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23C-065 (4) USER REVDATE FNAME z m y � on. � CL m CL n 3- o� C-Co N FL W m o A CL cr - (° 000 IT° 1 I L •j 00 ILI - 00 -- N co m I � /' .. -- --_ I W I N W 00 00 rQ OD kf�J W { I ' W N T8z `° O mm rio�i M � N ��^_m w I W w p N N W lJ A O r. rtl - j W n N 3 41 O a co !J� :3Z fD 7 s °3' N l 1 s ?1 W , -mac M w CO `i N 38 7/8 -- - 22 3/4 - - --41 3/8 N N USER REVDATE FNAME MY D 'N� N sv ro m K 1 CL a ro _ m M M 0 ° :3 ro - - Cf CL aN. ro ro m c�tQ a n o c c CD m C) N m ni N d ro .+ cr ro n Z ro ---- o a r. o CD N p0 0 -1._. C N) m0) cn 0 A c m tQ W m ° OS• cgo N p p. 3 CD CD Cp F N p p N CD X �' w IA –fin S — CD N fl] 9 S 7 ::r S CL O CD 0 13 `D x `) -w O ' 0 III AIL F 11 �[ ro \\\♦ CD ro � o A � � x t I 1 7 a I a I I - < 6 D < ro �o E D x § Z a � 0 j x _.. 0 I CD W .< z7 C? m C) (D W N 0- v v m H D I z t I II in �' I e]l, � IT' i I •j:I i�r•• I i I 3 I p w 123 v a� y C] n -144 -- N LEAVITT - FLORENCE Al r 4.58 kW PV Array: (14)SPR 327s Marsha Leavitt 113 Bliss St Florence, MA 01062 (Site and Mailing address are the same) n O Cell phone: 413.320.3646 e-mail: mleavitt @smith.edu, marsha3072 @gmail.com Array: Two rows of SPR-327s in Portrait. Upper row of 6 mods, lower row of 8 mods. Mounting: Posts on asphalt roof. Roof Structure: See stamped truss drawings from TEC Roofing Material: Asphalt.(new). I � r��.,F. `(,�.°r�trt.�rrrc:•�ctt.��cr�� c�c`�^�d�,rr� �,rt:�r.�1k:e?��� t Office of Consumer.Affairs and Business Rl:gulwinl 10 Park Plaza-Suite 5 170 Boston,Massachusetts 02116 Home improvement Contravlor Fegistraltion _:...._ Registration_ 140077 Type Private Corpxw lion . ._.. _ I=Wabon: 11U1M201.1 Ira 13:S e PIONEER VALLEY PHOTOVOLTAICS COO. PHILIPPE RIGOLLA JD 311 WELLS ST SUITE B '`' GREENFIEL©. MA 01301 Update Address end retu card.Mark ressus for chw@L L Address — Renewal — Imploymmt i_:l I.ose Card X10.1 h 2+Fe14},1 '. —.• \ 1.�%dC`y.*'itlPAl1[F dGi'1.Yf1+6 S�"w'PXS(kL'.f}Iat�+4i ofnn eK CGnP+arrr..lRalrs da =.341 Rf�rlrttaa Uceafe u r ngiArdilM valid rRr individul uze wly T ;106iE WPRDYfAAENT CAN1 trove c tllc wpirat6a Jaty. IF rswud rete.it kv: (Stratton: ^.spJJ7 Type: Office of t_'omcumcr Affairs and 111"mcaa Rquistian pllvllcar: f'rvab Cult::a xlci,:l lt1 Nark Pltrn-Smile i2?1) Boston,AL4 OQ 136 P1PNFFR V+I2.LF(1*I4OTCrMtTA1CS COOS f / PHN IPPF RIGOI.I AI)D 911 WELLS S-SltiTc 8 . •:•:''.r�t3.�S._ GREENFIEID,MA 0'301 Uadanecretar* Not valid wit t �k 0 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supeniuir License: CS-106329 �- Maya Fulford 159 Clark Drive CAulford VT 053 1 w at ", Expiration Commissioner 03114/2016 Attachment (A) AUTHORIZATION TO PROCEED AND SERVE AS AUTHORIZED AGENT I hereby agree to the Project as set out above, and I agree to pay the contract price according to the Terms of Payment. I further agree to the Terms and Conditions attached hereto as a part of this Proposal and Agreement. I hereby authorize Pioneer Valley PhotoVoltaics Cooperative to proceed with the above-referenced Project in accordance with this Agreement. I further authorize Pioneer Valley PhotoVoltaics Cooperative, or its designated representative, to obtain required permits for this project on behalf of the Owner and to begin work of obtaining a grant on my behalf, as applicable. Any photographs or videos of this project may be used by Pioneer Valley PhotoVoltaics Cooperative for marketing purposes. A check for the First Payment is enclosed and I am returning this Agreement within 21 days of the Proposal date. f�cirs �-M ✓1 3 .2 7- P/ Printed Name Date i Sig tur Title Proposal and Agreement Page 7 of 8 Marsha Leavitt-March 27,2014,2014 LU co 1 4 O CL 2) cc F- 0 0 LL 00 OQ cl' co X 09' M" 00 D 00 W)o r) V) cc) CY) < I > z LU Z �o 176' is g is A�jau3 ajqom@u@ajo uoddnS aqi o1 po1i!wwoD Lb6E-698-Z/8 (EA PIOS UaJSP�OD] Z7=t! W N M 'o E Id I ol � I k V � o CR I � I O a , 0 I Lq I N j i I i ° + O 0 i I �o �a ' I'a I 00 00 $ M � a ' e o I c 0 v 'a I a I v s M X2jau3 ajgom@uab jo wddnS aq1 o1 pail!wwoD Lb68-6S8-,L8 IoS ua;se�oo3 i o LU 0 i L4 4 Z) r) co 0 (Y) < O < LL- ; J z 0 D ::D u LU CY -7 Q�l t L") N x C14 CN 00 co c6 00 (Y) CD C4 LO CD (Yi � ig in is IQ js 1($Jau3 @jqom@u@�jjo ijoddnS aq�o�pa1�iwwo-) Zi76E-698-ZZ9 9-AL'IOS UaJSE�OD] domm, AMON., "4l AlllftLAftl—' -,- U-i — 0 I v m u C o m o O 4L x cC ; w 0 CL a L O ° O LL � z F I t M 1 1� Ln t� I � I I r t I i � I I � I I - I I i Ea g I o I � I4 i c at@u3 ajgomauaa jo uoddnS aq3 o�pall!wwo3 Lb6E-6S8-LL8 wQIoS uaISaJOD] jf O F � i� SUNPOWER E-SERIES • AR PANELS SUNPOWER OFFERS THE BEST COMBINED POWER AND PRODUCT WARRANTY POWER WARRANTY PRODUCT WARRANTY l00% 95% a da 901/1 85% E80% ♦ 46 p 75% 0 5 10 15 20 25 0 5 10 15 20 25 Years Years More guaranteed power: 95%for first 5 years,A.4%/yr.to year 25.8 Combined Power and Product Defect 25 year coverage that includes panel replacement costs.9 ELECTRICAL DATA OPERATING CONDITION AND MECHANICAL DATA E20-327 E19-320 Temperature —40°F to+185°F(—40°C to+85°C) Nominal Power12(Pnom) 327 W 320 W Max load Wind:50 psf,2400 Pa,245 kg/m2 front&back Power Tolerance +5/-0% +51-0% Snow: 112 psf,5400 Pa,550kg/m2 front Avg. Panel Efficiency13 20.4% 19.9% Impact 1 inch(25 mm)diameter hail at 52 mph (23 m/s) Rated Voltage(Vmpp) 54.7 V 54.7 V resistance Appearance Class A Rated Current(Impp) 5.98 A 5.86 A Solar Cells 96 Monocrystalline Maxeon Gen II Cells Open-Circuit rt Voltage(Voc) 64.9 V 64.8 V Tempered Glass High Transmission Tempered Anti-Reflective Shoort-CCircuit Current(Isc) 6.46 A 6.24 A Maximum System Voltage 600 V UL& 1000 V IEC Junction Box IP-65 Rated Maximum Series Fuse 20 A Connectors MC4 Compatible Power Temp Coef. (Pmpp) —0.38%/°C Frame Class 1 black anodized, highest AAMA Rating Voltage Temp Coef. (Voc) —176.6 mV/°C Weight 41 Ibs(18.6 kg) Current Temp Coef. (Isc) 3.5 mA/°C TESTS AND CERTIFICATIONS REFERENCES: Standard tests UL 1703,IEC 61215, IEC 61730 1 All comparisons are SPR-E20-327 vs.a representative conventional panel:240W, Quality tests ISO 9001:2008, ISO 14001:2004 approx.1.6 m2,15%efficiency. EHS Compliance RoHS,OHSAS 18001:2007, lead-free,PV Cycle 2 PVEvolution Labs"SunPower Shading Study,"Feb 2013. 3 Typically 7-9%more energy per watt,BEW/DNV Engineering"SunPower Yield Report," Ammonia test IEC 62716 Jan 2013. Salt Spray test IEC 61701 (passed maximum severity) 4 SunPower 0.25 5/o/yr degradation vs.1.0%/yr cony.panel.Campeau,Z.et al."SunPower PID test Potential-Induced Degradation free: l OOOV 10 Module Degradation Rate,"SunPower white paper,Feb 2013;Jordan,Dirk"SunPower Test Report,"NREL,Oct 2012. Available listings CEC,JET, KEMCO,MCS,FSEC,CSA, UL,TUV 5"SunPower Module 40-Year Useful Life"SunPower white paper,Feb 2013.Useful life is 99 out of 100 panels operating at more than 70%of rated power. 6 Out of all 2600 panels listed in Photon International,Feb 2012. 7 8%more energy than the average of the top 10 panel companies tested in 2012(151 —r panels,102 companies),Photon International,March 2013. 8 Compared with the top 15 manufacturers.SunPower Warranty Review,Feb 2013. 9 Some exclusions apply.See warranty for details. 10 5 of top 8 panel manufacturers were tested by Frounhofer ISE,"PV Module Durability 1046mm Initiative Public Report,"Feb 2013. [41.2in] 11 Compared with the non-stress-tested control panel.Atlas 25+Durability test report,Feb 2013. 12 Standard Test Conditions(1000 W/m'irradiance,AM 1.5,25'C). 13 Based on average of measured power values during production. 46mm [1.81 in] "I!~ I_ 1559mm _ See http://www.sunaowercoro.com/facts for more reference information. For further details,see supplementary specs:www.sunpowercono.com/datasheets.Read safety and installation instructions before using this product. O April 2013 S-Rover Corporation.All rights reserved.SUNPOWER,the SUNPOWER logo,MAXEON,MORE ENERGY.FOR LIFE.,and SIGNATURE are trademarks or registered trademarks of SunPower Corporation.Specifications included in this datasheet are subject to change without notice s u n po Werco rp.co m Document#504860 Rev B/LTR EN SUNPOWER SOLAR HIGH PERFORMANCE & EXCELLENT DURABILITY SERIES • 20.4%efficiency Ideal for roofs where space is at a premium or where future expansion might be needed. E20-327 PANEL • High performance Delivers excellent performance in real world HIGH EFFICIENCY° conditions, such as high temperatures, clouds and low light.1,2,3 Generate more energy per square foot • Proven value E-Series residential panels convert more sunlight to electricity producing 36% Designed for residential rooftops, E-Series more power per panel,'and 60% more energy per square foot over 25 panels deliver the features, value and yea rs.3,a performance for any home. HIGH ENERGY PRODUCTION 7 Produce more energy per rated watt High year one performance delivers 7-9% more energy per rated watt.3This advantage increases over time, producing 20% more energy over the first 25 years to meet your needs.4 0 120 3 More Energy 110% Per Rated Watt Maxeone Solar Cells:Fundamentally better. i? 8%mare,year t Engineered for performance,designed for durability. 100 2 90% 35%more, rz year 25 Engineered for peace of mind 21 so% Q) Designed to deliver consistent, trouble-free 70% a energy over a very long lifetime.45 } bo% LO N 50% Designed for durability 0 5 to Years 15 20 25 The SunPower®Maxeon Solar Cell is the only 3_ 10% cell built on a solid copper foundation. Virtually 3 Maintains High impervious to the corrosion and cracking that a% r � Power at High Temps PHOroN degrade Conventional Panels.45 a No Light-induced 0 6% �t Degradation 10 #1 Ranked in Fraunhofer durability test. a .�_ y , �aaiy` Q ) High Average Watts 100%power maintained in Atlas 25+ 0) a% Better Low-Light and comprehensive PVDI Durability 11 g p ry test. c Spectral Response w 2% High-Performance o Anti-Reflective Glass Y 0% sunpowercorp.com tW F3 cad m d- to .o _.. k VII ci} cn ui. lot �Mn.. .' -`, LU Idu x r_ n n. ,�. .._ Bright Thinki,g ►n S01ar .z. Cony Ponent 606'l-T6 Specifications •Sotaril�o a�d16o63-TS Code Compliant Pr►ant Solarm'rS al m extrusion The solarA4 unto Mountin rails Call Unirac for system is pC g dips and to Your buiidin d°cumenta certified. Tilt legs and L-feet tlon � feet �cone applicable Severe TWO-piece standoffs warranty zinc-pia e Condition 4 (very sever prolarMOunt®is one- , welded steel e) duct warrant covered by a 10_ piece standoffs warranty Y and Year limited 18-g stainle a S-Year limited finish •Fasteners ss steel Far complete Warranties anties 40 our web site Installation manudownload any fill on, Bright Thinkin gin Solar Visit us online at www•unirac,eom L c S v F- a c m a a` E g N E f c r o c !� r X ° c c E a o C v o c c c CL W 3 r a o ro a a ° 3 o a %J 0 c E a d C p o m d m 0 E r as o a ? o n o E a = c d o c N o p {_- : a a o J E m 3 c- O 5 c c a o - E c H - c ° 'm Lj,J � x LL o LB E � O o av aa � � m = E •■ m en ` O •�■ LU 52 80 v ry 3 a r a ° c c E E o°v° –s - = E E° E S E s = C a E ;eo ,p `°. o w 3 d o m a F. N O O - r x S L Y v C V Q d X cu Z CJ j o _ c p c ° c m N °in n E E ¢s c N – ° 3 ° in o ° – S C G N CIMC U F E O U lop X F � Q LL _ `o s m 0 E x c E c'L E v E L r - ° 0 y d N N d o �/1 N v7, V1 vi a . 1 t a� LD cu a"d_ nm 41 Or cu H 3 E U C v vn V E O N N m ro l/1 a Q SOLARMOUNT° PV's most versatilemountingsystem • •• • • •• see , • SolarMount is the most versatile PV mounting rail system on the market today. We've engineered installer-friendly components for maximum flexibility, allowing you to solve virtually any PV mounting challenge. The universal SolarMount rail system has three options which can be assembled into a wide variety of PV mounting structures to accommodate anyjob site. Unirac provides a technical support system complete with installation and code compliance documentation, an on-line estimator and design assistance to help you solve the toughest challenges. N@UNIRAC won on Bright Thinking in Solar Visit us online at www.unirac.com WO e P o U O a Y Lek 0 0 1 p f V) 4L. 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(2(p J LN A O N m o Z V1� 2�N C J."Um I C v N N AD co W q \\ Lh W) IL N I Ti M M 00 pp quuU) a p c = N 8 Cj T X V y y N N C V C O N 2 C 0: CL O N w ° N r wa J2U �w"J1, N � N M m N h O r0 O O � O p N n2 N NN M� NN Q NOON O o- a 4 dd rom m ��v Lm x N N 4 C C U U U F- N O U w 0 a OED J J J I1 O Z U OD rr �r0 C NN-OLL d i . N Z Z w y a d d E U 6op°oo vvv o C ' NNN> H N (�0°D N d n Q 00 0�0.6 w a0uin c c 2 K K 3IX C K N N Z mm c Z a Lu 2 2 2 2 2 O u u C u�u u _ rn U, m SJ�JJJ MOOw (jU U8 V = 0 UU�i 1�rn N aJ O�JU JCL Qa F-._ QW aa�no a W 2 OL)POO 000L� KO?O m K N M F- JI-SF-mm -j mF-wmof ������� LL�C � .4co CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD 12/17/2013 013 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 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). PROWLER NAMEA Jena Rodrlgue, CISR Webber & Grinnell PHONE (413)586-0111 FAx C No: (413)586-6461 8 North King Street AaDRr=ss. a @webberand gu grinlTell.com INSURERS AFFORDING COVERAGE NAIC f Northampton MA 01060 I INSURER A:Peerless/Libert INSURED INSURER B:Excelsior/Llbert 11045 Pioneer valley Photovoltaics Cooperative, Inc. INSURER 311 Wells Street INSURERD: Suite B INSURERE: Greenfield MA 01301 INSURER F: COVERAGES CERTIFICATE NUMBER:Maste 2015 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. ILTR A Jum DL SUd WMIIYY P TYPE OF INSURANCE POLICY NUMBER MMIDYYW MMI LIMIT'S GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �{ COMMERCIAL GENERAL LABILITY PREMISES 'L Ea occurrence $ 100,000 A CLAIMS-MADE Fx-1 OCCUR BP8378623 /1/2014 /1/2015 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 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED Ea accident 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BA8372626 /1/2014 /1/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS X NON-OWNED PROPERTY DAMAGE AUTOS P.,accident $ Undennsured motorist BI spit $ 100,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESSLIAB CLAIMS-M DE AGGREGATE DED X RETENTION 10,000 08377126 /1/2014 /1/2015 $ 2,000,000 B WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY Y i N X WC IIMIT OTH- ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1 000 000 UI-1-IGLRlMLMEitk LXC:LUULDY7 NIA (Mandatory in NH) 8376525 /1/2014 /1/2015 EL DISEASE-EA EMPLOYEE $ 1,000,000 f yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ 1 000,000 DESCMPT10N OF OPERATIONS!LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Project: 5OkW and Less Massachusetts Clean Energy Technology Center, the System Owner, & as applicable the Host Customer as Additional Insured with respects to General Liability as per the terms and conditions of the policy CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Massachusetts Clean Energy Technology Cen ACCORDANCE WITH THE POLICY PROVISIONS. 55 Summer Street, 9th Floor Boston, MA 02110 AUTHORIZED REPRESENTATIVE J Rodrigue, CISR/JER ACORD 25(2010/05) @11 10 ACORD CORPORATION. All rights reserved. INS025(2 01005)of The ACORD name and logo are registered marks of ACORD - .._. The Commonwealth of Massachusetts Print Form Print of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lelribly N1Itle (Business/Organization/Individual): PIONEER VALLEY PHOTOVOLTAICS COOPERATIVE Address:311 Wells Street, Suite B City/State/Zip:Greenfield MA 01301 _ Phone 4:413.772.8788 413.772.8668 fax Are you an employer'Check the appropriate box: Type of project(required): I.R(l I am a employer with 20 4. ❑ 1 am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 7 Remodeling ship and have no employees These sub-contractors have g. Demolition working or me in an capacity. employees and have workers' g y p Y- 9. Building,addition [No workers' comp. insurance comp. insurance.- required.] 5. 7 We are a corporation and its 10.� Electrical repairs or additions officers have exercised their 1 l.. Plumbing repairs or additions 3.[1 I am a homeowner doing all work g p myself. [No workers' camp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] c. 152, §1(4),and we have no 13.7 OtherPV System employees. (No workers' - comp. insurance required.] 'Any applicant that checks box 41 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 poliev and job site information. Insurance Company Name:Excelsior/Peerless Policy #or Self-ins. Lic. #: WC 8376525 Expiration Date:01/01/2015 Job site Address: 113 Bliss Street City/State/zip:Florence, MA, 01062 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 c. 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 up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cover verification. I do hereby certi v under the ains and , atties� er'ur y that the in ormation provided above is true and correct. Si nature: ' a . 4/22/2014 Phone#.413-772-8788 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Maya FUlford CS-106329 License Number 159 Clark Drive, Giulford VT, 05301 03/14/2016 Address Expiration Date � 4r,- ,F�1 --+ 413-772-8788 Signature Telephone 9.Reallstered Home Improvement Contractors Not Applicable ❑ Pioneer Vallev Photovoltaics Cooperative, LLC 140077 Company Name Registration Number 311 Wells Street, Suite B, Greenfield, MA, 01301 9/16/2015 Address Expiration Date Telephone 413-772-8788 SECTION 10-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...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings 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/she 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,you may 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [❑ Siding[:3] Other[d] Brief Description of Proposed Installation of mounting system for solar panels on south side of residence roof. Work: Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes x _No Plans Attached Roll -Sheet 6a.if New house and or addition to existina housing,complete the followina: a. Use of building : One Family Two Family Other 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 i. 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 AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Marsha Leavitt as Owner of the subject property hereby authorize Philippe Rigollaud to act on my behalf, in all matters relative to work authorized by this building permit application. See attachment (A) 4/22/2014 Signature of Owner Date Philippe Rigollaud as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. PHILIPPE RIGOLLAUD Print Name 4/2/2014 Signature of ner t Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in b Building Department Lot Size Frontage Setbacks Front Side L: R: L: R:__ Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained 0 , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO e 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 ® NO e IF YES,then a Northampton Storm Water Management Permit from the DPW is required. r r#t-----° *' a City of Northampton Pertt SNO�Aad�,>�., s £ Building Department C rot APR 212 Main Street IrptArlab�t Rn 3 2014 Room 100 Wile i^ e1lA J Northampton, MA 01060 oft 41�-587-1240 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: This section to be completed by office 113 Bliss St, Florence, MA, 01062 Map Lot Unit Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Marsha Leavitt 113 Bliss St,Florence,MA,01062 Name(Print) Current Mailing Address: 413-320-3646 See attachment (A) Telephone Signature 2.2 Authorized Aaent: Pioneer Valley PhotoVoltaics Cooperative,LLC 311 Wells Street, Suite B,Greenfield,MA,01301 Name(Print) Current Mailing Address: 413-772-8788 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building $4,827 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) $4,827 1 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1126 APPLICANT/CONTACT PERSON PIONEER VALLEY PHOTOVOLTAICS ADDRESSIPHONE 311 WELLS ST- SUITE B GREENFIELD (413)772-8788 PROPERTY LOCATION 113 BLISS ST MAP 23C PARCEL 065 001 ZONE URA(100)/WSP(100)/SR(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building,Permit Filled out Fee Paid Typeof Construction: INSTALL ROOF MOUNTED SOLAR ARRAY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildina Plans Included: Owner/Statement or License 106329 3 sets of Pans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF MATION PRESENTED: 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 n Delay Signature of Bui d ng fficial 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. 113 BLISS ST BP-2014-1126 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-065 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SOLAR PANELS BUILDING PERMIT Permit# BP-2014-1126 Project# JS-2014-001919 Est. Cost: $4827.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO Const. Class: Contractor: License: Use Group: PIONEER VALLEY PHOTOVOLTAICS 106329 Lot Size(sg.ft.): 111949.20 Owner: LEAVITT MARSHA Zoning: URA(100)/WSP(100)/SR(0)/ Applicant: PIONEER VALLEY PHOTOVOLTAICS AT: 113 BLISS ST Applicant Address: Phone: Insurance: 311 WELLS ST - SUITE B (413) 772-8788 Workers Compensation GREENFIELDMA01301 ISSUED ON.51112014 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL ROOF MOUNTED SOLAR ARRAY 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 5/1/2014 0:00:00 $55.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner