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38D-027 (3) May 29,2013 To: Building Department From: James A. Marx, Jr. P.E. Re: Engineer Statement for Bent Residence, 14 Hampden,Northampton,MA for Solar Roof Installation I have verified the adequacy and structural integrity of the existing roof rafters for mounting of solar panels and their installation will satisfy the structural roof framing design-loading requirements of the Massachusetts building code—780 CMR Residential Code 8th Ed. For the installation of the solar frame mounting, the Zep mounting system with QBase Composition Mount Type A and anchored with lag screws. The design is based on the added weight of the collectors,wind speed of 100 mph, exposure B and ground snow load of 40 psf. The Photovoltaic system and the mounting assemblies will comply with the applicable sections of the Residential Code and loading requirements of roof-mounted collectors. Thereby,I endorse the solar panel installation and certify this design to be structurally adequate. Sincerely, 7/��-�'' '`v>�v ,,,., j JAMES A, 0 '�';,� O MARX,JR, a U CIVIL Co .41.1 , NO.36365 E.% James A.Marx,Jr. P.E. t cl` Professional Engineer el'1\3. " MA Professional Engineer 36365 ...e..0'i t 5 C 10 High Mountain Road Ringwood,NJ 07456 cc: GAF Solar August 2,2012 14. Installer is responsible for verifying that all assumptions and limitations are met when applying the attached foot spacing tables. 15. For design conditions that are not covered in these Span Tables, please refer to Zep Solar's online design tool, www.zepulator.com, or contact Zep Solar, Inc. 16. Adequacy of the supporting wood framing is to be determined by others. However, because the photovoltaic modules used with the Zep System II weigh only approximately 2.5 psf and displace roof live loads of 12 to 20 psf,structural re- analysis of the roof framing system should prove unnecessary in most cases. In areas of heavy snow load, leveling feet at adjacent rows should be staggered to distribute snow loads more evenly over all rafters. Sincerely, *\ EKF 6 37,,20,,c /*i Jeremy Rogelstad Page 4 of 44 August 2,2012 7-05). For Occupancy Category III buildings, such as public schools(Snow and Wind Importance Factors=1.10 and 1.15 respectively), reduce foot spacing to 87%of that shown in the attached span tables. 6. Building is not located on a bluff or near the top of a hill (i.e. Topographic Factor= 1.0 per ASCE 7-05). 7. The bottom of the "Rockit" is a maximum of 1'A" above the top of the leveling foot as shown on sheet 3. 8. The tables apply to wood framed roofs with composition shingles, Wood sawn shingles, built up roofing, membrane roofs, curved tile roofs, metal standing seam roofs with a minimum thickness of 26 gage underlain by plywood, oriented strand board, or lx continuous sheathing, and corrugated metal roofing with a minimum thickness of 26 gage being supported by battens with a minimum thickness of 1 %". Wood shingles may require longer lag screws to achieve minimum required embedment. The tables also apply to metal trapezoidal roofs. Trapezoidal roofs are to be a minimum of 22 gage. The tables assume that the attachment of the metal roof to the framing is sufficient to resist the applied loads for the Schletter Fix2000 and S-5! clamps. 9. Direct Mount span tables may be applied to third party flashings provided that the flashing is attached using a 5/16" diameter lag screw with a 2 %2" embedment. 10. The Direct Mount span tables may also be applied to the flat pans of metal roofs between seams or raised flutes underlain by sheathing or wood rafters, provided the lag screw into the rafter is installed at the uphill end of the slot in the foot. 11. Lag screws are installed per the requirements of the 2005 National Design Specification for Wood Construction (NDS). Pre-drill with 3/16"or 7/32" diameter pilot holes. 12. Lag screws are fastened into wood roof rafters of competent material with a specific gravity of 0.42 or greater(e.g. Douglas Fir, Hem-Fir, Close Grain Redwood, Southern Pine, and Spruce-Pine-Fir graded by NLGA of British Columbia). Caveat: some roof framing softwoods commonly used in some areas of the central and eastern United States may have a lower specific gravity, such as Spruce-Pine-Fir (South), with a specific gravity of 0.36. In such a case,the tables still apply if a 5/16" diameter x 5" long stainless steel lag screw with a 3"thread is used. 13. Seismic code load requirements for Zep System II are met for all configurations in the attached tables for the range of seismic design parameters typically encountered in the United States, including seismically active areas (SE's parameter up to 2.0 in areas with ground snow loads less than 40 psf; SE's parameter up to 1.5 in areas with ground snow loads between 40 and 100 psf). Page 3 of 44 August 2, 2012 • Leveling Foot bolted with a stainless steel machine bolt to a standing seam roof via an S-5-S or S-5-E clamp by S-5!®. • Leveling Foot mounted to a Schletter Inc. Fix2000 attached to a trapezoidal metal roof with screws provided by Schletter Inc. • Big Foot attached through a minimum 26 gage corrugated roofing to timber framing with a minimum thickness of 11/2" with#14 wood screws. The attached tables define maximum attachment spacing requirements for a range of wind exposure categories, wind speeds, roof zones, roof slopes, and ground snow loads.The Span Tables apply to all Zep Compatible modules with the exception of Sharp SunSnap ND- F2Q230 and ND-F2Q235 modules and the Trina Solar Trinamount PA14.18 module. For maximum attachment spacing requirements for these modules please refer to Zep Solar's online design tool, www.zepulator.com, or the module's Installation Manual. Attachment spacing is calculated based on an allowable upward, downward, and lateral load values.These load values are determined from manufacturer provided test data for independently manufactured products,first principle calculations, and from tests conducted at an independent testing laboratory under ICC AC-13 guidelines. The attached Span Tables are based on the conditions illustrated in the attached sketches and listed below: 1. Wind exposure categories B, C, and D are as defined by ASCE 7-05. 2. Roof wind area zones 1 (interior), 2 (edge), and 3 (corner) are as defined by ASCE 7- 05. 3. Roof Height is 30 feet and roof slope is between 0 degrees (flat) and 45 degrees (12:12). See tables for specific slope subsets [0-14° (flat to 3:12), >14-27°(>3:12 to 6:12), >27-37° (>6:12 to 9:12), >37-45° (>9:12 to 12:12)]. For average roof heights greater than 30 feet, please refer to Zep Solar's online design tool, www.zepulator.com or contact Zep Solar. 4. Tables 1, 3, 5, 7, and 9 apply to modules installed in "landscape" orientation, with the long sides of the modules perpendicular to roof rafters that run with the roof slope (see sketch 1).Tables 2,4, 6,8,and 10 apply to modules installed in "portrait" orientation,with long sides running with the roof slope. For installations using Leveling Feet,the Leveling Feet and Interlocks are positioned on the module edges that run cross-slope, perpendicular to the roof rafters (see sheet 4). For installations using the Big Foot,the Big Feet and Interlocks are positioned on the module edges that run with the slope, parallel to the roof rafters (see sheet 9). 5. Building is not a special occupancy structure such as a public school, public safety building or assembly building (i.e. Snow and Wind Importance factors= 1.0 per ASCE Page 2 of 44 R. Jeremy Rogelstad, PE 233 Hillcrest Ave. Benicia, CA 94510 August 2, 2012 Zep Solar, Inc. 161 Mitchell Blvd. Ste. 104 San Rafael, CA 94903 Re: Zep System II Code Compliance Review To whom it may concern: The Zep System II photovoltaic mounting system has been reviewed and it was determined that,for the configurations and criteria below, it is in compliance with the structural requirements of the 2009 International Building Code and ASCE 7-05.The system has also been evaluated for conformance with the 2010 California Building Code where more stringent requirements may apply. Zep System II consists of Leveling Feet or Big Feet, Ground Zeps, Interlocks, and Hybrid Interlocks that connect the edge frames of photovoltaic modules designed to mate with Zep System II. The system has been analyzed for Zep Compatible PV modules with maximum dimensions of 1000 millimeters by 1660 millimeters. The leveling feet may be mounted to the following roof types with the methods listed: --Composition Shingles • Leveling Foot mounted directly to the roof and screwed to the roof framing with stainless steel lag screws. • Leveling Foot bolted with a stainless steel machine bolt to a Comp Mount flashing assembly with a 4" diameter base, manufactured by Quick Mount PV. --Tile Roof • Leveling Foot bolted with a stainless steel machine bolt to a Quick Mount PV Universal Tile Mount. --Metal Roof • Leveling Foot mounted directly to the pan of a standing seam metal roof and screwed to the framing with stainless steel lag screws. Z.; ) D)L—AL \ 11121 ZCRO)/ In DISCOVER QUENNEVILLE ROOFING 'V SIDING 'V WINDOWS 6 160 Old Lyman Road•South Hadley, MA 01075 BBB 1.800.NEW ROOF • 413.536.5955 Email:info @1B00newroof.net Website:www.1800newroof.net winner of the 2010 MA Construction Supervisors Lic.#070626 MA Registration#120982 TORCH AWARD Member of the Home Builder's Association of Western Mass. CT Registration#575920 Member of the Building&Trade Association Proposal Submitted To: Date Phone#'s C: (31 T / I SO K1 fi /mil I-- H I ( I 5 H: `(I - 5,5N -283g Street Email: 4-4-M 5! .41404 14---p 6N14t-,CO M City, State,Zip Code Job Name/Location: ►►vc t I +1 r� 'rC cv ;vim c>t c=60 Proposal to furnish and install the following N`�TT►At t_ TUB 1 tJ FA Cs bf `Ltd ,!-;4576,10 7- 1�'\1G1AN i `j J=1 r,"OII) icct ^ SF C= i�1N� A R5 -to c.t i LAD( k)6 1"1 rt"5 > 19 cos C K. 4 coo Ask us about affordable bank financing We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($ l 9J On.?,CO) ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are Down Payment($ /Oot).00 ) satisfactory and are hereby accepted.You are authorized to do work as specified. Payment will be 1/3 down at start of job,and balance due upon completion. Balance Due Upon Completion($ (if/008'00) �` !✓ Signature: Date: /l.�__ _ Date: `"i 16 1_l3 Estimator:(Print Name) Cf., t II 5000 K- (Sign Name) 14)Estimates are honored for sixty(60)days from above date ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris or dust coming in through cracks of the wood.Adam Quenneville Roofing will not be responsible for debris or dust in the attic or storage areas. i ' d N • . ©CC) 11) 111 N I \I 1 ZEP SOLAR , , N CO N A = N CD 03 00 6,_a, :::\ .0/ . N 4 o m ,�. < Z O = D 0 r z xi v M —1 r D Z M 0 23 m m m£ 0-0 a m G o Z g Z N n o o m w A N m 7 ,..s W v i v E O a CD°'—Z N MZ -0 co Cn n —1 1 0 0 r r' o r om C7Wn rn D ^' r• P. co G o m o 0 ` 0 w p ®.. ZEP SYSTEM II: QUICK INSTALLATION GUIDE Step 7: Grounding To connect the array to a grounding system, install a Ground Zep in the Zep Groove of a module.Install one Ground Zep for every section of array that is not conductively isolated by a thermal expansion joint (up to 72 modules per Ground Zep). See below for more information on thermal expansion joints. Ol 0 Ground Wire Torque AWG in In-Lbs. a\ 14 AWG 40 LBS. p . • �L� 12 AWG 40 LBS. 10 AWG 40 LBS. Use the Ground Zep "Driver" on Place Equipment Grounding 8 AWG 45 Les. the Zep Tool to push the Ground Conductor (EGC) into wire slot Zep "Key" into the Module and tighten set screw to proper 6 AWG 50 LBS. groove. Rotate exactly one torque setting (see table to the quarter turn clockwise. right). Thermal Expansion Joints GROUND ZEPS It L] uuu u 2 t 3 t J GROUND&THERMAL BREAKS Thermal Expansion Joints allow for the expansion and contraction of metal under thermal conditions.An east-west run of modules that is greater than 6 module lengths(landscape) or 12 module widths (portrait) requires a Thermal Expansion Joint.To create a Thermal Expansion Joint,install an Interlock with one Interlock Zep rotated to position 3 while leaving the other at position 2, allowing the Interlock to slide in response to thermal conditions.Note:The Thermal Expansion Joint does not provide a grounding path.A Thermal Expansion Joint must be jumped with Ground Zeps at the top of the array,as with Hybrid Interlocks. ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 8 of 8 Document#800-0213-001 Rev A 0. ZEP SYSTEM II: QUICK INSTALLATION GUIDE Step 6: Install Remaining Modules O O E O D 0 11011.11. � I ' Install each additional module along the first row.Add Leveling Feet along the top edge of each module and an Interlock at each north-south seam as before. After completing the first row, check that the array is level and adjust the elevations of the Leveling Feet as needed according to the instructions below.Then repeat the module installation procedure for all subsequent rows until the array is completely installed. Array Leveling Wire Clip Installation NNN. NN 9-1 O O n 1•4*,„ ,-- --y 40 NN iro/ • I �1 Squeeze clip,Men slide After Leveling Foot is attached Fully insert bottom portion of Once wires have been placed to roof,adjust height of the array wire clip into Module groove. in wire clip,squeeze wire clip by rotating a#30 Torx bit (bit Then push top of wire clip inward as shown above and slide along attaches to the handle end of until it clips into Module groove. groove to achieve desired wire the Zep Tool). tension. ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 7 of 8 Document#800-0213-001 Rev A k ®. ZEP SYSTEM II: QUICK INSTALLATION GUIDE Step 5: Interlock Installation , The Interlock provides north-south and east-west 1l`'- structural and grounding connections, creating a structurally contiguous, hyper-bonded array. ETL INTERLOCKZEPS ' ■ % listed to UL 1703. 'E LUG 0 10 1 mr 2 1 3 1 D _./7- ,sx_ l�' Estimating a 1/2' gap between modules, engage With Interlock engaged into Module groove, rotate Interlock into groove at an angle. Push "lug" into each Interlock Zep from position 1 to position 3 groove with a sweeping forward/upward motion. while maintaining the 1/2" gap between modules. r--- I --an_ A OK ■' Im......_ 6— , --7-Ammi il, DO NOT , u ll U L I i u , OVER-TIGHTEN — I 1 66- GAP IS OK II -MIMEMEINIMii.. 1411 DO NOT over-rotate Interlock Zep.Stop rotating Note that a gap between Interlock and Module is when position 3 is lined up with the alignment ok.Also, Interlocks can be installed at an angle to mark. take up variation in Module dimensions. ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 6 Of 8 Document A000-0213-001 Rev A O. ZEP SYSTEM II: QUICK INSTALLATION GUIDE Step 4: Install First Row of Modules giot \ O O A 1001..1.°° ss, I � O 0 ® O fu STANDARD Drop the first module into place After dropping in the first Note:To safely remove a mod- by setting the Groove on the module, install a Leveling Foot ule,the installer must(a) pull Tongue of the Leveling Foot and along the upper edge of the the module back before (b) rotating downward while module.To install, engage the rotating up. applying forward pressure. Key of the Leveling Foot and rotate downward. Repeat this procedure with the second module, maintaining an approximate 1/2' between modules.Then, interlock modules (A) and (B) along their upper edge according to the procedure outlined on the following page. Connect and manage module wiring per job requirements. ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 5 of 8 Document#800-0213-001 Rev A ®t ZEP SYSTEM II: QUICK INSTALLATION GUIDE a \�' ., With the Spacer between the Attach these sections to the front row Leveling Feet by resting the Array Skirt and the Interlock, upper part of the groove on the key side of the Leveling Foot and interlock the first two sections rotating downward.To lock the skirt in place, insert jams into the of skirt together. Install the holes in the top of the Leveling Feet. Attach additional sections in the Interlock (see page 5). same manner. After all sections are installed, level the Array Skirt, ensuring the ends are butted together at each joint (see page 6). Hybrid Interlock If you need to install a Leveling Foot in an Interlock location, remove the upper portion of the Leveling Foot (known as the Rockit)and replaced it with a Hybrid Interlock,which will then serve as both a Leveling Foot and an Interlock.There are three holes in the Hybrid Interlock to choose from when connecting the Foot Stud.The Foot Stud is threaded into the hole that allows the Foot to reach the rafter, or flashed attachment assembly, while allowing the Hybrid Interlock to be installed in the center-most position with respect to the module or Array Skirt seam. Note 1:The Hybrid Interlock does not provide a grounding path.A continuos column of Hybrid Interlocks must be jumped with Ground Zeps at the top of the array. Note 2: When using the Comp Mount Type A,only hole 2 may be used,except on the front row. -o REMOVE THE ROCKITFROM - "' FOOT CAN SWING TO ALIGN THE LEVELING F00T QQQ q -) 81_ o_o o a® THREAD THE LEVELING — FOOT INTO ONE OF HYBRID HYBRID INTERLOCK INTERLOCKS THREE HOLES Rock the Key side of the Hybrid Interlock into the Zep Groove of a module pair or Array Skirt in the same fashion as you would the Leveling Foot(see page 5). Because there are two Rockits per Hybrid Interlock, it may be necessary to use the Zep Tool to provide extra leverage when installing. ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 4 of 8 Document#800-0213-001 Rev A Et ZEP SYSTEM II: QUICK INSTALLATION GUIDE Step 2: Install Front-row Leveling Feet KEY TONGUE Install front-row Leveling Feet with Toe and Tongue-side up-roof. -- ROCKIT Attach to the roof framing or flashed attachment hardware according ',� ' to job requirements. This Guide illustrates Leveling Feet installed on f TOE Comp Mount flashings. For complete instructions on layout and installation procedures for Comp Mounts,see the Comp Mount Instructions on the Resources page of the Zep Solar website at: www.zepsolar.com/resources.html Leveling Foot Step 3: Install Array Skirt i B i iii (If you do not wish to use the Array Skirt,couple the first two modules together along their upper and lower edges following the interlocking procedure on Page 6. Drop the coupled modules onto the west-most set of Leveling Feet, according to the drop-in procedure outlined on page 5, and proceed with instructions.) ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 3 of 8 Document#800-0213-001 Rev A 0. ZEP SYSTEM II: QUICK INSTALLATION GUIDE Step 1: Array Layout 1. Visit:www.zepulator.com to access the Zepulator online design tool.The Zepulator will assist with your layout design,specify attachment-point span and cantilever allowances,and generate a bill of materials for your project. 2. Determine the locations of your attachment points in the north-south direction with the equation:Spacing north-south =module width plus 1/2" (landscape) or module Length plus Y2" (portrait). 3. Once you have determined your north-south spacing and your allowable foot spans and cantilevers, determine your roof attachment point layout accordingly.Check to make sure that there is a rafter located within the allowable cantilever at both east and west edges of the array. If not, adjust array location east or west. 4. After attachment point locations have been determined,snap chalk-lines to mark rafter locations(north- south) and the locations of each row of attachment points (east-west). CANTILEVER ZONE =1/3 MAX ALLOWABLE SPAN \ R 4 MODULE DIMENSION+'/"(13mm) \ ATTACHMENT POINT RAFTER LOCATED LOCATION WITHIN CANTILEVER ZONE MAXIMUM - ALLOWABLE SPAN \\ MODULE DIMENSION*'h"(13mm) • ( ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 2 of 8 Document#800-0213-001 Rev A Zep System II 0 Quick Start Guide Zep Solar This guide is intended to provide a quick introduction to the Zep System II standard installation procedure. It is not intended to replace the full Installation Manual. IMPORTANT: Read the Zep System II PV Module Installation Manual, in its entirety, prior to installing your first Zep System II PV array.The installation manual can be found at: www.zepsolar.com/resources.html, where you will also find the Zep System II Instructional Video, Engineering Certification Letter with Span Tables,and link to the Zepulator online design tool. ZEP COMPATIBLE PV MODULE HYBRID INTERLOCK INTERLOCK w r LEVELING FOOT FLASHED ATTACHMENT SOLUTION ARRAY SKIRT ZEP GROOVE V s` Zep Groove Zep Tool Flat Tool N\ ' O f '—'1 1 1 Frame Cut-away View Zep System II is installed with Zep Compatible PV The Zep Tool is used to install the Interlock, The Flat Toot is used to remove an Interlock modules whose frames have been manufactured Leveling Foot,Hybrid Interlock,and Ground Zep.It between two modules for the purpose of module with the Zep Groove. also receives a T30 Torx bit for easy array leveling. or Array Skirt removal. ©January 2012/EN Zep Solar,Inc.Zep Solar reserves the right to make specifications changes without any prior notice.All rights reserved. PAGE: 1 Of 8 Document#800-0213-001 Rev A . r E , tit \ NJ - -- - - — - - . M / ,J.';'-- \ / 77 . .....„....- . „J-... :, '1'1_ _ ., 'AYPOT . 1.j = , ,!-1,5 j ! Jilt]. '., j,".7. ; .'7, r •, , •::'. ::',. :,.. r._-__.= ...-.. 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V '1411 y$ =9 Faypm 6,1 _ _ ; D m wo oA zv ;� gym, a nfr Z V) n9 oo�i NpoDm0I owo o d R =s 4Ap 'I”; T wF< o rD0w, n �n mG„ litr j gy 3 A r m 0 Z m y f rs4"' ,i -'1 r F 1 a ^ w=ao�=N.. N3o 5F g- po ;r�< 0 mo w 9 ooi��zzzz sss max 'r"�"On°-,000s�wa�n° Z o3co� o�z . o 'aaioz - 9g wsc AOni yFO�nio°io;� ..,, r i�� m§mz ° � -�� - - ,w s°` �" � tm� � w w w a - m "` z,. z m F s? S A o r; 't 'f/J b+ r: r ter S na 'It \ 44",r 3 0) :, Massachusetts-Depart/1101i n;Puhtic tiateii 4 i it Board of Building Regulations and Standards License: CS 70626 ADAM A QUENNEVILLE 160 OLD LYMAN RD S HADLEY, MA 01075 Expiration: 8121/2013 (..,nm11,4+nrr +r 21002 e Ae ty7 Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5 170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 120982 Type: DBA Expiration: 3/25/2014 Tr# 222024 ADAM QUENNEVILLE ROOFING ADAM QUENNEVILLE 160 OLD LYMAN RD SO. HADLEY, MA 01075 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS-CA1 0 50M-04/04-G101216 ---- - i -lam •i51 t :e Ott t �'*"a �t'i •ti. ..� ; ,t Q i 't t '4,2.)1),t ... it , .;�} .0 tt..`!' 7 .;1 1 �. , 1i. •� t. �l i f�, { t,. fit" r tb .tl t yt. 1 t,tT it t tt((.v ,1 l t. �iY1r¢N tiu v+i , „•', .r„ }�, Jt vi h tttt� 110'. 'tt { t jA tt fy;,, tttr 6 � t .,..�., �t , t,•, •�:! t1. 1 e• t.,i ., , ,. y,,. p.! >t,, ; , �d•' `tF tit, ,,;ti. tt 1 of � �! +� �'•,� aiS tr>,,,� t a� fit+ t �i 11 �1 7 1 41Et �1ti � ` '' i'' � ' ' AISOOtt � 4* .. 4, .y rya \` 'z? STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PRO'T'ECTION t Be it known that ADAM QUENNEVILLE 160 OLD LYMAN ROAD SOUTH HADLEY, MA 01075-2632 ��,,fir ` Y.• ;14 is certified by the DDeharttnent of Consumer Protection as a registered HOME IMPROVEMENT CONTRACTOR F` Zif Registration # HIC 0575920 01 ADAM QUENNEVILLE ROOFING Effective: 12/01/2012 \f Expiration: 11/30/2013 `' �� �� William M.Rubenstein,Commissioner AC RD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 4/24/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT E: y L nne Methot, Ext. 102 NAM Foley Insurance Group Inc. PHONE 413)219-7474 FAX (413)214-7447 Y P WC No Fy51 ( (A/C.Not: 37 Elm Street ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC West Springfield MA 01089-2703 INSURERA:Peerless Insurance Company 24198 INSURED INSURERS:Safety Indemnity 33618 Adam Quenneville Roofing & Siding Inc. INSURER C:Scottsdale Insurance Co. 160 Old Lyman Road INSURER 0 AIM A/R INSURER E: South Hadley MA 01075-2632 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1342406968 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER (MM/LDDIYYl Y) (MMIDDIYYYY) LIMITS LTR ,INSR_WVD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) A CLAIMS-MADE X OCCUR GL6912267 6/23/2012 6/23/2013 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY X PF 7 LOC COMBINED SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 6215480 11/1/2012 11/1/2013 BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _, (Per accident) AUTOS $ 8,000,000 J PIP-Basic UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ XLS0082909 6/23/2012 6/23/2013 $ D - WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE Y N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? AWC7012861012013 4/29/2013 4/29/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000, DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Proprietor/Partner/Executive Officer/Member exclusion applies on Workers Compensation. The certificate holder named below is included as an additional insured for general liability coverage for ongoing operations if required by written contract, permit, or agreement executed prior to a loss. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR PERMITTING PURPOSES AUTHORIZED REPRESENTATIVE 5 Brian Foley/LYNNE ■ ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS1195 nninnc)nl The Ar non n.mn,nri Inn^am runiafnrnrl mnrirc^f Af'l1Dn The Commonwealth of Massachusetts c. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston; Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r Please Print Legibly Name (Business/Organization/Individual): Adam Quennev[lle Roofing&Siding,Inc. Address:_ I la U V ICI I lia rl oa ----- City/State/Zip: ^,Z {'i --7ael (-f'c' V Phone#: -6 ) ,. Are you an employer?Check the appropriate box: Type of project(required): I.X I am an employer with 16 4. I am a general contractor and I 6. ! New construction employees(full and/or part time).* have hired the sub-contractors 7. Remodeling 2. I am a sole proprietor or partner- listed on the attached sheet. } ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' q Building addition [No workers'comp. insurance comp. insurance. required] 5.I We are a corporation and its 10. ' Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 1 t, Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required]t c. 152, § 1(4),and we have no 12 Roof repairs Q �' employees. [no workers' 13 Other tif. comp. insurance required.] — -- i' *Any applicant that checks box t l must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contactors that check this box must attach 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 site information. Insurance Company Name:_/1 T/9 tit&(O / .� I15 It► 6(flee / Policy #or Self-ins. Lie. #:__Aiv_ti it)/ A6le I0 ' Expiration Date: Y Job Site Address:I ,S I , 5 -( tQ\ City/State/Zip: C''140 Q1 bla 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 152 can lead to the imposition of criminal penalties of a tine 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 $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations ante DIA for coverage verification. !do herby certify under t pains and penalties of perjury that the information provided above is true and correct. / Signature: I� Date: 5-1101 1r 13 Print Name: Md LYly IAA 1)T] v i l Le ' ' 1 �j - j 6 Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license tt: --�--_ Issuing Authority(circle one): l.Board of Heath 2. Building Department 3.City/I'own Clerk 4. Electrical inspector S. Plumbing Inspector 6.Other - i Contact person: Phone k SECTION 8 CONSTRUCTION SERVICES t 8.1 Licensed Construction Supervisor: Not Applicc-a�ble ❑ Name of License Holder A Quenon&Rook&Siding,Inc. /tea 160 Old Lyman Road License Number South Hadley,MA 01075 1a1 Address Expiration Date Signature Telephone 9.Registered Home Imorovenierit Contractor: Not Applicable ❑ Adam Quenneville Roofing&Sidiig,Inc. gga- Company Name160 Old Lyman Road Registration Number Address South Hadley,MA 01075 Expiration Date Telephone y 13°21. ...... _ _.. SECTION 10-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 ❑ 11. - Home Owner teem tit n The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside;on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature C SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House h Addition I xi Replacement Windows Aiteration(s.) Roofing I Or Doors Accessory Bldg. F1 Demolition I I New Signs [D] Decks" [C_'j fildthg[o] Other[tt]$06( Brief Description of Proposed, Work: .3:71 Sr-a LQ 7JQ T – �s t1L 0/l h C1 —• Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a::if New house ancf or addition to existinq housing, complete the folloviitic rot y, r.s , a. Use of building: One Family Two Family Other b. Number of r ooms in a ach family unit: Number of Bathr ooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each ' g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER-AUTHORIZATION-TO BE-COMPLETED WHEN OWNERS AGENT.:OR-CONTRACTOR APPLIES FOR BUILDING PERMIT I (S 5 1k , as Owner of the subject property `� hereby authorize 14�I-Gt.t rY\ to l ..0 162- i\O t� ` ---Sicb , ° �=-, to act on my behalf, in all matters relative to work authorized by this buil ng permit apple lion. _ S1ibi(3 Signature of Owner Date • i M' /26,0► I L ._ MCe 4 _S( .(i1 -' , as Owner/Authorized Agent hereby declare that the statements and information .; the foregoing-.plication are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. c),,epactiiith Print Name ),afi3 Signature of Owner/Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information ?~ Existing . Proposed Required by'toning This column to be filled in by 1 }.s ,. Building Department k Lot Size Frontage — Setbacks Front Side L:--= R:_ _ L: __a R: _ Rear ----- Building Height Bldg.Square Footage % Open Space Footage __— % (Lot area minus bldg&paved parking) r-. #of Parking Spaces -- Fill: (volume&Location) — "- - — A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued:, iF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW YES Q IF YES: enter Book Page: and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO • IF YES, describe size, type and location: • D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Fr 1.70 c'c' RECEt Department use only �J--'"" City of Northampton Status of Permit: 3,jo`3 Building Department Curb Cut/Driveway Permit , \ tug 1 212 Main Street Sewer/Septic Availability Room 100 Water/WeliAvailability INSPEC CIE u�LprON Mpp10�'0 Northampton, MA 01060 Two Sets of Structural Plans No at,---- phone 413-587-1240 Fax 413-587-1272' 13 587 1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1'-SITE INFORMATION 1.1 Property Address: This.section to be completed by office L 4 +,, V, i - m ��Cr Map Lot Unit �t� �'\ Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 4 •S t1-li- (l{ 0024-1.01-6-)k S---., Vi ng-I Nantn, faro Name(Print) Current icing dd a s: ne as3i Telephone Signature 2.2 Authorized Agent: f r 0� �212Q r/)K� `'3 :AC /LQ C�ici "/Y arc TS. �- J-t ly, 1K4O107s Name(Print) / Current Mailing A ess: V i _ Y/3-53& -c9s_ c Signature Telephone _ SECTION 3--ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be - Official Use Only completed by permit applicant 1. Building A. (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) _ , 5. Fire Protection 6. Total=(1 +2+3+4+5) f'191 C G f. too Check Number d t 4 1010 - - This-Section"For Official-Use Only Date Building Permit Number: Issued: _ - Signafui-e: Building Commissioner/inspector of Buildings Date 1 File#BP-2013-1091 APPLICANT/CONTACT PERSON ADAM QUENNEVILLE ADDRESS/PHONE 160 OLD LYMAN RD SOUTH HADLEY (413) 536-5955 0 PROPERTY LOCATION 14 HAMPDEN ST MAP 38D PARCEL 027 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 04.0X 4/�v Fee Paid Typeof Construction: INSTALL SOLAR PANELS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 070626 3 sets of Plans/Plot Plan THE FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN O ATION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management mol' ' elay r - - 3 0 - 13 Signature of Build e ng Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 14 HAMPDEN ST BP-2013-1091 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38D-027 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SOLAR PANELS BUILDING PERMIT Permit# BP-2013-1091 Project# JS-2013-001802 Est. Cost: $19008.00 Fee: $120.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 5619.24 Owner: MALLOY ALISON F Zoning:URB(100)/ Applicant: ADAM QUENNEVILLE AT: 14 HAMPDEN ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:6/4/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SOLAR PANELS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 6/4/2013 0:00:00 $120.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner