12/23/2015 REC Eligibility Application Result I/Alec Smith K ft~c f~ ~OO 3 REC Eligibility Application Result #Alec Smith Wed 12/23/2015 12:19 PM From: ~Barbara.Bernstein@puc~nh.gov~ To: linda@knollwoodenergy.com Please print two physical copies of this message and mail them to: Debra Howland, Executive Director Public Utilities Commission of New Hampshire 21 S. Fruit Street N~-~HL EC&5p~1:C~ Concord, NH 03301 Reference # 5756821 Status Login Username Login Email Who is submitting this request? Aggregator Batch Number Aggregator name Aggregator s Email Address Facility Owner Name Owner Prefix Facility Owner email Facility Address Complete linda modica linda@knollwoodenergy.com Aggregator KNO115 Knoliwood Energy linda@lmollwoodenergy~com Alec Smith Mr. a1ecdsmitho1776@gmail.com 148 Worcester Road Facility Town/City Facility State Hollis NH Facility Zip 03049 1/4
12/23/2015 REC Eligibility Application Result I/Alec Smith Is the facility address the same as the owne?s mailing address * Primary Contact (who should we call with questions) Yes Linda Modica Use Aggregator Email Address? Yes Utility Eversource Date of Utility 08/06/2015 Signoff * GIS ID * Panel Make Panel Model * N0N57147 SunEdison F27o Panel Rated 270 Output Panel Quantity 51 System capacity 13770.00 based on panels Inverter Make * Inverter Model Enphase Energy M215 Rated Output * 215 Inverter 51 Quantity * System capacity 10965.00 based on inverters System capacity 11.47 in kw as stated on the interconnection agreement Revenue Grade Hialeah http://mail 2/4
12/23/2015 REC Eligibility Application Result 1/Alec Smith Meter Make Was this facility installed directly by the customer (no electrician involved)? Sign-off EIectrician~s License Number Installation Company * Independent Monitor Name Monitor Company Name No 13363 M Granite State Solar Paul Button Energy Audits Unlimited Is the installer also the equipment vendor? * Equipment Vendor * Please attach your completed interconnection agreement including Exhibit B. No SunEdison Smith_COC.pdf (78k~ (hps://fs3o.forrnsite~corn/janl947/ffles/f-5-99-57568217jtxhjiussmithcoc~pdf~ Aggregator statement of accuracy Sign your name using a mouse or, if you are using a touchscreen device, a stylus or other pointer. Print Name Linda Modica Date Signed 12/23/2015 Last Update Start Time 2015-12-23 10:57:30 2015-12-23 10:44:52 3/4
12~23/2Ol5 Finish TIme 2015-12-23 10:57:30 REC Eligibility Application Result #Alec Smith IP 98.221.34.56 Browser OS Referrer Chrome Mac https://fs3o.fonnsite.com/res/formlogjnreturn (https://fs3o.formsite.com/res/formloginreturn) http: mah.knollwoodenergy.com/main
~E!D~1 JUL 012015 EVERSOURCE INTERCONNECTION STANDARDS FOR INVERTERS SIZED UP TO 100 KVA Simplified Process Jutereonnection Application and Service Agreement Eversource Application Project ld#: Contact Information: Legal Name and Address of Interconnecting Customer (or, Company name, ifappropriate) Customer or Company Name (print): AIstCSndrt Smith Contact Person, if Company: Mailing Address: 148 Worcester Rd Cily:1~~ State: ~ Zip Code: ~3om Telephone (Daytime): (617) 43~ ~ (Evening): - Facsimile Number E-Mail Address: ale dmith01776@gmait.com ~ (e.g~ System installation con08czor or cooniinating company, if appropriate): Name: Granite State Solar Mailing Address: 197 Nottit Main St State: ~ Hampshire zip Code: 03303 Telephone (Daytime): (~>~ (Evening): Facsimile Number: E-Mail Address: justs~gmnite515te5olaf.com Electrical Contractor Contact Information (ifappropriate): Name: Mailing Address: si~l9niuiic y. ayumcj. Facsimile Number: (Evening): Zip Code: E-Mail Address: Facility (Site) Address 143 WorceaterRd / City: Helm State: NH Zip Code: 0~ Electric 47 ~ ~ 44? x/~i) Service Company: Eversource Account Number: 56958745085 Meter Number: 099458463 (DL.~)>) Account and Meter Number: Please consult an actual Eversourec electric bill and enter the correct Account Number and Meter Number on this application. lithe uirciity is to be installed in anew location, please provide the Eversource Work Request number. Eversource Work Request# Non-liefanli Service Customers Only: Competitive Electric Energy Supply Company: Account Number: (Customer s with a Comperhive Energy Supply Company should verii5 the Terms & Conditions afthefr contract with their Energy Supp y Company.) Eversource SPTA rev, 03/14 Page 1 of4
EVERSOURCE INThRCONNECTION STANDARDS FOR TNVERThRS SIZED UP TO 100 KVA Simplified Process Interconnection Application and Service Agreement ~j, 1~ ~ Facility Machine Information: ~ 3eneratori Model Name & ~~~ lnveetermanufiicturer: E~Pham )/ Number: 111215 Quantity: 51 ~nepiate Rating: ~ (kval24~ (AC Volts) Phase: Single [~J Three C) / ~ l~ Nameplate Rating: The ACNamep! e rathig ofthe individual inserter. 1/~ystem Design Capacity: (ICVA) Battery Backup: Yes [1 No)~) System Design Capacity: The system total ofthe iiwerterac ratings. Ifthere are mult(rile inverters installed in the system. this is the sum oftheac nameplate ratings ofall inveriers, Net Metering: IfRenewably Fueled, will the account be Net Metered? Yes No ~rime Mover: Photovoltaic )~) Reciprocating Engine C) Fuel Cell C) Turbine[j Other VEnergy Source: Solar [~J Wind C) 1{ydro[J Diesel C) Naiural Gas C) Fuel Oil [] Other Inverter-Ijased Generating Facilities: [IL 1741 / IEEE 1547.1 Compliant (Refer To Part Poe 9116 Compliance Path Forinverter Units, Part Pee 906.01 Inverter Requirements) )tès~ NoEl VThe standard UL 174L1 dated May, 2007 or later. Inverters, Converters, and Controllers for Use With Independent Power Systems, addresses the electrical interconnection design of various forms ofgeneratingequipmenl Many manutbcturers choose to submit their equipment to a Nationally Recognized Testing Laboratory (NRTL) that verifies compliance with UI. 1741.1. This term Listed is then marked on the equipment and supporting documentation, Please include, any documentation provided by the invertermam,fadw-er deserthingiheinverter s (IL 1741/IEEE 1547.1 Idrmhi~g: External Manual Disconnect Switch: An External Manual Disconnect Switch shall be installed in accordance with Part Per 905 Technical Requirements For Ielerconneclions For Faelllties, Poe 905.01 Requirements For Disconnect Switches and 905.02 Disconnect Switch. / l es)~} NoC) V Location ofexternal Manual Disconnect Switch: NeXt to the meter Project Estimated Install Date: July Project Estimated In-Service Date: J~y Interconnecting Customer Signature: I hereby certil), that, to the best ofmy knowlcdg; all of the information provided in this application is true and I agree to the I6!~m and Conditions for Simplified Process Interconnections attached hereto: ~ ~ Title Homeowner Date i/i/ic Please snelade a one-mis and/or thre~uze diagram ofproposed sastaflaiwn. Diagram max irdica e the generator coerection point in relation to the customer remcc panel and the Eversource meter socket. ~4ppiwutions without sach a diagram may be returned Approval to Install Facility: For Eversource Use Only Installation ofthe Facility is approved contingent upon the~terins and Conditions For Simplified Process Intercoqnections ofthis Agreement, and agreement to any system modificationsy4~ required. Are system modifications required? Yes[] No[~j To be Determined C) Company Signature: Title: ~ E1 ~i~/ tvate: 7~ ~ Eversource SPIA rev. 03114 Page 2 of4
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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. Alec Smith Printed Name of signature owner A~ec Smdh ~Oct 22, 2CI~) Signature of system owner