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Home My WebLink AboutMiscellaneous - 1785 SALEM STREET 4/30/2018o _ 4 00 CP cn W D O m m cn o m o m o m o -' r Date....................... ....................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....� V. f' ............. ' f - ..............................................c.,.'...................... has permission to perform .,.... {��1?..±z.1 .. 5 .................................. / wiring in the building of..,..,., w Q..P..--- at ............. ....V.s .... .- � '................. North Andover, Mass. ....... Fee....../... .?....' Lic. No.`�.1&47................................................................................ ELECTRICAL INSPECTOR Check # � �� I � Id, O A C\\ (nomm.onwealtk o1 ;Waejac4u4eth I c�r 2epartment of _%. Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL 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 WORK 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) 1785 Salem St. Owner or Tenant Ronald Sweetra Telephone No. 9786830526 Owner's Address 1 18b Salem or Andover, 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 100 Amps 120 / 240 Volts 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 roof. 36 panels 7 9.000 RW Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- Elo. rnd. rnd. o Emergency Fighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and ce Initiating Devilex No. of Ranges No. of Air Cond. Total Tons g No. of Alerting Devicis No. of Waste Disposers Heat Pum Number ..........* Tons """"'' KW No. of Self -Contained Total ; Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ElOther Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or E uivalent No. of WaterKW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: $24000 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 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 of perjury, that the information on this application is true and complete. FIRM NAME: Skyline Solar LLC LIC. NO.: 21667A Licensee: James Leavitt Signature LIC. NO.: 12572B (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 a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No. The Commonwealth of Massachusetts Department of Industrial Accidents d Office of Investigations a I Congress Street, Suite 100 ,et 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: 1.9 I am a employer with 60 4. ® I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors listed on the attached sheet. 2. ®I am a sole proprietor or partner- sThese sub -contractors have hip and have no employees working for me in any capacity. employees and have workers' [No workers' comp. insurance pomp. insurance.1 required.] 3.0 I am a homeowner doing all work myself. [No workers' comp. insurance required.] t /e are a corporation and its ifficers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ® New construction 7. ® Remodeling 8. ® Demolition 9. ® Building addition 10.0 Electrical repairs or additions 11.® Plumbing repairs or additions 12.® Roof repairs 13.0 Other PV Solar *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. A.I.M. Mutual Insurance Company Insurance Company Name: Policy # or Self -ins. Lic. #: VWC-100-6018336-2015A Job Site Address: 1785 Salem St. North Andover, MA 01845 Expiration Date: 9/16/2016 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 cfrt Ad jr the pains and penalties of perjury that the information provided above is true and correct. I ..O, 1/26/16 111 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 #: a S LIC S ICNATURE': J Scanned by CarnScanner 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 he Hamilton Group, LLC Wing Drive edar Knolls NJ 07927 AFFORDING INSURED SKYLI-3 INSURER B : leC ive Ins Co Of 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS B GENERAL LIABILITY S 2106548 /6/2015 /6/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $100,000 CLAIMS -MADE 1i7 OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $3,000,000 POLICY F PRO X LOC $ B AUTOMOBILELIABILITY A 9093015 /24/2015 /24/2016 Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED Fy7 SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNX HIRED AUTOS X AUUTOS ED Peer acci'Zt) AMAGE $ A X UMBRELLA LIAB X OCCUR S 2000480 10/11/2014 0/11/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N VWC-100-6018336-2015A 3/8/2015 3/8/2016 X I WC STATU-OTH- TORY LIMITS R E.L. EACH ACCIDENT $1,000,000.00 ANY PROPRIETOR/PARTNER/EXECUTIVMI OFFICER/MEMBER EXCLUDED? N/A E.L. DISEASE - EA EMPLOYE $1,000,000.00 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 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 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 n 19RR-2010 ACORD CORPORATION_ All riahts reservpd_ lk )■ m g! 0 G!§ A] m ( ) § § §0 ° ( § &0 ■ z ) ) ( \ o ( §j§ `§/ f \ z0 \ ;7 m \ 2 ] Cl) q! « s B\ 0 ! m m I T cn r § ) 2 cn } � � \ � w ; < % � § ° § 4 x . 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O [* <, T 9 v_'A7 3v_'3o.02.2, a 3�mme gD.3 o. D 7 o 7 =no D. o 3 ti - o;- c � � Dcann nJ n� < o 0 S D y y � 0 v - O h o � O r c m n o' 0 0 N I� N O � 9 m CD CM O 0 W N5 G '+ S O C \7 § ° U WAR \ � m m m ■� \AS /`f` �}/\ \\/ - k�f\\ ;! 3 2. ! {2/ 3 o 5 - 00 ;{]}k o \\\ 0 `/f «e» _ 0�� ({§ $\\[( (0 \ ° U WAR \ � m m m ■� This certifies that ..-?'TP .. (/')WV.. . has permission to perform ... � . P G= (,< ..... . . . . . . . .. . plumbing in the buildings of ..W P.C' kK ' ,, , , ,, , , , , , , , , , , , , , , at ... 7�5� �Sy�> ....... firth Andover, Mass. Fee . ��:•�. Lic. No.��3� .. .. .. .... .... . /l� PLUMBING INSPECTOR Check # V ItiI,,11 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE / / PERMIT # JOBSITE ADDRESS _E�y _ OWNER'S NAME POWNER ADDRESS e m TELF w1'/-_ IFAxl TYPE OR OCCUPANCY TYPE COMMERCIAL ® EDUCATIONAL F-1 RESIDENTIAL PRINT CLEARLY NEW:[] RENOVATION: ® REPLACEMENT: PLANS SUBMITTED: YES 0 NO(j FIXTURES Z FLOOR— 8SM 1 2 3 1 4 5 6 7 8 9 10 11 1 12 13 1 14 BATHTUB — CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN _ FOOD DISPOSER FLOOR /AREA DRAIN INTERCEPTOR INTERIOR KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK _ TOILET URINAL ' WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liabilb nsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO 0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE OF INDEMNITY 0 BOND OWNER'S INSURANCE WAIVER: i am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement CHECK ONE O!Y: OWNER 0 AGENT SIGNATURE OF OWNER OR AGENT I hereby car* that all of the details and Information I have submitted or entered regarding this application are true aWiocurstiii to the best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in oompli th all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Steven Car LICENSE # 15366 SIGNATURE MPS JPQ -1k CORPORATION[3# PARTNERSHIPO# LLC©# SOLEPROP COMPANY NAME I SPC Plumbing 8 Heating ADDRESS 112 Concord S't. CITY Methuen ]STATE[ ZIP 01844 TEL 978-815-3936 FAX 978.208-1081 ]CELLI 978-815-3936 EMAILs er on.net _ ItiI,,11 r E -. COMMONWEALTH'bF,MASSACHUSETTS PLIJ'MBERS AND CASFITTERS 1 LICENSED AS A MASTER PLUMBER. t ISSUES THE ABOVE LICENSE TO: S'T?=VEN P CARR ' ' 12 CONCORD ST:;I :METJ� JEN MA 01844-147.' "I 11,366 05/01/14 164078- ;I x`,s Y a The Commonwealth ofMassachusetts - Department of Industrial Accidents Office of Invesfigations 600 Washington Street Boston, MA. 02111 www.mass gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): J / C ��1/h a J/ll G 7, A/7f �t-n/ Address: / 7 eON [D 2 C7 ST - City/State/Zip: Y) E 1-?-/ v E w _ IVA OJfY'y Phone #: ) ? -f/f - 352 6 Are you an employer? Check the appropriate box: - Type of project (required): 1. A] I am a employer with 3_ 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time) * have hired the sub -contractors listed (� �• P Remodeling 2. ❑ I am a soleproprietor orpartner- on the attached sheet. ship and'have no employees working for me in any capacity. These sub -contractors have workers' comp. insurance. 8. ❑ Demolition g• ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL 11.04 Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12, ❑ Roof repairs insurance required.] q ] employees. [No workers' 13.❑Other comp. insurance required.] 'Any applicant that checks box #f 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 anew affidavit indicating such. tContractors that checkthis box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the,policy and job site information. Insurance Company M2 Policy # or Self -ins. Lic. #: MI Z 0 ?7 P` yA Expiration Date: / / Job Site Address: 1,7P5- �r��c`� fi City/State/Zip: Al- A oode G t%9 Oy8 %T Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL 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 ips/t!ance coverage verification. X do hereby cert under t ains andpenalties ofperjury that the informationprovided above rs ruue anti correct. .. r,�tA• /�/ / ;? Phone #• / X W-5- - ?I 3 S 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 - - Ph nn P #i• Information and Instructio- ns Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...everyperson in the service of another under any contract ofhire, express or implied, oral or written." An employer is defined as "an individual, partnership,association, corporation or other legal entity, or any two or more Of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employes." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance Ve th the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone numbers) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are notrequired to carry workers' compensation insurance. If an LL C or LLP does have employees, a policy is required. Do advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only -'submit one affidavit indicating current Policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by .the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Mfassachv.:setls Depadmeat of 7andustdal Accidents Offtee ofI�yesiigalzon 604 Washington. StreSt Boston MA.02111 'ei,1`��4OQ est 406 ox-8��.;11�ASS.AFy, Revised 5-26-05 Fay # 617-72,7-7749 4\ 0 Date ...... zo./I ... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ..... <� ..... .......... �n . ............................................................ has permission for gas ins 11 'on, .. � i1m. ..................................................... �J, aft i.. .. .. .... inthe buildings of.. P . ....... ...... ........................................................... at.111,�.6 ...... a . ..... St . . ...................................I No h kndover, Mass. v....... ... Fee IC?. ... Lic. No. 1.5....2..&G..>.71 .... )=q ................................................... / . GASINSPECTOR Check #__\ 003 ful as 4 4 JC-\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY L".) MA DATC-AA-PERMIT# V JOBSITE ADDRESS 1OWNER'SNAME 2 r; G OWNER ADDRESS TEL, FAX TYPE OR OCCUPANCY TYPE COMMERCIAL Lj EDUCATIONAL ,j RESIDENTIAL^, PRINT CLEARLY NEW':--] RENOVATION: i REPLACEMENT: A; PLANS SUBMITTED: YES kDOWANMR1 FLOORS— I BSM 1 1 2 1 3 1 4 1 5 1 6 1 7 8 1 9 1 10 1 _11 1 12 iEj 14 I have a cxmt liabUtj insurance policy or Its substaritial equivalent which meets the requirements of MGL Ch. 142 YES CD, NO Lj I F YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER rm INDEMNITY L'__J BOND f_jj OWNER'S INSURANCE WAIVER: I am aware dW the licensee does not the irmirence coverage rquhW by Chapter 142 of the Massadwsetts General Law, VW that my signature on this pm* appintiori 121M this requirement 1 CHECK ONE ONLY: WHER AGENT jop SIGNATURE OF OWNER OR AGENT 4 1 hereby oertify that all of the details and inkimailon I have submitted or entered regarding this application are true and to the best of my WaWedge and that all Plumbing work and insiallafts performed under the permit issued for this application will be in wripi an Pertinent print lon of the Magaadwsalts Stale Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME j StSq-!r LICENSE #1 mro SIGNATURE MP' MGF 0 JP LD JGF -j DW EJ CORPORATION 4 —10 PARTNERSHIPL.--J#! COMPANY ADDRESS CITY Methuen STATE TEC978-815-M FAX 97HI&.'1936 !EMAIL \t p This certifies that ..� ............ . has permission for gas installation ......... �n .'. .. '�! ....... in the buildings of A" . ................................... at . 8S ............. ......... , North An ver, Mass. . YFee II -el... Lic. No?(�,� ... ... GAS INSPECTOR% Check # -5-() --'- 3560 e D BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES []NO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY ® BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in ance wi all Pe rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. , PLUMBER-GASFITTER NAME I Richard T. Bowman LICENSE # 13496 S RE MP 0 MGF ® JP ® JGF ® LPGI ® CORPORATION ©# PARTNERSHIP 0#LLC ❑# COMPANY NAME: Bowman Plumbing Services ADDRESS 16 Horne Street CITY Bradford STATE MA ZIP 01835 TEL 1978.994.6207 FAX CELLI 978.994.6207 EMAIL BPSMaster@aol.com MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I North Andover MA DATE 1/16/2013 1 PERMIT # JOBSITE ADDRESS L1785 Salem Street OWNER'S NAME I Ron Sweetra GOWNER ADDRESS 11785 Salem Street TE978.683.0526 71FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ® RESIDENTIALE] CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: ® PLANS SUBMITTED: YES ❑ NO E] APPLIANCES 7 FLOORS— BSM 1 1 1 2 1 3 1 4 1 5 1 6 7 1 S 1 9 1 10 1 11 1 12 1 13 1 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES []NO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY ® BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in ance wi all Pe rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. , PLUMBER-GASFITTER NAME I Richard T. Bowman LICENSE # 13496 S RE MP 0 MGF ® JP ® JGF ® LPGI ® CORPORATION ©# PARTNERSHIP 0#LLC ❑# COMPANY NAME: Bowman Plumbing Services ADDRESS 16 Horne Street CITY Bradford STATE MA ZIP 01835 TEL 1978.994.6207 FAX CELLI 978.994.6207 EMAIL BPSMaster@aol.com w F 0 z z o U w a z a d z w r N � o El z z O yEl W � ~ W D a O W z W c > w w d W U z a ad. I.- CL a CL Q 'ss CO) W = w F LL H 0 z 0 H w a. O a q i✓ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations UV. 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: 'U. )9;,- City/State/Zip: D,�/ � / j�f �� phone #: `)7�-- Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ElI am a general contractor and I — employees (full and/or part-time).* have hired the sub -contractors 2. am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] 3. ❑ 1 am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. 0 Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other kAny applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. P Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. f am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site nformation. assurance Company Name: 'olicy # or Self -ins. Lic. #: Expiration Date: ob Site Address: City/State/Zip: Mach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). 'ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine 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 f up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of avestigations of the DIA for insurance coverage verification. do hereby cerci' n r lie pain penalties of perjury that the information provided above is true and correct. Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: P, Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www,mass.gov/dia cL r 1 1 a OMMONWEALTH OF MASSACHUSE TTS+ �,. C ;... i " : PLUMBERS AND GASFITTERS LICENSED AS A JOURNEYMAN PLUMBER ISSUES THE ABOVE LICENSE TO: i RICHARD T BOWMAN 1� i` 6 NDRNE ST i BRADFORD -MA 01835-8024 183400 25201 05/01/14 N Location ! / No. �� Date 3 ,= TOWN OF NORTH ANDOVER n Certificate of Occupancy $ Building/Frame Permit F41,V, sAcMuSEs�+ Foundation Per Fee $ l��. mete .r PermiI7pe�- $ / Sewer Connectloq gee, $ Water Connection JWe $ /_ J TOTAL $ Z C7 � Building Inspector 6 7 A. 4 Div. 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C C. c M n X c aCD O x x F y 0 9 Z` `i A O C Location No. <�"' Date TOWN OF NORTH ANDOVER °_I - _ • �� n Certificate of Occupancy $ Building/Frame Permit Fee $ ��s''••°''tom s^<Musa Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ o / Building Inspector v J J 10;23/99 13:37 78. pp PAID Div. Public Works %. c c z u C = Z Z - _- C C C � i c V c \i c c c z u C = Is� MO r } c 0 0 z O m N O _ 0 C13 m m c m O N C 0. N rr H CD c?�o m �• NCQ N CD CL m col mCL C! C Ste- N = � m N OCL d O -4 O m N O ��m. m = O O n O' G ZS.0 N !7 i. n N CL CD m N O m ; CL CD N d N CL Cr D7 C �m m C CO) m: N •� x ti CM) m FFT m CA 4 D D C � ^n n " ;z� N!co n � C) Z cop) cn O O 'fl o. r �� w C/) C CO) m w < c v CD b �S Cl)CD V) m d CD � o p CD CD m v v B. C CD tZ co) CD CA o O CD � CI! v � � OCl) Z o O x � CD 0 t CD MO r } c 0 0 z O m N O _ 0 C13 m m c m O N C 0. N rr H CD c?�o m �• NCQ N CD CL m col mCL C! C Ste- N = � m N OCL d O -4 O m N O ��m. m = O O n O' G ZS.0 N !7 i. n N CL CD m N O m ; CL CD N d N CL Cr D7 C �m m C CO) m: N •� x ti CM) m FFT m CA 4 D D - ^n n " ;z� _ n � g cn -n w w C w C b O fD � UQ � a- o G1 °' o z rb rt C x tz a � d n a v 9 H � y ►n-3 p O x O n 0 c V 4y Au Permit NO-Rk�- Date Issued: LOCATION 1785 Salem St. tkORTH e Of 6 BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION 1 e� Date Received ° e �—t-A . +` ORTANT: Applicant must complete all items on this Print PROPERTY OWNERRonald sweetra 210-106 Print MAP NO: PARCEL:-oo9l-000CZONING DISTRICT: Historic District yes no Machine Shop Villaqe yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial X Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑ Wetlands ❑ Watershed Distr' ElWater/Sewer Installation of a safe and code compliant, grid tied PV solar system on and existing residential roof � i� 'riTC.l.I I1 e-),�� /?, ObC) A �,J Identification Please Type or Print Clearly) OWNER: Name: Ronald sweetra Phone:978-683-0526 Address: 1785 Salem St. North Andover, MA 01845 CONTRACTOR Name: Skyline solar l -Lc Phone: 7323543111 Address: 124 Turnpike St. Ste 10. W. Bridgewater, MA 02379 Supervisor's Construction License: Exp. Date: CS -027047 1119/17 Home Improvement License: Exp. Date: 172284 6/7/16 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULD/NG PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 32,000 FEE: $384.00 Check No. Receipt No.: NOTE: Persons contractin reregistered contractors do not have acc to the g �aranty fund 1Signature of Agent/Owner641i@A1 Signature of contractor a F -I Plans Submitted ❑ o' - t Plans Waived ❑ Certified Plot Plan [I Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales El Food Packaging/Sales El Private (septic tank etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Located 364 US900CI Street -FIF ELocat-JUEOMNFRO "X j b,§ter 6n�sit X fStme Fq r e'j' 111) e-- -p- 'a' M 0siq 9t fit COMMENT Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA — (For department use ® Notified for pickup Call Emai Date Time Contact Name Doc.Building Permit Revised 2014 0 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses .46 Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4. Building Permit Application 4 Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code & Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 Location No. A— ` 16'-' Date Check # 4 '� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee.' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 9 Building Inspector r L O = J Q = u. O W a H Z Z O W a � Z Z O W a H Z u C 0 W cn Z • Q O m N N � > m 0 m j -J d � U W J W N C9 +V+ j U N N O LL Q N C:W LL Of 3 U -Fum LL O cr O LL m O CC U N N LL L O c 9 O LL 0 C O 0 CU O a a� �a - o .0 N E d � L � d d y0,, E L = 0 0v 3 J d a L m r = L O a> > U) _ 'a O O c,NVQN O 44W O 0. Z - N O C w �_ o o mo, L � � d Q � � w _cu 0 A- in �... :.i O C C d.— m LUC _w O O EL 'y0 N C P w �= .0 O WE O -o C c) CO)0-0 CL a> v 2-0 O C cc F, .0 0 CL0U O U W CL z c� O J m CO N E ♦ A N Z co U) LU /�� > vi H xz W U ccd W = W J _ a z m L O O N O t w O Z O F= J O .r N 0 E ,O O v Z O N 0 � I = _ �E mm L O a _~ .-a W O G� O 2 L Q a O Q O i _v J � �CL O (D Z W /OCL N c _c CL 0 Taylor's Kitchen, Both, and Interiors, Inc. 175 Main St, Oxford MA. 01540 Phone 508-987-7000 Fax 508-987-1042 www.navlorskitchenandboth.com info I—dn avlorskitc heno n dbaf h.corn '.sunGEVITY' February 1, 2016 To Whom It May Concern At The Town of North Andover, MA: Sungevity is the master contractor, working on a solar installation for Ronald Sweetra o€1785 Salem St., North Andover, MA 01845, US This job is currently permitted with one of Sungevity's subcontractors: United Solar Associates Woburn. Mr Ronald Sweetra and Sungevity would like to transfer this permit to Skyline Solar MA (Lic# HIC 177284). Please allow this contractor to take over the application. Skyline Solar, LLC of Bridgewater, MA 124 Turnpike Street West Bridgewater, MA 02379 Jonathan Camarda — Principal 732.354.3111 Mr.Sweetra — Property Owner Date: Step en Snow --Sungevity Project Manager ADate: dL Very Best, Stephen Snow Sungevity Project Manager 816.492.3312 ssnow@sungevity.com 66 Franklin Street, Suite 310 510.496.5500 866.SUNAALL Oakland, CA 94607 USA 510.496.5501 x sunGEVITY` GENERATE POSITIVE - January 25, 2016 Subject: Structural Certification for Installation of Solar Panels Job #: 1342850 Client: Sweetra Address: 1785 Salem Street, North Andover, MA 01845 To Whom It May Concern, A field observation and design check of the subject property was conducted to determine the suitability of the existing roof structure to support the installation of solar panels. From the field observation of the property, the existing roof structure was observed as follows: The existing roof structure consists of a single layer of composition shingles over plywood sheathing that is supported by 2x8 roof rafters spaced at 16" on center at Array 1 and true 2x8 roof rafters spaced at 16" on center at Array 2. The rafters are sloped at approximately 12 degrees at Array 1 and 27 degrees at Array 2. The rafters have a maximum projected horizontal span of 12'-2" at Array 1 and 11'-6" at Array 2 between load bearing walls. The roof is about 10 years old and appears to be in good condition. Utilizing the information determined from the field observation, the attached structural calculations have been prepared for the subject property in accordance with the following design criteria: • Applicable Codes: 2009 IBC, ASCE 7-05 and 2005 NDS • Basic Wind Speed = 100 mph • Exposure Category = B • Ground Snow Load = 50 psf As a result of the completed field observation and design check, I certify that the capacity of the existing roof structure that directly supports the additional loading due to the installation of solar panel supports and modules has been reviewed and determined to meet or exceed the requirements of the 2009 International Building Code. Please feel free to contact me at (510) 496-4422 with any further questions or concerns regarding this project. Sincerely, �k.P�'�NOF1`[� Janyce Spencer, PE 66 Franklin Street, Suite 310 p 510.496.5500 Oakland, CA 94607 USA f 510.496.5501 JANYCE 'GJ,\ AKIKO SPENCER CML R N NO. 51861 \FF��STE� ZONAL E '� 866.SUN.4ALL www.sungevity.com Skyline Solar HOMEOWNERS AUTHORIZATION FORM Addendum to Contract I, Ronald Sweetra (print name) am the owner of the property located at address: 1785 Salem St. North Andover, MA 01845 (print address) I hereby authorize Skyline Solar to act as my Agent for the limited purpose of applying for and obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System located on my Property. Customer Signature: Electronic Signature Accepted/Addendum to Contract Date: 1/15/15 Sign Name: el Skyline Solar LLC 139 Glendale Ave. Edison, NJ 08817 HIC - 13VH0613060 Connecticut Office 121 A North Plains Industrial Rd. Wallingford, CT 06457 HIC.0632594 Massachusetts Office 124 Turnpike St. Suite 10 West Bridgewater, MA 02379 HIC -172284 DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of M.G.L. c. 40, s. 54, Building Permit # was issued with the condition that all debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L c. 111, s. 150A. The debris will be disposed of in: E.O.M.S Name of Waste Facility 318 Manley Street West Bridgewater, MA 02720 Address of Waste Facility 111.5 Debris: As a condition of issuing a permit for the demolition, renovation, rehabilitation or other alteration of a building or structure, M.G.L. c. 40 s. 54 requires that the debris resulting therefrom shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L. c. I I I s. 150 A. Signature of the permit applicant, date and number of the building permit to be issued shall be indicated on a form provided by the Building Department and attached to the office copy of the building permit retained by the Building Department. If the debris will not be disposed of as indicated, the holder of the permit shall notify the building official, in writing, as to the location where the debris will be disposed. 780 CMR — 6"' Edition 1 Oi"g��ref Permit Applicant 1/26/16 Date M1 IL y sunGEVITY' GENERATE POSITIVE - Structural Calculations for the Solar Panel Addition at The Sweetra Residence 1785 Salem Street, North Andover, MA 01845 tN OF s9 JANYCE cyGJ, AKIKO U SPENCMLER N NO. 51861 STE��c�� FsslOAIAL'\�v ��zufu. a�/,z-�-1ntJu�J January 14, 2016 Date Signed 66 Franklin Street, Suite 310 p 510.496.5500 Oakland, CA 94607 USA f 510.496.5501 866.SUN.4ALL www.sungevity.com 0,710 client: Sweetra Sheet No. S U f l G E V I T Y" sungevity #: 1342850 GENERATE POSITIVE- Date: 1/14/2016 1 GRAVITY LOADS Roof Angle = 27 degrees (Roof live load is not required in areas covered by PV array) Composition Shingle 4 2.8 Plywood 2 2.8 2x8 True Rafters @ 16 in o.c. 3.33 LLO Vaulted Ceiling 0 0 Misc. 1.67 a Total Dead Load (psf) = 11.00 2.7 Total Adjusted Dead Load (psf) = 12.35 2.7 Total Live Load (psf) = 20 (Roof live load is not required in areas covered by PV array) Photovoltaic System (psf) 2.8 2.8 2.8 1.09 Standoff Trib Width in X -direction (ft) 2 4 6 a Standoff Trib Width in Y -direction (ft) 2.7 2.7 2.7 uj Standoff Tributary Area (ft 2) 5.4 10.8 16.2 10 Point Load of Standoff (Ibs) = 16 31 46 Wood Siding 3 cn 2x4 Studs @ 16" o.c. 1.09 5/8" Plywood 2 3: Insulation 1 X Gypsum Board 2.5 uj Misc. 0.41 ? Total Dead Load (psf) = 10 Gypsum Board 2.5 J 2x4 Studs @ 16" D.C. 1.09 Q Insulation 1 Gypsum Board 2.5 ? Misc. 0.91 Total Dead Load (psf) = 8 Dcloll <71 r7), sunGEVITYt GENERATE POSITIVE- WIND CALCULATIONS Per ASCE 7-10 Components and Cladding Design Input: Client: Sweetra Sheet No. Sungevity #: 1342850 Date: 1/14/2016 2 Risk Category = II Wind Speed, V = 100 mph Figure 26.5-1A Exposure Category = B Section 26.7.3 Roof Slope = 27 degrees Mean Roof Height = 25 ft Building Least Width = 47 ft Effective Wind Area = 17.5 ftz Velocity Pressure: LoE qh = 0.00256 KZ Kt Kd VZ KZ = 0.7 Kn= 1.0 Kd = 0.85 V = 100 mph qh-nominal = 15.23 psf qh-design = 9.14 psf Table 30.3-1 Section 26.8.2 Table 26.6-1 See above Nominal (unfactored) uplift Design (factored) uplift based on allowable stress design basic load combination #5 = D+0.6W d at Standoffs: Uplift Zone 1 Uplift Zone 2 Uplift Zone 3 Downward Zones 1-3 GCP = -0.85 -1.45 -2.3 0.45 Wind Pressure p = qh-design*(GCp), (psf) = -7.77 -13.25 -21.02 4.11 Standoff Spacing in X -direction (ft) = 4 4 4 4 Standoff Spacing in Y -direction (ft) = 2.7 2.7 2.7 2.7 Tributary Area (ftz) = 10.8 10.8 10.8 10.8 Load at Standoffs (Ibs) = -84 -144 -228 45 Maximum Standoff Uplift = -228 lbs Standoff Uplift Capacity = 732 lbs D/C = 0.311. Standoff Okay Fastener Capacity Check: Fastener = 5/16" diameter lag screw Number of Fasteners = 1 Min. Embedment Depth = 2.5 in Wood Species = Spruce Fir Pine Specific Gravity, G = 0.42 Per 2012 NDS Table 11.3.3A Withdrawl Capacity Per Inch = 205 lbs/in Per 2012 NDS Table 11.2A Load Duration Factor, CD = 1.6 Per 2012 NDS Table 2.3.2 Fasteners Capacity = 819 lbs D/C = 0.28: Fasteners Okay n n w sunGEVITY' GENERATE POSITIVE - Existing Structure Check Per 2012 /BC Chapter 34, Section 3403.4 Weight of Existing Building Client: Sweetra Sungevity #: 1342850 Date: 1/14/2016 Weight of PV System Weight (psf) Area (ft) > PV 2.8 683 CL Total Weight of PV System = Comparison Check 10% of Existing Weight of Building (Allowed) _ Total Weight of PV System (Actual) _ % Increase = bs 1,911 1,911 4ssuming 8'-0" Wall Height 4ssuming 8'-0" Wall Height 5,926 lbs 1,911 lbs 3.2 % Seismic Upgrade is Not Necessary Sheet No. 3 Weight (psf) Area (W) Weight (lbs) Roof DL 12.35 2249 27,774 Z Ceiling DL 6 2249 13,494 Exterior Walls 10 1000 10,000 Lu Interior Walls 8 1000 8,000 Total Existing Weight of Building = 59,268 Weight of PV System Weight (psf) Area (ft) > PV 2.8 683 CL Total Weight of PV System = Comparison Check 10% of Existing Weight of Building (Allowed) _ Total Weight of PV System (Actual) _ % Increase = bs 1,911 1,911 4ssuming 8'-0" Wall Height 4ssuming 8'-0" Wall Height 5,926 lbs 1,911 lbs 3.2 % Seismic Upgrade is Not Necessary Sheet No. 3 Overall Sloped Length: 21' 1 1/16" 0 12 i — 2.55 Iv 1. r" 12'4" 7 1 2 All locations are measured from the outside face of left support (or left cantilever end).AII dimensions are horizontal. 0 Design Results Actual @ Location Allowed Result LDF Load: Combination (Pattern) Member Reaction (lbs) 1170 @ 13'5" 2281 (3.50") Passed (51%) 1.0 D + 1.0 S (Adj Spans) Shear (lbs) 609 @ 12'8 3/16" 1501 Passed (41%) 1.15 1.0 D + 1.0 S (Adj Spans) Moment (Ft -lbs) -1285 @ 13' 5" 1564 Passed (82%) 1.15 1.0 D + 1.0 S (Adj Spans) Live Load Defl. (in) 0.263 @ 6' 9 3/4" 0.623 Passed (L/569) 1.0 D + 1.0 S (Alt Spans) Total Load Defl. (in) 0.365 @ 6' 9 5/8" 0.831 Passed (L/410) 1.0 D + 1.0 S (Alt Spans) vetlection criteria: LL (L/2411) and TL (L/180). Overhang deflection criteria: LL (2L/240) and TL (2L/180). Bracing (Lu): All compression edges (top and bottom) must be braced at 6' 6 7/16" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. A 15% increase in the moment capacity has been added to account for repetitive member usage. Applicable calculations are based on NDS. System : Roof Member Type : Joist Building Use : Residential Building Code : IBC Design Methodology : ASD Member Pitch: 2.55/12 Supports Total Bearing Length Available Required Dead Loads to Supports (lbs) Roof Live Snow Wind Total Accessories 1 - Beveled Plate - SPF 3.50" 3.50" 1.50" 155 28 423 3/-222 609/-222 Blocking 2 - Beveled Plate - SPF 3.50" 3.50" 1.80" 326 27 844 -383 1197/-383 None 3 - Beveled Plate - SPF 3.50" 3.50" 1.50" 12 72 167/-3 58/-20 309/-23 Blocking • BlocKmg Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Loads Location Spacing Dead (0.90) Roof Live Snow (non -snow: 1.25) (1.15) Wind (1.60) Comments 1 - Uniform (PSF) 0 to 20'6" 16" 11.0 - 50.0 Roof 2 - Uniform (PSF) 0 to 1' 16" - 20.0 - Roof 3 - Uniform (PSF) 16' 10" to 20'6" 16" - 20.0 Roof 4 - Point (lb) 2' 4" N/A 31 - -144 5 - Point (lb) 4' 11" N/A 31 -84 6 - Point (lb) 7' 7" N/A 31 -84 7 - Point (Ib) 10'3" N/A 31 -84 8 - Point (lb) 12' 11" N/A 31 -84 9 - Point (lb) 15' 6" N/A 31 -84 Weyerhaeuser Notes Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software. Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com) Accessories (Rim Board, Blocking Panels and Squash Blocks) are not designed by this software. Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction. The designer of record, builder or framer is responsible to assure that this calculation is compatible with the overall project. Products manufactured at Weyerhaeuser facilities are third -party certified to sustainable forestry standards. Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR -1153 and ESR -1387 and/or tested in accordance with applicable ASTM standards. For current code evaluation reports refer to http://www.woodbywy.com/services/s_CodeReports.aspx. The product application, input design loads, dimensions and support information have been provided by ]Spencer 0) SUSTAINABLE FORESTRY INITIATIVE Forte Software Operator Job Notes 1/14/2016 2:54:53 PM Forte v5.0, Design Engine: V6.4.0.40 Janyce Spencer Sweets Residence g g Sungevity 1785 Salem Street SWEETR~I.4TE (510) 496-4422 North Andover, MA 01845 Overall Sloped Length: W 8 1/2" O 112 6.11 1I I f11i -. i,L111 1'2" 1 2 All locations are measured from the outside face of left support (or left cantilever end).AII dimensions are horizontal. Design Results Actual @ Location Allowed Result LDF Load: Combination (Pattern) Member Reaction (lbs) 642 @ 1' 3 3/4" 2504 (3.50") Passed (26%) -- 1.0 D + 1.0 S (All Spans) Shear (lbs) 483 @ 12' 1/16" 1126 Passed (43%) 1.15 1.0 D + 1.0 S (Alt Spans) Moment (Ft -lbs) 1477 @ 6' 11 5/16" 1521 Passed (97%) 1.15 1.0 D + 1.0 S (Alt Spans) Live Load Defl. (in) 0.456 @ 6' 113/4" 0.635 Passed (L/334) -- 1.0 D + 1.0 S (Alt Spans) Total Load Defl. (in) 0.642 @ 6' 113/4" 0.846 Passed (L/237) - 1.0 D + 1.0 S (Alt Spans) • Uetlection criteria: LL (L/24U) and TL (L/18U). Overhang deflection criteria: LL (2L/240) and TL (21-1180). Bracing (Lu): All compression edges (top and bottom) must be braced at 2' 17/16" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. A 15% increase in the moment capacity has been added to account for repetitive member usage. Applicable calculations are based on NDS. Bearing Length Loads to Supports (lbs) Supports Total Available Required Dead Live Roof Snow Wind Total Accessories 1 - Beveled Plate - SPF 3.50" 3.50" 1.50" 172 26 470 -155 668/-155 Blocking 2 - Beveled Plate - SPF 3.50" 3.50" 1.50" 163 4 388 -241 555/-241 Blocking ocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Loads Location Spacing Dead (0.90) Roof Live Snow (non -snow: 1.25) (1.15) Wind (1.60) Comments 1 - Uniform (PSF) 0 to 12' 10" 16" 11.0 - 50.0 Roof 2 - Uniform (PSF) 0 to 11" 16" - 20.0 - Roof 3 - Uniform (PSF) 12'8" to 12' 10" 16" 20.0 Roof 4 - Point (lb) 1' 8" N/A - - 5 - Point (lb) 3' 1" N/A 31 -84 6 - Point (lb) 4' 7" N/A - - 7 - Point (lb) 6' 1" N/A 31 -84 8 - Point (lb) 7'6" N/A - - 9 - Point (lb) 9'1 N/A 31 -84 10 -Point (Ib) 10' 5" N/A - - 11 - Point (Ib) 1111111 N/A 31 -144 Weyerhaeuser Notes Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software. Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com) Accessories (Rim Board, Blocking Panels and Squash Blocks) are not designed by this software. Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction. The designer of record, builder or framer is responsible to assure that this calculation is compatible with the overall project. Products manufactured at Weyerhaeuser facilities are third -party certified to sustainable forestry standards. Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR -1153 and ESR -1387 and/or tested in accordance with applicable ASTM standards. For current code evaluation reports refer to http://www.woodbywy.com/services/s_CodeReports.aspx. The product application, input design loads, dimensions and support information have been provided by ]Spencer System : Roof Member Type : Joist Building Use : Residential Building Code : IBC Design Methodology : ASD Member Pitch: 6.11/12 (Z� SUSTAINABLE FORESTRY INITIATIVE Forte Software Operator Job Notes 1/14/2016 2:55:41 PM Janyce Spencer Sweetra Residence Forte v5.0, Design Engine: V6.4.0.40 Sungevity 1785 Salem Street SWEETR-1.4TE (510) 496-4422 North Andover, MA 01845 Overall Sloped Length: 14'8 1/2* 0 12 ry 6.11 1.2" 1 F2 All locations are measured from the outside face of left support (or left cantilever end).AII dimensions are horizontal. Design Results Actual @ Location Allowed Result LDF Load: Combination (Pattern) Member Reaction (lbs) 658 @ 1' 3 3/4" 2504 (3.50") Passed (26%) -- 1.0 D + 1.0 S (All Spans) Shear (lbs) 473 @ 1' 1115/16" 1126 Passed (42%) 1.15 1.0 D + 1.0 S (All Spans) Moment (Ft -lbs) 1479 @ 7' 1 5/8" 1521 Passed (97%) 1.15 1.0 D + 1.0 S (Alt Spans) Live Load Defl. (in) 0.456 @ 6' 113/4" 0.635 Passed (L/334) 1.0 D + 1.0 S (Alt Spans) Total Load Defl. (in) 0.641 @ 6' 1113/16" 0.846 Passed (L/238) 1.0 D + 1.0 S (Alt Spans) Uenecnon criteria: a (L/t4U) and 1L (L/180). Overhang deflection criteria: LL (2L/240) and TL (2L/180). Bracing (Lu): All compression edges (top and bottom) must be braced at 2' 7/16" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. A 15% increase in the moment capacity has been added to account for repetitive member usage. Applicable calculations are based on NDS. Bearing Length Loads to Supports (Ibs) Supports Total Available Required Dead Roof Snow Wind Total Accessories Live 1 - Beveled Plate - SPF 3.50" 3.50" 1.50" 188 26 470 -254 684/-254 Blocking 2 - Beveled Plate - SPF 3.50" 3.50" 1.50" 147 4 388 -142 539/-142 Blocking (locking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Loads Location Spacing Dead (0.90) Roof Live Snow (non -snow: 1.25) (1.15) Wind (1.60) Comments 1 - Uniform (PSF) 0 to 12' 10" 16" 11.0 - 50.0 Roof 2 - Uniform (PSF) 0 to 11" 16" - 20.0 - Roof 3 - Uniform (PSF) 12'8" to 12' 10" 16" 20.0 Roof 4 - Point (lb) 1'8" N/A 31 - -144 5 - Point (lb) 3' 1" N/A - - 6 - Point (lb) 4'7" N/A 31 -84 7 - Point (lb) 6111, N/A - - - - 8 - Point (lb) 7'6" N/A 31 -84 9 - Point (lb) 9' N/A - - 10 -Point (lb) 10' 5" N/A 31 - - -84 11 - Point (lb) 11' 11" N/A I - - Weyerhaeuser Notes Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software. Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com) Accessories (Rim Board, Blocking Panels and Squash Blocks) are not designed by this software. Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction. The designer of record, builder or framer is responsible to assure that this calculation is compatible with the overall project. Products manufactured at Weyerhaeuser facilities are third -party certified to sustainable forestry standards. Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR -1153 and ESR -1387 and/or tested in accordance with applicable ASTM standards. For current code evaluation reports refer to http://www.woodbywy.com/services/s_CadeReports.aspx. The product application, input design loads, dimensions and support information have been provided by ]Spencer System : Roof Member Type : Joist Building Use : Residential Building Code : IBC Design Methodology : ASD Member Pitch: 6.11/12 (Z� SUSTAINABLE FORESTRY INITIATIVE Forte Software Operator Job Notes 1/14/2016 2:56:38 PM Forte v5.0, Design Engine: V6.4.0.40 Janyce Spencer Sweetra Residence g g Sungevity 1785 Salem Street SWEETR-1.4TE (510) 496-4422 North Andover, MA 01845 ( � 2 I ) z o z_ - _ { , U. _ --(-Ro K k % H...§ \ \ \ \ \ § j j \ ! § El o § m § k $ 7 k ) ) & § d o ; \ § � 0 §§ �9� , § s B < K § ! � » § \ \ § E / m w� 33:](§ o ( ., § z ' / ) k §�§ �` « ( ® ] ! ° 0 0 < = 5 §:> m _ ; k !z< § ¢ « , _ Gof .. ; x �[§�§l==� o oA� _ §§§ oz §/ ! \!tea �! _ :l2;(§m &: - §»§ �§§ § ƒ$` • mak$® i Z }, _ , ulj , , _ ,}El:�:�\ EI 2 zz0 „ 5 )2± g q w o [ O ) §§ ° < ®y 2 § g ! ? ƒ ƒ & § 002 k % ®; § of z k z z _ §| § ¥ 5 2 $ � 2 < ( _ ( ¥ z ; 75 < k 0 \ ) ( w(n w (n ~ \ w `o z ( -�\)W §( }f§ � *» !§ § ®§ wo ! /* 6« / ! ; . §\ ou o gk / )§ , \ § / ~ � \ W F co2 @ i � �z § cn( ` \ L� g \2 �< 2 \ mm \§ T� ® _ 0z k$ Q ;r -6` 0 ( < <a_ , p & 6\[ q 2 zo# 1 / \ Q§ b) wz ) m - g � \ § K » 6 § ! 2 2 § $ $ | CL < » ; 2 £ ¢ co U O r a 3 lo N a N Q oz m o o 3 � i O Ir K OLLI � > a M w w n W co O R 3: 2 O # m m Y a W O w Q N W Q J U, 2 O M j 3 w Z N � :3 O°r°Om w ~ ° U 2 Z rn D i 3 a N U Z m a 2 z Q W Y ~ m z w m a x w p m J O w z O ¢ _ O Q} 5 'U" O Z w m z J O Z m 3 N d O O u o z d m rr G z m Z a 2 3 o a z= 0 0 a N Z u u z = o a w d F N W ° w o a a° o o> j °° = U z z z w $ m w 20 s �o Z~ oG¢� g F- ° 2° d d Q G 2 z O O o a O z V d V ¢ 0 o m K 2 =1 U LL N Q m W U z D w 12 O N U Q Z w d ° Z 5 Q soz Z w rem a�� LL 5 a o 3 o �� o G o° m m o z�i a�< od 0' o^ u= z Q i a w a z° m m °u o w>~ m° �W Q o ° w W J ¢ d z w D U N Z U N w H Z O = Q LL d W m d W Y Z O » o a ly U' p >o Ju ° o F° 2 d m om �g LL z Nm z mo N o m~> mem j uz zmIz _ o �R ��2 m w ° `�� ~ w a �w m~ z i Za Wo ° �° m �3a~ H u w Q W> O 3 w ° O d ° 0 F- z Z m d O ox w m m z 7 d p - aJ a0 W a Z 0 = N p z m - ° m w 0 O < Z O a wZ w om w > a� a o ' 'm w au 0 C, w og = o u� ruo� om oz O Z K N `-� 2 H = Z O O S d y�j > Y U O z Z ¢ Q Z -0 w d0 O d 00 (7 N Q Z¢ O d ro o w oz C, V ° w O ¢1-zw0 d woo a d 'J s m S m m o m z m d U Z o o¢ >> D O Z >> QQ p ri is z a o Z d 3 Y J V Q m J o N O W V C H F- Z H Y W D p 2 > Z Q s d F Z Q O w 2 O '^ V 2, Z 0 'o 3 Z >¢ w 3 Q '^ l7 o f m O H w N d Q N J K N U p N Z d m H Q Z U O D 'M' W m J x O a Z W Z °d' U Z o m Q U Z O w N S t%1 H J Z m Z 7 F~ w N p= -° Z Q F C N w K p= U O 2 N m Q w J K N ¢ N w 2 N W H z w O W > 1 6 } d H w N Z m Q F w m w Z Z ° 2 N pw 7 o d' ° VI m H Z Z N W 0 W U V1 J 0 F F O K N ° w >° - w d N d G W` w W z Q H O fL d H F~ z N O¢ j N O F x a U N Z F W w (� d' Q W LL O m H K o D p OO U lN7 U O Q Q U V° z l:i N > Q~ d p ] J CI w Y O° G a l7 z d w Z¢ O m Y O 3 Q J u z z w f J Q z Q a i Z Z z m= F a¢ Q U a Q° O O m m w Z U Q W F H m 7 a d O z D Q= N Q N ' a> 3 w w w a w N Z p w ? w w a o O s w° u N O w a -i N Q 2 3> x> w M Z o v r!) 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ASHLAND MA 111721 r Expiration: Commi''''ssioner 11109/2017 Office of Consumer Affairs d Business Regulation 10 Park Plaza - Suite 5170 ` Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 172284 Type, Supplement Card SKYLINE SOLAR, LLC, Expiration: 6/7/2016 PHILIP CHOUINARD 124 TURNPIKE ST SUITE 10 WEST BRIDGEWATER, MA 02379 SCA 1 G 2OM-0& t a —17,,`f , wv" my -VIN, ,/ " *'!lite or Consumer Affairs & Business Regulation ME IMPROVEMENT CONTRACTOR egistration: 112264 Type:. Expiration: 6/712016 Supplement Card SKYLINE SOLAR, LLC, Update Address and return card. Mark reason for change. n Address 0 Renewal n Employment I'"'I Lost Card License or registration valid for individul use only before the expiration date. If found return to: Once of Consumer Affairs and Business Regulation 10 Park Pla=a - Suite 5170 Boston. MA 02116 PHILIP CHOLRNARD WN0tv 139 GLENDALE AVE.EDISON, NJ 08617Underueretar7 without signature