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Building Permit # 3/13/2014
TOWN OF NORTHA VE APPLICATION FOR PLAN EXAMINATION Permit N4: _ P � °°° [late Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION ray Street Print: PROPERTY OWNER AgwN064 „. Print 900 Year Old SttUcture yes ` no MAP NO; PARCEL: l'- ZONING DISC ICT:, Historic b(nct yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building Rl One family 0 Addition ❑Two or more family C:.1 Industrial ❑Alteration No. of units: ❑ Commercial 0 Repair, replacement ❑Assessory Bldg ❑ Others: 0 Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands ❑ Watershed District 11 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: lnstallation of a 10.15 kw(43 panels)rooftop solar array Identification Please Type or Print Clearly) OWNER: Name: Arny Provost. Phone: 617.803 7903 Address: 240 Gray Street CONTRACTOR Name: Domain tr cker Phone: 781-462,-8702 Address: 10 Churchill place,Imin>IVIA.0190 Supervisor's Construction License: 09,6385 Exp. Date: 10/8/2016 Home Improvement License: 169698 Exp. Date: 7/27/2015 ARCHITECT/ENGINEER James n..C;lKancq Phone: Address: _601 Asbury Aygne,National Park,gat 08063 Reg. No. FEE SCHEDULE:B(ILDING PERMIT:$12ASQED ON$125.00 PER S.F.0 PER$1000.00 OF THE TOTAL ESTIMATED COST W M Total Project Cost: $ 37,625 FEE: $ Check No.: „ i, .'. �' Receipt No.: , �` NOTE: Persons contracting ivft/r unregistered contractors do trot have access to the uarantvfmid Signature ofAgent/Owner� Signature of contractor P[Rnq qi ihmittp.rl 71 Planc 1A/ii ipr! Fi C Prtifiprl Plnf Plan n gf::imn arl Pkinc P1ry CU. � 0111 . IAORTH Town , of E :. ��� ndover 0 . .:�r "A No. lq,- T I * oCOIC K T ver Mass, CNMWCh RAreo okp���5 U BOARD OF HEALTH Food/Kitchen P RM IT LD Septic System THIS CERTIFIES THAT4 BUILDING INSPECTOR .......... A.. . .... .. .................. .... .............. ........... ............... has permission to erect .......................... buildings on .�. ................ .....�....... ............... Foundation Rough tobe occupied as .. .......... .. .. ... .. ........ ..:...... !... ... ........................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough Service ....................... ............................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. JAMES A. CLANCY PROFESSIONAL ENGINEER 601 ASBURY AVENUE NATIONAL PARI, NJ 08063 (856) 358-1125 FAX: (856) 358-1511 Date: February 19,2015 Re: Structural Roof Certification Subj: Amy Z Provost Residence,240 Gray St.,North Andover MA 01845 We have provided a review of the house roof construction of the above named property in regards to verifying the capacity of the existing roof for installation of a new Solar Panel Array. We have found the residence roof to be of wood frame construction bearing walls with Roof 1 of 2x10 @ 16"rafter framed roof with 2x6 collar ties @ 16" o.c. and is sheathed with 5/8" ext-ply decking and a single layer of composite shingle roofing. The wood framed roof structure bears directly upon the framed exterior wall system. The existing members as installed meet the required (MA 780 CMR) IRC-2009 table 802 design span ratings with sufficient capacity to carry the 2.89#/sf additional load imposed by the proposed solar array per the details below. Installation of solar rack systems shall be as follows: Each panel row shall be supported upon 2 mounting rails. Rails shall be screw anchored through roof and directly to rafters or purlins below. Rail attachment points to rafters shall be staggered each row with exception to the first fastener row from the gable end which is attached to two adjacent rafters/trusses with Stainless Steel fasteners. Rail attachment to roof shall be fastened 16-24"o.c. at corners and 48" o.c. through the field. Rails are to be placed at 24-48"o.c. on the roof. When installed per the above specifications the system shall meet the required 100 MPH wind load and 50 PSF ground snow load requirements. Should you have any further question or comment please feel free to contact our office. Respectfully, ACES A. CLRNCV v o.467775 y James A. Clancy oo FgIsT Professional Engineer ONA �Q MA License#46775 DocuSign Envelope ID:697E32CA-A204-41EA-8CB9-BC8396DE5DFB 111/af, u VITY' Homeowner's Agent Authorization Form State of Massachusetts Amy Z Provost (print name) am the owner of the property located at address: 240 Gray St North Andover MA 01845 (print address) hereby authorize Sungevity or its subcontractor 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. Oocuftned by: Customer Signature: rgw '� Praµai 9E1848938EB348E... Date: 2/22/2015 Print Name: Amy Z Provost Sungevity MA Home Improvement Contractors License # 168430 66 Franklin StreTt,Suite,310 ;.: 510A96.5500 866.SUNAALL Oakland,CA 946017 USA 1 510,496.5501 ;, , 1 2 3 4 5 SHEET INDEX PHOTOVOLTAICSYSTEM ' \ PV0.0 COVER AND SITE PLAN PV1.0 GENERAL NOTES- SYSTEM SIZE: GRAY ST ` \ PV2.0 ARRAY LAYOUT AC/DC kW STC: 9.327kW\10.75kW ♦ PV3.0 LINE DIAGRAM PV4.0 LABELS EQUIPMENT: A °` PV MODULES: (43)Hyundai HIS-M25ORG(BK) (1)SolarEdge SE380OA-US KEY: INVERTER(S): �` ---- PROPERTY UNE HSUSPANEL (1)SolarEdge SE6000A-US DEDICATED PV LOAD CENTER V� --- CONDUIT RUN V DC DISCONNECT ♦ay ` DRIVEWAY ®AC DISCONNECT SCOPE OF WORK: ---- FENCE ♦�J O� SOLAR MODULE ®®JUNCTION BOX 24-7 ACCESSIBLE 0 Vi Q MAIN SERVICE PANEL 0MONITORINGUNIT INSTALLATION OF A SAFE AND CODE-COMPLIANT yJ GRID-TIED SOLAR PV SYSTEM ON AN EXISTING AC DISCONNECT Pc m COMBINER BOX Q UTILITY METER RESIDENTIAL ROOFTOP. ' ® PV METER 0 ROOF OBSTRUCTION �1i ❑ INVERTER MAIN SERVICE PANEL AND APPLICABLE CODES: FUSED AC DISCONNECT LOCATED IN THE GARAGE yc 2014 NEC `� 2009 INTERNATIONAL CODES WITH MA AMENDMENTS ATTIC-MOUNTED CONDUIT RUNS DOWN AND ACROSS e9 CONTRACTOR INFORMATION: WALL TO INVERTERS BOSTON SOLAR WOBURN 55 SIXTH RD B ! z WOBURN,MA 01801 O B JURISDICTIONAL INFORMATION: NORTH ANDOVER,TOWN OF 1600 OSGOOD ST NORTH ANDOVER,MA 01845 ♦ \ P NOTES TO INSTALLER: DC CONDUIT RUN:FROM ARRAY,ATTIC-MOUNTED CONDUIT RUNS DOWN AND ACROSS WALL TO INVERTERS. ♦\ AC CONDUIT RUN:FROM SOS TO MSP THROUGH GARAGE WALL CONFIRM CONDUIT RUN WITH HOMEOWNER PRIOR TO INSTALL, O ADJUSTAS NECESSARY. POC:INSTALL A SUPPLY SIDE CONNECTION ON SERVICE ENTRANCE FEEDERS COMING FROM THE UTILITY METER IN MSP.LAND PV BREAKERS IN A DEDICATED PV LOAD CENTER ♦ TO BE LOCATED NEXT TO THE INVERTERS. THE INVERTER MUST BE INSTALLED OUTSIDE IN AN `\ ACCESSIBLE LOCATION IN COMPLIANCE WITH THE 2014 NEC 690.12 EMERGENCY SHUTDOWN REQUIREMENT. ♦ FOR INSTALLER USE ONLY \ POST INSTALL SUNEYES REQUIRED? NO `♦ I CERTIFYTHAT NO CHANGES HAVE O (E) POOL C \ BEEN MADE TO THE ARRAY LAYOUT: ♦ CUSTOMER INFORMATION: ♦ AMY Z PROVOST 240 GRAY ST ♦♦ NORTH ANDOVER,MA 01845 (61 7)803-7903/#223037 \♦ SITE PLAN N NOTE:BALANCE OF SYSTEM(BOS)EQUIPMENT ♦ SCALE: N.T.S. SHOWN FOR REFERENCE TO LOCATION ONLY- \ NOT TO SCALE DESIGNED BY: REV#: DATE: PV-®.O ♦♦ LVS 0 02/17/15 tUNOEVRI'MC.66fMNNLIN STSUITE J100PIfLWD.G9d60] By LVUn Dala03/t]/15 tem9an C'18oK Sync'hMeiMyOaumaMSLLwDesl�VCuelomxQPmrixi- THESEORAWN .SP Rd ONS,MID�IOMFRETHEPROP VOFSUNOWWING NO P 3-BECORED OR USMFOR OR N1Ti HW OTH =RKOTHER THSNTHE SKCRC PROJE4T FOR NhBCHTHEY W.VEBEEND LOPEDW OVTOUR WRrt CONSEW 1 1 2 1 3 4 5 GENERAL NOTES. ELECTRICAL NOTES: GENERAL NOTES: El.ALL EQUIPMENT IS LISTED FOR USE. N1.DRAWINGS ARE DIAGRAMMATIC ONLY.THE LOCATION AND ROUTING OF E2.MAXIMUM VOLTAGE DOES NOT EXCEED 600VDC. RACEWAYS SHALL BE DETERMINED BY THE CONTRACTOR UNLESS OTHERWISE E3.ANY EQUIPMENT OR ELECTRICAL MATERIALS USED FOR THIS INSTALLATION SHALL BE NOTED OR STANDARDIZED. NEW AND LISTED BY A RECOGNIZED ELECTRICAL TESTING LABORATORY. N2.ALL EQUATIONS ACCOUNT FOR WORST CASE CONDITIONS. E4.AN INVERTER IN AN INTERACTIVE SOLAR PV SYSTEM SHALL AUTOMATICALLY A N3.IF A DISCREPANCY IN QUANTITY OR SIZE OF CONDUIT,WIRE,EQUIPMENT DE-ENERGIZE ITS OUTPUTTO THE CONNECTED ELECTRICAL PRODUCTION AND A DEVICES,OVERCURRENT PROTECTION,GROUNDING SYSTEMS,ETC.(ALL DISTRIBUTION NETWORK UPON LOSS OF VOLTAGE IN THAT SYSTEM AND SHALL REMAIN EQUIPMENT AND MATERIALS)THE CONTRACTOR SHALL BE RESPONSIBLE FOR IN THAT STATE UNTILTHE ELECTRICAL PRODUCTION AND DISTRIBUTION NETWORK PROVIDING AND INSTALLING ALL MATERIALS AND SERVICES REQUIRED BYTHE VOLTAGE HAS BEEN RESTORED. STRICTEST CONDITIONS IN THE SPECIFICATIONS OR NOTED ON THE PLANS TO E5.ALL PV ARRAYS SHALL BE EQUIPPED WITH DC GROUND FAULT PROTECTION. ENSURE COMPLETE COMPLIANCE WITH ALL CODES AND TO ENSURE THE E6.ANY AC COMPONENT SHALL MEET OR EXCEED THE AVAILABLE FAULT CURRENT LONGEVITY AND SAFETY OF THE OPERABLE SYSTEM. CALCULATED AT THAT COMPONENT. N4.ALL OUTDOOR EQUIPMENT SHALL BE MIN.NEMA 3R RATED. E7.ALL MODULES AND ANY RELATED ROOF MOUNTED METALLIC EQUIPMENT SHALL BE N5.METAL CONDUIT AND ENCLOSURES SHALL BE USED WHERE PV SOURCE OR PROPERLY GROUNDED. OUTPUT CIRCUITS ARE RUN INSIDE A BUILDING. E8.DC EQUIPMENT SHALL BE 60OVDC RATED MINIMUM. N6.MODULES SHALL NOT BE PLACED OVER ANY PLUMBING VENTS AND AT LEAST E9.MARKINGS SHALL BE PROVIDED TO INDICATE THAT ALL CONTACTS OF THE 6"ABOVE FLUSH VENTS. DISCONNECT EQUIPMENT MIGHT BE ENERGIZED. N7.THE ELECTRICAL CONTRACTOR SHALL COMPLY WITH ANY AND ALL E10.CONDUIT RUNS SHALL BE PROVIDED WITH SUFFICIENT WEATHERPROOF PULL BOXES REQUIREMENTS GIVEN BY UTILITY COMPANIES. OR JUNCTION BOXES/COMBINER BOXES PER APPROPRIATE JURISDICTIONAL N8.FOR ADDITIONAL EQUIPMENT SPECIFICATIONS,SEE PROVIDED CUT SHEETS. REQUIREMENTS. N9.ALL LABELS AND MARKINGS SHALL BE ATTACHED ACCORDING TO Ell.FOR ANY UNGROUNDED PV SYSTEM,A LABEL READING: B REQUIREMENTS BY NEC AND THE LOCAL AHJ.THE AHJ MAY HAVE SPECIAL LABEL B REQUIREMENTS BEYOND THE SCOPE OF THIS DOCUMENT.THIS MAY ENCOMPASS "WARNING-ELECTRICAL SHOCK HAZARD.THE DC CONDUCTORS OF THIS PHOTOVOLTAIC LANGUAGE INCLUDING,BUT NOT LIMITED TO,THAT FOUND IN NEC ARTICLES SYSTEM ARE UNGROUNDED AND MAY BE ENERGIZED." 690.5(C),690.14(C)(2),690.17,690.53,690.35(F), 690.54,690.64(B)(7)and SHALL BE PLACED AT EACH JUNCTION BOX,COMBINER BOX,DISCONNECT AND DEVICE 705.10 WHERE ENERGIZED,UNGROUNDED CIRCUITS MAY BE EXPOSED DURING SERVICE. N10.INSTALLER TO FOLLOW ALL LOCAL JURISDICTION GUIDELINES. E12.INVERTER(S)SHALL CONTAIN A GROUND FAULT DETECTION AND INTERRUPTION NST.ALL NEC REFERENCES SHALL BE DIRECTLY INTERCHANGEABLE WITH CEC DEVICE. REFERENCES. E13.ALL METALLIC RACEWAYS AND EQUIPMENT SHALL BE BONDED AND ELECTRICALLY CONTINUOUS. STRUCTURAL NOTES: E34.THE POINT OF CONNECTION COMPLIES WITH APPLICABLE CEC/NEC. Sl.MOUNTS ARE DIAGRAMMATIC AND EXACT LOCATION MAY CHANGE,BUT ESS.BACKFED SOLAR BREAKER(S)SHALL BE INSTALLED AT THE OPPOSITE END OF THE SHALL BE ACCURATELY SPACED. CIRCUIT OR FURTHEST AWAY FROM THE MAIN BREAKER. S2.MOUNTS SHALL BE STAGGERED WHEN NECESSARY TO EVENLY DISTRIBUTE E16.ALL WIRE,VOLTAGES,AMPERAGES AND EQUIPMENT IS SIZED ACCORDING TO LOAD AMONGST RAFTERS. TEMPERATURE DERATING AND LOCATION. S3.DO NOT SPLICE RAILS IN MIDDLE 50%OF SPAN BETWEEN TWO MOUNTS. E17.ONLY COPPER(CU)CONDUCTORS SHALL BE USED.CONDUCTORS SHALL BE STRANDED OR SOLID WITH PROPERLY RATED CONNECTORS. C C E18.DISCONNECT SHALL BE WIRED SO NO BLADES ARE ENERGIZED E19.ALL MODULES AND RACKING SHALL BE GROUNDED VIA IRON RIDGE RAIL INTEGRATED CUSTOMER INFORMATION: GROUNDING(PLEASE SEE DATA SHEET)OR WITH TIN PLATED DIRECT BURIAL RATED LAY IN AMY Z PROVOST LUGS USING STAINLESS STEEL HARDWARE,STAR WASHERS,AND THREAD FORMING BOLTS 240 GRAY ST OR WEEBS. NORTH ANDOVER,MA 01845 E20.ALL EQUIPMENT SHALL BE GROUNDED,INCLUDING BONDING JUMPERS WHERE (617)803-7903/#223037 NECESSARY ACROSS RAIL SPLICE PLATES TO BOND INDIVIDUAL PIECES OF RAIL. DESIGNED BY:I REV#: DATE: PV-1.0 LVS 1 0 02/17/15 SUNOGVRY INC.0 FRANKLIN ST SUITE 310 WAND.CA-07 BYLSI.D1.-1TI15 THESE ORAVAN00SPECIFICATIONS,AND OESIGHBARE THE PROPERTY OF SUNOENTY INC.NO PART SHML BE COPIED ORUSED FOR OR WITH ANY OTHERWORKOTHER TIWV THE SPECIFIC PROJECT FOR WMCH THEY NAVE BEEN DEVELOPEDWITHOUT OUR WRITTEN CONSENT 2 3 4 5 MODULE SPECIFICATIONS 2'-2" 1-4- (43)Hyundai HISM250RG(BK) 37'-11 MODULE WEIGHT: 37.9 4'O.C.MAX MODULE LENGTH: 64.57 RO OF MODULEWIDTH: 39.29 ROOF I SPECS RAFTER SIZE: 2X10 NOMINAL _41NA RAFTER VAN, ; 4 RAFTER SPACING: 16!' ROOF MATERIAL COMPOSITE SHINGLE ARRAY 1 SPECS NUMBER OF MODULES: 43 L-,�_ F TOTAL MOD.WEIGHT Obs): 1629.7 A RACKING WEIGHT(lb.)! 368.2 '.7z_ ARRAY WEIGHT(Ibs): 1997.9 ARRAY AREA(sqft): A L 757.6 __ NU BER OF MOUNTS: 101 19.84 LR� I ): �Aol�AZ'MIRAY ft13 MR.' y ARRAY TILT(-) 3 0: NUMBER IRFR OF FLOORS 2 SYMBOL KEY: MOUNT RAIL RAFTERS ROOF _17 SETBACK SOLAR MODULE (D STRING CONFIG. 11 3'-4" KEEP ARRAY MIN.12"FROM SKYLIGHT EAVE AND EDGES OF ROOF �ARMY LAYOUT FOR SNOW SHEDDING CHIMNEY PLUMBING OR B �SCALE'�3116"�1'-T ATTIC VENT B 0 ATTIC VENT OF JAMES AtiG - o CLANCY SOLAR MODULE James A.Clancy,PE IRONRIDGEXR10u— 601 Asbury Avenue L-FOOT National Park,NJ 08063 C C QMSE-LAG SHINGLE-� COMPOSITE SHINGLE— CUSTOMER INFORMATION: S"X 5/16"-LAGAMY Z PROVOST 3"MIN.EMBEDMENT 240 GRAY ST NORTH ANDOVER,MA 01845 2X10 NOMINAL,160.C. (617)803-7903!#223037 WOUNTING DETAIL SCALE : NTS DESIGNED BY:lREV,#j DATE: PV-2.0 7 Lvs 1 0 102/171111 W-0—WNSTSUTE31-0-07 BY VIM-11— TH SEDRANA ,VMRIONSMDWSIQNSFR EPROPE OFSUNOWWINC.NOPMTSH LMMMEDORUSEDFORORMTH OTNE RKOTNERTHM ESPEOMCPROJECTFORWI9MTHET EBEENDE4FJ.OPEOKIT=OURWRnT MNKW 1 ELECTRICAL KEY: 2 MODULE ELECTRICAL SPECIFICATIONS3 4 INVERTER 1 SPECIFICATIONS INVERTER2 SPECIFICATIONS 5 (43)Hyundai HIS-M250RG(BK) SOLAREDGE SE380OA-US SOLAREDGE SE6000A-US fti BREAKER SHORT CIRCUIT CURRENT(ISC): 8.7 RATED WATTS(EACH): 3800 RATED WATTS(EACH): 6000 �— SWITCH OPEN CIRCUIT VOLTAGE(Voc): 37.4 AC OPERATING VOLTAGE(V): 240 AC OPERATING VOLTAGE(V): 240 El SCREW TERMINAL OPERATING CURRENT(IMP): 8.1 AC OPERATING CURRENT(A): 16 AC OPERATING CURRENT(A): 25 m FUSE OPERATING VOLTAGE(VMP): 30.9 NUMBER OF MPPT CHANNELS 0 NUMBER OF MPPT CHANNELS 0 • SPLICE MAX SERIES FUSE RATING: 15 INVERTER EFFICIENCY: 0.98 INVERTER EFFICIENCY: 0.975 'g EARTH GROUND STC RATING: 250 INTEGRATED DC DISCONNECT INTEGRATED DC DISCONNECT m CHASSIS GROUND IPTC RATING: 222 NVERTER I INPUTSPECIFICATIONS INVERTER 2 INPUT SPECIFICATIONS ———GEC DESIGN CONDITIONS NOMINAL CURRENT PER STRING(Inom): 129 NOMINAL CURRENT PER STRING(Inom): 8.6,9.3 EGC HIGHEST 2A DB DESIGN TEMP(°C): 32 NOMINAL VOLTAGE(Vnom): 350 NOMINAL VOLTAGE(Vnom): 350 MIN.MEAN EXTREME ANNUAL De(°C): -18 MAX SYSTEM VOLTAGE(Vmax): see MAX SYSTEM VOLTAGE(Vmax): 500 A MAX CURRENT PER STRING(Imax): 15 MAX CURRENT PER STRING(Imax): 15 A MAX INPUT CIRCUIT CURRENT IImax): 15 MAX INPUT CIRCUIT CURRENT(Imax): 30 (3)#6 THWN-2 (3)#6 THWN-2 (3)#6 THWN-2 (3)#6 THWN-2 (6)#10 PV-Wire (6)#10 THWN-2 (3)#10 THWN-2 (1)#10 EGC (1)#10 EGC (1)#10 EGC (1)#10 EGC (1)#10 EGC (1)#10 EGC (1)#10 EGC (1)#8 GEC (1)#8 GEC (1)#8 GEC (1)#8 GEC FREE AIR 3/4"EMT (1)#8 GEC 3/4"EMT 3/4"EMT 3/4"EMT 3/4"EMT 3/4"EMT (N)MIN.60A AC Combiner METER SUB PANEL SUPPLY SIDE CONNECTION (N)SE380OA-US (N)AC Disconnect, IN)AC Disconnect, WITH POLARIS BLOCK OR INVERTER W/INTEGRATED SIMILAR UL LISTED AND DC DISCONNECTS 60Amp,Non-Fusible, 60Amp,Fusible,C-H APPROVED CONNECTOR —_ C-H DG222UR6 DG222NRB 1 STRING OF + MPPT11 -AC 20A 2P LOCUS METER 60A FUSE PV 200A MAIN BREAKER 18 MODULES OPT.CURRENT=12.86A DC OUTPUT LOAD LINE LOAD LINE INVERTER 1 (E)LOADS (E)200A Siemens MSP 7�'TLIUTY AC DISCONNECT TO BE INSTALLED WITHIN (E)LOADS 24DV 2P 3-W 141 WITHIN 10,OF SUPPLY SIDE CONNECTION TE-120 MONITOR CELLULAR L-------- (3)#8 THWN-2 METER/B-LINE 011 METER SOCKET (1)#10 EGC NEMA3R,240V,100A _ B (1)#8 GEC B 3/4"EMT T`1f (N)SE6000A-US GEC IRREVERSIBLY SPLICED TO J INVERTER W/INTEGRATED EXISTING GEC OR BONDED DIRECTLY DC DISCONNECTS TO EXISTING GROUNDING ELECTRODE 1 STRING OF + MPPT 1 35A 2P 12 MODULES -AC OPT.CURRENT=8.57A OC OUTPUT ----- + JBOX MPPT2 1 STRING OF 13 MODULES �` OPT.CURRENT=9.29A INVERTER 2 (N)MIN.NEMA3R UL LISTED JUNCTION BOX WITH 90°C TERMINAL RATINGS LOCATED ON ROOF (1)SOLADECK J-BOX C C Inom=(13 x 250W)/350V=9.3A CONDITIONS OF USE=15A/0.76/0.8=24.67A 43 MODULES TOTAL OPERATING VOLTAGE=35OVDC(REGULATED) BASIC AMPACITY CALC=18.75 43 x 222(PTC WATTS)x 0.975=9307 CEC WATTS CUSTOMER INFORMATION: CONDUCTOR SIZE FOR 24.67ADC=#10 AWG AMY Z PROVOST 200 x 1.2=240 INSTALLATION SHALL USE MIN.#10 AWG SE380OA-US MAX OUTPUT CURRENT=16A 240-200(MCS)=40A MAX DESIGN CURRENT=16A x 1.25=20A 240 GRAY ST MAX ALLOWABLE AC PV BREAKER=40A SE6000A-US MAX OUTPUT CURRENT=25A NORTH ANDOVER,MA 01845 CONDUIT ELEVATION:1/2 TO 3-1/2"=22°C MAX DESIGN CURRENT=25A x 1.25=35A (617)803-7903/#223037 HIGH AMBIENT TEMPERATURE:32°C EXTREME LOW:-18'C ROOFTOP AMBIENT TEMP:54°C=0.76 DESIGNED BY:1 1 REV#: DATE: CONDUIT FILL:0.8PV-3.0 LVS 1 0 02/17/15 3ONONRY01C.00 FRAN—ST SUM 3100ANlAND CA U607 D-03.SPEdFlCRTONS,AND DESIONS ARE THE PROPERTY OF SUN—TY INC NO PMT SHALL BE COPIED OR USED FOR OR W1iH PNY OTHERWOF—ER THANTHE SPECIFIC PROJECT FOR WNICH T--BEEN DEV ELOPED—OLT OURMMEN CONSENT 1 2 3 4 5 NEC 690.5(c) NEC 690.31(E)3&4;2012 IFC 605.11.1 INTERACTIVE PHOTOVOLTAIC POWER SOURCE PLACE THIS LABEL ON INVERTER(S)OR NEAR PLACE ON ALL JUNCTION BOXES,EXPOSED RATED AC OUTPUT CURRENT(A): 41 GROUND-FAULT INDICATOR(ON INVERTER(S)U.O.N.) RACEWAYS EVERY 19 AND V FROM BENDS AND PENETRATIONS,ADJACENT TO THE NOMINAL OPERATING AC VOLTAGE(V): 240 MAIN SERVICE DISCONNECT INVERTER 1 DC DISCONNECT PHOTOVOLTAIC SYSTEM DISCONNECT RATED MAX POWER POINT CURRENT(Imp): 25.8 A ELECTRIC SHOCK HAZARD0 -------- -- RATED MAX POWER POINT VOLTAGE(Vmp): 350 A IFA GROUND FAULT IS INDICATED, PHOTOVOLTAIC POWER NORMALLY GROUNDED CONDUCTORS MAX SYSTEM VOLTAGE(Yoc): 500 MAY BE UNGROUNDED AND ENERGIZED - SOURCE SHORT CIRCUIT CURRENT(Isc): 10.9 NEC 690.17(E) NEC 690.35(F) PLACE THIS LABEL ON ALL DISCONNECTING PLACE THIS LABEL AT EACH JUNCTION BOX,COMBINER BOX, INVERTER 2 DC DISCONNECT MEANS WHERE ENERGIZED IN AN OPEN POSITION DISCONNECT AND DEVICE WHERE ENERGIZED,UNGROUNDED PHOTOVOLTAIC SYSTEM DISCONNECT CIRCUITS MAY BE EXPOSED DURING SERVICE: RATED MAX POWER POINT CURRENT(Imp): 35.8 RATED MAX POWER POINT VOLTAGE(Vmp): 350 MAX SYSTEM VOLTAGE(Voc): 500 ELECTRIC SHOCK HAZARD SHORT CIRCUIT CURRENT(Isc): 10.9 DO NOT TOUCH TERMINALS ELECTRIC SHOCK HAZARD TERMINALS ON BOTH THE LINE AND LOAD THE DC CONDUCTORS OF THIS SIDE MAY BE ENERGIZED IN THE OPEN PHOTOVOLTAIC SYSTEM ARE UNGROUNDED POSITION AND MAY BE ENERGIZED NEC 705.12(D)(2)(b) NEC 705.12(D)(2)(c) PLACE THIS LABEL AT P.O.C.TO SERVICE PLACE LABEL ON ALL EQUIPMENT CONTAINING B DISTRIBUTION EQUIPMENT(I.E.MAIN PANEL(AND OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER B SUBPANEL IF APPLICABLE)) TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE SOURCES. INVERTER OUTPUT CONNECTION DO NOT RELOCATE THIS OVERCURRENT DEVICE �A-Now THIS EQUIPMENT FED BY MULTIPLE POWER NEC 705.12(D)(3) SOURCES.TOTAL RATING OF ALL OVERCURRENT PLACE LABEL ON ALL EQUIPMENT CONTAINING DEVICES,EXCLUDING MAIN SUPPLY OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER OVERCURRENT DEVICE,SHALL NOT EXCEED TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE AMPACITY OF BUSBAR SOURCES. NEC 690.56 ) A CAUTION PLACE ON EQUIPMENT WHEN RAPID SHUT DOWN IS REQUIRED CONTAINS MULTIPLE POWER C D SOURCES CUSTOMER INFORMATION: AMY Z PROVOST 240 GRAY ST NORTH ANDOVER,MA 01845 (617)803-79031#223037 OUTSIDE LABELING OF SYSTEM COMPONENTS AND METERS IS TO BE DONE IN A WAY SUITABLE FOR THE ENVIRONMENT IN WHICH DESIGNED BY: REV#: DATE: THE EQUIPMENT IS INSTALLED.NO STICKERS ARE PERMITTED. LVS 1 0 1021171151- F--. 02/17/15 PFRPNNLIN STSUIiE 1100aRtwD.GSa6a] Br WM pelo:0111]f15laeeYanTIff9E DRA'MNDS,9PECIFlG1110NS.PNDDESIONS METRE PROPERtt OFSUNOEVIIYING NO PPRTSNN.L RECO-OR USED FOR OR N1TNnNT--RK-ER TlNN THESPECIFlC PROJECT FOR WMCHTHEY HAVE DEEN DEVEIOPEDNITHOUT OUR- CONSENT 1 2 3 4 5 PHOTOVOLTAIC SYSTEM SHEETINDEX `�\ PV0.0 COVER AND SITE PLAN PV1.0 GENERAL NOTES SYSTEM SIZE: GRAY S I ` PV2.0 ARRAY LAYOUT AC/DC kW STC: 9.327kW\10.75kW \. PV3.0 LINE DIAGRAM PV4.0 LABELS EQUIPMENT: A A PV MODULES: (43)Hyundai HIS-M25ORG(SK) y INVERTER(S): (1)$OlarEdge$E360OA-US KEY: — PROPERTY LINE SUBPANEL � (1)SolarEdge SE6000A-US DEDICATED PV LOAD CENTER --- CONDUIT RUN O DC DISCONNECT DRIVEWAY SCOPE OF WORK: \a ` FENCE ED AC DISCONNECT \ SOLAR MODULE ®BJUNCTION BOX INSTALLATION OF A SAFE AND CODE-COMPLIANT 24-7 ACCESSIBLE �0 �lo ❑MONITORING UNIT .wN MAIN SERVICE PANEL N GRID-TIED SOLAR PV SYSTEM ON AN EXISTING AG DISCONNECT PG�' \ Q UT UTY METER COMBINER BOX RESIDENTIAL ROOF TOP. ® PV METER ❑ROOF OBSTRUCTION INVERTER MAIN SERVICE PANEL AND APPLICABLE ABLe cones: FUSED AC DISCONNECT 2014 NECy� 2014 N LOCATED IN THE GARAGE 2009 INTERNATIONAL CODES WITH MA AMENDMENTS ATTIC-MOUNTED CONDUIT RUNS DOWN AND ACROSS CONTRACTOR INFORMATION: WALL TO INVERTERS BOSTON SOLAR WOBURN `\! W SIXTH B !.` OBURN,M MA 01801 B V� JURISDICTIONAL INFORMATION: \Q- NORTH ANDOVER,TOWN OF 1600 OSGOOD ST NORTH ANDOVER,MA 01845 \ R NOTES TO INSTALLER: \ DC CONDUIT RUN:FROM ARRAY,ATTICA90UNTED CONDUIT RUNS DOWN AND ACROSS WALL TO INVERTERS. AC CONDUIT RUN:FROM SOS TO MSP THROUGH GARAGE \\ WALL CONFIRM CONDUIT RUN V11TH HOMEOWNER PRIOR TO INSTALL. ` Q AMU ST AS NECESSARY. `\ PC:INSTALL A SUPPLY SIDE CONNECTION ON SERVICE ENTRANCE FEEDERS COMING FROM THE UTILITY METER IN MSP.LAND PV BREAKERS INA DEDICATED PV LOAD CENTER TO BE LOCATED NEXT TO THE INVERTERS. OUTSIDETHE INVERTER MUST BE INSTALLED IN AN CCESSIBLEL CATION IN COMPLIANCE W7THTHE 2014 NEC \ 690.12 EMERGENCY SHUTDOWN REQUIREMENT. FOR INSTALLER USE ONLY `\ POST INSTALL SUNEYES REQUIRED? No (E) POOL I CERTIFY THAT NO CHANGES HAVE C C \ BEEN MADE TO THE ARRAY LAYOUT: \ CUSTOMER INFORMATION: AMY Z PROVOST 240 GRAY ST NORTH ANDOVER,MA 01845 SITE PLAN {617)803-7903/#223037 N NOTE:BALANCE OF SYSTEM(SOS)EQUIPMENT `\ SCALE: N.T.S. SHOWN FOR REFERENCE TO LOCATION ONLY- NOT TO SCALE DESIGNED BY: REV#-- DATE: ` LVs o 02117/15 PV-OA SUNOEVRI'MC QB FRANNIIN STSUITE 3ISONMN0.CA 9aeeT 6y�slM Oab.O'JiT/18 Lecoeon OBe.9ywVVAaNN DocumenhLLwWeslpiCueNmarthow#- THESEDRAWA .SPE R TONS.MDDEIO6N ETNEPROPERWOFSUNOEYRYMC.W PPRT 3HFLL 89 WPIMOR USED FOROR-n OTHER wORNOMER TINN THESPEOMC PROJECT FOR HMCH THEY IWVE 8EQi 0EVElOPMWITHOUT WR WRITTEN CONSENT 2 3 4 MODULE SPECIE ICAT IONS 2'-2" 1'-41" (43)Hyundai HIS-M250RG(BK) 37'-11 MODULE WEIGHT: 37.9 MODULE LENGTH: 64.57 4'O.C.MAX ROOF I I MODULE WIDTH: 39,29 f f I ROOF 1 SPECS t EA _EEELIZE. -10 NOMINAL '7�: 13!-4" RAFTER NG 16, COMPOSITE SHINGLE ROOF M ASTPEARCI Al L ARRAY 1 SPECS NUMBER OF MODULES: 43 A _J_ TOTAL MOD.WEIGHT Ilbs): 1629.7 A RACKING WEIGHT(Ibs): 368.2 7 7 _4*_ ARRAY WEIGHT(Ibs): 1997F9 ARRAYAREA(sqft): 757.6 ARRAY DEAD LOAD(Ibs[sqfU: 2.6 NUMBER OF MOUNTS: 101 LOAD PER MOUNT(Ibs): 19.8 AR AY I ARRAY AZIMUTH(-) 139 r. ARRAY T]LT(•I 39 4L_ U 7 4! 4�� NUMBER SYMBOL KEY: �3 MOUNT g: z -7 1 7RAIL RAFTERS ro ROOF SETBACK SOLAR MODULE @ STRING CONFIG. 3!4' 53, KEEP ARRAY MIN.12"FROM SKYLIGHT EAVE AND EDGES OF ROOF CHIMNEY RRAY LAYOUT FOR SNOW SHEDDING PLUMBING OR B SCALE: 3116" ATTIC VENT B 0 ATTIC VENT OF JAMES A. CLA GY NO, SOLAR MODULE cr James A.Clancy,P IRONRIDGEXR10 601 Asbury Avenue L-FO National Park,NJ 08063 C C QMSE-LAG SHINGLE--- CUSTOMER INFORMATION: COMPOSITE SHINGLE 5"X 5116'-LAG -- AMY Z PROVOST 3"MIN.EMBEDMENT 240 GRAY ST NORTH ANDOVER,MA 01845 2X10 NOMINAL,16 O.C��� (617)803-79031#223037 AMOUNTING DETAIL SCALE: NTS ESE REV#: DATE- PV_210 I LVS 1 0 102J171151 1 2 3 4 5 NEC 690.5(c) NEC 690.31(E)3&4;2012 IFC 605.11.1 INTERACTIVE PHOTOVOLTAIC POWER SOURCE PLACE THIS LABEL ON INVERTER(S)OR NEAR PLACE ON ALL JUNCTION BOXES,EXPOSED GROUND-FAULT INDICATOR(ON INVERTER(S)U.O.N.) RACEWAYS EVERY 10'AND V FROM BENDS RATED AC OUTPUT CURRENT(A): 41 AND PENETRATIONS,ADJACENT TO THE NOMINAL OPERATING AC VOLTAGE(V): 240 MAIN SERVICE DISCONNECT INVERTER 1 DC DISCONNECT PHOTOVOLTAIC SYSTEM DISCONNECT RATED MAX POWER POINT CURRENT(Imp): 25.8 A ELECTRIC SHOCK HAZARD RATED MAX POWER POINT VOLTAGE(Vmp): 350 A IF A GROUND FAULT IS INDICATED, PHOTOVOLTAIC POWER NORMALLY GROUNDED CONDUCTORS MAX SYSTEM VOLTAGE(Voc): 500 MAY BE UNGROUNDED AND ENERGIZED SOURCE SHORT CIRCUIT CURRENT(Isc): 10.9 NEC 690.17(E) NEC 690.35(F) INVERTER 2 DC DISCONNECT PLACE THIS LABEL ON ALL DISCONNECTING PLACE THIS LABEL AT EACH JUNCTION BOX,COMBINER BOX, MEANS WHERE ENERGIZED IN AN OPEN POSITION DISCONNECT AND DEVICE WHERE ENERGIZED,UNGROUNDED PHOTOVOLTAIC SYSTEM DISCONNECT CIRCUITS MAY BE EXPOSED DURING SERVICE: RATED MAX POWER POINT CURRENT(Imp): 35.8 RATED MAX POWER POINT VOLTAGE(Vmp): 350 111 MAX SYSTEM VOLTAGE(Voc): 500 SHORT CIRCUIT CURRENT(Isc): 10.9 ELECTRIC SHOCK HAZARD M- R DO NOT TOUCH TERMINALS ELECTRIC SHOCK HAZARD TERMINALS ON BOTH THE LINE AND LOAD THE DC CONDUCTORS OF THIS SIDE MAY BE ENERGIZED IN THE OPEN PHOTOVOLTAIC SYSTEM ARE UNGROUNDED POSITION AND MAY BE ENERGIZED NEC 705.12(D)(2)(b) NEC 705.12(D)(2)(c) PLACE THIS LABEL AT P.O.C.TO SERVICE PLACE LABEL ON ALL EQUIPMENT CONTAINING B B DISTRIBUTION EQUIPMENT(I.E.MAIN PANEL(AND OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER SUBPANEL IF APPLICABLE)) TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE SOURCES. WN�� INVERTER OUTPUT CONNECTION DO NOT RELOCATE THIS — OVERCURRENT DEVICE _ THIS EQUIPMENT FED BY MULTIPLE POWER NEC 705.12(D)(3) SOURCES.TOTAL RATING OF ALL OVERCURRENT PLACE LABEL ON ALL EQUIPMENT CONTAINING DEVICES,EXCLUDING MAIN SUPPLY OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER OVERCURRENT DEVICE,SHALL NOT EXCEED TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE AMPACITY OF BUSBAR SOURCES. NEC 690.56(C) ACAUTION PLACE ON EQUIPMENT WHEN RAPID SHUT DOWN IS REQUIRED CONTAINS MULTIPLE POWER C C SOURCES CUSTOMER INFORMATION: 10 low W AMY Z PROVOST 240 GRAY ST NORTH ANDOVER,MA 01845 (617)803-79031#223037 OUTSIDE LABELING OF SYSTEM COMPONENTS AND METERS IS TO BE DONE IN A WAY SUITABLE FOR THE ENVIRONMENT IN WHICH DESIGNED BY: REV#: DATE: THE EQUIPMENT IS INSTALLED.NO STICKERS ARE PERMITTED. LVS 0 02/17115P{/-4.® SUNOCVRYMC.EB ERANINN STSNTE SIO OAi¢AND.-... SvTHESE DRA`MNOS,SPEOPICATIONS.AND DESIGNS ARE THE PROPERTYOFSUNDENtt INC NO-L BE COPIEDOR USED FOR OR WITHANY OTH =RKOTHER TMM THE SPEORC-ECTFOR-THEY-SEEN D LOPEDYATHOUT MRINiRTENCONSEM AHYUNDAI HF,Wy les MLM www.hhi-green.com/solar CERTIFICATE ®F COMPLIANCE Certificate Number 20141021-E325005 Appendix)Module Installation Instruction(HIS-M—RF,HIS-Mm RG,HIS-Sx—RF,HIS-S1 RG) Report Reference E325005-20131209 The installation methods which are described in Hyundai Heavy Industries installation Manual are issue Date 2014-OCTOBER-21 covered by 2,400Pa Warranty. Method Issued to: HYUNDAI HEAVY INDUSTRIES CO LTD 1-5 DAEJANG-RI SOI-MYEON T ♦ 1 1 EUMSEONG-GUN Bolting Long Bar CHUNGCHEONGBUK-DO 369-872 KOREA 1 1 Z 1 This is to certify that PHOTOVOLTAIC MODULES AND PANELS 1`1 171 representative samples of "HiS-SxxxRF,HiS-MxxxRF,HiS-SxxxRG and HiS-MxxxRG Series with specific construction described in installation Fi instructions compliant to Photovoltaic Module Fire L/4 I': Performance Type 1" Ij t100mm Have been investigated by UL in accordance with the i Lt2 Standard(s)indicated on this Certificate. I Long Bar Clamping 3 3 Standard(s)for Safety: UL 1703"Standard for Safety for Flat-Plate Photovoltaic t # Modules and Panels", p:Clamping area L I! ULC ORD/C1703-01"Flat-Plate Photovoltaic Modules and ©:Additional Panels", support bar Clamping Area sL/4 '� area L!8 U4 Additional information: See the UL Online Certifications Directory at 0:Additional L www.uLcom/database for additional information Clamping area for slipping U85 Clamping Area 5U4 - snow t100mm Only those products bearing the UL Certification Mark should be considered as being covered by UL's Certification and Follow-Up Service. U2 S/4 4 Look for the UL Certification Mark on the product. [, Short Bar I( is i, S F. Clamping Area 5S/4 L S/8s Clamping Area sS/4 Note 1)The certified mounting method is bolting method by TUV Rheinland. 2)The Mounting method has been qualified by Hyundai Heavy Industries,and the mechanical load tests are based on IEC61215 ed.2. 1111.ha.n.w....wm...Ch.r '..I..v'.—...1-1.m... U�LLc .reim.iron.namw�..mw.�..eninv u�rmn...r».m.,.Na.e.�emmeru�uc Nu...•r.uuwnw�k.m»aru�Poryu»um.,q».. Salol Office Page 15 of 15 Factory 12th F..Hyundai Bldg., 313,Sol-re.Sol-myeon,Eumaeor"un, 75,Yulgok-ro,Jongno-9u, Chungchoongbuk-do 389.872,Korea Page 1 of 1 Seoul 110-793,Koro. AUTHORIZATION TO MARK AUTHORIZATION TO MARK -- --- - -- _ - -- -- Product: Utility Interactive Inverter This authorizes the application of the Certification Mark(s)shown below to the models described in the Product(s) grand Name: SolarEdge Covered section when made in accordance with the conditions set forth in the Certification Agreement and Listing 7 models:SE3000,SE3300,SE3800,SE5000,SE6000,SE7000,SE7600 Report.This authorization also applies to multiple listee model(s)identified on the correlation page of the Listing Models: Report. (Option:followed by A to indicate Interface board,etc.) This document is the property of Intertek Testing Services and is not transferable.The certification mark(s)may be applied only at the location of the Party Authorized To Apply Mark. Applicant: SolarEdge Technologies Ltd Manufacturer. Jabil Circuit(Guangzhou)LTD DEV EAST DISTRICT Address: 6 Ha'Harash Street 45240 Address: 128 JUN CHENG RD Hod Hasharon GUANGZHOU GUANGDONG 510530 CHINA Country: Israel Country: China Contact: Mr.Oren Bechar or Contact: Elaine Ouyang Mr.MeirAdest +972 9 957 6620#293 or Phone: +972 9 957 6620#131 Phone: 020-2805-4025/1357023 5852 FAX: +972 9 957 6591 FAX: NA Email: OREN.B@SOLAREDGE.COM Email: Elaine.ouyang@jabil.com Party Authorized To Apply Mark: Same as Manufacturer Report Issuing Office: Cortland,NY 13045 Control Number: 4004590 Authorized by: 01% for Thomas J.Patterson,Certification Manager CUS Intertek This document supersedes all previous Authorizations to Mark for the noted Report Number. ihls AWiorimifon to M1btk Is for bre akolurNa—of bto.Ift Mot and b pnnAd.dN...to da GdNcation apreameru betxaen Iourokand ho-I.-1--We--noWityand It'l,tyan Ilmltotl to the tomos oundMbm of-apmemaM.IMortok a a —no Ilabllltyb ant Pont.Diner-n toihe a]..In a aorda—x -opaamerd,to,on,hu,oapame or d.mege—u.ned by lbe oea of Mh Aulhorbaden to Nark Only tin 011-In auM—ft permitmpyap or dknibdlon a1—AUlhodobpn to W*ant don only In ILL of 11,U dInrodokhConMlotlonmarkI- -iaool to fin eondPoom Wd out in tho a,,,aemoot and Inthia Aulb ub.Wn ro Wrk"fuftlwr uoe of tho In odok rare forint cola or—,iku mod d tho IeWd moodal,product or aoMca noun nrd bo a,,,io od inv by W irtorok IMWf FactoryAuoumoft ant Fo6ow up5anloea am rorfhe purp000 d onoudrg'PP Prot uupe of the Cardnodion rradc In 0"Indo oo nnh ha aprvamont,Choy on,rat for rho Purppxp d prodoptloo aua(ky oonboi ant do rot relieve tin alert d Mulrobftro ro In thh roepod. Intertek Testing Services NA Inc. 545 East Algonquin Road,Arlington Heights,IL 60005 Telephone 800-345-3851 or 847-439-5667 Fax 312-283-1672 UL 1741 Standard for Safety for Inverters,Converters,Controllers and Interconnection System Equipment for Use With Distributed Energy Resources,Second Edition Dated:January 28,2010 CSA C22.2 107.1 Issue:2001/09/01 Ed:3 General Use Power Supplies-(R2011) Standard(s): UL SUBJECT 16998,Outline of Investigation for Photovoltaic(PV)DC Arc-Fault Circuit Protection-Issue No.2,2013101/14 CSA TIL M-07,Interim Certification Requirements for Photovoltaic(PV)DC Arc-Fault Protection-Issue No.1,2013/03/11 ATM for Report 3188027CRT-001 a Page 1 of 8 ATM Issued:13-Nov-2014 ATM for Report 3188027CRT-001a Page 2 of 8 ATM Issued:13-Nov-2014 ED 16,3.15 Vt ..l 3)Mordatory ED 16.3.15(14413}JVlo—ry solar.=@@ solar=@9 SolarEdge Power Optimizer Module Add-On for North America P300 / P400 1 P405 SolarEdge Power Optimizer P300 P400 P405 {fore 11 oodmos) Iw.7z&ss-con moamez! {rortnlanlm moamozl Module Add-On For North America INPUT Rated Input DC Paweri" 300 400 _ 405 W Absolute Maximum Input Voltage 48 80 125 Vdc P300 P400 P405 tVoc at lowest t mperature} MPPT Opon2M gR nFe 8-48 F 8-80 12.5-105 Vdc Maximum Short Circuit Current List) -...- .... - ... 10. .., Ad c Maximum DC Input C ent ...., . _. _ __ 12.5 Ad c Mim axum Efficiency ., ..... _. _.. _.. 995 _. ._. '° Weighted Effiaency98.8 %. Overvolta eg Category II _. ._.. .,.. OUTPUT DURING OPE_ ...._. _..._ RATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER)Maximum Output Current _ _, _ 15 Adc ,. Maximum output Voltage 60 85._ ydc v��� OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) Safety Output Voltage per Power Optimizer 1 Vdc _STANDARD COMPLIANCE \� \\ EMC . __. _. _ ....... FCC Part15 Class B.IEC61000-6-2,IEC61000 6 3\V � safety IEC62104 1(Haas 11 safety),UI1741 yes INS NSTALLATION SPECIFICATIONS Maximum Allowed System Voltage 1000 Vdc Pxxx2 series 141x 212 x405/5.55 x8.34x 1.54 mm/in -- ��Ay�v���vtee `\y� Dmensions(wxLxH) P 5 e ugxlszxr7sl u§xl5zxas! 12sx152x4sJ mm/in 5 597x 1.08 5x5.97x 1-37 _ 5x597x 1.89_ Weight nPx 2 e+ -- - 950/21 gr/Ib vVA vA (including cables) - - \\ Pxxx 5 series 770/1.7 930/2-05 930/2.05 gr J Ib v �A�\VAA AAA � Input Connector MC4 Compabbleoutput Wire,Type ---. connector OutputW eLength - 0.9S/3.0 mP�1.21/39 - m/ft Double Insulated;A Operating Temperature Range -40 +g5/40 135 _ 'C/-F \\\ Pzxx2series IP65/NEMA4 gr/Ib protection Rating P-5 series IP6.8/NEMAGP" - gr/lb \\ Relative H mty d 0-100 % \` \ PV SYSTEM DESIGN USING SINGLE PHASE THREE PHASE 208V THREE PHASE 480V A SOWREDGE INVERTER .: _.._. _.. Minimum Stang Length 8 30 18 ' .. (power Optimaers), PV power optimization at-the module-level Maximum String Length 25 25 50 - Up to 25%more energy .h. (Power Optimaers) __.. __ ._._. ..._.._ .. _. ... _Maximum Power per String _ 5250 6000 12750 _W -Superior:efficiency(99.5%) Parallel Strings of Different Lengths or Orientations Yes Mitigates all types of module mismatch losses;:from manufacturing tolerance to partial shading.: - - - - --.-- - -- - - - - - - - -- -- -- --- - --- ----- �: cs r.1113xrr_0fxmrmc0 roe.xa. - 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 USA GERMANi' - l.a,., - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www,s O'aredge.us -vim IRONRIDGE Class A Fire Rating - AUTHORIZATION TO MARK Background jEW All roofing products are tested and - This authorizes the application of the Certification Mark(s)shown below to the models described in the Product(s) classed for their ability to resist fire. Test Setup Covered section when made in accordance with the conditions set forth in the Certification Agreement and Usmg Report.This authorization also applies to multiple listee model(s)identified on the correlation page of the Listing Recently,these fire resistance standards solar Modules Report were expanded to include Solar equipment solar modules are given a Type This document is the property of Intertek cess Services and is not transferable.The certification marks may be classification based on their P n9 () Y as part of the roof system.Specifically,this materials and construction. applied only at the location of the Party Authorized To Apply Mark. requires the modules,mounting hardware --— --- - - and roof covering to be tested together as Mounting System Applicant: IronRidge,Ina Manufacturer. IronRidge,Inc. Mounting Is tested as part of a 1495 Zephyr Ave 1435 Baechtel Road a system to ensure they achieve the same s Pyr system that Includes rat d mot eve Address: Hayward,CA 94544 Address: Willits,CA 95490 fire rating as the original roof covering. modules and nre rated root covering. Country: USA Country: USA Adoption of these new requirements will Roof soaring contact: Vann Schwarz Contact•. Jim Norsworthy begin in Cal'Ifomia in 2015 and extend to Roof covering products are given a Phone: (800)227-9523 Phone: (800)227-9523 g Pre Class Rating of A,8 or C based (510)225-0973 the rest Of the country in 2016. on their tested fire resistance. FAX: (707)459-1833 FAX: (707)459-1833 Email: yschwarz@iromidge.com Email: jnorsworthy@iromidge.com Party Authorized To Apply Mark: Same as Manufacturer IronRidge Certification Spread of Flame Test Report Issuing Office: Lake Forest,CA00 Control Number. 4007559 Authorized by: for Thomas J.Patterson,Certification Manager In August 2014,IronRidge was the first company to receive a Class A Fire Rating— ET CLASSIR® the highest possible rating-from IntertekPASS � Group plc.,a nationally recognized test121 ` laboratory. �u Flame at southern edge of roof Is aimed up the roof as a fan blovrs at 12 Intertek IronRidge ROOF Mount products were tested mph.The fiame cannot spread 6 feet or more in 10 minutes. This document supersedes all previous Authorizations to Mark for the noted Report Number. with Type 1 Solar Modules and Class A mea ern aMa scar ae awe°ro-�a °area^°awe aaeo�.M��a«aa� a, °aa"a.�"a a "a.aa"a,° n�na�oaemna° Rated roofing material in accordance with ecu»uwvmisama°,uamn m cont arrm°a.mKawwe.°r°oaaarccwyma aeev�eww^amanvmmonon m rnon<a"a mena,n i^mrnrrrn.uw ammna"°c°nv"awa mm�cm the new UL 1703&UL 2703 test standards. aaemaa a m abbe r n�aaa�a aaa a aaa °�aa°"mua ^^ar�aan°�a°"a"am°rauroa�°°,aa a ram°r°s°°ma ,�a°.°aim° Burning Brand Test +��°m »nungeyia ua�mm°iraearvAss..+a<m°a"e rbmwuosrn+casa�rorm°wnw�aa�ae^a°wram�ara unua°rn.acamnmaa^manNaa�°""..awmrro°ora°m.^c The testing evaluated the system's ability \ m are a„ae�aa,tea m am.a°°anaanaenao eau aaaaaaea°nr a a,a to resist flame spread,burning material and Intertek Testing Services NA Inc. structural damage 10 the roof. 545 East Algonquin Road,Arlington Heights,IL 60005 Telephone 800-345-3851 or 847-4335667 Fax 312-283-1672 All flush mounted solar arrays using PASS IronRidge XR Rails with Type 1 Solar Standard(s): UL Subject 2703 Outline of Investigation for Rack Mounting Systems and Clamping Devices for Flat-Plate Modules are certified to maintain the fire Photovoltaic Modules and Panels,Issue Number.1,October 4,2010 rating of the existing roofing material.No Burning wooden block Is placed on module as afan mows at 12 mph.Flame Product XR Rails with Integrated Grounding. additions or modifications to the IronRidge cannot be seen on underside of roof within 90 minutes. Brand Name: NIA Roof Mount System are required. Models: 51-61GD-005,51-611313-0058,51-5000-001,and 51-65-001 \\o Fire Rating Certificate \\\ Engineering Certification Letters \' 2703 certificatwnVisit our website tdocument.d the official UL \\ We offecomplete enineering �\ and prerstamped certification ettersurces \\ cc ATM for Report 101541132LAX-002 Page 1 of 3 ATM Issued:10-Nov-2014 IronRidge June 16.2014 lronRidge June 16,2014 Mr.David F.Taggart Page 8 of 11 Mr.David F.Taggart Page 9 of I I lronRidge XR100 Rail,Roof Flush Mounting System-Structural Analysis ImnRidge XRlOO Rail,Roof Flush Mounting System-Structural Analysis Table 7-MAXIMUM SPANS(inches)-Roof Vope 28 to 45 Degrees-Wind Zone 1 Table 8-MAXIMUM SPANS(inches)-Roof Slope 23 to 45 Degrees-Wind Zone 2 XR100 Wind Ground Snow Load XRIOO Wind Ground Snow Load Rai! Speed Rail Speed Exposure mph 0 psf 10 20 30 40 5 60 70 80 90 Exposure mph 0 Pf 10 20 30 40 50 60 70 80 90 psf psf psf Dsf Dsf osf Qsf psf psf psf Vsf Qsf psf Qsf osf Psf psf psf 100 107 98 84 75 67 61 56 52 49 46 100 107 98 84 75 67 61 56 52 49 46 105 [107 98 84 75 67 61 56 52 49 46 105 107 98 84 75 67 61 56 52 49 46 110 106 97 84 75 67 61 56 52 49 46 110 106 97 84 75 67 61 56 52 49 46 120 101 94 82 74 67 61 56 52 49 46 120 101 94 82 74 67 61 56 52 49 46 CategoryCategory -'1-30- 9-4 91 80 72 66 61 56 52 49 46 B 130 96 91 80 72 66 61 56 52 49 46 B 60 140 91 1 88 1 78 70 65 60 56 52 49 46 140 88 88 78 70 65 j 56 52 49 46 150 87 85 1 76 69 64 59 56 52 49 46 150 83 83 76 69 64 59 56 52 49 46 160 83 82 74 67 62 58 55 52 49 46 160 78 78 67 62 58 55 52 49 46 170 79 79 T2- 66 61 57 54 51 49 46 1 170 74 74 72 66 61 57 54 51 49 46 100 101 94 82 74 67 61 56 52 49 46 100 101 94 82 74 67 61 56 52 49 1 46 105 r98 93 81 73 67 61 56 52 49 46 105 98 93 81 73 67 61 56 52 49 46 110 95 91 80 72 66 61 56 52 49 46 110 94 91 80 72 66 61 56 52 49 46 120 90 87 77 70 65 60 56 52 49 46 120 87 87 77 70 65 60 56 52 49_ 46 Category -T3-0 8 52 49 46 C 85 84 75 68 63 59 56 52 49 46 -'9"Y 130 81 81 75 68 63 59 56 C 140 81 80 1 72 66 62 58 55 52 49 46 140 76 76 72 66 62 58 55 52 49 46 150 76 76 70 65 60 57 53 51 49 46 150 71 71 70 65 60 57 53 51 49 46 160 73 73 68 63 59 55 52 50 48 46 160 67 67 67 63 59 55 52 50 _ 48 46 1 170 69 69 66 61 57 54 51 49 47 45 170 64 64 64 61 57 54_ 51 49 47 45 100- 96 91 80 72 66 61 56 52 49 46 100 95 91 80 72 66 61 56 52 49 46 105 93 89 79 71 65 61 56 52 49 46 105 91 89 79 71 65 61 56 52 49 46 110 90 87 77 70 65 60 56 52 49 46 110 87 87 77 70 65 60 56 52 49 46 120 85 83 75 68 63 59 55 52 49 46 120 81 81 75 68 63 59 55 52 49 46 Category 130 80 80 1 72 66 61 58 54 52 49 46 Category 130 75 75 72_ 66 61 V5854 52 49 46 D 140 75 75 70 64 60 56 53 51 48 46 D 140 70 70 70 64 60 56 53 51 48 46 150 71 71 7 62 58 1 55 2 50 48 46 150 66 66 66 62 58 55 52 50 8 46 160 68 N T_ 6 60 57 54 51 1 T_ a Z 1 9 60 62 9 47 45 68 65 60 57 54 5 47 45 1 ? 170 64 64 62 58 55 52 50 48 46 44 1 59 58 155 52 50 1 AA AA I44 Notes-see page I I Notes-see page I I Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers -9- E-Mount Lag I QMSE - LAG E-Mount Lag Installation Instructions InstallationTools Required:tape measure,roofing bar,chalk line,stud finder,caulking gun,sealant compatible with roofing materials, THIS EDGE TOWARDS ROOF RIDGE No DESCRIPTION Ott./Box drill with 7/32"long-style bit,drill or impact gun with 1/2"socket. 1 FLASHING,9"X 1Z'X.040',5052,MILL 1 2 OBLOCK CLASSIC,A360.1 CAST AL MILL 1 3 PLUG.SEALING.5/16'X 7/8',EPDM/168 SS 1 4 LAGSCREW.HEXHEAD.5/16"x5-I/Z'.18ASS 1 6 ) 5 WASHER,FENDER,5/16"ID X 1-1/4"OD,18-8 SS 1 '' 1 RACKING COMPONENTS NOT INCLUDED �•. 1t �t 4 3 Locate,choose,and mark centers of rafters to be Carefully liftcomposition roofshingle with roofing Insert flashing between 1 st and 2nd course.Slide mounted.Select the courses of shingles where bar just above placement of mount.Remove nails up so top edge of flashing is at least 3/4"higher _.P_ mounts will be placed. as required.See"Proper Flashing Placement"on than the drip edge of the 3rd course and lower _ „ next page. flashing edge is above the drip edge of l St course. Mark center for drilling. 2 g PR `> Quick Mount PV ° S TITLE: QMSE-LAG:QMPV E-MOUNT AVAILABLE IN MILL,AND WITH LAG BOLT , BRONZE ANODIZED FINISHES w mcxo SIZE DRAWNBY. DFM REV u ty p} Iii '.:y6, A DATE Bn,=, 1 .w»vewn"`Ntii:"ni rz.wn.moue....,,�,.,n..r.u�o ""'•'"""e..avkm�r,.."a w oi.euu.ox.xrie me[[rue[0[avu .�.s .eAlf.Ia w00M.o.9e [mntoft tllVld I '� � '���. 5 4 3 2 Using drill with 7/32"bit,drill pilot hole into roof Clean off any sawdust,and fill hole with sealant Slide the flashing Into position.Insert the rubber Lag Bolt Specifications and rafter,taking care to drill square to the roofcompatible with roofing materials. plug into the QBlock cavity. Do not use mount as a drill guide.Drill should be S11, 511r mmn por]•mmad dapm snc:hnn po,r mmm dopm 'long style bit:aka aircraft extension ble to drilla Deagb4 FIf.L-1, .so 798 tag 13;"deep hole into rafter. Daug1n9F1r.Soulh .40 706 2]s enp"Imonn Spm—,Lodg h,Pi—NSR 1950 f 6 hlghar) 0 705 2]5 Hem.Flr A3 9]e 212 H"m,M,Na9h) 40 as 235 Iq @ . Saulhom Pino .66 021 307 , s—,Pino.Flr 42 016 206 Spm-Pino.Fir M.12 Hft,,poi d his-Omducof MSRpnd MEL) .50 7g0 200 *L^ Sources:Amerkan Wood CounclL NDS 2005,Table 111 A 11.3.2 A Notes: IlThmad must be embedded In a Mfierorothersnuctuml roofinember. 2)Sne NDSTable l IS.IC fmtequlrededgedlsdncax Quic oust Slide the washer and the L-foot(not Included)onto Using a 1/2 inch socket on an impact gun drive RESPECT THE ROOF the lag screw. the lag screw until the QBlock Stops rotating easily. DO NOT over-torque. 817.2.3-31 Sep-2014,Rev 1 BI 7.2.3-31 Sep-2014,Rev 1 - Without Bypass - - - • - Without Bypass 100•Amp Self-Contained 100 Amp Self-Contained Single meter position —o w o—wi—D---w Designed to receive watthour meters that meet ANSI 012.10 €n Surface or semi-flush mounting Overhead or ET underground feed HA Az HA O O ; •Type 3R construction - - '�„ Snap type sealing ring included 5th jaw provision at nine o'clock—Oil series only ! s • King style - UL414listed,complies with ANSI C12.7 = L ' ----------- -------------- ; o Q : ca L ANSI 61 gray acrylic electrocoat finish Fig.1 ae FIg.2 Aa `-- - I -o- Fig. 5th jaw kit—catalog#50365 I • Screw type sealing ring—catalog#25016D(included with MS73 4 . catalog numbers) Steeland clear lexan covers for socket opening AW hubs —D W—; 0—w CANDUCIOR I.uD RArcE @IhENS (INCHES) _ -- ---------------------- A __________ _ _4 AW 14 AWG-2t0AWG id AWG-2A1 AWG Fig,1 12 1 8 49 i 911Nf5T3 t 159 125 6W 103W _. 4 AW 14AWG-219AWG. 14AWG-2ALAWG 'a 12 O 4Zr.. t 159 125 .0 304W 7 AW 14AWG-1i0AWG 14AWG-210AWG Fig.3 17 8 4i4 -_ I CONDUCWR LSD RaNSE DINENSIONS(INCHES) L OO �O :O OtiP Fig.e 1 15D 125 699 103W 4 NONE 14AWG-2@AWG -14AWG-2m AWG FigiQ.Z6 12 8 4O= O© ;O O O Fig. 5 AB 0116F t 159 125 609 1@9W 4 ONE 14AWG-2/DAWG 14 AWG- AWG flg::Y:7 12 B Ota �Q 927E t 125 100 600 304W 7 NONE 14AWG-iNAWG 14AWG-2NAWG FIg.4 17 8 Aik 2V,e Fig.4 ��`� WNODcrisR Ur Rm DIMDGI 5(INCHES) i 0011 t 150 125 600 1 103W 4 NONE 14AWG-21OAWG i 14AWG-2A1AWG I n9.5 12 12 435 3 V; t=hfetersou@ets shown on this page have certain short CfmRcvnant ratings when used in wrifomrance with the fables an page 8. AB=W HA-AWHUB Fig, 2 COO B-Line Data subject to change without notice.Consult local utility forarea acceptance.All dimensions in inches. Data subject to change without notice.Consult local utility for area acceptance.All dimensions in inches. =Of&B-Line 3 INN. Po - A P P L I CA T10.m Suitable for use as follows —... mmww STRANDED m o For use in solar power applications COPPER , CONDUCTORS 9 Rated 90°C for exposed or concealed wiring in wet or dry locations a.. Rated for direct burial C" Wei s ..._... .,,, w._. ..._ .. . ......__.._. .._............... .... * Stranded copper conductors % * XLP insulation UL Subject 4703 UL 44 o Meets the requirement of UL 854 for TYPE USE-2 TR U C T . * Southwire PV Photovoltaic Wire is manufactured using stranded copper conductors with single layer XLP insulation * Bare or Tinned Conductors CL * -40°C to +90°C Sunlight Resistant CL RoHS Compliant * Direct Burial Qo Sample Print Legend: Bare or Tinned SOUTHWIRE E316464 (0) (UL) PV WIRE 10 AWG (5.26m M2)CU 2000V 90C Stranded Copper WET OR DRY(-40°C) WET OR DRY-40'C SUN RES DIRECT BURIAL VW-1 OR Conductors RHW-2 2000V—RoHS XLP Insulation Direct Burial -40°C to+90°C AWG SIZENO.OF STRANDS INSULATION NOMINAL O.D. NET WEIGHT _- _..._. _...._.. .._ THICKNESS 2000 Volts 14 19 0.075 0.220 31.9 12 19 0.075 0.237 41.3 10 19 0.075 0.261 56.6 8 19 0.085 0.312 85.7 14 7 0.075 0.220 31.9 12 7 0.075 0.237 41.3 10 7 0.075 0.261 56.6 8 1 7 1 0.085 0.312 1 85.7 Other sizes and strand configurations are available upon request.Also available in various colors. @ green(t)Spec' (h�'�¢�J=/ SOU.thWir LISTED RoHSCompliant T��/ OEM Division li ul I i'�I I� u� Iu uiuuuuil,,�°�api pui F_ D m Q v E.TeN Switching Devices 8-21 r February 2007 Product Selection 10.79[274] 1201240 Vac General-Duty,Fusible,Single Throw 1 10.23[260] 1 .42[11] Table 841.1201240 Vac Genera[-Duty,Fusible,Single Throw A .99[25] A System Ampere Fuse Madmum Horsepower Rednga U NEMA 1 Endoeure NEMA 3R Enclosure Rating type Sbrgia-0haseae 3•Phsm de Indoor Rainproof PraWdon I 120 Volt 240 Volt 210 Vok a 250 Volt Catalog Pries catalog Prim Number US.a Number US.S +0 3-Pola 3,Wire(Three Blades,Three Fuws)-240 Vac p8b/qQb/pQb/ eo —H 50-125 OG325FGKdr%— - - - I 20 400 _ - _ 200 'O DG325FRK 600 H 76-200 OG326FGK @-'�J DCW6FRK � Q=� 4wiro lThrm Bledaa,Thme Fours,SM)—17A240 Yet 10.66[271] q11I 30 H - 1-12-3 3-7-12 - DG321NG6 DG321NRB /I N 60 H = 3-10 7.72-15 = DG923NGO DG322NRB <<Qu 3.73[95] qqQ qq9 qQq qll 100 H 7-12-15 15-30 DG323NG8 DG323NR. 200 H 15 25-60 DG324NGK DG324NRK yo 2.03[51] 2.03[52] 400 H 50-125 DG325NGK DG325NRK 600 H - - 75-200 - DG326NGK DG326NRK 94[24] T Maximum hp ratings apply only when dual element time delay fuses aro used. X Use 4- ma catalog numbers below. X Solid neutral bars are not included.Order separately from Table&1 on Page M. W .67[17] .63[16] 9.00[229] W �9 WARNING]Switch Is not approved for service entrance unless a neutral kit Is Installed, 1201240 Vac General-Duty,Non-Fusible,Single Throw .. o iP 0 ® p moa W D _z o .fie[zz7 cN�o Dc3nufre �g Table B-421291240 Vac Genand-Dory,Non-Fusible,Single Throw System A-m Maximum Horsepower Ratings NEMA t Endowro NEMA 3R Endowro 4�ae r' Rating Indoor Rainproof a x 7 m N o ce Singie-Phase ee 3•Phese ae de N pg4 N 120 Volt 240 Von 210 VON 250 Voh Catalog Prim catalog Prim Number US.S Number US.S Non•Fusible-2-Pole 2-Wlro Rive Blades)-240Vsc e$ ¢$ aN d b 30 2 DG227UGB% DG211 ^9 a$Q N � / 60 3 10 - - OG272UGBS DG222URBC s .( 100 - 15 - - DG223UGB;o`. DG223UR6!c TTT 200 - 3-Pole 3-Wlm(fhr eBiedesl-240Yae - m cm Ppnm 30 2 3 7.12 - DG321UGBCV DG221UR6 C� ^ 60 3 10 15 _ DG322UG8'� OG322UR8 G; m m '^ O O - rTf 100 15 30 DG323UG8�:^ DG323UR:Cf v 200 - 15 60 - DG324UGK�'% DG324URK G, 400 - - 125 - DG32BUGK 6) OG32SURK 0,' 0 E ^�o�iz, 600 - - 200 - DG GK DG326URK� C - m WARNINGI Switch is not approved for sarvico enhance.,loss a neutral kit Is installed. n0 0 A w w�� Use 3•wim catalog numbers below, g Stn yw z 5? N r� .99[25] o -r •Q�Drilled to accept field installed neutral kits. 6 ? m Note:All general-duty safety switches are individually packaged. Note:Accessories are limited in scope on general-duty safety IO ; as ry sty switches.See Page B•5 for availability.In addition,alcor line shields are available to n4`^ D es an accessory on 200-600 ampere general-duty mmitehes.Catalog Numbere:200 A m 70.7759-11,400 A-70.8063-8,6DO A-70-80648. I p z t� o A p o� ox A - �1 inti o0 Discount Symbol.........................22CO 5 D CA08101001E For more information visit wwmorder.com �4 ; L n m n v UMCC ofConsumer "mAffairs fairs&Rusi nK�e "Regulation nregistration Ucense or valid for individui use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: rgistration, 165558 Typo: Office of Consumer Affairs and Business Regulation x iration: 7/27/2015 LLC LO Park Plaza-Suite 5170 P Boston,MA 02116 THE BOSTON SOLAR COMPANY LLC ROMAIN STRECKER , 10 CHURCHILL PLACE r '' Undersecretary aw,_ � LYNN,MA 01902 Utary Not vµ ali<i without signature Masswhusetts . Department of Pubhc Safety Board of Building Regulations and Standards f'a6BWrm fion L,i,; n : CS-096385 ROMAIN D STRE 10 CHURCHILL PLA LYNN MA 01902x m Expiration Convnisswer 10/08/2016 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 wliv;v.inass.gov1dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): The Boston Solar Company Address: 10 Churchill Place City/State/Zip:Lynn, MA 01902 Phone M 617-858-1645 Are you an employer? Check the appropriate box: Type of project(required): 1.M I am a employer with 20 4. F1 I am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.0 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. E] Building addition [No workers' comp. insurance comp. insuranceJ required.] 5. [:] We are a corporation and its 10.E] Electrical repairs or additions 3.n 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.n Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other solar comp. insurance required.]_ *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:HDI-Gerling America Insurance Company Policy#or Self-ins. Lic. M EWGCCOOO 153815 Expiration Date: 1/14/2016 Job Site Address:— 240 Gray Street City/State/Zip: North Andover,MA0184 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 certify under I wins andpenalties of per/iny that,the information provider!above is true and correct SigLiature: Date: 3/11/2015 Phone#: 6178581645 Qfflcial 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#: if Client#:103109 BOSSO YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 1113DATE(M111312015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:if the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Peggy J.Merati People's United Ins.Agency CT PHONE 860 524-7624 A Ne, 844 702-8075 AIC No Ext One Goodwin Square ADDRess: peggy.merati@peoples.com Hartford,CT 06103 INSURER(S)AFFORDING COVERAGE NAIC# 860 524-7600 INSURER A:HDI-Gerling America Insurance C 41343 INSURED INSURER B:Merchants Mutual Insurance Co 23329 The Boston Solar Company, LLC INSURERC: 55 Sixth Road,Suite 1 INSURER D- Woburn,MA 01801 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMIDD MM/DD LIMITS A GENERAL LtABILITY EGGCC000153814 0/03/2014 0110112016 EACHOCCURRENCE $110001000 X COMMERCIAL GENERAL LIABILITY PREMIIss Ea oT'T...) $100,000 CLAIMS-MADE F—R OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X JECT LOC $ A AUTOMOBILE LIABILITY EAGCC000153814 10/03/2014 01/01/201 E°e ED EUMIr 1,000,000 A X ANY AUTO EAGCC000153914 10/03/2014 01J0112016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIREDAUTOSX AUTOS Peraccident $ B X UMBRELLA LIAR X OCCUR CUP0001367 0/03/2014 01/01/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$10.000 $ A WORKERS COMPENSATION EWGCC000153815 D111412015 0111412016 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDEb? � NIA (Mandatory in NH) E.L.DISEASE-FA EMPLOYEE $1,000,000 If yas,dentt sce under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS t LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE:Permit Work Certificate Holder is included as Additional Insured per the terms,conditions and exclusions of the referenced general liability and umbrella policies,if required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S565647/M565467 SMGCT