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Building Permit # 11/23/2015
%%ORTI1 0 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received TOM C M Date Issued: X, "ORTANT:Applicant must complete all items on flus page nX A- TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential F1 New Building l One family 11 Addition 11 Two or more family 11 Industrial ZAlteration No. of units: I I Commercial 'I] Repair, replacement 11 Assessory Bldg 11 Others: 11 Demolition 11 Other ........... gJ Identification Please Type or Print Clearly) OWNER: Name: I 1 �00 IxLe"" 0-AL.. Phone: Address: ARCHITECT/ENGIN ER Phone: 19 tp LP '91P Address: Reg. No. -1-0 L-1 c -,Y- I If 14*4 Ix 4 t �506 A00 149 FEE SCHEDULE.BULDING PERMIT:MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $®H (go , C,0 — Check No.: /n 1-1 Receipt No.: 4 NOTE: Pers 4n'Irakting with unregistered contractors do not have access to Ae gud6ntyfund t f A'' Si �7 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer ❑ Well 11Tobacco Sales LlFood Packaging/Sales 11❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the 9"aranty,fund Signature of Agent/Owner je t,_ jjj4ASignature of contractor Plans Submitted tA Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING&DE LOP NT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance,Petition No: a Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature&Date Driveway Permit Temp Dumpster on site yes no Fire Department signature/date I Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approva8 of Electrical Inspector Yes No DANGER.ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) LA� CUA3 I� ® Notified for pickup Call Email Time Contact Name Date j i Doc.Building Permit Revised 2014 I i i v&O R'TH Town of Andover 0 to No. ���E h ver, `ass, I 3 /J COC"ICNCWICK 7®ADRi1TED I'P���J S U BOARD OF HEALTH Food/Kitchen PERMIT T L Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ' � ............................. .......................................... .............................. .. ... . has permission to erect.. g .. . .. . ....... Foundation ................... buildings ... ....... .. .�. ...... ... .... -�, Rough to be occupied as ....... ......®.4 . .........I .0 ....... .�..�,��. . - ...I.. ...... .................. Chimney provided that the person accepti this'per it 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 RoughLESS C CTI STA S 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. 21 Drydock Avenue, 2"' floor U01.1 next step ivi ,rM Boston, MA 02210-2384 home energy solutions 866-867-8729 NextStepLiving.com August 20, 2015 Town of North Andover Building Department 1600 Osgood Street Building 20,Suite 2035 North Andover,MA 01845 RE:Christopher Bowe Residence Solar Panel Installation 12 Foss Road North Andover,MA 01845 Structural Assessment of Roof Framing NSL Project No: SP252090 Dear Sirs, Next Step Living,Inc. has performed a limited structural evaluation of the roof framing at the above referenced site to determine if the roof has adequate capacity to support proposed solar PV panels.This analysis has been based on field measurements,framing information and configurations observed at the proposed site. The existing residence is located at 12 Foss Road,North Andover,MA 01845. Structural Data and Code Information Our analysis was performed in accordance with the requirements of the MA Rcs:uential Building Code 780 CMR—Eighth Edition.The main roof of this residence is framed with conventional roof rafters with j some collar ties in a gable configuration.The existing roof structure is in good condition and currently has one layer of asphalt shingles.as roof covering. The pertinent data is listed below: Main Roof Rafters:1 W x 7 X"(#1:2 Spruce Pine Fir,Hem Fir,D.Fir Larch ) Rafter Spacing:16"on center Roof Slope: 30 Degrees Horizontal projected Length of Rafter:14.83 feet Ceiling Joists:Present Collar Ties: Present every third rafter Roof Sheathing:Plywood sheathing Roof Covering: Asphaltshingles Condition of Framing: Good Ground Snow Load,Pg:50 PSF from'Table 8301.2(5) Importance Factor,l: 1.0 Exposurefaaor,Ce: 1.0(Partially Exposed) Christopher Bowe Residence Solar Panel Installation 12 Foss 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 Loadins: 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 6—16d nails OR 6 Ledger Lock screws as manufactured by Fasten Master. The panels will be installed using Unirac Solar Mount rails with L-brackets in either a landscape or 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 landscape orientation shall have a maximum spacing of 36"on center parallel to the roof slope and 32"on center perpendicular to the slope(e.g.,every other rafter),or 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). Christopher Bowe Residence Solar Panel Installation 12 Foss Road North Andover,MA 01845 Page 3 Each 5/16"diameter lag screw shall have a minimum of 3"thread penetration into the existing rafter. 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. lhlind Loadine: 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 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. Dean A.' o er,P.E. MA Prof. Eng. License#50405 ELECTRICAL DESIGN W PV MODULE RATINGS(a STC SOURCE COMBINER RATINGS INVERTER RATINGS m .�, Terrloeratures INVERTER MODEL:Enphase Microinverter IZ p� MODULE MANUFACTURER: Trina Average High:28'C MAX OCPD RATING(A):20 MODEL:M215-60-2LL-S22-IG Record Low:-28.9°C OCPD AMPERAGE RATING(A):20 MAX DC VOLT RATING(V):45 , = Q Q MODULE MODEL#:TSM-260PA05.08 MAX POWER @ 40°C(W):225 Ii O OPEN-CIRCUIT VOLTAGE(Voc): 38.2 OCPD VOLTAGE RATING(V):240 NOMINAL AC VOLTAGE(V):240 O � OPERATING VOLTAGE(Vmp): 30.6 NOMINAL AC CURRENT(A):0.9A [- 'Cl OPERATING CURRENT(Imp): 8.50 2 x#10 THWN-2 Wire BLACK MAX BRANCH AC CURRENT(A):9.9AI6.3A 1z O ; 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. Owner's Name: Christopher & Laura Bowe Solar Project Addr 12 Foss Rd. North Andover, Ma Signature: 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 Leaving,, CT HIC.0629266•MA OCABR#162111•RI Contractor Reg.#37185 Next Step ® 11• • ®—l"I Tim, • Date of Contract: 07/24/2015 next step Living. .+ home energy solutions 21 Drydock Avenue.2nd Floor,Boston,Massachusetts 02210 Customer(s)Name(s): Laura&Christopher Bowe Telephone:866-867-8729-www.nextstopliving.com Customers)Street Address: 12 Foss Rd City: North Andover State: MA ZIP: 01845-5258 Customer(s)Home Phone#:I Customer(s)Mobile Phone#: Peradt(s)Required: Building&Electrical City/County Issuing Permit(s): North Andover of Next Step Living,Inc.(" Customer(s)jointly and severally agrees to purchase the products and/or services Contractorin accordance with the terms and ") ent('Agreement')and the attached specification sheet(s).Customer(s) conditions described on the front and reverse of this Home Improvement Agreem hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. ESTIMATED STARTING DATE: Thursday,October 22,2015 ESTIMATED COMPLETION DATE: Thursday,October 29,2015 TOTAL SOLAR SYSTEM PRICE: $34,124.28 PAYMENT METHOD: select option(s) ESTIMATED STATE REBATES: $0.00 CashBCredit Card SOLAR PURCHASE PRICE: $34,124.28 Check ®Financing ROOFING PURCHASE PRICE: $0.90 TOTAL PROJECT PURCHASE PRICE: $34,125.18 See Payment Certificate for payment schedule In certain circumstances,Cttstomer(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)in consideration 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. 1 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. 07/24/2015 By: Todd Massicotte Print Name Lic.#(CT only) Signature Date 07/24/2015 CUSTOMER(S) Print Name Christo her Bowe SignaturW Date `I_ Laura Bowe 07/24/2015 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 TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky Next Sten Living, Inc. CT HIC.0629266•MA OCABR#162111•RI Contractor Reg.#37185 SPECIFICATION SHEET Date of Contract: 07/24/2015 :: next step living, home energy solutions 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 02210 Customer(s)Name(s): Laura&Christopher Bowe Telephone:866-867-8729•www.nextstepliving.com Customers)Street Address: 12 Foss Rd City: North Andover State: MA zip: 01845-5258 Customer(s)Home Phone M Customer(s)Mobile Phone#: Permit(s)Required: Building&Electrical City/County issuing Permit(s): North Andover The Customers)listed above hereby jointly and severally agrees to purchase the goods and/or services listed below,in accordance with the prices and terms described on this Specification Sheet and the front and the reverse of the accompanying HOME IMPROVEMENT AGREEMENT,of which this Specification Sheet is a part. Description of the Solar Project and Description of the Significant Materials to Be Used: (1)delivery of solar equipment,(2)complete installation to manufacturer's specifications,(3)installation of inverter,conduit runs,and racking system as needed,and(4)cleanup after installation, Scope _ Panel Brand:Trina Solar Panel type:TSM-260PA05.08 Panel Watts(DC STC)-260 Monitoring system with 5 year service(owners responsibility after 5 years) The solar array will consist of 18 panels for a total system size of 4680(DC STC) Description of the Rooting Project and Description of the Significant Materials to Be Used:except for areas highlighted in red,which are excluded,(1) delivery of roofing materials,(2)removal of existing roofing material(up to 2 layers)and inspection of roof deck after existing roofing material is removed, (3)recycling of existing asphalt shingles,(4)cutting in ridge venting as needed,(5)six feet of ice and water shield at the eaves and three feet along the rakes and in the valleys,(6)synthetic underlayment covering all other areas,(7)complete installation to manufacturer's specifications,and(8)cleanup after ..• of Roof worl( Scope of Work: See roofing work scope Color: ; Driftwood Roofing Brand:Owens Coming Roofing type: 30 year architectural Scope of Work:NSL shall perform all work and provide all materials described on the Work Scope attached to this agreement and will be responsible for any and all materials,and appurtenant items as may be required and necessary to perform all work described on the Work Scope and any performance reasonably inferable from it,including clean-up associated with NSL's work. It is agreed and understood by and between the parties that this Specification Sheet,along with the HOME IMPROVEMENT AGREEMENT, constitutes the entire understanding between the parties,and there are no verbal understandings changing any of the terms.This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both Customer(s)and Contractor. Customer(s)hereby acknowledges that Customer(s)has read this Specification Sheet. NEXT STEP LIVING, INC. 07/24/2015 By: Todd Massicotte / Print Name Lic.#(Cr only) Signature Date CUSTOMER(S) Christopher Bowe 07/24/2015 Print Name Signatur Date Laura Bowe 07/24/2015 Print Name Signature Date OBLLP2013.NSL.CTMARI TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky Living,Next Step Inc. CT HIC.0629266•MA OCABR#162111•RI Contractor Reg.#37185 NOTICE OF CANCELLATION next step tivingT. home energy solutions 21 Drydock Avenue,2nd Floor,Boston,Massachusetts 62210 Telephone:866-867-8729•www.nextstepliving.com The following Notice of Cancellation applies to all states. -------------- -------------NOTICE - CANCELLATION --___i_______-- NOTICEOF-----CANCEL%-QR1h/2®15 _____ Date of Transaction: 24/2015 Date 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 'traded 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, I BUSINESS DAYS following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be canceled.if and 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 'you under this Contract or Sale;or you may,if you wish,comply with the instructions of the Seiler 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 ISeller's expense and risk.if you do make the goods available to the Seiler and the Seiler does not pick them up within 20 days of the date of your and 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 Notice 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 !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, 02210, NOT LATER THAN MIDNIGHT OF 07/2$/2014 (Date) NOT LATER THAN MIDNIGHT OF 07/2$/2014 _(Date) 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 ----- __________ _ _ _ _ applies to .Rhode Island customers. _NC_ _ _ _ NOTICE OF CANCELLATION -�-----------NOTICE_OF CAELLATIONP -—-—-—___ Date of Transaction: Date 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(3)business days from the above date.If you cancel,your cancellation three(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 inotice 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 mailed 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. i Boston,Massachusetts 02210. 1 HEREBY CANCEL THIS TRANSACTION. ,I HEREBY CANCEL THIS TRANSACTION. Consumer's Signature Date Consumer's Signature Date ----------- The _____®.The 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. Christopher Bowe I Laura Bowe Print'Name 07/24/2015 Print Name 07/24/2015 Signa bate Signature Date TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky ADDITIONAL TERMS AND CONDITIONS (Connecticut Customers Only)The owner(s)of the home improvement contractor is or has been a shareholder,member,partner,or owner of the following corporations, limited liability companies, partnerships, sole proprietorships or other legal entities that have been a home improvement contractor during the previous five years:None. (Massachusetts Customers Only) In Massachusetts, all contractors and subcontractors must be registered by the administrator of the Board of Building Regulations and Standards and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation, Ten Park Plaza, Suite 5170, Boston,Massachusetts 02116 Telephone: (617)973-8700. Any deposit required under this Agreement to be paid in advance of the commencement of work shall not exceed the greater of one-third of the total contract price or the actual cost of any materials or equipment of a special order or custom made nature, which must be ordered in advance of the commencement of work,in order to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of the parties. In Massachusetts, the contractor is responsible for applying for and obtaining any and all necessary permitting.Homeowners who secure their own permits will be excluded from the guaranty fund provisions of Massachusetts law. Delay/Unknown Conditions: Contractor's failure to perform any term of this Agreement due to conditions beyond its control such as,but not limited to acts of God, material shortages, Customer's inability to qualify for or obtain financing, delays by local government authorities in issuing or otherwise approving inspections,permitting,or other required authorizations do not constitute abandonment and are not included in calculating time frames for performance by Contractor. Contractor and Customer(s)have determined that a definite completion date is not of the essence to this Agreement. Late Cancellation/Late Payment/Default: If Customer(s)attempts to cancel this Agreement after midnight of the third business day after the date of this Agreement,and Contractor accepts such cancellation,all work will be stopped as promptly as is reasonably possible and Customer(s)agrees to pay Contractor a cancellation fee equal to 15%of this Agreement's purchase price to offset Contractor's incurred labor, administrative,and material costs.Customer(s)agrees to pay a late fee of 1.5%per month on all amounts due and owing from Customers)to Contractor accruing from the date due and running to the date the payment is made.Any deposit amounts less than or equal to 15%of the Agreement's purchase price are deemed non-refundable after midnight of the third business day following the date of this Agreement.If Customer(s)is in default of this Agreement,Contractor shall be entitled to seek recovery of Contractor's attorney's fees and any other costs or Contractor's Right to Cancel: In the event that Contractor determines that this Agreement cannot be performed as intended by the parties due, for example,to incorrect pricing,unforeseen structural defects,or pre-existing conditions to Customer's property,Contractor may cancel this Agreement within Forty-Five(45) days of its execution, notify Customer(s) of such cancellation in writing, and return all money paid by Customer(s). No Set-Offs or Retentions: Upon completion of Contractor's work under this Agreement, Customer(s) shall pay all amounts due under this Agreement without any right of set-off or retention. Completion is defined as the job being materially completed,functional as intended,and a final inspection, permit or occupancy certificate, as the case may be, having been obtained. If after paying all amounts due, Customer(s) alleges that Contractor's work is defective,Contractor,without waiving any of its rights,shall inspect the work and perform any remedial work to the extent Customer(s)is entitled to under this Agreement or Contractor's warranty at no cost to Customer(s). Customer's Representations: Customer(s) represents that (a) Customer(s) owns the premises where the work is being performed, (b) the property is free of preexisting hazards, (c) Customers) maintains casualty insurance on the property covering the work performed, (d) if the existing electrical service at the property does not meet the standards of the utility company or electrical code, Customer(s) will make the necessary changes at Customer's expense unless Contractor has agreed to make these changes in writing. Contractor's Rights:Contractor accepts no responsibility for any damage resulting from pre-existing structural or other defects in Customer's property and Contractor is not responsible for remedying structural defects in Customer's property. Contractor shall not be responsible for(a) any damages arising in whole or in part from any causes beyond Contractor's control; (b) any incidental or consequential damages,including but without limitation, lost profits or reduction in value of Customer's property arising from Contractor's delay in performing under this Agreement or due to Contractor's breach of this Agreement; and (c) unintentional damage to Customer's personal property, it being understood that Customer(s)is responsible for protection and/or moving of such items prior to commencement of work.Customer(s)agrees to indemnify and hold Contractor and its employees, agents, and subcontractors harmless from any claims as to the identification, detection, abatement,encapsulation,or removal of mold,asbestos,lead-based products,or other hazardous substances inside or outside of the property at which work is performed.Any surplus materials remain the property of Contractor.Any manufacturers'warranties offered by the manufacturer of the products purchased shall be provided to Customer(s).No warranty will be effective while a balance due remains on this Agreement. TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-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 front 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 tailed against Contractor by a state or federal government agency even when such agency is seeking relief on behalf of a class of Customers. TSM260-M18-IVD2397-DC3021-IRO-CCO-RY-TN-Green Sky MODULE DATA DETAILS THE Universal MODULE TSM-PA05.08 DI.MEN51ONS 0#PV YAO0 ULE m ELECTRI cAu.D.u".T.'S.(STC) �ur,i r_arva�n , 57+41 1P2alk Paver W¢etts-Puwrz ItWpM ` 24.5 150 255 W Q S Power Ourpudfiolercricae-P.,nu (10 Mo.'Sm m.Po-er Voltage-V.:OV) f 25x9 30-3 30_S O � {_ 'IMaxlravurrn Power Current-iwam(A j B.2d .5.2? 8.37 El sb F � I• I Opera Circuit Voltage-Voe(14 i 37.8 38-.7 1 38.1 38.2 y � W 01 .wacwa,ss Short Circuit Clurrent•16c in.J 8.75 8.%9 8.38 9.00 Q > co LL 0 0„+amile Efficiency).4%) { 35.0 15.3 35.45 15.9 4 V N SIC:Ireadianea 1000 wjmt Ced.7ampanoture:5'C..Alr Mas AMtla"aeccading to EE-I a650a.0_ r Z n : Typieol Nficlerscy redvcEianor a.SY,.a1:2L'�LYJm°occardlrsg is Elc b09aa•:f_ � �f V ELECTRICAL DATA(Sd:9CTJ' ma*rum Pcwer-p.wsJwpp 3'82 786 15T0 i 193 aw+ia>rwum;Pcnrervola ,h+,wm�+A� ..6 2'8.3 .7 �s C� Q Z d -xA,m mum Powe CLmenr-i..aa:(A) 6.59 ! 4.65 6.74 6.84 3 A. Open circuit Voltage-'a°oG(Y) 35.1 3�.2 5.3 35x4 Shor7 Clrcull Current-Isc tAJ 7.07 r uo 7.17 X17 ' "OCT- of 20OWtm2,Ami:u-f TCrnpmo-2D.C,wind speed 1 m1.. Y: co O MECFS,r NICAJ.DATA \ sack A.-w Solar cetkrJt.nulticrystctllna 156 x 166 mm(6 Jnchesp � VR7 CU C"ad 6bceUs�8M1gq. � `_v MaOula dianens)ons j C65R x 992 x35 mm(6a,95>a39.o5x1.37 IniChesJ / Q . ''4Mi'eig77t g8.67:g(47.57 las] Glass 3.2 mm.X0.73 Irnc4iasJ.t)Igru TransmissGan,,4R Coated Tempered Glass ^ =, 7CaaCkSi Li -L Wl000 naarsa SvgtRe A�y+ heet Frame Black Anodized AluvninFurca Alt0y .�..1 A.h d-Bawl. IP 65 ar 13"&?rc�tnad� U J CU Cainlea. Photavolrole Technology coole 4_0 mm°(0=6 irccnes°J. O^ 700,A000mm I-V Cu R'vr:s OE.€V.MaYC+ SRLOE(2 V5`a"iy. Connector MC4 cr MCA Campota6le O V J 70•.'m' Z -::9:. TEMPERATURE RAT INSS T, a 4•+fm Nominal Operarlrng Cellad"C Z-CJ loyaar Proaucr 5, Femperoru (NOCTJ I J' Wvorknn u shlp Warranty 1E :�.se �' T�ert4vperonure Coa811cLetlt ad Pwwlr -0.a3Jr�C' 2.5 year I.Cnaar Pawer rroavrazl9y �_ ductwamnonr4 for dcloih) u� Fc mperarure Coe4itGenr o3 V- b,32�°C 4Vla-s fca la Pra -,, " 7emparatlwa Coa3tlicJan4 odisc p.p.5'�t'OC �. a.:. a CL. las arom 30A ; 'W- SAAR IW, 7t,i511 NGS �7 Operarlamal Temperature -40-+BS C' qy1. ,nAoldmum Syslem 4COV"Cm]: Qj.. Voltage MaJaxfierles Puse Raying 15.4 CERTWICATI ON 5 PAC.eAGIA;G+^..rJNPUGURAT3ON 3 QL545tp mocwles per r c w'30 places a r - macwles::per 401 container.840 places ARRAY DESIGN / SITE DIAGRAM HEIGHT OF HOUSE PANEL ORIENTATION (TRUE) ROOF PITCH (DEGREES) 225" 2130 300 Quick Mount PV Solar Flashings will be used on every roof penetration FOSS RO AD EWAY (-39.05'-4 W **"ARRAY LAYOUT IS NOT TO SCALE""" T = Do IL 0W � � UTILITY METER PLACE PV LOAD CENTER OUTSIDE TO THE LEFT OF THE re 0 > 00 I LGATE120 Z U. 0 0 UTILITY METER, THE CUSTOMER IS RESPONSIBLE FOR v N o MOVING OBSTRUCTIONS 3' FROM LOAD CENTER AC DISCONNECT ` Z ti CD H Q LOCATION; PLACE ENVOY MONITORING EQUIPMENT TO E ` 1.- r_ THE RIGHT OF THE MAIN ELECTRICAL PANEL = a 0 = PROPOSED CONDUIT THROUGHV Q z d ATTIC,DOWN EXTERIORTO PVLC;ELECTRICIAN WILL FIELD PIPE TO BE RELOCATED VERIFY to O QUICKMOUNT PV 34'-8" (416" PORTRAIT/LANDSCAPE .> CU .- 12"TYP. 9 Total J ® j I Total#of Panels: 18 CL N W Total#of Splice Bars: 8 (1) .0 L Total#of Bonding Jumpers: 8 (nco 12"TYP. 1 1a +1 11 Total# End Clamps: 14 a.., p Total#of Mid-Clamps: 36 x See Engineer's Structural Assessment O a, 1 1-14'+1-11 N i t' "tai Customer Signature: Date: TYPICAL ATTACHMENT DETAILS /—THIS EDGE TOWARDS ROOF RIDGE RACKING COMPONENTS �—.. I1EM DESCRIPTION - QTY(80X i NOT INCLUDED 2'29` NO, j 5 1 FLASHING,9"X 12'X,040",5052,MILL I 4 1,29 2 OBLOCK,CLASSIC,A360.1 CAST Al,MILL I 4 i � 3 PLUG,SEALING,5116'X 7/8",EPDM(13.8 SS 1 _ `==pry' 3 -' 4 LAG SCREW,HEX HEAD,5(16"x 5.1(2",IM SS 1 1,25 -- 5 WASHER,FENDER,51161D X 1.1(4"OD,18.8 SS 1 9:GG - .r • r • . .r. lbs) in typical lumber: Lag Solt Specifications Specific Gravity 5116"shaft per 3"thread depth 5116"shaft per V thread depth Douglas Fir, Larch .50 798 266 Douglas Fir,South .46 745 235 k Engelmann Spruce,Lodgepole Pine(MSR 1650 f&higher) .46 705 235 l Hem,Fir .43, 636 212 k Hem,Fir(North) .46 705 235 P Southern Fine .55 921 307 Spruce,Pine,Fir .42 615 205 u Spruce, Pine,Fir(E of 2 million psi and higher grades of IVISR and MEL) .50 798 266 NEERING Next Step Living Inc. Quick Mount "RT FOR ATTACHMENT REPORT FOR ATTACHMENT next step living. Module and Roof QMSE-LAG:QMPV E-MOUNT SPACING`-" Jh° eenargysolutions Attachment Detail WITH LAG BOLT Ur,ensee Details emographic Information Full Name: DONALD D EL WELL Gender: Owner Name: icense Address information lddress:. ddress 2: ity: BEDFORD tate: PAA ipcode: 01780 o nt : U ited tates icense InTormation icense No: CS-004414 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 8i1312015 Issue Date: Expiration Date: 814/2017 License Status: Active Today's.Date, 8;25/2015 Secondary License: Doing Business As: atus Chan e: is se Renew Prerequisite information No Prerequisite In`ormation isc'p ine No Discipline Information acumen um Close Yti'indow U 2011 Commonwealth of Massachusetts Site Policies Contact Us A Massachuseifs _De � Partment csr PE � on trilding Regraiatians ar i ticliri;7 supejZ:. License: c-S-0944gr; c,t t f ,J' 24,1 CAR -- A r By-:D-PO-RD 017 C l ' 3 ; � Issioner E"Piratioon 9 g Office of Consumer Affairs&Business Regulation HOWIE IMPROVEMENT CONTRACTOR --_ Registration: 178990 Type: .Expiration: 6i9f2016 Corporation STALKER ELECTRIC, INC. IAJILFRED STALKER 400 W.CUMMINGS PARK STE 17 ; 40 1�RN, MA 01801 Undersecretary Fold,Then Detach AlongAll Perforations COMIHIONWEALTHOtMASSACH € SE ' 1 � r YCmmm..gap�t BOARD OF ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS A REGISTERED MASTER ELECTRICIA --` �;w F ELECTRICIANS `----%�� ISSUES THE FOLLOWING LICENSE < AS.A R:EG JOURNEYMAN STALKER ELECTRICAL CONTROLS INC � ELECTRICIAN A STALKER } WI LFRED :F STALKER '�-.� -��; SHAWN 6 PERTH DR 9 KIERNAN AVE STRATHAM NH 03885-2222 , 14356 A 07/31/16 93540 W!LM I NGTON ISA . _ � �1i -, 2 01887-�- 2 �'�� r,�6 a0ilz:llf2762` k Nov 23 15 07:13p stalker electric 7817298433 p.2 /� /� i p /� �+ DATE(NMIDDNYYY) CERTIFICATE ®F LIABILITY INSURANCE 5/13/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVE AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED,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). CONTACT PRODUCER NAME: Dame Chrisos Provider Group PHONE . 4781)444-0347 AIC �:(761)414-0961 E-MAIL rov dchrisos@ ideri com 160 Gould Street ADDRESS: P g' Suite 13 Q ENSURE S NAIC F AFFORDING COVERAGE Needham MA 02494 INSURER A-LibertV Mutual PIC) 24198 INSURED ASURERSAllmerica Financial Benefits 41840 sta.lkes Electric Inc INsuRE.ac;The Ohio-Casualty Insurance 24074 400 West Cummings Park iNsuRERD Star Insurance { Suite 1725--142 INSURERE- I Woburn MA+ 01801 INSURERE: COVERAGES CERTIFICATE NUMBER:15-16 Master Liability REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL 9w POLICY EFF POLICY ERP LM)TS INSRR TYPE OFtNSURANCE POLICY NUMBER MNUDD/YYYY MMIDDfYYYY 1 000,000 GENERALUABILRY EACH OCCURRENCE $ r DAMAGE NTED $ 300,000 X COMMERCIAL GENERAL LIANLRY PREMISES Ea on Person) K555932269 /23/2015 /23/2016 MED EXP(Anyone person) :S 15,DD0 j�. CLAIMS-MADE aOCCUR 1,000,000 PERSONAL S�ADV INJURY $ X ISO Form C00001 2,000,000 GENERAL AGGREGATE $ X Contractual Liab 2,000,000 PRODUCTS-COMP/OP AGG 3 GENL AGGREGATE LIMIT APPLIES PER: $ X POLICY X PRO- LOC COMBINED SINGLE LIMITr S 1 000 000 AUTOMOBILE LABILITY Ea accident BODILY INJURY(Per person) S H I ANY AUTO ALL OWNED SCHEDULED 8772911 /12/2015 9/12/2016 gODILYINJURY(Per accident) S AUTOS AUTOS I PROPERTY DAMAGE 3 NON-OWNED Per accident aDEDX AUTOS Uninsured maloristcombined $ 1 D00,0013 EACH OCCURRENCE S 5,000,000 X S X OCCUR 5,000,000 AGGREGATE S C CLAIMS-MADE 1p�00 s055932269 /23/2015 /23/2016 S TENTIONS WCSTATU- XOTH- E) WORKERS COMPENSATION AND EMPLOYERS'LABILITY YIN E.L EACH ACCIDENT 5 500,000 ANY PROPRIETOR,PARTNERIEXECUTIVE OFFICERIm MBER ENCLUDED4 N/A 9/12/2015 /12/2016 EL DISEASE-EA EMPLOY((#$ 500.r000 (Mandatory in NH) (0378024 If yes,describe under E-L DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS below A Automobile Liability (MA) 55932269 /22/2015 /22/2016 Combined Single Limit 1,000,000 /16/15 /16/16 Clients Property 50,000 B Third Party Crime TED DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (At(ach ACORD 101,Additional Remarks Schedute,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Stalker Electric, Inc. PO BOX 155 AUTHORIZED REPRESENTATIVE oracle, AZ 85623 R Hill.berg/CATHYF ACORD 25(2010105) ©1986-2010 ACORD CORPORATION. All rights reserved. INS025 t9nin0.91 M Th-arnizin nnrna and Innn aro r ;n fr rorl m rlrc of&I'nPn DATE(MMIDDIYYYY) AC40RIDO® CERTIFICATE LIABILITY INSURANCE 5/13/2015 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(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). coNracr Dajhr Chrisos PRODUCER NAME: Provider Group PHONE 1aC No:(?81)444-8961E-MAIL dcsos@providerig.com 160 Gould Street ADDRESS: Suite 130 INSURER S)AFFORDING COVERAGE NAIC# Needham MA 02494 INSURERA:Libert Mutual (PIC) 4198 INSURED INSURERB>�lM6rica Financial Benefits 41840 Stalker Electric Inc INSURERC:The Ohio CasualtyInsurance 4074 400 West Cummings Park INSURERD:Star Insurance Suite 1725-142 INSURER E: Woburn MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 Master Liability REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR D 5 R POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER MM/DDIYY MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence �, CLAIMS-MADE OCCUR KS55932269 /23/2015 1/23/2016 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 X ISO Form C00001 GENERAL AGGREGATE $ X Contractual Liab 2000000 r r2 000 000 PRODUCTS-COMPlOP AGG $ r r GEN'L AGGREGATE LIMIT APPLIES PER: $ X POLICY X jR� LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ 1,000,000 BODILY INJURY(Per person) $ B ANY AUTO ALL OWNED X SCHEDULED WN8772911 9/12/2014 9/12/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIRED AUTOS AUTOS Uninsured motorist combined $ 1 000,000 }{ UMBRELLA LIAB X EACH OCCURRENCE $ 5,000,000 _fTOCCUR AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE 1/23/2015 1/23/2 2016 $ DED X RETENTION$ 10,00 WC STATU- I XOTH- D WORKERS COMPENSATION AND EMPLOYERS'LIABILITYEACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNERIEXECUTIVE Y/❑N 4 NIA 9/12/2 9/12/2015 OFFICER/MEMBEREXCLUDED? C0378024 E.L. ISEASE-EA EMPLOYEE $ 500,000 (Mandatory in NH) It yes,describe under . .DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS below A Automobile Liability (MA) A555932269 /22/2015 /22/2016 Combined Single Limit 1,000,000 /16/15 7/16/16 Clients Property 50,000 B Third Party Crime BO DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Stalker Electric, Inc. PO BOX 155 AUTHORIZED REPRESENTATIVE Oracle, AZ 85623 R Hillberg/CATHYF ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025rgmnnstm Tha Ar.nRrl name and Innn am raniefarorl martrc of arnRn NOTICE NOTICE TO o TO EMPLOYEES EMPLOYEES t The Commonwealth of O~ ! y S � Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114-2017 617-727-4900 - http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above-mentioned chapter by insuring with: STAR INSURANCE COMPANY NAME OF INSURANCE COMPANY P.O. BOX 49167 SARASOTA, FL 34230-6167 ADDRESS OF INSURANCE COMPANY WC 0378024 09/12/2015 to 09/12/2016 POLICY NUMBER EFFECTIVE DATES PROVIDER INSURANCE GROUP, LLC NEEDHAM HEIGHTS MA 02494 160 GOULD STREET, STE. 130 781-444-0347 NAME OF INSURANCE AGENT ADDRESS PHONE# STALKER ELECTRIC INC. 400 W. CUMMINGS PARK, STE.1725 WOBURN MA 01801-0000 EMPLOYER ADDRESS EMPLOYER'S WORKERS' COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the FirsReport of Injury must be given to the injured employee. The employee may select his ocher own physician. The reasonable cost of the services provided by the treating physicianwill be paid by the insurer, if the treatment is necessary and reasonably connected to thework related injury. In cases requiring hospital attention, employees are hereby notified thatthe insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER