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Miscellaneous - 11 DANA STREET 4/30/2018
11 DANA STREET 210/015.0-0053-0000.0 1 f� k ' Date......7... ................... OF AORT#1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING ss�c'4u This certifies that .. .... ........................................................................................................ Voof 6c) PA—As haspermission to perform ...........................................4.............................................................. wiring in the wilding of............ CJ ........................................................................................... at ......JA......... ................................................I North Andover,Mass. Fee Lic.No� ky. ,"*"*-'' ''*"* -**'*hLECTRCINSPECTOR Check# 01 y Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit Number I A CP �1 1 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (Leave Blank) 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: 12/8/2015 City or Town of: North Andover To the inspector of Wires By this application the undersigned gives notice of their intention to perform the electrical work described below. Location(Street&number) 11 Dana St Owner or Tenant Heather Rowe Telephone No. 978.836.0103 Owners Address Is this permit in conjunction with a building permit? YES ® NO❑ (Check appropriate box) Purpose of building Utility Authorization No. Existing service Amps Volts Overhead❑ Underground ❑ No.of meters New service Amps Volts Overhead ❑ Underground ❑ No.of meters Number of Feeders and Ampacity Location and nature of Proposed Electrical Work: Install 28 solar panels on existing roof. System size of 7.14 kW Completion of the following table may be waived by the Ins ector of Wires No. of Recessed Luminaires No.of Ceil.-susp. (paddle)fans No of Total Transformers KVA _ No. of Luminaires Outlets No of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above❑ Below❑ No.of Emergency Lighting Battery units No. of Receptacle Outlets No. of Oil Burners Fire Alarms Number of zones No.of Switches No. of Gas Burners No.of Detection and Initiating devices No.of Ranges No.of Air Total No.of Alerting Devices Cond. tons No. of Waste Disposers Heat pump Number Tons KW No.of self Contained Detection/Alerting 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 KW No. of No.of Data Wiring: Heaters I signs Ballasts No.of devices or Equivalent No.Hydro massage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of devices or Equivalent Other: SOLAR INSTALL 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): 07/23/2016 Estimated Value of Electrical Work $10,000 (When required by municipal policy) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC rule 10.And upon completion. 1 certify,under the pains and penalties ofperjury,that the information on this application is a and co lete. Firm United Solar Associates LLC l f/ic.' Name: ��' - No.: Licensee: Dan McGrathSignature: � ,� .No.: 20616A c (If applicable,enter"exempt"in the license number.line) City of Leominster contractor No. Bus. Tel..NO.: 855-786-1776 Address: 452 Pleasant Street, Second Floor,Malden,MA 02148 Alt.Tel..No.: * Security System Contractor License required for this work:If applicable,enter license number here Llc.NO.: Owner's Insurance waiver:I am aware that the licensee does not have the liability coverage I am the(check one)Owner❑ Owner's Agent❑ normally required by law.By my signature below I hereby waive this requirement Owner/Agent Telephone Signature Number Permit Fee: $ 1 2 3 4 5 ELECTRICAL KEY: MODULE ELECTRICAL SPECIFICATIONS INVERTER 1 SPECIFICATIONS (28)Trina Solar TSM-255 PD05.05 SOLAREDGE SE760OA-US BREAKER SHORT CIRCUIT CURRENT(Ise): 8.88 RATED WATTS(EACH): 7600 SWITCH OPEN CIRCUIT VOLTAGE(Vm): 38.1 AC OPERATING VOLTAGE(V): 240 SCREW TERMINAL OPERATING CURRENT(IMP): 8.37 AC OPERATING CURRENT(A): 32 m FUSE OPERATING VOLTAGE(VMP): 30.5 NUMBER OF MOOT CHANNELS 0 • SPLICE MAX SERIES FUSE RATING: 15 INVERTER EFFICIENCY: 0.975 EARTH GROUND STC RATING: 255 INTEGRATED DC DISCONNECT !77 CHASSIS GROUND PTC RATING: 232 INVERTER I INPUT SPECIFICATONS ——— GEC DESIGN CONDITIONS NOMINAL CURRENT PER STRING(Intim): 87.31.7 EGC HIGHEST 2%DB DESIGN TEMP("C): 32 NOMINAL VOLTAGE(VnOM): 350 MIN.MEAN EXTREME ANNUAL DB(°C): -18 MAX SYSTEM VOLTAGE(Vmax): 500 A MAX CURRENT PER STRING(Imax): 15 A MAX INPUT CIRCUIT CURRENT(Imax): 30 200A MAIN BREAKER (3)#8 THWN-2 (3)#8 THWN-2 (3)#8 THWN-2 (4)#10 PV-Wire (4)#10 THWN-2 (1)#8 GEC (1)#8 GEC (1)#8 GEC (1)#10 EGC (1)#10 EGC 3/4"EMT 3/4"EMT 3/4"EMT FREE AIR 3/4"EMT METER AC DISCONNECT, (E)LOADS (N)SE760OA-US 60AMP, INVERTER W/INTEGRATED NON-FUSIBLE, E LOADS DC DISCONNECTS CUTLER-HAMMER, ( ) DG222UR6 (E)200A GE MSP 1 STRING OF + LOCUS 40A 2P 12 MODULES C �- UT METER B OPT.CURRENT=8.74A DC OUTPUT LOAD LINE ————————— _________ -------- --- --- - - -- -- ----..... --------- - -------- B 1 STRING OF + C 16 MODULES D OPT.CURRENT=11.66A INVERTER GEC IRREVERSIBLY SPLICED TO EXISTING GEC OR BONDED DIRECTLY TO EXISTING GROUNDING ELECTRODE (IF APPLICABLE) MIN.NEMA3R UL LISTED JUNCTION BOX WITH 90"C TERMINAL RATINGS LOCATED ON ROOF C C Inom=(16 x 255W)/350V=11.7A CONDUIT ELEVATION:1/2 TO 3-1/2"=22°C 28 MODULES TOTAL OPERATING VOLTAGE=350VDC(REGULATED) HIGH AMBIENT TEMPERATURE:32°C 28 x 232(PTC WATTS)x 0.975=6334 CEC WATTS CUSTOMER INFORMATION: EXTREME LOW:-18°C HEATHER B ROWE 200 x 1.2=240 ROOFTOP AMBIENT TEMP(Tcorr):54"C=0.76 SE760OA-US MAX OUTPUT CURRENT=32A 240-200(MCB)=40A CONDUIT FILL(Cfill):0.8 BREAKER SIZE=32A x 1.25=40A=>40A 11 DANA STREET MAX ALLOWABLE AC PV BREAKER=40A NORTH ANDOVER,MA 01845 CONTINUOUS USE=Imax'1.25=15A (978)836-0103/#2154102 CONDITIONS OF USE=[max/Tcorr/Cfill =15A/0.76/0.8=24.67A CONDUCTOR SIZE FOR 24.67A DESIGNED BY: REV#: DATE: INSTALLATION SHALL USE MIN.#10 AWG VALID.B 0111/24/151PV-3.0 SUNDEVITYINC.SBFRANKUNSTSUTE310OAN D. N60T BYMGREINER O"m:—Lonlbn:Raw-315.103 SVl Slat Size:11.17 THESE DRAWINGS,SPECIFICATIONS,AND DESIGNS ARE THE PROPERTY OF SUNOENTY INL.NOPART SHALLSECOETWOR USED FOR ORMTHANYOTHERMEXOTHER THAN THESPECIFICPROJECTFOR—THEY NAVE BEEN DEVELOPEDWmH3UTOUR—TTENCONSEHT I r i Do uSign Envelope ID: 133D4B 1 B-4241-49AA-A339-4BE404BADF30 • sunrun` EXHIBIT A SOLAR FACILITY ADDENDUM CONTRACT P87A1VR1AAARKE1 THIS SOLAR FACILITY ADDENDUM CONTRACT("Addendum")is made by and between Sunrun Inc.("Sunrun")and Sungevity,Inc.("Contractor")for the design,engineering,procurement,installation,and construction of the Solar Facility described herein.This Addendum hereby incorporates, in total,the terms and conditions set forth in the Master Solar Facility Turnkey Contract("Contract"),and all schedules and exhibits thereto,executed by Sunrun and Sungevity,Inc.in March 10,2014.Capitalized terms contained herein have the meanings set forth in the Contract. SOLAR FACILITY TOTAL SOLAR CUSTOM Contract Price:$25,311.40 Host Customer:Heather B Rowe Street Address:11 Dana St,North Andover,MA,01845 Rebate Level:$0.00 per watt Utility:National Grid TECHNICAL SPECIFICATIONS System Size i i Description Rating Standard Test Condition Direct Current(STC DC kW) 6.885 CEC Alternating Current(CEC AC kW) 6.155 Generation Equipment Photovoltaic collectors Manufacturer Model number STC DC rating Quantity Array 1 Trina Solar TSM-255PD05.05 255 W 15 Array 2 Trina Solar TSM-255PD05.05 255 W 6 Array 3 Trina Solar TSM-255PD05.05 255 W 6 Inverters Manufacturer Model number Efficiency Quantity Array 1 SolarEdge Technologies SE6000(240V)w/-ER-US or 0.975 1 A-US Array 2 SolarEdge Technologies SE6000(240V)w/-ER-US or 0.975 1 A-US Array 3 SolarEdge Technologies SE6000(240V)w/-ER-US or 0.975 1 A-US Total Number of Panels: 27 Total Number of Inverters: 1 Meter Information Meter Description Manufacturer Meter selected from approved vendor list provided by Sunrun. Model number Meter selected from approved vendor list provided by Sunrun. 09/29/2015 P87A1VR1AAARKE1-H(Custom PPA Fixed) Page 1 of 2 DocuSign Envelope ID: 133D4B1B-4241-49AA-A339-4BE404BAD F30 sunrurt EXHIBIT SOLAR FACILITY ADDENDUM CONTRACT SOLAR FACILITY DESIGN DIAGRAMS Attach the single-line diagram and aerial-view module layout for the Solar Facility to this document. ASSIGNMENT When transfer of the title to the Work occurs pursuant to the Contract,title to the Work shall be transferred to the Person("Assignee")designated in Exhibit A-1. MISCELLANEOUS Neither this Addendum,nor the Contract,creates any employment,agency,partnership,joint venture or other joint relationship between the Parties. Should a conflict arise between the terms of this Addendum and the terms of the Contract that cannot be reconciled,the terms of this Addendum shall govern;provided,however•agreement on a conflicting term in this Addendum shall not operate to modify the conflicting term in the Contract for future addenda executed between the Parties.This Addendum may be executed in counterparts,each of which will be deemed an original,but all of which taken together will constitute but one and the same instrument. SUNRUN INC. SUNGEVIfY,INC. 5 Docu Signed by: DocuSig/n�ed by: t 73FE783DCW41D... Signature ig!WRW8068441 E... John Machulak Zak Federer Name Name Sunrun Operations Authorized Agent Title Title 10/29/2015 I 9/29/2015 Date Date i i i i I I 09/29/2015 P87A1VR1AAARKE1-H(Custom PPA Fixed) Page 2 of 2 com r ..rOF ti rAnnor • w 411 OEM " ELECTRICIANS , Si280$ ISSUES THE FOLLOWING LICENSE AS A-REG JOURNEYAAN ELECTRICIAN 'Moss Mh ' _ -- DANIEL J MCGRATH IB.rATH = ST 114 BOYLSTON "1MALMiiorLi MA N1 , s 00*OW2 Our V.*Iw MALOEN MA 02148-7931 - - lip _ 1146 B 01/31/16 MassathUSMS -I?epartmcnt Of Pub11C Safety Board of Building Reguiatio�s and Standard1l _ = 4 4,n%trueu,+n Sal r%i",r 1 4 Z F sn'tt% LICeITIM:C SFA-404 IS " Tftwda�trraaleysstlrrlrMrrillM�ss srrMasM�• DAN LJ MCGRATH WWII I SDrlr 114 BOYLSTON St MALOEN MA OR48 , DWddMbGrw% r..G•• ,�,,,, Expiration Keft M.PratdwVMt swwn Commsssionet Ogt1!lJ�O1iI � tltsrwst>rss—ems«MOM ICsirssss�erisl trnrroffwrf"1111f r�^��rx+rrr rr rlY, ffiee or Consumer etamer Arr"ira do Budges"IteeulsHea ME IMPROVEMENT CONTRACTOR ELECTRICAL UNLIMITED fOURNEYPERSON �e®rstf"On: 168524 Type: DANIEL)MCGRATH Mention: sm2on Individual 114 BOYLSTON ST DANIEL MCGRATH MALDEN,MA 02148-7931 ` DANIEL MCGRATH F AEG RO EFFECTIVE 114 BOYLSTON ST MALN,MA 02148 `* �� •_�' I LC.01 E2 20/.01/2014 09/30/2015 tladeraecreury ( ONEOSTATE OF CONNECTICUT r: STATE OF MAINE oEPr olr pxa�atoNr�L t�uNc�Ac t+�cl>w►T�u E1.,EC'I'P.ICAL UN1.RITEn C,0 NTRACTOR ' Ems"Ex mwol BOM DANIF,L) MCGRATH LICENSE#M66002M ltd BOYLSTON ST ' NIALDEN,NIA 027148-751 DANIEL MCGRATH MASTER ELECTRICIAN G'N0. �CTIGIA exP�� c EL(_0?.01855-E1 08131/2015 0/30/2016 18$UED Auq Z8,2043 EXPIRED Aup 31,2015 Sry���111 hNE) _ _ TSM-DC05A.05 Honeyv IN BLACK DIMENSIONS OF PV MODULE TSM-DC05A.05 ELECTRICAL DATA @ STC TSM-250 TSM-255 TSM-260 TSM-265 DC05A.05 DC05A.05 DC05A.05 DC05A.05 941 mm Peak Power Watts-PMAx(Wp) 250 255 260 265 Power Output Tolerance-PMAx(%) 0/+3 0/+3 0/+3 0/+3 uNcrroN o BOX Maximum Power Voltage-VMPP(V) 29.8 30.1 30.2 30.6 NAMEPLATE o Maximum Power Current-IMPP(A) 8.38 8.48 8.61 8.66 a�9z -Voc(V)NALLpenrcuVoltage 38.1 38.2 38.4 38.5 INGHOLE Short Circuit Current-Isc(A) 8.91 8.98 9.15 9.20 3 Module Efficiency rim(%) 15.3 15.6 15.9 16.2 E STC:Irradiance 1000 W/m',Cell Temperature 25°C,Air Mass AM1.5 according to EN 60904-3. E Average efficiency reduction of 4.5%at 200 W/m'according to EN 60904-1. 0 0 3 3 ELECTRICAL DATA @ NOCT TSM-250 TSM-255 TSM-260 TSM-265 DC05A.05 DC05A.05 DC05A.05 DC05A.05 Maximum Power-PMAx(Wp) 183 186 190 194 6043 GBOIINDING HOLE Maximum Power Voltage-UMPP(V) 26.9 26.9 27.0 27.2 17-011AIN HOLE A A Maximum Power Current-Imp,(A) 6.89 6.93 7.04 7.13 Open Circuit Voltage-Uoc(V) 33.8 34.6 34.8 35.0 L Short Circuit Current-Isc(A) 7.14 7.20 7.34 7.40 812mm 180 NOCT:Irradiance at 800 W/m°,Ambient Temperature 20°C,Wind Speed 1 m/s. Back View MECHANICAL DATA Solar Cells Monocrystalline 156 x 156 mm E Cell Orientation 60 cells(6 x 10) Module Dimensions 1650 x 992 x 35mm Weight 18.6 kg 35mm I A-A Glass High Transparency Solar Glass 3.2 mm Backsheet Black Frame Black Anodized Aluminium Alloy I-V CURVES OF PV MODULE TSM-255 DC05A.05 J-Box IP 65 rated Cables Photovoltaic Technology Cable 4.0 mm',1000 mm to.- 1 W m Connector Original MC4 9.0D 8.. m 740 s- TEMPERATURE RATINGS MAXIMUM RATINGS U a.- Nominal Operating Cell 44°C(±2°K) Operational Temperature -40 to+85°C 3.. Temperature(NOCT) 200w/m' 2.W Maximum System 1000V DC(IEC) 1 m Temperature Coefficient of PMAx 0.41%/°K Voltage 000 Temperature Coefficient of Voc -0.32%/°K Max Series Fuse Rating15A 20.00 30.- 40.- Voltage(V) Temperature Coefficient of Isc 0.053%/°K WARRANTY 10 year Product Workmanship Warranty CERTIFICATION 25 year Linear Power Warranty IEC61215/EN61215 IEC61730/EN61730 (Please refer to product warranty for details) IEC 627162 PIG 1917/05.11 IEC 61701 DIN EN 60068-2-68 LC2 MCS BBA 0016 0 h , 'Lit PACKAGING CONFIGURATION . N;;. Modules per box:29 pieces z t' C e -� Modules per 40'container:812 pieces E; P1l fYCLE � \a �i'G'o� solar CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. ©2013 Trina Solar Limited.All rights reserved.Specifications included in this datasheet are subject to change without notice. Smart Energy Together solar=ss Single Phase Inverters for North America SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ SE760OA-US/SE1000OA-US/SE1140OA-US SE3000A-US SE380OA-US I SE5000A-US I SE6000A-US I SE760OA-US I SE10000A-US I SE1140OA-US OUTPUT Nominal AC Power Output 3000 3800 5000 6000 7600 9980 @ 208V 11400 VA ........................................... ................ ............... ................. ................ ................ . .................. ........... Max.AC Power Output 33004150 5400 @ 208V 6000 8350 10800 @ 208V 12000 VA ........................................... ................ ........ 5450 240V 10950 240V AC Output Voltage Min:Nom:Max.11i 183-208-229 Vac - - � - - � - . ............................. . ......... ................ ............... ................. ................ ................ .................. .................. ........... AC Output Voltage Min:Nom:Max!') 211 240-264 Vac . AC Frequency Yin. -Max_(t) 59.3-60-60.5(with Hl country.setting 57:60-60.5) Hz .. f A Maxi4 6 .Continuous Output Current...... .....12.5......1......16......1..21.( .240V...1......25.......I......3�......I...42.@240V...1......475....... ....A..... GFDI Threshold 1 A ........................................... .......................................................................................................................... ........... Utility Monitoring,Islanding Protection,Country Configurable Thresholds Yes Yes INPUT Maximum DC Power(STC) 4050 5100 6750 8100 10250 13500 15350 W ........................................... ................ ............... ................. ................ ................ .................. .................. ........... Transformer-less,Ungrounded Yes Max.Input Voltage 500 Vdc ....................... 325 @ 208V/350 Vdc @ 240V....... .............. .... ......... . . .. . .. . 16.5 @ 208V 33 @ 208V Max.Input Current(2) 9.5 13 18 23 34.5 Adc ' ................. . 15 5Ad 240V.. ................ ............... 3.0. Ca 240V.. .................. ........... . Max.Input ShortCircuit Current 45 Adc ..Reverse-Polarity.Protection............ . .........................................................Yes......................................................... ................ . .................. .. .. Ground-Fault Isolation Detection 600kQ Sensitivity . ........................................... ................ ............... . . . ................ .................. .................. . Maximum Inverter Efficiency 97.7 98.2 98.3 98.3 98 98 98 ............................. ........... .............. .97.5 @ 208V. ................ ............. ...97 @ 208V... .............. ......... CEC Weighted Efficiency 97.5 98 9$.�°.240V 97.5 97.5 97.5 % ........................................... ................ ............... .. .. ................ ................ ....S @,240V.. .................. ........... Nighttime Power Consumption <2.5 <4 W ADDITIONAL FEATURES Supported Communication Interfaces RS485,RS232,Ethernet,ZigBee(optional) ........................................... ..................................... ........... Revenue Grade Data,ANSI C12.1 Optional(') ........................................... ............................................. ....................................... ...................... ........... Rapid Shutdown—NEC 2014 690.12 Functionality enabled when SolarEdge rapid shutdown kit is installed STANDARD COMPLIANCE Safety.................................• ..........._...__.. ....................UL1741:U L16998,U L1998:CSA 22:2 ........................................ ........... Grid Connection Standards IE E1547 ........................................... ........................................................P................................................................. ........... Emissions FCC art15 class B INSTALLATION SPECIFICATIONS AC output conduit size/AWG ran a 3/4"minimum/16-6 AWG 3/4"minimum/8-3 AWG �.... . .................................................. ..............g..... ........... DC input conduit size/#of strings/ 3/4"minimum 1-2 strings AWG ran a 3/4"minimum/1-2 strings/16-6 AWG . .........&.............................. .................................................................................... .............14.-6 AWG............. - Dimensions with Safety Switch 30.5 x 12.5 x 7.2/775 x 315 x 184 30.5 x 12.5 x 10.5/ in/ ... ................ ............ ...........(HXMW................................ ................................I................................................... ..........775 x 315 x 260 mm ................. ........... Weight with Safety Switch 5.1.2./.23.2.......... .................... 54.7/24.7 88. ..4. .40..1............. . Ib. /.kg . ... . .... ........... . . . . .. . .. . Natural convection Cooling Natural Convection and internal Fans(user replaceable) fan(user ........................................... ................................................................... replaceable), ..................................... ........... Noise25 50 dBA .................................. . . ............................... . ............................ ........... Min:Max.Operating Temperature -13 to+140/ 25 to+60(40 to+60 version available)')) F/°C Rang?................................... .......................................................................................................................... ........... Protection Rating NEMA3R . ................. ....................... .......................................................................................................................... ........... (rl For other regional settings please contact SolarEdge support. t (Z)A higher currensource maybe used;the inverter will limit its input current to the values stated. (')Revenue grade Inverter P/N:SE—xA-USOOONNR2(for 7600W inverter:SE7600A-US002NNR2). (°)Rapid shutdown kit P/N:SE1000-RSD-Sl. (s)-40 version P/N:SExxxxA-USOOONNU4(for 7600W inverter.SE7600A-US002NNU4). sunsaEc ROHS SolarEdge0 SolarEdge Technologies,Inc.All rights reserved.SOLAREDGE,the SolarEdge logo,OPTIMIZED BY SOLAREDGE are trademarks or registered trademarks of Technologies, IRONRIDGE Roof Mount System xR Rails -- -- — - XR10 Rail XR100 Rail XR1000 Rail Internal Splices(Q A low-profile mounting rail The ultimate residential A heavyweight mounting All rails use internal splices for regions with light snow. solar mounting rail. rail for commercial projects. for seamless connections. 6'spanningcapability 8'spanningcapability 12'spanningcapability Self-tapping screws Moderate load capability Heavy load capability Extreme load capability Varying versions for rails Clear&black anod.finish Clear&black anod.finish Clear anodized finish Grounding Straps offered Attachments Flash Foot Slotted L-Feet Standoffs Tilt Legs Anchor,flash,and mount Drop-in design for rapid rail Raise flush or tilted Tilt assembly to desired with all-in-one attachments. attachment. systems to various heights. angle,up to 45 degrees. • Ships with all hardware High-friction serrated face Works with vent flashing Attaches directly to rail IBC&IRC compliant Heavy-duty profile shape Ships pre-assembled Ships with all hardware Certified with XR Rails Clear&black anod.finish 4"and 7"Lengths Fixed and adjustable Built for solar's toughest roofs. Clamps&Grounding Iron Ridge builds the strongest roof mounting system in solar.Every component has been tested to the limit and proven in extreme environments. End Clamps Grounding Mid Clamps(B T-Bolt Grounding Lugs O Accessories Our rigorous approach has led to unique structural features,such as curved rails and reinforced flashings,and r is also why our products are fully certified,code compliant and backed by a 20-year warranty. 1 -� Strength Tested PE Certified X All components evaluated for superior Pre-stamped engineering letters Slide in clamps and secure Attach and ground modules Ground system using the Provide a finished and structural performance. 100available in most states. modules at ends of rails. in the middle of the rail. rail's top slot. organized look for rails. Mill finish&black anod. Parallel bonding T-bolt Easy top-slot mounting Snap-in Wire Clips Sizes from 1.22"to 2.3" Reusable up to 10 times Eliminates pre-drilling Perfected End Caps aClass A Fire Rating Design Software Optional Under Clamps Mill&black stainless Swivels in any direction UV-protected polymer Certified to maintain the fire resistance ® Online tool generates a complete bill of rating of the existing roof. materials in minutes. --- Free Resources Design Assistant 10.A 4 NABCEP Certified Training Integrated Grounding 20 Year Warranty _ Go from rough layout to fully Orr Earn free continuing education credits, engineered system.For free. while learning more about our systems. UL 2703 system eliminates separate Twice the protection offered by - ! Go to IronRidge.com/rm Go to IronRidge.com/training F61 NIP module grounding components. competitors. a ,:DocuSign Envelope ID:E7F9D52B-E971-49BE-AE59-F26FD35E5F9B sunruA EXHIBIT A SOLAR FACILITY ADDENDUM CONTRACT P87A1VRF94NDRNB THIS SOLAR FACILITY ADDENDUM CONTRACT("Addendum")is made by and between Sunrun Inc.("Sunrun")and Sungevity,Inc.("Contractor")for the design,engineering,procurement,installation,and construction of the Solar Facility described herein.This Addendum hereby incorporates, in total,the terms and conditions set forth in the Master Solar Facility Turnkey Contract("Contract"),and all schedules and exhibits thereto,executed by Sunrun and Sungevity,Inc.in March 10,2014.Capitalized terms contained herein have the meanings set forth in the Contract. SOLAR FACILITY TOTAL SOLAR PREPAID Contract Price:$30,862.04 Host Customer:Thomas C Secondo Street Address:163 Olympic Ln,North Andover,MA,01845 Rebate Level:$0.00 per watt Utility:National Grid TECHNICAL SPECIFICATIONS System Size Description Rating Standard Test Condition Direct Current(STC DC kW) 9.435 CEC Alternating Current(CEC AC kW) 8.478 Generation Equipment Photovoltaic collectors Manufacturer Model number STC DC rating Quantity Array 1 Trina Solar TSM-255PD05.05 255 W 13 Array 2 Trina Solar TSM-255PD05.05 255 W 9 Array 3 Trina Solar TSM-255PD05.05 255 W 15 Inverters Manufacturer Model number Efficiency Quantity Array 1 SolarEdge Technologies SE5000(240V)w/-ER-US or 0.98 1 A-US Array 2 SolarEdge Technologies SE5000(240V)w/-ER-US or 0.98 1 A-US Array 3 SolarEdge Technologies SE3800(240V)w/-ER-US or 0.98 1 A-US Total Number of Panels: 37 Total Number of Inverters: 2 Meter Information Meter Description Manufacturer Meter selected from approved vendor list provided by Sunrun. Model number Meter selected from approved vendor list provided by Sunrun. 11/12/2015 P87A1 VRF94N DRN B-A(Prepaid PPA) Pagel of 2 ,,'DocuSign Envelope ID:E7F9D52B-E971-49BE-AE59-F26FD35E5F9B sunrun EXHIBIT A SOLAR FACILITY ADDENDUM CONTRACT SOLAR FACILITY DESIGN DIAGRAMS Attach the single-line diagram and aerial-view module layout for the Solar Facility to this document. ASSIGN M ENT When transfer of the title to the Work occurs pursuant to the Contract,title to the Work shall be transferred to the Person("Assignee")designated in Exhibit A-1. MISCELLANEOUS Neither this Addendum,nor the Contract,creates any employment,agency,partnership,joint venture or other joint relationship between the Parties. Should a conflict arise between the terms of this Addendum and the terms of the Contract that cannot be reconciled,the terms of this Addendum shall govern;provided"howeveragreement on a conflicting term in this Addendum shall not operate to modify the conflicting term in the Contract for future addenda executed between the Parties.This Addendum may be executed in counterparts,each of which will be deemed an original,but all of which taken together will constitute but one and the same instrument. SUNRUN INC. SUNGEVITY,INC. DocuSiPam gned by: iD�oc�uSi'gpyned,by: Signat 1CNFBCBECDWA... -gMtBFe3996493... Adam Murray Zak Federer Name Name operations Associate Authorized Agent Title Title 11/17/2015 11/12/2015 Date Date 11/12/2015 P87A1VRF94NDRNB-A(Prepaid PPA) Page 2 of 2 i The Commonwealth of Massachusetts Department of Industrial Accidents m d 1 Congress Street,Suite 100 Boston,MA 02114-2017 ' www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aimlicant Information Please Print Legibly Name (Business/Organization/Individual):United Solar Associates, LLC Address:452 Pleasant Street, Second Floor I City/State/Zip:Malden, MA 02148 Phone#:855-786-1776 i Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 5 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3T�I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.EJ Plumbing repairs or additions 5.r7 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[:]Roof p Roof re airs These sub-contractors have employees and have workers'comp.insurance.: 6.n We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other Solar Install 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:TRAVELERS Policy#or Self-ins.Lic.#:7PJUB-5B50763-8-15 Expiration Date:7/23/2016 Job Site Address:11 Dana Street City/State/Zip:N.Andover, MA 01944 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A c of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify un r th pain and pe 1 i`e ofpury that the information provided pabove is true and correct. Si nature: G�'� / Date: ty-t q Phone#:855-786-1776 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#: .ACOO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/8/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER UUNIALA NAME: FAX Asset One Insurance A/C,Nr o,Ext: 714-625-8204 (AJC'No): 714-625-8290 575 Anton Blvd.,3rd FL ADDRESS: ara@solarinsure.com INSURER(S)AFFORDING COVERAGE NAIC# Costa Mesa CA 92626 INSURERA: Westchester Surplus Lines Insurance Company 10172 INSURED INSURER B: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERK 25674 United Solar Associates,LLC INSURER C: American Zurich Insurance Company 16535 452 Pleasant Street,Second Floor INSURER D: INSURER E: Malden MA 02148 INSURER F: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. N TYPE OF INSURANCE LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AMAE'UCLAIMS-MADE �OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 10,000 A G27527966001 11/10/2015 11/10/2016 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑X JECT � LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS DAMAGE NON-OWNED PROPERTY dent) $ HIREDAUTOS AUTOS (Per UMBRELLA LIAB )( OCCUR EACH OCCURRENCE $ 5,000,000 A )( EXCESS LIAB CLAIMS-MADE G27527966001 11/10/2015 11/10/2016 AGGREGATE $ 5,000,000 DED RETENTION$ $ OTH- WORKERS COMPENSATION X I STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? � N/A 7PJUB-5B50763-8-15 7/23/2015 7/23/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Property ER07771654 5/26/2015 5/26/2016 $522,302.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department AUTHORIZED REPRESENTATIVE 1600 Osgood St., Building 20,Suite 2035 //// North Andover MA 01845 wlze 9T�O�LlGIY ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD . y Date..............................T......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING ° t S3�CHU5� Thiscertifies that ............................................................................................................................ has permission to perform p /' >60�� 7. �qo �� ........................................................................................... wiring in the uilding of......... . � ................................................................................... h at ....../ ............G. ..r!. ..............................................................North Andover,Mass. Fee....)O? 5Noe?/.6,..4.7 ........Lic. . .................................................................................... ELECTRICAL INSPECTOR Check# ` ComnwnweaA4 o f MaddachaJef Official Use Only c�r� Permit No. I� k� - 1 �' aLJePartment o��ire�ervices Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank) 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: 1/26/16 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) 11 Dana St. Owner or Tenant Heather b. Rowe Telephone No. 9788360 Owner's Address 11 ana St. NormAndover, MA U1 84b Is this permit in conjunction with a building permit? Yes ❑✓ No ❑ (Check Appropriate Box) Purpose of Building PV Solar System Utility Authorization No. Existing Service 200 Amps 120 / 240Volts Overhead ❑ Undgrd ✓❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of a safe and code compliant, grid tied PV solar system on and existing residential root. 28 panels 11.140 RVV Completion o the fiollowing table may be waived by the Inspector of Wires. No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total r Transformers KVA No.of Luminaire Outlets No. of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ 1n- ❑ o.o Emergency Lighting rnd. rnd. Baiter 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 Devilex ce No. of Ranges No.of Air Cond. Total No. of Alerting Devic Tons g s No. of Waste Disposers Heat Pum Number Tons KW No. of Self-Contained Totals, .......T .....) ) .... - ...... "'""""""""""' Detection/Alerting Devices 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 KW No.of No. of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: 19000 Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:2/4/16 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 t 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 and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Skyline Solar LLC LIC.NO.: 21667A Licensee: James Leavitt Signature LIC.NO.:12,572B (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 732-354-3111 Address: 124 Turnpike t. Suite 10 West Bridgewater MA 0237 Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.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. $ The Commonwealth of Massachusetts ' Department of IndustrialAccidents ` n Y Office of Investigations a d 1 Congress Street,Suite 100 �t Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Skyline Solar LLC Address: 124 Turnpike Street Suite 10 City/State/Zip:West Bridgewater, MA 02379 Phone #:732-354-3111 Are you an employer? Check the appropriate box: Type of project(required): 1.9 I am a employer with 60 4. 0 I am a general contractor and I employees (full and/or part-time). * have hired the sub-contractors 6. ®New construction 2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling ship and have no employees These sub-contractors have g. ® Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance pomp. insurance.$ 9. ® Building addition required.] le are a corporation and its 10.CJ Electrical repairs or additions 3.® I am a homeowner doing all work ifficers have exercised their 11.® Plumbing repairs or additions myself. ' right of exemption per MGL Y �o workerscomp. 12.® Roof repairs insurance required.] t c. 152, §1(4),and we have no PV Solar employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:A.I.M. Mutual Insurance Company Policy#or Self-ins. Lic. #:VWC-100-6018336-2015A Expiration Date:9/16/2016 11 Dana St. North Andover, MA 01845 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 well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c( fy nd r the pains and penalties of perjury that the information provided above is true and correct. 1/26/16 Si nature. Date: Phone#: -35 111 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#• 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(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 CONTACT NAME: The Hamilton Group, LLC PHONE Fax 3 Wing Drive E-MAIL Ext:973-292-2292VC, /C No Cedar Knolls NJ 07927 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:SeleCtaVe My Ins 26301 INSURED SKYLI-3 INSURER B:Sleclive Ins Cof the S. East 39926 Skyline Solar LLC INSURER C:A.I.M. Mututal Insurance Company 3758 124 Turnpike Street, Ste 10 INSURER D: West Bridgewater MA 02379 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1089928575 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B GENERAL LIABILITY S 2106548 /6/2015 /6/2016 EACH OCCURRENCE $1,000,000 4_101 MERCIAL GENERAL LIABILITY DAMAGES(ERENTED PREMISc ES accc.rrene) $100,000 CLAIMS-MADE 15F] OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 POLICY PRO X LOC $ B AUTOMOBILE LIABILITY A 9093015 /24/2015 /24/2016 Ea accident) $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PeOacc den DAMAGE X HIRED AUTOS X AUTOS $ A X UMBRELLA LIAR �XTOCCUR S 2000480 10/11/2014 0/11/2015 EACH OCCURRENCE $5,000,000 EXCESS LIAB AIMS-MADE AGGREGATE $5,000,000 DED I X I RETENTION$10,000 $ C WORKERS COMPENSATION VWC-100-6018336-2015A 3/8/2015 3/8/2016 X I WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 000 000.00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS be E.L.DISEASE-POLICY LIMIT 1 $1,000,000.00 B Installation Floater S 2106548 /6/2015 /6/2016 Any One Occurrence $25,000 Property :t Business Property $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 17 1gRR-2010 ACORD CORPORATION. All rights resPrvPd. Fold, Then Detach Along All Perforations MM NWMr.m.-o- S-AH ISS ETT: ... t E L`TC3 l H Fo • ® . � ® E:#�.: fi� l I A S � : UVC., .... .... .. 1 TH LL 1�L N SS SE . © o . {. T o. •1 Jn moi! / �/. /G i G. r : .l f. . / r5 Vol 4 / E S L E E Si"T E / �1�•. .-1 A� � b o ,, } / 9' / J d.s 1 J / r� K { / 124 f •• E S T oy/� •S�.•.s..�,y ^•.'�/ �J,Fyi •yi //////:.......... 1P 11 `1 L f( . ni�f� Mdl/?!n/YIFNMJIIJ/� �� y. URA . R) G EWAT 4,.1021 6 Gi U .7. U r r .r. .. .• , '•. r1 ,I 0 to] I 11114:40 T r N C C as U 1 2 3 4 5 PHOTOVOLTAIC SYSTEM SHEET INDEX PV0.0 COVER AND SITE PLAN PV1.0 GENERAL NOTES SYSTEM SIZE: PV2.0 ARRAY LAYOUT AC/DC kW STC: 6.334kW\7.14kW PV3.0 LINE DIAGRAM PV4.0 LABELS EQUIPMENT: A PV MODULES: (28)Trina Solar TSM-255 PD05.05 A KEY: ! INVERTER(S): (1)SolarEdge SE760OA-US ---- PROPERTY LINE- --- CONDUIT RUN O INVERTER -- - DRIVEWAY O SUBPANEL SCOPE OF WORK: -- FENCE Q DC DISCONNECT FIRE CLEARANCE a AC DISCONNECT INSTALLATION OF A SAFE AND CODE-COMPLIANT ROOF 1 .a.a STRUCTURAL GRID-TIED SOLAR PV SYSTEM ON AN EXISTING ARRAY 1 UPGRADES ❑O)B JUNCTION BOX it O SOLAR MODULE E l MONITORING UNIT RESIDENTIAL ROOF TOP. MAIN SERVICE PANEL Q COMBINER BOX f i Q UTILITY METER 0 ROOF i ROOF 3 11 0 PV METER OBSTRUCTION ROOF 2 ` ARRAY 3 ;, APPLICABLE CODES: ARRAY 2 2014 NEC 2009 INTERNATIONAL CODES WITH MA 1 AMENDMENTS ROOF MOUNTED \ , CONDUIT 1 i � 1 B L- 1 CONTRACTOR INFORMATION: B UNITED SOLAR ASSOCIATES MALDEN z 1 452 PLEASANT ST. MALDEN,MA 02148 f JURISDICTIONAL INFORMATION: i g NORTH ANDOVER,TOWN OF 0014 1\ , 1600 OSGOOD ST. } NORTH ANDOVER,MA 01845 II NOTES TO INSTALLER: 1 7�0 LOCATION OF MAIN \ SERVICE PANEL INSIDE BASEMENT FOR INSTALLER USE ONLY \ POST INSTALL SUNEYES REQUIRED? NO I I CERTIFY THAT NO CHANGES HAVE DPNP ST it C BEEN MADE TO THE ARRAY LAYOUT: CUSTOMER INFORMATION: t HEATHER B ROWE \ 11 DANA STREET 1 NORTH ANDOVER,MA 01845 SITE PLAN N (978)836-0103/#2154102 SCALE: N.T.S. - DESIGNED BY: REV#: DATE. VALID.B o111/24/151PV-0.0 SGNGEVffYWC.66 FRPNNIlN3T SUITE SIS GA1¢ANp,CP SafiOT By MGREINER GaK.—Lacelbn:Roro-]1N133SVt 3han Sin:ttalT THESE GRAWINGS,SPECIFICPTION3,AND DESIGNS ARE THE PROPERTY OFSUNOENTY INC.NO PART SHPLL BE COPIED OR USED FOR OR WITH MY OTHER WORK OTHER TIWI THE SPECIFIC PROJECT FOR WHICH THEY NAVE BEEN DEVELOPED WITHOUT OUR WRITTEN CONSENT I A, 1 2 3 4 5 GENERAL NOTES. ELECTRICAL NOTES: GENERAL NOTES: El.ALL EQUIPMENT IS LISTED FOR USE. N1.DRAWINGS ARE DIAGRAMMATIC ONLY.THE LOCATION AND ROUTING OF E2.MAXIMUM VOLTAGE DOES NOT EXCEED 600VDC. RACEWAYS SHALL BE DETERMINED BY THE CONTRACTOR UNLESS OTHERWISE E3.ANY EQUIPMENT OR ELECTRICAL MATERIALS USED FOR THIS INSTALLATION SHALL BE NOTED OR STANDARDIZED. NEW AND LISTED BY A RECOGNIZED ELECTRICAL TESTING LABORATORY. N2.ALL EQUATIONS ACCOUNT FOR WORST CASE CONDITIONS. E4.AN INVERTER IN AN INTERACTIVE SOLAR PV SYSTEM SHALL AUTOMATICALLY A N3.IF A DISCREPANCY IN QUANTITY OR SIZE OF CONDUIT,WIRE,EQUIPMENT DE-ENERGIZE ITS OUTPUT TO THE CONNECTED ELECTRICAL PRODUCTION AND P` DEVICES,OVERCURRENT PROTECTION,GROUNDING SYSTEMS,ETC.(ALL DISTRIBUTION NETWORK UPON LOSS OF VOLTAGE IN THAT SYSTEM AND SHALL REMAIN EQUIPMENT AND MATERIALS)THE CONTRACTOR SHALL BE RESPONSIBLE FOR IN THAT STATE UNTIL THE ELECTRICAL PRODUCTION AND DISTRIBUTION NETWORK PROVIDING AND INSTALLING ALL MATERIALS AND SERVICES REQUIRED BY THE VOLTAGE HAS BEEN RESTORED. STRICTEST CONDITIONS IN THE SPECIFICATIONS OR NOTED ON THE PLANS TO E5.ALL PV ARRAYS SHALL BE EQUIPPED WITH DC GROUND FAULT PROTECTION. ENSURE COMPLETE COMPLIANCE WITH ALL CODES AND TO ENSURE THE E6.ANY AC COMPONENT SHALL MEET OR EXCEED THE AVAILABLE FAULT CURRENT LONGEVITY AND SAFETY OF THE OPERABLE SYSTEM. CALCULATED AT THAT COMPONENT. N4.ALL OUTDOOR EQUIPMENT SHALL BE MIN.NEMA 313 RATED. E7.ALL MODULES AND ANY RELATED ROOF MOUNTED METALLIC EQUIPMENT SHALL BE N5.METAL CONDUIT AND ENCLOSURES SHALL BE USED WHERE PV SOURCE OR PROPERLY GROUNDED. OUTPUT CIRCUITS ARE RUN INSIDE A BUILDING. E8.DC EQUIPMENT SHALL BE 60OVDC RATED MINIMUM. N6.MODULES SHALL NOT BE PLACED OVER ANY PLUMBING VENTS AND AT LEAST 6"ABOVE FLUSH VENTS. E9.MARKINGS SHALL BE PROVIDED TO INDICATE THAT ALL CONTACTS OF THE DISCONNECT EQUIPMENT MIGHT BE ENERGIZED. N7.THE ELECTRICAL CONTRACTOR SHALL COMPLY WITH ANY AND ALL E10.CONDUIT RUNS SHALL BE PROVIDED WITH SUFFICIENT WEATHERPROOF PULL BOXES REQUIREMENTS GIVEN BY UTILITY COMPANIES. OR JUNCTION BOXES/COMBINER BOXES PER APPROPRIATE JURISDICTIONAL N8.FOR ADDITIONAL EQUIPMENT SPECIFICATIONS,SEE PROVIDED CUT SHEETS. REQUIREMENTS. N9.ALL LABELS AND MARKINGS SHALL BE ATTACHED ACCORDING TO Ell.FOR ANY UNGROUNDED PV SYSTEM,A LABEL READING: B REQUIREMENTS BY NEC AND THE LOCAL AHJ.THE AHJ MAY HAVE SPECIAL LABEL B REQUIREMENTS BEYOND THE SCOPE OF THIS DOCUMENT. THIS MAY ENCOMPASS WARNING-ELECTRICAL SHOCK HAZARD.THE DC CONDUCTORS OF THIS PHOTOVOLTAIC LANGUAGE INCLUDING,BUT NOT LIMITED TO,THAT FOUND IN NEC ARTICLES SYSTEM ARE UNGROUNDED AND MAY BE ENERGIZED." 690.5(C),690.14(C)(2),690.17,690.53,690.35(F), 690.54,690.64(B)(7)and SHALL BE PLACED AT EACH JUNCTION BOX,COMBINER BOX,DISCONNECTAND DEVICE 705.10 WHERE ENERGIZED,UNGROUNDED CIRCUITS MAY BE EXPOSED DURING SERVICE. N10.INSTALLER TO FOLLOW ALL LOCAL JURISDICTION GUIDELINES. E12.INVERTER(S)SHALL CONTAIN A GROUND FAULT DETECTION AND INTERRUPTION Nll.ALL NEC REFERENCES SHALL BE DIRECTLY INTERCHANGEABLE WITH CEC DEVICE. REFERENCES. E13.ALL METALLIC RACEWAYS AND EQUIPMENT SHALL BE BONDED AND ELECTRICALLY N12.IT IS ILLEGAL FOR ANYONE UNLESS ACTING UNDER THE DIRECTION OF A CONTINUOUS. LICENSED PROFFESIONAL ENGINEER OR REGISTERED ARCHITECTTO ALTER ANY E14.THE POINT OF CONNECTION COMPLIES WITH APPLICABLE CEC/NEC. ITEMS ON THIS PLAN. E15.BACKFED SOLAR BREAKER(S)SHALL BE INSTALLED AT THE OPPOSITE END OF THE N13.THE ENGINEER HAS NOT BEEN RETAINED FOR JOB SUPERVISION. CIRCUIT OR FURTHEST AWAY FROM THE MAIN BREAKER. E16.ALL WIRE,VOLTAGES,AMPERAGES AND EQUIPMENT IS SIZED ACCORDING TO STRUCTURAL NOTES: TEMPERATURE DERATING AND LOCATION. 51.MOUNTS ARE DIAGRAMMATIC AND EXACT LOCATION MAY CHANGE,BUT E17.ONLY COPPER(CU)CONDUCTORS SHALL BE USED.CONDUCTORS SHALL BE SHALL BE ACCURATELY SPACED. STRANDED OR SOLID WITH PROPERLY RATED CONNECTORS. C 52.MOUNTS SHALL BE STAGGERED WHEN NECESSARY TO EVENLY DISTRIBUTE E18.DISCONNECT SHALL BE WIRED SO NO BLADES ARE ENERGIZED LOAD AMONGST RAFTERS. E19.ALL MODULES AND RACKING SHALL BE GROUNDED VIA IRON RIDGE RAIL INTEGRATED CUSTOMER INFORMATION: S3.DO NOT SPLICE RAILS IN MIDDLE 50%OF SPAN BETWEEN TWO MOUNTS. GROUNDING(PLEASE SEE DATA SHEET)OR WITH TIN PLATED DIRECT BURIAL RATED LAY IN HEATHER B ROWE LUGS USING STAINLESS STEEL HARDWARE,STAR WASHERS,AND THREAD FORMING 11 DANA STREET BOLTS. NORTH ANDOVER,MA 01845 E20.ALL EQUIPMENT SHALL BE GROUNDED,INCLUDING BONDING JUMPERS WHERE (978)836-0103/#2154102 NECESSARY ACROSS RAIL SPLICE PLATES TO BOND INDIVIDUAL PIECES OF RAIL. DESIGNED BY: REV#:I DATE: VALID.B 1 0 11!24/15 PV-1.0 I SUNGS-RIC.66 FRANRLINSTSUITE 3100pq.AND,CA 91607 3TNGREINER DeIe:-Locabn:Rowe-3154103GVt Gl,oet Giza:11v1) THESE DRAWINGS,SPECIFICATIONS.AND DESIGNS ARE THE PROPERTY OF SUNOEWTY INC.NO PART SHALL BE COPIED OR USED FOR OR`MTH pNY OTHER WORK OTHER THAN THE SPECIFIC PROJECT FOR WHICH THEY HAVE BEEN DEVELOPED WITHOUT OU0.WRITTEN CONSENT 1 2 3 4 5 MODULE SPECIFICATIONS (28)Trina Solar TSM-255 PD05.05 MODULE WEIGHT: 41 MODULE LENGTH: 64.95 1-5" MODULE WIDTH: 39.05 34'_2" CONTINUE TO ARRAY 3 ROOF 1 SPECS RAFTER SIZE: 2X8 NOMINAL - RAFTER SPAN: 111-11" i 5 13'_1" RAFTER SPACING: 16" "I ROOF MATERIAL: COMPOSITE SHINGLE ARRAY 1 SPECS ` I - NUMBER OF MODULES: 16 A ( }.. ..�. ..... ..... _�.. } } ( ( ROOF 2 1 1 } } } } } TOTAL MOD.WEIGHT Ibs): 656 A AR 2 RACKING WEIGHT Ibs 118.6 { I ARRAY WEIGHT(lb.): 774.6 ARRAY AREA(sqR): 281.8 ' } __ �_ ARRAY DEAD LOAD(Ibs/sgfl): 2.7 } ! R I i } !ROOF 11 } ARRAY 1 } I I I 60 I } ` ( } I I i NUMBER OF MOUNTS: 32 -- ® -- LOAD PER MOUNT(Ibs): 24.2 } } ( } I q ARRAY AZIMUTH(') 165 } i }.... }...._�....... .... I ........i... 'Z i ( ARRAY TILT(') 35 \! __ NUMBER OF FLOORS 1 } } } ( I } I ( } ROOF 2 SPECS RAFTER SPAN: 2X8 NOMINAL O4 INAL L RAFTER SPACING: 16" MATERIAL:ROOF SPECSCOMPOSITE SHINGLE ARRA 6 NUMBER OF MODULES: 6 TOTAL I I I I I 2 RRAY 2 LAYOUT RACKING WEIGHD. (bT)ba,: 5466 RACKING WEIGHT SCALE: 3/16 v 11-0N ARRAY WEIGHT(Ibs): 302 ARRAY AREA(Sgit): 105.7 ARRAY 1 LAYOUT SH OF MIq� ARRAY DEAD LOAD(Ibs/sgtt): 2.9 17 .y NUMBER OF MOUNTS: 17 PAUL K. LOAD PER MOUNT(Ibs):) SCALE: 3/16"=1'-0" PAUL ARRAY AZIMUTH(-) 255 B TRUCTURAL y ARRAY TILT(") 24 B 0��1pp0((0 NUMBER OF FLOORS 1 /I/ ROOF 3SPECS RAFTER SIZE: 1 2X8 NOMINAL `SS/ONAL RAFTER SPAN: e'-4" RAFTER SPACING:1 16" ROOF MATERIAL: COMPOSITE SHINGLE CONTINUE FROM ARRAY 2 ARRAY 3 SPECS NUMBER OF MODULES: 6 TOTAL MOD.WEIGHT(lbs): 246 7'-7" 13'_1" RACKING WEIGHT(IbS): 56 ARRAY WEIGHT(Ibs): 302 1 i I SOLAR MODULE ARRAY AREA(Sgtl): 105.7 � �0017 3 I } I 1 ) ( ) i I � ARRAY DEAD LOAD(Ibs/sqR): 2.9 ARRAY 31 _ - -- } NUMBER OF MOUNTS: 17 I I i I LOAD PER MOUNT(Ibs): 17.8 I } I �,:..... ....}.......}... .} .. .},..... ......(' } } ( .<! �"�...- ARRAY AZIMUTH(') 75 I ' 3` __ S _� !__ ' } IRONRIDGEXR100 - ARRAY TILT(") 24 SYMBOL KEY: m i _ NUMBER OF FLOORS 1 ------- RAILRAFTERS L-FOOT i 1, I QMSE-LAG SHINGLE ROOF } -�� COMPS"ITE X 5/116"I-GLE- LAG FIRE CLEARANCE p............(D STRING CONFIG. 2.5"MIN.EMBEDMENT PER C SCREW rFE+•I..�. STRUCTURAL UPGRADES 2X8 NOMINAL,16 O.C. CUSTOMER INFORMATION: C:3 SOLAR MODULE8" HEATHER B ROWE ® MOUNT MOUNTING DETAIL 11 DANA STREET 4 SCALE: NTS NORTH ANDOVER,MA 01845 ® SKYLIGHT (D!��RFLIAY 3 LAYOUT (978)836-0103/#2154102 ® CHIMNEY SCALE: 3/16"=1'-0" e PLUMBING OR ATTIC VENT DESIGNED BY: REV#: DATE: PV-2.0 O ATTIC VENT VALID.13 1 0 11/24/15 SUNGEYRY NO.FFFRANNUN STSUITE310OAKLrWD,CA N107 BY.MOREINER D"te.—Lwazbn.Rm -2-028V1 SMetsiz":11x17 THESE DRAWINGS.SPECIFICATIONS.AND DESIGNS ARE THE PROPERTY OF SUNGENTY INC.NO PART SHALL BE COPIED OR USED FOR ORWITH ANY OTHER WORN OTHER THAN THE SPECIFIC PROJECT FOR WHICH THEY HAVE BEEN DEVELOPED WITHOUT OURWRI3TEN CONSENT i I > 1 2 3 4 5 ELECTRICAL KEY: MODULE ELECTRICAL SPECIFICATIONS INVERTER 1 SPECIFICATIONS 1L BREAKER (28)Trina Solar TSM-255 PD05.05 SOLAREDGE SE760OA-US SHORT CIRCUIT CURRENT(Isc): 8.88 RATED WATTS(EACH): 7600 SWITCH OPEN CIRCUIT VOLTAGE(Voc): 38.1 AC OPERATING VOLTAGE(V): 240 l Q SCREW TERMINAL OPERATING CURRENT(IMP): 8.37 AC OPERATING CURRENT(A): 32 1 m FUSE OPERATING VOLTAGE(VMP): 30.5 NUMBER OF MPPT CHANNELS 0 • SPLICE MAX SERIES FUSE RATING: 15 INVERTER EFFICIENCY: 0.975 W EARTH GROUND STC RATING: 255 INTEGRATED DC DISCONNECT m CHASSIS GROUND PTC RATING: 232 INVERTER I INPUT SPECIFICATIONS GEC DESIGN CONDITIONS NOMINAL CURRENT PER STRING(Inom): 8.7,11.7 EGC HIGHEST 2%DS DESIGN TEMP("C): 32 NOMINAL VOLTAGE(Vnom): 350 MIN.MEAN EXTREME ANNUAL DS('C): -18 MAX SYSTEM VOLTAGE(Vmax): Sao q MAX CURRENT PER STRING(Imax): 15 A MAX INPUT CIRCUIT CURRENT(Imax): 30 200A MAIN BREAKER (3)#8 THWN-2 (3)#8 THWN-2 (3)#8 THWN-2 (4)#10 PV-Wire (4)#10 THWN-2 (1)#8 GEC (1)#8 GEC (1)#8 GEC (1)#10 EGC (1)#10 EGC 3/4"EMT 3/4"EMT 3/4"EMT FREE AIR 3/4"EMT METER AC DISCONNECT, (E)LOADS (N)SE7600A-US 60AMP, INVERTER W/INTEGRATED NON-FUSIBLE, E LOADS DC DISCONNECTS CUTLER-HAMMER, ( ) DG222UR8 (E)200A GE MSP 1 STRING OF + LOCUS 12 MODULES -___40A 2P 240V 2P 3-W 1 d1 D DC �- -p'C METER B OPT.CURRENT=8.74A GEC DC OUTPUT LOAD LINE _______INVERTER_ __— _ __T__ __ __—_____ _________ __ B 1 STRING OF + 16 MODULES `- OPT.CURRENT=11.66A i GEC IRREVERSIBLY SPLICED TO EXISTING GEC OR BONDED DIRECTLY TO EXISTING GROUNDING ELECTRODE (IF APPLICABLE) MIN.NEMA3R UL LISTED JUNCTION BOX WITH 90°C TERMINAL RATINGS LOCATED ON ROOF C Inom=(16 x 255W)/350V=11.7A CONDUIT ELEVATION:1/2 TO 3-1/2"=22°C 28 MODULES TOTAL OPERATING VOLTAGE=35OVDC(REGULATED) HIGH AMBIENT TEMPERATURE:32°C 28 x 232(PTC WATTS)x 0.975=6334 CEC WATTS CUSTOMER INFORMATION: EXTREME LOW:-18°C HEATHER B ROWE 200 x 1.2=240 ROOFTOP AMBIENT TEMP(Tcorr):54°C=0.76 SE760OA-US MAX OUTPUT CURRENT=32A 240-200(MCB)=40A CONDUIT FILL(Cfill):0.8 BREAKER SIZE=32A x 1.25=40A=>40A 11 DANA STREET MAX ALLOWABLE AC PV BREAKER=40A NORTH ANDOVER,MA 01845 CONTINUOUS USE=Imax"1.25=15A (978)836-0103/#2154102 CONDITIONS OF USE=Imax/Tcorr/Cfill =15A/0.76/0.8=24.67A CONDUCTOR SIZE FOR 24.67A DESIGNED BY: REV#: DATE: INSTALLATION SHALL USE MIN.#10 AWG PV"3•0 VALID.B 1 0 11/24/15 SUNGEVITY INC.66 FRANIUINSTSUITE3100Al6PND,CASIBIR By.NIGREINER Dab:L°Mon:Rwa-3t50103SV18Neet Size:ttxtT THESE DMWSNGS.SPECIFICATIONS,AND DESIGNS ARE THE PROPERTY OF SUNGEVITY INC.NO PART SHAL BE COPIED OR USED FOR OR WITH ANY OTHER WORK OTHER THAN THE SPECIFIC PROJECT FOR WNICN THEY NAVE BEEN DEVELOPED WITHOUT OURWRITTEN CONSENT I 1 2 3 4 5 NEC 690.5(c) NEC 690.31(E)3&4;2012 IFC 605.11.1 INTERACTIVE PHOTOVOLTAIC POWER SOURCE PLACE THIS LABEL ON INVERTER(S)OR NEAR PLACE ON ALL JUNCTION BOXES,EXPOSED RATED AC OUTPUT CURRENT(A): 32 GROUND-FAULT INDICATOR(ON INVERTER(S)U.O.N.) RACEWAYS EVERY 10'AND V FROM BENDS AND PENETRATIONS,ADJACENT TO THE NOMINAL OPERATING AC VOLTAGE(V): 240 MAIN SERVICE DISCONNECT WARNING INVERTER 1 DC DISCONNECT j PHOTOVOLTAIC SYSTEM DISCONNECT WARNING ELECTRIC SHOCK HAZARD RATED MAX POWER POINT CURRENT(Imp): 20.4 A IF A GROUND FAULT IS INDICATED, PHOTOVOLTAIC POWER RATED MAX POWER POINT VOLTAGE(Vmp): 350 A NORMALLY GROUNDED CONDUCTORS MAX SYSTEM VOLTAGE(Voc): 500 MAY BE UNGROUNDED AND ENERGIZED SOURCE SHORT CIRCUIT CURRENT(Isc): 11.1 NEC 690.35(F) NEC 690.17(E) PLACE THIS LABEL AT EACH JUNCTION BOX,COMBINER BOX, PLACE THIS LABEL ON ALL DISCONNECTING DISCONNECT AND DEVICE WHERE ENERGIZED,UNGROUNDED MEANS WHERE ENERGIZED IN AN OPEN POSITION CIRCUITS MAY BE EXPOSED DURING SERVICE: WARNING WARNING ELECTRIC SHOCK HAZARD ELECTRIC SHOCK HAZARD DO NOT TOUCH TERMINALS TERMINALS ON BOTH THE LINE AND LOAD THE DC CONDUCTORS OF THIS SIDE MAY BE ENERGIZED IN THE OPEN PHOTOVOLTAIC SYSTEM ARE UNGROUNDED POSITION AND MAY BE ENERGIZED NEC 705.12(D)(2)(b) B PLACE THIS LABEL AT P.O.C.TO SERVICE B DISTRIBUTION EQUIPMENT(I.E.MAIN PANEL(AND SUBPANEL IF APPLICABLE)) NEC 690.56(c) WARNING PLACE ON RAPID SHUT DOWN DISCONNECT WHEN RAPID SHUT DOWN IS INSTALLED INVERTER OUTPUT CONNECTION DO NOT RELOCATE THIS PHOTOVOLTAIC SYSTEM EQUIPPED OVERCURRENT DEVICE WITH RAPID SHUTDOWN NEC 705.12(D)(3) PLACE LABEL ON ALL EQUIPMENT CONTAINING OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE SOURCES. CAUTION NOTE: OUTSIDE LABELING OF SYSTEM COMPONENTS AND METERS IS TO BE DONE IN A WAY SUITABLE FOR THE ENVIRONMENT C CONTAINS MULTIPLE POWER IN WHICH THE EQUIPMENT IS INSTALLED.NO STICKERS ARE SOURCES PERMITTED. CUSTOMER INFORMATION: HEATHER B ROWE 11 DANA STREET NOTE: BACKGROUND AND LETTERING COLORS FOR NORTH ANDOVER,MA 01845 SIGNAGE/LABELS SHALL COMPLY WITH(IN ORDER OF (978)836-0103/#2154102 PRIORITY)AHJ&FIRE DEPARTMENT AMENDMENTS, STATE CODE,AND ANSI GUIDELINES.THIS PAGE IS INTENDED FOR SIGNAGE/LABEL VERBIAGE ONLY. P ESIGNED BY: REV#: DATE: PV-4.0 VALID.B 1 0 11/24/15 9UNGEVRY MC.N FRANKLIN ST SUITE atB DAN—B,CA8 1 BY.MGREINER Dete.—Lacmbn:Roxe-It511015Vt SM1eet Slm:Hzt] THESE DRAWINGS.SPECIFICATIONS,AND DESIGNS ARE THE PROPERTY OF SUNGEVITY INC.NO PART SHALL BE COPIED OR USED FOR ORWITH ANY OTHERWORK OTHER THAN THE SPECIFIC PROJECT FOR WHICH THEY NAVE BEEN DEVELOPED WITHOUT OUR WRITTEN CONSENT { THE Universal MODULE Mono Multi Solutions PRODUCTS LOWER RANGE ELECTRICAL DATA(STC) '+ TSM-PD05 -250-265W Peak Power Wats-P..IWp) 245 250 255 260 265 THE Universal TSM-PDO5.08 250-265W Ma""' ,PutT vdt,ce- IV) 0-5 ISM-PDO5.05 215-260W Moxknum Power Voltage-Vw.(VI 29.9 30.3 30.5 30.6 30.8 Maximum Power CUlroni-Ia (A) 8.20 8.27 8.37 8.50 8.61 DIMENSIONS OF PV MODULE Open Circuit Voltage-V«IV) 37.0 38.0 38.1 30.2 38.3 MODULE � unit.mm Short Circuli Curronf-Izc IAI 8.75 8.79 8.88 9.00 9.10 A{�O D U L E 941 Motlule E,,.,Cucy,lm(%I 15.0 15.3 15.6 15.9 16.2 SIC I VM, 000 w/m'.cell temperature 25•C.Air Mass AMTS. o � ypico elAc enryreducllonol d.5Ap1200 w/m'pccortlln910 EN 6090d 1. _ r ELECTRICAL DATA(NOCT) Msr Maximum Power-Pr.0 IWP) 182 186 190 193 197 60 CELL L MPx4num Pawn Voltage-V_IV) 27.6 2B.0 28.1 2B3 28., PDO5.05 Maximum Power Curront4I IAI 6.59 6.65 6.74 6.Od 6.93 MULTICRYSTALLINE MODULE Op" CI_HYaUage-Vo.IV) 35.1 35.2 35.3 35.4 35.5 Short Circuit Current-Izc(AT 7.07 7.10 7.17 7.27 7.35 PD05.08 Non. l eaw/m'Amo h'enl Tpmp-t..20•e speed w nd l mA. � I nm nota a 245-265W PD05 MECHANICAL DATA POWER OUTPUT RANGE ` A A Solarceln MUllcrystallmei56.156mm(61nchm) Our most versatile product •Compatible with all major BOS components and system Cell odentarpn 60c 111(6.10) de,,Jos mwws Module dimensions 1650.992.35 mm16495 x 39.05 x 1.37 in chest r e��� 1000V UL/1000V IEC cerlifecl �812� lad weight 18.6 kg 1QW) v Glpss 3.2mm(0A31nches),Nlgh Transmission,AR Coaled Tampered Glass MAXIMUM EFFICIENCY Backsheet WMteIPDO58PD05.OB):Black(PDO5.05) R ome SAverAnodizedAlumnum Alloy(PDOS);BIOck(PD05.088POO5.05) rf One of the industry's most trusted modules J-Bax IP 65 or IP 67 rated 0~�3i 0 •Field proven performance Cabi.S Photovoltaic Technology a onto4.Omm'10006hche,=), VK 1OOOmm(39.3]nches) POSITIVE POWER TOLERANCE AA C-aeator Mc4Cpmpmible 35 Highly reliable due to stringent quality control A.o S. r Io m to Over 30 in-house tests(UV,TC.HF,and many morel I-V CURVES OF PV MODULE(26OW) TEMPERATURE RATINGS MAXIMUM RATINGS r e L;, 3r u. r to all < "GFIJ In-house testing goes well beyond certification requlrernenls ,em Lr.r3U:It.wi - •PID resistant •m woo. ___ _ __.___.., Nominal I.N.JNng Cell 44•C I:2•CI OPemtlonalTemPeraturo -40-re5•C �.e Temperature Waal) _ sm --_ - _-- _- - -0.41%/°C oltagem SYsfem 1000V OC((U)IECI St to ):-1Nn-'Ts +.m__ „__,_____- _ _ -_^ _ TemPamture Coefficient of Paw iS CI r.:0i l0 s���e�t.W rn iCGai - F. a 1 y t .1 .]' •mom - - - "' Temperature Coeffic ant pfV« -0.32%/'C MmSerbs Fuse Rating ISA •m _ 7 P -tore Coefficient of ltc 0.Ds%7•C .. ... Certified to withstand challenging environmental obl H ,!ct conditions th f r I�'..k.n�0 ---- O O:.s 5t 3 C [ •2400 Pa wind load ' - WARRANTY ..urine.. Wv o a ,.mmrti,ra 5400 Po snow load o ,o a z9 .° m IOyeorPmducl Worker,n hip Warranty f b�:la�r.d t'ratoq.c.m--.,tL.a�y ..•c4,s bc-a.Fciol Col'abarOtiO^with 25 year Unear Power Wortanty iMto lit -3e�::.�N'-i,Jsit L�t:�••. IPa-reser I.product wprrply tprdemiizl a .10<:the,porn...os tt,- CERTIFICATION R ba kt.�ne of a.:share J.tuc'c:ss in r asm.7.lE,-gy`oge'^•' LINEAR PERFORMANCE WARRANTY iclE k®. PACKAGING CONFIGURATION s Mod Was per box 30 pieces ? Irina Solar liml}ed • j- Module, per 40'conlolner:840 pieces ? ltl Year Product Warranty 25 Year linear PowerWarranty L1', ....._ ..__... ._................._, . T.l,o -,.a. IIBnL Ada v t . manor vque ypm • IS vas _. /7fna loth Nnegr"a'7any a SAFE1y AN INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. ` annsolar BB,3 'Y inelsolar ®29lt,nneBeprLlmlted n,e ed tpp iA e,lpn,me tledln,hl,dello,heetore,ateettp pn9ewithp topica. Smart Energy Together redoS tB 15 r9 rs SmartEnugy Together CERTIFICATE OF COMPLIANCE CERTIFICATE OF COMPLIANCE { Certificate Number 20140630-E306515 Certificate Number 20140630-E306515 Report Reference E306515-20121213 Report Reference E306515-20121213 Issue Date 2014-JUNE-30 Issue Date 2014-JUNE-30 Issued to: TRINA SOLAR LTD The modules with the specified construction as below may be marked with its type for UL listed fire performance products only as the below table: 2 TIAN HE RD,ELECTRONICS PARK NEW DISTRICT, CHANGZHOU,JIANGSU 213031 CHINA, Module model Specific construction Marking TSM-xxxPD05, Superstrate: 3.2-4.36mm thick; Module Fire TSM-xxxPD05.08 EVA: 0.25-0.61mm thick; Performance: This is to certify that PHOTOVOLTAIC MODULES AND PANELS WITH Substrate: 0.30 mm - 0.64 mm Type 1 representative samples of SYSTEM VOLTAGE RATINGS OVER 600 VOLTS thick; Refer to addendum page for Models Frame: Cross sectional dimension: 35 x 35mm, Height: 35mm, Have been investigated by UL in accordance with the Thickness: 1.5mm Standard(s)Indicated on this Certificate. llSuperstrate: 3.2-4.36mm thick; Module Fire TSM-xx.PD05.05, EVA: 0.25-0.61mm thick; Performance: Standards for Safety: UL 1703-Standard for Safety for Flat-Plate Photovoltaic TSM-xxxPDos.oe Substrate: 0.284 mm o.30 mm T e 2 ( ) Y Y thick; Modules and Panels and ULC ORD/C1703-01 -Flat-Plate Frame: Photovoltaic Modules and Panels. Cross sectional dimension: 35 Additional information: See the UL Online Certifications Directo at x 35mm, rY Height: 35mm, www.ul.com/database for additional information Thickness: 1.5mm TSM-xxxPD14, Superstrate: 3.2-4.36mm thick; Module Fire TSM-xxxPD14.08 EVA: 0.25-0.65mm thick; Performance: Only those products bearing the UL Listing Mark for the US and Canada should be considered as Substrate: 0.284 mm - 0.300 mm Type 8 being covered by UL's Listing and Follow-Up Service meeting the appropriate requirements for US thick; and Canada. Frame: The UL Listing Mark for the US and Canada generally includes:the UL in a circle symbol with"C" Cross sectional dimension: and"US"identifiers:0&the word"LISTED",a control number(may be alphanumeric)assigned 40-35 mm, by UL;and the product category name(product identifier)as indicated in the appropriate UL Height: 40mm, Directory. Thickness: 1.5 mm Look for the UL Listing Mark on the product. TSM-XXXPD05.10 Superstrate: 3.2-4.36mm thick; Module Fire TSM-XXXPD05.18 EVA: 0.25-0.65 mm thick; Performance: Substrate: 0.025 - 0.284 mm Type 5 thick; Frame: Cross sectional dimension: 40* 38 mm, Height: 4 0mm, Thickness: 1.8mm .ny«�nrormmm.c�mv�R.�«�iawiw�e.�im»rviu..a nwar u�ucluue,.m wumnzee rk.n.»nu�.serau»wm.W»» .wma:wuiw comm:,smc.rtwix.�uum.a.a�..».a mau�uc rv.l.r.nv eumenae iiun».a u,..r«awpa"..n»» Page 1 of 4 Page 3 of 4 QSingle Phase Inverters for worth America S S �� solar=ooSE3000A-US/SE380OA-US/SE5000A-US(SE6000A-US/ Xo .-, I SE7600A-US/SE10000A-USlSE11400A-US r T SE3000A-US SE3800A-US SESOOOA-US SE6000A-US SE7600A-US SE10000A-US SE11400A-US7 1 1 �I 7 x d OUTPUT SolarEdge Single Phase Inverters r ® 80 208V N. ....AC Power Output 3000 3800 5000 6000 7600 190000 vd240V 11400 VA For North America fi ax ACP Output.. 3300 4150... 5400�206V 6000. 8350 0800 @�208V 12000 VA.... ,� - 5450 240V 10950 240V ',m.��`� output Voltage M n.Nom Maz'I _ �' ;. 183 208 229 Vac ...... .... .. ........ ... I J SE3000A-US/SE3800A-US/SE5000A US l SE6000A-US l � ' t" .......r.-N"'- "' " ,.6 AC Out ut Volta e M n Nom.Max.`I SE760OA-US/SE10000A-US/SE1140OA-US 211-240-264vec r �~�_�--T _-rT- —�..� k� ',''�,s��p�r�'�1',¢'�A z1' Y -��., ts,/,,w.r' e `fir ..AC..f.r.e.q.u..e..ic.,.y..M...n....N.om.....C.Mu..arxr.....`•... � ....... .. ,2A@208V I r I ....,... .I.'A. S@..2.0.RV.....I .... .........59 3 60 60.5(with III country 5ctnnP 87 60. 60.5) Max Continuous Output Current 12.S 16 7. . HA 25 32 .. ................ ....... . ..... ...... ..... z .. ... i ........ ................................... .............. ................... ..!.. ............................... y` Monitoring..land Proternnn Country Configurable Threshold. Ves r +�'`rv- INPUT n[or nq.is in8 _ V g —._ _ '—' w. � '4'ri r _ ✓" ay-°{ o� � s 44 � ,�'.'ns'v h Max mum DC P (STC) A050 5300 6750 8100^— 10250 13500 15350 W -.....-f... ... ...T.... . ...T.......... .I:...........-1 ... . Transformer less,.U..�.oundP.d Yes .... _Max'Inp tV It 6..... ........... ...................... ..........,SW.. ............... ................... .. ens d. 325@ 208V/350 Ca 240V., 1 1 @ 208V I 33 @ 208V Max.Input c [I 9.5 13 ' 18 23 345 Adc . ' r.; .-....... ..... ... AS S.@ 2A y.�.. .. ..............�..30 5,�?2a0... ........ ........................M1S.................. ............. AdC... Reverse P tv.P otecno Yes IsolationDetection ..._. ... .... ...............................600ke Sens tiv ty. .....-..... .. ........ ... ... Maximum ..... .. ..... ... .. .. Max mum In t Effi enry 97 7 98 2 98.3 9N 3 9R 98 98 9b 97 5 @ 20RV 97 IA. CTC weighted EIHc encV 9].5 98 9 .. 97.5 97 5 4fi 4�sr .� Z 1 d1"r' '4 d �2 ...... ................................ ... ... ...... ....... ..?A @,240V.............................. 7 5 to 24pV .......... .. .. k ,i >k 7 � # NI h[nme Pnwer Cnnsum ton 2 5 9 1 � �f -��E���r ��9'T��+� ���mom'' a� ✓z r" --e--- ---- _ � �' �-.,7"� ,� ,€� '� Supported Commun cat on Inlerface5 � _T�� � r R5485,RS232,Ethernet,ZIgB .(poo all t ,va 1'.� .v �� r� .... ...... ............. ....... ...... ..... .... ..... .. ............ ........ RevenueG,ade Data,ANSI C12 1 Opt Rap d Shutdo NEC 2014 690,12_1_—- _ ,Functional ty enabled when Solal Etlge ra0 d shutdown k't iz inslalledl° _ _ - 9'"-�� STANDARDCOMPLIANCE ,✓ Safety1.11741 UL1699R UL399A CSA 22 2 - ,yam " GI'd Connecbon Standard IEEE154] .... ... ....... ....... ....... .... .,... .......... ... .. ... .. Enn � $ zsons . FCC p t15 class8 INSTALLATION SPECIFICATIONS � : � 5'm av'�r `''" " AC out ut co idutsrze/AWB range 3/4`min'mum/166AWG� 3/4"mnlmum/8-3 AWG y�°` `�'� ,h,.y,-+fir; ¢£ ,✓��"` ''� '" OC np Pt co tdu'ls ze/IXof str ngz/ 3/q / 3/A m/12s[ngs/AWG ran 3/4" mm 1 a ....... ...... ....1-22,st"g/166AWG .......6 ... .... ........ .. ... MAAWG. .. /:.1 Y ,7p „q g�yas Dmension•.wth Safety 5w tch 30.5 z325x72/775x 315x1Aa 305x 125x 30.5/ n/ . °................... ........ .......... ......775,x 315 x 260..... .mm.. .... 547/2M17 .... ..........ASA%401 .... ...... Ib/.k&.. ��N3FUra� Cooling ( Natural Convection and Internal Fan,(uzerreplaceable) fan(us er The best choice for SolarEdge enabled systems _..............._.................__.......................................-....................,.fep1�e_,b)P1.....__........._............................ O Y Noise. ,1,,,,,,,,,,,,,,,,,,,,,,,,<50 dBA + Integrated arc fault protection(Type 1)for NEC2011690A1 compliance Min:Max.Operating.Temperature .13to+140/-25tot60(-40to+60vcrslonavailable"11 F/* Superior .Superior efficiency(98%) .F..nger_................................ ........... . ...................................................................................................................... Protection Rpnng ..............NEMA 3R................................................................... Small,lightweight and easy to install on provided bracket �o,ore..=�e........... �« �,h - Built-in module-level monitoring 'R n�ener r�„e�r,�„rre.p NriExyy a'rne m,�ner„,w um�I�r.m,�r r�n.�I rime�,me..Ixma. Rip-h—. -U,OOONNal Ifo,76r0pw,rw,u, 7ssV,U5002NNalj 0 , Internet connection through Ethernet or Wireless ...o�n�w�°iii vii+aetpoo,asnst. '� PM:S[vxxxht110DONNU1Ifor 1600W Invenar:Si.>4MhU5002NN114,. Outdoor and indoor installation Fixed voltage inverter,DC/AC conversion only Pre-assembled Safety Switch for faster installation Optional—revenue grade data,ANSI C12.1 USA-GER MANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-'IHE NETHERLANDS-ISRAEL www.solaredge.us AUTHORIZATION TO MARK AUTHORIZATION TO MARK This authorizes the application of the Certification Mark(s)shown below to the models described in the Product(s) Product: oli Interactive Inverter Covered section when made in accordance with the conditions set forth in the Certification Agreement and Listing Brand Name: SolarEd e Report. This authorization also applies to multiple listee model(s)identified on the correlation page of the Listing Models: 7 models:SE3000,SE3300,SE3800,SE5000,SE6000,SE7000,SE7600 Report. (Option:followed by A to indicate Interface board,etc.) This document is the property of Intertek Testing Services and is not transferable.The certification mark(s)may be applied only at the location of the Party Authorized To Apply Mark. Applicant: SolarEdge Technologies Ltd Manufacturer: Jabil Circuit(Guangzhou)LTD DEV EAST DISTRICT Address: 6 Ha'Harash Street 45240 Address. 128 JUN CHENG RD Hod Hasharon GUANGZHOU GUANGDONG 510530 CHINA Country: Israel Country: China Contact: Mr.Oren Bechar or Mr.Meir Adest Contact: Elaine Ouyang +972 9 957 6620#293 or Phone: +972 9 957 6620#131 Phone: 020-2805-4025!135-7023-5852 FAX: +972 9 957 6591 FAX: NA Email: OREN.B@SOLAREDGE.COM Email: Elaiine.ouyang@jabil.com Party Authorized To Apply Mark: Same asManufacturer Report Issuing Office: Cortland, NY 13045 ua- Control Number: 4004590 Authorized by: for Thomas J.Patterson,Certification Manager 0%- us Intertek This document supersedes all previous Authorizations to Mark for the noted Report Number. TNs AUMorlmdon m Mah Ia for 1be axclusiw use d Idedek's ON is provided jxn u..to droO ft.tmn W—.1—.n ldadek..ib Glad.1—1.res -Ulity and Imullty aro limited m[ba tertm and—iiti—d dl.apraemaM.1—1, Ilapptym eery psf,—Ilmnm the aierd in eccadame—dsa spree M.finery loan,eapama or —g.—1—d by the use ofdds ANhodntion to hark Oniy th.emit N.0 ImWm p—.10,or dh 11—nof—AUlhor' Wn m Mark ands my In d.e ty.t dIrrtedek'.as.Wnmm m recti ledm tlp wndtlmm lekout in the apream.nt—in Eris AW,or®lion m WM Any fuller use d6n Idertak—fort Gale or adwdi—d dm mamd neteriel,product,a nm,mst first tb aP—WInwkmp by Imedek Initial Fadary Aaseasimr,b and FOi—up Sarvk.s an for dre purpose d easuAq apprapdab usaged6wCrpfm n rmrk in aaordama xiN Hre ,pre ni.d y ere rnn mr the purpose,of predudlan gmlfty—ni and do mtro1b -ab dtheir obppe mIn Mb reap. Intertek Testing Services NA Inc. 545 East Algonquin Road,Arlington Heights,IL 60005 Telephone 800-345-3851 or 847-439-5667 Fax 312-283-1672 UL 1741 Standard for Safety for Inverters,Converters,Controllers and Interconnection System Equipment for Use With Distributed Energy Resources,Second Edition Dated:January 28,2010 CSA C22.2 107.1 Issue:2001/09/01 Ed:3 General Use Power Supplies -(R2011) Standard(s): UL SUBJECT 1699B,Outline of Investigation for Photovoltaic(PV)DC Arc-Fault Circuit Protection-Issue No.2,2013101/14 CSA TIL M-07,Interim Certification Requirements for Photovoltaic(PV)DC Arc-Fault Protection-Issue No.1,2013/03/11 ATM for Report 3188027CRT-001a Page 1 of 8 ATM Issued:13-Nov-2014 ATM for Report 3188027CRT-001a Page 2 of 8 ATM Issued:13-Nov-2014 ED 16 3.15(1J,-13)Mandamry ED 16.3.15 n1-13)Mergemry 3933 US Route 11 Cortland,NY 13045 ! Telephone:(607)753-6711 Facsimile: (607)756-9891 v ww.lntertekxom SolarEdge Technologies Ltd Letter Report 101703554CRT-001 June 20,2014 Letter Report No.101703554CRT-001 June 20th,2014 Project No.G101703554 • 3-ph Inverters: Mr.Meir Adest Ph:+972.9.957.6620 o SE91(US/SE101KUS/SE20KUS when the SolarEdge rapid shutdown cable labeled"MCI-CB-xxxxx- SolarEdge Technologies Ltd email:meir.a@solaredge.com 6 Ha'Harash St. x"which is part of kit SE1000-RSD-xx is installed in the inverter Safety Switch where xxxxx-xx is HOD HASHARON,ISRAEL any number;inverter part number may be followed by a suffix i Subject: ETL Evaluation of SolarEdge Products to NEC Rapid Shutdown Requirements This letter report completes this portion of the evaluation covered by Intertek Project No.G101703554. Dear Mr.Meir Adest, If there are any questions regarding the results contained in this report,or any of the other services offered by This letter represents the testing results of the below listed products to the requirements contained in the following Intertek,please do not hesitate to contact the undersigned, standards: Please note,this Letter Report does not represent authorization for the use of any Intertek certification marks. National Electric Code,2014,Section 690.12 requirement for rapid shutdown. Completed by: Radhe Patel Reviewed by: Howard Liu This investigation was authorized by signed Quote 500534459 dated 06110/2014.Rapid shutdown test were Title: Engineering Team Lead Title: Staff Engineer perform at SolarEdge Technologies Ltd,6 Ha'Harash St HOD HASHARON,ISRAEL and witness by Intertek �� GI personal on 06/17/2014. Signature: Signature The evaluation covers installations consisting of optimizers and inverters with part numbers listed below. Date June 2077,2014 Date: June 2d',2014 The testing done has verified that controlled conductors are limited to not more than 30 volts and 240 volt- amperes within 10 seconds of rapid shutdown initiation. Applicable products: • Power optimizers: o PBxxx-yyy-zzzz;where xxx is any number,0-9,up to a maximum value where xxx=350;yyy could be AOB or TFI;and zzzz is any combination of four letters and numbers. o OP-XXX-LV,OP-XXX-MV,OP-XXX-IV,OP-XXX-EV;where xxx is any number,0-9. o Paaa,Pbbb,Pccc,Pddd,Peee;where aaa,bbb,ccc,ddd,eee is any number,0-9 to a maximum upto aaa=300,bbb=350 ccc=500,ddd=600,eee=700. o Pxxx,Pyyy,Pzzz,Pmmm,Pnnn and P000;where xxx,yyy,zzz is any number,0-9 to a maximum up to xxx=300,yyy=350,zzz=500;where mmm,nnn,coo is any number,0-9 to a maximum up to mmm=405,nnn=300,000=350 • 1-ph Inverters: o SE3000A-US/SE3BOOA-US/SESOOOA-US/SE6000A-US/SE7600A-US/SE10000A-US/ SE11400A-US when the SolarEdge rapid shutdown cable labeled"MCI-CB-xxxxx-x" which is part of kit SE1000-RSD-xx is installed in the inverter Safety Switch where xxxxx-xx is any number; inverter part number may be followed by a suffix Page 1 of 2 TNI report h la the—,nive use al Irkaneka Giant aree Is provitle,1 Wrsmnt to tne agreement Canteen Intertek ant Its Gime ntertek's rmponsitllly esM Ibbey ars Ikrvtetl b Me terms erq coriAgom of ge aWeert•nt.lekertek assures re Iledlly to any W M.enter Men b Ma gbnt in epcortlarcs viM Me agreement,br ary baa,espanse or danage occasiomtl by the me of this mmR Ony the gieM is aiahor¢etl ro pemnt copylryl or tlh3nCutlan of Mb report ontl Men Dory in ib erNreN.AM use of the Inbrrek mma os ono of Ib marks br Mo sale or ativeNseennt of the bsbtl material,Patluct or service rWst first bo approvatl in writlng by Intertek.The oWemtlom ant lost reaWb In Mb report an relevem Dory ae semge tmtotl.Ttm report try its•Mdoes rotimpty Meter mabrbl,Iaotluct or urf her hesawr Seen u(rr�M7#e�n�IMortek wrtY tlon pragrom. iC 1U/ t 1/ •W+r 9 4> (•eAep tnt<nek� Page2pf2 tn�tert',e'k Irt�ilYtJek LrteYtek lnlCrlek lntet`tek 1nIM'tek Intertek Testing Services NA,Inc. So 12.1.2(11/11/10)Inf—ative Intertek Testing Services NA,Inc. So 12.1.2(11/11/10)Informat— i i i e SolarEdge Power OptimizergO�a 'Solal ' © � Module Add On for North America P300 / P400 / P405 SolarEdge Power Optimizer ' P300_ P400P40S (rorG .fl modulex b 72696cNt d I ) IT.,thl.flim modulerl 1 Module Add-On For North America �� �° INPUT ----- -- "6s .................. ..... ... .......`100 ...... .. .405 ...... ... ..W ... Absolute Maximum Input Voltage j P300 / P400 / P405 a 48. ..... .� ..... $°. ........ ....... ...125.... ...... Vdc .. c ,3�' ' s /' z +3' (Voc at lowest tem era[ure) P.. '" „i'.. ,rte - �.: MPPT Operating Range R.48 .. ...........8"g0.. ..... ..... .......12.5,-105....... ...Vdc .. Maximum Short Circuit Current(Isc). ............. .10. .. ................._..................... ....Adc .. "'�'� �7 > - ry Maximum DClnput Current ................ .................... ..... .... .... 12:.r'. .......__........... ........_.... ... Adc.... .................. .... .... ................ ......................... ... ............. 99.5 ........................ 4 . � ' t- Weighted Efficiency 98:8 % I `' -• ,� , ,.. Overvolta a Category .. ........................ ...... ..... ..... ..... II .............................................. .. ...... OUTPUT DURING OPERATION OWER OPTIMIZER CONNECTED TO OPERATING INVERTER) Output Current 15 Adc °' "`. Maximum Output Voltage. .. ............ ...60 ...' 85 .... Vdc STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) Safety Output Voltag�er Power Opnm .r� 1 L Vdc fA ® STANDARD..... .... ....................... ..... IEC61000.6 COMPLIANCE FCC Part15 Class B_ • � y � � � ,a + 5afetY...... .... .... .. ... ...... ... ..IEC62109 1 class II safety)UL3747 ......... .... ....... ....... RoHS_--____.-.._.._..—...... _..- _._.......__...__...... __ _�-.-- Yes _.. INSTALLATION SPECT FICATION_5 , ... �_.�_ Maximum Allowed System Voltage _ ......... ....1000......... ..... ................... ..Vdc.. _ ................... 141x 212 x.40.5/S.SS x8.34x 1.59, mm/in Dimensions(W xLx H) 128x 152x 27.5/ 128x 152x35/ 128x 152 x 48/ Pxxx 5 series mm/in .. .... .. .... ...... ..... ... 5 x 5.97 x 1.08........ ..5 x 5 97 x 1 37. ..... .....5 x 5.97 x 1.89..... .. Pxxx 25eues ...... 950/2.1 gr/Ib i R,�`i �* "`.v�l" ✓�`,zd '��€' r= ' Weight(including cables) ... ... ..... ... Pxxx5series 770,/L7.. .., ,., .................930/2.05,,,, ,,,, ,,,,,, s ^2" MC4 Com alible �� ✓v y >� � In ut .....onto ,W�.. ¢ + ; 'x", ' I'1, Output Wire Type/Connector.............. ....... ...... .. Double Insulatedi Amphenol ... ...... ....... � Output Wire Length. ........ ......x:95./3.�.. .....�......... .. 12/3.9 .._. ........_.. .. ...m/.k. �� -, y yr 3 r� ;L Operating Temperature Range, 40 r85/,40 f185 .. 'C/F ......... ................... 2senes... ..... ..IP65/...... ....... ...... ................. gr/Ib Protection Raring L..... .. .......... .............I Pxxx 5 renes... ............................ ..... IP68/NEMA6P.................................. ..gr/,Ib.... `., �� u a " Relative Humidity.. ........_. .. ........................................ .....96.... 'cY .•` �� ,,.: nam src hr mon„r nnoe�•o w w sw ire abr,.,a PV SYSTEM DESIGN USING SINGLE PHASE THREE PHASE 20$V THREE PHASE 480V �.., <"" = •..� „�.�.,. .,.±c. .��. �' .. :` ..,;; ASOLAREDGE INVERTERf'! Minimum String Length g 10...._.... ............ 18 (Power ORNmizersl...............................L......,..........................L............ ... . ..... . ...8...............{............. PV power optimization at the module-level "Maximum Su ... ing length PowerO nmizers 25 ; 25 50 Up to 25%more energy .f_.........P........,)............................._..... ...._..... ............._..L..................................._............................._�......._..... Maximum Powerper String..................... ......._,._5250_,__,., 6000 .,,,.,,.___12750_.. _..,W__.. .. .......i.................__.--. ........ Superior efficiency(99.5%) Parallel Strings of Different Lengths , Yes Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading or,Orientations ... ..... .... .._i........,,_._.,,_........ .................. Itu rotalb omia POM wtth P3r10/P3Ns/PEIXI/P6Ms/P)(W In a,v snug Flexible system design for maximum space utilization Fast installation with a single bolt Next generation maintenance with module-level monitoring Module-level voltage shutdown for installer and firefighter safety �' , 3 IT �. ]y 7 �� USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA WW W.SOId Y8CIg2.U5 Zlt�IRONRIDGE Roof Mount System AUTHORIZATION TO MARK This authorizes the application of the Certification Mark(s)shown below to the models described in the Product(s) Covered section when made in accordance with the conditions set forth in the Certification Agreement and Listing Report.This authorization also applies to multiple listee model(s)identified on the correlation page of the Listing Report. This document is the property of Intertek Testing Services and is not transferable.The certification mark(s)may be applied only at the location of the Parry Authorized To Apply Mark. tea" x _ Applicant: IronRidge,Inc. Manufacturer: IronRidge,Inc. l Address: 1495 Zephyr Ave Address: 1435 Baechtel Road Hayward,CA 94544 Willits,CA 95490 + - Country: USA Country: USA _ -- Contact: Yann Schwarz Contact: Jim Norsworthy Phone: (800)227-9523 Phone: (800)227-9523 (510)225-0973 FAX: (707)459-1833 FAX: (707)459-1833 Email: yschwarz@ironridge.com Email: jnorsworthy@ironridge.com _ Party Authorized To Apply Mark: Same as Manufacturer Report Issuing Office: Lake Forest,CA 0-r Control Number: 4007559 Authorized by: for Thomas J.Patterson,Certification Manager ETL CLASSIFIED offi- us Built for solar's toughest roofs. Intertek This document supersedes all previous Authorizations to Mark for the noted Report Number. IronRidge builds the strongest roof mounting system in solar.Every component has been tested to the limit cnw«r�mm arkoro xaa we eem sews cmm am i.awaee pu9ammt acenrneu«raym e m c nm rt�am inc erc ntearap«�uu an u rare ihnte0 m the re,maaM mnC4nne mare q�,eemeM hrortek aswmea rn Iiea9Ay ro aw peM.pm«man b ma CAen1 m aaoNarrve wM me apr¢emem,r«anY ba.expenee«damage oc®sonetl and proven in extreme environments. by the use INlhS Pum«Itatbnm MaM OnM me C9en1'a amhwizeampermA wpNeg ofd 4iCutionMm're Pum«¢albnb M1laM atm men mymi4 enYady llsemmM:eKs fcmgm,vn maM6 nre pp,mimaa and pM n me ag,eearept aM,ip trve mm�«eabpp m w�npymnne,�Mme km,mk same r«ma aam«aaemxmem Orme�xea mamwi,pmdau«aervk:e mw fi,M De appwetl n,+ntng by Nterlek.InNtl Fed«y Asseuments aM FMwv up Santos are bane purypea of aswnnp apVtVPnam usage Mme Cerldnatgn maM n acw,dance w5m me epreemenf, Our rigorous approach has led to unique structural features,such as curved rails and reinforced flashings,and mayara�mmrmeparppeeeMp�„wop�aeaia�Mmienaapama��.em«yemmtnz.pbwahp„enw.re�peM is also why our products are fully certified,code compliant and backed by a 20-year warranty. Intertek resting services NA Inc. 545 East Algonquin Road,Arlington Heights,IL 60005 Telephone 800-345-3851 or 647-4335667 Fax 312-283-1672 Strength Tested PE Certified UL Subject 2703 Outline of Investigation for Rack Mounting Systems and Clamping Devices for Flat-Plate F&IStandard(s): Photovoltaic Modules and Panels,Issue Number:1,October 4,2010 All components evaluated for superior Pre-stamped engineering letters structural performance. F(b available in most states. Product: XR Rails with Integrated Grounding. Brand Name: N/A Models: 51-61GD-005,51-61GD-005B,51-5000-001,and 51-65-001 17661 Class A Fire Rating Design Software Certified to maintain the fire resistance ® Online tool generates a complete bill of rating of the existing roof. materials in minutes. FflIntegrated Grounding 20 Year Warranty UL 2703 system eliminates separate Twice the protection offered by module grounding components. 1051 competitors. ATM for Report 101541132LAX-002 Page 1 of 3 ATM Issued:10-Nov-2014 --01—Q)—d" D o //d IRONRIDGE Integrated Grounding System Installation Overview Install Roof Attachments -- Simplified Grounding Install appropriate root flashing and/or standoff for roof type. For Greater Safety& Lower Cost ' .3,..._ •Attach L-Feet to flashing or standoff. _ Traditionally,solar modules are grounded by attaching lugs,bolts or clips to the module frame,then connecting _ Prepare Rail Connections these to a copper Conductor that runs throughout the a array.This process adds time and cost to the installation, Insert splice into first rail,then secure with Grounding Strap and N and often results in improper grounding,creating self-drilling screw. significant long-term safety risks. Slide second rail over splice,then secure with opposite end of The IronRidge Integrated Grounding System solves these Grounding Strap and self-drilling screw. challenges by bonding modules directly to the mounting rails.This approach eliminates separate module Mount&Ground Rails grounding hardware,and it creates many parallel grounding paths throughout the array,providing Attach rails to L-Feet and level rails. �,- greater safety for system owners. Grounding Mid Clamp •Install one Grounding Lug per row of modules. �\ Each Grounding Mid Clamp pleross through the Connect Grounding Lu to grounding conductor. anodized coatings of both the module frame and g 9 g g the mounting rail to form secure electrical bonds, which are repeated throughout the array. ElInstall 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. ani Testing&Certification The IronRidge Integrated Grounding F']l Module Frame Compatibility System has been tested and certified toDimension _ _Range UL 2703 by Intertek Group plc. FA 31.0mm-51.Omm UL 2703 is a proposed UL standard 5.08mm(minimum) for evaluating solar module mounting Any module frames whose parameters are not listed in the and clamping devices.It ensures these provided table have not been tested for compatibility. devices will maintain strong electrical and L — 3 mechanical connections over an extended The ng 60-call w period of time in extreme outdoor 72-cel'z s oln module frames with box rounding Clamp has proven c ontstrin c tion and as r na ge of environments. 2 The testing process closely mirrors that All solar modules listed to UL 1703 and with frame construction Grounding Strapof UL 1703,the solar module testing within the parameters stated above are compatible with the Grounding Straps are used to / standard,including temperature and IronRidge Integrated Grounding System. 14 bond rail-roan connections. / Grounding Lug They are only required on the humidity cycling,electrical and mechanical rail with the grounding lug. connect Grounding Lug load testing,and manufacturing y Q Go to ironridge.com/ig g g g connects an entire row 9. 9 gU81it y g of PV modules to the reviews. grounding conductor. K:.�anaY:t+.r�:,dC,�lalrin�:.rr-��s.�.nra�-gym"Fra.rrj.,.4c�xp��77KK?-rFsa�:r-y.�r,�,�rrrr.Yrmmm ,��� I I 1 ® 8431 Murphy Drive SN/L �"1 Middleton,W153562 USA Starlin Madison Lof Ulstr Inc. Tele Telephone:608.836 4400 Cans ultfrrg Struc�tur,'tf and F�fe•nsit £rr ginec•rs Facsimile; 608.831.9279 _. vnvw.intertek cam i ~ r � 5224 South 391 Street,Phcenbc,Arizona 85040 i Test Verification of Conformity tel:(602)438-2500 fax:(602)438-2505 www.smieng.com IronRidge June 16,2014 in the basis of the tests undertaken,the sample(s)of the below product have been found to comply with the requirements of 1495 Zephyr Ave Page 1 of 11 the referenced specifications at the time the tests were carried out. Hayward,CA 94544 Applicant Name&Address: IronRidge,Inc. Attn:Mr.David F.Taggart,Vice President Products 1495 Zephyr Ave. Hayward,CA 94544 Subject: IronRidge XR 100 Rail,Roof Flush Mounting System—Structural Analysis USA Product Description: XR Rails with Integrated Grounding. Dear Sir: Ratings&Principle Fire Class Resistance Rating: Characteristics: -Flush Mount(S mmetrical). Class A Fire Rated for Low Slope applications when using Type 1,2 We have analyzed the IronRidge XR 100 Rail for the subject solar module support system and and 3,listed photovoltaic modules. Class A Fire Rated for Steep Slope applications with Typel, determined that, for the configurations and criteria described below, it is in compliance with the 2 and 3,listed photovoltaic modules.Tested with a 5"gap(distance between the bottom the applicable sections of the following Reference Documents: module frame and the roof covering),per the standard this system can be installed at any gap allowed by the manufacturers installation instructions. No perimeter guarding is required. Codes:ASCE/SEI 7-10 Min.Design Loads for Buildings&Other Structures International Building Code 2012 Edition Models: 51.61GD-005,51-61GO-005B,51-5000-001 and 51-65-001 California Building Code 2013 Edition Brand Name: IronRidge Roof Mount Other: AC428,Acceptance Criteria for Modular Framing Systems Used to Support PV Relevant Standards: UL 2703(Section 15.2 and 15.3)Standard for Safety Mounting Systems,Mounting Devices, Modules,dated Effective November 1,2012. by ICC-ES Clamping/Retention Devices,and Ground Lugs for Use with Flat-Plate Photovoltaic Modules Aluminum Design Manual,2010 Edition and Panels,First Edition dated Jan.28,2015 Referencing UL1703 Third Edition dated Nov.18, 2014,(Section 31.2)Standard for Safety for Flat-Plate Photovoltaic Modules and Panels. The IronRidge XR 100 Rail is an extruded aluminum section with an overall depth of 2.438 in.and a Verification Issuing Office: Intertek Testing Services NA,Inc. net area of 0.583 sq.in. The rails are used to support solar modules, typically, onthe roof of a 8431 Murphy Drive building. See Exhibit A—attached. The rails are clamped to aluminum angle brackets that are either Middleton,WI 53562 Date of Tests: 08/27/2014 to 03/17/2015 attached directly to the roof framing or attached to a stand that is screwed to the roof framing. The Test Report Number(s): 101769343MID-001rl,301769343MID-001a,101915978MID-001&101999492MID-003arl-crl. rails are mounted across the slope with a small clearance(flush mounting)to the underlying roof This verification is part of the full test report(s)and should be read in conjunction with them.This report does not automatically structure. The installed solar modules are at the same slope as the underlying roof structure. Imply product certification. All loads are transferred to the roof framing through the angle brackets by simple bi-axial flexure of Completed by: Chad Naggs Reviewed by: Gregory Allen the rails. The maximum span of the rails is governed by either the mid-span flexural stresses or the Title: Technician 1�1,`Fire Resistance Title: Engineering Team Lead,Fire Resistance deflection requirement that the rail not come into contact with the roof. Signature: y Signature: Date: 03/30/2015 Date: 03/30/2blS The effect of seismic loads(for all design categories A-F)have been determined to be less than the effect due to wind loads in all load conditions and combinations. Therefore,the maximum allowable spans for common load cases are shown in Tables 1,2&3 below for 0-6 degree slopes,Tables 4,5, &6 below for 7-27 degree slopes,and Tables 7,8&9 below for 28-45 degree slopes. This Verification is for the exclusive use of Intertek's client and is provided pursuant[o the agreement between Intertek and its Client.Intertek's responsibility and liobilily are limited to the terms and conditions of the agree ent.Intertek assumes no liability to any party,other than to tha Clientin accordance with the agreement,forany loss,expense or damage acom,ored by the use ofthis Verification.Orly the Client is authorized to permrtcopying or distribution of this Venflcation.Anyuseoftheloterteknomeoroneofits arks for the sate o—ar,en-mart of the tested material,product or service must first be approved in wntmg by Intertek.The observufions and lest/inspection results Starling Madison Lofquisy Inc. Consulting Structural and Forensic Engineers referenced in this Verlficdtlan are relevant only to the sample testedlinspected.This Venfication byrt,,1f does not imply that the materiar,product,-service is or has ever been underan Intertekcertification program. GFT-OP-11a(24-MAR-2014) i I IronRidge June 16,2014 fronRidge June 16,2014 Mr.David F.Taggart Page 8 of 1 1 Mr.David F.Taggart Page 9 of 11 I IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis Table 7-MAXIMUM SPANS(inches)-Roof Slope 28 to 45 Degrees-Wind Zone 1 Table 8-MAXIMUM SPANS(inches)-Roof Slope 28 to 45 Degrees-Wind Zone 2 i XRWind Ground Snow Load XRWind Ground Snow Load Railail Speed Railail Speed j Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 sf sf sf sf sf sf sf sf sf sf PSI PSI psf PSI psf PSI psf PSI 100 107 98 84 75 67 61 56 52 49 46 100 107 98 84 75 67 61 56 52 49 46 105 107 98 84 75 67 61 56 52 49 46 105 107 98 84 75 67 61 56 52 49 46 110 106 97 84 75 67 61 56 52 49 46 110 106 97 84 75 67 61 56 52 49 46 120 101 94 82 74 67 61 56 52 49 46 120 101 94 82 74 67 61 56 52 49 46 Category 130 96 91 80 72 66 61 56 52 49 46 Category 130 94 91 80 72 66 61 56 52 49 46 140 91 88 78 70 65 60 56 52 49 46 140 88 88 78 70 65 60 56 52 49 46 150 87 85 76 69 64 59 56 52 49 46 150 83 83 76 69 64 59 56 52 49 46 160 83 82 74 67 62 58 55 52 49 46 160 78 78 74 67 62 58 55 52 49 4E- 170 79 79 72 66 61 57 54 51 1 49 46 170 74 74 72 66 61 57 54 51 49 46 100 101 94 82 74 67 61 56 52 49 46 100 101 94 82 74 67 1 61 56 52 49 46 105 98 93 81 73 67 61 56 52 49 46 105 98 93 81 73 67 61 56 52 1 49 46 ! 110 95 91 80 72 66 61 56 52 49 46 110 94 91 80 72 66 61 56 52 49 46 120 90 87 1 77 70 65 60 56 52 49 46 120 87 87 77 70 65 60 56 52 49 46 CateCgory 130 85 84 75 68 63 59 56 52 49 46 Category 130 81 81 75 68 63 59 56 52 49 46 140r69 80 72 66 62' 58 55 52 49 46 140 76 76 72 66 62 58 55 52 49 46 150 76 70 65 60 57 53 51 49 46 150 71 71 70 65 60 57 53 51 49 46 160 73 68 63 59 55 52 50 48 46 160 67 67 67 63 59 55 52 50 48 46 170 69 66 61 57 54 51 49 47 45 170 1 64 1 64 64 61 57 54 51 49 47 45 100 96 91 80 72 66 61 56 52 49 46 100 95 91 80 72 66 61 56 52 49 46 105 93 89 79 71 65 61 56 52 49 46 105 91 89 79 71 65 61 56 52 49 46 110 90 1 87 77 70 65 60 56 52 49 46 110 87 87 77 70 65 60 56 52 49 46 120 85 83 75 68 1 63 59 55 52 49 46 120 81 81 75 68 63 59 55 52 49 46 Category 130 80 80 72 66 61 58 54 52 49 46 Category 130 75 75 72 66 61 58 54 52 49 46 140 75 75 70 64 60 56 53 51 48 46 140 70 70 70 1 64 60 56 53 51 48 46 150 71 71 67 62 58 5552 50 48 46 150 66 66 66 62 58 55 52 50 48 46 160 68 68 65 60 57 54 51 49 47 t:14 5 160 62 62 62 60 57 54 51 49 47 45 170 64 64 62 58 55 52 50 48 46 170 59 59 59 58 55 1 52 50 48 46 44 Notes-see page t 1 Notes-see page 1 I Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers -8- -9- l IronRidge June 16,2014 IronRidge June 16,2014 Mr.David F.Taggart Page 10 of 1 I Mr.David F.Taggart Page I I of 1 I IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis Table 9-MAXIMUM SPANS(inches)-Roof Slope 28 to 45 Degrees-Wind Zone 3 Notes-Tabulated values are based on the following criteria: XR1o0 Wind Ground Snow Load 1. Building mean roof height=30 ft Rail Speed 2. Risk Category I Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 3. Solar module long dimension=67.5 in sf psf psf psf psf psf psf psf psf 4. Provide 2 in,clear between roof and rail 100 107 98 84 75 67 61 56 52 49 46 5. End cantilever span(max)=0.40 x maximum span from above tables 105 107 98 84 75 67 61 56 52 49 46 110 106 97 84 75 67 61 56 52 49 46 6. No rail splices in end spans 120 101 94 82 74 67 61 56 52 49 46 7. No tail splices in middle 1/3 of interior spans CateBgory 130 94 91 80 72 66 61 56 52 49 46 8. Single simple span(s). Spans listed in the tables above may be multiplied by 1.08 for 140 88 88 78 70 65 60 56 52 49 46 continuous rails of 3 or more spans. 150 83 83 76 69 64 59 56 52 49 46 160 78 78 74 67 62 58 55 52 49 46 170 74 74 72 66 61 57 54 51 49 46 Our analysis assumes that the rails,including the connections and associated hardware,are installed 100 101 94 82 74 67 61 56 52 49 46 in a workmanlike manner in accordance with the`IronRidge Roof Mount Installation.Manual"by 105 98 93 81 73 67 61 56 52 49 46 IronRidge and generally accepted standards of construction practice. Additional information is 110 94 91 80 72 66 61 56 52 49 46 available at the IronRidge web site,IronRidge.com. Verification of PV Module capacity to support 120 87 87 77 70 65 60 56 52 49 46 the loads associated with the given array shall be the responsibility of the Contractor or Owner and Category 130 81 81 75 68 1 63 59 56 52 49 46 not IronRidge or Starling Madison Lofquist. 140 76 1 76 1 72 66 1 62 58 55 1 52 49 46 150 71 71 70 65 60 57 53 51 49 46 160 67 67 67 63 59 55 52 50 48 46 1 The adequacy of the supporting roof framing is to be determined by others. 170 64 64 64 61 57 54 51 49 47 45 100 95 91 80 72 66 61 56 52 49 46 105 91 89 79 71 65 61 56 52 49 46 Please feel free to contact me at your convenience if you have any questions. 110 87 87 77 70 65 60 56 52 49 46 120 81 81 75 68 63 1 59 55 52 49 46 Category 130 75 75 72 66 61 58 54 52 49 46 Respectfully yours, D 140 70 70 70 64 60 56 53 51 48 46 vx �sqc 150 66 66 66 62 58 55 52 50 48 46 R TR S J. r� �G.j fI 160 62 62 62 60 57 54 51 49 47 45 WARNER m CIVIL w 170 59 59 59 58 55 52 50 48 46 I 44 I Tres Warner,P.E. No.40432 i Design Division Manager TFcisTcpFo Notes-see page 11 ""FSS7pNALettc� p/(i j i Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers -10- il- i i Tele Murphy Drive SN/L_ Middleton,W153562 USA Starling Madison Lofquist, Inc. Telephone:606.8364400 Consu/ti rug 5trur tural and F r e n s.ic frtg i n e.ers Facsimile: 608.837.9279 wvrvr.intertelc.cgm ''; " 5224 South 391 Street,Phoenix,Arizona 85040 Test Verification of Conformity tel:(602)438-2500 fax:(602)438-2505 www.smleng.com IronRidge June 16,2014 In the basis of the tests undertaken,the sample(s)of the below product have been found to comply with the requirements of 1495 Zephyr Ave Page 1 of 11. the referenced specifications at the time the tests were carried out. Hayward,CA 94544 i Applicant Name&Address: IronRidge,Inc. Attn:Mr.David F.Taggart,Vice President Products 1495 Zephyr Ave. Hayward,CA 94544 Subject: IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis USA Product Description: XR Rails with Integrated Grounding. Dear Sir: Ratings&Principle Fire Class Resistance Ratine: Characteristics: -Flush Mount s mmetrical. Class A fire Rated for Low Slope applications when using Type 1,2 We have analyzed the [rmrRidge XR100 Rail for the subject solar module support system and and 3,listed photovoltaic modules, Class A Fire Rated for Steep Slope applications with Typel, determined that, for the configurations and criteria described below, it is in compliance with the 2 and 3,listed photovoltaic modules.Tested with a 5"gap(distance between the bottom the applicable sections of the following Reference Documents: module frame and the roof covering),per the standard this system can be installed at any gap allowed by the manufacturers installation instructions. No perimeter guarding is required. Codes:ASCE/SEI 7-10 Min,Design Loads for Buildings&Other Structures International Building Code 2012 Edition Models: 51-1 51-61GD-0058,51-5000-001 and 51-65-001 California Building Code 2013 Edition Brand Name: IronRidge Roof Mount Other: AC428,Acceptance Criteria for Modular Framing Systems Used to Support PV Relevant Standards: UL 2703(Section 15.2 and 15.3)Standard for Safety Mounting Systems,Mounting Devices, Modules,dated Effective November 1,2012 by ICC-ES Clamping/Retention Devices,and Ground Lugs for Use with Flat-Plate Photovoltaic Modules- Aluminum Design Manual,2010 Edition and Panels,First Edition dated Jan.28,2015 Referencing UL1703 Third Edition dated Nov.18, 2014,(section 31.2)standard for safety for Flat-Plate Photovoltaic Modules and Panels. The IronRidge XR100 Rail is an extruded aluminum section with an overall depth of 2.438 in.and a Verification Issuing Office: Intertek Testing Services NA,Inc. net area of 0.583 sq.in. The rails are used to support solar modules, typically,on the roof of a 8431 Murphy Drive building. See Exhibit A-attached. The rails are clamped to aluminum angle brackets that are either Middleton,WI 53562 to 03/1717/2015 attached directly to the roof framing or attached to a stand that is screwed to the roof framing. The - Date of Tests: 08/27/2014 t Test Report Number(s): 101769343MID-001r1,101769343MID-001a,101915978MID-001&101999492MID-001arl-crl. rails are mounted across the slope with a small clearance(flush mounting)to the underlying roof This verification Is part of the full test report(s)and should be read In conjunction with them.This report does not automatically structure. The installed solar modules are at the same slope as the underlying roof structure. imply product certification. All loads are transferred to the roof framing through the angle brackets by simple bi-axial flexure of Completed by:. Chad Naggs Reviewed by: Gregory Allen the rails. The maximum span of the rails is governed by either the mid-span flexural stresses or the Title: Technician It,Fire Resistance Title: Engineering Team Lead,Fire Resistance deflection requirement that the rail not come into contact with the roof. Signature: ` Signature: �•'- �r_-l`'��"�'-- Date: 03/30/2015 Date: 03/30/2(115 The effect of seismic loads(for alldesign categories A-F)have been determined to be less than the effect due to wind loads in all load conditions and combinations. Therefore,the maximum allowable spans for common load cases are shown in Tables 1,2&3 below for 0-6 degree slopes,Tables 4,5, &6 below for 7-27 degree slopes,and Tables 7,8&9 below for 28-45 degree slopes. This VerFantion isfortheexclusiveuse oflatertek's chentandisprovidedpurs ant to the a greemember—,rat—kandits Client Mtertek'srespon.sibilityandliability mr. IimRed to the terms and conditions of the agreement.Int—ek assumes no liability ,to any parry,other than to the Client in accordance with the agreement,far anv loss,expense or damage occasionedby the use ofthis Verification.Only the Chemisauthorued to permi[copving or distribution of this Venfcation.Anyuseofthe Intertek nomeorone ofits marks for the tale or advertisement of the tested material,product or service must first be approved in writing by Intertek.The observations and test/inspection results Starling Madison Lofquist,Inc. Consulting Stmettiral and Forensic Engineers referenced In this Verlficadon ore relevant only to the sampie tested/inspected.This Verification byhself does notimply that the material,product,or service is or has ever been under on latentek cerh'fication program. GFT-OP-11a(24-MAR-2014) i I IronRidge June 16,2014 IronRidge June 16,2014 Mr.David F.Taggart Page 5 of 1 1 Mr.David F.Taggart Page 6 of 11 IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis IronRidge XR 100 Rail,Roof Flush Mounting System-Structural Analysis I 1 Table 4-MAXIMUM SPANS(inches)-Roof Slope 7 to 27 Degrees-Wind Zone 1 Table 5-MAXIMUM SPANS(inches)-Roof Slope 7 to 27 Degrees-Wind Zone 2 XR100 Wind Ground Snow Load XR1Q0 Wind I Ground Snow Load Rail Speed Rail Speed Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 Exposure mph 0 psf 10 20 30 40 50 60 70 8o 90 psf psf sf psf psf psf sf psf sf sf Pat psf psf psf psf psf psf psf 100 112 97 83 72 64 58 53 49 46 43 100 106 97 83 72 64 58 53 49 46 43 105 112 97 83 72 64 58 53 49 46 43 105 102 97 83 72 64 58 53 49 46 43 110 112 97 83 72 64 58 53 49 46 43 110 97 97 83 72 64 58 53 49 46 43 120 112 97 83 72 64 58 53 49 46 43 120 90 90 83 72 64 58 53 49 46 43 CateBgory 130 112 97 83 72 64 58 53 49 46 43 Category 130 83 83 83 72 64 58 53 49 46 43 140 105 97 83 72 64 58 53 49 46 43 140 77 77 77 72 64 58 53 49 46 43- 150 98 96 82 72 64 58 53 49 46 43 150 73 73 73 72 64 58 53 49 46 43 160 92 92 81 72 64 58 53 49 46 43 160 68 68 68 68 64 58 53 49 46 43 170 87 87 79 71 64 58 53 49 46 1 43 1 64 64 64 64 64 58 53 49 46 43 100 112 97 83 72 64 58 53 49 46 43 100 91 91 83 72 64 58 53 49 46 43 105 112 97 83 72 64 58 53 49 46 43 105 87 87 83 72 64 58 53 49 46 43 110 112 97 83 72 64 58 53 49 46 43 110 83 83 83 72 64 58 53 49 46 43 120 103 97 83 72 64 58 53 49 46 43 120 76 76 76 72 64 58 53 49 46 43 CateCgory 130 96 95 82 72 64 58 53 49 46 43 Category 130 71 71 71 71 64 58 53 49 46 43 140 89 89 80 71 64 58 53 49 46 43 140 66 1 66 66 1 66 1 64 58 1 53 49 46 1 43 150 84 84 78 70 64 58 53 49 46 43 150 62 62 62 62 62 58 53 49 46 1 43 160 79 79 76 69 63 58 53 49 46 1 43 1 160 58 58 58 58 58 58 1 53 49 46 43 170 74 74 74 67 62 57 53 49 46 43 170 55 55 55 55 55 55 53 49 46 43 100 112 97 83 72 64 58 53 49 46 43 100 84 84 83 72 64 58 53 49 46 43 105 108 97 83 72 64 58 53 49 46 43 105 80 80 80 72 64 58 53 49 46 43 110 103 97 83 72 64 58 53 49 46 43 110 77 77 77 72 64 58 53 49 46 43 120 95 95 82 72 64 58 53 49 46 43 120 70 70 70 70 64 58 53 49 46 43 CatDory 130 88 88 80 71 64 58 53 49 46 43 Category 130 65 65 65 65 64 58 53 49 46 43 140 82 82 78 70 63 58 53 49 46 43 140 61 61 61 61 61 58 53 49 46 43 150 77 77 76 68 62 58 53 49 46 43 150 57 57 57 57 5757 53 49 46 43 160 73 73 73 67 61 57 53 49 46 43 160 53 53 53 53 53 53 53 49 46 43 170 1 68 1 68 68 65 60 56 53 49 46 43 170 50 50 50 50 50 50 50 49 46 43 Notes-see page t I Notes-see page 11 Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers -5- -6- 1 ' I IronRidge June 16,2014 IronRidge June 16,2014 I Mr.David F.Taggart Page 7 of 1.1 Mr.David F.Taggart Page 11 of 11. IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis IronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis I Table 6-MAXIMUM SPANS(inches)-Roof Slope 7 to 27 Degrees-Wind Zone 3 Notes-Tabulated values are based on the following criteria: XR100 Wind Ground Snow Load 1. Building mean roof height=30 ft Rail Speed 2. Risk Category I Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 3. Solar module long dimension=67.5 in sf psf psf psf osf psf psf psf psf 4. Provide 2 in.clear between roof and mil 100 87 87 83 72 64 58 53 49 46 43 5. End cantilever span(max)=0.40 x maximum span from above tables 105 83 83 83 72 64 58 53 49 46 43 110 80 80 80 72 64 58 53 49 46 43 6. No rail splices in end spans 7. No rail splices in middle 1/3.of interior spans Category 120 73 73 73 72 64 58 53 49 46 43 8, Single simplespan(s). Sans listed in the tables above may be multiplied b 1.08 for 130 68 68 68 68 64 58 53 49 46 43 6 pp y P y 8 140 63 63 63 63 63 58 53 49 46 43 continuous rails of 3 or more spans. 150 59 59 59 59 59 58 53 49 46 43 160 56 56 56 56 56 56 53 49 46 43 170 52 52 52 52 52 52 52 49 46 43 Our analysis assumes that the rails,including the connections and associated hardware,are installed 100 74 74 74 72 64 58 53 49 46 43 in a workmanlike manner in accordance with the"IronRidge Roof Mount installation Manual'by 105 71 71 1 71 71 64 58 53 49 46 43 IronRidge and generally accepted standards of construction practice, Additional information is 110 68 68 68 68 64 58 53 49 46 43 available at the IronRidge web site,IronRidge,com. Verification of PV Module capacity to support 120 62 62 62 62 62 58 53 49 46 43 the loads associated with the given at-ray shall be the responsibility of the Contractor or Owner and Category C 130 58 58 58 58 58 58 53 49 46 43 not IronRidge or Starling Madison Lofquist. 140 54 54 54 54 54 54 53 49 46 43 150 50 50 50 50 50 50 50 49 46 43 160 47 47 47 47 47 47 47 47 46 43 The adequacy of the supporting roof framing is to be determined by others. 170 44 44 44 44 44 44 44 44 44 43 100 68 68 68 68 64 58 53 49 46 43 105 65 65 65 65 64 58 53 49 46 43 Please feel free to contact me at your convenience if you have any questions. 110 62 62 62 62 62 58 53 49 46 43 120 57 57 57 57 57 57 53 49 46 43 Category 130 53 53 53 53 53 53 53 49 46 43 Respectfully yours, 140 49 49 49 49 49 49 49 49 46 43 sqc 150 46 46 46 46 46 46 46 46 46 43o TRS J. 160 43 43 43 43 43 43 43 43 43 43 o WARNECl IL R m rr 170 41 41 41 41 41 41 41 41 41 41 Tres Warner,P.E. No.4SM32 " Design Division ManageroogFoia7eaF� Notes-see page 11 FSS�eNAt I Starling Madison Lofquisy Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers -7- -11- E-Mount Lag I QMSE - LAG E-Mount Lag Installation Instructions Installation Tools Required:tape measure,roofing bar,chalk line,stud finder,caulking gun,sealant compatible with roofing materials, ITEM DESCRIPTION QTY./BOX drill with 7/32"long-style bit,drill or impact gun with 1/2"socket. THIS EDGE TOWARDS ROOF RIDGE NO. I FLASHING,9"X 12'X.049',5052,MILL 1 _ 2 OBLOCK,CLASSIC,A360.1 CAST AL.MILL I 3 PLUG.SEALING,5116'X 7/8,EPDM/18-8 SS I -- A•.. p 4 LAG SCREW,HEX HEAD,5/16"x 51/7',I8-BSS 1 •�'�'' • "" 5 WASHER.FENDER.5/16"IDX 1-1/4"OD,18-8 SS, 1 4xEi, RACKING COMPONENTS NOT INCLUDED � e. 33 1 25 —.— Locate,choose,and mark centers of rafters to be Carefully lift composition roofshingle with roofing Insert flashing between 1st and 2nd course.Slide - mounted.Select the courses of shingles where bar,just above placement of mount.Remove nails up so top edge of flashing is at least 3/4"higher mounts will be placed. as required.See"Proper Flashing Placement"on than the drip edge of the 3rd course and lower i- 4-5p ..! next page. flashing edge is above the drip edge of l st course. 9.0J -___.._.-.. I Mark center for drilling. 29 Quick Mount PV` � .a nnE: AVAILABLE IN MILL,AND QMSE-LAG:QMPV E-MOUNT WITH LAG BOLT BRONZE ANODIZED FINISHES SIZE DR—BY: DFM REV x- n A DATE: 67297201< ..w,ermxoNme«°mexrw:'�°vosx,o a.n.ww,rve.wn®. °w.a„o4 ooucm.wru,wu a m"oreuu wn»+ro wffr�ua2 cu�iu x.z seise is caecal o.9e1 sHrttlori .`,g y.� �., tTt' Using drill with 7/32"bit,drill pilot hole into roof Clean off any sawdust,and fill hole with sealant Slide the flashing into position.Insert the rubber Lag Boll Specifications and rafter,taking care to drill square to the roof. compatible with roofing materials. plug into the QBlock cavity. Do not use mount as a drill guide.Drill should be sped&G.ovM SH6'ehefl per 3'IMeatl dopN s<ls enan perru,read depv, 'long style bit;aka aircraft extension bit'to drilla Dougma Fr.Lamh m 796 266 11,"deep hole into rafter. 0-,I a Fir,Soulh .ab 705 235 Eryelmann spruce.LM9epda Pine 1—16501 a higher) .46 705 235 Hem IBM— F1, JJ 636 212 Hem,F,INOM) A5 705 23s - • VVVV Souma R .55 921 '307 Spruce P f A4 615 --- 205 Spruce Pne Fr(E of2mlipn pa entl hgher grades.MSR-d MEL) .50 796 Sources:Amer can Wood Counc 1,Nos 2005,Table 11.2 A,11 3.2 A 0 Note 1)Th NDS ablb 11.5.ICf d narafteror others[ruccural roof member. _ D See NDS Table 11 5.1C far requ red edge d'stances =�•� _ QuickMount PV Slide the washer and the L-foot(not included)onto Using a 1/2 inch socket on an impact gun drive RESPECT T hl E ROOF the lag screwthe lag screw until the QBlock stops rotating easily. DO NOT over-torque. 817.2.3-31 Sep-2014,Rev 1 BI 7.2.3-31 Sep-2014,Rev 1 1 . Lo=U5Product Datasheet DIAGRAM-TYPICAL CONFIGURATION ENERGY I �� n®m nawm ini0�b-�i0® Shielded CATS RIM !n{ 130 = INTERNET i70-L7®- LGate 120 O® O an ERESIDENTIAL SOLAR MONITORING SOLUTIONLAM"MMThe - Inn�a • • • 7NOiaanrari ca=M CSO- ELECTRICAL • _ _ aaM.ya. ©®ILw O®! SERVICE • • • • • ..:..:5. i7® c3E3wl ®-"Sam communications module •automatically INVERTER(S) LGATE 120 • PV ARRAY operatorsr Ethernet networks allowing system owners and distributed solarDIMENSIONS SOCKET METER LOCUS ENERGY METER BASE COMM MODULE METER MODULE 6.95 In The LGate 120 combines a revenue-grade,sold-state power meter with an advanced communications gateway. ' .' 6.311n These components work in conjunction to remotely monitor the performance of residential solar energy installation ..•- ®v regardless of panel or Inverter type.The LGate 120 is a one-piece completely under glass meter which installs �"'—""• +I a r; easily using a standard socket Case.Performance data is uploaded in near real-time to the Locus Energy SolarOS monitoring platform which provides a suite of tools and analytics for asset managers. I 5.46 in —1 ------- �— 6.00 in —. �. 7.30 in �. DATA COLLECTION AC energy data is collected by the meter and passed to the communications module.Additional system performance data can be collected directly from meteorological sensors and supported inverters via available RS-485 or Ziobee connections.All data is stored in non-volatile memory and then automatically uploaded to the SOlar05 and SPECIFICATIONS SolarNOC platforms. Processor ARM9 embedded CPU Accuracy ANSI 1220(Class 0.2%) Os Custom version of Linux 2.6,OTA firmware updates voltage Inputs 120-480 VAC NETWORK CONNECTIVITY Memory 128MeRAM Max.currentmout 200A The communications gateway Inside the LGate 120 supports plug and play connectivity through a cellular or available Display LCD screen Service Type Single phase,60 Hz sp<k¢t Type zs Ethernet network connection.Once the unit Is Installed and powered on,It will immediately begin transmitting data without any configuration.For maximum reliability,the communications gateway will automatically route uploads Entloaure NEMA 3R Type between the wireless and wired connections If either of the networks are unavailable. weight 8 e: ANSI 1220 lase 0.2% Dimensions 6.95'x 6.5"x 7.3" FCC Part 156 Environment -20 to 60C.ail-weather PTCRS FEATURES warranty 5 year limited warranty AT&T Carrie C.—H.nce • ANSI C12.20 power meter Easy.low cost installation • RS-485 and Zigbee Inputs Doesn't require entrance into the building Meae1 Numb.r LGata12p3Ga lGate1203Gy LGatelzo-SGz Cellular-3G GSM J J J • GSM cellular or Ethernet connectivity Plug and play activation RS-4852 and wire ✓ Over the air firmware updates LCD display Modbus ✓ bgbee ✓ E theme[RJ-4510/100.DHCP/Static ✓ i Single Meter Sockets -Without Bypass Single Meter Sockets -Without Bypass 125&200 Amp 125&200 Amp _ Application `'t Single meter position Receive ANSI C12.10 watthour meters i _ - { Surface or flush mount(see chart) _i• f ,r Construction 011 F-Flush Mount 1A_ y, a a, Ring type (U)204 MS66-2"Conduit Hub 2A_lb* t7, w�• O (U)207 MS68A-MS73+MS66 NEMAType 3R U` 4F=2 114" 1l/a' 1' 927 MS73-Semi lushScreType Ring � •ANSI 61 gray Ecoat finish aG=2'h' 2" tth'-P/a' •Aluminum snap ring included SF-Semi Flush Mount Top Provision=See Chart SS Stainless Steel Standards Accessories UL 414 Listed 5th Jaw Kit-50365 •ANSI C12.7 200A Triplex Ground-ETB200 Knockout Layouts 011(closed) U204(open) AW Hub Pan/UPC C.W g Amp Stuart.. Ceemctioru Fig.1 Fig.2 Number Number Rating Jews Type A..ess Line Load Neutral9- .r 78205142000 011 125 4 10/3W OH/UG 114-2/0 114-2/0 #U-2/0 '-'"a Top Provision Top Provision 78205142040 011 F 125 4 10/3W OH/UG #14-2/0 #14-2/0 #14-2/0 78205142045 011 MS73 125 4 10/3W OH/UG #14-2/0 #14-2/0 114.2/0 78205142050 011 SF 125 4 10/3W OH/UG #14-2/0 #14-2/0 #14.2/0 78205144030 927 100 7 30/4W OH/UG 114-1/0 014-1/0 114-2/0 78205156000 204 200 4 10/3W OH #6-250MCM 16-250MCM #6-350MCM Q O 78205156020 201 F 200 4 10/3W OH #6-250MCM #6-250MCM 16-350MCM 78205156030 204FMS73 200 4 10/3W OH #6-250MCM #6-250MCM #6-350MCM 78205156040 204 MSB6 200 4 10/3W OH #6-250MCM @6-250MCM 16-350MCM _ 78205156035 204 MS68A 200 4 10/3W OH 06-250MCM 16-250MCM #6-350MCM - 78205108490 204 MS73 200 4 10/3W OH @6-250MCM @6-250MCM #fi-350MCM 4F 78205156005 U204 200 4 10/3W UG 06-250MCM 16-250MCM #6-350MCM 4F 4F 4F 78205156045 U204 F 200 4 10/3W UG #6-250MCM #6-250MCM 46-350MCM as -�LO "IF 782051560 60 U204FMS73 200 4 10/3W UG @6-250MCM 16-250MCM #6-350MCM 1A •tea 78205156070 1121314 MS73 200 4 10/3W UG #6-250MCM @6-250MCM @6-350MCM 4F 1A 78205156140 U207 200 7 30/4W OH/UG 16-250MCM 16-250MCM 16 250MCM 78205156170 U207 200 7 30/4W UG #6-250MCM #6.250MCM #6-250MCM 78205156180 U207 MS73 200 7 301 OH/1-113 16-250MCM 16-250MCM #6-250MCM Portion catalog —Overall Dimensions— Top Kno.tom Number Number Height Width Depth Provision Layout Fig.3 Fig.4 78205142000 011 12" 8" 4s/s" Hub Fig.1 Top Provision 78205142040 011 f 12" 8" 4s/u' 2""max Fig.1 Top Provision 78205142045 011 MS73 12" 8' 4e/e" AW Hubb Fig.1 P-4 78205142050 011 SF 12" B" 4s/a" 2"max KO Fig.1 78205144030 927 17' 8" 4s/e' AW Hub Fig.1 78205156000 204 15" 8" 4a/11" AW Hub Fig.2 78205156020 204 F 15" 8" 6" 2'max KO Fig.2 78205156030 204 F MS73 15' B" 6' 2'max KO Fig.2 78205156040 201 MS68 15" 8" 4n/e" AW/2'Hub Fig.2 0 4F 0 943 78205156035 204 MS68A 15' 8" 45/e' AW/2'Hub Fig.2 _ 78205108490 204 MS73 15" 8" 4e/e" None fig.2 78205156005 U204 15" 12" 4s/e" None Fig.3 -- 78205156045 U204 F 15" 12" 6' 1212"max KO Fig.3 I l^) 4F 4G 443 4F both 4r. 78205156070 U201 MS73 15" 12" 4e/e" None Fig.3 O 78205156060 U204 F MST! 15" 12' 6' None Fig.3 \ 78205156140 U207 18" 12" 5" AW Hub Fig.4 AIC Note: 78205156170 U297 F 1B" 12" 5" 21h"max KO Fig.4 For short circuit current 4G 1 V1 4G 2A 78205156180 U207 MS73 18' 12" 5" AW Hub Fig.4 ratings see page 131. B-Line Data subject to change without notice.Consult local utility for area acceptance.All dimensions are-riches.inches. Data subject to change without notice.Consult local utility for area acceptance.All dimensions are in inches. B-Line by BcT•0! 5 Meter Mounting Equipment Meter Mounting Equipment 6 by IF--T-0 1 ' r I U ENERGY October 22nd,2013 This letter is to certify that the LGate 120 and LGate 320 are communication boards built into the Vision Meter 2S CL200 and 16S CL320 socket meters,respectively. Each of these meters was certified to the ANSI C12.20(class 0.2%)standard by Underwriters Laboratory on June 7,2013 as part of the Vision Meter Family(Project Number 12CA71134,Job Number 1001541515,and Report Number R12CA71134- ANSI). ANSI 012.20 is currently recognized as the industry standard for electrical socket meters in both utility and PV monitoring applications.These tests cover both meter accuracy as well as several safety standards including electrical and environmental safety,as well as resistance to various types of mechanical shock. As electrical socket meters are generally installed and maintained by trained and certified professionals,rather than consumers,they do not fit the typical criteria for additional types of UL or IEC certification. If you have any further questions regarding the product certification of any Locus Energy LGate-branded device,please contact us at support@locusenerev.com. The Locus Energy Team Locus Energy,LLC -.locusenergvcom Classic Conduit Composition Mount I QMCC Classic Conduit Mounting Instructions Installation Tools Required:tape measure,roofing bar,chalk line,stud finder,caulking gun,1 tube of appropriate sealant,drill with ITEM NO. DESCRIPTION QTY. 1/8"bit,drill or impact gun with 7/16"deep socket. THIS EDGE TOWARDS ROOF RIDGE 1FLASHING,7'X I2'%.040",5052,MILL t • • • 2 QaLOCK,CONDUIT.5/16",6061-T6,MILL 1 WASHER,SEALING.1/4"ID X 7/8'OD,EPDM re NDED SS 1 4 LAG SCREW,HEX HEAD,1/4"z2-1/2',18955 I AVAILABLE IN MILL,CLEAR ANODIZED, AND BRONZE ANODIZED FINISHES. 12.0 $ .. CONDU/rCCAMP 13� NOT/NCLUDE v 4 23 Choose placement of conduit mounts along path Lift composition roof the with roofing bar,just Slide conduit mount into desired position.Remove 2.5 of conduit.Select location over center of rafter above placement of conduit mount any nails that conflict with getting the mount flush 3 with front edge of shingle course.Mark cernter for ® drilling. 4.5 2 e & 9.0 w tNOW .79 Quick Mount PV- TITLE: V TITLE: —}- QMCC:CLASSIC CONDUIT T COMPOSITION MOUNT n SIZE.D—N 3T: RAD REV V w I� �y yyV '�`},. ° -"$ 4 n A DArT: vn,mO 4 -_ I�III y'4- y�aa .. MErm Using drill with 1/8"long bit,drill pilot hole Into Clean off any sawdust and fill hole with roof Lift shingle and slide conduit mount into place. e. 5 4 3 2 1 roof and rafter,taking care to drill square to the manufacturers approved sealant. Prepare lag bolt with sealing washer and single We roof. clamp(riot Included)as shown.Insert lag through hole in block and position clamp over conduit. e I Lag Boll Specifications II Spectre Gmvrty 1l—en per l 3Ff•Ihreaa daptn 11—an per l•N,a nn, DD-!-Fir.Lerch .50 393 225 s i! All roofing I� Douglas Fir.SouN 4 353 202 ,. ten instructions must also bel Engelmvnn Spruce. 4p Lpepole P11-(MDR 1650 1&hi,-) .486 353 202 sfollowed by anyone modifying a Hem,Fir 03 313 t79 roof system.Please consult the Ham,Flr(W.) A6 353 202 roof manufacturer's specs and S-ham Pne .55 455 2a0 Spruce,Paw,Fir .42 302 173 mstrUCtions prior to touching Spruce,Pine.Fir(E a2 mlp,on Psi—hia—Braden of rASat—MEL .50 303 225the roof, Sources:Amerkan Wood Council,NDS 2005,Table IIIA.1132A Notes: UThread must beembddd Ina rafterorothe,structural roof member. In lag through hole in block,and position zlseelacbrreg19reddgedlrtanrn, clamp over conduit.Using drill with 7/16"socket IMPORTANr:Tomalntainwaterproofing it is imponantthat the aluminum flashing(hem l)itpmperlyplacdunde,,mfulic ,u abovethemountingbbckwXhatleastspmeofthe drive lag until block is tight flashing eRtedhtg up under the course above[h.s a<-11 Sea m-asv.v.nn I— P�l quick Mount k' Quick Mount PIF. 925-478-8269•www.quickmountpv.com •info@quickmountpv.com RESPECT THE ROOF 2700 Mitchell Dr.,Bldg2•Walnut Creek,CA 94598 BI 7.2.3-8 Aug-2014,Rev 4 BI 7.23-8 Aug-2014,Rev 4 02013 by Quick Mount PV.All rights reserved. s i '_ ZONING TABLE, ZONING DISTRICT.' R4 REQUIRED PROVIDED MAX. HEIGHT 35 FEET < 35 FEET SOP Day MIN. LOT FRONTAGE: 100 FT 100.00' DkftN t d)tfta SS MIN. LOT AREA: 12,500 S.F. 10,000 S.F. a MIN. FRONT SETBACK 30 FT 23.1 FT � MIN. SIDE SETBACK 15 FT 5.5 FT MIN. REAR SETBACK 30 F-7 6.9 FT NORTH ANDOVER ZONING RECORD OWNER: AARD OF APPEALS ASSESSOR MAP 15, LOT 53 FRANK & HEATHER ROWE • . 11 DANA STREET darrNORTH ANDOVER, MA 01845 DEED REF.• BK 2971 PG: 44 FOR REGISTRY OF DEEDS USE ONL Y PLAN REFERENCE: BOOK.• 173 PAGE: 600 i TAX MAP 15 LOT 41 TAX MAP 15 LOT 40 APPROVED 20_ #20 HAROLD STREET #10 HAROLD STREET N/F DAVID J. LICCIARDI EX. 1 ST. N/F CURTIS COGLIANO N86'00'00"E GARAGE �'- 100.00' LOT AREA= 5.7' 10,000 S.F. EX. 1 ST. OD o GARAGE ui N 36 EX. 1 STALL GARAGE (19'x25') TO BE RAZED. 12.4 PROP. ADDITION TO BE BUILT WITHIN DECK ( I EX. GARAGE f QOTPRINT AND EXTEND AS I SHOWN. ADDITION SHALL NOT BE 3 30'0' 0 -0 N CLOSER THAN 6.9 FEET TO REAR LOT LINE N U a p o �� o EXISTING I EX. ROOFED PLATFORM + STEPS 79 * " WOOD TO BE REMOVED f- w -'ui z STRUCTURE I O 0-: W I N to -''� 20.3' k �t vi a z w , 24.5' I o ui #1 DANA ST. Qo� I } I Ex. Bit. u)(Q 2 N iI aonc. ao oz lo a o: n Driveway I Q ooN l x "\N o I cn < a 4 S86*00'00"W I 100.00' DANA STREET GRAPHIC SCALE SCA LE.•1"=20' FEET 20 0 10 20 "I HEREBY CERTIFY THAT THE PROPERTY LINES SHOWN ON THIS PLAN ARE THE LINES DIVIDING 11 DANA EXISTING OWNERSHIPS, AND THE LINES OF THE STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY PW PZ" OF ZAJW ESTABLISHED, AND THAT NO NEW LINES FOR LOCATED IN DIVISION OF EXISTING OWNERSHIP OR FOR NEW NORTH ANDOVER, MASS. WAYS ARE SHOWN AND THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTRY OF DEEDS." (ESSEX COUNTY) I DECLARE, TO THE BEST OF MY PROFESSIONAL KNOWLEDGE, INFORMATION, AND BELIEF, THAT PREPARED FOR THIS PLAN WAS PREPARED IN ACCORDANCE FRANK ROWE WITH THE RULES AND REGULA 71ONS OF THE REGISTERS OF DEEDS SCALE' 1"= 20' DATE: FEB. 24, 2015 OF PREPARED BY FIN SULLIVAN ENGINEERING GROUP, LLQ' } 22 MOUNT VB'RNON ROAD �.� 116 ' BOXFORD, MA 01921 (978) 352-7871 L/ jam " >�auc Fl SHEET No. 1 OF 1 r Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-065128 SHAWN R DUFRONE --- �•�. 5 EQUESTRIAN WAYR° s Merrimac MA (060 rS )1W �� Expiration Commissioner 04/01/201( i Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 161510 _ Type: Individual _ Expiration: 10/23/2016 Tr# 259843 SHAWN R DUFRESNE SHAWN DUFRESNE r - 5 EQUESTRIAN WAY - MERRIMAC, MA 01860 Update Address and return card.Mark reason for change. SCA1 0 20M-05/11 �j Address Renewal [:] Employment F-] Lost Card -- - ��e Tpoanirno�rzuseaCG�e��j`aaoac�craeCl3.�� - - -- - - Office of Consumer Affairs&Business Regulation I License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 161510 Type: Office of Consumer Affairs and Business Regulation xpiration: .10/23%2016' Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 SHAWN R DUFRESNE SHAWN DUFRESNE 5 EQUESTRIAN WAY MERRIMAC, MA 01860 Undersecretary Not valid hout signature Date.......7 6.....o.4 e f �apR7M 1 7--!" TOWN OF NORTH ANDOVER ti p PERMIT FOR WIRING i o� � ti�w• SACMUSE'� This certifies .......................... ................... ....... ................... has permission to perform ...........1.�..!.//r�. / ................................... wiring in the building of..........r .. 0 i ' at.........F../....... /?/1 ....sr ........................ .North Andover,Mass. o P� } Fee....`C_ ...-. Lic.No. ... .. .. ........................ .... .. - s!✓�- * -^� ELECTRICAL INSPECTOR Check # r 6761) HIE COAMOATMAL HOFMASSACHUSF'77S Office Use o ly 76� DEPAR7i 1W0FPUBIICS4EETY Permit No. (�G BOARDOFFIREPREVE MONREGUTA7IONS5raIR12. 0 Occupancy&Fees Checked APPLICATTONFOR PERMIT TO PERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) /j /y 447/0yne Owner or Tenant k Rbt--) Owner's Address / .x.4/1/.4 S eel- Is this permit in conjunction with a building permit: Yes� 1 CLNo (Check Appropriate Box) Purpose of Building L95e,h� l Utility Authorization No. Existing ServiceD.� Amps Zv/_LLVolts Overhead Underground No. of Meters New Service _� Amps / Volts OverheadUnderground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 70.1677 o c 40 / ell No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of lighting Fixtures Swimming Pool Above Below Generators KVA round round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRM.ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained �--. Detection/Sounding Devices No.of Dryers Heating Devices KW Local r7 Municipal Other Connections Nof of Water Heaters KW No.of No.of Signs Bailasis Na.Hydro Massage Tubs No.of Motors Tota HP OTHER' )I)SlY'arY�:COVelage.PILSEYcIYblheQf1VI'1S�1�ILSCQIP!�11IaWS IbaveaammlmbTnyh&u•r=FbhcyirdAMCorruil aCo crJtsstbs rtW ec}atvak3at YES NO IhaNesubmatadvaTdpmofo(sartetodie Offm YES F"T IfyoulrawdrdodYLS,plemfdcwtheeAxofcoretag�by drcidngd-calpo box / NSURANCEBOND p CIIIIQt p fle?wSpeafy)4411 _ Dais W U C) 1 valueof bchicalwotk$ Wodclosatt 06 haspeMonDaeRet�sW RouJi __I L zoo ,eh U Final 1200 Or, Signedtulder't FU1aJtAofperjtuy. ( ,/ �/ FIRMNAME A*yam "fn /K�6+�A-id JC Jec4, LkemNo. 1y7 fQ 3 q 2 Litaasee , �•Dl ��G✓ C! signatine //_ / Lk=?,Io -Z!�Z-3 j'2— BunessTel No. f 6 7-5= 4/c/r AtTelNa 0WNWSINSURANCE WAIVER,Iatnawatethat theL=m does not have theirmtrtt=0Dv gmeoritssib-NYialegwvilentaswWiredbyMamdiwils(',mealLaws and that trey sig}rahue on this peunit apphcatk a wai`es this Iogtaitt3raerat (Please check one) Owner F-1 Agent Telephone No. PERMIT FEE$�,� • 00 Signature ot Uwner or Agent Location No. 411 Date NORTH TOWN OF NORTH ANDOVER O f � Certificate of Occupancy $ �sJACMUsBuilding/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ / TOTAL $ Check # 2a 1. , F- I i Ls J J J Building Inspector Z T The Commonwealth of Massachusetts ,. . d Department of Industrial Accidents Office of Investigations yw Boston, Mass. 02911 °+ Sy• Workers'Compensation Insurance Afdavit Name Please Print Name: '"' n k -7- 2—OC Location: City Phone # I am a homeowner performing all work myself. . I am a sole proprietor and have no one working in any capacity F-1 I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone#- Insurance.Co. Policy# Company name: Address City Phone# Insurance Co. Poli # Faikire to secure coverage as regwred under Section 25A or MGL 152 can lead to the bmposbon d onarnal penames af,a fine up to$1,500.00 and/or one years'imprisorwnent.as_rrdlas_civil.penakiesin thela=-da-STQPY K)W DRIIERarnd_afte-fAS1ADM)a-day against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. do hereby certify under the pains and penalties of perjury that the jnfonnateon provided above is true and correct_ Signature Date Print name P�ne. k Official use onty do not write in this area to be completed by city or fawn oftkcial City or Town Permit -ensi ng DCheck d irnr»ediate re El Building Dept sponse is required p Licensing Board Contact person: Phone#. p Selectman's Office Health Department Ei Other TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING us 006 . � fbil, asg fa 3 BUILDING PERMIT NUMBER: DATE ISSUED: �� 0 ic SIGNATURE: l' , /* Building Commissioner/1for of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: . 1.2 Assessors Map and Parcel Number: vc-X T� �f/ U Map Number Parcel Number v 1.3 Zoning Informattioon: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Rcquired Provided R red Provided 1.7 Water Supply M.G.I..C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHWIAUTHORIZED AGENT 2.1 Owner of Record Name(Print) Address for Service Signature Telephone G 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ V )_ (� (! /, r, I k-,, Licensed C nstruction Supervisor: 0 ee�� License Number an Address 7 ,7- x'8376 o Expiration Date Signatu Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Nam , ,6, 1'1y4- e Y / M f � J Registration Number '... 7 Y,C73 71 ! 0 Expiration Date J o{ Si nature Telephone G) SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) W-mkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the bu4ng permit. Signed affidavit Attached Yes......JV No.......❑ Fi CTION 5 Description of Proposed Work check au a Hcable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 0 0 /� Y/'� /r'/'t'Z SECTION 6-ESTIRAVEDf CONSTRUCTION COSYt Item Estimated Cost Dollar QFI�' G) ( )to be IIki(#NLY Completed by permit applicant 1. Building (a)^Building Permit Fee Multi Tier 2 Electrical (b) Estimated Total Cost of / O "� Construction 5 d., 3 Plumbing /U o W Building Permit fee(a) X (b) 4 Mechanical(HVAC) p 5 Fire Protection 77j o 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CO TRAC OR PLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize 24/ n to act on My b a ,in all matters r lat o w r authorized by this building permit applicatio . Si nature of Owner Date ' SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, Owner/Authorized Agent of subject property Hereby declare that the statements and informatio the foregoing application are true and accurate,to the best of my knowledge and belief Print Name 691 - 910 " OD- Si ature o o weer/A ent Date r NO.OF STORIES / SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I 2 3KD 77 SPAN DIN ENSIONS OF SILLS DINIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHI10NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover f NORT11 o oL Building Department o 27 Charles Street North Andover, Massachusetts 01.845 ? 4 Ore tOCMCMIWKR`y' (978) 688-9545 Fax (978) 688-9542 rPa .cy 9SSACHI) DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit.# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: Facility location Signatur of Applicant ;z d I Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. urrice orinvesugarions Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name' / Location: / D �✓ s fi p�Th 1/ Phone F-7 oZ g im a homeowner performing all work myself. ( ! am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Com any name. Address city: Phone# Insurance Co Policv.# Company name' / l °y ` r 7-1 Address �' Phone# _7 � 371/0 . � ' Insurance Co. 2 /)I Poli # /o/ Q /O 0S1(ge6 _ • Failure to secure coverage as required under Section 25A or MCL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herby certify under the pains and penalties of perjury that the information provided•above is true and correct Signature V Date Print name d cy l�` Phone# g"6�-3 /16) Official use onty do not write in this area to be completed by city or town official- ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person._ Phone A ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR t Number: CS 040151 Birthdate: 06/30/1951 ' Expires:06/30/2002 Tr.no: 24415 Restricted To: 00 ANDREW R GUERTIN 36 PINE STS METHUEN, MA 01844 Administrator NONE IMPROVEMENT CONTRACTOR Registration: 111199 Jl, - Expiration: 06/13/1002 Type: Individual ANDREU R. GUERTIN pKDREM GUERTIN ADMINISTRATOR 6 PINE ST, METHUEN MA 01844 t%ORT' E � , ® of Andover ............ No. over, C� tw_ L A Mass. 15� CHIC CQ 0"?ATE C7 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.....M..Z..*14A.S......... .......................................................................... BUILDING INSPECTOR ..... ..... ....... ... .. ..... ..... ....... ..... ...... .. . ..... Foundation has permission to erect..!��.GAA.r............ buildings on ....[1..... ..A. .a. Sftl- .......& ............................. Rough W* Chimney to be occupied as.5044? ............................................. P that the person accepting this permit shall in every respect conform to the terms of the app Ica on on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. YVON t T fft*b PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final h PERMIT EXPIRES IN 6 MONTHS T TS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S S Rough ...... Service ................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in -a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Ilei 63 �d IF I V , I ! e ; I l 'a , I I l 11 i I I ryll I ` Iialj:al;u' ! J L71JYCi1'i .._. + _ _ / r"7 1 � .•.F1 ,`I.7�.1� !� � i.u'L,e; �{.'s Pif L.1�ri {»� R /�l ' C;�,� :f t, �.. i`y J1 ':p- f i AIIO IIS IIAE RISUi1ERS. _ I CFRTIFY IIIA) 1 NAVE fl{AIIIUEEI IIIE PRf.MjsFS AllTl IIIE f)i111T1INCS SIS+".,-Mj !)0 t i r;.. CO011'00 ! 10 IIIE 1001110 LAWS ANU AME1101.011S, I* Will. Sivf, k REAFT lAfitl 5'c;f!At;1 NII.Y OF TJ�Ex»' } Wall coils lnucim. l .;. i TUIIRIER CERTIFY IIIAT 11115 PROPERIY IS (qIOCAIEII liI IIIc FSTA11t1`III)l i;i)r,ri .;tE;) IIA7AiT0 AREA, 250098 0005B JUne .15, 1983 FKAMIIIA11011 OF MC IIEf: POS IS MIT OIIk.Y S005F()}1llit 10 IIIE. iiE1;t)RI1EIt [>A,iE OF 11'rCAIM IlFEO. Alin h0f_S 1101 111c i)E VERIF11N0 IIIE ACCIMACY OF )!)r. k)Uj) ,,E.<,,,,,I T'AG£ i, IY I'RE41WS 10 IIS DAIE OF' 1iECOpl). ,;;ol•.:d•- ' : Wil. TIO. RI(S CONi"AtIY IS HOT RE.SPOIISIRIE F(A Af1Y 100ENIiIRES 1,IAIIE SUBSEQUENT 10 111F. RECOROW DATE OF IIIE LATEST UEEU OF 1JECORn• I I MIFNEyEq 11111111RICS ARE SlI01vI1 IF.SS TITAN ONE FOOT FliM IIIE 1'ROPERI4 1111E IT IS AWASH) Pt.All BK, PACE MAT MAT A 11011E PRECISE SURVEY BE MADE TO VERIFY Tl(tsK IIEASfIItEI!Ei1i5, r g PLAN - OAITo 1 TI IIS CERAFICATION IS BASE 011 WE I.00ATIOIT OF SURVEY 11ARKERS OF GOES AND OTHERS• Ir ,tiol Ru1'FIESENF A PROPERTY sumo. ���_� _�CAO 1 14!19 11115 CE.RIIFICA11011 TO UE U5ED }OR MCRiGA,GE pUiIpOSES 0111.Y', $CAI El T'- '` t1FFSF,TS AS S116M) ARE; NOT TO BE USED FOR IIIE ESMUS11MEPif or 1'CtOI'ERTY LillEs P.O. DOX 1244 HAVERHILL MA. 01831 'r t.ttI RO hal ttl �fi.�_ �103U7 IFI (eoel a»-4Toa L, .i m �2/YYI�� �J1GJ S t 1 W i YIO(ow _ m � A S-I'A t-L ( PATI + r3vJL� ��,c,oNy 4�X IZ� ?J o -JbP O( BAt,CANY' Tu Ise - - � 7 00 ,3 �G AV J 5�,w v N P i Location No. 6-12 2 6 Date "°"T" TOWN OF NORTH ANDOVER °t, •'° x,•,1'0 p Certificate of Occupancy $ � . . Building/Frame Permit Fee $ s;CHUs t� Foundation Permit Fee $ 4t Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works PER-MIT NO. 02-b APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. Y PAGE 1 PAAP K40. I LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. MC-�D �- -/�L YS� LOCATION PURPOSE OF BUILDING /1 �AAlA SI •' _ �Frd�,L/�•v7lA't. OWNER'S NAME r NO. OF STORIES / SIZE i F-r2yON/L /��AiI/(y/Z %Zoty� _ /ft 7r LL ?C 441 OWNER'S ADDRESS S,± BASEMENT OR SLAB 'a 4s 4 ARCHITECT'S NAME N�h SIZE OF FLOOR TIMBERS IST 1nx- 1, 2ND •la),sy 3RD BUILDER'S NAME N•G. SPAN I-�Aoc. Couritacro�s, dlv• i?,�/�7���� DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS --- DISTANCE FROM STREET 211 POSTS DISTANCE FROM LOT LINES—SIDES ZZI REAR 43/ "' " GIRDERS AREA OF LOT gyp/ pva 3•i-• FRONTAGE 1p0� HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW Nd. SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION f IS BUILDING ON SOLID OR FILLED LAND sp`/D WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Yi'S IS BUILDING CONNECTED TO TOWN WATER VA-S BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER yA'S IS BUILDING CONNECTED TO NATURAL GAS LINE kS INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST y� /S 0790•oy \ PAGE t FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. AGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM ` ,) SEPTIC PERMIT NO. FA,ECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE rhtt�� XBOARD OF HEALTH SIGNAT RE OF OWNER OR UTHORIZED AGENT OWNER TEL.#__bb7-2y'ZZ F E E ��• a-0 CON I H. I EL. 4- Lk- CONTR. LIC. PLANNING BOARD PERMIT GRA �, 19� BOARD OF SELECTMEN FFF3 _ 7 M2 BUILDING S CTC BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM , MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K* PINE BRICK OR STONE HARDW D PIERS PLASTER _Y ✓ _ _ DRY VJALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. BM'T AREA _ Y, 1/7 '/, FIN. ATTIC AREA _ N_O B-M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 bo DROP SIDING CONCRETE _ WOOD SHI lES �/ EARTH _ ASPHA"'SING HARDW'D ✓ —�{j_ ASBE; f/ DINE G —_ COMMON —_I VERT. 4,,_)JG ASPH.TILE _ STUCCO ON MASONRY STUCC ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I✓� POOR _ ADEQUATE 1 NONE 5 ROOF 11 10 PLUMBING GABLE I✓ HIP BATH 13 FIX.) ✓ GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED ✓ WATER CLOSET ✓ ASPHALT SHINGLES ✓ LAVATORY WOOD SHINGES KITCHEN SINK ✓ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST ✓ PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. _ STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS GA 7 j NO. OF ROOMS OILS B'M'T2nd _ ELECTRIC 1st 'I 3rd NO HEATING r – w I I I CEJ X14, i (7/a> aL 4 1 7 t t a t :,r' li MORIGM.\3E INS@EC*110H Pl_ka,, D_ 4 _ZA1'E+cf?- t` roc tfo Its BUYER, To 111E �1 . (:.G'.t ll�� �-_'`�ff'_ r o r` Jr7 ri � �� ►V(=. I A.110 Its MU INSURERS. .- MASSACi 1USETIS CERTIFY MAT I HAW EXAI.l11IE0 11 IE PRFMISFS MIT) 111E FI011PINCS -4i0YA1 t)0 COIIFc1NU 110 111E 70111110 tAWS AFIU AMENOME111S, I. iR0111, �10E, k REAR 'IAI%t) 5 !llft.K 01ItY Of 1 10F.:F44 t-',,NDcj :. wall r.(111sworlil). I F014 MEN CEI1111Y 11IA1 11115 PROPERTY IS oo-10CAII0 111 IM Es TAM ISIRD III1 O IIAtARO AREA. 250098 00058 June 15, 1983 DOW _ z�'�'+ tXMAI1IAT1(111 CIF PIC RECOM)S IS WIA0E Mill SI1VIN111111 110 lii£ WC0111)EF1 I,A1V Of ll,r IAIEST UEEO Attu DOES 1IOF 1111a110E LIRIFWIG 111E Ata;UI1Jr•tt OF Mr 01`11, 1,1.<;t C'1'11(,tI PACE !. 1'REVIMS 10 IIS iDAIE OF PECOIIU. CERI. N0. 11115 MAPAtIY IS 1100 RFSPOIISIHIE FOR MY IMEt1111RCS PAPE SUBSEQUENT' 10 111f. RECOR11Ct) DATE OF 111E LATEST UEEO OF RECORD. �7 Pt Ati BK, _ 3_PAf,F yAlF1)EYFH Hllllil!ftCS ARE 511/`1/411 IFSS 11IA)I 011F. 1`001 FR01! 111E 11P(X1ERT1( tit!£ if IS A.0�1Sf0 -- THAT A MONRE. PNEMI: SI/IIVLY UE MADE Tv 1fFt't ( IMSk 11LASItittlttNl5. PLAIT / -_- T)A110 PQ1U. 11115 CERMICATIM IS BASE Oil 111E LOCA1J 1011 Of SURVEY 11ARKERS OF 01HERS, AND DOES V NG I N0f RfrtItSEHT A rROI1RlY SURVEY. __---_—__ loao 11115 CE1111FICA11011 10 UE USED rOR MCRTGtAGE PURPOSES OWN. SCA.tE, OFFSETS AS S110M] ARE NOf TO BE USE'!) FOR 11111(✓ E5FA011S111.IFtlf OF PROPERTY 1.11![5 IMA1?rORi) T:Nf;illEf;f7iNr Co. P.O. DOX 1244 HAVERHILL MA, 01f131 01 ,� RQ SST t,1 fi.�_�. ¢10307 11`1 f,6Qby J7J-9108 :clsitxlr;l�w -------------------- - - i ComriavaJ Sarr'�r a;�D ,cidtc ICEwi. I 3vssec �cE ascr" w 9 iasv�rr:�oN �wr*+ P,zapAx ve" I - IAI'r . ; Ouws72vc� /2 wiBE _DaRAIEf..._.. . -- --- - SCA 4-6 I Location // No. Date d L N°"T"pt TOWN OF NORTH ANDOVER,gyp p Certificate of Occupancy $ s • Building/Frame Permit Fee $ MUFoundation Permit Fee $ �,SSACstt Other Permit Fee $ 7J• Sewer Connection Fee $ Water Connection Fe $ TOTAL . �7 Wnt nspector Div. Public Works I I SEWER/W A N NJ C� TA R FI N A L Town of n over No. 0 0*26 T I R K ......... er, M 19 C HEW":. ass 0 BOARD OF HEALTH PERMIT THIS CERTIFIES THAT404...T. A K.. ... .. atoqr..................................... has permission rawW&9....W. "I, I / BUILDING INSPECTOR g �&s on ..... AVA# .....ts. ........ Rough Chimney .............................................. occupied as...... V,-&JJFCUAJG,�.......... 1_1�_ Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids thism Rg it. PERMIT EXPIRES J 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONS RU T Service Final . . . ............... . ................. ......... UILDI SPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buil Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector Location zz r,�I No. Date NORTq TOWN OF NORTH ANDOVER F Certificate of Occupancy $ Ctits Building/Frame Permit Fee $ '?� y Nus Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 56 6 Building Inspect r � TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING k- "'iTAG.' BUILDING PERMIT NUMBER. 9 DATE ISSUED. X r � SIGNATURE: Building Commissioner/1for of Bidldin Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage 11 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply M.G.L.C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIUVAUTHORIZED AGENT m 2.1 Owner of Record 'Blame(Print) / Address for Service air ��'7v' %1? - 3�cf.3 Signti3ure Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O 70 rf�����cdN ` ��� License Number 0j mn Address V q Expira'on Date Si nature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number r• Address r P z.r-) 7pZ J'3 cN�j Expiration Date z Sin re Telephone G) q SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check applicable) New Construction '" Exismg P�uil�iittg Repair(s) 11AlterationsO Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify ' Brief Description of Proposed Work:ell SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN A- OWNERS AGENT OR CONTRACTOR APPLIES FOR BUH DING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on J My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, '-ry� '�y !4�` as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief aOt' Print Name a� Si nature of O mQent Date ' NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE , ` .NORTH E Town of Andover �. No. L49 ol ~ ;iT-77 CN / o�A �oC 'CX dover, Mass., ORATED P'P�,`�5 BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............ ............ ..... ............................... ............................ ........ .............................. Foundation has permission to erect................ ..................... buildings on .11.. ... ao-&..... .......................... Rough to be occupied aSChimney ...........................................................................................I..................... provided that the person acce ing this permit shall In every respect conform to the terms of the application on file in Final this office, and to the provisi s of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 N40NTHS Final UNLESS CONSTRUCTIMN T S ELECTRICAL INSPECTOR Rough ................................ ............................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina, No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. A QILIL UMDEdEC CDMD EU(D0F Chimneys Residential & Commercial Roofing Sidin 9 CHIMNEYS POINTED-REBUILT-CAPPED All Types Of g Expert Mas my Work Mass Toll Free Roof Leaks Esrperts �- Licensed & Insured Locally Owned&Operated Since 1976 "" 1-800-WAIT-4-US ® _ License#034200 (924-8487) IKO We Work Year Round Proposal Submitted To Phone Date Street Job Name City,State&Zip Code Job Location Job Phone We Propose hereby to furnish and labor in accordance with specifications below, for the sum of: Dollars ($ All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized manner according to standard practices.Any alteration or deviation from specifications be- Signature: : low involving extra costs will be executed only upon written orders, and will become an �, v extra charge over and above the estimate.All agreements contingent upon strikes,accidents NOTE:This proposal\mdy be- or delays beyond our control, Owner to carry fire,tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. We hereby submit specifications and estimates for: IJ Install 3 feet of special "Eave Seal" ice and water barrier protection along all bottom edges of roof and p to bottom in each valley. If roof is striDbed, we will apply conventi_ wipe-an-cLw.a r ahieJd- ( ) ft. high In the same locations previously described and tar paper will cover the remaining,ane-Do-d..-Ala.-rotted-or d _ag_e i_b.9a swill be replaced at ( S ) per linear ft. or ( .5-0 0 ) per sheet of plywood. � Install heavy gauge aluminum drip edges along eve edge surface of each roofline. every g d Cover entire roofs with IKO 25 year all asphalt, non-fiberglass, premium grade shingles (Color of choice). CoV,47TW 3s- YX_ SCC jr�rb cl a Replace all pipe boots where possible. Seal all with flashings I - g clear Geo Cel sealant. No black tar unless previously applied. Remove all work-related debris. Contractor warrants roof against all leaks due to defects in his workmanship for 12 years under normal circumstances. dLocal current references and proof of workman's compensation insurance gladly given. Remarks: r' 'lam v� sa©mil�d ,�� 3. 9 Acceptance of Proposal - The above prices, specifications L s s and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment Signature: will be made as outlined above. Date of Acceptance: Signature: A ✓le -�a,�marecuea� o��/�aaaaclzuaeC�`a ' BOARD OF BUILDING REGULATIONS 1 License: CONSTRUCTION SUPERVISOR Number: CS 034200 II Birthdate: 09/30/1945 I Expires: 09/30/2003 Tr.no: 4398 Restricted: 00 NORMAN GAY 70 JEFFERSON STa N ANDOVER, MA 01845 Administrator a �ti!:11.1/J/1N./Y.3G>Y.:! .�J.'/.-:i'Yri:!•..J_'J y:J � .{..J,»e .C'r ti{: .v.^C.'•` '%ry¢ .wf:!...r-�J:,•+�'+r^u +•vp f�J.vr.Wiri:.•J.•Y.'ih'J.�:.v.{v:::}:x.•.,: :rh5.::A,::.:�!,.ZS�.�_:�:::�::�::�:.,:.:r;t:t,`;o.... :rr.J.J{�:".%r'..�^..'.�.CY{i?:�i�ol>.�}J:{:.<::�.s.:�wJ.tJJ.•.•:: ::}t°•s.•rii:/k.•:'a.`.��i'9.;:vr.�:.'•:,'';::ic::a!;y.oy,.'m`:•-x�ta:...�A}:f3�: G%'3m•w;!•�,J•:.':+°. , jilt' iT yX.f;Grf,{J;J4'Jlaf•''Ji}+/{`i!.s:yx 110620 M INDIO PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lennox Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 462 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lynnfield, MA 01940 COMPANIES AFFORDING COVERAGE COMPANY Savers Property&Casualty Insurance Company A INSURED All Under One Roof/Pest In Peace """ 70 Jefferson St KY North Andover, MA 01845 c�MC COMPANY D tv...................:.u:•. .v •n:- ay.�v .. - % t x �yvn.::• i,r} ,.n'"'� 'J.x:."i :G• >-;{{}''!.:. //�:;ryy}�;�; (( •tr,[[ a•.-t-- y$:+'..:;yam .�t'rr,a- z'•.zr��s%�za �ssr,:.J,c'.r`^�.r rix•> '� ..J.•ii {}. :7. n fR�J}rf 7W`t V: Tf 7K:.��rJ%7!-K<<i Af ffff f YfKff TJ.�/�.t .I(.l'fiflf �rcfiii �')X n -i! rr!!!+X 'r r. !N'.t Fa. .eeu. ;;r,:^,....»•i^:^:^: '{.y,• +: J ^::/ J 2.;..:idJJ��.� fU/.�'.' r.:•..fr :.::�:.?t?{:�:: :<oxo»:aS�:�•:.,,.k'.'',`{.�.�.•:.>�`ww�`J+.,t{y:rs>,:^�.Cvi.'-.}.a>i:}J.'fn.•ic{{!Y•. {.�r-'v�,�7.' »dr�..H..?:'r}/.i�.,.,.{. / f'L<�:9�::�.;157:{.'...F�,.• ,..' ;:1.....!i:!u...............:... ... 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:, CO POUCY EFFECTIVE POLICY EXPIRATION LTR TYPEOFINSURANCE POLICYNUMBER DATE(MMONM DATES (MMIDONY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS•COMPOPAGG. S Y. CL MMS MADE E]OCCUR PERSONAL A ADV.INJURY S OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE S FIRE DAMAGE ow+ae $ MEM EXPENSE uw—w" S AUTOMOBILE LIABILITY COMBINED SINGLE UNIT S ANY AUTO ALL OWNED AUTOS BODILY INJURY (Perp--) S SCHEDULED AUTOS MIRED AUTOS BODILY INJURY (Peraeddent) S NONAWNL:D AUTOS PROPERTY DAMAGE S GARAGELIABILITY AUTO ONLY-EAACCIDENT ANYAUTO OTHER THAN AUTO ONLY: i;: %%jS{'%�,•,`'Y�fJf'i = EACHACCIDENT AGGREGATE EXCB2UAGIM &CH OCCURRENCE s UMBRELLA FORM AGGREGATE >: OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION ANDTOi, '%%i:?;:j::,.'•..,:;'•:•'•;;�i j•v RY.UMIIT ER EMPLOYERS'LIABILITY EL EACH acclDeNr $ ' UUU THE PROPTIETORI INCL AR0000776 11/09/2001 11/09/2002 ELoIsFASE-PoucY LwIT 75=00—— PARTNERSIEXECUTIVE OFFICERSAREXCL EL f ' E OTHER r DESCRIPTION OF OPERATIONSILOCATIONSNEWCLEIISPECUU.ITEMS % .. .Y/ .�"i Jr:/>••:•y ¢1J:z'.;.fr.::.fl•�t/�`.A:x�,:},.z�:-::�r2:};�:aSxtAw'.>�-.r:rnti':r.'b.,r:v.>I:::s:F»::.:.:;::;...:.,'._�.:•,;:S�:}..,.'i:r:21i.A!„f'/Y:.�;iY:.yn,.,Is{,'J,:J�...;lr'G..�.'::�J::,,.'Z: .�v<H.:.:L-:• :x .:w:y.�..:a0'. /ri;i.o;.�.}•„./�',..J:s:;•xr:..4.,:.?1<i:.%��,.:,?:Actrb�iti.a;:rfi':i1•1::;::{......... Y�•(. ,� }:ci'SJ:u.�•f,.•�>:5w'�}:fl�NNwEwN � ..NEWS, SHOULD J:i:}.."Yi':-3.J'.J}s£.„:�../}..'•:f•�.:c:'a,+'wY.iJi`''F-.4,I.,.1.:..(}r}'1,'J+,.:6}-}vy:{?.:y1:�i.:.v.:�..rv. :'•<<'!"^.:;'.�'J,v:.:�.».:- �:'<:o.}`:z•};}}s;}:e:>.'...;`_ #^:ice;{:a.•:;>: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIM. AUTHORIZED REPRESEMSATIVE ;•.-'. rf�x rr�''��'•m.:.:�.�.tf/�! .'rfr,�J'•.�;.''-•:J'i'. �f�;.»•.:,x.. r,.,4<-,.f4:�1,>.:`;,..X. xf•• �L'fI�GTaPs3,�lt�v>7niraxii►�S+:Tine{v{" i Location / ' DA A) 5 No. .5 &V Date �- /5 '6 a- N�RTM TOWN OF NORTH ANDOVER G � s • ; ,' Certificate of Occupancy $ Building/Frame Permit Fee $ a JACNUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3a Check # 0*"r-c�� `! 5 5 Building Inspector s ; TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. ,5— DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION Z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: i J!�,Oo p C�c? Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided ReqWred Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Ff,AN►C 'Da Nnit) Address for Service -9"0- re Telephone 2.2 jOwner of Record: bdl/k o Na 'P int Address for Service: 0 rn Si nature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ 5 Licens Con�Supervisor: Y� S O f 3 • �v f � 1 � 1417)4 G ? License Number A ess 9 7 9- 41 7 5- TJ Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor V Not Applicable ❑ 0 Ko7te ,- liS��w _ Company Name T 1 S 6 rn 3 Registration Number r. Address 979— 6oZ C�3 r b 8 Expiration Date S r Tele hone y, t SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......4 No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building N. Repair(s) ❑ A erations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: n � t�y �5 � �',• S l"� �� � 1�aw•tn:S �u�a, S � X� 1 � SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 45ka.,44 �- ������� ,as Owner/Authorized Agent of subject property lHereghalf, rite to act on i a ers ela ' e to wo y this building permit application. Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 2 0" r `L't cu. � as Owner/Authorized Agent of subject propertv Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief 1 P ' Nalne &ature&er/A crit Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS OT 2ND 3RD SPAN DITV ENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Roger u� P.O. Box 356 Gilmanton NH. 03237 Geriml conh actor 603-267-1772 603-770-4035 Mobiie March 24,2002 Frank Rowe 11 Dana St - No.Andover Ma 01845 Contract Project address: 11 Dana St. No.Andover Ma The following work will be completed at the above location. Remove existing decking from existing porch. Add new footings for additional support. Install new s/4"undedayment,glued and nailed with ring nails. Build three new walls of 2x6 construction and frame for windows supplied by owner. Install new 1/2"plywood on walls and install windows. Wrap new wails with Typar.or Tyvec House wrap. Side new walls with Gear red cedar clapboards. Insulate underside and cover with 1/4"plywood to keep rodents out. Enclose underside of deck Any material that may not be rutted is not included in this quote. No interior work is included in this quote but can be added. All debris will be removed and disposed of in proper facilities. Anything not stated here is not included. Building Permit will be obtained by myself but fees will be paid by homeamw. The total cost of the gbove meted wmrk is:$5190.00 Paymek-lbbe made as fol :%down,$2550.00 Balance upon compl_etion. Authorized sl n Date 3 7-O --A, Roger Dussault Thank you for your business ✓/re �mm�can�uea` all.t�aaracleusetts BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 046532 Birthdate: 08110/1960 Expires:08/10/2003 Tr.no: 24445 Restricted: 00 ROGER C DUSSAULT 137 MAY STS' LAWRENCE, MA 01841 Administrator ,f/ce �anvmo�uuea/.(f a�./l�aavar./uca�la Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards 1Vj Registration: 113566 One Ashburton Place Rm 1301 Expiration: 6/28/03 Boston,Ma.02108 Type: Individual ROGER C.DUSSAULT ROGER DUSSAULT 137 MAY ST G�-.� -- -- --- -- --- - - LAWRENCE,MA 01841 Administrator Not valid without signature • North Andover Building Department Tel: 978-6$8-954 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall disposed of irk a properly licensed solid.waste disposal facility as defined b e c 11, S 150A. y MGL The debris will be disposed of in: 12J (Location of Facility) Signature of Permit Applicant i G Date NOTE: Demolition permit from tije Town of North Andover most be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Wor'ers'Compensation Insurance Affidavit s_ Please Print Name: Location: City AVO �!� /?'� Phone am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. company name, Address C ft: Phone* Insurance CoPorfcv dompm name: Address Cit1C Phone# ,9--U flm_Go. Po lov# Failure to secure coverage as required under Section 25A or WX 1.52 can lead to the Woositlon ce c rkninal pence,or a fine up to$1.500.00 and/or one years'it nprisonment as well as civil penalties in the form of a STOP MRX ok)m and arm of($100.00)a day against rife. i understand that a copy of this statement may be forwarded to the Office of Ind of the DIA for coverage verification: I do herby certify un ad'les oP pe ury Mat the irt/orinatfon pnwrded above is true and-cornett Signature Date L//O Print name.` �2� S� D S Scc .r `'r Phone# ��•$ 6$�-� 3e J7ty-75-6is 3. Official use only do not write in thisareato be completed by city or town official' OBuilding Dept .Check irimmediate response is De Building Dept O Licensing Board ContactO SeiectmaanIs ice person: Phone# O Health Department O Other ?JW WORKMAN'S COMPENSATION i N V R ►y Town of over r �. r ,4•• r No. 8 "I��Rd zsL A y dover, Mass., -/r- 0? COCMICMEWIC V SRA7ED p'PG5 BOARD OF HEALTH PERMIT T Food/Kitchen Septic System AO w BUILDING INSPECTOR THISCERTIFIES THAT...... ............... ................ ................ .......................................... Foundation has permission to erect.. N.. buildingson t� 4 '4 �. gto be occu ied as � b C r�atNwt h 1 v T� sr 0 S0*0 RO O Chimney ps..... .................................................... .............. ........ .......................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. ,S—/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR .�.C Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner • Street No. SEE REVERSE SIDE Smoke Det.