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Massachusetts Electric Company M.D.P.U.No.1176
Nantucket Electric Company Canceling M.D.T.E.No. 11 I6-A
STANDARDS FOR INTERCONNECTING DISTRIBUTED GENERATION
ATTACHMENT 2
Certificate of Completion for Simplified Process Interconnections
Installation Information: Check if owner-installed
Customer or Company Name(print): Amy Verebay
Contact Person,if Company:
Mailing Address: 11 Bright Street
City: Northampton State: MA Zip Code: 01060
Telephone(Primary): 917-859-2418 Telephone(Secondary):
Fax: Email: averebay@gmail.com
Facility Address(If different from above):
City: State: Zip Code:
Account Number: 00888-76055 Meter Number: 31431141
Electrical Contractor's Company or Name(print): Insight Solar
Electrician Name,if Company: Ed Sepanski
Mailing Address: 59C North Street
City: Hatfield State: MA Zip Code: 01038
Telephone(Primary): 413-338-7555 Telephone(Secondary):Fax: Email: applications@getinsightsolar.com OrN-
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License number: 192102
Date of approval to install Facility granted by the Company: 6/8/21
Application ID number: 00358970 Work Request Number: 30398120
Inspection:
The system has been installed and inspected in compliance Iwith the local Building/Electrical Code of:
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Signed(Local Electrical Wiring Inspector,or attach
signed electrical inspection):
Wiring Inspector Name(printed): b(rt. & 1Th4 Ct)
Phone Number: S D-7- ) L/U
Email Address: f h l o Vt&� wz� �� 9° (Az k
As a condition of interconnection you are required to email a copy of this form along
with a copy of the signed electrical permit to distributed.generation@us.ngrid.com