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Miscellaneous - 1 POND STREET 4/30/2018 (2)
Date ..... ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 16) .............. ....... & ".4 . .............................................................. has pennission to perfonn ....... ip..,J� kkJ 5-11 7�� .................................. ........................................ wiring in the building of ..... ..................................................... at ........... I ..... ......... ........................... ....... IN rth Andover, Mass. ............. Fee.] *Z'-� ................ Lic. No . ............ f 20 5-46 A Check# 1.2773—/ ............. ......... LECTRICAL INSPEC�OR Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. I I Occupancy and Fee Checked y BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] mwblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/08/2015 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 1 Pond Street, North Andover, MA Owner or Tenant Eric Peterson Telephone No. (617) 512-6155 Owner's Address 1 Pond Street, North Andover, MA Is this permit in conjunction with a building permit? Yes Q No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 200 Amps 120 / 240 Volts Overhead ❑ Undgrd FKI New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No. of Meters 1 No. of Meters Location and Nature of Proposed Electrical Work: Installation of 10.53kW Grid -tied, Roof -Mounted Solar Photovoltaic System with Line -side Interconnection that requires replacing existing meter -main with new meter enclosure. Completion of the followine table may be waived by the Insoector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators 1 KVA 10.53 No. of Luminaires Above In- Swimming Pool rnd. ❑ rnd. ❑ o. o Emergency Lighung BatteEX Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Tot ` No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I Tons_ KW No. of Self -Contained Detection/Alerting Devices I I- No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water, Heaters No. of No. of Si ns Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Eq uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: $13,150.00 (When required by municipal policy.) Work to Start: 10/19/2015 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete FIRM NAME: Avid Solar LLC LIC. NO.: 20566A t Licensee: Ellsworth P. Mellor, Jr. SignatureW- I— '//Z44th. /A--- LIC. NO.: 30373E { (Ifapplicable, enter "exempt" in the license number line) r Bus. Tel. No.; (888) 517-3767 Address: 789 Wachusett St, Holden MA 01520 Alt. Tel. No.: (617) 285-4450 *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ LS �-���- P� JL4- Wo V, r �J o u n Ncr N O N 0 v) a = o, E W 75 = 0m c O j,2 m xM `-' u v oOD O 3 N SO C O ` Y N cn H O M M 14 d u zz m A m _ eM•I ; g 2 1 � O O I O O t j o o ) I j o 0 c 0 ;>y > C y N C 1 M ¢ Y C O m > C N N O Z O O 0 U p m a)O i E v Oct p u YO C-4 •� u a H w w Y aEaii v N f6 CO OO w C C C u d `m O a A 0 LA 0 l L 0 m u omc c a o 0 K uM O) r Q C O 0 Q z 2 N N (Um 00L a c ar w � C f0 p p L / c to G U 0 o w U c p' m r Ol > u C � 3 Ln u m °o aYci Y N Y u 2 ' O � >1Uto O W-0 C 'o O w m E p) � 7 m a0N w N 2 O N an � N O a N ti y u > ti 8 = a O O a - -1 Q m O cA :1 to to L w n � > . Q L M o a M iiI m � u y t o3�W c N > � !00 a a�°� d d y ti K w m u a 70 Y � u u+ J O n 0 vs C u y N O N LL U v c o E u E Q L U O N C) w V W n C Z y OO N O 2v mm Ny uO. m9 o'm .m-- N cmm o w;O ` m u j> T U N y Nx run O a w� H uti c F �coF_�+ EL a, EZ ET m E o m v c v v v m c u > c O O � N Z O c Y75 c m c D O N F O O ma V o - o y Y E �` m c yv o r C N O. O. 10 C m - � u 0 mC) 0 N vaa N o m z W n m X a o w w o c y n >u+ m o c E " a+L E� aJ O 7 www.hhi-green.com/solar nyund So ar Modu e Hyundai Heavy Industries was founded in 1972 and is a Fortune 500 company. The company employs more than 48,000 people, and has a global leading 7 business divisions with sales of 602 Billion USD in 2012. As one of our core businesses of the company, Hyundai Heavy Industries is committed to develop and invest heavily in the field of renewable energy. Hyundai Solar is the largest and the longest standing PV cell and module manufacturer in South Korea. We have 600 MW of module production capacity and provide high-quality solar PV products to more than 3,000 customers worldwide. We strive to achieve one of the most efficient PV modules by establishing an R&D laboratory and investing more than 20 Million USD on innovative technologies. Multi -crystalline Type HiS-M250RG HiS-M255RG HiS-M260RG RG -Series Mono -crystalline Type HIS-S260RG I HiS-S265RG 1 HiS-S270RG Mechanical Characteristics 998 mm (3929'1(W) x 1,640 mm (64.57")(L) x 35 mm (1.38'j(H) Approx.172 kg (37.9 lbs) 60 cells in series (6 x10 matrix) (Hyundai cell, Made in Korea) 4 mm' (12AWG) cables with polarized weatherproof connectors, IEC certified (UL listed), Length 1.0 m (39.4' IP68, weatherproof, IEC certified (UL listed) 3 bypass diodes to prevent power decrease by partial shade Front: High transmission low -iron tempered glass, 2.8 mm (0.11") Encapsulant:EVA Back Sheet: Weatherproof film Clear anodized aluminum alloy type 6063 High Quality • IEC 61215 (Ed.2) and IEC 61730 by VDE • UL listed (UL 1703), Class C Fire Rating • Output power tolerance +3/-0 % • ISO 9001:2000 and ISO 14001:2004 Certified • Advanced Mechanical Test (5,400 Pa) Passed (IEC) / Mechanical Load Test (40 Ibs/ft') Passed (UL) • Ammonia Corrosion Resistance Test Passed • IEC 61701 (Salt Mist Corrosion Test) Passed Fast and Inexpensive Mounting • Delivered ready for connection • IEC (UL) certified and weatherproof connectors •Integrated bypass diodes Limited Warranty • 10 years for product defect • 10 years for 90 %of warranted min. power • 25 years for 80 % of warranted min. power x Important Notice on Warranty The warranties apply only to the PV modules with Hyundai Heavy Industries Co., Ltd:s logo (shown below) and product serial number on it. DVf E oQas vV e�ircue ® ! HYUNDAI HEAVY INDUSTRIES CO,LTD. Electrical Characteristics I Multi -crystalline Type I Nominal output (Pmpp) W 250 255 260 Voltage atPmax (Vmpp) Current atPmax (Impp) V A _ 30.9_ 8.1 _31.0 rr 8.2 _ _ _ _31.1_ 8.4 31.3 Open circuit voltage (Voc) V 374 37.6 37.7 _ Short circuit current (Isc) A 8.7 8.8 - 8.9 -37.9 Output tolerance % - - Y T _ _�- +3/-0 - - No. of cells & connections PCs 60 in series Short circuit current (Isc) A Cell type 8.9 6"Multi-crystalline silicon (Hyundai cell, Made in Korea) Module efficiency % 153 15.6 15.9 Temperature coefficient of Pmpp Temperature coefficient of Voc %/K %/K -043 -032 -043 1 -043 -0.32 series 'cell, Temperature coefficient of Isc %/K 0.048 _-032 -- a - - - 0.048- - _ 0.048 _ -� XAII data at STC (Standard Test Conditions). Above data may be changed without prior notice I Mono -crystalline Type I Nominal output (Pmpp) W 260 265 270 Voltage at Pmax (Vmpp) V 31.1 31.3 31.4 Current at Pmax (Impp) A 8.4 _ 8.1 8.6 Open circuit voltage (Voc) V -37.9 -a- r -_ 381 -�- 38.2 Short circuit current (Isc) A 8.9 90 .Output tolerance % +3/-0 No. of cells & connections pcs601n series 'cell, Cell type 6"Mono-crystalline silicon (Hyundai 1n Korea) I Module efficiency % 159 16.2 16.5 Temperature coefficient of Pmpp 0/o/K r -0.45 _ - - T-0.45 ( -0.45 _ e Temperature coefficient of Voc %/K -033 -033 -0.33 Temperature coefficient of Isc j %/K 0.032 0.032 0.032 X All data at STC (Standard Test Conditions). Above data may be changed without prior notice I Module Diagram I I Installation Safety Guide I (unit: mm, inch) I IN Curves l cu.v W e aoowAH - 2s•C 7 _ 6 ... 45'C 4xPf7{ll - 75 (03� S - -1WC H (+) DETAILA - iommm - - (1171 ffOTTHRJ49317 (19371CORE"6 CONNKTOE1 CMdtCIOR COM8708 1'n Q u ' - 0 5 10 15 20 75 ID- 35 A 6 -- § oBr.e1 W volur m M GROUMMAM On"B - . 1,OODWAN GROU18 0.71 CitOIItDFIOIE 11 OA e -BOO WAN 60(747 600W/1W 1 6 954 756 5 400 WAN 200WAN C 753[9 30 1.1 18 OA . . SECTION C -C ' 0 l0 20 30 40 50 vokwm • Only qualified personnel should install or perform maintenance. • Be aware of dangerous high DC voltage. • Do not damage or scratch the rear surface of the module. • Do not handle or install modules when they are wet. LN omina Operaun _,elle emperature Operating emperatur :am m System Volta L r r r r .Cr aximum Rev_erseiirrent I Panted Date: January 2014 ) %� Sales &Marketing HYUNDAI ,a fl°'�d°"M0f� 2°° Fl, Hyundai Bldg.,75,Yulgok-ro,Jongno-gu,Seoul 110.793,Korea FSC ew*wd1 Tel: +82-2-746-M6.7422,8525 Fax:+82-2-7467675 HEAVY INDUSTRIES CO.,LTD. Enphase® Microinverters Enphase°M25O _6 _ 4 The Enphase® M250 Microinverter delivers increased energy harvest and reduces design and installation complexity with its all -AC approach. With the M250, the DC circuit is isolated and insulated from ground, so no Ground Electrode Conductor (GEC) is required for the microinverter. This further simplifies installation, enhances safety, and saves on labor and materials costs. The Enphase M250 integrates seamlessly with the Engage® Cable, the Envoy® Communications Gateway", and Enlighten®, Enphase's monitoring and analysis software. PRODUCTIVE - Optimized for higher -power modules - Maximizes energy production - Minimizes impact of shading, dust, and debris enphase® E N E R G Y SIMPLE - No GEC needed for microinverter - No DC design or string calculation required - Easy installation with Engage Cable f:i:14F-3 44 - 4th -generation product - More than 1 million hours of testing and millions of units shipped - Industry-leading warranty, up to 25 years SP® c us V -V Enphase® M250 Microinverter // DATA INPUT DATA (DC) M250-60-2LL-S22, M250-60-2LL-S25 Recommended input power (STC) 210 - 310 W Communication Maximum input DC voltage 48V The DC circuit meets the requirements for ungrounded PV arrays in Peak power tracking voltage 27V -39V Operating range 16 V - 48 V integrated into the microinverter. Min/Max start voltage 22V/48V Compliance Max DC short circuit current 15 A 0.4-04, and 107.1-01 OUTPUT DATA (AC) @208 VAC @240 VAC Peak output power 250 W 250 W Rated (continuous) output power 240 W 240 W Nominal output current 1.15 A (A rms at nominal duration) 1.0 A (A rms at nominal duration) Nominal voltage/range 208 V / 183-229 V 240 V / 211-264 V Nominal frequency/range 60.0 / 57-61 Hz 60.0 / 57-61 Hz Extended frequency range` 57-62.5 Hz 57-62.5 Hz Power factor >0.95 >0.95 Maximum units per 20 A branch circuit 24 (three phase) 16 (single phase) Maximum output fault current 850 mA rms for 6 cycles 850 mA rms for 6 cycles EFFICIENCY CEC weighted efficiency 96.5% Peak inverter efficiency 96.5% Static MPPT efficiency (weighted, .reference EN50530) 99.4 Night time power consumption 65 mW max MECHANICAL DATA Ambient temperature range -40°C to +65°C Dimensions (WxHxD) 171 mm x 173 mm x 30 mm (without mounting bracket) Weight 1.6 kg (3.4 lbs) Cooling Natural convection - No fans Enclosure environmental rating Outdoor - NEMA 6 Connector type M250 -60 -21 -L -S22: MC4 M250 -60 -21 -L -S25: Amphenol H4 FEATURES Compatibility Compatible with 60 -cell PV modules Communication Power line Integrated ground The DC circuit meets the requirements for ungrounded PV arrays in NEC 690.35. Equipment ground is provided in the Engage Cable. No additional GEC or ground is required. Ground fault protection (GFP) is integrated into the microinverter. Monitoring Enlighten Manager and MyEnlighten monitoring options Compliance UL1741/IEEE1547, FCC Part 1.5 Class B, CAN/CSA-C22.2 NO. 0-.M91, 0.4-04, and 107.1-01 Frequency ranges can be extended beyond nominal if required by the utility To learn more about Enphase Microinverter technology, 1 enphase® visit enphase.com E N E R G Y 0 2015 Enphase Energy. All rights reserved. All trademarks or brands in this document are registered by their respective owner. MKT -00070 Rev 1.0 14 Engage Cable System and Accessories Enphasee Engage Cable The Engage TM Cable is a continuous length of 12AWG cable with pre-installed connectors for Enphase Microinverters. The cable is handled like standard outdoor -rated electrical wire, allowing it to be cut, spliced and extended as needed. The Engage Accessories complement the Engage Cable and give it the ability to adapt to any installation. FAST - Quick installation - Large branch capacity enphaw E N E R G Y FLEXIBLE - Simple design - No additional cables SAFE - No high voltage DC - Reduced fire risk SA® C us + 'v Enphase® Engage Cable System // DATA CABLE TYPES / ORDERING OPTIONS Description Rating Cable temperature rating Voltage Connector Spacing PV Module Orientation Model Number #Connectors* Weights` 240 VAC, 4 conductors 1.025 meter (40") Portrait ET10-240-BULK 240 221 lbs 240 VAC, 4 conductors 1.7 meter (67") Landscape ET17-240-BULK 240 333 lbs 208 VAC, 5 conductors 1.025 meter (40") Portrait ET10-208-BULK 240 221 lbs 208 VAC, 5 conductors 1.7 meter (67") Landscape ET17-208-BULK 240 333 lbs *additional lengths available through Enphase authorized distributors. "weights are approximate CABLE SPECIFICATIONS Description Rating Cable temperature rating 90°C (194°F) wet/dry Cable insulator rating THWN-2 UV exposure rating UL 746 C, F1 Conductor size 12AWG Compliance IEC 60529 IP67, CAN/CSA 22.2 No. 21, 182.3, UL 486A/13, 514C, 6703, and 9703 Cable rating TC -ER Cable Diameter 1.25 cm (0.49") Minimum bend radius 12 cm (4.75") ENGAGE ACCESSORIES Branch Terminator Disconnect Tool One terminator needed per branch Plan to use at least one per circuit installation ET -TERM -10 (sold in packs of 10) ET -DISC -05 (sold in packs of 5) C— Watertight Sealing Cap Cable Clip ® One needed to cover each unused Many needed to fasten cabling connector on the cabling to the racking or to secure looped ET -SEAL -10 (sold in packs of 10) / cabling ET -CLIP -100 (sold in packs of 100) Engage Coupler Used for splicing two power cables within an array ET-SPLK-05 (sold in packs of 5) To learn more about Enphase Microinverter technology, 1 enphase- visit enphase.com E N E R G Y 0 2015 Enphase Energy. All rights reserved. All trademarks or brands in this document are registered by their respective owner. MKT -00071 Rev 1.0 NiDfliTc MNPV6 Disco / MNPV6 -250 S�IA�? irk MNPV6-AC Disco Installation W C CM <►a us te intertek MNPV6 Disco Shown with optional circuit breakers The MNPV6 Disco combiner is rated for outdoor use. Designed for combining PV strings up to 150VDC, 120 amps total output with the MNPV6 Disco or 300 VDC, 120 amps total output with the MNPV6-250 Disco, or 240 VAC, 120 Amps per phase with the MNPV6-AC Disco. Applications: • PV combiner up to six strings using MNEPV 150 VDC breakers with the MNPV6 Disco • PV combiner up to three strings using MNEPV 300 VDC breakers with the MNPV6-250 Disco • AC Combiner for up to three strings for use with micro inverters using MNEAC 240 VAC Breakers • DC load center using MNPV breakers Features: • Convenient disconnect handle • All aluminum powder coated housing that won't rust • Flip up cover that can stay in the open position during installation • PV Negative bus bar with 14 useable openings (10 # 14-6 and 4# 1/0- 14) • Chassis ground bus bar with 14 useable openings (10 #14-6 and 4#1/0-14) • Standard din rail to mount up to 6, 150V or 3, 300 Volt breakers • 120 Amp tin plated copper bus bar to combine breaker outputs - bus bar may be split in two • Dead front cover snaps into place after wiring is complete for safety • Knockouts for PV in and PV out on bottom and sides • Top surface is available to bring conduit in from directly above the enclosure MidNite Solar inc 17722-67 th Ave Ne 360-403-7207 Voice Did IRONRIDGE Simplified Grounding For Greater Safety & Lower Cost Traditionally, solar modules are grounded by attaching lugs, bolts or clips to the module frame, then connecting these to a copper conductor that runs throughout the array. This process adds time and cost to the installation, and often results in improper grounding, creating significant long-term safety risks. The IronRidge Integrated Grounding System solves these challenges by bonding modules directly to the mounting rails. This approach eliminates separate module grounding hardware, and it creates many parallel grounding paths throughout the array, providing greater safety for system owners. Integrated Grounding System Grounding Mid Clamp Each Grounding Mid Clamp pierces through the anodized coatings of both the module frame and the mounting rail to form secure electrical bonds, which are repeated throughout the array. 2�T�. Grounding Strap Grounding Straps are used to bond rail -to -rail connections. They are only required on the rail with the grounding lug. 3 Grounding Lug A single Grounding Lug connects an entire row of PV modules to the grounding conductor. Installation Overview 0 Install Roof Attachments • Install appropriate roof flashing and/or standoff for roof type. • Attach L -Feet to flashing or standoff. ® Prepare Rail Connections • Insert splice into first rail, then secure with Grounding Strap and self -drilling screw. • Slide second rail over splice, then secure with opposite end of Grounding Strap and self -drilling screw. ® Mount & Ground Rails • Attach rails to L -Feet and level rails. • Install one Grounding Lug per row of modules. • Connect Grounding Lug to grounding conductor. Q Install Modules & Clamps • Install first module using End Clamps and Grounding Mid Clamps. • Install additional modules using Grounding Mid Clamps. • Finish row with a second pair of End Clamps. Testing & Certification The IronRidge Integrated Grounding System has been tested and certified to UL 2703 by Intertek Group plc. UL 2703 is a proposed UL standard for evaluating solar module mounting and clamping devices. It ensures these devices will maintain strong electrical and mechanical connections over an extended period of time in extreme outdoor environments. The testing process closely mirrors that of UL 1703, the solar module testing standard, including temperature and humidity cycling, electrical and mechanical load testing, and manufacturing quality reviews. e� Module Frame Compatibility Dimension Range A 31.Omm - 51.Omm A B 5.08mm (minimum) Any module frames whose parameters are not listed in the LIL provided table have not been tested for compatibility. The Grounding Clamp has proven robust in grounding 60 -cell and 72 -cell solar module frames with box construction and a range of anodization thicknesses. All solar modules listed to UL 1703 and with frame construction within the parameters stated above are compatible with the IronRidge Integrated Grounding System. OGo to ironridge.com/ig Wireless Residential PV Monitoring Solar -Log° & GE Meter - Highlights Solar -Log 350 & GE Meter Alft Solar -Log" Dashboard Cellular Internet Includes 5 years of cellular data and Solar -Log® WEB online monitoring Contains free subscription to Generaytor social media platform Solar -Log" WEB The market leading Solar -Log° PV monitoring technology integrated into the General Electric's popular residential meter 1-210+; e Simple plug & play socket meter installation, with no on-site configuration o Certified Revenue Grade Metering (RGM) incentive reporting e Compatible with any microinverters and string inverters (240 VAC single phase) e Convenient online plant performance and power meter monitoring via Solar -Logi' WEB e Appealing Solar -Log* Dashboard for presenting plant performance via local or public display e Plant performance visualization via iPhone (iOS) and Android apps e Meteorological satellite data -based performance monitoring Optional: o Building load (self -consumption) monitoring e Inverter direct monitoring of over 80 manufacturers o Powermanagement & Weather station -e ';4 Product comparison Solar -Log 350 Solar -Log 360 Solar -Log 370 ANSI C12.20 Power meter O O O ............................................................................................................................................................ +-0.2% accuracy (RGM) ............................................................................................................................................................ O O O 3G cellular modem O O O ............................................................................................................................................................ 5 year cellular data plan service ............................................................................................................................................................ O O O 5 year Solar -Log"' WEB service ............................................................................................................................................................ O O O 5 year warranty ............................................................................................................................................................ O O O Production monitoring O O d (all inverter types) ............................................................................................................................................................ -40°C - +85°C / -40°F -185°F Voltage ............................................................................................................................................................ +/-20% Consumption monitoring ........................................................................................................................................................... Built in current transformers (CTs), 5 character LCD Display O optional . Direct inverter monitoring ............................................................................................................................................................ 80z Dimensions optional Weather station/sensor ............................................................................................................................................................ optional Inverter Power Management optional Technical Data Solar -Log 350 Solar -Log 360 Solar -Log 370 Datalogger ............................................................................................................................................................ 255850 Solar -Log 360 & GE Meter ............................................................................................................................................................ 3G cellular modem - compatible with AT&T, 3 LEDs for diagnostic ............................................................................ I .................... Solar -Log 370 & GE Meter 1 x RS485 Ethernet 1/0 Solar -Log 10 1 x RS485 (Energy Meter) 1 x RS485/RS422 ............................................................................................................................................................ 2 x 100A CTs Rating ............................................................................................................................................................ 240 V Current Class Class 200 ............................................................................................................................................................ Frequency ........................................................................................................................................................... 60 Hz . Typical Accuracy ............................................................................................................................................................ +/-0.2% Phases 240 VAC single phase ............................................................................................................................................................ Socket Type ............................................................................................................................................................ 2S Starting Watts ............................................................................................................................................................ < 5W Typical Watt Loss ............................................................................................................................................................ 0.7W Operational Temperature ............................................................................................................................................................ -40°C - +85°C / -40°F -185°F Voltage ............................................................................................................................................................ +/-20% Others ............................................................................................................................................................ Built in current transformers (CTs), 5 character LCD Display Enclosure NEMA 3 R Type . ........................................................................................................................................................... Weight ............................................................................................................................................................ 80z Dimensions 6.95" x 6.5" x 7.3" Part number Solar -Log 350 & GE Meter ............................................................................................................................................................. 255850 Solar -Log 360 & GE Meter ............................................................................................................................................................ 255851 . Solar -Log 370 & GE Meter 255852 ............................................................................................................................................................. Solar Data Systems, Inc. • 203-702-7189 • Bethel, CT 06801 • north-america@solar-log.com • www.solar-log.net Subject to change without notice (IPC) Insulation Piercing (Dual Rated) • Kup•L•Tap(R) insulation piercing connector. • Body is molded from tough, resilient glass -filled nylon. • UL 486A/B 90" C Listed and is CSA Certified. • For use with stranded conductor Class B or C • Compact design. • Tin Plated copper contact teeth and pre -filled with silicone lubricant. • Removable end tabs. • Dual Rated for Copper and Aluminum Conductor. • UL File E6207 IPC -4/0-6 2 4/0-4 AWG 6-14 AWG 600 1/2 12 0783669532692 rico 4]30 MADS ROAD ,,NM d 45227 5115334200 006]]697)5 AVIDS-1 OP ID: AC ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE (MW12015 10/08/2015 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(les) 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 Marshall & Diggins Insurance Agency, Inc. 2 Eastern Avenue Worcester, MA 01605 CONTACT Patrick J. Diggins, CIC PHONE FAX A� No F,:508-831-9200 AICNo: 508-831-9209 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Patrick J. Diggins, CIC INSURER A: Hanover Insurance Co 22292 INSURED Avid Solar LLC Russ Aney 789 Wachusett Street INSURER B: INSURER C INSURER D: Holden, MA 01520 INSURER E : INSURER F: 06/19/2015 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD R WVD POLICY NUMBER POLICY EFF MM/DD P UCY EXP MWDD LIMBS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 CLAIMS -MADE � OCCUR OHN9591311 06/19/2015 06/19/2016 AMAGE TO RENTEU-- PREMISES Ea occurrence $ 500,00 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY JE � LOC PRODUCTS -COMP/OP AGG $ 4,000,00 $ OTHER: AUTOMOBILE LIABILITY COEa acciMBINEDdent SINGLE LIMIT $ 2,000,000 BODILY INJURY (Per person) $ A ANY AUTO OHN9591311 06/19/2015 06/19/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident NON -OWNED X HIRED AUTOS fX AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,00 A EXCESS UAB CLAIMS -MADE OHN9591311 06/19!2015 06/19/2016 DEDTX TETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' UABILnY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A WHN9591292 06/19/2015 06/19/2016 X I STATUTE I X ERH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,00 ff yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $ 500,000 A Property Section OHN9591311 06/19/2015 06119/2016 Contents 81,953 Replacement Cost Ded 1,00 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached H more space is required) Operations of Insured: Solar Energy Installation and Repair per policy forms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. 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. 1600 Osgood Street Building 20. Suite 2035 North Andover, MA 01845 AUTHOREED REPRESENTATIVE �! ©1988-2014 ACORD CORPORATION. All rights reserved. Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 172537 Type: LLC Expiration: 7/3/2016 Tr# 255270 AVID SOLAR, LLC. RUSSELL ANEY 789 WACHUSETT STREET HOLDEN, MA 01520 Update Address and return card. Mark reason for change. SCA I Co 2OM-05m ❑ Address ❑ Renewal ❑ Employment ❑ Lost Card �f� �o7�zn�a�zruea�lf a�'C���cr�crc�Tc.�el Office of Consumer Affairs & Business Regulation ME IMPROVEMENT CONTRACTOR egistration: 172537 Type: xpiration: 7!3/2016 LLC AVID SOLAR, LLC. µ RUSSELL ANEY 789 WACHUSETT STRE=ET HOLDEN, MA 01520 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 Not valid without sign a re Avid Solar LLC Owner -Contractor Agreement AGREEMENT made as of the 7th day of October in the year Two Thousand Fifteen BETWEEN the Owner: Eric Peterson 1 Pond Street North Andover, MA 01845 and the Contractor: Avid Solar LLC 789 Wachusett St Holden, MA 01520 Tel. #: (888) 517-3767 MA Master Elec. #: 20566A MA HIC #: 172537, Exp. 07/03/2016 Federal ID #: 61-1685241 for the following Project: 10.530 kW Roof -mounted Photovoltaic System Installation Located at: 1 Pond Street North Andover, MA 01845 Summary Description: The assembly and electrical installation of an 10.530 kW grid -tied, roof - mounted solar photovoltaic system integrated into the existing electrical system serving the building. The Owner has already purchased most of the equipment, including the PV modules and inverters. The Owner is responsible for the Building Permit, and the Contractor will be Responsible for the Electrical Permit and work. The Contractor will purchase the remaining materials required to complete the installation. (see Exhibit A — Scope of Work for additional detail) The Owner and Contractor agree as follows: 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 TABLE OF ARTICLES 1 THE CONTRACT DOCUMENTS 2 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION DATE 3 CONTRACT SUM 4 PAYMENT 5 INSURANCE 6. GENERAL PROVISIONS 7. OWNER 8. CONTRACTOR 9. CHANGES IN THE WORK 10. TIME 11. PAYMENTS AND COMPLETION 12. PROTECTION OF PERSONS AND PROPERTY 13. CORRECTION OF WORK 14. MISCELLANEOUS PROVISIONS 15. TERMINATION OF THE CONTRACT 16. HOME IMPROVEMENT CONTRACTORS AND HOMEOWNER'S RIGHTS ARTICLE 1 THE CONTRACT DOCUMENTS § 1.1 Contractor shall complete the Work described in the attached "Exhibit A — Scope of Work" for the Project. § 1.2 Contractor shall obtain any necessary electrical or construction -related permits required to perform the Work. ARTICLE 2 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION The number of calendar days available to the Contractor to substantially complete the Work is the Contract Time. The date of commencement of the Work shall be the date upon which the Owner makes the initial deposit provided for in Article 3 in this Agreement unless otherwise indicated below. The Contractor shall substantially complete the Work, no later than 90 (ninety) calendar days from the date of commencement, subject to adjustment as provided in Article 9 and Article 10. §2.1 Contractor intends to perform the work in accordance with the attached schedule,"Exhibit B — Project Timeline. Page 2 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 ARTICLE 3 CONTRACT SUM § 3.1 Subject to additions and deductions in accordance with Article 9, the Contract Sum is: Thirteen Thousand One Hundred Fifty Dollars ($13,150.00) ARTICLE 4 PAYMENT § 4.1 Based on Contractor's Invoicing for Payment, the Owner shall pay the Contractor, in accordance with Article 9, as follows: Upon Contract Signing: $6,575.00 (50%) Upon Completion of the Contract and Final Electrical Inspection: $ 6,575.00 (50%) Total Contract Sum $13,150.00 § 4.2 Payments due and unpaid under the Contract Documents shall bear interest from the date payment is due at the rate below, or in the absence thereof, at the legal rate prevailing at the place of the Project. 18 % (eighteen percent) ARTICLE 5 INSURANCE § 5.1 The Contractor shall provide Contractor's general liability and other insurance as follows: Contractor's General Liability Aggregate $4,000,000 Each Occurrence $2,000,000 § 5.2 The Owner shall provide property insurance to cover the value of the Owner's property, including any Work provided under this Agreement. The Contractor is entitled to receive an increase in the Contract Sum equal to the insurance proceeds related to a loss for damage to the Work covered by the Owner's property insurance. § 5.3 The Contractor shall obtain an endorsement to its general liability insurance policy to cover the Contractor's obligations under Section 8.10. § 5.4 Each party shall provide certificates of insurance showing their respective coverages prior to commencement of the Work. § 5.5 Unless specifically precluded by the Owner's property insurance policy, the Owner and Contractor waive all rights against each other and any of their subcontractors, suppliers, agents and employees, each of the other, for damages caused by fire or other causes of loss to the extent covered by property insurance or other insurance applicable to the Work. ARTICLE 6 GENERAL PROVISIONS § 6.1 THE CONTRACT The Contract represents the entire and integrated agreement between the parties and supersedes prior negotiations, representations or agreements, either written or oral. The Contract may be amended or modified only by a written modification in accordance with Article 9. § 6.2 THE WORK The term "Work" means the construction and services required by the Contract Documents, and includes all other labor, materials, equipment and services provided, or to be provided, by the Contractor to fulfill the Contractor's obligations. Page 3 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 § 6.3 INTENT The intent of the Contract Documents is to include all items necessary for the proper execution and completion of the Work by the Contractor. The Contract Documents are complementary, and what is required by one shall be as binding as if required by all. ARTICLE 7 OWNER § 7.1 INFORMATION AND SERVICES REQUIRED OF THE OWNER § 7.1.1 If requested by the Contractor, the Owner shall furnish all necessary surveys and a legal description of the site. § 7.1.2 Except for permits and fees that are the responsibility of the Contractor under the Contract Documents, the Owner shall obtain and pay for other necessary approvals, permits, easements, assessments and charges. § 7.2 OWNER'S RIGHT TO STOP THE WORK If the Contractor fails to correct Work which is not in accordance with the Contract Documents, the Owner may direct the Contractor in writing to stop the Work until the correction is made. § 7.3 OWNER'S RIGHT TO CARRY OUT THE WORK If the Contractor defaults or neglects to carry out the Work in accordance with the Contract Documents and fails within a seven day period after receipt of written notice from the Owner to commence and continue correction of such default or neglect with diligence and promptness, the Owner may, without prejudice to other remedies, correct such deficiencies. In such case, the Contract Sum shall be adjusted to deduct the cost of correction from payments due the Contractor. § 7.4 OWNER'S RIGHT TO PERFORM CONSTRUCTION AND TO AWARD SEPARATE CONTRACTS § 7.4.1 The Owner reserves the right to perform construction or operations related to the Project with the Owner's own forces, and to award separate contracts in connection with other portions of the Project. § 7.4.2 The Contractor shall coordinate and cooperate with the Owner's own forces and separate contractors employed by the Owner. § 7.4.3 Costs caused by delays or by improperly timed activities or defective construction shall be borne by the party responsible therefor. ARTICLE 8 CONTRACTOR § 8.1 REVIEW OF CONTRACT DOCUMENTS AND FIELD CONDITIONS BY CONTRACTOR § 8.1.1 Execution of the Contract by the Contractor is a representation that the Contractor has visited the site, become familiar with local conditions under which the Work is to be performed and correlated personal observations with requirements of the Contract Documents. § 8.2 SUPERVISION AND CONSTRUCTION PROCEDURES § 8.2.1 The Contractor shall supervise and direct the Work, using the Contractor's best skill and attention. The Contractor shall be solely responsible for and have control over construction means, methods, techniques, sequences and procedures, and for coordinating all portions of the Work. § 8.2.2 The Contractor, as soon as practicable after award of the Contract, shall furnish to the Owner the names of subcontractors or suppliers for each portion of the Work. The Contractor shall not contract with any subcontractor or supplier to whom the Owner have made a timely and reasonable objection. § 8.3 LABOR AND MATERIALS § 8.3.1 Unless otherwise provided in the Contract Documents, the Contractor shall provide and pay for labor, materials, equipment, tools, utilities, transportation, and other facilities and services necessary for proper execution and completion of the Work. Page 4 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 § 8.3.2 The Contractor shall enforce strict discipline and good order among the Contractor's employees and other persons carrying out the Contract Work. The Contractor shall not permit employment of unfit persons or persons not skilled in tasks assigned to them. § 8.4 WARRANTY § 8.4.1 The Contractor warrants to the Owner that: a. Materials and equipment furnished under the Contract will be new and of good quality unless otherwise required or permitted by the Contract Documents; b. The Work will be free from defects not inherent in the quality required or permitted; and c. The Work will conform to the requirements of the Contract Documents. § 8.4.2 Warranty on installed equipment is limited to the warranty provided by the equipment manufacturer. § 8.4.3 Warranty on installation services provided by the Contractor is five years. § 8.5 TAXES The Contractor shall pay sales, consumer, use and similar taxes that are legally required when the Contract is executed. § 8.6 PERMITS, FEES AND NOTICES § 8.6.1 The Contractor shall obtain and pay for the inspections necessary for proper execution and completion of the Work. § 8.6.2 The Contractor shall comply with and give notices required by agencies having jurisdiction over the Work. If the Contractor performs Work knowing it to be contrary to applicable laws, statutes, ordinances, codes, rules and regulations, or lawful orders of public authorities, the Contractor shall assume full responsibility for such Work and shall bear the attributable costs. § 8.7 USE OF SITE The Contractor shall confine operations at the site to areas permitted by law, ordinances, permits, the Contract Documents and the Owner. § 8.8 CUTTING AND PATCHING The Contractor shall be responsible for cutting, fitting or patching required to complete the Work or to make its parts fit together properly. § 8.9 CLEANING UP The Contractor shall keep the premises and surrounding area free from accumulation of debris and trash related to the Work. At the completion of the Work, the Contractor shall remove its tools, construction equipment, machinery and surplus material; and shall properly dispose of waste materials. § 8.10 INDEMNIFICATION To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the Owner and employees of the Owner from and against claims, damages, losses and expenses, including but not limited to attorneys' fees, arising out of or resulting from performance of the Work, provided that such claim, damage, loss or expense is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than the Work itself), but only to the extent caused by the negligent acts or omissions of the Contractor, a subcontractor, anyone directly or indirectly employed by them or anyone for whose acts they may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. ARTICLE 9 CHANGES IN THE WORK § 9.1 The Owner, without invalidating the Contract, may order changes in the Work within the general scope of the Contract consisting of additions, deletions or other revisions, the Contract Sum and Contract Time being adjusted accordingly in Page 5 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 writing. If the Owner and Contractor cannot agree to a change in the Contract Sum, the Owner shall pay the Contractor its actual cost plus reasonable overhead and profit. § 9.2 If concealed or unknown physical conditions are encountered at the site that differ materially from those indicated in the Contract Documents or from those conditions ordinarily found to exist, the Contract Sum and Contract Time shall be subject to equitable adjustment. ARTICLE 10 TIME § 10.1 Time limits stated in the Contract Documents are of the essence of the Contract. § 10.2 If the Contractor is delayed at any time in progress of the Work by changes ordered in the Work, or by labor disputes, fire, unusual delay in deliveries, unavoidable casualties or other causes beyond the Contractor's control, the Contract Time shall be subject to equitable adjustment. ARTICLE 11 PAYMENTS AND COMPLETION § 11.1 CONTRACT SUM The Contract Sum stated in the Agreement, including authorized adjustments, is the total amount payable by the Owner to the Contractor for performance of the Work under the Contract Documents. § 11.2 PROGRESS PAYMENTS § 11.2.1 The Owner shall make payment in the manner provided in Article 4, tied to the ordering of materials and the completion of key project phases. § 1.1.2.2 The Contractor shall promptly pay each subcontractor and supplier, upon receipt of payment from the Owner, an amount determined in accordance with the terms of the applicable subcontracts and purchase orders. § 11.2.3 The Owner shall have no responsibility for payments to a subcontractor or supplier. § 11.3 SUBSTANTIAL COMPLETION § 11.3.1 Substantial Completion is the stage in the progress of the Work when the Work or designated portion thereof is sufficiently complete in accordance with the Contract Documents so the Owner can utilize the Work for its intended use. § 11.4 FINAL COMPLETION § 11.4.1 Final completion is the stage in the progress of the Work when the Work is acceptable and the Contract fully performed. ARTICLE 12 PROTECTION OF PERSONS AND PROPERTY The Contractor shall be responsible for initiating, maintaining and supervising all safety precautions and programs, including all those required by law in connection with performance of the Contract. The Contractor shall take reasonable precautions to prevent damage, injury or loss to employees on the Work, the Work and materials and equipment to be incorporated therein, and other property at the site or adjacent thereto. The Contractor shall promptly remedy damage and loss to property caused in whole or in part by the Contractor, or by anyone for whose acts the Contractor may be liable. ARTICLE 13 CORRECTION OF WORK § 13.1 The Contractor shall promptly correct Work reasonably rejected by the Owner as failing to conform to the requirements of the Contract Documents. The Contractor shall bear the cost of correcting such rejected Work, including the costs of uncovering, replacement and additional testing. § 13.2 In addition to the Contractor's other obligations including warranties under the Contract, the Contractor shall, for a period of one year after Substantial Completion, correct work not conforming to the requirements of the Contract Documents. Page 6 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 § 13.3 If the Contractor fails to correct nonconforming Work within a reasonable time, the Owner may correct it in accordance with Section 7.3. ARTICLE 14 MISCELLANEOUS PROVISIONS § 14.1 ASSIGNMENT OF CONTRACT Neither party to the Contract shall assign the Contract as a whole without written consent of the other. § 14.2 TESTS AND INSPECTIONS § 14.2.1 At the appropriate times, the Contractor shall arrange and bear cost of tests, inspections and approvals of portions of the Work required by the Contract Documents or by laws, statutes, ordinances,,codes, rales and regulations, or lawful orders of public authorities. § 14.2.2 If the Owner requires reasonable additional testing, the Contractor shall perform those tests. § 14.2.3 The Owner shall bear cost of tests, inspections or. approvals, including a reasonable charge for the Contractor's efforts, that are required by the Owner or do not become requirements until after the Contract is executed. § 14.3 GOVERNING LAW The Contract shall be governed by the law of the Commonwealth of Massachusetts. § 14.3 DISPUTE RESOLUTION § 14.3.1 If a dispute arises between the parties related to this Agreement or the Work, the parties agree to the following: a. WORK CONTINUANCE AND PAYMENT. The Contractor shall continue the Work during any dispute resolution proceedings. b. INITIAL DISPUTE RESOLUTION. If a dispute arises out of or relates to this Agreement or the Work, the parties shall endeavor to settle the dispute first through direct discussions between the parties' representatives, who shall have the authority to settle the dispute. If the dispute is not settled within seven (7) days from the meeting of senior executives, the parties shall submit the dispute to mediation. c. MEDIATION. The parties shall jointly appoint a mutually acceptable mediator and shall equally bear the costs of the mediation. The parties agree to attend such mediation within sixty (60) days of the service of the request. Prior _ to the mediation, each party shall exchange written submittals communicating each party's respective positions d. ARBITRATION. If mediation is unsuccessful, the parties shall submit the matter to arbitration before a single arbitrator. The Arbitration Service shall be approved by the Massachusetts Office of Consumer Affairs and Business Regulation. The Owner shall be required to submit to such arbitration as provided in MGL c 142A. The arbitrator shall have no authority to award punitive damages. The arbitrator's award shall be final. e. TIIIRD=bstamntiailn S.�TarCt�s agree to consent to the inclusion in any mediation, arbitration or litigation of any third paof ed in a question of law or fact common to a dispute between the parties under this OWNER (Signature) CON R (Signature) Notice: The signatures of the parties above apply only to the agreement of the parti s to alternative dispute resolution initiated by the contractor. The Owner may initiate alternative dispute resolution even when this section is not separately signed by the parties. § 14.4 ATTORNEY'S FEES § 14.4.1 In the event either Owner or Contractor institutes any action, suit or arbitration against the other party, arising under or relating to this Agreement, the prevailing party shall be entitled to recover its reasonable attorneys' fees, experts' fees and costs. Page 7 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 ARTICLE 15 TERMINATION OF THE CONTRACT § 15.1 TERMINATION BY THE CONTRACTOR If the Owner fails to make payment as provided in Section 11.4 for a period of 30 days, the Contractor may, upon seven additional days' written notice to the Owner, terminate the Contract and recover from the Owner payment for Work executed, including reasonable overhead and profit, foregone profits that would have accrued to Contractor had the Contractor completed the Work and costs incurred by reason of such termination. § 15.2 TERMINATION BY THE OWNER FOR CAUSE § 15.2.1 The Owner may terminate the Contract if the Contractor a. repeatedly refuses or fails to supply enough properly skilled workers or proper materials; b. fails to make payment to subcontractors for materials or labor in accordance with the respective agreements between the Contractor and the subcontractors; C. persistently disregards laws, ordinances, or rules, regulations or orders of a public authority having jurisdiction; or d. is otherwise guilty of substantial breach of a provision of the Contract Documents. § 15.2.2 When any of the above reasons exist, the Owner may without prejudice to any other rights or remedies of the Owner and after giving the Contractor seven days' written notice, terminate employment of the Contractor and may a. take possession of the site and of all materials thereon owned by the Contractor, and b. finish the Work by whatever reasonable method the Owner may deem expedient. § 15.2.3 When the Owner terminates the Contract for one of the reasons stated in Section 15.2.1, the Contractor shall not be entitled to receive further payment until the Work is finished. § 15.2.4 If the unpaid balance of the Contract Sum exceeds costs of finishing the Work, such excess shall be paid to the Contractor. If such costs exceed the unpaid balance, the Contractor shall pay the difference to the Owner, however in no case shall Contractor's obligation exceed 10% of the amount identified in Article 4. This obligation for payment shall survive termination of the Contract. ARTICLE 16 HOME IMPROVEMENT CONTRACTORS AND HOMEOWNER'S RIGHTS In the Commonwealth of Massachusetts, all home improvement contractors and subcontractors shall be registered. A homeowner's rights under the Home Improvement Contractor Law (MGL chapter 142A) and other consumer protection laws (i.e. MGL chapter 93A) may not be waived in any way, even by agreement. However, homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights, or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787, (888) 283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/ Page 8of14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787, (888) 283-3757 or visit the HIC website at http://www.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: http://db.state.ma.us/homeimprovement/licenseelist.asp For assistance with informal mediation of disputes or to register formal complaints against a business, call: Consumer Complaint Section Office of the Attorney General (617)727-8400 AND/OR Better Business Bureau (508) 652-4800, (508) 755-2548 or (413) 734-3114 Page 9of14 10.530 kW Rooftop PV System. Peterson - Avid Solar LLC Agreement This Agreement entered into as of the day and year first written.above. This Agreement may be cancelled within 3 days of its signing and acceptance. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES! OWNER (Signature) C TRACTOR October 7, 2015 Eric Peterson, Owner Russell Aney, CEO 1 Pond Street Avid Solar LLC North Andover, MA 01845 789 Wachusett St Holden, MA 01520 MA Master Elec. #: 20566A MA HIC #: 172537, Exp. 07/03/2016 Federal ID #:61-1685241 Page 10 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 EXHIBIT A - SCOPE OF WORK GENERAL DESCRIPTION Installation of a 10.530 kW (dc-stc) solar photovoltaic ("PV") system on the rooftop of the house at 1 Pond Street in North Andover, MA, interconnected to the main electrical service. Contractor will attach 39 Hyundai HiS-S270RG 270 Watt modules to an IronRidge XRS mounting system with S-5! standing seam roof clamps on the roof of the house. Each Hyundai module will be connected to a Enphase Energy M250 Microinverter, mounted on the rail behind each modules, and connected to an Enphase Energy Engage single-phase trunk cable. The Microinverters will be connected in three series strings which will homerun and connect to a MidNite Solar AC Disconnect and Combiner Box mounted in the attic. The output of the combiner will run to the basement to a Contractor -supplied 60 -Amp disconnect, located next to the Main Electrical Service Panel. The output of the disconnect will be wired to a an automated -reporting meter (Solar -Log GE 350 with CDMA cellular reporting) mounted on the exterior of the house, adjacent to the service entrance; the meter will be labeled as a solar production meter. The output of the production meter will be connected to a service -rated, fused, 60 -Amp AC -disconnect mounted on the exterior the house adjacent to the service entrance. This service -rated disconnect will be labeled as the Utility PV AC Disconnect, and its output conductors will run back into the basement where they will be spliced into the service wires before the Main Breaker in the Main Electrical Panel enclosure using insulation -piercing splices. The current electrical service's 200 -Amp Millbank "meter -main" with an exterior main breaker will be replaced with a new meter enclosure (without a Main Breaker), and the grounding electrode conductor will be re-routed to the 200 -Amp Main Electrical Distribution Panel in the basement, just behind and below the utility meter, where the Distribution Panel, currently operating as a subpanel to the exterior Main Breaker, will be wired to make it the Main Panel with the Main Breaker for the building. PERMITS AND APPROVALS Avid Solar will prepare and assist Owner in obtaining, as necessary: • Town of North Andover Electrical Permits & Approvals, including required electrical drawings; • Interconnection Completion Paperwork with National Grid; • Set up of the Solar -Log data acquisition system (i.e., cellular reporting meter); • Registration of the PV system with the Production Tracking System for the Solar Carve Out Program, typically performed by an SREC Broker/Aggregator. Avid Solar will make introductions to several brokers. SYSTEM COMMISSIONING In addition to installing the system, Avid Solar will carefully initiate and commission the system to ensure that all components are performing correctly. This will involve several steps, including: 1. Commissioning the array to ensure that all modules are functioning and interconnected properly, that all electrical connections have been made properly, and that the Enphase Microinverters are connected, configured and operating properly. 2. Demonstration to National Grid and/or the Town of North Andover Electrical Inspector, as necessary, that the system meets the requirements of the Massachusetts Electrical Code and meets all necessary utility interconnection requirements. As a grid -tried (a.k.a., "utility interactive") photovoltaic system that operates in parallel to the utility's electrical distribution system, this may include demonstrating to a utility witness and/or the Electrical Inspector that that the inverter, per UL 1741 specifications, will not produce power when it is disconnected from the utility's electrical service, and that the inverter will not allow the system to restart the generation of AC electricity within 5 minutes of being reconnected to the utility's electrical service. 3. Contractor will install and commission the Enphase Envoy communication system, registering it with the Enphase Enlighten online service. Contractor will also commission the Solar -Log GE350 cellular -reporting production meter with Solar -Log's online monitoring portal. Page 11 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 4. Instruction to the homeowner on how to operate and monitor the PV system via the internet after the system is connected to the internet and registered for online monitoring. ITEMS NOT INCLUDED IN THE SCOPE OF WORK 1. Any upgrades or repairs to the existing electrical service not included in this scope of work. 2. Provision of internet service, including Ethernet wiring or Wi-Fi bridge, required to connect the Envoy with the Owner's broadband internet connection. Page 12 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 EXHIBIT B - PROJECT TIMELINE From the date of Agreement, the timing of the project will be primarily dependent on the availability of materials, the time it takes to receive approvals from National Grid and the Town of North Andover, and weather conditions. After signing this agreement, Avid Solar will work with Owner to prepare your permit packages for the Town of North Andover and place necessary deposits on key material orders. Contractor will also schedule a Work Request with National Grid to disconnect the underground service to the house in order to accomplish the exchange of the current meter main with the new Meter Enclosure and to install the splices in the service wire before the Main Breaker in the Main Electrical Distribution Panel in the basement. The electrical power to the house will likely be off for a full day (8:00a - 4:00p); National Grid typically disconnects the service at the street in the morning, and returns in the afternoon to reconnect the power after the service work has been inspected by the North Andover Electrical Wiring Inspector. Avid Solar will coordinate with the Owner to schedule this temporary power disconnect on a convenient weekday. Please note that while we schedule National Grid's work request in advance, sometimes other emergencies preclude the utility's ability to disconnect the power on the scheduled day, causing an additional delay in the final completion of the project. After the Owner has received the necessary Permitting Approvals from the Town of North Andover to proceed with the project, Avid Solar LLC will schedule a mutually convenient time for the installation of the PV system. The installation work is dependent on favorable weather conditions. Avid Solar LLC cannot work on the roof when there is precipitation. Once installation has started, assuming good weather, the installation may take up to one week, but may take longer given the difficulty of the project and the complementary electrical work required. Avid Solar LLC will need access into the house during the construction period, as well as to perform the required building and final electrical inspections. After passing final electrical inspection, the system cannot be made operational until National Grid has installed a new bi- directional meter. It normally takes less than 3 weeks from the time that National Grid is informed that the system has passed its final electrical inspection to the time that the new bi-directional meter is installed. After it has installed its new meter, National Grid will provide you with a notice (typically an e-mail) authorizing you to interconnect and operate your PV system. The project is complete and final payment is due upon receiving final electrical approvals, and reporting the approval to National Grid to initiate the bi-directional meter installation and the subsequent request for Authority to Interconnect. Upon final payment, Avid Solar will review the operation of your system and provide you with a digital Owner's Manual, including information on all of your system components and all of the incentive programs for which your system qualifies. Avid Solar will also introduce you to qualified SREC brokers/aggregators who will assist you with registering your system with the Massachusetts Production Tracking system and in selling the SRECs you are awarded. After the project is complete and operational, Avid Solar will register your system on the Enphase and Solar -Log monitoring portals, and we will monitor your system's performance through those portals. Page 13 of 14 10.530 kW Rooftop PV System Peterson - Avid Solar LLC Agreement October 7, 2015 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE CONTRACTOR OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE CONTRACTOR AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE CONTRACTOR REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE CONTRACTOR'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE CONTRACTOR AND THE CONTRACTOR DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE CONTRACTOR, OR IF YOU AGREE TO RETURN THE GOODS TO THE CONTRACTOR AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO: Avid Solar LLC 789 Wachusett St Holden AU 01520 NOT LATER THAN MIDNIGHT OF (date). I HEREBY CANCEL THIS TRANSACTION. Date: Owner's Signature: Page 14 of 14 Datel..6-��J.Ij ..... ...... ..... .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING " t q I\j ee Thiscertifiesthat��.4�.��.�g.l.et-�1.0- b��4�4 � 4 - ....... ................. has permission to perform J�).a ................................. wiring in the building of ........ ... ... ........................................................................... at ......... P .................................. o hAndoverMass. Fee.A(Ocn ....... Lic. No. ... ...... ... ............. ........ ..... ... .... ... �L CTR'I'C'*' N S P*E"C*'* "R* Check # ip V" Commonwealth of Massachusetts Department of Fire Services 5w �Y 1 BOARD OF FIRE PREVENTION REGULATIONS official Use Only Permit No. 7iU Occupancy andeF e Checked [Rev. 11/991 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 5„27 CMR)2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: `/ p-`� `/ y City or Town of: <rkZ2)� Ab011�^ - To the Inspector of Wires: C By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) PQ/u Owner or Tenant E= JC— 67&U0 Telephone No. 17."51 Z- 6I5S Owner's Address / _pOPit) �iT' , A Ac o Is this permit in conjunction with a building permit? Yes [- No ❑ (Check propriate Box)1 �, No. of Recessed Fixtures f Building ��S 1€ N4s� Purpose o11 Utility Authorization No. No. of Lighting Outlets Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. o 3 New Service 7,CaJ Amps ) / 7J�/ QVoits Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity No. of Detection and r Location and Nature of Proposed Electrical Work: --nC- -[-D667)+t?(- ^ (/1410)v4A'Z -4�, � Afz4of I t3 S121Z\Ji!L l,S'ZAu.. U, 6U, C �x,y► � I Number Tons C 1-- of the follow' table may be waived bv the Inspector of Wires. - INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 391 BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: i (vl 0Q�� (When required by municipal policy.) Work to Start: 1 i I (. I l I Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete - FIRM NAME: S L A S IS Zf�Q L LIC. NO.: Licensee: (1, S'i�?rfiyL S�'l1 + ''� Signature ` C. N . 90-A (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: r� _g ' 3 Address: % Q L Alt. Tel. No.: OWNER INSURANCE WAIVER: I tim aware th t the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent I PERMIT FEE: $ Nob -- Signature Telephone No. om e No. of Total No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. ❑ rnd. oo mergency tg tmg Baite Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices Heat Pump I Number Tons KW No. of Self -Contained No. of Waste Disposers Totals: Detection/Ale rtin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connectton Heating Appliances KW Security Systems: No. Devices or Equivalent No. of Dryers of No. of Water, Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or E uivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent OTHER: _--.._..1 r .,.a *f',1 '4 nrepaired by the InsDector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 391 BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: i (vl 0Q�� (When required by municipal policy.) Work to Start: 1 i I (. I l I Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete - FIRM NAME: S L A S IS Zf�Q L LIC. NO.: Licensee: (1, S'i�?rfiyL S�'l1 + ''� Signature ` C. N . 90-A (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: r� _g ' 3 Address: % Q L Alt. Tel. No.: OWNER INSURANCE WAIVER: I tim aware th t the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent I PERMIT FEE: $ Nob -- Signature Telephone No. r `� ��- The Commonwealth of Massachusetts Department oflndustriglAccidents Office of Invesilgations 600 Washington Street Boston, MA. 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectriciansfPlumbers Applicant Information Please Print Legibly Name (Business/Orgmization/individual): S yLI/��S inn �—t'tZ-Z U Address: // 6 2r Z -A IC R/ i e-) Avg City/State/Zip: D (L•4-ckj-1 , 1 k ^' () i Y" Phone #: g -n - 9 V•} — � Y Are you an employer? Check the appropriate box: Type of project (required): 1 I employer with . am a em P Y 4. ❑ I am a general contractor and I 6. �ew construction ` _ employees (fall and/or part-time).* 2. ❑ I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. T 7• E] Remodeling ship and'have no employees These sub -contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. F1We are a corporation and its 10. F1 Electrical repairs or additions required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL 11. F1 Plumbing repairs or additions myself. [No workers' comp. C. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' 13. [1 Other comp. insurance required.] "Any applicant that checks box#1 must also fill outthe section bel6w showing their workers' compensation policy information. i -Homeowners who submit this affidavit indicating they a -re doing all work and then hire outside contractors must submit anew affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. A l n Oji �A � Policy # or Self -ins. Lic. #: �}l�-> C— �/y —� Z g Expiration Date: ��'►-�i Job Site Address: 1, Popo Si Pity/State/Zi p: /J, 0 ANI j�) VMVLA Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a finebp to $1,500.00 and/or one=year imprisonment, as wellas civilpenalties in the form of a STOP -WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido lzereby cert derthe a�ndpenaltles ofperjury that the information provided above is true and correct. Phone #: /w —9 (q-3 Y try Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, - express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a•deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employes." MGL chapter 152, §25C(6) also states that "every state or Ideal licensing agency shall withhold the issuance or renewal ofa license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced. acceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permithicense applications in any given year, need only submit one affidavit indicating current policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Co nomealth of M•assa.,chv°setts Department of Jufttrial Accidents (office of Investigations 600 Wa$hiu&n Street Boston MA 021.1.1. Tel. # 617-727-4900 ext 406 ox 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.ma.agovldia 10397 This certifies that ......... P.. j � .................. has permission to perform Date ... �.;;- 1 -1111 ........................ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING C -, r�-\ �, �,� k .................... k ................. 1-�Evlj v\0vN&-C- .................................................................... ^ r, plumbing in the buildings of ....... at....... t ........ ...... F e Lic. No. Check # 19S3 F- & k C , r L-- I i-� o— ........................... NorthAndover, Mass. .................. .................... �QN MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY . __.. .�__.....�_-- - -.--_ MA DATE _._.(� (_�... �. _ PERMIT # JOBSITE ADDRESS _ s�Q OWNER'S NAME POWNER ADDRESS ----I___-- -- ;_h.. _ _._.__sS ------_—___ __ TEL (�1�-_,_"_�F TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL Q RESIDENTIAL Ef PRINT � CLEARLY NEW: LJ RENOVATION: ( REPLACEMENT: PLANS SUBMITTED: YES�j1 NO( FIXTURES Z FLOOR—► BSM I 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 10 1 11 1 12 13 1 14 CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR iiNTEF [M -f i I W W I FMW NOFW—WK W.WIW�SHOWER STALLi ,GERVICE I MOP SINK _� . FM (Mi00�FW—F �[�__IMI�� �[l�MI OTHER I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES [0 NO D. i IF YOU CHECKED YES, PLEASE INDICATE TH TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY BOND _._. (!1 OWNER'S INSURANCE WAIVER: i am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. .__i SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER 0 AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be"mpli nce wi all Pertinent provt f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME 6CA -.- l ......_. bye.... _ . -. -_._ ...._i LICENSE # �? _ .... SIGMA RE NIP[, JP --i CORPORATIONE141=PARTNERSHIP[I# LLCD COMPANY NAME ADDRESS -_C. je dee e CITY ----- A 5kA---` STATE ZIP--(�_©��- TEL FAX �� CELL �o : -7fffl EMAIL e DU ` D^� 6.� Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 306,875.00 m $ - $ 3,682.50 Plumbing Fee $ 460.31 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 460.31 Total fees collected $ 4,703.13 1 Pond Street 151-15 on 8/14/14 New Single Family Home M ,r Ll"C' -ff C�(Zqlf it • � .• ' The Commonwealth of Massae useits Department of Industrigl Accidents Office of Investigations 600 Washington Street Boston, MA 02111 klip www.massgov/dia Workers' Compensation Insurance Affidavit: SuRders/Coniractoxs/ElectriciansIPlu nbexs Inv........ 'D.,i..b T nrAIJ, .M .UUUUt, Name (Business/Organization/tn.dividual): be Address: C ere, City/Sfaieaip: I /`Y Phare #� G 3c Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4• ❑ I am a general contractor and I mployees (full and(or parte part-tim )e)e * have liiredthe, sub -contractors listed on the attached sheet. 2. 1 am a sole proprietor or partner- ship an&have no employees These sub -contractors have working .for me in any capacity. workers' comp. insurance. 5. E]We area corporation and its [No workers' comp. insurance officers have exercised their required.] 3. El am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c.152, § 1(4), and we have no employees. Wo workers' insurance required.] i comp. insurance required.] r;XTojX0wC ect (required): onstruction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.[] Electrical repairs or additions 11.[] plumbing repairs or additions 12. Q Roof repairs 13.❑ Other *Any applicant that checks box#1 must also fill outthe section below showing their workers' compensation policy information. i -Homeowners who submit this affidavit indicating they s're doing all work and then hire outside contractors must submit anew affidavit indicating such. TContractors that checkthis box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. X am an employer that is•providing workers' compensation insurance for my employees. Below is the policy and jolt site information. Insurance Company Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: 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 Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one=year imprisonment, as wellas civil penalties in the form of a STOP WORK ORDER and a fine of -up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office -of Investigations of tho DIA for insurance coverage verification. X do hereby the information provided aho is true and correct. bat: 1ple/ /_4 Official use only. Do not write in this area, to he completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of health ,),. Building Department 3. City/Town. Clerk d. Electrical Inspector 5. Plumbing inspector 6. Other - �� Contact Person: Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,• express or implied, oral or written." An employer is defamed as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a: deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not b ecause of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political sub div cions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addresses) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If au LLC or LLP does have employees, a policy is required. De advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please tail the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom . of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be score to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple p ermit/lic ens a applications in any given year, need only submit one affidavit indicating current policy information (ifnecessary) and under "Job Site Address" the applicant shouldwrite "all locations iu (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year. 'There a home owner or citizen is obtaining a license ox permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone anal fax number: Tho CaMMoxIweafth ofWtassachvsetts Dopadment of WwWal ,A,coldexita Off toe of'Westigat ions 60Q Waftgtoa Stxea Boston, MA. 02111 TO, # 617-7-2.' -4900 QA. 406 or 1-877- iASSA`F, Revised 5-26-05 Fax# 61M27-7749 www.�ass,gav�d�a.