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23A-093 (4) RENEWABLES k t Owner Consent Form Owner: Seth Gottlieb Address: 17 Fairfield Avenue Town: Florence State: MA Zip: 01062 Phone: 617.852.2956 I hereby give permission to Alteris Renewables, Inc. and their representatives to pull the required permits for a solar installation on my property. Signed, i tij 1 700e Seth Gottlieb Date 34 Front Street Suite 321 P.O. Box 51924 i Springfield, MA 01151 t: 413.734.1456 f: 440 445 4054 www.alterisinc.com UNIRAW Installation Manual 201.1 SolarMount® Top Mounting Installing the modules , 4 * 'aa - Prewiring Modules. If modules are the Plug and Play type, no prewiring is 1 ,, /2 mi required, and you can proceed directly to "Installing the First Module" below. L... .141 If modules have standard J- boxes, each module should be prewired with one bolt end of the intermodule cable for ease of installation. For safety reasons, module +° prewiring should not be performed on the roof. r; „,ltd flange nut Leave covers off J- boxes. They will be installed when the modules are installed f ( on the rails. , „, : Rail Installing the First Module. In high - profile installations, the safety bolt and End clamp flange nut must be fastened to the module bolt slot at the aligned (lower) end of �J each rail. It will prevent the lower end clamps and clamping bolts from sliding out of the rail slot during installation. Figure 15 If there is a return cable to the inverter, connect it to the first module. Close the J -box cover. Secure the first module with T -bolts and end clamps at the aligned end of each rail. Allow half an inch between the rail ends and the end clamps , (Fig. 15). Finger tighten flange nuts, center and align the module as needed, and f ( 1 , securely tighten the flange nuts (15 ft lbs). / , Installing the Other Modules. Lay the second module face down (glass to \ glass) on the first module. Connect intermodule cable to the second module and �►” � y close the J -box cover. Turn the second module face up (Fig. 16). With T- bolts, mid clamps, and flange nuts, secure the adjacent sides of the first and second -1 J - boxes modules. Align the second module and securely tighten the flange nuts (Fig. 17). For a neat installation, fasten cable clamps to rails with self- tapping screws. Figure 16 Repeat the procedure until all modules are installed. Attach the outside edge of the last module to the rail with end clamps. 4 " Module frames 4 Trim off any excess rail, being careful not to cut into the roof. Allow half an inch r , between the end clamp and the end of the rail (Fig. 15). , Check that all flange nuts on T -bolts are securely fastened. d l /a' module bolt 5:, . ,i and flange nut ,� in' 1 i — M clamp Figure 17 ■ High- lipped module Spacer (cross Low-lipped module , (cross section) I ! Low -li section) SolarMount rail with G clamps and spacer SolarMount rail with S ize H clamps Figure 18. Size G clamps (for modules with high lips) ules with low lips) are identical and employ hexhead include a spacer for the end clamps but are otherwise bolts in place of T- bolts; their heads slide into Solar - identical. Size H mid clamps and end clamps (for mod- Mount® UllIORMIC: THE STANDARD IN PV MOUNTING STRUCTURES" Vag` - UniRac, Inc. 3201 University Boulevard SE, Suite 110 505.242.6411 6 www.unirac.com Albuquerque NM 87106 -5635 USA 505.242.6412 Fax vNumc® Installation Manual 201.1 SolarMount® Top Mounting '� Installing SolarMount rails ' ,.-" Keep rail slots free of roofing grit or other debris. Foreign matter will cause bolts to bind as they slide in t slots. Installing Splices. If your installation uses So larM ou nt splice bars, attach the rails together ,--,-0" „..” (Fig. 11) before mounting the rails to the foot- . ' ' ings. Use splice bars only with flush installations ' or those that use low- profile tilt legs. If using more than one splice per rail, con- tact UniRac concerning thermal expan- sion issues. Figure 11. Splice bars slide into the footing bolt slots of SolarMount rail sections. � Mounting Rails on Footings. Rails maybe :/�' attached to either of two mounting holes in the Clamping footings Fi 12). Mount in the lower hole for a bolt slot 0 - (Fig. r - low profile, more aesthetically pleasing instal - I ." lation. Mount in the upper hole for a higher profile, which will maximize airflow under the e. Mounting modules. This will cool them more and may Footing g slots enhance performance in hotter climates. bolt slot 1 Slide the 3 h -inch mounting bolts into the footing bolt slots. Loosely attach the rails to the footings 07 '. , 'V with the flange nuts. ',..` Ensure that the rails are oriented to the footings as shown in Figure 6, 7, 9, or 10, whichever is Figure 12. Foot - to - rail splice attachment appropriate. Aligning the Rail Ends. Align one pair of rail ends I to the edge of the instal- -- i — lation area (Fig. 13 or Fig. 14). ri u The opposite pair of rail I ends will overhang the side of the installation area. Do not trim them I off until the installation is 1 r°1 „ i I complete. r _ _ .. --- IL In low- profile mode (Fig. R 13), either end of the Edge of installation area \ Edge of installation area rails can be aligned, but the first module must be installed at the Figure 13. Low - profile mode Figure 14. High profile mode aligned end. For the safest high - profile installation (Fig. 14), the aligned end of the rails must face the lower edge of the roof. Securely tighten the flange nuts on the mounting bolts after alignment is complete (28 -32 ft lbs). Mount modules to the rails as soon as possible. Temperature changes may bow the rails within a few hours if module placement is delayed. Page 5 Installation Manual 201.1 SolarMount® Top MountingeRi Laying out standoffs I Standoffs (Fig. 8) are used for flashed installations, such as those with tile and shake shingles. +;t k.> Use Figure 9 or Figure 10 to locate and mark the standoff lag bolt? holes within the installation area Consult UniRac's SolarMount Code - Compliant Planning and Assembly to determine foot spacing that will meet code., Download the version for the applicable building code at t. a ; www.unirac.com. ` Remove the tile or shake underneath each standoff location, exposing the roofing underlayment. Ensure that the standoff base lies flat on Figure 8. SolarMount standoff choices: alumi- the underlayment, but remove no more material than required for the num 2 -piece (left), steel flat -top (center), and steel ra flange. Two -piece standoffs allow flashings to be installed properly. flashings to be precisely placed over bases pri- Use the standoff base as a template to mark lag bolt hole locations on or to installation of the standoff itself. Raised underlayment above the center of the rafters (Fig. 9 or Fig. 10). flange standoffs do not require L-feet. In low - profile layouts, stagger standoffs on rafters (Fig. 9) to distrib- ute the load. When determining the distance between the rails in high - profile mode, keep in mind that the center of each rail will be offset from the standoff lag bolt holes by' / of an inch. If multiple high - profile rows are to be installed adjacent to each other, it will not be possible for each row to be centered above the rafters. Adjust as needed following the guidelines in Figure 10 as closely as possible. Overhang -•-i Foot Installing standoffs rr-- spacing j'` I: Drill 3 /16 -inch pilot holes if / \ ! 1 25% typical each end through the underlayment into 1 3 /a" i ... 1 t 4 the center of the rafters at each 0' �� 50 % typical standoff location. Securely fas- \\\. /' t f t ten each standoff to the rafters j with the two 5 /16" x 3 lag Lower roof edge - — - bolts provided with it 1" Stagger standoffs on rafters Verify that the lag bolts you use are adequate for your installa- Figure 9. Low - profile layout tion by following procedural steps 4A or 4B (pp. 5, 8) in SolarMount Code - Compliant i 50% typical yp cal .�f� ifo Planning and Assembly. 25% t each end 1 1; ` !! / j i \ If you are using raised -flange 11 , standoffs, ensure that they face + ~ . 7/16" �, ..— _1_ _ -' ,' a , as shown in Figure 9 or Figure f s) + 10. Steel flattop standoffs Hi r —_� � l!' i ` should also be lagged at oppo- / �� , '. � it f site corners. ! _ Iii k Foot —4. 7/16. SolarMount steel standoffs are • ; spacing designed for installation with , I' / II collared flashings available from / it , 1 . UniRac. Aluminum flashings '' I 2 take all metal flashings, also available from UniRac. Lower roof edge Overhang Install and seal flashings and €\ standoffs using standard build ing practices. Ra fters Figure 10. High - profile layout Page 4 Installation Manual 201.1 SolarMount® Top Mounting MIMIC' Laying out L -feet c ', L -feet (Fig. 5) are used for installation through existing 1 roofing material, such as asphalt shingles or sheet metal. Use Figure 6 or Figure 7 below to locate and mark the L -feet lag bolt holes within the installation area. Consult UniRac's SolarMount Code - Compliant Planning and Assembly to determine foot spacing Figure 5 A that will meet code. Download the version for the applicable building code at www.unirac.com. _ Overhang -► — Foot 25% typical ii 1 I-.— spacing —+7 i each end In low - profile layouts, stagger feet on � ' rafters (Fig. 7) to distribute the load. ,- --, II I I; ; i If multiple high profile rows are to be 13/ i__ R 1 Y - l 6 i a — __ r - 1 installed adjacent to one another, it I � � �� ', ; will not be possible for each row to be \ / � 50% typical centered above the rafters. Adjust as '*,,, . :'N( )., -___ -__m�. _. _ _ 11 ', _ )_� needed, following the guidelines in "' — `{ Figure 7 as closely as possible. Lower roof edge ji I ' ' i {, Stagger feet on rafters Figure 6. Low - profile layout 25% typical --0- .r 50% typical each end 13/4" I u 1 -b. r.�-- - "1 1 % j � � _ . CI _ — L - / I t E 1 LI 1 I I II ! II I I 4 $ spacing`��, f / 1 I I / i II f •, -J_L k � i'I II 1 _— " I 1 I I 1 -4 : — r Lower roof edge ; 1 li Overhang II Rafters Figure 7. High profile layout Installing L -feet Drill pilot holes through the roof into the center of the rafter at each L -foot lag bolt hole location. Consult procedural step 6 and Table 4 (p. 8) in SolarMount Code Compliant Planning and Assembly to select the lag bolts that meet building code wind load requirements. Lag bolts are not provided with SolarMount rail sets. Apply sealant into the hole, and on the shafts of the lag bolts. Seal the underside of the L -feet with a suitable weatherproof sealant. Securely fasten the L -feet to the roof with the lag bolts. Ensure that the L -feet face as shown in Figure 6 or Figure 7. The single - slotted square side of the L -foot must always lie against the roof with the double - slotted side perpendicular to the roof. 3 V111I11Ar Installation Manual 201.1 SolarMount® Top Mounting Installer responsibility • Using only UniRac parts and installer- supplied A The installer is solely responsible for: parts as specified by UniRac (substitution of parts • Complying with all applicable local or national may void the warranty); building codes, including any that may supercede • Ensuring that lag screws have adequate pullout this manual; strength and shear capacities as installed; • Ensuring that UniRac and other products are ap- • Maintaining the waterproof integrity of the roof, propriate for the particular installation and the including selection of appropriate flashing; and installation environment; • Ensuring safe installation of all electrical aspects of • Ensuring that the roof, its rafters, connections, the PV array. and other structural support members can sup- port the array under building live load conditions. I I Laying out I I I I I the installation area I _ I - I 1 I The installation can be laid out with rails — I I I parallel to the rafters (high - profile mode) or perpendicular to the rafters (low- profile I mode). Note that SolarMount rails make ex- � cellent straight edges for doing layouts. Center the installation area over the rafters as much — I as possible. Low profile High - profile mode Leave enough room to safely move around the mode �— — array during installation. i The width of the installation area is equal to T the length of one module. — - I The length of the installation area is equal to: _ I I I • the total width of the modules, I • plus 1 inch for each space between — modules (for mid- clamp), r I TI 1 I _ _ I • plus 3 inches (1 inches for each set Lower roof edge of end clamps). Figure 4. Rails may be placed parallel or perpendicular to rafters. 10 year limited Product Warranty, 5 year limited Finish Warranty UniRac, Inc., warrants to the original purchaser the practices specified by AAMA 609 & 610 -02 If within the specified Warranty periods the ( "Purchaser ") of product(s) that it manufactures — "Cleaning and Maintenance for Architecturally Product shall be reasonably proven to be ( "Product ") at the original installation site that Finished Aluminum" (www.aamanet.org) are not defective, then UniRac shall repair or replace the Product shall be free from defects in material followed by Purchaser.This Warranty does not the defective Product, or any part thereof, and workmanship for a period of ten (10) years, cover damage to the Product that occurs during in UniRac's sole discretion. Such repair or except for the anodized finish, which finish its shipment, storage, or installation. replacement shall completely satisfy and shall be free from visible peeling, or cracking or This Warranty shall beVOID if installation of discharge all of UniRac's liability with respect to chalking under normal atmospheric conditions the Product is not performed in accordance this limited Warranty. Under no circumstances for a period of five (5) years, from the earlier with UniRac's written installation instructions, shall UniRac be liable for special, indirect or of I) the date the installation of the Product is or if the Product has been modified, repaired, consequential damages arising out of or related completed, or 2) 30 days after the purchase of or reworked in a manner not previously to use by Purchaser of the Product. the Product by the original Purchaser ( "Finish authorized by UniRac IN WRITING, or if the Manufacturers of related items, such as PV Warranty "). Product is installed in an environment for which modules and flashings, may provide written The Finish Warranty does not apply to any it was not designed. UniRac shall not be liable warranties of their own. UniRac's limited foreign residue deposited on the finish. All for consequential, contingent or incidental Warranty covers only its Product, and not any installations in corrosive atmospheric conditions damages arising out of the use of the Product by related items. are excluded.The Finish Warranty is VOID if Purchaser under any circumstances. Pa 2 b U NRAC THE STANDARD IN PV MOUNTING STRUCTURES SOLARMOUNT Installation with Top Mounting Clamps Installation Manual 201.1 U.S. Des. Patent No. D496,248S. Other patents pending. This manual details the procedure for flush mounting SolarMount to a pitched roof. `® If your installation includes tilt / '� q `` legs, see also the instructions ��� 4 shipped with the leg kit. / % Contents V ` � Installer reponsibility 2 �e � Laying out the ' � �, � � 1 411 I I I ‘ installation area 2 T - bolt slot yi 'n g for module ti . � \- I La li i, `` out L feet 3 mounting I ►` Installing L -feet 3 \- Laying out standoffs 4 •' Installing standoffs 4 Installing SolarMount Mid rails 5 .� s clamp EEs talling the mule 6 `� " Footing bolt slot '''''' ets No. of 3/8"" footing 3 /8 "" flange �► ; End L -foot G \ clamp Rail length (inches) rails L -feet bolts nuts Sri a 48 -106 2 4 4 4 — 120-180 2 6 6 6 192 -216 2 8 8 8 226 -288 (w/ splice) 2 10 10 10 300 -336 (w/ splice) 2 12 12 12 348 -408 (w/ splice) 2 14 14 14 420 - 432 (w/ splice) 2 16 16 16 Figure 3. Exploded view of a low - profile installation mounted flush to the roof with L-feet. Top Mounting Clamp Sets, Sizes A – F, G *, Ht, and J Modules End Mid %, " module %, "x % " / " flange Wrenches and torque per row clamps clamps T - bolts safety bolts nuts 2 4 2 6 2 8 Wrench Recommended 3 4 4 8 2 10 size torque (ft-lbs) 4 4 6 10 2 12 ' /," hardware 7 /6 " 15 5 4 8 12 2 14 3 /8 " hardware 9 /6" 30 6 4 10 14 2 16 7 4 12 16 2 18 8 4 14 18 2 20 9 4 16 20 2 22 Stainless steel hardware can seize up, a 10 4 18 22 2 24 A process called galling.To significantly re - I I 4 20 24 2 26 duce its likelihood, (I) apply lubricant to 12 4 22 26 2 28 bolts, preferably an anti -seize lubricant, available at auto parts stores, (2) shade hardware prior to * In size G, end clamps and mid clamps are identical, except that end clamps installation, and (3) avoid spinning on nuts at high include spacers. For illustration, see page 14. speed. See Installation Supplement 910, Galling t In size H, end clamps and mid clamps are identical. Hexhead bolts replace and Its Prevention, at www.unirac.com. T- bolts. For illustration, see page 14. UniRac welcomes input concerning the accuracy and user friendliness of Pub 05030 i © 2005 by UniRac, Inc. this publication. Please write to publications @unirac.com. March 2005 All rights reserved. r li t evergreensa la 1 Electrical Character Mechanical Specifications Standard Test Conditions (STC)1 PANEL ID LABEL ES -A -200 ES -A -205 ES -A -210 I -0.0 I i I -fa2* -fat* -fa2* 2.2 . 4.9 . Pmp 200 205 210 W • 1 JUN CTION BOX p �� i m Pt °lemnae 0/ +4.99 0/ +4.99 01+4.99 W u (IP65) Bx 0.16 PANEL GROUNDING Prop, max 204.99 209.99 214.99 W SERIAL NUMBER HOLE o 0 Pmp, min 200.00 205.00 210.00 W r)min 12.7 13.1 13.4 % M ° 0 P 180.6 185.2 189.8 W 0 AWG C CABLES ° Vrop 18.1 18.4 18.7 V PV - WIRE) Imp 11.05 11.15 11.23 A V. 22.5 22.8 23.1 V o ° a -10x 0.26 12 12.10 12.20 2.20 A PANEL MOUNTING HOLE Isc ID LABEL FOR K" BOLT Nominal Operating Cell Temperature Conditions (NOCT) ° ° T MC. LOCKABLE TNOCT 44.8 44.8 44.8 °C CONNECTORS e (TYPE 4) - T Proax 146.4 150.1 153.7 W ° (.) (`) ° Vmp 16.7 16.8 17.0 V m A CLEAR ANODIZED 1 12 FRAME Imp 8.76 8.93 9.04 A : ALUMINUM FRAME ��DRAINAGE HOLE 0 to V0. 20.5 20.7 21.0 V ' l ° 35.9 Isc 9.60 9.68 9.76 A f- 1.B( +o / -0) 37.5(,/ -0.1) ' 1000 W /m °, 25 °C cell temperature, AM 1.5 spectrum; All dimensions in inches; panel weight 41 lbs 2 Maximum power point or rated power ' At PV - USA Test Conditions: 1000 W /m°, 20 °C ambient temperature, Product constructed with 114 of c stalline silicon solar cells, anti - reflective 1 m/s wind speed p y rY ° 800 W /m', 20 °C ambient temperature, 1 m/s wind speed, AM 1.5 spectrum tempered solar glass, EVA encapsulant, polymer back -skin and a double - walled ' f - framed, a - low voltage, 2 - matt blue (textured) cells anodized aluminum frame. Product packaging tested to International Safe Transit Association (ISTA) Standard 2B. All specifications in this product information sheet Low Irradiance conform to EN50380. See the Evergreen Solar Safety, Installation and Operation The typical relative reduction of module efficiency at an Manual and Mounting Design Guide for further information on approved installa- irradiance of 200W /m both at 25 °C cell temperature and • tion and use of this product. spectrum AM 1.5 is 0 %. Due to continuous innovation, research and product improvement, the specifica- tions in this product information sheet are subject to change without notice. No rights can be derived from this product information sheet and Evergreen Solar Temperature Coefficients assumes no liability whatsoever connected to or resulting from the use of any a Pmp 0.45 %/ °C information contained herein. a Vmp -0.43 %/ °C Partner: a Imp -0.02 %/ °C a Von -0.32 %/ °C a L. -0.003 %/ °C System Design Series Fuse Ratings 20 A Maximum System Voltage (UL) 600 V s Also known as Maximum Reverse Current. Q ELECTRICAL EQUIPMENT ES -A_ 200_ 205_ 210_ US_ 010908; effective September 1" 2008 CHECK WITH YOUR INSTALLER Worldwide Headquarters Customer Service - Americas and Asia 138 Bartlett Street, Marlboro, MA 01752 USA 138 Bartlett Street, Marlboro, MA 01752 USA Evergreen Solar, Inc. T: +1 508.357.2221 F: +1 508.229.0747 T: +1 508.357.2221 F: +1 508.229.0747 www.evergreensolar.com info @evergreensolar.com sales @evergreensolar.com • • • evergreensoiar !:1415,6 or I A:34V* Think Beyond. �F ES -A SERIES 200,205 &210W photovoltaic panels Best power tolerance available A range of high quality String RibbonTM solar panels offering exceptional performance, cost effective installation and industry- leading environmental • credentials made with our revolutionary wafer technology. • No power below nameplate Never pay for power you're not getting • Get up to 5W more than nameplate* For enhanced field performance • Industry's lowest voltage per watt rating Delivers the most cost - effective installs • • UL4703 certified cables For use with the highest efficiency transformer -less inverters • New extended length cables Eliminates home -run wiring • New MC® Type 4 lockable connectors ** Complies with the latest codes for accessible arrays • • Most extensive range of mounting options Allows installs virtually anywhere and anyhow • Smallest carbon footprint of any manufacturer For the greenest of the green • 100% cardboard -free packaging Minimizes job site waste and disposal costs • • 5 year workmanship and 25 year power warranty * ** Born in the USA *Maximum power up to 4.99 W above nameplate rating; * *Locking sleeve not supplied with the panel. ** *For full details see the Evergreen Solar Limited Warranty avai on request or online. This product is designed to meet UL 1703, UL 4703, UL Fire Safety Clas C, IE 6121 Ed.2 and IEC 61730 Class A standards. String Ribbon is a trademark of Evergreen Solar, Inc. Evergreen Solars wafer manufacturing technology is patented in the United States and other countries. PERPENDICULAR VIEW OF THE ROOF 34' -7" . 32' -5" 1 J N pO O 1 1 1 J - - VIES + Vitosol 200 —F, SH2 Series `1 1 SOLAR HOT WATER COLLECTORS + 13' -2" 16' -6 3/4" VENT PIPE 22" TALL v 4.5' DIANA. ` :: SYSTEM SUMMARY DRAWNG TITLE 5.04 kW (DC) at Standard Testing Conditions SunRun Photovoltaic Array Layout alterisM 24 Evergreen ES — A - 210 PV Modules CUSTOMER DRAB CAR 1 Fronius IG— 5100 Inverter RENEWABLES UniRac SolarMount Racking System THE GOTTLIEB RESIDENCE SCALE/16 = r 0' (LETTER) 17 Fairfield Avenue DATEOPoGNAL Roof Pitch (Module Tilt) = 34° Florence, MA 01062 8/4/09 ALTERIS RENEWABLES, INC. Module Azimuth = 200° Magnetic DATE REVISION 8/4/09 17 BP � de Bristol, 0 2809 MOD 398-9301 - F: MOD C- c IV 01 0 (0 0 O 0, U • L MI Z M glie Z ''= " - � o a r� of : l ut i n ' e ua ons d and � tanar� s �� ! �' Boar, d l g m ` '_ One Ashburton Place - Room 1301 ..,„--z--j Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 163252 Type: Individual Expiration: 5/27/2011 Tr# 284599 ROBERT N. JENEN ROBERT JENEN - - -- P.O. BOX 158 HOUSATONIC, MA 01236 Update Address and return card. Mark reason for change. ' ; Address I - Renewal ['_! Employment L Lost Card DPS -CA1 0 40M- 08108- DBSLIFORMCA108212008 Jae Commonwealth r /6rawae.Aade42 Board of Building Regulations and Standards License or registration valid for individul use only w =_ ' HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: V Board of Building Regulations and Standards g k u -= i Registration: 163252 0 One Ashburton Place Rm 1301 Expiration: 5127/2011 Tr# 284599 Boston, Ma. 02108 N Type: Individual ROBERT N. JENEN • ROBERT JENEN 1066 MAIN ST C- 'rat. -^ ! HOUSATONIC, MA 01236 Administrator Not valid without signature j v Rtiar o1 + lirig Yfi1{utialinbs and Standard,' Construction Supervisor License License: CS 81308 Expiration: 2)412010 Tr# ' Restriction: 00 ROBERT M JENEN PO BOX 158 HOUSATONIC MA 01236 Cotnnrissboer J ACORD CERTIFICATE OF LIABILITY INSURANCE 12/16/20 9 PRODUCER (860) 928 -7771 FAX: (860) 928 -7144 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Gerardi Insurance Services Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 16 Pomfret St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Putnam CT 06260 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: ACadia Insurance Co 31325 Alteris Renewables Inc INSURER B: aka Solarwrights Inc & Solar Works Inc INSURER C: 17 Burnside Street INSURER D: Bristol RI 02809 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LIMITS LIR_INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YY) DATE (MM /DD/YY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 GD X COMMERCIAL GENERAL LIABILITY PREM SES occu ence) $ 100,000 A CLAIMS MADE X OCCUR CPP0241356 2/1/2009 2/1/2010 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000, GENERAL AGGREGATE _ $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY I JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 - A ALLOWNEDAUTOS CAP0241357 (CT & RI) 2/1/2009 2/1/2010 BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS MAA0249941 (MA Auto) 2/1/2009 2/1/2010 BODILY INJURY NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 X OCCUR CLAIMS MADE AGGREGATE $ • A DEDUCTIBLE CUA0241359 2/1/2009 2/1/2010 g — RETENTION $ $ A WORKERS COMPENSATION AND I WC STATU- OTH- EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICER /MEMBER EXCLUDED? WCA0241358 2/1/2009 2/1/2010 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Alteris Renewables Inc EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AKA Solarwrights & Solar Works Inc 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 17 Burnside St FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Bristol, RI 02809 INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /iG" Matthew Desaulnier ACORD 25 (2001/08) © ACORD CORPORATION 1988 I W Cfl'r. 1n4 no, no.. annc I of 9 The Commonwealth of Massachusetts it, Department of Industrial Accidents .41 Office of Investigations ill 600 Washington Street Boston, Mass. 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual) : /i t 7E k 6--- AI EZ J A . 3 L _ Address: /-26 � %( s 62- Y City /State /Zip: S1 PF l / 1 i 4 U 1 l6 Phone #: e-i/.37 Ar ou an employer? Check theappropriate box: Type of project (required): l .I am an employer with 4. H l I am a general contractor and 1 6. ❑ New construction employees (full and /or part time).* have hired the sub - contractors 7. 1 Remodeling 2. Li I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub - contractors have 8. I l Demolition working for me in any capacity. employees and have workers' 9. I I Building addition [No workers' comp. insurance comp. insurance. T. required] 5. I We are a corporation and its 10. I I Electrical repairs or additions 3. '. ] I am a homeowner doing all work officers have exercised their 1 1 . H I Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4), and we have no 12.11 Roof repairs employees. [no workers' �� comp. insurance required.] 13 Other c5 � ' 'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contactors that check this box must attach 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' com s. colic 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: Aee/4 s J this l(.. "f -itio (r a) Policy # or Self -ins. Lic. #: 9' U 2 y / 3 ; '!�' 1 / 3 6 Expiration Date: / / / J.6/6) Job Site Address: I ( -1- Ale Piet 0 b--z. i City /State /Zip: F Ci< gA_ri e. j i t /,4 C/ e :( Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and /or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify ) der the Lac. pain s and pf�rgities of perjury that the information pprovt ed above is true and correct. R Si nature: G' C i ( _ � °1 '�) Date: I e � Print Name: /LI (Ctt ((., f 1* Phone #: LL/3 7j 4 ) 1 t - f ' )7,' 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 Heath 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact person: Phone #: • CONSTRUCTION SERVICES LICENSED CONSTRUCTION SUPERVISOR: LICENSE: Name (print) NuMber Expiration Date Pc /3e 562_ci Address Si nature =S'P r I) A 6/(6/ Telephone W � 73 City/State/Zip REGISTERED HOME IMPROVEMENT CONTRACTOR: REGISTRATION: ke6-erj 4, /171/A6 tkiFti AC 3 -,;1,5 /7AQ / Company Name Nunr Expiration Date Pe /3cx 37 2L/ � � ,�- Address 'Signature 1` L. i /T 4 L/ / (c, Telephone (- / 7 ("1 / '7 Cit /State /Zi. ESTIMATED CONSTRUCTION COSTS: Items: Estimated Cost (Dollars) 1. Land 2. Building $ 3 1 3-1 3. Electrical $ 4. Plumbing $ S.TOTAL= (1 +2 +3 +4) $ OWNER IAUTHORIZED AGENT DECLARE L I , A--/ C ( I r ✓ 6 - l r ( ( Cf 3 / l as Owner Authorized Agent her by declare that the statements and information on the foregding application are true and ccurate, to th of my knowledge and belief. Signed under the pains and penalties of perjury: 1 l /26'67 SIGNATURE OF OWNER / AGENT DATE OFFICIAL NOTES: RECEIVED PAYMENT: ■ The Commonwealth of Massachusetts State Board of Building Regulations & Standards k v Massachusetts State Building Code 780 CMR - a A 5 2.uU9 , 1 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLIHA ONE OR TWO DWELLING Building Commissioner 1 Date Approved PROPERTY OWNERSHIP /AUTHORIZED AGENT: Owner of Record: Address: g 7 6,0 fri- / E 8 i 1 9R l- 0 ' /fit NAME (print) _ X H. Go'? . /U e / 4 U /6. 4 ? . SIGNATURE Telephone: (i' / 7. 8 ,., • ',1 c),..57.0 Authorized Agent: Address' NAMF rint) _ - r i� — ) (y /) - („ P-1,C.- - - 3Pir -c f -, /Y/!-) C/ 5/ SIGNATURE � Teleshone: 1 41E3'7 3L - / / '5 SITE INFORMATION Property Address: Assessors' Map & Parcel #: Lot #: House # Street Map Number . Parcel Number Zoning Information: Property Dimensions: Zoning District Proposed Use Lot Area (Sq. Feet) Frontage-(Ft.) Water Supply (M.G.L. 40 § 54) Sewage Disposal System Flood Zone Information Public Private Public Private Zone Outside Zone Building Setbacks (feet) _ Front Yard Side Yards Rear Yard Required 1 Provided Required Provided Required Provided / / Size of Buildina No. of Feet, Front: No. of Feet, Rear: No. of Feet, Deep: Height of Building: Sq Ft of Building: DESCRIPTION OF PROPOSED WORK (Check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alternation(s) ❑ 1 Addition ❑ Accessory Bldg ❑ Demolition ❑ SELECT 780 CMR CODE EDITION 6th ed. ❑ or 7th ed. ❑ Other: (specify) BRIEF DESCRIPTION OF PROPOSED WORK: /N 3 TN-t, 6 ,4 77 0/0 O ,s1 6 e_.. /9/4-N Ec. C /11 7i S c t - j- -ACtNC l5 cc2F or Ott /-n4E . 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 ild g Permit Signed Affidavit Attached: Yes No❑ File # BP- 2010 -0291 APPLICANT /CONTACT PERSON ALTERIS RENEWABLES INC ADDRESS/PHONE P 0 BOX 51924 SPRINGFIELD (413) 734 -1456 PROPERTY LOCATION 17 FAIRFIELD AVE MAP 23A PARCEL 093 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid OW 6 - gS L. ( Typeof Construction: INSTALL SOLAR PANELS ON SOUTH ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 81308 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOiVIATION PRESENTED: L Approved _ Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management Demolition Del „.e...."1 7" - Signature of Building Official Dat- Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. � F BP- 2010 -0291 GIs #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit /4 BP- 2010 -0291 Project # JS- 2010 - 000376 Est. Cost: $33934.00 Fee: $204.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALTERIS RENEWABLES INC 81308 Lot Size(sq. ft.): 13242.24 Owner: GOTTLIEB SETH G & JENNIFER N Zoning: URB(100)/ Applicant: ALTERIS RENEWABLES INC AT: 17 FAIRFIELD AVE Applicant Address: Phone: Insurance: P O BOX 51924 (413) 734 -1456 WC SPRI NGFI ELDMA01151 ISSUED ON:9/30/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SOLAR PANELS ON SOUTH ROOF 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 9/30/2009 0:00:00 $204.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo