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41-001 (3) Skystream 3.7Tm Technical Specifications Model Skystream 3.7 Rated Capacity 1.8 kW rated 2.4 kW peak PERFORMANCE GRAPH Weight 170 lbs./77 kg 2.5 2.4 Rotor Diameter 12 feet/3.72 meters 2.1 Mmm Swept Area 115.7 ft'/ 10.87 m2 1.8:.` 1.5 ■___, Type Downwind rotor with stall regulation control 3 1.2 Ad___ AMMM Direction of Rotation Clockwise looking upwind a° 0.9 -__ 0.6 Blades 3 Fiberglass reinforced composite 0,3 Rated Speed 50-330 rpm 0 mph 0 11 22.3 33.5 44.75 60 671 Shutdown Speed 370 rpm m/s 0 5 10 15 20 25 30 Tip Speed 66-213 f/s/9.7-63 m/s Wind Speed Alternator Slotless permanent magnet brushless Yaw Control Passive ENERGY CHART Grid Feeding Southwest Windpower Utility Interactive 120/240 VAC 50-60 Hz 900 and 120/208 VAC,60 Hz,3 Ph. 800 r Braking System Electronic stall regulation w/redundant relay switch control c 700 Cut-in Wind Speed 8 mph/3.5 m/s E 600 a 500 Rated Wind Speed 20 mph/9 m/s 400 User Control Wireless 2 way interface remote system c 300 3 200 Survival Wind Speed 140 mph/63 m/s 100 Total Harmonic Distortion 2.7%at 2400W,meets UL 1741 and IEEE 1547.1 requirements. 0 mph 5.6 79 10 12.3 14.5 16.8 19 21.2 23.5 24.6 Frequency Accuracy +/-0.02 Hz m/s 2.5 3.5 4.5 5.5 6.5 75 8.5 9.5 10.5 11 Voltage Accuracy +/-2.0 V(line to neutral) Average Annual Wind Speed Surge Rating IEEE 1547 Surge Rating B 6 Skystream 3.7711 Owner's Manual k i Fig. 11 Placing vibration isolators Fig. 12 Tightening bolts Fig. 13 Grounding turbine to tower Fig. 14 Ready to attach yaw shield Skystream 3.7TIOwner's Manual 25 Yaw ground AC Service Panel wire Transition to larger gauge wire if required due to dis- tance between Skystream and panel. Main disconnect Yaw connectors.See Fig.4(page 16) Optional kilowat-hour meter N fL N N White L1 L1 Buck L2 L2 Red Gnd Bare or green Disconnect switch 2-pole 30A,250VAC Tower ground = system Aluminum wires may be used for home/utility connection if transition is made in junction box. 14 AWG wire must be copper only. Use only copper wire at the generator terminals Mote:Refer to Appendix A for detailed wiring drawings Fig.3 Wiring diagram, 240V, 60Hz,split phase. 14 Skystream 3.7 rm Owner's Manual Fig. 1.Grid Connection Option A: 120/240 V,60 Hz,Split Phase,Junction Box at Tower Base I 6 7 8 Proprietary rights are 0cWded in the information discbsed herein,INS information k REVISION$ submitted in confidence and nether the document nor the information tl6ala5ed here FV. D ip DAiE APPR VED in shal pe,reproduced or troMferred tO Other document for rhonufacturing a,for any THIS DRAWING IS FOR REFERENCE _ other purpose except w specifically outhortzed in writing by Swthwest Windpower. SPAN BETW'N TOWER TOP USABLE AWG FOR 2% A VARIATIONS MAY BE MADE IN TO AC MAIN SERVICE POWER LOSS( FOR A EL FOR COPPER ACCORDANCE WITH NEC GUIDELINES PAN ONLLV,ASSUMING GRID CIONDUCTORSTONLY VOLTAGE IS 24OV, TURBINE PUTS OUT 1.8kW 1017 FT. 4 AWG "SKYSTREAM" 640 FT, 6 AWG NACELLE WIND TURBINE fABLE EXAMPLE AWGCABLEfBASD N 45 FT FROM THE TOWER TO 403 FT. 8 AWG If SWITCH,108FI 3 SWITCH TO M.NRANEL, 253 FT. 10 AWG B TOTAL=253FT.FOR 159 FT. 12 AWG LONGER SPANS SEE WIRE CHART. 100 FT. 14 AWG NACELLF 110-3 UF-B DIRECT CHASSIS BURIALCABLEWMIO 120/240V ---------7 ELECTRICALLY GND FROM YAW AC MAIN I I CONNECTED CONNECTION TO TOYAW,WHICH SAFETY SWITCH.240V SERVICE MUSTSE AC SPLIT-PH 6OHz PANEL ELECTRICALLY I C CONNECTEDTO 1 2oA C THE TOWER I oA DEDICATED WIND TOWER POWER SYSTEM I UTILITY 35 FT. X Q Q Q 10-3 W/11/GNDTHWIN-2 CABLE KILOWATT-HOUR I I KILOWATT-HOUR 35 FT. 6 9 FROM SAFETY SWITCH TO MAIN METER I HIGH) g I I METER SAFETY SWATCH SERVICE PANEL LENGTH<208FT. (OPTIONAL) ( I • 2-POLE,30A,240VAC I I SHOT TORE#DU22IR8 N(white) N/G N N N I G L1(black) L1 D LI L1 L2 red I j L2 D L2 L2 j I Is G ND bare/teen G 10 INCH MAX.MIN. Q l__ _____J Q7 WIND POWER GROUND SYSTEM SYSTEM DISCONNECT _ GROUND SWITCH 2-POLE —� VEL BOA,240VAC SCI-D ODU221 RB T TES: � ) F ✓ 6-MIN. 1.EQUIPMENT SHALL BE IN STALLED IN ACCORDANCE WITH NEC ARTICLE 705. 2.PROVIDE WARNING SIGN PER NEC 690.17 READING'WARNING-ELECTRIC 240 VAC TOq r r SHOCK HAZARD-DO NOTTOUCM TERMINALS-TERMINALS ON BOTH ME UNE TO SERVICE GROUND AND LOAD MAYBE ENERGIZED IN THE OFF POSITION'. SYSTEM RUN FROM INC.BOX AT 241NCH MIN. 3.IABEL'WIND POWER SYSTEM DEDICATED kW-HR METER". TRANSFORMER, _ TOWER BASE TO HOME 4.LABEL SNITCH AS"WIND GENERATOR SAFETY DISCONNECT SWITCH; UTILITY GRID REMOVING AC POWER TO TURBINE ACTIVATES ITS SAFETY BRAW. 5.OPTION IS TO USE A JUNCTION BOX AT TOWER BASE INSTEAD OF A SWITCH. 6.LABEL"REMOMNG AC POWER TO TURBINE ACTIVATES ITS SAFETY BRAKE". 7.BI-DIREC1ic NAL METER TO BE INSTALLED BY UTIUTY(WHEN REQUIRED). TOWER e.USE COPPER WIRES ONLY AT TURBINE TERMINALS FOUNDATION TOP 9. ALUMINUM WIRES MAY BE USED FOR HOME/UTILITY CONNECTION IF TRANSITION SURFACE TO BE WE RE DONE IN A INC.BOX 14AWG WIRE MUST BE COPPER ONLY. MIN.6"ABOVE F GROUND LVL. CAbgeneratad drawing St3VtItMnF?S C.W3/]CJj.KP14a:1', REFER TO SW WP do not mtlnuaPy update Fla stoI,Arizona U.S.A. FOUNDATION DWG. APPROVALS#DAIE 1"DIAL SCHED.40 S"" OV aw 120/240 V 60 Hz RIGID PVC CONDUIT; w/JCT eox P.IhSUNLIGHT RESISTANT; ESP eJC D.Cda . AL-1 UL LISTED g.n°3CMF-1083 I 3 a s APPLICATION NOT SCALE DRAWING r'LL la none v s¢e A3 sheet l of Skystream 3.7711 Owner's Manual Appendix A: Electrical Diagrams 3 NOTES: 1. THE BOTTOM OF THE EXCAVATION SHALL BE AT OR BELOW THE FROST DEPTH AT THE SITE LOCATION. THE FOUNDATION THICKNESS MUST BE THE FROST DEPTH MINUS 6 INCHES, BUT 3'-0" MINIMUM. 2. 13'"Q+ x 32" LONG ASTM F1554 ANCHOR RODS, ASTM A563 NUTS A46 ASTM F436 WASHERS SUPPLIED WITH ANEMERGONICS FOUNDATIONS` KITS ARE PRE—APPROVED. PROPOSED MONOPOLE 3. SPECIFICATION OF ANCHOR BOLT INSTALLATION PROCEDURES IS TOWER BY OTHERS. THE RESPONSIBILITY OF THE TURBINE MANUFACTURER. PROPER INSPECTION, INSTALLATION AND TESTING OF THE ANCHOR BOLTS IS THE RESPONSIBILITY OF THE INSTALLER. FORM WITH r2'—�O"O W ITH PIER PROPOSED HEX NUT SONOTUBE AND WASHER WITH NUT—LOCKING DEVICE PROPOSED TOWER FOUNDATION. PROPOSED BACKFILL. AMEND SOIL AND REVEGETATE EXISTING GRADE 12" ya" PROPOSED ANCHOR ° w BOLTS (TYP. OF 8). w SEE NOTE 2 ON THIS ,w w SHEET. z ; ° (4)—#3 REBAR � HOOPS Al 6" O.C. Z 0 o .1 Z M , W ' W DIAMETER --y� SEE TOWER DESIGN CRITERIA ON SHEET S-1 FOUNDATION ELEVATION (FINISHED) G 1 2 SCALE: 3$" = 1'-0" SCALE IN FEET PROJECT INFORMATION: 7 08-13-08 1 DRAWN BY: WtIMI CHECKED BY: MLG TOWER ENGINEERINGPMESSIONALS 6 06-25-08 3703 JUNCTION BOULEVARD AnenaErgonics,LLC SMarT Foundation 5 06-12-08 SHEET NUMBER: REVISION: RALEIGH,NC 27603.5263 7 � (919)661$351 G���. (303)940-7530 [Simple Modular Technology] 4 03-18-08 www.anemergonies.com wL S-3 REV DATE P #: 081330 ®® NOTE: PROPOSED 2" ABS o✓® ® PROPOSED 2" ABS 1. THE BOTTOM OF EXCAVATION SHALL BE AT OR BELOW THE FROST TEMPLATE SPACER. ® MALE ADAPTER, DEPTH AT THE SITE LOCATION THE FOUNDATION THICKNESS SHALL BE THE FROST DEPTH MINUS 6 INCHES, BUT 3'-0" MINIMUM. PROPOSED 2" ABS ---- PROPOSED 2" ABS FEMALE ADAPTER. FEMALE ADAPTER. PROPOSED 2" ABS PROPOSED 2" ABS PROPOSED UPPER ANCHOR BOLT TEMPLATE. PIPE EXTENSION. MALE ADAPTER. SEE SHEET S-5 FOR DETAILS. PROPOSED 3" TO 2" PROPOSED TEMPLATE SPACERS. (TYP OF 8) ABS PIPE REDUCER, 2'-0"0 PIER FORM WITH SONOTUBE PROPOSED LOWER ANCHOR BOLT TEMPLATE. SEE SHEET S-5 FOR DETAILS. PROPOSED 3" ABS PROPOSED BACKFILL. AMEND SOIL AND REVEGETATE PIPE STANCHION. ,� " !' PROPOSED TOWER FOUNDATION. EXISTING GRADE i r 12" y4" A PROPOSED ANCHOR , S2 S4 W BOLTS (TYP of s) W (4)-#3 REBAR HOOPS m AT 6" O.C. � z o 7:: PROPOSED 3" ABS o •1 PROPOSED STANCHION COUPLING Z 3 BASE, SEE SHEET S-5 Li FOR DETAILS. PROPOSED STANCHION N BRACE, SEE SHEET S-5 FOR DETAILS. (TYP OF 2) DIAMETER SEE TOWER DESIGN CRITERIA ON SHEETS FOUNDATION ELEVATION (ASSEMBLY) 0 1 2 SCALE: 4" = 1'-0" SCALE IN FEET PROJECT INFORMATION: 7 08-13-08 1 DRAWN BY: WHIVII CHECKED BY: MLG TORRENGINEERINGPROFESSIONALS 6 06-25-OS AN 3703 JUNCTION BOULEVARD AnemErgonics,LLC SMarT Foundation 5 OG-I2-08 SHEET NUMBER: REVISION: RALEIGH,NC 27603.5263 (919)661.6351 (303)940-7530 Simple Modular Technology] 4 03-18-08 ® 7 www.anemergonics.com REV DATE TEP #: OBI 330 Skystream 3.7 Owner's Manual Appendix B: Tower Grounding Important Safety Instructions 3 1)INTRODUCTION 4 External bond to tower 2)GROUNDING TECHNIQUES 4 Internal bonding 2-1 Copper Clad Electrodes Driven Into Soil 4 to tower bolts using listed or approved clamp 2-1-1 Grounding Electrode Installation 5 14. 2-1-2 Electric Resistance to Ground 5 ';i ii••I'r jl 4AWGor 2-1-3 Grounding Electrode Conductor:Material,Size, Al 11 `' larger copper wire Bonding to Electrode&Bonding to Tower 6 SOIL CONCRETE, `•• 2-1-4 Conductor Size 6 ` 2-1-5 Bonding the Grounding Electrode Conductor to the Earth Electrode 6 L... z inch min. 2-1-6 Bondng the Grounding Electrode Conductor to the at foundation bottom Tower 6 2-1-6-1 Using a Tower Bolt/Nut Assembly 6 20ft of 1/2 inch dia. Listed or approved clam for re-bar OR 4AWG connecting copper to steel. C 2 -1-6-2 Using a Grounding Lut at Tower Base 7 larger bare Clamp is generally tin plated and Copper conductor must prevent direct contact between 2-1-6-3 Using Exothermic Welding 7 Cu and steel to prevent corrosion 2-2 Electrodes Encased in the Concrete of the Tower Foundation 2-3 Bolting Grounding Lug to Tower Base 8 2 Skystream 3.7711 Owner's Manual Appendix B: Tower Grounding TOWER DESIGN CRITERIA EL7`11aTloN DESIGN VERTICAI. SASE" l3aS>* FOUNDATION ELEV. (SEE CHART) WIND SPEED LOAL3 NIOII+CT S �R7lal[EER VJ T/ TOWER ° MPH) "('LOS):: (FT-LSS) (08) } CASE 1 S 33.5 5 110 761 18,486 677 5'-8" CASE 2 S 33.5 150 761 31,156 1,179 CASE 3 5 45 S 110 998 27,612 828 6'-4" ASE 4 5 45 S 150 99$ 47,513 1,459 CASE 5 5 50 5 110 1,000 35,500 1,100 7'-0" CASE 6 50 S 150 1,000 66,000 2,000 CASE 7 5 55 S 110 1,543 43,995 1,129 7'-2" CASE 8 5 55 5 150 1,54,3 76,681 2,020 PROPOSED TOWER BY OTHERS — CASE 9 S 60 S 110 1,543 43,995 1,129 7'-2" CASE 10 6t3 5 150 1,543 76,681 2,020 NOTES: 1. THE FOUNDATION DESIGNS ARE BASED ON AN IBC CLASS 5 (OR BETTER) SOIL CLASSIFICATION AND AN ALLOWABLE BEARING PRESSURE OF 1500 PSF AND A LATERAL BEARING OF 100 PSF/FT BELOW GRADE. IT IS THE RESPONSIBILITY OF THE OWNER TO VERIFY BY GEOTECHNICAL INVESTIGATION THAT ACTUAL SOIL PARAMETERS AT THE SITE EQUAL OR EXCEED THOSE GIVEN. IF CONDITIONS OTHER THAN THOSE PROPOSED FOUNDATION. DESCRIBED ARE ENCOUNTERED, A FOUNDATION ANALYSIS SHOULD BE PERFORMED TO DETERMINE THE SEE DETAILS ON SHEETS STRUCTURAL ADEQUACY OF THE SUBSTRUCTURE. INSTALLATION SHALL NOT PROCEED UNTIL STRUCTURAL S-2 THRU S-4. ADEQUACY HAS BEEN CONFIRMED. 2. IF THE FROST DEPTH IS KNOWN TO BE GREATER THAN 42 INCHES, THE 3" ABS PIPE STANCHION SHALL BE LENGTHENED SO THAT ITS BASE IS AT OR BELOW THE FROST DEPTH. THE LENGTH OF THE EXTENDER (INCHES) SHALL 0'-0" (REFERENCE) BE EQUAL TO THE FROST DEPTH MINUS 42, AND MAY BE ATTACHED WITH A T/ BASE PLATE 3" ABS COUPLING. 3. INSTALLATION SHALL NOT PROCEED IF THE WATER TABLE IS LESS THAN THE FOUNDATION DEPTH. CONSULT WITH DESIGN ENGINEER FOR FOUNDATION ANALYSIS OR REDESIGN. CONSTRUCTION SHALL NOT PROCEED UNTIL APPROVAL FOUNDATION 0 IS OBTAINED FROM THE DESIGN ENGINEER. SEE CHART ��— PROJECT INFORMATION: 7 08-13-08 DRAWN BY: KMMI CHECKED BY: MLG TOWER ENGINEERING PROFESSIONALS ' G 06-25-08 01 3703 JUNCTION BOULEVARD AnemErgonics,LLC S11�arT Foundation 5 06-12-08 SHEET NUMBER: REVISION: RALEIGH,NG 27603-5263 (919)661.6351 (303)940-7530 LSlmple Modular Technology) a 03-15-08 7 www.anemergonics.com REV DATE TEP 081330 Declaration of Conformity s K Y ST R =AM M 0 For battery charging applications only iv rt O _ O Product: Skystream 3.7 n O Type: Skystream 3.7, Land, 230V, 50Hz, 1 P (Item# 1-SSL-1 1-230) 3. Skystream 3.7, Marine, 230V, 50Hz, 1 P (Item# 1-SSM-1 1-230) lz:" m c We hereby declare that Skystream 3.7 small wind turbine meets the essential European 0 Union requirements by design and construction as follows: - We fully comply with the Machinery Directive 98/37/EC. - We fully comply with the small wind turbine design standard IEC 61400-2. - We fully comply with Directive 2005/88/EC for noise limits and labeling requirements. - We believe we comply to all safety aspects of the Low Voltage Directive 2006/95/EC as Cn this product is certified in USA to comprehensive safety standards UL1741 /IEEE 1547. IT co - We fully comply to the RUTE directive 99/5/EC and will have undergone the CD necessary testing by Underwriters Laboratories to document conformity by July 1, 2007. 3 P - We will fully comply to the EMC directive 2004/108/EC by August 1, 2007. - We are 99% compliant to RoHS directive 2002/95/EC and will fully comply by July 1, 0 2007. c� Based on the above indicated conformance,we are applying the CE-mark to the above models for export to Europe. Remark: E The above CE compliance will be invalidated if: "a - The machine is modified in any way without the explicit written consent of Southwest Windpower. - The machine is used or connected in a manner or configuration that Southwest Windpower does CD not regard as its intended application. Q X �? Dated, April 5, 2007 n CD a' David Calley (President and Chief Technology Officer,Southwest Windpower) oSouthwest Windpower 3 1801 West Rt.66,Suite 100 • Flagstaff,AZ 86001, USA :3 Phone:+1928-779-9463 Q www.windenergy.com W info @windenergy.com �(VOIS Ml Vii( N N Cn C � r � n Certificate of ! 1 . C CD =� 0) 3 w Cert zie Namur 20071402E300731 page u,{ CD W Re,xeri Reference E300731,Issued 2006-10-17 0 V Undemiters o 3 ssus`ate 2007 February 14 n o L Laboratories Inc,�. m m w � Issued lo: Southwest Windpower Inc A) 1801 W Rte 66 D Flagstaff,AZ 86001 Q -0 United States Q', CD CL This is to certifi,that SkyStream invffter x representative samples of Component inverter for use with Skystream wind turbine,Utility Interactive Ready n n CD liave beery investigated fly L%raderrr.,rifers Laboratorr"es Irzc.r in accordance with the Standard(s)indicated on this Certificate. Standard(s)for Safety: UL 1741,Standard for Safety for Inverters,Converters,Controllers and n Interconnection System Equipment for Use With Distributed Energy Resources, 1st 0 Ed.;IEEE 1547-2003;CAN/CSA C22.2 No.107.1-01,3rd Ed.,General Use Power Supplies Additional Information; Output configuration: 120/240V,1,N-L,Oper.voltage range Vac:212-264;or CD 120/208V,UN-L,Oper.voltage range Vac: 183-229;Normal out frequency Hz: 60.0;Operating frequency range Hz:59.3-60.5;Rated output current Aac: 10.0; Rated continuous output power kW@25°C: 1.8;Rated continuous output power kW@50°C: 1.4;Max.peak output kW:2.4;Surge Rating B3 0-0i,Plrisc"n'Cx_acts n•ariny tlrt UL Kecrf rued('t,rii,.,.ent 13:rks for Iht US.and( .fad;shrnftC be a., bin, veered b) UL'4 Recognition Up Scrci,:c and uu'tsri, Ilea lh,t ,.. ,.•I i1m o.mt..0.^,.,rk+,v h�1 S� r ten 1.-sue, ..,� _het �. i,ai r,-i .r..nufi.,a.rr ni a r..t,�ce>. fiv'..tc pxrticola"'i2e n ii.tum I ib t h d in d" apt r i.i"r l i "7ir-tt r� 1-.�st p V❑.n nR'r t v e.I'ice wCeing prod tct th it eve boat producd t ntict CL,s R—gnnion f r y,a.n.U! R,..r,gnvcc.(pry o.K`trt%IiA.%,,m h_u,,d m coy iucuon ricaii�.��_�rt,nilitr�o nndc; lS.u� tgF h�i.,c v-'.d��iewgrm.�m ;'ha Cl.R {�-zLd t.t,p<rc.,,t'�4�e'h to*t armds con"",of thi i il,Kerogmrc i 4 ok Ra.anndz'."Wild Th,❑um tn,rarer>idcnnf catwn t nd aw.io„ m,t Lcr,moail .un.hcr, v,.-;"mat u..,,.ai:,.0.t,,P"ifcc .atirr"\Jm4Jn[; to,d,c R, wo'!;ts 1.it ,cd in!h'❑pop t t 1,Dims;,-y. Look for the lll_ Recognized Component Mark on the product Issued Chris Storbeck Reviewed by: ChristopheFlueckiger bv: Chris Storbeek,Project Engineer Christopher Flueckiger,Sr.Project Engineer Uudervrtiten Labaratories Ine. U„de,YVriters Laboratories lot. Any information and documeatation involving UL Mark services are provided an behalf or Undermiters Laboratories lot_(Uf.)-any authorized licensee of UL. Fir n.Fecff—in rhn i Wil.A qt—nr A—t—vxa mae rxtl 1-877.1 It_HFt m. to r i 4- 00 Fasthariipton-jo(-Nlc, earth 500 ft 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: cA QxQ I The debris will be transported by: Nit) v The debris will be received by: C, LA Building permit number: Name of Permit Applicant GR( S_[A [ Date Signature of Permit Applicant City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS r' t 212 Main Street • Municipal Building J1 fib, Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s)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 regulations. 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 inspected. 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 I, understand the above. (Home owner/reside es signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date j a( (r S" Address of work location L-.A N6 k-i-ck L yi ( `e P X MA O(GIZ ZX The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ` �► Please Print Legibly Name (Business/Organization/Individual): (�r��>(rt �„��%Y 4 Address: ao � S •etc,°y1�' C.t ,t City/State/Zip: LU_- -jjC _ 0 Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1.❑ I am a employer with 4. 0 I am a general contractor and I 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. ❑ Remodeling ship and have no employees These sub-contractors have g, 7 Demolition working for me in any capacity. employees and have workers' insurance. 9. E] Building addition comp._ [No workers' comp. insurance P• wired.] 5. E] We are a corporation and its 10.0 Electrical repairs or additions 3. a homeowner doing all work officers have exercised their 11.F1 Plumbing repairs or additions myself. ' right of exemption per MGL y �o workers comp. 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners 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 andjob site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: 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$250.00 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 coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature, ' � Date: S l ZI j t ' Phone#: 413 - 2? ­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 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 License Number Address Expiration Date Signature Telephone 9 Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone 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 buil5n permit. Signed Affidavit Attached Yes....... 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. J � Homeowner Signature � �/ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding[M] Other[tZQ Brief Description of Proposed Work: Installation of a 2.2 KWH Wind Turbine Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If New house and or addition to existing housino, complete the following: 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 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. Signature of Owner Date 1,A R c k-k VA D JSe!� (A as Owner/Authorized Agent hereby declare that the stsfiaMents 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. 9p,ffa � Q, o - Print Name ignature of Owner/AcIdnt 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 by Building Department Lot Size 11 Acres 11 Acres Frontage N/A Setbacks Front j( Side L: 100 R:!100 L: R: Rear 100 Building Height 45 Bldg.Square Footage N/A N/A Open Space Footage (Lot area minus bldg&paved N/A N/A parking) #of Parking Spaces N/A Fill: None p volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW Q YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW ® YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained O , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q 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 O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. — Department users#* ( ty of Northampton Stasis of Parr . MAY 2 6 2015 i� ilding Department curb Cl" riveway�Et 12 Main Street Sewert Arlifietrtt�r Elect,ia. P ��:ma CisirapealcN�a Room 100 Walw1wellAi►aik�ti ' Northam}ton.AAA o 1 UG0 mpton, MA 01060 Two"8ets,of Stn turat Planag phone 413-587-1240 Fax 413-587-1272 PkrttSito Plans fluter�pry �.. 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 � S'1'�'`�itt+1V1 1' j L�-c'ydtslC" Map ` Lot Unit L-c c) Zone Overlay District L are 018. Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Brian P.Duggan/Maryanne L.Duggan 200 Easthampton Road,Westhampton,MA 01027 Name(Printj Current Mailing Address: (413) 527-8789 -�- Telephone Si nature 2.2 Authorized Assent: Self Self Name(Print) Current Mailing Address: Self Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 18,500 (a)Building Permit Fee 75.00 2. Electrical 3,500 (b)Estimated Total Cost of 75.00 Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 75.00 5. Fire Protection 6. Total=0 +2+3+4+5) 22,000 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2015-1179 -ed 1J i V O 1 APPLICANT/CONTACT PERSON DUGGAN BRIAN&MARYANNE e /I ,„�""`�, ADDRESS/PHONE 200 EASTHAMPTON RD WESTHAMPTON01027 � PROPERTY LOCATION 41 NORTH LOUDVILLE RD MAP 41 PARCEL 001 001 ZONE 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 2.2KWH WIND TURBINE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF94MATION 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 Dela l Signature of uilding 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. 41 NORTH LOUDVILLE RD BP-2015-1179 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 41 -001 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: WIND TURBINE BUILDING PERMIT Permit# BP-2015-1179 Project# JS-2015-002208 Est. Cost: $22000.00 Fee:$75.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 365904.00 Owner: DUGGAN BRIAN&MARYANNE zoninc: Applicant: DUGGAN BRIAN & MARYANNE AT. 41 NORTH LOUDVILLE RD Applicant Address: Phone: Insurance: 200 EAST14AMPTON RD WESTHAMPTONMA01027 ISSUED ON:61212015 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 2.2KWH WIND TURBINE 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 6/2/2015 0:00:00 $75.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner