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Harvey, Felix Permit App
The Commonwealth of Massachusetts Board of Building Regulations and Standards Massachusetts State Building Code, 780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One- or Two-Family Dwelling FOR MUNICIPALITY USE Revised Mar 2011 This Section For Official Use Only Building Permit Number: _____________________ Date Applied: ______________________________ ___________________________________ ____________________________________________ ___________ Building Official (Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: ____________________________________________ 1.1a Is this an accepted street? yes_____ no_____ 1.2 Assessors Map & Parcel Numbers _____________________ ____________________ Map Number Parcel Number 1.3 Zoning Information: _______________ ___________________ Zoning District Proposed Use 1.4 Property Dimensions: _____________________ ____________________ Lot Area (sq ft) Frontage (ft) 1.5 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c. 40, § 54) Public Private 1.7 Flood Zone Information: Zone: ___ Outside Flood Zone? Check if yes 1.8 Sewage Disposal System: Municipal On site disposal system SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner1 of Record: ________________________________________ _________________________________________________ Name (Print) City, State, ZIP _____________________________________________ _________________ ___________________________________ No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction Existing Building Owner-Occupied Repairs(s) Alteration(s) Addition Demolition Accessory Bldg. Number of Units_____ Other Specify:________________________ Brief Description of Proposed Work2:_________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1. Building $ 1. Building Permit Fee: $_______ Indicate how fee is determined: Standard City/Town Application Fee Total Project Cost3 (Item 6) x multiplier _______ x _______ 2. Other Fees: $_________ List:_________________________________________________ ____________________________________________________ Total All Fees: $_______________ Check No. ______Check Amount: _______Cash Amount:______ Paid in Full Outstanding Balance Due:__________ 2. Electrical $ 3. Plumbing $ 4. Mechanical (HVAC) $ 5. Mechanical (Fire Suppression) $ 6. Total Project Cost: $ X Residential - Solar X Solar Install kW DC solar on roof ( panels) Will not exceed building footprint, but will add 6" to roof height. 24 Corticelli Street Northampton MA Felix Harvey 24 Corticelli Street (413) 588-8288 sharongladson@gmail.com 15,000 36,000 51,000 Northampton MA 01062 11.745 29 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) ________________________________________________________ Name of CSL Holder _________________________________________________________ No. and Street _________________________________________________________ City/Town, State, ZIP __________________ ______________________________________ Telephone Email address _____________________ ______________ License Number Expiration Date List CSL Type (see below) _______________ Type Description U Unrestricted (Buildings up to 35,000 cu. ft.) R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation D Demolition 5.2 Registered Home Improvement Contractor (HIC) ______________________________________________________________ HIC Company Name or HIC Registrant Name ______________________________________________________________ No. and Street ________________________________________ ____________________ City/Town, State, ZIP Telephone _____________________ ______________ HIC Registration Number Expiration Date _______________________________________ Email address SECTION 6: 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 ………. No ……….. SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER’S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property, hereby authorize_____________________________________________________ to act on my behalf, in all matters relative to work authorized by this building permit application. ______________________________________________________ ______________________ Print Owner’s Name (Electronic Signature) Date SECTION 7b: OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. _____________________________________________________________ ______________________ Print Owner’s or Authorized Agent’s Name (Electronic Signature) Date NOTES: 1.An Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor (HIC) Program), will not have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2.When substantial work is planned, provide the information below: Total floor area (sq. ft.) _________________________ (including garage, finished basement/attics, decks or porch) Gross living area (sq. ft.) __________________ Habitable room count ______________________ Number of fireplaces______________________ Number of bedrooms _____________________ Number of bathrooms ____________________ Number of half/baths ______________________ Type of heating system ___________________ Number of decks/ porches __________________ Type of cooling system_____________________ Enclosed ______________Open _____________ 3.“Total Project Square Footage” may be substituted for “Total Project Cost” Sean R Jeffords 13 Terrace View Easthampton, MA 01027 413-203-9088 applications.westma@trinity-solar.com CS-074539 11/28/2024 U Sean R Jeffords- Beyond Green Construction 13 Terrace View Easthampton, MA 01027 413-203-9088 191746 5/9/2024 applications.westma@trinity-solar.com Beyond Green Construction X 02/27/2024 X Sean Jeffords City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ● Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number ________________ is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: ___________________________________________________ The debris will be transported by: Name of Hauler: ______________________________________________________ Signature of Applicant: __________________________________Date: ___________ Casella- 295 Forest Street, Peabody, MA 01960 Sean R Jeffords 2/27/24 NJ, Electrical Contractor business permit number 34EB01547400 NJ, HIC reg. # 13VH12957000 For other jurisdictions, please visit: http://www.trinity-solar.com/about-us/locations-and-licenses HOMEOWNERS AUTHORIZATION FORM I, , (print name) am the owner of the property located at address: . (print address) I hereby authorize Trinity Solar LLC (“Trinity Solar”) and its employees, agents, and subcontractors, including without limitation, , to act as my Agent for the limited purpose of applying for and obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System, Battery System, roofing or other Trinity Solar offerings located on my property, applying and obtaining permission and approval for interconnection with the electric utility company, and registration with any state and/or local incentive program(s). This authorization includes the transfer/re-administering, and/or cancellation of any existing permits on file for the purpose of updating/applying with an alternate subcontractor. Without limitation to the generality of the foregoing I specifically authorize Trinity Solar et al. to populate technical details, fill-in, edit, compile, attach drawings, plans, data sheets and other documentation to, date, submit, re-submit, revise, amend and modify application, submission and certification documents (“Approvals Paperwork”), including those for which signature pages are included herewith for my signature, in furtherance of the related transaction, and I am providing any signatures to Approvals Paperwork for purposes of the foregoing. Trinity Solar will provide copies of Approvals Paperwork when submitted. My authorizations memorialized herein shall remain in full force and effect until revoked. I acknowledge that these authorizations are not required to proceed with the transaction and are not a condition of the related agreement included herewith but are being given for my own convenience and benefit in order to expedite the approvals processes. Electric Utility Company: __________________________ Electric Utility Account No.: ________________________ Electric Meter No.: _______________________________ Name on Electric Utility Account: ___________________ Customer Signature Print Name Date Corporate Headquarters 1-877-SUN-SAVES 2211 Allenwood Road Ph: 732-780-3779 Wall, New Jersey 07719 Fax: 732-780-6671 www.trinity-solar.com FOR INFORMATION ABOUT CONTRACTORS AND THE CONTRACTORS’ REGISTRATION ACT, CONTACT THE NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY, DIVISION OF CONSUMERS AFFAIRS AT 1-888-656-6225. Felix Harvey 24 Corticelli Street Florence, MA 01062 National Grid 9069265004 Felix Harvey Felix Harvey 87279347 1/24/2024 Northampton, MA February 22, 2024 212 Main St. Northampton, MA 01060 Trinity Solar No. 24 Corticelli Street 2024-01-998080 Northampton, MA 01062 MA License No. 56687 RE: HARVEY, FELIX Trinity Solar | 4 Open Square Way, Suite 410 | Holyoke, MA | (413) 203-9088 To the Building Official: The following information constitutes a summary of the relevant design criteria and recommendations for the support of a new photovoltaic [PV] system on the existing roof framing components at the above-referenced location. Criteria is as follows: 1. Existing roof framing: Conventional roof framing at R1 and R2 is 2x6 at 16 o.c.; existing rafter span= 10' 4"; (horizontal projection) Conventional roof framing at R4 is 2x6 at 16 o.c.; existing rafter span= 10' 8"; (horizontal projection) Conventional roof framing at R5 is 2x8 at 24 o.c.; existing rafter span= 10' 6"; (horizontal projection) 2. Roof Loading: • 3.0psf dead load (pounds per square foot - PV panels, mounting rails & hardware) • 5.7psf - existing roof loads (1.7 psf - 2x6 framing, 1.5psf roof sheathing, 2.5 psf shingles) • 6.3psf - existing roof loads (2.3 psf - 2x8 framing, 1.5psf roof sheathing, 2.5 psf shingles) • Ground Snow Load - 40psf - per AHJ (Authority Having Jurisdiction) • Wind criteria - Exposure Category B, 117 mph wind 3. Existing Roof modification - none required; existing roof framing is acceptable for PV installation. This installation design is in general conformance with the manufacturers’ specifications and complies with all applicable laws, codes, and ordinances – specifically the International Building Code (2015 edition) and the International Residential Code (2015 edition), including all Massachusetts regulations and amendments. The spacing of the mounting brackets - the ClickFit Smart Foot and/or RockIt Smart Slide by EcoFasten® (or approved equal) - cannot exceed a maximum of 48” o.c. between mounting brackets and will be fastened using #14x3" long (min.) lag screws per bracket (2 min.) for a rail system or #12x3" long (min.) lag screws per bracket (2 min.) for a rail-less system. The minimum thread penetration (embedment) is 2½" beyond all roofing materials - this is adequate to resist all stated demand loads above, including wind shear. In order to evenly distribute the PV load across the roof framing, in multi-row PV layouts there shall be a minimum of 2 mounting brackets per rafter/truss chord. Pilot holes for EcoFasten self-drilling screws are not required. Regards, Ihor Bojcun, PE Structural Engineer - Trinity Solar INSTALLATION OF NEW ROOF MOUNTED PV SOLAR SYSTEM 24 CORTICELLI STREET NORTHAMPTON, MA 01062 42.3324695,-72.6771687 CORTICELLI STREET P1 ISSUED TO TOWNSHIP FOR PERMIT 2/26/2024 NO.DESCRIPTION DATE HARVEY, FELIX- TRINITY ACCT #: 2024-01-998080 24 CORTICELLI STREET FLORENCE, MA 01062 42.3324695,-72.6771687 PROPOSED PV SOLAR SYSTEM DRAWING DATE:2/26/2024 DRAWN BY: TP REVISED BY: DC SYSTEM SIZE:11.745kW AC SYSTEM SIZE:10kW MODULE COUNT: 29 MODULES USED: HANWHA 405 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 405 UTILITY COMPANY: NAT'L GRID UTILITY ACCT #: 9069265004 UTILITY METER #: 87279347 DEAL TYPE: SUNNOVA P1 R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com ROOF 1 MODULES: 7 PITCH: 23 ORIENTATION: 249 ROOF 2 MODULES: 15 PITCH: 23 ORIENTATION: 69 ROOF 3 MODULES: 0 PITCH: 23° ORIENTATION: 339° ROOF 4 MODULES: 3 PITCH: 23 ORIENTATION: 69 ROOF 5 MODULES: 4 PITCH: 23 ORIENTATION: 159 ROOF 6 MODULES: 0 PITCH: 23° ORIENTATION: 159° ***NOTE: 2021 NFPA 1 - 11.12.3.2.4.1 PLAN VIEW TOTAL ROOF AREA: 1941.8 FT² PHOTOVOLTAIC ARRAY TOTAL AREA: 578.2 FT² ARRAY PERCENTAGE OF PLAN VIEW TOTAL ROOF AREA: 29.8% ***NOTE: PV DISCONNECT 24/7 ACCESSIBLE AND LOCKABLE DC AC D ep M NS270 90135225 45315 42.3324695,-72.6771687 29 HANWHA 405 (Q.PEAK DUO BLK ML-G10+ 405) 1 SE10000H-US000BEi4 INSIDE OUTSIDE. OUTSIDE (UTILITY ACCESSIBLE)OUTSIDE. P1 ISSUED TO TOWNSHIP FOR PERMIT 2/26/2024 NO.DESCRIPTION DATE HARVEY, FELIX- TRINITY ACCT #: 2024-01-998080 24 CORTICELLI STREET FLORENCE, MA 01062 42.3324695,-72.6771687 PROPOSED PV SOLAR SYSTEM DRAWING DATE:2/26/2024 DRAWN BY: TP REVISED BY: DC SYSTEM SIZE:11.745kW AC SYSTEM SIZE:10kW MODULE COUNT: 29 MODULES USED: HANWHA 405 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 405 UTILITY COMPANY: NAT'L GRID UTILITY ACCT #: 9069265004 UTILITY METER #: 87279347 DEAL TYPE: SUNNOVA P1 NOTES: 1.) ALL EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH THE MANUFACTURER'S INSTALLATION INSTRUCTIONS. 2.) 3.) ALL LOCATIONS ARE APPROXIMATE AND REQUIRE FIELD VERIFICATION. ALL OUTDOOR EQUIPMENT SHALL BE RAIN TIGHT WITH MINIMUM NEMA 3R RATING. M UD SP P DC AC ep D DC R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com SD TS CALCULATIONS FOR CURRENT CARRYING CONDUCTORS REQUIRED CONDUCTOR AMPACITY PER STRING [NEC 690.8(B)(1)]: (15.00*1.25)1 = 18.75A AWG #10, DERATED AMPACITY AMBIENT TEMP: 33°C, TEMP DERATING FACTOR: .96 RACEWAY DERATING = 6 CCC: 0.80 (40*.96)0.80 = 30.72A 30.72A >_ 18.75A, THEREFORE WIRE SIZE IS VALID TOTAL AC REQUIRED CONDUCTOR AMPACITY 42.00A*1.25 = 52.50A AWG #6, DERATED AMPACITY AMBIENT TEMP: 30°C, TEMP DERATING: 1.0 RACEWAY DERATING <_ 3 CCC: N/A 75A*1.0 = 75A 75A >_ 52.50A, THEREFORE AC WIRE SIZE IS VALID CALCULATION FOR PV OVERCURRENT PROTECTION TOTAL INVERTER CURRENT: 42.00A 42.00A*1.25 = 52.50A --> 60A OVERCURRENT PROTECTION IS VALID ARRAY CIRCUIT WIRING NOTES 1.) LICENSED ELECTRICIAN ASSUMES ALL RESPONSIBILITY FOR DETERMINING ONSITE CONDITIONS AND EXECUTING INSTALLATION IN ACCORDANCE WITH NEC 2023 2.) LOWEST EXPECTED AMBIENT TEMPERATURE BASED ON ASHRAE MINIMUM MEAN EXTREME DRY BULB TEMPERATURE FOR ASHRAE LOCATION MOST SIMILAR TO INSTALLATION LOCATION. LOWEST EXPECTED AMBIENT TEMP = -16°C 3.) HIGHEST CONTINUOUS AMBIENT TEMPERATURE BASED ON ASHRAE HIGHEST MONTH 2% DRY BULB TEMPERATURE FOR ASHRAE LOCATION MOST SIMILAR TO INSTALLATION LOCATION. HIGHEST CONTINUOUS TEMP = 33°C 4.) 2005 ASHRAE FUNDAMENTALS 2% DESIGN TEMPERATURES DO NOT EXCEED 47°C IN THE UNITED STATES (PALM SPRINGS, CA IS 44.1°C). FOR LESS THAN 9 CURRENT-CARRYING CONDUCTORS IN A ROOF-MOUNTED SUNLIT CONDUIT AT LEAST 0.5" ABOVE ROOF AND USING THE OUTDOOR DESIGN TEMPERATURE OF 47°C OR LESS (ALL OF UNITED STATES) 5.) PV SYSTEM CIRCUITS INSTALLED ON OR IN BUILDINGS SHALL INCLUDE A RAPID SHUTDOWN FUNCTION THAT CONTROLS SPECIFIC CONDUCTORS IN ACCORDANCE WITH NEC 690.12(A) THROUGH (D) 6.) PHOTOVOLTAIC POWER SYSTEMS SHALL BE PERMITTED TO OPERATE WITH UNGROUNDED PHOTOVOLTAIC SOURCE AND OUTPUT CIRCUIT PER NEC 690.41 (A)(4) 7.) UNGROUNDED DC CIRCUIT CONDUCTORS SHALL BE IDENTIFIED WITH THE FOLLOWING OUTER FINISH: POSITIVE CONDUCTORS = RED NEGATIVE CONDUCTORS = BLACK NEC 210.5(C)(2) 8.) ARRAY AND SUB ARRAY CONDUCTORS SHALL BE #10 PV WIRE TYPE RHW-2 OR EQUIVELANT AND SHALL BE PROTECTED BY CONDUIT WHERE EXPOSED TO DIRECT SUNLIGHT. SUB ARRAY CONDUIT LONGER THAN 24” SHALL CONTAIN ≤ 20 CURRENT CARYING CONDUCTORS AND WHERE EXPOSED TO DIRECT SUNLIGHT SHALL CONTAIN ≤ 9 CURRENT CARRYING CONDUCTORS. 9.) ALL WIRE LENGTHS SHALL BE LESS THAN 100' UNLESS OTHERWISE NOTED 10.) FLEXIBLE CONDUIT SHALL NOT BE INSTALLED ON ROOFTOP AND SHALL BE LIMITED TO 12” IF USED OUTDOORS 11.) DISCONNECTS FED BY SUPPLY-SIDE SOURCE CONDUCTORS SHALL BE BONDED AND CONNECTED TO GROUNDING SYSTEM IN ACCORDANCE WITH NEC 250.24 12.)OVERCURRENT PROTECTION FOR CONDUCTORS CONNECTED TO THE SUPPLY SIDE OF A SERVICE SHALL BE LOCATED WITHIN 10' OF THE POINT OF CONNECTION NEC 690.9(A)(3)(2) 13.) WHERE TWO SOURCES FEED A BUSSBAR, ONE A UTILITY AND THE OTHER AN INVERTER, PV BACKFEED BREAKER(S) SHALL BE LOCATED OPPOSITE FROM UTILITY NEC 705.12(B)(2) 14.) ALL SOLAR SYSTEM LOAD CENTERS TO CONTAIN ONLY GENERATION CIRCUITS AND NO UNUSED POSITIONS OR LOADS 15.) ALL EQUIPMENT INSTALLED OUTDOORS SHALL HAVE A NEMA 3R RATING NEUTRALEXISTING MAIN BREAKER LOAD CENTER INSULATED LINE TAPS INSTALLED ON MAIN FEEDERS NEC 705.11 M 2p200AMAIN240V 1Ø 200A MAIN BREAKER 200A BUSBAR a NEW 120/240V UTILITY METER EG NOTE: INTERNAL REVENUE GRADE MONITORING CONTAINED WITHIN SOLAR EDGE INVERTER SOLAR EDGE PN. RWND-3D-240-MB INVERTER #1 - SE10000H-US000BEi4 DC AC Imp 27 Pout 10000 Vmp 400 Imax 42 Voc 480 OCPDmin 52.5 Isc 45 Vnom 240 PV MODULE SPECIFICATIONS HANWHA 405 (Q.PEAK DUO BLK ML-G10+ 405) Imp 10.83 Vmp 37.39 Voc 45.34 Isc 11.17 A #6 THWN-2 TO GEC B 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#10 THWN-2, 1-#10 THWN-2 GROUND C 3/4'' CONDUIT W/ 6-#10 THWN-2, 1-#10 THWN-2 GROUND D 1-4/0 ALU SEU CABLE E 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#10 THWN-2, 1-#10 THWN-2 GROUND F #10 PV WIRE (FREE AIR) W/ #6 BARE COPPER BOND TO ARRAY G 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#6 THWN-2 NOTE: CONDUIT TYPE SHALL BE CHOSEN BY THE INSTALLATION CONTRACTOR TO MEET OR EXCEED NEC AND LOCAL AHJD REQUIREMENTS INVERTER #1 PV+L1 L2 N PV-C SOLAR MODULES MOUNTED TO ROOF ON 4 ARRAYS 29 - 405W MODULES W/ 1 SOLAR EDGE S440 PER MODULE 15 ADC MAX PER STRING 2 STRINGS OF 10 MODULES IN SERIES - 400 Vmax 1 STRING OF 9 MODULES IN SERIES - 400 Vmax *3 STRINGS TO BE TERMINATED IN PARALLEL INSIDE INVERTER 1 8"x8" JUNCTION BOXf BONDED NEUTRAL 240V 1Ø SQUARE D PN: D222NRB LOCKABLE 60A DISCONNECT FUSED W/ 60A FUSES ***NATIONAL GRID NOTES: D NEW 120/240V SERVICE RISER P1 ISSUED TO TOWNSHIP FOR PERMIT 2/26/2024 NO.DESCRIPTION DATE HARVEY, FELIX- TRINITY ACCT #: 2024-01-998080 24 CORTICELLI STREET FLORENCE, MA 01062 42.3324695,-72.6771687 PROPOSED PV SOLAR SYSTEM DRAWING DATE:2/26/2024 DRAWN BY: TP REVISED BY: DC SYSTEM SIZE:11.745kW AC SYSTEM SIZE:10kW MODULE COUNT: 29 MODULES USED: HANWHA 405 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 405 UTILITY COMPANY: NAT'L GRID UTILITY ACCT #: 9069265004 UTILITY METER #: 87279347 DEAL TYPE: SUNNOVA P1 R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com 24 Corticelli Street Northampton MA 01062 01/02/2024 Finck & Perras Insurance Agency Inc. 6 Campus Lane Easthampton MA 01027 Elizabeth Carballo, CISR, CPIA (413) 527-5520 (413) 527-5970 bcarballo@finckandperras.com Beyond Green Construction Inc, DBA: Sean Jeffords 13 Terrace View Easthampton MA 01027 RT Specialty CL241207654 A 948B001862 01/01/2024 01/01/2025 1,000,000 50,000 10,000 1,000,000 2,000,000 2,000,000 Employee Benefits Proof of Coverage Trinity Solar 4 Open Square Way Suite 410 Holyoke MA 01040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 City or Town of: __________________________________ Date: ___________________ To the Inspector of Wires: By this application, the undersigned gives notices of his or her intention to perform the electrical work described below. Location (Street & Number): ____________________________________________ Unit No.: ________________________ Owner or Tenant: __________________________________________ Email: ____________________________________ Owner’s Address: ____________________________________________________ Phone No.: ______________________ Is this permit in conjunction with a building permit? (Check appropriate box) Yes No Permit No.:_________________ Purpose of Building: _____________________________________ Utility Authorization No.: ___________________ Existing Service: _____________ Amps _____/_____ Volts Overhead Underground No. of Meters: _____ New Service: _____________ Amps _____/_____ Volts Overhead Underground No. of Meters: _____ Description of Proposed Electrical Installation: _____________________________________________________________ ______________________________________________________________________________________________________ Completion of the following table may be waived by the Inspector of Wires. No. of Receptable Outlets: No. of Switches: Generator KW Rating: Type: No. Luminaires: No. of Recessed Luminaires: No. Wind Generators: Wind KW Rating: No. Appliances: KW: No. Water Heaters: KW: No. Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No. Motors: Total HP: Total KW: No. Heat Pumps: Total KW: Total Tons: Fire Alarm System No. of Devices: Swimming Pool: In-Grnd. Above-Grnd. Hot-Tub No. of Self-Contained Detection/Alerting Devices: No. Oil Burners: No. Gas Burners: Video System No. of Devices: No. Air Conditioners: Total Tons: Telecom System No. of Outlets: No. Energy Storage Systems: KWH Storage Rating: Security System No. of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No. of Modules: Roof-Mount Ground-Mount No. of Electric Vehicle Supply Equipment: Level 1 Level 2 Level 3 Rating: OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: _________________________________ (When required by municipal policy) Date Work to Start: _________________ Inspections to be requested in accordance with MEC Rule 10, and upon completion. FIRM NAME: ___________________________________________________ A-1 or C-1 LIC. No.: ____________ Master/Systems Licensee: __________________________________________ LIC. No.: __________________________ Journeyman Licensee: _____________________________________________ LIC. No.: __________________________ Security System Business requires a Division of Occupational Licensure “S” LIC. S-LIC. No.: __________________________ Address: ____________________________________________________________________________________________ Email: __________________________________________________________ Telephone No.: ________________________ I certify, under the pains and penalties of perjury, that the information on this application is true and complete. Licensee: ____________________________Print Name: ________________________________Cell. No.: _______________ INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability including “completed operation” coverage or its substantial equivalent. The undersigned certifies that such coverage is in force and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND OTHER Specify: _____________________________________ OWNER’S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the: (Check one) Owner Owner’s agent Owner / Agent: _______________________________________________ Tel. No.: ________________________________ Signature: ____________________________________________________ Email.: _________________________________ Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No.: __________________________ Occupancy and Fee Checked: ____________ [Rev. 1/2023] Residential TBD Paul Mallett Paul Mallett 53681 B 466 Main St, Oxford, MA 01540 X X Paul Mallett 855-970-8255 applications.westma@trinity-solar.com 413-529-0544 Install kW solar on roof. () panels 02/27/2024Northampton, MA 24 Corticelli Street Felix Harvey sharongladson@gmail.com 24 Corticelli Street Northampton MA 01062 (413) 588-8288 N/A 200 120 240 1 11.745 29 29 $36,000 11.745 10 INSTALLATION OF NEW ROOF MOUNTED PV SOLAR SYSTEM 24 CORTICELLI STREET NORTHAMPTON, MA 01062 42.3324695,-72.6771687 CORTICELLI STREET P1 ISSUED TO TOWNSHIP FOR PERMIT 2/26/2024 NO.DESCRIPTION DATE HARVEY, FELIX- TRINITY ACCT #: 2024-01-998080 24 CORTICELLI STREET FLORENCE, MA 01062 42.3324695,-72.6771687 PROPOSED PV SOLAR SYSTEM DRAWING DATE:2/26/2024 DRAWN BY: TP REVISED BY: DC SYSTEM SIZE:11.745kW AC SYSTEM SIZE:10kW MODULE COUNT: 29 MODULES USED: HANWHA 405 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 405 UTILITY COMPANY: NAT'L GRID UTILITY ACCT #: 9069265004 UTILITY METER #: 87279347 DEAL TYPE: SUNNOVA P1 R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com ROOF 1 MODULES: 7 PITCH: 23 ORIENTATION: 249 ROOF 2 MODULES: 15 PITCH: 23 ORIENTATION: 69 ROOF 3 MODULES: 0 PITCH: 23° ORIENTATION: 339° ROOF 4 MODULES: 3 PITCH: 23 ORIENTATION: 69 ROOF 5 MODULES: 4 PITCH: 23 ORIENTATION: 159 ROOF 6 MODULES: 0 PITCH: 23° ORIENTATION: 159° ***NOTE: 2021 NFPA 1 - 11.12.3.2.4.1 PLAN VIEW TOTAL ROOF AREA: 1941.8 FT² PHOTOVOLTAIC ARRAY TOTAL AREA: 578.2 FT² ARRAY PERCENTAGE OF PLAN VIEW TOTAL ROOF AREA: 29.8% ***NOTE: PV DISCONNECT 24/7 ACCESSIBLE AND LOCKABLE DC AC D ep M NS270 90135225 45315 42.3324695,-72.6771687 29 HANWHA 405 (Q.PEAK DUO BLK ML-G10+ 405) 1 SE10000H-US000BEi4 INSIDE OUTSIDE. OUTSIDE (UTILITY ACCESSIBLE)OUTSIDE. P1 ISSUED TO TOWNSHIP FOR PERMIT 2/26/2024 NO.DESCRIPTION DATE HARVEY, FELIX- TRINITY ACCT #: 2024-01-998080 24 CORTICELLI STREET FLORENCE, MA 01062 42.3324695,-72.6771687 PROPOSED PV SOLAR SYSTEM DRAWING DATE:2/26/2024 DRAWN BY: TP REVISED BY: DC SYSTEM SIZE:11.745kW AC SYSTEM SIZE:10kW MODULE COUNT: 29 MODULES USED: HANWHA 405 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 405 UTILITY COMPANY: NAT'L GRID UTILITY ACCT #: 9069265004 UTILITY METER #: 87279347 DEAL TYPE: SUNNOVA P1 NOTES: 1.) ALL EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH THE MANUFACTURER'S INSTALLATION INSTRUCTIONS. 2.) 3.) ALL LOCATIONS ARE APPROXIMATE AND REQUIRE FIELD VERIFICATION. ALL OUTDOOR EQUIPMENT SHALL BE RAIN TIGHT WITH MINIMUM NEMA 3R RATING. M UD SP P DC AC ep D DC R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com SD TS CALCULATIONS FOR CURRENT CARRYING CONDUCTORS REQUIRED CONDUCTOR AMPACITY PER STRING [NEC 690.8(B)(1)]: (15.00*1.25)1 = 18.75A AWG #10, DERATED AMPACITY AMBIENT TEMP: 33°C, TEMP DERATING FACTOR: .96 RACEWAY DERATING = 6 CCC: 0.80 (40*.96)0.80 = 30.72A 30.72A >_ 18.75A, THEREFORE WIRE SIZE IS VALID TOTAL AC REQUIRED CONDUCTOR AMPACITY 42.00A*1.25 = 52.50A AWG #6, DERATED AMPACITY AMBIENT TEMP: 30°C, TEMP DERATING: 1.0 RACEWAY DERATING <_ 3 CCC: N/A 75A*1.0 = 75A 75A >_ 52.50A, THEREFORE AC WIRE SIZE IS VALID CALCULATION FOR PV OVERCURRENT PROTECTION TOTAL INVERTER CURRENT: 42.00A 42.00A*1.25 = 52.50A --> 60A OVERCURRENT PROTECTION IS VALID ARRAY CIRCUIT WIRING NOTES 1.) LICENSED ELECTRICIAN ASSUMES ALL RESPONSIBILITY FOR DETERMINING ONSITE CONDITIONS AND EXECUTING INSTALLATION IN ACCORDANCE WITH NEC 2023 2.) LOWEST EXPECTED AMBIENT TEMPERATURE BASED ON ASHRAE MINIMUM MEAN EXTREME DRY BULB TEMPERATURE FOR ASHRAE LOCATION MOST SIMILAR TO INSTALLATION LOCATION. LOWEST EXPECTED AMBIENT TEMP = -16°C 3.) HIGHEST CONTINUOUS AMBIENT TEMPERATURE BASED ON ASHRAE HIGHEST MONTH 2% DRY BULB TEMPERATURE FOR ASHRAE LOCATION MOST SIMILAR TO INSTALLATION LOCATION. HIGHEST CONTINUOUS TEMP = 33°C 4.) 2005 ASHRAE FUNDAMENTALS 2% DESIGN TEMPERATURES DO NOT EXCEED 47°C IN THE UNITED STATES (PALM SPRINGS, CA IS 44.1°C). FOR LESS THAN 9 CURRENT-CARRYING CONDUCTORS IN A ROOF-MOUNTED SUNLIT CONDUIT AT LEAST 0.5" ABOVE ROOF AND USING THE OUTDOOR DESIGN TEMPERATURE OF 47°C OR LESS (ALL OF UNITED STATES) 5.) PV SYSTEM CIRCUITS INSTALLED ON OR IN BUILDINGS SHALL INCLUDE A RAPID SHUTDOWN FUNCTION THAT CONTROLS SPECIFIC CONDUCTORS IN ACCORDANCE WITH NEC 690.12(A) THROUGH (D) 6.) PHOTOVOLTAIC POWER SYSTEMS SHALL BE PERMITTED TO OPERATE WITH UNGROUNDED PHOTOVOLTAIC SOURCE AND OUTPUT CIRCUIT PER NEC 690.41 (A)(4) 7.) UNGROUNDED DC CIRCUIT CONDUCTORS SHALL BE IDENTIFIED WITH THE FOLLOWING OUTER FINISH: POSITIVE CONDUCTORS = RED NEGATIVE CONDUCTORS = BLACK NEC 210.5(C)(2) 8.) ARRAY AND SUB ARRAY CONDUCTORS SHALL BE #10 PV WIRE TYPE RHW-2 OR EQUIVELANT AND SHALL BE PROTECTED BY CONDUIT WHERE EXPOSED TO DIRECT SUNLIGHT. SUB ARRAY CONDUIT LONGER THAN 24” SHALL CONTAIN ≤ 20 CURRENT CARYING CONDUCTORS AND WHERE EXPOSED TO DIRECT SUNLIGHT SHALL CONTAIN ≤ 9 CURRENT CARRYING CONDUCTORS. 9.) ALL WIRE LENGTHS SHALL BE LESS THAN 100' UNLESS OTHERWISE NOTED 10.) FLEXIBLE CONDUIT SHALL NOT BE INSTALLED ON ROOFTOP AND SHALL BE LIMITED TO 12” IF USED OUTDOORS 11.) DISCONNECTS FED BY SUPPLY-SIDE SOURCE CONDUCTORS SHALL BE BONDED AND CONNECTED TO GROUNDING SYSTEM IN ACCORDANCE WITH NEC 250.24 12.)OVERCURRENT PROTECTION FOR CONDUCTORS CONNECTED TO THE SUPPLY SIDE OF A SERVICE SHALL BE LOCATED WITHIN 10' OF THE POINT OF CONNECTION NEC 690.9(A)(3)(2) 13.) WHERE TWO SOURCES FEED A BUSSBAR, ONE A UTILITY AND THE OTHER AN INVERTER, PV BACKFEED BREAKER(S) SHALL BE LOCATED OPPOSITE FROM UTILITY NEC 705.12(B)(2) 14.) ALL SOLAR SYSTEM LOAD CENTERS TO CONTAIN ONLY GENERATION CIRCUITS AND NO UNUSED POSITIONS OR LOADS 15.) ALL EQUIPMENT INSTALLED OUTDOORS SHALL HAVE A NEMA 3R RATING NEUTRALEXISTING MAIN BREAKER LOAD CENTER INSULATED LINE TAPS INSTALLED ON MAIN FEEDERS NEC 705.11 M 2p200AMAIN240V 1Ø 200A MAIN BREAKER 200A BUSBAR a NEW 120/240V UTILITY METER EG NOTE: INTERNAL REVENUE GRADE MONITORING CONTAINED WITHIN SOLAR EDGE INVERTER SOLAR EDGE PN. RWND-3D-240-MB INVERTER #1 - SE10000H-US000BEi4 DC AC Imp 27 Pout 10000 Vmp 400 Imax 42 Voc 480 OCPDmin 52.5 Isc 45 Vnom 240 PV MODULE SPECIFICATIONS HANWHA 405 (Q.PEAK DUO BLK ML-G10+ 405) Imp 10.83 Vmp 37.39 Voc 45.34 Isc 11.17 A #6 THWN-2 TO GEC B 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#10 THWN-2, 1-#10 THWN-2 GROUND C 3/4'' CONDUIT W/ 6-#10 THWN-2, 1-#10 THWN-2 GROUND D 1-4/0 ALU SEU CABLE E 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#10 THWN-2, 1-#10 THWN-2 GROUND F #10 PV WIRE (FREE AIR) W/ #6 BARE COPPER BOND TO ARRAY G 3/4'' CONDUIT W/ 2-#6 THWN-2, 1-#6 THWN-2 NOTE: CONDUIT TYPE SHALL BE CHOSEN BY THE INSTALLATION CONTRACTOR TO MEET OR EXCEED NEC AND LOCAL AHJD REQUIREMENTS INVERTER #1 PV+L1 L2 N PV-C SOLAR MODULES MOUNTED TO ROOF ON 4 ARRAYS 29 - 405W MODULES W/ 1 SOLAR EDGE S440 PER MODULE 15 ADC MAX PER STRING 2 STRINGS OF 10 MODULES IN SERIES - 400 Vmax 1 STRING OF 9 MODULES IN SERIES - 400 Vmax *3 STRINGS TO BE TERMINATED IN PARALLEL INSIDE INVERTER 1 8"x8" JUNCTION BOXf BONDED NEUTRAL 240V 1Ø SQUARE D PN: D222NRB LOCKABLE 60A DISCONNECT FUSED W/ 60A FUSES ***NATIONAL GRID NOTES: D NEW 120/240V SERVICE RISER P1 ISSUED TO TOWNSHIP FOR PERMIT 2/26/2024 NO.DESCRIPTION DATE HARVEY, FELIX- TRINITY ACCT #: 2024-01-998080 24 CORTICELLI STREET FLORENCE, MA 01062 42.3324695,-72.6771687 PROPOSED PV SOLAR SYSTEM DRAWING DATE:2/26/2024 DRAWN BY: TP REVISED BY: DC SYSTEM SIZE:11.745kW AC SYSTEM SIZE:10kW MODULE COUNT: 29 MODULES USED: HANWHA 405 MODULE SPEC #:Q.PEAK DUO BLK ML-G10+ 405 UTILITY COMPANY: NAT'L GRID UTILITY ACCT #: 9069265004 UTILITY METER #: 87279347 DEAL TYPE: SUNNOVA P1 R 2211 Allenwood Road Wall, New Jersey 07719 877-786-7283 www.Trinity-Solar.com 24 CORTICELLI ST Northampton MA 01062 01/02/2024 Finck & Perras Insurance Agency Inc. 6 Campus Lane Easthampton MA 01027 Elizabeth Carballo, CISR, CPIA (413) 527-5520 (413) 527-5970 bcarballo@finckandperras.com Beyond Green Construction Inc, DBA: Sean Jeffords 13 Terrace View Easthampton MA 01027 RT Specialty CL241207654 A 948B001862 01/01/2024 01/01/2025 1,000,000 50,000 10,000 1,000,000 2,000,000 2,000,000 Employee Benefits Proof of Coverage Trinity Solar 4 Open Square Way Suite 410 Holyoke MA 01040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY N/A N/AN/A 01/02/2024 FINCK&PERRASINSURANCEAGENCYINC 6CAMPUSLANE EASTHAMPTON MA 01027 BethCarballo (413)527-3000 bcarballo@finckandperras.com LMINSCORP 33600 964018 N/A N/A N/A A WC533SB24T2V014 01/01/2024 01/01/2025 500,000 500,000 500,000 N/A Workers’CompensationbenefitswillbepaidtoMassachusettsemployeesonly.PursuanttoEndorsementWC200306B,noauthorizationisgivento payclaimsforbenefitstoemployeesinstatesotherthanMassachusettsiftheinsuredhires,orhashiredthoseemployeesoutsideofMassachusetts. Thiscertificateofinsuranceshowsthepolicyinforceonthedatethatthiscertificatewasissued(unlesstheexpirationdateontheabovepolicy precedestheissuedateofthiscertificateofinsurance).ThestatusofthiscoveragecanbemonitoreddailybyaccessingtheProofofCoverage- CoverageVerificationSearchtoolatwww.mass.gov/lwd/workers-compensation/investigations/. DanielM.Crowley,CPCU,VicePresident–ResidualMarket–WCRIBMA TrinitySolar 4OpenSquareWaySuite410 Holyoke 01040MA BEYONDGREENCONSTRUCTIONINC 13TERRACEVIEW EASTHAMPTON 01027MA