The URL can be used to link to this page

Home My WebLink About0117 STARLIGHT DRIVE i) aw �� r Application number Fee ..�.......15 ... v........................................ KAM Building Inspectors Initials. r. 4 Date Issued.:... .. ... 7................................. Map/Parcel.......1.0 d............... ,J,-3.................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: I V-7 Ayyl zgnr�-�$ hJC-L NUMBER STREET VILLAGE Owner's Name: -A'�vri ROWLA r-O Phone Number_ S-D C/--`/ 7 y Email Address: r2o,").! 7 h.Sri. C o h Cell Phone Number Project cost$ 7 d O Check one Residential _ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building 't in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK ❑ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to- . /,YA Cc,/,oa-S C)1 CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License # (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN . .....+�n.w�.e•rnl�r vo%o I ■AI IrT AM I 8019"TAe21.- A nnne+vA# n¢r_e+nC A nrnAA/T -A At nr_ Ie•r1lre% APPLICATION.NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No - (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes, a gas permit is required. Natural Gas'Yes No , if yes,a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: `Telephone Number - '5�1117-I71i 7 `l Cell or,Work numberl'O -S`7`7-L7L7 7 1j I understand my responsibilities 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 documentation required by 780 CMR and the own of Signaturey _ f Date 27-')d APWCANT9S SIGNATURE Signature Date / -- 7 /) _ All permit applications are subject to a building official's approval prior to issuance. 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 n� Please Print Legibly Name(Business/Organization/Individual): , �t� tGoz„i L A Z Address: 1/-7 S-rAP—L"G 0 r- a-)'L City/State/Zip: /-0 UA6 �-Phone#: Are you an employer?Check the appropriate box: Type of project(required): l.❑ I am a employer with 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. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition workingfor mein an capacity. employees and have workers' y p n'• t 9. ❑Building addition [No workers'comp.insurance comp. insurance. ryquired.1 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.E31I 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 13. ]Other 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: Policy#or Self-ins.Lic.#: Expiration Date-: Job Site Address: // 7 ��f �rT fl� City/State/Zip: ,,,n S-rvk)� QZ(,5 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 der the p ' nd penalties of perjury that the information provided above is true and correct. Si ature: Date: Ne 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-contractor(s)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 bum 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 Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia a 0 vox -- �S$,pARM Town of Barnstable *Permit# - gnlatory ServicesBIASS,( ' z .AN U 6 2016 >�chard v seau,Interim n ree�r OF BARNSTABLE Baftg Division Tom Perry,CBO,Binding Commissioner 200 Main Street,Hyannis;NIA 02601 _ www t n bamstable ma us Office. 508-862-4038 Fax:508 790-6230 ..: EXPRESS PERMIT ArrucAnoN - RESIDENTIAL ONLY Not Vaffd wfhoutRedX-Praslmpdnr M%%parcel Number /0 0 3 3 Property Address TCI��►li/z l i Y milt S To(l s p i ( I S J 93 Residential Va1ne of W -o -rk$ Afmimmn u fee of$35.00 for work under 56000.00 Owner's Name&Address `1 aS 00" l 17 , iLl ar soon S o`1 i d s A Contractor's Name �t'yl'� �OSP ! Aim' Telephone Number-f b1-7/V 4 3 Home Improvement Contract License#(if applicable) IoZ�c �/'.� Email- Construction Supervisor's License#(if applicable) 0 7 00 7 7 Worinaan's Compensation Insurance .Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance CompanyName lit) Workmen's Comp.Policy# 017 7 Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(hurricane named)(stripping old.'shingles) All construction debris wr'll betaken to .4 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) - ❑ Re-side _ �n 21keplacement Wmdows/doors/sliders;.0 Value 3 0 (maximum 35)#ofwind #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand iaspeetions required. Separate Electrical&Fire Permits required. "Whereregdm& L of ftpemmh dges nut exempt compfimmwith othertowu dgwr ,mmr aphfinns,i a Ifmric,Csnxnrat%ere. Note: Props F er 'go Property Owner Letter of Permission. A wpy of H Improvement Contractors License&Construction Supervisors Ucense is required. SIGNATURE: ' T.-\KEVIIJ D\Bwldmg rhmge� RS U= Revised 061313 , i FROM :)amgad FAX NO. :5083622271 Jul. 6 2012 8:04AM P1 HOME XMPROVEMENT CONTRACT PLEASE READ THIS Said,Fbmished and Installed by: Branch Name:New England Date / TIM At-Home Services,Inc. d/bla The Home Depot At-Home Services Branch Number:31 908 Boston.Tumpikes,Unit 1,Shrewsbury,MA 01545 Toll Free 877403-3768 Fcd&-A iD#75-2698460;m1d Tic#C 0243%P1 Cont.U00 i 6427 / CT Uc#HIC 0%5522;MA Roomc�InWmveroent Contractor Reg.#126893 Installation Address: �r �(�Of±t�/"ill--, city State lip Purchascr(n): f Work Phone: Home Phooey cell Pholm bmAAAn I. [ [ Q1�Fly T Home Address:_- (IT different from Installation Address) City State Zip E-mall Address(to receive project communications and home Depot updates): ❑1 AO NOT wish to receive any marketing emails from The Home Depot ProlectbDf rmation: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to buy, and THD Aervices,Inc.("The Home DepoY,)agrees to furnish,deliver and arrange for the installation("Installation")of all materials described on the below and on the referenced Spec Shect(s),all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#: a=,.w rare t w) ors: S s Shee #: Pro' Amount Rooting Siding Windows 0 Insulation C5 gg�j ��i7 ❑ arc rs ❑Guu /CoveEntryDwm El__ /0� `/1p 3 $ T Roofing LISiding 1JWiW6,ws Twulatiun $ ❑Guars/Covers❑Entry Tkxas ❑ Roofing USidQ L1 Windows U Insulation $ ❑Gutters/Covert ❑F,ntry Doors❑ Roofing USiding LJ Windows U Insulation $ ❑Guars/Covers ❑Entry Dorm% ❑ _ Nnimum 25%T)rlxrdt of Caatract Atonal due upon esecatioo of this coutrmt. Total Contract Amount $ Maine Purchasers may not deposit tote tban or third of the Contr to actAuN. Customer agrees that,immediately upon completion or the work for each Product,Customer'will execute a Completion Certificate (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly.and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perfinm it_%obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing errors or because work required to complete the job was not included in the Contract- Payment Summary: The Payment Summary#_/L 33L 0 / , included as part of this Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER Vim are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate•(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The Horne Depot or Authorized Service Provider through the date of termination,pies any other amounts set forth in this Agreement or allowed tender applicable law. THE HOME DEPOT MAY WiTHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DLPOS11' PAYMENT OR OTHER PAYMENTS MADE, Wi MOUT LIMITING THE HOME DEPOT'S CYPHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Attie lance and Authorization: Customer agrc e%and understands that this Agreement is the entire agreement between Customer an e me Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation.This Ag=mcnt cannot be assigned Or amended except by a writing signed by Customer and The Name Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has received a copy of this Agreement. by: Sub by: ?LJ _ '- i!2�_ ) 41Q�iU 5 rustomer's^ a Date Sakes nsultant's Signs p� ate Telephone No. d Customer's Sign, . re Date Sales Consultant license No_ CANC LLATTON: CUSTOMER MAY CANCEL THIS (a4"PPli�ble) AGREEMENT WTTROTIT PENALTY OR OBLIGATiON BY DELIVERiNG WRITTEN NOTICE TO THE ROME DEPOT BY MmNTGRT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPF.CiF CALi.Y PRESCRIBED BY LAW 1N CUSTOMER'S STATE. N(M F-ADDTTTONAT,TERMS AND CONDITIONS ARE STATED ON TIME REvt:RSR SIDE:AND ARE PART OF THiS CONTt;ACT 08-03-15 White-Branch File Yellow-Customer t MassaC1114"is •Oo dMent of Public Safoty Board of Building Rogulatrons and Standards i,ll•(/Us tluD %ttPs 1'1 illrt bean": CS-070077 X)SM1 C DUAR}K "'s 13 RALLST WARENAM MA;W ; , ram.- �r ac IV, Expitation C° sssonar 121�'DQi 1R office or Conte merAffairs OuSIOMWS41011oq •,►,efo"':::�HOME IMPROVEMENT CONTMCrOR Registration: I J12349 Y ; I � Expiration: titlJTp17� Pamorshlp J 3 J Re-modeling r r ti Xx� Jown Cuarte 15 fall St `Wareham,ma 0257t '•'" , All The Commonwealth of Massachuseus " Department of Industrial Accidents Office of Investigations ? ' 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zi :P1 Ofoo ad, 0 Z.3-4 Phone#: 77 76L-2-3 ZS 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 employees(full and/or part-time).* have hired the sub-contractors 6• New construction t 2.I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' `� insurance. 9. ❑ Building addition [No workers comp.insurance comp. required.] ' 5. We are a corporation and its 10.E Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.E Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12,E Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.E Other comp. insurance required.] *Any applicant that checks box#t 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-contactors 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 policy4ind job site information. Insurance Company Name: Policy#or Self ins.Lic.* Expiration Date: Job Site Address: 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 insurance coverage verification. — I do h ereby cerfift,4hder the at and Zen 'es o er u that the in ormadon provided above is true and correct Signature: l Date < <' b Phone#: :Z 77- 744-L 32- Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitlLicense# 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#: The Commonwealth of Massachusetts Department of Industrial Accidents Off'ice of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 ww».massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Busineworganizationandividual): ��-�- p1"t -Hoyy yo �,(U i(•r� Address:__ 0�; S_n�n 1-5,rri::'i e.. City/,State/Zip: EkCaLzShury MAois-!4S: Phone l ( Soa ) cl- 7 - 6,0l Are you an employer?Check the appr prlate bog: Type of project(required): 1.Y I��etn a employer with Ao0 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑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? required.] 5. We area-corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LE]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' 13.8Otth (,y��1d ai•�J comp. insurance required.]. re &Cein ei1. S *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. Lic. #: WC 0 1 7 7.2 Expiration Date:�T ( 0 10 Job Site Address: /L� �'lG!�i�,�i f�/'i d f City/State/Zip:( ��an s /4 0 1 s. M A 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.pf MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one ear imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day the 'olator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA r' ce coverage verification. I do hereby certify un a pai s a d pen of pei jury that the information provided above is true and correct Signature: Date: — — Phone#: SO 8 - Official use only. Do not write-in this area,to be completed by city or town q fficiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Binding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �� / / �2 t�U'�i?/l�Lt�2CG2CGG51'7, /C��l,�/.SC�{i121 2 - dice o� ozs ��eri"sasrand 3usiness Regvlauon 10 Park Plaza - Suite 5170 BOSion, ivjassachuserts 02116 Home haprove-meat.Contactor Registration - Registration: 126893 —- - Type: Supplement Card T HD AT HOME SERVICES, INC. - _ - Expiration: 813/2016 ANDREW SWEET - 2690 CUMBERLAND PARKWAY SUITE=300- A TLANTA, GA 30339 - - - UpdateAddress and return card.illarit reason for change- 5C�t w zoM osn1 .Address i_) Renewal a Employment host Card _Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ��}' HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation =`��"Registration:-126893 Type: 10 Park Plaza-Suite 5170 Expiration:�:8/3l2016 Supplement Gard Boston,MA 02116 THD AT HOME SERVICES,INC. THE HOME DEPOT AT HOME SERVICES ANDREW SWEET /J 2690 CUMBERLAND PARKWAY S GA 30339 Undersecretary No With t signature ACC CERTIFICATE OF LIABILITY INSURANCE d7A5not( 5 ilb � 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(Jes)must be endorsed. if SUBROGATION IS WANED,subject to the terns 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). NCT PRODUCER � MARSH USA,INC. PEE TWO ALLIANCE CENTER RO 3560 LENOX ROAD.SUITE 2400 DAo ATLANTA,GA 30326 INSURER(S)AFFORDING COVERAGE Nate_ . 100W HomeD.GAW-15-16 INSURER A:StI1 Aad Ifs UMM Cww"y 26397 INSURED INSURER B:Zfaich Ameriam lmwm a Co 16535 TKD-AT-HOME SERVICES,INC. DBA THE HOME DEPOT AT-HOME SERVICES INSURER C:Newer Ins CO 1 2690 CUMBERLAND PARKWAY,SUITE 300 ixiSURrzil D:i Md5 NdOIW b6Mr=Company 23817 ATLANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL403746646.13 REVISION NUMBER:8 THIS IS TO CERTIFY THAT THE 12OLIOES 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. UK TL R TYPE OF INSURANCE POLICY NU1fA8ER I POLICY EFF POLICY LMM A X GOMMERcIAL GENERAL LIABILITY O4887714.05 - 031D12m5 03tD1r"6 EACH OCCURRENCE S 9.MOADD i3E-To PANTED CLAIMS-MADE F1 OCCUR PREMSESIEaomuleneel S 1,000,000 I LIMITS OF POLICY XS MED EXP(AIry one person) S EXCLUDED ! DI'SIR:Slid PER OCC 9.M0.� Il PERSONALaAWINJURY S GEN L AGGREGATE LIMIT'APPLIES PER: j GENERAL AGGREGATE S 9•�•� X �PRO- POLICY ❑LOG i PRODUCTS-COMPIOP AGG S 9.000,000 S OTHER:: i ; 8 AUMMOBILE LIABMJ Y IBAP 293SM12 I03I01R615 03i0IM16 a MBINED sou LIMIT' s 1,001,000 X ANYAUTO 4 BODfLYMWRYIPerpmson) S ALLouvNED SCHEDULED !SELF INSURED AUTO PHY DMG BODILY INruRY(Peracddent) S AUTOS NON-OWN® PROPERTY DAMAGE S, HIRED AUTOS AUTOS S UMBRELLA UAB HOCcUR I EACH OCCURRENCE S EXCESS UAS CLAIM§MADE AGGREGATE $ DED RETENTIONS S C WORKERS compem-noN 03J M493(AOS) MrMS 03IM12016- X STATUTE I I SIPH" AND EMPLOYERS'LUIBILITY C ANY PROPRIETORIPAJrrrE Y 1 N 7731495(AK,KY,PU1.NJ,VT) 03101/LO15 031012016 EL EACH ACCiDHJT s 1,OE,OOD 0 OFFICERfl JE,T ER L7XCLUD®? N I A (Mandatory in NH) 7731494(FL) 031Ml�15 03iO1R016 EL DISEASE-EA t31PRA S 1,000.000 Byyes destt8leunder 80OnAdN90ird1 1,000,000 DESCRIPTION OF OPERATIONS below EL S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarlm Schedule,may km tdiached U mvfa space Is mquhum EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION THD AT-HOME SERVICES,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCHlED BEFORE DBA THE HOME DEPOT AT-HOME SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN 2455 PACES FERRY ROAD ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 3MM AUTHORIZED REPRESE9TAMVE j of 11 amh USA inc. M nashi Mukhe*e _T*AI4%"h0*" ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014M) The ACORD name and logo are registered marks of ACORD f Town of Barnstable "'E' Regulatory Services Or BARNSTABLE Richard V. Scali,Director aw MAS&i.e� Building Division. ? s63q. ♦0 i01F0 �{a Tom Perry,Building'Commissioner 200 Main Street, Hyannis,MA 02601 '".•.,a,�,,,,,,m,a,.ter. www.town.barnstable.ma.us � V I S I( ;` L Office: 508-862-4038 Fax: 508-790-6230 PERMIT# w ISD FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less i farl, Location of shed(addrers) Village OO 30 JCcSW I:ocQIart d 1�av&Sa 4.evv d Property owner's name Telephone number Size of Shed Map/Parcel# . 7 S� Signature Date Hyannis Main Street Waterfront Historic District? 1 V . Old King's Highway Historic District Commission jurisdiction? 0 You must file with Old King's Highway Conservation Commission(signature is required) Sign-off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIER BY A PLOT PLAN Q-forms-shedreg REV:040914 Town of Barnstable Geographic Information System July 24,2015 100035 100030, #91 \_100022001 #85 #76 100031001 i 100049 #75 #99 100034 V021 #105 968 ' V Q 100031002 �Q #67- 100050 100033 #112 #117 100032 05 099Q54 099052 #53 #131 099050 #124 0 ° °Feet . DISCLAIMERS:This map Is for planning purposes only. It Is not adequate for legal Map:100 Parcel:033 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:ROWLAND,JASON&LEONARD, Total Assessed Value:$273000 Selected Parcel 1'=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessors tax parcels. They are not We property Co-owner: Acreage:0.47 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:117 STARLIGHT DRIVE /J such as building locations. Buffer c COMPLETE • • • • • ■ Complete items 1,2,and 3. A Si atu e ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. Addressee ■ Attach this card to the back of the mailpiece, B• Received by(P 1 ted Name) Date of Delivery or on the front if space permits. ,_ G. .l�+j 1. Article Addressed to: Is elivery address different from item 17 ❑Yes If YES,enter delivery address below: ❑No (t.CfiY� I'll I I IIIIII IIII I'I I I I I II IIIII II IIII'I i I II II I I III 3. Service Type ❑Priority Mail Express® ❑Adult Signature ❑Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9403 0232 5146 5386 71 ified Mail® Delivery ❑Certified Mail Restricted DeliveryRetum Recelpt for ❑Collect on Delivery Merchandise —�—n.r��o-N„+,►+o./Transfer from_service-/ab�l) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation^^ ' i t �"` ed Mal i ❑Signature Confirtnatlon 7 01�4 ],2 0 D �0 0301 0 3'S 8 2'S{5 4� Q44C Mail Restricted Delivery Restricted Delivery f "I$50o PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt l/ UNITED STATES At•� First-Class Mail « Postage&Fees Paid USPS S .. ' Permit No.G-10 • Sender: Please print�Qyl_ gng,?WAea gg P+®In this box• UBUILDING DIVISION 200 MAIN ST. HYANNIS, MA 02601 04 USPS TRACKING# - 'rl �lr •r 1 'ir i � 'fil'!�1'�'irlllii"liii - - 9590 94�3 0232 5146 5386 71 ;I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 106 Parcel 033 Application # J Health Division Date Issued Conservation Division Application Fee CJ Planning Dept. Permit Fee Le ✓ Date Definitive Plan Approved by Planning Board Historic - OKH �� _ Preservation/ Hyannis R� Project Street Address /17 6�'2r/Qk/ Or: Village /,Gt/:5kr7S /2.,//5 OwneriQc.01 eo_wla/ Address �/7 S7[i?r11 IFI Dr- Telephone_S_O_$-_Qyy- 1/97� Permit Request //75 SO Qr e%c?17?c a17els o 00 0 house � i��ira�� flarr� c/ec�ncn� suss Square feet: 1 st floor: existing proposed 2nd floor: existing — proposed — Total new— Zoning District /ff Flood Plain Groundwater Overlay Project Valuation O4O Construction Type a1�t�net Lot Size — Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0< Two Family ❑ Multi-Family (# units) Age of Existing Structure y/yi"5• Historic House: ❑Yes d'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 Number of Bedrooms: existing _new _ Total Room Count (not including baths): existing — new �— First Floor Room Count Heat Type and Fuel: ❑ Gwr1P*0'0il ❑ Electric ❑ Other Central Air: ❑Yes 0 NaAh Fireplaces: Existing — New Existing wood/coal stove: Ll" 0 No Detached garage: ❑ exist4mgtAb new size_Pool: 0 existing ❑ new size _ Barn: ❑ existing LLAevANiz6-__ Attached garage: ❑ existip^ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use IY5lD&.410A. Proposed Use/10 Chi APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Crat C 0lar � Mall Telephone Number 71L 874- 7Y8'9 Address /6 O Care Parr. nrtre OA.YO License# CS 10764 3 &Cb/bPc. 0a35'1 Home Improvement Contractor# /(8'S'7o1. Worker's Compensation # "76wda ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Q w/�1,0.1�T[ SIGNATURESATE G Lo } FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP%PARCEL NO. r ADDRESS VILLAGE x OWNER DATE OF INSPECTION: ` +4—0UNDATzION�uR +;:x ��^tk� ,�v� a r<ua• FRAME - •;,�INSULATLQN,j��j:., �;�:- . r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL K' GAS: ROUGH FINAL .S FINAL BUILDING— DATE CLOSED OUT " ASSOCIATION PLAN NO. ' i y The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street, Suite 100 v Boston,MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): SolarCity Corporation Address:3055 Clearview Way City/State/Zip:San Mateo, CA 94402 Phone#:888-765-2489 Are you an employer?Check the appropriate box: Type of project(required): 1.M I am a employer with 7000 4. ❑ I am a general contractor and I s have hired the sub-contractors 6. ❑New construction employees (full and/or part-time). � 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• t 9. ❑Building addition [No workers' comp.insurance comp. insurance. required] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑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 13 ®Other Solar Panels 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:Liberty Mutual Insurance Company l Policy#or Self-ins.Lic. #:WA7-66D-066265-024 Expiration Date:09/01/2015 Job Site Address: l/-7 City/State/Zip:M,?1 td/IS M-k 1 I y� 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 under the pains and penalties of perjury that the information provided above is true and correct Sign iZJ'M•«ems Date: /4 LIZZO/y Phone#: 7818167489 Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermittUcense# 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 M, I ' � �`�L CERTIFICATE OF LIABILITY INSURANCE °0800"°°"""°oe12sI2014 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(iss)must be endorsed If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A el; ment on Oft certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: MARSH RISK&INSURANCE SERVICES PHONE FAX 345 CAUFOMIA STREET,SUITE I WO E,a No: CALIFORNIA LICENSE NO.0437153 E-MAIL ADDRESS: SAN FRANCISCO,CA 94104 INSU S AFFORDING COVERAGE NAIC0 . 998301-MD-GAWUE-14-15 INSURER A:Liberty Mutual Fre Irslxanoe CmWy 16586 INSURED Ph(650)963-5100 INSURER B,Liberty InSUlancelpo Coratloii 42404 SelarCityCorpomffon INSURERC:NIA NIA 3055 Cle2Mew Way INSURER D: San Mateo,CA 94402 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: SEA4W440269-M REVISION NUMBER:4 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. UI R TYPE OF INSURANCE DL SU wrin POLICY NUMBER M POLICY EFF POLICY ExP Lam A GENERAL LIABILITY TB2-661-066265.014 09101014 0901=5 EACH OCCURRENCE g 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES awaranae $ 100,000 CLAIMSMADE a OCCUR MED D(P(Any One penal) $ 10,000 PERSONAL&ADV INJURY $ 1,000,00D GENERAL AGGREGATE $ 2,000,000 GEN`L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2.000,000 X I POLICY X PRa LOC Deductible $ 25'000 A AUTOMOBILELMBILm AS2-6l-M65-044 09MrM4 0910V1(Ti5 t'o�MBI SINGLE LIMIT 1,000,000 1 ---- .- X ANYAUTO BODILY INJURY(Per person) $ ALL OVM ED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NONOWNED PROPERTY DAMAGE $ X HIRED X AUTOS X Phys.carnage COMPICOLL DED: $ $1,000/$1,000 UMBRELLA LIAB OCCUR EACHOCCURRENCE $ EXCESS LU1B HCLAIMS-MADE AGGREGATE i DM I I RETENTION$ $ B WORKERS COMPENSATION WA7-66DM265-02 09 12014 09101I2015 =STATU OTH- AND EMPLOYERS'LIABILITY g YIN WC7-66I-M265034 101Y1015 11000,000 ANY PROPIBETORIPARTNFJI/DECUIIVE i �) 09101=4 09 EL EACH ACCIDENT $ B OFFICER/MEMBFJI IXCLUDFA4 Q NIA l WC DEDUCTIBLE:$350,000 1,000,000 (Mandatory In NnI III EL DISEASE-EA EMPLOYEE i It yyes dasrse under 1,000,000 DESCRIPTIONb He OF OPERATIONS babes E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SolarCdy Corporatim SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3055 Clealview Wall THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo,CA 94402 ACCORDANCE WITH THE POLICY PROVISIONS. i AUTHORQED REPRF_SEHTATM of Marsh Risk&insurance Services ChalleSMarmotoo 019811-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Version#39.5 110,15olarCit y �tH of� 3055 Clearview Way, San Mateo, CA 94402 �'� (888)-SOL-CITY (765-2489) 1 www.solarcity.com O Y K IN K � October 27, 2014 VI y No.4 Project/Job#026585 RE: CERTIFICATION LETTER AL Project: Rowland Residence Digitally SI oo Jin Kim 117 Starlight Dr Marstons Mills, MA 02648 Date: 2014.10.27 12:59:30 To Whom It May Concern, -07'00' A jobsite survey of the existing framing system was performed by a site survey team from SolarCity. Structural review was based on site observations and the design criteria listed below: Design Criteria: -Applicable Codes = MA Res.Code,8th Edition,ASCE 7-05,and 2005 NDS - Risk Category = II -Wind Speed = 110 mph, Exposure Category C -Ground Snow Load = 30 psf -MPI: Roof DL=7.5 psf, Roof LL/SL= 21 psf(Non-PV Areas), Roof LL/SL= 12.9 psf(PV Areas) Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.19625 < 0.4g and Seismic Design Category(SDC) = B < D On the above referenced project,the components of the structural roof framing impacted by the installation of the PV assembly have been reviewed. After this review it has been determined that the existing structure is adequate to withstand the applicable roof dead load,PV assembly load,and live/snow loads indicated in the design criteria above. I certify that the structural roof framing and the new attachments that directly support the gravity loading and wind uplift loading from PV modules have been reviewed and determined to meet or exceed structural strength requirements of the MA Res.Code,8th Edition. Please contact me with any questions or concerns regarding this project. Sincerely, Yoo]in Kim, P.E. Professional Engineer Main: 888.765.2489,x5743 email: ykim@solarcity.com 3055 Clearview Way San Mateo,CA 94402 T(650)638-1028 (888)SOL-CITY F(650)638-1029 solarcity.com 10.27.2014 SleekMountTM PV System Version#39.5 ��;;SolarC•�t . . �, y Structural Design Software PROJECT INFORMATION &TABLE OF CONTENTS Project Name__Rowland,Residence AHJ: Barnstable Job Number: 026585 Building Code: MA Res. Code, 8th Edition Customer Name_. Rowland,Jason BaBased On: IRC 2009,/IBC 2009- Address: 117 Starlight Dr ASCE Code: ASCE 7-05 City/State: —Marstons.Mill_s, MA Risk Category; II Zip Code 02648 Upgrades Req'd? No Latitude_/_Longitude: 41.659214 _ -70.403298_ =Stamp.Req'd?? Yes SC Office: South Shore PV De__signer: Dimas-Daniel Urbieta Calculations: Ran Atwell EOR: Yoo Jin Kim P.E. Certification Letter, 1 Project Information, Table Of Contents, &Vicinity Map 2 Structure Analysis (Loading Summary and Member Check) 3 Hardware Design (PV System Assembly) 4 Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.19625 < 0.4g and Seismic Design Category(SDQ = B < D I 1/2-MILE VICINITY MAP 1 1: alu'dZe, 6hssGIS, Com�nlbnwealth of Massachusetts EOEA, USDA Farm Service Agency L I w 4 ev • 117 Starlight Dr, Marstons Mills, MA 02648 Latitude:41.659214, Longitude: -70.403298,Exposure Category:C i [LOAD ITEMIZATION - MP1 PV System Load PV Module Weight(psf) 2.5 psf Hardware Assembl Weight s 0.5 psf PV System Weight s 3.0 Psf Roof Dead Load Material Load Roof Category Description MP1 Roofing Type_` - �_ Comp Roof ( 1 Layers)� 2.5_psf Re-Roof to 1 Layer of Comp? No _ Underlayment_ - Roofing Paper 0.5,psf Plywood Sheathing _ T ^- Yes 1.5 psf _ Board_Sheathing. _ _ _None Rafter Size and Spacing 2 x 6 @ 16 in. O.C. 1.7 psf _ Vaulted Ceiling No_ Miscellaneous Miscellaneous Items 1.3 psf Total Roof Dead Load 7.5 psf MPi 7.5 sf Reduced Roof LL Non-PV Areas Value ASCE 7-05 Roof Live Load _ _ LO 20.0 psf __ Table 4-1 Member Tribu_tary_Area_ - `At~_ < 200 sf Roof Slope _ _ 7/12 Tributary.Area Reduction — Rt 1 Section 4.9 Sloped Roof Reduction R2 0.85 Section 4.9— Reduced Roof Live Load Lr 4= L.(Rt)(112) Equation 4-2 Reduced Roof Live Load Lr 17 psf(MP1) 17.0 psf Reduced Ground/Roof Live/Snow Loads Code Ground Snow Load p9 30.0 psf ASCE Table 7-1 Snow Load Reductions Allowed? Yes Effective Roof Slope 300 I Horiz.,Distance.from Eve,to,Ridge i W 15.6_ft I Snow Importance Factor IS 1.0 Table 1.5-2 Snow Exposure Factor Ce Partially Exposed Table 7-2 1.0 Snow Thermal Factor Ct All structures except as indicated otherwise Table 7-3 _ 1.0 Minimum Flat Roof Snow Load(w/� Pf-min 21.0 psf 7.3.4&7.10 Rain-on-Snow,Surcharge) Flat Roof Snow Load Pf pf= 0.7(Ce)(Ct)(I) pg; pf>_ pf-min Eq: 7.3-1 21.0 psf 70% ASCE Design Sloped Roof Snow Load Over Surrounding Roof Surface Condition of Surrounding All Other Surfaces Roof fOOf 1.0 Figure 7-2 Design Roof Snow Load Over PS-.�f= (�-.f)Pf ASCE Eq:7.4-1 SurroundingRoof PS-.00f 21.0 psf 70% ASCE Design Sloped Roof Snow Load Over PV Modules Surface Condition of PV Modules C " Unobstructed Slippery Surfaces S_° 0.6 Figure 7-2 Design Snow Load Over PV P.- "= (4- ")Pf ASCE Eq:7.4-1 Modules PS P" 1 13.0 psf 43% COMPANY PROJECT 'y Woodworks® SOFMARF FOR WOOD nrsicN Oct. 27, 2014 10:24 MP1.wwb Design Check Calculation Sheet WoodWorks Sizes 10.1 Loads: Load Type Distribution Pat- Location [ft] Magnitude Unit tern Start End Start End DL Dead Full Area No 7.50 (16.0) * psf PV-DL Dead Full Area No 3 .00 (16.0) * psf SL Snow Full Area Yes 21.00 (16.0).* psf *Tributary Width (in) Maximum Reactions (Ibs), Bearing Capacities (Ibs) and Bearing Lengths (in) : 0' 1'-8" 13'-5" Unfactored: Dead 124 94 Snow 214 164 Factored: Total 337 258 Bearing: F'theta 518 518 Capacity Joist 680 389 Supports 586 586 Anal/Des Joist 0.50 0.66 Support 0.58 0.44 Load comb #2 #4- Length 0.50* 0.50* Min req'd. 0.50* 0.50* Cb 1.75 1.00 Cb min 1.75 1.00 Cb support 1.25 1.25 Fcp sup 625 625 *Minimum bearing length setting used: 1/2"for end supports and 1/2"for interior supports MP1 Lumber-soft, S-P-F, No.1/No.2, 2x6 (1-1/2"x5-1/2") Supports: All-Timber-soft Beam, D.Fir-L No.2 .Roof joist spaced at 16.0"c/c; Total length: 15'-9.9"; Pitch: 7/12; Lateral support: top=full, bottom=at supports; Repetitive factor: applied where permitted (refer to online help); J WoodWorks® Slzer SOFTWARE FOR WOOD DESIGN MP1.wwb WoodWorks®Sizer 10.1 Page 2 Analysis vs. Allowable Stress (psi) and Deflection (in) using NDS 2012 : Criterion Anal sis Value Design Value Analysis/Design Shear fv = 39 Fv' = 155 fv/Fv' = 0.25 Bending(+) fb = 1178 Fb' = 1504 fb/Fb' = 0.78 Bending(-) fb = 97 Fb' = 922 fb/Fb' = 0.11 Live Defl'n 0.54 = L/302 0.91 = L/180 0.59 Total Defl'n 1.00 = L/163 1.36 = L/120 0.73 Additional Data: FACTORS: F/E(psi)CD CM Ct CL CF Cf.0 Cr Cfrt Ci Cn LC# Fv' 135 1.15 1.00 1.00 - - - - 1.00 1.00 1.00 2 Fb'+ 875 1.15 1.00 1.00 1.000 1.300 1.00 1.15 1.00 1.00 - 4 Fb' - 875 1.15 1.00 1.00 0.613 1.300 1.00 1.15 1.00 1.00 - 2 Fcp' 425 - 1.00 1.00 - - - - 1.00 1.00 - - E' 1.4 million 1.00 1.00 - - - - 1.00 1.00 4 Emin' 0.51 million 1.00 1.00 - - - - 1.00 1.00 - 4 CRITICAL LOAD COMBINATIONS: Shear : LC #2 = D+S, V = 229, V design = 213 lbs Bending(+) : LC #4 = D+S (pattern: sS) , M = ' 742 lbs-ft Bending(-) : LC #2 = D+S, M = 61 lbs-ft Deflection: LC #4 = (live) LC #4 = (total) D=dead L=live S=snow W=wind I=impact Lr=roof live Lc=concentrated E=earthquake All LC's are listed in the Analysis output Load Patterns: s=S/2, X=L+S or L+Lr, _=no pattern load in this span Load combinations: ASCE 7-10 / IBC 2012 CALCULATIONS: Deflection: EI = 29e06 lb-in2 "Live" deflection = Deflection from all non-dead loads (live, wind, snow...) Total Deflection = 1.50 (Dead Load Deflection) + Live Load Deflection. Bearing: Allowable bearing at an angle F'theta calculated for each support as per NDS 3.10.3 Design Notes: 1. Wood Works analysis and design are in accordance with the ICC International Building Code (IBC 2012),the National Design Specification (NDS 2012), and NDS Design Supplement. 2. Please verify that the default deflection limits are appropriate for your application. 3. Continuous or Cantilevered Beams: NDS Clause 4.2.5.5 requires that normal grading provisions be extended to the middle 2/3 of 2 span beams and to the full length of cantilevers and other spans. 4. Sawn lumber bending members shall be laterally supported according to the provisions of NDS Clause 4.4.1. 5. SLOPED BEAMS: level bearing is required for all sloped beams. 6. FIRE RATING: Joists, wall studs, and multi-ply members are not rated for fire endurance. 7. The critical deflection value has been determined using maximum back-span deflection. Cantilever deflections do not govern design. [CALCULATION_OF DMGNVINV ADS - MP1 Mounting Plane Information Roofing Material Comp Roof PV-System Type SolarCity SleekMountTM Spanning Vents No Standoff Attachment Hardware Como Mount TypeQ Roof Slope 300 Rafter Spacing 16"O.C. Framing Type Direction Y-Y Rafters. Purlin Spacing _X-X Purlins Only_ ! NA Tile Reveal Tile Roofs Only NA Tile Attachment System Tile_Roofsnly_ NA Standin Seam Spacing � O SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind Design,Method Partially/Fully.Enclosed Method Basic Wind Speed V 110 mph Fig. 6-1 Exposure Category' C —Section.6.5.6.3_ Roof Style Gable/Hip Roof Fig.6-11B/C/D-14_A/_B Mean Roof Height h 15 ft I Section 6.2 Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.85 Table 6-3 Topographic Factor Krt 1.00 _Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Importance Factor I 1.0 Table 6-1 Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(V^2)(I) Equation 6-15 22.4 psf Wind Pressure Ext. Pressure Coefficient U GC -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient Down GC 0.88 Fig.6-11B/C/D-14A/B Design Wind Pressure p p =qh(GC ) Equation 6-22 Wind Pressure U -21.3 psf Wind Pressure Down 19.6 psf ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable,Cantilever lLandscape� 24" NA Standoff Confi uration Landscape Staggered Max-Standoff Tributary.Area Trib 17 sf PV Assembly Dead Load W-PV 3 psf Net Wi-nd,Uplift at Standoff T-actual -339_lbs Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand Ca aci DCR 67.8% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48" 1 64" Max Allowable Cantilever Portrait 19" NA Co Standoff nfi_uration Portrait Staggered Max Standoff Tributary,Area Trib 21 sf PV Assembly Dead Load W-PV 3 psf Net.Wind Uplift at Standoff Tactual_ -424 Ibs Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand/Capacity DCR 84.8% DocuSign Envelope ID:A3E42C43-2AF3-4862-8192-CB15F8C63C53 ` i ,;SolarCity. Power Purchase Agreement Here are the key terms of your SolarCity Power Purchase Agreement Date: 10/15/2014 0 11500 2 0 years System installation cost Electricity rate per kWh Agreement term Our Promises to You • We insure, maintain,and repair the System(including the inverter)at no additional cost to you,as specked in the agreement. • We provide 240 web-enabled monitoring at no additional cost to you,as specked in the agreement. • We warranty your roof against leaks and restore your roof at the end of the agreement,as specked in the agreement. • The rate you pay for electricity,exclusive of taxes,will never increase by more than 2.90%per year. • The pricing in this PPA is valid for 30 days after 10/1512014. • We are confident that we deliver excellent value and customer service.As a result, you are free to cancel anytime at no charge prior to construction on your home. Estimated First Year Production 6,256 kWh Customer's Name & Service Address Exactly as it appears on.the utility bill Customer Name and Address Customer Name Installation Location Jason Rowland 117 Starlight Dr 117 Starlight Dr Marstons Mills, MA 02648 Marstons Mills, MA 02648 Options for System purchase and transfer: Options at the end of the 20 year term: • If you move,you may transfer this agreement to the purchaser of your • SolarCity will remove the System at no cost to you. Home,as specified in the agreement. • You can upgrade to a new System with the latest solar • At certain times,as specified in the agreement,you may purchase the technology under a new contract. System. • You may purchase the System from SolarCity for its fair • These options apply during the 20 year term of our agreement and not market value as specified in the agreement. beyond that term. • You may renew this agreement for up to ten(10)years in two(2)five(5)year increments. 3055 CLEARVIEW WAY, SAN MATEO, CA 94402 888.SOL.CITY 1888.765.2489 I SOLARCITY.COM MA HIC 168572/EL-1136MR Document Generated on 10/15/2014 �■ IR 335737 iv DocuSign Envelope ID:A3E42C43-2AF3-4862-8192-CB15F8C63C53 22. NOTICE OF RIGHT TO CANCEL. I have read this Power Purchase Agreement and the Exhibits in their YOU MAY CANCEL THIS CONTRACT AT ANY TIME PRIOR TO entirety and I acknowledge that I have received a complete copy of this MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE, Power Purchase Agreement. YOU SIGN THIS CONTRACT. SEE EXHIBIT 1,THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN Customer's Name:Jason Rowland EXPLANATION OF THIS-RIGHT. Docuftned by: 23.ADDITIONAL RIGHTS TO CANCEL. Signature: E 0 EDORMD385=425.. IN ADDITION TO ANY RIGHTS YOU MAY HAVE TO CANCEL THIS PPA UNDER SECTION 22,YOU MAY ALSO CANCEL Date: 10/15%2014 THIS PPA AT NO COST AT ANY TIME PRIOR TO COMMENCEMENT OF CONSTRUCTION ON YOUR HOME. 24. Pricing The pricing in this PPA is valid for 30 days after 10/15/2014. If you Customer's Name: don't sign.this PPA and return it to us on or prior to 30 days after 10/15/2014,SolarCity reserves the right to reject this PPA unless Signature: you agree to our then current pricing. Date: 0.SolarCity.. Power Purchase Agreement SOLARCITY APPROVED Signature: LYNDON RIVE, CEO (PPA) Power Purchase Agreement ��'SatarCltjt. Date: 10/15/2014 Solar Power Purchase Agreement version 8.1.1 335737 16%—KWM �Y Nm =' SolarCity. OWNER AUTHORIZATION Job#: Property Address: N 7 5 l k L LG 5 CDN Af 10-5� lv,4 0 Z 6Cgg 'sM L, O�� I as Owner of the subject property hereby authorize SOLARCITY CORPORATION to act on my behalf, in all matters relative to work authorized by this building permit application. Signature o Owner: Date: i SOLARCITY.COM AZRDC 243771+RCC e4S450rRC¢2/408,CA l Cult 4,GD Ef a3 W t-LT K COf<Ll7E;E y 012SSII5,CC 931t0142GECG902 85,t11 Cf-t9770,H A lift:t60S7Z V.A E-1lSEMR C D MH'. M34d NJ NIHICN15VH0EfEA'DO/34E86173e'-700,CRC®t90i38:CW-fPE1 tf2.PA H'CPA0T7040,TX TECL27008,6eASC1.ARC-919011SCLARC-90fiP.0 2014 EC LARM CCRPCRAT04.ALL R:6H7E RESERVED. i Office of Consumer Affairs and Business Regulation j 1 Y 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card SOLARCITY CORPORATION Expiration: 3/8/2015 CRAIG ELLS --� ---� -- 24 ST_ MARTIN STREET BLD 2 UNIT 11 - --- MARLBOROUGH, MA 01752 Update Address and return card.Mark reason for change. SCA 1 a nx.+-os,I Address ❑ Renewal F] Employment LI Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ?. Registration: 168572 TYpr, 10 Park Plaza-Suite 5170 a+ Expiration. 3/8/2015 Supplement :ard Boston,MA 02116 SOLARCITY CORPORATION CRAIG ELLS 24 ST MARTIN STREET BLD 2UNI WLBOROUGH,MA 01752 Undersecretary Not v lid without signature t Massachusetts -Department of Pjbiic Sa(etq Board of Building Regulations and Standards I tintr�ur�un Suht*r+11nr ,cense CS407663 ELLS 206 BA 20b BAKER STREET .. Keene NH 03431 08/29/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card. SOLAR CITY CORPORATION Expiration: 3/8/2015 WAYNE EUBANK 24 ST. MARTIN-STREET BLD 2 UNIT 11 MARLBOROUGH, MA 01752 Update Address and return card.Mark reason for change.. SCA r G 20rn-0511 i E] Address ❑ Renewal Fj Employment Lost Card �✓//ic�oiirrrrrirrccti�/�a�C:-l�i.;�rrr•�i%:r//i -9�-_NQlrce of Consumer Affairs&Business Regulation License or registration valid for individul use only "� ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 5 Office of Consumer Affairs and.Business Regulation z uRegistration: 168572 Type: 10 Park Plaza-Suite 5170 Expiration: 3/8/2015 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION WAYNE EUBANK 24 ST MARTIN STREET BLD 2UN1 --79��_ ITA0LBOROUGH,MA 01752 Undersecretary Npi valid without signature r I .b (DomesticCERTIFIED MAILTMRECEIPT ti For delivery Informatio C pp !! ' n Ln iv Iv/S ITl Postage $ C3 r / y I Certified Fee f ✓� O 1 // $ostmark;V O Return Receipt Fee c O (Endorsement Required) mere Oi Restricted Delivery Fee O (Endorsement Required) f'�ps O M Total Postage&Fees $ ra Sent To —/ Street,Apt.No.;/ or PO Box No. ................. City,State,ZIP+ PS Form 6 :0i August 2006 See Reverse for Instructions Certified Mail Provides: in A mailing receipt ■ A unique Identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Made or Priority Mail& ■ Certified Mail is notavailable for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a USPSO postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement'Restricted Delivery°. in If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present It when making an Inquiry. PS Form 3800,August 2006(Reverse)PSN 7530.02-000.9047 Parcel Detail Page 1 of 4 G_1 i V (/ . S.IRAVASS.. v CJJ! •v A . - wit+ ^:- y�po 1639. .moo t 'i �� //��y �.,�,�(`�jy� ��,,��/!/j� -._ -- -- -..# `� ww► ,pED MTV a. !__•��G!/!/%fiFJlfCiU{��1�� {,^..�-,..//��x��.� Logged In As: Parcel Detail Tuesday,July 21 2015 Parcel Lookup Parcel Info Parcel ID 100-033 I Develol_ot LOT 47 L Location 1117 STARLIGHT DRIVE I Pri Frontage 1130 Sec Road I Sec Frontage Village IMARSTONS MILLS I Fire District C-O-MM Town sewer exists at this address No I Road Index 1529 Asbuilt Septic Scan: Interactive 100033 1 Map -=��1 Owner Info Owner I ROWLAND,JASON & LEONARD,VANESSA A I Co-owner Streets 1117 STARLIGHT DRIVE I Street2 I City IMARSTONS MILLS I State MA I zip 102648 Country F • Land Info Acres 10.47 use ISingle Fam MDL-01 I zoning RF I Nghbd 0105 J Topography I Level I Road I Paved Utilities I Septic,Gas,Public Water ( Location Construction Info Building 1 of 1 Year 11973 I Roof Gable/Hip ( Wood Shingle Built Struct Wallall Living 1750 I Roof Asph/F GIs/Cmp I AC None Area cover Type Style Ranch I Int Drywall I Bed 3 Bedrooms I' ba.� a s Wall Rooms — Model Residential I Ior Hardwood ( Bath Floor 1 Full-1 Half Rooms 9AS ¢Ap Tot B,MT. Grade Average I THeat ype H0t Air I Rooms 6 Rooms d 24 , Stories 11 Story I Heat Gas I Found Fuel ation Typical Gross 3654 Area Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=5532 7/21/2015 r - Parcel Detail Page 2 of 4 Issue Date Purpose Permit# Amount Insp Date Comments INSTALL SOLAR ELECTRIC 11/17/2014 Solar PV System 201407663 $15,000 PANELS ON ROOF(24) PANELS 6.12 KW 1/24/2012 Insulation 201200254 $2,000 AIR SEAL-INSULATE 11/24/2009 New Windows 200905791 $1,526 REPL UV.35 12/1/1986 Addition B30262 $46,000 1/15/1988 MM ADD'N 12:00:00 AM 8/1/1973 Dwelling B16403 $0 6/15/1974 MM 1 STOR 12:00:00 AM - Visit History Date Who Purpose 7/26/2010 12:00:00 AM Denise Radley Change of Address 1/16/2009 12:00:00 AM Denise Radley In Office Review 6/13/2006 12:00:00 AM Paul Talbot Meas/Est 1/5/1999 12:00:00 AM Donna Dacey Meas/Listed-Interior Access 2/15/1988 12:00:00 AM IM Sales History Line Sale Date Owner Book/Page S7$237,5$000 1 10/21/2008 ROWLAND,JASON &LEONARD,VANESSA A C187188 2 10/21/2008 RODERICK, EVA J ESTATE OF C187187 3 6/16/1997 RODERICK, EVA J D697180 $0 4 7/15/1984 RODERICK, DANIEL M&EVA J C97509 $65,000 5 12/19/1973 1 LEVINE, BERNARD I IC60760 $32,750 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2015 $122,300 $38,700 $2,700 $109,300 $273,000 2 2014 $122,300 $38,700 $2,800 $109,300 $273,100 3 2013 $122,300 $38,700 $2,900 $109,300 $273,200 4 2012 $122,300 $37,900 $2,300 $109,300 $271,800 5 2011 $158,500 $3,200 $0 $109,300 $271,000 6 2010 $158,400 $3,200 $0 $109,300 $270,900 7 2009 $154,500 $2,600 $0 $146,300 $303,400 8 2008 $186,100 $2,600 $0 $152,500 $341,200 10 2007 $185,300 $2,600 $0 $152,500 $340,400 11 2006 $174,000 $2,700 $0 $157,900 $334,600 12 2005 $157,000 $2,600 $0 $107,600 $267,200 13 2004 $127,500 $2,600 $0 $107,600 $237,700 14 2003 $114,000 $2,600 $0 $40,600 $157,200 15 2002 $114,000 $2,600 $0 $40,600 $157,200 16 2001 $114,000 $2,600 $0 $40,600 $157,200 17 2000 $89,100 $2,600 $0 $25,800 $117,500 18 1999 $78,800 $2,300 $0 $25,800 $106,900 19 1998 $81,200 $2,300 $0 $25,800 $109,300 20 1997 $90,100 $0 $0 $22,100 $112,200 21 1996 $90,100 $0 $0 $22,100 $112,200 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=5532 7/21/2015 Parcel Detail Page 3 of 4 22 1995 $90,100 $0 $0 $22,100 $112,200 23 1994 $79,800 $0 $0 $29,900 $109,700 24 1993 $79,800 $0 $0 $29,900 $109,700 25 1992 $90,800 $0 $0 $33,200 $124,000 26 1991 $101,200 $0 $0 $40,600 $141,800 27 1990 $101,200 $0 $0 $40,600 $141,800 28 1989 $101,200 $0 $0 $40,600 $141,800 29 1988 $57,000 $0 $0 $12,900 $69,900 30 1987 $57,000 $0 $0 $12,900 $69,900 31 1 1986 1 $57,000 $0 $0 $12.900 1 $69,900 Photos c hi I i http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=5532 7/21/2015 Parcel Detail Page 4 of 4 , +:r Y�r_anc w http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=5532 7/21/2015 Town of Barnstable oF'ME r Regulatory Services do Richard V. Scali, Director s,AB Building Division BARNSTABI,E 0%nx6.ABLE.CBnmNUF.COME•M'4A'IS y Mnsa wrsmz Kius•amxvnu.61s16uwsam[ i639. �� Thomas Perry, CBO 1639.2014 ArED1"°�A Building CommissionerSDg 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 568-862-4038 Fax: 508-790-6230 July 21, 2015 Jason Rowland Vanessa A Leonard Re: 117 Starlight Drive 117 Starlight Drive Marstons Mills, MA Marstons Mills, MA 02648 Map: 100 Parcel: 033 Dear Property Owners, This letter will serve as a notice of violation on your property. A shed was installed on your property without the proper paperwork as required by the Massachusetts State Building Code 780 CMR and/or the Regulations of the Town of Barnstable. Please bring this notice to The Barnstable Building Department office of 200 Main Street, Hyannis, to begin the process to bring your property into compliance within' 14 business days of the receipt of this letter. Failure to comply may lead to fines and additional fees. Sincerely, Robert McKechnie Local Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 robert.mckechnie@town.barnstable.ma.us i S TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ) b Parcel �� Application # Health Division Date Issued Ia'� l Conservation Division Application Fee s o Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board _�► / Historic - OKH _ Preservation/ Hyannis Project Street Address __[177 STPVRL &ffT DR, Village_ / Owner 71-A SW R,0 W L ft2'h Address � l^l STD 12 L L(�rbtT `W! _ Telephone Permit Request a1z `�� 6P, d TLL S P�E f-t 12 5bqt-- $ r' Square feet: 1 st floor: existing _proposed 2nd floor: existing proposed Total new Zoning District ,Flood Plain Groundwater Overlay Project Valuation bDt 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 Number of Bedrooms: existing —new Total Room Count (not including baths): existing _ _new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric Ll 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 0 newer size_ ©, F2 a Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other 7• Zoning Board of Appeals Authorization ❑ Appeal # _ Recorded ❑ :Commercial ❑Yes ❑ No If yes, site plan review# Current Use _ Proposed Use a '`5 ri Go APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Neil 17 /A,C-1 NBZftA' 1 Telephone Number 33�I- 932 -22� Address 9-1 b 9W 13D License # 1 D2_7.1 ATV l7 I-)t G 64 / 4q Home Improvement Contractor Worker's Compensation # to()) 201!S `�1) 1 2b)2- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ( DATE L b 2 1. i. E` a ` FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED MAP/PARCEL NO. �r �7 ADDRESS VILLAGE OWNER DATE OF INSPECTION: ; FOUNDATION J .' FRAME -INSULATION':_:;lit ,. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL—, ROUGH FINAL ;►FLNAL BUILDING _ <' r _DATE,CLOSED OUT k ASSOCIATION PLAN NO f oll OWNER AUTHORIZATION FORM I, ��50 12o tom. A ,\A) (Owner's Name) owner of the property located at (Property Address) (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature lit Date i The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of In vestigations I Congress Street,Suite 100 Boston,MA 02I14-2017 If www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organi=tion/lndividua►): FRONTIER ENERGY SOLUTIONS Address:376 ROUTE 130,SUITE C City/State/Zio :SANDWICH, MA 02563 Phone#:339-832-2823 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓❑ I am a employer with 8 4. ❑ 1 am a general contractor and I employees(full and/or pan-time).' have hired the sub-conmactors 6. ❑ New construction 2.❑ 1 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• 9. ❑Building addition [No workers'comp.insurance comp.insurance.; required.] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.[]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 01 must also fill otn the section below showing their workers'compensation policy infonnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContrutors that check this box must attached an additional sheet showing the name of the subcontmetors and state whether or not those entities have employees. If the sub•commcttrrs 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:AIM MUTUAL INSURANCE Policy#or Self-ins.Lic.#:6012954012012 Expiration Date:7/25/2012 Job Site Address: in a 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereb cerd under the sins and enalties o 'er'u that the in ormatinn provided above is true and correct Date (1 �' Phone#: 339-832-2823 ' Offuia/use only. Do not write in this area,to be completed by city or town officiuL I City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: • DATE(IYN.UDD/YYy) CERTIFICATE OF LIABILITY INSURANCE 10/181201 TH IB CERTZPZCATE I9 ISSUED A9 A MATTER OP-INFORMATION ONLY AND CONFER$ NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIPIG'FE DOES NOT APPIRMATIVP.LY OR NEGATIVRLY 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(&). FRODOCSR 49MKT Rogers S Gray Insurance Agency vsoue ens Inc (A/C. .. . : (A/C. 1101: e-HAIL PO Box 1601 ADDR9eE' PRODVCSA South Dennis, MA 02660 CUSTOMS M. INWRRD(S)AFFORDING OMMRMM AAIC 6 1113mr' SSSUeEaI,: A.I.M. Mutual Insurance Co 33758 Frontier Energy Solutions LLC INSURER s: 39 Siasconset Drive inNDAR C: Sagalmore Beach, MA 02562 III6uREa 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 HAMM ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REgUUMbIENT, TERN 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 SEER REDUCED BY PAID CLAIMS. POLICY iRIMBER LIMITS POLICY EPP POLICY EXP Ivj TYPE OF INSURANCE Ublm/wm OM,w/SYm GENERAL LIABILITY SAW OCCUIV.UC¢ 6 OYIeW':IAL�,DIYSALUILITY DAM=TO RENTED aoI�IH.lIAI.I L:. - . PREMISRS(S..eaeuer I 6 ❑a�. H80 65P lMry one p.r.enl 6 a PIMSONAL E ADV INSURY S GIMBAL Acautz►TS S :nl'L A?JZ;ATE LIMIT AIILIE!VU 0.. �PP.C•10.f OL" PRODUCTS-COB/091ADD 6 5 AUTOWBI7E LIABILITY COMBINED SINQR LIMIT ' ate_AM (...ncLO.nE1 ❑ALL BODILY INIUAT (P.S P.—I 5 CWNSL NJT'it: QMMEULRD AUTJY BODILY IWUSTIP...cCta.ntl S PROPENTY DAHAOS OMREL Al1IFi8 (P.....I-"I I 6 �NCVI-i.alEL hu?W a LOn.LA LIAR ❑C."R . CACH DOxRRFwe S �CW:FJ9 LIAD � CLA1M7 RODS •Oa15426 1 �nslu.T6e11< 6 �sctwria7 s 6 WORKERS COMMSATION ® I•*A�,� Pn- AND EWLOYEES LIABILITY °A THE PRGIRIETOR/PAVIIER21 E.L. MNACCIOENS 6 1,000,000 E!'UTIVE.�PFIC A E.K ERS ARE i ❑ incl ® encl 6012954012011 07/25/2011 07/25/2012 E.L. DISEASE-POLICY LIMIT 6 1,000,000 C.L. DISRASC-eA emPLoree # 2,006,000 COMa!s OSSOU►TION OF OPERATIONS OR S.OFATIOWSI ALL MEMBERS ARE EXCLUDED FROM THE WORKERS'COMPENSATION POLICY. I CERTIFICATE HOLDER CANCELLATION CONSERVATION SERVICES GROUP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 50 WASHIL7GTON STREET POLICY PROVISIONS. AOTNOa[SSD RYPRSSSNTATi Ve WBSTSOROUGH, MA 01561 C U c W C_ I A W a Z O Si W CDp O >_ cep °1 p C W Q. _ +-G ce CL C (n CC W S O W W W ~u W s m w UU N w r UZOW C. =m w w w L 0Wc �d crag sA4 Crz License or registration valid for individul use only before the expiration date. If found return to: office of Consumer Affairs and Business Regulation d0 Park Plaza-Suite 5170 Boston,MA 02116 • alid without signntu �oFz Teti Town of Barnstabl e O Expires 6 months front is ate Regulatory Services Fee + ■axrtsrABr.,E, M^ Thomas F.Geiler,Director v� i639. �lfD N1A'I A IY/"/ 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 PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid.without Red X-Press Imprint Map/parcel Number 1 (�J :�13 Property Address_ 7 I/ ^/11 r S 11N A �. 0 [Residential Value of Work /_� 00—" Minimum ee of$25.00 for work under$6000.00 ' � N � Owner's Name&Address V/qN'e�� 20n I Contractor's Name / /� G S�' ��h7 'L Telephone Number Home Improvement Contractor License#(if applicable) T #1) / 6 D/3 J Construction Supervisor's License#(if applicable) 700 2 z ❑Workman's Compensation Insurance ��g Check one: -®®RESS PERMIT- ❑ I am a sole proprietor ❑ 14h the Homeowner NOV 2 4 2009 have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name S ^)� -�-�� C� Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑;Replacement e- ' e #of doors Windows/doors/sliders.U-Value (�.3,�� (maximum .44)#of windows _ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is r ed. SIGNATURE: Q:\WPFILES\FORMS\building permit forrns\EXPRESS.doc Revised 090809 I The Commonwealth of 1V1a5sachusett5 Department of Industrial.Accidents Office of Investigations 600 Washin-ton Street Boston, IM4 02111 www.mass.gov/dia Workers Compensation Insurance Affidavit: Builders/Contractors/El Please Print lumbers t Legibly Applicant Information ' � � U"N(!� Name(Business/Organization/Individual): v ' ' V of, Address 3 C'S 3 Phone #: City/State/Zip: G� Are you an employer? Check the appropriate b r6. pe of project(required): 1.�I am a employer with l/� 4. I am a general contractor and I ❑New constructionemployees(full and/or part-time).* have hired the sub-contractorsRemodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑ .. - ship and have no employees These sub=contractors have g. �Demolition employees and have workers 9 Building addition working for me in any capacity. comp. insurance.t . [No workers' comp. insurance 10.❑Electrical repairs or.additions required.] 5 We are a corporation and its 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 c. 152,§1(4),and we have no insurance required.]t 13.❑Other . 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. 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. compensation insurance for my employees. Below is the policy and job site I am an employer that is providing workers' information. Ox Insurance Company Name: . ZZ �f C% Expiration Date:F-3 / p Policy 9 or Self-ins.Lic.9: .J-� 1� L l 117 9b), " City/State/Zip: 1411 Job Site Address: ta 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 bf 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u r the pains and penalties of perjury that the information provided above is true and correct. Date: — S iQnature: Phone#: G r Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other a Phone 4: Contact Person: 1 r The Commonwealth of Massachusetts Department of Industrial Accidents PTA � �m Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): J /r1 e i1 Address: 5 W I hGA) UlAU City/State/Zip: A too Phone#: �;0 - Are you an employer? Check the approp ' e box. Type of project(required): 1.VI am a employer with 4. ❑ I am a general contractor and Imployees(full and/or part-time).* have hired the sub-contractors6. ❑Zodeling construction 2. am a sole proprietor or partner- listed on the attached sheet. 7. ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ 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' 13.0 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: II e�'l1'1dN /Ot/ N�- NS. CC/. Policy#or Self-ins.Lic.#: R P 1/0 510 Expiration Date:AnI0,1111K "a-� ` O Job Site Address: S /9 hj2 City/State/Zip: 5 /i ow,4r ZJ 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!Z7 t ains and penalties ofperjury that the information provided above is true and correct. Si ature: Date: Phone#: �08— 6"�' 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-contractor(s)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.mass.gov/dia V.../ L.J/ LVVJ VV•VJ LJVJIVL 1"14L V1 \Ia!,-a htnctt: - Ok-p;u•1m0nt '11. ('uhlit: Board id Buil►lin-, Re;ul;ttiun< and st;uul;u•d• Construction Supervisor. License License: CS 70077 Restricted to: 00 JOSEPH C OUARTE 15 FALL ST WAREHAM, MA 02571 r Expiration: 12/30/2010 r 1•nuni..illi�rr Tra: 7662 ' /� :� .�j;o�srmp�eu4aal•/�i, ry�'..'Gt¢,�yu,�+udel� Board of Building Regulatio!u Hnd 5t'l►►daNw lug HOME IMPROVEMENT CONTRACTOR Registration: 132349 Expiration: 1/11/2011 Tr0 278918 Type: Pahnership J&J Remodeling Joseph Duarte �.. 15 Fall St. � _ . Wareham.ma 02571 \Uministratur i ' ` iaearE d[•fie!�s��r� 6�low- �r9/20yQ SUOPWROM Ciao sor"m YORE*! �ER�ERS Uno COBS GALL~ i xw- L+cssst st rtg��va�ei i9► . oe fwe t�ex�irstier►9f�R. 10 Sow mom~c c s"rd of$ie and ,)ne ♦obbwreoa Place sun 1301 1 Stan. ti4s.Q21� 'toe► 'uieimd NOV-10-2009 10:23 HOME DEPOT HYANNIS P.001 HOME IMPROVEMENT CONTRACF PLEASE READ THIS• -4- Sold,Furnished and Tnsfallod by:- Branch Nia9@-. :Ro-ton- -TTJAD.At-Hornc Services,lnc. , .Ul3if2;-Worc4ztLr.;J%eA:0160.7 45A(3reCnwoodzStrec* Branch Number:31. F' .(509)7.56-.8823 Lic-'#..0 02439,;RT.Cont.Lid!16427 .,FcdmLID 75-2&8460;MP 'or InstallAtion.kdo rom; .:City PUrCb*s0jr(s)! Celf-Phone: ;;,Woi;kPhone. -H�6i ire-Phon Q, 11A (If dif-ferent from.1m allatiomAddrmy.- Zip E-nia1EAddrcs&(to c;6eive pT.oicet.commuiiicMons-lan-d--T4t)me'Depot updates): FI-IDO.NOT.wish,tD'rec6vvan5rmarketing-emaiis-*4om:Thc,-Iiome:Depot:- address,a&ccs to buy, and�MD At-Home krvices,Inc.("The Home Depot'D ag"'mie's:to fumisk-.'deliver ana-arran&for t)i6ffi-,- Of all materials:descrit Wou...therbelow.and.:on.thc)r6ferencedi S.pc%c,,Sheeks),W,:oP.whieh-.gc-:inwrpozated-into-ihis Contract by.-this any. y! Applic�b�c.State;Supp�ei�ent and,rayn jnachcd:hc;rctoan4,auy. CNw eis.(cd1ldctiYely, &'Ord pee sti&t(d. URo6ling ''Siding)Q Windows' ''Insulation —7 jy O.,'75 art._ Roofing, Siding Viriodows:. ins.utatidd vem Doors- 7MR_.of.g.0Siding:. -Wiud lwu)c�lion 'ORboring []Siding-L[Vrmdbws,Ulrtsulatibiv-. "'; .66V er% try Doors Minimum 2551.Dep 6ft of Contract unt o duei�"11;exewtioTrotthisamomi�-,,.�lt ,.:,i,6&I Aln. Matne Purcknsm n sy not deposit more than one-third of the ContractAmount -completi-'�'of��.'w'.o"rk-�foieacii.Produdt;Cu iot�-W:&,��nt�_6mpletion-Certificate (o.n e'f6r"e'a'c-])*'P6o"c1C�t...as*fined by-*.an individuat.,.Spec'ghe and'.,*pay_agy',&Ian*cedue,-..--ks ibis undejr- The Home:Repot re;ewes-the-;right,.Co,issue a'Cbangc,oTdcr or t erminate-this Con=:or=y:individtw-,Product(s)included berein at its discretion,,ifThe Home Depot or its authorized-service provider determineotbat.-it camot-peribm-imofigations.due:to ac-stractmi problem witb,the-b(me,cnViT0nmcntaI--hazarAs.-sqch-as mojdasb�estow.or_!cad paint,_other.safety concern s,pricing,crrors,ox because . ......... wolkiequ"-d..tocoi t.-tpl "th job.w."" 'Cl-uaediif)1c_Co0tniCt, cte 1.C.... as.not in. -.,:im1uded:,av-part of-thig:Conuact;,sets fb'rtbthe Total Contract wnouEt'anitp'aym'e'nts-fe4uired'.f6r.tlie,(tepbsite.:i id>finaT-payments by-Pr6dud,(as-apj licabic).: NOTICE TO CUSTOMER omoktionCertiecate-(6te:' there is one Comp)efion Certificate for each listed Prodiiet-as:de&&--byind&id4a-SVeeShitfi),beforew6rk-o6'Watw6anct is complete. In the event of ter,nination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provi led by The Home Depot or Authorized Service Provider through the date of termination,plus-any other amounts-set forth!n this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE-DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE I.1,OKF DEPOT'S OTHER REMEDIES-FOR RECOVERY OF SUCH AMOUNTS. Acceptance and A ithorization: -Customer agrees and understands that this Agreement is the entire agreement between Customer and The Home Dep)t with regard to the Products and Installation services and supersedes all prior discussions and agreement%,either oral or written,rcla;ipg to said Products and Tm;tallation.This Agreement cannot be assigned or amended except by a writing signed by Customer and T,ie Rome Depot.Customer acknowledges and agrees-that Customer has read,understands,vol T4 ily accLpts the tcryrLs of and has rec rived u copy of this Agreement. Acce ptefi by: Subm. by: .7 Af j JIV 0. / A,.f h Sales Cob-,- -Customke?t-_�ignatu-e Date Itant's Si Date w (5� .6 . Telepho a� No Customer's Signatu-e Date Sales Consultant License No. CANCELLA CUSTOMER*MAY CANCEL TWS (as applicable) AGREEMENT W ITHOUT PENALTY OR ODUCATION' By DELTVERINV WRITTEN NOTICE.TO THE HOME - DEPOT BY MU NIGHT ON THE THIRD BUSINESS DAY AFTER-$I GNING THIS AGREEMENT. ' THE STATE SUPP),EMENT ATTACHED HERETO CONTAINS A , FORM , TO USE IF ONE IS SPECIFICALLY'- PRESCRIBED By LAW IN CUSTOMER'S STATE. I NOTICE:AD))MONAL.TERMS AND CONDITIONS ARE STAT.FD ON'M REVERSE SIDE AN))AR1r-PAirr or THIS CONTRACT �z r Town of Barnstable *Permit# Expires 6 inortths jrom issue dale 1i;1 :i; Regulatory Services Fee �S- ``v KARNSrABLE "^039- �• Thomas F.Geller,Director 0 Building Division Tom Perry,CBO, Building Commissioner n `L jr 200 Main Street,Hyannis,MA 02601 C9 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - .RESIDENTIAL ONLY (� t Valid without Red X-Press Imprint Map/parcel Number Property Address Of MAf5tz" 1 /illI M f- 0264 r�Residential Value of Work 36Q,v Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �I t� l� t� P,i Contractor's Name k-PC-h"i t �vn 5'ffrJC�its Telephone Number ) 7(D 2 7o 2 Home Improvement Contractor License#(if applicable) %y 50_S, Construction Supervisor's License#(if applicable) ❑Workman'sCompensationInsurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor. AUG — 3 Z007 ❑ I am the Homeowner I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name 641A Workman's Comp.Policy# q l✓0.41 D J —&0 7 Copy of Insurance Compliance Certificate must be on tile. Permit Request(check box) 11// [� Re-roof(stripping old shingles) All construction debris will be to Yl.shv-VII El Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Pi;;iss —"—=,'t' Home Improvvemment Contractors License is required. SIGNATURE: h/ j..' Q:Fonns:expmtrg Revise071405 i � `tom✓� -�� e�u �� Board of Buiidiiig Regulations-and Standards ^, GNOME IMPROVEMENT CONTRACTOR Registration.,1i,?,�53 . Expiration: 6i l4/2008 ° • Type: D�ia' - KEATING CONST: -:' .,_. ':: =. .•;. •TIMOTHY KEATING; 5-OLOWER BROOK'RD.- SO YARMOUTH,•MA 02664 ? ` Deputy Administrator i ACORQ TM CERTIFICATE OF LIABILITY INSURANCE DATE DD/YYY1� ` � 03/06/20/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 34 MAIN ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WEST. YARMOUTH, MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED Timothy Resting Dba Beating Construction INSURER A: COLONY INSURANCE INSURERS: CNA 54 Lower Brook Rd INSURER C: INSURER D: South Yarmouth, MA 02664 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM/DD/YY) DATE(MMIDO/M LIMITS A GENERAL LIABILITY GL-0529075 03/06/2007 03/06/2008 EACH OCCURRENCE $1,000,000 R COMMERCIAL GENERAL LIABILITY PREMISES(Ea oceurence) $100,000 CLAIMS MADE FX I OCCUR MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE E2,000,000 GEKL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 POLICY IECT JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO $ (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident)[7ELIABILITY AUTO ONLY-EA ACCIDENT $ AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSAIMBRELlA LIABILITY EACH OCCURRENCE E OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION E E WORKERS COMPENSATION AND 9629AO9-6-07 03/09/2007 03/09/2008 X TORySTAT, ER B EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? . If yes,describe under EE.LDISEASE-EA EMPLOYEE $ 100,000 SPECIAL PROVISIONS beIS DISEASE-POLICY LIMIT E 500,0OO OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPEC ULL PROVISIONS TIMOTHY BEATING IS EXCLUDED FROM WORKERS COMPENSATION INSURANCE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NO CERTIFICATE HOLDER ON FILE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAR 21 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE -TO Do SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AN"NO UPON THE INSURER, ITS AGENTS OR ! REPRESENTATIVES. AUTHORIZED REPRESENTA ACORD 25(2001/08) ©ACORD CORPORATION 1986 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 Pent Lesribly Name(Business/Organization/Individual): Addrd9s: ail Lowe, B(upi. �1 City/State/Zip: .V. i/c/rn AA /Y1,4- y Phone ey7X o Z A) Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with�_ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet._ R�miidelirig ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c: 152,§1(4);and we have no f2.❑Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] 13.❑Other *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. 2Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: C NA Policy#or Self-ins.Lie.#: G•-y 7 Expiration Date: �5/U Job Site Address: I/7 J +'��t ®/ � t,lSb^ ��l�S l�h 1�1.6`rV City/State/Zip: /fl"J /l1,f/r /tj 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 under the pains and penalties of perjury that the information provided above is true and correct. Simature: Date: ,S%/3A4 7 Phone#: 9 k- 7w —2VZ- Official use only. Do not write in this area,to be completed by city or town of ciaL 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#: HA, ;'�� Town of Barnstable Ma-K Regulatory Services pjFd�A, Thomas F.Geiler,Director ' Building Division Tom,Perry;CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 - www,town-,l��rn�ta�ile.ir Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, ✓�- �t��r?��-- ,as Owner of the subject property hereby authorize jIeP C.fi'^f �D�S�✓y�� to act on my behalf, iil all iiiatfers relative to Work airthorized by this liiiil'dirig periiiit applicati6ii f6r 1/7 Sfi,r l,,i� Q' O��s/�, /h;11r 411- 26 � (Address of Job) f1�Lc)2 Signature of Owner Date Print Name Q:Fonns:expmtrg Revise071405 Assessor's offioe,(1st\floor): ` �?MEr G �.^.....U.3� SEPTIC SYSTEM °. Assessor's map and lot number ......:.�...... ..... �� ' �o Board of Health (3rd floor); :' IN�YALLED IN CO Sewage Permit number ................. .. ...�.� 1 , WIYH TIYL B6Sd9TAME, Engineering Department (3rd floor): ' ENVIRONMENTAL O + �Mb 9. . e� House number ........................:... ......1.1..?.......m.. .... } oraY'a` f TOWN REGUL�Tti�a,,,, APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. onlyl : _ TOWN 'OF ,-BARNSTABLE BUILDING INSPECTOR a X�3� .. . • APPLICATION FOR PERMIT TO ... .�� .� ..�V�...... (�?��E?...�.J'>°,//�CY�`.�............1................�a°¢��,Ir'.�,.. TYPE OF CONSTRUCTION Lf�4DC� l..d''wl ................................................................................. , ..................... ....... ..... ......... G........4...............19P i TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for a permit according to the following information: Location .........A........Y,2........ f...................!?!/ ................................................;... ProposedUse .............0:! Lr..................© ...../..W`q., ............................................................................................ Zoning District ............................. ............................Fire District ..........� 61................. y1/�..................................... Name of Owner .b/.AIY� .....�b�.4CPICk.........................Address / yI ................ .j.............?..................................... Name of Builder ...........Address .....t....�... ...Z? 1.. .1�..........�1.�.. � I� P� Name of Architect .T&Y.w5J......KWL........................Address ... ..1.................................. Number of Rooms ........... ..................................................Foundation ........4..:m ..O.z-J...... .............. Exlerior .............. ` JJ 91 . ��. .... (,i.cCi'�1�,........r5.�l.1.'.'f �.,5.............:...Roofing ......... . Floors G .. .. . 9 �b... . .../../.✓t'd••.(iU.f?. ....�I/QIP6fy. .... 'lr�.......... .�Y��Z. ...,�.......... �.. ....�....Gw(.t............lnterior HeatingQ...... 1. .....z ...... .............................Plumbing .................................................................................. Fireplace ...................................................................................Approximate Cost ............l.. .a ................................. Definitive Plan Approved by Planning Board ----_---------------------------19-------- . Area .........1pl.*-.3z& ............. ,0 0 Diagram.of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t r �- /6 � Sv„t/�cnnc f £xist,� 914arf,�z .2 yX a q U `O 3� Yoe z c-ro ref (l ✓ , Ll OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules'and Regu-lotions of the Town of Barnstable regarding the above construction.. A511/,-:. Name Construction Supervisor's License / 1 S7yy ........... RODERICK, DANNY No ...302.62 Permit for AD.D.I.T.ION. G.A.RA.GE Single Family..Dwelling ........ ............................ ...................... Location ..Lot.... ......�.17 Starlight Drive ........ ................................ Marstons Mills ............................................................................... Owner ....Danny,. Roderick ............................. .. .... .. .... Type of Construction ........F.r.ame...................... . .. ....... ....................................................0.................... Plot ............................ Lot ................................ Permit Granted .......December 9 ,.................................19 86 Date of-Inspection ..............19 e'>Date Completed ...... -A ................19 L Assessor's offioe Ost floor): Assessor's map and lot number p�TMETo Board of Health (3rd floor): Sewage Permit number � �...t. fti Z BlH39T&DLE, i Engineering- Department (3rd floor): �/' 'oo r639 \0� House number .............................# ......f f..1.........!' ......... APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...v?! A(�L .. 1��.,V/.h.......5 ?�!/¢� r....... . TYPE OF CONSTRUCTION ............W. ✓.... fAl! ! / ........................................................................v..._... 1.j......."�15...............19 �' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1df....y.7 Y�4 ?,�l�,�j/•...//,� 1.��b//1 S > 1 ./.l;S................................................................. ✓. ,.....,................... Proposed Use .............(7111.� .1...................�/Y...4...... / !,/�................................../.......................................................... �iZoning District ............................. ...................................Fire District .....................�..e�'!�!'I .............................................. Name of Owner .(,$1y1g>V..... ...........................Address '1,�5�1�� / ^� 19................. Name of Builder .�Y..f.!..C..'1..(.A.f..!....A.........0.,r-.vi.&4..iq......Address ....tr.. .....3h�_....��iQ�[aJ,� l....G.�:... r.�.4.US Name of Architect ... ..{.!! �..... 1? ��' .........................Address ...51..ZVI,..... ..!!'.!Je..,................................... Number of Rooms ........... ....................................................Foundation ........A..a0. J.....cowop-d.,?................. Exterior ..........IV/1.��. .1,. ........ .!. ..�.................Roofing .......... .� �.A�. ....................................................... Floors .e!f.. ........... Interior �. �j✓?, ,• �a gKl/Y6tq. ...... yl Heating � fnT�.�Q.!.✓ ......!2.V....... ............................Plumbing ............. . .......` ........................./.............. Fireplace ............................................................Approximate Cost ............7... v................................. Definitive Plan Approved by Planning Board ________________________________19-------- , Area .........��-� �� ......................... Diagram of Lot and Building with Dimensions Fee 0 SUBJECT TO APPROVAL OF BOARD OF HEALTH l3� Q . i 16 u S /6n16 I - _ I �xt5t��Aq I 1 x s �� 5�nwyZ 2 YAd 3� �o44 T� 2- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of.the Town of Barnstable regarding the above construction. / Name � '/.,. .v,,,/ ..... ............... .............._......_�. .. Construction Supervisor's License ..n.3. �l.y ..... RODERICK, DANNY A=100-033" No -3.0.2.6.2. Permit for ...ADDIT.I.O.N.11GARAGE .......Sijagle...FaMily...Dxel I j-ag......... Location .....Lot -#4 7.........11.7...S.t.ar.l.iq.h:t Dr. Marstons Mills ............................................................................... ......... Owner h ny..... ..Roderick........................ .. .... Type of Construction .......Frame....................... ................................................................................ Plot ............................ Lot ............. .................. Permit Granted ......December .9,.*....19 .8 r) . .. .. ... Date of Inspection ...................;......; ........19 Date Completed ...................................19 NOT STA(ZTED ode. �� - cqy(41 �Dv ZEPTIC SYSTEM MUST/ �3 _ BE INSTALLED IN COMPLIANCE WITH ARTICLE II STATE S'e wo taf S 71 SANITARY CODE AND TOWN y�fTMEtO REGULATION �♦ TOWN OF BARNSTABLt i 9Ad3STADLE, i "b G y ,,� BUILDING�� , INSPECTOR O'FpY{r APPLICATION FOR PERMIT TO .!..\.`. .. . . ......................... ................................ TYPE OF CONSTRUCTION .'t-�L.�srr.�Z,.,........................"..�-'�.1..+" J) ..... ....................................... . . 1....1.. ...19. s TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies/for a per it ac ording to the'I following informatio LLocation ....v©..Cam........ ..z.. ... r ...... ..... J Va� ProposedUse ................... ......................................................................... Zoning District ........................................................................Fire Di ct ... ,....�� .:�...v�'% aL"� '/'j'p°.' /// Name of Owner .. �� ids. - Address Ror..CJ.�.X. / 4 .5...�C)f'� Name of Builder. !h.na-i(? � G .. :......Address r. C�.7�. .. Name of Architect /��! �..............................Address .............cd ..E'',.............................................. .......... ....................... ''Number of Rooms .............. ..............................................Foundation ... .................................................. Exterior ...... �...S1.2.1/0.C.7 C7................................. ........��.�7 .�..�........................................ Floors ...............C14'1�., 5'- I...n...�./. .L.N/..(.'..............Interior ....15h.ge./.. Cr ..:......................................... .... . Heating .......l...l.. .✓ `/..1C....... /. / .%....� t7 Plumbing ......... .,C.../Z.... -!. ..:5:............................. Fireplace ................. C •.J..................................................Approximate Cost ... ..1 (0.0Q.............................................. y... Definitive Plan Approved by Planning Board ---------------_______________19 Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH L6-r SIz � y VJ z � 3a GARAGE oU-s-r - - , C I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... .: ....... ....................... Cammett Builders, Inc. No ..16503.... permit for .0ne..st0r7 ............ ................ single family dwelling ....................................................:................. location 1.1.9.Starlight-Diriv!........................ .... .......... ........ ......... . Marstons Ydlls ............................................................................... Owner ..........Hammett Builders, Inc* ......................................................... Type of Construction .............f.r...a....me..................... ................................................................................ Plot ............................ Lot ............. ............ . Permit Granted ......... us ...16 .........19 73 ........ /t .... Date of Inspection ...... ..... ... Date Completed ./I. . .. ... .... ..............19 PERMIT REFUSED ................................................................ 19 \J . ......................... ..................................................... z , ................................................................................ ............................................................................... ............................................................................... Approved ................................................. 19 ............................................................................... ............................................................................... ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONIC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER. ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(8). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAIN (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTTBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT W WATT 3R NEMA 3R, RAINTIGHT PV1 COVER SHEET PV2 SITE PLAN PV3 STRUCTURAL VIEWS PV4 UPLIFT CALCULATIONS z PV THREE LINE DIAGRAM LICENSE GENERAL NOTES Cutsheets Attached GEN #168572 1. ALL WORK TO BE DONE TO THE 8TH EDITION ELEC 1136 MR OF THE MA STATE BUILDING CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING ` MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: ZEP SOLAR , AHJ: Barnstable REV BY DATE COMMENTS REV A NAME DATE COMMENTS UTILITY: NSTAR Electric (Commonwealth Electric) • • - CONFIDENTIAL— THE INFORMATION HEREIN PREMISE OWNER: DESCRIPTION: DESIGN: JB-026585 00 - CONTAINED SHALL NOT BE USED FOR THE JOB NUMBER ROWLAND, JASON ROWLAND RESIDENCE Dimas—Daniel Urbieta �:;,S��a�C�ty. BENEFIT OF ANYONE EXCEPT SOLARCiTY INC., MOUNTING SYSTEM: NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 117 STARLIGHT DR 6.12 KW PV ARRAY 0'.a: PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: MARSTONS MILLS MA 02648 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE 24 CANADIAN SOLAR CS6P-255PX 2a St Martin Drive,BA 01 2 Unit 11 ( ) #SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME SHEET: REV. Marlborough, MA 50) PERMISSION OF SOLARCITY INC. INVERTER: SOH 944-4474 PV 1 1D 25 2014 T: (s50)s38-1028 F: (s50)638-1029 SOLAREDGE SE5000.A—USOOOSNR2 ( ) COVER SHEET / / (TTBB}soL-aTY(�ss-lass) w�r.sdarcity.�am PITCH: 30 ARRAY PITCH:30 MPi AZIMUTH:293 ARRAY AZIMUTH:293 MATERIAL:Comp Shingle STORY: 1 Story OF p YOO JIN !r„ K VI H No.4 A u A - Digitally si n Yoo Jin Kim Date: 2014.10.27 13:00:28 -07'00' o TdW g LEGEND eq A, O (E) UTILITY METER & WARNING LABEL INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS © DC DISCONNECT & WARNING LABELS Inv © AC DISCONNECT & WARNING LABELS AC Q DC JUNCTION/COMBINER BOX & LABELS ' Q DISTRIBUTION PANEL & LABELS Lc LOAD CENTER & WARNING LABELS • O DEDICATED PV SYSTEM METER (E) DRIVEWAY Q STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR --- CONDUIT RUN ON INTERIOR Front Of House — GATE/FENCE 117 Starlight Dr. O HEAT PRODUCING VENTS ARE RED INTERIOR EQUIPMENT IS DASHED L='J SITE PLAN 4 Scale: 1/8" = V 2 01' 8' 16' Ain! MMMIT!" J B-0 2 6 5 8 5 �� P'�6tl�°w"� DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER Dimas—Daniel Urbieta CONTAINED SHALL NOT BE USED FOR THE ROWLAND, JASON ROWLAND RESIDENCE S��C��C�ty.BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: W.O 1° NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 117 STARLIGHT DR 6.12 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: MARSTONS MILLS, MA 02648 ORGANIZATION, EXCEPT IN CONNECTION VATH 24 St.Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (24) CANADIAN SOLAR # CS6P-255PX SHE; REV- DATE: Marlborough,MA 01752 SOLARCITY EpUIPMENT, WITHOUT THE WRITTEN PAGE NAME T: (650)638-1028 F. (650)638-1029 PERMISSION OF SOLARCITY INC. [t7TIEDGE SE5000A—USOOOSNR2 ( � SITE PLAN -SOL-CI508 944-4474 PV 2 10/25/2014 (88B) TY(765-2489) �.solarcitrc«n �t1 OF p Y00 JIN K VI y No.4 1►1. Digitally Si oo Jin Kim Date: 201 .10.27 13:00:37 -07'00' PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER & FENDER WASHERS LOCATE RAFTER, MARK HOLE S1 ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT ZEP ARRAY SKIRT (6) HOLE. (4) (2) SEAL PILOT HOLE WITH ZEP COMP MOUNT C POLYURETHANE SEALANT. ZEP FLASHING C (3) (3) INSERT FLASHING. (E) COMP. SHINGLE (4) PLACE MOUNT. —$ 11 -9 (E) ROOF DECKING (2) 0 (E) LBW (5) INSTALL LAG BOLT WITH STEEL LAG BOLT LOWEST LOWEST MODULE) SUBSEQUENT MODULES SEALING WASHER. SIDE VIEW OF MPI NTS WITH SEALING WASHER (6) INSTALL LEVELING FOOT WITH A I (2-1/2" EMBED, MIN) BOLT & WASHERS. MP1 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES (E) RAFTER LANDSCAPE 64" 24" STAGGERED STANDOFF Si PORTRAIT 48" 11 19�� 1 Scale: 1 1/2" = 1' ROOF AZI 293 PITCH 30 RAFTER 2x6 @ 16 OC STORIES: 1 • ARRAY AZI 293 PITCH 30 C.I. 2x6 @16" OC Comp Shingle CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: PREMISE OWNER: OMPRON: DESIGN: INFORMATION CONTAINED SHALL NOT USED FOR THE J B-0 2 6 5 8 5 0 0 \\ BENEFIT OF ANYONE EXCEPT SOLARCITY-INC., MOUNTING SYSTEM: ROWLAND, JASON ROWLAND RESIDENCE Dimas—Daniel Urbieta ,'SolarCity NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 117 STARLIGHT DR 6.12 KW PV ARRAY 1171: PART TO OTHERS OUTSIDE THE RECIPIENTS I ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES: MARSTONS MILLS, MA 02648 THE SALE AND USE OF THE RESPECTIVE (24) CANADIAN SOLAR # CS6P-255PX 24 St.Martin Drive,Building 2,Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN . INVERTER: PAGE NAME: SHEET: REM. DATE Marlborough,MA 01752 PERMISSION OF SOLARCITY INC. 5O8 944-4474 PV 3 10 25 2014 T: (sso)63e-102e F: (650)638-1029 SOLAREDGE SE5000A—USOOOSNR2 STRUCTURAL VIEWS (flee)-SOL-CITY(765-24e9) www.solarcltr.aam UPLIFT CALCULATIONS SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. k CONFIDENTIAL THE INFORMATION HEREIN JOB NUMBER J B-0 2 6 5 8 5 00 PREMISE OWNER: DESCRIPPON: DESIGN: — \\,,`SolarCity. CONTAINED SHALL NOT BE USED FOR THE ROWLAND, ,1ASON ROWLAND RESIDENCE Dimas—Daniel Urbieta BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: ��01 NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 117 STARLIGHT DR 6.12 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: MARSTONS MILLS MA 02648 ORGANIZATION, EXCEPT IN CONNECTION WITH � 24 St.Martin Drive,Butld'mg 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (24) CANADIAN SOLAR # CS6P-255PX PAGE NAME: SHEET: REµ DAIS Marlborough,NA 01752 $OLARGTY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: T. (650)638-1028 F. (650)638-1029 PERMISSION OF SOLARGTY INC. SOLAREDGE SE5000A—USOOOSNR2 (508) 944-4474 UPLIFT CALCULATIONS PV 4 10/25/2014 1 (688)-SDL-CITY(765-2489) ww.solarcity.com GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO TWO (N) GROUND Panel Number: Inv 1: DC Ungrounded INV 1 -(1)SOLAREDGE ##SE5000A-USOOOSNR LABEL: A -(24)CANADIAN SOLAR CS6P-255PX GEN #168572 ODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:43939148 Tie-In: Supply Side Connection Inverter; 500OW, 240V, 97.5%; w�Unifed Disco and ZB,RGM,AFCI PV Module; 255W. 234.3W PTC, Black Frame, MC4, ZEP Enabled ELEC 1136-MR ` Underground Service Entrance INV 2 Voc; 37.4 Vpmax: 30.2 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 200A MAIN SERVICE PANEL E� 20OA/2P MAIN CIRCUIT BREAKER II1Vt?I t2C 1 (E) WIRING CUTLER-HAMMER Disconnect CUTLER-HAMMER 20OA/2P 5 Disconnect 4 SOLAREDGE B 30A SE5000A-USOOOSNR2 , A C Li 2aaV SOIarClty 2 - - M 1L2 A DC.N 3 DC- MP 1: 2x12 (E) LOADS GND _ ____ GND ___-________________--___ EGCI DC- DC- - - - I GEC I� DG OG r---� GND __ EGC- ---------------- ------ -- '---- ---EGC -- ---------- -- I N I I r _J o EGCLEC ' z � - I I I I llI _ GEC T-T TO 120/240V I I SINGLE PHASE I I UTILITY SERVICE I I I I I I I PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP Ol2)Ground Rod; 5/8' x 8', Copper B (1)CUTiJIt-HAMMER OG222NR8 /�� A (1)SolarCity 4 4 STRING JUNCTION BOX D� -�2)ILSCOy IPC 4/0-/6 Disconnect; 60A, 24OVac, Fusible, NEMA 3R A 2x2 STRMGS, UNFUSED, GROUNDED Insulation Piercing Connector, Main 4/0-4, Tap 6-14 C (1)CUTLER-HAMMER #DG221URB PV a4)SOLAREDGEoo-2NA4AZS S SUPPLY SIDE CONNECTION. DISCONNECTING MEANS SHALL BE SUITABLE Disconnect; 30A, 24OVac, Non-Fusible, NEMA 3R PowerBoxCrtimizer, 300W, H4, OC to DC, ZEP AS SERVICE EQUIPMENT AND SHALL BE RATED PER NEC. -(1)CUTLER-HAMMER &DGO3ONB Ground eutral It; 30A, General Duty(DG) nd (1)AWG g6, Solid Bare Copper -(1)Ground Rod; 5/8' x 8', Copper (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION NO. 2, ADDITIONAL ELECTRODE MAY NOT BE REQUIRED. DEPENDING ON LOCATION OF (E) ELECTRODE (I)AWG 16, THWN-2, Black 1 AWG #10, THWN-2, Black 1 AWG#e, THWN-2, Black Voc* =500 VDC Isc =30 ADC (2)AWG #10, PV WIRE, Black Voc* =500 VDC Isc =15 ADC O (1)AWG 16, THWN-2, Red ® (1)AWG 810, THWN-2, Red O (1)AWG J8, THWN-2, Red Vmp =350 VDC Imp=17.26 ADC O (1)AWG #6, Solid Bore Copper EGC Vmp =350 VDC Imp=8.63 ADC (1)AWG 16. THWN-2, White NEUTRAL Vmp =240 VAC Imp=20.83AAC (1)AWG#10, THWN-2, White NEUTRAL Vmp =240 VAC Imp=20.83AAC (1)AWG/10, THWN-2,.Green.. EGC, ,•,-{1)Conduit.Kit., /,'.EMT.. , .. . .. , , .,-(1)AN /6,.Solid Bare_Copper. GEC. . . -(1).Conduit.Kit;.3/4'.EMT. .. . . . . • • . • • • ,.. .-(1)AWG�8,.1}iWN-2,.Green ,, EGC/GEC-(1)Conduit.Kit;,3/4".EMT__ . . __ • ••_ u .0 AWG 06. PV WIRE, Black Voc* =500 VDC Isc =15 ADC O 9-(1)AWG B6, Solid Bare Copper EGC Vmp =350 VDC Imp=8.63 ADC . . . . . . .. . . . . .. .. . . . . .., . . . .. . . . . .... . . .. .. . . .. .. . . .. .. . . ... . . . . . . CONFIDENTIAL E INFORMATION HEREIN JOB NUMBER: PREMISE OWNER: DESCIBPTION: DESIGN: - TH CONTAINED SHALL' NOT INFORMATION USED FOR THE J B-0 2 6 5 8 5 00 . ROWLAND, JASON ROWLAND RESIDENCE Dimas-Daniel Urbieta i,`�Olar,�l�� BENEFIT OF ANYONE EXCEPT SOLARCnY INC., MOUNTING SYSTEM .,S NOR SHALL IT BE DISCLOSED IN WHOLE.OR IN Comp Mount Type C 117 STARLIGHT DR 6.12 KW PV ARRAY PART IZ OTHERS C PT IN THE RECIPIENTS MODULES MARSTONS MILLS MA 02648 ORGANIZATION, EXCEPT IN CONNECTION WITH r ' THE SALE AND USE OF THE RESPECTIVE (24) CANADIAN SOLAR # CS6P-255PX 24 SL Martin Drive,Building 2,Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME SHEET: REV DATE T; (gsp)Marlborough, F:A(61752 638-1029 PERMISSION of soLARaTY INC. SOLAREDGE SE5000A-USOOOSNR2 (508) 944-4474 THREE LINE DIAGRAM PV 5 10/25/2014 (688)-SOL-CITY(765-2489) www.solarcity.corn Label ..- PHOTOVOLTAIC PObVER SOURCE Code:Per WARNING Code:Location: WARNING ••_NEC Location: 690.31.G.3 ELECTRIC SHOCK HAZARDNEC •.° ELECTRIC SHOCK HAZARD NEC690.35(F) DO NOT TOUCH TERMINALS THE DC CONDUCTORS OF THIS Label • • TERMINALS ON BOTH LINE AND PHOTOVOLTAIC SYSTEM ARE TO BE USED WHEN LOAD SIDES MAY BE ENERGIZED UNGROUNDED AND PHOTOVOLTAIC DC � IN THE OPEN POSITION MAY BE ENERGIZED GROUNDED INVERTERIS Per Code: .O D D NEC DISCONNECT .•° Label Location: Label Location: WARNING Code: MAXIMUM POWER- Per POINT CURRENT(Imp)�A Per Code: INVERTER OUTPUT NEC 690.64.B.7 MAXIMUM POWER- CONNECTION POINT VOLTAGE(Vmp)_VNEC 690.53 DO NOT RELOCATE MAXIMUM SYSTEM THIS OVERCURRENT VOLTAGE(Voc) V DEVICE SHORT-CIRCUIT A CURRENT(Isc) Label • • PHOTOVOLTAIC POINT OF '• Label • • INTERCONNECTION • _ WARNING WARNING: ELECTRIC SHOCK NEC •.° 690.54 Per HAZARD. DO NOT TOUCH Code: TERMINALS.TERMINALS ON ELECTRICAL SHOCK HAZARD NEC 690.17(4) BOTH THE LINE AND LOAD SIDE DO NOT TOUCH TERMINALSMAY BE ENERGIZED IN THE OPEN TERMINALS ON BOTH LINE AND POSITION. FOR SERVICE LOAD SIDES MAY BE ENERGIZED DE-ENERGIZE BOTH SOURCE IN THE OPEN POSITION AND MAIN BREAKER. DC VOLTAGE IS PV POWER SOURCE ALbVAYS PRESENT WHEN MAXIMUM AC � A SOLAR MODULES ARE OPERATING CURRENT EXPOSED TO SUNLIGHT MAXIMUM AC OPERATING VOLTAGE V Label • • WARNING ' �'" Location:_ ELECTRIC SHOCK HAZARD NEC 690.5(C) CAUTION IF A GROUND FAULT IS INDICATED _NEC PHOTOVOLTAIC SYSTEM NORMALLY GROUNDED CIRCUIT IS BACKFED 690.64.B.4 CONDUCTORS N1AY BE UNGROUNDED AND ENERGIZED Label • • Label • - CAUTION '• PHOTOVOLTAIC AC' • ) Per Code: Disconnect DISCONNECT Per NEC :;; PHO OVOLTAONEC ICSYSTEM 690.64.B.4 Combiner Box nduit (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit LabelIntegrated DC Disconnect MAXIMUM AC •• Load Center OPERATING CURRENT A Per ••- MAXIMUM AC V NEC 690.54 • • OPERATING VOLTAGE 1 1 /• 1 '7 1 1 • 1 1 1' now nuuuu■m :7 / r 7• 1 ••• 1• • 1 • 1, 1 w •ounln. .loon. 1 1• 1 1 7' 1 �1 ., 1' / ,e 111111111••IIIIIIIIIIIII••IIIIIIIIII••IIIIIIIIIIIII• SC I . 1 •1 1 •/ Label 1111111111:• 1/1 111111111111111111■��Illilllni llll'.11111■ SolarCity SleekMountTM - Comp SolarCity SleekMountTM - Comp The SolarCity SleekMount hardware solution •Utilizes Zep Solar hardware and UL 1703 listed — Installation Instructions is optimized to achieve superior strength and Zep CompatibleT"'modules r ,� aesthetics while minimizing roof disruption and .Interlock and grounding devices in system UL `� 1Q Drill Pilot Hole of Proper Diameter for labor.The elimination of visible rail ends and listed to UL 2703 Fastener Size Per NDS Section 1.1.3.2 mounting clamps,combined with the addition of array trim and a lower profile all contribute •Interlock and Ground Zep ETL listed to UL 1703 a O Q Seal pilot hole with roofing sealant to a more visually appealing system.SleekMount as"Grounding and Bonding System" O�` O3 Insert Comp Mount flashing under upper utilizes Zep Compatible TM modules with •Ground Zep UL and ETL listed to UL 467 as � \ layer of shingle strengthened frames that attach directly to grounding device ® Place Comp Mount centered Zep Solar standoffs,effectively eliminating the }-" _ need for rail and reducing the number of •Painted galvanized waterproof flashing ! upon flashing standoffs required. In addition, composition .Anodized components for corrosion resistance O5 Install lag pursuant to NDS Section 11.1.3 shingles are not required to be cut for this with sealing washer. system,allowing for minimal roof disturbance. •Applicable for vent spanning functions t: © Secure Leveling Foot to the Comp Mount using machine Screw Place module O Components Q 5/16"Machine Screw Leveling Foot ®- \ © Lag Screw Comp Mount © Comp Mount Flashing j , Solaitity® January �cOW UL LISTED SolarCity® January 2013 Janua 2013 m Janua . t e��d%eQ5;g1, CS6P-235/240/245/250/255PX Neak��1°�ghF _r CanadianSolar Electrical Data Black-framed src CS6P-235P CS6P-240P CS6P-245P CS6P-250P CS6P-255PX Temperature Characteristics Nominal Maximum Power(Pmax) 235W 240W 245W 250W 255W Optimum Operating Voltage(Vmp) 29.8V 29.9V 30.OV 30.1V 30.2V Pmax -0.43%rC NewEdge Optimum Operating Current(Imp) 7.90A 8.03A 8.17A 8.30A 8.43A Temperature Coefficient Voc -0.34%rC Open Circuit Voltage(Voc) 36.9V 37.OV 37.1 V 37.2V 37AV Isc 0.065%rC Black-framed Short Circuit Current(Isc) 8.46A 8.59A 8.74A 8.87A 9.00A Normal Operating Cell Temperature 45t2•C Module Efficiency 14.61% 14.9,% 15.23% I 15.54% 15.85% Operating Temperature -40°C-+85•C Performance at Low Irradiance Maximum System Voltage 1000V IEC 1600V UL Industry leading performance at low irradiation Maximum Series Fuse Rating 15A environment,+95.5%module efficiency from an Application Classification ClassA irradiance of 1000w/m'to 200w/m' Power Tolerance 0- 5W (AM 1.5,25-C) Next Generation Solar Module Under Standard Test Conditions(STC)ofirradiance of 1000W/m'.spectrum AM 1.5and cell temperature of251C NewEdge,the next generation module designed for multiple Engineering Drawings NOCT CS6P-235P CS6P-240P CS6P-245PX CS6P-250PX CS6P-255PX types of mounting systems,offers customers the added Nominal Maximum Power(Pmax) 170W 174w 178W 181W 185w value of minimal system costs,aesthetic seamless Optimum Operating Voltage(Vmp) 27.2V 27.3V 27.4V 27.5V 27.5V appearance,auto groundingand theft resistance. Optimum operating Current(imp) 6.27A 6.38A 6.49A 6.60A 6.71A Open Circuit Voltage(Voc) 33.9V 34.OV 34.1V 34.2V 34AV The black-framed CS6P-PX is a robust 60 cell solar module Short Circuit Current(Isc) 6.86A 6.96A 7.08A 7A9A 7.29A incorporating the groundbreaking Zep compatible frame. Under Normal Operating Cell Temperature.Irradlance of 800 W/m',spectrum AM 1.5,ambient temperature 201C, The specially designed frame allows for rail-free fast wind speed 1 m/s installation with the industry's most reliable grounding t Mechanical Data system.The module uses high efficiency poly-crystalline Cell Type Poly-crystalline 156 x 156mm,2 or 3 Busbars Key Features silicon cells laminated with a white back sheet and framed Cell Arrangement 60(6 x 10) with black anodized aluminum.The black-framed CS6P-PX Dimensions 1638 x 982 x4Omm(64.5 x 38.7 x 1.57in) • Quick and easy to install - dramatically is the perfect choice for customers who are looking for a high weight mm Tempered (45.2ed glass reduces installation time quality aesthetic module with lowest system cost. Front cover 3.2mm Tampered glass Frame Material Anodized aluminium alloy • Lower system costs - can cut rooftop Best Quality J-Box IP65,3 diodes installation costs in half Cable 4mm'(IEC)/l2AWG(UL),1000mm 235 quality control points in module production Connectors MC4 or MC4 Comparable • Aesthetic seamless appearance - low profile • EL screening to eliminate product defects Standard Packaging(Modules per Pallet) 24pcs with auto leveling and alignment • Current binning to improve system performance Module Pieces per container(40 ft.Container) 672pcs(40'HO) • Accredited Salt mist resistant • Built-in hyper-bonded grounding system - if it's I-V Curves(CS6P-255PX) ! mounted,it's grounded Best Warranty Insurance 'o I - ! • Theft resistant hardware • 25 years worldwide coverage ' V I I I 100%warranty term coverage • • Section A-A - • Ultra-low parts count - 3 parts for the mounting • Providing third party bankruptcy rights ! ' and grounding system • Non-cancellable ' ! • Industry first comprehensive warranty insurance by • Immediate coverage AM Best rated leading insurance companies in the • Insured by 3 world top insurance companies i 3 o V. _7 I world Comprehensive Certificates ' -_�°-/T' 2 • Industry leading plus only power tolerance:0-+5W -ow m: -asc • IEC 61215,IEC 61730, IEC61701 ED2,UL1703, • Backward compatibility with all standard rooftop and CEC Listed,CE and MCS +: _ 3. m 4.1 1 . ,6 p N y .. ., ground mounting systems • IS09001:2008:Quality Management System vh -`•�'"�' • ISO/TS16949:2009:The automotive quality 'SpeciOcations included in this datasheel are subject to change without prior notice. • Backed By Our New 10/25 Linear Power Warranty management system Plus our added 25 year insurance coverage IS014001:2004:Standards for Environmental About Canadian Solar management system Canadian Solar Inc. is one of the world's largest solar Canadian Solar was founded in Canada in 2001 and was 100 QC080000 HSPM:The Certification for companies. As a leading vertically-integrated successfully listed on NASDAQ Exchange (symbol: CSIQ) in sT Added Value F manufacturer of Ingots,wafers,cells,solar modules and November 2006. Canadian Solar has module manufacturing Sox rOm tyarrarlty Hazardous Substances Regulations solar systems, Canadian Solar delivers solar power capacity of 2.05GW and cell manufacturing capacity of 1.3GW. • OHSAS 18001:2007 International standards for products of uncompromising quality to worldwide 80% occupational health and safety customers. Canadian Solar's world class team of REACH Com Rance professionals works closely with our customers to ox 5 10 1s 20 2s ' P provide them with solutionsforall theirsolar needs. Headquarters 1545 Speedvale Avenue West 10 year product warranty on materials and workmanship Oz 4i aSP��E C7 ( `era' 1 25 year linear power output warranty www.canadiansolar.com EN-Ro,10.17 Copyright a 2012 Canadian Sole,Inc. solar=ee solar=ee SolarEdge Power Optimizer Module Add-On for North America P300 / P350 / P400 SolarEdge Power Optimizer Module Add-On For North America ( P300 P350 Paoo for 60-tell PV (for 72-cell PV (for 96•cell PV modules) modules) modules) P300 / P350 / P400 • INPUT Rated Input DC Power"I 300 350 400 W ............................................................................... .......................... ....................................................... ............. Absolute Maximum Input Voltage(Voc at lowest temperature) 48 60 80 Vdc +',, - ". MPPT OPeradng Range...........:.... 8 48 8 60. ..............8.:.80....... ....Vdc '. .,.: - - r Maxmum Short Grcw[Curren[Ilsc)............................... ......... ......... ........... 10 ... ....Adc.. .r _f, , -. ....... .. .. ............................ ............................................................................... ..... .;.,� - "+ • MaX1 um.Dt Input Current.... •12.5 Adc .a.r l� Maximum Efficiency .... .. .....% . Weighted ................................Efficiency..................................................... .. ...985.. ....%.. .. ....................................... ..... ...... Ovemoltage Category II + sro OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) } `• ",:� „- V Maximum Output Curren[ 15 Adc ............................................................................. ........................................................ ......................... .. ............. Maximum Output Voltage 60 Vdc /� • OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) Safety Output Voltage per Power Optimizer 1 Vdc STANDARD COMPLIANCE EMC FCC Part15 Class B.IEC61000:6.2.IEC61000.6- .................... ..... Safety IEC62109 1(class II safety)UL1741 . ROHS Yes INSTALLATION SPECIFICATIONS - - Maximum Allowed System Voltage 3000 Vdc Dimensions(Wxlx H) 141 x212x40.5/S.SSx8.34x1.59 mm/in ............................................................................... ................................................................................................. Weight(including cables)...................... ...................................950/2:1.................................... Input Connector MC4/Amphenol/Tyco ' Output Wire Type/Connector Double Insulated;Amphenol ............................................................................... .......................... ........................................................ ............. Output Wire Length..................................................... .......�95.�3�.......I.......................1:2/3:9 m/k Operating Temperature Range 4 -+85/-40-+185 'C/'F ' .....................g........................................................ ................................................................................................. Protection Ratin IP65/NEMA4 ............................................................................... ................................................................................................. Relative Humidity .....................................0_:100 % of pme0 tTC powerol Ua npUWe.MaENe al,q[o,t%power[ox+arce albwM. PV SYSTEM DESIGN USING A SOLAREDGE SINGLE PHASE THREE PHASE THREE PHASE INVERTER 208V 480V PV power optimization at the module-level Minimum String Length(Power Optimizers) 8 10 18 ............................................................................... Up to 25%more energy Maximum Strin Length Power Optimizers) 25 25 50 ....................�....................P.........�........................ ........................... ........................... ........................... ............. Maximum Power er Strin - Superior efficiency(99.5%) I P 8 5250 6000 12750 W Parallel Str(ngs of Different Lengths or Orientations Yes ' - Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading 1 � ""-"•"'•••••'••�••�•�-��••��•��•�••••••••••��•••-��............... ............................• ............. - Flexible system design for maximum space utilization it Fast installation with a single bolt I - --- - - - --•-- -- - _ - - -Y - -__ _ _ - _��_ _. - _ Next generation maintenance with module-level monitoring - Module-level voltage shutdown for installer and firefighter safety - USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www.solaredge.uS CE ON I I - Single Phase Inverters for North America =ee solar SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-USsolar • SE7600A-US/SE10000A-US/SE11400A-US SE3000A-US SE380OA-US I SESOOOA-US SE6000A-US SE76COA-US I SE10000A-US I SE1140OA-US _ OUTPUT 9980 @ 208V S o I a rE d g e Single Phase Inverters • Nominal AC Power Output 3000 3800 5000 6000 7600 10000 @240V 11400 VA . . . . ... ........... . .5400 @.208V . ............ ............ . .10800 @ 208V.. ............... ......... For North America Max.AC Power Output 3300 4150 6000 8350 12000 VA 5450 @240V 10950 @240V . .........ol.....Min..... ..-M...... ................ ............... ................. ................ ................ .................................. AC Output Voltage Min:Nom:Max.• SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ AC Output Voltage ......... .................................... ........... . ........................................ . AC Output Voltage Min:Nom:Max.• � � � � Or SE760OA-US/SE1000OA-US/SE1140OA-US 211-24D-264vac .AC Fre4uency.Min..Nom.;Max.•.._.. 59.3.-.60-.60.5(with HI country.setting•57:60;60.5).............. .•............ ..Hz..... Max.Continuous OutputCurrent..... .....1.........I...............I.. .16@ 40V..I......2........I......3Z.......I.........240V...I......4............ ....A..... • GFDI............................:...... ............................................................1............................................................. ....A..... Utility Monitoring,Islanding Protection,Country Configurable Yes ""---•fgpv a rte j'^• Thresholds —� � 2J•� INPUT 12� n.^ Recommended Max.DC Power" 3750 4750 6250 7500 9500 12400 14250 W m �� aRanrl c)................................... ................ ............... ................. ................ ................ .................................... ........... IS? xv T1'1 ••�' Transformer-less,Un rounded Yes ,,.,na•^ Max.In ut Volta e .....................................500 Vdc.... Nom.DC Input Voltage 325 @ 208V/350 @ 240V Vdc .............. ........ ............... ............ ..16.5 @ 208V ...... a� .r Max.Input Currerl 9.5 13 18 23 34.5 Adc - p .... ..............I............... .15.5.@_240V.I................I................I..30.5...240V.................... ........... Max.Input Short Circuit Current 30 45 Adc .................................... .. ..... ....................... .. .. .... Reverse-Polarity Protection Yes ........... .......................................................................................................................... ........... �" Ground-Fault Isolation Detection 600kn Sensitivi .� Maximum InverterEfficien.y......... ...... �::98.2. 98.3 98.3. . .•...9..... .....98...•. ......98..... ...%..... ....M.................�Y.......... ............. ......... ............... i - - CEC Weighted Efficiency 97.5 98 97.5 @ 208V 97.5 97.5 97 @ 208V 97.5 % 98 @ 240V 97.....240V.................... Nighttime Power Consumption <2.5 <4 W ..ADDITIONAL FEATURES - -- Supported Communication Interfaces R5485,RS232,Ethernet,ZigBee(optional) .......................................... ................................... ................P............................................................. ......... .d, .. Revenue Grade Data,ANSI C12.1 Optional STANDARD COMPLIANCE } -� :- --- - Safet UL1741,UL1699B,UL1998,CSA 22.2 Grid Connection Standards IEEE1547 _. Emissions FCC partIS class B INSTALLATION SPECIFICATIONS AC output conduit size/AWG range 3/4"minimum/24-6 AWG 3/4"minimum/8-3 AWG y �, I ..................................... ................................................................... ...................................................... ........... ..DC input conduit size/ft of strings/ 3/4"minimum/1-2 strings/24-6 AWG 3/4"minimum/1-2 strings/14-6 AWG (i.............................. ............. ........... / Dimensions with AC/DC Safety 30.5 x 12.5 x 7.5/ 30.5 x 12.5 x 10.5/775 x 315 x 260 in/ i. .Switch(HxWxD) 775 x 315 x 172 775 x 315 x 191 cam 01 - - A' .......... ................................ .................................. - - _.,..: Wei ht with AC DC_..__,.,_ _ - g . Safety Switch 5..2/23,2..,... 54.7/24.7 88.4/40.1 Ib/,kg_.. Cooling. ...............NaturalConvection .............fans(user replaceablel.........••.•. „••,•,,,,, .................................... . The best choice for SolarEd a enabled s Noise <zs <so g Y Min:Max.Operating Tempera[ure�� .��.�.��....�.�.........�... "••-4 _13to+140/-25to+60(CANversion0to+60)....��..•..'...��...�..��'.. �. stems -F/'F/-C � • - Integrated arc fault protection(Type 1)for NEC 2011690.11 compliance Range . ....... , — Superior efficiency(98%) Protection Rating........ ............. ..... ..............................................NEMA 3R........................................................ ........... •For other regional settings please mntatt SolarEdge support Small,lightweight and easy to install on provided bracket limited to 125%for locations where the yearly average high temperature is above77-F/25'C and to 135%for locations where it is below 77'F/25•C Fordetalled information,refer to htto//www solaredae us/files/odfstinverter do oversi[Inx aulde.odf Built-in module-level monitoring A higher wrl soume may be used;the Inverter will limit its input wrent to h U values stated. CAN P/Ns are eligible ble for the Ontario FIT and microFlT lmimFIT es S SCAN).E 11400A — Internet connection through Ethernet or Wireless — Outdoor and indoor installation I — Fixed voltage inverter,DC/AC conversion only I I — Pre-assembled AC/DC Safety Switch for faster installation — Optional—revenue grade data,ANSI C32.1 sunsa:c RoHS USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL www-solaredge.us D By SGUMEDGE