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Building Permit # 6/9/2015
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 1.01 Permit NO: "' Date Received Date Issued: p X PORTANT: A licant must complete all iters on this page LOCATION 134 r't(&y oad Print, PROPWrY OWNER Wayne clenoroti Prin# 100 Year:old'SYucture yes MAP NO: PARCEL: a ZONING DISTRICT: Historic District yes no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential D New Building 0 One family ❑Addition ❑ Two or more family 11 Industrial 0 Alteration No. of units: F1 Commercial F3 Repair, replacement U Assessory Bldg 0 Others: 0 Demolition 0 Other ❑ Septic ❑Well 0 Floodplain ❑Wetlands ❑ Watershed District D Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Installation of 5.40 kw(18 panels)rooftop-solar array Installation of cellar ties Identification Please Type or Print Clearly) OWNER: Name: w11 (,endro Phone' 97,9-314-1()34 Address: 134 Berkeley Road CONTRACTOR Name: Romain Strecker Phone: 7814,62-8702 Address: 10 C burr-bill Place,Lynn MA 01902 Supervisor's Construction License: 09,085 Exp. Date: 10/16/20,16 Home Improvement License: 16969$ Exp. Date: 7/27/2015 ARCHITECT/ENGINEERmean Spooner Phone: Address: 21 Drydock avenue,Boston IylA Reg. No. 50405 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000,00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F. Total Project Cast: $ $39,688 FEE: $ Check No.: °�{ Receipt No.: NOTE: Persons contracting with aturegrstered contractors do not have access to th guara Y fuat- i Signature of Agent/Owner - Signature of contractor " i—, rim O TH _t own of I ndover 0 " 0 No. 142 - 16 y 7 6s�� 0 LAKs h ver, ass, COC KICK'WICK �� S RATED UBOARD OF HEALTH 0 An Food/Kitchen wERMIT T L Septic System THIS CERTIFIES THAT ,,j ry BUILDING INSPECTOR ................. .... ....... ................. ...................................................... T ��LL Foundation has permission to erect .......................... buildings oA. ........... �. :..... ......!'r`:.r................... e Rough to be occupied as ..........5 ... ....' .... ... ....... &. .. .....W.............................................................. 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 16 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION A Rough Service ........................ ........ .. ................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired to Occupy Buildin 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. Next Step Living, Inc. CT HIC.0629266•MA OCABR#162111•RI Contractor Reg.#37185 HOME IMPROVEMENT Date of Contract: 03/24/2015 :: next step Living,. home energy solutions 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210 Customer(s)Name(s): Wayne Gendron Telephone:866-B67-8729•www.nextstepliving.com Customer(s)Street Address: 134 Berkeley Rd City: North Andover State: MA ZIP: 01845-5254 Customer(s)Home Phone#: Customer(s)Mobile Phone#: Permit(s)Required: Building&Electrical City/County Issuing Permit(s): North Andover Customer(s)jointly and severally agrees to purchase the products and/or services of Next Step Living,Inc.("Contractor")in accordance with the terms and conditions described on the front and reverse of this Home Improvement Agreement("Agreement')and the attached specification sheet(s).Customer(s) hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. ESTIMATED STARTING DATE: Wednesday,July 15,2015 ESTIMATED COMPLETION DATE: Wednesday,July 22,2015 TOTAL SOLAR SYSTEM PRICE: $39,687.17 PAYMENT METHOD:select option(s) ESTIMATED STATE REBATES: $0.00 HCash ®Credit Card SOLAR PURCHASE PRICE: $39,687.17 Check Financing ROOFING PURCHASE PRICE: $0.00 TOTAL PROJECT PURCHASE PRICE: $39,687.17 See Payment Certificate for payment schedule In certain circumstances,Customer(s)may agree to assign to Contractor the right to receive and retain the rebate(s)associated with ownership and use of the product(s)inconsideration of a reduction to the Total Price equal to the amount of the rebate. By signing below,Customer(s)hereby irrevocably assigns to Contractor the right to receive and retain such rebate.Owner agrees to provide all required support to receive the rebate. Amount $0.00 (Customer's Initials) I'm fine receiving autodialed and/or pre-recorded calls or text messages from or on behalf of Next Step Living to tell me about new products,sales or other events I may be interested in,and you can use any of the telephone numbers I have provided above. I understand my approval to receive these calls is not required for me to make a purchase. (Signature) Customer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing any of the terms of this Agreement.Customer(s)acknowledges that Customer(s)(1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two accompanying Notices of Cancellation,on the date first written above and(2)was orally informed of Customer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. NEXT STEP LIVING, INC. 03/24/2015 By: Todd Massicotte l � Print Name Lic.#(CT only) Signature Date CUSTOMER(S) 03/24/2015 Wayne Gendron Print Name Signature Date Print Name Signature Date YOU,THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ©BLLP2013.NSL.CTMARI LG-300-M18-IVD2927-DC1500-IRO-CCO-RN-TN-Green Sky Rebates:Unless Customer(s)has assigned its rights to Contractor,Customer(s)shall be entitled to receive and to claim any and all rebates and any other benefits associated with ownership and use of the product(s). Customer(s) shall have the sole responsibility of making any application for any such benefits. Contractor shall have no obligation and assumes no responsibility to apply for or collect any benefits on Customer's behalf nor has Contractor made any representation or warranty to Customer(s)with respect to Customer's eligibility to receive, or the value of, any such benefits, including any net metering credits or solar renewable energy certificates. In all cases, Customer(s) agrees to consult with the relevant governmental officials and Customer's professional tax preparer when evaluating Customer's eligibility for and the financial and tax consequences of receiving benefits.The Attachment includes a summary and estimate of the benefits that may be applicable to the product(s), plus the estimated net cost to Customer(s) after application of such financial incentives; contingent in each case upon Customer(s)receiving or being eligible to receive such benefits. Security Interest: Customer(s) agrees and understands that in the event that Customer(s) does not pay Contractor any of the money owed when it is due, Contractor may have a claim against Customer(s) that may be enforced against Customer's property in accordance with the applicable lien laws. Customer(s) also understands that if Customer(s) finances the work with Contractor or a third party, Customer's separately provided financing documents may include a security interest. Customer(s) understands that Customer(s) should read those documents closely. Miscellaneous:No waiver of any breach of this Agreement shall be construed as a waiver of any prior,concurrent,or subsequent breach hereof.The section headings contained in this Agreement are inserted for convenience only and shall not affect in any way the meaning or interpretation of this Agreement.In construing this Agreement,the gender and number of words used may be changed to meet the context. This Agreement shall be governed by and construed in accordance with the laws of the state in which it is performed,except as may be preempted by federal law.If a provision of this Agreement is held to be invalid or unenforceable,this Agreement shall continue in full force and effect and shall be construed as if the invalid or unenforceable provision was omitted.Customer(s)agrees that Contractor can assign any of Contractor's rights under this Agreement without Customer's consent and that the person to whom Contractor assigns this Agreement shall be entitled to all of Contractor's rights under this Agreement.The Purchase Price listed on the fi•ont of this Agreement includes all applicable sales tax and all governmental fees required for Contractor to perform this Agreement.To the extent any goods or material are not specifically listed in this Agreement but are necessary to complete the work,Contractor will select goods and materials of commercial grade(i.e.,of the grade,type,or condition,ordinarily or customarily used for such work),such selection being at the sole discretion of Contractor.Contractor may engage independent subcontractors to perform work under this Agreement. Five-Year Warranty:Contractor warrants its workmanship under this Agreement for a period of five(5)years.In the event of a valid claim, Contractor will repair or replace,at its option,and at its sole expense and at no cost to Customer(s),any defects in workmanship provided by Contractor or its subcontractors.Effective immediately upon Customer(s)making of the final payment under this Agreement,Contractor assigns to Customer(s),to the extent assignable,any and all manufacturer warranties covering the equipment and shall deliver copies of such warranties after its receipt of such final payment.No warranty will be effective while a balance due remains on this Agreement. Documents Incorporated by Reference: Specification Sheet(s),Notice of Cancellation CLASS ACTION WAIVER: Customer(s)agrees that Customer(s)will assert a dispute,claim,or controversy(hereafter referred to as a"Claim")arising under or relating to this Agreement only on behalf of Customer's own self and that Customer(s)will not assert a Claim on behalf of,or as a member of,a class or group in either an arbitration proceeding,a private attorney general action,or in any other forum or action.If a court determines that this specific paragraph is not fully enforceable,the court's determination shall be subject to appeal.This paragraph does not apply to any lawsuit or administrative proceeding filed against Contractor by a state or federal government agency even when such agency is seeking relief on behalf of a class of Customers. LG-300-M18-IVD2927-DC1500-IRO-CCO-RN-TN-Green Sky Next Step Living, Inc. CT HIC.0629266•MA CCABR#162111•RI Contractor Reg.#37185 NOTICEOF • next step living. home energy solutions 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210 Telephone:866-867-8729•www.nextstepliving.com The following Notice of Cancellation applies to all states. NOTICE OF CANCELLATION ' NOTICF NELLATI CON Date of Transaction:! 03/24/2015 1 E OCADate of Transaction: You may CANCEL this transaction,without any Penalty or Obligation,within You may CANCEL this transaction,without any Penalty or Obligation,within THREE BUSINESS DAYS from the above date.If you cancel,any property THREE BUSINESS DAYS from the above date.If you cancel,any property traded in,any payments made by you under the Contract or Sale,and any itraded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed by you will be returned within TEN negotiable instrument executed by you will be returned within TEN BUSINESS DAYS following receipt by the Seller of your cancellation notice, BUSINESS DAYS following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be canceled.If land any security interest arising out of the transaction will be canceled.If you cancel,you must make available to the Seller at your residence,in ,you cancel,you must make available to the Seller at your residence,in substantially as good condition as when received,any goods delivered to substantially as good condition as when received,any goods delivered to you under this Contract or Sale;or you may,if you wish,comply with the iyou under this Contract or Sale;or you may,if you wish,comply with the instructions of the Seller regarding the return shipment of the goods at the .instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make the goods available to the Seller Seller's expense and risk.if you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your land the Seller does not pick them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of the goods without any iNotice of Cancellation,you may retain or dispose of the goods without any further obligation.If you fail to make the goods available to the Seller,or if Ifurther obligation.If you fail to make the goods available to the Seller,or if you agree to return the goods to the Seller and fail to do so,then you you agree to return the goods to the Seller and fail to do so,then your remain liable for performance of all obligations under the Contract.To 'remain liable for performance of all obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of this I cancel this transaction,mail or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram,to Next cancellation notice or any other written notice,or send a telegram,to Next Step Living,Inc.,at 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 'Step Living,Inc.,at 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210, 03/27/2015 102210, NOT LATER THAN MIDNIGHT OF (Date) INOT LATER THAN MIDNIGHT OF (Date) I HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION. Consumer's Signature Date Consumer's Signature Date ------------------------------------------------------------------- In addition to the above notice, the following Notice of Cancellation -----_ _ _ _ _ q flies to Rhode_Island_customers. _ _ _ _ ------------ - _________ NOTICE OF CANCELLATION T- NOTICE OFCANCELLATION - Date of Transaction: I Date of Transaction: You may cancel this transaction,without any penalty or obligation,within iYou may cancel this transaction,without any penalty or obligation,within three(3)business days from the above date.If you cancel,your cancellationthree(3)business days from the above date.If you cancel,your cancellation notice must state that you do not wish to be bound by the agreement and notice must state that you do not wish to be bound by the agreement and mailed by registered or certified mail not later than midnight three(3)days Imailed by registered or certified mail not later than midnight three(3)days following the buyer's signing the agreement,excluding Sunday and any 'following the buyer's signing the agreement,excluding Sunday and any holiday on which regular mail deliveries are not made.All cancellations holiday on which regular mail deliveries are not made.All cancellations must be mailed to:Next Step Living,Inc.,at 21 Drydock Avenue,2nd Floor, must be mailed to:Next Step Living,Inc.,at 21 Drydock Avenue,2nd Floor, Boston,Massachusetts 02210. 'Boston,Massachusetts 02210. 1 HEREBY CANCEL THIS TRANSACTION. I I HEREBY CANCEL THIS TRANSACTION. Consumer's Signature Date Consumer's Signature Date ----------------------------------L above-signed individuals acknowledge receipt of the above Notices of Cancellation,with all blank lines filled in,and further acknowledge that they were orally informed of their right to cancel this transaction. Wayne Gendron Print Nayr1/ 03/24/2015 Print Name SignatureDateDate Signature Date LG-300-M18-IVD2927-DC1500-IRO-CCO-RN-TN-Green Sky OWNER'S AUTHORIZATION FORM For Permit Application(s) The sole purpose of this form is to provide Next Step Living with the Necessary permission from the Owner to file Permit Application(s)for such Project work as agreed upon between the Owner and the Owner's Authorized Company and its designated subcontractors. Wayne & Robin Gendron Owner's Name: Solar Project Address: 134 Berkeley Rd. North Andover, Ma 01845 Signatur0 4�Z7— Owner's Authorized Company: Next Step Living Inc. Company's Address: 21 Dry Dock Avenue South Boston,MA 02210 Affiliation: Contractor Applicable License: HIC#162111 State: MA I Wayne Gendron Residence Solar Panel Installation 134 Berkeley Road North Andover, MA 01845 Page 2 Thermal Factor Ct., 1.0 Existing condition (Warm Roof) 1.1 With panels(Cold Roof) Design Snow Loads: 35 PSF(Existing—Unobstructed Warm Roof) 25.68 PSF(New Condition—Slippery Surface on Cold Roof) Basic Wind Speed: 100 MPH from Table R301.2(4) Importance Factor: 1.0 Exposure: B Analysis Results General The proposed solar panels impose a total weight of approximately 3 pounds per square foot(PSF) on the roof surface.The International Residential Building Code allows up to two(2) roof coverings on a residential dwelling. Each roofing layer of asphalt shingles imposes a dead load of 2.5 to 3.0(PSF) on the roof. Because the existing roof has only one layer of shingles,the code allows a second layer to be added without analysis.The weight of the second layer of shingles is approximately the same as the solar panels which will be installed instead of the second layer of shingles. Solar panels are considered a slippery surface and are mounted a small distance above the existing roof. Therefore,one would be cautious in considering a thermal factor,Ct, of 1.1,treating the panel surface as a cold roof, rather than a warm roof.After considering the roof slope factor,Cs,from figure 7-2,ASCE 7-10,the snow load is reduced by 27%for the main roof compared with the snow loading on the existing shingled roof,which is not considered a slippery surface.The reduction in snow load due to this consideration is about 9.32 PSF for the main roof,which essentially offsets the weight of the solar panels. Gravity Loading: 4 Although the addition of solar panels results in a net reduction in the overall loading,the existing rafters are overstressed.As such,we recommend that a 2 x 6 collar tie be added at every set of rafters.The collar ties should be at least eight(8)feet long,cut flush to the roof sheathing,and shall be fastened to each existing rafter with a minimum of 5—16d nails OR 5 Ledger Lock screws as manufactured by Fasten Master. The panels will be installed using Unirac Solar Mount rails with L-brackets in a portrait configuration with a rail toward the top and bottom of each panel edge.The L-brackets will be fastened directly to the roof rafters with 5/16"diameter lag screws.The fastener layout shall start near each corner and for portrait orientation shall have a maximum spacing of 54"on center parallel to the roof slope and 32"on center perpendicular to the slope(e.g.,every other rafter). Each 5/16"diameter lag screw shall have a minimum of 2.5"thread penetration into the existing rafter. I i i i i i Wayne Gendron Residence Solar Panel installation 134 Berkeley Road North Andover,MA 01845 Page 2 Thermal Factor Ct: 1.0 Existing condition(Warm Roof) 1.1 With panels(Cold Roof) Design Snow Loads: 35 PSF(Existing—Unobstructed Warm Roof) 25.68 PSF(New Condition—Slippery Surface on Cold Roof) Basic Wind Speed: 100 MPH from Table R301.2(4) Importance Factor: 1.0 Exposure: B J Analysis Results General The proposed solar panels impose a total weight of approximately 3 pounds per square foot(PSF) on the roof surface.The International Residential Building Code allows up to two (2)roof coverings on a residential dwelling. Each roofing layer of asphalt shingles imposes a dead load of 2.5 to 3.0(PSF) on the roof. Because the existing roof has only one layer of shingles,the code allows a second layer to be added without analysis.The weight of the second layer of shingles is approximateiy the same as the solar panels which will be installed instead of the second layer of shingles. i Solar panels are considered a slippery surface and are mounted a small distance above the existing roof. Therefore,one would be cautious in considering a thermal factor, Ct,of 1.1,treating the panel surface as a cold roof, rather than a warm roof.After considering the roof slope factor,Cs,from figure 7-2,ASCE 7-10,the snow load is reduced by 27%for the main roof compared with the snow loading on the � existing shingled roof,which is not considered a slippery surface.The reduction in snow load due to this consideration is about 9.32 PSF for the main roof,which essentially offsets the weight of the solar panels. i Gravity Loading: i } Although the addition of solar.panels results in a net reduction in the overall loading,the existing rafters are overstressed.As such,we recommend that a 2 x 6 collar tie be added at every set of rafters.The collar ties should be at least eight(8)feet long,cut flush to the roof sheathing,and shall be fastened to each existing rafter with a minimum of 5—16d nails OR 5 Ledger Lock screws as manufactured by Fasten Master. The panels will be installed using Unirac Solar Mount rails with L-brackets in a portrait configuration with a rail toward the top and bottom of each panel edge.The L-brackets will be fastened directly to the roof rafters with 5/16"diameter lag screws.The fastener layout shall start near each corner and for portrait orientation shall have a maximum spacing of 54"on center parallel to the roof slope and 32"on center perpendicular to the slope(e.g.,every other rafter). Each 5/16" diameter lag screw shall have a r minimum of 2.5"thread penetration into the existing rafter. i i i Wayne Gendron Residence Solar Panel Installation 134 Berkeley Road North Andover,MA 01845 Page 3 It is also important that the L-bracket attachment locations be staggered between adjacent rails so that no single rafter supports more load than under the existing conditions Wind Loading: Provided the leveling feet attachments to the roof are made in a typical staggered pattern,the overall wind loading imposed on the structure will not be impacted to any great extent.The net wind loads imposed on the roof framing will be less than the current loading with an attachment spacing described above. Conclusions: Our evaluation of the proposed solar-electric installation has established that the framing is NOT adequate to support the addition of the solar panels to the existing roof as indicated on the Solar PV plans without strengthening the structure as previously discussed herein.Once the roof framing is reinforced, it will be adequate to support the solar panels.We have only reviewed the adequacy of the connection to the existing rafters and the capacity of the existing rafters to support the vertical and lateral loads from the solar electric system.We do not take responsibility for any other portion of the solar panel array support system,the existing roof framing construction,or the integrity of the structure i as a whole. ' Do not hesitate to contact my office at 866-867-8729 should you have any questions or if you require any additional information. Respectfully, Next Step Living, Inc. 11 Dean MA Prof. Eng. License#50405 i i i i I ELECTRICAL DESIGN 0 � PV MODULE RATINGS 0 STC SOURCE COMBINER RATINGS INVERTER RATINGS d• _0 o Temperatures INVERTER MODEL:Enphase Microinverter C14 (D Z MODULE MANUFACTURER: LG Average High:28`C MAX OCPD RATING(A):20 MODEL:M250-Bo-2LL-S22 v' () - MODULE MODEL#:LG30ON1C-A3 Record Low:-29'C OCPD AMPERAGE RATING(A):20 MAX DC VOLT RATING(V):48 C a) W LO OPEN-CIRCUIT VOLTAGE(Voc): 39.80 OCPD VOLTAGE RATING(V):240 MAX POWER @ 40°C(VV):250 �,N OPERATING VOLTAGE(Vmp): 32.0 NOMINAL AC VOLTAGE(V):240 W03 a) L9 CO NOMINAL ACCURRENT(A):1.0A , a) LO OPERATING CURRENT(Imp): Y rt ( p)' 9.40 2 x#10 THWN-2 Wire BLACK MAX BRANCH AC CURRENT(A):9A/9A J ap , SHORT-CIRCUIT CURRENT(isc):9.98 2 x#10 THWN-2 Wire RED MAX BRANCH OCPD CURRENT(A):20A z MAXIMUM POWER(W}:300 zm 2 x#10 THWN-2 WHITE tu Voc TEMP COEFF(mV or°loJ°C)=-0.29%/°C Ii r z M Q00 1 x#6 THWN-2 EGC 1 a L2 ISG=0.04%/°C 2oA N = L 1"EMT INDOORS Z a) • tI! 7 WIRES -----------------------------------------------------------•: _ — >= oa a) p d o « PV LOAD U) Z p ----------------------• i W Q : First End-Fed Branch of -M215 Inverters 2 T.W of 0 Pawl.connected 1.AC LG199NiC- <Ircultbpneh LCOOONiC- LC300N1C- LC900N'IC- A3 M1i.fdmum output Wt-1—t A3 A9 ° Al _ ��•( o.9a rm.Por p.nPt i J-box 95A E c V EnPh.v° EnPh.00 Enpiww En.Ph..o « iL � -----------------------------_____________________ 21 --------...... ._...._..._. 2LL '_••••_••••••••-••••: CU co Second End-Fed Branch of 9-M215 Inverters p Co oblof�p.n.4<.nn.ct.a In AC � I L°SOONIG cirPultbmnch LG900N16 LG300NiG LG900NiG• « AO M..immn"'Tut twit O t py 0.9A rmp.rpan.i LGate EnPb...' Enph.se EnphOw _ EnOMSP 120 � X4 ••_________________________________________________ 2LL _----- --_--_____ 2LL ••••_..__..•.._.__._.. 2LL .. _.••_..._.. ' « L U) J rt NOTE:A GEC(grounding electrode conductor)is INSIDE M X required only for M215-60-21-L.It is not required FUSED AC ENVOY COMMUNICATIONS DISCONNECT for M215-60-2LL-IG GATEWAY 60A 240V z I 2SALTS L2 Li TN ETHERN CONNECTION TO BROADBAND ROUTER 120 VAC POWER CABLE i Symbol Conventions: /OUTSIDE AC 100A) ) 1 x#6 THHN Wire BLACK DISCONNECT 2-Pole I-ICensed Electrician ssu s All Responsibility For 1 x#6 THHN-Wire RED 30A 240V 100A Circuit Breaker n . Bite O d;1=C r and Executing 1 x#6 THHN-Wire WHITE MSP _ e ? l a I Installatio iD ccord n e wi ly NEC 21014 Odes 1 x#6 THWN-2 EGC UL Ei o;o Fuse 1"EMT INDOORS 4 WIRES -_ Visible Break AC DISCONNECT RATINGS CONDUIT SIZING SERVICE PANEL RATINGS o!o Knife Switch i......................•----•----•--- �° 1"PVC OUTDOOR MEP BRAND:I-T-E DISCONNECT AMP RATING(A):30 1"EMT INDOOR BUS AMP RATING(A):200 DISCONNECT VOLT RATING(V):240 SERVICE VOLTAGE(V):240 A ................... Equipment NEMA 3R MAIN AMP RATING :200 Grounding BREAKER RATING(A):NA Conductor Drawn by:H-Menkani ARRAY DESIGN / SITE DIAGRAM HEIGHT OF HOUSE PANEL ORIENTATION (TRUE) ROOF PITCH (DEGREES) 240" 215° 30` Lh DRIVEWAY N 2 o N Z Microinverter System W ca a) "o gQ z a, mc) co z E o co 210 1A -UTILITY METER z W H AC DISCONNECT 3 to pL o > W M -p O LGATE 120 'PROPOSED CONDUIT RUN, � W = 'a c = ELECT I I LL FIELD VERI 0 Ix 0 Q Q CL 'FINISHED IC��� I c: E c: o 1411- .03 4 1211 C) Co t6 Quick Mount PV 4-a �1 Cn -2-(17.33)'- LL a N Portrait Total's .0 — IV 1 X14)• o Total#of Panels: 18 �— W 00U) CU Total#of Splice Bars: 2 O 114) Total#of Bonding Jumpers:2 C C O Total#End Clamps: 12 O O U) (a) Total#of Mid-Clamps: 30 z e 246" PLACE PV LOAD CENTER OUTSIDE TO THE LEFT OF g E <--3s.o5° -> TILITY METER, T!HE CUSTOMER IS RESPONSIBLE FOR MOVING OBSTRUCTIONS 1' FR VILC ILCTI *—ARRAY LAYOUT!S NOT TO _ALEa PLACE ENVOY MONITORING EQUIPMENT I_ O THE LEFT OF L Quick Mount PV Solar Flashings THE MIs ELECTRICAL PANEL will be used on every roof penetration Customer Signature: Date: TYPICAL ATTACHMENT DETAILS –T=iS EDGE TOWARDS ROOF;JDCE — /--RACKING COMPO�IEVS ,I NCTINCLUDEC DECRIFICN kr),1UCK,OAS A3611 NT AL MU §. £G....S @ P 41 V"1it PTIM ,W S . pull-out f'withdrawal)capacities . be Lag Bolt Specifications Gpevi#`r Gra�tg ` 511Ti`shaft per 3"thread depth 5TI6"s of per s' read depth I Douglas Fir,Larch -50 798 266 Douqias Fir South 5 705 235 Enw1mann•3p jce,L0G'gepo4e Fire WSR 1650f higher; .465 l 705 235 ;err. Fir _ 3 336 212 Fleur,Fir`N th 705 235 Southern;Pine i .55 921 307 Spruce, Pine, 2 615 2015 Sprice,Fine,Err iE of 2 millian ps and higher grades of&4SR and MEL) '50 798 266 NG Next Step Living Inc. Quick Mount ORTF R I EE I 3 HMENT QMSE-LAG:QMPV E-MOUNT SE i lG— _exts teo Module and Roof [i °,' n"rn. .n er_g` -siol u0n Attachment Detail WITH LAG BOLT ELECTRICAL DESIGN r O C PV MODULE RATINGS 0 STC SOURCE COMBINER RATINGS INVERTER RATINGS d - Temperatures INVERTER MODEL:Enphase Microinverter tV Z MODULE MANUFACTURER: LG Average High:28'C MAX OCPD RATING(A):20 MODEL:M250-60-2LL-S22 4 (5 .6 MODULE MODEL#:LG300N1C-A3 Record Low:-29'C OCPD AMPERAGE RATING(A):20 MAX DC VOLT RATING{10:48 c c It MAX POWER @ 40°C(W):250 � OPEN-CIRCUIT VOLTAGE(Voc): 39.80 OCPD VOLTAGE RATING(V):240 NOMINAL AC vOLTAGE(�:240 W ca >'ten, OPERATING VOLTAGE(Vmp): 32.0 NOMINAL AC CURRENT(A):1.OA IX CD OPERATING CURRENT(Imp): 9.40 2 x#10 THWN-2 Wire BLACK MAX BRANCH AC CURRENT(A):9At9A ' SHORT-CIRCUIT CURRENT(Isc):9.98 2 x#10 THWN-2 Wire RED MAX BRANCH OCPD CURRENT(A):20A Z E m o co MAXIMUM POWER(W):300 2 x#10 THWN-2 WHITE Voc TEMP COEFF(mV or°l°(°C}=-0.29°k(°G r Z Q 1 x#6 THWN-2 EGC 2oA L2 N = 2 _Col Isc=0.04°lot°G 1 L 1"EMT INDOORS 1 -• O m U) >= 7 WIRES ---------------------------------------------------- C — of N p as > 0 PV LOAD ------------ I L W c ® � t, aa First End-Fed Branch of -M215 Inverters a i Total ot9 P-M.mnnect°d In AC : LA__ Lp00N+G lbranch LG100N+C- L°900N+F LGSOONiC- MPtimOmotttpM Wit currantC13 0 a9aPa.penal : J-box EnPtuw EnPhew Ermhaw•, EnPtmw L . 2LL ________ ____----- - -------------_________ 2LL -.-.-.-------.---_---_ VJ m Second End-Fed Branch of 0--M215 Inverters F .> ®v CU oral of 9 paneNconmct°d MAC L0300NiC- circul[btanM L°]OON+C- LG]OON+P L°]O9N+C- . [ P3 MatdmOm ouipottaoitcu"ent A] € 0.9A nna p.,W.1 : E LGate ^, EnPhaw EnPhwa EnPhaw Enphew 120 W 2LL ••------------------------------------------------- 2LL --------------------- CIO 2LL _..._..___.___________ 2LL •_.________________. ` V1 4—i NOTE:A GEC(grounding electrode conductor)is ' INSIDE M X required only for M215-60-2LL.It is not required FUSED AC for M215-60-2LL-IG ENVOY COMMUNICATIONS DISCONNECT z GATEWAY 60A 240V 25AMP N L2 L+ ETHERN CONNECTION TO BROADBAND ROUTER 120 VAC POWER T� Symbol conventions: CABLE OUTSIDE AC toaA) ) ' 1 x#6 THHN-Wire BLACK DISCONNECT 2-Pole Licensed Electrician Assumes AllResponsibilityi=on —� 1 x#6 THHN-Wire RED 30A?240V 100a - Circuit Breaker . °• — L360 Onsite OCEtIOa,S EX tin1 z#6THHN-Wire WHITE MSP Installation in Accordance it t NEC 2014("odes 1 x#6 THWN-2 EGG �o Fuse 1"EMT INDOORS lJ 4 WIRES i Visible Break AC DISCONNECT RATINGS CONDUIT SIZING SERVICE PANEL RATINGS Knife Switch P/P 1"PVC OUTDOOR MEP BRAND:I-T-E I------------------------------------ .-. DISCONNECT AMP RATING(A):30 1"EMT INDOOR BUS AMP RATING(A):200 DISCONNECT VOLT RATING(V):240 SERVICE VOLTAGE(V):240 ----------------- Equipment NEMA 3R MAIN AMP RATING(A):200 Grounding BREAKER RATING(A):NA Conductor = Drawn by:H-Menkari ARRAY DESIGN / SITE DIAGRAM HEIGHT OF HOUSE PANEL ORIENTATION (TRUE) ROOF PITCH (DEGREES) 240" 215° 300 DRIVEWAY o N 2 -c O N vZ I Iq 0 MicroinVSystem r W >' N N ca co N tC? O t� d m 9r� Z E O (y) UTILITY METER O m in AC DISCONNECT = to C > ei LGATE 120 > w a o —PROPOSFD CONDUff RUN, LU 'a Q a ELECTRICIAN MLL FIELD FUF *** 'FINISHED ATTIC E c: co O 14" 12" � > •- 2 g„ Quick Mount PV J (n 2{17.33)` Portrait Total's IfV 1 t14>' o Total#of Panels: 18L- c 00 Total#of Splice Bars: 2 • Total#of Bonding Jumpers:2 -7-16 , Total#End Clamps: 12 Total#of Mid-Clamps: 30 z .4-246"- ' CE PV LOAD CENTER OUTSIDE TO THE LEFT OP THE UTILIrf METER, THE (_'OUSTOMER IS RESPONSIBLE FOR MOVING OBSTRUCTIONS 1' FROM PVILC.. LOC TION; - **A.RRAY LAYOUT IS NOT TO in Qj CE EMONITORING EQUIPME T T THE LEFT F SCALE � CDCD Quick Mount PV Solar Flashings THE MAIN ELECTRICAL PANEL will be used on every roof penetration Customer Signature: Date: TYPICAL ATTACHMENT DETAILS =15 EDGE TGOV ARDS ROCF RaDGE /—RACKING`OMPO E'�M 4 'ON-M,CLASSIC.AXI CAY AL.1.41L t � LUG SEALING.. t`'lot,ETIA i , ss -- - 2 1 til Lag • typical lumber- LagBolt SDeeificabons - - Spezifi:Gravity 5/16'shaft Der 3"thread depth 116"s aft par 1"thread slept j i Douglas Er:Lar - 50 E 256 Douglas Fir.South 705 235 Er lr^arn Sp-uce.Lo gepole Parse WS 1 E_50 f higher) . 6 7 I 235 Hem, Fir 43 1 Hers,Fir3North '46 715 235 Sostern Pine 92; -1)7 Spruce, Fire.it � -42615 I 205 Spruce, rine.Fir E of 2 milt€ar ps and h; ,.,e-grades of MSR aid MEL) '50 7982'S "*SEE ENGINEERING Next Step Living Inc. Quick Mount PV REPORT FOR T`ACHMENT, n.ext SmLep 1, i Module and Roof QMSE-LAG:QMPV E-MOUNT ome 3, ; Attachment Detail WITH LAG BOLT http://www.readyshare.com/Users/cbateman@rstcenterprises-comlUpl o... jdPM%�A Now Available,!, 1r�alaDeck, it � �� I,,,;i 9,,,,,, S 'Di 7 i II FLASHED PV ROOF-MOUNT COMBINERANCLOSURE I Basic Features Stamped Seamless Construction 18 Gauge Galvanized Steel �` ,� Powder Coated Surfaces Flashes Into the Roof Deck Law Profile- 2.625" Deep 3 Roof Deck Knockouts .5", .75", 1" 5 Centering Dimples for entry/exit of SOIaDeckkbdel 0783-41 fittings or conduit 2 Position Ground Lug Installed Mounting Hardware Included Roofing Industry Approved �Grei i �� �� l�0,'U a,°J Vryn mgiru uaiu�tqu78rlll�WPI mr�, rG'�, t � c `",` r v a r, � d , �,,, �ni,� � i � ,, � �� 1„� °� 1���� �1,�u ISH ��� ��m ,�� u�r,�n,�,,� ,,, � '- ' 1 J;o M W VV VV. C 0 M M 1)E C Via„ COv SolaDeck UL50 Type 3R Enclosures All the basic features listed above, ideal for pass through wiring. Transition to house wire is simple, clean and contained in the flashed enclosure. UL50 Type 3R Models: f � Model 0783 - (3" Fixed Din Rail) Model 0786-(6" Slotted Din Rail) �frf 1 of 11/18/2009 1:39 PM http://www.readyshare.corn/Users/cbatenian c@i rstcenterprises-conifUplo... �ii�u""� �" ISP. �Iulilluuu PV negative combined with Power Block �art�t�1784�8 �2n, irf,; 17n�+ r .,k Parl '1440 tum F4�lrs 1, FyBrl�'142 � II ,u�i ,I�i� I�„u� SolaDeck Model 0786-41 111E��'���'�mu�l ETL listed UL STD 1741 Combiner/Enclosure ik 'a¢�Buy&;t�PtlatFh98Shown: with 4 strings with UL Recognized ` Fuse Holders for PV Positive �%�'�i�`a �� ER 10 Terminal Blocks for PV Negative �ail,,,n�� ESC"Nbrn`maa� l°"� Fuses combined with Positive Bus Bar °°°j �rA lafn� ER 10 Terminal Blocks combined using Negative Bus Bar �� ru �II '(*�' Jy� `✓l,,tYaj. L , Accessory rl"I'ai i s Now1 ' I r �r� '� �1(� raw Ij�I ai �„i,� :�U °"r,�� 1�i) r 6/6 ruy {�I)�n�i V 1��� ,v� �I +,iv 4 String kit for SolaDeck Model 0783-41 (Part#0783K) Includes: 4-Midget Fuse Holders Rail Mount(Part#1452) 1 - Power Block(Part#1440) 1 - Bus Bar for Fuse Holders(Part#078466) 4 String kit for SolaDeck Model 0786-41 (Part#0786K) Includes: 4-Midget Fuse Holders Rail Mount(Part#1452) 4-ER 10 Rail Mount Terminal Blocks(Part#1451) 1 -Bus Bar for Fuse Holders ( Part#0784BB 1 -Bus Bar for ER 10 Terminal Blocks (Part#0785BB) 1 - ER 10 End Plate Cover(Part#1453) 3 of4 11/18/2009 1:39 PM Classic Composition Mount I AMSC THIS EDGE TOWARDSRACKING COMPONENTS 2.50 ROOF RIDGE I Na ���—NOT INCLUDED II 1 II 'I 5 6 = '1 8 5 7 4 1200. 3 1.50 2 3.00 1 ITEM DESCRIPTION QTY. 6.00 1 FLASHING,12"X 12"X.050",5052,MILL 1 12.00 2 QBLOCK,CLASSIC,A360.1 CAST AL,MILL 1 3 HANGER BOLT,PLAIN CENTER,5/16"x 6",18-8 SS 1 F= _- t; 4 WASHER,SEALING, 5/16"ID X 3/4"OD,EPDM BONDED SS 1 5 NUT,HEX,5/16-18,UNC-26, 18-8 SS 2 6 WASHER,FLAT,19/64"ID x 7/8"OD x 1/8" EPDM 1 1.30 7 WASHER,FENDER,5/16"ID X 1"OD,18-8 SS 1 _ 8 WASHER,SPLIT-LOCK,5/16"ID,18-8 SS 1 (wick Mount PV` 3.00 TITLE: AMSC: CLASSIC COMPOSITION MOUNT AVAILABLE IN MILL,CLEAR ANODIZED, AND BRONZE ANODIZED FINISHES. UNLESS OTHERWISE SPECIFIED: SIZE DRAWN BY: RAD REV DIMENSIONS AREININCHES _. L TOLERANCES: A DATE: 7/23/2013 6 _. _.._. FRACTIONAL.1/8 ttOruUMAND M11FIDFN11A1TVlO PIACEDECIMAL 5.5.118 ,'nvmo mxOMl Mmes PrF�,ssOIOFQ� KKMOWrt PVV�o®KMWNf Pv.arm Re=RooucrroF+n PAxr OR As DO NOT SCALE DRAWING THREE PLACE SCALE:1:4 WEIGHT:1.24 _5 4 3 2 SHEETI OF1 DECIMAL 25 1 • • typical Lag Bolt Specifications Specific Gravity 5/16"shaft per 3"thread depth 5/16"shaft per 1"thread depth Douglas Fir,Larch .50 798 266 Douglas Fir,South .46 705 235 Engelmann Spruce,Lodgepole Pine(MSR 1650 f&higher) .46 705 235 Hem,Fir .43 636. 212 Hem,Fir(North) .46 705. 235 Southern Pine .55 921 307 Spruce,Pine,Fir .42 615 205 Spruce,Pine,Fir(E of 2 million psi and higher grades of MSR and MEL) .50 798 266 Sources:American Wood Council,NDS 2005,Table 11.2 A,11.3.2 A Notes: 1)Thread must be embedded in a rafter or other structural roof member. 2)See NDS Table 11.5.1C for required edge distances. quick Mount PV; RESPECT THE ROOF BI 7.2.3-7 Apr-2014,Rev 6 Reference and Tips Proper Flashing Placement y 'w , X14 ! N M I M 1 I i Additional tips and information for installing mounts: is See Classic Composition Mount install and Quick Tips videos on nail removal,bolt prep,and more at: www.quickmountpv.com/support/videos.html ® It is not necessary or advisable to use nails or other fasteners to secure the perimeter of the flashing. ® The Classic Composition Mount is made to work with standard and high-definition composition/ asphalt and wood shingle roofs with 5"to 5-5/8"courses. If the exposed surface of the course exceeds this measurement you may need to use our Classic Shake Mount instead. Depending on the season and climate,size and location of seal tabs,and quality of the shingles, the seal tabs that adhere the shingle courses together may not effectively seal the shingles to the flashings.If this is the case,simply add several quarter-sized dabs of manufacturer accepted sealant or asphalt roofing cement,meeting ASTM D 4586 Type II,between the flashing and the shingle above. ® Mounts should not be installed in areas of the roof susceptible to ice damming.Water ponding under the shingles can reach the bolt penetration. Take care not to damage the roofing material while working on the roof.Removing stone granules and deforming the shingles in any way can shorten the lifespan of the roofing.The value of the solar array is directly affected by the condition of the roof it is attached to. BI 7,2,3-7 Apr-2014,Rev 6 S U N POWE R E20/327 SOLAR PANEL 20% EFFICIENCY (" SunPower E20 panels are the highest ` efficiency panels on the market today, S E R I E S providing more power in the same amount of space MAXIMUM SYSTEM OUTPUT Comprehensive inverter compatibility ensures that customers can pair the highest- efficiency panels with the highest-efficiency inverters, maximizing system output REDUCED INSTALLATION COST More power per panel means fewer panels per install. This saves both time and money. RELIABLE AND ROBUST DESIGN SunPower's unique MaxeonT''"cell THE WORLD'S STANDARD FOR SOLAR'm technology and advanced module SunPower' E20 Solar Panels provide today's highest efficiency and design ensure industry-leading reliability performance. Powered by SunPower Maxeon'cell technology, the E20 series provides panel conversion efficiencies of up to 20.1%. The E20's low voltage temperature coefficient, anti-reflective glass and exceptional low-light performance attributes provide outstanding energy delivery per peak power watt. SUNPOWER'S HIGH EFFICIENCY ADVANTAGE 20% 15% 10/o 5% _ e THIN FILM CONVENTIONAL IV P MAXECIN' CELL sERIFs SFRiEs sFRIEs TECHNOLOGY sunpowr orp.com Patented all-back-contact solar cell, providing the industry's highest efficiency and reliability C@qg LG Life's Good LGElectronics,Inc.(Korea Exchange:0aasr.KS) isone of the globally leading companies and technology innovator for electronics,information and communicativnproducts.LGElectronics currently employs more than pl80Opeople worldwide in1l7companies.|ofiscal year znl1a turnover,f*o,97billion USD has been achieved, LGisone o[the world's largest manufacturers of mobile phones,flat screen TVs,air conditioners, washing machines and refrigerators,/oah/me' oriented company,L6relies vnthe technology o[renewable energies and isexpanding it.The entire range u[high quality solar products are being manufactured inLGsleading production site Korea. o&US ��r s !"MY/ NOV11101,11 Fligh Efficient Cell Technology Reliable Warranties Dhvenby �sown N�ype�chno|vg«�shigh' ussmn��hyi�,pmduu��i,h�heuougNo{a dhdeo,ymndv|r,wi||pmwdemsmmeowhhh|gh global corporation and sterling warranty policies. e(oo^micbenehu. Together with a|nyear product warranty azsyear linear perforrnanowarranty is offered. 100%ELTestCompleted �sitke��v�le�m� � AULsmudu|e,a�trstcdatva,ivu,,�ge,ofthe Lmpmvides'igomu"qoa|i�teming/om|a,modules � � �1�� production ���`' ma`m�cuuumeavkhruac power outputs u~" ELin�euunde�cuoadoo^�enbythe na�d —F", "faUnodules,will)apositive nmnina|^olemice *r. °~^'=^°- ,mui^gato%, | Light and Robust Q 11 Comvemient|nstaflatior | With aweight o(just 1o.okg,LGmodu|esare uomodules are carefully designed mhelp inua||cn nmv nwdemvnstmtevutstandmgdumbi|ity benefit homquick and easy installations thmunhout against external pressure upmm0VPa. carrying,grounding,and connecting stages uf moou|eS, Enphase Microinverters Enphase@M250 I'll ON, / �i !-1',Illl"IIIfllVlll Yl i,'i'91 V+vl1kG"':'i✓Ilfi/ / YIJY '�.'ffffffIIII////////iG'r/��AI{IIAIl//G PId(D//I/I/IlilY,llYIA'1lAl]pYIITAYBfIN�IIIYdpI/fllllrXtll lA fNl/4 1HIY'IO Ni fll /b f1//nMGILY '/IIIIM III R!1111/llilll'ifllAl//J//1111//hill AfN(rlllA!INTIAFIII!!l l,flll Ydf 1/I/1//i/JG101O�d/2/U/Gr,VNYIGIfIG➢LY/Rllllllll!!!!d(r(IIIIIRl(/(M/Y//YIIYIIQIIYIFNIUIIIIMRAY/IAi/dJLDAI/hl/LLL//////i0/i✓',"`,/l////OJi�m dd7�/G dlfill/IIAIIYIIlOG 29U?I N<NIA/PiJYf/1i91f1R1l kMfJNI IH�I.I/ ! i The ... o. �;�,,, improves energy harvest, increases reliability, and dramatically simplifies design, installation, and management of solar power systems. The Enphase System includes the microinverter, the Envoy Communications Gateway,"and Enlighten® Enphase's monitoring and analysis software. ':r"Lhi//11111%l%//IIIIIIIIIIIIIIIIIIIIIIIIII1ll1'Allil'f[rllllllll l'11111111111A I "all'IIY/%N///Gffa////1i11%Alllllf/?N/!.///?II AN/IIII(11<LfIt�J/A/Ill//PI/N///// I 1 fi 1l/I ' ll/l((((((Rr///(INkRillllll!lIIINIiIIIIIIIffAillfi11111Y,'NRllillllllllllllllllll!/!N!N!((fIIIIIIIA'hf+lliflG/11/,/f.fll / 00/LXfGI/dlPf N//ll'Nl�ln fillflll011G�1NP00fOlW!(!(IIIRlAnIAd/QJ1G/0/VI(G@Vll@PIIINN(l dll/RGgMI d1'OAIIYP!!lY/li//Y//l/III!!!!(AIYRlllllllli&IR///Alf?////GPImINJ/////Hd/lll(R(III(NMII/tlllllll/ pp��;r� �V.f �V"°'.',h 0 D �U '+,;n��j 11V�lf;� e,�,� f kfj, A R T -Optimised for higher-power modules Quick and simple design, installation, -Maximises energy production and management -Minimises impact of shading,dust,and debris -24/7 monitoring and analysis R E 111 A B L E SAFE -4th-generation product -Extra low-voltage DC reduces fire risk -More than one million hours of testing -No single point of system failure -System availability greater than 99.8% -Easy installation with Engage Cable enphase- �' °° E N E R G Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of`Investigations 1 Congress Street, Suite 100 Z Boston, MA 02114-2017 `" www.mass. ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriicians/Plumbers Applicant Information Please Print Legibly Norrie (Business/OrganizationThe Boston Solar Companyllndividual): _ Address: 10 Churchill Place City/State/Zip:Lynn, MA 01902 Phone #:517-858-1645 Are you an employer? Check the appropriate box: Type of project(required): 1.Al I am a employer with 20 4. ❑ I am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 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 workingfor me in an capacity. employees and have workers' y9. ❑ Building addition [No workers' comp.insurance camp. insurance. 5. ❑ We are a corporation and its 10.[:] Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions right of exemption per MGL myself. [No workers comp. 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no solar employees. [No workers' 13.[� Other camp, 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. tContractors 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. #:EWGCCO00153815 Expiration Date: 1/14/2016 Job Site Address: 134 Berkeley head City/State/Zip: Nortli Andover MA 01845 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 forni of a STOP WORK ORDER and a fine of tip 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 undeelains and penalties of peijiny that the information provided above is true and correct. ............. Si iature: Dat e: 5121/2015 Phone#: 8178581645 Offi=cial use only. Do not write in this area,to be completed by cite or town official. City or Town: Permit/Licensc # 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#: ��y. C✓e B6pMNMa'-rrdmwa�n��d�" �1 rtsAFCGT�dYA Frt`�P°J License or registration valid for individui use only Office of Consumer Affairs di:Business Regulation Y �sN ra ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to; 14 ,w A egistration: 169898 Type: Office of Consumer Affairs and Business Regulation xpiration: 7/27/2015 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 THE BOSTON SOLAR COMPANY LLC ROMAIN STRECKER 10 CHURCHILL PLACE Undtrserr���_.,_... �. LYNN,MA 01902 tart' Not valid without signature Massachusefts - Department lent Of Pu bhe Safely Board of Building Regulations ion and Standards �.'uidlhwEi hdt lr4naip ��tt'P'�n"h`'o gaan�" ��//�^ L Pe ; CS-096385 ROMAIN D STRE 10 CHURCHILL PLAT LYNN MA 0190 >t ^^P n S;� ..� �r�r� +I Ikk b' Expiration II Commissioner 1010812016 Client#: 103109 BOSSO DATE(MMIDDIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 1/13/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NSE CT Peggy J.Merati People's United ins.Agency CT PHONE 860 524-7624 AIc No:844 702-8075 Alc 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 INSURER C: 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. LTR TYPE OF INSURANCE INSRL WV, POLICY NUMBER MMIDDY EFF MMIDD EXP LIMITS A GENERAL LIABILITY EGGCC000153814 0/03/2014 01/01/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea o.Tu encs $100,000 CLAIMS-MADE F;1 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 52,000,000 POLICY X E j LOC COMBINED SINGLE LIMIT $ A AUTOMOBILE LIABILITY EAGCC000153814 10/03/2014 01/01/201 Ea accident 1,000,000 A X ANYAUTO EAGCC000153914 10/03/2014 01/01/201 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOSNON-ONED PROPERTY DAMAGE $ X HIRED AUTOS Per accident AUTOS $ B X UMBRELLA LIAB X OCCUR CUP0001367 0/03/2014 01/01/2016 EACH OCCURRENCE S5 OOO 000 EXCESS LIAB CLAIMS-MADE AGGREGATE 55,000,000 DED I X RETENTION$10.000 $ A WORKERS COMPENSATION EWGCC000153815 1/14/2015 01/14/201 X WCSTATU- ER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000._ OFFICER/MEMBER EXCLUDEb? � N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If es,descnbeunder E.L.OISEASE-POLICY LIMIT S1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It 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(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S565647/M565467 SMGCT