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29-378 (3) BP-2024-1056 6 BROOKWOOD DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-378-001 CITY OF NORTHAMPTON Permit: Solar Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-1056 PERMISSION IS HEREBY GRANTED TO: Project# 2024 SOLAR Contractor: License: SUNRUN INSTALLATION SERVICES Est. Cost: 19270 INC CS-090170 Const.Class: Exp.Date: 05/09/2026 Use Group: Owner: MANUEL SANTOS KATHLEEN & Lot Size (sq.ft.) Zoning: WSP Applicant: SUNRUN INSTALLATION SERVICES INC Applicant Address Phone: Insurance: 240A CHERRY ST 413-259-8044 WC614287602 SHREWSBURY, MA 01545 ISSUED ON: 08/22/2024 TO PERFORM THE FOLLOWING WORK: INSTALL 25 PANEL 10.25 KW ROOF MOUNT SOLAR SYSTEM (DECK MOUNT, NO STRUCTURAL UPGRADES OR BATTERY) POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 11 "" Fees Paid: S125.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner I RECEIVED The Commonwealth of Massa husetts lt Board of Building Regulations an StandarcAU� 0 2024 FOR Massachusetts State Building Cod ,780 CMR MUN CIPALITY _ USE Building Permit Application To Construct, Repai , Renpvatgdytimpwo@kftTiAevised Mar 2011 One-or Two-Family Dwe1 i'ng NORTHAM1'?ON.MA 01060 This Section For Official Use Only Building Permit Number:jQ-2lf../ 5 C# Date Applied: Building Official(Print N e gnature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 6 BROOKWOOD DR l.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use 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) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? — Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: KATHLEEN SANTOS NORTHAMPTON MA Name(Print) City,State,ZIP 6 BROOKWOOD DR 4132107604 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: INSTALLATION OF ROOFTOP PHOTOVOLTAIC SOLAR SYSTEM#OF PANELS 2510.25KW NO BATTERY SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building S 3854.00 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $15416.00 ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing S 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) 'LL Total All Fees:SA Check No. ajgf-I`check Amount: i)Cash Amount: 6.Total Project Cost: $19270.00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-090170 5/9/2026 ROBERT J DECKER IV IV License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 240A CHERRY ST SHREWSBURY MA 01545 No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding Fpioneervalleypermits(d3sunrun.com 413-259-8044 SF Solid Insulattionion Burning Appliances Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(H IC) 180120 10/13/2024 SUNRUN INSTALLATION SERIVCES HIC Registration Number Expiration Date I I12CICoffir PmeiJA ISCNIEleir}V08853 pioneervalleypermits©sunrun.com No.and Street Email address 4132598044 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 0 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: OWNER' 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. �G,✓/ 7.1424.4LA 8/19/2024 Print Owner's or Authorized Agent's Name(Electronic Signature) Date 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 at www.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" The Commonwealth of Massachusetts Department of Industrial Accidents =/1►=_ 1 Congress Street,Suite 100 3_� Boston,MA 02114-2017 . ``_y www.mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AGTHORIT't. Applicant Information Please Print Legibly Name(Business/Organization/Individual):SUNRUN INSTALLATION SERVICES Address:225 BUSH ST STE 1400 City/State/Zip:SAN FRANCISCO CA Phone#:415-946-7500 Are you an employer?Check the appropriate box: Type of project(required): I_®I am a employer with 50 employees(full and/or pan-time).* 7. 0 New construction '_.❑lam a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. 0 Demolition a I am a homeowner doing all work myself.[No workers'comp.insurance required.' 10 0 Building addition 4.❑I 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 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.; 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0Other SOLAR INSTALL 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:AMERICAN ZURICH INSURANCE COMAPNY Policy#or Self-ins.Lic.#:WC614287602 Expiration Date: 10/1/2024 Job Site Address:6 BROOKWOOD DR City/State/Zip:NORTHAMPTON MA 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 certi 'under the pains and penalties of perjury that the information provided above is true and correct. Signature: _49CI c"---Tt7— Date: 8/19/2024 Phone#: 4132598044 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia SHEET INDEX SCOPE OF WORK GENERAL NOTES PAGE N DESCRIPTION •SYSTEM SIZE 10250W DC,7600W AC •ALL WORK SHALL COMPLY WITH MA 9TH ED.CMR 780(2015 IRCIBCAEBC),7-10 PV-1.0 COVER SHEET •MODULES (25)HANWHA 0-CELLS:Q.PEAK DUO BLK ASCE&2015 NDS.2023 NEC AND 2023 MA ELECTRICAL CODE 527 CMR 12.00(2023 ML-G10+410 NFPA 70 WITH MA AMENDMENTS),MUNICIPAL CODE.AND ALL MANUFACTURERS' PV-2.0 SITE PLAN •INVERTERS (1)SOLAREDGE TECHNOLOGIES: LISTINGS AND INSTALLATION INSTRUCTIONS. PV 3.0 LAYOUT SE7600H-USMN •PHOTOVOLTAIC SYSTEM WILL COMPLY WITH NEC 2023. •RACKING TOPSPEED.ATTACHMENT DETAIL,MOUNT TO PV-4.0 ELECTRICAL WOOD DECK SNR-DC-30004 •ELECTRICAL SYSTEM GROUNDING WILL COMPLY WITH NEC 2023. PV-5.0 SIGNAGE •PHOTOVOLTAIC SYSTEM IS UNGROUNDED.NO CONDUCTORS ARE SOLIDLY GROUNDED IN THE INVERTER.SYSTEM COMPLIES WITH 690.35. •MODULES CONFORM TO AND ARE LISTED UNDER UL 61730. •INVERTER CONFORMS TO AND IS LISTED UNDER UL 1741. •RACKING CONFORMS TO AND IS LISTED UNDER UL 2703. •SNAPNRACK RACKING SYSTEMS,IN COMBINATION WITH TYPE I,OR TYPE II MODULES,ARE CLASS A FIRE RATED. •RAPID SHUTDOWN REQUIREMENTS MET WHEN INVERTERS AND ALL CONDUCTORS ARE WITHIN ARRAY BOUNDARIES PER NEC 690.12(1). •CONSTRUCTION FOREMAN TO PLACE CONDUIT RUN PER 690.31(D). •ARRAY DC CONDUCTORS ARE SIZED FOR DERATED CURRENT. •11.2 AMPS MODULE SHORT CIRCUIT CURRENT. •14 AMPS DERATED SHORT CIRCUIT CURRENT(690.8(A)&690.8(B)). •PV INSTALLATION COMPLIES WITH THE NEC 2023 ARTICLE 690.12(B)(2)(2). CONTROLLED CONDUCTORS LOCATED INSIDE THE ARRAY BOUNDARY ARE LIMITED TO 80 VOLTS WITHIN 30 SECOND OF A RAPID SHUTDOWN INITIATION sunrun /180120 ABBREVIATIONS VICINITY MAP ,SOPWOFTIfi Sf,RRA c•.cooF)W oaauu WOE A AMPERE Fuo AC ALTERNATING CURRENT - CUSTOMER RESIDENCE' AFC ARC FAULT CIRCUIT INTERUPTER KATHLEEN SANTOS °O AEM AZIMUTH6 BROOKWOOD OR, .. COMP COMPOSI NORTHAMPTON.MA.01062 TION DC DIRECT CURRENT _ TEL(413)210.7604 (E/ EMEND APN:NHAM-000029-00376-000001 EN ENERGY STORAGE SYSTEM PROJECT NUMBER. RASP MAIN SERVICE PANEL . 224R-006SANT (N/ NEW DESIGNER: (415)560-6920 ex3 PRE.AI PRE.FASRICATED ZAIRA MARCOS PSF POUNDS PER SQUARE FOOT SHEET PV PNOTOVOLTAIC COVER SHEET RSD RAP))SHUTOONN DEVICE TL TRAMSFORMERLESS REV Al 6/16/2024 ✓ VOUS PAGE PV-1.0 W WATTS SITE PLAN-SCALE=1/8"•1'-0" SITE PLAN DETAIL-SCALE•1/64"•1'-0" \1I Qp (E)DRIVEWAY ROOF PATHWAYS 00� �-(E)RESIDENCE (3'TYP) P00o� 0 4 i'i (N)ARRAY AR-01 (E)GATE 9 \.777 1.' FIRE SETBACKS ROOF PATHWAYS (3'TYP) ##**' #441 I 11* (3'TYP) NOTES: sunrun .. \-(N)ARRAY AR-02 • RESIDENCE DOES NOT CONTAIN ACTIVE FIRE SPRINKLERS. #180120 ARRAY DETAILS: •x Pnoo[n[er Leal A cHconc¢.w oron. ®PE • TOTAL ROOF SURFACE AREA:1470 SOFT. �+^ • TOTAL PV ARRAY AREA 528.4 SO FT. • PERCENTAGE PV COVERAGE: CUSTOMER RESIDENCE: IQ (TOTAL PV ARRAY AREA/TOTAL ROOF SURFACE KATHLEEN SANTOS AREA)'100=35.9% 8 BROOKW000 DR, NORTHAMPTON,MA•01062 ARRAY TRUE MAG PV AREA PITCH AZIM AZIM (SOFT) TEL.(413)210.7604 AR-01 18' 323'• 337'-- 253.6 APN.NHAM-000029-000378-000001 AR-02 18° 144' 158' 274.8 PROJECT NUMBER: 224R-006SANT LEGEND AC INTERIOR EQUIPMENT PVC PIPE VENT DESIGNER: (415)580.8920 4x3 � S SM SUNRUN METER 0 AC DISCONNECT(S) SHOWN AS DASHED r% METAL PIPE VENT HARDSCAPE SOLAR W;NDT ALL(TE1AS NLEOE/D LJ - . MODULES ZAIRA MARCOS L EARN SITE PLAN PM DC DEDICATED PV METER DC DISCONNECT(S) G T-VENT CHIMNEY -PL- PROPERTY LINE SHEET SERVICE ENTRANCE SP SUB PANEL INVERTERS) ATTIC VENT ^ SATELLITE DISH SITE PLAN REV Al 8/18/2024 J��,�-��-� LC]MAIN PANEL PV LOAD CENTER CB 1Q COMBINER BOX FLUSH ATTIC VENT FIRE SETBACKS -TOPSPEED PAGE -�I MOUNT PV-2.O • ROOF INFO FRAMING INFO ATTACHMENT INFORMATION DESIGN CRITERIA Max OC Minimum Number of Mounts per Max Landscape Max Portrait MAX DISTRIBUTED LOAD:3 PSF Name Type Height Type Span Spacing Detail Up-Slope(Landscape/Portrait) Overhang Overhang SNOW LOAD:40 PSF COMP SHINGLE- TOPSPEED,ATTACHMENT DETAIL,MOUNT WIND SPEED: AR-01 TOPSPEED 1-Story 2X4 CARPENTER TRUSSES 6'-7" 24" TO WOOD DECK:SNR-DC-30004 2/NA 1'6" NA 117 MPH 3-SEC GUST. • FASTENERS: AR-02 COMP SHINGLE- 1-Story 2X4 CARPENTER TRUSSES 6'-1" 24" TOPSPEED,ATTACHMENT DETAIL,MOUNT 2/NA 1'-6" NA (4)#14 S.S.SEALING WASHER TOPSPEED TO WOOD DECK SNR-DC-30004 WOOD SCREWS FULLY PENETRATING THROUGH WOOD D1-AR-01-SCALE:1/8"=1'-0" DECK AZIM:323' PITCH:18" 3 • 37'.4" "—g,2'— - / 8'" 0 0 0 0 0 0 • • 0 0 0 • • NO.54067 I I1" (' G ST. 0 e 0 0 0 • • • 0 0 0 o sya an r11.7024 r_-.. D2-AR-02-SCALE:1/8"=1'-0" AZIM.144' sunrun PITCH:18' 143"1—, 7743.-7/" 3'-4"I- //i 9/( / D //�///�//O ///// 3,I- #180120 1 ''. mrt UHTo•J PAEE u A OVEE MA oqn-'1 ,c.E0 O OOO o •, • • e o a o 0 0 / 8'-11" j ;/ CUSTOMER RESIDENCE !�/ KATHLEEN SANTOS o 0 0 o O • 0 coo 0 • o o < 1 6 BROOKWOOD DR, • / 3,-4. NORTHAMPTON,MA,01062 I TEL.(413)210-7604 AM-NHAM-00002400037a-000001 PROJECT NUMBER 224R•006SANT DESIGNER: (415)560.6920 ex3 STRUCTURAL NOTES:TOPSPEED ZAIRA MARCOS • INSTALLERS SHALL NOTIFY ENGINEER OF ANY POTENTIAL STRUCTURAL ISSUES OBSERVED PRIOR TO PROCEEDING W/INSTALLATION. SHEET • MOUNT NUMBER FOR LEADING DOWNSLOPE EDGE SHALL MATCH REQUIREMENTS LISTED ABOVE LAYOUT • IF A MODULE(EXCLUDING SKIRT)IS WITHIN 12"BOUNDARY REGION OF ANY ROOF PLANE EDGE(EXCEPT VALLEYS),ADDITIONAL MOUNTS WILL BE REQUIRED IN THE FOLLOWING CONFIGURATIONS REV:Al 8/182024 • EAVE&RIDGE-3 TOPSPEED ATTACHMENTS MUST BE USED ON THE MODULE EDGE. PAGE • GABLE&HIP-3RD TOPSPEED ATTACHMENT MUST BE ADDED ON THE MODULE CORNER NEAREST TO THE ROOF EDGE. PV_3.0 0 II (B)LOCKABLE TYPE TYPE AC DISCONNECT EXISTING 200A MAIN BREAKERLi 0 _ HAIL 0-CELLS END FED ()PEAK DUO BLK EXISTING 200A I ML-G10.410 MAIN PANEL SOLAREDGE .r . STRING 2 OF 12 MODULES 200A BUS 78 7600 �USMW © ii�m (1MTH S440 OPTMIZERS) .� © INVERTER _,_ rr0 _ HAN WA QCELLS 0.PEAK DUO BLK Eli ML-G10+410 Im I-� o'fo .r� STRINc 1 of 13 MODl1LES • ii!�= r� oJ''o .I (WITH$440 OPTIMIZERS) J•BOx SQUARED LOAD RATED DC DU222RB DISCONNECT WITH 3R.60A.2P AFC!RAPID 120/240VAC SHUTDOWN COMPUANT 'POINT OF INTERCONNECTION:705.12(B)(2).LOAD BREAKER AT OPPOSITE END OF BUSBAR METER NLwMBER.96647405 .EQUIPMENT CHARACTERISTICS INCLUDED IN SPEC SHEETS -NOTE-TOTAL PV BACKFEED •40A USED FOR INTERCONNECTION CALCULATIONS CONDUIT SCHEDULE TAG CIRCUIT DESCRIPTION CONDUCTOR NEUTRAL GROUND CONDUIT 1 Inverter Input (2)10 AWG(PV WIRE) N/A 10 AW0(BARE) Open Air 2 I THH/0WTHINN-2 N/A 10 AVYG THHN?FNMI 2 3/4 EMT AVVG s u n r u n 3 Invader Output (2)8AVLG (i)10ANC 8A1NG THHWTHWN-2 3/4 EMT THHWTHWN-2 THHN/THWN-2 6180120 »n m¢TW sT UV ncCCEE w 04112 IN. ,.no CUSTOMER RESIDENCE: KATHLEEN SANTOS 8 BROOKWOOD DR. NORTHAMPTON,MA.01062 MODULE CHARACTERISTICS S440 OPTIMIZER CHARACTERISTICS: HANWHA 0-CELLS:O.PEAK DUO BLK TEL.(413)210-7604 ML-G10+410: d10 W MIN INPUT VOLTAGE 8 VDC OPEN CIRCUIT VOLTAGE. 45.37 V MAX INPUT VOLTAGE: 60 VDC APN-NHAM-000029-000378-000001 MAX POWER VOLTAGE 37.64 V MAX INPUT ISC 14.5 ADC PROJECT NUMBER' SHORT CIRCUIT CURRENT 11.2 A MAX OUTPUT CURRENT 15 ADC 224R-OO6SANT DESIGNER: (415)580-6920 ex3 SYSTEM CHARACTERISTICS•INVERTER 1 ZAIRA MARCOS SYSTEM SIZE 10250 W SYSTEM OPEN CIRCUIT VOLTAGE: 13 V SHEET MAX ALLOWABLE DC VOLTAGE: 480 V ELECTRICAL SYSTEM SHORT CIRCUIT CURRENT: 30 A REV:Al 8/16/2024 PAGE PV-4.0 INVERTER 1 I I_ G PHOTOVOLTAIC DC DISCONNECT NOTES AND SPECIFICATIONS:•SIGNS AND LABELS SWILL MEET THE REQUIREMENTS OF THE NEC 2023 ARTICLE 110.21(8).UNLESS SPECIFIC INSTRUCTIONS ARE REQUIRED BY SECTION 690.OR ELECTRICAL SHOCK HAZARD IN .' .'SYSTEM VOLTAGE 480 IF REQUESTED BY THE LOCAL AHJ. •SIGNS AND LABELS SHALL ADEQUATELY WARN OF HAZARDS USING EFFECTIVE TERMI4ALS ON LINE AND WAD LAEEL LOCATION WORDS.COLORS AND SYMBOLS. •LABELS SHALL BE PERMANENTLY AFFIXED TO THE EQUIPMENT OR WRING SIDES MAY BE ENERGIZED N INVERTER(S).DC DISCONNECT(S). METHOD AND SHALL NOT BE HAND WRITTEN. THE OPEN POSRION PER CODE(S):NEC 2023.690.7(D) •LABEL SHALL BE OF SUFFICIENT DURABILITY TO YNTHSTAND THE ENVIRONMENT INVOLVED. LABEL LOCATION •SIGNS AND LABELS SHALL COMPLY W TH ANSI Z535.4-2011.PRODUCT SAFETY INVERTER(S).AC/DC DISCONNECT(S). SIGNS AND LABELS.UNLESS OTHERWISE SPECIFIED. AC COMBINER PANEL(IF APPUCABLE). •DO NOT COVER EXISTING MANUFACTURER LABELS. PER CODE(S):NEC 2023.690.13(8). 705.20(7),708.15(C) ! WARNING_ DUAL POWER SUPPLY SOURCES:UTILITY GRID AND PV SOLAR ELECTRIC SYSTEM LABEL LOCATION - UTILTTY SERVICE METER AND MAIN SERVICE PANEL. PER CODE(S):NEC 2023.705.30(C) 1.833.607.6937 ext. 0 A :iil 1.855.478.6786 . POWER SOURCE OUTPUT L:Q Ni 911 MULTIPLE SOURCES OF POWER THIS DO NOT RELOCATE THIS - ' ^�"� OVERCURRENT DEVICE Sunrun LABEL LOCATIONS e---- ADJACENT TO PV BREAKER AND ESS LABEL LOCATION. OCPD(IF APPLICABLE). MAIN SERVICE DISCONNECT $u n r u n PER CODE(S):NEC 2023:705.12(8)(2) RAPID SHUTDOWN SWITC- SOLAR PV SYSTEM EQUIPPED , - Ileol2o SOLAR PANELS - .».40IITTS 4r UNIT 404.X.H.NA owan+s Naal FOR SOLAR PV SYSTEr WITH RAPID SHUTDOWN ON ROOF ` _ CUSTOMER RESIDENCE: LABEL LOCATION' KATHLEEN SANTOS INSTALLED W TWIN 3'OF RAPID SHUT DOWN 6 BROOKWOOD DR, SNATCH PER CODE(S):NEC 2023.690.12(0)(2).IFC NORTHAMPTON,MA,01082 2018.1204.5.3 3" TURN RAPID SHUTDOWN SWITCH TO THE"OFF" �; "' (� TEL.(413)210-7604 POSITION TO SHUT DOWN APN:NFV1M-000029-000378-000001 WARNING: PHOTOVOLTAIC PV SYSTEM AND REDUCE INVERTER (EXT)1 MAIN PANEL AND PV PROJECT NUMBER: POWER SOURCE SHOCK HAZARD IN THE BREAKER 22aR-008SANT ARRAY. MAI AC DISCONNECT (EXT)- LABELLOCAI1oN DISCONNECT (INT) DESIGNER: (415)580-6920 ex3 A�RFAo�BEA EVERYT EACH WTRATONS. SERVICE ENTRANCE (EXT)- ZAIRAMARCOS ON EVERY JBIPULL BOX CONTAINING DC CIRCUITS. PER CODE(S):NEC 2023.690.31(D)(2) �--- SHEET LABEL LOCATION. ON OR NO MORE THAT IM(3 F1)FROM THE SERVICE 6 BROOKWOOD DR, NORTHAMPTON, MA. 01062 SIGNAGE DISCONNECTING MEANS TO WHICH THE PV SYSTEMS ARE CONNECTED. - - -- - -- REV:Al 8/16/2024 PER CODE(S)NEC 2023:690.12(D) PER CODE(S):NEC 2023:705.10(2) PAGE PV-5.0 10 sunrun Astray.2.0 8/16/2024 02:40 PM PILIL CAT 1 ��~OF MASS Subject Structural Certification for Proposed Residential Solar Installation. Job Number:224R-006SANT:Rev Al ' /\s% J MATTME+N r1 Client:Kathleen Santos n a-,+vA w Address:6 Brookwood Dr, Northampton,MA 01062 o NO 54057 5- pow•.FGrSTER�G�?Y� SSioN Al 04 Attn:To Whom It May Concern Exp.6/30/2026 Signed On:8/16/2024 A field observation was performed by a qualified Sunrun Technician to document the existing structure of the above mentioned address.From the field observation.the existing roof structure was observed as the following: •AR-01:Comp Shingle roofing over plywood supported by 2x4.SPF#2 Trusses @ 24"OC.Truss web members break up the top chord span. •AR-02:Comp Shingle roofing over plywood supported by 2x4.SPF#2 Trusses @ 24"OC.Truss web members break up the top chord span. Design Criteria: •MA 9th Ed.CMR 780(2015 IRC/IBC/IEBC).7-10 ASCE&2015 NDS •Basic(Category II)Wind Speed V=117 mph,Exposure B •Ground Snow Load=40 psf,Min Flat Roof Snow Load=35 psf Based on this evaluation,I certify that the alteration to the existing structure by the installation of the PV system meets the requirements of the applicable existing and/or new building code provisions referenced above. Additionally,I certify that the PV module assembly including all attachments supporting it have been reviewed to be in accordance with the manufacturer's specifications. Results Summary(Hardware Check Includes Uplift Check on Attachments/Fastener,Structure Check Considers Main Structure) Orientation Min.#Mounts per up-slope edge Configuration Max DCR Result _andscape 2 NA 99= Pass AR-01 Portrait NA NA NA Roofing Material Pitch Structure Check Comp Shingle 18' Pass Orientation Min.#Mounts per up-slope edge Configuration Max DCR Result Landscape 2 NA 99=o Pass AR-02 Portrait ,; NA NA Roofing Material Pitch Structure Check Comp Shingle 18" Pass 225 Bush St.Suite 1400 San Francisco,CA 94104 AR-01 Roofing Material Root Pitch Spacing Hardware Results Structural Results Comp Shingle 18` 24" Pass Pass Hardware Calculations Attachment Information Attachment TopSpeed-RL Uplift Force 0.6(p-(3psf x cos(pdch)))x alb area=208 lb Uplift Capacity 210 lb a•4.0 ft Wind Design Criteria(Partially/Fully Enclosed Method,ASCE 7-10) Basic Wind Speed V 117 mph Wind Speed-Category II Wind Pressure Exposure Kz 0.70 Section 30.3.1 Topographic Factor Kzt 1.0 Equation 26.8-1 Wind Directionality Factor Kd 0.85 Section 26.6 Velocity Pressure qh•0.00256 x Kz x Kzt x Kd x V' 17.85 psi Equation 27.3.1 Solar Adjustment Factors ye(Port/Land)_ (1,1.01) ya• 0.535 Figure 29.4-8 Zone 1(up) Zone 2(up) Zone 3(up) Zone 1(down) Ext Pressure Coefficient GCp -0.87 -1.54 -2.40 0.43 Figures 30.3-2(A-H) Ultimate Design Wind Pressure p=qh x GCp -16 psf -16 psi -16 psi 16 psi Equation 30.4-1 Mod Orientation _Min.I Mounts per up-slope edge Cantilever Demand OCR Final Result Landscape 2 18' 25.8 psi 99% Pass Structural Calculations Gravity Loading Summary Load Definitions Code Factors Pg 40 psf PI 0.7 x Ce x Ct x Pg Initial Pre-PV Load Post-PV Load Ps =CsxPf Roof Dead Load(D) DL 10.0 psf 10.0 psf _ 10.0 psi' PV Dead Load(D) PV DL 3.0 psf 0.0 psf 3.0 psf Roof Live Load(Lr) RLL 20.0 psf 20.0 psf 1.00 0.0 psf Sloped Snow Load(Pr->Ps) LL/SL 35.0 psf 35.0 psf 1.00 I 0.87 30.3 psf Total Design Load 45.0 psf 43.3 psf Cd Factor of Governing LC 1.15(D+S) 1.15(D+S) Total Design Load(Normalized) 39.1 psf 37.7 pet IEBC 5%Check Net Design Gravity Loading Change(Normalized w/Cd Factor) [ -1.4 psf I DCR:96% I Pass Detailed Loading Summary Total Span(Horiz.) 12'-9" Support Type Truss Top Let Bracing Full Overhang 0'-0" Wood Species SPF Bot Let Bracing At Supports Span 1 6'-1" Wood Grade e2 A(in"2) 5.25 Member Size 2x4 Sx(in"3) 3.06 Actual Breadth 1.50" lx(in"4) 5.36 PV Locations Start End Actual Depth 3.50" No Upgrades Required Array 1 Location 0'-0" 6'-1" OC Spacing 24" Sheathing 1/2"OSB Framing Analysis Results Governing LC Cd CL(+) CL(-) CF Cr D+S 1.15 1 1.00 1.5 1.15 Demand Capacity DCR Final Result tb(+) 533 psi Fb'(+) 2083 psi 26% Pass fb(-) 1074 psi Fb'(-) 2083 psi 52% Pass lv 73 psi FV 186 psi 39% Pass AR-02 Roofing Material Roof Pitch Spacing Hardware Results Structural Results Comp Shingle 18° 24" Pass Pass Hardware Calculations Attachment Information Attachment: TopSpeed-RL Uplift Force:0.6(p-(3psf x cos(pitch)))x trib area=208 lb Uplift Capacity:210 lb a=4.0 ft Wind Design Criteria(Partially/Fully Enclosed Method,ASCE 7-10) Basic Wind Speed V 117 mph Wind Speed-Category II Wind Pressure Exposure Kz 0.70 Section 30.3.1 Topographic Factor Kzt 1.0 Equation 26.8-1 Wind Directionality Factor Kd 0.85 Section 26.6 Velocity Pressure qh=0.00256 x Kz x Kzl x Kd x V2 17.85 psf Equation 27.3-1 Solar Adjustment Factors ye(Port/Land)_ (1,1.01) ya= 0.535 Figure 29.4-8 Zone 1(up) Zone 2(up) Zone 3(up) Zone 1(down) Ext Pressure Coefficient GCp -0.87 -1.54 -2.40 0.43 Figures 30.3-2(A-H) Ultimate Design Wind Pressure p=qh x GCp -16 psf -16 psf -16 psf 16 psf Equation 30.4-1 Mod Orientation Min.#Mounts per up-slope edge Cantilever Demand DCR Final Result Landscape 2 18" 25.8 psf 99% Pass Structural Calculations Gravity Loading Summary Load Definitions Code Factors Initial Pre-PV Load Post-PV Load Pg=40psf I Pf=0.7 x Ce x Ct x Pg Ps =CsxPf Roof Dead Load(D) DL 10 psf 10.0 psf 10.0 psf PV Dead Load(D) PV DL 3 psf 0.0 psf 3.0 psf Roof Live Load(Lr) RLL 20 psf 20.0 psf 1.00 0.0 psi Sloped Snow Load(Pf->Ps) LL/SL 35 psf 35.0 psf 1.00 I 0.87 30.3 psf Total Design Load 45.0 psf 43.3 psf Cd Factor of Governing LC 1.15(D+S) 1.15(D+S) Total Design Load(Normalized) 39.1 psi 37.7 psf IEBC 5%Check Net Design Gravity Loading Change(Normalized w/Cd Factor) I -1.4 psf I DCR:96% I Pass Detailed Loading Summary Total Span(Horiz.) 12.-9" Support Type Truss Top Lat Bracing Full Overhang 0'-0" Wood Species SPF Bot Lat Bracing At Supports Span 1 6'-1" Wood Grade #2 A(in"2) 5.25 Member Size 2x4 Sx(in"3) 3.06 Actual Breadth 1.50" Ix(in"4) 5.36 PV Locations Start End Actual Depth 3.50" No Upgrades Required Array 1 Location 0'-0" 6'-1" OC Spacing 24" Sheathing 1/2"OSB Framing Analysis Results Governing LC Cd CL(+) CL(-) CF Cr D+S 1.15 1 1 1.5 1.15 Demand Capacity DCR Final Result fb(+) 533 psi Fb'(+) 2083 psi 26% Pass ib(-) 1074 psi Fb'(-) 2083 psi 52% Pass fv 73 psi Fv' 186 psi 39% Pass L?u.ubryrl errvervl,m IIJ.oocroccu-vot VWyev-or vu-ciac4OJOYI,v cc SEASONALITY Solar production typically peaks in the summer and dips in the winter This chart is for demonstration purposes only.Your solar system production will differ. Ibk I I IllahLb System overview y Spring Summer Fall Winter i Produces approximately 10,080 kWh/yr This chart is for demonstration purposes only.Your production may differ. Equipment Solar Panels & inverters BILLING The solar energy system and your local grid Service coverage work together to power your home 90% Performance guarantee 25 years SOLAR SYSTEM or'i.e pay ycu Tut tnc cdterencr: Sunrun Your Sunrun bill stays the same each month,even if you Parts, Labor&Workmanship produce more solar energy than expected. It any part of the system nreaks well repair or replace it 25 years Three ways to pay your bill: If there's an issue with the 1. Autopay installation v,.,N 2. MySunrun.com 3. Over the phone at 1 (855)478-6786 Solar Roof Fasteners 10 years For the first 12 months.Does not include taxes,if applicable,or$7.50 discount for auto-pay enrollment. If you violate the terms and conditions of our agreement.including but not Our service cost and terms limited to tampering with the system,we may choose to revoke warranty coverage. We own the system and provide you with its electricity. You can choose to stop receiving prescreened offers of credit from us and other companies by calling toll-free 888-567-8688.See prescreen notice Year 1 solar rate $0.175/kWh below for more information. Year 1 total monthly payment UTILITY GRID Includes$/.50 ACti discount $147.00/month Your local utility Annual payment escalator 3.50% Your utility bill will vary based on how much utility energy you use,when you use it,and how much surplus solar Deposit due today $0.00 energy you sell to the grid IJuwbly1I cllveiuIlV IU.DOGr DCCOMJJI V-.tvuu-or VV-GIJGYDJ04l+VGc • work or a change order to complete your installation, but you don't agree to completing and/or paying for said work, (c) you have fulfilled all of your obligations under this Agreement but Sunrun has not completed installation within 180 days of the Effective Date below. • You are entitled to a completely filled out copy of this Agreement signed by both you and Sunrun before any work begins. This Agreement is effective as of 7/201v224#Effective Date"). The Effective Date is the date on which the last Party signed this Agreement. Contract Version 1.0 Proposal:PKV73VR9AC64-H Version 2021Q4V1 Proposal Id:a086Q00000opfcd Agreement:a4m6Q0000030pG5QAK Template Order:320 Template Key: OT_213EA1437705 26 Uut.uDlyl I CI lvCluily IL/.oocroccu-uull.-YV.7u-oryu-c UCYOJOYI.vcc IIlb • Your signature below indicates that (a) you're 18 years of age or older, (b) you're the owner of legal title to the Home and that every person or entity with an ownership interest in the Home has agreed to be bound by the terms of the Agreement, (c) that you have been advised on your rights to cancel this agreement,and(d)that you have read,understood,and accepted the provisions set forth in this contract. You also understand that if you do not give us a written request on which end of term option you choose 30 days before your Agreement terminates, we will automatically renew this Agreement for 5 years. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO THE DATE WE COMMENCE CONSTRUCTION AT YOUR HOME. PLEASE REVIEW THE ATTACHED NOTICES OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT. Do not sign this contract if there are any blank spaces. Signed by: Agreed and accepted by: Agreed and accepted by 8239D6DE4EDS4A7 (Second Signer, optional): Print Name: Kathleen Santos Print Name (Second signer, optional): Date: 7/27/2024 Sales Cosai tby. tA Corporatf�p nau by: Signature Signature.8AC 25ED8347A 1A4C7D8A4F6648A Print Name: Andrei Grama Print Name: Alexa Marsh Sunrun ID Number: 1873978073 Date: 7/27/2024 Title: Project operations Contract Version 1.0 Proposal:PKV73VR9AC64-H Version 2021 Q4V1 Proposal Id:a086000000opfcd Agreement:a4m600000030pG5QAK Template Order:320 Template Key: OT_213EAI437705 27 uuuuaiyn urvaiupe iu.oocroccv-vo V-+ u-oryu-cuca000tiwcc 1110 I hihit iA As we detailed above, we guarantee that the System will produce at least 90% of the Estimated Production over its lifetime. Here is the Estimated Solar Output and Performance Guarantee Refund Rate, by year Estimated Solar Output and Performance Guarantee Refund Rate, by year Year Total Guarantee Output to Performance Guarantee Refund Date (kWh) Rate ($/kWh) 1 9,072 $0.175 2 18,099 $0.175 3 27,080 $0.190 4 36,017 $0.190 5 44,909 $0.205 6 53,756 $0.205 7 62,559 $0.222 8 71,319 $0.222 9 80,034 $0.240 10 88,706 $0.240 11 97,334 $0.260 12 105,920 $0.260 13 114,462 $0.282 Contract Version 1.0 Proposal:PKV73VR9AC64-H Version 2021 Q4V1 Proposal Id:a086000000opfcd Agreement:a4m6Q0000030pG5QAK Template Order:32 Template Key:0T_048UAE792318 28 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type. Supplement Card SUNRUN INSTALLATION SERVICES INC. Registration: 180120 21 WORLDS FAIR DR Expiration- iration 10/13/2024 SOMERSET,NJ 08873 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 Business Regulation Registration valid for Individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. if found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 180120 10/13/2024 Boston,MA 02118 SUNRUN INSTALLATION SERVICES INC. ROBERT J.DECKER IV 225 BUSH STREET xllJ�fr :I '. / L '�{. SUITE 1400 SAN FRANCISCO,CA 94104 Undersecretary Not alid without signature vis Commonwealth of Massachusetts Construction Supervisor Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than Board of Building Regulations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space. C onstoiehionf$dl'ppervisor CS-090170 spires: 05/09/2026 ROBERT J DECKER IV,IV F 77 FEDERAL'ST MONTAGUE t2.1.A 01349 ? rillill:\ ? bMO/.LVdS1'33o \ Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. CommissionerEVaILs.—_ Contact OPSI:(617)727-3200 or visit www.mass.gov/dpl/opsi SUNRINC-02 TWANG ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `-� 9/1/2023 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 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). PRODUCER License#0C36861 CONTACT Walter Tanner NAME: Alliant Insurance Services,Inc. PHONE FAX 560 Mission St 6th Fl (A/c,No,Ext): (NC,No). San Francisco,CA 94105 E-MAIL ADDRESS.Walter.Tanner@alliant,com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A.Evanston Insurance Company 35378 INSURED INSURER B Zurich American Insurance Company 16535 Sunrun Installation Services, Inc INSURER C American Zurich Insurance Company 40142 775 Fiero Lane,Suite 200 Ph#805-540-7643 INSURER D San Luis Obispo,CA 93401 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY 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. INBR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS IN D WV IMM/DD/YYYY) (MM/DDFYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR MKLV5ENV104332 RENTED 10/1/2023 10/1/2024 PREMIISES(AGE Esococcurrence) $ 1.000,000 MED EXP(Any one person) , $ 5,000 PERSONAL d ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY X LOC PRODUCTS-COMP/OPAGG $ 2,000,000 X OTHER:Retention: $200,000 Per Project Agg 5,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 (Ea accident) X ANY AUTO BAP614287702 10/1/2023 10/1/2024 BODILY INJURY(Per person) ,$ OWNED SCHEDULED AUTOSIRE ONLY AUTOS BODILY BODILY INJURY(Per accident),$ AUTOS ONLY AUTOS ONLY (Per PROPERTY X Cg Ded.: x Coll.:Not Covered Liability Ded.: 1,000,000 UMBRELLA LJAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTIONS $ C WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE OTH- ER WC614287602 10/1/2023 10/1/2024 1,000,000 OFFICERIMEMBER EXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT 5 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 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) Workers'Compensation Policy WC614287601 Deductible:$1,000.000. Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 6 Brookwood Dr, Northampton The debris will be transported by: Casella Waste Systems Casella Waste Systems The debris will be received by: 686 Main St, Holyoke, MA 01040 Building permit number: Name of Permit Applicant Robert Decker IV 8/20/2024 LAu Date Signature of Permit Applicant