31A-049 (4) Massachusetts Electric Company&Nantucket Electric Company(d/b/a National Grid) 3? M.D.P.U. 1219
Certificate of Completion for Simplified Process Interconnections
Installation Information: ❑ Check if owner-installed
Interconnecting Customer: Mark Augarten Contact Person: Jonathan Camarda
Mailing Address: 235 Crescent St
City: Northampton State:MA Zip Code: 01060
Telephone (Daytime): 732-354-3111 (Evening):
Facsimile Number: 732-354-3071 E-Mail Address: is@skylinesolar.net
Address of Facility(if different from above):
Electrical Contractor Contact Information(if appropriate):
Name: Skyline Solar LLC E-mail Address: jc@skylinesolar.net
Mailing Address: 95 Ryan Dr. Telephone: 732-354-3111
City: Raynham State: MA Zip Code: 02761
License number: 21667A
Date of approval to install Facility granted by National Grid: _
Application ID number:
Inspection:
The system has been installed and inspected in compliance with the local Building/Electrical Code of
(City/County):
Not vyv �'N
Signed ( ocal Elec ' al Wiring Inspector, or attach signed electrical inspection):
Name (printed): hC n
n (,- & M4 n Date: 7- C
License#: lO (&(e,(
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/energyeffldistributed aeneration.asp
Nantucket: http://www.nationalgridus.com%nantucket/home/energyeff/distributed generation.asp Page 1 of 1