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Massachusetts Electric Company&Nantucket Electric Company(d/b/a National Grid) M.D.P.U. 1320
Certificate of Completion for Simplified Process Interconnections
Installation Information: ❑ Check if owner-installed
Interconnecting Customer: ERICSSON BROADBENT Contact Person: ERICSSON BROADBENT
Mailing Address: 264 OLD WILSON RD LOT 2
City: NORTHAMPTON State: MA Zip Code:01062
Telephone (Daytime): 978-906-5592 (Evening):
Facsimile Number: E-Mail Address: ebroadbent@mac.com
Address of Facility (if different from above):
Electrical Contractor's Name (if appropriate): PV Squared
Mailing Address: 311 WELLS ST. SUITE B
City: GREENFIELD State: MA Zip Code: 01301
Da ime Telephone : 413-772-8788 (Evening): SAME
p (Daytime):) ( g) 0.. v
Facsimile Number: 413-772-8668 E-Mail Address: interconnection@pvsquared.coop * e lt12o2
License number: Al3764
Date of approval to install Facility granted by National Grid: 9/29/2021
Application ID number: 00378164
Inspection:
The system has been installed and inspected in compliance with the local Building/Electrical Code of
(City/County):
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Signed Itt_t)
al Ele 'camel Wiring Inspector, or attach signed electrical inspection):
Name(printed): o c,erw r 'N. Date: 7'— I—c` -)-
License#: 1Y6 (i (Q `
As a condition of interconnection you are required to send/e-mail a copy of this form along with a copy of the
signed electrical permit to National Grid:
National Grid
Attn: Distributed Generation
40 Sylvan Rd
Waltham,MA 02451
E-mail: distributed.generation(ii;nationalgrid.com
Massachusetts:http://www.nationalgridus.com,'masselectric'home/energveff/distributed generation.asp
Nantucket:http://www.nationalgridus.com/nantucket/horne"enereveff,'distributed generation.aso Page 1 of 1