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HomeMy WebLinkAboutBuilding Permit # 1/20/2016 O t Noe oT a,9tip BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION e Permit NO: 6 Date Received Date Issued: .: �9SSACHU5�� IMPORTANT: Applicant must complete all items on this page 06 e ''d Rci M a , �QCATION P int Hsi, n wen�Hsu ; PROPERTY 01NN.ER, Font s o:.c D strict es o -:MAP ND. PARCEL._ZONaNG,©ISTRICT. _'Hit r► l.:, Y Machine Shop Village'° yes: o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building VOne family ❑Addition ❑ Two or more family ❑ Industrial 6/Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Flood`;lain: ; '`;�:UVetlands ❑ 1Natershed District; p p Installation of an interconnected rooftop solar PV system: 16 panels (4.24kW DC) Identification Please Type or Print Clearly) OWNER: Name: Hsien-wen Hsu Phone: Address: 106 Meadowood Rd, North Andover MA 01845 CONTRACTOR Name 7s Phone; 78 3 7 9 227 Siirirun fns#alfa#+on`Serv�aes;Inc /StephenA,Ke!!y, Ad,CIC2SS ;. , 734 Forest S# Suite 400 arlbor©ugh,MA 01752, Supervisor's Constructton License ExpR90d eARCHITECT/ENGINEER PaulK.Zacher Pho Address: 8150 Sierra College Blvd. Suite 150 Roseville, CA 95661 Reg. No. 50100 FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. lI ' Total Project Cost: $ 8861.60 FEE: $ Id 67 '' Check No.: Receipt No.: NOTE: Persons con ratting with unregistered contractors do not have ac ess to the guaranty fund Signature ofAgent/Owner Signature of contractor, P,.✓ rim town Ofl !2 Anctover 2 'i 25 No. T _ COCHICHRWICK ��• ADRATE D BOARD OF HEALTH Food/Kitchen E R M) T �T Septic System THIS CERTIFIES THAT .. . . , . BUILDING INSPECTOR ...................... .................. .......... ................................ Foundation has permission to erect.......................... buildings on .. ..�iL....... 1.l! . ...... A... Rough t0;be occupied aSs........ .�.. ...... ................. .. .. ....................................................................... Chimney 'provided that the person accepting this permit shall in eve respect conform to the terms of the application Final 'ori 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 I I MONTHS ELECTRICAL INSPECTOR UN LES S IO T S Rough Service ................. .... ................ .............................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy BuRough Display in a Conspicuous lace on the Premises — o of a oe Final ® Lathing r Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Mow /�� 1 i%// , If STRKTURAL ENGINEERS January 5, 2016 Sunrun Inc. 23052 Alcalde Dr. Irvine, CA 92653 Attn.: To Whom It May Concern re: Job 2016-00122 : Hsien-Wen Hsu - 222R-106HSU The following calculations are for the structural engineering design of the photovoltaic panels located at 106 Meadowood Road, North Andover, MA 01845. After review, PZSE, Inc. certifies that the roof structure has sufficient structural capacity for the applied PV loads. If you have any questions on the above, do not hesitate to call. I OF kg6o-q Prepared By: PAULK PZSE, Inc. -Structural Engineers ZACHER m Roseville, CA o STRUCTURALCn No.50100 '2c'.x,�q fico q "S/ONAL���\ 1 of 6 '8150Sie rru(04l gL� Btxkevuid, Bode 150 Neville, (A 95661916.,961,3960 P 91061,3765 DocuSign Envelope ID:55A92408-00BD-4B1 3-9D5F-E2B1 F5ABD22C 30. NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE 10TH CALENDAR DAY AFTER YOU SIGN THIS AGREEMENT AND ANY DEPOSIT PAID WILL BE REFUNDED. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. By initialing below,you expressly acknowledge that you have been advised on your right to cancel this Agreement and have received duplicate copies of the Notice of Cancellation. DS Accepted by(Initioa~k)., SUNRUN INC. CUSTOMER Date: 12/14/2015 &6DaryAccount Holder DocuSigned by: �V/jaun A Pa,6a,[n e Signature 5DC59F4172C2489... DocuSigned by: Print Name: Suzanna Paci ano EA45 4C88904MI.. sien-wen Hsu Title: operations Administrator AecauntemaJIadclress0: hsienwen2007@gma-i4.-c-arn *This email address will be used by Sunrun for official correspondence,such as sending monthly bills or other invoices.Sunrun will nevershare orsell your email address to any SALES CONSULTANT thirdparties By signing below acknowledge that I am Sunrun accredited,that Ipresentedthis agreement according to"The Right Stuf!"'andthe Account phone number: (508.)_H2.4-984_..............._ Sunrun Code of Conduct,and that obtained the homeowners signature on this agreement. SecondaryAccount Holder[mot/onall Name.Marty Cormier ��IIDo__cuSSigned[CftntName] Signature: Signatur � rVuou'ly �VtMIW Print Name: _ Sunrun ID#.• 5262941171 [10-digit number you received from Sunrun] 12/12/2015 PK17D6DKNRKD Page 5 of 8 DocuIIIIlIlISign Envelope ID:A453F531-761E-41A2-B88D-B21F6ACDOACD II uu OWNER'S AUTHORIZATION FORM For Permit Application(s) The sole purpose of this form is to provide Sun Run Inc 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: Hsien wen Hsu Solar Project Address: DocuSigned by: Signature: ht v, U& srti Owner's Authorized Company: Sun Run Inc. Company's Address: 595 Market St 29th Floor, San Francisco, CA 94105 Affiliation: Contractor Applicable License: State: MA DS �w1 �'a`„ , I"1 lii',21 �, J Gravity Loading Roof Snow Load Calculations pg=Ground Snow Load= 55 psf C0=Exposure Factor= 0.9 (ASCE7-Table 7-2) Ct=Thermal Factor= 1.1 (ASCE7-Table 7-3) 1=Importance Factor= 1 pf=0.7 Ce Ct I pg 38 psf (ASCE7-Eq 7-1) where pg<20 psf,Pf min=I x pg= N/A min snow load(roofs,ofre<15°) where pg>20 psf,Pf min=20 x I= N/A min snow load(roof slope<15°) Therefore,pf=Flat Roof Snow Load= 38 psf P5=C$pf (ASCE7-Eq 7-2) Cs=Slope Factor= 0.850 ARRAY 1 Cs=Slope Factor= 0.850 ARRAY 2 Ps=Sloped Roof Snow Load= 32.4 psf ARRAY 1 Ps =Sloped Roof Snow Load= 32.4 psf ARRAY 2 PV Dead Load=3 psf(Per Sunrun Inc.) Roof Dead Load ARRAY 1 Composition Shingle 4.00 Roof Plywood 1.50 2x10 Rafters @ 16"o.c. 1.90 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.60 Total Roof DL ARRAY 1 8.0 psf DL Adjusted to 36 Degree Slope 9.9 psf Roof Dead Load ARRAY 2 Composition Shingle 4.00 Roof Plywood 1.50 2x10 Rafters @ 16"o.c. 1.90 Vaulted Ceiling 4.00 Miscellaneous 0.60 Total Roof DL ARRAY 2 12.0 psf DL Adjusted to 36 Degree Slope 14.8 psf 2 of 6 Wind Calculations Per ASCE 7-05 Components and Cladding Input Variables Wind Speed 110 mph Exposure Category C Roof Shape Gable/Hip Roof Slope 36 degrees Mean Roof Height 23 ft Building Least Width 26 ft Effective Wind Area 11.0 ft Design Wind Pressure Calculations Wind Pressure P=qh*(G*Cp) qh=0.00256*Kz*Kzt*Kd*V^2*1 (Eqj-1 5) Kz(Exposure Coefficient)= 0.924 (Table 6-3) Kzt(topographic factor)= 1 (Fig.6-4) Kd(Wind Directionality Factor)= 0.85 (Table 6-4) V(Design Wind Speed)= 110 mph Importance Factor= 1 (Table 6-1) qh= 24,33 Standoff Uplift Calculations Zone Zone 2 Zone 3 Positive GCp= -0.88 -1.08 -1.08 0.90 (Fig.6-11) Uplift Pressure= -21.39 psf -26.26 psf -26.26 psf 2187 psf X Standoff Spacing= 4.00 4.00 4.00 Y Standoff Spacing= 2.74 2.74 2.74 Tributary Area= 10.95 10.95 10.95 Footing Uplift= -2341b -2881b -2881b Standoff Uplift Check Maximum Design Uplift= -288 lb Standoff Uplift Capacity = 700 lb 700 lb capacity>288 lb demand Therefore,OK Fastener Capacity Check Fastener= 1 -5/16"dia Lag Number of Fasteners= 1 Minimum Threaded Embedment Depth= 2.5 Pullout Capacity Per Inch= 2051b Fastener Capacity= 8201b 820 lb capacity>288 lb demand Therefore,OK 3 of 6 Framing Check ARRAY 1 PASS w=60 plf Dead Load 9.9 psf PV Load 3.0 psf Snow Load 32.4 psf 2x10 Rafters @ 16"o.c 4----LLL=- -----9 Member Span=11' 11" Governing Load Combo=DL+SL Note:Attachments shall be Staggered. Total Load 45.3 psf Member Properties Member Size S(in"3) 1(in"4) Lumber Sp/Gr Member Spacing 2x10 21.39 98.93 SPF#2 @ 16"o.c. Check Bending Stress Fb(psi)= fb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.1 x 1.15 Allowed Bending Stress=1272.9 psi Maximum Moment = (wL"2)/8 = 1072.1 it# = 12865.2 in# Actual Bending Stress=(Maximum Moment)/S =601.5 psi Allowed>Actual--47,3%Stressed -- Therefore,D Check Deflection Allowed Deflection(Total Load) = U120 (E=1400000 psi Per NDS) = 1.191 in Deflection Criteria Based on = Simple Span Actual Deflection(Total Load) _ (5*w*L^4)/(384*E*1) = 0.198 in = U723 < L/120 `Therefore D Allowed Deflection(Live Load) = U180 0.794 in Actual Deflection(Live Load) _ (5*w*L"4)/(384*E*1) 0.142 in L/1008 < U180 Therefore OK Check Shear Member Area= 13.9 in A2 Fv(psi)= 135 psi (NDS Table 4A) Allowed Shear = Fv*A = 1873 Ib Max Shear(V)=w*L/2 = 360 Ib Allowed>Actual--19.3%Stressed -- Therefore,DIC 4nfF Framing Check ARRAY 2 PASS w=67 Dead Load 14.8 psf PV Load 3.0 psf Snow Load 32.4 psf 200 Rafters @ 16"o.c. Member Span=8'-1" Governing Load Combo=DL+SL Note:Attachments shall be Staggered. Total Load 50.2 psf Member Properties Member Size S(in A3) I(in"4) Lumber Sp/Gr Member Spacing 200 21.39 98.93 SPF#2 @ 16"o.c. Check Bending Stress Fb(psi) fb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.1 x 1.15 Allowed Bending Stress=1272.9 psi Maximum Moment = (wL"2)/8 = 546.656 ft# = 6559.87 in# Actual Bending Stress=(Maximum Moment)/S =306.7 psi Allowed>Actual„24.1%Stressed -- Therefore,Cly Check Deflection Allowed Deflection(Total Load) = U240 (E=1400000 psi Per NDS) = 0.404 in Deflection Criteria Based on = Simple Span Actual Deflection(Total Load) _ (5*w*L"4)/(384*E*I) = 0.047 in = U2064 < U240 Therefore CJS Allowed Deflection(Live Load) = U360 0.269 in Actual Deflection(Live Load) _ (5*w*L"4)/(384*E*I) 0.030 in U3234 < U360 Therefore C Check Shear Member Area= 13.9 in A2 Fv(psi)= 135 psi (NDS Table 4A) Allowed Shear = Fv*A = 1873 Ib Max Shear(V)=w*L/2 = 2711b Allowed>Actual--14.5%Stressed .. Therefore,OK 5 of 6 Lateral Per 2009 IBC Chapter 34 Existing Weight of Effected Building Level Area Weight(psq Weight Ib Roof 936 sf 9.9 psf 9266 Ib Ceiling 936 sf 0.0 psf 0 Ib Vinyl Siding 124 ft 2.0 psf 5704 Ib (8'-0"Wall Height) Int.Walls 124 ft 6.4 psf 18253 Ib Existing Weight of Effected Building 33223 Ib Proposed Weight,of PV System Weight of PV System(Per Sunrun Inc.) 3.0 psf Approx.Area of Proposed PV System 288 sf Approximate Total Weight of PV System 864 Ib 10%Comparison 10%of Existing Building Weight(Allowed) 3322 Ib Approximate Weight of PV System(Actual) 864 Ib Percentlncrease 2.6% 3322 Ib>864 Ib,Therefore OK 6 of 6 January 5, 2016 RI1fTURAL.ENGINEERS Sunrun Inc. 23052 Alcalde Dr. Irvine, CA 92653 Subject: Structural Certification for Installation of Solar Panels Job Number:2016-00122 Client: Hsien-Wen Hsu-222R-106HSU Address: 106 Meadowood Road, North Andover, MA 01845 Attn.: To Whom It May Concern A field observation of the condition of the existing framing system was performed by an audit team from Sunrun Inc.. From the field observation of the property,the existing roof structures was observed as follows: The existing roof structure consists of: • Composition Shingle over Roof Plywood is supported by 2x10 Rafters @ 16"o.c. at ARRAY 1. The rafters are sloped at approximately 36 degree and have a maximum projected horizontal span of 11 ft 11 in between load bearing walls. • Composition Shingle over Roof Plywood is supported by 2x10 Rafters @ 16"o.c. at ARRAY 2. The rafters are sloped at approximately 36 degree and have a maximum projected horizontal span of 8 ft 1 in between load bearing walls. Design Criteria: • Applicable Codes=2009 IBC,ASCE 7-05, and NDS-05 • Ground Snow Load = 55 psf • Roof Dead Load=9.9 psf ARRAY 1 ; 14.8 psf ARRAY 2 • Basic Wind Speed= 110 mph Exposure Category C • Solar modules=as indicated in attached drawings As a result of the completed field observation and design checks: • ARRAY 1 is adequate to support the loading imposed by the installation of solar panels and modules. Therefore, no structural upgrades are required. • ARRAY 2 is adequate to support the loading imposed by the installation of solar panels and modules.Therefore, no structural upgrades are required. I certify that the capacity of the structural roof framing that directly supports the additional gravity loading due to the solar panel supports and modules had been reviewed and determined to meet or exceed the requirements in accordance with the 2009 IBC. \lv\OFA4,1& If you have any questions on the above,do not hesitate to call. �y PAULK. ZACHER Prepared By: O STRUCTURAL PZSE, Inc.-Structural Engineers No.50100 Roseville, CA M �S&/ONh 4�NG\ 1 of 1 8150ierra(04efle, 10e1 'viir ,Soite 150 Roseville, G 95661 MALMO wl O P 91&961.3965 # The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street, Suite 100 Boston,MA 02114-2017 jvww.mass.gov1dia Workers' Compensation Insurance Affidavit:Builders/Contractoi-s/Electi-icians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Sunrun Installation Services, Inc. Address:775 Fiero Lane, Suite 200 City/State/Zip:San Luis Obispo, CA 93401 Phone 4:978-549-9438 Are you an employer?Check the appropriate box: Type of project(required): 1.[Z]I am a employer with 35 employees(full and/or part-time).* 7. E]New construction 2.0 1 am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.[:]1 am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 ®Building addition 4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I L E]Electrical repairs or additions proprietors with no employees. 12.EJ Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.[Z]Other Rooftop Solar 6.0 we are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that isproviding workers'compensation:insurance for my employees. Below is the policy and job site information. Insurance Company Name:Zurich American Insurance Company Policy#or Self-ins.Lic.#:WC01 3696001 &WC01 3696101 Expiration Date: 10/01/2016 Job Site Address:106 Meadowood Rd North Andover, MA 01845 City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone 9:978-544-9438 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: AICC)RDO ­DATE CERTIFICATE OF LIABILITY INSURANCE 10/01/2015 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 CONTACT MARSH RISK&INSURANCE SERVICES NAME: PHONE FAX 345 CALIFORNIA STREET,SUITE 1300 AIC No Ext): A/C No): CALIFORNIA LICENSE NO.0437153 EMAIL SAN FRANCISCO,CA 94104 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 104960339-STND-GAX-15-16 INSURER A:James River Insurance Company 12203 INSURED INSURER B:NIA N/A Sunrun Installation Services,Inc. and REC Solar,Inc. INSURER C:Houston Casually Company 42374 775 Fiero Lane,Suite 200 INSURER D: San Luis Obispo,CA 93401 INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: SEA-002994222-03 REVISION NUMBER:5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AD DL SUBR POLICY EFF POLICY EXP LIMITS LTR D D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 000641241 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 D AGE CLAIMS-MADE a OCCUR PREES(E.occurrence) M S $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY FIPRO ❑ X RO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 X OTHER:Host Liquor Liability TOTAL POLICY LIMIT $ 10,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NO OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident C UMBRELLA LIAB X OCCUR H15XC5023203 10/01/2015 10/01/2016 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STER H UTE EER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A '.. (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Permitting within jurisdiction. CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 120 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover,MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk&Insurance Services Stefan Szulc ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD ®A`C40R® DATE(MM/DD/YYYY) `.►, CERTIFICATE OF LIABILITY INSURANCE 10/8/2015 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 CONTACT NAME: Arthur J.Gallagher&Co. Insurance Brokers of CA. PHONE 415-546-9300 FAX No; 415-536-8499 1255 Battery Street#450 E-MAIL San Francisco CA 94111 DDE INSURERS AFFORDING COVERAGE NAIC# INSURERA:Zurich American Insurance Company 16535 INSURED SUNRINC-01 INSURER B: SUnrun Installation Services Inc. INSURERC: 775 Fiero Lane, Suite 200 San Luis Obispo, CA 93401 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:944362624 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE FlOCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO LOC JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMII Ea accident) ccident $ ANY AUTO BODILY INJURY(Per person) $ AUTOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ HDED RETENTION$ $ A WORKERS COMPENSATION Y WC013696001 0/1/2015 10/1/2016 X STATUTE ERH A AND EMPLOYERS'LIABILITY Y/N WC013696101 0/1/2015 10/1/2016 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $1,000,000 OF EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) WC013696001 -$25,000 Deductible;WC013696101 -FL, HI, MA, NJ, NY, OR,VA,WI only. Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main St North Andover MA 01845 USA AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs d Business Regulation Tw 10 Park Plaza - Suite 5170 Boston, Massachusetts 02 116 Home Improvement Contractor Registration Registration: 180120 Type: Supplement Card Expiration: 10114/2016 SUNRUN INSTALLATION SERVICES INC. STEPHEN KELLY 775 FIERO LANE SUITE 200 SAN LUIS OBISPO, CA 93401 Update Address and return card.Mark reason for change. SCA 1 0 20M-05/11 Address ❑ Renewal D Employment ❑ Lost Card �e t�cr�artx+t�rtrerr.�� '12C 1 3�rczaue- *- ExpiratiaA.-A.DA4f20,j-6 e of Consumer Affairs&Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: It Office of Consumer Affairs and Business Regulation lstration: {}� Type: 18 Park Plaza-Suite 5170 Supplement Card Boston,MA 02116 SUNRUN INSTALLATION SERWCES INC. STEPHEN KELLY 775 FIERO LANE SUITE 200 SAN LUIS OBISPO,CA 93401 Undersecretary Not valid without sigpture - - l Ex LICE 4d mm NONE \ \ \. �- STONE W80-2W r Massachusetts oartmen. of Pub-ic Safety Board of Building 14eaulations andto License# 6,22 Construcntlion Supervusor STEPHEN A KELLY 16 PARKWAY ROAD STONESTONEHAM MA 42 xpiratlorll Commissioner 0 /101 .19