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Guest Building Permit App The Commonwealth of Massachusetts Board of Building Regulations and Standards Massachusetts State Building Code, 780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One- or Two-Family Dwelling FOR MUNICIPALITY USE Revised Mar 2011 This Section For Official Use Only Building Permit Number: _____________________ Date Applied: ______________________________ ___________________________________ ____________________________________________ ___________ Building Official (Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: ____________________________________________ 1.1a Is this an accepted street? yes_____ no_____ 1.2 Assessors Map & Parcel Numbers _____________________ ____________________ Map Number Parcel Number 1.3 Zoning Information: _______________ ___________________ Zoning District Proposed Use 1.4 Property Dimensions: _____________________ ____________________ Lot Area (sq ft) Frontage (ft) 1.5 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c. 40, § 54) Public  Private  1.7 Flood Zone Information: Zone: ___ Outside Flood Zone? Check if yes 1.8 Sewage Disposal System: Municipal  On site disposal system  SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner1 of Record: ________________________________________ _________________________________________________ Name (Print) City, State, ZIP _____________________________________________ _________________ ___________________________________ No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction  Existing Building  Owner-Occupied  Repairs(s)  Alteration(s)  Addition  Demolition  Accessory Bldg.  Number of Units_____ Other  Specify:________________________ Brief Description of Proposed Work2:_________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1. Building $ 1. Building Permit Fee: $_______ Indicate how fee is determined:  Standard City/Town Application Fee  Total Project Cost3 (Item 6) x multiplier _______ x _______ 2. Other Fees: $_________ List:_________________________________________________ ____________________________________________________ Total All Fees: $_______________ Check No. ______Check Amount: _______Cash Amount:______  Paid in Full  Outstanding Balance Due:__________ 2. Electrical $ 3. Plumbing $ 4. Mechanical (HVAC) $ 5. Mechanical (Fire Suppression) $ 6. Total Project Cost: $ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) ________________________________________________________ Name of CSL Holder _________________________________________________________ No. and Street _________________________________________________________ City/Town, State, ZIP _________________________________________________________ __________________ ______________________________________ Telephone Email address _____________________ ______________ License Number Expiration Date List CSL Type (see below) _______________ Type Description U Unrestricted (Buildings up to 35,000 cu. ft.) R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation D Demolition 5.2 Registered Home Improvement Contractor (HIC) ______________________________________________________________ HIC Company Name or HIC Registrant Name ______________________________________________________________ No. and Street ________________________________________ ____________________ City/Town, State, ZIP Telephone SECTION 6: WORKERS’ COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ……….  No ………..  SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER’S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property, hereby authorize_____________________________________________________ to act on my behalf, in all matters relative to work authorized by this building permit application. ______________________________________________________ ______________________ Print Owner’s Name (Electronic Signature) Date SECTION 7b: OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. _____________________________________________________________ Print Owner’s or Authorized Agent’s Name (Electronic Signature) NOTES: 1.An Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistered contractor(not registered in the Home Improvement Contractor (HIC) Program), will not have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found atwww.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2.When substantial work is planned, provide the information below: Total floor area (sq. ft.) _________________________ (including garage, finished basement/attics, decks or porch)Gross living area (sq. ft.) __________________ Habitable room count ______________________ Number of fireplaces______________________ Number of bedrooms _____________________ Number of bathrooms ____________________ Number of half/baths ______________________ Type of heating system ___________________ Number of decks/ porches __________________ Type of cooling system_____________________ Enclosed ______________Open _____________ 3.“Total Project Square Footage” may be substituted for “Total Project Cost” Michael A White 48 Moore Street East Longmeadow, MA 01028 413-203-9088 applications.westma@trinity-solar.com CS 098295 9/29/20219/29/2023 U Trinity Solar Inc DBA Trinity Solar 20 Patterson Brook Road - Unit 10 West Wareham MA 02576 413-203-9088 170355 applications.westma@trinity-solar.com Please See Attached X X X x x ______________ Date ______ _ ____ _ _________ _______________ HIC Registration Number Expiration Date _ _ ____ _ _ _ _ _ _ __ _ _ _ ______ ___ _ ____ _ _______ Email address NJ, ElectricalContractor business permit number34EB01547400NJ, HIC reg. # 13VH01244300 For other jurisdictions, pleasevisit: http://www.trinity-solar.com/about-us/locations-and-licenses HOMEOWNERS AUTHORIZATION FORM I, , (print name) am the owner of the property located at address: . (print address) I hereby authorize Trinity Solar Inc.(“TrinitySolar”)and its employees, agents, and subcontractors, including without limitation, , to act as my Agent for the limited purpose of applyingfor and obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System, Battery System, roofing or other Trinity Solar offerings located on my property, applying and obtaining permission and approval for interconnection with the electric utility company, and registration with any state and/or local incentive program(s). This authorization includesthetransfer/re-administering, and/or cancellation of any existing permits on file for thepurpose of updating/applying with an alternate subcontractor. Without limitationto thegenerality of theforegoing Ispecificallyauthorize TrinitySolar et al.to populate technical details, fill-in, edit, compile, attach drawings, plans, data sheets and other documentation to, date, submit, re-submit, revise, amend and modify application, submission and certificationdocuments(“ApprovalsPaperwork”),includingthoseforwhichsignaturepagesareincluded herewith for my signature, in furtherance ofthe relatedtransaction, and I am providing any signatures to Approvals Paperwork for purposes of the foregoing. Trinity Solar will provide copiesof Approvals Paperwork whensubmitted. My authorizations memorialized herein shall remain in full force and effect until revoked. I acknowledge that theseauthorizations are not required to proceed withthe transaction andare not a condition of the related agreement included herewithbut are being given for my own convenience and benefit inorder to expedite the approvals processes. ElectricUtility Company: ElectricUtilityAccountNo.: Name on Electric UtilityAccount: CustomerSignature PrintName Date CorporateHeadquarters1-877-SUN-SAVES 2211AllenwoodRoadPh:732-780-3779Wall,NewJersey07719Fax:732-780-6671www.trinity-solar.com FORINFORMATIONABOUTCONTRACTORSANDTHECONTRACTORS’REGISTRATION ACT,CONTACT THE NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY,DIVISION OF CONSUMERS AFFAIRS AT 1-888-656-6225. Corinne Guest 30 Park St Florence 78222-70018 National Grid Ma Tessa Corcoran Guest CorinneCorinne Northampton, MA December 1, 2021 212 Main St. Northampton, MA 01060 Trinity Solar No. 30 Park Street 2021-11-645028 Northampton, MA 01062 Trinity Solar | 4 Open Square Way, Suite 410 | Holyoke, MA | (413) 203-9088 MA License No. 56687 RE: BUTLER-GUEST, CORINNE; SAYERS, KAREN To the Building Official: The following information constitutes a summary of the relevant design criteria and recommendations for the support of a new photovoltaic [PV] system on the existing roof framing components at the above-referenced location. Criteria is as follows: 1.Existing roof framing: Conventional roof framing at R1 is true 2x5 at 30 o.c.; existing rafter span= 11' 6"; Conventional roof framing at R5 is true 2x5 at 30 o.c.; existing rafter span= 7' 0"; (spans are horizontal projection) 2.Roof Loading: • 4.33psf dead load (pounds per square foot - PV panels, mounting rails & hardware) • 5.7 psf - existing roof loads (1.7 psf - 2x6 framing, 1.5psf roof sheathing, 2.5 psf shingles) • Ground Snow Load - 40psf - per AHJ (Authority Having Jurisdiction) • Wind criteria - Exposure Category B, 117 mph wind 3. Existing roof modification - provide new 2x6 collar ties at all rafters without collar ties at 1/3 of the ridge-eave height down from the roof ridge elevation. Collar ties to be connected to each rafter using (6) 10d common nails. Alternatively, "sister" existing rafters with new 2x6 rafters extending the full length of the existing rafters and terminated before the existing rafter support connection. Non-full-length rafter sisters must "overlap" its accompanied sister a minimum of 24" with nailing from each side in the overlap. This installation design is in general conformance with the manufacturers’ specifications and complies with all applicable laws, codes, and ordinances – specifically the International Building Code (2015 edition) and the International Residential Code (2015 edition), including all Massachusetts regulations and amendments. The spacing and fastening of the mounting brackets is a maximum of 48” o.c. between mounting brackets (staggered) and is secured using 5/16” diameter corrosive-resistant steel lag bolts. A minimum of 2½” of penetration (embedment) per lag bolt is required, which will resist all stated loads above – including wind shear. Per NDS Section 12.1.4, clearance holes - equal to the diameter of the shank - need to be bored into a primary framing member for the full-length of the threaded portion of the bolt to avoid splitting of the framing member. Regards, Ihor Bojcun, PE Structural Engineer - Trinity Solar INSTALLATION OF NEW ROOF MOUNTED PV SOLAR SYSTEM 30 PARK STREET NORTHAMPTON, MA 01062 42.333534,-72.6746256 PARK STREET P1 ISSUED TO TOWNSHIP FOR PERMIT 11/24/2021 NO.DESCRIPTION DATE GUEST, CORINNE- TRINITY ACCT #: 2021-11-645028 30 PARK STREET NORTHAMPTON, MA 01062 42.333534,-72.6746256 PROPOSED PV SOLAR SYSTEM DRAWING DATE:11/24/2021 DRAWN BY:KTD REVISED BY: DC SYSTEM SIZE:7.6kW AC SYSTEM SIZE:6kW MODULE COUNT:19 MODULES USED:HANWHA 400 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 400 UTILITY COMPANY:NAT'L GRID UTILITY ACCT #:7822270018 UTILITY METER #:05088063 DEAL TYPE:SUNNOVA P1 R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com ROOF 1 MODULES: 8 PITCH: 32 ORIENTATION: 198 ROOF 2 MODULES: 0 PITCH: 32° ORIENTATION: 18° ROOF 3 MODULES: 0 PITCH: 29° ORIENTATION: 19° ROOF 4 MODULES: 0 PITCH: 20° ORIENTATION: 17° ROOF 5 MODULES: 11 PITCH: 29 ORIENTATION: 199 ROOF 6 MODULES: 0 PITCH: 42° ORIENTATION: 197° ROOF 7 MODULES: 0 PITCH: 42° ORIENTATION: 18° ROOF 8 MODULES: 0 PITCH: 42° ORIENTATION: 198° ROOF 9 MODULES: 0 PITCH: 15° ORIENTATION: 107° ROOF 10 MODULES: 0 PITCH: 18° ORIENTATION: 197° ROOF 11 MODULES: 0 PITCH: 18° ORIENTATION: 107° ROOF 12 MODULES: 0 PITCH: 2° ORIENTATION: 19° ROOF 13 MODULES: 0 PITCH: 14° ORIENTATION: 199° ROOF 14 MODULES: 0 PITCH: 20° ORIENTATION: 288° ROOF 15 MODULES: 0 PITCH: 20° ORIENTATION: 18° ROOF 16 MODULES: 0 PITCH: 20° ORIENTATION: 198° D UD epM P DC AC N S270 9013522545 31542.333534,-72.6746256 19 HANWHA 400 (Q.PEAK DUO BLK ML-G10+ 400) 1 SE6000H-US0SHBNC4 IN BASEMENT OUTSIDE. OUTSIDE (UTILITY ACCESSIBLE)OUTSIDE. P1 ISSUED TO TOWNSHIP FOR PERMIT 11/24/2021 NO.DESCRIPTION DATE GUEST, CORINNE- TRINITY ACCT #: 2021-11-645028 30 PARK STREET NORTHAMPTON, MA 01062 42.333534,-72.6746256 PROPOSED PV SOLAR SYSTEM DRAWING DATE:11/24/2021 DRAWN BY:KTD REVISED BY: DC SYSTEM SIZE:7.6kW AC SYSTEM SIZE:6kW MODULE COUNT:19 MODULES USED:HANWHA 400 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 400 UTILITY COMPANY:NAT'L GRID UTILITY ACCT #:7822270018 UTILITY METER #:05088063 DEAL TYPE:SUNNOVA P1 NOTES: 1.) ALL EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH THE MANUFACTURER'S INSTALLATION INSTRUCTIONS. 2.) 3.) ALL LOCATIONS ARE APPROXIMATE AND REQUIRE FIELD VERIFICATION. ALL OUTDOOR EQUIPMENT SHALL BE RAIN TIGHT WITH MINIMUM NEMA 3R RATING. M UD SP P DC AC ep D DC R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com SD TS CALCULATIONS FOR CURRENT CARRYING CONDUCTORS REQUIRED CONDUCTOR AMPACITY PER STRING [NEC 690.8(B)(1)]: (15.00*1.25)1 = 18.75A AWG #10, DERATED AMPACITY AMBIENT TEMP: 33°C, TEMP DERATING FACTOR: .96 RACEWAY DERATING = 4 CCC: 0.80 (40*.96)0.80 = 30.72A 30.72A >_ 18.75A, THEREFORE WIRE SIZE IS VALID TOTAL AC REQUIRED CONDUCTOR AMPACITY 25.00A*1.25 = 31.25A AWG #8, DERATED AMPACITY AMBIENT TEMP: 30°C, TEMP DERATING: 1.0 RACEWAY DERATING <_ 3 CCC: N/A 55A*1.0 = 55A 55A >_ 31.25A, THEREFORE AC WIRE SIZE IS VALID CALCULATION FOR PV OVERCURRENT PROTECTION TOTAL INVERTER CURRENT: 25.00A 25.00A*1.25 = 31.25A --> 40A OVERCURRENT PROTECTION IS VALID ARRAY CIRCUIT WIRING NOTES 1.) LICENSED ELECTRICIAN ASSUMES ALL RESPONSIBILITY FOR DETERMINING ONSITE CONDITIONS AND EXECUTING INSTALLATION IN ACCORDANCE WITHNEC 2020 2.) LOWEST EXPECTED AMBIENT TEMPERATURE BASED ON ASHRAE MINIMUM MEAN EXTREME DRY BULB TEMPERATURE FOR ASHRAE LOCATION MOST SIMILAR TO INSTALLATION LOCATION. LOWEST EXPECTED AMBIENT TEMP = -16°C 3.) HIGHEST CONTINUOUS AMBIENT TEMPERATURE BASED ON ASHRAE HIGHEST MONTH 2% DRY BULB TEMPERATURE FOR ASHRAE LOCATION MOST SIMILAR TO INSTALLATION LOCATION. HIGHEST CONTINUOUS TEMP = 33°C 4.) 2005 ASHRAE FUNDAMENTALS 2% DESIGN TEMPERATURES DO NOT EXCEED 47°C IN THE UNITED STATES (PALM SPRINGS, CA IS 44.1°C). FOR LESS THAN 9CURRENT-CARRYING CONDUCTORS IN A ROOF-MOUNTED SUNLIT CONDUIT AT LEAST 0.5" ABOVE ROOF AND USINGTHE OUTDOOR DESIGN TEMPERATURE OF 47°C OR LESS(ALL OF UNITED STATES) 5.) PV SYSTEM CIRCUITS INSTALLED ON OR IN BUILDINGSSHALL INCLUDE A RAPID SHUTDOWN FUNCTION THATCONTROLS SPECIFIC CONDUCTORS IN ACCORDANCE WITHNEC 690.12(A) THROUGH (D) 6.) PHOTOVOLTAIC POWER SYSTEMS SHALL BE PERMITTEDTO OPERATE WITH UNGROUNDED PHOTOVOLTAICSOURCE AND OUTPUT CIRCUIT AS PER NEC 690.41 (A)(4) 7.) UNGROUNDED DC CIRCUIT CONDUCTORS SHALL BEIDENTIFIED WITH THE FOLLOWING OUTER FINISH: POSITIVE CONDUCTORS = REDNEGATIVE CONDUCTORS = BLACK NEC 210.5(C)(2) 8.) ARRAY AND SUB ARRAY CONDUCTORS SHALL BE #10 PV WIRE TYPE RHW-2 OR EQUIVELANT AND SHALL BE PROTECTED BY CONDUIT WHERE EXPOSED TO DIRECT SUNLIGHT. SUB ARRAY CONDUIT LONGER THAN 24” SHALL CONTAIN ≤ 20 CURRENT CARYING CONDUCTORS AND WHERE EXPOSED TO DIRECT SUNLIGHT SHALL CONTAIN ≤ 9 CURRENT CARRYING CONDUCTORS. 9.) ALL WIRE LENGTHS SHALL BE LESS THAN 100' UNLESS OTHERWISE NOTED 10.) FLEXIBLE CONDUIT SHALL NOT BE INSTALLED ON ROOFTOP AND SHALL BE LIMITED TO 12” IF USED OUTDOORS 11.)OVERCURRENT PROTECTION FOR CONDUCTORS CONNECTED TO THE SUPPLY SIDE OF A SERVICE SHALL BE LOCATED WITHIN 10' OF THE POINT OF CONNECTION NEC 690.9(A)(3)(2) 12.) WHERE TWO SOURCES FEED A BUSSBAR, ONE A UTILITY AND THE OTHER AN INVERTER, PV BACKFEED BREAKER(S) SHALL BE LOCATED OPPOSITE FROM UTILITY NEC 705.12(B)(3)(2) 13.) ALL SOLAR SYSTEM LOAD CENTERS TO CONTAIN ONLY GENERATION CIRCUITS AND NO UNUSED POSITIONS OR LOADS 14.) ALL EQUIPMENT INSTALLED OUTDOORS SHALL HAVE A NEMA 3R RATING SQUARE D DU222RB 60A UNFUSED DISCONNECT ISOLATED NEUTRAL 240V 1Ø B LOCKABLE 60A DISCONNECT FUSED W/ 40A FUSES SQUARE D PN: D222NRB ISOLATED NEUTRAL 240V 1Ø B NOTE: INTERNAL REVENUE GRADE MONITORING CONTAINED WITHIN SOLAR EDGE INVERTER SOLAR EDGE PN. RWND-3D-240-MB SMART METER PRODUCTION METER M ISOLATED NEUTRAL LINE SIDE LOAD SIDENEUTRAL EXISTING MAIN BREAKER LOAD CENTER INSULATED LINE TAPS INSTALLED ON MAIN FEEDERS NEC 705.12(A) M 2p100AMAIN240V 1Ø 100A MAIN BREAKER 100A BUSBAR EXISTING 1Ø 120/240V UTILITY METER EG INVERTER #1 - SE6000H-US0SHBNC4 DC AC Imp 16.5 Pout 6000 Vmp 380 Imax 25 Voc 480 OCPDmin 31.25 Isc 30 Vnom 240 PV MODULE SPECIFICATIONS HANWHA 400 (Q.PEAK DUO BLK ML-G10+ 400) Imp 10.77 Vmp 37.13 Voc 45.3 Isc 11.14 A #6 THWN-2 GEC TO EXISTING GROUND ROD B 3/4'' CONDUIT W/ 2-#8 THWN-2, 1-#10 THWN-2, 1-#10 THWN-2 GROUND C 3/4'' CONDUIT W/ 4-#10 THWN-2, 1-#10 THWN-2 GROUND D 3/4'' CONDUIT W/ 4-#10 THWN-2, 1-#10 THWN-2 GROUND E 3/4'' CONDUIT W/ 2-#8 THWN-2, 1-#10 THWN-2, 1-#10 THWN-2 GROUND F #10 PV WIRE (FREE AIR) W/ #6 BARE COPPER BOND TO ARRAY G 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#6 THWN-2, 1-#8 THWN-2 GROUND NOTE: CONDUIT TYPE SHALL BE CHOSEN BY THE INSTALLATION CONTRACTOR TO MEET OR EXCEED NEC AND LOCAL AHJD REQUIREMENTS INVERTER #1 PV+L1 L2 N PV-D SOLAR MODULES MOUNTED TO ROOF ON 2 ARRAYS 19 - 400W MODULES W/ 1 SOLAR EDGE P401 PER MODULE 15 ADC MAX PER STRING 1 STRING OF 11 MODULES IN SERIES - 380 Vmax 1 STRING OF 8 MODULES IN SERIES - 380 Vmax *2 STRINGS TO BE TERMINATED IN PARALLEL INSIDE INVERTER 1 f 8"x8" JUNCTION BOX P1 ISSUED TO TOWNSHIP FOR PERMIT 11/24/2021 NO.DESCRIPTION DATE GUEST, CORINNE- TRINITY ACCT #: 2021-11-645028 30 PARK STREET NORTHAMPTON, MA 01062 42.333534,-72.6746256 PROPOSED PV SOLAR SYSTEM DRAWING DATE:11/24/2021 DRAWN BY:KTD REVISED BY: DC SYSTEM SIZE:7.6kW AC SYSTEM SIZE:6kW MODULE COUNT:19 MODULES USED:HANWHA 400 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 400 UTILITY COMPANY:NAT'L GRID UTILITY ACCT #:7822270018 UTILITY METER #:05088063 DEAL TYPE:SUNNOVA P1 R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com 10/11/21, 11:04 AM Office of Consumer Affairs & Business Regulation - Mass.Gov https://services.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=170355 1/2 HIC Registration Complaints Registration # 170355 Registrant TRINITY SOLAR INC. DBA TRINITY SOLAR Name BRIAN MACPHERSON Address 20 PATTERSON BROOK ROAD UNIT 10 City, State Zip WEST WAREHAM, MA 02576 Expiration Date 10/11/2023 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Mass.govMass.gov Office of Consumer Affairs and BusinessRegulation (OCABR) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 5/20/2021 Arthur J.Gallagher Risk Management Services,Inc.4000 Midlantic Drive Suite 200MountLaurelNJ08054 Mark Grasela 856-482-9900 856-482-1888 CherryHill.BSD.CertM@AJG.com Gotham Insurance Company 25569 TRINHEA-03 National Union Fire Insurance Company of Pittsburg 19445TrinitySolarInc.4 Open Square Way,Suite 410Holyoke,MA 01040 Endurance American Specialty Ins Co 41718 Liberty International Underwriters 206332321 A X 2,000,000 X 100,000 5,000 1,000,000 2,000,000 X GL202100013378 6/1/2021 6/1/2022 2,000,000 B 2,000,000 X CA 2960145 6/1/2021 6/1/2022 ACD X 5,000,000 X EX202100001871ELD300069891001000231834-05 6/1/20216/1/20216/1/2021 6/1/20226/1/20226/1/2022 5,000,000 Limit x of$5,000,000 19,000,000 B WC 13588107 6/1/2021 6/1/2022 1,000,000 1,000,000 1,000,000 B AutomobileComp/CollusionDed.CA 2960146 6/1/2021 6/1/2022 All Other UnitsTruck-TractorsandSemi-Trailers $250/500 $250/500 Evidence of Insurance. Evidence of Insurance 6/1/2022 Holyoke MA, 01040 WC13588107 4 Open Square Way, Suite 410 JOB NAME:GUEST, CORINNE- ADDRESS:30 Park Street Northampton, MA 01062 42.333534,-72.6746256 52.16 ESTIMATED PERSONNEL HOURS 2.17 DAYS 1.63 DAYS 1.09 DAYS •19 HANWHA 400's (7.6KW)(CREW OF 3)(CREW OF 4)(CREW OF 6) •2 SEPARATE ARRAYS •28' PEAK TO GROUND •19 PORTRAIT & 0 LANDSCAPED •1 INVERTERS INSTALLED OUTSIDE •NO TRENCH ESTIMATED SENT TO JOB USED □HANWHA 400 (Q.PEAK DUO BLK ML-G10+ 400)19 ______ □P401 SE OPTIMIZERS 19 ______ □SE6000H-US0SHBNC4 1 ______ □60A OUTDOOR FUSED DISCONNECT W/ (2) 40A FUSES 1 ______ □60A OUTDOOR NON-FUSED DISCONNECT 1 ______ □SOLADECK BOX(ES) & HAYCO CONNECTOR(S)2 ______ □PV LEAD WIRE 100'______ □INSULATED BUG BITES (LINE TAPS)2 ______ □CASE(S) OF BLACK SPRAY PAINT 1 ______ □CASE(S) OF TAR 1 ______ □ECOFASTEN 2012021 CF STD RAIL MLL AL 165.4 11 ______ □ECOFASTEN 2012013 CF RAIL SPLICE 9 ______ □ECOFASTEN 2099017 CF END CLAMP 32MM BLK 8 ______ □ECOFASTEN 2099022 CF MID CLAMP SHORT BLK 34 ______ □ECOFASTEN 4011011 MODULE JUMPER 0 ______ □GROUNDING LUG (NOT PROVIDED BY ECOFASTEN)2 ______ □ECOFASTEN 2012022 CF UNIV L-FOOT MLL 3 38 ______ □ECOFASTEN 3012020 GF-1 FLASHING GLV BLK 8 x 10 38 ______ □ECOFASTEN 2012019 CF MLPE MOUNT 19 ______ □ECOFASTEN 2012020 CF WIRE MGMT CLIP 19 ______ □ECOFASTEN 2012024 CF END CAP 8 ______ MATERIAL LIST R(FOR INTERNAL USE ONLY) 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com INSTALLATION OF NEW ROOF MOUNTED PV SOLAR SYSTEM 30 PARK STREET GUEST, CORINNE- 30 PARK STREET NORTHAMPTON, MA 01062 42.333534,-72.6746256 R APPENDIX CONTENTS LABELS, STICKERS, AND PLACARDS EQUIPMENT DATA SHEETS 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com