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31C-032 (9) BP-2021-2200 119MOSER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31 C-032-001 CITY OF NORTHAMPTON Permit: Solar Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-2200 PERMISSIONISHEREBYGRANTED TO: Project# 2021 SOLAR SYSTEM Contractor: License: PIONEER VALLEY Est. Cost: 16373 PHOTOVOLTAICS 111266 Const.Class: Exp.Date:03/14/2023 Use Group: Owner: DERMAN ERIC M TRUSTEES Lot Size (sq.ft.) Zoning: PV Applicant: PIONEER VALLEY PHOTOVOLTAICS Applicant Address Phone: Insurance: 3 I 1 WELLS ST - SUITE B (413)772-8788 375928710101 GREENFIELD, MA 01301 ISSUED ON:11/18/2021 TO PERFORM THE FOLLOWING WORK: INSTALL 7 PANEL 3.08 KW ROOF MOUNT SOLAR SYSTEM WITH INVERTER IN BASEMENT 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. Signature: i I�a . '1 • Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans • phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify 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 Map Lot Unit 119 Moser St Northampton, MA Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Eric Derman 119 Moser St. Northampton,MA 01060 Name(Print) Current Mailing Address: (413)727 3088 See Attachment A Telephone Signature 2.2 Authorized Agent: Pioneer Valley Photovoltaics 311 Wells St. Greenfield, MA 01301 Name(Print) Current Mailing Address: / �/.1`' 413-772-8788 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $5,458 (a)Building Permit Fee 2. Electrical $10,915 (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) *-7C 5. Fire Protection 6. Total = (1 +2 + 3+4 +5) $16,373 Check Number (� This Section For Official Use Only Building Permit Number: _3 --a a U-o Date Issued: Signature: _ 7/72 /1- /7- ZOZ 1 Building Commissioner/Inspector of Buildings Date buildingpermits @ pvsquared.coop EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot arca 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 O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO O 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. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacement Windows Alteration(s) n Roofing n Or Doors Cl Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding [lam] Other[El] Brief Description of Proposed Installation of a solar array on the garage and breezeway roof. Work: Alteration of existing bedroom Yes XX No Adding new bedroom Yes XX No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, 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 Eric Berman ,as Owner of the subject property PV Squared (Pioneer Valley Photovoltaics) hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. See Attachment A See Attachment A Signature of Owner Date PV Squared 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. Daniel Gomez Print Name //IJ.J 4/15/2021 Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: Daniel Gomez Gonzalez License Number 43 Hatfield St. Northampton, MA 01060 CS-111266 Address Expiration Date 03/14/2023 Signature Aviv Telephone 413-772-8788 9. Registered Home Improvement Contractor: Not Applicable ❑ Pioneer Valley Photovoltaics Cooperative Company Name Registration Number 311 Wells Street, Suite B, Greenfield, MA, 01301 140077 Address Expiration Date 413-772-8788 Telephone 09/15/2021 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 I✓ No ❑ Attachment A PV Squared is committed to providing a high quality product and service and we look forward to working with you on your renewable energy project. Sincerely, Pioneer Valley PhotoVoltaics Cooperative ,i4":„.(4; Jonathan Child Design and Sales Team Attachments: A-PV Array Sketch General Terms and Conditions Right of Rescission AUTHORIZATION TO PROCEED AND SERVE AS AUTHORIZED AGENT I hereby agree to the Pr eject as set out above, and I agree to pay the coi tlt act .n tte act.erdtl ig to the Tet t ri 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 Looperative, or its designated representative, to obtain required permits for this project on behalf of the Owner. I will allow any photographs or videos of this project to 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. _ 2/ Dat ` r Printed Name � 4jt(9 (� \ Signature Title Proposal and Agreement ii 00016539 Page 7 of 13 Eric Demon-June 4,2021 { DERMAN RESIDENCE O SITE MAP 119 MOSER ST c g.,�: ... �:Y r f :- ' : ' " &I, ii NORTHAMPTON, MA 01060 '' fY t -�, • tl01001:11NO3 2131401530 a • • 4 -c PHONE: 413.727.3088 f,.'„ * • : , .—� 1. i71, E-MAIL: EMD462@YAHOO.COM .i. • ' ,4' ',•°�' .T. •.: ROOF MOUNTED PHOTOVOLTAIC SYSTEM ,.fI , •, ti - .�-, 1 ,i.1 : i„ � 0 I— PHOTOVOLTAIC SYSTEM DETAILS � ,a • . ► _ z g • MODULES = LG LG4400AC-A6 440W (7 PCS) If. L';„ + C'\,, Q Z • INVERTER = SOLAREDGE SE3000H-US (I PCS) ••• 4 ;•., i 1 CC _ • RACKING SYSTEM = IRONRIDGE XRI00 W/ FLASHFOOT2 .." ,. - •y_ W f— • DATA ACQUISITION = CELL MODEM 0 Et O z AUTHORITY HAVING JURISDICTION ••BUILDING REFERENCCE AUTHORITY 2020 NECNORTHAMPTON O VICINITY M A P •ELECTRICAL UTILITY COMPANY = NGRID OY,ospI DESIGN CRITERIA cm`''9 •DESIGN WIND LOAD = 117MPH 06 �p • DESIGN ROOF SNOW LOAD =40PSF 0 81, • EXPOSURE CATEGORY = C r Norm Commons 0,4 ,a at WIWI-11D • HIGH TEMP (ASHRAE 2%HIGH) = 34°C 119M st, 11.3 • LOW TEMP (ASHRAE EXTREME LOW) = -25°C • os Northampton.MA01060", :an Og g •ROOF TYPE = ASPHALT SHINGLE z ,±3$w 'S� `1 ,gP 3 SHEET INDEX w;8 Vim 2 a"; PV-G.0 COVER PAGE •• . PV-A.I ARRAY LAYOUT „s. PV-A.2 DIMENSIONS �0. PV-E.I LINE DIAGRAM w Q PV-E.2 ELECTRICAL CALCS LU LLI r n PV-P.I PLACARDS w C) N t1 ,a„,.s' Villages At Hospital H 1 e e o a- 5 o R ROOF CONSTRUCTION DESIGN INPUTS-SATELLITE IMAGERY 8 FIELD MEASUREMENTS • `. EZ o-i • ROOF TYPE = ASPHALT SHINGLE ;C��\)!; ?. ��,:N K • PV ARRAY = 150 SQUARE FEET - N QQ kq • TYPICAL ATTACHMENT SPAN =48" VV • MAX ATTACHMENT SPAN = 76" • MAX CANTILEVER =30.4' vci-vaITT, a3,1Sa • ATTACHMENTS SHALL BE STAGGERED SO THE LOAD IS DISTRIBUTED EVENLY TO RAFTERS UNDERNEATH THE ARRAY 0 LG440QAC-A6 CLAMP ZONES w cp • DIMENSIONS = 75.2' X 41' U 0 • PORTRAIT CLAMP ZONE: 7.8'TO 15.6' Z • LANDSCAPE CLAMP ZONE: 0" TO 11.8" 0 V) z s _f - di- QZ � MAIN BILLING METER - EXTERIOR PV AC DISCONNECT - EXTERIOR Z a a_' ct INVERTER - INTERIOR MAIN SERVICE PANEL - INTERIOR w F- (BASEMENT) II (BASEMENT) o z Lit II IlirI I , ....... NW � TRUSSES, 16" O.C.1111 o£� ei, Eos ATTACHMENTS 141 RAIL >1 z;g.p 3 w� t: ARRAY INFORMATION V ARRAYI ARRAY2 STRING CONFIGURATION MOD QTY 5 2 I— STRING SIZE DOES NOT VARY Q `_' Q TILT 33° 33° STRINGS OTY CC 1 AZIMUTH 185° 185° STRING I 7 Q Q 06 148 2 6'-3" w 0 CD I V'1 N � O V 1— N O N�� 6'_3", 02 13'-4" SYSTEM DETAILS-.3.08.W DC • • 7 LG LG4400AC-A6.440W MODULES `. • I SOLAREDGE CONTACT MATT VALLIIERE�INVERTER DIMENSIONS • MATTV.MASSVARED000P DERMAN RESIDENCE w � . (413)992-7252 119 MOSER ST DESIGNER.DAN BOWLING NORTHAMPTON, MA 01060 �L ste New England Construction Engineering, PLC 436 Campbell Street (NECE) Structural Construction Solutions White River Junction, VT 05001 Jonathan Rugg, P.E. 603-903-9798 j.rugg@NewEnglandConstructionEngineering.com October 29, 2021 Mr. Bill Killough-Hill Pioneer Valley PhotoVoltaics Cooperative, Inc. 311 Wells Street, Suite B Greenfield, MA 01301 Re: Derman Residence, Northampton, MA NECE Project No. 21-01 T110 Dear Mr. Killough-Hill, At your request, New England Construction Engineering, PLC (NECE) has reviewed the information that Pioneer Valley PhotoVoltaics Cooperative, Inc. (PV Squared) provided on the roof supporting structure of the Derman residence, at 119 Moser Street, in Northampton, MA. The purpose of this review was to provide an opinion regarding the structure's capacity to support a proposed rooftop mounted photovoltaic (PV) array.The information that you provided is attached to this letter for reference. You are proposing to mount PV panels on the roof of the breezeway and attached garage. The house is a recently constructed single family home with a single-bay attached garage. The information that you provided included partial architectural plans by Pecoy Builders, dated march of 2016. The garage and breezeway have gable roofs with an 8/12 pitch. The garage is 12' wide. The garage roof is supported by 2x8 rafters at 16" O.C. These rafters span 6' on the horizontal. Ceiling joists, at the top of wall, resist the outward end reactions of the rafters on the walls. The breezeway is 14' wide. The rafters supporting the breezeway are concealed by finishes and cannot be directly observed. For the purposes of analysis NECE has assumed that these rafters are also 2x8 at 16" O.C. These rafters span 7' on the horizontal. The roofs have plywood decks and asphalt shingles. The photographs that you provided suggest that the home is well constructed and well maintained, and the roof is performing well. There is no evidence of distress or large deflections. NECE's review and analysis included the controlling gravity load combinations (snow and dead load). New England Construction Engineering, PLC PV Squared-Derman Residence Jonathan Rugg, P.E. Northampton, MA Page 2 of 2 Conclusion: Based on the information that you provided, I conclude that, the roof will support your proposed PV array. I base this on the following. The proposed PV panels will be installed parallel to the existing roof, eliminating additional wind load. Based on the information that you have provided on similar projects; I assume that the PV panels weigh approximately 2.3 psf. The Ground Snow Load (Pg) for Northampton is 40psf. The minimum Flat Roof Snow Load (Pf) is 35psf. In summary, in my opinion, the roof will adequately support your proposed roof mounted PV array. Thank you for the opportunity to assist with this project. If NECE can be of further assistance, please contact Jonathan Rugg at NECE. OJONRAuTHGAGN Sincerely, -+� ,. ALL Jonathan Rugg, P.E. New England Construction Engineering, PLC. �1i��9/ 021� v' Attachments: -Building Information Commonwealth cat Massachusetts Division of Professional Licensuure Board of Building Regulations and Standards Con IlAupprvisor -1 11266E pmrtes: 03)14/2023 DANIEL GOMEZ-GONZALE 43 HATFIELD STREET , NORTHAMPTON MA 01060 . r Corn missioner ( a . / /'/1//jlO/G//rt.ezC ,/, Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 140077 PIONEER VALLEY PHOTOVOLTAICS COOP Expiration: 09/15/2021 311 WELLS ST SUITE B GREENFIELD, MA 01301 SCA i 0 201.4-0517 Update Address and Return Card. • III //. / //f,/, /6i.1: Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Suoolemenl Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 140077 0915/2021 1000 Washington Street -.Suite 710 PIONEER VALLEY PHOTOVOLTAICS COOP Boston,MA 02118 /1./ MAYA FULFORD 1'� 311 WELLS ST SUITE B i.> .% - GREENFIELD,MA 01301 Ot Vail ithout signal e Undersecretary DATE(MM/DD/YYYY) A ICC)Ft o® CERTIFICATE OF LIABILITY INSURANCE 12/22/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kathy Parker NAME: Webber&Grinnell PHONo,Extl: (413)586-0111 FAX No): (413)586-6481 8 North King Street E-MAIL kparker@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE _ NAIC# Northampton MA 01060 INSURER A: Ohio Casualty/Liberty 24074 • INSURED INSURER B: Ohio Security/Liberty 24082 Pioneer Valley PhotoVoltaics Cooperative,Inc. INSURER C: Continental Indemnity/AUW Attn:Kim Pinkham INSURER D: 311 Wells Street,Suite B INSURER E: Greenfield MA 01301 INSURER F COVERAGES CERTIFICATE NUMBER: CL20122214681 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. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 RED CLAIMS-MADE X OCCUR PREMISESDAMAGE TO(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 15,000 A BKS57072282 01/01/2021 01/01/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 PRO 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED �/ SCHEDULED BAS57072282 01/01/2021 01/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS X HIRED N/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) _Underinsured motorist $ 300,000 X UMBRELLA LIAB y E 5,000,000 OCCUR EACH OCCURRENCE $ A EXCESS LIAB CLAIMS-MADE US057072282 01/01/2021 01/01/2022 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A 375928710101 01/01/2021 01/01/2022 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Business Pers Property $1,820,700 Commercial Property A BKS57072282 01/01/2021 01/01/2022 Installation $25,000 Transportation $75,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Worker's compensation includes MA and NY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Proof of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE '1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD _ The Commonwealth of Massachusetts II 1_* I, Department of Industrial Accidents ]_ 1 Congress Street, Suite 100 € _ i= ' Boston, MA 02114-2017 — www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WiTH THE PERMITTING AUTHORITY. Applicant information Please Print Legibly Name (Business/Organization/Individual): Pioneer Valley PhotoVoltaics Cooperative Inc. DBA PV Squared Solar Address:311 Wells Street, SuiteB City/State/Zip:Greenfield MA 01301 Phone #:413-772-8788 Are you an employer?Check the appropriate box: Type of project(required): 1.0 i am a employer with 48 _employees(full and/or part-time).* 7. ❑New construction 2.0 i am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 3.0 i am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 10❑ Building addition 4.0 i am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and i have hired the sub-contractors listed on the attached sheet. ]3.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We arc a corporation and its officers have exercised their right of exemption per MGL c. 14.ID Other Solar PV 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. I'Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Continental Indemnity/AUW Policy#or Self-ins.Lic. #:37-592871-01-01 Expiration Date:01/01/2022 Job Site Address: 119 Moser St. City/State/Zip:Northampton, MA Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer t 'r t e ai s nd penalties of perjury that the information provided above is true and correct. Signatu \ Date: 11/4/2021 Phone#:413-7 -87 8 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#: .. .. .L . L• . LGNON®R .:- . .„. 0 ,. , . . LG440QAC-A6 Preliminary 440W LG NeON°R is powerful solar module that provides world-class -_ performance.A new cell structure that eliminates electrodes on ---------- the front maximizes the utilization of light and enhances reliability. - - - - - - ^ - _ LG NeON®R is a result of LG's efforts to increase customer's - _ _ values beyond efficiency.LG NeON®R features enhanced durability, - - _ _ - _ 7 performance under real-world conditions,an enhanced warranty and aesthetic design suitable for roofs. - nd• moveowa: - _ -4'''''s--4.--...71IN''...........4„..„,,,,,,k, "' DVEC ® US E v- - - - • • . YEAR PRODUCT•PERFORMANCE.•LABOR WARRANTY Features + Roof Aesthetics ® 25-Year Limited Product Warranty III_I LG NeON°R has been designed with The NeON°R is covered by a 25-year limited aesthetics in mind:the lack of any product warranty.In addition,up to$450 of electrodes on the front creates an labor costs will be covered in the rare case that improved,modern aesthetic. a module needs to be repaired or replaced. Enhanced Performance Warranty itis More generation per square meter The LG NeON°R has an enhanced • The LG NeON°R has been designed to performance warranty.After 25 years, significantly enhance its output,making LG NeON°R is guaranteed at least it efficient even in limited space. 92.5%of initial performance. When you go solar, ask for the brand you can trust: LG Solar About LG Electronics USA,Inc. �� LG Electronics is a global leader in electronic products in the clean energy markets by offering solar PV panels and energy storage systems.The company first embarked on a solar energy source research program in 1985,supported by LG Droop's vast experience in the semi-conductor,LCD,chemistry and materials industries.In 2010,LG Solar successfully 0 released its first MonoX°series to the market,which is now available in 32 countries.The NeON°(previous MonoX°NeON),Ne0N°2,NeONc'2 B&Facial won the"Intersolar AWARD"in 2013,2015 and 2016,which demonstrates LG's leadership and innovation in the solar industry. Llfe's Good LG N e N R Preliminary LG440QAC-A6 General Data Electrical Properties(STC*) Cell Properties(MateriaVType) Monocrystalline/N-type Model LG440QAC-A6 Cell Maker LG Maximum Power(Pmax) [W] 440 Cell Configuration 66 Cells(6 x 11) MPP Voltage(Vmpp) [V] 41.4 • Module Dimensions(L x W x H) 1,910mm x 1,042mm x 40mm MPP Current(Impp) [A] - 10.64 Weight - .... • 20.5 kg Open Circuit Voltage(Voc,t.5%) [V] 48.2 • Glass(Material) - Tempered Glass with AR Coating Short Circuit Current(Isc.o 5%) [A] 11.20 Backsheet(Color) - White - Module Efficiency • [N] ---- 22.1 Frame(Material) .. - Anodized Aluminium Power Tolerance - _ [%] Junction Box(Protection Degree) IP 68 with 3 Bypass Diodes *STC(Standard Test Condition),Irradiance 1000 Wm',Cell temperature 25°C,AM 1.5 ----------- ------ Measure Tolerance:±3% Cables(Length) - • - 1,250mm x 2EA Connector(Type/Maker) - - . MC.4/MC Operating Conditions Certifications and Warranty Operating Temperature' [°C] - 40-+85 Maximum System Voltage - [V] 1,000 IEC61215-1/-1-1/2:2016,IEC 61730-1/2:2016, --- -- - ---- ---- - - -- UL 61730-1:2017,UL 61730-2:2017 Maximum Series Fuse Rating [A] 20 Certifications" ISO 9001,I50 14001,ISO 50001 Mechanical Test Load"(Front) - • „[Pa/psf] 5,400 OHSAS 18001 Mechanical Test Load-(Rear) - [Pa/psf] 4,000 • Salt Mist Corrosion Test IEC 61701:2011 Severn 6 The operating ambient temperature of these devices may exceed 40°C at full load for all wire sizes if is determined suitable in the field use apphcation. Ammonia Corrosion Test - . . IEC 62716:2013 - **Based on IEC 61215-2:2016(Test Load-Design Load x Safety Factor(1.5)) Hail Test - - 25mm(1")diameter at 23m/s(52mph) Module Fire Performance Type 1(UL 61730) Packaging Configuration Fire Rating - Class C(UL 790,ULC/ORD C 1703) Number of Modules per Pallet [EA] 25 Solar Module Product Warranty- - 25 Years Number of Modules per 40'Container [EA] 600 Solar Module Output Warranty: :- -.. - Linear Warranty* Number of Modules per 53'Container [EA] TBD *Improved:1"year 98.5%,from 2-24th year:-0.25%/year down,92.5%at year 25 Packaging Box Dimensions(L x W x H) [nun] 1,960 x 1,120 x 1,221 **In Progress Packaging Box Dimensions(L x W x I-I) [in] 77.2 x 44.1 x 48.1 Temperature Characteristics Packaging Box Gross Weight [kg] 549 NMOT [°C] 44 3 3 Packaging Box Gross Weight [lb] 1,210 Pmax [%PC] 0.29 Voc (%PC] 0.24 Dimensions(mm/inch) [%PC] 0.04 - •NMOT(Nominal Module Operating Temperature),Irradiance 800 W/m',Ambient temperature 20°C, Wind speed 1 m/s,Spectrum AM 1.5 1042.0/41.0(Size of Shot Side) Electrical Properties(NMOT) 175.0/6.9 Model LG440QAC-A6 •'ooze/394(Distance between Holes). Maximum Power(Pmax) [W] 334... t " ,') �f -" 16 60e30/03)0.1 - ' MPP Voltage(Vmpp) [V] 39.1 Drain Holes MPP Current(Impp) [A] 8.53 -..-._ 8-043/02 (-) (•) If • Open Circuit Voltage(Voc) [V] 46.0 Grounding Holes Short Circuit Current(1st) [A] 9.03 - a-8 o Mounting Holes os I-V Curves 260.0/49.2 z Cable Length 120 2g 1000W 9 to 100 ii 800W 8.0. 5 600W i l 60 400W tOO7 4.0- 200W 20• \ u• QO {+. 0.0 5.0 10.0 15.0 •20.0 25.0- 30.0 35.0 40.0 45,0 ry .o I • Voltage IV] LG Electronics USA,Inc. Product specifications are subject to change without notice. 0 LG Solar0 Business Division 1 G440QAC-A6 pdf 2000 o ire,IL Drive 1244o Lincolnshire,IL 60069 Life s Good www.lg-solaccorn 0 2020 LG Electronics.USA,Inc.All,rights reserved. Cut Sheet iorifietL. IRONRIDGE XR100 Rail See Description / 1 ennih <"---' 11; Rail Section Properties Property Value Total Cross-Sectional Area 0.582 in2 .66 Section Modulus (X-axis) 0.297 in3 .46 Moment of Inertia (X-axis) _ 0.390 in' Moment of Inertia (Y-axis) _ 0.085 in' Torsional Constant 0.214 in3 Polar Moment of Inertia 0.126 in4 1.99 APPROVED MATERIALS: 2.44 6005-T6, 6005A-T61, 6105-T5, 6N01-16 2.34 I (34,000 PSI YIELD STRENGTH MINIMUM) .58 Clear Part Black Part Description/Length Material Weight Number Number . XR-100-132A XR-100-132B XR100, Rail 132(11 Feet) 7.50 lbs. XR-100-168A XR-100-168B XR100, Rail 168"(14 Feet) 6000-Series 9.55 lbs. XR-100-204A XR-100-204B XR100, Rail 204"(17 Feet) Aluminum 11.60 lbs. 0.1 Cut Sheet dela& IRON RIDGE XR100 Bonded Splice I velliiii./ XR-100 RAIL co 4 12.0 :1 I O XR-100-SPLC-BD li KIT, XR100 BONDED SPLICE 0 1) Splice, XR100, Mill 12" long 2) Screw, Self Drilling i _,Oilj 1.24 1 —el .63 f 1.93EN .31 /`\ IlliiiIIM MI 0.42 .15hi- -0— .93 .f #12-14 TYPE "B"THREAD Property Value Property Value Material 6000 Series Aluminum Material 300 Series Stainless Steel Finish Mill Finish Clear v1.0 `V 1 , ,, z • 1 UIKFOOt PRODUCT GUIDE Exploded Product View/B.O.M. - 1 Installation Instructions - 2 Cut Sheets - 3 Specifications -4 14 ii 49EcoFasten Solar QuikFoot— Product Guide Exploded Product View, Bill of Materials Materials Needed for Assembly O - r Item No. Description of Material/Part Quantity + 1 QuikFoot Base Plate 1 1 ' 2 Fastener(Length to be determined) 2 ct3 QuikFoot Flashing 1 © N._ 4 EPDM Washer 1 0 5 L-102-3"Bracket*(other options available) 1 Vv) O 6 5/16"EPDM Bonded 18.8 SS Washer 1 7 3/8"Stainless Steel Hex Nut 1 Z 3 CD O Required Tools r.7.. .tit i i 0 V0 kr..............,kii....410 l CmT4 Vii P�4 PalD�4 el 877-859-3947 EcoFasten Solar'All content protected under copyright.All rights reserved.10/09/14 1.1 EcoFasten Solar products are protected by the following U.S.Patents:8,151,522 B2 8,153,700 B2 8,181,398 B2 8,166.713 B2 8,146.299 B2 8,209,914 B2 8,245,454 B2 8,272,174 B2 8,225,557 B2 QuikFoot— Product Guide Cut Sheets: QF-AL-Base 2X 0 .33in [8.38mm] A i 11* Ui cid 00 O 41 CID -,,r.0 E i7,c E ,._ _...---- 0 ..-- h. .---,..., Lo NLO N CO0 Lo Ctin tild 1 w O 1 .50in L. Coe [38.10mm rilml 3/8"-16 Stud i 4 I rco d QF-M : 1 .5" u QF-L : 1 .75' t imili. 1 A A 877-859-3947 EcoFasten Solar All content protected under copyright.All rights reserved.10/09/14 3.1 EcoFasten Solar products are protected by the following U.S.Patents:8,151,522 B2 8,153,700 B2 8,181,398 B2 8,166.713 B2 8,146.299 B2 8,209,914 B2 8,245.454 B2 8,272.174 B2 8,225,557 B2 QuikFoot— Product Guide Cut Sheets: QFL-812 R.38in \-9.53mm 1 .032in limi [0.81mm] 1 f� A NIS V1 t NW CO) 12.00in [304.80mm] rT1 Da 0 0 _ I 44 3.00in - d4 76.20mm] 0. 11 agawp',o ' pia J II .50in 8.00in [ 12J0mm] [203.20mm] • 877-859-3947 EcoFasten Solar'All content protected under copyright.All rights reserved.10/09/14 3.2 EcoFasten Solar products are protected by the following U.S.Patents:8,151,522 B2 8,153,700 B2 8,181,398 B2 8,166,713 B2 8,146,299 B2 8,209,914 B2 8,245,454 B2 8,272,174 B2 8,225,557 B2 QuikFoot— Product Guide Cut Sheets: Bracket Options-SCL-1 01-3 ii 3/8"Vii L ;,.. • A i 46 SERRATIONS O : . Cr) ,_, rnH a. _ 1 7/8" - R1/16" --1 3 J4" 1/16" 1 1/4" ! — Sad co R.005 R.010 � 2X R.01 r'''''''''.---„ 'Pot 1 6 0.00 QD 3 ,4- 00680 1/8 DV -. 02 \/ fi 7/8 X 82° DETAIL A SCALE 3:1 877-859-3947 EcoFasten Solar°All content protected under copyright.All rights reserved.10/09/14 3.7 EcoFasten Solar products are protected by the following U.S.Patents:8.151,522 B2 8,153,700 B2 8,181,398 B2 8,166.713 B2 8,146.299 B2 8,209.914 B2 8,245,454 B2 8,272,174 B2 8,225.557 B2