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0276 COTUIT BAY DRIVE
J-7(o H EAT LO Ka I ®® Company Name Cape Cod Insulation Inc. Phone Number 508-775-1214 Applicator Name Z�Iav, �'ca 2 Installation Date 10-25-2018 Jobsite Address 276 Cotui Bay Ln. Cotuit Ma. A-Side Lot #'s PA86001801 Permit Number B-Side Lot #'s P11881908318 Walls 311 R-20 350 Attic 5.5" R-38 180 Floor 4.5" R-30 140 t n www.Demilec.com v � � _ _ Town_ of Barnstable = Building en �asrwe a ;Post This Card'So That it is Visible From the Street `Approved Plans Must be Retained.on.°Job and this Card Must be Kept '3 Posted Until Final InspectiortHas Been Made. FOMs''" Where a Certificate of Occupancy�is Required;such Building shall Not.be Occupied until a Final Inspection has been made. Permit. �i Permit No. B-18-3070 Applicant Name: J,OHN F GILLIS Approvals Date Issued: 09/27/2018 Current Use: Structure 0f— Permit Type: Building-Addition/Alteration-Residential Expiration Date: 03/27/2019; Foundation: Location: 276 COTUIT BAY DRIVE,COTUIT Map/Lot: 056-,030 Zoning District: RF Sheathing: d Owner on Record: MCNAMARA,THOMAS J&HAGERTY, Contractor Name: JOHN F GILLIS Framing: 10-�p Address: 276 COTUIT BAY DRIVE Contractor License: 'CS-051497 2 COTUIT, MA 02635 Est. Project Cost: $30,000.00 Chimney: Y Description: ADD TO EXISTING HOUSE ADDITION OFF MASTER BEDROOM Permit Fee: $203.00 10X14X2 WITH DECK OFF REAR APPROX. 14X4X6 WOOD FRAME Insulation: Ou-1,0 ) Fee Paid: $203.00 CONSTRUCTION. Final: O\(— Date: 9/27/2018 Project Review Req: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: _ Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: _Town of Barnstable_ _ Building Post This Card So That it is Visible From t swans-rwsM he Street-Approved Plans Must be Retained on Job and this Card Must be Kept MASS Posted Until Final Inspection Has Been Made. Permit ' i63Q. �� i . Where a Certificate of Occupancy is Required,.such Building shall Not be'Occupied until a Final Inspection has been made. f Permit NO. B-18-3070 Applicant Name: JOHN F GILLIS Approvals Date Issued: 09/27/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 03/27/2019 Foundation: Location: 276 COTUIT BAY DRIVE,COTUIT Map/Lot: 056-030 Zoning District: RF Sheathing: Owner on Record: MCNAMARA,THOMAS J&HAGERTY, Contractor Name: JOHN F GILLIS Framing: 1 Address: 276 COTUIT BAY DRIVE Contractor License: CS-051497 2 COTUIT, MA 02635 Est. Project Cost: $30,000.00 Chimney: Description: ADD TO EXISTING HOUSE ADDITION OFF MASTER BEDROOM Permit Fee: $203.00 10X14X2 WITH DECK OFF REAR APPROX. 14X4X6 WOOD FRAME Insulation: - Fee Paid: $203.00 CONSTRUCTION. Final: Date: 9/27/2018 Project Review Req: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials-are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation Health 7.Final Inspection before Occupancy Final: Where applicable,separate permits are required for Electrical,Plumbing,.and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Town of Barnstable FRECE T ' T 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-3070 Date Recieved: 9/14/2018 Job Location: 276 COTUIT BAY DRIVE,COTUIT Permit For: Building-Addition/Alteration-Residential Contractor's Name: JOHN F GILLIS State Lic. No: CS-051497 Address: , MARSTONS MILLS, MA 02648 Applicant Phone: (Home)Owner's Name: MCNAMARA,THOMAS J&HAGERTY, Phone: ELIZABETH (Home)Owner's Address: 276 COTUIT BAY DRIVE, COTUIT,MA 02635 Work Description: ADD TO EXISTING HOUSE ADDITION OFF MASTER BEDROOM 1 OX14X2 WITH DECK OFF REAR APPROX. 14X4X6 WOOD FRAME CONSTRUCTION. i 3UILDING DEPT. SEP 26 IN Total Value Of Work To Be Performed: $30,000.00 LE (OWN OF BA�NSTAB Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: JOHN F GILLIS 9/14/2018 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $30,000.00 j Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $203.00 9/14/2018 $203.00 3225 Check Total Permit Fee Paid: $203.00 THIS:IS NOT A PERMIT REScheck Software Version 4.6.2 Compliance Certificate Project Addition Energy Code: 2015 IECC Location: Cotuit, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 276 Cotuit Bay Rd. Silva Home Improvement Cotuit, MA 02635 40 Industry Rd. Unit 4 Marstons Mills,MA 02648 Compliance: Passes using UA trade-off Compliance: 0.0%Better Than Code Maximum ILIA: 31 Your ILIA: 31 The%Biter or Worse Than Code Index reflects how dose to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Perimeter Ceiling 1: Flat Ceiling or Scissor Truss 80 38.0 0.0 0.030 2 Ceiling 2:Cathedral Ceiling 80 30.0 0.0 0.034 3 Wall 1:Wood Frame, 16"o.c. 360 21.0 0.0 0.057 21 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 140 30.0 0.0 0.033 5 Compliance Statement. The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 IECC requirements in REScheck Version 4.6.2 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: Addition Report date: 08/22/18 Data filename: Untitled.rck Pagel of 8 REScheck Software Version 4.6.2 Inspection Checklist Energy Code: 2015 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the"Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception is being claimed.Where compliance is itemized in a separate table, a reference to that table is provided. section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions &Re .ID 103.1, ;Construction drawings and ❑Complies 103.2 documentation demonstrate []Does Not [PRl]1 ;energy code compliance for the 0 ;building envelope.Thermal ❑Not Observable envelope represented on ❑Not Applicable construction documents. ; 103.1, ,Construction drawings and ❑Complies ; 103.2, documentation demonstrate []Does Not 403.7 ;energy code compliance for [PR3]1 ;lighting and mechanical systems. []Not Observable 0 :Systems serving multiple ❑Not Applicable ; dwelling units must demonstrate ;compliance with the IECC Commercial Provisions. 302.1, Heating and cooling equipment is;, Heating: ; Heating: ;❑Complies ; 403.7 sized per ACCA Manual S based Btu/hr Btu/hr UDoes Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: Manual J or other methods ❑Not Observable U ; Btu/hr ; Btu/hr :❑Not Applicable approved by the code official. ; Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Ter 2) 3 Low Impact(Tier 3) Project Title: Addition Report date: 08/22/18 Data filename: Untitled.rck Page 2 of 8 Section # Foundation Inspection Complies? Comments/Assumptions & Re .ID 303.2.1 A protective covering is installed to ;❑Complies [FO11]2 protect exposed exterior insulation :❑Does Not v and extends a minimum of 6 in.below ; grade. :❑Not Observable ;❑Not Applicable 403.9 Snow-and ice-melting system controls;❑Complies [FO12]2 installed. ;❑Does Not tJ ;❑Not Observable []Not Applicable Additional Comments/Assumptions: �I b 3 ' 1 High Impact(Tier 1) 12 IMedium Impact(Tier 2) 13 1 Low Impact(Tier 3) Project Title:Addition Report date: 08/22/18 Data filename: Untitled.rck Page 3 of 8 section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Re .ID 402.4.1.1 ;Air barrier and thermal barrier ❑Complies [FR23]1 :installed per manufacturer's ❑Does Not instructions. []Not Observable []Not Applicable 402.4.3 ;Fenestration that is not site built ❑Complies [FR20]1 :is listed and labeled as meeting ❑Does Not ;AAMA/WDMA/CSA 101/i.S.2/A440 :or has infiltration rates per NFRC []Not Observable :400 that do not exceed code []Not Applicable limits. 402.4.5 IC-rated recessed lighting fixtures ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not and labeled to indicate s2.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable 403.2.1 :Supply and return duds in attics ❑Complies [FR12]1 insulated>=R-8 where duct is []Does Not >=3 inches in diameter and>= ce R-6 where<3 inches.Supply and []Not Observable return duds in other portions of ❑Not Applicable ;the building insulated>=R-6 for :diameter>=3 inches and R-4.2 :for<3 inches in diameter. : 403.3.3.5 Building cavities are not used as ❑Complies [FR15]3 duds or plenums. ❑Does Not AJ ❑Not Observable ❑Not Applicable 403.4 HVAC piping conveying fluids : R- R- ;❑Complies ; [FR17]2 above 105°F or chilled fluids ;❑Does Not U below 55 sF are insulated to>_R- 3 :❑Not Observable : :,[]Not Applicable 403.4.1 ;.Protection of insulation on HVAC 111complies : [FR24]1 ;piping. ❑Does Not ❑Not Observable : ❑Not Applicable 403.5.3 Hot water pipes are insulated to R- R- :❑Complies [FR18]2 >R-3. TIDoes Not .BJ �❑Not Observable .;,[]Not Applicable 403.6 Automatic or gravity dampers are ❑Complies ; [FR19]2 installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable 11INot Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition Report date: 08/22/18 Data filename: Untitled.rck Page 4 of 8 Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Re .ID 303.1 WI installed insulation is labeled []Complies (IN13]z Eor the installed R-values []Does Not J provided. ❑Not Observable ❑Not Applicable ; 402.1.1, ;,Floor insulation R-value. ; R- R- ;❑Complies ;See the Envelope assemblies 402.2.6 ;❑ Wood ;❑ Wood ;❑Does Not table for values. [IN1]1 ❑ Steel ❑ Steel ;❑Not Observable ❑Not Applicable 303.2, ;Floor insulation installed per ❑Complies ; 402.2.7 :manufacturer's instructions and ❑Does Not [IN2]1 :in substantial contact with the Q ;underside of the subfloor,or floor []Not Observable ; framing cavity insulation is in ❑Not Applicable ; ;contact with the top side of sheathing,or continuous insulation is installed on the underside of floor framing and extends from the bottom to the ' ;top of all perimeter floor framing 1 members. 402.1.1, ;,Wall insulation R-value.If this is a; R- R- ;❑Complies ;See the Envelope Assemblies 402.2.5, mass wall with at least Y2 of the ;❑ Wood ❑ Wood ;❑Does Not ;table for values. 402.2.6 ;wall insulation on the wall [IN3]1 exterior,the exterior insulation mass ❑ Mass ;❑Not Observable requirement applies(FR10). ;❑ Steel ❑ Steel ;❑Not Applicable ; , 303.2 ;Wall insulation is installed per []Complies [IN4]1 :manufacturer's instructions. ❑Does Not ❑Not Observable ; ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Addition Report date: 08/22/18 Data filename: Untitled.rck Page 5 of 8 section Plans Verified . Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Re .ID 402.1.1, ;Ceiling insulation R-value. R- R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ;❑ Wood ;❑ Wood ;❑Does Not ;table for values. 402.2.2,402.2.6 ❑ Steel ❑ Steel ;❑Not Observable [Fl1]1 ; ;❑Not Applicable ; ; 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 :manufacturers instructions. ❑Does Not [FI2]1 ;Blown insulation marked every 300 ft2. ❑Not Observable IE]Not Applicable 402.2.3 Vented attics with air permeable [ Complies ; [FI22]2 insulation include baffle adjacent []Does Not to soffit and eave vents that extends over insulation. ❑Not Observable ; ❑Not Applicable 402.2.4 ;Attic access hatch and door R- R- ;❑Complies [F[3]1 insulation>_R-value of the ;❑Does Not adjacent assembly. ;❑Not Observable ' ❑Not Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ACH 50= ; ACH 50= ;❑Complies [FI17]1 :ach in Climate Zones 1-2,and ;❑Does Not <=3 ach in Climate Zones 3-8. ❑Not Observable ❑Not Applicable 403.2.3 ;.Duct tightness test result of<=4 ; cfm/100 cfm/100 ;❑Complies [F14]1 cfm/100 ft2 across the system or ft2 ft2 ;❑Does Not <=3 cfm/100 ft2 without air handier @ 25 Pa.For rough-in UNot Observable tests,verification may need to ; ;❑Not Applicable ; ;occur during Framing Inspection. ; 403.3.2 :Ducts are pressure tested to cfm/100 cfm/100 ;❑Complies ; [F127]1 :determine air leakage with ft2 ft2 ❑Does Not ;either:Rough-in test:Total leakage measured with a :❑Not Observable pressure differential of 0.1 inch ;❑Not Applicable w.g.across the system including ;the manufacturer's air handler ; enclosure if installed at time of ;test.Postconstruction test:Total leakage measured with a ; pressure differential of 0.1 inch ;w.g.across the entire system including the manufacturers air ; ;handler enclosure. 403.3.2.1 ;Air handler leakage designated ❑Complies [FI24]1 ;by manufacturer at<=2%of ❑Does Not ;design airflow. ❑Not Observable ❑Not Applicable 403.1.1 Programmable thermostats ❑Complies [FI9]2 installed for control of primary ❑Does Not heating and cooling systems and initially set by manufacturer to []Not Observable code specifications. ; ❑Not Applicable ; 403.1.2 Heat pump thermostat installed ❑Complies ; [FI10]2 on heat pumps. ❑Does Not ❑Not Observable ; ❑Not Applicable 403.5.1 Circulating service hot water ❑Complies ; [Fl11]2 systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ; ❑Not Applicable 1 I High Impact(Tier 1) 2 Medium Impact(Ter 2) 3 1 Low Impact(Tier 3) Project Title: Addition Report date: 08/22/18 Data filename: Untitled.rck Page 6 of 8 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions &Re .ID 403.6.1 All mechanical ventilation system ❑Complies (FI25]2 fans not part of tested and listed []Does Not HVAC equipment meet efficacy and air flow limits. ❑Not Observable ❑Not Applicable 403.2 Hot water boilers supplying heat ❑Complies ; [F12612 through one-or two-pipe heating []Does Not systems have outdoor setback control to lower boiler water ❑Not Observable temperature based on outdoor ❑Not Applicable temperature. 403.5.1.1 Heated water circulation systems ❑Complies ; [F128]2 have a circulation pump.The ❑Does Not system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable pipe.Gravity and thermos- ❑Not Applicable ; syphon circulation systems are not present.Controls for ' circulating hot water system pumps start the pump with signal for hot water demand within the occupancy.Controls automatically turn off the pump when water is in circulation loop is at set-point temperature and no demand for hot water exists. 403.5.1.2 Electric heat trace systems ❑Complies [F129)2 comply with IEEE 515.1 or UL ❑Does Not 515.Controls automatically adjust the energy input to the ❑Not Observable heat tracing to maintain the S ❑Not Applicable desired water temperature in the piping. 403.5.2 Water distribution systems that ❑Complies ; [F130]2 have recirculation pumps that ❑Does Not pump water from a heated water supply pipe back to the heated []Not Observable ; water source through a cold ❑Not Applicable water supply pipe have a demand recirculation water ; system.Pumps have controls that manage operation of the pump and limit the temperature ; of the water entering the cold water piping to 1049F. 403.5.4 Drain water heat recovery units ❑Complies ; [FI31)2 tested in accordance with CSA ❑Does Not B55.1.Potable water-side pressure loss of drain water heat ❑Not Observable recovery units<3 psi for ❑Not Applicable individual units connected to one or two showers.Potable water- ; side pressure loss of drain water heat recovery units<2 psi for individual units connected to three or more showers. 404.1 ;75%of lamps in permanent ❑Complies ; [F16]1 :fixtures or 75%of permanent ❑Does Not ;fixtures have high efficacy lamps. ;Does not apply to low-voltage ❑Not Observable lighting. ❑Not Applicable ; 404.1.1 Fuel gas lighting systems have ❑Complies [FI23]3 no continuous pilot light. ❑Does Not IONot Observable ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Addition r Report date: 08/22/18 Data filename: Untitled.rck Page 7 of 8 Section& Req.ID Plans Verifled Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions P 401.3 Compliance certificate posted. ❑Complies [FI7]2 ❑Does Not ❑Not Observable ; []Not Applicable 303.3 Manufacturer manuals for ❑Complies [FI18)3 mechanical and water heating ❑Does Not systems have been provided. ; []Not Observable ; ❑Not Applicable Additional Comments/Assumptions: i a 1 High Impact(Tier 1) 2 Medium Impact(Ter 2) 3 Low Impact(Tier 3) Project Title: Addition Report date: 08/22/18 Data filename: Untitled.rck Page 8 of 8 1 t 2015 IECC Energy Efficiency Certificate Insulation . Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling/ Roof 38.00 Ductwork (unconditioned spaces): Glass&Door Rating U-Factor SHGC Window Door Heating &Cooling Equipment Efficiency Heating System: Cooling System: Water Heater: Name: Date: Comments fl. C O R 96 O L I 2 - ,¢o _-9 oo !, s r Iat � n III, i�' nl n ,\ II 50 91�. �a CO T u/ T BAY R !, +. ,1: f , `' '/ Thereby. certify that the PLOT Q L•AN �3� ;r . ,q (Foundation is located as shown or i, pond conforms to the Zoning Qy!.' Lams. of"the Town of "�s�•, COTUIr BAY J I I V RES i ao� '' COTUIT, SAR/VS.TASLE ,. INA. .SS. ' scale = 40 GRETE M. BOHA NNON West Bridgewater o 9 Moss., O 37,, ACORD clienw. DATE TM CERTIFICATE OF LIABILITY INSURANCE 9I13I2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sh AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. �� IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the poliayr(tes)must be endorsed.If SUBROGATION IS WANED,subject to the ITns and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such end s. PRODUCER CONTACT Raphael Oliveira �??A At� PHONE (508)7714600 FAX (508)7714601 DISCOVERY INSURANCE AGENCY LLC 'No, (AIC'No.E)d)' 668 MAIN ST UNIT A EMAIL repneemiscoven'Bgmai).eom DRESS: HYANNIS,MA 02601 INSURER(S)AFFORDING COVERAGE NAIL p` j e INSURED INSURER A:THE BURLINGTON INSURANCE COMPANY J [C INSURER B: LIONS FRAMING S CONSTRUCTION INC INSURER C: 107 OLD TOWN HOUSE INSURER D:ACE AMERICAN INSURANCE CO SOUTH YARMOUTH,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO TALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. INSRL TYPE OF INSURANCE FOR SOR POLICY NUMBER POLICY LIMITS TR A GENERAL LLUaftm EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED COMMERCIAl.GENERAL LIABILITY PREMISES(Fa ac—e) $ 100,000.00 MED EXP VM me pmmn) CWMS#KDE I X I OCCUR $ 5,000.00 i 735BOO1402 05/22/2018 .05/22/2019 RSOHAL 6 AOV INJURY S 1,000,000.00 GENERAL AGGREGATE S 2,000,000.00 hGENL AGGREGATE LRBr APPLIES PER: PRODUCTS-COMPAOPAGG S 1,000,000.00 X POLICY PRO ECT LOC B AUTOMOBaE LIABarTY COMBNED SINGLE LIMIT (Ee—d-0 ANY AUTO BODILY INJURY(Per P—) ALL OWNED ALTOS SCHEDAUTOSULED GODLY Rl1I1RY(Perm�Nd) NONOWNED PROPERTY DAMAGE �/ HIRED AUTOS (Peeremdar� C UMBRELLA OCCUR EACH OCCURRENCE EXCESS IIAB CIAMIS-MADE AGGREGATE DED RETENTION I D WORKERS COMPENSATION IM STATUTORY OTH AND EMPLOYERS'LNBMY YIN . ER ANY PROPRETOR/PARTNERIE%ECUTNE ENIA OFFICER/IEMSER EXCLUDED? EL EACH ACCIDENT N/A 6S62UB8H12785418 1!6/2018 1!6/2019 1$ 1,000,000.00 (Memabry b NIO EL DISEASE-EA EMPLOYEE S 1,000,000.00 Nym,desnBe under EL DISEASE-POLICY UM DESCRIPTION OF OPERATIONS Wltm S 3,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,R more space is required) Workers'Compensation benefits Will be paid to Massachusetts employees only Pursuant to Erdwsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This oer ihcate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this cetificate of insurance).The status of this coverage can be monitored dady by accessing the Prof of Coverage-Coverage Verification Search tool at www mass.govAwdAwrkers-compensakMnvesbgationst.. General Liabifily:for regular and usual jobs. Job Address 276 C"Bay Road Cotuit,MA 02635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Silva Property Improvement Inc. EXPIRATION DATE IT IS THE CUSTOMER'S RESPONSABLITY TO PIFORME ANY 40Industry RD Suite 4 CHANGES OR CANCELATIONS. Marston Mills,MA 02648 silvaimprovemerlt@hotmaii.com RAPHAEL OLIVEIRA 1 1 (01998-2010 ACORO CORPORATION.All rights reserved. I JGILUS-01 CGOT 1 DATE(MWDDJYYM CERTIFICATE OF LIABILITY INSURANCE 09hSao18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(fes)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsemenL A statement on this certificate does not confer rights to the certificate holder in lieu of such endorseme s. cT PRODUCER Ma Mason A Mason Insurance Agency,Inc. PHONE :(781 447-0531 Fax No:(781)447 7230 458 South Ave. E Whitman,MA 02382 INSUiR AFFORDaIG COVERAGE NAIc: INSURER A:Western World 13196 41SUR® INSURER e:SOPIV Pro 12808 J.Gillis,Inc. nvsURER c:Star Insurance CamMy 18023 PO Box 650 INSURER D: Marstons Mills,MA 02648 WSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOWATHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DL BR POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCEommmam 11000,000 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CW MS MADE OCCUR PP1490523 07/282018 07/282019 DAMAGE TO RENTED $ 50,000 NED EXP(Any one n $ 5,000 PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE UMIT APPLIES PER 2,000,000 POUCY❑ F]LOC PRODUCTS-COMP/OP AGG $ j�T $ OTHER COMBINED SINGLE UMIT $ 1,000,000 B AUTOMOBILE LIAwLrry AUTO 5904775 0820P2018 OW=019 BODILY INJURY Per erson S OWNED X �mULED BODILY INJURY Peer AUTOOSONLY y�� t_ pROP�E$dTYe DAMAGE X HAUTOS ONLY X AO OS O� $ UMBRELLA LIARHCLAIMSAIADE OCCUR EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ $ DED RETEMION$ PER OTFL C MEKERS ODMPERSATION X MSTATUTE-I— ERR PLOYERS u Lny Y/N C0584433 01P31/2018 01/3112019 EL EACH ACCIDENT $ 1,000,000 Agy ppRop r EXCLUDED?� ETNE [NJ N/A 1,000,000 (Mar M-MyE inMOR N ) EL DISEASE-EA EMPLOY $ If yes,rescrbe under EL DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS bebw DESCRIPTION OF OPERATIONS/LACAMONS/VEHICLES(ACORD 101,'AdMonal Remarks sctedLde,may be aftwhed d more Space Is rKWfeCQ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable Building Dept. ACCORDANCE W(TH THE POLICY PROVISIONS. 200 Main St. Hyannis,MA 02601 AUTHORQED REPRESENTATIVE ACORD 25(20161IX�) 22:��015A�WRD�CORPO�RATION. M fights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Let?ibly /� Name(Business/Organization/Individual): Jo�&I (-�0 11 I"s Address: i K �ho;re- ,��car,)A, 01 .A . City/State/Zip: Vv�p s ima- o:t.64 g Phone#: Lf8' Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ERI am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P ty� x 9. 2 Building addition [No workers' comp.insurance comp•insurance• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.[1 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: .3'&e //v 5- L`d Policy#or Self-ins.Lic.#: l t�nL' a SW If Y a 3 Expiration Date: /-3 /-I 9 Job Site Address: oZ 7 ra Co w, U�7mv a7/^rst City/State/Zip: C ejj rh&.s-4 o a(. 3,2 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby ce un the airs and p nalties of perjury that the information provided above is true and correct Signature: Date: f° C Phone#: /S68" VJ-9—*1 Official a only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,`and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.m=.gov/dia i ,z� _ -- V/ie rpavrirlr.rz�eraeri�C�n�C�/<�`l[J1CLC�u:relf , Office W Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR AN •:TYPE:Individual Reoist�ration Expiration t-3T*46" 01/01/2019 JOHN R GILLI K.M. O t t Jack Gillis 18 Shorevrood Dr. f Mashpee,MA 02649 Undersecretary 42 Massachusetts Department-of Public Safety Board of Building Regulations and Standards License: CS-051497 Construction Supervisor 1 4 JOHN F GILLIS s �+- _ •� ! Jade Gillis ' i 18 Shore<wod Dr. ` Mashpee,MA 02649 j Expiration: Il Commissioner 1111312018 J t i SILVA-2 P 0: ACORO" CERTIFICATE OF LIABILITY INSURANCE °�'�`093120N3120 8 `•� 18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the terns and condition of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endomeme s. PRODUCER 508-428-8999 M CT Kathleen Geddis SG&D Agencies PHONE 508-428-8999 FAX Hyannis Office -M No,Ext: (,VC No): 540 Main Street,Suite 9 ADOI M: Hyannis,MA 02601 INSU S AFFORDING COVERAGE NAIC# INSURER A:Western World Insurance Co INSURED Silva Property Improvement Inc INSURER B:Travelers Insurance Company 40 Industry Rd.Unit 64 Marston Mills,MA 02648 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIM&WDE �OCCUR NPP1476804 11/20/2017 11/20/2018 DAMAGE TO RENTED E 100,000 MED EXP oneperson) 5,000 PERSONAL&ADV INJURY E 100,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 200,000 POLICY PRO-JECT ❑LOC PRODUCTS-COMP/OP AGG $ 1,000'000 OTHER: AUTOMOBILE LIABILITY CO aBINED SINGLE LIMIT $ ANYAUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE DED I I RETENTION$ B WORKERS COMPENSATION PER I I 0T1, AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE CERT WILL FOLLOW FROM CO 0811512018 08/15/2019 E.L.EACH ACCIDENT E 1,000,000 OFFICER/MEMBEREXCLUDED? NIA (THIN 5 DAYS 1,000,000 (Mandatory In NH) EL DISEASE-EA EMPLOYEE I S describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached U more space Is required) CERTIFICATE OD CANCELLATION SILVAPR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SILVA PROPERTY IMPROVEMENT INC ACCORDANCE WITH THE POLICY PROVISIONS. 40 Insustry Rd.,Unit 4 Marston Mills,MA 02648 AUTHORIZEDDREPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Ae ,4co fl� CERTIFICATEC\Or F LIABILITY INSURANCE �"�`�°'�DD"/1"'�' L.� osti4,1a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S).AUTHOR® REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER- IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provLslorls or be endorsed. If SUBROGATION IS WAIVED,subject to the tens and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER N"E. JIM HINDMAN Schlegel 8:Schlegel Ins Broker PHONE 508-771-8381 No 508-771-0663 34 Main Street E-MJUL West Yarmouth,MA 02673 ADDRESS. SCHLEGELINSURANC MAIL.COM INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA: NGM INSURANCE COMPANY 14788 INSURED INSURER B: PROGRESSIVE ROBERTS LANDSCAPE DESIGN& INSURERc: AIM MUTUAL CONSTRUCTION INC INSURER D PO BOX 2151 HYANNIS,MA 02601 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMnS SD POLICY NUMBER {AMID X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 7,000,000 CLAIMS-MADE �OCCUR PREMISES QE4 ooaurenoe $ 500,000 MED EXP one S 10,000 A MPT0526J 05/06H8 06106/19 PERSONAL&ADV INJURY S 1,000,000 GENLAGGREGATE UMITAPPLIES PER: GENERALAGGREGATE S 2,000,000 POLICY 0 JECT F1 LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accede t X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED 02193390 12JO1117 12/01/18 BODILY INJURY(Per-ddent) t AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGES AUTOS ONLY AUTOS ONLY S UMBRELLA IJAR OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMSldADE AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSAM014 AND EMPLOYERS'LIABILITY SIN AT LITE OR ANY PROPRIETORIPARTNER/EXECUTNEY- ELEAp1ACCIDENT $ 100,000 C OFFICEWMEMSEREXCLUDED? �N NIA AWC-4W70324890-2015 05113118 05/73/19 (Mandatory in NMI ELD ASE-EAEMPLOYEE $ 100,000 Ifg Oescnbeunder DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Rernarks Schedule,may be attaMed If more space is required) CORPORATE OFFICERS HAVE ELECTED TO BE COVERED UNDER THEIR CURRENT WORKER COMOENSATION POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Silva Property Improvement Inc. THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 40 Industry Rd Ste 4 ACCORDANCE WITH TnLICY PROVISIONS. Marstons Mills,MA 02648 silvaimprovement@hotmail.com AUTHORIZED REPRE7 ©19 rICRD 5 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered mareks of . SotMAE& + N�L1� P=it Fee....*-61-iM.. ......Otb a Fee.".. � �®, Total Fee Paid.................. .......... .. J0.0............. "TOWN OF BARNSTABLE`K,,s Pe=&Approvalby....... . ............ol..... °I BUIELDINGF PERMIT 0 S4 0 3 0 Map........Q. . ....................Pa=L.................0..3.0.-3A.................. APPLICATION Section I —Owner's Information and Project Location Project Address 7(o o ,�,�� 24,e Q 1Q v Village �a lei; Owners Name Owners Legal Address City r, ' f State Zip d Owners Cell# 52e �L E-mail 4 1 1�1"/stM 4=e 0 &M g sAlel" Section 2—Use of Stractare Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structm) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ® Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 -Work Description o� T Act Tmdatit&-2l9=19 ' n , Application Number.................................................... Section 5—Detail ,. Cost of Proposed Construction f-1d, ono s,, Square Footage of Project Age of Structure 1` spa yes. Dig Safe Number_ 8'3 7a 33 # Of Bedrooms Existing 3 Total#Of Bedrooms(proposed) i 110 MPH Wmd Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist 0 Design ' Section 6—Project Specifics B W'ring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas .❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ©'Private Sewage Disposal ❑ Municipal '0'On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: ��„„�,s �e�lt4,(�,,, b,,1 I am using a crane ❑ Yes 0 No Section 7—Flood/Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information ? Zoning District Proposed Use Lot Area Sq.Ft. 0.3'46 Total Frontage _Percentage of Lot Coverage #of Dwelling Units (on site) / Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes © No i.atimd&cd 2/92019 Application Number........................................... Section 9—.Construction Supervisor Y Name 0�, ,� Telephone Number Y O 8' Z� Address 1$ City State M c. Zip o 2 y License Number s$ -o S/ 9 7 License Type ux vie s.-..,_Aj Expiration Date Contractors Email .�� �' ; ),'s fir,e_ C� (`oa�e c�As�.A P_+- Cell# 76P- z.s-a I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Bolding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date -0,4 Section-10—Home Improvement Contractor Name— Telephone Number • _D * L.9-0 d1 kS__1 Address P,�= CRY lea S Q a, State_A G Tip a 6 �f Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Bolding Code. I understand the construction inspection procedures,specific inspections and docimmentation required by 80 CMR and the Town of Barnstable.Attach a copy of your H.LC... Signature — Date Section 11 —Home Owners License Exemption Home Owners Name: , Telephone Number eP Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Bolding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Print Name ,� Cam" t��S Telephone Number 2,dPV y'S-A/ E-mail permit to: e�- r Section 12—Department Sign-Offs Health Department ® Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation _ ❑ For commercial work,please take your plans directly to the f re deparbnent for approval Section 13—Owner's Authorization X I, 4U as Owner of the-subject property hereby authorize o t to act on my behalf in all matters relative to work•authorized by this building permit application for: ' cV-7 G1DZ/T (Address of j ob) /3 -Zoi $' Si a of er , 1 1 Print Name i Last wdatc&Laois Town of Barnstable - Building �'k°�nfart;. •z .s. , .r` ,�'4.�.`.: �,ar� m3�''`.. ..... .. ..u�s � �n Post This Card: OojFgt rt-�s Vi"sible m�the Street Approved Plans Must be Retained on Job�and this Catd Musttbe Kept •. �ARtiB'['ABIE, Ya�.k� t.:... , �», •?Yr'^� z .z;ar., hTAS6 Posted UntilrFinal::lns ' .. en Made. " '�' < �a ' ; 1 + �� .; . 63p.. e Y r y pect{ion Has Be T i s � ac,.rFk s tom* m R Where Ca ertificate of 0"" nc"is Re uir�ed u�h'Buildin sha 1?'Not be Oc u�ied unt�ha Final Ins ection�ha een made: Permit r ccupa y K x a � c„: cpsc ._,.. ... . .;Ps Permit No: 9-17-4384' ;Applicant Name: MCNAMARA,THOMAS J&HAGERTY, ELIZABETH Approvals Date Issued: 01/05/2018 Current Use: Structure Permit Type: Building-'Alteration-INTERIOR Work Only- .Expiration Date: 07/05/2018 'Foundation: Residential . Map/Lot: 056 030 Zoning District: ..RF Sheathing: Location: 276 COTUIT BAY,DRIVE COTUITy �Contnkib GNah ; framing:. 1 Owner on Record: MCNAMARA,THOMASJ StHAGERTY, � Confractpor Licensed £n ? sdr• b� � 2 Address: -276.COTUIT BAY DRIVE $ � ` Est Protect Cost: $ 16,000.00 d Chimney: COTUIT, MA 02635 � �PerMi Fee: . $ 131.60 h { , Insulation: Description: enlarge 8x7 to 8x10 existing bath �$ �ar. Fee Paid $131:60 Remodel Bathroom_no additions rvr x Date 1/5/2018 Final: Project Review Re Plumbing/Gas Rough Plumbing: Building Official r <° g •w �Y =r Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized4by this permit is commenced within six months after.issuance. Rough Gas: All work authorized by this permit shall conform to the approved apphcatio anted t e approved construction documents.for which th s permit has been granted. g All construction,alterations and changes of use of any building and stractures shalMe in compliance with the local zonrngT;by laws and 1. codes: Final Gas: This permit shall be displayed in a location clearly visible from access street orkr 11 oa6and shall be maintained open_for public inspect�o.nfo�tfie.entire duration of the- work'until the-completion of tfie 'Wis same. Electrical . The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are�provided on this permit. Service: Minimum.of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing � Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage final Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health ' Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final:. . All Permit Cards are the property of.the APPLICANT-.ISSUED RECIPIENT The Commonwealth of Massachusetts Department of Industrial Accidents = = Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le>?ibly Name (Business/Organization/Individual): L t�2 S C4 ZL . LS _C Address: / 'S Phone#:City/State/Zip: �(�� Z, Z Z Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. .❑ I am a general contractor and I em -(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. am a sole proprietor or partner- listed on the attached sheet. 7. ❑ modeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'� t 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: c City/State/Zip: 0Yv. -b Oa��.� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c tify under the pair and penalties ofperjury that the information provided above is true and correct. Si a e: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number:The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Roston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-NIASSAFE Fax##61.7-727-7749 Revised 4-24-07 www.mass.gov/dia 1 ACORO� DATEPnVM YY1rM CERTIFICATE OF LIABILITY INSURANCE , W,, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER POR a certificate holder is an ADDITIONAL INSURED.the po kypes)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the teens and conditions of the policy.certain policies may require an endorsement. A statement on this certificate does not corder rights to the certificate holder In lieu of such andomement(s). PRODUCER WNIAUT NAME: Pam Porter Pike Insurance Agency,Inc. E 508.255-7880 NOV. 508-240.2908 6 Mate Street PO Box 2743 ADDRESS: pam@pikelnsurance.Com Orleans.MA 02653-2418 INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A: Mapm/Commerce INSURED INSURER B: Shaun Law DBA INSURER C 19S James Circle INSURER D: Mashpee,MA 02649 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER IMM; MMID LIMITS X coMMERcI&cENERALuAeRJTY EACH OCCURRENCE $ i.000.000 DAMAGE TO KLI41 CLAIMS�MADE OCCUR MISES Eeaoaarerce S S01000 MED EXP ore $ S.000 A 8008030012068 `l2112117 12112118 PERsoNAL&AoviwuRy s GEWL AGGREGATE L{MITAPPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICYaCT1:3 LOC PRODUCTS S 2000.000 OTHER S AUTOMOBILE LIABILITY CEOMHc1�S GLELINpT : ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per acddant) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROP GE _ AUTOS ONLY AUTOS ONLY I H - -$ UMBRELLA UA13 OCCUR EACH OCCURRENCE S EXCESS LJAB HCL6M&MADE AGGREGATES DEO RETENTIONS $ WORKERS COMPENSATION I PUTARnm AND EMPLOYERS LIABILITY Y I N ANY PROPRIEfORIPARTNEAIEXECUiIVE❑ NIA EL EACH ACCIDENT S OFFICEWMEMBER EXCLUDED? (Myya�erdalay In NH) E_L DISEASE-EA EMPLOYEE S orsdRI OF OPERAIONSbd- E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.AdOlonal Remarks Sdnddle.may be slruMd U more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Tom McNamara 276 Cotult Bay Drive Cotuit,MA 02635. AUTHOF4=REPRESENTATIVE Pam Porter U�011-9V88r20`1SACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents MW Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Or dhid Address: 2 / City/State/Zip: DZ Phone#: _ i Are you an employer?Check the appropriate born 'Type of project(required): 1.[1I am a employer with 4 firm a general contractor and I employees(full and/or part-time).* /have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. modeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers'comp.insurance comp.insurance x required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.©I I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions %myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs inc,rrance required]t c. 152, §1(4),and we have no 13.❑Other employees. [No workers' comp.insurance required.] *My applicant that checks box#]must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. .:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state vrhether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �� Policy#or Self-ins.Lie.#: t3U �bet �� �^ Expiration Date:__ Job Site Address:-2. City/State/Zip�____L,,• Z�� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify er the pawns and penalties of perjury that the information provided above is true and correct: Signafore: �— Date: 2 Phone#: G Official use only. Do not write in this area,to be comTleted by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an mTfoyee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or . renewal of a license or permit to operate a business or to eonstract buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant, t Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town);'A copy of the affidavit that has been officially stamped or marked.by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to buts leaves etc.)said person is NOT required to complete this affidavit. like to thank you in advance for your cooperation and should you have any questions, The Office of Investigations would please do not hesitate to give us a call. The Department's address,telephone and fax number- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Dostaa,MA 02111 Tel.#617-727-4400 ext 406 or 1-977-MASSAFE Fax#617-727-7749 Revised 4-24-07 ww,mass,.gpv/dia V7 try Application Nimmb&....).6..... ......... ` sssN6s'ea • Pe®itFex......,1. f.»..�P.Q......OtherFee........................ 3uA8s. �G Tota1 Fee Paid..................................................................... TOWN OF BARNS° ABUTO -(P P=itApprovalbyla...P).............on..1...... ....1. BUILDING PERMITr:.J APPLICATION ��'° mv...6`. .:................. 1. Section 1 — Owners Information and Project Location Project Address Village L �j Owners Name ' /l ,o �,/Ld S �i C6(�� pt AH►^,ca Owners Legal Address_ City 1� )) - ,a l State = zip 2 Owners Cell# _E-mail Section 2—Structural Use �c JQ-Tiigie/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3—Type of Permit ❑ New Construction ❑ . Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(else structa e) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar 0-Renovation ❑ Pool ❑ Insulation Other—Specify. Section 4—Detail 17 ACost.-of Proposed Construction Da Square Footage of Project ( Age off Structure '� Dig Safe Number Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updated:I ln2017 Section 5 -Work Description / x o Section 6—Project Specifics g ❑ Oil Tank Storage . ❑ Smoke Detectors. ❑"=b ❑ Gas ❑ Fire Suppression ❑.Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal P- n Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: ��rvP,c n S � I am using a crane C Yes 0"No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ i Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed ` Side Yard Required Proposed i Has this o had relief from the Zonis Board in the past? ❑ Yes property g P No Last updated:11C12017 Section 9—Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell# I understand my responsibiities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the.construction inspection procedures,specific inspections and docummentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Side Date Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulafions for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Bolding Code. I understand the construction inspection procedures,specific inspections and w documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11—Home Owners License Exemption Home Owners Name-'�f "led z Telephone Number Cell or Work Number ��, I understand my responsib . ' under the rales and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachuusetts� Building Code. I understand the construction inspection procedures,specific inspections and documentation 780 CUR and the Town of Barnstable. Signature Date/APY 2 '� LICANT SIGNATURE At Signature ZYLDate Al, Print Name �z -(elkTelephone Number b E-mail permit to: . C_ ) s T Last updated:iinrz0i7 Section 12-Department Sign-Offs Health Department © Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire depwftent for approPaL - j Section 13— Owner's Authorization h , as Owner of the subject property hereby authorize to.act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name r _J r' Last updated:-1 L//b017 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0b Parcel_ 036 Application # d Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 10,00 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address� -7G 6a7vrr Tay T)Z Village Agt OwnerTr-►cmAs k&A—)AHA-&& Address g76 i2a=rr MAY 12rL Telephone SoC�►-06� ' Permit Request T0srA.uADG ao 'P[i Soc.A7z.. -peNEjS oi7) 7120tF, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Pq 76 Historic House: ❑Yes ®'No On Old King's Highway: ❑Yes d'No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/,coal stove: ❑=Yes ❑ No Detached garage: ❑ existing ❑ new size— ❑ existing ❑ new size _ Barn:`-q existing 0 new size_ 9 9 g 9 �� 9 .. Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other _ rn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ J ��// .-� Commercial ❑Yes VNo If yes, site plan review# a ; "_, Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 171 Name�asehK 11mrGe!) Telephone Number 4 Address /Q/ &AD 3 �Ztyr> License # o 157 VkAJ uAZ:) /114 Mo3Z Home Improvement Contractor# 170a"79 Email Worker's Compensation # C nK X177a-7-74Cr—O ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE I If h< FOR OFFICIAL USE ONLY APPLICATION# '1 r DATE ISSUED MAP/PARCEL N0. ' r ADDRESS VILLAGER i OWNER DATE OF INSPECTION: 1 - s. FOUNDATION FRAME 4 INSULATION - FIREPLACE ELECTRICAL: ROUGH - ; FINAL J l _ ' PLUMBING: ROUGH FINAL GAS: ROUGH ' FINAL FINAL BUILDING DATE CLOSED OUT F ASSOCIATION PLAN NO. • - The Commonwealth of Massachusetts Department of Industrial Accidents a I Congress Street, Suite 100 Boston,MA 02114-2017 5, www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Information Please Print Legible Name (Business/Organizatiort/Individual):Roof Diagnostics Solar/NRG Home Solar Address: 101 Constitution Blvd. City/State/Zip: Franklin MA 02038 Phone#:508-315-6663 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓❑I arr a employer with 70 employees(full and/or part-time).* 7. ❑New construction 2.[]1 am a sole proprietor or partnership and have no employees working for me in 8. EJ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.F1 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q Building addition 4.[:]1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 1 L❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.rl I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurances 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[Z Other PV Solar 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Federal Insurance Co. Policy#or Self-ins.Lic. #:0044727794-01 Expiration Date:4/1/2016 Job Site Address:276 Cotuit Bay Dr City/State/Zip: Barnstable Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Pfione'#:508-545-0989 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MM/DD/YYYY) AC11O D® CERTIFICATE OF LIABILITY INSURANCE 07/0112 0 1 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTANAME:C Destiny Soria MCGRIFF,SEIBELS&WILLIAMS,INC. AX P.O.Box 10265 AHC No Eat:800-476-2211 AIC No): Birmingham,AL 35202 EMAIL dsoria m ri(f.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Kinsale Insurance Company 38920 INSURED INSURER B:Liberty Mutual Fire Insurance Company 23035 Roof Diagnostic Solar Holdings LLC;Roof Diagnostics Solar and Electric LLC;Roof Diagnostics Solar and Electric of NY,LLC:Roof Diagnostics Solar and Electric of INSURER C:Federal Insurance Company 20281 Connecticut,LLC; Roof Diagnostics Solar of Mass,LLC;Restoration Design LLC;RDI Consulting,LLC INSURER D:Travelers Property Casually Company of America 25674 2333 Highway 34 INSURER E:Navigators Specialty Insurance Company 36056 Manasquan,NJ 08736-1423 INSURER F COVERAGES CERTIFICATE NUMBER:RKP9RUNX REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD A X COMMERCIAL GENERAL LIABILITY MSW45968 07/01/2015 04/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO�OCCUR RENTED CLAIMS-MADE PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$ 2,000,000 POLICY JEST LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B I AUTOMOBILE LIABILITY SISIPCA08335015 07/01/2015 04/01/2016 EaMacci IN SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED I BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Deductible: Comp/Coll $1,000 E UMBRELLA LIAB X OCCUR MSW74841 07/01/2015 04/01/2016 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE Is 1,000,000 DED F I RETENTION$ I$ C WORKERS COMPENSATION 0044727794-01 07/01/2015 04/01/2016 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETORNARTNER/EXECUTIVE � N/A E.L.EACH ACCIDENT Is 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DIf Ees SC describe under RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000 D Installation QT6601F654654TIL15 07/01/2015 04/01/2016 Installation Limit 50,000 In Transit $ 200,000 Deductible $ 1,000 Leased/Rented from others $ 50,000 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE For Evidence Purposes Only 666�777ffff Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I cec of Coosurner Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Offtcc of Consumer Affairs and Business Regulation IstraOon•-170279 Type-, 10 Park Plan-Suite 5170 pplement Card Eftpltatlon:a,l0gl201$�;(a Su Boston,MA 02116 ROOF DIAGNOSTICS,SOIAR OFr SS,LLC. NRG HOME SOIARc, JOSEPH WY LD CHI RICO._` 89 WASHINGTONAVE���< NATICK,MA 01760 Undersecretary Not valid without signature Massachusetts -Department of Public:Safety Board of Building Regulations and Standards Con%trurtiorn Super,i•ur License: CS-093115 I r JOSEPH M WYLDCHEUCO- 1I HILL CREST AVENUE Seekonk MA 02771 Expiration Commissioner 05/1412017 (7) .-, Office ol'Consumc-i Affairs and Business Regulation 10 Part: Plaza - Suite 5170 Boston, Massachusetts 021 16 -1.011le II7�(O1'UVGnlrrnt C011ti'aCtU1 Re~lsll'�tt1On Reqistration: 170279 Type: LLC Expiration: 10/5/2017 Tray 269777 ROOF DIAGNOSTICS SOLAR OF MASS, LL PETER LACAMERA 2100 HIGHWAY 35 K SEA GIRT, NJ 08750 -update A41111•ess surd return caul. \lark rcaso!r for chan�.1c• :Address Renew.11 E;mpluyment Lost Coar'd SCA 1 0 20?A•05111 s-w'!�r' '(�r n�»r It��,•r��/� f'" �lar�.r ,r•rii.r1/s _ '» + otrec & Ref-1ul:11iun License or rcostration v;iIid I'or individul use only f: wHOME IMPROVEMENT CONTRACTOR L>efure the expit•ation date. 1f found return tu: Registration: 170279 Type: Uf(ice Or Cunsunler Aff;tir•s ;urd Business Ite"lliation T Expiration: 10/5/2017 LLC tll I'arl< I'I:rz;t - suite 5170 Boston, .IA 02110 ROOF DIAGNOSTICS SOLAR OF MASS, LLC. NRG HOME SOLAR ,. . � •,,. per,. PETER LACAMERA 2100 HIGHWAY 35 SEA GIRT, NJ 08750 t`ndcrsccrrctary .� ! 'ot valid wifhoul signuturc .lope ID:A031F48F-1DCB-4276-B7BB-CF0E0D603"C nrg Home SOLAR POWER SYSTEM LEASE SOLAR Between NRG Home Solar and Thomas Mcnamara Elizabeth Hagerty DATE:July 30, 2015 TERMS AND CONDITIONS OF YOUR SOLAR POWER SYSTEM LEASE Estimated annual Wh Consumption Year One:6244.00 kWhs Pdorto Solar. Property Owner: Thomas Mcnamara Elizabeth Hagerty Year One:6014 kWhs Estimated Solar MacbldlyOutput Term(20Years):107000 kWhs Email: t.i.mcnamaranacomcast.nct Fagmated Solar Elechidly rate par kwh: Year One:$0.165 Phone: 508681665 Fax: Monthly Lease Payments: Year One:$82.69 per month,for 240 total monthly lease payments. Lease Escalator. 0% Property Owner Mailing Address: 276 Cotuit Bay Dr Optional Buy Down Payment: $0.00 Street Address Line 1 Total tease Payments over20 years: $19845.60 Street Address Line 2 Each yearwe will measure cumulative production and reimburse you for Barnstable MA 02635 Performance Guarantee underproduction according to Exhibit 4.You City State zip will not pay extra for any surplus energy Installation produced by the system. Address: 276 Cotuit Bay Dr Amount Due at Lease Slgrling: $0 Street Address Line 1 Street Address Line 2 Delivery/Installation ram: $0 OtherCharpm(not partofyour monthly $0 payment,If arty): Barnstable MA 02635 city state zip Amount Due at Dellwery(production $_ date): Cost to Insure the Solar System: $0,see section 12. NRG Home Solar Lease Quick Facts You have the option to purchase the Solar System at the seventh(7th) NRG Home Solar insures,maintains and repairs the Solar System at no additional anniversary of the Production Date or at the expiration of the Lease Term as cost to you,as described in the lease. described in the Lease. NRG Home Solarwill moribrthe Solar System at no additional cost to you,as If you move,you may transferthe Lease to a purchaser of your Property oryou described in the Lease. can prepay the remaining balance,as described in the Lease. NRG Home Solar guarantees the Solar System's kWh production,as described in the At the end of the term of the Lease you will have the option to:renew the Lease, Lease. purchase the Solar System or request removal of the Solar System from your See remaining sections of this Lease for other important terms. Property as described in the Lease. The monthly Lease payment does not include taxes,if applicable.See Section 2.3 for more information on taxes. Description of Leased Solar System The Solar System is a 5.6 KW DC(STC)photovoltaic system,consisting of photovoltaic modules,inverter(s),mounting system(s)and monitoring system(s) 1000 N.POSr GAKROAD,SUITE240,HOUZIN 7X77055 I (P)IBOO-757-6527 I WWW.NRGHOMESOLAR.COM Lease Number. f10-0049227154-000-00001; Lease Version.01 NRG Residential SolarSolutlons LIZ,d/b/a NRG Home Solar;isa wholly owned subsidiary of NRG Energy,Inc.®2015 NRG Energy,Inc.All rights reserved. r DocuS'n E'lope ID:A031F48F-10CB-4276-B7BB-CF0E0D60344C Accepted and agreed to as of the date first above written. NRG Residential Solar Solutions LLC CUSTOMER i 30 July 2015 Date Date uSigned by: FILmo-s kw amAr'A Signature Sign. ure23,°'eoFcocA4cc... Thomas Mcnamara Name, Title Print name Customer Email Address CUSTOMER [if more than one] F '30 July 2015 Date DocuSigned by: i~ Signature 23,°78°FC°C,�C`_.. Elizabeth Hagerty Print name INSTALLER 30 July 2015 Date DocuSigned by: VtG wuSl Sig nature'2DFD34FSEA1412... Eric Weisz Print name 14 MCA Schedule 6.4.6 dated 12/03/13 a was ,eR��,y •YY /."i s■y STRUCTURAL EN4t'NEgrERS. M � i r r October 21,2015 Mr.Wissem Taboubi NRG Solar 89F Washington Ave Natick, MA 0176.0 . RE: Mcnamara Residence Solar Installation 276 Cotuit Bay Drive Cotuit,MA 02635 Structural Assessment of Roof Framing MPP Project No: 15-2958 Dear Mr. Taboubi: Pursuant to your request,MPP Engineers has performed a limited structural evaluation of the roof framing at the above referenced site to determine if the roof has adequate capacity to support the proposed solar panels. Our analysis was based on the framing information and configurations provided by NRG Solar. It is our understanding that the structural components of the existing roof framing are in good condition.It is further understood that all existing connections between the various roof framing members, including ceiling joists and rafters are adequate to resist the current loading conditions and behave in the manner that.a typical rafter and ceiling tie system is intended to behave prior to installation of the solar panels. Results Roof House Rear—adequate to support the proposed solar panels Structural Data and Code Information Our analysis was performed in accordance with the requirements of the 780 CMR 51.06:Massachusetts Residential Code which has adopted the 2009 International Residential Code with Massachusetts amendments.Per Table R301.2(1),the ground snow load to be used for each town is in accordance with Table R301.2(5). Similarly,the wind speed for each town is in accordance with Table R301.2(4). The roof framing was analyzed in accordance with Section R104.11 of the of the 2009 International Residential Code which allows for alternate approved design such as using the ASCE 7 code.for determining actual snow loads on roofs(e.g. deriving flat or sloped roof snow loads from the specified ground snow load referenced in Table R301.2(5)). Wood members were analyzed and designed in accordance with the NDS 2005. The roof area for the solar panels of this residence is framed in a gable configuration with conventional 2x roof rafters. The existing roof structure is in good condition and is assumed to have two layers of asphalt MPP Engineers,LLC 1 34.South Main Street, Suite D Allentown,NJ 08501 609-489-5511 (office) www.Mengineers.com 609-489-5916(fax) Mcnamara Residence Solar Installation, 276 Cotuit Bay Drive Barnstable,MA 02635 shingles.The pertinent data is listed below: Roof House Rear(20 Panels Total): Rafters: 2"x 8"(#2 Spruce-Pine Fir Assumed) Spacing: 16"O.C. Roof Slope: 30 Degrees Horizontal Projected Length of Rafter (Horizontal Projection): 16 feet Ceiling Joists: Present Collar Ties: Not Present Roof Sheathing: Plywood Sheathing Condition of Framing: Good Roof Covering: Asphalt Shingles Ground Snow Load,Pg: 30 PSF from Table R301.2(5)of Massachusetts Residential Code Importance Factor,I: 1.0 Exposure Factor,Ce: 1.0(Conservatively taken as Partially Exposedj Thermal Factor,Ct: 1.1 with Panels (Cold Roof) 1.0 existing condition(Warm Roof) Design Snow Loads On sloped roof: 21.00 PSF(Existing—Unobstructed Warm Roof) 15.40 PSF(New—Slippery Surface on Cold Roof) Wind Speed: 110 MPH from Table R301.2(4)of Massachusetts Residential Code Exposure B Analysis Results: General Considerations ➢ Materials such as metal roofs or solar panels are considered slippery surfaces. Since the solar panels are mounted slightly above the roof line,it would be conservative to consider a thermal factor Ct of 1.1,treating the panel surface as a cold roof rather than a warm roof.Based on the roof slope and considering it as a slippery surface,the snow load is reduced by 27%compared with the snow loading directly on the existing shingled roof surface. This reduction equates to 5.60 PSF which essentially offsets the weight of the solar'panels. Gravity Loading: Roof House Rear—adequate to support the proposed solar panels This our understanding that the panels will be installed using Unirac rail with L-feet(or equal)at approximately 48 inches on center(e.g. every two to three rafters).The leveling feet will be fastened directly into the existing joists with 5/16"diameter lag screws with a minimum embedment of 2.5". In addition, it is important that the leveling feet support locations be staggered between adjacent panels so that no single rafter supports more load than under the existing conditions. Mcnamara Residence Solar Installation 276 totuit Bay Drive Barnstable,MA 02635 Wind Loading: Based on our calculations,the net wind loads imposed on the roof framing with an attachment spacing as indicated above will be less than the current loading on the roof framing. In addition,provided that the leveling feet are attached to the roof framing members in a typical staggered fashion,the overall wind loading imposed on the structure and the individual framing members will not be impacted to any great extent. If you have any questions regarding this matter,please feel free to contact my office at 609-489-5511. We appreciate the opportunity to assist you with this evaluation. Sincerely, MPP Engineers,LLC Chiranjib IVlukherjee OF, o ASHO , G N Ci �' A No. t35 /STER�� �Q FS`��yNAL Ashutosh Patel,P.E. MA Prof Eng. Lic.No. 48235 Mcnamara, Thomas - Barnstable 5.600 kW (DC) PHOTOVOLTAIC SYSTEM $ • 276 Cotuit Bay Drive Cotuit, MA 02635 < 41 Oa O P' SCOPE OF WORK: 0 LG280SIC-B3 SOLAR PANELS m z,n 0 MZ50-60-AL-S22 INVERTER Do ROOF TOP AND WALL MOUNTED ELECTRICAL EQUIPMENT E REQUIRED PER CODE,AHJ&FIRE DEPARTMENT 1 F 3 CONNECT TO 100A/ 100A MAIN SERVICE PANEL W NS OTAL SYSTEM SIZE 5.600kW DC SHEET INDEX: ca EXISTING 100A BUS E1 — SITE PLAN E6 — DETAILS 3 � 20-LG280 SOLAR EXISTING 100A TOP FED E2 — NOTES E7 — SINGLE LINES a PANELS w/ MAIN BREAKER SERVICE E3 — PROPERTY PLAN E8 — ELECT. NOTES 20-M250-60-2LL-S22 I;U7 POINT w/LINE SIDE TAP E4 - ELEVATIONS E9 - SIGNAGE MICRO INVERTERS E5 - ROOF PLAN E10+ - CUT SHEETS' VICINITY MAP ell /N s s EXISTING,SERVICE POINT ' <� • N &UTILITY METERING PV DISCONNECT FOR UTILITY OPERATION (N)LOCUS 120 PV METER 240V NEMA-311 276 Cotuit Say Dr J N (N)100A SOLAR ONLY LOAD 3 # SITE PLAN CENTER 240V NEMA-3R :a SCALE:3„Z.a t.A. NOTE: ALL SCALES SET TO 11X17 SHEET SIZE SOLAR PHOTOVOLTAIC SYSTEM NOTES: ABBREVIATIONS All materials equipment,installation and work 9.All conductor exposed to weather shall be 22. Flexible,fine-stranded cables shall be ,eQ p , Po A AMPERE c shall comply with the following applicable codes: listed and identified for use in direct sunlight. terminated only with terminals,lugs,devices or AC ALTERNATING CURRENT AHJ AUTHORITY HAVING JURISDICTION • 2012 IBC [NEC 690.31(B),310.8(D)] connector that are identified and listed for such use. F p BUILDING 2012 IRC 10.The module conductors must be type USE-2 [NEC 690.31(F)] CONC CONCRETE c4 • 2011 NEC or listed for photovoltaic(PV)wire.(NEC 23.Connectors shall be of latching or locking type. CB COMBINER BOX a '� 2012 UMC 690.31(B)) Connectors that are readily accessible and operating CEC CALIFORNIA ELECTRICAL CODE cu COPPER • 2012 UPC 11.All conductors shall be marked on each end at over 30 volts shall DP DISTRIBUTION PANEL wtiP • 2012 IFC for unique identification. 24.Require tool to open and marked"Do Not DC DIRECT CURRENT LM Q • 2013 Building Energy Efficiency Standards 12.PV module negative shall be grounded.All Disconnect Under Load"or"Not For Current EEc EQUIPMENT GROUNDING CONDUCTOR • AuthorityHaving Jurisdiction IV (EXISTING) C g grounded conductor shall be property color Interrupting". [NEC 690.33(C)&(E)(2)] Fv FIELD VERIFIED • Fire Authority Having Jurisdiction identified as white.[NEC 200.6] 25.Equipment grounding conductor for PV modules GALV GALVANIZED 13.PV physical em connected on the load side of the smaller than 6AWG shall be protected from GEC GROUNDING ELECTRODE CONDUCTOR GND GROUND 1. Existing plumbing vents,skylights,exhaust service disconnecting means of the other damage by a raceway or cable armor.[NEC 690.46 HOG HOT DIPPED GALVANIZED outlets,ventilations intake air openings shall not source(s)at any distribution equipment on the &250.120(C)] I CURRENT be covered by the solar photovoltaic system. premises shall meet the followingNEC 26. Equipment roundin conductor for PV stems Imp CURRENT AT MAX POWER [ grounding Sy INVr INVERTER 2.Equipment Inverters,motor generators, 705.12(D)]: without Ground Fault Protection(GFP)and installed Isc SHORT CIRCUIT CURRENT photovoltaic modules photovoltaic panels,ac kVA KILOVOLT AMPERE P Pa 14. Each source connection shall be made at a on non-dwelling unit must have ampacity of at least n photovoltaic modules source-circuit combiners kW KILOWATT p dedicated circuit breaker or fusible disconnecting 2 times the temperature and Conduit fill corrected Lew LOAD BEARING WALL and Charge controllers intended for use in means.[NEC 705.12(D)(1)] circuit conductor ampacity.[NEC 690.4S(B)] MIN. MINIMUM fis E photovoltaic power systems shall be identified 15.The sum of the ampere rating of the 27. Fine stranded cables used for battery terminals, Mce MAIN CIRCUIT BREAKER ��m P 9 NSP MAW SERVICE PANEL 1ofd and listed for the application. (NEC 690.4(D)) overcurrent devices in circuits supplying power to devices,and connections require lugs and terminals (N) (NEW) m m 2l 3.All outdoor equipment shall be NEMA 311 rated, the busbar or conductor shall not exceed 120% listed and marked for the use. NEC 690.74 N3R NEMA 3R,RAINTIGHT OUTSIDE RATED E I I m including all roof mounted transition boxes and of the ratingof busbar or conductor. 28.Grounding bushings are lured around NEC NATIONAL ELECTRICAL CODE o a [NEC[ � � � NTS NOT TO SCALE �F=- $� switches. 705.12(D)(2)] pre-punched concentric knockouts on the DC side of oC ON CENTER m p point shall be on the line the OCPD OVERCURRENT PROTECTION DEVICE 4.All equipment shall be property grounded and 16.The interconnection system(NEC 250.64 C) IE N bonded in accordance with NEC article 250. side of all round-fault protection P POLES-BREAI S POLES- g p equipment 29.Grounding electrode conductor will be PL PROPERTY LINES W S.All circuits connected to more than one source [NEC 705.12(D)(3)] continuous,expect for splices or joints at busbars Pv PHOTOVOLTAIC r cr5 shall have overcurrent devices located so as to 17.Equipment containing overcurrent devices in within listed equipment PVC POLYVINYL CHLORIDE a RR ROOF RAFTER provide overcurrent protection from all sources. circuits supplying power to a bus bar or (NEC 250.64 C) sac SOLID BARE COPPER a [NEC 690.9(A)] conductor shall be marked tD indicate the 30.All smoke alarms,Carbon monoxide alarms and SP SOLAR PLANE 6.All photovoltaic(PV)modules shall be mounted presence of all sources. [NEC 705.12(D)(4)] audible notification devices shall be listed and SCH SCHEED� on the roof.Additional equipment of the PV 18.Circuit breaker,if bac kfed,shall be suitable labeled in accordance with UL 217 and UL 2634. SS STAINLESS STEEL system shall be located outside the building near for such operation.[NEC 705.12(D)(5)] They will be installed in accordance with NFPA 72 PTC PRACTICAL TESTING CONDITIONS 690.14 C SYM SOLAR WATER HEATER the main electrical services. [NEC ( )] 19.To minimize overheating of the busbar.in and NFPA 720. (IRC 2013 R314&R315). TYP TYPICAL 7.The utility interactive inverters shall panelboard,the panelboard main circuit breaker 31.2013 California Residential Code(CRC)requires LINO UNLESS NOTED OTHERWISE automatically de-energize its output to the and the PV power source circuit breaker shall be that Smoke alarms and Carbon Monoxide Alarms be V VOLT € connected electrical production and distribution physical) located at the opposite end of the retrofitted into the existing dwelling. Smoke Voc VOLTAGE AT MAX POWER CIRCUIT y 9 9 Voc VOLTAGE AT OPEN CIRCUIT network upon loss of voltage in the system and busbar. alarms are required to be in all bedrooms,outside W WATT shall remain in that state until the electrical 20.All the NEC required warning signs,markings, each bedroom,and at least one on each floor of the production and distribution network voltage has and labels shall be posted on equipment and house.Carbon Monoxide alarms are required to be been restored.[NEC 690.61] disconnects prior to any inspections to be retrofitted outside each bedroom and at least one 8. Due to the fact that PV modules are energized performed by the Building Department inspector. on each floor of the house.These alarms may be J whenever exposed to light,PV contractor shall 21.Metallic raceways or metallic enclosures are solely battery operated if the Photovoltaic project disable the array during installation and service required wiring method for inside a building for does not involve the removal of interior wall and by short circuiting,open circuiting,or covering PV System. [NEC 690.31(E)] ceiling finishes inside the home,otherwise,the [:E2 the array with opaque covering.[NEC 690.18] alarms must be hard wired and interconnected. OCCUPANCY TYPE: R-3 •CONSTRUC110N TYPE: TYPE V-B •UNSPRINKLERED 'tea a �z I rn , p N � � o � p t PROJECT: FROPOSFO SYSTEM SIMIS&WDW sonar et^. TUG mtca ier. 5800 the R PNOTOV0.TNC SYSTEMSYSTEMOR F S tioF BOtA Mi are ,i„i„6 UNMC Mcnamara,Thomas-Bamstable � . W uua�c KSI nasoeo usa _ Q I' 1 6�,s �.: ,STOW .,: _ rmut's 1,02 stcas 276 Cotuft Bey Drive - Coluft,MA 02835 SOLAR �� 33'- 3„ 32 -10" rn r D N Ln 0 a n b PROJECT: PROPOSED ssTvMsuEIS&GWIW �a murm er: T� ma,r�.w aria PwTovarac 7mm FOR Y: ,�}slµ0"aL•. are „„,„ �5 „„ Mcnamara,Thomas-Bamstable n � s ux,a Svsoao-aisn _ ©t 1 6�S' Re n' M: 'eToav 4 r°naFs W28astc-83 278 Cotuit Bey Drive .a a Cotuit.MA 02635 S(..1 L-AR R. SPA 1 PITCH AZIMUTH MATERIAL SP SQ Ff ARRAY SQ.Ff RAFTER SPECS RAFTER MAX SPAN SHADE 30 232 COMP 1227 361.47 2X8@ 16 O.C. 80% pc rrs .dk- `Co 1p- m s mr +�+p H m go IS �le, b E 38 ATTACHMENTS s ' 48"O.C.MAX.(TYP.) `!'2 r �• m " ALL ARRAYS 1p sr E L/ �r O • sr ® � � sr s NEW PV CONDUIT TO BE RUN WITHIN ATTIC AND HIDDEN FROM VIEW. . CONDUIT TO BE PAINTED TO MATCH . THE EXISTING SURFACE. N ROOF PLAN — — SCALE:1/8"=r-D• a a EQUIPMENT LEGEND ACCESS ❑COMBINER HJUNCTION nm C DISCONNECT w/ QDC DISCONNECT w/' ❑LOAD CENTER w/ ❑DISTRIBUTION PANEL ❑.WALL INVERTS w/ DEDICATED PV SERVICE POINT @ A�" LADDER BOX BOX ARNING LABEL WARNING LABEL WARNING LABEL 0 w/WARNING LABEL WARNING LABEL O SYSTEM METER 0 UTILITY METERING �� STRING LEGEND S1.- STRING 1 S2- STRING 2 ¢moo S3.- STRING 3 S4- STRING 4 h S5- STRING 5 �kp - S6- STRING 6 v" S7- STRING 721, S8- STRING 8 C Cv S9- STRING 9 s� d T. .P! j0, a o co ',/'la f• a m m b� `P2 sr J'r S H Cg s�s � E Of sue, r U c/ sr op p sr Os � � • N STRING PLAN sw e:1/8•=r-O" EM PV MODULE $ UFORAC SQARNOUM +u;..�• RAIL WITH ECO FASTEN GROUND WEED k L-F'OOT MODULE CLAM 5/t8'EPOM BONDED PV MODULE y. . 304-18.8 SS WASHER COMP VON S t `�q•�y r L-102-,Y BRALPET'(OTHER- GREEN FASTEN FLASHING - • �^ OPTIONS-AVAOABIQ BM-GFI-W-812 WRH GF-1 FIASFONG ECO•CP-SO COMPRESSION BRADO:.T PP Ws 5/1rx4'S.S.LAC BOLT WITH 2.5- �0 MIMMUM PENETRATION SEALED PAIN APPROVED SFAIANT LAG BOLT 5/16' (TO BE VERIFIED) (TO BE VERRFIED) I m I - a ' A STANDOFF DETAIL _ J�E. SCALE:1'=V-O" H m o m NEW 100A LBNEM E EXISTING 100A BUS REXISTING 100A MAIN BREAKER240VR 12D/240V 1�3W N (OUTSIDE) AIN 120/2 METER EE 3W PANEL SUB PANEL E UNDERGROUND (INSIDE) NEW 125A SOLAR w g CENTER 240V NM3R M I I • I �—•• 1 Comm � I II I EIE3 I IEI31 1 `F1=1 IF-Hl 1 � NEW 30A AC DISCONNECT 240V NEMA-3R (OUTSIDE) u ` a OUTSIDE ELECTRICAL ELEVATION DETAIL INSIDE ELECTRICAL ELEVATION DETAIL IFE6 SCALE:63/128"=1'-O" SCALE:63/128"=V-0' SERVICE INFO INVERTER SPECS MODULE SPECS AMBIENT TEMPERATURE SPECS UTILITY COMPANY: MSP VOLTAGE: INVERTER:M25W-2LL-S22 MODULE TYPE: QTY: WATTAGE: FRAME COLOR: AMBIENT TEMP RECORD LOW CONDUIT HEIGHT ROOF TOP ADDER ROOF TOPTEMP CONDUCTOR TEMP RATE TY:20220 �c rrs Eversource 240V Q LG280S1C-83 20 280 BLACK 29°C -16°C .5"-3.5" _ 22°C 51 °C 90°C MSp LOC: SERV.TYPE: MSP GROUND: VOLTAGE: WATTAGE: CEC EFF: Voc:38.8 Isrr 9.33 Imp:8.78 Vpmax:31.9 TEMP COP RECTION: .76 LEFT WALL UNDERGROUND ( UFER 240V 25OW %.5% PER310.15(0)C2)(°) •Q WIRE OCP FOR WIRES CONNECTED TO BREAKERS 120%RULE MAX VOLTAGE ''(" TO BE GREATER THAN THE SIZE OF THE BREAKER. BUS - MAIN MAX (VOLTAGE x699.7=MAX VOLTAGE)MAX ' ....�. .. BAR BREAKER PV OCP VOLTS 690.7 VOLTS (100 x, 1.2 )- 100 = 20 38.8 x 1.18 = 45.78 ° LINE SIDE TAP EQUIPMENT TERMINALS ARE RATED AT 75'C. STRING AMPERAGE NOT TO EXCEED � Insulation Piercing- CPC-4/0-6 THE 75'C RATING OF THE WIRE THAT IS ATTACHED TO THE TERMINALS. 1MET LOAD 10 SOLAR ONLY 0 Ln (E) 100A TOP 60A 30A PY METER LOAD CENTER MAIN SER ANEL U71UTY AC DISCONNECT UTILITY 240V NEMA-3R NEMA-3R r/30A FUSES AC DISCONNECT 240V NEMA-31? 240V NEMA-314 3-#10 THWN-2 - 3 3 ♦ 3 100A/2P Ll I 20A/1P ENPHASE OUTLET [e a (E)LEADS E DO CD I I m I I F m 0mo I I PASS THROUGH 1 String E I • I 2 600V NEMA-0 1 Of 16. N$0 I I 20A a vH tg� I I u '�' MODULES GROUNDED, �' m I I u NTH UNQtAC al N N To 12o/24W a E m IP 3N N c 0 U 'ACE z EC GEC 1 String a ' of 10. 20A e u ti YOalA15 BRaINOFD ~ }}yy �3 MM UNM _ +9 (E)GROUND ROD N GEc a WIRE WIRE WIRE WIRE TYPE TEMP WIRE I TEMP CONDUIT WIRE TERMINAL INVERTER ! STRING GRND GRNDWIFtE a TAG# CONDUIT CITY GAUGE: 0.�a+�s `am�uuo RATING: AMP DE-RATE: FILL: OCP: 75°CRATING: CITY: NOG. NEC: AMPS SIZE TYPE O OPEN AIR 6 #12 TRUNK CABLE 90'C 30 x .76 x 1 = 22.BA 25A 10 x 1 x 1.25= 12.5A 96 SBC O 1'EMT 6 98 THWN4 90'C 55 x .76 x .8' = 33.44A 50A 10 x 1 x 1.25= 12.5A #6 THWN,2 � a 33 1'EMT 3 #8 THWN-2 90°C 55 x .76 x 1 = 41.8A 5GA 20 x 1 x 125= 25A 96 THWN-2 ®E O VEMT 3 #6 THWN-2 90°C 75 x .76 x 1 = 57A 65A 20 x 1 x 1.25= 25A #8 THWN-2 ELECTRICAL NOTES: pUITS 1) All modules will be grounded in accordance with code and the manufacturer's installation instructions, : 2) All pv equipment shall be listed by a recognized tested lab. 3) Notify serving utility before activation of pv system. 4) When a badded breaker is the method of utility TO W interconnection,breaker shall not read line and loads 5) When a backfed breaker is the method of utility G E interconnection,the breaker shall be installed at the opposite end of the bus bar of the Main Breaker. O } 6) Work clearances around electrical equipment will be maintained per NEC 110.26(a)(1), 110.26(a)(2)& _ 110.26(a)(3) 7) All exterior conduits,fittings and boxes shall be rain-tight and approved for use in wet locations per NEC d a 314.15. - m 8) All metallic raceways and equipment shall be bonded E and electrically continuous. ��m 9) All pv equipment,systems and all associated wiring and o CDTea m os interconnections shall be installed by Qualified Persons. _ 10) The photovoltaic system conductors shall be identified and grouped.The means of identification shall be permitted ~ by separated color coding,marking tape,tagging or other N approved means.NEC 690.4(b) E 11)Adequate spacing must be maintained between any plumbing sewer vents extending through the roof and the W g underside of the photovoltaic panels(6"minimum 3 recommended). o. 12)Pv equipment,systems and all associated wiring and interconnections shall only be installed by qualified persons (nec 690.4 e). 13)Photovoltaic system conductors shall be identified and grouped.the means of identification shall be permitted separate color coding,marking tape,tagging or other t approved means.(nec 690.4b) 14)Externally operated knife blade type ac disconnect switch — 1 which is lockable in the open position and"on"and"off'visible designations which is directly accessible to riverside utility i department employees at all times 60amp,250yac utility lockable(ac)disconnect(nem 6.3 and nec 690.17)(nema 3r) 15)Photovoltaic meter socket will be provided within 10'to a 72'(center to center of meters)from the existing service ' meter and that it will be installed between 48"to 75"above the floor or grade level. S CAUTION: SOLAR ELECTRIC SYSTEM CONNECTED PHOTOVOLTAIC DISCONNECT LABEL FOR MAIN SERVICE FOR UTILITY OPERATIONSCAUTION i' �''�•, LABEL FOR AC DISCONNECT za •>YJ�? sew. CAUTION THIS PANEL HAS SOLAR&UTILITY WARNINGI POWER TO THIS BUILDING IS ALSO POWER. THIS SERVICE ALSO SERVED SUPPLIED FROM THE FOLLOWING ALWAYS SHUT OFF BOTH BEFORE BY A PHOTOVOLTAIC SYSTEM SERVICING. SOURCES WITH DISCONNECTS AT THE MAIN SERVICE PANEL' FOR MAIN SERVICE PANEL LOCATED AS SHOWN: N WARNING! 0 PHOTOVOLTAIC POWER SOURCE —ELECTRIC SHOCK HAZARD. OPERATING AC VOLTAGE: 100 V DO NOT TOUCH TERMINALS. MAXIMUM OPERATING AC OUTPUT TERMINALS ON BOTH THE LINE AND (N)SOIARARRAY CURRENT: IN AMPS LOAD SIDES MAY BE ENERGIZED, IN THE OPEN POSITION. m a LABEL FOR MAIN SERVICE PANEL COVER LABEL FOR COMBINER BOX ® SUB PANEL E PHOTOVOLTAIC ARRAY cc AC DISCONNECT g m ON OPERATING CURRENT: 20 A THIS PANEL HAS CAUSOLAR&UTILITY SERVICE POINT& ' m m� OPERATING VOLTAGE: 100 V POWER. UTILITYMETERING a LABEL FOR AC DISCONNECT PV DISCONNECT ALWAYS SHUT OFF BOTH BEFORE FOR UTILITY g ° SERVICING. (N)LOAD CENTER OPERATION N U WARNING! (N)PV METERS ELECTRIC SHOCK HAZARD. (MID)AT THE MAIN SERVICE PANEL: c DO NOT TOUCH TERMINALS. TERMINALS ON BOTH THE LINE AND SOLAR PRODUCTION METER °1 LOAD SIDES MAY BE ENERGIZED IN THE OPEN POSITION. (MID)AT PRODUCTION METER a LABEL FOR AC DISCONNECT WARNING:PHOTOVOLTAIC POWER SOURCE CAUTION:SOLAR CIRCUIT DISCONNECT WARNING LABEL SHALL BE PLACED ON INTERIOR AND LABEL FOR AC DISCONNECT EXTERIOR DC CONDUIT,RACEWAYS,ENCLOSURES,CABLE ASSEMBLIES,JUNCTION BOXES,AND DISCONNECTS.MARKING ' WARNING! SHALL BE PLACED ON INTERIOR AND EXTERIOR DC CONDUIT, RACEWAYS,ENCLOSURES AND CABLE ASSEMBLIES EVERY 10 INVERTER OUTPUT CONNECTION FEET(3048 MM),1 FOOT OF TURNS OR BENDS AND WITHIN 1 . DO NOT RELOCATE THIS FOOTABOVE AND BELOW PENETRATIONS OF ROOF/CEILING OVERCURRENT DEVICE ASSEMBLIES,WALLS OR BARRIERS. MARKING PV CIRCUIT c LABEL FOR MAIN SERVICE _ r MARKING IS REQUIRED ON ALL INTERIOR AND EXTERIOR PV MARKING CONTENT AND FORMAT CONDUIT,RACEWAYS,ENCLOSURES,CABLE ASSEMBLIES,AND MARKING CONTENT:CAUTION:SOU I _ JUNCTION BOXES TO ALERT THE FIRE SERVICE TO AVOID CUTTING CIRCUIT THEM.MARKING SHALL BE PLACED EVERY 10 FEET,AT TURNS AND ABOVE AND/OR BELOW PENETRATIONS,AND AT ALL PV COMBINER -RED BACKGROUND a 5� AND JUNCTION BOXES. -WHITE LETTERING -MINIMUM 3/8"LETTER HEIGHT am�uweea REFLECTIVE WEATHER RESISTANT MATERIAL SUITABLE FOR THE -ALL CAPITAL LETTERS �� ENVIRONMENT(DURABLE ADHESIVE MATERIALS MUST MEET THIS -ARIAL OR SIMILAR FONT,NON SOl REQUIREMENT) Ion N $ 13j 12 H X j g i > �o _c c = S 15 a • 2 5 QQ �i TES I A4, Via' :z g yy ga gY }e I i f i t 7,, e 9 $�� Q p�6. 3 f`�pp�9 t• in F' l .� jga l^ y,j T p PROJECT: PROPOSED SYSTEM SIZE 18&600kW p„pA,qt; TMO 6M6�EM NY. ILWIN SOLAR PHOTOVOLTAIC SYSTEM FM m -S}. ��IYVF wee „nvs UNOW Mcnamara,Thomas-Bamstable ergs s� AS Tf i MAfWP. REST UMERTER M250E0.2LLS22 O SMt4M0 M: ISTORT AML /4rYjl � r��f• R•rc-,Eµ`,aF` � me 276 Cotuit Bay Ome COW,MA 0265 70 1 AR - c•,. ' r Its Enphase°M250 Mlcroinverter//DATA Enphase•Microinverters INPUT DATA(DC) M250.60-2LL-S22/S23/S24 Recommended Input power(STC) 210-300 W Maximum input DC voltage 48 V Enphase M/%��N 250 Peak power tracking voltage 27 V-39 V Operating range 16 V-48 V � '�•, Min/Max start voltage 22 V/48 V Max OC short circuit current 15 A r n Max input current 9.8 A w 1 yy� OUTPUT DATA(AC) C208 VAC @240 VAC Peak output power _ ._ 250 W _ 250 W .. —z Rated(continuous)output power 240 W 240 W Nominal output current 1.15 A(A rma at nominal duration) 1.0 A(A"a et nominal duration) Nominal voltage/range 208 V/183.229 V 240 V/211-264 V 0) i I Nominal frequency/range 60.6/57-61 Hz 60.0/,57-61 Hz Extended frequency range' 57-62.5 Hz 57-62.5 Hz tin U } Power factor - _ _ >0.95 >0.95 .. Maximum units per 20 A brooch circuit 24(three phase) 16(single passe) 22�m ``;I, •^i' Maximum output fault currant 850 mA nos for 6 cycles 850 mA Major 6 cycles u M O EFFICIENCY CEC weighted efficiency,240 VAC 96.5% O I CEC weighted efficiency.208 VAC 96.0% +._...�.._..__.__s. ... ..._ F - o 'Peak[matter efficiency 96.5% Static MPPT efficiency(weighted,reference EN50530) 99.4% v�3 to Night time power consumption 65 mW max The Enphase`M250 Microinverter delivers increased energy harvest and reduces design and MECHANICAL DATA V installation complexity with its all-AC approach.With the M250,the DC circuit is isolated and insulated Ambient temperature range -40°C to 465-C from ground,so no Ground Electrode Conductor(GEC)is required for the microinverter.This operating temperature range(internal) -40°C to+65°C a further simplifies installation,enhances safety,and saves on labor and materials costs. Dimensions(WxHxD) 171 In x 173 min x 30 mmlwhhout mounting bracket) a Weight 2.0 kg The Enphase M250 integrates seamlessly with the Engage°Cable,the Envoy"Communications Cooling Natural convection-No fans Gateway'",and Enlighten,Enphase's monitoring and analysis software. Enclosure environmental rating outdoor-NEMA 6 FEATURES Compatibility Compatible with 60-cell PV modules. PRODUCTIVE SIMPLE RELIABLE Communication Power line •Optimized for highor-power -No GEC needed for m'eroinverter -4th-generation product Integrated ground The DC circuit meets the requirements for ungrounded PV arrays in $ 1 modules -No DC design or string calculation -More than 1 million hours of testing NEC 690.35.Equipment ground Is provided In the Engage Cable.No y -Maximizes energy production requlred and 3 million units shipped _ additional GEC or ground is required. _ t -Minimizes Impact of shading. •Easy installation With Engage -Industry-leading warranty,up to 25 Monitoring Free lifetime monitoring via Enlighten software dust,and debris Cable years Compliance UL1741/IEEE1547.FCC Part 15 Class e.CAN/CSA-C22.2 NO.0-M91. 0.4-04,and 107.1-01 o 'Frequency tangos can be extended beyond nominal if required by the utility f° [e]Enphase• To learn more about Enphase Microinverter technology,gy, [e]Enphase° 4 g E N E R G Y C US visit enphase.com N E 3 G v 0 2013[nlxttiu E!.W Pi on,.ew—,M 1,26,.ls .9islned by 0-I-ixxl.v°awnu. B 9 33EE OrtEr•uwo¢ Ell V '(.Gq Enphase-Engage Cable System//DATA Engage Cable System and Accessories ' Enphase®Engage Cable CABLE TYPES/OR- RING OPTIONS Voltage Connector Spacing PV Module Orientation Model Number gConnectors' Weight" � 240 VAC,4 conductors 1.025 meter(40') Portrait ETIO-240-40 40 401bs 240 VAC,4 conductors 1.7 meter(67") Landscape ET17-240-40 40 45 ibs E C�N�' 208 VAC,5 conductors 1.025 meter(40") Portrait ET10-208-30 30 30lbs I 208 VAC.5 conductors 1.7 meter(67") Landscape ET17-208-30 30 35 Ibs 0 `•. •mnNmal Yngtn a:lNNo mxu�FsM.uvm nirtncmrin Nsvuvnnf.••wagnm am ritymMn m CABLE SPECIFICATIONS Description Rating Cable temperature rating 900C(1946F)wet/dry _N Cable Insulator rating THWN-2 Z UV exposure rating UL 746 C.F1 E Conductor size 12AWG W m Compliance IEC 60529 IP67,CAN/CSA 22.2 No.21.182.3,UL 486A/B,514C,6703.and 9703 fl m f] Cable rating TCGER MW p Cable Diameter 1.25 cm(0.49") E Minimum bend redius 12 cm(4.75") O �p �f• V c ENGAGE ACCESSORIES f0 NU E Branch Terminator P Disconnect Tool One terminator needed per branch Plan to use at least one per The Engager Cable is a continuous length of 12AWG cable with pre-installed connectors for circuit Installation ILI Enphase Microinverters.The cable is handled like standard outdoor-rated electrical wire,allowing it ET-TERM-10(sold In packs of 10) ET-DISC-05(sold In packs of 5) to be cut,spliced and extended as needed. 0L The Engage Accessories complement the Engage Cable and give it the ability to adapt to any Watertight Sealing Cep Cable Clip AA installation. One needed to cover each unused Many needed to fasten cabling %ate, connector on the cabling �� to the racking or to secure looped ET-SEAL-10(sold in packs of 10) cabling ET-CLIP-100(sold In packs of 100) FAST FLEXIBLE SAFE -Quick installation -Simple design •No high voltage DC eg -Large branch capacity -No additional cables -Reduced fire risk Engage Coupler g t3� Used for splicing two power cables within an army AT ET-SPLK-OS(sold in packs of 5) $ [e�enphase• sR. To learn more about Enphase Microinverter technology, ref enphase` E N E R G Y C US visit enphase.com L E N E R G Y b C 2013 SN"P Erb'.N dt/Y.9I—d.NtnU—W pbEYffin Ilb d.—I a9 raa 11b byVNW'-0-ake OvrlBr, j p1EkT xyM9E0. E12 Vc i'ry 'pOr. Envoy Communicalions,Gateway Envoy Comrnunlcatlons Gateway//DATA Envoy Communications Gatewayt- INTERFACE i� Power Line Communications Enphase proprietary ,fr^� Local Area Network(LAN) 10/100 auto-sensing,auto-negotiating,802.3 "'"' - LAN CONNECTION OPTIONS •' Cable Assembly,Ethernet,RJ45,Orange,10ft Included with ENV-120-01 and ENV-120.02 Power line wmmuniwtion bridge pair Included with ENV-120.01 ' Wireless N USB adapter(802.11Wg/n) Included with ENV-120-02 t a0 C7 r POWER REQUIREMENTS +� AC supply 120 VAC,60 Flz -� l4 Power consumption 2.5 watts typical,7 watts maximum ygy m O CAPACITY C� m Number of mlcroinverters polled Recommended up to 600 N MECHANICAL DATA - t0 Dimensions(WxHxD) 222.5 min x 112 min x 43.2 ram(8.6"x 4.4"x 1.7") to The Enphase Envoy'Communications Gateway.provides network access to the solar array weight -40-C4o g(1z oz.) L enabling comprehensive monitoring and management of an Enphase system. Ambient temperature range Natural l comTec(-40°l0 fans a Cooling Natural convection—no tons � Solar professionals and system owners can easily check the status of their Enphase System using "e Enclosure environmental rating Indoor NEMA 1 d the Envoy's LCD display or get more detailed performance data via Enlighten`Software,included with purchase of Envoy. FEATURES Standard warranty term Two years Compliance UL 60950-1,EN 60950-1,CSA22.2 No.60950.1 and IEC - SMART SIMPLE SCALABLE 60950.1.FCC Part 15 Class •Indudes web-based monitoring -Plug and play installation -Residential or commercial ready out API available System-level production date rid and control -Flexible network configuration of the box Integrates with smart energy devices -No additional AC wiring required -Supports up to 600 m1cmInverters -Automatically upgrades and sends performance data - [e]enphase' To learn more about Enphase Microinverter technoiogy, [e�enphase` J E N E R G Y C us visit Onphase.Com E N E 17 G Y b ' 02011 Ela a5—ity.AT Apli9 raEe W.Al VeEeTahs a oWth h INS 4Curo'M1CaSt=i by Thai Mc IKe_,r.n' pCEt•UMBah El aE.rrG _fit p Locus DIAGRAM-TYPICAL CONFIGURATION � s 4 Product Datasheet '��,� c. eNERGYEMI Niilll•1 EaiMdfa CA15 1 _ miss INTERNET • Es in i • Q} M RESIDENTIAL SOLAF!'MONITORIN,G SOLUTIONG EMIRPieter L <Y EMS E � �j � ELECTRICAL far-rernote-manitor(rig or . • 0s BIIMrySL i•�� SERVICE *� r•t•�r INVERTER(S) LGATE 120 PV ARRAY clisnibjt6d solar DIMENSIONS N a SOCKET METER N LOCUS ENERGY E METER BASE METER MODULE COMM MODULE ! LII m The LGate 120 combines a revenue-grade,solid-state power meter with an advanced communications gateway. 691 in i These components work in conjunction to remotely monitor the performance of resicential o.ar energy Installation - - I ] lO Io of • 10 regardless panel o•inverter type.Tie LGate 120 is a one-piece completely under glass meter wh ch installs 6.31 in '" E I 'To using a standard socket base.Performance data is uploaded in near real-time to the Locus=ne•gy SOlarOs - ®�' • t monitoring platform which provides a Suite of tools and analytics for asset managers. W" it _I �_I I ~ U o s,46 n--� N N U 6.00 In —. to DATA COLLECTION ,r `•—730in =•. C AC energy data is collected by the meter and passed to the communications module.Additional system - - - performance data can be collected directly from meteorological sensors and supported inverters via RS-485 or W Zigbee connections.All data is sto•ed in nor-volatile memory and then automatically uploaded to SolarOS at user "- "` ` ' " -.- ' " "' -"` - -' --' a configurable intervals. SPECIFICATIONS tl Procassdr AR`l92'ndadde CPU rarararY aM5112.2Uaus O2X " NETWORK CONNECTIVITY os c:ra r,on on,ra.2c.o:ai ..,rP rndMa valaYa roams IZD-aec vac - F1 The cgmmunical ions gateway,ins'de the LGate 120 sup0ot's plug and play connectivity through a cellular or Ethernet M'norr 28 N3RA' 7nasaa wa onaso ae sow cO M,. network ccinnection.Once the unit is installed and polvered on,it will immediately begii Transmitting data without o m'nv t D sa:va Imp 25 any configuration.For maximum reliability,the communications gateway will automatically route up Dads betweer.the wireless and wired connections if either of the networks are Lnavailab'e. ' � i1 Bs2-1-1 1 A•irc ANSI 121U 5s03b "a10 s FCC I UB _ - 2qb.i, i1CRB � y FEATURES Cal r rr>,.,omm,nra ANSI C12.20 power mete, Lour Cost installation .AN Rt15'ap00 El—not.run Mir abplo:.mno AtIAliry • RS-485 and Zigbee irputs Doesn"require entrance into the house c nnM' 3G Gss'. - Enrb:��P NE 1.3R-yP,, _ C y GSht cellular or Ethernet connectiv ty Plug and play actwa;'on Bon • Ove•the air firmware updates Con`igureble data upload interval 5 zn En.Iran+rant 201d,OC 95%RM.+vn•cPnuarsind tvaran:T Slva-"r,rM M•ar.anly aEfi MllMeno, E14 ' yt rrs :9°U N I RAC SOLARMOUNT - Datasheets , :e UNIRAC uniracCode-Conipliant;0istallationMantial SolarAiount SOLARMOUNT Beams Part III.Installing So.larMount Part No.310132C,310132C-8,3101.68C,310168C-B,310168D 310208C,310208C-B,310240C,310240C-6,310240D, The Ilnirac Code-Compliant Installation Instructions support applicarions for building permits for 410144M,410168M,410204M,410240M t nl photovoltaic arrays using Unirac PV module mounting systems. This manual,SolarNlount Planning and Assembly,governs installations using the SolarMOunt and Properties Units SOLARMOUNT SOLARMOUNT HD SolarMountHD(Heavy Duty)systems. Boom Height in 2.5 3.0 �•, [3.1.J SolarMouni:6 rail components Approx mate Weight(perllnear it) plf 0.811 7,271 0 (fJ ,r~ Total Cross Sectional Area In, 0.676 1.059 Section Modulus(X-Axis) In' 0.353 0.898 QJ 0� Section Modulus(Y-Axis) ins 0.113 0.221 © Moment of Inertia(X-Axis) in' 0.464 1.450 0) p: �r O' r �I4y _ Moment of Inertia(Y-Axis) in 0.044 0.287 ,},Q ' m ,. Pr�. E Radius of Gyration(X•Axis) in 0.289 1.170 d Radius of Gyration(Y-Axis) in 0.254 0.502 °�f m 0� / .Figure 4.Sofanlsounr standard rail componemn. � • 'Rails ore extruded using rtrese aluminum alloys:6W5.75,610545,6O67-T6 0 li Q Rail-Supports PV modules.Use two per row,of Includes 3/8"x,'A'bolt with lock wisher for attaching. Gmodules.6105-1'Saluminumextrusion,onodized. L-four.Flash ng$:Use one per standoff.Unt=offers' 21appropriat flashing,for both standoff types. N V ©Rail splice-joins and aligm rail sections into single Note:There is aCwa Range type standoff that does nor uite an 1:mot. length of rail..it can formrithern rigid or thermal req E aspamionjoint 8 inches long,prediilled.610S-r5 O'Aluminumtwo•peleestandoff(4"and7') -Useone aluminum arnsion,'anodized. per L-fooS.TWv piece 610545.alumn Im extrusion. Includes M x A"serrated flange bolt with EPDM SLOT FOR T•BOLT OR T W ©Self-drillin sere (No.WxV4')-Use4 rri id washer for mulching Woa,and nim AV lag bolts, r SLOT FOR T-BOLT O R ce 8 /"HEX HEAD SCREW splice or 2)tzr expansion joint;Galvanized creel. O.Lag screw for.L-fuot(5/16")-Attachessandnffco yHFJI HEAD SCRE —sT- rnfrcr. 2x SLOT FOR SLOT rORI a Q L-foot-Use to secure mils either through roofing BOTTOM CLIP 2,900 BOTTOM CUP material m building structure or standoffs.Refer 0'Top Mounting Clamps loading tables for spacing.Note Plem conract Un rat, 3 000 .For use and specification ofdouble L foot: Is ibp Mounting Grounding Clips and Lugs / ©.L400t bolt(3/8"x 71")-Use one per L-fort to secure I rail to L•fout.304 stainless steel. SLOT FOR Installer supplied materials: ] SLOT FOR .385 �"HD(BOLT �lIIl.J1II. 0.Flange nut(3/8'9-Use.one per L-footm secure rail to La screw for L-foor-Attaches L-tout or standoff to I jig•HEX BOLT r� L-faut.304 stainless steel. out varafterlues. If lag the lengat is expod sedtometer elembaseents. oepusl 387� E rIX out values,If log screw Lend is espused mdectents,use 44 §aC stainless steel.Under flashings:2in c plated hardware is 750 1.307 O Flattop standoff(optional)(3/8")-Use If L-foot adequate. Y Y 1.875 Lott cannut be secured directly tomfter(with the or shays=is,for example).Sized to minimize roof to a A rail spacing.Use one per L-foot.One piece:Service Wnterproofroofing sealant-Use a sealant appropriate L."..x L.x Condition 4(ver•se%Yre) d.%.tided steel.zinc-lnte toyourroofingmaterial:Consul,with the company ? p p currently Vro•.iding warranquF roofing. SOLARMOUNT Boom SOLARMOUNT HD Beam ,t. 14 Dimeroloas specified In inches unless noted wcmusea 65 - 3 i - a 7 t lb I w Sys s g •TF •fix - kr a3 • 1 -'i g o fix' �� ,� '3 ,� a�,- NL A-- a w •- - -- �if x i M n�. yas $ � ag� All PROJECT: RWOSM&ST¢M&MIS LW0kW TA%1 rmp,ip, 6molcn SOLAR PHOTOV0.TAIC SYSTEM Fart •'• ��'�'@�w�.. moATt 11f11715 ,� aNMc Mcnamara,Thomas-Barnstable n�. eA Wrar: REST WV&V l Aa50e0-2LL-M SUtAiIG M• 15TORY yy o 1 ,e ?'.�••'.�� L 276 Cotun Bay DM IL Cotuit MA 02635 X-PRESSPEROT 8 2011 Town of Barnstable *Permit#&� � � 0�c� F. r 6 nthsjr.m► dat _ Regulatory Services Fee T., sr !RNST. ?E 0 9. Thomas F.Geiler,Director '°rEb�► Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY ll Not Valid without Red X-Press Imprint Map/parcel Number U ry 3 Property Address 2 7 G (a-Au.,f 94 7 A/Z/l/,5 rO It-14 6 a 6 3 S EA �pDQQ(J Residential Value of Work e/ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address h0�<I 5 T /yC��1/nA44 M0 a2 7(� lo�if- P��y Dom•�e Co��,i�� ohs ©a�,�- Contractor's Name. .4 C�U�/��fA✓o/ Telephon e Number 5'06 ya00 f/.�le Home Cmp4 vekA C9aactor License#if applicable) 7 5/6 Construction Supervisor's License#(if applicable) 71 6 f o 51/workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ro/I have Worker's Compensation Insurance Insurance Company Name 14 CC 40 e RTY C4.ragCl�J Workman's Comp.Policy# Al W C C `f Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side WIV&1f0-f f 0#ofdoors [�Replacement Windows/doors/sliders.U-Value ` 'Z 9 (maximum.35)#of windows jP *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property O er must sign Property Owner Letter of Permission.' A opy o th Home Improvement Contractors License&Construction Supervisors License is quir SIGNATURE: C:\Users\decollik\AppData\Local is oft\Windows\Temporary Intemet Files\Content.0utlook\DDV87AAZ\F.}1pRF-SS.doc Revised 072110 r ` Page 7 of 7 '4 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT WE, THOMAS & BETSY MCNAMARA, OWN THE PROPERTY LOCATED AT 276 COTUIT BAY DRIVE IN COTUIT, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PE IT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CO E. SIGNATURE OF OWNER: ,/ OWNER'S ADDRESS: 276 COTUIT BAY DRIVE, COTUIT, MA 02635 OWNER'S TELEPHONE: 508-681-0665 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: /�� K/ 0►�U RESPONSIBLE OFFICER ADD 4S: RESPONSIBLE OFFICER TELEPHONE: i • ✓/te Z��:.m.0nuiecsl.Ui v..,iucaosasJuuell� Office of.Consumer Affairs&Business Regultation 'License or registration valid for individul use only ,Ot'.iE[IMPROVEMENT CONTRACTORbefore.the expirationdate. if found return to: 6 Office of Cbmunfer Affairs and Business Regulation - = Registration:`- O7,,44 Type: 10 Fark PIaza-Suite 517o £xpira�inn - 1 Supplement Card Bosfonx i U.02116 CAP1711 HOM cWit fE MNWIIC, � ��&1 GAaRY GUS� FSP)a-1 A@EF�, ; 1645 Nev4on Rd. WWI,RSA 02635 Undersecretary , d without sign .. ll:tcr:lCltu�cttt_ Della' of Public SnfictE .. $.trartf t} Suiltlin'� :trcci Standards Construction Supervisor L.icectse License: CS 74640 GARY GUSTAFSON B S.kC)RT WAY SANC)WICH,NAA 02563 . Expiration: 11129I2R42 Tr. 7MB.. f I Client#:47298 CAPIHOM ACORD. CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DDfYYYY) 6/02/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY-AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Karen Walther NAME: Rogers&Gray Ins.-So.Dennis PHONE F ac No Ext:508-760-4630 AIC,No): 508-258-2230 434 Route 134 E-MAIL ers ra waltherka^ro com P.O.Box 1601 PRODUCER v g g y- South Dennis,MA 02660-1601 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC a3 INSURED INSURER A:National Grange Insurance Co. Capizzi Home Improvement,Inc. Capizzi Enterprises,Inc. INSURER B:ACE Property 8r Casualty Ins.Co INSURER C: 1645 Newtown Road INSURER D Cotuit,MA 02635 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AODLSUBR POLICY EFF. POLICY EXP LTR TYPE OF INSURANCE _INSR VVVD POLICY NUMBER MM/DDIYYYY) (MMfDDNYM LIMITS A GENERAL LIABILITY MPB1075H 06/08/2011 06/08/2012 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE O R NTED PREMISES Ea occurrence $500 OOO CLAIMS-MADE I l OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY PRO- LOC $ A AUTOMOBILE LIABILITY M1 M280d4 06/08/2011 06/08/2012 COMBINED SINGLE LIMIT (Ea accident) $500 OOO ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ X1 Drive Other Car $ A UMBRELLA LIAR X OCCUR CUB1076H 06/08/2611 06108/2012 EACH OCCURRENCE $5 000 000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5 000 000 DEDUCTIBLE $ X RETENTION 10000 $ B WORKERS COMPENSATION NWCC45843208 12/25/2010 12/25/2011 X IWC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNE OFFICER/MEMBER EXCLUDED?ECUTIVE N] NIA E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Additional insured status is provided under the general liability when required by a written contract with the certificate holder CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©198 -2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S67537/M67480 M EE The Commonwealth of Massachusetts Department of Industrial Accidents . Office of Invesdgations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): C A P 1 y 2 t d d t7'1C -4 m l youlf m eA-tf :tA/G Address: G 4 5 N Qw;v w,aL y City/State/Zip: (64ui4 . MA 0a4P 9s Phone#: J-o - Are you an employer?Check the appropriate bog: Type of project(required): 1.E34am a employer with O f 4. I am a general contractor and I employees(full and/or part=time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g; Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance.1 required.] 5. E] We are a corporation and its 10.E Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.[]Plumbing repairs or additions myself:[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no �/�//�D Ocl/ employees. [No workers' 13.[�O�ner comp.insurance required] �� �v��l��J-T/®`I . *Any applicant that checks box#1 must also fdl out the'section below showing their workers'compensation policy information: t HQmeownera.who submit this affidavit indicating they are doing all work and then hire outside contractors musta^ubmit a new affidavit indicating such. :Contractors;hat check this%oz.must attached'ao additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp:policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: C.6 p���-eP,T L/ TA" N2� 'fSa� Policy#or G 6 �3Z6 Self-ins.Lic.#: d- Expiration Date: ►2- Job Site Address: a �AY !fir/V� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).. Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500-00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that.a copy of this statement may be forwarded to the Office of Investigations of the DIA for insuranceeAverage verification. I do hereby certify un the 'n and penalties ofperjury that the information provided above is true and correct Si ature: Date: 10 Phone#: 02 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel Permit# Health Division Date Issued 37— l / Conservation Division Fee oohs Tax Collector ` AAO001p�Y,;w Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis n , Project Street Address (^,l�Q-C 'Y e_Jt �mt� Village a-16 � i ,2��� : u,t �1c� • ' Owner ,Q Address Telephone wg", 5553 • p p Permit Request U q - U U 5� - - r Square feet: 1 st floor: existing proposed ' 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other -Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new v Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other © Central Air: ❑Yes ' ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No -� Detached garage:'❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: - Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use n BUILDER INFORMATION Name ,R) _& "I& Telephone Number Address * -q d0kf4mao L'iD License# 0 0 FO ' a;I,}1 ft o IT 4, oln. Home Improvement Contractor# Worker's Compensation# GyCV—6 5 366 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ( g�� ' ��rsa 1�'y SIGNATURE 8f)_PwQ DATE -d�' T ' FOR OFFICIAL USE ONLY PtRMIT NO. f DATE ISSUED MAP/PARCEL NO. ADDRESS — VILLAGE i OWNER DATE OF INSPECTION' FOUNDATION .. , FRAME - ' INSULATION t s FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , ► GAS: ROUGH FINAL s i } FINAL BUILDING U 1' DATE CLOSED OUT ASSOCIATION PLAN NO. f' ' •"ter.•-� �`�. •1• u The Town of Barnstable • 9�A �`0�' Department of Health Safety and Environmental Services rFo Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 k Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than,four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost 5,c,C , Address of Work: Ce-Q.A_,A r P a=�, Owner's Name: C Date of Application: -.-----.____-_. .-- I hereby certify that: Registration is not required for the following reason(s): Work excluded by law OJob Under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachuseas Department of Industrial Accidents Tx - � OlfiC-6 DI MICS1Ig8110OS �s: --dam' ° 600 Washington Street Boston,Mass 02111 "„r•�•:�••,,,,�,,,,�•••,•�• • / /� Workers'/ ion Insurance Affidavit at W //% em//�-...... name: location city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole r=nctor and have no one working in ably capacity ` Tam an employer providing workers' compensation for my employees working on this job. comonnv name• 7. address: 2 q' ��p �t�['11i► ;;.,.:•.. :. .......... city- Q,Q�/{i41�6 svrnT'A A L QKA _ phone —4) insurance co. nlicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have . the follo«ing workers' compensation polices: comuanv name, address' ::::•......:••:•.:.>:.:. dtv. phone insarnnce cn. galky a "�" '"'•• �q �( .:..'.:::•;::::v:;;a•`:ai:::•. :;:.:.'is U�1 C��l 1 Q. — C l�Cam.V��n 1l'C M .. comnanv Hamer w o_�1 "`' • ' " • • address: 1) �-U20�..� cih^ /I o sue°D—ic �V11 /� ml't phone#? Insurance co. :`::: : ' Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in-the form of a STOP WORK ORDER and a fine of 3I00.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. !do hereby terrify under the pairs and penalties of perjury that the information provided above is true and correct Sigaa=e Date _ Print name # Ccontact use do not write is this area to be completed by city or town otllcial perrnit/lhcense# ❑Building Department OLkensing Board ediate response is required ❑Selectmen's Office ❑Health Department phone#; ❑Other_�, (mnsea 9 95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the.r employees. As quoted from the "law", an employee is defined as every person in the service of another under any come- of hire, express or implied, oral or written. An employer is defined as an individual.partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the recmvc c trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do e, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the . commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ----------------- Applicants ' Please fill in the workers' compensation affidavit completely, by checIdng the box that applies to your situation supplying company names,_address-and-phone unbers-along_with a certificate of mi sura ce as all affidavits may be, - submitted to the Department-of-_-Industrial_Accideits#or-coation of.ins+,rae coveiage: Also be sure_to sign:and _ date the affidavit. The affidavit should be returned to the-city or town that the application for the permit or license is being requested, not the Department of Inusd xW Accidents.:_Sbauld:you have_auy questions regarding.the`law"or if y ou, are required to obtain a workers"coiapensatimrpolicy,please=caU the-Depar=t=-at thenumber listed below - — City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitllicense number which will be used as a rc&r®ce number. The affidavits may be returned io the Department by maul or FAX uules's other arrangements have been,made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Depar rocat's address,telephone and fax-number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0111ce of Investigations 600 Washington street Boston;Ma. 02111 fax#: (617) 727--7749 phone #: (617) 727-4900 ext. 406, 409 or 375 Y neenng Dept. (3rd floor) Map Parcel ©`3' Permit# 4c)s, House# c?, �(o 6 Date Issued " �q -q U Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) �y e Z5 0� ~ Conservation Office (4th floor)(8:30- 9:30/1:00-2:00) SEPTIC SYSTEM MAST BE Planning Dept.(1st floor/School Admin. Bldg.) INSTALLED IN CO ANCE WiiTli TI Definitive PlanRAbyPlanning Board 19 ENVIRONMENT STAB ND TOWN RE . ���TOWN OF BARNSTABLE�Buildin Permit Application Project Stre /� to Village Lp—IV/7' Z�W D Z-ze cr Owner f7l.ZZ-90 Address Telephone Permit Request ,/^A-17- 12G - -k/- J Ad,J 2A-r 1_-V_eY10_9 -��J/✓itJ/�Ltrn "'T� L/dui,! r��oin First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �:o��n Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 1- Historic House ❑Yes W No On Old King's Highway ❑Yes Uk<io Basement Type: &Full ❑Crawl l)❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing _ New Half: Existing New No.of Bedrooms: Existing . 3 New Total Room Count(not including baths): Existing �2 New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) dAttached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes YNo If yes, site plan review# Current Use Proposed Use Builder Information Name /o/yJ dW221 �/� Telephone Number AAddddress (0 6(k ,0'V License# 49=,0,3 2- C� 2 cC Home Improvement Contractor# JOQ'7W �^ Worker's Compensation# aV(,JOB 7 _0�9Z�6 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE q r/7—9 ef B I; ING PERMIT DENIM FO�OL WING REASON(S) .. 1, • T FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ` d - lam✓ - INSULATION FIREPLACE' + ELECTRICAL: 'ROUGH FINAL PLUMBING: ' ROUGH FINAL ._ GAS:- ! % ` ., ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. r The Town of Barnstable • •nnivsrnB�. • 1'16A59.. Department of Health Safety and Environmental Services 10rEDN1A'�� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Cross en Fax: 508-790-6230 Building Commissioner PLAN REVIEW Owner: �, I zj�l Map/Parcel: 05 — 030 Project Address: y ` Builder: C11✓ f ,L 2A 0--c- The following items were noted on reviewing: —� c) K Please call 508 862-4038 for re-inspection. Reviewed by: 1 C CT Date: �' 1 U r 7 q:building:forms:review The Commonwealth oftLtassachuse::s = fZ Department of ladustrial Accidents r = ONC.-vf1oYesif9Vfv17s 600 Washtnoton Stree! Boston,.lass• 02111 -- Wor�z:s' Carzne:.sation Iasu�ncz�f idsti-i: � a i _- z^ _. �EC�e- • ':.�':_--_ ^C'.<zn CC-?tr.S1CC..:C; 'r_ _cve'_5'xC C s CC C:_:S -c.::- 0. s/ - '. rye ,.... -_� `'7 �crn Q �rfiiC'j 4' GCJ f��i3 :.:•'..: ".L'' -- . C:II CCC,C: oT:Z) 'SC.^.zvC v WCrK2 a• ':tit..-:J iC:_��;�vt�-��r:S •'_" •' � _�.._�:t::::R-:.>Ql}IG�..��::R ._G:3..:G.==OSICOn`7 =__ Y• :.. ir..;.r.sonnca. :S t.?3: __ :i Via.^...i3.....3r-1r 3 Et hi?�`OR. Attu G�:RC 1 ..1 5 i_ ._ .�' . f e- - - 4 1 T"A The Town of Barnstable gA$HgrARi c IV 'A p_q Department of Health Safety and Environmental Services o; ►�0 Building Division 367 Main Street, Hyannis MA.02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work:o2 *Vd J Est. Cost Address of Work: a27,41, Owner's Name^ 4;w" Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGIZAb1 OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: r d(/75/'ll Date Con _actor ame Registration No. OR Date Owner's Name Y • �:�': 1 . I ' 3 4 M.4-r-ri tS-17N . - ..•�:::'. 1. �� , \ I 92-el E HOME IMPROVEMENT CONTRACTORS REGISTRATION " Board o•f Building Regulations and Standards i One Ashburton Place — Room 1301 I Boston , Massachusetts 02108 .. HOME IMPROVEMENT CONTRACTOR -'--____________ ---------- l �.z Registration 100740 Expiration 06/23/00 i Type — PRIVATE CORPORATION j ✓^� � � IF HOM= IMPROVEMENT CONTR;CiOR CAPT_ZZZ HOME IMPROVEMENT , INC . I ��a�^, Re,,istration 100740 Thomas C a p i z z i , S r . � I Tr.' - PRI4AiE CORPORATION 1645 Newton Rd . '�`` Expiration 06/23/00 Cotuit MA 02635 CAPI?%I HOME IMPROVEMENT, INC 1 rj y,as Capizzi, Sr. 1 1645 Nawtor Rd. AD,'.'. Ste, -.C`Fi Cotuit MA 02635 ------------- - ✓/e iJanr��co�Q/j/, o� DEPARTMENT OF PUSIIC SAFETY CONSTP.UCTION SUPEPVISOR LICENSE Nu¢5er. Expires: ' ti . L— .. Restricted To: It THOMAS z CAPI22I JP. 288 PERCIVAI OR { _ QB ,Asyessor's map and lot number/4' ���• FTNET Sewage Permit number /(�' ......... ..... .. ....... ,..... '... . Z BAUSTADLE, i House number ........................ .........................:...........4...... 900 7.58 . MAY a\ TO N OF BARNSTABLE BUILDING - INSPECTOR APPLICATION FOR PERMIT TO ........... . ..:...................................................................................... TYPE OF CONSTRUCTION ...........J:FGC /....?l.�(....'!�/... ..........LDS .........19.. 3 11 .1 _45 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........:...Z..Z. ........�`�./,,J.. l/��J-..... . . fv` ....:...................... ................................... Proposed Use ...........� .. 5.....ci..��. ?f.,1`/�.y�............... 1./...y :...,�1,.%. 1.....:.................... � '. ZoningDistrict ........................ . ...................................Fire District ............ ................................................ Name of Owner .�/vv..,l, ,l••. .V a..�l.:......Address .1 �1..1�L�t� `1G°vb,�. ..Z)K ��s�.��o . a� Name of Builder /r /••....5��`/..YJ�jI��.....e�.............Address 1. 1�......l�t�'�l�icr��'�..(`�/��1� a � Name of Architect ..................................................................Address .................................................................................... .Number of Rooms •......;Foundation Exterior .................................... ...........................................i.Roofing ........................................ Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .............................................. ....................... Fireplace ..................................................................................Approximate Cost ..... ....... r.� ............................................... Definitive Plan Approved by Planning Board ___--------_______-----------19_______. Area ................. ................. Diagram of Lot and Building with Dimensions �; �(, //� D a� J �� � / Fee .... ....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all- Rules and Regulation n of Ba s a ing the above construction. / Name .... .................................. G :. ..��.Construction Supervisor's License .......... j PFTERSON, ALAN 25123 Swimming Pool No ...7............. Permit for .................................... Accessory to Dwellinq ............................................................................ 276 Cotuit Bay Drive Location ...................................;........ .................... cotuit ............................................................................... Owner Alan Peterson .................................................................. Type of Construction Frame ............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ......M.ay....2.7...................19 83 ....................................19 Date Completed ............:... cam... . .........19 J .4 J/ Assessor's map and lot number ....... �`.. ....T.. `.'. 6)K, '- %p Sge Permit number �7/ r .................. ............. yoFT"ET°� TOWN OF BARNSTABLE I B49ST"M f"b q BUILDING INSPECTOR �E'p YPY a• - . APPLICATION FOR PERMIT-,TO ......................................� a �:.......................................... ` TYPE OF CONSTRUCTION /,/ v." or—d....../..•......w...................................................................... .....:: .. :./v.................197... TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for /a permit. according to the following information: 4�2.i z1 !� t .✓4......................... �..Location .......... .................................. ...............................�....................`........ , � ........................ ProposedUse .......................... ........................................................................................................................................... ((� '?.� Zoning District ....................................Fire District ............. .` -L?:? � Cfi ti / Cc�o a 0`v�� Address ......��UP� ���;� Name of Owner .............................................r....................... ............................................................ r Name of Builder ..........Address �" ''� /(�/ Name of Architect .,'�/� "� ...........Address ... .... ..... ^ ... P!!.... .......................................... Number of Rooms ..................................................................Foundation Yt� t.. /�%c��P Exterior _....... ............... � ......�..�....................Roofing ....I.............-n�i��a Floors ` " G .Interior �Q ' ��.. ........... .'�J ti Heating ...........................................................Plumbing ^........... ....................................................... Fireplace ........:...�................................:................................Approximate Cost ...........��..�.:.1'.00........................... : Definitive Plan Approved by Planning Board ---------------____------>----19________. Area ....rA. ... '. ..�.::• Diagram of Lot and Building with Dimensions Fee / /� ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..: .... ............ ....... ...... Peterson, Alan A=56-30 18738 one story No ........ Permit for .................................... single family dwelling .................................................................... Location 2-10 Cot�uit Bay Drive ................................................................ Cotuit ............................................................................... A Owner ............... kSh--Reters-on .............. .............................. frame Type of Construction ............ ............................................. ......... 4691 Plot ......................... .. Lot Permit *Granted ...........I.t.a.b6r...1.5...........19 76 Date of Inspection .......:............................19 Date Comple*te-&,........................................19 PERMIT REFUSED ............. . .... .... ...Ir... 19 ............ ...... .... .............0............ ...... ......... ... ..... .... ......... ... ........... ..... ...I. ..... .. ........................ .......................... ........... ....................................................................... Approved .................. . ..... 19 ....................j ...................i ................. ..... �l ......... .............................. : L =96 C LOT �I 9 N O 41) 407 I � m 3a �Se/hock Line �- S 39'-ZG /0` t P_ 320 OD. corU/ r BAY D /? G l hereby certify that the PLOT PL AN Foundation is located as shown LOT 9/ and conforms to the Zoning By Lows of the Town of 01 " COTUIT ' BA.r SHORES " _ s Barnstable. o:'� cRETE �cy��� IN, BOHArr 0 . ' A coru/r, 6ARNSrABLE , MASS. "0 " 1 Scale l = 40 1975 F STik"i GRETE M. BOHANNON R.L.S. o�s �`✓ ___ , --- Bridge --�-ter Mass.;02-379-`�' 1----' _ 1 Assessor's map and lot number . .. ... vj�?... ....... .. .......... THE _ // � OF TCIr • 4rP •. O Sewage Permit number ... ....... r...... ........ ...... d EABBSTADLE. i House number ...............................................s;......................... r a 9 � �p 16}9• 6 �EYAYa\ TOWN OF . BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... 3..< �l ........................................................................................... TYPE OF CONSTRUCTION .......... .,),/f?. fl/7� .. .S..t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby //applies for a permit according to the following information: Location ..........:.... .. Y......... /ti 411.1.11. y✓...v✓„ , ; .`. .....z............................................................. Proposed Use , /. ..`?.!��/ t 9.?�Z..�..� ` ..., ,. ... ,� ZoningDistrict ......................., ......................................Fire District ........... ............................................................. Name of Owner .�.����1 .,�,1O,1 �`'.r-1`.©..T�........Address Name of Builder �!?,a�..�.....` �l..y/.,.!5..��?...... ...........Address9... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .....""'—"�" ..... ........................................:................Foundation .............................................................................. Exterior .................Roofing .....................:........................................... .................................................................................... Floors ......................................................................................Interior ...........................................................>........................ Heating .................................`....................................•.........Plumbing ........:......... . Fireplace ..........................."':''.................................................Approximate Cost ..... ......��'J.�.�...................................... _ i�5-X 3o Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ...... Diagram of Lot and Building with Dimensions �'�,' Fee.. ..... ....... ........................ `SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations �he•Town.of Barest b e rega ing the above construction. _ Name ....�f....... ....... ..y, .n ......:........................ Construction Supervisor's License �.........1.<e.:.,.......;........ r ` �---PETERSO0' AIAN A�=50-30 ' 25123 Swimming Pool . No ................. Permk'for ------------ [� ^~ Access' ---'.----. ................................................. 276 r6tuit Bay Drive � Location ----..-.---------------. ' Cotoit ' --------------------------. . ' Owner, --Alan, Peterson ' ----------------___— ' Frame ' ' Type of Construction .......................................... ' --------..`----------------- ` ' Plot ............................. Lot `_--------- ' ' � ^ ' - D8a�� 27^ 83 � . Permit Granted ... - ]g ' �------------- ` Date of Inspection .................................... ) ` . Date [omplete6 .... .................................. P / ' � - ` . ~ ` ~ � ` . ' ! " � nn / -- err Assessor and lot number ........��`•.....:>•............... SEPTIC SYSTEM -7 EM MUST BE ^' /C INSTALLED IN COMPLIANCE Sewage Permit number ....... ................. WITH ARTICLE II STATE SANITARY CODE AND TOWN °FTIN ET° TOWN OF BARN 'rTfLE Z MARNSTAML i "6 01 BU::ILDING INSPECTOR APPLICATION FOR PERMIT-TO ... TYPE OF CONSTRUCTION •�.�........ ... .�- ....:.........:......:....................................... -�.......'.: ......................9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a perm' according to the followi information: -� ��.� ...... .......................... Location ............. ..�.�..�../../..............................� .....� ..,�......................... Proposed Use ......... ZoningDistrict ........................................................................Fire District .. .-...4. ...................................... (/�C[it .� /� 2,�d �.................Address �� 41J. �:r ..... ct�� Name of Owner .............................J...�..... .............. ..................................... Name of Builder ... � 1 > ' J�.... ...�. ........................Cc.."em ��� - :..`�!�..../ .�........ ....... ..........Address .... ........ ...... Name of Architect ... !� .`..�J...l..! ..1��`(�...............Address ...........................:EE !`.4�.:............................................ Number of Rooms .............. ..................................Foundation (6 't-o...I ."(f) Exterior zve C. "�. ` ....................Roofing qa/ ........................................... Floors C.G. ... ....................................... ..............Interior ..... .. .... � �-�...�..................................�...`................. 17 Heating v .:.. ..' P .../ a..� "..........Plumbing ........... ,.... .�.�..4........:.............................. Fireplace ......Approximate Cost,(. O n... ............................................................................. .....:.......... ..................... .. .... 3o SIP Definitive Plan Approved by Planning Board -----------_______-----------19_______ . Area ....�/....a�.............:..... Diagram of Lot and Building with Dimensions Fee �Iy� SUBJECT TO APPROVAL OF BOARD OF. HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ✓... .........�............................ Peterson, Alan 18738 s tZ7�, No ................. Permit for, ..one................................. pingle family dwelling ...................................................................... Cotuit Bay Drive ation ... .......................................................... Cotuit ............................................................................... Alan Peterson Owner . ................................................................ Type of Construction ...............frame........................... ........................... .................................................... 'Plot ............................ Lot ......#91 .......................... October 15 76 Permit Granted ...... .............................19 Date of Inspection 0�j/�6 .... .T.....19 F Date Completed .................19 PERMIT REFUSED ................................................................ 19 .......................... .................. .................................. Z, ................... ...... ................................................. .......................................................................... ............................................................................ Approved. ............. ......................... ....... 19 ............................................................................... ...................... .................................................... s- C 0 2 h1✓0 0 _ LOT 90 ,� I 40 I \ �30 14 23' "-25- c� ��Se�hcrck L ins �t30 S 39'-Z6 /Z"c 70.DO " gg. 27• - 32o OO COTU/ T` BAY DR V E l hereby certify that the PLOT PL AN Foundation is located as shown LOT 9/ and conforms to the Zoning By Laws of the Town of /OF JW4SS " COTU/T Bi4Y SHORES Barnstable. o:� GRETE s IN BOFiA! no `ff COTU1 T, BARNSTABLE , MASS. `y l Scale l = 40 1975 SU GRETE M. BOHANNON, R.L..S. Rvi West Bridgewater � Mass., .02379.__ _ �__ ! r -RENOVATED RESIDENCE (x� 6 276 CONIT SAY RD _ •.,,� p./ COTUIT MA.02G75 14i_0. 37'-O' 16011, 1 SUM 7'-7' REMOVE WALL AND e SLIDING GLASS DOOR - - j J o I DW I ob O REMOVE BATH MTURES AND EXISTING jill WALL BETWEEN BATH AHD TING W BEDROOM #2 �L � /� 11wnnRr EXISTING AND PREP oPENING FOR . PINING ;/ J BEDROOM #3 NE AWNING wmDow Q KIT IDEA } v_ t C REF i REMOVE DOOR AND i/ /;• WALL TO HALLWAY REMOVE WALL AND O BFOLD DOORS AT OPEN WALL AND PREP IN OPENG FOR NEW AWNING CLOSET WINDOW k ....._.. .....,..Is,......, ._.fi ---- �. ._ i CA9FJJ OPETIINJG s ? r-----------, I EXISTING '" I LIVING ROOM I ` ED CATHEDRAL CEIUr1G I HAEARTTM . UP i ABOVE 9KYLIGNT9 r a I I ;YErI L-----------J f EXISTING E` 2-GAR GARAGE S EXISTING d BEDROOM #1 EXISTING FRONT PORCH y . .. E.. EXISTING FIRST FLOOR PLAN :. SCALE. 114' I'-O' 16'-O' 27'-0' 24'-0° N%T@�o ocloew zmr TITLE:. EXISTING FIRST FLOOR PLAN X1 . 1 • EXISTING FIRST FLOOR PLAN SCNLE:uc•-,a RESIDENCE 275 COTUIT BAY RD V COTUIT MA.02635 1 I '^ P I S S-Uoom . .. REMOVE WALL AMID _ - SLIDING GLASS DOOR .. - r_'__J I pW ---T / 3 Ob �IZEM` ;i AND EXISTING - 5 / LAUHOR BETWEEN BATH TH EAND .REMOVE EXISTING WINDOW . I WALLLOV7 A ... .. AEDROOM' #2 - ... S C -I. I I /_�� _ EXISTING AND PREP OPENING FOR Q .. . " BEDROOM #3 E H7HG W J b NEW AWNING WINDOW KITS EEF REMove DOOR AMID . WALL HALLWAY i REMOV BFOLDED00 R NEW AWNING - .. WALL AMD -OPEN WALL AND PREP _ RS AT :OPEHPIG FOR GI-0SET WINDOW - - l _ CA9ED OPENING. f IScl ———————— I pX�S�'I C� m I �L } Aaove OL CEILING wars CATHEDRAL I ... RAISED CAT . . UP I W/ 2 SKTL EXISTING tB0014ASE3 2-GAR GARAGE EXISTING BEDROOM #1 EXISTING FRONT PORCH 3 ! EXISTING FIRST FLOOR PLAN SCALE, 114' - 1'-O° i .. � .. 6CfyE A6 NOlED 27'-0' .. 24'-0° .. ._ #I nne: EXISTING.RRST FLOOR PLAN I ` I X 1 1 EXISTING FIRST FLOOR.PLAN scALE:v°•e,w y I w. V t 6 � y � 7 1 oZ r t L A Nr . o T U i - W � .