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HomeMy WebLinkAboutBuilding Permit #802-16 - 19 WOODLEA ROAD 1/12/2016TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this pAge LOC�ATON t l9 Woodlea Circle ooe.) TYyOWNER Amir Satam �. MAPyNO:: w��. _ PARCE ®ISTRICT' yes n0 - yesn ono:: TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building E One family ❑ Addition ❑ Two or more family 0 Industrial 0 Alteration No. of units: 0 Assessory Bldg p Commercial 0 Repair, replacement ❑ Others: ❑ Demolition 0 Other _ O Septic ®Well ;. O'Floodplaiii MWetlands: 0 Vv to etl�Di"strict DESCRIPTION OF WORK TO Se PERFORMED: Installation of an 11.445 kw (35 panels) rooftop solar array i - Identification Please Type or Print Clearly) OWNER: Name: Amir Satarri Phone: 508-423-0911 a Address: 19 Woodlea Circle .(CON.. �RACTOR ;.Name: Romain Strecker Phone 781�462.87.Q2 = , Y _ - _ _ ¢'Address4 55 Sixth"Road Woburn MA_ 01801 10/8/2016'' . SupervisorsConstruction,License;�_096385. _ __. Expo Date _ k Home, Irnprovemgriflt cense _ _169698 .Exp rDate g KZL2712o17_ _ y ARCHITECT/ENGINEER Roger T Alworth Phone: Address: 9138 S Street, Sandy UT Reg. NO. 47740 FEE SCHEDULE: BULDING PERMIT: $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. �f Total Project Cost: $ 50,743 FEE: Check No.: Receipt No.:� NOTE:. Persons contracting with unregistered contractors do not have access to th guarantyfund Signatureof Agent/Owner see signed contract Signature of :contractor Plans Submitted'[] Plans UVaived ❑ Certified Plot Plan ❑ Stamped Plans :TYPE OFSEWERAGEDISPOSAL- - Public Sewer Tanning/Massage/BodyArt ❑ . Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc.. ❑ ... ..Permanent Dumpster on'Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: DATE..APPROVED PLANNING & DEVELOPMENT` ❑ COMMENTS COft1SERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation. Decision: Comments Water & Sewer ConnectiOn/Signature & Date Driveway Permit DPW Tow;! Engineer: Signature: FIRE ttPAATMr=NT-Terhp 'Du- mj Located'at 124 Mair. Street Fire Depa iiieritsignature/date` COMMENTS r on site yes.. no —, , -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.$100-$l000.fine NOTES and DATA — (For department use Doe.Building Permit. Revised 2010 Building Department , ° The fol:swing is' list of the r.0uired.forms to be filled out for the appropriate. permit to, be obtained. II Roofing, Siding, Interior Rehabilitation Permits f b : Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or. Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building PP Permit Application o Certified Surveyed Plot Plan I o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) .13. Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits.require sign off from Fire De artment prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) oCopy of .Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products MOTE: 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 appal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording mast be subm:+.ted with the building application Doc: Doc.1301ing Permit Revised 2012 Location f V No. '�..�- Date � ! y 9 N -- A WN VI Ci0 O Q W LL O Q O m v u Y O 0 N N N u O_ cuLL N O0 W C Z Z J m C: O N a 7 LL s 2' N c E U _ LL o V W CL (A Z Z m d t 7 d' _ (6 LL 0 U _ W H Z U ? W s d' i {n _ (O LL O V W y Q s . 7 d' f0 LLEm Z W W W v L ZO �, UJ ` Ln v N 7ml m ;v N 0 r.- 2 2 w L W N _ _ U) O O L O O = t Q _Cc X00 d Q � _ y V E d • � t •• o = _•>0 as CLcc �0`—c • �V L �+ y " 3 • Q M J L m 0 ;v N 0 r.- 2 2 w L W N U) 'a O O • O = t Q X00 � O y �2 _•>0 as CLcc 0 O = c = q� •� Q. 0cn _ O O W LL C •C +�• *' y C U) .D CL0 — oc LU 0' V C i. cd V. Vi Q O ., ;F y F t o U 0- ;v N 0 r.- 2 2 w L W N Project Number: U1876-0077-161 January 8, 2016 Boston Solar 55 Sixth Road Woburn, MA 01801 ATTENTION: Race Traver REFERENCE: Amir Satam Residence: 19 Woodlea Circle, North Andover, MA 01845 Solar Panel Installation Dear Mr. Traver: UTAH OFFICES Sandy Layton St. George Per your request, we have reviewed the layout and photos relating to the installation of solar panels at the above - referenced site. The following materials and components are proposed in the installation of the solar panels. Roof Structure: 2x8 Rafters @ 16" O.C. Roof Material: Composite Shingles Solar Panels: SPWR E20-327 Rail Connection System: Invisimount Mounting Connections: 5/16" Diameter Lag Bolt with 2.25" Embedment, Minimum Based upon our review, it is our conclusion that the installation of solar panels on this existing roof will not adversely affect the structure of this house. The design of solar panel supporting members is by the manufacturer and/or installer. The adopted building code in this jurisdiction is the 2009 International Residential Code and ASCE 7-05. Appropriate design parameters which must be used in the design of the supporting members and connections are listed below: Ground snow load: 50 psf per Massachusetts amendments to the IRC (verify with local building department) Design wind speed for risk category II structures: 100 mph (3 -sec gust) Wind exposure: Category C Our conclusion regarding the adequacy of the existing roof is based on the fact that the additional weight related to the solar panels is less than 3.5 pounds per square foot. In the area of the solar panels, no 20 psf live loads will be present. Regarding snow loads, it is our conclusion that since the panels are slippery, effective snow loads will be reduced in the areas of the panels. The attached calculations verify the capacity of the connections against wind, the governing load case. Solar panels will be flush -mounted, parallel to and no more than 6" above the roof surface. Thus, it is our conclusion that any additional wind or seismic loadings related to the addition of these solar panels is negligible. During design and installation, particular attention must be paid to the maximum allowable spacing of attachments and the location of solar panels relative to roof edges. The use of solar panel support span tables provided by the manufacturer is allowed only where the building type, site conditions, and solar panel configuration match the description of the span tables. Attachments to existing roof joist or rafters must be staggered so as not to over load any existing structural member. Waterproofing around the roof penetration is the responsibility of others. All work performed must be in accordance with accepted industry -wide methods and applicable safety standards. Vector Structural Engineering assumes no responsibility for improper installation of the solar panels. Please note a representative of Vector Structural Engineering has not physically observed the roof framing. Our conclusions are based upon the assumption that all structural roof components and other supporting elements are in good condition, free of damage and deterioration, and are sized and spaced such that they can resist standard roof loads. Very truly yours, VECTOR STRUCTURAL ENGINEERING, Roger T. Acworth, P.E. Principal RTA/mbt 18, 2016 9138 S. State St., Suite 101 / Sandy, UT 84070 / T (801) 990-1775 / F (801) 990-1776 / wwwvectorsexom E PROJECT: JOB NO.: U1876-0077-161 TO R DATE: 01/08/16 n e 1 n E E R S it . SUBJECT: DESIGNED: MBT Com onents and Cladding Wind Calculations Label: Solar Panel (Unit Area) Note: Calculations per ASCE 7-05 SITE-SPECIFIC WIND PARAMETERS: Basic Wind Speed [mph]: 100 Notes: Exposure Category: C Used f6­sf for effective wind area. ADDITIONAL INPUT & CALCULATIONS: Height of roof, h [ft]: 24 Comp/Cladding Location- Gable/Hip Roofs 7' <_ 0:5 27° Enclosure Classification: Open Buildings GCP: 1.6 'Figure 6-11 C (enter largest abs. value) a: 9.5 Table 6-2 z9 [ft]: 900 Table 6-2 Kn: 0.937 Table 6-3 K,: Figure 64 (leave blank for negligible topographic effects) K2: Figure 64 (leave blank for negligible topographic effects) K3: Figure 6-4 (leave blank for negligible topographic effects) Kt: 1 Equation 6-3 Kd: 0.85 Table 6-4 Velocity Pressure, qh [psf]: 20.39 Equation 6-15 GCP;: 0 Figure 6-5 (largest abs. value) OUTPUT: Design Pressure, p [psf]: 32.63 psf (1.OW) P = qh GCS — GC,, JOB NO.: U1876-0077-161 DESIGNED: MBT T OL DATE: 01/08/16 no in F-eRs PROJECT: Amir Satam SUBJECT: CONNECTION CAPACITY Lag Screw Connection Capacity: Demand: Lag Screw Size: 5/16 Wind Pressure: 32.63 psf Cd: 1.6 Tributary Area: 16 sf Embedment: 2.25 in Demand: 522 lbs Capacity: 205 lbs/in. emb. Number of Screws: 1 Total Capacity: 738 lbs Demand< Capacity: CONNECTION OKAY a' BOSTON SOLAR Solar System Purchase and Installation Agreement Overview Installer The Boston Solar Company, LLC 55 Sixth Rd Woburn, MA 01801 Major Components Sunpower E20-327 Inverter Production Monitoring e) !D.0. 35 Solaredge,#04 RGM Automated Owner Sandhya Lonial 19 Woodlea Road North Andover, MA, 01845 System Size: 11.45 kW Estimated Year i Production 12,079 kWh Total System Cost $50,742.99 Payment Schedule: Federal Tax Credit $15.222.90 At Signing (refundable ) $1,000.00 State Tax Credit $1,000.00 At Design Sign Off $14,222.90 MA Solar or Utility Rebate At Installation $30,445.80 Final System Cost $34,520.09 At System Commissioning $5,074.30 Total of Payments: $50,742.99 Payment Type: CASH These financial estimates are provided for illustrative purposes, For actual financial and tax advice, please consult an independent tax advisor. £1000 deposit is refundable if price increases by more than 5%, production decreases by more than S% or it is determined customer needs to replace roof. Overview.' As part of this Agreement, The Boston Solar Company will: e Handle all aspects of the project from initial paperwork through to installation and activation of your Solar System • Secure State or Utility rebates {if applicable), permits, and utility interconnection approval • Install revenue grade monitoring, giving you real time insight into your system's performance, and allowing you enjoy automatic production reporting to generate your SRECs (Owner is required to have secure and stable Internet connection on the Property) • Set up your brokerage account with SRECTrade, the largest SREC aggregator, who will sell your SRECs and pay you quarterly (starting approximately six months after your system is activated) • Provide you with all related manufacturer warranties Time for Completion. It is expected that installation will be completed within 90 days after contract signing. The actual Installation is expected to take 2-3 days. Once installation is completed, the Owner will need to make the Property available for electrical and building inspections within two weeks after installation. After inspections, the utility is expected to.give us final approval to tum on the system within 2-4 weeks. The entire process from contract signing to system commissioning is expected to take 4 months, but may take longer depending on town and utility approvals, weather and equipment availability. Additional Contract Piovi 1mm AI) payments are due immediately upon completion of each stage of the project Quoted system price includes permit costs and utility interconnection fees. This Solar System includes a 10 -year labor warranty, 25 -year inverter warranty and 25 -year panel power warranty. Agimment This Attachment forms part of the Solar Purchase and Installation Agreement. Boston Solar Representative Signature: Date. 0--N Owner's Sign ure' Date: (f 12/29/2015 Co -Owner's Signatur : Date: 1 BOSTON SOLAR SOLAR SYSTEM PURCHASE AND INSTALLATION AGREEMENT Owner: �/( 11(101A)vv (the "Ovrner") Site Address: .i 61 v C I • N -AVIV .tt % r '�(the "Property' ) Date: This Solar System Purchase and Installation Agreement ("Agreement") is entered into effect as of the latest date of signature of the parties below by and between The Boston Solar Company LLC, 55 Sixth Rd; Woburn, MA 01801 ("TBSC") and the Owner, who is the owner of the Property. All capitalized terms used in this Agreement but not defined herein shall have the meanings set forth in The Boston Saar Company Proposal attached hereto (the "Attachment"). 1. THE WORK TBSC shall perforin work, provide the Services; supply such Equipment and furnish such other materials, supplies and other items as it determines are required to install the System described In the Attachment (the "Work"). TBSC will perform or cause its subcontractors to perform the Work in a good and Workmanlike manner, in accordance with prudent industry standards and practices. TBSC shall not make any change_ s in the Work unless agreed to in writing by the Owner. 2. REQUIRED PERMITS TBSC shall be responsible for acting as the Owner's agent to secure any permits required for the installation All permit costs are included in the price for the Work. If you secure your own permits, you will be excluded from the Guaranty Fund provisions of Chapter 142A of the Massachusetts General Laws. 3. WARRANTIES T85C Warrants that, under normal use and service conditions, the System will be free from defects in workmanship and/or materials for ten (10) years after the date of the Work being completed (this "Limited Warranty"). This Limited Warranty includes servicing manufacturer warranties free of charge. TBSC Warrants any damage to Owner's roof within a five (5) inch radius of roof penetrations during performance of the Work. If a defect is discovered, TBSC will, at no additional cost to Owner, provide such labor and materials as required to restore the System to its originally installed state. if TBSC finds that the problems were not caused by the Work, or if the problems are not an actual problem of the System (e.g. shade or unauthorized alterations to the System), Owner will pay for any.new parts and materials, and TBSC reserves the right to charge owner a service charge of $100 per hour with the minimum service charge equal to $200. 1 V G-11 BOSTON SOLAR SOLAR SYSTEM PURCHASE AND INSTALLATION AGREEMENT Effective immediately upon Owner making the final payment under this Agreement, TBSC hereby assigns to Owner, 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. 4. TIME FOR PERFORMANCE T85C shall perform the Work diligently, without unnecessary delays or interruptions and in a timely manner until completed. TBSC shall use reasonable efforts to start and complete the Work according to the timing described in the Attachment. 5, INSURANCE AND LICENSING TBSC represents and warrants to the Owner that TBSC or any .subcontractors performing the Work shall be licensed and hold insurance coverage as required by applicable laws. T65C is registered as a Home Improvement Contractor with the Massachusetts Office of Consumer Affairs and Business Regulation, under registration #169698. 6. OWNER CANCELLATION RIGHTS If Owner delivers a completed Notice of Cancellation within three (3) business days after the date of this Agreement, TBSC shall refund and return the Deposit in full to the Owner within ten (10) business days after its receipt of such Notice of Cancellation (attach to this Agreement). Owner acknowledges that TBSC will spend time and money evaluating the Property, designing the System and preparing the Work. if Owner cancels this Agreement after ten (10) business days, a cancellation fee of $1,000 will tie deducted from the Deposit. Any permit costs and unrecoverable equipment costs in by TBSC will be added to the cancellation fee and deducted from the Deposit. 7. TAX CREDITS, REBATES AND SRECS The Owner may be entitled to certain financial benefits related to the ownership. and use of the System, including state or utility rebates ("Rebates"), solar renewable energy certificates ("SRECs"), state and federal income tax credits and net metering credits ("Net Metering") (collectively defined as "Benefits"). TBSC shall prepare, process and submit applications on behalf of Owner for Rebates, SRECs and Net Metering. TBSC is acting purely as an administrative agent and cannot guarantee the outcome of such applications. The Attachment includes an estimate of the Benefits that .may .be available to the Owner. TBSC makes no representation or warranty with respect to the Owner's eligibility to. receive such Benefits. In all cases, Owner agrees to consult with the relevant governmental officials and Owner's accountant when evaluating Owner's eligibility for and the financial and tax consequences of receiving Benefits. 611 G, BOSTON SOLAR SOLAR SYSTEM PURCHASE AND INSTALLATION AGREEMENT 8. PRE-EXISTING CONDITIONS AND PROPERTY PROTECTION TBSC shall not be responsible for any damages as a consequence of the Work performed on the site due to pre-existing conditions (e.g. cracked or broken shingles, faulty electrical wiring, etc.) TBSCreserves the right to suspend performance of the Work or terminate this Agreement with no liability to TBSC whatsoever if it discovers unanticipated site conditions that will increase the cost to perform the Work. If such termination occurs, TBSC shall refund all monies paid to TBSC reduced by any expenses actually incurred. However, if Owner and TBSC agree, the price may be renegotiated to reflect the true cost of the Work. TBSC will make best efforts to protect any property of the Owner, but the Owner is responsible for removing and replacing appliances, floor coverings, and any other obstacles or hazards required to perform the Installation. TBSC is not responsible for replacement of or damage to these items if they are removed by TBSC. 9. CUSTOMER OBLIGATIONS Owner agrees to: (a) notify TBSC immediately upon discovery of an emergency condition relating to the System; damage to the System, or theft of the System; (b) only have the System repaired pursuant to the Limited Warranty (as defined herein); (d) not modify the Property in away that shades the System; (e) not do anything, permit or allow to exist any condition or circumstance at the Property which would cause the System not to operate as intended; and (g) permit TBSC, after providing reasonable notice, to inspect the System for proper operation, and to make any necessary repairs. Customer agrees to not make any modifications, improvements, revisions or additions to the System or take any other action that could void the Limited Warranty (as defined herein) without TBSC's prior written consent. If Owner fails to comply with the provisions of this paragraph, owner's Limited Warranty shall be automatically voided. 10. GENERAL PROVISIONS Any disputes which may arise between the Owner and TBSC shall not impede or interfere with the diligent performance by TBSC of the Work. This Agreement shall be subject to and interpreted in accordance with the laws of the State of Massachusetts. Title, ownership and risk of loss to the System shall pass to Owner immediately upon Owner's payment of the final payment required under this Agreement. Owner shall provide all insurance necessary for the coverage of the System and risks to the Property related thereto after such payment. 3 G, BOSTON SOLAR SOLAR SYSTEM PURCHASE AND INSTALLATION AGREEMENT This Agreement, including the documents incorporated into this Agreement, forms the complete integrated agreement between TBSC and the Owner. The parties represent and warrant that in executing this Agreement, they are not relying on representations other than as expressly contained herein. There are no other terms or conditions that form a binding agreement between the parties other than this Agreement and its incorporated documents. This Agreement supersedes all prior agreements between the Owner and TBSC and may not be altered absent a subsequent written agreement.signed by both parties. Both parties have reviewed this Agreement and represent that they understand and agree to the terms herein. Owner's Signature: Co -Owner's Signature:. Owner's Nam : f1 Co-Owner'slName: SANDII'A tWAL Date: 1 D te: 12/ai/2015- TBSC Authorized Representative Signature: TBSC Authorized prese tative Name:d� I Date: 4 r d,, G) -I BOSTON SOLAR Homeowner's Agent Authorization Form (Print Name) am the owner of the property located at address: (Print Address) I hereby authorized The Boston Solar Company to act as my Agent for the limited purpose of applying for obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System located on my Property. Print Name: Customer Signature: Date: ►�-a��� The Boston Solar Company 55 Sixth Road Woburn, MA 01801 BostonSolar.us (617)858.1645 W 3 5 2 2 N M o M T co W n W U.) Z N 0 N O f0 U N O� V y d' N Q C N a N 10 r d L... m CL 7 @ .E (n cn C L 7 o f r.+ In 'O N W O m U o Z m Q rn o .N 01 rn 3 m' LP E c o z 6 E C W 3 5 2 2 N M o M T co W n W U.) 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O N N d N 0 IM C > (0 cC a �Q�E fN C C � Q N Q F VQ �e o� o� m� Q ma Na > u < > �C'i0mao 6e e e O y 01 C C O O O 0 O y0 2 j O Ui d o !73 U> m>V5g a a L O O 7 x 5 5 U U 2 x x x x a m m m m > Q Q > I I 1 I I r)�nm lnuiu;m a a EL iaU)> 2 > c th '+ od°d°�j j : + + +.. + IL N N ` - O- o U U I I I I m c m t p N OJ O J t ��>u(no The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.massgov/dia \Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Avylicant Information Please Print . Leaibiv Name (Business/Organization/Individual): The Boston Solar Company Address: 55 Sixth Road t` itv/State/Zin: Wobum MA 01801 Phone #: 617-858-1645 Are you an employer? Check the appropriate box: Type of project (required): 1.01 am a employer with 20 employees (full and/or part-time).' 7. New construction 2.❑ l am a sole proprietor or partnership and have no employees working for the in $. Remodeling any capacity. [No workers' comp. insurance required.] 9. 0 Demolition 3.® I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4.a I am a homeowner and will be hiring contractors to conduct all work on my property. twill all have insurance are sole 10 Building addition I I Electrical repairs or additions ensure that contractors either workers' compensation or .E] proprietors with no employees. 12. ❑ Plumbing repairs or additions 50 1 am a general contractor and I have hired the sub -contractors listed on the attached sheet t 13.❑Roof repairs 3ltesecub-contractors have employees and have workers' comp. insurance. 14. QOther solar 6.a We are a corporation and its officers have exercised their right of exemption per MGL C. 152, §1(4), and we have no employees. [No workers' comp, insurance required.] 'Any applicant -that checks box #1 must also rill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating thcy are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees..Ifthe 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: HDI -Gerling America Insurance Company Policy # or Self -ins. Lic. M EWGCC000153815 Expiration Date: 1/14/2017 Job Site Address: 19 Woodlea Circle City/State/Zip.-North 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 MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA. for insurance coverage verification. I do hereby certify under the pain a fthdi ies of perjury that the Phone #: 617-858-1645 Oficial use only. Do not write in this area, to be completed by city or town official. we is true and correct 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 #: PI:....Mf. Af14Af10 Ianccn ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) TE(MMDD1 08/2016 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). PRODUCERPe People's United Ins. Agency CT One Goodwin Square Hartford, CT 06103 860 624-7600 NAME: Peggy J. Merati PNAIC NONEo 860 524-7624 AIC,No): 844 702-8075 Ext E-MAIL a merati eo les.com ADDRESS: P ggy @p p INSURER(S) AFFORDING COVERAGE NAIL # NSURERA : HDI -Gerling America Insurance G 41343 INSURED The Boston Solar Company, LLC 55 Sixth Road, Suite 1 Woburn, MA 01801 INSURER B: Merchants Mutual Insurance Co 23329 INSURERC: Philadelphia Indemnity Insuranc 18058 INSURER D INSURER E INSURER F : f•A\/C�A/�CC .. l-G�TI GIf ATG NI IRRMFW- FTF VI\I[]N mlimmFw- 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. LTR TYPE OF INSURANCE NSRLSUBR WVD POLICY NUMBER POLICY M IDDM EFF MM/DDI EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EGGCC000163814 1/01/2016 0110112017 EACH OCCURRENCE$1'006,000 PREMISES Ea occu ante 5.100 000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FX1 ECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ C C AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS.AUTOS NON -OWNED X HIRED AUTOS X AUTOS PHPK1438834 PHPK1438838 1/01/2016 0110112016 01/01/201 01101/2017 COMBINED SINGLE LIMIT Ea accident$1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP0001367 0116V2016 01/0112017 EACH OCCURRENCE $6,000,000 AGGREGATE $6,060,000 DED X RETENTION $10,000 $ A WORKERS COMPENSATIONEWGCC000153815 AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? Y (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 1/14/2016 OV1412017 X PER OTH- E.L. EACH ACCIDENT $1,000,0000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) CERTIFICATE HOLDER c�an�eLIt�tnvn Town Of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 AGORD CORPORATION. All rignts reserNea. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #$657624/M655319 SMGCT Office of Consumer Affairs & Business Regulation i = HOME IMPROVEMENT CONTRACTOR Registration: 169698 Type: Expiration: 7/V/2017 LLC THE BOSTON SOLAR COMPANY LLC ROMAIN STRECKER 55 SIXTH ROAD WOBURN, MA 01801 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza -Suite 5170 Boston, MA 02116 Massachusetts - Department of Public Safety Board of Building R64ulations and Standards cowitrtlrtion Stipen-iior License: CS -096385 ROMAIN D STRE 10 CHURCHILL PLA 3E LYNN MA 0190 J.�w••• � Expiration Commissioner 10/08/2016 Not valid without signature