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42 CLARK STREET - BUILDING JACKET What is the current use of the Building? Material of Building? If dwelling, how many units? Will the Building Conform to Law? Asbestos? Architect's Name 1V'E6c/1O,20 — 77�l�! z7OXOW Address and Phone 9& L' EW- ST- GUDB ?63 ,?14 O Mechanic's Name Address and Phone Construction Supervisors License# Qci 90 9�) HIC Registration# Estimated Cost of Project$ 53 /. — Permit Fee Calculation Permit Fee$os� - 6� Estimated Cost X$7/$1000 Residential Estimated Cost X$11/$1000 Commercial An Additional$5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury X +7 fot��+js Date a � � Ica � � a a c (A 4d C V 6 6 ACORD CERTIFICATE OF LIABILITY INSURANCE c6 JB M12/15 YI ' PI 1 -sans THIS CERTIFICATE 18ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE i Ascrions, First Ins Agency Inc HOLDER.THIS CERTIFICATE DOES NOT.AMEND,EXTEND On N123 or hQuincyQuin shore Drive —ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.v Noit Quincy PW 02171 Phcne,61]Q]0-9000 INSURERS AFFORDING COVERAGE NPICr , = r onseD - - NoNMA Arbelle Protection Inc. Cc IN9VNi Meg. 00etet=0 LLC wwMc PG HD% 11E69 INPUREgn 66 Woburn NA-U1801 IMUAERE. t COVERAGES - 3 - - THE FoLiCN00F IN8J14WEELIBIE NMM INVEOEEX IL01 NMTNE INOUREONMEDiPoWEI EMLHC NE MD Tw.N IWIIH0rN NO , r w NNT Y RE4UWEUEM.TENH4RLOpLR10.JOFAYYLONIMCTOROrNENLCCVMEM WI1NflEbPECi TO WNIEM rH aLFRLWC0.IEXPYM169RD011 ' MRYpFAiNN.1ME N5URWCEIFPoRDEDe(iNCPoLIpE9OEXPBFA 11EgEIHI8 SV0lECiiOP1LTHETFAMA EXMU8KK19wDCfiVDNICN9O 6VCN MLICIEa.MOgaO AlE LN1185xOWNxAV RAVE OEBIPEOVCFll RY PNO<NUV '- "" 'N LTN XSR ivpIOFINPVRWEE POLOYHUNaCP D iB VOO OP N NxM OM NI LIABNFY PPLHMI MEACE E1,000,000 A X"."'recEe ease AELdmu. 890000010649 01/01/07 01/01/08 Es awrc 160,000 r CI MAE.O DoMR MEO EMI µ+F mopnyy $5,000 PEMONau IAV IWUR✓ 51,000,000 - - - aENBPw AoogE.A. $2,000 000 6Er1LM4REGNMpIpl p.t.MVYESFLR: PRONUM-LVMRVFMB sa 000,000 POLILY - ,RCr, Me __ - AmaxobneuMvm'.. wNcEsBssmLM' f1,000,000 III _ A ,wv AV*D B1037400001 12/31/06', 12/31/07 WX'oo) AumrxlRNNOs s.Gly.w111Y S' x SoNMAExwF[V _ 8 ONW`N $ NONOWNEO.VFTOb . �PP�UAxa4E E J ' OMADIUAOILnY MrOOMV.ERMG4PNi 9. ' Nn PAIrO .. pI 'sse EA. 6 MEOU.KY UNION XBglLLPLIABI4IT .. FPCNOLLURREI a5 000,000 A A WI ❑OLVMONME A8000i0709 OV01/0] 01/01/OS /OQNEINIE $5 000 000 • ' DEWCTBIE y" ' PEIENnOX i N WOPNERBCeWMAnn AND N NIRYUWIS MFLOYERa'UMIULY A. 90%6]005 09/01/06 05/01/07 NI MUN AKWNNT X.500 000.°"xFFI°rEppORnrex"Naz ePMci"uuMDunvEEwm e1olsasB E+Exmov 1500,000 'I•r. pI DO eXFnb.Illwr - O.L. NIITaI".IT s500 000 - 0PE/.IALIROVIbnN9Y4ox u ` �I x�i,�.OpbCXIPrNXOPOFEMr10X8/LOE0.fiDHB/V¢HICLE9IEMELUSNNBAOOEO aYONOOPa MENi/aPEEIAL RONa1DNa - JI CHATIRCATE NOLOER CANCELLATION " - 6PE0001 MUM ANT OiTHEAe4woeacnlOeovOL%IESOecMEeuevo0 TNBeMP emce t ull. iMFREOP:INIIROUc ...sNNTNU_ OEAVDRLON+M 10" MYBWBrtEN r OPl¢ r • ., XO11CeiOlNPEERgF6Ri0NOLOEgNAN00tOTMELEIT.BVTfNLUNEN00a00Nh4 ' 6PBCIMN IX1DOEXOOBLWALIDNWwo.nYDFINYMIXOVWXINE.INBVREe1T8 AconooR NBIREOMTAns. ' k M(NORQIONVNEBe1TATVE ' Jevlae IN FDlren CPC IVACOHOa6(0001N0) - CPO CORPORATION 108E y� l//la .c/ruoella" i _.... -- - ✓lie�j/pB0rype9EEl1GI6aT' ac^lurdelA 1 a ,¢' orwrnareuie, I aaa ry Nyp Iv BOARD OF BUILDING REGULATIONS - Board of Building Regulatlons'And Standards , E r I License: CONSTRUCTION SUPERVISOR B HOME IMPROVEMENT CONTRACTOR i a .,, mber CS -029090 19Nu -' Registration 146589 Birthdate t111911953, .' t ExpIrdtlbri 615/2007 ,r I I•. 1- � ,Y. t c A !'7r i ;kxpire's 11/11912007 Tr no. 9879 0 W: Ty ,S lupplemeni Card I _ ncrn99t4.JPG R�`Btrict tl 00 1 �a r t n r NEWPRO OPERATING LLCf1 THOMASP FOXONB {r �' ( .a s s THOMAS FOX ONt'j I 230 WALNIp' 26 CEDAR ST. Y ,�tf ,,,_,-� �� READING MA 01867 `+ `t ., ,�. ��— Commissioner a.' - WOBURN,MA 01801; r` Adminicvumr f _ ,. __. ;W.Lti .m, _�.-_N�,....vim,-•. Ic,b,. — .--r�-ti.�. - m Highlighted Regions .OYBNIBO In all Z011ee Ora DEVCO PRODUCTS, INC. FIN Newpro/Denali fi 3000 Double Hung aaeonel Fere0auon Vinyl frame, Double glazed, Nalina Courlcd Low E coating(e=0.036,53), ® Argon/air filled ENERGY PERFORMANCE RATINGS U-Factor (U.5JI-P) Solar Heat Gain Coefficient 0,26 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance Air Leakage (U.SJI-P) Condensation Resistance illwadoverstipulatwNattese ratiop odntam to appdoeWe NFAC procedures for detMadrlinp we produdperformance.NFAC!wings am deletmeted lira fixed setol emlmnmantal conditions and a spelNricpmductsize,Consultmanuwurers literature for odraptoduttpenurmanceinnormaliar. www.nfrc.com TA ggVA C1NT?IIlI1k14nwww nNAm,4N ggqb_qqp,_qAC bC :CIT /mm7/CTi7M CITY OF SALEM ROUTING SLIP NEW CONSTRUCTION CERTIFICATE OF OCCUPANCY LOCATION: 4aq OLA2/�, cS7 DATE APPLICANT: AIEZ( R0 - 21-1 FOa(61\1 ASSESSORS FRANK KULIK DATE: (93 Washington Street) CITY CLERK CHERYL LAPOINTE DATE: (93 Washington Street) PUBLICE SERVICES BRUCE THIBODEAU DATE: (I20 Washington Street)46 Floor WATER DOTTIE THIBODEAU DATE: (120 Washington Street)4i6 Floor CROSS CONNECT SUPERVISOR BRIAN THIBODEAU DATE: (5 Jefferson Avenue) PLANNING VALERIE GINGRICH DATE: (120 Washington Street)P Floor CONSERVATION COMMISSION FRANK TAORMINA DATE: (120 Washington Street)34 Floor ELECTRICAL JOHN GIARDI DATE: (48 Lafayette Street) FIRE PREVENTION ERIN GRIFFIN DATE: (29 Fort Avenue) HEALTH JOANNE SCOTT DATE: (120 Washington Street)4i°Floor BUILDING THOMAS ST.PIERRE DATE: (120 Washington Street)3 d Floor VDepartment of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): NEWPRO Address: 26 CEDAR STREET City/State/Zip: WOBURN,MA 01801 Phone#: 781-932-8300 Ext.251 Are you an employer?Check the appropriate box: Type of project(required): 1.X I am a employer with 50+ 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 1 7. X Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9 ❑ Building addition [No workers' comp, insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL l 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4),and we have no 12.❑ Roof repairs insurance required.]+ employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box kl must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most 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. I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: ARBELLA PROTECTION INSURANCE Policy#or Self-ins. Lie.. 90967005 Expiration Date: 05/01/2007 ' Job Site Address: Tpf e Ll�oe� VT City/State/Zip: 19 LEH, HA 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$250.00 a day against the violator.Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u uter the pains and penalties of perjury that the information provided above is true and correct. Signature�� FOR NEWPRO Date: Phone#: 781-953-8146 Official use only.Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health . Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Crrx OF SALF.M ' PUBLIC PROPERLY DEPARTMENT MANS ,1tiAYO1�10MhYR•sua�xwuoa�,s0,l1t Tft M7464M 0 PAS f7 ?4&" Coutmdom Debrb Dbpeed A(Wavit (cequi�td��dddoa��eo,►�eta.woeq Is u mdmo wide dw&&WW s ddN Suet BWWIog CWk 780 CMI ud a 111.5 04m%ddrpw dawdMrjLa40r01N ,3un&g lrnett N - it iwowl wid dr 000dWm&d dw ddwb mwdb0 Soot �,�d,tg Dt di;oNd otiw t P�4►lteettd wnM dlgad S►dgty at d�aad byl�GL s 1t1.S15OA. ZhtddwWgill bs trwpod d by: (amt db.rM�l 19u&bdt wig be dispowd OCR: 13 Zk)H&�L/nl6 AVE - N68L en/ �rww.oto+nns�iw 03/15/2007 09:41 5088429248 NEWPRO PAGE 01 m.a:r•, ate. Qnc� 'A/ ,Reg.111A6669 'l ieg.110605216 11 eg.#26463 �iMaaePuce Federal ID a20-3625129 c0la++'.m w,P„rn+n:,M Ci P..M r.an.win uydn,uu more rml t+-IIM Im/ni�jr.Frl: '1' (CONTRACT MADE THE 8 day of. . M.Cl. . . 200. ./ bclwPan .o rrol A,%C h� y7 awmraj . . I�MtpPnnn01 IOile.lCell nA I�IMIe.)� � . . . c1a c• . .5.T"'. . ,5.4 !e�.. . Wi�1n . � 9.� (annmx.l IStalo 0. 'RiD Cote.) Owner"and NEWPROOperating,LLC,"NEWPRO'. VEWPRO hereby agrees that it will for the considolallon K)APIM tllor monllnnod, furnish Al labor end melprl,01 necon-mry Ball the following d0$Cnbed work al the promise$loonfnd AI 5&�. . . . . . . . . . . . . . . . . . . . . . . . .IE,Mnil no,Pn2Mj T TpL Addlllenal TOTAL CASH u •tllawB Pumnnsetl NEWPRO UU Work...-_.. _...—_.— SNIo„._ON/. PRICE _ _. ../ V -dew Color Specify Sliding Glas: Lbor DEPOSIT G r Vag Color Speclty Im. DIV Steel Senlm,Door WITH ORDER I Ible Hung I um Window Obscure Gla:.^, T COMM OALANCE Iianery Casement---- - $C/29115 _- IgLT FULL DUE AT 3s¢� :emem-MpAPI A _ _ INSTAI,1 nTIUN G/ II913 Life Slider NaweOa' 0nnn no no Mir rnlnnno or 1 Bow Frame "EWPR CASH N siel". b nMl rnaMONolr ter nOhdlnM+a TUOM Pald In 'doe Window OT nlCuaminr.1 Vini"d 11,conleel lnelu01n0 nstaner al Installation ring Fondennmion rn+unln0 lroln m nun to on,. . ter glmm....a'MOM,. FINANCF, Bank Completion -•_—........ .... .. . 4iill — Firm S!med nt Inclallallan .IDS Colonial — .... j I SCRIBE WORK: di r 'h'fio �� _!�3 ._�vJL,. .-. �� .._ :..�,(`:••f-r._, 5 mal xg1:,Lmy nnmF M Tin n o(V/n" IuflWlnm IeP n InxIaIIM Mnr,dollop t r.Mpl f� �_ ru+room Inllitln Stott I., - -- O ...Esj.temp.0aln: .. Or—'- " JI be me nNotiom d WPRO D dbinin arrtyry nM Tin mtmlln amr:ea,zry wl Jar I i!nl•no Ito rMMV nnnm, inn nn of MS win x147A Own o01fMNCIM.An P. M ont, T M iTT wdr en0eTM llr "Ond,r will 00 1,11,M from Ihm gain.nh Inn'O pprrlwsbn. nl MntC, 19�n. tmmP Imry,Wmm�n+nonlmflnr<aM 4mnnnlrodnro MAMa Tin mmnlnm ta'Ilw CVa;ld aml Anv I40N4ne Oj,,,a Conendvr at GubIrno,,er •: no ro a t MIA norm M dIAMIM In: Olmmor, Now. Im1 mvmmnm Commonr NMghrmmn, On? A.hMmo4 oin,. nobro +ioi. goolm MA 021011, 017)727-e5011. t' Llwnor IS nhl•,"mor unnndnp by wm of.e Pmnn Innlnn1N1111 GPoA Ap`NmM1,pL ll AOroamnM nhnn Include A Ieen nrhrdilln nl pAymnnl.In M ndar mot ronlmrl Ann IN Timmins of Tinter,omMnm setn0 innoun a.Indunlnp nil rhAA 0 0118OW.n,.T1c Apinil Irrn!lmnnl Galne APmmmnnl Tic Nmmnramn hereon fry rrin. .If IM t}nm K wilintift n rMe,(Alf Amon Ilan 10 pPpp,InWhak AT 01 Dail.M Isle ToMbncl amounl hnmin, nms of f n revrNinp Jinn m mmdl mrJudnn Imnmm nun end pnymm r nrmn,norm In onorly of nl,e Dn the cool MppliCAllon.Tllo Iro,vun,.r she I AGplroenmt reeneh+R n slmn nchnd,An of reynllTl,to no mad im m n rml Ihln noles,inn Inn nmm Kul of n.Tin pnylnanl Atainv In{INWIS.I11CIINa49 'I 1.1no0 chelmec,dell Ni mcorynrnrd hmnln by minmern. 'DRO"on.1ltrr,If,,]is ooninn Wnrkmnn'.Cnor r.millnn And pldMia 11 WIN, Imiraneo In inn M ilinn11 nl Sion,17LD7.6am, Owner rrhern to pe.mil NEWPRO In pprncnnd W h site work hrrrin,nr m Ito Mont At no,storm of no r h r r OI into opmemnnl.IN env rnnern +Amer thou muff.inn owner In poy bi- PRO A.Tim nl nervy rttryryml1 shim Immn inn rnminlM pnrcors of Iln pre,nonnd to Is,pnid.is uxM. �• !rued entl incrnIhInd dmm�gm..,and nil ne a rnndty,wilhne hmMr 0 Tim n1 let,or dhmnno raO Moss'Al M hnln"We m on-Mon Iry dolmya In Mn pndnrmrnm nl o,Moen,,O,m In nniwn,hevono My mnwnm•In nntna. b! ,wazram,Ihm on.in Inn rumrr of the prnnnm m+whkh rho.wink in h he pMnmmn ter Mnl hn IA Mnnlwbo edllMzeo 0n Lnhnll at 11.0 Dnnme • IM,Into 1llr.aammtenl. " "onoid Mrinoocnlp Isnl nnllm nomennl hnlmmnn Ihn Cwnnrnnn NF.w rRO and rannnl he nnnmmon n.rq. l or A wrmnn xlon,n ov Inch m,Own!•, NEWPIIO. `• are entitled to a copy of the Contract al the rime you e'en,Keep H to protect your legal rights.We,the nforrmild tors,certify,that Immrdlahly affor the signing of the al0 esald agreement,a copy was furnished to us. Y' may commit This agreamem B It halt been siggnrtd by a C fifty therldo it a Plate other than an address of the seller, -h may be his main office,or branch themes,provided -ou nollfy sollor n writing At his main office or branch by I. nary maa passed, by Mlogram Bent or by delivery,not I der then midnight of the third buslnrss day following the ni ring of this agreement.(Saturday 19 a legal business Asti.)• the attached(route of cancellation form for an nirptana+ton of this right, DO NOT SIGN THIS CONTRACT IF-HERE ARE ANY BLANK SPACES, T' r�O'-lw1ner hey seen'saMply"wamanlig;that will be provided b, NEWPRO upon Installation. 1J samosa warm a6 on,vidod to owner. N SS OR,Ire niea have hereunto slpned Ihm! names Ala_ ..diy cl !EINa Si)ned `/ d g Pdmad Name Owner A .ap P Operatin C 8 ShIned _........, N Repro a rva Signature Owner wdapa PaONpnOmme 61n6w6aeYM 1104011 WMAWncAeMNCHOFFICF. 7BCIWr51lan1 161160NamaWU•aadnm.M,i, n6 Gabon BlroM Ib4m+,MAO+tm Ate l'C 1R101AUJ1]oO�Yl:1M wylwbafi066t0 6m AM.I'AMFS TF,1,;�OIT]RQMi eyDRa99r0IFa0N ML1 7a.i1m,'29nm ka4Cn.0JI6 LFa0M Me Fna:Tpr.ny.mlT eallArfmfl.imaa NlFl M.rnlTa'•1A1+ Mk:rMeTAeY W1fITEl Rainen Copy YELLOW:Cudmtlor'a Copy FANK!FGO Copy OOLO:F."co M to MAmao IrnM EITY-O��XLE PUBLIC PROPERTY DEPARTNIENT KIMBERLEY DRISCOLL MAYOR M WASHINGTON STREET•SALENSAASSACtliI' 1 S 01970 14t 978-735-9595*BAx.978-740-9846 APPLICATION FOR THE REPAIR,RENOVATION, CONSTRUCTION. DEMOLITION OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING F E INFORMATION on Name: Building: ty Address: a CLA�/� CST Property is located in a; Conservation Area Y/N Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land Name: LOR4eA/NE GfJ6AI Address: Telephone: — / l0 3.0 COMPLETE THIS SECTION FOR WORK IN E7USIING BUILDINGS ONLY Existing Renovation Number of Stories Renovated Change in Use New Demolition Existing Approximate year of Area per floor (so Renovated construction or renovation of existing building New Brief Description of Proposed Work: O�Elvin/C�S. NFRC = . (a Mail Permit to: O CJy 10 c? The Commonwealth of Massachusetts �� Board of Building Regulations and Standards - \Y7 Massachusetts State Building Code, 780 CMR, 71"edition Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section F fficial Us Only. Building Permit Number: �1� �� to plie Signature: �'+✓ ��`I/0 2 Building Commissioner/Inspect of Buildings ate SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers y a Clorlc S-t . Salem , MA 17 9(0 I.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: .. - Zoning District Proposed Use 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) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? ` Municipal ❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' ' 2.1 Owner'of Record: CAIII S+one- � Lorraine Gagne U,3, C(Ork S+ . S CA-IerY.) Name(Print) Address for Service: G .A.t,� Ate,,, ra.�7f_' - r) g • ''1 U Li-1 U U� Signature Telephone SECTION 3:DESCRIPTION OF PROPOSED WORK'(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 Work': lns+nll 011e n a den windoW and One Si-orm dO Or' In y eXt Si-1 ti ng -ntn9 r, SECTION 4: ESTIMATED CONSTRUCTION:COSTS Item Estimated Costs: Official Use Only Labor and Materials I. Building $ 3 Gj 2O , 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ '3 52 0- 13 Paid in Full 13 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 2 cl Dq0 I I I q —rh on,a S P F0 X on License Number Expiration Dale Name of CSL-Holder List CSL Type(see below) a(o Cedo✓ Sf VJUbu�n Type Description Address O Unrestricted u Cu. Ft.) R Restricted 1&2 Family Dwelling Signature M Masonry Only 7 8 1- q 3a,-8300 RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Aepliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) I y 65 9-R NeLu�rd HIC Compan Name or HIC Registrant Name Registration Number _co Ceo�Qf St WQb�t�r1 rj 5 2011 Adqrss, 1 Q 3a �1 3U(� Expiration Date Signature Telephone 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, $I I I Siy✓)e o n d LOr fo i n e G Gl q✓1 e_ , as Owner of the subject property hereby authorize N 2 W pr U to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION 1 Th O inn S P Y 0X c5 l ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. lYlofYlCtS P�I=/axon /-� Print Name /Y Signature of Owner or Authorized Agent Date (Signed under the pains and penalties ofperjury) 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.116 and 1 IO.RS, respectively. 2. When substantial work is planned,provide the information below: Total Floors 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" CITY OF SALEM t PUBLIC PROPRERTY DEPART/1ENT !1y v construction Debris Disposal ."11'tida% it (required liu all dcnwlitiun and renucatiun \cork) In attunfancc \%ill' the sixth edition ol'the State Building Code, 7S0 CNIR section 111 5 Debris, and the procisiuns ut MU e 40, S 54: Building Permit it is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c I 11. S 1 50A. The debris will be transported by: t11JnIC ul iaulcr) I he debris will be disposed of in (urine of aeliny) 13 W hcet%n QVe WObUvfL- InJdrr+� , I�rililcl / H L'lIr1U1I' DIY parrot dppllcrnt daw k—A MA Reg#146589. r�WkWORISO ° / J Federal ID#20-2625129 CT Reg#0605216 58649 RI Reg#26463 Windows siding and More Corporate Headquarters,26 Gedar St,Woburn 800-342-2211 (F)781-933-9626,www.newpro.com THIS CONTRACT ADE THE day of J( tAp ; 20--1 between q I 1('�[� ) e l f �- h � � � 7c/l6 (Home wnersJ Home Phone (Bus/Cell Phone) of C 0 (Address) (City) (State) (Zip) the"Owner"and NEWPRO Operating, LLC, "NEWPRO". The job address is a condominium. NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,furnish all labor and material necessary to install the following described work at the premises Io e�tn n �/ IUVI (Job Address) (E-Mail) for proprietary use only TOTAL Additional Model TOTAL Windows Purchased NEWPRO (40 Work Number City CASH 3�oCV Window Color In: %_,/ Out: Sliding GlassDoor PRICE o�v Capping Color n_i) Steel Securityor wt'1 rL Door Color In: Out: DEPOSIT (( Model Name Model Numbers Qty Sidelites WITH '' �'7✓ Double Hung New Construction Unit ORDER / Picture Window Storm Door BALANCE Casement Obscure Glass TOP B M DUE AT 2 Lite/3 Lite Screens HALF U INSTALL Be Lsaw7rame Please Initial: Roof: ❑ Soffit: ElCustomer understands that NEWPRO®does not CASH Garden Window do any painting or staining. Ile:when removing Balance pa Iler at installation Awning or replacing interior stops or trim) Hopper NEWPRO®is not responsible for conditions or " Shaped circumstances beyond its control including con- FINANCE Other ( densation resulting from or due to pre-existing Bank completion form signed at installation GRIDS Colonial SDL uro conditions. DESCRIBE WORK: CiN Est. Start Date: U 7 Customer understands this is an"estimated date Est.,Comp.Date: mas Initials Customer understands all steel security doors will have a 3/4"aluminum threshold installed over existing threshold. It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owners Agent. The Owners who secure their own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A. All Home Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Room 1301,Boston,MA 02108,(617)727-8598. If the Owner is obtaining finanding by way of a Retail Installment Sales Agreement,such Agreement shall include a time schedule of payments to be made under said contract and the amount of each payment stated in dollars,including all finance charges. The Retail Installment Sales Agreement shall be incorporated herein by reference. If the Owner is obtaining a revolving credit line to pay,in whole or in part,for the contract amount herein,the terms of the revolving line of credit including interest rate and payment terms,shall be clearly set out on the credit application. The portion of the credit application referencing a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including all finance charges,shall be incorporated herein by reference. NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100,000-$300,000. If the Owner refuses to permit NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed, liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage. NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable control. Owner warrants that he is the owner of the property on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter into this agreement. This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and NEWPRO. You are entitled to a copy of the Contract at the time you sign. Keep it to protect your legal rights. We,the aforesaid owners,certify that immediately after the signing of the aforesaid agreement, a copy was furnished to us. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office, or branch thereof, provided you notify seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. (Saturday is a legal business day). See the attached notice of cancellation FThe r an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. wner has seen"sample"warranties that will be provided by NEWPRO upon' stallation. S mies provided to Owner. IN ESS HEREOF,t parties have hereunto signed their names this day of 20 EIN# Signed Marketing Represent�AthrOknted Name Owner Accepted: NEW ROO ra' ,LLC 7- 1 BY Signed % Owner RPO E OFF E. SHREWSBURY BRANCH OFFICE WARWICK BRAN OFFICE 26 Cedar St 151-153 Memorial Drive Business,Pk 24 Minnesota Ave Woburn,MA 01801 Suite B-C Warwick,RI 02888 (P)800-242-9974(From NE) - Shrewsbury,MA 01545 - (P)800-356-3312(From NE) (F)781-933-0717 (P)800-456-0555(From NE)' (F)401-732-1371 (F)508-842-9248 WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy uses RO50a - o , AN JOB# window, and More !s'y Page Lott CUSTOMER � rr /C?✓/`(,Y. I,C/5Q� +1 e� U G � , '-J ,evs:..�rr, Jx�.RIP ` E-MAIL ADDRESS - q HOME PHONE q D- -7'iq 14-0 7 DATE. T(� (Circle oneJ - ADDRESS Ch CIr C 1 //^^ / BEST DAY TO INSTALL. M T W TH f CITY, STATE —s c l e��TLL?� � 1/�� (Please circle one)one)` PRODUCT SPECIALIST �' BRANCH. V `� ESTIMATED START DATE / 1:3 TOTAL#OF #OF DOORS WINDOW COLOR WINDOWS #OF BOW/BAY GARDE Storm [80 Patio Inside/Outside CAP COLOR o ",� OPENING SIZE STOPS NO. STYLE W x H U.I. LOCATION GRID SCR IN OUT OPENING CUT /U �7 yok�(l o ass e x x oo� 3 �v „fi / x x 3- x x r4 x x, x x x x x x xx x x x x +n a — x x x — x ; x x x x x x x x Measurement: Initials Date CrewSi ze Needed Time Frame to Complete Job Capping Type Special Installation Instructions: - -- Dlrections to site: - Ranr d 1101 ggarcree 425 S.Broadway•Sugarcreek,Ohio 44681 MANUradTUPETEOOOflASSPECIFIED oN Industries Page#: of �Aireda"""rem.wn�� E-mail:sicustserQsugarcreekindustries.com THISwR�pS ORDERED IMPROPERLY IBLE ~� Tel:(330)852-2416•Fax:(330)852-2490 Ship Storm Door with Precision DealerE Entry Door? ❑Yes Address JOB#: Size Storm Door to fit Entry Door ordered for this Job? City ❑Front ❑Back. ❑yes ❑No State ZIP ❑Side ❑Othe STORM DOOR ORDER.FORM SELECT DOOR: QUANTITY Openings Spectrum Decorator Deluxe DuraGuard Supervlew* Lift-Assist" STANDARD SIZES: CUSTOM OPENING SIZES:* ❑291 ❑588 ❑382 ❑395 ❑374 ❑094 ❑895 ❑440 Not all ties available in all sizes. Note:Cusmm Size lim ations vary 0298 ❑589 0385 0396 0379 ❑094.G 11896 (Pet Door) see Prize List for availability. eye See Price List for mmilability. ❑590 0391 0396-V (Pet door) ❑096 ❑897 0440Medium Width: Height: 0591 0392 ❑397 ❑374 Medium ❑096-G ❑898 ❑440Large 0301j�'32" ❑36" Width: ❑593 ❑393 ❑ 98 0374 Large ❑096-GV 0899 HeI ht: BO" ❑81"t ❑ French Doors ❑595 ❑394 399 ❑379Medum ❑099 MIA inLtft-Assist" ❑596 0379 Large ALL OTHER * ❑ Brass 2"Bottom Expander* SELECT COLOR DO S SUPERVIEW LIFT-ASSIST STANDARD FEATURES SPECIFIC OPTIONS ❑ Shin Nickel 2"Bottom Expander* Snow Mist(01) Q ❑ El ❑Standard Features ❑ Expander Door ❑ Painted 2"Bottom Expander Cafe Cream(06) ❑ ❑ WA Only ❑ Eastern Z-bar PRE-HURG: ❑"Slim Line Z-bar ❑ Brass 1 Vz"Bottom Expandert Chateau(50) "IA NIA [ISati Nickel 1 V,Bottom Expandert Sandpiper Beige(03) ❑ WA ❑ ❑Non Pre-Hung ❑ Brass Piano Hinge* n Sandstone(14) El WA WA {�p�q/ry'Inge Left ❑ Satin Nickel Piano Hinge* El Painted 1yz"Bottom Expandert Sterling Gray(26) El WA WA LJ H!nge Right ❑ Painted Plano Hinge* ❑ Inswing Kit(WA on suParviewNn-AsslsU Clay(15) f Outside) (Hinge from❑ WA WA ❑ Painted Leaf Hinge ❑ Insulated Frame Geneva Blue(21) ❑ WA WA ❑ Screen(Decorator only) ❑ Reinforced Kick Panel* Forest Green(24) ❑ WA WA HANDLE PREP: ❑ Aluminum Screen Wire(WA on spectrum Mountain Berry(20) El WA NIA El Handle Prep(39"sW,) MULLION LOCATION* Rustic Bronze(44) El Elfrom bottom ❑Special Mullion Location* Tudor Brown(08) ❑ ❑ WA Coal Black(13) ❑ WA WA "from to of door to tolift of mullion HANDLESETS- SPECTRUM DECORATOR DELUXE DURAG❑UARD SUPE"HVIEW uFLwSSIST NOTE CLOSERS*: (wA closers no r Su Storm Chain and Sleeve Sierra,Bright Breast ❑rem.) ❑ ❑ ❑ WA WA Venice,Bright Breast ❑ Sierra,Satin Nickel# ElO O El WA WA El Color matched Dual(2)920 Closer Venice,Satin Nickel# ❑ El El ❑ WA WA ' - `9color matched Heavy Duty Closer* r Windsor,Brass Look ❑ ❑(Bid.) ❑ ❑ W El [IA White Dual Closers(1)Touch'N Hold'"'(1)Regular* Windsor,Satin Nickel ❑ ❑(sm.l ❑ NIAA ❑ El WA ❑ ❑Black Dual Closers(1)Touch'N Holi1TM(1)Regular' Contemporary Curve,Brass Look ❑ ❑ Contemporary Curve,Satin Nickel El El ❑ El WA El El white Heavy Duty Touch'N HoIdTM Closer* Contemporary Curve,Antique Brass❑ - ❑ ❑ ❑ WA ❑ ❑Black Heavy Duty Touch'N Hold-Closer* Contemporary Curve,Black ❑ ❑ ❑(Sm.) ❑(Sma WA ❑(sd.) Contemporary Curve,White ❑ ElElWA ❑ ` Colors,custom sizes and any Push Button,Black WA WA ❑ El WA Eloptions marked with an asterisk Push Button,White WA WA ❑ ❑ WA ❑ are not available on Superview,doors. Push.BuHon,Black(DH192) WA WA WA WA ❑ WA $ Not available on french storm or Pull Handle,Black WA WA NIA WA ❑(Sm.) WA expander door applications. Pull Handle,White WA WA WA WA ❑ WA ❑ ❑ ❑ WA ❑ f For Spectrum storm doors only. Townsend,Brass Look ❑ ❑ WA ElTownsend,Satin Nickel, ❑ ❑ ❑ Black Inswing Lever Handle NIA ❑ ❑ ❑ WA ❑ SPECIAL INSTRUCTIONS Customer x Sales Person x Order not valid unless signed. Note:Doors whose options are not specified will be built with standard features.Not all options are available on all doors.See price list for details. Rev.0623N6 s-MK-90034 5/7/2009 3:59 rn FROM: nac"nure Insurance Mack nti[e Insurance A e TO: 8,17919320460 ?AGE: 002 OF D03 ACORD CERTIFICATE OF LIABILITY INSURANCE 05/07/2009 Macke1 (SeBInsurance FAX (508)366-5202 ONIS LYANDICONFEIS ISSUED RIGHTS UPONOF CERTIFICATEINFORMATION 11 We tire Main Insurance Agency, Inc. ONLY AND CERTIFICATE NOOTEDOEUNOT AMEND. TCATE We West Main Street MOLDER. ECO ERAGE ATE DOES NOT AMEND,EIES BELOW. R ALTER THE COVERAGE AFFORDED�BV THE POLICIES BELOW. Westborough, MA O15B7-1931 - INSURERSAFFORDINGCOVERAGE NAICa IIoUsED Newpro Operating LLC Irml✓ERA Peerless Insurance Co. 24188 26 Cedar St. - IN9WER D: Woburn, MA 01801 IN"IIRERI MURERm ROOMER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW WIVE BEEN ISSUED TO WE INSURED NAMED ABOVE FOR WE POLICY PERIOD INDICATED.NO7WOHSTMOING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIIII RESPECT TO WHICH THIS CEROFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. V9a O' TWEOFWBNM ce POuc'. EA rOLICYEfPE°BNE P ICY 2% TON Lane FEKR&UMIU Y CUP 8588370 - MA POLICY 12/31/2009 12/31/2009 FA010CCIAPENQ 1 1 000 7 /� % wi 0c.M oorePa U"'U"C P 8589S77 - RI POLICY ° 1 300,00( ✓1te -l0om� + ✓�'/4�� °WMRNADE X�OCCUR NEDE%P(AgaMPNeen) 1 15 ,A A PEasronaa/ov INBAY 1 1,000,00( �'\ Board of Building Regulations and Standards oErawAGGREwn: 1 2 000 o HOME IMPROVEMENT CONTRACTOR m+L AGwEw9E UNnroPLIEa PER: - PRmDcrs-colaroPAW / 2,000.00 Regis(rettiOB,, 146889 «ucr ,°ERR L« RLIIDNONlE LM9LLT' RA 8594174 12/31/2006 12/3I/2009 CCMa,teD aINGLELIMn E`xpiratiGtt&%55/2011 oNV AVfO IEeecday 1 .. f Y .r 1,000,00 I�}.. ^10Y"�D"1f06 a«ILr wAAv F-#Tjpe Supplement Card i A x samwmAumS IP.oNY=n) - 1 - , "3i11} X waEoeuroa BODILY INJURY NEWPROOPEITtNC.LLG� 9 THOMAS FOXON � '_t PROPERTY (PneeBGMI - 26 CEDAR ST. ww9euAelLm ADrooar-FAA«IOfNr 1 w•^. WOBURN,MA 01801 Administrator 1 ruro roar. Acc 1 . E9cEeAVM9RELULwBRm CU 8582578 12/31/2008 12/31/2009 EAOn OCCLPROX£ F 5 000 00 X «CUR �¢Aeu vets ,woREwnt 1 5 000 A 1 DEnurnaE - 1 . % REIEMIOtl / 10,00 1 woRlrtRe coNPERwnoxaxo we A7u om - a1vL°vERa SOO 00 W8645974 OS/01/2009 OS/01/2010 E.L.erwxcroENr 1 _ p Am PROParc7oRRxImeR,ElEwnNE 0 O FAENPL s 500 _ OFFICE2MEMBFA EN4tAE°R EL.CISFASE- 500.00 'p nys 9wnue�nes PWCY Luur 1 I rhai �i O / ePE<YL PROVIMONS bbn E.L.gSFASE- OTTER vnM L(O ' Board ofBwl{im nd g Regulati0ns and Staards _ '`- Construction SuP ery License isCir Lice 'JF9CWPTONK°PFR1nOM91LOCATONaIVEWCLE9l EYClY910NII100EDRYfXOOREFMFNt19PEC9YPgOVIa@19 '�� _., /�. -:y LI (ei� -i 29090 i ( i JfD/2009 Tr# 8131 1 _i -ERTIFICATE HOLDER 9NmaoANYOF TNf RaowoEswmfoPaLR¢s of CANCELLEOSEFORE THE - \.,r N- . E9PvunoN wre TRRERP,THEa9uNo w9uRFRN1L ExoEAvm9ro NeR THOMASP FOXt 1 1p_wr9 wAmfNnanceroTNe cumFlwTENmoe1 N9NEnroTnE Lerr, ! 230 WAt,NU7 ST�\�� "l��_ _1y�j - I 1 Town of Saugus aurcNLwFrouuLaucNnonoE axua R:Po9E No o9ucanoxoaLWwn READING,MA01867 298 Central Street oPAM'MMp waNn+E w9uRaLm AOEM9oR RFRaE9BerATIYE6 , Commissioner i Saugus, NA ANINORIEOREnR98ENMnK ,,:, - :. , Tisurthy J. Maynagh ACORD 25(2001106) "CORD CORPORATION t888 —The Commonwealth oJ—Massacnuserrs = Department of Industrial Accidents oOffice of Investigations 600 Washington Street --`� Boston, 31A 02111 ` www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Oreanizationlndividual): NEWPP_0 Address: 2Lr CEMP_ ST City/StateZip: W0/3UQn( W 0/ 801Phonef: 781 9301- 836p ExT 5/ Are you an employer" Check the appropriate box: Type of project(required): r 4. ❑ I am a general contractor and I 1.® I am a employer with 50 6' ❑ New construction employees (full and/or part-time)." have hired the sub-contractors �.❑ I aSi a se,e propnctor or parmer- listed nu the attached sheet : Remodeling These sub-contractors have S. ❑ Demolition ship and have no employees working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers Electrical repairs or additions required.] officers have exercised their 3.❑ I a homeowner doing all work right of exemption per MGL I LE] Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 1 ).❑ Roof repairs insurance required.] + employees. [No workers' 13.❑ Other comp, insurance required.] 'Any applicant that checks box"'t must 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 most 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 polic, inforrtration. I am an employer that is providing workers'compensation insurance for my employees. Below is the polio'and job site information. �,� , _ Y Insurance Company Name: "QCk.ln+ire =nsurance enC .000J' _ Policy or Self-ins. Lic. IN G R L y 5 g 9 4 Exp ation Date: 5- 1 - Z O o Job Site Address: ua C (01- IL S t City/State/Zip: S Q e rr> IYIy 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 S 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 S250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofper'ur)-that the information provided above is tr epand correct Sinature: FOR N " P Date: 4eKo Phone r1 $ 1-q53- 8lLItp Official use only. Do not write in this area, to be completed by ch),or town official. 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 Contact Person: Phone#: ( + Qualified in W HighlightedI a =40alifled In all zones mimmmm NE:WPRO MANUFACTURING Jrraac NEWPRO 2000 DOUBLE HUNG aidCellular PVC frame,Triple glazed, Na e>Ve�On Low E coating(e=0.034,S2&5), Rdne Cdundl® Krypton/Argoh/air filled DEV.K-2T•00016-00001 - ENERGYPERFORMANCE RATINGS U-Factor(U.S.A-P) Solar Heat GainCoeffident 0.19 0.27 - -- ADDITIONAL PERFORMANCE RATINGS Visible Transmittance Alr Leakage (U.S./I P) 0.40 O.1 Condensation Resistance 70 pMiDNdu�dp rortllD ro�N�CretlnW�ara�de�bim�udmf�¢Ifiz�dutW�dM�ionme�idN�cMdd�ltlm�ienl�xfide . c eetelxq NPPC¢gqe0ee ndracammendmYpprrppdtlnnemddceenD!W°rredrNewNW01(tyy ale 'D w1�0e°IdO IroD. µµW.nlfaar CDn6nIImNNreDhlrtw Mor rofor niFlBrpNQDntpedamr>Nne 6d6[meu�n . p A The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY •! Massachusetts State Building Code, 780 CMR, 71h edition OF SALEM Revised Junra.w ^ Building Permit Application To Construct, Repair, Renovate Or Demolish a ). 2008 .�` One-or Two-Family Dwelling This Section For Official Use Only Building Permit Num r: Date Applied: Signature: 5 /0 Building Cummissioncrrrnspector of Buildings Dale SECTION 1: SITE INFORMATION 1.1 7be. K S �— 1.2 Assessors Map& Parcel Numbers I.la Is this an accepted street?yes ✓no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: -"- l)?00 F� Zoning District Proposed Use Lot Area(sq 11) Frontage(It) 1.5 Building Setbacks(R) From Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: / Zone: _ Outside Flood Zone? Public a Private❑ Check if eslsl� Municipal On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: A oR n I-10= � rf S Name(Print dress for Service: Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building Er Owner-Occupied ❑ Repairs(s) GrI Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work-: ,Q i PA) R S Q d D 1-' SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building S I. Building Permit Fee:S Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing 5 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire S Suppression) � Total All Fees: S Check No. Check Amount: Cash Amount: 6.Total Project Cost: S �, 13 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) License Number E.xpiratiun Date Name of CSL- I lolder List CSL'fype Oft below) T PC Description Address u Unrestricted(up to 35,000 Cu.Ft. R Restricted IR2 Family Dwelling Signature M Masomy Only RC Residential Roaring Covering rclephone ws Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition _ 5.2 Registered Home Improvement Contractor(HIC) I IIC Company Name or IIIC Registrant Name Registration Number Address Expiration Dale Signature 'relephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 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 1. , 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. Si mature of Owner Date SECTION 71s: OWNER'OR AUTHORIZED AGENT DECLARATION y? �-7-es 1, Ul L /1,q/ /✓E7 ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. Print N e Signature of Owner or Authorized Agent Date (Signed under the pains and penalties of 'u NOTES: I. 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 nu.1 have access to the arbitration program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and I IO.RS, respectively. 2 When substantial work is planned,provide the information below: Total floors 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"maybe substituted for"Total Project Cost" o� j CITY OF S.UL E.%vt PUBLIC PROPERTY DEPARTMENT .wrae 130 wA*d?AG W 9TIFR•SMAK VwQA00.*SWM 01970 TVA.9T8•7454S"• r•.%x.97$.74&9&* HOMEOWNER LICENSE EXEMPTION Please Ftirat Dab Job Location 6 ,9LE'^4 Home Owner Address s4�A eae n A K s T Home Owner Telephone 9 7 Present Mailing Address y�Z r5Lrl The current exemption of"Homeowners"was extended to include owner-occupied dwellings of two Units or less and to allow such homeowners to engage an individual for hire who.does not possess a licatse,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Pason(s) who owns a parcel of land on which he/she resides or intends to reside. on which time is. or is intended to be. a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, on a form acceptable to the Building Official. that he/she be responsible for all such work performed under the Building Permit The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable by laws and regulations. The undersigned "homeowner"certifies that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING INSPECTOR See other side for state code r ,\ CITY OF SALEM � PUBLIC PROPRERTY ]N DEPARTMENT -.r.u. xlrt ' xl•. u \I .1.'x I:C �%.\+I 11.�1..•lV 51'Mtl'f ��.\I I\1, fit.\+i4 I11 J I ,•.1'I'. rF1''/,ry.N4'Ji'N F.\`J:H7YJJ}78JR Construction Debris Disposal Affidavit (required I'or all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR scetion It 1.5 Debris. and the provisions of MGL c 40. S 54; Building Permit p is issued with the condition that the debris resulting from this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c I 11. S 150A. The debris will be transported by: prams uE hauled The debris will be disposed of in (name ul aci 1,1 . laddram+od'I:rc MY) /iO 0 ,joiature o0odriffil,apphcam dart Xb II tsPECFR0NA sERVICE3 a The commonwealth of Massachusetts to�� QCI 61Q ° Board of BuildingRegulations and Standards Massachusetts State Building Code, 780 CMR SALEM Revised Mar 201I Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: F;; Official(Print Name) Signature Date SECTION 1:SITE INFORMATION roperty dress: 1.2 Assessors Map&Parcel Numbers . a s this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use 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) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Check ifyes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Lo�. (Dag p SaIern MA dl�lo�- Name(Pont) City,State,ZIP No.and Street elephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ I Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': S-FCt1 p Yttr}DV }-LLIC- So10.1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $ ` _OD 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ _ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire -Suppression) $ Total All Fees:$ 6.Total Project Cost: $ Check No._Check Amount: Cash Amount:_ ❑Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Jrx wle s ©t1-5 z5 4 2$ 9 �y\�� LlcenSe Number Expiration ate Name of CSL Holder List CSL Type(see below) U No.and Street Type Description SCL LLS C))q b 1 U Unrestricted(Buildin s u to 35,000 cu.ft.) City/Town,Slat ZIP W R Restricted I&2 Famil Dwellin (/ M Maso RC Roofin Coverin WS Window and Sidin SF Solid Fuel Bunting Appliances Telephone I Insulation .. Emad address L.Orn D Demolition 5.2 Registered Home Improvement Contractor(HIC) \lIVffl± '-�;olarDevelofeY PLC. 1-70`164'9 HIC 4a3 Company Name HOIC_Rggrstraut Name HIC Registration Number E pira on Date N W No.and Street Yv\aSO ll�Lr C7 V L V IVl}SohY ProV0 In— $t{(OOq —I8"1305301v5 Email address Cy)m Ct /Town,State,ZIP Tele hone 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 ..........A No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize V IV 1✓)'f SD ICLr to act on my behalf,in all matters relative to work authorized by this building permit application. 11VIAnmal) o A 4L -- �q Pnnt Owner s Name(Electronic Signature) Date SECTION 7b:OWNEW 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 IN p ' tion is true and accurate to the best of my knowledge and understanding. V + cU-- LP-P-1-1 Print O s r rized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building petmit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will nor have access[o 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 eov/oca Information on the Construction Supervisor License can be found at www ass.sov/dos 2. When substantial work is planned,provide[he information below: Total floor area(sq.ft.) (including garage,finished basemenUattics,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" A� CERTIFICATE OF LIABILITY INSURANCE °"'�'M�°°""""' 11MI12013 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(les)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 endomement(s). PRODUCER MARSH USA INC. NAME: 122517TH STREET,SUITE 1300 PHONE FAX DENVER,CO 80202-5534 EMAIL No: Attn:Denver.certrequest®marsh.mm,Fez:212.948.4381 ADDRESS: INSURE S AFFORDING COVERAGE NAIC9 462;SiNDGAWUE-13-14 INSURER A,Evanston Insurance Company 35378 INSURED National Union Fire Insurance On of PA Vivint Solar,Inc. wsuRER a: 4931 N 300 W INSURER C:Now Hampshire Insurance Company 21141 Pmvo,UT 14114 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002368030-06 REVISION NUMBER:0 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. ILTR TYPE OF INSURANCE DL eR Po PMOUCY EFF MMIi EXP LIMITS im am UCYNUMBER A GENERAL LIABILITY 13PKGWE00274 11/01/2013 11101Y2014 1,000,000 EACH OCCURRENCE E X COMMERCIAL GENERAL UABIUTY m 50,000 P EMISES Eaorrrenre E CLAIMS-MADE MOCCUR MED EXP(Any one person) $ 5,000 PERSONAL S AM INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG E 2,000,000 X POLICY JFCT PRO- PRODUCTS a B AUTOMOBILE LIABILITY 9701087 11/0112013 11/0112014 COMBINED INGLE LIMIT g Ea accident 1,000,000 g ANY AUTO 9701098 11/0112013 11/01/2014 BODILY INJURY(Per person) S A O SCHEDULED AUTOS AUTOS BODILY INJURY(Per ecdtlerrt) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMgGE E Per acddent E A UMBRELLA LIAR X OCCUR 13EFXWE00088 1110112013 11MI/2014 EACH OCCURRENCE $ 10,000,000 X EXCESS LING CLAIMS-MADE AGGREGATE g 10,000,000 DED RETENTION$ C WORKERS COMPENSAnON 029342334; 029342335 11/0112013 11101/2014 WC STATu- $AND EMPLOYERS'LIABILITY OTH- D ANY PROPRIETOR/PARTNERIEXECUMVE YIN 029342336; 029342337 11/0112013 Ii/01/2014 E.L EACH ACCIDENT 1,000,000 C OFFICERMEMBER EXCWDEDT ❑N NIA g (Mandatory In NH) 029342338 11/01/2013 11101l2014 1,000,000 If es,describe under E.L.DISEASE-EA EMPLOYE 8 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT E 1,000,000 A Enors&Omissions& 13PKGW00029 11N1/2013 111012014 LIMIT 1,000,000 Contractors Pollution DEDUCTIBLE 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Atach ACORD 101.Addwenal Remarks Schedule,If more space Is required) e Certificate Holder and others m defined in the written agreement are included as additional insured where required by written contract with respect to General Liability.This insurance is prinwy and no' - aributory over any wasling insurance and limited to liability arising out of the operations of the named insured and where required by written contract Waiver of subrogation is applicable where required by written ntract with respect to General Liability and Workers Compensation. CERTIFICATE HOLDER CANCELLATION City of Salem 93 Washington Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Salem,NIA 01970 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Kathleen M.Pamloe ,jam , fgaolst. ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Boston, i A 02114-2017 www.mass.gov/dia `Vorkers' Compensation Insurance Affidavit. Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Marne (Business/Organization/Individual): Vivint Solar Developer, LLC Address:4931 North 300 West City/State/Zip:Provo, UT 84604 Phone#:801-704-9389 Are you an employer? Check the appropriate box: Type of project(required): l.® I am a employer with 10 4. ❑ I am a general contractor and I employees (full and/or part-time). « have hired the sub-contractors 6. ❑ New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑ Building addition cooP- [No workers' comp. insurance required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.ElI am a homeowner doing all work officers have exercised their I LEJ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] -Any applicant that checks box irl must also fill out the section below showing their workers'compensation policy information. r 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 state whether or not those entities have employees. If the sub-contractors have employees, they must provide their workers'comp.policy number. d am an employer that is providing workers'compensation insueance for my employees. Below is the policy and job site information. Insurance Company Name: New Hampshire Insurance Comany Policy# or Self-ins.(Lic. #:029342228 L Expiration Date:11-01-14 Job Site Address: I � �'1 City/State/Zip: �lp 1R , 76 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tinder 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, f do hereby cer und tftpaiqs and penalties ofperjury that the information provided above is true and correct. Signature: Date — � Phone#: 801-704-9389 Official use only. Do not write in this area, to be completed by city or town official. 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 Contact Person: Phone#: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 170848 Type: Supplement Card VIVINT SOLAR DEVELOPER LLC. Expiration: 1/5/2016 JAMES SHERMAN 4931 NORTH 300 WEST PROVO, LIT 84604 Update Address and return card.Mark reason for change. SG11 G 20M-05nl Address ❑ Renewal ❑ Employment Lost Card L/�ie Y-'anrmarnu�ea�z o�VU,.a.»f�rc�u>� WffExpiration: ice of Consumer Affairs&Business Regulation License or registration valid for individul use only NIE IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration: 170848 Type: 10 Park Plaza-Suite 5170 1/5/2016 Supplement Card Boston,MA 02116 VIVINT SOLAR DEVELOPER LLC. JAMES SHERMAN 4931 NORTH 300 WEST g i PROVO, UT 84604 Undersecretary Not valid without signature -- Massachusetts -Department of Public Safety Board of Building Regulations and Standards Cnnatruction Supcni.sor /^y License:CS-045254 F „y JAMEES R SHERMAN #� fi 815"'Pi ST t SAUGUS FIA 01906 f7Z, Expiration Commissioner 08/2812014 4911 North 100 West.Provo,UT 84604 Employer Identification No.: 80-0756438 VIV111t. solar r"Phone(Rup)404-41 vi Fax coin 765-5758 Massachusetts HIC Licrnps'e No: 170648 y - E-Mail support.c.an ntsolm.wm J 1 1 31D56 www:vivinlwlar.com AR No.: RESIDENTIAL POWER PURCHASE AGREEMENT "Phis RESIDENTIAL POWER PURCHASE AGREEMENT Ihis"Agreement")is entered into by and between VIVINT SOLAR DEVELOPER,LLC,a Delaware limited liability company("We',"Us","Out')and tie undemi cd Customer(s)("You", Faur"),as ofthe Transaction Date set forth below. Full Name rt-i n,au,co,o 1 rye.. y� Full Name rrrr,..en,cram Customer(s): A'P`vomrer: 1„Qr mil :e N,,a n U s, 0&s O.vu Telephone No.:Co$'- — E-Mail: Property Street Address: Z S Address: City,County,State,Zip: 1.SERVICES A. DESIGN AND INSTALLATION. We will design,install,service and maintain a solar photovoltaic system on Your Property,which will include all solar panels,inverters,meters,and other components(collectively,the"System"),as further described in the Customer Packet and the Work Order that We will provide to You hereafter. All material portions of the System will be installed by Our employed technicians and electricians.and not subcontractors. With Your cooperation, We will (i) design, install and connect the System in material compliance with all applicable laws; (if)complete all required inspections;anA(iii)obtain all required certifications and permits. In order to design a System that meets Your needs,You agree that We may obtain Your electrical usage history room Your electric utility(the"Ud i�")and You shall ,mrtde Us with copies of Your Utility bills as We may reasonably request. Other than the activation fee described in Section LB. n I esi ,and install the System R. ACTIVATION. You agree to pay Us a one-time activation let in the amount o $ We will interconnect the System with the Utility,and cause [he System to generate pnerg�mcasureJ in kilowatt hours ("k Wh")) (the"Factgy� Installation of the System generally takes one day and is antimpatzd to begin and be sub sltaannna ly complete between two(2)and six(6)weeks hercatter. C. OW'NERSHIP OF SYSTEM. We shall own the System as Our sole personal property. You will have no property interest in the System. D. OPERATIONS AND MAINTENANCE. We will operate and maintain the System(i)at Our sole cost and expense;(it)in good condition;and(iii)in material compliance withal]applicable laws and permits and the Utility's requirements. E. INSURANCE,. We carry commercial general liability insurance,workers'compensation insurance,and property insurance on the System. For more information concerning Our insurance,and to obtain a copy of Our certificate of insurance,please visit: www.vivmtsolareom/insurance. 2.'rF.RM,PRICE,PAYMENTS,AND FINANCIAL DISCLOSURES A. ENERGY PRICE. For all Energy produced by the System,You shot s So . per kWh(the"Energy Price"),plus applicable taxes. The Energy Price shall increase each year byy two and nine-tenths percent V, . A goo rat estimate of the System output,measured in kilowatt hours, will be pprovided to You in the Customer Pat ct. THIS AGREEMENT IS E SALE OF ENERGY BY US 1'0 YOU AND NOT FOR THE SALE OF A SOLAR ENERGY DEVICE. B. TERM. This Agreement shall be effective as of the Transaction Date and continue until the twentieth(20")anniversary of the In-Service Date(the 'Term"). The"An-Service Date"shall be the first day after all of the following have been achieved: (i)the System has been installed and is capable of generating Energy,(ii)all permits necessary to operate the System have been obtained,(iii)the System has been interconnected with the Utility,and(iv)all inspections and certificates required under applicable law or by the Utility have been completed or received. C. PAYMENTS. Bzitining with the firs[month following the In-Service Date and throughout the Tenn.We will send You an invoice refectin the charges for Energy pr need ny the System in the previous month. You shall make monthly paymrnts to Us by automatic payment deduction from Your designated checking account or credit card. It rs Your responsibility to ensure that there are adequate funds or adequate credit limit. There is no financingg charge associated with this Agreement. For all vvayymenu more than ten(10)dVs past due,We may impose a late charge equal to Twenry-Five Dollars($2�) and interest at an annual rate of ten percent(10%),plus appplicable[xzes. If You continue m fail to make any paymrnt wnhm ten(I I days after We give You written notice,then We may exercise all remedies avatlable to Us pursuant to Section 130fl. D. RENEWAL. At the end of the Term,You may elect to(i)continue with this Agreement on a year-[o-year basis,(ii)enter into a new Agreement with Us and cancel this Aggrreement;(iii)purchase the System at the end of the Term and cancel this Agreement([he"Purchase Qatfnn");or(iv)cancel this i Agreement and have[he System removed at no cost to You. You will need to notify Us in writing concerning Your election sixty(60)days prior to the end 11 of the Tenn. If You elect the Purchase Option, the Purchase Option Price"will be the then-current I"air market value of the System based on an independent appraiser's valuation of similarly sized photovoltaic systems in Your geographic region. The appmiscr s valuation will be provided to You m writing and will be binding. If' receive Yaur payment of the Purchase Option Price costs of the appraisal),applicable taxes.and all other amounts then owing and unpaid hereunder,We will transfer ownership of the System to You at the end of the Term tin an"As Is,Where Is"basis. If You elect to have the System removed,We will remove the System from Your Property within ninny(90)dayyss after the end of the Term. IF YOU DO NOT NOTIN'Y US OF YOUR ELECTION TO CANCEL BY SENDING A WRITTEN NOTICE TO US, THEN THIS AGREEMENT WILL. AUTOMATICALLY RENEW ON A YEAR-TO-YEAR BASIS UNTIL YOU NOTIFY US IN WRITING OF YOUR ELECTION TO CANCEL AT LEAST SIXTY(60) DAYS PRIOR TO THE END OF THE.RENEWAL TERM. E. CREDIT CHECK. In connection with the execution of this Agreement and at anytime during the Term,You hereby authorize Us to(i)obtain Your credit rating and repon from credit reporting ag,cnces;(m)to report Your payment pertbrroance under this Agreement to credit reporting agencies;and 1. (iii)disclose this and other information to Our af7liatea and actual or prospective lenders,financing parties,investors,insurers,and acquirers. WE MAY HAVE PRESCREENED YOUR CREDIT. PRESCREENING OF CREDIT DOES NOT IMPACT YOUR CREDIT SCORE. YOU CAN CHOOSE TO STOP RECEIVING"PRESCREENED"OFFERS OF CREDIT FROM US AND OTHER COMPANIES BY CALLING TOLL-FREE (888) 567-8688. SEE PRESCREEN & OPT-OUT NOTICE(SECTION 29)BELOW FOR MORE INFORMATION ABOUT PRESCREENED OFFERS. 3.LIMITED WARRANTY A. LIMITED INSTALLATION WARRANTY. We mo idc a workmanship warranty that the System shall be free from material defects in design and workmanship under normal gpera[ing conditions for the Term. We further warrant that all rooftop penetrations We install shall be waterttpgJhtt as ofthe date of installation. We do not providde any warranty to You with respect to any component of the Sys[era. Any manufacturer's warranty is in addition to,not m lieu of,this limited installation warranty. This warranty does not cover problems resulting from exposure to hamtfd materials and chemicals, fire, Rood, earthquake,or other acts of god.vandalism,aircraft.of system by anyone not authorized by Us,or any other cause beyond Our control. R. MANUFACTURERS' WARRANTIES. The Sysman's solar modules carry a minimum manufacturer's warranty of twenty(20)years as follows: ((a))during the Ctrs[ten(10)pears of use,the modules'electrical output will not degrade by more than ten Percent(10%)from the ongmallyy rated output;and (b)during the lust twenty(20)years of use,the modules'electrical output will not degrade by more than twenty percent(20%)-from the originally rated outptit The System's inverters cart'a minimum manufacturer's warranty often(10)years against defects or component breakdowns. During the Term,We will enforce these warranties to the fullest extent possible. C. DISCLAIMER OF WARRANTY. EXCEPT AS SET FORTH IN THIS SECTION 3, WE MAKE NO OTHER WARRANTY TO YOU OR ANY OTHER PERSON, WHETHER EXPRESS, IMPLIED OR STATUTORY, AS TO THE MERCHANTABILITY OR FITNESS FOR ANY PURPOSE OF THE EQUIPMENT, INSTALLATION, DESIGN, OPERATION, OR MAINTENANCE OF THE SYSTEM, THE PRODUCTION OR DELIVERY OF ENERGY, OR ANY OTHER ASSOCIATED SERVICE OR MATTER HEREUNDER, ALL OF WHICH WE HEREBY EXPRESSLY DISCLAIM. OUR LIABILITY FOR ANY BREACH OF ANY WARRANTY IS LIMITED TO REPAIRING THE SYSTEM OR YOUR PROPERTY TO THE EXI"ENT REQUIRED UNDER THIS AGREEMENT. YOU ACKNOWLEDGE THAT WE ARE RELYING ON THIS SECTION 3,C. AS A CONDITION AND MATERIAL INDUCEMENT TO ENTER INTO THIS AGREEMENT. THERE ARE NO WARRANTIES WHICH EXTEND BEYOND THE DESCRIPTION OF THE FACE HEREOF. 4.REMOVAL OF THE SYSTEM you shall not make any Alterations(as defined in Section 9 c to the System. If You want to make repairs or improvemenrs In Your Property that require [he temin.ury removal of[he System or that could in ere wit its performance or operation,You must hove Us a[least thirty(30)days'print wnt[en nmhce (a"L'usromer-Requested ShutAowri'). You agree the[any repau or Improvement to Your Property shall not materially alter Your roof where the System is .stalled. om rnson.n for Our removal,stooge and reinstallation of the System,You agree to ay to Us a fee equal to Four Hundred and Ninety-Nine Dutlar 499) efPre We remove the System You s),all be reymred to pay the Shutdown Payment(as defined in Sce on IS)tfthe System is no reins411cd within 0)days of removal. In the event of an emergency affecting the System,You shall contact Us tram' edia[ely. IC We are unable to vmely respond,You may(al Your awn expense)contract wnh a licensed and qualified solar installer w emove the Syslem as necessary to make repairs required by the emergency. Ynu shall be responsible for any damage to the System that results fora actions taken by Your contractor. 5.ARBITRATION OF DISPUTES Most customer concerns can be resolved quickly and amicably by calling Our customer service department at (877) 404-4129. If Our customer service department is unable to resolve Your concern,You and We agree to resolve any Dis ute(as defined below)through bindin6r arbitration or small claims court instead of courts of general jurisdiction. BY SIGNING BELOW,YOU ACKNOWLEDGE AND AGREE THAT(1)YOU ARE HEREBY WAIVING THE RIGHT TO A TRIAL BY JURY;AND(H)YOU MAY BRING CLAIMS AGAINST US ONLY IN YOUR INDIVIDUAL CAPACITY,AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING. You and We agree to arbitrate all disputes, claims and controversies arising out of or relating to ci i a. ."",•. i u .,,r,,.uc_niu_ ,;m,rrv<d. r "uv ro-rea"aa, (i)any aspect of the relationship between You and Us,whether based in contract,tort,statute or any,other legal theory;(ii)this Agreement or any other agreement concommg the subJect matter herenF, (iii) any breach, default, or termination of this Agreement; and iv)the interpretation,validity,or enforceability of this Agreement,including the delertnma[ion of the scope or applicability of this Section 5(each,a w� "Dispute")). Prior to commevcing arbitration,a Party must lirst send a written"Notice of Dispute"via certified mail to the—et�p ny. The Notice of bis'pute must desenbe the nature and basis Cot[he Dispute and the relief sought. It You and We are unable to resolve the Dispute within thirty (30) days, then either party ma commence arbitration. The arbitration shall be administered by JAMS pursuant to LLs Streamlined Arbitration Rules and Procedures�avai/ahle ar: hitpp://www.amsadr.com/mles-streamlined-arbivation,the"JAMS Rules'")and under the rules set forth in this Agreement The arbitrator shall be bound'by the terms of this Agreement. No matter the circumstances,the arbitrator shall nut award punitive,special,exemplary, indirect,or consequential damages to either pany. If You initiate arbitration You shall be responsible to ay 5250. All a[[omeyys' fees,navel expenses,and other costs of the arbitration shall be bome by You and Us in accordance with the JAMS Rules and appphcable law. The arbitration shall be conducted at a mutually agreeable location near Your Propenyy. Judgment on an arbivation award may be entered in anyy court of comyetent jurisdiction. Nothing in this Section 5 shall preclude You or We from seeking provisional remedies in aid ofarbitrat1 11 fiom a court of"competent jurisdiction. NOTICE:BY INITIALING IN THE SPACE BELOW YOU ARE AGREEING TO HAVE ANY DISPUTE ARISING OUT OF THE MATTERS INCLUDED IN THE"ARBITRATION OF DISPUTES"PROVISION DECIDED BY NEUTRAL ARBITRATION AS PROVIDED BY APPLICABLE LAW AND YOU ARE GIVING UP ANY RIGHTS YOU MIGHT POSSESS TO HAVE THE DISPUTE LITIGATED IN A COURT OR JURY TRIAL. BY INITIALING IN THE SPACE BELOW YOU ARE GIVING UP YOUR JUDICIAL RIGHTS TO DISCOVERY AND APPEAL. IF YOU REFUSE TO SUBMIT TO ARBITRATION AFTER AGREEING TO THIS PROVISION, YOU MAY BE COMPELLED TO ARBITRATE. YOUR AGREEMENT TO THIS ARBITRATION PROVISION IS VOLUNTARY. YOU HAVE READ AND UNDERSTAND THE FOREGOING AND AGREE TO SUBMIT DISPUTES ARISING OUT OF THE MATTERS INCLUDED IN THE "ARBITRATION OF DISPUTES"PROVISION TO NEUTRAL ARBITRATION. Custom.n:nna;,ls I/WE AGREE TO ARBITRATION AND WAIVE THE RIGHT TO A JURY TRIAL: 6.NOTICE TO CUSTOMERS A. LIST OF DOCUMENTS TO BE INCORPORATED INTO THE CONTRACT: (i)this Agreement,(ii)the Additional Terms and Conditions,(iii)the Customer Packet,and(iv)the Work Order. These documents are expressly incorporated into this Ag to the relationship between You and Us. reement and apply B. IT IS NOT LEGAL FOR US TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE IIf TO REMOVE GOODS INSTALLED UNDER THIS AGREEMENT, C. DO NOT SIGN THIS AGREEMENT BEFORE YOU HAVE READ ALI,OF ITS PAGES. You acknowledge that You have read and received a legible copy of this Agreement,that We have signed the Agreement and that You have read and received a legible copy of every document that We have signed during the negotiation. D. DO NOT SIGN THIS AGREEMENT IF THIS AGREEMENT CONTAINS ANY BLANK SPACES. You are entitled to a (completely filled in copy of this Agreement,signed by both You and Us)),before any work may be started. E. YOU NSACTION AT ANYTIME PRIOR THE LATER OF: DNIGHT T E RD NOTICESS DAY F CANCELL IY CANCEL THIS ON BBANSACTION ELOW OR ANAXPLAN OR ATITHE ON OFTHIS RIGHT.INSTALL AT OIN OF THE SYSTEMF THE H3EE VIVINT SOLAR DE D CUSTOMER(S): Printed Name: By: v!/ _ Printed Name: .Q- Title: S/11cbr CC2Y�k l�h� By: Printed Name: Transaction Date. rj—�'3—' FOR INFORMATION ABOUT CONTRACTOR REGISTRATION REQUIREMENTS, CONTACT TE MASSACHUSETTS OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATION: TEN PARK PLAZA,SUITE 5170,BOSTON,MA 02116, (617)973-8700 OR 888-283-3757. x-----------------------------------------------------------------------------------------------------------. NOTICE OF CANCELLATION Transaction Date: AR No.: YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE(3)BUSINESS DAYS OF THE ABOVE DATE, OR (IF LATER) UNTIL THE START OF INSTALLATION OF THE SYSTEM. IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST 'THE SELLER AT ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCELAS GOOD ,YOU MUST MAKE AVAILABLE TO DELIVERED TO YOUBUNDERENCE TH S CONTRACTTIALLY OR SALE, OR Y UO MAY, IFNDITION YOU AS W SH,ECEIVE COMPLYANY W TH THDS E INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK_'HEM UP WITHIN TWENTY(20)DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION,YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FUR_'HER OBLIGA"PION. IF YOU FAIL TO MAKE Tk1E GOODS AVAILABLE TO THF,SELLER,OR IF YOU AGREE TO RE_'URN 'fHE GO011S TO THE SELLER AND FAIL TO DO SO, THEN YOU MAIN LIABLF, FUR PERFORMANCE OF ALL OBLIGA"PIONS UNDER THE CONTRACT. to CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM,TO VIVINT SULet DEVELOPER,LLC,AT 493I N'3W W,PROVQ U"f 84604 PRIOR TO THE LATER OF: Q)MIDNIGHT OF THE THHit/ 3 )BUSINESS DAY AFTER THF. TRANSACTION DATk:,OR(H)THE START OF INSTALLATION OF THF.SYSTEM. I HEREBY CANCEL THIS TRANSACTION: Date: Customer's Signature: t I i I I (:up:pi�ln^'.:'ul]Vie n;rir'ur l4-.011—LLC."I Po5TS Nwarsl �I nR!II=Yl:'i YIM1 I„�ivi U 42 Clark St, Salem MA 01970 0 Fn W NQJ Jz OEr . eve .0 JUNCTION BOX ATTACHED TO 0) Q ARRAY USING ZEP ZS-GAB TO M PV INTERCONNECTION POINT, KEEP JUNCTION BOX OFF ROOF I r I LOCKABLE DISCONNECT SWITCH, _ 1 ANSI METER LOCATION, &UTILITY METER LOCATION I PV SYSTEM SIZE: I 45'OFI-PVC CONDUIT I /irVe FROM JUNCTION BOX TO ELEC PANEL 5.61 kW DC o ' I � � I I I � � o I •0 � I J � oa (22)Tnna Solar TSM-255 PA05.18 MODULES WITH A I w ¢ p Q Enphase M215-80-2L1_-S2x-ZC MICRO- w INVERTER I z m t N MOUNTED ON THE BACK OF EACH MODULE _———————————_— ——_— — _— —J z D w � � z m z Q Q Mw 3 N N Q p � z Ew O SHEET NAME: Q � J d f SHEET NUMBER: PV SYSTEM SITE PLAN SCALE: 3/32"= V-0" > d �m $z �0 ' m a A u A C m 2 G) m y N o� 0n DOA CC Iy mx 9 2 a m AA� 0 0 Wz n C NB U! D r Cosm m Co .0 �< m gA 0n rC mr O X V'� Oro O n r D Z Ci >Z INSTALLER:VIVINTSOLAR . . Gagne Residence P\/ OO py ROOF nyMALACENSE'MAHC7 70848404 47 28 VjVon�. solar SalemCMA01[970 V L PLAN DRAWN BY:Laura 4 AR 3142332 Lasi Motlifed'.5/23/2014 UTILITY ACCOUNT NUMBER'3824325003 U N MOUNTING PV3.0 DETAIL NNom LEVELING FOOT RSLF M10'0.18nt'STAINLE55 vU�Z STEELMB:TOROUE=1fi11 flVps, /Ila EZ COMP MOUNT RS-CMA) W fop WASHER PACKAGED U PV MODULE,TVP.MOUNT WATERPROWINGSEPIA T WITH COME MOUNT Q TO RAFTERS OF COMP. AS NEFDED SHINGLE ROOF,PARALLEL WITH PLANE OF ROOF a` PV ARRAY TYP. ELEVATION 5MBOx 41 IT MINIMUM STAINLESS STEEL LAG SCREW NOT TO SCALE c TDRDUE=LJ THIW, m 'O V. (LEVELING FOOT ON COMP MOUNT PERMITTED LEVELING FOOT SPACING NOT TO SCALE n •c=s n •LEVELING FOOT(ZSiFB) c ICI FR WI GBELOW SHOWN J r DASHEOFORCLPRITY II ZEP COMPATIBLE d n PM MODULE HYBRID INTERLOCK a m < ^ e m FE O I I I I I I I N � UQ I I I I I FW CAN SIT E0.=L/J L=PERMITTED SPACING Z Q E OR LE55 SEE CODE COMPLIANCE LEITER FOR ALLOWABLESPACING > 70 N PHOTOMOLTAIG MODULE Z J J UD w I I I I I jm I I SHEET INTE FLOCK HYBRID INTERLOCK LEveuNG FGor(zupB) NAME: ROOF FRAMING LEVELING FOIOT(ZSLFR) H" co I 0 Q INTERLOCK RS')LBJ �l PERMITTED LEVELING FOOT SPACING PV SYSTEM MOUNT DETAIL SHEET NUMBER: MODULES IN PORTRAIT/LANDSCAPE SCALE:318-=1'-0- NOT;TO SCALE 1 O C'7 InveneF Ratings(Guide Section 4) Invader Manada Nel empress M21 Sas 21 Zc O Conduit and Conductor Schedule MODULE DETAIL Max oC Vol RoMA 4s V.IR Tag Gpo-ipuon wo-a Gangs pdcmneunBa cmneunTrye cmeuil siae Maa Puwar®4o•c 21s Wana Nominal AC VdlaAa 260 Volts t Enpraae engage caEle-THWNd IIPWG 4 RM Free Air N/q-Errs Air Trine Solar TSM-255 PAo5.iB Maa AC Cnrtanl 1 Bere Copper Ground EGCIGELI 6PWG t N/A-FreB Air N/P-'s;XCp SOLAR MODULE Max ocpo Rming 20 AmpB 2 THwrv-2 mwe V 6 PVL 0'-1' 2 THWN-2-Groune 9gWG 1 PVC p'-t• /ICE < Max NumEer of PanelLCircuil iT 3 iHWN�2 ¢qWG g PVL n' • xy an an 1 THAN-2-Gmune IIPWG , PJC 0'-1' on NOTES FOR INVERTER CIRCUITS IGu'tle SeNon a and 91' � orof 1.)IF UTILITY REQUIRES A VISIBLE-BREAK SW ITCH,DOES THIS N ad SWITCH MEET THE REQUIREMENTS? PV Module Ratings @ STC(Guide Section 5) t ¢j EOphase M215-fi0.2LL-S2JED YES NO XNA Model MekelModal Tnna Solar TSM-255 PA05.10 MICRO-INVERTER AT Max Power-Point currem gmp) 8.36 Amps �a.Z EACH MODULE,ATTACH2.)IF GENERATION METER REQUIRED.DOES THIS METER Max Power-Point Voltage(Vmp) 3D.5 Volts WITH ZEP HARDWARESOCKET MEYES hETT THE NEAQUIREMENTS? open-Cil voltage(Von) 3).] Volts C U Short-Circuit Current ter) 6.92 Amps ¢) 3.)SIZE PHOTOVOLTAIC POWER SOURCE(DC)CONDUCTORS Max Sense Fuse(Oni 15 Amps F co BASED ON MAX CURRENT ON NEC 69053 SIGN OR OCPO Nominal Maximum Poweral STo(Pmax) 255 Watb RATING AT DISCONNECT. Maximum System Voltage tOg611ECy60D(UL) j 4.)SIZE INVERTER OUTPUT(AC)CONDUCTORS ACCORDING Voc Temperature Coemm and M CROINVERTER CONNECTIOTO INVERTER OCPD AMPERE RATING(Sea Guide Sadian 9)TO ENGAGE TRUNK CABL5.)TOTALOF 2 INVERTER OCPDs).OrvE FOR EACH NOTES FOR ARRAY CIRCUIT WIRING(Gu'tle Secllo 8 d 0PV CIRCUIT.DOES TOTAL SUPPLY BREAKERS COMPLY WITH 120%BUSBAR EXCEPTION IN i3 Lowest expelled ambient temperature basetl on ASHRAE minimum mean extreme NEC69064(B)(2)(a)? XYES NO tlry bulb temperaturefor ASHRAE location most similar to installation looagon' -09°C$I n3 $ ) 2.1 Highest continuous ambient temperature basetl on ASHRAE highest month 2%dry bulbR6 BARE IN GROUNDg (See Guide Section 7 O (GROUNDING ARRAY) temperature for ASHRAE location most similar to Installation Idcatlon: 39°C Sign for inverter OCPD and AC Disconnect: 3.)2005 ASHRAE fundamentals 2%design temperatures do not exceed 47°C in the Solar PV$ stem AC Point of Connection United States(Palm Springs,CA is 44.1°C),For less than 9 current-carrying conductors Y roof-mounted sunlit Condait at least 0.5'above roof and using the outdoor design AC Output Current 19.000000 Ampa temperature of 47°C or less(all of United States). Nominal AC Voltage 240 Volts ri 12 AWG,90°C conductors are generally acceptable for modules with lsc of 7,60 Amps �e THIS PANEL FED BY MULTIPLE-SOURCES or less when prompted by a 12-Amp or smaller fuse. (UTILITY AND SOLAR) ba 10 AWE.90°C conductors are generally acceptable for modules wild led of 9.6 Amps ry or less when prompted b a 1 5I%rdp or arl fuse. �L n 404 PV CIRCUIT 1: 10 MODULESIPARALLEL ENVOY BOX do ^ g m `"' POINT OF DELIVERY ad AND INTERCONNECTION o m ea m G U ¢ - HOUSE EXTERIOR c ad a E— VISIBLE/LOCKABLE > no I COMBINER SREC/ANSI 'KNIFE'A/C m PV CIRCUIT 2: 12 MODULES/PARALLEL PANEL METER DISCONNECT ad to z m 15A EXISTING ENTRANCEU 1 CONDUCTORS ¢ Q 1 15q O RATED:100A i i o - E 1.0 15A M SUPPLY-SIDE SHEET SOLAR TAP NAME: c NEC 705.12(A) C _ ___ _ __ _______ PANEL00A Z 2'_______ __ PANEL VisionMetenng Siemens I Q I 2 3 V25-25 3 !l LNF222R 3 LTO O EXISTING JUNCTION BOX TER O 5 WITH I REVERSIBLE E 1.0 E 1.0 E 1.0 FUSED V E 1.0 NUMBER: GROUND SPLICE NEMA3 � O NOTE:NEUTRAL CONDUCTOR(S)OMITTED FOR CLARITY NEC 2011 Compliant ar ALL INVERTER OUTPUT CIRCUITS WILL HAVE A NEUTRAL CONDUCTOR Lll Vivint Solar - PV Solar Rooftop System Permit Submittal 1. Project Information Project Name: Lorraine Gagne Project Address: 42 Clark St,Salem MA A.System Description: The array consists of a 5.61 kW DC roof-mounted Photovoltaic power system operating in parallel with the utility grid.There are(22) 255-watt modules and(22)215-watt micro-inverters,mounted on the back of each PV module.The array includes(2)PV circuit(s).The array is mounted to the roof using the engineered racking solution from Zep Solar. B.Site Design Temperature: (From Boston Logan INT'L ARPT weather station) Average low temperature: -21.1 °C (-5.98°F) Average high temperature: 38.4°C (101.12°F) C. Minimum Design Loads: Ground Snow Load: 40 psf (State Board BR&S) Design Wind Speed: 100 mph (State Board BR&S) 2.Structural Review of PV Array Mounting System: A.System Description: 1.Roof type: Comp.Shingle 2.Method and type of weatherproofing roof penetrations: Flashing B. Mounting System Information: 1.Mounting system is an engineered product designed to mount PV modules 2.For manufactured mounting systems,following information applies: a.Mounting System Manufactures Zep Solar b.Product Name: ZS Comp c.Total Weight of PV Modules and mounting hardware: 1034 Ibs d.Total number of attachment points: 41 e.Weight per attachment point: 25.21 Ibs/square toot f.Maximum spacing between attachment points: * See attached engineering talcs g.Total surface area of PV array: 387.42 square feet h.Array pounds per square foot: 2.66 Ibs/square foot i.Distributed weight of PV array on roof sections: -Roof section l: (22)modules,(41)attachments 25.21 pounds per square foot viv6nt. solar 3. Electrical Components: A. Module (UL 1703 Listed) Qty Trina TSM 255-PA05.18 22 modules Modulc Specs Pmax-nominal maximum power at STC - 255 watts Vmp-rated voltage at maximum power - 305 volts Voc-rated open-circuit voltage - 37.7 volts Imp-rated current at maximum power - 8.36 amps Ise-rate short circuit current - 8.92 amps B. Inverter (UL 1741 listed) Qty Enphasc M215-60-2LL-S22 22 inverters Inverter Specs 1. Input Data (DC in) Recommended input power(DC) - 260 watts Max.input DC Voltage - 45 volts Peak power tracking voltage - 22V-36V Min./Max,start voltage - 22V/45V Max.DC short circuit current - 15 amps Max.input current - 105 amps 2. Output Data (AC Out) Max.output power - 215 watts Nominal output current - 0.9 amps Nominal voltage - 240 volts Max.units per PV circuit - 17 micro-inverters Max.OCPD rating - 20 amp circuit breaker C.System Configuration Number of PV circuits 2 PV circuit 1 - 10 modules/inverters (15)amp breaker PV circuit 2 - 12 modules/inverters (15) amp breaker vivint. solar D. Electrical Calculations 1.PV Circuit current PV circuit nominal current 9 amps Continuous current adjustment factor 125% 2011 NEC Article 705.60(R) PV circuit continuous current rating 11.25 amps 2.Overcurrent protection device rating PV circuit continuous current rating 11.25 amps Next standard size fuse/breaker to protect conductors 15 amp breaker Use 15 amo AC rated fuse or breaker 3.Conductor conditions of use adjustment(conductor ampacity derate) a.Temperature adder Average high temperature 38.4°C (101.12°F) Conduit is installed I"above the roof surface Add 22°C to ambient 2011 NEC Table 310.15(B)(3)(c) Adjusted maximum ambient temperature 60.4°C (140.72°F) b.PV Circuit current adjustment for new ambient temperature Derate factor for 60.4°C (140.72°F) 71% 2011 NEC Table 310.15(B)(2)(a) Adjusted PV circuit continuous current 15.8 amps c.PV Circuit current adjustment for conduit fill Number of current-carrying conductors 6 conductors Conduit fill derate factor 80% 2011 NEC Tablc 310.15(13)(3)(a) Final Adjusted PV circuit continuous current 19.8 amps Total derated ampacity for PV circuit 19.8 amps Conductors(tag2 on Mine)must be rated for a minimum of 19.8 amps THWN-2(90°C)#14AWG conductor is rated for 25 amps (Use#14AWG or larger) 2011 NEC Tablc 310.15(B)(16) 4.Voltage drop(keep below 3%total) 2 parts, 1.Voltage drop across longest PV circuit micro-inverters (from modules to j-box) 2.Voltage drop across AC conductors (from j-box to point of interconnection) 1.bfireo-inverter voltage drop: 0 48% The largest number of micro-inverters in a row in the entire array is 10 inCircuit 1.According to manufacturers specifications this equals a voltage drop of 0.48%. 2.AC conductor voltage drop: =I x R x D (-240 x 100 to convert to percent) _ (Nominal current of largest circuit)x (Resistance of#14AWG copper)x(Total wire run) = (Circuit 2 nominal current is 10.8 amps)x(0.00319Q) x(90) -(240 volts)x(100) 1.29% Total system voltage drop: 1.77% vivint.solar ZepSolar Engineering Calculations 3142332 land Project Designer Name: Ryan Salmon Street Address: Email: rsalmon@vivintsolar.com Suite/PO#: Phone: City, State, Zip: 84604 Country: United States Customer Information Name: Street Address: 42 Clark St Email: Suite/PO#: Phone: City, State, Zip: Salem, Massachusetts 01970 Country: United States System Details Module Manufacturer: Trina Solar Mounting System Manufacturer: Zep Solar PV Module Model: TSM-250-PA05.18 Mounting System Type: ZS Comp Quantity of PV Modules: 12 Roof type: Composition Shingle Array Size (kW): 3.000 Attachment Type: Comp Mount, Type C Module-level electronics: Enphase Energy M215-Z Zep Solar, LLC. www.zepsolar.com i 2014-05-23 12:50 UTC Page 1 of 4 ZepSolar Engineering Calculations Design Variables Description (Symbol) Value Unit Module Orientation Landscape Module Weight 44.8 Ibs Average Roof Height (h) 25.0 ft Least Horizontal Dimension (Ihd) 15.5 ft Edge and Corner Dimension "a" 3.0 ft Roof Slope (8) 22.0 deg Rafter/Truss spacing 16.0 in Rafter/Truss dimension Min. nominal framing member depth of 4" Basic Wind Speed (V) 110 mph Exposure Category B Ground Snow Load (Pg) 40 psf Risk Category 11 Topographic Factor (K,j 1.0 Thermal Factor for Snow Load (Ct) 1.2 Exposure Factor for Snow Load (C.) 0.9 Effective Wind Area 10 ft2 Zep Solar, LLC. www.zepsolar.com 1 2014-05-23 12:50 UTC Page 2 of 4 ZepSolar Engineering Calculations Snow Load Calculations Using calculation procedure of ASCE 7-10 Chapter 7 Description (Symbol) Interior Edge Corner Unit Flat Roof Snow Load (Pf) 30.2 30.2 30.2 psf Slope Factor (C,) 0.9 0.9 0.9 Roof Snow Load 26.4 26.4 26.4 psf Wind Pressure Calculations Using simplified procedure of ASCE 7-10 Chapter 27 Description (Symbol) Interior Edge Corner Unit Net Design Wind Pressure uplift (P ,00 p) -19.9 -34.7 -51.3 psf Net Design Wind Pressure downforce (PnetNdown) 12.5 12.5 12.5 psf Adjustment Factor for Height and Exposure 1.0 1.0 11.0 Category (a) Design Wind Pressure uplift (W p) -19.9 -34.7 -51.3 psf Design Wind Pressure downforce (Wdown) 16.0 16.0 16.0 psf ASD Load Combinations Using calculation procedure of ASCE 7-10 Section 2.4 Description (Symbol) Interior Edge Corner Unit Dead Load (D) 2.5 2.5 2.5 psf Snow Load (S) 24.5 24.5 24.5 psf Load Combination 1 (D+0.75*(0.6*Wdpw,)+0.75*S) 26.6 26.6 26.6 psf Load Combination 2 (D+0.6*WdowJ 12.0 12.0 12.0 psf Load Combination 3 (D+5) 25.0 25.0 25.0 psf Uplift Design Load (0.6*D+0.6*W p) -10.5 -19.4 -29.4 psf Maximum Absolute Design Load (P,,,) 26.6 26.6 26.6 psf Zep Solar, LLC. www.zepsolar.com 1 2014-05-23 12:50 UTC Page 3 of 4 ZepSolar Engineering Calculations Spacing Calculations Description (Symbol) Interior Edge Corner Unit Max allowable spacing between attachments 72.0 72.0 67.0 in User selected spacing between attachments given 64.0 64.0 64.0 in a rafter/truss spacing of 16.0 in Max cantilever from attachments to perimeter of 24.0 24.0 22.0 in PV array Distributed and Point Load Calculations In conformance with Solar ABC's Expedited Permit Process for PV System (EPP) Description (Symbol) Value Unit Weight of Modules 537.6 Ibs Weight of Mounting System 49.8 Ibs Total System Weight 587.4 Ibs Total Array Area 211.36 ftz Distributed Weight 2.78 psf Total Number of Attachments 21 Weight per Attachment Point 27.97 psf Zep Solar, LLC. www.zepsolar.com i 2014-05-23 12:50 UTC Page 4 of 4 ZepSolar Engineering Calculations 3142332 port Project Designer Name: Ryan Salmon Street Address: Email: rsalmon@vivintsolar.com Suite/PO#: Phone: City, State, Zip: 84604 Country: United States Customer Information Name: Street Address: 42 Clark St Email: Suite/PO#: Phone: City, State, Zip: Salem, Massachusetts 01970 Country: United States System Details Module Manufacturer: Trina Solar Mounting System Manufacturer: Zep Solar PV Module Model: TSM-250-PA05.18 Mounting System Type: ZS Comp Quantity of PV Modules: 10 Roof type: Composition Shingle Array Size (kW): 2.500 Attachment Type: Comp Mount, Type C Module-level electronics: Enphase Energy M215-Z Zep Solar, LLC.www.zepsolar.com i 2014-05-23 12:52 UTC Page 1 of 4 ZepSolar Engineering Calculations Design Variables Description (Symbol) Value Unit Module Orientation Portrait Module Weight 44.8 Ibs Average Roof Height (h) 25.0 ft Least Horizontal Dimension (Ihd) 15.5 ft Edge and Corner Dimension "a" 3.0 ft Roof Slope (0) 22.0 deg Rafter/Truss spacing 16.0 in Rafter/Truss dimension Min. nominal framing member depth of 4" Basic Wind Speed (V) 110 mph Exposure Category B Ground Snow Load (P9) 40 psf Risk Category II Topographic Factor (K,,) 1.0 Thermal Factor for Snow Load (Cj 1.2 Exposure Factor for Snow Load (C.) 0.9 Effective Wind Area 10 ftz Zep Solar, LLC. www.zepsolar.com 1 2014-05-23 12:52 UTC Page 2 of 4 ZepSolar Engineering Calculations Snow Load Calculations Using calculation procedure of ASCE 7-10 Chapter 7 Description (Symbol) Interior Edge Corner Unit Flat Roof Snow Load (Pf) 30.2 30.2 30.2 psf slope Factor (Cs) 0.9 0.9 0.9 Roof Snow Load 26.4 26.4 26.4 psf Wind Pressure Calculations Using simplified procedure of ASCE 7-10 Chapter 27 Description (Symbol) Interior Edge Corner Unit Net Design Wind Pressure uplift (Pne130 ,) -19.9 -34.7 -51.3 psf Net Design Wind Pressure downforce (P ef3o down) 12.5 12.5 12.5 psf Adjustment Factor for Height and Exposure 1.0 1.0 1.0 Category (A) Design Wind Pressure uplift (W p) -19.9 -34.7 -51.3 psf Design Wind Pressure downforce (Wdown) 16.0 16.0 16.0 psf ASD Load Combinations Using calculation procedure of ASCE 7-10 Section 2.4 Description (Symbol) Interior Edge Corner Unit Dead Load (D) 2.5 2.5 2.5 psf Snow Load (S) 24.5 24.5 24.5 psf Load Combination 1 (D+0.75*(0.6*Wd,wn)+0.75*S) 26.6 26.6 26.6 psf Load Combination 2 (D+0.6*Wdown) 12.0 12.0 12.0 psf Load Combination 3 (D+5) 25.0 25.0 25.0 psf Uplift Design Load (0.6*D+0.6*W,,) -10.5 -19.4 -29.4 psf Maximum Absolute Design Load (P.,J 26.6 26.6 26.6 psf Zep Solar, LLC. www.zepsolar.com i 2014-05-23 12:52 UTC Page 3 of 4 ZepSolar Engineering Calculations Spacing Calculations Description (Symbol) Interior Edge Corner Unit Max allowable spacing between attachments 63.0 63.0 49.0 in User selected spacing between attachments given 48.0 48.0 48.0 in a rafter/truss spacing of 16.0 in Max cantilever from attachments to perimeter of 21.0 21.0 16.0 in PV array Distributed and Point Load Calculations In conformance with Solar ABC's Expedited Permit Process for PV System (EPP) Description (Symbol) Value Unit Weight of Modules 448.0 ibs Weight of Mounting System 48.06 Ibs Total System Weight 496.06 Ibs Total Array Area 176.13 ft2 Distributed Weight 2.82 psf Total Number of Attachments 20 Weight per Attachment Point 24.8 psf Zep Solar, LLC. www.zepsolar.com 1 2014-05-23 12:52 UTC Page 4 of 4 1I:111I6itN"ST13Ef gEG-A 0 APPROVED 8Y T+IE .1NSPZCTDR PRWR TD A PERMIT BEING GRANTED \ CITY OF SALEM No. � Data ward �. Zoning District Is Property Located in Laing of �t I the Historic District? Yes No � Is Property Located In the Conservation Area? Yes No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Rgroof, Install Siding, Construc Deck Shed, ool, Repai eplact�; Other: PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name Address & Phone �^! ��[�� (f l� -2 ��—I�07 Architect's Name Address & Phone Mechanics Name Address & Phone ' What Is the purpose of building? J �/ Material of building? /.Q-)"Co— If a dwelling,for how many families? Will building conform to law? Asbestos? Estimated cost 00000,Cn ttv License# State k 6me Improver eat (l'U rc. e S,)' ature of Applican SIGNED UNDER THE PENA TY OF PERJURY DESCRIPTION OF WORK TO BE DONE MAIL PERMIT TO: r No. APPLICATION FOR PERMIT TO LOCATION loZ (r/k - (4yzvl PERMIT GRANTED 19 APPR'OV�D INSPECTOR'OF BUILDINGS PUBLIC PROPERTY DEPARTMENT -J20 WA5H1"aTON STREET, aRDFLDOR SALEM,MA 01970 TEL (976)74"595 EnT.360 U* FAX (976) 740.9646 STANLEY J. UsOvIC7, JR., MAYOR DISPOSAL OF DEBRIS AFFIDAVIT In accordance with the provisions of MOL c 40,S34,I acknowledge that as a condition of Building Permit 0 .all debris resulting fiom the construction activity governed by this Building Permit Shag be disposed of in a pmpely licensed solid.wade disposal facility,as defined by MGL OM S150A. The debris will be disposed of at Location ofFacility ignanue of P Date FULLY complete the following info>mation. (PLEASE PRW CLBARLY) Name of Permit Applicant Firm Nme if , any Address,City&State The above Statute requires that debris from the demolition,renovation,rehab or other alteration of building or stiucWm be disposed in a properly-licensed solid-wade disposal facility as defined by M(Z cIII, S 150A, and the building permits or licenses sre to indicate the location of the facility. CITY OF SAIEM BUIIDING DEPARTMENT HOMbOWNER LICENSE E)MOMON Picric Prig • DAlE a a - IOBlACATION ADDRESd TELEPHOW PRESENT MAILING ADDRESS The emrefd.exempdon of-honeownas-was emcsded to include wroeroccupied dweMip a(TWO Unit;a Ica and to allow suck homcvwnas to engage an individual foes bite who does not paaaes a license,.pruyWcd t mthe owner act as supervboa DEFINMON OFHOMEOWHIM' Pcnm(s)wbo owns a pwvd of land on which hclshe resides of intends to reside,on whkblb=kkor aa inmrded to be,a one so two family dwelling hed atrucnaea se"anadhcd of detodmy t trotbe amb ae A ed farm suucnmt A pcnon who cormrmw uwm than one home in a twc-y period Offidal.on a form a�bk to*A a union• M Such-horr04 be r' �b��sll such work paWrtmod mda the��g p� Building Official,that krJahe be resporasa . The undersigned-bov=wnef-assmnes Tcgm Lability for compliarhee with the Stan Building Code trail otha applicable goes by-lane,rules and Teguls>ions• ccrufia that he/she undaaaards the City of Satan Building Dcpa v=K. The ta,dcnigrard-hovheowstet" mu and thhat Nsht wiU faply will►said psooedma tmd minimwn becclion proczdmes rod req ' rwuirzaac HOMEOWNER'S SIGMA APPROVAL OF B=ING INSPECTOR I � Sec otha side for state code HOMEOWNER'S EXEMPTION The co&sutes that: 'any homeowner performing work for which a binding permit is=egaired sball be cscmpt from the prrnisions of Ibis sccdoa (SCClion 10?.LI-IUceosiag of Coaatruetion Sipervbars) Provided tbat is a homecomcr engages a person(s)for hire to do.such work tbat such homwwaet shall art as supa . Marry homeowners who use this exemption arc i rawanc that they are asmudme the uspommudes da sipwovbor (see Appcodis Q,Rules and Regulations for Liecosing Coostruclkm Supervisors,Seed. at .2.24 This lock of awareness oftern nsilu in serious problems,pardeularl)r w'heu the bomeowm bbaa unlicensed persoac In Ibis Case your Board cannot proceed against the wXccnsed person sa it weadd sAd lictund Sipcnisor. TTe bomeoetser&ding as wptnisor d ehimatcl rca�oo;ibN, To ctuure that the homeowner Is fully aware of M%cr msponsibi8tles mmry eommtaddes regoK m pnl of the pcmnii applic2doq that the homeowner ccnnify that he/she understands the tesponsibilid"era suptnim. You may care to ar end and adopt sui b a form/Ccnif=d=for tee in year cwmm®ip, 42 CLARK STREET ....:. •.. -:.n':'f ._. d_... ti a's''+r3r yv.?.: .IF:A'-T•H: 4n. �.J�'iSl•&Y• rYa`A4.i A N1(I Tyry' �0� CERTIFICATE ISSUED DATE 6/9/93 . I' CITY OF SALEM SALEM. MASSACHUSETTS 01970 BUILDING PERMIT - a•Ec CERTIFICATE OF OCCUPANCY DATE act. 150 19- 92 PERMIT NO. 472-92 Ralon alvo APPLICANT ADDRESS LRVTT'' IND.) LL•� ISTRC[TI IC>UTxLI N'3 EIC[NS[� PERMIT TO ��.+.w.l l� f' � 2 LNiA:uill....N NUMBER OF CNE 1_1 STORY DWELLING UNITS 11./[ OF IM f.OVt.E.I. x0, IVYOrOStO USE, AT ILOCATIONI 42 C.7UVW STY if _'Tm 3 ZONI—DISTNGcTF.-Z IxO.I )STREET) BETWEEN AND (CROSS STREET) ICR033 STREET, LOT SUBDIVISION LOT BLOCK S12E BUILDING IS 'O BE FT, WIDE P.• FT. LONG BV FT, IN MEIDNT AND SMALL CONFORM IN CONSTRUCTION TO TYPE USE GROJP BASEMENT WALLS OR FOUNOATiON ITIIEI tRzm'.A yn.To my' oza; ik` my4..dT ur. 36'y26E :95E REMARKS: CALL I�OR p!IUP L`i O CX.CUPY 745-5595 - ($$(-S'��J�]]�I�(E�� gElI 015 AREA � EAI mWE _ VOLUMEE L.S16 SOWRE FEET) ''� '1E' "S2 :;a�$O orrlAs4rlsR�Es.+arnoeY(srr(A+vlodlvcrloennvlsrrl FrcvsrravlAs nwNER TO BE GGOS,TED.ON PREMISES I�.V =ox ii�5r ,:.�1s�Y?tr+'sT9 SEE REVERS611W 06CONDJ3$E�OF CERTIFICATE ADDRESS - John J. Jennings vS ISTr1dI ASSISTANT BUILDING INSPECTOR EM II CERTIFICATE ISSUED DATE 6/9/93 . CITY OF SALEM " SALEM. MASSACHUSETTS 01970 BUILDING PERMIT - a46Bm„ CERTIFICATE OF nOCCUPANCY DATE �" j5, 19 `32 PERMIT NO. 478-9G APPLICANT Ralph vaTHU ADOPESS ` alc 5,.1T , (( INO.I yy (STREET) ��iiICUXIR•S CIC[Xf[I PERMIT TO ERECT- 11!Iyu1I1z I 21 STORY oKuz.tl`U NUMBER OF f2NE OW , LING UNITS (IIFE 01 IMRROVEu(NTI 4pooposco USE, �L C12W STRF WAR[) S ZONING [�j AT (LOCATION) 0ISTR ICT— INC.) (STR((ll BETWEEN AND ICR016 STAEFI) ICRO]] ]1REET1 LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TD BE FT, WIDE F..I FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OP FOUNDATION_ ITIRE) rStRF� F1 'dVJO. STORY, xIE TANGLY LX+IL"'.0 G 36'X2o'_s45' REMAP KS'. CAT;, i oR P: jOf ZO O� ;��—h595 VKSsu( AREAOa �� VOLUME 4.81E 50V/R( IF Ct) )�wtherma ;:aleu seFlsF]m-Elv.-E.eTnly rll v]+Iv�mdlve•II–.•vvm TnlsTmis..mmv OWNER -'`tel ila7 1 uu TO BE P.OSSEO.ON PREMISES �.0 1:o}. irOJF Saltmw-IA SEE REVERSVI16mos CON O 1 >Oi CERTIFICATE ADDRESS - John J. Jennings 3S 3ISTt1-;I' ASSISTANT BUILDING INSPEC'T'OR vz' - -- DATE OF PERMIT PERMIT No. OWNER ( LOCATION Ralph Salvo 42 Clark St. R-1 STRUCTURE MATERIAL DIMENSIONS No.OF STORIES No.OF FAMILIES WAIID COST DWELLING NOOD FRAME 26'X36'X45' 2 I 1 13 $74,000.00 BUILDER Customized Structures, Inc. Claremont, N.H, BOARD OF APPEAL: 10/16/91 - Variance GRANTED - from frontage to allow construction of a single family dwelling. 10/15/92 #478-92 ERECT A TWO STORY, ONE FAMILY DWELLING 36'X26'X45' cost $74,000. fee $449. D.H. 6/9/93 #478-92 CERTIFICATE OF OCCUPANCY ISSUED BY JOHN J. JENNINGS (Cit" of ttlrm, � ttsstttliusetts r l DECISION ON THE PETITION OF RALPH SALVO FOR VARIANCES AT 40 AND 42 CLARK STREET ; (R-2) A hearing on this petition was held October 16, 1991 with the following Board Members present: Richard Bencal,Chairman; Joseph Correnti, Richard Febonio,Mary Jane Stirgwolt and Associate Member Ronald Plante. Notice of the hearing was sent to abutters and others and notices o the hearing were properly published in the Salem Evening News in accordance with Massachusetts General Laws Chapter 40A. Petitioner, owner of the property, is requesting Variances from frontage to allow a single family dwelling to be built on 40 Clark St . and a single family dwelling to be built on 42 Clark St. Property is located in a single family district. The Variances which have been requested may be granted upon a finding of the the Board that: 1. Special conditions and circumstances exist which especially affect the land, building or structure involved and which are not generally affecting other lands, buildings or structures in the same district. 2. Literal enforcement of the provisions of the Zoning Ordinance would involve substantial hardship, financial or otherwise, to the petitioner. 3 . Desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent ofthe district or the purpose of the Ordinance. The Board of Appeal, after careful consideration of the evidence presented at the hearing and after viewing the plans , makes the following findings of fact: 1. A variance from frontage to allow the construction of single family dwellings on these lots was granted by this Board on July 16, 1986. 2. Both 40 & 42 Clark St. have 75 .61 feet of frontage DECISION ON THE PETITION OF RALPH SALVO FOR VARIANCE AT 40 AND 42 CLARK STREET, SALEM NOY page two �S CIfY � � 3 . Both single family dwellings will meet all other C;_ :SS density and setback requirements . F 4 . Each lot has over 20, 000 square feet of land, 40 Clark St. having 22 , 864 sq. ft . and 42 Clark St . having 20, 553 sq. ft. 5 . There was no opposition to the petition. On the basis of the above findings of fact, and on the evidence presented at the hearing, the Board of Appeal concludes as follows : 1 . Special conditions exist which especially affect the subject property but not the district in general . 2 . Literal enforcement of the provisions of the Zoning Ordinance would involve a substantial hardship to the petitioner. 3 . The relief requested can be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent of the district. Therefore, the Zoning Board of Appeal voted unanimously, 5-0, to grant the variances requested, subject to the following conditions : 1 . Petitioner shall comply with all city and state statutes, ordinances , codes and .regulations . 2 . Petitioner shall comply with all requirements of the Salem Fire department relative to smoke and fire safety. 3 . The division of the lots shall be as per the plans submitted. One lot having square footage of 22 ,894 plus/minus and one lot having square footage of 20 , 553 plus/minus . Each lot to have frontage of 75 . 6 plus/minus feet . 4 . A Building Permit is to be obtained for each dwelling. 5 . A Certificate of Occupancy is to be obtained for each dwelling. DECISION ON THE PETITION OF RALPH SALVO FOR VARIANCES AT 40 AND 42 CLARK STREET, SALEM page three Ploy I I 7 Variance Granted October 16, 1991 S Ronald G. Plante. Associate Member Board of Appeal A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK Appeal from this decision, if any, shall be made pursuant to Section 17 of the Mass . General Laws , Chapter 40A, and shall be filed within 20 days after the date of filing of this decision in the Office of the City Clerk. Pursuant to MGL, CHAPTER 40A, Section 11, the Variance or Special Permit granted herein shall not take effect until a copy of the decision, bearing the certification of the City Clerk that 20 days have elapsed and no appeal has been filed, or that, if such appeal has been filed, that it has been dismissed or denied is recorded in the South Essex Registry of Deeds and indexed under the name or the owner of record or is recorded and noted on the owner' s Certificate of Title. { y Chi of 4nesadjusetts t s Botts of Au}ieul tr4/ 4 Ai I DECISION ON THE PETITION OF RALPH SALVO FOR VARIANCES AT 40 AND 42 CLARK STREET ; (R-2) A hearing on this petition was held October 16, 1991 with the following Board Members present: Richard Bencal,Chairman; Joseph Correnti , Richard Febonio,Mary Jane Stirgwolt and Associate Member Ronald Plante. Notice of the hearing was sent to abutters and others and notices o the hearing were properly published in the Salem Evening News in accordance with Massachusetts General Laws Chapter 40A. Petitioner, owner of the property, is requesting Variances from frontage to allow a single family dwelling to be built on 40 Clark St. and a single family dwelling to be built on 42 Clark St. Property is located in a single family district. The Variances which have been requested may be granted upon a finding of the the Board that: 1. Special conditions and circumstances exist which especially affect the land, building or structure involved and which are not generally affecting other lands, buildings or structures in the same district. 2. Literal enforcement of the provisions of the Zoning Ordinance would involve substantial hardship, financial or otherwise, to the petitioner. 3 . Desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent ofthe district or the purpose of the Ordinance. The Board of Appeal, after careful consideration of the evidence presented at the hearing and after viewing the plans, makes the following findings of fact: 1. A variance from frontage to allow the construction of single family dwellings on these lots was granted by this Board on July 16, 1986. 2. Both 40 & 42 Clark St. have 75 .61 feet of frontage t DECISION ON THE PETITION OF RALPH SALVO FOR VARIANCE AT 40 AND 42 CLARK STREET, SALEM NOV page two V uZ iii 'off C; } 3 . Both single family dwellings will meet all other C density and setback requirements . FSS 4 . Each lot has over 20, 000 square feet of land, 40 Clark St. having 22 , 864 sq. ft . and 42 Clark St . having 20,553 sq. ft. 5 . There was no opposition to the petition. On the basis of the above findings of fact, and on the evidence presented at the hearing, the Board of Appeal concludes as follows : 1 . Special conditions exist which especially affect the subject property but not the district in general . 2 . Literal enforcement of the provisions of the Zoning Ordinance would involve a substantial hardship to the petitioner. 3 . The relief requested can be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent of the district. Therefore, the Zoning Board of Appeal voted unanimously, 5-0 , to grant the variances requested, subject to the following conditions : 1 . Petitioner shall comply with all city and state statutes, ordinances , codes and .regulations . 2 . Petitioner shall comply with all requirements of the Salem Fire department relative to smoke and fire safety. 3 . The division of the lots shall be as per the plans submitted. One lot having square footage of 22, 894 plus/minus and one lot having square footage of 20, 553 plus/minus . Each lot to have frontage of 75 . 6 plus/minus feet . 4 . A Building Permit is to be obtained for each dwelling. 5 . . A Certificate of Occupancy is to be obtained for each dwelling. DECISION ON THE PETITION OF RALPH SALVO FOR VARIANCES AT 40 AND 42 CLARK STREET, SALEM page three YPOy �� ( 0 �1 tiil �Jl Variance Granted October 16 , 1991 Ronald G. Plante. Associate Member Board of Appeal A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK Appeal from this decision, if any, shall be made pursuant to Section 17 of the Mass . General Laws , Chapter 40A, and shall be filed within 20 days after the date of filing of this decision in the Office of the City Clerk. Pursuant to MGL, CHAPTER 40A, Section 11, the Variance or Special Permit granted herein shall not take effect until a copy of the decision, bearing the certification of the City Clerk that 20 days have elapsed and no appeal has been filed, or that, if such appeal has been filed, that it has been dismissed or denied is recorded in the South Essex Registry of Deeds and indexed under the name or the owner of record or is recorded and noted on the owner' s Certificate of Title .