The URL can be used to link to this page

17 OSBORNE HILL DR - BUILDING INSPECTION .,�• ' rt 3 -( �( - l 3 Viz, ��%�� 05/ & _P 1790" The Commonwealth o), COS Department 296 ety Massachusetts State Building Code(780 CMR Building Permit Application for any Building �a� �i Mo-Family Dwelling (This:Section For - Use Only) Building Permit Number. Date.Applied: YR4M Building Official: SECTION 1:LO ONnn(Please in Cate Blo ck#-and' f r locations for which a street address is not available) /�i No.a4d gireet City/Town Zip Code Name of Building(if applicable) SECTION 2•PROPOSED WORIC Edition of MA State Code used_ If New Construction check bere or check all that apply in the two rows below Existing Building❑ Repah ❑ Alteration ❑ Addition❑ Demolition ❑ (Please fin out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes No ❑/Qu F1.1 Is an Independent Structural Engineering Peer Re w r u�red? (l [ Yet ❑ No Yl Brief Description of Proposed Work:�� U� 1� U) S'It ale f_ QM,jy SECTION 3:COMPLETE THIS SECTIONIF:EXISTING BUILDING.UNDERGOING RENOVATION,ADDITION,OR CHANGE INFUSE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): I Proposed Use Group(s): _ SECTION4.,BUILDING HEIGHT.AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq,ft.)and Total Height(ft.) SECTIONiS.USE GROUP(Check as.applicable A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ I M Hi -Hazard H-1❑ H-2❑ H-3 H-4❑ H-5❑ 1: Institutional 1-1❑ 1-2❑ 1-30 1-4❑ M: Mercantile❑ R: Residential R-1 R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION,&CONSTRUCTION TYPE(Check as applicable) LA IB ❑ II❑ IIAB ❑ IIIA ❑ m r3 I IV ❑ VA ❑ VB ❑ SECTION 7:SITE wFORMATION.(refer_to:780 CMR 111.0 for details on each item) Water Suppl Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: Public Check if outside Flood Zone❑ Indicate municipal A trench not he Licensed Disposal Site Private❑ or indentify Zone: or on site system❑ required or trench or permit is enclosed ❑ Railroad right-of-Way: Hazards to Air Navigation MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review comple d? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: _Use Group(s): Ke3, Type of Construction: - Occupant Load per Floor: Does the building contain an Sprinkler System?: IJO Special Stipulations: �^ SECTION 9: PROPERTY OWNER AUTHORMATION Name nd Address Prope Owner # Qs ,et� T. Po �80 L oftfn Name(Print) No.and Street SW/Town J Zip Proper Owner Contact Information: M Title Telephone No. (business) Telephone No. (cell) a-mail addre If applicable,the props owner hereby authorizes Po. ax U 0 Lpn MA oL'i.o Name Street Address ty/Town State Zip to act on theproperty owner's behalf,in all matters relative to work authorized by this building rmit application. SECTION illi CONSTRUCTION CONTROL(Please fill out Appendix 2) CH budding is less than 35,000 m.ft of enclosed spaice and/or not under:Consiruction Control thencheck here O and skip Section 10.1 10.1 Registered Professional.Responsible fof Construction Control -i�i4�Mg I.J� E(Re ' ant) # Jt�o Telephone No I as mail Registration Number �Stt�r7eet Address Ci Town State Zip Discipline Expiration Date 102 General Contractor DORimp— Com an Name �p 01 1ZBirf, Pion w. 'on S rN1 So( me of Pe Responsible for Construction License No. and Type if AP licable O• oX * 796 g 01gq Street Address ity/Town State Zip 46 Telephone�og8gq hone Tele hone No. ceIl e-mail address SECTION IL-WORKERS'COMPENSATI' NCRAFFIDAVIT. G.L.:c.152 25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Acrid must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the ' uance of the building permit. Is a signed Affidavit.submitted with this.application? Yes No ❑ SECrION lim CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor. . and Materials) Total Construction Cost(from Item 6)=$ 1.Building - $ O Building Permit Fee=Total Construction Cost x_(Insert here 2 Electrical $ appropriate municipal factor)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ d Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ I (contact municipality)and write check number here SECTI6N33:AiGNATuRE OF BUILDING Pmmur APPLICANT By entering my name below,I he a best under the and penalties of perjury that all of the information contained in this application is true and accurate the t ge and understanding. 101/ Please print and si a � Q.H.R.1. t Ti _ _ Telephone No. Date 780 Street Address city,4own State Zip i Municipal Inspector to fill out this section upon application approval: �7 / Name Date ACOKiD® DATE(MWDDNYYY) 1 CERTIFICATE OF LIABILITY INSURANCE DATE 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,-the-_policy(ies)must 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). PRODUCER CONTACT Select Dept ext 66807 Eastern Insurance Group LLC PHONE .ae(SOB)651-7700 FAX Nal,(781)586-8244 233 West Central Street E-MAIL lectwork@easterninsurance.com INSURERS AFFORDING COVERAGE NAIC s Lllatik MA 01760 INSURERAAcadia Insurance Company 1325 NSURER Bse Corporation, DUC Residential LLC INSURERC: ne Hills Realty Trust INSURER D: ox 7B0INSURER Eield MA 01940 INSURER F: COVERAGES CERTIFICATE.NUMBERMaster 14-15'/ GL Only REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES.OF INSURANCE LISTED.BELOW HAVESEEWISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT; TERM OR CONDITION OFANY 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. TN-SR Alw suall -POLICY EFF POLICY EXP L TYPE INSURANCE POLICY NUMBER MWDD MIDDI LIMITS GENERAL LIABILITYTY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY MAEREM E E N $ 250,000 A CLAIMS-MADE OCCUR LA0191229-17 /23/2014 /23/2015 MED E%P A one arson) $ 5,000 PERSONAL$ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S 1,000,000 E POLICY M PRO- LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED _ SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS A�TO-0SVvNED PROPERTY DAMAGE $ Peramitlent UMBRELLA UAB OCCUR Id EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION Is WORKERS COMPENSATION (A0286788-15 /23/2014 /23/2015 WC STATU- OTH- ANDEMPLOYERTUABILITY YIN x TS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100 000 (MandatoryCrFICERIM In H)EXCLUDED? NIA Mo..describe In and EL DISEASE-EA EMPLOYE S 100,000 I( as,tleacdbe under DESCRIPTION OF OPERATIONS bO" E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCA71ONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If Inane space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Salem ACCORDANCE WITH THE POLICY PROVISIONS. Salem, MA 01970 AUTHORIZED REPRESENTATIVE John ICoegel/RABI ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9ntrlll5l m Thn aelnpn f Ar.npn Professional Land Surv4yors Er Civil Engineer ESSEX SURVEY-SERVICE 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1886 - 1972 PLOT PLAN OF Yam LOOATM IN Sk,L�T�� MASS. ' A i� S� �ct °Idyi of Z w eiLw " WET Ni<<. D/1!r t I hereby certify to the ZONE: Btlild-i 1g Inspector that the pro-. L� AREA: � f LOT FROWAGE: /UGh C Posed eanstruction shoran conforms FRONT UO: :16F-1 SIDE YAM: )U 1-r REAR YARD: G` to t1� dimensional zoning of J�/-�'�/ Haas. o u .s. $rOPHER REFIIZENCE: EK 462 PG 7q christopher K. PjaHa 3I "31317 104 LOWELL STREET � - - PEABODY, MASS.01960 "k <: "kJ (978) §31-8121 Professional land Surveyors Er Civil Engineers ESSEX SURVEY SERVICE. 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN SaLC/� MASS. 137Do -- �c711 �2�iPQ5CC10fi;LLuI,L. Z61Tl a ti 35° t Al�h 5� '! �� I hereby certify to the 5�VlZllf r7r Building Inspector that the pro- ZONE: cr LOT AREA: A;AP� LOT FRONTAGE: 4�I posed construction shown conforms to the dimensional zoning of FRONT YARD: SIDE YARD: 1G REAR YARD: �Wl 5 1Zo W Mass. SCALE: 'fv //II E aaass DATE: � J, i ^ j�f llN �60✓C 17 1Gl�( NI `�8 L1ER cy°Nly> 41'1 MEI10 REFERENCE: BK IIDL PG 79 Chfwfstopher R. Me11.p�iRLS133,1i. 7�p3 104 LOWELL STREET PEABODY, MASS. 01960 " (978) 531-8121, '.v. 'r'M ro. .n CITY OF SALEM ROUTING SLIP .New Construction Certificate of Occupancy L0CAT10N�A(Aee-1,e AlkDATE ASSESSORS Ay& DATE 93 Washington St. CITYGLER,yJIC; a TE: z z�ta�su� $ '�.'A'�i`&^".aa0-71 nmcusi,a��.wv�. yaiiY ashtrlgton St. PUBLIC SERVICES "v DATE__�L41..f! 120 Washington St. rr�I WATER DATE k 9A I` � 4 120 Washington St. �/ CROSS CONNECTION DATE Q U l'Q \ I fl C�CA�IU Y1 5 Jefferson Ave PLANNING. , �� DATE C( 120 Washington St. CONSERVATION ATE a l� 120 Washington St. ELECT:R, ICALa ? ?i jht� LAC .wtf3 SAl Th at �"—az �a FIRE PREVENTION f DATE 29 Fort Avenue BUILDING INSPECTOR DATE 120 Washington St. 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): I SolarCityCorporation Address: P055 Clearview Way City/State/Zip: JSan Mateo,CA,94402 Phone #: 888-765-2489 Are you an employer?Check the appropriate box: Type of project(required): 1. 1 am a employer with 5000 4. On 1 am a general contractor and 1 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2. 1 am a sole proprietor or partner- listed on the attached sheet. t 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers' comp. insurance. 9, 0 Building addition [No workers' comp. insurance 5. [3 We are a corporation and its required.] officers have exercised their 10.90Electrical repairs or additions 3.® 1 am a homeowner doing all work right of exemption per MGL I I.[3 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12,O Roof repairs insurance required.] t employees. [No workers' 13.IM Other Solar comp. insurance required.] *Any applicant that checks box#1 most also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: iberty Mutual Insurance Com any Policy#or Self-ins. Lic.#: A76 DO6626 023 Expiration Date: 9/1/14 Job Site Address: rd e 5 City/StatclZip: r Saje Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer rtti/fy under the pains and penalties of perjury that the information provided above is true and correct. iGL� 7 Signature: � Cy Date: Phone#: 888-765-2489 7771 OJf<cfal use only. Do not write in this area,to be completed by city or town ofjiciaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other f nntvrt Pnrenn- Db......R. s�coR CERTIFICATE OF LIABILITY INSURANCE °""21/2013 ATE RUR2013 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. IMPORTANT: H the certificate holder 15 an ADDITIONAL INSURED,the P011oy(1e6)must be endorsed. If SUBROGATION IS WAIVED,Subject to the terms and conditions of the policy,certain polices may require an endorsement A statement on this certificate does not confer rights to the corti cats holder In lieu of such endorsement s PRODUCER 0726293 1-e15-5e6-9300 Brendan Arthur J. Gallagher i Co. NAME: _ _ Quinlan Insurance Brosere of California, Inc., Linanee f0726293 INOUE EXO:415-536Aa020 _ IIIF- , 1255 Battery Street pe50 6"A*L ^-L1A - EF---�-- ADONEas:_ bran dan goislanpajq.Cos San 1!Yrne1eCO3 CA 9a111 AFFOROa1G p9YERAeE INSURER 11: LIBERTY f10T FIRE IN9 CO 12303INSURED 5 - SolarCit INgtWRB: LIBERTY_INS CORE - (4 -- y Corporation d2<D< INSURER C: _ 3055 Clearviee Nay NrsuRER D_: San NsteO , CA 94e02 INSURER E_..____`_`____.__. INSURER F: COVERAGES CERTIFICATE NUMBER: 35272277 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT.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 SY PAID CLAIMS. LTR, TYPE OF INSURANCE I POUCY NUMBER PoucYEPi POLICYErP -�•.•�. 010r8.A_•_�— A IGEREM ujunurY 'TBT661066T65053 09/01/1 09/02/11 EACH OCCURRENCE _ X OWUI1RCULGENERALIAB1LRv A f1,000,000t 15 uN ,FYS1i�q rF.D' 100,000 -� - �±ESEs fee ncc�we�c f �. _ J ctble: I X OCCUR AfEO EXP ae 10,000 t% Deductible: $25,000 "-- PERSONA J ADV BIXIRY, 11,000,000 I _ 00,000 �GENL AGGREGATE LaDT APPIICSPER A AOOREOATE f 2,0 PRODUCTS-COMPIOP AOU $2,000,000 Ix MMY I PRO- I LOC A AUTOMOBNE UABRIfY A92662066205043 :C BIKED SRMdE LWR f �X ANYAUTO LIEPw.asn_JI—.--- 11_000,000 ALL OWNEO �I SCHEOULE9 t SOUILY R RV WwP ) f AUTOS '.._ AUTO i SOOAY INWRY IPw errileml�i -_-- HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE f PPr.aCfiVenA _ UYSREUA NA6 OCCUR EXCESSLIAS EACH OCCURRENCECOUMSAwE If AGGREGATE _ f DE G, RE7F.NIIOM$ _-- - - e AND EMPPLLOYea uAeur MC7661066265033 (N2 Retr ' WC ONYSTATU IOTM• 1 09/01/13 09/01/ls X B ANYCIOR RMSFRFXCIuERIFXECUTAA: rip NIA NA766DO66265023 (Ded) 09/01/13 09/Ol/11 EL.EACH-NITS Nr _ ' OrfICERAN?NRell UpEOT E 1,0g0,000 I ER (ManONOrybNX) 1O1 EC I E1 91SWIi7EAEMPLOYEF It S 2,000,000wffwNOFO _ E.L.DISEASE-POLICY LWIl If 1,000,000 I DESCRIPi OFOPE1GT10N51LOC MMIVENICLEB fAW ACOROTOI,AEOWOnn RM,ft SeasaPN,1/ARYNtPAU HraRWIFOp Proof 0£ Insurance. CERTIFICATE HOLDER CANCELLATION Evidence of Insurance 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 AVIRGRNED REPNESENTAINE ACORD ®1958.2010 ACORD CORPORATION. A nights reserved. satyasan 2S(2010105) The ACORD name and logo are registered marks of ACORD lyta 35272277 r?%�r' ` '�>rrirrnirrr�rri�l/ r��'<�irrr.;:�rrerr.�r�/�; Office of Consumer Affairs and Business Regulation M 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card SOLARCITY CORPORATION Expiration: 3/8/2015 CRAIG ELLS t --.__._�-- --- ------- 24 ST. MARTIN STREET BLD 2 UNIT 11 ' - - - --- - MARLBOROUGH, MA 01752 Update Address and return card.Mark reason for change. SCA t a xu•psni 0 Address ❑ Renewal n Employment [-j Lost Card ^�-Office of Consumer Affairs&Business Regulation License or registration valid for individul use only r. w FfOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: of Office of Consumer Affairs and Business Regulation aq ,$Registration: 168572 Typr 10 Park Plaza-Suite 5170 Expiration: 3/8/2015 Supplement :ard Boston,MA 02116 ' SOLARCITY CORPORATION CRAIG ELLS _ 24 ST MARTIN STREET BLD 2UN1 i e WALBOROUGH,MA 01752 Undersecretary Not v lid without signature f { i{ Massachusetts -Deparlment OI PubliC Safety Board of Building Regulations and Stanuatds i (�i Ylttru6 hitM Sufll'ft Nill' License CS-107663 CRAIG ELLS ' 206 BAKER STREET Keene NH 03431 t 1 I Ptltit-OR, CmnnnssiMuu 0012912017 i � t � �C Ll-JiZ7J1fJ7111«C!<� Ca'�lClJi((CIICIJC'�t�J Office of Consumer Affairs end Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card SOLAR CITY CORPORATION Expiration: 3/8/2015 ASTRID BLANCO 24 ST. MARTIN STREET BLD 2 UNIT 11 — MARLBOROUGH, MA 01752 Update Address and return card.Mark reason for change. SCA r 6 eoµosht Cj Address [:] Renewal ❑ Employment Q Lost Card `� 4/�0`�•.�nruir.iunra///.njlZ'l�r.;:uc�iruc/G . s tree of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: C :>"• Office of Consumer Affairs and Business Regulation _v It 168572 Type: 10 Park Plaza-Suite 5170 — Expiration: 3l82015 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION ASTRID N 24 ST MARTIN STREET BLD 2UN1 lTiIAhLBOROUGH,MA 01752 Undersecretary Not valid without signature r i DocuSign Envelope Il 2F8D98B2-86F8-44D4-BBA8-DD52DOA175EB wo SolarCity. SolarLease 3055 Clearview way, San Mateo, CA 94402 AMENDMENT T (888) SOL-CITY F(650) 638-1029 SOLARCITY.COM Customer Name and Address Customer Name Installation Location Contractor License Stephen Iwanicki 3 Border St MA HIC 168572/MA Lic. IM 3 Border St Salem, MA 01970 1136 Salem, MA 01970 1. The SolarLease Agreement between SolarCity and You, (the "Agreement") including the Exhibits to that Agreement, are hereby amended as follows: a. Section 3 of the Agreement, "System Description" is replaced in its entirety with the following: 9.945 l DC ISM photovoltaic system Photovoltaic Modules Inverters) Mounting system Monitoring system Electric meter number: Extras: None b. Section 4 of the Agreement, "Lease Payments; Amounts" is replaced in its entirety with the following: SolarLease Amendment,June 1111, 2014 - Copyright©2008-2014 SolarCity Corporation. All Rights Reserved. 1 L DocuSign Envelope ID:2F8D98B2-86F8-44D4-B8A8-DD52DOA175EB I have read this Amendment in its entirety and I acknowledge that I have received a complete copy of this Amendment. This amendment supersedes any prior amendments that are inconsistent with the subject matter contained herein. The pricing in this Lease Amendment is valid for 30 days after 7/16/2014. If you don't sign this Lease Amendment and return it to us on or prior to 30 days after 7/16/2014, SolarCity reserves the right to reject this Lease Amendment unless you agree to our then current pricing. Customer's Name: Stephen Iwanicki Signature[�Pj`u" laauarkt 191A1fO10t®Oli. Date: 8/10/2014 Customer's Name: Signature: Date: =�"SolarCity. SolarLease SOLARCITY APPROVED Signature: -- LYNDON RIVE.CEO SolarLease >`SolarCity. Date: 7/16/2014 SolarLease Amendment,June 1It', 2014 Copyright©2008-2014 SolarCity Corporation. All Rights Reserved.