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16B-001 (2) 5 MARK WARNER DR-20 BRIDGE RD BP-2014-0074 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16B-001 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-2014-0074 Project# JS-2014-000151 Est. Cost:$25000.00. Fee: $150.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALTERIS RENEWABLES INC DBA REAL GOODS SOLAR INC 105675 WILLIAM Size(so.P..): 1206345.60 Owner: MASSY WILLIAM Zoning: SR/URA/WSP Applicant: ALTERIS RENEWABLES INC DBA REAL GOODS SOLAR INC AT: 5 MARK WARNER DR - 20 BRIDGE RD Applicant Address: Phone: Insurance: 32 TAUGWONK SPUR RD UNIT Al2 (860) 535-3370 0 Workers Compensation STO N I N GTO N CT06378 ISSUED ON:7/26/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SOLAR ARRAY SYS 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: 7 -/C l_3 House# Foundation: ■ Driveway Final: Final: Final: 9-z 4-i 3 ��c'' Rough Frame: O Y Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: ['* Final: Smoke: Final: .5.— tit THIS PERMIT MAY BE REVOKED BY THE CITY I F NORTHAMPTON UPON V�TION OF ANY OF ITS RULES AND REG;- A/ON Certificate of Occusanc ' i ature: FeeType: Date Paid: Amount: 7/26/13 150.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner OZ 6L6#ioefo.id IN h 09060`dW 'uoidweypoN 0 N n,... cc o %la Jewell Jew 9 c Q v m ASSev we!H!M E 0 @ W CD �, Y 'u; J O o U Z d � � O1S@ OaMo9 - o w > Q z °° weisAS o!eHionoloyd (NI c a. o uoiiduosao alea A8 '^a21 >- m aouepisal Asse j u) SNOISIn321 s 0, a a O r O M m : � ca N U U U o § 0 > > U EC- 0 u n U O N < < < LI g O E 8 8 A > 2 `') N- > 8 0 J r- CO N ,' 8 M 1! > > p I I - it I I I I 8 y� a? o 0 0 V OM N II) a X) U.) 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I- N 2 < u) 0. 1 (./) w Ce (.0 < , ! ..., 9L-Lo-cLoz (seopulooLLx0oLL) 130019 H ISNV OZIL6 s- v 3/8-16 X 3/4" SS HEX BOLT 3/8-16 SS FLANGE NUT (14' < c(P � t 3* 4N 6105-T5 1 ALUMINUM • 1. 4 0000 0 N A C 00 SolarMount/SunFrame ©2008 UNIRAC, INC. 2" Aluminum 1411 BROADWAY BLVD NE ALBUQUERQUE, NM 87102 USA Serrated PHONE UNIRAC.COM 505.242.6411 L-Foot UNIRAC-310068 0:AAutoCad Detail Library\CAD\UNU AC-210068_2in Serrated L Loot.dwg, 6/24/2008 1:44:32 CM SOLARMOUNT Technical Datasheets IP U N I RAC SolarMount Beams Part No. 310132C, 310132C-B, 310168C, 310168C-B, 310168D 310208C, 310208C-B, 310240C, 310240C-B, 310240D, 410144M, 410168M, 410204M, 410240M Properties Units SolarMount SolarMount HD Beam Height in 2.5 3.0 Approximate Weight(per linear ft) plf 0.811 1.271 Total Cross Sectional Area in2 0.676 1.059 Section Modulus(X-Axis) in3 0.353 0.898 Section Modulus(Y-Axis) in3 0.113 0.221 Moment of Inertia(X-Axis) in4 0.464 1.450 Moment of Inertia(Y-Axis) in4 0.044 0.267 Radius of Gyration(X-Axis) in 0.289 1.170 Radius of Gyration(Y-Axis) in 0.254 0.502 SLOT FOR T-BOLT OR 1.728 -I SLOT FOR T-BOLT OR 1"HEX HEAD SCREW a"HEX HEAD SCREW , 2X SLOT FOR I 1 SLOT FOR BOTTOM CLIP ill 2.500 BOTTOM CLIP NT 3.000 1.316 alp I SLOT FOR 34" HEX BOLT SLOT FOR All 1.385 Low 14" HEX BOLT I .387 .750 sil 1.207--1 Y Y 1.875 JI A A ►X rX SolarMount Beam SolarMount HD Beam Dimensions specified in inches unless noted 4 SOLARMouNT Technical Datasheets :El U N I RAC SolarMount Beam Connection Hardware SolarMount L-Foot Part No. 304000C, 304000D • L-Foot material: One of the following extruded aluminum alloys:6005- T5,6105-T5,6061-16 • Ultimate tensile:38ksi,Yield: 35 ksi • Finish: Clear or Dark Anodized * L-Foot weight:varies based on height:—0.215 lbs(98g) Allowable and design loads are valid when components are Bea .•- [ assembled with SolarMount series beams according to authorized qp Bolt UNIRAC documents i (L -Foot • For the beam to L-Foot connection: . •Assemble with one ASTM F593%"-16 hex head screw and one •"r errated ASTM F594%"serrated flange nut Flange Nu 2 •Use anti-seize and tighten to 30 ft-lbs of torque • Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third-party test Y results from an IAS accredited laboratory A NOTE: Loads are given for the L-Foot to beam connection only; be R X sure to check load limits for standoff,lag screw,or other attachment method 1,01 Applied Load Average Safety Design Resistance AStOTFOO Direction Ultimate Allowable Load Factor, Load Factor, 6w"°` lbs(N) lbs(N) FS lbs(N) W . 1 T a,nE _ Sliding,Z± 1766(7856) 755(3356) 2.34 1141 (5077) 0.646 Tension,Y+ 1859(8269) 707(3144) 2.63 1069(4755) 0.575 Dimensions specified in inches unless noted Compression,Y- 3258(14492) 1325(5893) 2.46 2004(8913) 0.615 Traverse,X± 486(2162) 213(949) 2.28 323(1436) 0.664 3 SOLARMOUNT Technical Datasheets :LI U N I RAC SolarMount Mid Clamp Part No.302101C,302101D,302103C,302104D, 302105D,302106D Bolt •• Mid clamp material: One of the following extruded aluminum Mid``� :rre`• alloys: 6005-T5, 6105-T5, 6061-T6 Ala •e Nu Clamp \ Ultimate tensile: 38ksi,Yield: 35 ksi , '., •'', • Finish:Clear or Dark Anodized °, • Mid clamp weight:0.050 Ibs(23g) • Allowable and design loads are valid when components are ` ,..• assembled according to authorized UNIRAC documents 1W -, • Values represent the allowable and design load capacity of a single mid clamp assembly when used with a SolarMount series beam to retain a module in the direction indicated • Assemble mid clamp with one Unirac%"-20 T-bolt and one'/4"-20 ASTM F594 serrated flange nut Beam • Use anti-seize and tighten to 10 ft-lbs of torque • Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third- party test results from an IAS accredited laboratory Applied Load Average Allowable Safety Design Resistance 7.00DISTANCE - - Direction Ultimate Load Factor, Load Factor, 9E"W'EER NCOULtS lbs(N) lbs(N) FS lbs(N) 0 Tension,Y+ 2020(8987) 891 (3963) 2.27 1348(5994) 0.667 Transverse,Z± 520(2313) 229(1017) 2.27 346(1539) 0.665 � Sliding,X± 1194(5312) 490(2179) 2.44 741 (3295) 0.620 ►X Dimensions specified in inches unless noted SolarMount End Clamp Part No.302001C,302002C,302002D,302003C, 302003D,302004C,302004D,302005C,302005D, 302006C,302006D,302007D,302008C,302008D, 302009C,302009D,302010C,302011C,302012C • End clamp material: One of the following extruded aluminum alloys: 6005-T5, 6105-T5, 6061-T6 ------~ =off • Ultimate tensile: 38ksi,Yield: 35 ksi ., -ar • Finish:Clear or Dark Anodized ..--------- if End clamp weight:varies based on height: -0.058 lbs(26g)•G •Clamp • Allowable and design loads are valid when components are Serrated ow" assembled according to authorized UNIRAC documents Flange Nut • Values represent the allowable and design load capacity of a single end clamp assembly when used with a SolarMount series beam to retain a module in the direction indicated ` • Assemble with one Unirac%"-20 T-bolt and one%"-20 ASTM F594 serrated flange nut Bea' ( Use anti-seize and tighten to 10 ft-lbs of torque "' •• Resistance factors and safety factors are determined according to Y part 1 section 9 of the 2005 Aluminum Design Manual and third- 4 party test results from an IAS accredited laboratory A • Modules must be installed at least 1.5 in from either end of a beam ►X ..s Applied Load • Average Allowable Safety Design Resistance "°"`"- Direction Ultimate Load Factor, Loads Factor, , I „ i lbs(N) lbs(N) FS lbs(N) 0 w T Tension,Y+ 1321 (5876) 529(2352) 2.50 800(3557) 0.605 T"`{''ts`` Transverse,Z± 63(279) 14(61) 4.58 21 (92) 0.330 Sliding,X± 142(630) 52(231) 2.72 79(349) 0.555 Dimensions specified in inches-unless-noted 2 SOLARMOUNT Technical Datasheets iV U N I RAC SolarMount Technical Datasheet Pub 110818-ltd V1.0 August 2011 SolarMount Module Connection Hardware 1 Bottom Up Module Clip 1 Mid Clamp 2 End Clamp 2 SolarMount Beam Connection Hardware 3 L-Foot 3 SolarMount Beams 4 SolarMount Module Connection Hardware SolarMount Bottom Up Module Clip Part No. 302000C ' Washer • Bottom Up Clip material: One of the following extruded aluminum Bottom mit (hidden..s alloys: 6005-T5, 6105-T5, 6061-T6 Up Clip no • Ultimate tensile: 38ksi, Yield: 35 ksi • Finish:Clear Anodized 4.,N Bottom Up Clip weight: -0.031 Ibs(14g) SS '"Bolt Allowable and design loads are valid when components are Beam ,.,+ assembled with SolarMount series beams according to authorized • UNIRAC documents Assemble with one'/"-20 ASTM F593 bolt,one'/<"-20 ASTM F594 serrated flange nut,and one 1/4"flat washer . "`ti Use anti-seize and tighten to 10 ft-lbs of torque ' Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third- ,.,. ' party test results from an IAS accredited laboratory • Module edge must be fully supported by the beam * NOTE ON WASHER: Install washer on bolt head side of assembly. 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I n n n n n r�i r, Q 4. a CS6P-220/225/230/235/240/245/250P Electrical Data CS6P-220P CS6P-225P CS6P-230P CS6P-235P CS6P-240P CS6P-245P CS6P-250P Nominal Maximum Power at STC(Pmax) 220W 225W 230W 235W 240W 245W 250W Optimum Operating Voltage(Vmp) 29.2V 29.4V 29.6V 29.8V 29.9V 30.0V 30.1V Optimum Operating Current(Imp) 7.53A 7.65A 7.78A 7.90A 8.03A 8.17A 8.30A Open Circuit Voltage(Voc) 36.6V 36.7V 36.8V 36.9V 37.0V 37.1V 37.2V Short Circuit Current(Ise) 8.09A 8.19A 8.34A 8.46A 8.59A 8.74A 8.87A Operating Temperature -40C-+85t Maximum System Voltage _ 1000V(IEC)1600V(UL) Maximum Series Fuse Rating 15A Power Tolerance +5W Pmax -0.43%/`C Temperature Coefficient Voc 0.34%fG IsC 0.065%%C NOCT 45°C Under Standard Test Conditions(STC)of irradiance of 1000W/m',spectrum AM 1.5 and cell temperature of 25t Mechanical Data Cell Type Poly-crystalline Cell Arrangement 60(6 x 10) Dimensions 1638 x 982 x 40mm(64.5 x 38.7 x 1.57in) Weight 20kg(44.1 Ibs) Front Cover Tempered glass Frame Material Anodized aluminium alloy Standard Packaging(Modules per Pallet) 20pcs Engineering Drawings I-V Curves (CS6P-250P) 982 9 —_ - a 1111 011111 , _. -1111111111111311 1 i , , - 'lhlu11W1l , .„ , ........... r 111111111111111111111111311 lll (I1111II�111 111111•111111111 " IIUIIll1UI1IIlI — — 'Specifications included in this datasheet are subject to change without prior notice. About Canadian Solar Canadian Solar Inc. is one of the world's largest solar Canadian Solar was founded in Canada in 2001 and was successfully companies.As a leading vertically-integrated manufacturer listed on NASDAQ Exchange (symbol: CSIQ) in November 2006. of ingots, wafers, cells, solar modules and solar systems. Canadian Solar is on track to expand cell capacity to 700MW and Canadian Solar delivers solar power products of module capacity to 1.3GW in 2010. uncompromising quality to worldwide customers. Canadian Solar's world class team of professionals works closely with our customers to provide them with solutions for all their solar needs. Headquarters 1 650 Riverbend Drive.Suite B Kitchener.Ontario I Canada N2K 3S2 Tel.+1-519-954-2057 Fax:+1-519-578-2097 inquire.ca @canadiansolar.com www.canadiansolar.com • •r CanadianSolar CS6P 220/225/230/235/240/245/250P On-grid Module CS6P is a robust solar module with 60 solar cells.These modules can be used for on-grid solar applications.Our meticulous design and production techniques ensure a high-yield, long-term performance for every module produced.Our rigorous quality control and in-house testing facilities guarantee Canadian Solar's modules meet the highest quality standards possible. Key Features • Top ranked PVUSA(PTC)rating in California for higher Applications energy production • On-grid residential roof-tops • 6 years product warranty(materials and workmanship); • On-grid commercial/industrial roof-tops • Solar power stations 25 years module power output warranty Other on-grid applications •• Industry leading plus only power tolerance:+5W(+2%) • Strong framed module,passing mechanical load test Quality Certificates of 5400Pa to withstand heavier snow load • IEC 61215,IEC 61730,IEC 61701,UL 1703, • Ultra reliable in corrosive atmosphere,verified by CEC Listed,CE,KEMCO and MCS IEC61701 "Salt Mist Corrosion Testing" • ISO9001:2008:Standards for quality management systems • The 1st manufacturer in the PV industry certified for • ISO/TS16949:2009:The automotive quality ISO:TS16949(The automotive quality management management system system)in module production since 2003 • QC080000 HSPM:The Certification for Hazardous Substances Regulations • ISO17025 qualified manufacturer owned testing lab, fully complying to IEC,TUV,UL testing standards t"1 PUS /l1YE\ IEC .O. \! ®A PVC�- www.canadiansolar.com ACORCY CERTIFICATE OF LIABILITY INSURANCE 12/1/?13 DATE YY) I2/3/2012 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 Lockton Companies,LLC Denver CONTACT 8110 E.Union Avenue PHONE FAX Suite 700 (A/C,No,Ext): I(NC,No): E-MAIL Denver CO 80237 ADDRESS: (303)414-6000 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: First Specialty Insurance Corporation 34916 INSURED Alteris Renewables,Inc. INSURER B: Zurich American Insurance Company 16535 1344665 dba Real Goods Solar INSURER c: James River Insurance Company 12203 32 Taugwonk Spur,Unit Al2 Stonington,CT 06378 INSURER D: Starr Indemnity&Liability Company 38318 INSURER E: INSURER F COVERAGES REAG001 23772ERTIFICATE NUMBER: 11970279 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY1(MM/DD/YYYY) LIMITS A GENERAL LIABILITY N N 1RG200052800 12/1/2012 12/1/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED s0 000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE© OCCUR MED EXP(Any one person) $ XXXXXXX PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 LI POCYI 7 I JET II LOC $ B AUTOMOBILE LIABILITY N N BAP5852403 12/1/2012 12/1/2013 COMBINED SINGLE LIMIT cident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX X AUTOS NED El-RULED BODILY INJURY(Per accident $ XXXXXXX NON-OWNED - PROPERTY DAMAGE $ XXXXXXX X HIRED AUTOS X AUTOS (Per accident) $ XXXXXXX C X UMBRELLA LIAB X OCCUR N N 000557240 12/1/2012 12/1/2013 EACH OCCURRENCE $ 10,000,000 D X EXCESS LIAB CLAIMS-MADE SISCCCL01954212 12/1/2012 12/1/2013 AGGREGATE $ 10,000,000 DED I I RETENTION$ $ XXXXXXX H- B 1122)4 EMPLOYERS'LIABILITY Y/N N WC5852405 1/1/2013 1/1/2014 X ITORY LIMITSI IOER ANY PROPRIETOR/PARTNER/EXECUTIVE 1—N1 N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 H yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/(Attach ACORD 101,Additonal Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11970279 AUTHORIZED REPRESENTATIVE For Evidence Only I /a(kS Pi, erPaortof ACORD 25(2010/05) ©1 8 010 ACORD CORPO ION.All rights reserved The ACORD name and logo are registered marks of ACORD July 16, 2013 To: Code Enforcement Division From: James A. Marx, Jr. P.E. Re: Engineer Statement for Massy Residence, 5 Mark Warner Dr., Northampton, MA - Solar Roof Mount Installation I have verified the adequacy and structural integrity of the existing Roof 1 (one layer shingles): 2"x 10"roof rafters @ 16" c-c, roof slope distance approx. approx. 24'-6"and pitch 34 deg. and Roof 2 (one layer shingles): 2"x 6"roof truss rafters @ 24" c-c, roof slope distance approx. approx. 19'-0"and pitch 42 deg. 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 mounting, the Unirac Solarmount rails will be anchored to the rafters with L-foot supports with Ecofasten GF1-BLK-812 flashing and ECO-CP-SQ Bracket located on the center of the rafters and will be securely fastened to the rafters at 48" sp. with 5/16"x 3 1/2" SSTL lag screws. The mounting system has been designed for wind speed criteria of 90 mph Exp. B and ground snow criteria of 40 psf. All attachments are staggered amongst framing members. 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, James A. Marx, Jr. Professional Engineer MA 36365 10 High Mountain Road N 7/G/j., Ringwood,NJ 07456 � cc: Real Goods Solar The Commonwealth of Massachusetts Department of Industrial Accidents =_±i = Office of Investigations 7-=___: ; ;�_= 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Alteris Renewables, Inc. dba Real Goods Solar Address: 32 Taugwonk Spur, Unit A-12 City/State/Zip: Stonington, CT 06378 Phone#: (860)535-3370 Are you an employer?Check the appropriate box: Type of project(required): 1.© I am a employer with 120 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.I 7 ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10E1 Electrical repairs or additions 3.❑ I 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 12.0 Roof repairs insurance required.] t employees. [No workers' 13.E1 Other solar panels comp.insurance required.] *Any 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 must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Zurich American Insurance Co. Policy#or Self-ins. Lic.#: WC5852405 Expiration Date: 01/01/2014 Job Site Address: 5 Mark Warner Drive City/State/Zip: Northampton,MA 01060 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 un er the ii - d penalties of perjury that the information provided above is true and correct. ,e Signature: :‘,/ C Date: 7/i al/I; Phone#: (860)535-3370 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#: • R F, A GOODS OLA Property Consent Form Owner: /( ///4I F M455-1 Address: Town: /Tie t'eaCe State: 444 Zip: /0 6 t7-- Phone: /(35k ) I hereby give permission to Alteris Renewables, Inc., dba Real Goods Solar and their representatives to pull the required permits for a solar installation on the above stated ilroperty. Signed, ,7-77 Homeowner(s) Date 321augworik Spiv, Al2 Stuninqton CT 0637 p:W-,53.5 3370 F: 4 1 34,83-2225 www,Re(11(,00dsSolcg.com SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Dan McLean 105675 License Number 481 Kennedy Dive, Leeds, MA 01053 7/22/15 Addre// Expiration Date 413-588-2252 ignature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Alteris Renewables dba Real Goods Solar 162709 Company Name Registration Number 32 Taugwonk Spur,A-12,Stonington,CT 06378 4/6/15 Address r /) Expiration Date \ /t „�Cti�i✓��'/ Telephone 860-535-3370 — 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 l l No El 11. - Home Owner Exemption 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing l i Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks [p Siding[CI] Other[El] solar Brief Description of Proposed Work: Installation of a 6kW roof mounted solar array using 24 Canadian Solar CS6P-250P modules,24 Enphase M2 I 5-60-2LL-S22 micro inverters&all associated electrical work. Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet 6a.if New house and or addition to existing housina. complete the foilowina: a. Use of building :One Family X Two Family Other b. Number of rooms in each family unit: Number of Bathrooms 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 1 William Massy , as Owner of the subject property hereby authorize Alteris Renewables dba Real Goods Solar to act on my behalf,in all matters relative to work authorized by this building permit Application. / see attached authorization form Ai 13 Signature of Owner Date ` t I, Alteris Renewables dba Real Goods Solar ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Kim Hendel Print Name kl." (k/ 4 , j,,L,p, 1,q1, 5 Signature Owner/Agent Date Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO Q 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 Q 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 O NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit Building Department Curb Cut/Driveway Permit e 212 Main Street Sewer/S optic Availability 21 0 Room 100 Water/Well Availability 8U``p1NGoNSPEe'noc» No hampton, MA 01060 Two Sets of Structural Plans of oN, • -587-1240 Fax 413-587-1272 Plot/Site Plans 0,-tiovcrwo 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 Map Lot Unit 5 Mark Warner Drive Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: William Massy 5 Mark Warner Drive,Northampton,MA 01060 Name(Print) Current Mailing Address: 413-588-1910 see attached authorization form Telephone Signature 2.2 Authorized Agent: Alteris Renewables dba Real Goods Solar 32 Taugwonk Spur,A-12,Stonington, CT 06378 Name(Print) Current Mailing Address: ��� 860-535-3370 A Signature , Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 5,000 (a)Building Permit Fee 2. Electrical 20,000 (b)Eimated To of Construction st from tal Cost(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 35'L( 6. Total=(1 +2+3+4+5) 25,000 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0074 APPLICANT/CONTACT PERSON ALTERIS RENEWABLES INC DBA REAL GOODS SOLAR INC ADDRESS/PHONE 32 TAUGWONK SPUR RD UNIT Al2 STONINGTON (860) 535-3370 0 PROPERTY LOCATION 5 MARK WARNER DR-20 BRIDGE RD MAP 16B PARCEL 001 001 ZONE SR/URA/WSP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out '` Fee Paid 3�`� `7 Aco Typeof Construction: INSTALL SOLAR ARRAY SYS �( New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 105675 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: proved 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 ,jio ,elY 72,E—/ Sign. re of Bui ding Officia 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. 5 MARK WARNER DR-20 BRIDGE RD B P-2014-0074 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16B-001 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-2014-0074 Project# JS-2014-000151 Est.Cost: $25000.00 Fee: $150.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALTERIS RENEWABLES INC DBA REAL GOODS SOLAR INC 105675 Lot Size(sq.ft.): 1296345.60 Owner: MASSY WILLIAM Zoning: SR/URA/WSP Applicant: ALTERIS RENEWABLES INC DBA REAL GOODS SOLAR INC AT: 5 MARK WARNER DR - 20 BRIDGE RD Applicant Address: Phone: Insurance: 32 TAUGWONK SPUR RD UNIT Al2 (860) 535-3370 0 Workers Compensation STONINGTONCT06378 ISSUED ON:7/26/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SOLAR ARRAY SYS 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: � 1 x(,/13 f Is_ 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner