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BUILDING JACKET !� CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT 41]I9f RUN na1Se:01-1. VI.%YOR Ir.WASHLINGfON STREET*SAIE34.MASSAc11v:'rfsG19TJ 'rva_973.743-9595 •Fix:979-740.9846 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information Please Print Leeibly Name tauciiw.worgani/zattiooNlnydi/v'tdual): Address: g�� /` City6tatcizip: L11�W d / "J9 Phone I!: 22e— 29 7 "_-3_;?8 Are you an employer?Check the appropriate box: 'rype of project(required): I ant a employer with .3 4. ❑ 1 am a general comlraetor and 1 6. New construction employees(full and/or part-time).• have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. : 7• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition workingfor me in an capacity. workers' comp, insurance. Y9. 0 Building addition q workers Elcomp. insurance S. We are a corporation and its required.) officers have exercisedtheir 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 LEI Plumbing repairs or additions myself. (No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.) t employees. [No workers' 13.0 Other comp. insurance required.] 'Ally ap plicuta anal clucks box el mu21 ale Jill out ate.waiun below diowiag their wurkm'cumpensasiwt policy iofurmatiun. 'I Wnpa,wtmn who submit ibis affidavit indicating they are doing all work and then him outside cottontail mwl.uhmk a new affidavit indicting usch. fiarttrxwn that check this box mass aaaelxd an additional wheel showing the name of the sub-contractors and their workm'comp.policy information. I um un employer that&providing workers'conttpenradan insurance jar nny emmplayees. Below is the policy and job site information. Q Insurance Company Name: r /rb—a Policy#or Self-ins. Lic. #: Odd . -. ..____. Expirauon Datc:_ Job Site Address: _20 Odd /`7" --City/Slalcizip: Attach a copy of the workers'compensation policy declaration pale(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of.'vIGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one-year imprisonment,as well as civil penallies in the form of a STOP WORK ORDER and a fiat of up to S250.00 it day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Imrc,ngaJiuns of the DIA for insurance coverage verification. I do hereby certify wider die pains and penuhier of perjury that the information provided above is true mild correct. _Z tiic:rnure: _._ �GGr' :�%LC,/,aU-1T1Date• / /&/O r 1--3 1-15, Official use unly. Do not write in thlr area,to be cannpleted by city or town ojjlciaL City or Town: _-. Permit/License# Issuing Authority (circle one): I. Board of Ilealth 2. Building Department 3. City/rosin Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Cuatuct Person: _—. Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their empldyees•_ Pursuant to this statute,an empfojve is defined as"...every person in the service of another under any contract of hire. express or implied,oral or written." An erapfoj er is defined as"an individual,partnership,association.corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership.association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because.of such employment be deemed to be an employer." MGL chapter 152. §25C(6)also states thug"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compnance with the insurance coverage required." Additionally.MGL chapter 152,$25C(7)states"Neither the commonwealth not any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name($),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. if an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the•affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' at the number listed below. Self-insured companies should enter their compensation policy,please call the Department ,elf-insurance license number on the appro rule line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of the affidavit for you to fill out in the event the Office of investigations has to contact you regarding the applicant. Please be sure to till in the permit/license number which will be used as a reference number. to addition,an applicant that must submit multiple pennit/licease applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address'the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be tilled out each year. Where a home owner or citizen is obtaining a license or pennit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. 1'he Ot1icc of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Invatlgatlong I 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT n.ut::Ml Rtt''�t�:Jll \L.Mit lam'1x.\ytt �: �7F1T•$ALc11.fit.\�YN:'c1l�tlla�i'»� Construction Debris Disposai Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 7S0 CNIR section 1 11.5 Debris, and the provisions of M. GL c 40.S 54. Building Permit N _ _ is issued with the condition that the debris resulting from this wart shall be disposed of in a properly licensed waste disposal facility as defined by%4GL e It 1. S 150A. The debris will be transported by: i IL1Itt0 0!tt�tta) rho Jcbris will be disposed of in rz �r� W=c ur ra:dlty) ♦ _...I�i:.)( 7C111.1C+t7 jLlC l.lt I� BROWN'S KITCHEN c& BATH CE, ,"E'ER 15 Elm Street * Danvers, MA 01923-2058 Mailing address: 72 Holten Street, Danvers, MA 01923 Telephone (978) 774-3333 * Fax(978) 774-8709 Home Improvement License#103611 * Mass. Builders License #073375 CONTRACT This contract,dated below,for materials and/or labor to be supplied by Browns Kitchen&Bath Center (Hereinafter,referred to as the contractor),at the sole request and order of: NAME: Gerry Gauey PHONE: 978-744-6603 DATE: July 31,2007 ADDRESS: ZO Cedarcrest Ave. Salem,Ma 01970 (Hereinafter referred to as the owner or buyer)to be supplied/performed at premises set forth above,subject to all of the terms and conditions set forth on both sides of the Agreement,as follows: Brown's Kitchen and Bath Center is happy to furnish you with a quote on your Bathroom project. Carpentry: We will remove walls to the studs. We will also remove the ceiling. The outside walls will be insulated. The walls will have new blue board and plaster. The tub walls will have Durock(cement board) and Swanstone tub walls. Color W \�� There will also be new trim around doors and windows, and around the base of the room. We will supply and install a vanity size color knobs are included with vanity. This vanity will have a Corian counter top with integral bowl. Above the vanity will be a medicine cabinet. We will supply and install newawning window. e�QYYI top CL., Flooring: The floor will be preparedfor owner supplied and Brown's installed tile. Plumbing: We will disconnect all fixtures. We will supply and install an American Standard Princeton tub. The shower will have a Symmons tub and shower valve, Model#S76-2. We will supply and install a Kohler 8"Forte lave faucet. _ We will supply and install a Welworth toilet w/seat#K-3423. — Ct-f&tLti I q b Qv6e— e I�In All work to be connected to existing plumbing. If any upgrades are needed a quote will be provided. Heating: None. Ventilation: None. Electrical: We will supply and install a GFI outlet. We will supply and install a fanlight. We will supply and install a light above the mirror. All electric will be connected to the existing electrical service, if any upgrades are needed a quote will be provided (Allowance for electrical is$1,600.00, but this will be quoted) W1 � 3�- - OF *Tile quote is based on a straight installation. ntrtca1e patterns are higher in price for install Marble like tile is a higher price for install. *At time ofjob all knobs,handles, TP holders,dowel bars etc. must be on site for installation.If not on site during job installations a service fee will be charged to return to job and install these items. Nothing other than stated above is included in this quote.No paint or paper.A[[sales tax is included All necessary permits are Included,All work is fully insured Any debris created by,Browns will be disposed of by Browns. `J I.UC�1�O'YUt— — lA�h t�-k •�t�M'Lv. ��1�(v Q S _i 6011 16 i ��.emirla`C�. i r 60R BATH 1 lI --- ----- ---- r � � g p I 0 j III - — CD LO d r i I Va SW cen>�diL J G 9" 2111 I 186" --�� 41 ;6" -- -�, - -- I I � I 6011 - I , I �i i All dimensions size designations given are 20 20 jl, This is an original design and most not be Designed: 7/25/2007 i subject to verification on job site and uce noLomes released or copied unless applicable fee Printed: 7/25/2007 it adjustment to fit job conditions. has been paid or job order placed. i Design3 All Drawing#: I EITY-OF PUBLIC PROPERTY DEPARTMENT ►�.sey sv�....w MGrae 130W buar• Ski Ywsuaa:se-ns 01970 APPLICATION FOR THE REPAIR RENOYATION CONSTRUCTION DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY FMSTING IL STRUCTURE OR BUILDING. _ 1.0 SITE INFORMATION G l04 Location Nanw: ve buuildtng: Property Is located In a;Conservation Ares TM_ _Historic 01sklot YM Jy_ 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land Name: ZD Ce Q Address: Telephone: &0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use Now Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New add Description of Proposed Work: Mail Permit to: - What is the current use of the Building? 1 D� Material of Building? ljb B dwellin%how many units? L/{S' will the Buildup conform to t.aw? Asbestos?T'' Architeas Name Address and Phone 1 1 Machanies Name Address and Phone �/� !/ Construction Supervisors license S o733'si HIC Registration Estimated Cost/off P�roj�ed Poma Fee CsWuh lon Permit Fee Estimated Cost X$7/51000 Residential Eslansted Coet X$11/i1000 C----An Addf k)OW $5.00 is added as an Administrative charge. Maio sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated speciNcations. Signed under penalty of perjury X ��.�! Date s e� 1 F` '3 QL) What is the current use of the Building? Material of Building? If dwelling.how many units? Will the Building Conform to Law? - Asbestos? Architect's Name Address and Phone 230•C Soutb Main Street Mechanic's Name Address and Phone Toll Free(800) 424.0090 www sun nao�fi ngf Construction Supervisors License# Y35-1, 0 HIC Registration Estimated Cost of Project$Al Sa p Permit Fee Calculation Permit Fee Estimated Cost X$7/$1000 Residential Estimated CostX-$11/$1000 Commercial-- An Additional $5.00 is added as an- Administrative charge. a 2. 1 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 S u All>P,--e-4--R l specifications. Signed under penalty of perjury X Date Ip ... � N YY a c 9 F a o i �S5 u u 7r O V V O G .. 4 WOk EIT�t — PUBLIC PROPERTY DEPt1RTNiEIVT KI\MFALEY DRISCULL MAYOR 120 WASHINGTON 51AEET aAtEer,MAssncxt;sEl-rs 01970 TmL 97&745-9595#FAx 97&740.9846 APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION. DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING 1.0 SITE INFORMATION Location Name Ti r rF cy, Building: Property Address. — -- A) J2J.=S Property is kxxted in a; Conservation Area Y/N Historic District YIN 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land Name: JXJL� ✓ Address: ,p ct AA2ee2cf� Telephone: 7 — y — 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing i Renovation Number of Stories Renovated Change in Use New Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation L N r of existing building b New Brief Description of Proposed Work: r 4 S F I" /qclyh_� Mail Permit to: / b2 _ Independently Owned H Operated 77 / q /t 230 C South Main Street,Middleton,Ma 01949 978-774-4999 Fax:978-774-8422 uijNa...�,_¢cs.no www.sunspaces.net Independently Owned and Operated MA Registration# 140780 Page 1 of pages July 7, 2007 978-744-6603 Jeff& Geraldine Ganey 20 Cedarcrest Ave. Salem, Ma. 01970 One Four Seasons Sunroom System 8 Sun & Stars Straight Eave Model: #8SLT413 Width: 15' 9" Depth 12' 5" Ridge Height 10' 0", pitch 2 7/8" Frame: White thermally broken aluminum exterior&wood beam interior. Glazing: Insulated double tempered clear throughout with MC56 (code 74)verticals, MCI (code78) roof glass Front: 2-5'& 1-4' Double Casement Window Left Gable: 1-6' & 1-5'Double Casement Window Right Gable: 1-6' & 1-5'Double Casement Window A$1,400 electrical allowance has been included in the price of this contract. Any additional amount will be charged via a change order contract and paid for upon customer approval. Materials & Installation $ 61,573.00 Less Summer Sale $ (6,071.00) Sub-total $ 55,502.00 Shipping & Handling $ 998.00 Total $ 56,500.00 Sunspaces Inc. proposes to furnish the materials as specified above for the sum of: Fifty Six Thousand, Five Hundred and 00/100 $56,500.00 Deposit of$17,000.00 with signed proposal,$9,356.00 due on material delivery,$15,115.85 when construction begins,— $12.778.15 when weather tight&Balance of$2,250.00 upon completion. All prices and specifications are subject to change without notice PRIOR TO ACCEPTANCE. AFTER ACCEPTANCE, purchaser may cancel this agreement by notifying seller in writing by ordinary mail or fax,not later than midnight of the third business day following the signing of this agreement. All deposits are NON-REFUNDABLE after the third business day. If unable to accept delivery to site, owner will be responsible for storage and re- delivery charges. NOTE: Outstanding balance for materials is due PRIOR to delivery to either site OR storage facility. Installation will not be scheduled until balances of materials, storage,and redelivery charges(if applicable)are paid in full. FINANCE CHARGE OF 1.5%PER MONTH WHICH IS AN ANNUAL PERCENTAGE OF 18%ON ANY BALANCE NOT PAID WITHIN 30 DAYS. 64 All materials are guaranteed to be as specified. Work will be completed in accordance with standard practice in a workmanlike manner. Deviations or alterations from the above specifications generating additional costs will be executed upon a wri change o d r, wh' will include additional charges over and above this proposal. All agreements contingent upon strikes, accidents or delays be and our con I Ow to carry fire, tornado and other necessary insurance.Our workers are fully covered by Workman's Compensation Insurance. If this proposal is not accepted by 06/30/2007 it may be withdrawn Authorized Signature Acceptance Jay Salem, President, Sunspaces, Inc. You are authorized to proceed with this proposal and we agree to complete payment as indicated above. The specifications, conditions, and prices as indicated in this proposal are hereby accepted. No Verbal Agreements Will Be Accepted Signature 'l^ Date /rfI Signature — SPACES 230 C South Main Street,Middleton,Ma 01949 ' 978-774-4999 Fax:978-774-8422 �,ro ,11p�,znet www.sunspaces.net Independently Owned and Operated July 7, 2007 Jeff& Geraldine Ganey 20 Cedarcrest Ave. Salem, Ma. 01970 SCOPE OF WORK 1. To build an insulated floor structure level with house floor to accept the sunroom dimensions. Includes 12" diameter x 4' + 3000 lb concrete Sono tubes or Techno-metal posts, 2x10 joists, 3/4" Tongue and Groove Plywood Sub Floor, R30 Icynene Insulation is to be applied. (Owner to choose the interior flooring within 30 days so the height of the sub floor for the room can be determined. Floor not supplied by Sunspaces, Inc) Included is a set of Pressure Treated stairs & railing down to existing grade. 2. Remove existing window 3. Rework and build 3" roof to accept existing eave corners of house. 4. To provide all wood nailers and flashing to properly install sunroom to the house. 5. To erect and glaze the sunroom structure. 6. To install flashing & caulk the sunroom to the existing house structure. 7. To remove the existing siding from the house wall inside the sunroom area. 8. To sheetrock &plaster the existing house wall & base wall inside the sunroom area 9. To install unfinished pine trim inside the sumoom area where needed including around the door opening. 10. To install vinyl Clapboard on the exterior of the new base wall. 11. To remove all rubbish derived from the building of the sunroom & deck. The home owner is responsible for any shrub removal that may be necessary for the installation of the sunroom and is to be done prior to installation. Note: Not included: Heat, A.C., interior flooring, interior & exterior painting or staining, any drawing fee's needed by the building department to obtain a building permit. Initialize Date c� Initialize 1 aNSPACES 230 C South Main Street,Middleton,Ma 01949 978-774-4999 Fax: 978-774-8422 n,isr�sw�sp:,e.¢. .�ei.wwwsunspaces.net Independently Owned and Operated July 7, 2007 a Jeff& Geraldine Ganey 20 Cedarcrest Ave. Salem, Ma. 01970 The Installation of One(1)Four Seasons System 8 Sun&Stars Straight Eave This contract is part of the material contract dated 07/07/2007. * Includes additional work on page 2. This proposal DOES NOT INCLUDE: Masonry, Carpentry, Plumbing,Painting, Staining, Landscaping, or any work to overcome unforeseen obstacles or unusual conditions at the site unless otherwise specified on this contract. Any alterations or additional work not listed will become an extra charge over and above this contract. Additional work will only be performed after acceptance of a"Change Order",and payment is received in full. Access to the home is critical for some parts of this project. Electrical, flooring and some construction processes demand access and the homeowner is responsible for providing this access to Sunspaces, Inc without delay. Delays could be charged at Sunspaces prevailing rates on an hourly basis. Electricity is a fundamental requirement and is the responsibility of the homeowner to provide this to Sunspaces in order to build a sunroom. In the absence of outdoor outlets, extension cords will be used and in some cases access to the circuit breaker panel will be needed to reset breakers from time to time. Delays caused to Sunspaces,Inc. by the Homeowners own contractors could be charged to the homeowner at Sunspaces prevailing rates on an hourly basis. Sunspaces, Inc shall obtain a building permit for the homeowner. Building Permit fees are not included in the contract and will be paid by the homeowner. All debris to be removed from the site. and the area to be broom swept and/or raked clean. All excess silicone to be removed from glass and glass areas to be cleaned. All work to be done according to local and state codes. Owner shall allow Sunspaces Inc., to place a sign and a dumpster at the site during installation and allow photo's of the job to be taken for marketing purposes. Sunspaces Inc. warranties the installation for a period of One (1) year after the date of completion against leaking and defects in general workmanship. Company's obligation is limited to repairing or replacing, without charge, replacement parts necessary to correct any condition resulting directly from defects in workmanship. WARRANTY SERVICE SHALL BE RENDERED ONLY WHEN CONTRACT IS PAID IN FULL. Manufacturers frame warranty and glass warranty will be serviced without labor charge for one year from date of completion. This contract shall be re-negotiated if installation has not begun within six(6)months after the date of signing of this contract. You are authorized to proceed with this proposal and we agree to complete payment as indicated above. The specifications, conditions, and prices as indicated in thh' p�posal are hereby accepted. Signature 6 Date Signature _ RUG-8-2007 08:53P FROM:TERENZONI 978 531 1755 TO: 19787748422 P.2 Lot 461 50.80' LOT 449 10$ 674 S.F.t a Lot 450 m_ rn Lot 448 N 06 O N PROPOSED SUNROOM 11'5"x15'9" 1io't or DAVID i HW P s't wulr i No.20 7 / Dwelling 1/2 Story Alum. M w 50, CEDARCREST AVENUE Zoning_ District: Ri eference: Book 14768, Page 254 PLOT PLAN OF LAND Deed Assessors Map 21 , Lot 49 SALEM, MA. Proposed Lot Coverage = 10% t PREPARED FOR: Note: This plan was prepared from a tope survey GERALDINE M. DUMAS—CANEY and is intended for building inspector purposes only. 20 CEDARCREST AVENUE Offsets shown on or scaled from this plan are SCALE: 1"=30' DATE: AUGUST 8, 2007 approximate only and should not be used to determine property lines. P07-067 rry , xr�axn{"•• Y �^ 4nr �i Rfr"3'"+, 'kJ'� r.Ass i ✓ r'm"Z � '""�s',r m , r ,fk ur Fes, r r TECHNO METAL POST specializes in permanent ; 1,, ', structure support. It is reliable and recognized technology for the installation of metal post foundations drilled into the ground These metal posts give the advantage of an installation without costly excavation In addition, there is no damage to the posts due to frost. 5 Fig IF TECHNO METAL POST is highly recognized for its expertise and technical support The unique concept evaluates the structural capacity of the post and the baring capacity of the ground. 'a Load testing standards are based on ASTM-D1.143 and ASTM-D3689 for deep foundation. Our experts can provide solutions to any project that requires technical assistance on bearing capacity (compression and tension) for the installation of M posts. We can also assist in the load,evaluation according to building codes. I" f Pi, d-NM� �. zy ..:,. v...- ...m xl'�� r rwru.i!��/y,,h •1;7'.nub I�/1,,L.3 d 'Zd.s2,,i ,"'u, i,. -•'No digging necessary • No delay,construction:begins as soon as posts • Guaranteed against frost are installed • Competitive pricing • Can be installed under existing structures - Technical support available, • Ideal for rough and restricted areas No damage to the landscape: t •Installation equipment adapted for any structure The posts can be relocated • Can be installed below the water table • ,Bearing capacity of posts approved by sj Most importantly,we have the solution to your pw"r rofessionalengineers difficult and hazardous work ' TECHNO,META I POSTS are installed according to � �� definite and rig orous = stantlards certified; by g, professionals :specialized m soil-;engmeerl Authorized installers have technical l 'x ;and practical training iq the installation of the TECHNO METAL POST. The metal } posts are drilled'Into the ground at;a depth of at least'1 83m (6') and can reach more Or, n than 15.24m (50') Our Techno exclusive plastic sheath made of polyethylene is Pam; inserted simultaneously;on our ;TECHNO METAL POST Our installations are guaranteed against any movement caused by frost:or settling of the ground. Inmost cases, no excavation is required, avoiding damages to the,landscape during ,`the installation. Each project is evaluated to determine the installation criteria and , equipment requirements. �,�'' •� `'� ' . ..'ter rt, � ��,�� yf � ��ruJj ..i� w �:,,r� ,,. . : :. � ; ,. 4F . p Techno Metal post of New York 819 Route 67 'N Ballston Sp NY 1 Spa, 2020 Tel.: (518) 884-2600 M U.S.A Location TECHNO PIEUX DU NORD - Jean-Yves and Nicole Gravel Tel (41B)695 7013•Fax:(418)695 7013 TECHNO METAL POST MAINE TECHNO PIEUX DE LA MAURICE iNC. Michael and Guy Brochu Yves Marco.. ; a Tel.:(819)375-0666•Fax.(819)375-0110 r �k Phone :(207)445-5756 or(207) 623-3244•Fax (207)445-4722 TECHNO PIEUX ouraouAls Frangois Gamache and Yves.Langevin Tel.:(819)712-2067•Fax.(819)457-1674 Pag:(613)780 8320 - CONNECTICUT rgI ! TECHNO PIEUX DES BOIS-FRANCS Eric Lessard MASSACHUSETTS Tel (819)752 9136 y TEOHNO:PIEUX DE LA'BEAUCE 'p NEW HAMPSHIRE stephana Paquet Tel (416)',685 2210 Fax (418)685-2212 TECHNO PIEUX THETFORD MINES INC RHODE ISLAND Clement Binat and Daniel Thrvierge Teo (41 B)`332 2139,-Fez (418)-332 4339 VERMONT TECHNO PIEUX RIMOUSKI Gaelen amee,'and${ephone Paquet r' - Tel (415)J22,3885,' ONTARIO TECHNO-PIEUX RNIERE DU LOUP: Y;$ Gaetain Demersand StSpha- Paquet = TECHNO METAL POST COMMERCIAL Tel (418)860 4452 Marcel Leroux and Richard Turpin PEn9 MBA,,, -II'TECHNO PIEUX QUEBEC EAST INC Phonc 1 Fax '(613)5 7 5054. Gaetan pemera r Tel.:(613)262 8649 Fax(613)262 @648 Tel carj_835 3262.Fax (418)835 1821 r ' Tel (0.16p 6,y58 6302(North Shame)t TECHNO METAL POST OTTAWA c Marcel Leroux- ✓ v r + - I. -17 -Phone/Fax,. + TECNNO';PIEUX pE L E$TRIE (613)527 5051. c+ �3 ?' r r GuY Plante end Bruno Qiroux �: ' Tq) (B79),1 943a Fai (819)647 4062 . TECHNO.METAL POST OTTAWA WEST -r , 1 877�@Aen,13436 Horr�e (819)829 7355 ' 1 'Pichartl Turpiri PEng MBA; - ,�.. ,, Tel (613)262 86.49 )✓mf(8'.1,3)262�648 ° r - RUMMONDHILLE ' TECHNO METAL POSTTERR TORIES 4 s ('uy Plante i "' - f? i AVAILABLE �`` h 3T�1 (819)74 4842 4 -1>L..T ,v i r^ Marcel Leroux r r '1 j "r t a 1` (YECHN91�IEUX�v10N F,REGI a f �" ' Phonc/Fax (613)627,506 e A y`fRJUE SW4 ��a8'ri� �' 7i{ai �' 7 QurBEC , ax y:.'r°.Ek'�';r'"' r y e4 Fax�L46Q1 a44&�4,2drQ �k. �TECHNO PIEUX COMMERCfAD�ANx Cgll (594) 16/0414r rtV$4p � rye + fi j Pascal Marceau engmfeei yr✓a ^t r "Monhaalr Laval Riv ✓9u41 N iu yT I (4M1BJr +t`TECHNO PIEUK,LP�f!{L R1U I+,ORDod �* �Kax (4100)332."4'�9)334.42ir ti .`^-7th35`�dxp > �i RIYu S;rMu Soy d 1( ,I`fMrr''>g4ll T<` ,rk 'i Tom. r 'k rat+ r"u' 4r ,F; i' "rRUSS1A;inYt .� v''�a-r „" may a�1'f +yv f, t r y . 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M4AYlANO MAS&IUfUSETTS MICHIGAN MINNESOG, M1591551PR WSSOU-RI cl-11-N Ow mK N10E l 6nfa 5k'n<k °e>N'o>w° to MONITANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH UMOTA OHIO OKLAHOMA ,t A> ZA wancensn,a ••••••• l-;NA .s-u-a.I ��.�� '�� NOTES: s...._..?.../�. i f ^, a„ >as (•firma s'i '1 Y'eE' ` ! 1 1)ROOF RAFTERS ARE GLUE-LAMINATED NORTHERN PINE zMa OREGON PEN NSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA 2)DEAD LOAD OF ROOF SYSTEM IS 7 PSF /^i..'o'� 3)ALL UNITS SHOWN ON THIS PAGE ARE ACCEPTABLE FOR CONSTRUCTION IN e,`"1 .F� -��' Q .Lj �` vp SEISMIC ZONE 4. 4)A LOCAL PROFESSIONALENGINEER SHOULD DETERMINE THE SITE SPECIFIC • LOADING AND PERFORM ANYADDRIONAL NECESSARY CALCULATIONS.WHICH TENNESSEE TEXAS UTAH VERMONT VIRGINIA WpSHINGTON MAY INCLUDE MINIMUM DESIGN LOADS REQUIRED BY LOCAL MUNICIPALITIES, , OR ANY DRIFTING OR UNBALANCED SNOW LOADS PRODUCED BY ADJACENT a•.ce.u_ �A"'`^c, � STRUCTURES. 1 i_ ? d w • 5)THIS SUMMARY PERTAIN5T0 THE STRUCTURAL INTEGRITY OF OUR UNIT UP TO -fa e THE CONNECTIONS TO THE EXISTING STRUCTURE AND/ORANY NEW+ ' CONSTRUCTION. THE CONNECTIONS TO THE EXISTING AND/ORANY NEW WEST VIRGINIA WISCONSIN WYOMING D.C. CONSTRUCTION MUST BE ANALYZEDACCORDING TO CONDITIONS SPECIFIC TO EACH JOB,BY A LOCALPROFESSIONAL ENGINEER. 6)ENGINEERS CERTIFICATION:I LAWRENCE FISCHER CERTIFYTHAT THESE ENGINEERING SPECIFICATIONS HAVE BEEN PREPARED UNDER MY DIRECT.::- SUPERVISION AND THAT I AM AREGISTERED PROFESSIONAL ENGINEER IN THE STATES SHOWN. FILE:ROFENG38.CDR yOF ►►�trr f4� `tt E W f IJYRF.HCE ''k FNaCH6R : - :• LAWFM=' Z v ; STRUCTURAL i MCHER uZ � f F � � R• P34 • to P7 gR �jX�►�l,�l f�1}M��►'� �AWI�rlCE �/Sc��e REFERENCE NLRAVER lzw �� yea-��-4 SJNSPACES UVll�7C3�3 /�Uti3��`]0�3�y�C^J'i�l�OCi] To be completed when owner's agent or contractor applies for a building permit. C-14A) as owner of the subject property located at �•�7�1 2L° J?. 2'3 T//)-L-- t Sri i 6-;2 7 hereby authorize Sunspaces Inc., Four Seasons Sunrooms to act on my behalf in all matters relative to work to this building permit application, and all permitted work. - (; A �Z /f 1//7 Sig ature of Own r Date Owner authonzation.doc Sunspaces Leisure Living Expo 230C South Main Street, (Rt.114) Middleton, MA 01949 978-774-4999 Fax: 978-774-8422 www.sunspaces.net ;• CONSUMER INFORMATION FORM: "SUNROOMS" Massachusetts State Building Code (780 CMR, Appendix J, Section JI.I.2.3.1) The Massachusetts State Building Code (780 CMR) includes:provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom" of any size, configuration, orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom" addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below. is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/instal ling a "sunroom". It is recommended that consumers carefully review these options with their designer, builder; or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the.company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO:"SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation - Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls, and ceilings • Possible Sunroom isolation.from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls . Homeowner Acknowledgment The Massachusetts State Building Code, Section.JI.I.2.3.1, requires that the actual property owner (not the owner's agent or representative) acknowledge receipt.of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the informa on in this document concerning sunroom comf rt and energy conservation. Signature of Actual Building Owner Date Print Name Address of Permitted Project Owner.Address (if different than project location) Owner's telephone number The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 u,p www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Orgmization/Individual): Address: 230-e SoutM Main Street City/State/Zip: Tnn Fraa ran lelon„M]A 01949 Are you an employer? Check the appropriate box: 55DD Type of project(required):. 1.❑ I am a employer with 4. XI am a general contractor and I 6..❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance comp.insurance.:. J°F required.] 5. ❑ We are a corporation and its ME] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 13.❑ Other employees. [No workers' comp.insurance required.] *My applicant that checks box#1 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 anew 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job.cite information. Insurance Company Name: /_�'0114 M 4 Re—c 10A > U-?A 9C N 4 Policy#or Self-ins. Lic.#: � '7 '�t�/ Expiration Date: Job Site Address: City/State/Zip: 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 under t ins and penalties of perjury that the information provided ab ve is tray and correct. Signature r�e4\ `,��AM �y �3 Date: t3 Phone# �6 `e /r��% I/% / 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#: DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of MGL C40, 554, a condition of your Building Permit is that the debris resulting from this work shall be disposed of in a properly licensed solid waste facility as defined by MGL C111, S150A. t I The debris will be disposed of at: Cd A SY-e Yk1�✓I(a e— /,ta I Name of Facility " Mn�Y>r �� Address i i � 4 Signature of Applicant NSPArFq 230-C South Main Street Address of Applicant ®IUg T00(000)424.9090 Www.sunspaces.net Date i i I d i �/ie 1Giomvnza a�'✓7%�aaiac/u�oetls lug Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR _ Registration: 140780 Expiratiow. 11/20/2007 Type: Private Corporation SUNSPACES, INC.' JOEL SALEM 285NEWBURYST: PEABODY, MA 01960 Administrator UaTe: -I'I/la/LwG -w:O2 Aryl Jenaers Fax IU:cOle Insurance Agenc Page 2 Ot 3 ACORD_ CERTIFICATE OF LIABILITY INSURANCE CSR DC DATE(MM/DD/V9YY) SUINSP-1 11/17/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Cole Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 194 Haven Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Reading MA 01867 Phone: 781-944=1245 Fax:781-942-1797 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Harlaysvills Worcester Ina co 26182 INSURER B', Commerce Insurance Company 34754 Sunspaces Inc. dba Four §easons Sunrooms INSURER C. 230 C South Main Street INSURER D: Middleton MA 01949 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/ODM1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 INIIIJ A COMMERCIAL GENERAL LIABILITY B0887740 PREMISES(Ea occu..nce) $ 100000 CLAIMS MADE OCCUR MED EXP(Any one parson) $ 10000 X Business Owners 11/01/06 11/01/07 PERSONAL B ADV INJURY $ GENERAL AGGREGATE s2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2000000 X POLICY P OF LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B ANY AUTO RHX954 02/26/06 02/26/07 (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $2S000O X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Peraccid.nt) $ SOOOOO PROPERTY DAMAGE IS 100000 IPer accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ PNV AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TCRY LIMITS ER A EMPLOYERS'LIABILITY WC OJ9401 11/23/06 11/23/07 E.L.EACHACCIDENT $ 100000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE $ 100000 If yes,describe under SPECIAL PROVISIONS below EL.DISEASE-POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS sun Room Kit Show Room CERTIFICATE HOLDER CANCELLATION SERVI-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN ServiceMaglc, Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Insurance Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR 14023 Denver West Parkway Building 64, Suite 200 REPRESENTATIVES. Golden CO 80401 A OREPRBSE TVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 iE. �re {oanvirwru�ea�� a��/��.am¢c�uuella y' - �-:Board of Building Regulations and Standards -- <' Construcoon Supervisor License License.: CS43518 Rthdate: '1/11/1962 F�piration 1/1;1/2009 Tr# 7974 Restriction 00', tt JOHNH SEVER,NI,` '. 19 DODGE RD AMHERST,NH 03031 Commissioner Date : 5/4/2007 Time : 1 : 39 PM To; Severini , John e 19787748422 Provider Ins . Group Page : 2 ACORDM CERTIFICATE OF LIABILITY INSURANCE osjoa%z o PRODUCER (617)489-2720 FAX (617)489-5215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Provider Insurance Group Inc. ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE 258 Blanchard Road HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Belmont, MA 02478 INSURERS AFFORDING COVERAGE NAIC# INSURED SEVERINI & ASSOCIATES,INC. INSURER A. Travelers Indemnity of CT 25682 j 80 WEST TECH DRIVE INSURER B. Travelers Indemnity Co 2S658 TYNGSBORO, MA 01879 INSURER c. Travelers INSURER D'. INSURER E'. COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 00 ' TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTNE POUCYEXPIRATION LIMITS LTR NSR E MMI00 DATE MWDO GENERAL LIABILITY -680-275CS32-3-TCT-06 09/13/2006 09/13/2007 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 F.CLAIMS MADE F-] OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL R ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP ASS $ 2,000,000 POLICY PEO LOC AUTOMOBILE LIABILITY BA-4668CO63-06-SEL 04/18/2007 04/18/2008 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per persun) $ B HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (POTacoiCent) $ PROPERTY DAMAGE $ (Per accidonq GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ MY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGO $ EXCESSIUMBRELLA LIABILDY IS -CUP-275CS32-3-IND-06 09/13/2006 09/13/2007 EACH OCCURRENCE $ 1,000 000 OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 C $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND IE-UB-762D646-6-06 12/01/2006 12/01/2007 We sTATu- orH- EMPLOYERS'UNBILTTY A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ SOD,OOO OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EAEMPLOYFE $ 500,000 It yes,descnbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ SOD,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HO CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Sunspaces, Inc. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, dba Four Seasons Sunrooms Jay BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 230C South Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Middleton, MA 01949 AUTHORIZED REPRESENTATIVE Glen Davis/GLEN / J ACORD 25(2001/08) OOACORD CORPORATION 1908 Jeff& Geraldine Ganey OOP 20 Cedarcrest Ave. initial Salem, Ma. 01970 i j co , i- Front Elevation Jeff& Geraldine Ganey 20 Cedarcrest Ave. Salem, Ma. 01970 initial i a o ar M W i r 12'4" --- Left Elevation Jeff& Geraldine Ganey 20 Cedarcrest Ave. initial Salem, Ma. 01970 1 I -1 1 1 12,_5" 1 Right Elevation Jeff& Geraldine Ganey 20 Cedarcrest Ave. initialSalem, Ma. 01970 T i r a i� r s 0' Plan Jeff& Geraldine Ganey 20 Cedarcrest Ave. initial Salem, Ma. 01970 • y y �_ Y r � Di . 12' a. 12' Dia. 1 Z' -2'L G Q Q r � W-10 12" W-10112" Deck Plan What is the current use of the Building? Material of Building? B 'hold many units? will the Building Conform to Law? Asbestos? Arohited's Name Address and Phone ( 1 Mechanic's Name Address and Photo .G Consbuction Supervisors License tr Iq,�a) HIC Registration S Estimated Cost of Projed i oo permit Fee Calculation Permit Fee i / ,lam Estimated Cost X$7/$1000 Residential Estimated Cost X$41/111000 Commercial-- -------- - - �� 7 An Additional $5.00 Is added as an Administrative charge. Make sure that all fields are property and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build tot a above 7stated Signed under penalty of penury e Date �G '22 3 clTrOF-aXLEML PUBLIC PROPERTY DEPARTMENT I JVWAUUNG"aver.&M&Ku&,ew«:se,M01970 M&W&745-"".IPA=M'?46. ft APPLICATION FOR THE REPAIR RENOVATIAN_ ONSTRUC n0& DEM N O OR EXI OLITIO .OR CHANGE FUSE OR OCCUP�xrv__ F ANy SSG STRUCTURE OR BUILDING 1.0 SITE INFORMATION Location Name: Suitdtng: -- -- 196 (fr13/ r c/'l--�sT �l/� Property Is located In a;Conservation Arse YIN Histario District YIN 2.0 OWNERSHIP INFORMATION 2.1 Owner o1 Land _ Name: Address: �U CE�Ar crrsj �� Telephone; 03 3.0 COMPLETE THIS SECTION FOR WORK IN EYISIWQ BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use Now Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New add Description of Proposed Work: Mail Perrnitto: CITY OF SALEM 4D PUBLIC PROPRERTY DEPARTMENT \L%WR IICwail ll�t :JI:!9EM•>�1:4, :Ii.t Tat:Y7►74s-.)s S •F.%x:97s-7 C-" Construction Debris Disposat Aftidavit (required for all demolition afui renovation work) i in accordance with the sixth edition of the State Building Code, 7S0 Cb1R section 1 11.5 Debris.and the provisions of N4GL a 40.S 54, Building{ Permit 0 _ _ 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.1GL c I11. S 150A. The debris will be transported /by:- ( of hauler) rho debris will lbbedisposed of in : (Ilamr of ixillty) E C -4W I,I CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT� NT III - k nI�1Rr R[F.Y URIX:VLL Vt.%yoR 12C WAS-112%G roN STREET a SAMM,MAaAU n\y.'1-IN 01979 'fat_978.745.9595 0 FAX:978.740.9846 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/plumbers Annlicant Information / Please Print Leejeibly NIMC lBusiiwssfOrganizationtindivtdual): RIGC-11J-r6 44�97S;OA� I)Ql+ / (1 5 C= n Address: / City:Sfarcizip: 4nZ Phone: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I um a er w employer with 4. ❑ i am a general contractor and[ P y 6. ❑ New construction em full and/or parr-tintt).• have hind the sub-contractors 2 am a sole proprietor or partner- listed on the attached sheet. : ?• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition iNo workers'comp. insurance 5. ❑ We are a corporation and its nquin;d] officers have cxcrcLstxl their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers'comp. C. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] r employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant this checks box et must alxu till out the W. Coaa beiuw showing ibeir wwlians curpentatiwt policy infurmatiun ' It�ownon who submit this affidavit indicating they are doing all work snd rhea Aire onside contr:Klera mug euhmii a new affidavit indicating etch. :Conomson,tlal ckssk this box must attached an additional xhan showing the nano of the sub-contractaa and their worker'epnp.policy informarion. fain an cutployer that is providing workers'compensaton itisara ice for sty employees. Below is the pukcy and job site information Insurance Company Name: Policy li or Sclf•ins. Lic.#: Expiration Date;- Jun Site Address: 6) C' C ,,7, City/state/zip; _ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Puilurc to secure coverage as required under Section 25A of�IGL c. 152 can lead to the imposition of criminal penalties of a nine up to S1.500.00 and/or one-year imprisonment, us well as civil penalties in the form of a STOP WORK ORDER and a fine Of up to S250.00 is day against the violator. Be advised that a copy of this statement may be turwarded to the Ot7ice of Ins can�ations ul'thc DIA for insurance coverage verification. !dd hereby cerfirmander the ptii •dud rnuhies ufprrjury that the iuformiition provided above is true and correct titn:ruurc' Date! U 3 O�cia!ase duly. Do not write its this area,to be completed by ury or town official City or'rown: __ Permit/l.icense# Issuing Authority(circle one): I. hoard of health 2. Building Department 3.Cityffotvn Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other _ C'dat 1'. Person: — _ - Phone ti Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written" An employer is defined as"an individual,partnership,association.corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shag not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Weal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the Insurance coverage required." Additionally. MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have seen presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of the affidavit for you to till out in the event the office of Investigations has to contact you regarding the applicant. Please be sure to till in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitilicense applications in any given year,need only submit.one affidavit indicating current policy information(if necessary)and under"Job Site Address' the applicant should write"all locations in (city or rown)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be tilled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The O(licc of investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised i-26-05 www.mam.gov/dia � �� L/MX�LOK�.(JP¢L[IL o� lA<dC�b card of Baildmg Regulations and Standards a onstruction Supervisor License `` T _ a License CS ,30000y *�„ ; ' P `- �i Aw 3`a(3irthdats: .W21/1948 f,,Expirsuon: 7/21/2009'�� jr# 322r Rea ricuon 00 -; .421. - �� '} RICHARDtJ MADISON* - 3 MADISON-AVEiy GROVELA,ND MA 01839r ±Commisalonor y� 7k eio�nmsorz.�ieo o�,/��aac/u�aeCta. UTBoard of Building RegulaEonsandStandards ]Board HOME IMPROVEMENTi�ONTRACTOR Registration;` V 85 r` 09Expiration: -3/29209�, Q Tr# 130819DBA` i R.J.CONSTR _ i � UCT.ION.'- p _' RICHARD MADISON', 3 MADISON AVE GROVELAND,I 01834 Administrator Ik R a IpI i ug-2007 Kitchen Install Worksheet for Order#: 160531:st2686 Pagel DUMAS-GANEY,GERALDINE Design Description: KD AFTER MEASURE 8/4 20 CEDAR CRE ST AVE Design File Name: 8040D7A8.KIT Install File Name. 8040D7 A8.KIW Order#: 1*@=:8t2686 SALEM,MA 01470 O�(e �I Y7 Home Phone; (678)744-6603 Work Phone: ext. SKU 240-285 KITCHEN POINT(NATIONAL) !—AL AEMO1%AL=I DEMbLiFfIOtY Y LOOM _ a. Remove cabinets, laminate counter tops,disconnect plumbing/appliances.......................... 15.00 If b. Remove mortar bed tile,granite,&solid surface counter tops...................................................... ...Customer... c. Remove existing soffits..................................................................................................-.......... ...Customer... d. Remove existing finished floor................................................................................................... ...Customer... Notes: .......... ...Customer... Notes: ........... ...Customer... *Cabinets,counter tops, appliances, &factures may not be re-usable after removal. Do not remove cabinets,tops,&appliances until new products have been Inspected. '33-`I3Eg1it91tEVl OTY UOM --- a. Haul away cabinets and/or Install debris from install (fob site quote).................................. 20.00 ]SQ b, Haul away cardboard only.............................................................................................. 3.00 per job c, Haul away appliances(except refrigerators)................................................................................ ...Customer... dHaul away refrigerators ............ ... ..........................................................................._...Customer... — Notes: ........... ...Customer... Notes: ,} ........... ...Customer... 1 I . .. '31" [;0CTRI , f1VORIC.I OTY UOM a. Replace existing receptacle/switch-Indudes upgrade to GFCI(Installer provides)............................ ...Customer... — New switch on circuit(Installer provides).................................................................................... ...Customer... c.Install new surface mount light,ceiling fan, can light to existing service,same location................... ...Customer... customerprovides fixture ........................................................................ d. Install new under cabinet light to existing service, some location (customer provides...................... ...Customer... fixture) e. New outlet tied to existing circuit( Installer provides components)................................................ ...Customer... f. Run a new circuit for a dedicated microwave hood(installer provides components)......................... ...Customer... o. Electric appliance Preparation_pigtails etc (installer provides components)...................... ........... ...Customer... Notes: h.new elec to state and local code for counter outlets»» 14.00 ]SQ 10-Aug-2007 Kitchen Install Workshest for Order#: 160531:st2686 Page 2 Notes: ........... ...Customer... I * Electrical requirements/pricing may vary due to local codes iil``ISL�UMBINGI OTY UOM a. Install/hookup temporary sink,faucet: includes 48"temporary top,sink, faucet, strainer..... 1.00 ea basketsprovided by installer........................................................................................... b. Install double/single bowl topmount sink w/faucet,disposal: within 3"of existing location... 1.00 ea (installer provides shut off,traps and valves as needed)..................................................... c. Connect to undermount or integral bowl sink with faucet, disposal: within 3"of existing................. ...Customer... I location. (Installer provides braided supply lines,shut off valves, piping and traps as............ needed) d. Install new reverse osmosis(fittings provided by installer)............................................................ ...Customer... e.Install new insta-hot-hot water dispenser(fittings provided by installer)...................................... ...Customer... f.Install Bar or vanity sink with faucet within 3"of existing location (Installer provides shut................ ...Customer... off,traps,valves, all materials as required)....................................................................... a. Gas Appliance Preparation: gas supply lines etc (Installer provides components) Customer... Notes: 9 h.move water pipe drain new plumbing 12.00 JSQ t I P - i I I Notes: t ........... ...Customer... i t * Plumbing requlrements/pricing may vary due to local codes 51 CABINE $TALL'%ft I QW UOM a.Wall cabinet installation: includes fillers,scribe, handles/knobs.......................................... 8.00 ea b. Base cabinet installation: includes fillers,scribe, handles/knobs,toe kick........................... 5.00 ea c. Peninsula/island cabinet installation: Includes fillers,scribe,handles/knobs,toe kick....................... ...Customer... d. Pantry/tall cabinet installation: Includes fillers,scribe, handles/knobs,toe kick............................... ...Customer... e. Single/double oven cabinet installation,include fillers,scribe,handles/knobs,toe kick.................... ...Customer... Includes all necessary cutouts and bracing to support ovens and microwaves...................... f. Fillers and overlay fillers,each.................................................................................................... in g. Handles or knobs...................................................................................................................... Included h.Assemble Mills Pride cabinets&RTA.......................................................................................... ...Customer... ` i.Appliance garage..................... ..................................................................................1.00 ...Customer... j.Accessories installed In the field (not factory installed).................................................................. ...Customer... fk. Valances&shelf............................................................................................................ ea Notes: ........... ...Customer... Notes: ........... ...Customer... C • r 10-Aug-2007 Kitchen Install Worksheet for Order#: 160531:st2686 Page 3 I fi) CkBINEI;lFIil RllF 0H5I OTY _ UOM _ a. Alterations to cabinetry(holes cut In back or bottom of sink base for pipes are not an.................... ...Customer... alteration) b. Build up base cabinet to offset floor thickness(Up to 3/4" In height, materials provided by... 8.00 JSQ installer) _ _ — Notes: I ....... ...Customer... i - ........... ...Customer... F 7110 E0WN4 SKIN-1N57`AL'LW73CIN; QTY UOM a. 3/16"skins or decorative end panels.......................................................................................... ...Customer... j b. Base or wall end panel, or panel back of cabinets(per panel)....................................................... ...Customer... c.Assemble and Install appliance deco panels,trim kits provides customer(per panel)................_... ... Customer... I Notes: .Customer... Notes: ........... ...Customer... II, — Is)I�O1�olu��I �'bkLATlo7il� QTY - a. Molding for top or bottom of wall cabinets. Each layer priced separately(includes bloddng.. 32.00 if atno charge)..............................................:.....:::............::............................................ b. Scribe or cover molding included as part of cabinet Install............................................................ included c.Toe kick................................................................................................................................... included Notes: ........... ...Customer... Notes: ........... ...Customer... I9)4PPL3 WCE^IIVSTAL� W"I — OTY UOM a. Free standing range(Includes range cord, installer provides)............................................. 1.00 ea 10-Aug-2007 Kitchen Install Worksheet for Order#: 160531:st2686 Page 4 b. Cooktop.................................................................................................................................. ...Customer... c. Single wall oven....................................................................................................................... ...Customer... d. Double wall oven...................................................................................................................... ...Customer... e. Drop-in/slide-in range, including building deck/support(range cord installer provides).................... ...Customer... f. Micro-hood combo into existing vent, into dedicated circuit........................................................... ...Customer... g. Range hood into existing vent, existing code approved circuit............................................ 1.00 ea h.Trash compactor...................................................................................................................... ...Customer... I. Refrigerator................................................................................................................... 1.00 ea J. Add for each gas appliance shut off............................................................................................ ...Customer... k. Install dishwasher with fittings&air gap(fittings provided by installer).......................................... ...Customer... I. Downdraft unit or professional,commercial appliances, "Sub Zero"or"Under Counter..................... ...Customer... refers"(job site quote)................................................................................................... m. Install new refrigerator ice maker water line(materials provided by installer), (code...................... ...Customer... approvedcoppef lines)................................................................................................... nnReplace existing refrigerator Ice maker water line(materials provided by installer).......................... ...Customer... Notes: ........... ...Customer... Notes. ........... ...Customer... * Existing appliances may not be re-usable after removal 661PY-bidI W6 k OTY u0M a. Patch and repair drywall............................................................................................................ ...Customer... b. Remove drywall............................................................................................................_.......... ...Customer... c. Remove and replace drywall, non-textured.................................................................................. ...Customer... d. Remove and replace drywall,textured.................................................................................. .. ...Customer Notes: e.cut sheetrock between cabinets for new elec and plumbing resheetrock and compond ,tape 15.00 JSQ and prepare for paint. Notes: ........... ...Customer... l I f 11) OT157ICUCiI017lCBOlti OTY UOM a. Install new soffits..................................................................................................................... ...Customer... Notes: ........... ...Customer... {( Notes: -- ........... ...Customer... f _ Grand Total $4,919.85 Grand Total Points 169-650 Enter the grand total points into the Special Services POINTS Install line Item. Job Site Quote(JSQ)values are entered In POINTS. Materials to be sold to customer: ...Kitchen Cabinets ...All necessary accessories and hardware ...Appliances ...All necessary plumbing items Q.e.kitchen sink,Mucet, disposer,strainer baskets,water fil ...All necessary electrical and undercabinet lighting Sales Guidelines. ***Kitchen Projects are now quoted using the Home Depot Automated Kitchen Estimate Worksheet.Please Review Ws )rkshe on ___ _____ w to Quote a Customer.Its Easy: I)Enter the values Into the automated kitchen Install worksheet, (This Information will come from the measurer, the Installer,the customer, the 20/20 design). 2)Add any points for JSQ(Job Site Quote)labor that must be estimated.These points Will come directly from your kitchen Installer.These points can be entered directly Into the automated kitchen Install worksheet(KIW). 3)The worksheet then acts as a calculator and will create a quote for your customer.The quota will reside as a file in the stores'computer.The quote will not reside In the Special Services System. 4)Complete the woksheet and obtain customer signatures. -'N_—' the_customer_ that permit—charges are~calculated 6)After the quote Is complete,enter the total number ofseparately and will vary depending on local municipalities points Into the Special Services System to create the PO. \ ' i - III 10-Aug-2007 Kitchen Install Workshest for Order#: 160531:st2686 Page 6 7)Add Permit charges into special Services(to be obtained from the Installer). - B)Complete the Sale! i NOTE:If the Automated KRchen Install Worksheet is not active,as a back-up procedure use form HDS-2780. Remember ` the automated KIW will not create a file in 20/20. Basic Installation: ...An in-home measure and consultation is required to verify proper fit of kitcha cabinetry and other products to be Installed.During this consultation the Installer will check for unusual situations which may require additional labor. ...Daily dean-up of job site. ...NOTE: ***Measurement/Consultatlon fee Is NON-REFUNDABLE #**If customerpurchaseslaborTrnn the Home Depot the measure/consultation fee is applied to the purchase. THE FINAL KITCHEN ESTIMATE WORKSHEET MUST BE SIGNED BY BOTH THE CUSTOMER AND ASSOCIATE AND THEN IT MUST BE MANUALLY FAXED TO TE INSTALLER.A COPY OF THE FINAL KITCHEN ESTIMATE WORKSHEET MUST ALSO BE GIVEN TO THE CUSTOMER. �i�Customer Signature. r Date 8�i7/d7 4 f Associate Signature O\\0-��+- `1N�b� � Date 0Q - l7 -O ^1 Ikl I III i Program Version# 3.0.0 The Home Depot-Confidential III The Commonwealth of Massachusetts CITY Board of Building Regulations and Standards Massachusetts State Building Code, 780 CMR, 71h edition OF SALF.M Revised January Building Permit Application To Construct, Repair, Renovate Or Demolish a i• '008 One-orco-Family Dwelling This is Seec ' r Official Use Only Building Permit Number: Date Applied: //I z2rl`� Signature: /A Building Commissioner/Inspector of Buildings Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 20 C E=DA2Ct4EST AVE I.1 a Is this an accepted street?yes r-� no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq R) Frontage(R) 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: Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Public❑ Private❑ Check ifyes❑ P p y SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: r 64�FRt2Y CsA'>` ee Name(Print) Address for Service: Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials 1. Building S (p (5,OU 1. Building Permit Fee:S Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Cost' (Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: r 5. Mechanical (Fire S Suppression) Total All Fees: S Check No. Check Amount: Cash Amount: 6.Total Project Cost: S ❑Paid in Full ❑Outstanding Balance Due: v\ k C1� SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) C S la6'�S Z CS (p6-7SZ S �&OE7J r` , g(ZtJo License Number I .spiratiun Date Name of CSL-I]older U 6 CON p� �/ List CSL"Type(see below) Type Description WyJ,rrrs �yt ,^� /'r��Jl-e-s?".0 ?7 P9 -0 l9�� R tln Restricted 1 u l0 Family Dwelling Ca Ft. ��"��I �7 R Restricted I&2 Famil Sonialu M Mason Only RC Residential Routing Covering lblc ho WS Residential Window and Siding 8/-63i- `�z 77 SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC> 2 S R i2red. o SOn/S ST�PPHE.t/ A B�dn/D //6 S'3 HIC Company Name or fIIC Registrant Name Registration Number S Li2d1 i9>!% 2!7 —7—Z s —12— Address. Expiration Date Signature Telephone SECT ON 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...........0- 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. Signature of Owner Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 1, /V , ,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. -3 wit/ - . 0RCJ1J0 Print e Signature o' )wner or-AulthcIrtkeld Agent Date (Signed under the pains and penalties ofperjury) 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 not have access to the arbitration program or guaranty fund under M.G.L. c. 142A.Other important information on the "IC 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 half7baths 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" _ik CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT .11ie:X:I Y:)xhCl It L vl Est a 12C WnsruNc:uyN Staet:a' * $•ubat,Ms>snc:rn sc niGPi7.^ TrJ.: 09.7 6-9i95 • p.tx. 9I8-74C�nYN6 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Uml]cant Information Please Print Leeibly Naine trio<nxvsiQrganiruinNindry uluul): �/ � '�✓ B�2y�0 Address: y COAl oYLA1 i2/�> City,smwizip. s�i.92%C�s✓/Z > 1'hunc •'.(: ® 7YI —lio /�77 Are you in employer'.'Check the appropriate box: "Type of project(required): I.❑ 1 am a employer with 4. ❑ I :tin a general contractor and 1 6. ❑ New construction col to ces(full and/ur art-tinlc). have hired the sub-contractors 7. ❑ Remodeling 2.0j :tin a sole proprietor or partner- listed rat the attached sheet. ship and have no eanpioyces These subcontractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. q. ❑ Building addition ]No workers'cutup. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exorcised their 3.❑ 1 ans a homeowner doing all work right of exemption per N(GL I L❑ Plumbing repairs or additions myself. INo workers'comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance requited.] r employees. INo workers' 13.0 Other comp. insurance required.] •nny u;tphcant amt checks box nl must alsu lill our the section Wow dtuwiny their wulkui cumpensmiun pulicy inliamaliun '1 rumeuwrwn who submin this affidavit indicariny they are duiny all twrk and them him outside ctaunwlon must submit a new affiidavil indisW ins such. -('omrwwn fl ul chuck this box mtal anaehLrl an additional slwrcl shuwiny the omlle of the mb•eontrwfors and their wurkeri camp.policy infurmuiun. /nun rat etnp(uyrr shut lv pruvidinx rvurkers'c•anpcn.vainn insurance jet any eop/uyrev. Below is the policy and job site inj✓nnutiun Insurance Company Vmne: Policy 4 ur Sclf-ins. Lie n: _._... .... .._ Expiration Date: Job Site -Address: City;Slate/Zip: Altach it copy of ilia workers'compensation policy declaration page (showing the policy ntunber and expiration date). Failure to secure coverage as required under Section 25A uf.NIGL c. 152 can lead to the imposition of criminal penalties of a tine up u)S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine ofitp to S250.00 it day againbt the violator. lie advised that a copy urthis statement may be torwardcd to the Office of I a1'e.% ha tions el llle DIA for Instlrance coverage % tIiflLJtion. /do hereby ccrfjy nude 'av old n '•v ajperjury that the injurrnation provided above is true and correct. [Issuing.whorily flicimi use ady. Do not write fit this areu,to be completed by city or tolvrl ojjicial i fy or Town: _ Permit/License ll-- _ (circle sue): Ilaard of llcalih 2. Building Deparuncnl3. Cilyrfoe n Clerk 4. Metrical Inspector 5. Plumbing luspeclor 01 her Cnulacl 1'cnuu: _ _. 11hoale tY: Information and Instructions \Inssachusetts General Laws chapter Ij2 tequires all employers to provide workers' compensation for their employees. Pursuant to this,tatute,in emplowe is defined as"...every pci son in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or.other legal entity, or any two or more d the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the Dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house Or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." .MGL chapter 152. §25C(6)also states that"every state or local licensing agency shall withhold the Issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, AIGL chapter 152, 325C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of conipliance w ith the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should he returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain u workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or'rown Official Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom Of the affidavit for you to fill not in the event the Office of Investigations has to contact you regarding the applicant. Plaasc be sure to till in the permit/license number which will be used is a reference number. In addition, an applicant that must submit multiple pennitilicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. I he 0I-ficc tit Investigations would like to thank you in advance fur your cooperation and should you havc any questions, please do not hesitate to give us a call The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Of lee of Investigations 600 Washington Street Boston, MA 02111 Tel. k 617-727-4900 ext 406 or 1-877-MASSAFE Fax N 617-727-7749 Kcvi,eJ 5-26-05 www.mass.gov/else CITY OF S�ALEM, , L-kSS.AcHusETTS • BI:I mmr, DEPART%LENT • 120 W.ASHLNGTON STREET, r FLOOR TEL (978) 745-9595 FAX(978) 740.9846 KIN(BERLEY DRMOLL THO MAYOR .'NAS ST.PIERRB DIRECTOR OF PUBLIC PROPERTY/BUMDCKG CMWISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# is issuoiwith 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 1 11, S 150A. They debris will be transported by: (name of hauler) The debris will be disposed of in : (name of facility) (address of facility) sin a of permit ap 'c t '7--2 z-ib date dcbns [Tdaa BRUNO & SONS not your general contractor Galley Proposal November 1, 2010 Gerry Ganey aiganev(dverizon.net 20 Ceadrerest Ave 978.744.6603 Salem, MA 01970 subject: estimate for proposed roofing description: roofing- • remove all asphalt roofing shingles, metal drip edges and step flashing, remove roll roofing on rear main roof >install white aluminum drip edge around all roofing perimeters > cover all of rear main roof with ice and water shield, cover leading edges of roof with 36" of ice and water shield and sides of roof with I W of ice and water shield > cover all exposed roofing areas with new 3 tab asphalt shingles ( color to be determined by owner) > side roof above side steps is roll roofing and appears not to be leaking so I will not include it in this estimate, although the upper structure will need some attention at some point >remove all construction debris and dispose of properly > if there are additional items that you would like to incorporate, call or email me so that we can discuss them 5 Conant Road Marblehead MA 01945 MA-CSL#66752 MA-HIL#116832 brunosons@excite.com 781.576.9093 USCG Unlimited Chief Engr's Lic. #055682 BRUNO & SONS not your general contractor Ganey Proposal 20 Cedarcrest Ave., Salem, MA 01970 November 1, 2010 pg2of2 >all work to conform to state and local building codes > the estimated cost of this proposal is approximately$6,915.26. All supplies necessary to complete the work as described above are included in this estimate unless otherwise noted. Owner ate _ C actor Date Gerry Ganey Stephen A. Bruno 20 Cedarcrest Ave 5 Conant Road Salem, MA 01970 Marblehead, MA 01945 5 Conant Road Marblehead MA 01945 MA-CSL#66752, MA-HIL#116832 brunosons@excite.com 781.576.9093 USCG Unlimited Chief Engr's Lic. #055682 � , � . � � The Commonwealth of Massachusetts `CITY Ok'`"' " ' ,r� Board of Building Regulations and Standards ` Massachusetts State Building Code, 780 C1vIR �p SALEM . ' eC4YisedMcrr�Ol �: .� ; Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Famlly Dwelling This Section For Official Use Only � � BuildingPermitNumber: Date pplied: �-' //,�,".� ` 1 /3l .�, Building Otficial(PrintName) Signature Date � SECTION 1: SITE INFORMATION � 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers "� 20 Cedarcrest Avenue ' I J a Is[his an accep[ed street?yes no Map Number Parcel Numbcr r.n 1.3 Zoning Information: 1.4 Property Dimensions: �� RESIDENTIAL I Zoning District Proposed Use Lot Area(sq ft) _ Frontagc(ft) 1.5 Building Setbacks(ft) Fron[Yard Side Yards Rear Yard Required Provided Requircd Provided Required Provided 1.6 Water Supply: (M.G.L c.4Q§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public❑ Private❑ Check if yes� Municipal O On sile disposal syslem ❑ SECTION 2: PROPERTY OWNERSHIP� 2.1 Owner'of Record: � � � Geraldine Ganey SALEM. MA. 01970 Name(Print) City,State,ZIP 20 Cedarcrest Avenue (978) 744-6603 qjqanevCa?verizon.net - No,and Streel � Telcphone Email Address ��, SECTION 3: DESCRIPTION OF PROPOSED WORKZ(check all that apply) . New ConsYrucCion ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ AI[eration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:souR Pv � Brief Description of Proposed Work2:Install Solar Electric panels on roof of existinq home to be interconnected with the home's Electrical Svstem(20 panels at 52 kV� � SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $3,000 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $6,000 ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire Su ression $ Total All Fees: $ Check No. Check Amount Cash Amount: 6. Total Project Cost: $9 000 ❑paid in Full ❑Outstanding Balance Due: m�t��-e tN �S� 12I� 1 , SECTION 5: CONSTRUCTION SERVICES 51 Construction Supervisor License(CSL) - � � . 10168] 9/13/2018 ' . � SOLARCITY CORP./DANIEL D. FONZI Licensc Number Expiration Date Name of CSL�Holder � List CSI."type(see below) � 800 RESEARCH DR No.and Strcet Type Description � U Unrestricted(Buildings u to 35,000 ca ft.) WILMINGTON MA. 01887 R Restricted I&2 Family Dwelling City/Town,Sta[e,ZIP M Masonry � RC Roofing Covering . WS WindowandSidin � � SF Solid Puel Buming Appliances 9]e-215-2383 an�so�.keney@soiarciry.com I Insulation Tele honc Email address D Demoli[ion 5.2 Registered Home Improvement Contractor(H►C) � i sasn arein SOLARCITY CORP. I-IIC Regislration Numbcr Gxpiration Datc � HIC Company Name or HIC Registran[Name � � 800 Research Dr allison.kelley@solarcity.com � No.and Strcet . Email address � Wilminqton Ma. 01887 978-215-2383 Cit /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 �I this affidavit will result in the denial of the lssuance of the building permit � Signed Affidavit Attached? Yes ..........0 No...........❑ � '� SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPWES FOR BUILDING PERMIT I, as Owner of the subject property�hereby authorize So�arCiry�oaniel D Fonzi to act on my behalf, in all matters relative[o work authorized by[his building permit application. "See ContracUOwner Authorization 12/5/16 Print Owner's Name(Electmnic Signature) Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below reby ttest�unde9r the pains and penalties of perjury that all of the information contained in this applie i' n is tr � nd Ed t2"Yo Che best of my knowleclge and undersYanding. 12/5/16 Print Owner's or Authorized Agent s Name(Electronic Signature) � Date � NOTES: 1. An Owner who obtains a building permit to do his/her own work,oc an owner who hires an unregistered contractor (not registered in the Home lmprovement Contractor(HIC)Program),will nat have access to the arbitration � program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: � Total floor area(sq.ftJ - (ineluding 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 Projec[Square Footage"may be substituted for"Total Project CosY' .,r CITY OF $.�LE:�1, ti'I.�SS.�ICHUSETTS �'• • BtiII.D4�SG DEP�R'iJ�+�iT \ �`� 120 W 1SH .NGTON STREET, 3"D FLOOA TEL (97� 745-9595 F�.r(978) 7a0-9846 ICi�{gERL,EY DRISCOI,L i1MYOR THOMAs ST.P�RRB DIRECTOR OF PI:BLIC PROPER'IY�SI'ILDING CO�L�QSSIO�iEA Construction De6ris Disposal Affidavit (required for all demolirion and renovation work) In accordance with the siacth edidon of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# 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 11 l, S i 50A. The debris will be transported by: SolarCity (name of hauler) The debris will be disposed of in : SolarCity Wilmington (name of facility) 800 Research Dr. Wilmington Ma (address of facility) signahue of permit applicant 12/5/16 date ��n�„��r.d,x ' . � Tlie Com►rromveatlh ofMa.stachusetls �. ,, ^ Department nflnduslrialAceidents ` O�ce offnvesdfgatiaxs I Co»gressSbee�Sutte la0 � Sostax,MA 01134-20f7 www.muss.gau/dia Warkers'Campensation Ii�saraace Afiidbvih Huildere/Coatraclors/ElectricianslPiumbers Applicant Iaformatian Please Print L�gi�y Name�a„�,�o�,;;za.uo„nnarv�c�>: SolarCity Corp. � Addmss: 3055 Clearview Way CitvtStatelZ' : San Mateo CA. 94402 Phone#: 888-765-2489 Are yoa Ra empiuycr?Cbeck Ehe eppropr{afe box: Typ¢of project(required): l.�1 am a employer with 5,000 4- ❑ I am a genaml contractor a�7 �p��/��. have hiredthe sub-contractors 6• �New construcNon 2.� ]am e sde proprietm or partncry listed on the atteched s�e� 7. �Remadeling sAip and have no em 7u es '1'hae sub-conlreetors hsve 8. P � em ea snd heve worlce�s' �Demofition working fix'me in eny capaciry. P�Y = 9. []IIuitding addition (]�Toisakars comP, insuranca comp. insurance. ny�,t 5. [� We mc a corporatIon and its i0.[]Eiecvical repairs or additions 3.�I am e h�eownw daing all work ol�icars ha�e cxercisad the'v �(.Q p�u�bir�g rcyairs or additions my�IC.[ko workers' canp. ;•iY��ivi c,cen�tian par hiGL 12.❑RooFrepairs insurmcereqniredj+ c. t52,§1(0.),andwehavem �3 ✓ o�her Solar/PV employces.[No workers' � comp.�nsurance required.] 'Aay rpPlicsm d�a eFecks hox UI m's[alao{fN ow�he scuioa belaysbpwistB 15dr workcw'wmpexmt9on pelicy inlb�me�iaa. t Fbexo.mns w6o mhmuihis a07davit i�lw6ag u�ey ae doi�atl avrk sad fAen hiieaasid-.en�melws mLLs�s�rteh a nea sflidavit fndiaWingsnch. � �CmaeaGonldat�hxYihkhoxmugtan9chedonedditinndahaushowipgpcenameo(Nesn6�ep�maandatefewiut6erwuottlwseemiticshavc empFoyeeg. Ifides�raetorsharesmpbyces,dwwmuslptavidethcfrworkcrs comppoliryrwmber. I ani nn artp(aytr that fs pmWding worker.c'compmsn�ren insarmrcejormy empWyee,r. Be/aw is ltie policy and job sNe ipfarmaUon. . _ � L�sucaace��yw�: Zurich American Insurance Company Policy fl ar Soif ins.Lic.N: WC0182015-01 Expiration Date;9/1/2017 �ob s��eAd�hess: 20 Cedarcrest Ave �ny��;y; Salem Attach a cepyo[t6e workers'compenratton poliey daclarativo page(showfig the�oliey nnmber and ezpirotfon daie). Failure w ucure coverage as required undcr Secticn 25A of MGL a 152 can ks�to ihe itnyasition of cruninal yenalrixs of a firre up to 51,500.00 end/or ane-year imprisanment,as wel]as civil peaeJties io Ne fmm of a STOP WORK QRllER and a fioe af up to 3150.�a day against the violator. Be advised[haz e capy of this sta[ament may be forwarded to tha Oftica of idVesdgatioas oftbe pIA f�insucance caVer�ge verificatia�. I da perrby cerllJ'y er Ihe pafNS and penaHler af pe�Jldp�7k�pl!he iBformaUou p�ovMed 4bpva ls trrre arld corrert s,ena� - ��i-�,�,�—r':�.i'`�nsto• 12/5/16 Phone q: OJfs}a!rrse oaly. Do nc!w:ka!x ihis crea,to be cnntpleted by c!ry ar tswn ejj7ciaL City or Town� permil2{cense',f Issu(ng Anmortty{circle oneY i.Boanl uflieaNh 2,Buildieg Departmen! 3.City/y'own C1erk 4.�Iecteica�Insyector 5.Plumbing Inspectur 6.Other C00�'dCl YlR00: Ph0118#: � , f / / / ,// � y . �y ��i �� r }�filJr tt(/ prfrl`�l/ �� (�rJ.r.r+lfl!l�.:t !/ , . �� , Office of Consumer Affairs and Business Regulation � ' ;�� 10 Pazk Plaza - Suite 5170 . ' Boston, Massachusetts 02116 Home Improvement Contractor Registration � � � Registrelion: 188572 l Type: SuDDfement Cerd � ; Expiration: 318/2017 SOLAR CITY CORPORATION . DAN FONZI - ------ .. ._.. __------ 24 ST MARTIN STREET BLD 2UNIT 11 - ---�� - ---- - MARLBOROUGH, MA 01752 _. _ _._.._._-_._. _ ._.-_.___� - Updete Addreas aod remm eerd.Mork reason Por changa � - . [] Address � Reoewal � Employmenf !_� LostCard � . "(Mlice ofCovtomer Afhhs&Bminen�Regnlctioc Licenee or reglttration wtid tor individul uea only � . �x'�MB IMPROVEMENT CONTRACTOR beforo t6e espiratton deta Ittound rowm to: � Ofiia of Consumer Affalrs and Bustness Regolelion Reg�atra8oe: �ggg7p TYPa: lO Park Plam-Sulte 5170 � E�cpiretlon: ygn017 SupplemaM Cerd Boston.MA OE116 � SOLAR CITV CORPORATION . DAN FONB 90SBClEARVIEW WAY �:� •.e �:-y - - � . � SAN MATEO,CA 94402 � - -'". I � Underaeereary � Not velid without 9ignawre � ' ! M�ixhtcFdti Ospartm�t of Ru1F1a i�aNt�t � .. � BoatO o!-&rMd�nC ��7tiatMt�s4 fM its� f ��I � � i � ' LScrr�sQ-CS-001687 . .;f 4 , . con�uuawn 5�'•u« � . i '��, • pAN�D FOPRi � ��I 390AI�OVERSTREL''�f� � ; , li VYLMWGTONMA�t�� .. ._.. i t I M..�n V�.� EXWIAb[sn' ' � t li C�hsmiss{oa¢r OB(7SfZ01s ' � � d '� � � � � , ��, 1 � \ DocuSign Envelope ID:4DD818F7-23E5453D-B785-0638322ADE4C , �. � �` �� ' =� � , �_� SO��f�lt�/ SolarLease%� � ` � � � • / _ � ., ^ \ ' � Customer Informabon / '' ��stallation Location/ .� Da[e �� lereldineGaney � � 1 20CedarcrestAvenue 11/29/2016 \ + �� 20 Cedarcrest Avenue �.Sa�;MA 01970 �=J�� Salem,MA 01970 � �y'� \� `� 9787446603 r \\ �//� \ ; .�S �. �_� i� � .C-�_�t.�.�—.. . �._ ___... _ a i.-�.- ` � � �_- ._,_..«. . . . _ .3 L..—� . �� , Here are the key terms of your Solarlease Agreement �� I � • � � � �S � I � � , � . !; � � o � � , �yrs � � � Amount due at contrect signing ii First year mon �ayment Agreeme �m I ,_ (Es[.Price per kWh rst K9er:$0.1450) ^p �, ,1�� t� Initial here. Initial her . W y �_ �._ _ _. ..___ . _ _'_ .._ .— ' ' . _ _._._ __._ —' �_..._ .� ___ .. —._. _' _ _"__ ��. � , , p The SolarCity Promise os •We provide a money-back energy performan,ce guarantee. � i�IG+� •We guarantee that if you sell your Home,the buyer will qualify to assume your Agreement. _._...inicia�here � ` �. •We warrent all of our roofing work.�'' ��~`'� , � �. � � � •We restore your roof at the end of the Agreement � ' / \ �G � ,'`.i I � ' . . �� •We warrant,insure and repair the System. _...� 1_.._—__..—�__�_______—___ ....._.. ......._.......�..__Initiai her ` .We fix or pay for any damage we�m�y cause to.your'property.�"� � �� . .We provide 24/7 web-enabled monitoring at no addifional cost. � �� . .The rate you pay us will never,increase by,m ro e4han 2.90%per year. � � � �. .The pricing in this Agreement is valid�.for 30 tlays after il/29/2016. - � . � y , �, � '•� � Your SolarCity,Lease Agreement Details �� J� �• � � _._ -- - �- � - ' I � ._� , '� Your Choices at tbe End of the Initial r`�Your Prepayment Choices During Amount due at cont�act signing ( Term: ; , \ the Term: $� •SolarCity will remove.the System at no � •If you move,you may prepay the � Est.amount d e at installation � additional cos[to you. �� -- J� remaining payments(if any)at a � $0 � .You can upgrade[o a new System with. � discount. � ( the latest solar technology under a new Est.amount due at building inspection j �ontract. s 5o y � � •You may renew your Agreement for up to � Est.first year production , ten(10)years in two(2)five(5)year �, ' 4,678 kWh !� increments., �`- � �___ _ ___ _ . _ ._ _ ._. , _ _ ! �herwise,theAgreementwill ! �' ,, � automatically renew for an additional one /''- �� 1 earterm at 10%less than the then- 1 �" 1I )Y / '�.. current average rate charges by your local � r' � �l ' utility. J ( ' � �� `�.,/ �+ � � J I �,,/ � J . - / , 3055 Clearview W�,San M�'�ateo,CA�02�888J65.2489 � solarcity.com ; ' �* �2361280 ' \ i � SolarLease Agreement,version 8.01,November,l6,2016 - � � \. ' SAPC/SEfACompliant .� �, � � �� . � � � Q �O Con[rac[or License MA HIC 168572/EL-1136MR�� r ;� Document generated on 11/29/2016 -f �� f �, `� �- � �a� fopyright 2008d015 SolarCity Corporation,All Rights Aeserved � � .'`. / ��! �,� + � �� . - - L�- f . _ . .a - DocuSign Envelope ID:4DD818F7-23E5453D-878S063B322ADE4C � � l` � .. • . ' ��. 23. NOTICE OF RIGHT TO CANCEL !� � �� ' � �. � YOU MAY CANCEL THIS LEASE AT ANY TIME PRIOR TO ��/�. By signing below,I agree that SolarCity can contact me for �� . MIDNIGHT Of THE THIRD BUSINE55 DAY AFTER�THE DATE telemarketing and informational purposes via calf or text�using YOU SIGN THIS LEASE.SEE ERHIBIT�1.THE�A7TACHED automated technology and/or pre-recorded messages using ,� � ♦ � r � � � A NOTICE OF CANCELLATION��F,ORMi FOR�AN EXPLANATION the phone number(s)I provided that are listed omthe flPst page OF THIS RIGHT. � of this cont[act._I.understand that consent is not a condition of � ? \ � J % l > . � purchase. You may opt-out of this authorization at any time by 24. �ADDITIONAL RIGHTS TO CANCEL calling us at:888Y765-2489 or�sending us written notice and f � � . . 1IN ADDITION TO ANY RIGHTS YOU MAY HAVE TO CANCEL mailing it to:SolarCity Corporation,Attention:Phone � Authorizati;pt-Out,3055 Clearview Way,San Mateo,CA 1,THI5 LEASE UNDER SERIONS 6 AND 23,YOU MAY ALSO � CANCEL THIS LEASE AT NO COST AT ANY TIME PRIOR TO 9�02' � ,� COMNIENCEMENT OF CONSTRUCTION ON YOUR HOME. I have\ad this Lease and the Exhibits in their entirety and 1 25. Pricing acknowledge that I have received a complete copy of this The pricing in this Lease is valid for 30 days after �ease. . . il/29/2016. If you don't sign this Lease and retum-it to us Customers Name:Jereldine Ganey - � on or prior to 30 days after 11/29/2016,SolarCity re;erves � oacusig�rcd er the right to reject this Lease unless you agr/ee to our then� 1yy� � �� ,._ � � � current pricing. � ��.� 'y Signature: ��J�'� � 1� l �� `- � . �., aieeezmrecaeo... `+` ` ``� �, ` . ��\ �` Date: 11/29/�01� f � ' � � � � �. . , �, � ,, � �., /�� i ^:, ' �` . � � � � � (; � f� �� J �� Customers Name:� ` ��, , . % � ,, . � � f, � � �� . Signature: �_. ��* , � \ . � � __'�� , \� .. � ; ` �� Date: �� u �..'� � . �, ��--� �\.� . �� r, / - \`\ . �' .� � � r � SolarLease AgreemeM '� 1 , , � � �- �� ,`� SolarCity ' � �'- approved `, , Signature: � �, � � Lyndon Rive, CEO �� \ , <l 'y ` l F �4� ,, . ` .� , , „ � � Date: il/29/2016 r� l � \ � ��V ``� � �, t �� , .^� ! ` _�� \, \ ` � , \ '` ` , 4 � ' � \ . � , , 1 � - �' �V � , � , , � �, ' 0�0 SolarLease Agreement,version 5.01,Nmember 16,2016 � � �` � � 2361280 . �� / •� \ � . �� \��,. � Version#64.1-7BD �;,;�O�afClt�/ • v�„r December 2, 2016 RE: CERTIFICATION LETfER ��a�'� �q' � � �`� JASON WILLIAM yG Project/Job # 0192444 � m Project Address: Ganey Residence o STAUCTURAL w � 20 Cedarcrest Ave � Salem, MA 01970 No.51554 . q90 9FG/S7EPE��t'Q � AHJ Salem �SS/ONALENG\ SCOffice Wilmington _ _ 0,16 Design Criteria: - . � -Applicable Codes = MA Res. Code, 8th Edition,ASCE 7-05, and 2005 NDS � - Risk Category = II -Wind Speed = 100 mph, Exposure Category C, PartiallY/Fulh/Enclosed Method -Ground Snow Load =40 psf - MPl: 2x6 @ 16"OC, Roof DL = 14 psf, Roof LL/SL = 28 psf(Non-PV), Roof LL/SL= 15.52 psf(PV) . Note: Per IBC 1613.1; Seismic check is not required bewuse Ss = 0.31364 < 0.4g and Seismic Design Category(SDC) = B < D To Whom It May Concern, A jobsite survey of the existing framing system of the address indicated above was performed by a site survey team from SolarCiry. Structural evaluation was based on site observations and the design criteria listed above. - Based on this evaluation, I certify that the existing s[ructure directly supporting the PV system is adequate to withstand all loading � indicated in the design criteria above based on the requirements of the applicable existing building and/or new building provisions adopted/referenced above. Additionally, I certify that the PV module assembly including all standoffs supporting it have been reviewed to be in accordance with the manufacturer's specifications and to mee[and/or exceed all requirementr set forth by the referenced codes for loading. � The PV assembly hardware specifications are contained in the plans/docs submitted for approval. Digitally signed by Jason Toman Date: 2016.12.02 11 :0539 -07'00' � 3055 qearview Way San Mateo,CA 94402 1(650)638-1026 (8BB)SOL-qTY F(650)638-1029 solardty.com RL055UJ.MM�003].�ZPOC345)IflPOC$�5�40.Q451P.90B1W.fAFC804.CTNilpd}1n0/ELC9R405.bCAfp5lapp�Op�/ECCV�]Ai.�fP0�40.'bcI11�EN],RECt340b3PL.HICI44!A,ItAY6J5P.H4HIC�LBS)3/ . Eb166MA,MpH�C3B4A8/IHLG.Nf.3%�OU.NHW<)GIISRJM.IUNJHIE/3vHWIE06G0/SaFR0953>W.VFE9B3MG96NVNY3U11�3E1ILCF�W)86�9/6]-DJ]9J19.OHEL<)]%.ORRlUMCP%CSE3:PoWfFAO)AGS,W ALDJ9]M/Pry383II,t%iEClDh56.Ui 8)369LJ�SSO1.V4 EIEIID51R0]6.Vi EM-0:BY2 Nq SOLPAC9ICO VSCLAPC'OpSM,A Wm�430.Grnns�-eqb.0nnu N3EOWInp�WM�m PCe0t1.Po<H�np H-Ilfid�dU-0O-0U.SuOde 510A-H k'enU�tllx WC-4lC98-M3,i4 Y C MI W130a-0CP«EM'C N Y C Liqrn�tl fJ+abl!len.XiREfO.YM<�BE.155YIalw SL GN R.Unll U,omOHM.NP��tUl X24I544o-�fA NI lom�yoAYM 4/SebrClhFlnnme ComMrry.LLC C0.flnnc�L�r1Gn��lic�n[�bIXJ)0.boIpCIN��Ma iomryiry LI C If�le�ns�tl Iry NY pi�x'or�SLLl�f��k fqniTllXon�f U�i�(3g�rn WNnstf itl��Hx�I�Mx11qm��umCa��{T��1L MD COn�N�N Lutn LIc�nH T$AI,NV M�t Vmenl toenlb:mrt IpUA/Il➢OR4 M bcenwe l�dx ti30G31G3LL IX RW��'+'�G�duor fa40J50in5-303JCV.4T tq�lw llcmw/0166 `��,� � Version#6Q.1-TBD . ;•;;SO��fCit�/. ' , HARDWARE DESIGN AND STRUCTURAL ANALYSIS RESULTS SUMMARY TABLES Landscape Hardware-Landscape Modules'Standoff Specifications � - Harclware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MP3 64" 24" 39" NA Staggered 51.0% � Portrait � Nardware-Portrait Modules'Standoff Speci£cations � Hardware� X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Confguration Uplift DCR MP1 48" 20" 66" NA Staggered 64.2% Structure Mounting Plane Praming Qualification Results Type Spacing Pitch Member Evaluation Results MP3 Fnished Attic 16"O.C. 37° Member Impact Check OK � Refer to the submitted drawings for details of information collected during a site survey. All member analysis and/or evaluation is based on 6aming information gathered on site.The existing graviry and lateral load wrrying members were evaluated in accordance with the IBC and the IEBC. � 3055 pearview Way San Mateo.CA 9440Y r(650)638-1028 f68B)SOL-CITY p(650)638-1029 wlarcity.com 4 05500.M N-803).e2 PD(.1all)i/POC 3�Sn50,Gr CSLfl BB810a.N ECpOM.Ct HICGbt.1110/6C OR90C.DG1p51d0000B0/�CCV0150l.DE PO¶120186/ibdN2,ft[C130p5218.NI fi-I'1]]OJL u'�WS].NP 111C kB5)L E1-0136Mft.MD HIC q60nBbHCS.NC S090L4 N1103<)C/1Y548M.WJ NJIIICM13NId160HYJ/D<[601I31>fA.NM EECB�SNSBQ NY NVNI411359yf,�-0Jfidae/PB�W i9]W.OH ElA))W.OR GAbC40B/Cfib2 PC�tl6�J)]943.N OCOOd)N/Nap3814,i%lECt11Wb.UiB)26ap.5:01.VPELF3I05'f+5'Jfl,`IIEM-0SB4P W450vMG'9FJV501MC9M`P),41aM�30.GrwnaM�Bd.N�nauH2qu0111�q rytmmPCdOu.Re.Y4ntlN-I1b6E-GO-00-04`ulb� 5205)�Il WniUuiw W C-4 WOB-Hp.N Y C+3WR��-0C4 SCCi+lC�u v.G LIc�mN M.Midm.�L^LIO.ROOu6'..IS:W�W SL 6th Fl_IN�I O.frooYnt NY 1ROl M[013C65-0CA Pll bm�pondt]b�SolvClryP�nur2e:wnq�,ltC ('p FinmwLmtlartUcrH 6Mq0:$oluClryFinmce Comq�ry.LlC I�fcns�tl by Uu O�ba'anSGta Emk Cemmlitlaro�lo anVM��^u�InDel�wrte urvla 4Cpme munqr 01442 M�Cmmmer Lom llnnN 2$<I.NV In�Nlimrn�lo�nO:en�i Ibq?i/i11102a.P��icao�W l.mE�N'bG310kt.t%Rcyium Ge3do.iaiN054e6]-3UIaM.�4 t�+dr Lmr�sa X6)bo � S�RIGCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK—MPl Member Properties Summary MPl Horizontal Member Spans Rafter Properties Overhang 0.16 k Actual W 1.50" Roof S stem Pro erties 5 an�1 � � 12.05 ft � �� Actual D �� 5.50" -__-._ __-. . Number of S ans w/o Overhan 1 � Span 2 Nominal Yes RoofingMaterial . . ...__.__CompRoof.__ "�Span3.... . .... ___A(in^2) __ . 8.25 �� Re-Roof No Span 4 Sx(in.^3) 7.56 Plywood Sheathin � __._. _�— — - _ .- — _._._ 9� Not��" . S an5�"".' ° ` . Ix m^4 20.80 � .u�� Board Sheathing Solid-Sheathing 7oWl Rake S an 15.29 ft TL Defl'n Limit 120 Vaalted Ceiling � ��;�� 3 � �� .�-"Yes'�.�z: ,___PV i 5tart � ��s�.�;_OJS ft Wood Species . � SPF ,��>.�. . Ceilin Pinish 1/2"Gypsum Board PV 1 End � 11.33 ft Wood Grade � #2 RaRerSlope .. � 37°_ =.....w ..�.PV2SWrt— .'__.._�_. . Fb(ps�) .__ __.---875___._-.. Rafter S acin 16" O.C. PV 2 End Fv si 135 , Top Lat Brating . „.._______ Full PV 3 Start .... ,,, .__ � _'E(psi) . � � �Y,400,000�� Bot Lat Bracin � Full PV 3 End E-min si 510 000 Member Loading Summary Roof Pitch 9/12 Initial Pitch Ad'ust Non-PV Areas PV Areas Roof Dead Load DL 14.0 sf x 1.25 17.5 psf 17.5 sf PV Dead Load ......,:°T'�e.� � 'PV-DL*`:i"�r 3A psf �,_ �x -x 1.25 __.� �� . 3.8 psf 'm� Roof Live Load RLL � 20.0 psf x 0.75 15.0 psf _...__ —. ..._ - - - .,.:.._ ....,. Live/Snow Load �� " � -�� LL/SL''Z �40.0 psf x OJ � x 0.39 -28.0 psf �� 15.5 psf Total Load Governin LC TL 45.5 sf 36.8 sf Notes: 1. ps =Cs*pf; Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=07(CQ)(C�(Is)pg; CQ=0.9,C.�=1.1,I,=1.0 Member Design Summary( er NDS) Governin Load Comb CD CL + CL - CF Cr � D +5 1.15 1.00 1.00 13 1.15 Member Analysis Results Summary Governin Anal sis Pre-PV Moment � Ib-in Post-PV Moment Net Im act Result Grevi Loadin Check 1748 1417 0.81 Pass � �LCUL'ATION'OF DESIGN WIND'LOADS'MP3 �`'� I . Mountin Plane Information ..,; , � Roofin �Matenal ... ..,. � � � . .... .,� ` .. .. CompRoof;fi "� � " , � � �_A Roof Slope � 37° , Rafter 5 acin 16" O.C. �"�] Framing Type/ Direction Y-Y Rafters PV SystemLLType�� '�Sola�City SleekMountT"'� Zep System Type - ZS Comp Standoff Attachment Hardware i Como Mount SRV Spanning Ventr No � -- .�..-.,. -b.,,_,��. . us�^a .- , �N... �..� �.+�r .,�� r y, «, Wind Desi n Criteria Wind Design Code IBC 2009 ASCE 7-OS � � Wmd_De_sign_Method_ � Partially/Fully En'closed Method � _ _ Basic Wind Speed V 100 mph Fig. 6-1 � - -�� -- --------- � Exposure Category .__ _ _- ___ C y Sedion 6.5.6.3y Roof Style Gable Roof Fig.6-11B/C/D-14A/B -_.--�-tr�..r��:h Mean Roof Hei ht .:�..s'..z... 15 ft .��mw.c..,. ��. �Section 6.2�' Wind Pressure Calculation Coefficients Wind Pressure Exposure K� 0.85 Table 6-3 � Topographic Pactor Krt� 1.00 �3'ecEion 6.SJ� Wind Diredionality Factor ICtl � 0.85 Table 6-4 � -��----_--.�-5--,_ _ .. ... .. . �->>_-,r � Im ortance Factor I 1.0 � . Table 6-1....,... VelocityPressure qh � qh = 0.00256(Kz)(Kzt)(Kd)(W 2)(I) � Equation 6-15 15.5 psf Wind Pressure Ext. Pressure Coefficient U GCp(Up) -095 � Fig.6-11s/C/o-laA/e � Ext. Pressure Coefficient Down ___ __GCp Down _ __ _-_r__ _.__0.88 �ra:a� � �-� �� Fig:6-11s/C/�-1aa/B Desi n Wind Pressure � p p = qh (GCp) E uation 6-22 Wind Pressure U P„ —�--�----.-...... .-17.5 psf � .. . Wind Pressure Down aow� 16.2 sf �ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape � 64" 39" _ �-t,�.. .,,.�,,,� �_,�_.,.,,,�w. __ MaxNlowableCantileyer_ . �Landscape.� 24" � -�NA _ .. .. ..._.�.. Standoff Confi uration Landscape Staggered - Max Stan_doff Tributary.Qrea �� Trib � � ��`ll sf �� ' � � � PV Assembly Dead Load W-PV 3.0 psf --'---_-----�._,-.-_��,:�- -— Net Wind UpliR at Stando_ff T-aduat� -279 Ibs Uplift Capacity of Standoff T-allow 548 Ibs � SWndoff Demand Ca aci '�-DCR 51.0% �� • � � � X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48" 66" _ _-- _.....T�: -�. ��- -�-s �_�- -� Max Allowable Cantilever _Portreit� 20"�'�' NA - � �.�__ A SWndoff Confi uration Portrait Staggered Max Standoff Tnbuta Area �T�ib� � 22 sf " " `� ` — ----ry- - ---- PV Assembly Dead Load �W-PV 3.0 psf ..,�.�--__..,e- �.. Net Wind Uplift at.Stando_ff �,_,T-a_ctual� . -352 Ibs - - �, Uplift Capatity of Standoff T-allow 548 Ibs� Standoff Demeod Ca ac'�'i'�� DCR � .= 64.2% � '� - 1 - . � . . ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID-INTERTIED VIA A AC ALTERNATING CURRENT UL-LISTED POWER-CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONC CONCRETE 3. A NATIONALLY-RECOGNRED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WIiH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF iHE DISCONNECTING EMT ELECiRICAL METALLIC iUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET-BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECIRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF iHE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSiEM PER ART. 210.5. I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WIiH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENiER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAW (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL-LISTED LOCATION PROVIDED BY THE PL PROPERTY LINE MANUFACTURER USING UL LISiED GROUNDING P01 POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 70. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT ', Vmp VOLTAGE AT MAX POWER VICINI� MAP INDEX I Vac VOLTAGE AT OPEN CIRCUIT 3R NE A 3R, RAINIIGHT PV1 COVER SHEET I PV2 SITE PLAN PV3 STRUCTURAL VIEWS PV4 UPLIFT CALCULATIONS LICENSE GENERAL NOTES V CutsheetsEAttalchedlAGRAM 0 DONE TO THE STH EDI�ON A GEN 168572 1. ALL WORK T BE � OF THE MA STATE BUILDING CODE. ELEC 1136 MR p, ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: * 1A AHJ: Salem REV BY DATE COMMENTS REVA NAME DATE COMMENTS UTILITY: National Grid USA (Massochusetts Electric) • O � . " • • r • • � (%NlFlOEN1IAL— 7HE INFORNATION HQ2EIN JOB NUNBER PREMISE OXNER: OESCA�710N: UE9(N: JB-0192444 00 �\,,,S��a��lty CIXVTAINED SHN.L N0T BE USED FOR 7HE GERALDINE GANEY Geraldine Ganey RESIDENCE Andrew Merolillo �_ , BENEFlT OF ANYONE IXCEPT SOLARCItt INC., yWN71NG SYSIF71: �•�J Nqt SHALL IT BE DISCLOSED IN YMOIE OR IN ZS Comp V4 w Flashing-Insert � 20 CEDARCREST AVE 5.2 KW PV ARRAY ►�� PPRT TO O7HFR5 W151DE 7HE REqPIENYS uaou� SALEM MA 01970 - ORCANIZATION, IXCEPT IN CONNEC710N N17H � ' . 7HE SALE RND t15E OF 7ME RESPECIIYE (20) REC # REC260PEZ 24 SL Mmtin Driw,BudEing 1,Unil 71 SOLARpTY EWIPMENT, WI7HOlIT THE NRIT7EN w�� PAGE NAME 91EET: �Y: OAIE T: (650)6 Bbora�h.NR(650)838-1029 PERMISSION �SOLARqTY INC. DBItd Solivia 3.8 TL COVER SHEET PV 1 12/2/2016 (eea)-sa-aTr��es-zeas� ....�arery.�om PITCH: 37 ARRAY PITCH:37 MPl AZIMUTH: 166 ARRAY AZIMUTH: 166 MATERIAL:Comp Shingle STORY: 1 Story LEGEND ' � (E) UTILITY METER & WARNING LABEL ..a�.t ' '�A,g. � y O INVERTER W/ INiEGRATED DC DISCO �� JASON WILLIAM N �"" & WARNING LABELS f TOMAN ^'. � - O � STRUCTURAL v � DC DISCONNECT & WARNING LABELS �nV R� Rm � No.51554 90 9FG/STEP�� F,�Q � AC DISCONNECT & WARNING LABELS AC F�SS/ONAL E��'\� 016 OO DC JUNCTION/COMBINER BOX & LABELS � ' DigitallysignedbyJasonToman 0° DISTRIBUTION PANEL & LABELS � � sP M 1 M D ' i Date:2016.12.02 11:06:06-07'00' _ ' 0 LOAD CENiER & WARNING LABELS A O DEDICAiED PV SYSIEM METER Rm RAPID SHUiDOWN Q STANDOFF LOCATIONS Front Of House CONDUIT RUN ON NTERIOR — GAiE/FENCE � HEAT PRODUCING VENTS ARE RED r,,� �� `� INIERIOR EQUIPMENT IS DASHED L_J SITE PLAN N Scale: 1/8" = 1' W� � � O 1' 8' 16' E S CIXJFlDENTIAL— THE INFOf2AlA71�1 HQtEIN JOB NUMBER: PRFJ�ff OYMER: UESCR�IION pE9CN: CONTAINED 51ALL N�T BE USFD FOR h1E J B-0192444 0 0 �u\��OI��wl�� seNenToru�mNeexcearsauiarriNc., uauNnNcrnieu: GERALDINE GANEY Geraldine Ganey RESIDENCE Andrew Merolillo �_ . i NOR SHALL IT BE DISClOSED IN YMOLE OR IN ZS Comp V4 w Flashin —Insert 20 CEDARCREST AVE 5.2 KW PV ARRAY ��i� �� gr�aT ro on��as wisoe n�e aEaaiars �� SALEM MA 01970 ORGANIZA710N, IXCEPT IN CONNEC710N M17H � 7HE SALE AND USE OF 7HE RESPECTI�£ (20) REC REC260PEZ Y4 SL Martln Dtive,Bullding T, ONl fl SOLARGTY.EWIPMENT, Ni7H011T THE NRITIEN w��, PACE NP11L ��' �' �A�' T: (650)8 Bb 1026h i:A(65U)6J8-1029 PERMISSION OF SOLARqtt INC. DBILO soi��a 3.8 TL SITE PLAN PV 2 �2/2/2o�s (888}-S0.-pTY(765-2489) wn.adarcity.wm . , (E) COLLAR ilE • (E) KNEE WALL S1 4" 72'—1" — (E) LBW � SIDE VIEW OF MP1 NTS H MP1 X-SPACING %-CANTILEVER Y-SPACM6 Y-fANTILEVER NOTES LANDSCAPE 64" 24" 39" 0" STAGGERED PORTRAIT 4$�� 20�� 65�� 0�� " W RAFfER 2X6 @ 16"OC ROOFAZI 166 PITCH� 37 STORIES: 1 . eyt •� ' A.,� . ARRAV AZI 166 PITCH 37 �� CJ. 2X8 @16"OC Comp Shingle-Solid Sheathing o`� JASON WILLIAM yN � TOMAN ^_�, �.. . . � $THUCTUHAL u�i i No.51554 � � 9 O Q 90,o F@/STEQ`�c �4' PV MODULE FSSipNA��'�� 5/16"x1.5" BOLT WITH 016 5/i6" FLAT WASHER INSTALLATION ORDER ZEP LEVELING F00T LOCATE RAFTER, MARK HOLE ZEP ARRAY SKIRT (1) LOCATION, AND DRILL PILOT HOLE. --------(4) --- -------- ZEP MOUNTING BLOCK ATTACH FLASHING INSERT TO ZEP FLASHING INSERT (3) (2) MOUR FTER USING LAG SCREW. (E) COMP. SHINGLE �� INJECT SEALANT INTO FLASHWG (E) ROOF DECKING (2) �3� INSERT PORT, WHICH SPREADS SEALANT EVENLY OVER THE , 5/16" DIA STAINLESS ROOF PENETRATION. STEEL LAG SCREW LOWEST MODULE SUBSEQUENT MODULES (2-1/2" EMBED, MIN) INSTALL LEVELING FOOT ON TOP (4) OF MOUNTING BLOCK & (E) RAFTER SECURELY FASTEN WITH BOLL � STANDOFF J 1 Scale: 1 1/Z" = 1' � CONFlDEN7IAL- 7HE INFORNA710N HER�N JOB NUNBEIC PREMI�OYMER: UESCRPPIN7: DE9CN: JB-0192444 00 ��a,, . CONTAINED SHALL NOT BE UgD FOR THE GERALDINE GANEY Geraldine Ganey RESIDENCE Andrew Merolillo �' .�OI��I}" BENEFIT OF ANYONE EXCEPT SOLARCITY INC., NWN7ING SYSTEN: �'•.a NOR SHALL IT BE DISq.O�D IN VMOLE OR IN ZS Com V4 w Flashing—Insert 20 CEDARCREST AVE 5.2 KW PV ARRAY ►�� `y PART TO O7HER5 W7510E 1HE REpPIENTS w�� SALEM MA 01970 ORGANIZATION. IXCEPT IN CONNEC110N YA7H i IHE SAl£ AND USE OF THE RESPEC➢VE (20� REC REC260PEZ � xa s� uatm Drhrc,BuAdbg 1, UNt fl SOIARCItt EQUIPMENT. N91HWT THE NTtlT1EN I��: PACE NA1� �NF�T: AEV' DAh' L (650)Ma63B-1028'Mp(650)639-1029 PERNISSION OF SOLARqtt INC. DBItO Solivia 3.8 TL STRUCTURAL VIEWS PV 3 12/2/2016 �eea>-sa-an(�es-zaae� ....sao��ny.� UPLIFT CALCULATIONS � SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. CONFlDEN7IAL- THE INFORMA7IIXV HEREIN ,pg MJMBEIL PItENISE OYMFR: OESCftlPPON: DE9CN: CONTAINEU SHALL NOT BE US�D FOR 7HE J B-0192444 00 ��t� � �N�,r or �,mNe �cEPT�a��n�Nc., v�,nN�s�,a,: GERALDINE GANEY Geraldine Ganey RESIDENCE Andrew Merolillo „ '�Olar�'}" NOR SMALL IT BE DISCLOSED IN WHOLE OR IN ZS (,`Ofil V4 w Flashin —Insert 20 CEDARCREST AVE r�� RART TO OTHERS OUTSIDE THE REqPoENTS P 9 5.2 KW PV ARRAY h� ��y ORGANIZA710N, IXCEPT IN CONNECPON WIIH NOWIES SALEM,- MA 01970 � iHE SALE AND USE OF iHE RESPECIIOE (20) REC # REC260PEZ 24 St Martm Drive,�ndfng 2,UNt 77 SOLARCItt cQUIPMENT. YATHWT 7HE NRITiEN IN��: PAGE NAAIE SNFET: flEN. OAIE: T: I650)638-1028 F:A(650)638-1029 . PERAIISSION OF SOLARqTY INC. D@ItO Solivia 3.a r� � UPLIFT CALCULATIONS PV 4 12/2/2016 (BBB)-SOl-qtt(765-2189) NNY.BOIORIIY.Ldl1 GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE . BOND (N) �8 GEC TO TWO (N) GROUND Panel Number:LC120DC Inv t: DC Ungrounded INV 1 -(1)Delta � Solivia 3.8 iL LABEL• q -(20)REC gREC260PEZ GEN �j168572 ODS AT;PANEL W1TH IRREVERSIBLE CRIMP Meter Number:�gp77004 Inverter;3800W, 24DV, 97.5%, Zigbee, PLC, RGM PV Flodule; 2fi0W, 236.6W PTC, MC4, 40mm, Black Frame, ZEP Enabled . ELEC 1136 MR . Underground Service Entrance INV 2 � Voc: 37.6 Vpmaz: 30.7 � INV 3 Isc AND Imp ARE SHOWN IN THE DC STRMGS IDEN71flER �E) 125A MAIN SERVICE PANEL E) 100A/2P MAIN CIRCUIT BREAKER Inverter 1 (E) N7RING CUTLER-HAMMER . 100A/2P Disconnect a Delta Solivia 3.8 7L � (E) �OnDs � �^o° MBranch Sock tT z � i u � �z oc. N 3 �q oc 20A 2P ---- ceo ----------------------------------- -ECG ___ oc. oc. i n cEc �� oa oc. i MPl: 2x10 B � GND __ EGC___—___________ ___________ ___________ _ EGG________________rJ I y I N � — __� � � EGGGEG_, I I � I � � � GEC 1 `_ T—T TO 120/240V I I � SINGLE PHASE � � U7ILITY SERNCE i i ' i i i i i i i i i _L__� - PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUIDOWN Voc* = MAX VOC AT MIN TEMP OT (1)MURRAY�MP2�020 PV gA� q(FfED BREAKER (I)WTLER—HAMMER R DG221UR8 (2)Delta pSoliria (1)MUL71—CONTACT/PV—AIB4 �� + Breaker, 20A/1P-20A/1P-20A/iP, 2 Spa<w, Quad Discmnect; 30A, 240Vac, Non—FusTle, NEA1A 3R AC Smnd R55 Rapid Shuldown, 600V, 200. NEMA 4%, MC4 � Bmnch Socket uC4 U—Joint Connata. Female Fanale Male DC —(2)Groy d RoQ —(I)W TLER—N_ANMER 8 DG030N8 —(1)MULT—CONTACT;!PV—AZ54 5/BR z e, Capper Ground/NeubN Kit 30A, Genaal Duty(DG) 8ranch %ug; A1C4 U—Joinl Connectar, Nale Mde Female ' nd (1)AWC A6, Salid Bare Cappx . —��) (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEP110N N0. 2, ADDITIONAL ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE O� 1 AWG/10, 7HWN-2, Black [� 4 AWG /1D, PV Wre, 600V, Black Voc* _¢25.97VDC Isc =18A2 ADC (4)qWC�10, PV Yhre, 600V, Blade Voc` =425.97VDC [sc =9.01 ADC 14F(1)AWG 810, 7HWN-2, ReO O k�F(1)AWG /6, SoliO Bare Copper EGC Vmp =307 VDC Imp=17 ADC O�(7)pWG B6, Solid Bare Coppa EGC Vmp =307 VDC [mp=8.5 ADC Y . . . .. . '. �1 Canduit Kt:.3(4�.EA1T. . . . . . .. .... . . . . .. ..... . . . . . . . .... . . . . . . . . . . . �1)Co,nduil Ki,t:.3(4�.�?T. . . . . .. . . . . .. . . . . .. .. . . . . . . . . . . . . . . ... . (1)AMG 10. 7HNM-2. White NEUIRAL Vmp =240 VAC ImP=15.8 ANC . _ . . _ . .-(1�AWG YB,.7FI.WN-T,_(7e?n . , EGC/GEC-{1)Conduit Kih,,3/4,' ENT , , ,, , , , , (2 AWG /10, PV Wre, 600V, Black Voc* =425.97VDC Ix =1$.02 ADC O�(1)AWGi6, SolidBareCopper EGC Vmp =307 VDC Imp=�7 ADC . . . ..��L(1)Conduil Mt;.3/4',EMT . . . . . . . . . . . .. .. . . .. . . . . . . ... . . . . . . . .. . . .. . CONFlDENTIAI — 7HE INFIXtMAT10N HQffIN ,XIB NUNBER: PRFYISE OONER DESCPoP110k� DE9Ql: JB-0192444 00 �\`l�SolarCity. CONTAINm SHALL NOT BE UffD FOR 7HE GERALDINE GANEY Geraldine Ganey RESIDENCE Andrew Merolillo �_ . BENEf1T OF ANYONE E%CFPT SOLRRCItt INC., �HPNG SYSIEY: �.�;x NIXt 9iN1IT BE DIS0.0SED IN MHOLE IXt IN. ZS COfIIP V4 w Flashing—Insert 20 CEDARCREST AVE 5.2 KW PV ARRAY � ►�� r,wT m omtas arnoe me aEaviwrs umu�s SALEM, M A 01970 ORCANIZA710N, IXCEPT IN CONNEC110N N1TH 7HE SALF PND USE Of 7HE RESPEC7IYE (20) REC # REC260PEZ 24 SL Nartin ome,Buileing 1,Wil fl SOLARptt E�UIPMENT. M1IHOUT 1HE WRIiIEN w�� PACE NAYE: 91EEf: AEY: DAIE T: (650)6�78�10�h F:A(B50)638-1029 PERMISSION OF SOIARCItt INC. DBIfO sou��a 3.a Tt THREE LINE DIAGRAM / / P�/ 12 2 2016 (eee�sa�-an(�ss-zaaa) .�,,.sa��iry.�� CA TI N U POWER TO THIS BUILDING IS ALSO SUPPLIED FROM THE FOLLOWING SOURCES WITH DISCONNECTS LOCATED AS SHOWN: - Address: 20 Cedarcrest Ave UTILITY �---� SERVICE � , � i rJ I I I I I I 1 I I I ' ' AC� � � � DISCONNECT � � � � � � � � � � I L, I � � ' ' INVERTER AND ISCONNECT � SOLAR PHOTOVOLTAIC ARRAY(S) � L__________________________J . PHOTOV�OLTNC BAq(-FED qRCUIT BREAKER IN MAIN ELEC1F21CAL PANEL IS AN A/C DISCONNECT PER NEC 690.17 OPERATING VOLTAGE = 240V JB-0192444-00 CONFlDENTIAL— 7HE INFIX2MA710N HQ2EIN ,qB NUNBFR: PREAIISE OMNER DESCRIP110k DE9(N: CONTAINFD SHPLL NOT BE Uff0 FOR 1HE JB-0192444 00 . ��,t:, . GERALDINE GANEY Geraldine Goney RESIDENCE Andrew Merolillo „ 'COlar�'}" BENEFlT OF ANYONE EXCEPT SOLARqTY INC., MWNPNG SYS7EN: �• � NOR SHALL IT BE DISCLOSED IN NHOLE OR IN ZS Comp V4 w Flashing—Insert - 20 CEDARCREST AVE • 5.2 KW PV ARRAY ��J �y P,MT ttl O7HER5 WTSIDE IHE REqPIFHYS N�� SALEM, MA 01970 ORG9NIZA710N, IXCEPT IN CONNEC710N WI1H - 1HE SN.E AND USE OF 7HE RESPEC7IYE (20) REC �J REC260PEZ 24 SL Martin Ddve,Building 2,UMt fl SOIARqtt.Eq11PMQ1T. 'MhiWT 7HE NitITiEN w�� . PAGE NAME . - SHF£T: REV. DAIE T: (850)6�8-7028' MA( 50)878-10ri , PERMISSION OF SOLARqtt INC. DCItO Solivia 3.8 TL SITE PLAN PLACARD PV � 12/2/2016 (aea}-sa-aTr��es-zaes) ....�aa«iey.� , � � � , ,� Label Location: Label Location: Label Location: (C)(CB) � � (AC)(POI) � � (DC)QNV) Per Code: Per Code: Per Code: NEC 690.31.G.3 �� NEC 690.17.E � �� . �� NEC 690.35(F) Label Location: • =• ' ■ ' • • • ' TO BE USED WHEN � � •�� . � . ,� � ■ ■ • � . INVERTER IS O O � D� . (DC) (INV) �- �-� � ' UNGROUNDED D O Per Code: NEC 690.14.C2 Label Location: . � � � ��• (DC) (INV) • -- � •- � Per Code: PerCode: '• NEC690.56(C) � , NEC 690.53 • . Label Location: � � (POI) Per Code: � NEC 690.64.67 • •• Label Location: �• • ' • ' ! � � (DC) (INV) � Per Code: � ' � NEC 690.5(C) � / • � y� ■ . �' '� ■ � - � ' � � -• • � ■ � Label Location: � � (D)(POI) - • • • Per Code: � NEC 690.64.B.4 Label Location: � � (DC) (CB) � ,_� Per Code: .�� = NEC 690.17(4) Label Location: . -• � . . •�� : � 1. . � � p (POI) -• • . • •• - • � Per Code: � • - , � �� °� �� NEC 690.64.B.4 . .- • � •� •• � Label Location: - • •�� •. .� �. � (POI) Label Location: Per Code: ' O O O • � (AC) (POI) ,_� �� NEC 690.17.4; NEC 690.54 (AC): AC Disconnect D O Per Cade: � ' (C): Conduit NEC 690.14.C.2 :� • � � •�� (CB): Cambiner Box � •• (D): Distribution Panel :� � �_ � .� �� . (DC): DC Disconnect . � (IC): Interior Run Conduit Label Location: - -� -� - (INV): Inverter With Integrated DC Disconnect (AC) (POI) •' ' 4 PerCode: ' � (LC): Load Center (M): Utility Meter �.'. ' � , � �� NEC 690.54 •• - � • • (POI): Point of Interconnection CONFlOENIIAL— THE INFp2MA710N HEREIN CONTAMED SHALL NOT BE USFD Fp2 -��r�j 3ass neaniew way 7HE BENEFlT OF ANYWE EXCEPT SOWiqTY INC., NOR SHALL IT BE DISCLOSED �. /� /�� sannateo,ca999ox IN WHOLE OR IN PART TO O7HQt5 OUTSIDE 7HE REqPIENI'S ORGANIZATION, L8I78I SBt ��P�` /�M _ yT T:(65o)63e-mze F:(65o)638-1029 EXCEPT IN CONNEC710N YA1H 7HE SALE AND USE OF 7HE R6PEC71VE ��'JO�A' ■ -I ■ (eee)-SOL-Cm(�6s2469)www.mlamiry.mm SOLARpTY EWIPMENT, WI7HWT 7HE NRITiEN PERA115510N OF SqARCItt INC. . V � o �``` • • - ��• REC PEAK ENERGY Z LINK SERIES - 65.55 t0.i HIGH PERFORMANCE -_ �� _ _ _ 39.02 _ _ - "•, EFF��E"�v SOLAR PANELS � �O YEAR PROOUCT WARRANTY I G�7'� YEAR LpVEAR POWER � C4J �UTPIJT WARRANTY REC PEAK �__ _ _ i o ',. I _ azza 'o.m o ._ � �VTY»pR�� US IMPORT OLITY FREE ENERGY � e�U ;P �� . . � I NominalOpera[ingCellTemperature(r+oCi� q57•C�t2•C) _.__ 1 - — - TemperaNreCoefficientofP,,,, -040%/°C �'n. TemperahreCoefficienmfVa -O.D%/°C 1� TemperatureCoefficienroFl« 0.024%/°C REC Peak Energy Z Link Series solar a��m.a.��eme��.��n� panels are the perfect choice for building ,. solarsystemsthatcombinelonglasting Nommaiaowe,-a„„�wP� zeo �QurYPe: aoaecPem�in-«Ys�au��e - Pf0(jL1CtC�UB�ItyWltflfe�IBb�2POWBfOl1tPIJt. WattClassSorting�Wp� y-5 3shingsof20wllswi[hbypassdiodes NominalPowcrVol[a e VMpoV 30] Glass: 0125insalarglasswi[hanti-reFlection RECcombineshighqualitydesignand g - � 1 s�,f,�e„e,�me�� NominalPowerCurrenalM�y(A) 8.50 ffldflUfdCtllflflg5td(lddfdStOPfOC�llCerllgh- BackSheet Doublelayerhighlyresistantpolyester peffO�fTldf1C250�dfPBfl2�5Wlth OpenCircuitVoltage-V��V) 3?8 Frame: Anodizedaluminum�black) Shor[CirmitCurrent-Iyi(A) 9.01 Zep6roovecompatible UIICOfT1�JfOfT1151fIgqlJB�lt�/. PanelEfficienry�%) �gg lunctionBox: 0156in(12AWWsolarcable,zxfi'r24ed rneeienrmaimara��e��:r�:arew�mm�/-m%oimemammee�awe:on,,,v,�a�dr,,,,ao:oa�aamre:��o�amo�:�srq. Connectors: N4Am henol pMPAT vawesa�:ea�da�m.:c�o�a�cm�:srqa�,ma::nmu,��«saro ceioo�w/m=.�ewempe.aw,en•Flss•ql. p �IIIIII�IIIII�III'IIIIIII�IIIII • G �e . A�lowimadianc'of20�W/;'�AMIS&rell[empera�ure�TF�2SQ�a�least9]%oftM1eACpanelef(icienrywlllbeacM1levetl. �Q ( Origin: MadeinSingapare � ti F � � / � � FA �v NominalPower-P�(Wp) �9� OperationalTemperature: -40._d65'F(-40....85'C) COMPP�� NominalPowerValtage-VMw�V) 290 Maximum5ystemVoltage: IOOOVUL NominalPowerCurrenFlMp�(A� 68I DesignLoad: SOlbs/k'(2400Pa)longside MOpEPOWER [OMPITIBLEWITH PERFT' ZEP6POOVEFHAME OpenCucuitVoltage-Va��V) 35] 301bs/k'�1436Pa)shor[side ShortCircuitCurreni-Is�(A) �24 MaxSeriesFuseRating: l5A Nom��aiope..r��e�en�empe�.,mrervoa(eoaw/��,aMi.s.wma:veeeim/:,ame�e�uempe�am�.se°F�zo°q. MaxReverseCurrenc 15A �GT� � �`�'� � � l0yearpmductwarranty Dimensions ' 6555x39.02x1.57in�1665x991x40mm) . 25yea�linearpoweroutpu[warranty Area: 7775k'165m' USIMPONT EASYTO eOua (maz.degressioninperformanceof07%pa.�. ( ' UUTVFREE INSTALL uu�o3.Flre.acm r taa::c WeighC 431bs(195kg) 6' YPe _ , Note! Allgivenspecificatiansaresubjectmchange — '� I h utno' ea[anytlme. REC is a leading global provider ot solar energy solu[ions. With more than 15 years of experience,we offer sustainable,hlgh performing �`^�� pmducts,serviwsandlnvestmentsforthesolarindushy. Togetherwithourparmers.wecreatevaluebyprovidingsoWtionsthatbetter �� meet the wodd's gmwing energy needs.REC is headquartered in Norway and listed m the Oslo Srock Exchange(ticken RE60L).Our1,600 employees woridwide generated revenues of US�647 million in 2073. - vrxw.recgroup.mm / � .-` Technical Data for Delta Smart Rapid Shutdown System enm��s I -- �� . «�w� � �<,� .,a: .... �, , , soov oc . - - - - - - . .,. � aa� n�.ncurem ....., . .,, ..::.. _. r zoaoc .. rs�a ,�.�,.��j;wu� :.i"so ssovoc—_ '�� . r�m� ,_.o=,p�r�ur u�od.r�e o zonoc - - _ . r wsaRaw ,_:, , �..:� . ... rvn � Maa. ca�va riails �- . ..�... ., 1- - - - - Sellpouerm�urtio4on � _ AW - _ __ _- _ - GENERAL DATA ___ _ zWZDi�wY� __ =:.....e...<; . ,r___ . 7.87n5.97x2.09 _ 0.5�s. �._ -+ . . . _ _ �q' y: . .o-:� .. .. .... . NaluralCa��on_ _.. . - . � DC.. .�.�ul,mmeclws. __ - r _ �- . �� Ampherrol HeGos H4 w MC4 PV Ca�eGw 8. .,. . . � . GrooveAtlaPter&atl�el��y��._�, , . � _"n,'_ ' '__��__�� ...re. . , _ �ecestauminum i��r�� Oocralim e ... <z A0-158 F(-00 90'C) . __ - -.-___ . Stame temcerabre � .�> . 40'-.i&5 F(40_85°C) _ _. _ _ _— mW ". - _ n_100% -r r Maz.o�,,,ra„�Ino aidtiitle - 2000m aEwe sPa level ___ ST/WDMD COMPLIANCE Erclaswe wdaapn ratim. NEM1N 4X eN _ '�'UL 1]41 UC.1747 CRD PVRSS CSA-0222 No_i07_t-07_� ___ — _ _ ' _' Ha(ii� �' . z_'" __� NEC 2014 ANde 69U.12 _.�__«� ..�-_-_�.. .. ElAC _ _ _ . FCCPehtSA . . � WARRANTY _. " ___ 5_IanEaN_xa�anlv. __ _ _ 70YEars _ QGpMP4Tje 1 DELTASMARTRAPIDSHUTOOWN� - . . ti � �a^� � BOX ON ROOF N7iHIN 70'OF PV � �, � I � W i ::. ,--a--�. � � � d+ 1 I . � �1PP'``_ i � ; p^`�'�c( i dt � 9 � I I _ 1 I. � � I + _'_ I I � C� � awr�m " " " � u ........... -ps�-r�� ._� ..� � I •'• • N I �I 1 I � I I I I I � L_____ . . ... ____J AC AC , ____________ . ..... GRID —oc w, One conduit ....� °LW- forallwirirg I(11)�., �qL • L___ o�m r�oa�m c�w..m.i� . asioi FremweHa. � Fre�t�sas�e - . 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Transformerless(TL): 3.0 kW, 3,8 kW, 52 kW, 6.6 kW, 7.6 kW ,� �.:' Nz, x��3s u�„s,cwo ' - -.h+ F 3 _, IEF£1Wl.IffEtSI].1 � ..+„!'�"` � .•�li', iLCP�tlILUB . ... i�# � WdeOperatingVotlageRange:85-550V +� ' �� m�ewep�.»,uccem.�� u�iraicqownes.x[caeo.izM?��um nsel �Wde Opera�ing TemperaWre Range:-13-158'F(-25-70°C) ,:�`+'�',;�_ eraicaa im.asr,v�.m . �liigh CEC ENcie.n,ry:97.5% +', � cmanra�wx�.�wc�o�.��eia� - p.:., . '�� wanwwn � Inreyreletl AFq(Arc fault Circuit Intermption) ' �'` � +ore.• . ,. � NEMA 4%plus Sd11 Mist Cortusi�n Pio�ectlon �� isioi rmnnero. � Nalural ConvecUon Cnoling �' ��.��e�.� _ � � Dual MPl'((5.2kW/6 tikW 17.8k41� � �+ � s.wwe�.i�...,.,..a,�,ea.�...� .'b�. `. sm�ruc s.i.enwaeuiv naa�mra� Compaa and LiHhtweight � �� aswr�mibi �,�sa�� AELTA - � UL 1741/IEEE 1547!IEEE 1547 1/C[C �� r GFj� � i� wm.rmrmr�w„��n,usm�osw.�.�Nem,n ^ Listed NL 7G99B(Type 1):NEC Fi50.1'I � � :'.,�,�� t': 4ir N�.}°''` �` R ,:�`�. -R�`. t • ' ''^SO�af�lty I �p$olaf NeM-Level PV Mounting Technology '��SOIBf�ILy I �p$olar Next-Level PV Mounting Technology Z.S Ci01'Yl ComponeMs � p . �� '�e�;�� . for composilion shingle roofs - - .. �,w: .. " s. r � ` <' � � � Mounting Block Arrey Skirt Interlock PartNo.850-1633 PartNo.85P1608or50P0113 PadNo.8541388or850-1613 � Listed to UL 2703 Listed to UL 2703 Listed lo UL 2703 W � r' T � . � . . . ,.. . , . � F+ - �' .,.,... r , x � j.- . �... .- ��'�}.<:." � � i `, Flashing Insert Grip Ground Zep V2 . PaR No.850-1628 Parl No.850.1606 or 850.1421 Part No.8541511 ��'`•... ,-'3J Lis�ed�oUL2703 Listed�oUL2703 ListedtoUL467andUL2703 pOMPATiB A�j'� � �,� Description � � � � PV mounting solu0on for composd"pn shuigle roofs � `�onrnt`° : Works with all Zep CompatiWe MoOules Au[o bonding UL-I�ted hardwa2 creales s4ucWral and electncal bond • ZS Comp has a UL 1703 Gass'A'R1e RaO1g when installed using modules from any manufacturer cenifed as"Type 1"or"Type 2" CBptured Washe�Lag Erld Cep DC Wire Clip V� qy�0 PaA No.8504 6 31-001 Parl No. Part No.850.1509 SpeClfiCatiOnS 850.1631-002 (1j85�-1586or850.1460 a ListedtoUL1565 ' • Designed for pRched raofs 850.1631-004 (R)850-1588 or 850-1467 • Installs in portrait an0landuape orienhations • ZS Comp supports motlule wuM upliR and snow load pressures to 50 psf per UL 2703 • Wi�tunnel report to ASCE 7�5 and 7-10 5larqartls • ZS Comp grountling produGs are UL listed to UL 2703 and UL 467 - • ZS Comp bonding qoduds are UL lis[ed ro U12703 .. � ��" " • Engineered for spans up l0 72'arM can0levers up to 24" �� %+"�. • Zep vrire man�qemen[producGs fistetl ro UL 1565 for wire positioning devices ��`_��.�_�� . � Leveling Foot Pad No.850-1397 zepsolar.com " zepsolaccom ListedtoUL2703 instlocumenttloasnotveataanY�W��nrybyZepSdaraaEwnilspadurJsamrvims.ZspSolarssdewarranryiscontanetlinihewrinenproduawarranryM inseoc�memaoesm�aee�eanyaxpre:swarra�rybvzepsaar«abouii�sproaucis«semms.zepsdarssdaw wrrty�swn�a'veainmewnnenproeuawamanryt« . eacM1p�otluctTheenduserdocumenlationsM1ippetlwilM1ZepSolarspmdu<IswnstilWeslnesolespeuflwtionsre�erretltoinlhepmduclwartantyThecustomerissolely acnprodud.Theena-userdocumentationshlppetlwi�hZepSolar'spmtlucisconstiNteslnesolespecifiwlionsrefertetltointnepmduciwartanry.Thecustomerissolety responsible for venying tFe suitaEiliry o(ZepSdar's Oroducis for eacb use.SOecifwtions are subject to change wifhout notice-Patenis anE Apps:zspatsmm. responsible for venfying ihe suitabiliry of ZepSdar s protlucts for eac�use.Specifcations are sublect to cM1ange wi[hout notice.Patenis antl Apps:zspa5.com. Doc�menl#800.1839001RevD Da�elastaxportetl:Apn129.20161�:22AM Doa�menl#&q-1834001RevD Dale last eqwrtetl:Apnl 29,20161122 AM .1)/ 4 0 `i d 0 N