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HomeMy WebLinkAboutBuilding Permit #960-16 - 280 FARNUM STREET 3/9/2016Permit NO: %0 -1 � Date Issued: 47 -""1 — BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMIPORTANT: Applicant must comr)lete all items on this LOCATION 280 Farnum Street Print PROPERTY OWNER_ George Perna 411 Print MAP NOA.?4PARCEL:/�� ZONING DISTRICT: Historic District yes no 0 Machine Shor) Villacie ves (no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building VOne family 11 Addition El Two or more family 11 Industrial El Alteration No. of units: El Commercial 0 Repair, replacement El Assessory Bldg El Others: El Demolition VOther: rooftop solar El Septic El Well El Floodplain El Wetlands El Watershed District 11 Water/Sewer I I Installation of an interconnected rooftop solar PV system: �Tu 9.625 KW DC/ 35 solar panels Identification Please Type or Print Clearly) OWNER: Name: George Perna Phone: 978-683-8948 Address: 280 Farnurn St, North Andover MA 01845 1 CONTRACTOR Name: Address: Phone: 978-793-7881 734 Forest St, suite 400, Marlborough MA 01752 Supervisor's Construction License: Exp. Date: CS -040622 1/22/17 Home Improvement License: Exp. Date: 180120 10/14/16 ARCH ITECT/ENGI NEER PZSE, Inc. / Paul K. Zacher Phone: 916-961-3960 Address: 8150 Sierra College Blvd, suite 150, Roseville CA 95661 Reg. No. 50100 FEE SCHEDULE: BULDING PERMIT. $1Z00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER &F. Total Project Cost: $ 20,116.25 FEE: $ 'Pq I -- Check No.: P Receipt No.: k' NOTE: Persons contracting with unregistered contractors do not have aees7s k dre guaranty fund ature AN er of contractor 0) Location r--'x!kV -k70/7,.J e4 N Date .3 A 4�d �,, -.41 -, . Check # - -1 3> --� ) -4,�L 0 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Building Inspector Plans Submitted Plans Waived F1 Certified Plot Plan Stamped Plans F1 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Mas s age[B o dy Art Swimming Pools 11 well Tobacco Sales 11 Food Packaging/Sales 11 Private (septic tank etc. Permanent Dumpster on Site F1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM I PLANNING & DEVELOPMENT Comm Reviewed On Signature, CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Sicinature 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 DPW Town Engineer: Signature: L.Ocatea W4 US900CI 6treet E 41 E PR A -; UT I - NM-- Te'rh * Q t 6 n s ite,,.,. .yq§ c.4: n -F.IR p unips ei V-N;iz R � iilf t ml- J.- 4ocati M1,24- MaifnKtree M� A a AN IWITM'710 R" N F; i r e i;�� e p. a ft;� 64�k� m, gt Mgnaturefflat RNT 0 'M" 0 M E 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.$100-$l 000 fine Doc.Building Pen -nit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses ,6 Copy of Contract 4� Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permitsrequire sign off from Fire Department prior to i ssuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) ... Eng . in . eer . ing - Aff - id - avi . t s - for - E - ng .- i , neered products OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products E: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doe: Building Permit Revised 2014 U) 0 0 0 (D 0 m r.q. o CD CL o A) =r 0 r - U) > 0 0 CD <o CD CL cr CD CD 0 CD CD U) CL 0 CD 0 U) 5, = CC CD CO) 0 -0 z CD 0 0 f -OL 0 CD a 0 CD < 0 0 -0 I'L =r --q Z5 0 -0 cor no)) Ic U) 5. CD cn CD CL 0 CD 0 S . M 0 -1 m 0 CL 0 a ;u = — r - z o =r -a 0 at -. T. =ii r- CD 0 0 0 CL m %=A=C) Cl) CD CD U) 0 Mo . —"- CD CD 0 CD > 0 - CL (0 U3 U) 0 SCD) Ell* CD CD r CD Z CE --I 0 <to r- m m to U) E X 75- (A Cl) m 0 U),o Z CD 0 2) Cr 0 m 0 =r > CD U) z U) =. C-) = C/) < CL 0 0 0 CL 55 a < CD m CA CD Cn CD cn CL 0 cn Z , -0 CD U) 0(374% Q) -o V CD C.) r- Cp T. 0 M > 0 cn T CD (A CD > (D Z Cl) CD m 0 0 0 CL Ln 3 0 (D 0 (D C co Z3 (D -n cu 0 0 -n 5. w Lp !� < (D :;o 0 c 0 ;v I 0 c UQ -n Ej, lu 3 m (D ;a 0 c -n 0 C: = CD - a) 0 Ln 3 0 (D 0 (D (n (D (D - z co Z3 (D -n cu ;o 0 r- -n 5. w Lp !� < (D :;o 0 c -n 5. w ;v I 0 c UQ -n Ej, lu 3 m (D ;a 0 c -n 0 C: = CD - a) 0 (n (D Ln -n 0 0 a- m m M > m z m r— m c P 2 z C) z M m (D 3 rD 0 > 0 m > m "q low- iA 0 STRU(TURAL ENGINEERS March 3, 2016 Sunrun Inc. 133 Technology Dr, Suite 100 Irvine, CA 92618 Attn.: To Whom It May Concern re: Job 2016-02836: George Perna - 221R-28OPERN The following calculations are for the structural engineering design of the photovoltaic panels located at 280 Farnum St. , North Andover, MA 01845. After review, PZSE, Inc. certifies that the roof structure lacks sufficient structural capacity for the applied PV loads. See the following calculations and Plan Sheets for location and repair to bring the roof structure up to the required capacity. If you have any questions on the above, do not hesitate to call. jVk OF ULK. Prepared By: CHER 0 STRUCTURAL PZSE, Inc. - Structural Engineers 0 No.50100 Cn Roseville, CA I . , ) 8150 Sletto Col4e Wevatd, Suh I SO * Rmville, U 9S661 * 9116,9611.3960 P - 916.961.376S 0 WW%v,pzW.00M 1 of 8 Gravity Loading Roof Snow -Load Calculafi;"ns, p, = Ground Snow Load 50 psf C, = Exposure Factor 0.9 (ASCE7 - Table 7-2) Ct = Thermal Factor = 1.1 (ASCE7 - Table 7-3) 1 = Importance Factor 1 pf= 0.7 CeCt I Pq where p,!5 20 psf, Pf min = I x p. = where pg > 20 psf, Pf min = 20 x I = Therefore, pf = Flat Roof Snow Load = 35 psf (ASCE7 - Eq 7-1) WA min snow load p�f,,Ope � 15-) N1A min snow load (mof dope < e) 35 psf P, = CJh ----7 (ASCE7 - Eq 7-2) Cs = Slope Factor = 0.867 ARRAY VARRAY 41 ARRAY5 Cs = Slope Factor = 0.867 ARRAY 21 ARRAY 6 Cs = Slope Factor = 1.000 ARRAY 3 Ps = Sloped Roof Snow Load 30.0 psf ARRAY I/ ARRAY 4/ ARRAY5 Ps = Sloped Roof Snow Load 30.0 psf ARRAY 21 ARRAY 6 Ps = Sloped Roof Snow Load 34.7 psf ARRAY 3 PVDead Coad =-3 psf (ie -r Su-nrun lgc-)' - Roof Live Load = 20 Psf, Note: Roof live load is removed in area's covered by PV array. Riif Dead-Co-ad.ARRAYl ----7 Composition Shingle 2.00 Roof Plywood 1.50 2x6 Rafters @ 16"o.c. 1.13 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.00 Total Roof OL ARRAY 1 4.6 psf DL Adjusted to 18 Degree Slope 4.9 psf Roof Dead.Load ARRAY -21 ARRAYJ6 Composition Shingle 2.00 Roof Plywood 1.50 2x6 Rafters @ 16'o.c. 1.13 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.00 Total Roof DL ARRAY 21 ARRAY 6 4.6 psf DL Adjusted to 18 Degree Slope 4.9 psf RoofNaR Load ARRAX-3, Composition Shingle 2.00 Roof Plywood 1.50 Double 2x6 Rafters @ 16"o.c. 2.26 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.00 Total Roof DL ARRAY 3 5.8 psf DL Adjusted to 18 Degree Slope 6.1 psf RER Di7ad C-oad ARRAY --41 ARRAY5 Composition Shingle 2.00 Roof Plywood 1.50 2x6 Rafters @ 16"o.c. 1.13 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.00 Total Roof DL ARRAY 41 ARRAY5 4.6 psf DL Adjusted to 18 Degree Slope 4.9 psf 2 of 8 Wind Calculations Per ASCE 7-05 Components and Cladding kFp—itViiia les Wind Speed 100 mph Exposure Category C Roof Shape Gable/Hip Roof Slope 18 degrees Mean Roof Height 26 ft Building Least Width 25 ft Effective Wind Area 10.9 sf Desig—n Wi—nd Pressure Calculatiion�� — — ------- Wind Pressure P = qh*(G*Cp) qh = 0.00256 * Kz * Kzt * Kd * VA 2 * I (Eq -6-15) Kz (Exposure Coefficient) 0.948 (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 Importance Factor 1 (Table 6-1) qh 20.63 Standoff Uplift Check.' Maximum Design Uplift = -584 lb Standoff Uplift Capacity = 700 lb 700 lb capacity > 584 lb demand Therefore, OK if Fastener Capacity Checle, Fastener = I - 5/16" dia Lag Number of Fasteners = I Minimum Threaded Embedment Depth = 2.5 Pullout Capacity Per Inch = 205 lb Fastener Capacity = 820 lb 820 lb capacity > 584 lb demand Therefore, OK 3 of 8 Ptandoff Uplift Calc@itions� Zone 1 Zone 2 Zone 3 Positive GCp = -0.90 -1.69 -2.59 0.50 Uplift Pressure = -18.54 psf -34.96 psf -53.51 psf 10.27 psf Max Rail Span Length = 4.0 ft 4.0 ft 4.0 ft Longitudinal Length = 21 ft 2.7 ft 2.7 ft Attachment Tributary Area = 10.9 sf 10.9 sf 10.9 sf Footing Uplift = -202 Ib -382 Ib -584 Ilb Standoff Uplift Check.' Maximum Design Uplift = -584 lb Standoff Uplift Capacity = 700 lb 700 lb capacity > 584 lb demand Therefore, OK if Fastener Capacity Checle, Fastener = I - 5/16" dia Lag Number of Fasteners = I Minimum Threaded Embedment Depth = 2.5 Pullout Capacity Per Inch = 205 lb Fastener Capacity = 820 lb 820 lb capacity > 584 lb demand Therefore, OK 3 of 8 Framing Check ARRAY I PASS w = 51 pff Dead Load 4.9 psf PV Load 3.0 psf rs Snow Load 30.0 psf Oc�' Member Span = 12'- 2" Governing Load Comb. DL+SL Note: Attachments shall be Staggered. Total Load 37.9 psf Mgm-ge—r0r—operfiis7, Member Size S (in A 3) 1 (in'4) Lumber Sp/Gr Member Spacing 2x6 7.56 20.80 SPF#2 @ 16"o.c. F-- C WlBiiniding �Ue"ss Fb (psi) = fb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.3 x 1.15 Allowed Bending Stress = 1504.3 psi Maximum Moment = (wLA2)/8 = 935.782 ft# = 11229.4 in# Actual Bending Stress = (Maximum Moment) I S = 1484.9 psi Allowed :-Actual -- 98.8% Stressed - Therefore, OK F t$e7c0ifiectidif Aiiowea ueTiecuon k i oiai Loaa) U-1 zu kt i4uuuuu psi t-er iiub) 1.216 in Deflection Criteria Based on Simple Span Actual Detection (Total Load) (5"w"L-4) / (384'E"1) 0.630 in U232 < L/I 20 Therefore OK Allowed Deflection (Live Load) U1 80 0.811 in Actual Deflection (Live Load) (5*w*LA4) / (384*E*I) 0.679 in L/216 < Ul 80 Therefore OK CQIC7$K—ea�, - --- - - -- -- - -- - - -- – ---- --- F-- Member Area 8.3 in A 2 Fv (psi) 135 psi (NDS Table 4A) Allowed Shear = Fv *A 1114 lb Max Shear(V) =w*L/2 = 308 lb Allowed > Actual -- 27.7% Stressed – Therefore, OK 4 of 8 Framing Check ARRAY 2/ ARRAY 6 PASS w = 51 Dead Load 4.9 psf PV Load 3.0 psf Snow Load 30.0 psf �2W 1-6"o.c.:- __R RQers @ f6 o.c7 77 Member Span = 6'- 5' Governing Load Comb. DL + SL Note: Attachments shall be Staggered. Total Load 37.9 psf Member Properties, Member Size S (in A 3) 1 (in'4) Lumber Sp/Gr Member Spacing 2x6 7.56 20.80 SPF#2 @ 16"o.c. �CkiW ii—gSlieis� Fb (psi) = fb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.3 x 1.15 Allowed Bending Stress = 1504.3 psi Maximum Moment = (wLA2)/8 = 260.286 ft# = 3123.43 in# Actual Bending Stress = (Maximum Moment) / S = 413.1 psi Allowed > Actual - 27.5% Stressed — Therefore, OK CWe—cktiflecti6n- Allowed Deflection (Total Load) Deflection Criteria Based on Actual Deflection (Total Load) Allowed Deflection (Live Load) Actual Deflection (Live Load) Ul 20 (E = 1400000 psi Per = 0.641 in Simple Span (5-w-LA4) / (384-E-1) = 0.049 in = U1572 < U120 Therefore OK Ul 80 0.427 in (5-w-1-114) / (38,PE"1) 0.053 in U1453 < U1180 Therefore OK --- Me—ck-Srea—r) nber Area 8.3 in A 2 Fv (psi) 135 psi (NDS Tabl74—A Allowed Shear = Fv *A = 11141b WxShearM=w*L/2 162 lb Allowed > Actual -- 14.6% Stressed — Therefore, OK 5 of 8 Framing Check ARRAY3 PASS - With Framing Upgrades w 58 Dead Load 6.1 psf PV Load 3.0 psf Snow Load 34.7 psf b7o"ub—Ii2WRift "rs.T6�—oc.," 9 - Member Span = IT- 4" Governing Load Comb. DL + SL Note: Attachments shall be Staggered. Total Load 43.8 psf ke—mberPropertiiis-- Bis­ed`oTn—UFg—ra—ded Secfion- Member Size S (in'3) I (in'4) Lumber Sp/Gr Member Spacing Double 2x6 15.13 41.59 SPF#2 @ 16'o.c. CfiiWBi-n-din—g Str—ess Fb (psi) = fb x Cd x Cf x Cr 875 x 1.15 x 1.3 x 1.15 Allowed Bending Stress = 1504.3 psi Maximum Moment = (wLA2)/8 = 1296.3 ft# = 15555.6 in# Actual Bending Stress = (Maximum Moment) / S = 1028.5 psi Allowed :,-Actual - 68.4% Stressed — Therefore, OK (NDS Table 4.3.1) Allowed Defiection (Total Load) L/1 20 (E 1400000 psi Per NDS) 1.333 in Deflection Criteria Based on Simple Span Actual Deflection (Total Load) (5 -w -L,14) / (384"El) 0.474 in U338 < L/1 20 Therefore OK Allowed Deflection (Live Load) L/1 80 0.888 in Actual Deflection (Live Load) (5"w"LA4) / (384'E"1) 0.565 in U284 < L/1 80 Therefore OK Checl�Slie—ar, Member Area= 16.5 in12 Fv (psi) 135 psi (NDS Table 4A) Allowed Shear = Fv * A 2228 lb Max Shear (V) = w L 2 = 389 lb Allowed > Actual -- 17.5% Stressed -- Therefore, OK ZOW. Framing Check ARRAY 41 ARRAY5 PASS w = 51 pff Dead Load 4.9 psf PV Load 3.0 psf Snow Load 30.0 psf �6o.c. Z�6 "I Member Span = 8' - 2' Governing Load Comb. DL+SL Total Load 37.9 psf r— -- --- -- 2x6 7.56 20.80 Note: Attachments shall be Staggered. Lumber Sp/Gr Member Spacing SPF#2 @ Wo.c. Fb (psi) = fb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.3 x 1.15 Allowed Bending Stress = 1504.3 psi Maximum Moment = (wl-12) / 8 = 421.62 ft# = 5059.44 in# Actual Bending Stress = (Maximum Moment) I S = 669.1 psi Allowed > Actual -- 44.5% Stressed — Therefore, OK 'ChWWD iic—ti—n-- Allowed Deflection (Total Load) Ul 20 (E 1400000 psi Per NDS) 0.816 in Deflection Criteria Based on Simple Span Actual Deflection (Total Load) (5-w"L-4) / (384-E-1) 0.128 in 1-1766 < L/I 20 Therefore OK Allowed Deflection (Live Load) Ul 80 0.544 in Actual Deflection (Live Load) (5-w-LA4) / (384'E"1) 0.138 in U711 < Ul 80 Therefore OK Member Area= 8.3 in12 Fv (psi) 135 psi (NDS Table 4A) Allowed Shear = Fv *A 11141b MaxShearM=w*L/2 = 207 lb Allowed > Actual -- 18.6% Stressed — Therefore, OK 7 of 8 Lateral 2009 IBC CH34 Existing Weight of Effected Buildin4 Level Area Weight (psQ Weight (lb) Roof 15.00 sf 4.9 psf 7350 lb Ceiling 1500 sf 6.0 psf 9000 lb Vinyl Siding 170 ft 2.0 psf 8840 lb Int Walls 170 ft 6.4 psf 28288 lb Existing Weight of Effected Building 53478 lb Proposed Weight of PV Systed Weight of PV System (Per Sunrun Inc.) 3.0 psf Approx. Area of Proposed PV System 621 sf Approximate Total Weight of PV System 1863 lb I- il 0-%.—C—Ompa -n, i -0-1i 10% of Existing Building Weight (Allowed) 5348 lb Approximate Weight of PV System (Actual) 1863 lb Percentincrease 3.5% 5348 lb > 1863 lb, Therefore OK 8 of 8 (26'Wall Height) March 3, 2016 STRU(TURAL ENGINEERS Sunrun Inc. 133 Technology Dr, Suite 100 Irvine, CA 92618 Subject: Structural Certification for Installation of Solar Panels Job Number: 2016-02836 Client: George Perna - 221 R-280PERN Address: 280 Farnum St. , North Andover, MA 01845 Attn.: To Whom It May Concern A field observation of the condition of the existing framing system was performed by an audit team from Sunrun Inc.. From the field observation of the property, the existing roof structures was observed as follows: The existing roof structure consists of: e Composition Shingle over Roof Plywood is supported by 2x6 Rafters @ 16"o.c. at ARRAY 1. The rafters are sloped at approximately 18 degree and have a maximum projected horizontal span of 12 ft 2 in between load bearing walls. a Composition Shingle over Roof Plywood is supported by 2x6 Rafters @ 16"o.c. at ARRAY 2/ ARRAY 6. The rafters are sloped at approximately 18 degree and have a maximum projected horizontal span of 6 ft 5 in between load bearing walls. e Composition Shingle over Roof Plywood is supported by 2x6 Rafters @ 16"o.c. at ARRAY 2/ ARRAY 6. The rafters are sloped at approximately 18 degree and have a maximum projected horizontal span of 6 ft 5 in between load bearing walls. Composition Shingle over Roof Plywood is supported by 2x6 Rafters @ 16'o.c. at ARRAY 4/ ARRAY5. The rafters are sloped at approximately 18 degree and have a maximum projected horizontal span of 8 ft 2 in between load bearing walls. Desi.qn Criteria: • Applicable Codes = 2009 1 BC, ASCE 7-05, and NDS -05 • Ground Snow Load = 50 psf • Roof Dead Load = 4.9 psf ARRAY 1 ; 4.9 psf ARRAY 2/ ARRAY 6; 6.1 psf ARRAY 3 • Basic Wind Speed = 100 mph Exposure Category C • Solar modules = as indicated in attached drawings As a result of the completed field observation and design checks: ARRAY I is adequate to support the loading imposed by the installation of solar panels and modules. Therefore, no structural upgrades are required. ARRAY 2/ ARRAY 6 is adequate to support the loading imposed by the installation of solar panels and modules. Therefore, no structural upgrades are required. ARRAY 3 is inadequate to support the loading imposed by the installation of solar panel and modules. New 2x6 SPF#2 rafters are required to be sistered to the existing roof rafters to support the additional loading. ARRAY 4/ ARRAY5 is adequate to support the loading imposed by the installation of solar panels and modules. Therefore, no structural upgrades are required. I certify that the capacity of the structural roof framing that directly supports the additional gravity loading due to the solar panel supports and modules had been reviewed and determined to meet or exceed the requirements in accordance with the 2009 IBC. If you have any questions on the above, do not hesitate to call. �k OF Prepared By: PAUL K. ZACHER PZSE, Inc. - Structural Engineers 0 STRUCTURAL Roseville, CA No. 50100 06/.30/ 150 Sierm Colter 8W60A, SA 150 * Rowde. (A 95661 * 916.96 13960 P * 916 A . - . ..A' DocuSign Envelope ID: 257A6C3D-5429-483F-AB30-E5F5lD35D68D 22. NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THE 10TH CALENDAR DAY AFTER YOU SIGN THIS AGREEMENT AND ANY DEPOSIT PAID WILL BE REFUNDED. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. By initialing below, you expressly acknowledge that you have been advised on your right to cancel this Agreement and have received duplicate copies of the Notice of Cancellation. DS CD FACTCpted by (Initials): SUNRUNINC. Date: 6/27/201 DocuSigned by: Signatu,e["' h" 1CD4F8C6ECD74FA PrintName: Adam Murray Title: OpOrations Associate SALES CONSULTANT Bysigningbelowlacknowledgethatiamsunrun accredited that 1presented this agreement according to 'The Right 5tuff"and the 5unrun Code of Conduct and thatI obtained the homeowneK5 signature on this agreement. Name.-william Paulin DocuSlgnedafnt Name] Signatur wiwm PAZW I C111E39D8D06F94AA 5unrunlD#.* 571—R3420311 [10-dgit numberyou received from 5unrunj CUSTOMER P .dmao�Alccount E] 5/1/2015 DocuSigned by: S S ,SnatUre. ignature: E'eeC06BD4Q&C4'0— rge erna [Account email a gc1pe-r-naftamcas-t—net *7his emafl address will be used by5unrun for official correspondence, such assending month4ebills or otherinvoices. Sunnin willnevershare orsellyour einailaddress to any thirdpardes. Account phone number: (979)--683--994&- Secondd�yAlccount htdMer Signature: Print Name: 05/01/2015 PK1 3VRNKZRAZ-H (Custom PPA Fixed) Page 12 of 18 The Commonwealth ofMassachusetts 4-3) Department of IndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov1dia 117orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information - Please Print Le2ibl Name (Business/Organization/Individual): Sunrun Installation Services, Inc. Address: 775 Fiero Lane, Suite 200 City/State/Zip: San Luis Obispo, CA 93401 Are you an employer? Check the appropriate box: Phone #: 978-549-9438 I.E] I am a employer with 35 employees (full and/or part-time).* 2.n I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.F1 I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4.[:]l am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.M I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.: 6. n 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.] Type of project (required): 7. E] New construction 8. E] Remodeling 9. El Demolition 10 E] Building addition I I. Electrical repairs or additions 12. Plumbing repairs or additions 13.E:]Roof repairs 14. E] Other Rooftop Solar *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. � Homeowners who submit this affidavit indicating they 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. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurancefor my employees. Below is the policy andjob site information. Insurance Company Name: Zurich American Insurance Company Policy 9 or Self -ins. Lic. #: WCO 13696001 & WCO 13696101 Expiration Date: 10/0 1 /2016 Job Site Address: 280 Famum St, North Andover MA 01845 City/State/Zip: 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 pains andpenalties ofperjury that the information provided above is true and correct. 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 #: AeCOR& CERTIFICATE OF LIABILITY INSURANCE DATE [MM/DD/YYYY) F 10/0112015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MARSH RISK & INSURANCE SERVICES 345 CALIFORNIA STREET, SUITE 1300 CALIFORNIA LICENSE NO. 0437153 SAN FRANCISCO, CA 94104 CONTACT -NAME: PHONE FAX (A/C. No. Ext): (AfC, No): E-MAIL -ADDRESS: -NUMBER 000641241 - 10/01/2015 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : James River Insurance Company 12203 104960339-STND-GAX-15-16 INSURED Sunrun Installation Services, Inc. INSURER B: N/A N/A INSURER C : Houston Casualty Company 42374 and REC Solar, Inc. 775 Fiero Lane, Suite 200 San Luis Obispo, CA 93401 INSURER D: TOTAL POLICY LIMIT $ 10,000,000 -INSURER E: INSURER F: COVERAGES CERTIFICATF NI]MRFR- SEA -002994222-03 PF:VIqIe)M Kil IMPF:11P.5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE ADDLSUBR POLICY POLICY EFF (MMIDDNYYY) POLICY EXP (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR -NUMBER 000641241 - 10/01/2015 10/0112016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 EXP (Any one person) $ 10,000 -MED PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICYF PRO- —1 JECT F__] LOC X OTHER� Host Liquor Liability GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COM P/OP AGG $ 2,000,000 TOTAL POLICY LIMIT $ 10,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COM BINED SINGLE LIMIT (E, a..id.rt) $ BODILY INJURY (Per person) $ BODILY INJURY (Pe accident) $ PROPERTY DAMAGE (Par accident) $ C X UMBRELLA LIAB I EXCESS LIAB X � OCCUR CLAIMS -MADE H15XC5023203 10/01/2015 10/01/2016 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 I DED I I PFTENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? F_� (Mandatory In NH) Ifies, describe under D SCRIPTION OF OPERATIONS below N/A PER OTH- ISTATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: Permitting within jurisdiction. %,r -F,. i iri%,m i rz ri%jL_LPr_r% LANLtI_LA I lUIN Town of North Andover 120 Main Street North Andover, MA 01845 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 of Marsh Risk & Insurance Services Stefan Szulc @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 0 ACC)RV CERTIFICATE OF LIABILITY INSURANCE DATE [MMIDD/YYYY) 110/8/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher & Co. Insurance Brokers of CA. 1255 Battery Street #450 San Francisco CA 94111 CONTACT NAME: FAX = Ext)' 415-546-9300 (AQ� N,I, 415-536-8499 E A A iM) RILE S S' INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Zurich American Insurance Company 16535 EACH OCCURRENCE $ INSURED SUNRINC-01 INSURER B: Sunrun Installation Services Inc. 775 Fiero Lane, Suite 200 San Luis Obispo, CA 93401 INSURER C : INSURER D: GENERAL AGGREGATE $ - COMP/OP AGG $ -INSURER E: INSURER F: AUTOMOBILE r0VFRAr.FA rFRT11:IrAT1: mi imptriz. 9443(32624 0I=X1IQIf%KI KIIIHIRAM11=110- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADULSUBR INSD WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1-1 OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMI_ ES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [7 PRO- 7 LOC JECT OTHER: GENERAL AGGREGATE $ - COMP/OP AGG $ -PRODUCTS $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED q SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS COMBINED SnTGrI7Tr9T__ (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERT DAMAGE (Par a.cdant) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ I DED I I RETENTION$ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUE El (Mandatory In NH) If ies, describe under D SCRIPTION OF OPERATIONS below NIA y WC013696001 WC013696101 10/1/2015 10/1/2015 10/1/2016 10/1/2016 x SPTERT OTH- - A UTE ER _ E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) WC013696001 - $25,000 Deductible; WC013696101 - FL, HI, MA, NJ, NY, OR, VA, WI only. Evidence of Insurance CERTIFICATE HOLDER CANCFILLATIONI @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main St North Andover MA 01845 USA AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 18v 12v Type: Supplement Card Expiration: 10/14/2016 OUNMUINI STEPHEN KELLY 775 FIERO LANE SUITE 200 SAN LUIS OBISPO, CA 93401 SCA 1 0 2om-osni - of Consumer Affairs & Business Regulation IMPROVEMENT CONTRACTOR k�-� N SUNRUN INSTALLATIOW SERVfr;E STEPHEN KELLY 775 FIERO LANE SAN LUIS �OBISPO, CA 93401 Type: Supplement CaM INC. Update Address and return card. Mark reason for change. E] Address E] Renewal F-1 Employment n LostCard 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 A— Undersecretary �eafld without S ure 4�rl` V�i�SAC IftIJSETTS-- DOWS UCENSE 4d NIOM Nm sowi292- -0-743-201 S"' W EV 48-01-2020 959. 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