4 /r /I r "i� r il;r/+I Jx r / l"3 "r rrr r y r' "t t�,rft F � , l ,err v+ v p y a ✓J d ; 7✓."5,1 �t� r r '+r r k� r P / 4 W �+ i r f � � (i r y F � r' i t k rrr�r� Y r s fk y LC7Cr4TIONr✓r����� �� '�� �r ��' �e iY rn � ( �, r�,, ,, x /r/Y';' 1/r+A t fr{ ,, /r rr r //a r r a!;✓'� bl✓lGf)rfl4f!`hrl 4hi`. nt rL 1''*r z 1 i rJf/y✓ r +t ; / a✓ sr x>` F > / 1,1 t,. !f[j1 f r��l—.rly,r`'�,..1,1; r... rlrlfk�,pi„�k,(i r/rf� �;f(i j�° f it„rxJ�l� fl f�,.�!'gM rJ,7 rr t 4jir xr ? 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":r .r'fl+,. ,�nJ,nr�,,,?fF�c an„w v/n+ 9rr „��1,,,,,K�. ,,, ,,.4 ko,,,r./� eacv .'v f „4r :;'�(fr/x �✓w.:, '2 N,4 ur; ;l�,qt/;4",�11 ro`4/r/'`"�6`.fr4 off s /F1 1.f,,,,,.,t{ / % V �,/�ir'��/'" � ��`il ! rl fir- r n s�kt 5J7�� In[� ppp�/p�,P�'^NO' ,.y�.r,✓���/PAR:.+r EL��;�� r ;ZONING DISTRICTt4� F�� / Hlstarlc ;�,, IYI(�1 it./ ,.,, f +,,,+' rr� f�tiV,"y rlY�i✓`r+t fr-. r�,tn �,i�l+ xr�J�7/1 v °St1'r�'f fig/ ff �r�t��+� t r r / �ih��R ��",Q�r� er .x+'- (Vla � „Illag ,y��r 'llt3 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition El Two or more family ❑ Industrial El Alteration No. of units: ❑ Commercial El Repair, replacement ❑ Assessory Bldg ❑ Others: Q-e . ❑ Demolition (,Other So V ❑ Septic f �❑Well"`��' �� ��,, 1F Q AFloodplain ,,�, °❑ ! etlands , r J '❑ `Watershed Distr-�ct l , ' '`�����"" Jr xf ,,. l,f r/,t,,, 1 tl t � u d,✓ ,� �)r/ ,..!'r .: r /� r r r ;✓fj Y f t / l' ¢ ^ '� r l r r ' '❑L�4�'tC'il l., c3w�lli. .,..r. . ,.,f. 'e s ;i ,�a r„ri;,,<< ,. F' r,.ri �.. `a� ,, r .. J fryW DESCRIP'TIOIV C1F VVOt�K TO �E PREFORII�ECI. w iro ha rn-f CIG 1--rt CC'4 S 9 w-vv Identification Please Type or Print Clearly) OWNER: Name: �v1 Phone: ��� 6S--1 2-01-2-q Address: f CONTRACTOR Name Address a 0. ✓ �► �� �t 1, a /✓ Na Nkyf �lce Supervisor's on-, I x r Hartle Pmprove'meht:l.�cense ` Exp^ ,:Date' x ' ARCHITECT/ENGINEER C. f1VJ=A Phone: Address: MS-Sy Reg. No.Ci q FEE SCHEDUL :BULDING ER :$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$425.00 PER S.F. Total Project Cost: $ '1 1 CMCJ FEE: $ ( � C i Receipt No.: Check No.: a1 NOTE: Persons contracting with reg stered cantractar^s do not have access to the ranty fu'zd Sigriature of Agent/Owner` Signature of contractor V - DocuSign Envelope ID:5402F82F-05D1-4840-9820-EOFB649A162F SolarCity Customer Name and Address Installation Location Date Wendy Ringdahl 543 Massachusetts Ave 4/3/2016 543 Massachusetts Ave North Andover, MA 01845 North Andover,MA 01845 Here are the key terms of your Power Purchase Agreement 13e701 2 Oyrs System installation cost Electricity rate kWh Agreement Tgjm Initial he Initial here DS The SolarCity Promise •We guarantee that if you sell your Home,the buyer will qualify to assume your Agreement. ................... . Lc�L� Initial here •We warrant all of our roofing work. Ds` •We restore your roof at the end of the Agreement. n •We warrant insure maintain and repair the System. ._....' Initial her ';e L I` •We fix or pay for any damage we may,cause to your;property. •We provide 24/7 web-enabled monitoring at no additional cost. •The rate you pay us will never increase by more than 2.90%per year. •The pricing in this Agreement is valid for 30 days after 4/3/2016. Your SolarCity Power Purchase Agreement Details Your Choices at the End of the Initial Options for System Purchase: Amount due at contract signing Term: ®At certain times,as specified in $a •SolarCity will remove the System at no the Agreement,you may Est.amount due at installation cost to you. purchase the System. $0 •You can upgrade to a new System with •These options apply during the 20 the latest solar technology under a new year term of our Agreement and Est.amount due at building inspection $Q contract. not beyond that term. •You may purchase the System from Est.first year production SolarCity for its fair market value as 8,412 kWh specified in the Agreement. •You may renew this Agreement for up to ten(10)years in two(2)five(5)year increments. 3055 Clearview Way, San Mateo, CA 94402 1 888.765.2489 solarcity.com 1718948 Power Purchase Agreement,version 9.2.0,March 28,2016 SAPC/SEFA Compliant Contractors License MA HIC 168572/EL 1136MR Document generated on 4/3/2016 Copyright 2008-2015 SolarCity Corporation,All Rights Reserved DocuSign Envelope ID:5402F82F-05D1-4B40-9820-EOFB649A162F 23. NOTICE OF RIGHT TO CANCEL. I have read this Power Purchase Agreement and the Exhibits in YOU MAY CANCEL THIS CONTRACT AT ANY TIME PRIOR their entirety and I acknowledge that I have received a TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE complete copy of this Power Purchase Agreement. DATE YOU SIGN THIS CONTRACT. SEE EXHIBIT 1,THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN Customer's Name:Wendy Ringdahl EXPLANATION OF THIS RIGHT.< DocuSigne(J by: 24. ADDITIONAL RIGHTS TO CANCEL. Signature: IN ADDITION TO ANY RIGHTS YOU MAY HAVE TO CANCEL THIS PPA UNDER SECTION 23,YOU MAY ALSO CANCEL THIS PPA AT NO COST AT ANY TIME PRIOR TO Date: 4/3/2016 COMMENCEMENT OF CONSTRUCTION ON YOUR HOME. 25. 'Pricing The pricing in this PPA is valid for 30 days after 4/3/2016. Customer's Name: If you don't sign this PPA and return it to us on or prior to 30 days after 4/3/2016,SolarCity reserves the right to reject this PPA unless you agree to our then current pricing. Signature: Date: Power Purchase Agreement SolarCity approved Signature: Lyndon Rive, CEO Date: 4/3/2016 Power Purchase Agreement,version J.2 0,March 28,2016ELM 1718948 Version #56.4-TBD PIL April 12, 2016 RE: CERTIFICATION LETTER Project/Job #0183662 Project Address: Ringdahl Residence 543 Massachusetts Ave North Andover, MA 01845 AH] North Andover SC Office Wilmington Design Criteria: -Applicable Codes= MA Res. Code, 8th Edition,ASCE 7-05, and 2005 NDS - Risk Category= II -Wind Speed = 100 mph, Exposure Category C - Ground Snow Load = 50 psf - MP2&MP3: Roof DL= 13 psf, Roof LL/SL= 35 psf(Non-PV Areas), Roof LL/SL= 35 psf(PV Areas) Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.33365 < 0.4g and Seismic Design Category(SDC) =C < D To Whom It May Concern, A jobsite survey of the existing framing system of the address indicated above was performed by a site survey team from SolarCity. Structural evaluation was based on site observations and the design criteria listed above. Based on this evaluation,I certify that the existing structure directly supporting the PV system is adequate to withstand all loading indicated in the design criteria above based on the requirements of the applicable existing building and/or new building provisions adopted/referenced above. Additionally, I certify that the PV module assembly including all standoffs supporting it have been reviewed to be in accordance with the manufacturer's specifications and to meet and/or exceed all requirements set forth by the referenced codes for loading. The PV assembly hardware specifications are contained in the plans/docs submitted for approval. PRN K. Sincerely, VST UCTUHAL Digitally signed by Humphrey No.51933 Humphrey Kariuki, P.E. Kariuki � �FGisT ¢�o Professional Engineer S �AL T: 443.451.3515 Date: 2016.04.12 15:22:03 -04'00' si email: hkariuki@solarcity.com 305-1 O'lsarv:e.v way San Mateo,CA 94402 (65-3 0) 6 8 -10'28 (888)SnL--CITY (650)638- 1029 nolarcitq.com Version#56.4-TBD SolarC® P't L. HARDWARE DESIGN AND STRUCTURAL ANALYSIS RESULTS SUMMARY TABLES Landscape Hardware-Landscape Modules'Standoff S ecifications Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever configuration Uplift DCR MP2&MP3 64" 24" 39" NA Staggered 50.5% Portrait Hardware-Portrait Modules'Standoff Specifications Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MP2&MP3 32" 15" 65" NA Staggered 42.0% Structure Mounting Plane Framing QualificationResults' Type Spacing Pitch Member Evaluation Results MP2&MP3 Vaulted Ceiling @ 16 in.O.C. 261 Member Analysis OK Refer to the submitted drawings for details of information collected during a site survey. All member analysis and/or evaluation is based on framing information gathered on site.The existing gravity and lateral load carrying members were evaluated in accordance with the IBC and the IEBC. 3055 C:Iflar'ne.r Wpy man,Aate`r,CA 94402 (650)6>8 1028 (^a88),>I_ CITE r(650)658- 102, nc larclty.crfn STRUCTURE ANALYSIS- LOADING SUMMARY AND MEMBER CHECK MP2&MP3' Member iPropeAies Summary MP2&MP3 Horizontal Metnbar S ens RfteX Properties,,.= ", ;` Overhang 1.16 ft Actual W 1.50" goo, System Properties San 1 9.63 ft Actual D 5.50" Number of Spans w/o Overhang) 1 Span 2 Nominal Yes Roofing Material Comp Roof San 3 A 8.25 in A2 Re-Roof No Span 4 S. 7.56 in.^3 Plywood Sheathing Yes San 5 1, 20.80 In A4 Board Sheathing None Total Rake Span 12.00 ft TL DefPn Limit 180 Vaulted Ceiling Yes PV 1 Start 1.00 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 10.25 ft Wood Grade #2 Rafter Slope 260 PV 2 Start Fe 875 psi Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Too Lat"Bracing Full s PV 3 Start E 1400000 psi Bot Lat Bracing Full PV 3 End E,„i„ 510000 psi Member Loading Summa Roof Piteh 6/12 Initial Pitch Ad"ust Non-PV AreasPl%Areas Roof Dead Load DL 13.0 psf x 1.11 14.5 psf 14.5 psf PV Dead Load PV-DL; 3.0 psf x' 1.11 3.3 psf Roof Live Load RLL 20.0 psf x 0.90 18.0 psf Live/Snow Load LL/SL 1,2 50.0 psf x 0.7, 1 x 0.71 35,0 psf 35.0 psf, Total Load(Governing LG I TL 1 49.5 psf 1 52.8 psf Notes: 1. ps=Cs*pf; Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(Ce)(Ct)(Is)py; Ce=0.9,Ct=1.1, I5=1.0 Member Design Summa ' of NDS) '064tehing Load Comb CD CL + GL 1,CF Cr D+S 1.15 1.00 1.00 1.3 1.15 Member Anal sis Results,Summary GoVernln Anal sis Max',0ernand @"Location Ca""aci DQIL" Result Bending + Stress 1259 psi 6.0 ft 1504 psi 0.84 Pass CALCULATION OF DESIGN WIND LOADS - MP2&MP3 Mounting Plane Information Roofing Material Comp Roof PV System Type SolarCity SleekMountTm Spanning Vents No Standoff Attachment Hardware Comp Mount Type C Roof Slope 260 Rafter Spacing 16"O.C. Framing Type/ Direction Y-Y Rafters Purlin Spacing X-X'Purlins Only NA Tile Reveal Tile Roofs Only NA Tile Attachment System Tile Roofs Only NA ,Standing Seam/Trap Spacing SM Seam Only NA Wind Desi n Criteria Wind Design Code ASCE 7-05 Wind Design Method Partially/Fully Enclosed Method Basic Wind Speed V 100 mph Fig. 6-1 Exposure Category C Section 6.5.6.3 Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Height h 15 ft Section 6.2 Wind Pressure'Catculation Coefficients i Wind Pressure Exposure KZ 0.85 Table 6-3 Topographic FactorKA 1.00 Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Importance Factor I 1.0 Table 6-1 Velocity Pressure qh qh 0.00256(Kz)(Kzt)(Kd)(V^2)(I) Equation 6-15 18.5 psf Wind Pressure Ext. Pressure Coefficient U GCp(Up) -0.88 Fig.6-11B/C/D-14A/B Ext.Pressure Coefficient Down GCp(Down) 0.45 Fig.6-11B/C/D-14A/B Design Wind Pressure p p= qh (GCp) Equation 6-22 Wind Pressure U „ -16.2 psf Wind Pressure Down 10.0 psf ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable Cantilever Landscape 24" NA Standoff Configuration Landscape Staggered Max Standoff Tributary Area Trib 17 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff T-actual -253 lbs Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand Ca aci DCR 50.5% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 32" 65" Max Allowable Cantilever Portrait 15" NA Standoff Configuration Portrait Staggered Max Standoff Tributary Area Trib 14 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff T-actual -210 lbs Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand/Capacity DCR 42.0% The Catmnoniveaith oflt assuelausetts Department oflndustrialAceidents Dice oflnvestigatrons Z Congress Street,Suite Igo Aostatt,MA 02JI4•2017 wwmmAss gotldia Workers'Comlpensrttia-t hisuraoce Affidavit;Rui>Er)cxet/Contrtelers/Electriciatns/Plumbers AapLiont Info' tion Please Print Ls ibl NaMO(Business(Org"ization/individual): SolarCity Corp. _ Address: 3055 Clearview Warr City/S€atcaaa : San Mateo CA. 94402 Phone#: 888-765_-2489 Are you as employer?Check the appropriate box: .Type otproject(required): 1.0 am a employer with 5,000 4. ❑ I am a general contractor and I employees{full and/or part-time}.'o have hired the sub-contractors New construction 2.❑ I am a sole proprietor or partner- listed on the attached shet:i. 7. []Remodeling ship and have no employees These snb-contractors have 8, E]Demolition working for the in any capacity. employees acid have workers' 9. 0 Building addition [No-workers`comp, insurance comp, insurtmce. required.l 5. U We lire a corporation and its 10.0 Electrioal repairs or additions 3.❑1 am a homeowner doing all work officers have exercised their ILEI-Plumbing repairs or additions myself. [No workers'comp. or,per MGI. 12.❑Roof repairs insurance required]t c. 152,§1(4),and we have no employees.[No workers' 13[DOther Solar/PV comp-insurance required.] *Any oppticatu that checks box N t must also MI out the section belowshowing their workers'compcnsotien Policy inibrmation. t Homeowners who submit this affidavit indicating lticy are doing all work and than hire outside contractors must submit anew a0davil indicatingsueh. tConttnetars that check this hos must attuchcd on sdditiaaal sheat showing the name of the sub-contractors and state whether or not those entities have lmployos. ffthe sub-contractors have employees,they utustprovide their workers*comp polieynumber. Iain alt etrmployer that is provlding workers'compensation insurance for my employees. Below is the policy and job site itrforaiallon. Insurance Company Name: Zurich American Insurance Company Policy#or Sell'-ins.Liu.#: WC0182015-00 Expiration bate;9/1/2016 ,, ^, Job Site Address;:_f,Z� MQ SS41.( hy �� Q, City/State/Gip: ����"�. �'�(�(l' t�G Attach a copy of the.workers'compensation policy doeluration page(showing the policy number and expiration date). J Failure,to secure coverage as required under Stiction 25A of MGL e. 152 can lead to the imposition of criminal pertaltitm of a Pint;up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the forth of STOP WORK ORDER and a fine of up to$250.00-a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. X do hereby rerfi'y!In rile pail:$anti penalties o, Perjury that Me in formatlon provided above is tru e �and correct. Phone#: U1 use only. Do tiol write in flus area,to be ccr:rJ7feted by city or taloa offieidl. City or Town. Pernih/License# Issuing Authority(circle one): I.Board of'1`Icalth 2,Building Department 3.City/Town Clerk 4.Vectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M DIY ATE(fAMIDDYYYi ,4 ung CERTIFICATE OF LIABILITY INSURANCE M17120`15 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(les)must be endorsed. If SUBROGATION IS WAIVED,sub)ect 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 endorsements . PRODUCER CONTACT MARSH RISK& INSURANCE SERVICES ...NL_.........PHO ._........ . . .... rAz...._._.._._ ...--'-.'-.-.—.--- 34bCALIFORNIA STREET,SUITE 1300 dAcExSl:.... ..._...._ .-- .._ ........... .. ..-.. ...IvN�I:......._.. .............................. CALIFORNIA LICENSE NO.0437153 E-MAIL SAN FRANCISCO,CA 94104 AnP_8t Ss:. ..... .... ........ _........_.__-._-.._._....___._. _ INSURERS)AFFORDING CQVERA4E _. _ I MAIC# Attn:ShannonScott415-743-8334 ----..._..... . ..__. .. ._. .- ---....----+--....---------... 998301-STND•GAWUE-15.16 _ _ INSURER A:Zurich American Insurance Company 116535 INSURED INSURER 8:N/A N1A SolarCity Corporation t- 3055 Clearview Way _INSURER c:.N1A NIA San Mateo,CA 94402 INSURER D:American Zurich Insurance Company A0142 _... ._ ........ ..... _. ...... ........ - - .... t _....... .... .I,NSURFJt E INSURER P: COVERAGES CERTIFICATE NUMBER, SEA-002713636-08 REVISION NUMBERA THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCI~LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 13Y 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- III NSEi .... .._._._._-..... .._... _...TADDI.�Sl18 T--..._...- - ---' --'- _ ... .POLiCYEFF POLICYEXP_T.. ........._.. ._._...._._.. ...._ ._.. ..._. ......... .... _..._ LTR TYPE OF INSURANCE POLICY HUP40ER iMMIDDA"YI:IMMIDD/XffYI 1 LIMITS A K COMMERCIAL GENERAL LIABILITY i GLO0182016-00 0910112015 ;OWD112016EACH OCCURRENCE S 3,000,000 CLAIMS-MADE ~DAMAGE TO RENTED X OCCUR p $ 3,000,000 - RF. IBES LEa oaurrence�._-._ X SIR:$250,000 MED EXP(Any ono parson) S - - _i .................. .................... , 5,000 I I PERSONAL&ADV INJURY :S 3,000 __,Daa r..._� _..--�•----..._....._....--'--.._._.._ _. . ...._. ....._........ .__._.—._..__....... .. EN'L AGGREGATE LIMtTAPPLIES PER' _-'-6:000 DDDG GENERAL AGGREGATE $ X POLICY': P�Cf PRODUCTS-COMPIOP AGG :$ 6,000,000 I LOC ._..._... _.._. ._ .... . __... OTHER $ A ,AUTOMOBILE LIABILITY :.BAP0182017.00 '09lO1110t5 0910111016 COMBINED SINGLE LIMIT $ 5,000,000 X ANY AUTO I :BODILY INJURY(Per person) $ X AUTOS NEO SCHEDx.�AU7 SULK ,BODILY INJURY(Peracedent);y XX NON-OWNED PROPERTY DAMAGE $ r...�HIREOAUTOS �,.,i AUTOS i I COMPICOLL DED: $ $5,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ UL EXCESSAB CLAIMS-MADE: AGGREGATE $ 1..._'.. ..--SSr.._. ..---.1..--�-�-----.. ..----..1 r...__. ..... - .. ... .. .... . ._.._..._..._ DED I RETENTION S I $ D 'WORKERS COMPENSATION 1NC0IS2014.00(AOS) 0910112015 09101f2016 X PER ' DTH• ER- ._ AND EMPLQYERS'LIA6ILITY ' L...i.._. . .. _.,.... 1_. . .. ._._........_..__ ._ A ANY PROPRIETORIPARTNERIEXECUTIVE Y/N 1 WC01$2015.00(MA) 69101/2015 10910112016 ;E L EACH ACCIDENT 1$ 1,000,000 OFFICERIMEMeER EXCLUDED? N N f A i I '- - - t.. . -.... .............. (Mandatory in NHf 14IC DEDUCTIBLE:$500,000 I `q.t.DISE.W:EA EMPLOYE__S 1400,000 II yes"describe undo L _.. ... .... .. 1 ;E L DISEASE-POLICY LIMIT;$ 1,000,000 DESCRIPTION OF OPERATIONS below I I I t 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD.101,Additional Remarks Schedule,maybe attached If more space Is required) Evidence of insurance. CERTIFICATE HOLDER CANCELLATION SolarCAyCorporation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3055 Clearview Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo,CA 99401 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk&Insurance Services Charles Marmolejo - ©1988-2014 ACORD CORPORATfON. All rights reserved. ACORQ 25(2014101) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Horne Improvement Contractor Registration Registration: 168572 Type: Supplement Card SOLAR CITY CORPORATION Expiration: 3/8/2017 DAPI FONZ( - - ----- - --- -- 24 ST MARTIN STREET BLD 2UNIT 11 -- ---- MARLBOROUGH, MA 01752 _-- - Update address and return card.Marie reason for change. ❑ address -:] Renewal :] Employment __R host Card §`Mice of Consumer Affairs&Business Regulation License or registration valid for individul use only -SOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer affairs and Business Regulation Registration: 188572 Type: IO Park Plaza-Suite 5170 Expiration: 318/2017 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION DAN FONZI d / 3055 CLEARVIEW WAY SAN 1NATEO,CA 9402 Undersecretary Not valid without signature — CS-101687ONO 15 KELLEY RD WI12VIINGTON MA 01887 «� 0911312016