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HomeMy WebLinkAboutBuilding Permit #660-16 - 36 MAPLE AVENUE 11/25/2015Permit No#: Date Issued: � BUILDING PERMIT A��%ORORYf-r TOWN OF NORTHANDOVER �� ' 6 °L APPLICATION FOR PLAN EXAMINATION Date Received 'ti QA°RAreo �SSACHUS�( RTANT: Applicant must complete all items on this page 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 ® Sep�fic ®1Nel ®nl©odplain k® W9 land 1N tern ied ®istrricti L AiORater/SewerC— n s+al l OWNER: Name: Address: DESCRIPTION OF WORK TO hSt F L41-UKIVILU: - Please Type or Print Clearly U N !TSTTffiT- d_4 I 62VM ISu-`erc-bail s Const uction License;' -0 13 ►i �_.- _ - - 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: $ 1-0.00( FEE: $ 24 0 Check No.: ` Receipt No.:Qqrqq ( NOTE: Persons contracting with unrggistered contractors do not have acces o t e guaranty fund i nature'ofcoiitracts=tl.�'e:,a x-a.,.,�a,,.'?t Signature.of Agent/Qvvner `4 . _g a Plans Submitted ❑ Plans Waived.❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanaing/MassageBody Art ❑ 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 m U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Commen Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: _ Located 384 Osgood Street FIRE DEPWR� ENTS TLemp Dumpster�Fon4site� Lrocatecl at61M 41Mam1 treetffie-e' a COMMENT�S� 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-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup Call Email I Date Time _ Contact Name _ Doe.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ 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 TOTE: 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 Clerics office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 F0 J = LL O(D m C N aU+ Y \ O LL EJ O NN U fl_ (n (� W Z Z m C "O 7 LL t K C U N C LL O W Z Z m d t j of f0 C LL O W a Z a U W J W t j U O N (O C LL 0 H a Z —uj t . j O to C LL z W a LLIN LL y N O m O z O (% N O E y n R! o cc D Cc LU :W s Q C!) c z E * c C s m d m 4 S �v W 0 J F- _ < E Of �Q cc Z O E _ N GCL Cc E CD ** a Z H >0 1- � LU O.� G 'a > a ♦� N yr c NVQ xZ E ar o W 0 Q cn Z tm C C_ O - N �.3 W c J � _ o C- Z SOWm v �_ = o ccs 'y a) NCDQ j0 C C Q � env T3 o �•- o vs O. 2 m as y.r F. LLJW = m - O O Li •2 a N O O F- N � � � Z W0 O E O O Q- 0 c Z N .0 •O�O 2 w .N 5 I CL m Z m, DocuSign Envelope ID: 7E757DE0-F118-41397-80F1-334B03EAE474 Customer Name and Address peter doherty 36 Maple Ave North Andover, MA 01845 2 System installation cost 0 The SolarCity Promise Installation Location Date 36 Maple Ave 11/3/2015 North Andover, MA 01845 Here are the key terms of your Power Purchase Agreement Electricity rate ng kWh Y � Initial here • We guarantee that if you sell your Home, the buyer will qualify to assume your Agreement • We warrant all of our roofing work. • We restore your roof at the end of the Agreement. • We warrant, insure, maintain and repair the System.................................................................................................................................. • We fix or pay for any damage we may cause to your property. • We provide 24/7 web -enabled monitoring at no additional cost. • The rate you pay us will never increase by more than 2.90% per year. • The pricing in this -Agreement is valid for 30 days after 11/3/2015. El Your SolarCity Power Purchase Agreement Details Amount due at contract signing 1 $0.:. `. Est. amount due at installation $0 l Est. amount due at building inspection $0 Est. first year production 9,731 kWh Your Choices at the End of the Initial Term: • SolarCity will remove the System at no cost to you. • You can upgrade to a new System with the latest solar technology under a new contract. • You may purchase the System from SolarCity for its fair market value as specified in the Agreement. • You may renew this Agreement for up to ten (10) years in two (2) five (5) year increments. 3055 Clearview Way, San Mateo, CA 94402 1 888.765.2489 1 solarcity.corn Power Purchase Agreement, version 9.0.4, October 22, 2015 SAPC/SEFA Compliant Contractors License MA HIC 168572/EL-1.136MR Document generated on 11/3/2015 Copyright 2008-2015 SolarCity Corporation, All Rights Reserved Agreement Tim Initial here DS [�� Initial here DS Initial here. Options for System Purchase: • At certain times, as specified in the Agreement, you may purchase the System. • These options apply during the 20 year term of our Agreement and not beyond that term. 1272545 DocuSign Envelope ID: 7E757DE0-F118-41397-80F1-3341303EAE474 23. NOTICE OF RIGHT TO CANCEL. YOU MAY CANCEL THIS CONTRACT AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE YOU SIGN THIS CONTRACT. SEE EXHIBIT 1, THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. 24. ADDITIONAL RIGHTS TO CANCEL. I have read this Power Purchase Agreement and the Exhibits in their entirety and I acknowledge that I have received a complete copy of this Power Purchase Agreement. Customer's Name: peter doherty LRA - Signed by: Signature: 97 &q IN ADDITION TO ANY RIGHTS YOU MAY HAVE TO CANCEL THIS PPA UNDER SECTION 23, YOU MAY ALSO CANCEL Date THIS PPA AT NO COST AT ANY TIME PRIOR TO COMMENCEMENT OF CONSTRUCTION ON YOUR HOME. 25. Pricing The pricing in this PPA is valid for 30 days after 11/3/2015. If you don't sign this PPA and return it to us on or prior to 30 days after 11/3/2015, SolarCity reserves the right to reject this PPA unless you agree to our then current pricing. Customer's Name: Signature: 11/3/2015 Date: Power Purchase Agreement SolarCity approved J Signature: Lyndon Rive, CEO Date: 11/3/2015 mower Purcrlase;,greeme ;C, veislon 9.:'.4, October %2, 201`5 2 November 4, 2015 bv; l Project/Job # 0183065 Project Address: Design Criteria: CERTIFICATION LETTER Doherty Residence 36 Maple Ave North Andover, MA 01845 - Applicable Codes = MA Res. Code, 8th Edition, ASCE 7-05, and 2005 NDS - Risk Category = II - Wind Speed = 100 mph, Exposure Category C - Ground Snow Load = 50 psf - MP1: Roof DL = 12 psf, Roof LL/SL = 35 psf (Non -PV Areas), Roof LL/SL = 20.5 psf (PV Areas) Version #52.6 - TBD PIL /tk7?24 / Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.33365 < 0.4g and Seismic Design Category (SDC) = C < D To Whom It May Concern, A jobsite survey of the existing framing system of the address indicated above was performed by a site survey team from SolarCity. Structural evaluation was based on site observations and the design criteria listed above. Based on this evaluation, I certify that the existing structure directly supporting the PV system is adequate to withstand all loading indicated in the design criteria above based on the requirements of the applicable existing building and/or new building provisions adopted/referenced above. This review relies on the roof's structural system having been originally designed and constructed in accordance with the building code requirements and having been maintained to be in good condition. Additionally, I certify that the PV module assembly including all standoffs supporting it have been reviewed to be in accordance with the manufacturer's specifications and to meet and/or exceed all requirements set forth by the ASCE 7 standards for loading. The PV assembly hardware specifications are contained in the plans submitted for approval. Additionally a summary of the structural review is provided in the results summary tables on the following page. Digitally signed by William A. Eldredge, P.E. William A. Eldredge Jr. Professional Engineer Date: 2015.11.04 T: 888.765.2489 x58636 14:12:17 -05'00' email: weldredge@solarcity.com 3055 Clearview Way San Mateo, CA 94402 T (650) 638-1028 (888) SOL -CITY F (650) 638-1029 solarcity.com fil- A- "- olo-r"Oty. Version #52.6 - TBD PIL HARDWARE DESIGN AND STRUCTURAL ANALYSIS RESULTS SUMMARY TABLES Landscape Hardware Hardware - Landscape Modules' Standoff Specifications X -X Spacing X -X Cantilever Y -Y Spacing Y -Y Cantilever Configuration Uplift DCR MP1 64" 24" 39" NA Staggered 55.9% Portrait Hardware Hardware - Portrait Modules' Standoff Specifications X -X Spacing X -X Cantilever Y -Y Spacing Y -Y Cantilever Configuration Uplift DCR MPI 48" 19" 65" NA Staggered 69.7% Structure Mounting Plane Framing Qualification Results Type Spacing Pitch Member Evaluation Results MP1 Stick Frame @ 16 in. O.C. 350 Member Impact Check OK Refer to the submitted drawings for details of information collected during a site survey. All member analysis and/or evaluation is based on framing information gathered on site. The existing gravity and lateral load carrying members were evaluated in accordance with the IBC and the IEBC. 3055 Clearview Way San Mateo, CA 94402 T (650) 638-1028 (888) SGL -CITY F (650) 638-1029 solarcity.com ..7,_x. Fz8 Ec. .ii,l_:'1'I .... (N:,1.;"'S Uc '''?'-v-C�_VC.k-s I" 'llC ry ;b, k'FSK- ;.>5.<.NI I FLe„�.t?�a., .J.1 . .,..,3 ti k. ,£. �, ,; isa3.. rx T., 's , f� o ', ,A ,"� ;t`i,. ,. -ii., ocl„rC .y, STRUCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK - MPI Notes: 1. ps = Cs*pf; Cs -roof, Cs -pv per ASCE 7 (Figure 7-2] 2. pf = 0.7 (Ce) (CO (IS) p9; Ce=0.9, Q=1.1, I5=1.0 Member Design Summa(per NDS Governing Load Comb CD CL + CL - CF Cr D + S 1.15 1.00 1 0.27 1 1 1.15 tuber Analysis Results Summary Governing Analysis Pre -PV Demand Post -PV demand Net Impact Result Gravity Loading Check 635 psi 1 490 psi 0.77 Pass Member Properties Summary mary MPI Roof Pitch Horizontal Member Spans Overhang 1.16 ft Rafter Pro erties Actual W 1.50" Roof System Properties San 1 14.30 ft Actual D 11.25" Number of Spans w/o Overhang) 1 Span 2 Nominal Yes Roofing Material Comp Roof San 3 A 16.88 in.^2 Re -Roof No Span 4 SX 31.64 in.^3 Plywood Sheathing Yes San 5 I 177.98 in.^4 Board Sheathing None Total Rake Span 18.87 ft TL DefTn Limit 120 Vaulted Ceiling No PV 1 Start 1.75 ft Wood Species SPF Ceiling Finish 1/2" Gypsum Board PV 1 End 15.08 ft Wood Grade #2 Rafter Sloe 350 PV 2 Start Fb 875 psi Rafter Spacing 16" O.C. PV 2 End F„ 135 psi Top Lat Bracing Full I PV 3 Start E 1400000 psi Bot Lat Bracing At Supports PV 3 End E,„i„ 510000 psi Notes: 1. ps = Cs*pf; Cs -roof, Cs -pv per ASCE 7 (Figure 7-2] 2. pf = 0.7 (Ce) (CO (IS) p9; Ce=0.9, Q=1.1, I5=1.0 Member Design Summa(per NDS Governing Load Comb CD CL + CL - CF Cr D + S 1.15 1.00 1 0.27 1 1 1.15 tuber Analysis Results Summary Governing Analysis Pre -PV Demand Post -PV demand Net Impact Result Gravity Loading Check 635 psi 1 490 psi 0.77 Pass Member Loading mary Roof Pitch 9112 Initial Pitch Ad'ust Non -PV Areas PV Areas Roof Dead Load DL 12.0 psf x 1.22 14.6 psf 14.6 psf PV Dead Load PV -DL 3.0 psf x 1.22 3.7 psf Roof Live Load RLL 20.0 psf x 0.78 15.5 psf Live/ Snow Load LL/SL 1,2 50.0 psf x 0.7 1 x 0.41 35.0 psf 20.5 psf Total Load(Governing LC TL 49.6 psf 38.8 psf Notes: 1. ps = Cs*pf; Cs -roof, Cs -pv per ASCE 7 (Figure 7-2] 2. pf = 0.7 (Ce) (CO (IS) p9; Ce=0.9, Q=1.1, I5=1.0 Member Design Summa(per NDS Governing Load Comb CD CL + CL - CF Cr D + S 1.15 1.00 1 0.27 1 1 1.15 tuber Analysis Results Summary Governing Analysis Pre -PV Demand Post -PV demand Net Impact Result Gravity Loading Check 635 psi 1 490 psi 0.77 Pass CALCULATION OF DESIGN WIND LOADS - MP1 Mounting Plane Information Roofing Material KZ Comp Roof Table 6-3 PV System Type KA SolarCity SleekMountTM Section 6.5.7 Spanning Vents V No Fig. 6-1 Standoff Attachment Hardware I Comp Mount Type C Section 6.5.6.3 Roof Slope qh 35° Fig. 6-11B/C/D-14A/B Rafter Spacing I h 16" O.C. I Section 6.2 Framing Type Direction Y -Y Rafters T -allow Purlin Spacing X -X Purlins Only NA DCR Tile Reveal Tile Roofs Only NA Tile Attachment System Tile Roofs Only NA Standin Seam/Trap Spacing SM Seam Only NA Wind Design Criteria Wind Design Code KZ ASCE 7-05 Table 6-3 Wind Design Method KA Partially/Fully Enclosed Method Section 6.5.7 Basic Wind Speed V 100 mph Fig. 6-1 Exposure Category I C Section 6.5.6.3 Roof Style qh Gable Roof Fig. 6-11B/C/D-14A/B Mean Roof Height I h 15 ft I Section 6.2 Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.85 Table 6-3 Topographic Factor KA 1.00 Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Importance Factor I 1.0 Table 6-1 Velocity Pressure qh qh = 0.00256 (Kz) (Kzt) (Kd) (V^2) (I) Equation 6-15 3.0 psf 18.5 Psf T -actual WindPressure Ext. Pressure Coefficient U GC -0.95 Fig. 6-11B/C/D-14A/B Ext. Pressure Coefficient Down - G Down) 0.88 Fig. 6-11B/C/D-14A/B Design Wind Pressure p p = qh (GC) Equation 6-22 Wind Pressure U -17.6 psf Wind Pressure Down 16.2 psf ALLOWABLE STANDOFF SPACINGS X -Direction Y -Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable Cantilever Landscape 24" NA Standoff Configuration Landscape Staggered Max Standoff Tributary Area Trib 17 sf PV Assembly Dead Load W -PV 3.0 psf Net Wind Uplift at Standoff T -actual -279 lbs Uplift Capacity of Standoff T -allow 500 lbs Standoff Demand/Capacity DCR 55.9% X -Direction Y -Direction Max Allowable Standoff Spacing Portrait 48" 65" Max Allowable Cantilever Portrait 19" NA Standoff Configuration Portrait Staggered Max Standoff Tributary Area Trib 22 sf PV Assembly Dead Load W -PV 3.0 psf Net Wind Uplift at Standoff T -actual -348 lbs Uplift Capacity of Standoff T -allow 500 lbs Standoff Demand/Capacity DCR 69.7% A ,"i,SolarCitj. 0106 OWNER AUTHORIZATION Job #: Property Address: 65 Second St North Andover, MA 01845 I Peter Doherty as Owner of the subject property hereby authorize SOLARCITY CORPORATION to act on my behalf, in all matters relative to work authorized by this building permit application. SOLARCITY.COM November 18, 2015 To whom it may concern, Please note the ELECTRIC METER address and its physical location is is 65 Second Street. My property and Solar City installation, and my billing and mailing address is 36 Maple Avenue, North Andover Ma. 01845.1 live on a corner and buildings are connected. Just wanted to clarify this as I am signing a document. Peter Doherty 36 Maple Ave. North Andover Ma. 01845 c. 978 8521814 h. 978 794 0013 https://www.google.com/maps/place/36+ Maple+Ave, +North+Andover,+MA+01845/@42.7011112,- 71.1328011,67m/data=!3m 1 ! 1 e3!4m2!3m1 ! 1 sOx89e30650ac98b977:Oxc86474e890691479 o n at o na l(an1 SERVICE FOR BIwNG PERIOD PAGE 1 of 2 PETER DOHERTY Oct 26, 2015 to Oct 31, 2015 RHONDA DOHERTY 65 ECOND ST ACCOUNT NUMBER NORTH ANDOVER MA 01845 41183-76000 Upon Receipt $ 99.49 www.nationalgridus.com Dollvwy Sorofoos 110 -FINAL SERVICE BILL CUSTOMER SERVICE Service Period No. of days 1 -NO -322-3223 it has been our pleasure to be your energy services provider. We hope to have you as a customer again. CREDIT DEPARTMENT You have established an excellent payment record. If you need to establish credit at another utility, 1.888-211-1313 please feel free to use this message as a credit reference. POWER OUTAGE OR DOWNED LINE ACCOUNT BALANCE 1 -NO -4e5-1212 CONTACT US Previous Balance As shown on bill dated Oct 28, 2015 85.69 n0rid.com/ma-contactus Payment Received -0.00 CORRESPONDENCE ADDRESS 0.03981 x 74 kWh 2.95 PO Box 960 Balance Forward 85.69 Northborough, MA 01532-0960 Current Charges + 13.80 ELECTRIC PAYMENT ADDRESS 0.02614 x 74 kWh 1.93 PO Box 11737 Amount Due ► $ 99.49 Newark, NJ 07101-4737 ➢ Go paperlessl Electronic billing and payments make managing your monthly bill DATE BILL ISSUED easier. Save time, money, and natural resources www.ngrid.com/paperless. Nov 2, 2015 > Payment concerns? We are here to help. To learn about solutions to help you Underground Surcharge take control of your energy use and bills, visit www.ngrid.com/billholp. 000001380 41183760008000009949330 DETAIL OF CURRENT CHARGES Dollvwy Sorofoos Service Period No. of days Curets Reading - Previous Reading = Total Usage Oct 26 - Oct 31 5 42568 Poreamd 42494 Acmar 74 kWh METER NUMBER 41697601 RATE Residential Regular R-1 ELECTRIC USAGE HISTORY (kwh) Customer Charge 0.87 1350 Dist Chg First 74 KWH 0.03981 x 74 kWh 2.95 low 810 Transition Charge -0.00164 x 74 kWh -0.12 540 jjj& Transmission Charge 0.02614 x 74 kWh 1.93 27o Energy Efficiency Chg 0.01624 x 74 kWh 1.21 N D J F M A M J J A S O N Renewable Energy Chg 0.0005 x 74 kWh 0.04 14 15 Delty Averages Nov 14 Nov 15 Underground Surcharge 2.0% 0.27 1a.6 5.0 cow $5.0� t 2.7a cosi Total Delivery Sorvioes $ 6.95 ry 1111111ACtual ❑Estimated KEEP TMPORrIONFOR YOLF1ReODFIDS. FETURN THrS PORRON WITH YOUR PAYMW ACCOUNT NUMBER • n at o n a l g r i d 41183.76000 Upon Receipt $ 99.49 ► FINAL SERVICE BILL / PO Box 960 ENTER AMOUNT ENCLOSED Northborough MA 01532 Wrlee Wcouir number on Check and make Payable M Nadonal Gid Please pay Lias 6 Elect* bills separably PETER DOHERTY NATIONAL GRID RHONDA DOHERTY PO BOX 11737 36 MAPLE AVE 099457 NEWARK NJ 07101-4737 NORTH ANDOVER MA 01845-2412 000001380 41183760008000009949330 SERVICE FOR BIWNG PEROD PAGE 2 of 2 n at i o n a I a r o d PETER DOHERTY Oct 26, 2015 to Oct 31, 2015 RHONDA DOHERTY 65 SECOND ST ACCOUNT NUMBER NORTH ANDOVER MA 01845 41183-76000 Upon Receipt $ 99.49 Enrollment Information To enroll with a supplier or change to another supplier, you will need the following information about your account: Lofton NEMA/BOST Aod No: 41 1 83-760 0 0 cycle: 20, DOHE Electric Usage History Month kWh Month kWh Nov 14 627 Jun 15 873 Dec 14 790 Jul 15 1166 Jan 15 870 Aug 15 1316 Feb 15 652 Sep 15 919 Mar 15 468 Oct 15 461 Apr 15 517 Nov 15 74 May 15 746 Payment Plans are AvaHsble for Four or More Months. Please Contact Us at 1-888-211-1313. Av!so Importmmte! Si usted no entiende este aviso, Ilame a Is compania al: 14300-322-3223. Right to Dispute Your Bill If you believe your bill is inaccurate or you wish to dispute all or part of your bill, please contact: National Grid at 1.900.3223223and request an investigation by a Company Complaint Officer. If you are not satisfied with the written decision or did not receive a written decision within 30 days, you have the right to appeal to the Massachusetts Department of Public Utilities, Consumer Division, One South Station, Boston, MA 02110. Telephone 617-737-2836 or 1377386.5066. Department of Public Utilities DPU regulations provide that a company may not terminate electric service for failure to pay any portion of a bill when a customer complaint or appeal is pending. Arrearage Management Program (AMP) AMP provides arrears forgiveness to !ncon"ualified residential customers. Participants must accept and stay current with monthly Budget Billing payments. For complete details and an application, visit www.nationalgddus.com or call the number on the front. Supply Services 8UPPUER National Grid Basic Service Fixed 0.09257 x 74 kWh 6.85 Total Supply Services 6.85 Explanation of General Billing Terms Delivery Service Charges are comprised of: KWH: IGlowatt-hour, a basic unit of electricity used. Off -Peak: Period of time when the need or demand for electricity on the Company's system is low, such as late evenings, weekends and holidays. Peak: Period of time when the need or demand for electricity on the Companys system is high, normally during the day, Monday through Friday, excluding holidays. Estimated Bili: A bill which is calculated based on your typical monthly usage rather than on an actual meter reading. It is usually rendered when we are unable to read your meter. Meter Multiplier. A number by which the usage on certain meters must be multiplied by to obtain the total usage. Demand Charge: The cost of providing electrical transmission and distribution equipment to accorrrnodate your largest electrical load. Supplier Service Charges are comprised of: Generation Charge: The charge(s) to provide electricity and other services to the customer by a supplier. Right To Electric Service If you have a financial hardship you (or anyone presently and normally living in your home) have a Right to Electric Service in the following situations: • During serious illness: Contact your physician or Board of Health and have them telephone the Company Immediately at 1388-211-1313. Within seven m days of the phone call your physician or Board of Health must certify in writing, to the Company, that serious illness exists. The certificate protects against lamination for 90 days (180 days if chronic illness) and may be renewed. Your failure to renew such certification of serious illness as set out above may result in your service being terminated. Customer Charge: The cost of providing customer related service such as metering, meter reading and billing. These fixed costs are unaffected by the actual amount of electricity you use. Distribution Charge: The cost of delivering electricity from the beginning of the Company's distribution system to your home or business. Transition Charge: Company payments to its wholesale supplier for terminating its wholesale arrangements. Transmission Charge: The cost of delivering electricity from the generation company to the beginning of the Company's distribution system Energy Efficiency Charge: The cost of energy efficiency program services offered by the Company. Renewable Energy Charge: A charge to fund initiatives for corn unicating the benefits of renewable energy and fostering formation, growth, expansion and retention of renewable energy and related enterprises. • You have a child under twelve months old IMng in that home. • Between November 15 and March 15 H your service Is heat related. • Elderly Household: If all residents in your household are 65 years of age or older, or a minor (under the age of 18), the Company can not terminate your service for failure to pay a past due bill without the approval of the Massachusetts Department of Public Utilities (DPU). • For additional IMormution on the right to electric service, please contact our Credit Department at 1.888-211.1313. Questions: If you have questions or complaints regarding this bill or National Grid's service quality, please contact Customer Service at 1-806322.3223. You may also contact the Massachusetts Department of Public Utilities, Consumer Division at 617-737-2836 or toll free at 13774886.5066 or web site www.mass.gov/clpu. The Cainmonlaearlth of Massacfaasetts D"rin:errs of Industrial Accidents VOffice ofInvest€gadans I Congress street, Smite 100 Boston, MA 02114-24J7 z ww mass.govIdia Workers' Compensation Insurance Affidavit: Buiidelrs/Contractors/EloctriciansJPtumbers AppLicant Itltformafitsn Please Print Le ib[ Name(Busincss/Organization(tndividual): SolarCity Corp. Address: 3055 Clearview Way cityls€atefZip: man lvlateo um. yz+z+uz Phone #:000-1 v0 -/-1+0z Are you an ernploycr? Check the appropriate box: - 1. (✓ I am a employer witli 5,000 4• ❑ I ant a general contractor and I Type of project (requitreti): employees (full and/or part-time),* have hired the sub -contractors d ❑ Now construction 2. ❑ 1 am a solve proprietor or }partner- listed on the attached sheet. ?. ❑ Remodeling ship and have no employees These sub -contractors have g, ❑ Demolition working for me in any capacity, employees and have workers' 9. El Building addition [ oworkets' comp. insurance required.) camI'igsranae? 5. E] We are a corporatian and its 10.[D Electrical repairs or additions 3. ❑ 1 am a homeowner doing all work officers have exercised their I i.n Plumbing repairs or additions Inybo f. [No workers' . cam p tight o exualption Flat MAM 12.❑ Roof repairs insurance required,) t c. 152, § 1(4), and we have no v[a other Solar/PV employees. [No workers' comp, insurance required.) *Any appticara that ebecks boxfl t must also fill out the section blow showing their workers' conpcmntion policy information. I Homeowners who submit this affidavit indicating /hey are doing all nark and then him outside wntrustors mull submit a new atrrdavit indicating such. :Contracwrs that check this box must attached an additional shcat showing; the name of the subcontractors acrd state whenicr or not chasm entities havo employees. if the subcontractors have employees, they must provide their workers' comp policy number. I am an employer that isproviding workers' compensation, insurance for my employees. Below rs elte pelley and job site information. Insurance Company Name. Zurich American Insurance Company Policy 9 or SeF-ins. Lic. #: WC0182015-00 Expiration Date; 9/1 /2016 Job Site Address: ��6 ON G. City/State/Zip; � � 0Vtr (YtJO6 6(,yqS Aitsteh a copy of the workers' compensation policy declumflon 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 crminal penalties of a fine up to S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for inswance coverage verification. X do hereby eertr xudq (lie pains and penalties ofperjury that the Informaden provided above is true and correct Phgne il' Ofeicial use only, Do not,urNe Ar this area, to be completed by city or town offilelal. city or Town: Permit/Lleense b 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 #; a 40RO0 CERTIFICATE OF LIABILITY INSURANCE D0811712015DIYYY�I 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 1S WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAMg;_.._.._-._....__. MARSH RISK & INSURANCE SERVICES ... ...... ................... ............ .................. 345 CALIFORNIA STREET, SUITE 1340 iAIC.Nit ExrIL....... _ .... .... ............... ........... dGlc, Nol:..............................._...... CALIFORNIA LICENSE NO. 0437153 EMAIL SAN FRANCISCO, CA 94104 _aongEs�:.................... .............. .................... ......................T ..................._ ._.. Atln: Shannon Scoff 415-743.6334 INSURERLS] AFFORDING COVERAGE. . + NAIC # 998301-STND-GAWUE-15.16 INSURER A; Zurich American Insurance Company 16535 INSURED INSURER 8: NIA NIA SolarCity Corporation +.. ......... .... 3055 Clearview Way tNSURER c.: NIANIA . ........ ....................... ._.._. +........ San Mateo, CA 94402 INSURER.D : American Zurich Insurance Company .40142 MED EXP (Any one person) r.... ...... ... _ .. ._.... ..3,000,044 ` . s .........._................... _........................ INSURER E: PERSONAL & ADV INJURY ..._ .._.5............ INSURER F: COVERAGES CERTIFICATE NUMBER: SEAA02713836.08 REVISION NUMBER:4 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 ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. San Mateo, CA 99402 ACCORDANCE WITH THE POLICY PROVISIONS. INSRT. ...... ....... .. .. ...... ................:.. ..... ADDLSUBR....._...................—....._............._. ....'i'OLiCYEFF .` POLICY EXP i8 ... ...... ................... ............ .................. ............ LTR TYPE OF INSURANCE POLICY NUMBER MMIDDI MMfDD1YYYY LIMITS A XCOMMERCIAL GENERAL LIABILITY !GL00182016-00 0910112415 `0910112016 EACH OCCURRENCES 3,400,004 X I 3,040,000- ....... ....,'CLAIMS -MADE OCCUR PREMISES {Ea oocurrencel S _ .......... X SIR; $250,40D .... ................................... ... .... ...... MED EXP (Any one person) r.... ...... ... _ .. ._.... ..3,000,044 ` . s .........._................... _........................ PERSONAL & ADV INJURY ..._ .._.5............ ........._. 'GEN'LAGGREGA7ELIMITAPP..!SPER* GENERAL AGGREGATE 5 6400040 i .._.., PRa- i X POLICY i JECT ;... _, LOC ' PRODUCTS - COMPIOP AGG : $ 6,000,000 i OTHER . S A . AUTOMOBILE LIABILITY BAP0182017.00 1:0910112015 ?0910112016 COMBINED SINGLE LIMIT $ 5,000,000 ' X ANY AUTO BODILY INJURY (Per person): 3 X : ALL OWNEDX SCHEDULED AUTOS AUTOS : I BODILY INJURY IPeraccdenty; $ ...... ...... ;.. ..i X r NON -AWNED X .................. PROPERTY DAMAGE $ HIRED AUTOS AUTOS r ; i (Peraccldenfl . .,. _........+.5 ........ _... .......$5.000 i COMPICOULDED: UMBRELLA LIAR OCCUR EA.C..C.$ }..... -a ! EXCESS LIAR :CLAIMS MADE .... ....... r.... ., ............1. ... ..... --- ......__.1 .......__.. ...... .....+.._ ..... ........... .E.N.. AGGREGATE $ r ......... ... ....... .. .. i..... ......... ... ................ . DED i RETENTIONS ; S D WORKERS COMPENSATION WC0162014.00(AOS) 0910112015 0910112016 X ;PER ' A FANO EMPLOYERS' LIABILITY rrN PTN:WC0182015.00 MA .0910112015 0910112016 IANY PROPRIETOR . a;NIA E. .... I... . P ' E.L EACH ACCIDENT ' $ 1,004,000 EXCLUER/EXECUTIVE OFFICERIMEMBEREXCLUOED� .r_._.___.---.._......_ ;Mandatory In NHI I WC DEDUCTIBLE: $500,000 I .............;.. . E.L DISEASE - EA EMPLOYE ' S _.._................ .. .. .........�--.... ._ . . 1.000,000 If es. describe under DESCRIPTION OF OPERATIONS below E L DISEASE •POLICY LIMIT I S 1.404,004 i I DESCRIPTION OF OPERATIONS] LOCATIONS] VEHICLES (ACORD 401, Additional Remarks Schedule, may be aHached If more space Is required) Evidence of insurance. CERTIFICATE HOLDER CANCELLATION SolarCity Corporation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3055 Clearview Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo, CA 99402 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services Charles Marmolejo-�/� ��--- ACORD 26 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. 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 SOLAR CITY CORPORATION ASTRID BLANCO 3055 CLEARVIEW WAY SAN MATEO, CA 94402 SCA 1 C: 20M -05A t 014Gf.1 Ir`Clli Ari)lU(1CU1i� isQ /aJi<tt�((rC/�' rffice of Consumer Affairs & Business Regulation N:. `• ti �qrj ,OME IMPROVEMENT CONTRACTOR Registration: 168572 Type: Expiration: 3/8/2017 Supplement Card SOLAR CITY CORPORATION ASTRID BLANCO 24 ST MARTIN STREET BLD 2UNI TAAhLBOROUGH, MA 01752 Undersecretary Registration: 168572 Type: Supplement Card Expiration: 3/8/2017 Update Address and return card. Mark reason for change. Address n Renewal ❑ Employment 0 Lost Card License or registration valid for individul use only before the expiration date. 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