HomeMy WebLinkAboutBuilding Permit #596-14 - 168 SUTTON HILL ROAD 2/13/2014 z
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BUILDING PERMIT
TOWN OF NORTH ANDOVER t ,.
APPLICATION FOR PLAN EXAMINATION * -
Permit NO: Date Received °44 11C.. C.1 "
�9SSAC NUS����
Date Issued: 3 t
IMPORTANT:Applicant must complete all items on this page
LOCATION—A 7- S JV0o 841 6b. AfA 114v6r M UI ZVI
Print
PROPERTY OWNER o
Print
MAP NO:
PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building )(One family
AWAddition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
[l Septic ❑Well ❑ Floodplain ❑Wetlands ri Watershed District
❑ Water/Sewer
ouA� gmj -TAS a
Identification Please Type or Print Clearly)
OWNER: Name: �►� co Phone: �- 7S- 07
9 � To�ce i 97 4 l 3
Address: /G d' S,4en 841 fe, AE-6440 O/FlE
CONTRACTOR Name- Phone: 7rI
dr a
!U ldt &r�6/ .�c
Address:
Supervisor's Construction License: Exp. Date:
Cs-0737 q .2-6 -AJ9
Home Improvement License: MOW Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ S,l, 19,z� FEE: $
Check No.: Receipt No.:
NOTE: Perso s contracting with unregistered contractors do not have a cess to the guaranty fund
Signature of Agent/Ovvner CP/ Signature of contractor �
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION _
Print_
PROPERTY OWNER
Print 100 Year Old Structure yes no
MAP NO: PARCEL: _ZONING DISTRICT:._ Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
p Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
_0 Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR Name:. Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
0
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
gnature of AgeR rjer Signature.of contractor
Plans Submitted Li Plans Waived ❑ Certified Plot'Plan ❑ Stamped Plans ❑
Plans Submitted-❑ - PlansWaived ❑ '-:-Certified Plot Plan ❑ Stamped Plans ❑
TYPE-OF.SEWER-GEDIS-POSAL- - '
Public Sewer ❑ Tanning/Massage/Body Art ❑. . . Swimming Pools ❑
Well Tobacco.Sales . .ToodPackaging/Sales ❑
Private{septic tank,ete..
Pdrniaiient Dumpster on Site ❑
THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED: DATE APPROVED
PLANNING & DEVELOPMENT" ❑ - ❑
i
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
i
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: :Comments
Water& Sewer Connection/Signature & Date Driveway Permit
i
DPW T'ow�-: Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMr NT Temp Dumpster on site yes no
Locatedat,l24tMair Strdet -
Fire-Departme►it.sig --' 04- Mate ' `'` •-
.i
COMMENTS � ` ,
IIIDimension.
_.
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
DANGERZONE LITERATURE: Yes No j
MGL Chapter-166 Section 21A--F and G min.$100-$1000fine
NOTES and DATA— (For department use
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EI Notified for pickup - Date
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Doc.Building Permit Revised 2010
Building Department
1"he foi�bwing i'A*i'st of the required.forms to be filled out for the appropriate.permit to be obtained.
RoofirA g, Siding, Interior Rehabilitation Permits
❑` Biailding Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Gr C.S.L Licenses
o Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster_permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
4.
o Building PP Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Crossection/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
NOTE: 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
❑ Photo of H.I.C. And C.S.L. Licenses
❑ 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
NOTE: 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 apw•al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm-tted with the building application
Doo: Doc.Building Permit Revised 2012
Location
No. / 7 Date j
• - TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check#��
_ Building Inspector
u
Enter construction cost for fee cal- North Andover Fee Cakulat►on
Construction Cost
$ 529629.00 m
$ - $ 631.55
Plumbing Fee $ 78.94
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 78.94
Total fees collected $ 889.44
168 Sutton Hill Road
596-14 on 2/13/14
35 Panel Solar Arra
� NOF�Tfy
Town of s n ove r
p -. - `" 0
% , ver, Mass, t
COC
.NIc NlwtCK �'�•
�•9 A°pATEo fkPP,��(5
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BOARD OF HEALTH
Food/Kitchen
Septic System
THIS CERTIFIES THAT .....PERq!IT
0-d...... )....................................... .......... ......;....................
BUILDING INSPECTOR
has permission to erect ........ buildings on ...J. 1� .................... Foundation
.................. ........... .. .. .. .
Rough
to be occupied as ..... . ..t..4 ..... ... .........Soft
1 ...................................................... Chimney
provided that the person accepting this permit 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
Z PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
6 UNLESS CONSTRUCTIOT 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.
SEE REVERSE SIDE
fl. �
. I
a s EAH€-Structural Consulting
35 Kendall Court�
Bedford, MA€,173
PHONE 1.978,406.8921
.AH CONSUI.-ritio, Elaine C EAHStructural.vorn
.......... . _.......... .......... ......._._.... ...................................... ................
January 13,2014
To: Revolu5un-Northeast Electrical
1 North Ave
Burlington,MA 01803
Subject: Structural Certification for Installation of Solar Panels
Ko Residence
168 Sutton Hill Road
North Andover,MA.01845
To Whom It May Concern,
A design check for the subject residence was done on the existing roofing and framing systems for the installation of
solar panels over the roof. From a field inspection of the property,the existing roof support structures were observed
as follows:
The roof structure of(MP1)consists of composition shingle on roof plywood that is supported by nominal 2x10 rafters
@ 16"o.c.,paired with nominal 2x10 ceiling joists @ 16"o.c..The rafters have a max projected horizontal span of 27-6",
with a slope of 21 degrees.The rafters are connected at the ridge to a continuous 2x12 ridge board and are supported
at the eave by a load bearing wall. There are 2x6 collar ties @ 16"o.c.for structural stability.There are 2x4 diagonal
struts at 16"o.c.to provide additional support to the rafters. The diagonal struts are landing on a load bearing wall.
The struts and the collar ties work together to form a truss system.
The existing roof framing system of(MP1)is judged to be adequate to withstand the loading imposed by the installation
of the solar panels.No reinforcement is necessary.
The spacing of the solar standoffs should be kept at 48"o.c.with a staggered pattern to ensure proper distribution of
loads.
I further certify that all applicable loads required by the codes and design criteria listed below were applied to the
Unirac Sunframe solar rail system and analyzed.Furthermore,the installation crews have been thoroughly trained to
install the solar panels based on the specific roof installation instructions developed by Unirac Sunframe for the racking
system and Quickmount for the roof connections. Finally,I accept the certifications indicated by the solar panel
manufacturer for the ability of the panels to withstand high wind and snow loads.
Design Criteria:
• Applicable Codes=Massachusetts Residential Code,8th Edition,ASCE 7-05,and 2005 NDS
• Roof Dead Load=9 psf(MP1)
• Roof Live Load=20 psf
• Wind Speed=100 mph,Exposure B j
• Ground Snow Load=50 psf - Roof Snow Load=35 psf
Please contact me with any further questions or concerns regarding this project.
Sincerely,
ruAw= a
HUAN
1� CIVIL tni
f Ir`�.9c,`S7a
Elaine Huang,P.E.
q
Project Engineers
CNAL
Ko Residence, North Andover 1
A-
Ei4H Structural CGIIsulting
35 Kendall Court
Bedford, MA 01730N
PHONE 1.978.406-.8921
3.
CAM CQN5ULTING
Eliec2� Htruu�'ai.c'. m
Gravity Loading
Roof Snow Load Calculations
p9=Ground Snow Load= 50 psf
p,=0.7 Ce Ct t p9 (ASCE7-Eq 7-1)
Ce=Exposure Factor= 1 (ASCE7-Table 7-2)
Ct=Thermal Factor= 1 (ASCE7-Table 7-3)
1=Importance Factor= 1
pt=Flat Roof Snow Load= 35.0 psf
ps=CSpr (ASCE7-Eq 7-2)
Cs=Slope Factor= 1
ps=Sloped Roof Snow Load= 35.0 psf
PV Dead Load=3 psf(Per RevoluSun-Northeast Electrical)
Roof Dead Load(MPI)
Composition Shingle 4.00
Roof Plywood 2.00
2x10 Rafters @ 16"o.c. 2.90
Vaulted Ceiling 0.00 . (Ceiling Not Vaulted)
Miscellaneous 0.10
Total Roof DL(MPI) - 9.0 psf
DL Adjusted to 21 Degree Slope 9.6 psf
Ko Residence, North Andover 2
EAH Structural Consulting
35 Kendall Cou€-t
-d, MA 01730
Bedfoi
P H 0 N E 1 9x84F...E9,2l.
EAHi CoNsut--rtNo Ela€n rti E� 'Strucural.CCIM
Wind Calulations
Per ASCE 7-05 Components and Cladding
Input Variables
Wind Speed 100 mph
Exposure Category B
Roof Shape Gable/Hip
Roof Slope 21 degrees
Mean Roof Height 20 ft
Building Least Width 40 ft
Effective Wind Area 17.5 ft
Design Wind Pressure Calculations
Wind Pressure P=qh*(G*Cp)
qh=0.00256*Kz*KZt*Kd*V^2*I (Eq_6-15)
Kz(Exposure Coefficient)= 0.7 (Table 6-3)
Kzt(topographic factor)= 1 (Fig.6-4)
Kd(Wind Directionality Factor)= 0.85 (Table 6-4)
V(Design Wind Speed)= 100 mph
I Importance Factor= 1 (Table 6-1)
qh= 15.23
Standoff Uplift Calculations
Zone 1 Zone 2 Zone 3 Positive
GCp= -0.85 -1.45 -2.30 0.40 (Fig.6-11)
Uplift Pressure= -12.95 psf -22.09 psf -35.03 psf 10.0 psf (Minimum)
X Standoff Spacing= 4.00 4.00 4.00 -
Y Standoff Spacing= 2.75 2.75 2.75
Tributary Area=. 11.00 11.00 11.00
Footing Uplift= -142 Ib -243 Ib -385 Ib
Standoff Uplift Check
Maximum Design Uplift= -385 Ib
Standoff Uplift Capacity = 400 Ib
400 Ib capacity>385 Ib demand Therefore,OK
Fastener Capacity Check
Fastener= 1 -5116"dia Lag
Number of Fasteners= 1
Embedment Depth= 2.5
Pullout Capacity Per Inch= 250 Ib
Fastener Capacity= 625 Ib
w/F.S.of 1.5= 417 Ib
417 Ib capacity>385 Ib demand Therefore,CCK
Ko Residence, North Andover 3
1
EAti Structural Consulting
35€endall Couet
y Bedford MA 01730
..F: FHS. hIE 1 97€ 4f-.92
► gar :rte � , ? Elairia@ EAHStr-ucWralxon-i
Framing Check (Mp1)
PASS
w=64 plf
Dead Load 9.6 psf
PV Load 3.0 psf
n.2x1D Raf#ers6"�
Snow Load 35.0 psf
c_ '
Governing Load Combo=DL+SL < Member Span 15'-0"
Total Load 47.6 psf
Member Properties
Member Size S(in^3) 1(in^4) Lumber Sp/Gr Member Spacing
2x10 21.39 98.93 SPF#2 @ 16"o.c.
Check Bending Stress
Fb(psi)= fb x Cd x Cf x Cr (NDS Table 4.3.1)
875 x 1.15 x 1.1 x 1.15
Allowed Bending Stress=1272.9 psi
Maximum Moment = (wL^2)18
= 1786.51 ft#
= 21438.1 in#
Actual Bending Stress=(Maximum Moment)I S
=1002.3 psi
Allowed>Actual--78,8%Stressed •- Therefore,OK
Check Deflection
Allowed Deflection(Total Load) = L(180 (E=1400000 psi Per NDS)
= 1in
Deflection Criteria Based on = Simple Span
Actual Deflection(Total Load) _ (5*w*L^4)1(384*E*I)
= 0.523 in
= L1345 > LI180 Therefore 4K
Allowed Deflection(Live Load) = L1240
0.75 in
Actual Deflection(Live Load) _ (5*w*L"4)I(384*E*I)
0.385 in
L1468 > U240 Therefore DK
Check Shear
Member Area= 13.9 in^2 Fv(psi)= 135 psi (NDS Table 4A)
Allowed Shear = Fv*A = 1873 Ib Max Shear(V)=w*L/2 = 476 Ib
Allowed>Actual--25.5%Stressed -- Therefore,OK
I
Ko Residence, North Andover 4
4 `
REVOLU UN
25 8 Street
Burlington,MA 01803
Phone:781.270-6555
Fav:781.281-6166
www.revolusun.com/MA
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(N) TERMINATED
(N) JUNCTION BOX TIGO GATEWAY PROJECT:
OR LB ON ROOFq ,: .. BING&JOYCE KO
.. 7 168 SUTTON HILL ROAD
NORTH ANDOVER,MA 01845
(N) CONDUIT RUN IIS x., ta
ON EXTERIOR * ' �
WALL II e1'` " " `' �' (E) SKYLIGHT, TYP. PROJECT SPECinCATIONS:
: � tY
. a
INVERTERS 1—SPR 4000
El� 1—SPR 6000
MONITORING INCLUDED
a 3 (N) PHOTOVOLTAIC MODULES MODULES 32-SPR 327 WHT
FLUSH MOUNTED, TYP. 327.0W(STC)-301.4W(PTC)
ko A h SYSTEM 10.46 kW(STC)
II)a�w 1 4� 512E 9.64 kW(PTC)
Dale IDescription
II
(E) UTILITY METER II
PROJECT NO: MA02 14-0020
(N) PV SYSTEM (E) MAIN LOAD DRAWN BY: GR
AC DISCONNECT CENTER REVIEWED BY: re
_ _______________ __ DATE: FEBRUARY 12,2014
SHEET NAME:
PLOT AND
(N) INVERTER
LOCATIONS 2 ROOF LAYOUT PLAN
(E) DRIVEWAY
SHEET NO:
ROOF LAYOUT PLAN SCALE: 1/8" = v-0- E1
i
INVERTER # 2 REVOLU{�SIUN
6000 GRID—TIED
INVERTER # 1 Bur gSonn,5 B sMA 01803
4000 GRID—TIED MAXIMIZER Phone:781.270-6555
Fax:781.281-6166
MANAGERMENT UNIT ww molusun.com/MA
TERO
GATLVlAY DC AC DC AC
IN OUT IN OUT (N)INVERTER OUTPUT
PANELBOARD
125A 120/24OV, 10,3W
PV SOURCE PV SOURCE NEMA-1R
JUNCTION BOX DC DISCONNECT DC DISCONNECT
SYSTEM# 1 ON ROOF
14 MODULES
2 STRINGS OF 7
® I 20A-2P
30A-2P I
® ® 1 G GND
518 AWUSE-2/RHW-2, I — 40A-2P
r
SYSTEM 1112 1 EMT C.(INTERIOR)
18 MODULES 1-PVC C. (EXTERIOR) RS-485 CABLE
3 STRINGS OF 6 1/2'EMT C.
® ® RS-485 CABLE 3/12 AWG TNWN-2/THH
1/2'EMT C. I= 16.6 x 1.25=20.8 A 112 AWG GND
® ® V=2405 3/4'PVC C.
125.0 x 1.25=31.3 A PROJECT:
V-240V 3610 AWG THWN-2/THHN, I BING 8 JOYCE KO
3#10 AWG 3#8 AWG THWN-2/THHN, 168 SUTTON HILL ROAD
THWN-2/THHN, 1#8 AWG GND 1/2-EMT.C 3/4-EMT C.(INTERIOR) I NORTH ANDOVER,MA 01845
3/4'PVC C.(EXTERIOR)
I=Isc(6.46)z 1.56= 10.011A 3/4-
I
Vmm- (Voc(64.90)x 7)x 1.16 ETHERNET
=526.99 VDC PROJECT SPECIFICATIONS:
I=Isc(6.46)z 1.56 10.08A INVERTERS 1-SPR 4000
V-= (Voc(64.90)z 6)x 1.16 �w -
= 451.70 VDC 1-SPR 6000
L$ �_ (E)MAIN LOAD CENTER MONITORING INCLUDED
-...� I 200A, 120/2405, 10, 1/22 PVCC.G THWN-2/THHN, MODULES 32-SPR 327 WHT
3W,NEMA-1R ' _ 327.OW(STC)-301.4W(PTC)
\ F 3#6 AWG 1 O ONO N-2/THHN
1#8 AWG
M�+———— I 2I SIZE 9.64
10.46 kw(STC)
3/4'PVC C.
I 9.64 kW(PTC)
w L——J — I I (I 41.60A x 1.25 52.00A) Dole DeecripBen
OTO
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LOAD I PROJECT NO: MAD2 14-0020
DRAWN BY: OR
TO DNSCONNEPV CT�6QA-60F REVIEWED BY: JB
I- -1 LOAD NEMA-3R DATE: FEBRUARY 14 2D14
20A-2P SHEET NAME
O PER NEC ARTICLE 690.54: AT THE POINT OF INTERCONNECTION WITH THE I I 60A SINGLE-LINE DIAGRAM
UTILITY SOURCE THE CONTRACTOR SHALL PROVIDE MARKING AT AN ACCESSIBLE L
LOCATION AT THE DISCONNECTING MEANS AS A POWER SOURCE WITH THE 7 (-
MAXIMUM AC OUTPUT OPERATING CURRENT AND THE OPERATING AC VOLTAGE. L
O2 TAP LENGTH TO COMPLY WITH NEC 240.218
SHEEP N0:
SINGLE-LINE DIAGRAM NOT TO SCALE 1 E2
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REVOLU 4. N
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25 B Street
Burlington,MA 01803
Phone:781.270-6555
$,. _ � g . �• :,� � Fax'781.281 6166
w—molusun.com/MA
N PHOTOVOLTAIC MODULES
( > I� ..
FLUSH MOUNTED, TYP.
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MI �t �� fir: r �� ,�;, s� �f :� ��i`
I� #2A2 81 i$ 2 X18'I H3 4 X9:89 1138 187
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PROJECT:
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GING&JOYCE KO
S - 3 166 SUTTON HILL ROAD
NORTH ANDOVER,MA 01845
PROJECT SPECIFICATIONS:
�� �'4c'•••� d & �- s INVERTERS 1—SPR 4000
2A 3 2A 48 9 28 �, 2 28
—SPR 6000
MONITORING INCLUDED
-w
MODULES 32-SPR 327 WHT
327.0w(STC)-301.4w(PTC)
IAlI t tips SYSTEM 10.46 kw(STC)
g� �, SIVE 9.64 kW(PTC)
� � '" _ ���$, Dere CaeerlP6ee
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I A t > 7 � 6 PROJECT NO: MA02 14-0020
a�
DATE:
Ery: GR
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EBY: JB
OAiE: FEBRUARY 12.2014
SHEET NAME:
STRING LAYOUT PLAN
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STRING LAYOUT PLAN SCALE: 3/8" = 1--0°
REVOLUSUN
25 B Street
Budington,MA 01803
4'-0" Phone:781.270-6555
(N) CONDUIT RUN Fax:781.281-6166
FROM PV MODULES www.molusun.com/WA
INVERTER #2
O (E) MAIN LOAD (N) CONDUIT RUN
CENTER FROM PV MODULES
INVERTER #1 (N) CONDUIT RUN
8" FROM AC DISCONNECT (N) CONDUIT RUN
MIN. TO UTILITY METER
(E) UTILITY METER
1 G (N) PV SYSTEM
.n H AC DISCONNECT
O J
A A
O t
E D o
O OC (N) CONDUIT RUN PROJECT:
TO OUTPUT PANEL
BING&JOYCE KO
48 168 SUTTON H
4 4 ILL ROAD
o NORTH ANDOVER,MA 01845
I
(N) LOCUS (N) WIREWAY (N) CONDUIT RUN PROJECT SPECIFICATIONS:
MONITOR FROM AC DISCONNECT
(N) TIGO MMU (N) 3/4" PLYWD. INVERTERS 1—SPR 4000
(N) INVERTER BACKERBOARD i—SPR 6000
OUTPUT PANEL MONITORING INCLUDED
MODULES 32-SPR 327 WNT
327.DW(STC)-301.4W(PTC)
SYSTEM 10.46 kW(STC)
SIZE 8.64 kW(PTD)
INTERIOR ELEVATION AT UTILITY METER. MAIN LOAD CENTER AND ELECTRICAL EQUIPMENT EXTERIOR ELEVATION AT AC DISCONNECT Date DescrIpbon
PROJECT NO MA02 14-0020
O DC DISCONNECT SWITCH: MAXIMUM HEIGHT IS 6'-6". DRAWN BY: GR
REVIEWED BY: JB
DATE: FEBRUARY 12,2D14
SHEET NAME:
ELECTRICAL EQUIPMENT
ELEVATION,AND
LABEL LOCATIONS
SHEET N0:
E4
SCALE: 3/4" 1'-0"
ELECTRICAL EQUIPMENT ELEVATION AND LABEL LOCATIONS =
�1
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4e 4e
REVOLU UN
O INTERACTIVE PHOTOVOLTAIC POWER O PHOTOVOLTAIC DC DISCONNECT
INVERTER#1 25 B Street
X 2 FLOWING THROUGH THIS PANEL Burlington,MA 01803
OPERATING CURRENT 11.96A Phone:781.270-6555
OPERATING VOLTAGE 382.90V Faz:781.281-6166
RATED AC OUTPUT CURRENT 41.60A SHORT CIRCUIT CURRENT 16.1 SA www.—Olusun.com/MA
NOMINAL OPERATION AC VOLTAGE 240V MAXIMUM SYSTEM VOLTAGE 526.99V
O PHOTOVOLTAIC DC DISCONNECT
PHOTOVOLTAIC SYSTEM INVERTER#2
O AC DISCONNECT OPERATING CURRENT 17.94A
OPERATING VOLTAGE 328.20V
SHORT CIRCUIT CURRENT 24.23A
O INVERTER OUTPUT PANEL MAXIMUM SYSTEM VOLTAGE 451.70V
DO NOT ADD LOAD 5-
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O INTERACTIVE PHOTOVOLTAIC POWER \ Oj
RUNNING THROUGH THIS WIREWAY
CAUTION !
O PHOTOVOLTAIC SYSTEM \ PROJECT:
X 2 MONITORING ENCLOSURE POWER TO THIS BUILDING IS ALSO BING&JOYCE KO
SUPPLIED FROM THE FOLLOWING 168 SUTTON NORTH ANDOVVERER,,MMA 01188
A 45
SOURCES WITH DISCONNECT
ONOT USED LOCATED AS SHOWN PROJECT SPECIFICATIONS:
PHOTOVOLTAIC INVERTERS 1—SPR 4000
MODULES 1—SPR 6000
MONITORING INCLUDED
�p MODULES 32—SPR 327 WHT
327.0W(STC)-301.4W(PTC)
SYSTEM 10.46 kW(STC)
G SIZE 9.64 MR(PTC)
Dote Description
(E) UTILITY PROJECT NO: MA02 14-0020
METER DRAWN BY. I CR
PHOTOVOLTAIC SYSTEM REVIEWED BY: JB
AC DISCONNECT DATE I FEBRUARY 12.2014
SHEET NAME:
EMERGENCY CONTACT INFORMATION EQUIPMENT LABELS
NORTHEAST ELECTRICAL
EMERGENCY TEL:781-270-4899
SHEET NO:
EQUIPMENT LABELS I E5
SCALE: FULL SIZE
EAH Structural Co€sultiti€g
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Kendall COUrt
E,edfo dr P9A®r1-730
PHOF,4E 1 978.406 8921
ArEIS€n F EHSt€-uctbral. on-i
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January 13,2014
To: RevoluSun-Northeast Electrical
1 North Ave
Burlington,MA 01803
Subject: Structural Certification for Installation of Solar Panels
Ko Residence
168 Sutton Hill Road
North Andover,MA.01845
To Whom It May Concern,
A design check for the subject residence was done on the existing roofing and framing systems for the installation of
solar panels over the roof. From a field inspection of the property,the existing roof support structures were observed
as follows:
The roof structure of(MP1)consists of composition shingle on roof plywood that is supported by nominal 2x10 rafters
@ 16"o.c.,paired with nominal 2x10 ceiling joists @ 16"o.c..The rafters have a max projected horizontal span of 27-6",
with a slope of 21 degrees.The rafters are connected at the ridge to a continuous 2x12 ridge board and are supported
at the eave by a load bearing wall. There are 2x6 collar ties @ 16"o.c.for structural stability.There are 2x4 diagonal
struts at 16"o.c.to provide additional support to the rafters. The diagonal struts are landing on a load bearing wall.
The struts and the collar ties work together to form a truss system.
The existing roof framing system of(MPI)is judged to be adequate to withstand the loading imposed by the installation
of the solar panels.No reinforcement is necessary.
The spacing of the solar standoffs should be kept at 48"o.c.with a staggered pattern to ensure proper distribution of
loads.
I further certify that all applicable loads required by the codes and design criteria listed below were applied to the
Unirac Sunframe solar rail system and analyzed. Furthermore,the installation crews have been thoroughly trained to
install the solar panels based on the specific roof installation instructions developed by Unirac Sunframe for the racking
system and Quickmount for the roof connections. Finally,I accept the certifications indicated by the solar panel
manufacturer for the ability of the panels to withstand high wind and snow loads.
Design Criteria:
• Applicable Codes=Massachusetts Residential Code,8th Edition,ASCE 7-05,and 2005 NDS
• Roof Dead Load=9 psf(MP1)
• Roof Live Load=20 psf
• Wind Speed=100 mph,Exposure B
• Ground Snow Load=50 psf - Roof Snow Load=35 psf
Please contact me with any further questions or concerns regarding this project.
Sincerely,
E Arn A.
�l I
teg.-
Elaine Huang,P.E. , r tom;
Project Engineer '3ta�
a
Ko Residence, North Andover 1
f�
EAH Structural Cansulbiig
35 Kendall Court
a Bedford, MA 01730
PH01"IE 1-978,406,8921.
:a w, YM�r �€€+ Elam �,,E-AHStrua uralxorn
Gravity Loading
Roof Snow Load Calculations
p9=Ground Snow Load= 50 psf
pf=0.7 CQ Ct l p9 (ASCE7-Eq 7-1)
Ce=Exposure Factor= 1 (ASCE7-Table 7-2)
Ct=Thermal Factor= .1 (ASCE7-Table 7-3)
1=Importance Factor= 1
pf Flat Roof Snow Load= 35.0 psf
ps=CSpf (ASCE7-Eq 7-2)
Cs=Slope Factor= 1
pS=Sloped Roof Snow Load= 35.0 psf
PV Dead Load=3 psf(Per RevoluSun-Northeast Electrical)
Roof Dead Load(MPI)
Composition Shingle 4.00
Roof Plywood _ 2.00
2x10 Rafters @ 16"o.c 2.90
Vaulted Ceiling 0..00 (Ceiling Not Vaulted)
Miscellaneous 0.10
Total Roof DL(MPI) 9.0 psf
DL Adjusted to 21 Degree Slope 9.6 psf
Ko Residence, North Andover 2
1 '
EAH Structural Consulting
35 Kendall +_eu€-t
... Bedford lvi 017,30
PHONE I.S78,406; &921.
CAM t SUi.,-rtNc. Elairc-(=DEAHStructural.com
Wind Calulations
Per ASCE 7-05 Components and Cladding
Input Variables
Wind Speed 100 mph
Exposure Category B
Roof Shape Gable/Hip
Roof Slope 21 degrees
Mean Roof Height 20 ft
Building Least Width 40 ft
Effective Wind Area 17.5 ft
Design Wind Pressure Calculations
Wind Pressure P=qh*(G*Cp)
qh=0.00256*Kz*Kzt*Kd*V112*I (Eq_6-15)
Kz(Exposure Coefficient)= 0.7 (Table 6-3)
Kzt(topographic factor)= 1 (Fig.64)
Kd(Wind Directionality Factor)= 0.85 (Table 64)
V(Design Wind Speed)= 100 mph
I Importance Factor= 1 (Table 6-1)
qh= 15.23
Standoff Uplift Calculations
Zone 1 Zone 2 Zone 3 Positive
GCp= -0.85 -1.45 -2.30 0.40 (Fig.6-11)
Uplift Pressure= -12.95 psf -22.09 psf -35.03 psf 10.0 psf (Minimum)
X Standoff Spacing= 4.00 4.00 4.00
Y Standoff Spacing= 2.75 2.75 2.75
Tributary Area= 11.00 11.00 11.00
Footing Uplift= -142 Ib -243 Ib -385 Ib
Standoff Uplift Check
Maximum Design Uplift= -385 Ib
Standoff Uplift Capacity = 400 Ib
400 Ib capacity>385 Ib demand Therefore,OK
Fastener Capacity Check
Fastener= 1 -5i16"dia Lag
Number of Fasteners= 1
Embedment Depth= 2.5
Pullout Capacity Per Inch= 250 Ib
Fastener Capacity= 625 Ib
w1 F.S.of 1.5= 417 lb
417 Ib capacity>385 Ib demand Therefore,OK
i
Ko Residence, North Andover 3
E.AH Structural consulting
35 Kendall Court
Bedford, MA 01.730
PHONE 1.978,406.8921
CAwrar� cc ream EiineriE;Ht3_rural,crzrn
Framinq Check (MP1)
PASS
w=64 plf
Dead Load 9.6 psf
PV Load 3.0 psf
Snow Load 35.0 psf y 2xi0 Rfi#ets @161 c _
Governing Load Combo=DL+SL Member Span 15'-0"
Total Load 47.6 psf
Member Properties
Member Size S(in^3) I(in^4) Lumber Sp/Gr Member Spacing
2x10 21.39 98.93 SPF#2 @ 16"o.c.
Check Bending Stress
Fb(psi)= fb x Cd x Cf x Cr (NDS Table 4.3.1)
875 x 1.15 x 1.1 x 1.15
Allowed Bending Stress=1272.9 psi
Maximum Moment = (wL^2)18
= 1786.51 ft#
= 21438.1 in#
Actual Bending Stress=(Maximum Moment)/S
=1002.3 psi
Allowed>Actual--78.8%Stressed -- Therefore,OK
Check Deflection
Allowed Deflection(Total Load) = L/180 (E=1400000 psi Per NDS)
= lin
Deflection Criteria Based on = Simple Span
Actual Deflection(Total Load) _ (5*w*L^4)/(384*E*I)
= 0.523 in
= L1345 > U180 Therefore OK
Allowed Deflection(Live Load) = 1-1240
0.75 in
Actual Deflection(Live Load) _ (5*w*L^4)/(384*E*I)
0.385 in
L/468 > L/240 Therefore OK
Check Shear
Member Area= 13.9 in"2 Fv(psi)= 135 psi (NDS Table 4A)
Allowed Shear = Fv*A = 1873 Ib Max Shear(V)=w*L 12 = 4761b
Allowed>Actual--25.5%Stressed - Therefore,OK
I
I
Ko Residence, North Andover 4
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REVOLUCSUN
1.
25 B Stmet
Burlington,MA 01803
Phone:781.270-6555
F—781.281-6166
WwW.revolueun.com/MA
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I (N) TERMINATED
TIGO GATEWAY PROJECT:
(N) JUNCTION BOX
OR LB ON ROOF BING&JOYCE KO
1 168 SUTTON HILL ROAD
Il - NORTH ANDOVER,MA 01845
(N) CONDUIT RUN ,
ON EXTERIOR §
WALL (E) SKYLIGHT, TYP,
PROJECT SPECIFICATIONS:
INVERTERS 1—SPR 4000
1—SPR 6000
mk MODULES 32—SPR32277(N) PHOTOVOLTAIC MODULES MONITORINGINCLUDED
C FLUSH MOUNTED, TYP. S2—SPR WHf
327.OW(STC)-301.4W(PTC)
If SYSTEM 10.46 kW(STC)
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-�'� - SIZE 9.64 kW(PTC)
i f ,�1 Dale D—riplion
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(E) UTILITY METER II
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PROJECT
(N) PV SYSTEM I (E) MAIN LOAD : MA02 14-0020
DRAWN B(: CR
AC DISCONNECT CENTER REVIEWED BY: JB
DATE: FEBRUARY 12,2014
SHEET NAME:
(N) INVERTER PLOT AND
LOCATIONS 2 ROOF LAYOUT PLAN
(E) DRIVEWAY
SHEET N0:
ROOF LAYOUT PLAN SCALE: 1/8" = r-o" E1
I
INVERTER # 2
6000 GRID-TIED R E V O L U(S U N
25 B Street
INVERTER # 1 O Burfington,MA 01803
4000 GRID-TIEDPhone:781.270-6555
MAXIMIZER Fax:781.281-6166
MANAGERMENT UNIT WWW.revolusun.com/MA
TCA INATED O D
GATEWAY DC AC DC AC
Itd OUT IN OUT (N)INVERTER OUTPUT
PANELBOARD
125A 120/24OV, 10,3W
PV SOURCE PV SDURCE CFs NEMA-1R
JUNCTION BOX DC DISCONNECT DC DISCONNECT
SYSTEM(j 1 ON ROOF
14 MODULES
2 STRINGS OF 7
® I 20A-2P
30A-2P
® / (5)2#12 AWG USE-2/RHW-2, I —40A-2P
— —
118AWG GND ----
-- — ------------ — — GND
SYSTEM#2 1 EMT C.(INTERIOR)
18 MODULES 1'PVC C.(EXTERIOR) RS-485 CABLE
3 STRINGS OF 6 1/2-EMT C.
® ® j 1/2 EMT 7RS-485 C.C� I= 16.6 x 1.25=20.8 A 13#12 AWG G12 AWG ND—2/THH
V-240V 3/4-PJC C.
I-25.0 x 1.25-31.3 A PROJECT:
V-240V 3#10 AWG THWN-2/THHN, BING 8 JOYCE KO
3/10 AWG 3j8 AWG THWN-2/THHN,//® 168 SUTTON HILL ROAD j THWN-2 r.C 3/ AEC GND 1/2-EMT.C 3/4'EMT C.(INTERIOR) NORTH ANDOVER,MA 01845
3/4-PVC C.(EXTERIOR)
I =Isc(6.46)x 1.56 = 10.08ATO E
Vmaz= (Voc(64.90)z 7)x 1.16 ETHERNET PROJECT SPECIFICATIONS:
=526.99 VDC
I
I=Isc(6.46)z 1.56 = 10.084 INVERTERS 1—SPR 4000
Vmaz= (Voc(64.90)z 6)x 1.16
451.70 VDC 5Y 1—SPR 6000
x Rig (E)MAINLOAD CENTER 2/12 AWG THWN-2/1HHN, MONITORING INCLUDED
�r —1 2DOA, 120/240V, 10, 1/2-PVC C. I MODULES 32—SPR 327 WHT
3W,NEMA-1R 3�6 AWG THWN-2/THHN, 327.0W(STC)-301.4W(PTC)
—
118 AWG GND SYSTEM 10.46 kW(STC)
GND — 3/4-PVC C. SIZE 9.64 kW(PTC)
L I (1=41.60A x 1.25=52.00A) Dote Da ipti
I LOAD I I PROJECT W. MA02 14-0020
DRAWN BY: GR
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NSPV ECT�
TO 6OA-60F I REVIEWED BY: JB
r LOAD NEMA-3R DATE FEBRUARY 12,2014
20A-2P SHEET NAME:
60A SINGLE-LINE DIAGRAM
Oi PER NEC ARTICLE 690.54:AT THE POINT OF INTERCONNECTION WITH THE I
UTILITY SOURCE THE CONTRACTOR SHALL PROVIDE MARKING AT AN ACCESSIBLE L — L_——————— — — —.._ __——J
LOCATION AT THE DISCONNECTING MEANS AS A POWER SOURCE WITH THE 7 F
MAXIMUM AC OUTPUT OPERATING CURRENT AND THE OPERATING AC VOLTAGE. L
O TAP LENGTH TO COMPLY WITH NEC 240.218 SHEET NO:
SINGLE-LINE DIAGRAM1 E2
NOT TO SCALE
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REVOLUUN
25 8 Street
Burlington,MA 01803
Phone:781.270-6555
Fax:781.281-6166
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168 SUTTON HILL ROAD
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MODULES 32-SPR 327 WMi
327.0W(S1C)-301.4W(PTC)
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>i3 ,. ) 6 Y $ 8.64 IZE kW(PTC)
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PROJECT No: uADz a—oD2o
DRAWN GR
. REVIEWED BY: JB
a ` DATE: FEBRIIARi 12�2014
SHEET NAME:
I i STRING LAYOUT PLAN
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STRING LAYOUT PLAN SCALE: 3/8" = 11-0-
REVOLU Uri
25 B Street
Burlington,MA 01803
4'-0" Phone:781.270-6555
(N) CONDUIT RUN Fox:781.281-6166
FROM PV MODULES www.r lusun.com/MA
INVERTER #2
(E) MAIN LOAD
CENTER (N) CONDUIT RUN
FROM PV MODULES
INVERTER #1 (N) CONDUIT RUN
0 8" FROM AC DISCONNECT (N) CONDUIT RUN
MIN. TO UTILITY METER
(E) UTILITY METER
c 1 G (N) PV SYSTEM
uO O O AC DISCONNECT
E� CJ
O A OO B
E O o
O C (N) CONDUIT RUN
PROJECT:
TO OUTPUT PANEL
GING 8 JOYCE KO
4X4X48 168 SUTTON HILL ROAD
NORTH ANDOVER,NIA 01845
(N) LOCUS (N) CONDUIT RUN
N
MONITOR ( ) WIREWAY FROM AC DISCONNECT PROJECT SPECIFICATIONS:
(N) TIGO MMU (N) 3/4" PLYWD.
INVERTERS 1—SPR 4000
(N) INVERTER BACKERBOARD 1—SPR 6000
OUTPUT PANEL MONITORING INCLUDED
MODULES 32-SPR 327 WHT
327.0W(STC)-301.4W(PTC)
SYSTEM 10.46 kW(STC)
S1ZE 8.64 kW(PTC)
INTERIOR ELEVATION AT UTILITY METER, MAIN LOAD CENTER AND ELECTRICAL EQUIPMENT EXTERIOR ELEVATION AT AC DISCONNECT DO, D—dplion
PROJECT NO: W2 14-0020
(DDC DISCONNECT SWITCH: MAXIMUM HEIGHT IS 6'-6". DRAWN BY: CR
REVIEWED BY: J8
DATE FEBRUARY 12,2014
SHEET NAME:
ELECTRICAL EQUIPMENT
ELEVATION,AND
LABEL LOCATIONS
SHEET NO:
ELECTRICAL EQUIPMENT ELEVATION AND LABEL LOCATIONS 1 Ea
SCALE: 3/4" = 1�-0"
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� REVOLU SUN
PHOTOVOLTAIC DC DISCONNECT
O INTERACTIVE PHOTOVOLTAIC POWER O INVERTER#1 25 B Street
X 2 FLOWING THROUGH THIS PANEL a Burlington,MA 01803
OPERATING CURRENT 11.96A Phone:781.270-6555
OPERATING VOLTAGE 382.90V F—781.281-6166
RATED AC OUTPUT CURRENT 41.60A SHORT CIRCUIT CURRENT 16.15A www.revolusun oom/MA
NOMINAL OPERATION AC VOLTAGE 240V MAXIMUM SYSTEM VOLTAGE 526.99V
O PHOTOVOLTAIC DC DISCONNECT
OPHOTOVOLTAIC SYSTEM INVERTER#2
6 AC DISCONNECT OPERATING CURRENT 17.94A
OPERATING VOLTAGE 328.20V
SHORT CIRCUIT CURRENT 24.23A
INVERTER OUTPUT PANEL MAXIMUM SYSTEM VOLTAGE 451.70V
O DO NOT ADD LOAD 5"
O INTERACTIVE PHOTOVOLTAIC POWER \ Oj
RUNNING THROUGH THIS WIREWAY CAUTION !
PHOTOVOLTAIC SYSTEM \ PROJECT:
O
X 2 MONITORING ENCLOSURE POWER TO THIS BUILDING IS ALSO BIN08JOYCE KO
168 SU77ON HILL
SUPPLIED FROM THE FOLLOWING NORTH ANDOVER,MA0AD 01845
SOURCES WITH DISCONNECT
ONOT USED LOCATED AS SHOWN PROJECT SPECIFICAT ONS:
PHOTOVOLTAIC INVERTERS 1—SPR 4000
MODULES 1—SPR 6000
MONITORING INCLUDED
MODULES 32—SPR 327 WHT
327.0W(STC)-301.4W(PTC)
SYSTEM 10.48 kW(STC)
G SIZE 9.64 kW(PTC)
Dale Deeeription
(E) UTILITY PROJECT NO MAO 14-0020
METER
DRAWN BY: CR
PHOTOVOLTAIC SYSTEM RVAEM BY: J8
AC DISCONNECT DATE: FTMRUAM 12.2014
SHEET NAME:
EMERGENCY CONTACT INFORMATION EQUIPMENT LABELS
NORTHEAST ELECTRICAL
EMERGENCY TEL:781-270-4899
SHEET NO:
EQUIPMENT LABELSE5
SCALE: FULL SIZE
The Commonwealth of Massachusetts Print Form
Department of Industrial Accidents
Office of Investigations
1 Congress Street, Suite 100
Boston, MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
Northeast Electrical
Address: 1 North Ave Suite A
City/State/Zip:Burlington/MA/01803 Phone#:781 - 270 -4899
Are you an employer?Check the appropriate box: Type of project(required):
1.❑✓ I am a employer with 12 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers'
[No workers' comp.insurance comp. insurance. 9. ❑ Building addition
required.] 5. ❑ 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
y [ t p c. 152 1(4),and we have no 12.E] Roof repairs
insurance required.] ' § 13.F/1 OtherSolar PV
employees. [No workers
comp.insurance required.]
*Any applicant that checks box 41 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.
lContractors 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: Federated Mutual Insurance Company
Policy#or Self-ins.Lic.#:9884086 Expiration Date: 12/31/2014
Job Site Address: 168 Sutton Hill Rd City/State/Zip:N Andover/MA/01845
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 ce!tifv uRder the ains andpenalties*e that thein ormation provided above is true and correct.
Si ature: _. _._... Date. _ i / y
Phone#:781- 70-4899
Official use only. Do not write in this area,to be completed by city or town officiaL
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
1 Congress. Street, Suite 100
Boston, MA 02114-2017
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 7-2010
www.mass.gov/dia
i
'4 CERTIFICATE OF LIABILITY INSURANCE DATE1 '
01!062014
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 0011(lholder Is an ADDITIONAL INISURED,1he.PMlcy(ies)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms
and conditions of the peficy,certain Policies may/require an endorsement.A statement on this certificate does not confer rights to the certificate holder
in lieu of such endors s.
PRODUCER CONTACT
FEDERATED MUTUAL INSURANCE COMPANY JAMEPNONE
HOME OFFICE: P.Q.BOX 328 JAIC No Ext):88833.4949 No):507-446-4664
OWATONNA,MN 55060 E-MAIL
DO
E R F DINS.COM
INSURERS AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 297.673-6 INSURER B:
NORTHEAST ELECTRICAL INC INSURER C:
1 NORTH AVE
BURLINGTON,MA 01803 INSURER D.
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:5 REVISION NUMBER:0
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 SEEN REDUCED BY PAID CLAIMS.
INS RDL UBR POLICY EFF POLICY EXP
LTRTYPE OF INSURANCE INSR WVD POLICY MMIDD MM LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITYV.
DAME T RENTED $100,000
CLAIMS-MADE a OCCUR MED EXP(Any One person)
A N N 9884064 12/31/2013 12/31/2014 PERSONAL ADV INJURY $1,000,000
GENERAL AGGREGATE $2.00D.000
GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $2,000,000
X POLICY hCTT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Me Red
ANY AUTO BODILY INJURY OW person)
ALLOWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accideni)
HIRED AUTOS AUTPROPERTY E
X UMBRELLA LIABX OCCUR EACH OCCURRENCE $5,000,000
A MCCESS LIAa CLAIMS-MADE N N 98840ST 12/31/2013 12/31/2014 AGGREGATE $5,000,000
DED I RETENTION
WORKERS COMPENSATION INC STATU• OTH
AND EMPLOYERS'LIABILITY X TORY LIMITS ETt
ANY PROPRIETORIPARTNEItIEXECUTIVE � ILL EACH ACCIDENT
A OFMMEMBER EXCLUDED! 06 $500,000
12131/2013 12131/2014
(Mandatory In NH) E.L.DISEASE•EA EMPLOYEE MOOD
N yes,describe under
DESCRIPTION OF OPERATIONS below LL DISEASE•POLICY LIMIT $555.000
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(AUadf ACORD 101,Addidmnl Remarks Sdre*de,N tno:s spew k Ieeiuke�
CERTIFICATE HOLDER CANCELLATION
50
�OVVn of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988,2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston, Massachpsetts 02116
Home Improvement !4or Registration
X Registration: 174120
Type: Corporation
Expiratidn: 12/27/2014 Tr# 234344
NORTHEAST ELECTRICAL INC.
MATTHEW POWERS
25BST
BURLINGTON, MA 01803
Update Address and return card.Mark reason.for change.
SCA 7 Co 20M-05/11 Address 7 Renewal E] Employment Lost Card
Unrestricted-Buildings of any use group which
Massachusetts -Depart;-gent of Public Safety
s . Board of Building Regulations and Standardscontain less than 35,000 cubic feet(991m )of Conxtructian Super
enclosed space. License: C"78379
JOHN D BRIGGS x
66 CLIFTON AVE
Saugus MA 01901
Failure to possess a current edition of the Massachusetts t,
State Building Code is cause for revocation of this license. Expiration
For DPS Licensing information visit: www.Mass.Gov/DPS commissioner 02/06/2015
EVOLV .
THIS HOME IMPROVEMENT SOLAR ENERGY CONTRACT(this"Contract")IS BETWEEN:Bing and Joyce Ko("Client")located at 168 Sutton Hill Road
North Andover,MA 01845("Client's Property")
-AND-
Northeast Solar Services,Inc.@("Contractor")of 25 B Street Burlington,MA 01803,with Home Improvement Contractor Reg.No.174120,which expires on
May 30,2014,and Federal Employer ID 46 0569853.Contractor's sales person for this contract is Andrea DeGiovanni.
The parties to this Agreement agree as follows:
I.SCOPE OF WORK
A.Installation of PV System.The above Client(s)has engaged Contractor to perform the following residential contracting work(the"Work")in connection
with the installation of the following photovoltaic solar energy system(the"PV System"):
28 SunPower-SPR-327X BLK watt modules(or equivalent) with 2 Sunpower-SPR 4000 inverters(or equivalent)and all mounting,disconnects,and
all other PV System components necessary for a National Electric Code compliant PV System,totaling 9.156kW,located at Client's Property.
B.Other Inclusions The Work shall further include:
•Installation of the PV System in accordance with all State of Massachusetts interconnection standards.
•All reasonable engineering and permitting costs.
•The following building permits are required and will be secured by Contractor as Client's agent:Building and Electrical Permit.
•Following the installation,Client will receive a PV System orientation and a PV System Client's manual.
Notice: It shall be the obligation of the Contractor to obtain all permits related to the Work. Clients who secure their own permits will be excluded from
the guaranty fund provisions of Chapter 142A of the Massachusetts General Laws.
It.COMPENSATION AND SCHEDULE
A.Contract Price For Contractor's performance of the Work under this Contract,Client will pay Contractor a total of:
$52,629.27(FIFTY TWO THOUSAND SIX HUNDRED TWENTY NINE AND 27/100)DOLLARS USD(the"Contract Price").
B.Payment Schedule The Contract Price will be payable in accordance with the following payment schedule:
Date Paid:
8 26 314.63 Initial Payment-50% (Due upon Contract signing,which is an amount less than the cost of the materials and equipment
which must be specially ordered in advance of commencement of PV System installation)
$23 683.17 Progress Payment-45% (Due upon Substantial Completion)
12,631.47 Final Payment-5% (Due upon Final Completion)
C.Schedule The"Start Date"of this Contract is the date Contractor receives the full amount of Client's initial payment of 50%of the Contract Price.
Subject to adjustment for any Force Majeure reason stated in Section IV.J.,the Work is estimated to begin within 12-16 weeks from the Start Date of this
Contract.The parties agree that this date shall be automatically extended to the date of delivery of all materials and equipment which mut be specially
ordered.
Substantia!Completion is estimated to occur within 16-20 weeks from the Start Date of this Contract,but the parties agree that this date shall be
automatically .
shortened or extended to the date on which all racking and electrical work are complete and the PV System is
capable of
p generating ower and read and available for 9 9 p y o use subject to final government and utility approval.
Final Com tp etion is defined as the date on which all punch list items are complete,all permits are closed,all other government and utility
approvals are obtained and the Work is complete to the satisfaction of Contractor and Client.
Client acknowledges and agrees that the Work involves permits,inspections and approvals from various government agencies and utilities,and
therefore the timing of the Work may vary and is not within Contractor's control. Client further agrees that Contractor shall not be liable for any losses,
costs or damages related to any delays for reasons beyond Contractor's control,including all causes noted in the Force Majeure section of this
Contract below.
1 Northeast Solar
25 B Street
Burlington,N+A 01603
0'r evo i u S u n"C or„ 781.270.4699
I
R EVO LU .
W.IMPORTANT NOTICES
A.Contractor's Registration: All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically
exempt from registration by provisions of Chapter 142A of the Massachusetts General Laws,must be registered with the Commonwealth of
Massachusetts. Inquiries about registration and status should be made to the Director of the following state agency:
Office of Consumer Affairs and Business Regulation
Home Improvement Contractor Registration
Ten Park Plaza,Room 5170
Boston,MA 02116
(617)973-8700
B.Client's Cancellation Rights: Client may cancel this Contract,without penalty or obligation,within three business days following the date on which
Client signs this Contract. A Notice of Cancellation is attached hereto for Client's convenience.
C.Warranties:For a period of five(5)years from Substantial Completion,Contractor warrants that the PV System has been designed and installed in a
good,workmanlike and substantial manner in accordance with all applicable building codes.
In the event Contractor is required to penetrate the roof of the Client's property in the course of installation,and causes damage to the roof within a three
(3)radius of a penetration,Contractor will repair such roof damage for a period of five(5)years from Substantial Completion or the remaining term of the
roofs existing installation warranty,whichever is shorter,to prevent any water,rain or other moisture leak,seepage or entry directly caused by such
penetration.These warranties are for normal use and conditions only.All warranty coverage to equipment and workmanship installed by Contractor will be
VOID if any alterations or repairs are performed by any person or persons not expressly authorized,in writing,by Contractor.\(PHIS WARRANTY DOES
NOT COVER:(a)Damage caused by external forces such as,but not limited to,vandalism,theft,terrorism,fire or act of God;(b)Damage caused by
weather effects exceeding manufacturer tolerances;(c)Normal wear and tear or aging of a PV System;(d)Any implied warranties:(e)Electric bills,water
damages or any other consequential damages;or(f)Damage to the PV System or its efficiency due to adjustment,moving,or tampering with the PV
System or any of its components by individuals not approved by Contractor.
D.Change Orders: Any alteration or deviation from above specifications involving extra costs must be subject to a written change order signed by both
parties,which shall be incorporated into this Contract,and Client shall be liable for any additional costs resulting from each change order. By initialing the
space below,Client hereby specifically agrees to execute a change order,and pay the additional costs,if it becomes necessary for Contractor to repair or
replace un-approved or non-code compliant electrical work in order to complete the PV System installation and satisfy code requirements.
Client's Initials: �J
Client's Initials:
ARBITRATION: CONTRACTOR AND CLIENT HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT CONTRACTOR HAS A DISPUTE
CONCERNING THIS CONTRACT,THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN
APPROVED BY THE DIRECTOR OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS ANDC L
IENT SHALL BE
RE
QUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L.c. 142A.
Client: Date:
Client: Date:
Contractor: Date:
NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by Contractor. Client may
initiate alternate dispute resolution even where this section is not separately signed by the parties.
E.Incentive Guarantee: By Client's initials below,Client acknowledges and agrees that Contractor has not and does not guarantee Client's qualification
for,receipt of or amount of any tax credit,rebate,solar renewable energy credit(SREC)or other incentive amount in connection with the PV System,and
any estimates of incentives(wither in a PV System proposal or otherwise)are not guaranteed to be accurate or available. Client is responsible for
determining Client's and/or the PV System's eligibility for any incentives and should consult with tax,legal and other advisors regarding availability and
possible tax consequences of claiming the same.
Client's Initials: f
Client's Initials:
2 Northeast Solar
25 B Street
Burlington,MA 01803
OrR I U"Su I l.C 011"l 781.270.98999
v
i E V OLV C -
IV.OTHER TERMS AND CONDITIONS
A.Access: To enable Contractor to perform its Work hereunder,Client shall grant during daylight hours adequate space on Client's property,as mutually
designated by Contractor and Client,for the complete and proper installation,operation,maintenance and repair of the PV System as well as rights of
ingress and egress to,through and from such property and the space designated for the PV System.
B.Scarcily of Materials Rights of Termination: The PV System components to be obtained under this Contract are scarce commodities.In order to meet
the performance requirements of the PV System described in this Contract,Contractor may substitute the specified brand of solar module or inverter for a
similar brand of module or inverter that allows for more timely completion of the installation. Such substitution,if necessary,shall be of UL approved
devices,with aggregate performance criteria the same as equipment specified. The governing body for determining performance criteria shall be the CEC
(California Energy Commission)that rates all UL approved modules. The key module statistic used for performance criteria will be the DC STC rating of
the sum of the modules. The key inverter statistic used for performance criteria will be the AC output of the device.
If,due to code requirements,equipment substitution,final engineering,space availability,etc.,the size of a PV System decreases,Contractor shall re-
calculate the Contract Price using its standard pricing method and the Contract Price shall be automatically reduced.Client shall be credited by the
reduced amount. If due to substitution the DC STC size of the PV System increases slightly,then Client shall not have to pay Contractor similarly.
Contractor shall make every reasonable effort to ensure that PV System size does not decrease from the specifications. If the DC STC size of the PV
System decreases more than 15%from the Contract's specification amount for any of the reasons stated in this paragraph,Client shall have the right to
terminate this Contract within ten(10)days of Contractor's written notification to Client of such decrease,and Contractor shall then refund in full all funds
paid to date under this Contract,but shall have no other liability to Client.
Contractor reserves the right to unilaterally terminate this Contract within 45 days of its approval without any liability to Client if any of the PV System
components required for the completion of Contractor's Work in a timely manner are not available. In the event of such termination,Contractor shall
refund all monies paid by Client to Contractor as of the date of termination.
C.Limitation of Liability:In no event shall Contractor be liable in an amount exceeding the compensation paid by Client to Contractor under this Contract.
Contractor shall not be liable for any incidental,consequential or ectal damages q p g s or for economic toss or expense of for loss or profits or income of
Client,or Client's consultants or agents or employees,or any of them,including but not limited to any electricity costs incurred should installation of the PV
System be delayed beyond the commencement or completion schedule set forth above.
D.Zoning:Client shall pay for all variances,special permits,or other costs related to zoning,including without limitation any fees or costs related to
attorneys or engineers.
E.Client's Property:Client agrees to remove or to protect any of Client's personal property,inside or out,which may interfere with or obstruct the Work,
including but not limited to landscaping,and Contractor shall not be held responsible for damage to such property. Client understands and acknowledges
that proper operation of the PV System purchased hereunder is dependent on Client's existing roof and equipment and Contractor shall have no obligation
or liability for the condition thereof,or any other part of Client's improvements or equipment not purchased hereunder. Client expressly represents that the
roof of the property upon which the PV System will be installed is in good condition,with no known water infiltration problems or other structural defects.
F.Insurance:Client must carry all fire,casualty,hurricane,earthquake,theft,and other insurance related to Client's real and personal property.
G.Cancellation of Contract: If Client cancels or breaches this Contract after the opportunity to execute three(3)day rescission has passed but before
commencement of construction,Client shall pay Contractor the amount of expenses incurred to that date plus 20%of the Contract Price. if Client fails to
pay said amounts within thirty(30)days of Contractor's demand for payment and Contractor files suit,Contractor shall be entitled to recover all of its
damages including its loss of net profits and attorneys'fees and costs if Contractor is the prevailing party.
H.Costs of Collection: If Client fails to pay any amounts owed to Contractor when due,Client shall be liable for all costs of collection,including
reasonable attorneys'fees,plus 18%interest per annum on the unpaid balance. Contractor also shall have option of removing all or part of the PV
System from Client's premises in addition to receiving payment equal to the value of the unpaid balance to cover all or a portion of Contractor's
consequential damages.
1.Liens:Contractor,any subcontractor(s)and any other persons or entities supplying labor and materials to Client under this Contract,have the right
under applicable law to impose a lien on Client's real property for the value of the labor or materials provided. Upon Client's payment of all amounts due
under this Contract,Contractor will provide,upon Client's request,a release and waiver of any liens.
J.Force Majeure:Contractor shall not be liable for any delay in material and/or equipment delivery or for failure to deliver or failure to perform the Work
which results from any cause beyond the Contractor's control. Such causes include but shall not be limited to:an act of God or of h
.. the public enemy;
. p y,an
act(or failure to act)of any government or utility,a fire,flood or epidemic;quarantine,restriction,strike,freight embargo,terrorism,theft or unusually
severe weather;Contractors inability to obtain necessary materials,labor or transportation;custom permitting caused by Client's site conditions;
homeowner association review or approval;building or other code requirements relating to Client's existing electrical system or building characteristics;
and any other impediments to the installation of the PV System arising from Client's acts or omissions and/or the condition of Client's property.
3 Northeast Solar
25 13 Street
Burlington,MA 01803
OvRevnoluSun,corn 781.270.4899
;., T21-
REVOLU.
K. Legal ompliance and Severability.:Contractor and Client acknowledge that the form,substance,content and notices contained in this Contract are
intended to comply with Chapter 142A of the Massachusetts General Laws,and regulations promulgated thereunder. In the event of any instance of non-
compliance,only such portion shall be invalid and the remainder of this Contract shall be in full force and effect. in addition,any such portion not in
compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and applicable regulations.
L.Entire Contract No Waiver Unless In Writing:This Contract constitutes the entire contract between the parties;there is no representation,warranty,
collateral contract or condition affecting this Contract except as expressed in it. No provisions of this Contract shall be changed or modified,nor shall this
Contract be discharged or waived,in whole or part,except in writing signed by both parties.This Contract shall not be effective until fully executed by
Client and an Authorized Representative of Contractor.
M. li of Representation of Authority:If this Contract is signed by less than all of the persons or entities who own the subject property,then Client who
signs this Contract(or any of the provisions hereof)i represents to Contractor that he,she or it has full legal authority to bind the other persons and/or
entities.
N.Governing Law:The laws of the Commonwealth of Massachusetts shall govern any proceeding or disp rela d to this ntract.
Client: ( Contractor:
-Elfmg-SM 40yee-Ka .1 o Y(IC t-i a Name:
Date: C - - o 2-0/3 Title:
Date: 2
4 Northeast Solar
25 8 Street
Burlington,MA 01803
Revo l U S u Il.ccorn 781.270A899
REVOLU(iUN,
NOTICE OF CANCELLATION
If you decide that you do not want the goods or services described above,you may cancel this Contract by mailing or delivering a signed and dated copy
of the cancellation notice,or any other similar written notice,to Contractor at the address set forth above no later than midnight of the third business day
following the date on which you signed this Contract.
If you cancel by the date and time indicated,any payment made by you under this Contract will be returned within ten(10)business days following
receipt of your cancellation by Contractor,and any security interest arising out of the transaction will be released.
If you cancel,you must make available to Contractor,at your residence,in substantially as good condition as when you received,any goods delivered to
you under this Contract;or you may,if you wish,comply with Contractor's written instructions regarding the return shipment of the goods at Contractor's
risk and expense. If you fail to make the goods available to Contractor,or if you agree to return the goods to Contractor and fail to do so,then you remain
liable for performance of all obligations under this Contract.
If we do not pick up,or attempt to pick up,the goods within 20 days of the date of your notice of cancellation,you may retain or dispose of them without
further obligation.
I HEREBY CANCEL THIS TRANSACTION:
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Client's Signature(sign here mly if you wish to Date
cancel this transaction)
Client's bignature sign here D111y i you wish to Date
cancel this transaction)
i
CLIENT ACKNOWLEDGES RECEIPT QF
ORiGyNAL OF THIS CANCELLATION FQ�tIUI f
a#
Slgnaturg
pate 1
_
? 1
Signature pate }}{
1
(Client Initials):
5 Northeast Solar
25 13 Strcet
Burlington,MA 01803
781.270.4893
` Location G
No. Date 03
HORTN TOWN OF NORTH ANDOVER
� A
Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 17
657
Building Inspec
L
J
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
7777777
M IS °f(1,CA i
y
BUILDING PERMIT NUMBER:' _? DATE ISSUED:
v
SIGNATURE-
Building Commissioner/Inspector of Buildings Date _d_3 Z
SECTION 1-SITE INFORMATION . s• O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
SIU 06U , U �
A))i/yZ� !� �, ✓ , Map Number Parceum
l
1.3 Zoning Information:(�, 1.4 Property Dimensions:
Zoning Diaiic_t Proposed Use Lot Area sf) Frontage ft
1.6 BUILDING SETBACKS ft
. Front Yard Side Yard Rear Yard
Required Provide Required Provided Required Provided
v
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ -Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn
2.1 Owner of Record 1�
alf
N�rd( (Pn;}it) Address for Service
l?� G 0e,0
Signature Telephone
2;2 Owner of Record:
O
Name Print Address for Service: Z
M
Signature Telephone
90
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
—1 Duval Roofing
Licensed Construction Supervisor: P.O. 37
NOfth Reading,MA � License Number / Mn
Address 018f 4 /�/ D
`J Expiration Date <
SiKature Telephone r
3.2 Registered Home Improvement Contractor Not Applicable ❑ v
Duval Roofing
Company Name P.O.Box 637 10) 2 C2 4R Ell— RI
North Readh,,� mA Registration Number r
Address •` 64 r
7 !o a2SrS Expiration Date n�
nature Telephone Y,
SECTION 4-WORKERS COMPENSATION(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 buildiApermit.
Signed affidavit Attached Yes....... No.......❑
SECTION 5 Descri tion of Proposed Work check auapplicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify �.
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be OFFICIAL ONLY
Completed
Com leted b ermit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee(e)X(b)
4 Mechanical HVAC `
5 Fire Protection
6 Total 1+2+3+4+5 a Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, ,as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf irL all matters relati°eo work authorized b his b g permit application. -
���
Signature of O er Date `
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
V '�-d&--Q
Print Name
:::�� & Z -7
S ignaturofof Owner/A ent Date
w`
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS I ST 2ND 3RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
IIEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
a
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be disposed of in properly
licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A.
The debris will be disposed of in:
(Location of Facility)
Signature of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for this project
through the Office of the Building Inspector
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 1'09288
Expiration 4/9[:2004.
•Type... DBA
DUVAL ROOFING
Kenneth Duval
PO BOX 190/72 NORTH-ST
N.READING,MA 01864 Administrator
i ✓/ze r�anvr�zaizulea� a��actzcraeCt
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR d
Nurnber: CS., 058443 ;
w; Birthdate: 12/14/1966
Expires: 12/10/2003 Tr.no: 9505 I
Restncted: 00
KENNETH P DUVAL _
PO BOX 190/72 NORl H;ST
N READING, MA 01864'
Administrator
e - _
l "
Town of over
0
No.
7
t-o,': Mp
43
c
0 over, Mass...
"?ATED
H BOARD OF HEALTH
Food/Kitchen
PERMIT T Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT............ ........... ................... ............ Foundation
L
has permission to erect...................... ................. buildings a . . . .............. . . ...... Rough
n ..14.. .... . .............. ... ......
tobe occupied a ....................:... .....W................................................................................................................................... Chimney
P that the arson accepti tihis permit shall in every respect conform to the terms of the application on file in Final
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
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
000 Rough
....................................................................Vow......................................... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
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..
SEE REVERSE SIDE Smoke Det.