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Building Permit #645-16 - 12 FOSS ROAD 11/23/2015
E NORTFI BUILDING PERMIT TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION � s bb Permit NO: c Date Received Date Issued: CMU`��� ORTANT:Applica t must com Tete all items on this page PROPERTY.OWNER ` a 1 r ( jj q1, AJ SPC=L2tG TRIC NO:Dq, . Machine-Shap;Village .:yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential F1 New Building XOne family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: I i Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other a tic iLLVllell Hood Iain i Wetlands i ! V1/aterslled Distnct p A ❑`Water/Svvor GD�C�r n CA �c eel 5 Identification Please Type or Print Clearly) OWNER: Name: Phone: 7 g - CP g q ~7 Address: CONTRACTOR Name. Phone: Address: ( jjjv�rt /� Supervisor's Construction License.. Exp. Date: Home Impr©vement License. Exp- Date:" l:- ARCHITECT/ENGIN ER t L u;►ei ! Phone: 8 LP Cp - Itp 7 - 97 of Address: JReg. No. _1 �(,v 5'" 05 On ;lJ O,7z FEE SCHEDULE. UL DI G PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$12500 PER S.F. Total Project Cost: $_ !I() , n FEE: $ H `go " ©O Check No.: Receipt No.: NOTE: Pers ontr ting with unregistered contractors do not have access to a gu anty fund a ursf�A ni thh1;5 tures3 ,eontra . Location /f 7 No. Date I� . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ _ � Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL $ Check#�V Ir29726 7 6 BuiTrig9nspector t TYPE OF SEWERAGE DISPOSAL Swimming Pools El❑ Tanning/Massage/Body Art ❑ Public Sewer l Well ❑ Tobacco Sales ❑ Food Packaging/Sales 11 Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner e Q, 14YACGt Signature of contractor Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING&DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CbNSERVATION ❑ ❑ COMMENTS I DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance,Petition No: s Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature&Date Driveway Permit Temp Dumpster on site yes no_ Fire Department signature/date I I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL.: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$1oo-$1000 fine NOTES and DATA— (For department use) ,"w7 ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department - The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products IOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 }, r 1 NORTH - E : :c ver o No. h ver, Mass, 1 I azl coc.ac"IWICK �ds 4ATED 0a��S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT �% `f ,� /` BUILDING INSPECTOR ......................r..!........... .... ..........�.... .. �—........................... -rD has permission to erect .................... buildings on ...ID ..... �.,�.... Foundation .. .. .... � Rough f� i tobe occupied as ....... ......D.D . .........1..!? ....... .�. .�,��... .................I.. .....�.�.................. Chimney .provided that the person accept! this per it shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI STA S Rough Service ................... ............... ..... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final - No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 21 Drydock Avenue, 2"6 floor ii next step Livi ng Tm Boston, MA 02210-2384 0 home energy solutions 866 867-8729 NextStepLiving.com August 20, 2015 Town of North Andover Building Department 1600 Osgood Street Building 20,Suite 2035 North Andover,MA 01845 RE:Christopher Bowe Residence Solar Panel installation p I la 12 Foss Road North Andover,MA 01845 Structural Assessment of Roof Framing NSL Project No: SP252090 Dear Sirs, Next Step Living,Inc.has performed a limited structural evaluation of the roof framing at the above referenced site to determine if the roof has adequate capacity to support proposed solar PV panels.This analysis has been based on field measurements,framing information and configurations observed at the proposed site. The existing residence is located at 12 Foss Road,North Andover,MA 01845. Structural Data and Code information Our analysis was performed in accordance with the requirements of the MA R:s:dential Building Code 780 CMR--Eighth Edition.The main roof of this residence is framed with conventional roof rafters with some collar ties in a gable configuration.The existing roof structure is in good condition and currently has one layer of asphalt shingles-as roof covering. The pertinent data is listed below: Main Roof Rafters:1 W x 7 3L"(#2 Spruce Pine Fir,Hem Fir,D.Fir Larch Assumed) Rafter Spacing:16"on center Roof Slope: 30 Degrees Horizontal Projected Length of Rafter:14.83 feet Ceiling Joists:Present Collar Tles: Present every third rafter Roof Sheathing:Plywood sheathing Roof Covering. Asphalt shingles Condition of Framing: Good Ground Snow Load,Pg:50 PSF from Table R301.2(S) Importance Fador,1: 1.0 Exposure-Factor,Ce: 1.0(Parially Exposed) Christopher Bowe Residence Solar Panel Installation 12 Foss Road North Andover,MA 01845 Page 2 Thermal Factor Cb 1.0 Existing condition(Warm Roof) 1.1 With panels(Cold Roof) Design Snow Loads: 35 PSF(Existing—Unobstructed Warm Roof) 25.68 PSF(New Condition—Slippery Surface on Cold Roof) Basic Wind Speed: 100 MPH from Table 8301.2(4) Importance Factor: 1.0 I Exposure: B j Analysis Results General The proposed solar panels impose a total weight of approximately 3 pounds per square foot(PSF)on the roof surface.The International Residential Building Code allows up to two(2)roof coverings on a residential dwelling.Each roofing layer of asphalt shingles imposes a dead load of 2.5 to 3.0(PSF)on the roof. Because the existing roof has only one layer of shingles,the code allows a second layer to be added without analysis.The weight of the second layer of shingles is approximately the same as the solar panels which will be installed instead of the second layer of shingles. Solar panels are considered a slippery surface and are mounted a small distance above the existing roof. Therefore,one would be cautious in considering a thermal factor,Ct,of 1.1,treating the panel surface as a cold roof, rather than a warm roof.After considering the roof slope factor,Cs,from figure 7-2,ASCE 7-10,the snow load is reduced by 27%for the main roof compared with the snow loading on the existing shingled roof,which is not considered a slippery surface.The reduction in snow load due to this consideration is about 9.32 PSF for the main roof,which essentially offsets the weight of the solar panels. Gravity Loadlnw Although the addition of solar panels results in a net reduction in the overall loading,the existing rafters are overstressed.As such,we recommend that a 2 x 6 collar tie be added at every set of afters.The collar ties should be at least eight(8)feet long,cut flush to the roof sheathing,and shall be fastened to each existing rafter with a minimum of 6—16d nails OR 6 Ledger Lock screws as manufactured by Fasten Master. The panels will be installed using Unlrac Solar Mount rails with L-brackets in either a landscape or portrait configuration with a rail toward the top and bottom of each panel edge.The L-brackets will be fastened directly to the roof rafters with 5/16"diameter lag screws.The fastener layout shall start near each corner and for landscape orientation shall have a maximum spacing of 36"on center parallel to the roof slope and 32"on center perpendicular to the slope(e.g.,every other rafter),or far portrait orientation shall have a maximum spacing of Won center parallel to the roof slope and 32"on center perpendicular to the slope(e.g.,every other rafter). Christopher Bowe Residence Solar Panel Installation 12 Foss Road North Andover,MA 01845 Page 3 Each 5/16"diameter lag screw shall have a minimum of 3"thread penetration into the existing rafter.It is also important that the L-bracket attachment locations be staggered between adjacent rails so that no single rafter supports more load than under the existing conditions. Wind Loading: Provided the leveling feet attachments to the roof are made in a typical staggered pattern,the overall wind loading imposed on the structure will not be impacted to any great extent.The net wind loads imposed on the roof framing will be less than the current loading with an attachment spacing described above. Conclusions: Our evaluation of the proposed solar-electric installation has established that the framing is NOT adequate to support the addition of the solar panels to the existing roof as indicated on the Solar PV plans without strengthening the structure as previously discussed herein.Once the roof framing is reinforced,it will be adequate to support the solar panels.We have only reviewed the adequacy of the connection to the existing rafters and the capacity of the existing rafters to support the vertical and lateral loads from the solar electric system.We do not take responsibility for any other portion of the solar panel array support system,the existing roof framing construction,or the integrity of the structure as a whole. Do not hesitate to contact my office at 866-867-8729 should you have any questions or if you require any additional information. Respectfully, Next Step Living, Inc. ;a Dean A. o er,P.E. MA Prof. Eng.License#50405 ELECTRICAL DESIGN PV MODULE RATINGS 0 STC SOURCE COMBINER RATINGS INVERTER RATINGS 0 m Teperatures INVERTER MODEL:Enphase Microinverter m MODULE MANUFACTURER: Trina Average High:28°C MAX OCPD RATING(A):20 MODEL:M215-60.2LL-S22-IG MODULE OPEN-CIRC UUIIT VOLTAGE(DELM Voc): 38.2 Record Low:-28.9°C OCPD AMPERAGE RATING(A):20 MAX POWER @ 40°C(W),225 i 4 MAX DC VOLT RATING(V:45 Q ORRENT(A) OPERATING VOLTAGE(Vmp): 30.6 OCPD VOLTAGE RATING(V):240NOMINAL AC IL O so NOMINAL AC CU :0.9A 0 W OPERATING CURRENT(imp): 8.50 2 x#10 THWN-2 Wire BLACK MAX BRANCH AC CURRENT(A):9.9A/6.3A N/� SHORT-CIRCUITCURRENT(Isc):9.00 N Was 2 x#10 THWN-2 Wire MAX BRANCH OCPD CURRENT(A):20A MAXIMUM POWER(W):260 rxO > Voc TEMP COEFF(D/D/°C)=-0.32 D/d'C r Z x#10 THWN-2 WHITE Ii OQ Ise TEMP COEFF(%/PC)=-0.05°/d N Z ~ °C 1 x#6 THWN-2 EGC 2 av ^ 1"EMT INDOORS Lono CENTER ZWIREag (PVLC) E w = d L � C 7 130 C End-Fed Branch of 11-M215 Inverters V a z a T.01011".1.--ad N AO Pku B b"Pch W.Imum aupulhult cumMO.PA rm.P.nP...l ..2.0 C C Tsm-no TS AI•ZBO T6ALZ80 G D PA00.w D PA06.08 D PA05.0B D PA06.OB J-t1L7% �- - CU En(hai 6nlh.0 6nlhes 15A_ O �`.._ 21b.B •2,6-8 N-2,60 , 2u`: z zuCM End-Fed Branch of 7-M215 Inverters :� .r/��' --�� TI'lll7 gP.l.wmi.eh6NAD0Niu Bh"nch I� {./ p TB A1.00 W.Imunl.uyW hull eu u.,M1 0.0A mit grP.n.l T0K280 - iHN-280 TSWZ60 ;V^I PA00.08 D PP06.00 D PMO.OB D PP00.08 d M} 601h.aEny,le EnPM1.. Le'ee � .� iu 2L1 UTILITY '^ L AR AC DISCO METER V J J CU NOTE:A GEC(grounding electrode conductor)is ® FUSIBLE O X required only for M215-60-2LL.It is not required AC DISCO for M215-60-2LL-IG ENVOY COMMUNICATIONS OUTSIDE 2 A RATING Z GATEWAY NON-FUSIBLE 25A FUSES 30A RATING GF222N GNF321R U LN ETHERNE CONNECTION TO 1 x#10 THWN•2 Wire BLACK cm BROADBAND ROUTER 120 VAC POWER CABLE 1 x#10 THWN-2 Wire RED 1 x#10 THWN-2 Wire WHITE - Symbol Converdbns: 200AJ eN1 x#6 THWN-2 EGC ,.�, 2-Pole Licensed Electrician Assumes All Responsibility For I"EMT INDOORS ca Circuit Breaker200A ArT Determining Onsite Conditions and Executing 4.l0IlBE8 MSP o Fuse Installation In Accordance with NEC 2014 Codes 0%10oma Visible Break I= e% Knife Switch AC DISCONNECT RATINGS CONDUIT S17ING SERVICE PANEL RATINGS o% 1"PVC OUTDOOR MEP GRAND-GOULD DISCONNECT AMP RATING(A):60 1"EMT INDOOR BUS AMP RATING(A):200 DISCONNECT VOLT RATING(V):240 SERVICE VOLTAGE(V):240 Equipment NEMA 3R MAIN AMP RATING(A):200 Grounding BREAKER RATING(A):25 ConduoW OWNER'S AUTHORIZATION FORM For Permit Application(s) The sole purpose of this form is to provide Next Step Living with the Necessary permission from the Owner to file Permit Application(s)for such Project work as agreed upon between the Owner and the Owner's Authorized Company and its designated subcontractors. Owner's Name: Christopher& Laura Bowe Solar Project Addr 12 Foss Rd. North Andover, Ma Signature; Owner's Authorized Company: Next Step Living Inc. Company's Address: 21 Dry Dock Avenue South Boston,MA 02210 Affiliation: Contractor Applicable License: HIC#162111 State: MA Next Step Living, Inc. CT HIC.0629266•MA OCABR#162111•RI Contractor Reg.#37185 HOME IMPROVEMENT Date of Contract: 07/24/2015 next step living.. home energy solutions 21 Drydock Avenue.2nd Floor,Boston,Massachusetts 02210 Customer(s)Name(s): Laura&Christopher Bowe Telephone:566-867-9720•www.nextstepliving.com Customer(s)Street Address: 12 Foss Rd City: North Andover State: MA ZIP: 01845-5258 Customer(s)Home Phone:# Customer(s)Mobile Phoae#; Permit(s)Required: Building&Electrical City/County Issuing Permit(s): North Andover Customer(s)jointly and severally agrees to purchase the products and/or services of Next Step Living,Inc.("Contractor")in accordance with the terms and conditions described on the front and reverse of this Home Improvement Agreement("Agreement')and the attached specification sheet(s).Customer(s) hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. ESTIMATED STARTING DATE: Thursday,October 22,2015 ESTIMATED COMPLETION DATE: Thursday,October 29,2015 TOTAL SOLAR SYSTEM PRICE: $34,124.28 PAYMENT METHOD select opti11 on(s) ESTIMATED STATE REBATES: $0.00 ECash Credit Card SOLAR PURCHASE PRICE: $34,124.28 C heck ®Financing ROOFING PURCHASE PRICE: $0.90 TOTAL PROJECT PURCHASE PRICE: $34,125.18 See Payment Certificate for payment schedule In certain circumstances,Customer(s)may agree to assign to Contractor the right to receive and retain the rebate(s)associated with ownership and use of the product(s)in consideration of a reduction to the Total Price equal to the amount of the rebate. By signing below,Customer(s)hereby irrevocably assigns to Contractor the right to receive and retain such rebate.Owner agrees to provide all required support to receive the rebate. Amount $0.00 (Customer's Initials) I'm fine receiving autodialed and/or pre-recorded calls or text messages from or on behalf of Next Step Living to tell me about new products,sales or other events I may be interested in,and you can use any of the telephone numbers I have provided above. 1 understand my approval to receive these calls is not required for me to make a purchase. (Signature) Customer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing any of the terms of this Agreement.Customer(s)acknowledges that Customer(s)(1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two accompanying Notices of Cancellation,on the date first written above and(2)was orally informed of Customer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. NEXT STEP LIVING, INC. 07/24/2015 By: Todd Massicotte Print•Name Lic #(CT only) Signature Date; CUSTOIVIER(S) 07/24/2015 Christopher Bowe Print Name„ r Signat`� Date', Laura Bowe e� 07/2 ;Print Name 5 ignAture YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ©BLLP2013.NSL.CTMARI TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky it Next Step Living, Inc. CT HIC.0629266-MA OCABR#162111•RI Contractor Reg.#37185 SPEOFICATION SHEET Date of Contract 07/24/2015 :: next step living. ;. home energy solutions " 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210 Customer(s)Name(s): Laura&Christopher Bowe Telephone:866-867-8729-www.nextstepliving.com Customer(s)Street Address: 12 Foss Rd City: North Andover State: MA Zip: 01845-5258 Customer(s)Home Phone ;! Customer(s)Mobile Phone# Permit(s)Required: Building&Electrical City/County issuing Permit(s): North Andover The Customer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services listed below,in accordance with the prices and terms described on this Specification Sheet and the front and the reverse of the accompanying HOME IMPROVEMENT AGREEMENT,of which this Specification Sheet is a part. Description of the Solar Project and Description of the Significant Materials to Be Used:(1)delivery of solar equipment,(2)complete installation to manufacturer's specifications,(3)installation of inverter,conduit runs,and racking system as needed,and(4)cleanup after installation. Scope of Solar Work Panel Brand:Trina Solar Panel type:TSM-260PA05.08 Panel Watts(DC STC)-260 Monitoring system with 5 year service(owners responsibility after 5 years) The solar array will consist of 18 panels for a total system size of 4680(DC STC) Description of the Hooting Project and Description of the Significant Materials to Be Used:except for areas highlighted in red,which are excluded,(I) delivery of roofing materials,(2)removal of existing roofing material(up to 2 layers)and inspection of roof deck after existing g roofin material is removed, (3)recycling of existing asphalt shingles,(4)cutting in ridge venting as needed,(5)six feet of ice and water shield at the eaves and three feet along the rakes and in the valleys, 6 synthetic underla ent covering all other areas 7 complete installation to manufacturer's specifications,and 8 cleanup after ( ) Yn Ym g ,( ) mP P ( ) P Scope Scope of Work: See roofing work scope :Color " DrIftW00 Roofing Brand:Owens Corning Roofing type: 30 year architectural Scope of Work:NSL shall perform all work and provide all materials described on the Work Scope attached to this agreement and will be responsible for any and all materials,and appurtenant items as may be required and necessary to perform all work described on the Work Scope and any performance reasonably inferable from it,including clean-up associated with NSL's work It is agreed and understood by and between the parties that this Specification Sheet,along with the HOME IMPROVEMENT AGREEMENT, constitutes the entire understanding between the parties,and there are no verbal understandings changing any of the terms.This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both Customer(s)and Contractor. Customer(s)hereby acknowledges that Customer(s)has read this Specification Sheet. NEXT STEP LIVING, INC. 07/24/2015 By: Todd Massicotte / Sixrtature>�`,k. CUSTOMER(S) Christopher Bowe 07/24/2015 Print Nam`2. k..<. . F .a . v.. ._. _.. .. .. .. .,... ignatur Laura Bowe Biu 07/24/2015 Signature= ©BLLP2013.NSL.CTMARI TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky Next Step Living, Inc. Cr HIC.0629266•MA OCABR#162111•RI Contractor Reg.#37185 NOTICEOF • O:: 7 next step Living .. ,home energy oLutions 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210 Telephone:866-867-8729•www.nextstepliving.com The following Notice of Cancellation applies to all states. NOTICE OF CANCELLATION ', NOTICE OF CANCELLA�ON./2015 - Dat of�transcctic�iin 24/2015 Date of Transaction You may CANCEL this transaction,without any Penalty or Obligation,within You may CANCEL this transaction,without any Penalty or Obligation,within THREE BUSINESS DAYS from the above date,If you cancel,any property (THREE BUSINESS DAYS from the above date.If you cancel,any property traded in,any payments made by you under the Contract or Sale,and any 'traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed by you will be returned within TEN !negotiable Instrument executed by you will be returned within TEN BUSINESS DAYS following receipt by the Seller of your cancellation notice, I BUSINESS DAYS following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be canceled.If i and any security interest arising out of the transaction will be canceled.if you cancel,you must make available to the Seller at your residence,in ,you cancel,you must make available to the Seller at your residence,in substantially as good condition as when received,any goods delivered to Isubstantially as good condition as when received,any goods delivered to you under this Contract or Sale;or you may,if you wish,comply with the ',you under this Contract or Sale;or you may,if you wish,comply with the instructions of the Seller regarding the return shipment of the goods at the instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make the goods available to the Seller ISeller's expense and risk.If you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your and the Seller does not pick them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of the goods without any Notice of Cancellation,you may retain or dispose of the goods without any further obligation.If you fail to make the goods available to the Seller,or if Ifurther obligation.If you fail to make the goods available to the Seller,or if you agree to return the goods to the Seller and fail to do so,then you 1you agree to return the goods to the Seller and fail to do so,then your remain liable for performance of all obligations under the Contract.To sremain liable for performance of all obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of this Icancel this transaction,mail or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram,to Next Icancellation notice or any other written notice,or send a telegram,to Next Step Living,Inc.,at 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 'Step living,Inc.,at 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210, 1 02210, NOT LATER THAN MIDNIGHT OF 07/28/2014 (pate) I NOT LATER THAN MIDNIGHT OF 07/28/2014 {pati) 1 HEREBY CANCEL THIS TRANSACTION. I I HEREBY CANCEL THIS TRANSACTION. Consumer's Signature Date Consumer's Signature Date --------------------------------------- In addition to the above notice, the following Notice of Cancellation __________ _ _ _ _ applies to Rhode_Island customers. _ _ _ 6-N __________ NOTICE OF CANCELLATION T' NOTIElf-0F CANCELLATION Date of Transaction: I Date of Transaction: You may cancel this transaction,without any y penalty or obligation,within IYou may cancel this transaction,without any penalty or obligation,within three 3 business da from the above date.ff cancel, r 1 1 Ys you ca ce,you cancellation three(3)business da from the above date.If you cancel our cancellation Ys V ,Y notice must state that you do not wish to be bound by the agreement and inotice must state that you do not wish to be bound by the agreement and mailed by registered or certified mail not tater than midnight three(3)daysmailed by registered or certified mail not later than midnight three(3)days following the buyers signing the agreement,excluding Sunday and any 'following the buyer's signing the agreement,excluding Sunday and any holiday on which regular mail deliveries are not made.All cancellations holiday on which regular mail deliveries are not made.All cancellations must be mailed to:Next Step Living,Inc.,at 21 Drydock Avenue,2nd Floor, I must be mailed to:Next Step Living,Inc.,at 21 Drydock Avenue,2nd Floor, Boston,Massachusetts 02210. iBoston.Massachusetts 02210. I HEREBY CANCEL THIS TRANSACTION. ,I HEREBY CANCEL THIS TRANSACTION. I Consumer's Signature -_-_-_-___-__ Date _______ 11onsumer'sSignature_-_-_-_-_-_-_ Date _-_-_-_- The above-signed individuals acknowledge receipt of the above Notices of Cancellation,with all blank lines filled in,and further acknowledge that they were orally informed of their right to cancel this transaction. Christopher Bowe Print :: Laura Bowe Name; 07f24/2015 Pant Name 07/24/2015 Signa Date nare Date f' S1gtu .i TSM260-M18-IVD2397-DC30214RO-CCO-RY-TN-Green Sky ADDITIONAL TERMS AND CONDITIONS (Connecticut Customers Only)The owner(s)of the home improvement contractor is or has been a shareholder,member,partner,or owner of the following corporations, limited liability companies, partnerships, sole proprietorships or other legal entities that have been a home improvement contractor during the previous five years:None. (Massachusetts Customers Only)In Massachusetts, all contractors and subcontractors must be registered by the administrator of the Board of Building Regulations and Standards and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation, Ten Park Plaza, Suite 5170, Boston,Massachusetts 02116 Telephone: (617) 973-8700. Any deposit required under this Agreement to be paid in advance of the commencement of work shall not exceed the greater of one-third of the total contract price or the actual cost of any materials or equipment of a special order or custom made nature, which must be ordered in advance of the commencement of work,in order to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of the parties. In Massachusetts,the contractor is responsible for applying for and obtaining any and all necessary permitting.Homeowners who secure their own permits will be excluded from the guaranty fund provisions of Massachusetts law. Delay/Unknown Conditions: Contractor's failure to perform any term of this Agreement due to conditions beyond its control such as,but not limited to acts of God, material shortages, Customer's inability to qualify for or obtain financing, delays by local government authorities in issuing or otherwise approving inspections,permitting,or other required authorizations do not constitute abandonment and are not included in calculating time frames for performance by Contractor. Contractor and Customer(s)have determined that a definite completion date is not of the essence to this Agreement. Late Cancellation/Late Payment/Default:If Customer(s)attempts to cancel this Agreement after midnight of the third business day after the date of this Agreement,and Contractor accepts such cancellation,all work will be stopped as promptly as is reasonably possible and Customer(s)agrees to pay Contractor a cancellation fee equal to 15%of this Agreement's purchase price to offset Contractor's incurred labor, administrative,and material costs.Customer(s)agrees to pay a late fee of 1.5%per month on all amounts due and owing from Customer(s)to Contractor accruing from the date due and running to the date the payment is made.Any deposit amounts less than or equal to 15%of the Agreement's purchase price are deemed non-refundable after midnight of the third business day following the date of this Agreement.If Customer(s)is in default of this Agreement,Contractor shall be entitled to seek recovery of Contractor's attorney's fees and any other costs or Contractor's Right to Cancel: In the event that Contractor determines that this Agreement cannot be performed as intended by the parties due,for example,to incorrect pricing,unforeseen structural defects,or pre-existing conditions to Customer's property,Contractor may cancel this Agreement within Forty-Five(45)days of its execution, notify Customer(s)of such cancellation in writing, and return all money paid by Customer(s). No Set-Offs or Retentions: Upon completion of Contractor's work under this Agreement, Customer(s) shall pay all amounts due under this Agreement without any right of set-off or retention.Completion is defined as the job being materially completed,functional as intended,and a final inspection, permit or occupancy certificate, as the case may be, having been obtained. if after paying all amounts due, Customer(s) alleges that Contractor's work is defective,Contractor,without waiving any of its rights,shall inspect the work and perform any remedial work to the extent Customer(s)is entitled to under this Agreement or Contractor's warranty at no cost to Customer(s). Customer's Representations: Customer(s) represents that (a) Customer(s) owns the premises where the work is being performed, (b) the property is free of preexisting hazards, (c) Customer(s)maintains casualty insurance on the property covering the work performed, (d) if the existing electrical service at the property does not meet the standards of the utility company or electrical code, Customer(s) will make the necessary changes at Customer's expense unless Contractor has agreed to make these changes in writing. Contractor's Rights:Contractor accepts no responsibility for any damage resulting from pre-existing structural or other defects in Customer's property and Contractor is not responsible for remedying structural defects in Customer's property.Contractor shall not be responsible for(a) any damages arising in whole or in part from any causes beyond Contractor's control; (b)any incidental or consequential damages, including ,but without limitation, lost profits or reduction in value of Customer's property arising from Contractor's delay in performing under this Agreement or due to Contractor's breach of this Agreement; and (c) unintentional damage to Customer's personal property, it being Iderstood that Customer(s)is responsible for protection and/or moving of such items prior to commencement of work.Customer(s)agrees to `emnify and hold Contractor and its employees, agents, and subcontractors harmless from any claims as to the identification, detection, dement,encapsulation,or removal of mold,asbestos,lead-based products,or other hazardous substances inside or outside of the property at \oducts ork is performed.Any surplus materials remain the property of Contractor.Any manufacturers'warranties offered by the manufacturer purchased shall be provided to Customer(s).No warranty will be effective while a balance due remains on this Agreement. TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky Rebates:Unless Customer(s)has assigned its rights to Contractor,Customer(s)shall be entitled to receive and to claim any and all rebates and any other benefits associated with ownership and use of the product(s). Customer(s) shall have the sole responsibility of making any application for any such benefits. Contractor shall have no obligation and assumes no responsibility to apply for or collect any benefits on Customer's behalf nor has Contractor made any representation or warranty to Customers)with respect to Customer's eligibility to receive,or the value of, any such benefits, including any net metering credits or solar renewable energy certificates. In all cases, Customer(s) agrees to consult with the relevant governmental officials and Customer's professional tax preparer when evaluating Customer's eligibility for and the financial and tax consequences of receiving benefits. The Attachment includes a summary and estimate of the benefits that may be applicable to the product(s), plus the estimated net cost to Customer(s) after application of such financial incentives; contingent in each case upon Customer(s)receiving or being eligible to receive such benefits. i i Security Interest: Customer(s) agrees and understands that in the event that Customer(s) does not pay Contractor any of the money owed when it is due, Contractor may have a claim against Customer(s) that may be enforced against Customer's property in accordance with the applicable lien laws. Customer(s) also understands that if Customer(s) finances the work with Contractor or a third party, Customer's separately provided financing documents may include a security interest. Customer(s) understands that Customer(s) should read those documents closely. Miscellaneous:No waiver of any breach of this Agreement shall be construed as a waiver of any prior,concurrent,or subsequent breach hereof.The section headings contained in this Agreement are inserted for convenience only and shall not affect in any way the meaning or interpretation of this Agreement.In construing this Agreement,the gender and number of words used may be changed to meet the context. This Agreement shall be governed by and construed in accordance with the laws of the state in which it is performed,except as may be preempted by federal law.If a provision of this Agreement is held to be invalid or unenforceable,this Agreement shall continue in full force and effect and shall be construed as if the invalid or unenforceable provision was omitted.Customer(s)agrees that Contractor can assign any of Contractor's rights under this Agreement without Customer's consent and that the person to whom Contractor assigns this Agreement shall be entitled to all of Contractor's rights under this Agreement.The Purchase Price listed on the front of this Agreement includes all applicable sales tax and all governmental fees required for Contractor to perform this Agreement.To the extent any goods or material are not specifically listed in this Agreement but are necessary to complete the work,Contractor will select goods and materials of commercial grade(i.e.,of the grade,type,or condition,ordinarily or customarily used for such work),such selection being at the sole discretion of Contractor.Contractor may engage independent subcontractors to perform work under this Agreement. Five-Year Warranty:Contractor warrants its workmanship under this Agreement for a period of five(5)years.In the event of a valid claim, Contractor will repair or replace,at its option,and at its sole expense and at no cost to Customers),any defects in workmanship provided by Contractor or its subcontractors.Effective immediately upon Customer(s)making of the final payment under this Agreement,Contractor assigns to Customer(s),to the extent assignable,any and all manufacturer warranties covering the equipment and shall deliver copies of such warranties after its receipt of such final payment.No warranty will be effective while a balance due remains on this Agreement. Documents Incorporated by Reference: Specification Sheet(s),Notice of Cancellation CLASS ACTION WAIVER:Customer(s)agrees that Customer(s)will assert a dispute,claim,or controversy(hereafter referred to as a"Claim")arising under or relating to this Agreement only on behalf of Customer's own self and that Customer(s)will not assert a Claim on behalf of,or as a member of,a class or group in either an arbitration proceeding,a private attorney general action,or in any other forum or action.If a court determines that this specific paragraph is not fully enforceable,the court's determination shall be subject to appeal.This paragraph does not apply to any lawsuit or administrative proceeding filed against Contractor by a state or federal government agency even when such agency is seeking relief on behalf of a class of Customers. I �I I TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky MODULE DATA DETAILS THE Universal MODULE 'CSM—PA05.08 DYi.SENSYi•'Tbl#:CAp Ptd iV40#,tEE .': . Et.£CTRICAL.DATA(STC) m unto r+�m 9111 Peak tA Povrer+iwfrxtts-FSaar'AV'/Pl ` 24,E -- 25 x55 .:, 264 W 0 O awCnnu .) btaa6mPM Ro;ti+e5<Valra -Y1«.r YV7 24'4 ,3(t$ x$Oc$ 90 4 r t IL 0 O 0 Oi' : $adazlrrrurEt tfirHra Iwa►� ,8 27' - H Qf � 4Pen Clrcall'.Yoltope Vac tYj X7.8 38.0 3$7 38 2 " � (/� W OY w�ituaemxnuc ,{�'"prrt 45111 ,Y10 nT YAc tqJ 'yq,. + SrS J µ r,rE' P' �-� �'7 r� g. q¢p ,CCss `. x = tl C Mga7q�le E6kc6erlcy n*f9J GSdN 1S a > 1S 6 .t 76.4 : t ji co SIC:Mwpinna 70bD WHe�•.Cer.TempCwN�e'd5'C',.Jilr Moss wrai:Sacwptng t0 EN 50M11C1-0.]. v r 7. Y� rryleal dfi<le,r cy resdwclbnnf*+,59s alaID WJm'enecnrdirg tof;ho 6a.aa.7. iELECTRiCAIL DATA(NOCT) E o 11 m >ariadmum F'onroer P.a oo�Iv+`PY I52 18b 1 . t93 t�A $ C >d+rtaum rrn''r' Y .,�, I"r S " .+6 R�».3.."I'�y, .f➢h4�4 i A.1 .. .�,. x'26 1`. � 7 V G t rtuitlesuresFr4WerCtrrcent iaw►Ip1 : d.54 �la.b5 d va 83!a V Q a d i�?p4®{^,Irlt-ti{csllt! e '" k " - r ddd acyxmaw.c 6 rfQ, ao...rxe�a Shget CltcG114urrem 4c,tlAt `:' ?A� �;tl0..` 7:17' 7n9 bPIGF rrnP�wnc,c as 817Bvn'ha'�.+ambiens Tomyperotawo 30'C.Wle d 9p— t.mX .... i.. B't Z 'r 1lirJcu MECHANl CA!6ATA f!\ /0.� ®ocic Nrnw 13aAiar o6tls MutltllCryra'faYAne15a 156 Tram t4NnchssY ` �VJ \V Ceeael(irabra toris b 7 rt ra 41 \V ,� 1✓rd .� L'At � '.i 4"m �, rsd- j'tiv rir. � tk 'rR �>_ E MOddule dlmen�lons 4654: 4412 3..5:mm f6A 46p34.fASKt 3]&,ches'J Q 'IMeat 9 �' >S wrxwa 9.k r41 JI .41n''8141 lb o �, avi s,"' ,.S' `� r ✓ c t �� _G3 COf A 7 �CYd rwn A •''2 rnrra lfy i3lnchesS NlgkTranstralssbon hRCapledTgryt ereK/Gtoss ^ O A33a` frame � - �Black Anadlieri A1twnlri4um xl6cyy sawe 0ts y � x ,�9', 1 ✓' A r+ r r �, +u��* "P w ''' >N>c{ ra yti�- O .►.,Baa! V 5 ...,a::ax il�d5ar Ptt7iiaEed R v _. t �: ^, Cabiea, - PhMwdltolc Tochn0 do*cahle6Qtrum Lfl AOfi tncYaest �,xr W 3'Otk�ttlOOrram O A 1Naew'UR4E$upP''�MCIb41tE(,.�I451Y4f� S"uuMCtlKar' h' s� a'% ,'.MCb..crNA4x',e'> mpabtle4 <... ,^ U) 10° Z s w TEMPE:RATURtE Ix•AF1Nd`r5 tiV1LY4kANTY. NominplQprpratingGell - 14 yeararocluat 6 trpmpercture}I�N,O+CTt 4 CfiL24CJ WarkmcanshtpLticrmnty 5." 4 peraburp 40. fBrBf�",t"t �` �i"'S y Y�C6n a�tr"¢+7�anlYafrraa f"...,.�,..u-�,M...<..•! Temperatl,tre euaoflc7en n ap xx ;R 329fJi iwoos�scar iopraductwa nanhy ro.aerousy 2 �Tempersattwe�osicYe!h of Inc q p a w s amu. r ` 'V�irJtyV} Q MAXIMUM RATINGS Agtgratlana94emperahuna� ap t89fC �. QJ �vtanlrr.urrr5ystem^4a�.�,x r �441!D'{;�Ut1i �"""� � .�. ttr$b 5er9ss pose kaling t 5p..;'. - �: CERTIPICATtCNJ � tiR.s �, e oa PACKAGING CON FIGURATION n i.�7[D Mq�kAea per bay 8b pEaces - - z tr . hioddttes p®r 0^ oeN�aFnlrE8O , es 12 O q ARRAY DESIGN / SITE DIAGRAM HEIGHT OF HOUSE PANEL ORIENTATION (TRUE) ROOF PITCH (DEGREES) 225" 213° 30° Quick Mount PV Solar Flashings FOSS ROAD 0 will be used on every roof penetration DRIVEWAY +-39.05"-4 ***ARRAY LAYOUT IS NOT TO SCALE*** = Q is 0 x UTILITY METER PLACE PV LOAD CENTER OUTSIDE TO THE LEFT OF THE °- 1z o > LGATE120 a Q UTILITY METER, THE CUSTOMER IS RESPONSIBLE FOR MOVING OBSTRUCTIONS T FROM LOAD CENTER Ac DISCONNECT m a LOCATION; PLACE ENVOY MONITORING EQUIPMENT TO I o 4 V 00 THE RIGHT OF THE MAIN ELECTRICAL PANEL �r PROPOSED CONDUIT THROUGH Q z a ATTIC,DOWN EXTERIORTO i PVLC;ELECTRICIAN WILL FIELD VERIFY C PIPE TO BE RELOCATED I c I O QUICKMOUNT PV 'CU — 34'-8" (416") PORTRAIT/LANDSCAPE :> J +r 12"TYP. I Total#of Pyla ls: 18 Q U) Total#of Splice Bars: 8 L 0 ❑ I Total#of Bonding Jumpers: 8 (n CU 12"TYP. H. .14'+1-11 - I Total# End Clamps: 14 C 4 {° Total#of Mid-Clams 36 X See Engineer's Structural Assessment O 1.14'+1-11 •p m "1 h 4 +�. t✓ xAt..,t ....-•.. CU Ct4stomer Signature: Date: TYPICAL ATTACHMENT DETAILS ,,/—THS EDGE TOWARDS ROOF RIDGE RACKING COMPONENTS ITEM.. .... � _ r NOT INCLUDED - 2.25 NO, DESCRIPTION QTY,IBOX 5 l 1 FLASHING,V'X 12100',00,052,MILL 1 4 1,24 2 OBLOCK,CLASSIC,A3601 CAST AL,MILL 1 3 PLUG,SEALING,5116"X 718",EPDM 1 IN SS 1 4 LAG SCREW,HEX HEAD,5116"z 5.112",1N SS 1 I.2S 5 WASHER,FENDER,5116'IDX 1.114"OD, IN SS 1 3.00 � 2 1 4.50 9.00 .E • a . • al lumber: Lag Bolt Specifications Specific Gravity 511 6'shaft per 3"thread depth 5116"shaft per 1"thread depth Douglas Fir.Larch .501798 266 Douglas Fir,South .46 705 235 Engelmann Spruce,Lodgepole Pine(MSR 1650 f&higher) 46 705 235 Hem.Fir .43 636 212 Hem,Fir(North) .46 705 235 Southern Pine .55 921 307 Spruce,Pine„Fir .42 615 205 Spruce,Pine,Fir(E of 2 million psi and higher grades of MSR and MEL) .50 798 266 Next Step Living Inc. Quick Mount PV REPORT FOR AITTACHMENT next step living. Module and Roof QMSE-LAG:QMPV E-MOUNT SPACING' home energy solutions Attachment Detail WITH LAG BOLT r • ensee Details raphic Information ull Name: `DONALD.D,ELWELL ender. er Name: Llcenlse.Address InTormation ddress:. ddress 2:: ity. BEDFORD, tate:: MA ipcode: '01780 .. o ht : Unitedgtates icense InTorm. 9tion. icenseNo: CS-094414 License.T:e:, Construction Supervisor rofession: Building Licenses. Date o€Last Renewat oil 31-2015 slue Date: Expiration Date: 814'12017 icense Status: Active Today's.Date° -8/25(2015 ecodo y'License: ging Business As atus Change- is se Renai rere uisi e ' or a ion No Prere ulsite'Infotmation IScip' the No Discipline Information ocumen um - CIU V�rtdati. Q 2011 Commonwealth.of Massachusetts Site Policies Contact Us i ya. r t" ? _ A4 assachusetts- Department of Feu ' i(dinn Re gc±3ations Conttrcic iiia Supe-z'.. r License: CS-094414 - DO ALO D EL � Y Q� 240 CARLISLE PtD BEDFORD AIA 0-78 � l= '`i"-• s• ; - tlsssioner F:.piration Office of Consumer Affairs&Business Regulation =SOME IMPROVEMENT CONTRACTOR Registration: 178990 Type: -;Expiration: 6/912016 Corporation STALKER ELECTRIC,INC. WILFRED STALKER 400 W.CUMMINGS PARK STE 17X__r WdVORN.MA 01801, Undersecretary Fold,Then Detach Along All Perforations r COMMONWEALTH OF MASSACHUSETTS. MMON:: BOARD OF >�LTH OF�SSACHUS ELECTRICIANS @ ISSUES THE FOLLOWING LICENSE AS f €GTR fSTERE� MASTER ELECTR.ICIA � �:� lCIAN S REG ISSUES THE FOLLOW A ING LICENSE. OURN.EYM_ AN' EL E •STALitER ELECTRICAL CONTROLS INC :� _ - CTRiCIAN •¢ W I LFRED ;Fa:STALKER `z SHAW A STALKER �` z 6 PERTH DR 9 K I ERMAN''AVE '•S,TR-OHAM -NH 03885-2222 14 56 A` "31/16:. 93540 P'..-WILMINGTON MA 01887-322-9 a '��� ' s a. - ,• - 'O> 2 62 Nov 23 15 07:13p stalker electric 7817298433 p.2 DATE CERTIFICATE OF LIABILITY INSURANCE 5/13/2015» 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(ies) must be endorsed. If SUBROGATION IS WAIVED,subject 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 endersement(s). PRODUCER NAIAEACT Dave Chrtsoz Provider Group PHONE (781)444-0347 FAX (701)444-0961 Are Ne 160 Gould Street ADDREMAILESS• provdchrisos@ iderig- com Suite 130 ENSURE S AFFORDING COVERAGE NAIC R Needham MA 02494 INSURERA:Llber Mutual (PIC) 24198 INSURED INSURERBAllmerica Financial Benefits 41840 Stalker Electric Inc RISURERC The Ohio Casualty Insurance 24074 400 West Cummings Park INSURERo:Star Insurance I Suite 1725-142 INSURER E: f wobu=n M 01801 I145URER F: COVERAGES CERTIFICATE NUMBERAS-16 Master LiabIlIty REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 BY 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. INSR ADOLSUBR TYPE OF INSURANCE POUGY NUMBER N1wDDrIX(YCY YY MMIDOfYYYY LIMBS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIA9ILITY PREMISES Ea Occurrence)k$ A CLAIMS-MADE aOCCUR ICS55932269 /23/2015 /23/2016 MEOEXP(Anyoncperson) S$ 15,000 X ISO FoLm CG0001 PERSONAL&ADV INJURY $ 1,000,000 X Contractual Liab GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S 2,000,000 X POLICY X PRa LOC $ AUTOMOBILE LIABILIT/ Easc6dentMID SINGL£LIMfI $ 11000,000 13 ANY AUTO BODILY INJURY(Per person) 3 ALL OWNED F-,-1 SCHEDULED LM772911 /12/2015 /12/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS I NON-OWNED PROPS - DAMAGE HIRED AUTOS $ AUTOS Per. Uninsured molorist combined $ 2,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAR CLAIMS-MADE. AGGREGATE Is 5,000,000 DED I R I RETENTION$ 10,00 LIS055932269 /23/2015 /23/2016 is j� WORKERS COMPENSATION WC STATU• X O R AND EMPLOYERS'LIABILITY ANY PROPRIEfORMARTNERIEXECUTIVE YNIA EL.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? 0378024 9/12/2015 /12/2016 EL DISEASE-F1\EMPLOYEES _..___500f000 (Mandatory in NH) If yos,describe undor DESCRIPTION OF OPERATIONS below E_L DISEASE-POLICY LIMIT S 500 000 A Automobile Li.abi.11ty (MA) RAS55932269 /22/2015 /22/2016 Combined Single Limit 1,000,000 B Third Party Crime D /16/15 /16/16 Clierft Property 50,000 I DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(Atlach ACORD 109,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Stalker Electric, Inc. PO Box O aale,3AZ 85623 55 AUTHORIZED REPRESENTATIVE R Hillberg/CATHYF ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 roninn.si M The or:rlRn names and Inn^arta it nicfo► rl marlrc of A!_nRll �1 '��E' CERTIFICATE OF LIABILITY INSURANCE 5i13i201'S' � 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(ies)must be endorsed. If SUBROGATION IS WAIVED,subject 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 endorsement(s). PRODUCER CONTACT Dave Chrisos NAME: Provider Group PHONE (781)444-0347AX No:(781)444-8961 160 Gould Street noo Ess:dchrisos@providerig.com Suite 130 INSURERS AFFORDING COVERAGE NAIC# Needham MA 02494 INSURERA:Libert Mutual (PIC) 24198 INSURED INSURER B Allmerica Financial Benefits 41840 Stalker Electric Inc INSURERC:The Ohio Casualty Insurance 24074 400 West Cummings Park INSURERD:Star Insurance Shite 1725-142 INSURER E: Woburn MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 Master Liability REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 BY 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. INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/D MM)DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED PREMISES Ea occurcence1 $ 300,000 A CLAIMS-MADE FxI OCCUR BKS55932269 /23/2015 /23/2016 MED EXP(Any one person) $ 15,000 X ISO Form CG0001 PERSONAL&ADV INJURY $ 1,000,000 X Contractual Liab GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X1 POLICYFX PRO LOC $ OMBINED AUTOMOBILE LIABILITY CSINGLE LIMIT Ea accident 1 000 000 BANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED WN8772911 /12/2014 /12/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE Per ac $ AUTOS cident Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,00 5055932269 /23/2015 /23/2016 $ ]� WORKERS COMPENSATION WC STATU- X OTH- AND EMPLOYERS'LIABILITY Y/NJEEL ANY PROPRIETOR/PARTNER/EXECUTIVE EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) KC0378024 /12/2 9 /12/2015 E.L. ISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below . .DISEASE-POLICY LIMIT $ 500,000 A Automobile Liability (MA) BAS55932269 /22/2015 /22/2016 Combined Single Limit 1,000,000 B Third Party Crime BD /16/15 /16/16 Clients Properly 50,000 El DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Stalker Electric, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 155 Oracle, AZ 85623 AUTHORIZED REPRESENTATIVE R Hillberg/CATHYF ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgntnnsi m Thr+ernRr1 name and Innn am rnnictnrorl marlrc of ernpn S111\ NOTICE NOTICE TO o TO EMPLOYEES EMPLOYEES v v The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114-2017 617-727-4900 - http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above-mentioned chapter by insuring with: STAR INSURANCE COMPANY NAME OF INSURANCE COMPANY P.O. BOX 49167 SARASOTA, FL 34230-6167 ADDRESS OF INSURANCE COMPANY WC 0378024 09/12/2015 to 09/12/2016 POLICY NUMBER EFFECTIVE DATES PROVIDER INSURANCE GROUP, LLC NEEDHAM HEIGHTS MA 02494 160 GOULD STREET, STE. 130 781-444-0347 NAME OF INSURANCE AGENT ADDRESS PHONE# STALKER ELECTRIC INC. 400 W. CUMMINGS PARK, STE.1725 WOBURN MA 01801-0000 EMPLOYER ADDRESS EMPLOYER'S WORKERS' COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the FirsReport of Injury must be given to the injured employee. The employee may select his other own physician. The reasonable cost of the services provided by the treating physiciarwill be paid by the insurer, if the treatment is necessary and reasonably connected to thework related injury. In j cases requiring hospital attention, employees are hereby notified thatthe insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER