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HomeMy WebLinkAbout116 LISA DR Town of South Windsor Building Department CERTIFICATE OF PROJECT COMPLETION Building Permit: BLDP-20-101 �nSOp GOP APPLICANT LOCATION NAME: Christopher Soverns ADDRESS: 116 LISA DR EMAIL ADDRESS:chris@risingstarroofing.com South Windsor, CT 06074 ADDRESS: 12 Sea Pave Road OWNER: MACPHERSON JAMES A&PAULA B South Windsor, CT 06074 116 LISA DRIVE DESCRIPTION OF WORK: Complete roof system replacement with Ice and Water over the whole roof. CONSTRUCTION TYPE: USE GROUP: a4t,A— September 2, 2020 BUILDING OFFICIAL DATE SIGNED —ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT— "`PERMIT ONLY VALID IF SIGNED BY BUILDING OFFICIAL`"' - -- _ - ---- APPLICATION FOR ELECTRICAL PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT AP P O D 1540 SULLIVAN AVENUE prrBldg. Permit# 644-2511 ext. 230 Date — Building Inspector - Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Fr!� S A D P Over$1,000= Street Lot No. $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS APPLICANT'S PHONE# OWNER �(AO E:5 "A(? P(-kEIz�OJ - 1 � N SFq< OWNER ADDRESS SAAC� OWNER PHONE `� AZ ti l G M ` ESTIMATED COST$ •00 ,.� V IS THIS A CONTRACT COST? Yes No FEE ENCLOSED$ (5 ° C TYPE OF JOB: 7Y2— SOR•CO New Installation Alteration/Addition/Repair �2 Revised 03/05/10 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES ❑ NO IA RESIDENTIAL CURRENT USE AND OCCUPANCY I��L r F�l l L 1 ❑ BUSINESS ❑ ASSEMBLY FUTURE USE AND OCCUPANCY (3 EDUCATIONAL ❑ INSTITUTIONAL ENGINEER'S NAME PHONE ❑ FACTORY ❑ STORAGE ADDRESS _ ❑ GARAGE ❑ MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS NUMBERS OF PANELS NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO NUMBERS OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK C-) THE UNDERSIGNED HEARBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFOR- MANCE OF SUCH WORK f o p of 006.kj,!—_—r, CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OFAPPLICAN7712_g Jz,. /�' .-�&t DATE ape�Rt APPLICATION FOR PLUMBING PERMIT TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 (PHONE)860-644-2511 EXT. 230 PERMIT NUMBER: DEPARTMENT DECISION APPLICATION IS HEREBY: Iq�)o(b7 APPROVED. BLDG.PERMIT NUMBER: � S�6i&" " LA, DATE INSPECTOR LOCATION OF WORK: (I1,,::, L(S A� APPLICANT: OWNER: TYPE OF STRUCTURE: }�`/`i�� O NEW BUILDING NAME: �JANEs l�- '1 y( 4eZ50N NAME: �'""'� ❑ADDITION PHONE NUMBER-- YP� i`S S PHONE NUMBER: tFE)aSTING BUR DING ADDRESS: ADDRESS: TYPE OF USE: tKRESIDENTIAL ❑COMMERCIAL PLUMBING INFORMATION: r FURTHER DESCRIPTION WORK: TYPE OF INSTALLAT W ION: QTETZ H EATEX, /\ NO.OF TOILETS: STYLE: NO.OF BATHTUBS: NO.OF SHOWERS: NO.OF LAVATORIES: NO.OF CATCH BASINS: NO.OF FLOOR DRAINS: ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY WINDOW? oYES oNO ESTIMATED COST: S 1.4 SITE OF WINDOW: SITE OF DUCTS: SEWER OR SEPTIC TANK: FEE ENCLOSED:S 321 cc SITE OF WATER PIPING AND RISER: CA WATER HEATER: TYPE MANUFACTURER FEE SCHEDULE:$18 PER S1,000 OF THE ESTIMATED COST. ROUND UP TO THE NEXT THOUSAND ONCE THE PROJECT IS S1.00 OVER (.26 CENT EDUCATIONAL FEE INCLUDED AS PART OF THE PERMIT FEE) THE UNDERSIGNED HEARBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFOMANCE OF SUCH WORK. CONTRACTORS LICENSE NO.: � A��=Z TYPE: STATE: SIGNATURE OF APPLICANT: WiL—" DATE: --(ti- S �Q��COI$ � Electric # 1400116' APPLICATION FOR BUILDING PERMIT Plumbing# HVAC# I I to 1_�cin— D Date: 'S Sprinkler# 1 y o0 o2y to Estimated Cost $ 2,� C FINAL APPROVA S Permit Fee Building COMPLETE RED BOXED AREAS Occupancy Fee $ Engineeri TYPE OR PRINT ONLY Eng. Insp. Fee $ Affidavit Appr.for CO. SIGN ON REVERSE SIDE t Total Fee $ �S TO THE BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) The undersigned hereby applies to do work according to the following: Applica -N Location of Work 1 _Lot No. Applicant's Address�114 &,C) lC S+- Tel # Town KQ� Hi It C}- Q�)1 Zip Lic.# H 1 L.O1o3211%- Owner Architect Owner's Address i ho L1 -C.N D r I,,_Q Architect's Address Zip Zip__ Sq. Ft.New Area: 1st FI. 2nd FI. 3rd FI. Total New Area Pxrpos^G this permit I r1 �(G11-+Cn Cr 16 Y*( ' mC'�--� .5'� 3c)1 G�/ City Water J Well ❑ Septic System ❑ Sewer 0 '201(f6 C,to Ins: HO SP Area Basement Garage Approved by ate Use Group Construction Type Revised 1108 1 hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building and its use is allowed. Signed ------ I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS INSPECTION FIELD SHEET 08/11/14 Printed by Peart, Dayshell 08:42 44 INSPECTION: 67716 FOOTING PERMIT: STATUS: APPLICATION: 201400638 LOC: 116 LISA DRIVE SOUTH WINDSOR PROPERTY ID: 54000116 OWNER: MACPHERSON JAMES A & CONTRACTOR: REQUEST BY: PROJ DESC: INSTALLATION OF 16 ROOF MOUNTED SOLAR PANELS WORK ORDER: INSPECTOR: ROSE RESULT: N/A REQUESTED: PRIORITY: SCHEDULED: COMPLETED: 08/11/14 UNPAID FEES 00 Date Time MILEAGE: 00 TIME: TRAVEL ONSITE COMMENTS: ALL INSPECTIONS INSPECTED INSPECTOR RESULT INSP DESCRIPTION 08/11/14 ROSE N/A B002 FOUNDATION 08/11/14 ROSE N/A B003 FRAMING (ROUGH) 08/11/14 ROSE N/A B004 INSULATION 08/11/14 ROSE N/A B005 FIREPLACE / CHIMNEY 08/11/14 ROSE N/A B006 WOOD / GAS STOVE 08/11/14 ROSE N/A B009 OTHER X08/08/14 DOUG PASS B010 FINAL IAN @ 860-929-6412 y, 08/08/14 DOUG PASS E010 ELECTRIC FINAL APPLICATION FOR ELECTRICAL PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT AP O D 1540 SULLIVAN AVENUE r, 644-2511 ext. 230 Bldg. Permit 1 H tX o Date Building Inspe for Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 1 1 L LI Uv-I�-K- Over$1,000= Ft No. Street Lot No. $l 5.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS LI APPLICANT'S PHONE# — OWNER 0W N S fq< OWNER.ADDRESS i 1t' ' Q O C,OWNER.PHONE ESTIMATED COSTS •ai U IS THIS A CONTRACT COST? Yes No GFEE ENCLOSED $ I(�� TYPE OF JOB: �SOR•COS New Installation Alteration/Addition/Repair Revised 03/05/10 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES ❑ NO SIDENTIAL CURRENT USE AND OCCUPANCY ❑ BUSINESS ❑ ASSEMBLY FUTURE USE AND OCCUPANCY ❑ EDUCATIONAL ❑ INSTITUTIONAL ENGINEER'S NAME PHONE ❑ FACTORY ❑ STORAGE ADDRESS ❑ GARAGE ❑ MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS NUMBERS OF PANELS NUMBERS OF DISCONNECTS REQUIRED? O YES ❑ NO NUMBERS OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK THE UNDERSIGNED HEARBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFOR- MANCE OF S2 WORK"S / CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE 5 /���1 Ground Source Heat Pump(GSHP)Water to Water VIP 2010 This worksheet is used to measure water-to-water geothermal heat pump peAormace. The efficiency calculation is a whole system calculation and includes any pumps or tans that are part of the distritwtion system. Also,the inputted values ere adjusted to worse case IooP temperatures of 32 degree F Instructions heating and 77 tle rees F co tin S stem must d monstrale an adLst leant of al le st COP for healin or 15 1 EER for coolin Enter Customer Information —Record the customer name,address,town,installer into,etc. Customer Name Address Town State Zip Date ---Enter manufacturer and model number of the equipment. jim mcpherson 1116llsadr southwindsor ct 06074 5/21/2012 CL d: —CL Record nominal(nameplate)capacity in tons,typically to the nearest'A ton,for refer, M Contractor Technician House Bunk Yr Manufacturer Model No. Nomial Tons t/1 ---Record presence of a connected domestic water-heating desuperheater coil(YIN). V) Iddhvec Innatt I1987 Cartier J50yer03Sccd311 3 Desupemeater7 System Install Lion Date Yes ,_Fy 012 Note that PrT ports must be mounted directly at the water4o-water toll or the reading ports and the coil result in inaccurate P/r readings. Important-PR a moat be preaeMt Enter Factory Coil Data In GPM and PSI N GPM 1 0.5 Pressure 1 1.3 rid Enter the manufacturers data for coil fluid flow in gallons per minute(GPM)and the co �6 GPM 2 Pressure 2 a Typically,the manufacturers data shows different PSI for various entering water tempe 6.8 3 4 $ Conditions If the manufacturer supplies more than 3 pairs of GPM/PSI data, enter th( N GPM 3 9.0 Pressure 3 6 0 0 (Note:d the manufacturers data shows feet of head instead of PSI,divide the feet nun Fan and Pump information —List all HVAC fans and Pumps(Excluding the loop pump)that are between the geotf Fan Information Pump Information �$For example,H a water to water unit produces hot water which is circulated to a fan coi Current(Amp) Voltage(V) Location Current(Amp) Voltage V Location section. �., 064 238.4 basement 0.62 118A basement e'f�,—Use the"Location"field to identify the location of the pump or air handler. fS 0.22 239.7 attic 062 118,4 basement cL.—These values are used to calculate an overall system(geothermal plus distribution) A' N) U)i O erating Mode(Heating or Cooling) a,Record equipment test in heating or cooling(H or C)mode. For healing,be sure elects Cooling H disable the electric resistance during the lest. In Out n All systems:While equipment is running,indentify and locate proper test locations to i Water T(°F) 59.2 71,2 -22.0 of in a well-mixed air stream. If testing in cooling mode,also prepare wet-bulb thennocou Water P(PSI) 53.0 48.0 5.0 PSI temperatures(be sure wet-and dry-bulb sensors don't touch). Once the equipment h. step 4),write down the following measurements,and enter into the sheet: --Enter Water ground loop temperature in and out at the heat exchanger coil. Use the Operating Power Measurement time to stabilize. Heat Pump unit Loop Pump Current(Amp) Voltage IV) HP-Watts Current(Amp) Voltage(V) Pum -Wetls —Enter Water ground loop pressure in and out at the heat exchanger coil. Use the sa 23&9 8.62 0781 239.8 0 ---The'GPM"in the sheet shows the coil flow rate as calculated,based on the measur Is pump power included? Yes entered in step 2. If data is not available the GPM is calculated from the air side mea Total Comp.Power --Measure the volts and amps of the circuit that supplies power to the heat pump unit. --Measure the volts and amps of the circuit that supplies power to the water pump. N, Calculation --Indicate whether the circulatingum power is fed through the heat um Total Sys Capacity '• ?'Btu (A) GPM (G) es or no) pump P 9 pump equlpmen Heat Pump Capacity is Btu (B) GPM(mea,) (14) y� GPM/nominal Tons MDIV/rn (A)Total system capacity in BTU Including Impact of pumps+ (H) Heat Pump EER (B)Capacity in BTU of the Heal Pump unit (J) Measured Compressor EER {C) �J (C)Measured Heat Pump efficiency(COP or EER) (K) W. Adjusted for EWT EER (E) Aaluasa err, EER (J) (D)Efficiency of HP adjusted based on EWT Adjusted Compressor P Watts (E) Eligibility QEW 1 EER (K) (E)Operating power o1 HP In watts Adjusted System Power Watts (F) Final VIP Pass (F)Operating power of the overall system(includes fans R pumps) (G)Water flow rate in GPM calculated based on measured pressure drop Q S JUL 11 �n17 South Windsor BUILDING DEPARTMENT r� Revised 4/0I//2002 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT APPROVE 1540 SULLIVAN AVENUE ri 644-2511 "t. 230 Bldg.Permit# Date Building Inspw6r Application must be printed or typed FEE SCHEDULE Location of Job: 114 1,1r v $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Desig nation Apt.No. APPLICANT i?6 rzz©x d iJ +i aq --t- l APPLICANT ADDRESS ,WOAo11,4 Tc�e✓ �!L Sores Err- APPLICANT PHONE# ekD Of 9G 5 6 O W N S Fq OWNER TmES /�ev,;d C Ah e,or—r S,�/ OWNER ADDRESS //�� L/,J's� ID�- S All" Or OWNER PHONE ,( C :D ESTIMATED COST$ ZS, oy O , D� IS THIS A CONTRACT COST? _Yes No FEE ENCLOSED$ 146 S O�� TYPE OF JOB: -It -j&Y,6 OR-C New Installation Alteration/Addition/Repair r 1 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: WHEATING ❑RESIDENTIAL OA/C ❑COMMERCIAL U VENTILATION 0 INDUSTRIAL HEATING ❑STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC O WARM AIR O UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) -- Z: E0;7M9 h'I Sc> Vzf Q 3, ToFO -i✓,40rJ GROSS HEATING CAPACITY(INPUT—BTUH)Ja NET RATING(OUTPUT—BTUH) TYPE OF FUEL ❑OIL--GPM OIL TANK LOCATION:❑ INSIDE❑ OUTSIDE CAPACITY ❑GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW v AIR CONDITIONING DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) TONNAGE COOLING CAPACITY(BTUH) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) FURTHER DESCRIPTION OF WORK THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CT S-i 3a^g 7� 9 S=/ C'T CONTRACTORS LICENSE;_44,Ar E STATE SIGNATURE OF APPLICANT DATE M � Load Short Form Job:- wright5oft' Date: Feb 02,2012 Entire House By: D & D Heating & Air Conditioning LLC 6 Huntington Drive,Somers,Ct 06071 Phone:860-69&9696 Fax 860-698-9785 Email:ddhvacChotmail.com Web:ddhvac.com License:CT S-1 389799 Project • • For: James MacPherson 116 Lisa Drive, South Windsor, Ct 06074 Phone: 860-644-5585 Design Information Htg Clg Infiltration Outside db(OF) 2 91 Method Simplified Inside db(OF) 70 75 Construction quality Semi-tight Design TD (OF) 68 16 Fireplaces 0 Daily range - M Inside humidity (%) 50 50 Moisture difference(gr/lb) 50 31 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref non/a Coil n/a AHRI ref non/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) 2nd Floor d 1007 15471 8372 381 381 1stfloor d 1280 20864 10174 463 463 Entire House d 2287 36335 18514 844 844 Other equip loads 0 0 Equip. @ 0.96 RSM 17811 Latent cooling 1589 TOTALS 2287 36335 19400 844 1 844 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. wri htsoft' 2012-Mar-0519:43:35 t 9 Right-Suite®Universal 2012 12.0.03 RS000670 Page 1 C:lUserslOwnerlDocumentslWrightsoft HVAC1MacPherson.rup Calc-MJ8 Front Door faces: N 2011 CONNECTICUT -.iLz=.."E-�----.6• -i---ResidknLi&LGeothermaI Eligibility Application For Existing Homes 4 � .ticur CONNECTICUT W I*M&Powrr ENERGY EFFICIENCY FUND 7t.\vdr.r('+am Pw.arn www,CT(nrgyWo.com The vniw lRumtnatow compmtr Connecticut's Erwgy Eflicwn y PrcVann are tunded by a ChaW on Custonw eimV bft. The Provarm are despised to nNp cusoatm mntaw Vteir enemy uu p and cog. EMS6W7-5 REV 10-11 TO RECEIVE YOUR FINAL APPLICATION, PLEASE READ THE PROGRAM REQUIREMENTS ON THE BACK AND SIGN Please fill out this form completely and mail it to the appropriate address below. You must include:1)An AHRI reference number,2)A Home Energy Solutions assessment service job number CT11'""'•,3)Any follow up documents indicating your home has been improved to meet minimum program requirements. CLBP CUSTOMERS SEND TO: The Connecticut Light and Power Company P.O.B Box 270 1)The installing contractor must be listed Hartford, 0641-0270 as approved by the CT Clean Energy com Fax#860-665-3874IM Fund at systewww.m design also Attn.Tammy Wilson 2)The system design must also be wilsoa nuW is approved by the CCEF 3)The home must be assessed by a or $500 per AHRI reported cooling Home Energy Solutions weatherization ton in'/h ton increments to a contractor and meet minimum UI CUSTOMERS SEND TO: maximum of$1500 per home. requirements 4)The system must be ENERGY STAR® The United Illuminating Company rated and meet 2012 efficiency 1 e Church St,MS 510 requirements www.energystar.00v New Haven,Ct 2800 5)The system must be AHRI rated as Fax#Michael Chesney assembled www.ahridiredory.ora Attn.Michael Chesney 6)The system must pass a utility michael.chesnev_Quinet.com verification of installed performance test (VIP). CUSTOMER • ' • (PLEASE PRINT)Customer First Name Last Name ll Electric Utility Taonas randv n e%S On (Check one) I�CLBP O UI dress(where equipment was installed) Electric Account Number(as stated on bill) Y .2 t Zip Telephone Number rJ - r - q - E-mail Address Mailing Address(if different from above) City State Zip ExisTING HOME INFORMATION Year Built? •If Home Renovation and/or addition occurring, Current Primary Heating System Fuel: Current Cooling System: 7 please complete below: #of Bedrooms (Window Unit ❑ Electric Baseboard/Panel/Furnace �OII ❑Central AC 12 41 ❑Conditioned sq.ft.to be added ❑ Electric Air Heat Pump ❑ Propane ❑Other ❑None House sq.ft. ❑Full Gut Renovation sq.ft. ❑ Electric Ground Heat Pump ❑Nat Gas *If new conditioned area exceeds 50%of floor space ❑ Other (J U apply to Residential New Homes Program! ExISTING EQUIPMENT INFORMATION Make Model Number Capadty Approximate Age Effclency A - T /07 vo 2-5 t oK ;,S 6_' - o - • • Estimated Brand Tons Compressor Section Model No. Fan/Coil Section Qt,rh,n MAW Pin of Salit Coin OP 3 A 4 30 Gi lJr S/S9 7-1"0 Select proposed system type: Minimum Energy Star 2012 Full Load Efficiency Requirements ❑GLHP Closed Loop Water to Air............................................................... 17.1 EER,3.6 COP Minimum ❑DX Direct Expansion Refrigerant............................................................. 16.0 EER,3.6 COP Minimum ` ,jjrWtoW Water to Water......................................................................... 1 16.1 EER,3.1 COP Minimum l ..., g,rv"=•`!'' m- ,p "C`:P �•:�• - .i yy.G�'t+ c -y...s... __ ...i_ ,4 ' t�^Y r� �;y �r st" R. 4 S ?`�ti�:R�. �•- ,. �.: .rk; -,'d wFS.�.; _ :Fes'�=,P+�j;- :�y' .�..n.C. ����, tir- • • • • • .r'^3:fr? aS rjsrkr-'�'~ .�,:'f�"�' :.'S2e. ' ''� Geothermal Contractor Company Telephone Number Fax Number vd pf./rvr,�,✓C ,oi�� (�'R1v�i7o�rtJ AC) G10P 9G9G AJO G9? 97(� Address Piz E-Mail City State T ip OG D-7/ WAN 0 OM • ,<H Purpose:The 2011 Geothermal Heat Pump Retrofit Minimum Requirements Insulation: Pass /Needs Improvement/Current Value Prequalification Application has been created to: / 1.Verify existing homes meet required energy Roof/Attic insulation>or=R-30 13 R- efficiency levels to maximize benefit to customers 2.Reserve incentive dollars for the proposed project Floor over basement>or=R-19 13 R- a lie_ L7-0XJ - 3.Notify Connecticut Clean Energy Fund(CCEF)of a geothermal project Floor over other unheated space>or=R-30 0 ' R- A/A Application:This eligibility application must be filled Above grade exterior walls>or=R-13 R- out completely,truthfully and accurately and signed by the customer and the home energy inspector. Incomplete inspection reports will not be accepted Approval and Verification:The home must meet Minimum Window Requirements: the minimum requirements described. The Home may be improved and re-verified. Re-verification Double Pane or U-value<or=.40 or equivalent U= may be by any approved auditor. There may be an (storms+single pane is acceptable) additional cost for re-verification. You will be notified within three business days if your geothermal project has been approved. Minimum Air Leakage: 13'A stamped Residential Geothermal CFM50/sq.ft= Performance Incentive Final Application for Tested CFM 50 per square foot of conditioned Existing Homes form will be mailed to the floor area<or=1 CFM50 per square foot of all customer once the home is approved space to be conditioned Once pre-approval is obtained,you have six months to complete the project and submit: 1)A stamped Residential Geothermal Performance Incentive Final Application for Existing Homes form If an of the above provided by the utility y requirements are not met 2)An installation invoice copy at the time of inspection,applicant must 3)A recent electric bill copy submit receipt or other documentation that 4)An AHRI certification form located at deficient items have been improved. www ahridirectory ora To Participate in Home Energy Solutions,Call Additional detail is provided on the 5)A Verification of Installed Performance(VIP) 1-877-WISE-USE(1-877-947-3873) Residential Geothermal Performance worksheet completed on-line by the start up For CLBP customers:https://www.ct-p.com Incentive Final Application For Existing Homes which will be provided once the home contractor at For UI Customers:www.uinet.com, P www.cl-D com or www.uinet.com. is approved. New homes and over 50%of total conditioned square footage new additions should apply through the Residential New Construction Program at www.cl-o.com or www.uinet.com. I HAVE READ AND UNDERSTAND THE TERMS AND CONDITIONS ON THIS APPLICATION. I CERTIFY THAT THE INFORMATION I HAVE PROVIDED IS TRUE AND CORRECT AND THE PRODUCT(S)AND EQUIPMENT FOR WHICH THE APPLICANT IS REQUESTING AN INCENTIVE MEETS THE /RE�QjUIIREMENT THIS APPLICATION. l Sign CUSTOMER SIGNATURE: !i(,' /h DATE: Here TECH SIGNATURE: t DATE: Home Assessment Company Name: Cr)l',, - re- t�rr,�n-�r/T �� (_Ijw S f Home Energy Solutions Job Number: CT1L 53 G qfR You maybe eligible for federal tax credits.Please refer to www.energystar.gov for more information. 9 Load Short Form Job: wri htSoft6 Date: Feb 02,20,2 Entire House By: D & D Heating & Air Conditioning LLC 6 Huntington Drive,Somers,Ct 06071 Phone:860-698-9696 Fax:860-698-9785 Email:ddhvac(Mhotm ail.com Web:ddhvac.com License:CT S-1 389799 Project • • For: James MacPherson 116 Lisa Drive, South Windsor, Ct 06074 Phone: 860-644-5585 Design Information Htg Clg Infiltration Outside db(OF) 2 91 Method Simplified Inside db(OF) 70 75 Construction quality Semi-tight Design TD (OF) 68 16 Fireplaces 0 Daily range - M Inside humidity (%) 50 50 Moisture difference(gr/lb) 50 31 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref non/a Coil n/a AHRI ref non/a Efficiency r1/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 ROOM NAME Area Htg load Clg load Htg AVF Cig AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) 2nd Floor d 1007 15471 8372 375 375 1stfloor d 1280 20864 10174 375 375 Entire House d 2287 36335 18514 751 751 Other equip loads 0 0 Equip. @ 0.96 RSM 17811 Latent cooling 1589 TOTALS 2287 36335 19400 751 751 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. t 2012-Mar-07 1 wrightSoft' Right-Suite®Universal 2012 12.0.03 RS000670 Page 1 Page 1 C:\Users%OwnerlDocuments%WrgMsott HVACUNacPherson.rup Cak-MJ8 Front Door faces: N Ileating &Air Conditioning February 2,2012 Mr.James MacPherson 116 Lisa Drive South Windsor, Ct. 06074 Dear Mr. MacPherson, It is my pleasure to submit for your approval our quote to heat and air condition your home. I recommend the installation of two Unico High Velocity Small Duct Systems,one for each floor.The units will be 2 tons(24,000 btu) for the first floor and 1.5 tons for the second floor. The first floor unit will be installed in the basement and feed each room from the floor.The outlets provided for the first floor will be red oak and can be finished to match the floor.The second floor unit will be located in the attic and feed each room through the ceiling. The heating and cooling will be provided by a Climate Master Geothermal Heat Pump,EW036,with a 80 gallon buffer tank and electric heat backup.There will be 1 well,400 feet bore depth. Extra casing required for the wells that are required to be left in place are not included and will be an additional charge of$15.00 per foot. Lawn remediation is not included in this contract. The quote includes all to make complete, (panel wiring by others and permits costs are not included in this quote) piping,material and equipment. The price for the system installed is$35,990.00. Option: Desuperheater with 50 gallon hot water heater will be $2500.00 Option: Aprilaire By-pass Humidifier $750.00 A deposit of 50% is required to schedule an installation,and a payment of 25%of the balance will due at the start of the project and the balance is due upon completion. Guarantee All material is guaranteed to be as specified. All work to be completed in a workman-like manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only on written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire,tomado and other insurances. Our workers are fully covered byworkman's compens n Insurance. j v ��_ Date: Authorized Signature: / NOTE:This proposal may be withdrawn by us if not accepted within thirty(30)days. Acceptance of Proposal The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to dot e work as specified.Payment will be made as outlined above.Any amount 30 days past due will incur 1.5%interest per month. Should this need to go to collection the belo ned,will be responsible for court costs and attorney fees. Authorized Signature: ii 6 Huntington Drive.Somers,Connecticut 06071 •CT. Lic:. S-13N9799/T•R60.698.9696/Fax: 860.698.9785/ddhvacCaPhotmaiLrom N First floor 25 cfm -1AIII 4 cfm 2w oom c 4 cfm 1 cfm 2 cfm 2 Room6 Kocrnt 6. Ro 1 7 6.5 x 6. 8 cfm 2- 6.5 x 6.5 32 7 cfm 4 cfm F94 cfm Ro 4 Room3 Room2 2 2 4 cfm 4 cfm 3 cfm Job#: Scale: 1 81 D 8� D Heating &Air Conditioning L...Performed for: page 2Right-Suite®lfiiversa12012 James MacPherson 6 Huntington Drive 12.0.03 RS000670 116 Lisa Drive Somers,Ct 06071 y01.0.03 7 D06712 South Windsor,Ct 06074 Phone:860.698-9696 Fax:860-698-9785 s�W2012 Mrightsoft -07 13: 3:12 o... Phone: 860-644-5585 ddhvac.com ddhvac@hotmail.com N Second floor 4 Cfm 2 2 cfm Roo " Room14 2/ 375 cfm 2 2 " Room15 .5 x .5 6. 6.5 6.5 6 2 cf 6.5 x 6.5 Roc m9 12" 2cfm 12' 375 cfm 30 de I Room16 2 cfm R L12 _ 6.5 6.5 2 - Room10 2 2 2^ 2 " 29 cfm 0 0 cf„ 1 cfm Job#: p & D Heating &Air Conditioning L.. Scale: 1 81Page 1 Performed for: liig ht-Suite®Universal 2012 James MacPherson 6 Huntington Drive12.0.03 RS000670 116 Lisa Drive Somers,Ct 06071 2012-Mar-07 13:5111 South Windsor, Ct 06074 Phone:860-098-9696 Fax:860-098-9785 ...s\Wrightsoft WACOacPherso... Phone: 860-644-5585 ddhvac.com ddhvac@hotmaii.com MACPHERSON GEODESIGNER® SYSTEM ANALYSIS Pre ared For: 1 D & D Heating &Air Conditioning LL 6 Huntington Drive Somers, Ct 06071 860-698-9696 860-698-9785 3/7/2012 ClimateMaster,Inc. MacPherson GeoDesignerO 3/7/2012 Page 3 System Summary GSW Tons 11OF Load / Vert 1 U-Tube - 1.25" ClimateMaster Unit Heating Series: Tranquility-Hydronic-TMW Tranquility- Hydronic-TMW Model: 36 Electrical Use: 5,480 Kwh Style: 11OF Htg Load + Fan Coil Cig Average Efficiency: 3.19 COP Hot Water Generator: Yes Annual Contribution: 99 % Heating Run Time: 2,120 Hours Annual Cost: $438 Cooling Run Time: 459 Hours Electric Resistance Electrical Use: 139 Kwh Geothermal Source Average Efficiency: 100 % Annual Contribution: 1 % Source Type: Vertical Closed Loop Annual Cost: $11 Soil Type: 1.40-Average Rock Pipe Type: 1-1/4" IPS PE SCH 40 Annual Heating Cost: $450 Pipe Configuration: 1 U-Tube in Bore Avg Pipe Depth: 225 Feet Cooling Bore Length: 370 Feet Tranquility- Hydronic-TMW Min Freeze Protect: 10 Deg F Electrical Use: 838 Kwh Average Efficiency: 18.2 EER Max Source-Cooling: 89 Deg F Avg Source-Cooling: 64 Deg F Annual Cooling Cost: $67 Avg Source-Heating: 38 Deg F Min Source-Heating: 30 Deg F Water Heating Geothermal Hot Water Generator Deep Earth Temp: 51 Deg F Electrical Use: 656 Kwh Surface Swing: 20.6 Deg F Average Efficiency: 3.95 COP Swing Time Lag: 43 Days Annual Contribution: 42 % Soil Conductivity: 1.40 Annual Cost: $52 Soil Diffusivity: 0.96 Loop Conductivity: 2.11 Electric Storage Water Heater Electrical Use: 4,051 Kwh Auxiliary Heat Average Efficiency: 88 % Annual Contribution: 58 % Type: Electric Resistance Annual Cost: $324 Style: Forced Air Auxiliary Required: 2 Kw Annual Water Heating Cost: $377 Optional Emergency: 10 Kw Efficiency: 100 % Continuous Fan Aux Balance Point: 11 Dea F Electrical Use: 0 Kwh Water Heater Annual Continuous Fan Cost: $0 Type: Electric Storage Water Heater Style: Standard Efficiency Efficiency: 88.0 % Total Annual Operating Cost: $893 Due to the variability of weather, system installation, and living habits this analysis is to be considered an estimate. 3m1 2 ClimateMaster, Inc. MacPherson GeoDesignerS 3/7/2012 Page 4 Temperature Bin Analysis GSW Tons 11OF Load / Vert 1 U-Tube - 1.25" Outdoor Annual Space Hot Water Geo Htg-Clg H.W.Gen Geo Geo Aux Aux Air Weather Load Load Source Capacity Capacity Run Operating Heating Hot Water Temp Hours Btu/Hr Btu/Hr Temp Btu/Hr Btu/Hr Time Cost Cost Cost 112 107 102 97 3 27,294 2,399 90 29,319 2,577 93% $0.68 92 29 22,783 2,399 81 30,581 3,220 75% $4.97 87 118 18,273 2,399 73 31,779 4,173 57% $14.75 82 276 13,762 2,399 66 32,782 4,034 42% $23.94 $5.19 77 422 9,251 2,399 59 33,742 3,555 27% $22.68 $16.01 72 621 7,447 2,399 57 34,124 3,365 22% $27.54 67 771 2,399 $49.27 62 756 2,399 $48.31 57 757 2,399 $48.38 52 654 -2,615 2,399 51 32,483 4,114 8% $12.82 $36.02 47 579 -5,410 2,399 48 31,464 3,974 17% $24.01 $26.46 42 688 -8,205 2,399 45 30,466 3,836 27% $44.23 $25.03 37 813 -11,000 2,399 43 29,487 3,701 37% $71.64 $22.06 32 831 -13,795 2,399 40 28,530 3,569 48% $93.87 $14.91 27 556 -16,590 2,399 37 27,594 3,440 60% $77.19 $4.90 22 372 -19,385 2,399 35 26,694 3,304 73% $61.64 17 234 -22,181 2,399 33 26,252 2,840 84% $44.61 12 154 -24,976 2,399 30 25,733 2,472 97% $33.33 7 77 -27,771 2,399 30 25,607 2,399 100% $17.12 $3.91 2 33 -30,566 2,399 30 25,607 2,399 100% $7.34 $3.84 -3 11 -33,361 2,399 30 25,607 2,399 100% $2.45 $2.00 -8 3 -36,156 2,399 30 25,607 2,399 100% $0.67 $0.74 -13 2 -38,951 2,399 30 25,607 2,399 100% $0.63 -18 -23 -28 -33 8760 $558 $11 $324 317/12 ClimateMaster, Inc. MacPherson GeoDesignerO 3/7/2012 Page 1 Project Information Prepared For: Prepared By: Mr James MacPherson D & D Heating &Air Conditioning ILL 116 Lisa Drive 6 Huntington Drive South Windsor, USA 06074 Somers, Ct 06071 860-644-5585 860-698-9696 860-698-9785 Notes: Sample Customer Note Notes: Sample Dealer Note Design Data Heating Load: 36,336 Btu/Hr Heating Setpoint: 70 Deg F Htg Load Temp Diff: 65 Deg F Cooling Setpoint: 75 Deg F Cooling Load: 30,000 Btu/Hr Begin Cooling At: 70 Deg F Clg Load Temp Diff. 25 Deg F Hot Water Setpoint: 130 Deg F Sensible Cooling: 26,500 Btu/Hr Hot Water Users: 4 Continuous Fan: No Reference City: Hartford, CT Winter Design: 7 Deg F Annual Heating: 60.1 Million Btu Summer Design: 91 Deg F Annual Cooling: 15.2 Million Btu Bldg Balance Temp: 57 Deg F Annual Water Heating: 21.0 Million Btu Avg Internal Gains: 7,447 Btu/Hr Daily Hot Water Use: 70 Gallons Estimated Operating Cost Summary System Heating Cooling Hot Water Constant Total Per Cost Cost Cost Fan Cost Month GSW Tons 11OF Load /Vert 1 U-Tube - 1.25" $450 $67 $377 $0 $893 $74 12 SEER - R22 System $767 $132 $503 $0 $1,402 $117 Boiler-80%-Oil-Natural Draft System $2,542 $122 $524 $0 $3,189 $266 Comments: Utility Cost Rate Summer Winter Sample Project Note. Electric- Geothermal $/kwh .080 .080 Electric- Heat Pump $/kwh .080 .080 Electric- Furnace $/kwh .080 .080 Natural Gas $/therm 2.30 1.00 03072012A Propane $/gallon 4.60 4.60 MacPherson.ged Fuel Oil $/ allon 4.00 4.00 Due to the variability of weather, system installation, and living habits this analysis is to be considered an estimate. 3i7/1 2 ClimateMaster, Inc. MacPherson GeoDesigner& 3/7/2012 Page 2 System Comparison Graph Annual Operating Cost $3,200 $2,880 $2,560 $2,240 $1,920 $1,600 $1,280 $960 !. $320 --- - Heating Cooling Hot Water Fan Total GSW Tons 11 OF Load/Vert 1 U-Tube- 1.25" ■ 12 SEER- R22 System ■ Boiler-80%-Oil-Natural Draft System 317/12 Boiler-80%-Oil-Natural Draft System 110 Type: Air Conditioner-Split Oil Boiler Style: 13 SEER - R410a Fuel Use: 628 Gallons 95 F Cool Capacity: 36,000 Btu/Hr Electrical Use: 382 Kwh i 95 F Cool Efficiency: 10.8 EER Average Efficiency: 69 % Indoor Coil Match: Standard Outdoor Coil Rating: Average Annual Heating Cost: $2,542 4 Air Conditioner- Split Run Time: 493 Hours Electrical Use: 1,528 Kwh Average Efficiency: 10.0 EER Annual Cooling Cost: $122 Type: Oil Boiler Style: Natural Draft a ea m Input Capacity: 102,000 Btu/Hr Output Capacity: 87,720 Btu/Hr Electric Storage Water Heater Efficiency: 80.0 AFUE Electrical Use: 6,551 Kwh Average Efficiency: 94 % Annual Water Heating Cost: $524 jaw-ma Run Time: 850 Hours Electrical Use: 0 Kwh L $0 Annual Continuous Fan Cost: Type: �ctric Storage Water Heater _ Style: High Efficiency Efficiency: 94.0 % Due to the variability of weather, system installation, and living habits this analysis is to be considered an estimate. 317/12 Geothermal • Incentive Program— CONNECTICUT -< CLEAN ENERGY FUND `'r1r GEOTHERMAL HEAT PUMP REBATE APPLICATION FORM Program Opportunity # CCEF-GT-001 Version 3 (Revised 11-24-2010) FOR RESIDENTIAL PROJECTS Version 3 Page 1 of 19 APPLICATION FORMS Geothermal • Incentive Program Questions or clarifications about this document should be directed to: Connecticut Clean Energy Fund 875 Brook Street Rocky Hill, CT 06067-3444 Telephone: 860.563.0015 FAX: 860.563.4877 E-mail: geothermal(aD-ctcleanenergv.com This document is available on the following Web site: Connecticut Clean Energy Fund hfp://www.ctcleanenergy.com/geothermal Applicants should review the Program Description, located on CCEF's Web site, carefully before completing the Application Forms. Table of Contents Tableof Contents...................................................................................................................2 General Instructions ..............................................................................................................3 ApplicationCertification........................................................................................................6 Homeowner Contact Information..........................................................................................6 Team Experience and Qualifications....................................................................................7 ProposedHeat Pump Equipment.........................................................................................7 RetrofitSection ......................................................................................................................8 ProjectSite Information ........................................................................................................8 Warranties (must be declared in customer contract): ...........................................................8 SystemEnergy Estimates ....................................................................................................8 NewConstruction Section ....................................................................................................9 ProjectSite Information ........................................................................................................9 Warranties (must be declared in customer contract) ............................................................9 SystemEnergy Estimates ....................................................................................................9 Land Use, Ownership, and Permitting ...............................................................................10 Project Budget and Schedule .......................................... 10 ................................................... Additional Documentation ..................................................................................................11 UtilityBills...........................................................................................................................11 SystemInformation.............................................................................................................11 EnergyEfficiency Measures...............................................................................................11 ProjectAgreements............................................................................................................11 Checklist...............................................................................................................................11 SHPO Review Request Form...............................................................................................18 Version 3 Page 2 of 19 APPLICATION FORMS Rebate Application Residential • Incentive Program General Instructions This Geothermal Heat Pump Rebate Application Form is the legal agreement between the Connecticut Clean Energy Fund(CCEF) and the rebate recipient (Homeowner)governing CCEFs funding of this project. Please carefully read all of the following information. This CCEF incentive program is being conducted in parallel with the Connecticut Energy Efficiency Funds (CEEF) incentive programs for geothermal heat pumps, which are administered by Connecticut Light& Power Company and the United Illuminating Company. Projects approved under the CCEF incentive program must meet the energy efficiency and performance verification requirements of the CEEFprograms, so application and approval for assistance under those programs is also required. Additional information about the CEEFprograms is provided in this application form. For sites in the service areas of Connecticut's municipal electric cooperatives, applicants should contact the utility for information about energy efficiency incentives. IMPORTANT: Until further notice, geothermal heat pump projects that have started construction or have been placed in-service before receiving CCEF's written approval are not eligible for funding under this program. NOTE: Projects funded in part by the American Recovery & Reinvestment Act(ARRA) are subject to special terms and conditions that may not apply to other CCEF programs. Please take careful note of these requirements, and make sure that you have complied with them in a timely fashion: 1. Historical Preservation—Until further notice, all geothermal heat pump projects must be reviewed by the State Historical Preservation Office (SHPO). The review request form is included in the CCEF application, and all requested information must be provided. CCEF will send the review request to the SHPO, and will notify applicants if additional information is required. Applicants are not to contact the SHPO directly. SHPO will not review projects that have started or completed construction. 2. "Buy American"requirement—All projects for government-owned buildings must use American-made steel and manufactured goods wherever possible. Documentation of the source of such materials must be obtained by the building owner from the manufacturer of the major equipment items. See hnp://eere.enerp-y.gov/recove[y/buy american provision.html for more information. 3. National Environmental Protection Act—All geothermal heat pump projects larger than 10 tons must submit a NEPA questionnaire as part of this application. The questionnaire can be found at: http://www.netl.doe.pov/business/forrns/ES-I SEP.vdf 4. Review the Geothermal Heat Pump Incentive Program Description document(see Download detailed Program Description) for information about how to participate in this rebate program. 5. Complete either the"New Construction" or"Retrofit" section, and all other sections,of this Geothermal Heat Pump Rebate Application Form. All information is necessary for processing the application. Illegible or incomplete forms will be discarded and the Homeowner will be notified. NOTE: If any part of the space to be conditioned by the geothermal heat pump system is existing space, then the"Retrofit" form should be used. Version 3 Page 3 of 19 APPLICATION FORMS Rebate Application Residential • Incentive Program 6. Applications for geothermal heat pump systems received after the program start date (December 15, 2009) on residences anywhere in Connecticut are eligible for a rebate under this program,provided the purpose of the system is to provide the primary space heating and cooling for the conditioned area, the system is designed and installed by a qualified installer and the system meets all minimum requirements of the Geothermal Heat Pump Incentive Program. 7. Mail the completed original of the Geothermal Heat Pump Rebate Application Form and appropriate documents to: Project Assistant—Geothermal Connecticut Clean Energy Fund 865 Brook Street Rocky Hill, CT 06067-3444 ggothermalgctcleanenergy.com Note: Applications and supporting documents will not be accepted via facsimile or email. 8. Homeowners will be notified by email within thirty (30) business days if their applications have been approved, denied, or if more information is required. The approval notice will include the rebate amount and a Rebate Reservation Number from CCEF. 9. Upon receiving a Rebate Reservation Number from CCEF, Homeowners will have six (6) months to complete the system installation. If an extension of the completion date is required, then CCEF must be notified in writing at least three(3) months prior to the original due date. NOTE: if a project cannot be completed and made operational by March 31, 2012,the rebate CCEF approved the rebate cannot be paid, even if pp application earlier. 10. CCEF will remit the rebate payment to Homeowner within thirty(30)business days following receipt of notice of project completion, successful completion of the system commissioning process, performance verification, inspection and receipt of copies of all required municipal and utility approvals. 11. Systems are subject to inspection at completion. By submitting this application, Homeowner agrees to such an inspection by a CCEF representative or designated contractor at a mutually convenient time. 12. The CCEF will not make any payments without proof that all required permits, approvals and performance verifications have been obtained. 13. CCEF reserves the right to refuse any rebate application for cause at its discretion; withhold payment until any identified problems with the geothermal heat pump system are resolved; terminate this reward in whole or in part due to the Homeowner's or contractor's failure to fulfill the terms and conditions in this document; to make the final determination on whether items meet the standards set forth in the Program Description; and to inspect the system to ensure that it is consistent with program guidelines. 14. By accepting the benefits of the rebate, Homeowner agrees to cooperate with CCEF, if requested, by approving the release of photographs or information about the system that may be used in various communications to the media and in educational publications. 15. By accepting this rebate offer, Homeowner agrees to forego all rights to any credits for the electric Forward Capacity Market, Class III conservation credits, "green tags," "white tags," and any other environmental attribute credits such as carbon credits that may accrue to the Version 3 Page 4 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program incented geothermal heat pump system now or in the future. Homeowner further agrees to assign these rights, if requested,to the Connecticut Clean Energy Fund. 16. Acceptance of this rebate does not constitute the approval, acceptance, warranty, guarantee or endorsement of CCEF. 17. For all inquiries regarding this Geothermal Heat Pump Incentive Program, contact Program Manager, Bill Colonis, by email at bill.colonis(&ctcleanenergLcom or by phone at (860) 257- 2888. 18. NOTE: All residential projects must adhere to the SPECIAL TERMS AND CONDITIONS APPLICABLE TO RECEIPT OF RECOVERY ACT FUNDS (attached). d Version 3 Page 5 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program Application Certification I certify that the information contained in this Application or any part thereof, including its Exhibits, Schedules, and other documents and instruments delivered or to be delivered to CCEF, is true, accurate, and complete. This Application includes all information necessary to ensure that the statements herein do not in whole or in part mislead CCEF as to any material fact. The undersigned applicant is a duly authorized representative of the Homeowner listed below with the authority to bind the Homeowner to this Application's terms and conditions for the proposed project. In addition, Homeowner has read, understands, and agrees to be bound by the terms and conditions of the Geothermal Heat Pump Incentive Program, as found at www.ctcleanenerg,y.com/geothermal. HOMEOWNER SHALL COMPLY WITH THE FOREGOING AND ALL ADDITIONAL FEDERAL AND STATE REQUIREMENTS THAT ARE OR MAY BE INCORPORATED HEREIN. Legal name of Homeowner: `Ykc .412�TUI✓ Signature of Homeowner Date signed: ✓�� � : � (� Homeowner Contact Information Name: Installation Address: �,f' .j.9, j 16 Mailing Address: CitylTown: So4774 , State: CT Zip: Phone: &W -6)�V -.<595 Cellphone: E-mail: 7-7 of A67mPr rFax: Version 3 Page 6 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program— Team Experience and Qualifications Projects involve participants in a variety of roles including, among others, a host site and those responsible for design, installation, testing, maintenance, and operation. In each of the following tables identify all members of your team and their respective roles on this project. Role: HVAC General Contractor Company: v e 0 11612,-1,,jCT ('orJ r odln/" ZZ C Contact: ,p , r CCIII.10.Al Address City/Town: :�O„-7E4f State: CT Zip: / Phone: 2r&2 G 1d M E-mail: ✓l C ,;,r ,a Iz- ' Role: Geothermal Heat Pump System Designer Company: LLV � ' ,vt» o r/ r✓c Contact: ✓t e eolze,n n poi Address City/Town: moo-meAs State: 0 Zip: Phone: T o ('61 qG l(/ E-mail: Role: Ground Loop Installer Company: ' iiie cT- t4 T P-1i Contact: Address City/Town: State: Zip: Phone: E-mail: Proposed Heat Pump Equipment System Type: ❑Water-to-air For water- AHRI Ratings ]Water-to-water to-waters stems Brand Compressor Fan/Coil Nominal EER COP Hot Water Number Model No. Section Tons Desuper? of Units Model No. Does this proposed equipment replace any existing ground source heat pump equipment? Please explain: Version 3 Page 7 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program— Retrofit Section Project Site Information 1. Total building area square feet)that will be conditioned by the geothermal heat pump system. 2. If the geothermal heat pump project includes some new construction provide%of space that is new: 3. Year existing home was built: /q f 7 4. Is the building a historic property that is listed in or eligible for listing in the National Register of Historic Places? i ' Yes ; No 5. Present heating system: ; . Electric ;7 Gas 'Oil :Other 6. Backup heating system planned: )(Electric : Gas Oil 1-':Other 7. Please provide copies of last twelve months' fuel and electric bills. 8. Present air conditioning system: y None ! Electric tons Other(describe): 9. Home Energy Solutions report attached: ) Yes No(if not,attach other energy audit results, including blower door test results) 10. Please attach documentation of building envelope improvement measures implemented within the past three years, including HES recommendations. 11. ACCA Manual J Sizing report attached? V Yes (provide input and output sheets) No(give reason,and attach sizing calculations) 12. Please attach a description of the ground loop type and basic design calculations. Include a description of the grouting system to be used, and its thermal conductivity. 13. Please provide ductwork description and design calculations. utv/c p //d 14. What percent(%)of the home's total annual heating load is the geothermal heat pump system designed to provide? /aa % Percentage provided by I I backup system or I '. other? —% 15. A one-page site sketch must accompany this application. The sketch must indicate the location of each well or trench,and separation distances. Warranties (must be declared in customer contract): Installer's warranty on system: Parts _L_years Labor L years Manufacturers' warranties(must be passed on to Homeowner): Heat pump(s):__E years Ground loop integrity: ,years System Energy Estimates 1. Geothermal heat pump system estimated annual energy consumption: $ _kWh 2. Geothermal heat pump system estimated annual MMBtu output(heating mode): MMBtu 3. Previous heating system estimated annual energy usage: MMBtu Previous cooling system estimated annual energy usage: MMBtu 4. Please attach your calculations, including assumptions. Version 3 Page 8 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program Land Use, Ownership, and Permitting Installation address: //G i7lz Street Address: Municipality: �h��✓ Jar✓v30/�� Zip Code: 0607V What is the Homeowner's control over the intended host site? ,V Owner ❑ Lease agreement ❑ Purchase option ❑ Other(describe): If the host site is not owned by the Homeowner, provide written proof of rights to install the proposed equipment at the site. What(if any) land use permits will be required to install the proposed equipment at the site (such as conditional use, special use, or other similar permits and approvals)? Identify all, if any,permits that will be required. Permit c ,oN, Application filed Permit secured El El El Project Budget and Schedule Project Schedule Date(expressed in # Expected Calendar of months after Date contract signing) Execution of project contract Site design complete / Commencement of construction / Start of operation(system commissioning) ?PX iL 15 Z C1 7-2- Total Project Budget Projected Cost - $ include direct labor in all costs Total labor hours estimated for project TV hours Heat pump(s) $ 6,5-W, O Ground loop, including piping and grouting $ 7, O- Interior ductwork if new or upgrades $ _20 Ooa. V Site engineering,design, and permitting $ _;7— Total: $ 0.00 Incentive amount requested from CCEF 0L-2- to Version 3 Page 10 of 19 APPLICATION FORMS Incentive Program -Rebate Application Residential • Additional Documentation All applicants must provide the following documentation as attachments to their application forms. Utility Bills Provide copies of: • Utility or fuel bills covering the most recent twelve (12)months for the heating system. • Bills covering the most recent twelve (12) months of electric energy consumption. System Information Please provide a ground loop drawing showing all significant design information, and a list of all major equipment items. Please identify all major components by brand and model, and include specification sheets. Energy Efficiency Measures An energy audit and implementation of recommended energy efficiency measures is required for existing homes, if no efficiency upgrades have been completed within the past three(3) years. With the assistance of the federal tax rebates and conservation/energy efficiency rebate programs run by the utilities, economic payback for building shell improvements is usually very short. Please check http://www.ctenergyinfO.OTP-/enerpy-pro2mms.htm for program information regarding Energy Star certification for new construction, or the Home Energy Solutions program for existing homes. Eligible homeowners are strongly encouraged to participate in CL&P's Weatherization Residential Assistance Partnership(WRAP) program: hqp://www.cl- p.com/Home/SaveEnergv/Rebates/WRAP.aspx or United Illuminating's"UI Helps's"program (https://beta.uinet.com:9444/uinet/connect/U lNet/Top+NavigatorNour+Home/UI+Products+&+Services/U I+Hel PS/) Project Agreements Provide any existing relevant documentation as outlined below that demonstrates the ability of the Homeowner to successfully develop and operate the proposed project. • Any contract or letter of intent to negotiate (a) a lease,or option to lease, the site for a term necessary to assure financing of the project, or(b)a purchase, or option to purchase, the site. • Any letters of intent to negotiate necessary easements. Checklist ❑ Utility/fuel bills ❑ Customer Purchase Agreement ❑ System schematic 0 Manual J sheets 0 Specification sheets for heat pump ❑ Other agreements/contracts ❑ Site sketch/drawings 0 HERS Performance Summary Report or Home Energy Solutions Report ❑ NEPA questionnaire 0 Condominium association approval, or other approval/permit needed for installation on site 0 Signed copy of the Terms and Conditions(attached) ❑ SHPO Review Request Form Version 3 Page 11 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program— Connecticut Clean Energy Fund STATE ENERGY PROGRAM GEOTHERMAL PROJECT OWNER SPECIAL TERMS AND CONDITIONS APPLICABLE TO RECEIPT OF RECOVERY ACT FUNDS Funding is provided from the American Recovery and Reinvestment Act of 2009(Recovery Act)through the State Energy Program.This document contains the special terms and conditions that apply to the use of these funds. If the geothermal project is of greater than ten (10)tons of capacity,then all work on the project shall comply with all applicable requirements of the National Environmental Policy Act(NEPA). Additional guidance from the Federal and State governments on the use of funds is expected and contractors are required to meet any new Federal or State requirements. Project Owner shall comply with all applicable terms and conditions in the Recovery Act relating generally to governance,accountability,transparency, data collection and resources as specified in the Act itself and as discussed below. Project Owner and the CCEF understand that the following provisions may be changed and additional requirements may be added and that each agrees to be bound by such changes, additions,and guidance as may be issued with respect to,and as required under,the Recovery Act or by the State. I. Reporting Requirements Project Owner agrees to cooperate fully with the CCEF to enable the CCEF to comply with its reporting requirements under the Recovery Act and to respond to any Federal or State inquiry regarding projects funded under this Agreement. Such cooperation includes, but is not limited to, providing any project-specific information requested by and deemed necessary in the sole discretion of the CCEF. 11. Prohibition on Use of Funds—§ 1604 of the Recovery Act None of the funds provided under this Agreement may be used for any casino or other gambling establishment, aquarium, zoo,golf course,or swimming pool. 111. Access to Records—§§ 902 and 1515 of the Recovery Act With respect to each Agreement awarded utilizing at least some Recovery Act funds,any representative of an appropriate inspector general appointed under section 3 or 8G of the Inspector General Act of 1978(5 U.S.C.App.)or of the Comptroller General is authorized to: (1) examine any records of contractor or any of its subcontractors or subgrantees,administering such contract that pertain to, and involve transactions related to,the use of funds pursuant to this Agreement; and (2) interview any officer or employee of contractor,subgrantee or subcontractor regarding such transactions. Version 3 Page 12 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program 1V. Historic Preservation Project Owner agrees to inform the CCEF of the project site's status pursuant to the National Register of Historic Places. If the site is listed in or eligible for listing in the National Register of Historic Places,then no Recovery Act funds can be expended to alter the site until completion of a National Historic Places Act Section 106 review. V. Connecticut State Contracting Obligations Project Owner understands and agrees that Cl,the administrator of the CCEF, is a political subdivision of the State of Connecticut and therefore must comply with Connecticut General Statutes(Conn. Gen. Stat.) § 4a-60 and with Conn. Gen. Stat. §4a-60a. These statutes provide that every contract to which a political subdivision of the state other than a municipality is a party must contain the provisions below. Project Owner understands and agrees that this Agreement is such a contract. Accordingly, for purposes of this Agreement, Project Owner agrees to comply with the state contracting obligations in this section for the term of this Agreement. For purposes of this Section V, Project Owner and contractor shall have the same meaning,and contract and Agreement shall have the same meaning. Conn. Gen. Stat. §4a-60: "(a) Every contract to which the state or any political subdivision of the state other than a municipality is a party shall contain the following provisions: (1)The contractor agrees and warrants that in the performance of the contract such contractor will not discriminate or permit discrimination against any person or group of persons on the grounds of race, color, religious creed,age,marital status, national origin,ancestry, sex, mental retardation, mental disability or physical disability, including,but not limited to, blindness, unless it is shown by such contractor that such disability prevents performance of the work involved, in any manner prohibited by the laws of the United States or of the state of Connecticut;and the contractor further agrees to take affirmative action to insure that applicants with job-related qualifications are employed and that employees are treated when employed without regard to their race, color, religious creed,age,marital status,national origin, ancestry, sex, mental retardation, mental disability or physical disability, including, but not limited to, blindness, unless it is shown by such contractor that such disability prevents performance of the work involved; (2)The contractor agrees, in all solicitations or advertisements for employees placed by or on behalf of the contractor,to state that it is an "affirmative action-equal opportunity employer" in accordance with regulations adopted by the commission;(3)The contractor agrees to provide each labor union or representative of workers with which such contractor has a collective bargaining agreement or other contract or understanding and each vendor with which such contractor has a contract or understanding,a notice to be provided by the commission advising the labor union or workers'representative of the contractor's commitments under this section, and to post copies of the notice in conspicuous places available to employees and applicants for employment;(4)The contractor agrees to comply with each provision of this section and sections 46a-68e and 46a-68f and with each regulation or relevant order issued by said commission pursuant to sections 46a-56, 46a-68e and 46a-68f;and(5)The contractor agrees to provide the Commission on Human Rights and Opportunities with such information requested by the commission, and permit access to pertinent books, records and accounts, concerning the employment practices and procedures of the contractor as relate to the provisions of this section and section 46a-56." Subsection(c)(1)of Conn.Gen. Stat. § 4a-60: "Prior to entering into a contract valued at less than fifty thousand dollars for each year of the contract,the contractor shall provide the state or such political subdivision of the state with a written representation that complies with the nondiscrimination agreement and warranty under subdivision(1)of subsection(a)of this section." Subsection(h)of Conn.Gen. Stat. § 4a-60: "The contractor shall include the provisions of subsections(a)and (b)of this section in every subcontract or purchase order entered into in order to fulfill any obligation of a contract with the state and such provisions shall be binding on a Version 3 Page 13 of 19 APPLICATION FORMS Program- subcontractor,vendor or manufacturer unless exempted by regulations or orders of the commission.The contractor shall take such action with respect to any such subcontract or purchase order as the commission may direct as a means of enforcing such provisions including sanctions for noncompliance in accordance with section 46a-56; provided, if such contractor becomes involved in,or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the commission,the contractor may request the state of Connecticut to enter into any such litigation or negotiation prior thereto to protect the interests of the state and the state may so enter." Conn.Gen. Stat. § 4a-60a: "(a)Every contract to which the state or any political subdivision of the state other than a municipality is a party shall contain the following provisions: (1)The contractor agrees and warrants that in the performance of the contract such contractor will not discriminate or permit discrimination against any person or group of persons on the grounds of sexual orientation, in any manner prohibited by the laws of the United States or of the state of Connecticut,and that employees are treated when employed without regard to their sexual orientation;(2)The contractor agrees to provide each labor union or representative of workers with which such contractor has a collective bargaining agreement or other contract or understanding and each vendor with which such contractor has a contract or understanding,a notice to be provided by the Commission on Human Rights and Opportunities advising the labor union or workers' representative of the contractor's commitments under this section,and to post copies of the notice in conspicuous places available to employees and applicants for employment;(3)The contractor agrees to comply with each provision of this section and with each regulation or relevant order issued by said commission pursuant to section 46a-56; and (4)The contractor agrees to provide the Commission on Human Rights and Opportunities with such information requested by the commission, and permit access to pertinent books, records and accounts,concerning the employment practices and procedures of the contractor which relate to the provisions of this section and section 46a-56." Subsection(b)(1)of Conn. Gen. Stat. § 4a-60a: "Prior to entering into a contract valued at less than fifty thousand dollars for each year of the contract,the contractor shall provide the state or such political subdivision of the state with a written representation that complies with the nondiscrimination agreement and warranty under subdivision(1)of subsection (a)of this section." Subsection(c)of Conn. Gen. Stat. § 4a-60a: "The contractor shall include the provisions of subsection(a)of this section in every subcontract or purchase order entered into in order to fulfill any obligation of a contract with the state and such provisions shall be binding on a subcontractor,vendor or manufacturer unless exempted by regulations or orders of the commission. The contractor shall take such action with respect to any such subcontract or purchase order as the commission may direct as a means of enforcing such provisions including sanctions for noncompliance in accordance with section 46a-56; provided, if such contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the commission,the contractor may request the state of Connecticut to enter into any such litigation or negotiation prior thereto to protect the interests of the state and the state may so enter." Nondiscrimination Certification. Project Owner represents and warrants that, prior to entering into this Agreement, Project Owner has provided Cl with documentation evidencing Project Owner's support of the nondiscrimination agreements and warranties of the statutory nondiscrimination sections,above. A form of the Nondiscrimination Certification to be signed by the Project Owner is attached. VI. National Environmental Policy Act(NEPA) § 1609 of the Recovery Act If the geothermal project is of greater than ten (10)tons of capacity,then Project Owner agrees to comply with all applicable requirements of NEPA and understands and agrees that complying with NEPA may require the preparation of an Environmental Assessment and/or Environmental Impact statement as directed by the federal government. Version 3 Page 14 of 19 APPLICATION FORMS Rebate Application - Residential Geothermal Heat Pump Incentive Program VII. Project Owner shall also comply with the applicable requirements of: (i) Anti-Discrimination and Equal Opportunity requirements (ii) Title VI of the Civil Rights Act of 1964 (iii) Title IX of the Education Amendments of 1972 (iv) Section 504 of the Rehabilitation Act of 1973 (v) Age Discrimination Act of 1975 (vi) Anti-discrimination requirements of program-specific statutes (vii) Americans With Disabilities Act (viii) State Energy Program Financial Assistance Rules(10 C.F.R. Part 420 et seq.) (ix) DOE Financial Assistance Rules(10 C.F.R.Part 600 et seq.) V III. Indemnification Project Owner agrees to indemnify Cl, the CCEF, and their respective officers, directors,employees,agents, and affiliates against,and defend and hold each of them harmless,from any and all claims or liabilities related to or arising in any manner from this financing or the Project other than claims or liabilities resulting from the gross negligence or willful misconduct of Cl. IX. Limitation on Recourse Project Owner acknowledges that(a)Cl is acting hereunder in connection with the fulfillment of its statutory obligation to manage the CCEF,and(b)CI's liabilities and obligations under this Agreement are subject and limited to the funding available under Connecticut law. X. Available Funding Cl and the CCEF shall not be obligated to provide the funding or any portion of the funding under this Agreement if there are insufficient funds for such purpose because of any legislative or regulatory action expressly curtailing,reducing, or eliminating Recovery Act funding. X1. Freedom of Information Act Cl is a"public agency"for purposes of the Connecticut Freedom of Information Act("FOIA"). Accordingly, this Agreement and information received pursuant to this Agreement will be considered public records and will be subject to disclosure under the FOIA, except for information falling within one of the exemptions in Conn.Gen. Stat. Section 1-210(b). Because only the particular information falling within one of these exemptions can be withheld by Cl pursuant to an FOIA request, Project Owner should specifically and in writing identify to Cl the information that Project Owner claims to be exempt. Project Owner should further provide a statement stating the basis for each claim of exemption. It will not be sufficient to state generally that the information is proprietary or confidential in nature and not,therefore, subject to release to third parties. A convincing explanation and rationale sufficient to justify each exemption consistent with General Statutes §1-210(b)must be provided. Project Owner acknowledges that(1)Cl/CCEF has no obligation to notify Project Owner of any FOIA request received by CCEF,(2)Cl/CCEF may disclose materials claimed by Project Owner to be exempt if in CI's judgment such materials do not appear to fall within a statutory exemption,(3)Cl/CCEF may in its discretion notify Project Owner of FOIA requests and/or of complaints made to the Freedom of Information Commission concerning items for which an exemption has been claimed, but Cl/CCEF has no obligation to initiate,prosecute,or defend any legal proceeding,or to seek to secure any protective order or other relief to prevent disclosure of any information pursuant to Version 3 Page 15 of 19 APPLICATION FORMS thermal Heat Pump Incentive Program RebateApplication • • an FOIA request,(4)Project Owner will have the burden of establishing the availability of any FOIA exemption in any such legal proceeding,and(5) in no event shall CUCCEF or any of its officers,directors,or employees have any liability for the disclosure of documents or information in Cl/CCEF's possession where CUCCEF,or such officer, director,or employee, in good faith believes the disclosure to be required under the FOIA or other law. I have read and agree to the preceding Terms&Conditions for the Geothermal Heat Pump Incentive Program: Applicant Name(Please print) f — lZ Applicant Signature Date Version 3 Page 16 of 19 APPLICATION FORMS GeothermalRebate Application - Residential • Incentive Program •mot STATE OF CONNECTICUT NONDISCRIMINATION CERTIFICATION — Representation By Individual For All Contract Types Regardless of Value Written representation that complies with the nondiscrimination agreements and warranties under Connecticut General Statutes§4a-60(a)(1) and 4a-60a(a)(1), as amended INSTRUCTIONS: For use by an individual who is not an entity (corporation, limited liability company, or partnership) when entering into any contract type with the State of Connecticut, regardless of contract value. Submit to the awarding State agency prior to contract execution. REPRESENTATION OF AN INDIVIDUAL: I, •,/1 ML5 1-f k--PH51Z'a2M, of l/(o 1-15Tq 6� CtTk Ct) 1A)ZX,30 r!' Signatory Project Site Address represent that I will comply with the nondiscrimination agreements and warranties of Connecticut General Statutes §§ 4a-60(a)(1)and 4a-60a(a)(1), as amended. r ,t 'A' 14",, J Si nature Date A �,1t4�,�fEX�JU Printed Name Version 3 Page 17 of 19 APPLICATION FORMS : .-Terms & Conditions- Residential Geothermal Heat Pump Incentive Program SHPO Review Request Form Return to: Lynne Lewis For CCEF use only: Connecticut Clean Energy Fund Date: 865 Brook Street CCEF Project#10-FED-R-OSDG. Rocky Hill, CT 06067-3444 Email: lynne.lewisnctcleanenergy.com Property Address: Owner's Name: Fyn 1,or PA ex f-0-,,/ Street Address: y I✓a Apt./Unit: City, State, ZIP: Type of Structure: Year Constructed: .�Lc�i✓,nc� Project Description: Solar PV ❑ Solar Thermal ❑ Geothermal Heat Pump Other ❑ System details: 37�^✓ ���7WEL�m/�G f�l 71j A`�/r 7Lo J O �if,4tLe�✓ SxSYz�F1 T"/J<��C ,�G tc�r,Jq �, //J//CU ez/1 q Color photograph of structure(full front view): Please attach a plot plan showing the extent and location of the proposed renewable energy system, including a delineation of the area of anticipated ground disturbance,if any. Version 3 Page 18 of 19 APPLICATION FORMS • Conditions- Geothermal . . . . . . . . . • 1 : ...;...-:----:----4....;....;....;....;.---:--..;..•-}....;....;.•--...............\....}.........;....; ....;....s....;._..c....:....:................... ........................s...-c•---::----:--..;....;....`�+��;....;....;....; 1 I . . 1 . •}.............. �.•..J....�.._.J....s....;....;....}....;.._.s.._.1....}....:....:....L.... } }....1. • tt the .�.. .L. , r r r 1 1 1 • 1 r r • I I , , • . • 1 I' , • 1 1 .• ... ... •.. .•• ... .•_ .._ .._ ... • r • •• V • �•• __ ._ • .•,.•..�.._.;.._.;.•..�•_.• _•.:.... ....:....:..............r_...;......................... .. . •. ;.........., 1 • . • • . , . I . • •• • .... _. . . . 1 1 .......... - ;-...�... _..}..._i. ---;... .- - .. _ ...}.---i-•-•i--- ...}.---i....}.......................... .. .. .. .. ._ ...�... ' .. ..............................� I �-..-1....r._•.1_...1._..1....r_...1....1....1•-'-f... ...f....f....;-...;_-..f....;....;....,..-.;....f•...f..._,....f-.-.1 • • , • • . , , . • . 1 • , / • • I . I I 1 I I . •1 . I . 1 I . •1 1 I /..............J....l....I....l....t....l....l....a.--'a....l....1..._!•...\....L....a....t....\....t....L....l....L.........1 Version 3 Page 19 of 19 APPLICATION FORMS REINO E. HYYPPA B ASSOCIATES CIVIL ENGINEERS 9 LAND SURVEYORS GLASTONBURY, CONK OL r r r �4NXI I - �' �S`�''� ¢ � �� ✓c ra s I ci a 4Sd: 2L—lit j t r Vwet uj 3 \v/ ! v 4W, ci a 1-� �.-°nt ��. „{ _ -k' > f.•, � r. �. � �^.. -�5 'p�{,.y key V' I� "a a {Y '�-R}� ! y� > .. P. y r af '^ ,1�ayi;• >d N+.S.+,l .� L {'r ry�.',�rY`" '+`AREA 20,000 S.F N 3 A . t ` .�. �. �. . .,..�fir, �� `' � � .5r OTHER LAND OF DART. HILL REALTY LOT LINES FROMMAP O►J FIDE IM-F-C � y 1 � dt 'OPEN SPA-rE Suecivlslow 6,-30 ZONE �' ,=R♦ ti`'�+,k{ .�'� ��'' €'�iEir*-f�,.>t. ,�.'�.te�vgcr' e .'a�v� ,rye` wA°� PLOT PLAN SECT{ORJ 3 MOl1NTA+NVIEW a y ESTATES SOUTH WlmoS( R,Co► �BV Rnwo E. H"PPA 0 As ociAlEs "=40' DATE:E;-23-%s MAP No 180.83A 5HEET 2 OF 4 5wEETS REV. Z_-Z�_gam PREPARED FOR I g.WTN 2^a, DART HILL REALTY INC t\�o try.f►►ata vbLRT�p.�. QCPECT To $v{k.Ol•Ata �ccwr%0--a i CERTIFIED ':055IA.NTIALL`I CDRRECT SOUTH WINDSOR, CONN, I 5CALE ', C=40' `� � DATE. %0-3%-tco ,0 31,3��7 _ v A Wry o� -0 0 �� LISA DRIVE -#:- 116 091 30" E. cot uroe N ss YS.4.' qJ s axe» 3- � R 4 Z � l 00 BASED cw MAP 5u8µITMO 'BY -aAIzr rt�u.. y y-4-ff7 TO THE BJILMN4 DEPT, TOWN OF SOUTH N143.% This certri d that this plan and speclfic�tlons are trow Copi_s ct t:.e proposed building or alterations to 0e erected at //& AIJA �r�u L- strut toget�er rn", amevd.—ts stated in apDltc tin. end filed ith pi-n irC 1 :grze to comply wrth It zoning, 9u,-.1 -+d rt'tr I +s and such Drd•-rs ss•h.,lt Iw ]S&L,d y t.ie Department d,irlig pendency of this ..pplic,,tion .,nd final (ssuancp of a bulldlhs: berm it. Signed This plan it 'ppr,v-d subject to pi, e,nd th t thot ord rs 3nJ roi nc,s rcguluung b Ilding shall tad co..pLid to Condrtton_Ify Al pr,ved These ul d �Ahk _ dim Building lncp,ctt000r i.tiiink )ate I/_ V No 17y� REINO E. HYYPPA I& ASSOCIATES ` CIVIL ENGINEERS & LAND SURVEYORS GLASTONBURY, CONK. LISA DRIVE S 086 06' 30- E _ -- 100.00, - � I Lr tI �� �+- So'L�LDG �NE 40 r_ tv w 3 89 0 o a� o— o Iv c') 0 Z Q A� C�tL� �1EU a�E �r�NE✓ A AREA% 20,000 S.F. G'Au LA \00.00 - - LOT LIWES FROM MAP ON FILE TITLED, OTHER LAND OF DART HILL REALT` s INC. •oPE„ESE yutOVISION A-30 ZONE PLOT PLAN SEGTIOIJ 3 MWWAMMEW ESTATES S<>UTH wIN050R,cDw"-'HY ReINo E.N-rrpqA*AssocmlEs.5cALE V=40' DATE:8-23-85 MAp No.180-831L JHEET 2 of 9 SNEE.TS Rcv. 2--Z\-Bc, PREPARED FOR DART HILL REALTY INC EE_�E�T To rGu�t„CwV ��A-CIe.�1 CERTIFIED 5u5SlANTiALL`f CORRECT SOUTH WINDSOR, CONN. SCALE 1"-40' GATE' 4-q-8� 58-05-90 A REINO E. HYYPPA 6 ASSOCIATES CIVIL ENCANEERS 9 LAND SURVEYORS GLASTONBURIf, COIN L �I Fa+. y A Fri Ll A DRIV ?" $ 4 �� �:� • � �'� i '' � �`' � _ - - - - ! -1- - ° :..� �►- `- Asa iy 4 5o m-or r,': � "� -. a' Y .�i• "t 1 \ TF. 338? V.Z. J 4S A.; ¢fir 't� ar71a F ra J y" r2 tL `) L ass. * y (]• a.; O i` "^u�lyP�, .y��t'3• -r +y";v�p` `.. i?. ^ x s'�V'n -t�_..i a (j r \ J s g� �-:.��a 4�, r ���,;1, �;��c'�ts`"'��` <' 4 �_.. .',:�f '�''•�:W"�r n .�•' �. ,sn i F �'-y�� }�F /O'� 90"y?g)-.� A 20,0 i � c N 38 08' r �,A,,',�'_. „X" ram' -x� ��`,�.ia �� -•` .. 4 '' 4 ` LOT LIMES FROM MAP ON FILE iITI-EO, ;.t OTHER LAND OF DART HILL REALTY, INC. +OPEN SPACE SUWY1540N bl-30 ZONE , PLOT PLAN 5ECTIOtl 3 MooNTAIMIJ,t vJ �� ESTATES SOt1TH lAJlMv`.e-lR,:L)WN."BY Rewo E. HYPPA!Assoc WE5 5cALE Y.; i :40' DATE:e-23 85 MAP NO 180.65-IL SHEET 2 of 9 SWEETS RCV. 7 ' >r-o,.�. t«,, fl c>P, 5«,n •.4 5-z a� PREPARED FOR ,N� vb�T W,�H DART HILL REALTY INC, CERTIFIED )B5TA.WTiALL`f CORRECT SOUTH WINDSOR, CONN. SCALE , C-40' QATE. k0-3►-8(0 58- 85-90 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES ❑NO ❑RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑ INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑ GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WHUNG METHOD��1/ S}�l7L�M- SIZE OF SERVICE /ao SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES ❑NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED., DESCRIPTION OF WORK THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. /Zly `ZD E'- CONTRACTORS LICENSE NO. 4 TYPE STATE SIGNATURE OF APPLICANT ' DATE L .� i I DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# TOWN OF SOUTH WINDSOR Application,ishezeb�►:—• / BUILDING DEPARTMENT PR 1540 SULLIVAN AVENUE Bldg. Permit# 2; 644-2511 ext. 230 D to &vg Inspector Application must be printed or typed FEE SCHEDULE Location of Job: FTenant Zl,sA �2. $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof tion Apt.No. APPLICANT SO4dq.-/,z,,r ' APPLICANT ADDRESS 7,?5 , 0; APPLICANT PHONE# {D��j 110 N S OWNER OWNER ADDRESS S-40,.vbre•►.• G7: O 6 4 75� U w. OWNER PHONE C ESTIMATED COST$ O Op,U D r� .r IS THIS A CONTRACT COST? Yes _No �r 0 �� FEE ENCLOSED$,�n. � '""'' co'- c TYPE OF JOB: / OSOR-Cod -"New Installation t/Alteration/Addition/Repair REINO E. HYYPPA & ASSOCIATES N CIVIL ENGINEERS 8 LAND SURVEYORS F GLASTONBURY, CONK ,n-y., r. b- r-,�`a•na.�-+'s_ ... �` -.-- +�°•II��. � � t!�vY' ;-� :.�M' ���¢�P': �,�^,rf'�� ��'+ ? .d�.: 4y4 n N� b y e r Y.tr•,�r �"3 LIC A �RIV -�'►k s 4 '.. LI y, N.Z w2 � Lt=. 0 YL LIB �. 3 l r 1) q \\ Oh 0 -j — z 0 AREA%X�000 S-F \00.00' CTHER LAND vF DART HILL REALIT ,, INC LOT LINES FROM MpP�NJ FIIE 7�tt Efl, 'OPIE«SPA-CE SueDFVISION A-30 ZONE PLOT PLAN 5ECTt014 3 MOI)NTANJviEw .a E �Gw.l►' , y. r .� A , ��' cF` �' ` H ,r 5r nib "` ` ri.. '`�'' STATES SOVTFi rVINL�.70K 8 I j r� Rr-uaO E. H-NPPA t ASSOC IAT ES 5[AIJ A 1"=40 DATE.'8-23-85 MAP SHEET z OF 9 S►.EETS REV Z-21-gam PREPARED FOR + No 7-omiwG V1oLA:T►o►J5 DART HILL REALTY INC. CERTIFIED 1:�5TANTIALLY COWRECT SOUTH WINDSOR, CONN. ! 5CALE : 1" --40' DATE'. 10-3►-S6 58-85-90 r `'' y REINO E. HYYPPA A ASSOCIATES CIVIL £NWNEERS 9 LAND SURVEYORS 4R. e, GLASTONBURY. CONN " wil Ar -43 t _ � 94`� ���'�� .s, .�..,. '��.tr'.,�3Md � •YSt'Y'�?'�;r �''� '� ��sr=S T a Y A�w�e SO ianLo4 �x IW 2 ?pia.h a 1c.z r W 41 ��. Ln S �4,'" Y � S F �` w ¢� x� \00.00 4 �,.n ?� OTHER LAND OF DART HILL REAL.T Y, INC, `�-tir LOT LIME$ FROM MAP 01)FILE TITLEC, � 'OPEN SPACE 5Uti0+vl54OW A-3o ZONE a 3 ` W 5 4p 9F s t PLOT PLAN 5ECT10r-1 3 MOUNTP4NVIEW ;# y r y f i R,- 4K' � N� ^ y.. Y• As ': P Y ES-ATE5 SOUTH I�INO�. c,-�� BY ^ . Rewo E. H"PPA f A S!OC I Al Es ScAtF I"=40• DATF 8-e3-85 MAP No.ISO-65-IL SHEET 2 OF q �V<ETS REv. -2i-gam PREPARED FOR r No ToNIN614-- LA.T10N_ DART HILL REALTY INC. CERTIFIED e,;UB5%NTIALL`! CORRECT SOUTH WINDSOF,, COW 5CALE ' I" =40' OATE 1�-3►-8to 58- 85-90 AF' P O�lED TOVII'l rr ^iJT!-_ NIDSOR ENSIN1_=:ZING D-_PA :TT,?-NT 4 DATE: � ��-8� _•s SotaARBRITF tW i*Fmm the Sufi Photovoltaic Grid Tied Systems,Battery Backup Stand alone Power Generation Fuel Cells-Wind Turbines Office/Fax visit our Showroom Glenn Barresi 860-648-9198 745 John Fitch Blvd,South Windsor,06074 Owner JOB LOCATION: JIM MACPHERSON 116 LISA DR. SOUTH WINDSOR, CT. 06074 INSTALLER: SOLARBRITE 785 JOHN FITCH BLVD. • SOUTH WINDSOR, CT.06074 ti CONTACT INFO: GLENN BARRESI OFFICE 1-860-648-9198 CELL 1-860-808-8691 SOLAR PV SYSTEM i i 41' GARAGE 17' V COMBINER BOX AC DISCONNECT KW METER INVERTER 36 SCHUCO 170W PNLS DC DISCONNECT BACK OF MAIN HOUSE ELECTRICAL SERVICE UTILITY METER 1) UTILITY ACC#884610124 2)AC DISCONNECT HU 362RB 60A 240V 3)DC DISCONNECT DU 222RB 60A 600V 4)3 STRINGS OF 12 PNLS USING USE-2#10 WIRE TO COMBINER BOX 5)COMBINER BOX CONTAINS 3 15A 600V DC FUSES FOR EACH STRING 6)BUILDING WIRE IS THWN-2#8 COPPER WIRE 7)#8 SOLID TO GROUND ALL PNLS AND RAILS TO GROUND 8)36 SCHUCO S 165-SP PNLS 170W EACH 9)INVERTER SMA 6000U 240V 25A 10)KW METER FOR PV PRODUCTION SOLARBRITE SITE-DRAWING 11)SERVICE IS 100A WITH A 125A BUS RATING PER CODE 785 JOHN FITCH BLVD. 12) BACK FEED WITH A 2 POLE 40A BREAKER SOUTH WINDSOR CT. 06074 TITLE JIM MACPHERSON 116 LISA DR. SOUTH WINDSOR CT. 06074 ___ SIZE CAGE CODE DWGNO IREV ENN GL BARRESI A4 1 ------------------ 1-860-648-9198 SCALE SHEET 1 36 ASSp 2 3 4 5, 6 7 TO UTILITY 1)#1 DC COMBINER BOX CONTAINS 3 SERIES STRINGS OF 12 PNLS FUSED WITH 1 15A 600V DC FUSE FOR EACH STRING 2)#2 DC DISCONNECT HU 362RB 60A 600V DC 3)#3 INVERTER SMA 6000U 25A 240V AC 4)#4 KW DEMAND METER FOR PV PRODUCTION 5)#5 AC DISCONNECT DU 222RB 60A 240V AC 6)#6 EXISTING OWNERS SERVICE PNL 7)#7 UTILITY METER 8)WIRES FROM PNLS TO COMBINER BOX USE-2#10 WIRE WITH CRIMPED CONNECTORS 9)BUILDING WIRE THWN-2#8 COPPER WIRE 10)ALL PNLS AND RAILS BONDED WITH#8 SOLID WIRE SOLARBRITE 1 LINE DRAWING 11) PV SYSTEM FEEDS SERVICE PNL WITH A 2-POLE 40A 785 JOHNFITCH BLVD. SOUTH WINDSOR CT. 06074 TITLE z j M MAG P opi W lji A DR. SouTK G1iNpsO4- G,T. 0607i SIZE CAGE CODE DWG NO IRE GLENN BARRESI _____ A4 I 1 1-880-648-9198 ALE NTS SHEET • 0 • • Sunny Boy 6000U • • 'eatnla i sDeclivaftons Soecificafims Inverter Tech Sine-wave,e, current source high frequency equency PVM AC Interface Voltage 183 - 229(208 V) 213 -262 (240 V) 244-305(277 V) AC Interface frequency 59.3 -60.5(60 Hz) Peak Power Trucking Voltage 600 V DC Minimum DC Input Voltage 250 V DC Maximum DC Input Voltage 600 V DC Maximum (D O Input Power 6000 Wp Maximum AC Power Output 6000 W Currant THD Less than 3% • Power factor 0.99 @ nominal power Peak Inverter Efficiency 96% Cooling Fan, speed controlled PV Start Voltage 300 V DC Maximum:ACOutput Current 25 A 208, 240 VAC 21.7 @ 277 VAC Maximum DC Input Current 25 A DC Voltage Ripple Less than 10% Power Consumption 0.1 W nighttime,<7 W in operation Ambient Temperature Rating 45°C Enclosure NEMA 3R. (IP54) stainless steel 'A6000U-13-SE2705 SMA America 10.3 • • Ted"cal Sowificatians Dimensions 16.94 W x 23.64 H x 9.84 D inches (430 W x 600 H x 250 D mm) Weight 141 lbs. (63 kg) Compliance UL1741, E210376, UL 1998, IEEE 519, IEEE 929,ANSI C62.41 Dl 8r C3,FCC Part 15 A 8r B Specifications subject to change without notice. • 10-4 SMA Americo S96000U-I ISE2705 • • Sch0co • • • ELECTRICAL SPECIFICATIONS PeAormance data(except NOCT)under standard test conditions STC': Rated output(Pm") 165 W Output tolerance(A Pmpp) +5%1-0% Guaranteed minimum output(Pmpp min) 165 W Nominal voltage(Umpp) 24.2 V Nominal current(tmpp) 6.83 A Open circuit voltage(Uoc) 30.4 V Short circuit current(Isc) 7.36 A Module efficiency 13.1 % Temperature coefficient u(Pmpp) Temperature coefficient(3(ISG) +0.057%rC Temperature coefficient x(Uoc) Temperature coefficient S Im . %004 rC Temperature coefficient c(Umpp) -0.474%PC • Normal Operating Cell Temperature(NOCT••) 46.2"C Maximum permissible system voltage(in accordance with UL 6 NEC) 600 V Maxrmurn Parrrossiole system voltage(in accordance with T(JV Safety Class II) 780 V STC.Intensity of solar irradiance 1000 W/m',air mass AM 1.5,co temperature TrF(25-C) .. NOCT:1nta u4y of solar i radiance 1100 WMn'.ambient air bmPerabrre 6B°F(20-C).wind speed 2.24 mph(1 m1s) Eleebical Perfonnana TWNwature dependence of kradhowe dependence of 6e.Uac a Paw bc.Uoc a P w a too uo w... 1+0 12D in 150 �. F 100 tan S ; IL sou_ L u 1001 3 L 3} 2 - .__ 60 /0 40 1 �. —Os�w - - q�� 21 0 0 O 0 10 20 30 40 -127 3" "T 1=7 tOT 2t2T 0 -2a'c arc riT Svc rs c 1ao-c o tao aao aoo son lane 1200 w,aaa(v I arairla.oa[M1bt] • • Photovoltaic Module MECHANICAL SPECIFICATIONS Outer dimensions 62.2 x 31.5 in.(1580 x 800 mm) Height of aluminum frame 1.81 in.(46 mm) Design of aluminum frame Silver anodized(similar to RAL 7035) Front glass Tempered safety glass Weight 34.17 Ibs(15.5 kg) Height of plug-in box 0.45 in.(11.5 mm) Connecting system Multi Contact Type 3 Diameter of solar cable 0.01 in.(4 mm') Length of positive cable 49.2 in.(125 cm)t 1.97 in.(5 cm) Length of negative cable 31.5 in.(80 cm)f 1.97 in.(5 cm) CERTIFICATIONS & GUARANTEES Suitability/Approval UL 1703,IEC 61215(DIN EN 61215) Electrical classification Safety Class If • Testing resistance using salt water spray test DIN 50021 Testing resistance using condensation test DIN 50017 Product guarantee 5 years Performance guarantee(90%of P .m ) 12 years Performance guarantee(80%of P w m ) 25 years MISCELLANEOUS Schuco article number S 158-SP 231 471 Packing unit 2 modules Weight of packing unit 70.55 Ibs(32 kg) Schuco installation system SolarEZTM Please NOTE- Due to constant R&D and product mpro�ement we resene the right to changes concerning the specifications and the details mentioned m mm data sheet without prior notice Date of issue 06r2006-TR Solar 240 Pane Road, Newington,CT 06111 Phone. • f ••• 2359 SCHUCO F,�� in Sch0co • Rail Span C'' `` -- 7 harts �O Pr rel !J 16 "'614 I IBC: --Wind=120 mph/Snow=30 psf ezRail W:Maximum Rail Fixing Distance'X" ft-in Panel Panel Slope and Mean Roof Height ft Width?' 0-10 degrees 15-25 deqrees 30-45 deqrees inches 30 1 60 300 30 60 1 300 30 60 300 24 6-7 6-5 5-4 5-3 5-1 4-9 4-5 4-5 4-3 30 5-10 5-9 4-10 4-8 4-7 4-3 4-0 3-11 3-9 36 5-4 5-3 4-5 4-3 4-2 3-10 3-8 3-7 3-5 42 4-11 4-10 4-1 3-11 3-10 3-7 3-4 3-4 3-2 48 4-7 4-6 3-9 3-8 3-7 3-4 3-2 3-1 3-0 54 4-4 4-3 3-7 3-6 3-5 1 3-2 2-11 2-11 2-10 60 4-2 4-0 3-5 3-3 3-3 1 3-0 2-10 2-9 2-8 66 3-11 3-10 3-3 3-2 3-1 2-10 2-8 2-8 2-6 72 1 3-9 1 3-8 1 3-1 3-0 2-11 2-9 2-7 1 2-6 2-5 78 3-7 3-6 3-0 2-11 2-10 2-7 2-5 2-5 2-4 85 3-6 3-5 1 2-10 2-9 2-8 2-6 2-4 1 2-4 2-3 VzRa trWaximum Rail Fixing Distance W ft-in Panel Panel Slope and Mean Roof Hei ht ft Width'P' 0-10 degrees 15-25 degrees 30-45 de rees inches 30 60 300 30 60 300 30 60 300 • 24 6-6 6-1 5-1 5-6 5-4 4-5 4-11 4-9 4-4 30 5-10 5-5 4-6 4-11 4-9 4-0 4-3 3-10 40, 5-4 4-11 4-1 s4= 4-4 3-7 4-0 3-11 3-6 42 4-11 4-7 3-10 4-2 4-0 3-4 3-8 3-7 3-3 48 4-7 4-3 3-7 3-11 3-9 1 3-2 3-5 3-4 3-1 54 4-4 4-0 3-4 3-8 3-6 2-11 3-3 3-2 2-10 60 4-2 3-10 3-2 3-6 3-4 2-10 3-1 3-0 2-9 66 3-11 1 3-8 3-0 3-4 3-2 2-8 2- 11 2-10 2-7 72 3-9 3-6 2-11 3-2 3-1 2-7 2-10 78 3-7 3-4 2-9 3-1 2-11 2-5 2-8 2-8 2-5 85 3-6 3-2 1 2-8 2-11 2-10 2-4 2-7 2-6 2-3 ezRail WS+:Maximum Rail lFixing Distance W ft-in Panel Panel Slope and Mean Roof Height ft Width'P' 0-10 de rees 15-25 degrees 30-45 deqrees inches 30 60 300 30 60 300 30 60 300 24 8-4 7-10 6-6 6-10 6-8 5-9 5-11 5-10 5-6 30 7-5 7-0 5-10 6-1 5-11 5-2 5-3 5-2 4-11 36 6-9 6-5 5-4 5-7 5-5 4-8 4-10 4-9 4-6 42 6-3 5-11 4-11 5-2 5-0 4-4 4-6 4-5 4-2 48 5-10 1 5-6 4-7 4-10 4-8 4-1 4-2 4-1 3-11 54 5-6 5-3 4-4 4-6 4-5 3-10 3-11 3-10 3-8 60 5-3 4-11 4-1 4-3 4-2 3-8 3-9 3-8 3-6 66 5-0 4-9 3-11 4-1 4-0 3-6 3-7 3-6 3-4 72 4-9 4-6 3-9 1 3-11 3-10 3-4 3-5 3-4 3-2 78 4-7 4-4 1 3-7 1 3-9 3-8 3-2 3-3 3-2 3-1 5 1 4-5 1 4-2 1 3-5 1 3-7 3-6 3-1 3-1 1 3-1 2-11 • 'Chart values are for 3-span condition on rails(minimum of 4 supports per rail). Multiply span by 0.8 for other span conditions. 04.M 232101 2.7 SCHUCO • Horizontal Installation Of ezRails On ezL Stand-Offs Locate exact position of rafter! %` '^ Make pre-drill marks - Start at lower edge of roof in the middle of the rafter! � - Predrill centrically, aI8 In order to prevent damage of the rafter. H9 r _'•�_.--- =\ Ghat- . �- R�\fin '• i • Use suitable drill,drill-bit and -�•� ,,`- :. screws! TIP Stretch a cord parallel to the edge of the roof,to ensure accurate s adjustment of the ezL Stand-Offs before tightening the screws. 3.3 232101 oa 2006 SCF4UCO Y Horizontal Installation Of ezRails On ezL Stand-Offs Option A 0 O O ' Turn ezT-Bolt screw 9o• - f =`" ` to secure O I 't connection to ezRail! Right! ' • - --•- wrong I 0- turn 90' � TIP Use a cord again and ` measure diagonally starting at one end of the ezRail. - d1�- _ - Rail may also be attached to the other sideof the ezL Stand-Off. di e+-IM 232101 3.4 SCHUCO ° Ctlipse Engineering, Inc. r u c t u r A l s o l u t i o n s IBC ENGINEERING CERTIFICATE Date: April 20,2006 To: SCHOCO USA L.P./SCHOCO Solar RE Structural Engineering Certification for SCHOCOrs SolarEVA Mounting System To Whom It May Concern: We have completed the analysis of the SCHOCO SolarEVm regarding the rail span drarts for the ezRail W, ezRail WS and ezRail WS+. The analysis was done in accordance with general structural engineering practices. The analysis was based on the following code and reference data 1. International Code Council. lntemabanal Builft Code. Country Club His:ICC,2003. 2. American Society of Civil Engineers and Structural Engineering Irstitinte. Mrmrnm Design loads for Building and toner Stnxxnres(SEUASCE 7-02). 2 w ed.Reston:ASCE,2002. 3. The Aluminum Assoaatbn Aluminum Design Mond SPer6caborrs and Guidel w forAkirrim m StruMxes. 80 ad.Washington D.C.:TAA,2005. 4. American Institute of Steel Construction Manua►of Steel Corlst<uQlon:Akw&e Stress Design. 9" ed. Chicago:AISC.1989. 5. Mechanical properties of SCHOCO ezRail W,WS,and WS+based on material speaficabons provided by SCHOCO. Eclipse Engineering,Inc.has reviewed and verified the adequacy of the existing rails to wittstard the stated design bads provided all installations blow the SolarEfm Morning System Installation Manual,copyrighted by SCHOCO USA LP,2006,and the rail spans and limits fors referenced therein, Troy Leistiko.PE ' , p•' 235 North 1"SL West,2w Floor t�asorlfe,AlOntana 59902 Phone:(406)7214M Fax:(406)72149M wwrreeimtcom • 04.2M 232101 7.2 ACORD COMMERCIAL INSURANCE APPLICATION DATE PRODUCER — APPLICANT INFO' ATION SECTION 02/01/2006 (A/C,No,Ext):(860)563-0942 '4R NAIC CODE: UNDERWRITER FAX (860)257-4713 NIF GROUP,INC. Baldwin Insurance Agency, Inc. POLICIES OR PROGRAM REQUESTED 30 Jordan Lane BOX 290128 INDICATE SECTIONS ATTACHED EQUIPMENT FLOATER GARAGE AND DEALERS hersfield, CT 06129-0128 PROPERTY INSTALLATIONIBUILDERS RISK VEHICLE SCHEDULE GLASS AND SIGN ELECTRONIC DATA PROC BOILER&MACHINERY CODE: SUB CODE: ACCOUNTS RECEIVABLE/ COMMERCIAL AGENCY CUSTOMER ID VALUABLE PAPERS X GENERAL LIABILITY WORKERS COMPENSATION CRIME/MISCELLANEOUS CRIME BUSINESS AUTO UMBRELLA 00003496 TRANSPORTATION/ MOTOR TRUCK CARGO TRUCKERSIMOTOR CARRIER STATUS OF SUBMISSION PACKAGE POLICY INFORMATION X QUOTE ISSUE POLICY ENTER THIS INFORMATION WHEN COMMON DATES AND TERMS APPLY TO SEVERAL LINES.OR FOR MONOLINE POLICIES BOUND(Gne Date and/or Attach Copy) PRO SED EFF DATE PROPOSED EXP DATE BILLING PLAN PAYMENT PLAN AUDIT DATE TIME AM (7 41rci DIRECT BILL PM 7 G AGENCY BILL APPLICANT INFORMATION NAME(First Named Insured a Other Named Insureds) (of First Named Insured): MAILING ADDRESS INCL ZIP-4(of First Named Insured) Hart ford Solarbrite L L C PHONE(A/C,No,Ext): 644-9598 45 Austin Circle South Windsor, CT 06074 INDMDUAL CORPORATION SUBCHAPTER'S" NOT FOR CR BUREAU ID NUMBER CORPORATION PROFIT ORG NAME YEAR BUS STARTED PARTNERSHIP JOINT VENTURE LIMITED CORPORATION INSPECTION CONTACT PHONE ACCOUNTING RECORDS CONTACT PHONE PREMISES INFORMATION LOC# BI.D 0 STREET,CITY,COUNTY,STATE,ZIPr4 CITY LIMITS INTEREST YR BUILT PART OCCUPIED 4S Austin Circle X INSIDE X OWNER Part 0000100001 Hartford OUTSIDE TENANT Solar Energy Installer South Windsor CT 06074 INSIDE OWNER OUTSIDE TENANT INSIDE OWNER OUTSIDE TENANT NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS BY PREMISE(S) Sells and install solar panel to produce electricity in homes and businesses. The energy produced by the panels is converted to electricity. There is no plumbing or hot water involved. He will use a sub contractor to assist on the electrical hook-up on some jobs and may pay him about S2S,000. The insured is a licensed electrician so can do is not dependent on the sub, however, GENERAL INFORMATION EXPLAIN ALL"YES"RESPONSES YES NO EXPLAIN ALL"YES"RESPONSES YES NO t IS THE APPLICANT A SUBSIDIARY OF ANOTHER ENTITY OR DOES X 7 ANY PAST LOSSES OR CLAIMS RELATING TO SEXI IAL ABUSE OR THE APPLICANT HAVE ANY SUBSIDIARIES? MOLESTATION ALLEGATIONS,DISCRIMINATION OR NEGLIGENT HIRING' X 2 IS A FORMAL SAFETY PROGRAM IN OPERATION? X 8 DURING THE LAST TEN YEARS HAS ANY APPLICANT BEEN CONVICTED 3 ANY EXPOSURE TO FLAMMABLES,EXPLOSIVES.CHEMICALS X OF ANY DEGREE OF THE CRIME OF ARSON')(in RI,this question must be answered by any applicant for property insurance Failure to d.sclose X 4 ANY CATASTROPHE EXPOSURE? X the existence of an arson conviction is a misdemeanor punishable by a sentence of up to one year of Imprisonment) 5 ANY OTHER INSURANCE WITH THIS COMPANY OR BEING SUBMITTED? X 9. ANY UNCORRECTED FIRE CODE VIOLATIONS) X 6 ANY POLICY OR COVERAGE DECLINED.CANCELLED OR NON-RENEWED X 10. ANY BANKRUPTCIES.TAX OR CREDIT LIENS AGAINST THE APPLICANT DURING THE PRIOR 3 YEARS?NOT APPLICABLE IN MO IN THE PAST 5 YEARS? X REMARKS ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS AFRAUDULENT INSURANCE ACT,WHICH IS A CRIME AND WHIJE, NE, OH, OK, OR; IN ME CTS THE PERSON TO AjND MINAL AND r VA, INSURANCE BE EF TISL1 MAY CIVALS BE DENIED)PENALTIES. ( APPLICABLE IN APPLICANTS PRODUCER'S Thoma$ 1 dwi n SIGNATURE . 5 SIGNATURE TOM _ ACORD 125(7198) PLEASE COMPLETE REVERSE SIDE ©ACORD CORPO ATION 1993 AGORDy 02/O1/2006 �►v�v��v�tK�."�L UtNttKAL LIABILITY SECTION DATE PRONE PRODUCER (AC No.E:t): (860)563-0942 APPLICANT SO arbri to (Fret FAX (860)257-4713 Unied Baldwin Insurance Agency, Inc. 30 Jordan Lane EFF 77'ryry/��//DpA�TE EXPI//QATTIO'DATE DIRECT BILL PAYMENTPLAN AUDIT BOX 290126 FO ' V6 7 1 D�Q AGENCY BILL ersfield, CT 06129-0128 COMPANY CODE: SUB CODE: USE ONLY CUSTCY OMER ID: 00003496 COVERAGES LIMITS X COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 PREMIUMS CLAIMS MADE X OCCURRENCE PRODUCTS&COMPLETED OPERATIONS AGGREGATE S 2,000,000 PREMISESIOPERATIONS OWNER'S d CONTRACTOR'S PROTECTIVE PERSONAL i ADVERTISING INJURY $ 1,000,000 EACH OCCURRENCE S 1,000.000 PRODUCTS DEDUCTIBLES FIRE DAMAGE(Any one Tire) $ 100,000 PROPERTY DAMAGE $ MEDICAL EXPENSE(Any one person) $ 5,OOO OTHER BODILY INJURY S cur EMPLOYEE BENEFITSPER S $ OCCURRENCE I TOTAL OTHER COVERAGES.RESTRICTIONS AND/OR ENDORSEMENTS(For hired/non-owned auto coverages attach the Business Auto Section.ACORD 127) SCHEDULE OF HAZARDS LOCATION CLASSIFICATION CLASS PREMIUM RATE PREMIUM CODE BASIS TERR PREM/OPS PRODUCTS PREM/OPS PRODUCTS 00001 Solar Energy Installation 46041 P) 20,800 RATING AND PREMIUM BASIS (P)PAYROLL-PER$1.000/PAY (C)TOTAL COST-PER$1.000/COST (U)UNIT-PER UNIT IS)GROSS SALES-PER S1,000/SALES (A)AREA-PER 1.000/SO FT (M)ADMISSIONS-PER 1.000/ADM (T)OTHER CLAIMS MADE(Explain all"Yes"responses) EMPLOYEE BENEFITS LIABILITY 1.PROPOSED RETROACTIVE DATE. 1.DEDUCTIBLE PER CLAIM. $ 2.ENTRY DATE INTO UNINTERRUPTED CLAIMS MADE COV: 2.NUMBER OF EMPLOYEES. 3.HAS ANY PRODUCT,WORK.ACCIDENT.OR LOCATION YES No 3.NUMBER OF EMPLOYEES COVERED BY EMPLOYEE BENEFITS PLANS BEEN EXCLUDED.UNINSURED OR SELF-INSURED FROM ANY PREVIOUS COVERAGE? 4.RETROACTIVE DATE: 4.WAS TAIL COVERAGE PURCHASED UNDER ANY PREVIOUS POLICY? REMARKS REMARKS ACORD 126-S(1197) PLEASE COMPLETE REVERSE SIDE 0 ACORD CORPORATION 1993 r T � STATE F CONNECTICUT ♦ DEPARTMENT OF _ CONS Be it known that UMER PROTECTION 1 JosEPH F7 i ABARRESI i 67 SIMpN f ENF� :�� RI) ;0($82 ha s been certified by t@1D r. t '` usurner Protection as a ELECTRICAL CTOR r � r Nsr� Effective: 10/01/2005 Rg 1�'r Expiration: 09/30 /2006 i mrnissioncr • • I r� Revised 4'01,'2002 DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg. Permit# 644-2511 ext. 230 Date BuiltOrgInspector Application must be printed or typed FEE SCHEDULE Location of Job: Fi �. 5�1$0-$1,000=$15.00 Street Lot No. Over$1,000$15.00 per$1,000 or any fraction thereof gnation Apt.No. II�iII j APPLICANT �C"a ✓ re, l u ` r 1 I LUU4 APPLICANT ADDRESS Soutn vvindbor TO//A ry / BUILDING DEPARTMENT APPLICANT PHONE# 60 W N St OWNER ..1 " h '1-)/*C �Il if i`-S o rt./ q� OWNER ADDRESS L i` b T— So o �,x /tJ.wolf o 0 r E„r OWNER PHONE C ESTIMATED COST$ 1 CJ Ud IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ / ?'- r2 TYPE OF JOB: r�YOSOR•CO�� _New Installation Alteration/Addition/Repair 1 1 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION? ❑YES;WNO ' ❑BUSINESS CURRENT USE AND OCCUPANCY D1-7 e, ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATIONIWIRING METHOD S&,r- ce SIZE OF SERVICE Q OD /f/`ZPS SIZE OF MAIN CONDUCTORS NUMBER OF METERS / NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES O NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK C200,# G k5 --?4& So/ gin THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. - CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE / '" �'49Io/ •� 'I ELECTIUCAI,'JUUAHMUM N,4m tl,%lD —7 CONTRACTOBRUR I VCF} 3BE UPR_E TOLL6p RD.. Y: 41' 06084 > t EXPIRES you;=10%01/2005€t9/30/2006 SIGNED J APPROVED ` 1Wpe of Inspection NEY Inspection 114 1 / / .� r i C e ff�cial Lot o permit number i �ti Vaj o� �u w� � J r _ . Ground Source Heat Pump(GSHP)Water to Water VIP 2010 This worksheet is used to measure water-to-water geothermal heat pump performace The efficiency calculation is a whole system calculation and includes any pumps or fans that are part of the distabubon system. Also,the inputted values are adjusted to worse case loop temperatures of 32 degree F heatog and 77 degrees F coolinct S stems must demonstrate an adiusted efficencv,of at least 3 0 COP for heatinq or 15 1 EER for coolino Instructions Enter Customer Information —Record the customer name,address,town,installer info,etc. Customer Name Address Town State Zip Date --Enter manufacturer and model number of the equipment. im mcpherson 1116 ilea dr south Windsor I ct 1 060741 5/21/2012 m --Record nominal(nameplate)capacity in tons,typically to the nearest h ton,for refen cl Contractor Technician House Built Yr Manufacturer Model No. Nomial Tons H --Record presence of a connected domestic water-heating desuperheater coil(Y/N) h Iddl Imatt 11987 Icamer J50yer036ccd311 3 Desuperheater? System Installation Date Yes 5/21/2012 Note that PIT ports must be mounted directly at the water-to-water toll or the reading ports and the coil result in inaccurate P/T readings. Important-Prr ports must be present' Enter Factory Coil Data in GPM and PSI N GPM 1 4.5 Pressure 1 1 3 N Enter the manufacturer's data for coil fluid flow in gallons per minute(GPM)and the co iS C. Typically,the manufacturers data shows different PSI for various entering water tempe GPM 2 6 8 Pressure 2 3 4 conditions. If the manufacturer supplies more than 3 pairs of GPM/PSI data, enter the GPM 3 9 0 Pressure 3 6 0 (Note:if the manufacturers data shows feet of head instead of PSI,divide the feet nun Fan and Pump Information .jst all HVAC fans and Pumps(Excluding the loop pump)that are between the geolt Fan Information Pump Information For example,A a water to water unit produces hot water which is circulated to a fan cot Current(Amp) Voltage IV) Location Current(Amp) Voltage(V) Location section. 0.64 238.4 basement 062 118 4 basement M Use the"Location"field to identify the location of the pump or air handler. o. 0.22 239.7 attic 062 118.4 basement a `hese values are used to calculate an overall system(geothermal plus distribution)e « °1 N H a Operating Mode Heating or Cooling) 4 p, Record equipment test in heating or cooling(H or C)mode. For heating,be sure elecb tlisable the electnc resistance during the test N Coosng y In Out - All systems:While equipment is running,indentify and locale proper test locations to I Water T(IF) 59.2 71 21 in a wel,mixed air stream. If testing in cooling mode,also prepare wet-bulb thennocou Water P(PSI) 53.0 48.0 5 C PS temperatures(be sure wet-and ary-bulb sensors don't touch). Once me equipment h. Step 4),write down the following measurements,and enter into the sheet: --Enter Water ground loop temperature in and out at the heat exchanger coil. Use the Operating Power Measurement time to stabilize. Heat Pump unit Loop Pump • Current(Amp) voltage M HIP-Watts Current(Amp) Voltage IV) Pump-Watts —Enter Water ground loop pressure in and out at the heal exchanger coil. Use the sa 238.9 8.82 0781 239.8'C> 159.0 —The'GPM*in the sheet shows the coil flow rate as calculated,based on the measur Is ptaltp power kloktdsd9 Yes entered in step 2 If data is not available,the GPM is calculated from the air side mea Total Comp.Power --Measure the volts and amps of the circuit that supplies power to the heal pump unit. ---Measure the volts and amps of the circuit that supplies power to the water pump. Nu Calculation Indicate whether the circulating pump power is fed through the heat pump equipment Total Sys Capaclry r Btu (A) GPM (G) ---es or no. Heat Pump Capacity, Btu (B) GPM(meas.) (H) GPM/nominal Tons r BDIV/01 (A)Total system capacity in BTU including impact of pumps+ IN Heat Pump EER A Capacity in BTU of the Heat Pump unit (J) to Measured Compres EER (C) (C)Measured Heat Pump efficiency(COP or EER) (K) Adjusted for EWT EER (E) Aqu.w sya. EER EER (J) In (D)Efficiency of HP adjusted based on EWT Adjusted Compressor Watts (E) Eligibility QEWT G EER (K) (E)Operating power of HP in watts Adjusted System Power t.Watts (F) Final VIP Pass (F)Operating power of the overall system(includes fans 8 pumps) (G)Water flow rate in GPM calculated based on measured pressure drop rl ,I 2 ') NOS D SOO)VIJ"X BUILDING DEPARTMENT L ­;s ore k, x I E W­_12 -:d A#LiWHqg -A aiter.n ions to t- J of ­rh in application 7 1; 1 19r,c I with all k.t, .3,Vs a''A S,o crdIrs as steal. d V t+le BUIII�iIIP3 1-.: during Pendel­�by1, �P V t�catlan and final js.uanoo of a bulidin� J ate. ily Apr rcved These filed with 0 �!cr Cler* CERTIPt'*ATION OF ZOMM CCMIPWNCE Propo� ng(s)/ use(s) and/or structure(s) as she w, this plan appear(s) to be in conformance with current S, ith Windsor regulations. Variw"M and spv, ;ial tsxwptions may apply. Date— j 4A& UARing nt Officer L l SA DR I V 116 S Ss, OS' 30" E 00� So' Bt�:3 y0' uNe N s — 'ys•�' cQ /s.3 0 Z h IWAAMWM�1WDINYTP lrM33 OvAw 1s (e"04ow ?ogom end of t l-,�Q qs nd4 O ids M i L aC! �Am O SUI.� 'tb'ilGH 'pTjoR'�S�J 14�1�(Tl�/� BASED 0A4 MNP 5C,35MU7 M Sy Electric # APPLICATION FOR BUILDING PERMIT Plumbing# 116 Lisa Drive Date: S I e &1 of HVAC # I Sprinkler# 900176 Qt .- FINALJR00VALS --- � Estimated Cost $ i s o oa�o - - -------- — ---- - - Permit Fee -'Building COMPLETERED BOXED AREASEngineeri TYPE OR PRINT ONLY j Eng.OccuIns . Fee ancy e $ � Affidavit SIGN ON REVERSE SIDE I g� P� Appr. for C - 0 I' - - - - - -- i Total Fee $ s35, ac TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant& e ti 4 !-AC 9 Location of Work// 6 L l Ste} 72, Lot No. Applicant's Address 1 7, S til r yp D z-0 . 7 P fs . !.v . Tel.# F 6 o % 78 S'o 8 Town_ dA /t.,& H ir. iER Zip r,covd Lic.# Owner- L7_/ 'Ad r- P d.,C S c- A.- Architect Owner's Address �� 'S A V A. Architect's Address 5 7 c`i e P -To A Zip o C P 79 Zip- -Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area Purpose of this permit ( R A C t Z? P i i 1 o w z n x z o City Water[C� ell❑ Septic System❑ Sewer Ins: HO SP Cert. Area—Basement- Garage Approved by Date Use Group Construction Type .'As d WO - �t o6b\ I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building an its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the w escribed inthis application for the permit. Signed DO NOT WRITE BE9W THIS LIN INSPECTION COMMENTS Town of South Windsor Building Department 40MM ��1 .v �R CERTIFICATE OF PROJECT COMPLETION ob Building Permit: BLDP-20-101 ti"';0 cc" APPLICANT NAME:Christopher Soverns LOCATION DR EMAIL ADDRESS:chris@dsingstarroofing.com ADDRESS: or, LI 0 07 ADDRESS: 12 Sea Pave Road South Windsor, CT 06074 South Windsor,CT Pave OWNER: MACPHERSON JAMES A&PAULA B 116 LISA DRIVE DESCRIPTION OF WORK: Complete roof system replacement with Ice and Water over the whole roof. CONSTRUCTION TYPE: USE GROUP: September 2, 2020 BUILDING OFFICIAL DATE SIGNED ' ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT"" "'PERMIT ONLY VALID IF SIGNED BY BUILDING OFFICIAL"` 14000246 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER BUILDING PERMIT DATE: 06/06/2014 GIS ID: 54000116 FEE: 45.00 MUNIS APPLICATION# 201400638 BUILDING DESCRIPTION: APPLICAN 41LOCATION NAME: SOLARCITY ADDRESS: 116 LISA DRIVE ADDRESS: 714 BROOK STREE &0) OWNER: MACPHERSON JAMES A& SUITE 150 116 LISA DRIVE ROCKY HILL,CT SOUTH WINDSOR,CT 06074 00 DESCRIPTION OF WORK: INTAr.L�LATION OF 16 ROOF MOUNTED SOLAR PANELS. CONDITIONS: v. SPECIAL - ALL WORK TO BE DONE IN ACCOR WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: ' OR - CO OCCUPANCY GROUP: BUILDING OFFICIAL 6/6/2014 12:42 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE 1200140 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER HVAC PERMIT DATE: 04/11/12 GIS ID: 54000116 FEE: 375.00 MUNIS APPLICATION# 201200217 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: D&D HEATING AND A/C. ADDRESS: 116 LISA DRIVE ADDRESS: 6 HUNTINGTON STREET OWNER: MACPHERSON JAMES A& SOMERS,CT 06071 116 LISA DRIVE SOUTH WINDSOR,CT 06074 DESCRIPTION OF WORK: GEOTHERMAL SYSTEM TO 80 GALLON TANK TO TWO AIR HANDLERS. SPECIAL CONDITIONS: ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS'APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: BUILDING OFFICIAL 4/1 1/2012 12:58 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE 1400182 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER ELECTRICAL PERMIT DATE: 06/06/2014 GIS ID: 54000116 Mn FEE: 105.00 MUNIS APPLICATION# 201400638 � BUILDING DESCRIPTION: APPLICAN r LOCATION NAME: SOLARCITY ADDRESS: 116 LISA DRIVE ADDRESS: 714 BROOK STREET e) OWNER: MACPHERSON JAMES A& SUITE 150 116 LISA DRIVE ROCKY HILL, CT 06067 SOUTH WINDSOR,CT 06074 DESCRIPTION OF WORK: INSTALLATION OF 16 ROOF MOUNTED SOLAR PANELS. WIRING OF 16 ROOF MOUNTED SOLAR PANELS.(4KW). SPECIAL CONDITIONS: ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: , , 00 OCCUPANCY GROUP: BUILDING OFFICIAL 6/6/2014 12:42 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE 1200147 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER ELECTRICAL PERMIT DATE: 05/09/12 GIS ID: 54000116 FEE: 15.00 MUNIS APPLICATION# 201200217 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: MACPHERSON JAMES A ADDRESS: 116 LISA DRIVE ADDRESS: 116 LISA DR I OWNER: MACPHERSON JAMES A& S WINDSOR,CT 06074-1836" -116 LISA DRIVE SOUTH WINDSOR,CT 06074 DESCRIPTION OF WORK: GEOTHERMAL SYSTEM TO 80 GALLON TANK TO TWO AIR HANDLERS. INSTALL TWO 240 VOLT CIRCUITS. SPECIAL CONDITIONS: ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS'APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: BUILDING OFFICIAL 5/9/2012 11:00 AM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE 1800102 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER PLUMBING PERMIT DATE: 02/28/2018 GIS ID: 54000116 FEE: 36.00 MUNIS APPLICATION# 201800183 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: MACPHERSON JAMES Av ADDRESS: 116 LISA DRIVE ADDRESS: 116 LISA DR OWNER: MACPHERSON JAMES A& SOUTH WINDSOR,CT 06074-1836 116 LISA DRIVE SOUTH WINDSOR,CT 06074 k %tsYN� 1 DESCRIPTION OF WORK: 50 GALLON ELECTRIC WATER HEATER REPLACEMENT. SPECIAL CONDITIONS: Y ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: BUILDING OFFICIAL 2/28/2018 3:38 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE