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Miscellaneous - 452 MASSACHUSETTS AVENUE 4/30/2018 (2)
452 MASSACHUSETTS AVENUE 210/033.0-0027-0000.0 I I I I I I j e Date..........,. .. �. .............. RTH 03�; oo� TOWN OF NORTH ANDOVER '- n PERMIT FOR WIRING Y �,SSACHU�S4g This certifies that ..SIA.4 0...... � n , has permission to perform`5:01...... ........... .....C.1 r-......... ...{.. ... .1� wrong m the building of...... ..4 :.+......... :P........":.............................................................. atilt..... `�............. ` .......(....�.. ...:......... .....,North Andover,Mass. Fee.... .�?-..-.........Lic.No.U ... ............../(„ �.�1....,.., .-'��! ....... v ELECTRIC�,L NSPECOrR� Check 4t 1 / jP Ii-- "5 Vy\ Print Form mneaaweaa��o�I//a ac�u�elt;+ Official Use Only t� Permit No. 1 5Z-�Z 2eparlmeal o/ Ssnaicea 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 pedomtcd in accordance with the Massachusetts Elcctricat Cade(MEC),527 CMR 12.00 (PLEASE PRINT"IN INK OR TYPE ALL INFORMATION) Date: 4/14/15 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. N Location(Street&Number) 452 Massachusetts Ave L OwnerorTenant Nicholas Guilbeault Telephone No. 617-763-7077 Owner's Address Is this permit in conjunction with a building permit? Yes ❑w No ❑ (Check Appropriate Box) Purpose of Building w/Solar-PV Utility Authorization No. n/a Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps f Volts Overhead❑ Undgrd'❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install Solar Electric-Photovoltaic(PV)system 23panels j rated 5.98 kW-DC @ S.T.C.Grid Tied. In conjunction with a Building Permit. \� Gorn k7iaa n'lite. alGnwite table near•he ivaivcd h 11€e Itis rcdvr a'Wiicc. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans o.Of ota Transformers KVA No,of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ n- ❑ o.o Emergency g ng rnd. rnd. Batte Units No.of Receptacle Outlets No.of Off Burners FIRE ALARMS No.of Zoncs No.of Switches No.of Gas Burnrs = o.o etection an Burne Initiating Devices No.of Ranges No,of Air Cond. To tal No.of Alerting Devices Na.of Waste Disposers eat Pump Number ons o,o Self-contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ un pa ❑ Other Connection No.of Dryers Heating Appliances KW ecu tystems: No.of Devices or Equivalent No.o aterKW o.o o.o Data Wiring: Heaters Signs Ballasts No.of Devices or Eaulvalcut No.Hydromassage Bathtubs No.of Motors Total HP a ecommuntcations Wtrin No.or Devices or E uivaent OTHER: Attach additional detail if desired,or as required 1�v the Inspector of'Wires. Estimated Value of Electrical Work: $10,000 (When required by municipal policy.) Work to Start: A.S.A.P. Inspections to be requested in accordance with MEC Rule 10,and upon completion.. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ 13OND ❑ OTHER ❑ (Specify:) I certify,under rite pains and penalties of perjury,that the information on tkis application is true and complete. FIRM NAME: SOLARCITY CORPORATION LIC.NO.: 1136 MR [Arens"! Matthew T.Markham Signature LIC.N 1136 MR (I/'applicable,enter"exempt"in the fluence aunther fine.) Bus.Tel.No.,774-258.8180 Address: 24 St.Martin Drive(Building 2/Unit 111,Marlborough,MA,01752 Alt,Tel,No.:774-2513-8505 *Per M.G.L.c. 147,S.57-6 i;security work requires Department of Public Safety"S"License: Lic,No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Liability insurance coverage nornsally required by law. By my signature below,l hereby waive this requirement. I am the(check one Qowner Q ownor's agent. Own ne r PERMIT FEE:$ Signature Telephone Na. ffke of Consumer Affairs.&B oxinen Regniniion ME IMPROVEMENT CONTRACTOR Registration: 168572 Type Expimban: 3l812017i Supplement SOLARCITY CORPORATION MATTHEW MARKHAM 24 ST MARTIN STREET OLD ZUNI ITaIMLSOROUGH,MA 01752 Undersecretary 01 O a *7* , EIEETR CIANS 15SUES THE FOLLOWING LICENSE AS Af,, REGISTERED RASTER ELECTRICIAN SOLARGITY CORPORATION MATTHEW T RARKHAM 24 'SA 1NT MA 71N OR BOG2UNIT 11 k AARLBOROUGH MA 01752 3060 � s,_ r J' The Commonwealth of Massachusetts w Department o,j'IndustriatAccidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.inass gov1dia Workers'Compensation Insurance Affidavit:Builders/Contractors/BEectricians/Plumben Applicant Information Please Print Legibly Name(Busineworganization/individual): ©LARC[TY CORP Address:3055 CLEARVIEW WAY City/StatgZi :SAN MATEO,CA 94402 phone#:888-765-2489 Are you an employer?Check the appropriate box: Type of project(required): I. I am a employer with 5000 _ 4• [] 1 am a general contractor and 1 employees(full and/or part-time),* have.hired the sub-contractors 6• El New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any capacity. employees and have workers' 9. ®Building addition [No workers'comp.insurance comp.insurance.$ required.] 5, ❑ We are a corporation and its 10.[]Electrical repairs or additions 3:❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12,0 Roof repairs insurance required.]t c. 152,§1(4),and we have no SOLAR/PV employees. [No workers' 13.H Other comp. insurance required.] *Any applicant that checks box N t mets(also fill out the section below showing their workers'compensation policy information. t t lome:owners who submit this affidavit indicating they we doing all work and then hire outside contractors must submit a new afft evit indicating such. lControcion;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 subcontractors have employees.they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for ary employees. Below is the policy oud Job sire Information. Insurance Company Name:LIBERTY MUTUAL INSURANCE COMPANY 4 _ Policy#orSelf--ins.Lic. !#:WA7-66D-066265-02Expiration[Yate:09101/2015 Job Site Address: 452 Massachusetts Ave City/Statetzip:North Andover 0181A 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 tine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DA for insurance coverage verification. L do hereby certify under the pains rand earattles of perjury that the tr;formadon provided above is true and correct. . tt Signal e: -- d Wy._a _._ i�:et;, 4/14/15 Phone#: Oj)!icial tree only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: w DATE VMM1DDNYYYp CERTIFICATE OF LIABILITY INSURANCE 02T2014 THIS CERTIFICATE IS ISSUE©AS A MATTER OF INFORMATION ONLY AND CONFERS NO'RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES, NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORM REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT-. it the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION 13 WAIVED,subject to the toms and conditions of the policy,certain policies may require on endorsement: A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT : NAME _ MARSH RISK S INSURANCE SERVICES NAMEPHONS !FAX 345 CALIFORNIA STREET,SUITE 1300 ►AIC %Esq: '(AIC,Not: CALIFORNIA LICENSE NO.0437153 E M L SAN FRANCISCO,CA 94104 ADDRESS: fft5!!RER(S)AFFORDING COVERAGE N=a 9983G1•STND4AWMUE,I4.16 INSURER A:Liberty Mutual Fite InsurdwA Company 16506 INSURED INSURER a:I"Ii1$I ww Corpotation 42404 Ph 1650)963.5100 - . SolarCilr CorWa6an INSURER 0:MA INCA 3055 CteaMeat Way INSURER 0: San Marva CA 94402 INSURER E: I , COVERAGES CERTIFICATE NUMBER: SEA-002440269-02 REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE P43LICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY RECUIREMkNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS CERTir"TE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. C XCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE,BEEN REDUCED BY PAID CLAIMS. MSR WIPE OFINSURANCE "�ADD1.ISUSR,. .�."hoL1cYEFF ' POUCYVX0 LIMITS POLICY NUMBER r MM A 'GENERAL LIABILITY TB?•661.066265II14 0M 0900112015 EACH OCCURRENCE 4 1.(00.000 % COMMERCIAL GENERAL LiASII ITK DAMAGE TO NENTEO 100,000 PREMISES(Ea oeEyrteuo) '-s 1 i GIAtlMS•MADE i x10.000 l MED EXP(Any taro parsonT S 10.000 i I PERSONAL&ADV INJURY 6 1.000 Q00 i GCNERAI AGGREGATE S 2,000.000' r GEWL AGGREGATE I'IMIT APPLIES PER � PRODUCTS•COUPIOP AGO $ 2400.000 X POLICY, X %0 LOC i t?sdvclihlc S 25.000 A Au1OhTOSILEUASILITY AS2-661.N(126.044 6910112014 09!0112015 I a �tN tLtuw T 1.�O.OW X I ANY AUTO t 80011 Y INJURY(Per pwoon) S ALL OWNED j SCNEOULIII) BODILY INJURY(Perserdem).S AUTOS !AUTOS X 11i 1 AU705 X {AUTO5 E0 I PROPERTYmeOAMAGE t S X oPhyr"Damapu COMPICOLLOFM, $ $1,000181.000 UMBRELLA UAS OCCUR ,. i _._ _.. _ €ACH OCCURRENCE. $ Y EXCESS UAB CLAIMS MADE, t ,AGGREGATE $ O>O RETENTION ! _ $ ® ;YYORKERSCOMPENSATION WA7•660-0162M24 11)"112014 i69Kl112015 X WCSTATU- 0111.• AND EMPLOYERS'LIABILITY I ? ,TORY LIMITS ER I B ANY PROPMETORMARIREOJT XErt1rIVI Y1M � itWCI-6661-OW265.0341WI) X090112014 09101/2015 .1 1,000.4') fOFrICERWEMP.YR EXCLUDED° b N 1 A I E L I ACH ACCIDENT )$ B I Imandatory)n NHI 'WCDEOUCTIBLE:$350.000 I E I DISkASF•EA EMPLOYEE S 1.0000w I yos dose atom 1.900,000 DEG PT1ON Or OPERAI I NS Wm. k I DISEASE. POLICY LIMIT $ 1 I DESCRIPTION OF OPERATIONS I LOCATIONS 1 VENICLES(ANach ACORD 101.Additional Raeurks Schodoto,if more speco to required) I V4101 21 or lnsilratme CERTIFICATEE HOLDER CANCELLATION Sj-WULD ANY OF THE ABOVE L USCRIEIEG I"'OUCIES Ise.CANCELLETI BEFORE I 3055 CleaMew Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo.CA 94402 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Match Risk i Insurance Services CharlesMarmotelJ 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 12010105) The ACORD name and logo are registered marks of ACORD ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING - 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAIN (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT W WATT ' PV1 COVER SHEET 3R NEMA 3R, RAINTIGHT "' PV2 SITE PLAN PV3 STRUCTURAL VIEWS • PV4 STRUCTURAL VIEWS PV5 THREE LINE DIAGRAM LICENSE GENERAL NOTES Cutsheets Attached 1 1. ALL WORK TO BE DONE TO THE 8TH EDITION GEN 1OF THE MA STATE BUILDING CODE. ELEC 113366 M MR 2• ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: ZEP SOLAR REV BY DATE COMMENTS AHJ: North Andover REV A NAME DATE COMMENTS * * * * UTILITY: National Grid USA (Massachusetts Electric) # i — .too, * r i s PREMISE OWNER DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN F(w23) CONTAINED MALL NOT BE USED FOR THEJ B=0181726 DO GUILBEAULT, NICHOLAS GUILBEAULT RESIDENCE Regina Taurino �' ''SolarCity BENEFIT OF ANYONE EXCEPT SOLARCITY INC., M: 452 MASSACHUSETTS AVE 5.98 KW PV ARRAY �'1` NOR SHALL IT BE DISCLOSED IN WHOLE OR INunt Type C PART TO OTHERS OUTSIDE THE RECIPIENTS ANDOVER, MA 01810 ORGANIZATION,EXCEPT IN CONNECTION WITH24 St Martin Drive, MABuilding 2 Unit 11 THE SALE AND USE OF THE RESPECTIVE A SOLAR # TSM-260PDO5.18 PAGE NAME SHEET: REV: DATE Marlborough,MA 50)SOLARCITY EQUIPMENT,WITHOUT THE WRITTEN T: (s50)s3S-105— F: (s50)s38-1029 PERMISSION OF SOLARCITY INC. GE SE5000A—USOOOSNR2 6177637077 COVER SHEET PV 1 3�18�2015 (ass}soL-aTY(ass-24s9) www.solar�ity.�am PITCH:37 ARRAY PITCH:37 IVIP2 AZIMUTH:212 ARRAY AZIMUTH:212 MATERIAL:Comp Shingle STORY. 1 Story Fence PITCH:30 ARRAY PITCH:30 MP3 AZIMUTH:122 ARRAY AZIMUTH: 122 MATERIAL:Comp Shingle STORY: 2 Stories v a v 0 c nce Of -- =� a f, Arl[3AT rc fiL- a. t, MITE Inv B STftV;l't3FT,Aq„ ti W 4701 9 AC LEGEND NAL O � Q (E) UTILITY METER & WARNING LABEL --J STAMPED & SIGNED FOR STRUCTURAL ONLY Ing INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS Digitally signed by Andrew White © DC DISCONNECT & WARNING LABELS Date:2015.03.18 13:49:07-04'00' AC DISCONNECT & WARNING LABELS 0 DC JUNCTION/COMBINER BOX & LABELS I"IP2 B DISTRIBUTION PANEL & LABELS Lc LOAD CENTER & WARNING LABELS Front Of House _ (E)DRIVEWAY O M DEDICATED PV SYSTEM METER 452 Massachusetts Ave STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR —� CONDUIT RUN ON INTERIOR GATE/FENCE Q HEAT PRODUCING VENTS ARE RED INTERIOR EQUIPMENT IS DASHED L-'J SITE PLAN Scale: 3/32" = 1' 01' 10' 21' IN S CONFIDENTIAL THE INFORMATION HEREIN JOB NUMBER: J B-01817 2 6 0 0 PREMISE°N"� DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR,HE BENEFIT OF ANYONE EXCEPT SOLARCITY INC., GUILBEAULT, NICHOLAS GUILBEAULT RESIDENCE Regina Taurino �Olar�'}" MWN7ING SYSTEM: 452 MASSACHUSETTS AVE "� l.ro NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type c 5.98 KW PV ARRAY r PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION,D(CEPT IN CONNECTION WITH MODULES ANDOVER, MA 01810 THC SALE AND USE OF THE RESPECTIVE (23) TRINA SOLAR # TSM-260PDO5.18 24 SL Martin Drive,Building 2 Unit 11PAGE NAME SHEET: REV DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER PERMISSION OF SOLARCITY INC. SOLAREDGE SE5000A—USOOOSNR2 6177637077 T: (650)638-1028 F: (650)638-1029 SITE PLAN PV 2 3/18/2015 (B88)–SOL–CITY(765-2489) Www.sol°rsityaum (E) 2x4 Add 2x6 SPF#2 rafter tie (E) 2x upgrade at 4' O.C. S1 S1 2x6 SPF#2 (N) (4) SDW Screws TYP. (3) SDW Screws TYP. (3) SDW Screws TYP. 4' 4'-7" 7'-2" 12-8 P)" 12'-6" 1'— ' (E LBW 1'— (E) LBW (E) LBW B SIDE VIEW OF MP2 NTS SIDE VIEW OF MP3 NTS MP2 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES MP3 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES LANDSCAPE 72" 24" STAGGERED LANDSCAPE 64" 24" STAGGERED PORTRAIT 48" 20" PORTRAIT 48" 18" RAFTER 2x6 @ 24"OC ROOF AZI 212 PITCH 37 STORIES: 1 RAFTER 2X10 @ 16"OC ROOF AZI 122 PITCH 30 STORIES: 2 ARRAY AZI 212 PITCH 37 ARRAY AZI 122 PITCH 30 C.7. 2x8 @24"OC Comp Shingle C.J. 2x10 @16"OC Comp Shingle a 9�, PV MODULE 'l NORSIV D 5/16" BOLT WITH LOCK INSTALLATION ORDER "'111I TE r & FENDER WASHERS �, STfrU:1't i✓r,p t1 LOCATE RAFTER, MARK HOLE No.47.1T1-1 ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT ZEP ARRAY SKIRT (6) HOLE. '�fi'� I ��``� < •' (4) (2) SEAL PILOT HOLE WITH POLYURETHANE SEALANT. J ZEP COMP MOUNT C _ - __ ____ (3) INSERT FLASHING. STAMPED & SIGNED ZEP FLASHING. C (3) FOR STRUCTURAL ONLY (E) COMP. SHINGLE (1) (4) PLACE MOUNT. (E) ROOF DECKING (2) INSTALL LAG BOLT WITH 5/16" DIA STAINLESS (5) a(5) SEALING WASHER. STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES INSTALL LEVELING FOOT WITH WITH SEALING WASHER (6) BOLT & WASHERS. (2-1/2" EMBED, MIN) (E) RAFTER STANDOFF J B-01817 2 6 0 0 PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: CONTAINED SHALL NOT BE USED FOR THE GUILBEAULT, NICHOLAS GUILBEAULT RESIDENCE Regina Taurino �:,,SolarCity. BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �•'" r NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 452 MASSACHUSETTS AVE 5.98 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: ANDOVER, MA 01810 ORGANIZATION, EXCEPT IN CONNECTION WITH 24 St Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (23) TRINA SOLAR # TSM-260PDO5.18 PAGE NAME SHEET: REV: DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: T. (650)638-1028 F. (650)638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE SE5000A—US000SNR2 6177637077 STRUCTURAL VIEWS PV 3 3/18/2015 (866) sol-CITY(765-2469) www.soiarcityaorn GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO TWO (N) GROUND Panel Number:Cutler-Hammer Inv 1: DC Ungrounded INV 1-(1)SOLAREDGE#SE5000A-US000SNR� -(23)TRINA SOLAR#TSM-260PDO5.18 GEN #168572 ODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:12 807 742 Inverter; 5000W, 24OV, 97.5% w Unifed Disco and ZB,RGM,AFCI PV Module; OW, 236.9W PTC, 40MM, Black Frame, MC4, ZEP, 1000V ELEC 1136 MR Overhead Service Entrance INV 2 - - Voc: 38,2 Vpmax: 30.6 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 125A MAIN SERVICE PANEL E� 10OA/2P MAIN CIRCUIT BREAKER SolarCity (E) WIRING Inverter 1 CUTLER-HAMMER 4 A 1 10OA/2P Disconnect 5 SOLAREDGE Dc+ SE5000A-USOOOSNR2 I JDC- MP2,MP3: 1x11 (E) LOADS B _ EGC 240V _ -______---__ _____-__ _ ____________________ Ll Dc+ 0- Lz I I 1 1 N DG I 3 2 I I 30A/2P 1 ---------- _EGG OC+ OC+ I 13) -�- A -___ GND __-____-_____-___________-_ GEC -_-TN DG DG MP2,MP3: 1x12 6 GND __ EGC___ ____-____ --_ ___ __ EGC I I N I T(I)Conduit Kit; 3/4' EMT - _J o EGCIGEC 1 I I I I _ GEc_r-1 TO 120/240V SINGLE PHASE I I UTILITY SERVICE 1 I I I I I I 1 I I I I I PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP POI (1)CUTLER-HAMM R #BR230 PV BACKFEED BREAKER B (I)CUTLER-HAMMER #DG221URB (1)SolarCity g 4 STRING JUNCTION BOX Breaker, 30 P, 2 Spaces Disconnect 30A,�24OVac, Non-Fusible, NEMA 3R AC ^ 2x2 SiRMGS, UNFUSED, GROUNDED DC -(2)Ground Rod; 5/8' x 8', Copper -(i)Gound�NAeutraKitD30A, General Duty(DG) PV (23)SOLAREDGE300-2NA4AZS PowerBox pt"ver 300W, H4,DC to DC,ZEP nd (1)AWG#6, Solid Bare Copper -(1)Ground Rod; 5/8'x 8', Copper (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION N0, 2, ADDITIONAL ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE (1)AWG#10, THWN-2, Black (1)AWG#10, THWN-2, Black Voc* =500 VDC Isc =15 ADC (2)AWG#10,PV WIRE, Black Voc* =500 VDC Isc=15 ADC O IoF(1)AWG#10, THWN-2, Red O (1)AWG#10, THWN-2, Red Vmp =350 VDC Imp=8.8 ADC O (1)AWG#6,Solid Bare Copper EGC Vmp =350 VDC Imp=8,07 ADC LLLL�=_=CELL(1)AWG#10, THWN-2, White NEUTRAL Vmp =240 VAC Imp=21 AAC (1 AN#10, TIiWN-2, Green,. EGC, ,.,., , . .. .. ..... .... ..... .. .. ........ ....... .. .. .. . . .. ........ .. . .70)AWG A.TI1"72,,Green ., EGC/GEC,-(1)Conduit,Kit;,3/4".EMT... , ,,, ,,, (i)AWG#10, THWN-2, Black Voc* =500 VDC Isc =15 ADC �(2)AWG#10, PV WIRE,Black Voc* =500 VDC Isc=15 ADC ®�(1)AWG#10, THWN-2, Red Vmp 350 VDC Imp-8.07 ADC O lol (I)AWG#6,Solid Bare Copper EGC Vmp =350 VDC Imp=8.8 ADC AWG#10, MM7N .,Green,. EGC. ..... .. ... ...... .... .... ....... .. ...�JJ. ..................... ... .......... ........... ... .... .... CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER PREMISE OWNER: DESCRIPIlON: DESIGN: CONTAINED SHALL NOT FO USED FOR THE JB-0181726 00 GUILBEAULT, NICHOLAS GUILBEAULT RESIDENCE Regina Taurino BtNEFIT OF ANYONE EXCEPT SOLARCITY INC., MOIJN11NG SYSTEM: "V �SolarCity. 452 MASSACHUSETTS AVE NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type c 5.98 KW PV ARRAY �1� ° PART TO OTHERS OUTSIDE THE RECIPIENTS Mo�N�s ANDOVER MA 01810 ORGANIZATION, EXCEPT IN CONNECTION WITH TU SALE AND USE OF THE RESPECTIVE (23) TRINA SOLAR # TSM-260PDO5.18 24 SL Martin Drive,Building 2 Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME SHEET: REV: DATE Marlborough,MA 01752 PERMISSION OF SOLARCITY INC. INVrR11R 6177637077 PV 5 3/18/2015 - (650)638-1028 F. 650)638-10� SOLAREDGE SE5000A-USOOOSNR2 THREE LINE DIAGRAM (888T)-SOL-CITY(765-2489) www.solarcit.com WARNING.PHOTOVOLTAIC POWER SOURCE • • • "• • • ,• • , • ti , WARNING WARNING Code:Per Code: Per Code: Per NEC NEC ELECTRIC SHOCK HAZARD .. • ELECTRIC SHOCK HAZARD 690.31.G.3 �DO NOT TOUCH TERMINALS THE DC CONDUCTORS OF THIS 1 1 NEC Label • • •TERMINALS ON BOTH LINE AND PHOTOVOLTAIC SYSTEM ARE • LOAD SIDES MAY BE'ENERGIZED � UNGROUNDED AND PHOTOVOLTAIC DC BE USED WHEN ••- INVERTERIS - IN THE OPEN POSITION MAY BE ENERGIZED UNGROUNDED NEC DISCONNECT v. ._ a�. .•1 Label Location: Label Location: (POI -_ _ -----MAXIMUM PGWER- A — -WARNING:ELECTRIC SHOCK- •• POINT CURRENT{Imp)_ T Per ••- HAZARD.DO NOT TOUCH 690.17.4; 690.54 MAXIMUM POWER- vNEC 690.53 TERMINALS.TERMINALS ON POINT VOLTAGE(Vmp)_ BOTH THE LINE AND LOAD SIDE MAXIMUM SYSTEM � MAY BE ENERGIZED IN THE OPEN VOLTAGE(Voc)— POSITION. FOR SEP.VICE SHORT-CIRCUIT A DE-ENERGIZE BOTH SOURCE CURRENT(isc)— AND MAIN BREAKER. PV POWER SOURCE MAXIMUM AC A OPERATING CURRENT _ MAXIMUM AC Label Location:Per Code: OPERATING VOLTAGE — WARNING ELECTRIC SHOCK HAZARD 690.5(C) IF A GROUND FAULT IS INDICATED NORMALLY GROUNDEDLabel L• • CONDUCTORS MAY BE CAUTION • UNGROUNDED AND ENERGIZED. DUAL POWER SOURCEPer Code: SECOND SOURCE IS 690.64.B.4 PHOTOVOLTAIC SYSTEM Label • • WARNING - Labeler Code: ELECTRICAL SHOCK HAZARD DO NOT TOUCH TERMINALS ••1 CAUTION _•Location: TERNIINALS ON BOTH LINE AND Per ••- NEC LOADSIDES MAYBE ENERGIZED PHOTOVOLTAIC SYSTEM •1 IN THE OPEN POSITION CIRCUIT IS BACKFED DGVOLTAGE IS ALWAYS PRESENT WHEN '-SOLAR MODULES ARE EXPOSED TO SUNLIGHT Label • • WARNING -• Per Code: INVERTER OUTPUT •- • • NEC 690.64.B.7 CONNECTION PHOTOVOLTAIC AC DO NOT RELOCATEDisconnect DISCONNECTPer C•• THISODEVICERRENTConduit NEC .•1 Combiner :. Distribution Panel Conduit(DC): DC Disconnect (IC): Interior Run Location:Label Inverter - ct AC A -OI) (LC): Load Center OPERATING CURRENTPer Code: (M): Utility Meter MAXIMUM AC �•1 OPERATING VOLTAGE V Interconnection 3055 aeaview Way r . • a . r . a • r San :a r • a a • • . , r . •, r • r . . a . r • • .•- - r Mateo,• r • r . ' % ' r r a . � •r • . r Next-Level PV Mounting Technology '-r,SOlarCity I ZepSolar Next-Level PV Mounting Technology ^SOIarCity ZepSolar Zep System Components for composition shingle roofs Z`,-,Up-roof ' r' f Ground ZeP IhOertoek flSer sde shuvnl a Zep Compatlble Py Module Roof Attachment ,/ Array Skirt ✓ OOMPgT� � ti ASF Description rFA j o� PV mounting solution for composition shingle roofs �.OMpP- • Works with all Zep Compatible Modules • Zep System UL 1703 Class A Fire Rating for Type 1 and Type 2 modules Auto bonding UL-listed hardware creates structual and electrical bond U� LISTED Comp Mount Interlock Leveling Foot Part No.850-1345 Part No.850-1388 Part No.850-1397 Listed to UL 2582, Listed to UL 2703 Listed to UL 2703 'j Specifications Mounting Block to UL 2703 ET! Designed for pitched roofs �---�� Installs in portrait and landscape orientations l t l • Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 • Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and ETL listed to UL 467 • Zep System bonding products are UL listed to UL 2703 • Engineered for spans up to 72"and cantilevers up to 24" • Zep wire management products listed to UL 1565 for wire positioning devices Ground Zep Array Skirt,Grip,End Caps DC Wire Clip • Attachment method UL listed to UL 2582 for Wind Driven Rain Part No.850-1172 Part Nos.500-0113, Part No.850-1448 Listed to UL 2703 and 850-1421,850-1460, Listed UL 1565 ETL listed to UL 467 850-1467 zepsolar.com zepsolar.com Listed to UL 2703 This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com, 12 22 14 ZS for Comp Shingle Cutsheet Rev 02.pdf Page: 1 of 2 12 22 14 ZS for Comp Shingle Cutsheet Rev 02.pdf Page: 2 of 2 • solar=ee so I a r ' e • z SolarEdge Power Optimizer Module Add-On for North America SolarEdge Power Optimizer P300/ P350/ P400 P300 P350 P400 odule Add-On For North America (for 60-cell (for 72- 11 PV (for 96-cell PV modules) modules) modules) P300 / P350 / P400 • INPUT. _ Rated Input DC Power"I 300 350 400 W Absolute Maximum Input Voltage(Voc at lowest temperature) 48 60 80 Vdc MPPT Operating Range 8-48 8-60 8-80 Vdc • Maximum Short Circuit Current(Isc) 10 Adc Maximum DC Input Current 12.5 Adc Maximum Efficiency 99.5 % Weighted Efficiency 98,8 % Overvoltage Category II OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) _ Maximum Output Current 15 Adc Maximum Output Voltage 60 Vdc • OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) Safety Output Voltage per Power Optimizer 1 Vdc ;t STANDARD COMPLIANCE `!1EMC FCC Part15 Class B,IEC61000-6-2,IEC61000-6-3 Safety IEC62109-1(class II safety),UL1741 l RoHS Yes INSTALLATION SPECIFICATIONS Maximum Allowed System Voltage 1000 Vdc Dimensions(W x L x H) 141 x 212 x 40.5/5.55 x 8.34 x 1.59 mm/in Weight(including cables) 950/2.1 gr/lb y',. p'• Input Connector MC4/Amphenol/Tyco ' ^rt Output Wire Type/Connector Double Insulated;Amphenol - "gaf` Output Wire Length 0.95/3.0 I 1.2/3.9 m/ft Operating Temperature Range -40-+85/-40-+185 'C/'F Protection Rating IP65/NEMA4 Relative Humidity 0-100 % ��nam s*c mow.,erne ewam..rnee�ie o�ea w+sx--n-1—d. -- -PV SYSTEM DESIGN USING A SOLAREDGE - THREE PHASE THREE PHASE INVERTER SINGLE PHASE 208V 480V PV power optimization at the module level Minimum String Length(Power Optimizers) 8 10 18 — Up to 25%more energy Maximum String Length(Power Optimizers) 25 25 50 -Superior efficiency(99.5%) Maximum Power per String 5250 6000 12750 W Parallel Strings of Different Lengths or Orientations Yes — Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading , — 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 _ I USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www.solaredge.us so i a r o ® Single Phase Inverters for North America s o I a r e o SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ ® ® SE760OA-US/SE1000OA-US/SE1140OA-US SE3000A US SE380OA US I SES000A-1 S SE760OA-US SE100004,-US SE11400A-US OUTPUT SolarEdge Single Phase Inverters ® 9950@208V 11400 VA Nominal AC Power Output 3000 3800 5000 6000 7600 10000 @240V 5400 @ 208V 10800 @ 208V 12000 VA North h h /� p rY Max.AC Power Output 3300 4150 5450 @240V 6000 8350 10950 @240V Forr Nor f' Meica AC Output VoltageMin:Nom:Max.* - _ - 183-208-229 Vac ' SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ AC output Voltage Min.-Nom.-Max.* v/ , , r .1 r r SE760OA-US/SE1000OA-US%SE1140OA-US ACFreq Frequency Vac AC Frequency Min.-Nom.-Max.* 59.3-60-60.5(with HI country setting 57-60-60.5) Hz @ 208V Max.Continuous Output Current 12.5 I 16 24 @ 208V I 21 @ 240V l 25 I 32 I 42 @ 240V I 47'5 A -- ._ GFDI 1 A Utility Monitoring, Configung rable Protection,Country Yes Thresholds !t, C• ;x INPUT r "-F 12�2J Recommended Max.DC Power** 3750 4750 6250 7500 9500 12400 14250 W 1 t _ -feats (STC) I ` watfaQ" Yes Transformer-less,Ungrounded { �at2aN Max.Input Voltage 500 Vdc ^• 325 @ 208V/350 @ 240V Vdc s` .Nom.DC Input Voltage Max.Input Current*** 9.5 I 13 115.5 @ 240V I 18 23 30.5 @2240V 34.5 Adc ( _ 30 45 Adc •� I i`.-. Max.Input Short Circuit Current — Reverse-Polarity Protection Yes s Ground-Fault Isolation Detection 6001caz Sensitivity I - •Maximum Inverter Efficiency 97.7 98.2 98.398.3 98 98 98 - -- CEC Weighted Efficiency 97.5 I 98 ' 998 @ 240V , 97.5 97.5 I 97.5 @224 V 97.5 % { Nighttime Power Consumption <2.5 <4 W , j ADDITIONAL FEATURES 4 i o, Supported Communication Interfaces RS485,R5232,Ethernet,ZigElee(optional) W Revenue Grade Data ANSI C12 1 Optional r STANDARD COMPLIANCE _ Safety UL1741,UL1699B,UL1998,CSA 22.2 r Grid Connection Standards IEEE1547 Emissions FCC partly class B f INSTALLATION SPECIFICATIONS 1 1AC out conduit size/AWG range 3/4„minimum/24-6 AWG 3/41'minimum/8-3 AWG DC input conduit size/#of strings/ 3/4"minimum/1-2 strings/24-6 AWG 3/4"minimum/1-2 strings/14-6 AWG • ii AWG range ' iin/ Dimensions with AC/DC Safety 30.5 x 12.5 x 7/ 30.5 x 12.5 x 7.5/ 30.5 x 12.5 x 10.5/775 x 315 x 260 Switch(HxWxD) 775 x 315 x 172 775 x 315 x 191 mm Weight with AC/DC Safety Switch 51.2/23.2 54.7/24.7 88.4/40.1 Ib/kg - Cooling Natural Convection Fans(user replaceable) _ Noise <•2S <50 dBA The best choice for SolarEdge enabled systems Min.-Max.Operating Temperature -13 to+140/-25 to+60(CAN version****-40to+60) 'F/'C Integrated arc fault protection(Type 1)for NEC 2011 690.11 compliance Range Protection Rating NEMA 3R Superior efficiency(98%) For other regional settings please contact SolarEdge support. •'Limited to 125%for locations where the yearly average high temperature is above 77'F/25'C and to 135% far locations where it is below 77'F/25'G — Small,lightweight and easy to install on provided bracket Fordetailed Information,refertohtu dog.us/`bles/odfs(ijer dc,mersizine nuide,Dclf t '•Ahigher current source maybe used;the inverter will limit its input current to the values stated. — Built-In module-level monitoring '•"CAN P/Ns are eligible for the Ontario FIT and micmFlT(microFIT exc.SE31400A-US-CAN). — Internet connection through Ethernet or Wireless - - Outdoor and indoor installation — Fixed voltage inverter,DC/AC conversion only - Pre-assembled AC/DC Safety Switch for faster installation Optional—revenue grade data,ANSI C12.1 <txsaEc • HS USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL www.solaredge.us Mono Multi solutions THE "Prinemount MODULE TSM-PD05.18 DIMENSIONS OF PV MODULE ELECTRICAL DATA @ STC - unit:mm Peak Power Watts-PM (Wp) 245 250 255 260 • 941 N E Power Output Tolerance-P(%) 0-+3 T 1 1 ���� f m o „ Maximum Power Voltage-VMv(V) f 29.9 30.3 30.5 30.6 m Maximum Power Current-lora°(A) 8.20 827 8.37 8.50 "'"°EP1A1E c Open Circuit Voltage-Voc(V) 1 37.8 38.0 38.1 38.2 u n t wsrauuHC HOU Short Circuit Curren}-Isc(Ai 8.75 8.79 .8.88 + 9.00 t MODULE A ® � I C _ Module Efficiency q.,(%) ! 15.0 15.3 15.6 15.9 '\v/' L_L_ STC:Irradiance 1000 W/m',Cell Temperature 25°C.Air Mass AMI.5 according to EN 60904-3. Typical efficiency reduction of 4.5%at 200 W/m2 according to EN 60904-I. 0 e e 0 i � ELECTRICAL DATA @ NOCT �/0 ELL Maximum Power-P-(Wp) 182 1 186 1 190 193 (L� 1 Maximum Power Voltage-Vr (V) 27.6 28.0 28.1 28.3 MULTICRYSTALLINE MODULE 4.34ROUN01NGHOU Maximum Power Current-IMaa(A) 6.59 6.65 6.74 17 6.84 WITH TRINAMOUNT FRAME Open Circuit Volt'ge(V)-Voc IV) 35.1_ 35.2 35.3 35.4 t '"`^•._. Short Circuit Current(A)-lsc(A) t «7.07 • 7.10• t •7.17• 7.27 t 245 260W f I NOCT:Irradiance at 800 W/m',Ambient Temperature 20°C,Wind Speed l m/s. f PD05.18 B12 180 POWER OUTPUT RANGEBack View i MECHANICAL DATA 111 Solarcells ' Multicrystalline 156 x 156 mm(6 inches) �`� fast and simple to install through drop in mounting solution -_ •9/ u' ii b Cell orientation I 60 cells(6•10) Module dimensions i 1650 x 992 x 40 mm(64.95 x 39.05 x 1.57 inches) v r Weight 21.3 kg(47.0 lbs) MAXIMUM EFFICIENCY - - - ` (\ Glass 3.2 mm(0.13 inches),High Transmission,AR Coated Tempered Glass ( u A-A Backsheet White - Good aesthetics for residential applications f�E� � � Frame ± Black Anodized Aluminium Alloy with Trinamount Groove ■ J-Box IP 65 or IP 67 rated 0-- 3% I -- I-V CURVES OF PV MODULE(245W) - Cables I Photovoltaic Technology cable 4.0 mm'(0.006 inches'), POWER OUTPUT GUARANTEE 1 lam ' 1200 mm(47.2 inches); 9.°' 80gW/m' .. 8.01 Fire Rating Type 2 Highly reliable due to stringent quality control 7. �0N'm - - -- 4 • Over 30 in-house tests(UV,TC,HF,and many more) <6.a As a leading global manufacturer 5:- of next generation photovoltaic • In-house testing goes well beyond certification requirements u 3m B0 m TEMPERATURE RATINGS MAXIMUM RATINGS products,we believe close 20° 200W/m' Nominal Operating Cell Operational Temperature I-40-+85°C cooperation with our partners t m Temperature(NOCT) 44°C(t2°c) is Critical to Success. With local Maximum System 1000V DC(IEC) om Temperature Coefficient of P_w -0.41%/°C Voltage 1000V DC(UL) presence around the globe,Trina is om t°.^' zom 30.m 40.m . able to provide exceptional service Voltage(V) Temperature Coefficient of Voc 1-0.32%/°C Max Series Fuse Rating 15A to each customer in each market Certified to withstand challenging environmental Temperature Coefficient of Isc 0.05%/°c and supplement our innovative, conditions reliable products with the backing2400 Pa wind load of Trina as a strong,bankable partner. We are committed • 5400 Pa snow load WARRANTY to building strategic,mutually beneficial collaboration with Io year Product workmanship Warranty Linear Power Warranty installers,developers,distributors 25 year L�_ and other partners as the (Please refer to product warranty for details) < backbone of our shared success in <' driving Smart Energy Together. LINEAR PERFORMANCE WARRANTY CERTIFICATION RI rADPACKAGING CONFIGURATION rn 10 Year Product Warranty•25 Year Linear Power Warranty ` 4i B= SP• trio°Solar Limited use c as Modules per box:26 pieces i www.trinosolar.com `:tBO% Modules per 40'container:728 pieces f a Adgfltonal voruI_ J e 90% from T,rrina COmaaaEEE SOiO1 S lirlegrnty w 4HIn-asolar I T CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. �ot4PAt O 80% ��o��iso�ar ®2014 Trina Solar Limited.All rights reserved.Specifications included in this datasheet are subject to 4 1 Y w changewithout notice. Smart Energy Together Smart Ener Years 5 10 IS 20 25 Energy Together A 13 Trinastandafd Indusuy;wndard roA19Pr0 0609 FIT TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies ........................ has permission to perform.......4. ......... ........................................... ..... plumbing in the bf yi ings o ............................................................................................. at.. 2-....../.�r .............e^.11.................. North Andover, Mass. Fee 40 "P.Lic. NO.3.,�.��... ..... ....................................................... ...... PLUMBING INSPECTOR Check# 1-174 I � MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: MA. Date: - a,�'- Permit# , d� Building Location: ' , p� SS dv-e Owners Name:.(j ) c�,L Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential New: Alteration:❑ Renovation: ElReplacement:ElPlans Submitted: Yes E] No El FIXTURES DEDICATED SYSTEMS +mow Y O W Z y Ln V O a a Z E Y Q _j U w v o w z W z F a N z = rr z cn w 0 ¢ Z = Y h (D Q _ O w O OW Z w Z v a LL 2 Q Q a s o > > o o a z W at o En W �' LL W Q N SUB BSMT. 3 O Q < 3 BASEMENT 1sT FLOOR 2ND FLOOR 3RD FLOOR =- 4T"FLOOR ST"FLOOR 6T"FLOOR 7'FLOOR I� 8T"FLOOR Anstalling con-1pany tqame: Check One only Certificate?a jl �/ddress: Q ,,► �G' Corporation City/Town: `s► -�_/ �aze State: Business Tel:-.2>'i' -G�(. p a a Fax: Partnership Tel:-.2>'i' - I� Name of Licensed Plumber: ❑FirmlCompany INSURANCE COVER w�� AGE: � 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.942 Yes No❑ If you have checked Yes,please indicate the-type of coverage by checking the appropriate box below. liability insurance policy.[J� Other type of indemnity ❑ Bond ❑ WNER'S INSURANCE WAIVER:1 am aware that the licensee does the insurance coverage required b Ch 9assachusetts General Laws,and that my signature on this permit application waives this requirement. y Chapter 942 of the Check One Only Si nature of Owner or Owner's A ent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and ace,• Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts state Plumbing Code and Chapter t4 of the General Laws. a•ate to the best of my By r.J Type of License: ' Title r❑�Plumber ignature of L' nsed lumber INMaster Master APPROVED(OFFICE USE ONLY) ❑Journeyman License Number: �d3� es I� 9 f i i i T SSjid � l The Commonwealth gfMassachusetts - Department of IndustriglAceikks office oflnvestigations 600 Washingion Street Boston,MA 02111 wipmmass govIdia Workers'Compensation Insuxance Affidavit:BuiXdersiContrcactors)Electrzcians� I*Per$ A.uplieant 1'n£oiranat on Please PrimEealy Name(Businessforgamzatsonftdi-vzdual): r S 5 6:le 4-1 C � l� Address: 190 66"V, C5 City/Stade/Zip: U � �/� eve 94+, Phone#: Y 7 6 a 1— . � /�- U Axe you an employer?Check the appropriate box: Type of Project(required.): 1.0fam a employer with 7i A. El am a general contractor and I 6. @"fTew construction F employees(full andlox part-time).* have lvxedthe sub-contractors 2.❑ I am a sola proprietor or partner listed on the attached sheet 7. ❑Remodeling ship and`havena.employees These,sub-contractors have 8. El Demolition working forme in any capacity. workers'comp.insurance. 9. ❑Building addition tNo workers'comp.insurance 5. ❑We area corporagon and its 10.j]Electrical repairs or additions required.] officers have exercised.theix 3.Elm I am a hoeowmr doing all work right of exemption per MGL l l.[]Plumbing repairs or additions myself o workers'comp. c.152,§1(`I),and we,have no 12.]]Roo£repairs k e o es. . o workers'insurancexequired.j i em tp �' 13.❑Other comp.insurance required.] Mny applicantthat checks b0x#1 must also fill outthe section bel6w showingtheir workers'compensation.poHcyinformati0n. -Homeowners•who submitihis affidavit ind catingthey are doing allworlc and then hire outside contractors must submit a new affidavit indicating such. Teoutractors that cheAthis box must attached as additional sheet slhowingthe name ofthe sub-contractors andihok workers'comp.policy information. I atn an employer that isproviding workers'com,perzsatian insuranee f"MY eYnployees Belot is the policy ancijo�i site information. L Tnsuxance Company Name..—L1 , ✓a � �- �' ef policy#or Self ins.Lic.M. Expiration Date: Sob Site Address, Attach a copy of the workers'compensation-polzcy declaration page(showing the policy number and expiration.date). Failure to secure coverage.as requiredunder Section 25A ofMGL o.152 can lead to the imposition of criminalpenaltim of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD.ORDER_and a fine o£upto$250.00aday against theviolator. Be advised that a copy of this statem,entmaybeforwarded tothe Office of Investigations of the DIA.for insurance coverage verification. X do riereby ari triepains and penalties per'u ,mat tree information provided above is trae and cornett. Signafore —<9��i;�`' Date: (0 Phone 0 ofcial use onry. Do not write in this area,to be completed by city or town official. City or Town: PermiffIcense# Dsuing.A.uthority(circle one): 1.Board of Health 2.Building Department 3.CityMown Clerk 4.Electrical Inspector 5.Plumbing1aspector 6.Other Information and Instrnctiol.s - Massachusetts General Laws chapter 152 requires aft empIoyers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as ,...every person ti the service of another under any contract of hire, express oximplied,oral oxwxitten." An emTloyWis defined as"an individual,partnership,association,corporation or otherlegal entity,or anytwo ormore of the foregoing engaged in ajoint enterprise,and includingthe legal representatives of a deceased employex,_or the xedeive'r or'.ti'dstee ofan individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house havingnotmore than three,apartments andwho resides therein,or the occupant of no 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 employ hent be deemed to bean employer" MGL chapter 152,§25C(6)also states that"every state or Ideal 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 perforzmance ofpublic work until acceptable evidence of compliance with fie insurance requirements of this chapter have beenpresentedtathe contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checlang the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)andphonenumber(s)along with theircorecate(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 LLC ox LLP does have employees,a policy is required. Be advised thatthisaffidavit maybe submitted tothe Department ofludustdal Accidents for confirmation of insurance coverage. .Also be sure to sign and date the affidavit The affidavit should be retumed 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' compensationpoliey,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 andpxinted 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 tofu in the Pu mit/license number Which-will be used as a reference number. In addition,an applicant thatrnust submit-Multiple permit/11cense applications is any givenyear,need only submit one affdavitindicathag current Policy information(ifnecessary)and under"Job Site Address"the applicantshouldwrite"alllocations in ,(city or towzl):'A copy of the affidavit that has been officially stamp ed or marked by the city or town may be provided to the applicant as proof that a valid affidavit-is on file for future permits or licenses. Anew affidavit must be filled out each year.Where ahome owner or citizen is obtaining alicense oxpermitnot related to any business or commercial venture (i.e,a dog license orpermit to burn leaves eta,)said person is NOT required to complete this affidavit, The Office of Investigations would like to thank you in advance for youx cooperation and should you have any ctuestions, please do not hesitate to give us a call. The Department's address,telephone aird fay,number: Tho CQxox��wcatZosachuPtt A-TartmQnt Qfkdu*ial AccldozM Office QUn,YPS60-00)m 6.04asg(Qsa.Street B(,)Am,S 0.2111 Tei, 617-7-2Q-_49 0 0 e 406 Qx Z-87"7—MM8AF'F _ Revised 5-26-OS Fax#617-727-7749 ' :COMMONWEALTH OF MASSACHUSETTS:.;: :;:`'; � o e - e • :::BOARD Of PLUMBERS AND GASFI:;TT€R5': ISSUES THE FOLLOWING 1 iCENSE LiCENSED` AS A MASTER PLUMBER r �F .ROBERT .J SALEMME 73 VARNEY POINT 4 44f 1t 4 5�`,. IJ F.oRD NH 03249 7639~ , 80 Vii': 0510]:f.16 MY 208742 Date.........7�Iz-3.--zOF V 17 40RTh TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING C U This certifies that .......Dmto........... C................................... has permission to perform *--/Vz....... wiringin the building of........................ ................................................................ at ... ......... ............................,,,North Andover,Mass. Fee ......... ........ Lic. No.J'7. .. A F(01�CtAL:�X?EECITOR Check# \ cl)EJnlnE.A Or VM."� Official Use Only '�\ rxe�parf�e�af o�/c7_ �erviees Permit No. e[J lira Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.l/o7j (leave blank) APPLICATIONFOR�PERMIT TO PERFORM ELECTRICAL ORK All work to be performed (PLEASE PRINT IN INfK OR TYPE ALL INFO TION) Date: _ 7 27�� City or Town-of To the Inspector of Wares: a By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) / 416— Owner or TenantTelephone No. Owner's Address Is this permit in conjunction with a building permit? Yes F4— No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / 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: �,���' Z ��? -:5y52=?n vri di4f CompletionofthefoUmving,table maybe waivedby the Inspector of Wires. No.of Recessed Luminaires No.of Cell.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- ❑ o.o mergency g ` d. rud. BatteKy Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Z ' No.of Detection andInitiating Devices No.of Ranges No.of Air Cond. �- Total Tons :5- No.of Alerting Devices No.of Waste Disposers Heat.Pump Number Tons KW No.of Self-contained Totals: Detection/Alerting Devices No.of Dishwashers SpacelArea Heating KW Local❑ Municipal ❑ Other Connection No of Dryers Heating Appliances KW SecuritySystems:* No.of Water_ IOW No.of No.of No.Data Wiring:Devices or Equivalent Heaters Si Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Whingg No.of Devices or uivaient OTHER: 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: 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 cerhify,under the pains andpenalties ofperjury,that the information on this ap lication is true and complete FIRM NAME: C T R i CA L C0hJ %��L I A441C. LIC.NO.: Licensee:(i 1> (.. *466 4P, Signature LIC.NO.: 1 y q (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.•9 78 Address: A-7 31r L m D N r a jN IANDB J t:2 I3't v i ` `J Alt.Tel.No.:J U -.3757-5-11511 *Per M.G.L.c.147,s.57-51,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,l hereby waive this requirement. lam the(check one)❑owner ❑owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE.S r' i� 2 t� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' I Congress Street, Suite 100 Boston,MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name:DAVID ELECTRICAL CONTRACTING LLC Address:87 BELMONT ST i City/State/Zip:NORTH ANDOVER,MA 01845 Phone#:978-682-6262 Are you an employer?Check the appropriate bog: Business Type(required): 1.❑ I am a employer with 8 employees (full and/ 5. ❑Retail or parttime)* 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7_ ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp-insurance required] g- E]Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152, §1(4),and we have l 0.❑Manufacturing no employees. [No workers' comp. insurance required]** 11.0 Health Care 4.ElWe are a non-profit organization,staffed by volunteers, 12 er ELECTRICAL CONTACTING with no employees. [No workers' comp. insurance req.] ',4ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. #°If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name:FEDERATED MUTUAL INSURANCE CO Insurer's Address:PO BOX328 City/State/Zip: OWATONNA, MN. 55060 Policy#or Self-ins. Lie. # 9353694 Expiration Date:MARCH 1, 2015 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 firte 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 ofup to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of hi4 estigations of the DIA for insurance coveragev ficatio . I do hereby certify, under the pains and pen i of,er at tl:e information provided a ove is true and correct Signature: (� Date: 7 23' Phone#: F2 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.,Cityfrown Clerk 4.Licensing Board 5.Selectmen's Office b.Other I Contact Person: Phone#• www.mass.gov/dia —/ Date....... /4 7 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHU This certifies that --7 ............................................................... . ................................................ has permission to perform ........ .. ........................................................ wiring in the building of.......... . ....................... at ........... North Andover,Mass. Fee... ............... f .........Lic. No.T-Y��3/ S ELECTRICAL INSPFy, OR Check# zel 1957.n Commonwealth Of Massachusetts Official Use `Only Department of Fire Services Permit No. l �`' 7&-2' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank e N APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK !-/ 4 All work to be performed in accordance with the Massachusetts Electrical Code ),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 City or Town of. NORTH ANDOVER To the Inspector of ' ires: \ By this application the undersigned gives notice o 's or her inten ' n to perform the electrical work described below.IA5 Location(Street&Number) ZM Owner or Tenant l Glc fi1 Telephone No. Owner's Address Is this permit in conjunction with a b Ming permit? Yes No ❑ (Check Appropriate Box) Purpose of Building l Ci Utility Authorization No. Existing Service mServiAPs / 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: -- 4 K-,4. Completion o the following table maybe waived by the Inspector of Wires. No.of Ceil:Susp.(Paddle)Fans Tr s Total No.of Recessed Luminaires �� Transformers KVA ~ No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above ❑ In- No.of Luminaires Swimming Pool Elo.o mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons TotNo.of Alerting Devices No.of Waste Dis osers Heat Pump Number Tons KW No.of Self-Contained P Totals: Detection/Akfting Devices No.of Dishwashers S ace/Area Heating KW Local unicipal ❑ Other P g Connection No.of Dryers Heating Appliances KW Security Systems:* Y No.of Devices or Equivalent No.of Water KW 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: Attach additional detail if desired, or as required by the Inspector of Wires. r Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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' surance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force,and has exhibited proof ofia to a permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) 2 °"/I certify,under the pain enaltie o perury,t)tat t)ze 'nform on on tapph atton is true and complete FIRM NAME: , tf � � PSC/ rLtC C LIC.NO.: Licensee: Sleok" —J—L,b,A Signature LIC.NO.• (If applicable,entexempt" 'h a licen nz b'r 1'ne.) Bus.Tel.No.: ` Address: � t C, Alt.Tel.No.: *Per M.G.L c. 147,s. 57-61,security work requiro Department of Public Safe "S"License: Lic.No. tVV I` 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(heck one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. s X,allLttt..,d,L&AL.C.Ls+Mlt RO .^ lt11J�dJuL.kl'lJl�{.lLa1uE® R: Iasset� ,[ 'ailefl�j ] 33e-is�spectzon xequzze�(��0.00)~j �ns,pectoxs'�apame�afs: I ffugectoxs°Signature-n it-Wals) •^ plate �.'assec�.--j ) �" �+'ailet�--j ) u �teins�ectiox�xec�uixec�050.00)-•j � . �tt5�]eGtOTCS'CDI11�entS: . (JCns ectoxs',signature••xio ixaitials) Pate 3,UNDDER GROTJND WgRACT`XON: �.'assed•-j I �'ailec�-•j � ate-f.�s�ectio�xet�uixet�050.00)�j j Znspecto7rs'comments: (Inspectoxs'signature- 0 7uit:as} Pate Re-inspeedonxequixed($50.00)-j ) ' ispectbxs'co m f9: (Cusp ec s',5'i tuxe..no zn-Hals) Date �7�7P�C7CZo ��.: • .sed---j " aiier j )• e nspectionxequkea($50.00).-j - pectox�'coznm.enfs: S . sp ectoxs'gignatrare••no xnitiaTs} �t ate :P OR TAGS AM TOME IMED OUT AM LEFT ON RITE P TM APXAs.TO BE INSPECTED 19 NOT - 555 SK:EM ST s KORTH MOVER Kk 0118 - i L Fold,Then Detach Along All Perforations $at�3 tX7 1.7 = I' X.N� ;V-i W5 JAG J-:1 W QST ; A U 184$ 5- ag ' _.� 4 f , Date.. .�� ........................ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION w ggACHUS� This certifies that ............... . .5.........G' `"......... ........................................... has permission forgas installation ........�-............ 1!.R...N.....4r .r...... inthe buildings of... ...................................................................................... at.............' . Gt ss.......... ...., North Andover, Mass. Fee., ' Lic. No. GASINSPECTOR Check# 9421 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY NORTH ANDOVER MA DATE 7/23114 ,& PERMIT# JOBSITE ADDRESS' 452 MASS AVE OWNER'S NAME K_EEN CONSTRUCTION GOWNER ADDRESS TEI FAX TYPE R PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIALM CLEARLY NEW. � RENOVATION:El REPLACEMENT: PLANS SUBMITTED: YES NOED EAPPLIAN!CES Z FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ILER __ .::,. OSTW „ �" NVEON BURNER I, ra... COOK STOVE " DIRECT VENT HEATER g g— M- DRYER FIREPLACE � FRYOLATOR ...� ----- FURNACE GENERATOR � .m.. i GRILLE INFRARED HEATER I. I � LABORATORY COCKS MAKEUP AIR UNIT I OVEN POOL HEATER _ ROOM/SPACE HEATERS I ROOF TOP UNIT �^J TEST UNIT HEATER r UNVENTED ROOM HEATER WATER HEATER OTHER 3 , � 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 0 OTHER TYPE INDEMNITY _ BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 f he Massachusetts General Laws,and that my signature on this permit application waives this requirement. 3 CHECK ONE ONLY: OWNER AGENT Ej 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 ccurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be incomplia II P rtinent provisio 6f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME JEFF HUTNICKLICENSE# 15212 SI ATURE MP MGF JP 0 JGF LPGI CORPORATION #F3_53__2 ___1 PARTNERSHIP El#=LLC # COMPANY NAME: CALLAHAN AC AND HTG ADDRESS 91 BELMONT ST CITY I NORTH ANDOVER STATE MA ZIP 01845 TEL 978 689 9233 FAX CELL EMAIL PLUMBING@CALLAHANAC.COM I I i i OP ID:PS '4�Rte• CERTIFICATE OF LIABILITY INSURANCE °A 'M�`°°"'""' 1110112013 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 terns 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). PRODUCERCTACT Phone:978-686.2266 NAMONE: North Andover Insurance Agency PHONE M.J.Foster Insurance Services Fax 978-686-6410 (AIC. No): 163 Main St. E-MAIL North Andover,MA 01845 PRooucEie Stephen Sullivan CALLA-1 INSUR S AFFORDING COVERAGE NAIC 0 INSURED Callahan A C and Heating INSURER A:PEERLESS INSURANCE COMPANY Services,Inc. INSURER e:GUARD INSURANCE COMPANY Callahan Air Conditioning and Heating,Inc. INSURER C: I 91 Belmont Street INSURER D: North Andover, MA 01845 INSURER E: 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 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 INSVRANCE POLICY EFF POLICY EXP POLICY NUMBER MMM IMM LIMITS GENERAL LIABILITY EACH OCCURRENCE is 1.000,00 A X COMMERCIAL GENERAL LIABILITY CBP4016164 0912512013 09/25/2014 PREMISES a 13 occurrence) Is 100.00 CLAIMS-MADE rx-�OCCUR MED EXP(Any one person) is 5,00 CONTRACTUAL LIAB -PERSONAL BADV INJURY 13 1,000,00 GENERAL AGGREGATE s 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY X PROT F - LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 A ANY AUTO BA46UO35 09/2512013 0912512014 (Ea accident) BODILY INJURY(Per person) $ X SCHEDUALL LEDED AUTAUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE I$ X HIRED AUTOS (Per accidem) X NON-OWNED ALTOS Is Is X UMBRELLA LIAS X OCCUR EACH OCCURRENCE s 5,000,00 EXCESS LIAR CLAtMS•MAOE AGGREGATE s 5,000,00 A CU8809334 09125/2013 0912512014 DEDUCTIBLE Is RETENTION $ $ WORKERS COMPENSATION I NC STALIMTU- X OTH- AND EMPLOYERS'LIABILITYFR B ANY PROPRIETORIPARTNERIEXECUnVE Y/N CAWC471731 0912512013 0912512014 E.L.EACH ACCIDENT 3 500,00 OFFICER/MEMBER EXCLUDED? EN N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 3 500,00 If yesunder `DS640scriboDRIPTION OF OPERATIONS below ` E.L.DISEASE-POLICY LIMIT S 500,00 I 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AtUch ACORD 101,Additional Remarks Schedule,It moro 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. fax#978 688-9542 BLDG.INSPECTOR AUTHORIZED REPRESENTATIVE 1600 OSGOOD STREET NORTH ANDOVER,MA,01845 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD e M11VIVIV:WL�AUT-,H,.fOFG. . .....�7 Ci1-T+;�iao[�!•1d.ir�'!,f�k'3G, rY,C ;}�'f•.:'. G7A..7Cr .G��S' I�XI'ai� + fi n NSA qS A�1�,1g1�� EF ' 'M„�dAasN�;aPhh.0 31 r � � Al�n� FEs JNIaG -! a• ,+ � n wA3# � 3r �i"i �'!�5 •y�f�tr�,s! "I rt� s . 657 P I !M Y .! M y.°3 x"o#tl' i*S�k rh t,{+a y�, •��'� r ' ` � p.w / "tu .� { 4 OMMOIJW • • EALTHMASSA M""""' r t, } v. s oo• DD • s 5 'u .�h Y�I`�t���M.1.�4"'�I,��i��'�FB ppb�b t;y - f1� O �gN{p. � l,�l G�I�$�r 31tir by xl,Y` �9l`rts �s" {P t1a �U�L7 }NN;CO Art N. v NGS lSI �� W101-11 1a..r. :•a'/"'11 0 � y� .r.y ( •' t .�/s 41`w ��lti I - 1 Y� OMMOIW ALT�1¢ e �DF,{M CRUS 1 s ""S tr aE d.t aZm i ry IAt�,olt$�+4,�.,42Ea 1,�dt Ftbd ■ • • • • r r r 3.£�-.(s'3� �td1•_..i ,L rv. �%Q{11� 77[`�h 4,W, , t .h ie r'a-P <e r 'r , .. ❑ �,,�j� �,, . ,�• �* rah . . 4 .'r q "if rr�,nf fyJl�fUl'IL7� � � 11'� l�Ry,�IA����1�.}r•:il�Ici�� �r} � � 4'� d fah t tV y�i fi , ys evlw,G } �'!r�1d U•h rpt'I°s � h 4�tY��I»+I��N S�£1K���A S a�prr'r'►`A,�'1"'�'R�P L.UM,�y I�'k° 3 _1 7 ���*er�."r � ����" {��'�t U � j4 ,jxt.ry �nk,�ta - � �y'1•. bJ�Y U,MMA,l,^aX�Mffkl I';M€,SI NGJN+14r 1 / i A; Cdr 6 �nEE t f R'n. 7,! r / tr•i r +r! M�1"hI,U�N�ty,�nk 1MrfAs�+r4/�ri�MA}oVN1�G`#'�R,`i'�r4��Cy�'ay4��it�,ar4�`a � 5 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurapce Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone 4: A you an employer? Check the appropriate box: Type of project (required): 1. I am a employer with 4. ❑ 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' 9. ❑Building addition [No workers' comp.insurance comp.insurance.+ required.] 5. ❑ We are a corporation and its 10.7 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13. ❑ Other comp. insurance required.] *Any applicant that checks box--1 must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all wore 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 whet.`;er or not those entities ha,,,- employees. aveemployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that isproviding Workers'compensation insurance for my employees. Below is thepolicy and job site information. f Insurance Company Name: 1 l'/2_ /7 l'P Policy#or Self-ins.Lic.'I: e ` -7 /:7.3 / Expiration Date: � L,2� y Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(shotiving 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. 1 do hereby certify and r thepains andpenalties ofperjury that the info rmation rovided above is true and correct. Signature: a Date: Phone g: �7g Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License n 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 n: 256 Date... Q. ��' .. .. i NpRTry TOWN OF NORTH ANDOVER pf t�.to ,e,tip o= p` PERMIT FOR MECHANICAL INSTALLATION F P h �9SSaCMUSEt< iV This certifies that . //,C, k�,'t . . .Ale • •4• • . . . . has permission for mechanical installation . . . . .�f in the buildings of . . .7 . . . .M..10-U . :1-11 • • • • • • • • at . . . . . . . . . . ., North Andover, Mass. Fee. � 4. . Lic. No.. . . . . . . . . . . . _ . . . . . . . . . . GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Sheet Metal Permit Date: Permit# / r Estimated Job Cost: $ KS 1(066 Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO Business License# Applicant License# lq?46 Business Information: Property Owner/Job Location Information: Name: ar-i'� eo,,1�6 Name: Street: Street: City/Town: AM, /4,J,, / AM City/Town: /U�`4 An Telephone:&TS 6p7-g133 Telephone: �7 Photo I.D. required/Copy of Photo I.D. attached: YES_L,,Z NO Staff Initial J-1 /unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. zover 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work:y Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: �6'Is �k' � � ®'►i'�.cd C V�ro�l� 74 o6o 14-L) �� � � 9® � � x INSURANCE COVERAGE: I have a current liabilitv insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 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 Owner's Agent By checking this boxere by certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best oky owledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Progress Inspections Inspections Date Comments Final Inspection Date Comments Type of License: ByAaster Title ❑Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted 16)10 V License Number: V Fee$ ❑ Check at www.massaov/dpl/dpl Inspector Signature of Permit Approval ` OP ID:PS CERTIFICATE OF LIABILITY INSURANCE �`M ' 11101/2013 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.certalri 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 Phone:978.666.2266 coRTACT North Andover Insurance Agency PHONE FAX M.J.Foster Insurance Services Fax:978.686.6410 Afc No): I� 163 Main St. Me, North Andover,MA 01845 R ucER CALLA-1 Stephen Sullivan CUSTOMER 1p p, BISUR S AFFORDING COVERAGE I NAIC 0 INSURED Callahan A C and Heating INSURER A:PEERLESS INSURANCE COMPANY i Services,Inc. INSURER B:GUARD INSURANCE COMPANY Callahan Air Conditioning and Heating.Inc. INSURER c 91 Belmont Street INSURER 0: j North Andover,MA 01845 INSURER E: INSURER P: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R LTTYPE OF INSURANCE POLICY NUMBER MIDO EPF MMfD Y UNITS OENERAL LIABILITY EACN OCCURRENCE $ 11000,00 A X COMMERCIAL GENERAL LIABILITY CBP4016154 09/25/2013 09/25/2014 pR luS S 100,00 CLAMIS-MADE Fx-1 OCCUR MED EXP IMY aro porea+) E 6,00 CONTRACTUAL LIAB PERSONALSAOVINJURY s 1,000,00 GENERAL AGGREGATE S 2,000.00 GEWL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPiOP AGG S 2,000,00 POLICY X PRaT r7 LOC S AUTOMOBILE LIABILITY COMBINED BIM'INGLE LIMIT S 11000.00 A ANY AUTO BA4544035 09/25/2013 09/25/2014 BODILY INJURY(Pur Oman) S X ALL OWNED AUTOS BODILY INJURY(Pur aevduntl S SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Perms) X NON-OWNED AUTOS I S I �S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE s 51000.00 EXCESS UAB CLAIMS-MADE AGGREGATE S 5,000,00 A CU8809334 09125/2013 09/2512014 DEDUCTIBLE S RETENTION 9 $ WORKERS COMPENSATIONJIM?TATU• X DTH. AND EMPLOYERS'LIABILITY B ANY PROPRIETO"ARTNERMXECUTIVE YIN CAWC411731 0912512013 09/2512014 E.1.EACH ACCIDENT S 600.00 OFFICERIMEMBEREXCLUDED? 7N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 500,00 Ifes,Edaoribo tulle► DESCRIPTION OF OPERATIONS below I E.L.DISEASE.POLICY LIMiT I S 600100 DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES(Attach ACORD 101,Addltlonal Remarks Schodulo,It rosro spaco Po roqulrud) 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. fax#978 688.9542 BLDG.INSPECTOR AUTHORIZED REPRESENTATIVE 1600 OSGOOD STREET ORTH ANDOVER, A 01846 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD IDA'ismi ,; a ml I ..1 - aSt3�lll ; st- Cfljj M--'NWEALT`-OF MASSACHUSETTS -SHEET MEAL WOi:KERS AS'A MASTE 1-UNREo1"RICTED ISSUES THE ABOVE LICENSE TO: $ I -KEVIN :J MCDON4L.0 .91- BELMONT ST NORTH ANDOVER 0A Q1845..-2304 Ilk, { 12404 05/28,"14 164511 F_ 1 i Page 1 Residential Heat Loss and Heat Gain Calculation 7/10/2014 In accordance with ACCA Manual J Report Prepared By: Callahan A/C & Heating For: Keen Construction (1st Floor) 452 Mass Ave North Andover, MAO 1845 Design Conditions: Lawrence Indoor: Outdoor: Summer temperature: 70 Summer temperature: 87 Winter temperature: 70 Winter temperature: 0 Relative humidity: 50 Summer grains of moisture: 95 Daily temperature range:Medium Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Infiltration 2,746 3,994 6,740 13,241 Ceilings 5,976 0 5,976 10,817 Windows 10,264 0 10,264 10,404 Floors 1,138 0 1,138 6,392 Duct 0 0 0 5,102 Walls 1,284 0 1,284 4,366 Fireplaces 0 0 0 3,606 Glassdoors 1,546 0 1,546 1,790 Doors 119 0 119 403 Skylights 0 0 0 0 Misc 1,200 0 1,200 0 People 1,500 1,150 2,650 0 Whole House 25,773 5,144 30,917 56,121 2.5 tons HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads may vary due to weather and construction differences. Page 1 Residential Heat Loss and Heat Gain Calculation 7/10/2014 In accordance with ACCA Manual J Report Prepared By: Callahan A/C & Heating For: Keen Construction (2nd Floor) 452 Mass Ave North Andover, MA 01845 Design Conditions: Lawrence Indoor: Outdoor: i Summer temperature: 70 Summer temperature: 87 Winter temperature: 70 Winter temperature: 0 Relative humidity: 50 Summer grains of moisture: 95 Daily temperature range:Medium Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Infiltration 3,082 4,483 7,565 15,184 Windows 13,606 0 13,606 12,985 Walls 2,599 0 2,599 8,834 Ceilings 4,157 0 4,157 7,098 Duct 0 0 0 4,410 Skylights 0 0 0 0 Glassdoors 0 0 0 0 Doors 0 0 0 0 Misc 1,200 0 1,200 0 Fireplaces 0 0 0 0 People 1,500 1,150 2,650 0 Floors 0 0 0 0 Whole House 26,144 5,633 31,777 48,511 (2.5 tons ) HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads may vary due to weather and construction differences. ' a Callahan PROPOSAL A/C&HEATING SERVICES PROPOSAL#: 107961 91 Belmont Street North Andover,MA 01845 DATE: 1/23/201.4 www.callahanac.com REP: KJM 978-689-9233 TO: JOB LOCATION: KEEN CONSTRUCTION COMPANY GP 452 MASS AVE 21 HEWITT AVE. NORTH ANDOVER,MA NORTH ANDOVER,MA 01845 DESCRIPTION Total INSTALLATION OF NEW FORCED HOT AIR HEATING SYSTEM CONSISTING OF THE FOLLOWING:(FIRST FLOOR) A_GOODMAN MODEL#GMH95703B GAS FIRED 95%HOT AIR FURNACE 70,000 BTU B_GOODMAN MODEL#CAPF3030B COIL C_GOODMAN MODEL#GSX13301 CONDENSER D_ALL NECESSARY REFRIGERATION PIPING E_INSULATED DUCTWORK WITH FLEXIBLE BRANCH LINES TO REGISTERS FALL NECESSARY ELECTRICAL G_NEW GAS PIPING FROM THE METER TO THE FURNACE H_PVC FLUE AND COMBUSTION AIR PIPING THROUGH SILL PLATE TO OUTSIDE I_CONDENSATE PUMP AND PIPING J_CENTRAL RETURN REGISTERS FOR FIRST FLOOR K_APRIL AIR HEATING AND COOLING MODEL# 8463 DIGITAL THERMOSTAT L_SUPPLY REGISTER FOR EACH ROOM M ALL NECESSARY PERMITS AND INSPECTIONS PAYMENT TERMS UPON COMPLETION Total All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All covered by Workman's Compensation Insurance's. Equipment warranty by manufacturer. Contractors labor warranty for one year. AUTHORIZED SIGNATURE: DATE: CUSTOMER ACCEPTANCE: DATE: **A signed copy of this proposal and deposit must be received for us to schedule this installation. (This proposal may be withdrawn by us if not accepted within 30 days.) — Authorized rilaiMI Partner in Comfort =Pagel `<1 Callahan PROPOSAL A/C&HEATING SERVICES PROPOSAL#: 107961 91 Belmont Street North Andover,MA 01845 DATE: 1/23/2014 www.callahanac.com REP: xJM 978-689-9233 TO: JOB LOCATION: KEEN CONSTRUCTION COMPANY GP 452 MASS AVE 21 HEWITT AVE. NORTH,ANDOVER,MA NORTH ANDOVER,MA 01845 DESCRIPTION Total INSTALLATION OF NEW FORCED HOT AIR SYSTEM CONSISTING OF THE FOLLOWING:(SECOND FLOOR) A_GOODMAN MODEL#GMS80803$3B GAS FIRED STANDARD EFFICIENCY HOT AIR FURNACE 80,000 BTU B_GOODMAN MODEL#CUPF3030B COIL C_GOODMAN MODEL#GSX13301 CONDENSER D_ALL NECESSARY REFRIGERATION PIPING E_INSULATED DUCTWORK WITH FLEXIBLE BRANCH LINES TO REGISTERS FALL NECESSARY ELECTRICAL G_NEW GAS PIPING FROM THE METER TO THE FURNACE H_APRIL AIR DIGITAL HEAT/COOL MODEL# 8463 THERMOSTAT I_SUPPLY REGISTER FOR EACH ROOM J_CENTRAL RETURN REGISTER K_B-VENT FLUE THROUGH ROOF L_REQUIRED SHEETMETAL PERMIT AND INSPECTION M ALL NECESSARY PERMITS AND INSPECTIONS PAYMENT SCHEDULE: _DEPOSIT UPON ACCEPTANCE OF ESTIMATE 8,600.00 _UPON 1/2 COMPLETION OF THE ROUGH 8,500.00 _BALANCE DUE UPON COMPLETION (WHEN UNITS ARE STARTED UP) 8,500.00 PAYMENT TERMS UPON COMPLETION TTotal $25,600.00 All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All covered by Workman's Compensation Insurance's. Equipment warranty by manufacturer. Contractors labor warranty for one year. AUTHORIZED SIGNATURE: DATE: CUSTOMER ACCEPTANCE: DATE: **A signed copy of this proposal and deposit must be received for us to schedule this installation. (This proposal may be withdrawn by us if not accepted within 30 days.) ��- Authorized Pliaire' Partner in Comfort Page 2 0258rev Date........ NORrM 41 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS, us M Owe IE7u-0 Thiscertifies that ......................................................................................... has permission to perform ..... � .................... wiring in the building of............... ......................... Andover,Mass. at...... ...kl�14-55...AiF ........................./INorth An d 'V— lic.No...91nS Fee.,5..5.......9.......... ........ ............. Check # Commonwealth of Massachusetts Official Use only U19Department of Fire Services Permit No.Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank 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: 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) V y S Z, VA Owner or Tenant iV/C CIS �y Ff 1 ` �j elephone No. Owner's 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 ❑ 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: 1f C S Pry Completion of the ollowing table may be waived by the Inspector o 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 Above In- o.o mergency LigRing No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection e No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent 1 No.of Water KW 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: 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: 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 f rce,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the sins and penalties opf VerJur lzat the(Iformation on this application is true and complete FIRM NAME: LIC.NO.: Licensee: numdS,04 Signatur v LIC.NO.: (If applicable, enter "exempt"in the license number line. Bus.Tel.No. � ' Address: 0 s Alt.Tel.No.: *Per M.G.L c. 14-T,s. 57-61,security 1kork 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 Owner/Agent PERMIT FEE: $ Signature Telephone No. �� ._� x l si _C_%x The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): U M►A ��m M.I C Address: 22 vvt l I wkl ural R 4S+°I'I'�0o'w!N N , l-4 03 k 7 S City/State/Zip: la ' Phone #: k 0 7 - / ) Ao u an employer?Check the appropriate box: Type of project(required): :]. am a employer with 0 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.E] I am a sole proprietor or partner- listed on the attached sheet. $ E] Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their ❑ 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]i employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ' Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as 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 ify under the pains ah pen�flesofpe�u. that the information provided above is true and correct. r Si nature: i Date: Phone#: (0 L4 "1 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#: