I :-o~-~o. IMr. Who is submitting this request? Aggregator. Aggregator Batch Number KN0215. Aggregator name ~ Knollwood Energy

Transcription

1 :-o~-~o Who is submitting this request? Aggregator Aggregator Batch Number KN0215 Aggregator name ~ Knollwood Energy Aggregator ~ linda~knoiiwoodenergy.com Other Aggregator name F Other aggregator address Facility Owner Name ~ Jack Dibb Owner Prefix IMr. Facility Owner I jack.dibb@unhedu Owner Phone ~ Facility Address ~ l86swain Road Facility Town/City ~ Barrington Facility State NH Facility Zip [E825 Is the facility address the same as the owners mailing address

2 Yes ONo Mailing Address Mailing Town/City Mailing State Mailing Zip Primary Contact (who should we call with questions) ~ Linda Modica Contact Phone Other Address Faci ity Inforrnat~on Class I ii Utility ~ Eversource I Other Utility Name Date of Utility Signoff 08/15/2015 To obtain a GIS ID contact: James Webb jwebb@apx.com

3 GIS ID (include NON ) ~ N0N57218 Facility Operator Name, if applicable Panel Quantity 34 Panel Make ~ Solarworld Panel Model ~ SW285 Panel Rated Output 285 System capacity based on panels [ Inverter Quantity I3~ lnverter Make ~ Enphase Energy Additional lnverter Rated Output 250 System capacity based on inverters 8.50 System capacity in mw as stated on the interconnection agreement 8.77 Revenue Grade Meter Make GE 1 Was this facility installed directly by the customer (no electrician involved)?

4 o Yes No Date of Electrician Signoff Sign-off Electrician s License Number ~85 Installation Company ~ Other Other Installation Company Name [ ETESoIar Other Inst. Company Address ~ 32 Tyler Lane Other Inst. Company City ~ Berwick Other Inst. Company State ME Other Inst. Company Zip ~ Independent Monitor Name ~ Tom Kelly Monitor Company Name Monitor Company Name F.1 Monitor Company Name Monitor Company Name ~ Natural Capital, LLC Other Monitor Company Name r

5 Is the installer also the equipment vendor? Yes ONo Equipment Vendor Please attach your completed interconnection agreement including Exhibit B /files/f J RG RQm RO_Dibb_SP IA. pdf The project described in this application will meeet the metering requirements of PUG 2506 including: Electricity generation in megawatt hours shall be reported to the GIS quarterly with a statement that the submission is accurate by the owner of the source, the independant minitor or a designated representative. A revenue quality meter is used to measure the electricity generated. The facility owner has certified to the independant monitor that the meter operaes according to manufacturing standards. The meter shall be maintained according to the manufacturer s recommendations. The project is installed and operating in conformance with applicable building codes. A copy of the facilitiy s interconnection agreement is attached. Please attach additional document here /files/f-S-I _xz9cnZO3_Dibb_NHOS.pdf I Please attach additional document here I corn/jan I 947/files!f _yOZwRAVq_Dibb_COC. pdf I Aggregator statement of accuracy Sign your name using a mouse or, if you are using a touch-screen device, a stylus or other pointer.

6 Print Name Linda Modica Date Signed 12/31/2015

7 RECE~~JED EVERSOURCE ~in INTERCONNECTION STANDARDS FOR INVERTERS SIZED UP TO 100 KVA Simplified Process Interconnection Application and Service Agreement Eversource Application Project 11)11:,4/ 3 ~ I ~ Contact Information: Legal Name and Address of Interconnecting Customer (or, Company namn, if appropriate) Customer or Company Name (print): ~ Dibb c/n Salle Whitlow Contact Person, if Company: Mailing Address: ~~wai~ Rd City: ~ State: ~ Zip Code: Telephone (Daytime): (Evening): Facsimile Number: Address: jack.dthb@uflh.edu Alternative Contact Information (e.g., System installation contractor or coordinating company, if appropriate): Name: Kelly Smith wiete Solar Mailing Address: 32 Tyler Lane City: BeTWlck State: ME Zip Code: Telephone (Daytime): (Evening): Facsimile Number: Address: kelly.smith@etesolar.com Electrical Contractor Contact Information (ifappropriate): Name: Tim Congram witec Electrical Systems Mailing Address: 723 Stratford Rd City: 5t~td State: NFl Zip Code: Telephone (Daytime): (Evening): Facsimile Number: Address: tecetectlic@metrocast.net Facility Site InformatIon: Facility (Site) Address: 186 Swain Rd City: Banington State: Zip Code: Electric Service Company: Eversource Account Number: Meter Number: G Account and Meter Number: Please consult an actual Eversource electric bill and enter the correct Account Number and Meter Number on this application. If the facility is to be installed in a new location, please provide the Eversource Work Request number. Eversource Work Request # Non-Default Servi~~ Customers Only: Competitive Electric Energy Supply Company: Account Number: (Customer s with a Competitive Energy Supply Company should ver~/j the Terms & Conditions oftheir contract with their Energy Sltpply Company.) Eversource SPIA rev. 03/14 Page 1 of 4

8 Facility Machine Information: Generator! EVERSOURCE INTERCONNECTION STANDARDS FOR INVERTERS SIZED UP TO 100 KVA Simplified Process Interconnection Application and Service Agreement Model Name & Inverter Manufacturer: Enphase Number: 1t1250 Quantity: ~ Nameplate Rating:.250 (kw) (kva) 240 (AC Volts) Phase: Single ~J Three LI Nameplate Rating: The AC Nameplate rating ofthe individual invertefr: SysteinDesignCapacity: )~77 ~lcw) (kva) Battery Backup: Yes [J No~j System Design Capacity: The system total ofthe inverterac ratings. Ifthere are multiple inverters installed in the system, this is the sun: ofthe AC nameplate ratings ofall inverters. Net Metering: If Renewably Fueled, will the account be Net Metered? Yes El No LI Prime Mover: Photovoltaic [~ Reciprocating Engine [] Fuel Cell [] Turbine [] Other Energy Source: Solar [~} Wind [J Rydro[] Diesel [J Natural Gas [] Fuel Oil [J Other Jnverter-based Generating Facilities: UL 1741 / IEEE Compliant (Refer To Part Puc 906 Compliance Path For Inverter Units, Part Pue 906,01 Inverter Requirements) YesE~I NoD The standard UL dated May, 2007 or later, Inverters, Converters, and Controllers for Use With Independent Power Systems, addresses the electrical interconnection design of various forms of generating equipment Many manufacturers choose to submit their equipment to a Nationally Recognized Testing Laboratory (NRTL) that verifies compliance with UL This term Listed is then marked on the equipment and supporting documentation. J~]e2xe include~, any documentation provided by the inverter manufacturer describing the inverter s CL 1741/IEEE 154Z1 listing. External Manual Disconnect Switch: An External Manual Disconnect Switch shall be installed in accordance with Part Poe 905 Technical Requirements For Interconnections For Facilities, Par Requirements For Disconnect Switches and Disconnect Switch. YesEl No~J Location of External Manual Disconnect Switch: Project Estimated Install Date: Summer 2015 Project Estimated Tn-Service Date: Summer 2015 Interconnecting Customer Signature: I hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions for Simplified Process Interconnections attached hereto: Customer Signatu~3~ ~ Title: Owner Date: 6/ Please include a one-line and/er three-line diagram ofpreposed installation. Diagram must indicate the generator connection point in relation to the customer servieepanel and the Eversource meter socket Applications without such a diagram may be returnerl Approval to Install Facility: For Eversonree Use Only Installation of the Facility is approved contingent upon the Terms and Conditions For Simplified Process Interconnections of this Agreement, and agreement to any system modifications, ifrequired. Are system modifications required? Yes[J Ne~j To be Determined LI Company SignatureI~_/~~~ Ever,source SPIA rev. 03/14 Title: ~ ~ ~ ~~r~ate: Page 2 of4

9 Eversource 1j AUG 17 ZO 15 Interconnection Standards For Inverters Sized Up To 100 kva Exhibit B - Certificate of Completion for Simplified Process Interconnections Installation Information: Customer or Company Name (print): Contact Person, if Company: Mailing Address: 186 Swain Rd []Check ifowner-installed Jack Dibb do Sallie Whitlow City: Barrington State: NH Zip Code: Telephone (Daytime): (Evening): Facsimile Number: Address: jack.dibb@unh.edu Facility information: _~ Eversource Meter # G Address of Facility (ifdiffhrent from above): City:.~. Zip Code: Electrical Contractor Contact Information: Electrical Contractor s Name (if appropriate): Mailing Address: 723 Strafford Rd Tim Congram wl TEC Electric Systems City: Strafford State: NH Zip Code: Telephone (Daytime): (Evening): Facsimile Number: Address: License number: M7985 Date ofapproval to install Facility granted by the Company: Eversource Application ID number: #N 3616 lusnection: ILl tecelectric@metrocast.net The system has been installed and inspected in compliance with the local Building/Electrical Code of~ City: Town of Barrington County: Stratford Signed (Local Electrical Wiring Inspector, or attach signed electrical inspection): Signature: Name (printed): Thomas Abbott Date: 8/13/2015 Customer Certification: I hereby certify that, to the best of my knowledge, all information contained in this Exhibit B Certification of Completion is true and correct. This system has been installed and shall be operated in compliance with applicable standards. Also, the initial start-up test required by Puc has been successfhhly completed. Please remember to provide digital photos of the installation, including the AC disconnect switch (if required), the existing Eversource meter, the inverters, and the point of electrical interconnection. Customer Signature: ~ t ~bb As a condition of interconnection you are required to send/fax a copy ofthis form to: Eversource Distributed Generation 780 North Commercial Street P.O. Box 330, Manchester, NH Fax No.: (603)

10 New Hampshire PUC REC Certification Application Owner Statements The information provided on this application for New Hampshire Renewable Energy Certificate eligibility is accurate to the best of my knowledge and I authorize Knoliwood Energy to act on my behalf in filing said application. The project described in this application will meet the metering requirements of PUC 2506 including: Electricity generation in megawatt hours shall be reported to the GIS quarterly with a statement that the submission is accurate by the owner of the source, the independent monitor, or a designated representative. A revenue quality meter is used to measure the electricity generated. The facility owner has certified to the independent monitor that the meter operates according to manufacturing standards. The meter shall be maintained according to the manufacturer s recommendations. The project is installed and operating in conformance with applicable building codes. A copy of the facility s interconnection agreement is attached. Jack Dibb Printed Name of signature owner ack Dibb (Sep 10, 2015) Signature of system owner