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36-273 SMO .�cn aervaofan Arsc a x%mib a Gawaamn nhr 12/15/2005 Service Contract Quote#:051215ps-1 This agreement between Kosmo Solar and: Mr Matthew Kane Work Phone#: 124 Maple Ridge Rd Home Phone#:413 586 3334 Florence,MA 01062 Customer—Email: Scope of Work Kosmo Solar will provide the materials and installation for your solar domestic hot water system,as well as all other services listed below. Parts will be ordered after receipt of initial payment,and are generally received within 2 weeks. Installation times will be coordinated shortly after receipt of contract,typically scheduled within 2 to 4 weeks after receipt of initial payment. Installation is typically completed within one to two calendar weeks,with a total duration of about 3 days. Kosmo solar reserves the right to alter system components with equivalent performing components based on product availability. Installation of solar hot water system Installation of ail required plumbing for the solar hot water collection. Submittal of building permits as required. Submittal of utility interconnect agreement. Printed instructions for the use and operation of the system. Removal of all debris associated with the job. Pricing $4,382.76 Material Price Labor Price $3,762.11 Sales Tax $0.00 Total Project Price $8,144.87 Total Estimated Rebate -$2,814.49 Net Project Cost $5,330.38 Payment Terms Owner agrees to pay Kosmo Solar according to the following payment schedule. 1 I (1) $2443 Thirty percent(30%)due to initiate the contract. Send in check made out to Kosmo Solar and a signed copy of this contract. (2) $3665 Forty five percent(45%)upon receipt of materials. (3) $2036 Remaining twenty five percent(25%)due at the completion of installation. 0 Signatures The above prices,specifications,and conditions are satisfa*J and are hereby accepted. Authorization to Kosmo Solar is granted to perform work as specified. Payment will be made as,,outlined e. Offer valid for 30 days 7 L Buyer's Signature: Date: Kosmo Solar Representative: Date: Note that you the buyer have the right to cancel this contract within 3 business days of signing. See attached Notice of Cancellation form for details. Kosmo Solar*PO Box 90597*Springfield,MA 01139*Phone(413)734-1456*FAX(440)445-4054 7 RANITE STATE INSURANCE COMPANY 73445-0000 WC 279-43-78 02 --------------------------------------------- 013-b6-0905-00 MI •-• . PENNSYLVANIA ..- . • 0 BOX590597 I NC 011n Member Companies of PRINGF I ELD, MA 01 109-0000 American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 EE NAME AND ADDRESS SCHEDULE - WC990610 D# MA UI#: PRODUCERS NAME & MAILING ADDRESS WHALEN INSURANCE AGENCY INC WORKERS COMPENSATION AND EMPLOYERS PO BOX 478 LIABILITY POLICY INFORMATION PAGE NORTHAMPTON, MA 01061-0478 11SURED IS PREVIOUS POLICY NUMBER ORPORATION I NEW ITHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - WC 0610 TEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 09/24/05 TO 09/24/06 TEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500.000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC2003o6A TEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Remuneration $100 OF Re- Premium Annual❑3 Year muneration 0 Annual 03 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $25 (PENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $284 MA INIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $856 indicated below, interim adjustments of premium shall be made: 11 Semi-Annually E] Quarterly El Monthly DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 pgoz"� tcros'd ' (:p-00-001S)o-�Tj v •po'--V o 1-!A dcnS•P'a'O)'917!oN11(16F P"a--C aoo 01"JO oo'Oot T S ai daP*cmj*Jo ftTStmoo fl �!�asccn aTai�o�as*t7o-s o1 scgr)Tsgl i+c'cc V co '4i J.-uu;o Am&pwv P.—Folio V"In"dla u ql a,P-P•—i`9 C-= a4jo Xdoo a)rq7 PeT4�Pa4,T 'Yr/--rrc d--o 1,10"M OV 3*rm�.Xo(b as Jo rR-rta(C9-( Sqt xaP'..�d�iJacad ao Z.�q,za)aaavamoq v X4 CocYG's(dc;s rn vo'P coo w�-c9 xu a.:7 riaan4'gi oo w°P°=s as�oomoq"4t:Pa}+,Cq c+-. ;j c_•4t_V-tw )o��(-i..p,co 7uo...auat�w�:��r?'ra cp at scossd,Co(dasa uq,nn c�c.,nmmoq�T::r•��r�1�+s�eo�q�(d-3.LOfT as.Cal .{JOh4,�aqi jie ouTTZUop2d laanko:Dwoq-e`ure I ( ) "am Joj 8ap.)ora QUO ou anEq put Joiaudojd zps t M-e I ( } � - I (corar_aoo tr of 3=Fxpm-mod oopv=-,jm =pT%- aonndt3 (J 4�1 �r�o jifz?- oj�� msav (1ot3EZauorj jo=21,0 i .(ardmoo=VUnSUD (_ouersuo:)jo zm-,w (7RQ uot?:.ndia. ) (1'.�tTSn\ .LO(jOdltCEC3030� II7JnSCt� (IOL7:17D0�To 7t � (31gj idoneuTt(� --outins-ul) (J01�i:;�uOJ u0 JC[I^ut� :sai1Dgod uoca-gaacmoo sda:ilorn aowono; aqa anzq oq�a neoiaq paasq slop-e atn pa1'Tq a.-,-2q put (auo a,o ) .acua0QwOq uo:Jo1oeMTZ6:) reiaaaS 'Jonudosd z1os a Lua 1. ( ) (rm(i uon:ltdx� (1xr¢.:� ror(odj (.�r_sIIOJ zoa--nxsag dad- - ,o zO — -,, , , :ga(srtp uo $uc}�o.t� sa)�ojdnm iul Ja; °�ano� Lor7-suaduioo s,�a: o.��,aatn.aiioi atp Scrrptnoid Ja.(oidu Z ue an I S/) (zq- 'kmLmd;o satljzuad pe, mTzd otp Jaoun ':C,t :) Aga)aq op TT` -9191&4S � _ :ti �uap(saJjssaTrTs7nq jo aoEid pdtoL. z GiLti� (�t�rcn.s�cl�sn:so rp :LIe1��(II.Z:J'� �J�TnS�. NOT.I.`✓SU��LO� S.2ITSPSO.t�:� __ _. 090to -Ssuy\ •Uo1dLu-vgj1o.,\j . Jutpl,na .(vdtotanp� . =arils atay� ZIZ S:ip117adSN1 Or\(JC 71n9 dO jP3y(-L-dVd30 ZJ) y0 -2- DEPARTMENT OF BUILDDIG INSPECTIONS - INSPECTOR 212 Main Strut • Municipal Building V SC Northampton,MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supc:­, sor. The state defines"Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or two anru y — dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner." The�uild`tmg departmentfoi the City ofNorthainpton-wants any persoro)-who--seek--to use the home owner exemption, to act as their own construction supervisor,to be aware that by doing so you become responsible for compliance with state building codes and fegulations. The inspection process-requires that the building department be called to inspect work at various stages, which include foundation/footings(before backfill), sonotube holes (before pour). a rough building inspection(before work is concealed) insulation inspection(if required) and a final building inspection-'The building department requires these inspections before the work is concealed,failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be insbected. If the homeowner hires other trades to perform work(electrical, plumbing&gas) the homeowner will.be responsible to make sure that the trades hired secure their proper - . permits in conjunction to the building permit issued, and that they get their required inspections.Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made L understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to nee. Date Address of work location SECTIONS-CONSTRUCTION SERVICES ya 8.1 Licensed Construction Supervisor: Not Applicable E3 Name of License Holder: License Number Address Expiration Date Signature Telephone �33eas`l=end�foriem`-paver erifont acto 3 ' '� ,. Not Applicable ❑ Compa p� ^-� Registration um r - - ---n KQSMO En.gy Cont rva firtt Rerrewanle GeneraGOn Next — �"{�_.___ ____ " Address PQ Box 90597 Expiration Date Springfield, 01 139 (413) 734-14545 6 3lephone SECTION 10-WORKERS'COMPENSA TION'INSURANCE.AFFIDAVIT(M.G.L.i:�.-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...... ❑ The current exemption for"homeowners"was extended to include Owner-occupied Dweltings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts - . as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/sbe shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,von M be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature r I y J.. SECTION -DESCRIPTION OF PROPOSED VI[ORK(check all-aanlicabie) Now House Addition ❑:: Replacement Windows Alteration(s) [❑ Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [©] Decks to Siding[01 Other[i,t Brief Description of Proposed f Work: Na C T VV C (S �N c(Tt - Alteration of e)dsting bedroom Yes v No Adding new bedroom Yes f No Attached Narrative Renovating unfinished basement Yes ��No Plans Attached Roll -Sheet sas(#New t�oi�se=and��tliaoi.x�tiing�as�iri ii�rlet�t( � `��- a. Use of building:One Family Two Family Other J_ b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 1. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain - Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply .SECTION 7a OWNER�IUTHOF2lZATION=TO BE COMPLETED WHEN. OWNERS AGENTAR ON LRACTOKAPPt:IES'POR BUILDINI PERMIT 1 ,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. Date I [ .aslftwJAuthorized Agent hereby declare that the statements and information oh the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Z Signature of Owner/Age t Date r 4 Section 4. ZONING All Informag6h Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required,by Zoning This column to be filled in by Building Department Lot Size i Ffonta e Setbacks Front �- Si_a L:= R.; R--; Roar Building Height Bldg.Square Footage �--� % s Open Space Footage �-; (Lot area minus bldg&paved #of Parking Spaces �! (- Fill: I f volume,&Location)i A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW Q YES 0 IF YES, date issued:! IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES 0 IF YES: enter Book i Page. Document# B. Does the site contain a brook, body of water or wetlands? NO Vj DONT KNOW Q YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained Q , Date Issued: �— C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: Q. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES r NO Q i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. F Nortoarripton r ( � W��0(),epartrnent 212 Win Street ; n^ Rooi i 100 Idtikiiamp1on;:IWA 01060 „t phone 413-587-140 Fax 413-587-1272 - -' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1,-SITE INFORMATION 1.1 Property Address: TFtiss ctton to be cx�mpleted bx Qce �(- M fte c r t o L-E R GI* 11Aap=� Lot �, lJart � r O�►etlayIStGt�t -,EI lk.'Distri ct GBD�strict SECTION 2-PROPERTY OWNERSHIPIAUTHORtZED AGENT 2.1 Owner of Record r't ft-r H 61w !` A't Name(Print) Current Mailing Address: Telephone 2 Autorzed Aoerit ' - in (KE rcts",F Cb f �j 0 Name(P Current Mailing Address: 4-S b Signature s I-C v c ;y,` Telephone SECTION'S-ESTiMATEDtONSTRUC710N GOS1'S Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building ;(a)Building,Permit Fee 2. Electrical _(b)-Estimated Total Cost of consfrucHon from:6 3. Plumbing Building Permit Fee. 4. Mechanical(HVAC) 5.Fire Protection 6. Total=(1+2+3+4+5) k r Check'Number © _ ThWSectioe Fo'rOffIcIff -Only Building-Permit Number.' .:Date . Signature: Building Commissionerfinspector of Buildings Date File#BP-2006-1201 APPLICANT/CONTACT PERSON KOSMO SOLAR ADDRESS/PHONE P O BOX 90597 SPRINGFIELD (413)734-1456 PROPERTY LOCATION 124 MAPLE RIDGE RD MAP 36 PARCEL 273 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid I Permit Filled out Fee Paid T_ypeof Construction: INSTALL SOLAR PANELS New Construction Non Structural interior renovations Addition to Existing_ Accessory Structure - Building Plans Included• - — Owner/Statement or License 145811 3 sets of Plans/Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 Commis ' n Signature of Building Official Date 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. 41kAPLE RIDGE RD BP-2006-1201 GIS#: COMMONWEALTH OF MASSACHUSETTS M l ck:36-273 CITY OF NORTHAMPTON Lot: -001 Perrnrt: Building Category BUILDING PERMIT Perrnit# BP-2006-1201 Project# JS-2006-1772 Est. Cost:$5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOSMO SOLAR 145811 Lot Size(sq.ft.): 66646.80 Owner: KANE MATTHEW&ANN MARKES Zoning: SR Applicant: KOSMO SOLAR AT. 124 MAPLE RIDGE RD Applicant Address: Phone: Insurance: P O BOX 90597 (413) 734-1456 SPRINGFIELDMA01139 ISSUED ON.511112006 0.00.00 TO PERFORM THE FOLLOWING WORK.-INSTALL SOLAR PANELS 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 5/11/2006 0:00:00 $50.001278 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 124 MAPLE RIDGE RD BP-2006-1201 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-273 CITY OF NORTHAMPTON Lot: -001 Pernut: Buildinq Cateeory: BUILDING PERMIT Permit# BP-2006-1201 Project# JS-2006-1772 Est.Cost: $5000.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOSMO SOLAR 145811 Lot Size(sq. ft.): 66646.80 Owner: KANE MATTHEW&ANN MARKES zoninv` SP, Applicant: KOSMO SOLAR At X24 NJ J"LE - Applicant Address: Phone: Insurance: P O BOX 90597 (413) 734-1456 SPRINGFIELDMA01139 ISSUED ON:511112006 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL SOLAR PANELS 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: f "I - 0 Final: 111 Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke. F:na:: t l< Q �l (8 ZAUI 5 PHIS PERMIT MAY BE REVOKED BY THE C,TY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS-1, ; Certificate of Occu anc Signature: FeeType:_ Date Paid: Amount: Building 5/11/2006 0:00:00 $50.001278 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo