31C-081-012 C of C 3i - of— 0/ 2—
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:DAMES GLICKMAN Contact Person:
Mailing Address: 117 OLANDER DR LOT 10
City: NORTHAMPTON State: MA Zip Code:01060-3658
Telephone (Daytime): (774) 452-6290 (Evening):
Facsimile Number: E-Mail Address:jaglickman@yahoo.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
Telephone (Daytime): 413-772-8788 (Evening): SAME
Facsimile Number: 413-772-8668 E-Mail Address: interconnection@pvsquared.coop (,)gi2o2z
License number: A13764
Date of approval to install Facility granted by National Grid: 1/8/22
Application ID number: 00395516 wr#30535412
Inspection:
The system has been installed and inspected in compliance with the local Building/Electrical Code of
(City/County):
A/c. tkv,,,
Signed(Local etri ,,/Wiring Inspector, or attach signed electrical inspection):
Name (printed): sl ()cArry" YInA,to Date: s2.,- - 20-
License#: L/0 (A..(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@nationalgrid.com
Massachusetts:http://www.nationalgridus.com/masselectric/home/energyeff/distributed generation.asp
Nantucket: http://www.nationalgridus.com/nantucket/home/energyeff/distributed generation.asp Page 1 of 1