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0194 TOWER HILL ROAD
a .�a � ° .. � o° � v � � m �� � � � �, �r �' e a , o o � � ,. � - t' , i n � . e - a ,.. b ^ , �.r � �� � � a il� i. .. .. i � i, ^ � .. e T j r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I .. o��J n� Ma l Parcel O I �'('i `� It AR. STABI Application # 15 03 P PP Healthbivision 9 p j 9 Date Issued Conservation Division Application Fee ' O Planning Dept. Permit Fee C-1,6 ' s Date Definitive Plan Approved by Planning Board 1 !V! pp pf Historic - OKH _ Preservation / Hyannis Project Street Address �qy 1-6we,- 41 Village 0 -s+e,-Vi II e Owner Joe I Fe-org4rg Address wY Towt,_ leiP R d f Q S�tr�,`lC Telephone1` fJW- .2 $ 2 '19 Permit Request R S Q ( 501 g r Pgn-e�S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation l 3i Doo 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 ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C 6 ' har� Telephone Number .732 35'1 3110 Address D4 k S n� r'0 3 License # a�121 Home Improvement Contractor# M2 2 OL/ Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 12Ll Tvr�n,p G(Q Lyn- SIGNATURE / DATE FOR OFFICIAL USE ONLY _ APPLICATION# r. t DATE-ISSUED MAP/PARCEL NO. 5 ADDRESS VILLAGE OWNER ' n t DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL k $ FINAL BUILDING DATE CLOSED OUT - Y ASSOCIATION PLAN NO. r - Town of Barnstable Regulatory Services • 13AJ MSTwEffA • Richard V.Scali,Director s639. �0 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, J 6&] Fesn sera ,as Owner of the subject property hereby authorize h i 7 C D u i►1 a rd- to act on my behalf, in all matters relative to work authorized by this building permit application for. 19y Towt-r P I Il �I (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner- Signature of Applicant J Dh► 1� a Print Name Print Nanvie Date _ Q:FORMS:OWNEUERMI.SSIONPOOLS Town of Barnstable ' Regulatory Services ��oFirre rOiyy Richard V.ScaIi,Director Building Division A MASS. Tom Perry,Building Commissioner i639• ��� 200 Main Street; Hyannis,MA 02601 QED0. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATIOR, number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRFSS: city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigaed`homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. - The undersigned``homeowner",certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that. "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.:1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner ceflify that he/she understands the"responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WpFII ES\FORMS\buflding permit forms\EXPRFSS.doc Revised 061313 91te &wwwwaxeald Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 172284 Type: LLC Expiration: 6/7/2016 Tr# 251923 SKYLINE SOLAR, LLC. PETE DEBBAS 124 TURNPIKE ST SUITE 10 WEST BRIDGEWATER, MA 02379 Update Address and return card.Mark reason for change. DPS-CAI b song-o4ro4.a/o121s [' Address IJ' Renewal E] Employment Lost Card 71. �o�srmzo7uo�eal!/ o�✓�foaaac/auaetld 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: Registration: 172284 Type: Office of Consumer Affairs and Business Regulation Expiration: 6/7/20116 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 SKYLINE SOLAR,LLC. PETE DEBBAS 124 TURNPIKE ST SUITE:10 WEST BRIDGEWATER,,MA 02379 Undersecretary Not valid without signature Massachusetts-Department of Public Safety Board of Building Regulations and Standards 0imtruction supenisor License: CS-027047 p11S PHQ.IP J CHOUIlr1> - '79 Oak St.Unit#NJ Ashland MA 0171L Expiration Commissioner 11/09/2015 GXC �f�Ol`17��'�st�2/��i�+fr�C�I_(✓ t�p� �.%'�F������'/�f/l�f�f(.;7,:A• Office of Consuaier Affairs end Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 0211.6 Home Improvement Contractor Registration Registration: 172284 Type: Supplement Card SKYLINE SOLAR, LLC. Expiration: 6I7/2016 PHILIP CHOUINARD - - -- 124 TURNPIKE ST SUITE 10 - WEST BRIDGEWATER, MA 02379 Update Address and return card.Mark reason for change. SCA i Co 24M.05S11 0 Address Q Renewal n Employment n Lost Card (V�1$ ficc of Consumer Affairs& Business RegulationLicense or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration: 172284 Type: 10 Park Plaza Suite 5170 Expiration: 6/7%2016 Supplement Card Boston,MA 02116 SKYLINE SOLAR,LLC. PHILIP CHOUINARD 139 GLENDALE AVE. EDISON,NJ 08817 Undersecretary Not valid withopt signature I ® �Olg�1Z - U CAPE COD TO 0 INSULATION 7 7— 0"T -9 ,,a 8- i5 c-/ ®®® !IBlY O1A33 StAMlE33 SPRAT LOAM SUSPENOEO --- --- --- -- BATTS OUTTIBS UVSU.'ON CNEINOS 1-800-696-6611 0I"`I S" Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village 1 L©Y' eQ�sa. Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) YO Crawl Floors � ) ( >) ( %) O (X) Kett Walls (jC ) ( ) (10 ) ( ) (X) �iP Yea io 1 Sincerely He y E C sidy J , President Cape Cod nsulation, Inc. ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TOW-i OF BARINSTAB±P Map-/Yz. Parcel L Application Health Division �QfZ J[IL I 'a 6 ate issued __l 10 l Z, Conservation Division Application Fee Planning Dept.t. � :E—Permit-Fee L)1�ft�.C��r Date Definitive Plan Approved by Planning Board -71zo flZpe Historic - OKH _ Preservation/ Hyannis Project Street Address / /mow eye ,f� w Village Owner -Address j;' Telephone ti��J � Permit Request Z �D ��/.�✓�� / G'G �U�a 1�' /�G ��t/�� f/ �1�� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation R Yeo d Construction Type lWjz, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,0-- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Q-No On Old King's Highway: ❑Yes -2-Mo 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 ❑ ElectriQ ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning`Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �� G'�o� Zf :(,A7;�0A,4 Telephone Number Address �f-�S i � ��U �c1 License # Jl/✓�i���l�� Home Improvement Contractor# A 7,5rZ 7 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY 1 APPLICATION# DATE ISSUED { MAP/PARCEL N0. r.t• . } I i 1 ADDRESS VILLAGE s OWNER � 4 DATE OF INSPECTION: ' FOUNDATION '. FRAME I INSULATION FIREPLACE j 'ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL—, GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT f ASSOCIATION PLAN NO, 1 'A OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) , (Property Address) hereby authorize Co (Subco t actor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. O j s . ignatur Date -i U 1C . 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 " Home Improvement Contractor Registration Registration: 153567 - Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 r a CAPE COD INSULATION, INC t z ;:_;. HENRY CASSIDY �" 455 YARMOUTH RD. HYANNIS, MA 02601 `{ ------ •.� `fUpdate Address and return card.Mark reason for change. .. /� Address Renewal Employment ❑ Lost Card �;Lsti DPS-CA1 0 50M-04/04-G101216 Office o umer Affairs us ne �Re,gu.fI tion License or registration valid for irdividu! use en!y HOM� � �ivael�a before the expiration date. If found return to: Registration: 153567 Type: Oft-ice of Consumer Affairs and Business Regulation Expiration: 12/15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 D INSULATION;.INC.,... kluz:'vo HENRY CASSIDY`: 455 YARMOUTH RD_ HYANNIS, MA 02601 Undersecretary AIi .th ture 1�I9:-ss"llusetts I)cpartmcnt of Public Sal'eth Board of Buitding Regulations and Standards'. . Construction Supervisor License License: CS 100988 HENRY CASSIDY 8 SHED ROW WE%�TI YARMOUTH,:MA 02673 Expiration: 11/11/2013 ('ununissil"1e1• Tr#: 7620 1 • The Commomcc alth of Massachusetts Department o ndustrial Accidents W Office of lavestigations a - w 600 o,.N'hington Street F .ry - Boston, AIIA 02111 WVVll.11tr.l,s.gov1dla Worker's conipensation Insurance Affidl;a..it: Builders/Cofitractors/Electricians/Pluiiibers rtpplicant Information Please Print Legibly Name(B Lis ir)ess/Organization/individual): C2 r. Q \tidress: C*11)'/Srtll4/'lip:. rey2 tV )VIA a 2 de- � Phone#: !rd -72 6 -r— Are you an employer? Check the appropriate box: Type of project(required): I. �l 1 ant a employer with ©_ 4• ❑ I am a gc-ntr r:J contractor and I have 6. ❑ New construction culplUyecs (full and/or part-tinie).* hired the sub-contractors listed on 7. ❑ Remodeling ❑ the attached sheet.$ and a rule proprietor or partnership These sub' ontractors have 8• ❑ Demolition and have no employees working for employer.;:ind have workers' comp. 9. ❑ Building addition me in any capacity. [No workers' insurance j: 10. ❑ Electrical repairs or additions comp insurance required.] 5. ❑ We are a cot poration and its officers have•exercised their right of 11. Plumbing repairs or additions l ❑ l an,a homeowner doing all work exempriorl per MGL c. 152§(4),and 12. Roof repairs myself. [No workers' comp. we have:im crinployees.[No workers' 13. Other e(,� insurance required.] t comp. insur:nlce required.) l� r F. 'Any applicant that checks box #1 must also fill out the section below showing their workers'compensation policy information. f ttumrowncrs wlto submit this affidavit indicating they are doing all work:md thcn hire outside contractors must submit a new affidavit indicating such. Wontrtctors that check this box must attach an additional sheet showing dtc n:une of the sub-contractors and state whether or not those entities have enyrloyees.II' the sub-contractors have crnployccs,they MUSE provide their workers'comp.policy number. I run cut employer that is providing workers'compensation insa.,•ance for my employees.Below is the policy and job site irtfurntaliort. ^ ,t�-� r,t /� AflInsurance.Company Name: 1 1 �. f^ L1 I Q 04!6 C_..6 Policy it or Self-iris. Lie. #: 02r Expiration Date: Job Site Address: _ _ City/State/Zip: !leach 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. I5_'can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or 011e-year il"PIlsolttttent,as well as civil penalties in the form of a STOP Wol,,K ORDER and a fine of up to$250.00 a day against the violator.Be advised that a copy of this statement ma e forwarded to the Office of Investig:uhnis of the DIA for insurance coverage verification. 1 d4her�e�c, under the pains and penalties of'perjtay that the information provided above is true and correct. Sionatufc, Date: `��/71.zy ['hone##: Uff'iciul use only. Du not write in this area,to be completed G_r ci[y or town official City or Towit: Permit/License# Issuing Authority (circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Uther • Contact Person: Phone#: 1 Ju 1. 2. 2012 3: 17PM No. 1605 P. 1 Client#:4597 CCINSLIL ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 07/02/2012 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 cerllflcate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and condltlons of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certifcate holder in lieu ofsuch endorsemenl(s). PRODUCER NAME: Margaret Young Rogers&Gray Ins.-So.Dennis PHONE 508-760-0602 -11 434 Route 134 E ac AIL L Exl: q/C No: 677-816.2158 -M South Dennis,MA 02660-1601 508 398-7980 WaURER(B)AFFORDING COVERAGE NAIC8 INSURER A:Peerless Insurance 18333 WSURED INSURERS:Evanston Insurance Company Cape Cod Insulation Inc INSURERC:Atlantic Charter Insurance 455 Yarmouth Road Hyannis,MA 02601 INSURERD:Commerce Insurance Company 34754 INSURER E: IN6URER F COVERAGES CERTIFICATE NUMBER; RFVISION NUMBER: THIS 19 TO CERTIFY THAT THE POLICIES OF INSURANCE I.ISTED 13EI-OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, Lq EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY MAVF BEEN REDUCED BY PAID CLAIMS. tY TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLI MMIDC YEEF POUCYNYW LIMNS A GEN£RALLIAeIL17Y CBP8263063 4101/2012 04/011201 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY PREMISES NTED $100000 ocarrcnce CLAIMS-MADE X OCCUR MEO EXP(Any one Penton) s 5 000 PERSONAL,&ADV INJURY 51000000 G£NERALAOOREpATE $2,000,000 GEML AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMPIOPAGG $2000000 POLICY PRO- LOC $ 17 AUTOMONILELIA9ILITY 12MMBCKVMK 4/01/2012 04101/201 COI�CDSINGL-LIMIT 1 OOOOOO ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Pat ateidenq $ X HIRED AUTOS X NON-OAUTOSWNED PROPERTY AM $ $ B X1 IIMERELL.ALIAa OCCUR XONJ453512 4/01/2012 04/01/201 EACHOCCURRENCE 31,000,000 EXCE56 uqs CLAIMS-MADE AGGREGATE $1 OOO OOO DED X RETENTION 1000U $ C AND EMPS COMRENBA IONILIT WCA00525902 6/30/2012 06/30/201 X WC STATU. OTH- AND EMPLROYE7RSq'/pLfgAgB�INLITY X Y/N Y I i OFFICERIMEM90ERE 96EQTf�7 ECVTIVFa N/A E L.EACH ACCIDENT 1 OOQ OOO It es,deory scrinNH) E.L DISEASE-FaQI PLOYEE $1 000O00 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Atfaoh ACORD 101,Addlilonal Remarks Sehedwe,If mole apace la required) `t Workers Comp Information*r Included Officers or Proprietors Certificate Holder is Included as an additional insured under General Liability when required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION Cape Cod Insulation,lnc SHOULD ANY OF THEABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DELIVERED IN ACCORDANCE WITH THE POLICY PROVIsloNs. AUTHORIZED REPRESENTATIVE ®198 -2010 ACO)7D CORPORATION.All rights reserved. ACORD 25(2010105) 1 Df 1 The ACORD name and logo are registered marks of ACORD #383849/M83848 MEY 03/20/2010 22:39 5087785731 CAPE COD INSULATION PAGE 01 1 Cape Cod Insulation, Inc. 03/1.0/20 1 0 45 5 Yarmouth. Road Hyannis, Ma. 02601 Ph..l -800-696-661 1 Fax. 1 -508-778-5735 To, Barnstable.Building Department, Cape Cod Insulation installed CertainTeed Insulsafe 4 R-1. 5 blown in-fiberglass insulation in outside walls at 194 Tower Hill Road In th.e village of Osterville. Thanks Keith Presswood Sales Manager o. Cn o o 10 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- 6 Parcel Application #UC on? Health Division Date Issued 1 Conservation Division Application Fe$ 0 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board JO�i�oy Historic - OKH Preservation/ Hyannis Project Street Address k10 Village STERVW, Owner Address SAMcr Telephone� e�9Z8-6 T6 2 H (seB B•/fzo w Permit Request / ls.oe �-A fIE JTt7F F er � t tt �a�+2r. Ei- �.ix+T ti✓/NOo+✓ OAJ SEtev� �s-ooR W0-or-/IdE� /�iT�/LIN�T��Ls. QfOO/C (fotiTbfOE� 6fld/�/[�� 6ARAG6, Square feet: 1 st floor: existing /68 proposed 2nd floor: existing proposed Total new i Zoning District Flood Plain Groundwater Overlay Project Valuatiot; ,oo Construction Type Lot Size Grandfathered: ❑Yes U No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 51 — IHistoric House: ❑ Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: 51 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) fI6 Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing new First Floor Room Count S— Heat Type and Fuel: ❑ Gas , Oil ❑ Electric ❑ Other Central Air: ❑Yes 16 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No hed garage existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ A 'hed garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: � � o Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ o UJ _ Commercial ❑Yes ❑ No If yes, site plan review # o Current Use Proposed Use APPLICANT INFORMATION --�� (BUILDER OR MEOWNER Name SriQA Telephone Number 1!4 Z6ib- 7z79 CEa4- Address f License # AIA e 2- 5-f Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO, �R,�v£�p� SIGNATURE DATE eZ4 4� ' . FOR OFFICIAL USE ONLY ,APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE. OWNER , DATE OF INSPECTION: f FOUNDATION FRAME INSULATION v I a�Zbly7 FIREPLACE ELECTRICAL: ROUGH FINAL a PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING d 31K/0 Fl DATE CLOSED OUT ASSOCIATION PLAN NO : F C - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): r�L Z, F�6NfrAx Address: /9sf Two �iat. .� City/State/Zip: o z6 SS Phone #: S oe zBo 7i71 eve— Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. E'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 workingfor me in an capacity. employees and have workers' y p ty comp. insurance.$ 9. ❑ Building addition [No workers comp. insurance p 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.® Other /Nf ,.drin/G comp. insurance required.] "Any applicant that checks box til 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: 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 hereby certify under the pains andpenalties ofperjury that the-information provided above is true and correct. Si nature: .f Date: .S"/4/, 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#: C W 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." . Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. 'Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax # 617-727-7749 www.mass.gov/dia i ENE-RGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE,, A_ND TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (790 CMR 61.00) Applicant Name: G �c- Site Address: - print Town: Applicant Phone: o�;;;y10-Zx 7,P wire Applicant Signature: j Date of Application: o NEW CONSTRUCTION: choose ONE of the following tWO'0 tions 780 CMR TABLE 6107.1 PRESCRIPTIVE EN--fELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXEMUM MINIMUM Ceiling or Slab ❑ Option 1: Fenestration exposed Wall Floor Basement perimeter Wall AFUB HSPF SEEI U-factor floors R Value R-Value R-Value R Value R-Value and Depth National Appiiancc•Encrgy 3 5 R-3 8 R-19 R=19 R-10 R-10, Conservation Act(NAECA)of 4 ft.' 1987 as amcndcd,minimums or cater as!22licabir, Note: This form is not required if you choose either of the two versions of RES check as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck--Web which can be accessed at http•//www.enCrgycodes.gov/rescheck/ ADDZ�' ONS:OR AI,T tAT)Ol S.T0 EXYS P R S YEARS O) I)* *Buildings under 5 years old must use option#1 or 42 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b- a) SF 100 x — _ % of glazing (b) Glazing area equals SF 6 a If glazing—is<�40%.use the chart beloW, If glating is > 40 % rocee.•d to "SUNROOM" section 780 CMM TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESLOENTIA.L BUILDINGS MAX MUM Ceiling and Slab Perimeter Fenestration -Wall Floor Basement Wall R_Value U-factor Exposed floors R-Value R-value R-Value R-Value and Depth .39 R-37 a R-13 • R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not com ressed over exterior walls, and including any access o enin s), ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Conygmer In ormation.Form found in A endix 120.P P�oFzr+E r�ti . Town of Barnstable y o Regulatory Ser'Vices BARNSTBLF- Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Maiu.Str-eet, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ��O.FS�T�IER-IrTCET�SE-EXEMPT70N oo Please Print -number street � village ._-,HOME -W DNER":-- /oEG E iV177P.O 6-0SY2BGTb;z name home phone# - work phom# CURRENT MArLiNG_ADDRESS-- �� T..�ae.Q //.t Ro . • �Srzss2�n L L.r � o�.6 city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINrnoN OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that_he/sbe understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirem -%e( �5.1 lure=of-Homco a--%--� Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION 'The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section.(Scctian 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a pc son(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this rxcmption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulation for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against thc unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of hisAr.r respannbilities,many communities require,as part of the permit application, that the homeowner certify that hc/shc understands the responsibilities of a Supervisor. On the last page of this issue is a.form currently used by several towns.'You may care t amend and adopt such a forrrrtcertification for use in your community. Q:forrrrs:homccx cmp t �► r Town' of Barnstable Regulatory Services NSTAB'Y� Thomas F_ Geiler,Director Fo; 16 Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.b arnstab l e.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Us ina A Builder I� er of the subject.property hereby authorize to act on my behalf, in all matters relative to work autho y this building permit application for. Address of Jo Signature of er Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERM ISS ION Date: 9/25/2009 Time: 3:37 PM To: Feenstra, Joel @ 9,15087713277 Rogers & Gray Ins. Page: 002 Client#:4597 CCINSUL ACORD,. CERTIFICATE OF LIABILITY INSURANCE 092s09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.-So. Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.Box 1601 South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Peerless Insurance 34754 Cape Cod Insulation Inc INSURER B: Atlantic Charter Insurance 455 Yarmouth Road INSURER C: Commerce Insurance Company Hyannis, MA 02601 INSURERD: 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 NSAOkUU TYPE OF INSURANCE POLICY NUMBER DATE(MWWDDDm PDATE EI�X 0D TION LIMITS IN5RA GENERAL LIABILITY CBP8263063 04/01/09 04/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100 000 CLAIMS MADE a OCCUR MED EXP(Any one person) $5 000 PREMISES Me occuffence) PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC PRO- JECT C AUTOMOBILE LIABILITY 09MMBCKVMK 04/01/09 04/01/10 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULEDAUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON OWNED AUTOS (Peraccidenl) PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WCA00525900 06/30/09 06/30/10 X WC I IMIT OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Joel Feenstra DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAU. I Q_ DAYS WRITTEN 194 Tower Hill Road NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Ostervllle,MA 02655 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #S46256/M46044 CBR 0 ACORD CORPORATION 1988 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A6 s l'y�t0/ Parcel,-," arcel, p Application # Ma HealthDivision 'Date Issued Conservation Division .?�Application Fee Planning Dept. Permit Fee •�= Date Definitive.Plan Approved by Planning Board Historic t OKH Preservation / Hyannis Project Street Address LZ_ Village 1//L-LLs Owner saeI trt141 Address S,�✓%L= Telephone 5�� �a?d�- 7l Permit Request ��v,S�/jur7 ��t/ JV 1y--0V �C1 4 Waw7- �i���P�'�� �'PtiS���K cc/ Square feet: 1 st floor: existing`r proposed //_Q 2nd floor: existing proposed ' Total new 0 i Zoning District Flood Plain Groundwater Overlay Project Valuation .2 6-11-4 00' Construction Type weop AWM& Lot Size /00 a a D Grandfathered: ❑Yes 0<o If yes, attach supporting documentation. Dwelling Type: Single Family ij�_ Two Family ❑ Multi-Family (# units) Age of Existing Structure _ 0 e Historic House: ❑Yes C9"No On Old King ghway: 0 Yesxolo - Fa') Basement Type: 0"Full O Crawl ❑Walkout ❑ Other CVcul- !,'4 U S; Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) ? ` . Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: �✓ existing _new Total Room Count (not including baths): existing new First Floor Room Count .� Heat Type and Fuel: ❑Gas © Oil ❑ Electric ❑Other rffQ Central Air: ❑Yes oo Fireplaces: Existing New Existing wood/coal stove: ❑Yes O'Nlo Detached garage: Of existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: Ur/existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION l (BUILDER OR HOMEOWNER) Name A//�c� - Telephone Number g a Address 3& fl License#_Cf .57 IL1�/�✓i,S /�,� a�GG% Home Improvement Contractor# 11,�,�09 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THISPROJECT WILL BETAKEN TO 7/s-IC4e SIGNATURE -/�� L �e� DATE ll FOR OFFICIAL USE ONLY _ APPLICATION# DATEISSUED MAP/PARCEL NO. ~ADDRESS - VILLAGE 4OWNER DATE OF INSPECTION: V.FOUNDATION x FRAME 50F*T `7131 .INSULATION OR,Y/Zc!o FIREPLACE ELECTRICAL: ROUGH FINAL `:PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING g t3� `21�L4 9 fit DATE CLOSED OUT ASSOCIATION PLAN NO. F i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations- ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 11PItl lz�;, (14/7-142-ITiV Address: City/State/Zip: 4.+ t5 Y'f� 0,2G Of Phone.k 5^C-�- XY0— 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 ployees(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 8.'❑ Demolition workingfor me in an capacity, employees and have workers' Y P tY• $ 9. wilding addition [No•workers' comp.-insurance comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P .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.❑ 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. XContractors that check this box must attached an additional sheet showing the name of the sub-contractors and sttte 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.M 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 tip 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. Ido hereby certify under the .¢ins andpenalties ofperjury that the.information provided above is true and correct Si ature: Date: Phone#: S-C!1�__ a Si(1— 3 S'6_-I_ 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 of 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 azth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of . insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions'regarding the law or if you are required to obtain a workers' compensation policy,please-call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials .Please be sure that the affidavit is complete"and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/hGense 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 eitizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license of 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 C6mmonwea—M- of Massachusetts Department of ladust idl Accidents Office of Investigations- 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-$77-MASSAFE Fax# 617-727=770 Revised 11-22-06 /,�ww.mass.gov/dia . :www.mass.g4v/dia oxTa�ti Town of Barnstable Regulatory Services . • ,uu„sr"urn . NAM l Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnsta:ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject.property hereby authorize ,5�i1,, Y E Cx v 1-71EN to act on my behalf, in all matters relative to work authorized by this budding permit application for. (Address of Job) /Signature of o vner Date �G c L C. f��xrS77eA Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERM ISSION Town of Barnstable SHE Tp Regulatory Services • Thomas F.Geiler,Director aAuvstesre. A.�� Building Division 1F01A/li Tom Perry,Building Commissioner 200 Main.Strept,_-Hyannis,MA 02601.. www.town.bax-nstable-ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: ciwtown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF BOMEOVVNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Department MIMMtun inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that Any bonreowner performing work for which a building parrot is mquirtd shall be exempt from the provisions of this section(Section I09.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption art unaware:that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bflat results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it Mould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensurt that the homeowner is fully ae of his/her responsibilities,many communities require,ea part of the permit application, war that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community.. Q:fcr ms;:hom=xcmpt ,per ✓2.Lr o,�ea o�./�iraa¢aEu�4ella i' Board of Buildifig Regulations acid Stafidiii tea HOME IMPROVEMENT CONTRACTOR ---= Registrations, 116609 Ex01ration 6V29/2l)90 Tr# 268043 � j . Type__Indivitlual BILLY'E:CAUTHEN BILLY CAUT H b - . -t HYANNIS,NIA`02601 � Adwaistrafo� �'�; �✓tieoa�a�3urnwea� d� �G����audcr�ella Board of Building Regulations and.Standards - k....:,_ ConstcucUon`Supefv"r CS=' 5 _�s'C �;�s ::ii4�:%':y';:�:i�':.i•iit�l:i:i:�:'i.':�;:a:'�.;`:dE:G:{�:::;%.�5 rz� � � Bi�thda �8113 ` � �� Exp�raUon 8/13/20Q9 � h Restnction SOU... ........:. .:....:.. BILLt£E CAIJTHEN "> ";�` - `.iComm�ss►oner 9 S;18 1. F 4')2 "7 A QUITCLAIM DEED 1, LAWRENCE E. KEANDER, of 194 Tower Hill Road, Osterville, MA 02655 For consideration paid and in full consideration of LESS THAN ONE HUNDRED AND oo/loo ($ioo.00) DOLLARS grant to LAWRENCE E. KEANDER, of 194 Tower Hill Road, Osterville, MA 02655, and JOEL E. IFEENSTRA and LORI A. FEENSTRA, husband and wife, as tenants by the entirety, both of 194 Tower Hill Road, Osterville, MA 02655, as Joint Tenants with quitclaim covenants the land together with the buildings thereon situated in the Village of Osterville, so called, Town and County of Barnstable, Massachusetts, the land being more particularly described as follows: Bounded on the North by land of John B. Lebel 193.99 feet. .On the East by land of Kenneth Perkins, 100.38 feet. On the South by land of Albert G. Williams et ux., 202.53 feet. On the West by Tower Hill Road 100.00 feet. Be any or all of said measurements more or less or however otherwise the granted premises may be bounded, measured, or described. Property Address: 194 Tower Hill Road, Osterville, MA 02655 For my title, see Deed recorded with the Barnstable County Registry of Deeds in Book 685, Page 458. Note: Title was not examined in connection with the preparation of this deed. Executed as a sealed instrument this 24 1h day of February, 2009. 4 m4ey' AWRENCE E. KEANDER r 4 0000� � y �� ✓ a •ram 8 � 3 tz s t�� -r IVY"'_ Bra„ , P� A) 189 Harbor Point : Gu►189; ud. M. 02637-0361 2; -- Oct i 2� p �L oaf Try Ar 2-) _.._.:. , 0>13 �. 2• -- 5 o 2 Of • D IEL E. -.. __. cm 3T C' h h O a a Simpoon5trong-Tie H IOA l� ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL*CONSTRUCTION (780 CMR 61.00) Applicant Name: .����� t� ��v7f/Gs� Site Address: pri r Town: Applicant Phone: Uk _ 3 DSt�i2vCl�� a2f,9 Applicant Signature: �� �,� Date of Application: ZE Cr9 NEW CONSTRUCTION: choose ONE of the folIowin two-options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM 'MINIMUM Ceiling or Slab dOption 1: Fenestration exposed Wall Floor Basement perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance-Energy 3 5 R-3 8 R-19 R=19 R-10 R-10, Conservation Act(NAECA)of q ft.• 1987 as amended,minimums or cater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ _Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck—Web which can be accessed at http://www.encrgycodes.goy/rescheck/ A,DDIT)IONS.OR ALTERATIONS.TO EXISTING BUILDIN68bVER`5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b-a) �j37,.6— SF 100 x -3S'�.��% of glazing (b) Glazing area equals 16 SF b a If glazing is<40%.use the chart below. If glazing is > 40 %' roceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM d Ceiling and Slab Perimeter Fenestration � Wall Floor Basement Wall U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and Depth 3 RR-3 7 a R-13 . R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling r(i. not com ressed over exterior walls, and includin an access o enin s).SUNROOM=An addition or alteration to an existing building/dwelling unit.where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in Appendix 120.P) 1Y12SS2.C111iSeLTS Ur1e.CWISt 101- �,.U11LjJ1J411C;t Pdu Loadbearing Wall Connections ' Lateral (no. of 16d common nails)................................(Tables 7)..................................................... Non-Loadbearing Wall Connections Lateral (no. of 16d common nails)................................(Table 8)....................................................... I' Load Bearing Wall Openings (record.largest opening but check all openings for compliance to Table 9) Header Spans ........... ........................................(Table 9).................................. a ft�in.5 1 1' ✓ Sill Plate Spans ........ .......................... ........(Table 9).................................. R 6 in.5 11' Full Height Studs (no. ofstuds)....................................(Table 9).................................................,...... Non-Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9).................................._ft_in.512' . Sill Plate Spans................:...........................................(Table 9).................................._ft—in.5 12" Full Height Studs (no. of studs)....................................(Table 9).................................I........................ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Minimum Building Dimension, W Nominal Height of Tallest OpeningZ ...............................................................................< < 6'8" ✓ Sheathing Type..............................................(note 4)....:................................................. C Edge Nail Spacing................ .................. (Table 10 or note 4 if less)........................ _in. Field Nail Spacing ............. ...... Table 10 ................................................. i2. in. Shear Connection (no. of 16d common nails)(Table 10)....................................................... /6. Percent Full-Height Sheathing...................:...(Table 10)...... ........_..................................._% 5%Additional Sheathing for Wall with Opening > 6'8'(Design Concepts).................... Maximum Building Dimension, L Nominal Height of Tallest Opening ......................................................................... <5 6'8" V SheathingType..............................................(note 4)..... *.............................................. -1 Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................_in. Field Nail Spacing ...... . ............ Table 11 .........:.....................................:. /ti in. Shear Connection (no. of 16d common nails)(Table 11)........................................................ Percent Full-Height Sheathing.......................(Table 11)............................................:......._% 5%Additional Sheathing for Wall with Opening > 6'8" (Design Concepts).................... ,,Nall Cladding Rated for Wind Speed?....::....................................... ZOOFS Roof framing member spans checked? Z... Rafters use AWC Span Tool, see BBRS Website) Roof Overhang ...................................................(Figure 19) ............. .c ft s smaller of 2' or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)......:.....................................U=/70 plf Lateral.............................................(Table 12).............................................L=/7/ plf Shear...............................................(Table 12).......:....................................S= 77 Of Ridge'S{rap Connections, if collar ties not used per page 21... (Table 13)...............................T= plf Gable Rake Outlooker..........................................(Figure 20 ft s smaller of 2' or U2 ' Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= lb. Lateral(no. of 16d common nails)...(Tabl' 14)....................... - ' b. Roof Sheathing Type................:..................................(per 180 CMR Chapters 58 and 59) �le.e..-pk Roof Sheathing Thickness.....................................:..... .................. AA /...J.... in. 7/16" W Roof Sheathing Fastening....•........................................(Table 2)... d/........G.:. (a.....- i � ✓ is checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of CMR•5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not wired per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b eption: Opening heights of up to 8 fL shall be permitted when 5% is added to th•e percent full-height sheathing ,iren ents shown in Tables 10 and 11. bottom sill plate in exterior walls shall be a minimum 2 In. nominal thickness pressure treated#2-grade. L�1 Check ,Compliancc SCOPE , P - ✓'f Wind Speed,(3-sec. gust).................... ............._....... .....__....... _.................... 110 m h Wind Exposure Category .............. ..................:.......................................... p g ry....:............. ............................... . Wind Exposure Category................Engineering Required For Entire Project .................. APPLICABILITY Number of Stories (a roof which exceeds 8 in'12 slope shall be considered a story) 2 'stories stories (Fig 2 .......:......................... RoofPitch ....................:..........................:...........................( 9 ) ........_. ft < 33' ►�� MeanRoof Height ...................:............................................(Fig 2)........................ ; ft 5 80, .....:..:..(Fig 3 .................................. Budding Width',W ....................................................... ( 9 ).............. "c s 80' ... .. Fi 3 ft 'Buddin Len th, L ......................................................... g• • g 9 : 5 3:1 ✓ Budding Aspect Ratio (LlW) .......•-.Z...............................:... .(Fi 9 4)...............,:......... .. ................... /•go G Nominpl Height of Tallest Opening ............................. .....(Fig 4)......-......... FRAMING CONNECTIONS ✓ General compliance with framing connections_:....:.............(Table 2).................... ...........................:.............. FOUNDATION Foundation Walls meeting requirements of 780•CMR 5404.1 ......................................... �� Concrete...' on cr�i e... � SOn/(f_.7Uf3[..; .................. Concrete Mason ••••••'•••••••••••••••. ANCHORAGE TO FOUNDATION"' 5/8'Anchor Bolts imbedded or 5/8' Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing-general .........................................:.(Table 4).................:..............:.............. in. Boll Spaci•rig from endfjolnt of plate .............................(Fig 5)..................:.._..........._.. 3_in. < 6"-12", Bolt Embedment-concrete..........................:..............(Fig 5)......_.............: — _....... .............:.. .._in. 1 7" : Bolt Embedment- mason. ................ (Fig5 ...._..............--...... in. >_ 15" ............(Fig 5 ..............................................>3"x 3" x Place Washer..........:......................................... ( 9 ). =LOORS 780 CMR Chapter 55 •••••••••••••-••• door framing member spans checked ..........................:..,.(perP •••••••••••••'•••' �` ... . .......(Fig 6).....................I.............................=ft 5 12' Maximum Floor Opening dimension....:............... . . . =ull Height Wall Studs at Floor Openings less than 2' from Exterior WaII (Fig 6).......•............................... ✓ M13ximum Floor Joist Setbacks ft. 5 d Supporting Loadbearing Wails or Shearwatl................(Fig 7)........................... T Maximum Cantilevered Floor Joists ft d Supporting Loadbearing Walls pr Shearwall............... (Fig B).................................................... _ < (Fig 9 " -.loot Bracing at Endwalls....................................................( g ......... -�•- er 780 CMR Gha ter 55 ••••••••... -� =1oor Sheathing Type (P P )................. . ... loot Sheathing Thickness .......................................•• •' '(Ter 780 CMR Chapter 55).......................�able d nails at in edge/ in field door Sheathing Fastening.............. ............................... ...( 2).. VALLS Nall Height 10 and Table 5 ........._�� ft -< 10' Loadbearing walls..........:.............................................(Fig )................. ��- ••-.••.•.-.•............(Fig 10 and Table 5 ...�ft _<20' Non-Loadbearing walls ......:.•............... ( 9 )...................... . ----- Vail Stud Stud Spacing :.............................(Fig 10 and Table 5)................... 4, in. <_24'o.c. —� .............(Figs ............................ O ft Sd I/ Vall StoryOffsets •....••--•:-• ( g )"""""""" XTERIOR WALLS' Vood Studs 2x•4 ✓ Loadbearing walls....................................................... (Table 5-)...........................__ •- f1 '/ in. 2x�- Non-Loadbearing walls ................................................('fable 5).............................. Z fi in. ✓ able End Wall Bracing I • • ✓ f Fi 10 •••••• ........ Full Helght•Endwall Studs..................................... ...... - ' ' ' _ ft>_W/3 WSP•Atlic Floor Length.................:..................•...... ....'(Fig 11).........:.............................. .... ft Z 0.9W 'Gypsum Ceiling Length (if WSP hot used) ::-.(Fig............... 1 1 • and 2•x 4 Continuous Lateral'Brace 6•ft. O.C. ._ (Fig11 •••••••••••••• ••-••�•-•••-•-•-•--••••-••-•" or 1 x 3 ceiling furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ft..spacing in end joist•or trust bays? ouble Top Plate `' ' Splice Length ..(Fig 13 and Table 6).................................... _ft P g Splice Connection (no, of 16d common nails)..............(Table 6).............................:.......,...................... . BOISE' Triple 1-3/4" x 14" VERSA-LAM® 2.0 3100 SP Floor Beam\F1301 BC CALCO 2.0'Design Report- US 1 span No cantilevers 1 0/12 slope Tuesday, March 03, 2009 09:52 Build 276 File Name: Cauthen Feenstra.BCC Job Name: Feenstra Description: Beam replacing exterior wall Address: 194 Towerhill Rd Specifier: Bill Campbell City, State,Zip: Osterville, Ma Designer: Customer: Bill Cauthen Company: Shepley Wood Products Code reports: ESR-1040 Misc: 1 3 1 15-00-00 - - -- B0,3-1/2" B1,3-1/2" LL 2,550 Ibs LL 2,550 Ibs DL 2,705 Ibs DL 2,705 Ibs SL 2,700 Ibs SL 2,700 Ibs Total Horizontal Product Length= 15-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 15-00-00 40 10 06-00-00 2 ceiling Unf.Area(psf) Left 00-00-00 15-00-00 10 10 10-00-00 3 Roof Unf.Area (psf) Left 00-00-00 15-00-00 15 30 12-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 28,037 ft-Ibs 56.0% 115% 2 1 - Internal Completeness and accuracy of input must End Shear 6,408 Ibs 39.9% 115% 2 1 -Left be verified by anyone who would rely on Total Load Defl. U393 (0.444") 61.1% 2 1 output as evidence of suitability for Live Load Defl. U595 (0.293") 60.5% 2 1 particular application.Output here based Max Defl. 0.444" 44.4% 2 1 on building code-accepted design properties and analysis methods. Span/Depth 12.5 n/a 1 Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 7,955 Ibs n/a 75.3% Unspecified or ask questions, please call (800)232-0788 before installation. B1 Post 3-1/2"x 3-1/2" 7,955 Ibs n/a 75.3% Unspecified BC CALCO, BC FRAMER@,AJS-, Cautions ALLJOISTO, BC RIM BOARDT"" BCIO, BOISE GLULAMT"' SIMPLE FRAMING Member is not fully supported at post BO. A connector is required at this bearing. SYSTEM@,VERSA-LAM@,VERSA-RIM Member is not fully supported at post B1. A connector is required at this bearing. PLUS@,VERSA-RIM@, VERSA-STRAND@,VERSA-STUD@ are Notes trademarks of Boise Wood Products, Design meets Code minimum(U240)Total load deflection criteria. L.L.C. Design meets Code minimum (U360) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Connection Diagram b r—d—� a - • I-• • N SA a minimum =2" c= 10" b minimum=2-1/2" d =24" Bolts are assumed to be Grade A307 or Grade 2 or higher. Member has no side loads. Connectors are: 1/2 in. Staggered Through Bolt Page 1 of 1 f BOiSE" Triple 1-3/4" x 14" VERSA-LAM® 2.0 3100 SP Floor Beam\F13O1 BC CALC@ 2.0 Design Report-US 1 span No cantilevers 1 0/12 slope Thursday, September 10,2009 08:17 Build 276 File Name: Cauthen Feenstra Job Name: F Description: Beam replacing exterior wall Address: 4 Towerhill R Specifier: Bill Campbell City, State,Zip: Osterville, Ma Designer: Customer: Bill Cauthen Company: Shepley Wood Products Code reports: ESR-1040 Misc: 3 15-00-00 - v BO,3-1/2" 131,3-1/2" ILL 2,550 Ibs ILL 2,550 Ibs DL 2,705 Ibs DL 2,705 Ibs SL 2,700 Ibs SL 2,700 Ibs Total Horizontal Product Length=15-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 15-00-00 40 10 06-00-00 2 ceiling Unf.Area(psf) Left 00-00-00 15-00-00 10 10 10-00-00 3 Roof Unf.Area(psf) Left- 00-00-00 15-00-00 15 30 12-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 28,037 ft-Ibs 56.0% 115% 13 1 - Internal Completeness and accuracy of input must End Shear 6,408 Ibs 39.9% 115% 2 1 -Left be verified by anyone who would rely on Total Load Defl. L/393(0.444") 61.1% 2 1 output as evidence of suitability for Live Load Defl. L/595(0.293") 60.5% 2 1 particular application.Output here based Max Defl. 0.444" 44.4% 2 1 on building code-accepted design properties and analysis methods. Span/Depth 12.5 n/a 1 Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide 8 BO Post 3-1/2"x 3-1/2" 7,955 Ibs n/a 75.3% Unspecified ( ask questions,please call B1 Post 3-1/2"x 3-1/2" 7,955 Ibs n/a 75.3% Unspecified 00)232 0788 before installation. BC CALC@, BC FRAMER@,AJS-, Cautions ALLJOIST@,BC RIM BOARD-,BCI@, Member is not full supported at post BO. A connector is required at this bearing. BOISE M@,VE S SIMPLE FRAMING Y PP P q 9• SYSTEM@,VERSA-LAM@,VERSA-RIM Member is not fully supported at post B1. A connector is required at this bearing. PLUS@,VERSA-RIM@, VERSA-STRAND@,VERSA-STUD@ are Notes trademarks of Boise Wood Products, Design meets Code minimum(L/240)Total load deflection criteria. L.L.C. Design meets Code minimum (L1360)Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Connection Diagram ►{ b - —d — I a •I — e a minimum= 1-1/2" c= 11" b minimum=4" d=24" e minimum= 1" Calculated Side Load=250.0 plf Connectors are: SDS 1/4 x 3-1/2 Page 1 of 1 f f DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of M.G.L. c. 40, s. 54, Building Permit # was issued with the condition that all debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L c. 111, s. 150A. / Sao The debris will be disposed of in: o 1 � E.O.M.S Name of Waste Facility 318 Manley Street West Bridgewater, MA 02720 Address of Waste Facility 111.5 Debris: As a condition of issuing a permit for the demolition, renovation, rehabilitation or other alteration of a building or structure, M.G.L. c. 40 s. 54 requires that the debris resulting therefrom shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L.c. 1 l 1 s. 150 A.Signature of the permit applicant, date and number of the building permit to be issued shall be indicated on a form provided by the Building Department and attached to the office copy of the building permit retained by the Building Department. If the debris will not be disposed of as indicated, the holder of the permit shall notify the building official, in writing, as to the location where the debris will be disposed. 780 CMR—6`h Edition 1 ig re of Permit Applicant 6/5/15 Date STRU(TURALENGINEERS June 4, 2015 Sungevity 66 Franklin Street Oakland, CA 94607 TEL: (510)496-5621 FAX: Attn.: To Whom It May Concern re: Job 20152070: Feenstra- 1756873 The following calculations are for the Structural Engineering Design of the Photovoltaic Panels located at 194 Tower Hill Rd, Osterville, MA 02655. After review, PZSE, Inc. certifies that the roof structure has sufficient structural capacity for the applied PV loads. If you have any questions on the.above, do not hesitate to call. Sincerely, Paul Zacher, SE -President �1 f1 OF&'ti9ss PAUL K. G ZACHER mi TRUCTURAL 50100 �G/S T E� SSIONAL� EXP.6/30/1-6 8150 Sierra College Boulevard,Suite 150 • Roseville,CA 95661 • 916.961.3960 P • 916.961.3965 • www.pzse.com 1 of 7 Gravity Loading Roof Snow Load Calculations p9=Ground Snow Load= 35 psf Ce=Exposure Factor= 0.9 (ASCE7-Table 7-2) Ct=Thermal Factor= 1 (ASCE7-Table 7-3) 1=Importance Factor= 1 pf=0.7 Ce Ct I py 22 psf (ASCE7-Eq 7-1) where pg<_20 psf, Pf min=I x pg= N/A min snow load(root siope<15) where pg>20 psf, Pf min=20 x I= N/A min snow load(roof siope<15) Therefore,pf=Flat Roof Snow Load= 22 psf ps=Cspf (ASCE7-Eq 7-2) Cs=Slope Factor= 1 ps=Sloped Roof Snow Load= 22.1 psf g PV Dead Load=3 psf(Per Sungevity) . Roof Dead Load(ARRAY 1). Composition Shingle 4.00 Roof Plywood 2.00 2x6 Rafters @ 24"o.c. 1.15 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.85 Total Roof DL(ARRAY 1) 8.0 psf 1 DL Adjusted to 23 Degree Slope 8.7 psf Roof Dead Load(ARRAY 2) Composition Shingle 4.00 Roof Plywood 2.00 2x8 Rafters @ 16"o.c. 2.27 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.73 _Total Roof DL(ARRAY 2) 9.0 psf t DL Adjusted to 40 Degree Slope 11.7 psf Roof Dead Load(ARRAY 314) Composition Shingle 4.00 Roof Plywood 2.00 2x8 Rafters @ 16"o.c. 2.27 Vaulted Ceiling 0.00 (Ceiling Not Vaulted) Miscellaneous 0.73 Total Roof DL(ARRAY 314) _ 9.0 psf_'_ DL Adjusted to 40 Degree Slope 11.7 psf 2 of 7 Feenstra 1756873 Calcs 1 Wind Calculations Per ASCE 7-05 Components and Cladding Input Variables Wind Speed 120 mph Exposure Category C Roof Shape Gable/Hip Roof Slope 40 degrees Mean Roof Height 18 ft Building Least Width 25 ft Effective Wind Area 17.5 ft Design Wind Pressure Calculations Wind Pressure P=qh*(G*Cp) qh=0.00256*Kz*Kzt*Kd*VA *I (Eq_6-15) Kz(Exposure Coefficient)= 0.88 (Table 6-3) Kzt(topographic factor)= 1 (Fig.6-4) Kd(Wind Directionality Factor)= 0.85 (Table 6-4) V(Design Wind Speed)= 120 mph Importance Factor= 1 (Table 6-1) qh= 27.57 Standoff Uplift Calculations Zone 1 Zone 2 Zone 3 Positive GCp= -0.90 -1.10 -1.10 0.85 (Fig.6-11) Uplift Pressure= -24.82 psf -30.33 psf -30.33 psf 23.4 psf X Standoff Spacing= 4.00 4.00 4.00 Y Standoff Spacing= 5.38 5.38 5.38 Tributary Area= 21.52 21.52 21.52 Footing Uplift= -534 lb -653 lb -653 lb Standoff Uplift Check Maximum Design Uplift= -653 lb Standoff Uplift Capacity = 700 lb 700 lb capacity>653 lb demand Therefore,OK Fastener Capacity Check Fastener= 1 -5/16"dia Lag Number of Fasteners= 1 . Minimum Threaded Embedment Depth= 2.5 Puilout Capacity Per Inch= 205 lb Fastener Capacity= 820 lb 820 lb capacity>653 lb demand Therefore,OK 3 of 7 Feenstra 1756873 Calcs 2 Framing Check (ARRAY 1) PASS w=68 plf Dead Load 8.7 psf PV Load 3.0 psf Snow Load 22.1 psf 2x6 Rafters @ 24"o:c. Governing Load Combo=DL+SL Member Span=8'-11" Total Load 33.8 psf Member Properties Member Size S(in A3) 1(in A4) Lumber Sp/Gr Member Spacing 2x6 7.56 20.80 SPF#2 @ 24"o.c. Check Bending Stress Fb(psi)= fb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.3 x 1.15 Allowed Bending Stress=1504.3 psi Maximum Moment = (wLA2)/8 = 671.834 ft# = 8062 in# Actual Bending Stress=,(Maximum Moment)/S =1066.1 psi Allowed>Actual--70.9%Stressed -- Therefore,OK Check Deflection Allowed Deflection(Total Load) = U120 (E=1400000 psi Per NDS) = 0.891 in Deflection Criteria Based on = Simple Span Actual Deflection(Total Load) _ (5*w*LA4)/(384*E*I) 0.331 in = U324 > U120 Therefore OK Allowed Deflection(Live Load) = U180 ' O'594 in Actual Deflection(Live Load) _ (5*w*LA4)/(384*E*I) 0.216 in U496 > U180 Therefore OK Check Shear Member Area= 8.3 inA2 Fv(psi)= 135 psi (NDS Table 4A) Allowed Shear = Fv*A = 1114 lb Max Shear(V)=w*L/2 = 301 Ib Allowed>Actual--27.1%Stressed -- Therefore,OK 4of7 Feenstra 1756873 Calcs 3 Framing Check (ARRAY 2) PASS w=49 plf Dead Load 11.7 psf PV Load 3.0 psf _ Snow Load 22.1 psf 0 2x8 Rafters @ 16"o.c. Governing Load Combo=DL+SL Member Span=5'-6" Total Load 36.8 psf Member Properties Member Size S(in A3) 1(in A4) Lumber Sp/Gr Member Spacing 2x8 13.14 47.63 SPF#2 @ 16"o.c. Check Bending Stress Fb(psi)= Yb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.2 x 1.15 Allowed Bending Stress= 1388.6 psi - Maximum Moment = (wLA2)/8 = 185.533 ft# = 2226.4 in# Actual Bending Stress=(Maximum Moment)/S = 169.5 psi Allowed>Actual-12.3%Stressed -- Therefore,OK Check Deflection Allowed Deflection(Total Load) = U120 (E=1400000 psi Per NDS) = 0.55 in Deflection Criteria Based on = Simple Span Actual Deflection(Total Load) _ (5*w*LA4)/(384*E*I) = 0.016 in = U4125 > U120 Therefore OK Allowed Deflection(Live Load) = U180 0.366 in Actual Deflection(Live Load) _ (5*w*LA4)/(384*E*I) 0.010 in U6600 > U180 Therefore OK Check Shear Member Area= 10.9 inA2 Fv(psi)= 135 psi (NDS Table 4A) Allowed Shear = Fv*A = 1468 Ib Max Shear(V)=w*L/2 = 135 Ib I Allowed>Actual--9.2%Stressed -- Therefore,OK 5 of 7 Feenstra 1756873 Calcs 4 i . Framing Check (ARRAY 3/4) PASS w=49 plf Dead Load 11.7 psf PV Load 3.0 psf Snow Load 22.1 psf 2x8 Rafters @ 16"o.c. ) 0 Governing Load Combo=DL+SL Member Span=6'-1" Total Load 36.8 psf Member Properties Member Size S(in A3) 1(in A4) Lumber Sp/Gr Member Spacing 2x8 13.14 47.63 SPF#2 @ 16"o.c. Check Bending Stress Fb(psi)= Pb x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.15 x 1.2 x 1.15 Allowed Bending Stress= 1388.6 psi Maximum Moment = (wLA2)/8 = 226.976 ft# = 2723.71 in# Actual Bending Stress=(Maximum Moment)/S =207.3 psi Allowed>Actual-15%Stressed -- Therefore,OK Check Deflection Allowed Deflection(Total Load) = U120 (E=1400000 psi Per NDS) = 0.608 in Deflection Criteria Based on Simple Span Actual Deflection(Total Load) _ (5*w*LA4)/(384*E*I) = 0.023 in = U3174 > U120 Therefore OK Allowed Deflection(Live Load) = U180 0.405 in Actual Deflection(Live Load) _ (5*w*LA4)/(384*E*I) 0.014 in U5215 > U180 Therefore OK Check Shear Member Area= 10.9 inA2 Fv(psi)= 135 psi (NDS Table 4A) Allowed Shear = Fv*A = 1468 lb Max Shear(V)=w*L/2 = 149 Ib Allowed>Actual--10.2%Stressed -- Therefore,OK 6 of 7 Feenstra 1756873 Calcs 5 I Lateral Per 2009 IBC Chapter 34 Existing Weight of Effected Building Level Area Weight(psf) Weight(lb) Roof 875 sf 8.7 psf 7613 lb Ceiling 875 sf 6.0 psf 5250 lb Wood Siding 120 ft 5.0 psf 10800 lb (8'-0"Wall Height) Int.Walls 120 ft 1 6.4 psf 13824 lb Existing Weight of Effected Building _ 37487 lb Proposed Weight of PV System Weight of PV System(Per Sungevity) 3.0 psf Approx.Area of Proposed PV System 960 sf Approximate Total Weight of PV System 2880 lb__ 10%Comparison -10%of Existing Building Weight(Allowed) 3749 lb Approximate Weight of PV System(Actual) 2880 lb Percent Increase 7.7% 3749 lb>2880 lb,Therefore OK I I 7 of 7 Feenstra 1756873 Calcs 6 STRUCTURAL ENGINEERS June 4,2015 Sungevity 66 Franklin Street (N of Massy Oakland, CA 94607 PAUL K. CyG TEL: (510)496-5621 VkCHER TRUCTURAL r; Subject: Structural Certification for Installation of Solar Panels 50100 Job Number: 20152070 �'o�FoisTE�`` Client: Feenstra-1756873 �SS�oNA1.ENG Address: 194 Tower Hill Rd,Osterville,MA 02655 exv.6/30/16 Attn.: To Whom It May Concern, A field observation of the condition of the existing framing system was performed by an audit team from Sungevity. From the field observation of the property,the existing roof structure was observed as follows: The existing roof structure consists of composition shingles over plywood sheathing that is supported by 2x6 roof rafters at 24"on center at Arrays 1,2x8 rafters at 16"on center and 2x8 rafters at 16"on center at Array 3 &4. The rafters Array 1 is sloped at approximately 23 degrees and Arrays 2, 3 &4 are sloped at approximately 40 degrees and have a maximum projected horizontal span of 8'-11"at Array 1, 5'-6"at Array 2 and 6'- 1"at Array 3 &4 between load bearing walls. All attached structural calculations are based on these observations and the design criteria listed below: Design Criteria: • Applicable Codes=.2009 IBC,ASCE 7-05 and 2005 NDS • Ground Snow Load=35 psf • Roof Dead Load=8.7 psf(Array 1)and 11.7 psf(Array 2, 3 &4) • Basic Wind Speed= 120 mph Exposure Category C • Solar modules=as indicated in attached drawings. As a result of the completed field observation and design checks: • Arrays 1,2, 3 &4 are adequate to support the loading imposed by the installation of solar panels and modules.Therefore,no structural upgrades are required. I certify that the capacity of the structural roof framing that directly supports the additional gravity loading due to the solar panel supports and modules had been reviewed and determined to meet or exceed the requirements in accordance with the 2009 IBC. If you have any questions on the above,do not hesitate to call. Sincerely, Paul Zacher, SE-President 8150 Sierra College Blvd,Suite 150—Roseville,CA 95661 —916.961.3960 p —916.961.3965—www.pzse.com 1 2 3 4 5 PHOTOVOLTAIC SYSTEM SHEET INDEX PV0.0 COVER AND SITE PLAN - PV1.0 GENERAL NOTES SYSTEM SIZE: PV2.0 ARRAY 1 LAYOUT AC/DC kW STC: 12.978kW 114.85kW - � PV2.1 ARRAY 2 AND 3 LAYOUT / PV3.0 LINE DIAGRAM A EQUIPMENT: � � PV4.0 LABELS A PV MODULES: (55)Hyundai HIS-S27ORG(BK) (1)SolarEdge SE6000A-US AC DISCONNECT,24(7 ACCESSIBLE KEY: INVERTER(S): (1)SolarEdge SE760OA-US WITHIN 10 FT OF UTILITY METER ' --•— PROPERTY LINE ®SUBPANEL i --- CONDUIT RUN Q OC DISCONNECT SCOPE OF WORK: INVERTERS WITH INTEGRATED i DRIVEWAY ❑K AC DISCONNECT DC DISCONNECTS MAIN SERVICE PANEL FENCE Q SOLAR MODULE ®©AUNCTION BOX INSTALLATION OF A SAFE AND CODE-COMPLIANT ON EXTERIOR WALL AND UTILITY METER MAIN ON EXTERIOR WALL GI MONITORING UNIT Q GRID-TIED SOLAR PV SYSTEM ON AN EXISTING � � UTILITYLITY METER PANEL R ❑°COMBINER 90X RESIDENTIAL ROOF TOP. V, ® PV METER ❑ROOF OBSTRUCTION ® INVERTER EXTERIOR CONDUIT, V SVa AO MAIN APPLICABLE CODES: ' TYP OF ALL INN INN 2014 NEC ' 2009 INTERNATIONAL CODES WITH MA AMENDMENTS Q 1 L" CONTRACTOR INFORMATION: B , MT 1 Q SKYLINE SOLAR WEST BRIDGEWATER B 124 TURNPIKE ST. ® WEST BRIDGEWATER,MA 02379 cn JURISDICTIONAL INFORMATION: O (E)GARAGE BARNSTABLE,TOWN OF 1y 200 MAIN STREET, HYANNIS,MA.02601 1 NOTES TO INSTALLER: DC-CONDUIT RUN FROM ARRAY TO ARRAY ROOFMOUNTED THEN TOWARDS B.O.S.LOCATION,AC-CONDUIT RUN FROM INVERTERS TO(NJ SUB-PANEL THEN TO AC DISCONNECT THEN - - TO JEl MSP.INSTALL SUPPLY SIDE CONNECTION ON FEEDERS COMING FROM METER. (E)RESIDENCE p FOR INSTALLER USE ONLY _ POST INSTALL SUNEYES REQUIRED? NO r I CERTIFY THAT NO CHANGES HAVE C AO ' BEEN MADE TO THE ARRAY LAYOUT: \ _ / CUSTOMER INFORMATION: E S 194TOWERHILL RD. Og`Vs.TIPN SITE PLAN N O08)280LLE,M#17568 / (508)280-7279/#1756873 \ SCALE: N.T.S. - DESIGNED BY: REV#: DATE: • / ANEWCOMB 0 06/03/15 PV� -� SUNOEYIT'RC.55 FRANN4N 9T 541E lf0OrvLLNN.GBL®] SY.ArwmnO Oab URWNf Leutgn.C.WwrbnFrmngDPnbAlT,mpLwemFnlF,rLnm THESE M4n+W3,SPECIFTA00]TS.NAOESIGN9 N]E TTE R]OPERTY OF SUNCENTY INC.NO PMiSNKL BE CORE00N USED FOiIOR VATH NaV OTNER VAiRtOTHERi]4N THE 5PELIFlC PROTECT FOR WMCN Th'MA`YE EETNOEVELOPEO N1TgUi OUR NRITTENWNSEM 1 2 3 4 5 GENERAL NOTES. ELECTRICAL NOTES: GENERAL NOTES: El.ALL EQUIPMENT 15 LISTED FOR USE. Nl.DRAWINGS ARE DIAGRAMMATIC ONLY.THE LOCATION AND ROUTING OF E2.MAXIMUM VOLTAGE DOES NOT EXCEED 600VDC. RACEWAYS SHALL BE DETERMINED BY THE CONTRACTOR UNLESS OTHERWISE E3.ANY EQUIPMENT OR ELECTRICAL MATERIALS USED FOR THIS INSTALLATION SHALL BE NOTED OR STANDARDIZED. NEW AND LISTED BY A RECOGNIZED ELECTRICAL TESTING LABORATORY. N2.ALL EQUATIONS ACCOUNT FOR WORST CASE CONDITIONS. E4.AN INVERTER IN AN INTERACTIVE SOLAR PV SYSTEM SHALL AUTOMATICALLY A N3.IF A DISCREPANCY IN QUANTITY OR SIZE OF CONDUIT,WIRE,EQUIPMENT DE-ENERGIZE ITS OUTPUT TO THE CONNECTED ELECTRICAL PRODUCTION AND A DEVICES,OVERCURRENT PROTECTION,GROUNDING SYSTEMS,ETC.(ALL DISTRIBUTION NETWORK UPON LOSS OF VOLTAGE IN THATSYSTEM AND SHALL REMAIN EQUIPMENTAND MATERIALS)THE CONTRACTOR SHALL BE RESPONSIBLE FOR IN THATSTATE UNTILTHE ELECTRICAL PRODUCTION AND DISTRIBUTION NETWORK PROVIDING AND INSTALLING ALL MATERIALS AND SERVICES REQUIRED BY THE VOLTAGE HAS BEEN RESTORED. STRICTEST CONDITIONS IN THE SPECIFICATIONS OR NOTED ON THE PLANS TO E5.ALL PV ARRAYS SHALL BE EQUIPPED WITH DC GROUND FAULT PROTECTION. ENSURE COMPLETE COMPLIANCE WITH ALL CODES AND TO ENSURE THE E6.ANY AC COMPONENT SHALL MEET OR EXCEED THE AVAILABLE FAULT CURRENT LONGEVITY AND SAFETY OF THE OPERABLE SYSTEM. CALCULATED AT THAT COMPONENT. N4.ALL OUTDOOR EQUIPMENT SHALL BE MIN.NEMA 3R RATED. E7.ALL MODULES AND ANY RELATED ROOF MOUNTED METALLIC EQUIPMENT SHALL BE N5.METAL CONDUIT AND ENCLOSURES SHALL BE USED WHERE PV SOURCE OR PROPERLY GROUNDED. OUTPUT CIRCUITS ARE RUN INSIDE A BUILDING. E8.DC EQUIPMENT SHALL BE 60OVDC RATED MINIMUM. N6.MODULES SHALL NOT BE PLACED OVER ANY PLUMBING VENTS AND AT LEAST E9.MARKINGS SHALL BE PROVIDED TO INDICATE THAT ALL CONTACTS OF THE 6"ABOVE FLUSH VENTS. DISCONNECT EQUIPMENT MIGHT BE ENERGIZED. N7.THE ELECTRICAL CONTRACTOR SHALL COMPLY WITH ANY AND ALL E10.CONDUIT RUNS SHALL BE PROVIDED WITH SUFFICIENT WEATHERPROOF PULL BOXES REQUIREMENTS GIVEN BY UTILITY COMPANIES. OR JUNCTION BOXES/COMBINER BOXES PER APPROPRIATE JURISDICTIONAL N8.FOR ADDITIONAL EQUIPMENT SPECIFICATIONS,SEE PROVIDED CUT SHEETS. REQUIREMENTS. N9.ALL LABELS AND MARKINGS SHALL BE ATTACHED ACCORDING TO Ell.FOR ANY UNGROUNDED PV SYSTEM,A LABEL READING: REQUIREMENTS BY NEC AND THE LOCAL AHJ.THE AHJ MAY HAVE SPECIAL LABEL B REQUIREMENTS BEYOND THE SCOPE OF THIS DOCUMENT.THIS MAY ENCOMPASS "WARNING-ELECTRICAL SHOCK HAZARD.THE DC CONDUCTORS OF THIS PHOTOVOLTAIC B LANGUAGE INCLUDING,BUT NOT LIMITED TO,THAT FOUND IN NEC ARTICLES I SYSTEM ARE UNGROUNDED AND MAY BE ENERGIZED." 690.5(C),690.14(C)(2),690.17,690.53,690.35(F), 690.54,690.64(B)(7)and SHALL BE PLACED AT EACH JUNCTION BOX,COMBINER BOX,DISCONNECT AND DEVICE 705.10 WHERE ENERGIZED,UNGROUNDED CIRCUITS MAY BE EXPOSED DURING SERVICE. N10.INSTALLERTO FOLLOW ALL LOCAL JURISDICTION GUIDELINES. E12.INVERTER(5)SHALL CONTAIN A GROUND FAULT DETECTION AND INTERRUPTION Nll.ALL NEC REFERENCES SHALL BE DIRECTLY INTERCHANGEABLE WITH CEC DEVICE. , REFERENCES. E13.ALL METALLIC RACEWAYS AND EQUIPMENT SHALL BE BONDED AND ELECTRICALLY N12.IT 15 ILLEGAL FOR ANYONE UNLESS ACTING UNDER THE DIRECTION OF A CONTINUOUS. LICENSED PROFFESIONAL ENGINEER OR REGISTERED ARCHITECT TO ALTER ANY E14.THE POINT OF CONNECTION COMPLIES WITH APPLICABLE CEC/NEC. ITEMS ON THIS PLAN. E15.BACKFED SOLAR BREAKER(S)SHALL BE INSTALLED ATTHE OPPOSITE END OF THE N13.THE ENGINEER HAS NOT BEEN RETAINED FOR JOB SUPERVISION. CIRCUIT OR FURTHEST AWAY FROM THE MAIN BREAKER. E16.ALL WIRE,VOLTAGES,AMPERAGES AND EQUIPMENT IS SIZED ACCORDING TO STRUCTURAL NOTES: TEMPERATURE DERATING AND LOCATION. Sl.MOUNTS ARE DIAGRAMMATIC AND EXACT LOCATION MAY CHANGE,BUT E17.ONLY COPPER(CU)CONDUCTORS SHALL BE USED.CONDUCTORS SHALL BE SHALL BE ACCURATELY SPACED. STRANDED OR SOLID WITH PROPERLY RATED CONNECTORS. C 52.MOUNTS SHALL BE STAGGERED WHEN NECESSARY TO EVENLY DISTRIBUTE E18.DISCONNECT SHALL BE WIRED SO NO BLADES ARE ENERGIZED LOAD AMONGST RAFTERS. E19.ALL MODULES AND RACKING SHALL BE GROUNDED VIA IRON RIDGE RAIL INTEGRATED CUSTOMER INFORMATION: _ S3.DO NOT SPLICE RAILS IN MIDDLE 50%OF SPAN BETWEEN TWO MOUNTS. GROUNDING(PLEASE SEE DATA SHEET)OR WITH TIN PLATED DIRECT BURIAL RATED LAY IN JOEL FEENSTRA LUGS USING STAINLESS STEEL HARDWARE,STAR WASHERS,AND THREAD FORMING BOLTS 194 TOWER HILL RD. OR WEEBS. OSTERVILLE,MA 02655 E20.ALL EQUIPMENT SHALL BE GROUNDED,INCLUDING BONDING JUMPERS WHERE (508)280-7279/#1756873 _ NECESSARY ACROSS RAIL SPLICE PLATES TO BOND INDIVIDUAL PIECES OF RAIL. DESIGNED BY:IREV#: DATE: ANEWCOMB PV-1.0 0 06/03/15 bWroBVR1 RK.68 FRMeOIN eT-E]-. By:n,wwnme Osb 06 t/iSloovon'.C.WUMenFumnVDvx,basTmpCmurmnKmw. THESE gUvnNp9,6PECIFIGlION9.NA0ESiGN9 METIE WOPEPTVOF bUNGlYITY WL.NO PMTSWLLL BE ODREDDi1 U5EO FOR OF VAMMfv OIMERvt KOTNERTWW iNE SPEpFlC PPOIER FOR wMCH TNEV WIVEBEEN DEVELOPED VAT1gUt pUp WSBTTEN OONSENf 1 2 3 4 5 SYMBOL KEY: - o SPECIFICATIONS (55)Hyundai HIS-S270RG(SK) ® MOUNT MODULE WEIGHT: 37.9 ------- RAIL 32'-6" 1'-4" MODULE LENGTH: 64.57 RAFTERS MODULE WIDTH: 39.29 ———— ROOF ISPECS ROOF i RAFTER SIZE: 2X6 NOMINAL — SETBACK R OF 1 RAFTER SPAN: I 8'-11" SOLAR MODULE rt- T —Y -1 7 -� -�- 'Y -r �1 ROOF MATERIAL: COMPOSITE SHINGLE E).............E)STRING CONFIG. -- _—�_ --�--- _ -- -_ I -- -- -- --_I �--- -- I ARRAY 1 SPECS ® NUMBER OF MODULES: 26 SKYLIGHT TOTAL MOD.WEIGHT(Ibs): 985.4 A A ® CHIMNEY I I I I I I I i I I. RACKING WEIGHT(Ibs): 139.7 ARRAY WEIGHT(Ibs): 1125.1 PLUMBING OR I I T I ARRAYAREA(sgn): 458.1 ATTIC VENT I I I I I I I I AR Y 1 ( I I I ( I I ARRAY DEAD LOAD(Ibs/sgn): 2.5 ATTIC VENT NUMBER OF MOUNTS: 57 I I I I I I LOAD PER MOUNT(Ibs): 19.7 ARRAY AZIMUTH(') i 254 ARRAY TILT(') 23 -{ -- -- NUMBER OF FLOORS 1 II I I I I I I I I i l i l I I I F I I I .. 33'-1„ (D6RRAY 1 LAYOUT SCALE: 3/16" 1'-0" B B ... ... ZH OF MA'L9 PAUL K. SOLAR MODULE ZACHER LT TRUCTURAL N 50100 PO/STEa� IRONRIDGE XR1 S�ONAL L-FOOT oro.4/90/34 OMSE-LAG SHINGLE C COMPOSITE SHINGLE 5" X 5/16"-LAG CUSTOMER INFORMATION: 2.5"MIN.EMBEDMENT PER SCREW JOELFEENSTRA 2X6 NOMINAL,24 O.C. 194 TOWER HILL RD. OSTERVILLE,MA 02655 (508)280-7279/#1756873 OOUNTING DETAIL SCALE: NTS DESIGNED BY: REV#: DATE: IE ANEWCOMB 0 06/03/15 PV-2.0 lIpOM]Y DIC 6D FD/JIKLINBT6VI]EIiDONNLNA.GF®] BY�N'N'�lvnlWbDlOYiSLmtm-.0 WuTmwmnclDevnle�m\iwrp Mmmwa'Fxnm�� TIQ:lE PUN1N09.SEOFlGTONI,NADElWN9 METE PNOPOiiYOF SUNGEVn•Y LNG NOVMTSW�IL BECONEDOP UlFO FOROH vtTI NfI0i11piNdtNOINEPTWW iL@lPEdFlC P110JECi FgiWWGIITNEY NN`/E DEEM DEVELOPEDWI]MWfWR NAITTENCO115ENf 1 2 3 4 5 MODULESPECIFICATIONS SYMBOL KEY: (55)Hyundai HISS270RG(BK) ® MOUNT MODULE WEIGHT: 37.9 ------- RAIL MODULE LENGTH: I 64.57 ———— RAFTERS MODULE WIDTH: 39.29 ROOF 2 SPECS ROOF RAFTER SIZE: 2X8 NOMINAL — SETBACK 1 I 1 ROO 2 I RAFTER SPAN: 5'-6' RAFT C] SOLAR MODULE 1 ROOFER MATERIAL: COMPOSITE SHINGLE O.............O STRING CONFIG. 1 ' �' -- 1 1 ARRAY 2 SPECS ® SKYLIGHT I I I I I I I I I I i t I® NUMBER OF MODULES: 10 A 1I- II AiRA z l i I I I I I I I I I TOTAL MOD.WEIGHT(Ibs): 379 A CHIMNEY RACKING WEIGHT(Ibs): 46.8 PLUMBING OR ARRAY WEIGHT(Ibs): 425.8 ARRAY AREA(sqft): 176.2 VENT i ARRAY DEAD LOAD(Ibslsgft): 2.4 0 ATTIC VENT NUMBER OF MOUNTS: 19 LOAD PER MOUNT(Ibs): 22.4 33'-1" 1' ARRAY AZIMUTH(°) 254 ARRAY TILT(') 40 BRAY 2 LAYOUT FLOORS 1 1 ROOF S SPECS SCALE: 3/16"=1'-0" RAFTER SIZE: 2X8 NOMINAL RAFTER SPAN: 6'-1" RAFTER SPACING:1 16" ROOF MATERIAL: COMPOSITE SHINGLE ARRAY 3 SPECS NUMBER OF MODULES: 7 TOTAL MOD.WEIGHT(Ibs): 265.3 RACKING WEIGHT(Ibs): 34.6 ARRAY WEIGHT(Ibs): 299.9 ARRAY AREA(sgft): 123.3 ARRAY DEAD LOAD(Ibs/sgft): 2.4 10'-10" 3'-10" * NUMBER OF MOUNTS: 15 LOAD PER MOUNT(Ibs): 20 ARRAY AZIMUTH(') 74 II II III II II III iII lI lI iII l lIII 3lIII IIil ARRAY TILT(-) 410 Be ROOF NUMBER OF FLOORS ARRAY 4 SPECS_7 --- NUMBER OF MODULES: 12 I TOTAL MOD.WEIGHT(Ibs): 454.8 RACKING WEIGHT(Ibs): 65.2 1 I I _ 1 ARRAY WEIGHT(Ibs): 520 1 __ 1 1 1 I ARRAY AREA(sgft): 211.4 1 I I I I I I I I I I I I I I I SOLAR MODULE ARRAY DEAD LOAD(Ibslsgft) 2.5 NUMBER OF MOUNTS: 28 _ _ _ - _ _ _ LOAD PER MOUNT(lbs): 18.6 ARRAY AZIMUTH(°) 74 7 ARRAY TILT(') 40 AR 4AY 3 L j i I ®7 7= RAY 4 + i IRONRIDGE XR1 NUMBER OF FLOORS 1 I I I I I I I I I I I I I I I I I I I I i I I I I L-FOOT SF1 OFAL9 9 I I I I I I i I I I I I I I I I I I I I aI I I I I OMSE-LAG SHINGLE PAUL K. I ) OI ❑ I l T I I I COMPOSITE SHINGLE ZACHER y TRUCTURAL 2.5"MIN.EMBEDMENT PER 0100 SCREW FO/sTEa� 1 13'-3" 16-15" 2X8 NOMINAL,16O.C. S/ONAL DtP.eno/16 C RRAY 3 AND 4 LAYOUT MOUNTING DETAIL CUSTOMER INFORMATION: 2 SCALE: 3/16"=1'-0" 3 SCALE: NTS JOEL FEENSTRA 194 TOWER HILL RD. OSTERVILLE,MA 02655 (508)280-7279/#1756873 DESIGNED BY: REV#: DATE: PV-2.1 - ANEWCOMB 1 0 06/03/15 ]NWBNTY RK.WFRIIdtUN 9T SUTE]I004¢NA.G&W] BY'Nwa,m Dab.OBROIISIartm:C.WaFMm�awruLwnbMTw,O CuatmwOFwnrtF- —EWU]NNOS.SPEQFK;NTIONS,—SgNSMETLEPROPEATYOFSUNOENW—WO TSB LBEMMEDMWEOFORORNITM OTUERY KOTLQ•:R THSP RCPROIECTFMW1UCHTHEVI BEENOE WPEOMYT TOURWlrt ENCONSEM 1 2 3 4 5 ELECTRICAL KEY: MODULE ELECTR CAL S C C O S INVERTER I SPECIFICATIONS INVERTER2 SPECIFICATIONS (55)Hyundai HIS-S270RG(BK) SOLAREDGE SE6000A-US SOLAREDGE SE7600A-US It BREAKER SHORT CIRCUIT CURRENT(Isc): 1 9.2 RATED WATTS(EACH): 6000 RATED WATTS(EACH): 7600 �— SWITCH OPEN CIRCUIT VOLTAGE(Voc): 38.2 AC OPERATING VOLTAGE IV): 240 AC OPERATING VOLTAGE IV): 240 O SCREW TERMINAL OPERATING CURRENT(IMP): 8.6 AC OPERATING CURRENT(A): 25 AC OPERATING CURRENT(A): 32 .W FUSE OPERATING VOLTAGE(VMP): 31.4 NUMBER OF MPPT CHANNELS 0 NUMBER OF MPPT CHANNELS 0 • SPLICE MAX SERIES FUSE RATING: 15 INVERTER EFFICIENCY: 0.975 INVERTER EFFICIENCY: 0,975 MF EARTH GROUND STC RATING: 1 270 INTEGRATED OC DISCONNECT INTEGRATED DC DISCONNECT m. CHASSIS GROUND PTC RATING: 242 INVERTER I INPUT SPECIFICATIONS INVERTER 2 INPUT SPECIFICATIONS —GEC DESIGN CONDITIONS NOMINAL CURRENT PER STRING(Inom): III.io NOMINAL CURRENT PER STRING(Isom): 10.9,11.6 EGC HIGHEST 2%DB DESIGN TEMP(°C): M om 2g NOINAL VOLTAGE 350 NOMINAL VOLTAGE(Vnom): 350 MIN,MEAN EXTREME ANNUAL D8(°C): 1 .16 1 MAX SYSTEM VOLTAGE(Vmax): 500 MAX SYSTEM VOLTAGE(Vmw): 500 A MAX CURRENT PER STRING(Imax): 15 MAX CURRENT PER STRING(Imax): 15 A MAX INPUT CIRCUIT CURRENT(Imax): w MAX INPUT CIRCUIT CURRENT(Imax): 30 -° (3)94 THWN-2 13)#4 THWN-2 (3)94 THWN-2 (8)#10 PV-Wire (8)#10 THWN-2 (3)#8 THWN-2 (1)#8 GEC (1)#8 GEC (1)#8 GEC (1)#10 EGC (1)#10 EGC (1)#8 GEC 1"EMT 1"EMT 1"EMT FREE AIR 314"EMT 3/4"EMT (N)MIN.100A AC Combiner METER SUB PANEL SUPPLY SIDE CONNECTION WITH (N)SE6000A-US POLARIS BLOCK OR SIMILAR INVERTER W/INTEGRATED AC Disconnect, 250VAC RATED UL LISTED AND DC DISCONNECTS 100Amp,Fusible APPROVED CONNECTOR ——— — -OF-— MPPT 1 35A 2P 200A MAIN BREAKER 1 STRING -AC LOCUSMETER 80A FUSE pV 13 MODULES OPT.CURRENT=10.03A DC OUTPUT LOAD LINE _————___ 1 STRING OF �T 2 I(E)LOADS 13 MODULES OPT.CURRENT=10.03A (E)200A Square D MSP ———————— INVERTER � i(�LOADS 240v 2P 3-w 141 I I (3)#8 THWN-2 I (1)#8 GEC wI B 3/4"EMT uy B (N)SE760OA-US INVERTER W/INTEGRATED GEC IRREVERSIBLY SPLICED TO DC DISCONNECTS EXISTING GEC OR BONDED DIRECTLY MPPT 1 40A 2P TO EXISTING GROUNDING ELECTRODE 1 STRING OF 14 MODULES �' -AC OPT.CURRENT=10.80A DC OUTPUT 1 STRING OF MPPT 2 15 MODULES57 OPT.CURRENT=11. A INVERTER MIN.NEMA3R UL LISTED JUNCTION BOX OMTH 90°C TERMINAL RATINGS - LOCATEDONROOF C Inom=(15 x 270W)/350V=11.6A CONDUIT ELEVATION:12 TO 3-12"=22°C 55 MODULES TOTAL OPERATING VOLTAGE=350VOC(REGULATED) HIGH AMBIENT TEMPERATURE:29°C 55 x 242(PTC WATTS)x 0.975=12977 CEC WATTS CUSTOMER INFORMATION: EXTREME LOW:-16°C JOEL FEENSTRA 200 x 1.2=240 ROOFTOP AMBIENT TEMP(Tcorr):51°C=0.76 SE6000A-US MAX OUTPUT CURRENT=25A 240-200(MCB)=40A CONDUIT FILL(Cfill):0.7 BREAKER SIZE=25A x 1.25=31.25A=>35A 194 TOWER HILL RD. MAX ALLOWABLE AC PV BREAKER=40A SE760OA-US MAX OUTPUT CURRENT=32A OSTERVILLE,MA 02655 ' CONTINUOUS USE=Imax°1.25=15A BREAKER SIZE=32A x 1.25=40A=>40A (508)280-7279/#1756873 CONDITIONS OF USE=Imax/TCorr/Cfill , =15A/0.76/0.7=28.20A CONDUCTOR SIZE FOR 28. #:20A DESIGNED BY: REV DATE: INSTALLATION SHALL USE MIN.#10 AWG PV-3.0 ANEWCOMB 1 0 06/03/15 BIBIOEVIT pC.fiB FRRNIalN9T 6VILEBiBOnIau41.G&®) BT:�mm°UD+b BBOLtSI°nvon'.C'.WunYnw�m�➢o�bsmtimpCummw�lF°w,W- TNEBE pUM1NGB,SOEpFKATON9,NN OE5�ON9 METE WIOPERTV OF 6NNfiF'ITY iNG NO PMT BROIL BE O]PIEOOR USEO FOR OR xtTM aNV Oit�RNVRR O1t1ERTWW TI@SPECIFlC NiQECi FOR WMON TI�I N4VE BEEN OEVELWEO WITNWTOUH NFIREN OONSEM 1 2 3 4 5 NEC 690.5(c) NEC 690.31(E)3 6 4;2012 IFC 605.11.1 INTERACTIVE PHOTOVOLTAIC POWER SOURCE PLACE THIS LABEL ON INVERTER(S)OR NEAR PLACE ON ALL JUNCTION BOXES,EXPOSED GROUND-FAULT INDICATOR(ON INVERTER(S)U.O.N.) RACEWAYS EVERY 10'AND V FROM BENDS RATED AC OUTPUT CURRENT(A): 57 AND PENETRATIONS,ADJACENT TO THE NOMINAL OPERATING AC VOLTAGE(V): 240 MAIN SERVICE DISCONNECT ��11 AWARNING A� e p oY V� INVERTER 1 DC DISCONNECT I`JAv\J' PHOTOVOLTAIC SYSTEM DISCONNECT RATED MAX POWER POINT CURRENT(Imp): 20.1 q ELECTRIC SHOCK HAZARD RATED MAX POWER POINT VOLTAGE(Vmp): 350 A IF A GROUND FAULT IS INDICATED, PHOTOVOLTAIC POWER NORMALLY GROUNDED CONDUCTORS MAX SYSTEM VOLTAGE(Voc): 500 MAY BE UNGROUNDED AND ENERGIZED SOURCE SHORT CIRCUIT CURRENT(Isc): 11.5 NEC 690.17(E) NEC 690.35(F) INVERTER 2 DC DISCONNECT PLACE THIS LABEL ON ALL DISCONNECTING PLACE THIS LABEL AT EACH JUNCTION BOX,COMBINER BOX, MEANS WHERE ENERGIZED IN AN OPEN POSITION DISCONNECT AND DEVICE WHERE ENERGIZED,UNGROUNDED PHOTOVOLTAIC SYSTEM DISCONNECT CIRCUITS MAY BE EXPOSED DURING SERVICE: RATED MAX POWER POINT CURRENT(Imp): 22.4 AWARNIN G AWA R N I N G RATED MAX POWER POINT VOLTAGE(Vmp) 500 MAX SYSTEM VOLTAGE(Voc): 500 ELECTRIC SHOCK HAZARD SHORT CIRCUIT CURRENT(Isc): 11.5 DO NOT TOUCH TERMINALS ELECTRIC SHOCK HAZARD TERMINALS ON BOTH THE LINE AND LOAD THE DC CONDUCTORS OF THIS SIDE MAY BE ENERGIZED IN THE OPEN PHOTOVOLTAIC SYSTEM ARE UNGROUNDED POSITION AND MAY BE ENERGIZED NEC 705.12(D)(2)(b) PLACE THIS LABEL AT P.O.C.TO SERVICE B DISTRIBUTION EQUIPMENT(I.E.MAIN PANEL(AND B SUBPANEL IF APPLICABLE)) NEC 705.12(D)(2)(c) A WA R N I N G PLACE LABEL ON ALL EQUIPMENT CONTAINING OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER NEC 690.56(c) INVERTER OUTPUT CONNECTION TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE PLACE ON RAPID SHUT DOWN DISCONNECT WHEN RAPID SHUT DO NOT RELOCATE THIS SOURCES. DOWN IS INSTALLED OVERCURRENT DEVICE NEC 705.12(D)(3) AWARNING PLACE LABEL ON ALL EQUIPMENT CONTAINING OVERCURRENT DEVICES IN CIRCUITS SUPPLYING POWER TO A BUSBAR OR CONDUCTORS SUPPLIED FROM MULTIPLE THIS EQUIPMENT FED BY MULTIPLE POWER SOURCES. SOURCES.TOTAL RATING OF ALL OVERCURRENT DEVICES,EXCLUDING MAIN SUPPLY A CAUTION OVERCURRENT DEVICE,SHALL NOT EXCEED AMPACITY OF BUSBAR CONTAINS MULTIPLE POWER SOURCES • CUSTOMER INFORMATION: _ JOELFEENSTRA 194 TOWER HILL RD. OSTERVILLE,MA 02655 (508)280-7279/#1756873 DESIGNED BY:IREV#: DATE: PV-4.0 ANEWCOMB 1 0 06/03/15 6YMO6VITY MC.86 FPNIRIIN 6T 6U TE 660Ll5loobon'.C'.Wununv+mn'tlLenbm—p CurmmwYFmm THESEOMINNG6,SPEpFlGTON6.AHDOE61GN6 METIE RiOPEP]Y 66UNGLV TV INC NO PMT 6WLLL 0E plRE00R U6EDFOR OR VATH AN/ON4R VAFN OIIQR TNANIHE 6PEgFIC RLOJECT FOR WIUCH IHEY HAVE BEEN OtYELOREO WiIHOUt OLIR YALNIENCONSEM \ www.hhiymenxom/sobt/en �/�a • O y f] PERL:Passivated Emitter,Rear Locally-Diffused Cell H Y u'r "da � \ ��`` �' � I Higher Cell Efficiency I u -� Conventional Selective-Emitter Cell:Max.19.3% PERL Solar Module ��K--/j ya"meuwe E 51'ea ing quanrum e fi kncy I Higher Module a Out '1 at shoo wavelength ~� Minimlai"mm-man IHigher Module Output) ��. ../� a�t+k"{� 'e n xe 275 W 280 W,285 W G Minimki back side electron- nwhita backYwel Hyundai Heavy Industries was founded in 1972 and is a company.The company employs more than 48,000 people,and has a global y •" n9 leading7 business divisions with sales of 513 Billion USO in 2013.M one of our core businesses of the coma Hyundai Heavy Industries is r. hole Pat,tecombinatbn company, y vy Mower Temperature Ccefficientl . committed to develop and invest heavily in the field of renewable energy. ° sr -f— Enhancirgquamumesficlemy Lower output loss at higher temperature Hyundai Solar is the largest and the longest standing PV cell and module manufacturer in South Korea.We have 600 MINof module production l at long wavelength capacity and provide high-quality solar PV products to more than 3,000 customers worldwide.We strive to achieve one of the most efficient PV Minimlcirg hack—act I Affordable Price I modules by establishing an R&D laboratory and Investing more than 20 Million USD on innovative technologies. --- ^' -- Premium monxryztallinetechnology with affordable price PERElectrical Characteristics Cf�L Mono-crystalline Type Black—Series HIS-5265RG(BK)i HiS-S270RG(BK)I HiS-S275RG(8K) I Mono crystalline Type I ®® Nominal emput(Pmpp) IN ( _165 -_ 270 •-l. 275 Mechanical Characteristics vohagaatrm Px(vmpp) v _ _'313__ _ 31.4 31L } Cunem at Pmaxllmpp) A 85 8.6 8.7 998 mm(39.29'K W)x 1,640 mm(6457'KL)x 35 mm(1.38'KH) Open circuit vohage(vm) v _ 38.1 _ _ _ 38.2 _, _ 38A _• Approx.17.2 kg(37.9 lbs) Shon circuit current(W A .- 9D 9.2 9.3 I..titiFJilYk7� 60cellsinsefies(6 xlOmatrix)with PERIL technology(Hyundai cell.Made in Korea) Orny.tola..e % _ _ _ 3/a 4mm'112AWG)cables withpdariredweatherproofconnectors. No.ofcellt&tom—,C -Pcs In series IEC certfied(UL listed).Length 1.0 m(39.4') Cell type __ 6Mono ystaillne silkenhit PERIL technology(Hyundel cell.Made to Kotea) M.I t efhcFancy % 16.2 165 I 16A y� IP68,weatherproof,IEC certified(UL listed) Tempemtme coefficient of Pmpp WK -OAS 4)AS �7• _-0./5 3 bypass diodes to prevent Power decrease by Partial shade TempesatureccefhclentofVoc WK a33 .033 r -c).33_ Front:Antirefiective coating low-iron tempered glass.2.8 mm(0.11� TemperatsaecceFxlem oflsc Sa/K r_. 0.032 0.037 - _ t. v 6.037 Encapsulant:EVA Back Sheet:Weatherproof film w,vlmum SIC OW.AntestCudxvN AWRCau mar t•1crmyal rxron mor rorce Clear anodized aluminum alloy type 6063(Black color) I Module Diagram I F—mm—) 11-V Curies High Quality I I i `n\ �arax a imp •EC 61215(Ed.2)and IEC 61730 by VDE ( _ -ULlisted(UL 1703),Class C Fire Rating •Out put power tolerance+3/-0% I I pun. / or •ISO9001:20DO and ISO 14001:2004 Certified I awma� kI •Advanced Mechanical rest(8,000 Pal Passed(IEC) - ¢ 0.-41 a • "w:om /Mechanical Load Test(40 lbs/hj Passed(UL) •A.—nia Corrosion Resis[anceTest Passed •IEC 61701(Salt Mist Corrosion Test)Passed ocooroc I °ss _ Limited Warranty I -3' a 2 a esn — �•- •l0 years for product defect - uaaoc • • ^^ " " �vvus.m •l0years for 90%of warranted min.power •25 years for 80%of warranted min.power I Installation Safety Guide I 46'C t 2 •Only qualified personnel should install or perform maintenance. -4o-85-C a Imports.Notes-tv my •Be aware of dangerous high DC voltage. oc1.000VOEc nxwmuon yanxv nrry•mnwlVnw4Ju.m1lp.Maukxylnh.,gsCn,u4'` •Do not damage or scratch the rear surface of the module. ' DC600V(0U kxro Nxxvaslxow)axl Ixw.,wral rxxntx,ma. •Do not handle or install modules when the ISA y are we[. 1°xvsaau<<plmwx xul cE am- HYUNDAI a �Ie°Ma��b9 la HYUNDAI p tE Tel: Hy.exlal Bltl9.75,y. A-.852S ✓gu.Sia-2_793.Kuea - 'cos HEAVY INDUSTRIES C0.,LTD. � Tel:Nu-a7a66406,4671.763s.esxs r..:.eax-74s7ms HEAVY INDUSTRIES CO.,LTD. I /AHYUNDAI CERTIFICATE OF COMPLIANCE HEAVY INDUSTRIES C0.U0. wWw.hhi-green.conl/solar Certificate Number 20141021-E325005 Appendix)Module Installation Instruction(HIS.MxxxRF,HIS-MxxxRG,HISSxxxRF,HISSxxxRG) Report ReferenceE325005-20131209 The installation methods which are described in Hyundai Heavy Industries installation Manual are Issue Date 2014-OCTOBER-21 covered by 2,40OPa Warranty. Method 2400 Pa 5400 Pa Issued to: HYUNDAI HEAVY INDUSTRIES CO LTD 1-5 DAEJANG-RI SOI-MYEON t t t t EUMSEONG-GUN Bolting Long Bar CHUNGCHEONGBUK-DO 369-872 KOREA This is to certify that PHOTOVOLTAIC MODULES AND PANELS representative samples of "HiS-SxxxRF,HiS-MxxxRF,HiS-SxxxRG and HiS-MxxxRG Series with specific construction described in installation L/4 instructions compliant to Photovoltaic Module Fire Performance Type 1" f100mm Have been investigated by UL in accordance with the U2 I Standard(s)indicated on this Certificate. Long Bar i Clamping Standard(s)for Safety: UL 1703"Standard for Safety for Flat-Plate Photovoltaic Modules and Panels", ❑:Clamping area L I ULC ORD/C1703-01"Flat-Plate Photovoltaic Modules and ❑:Additional Panels support bar - Clamping Area sU4 $ Additional Information: area U U4 See the UL Online Certifications Directory at ❑:Additional L www.ul.com/database for additional information Clamping area for slipping U8s Clamping Area sU4 snow t100mm Only those products bearing the UL Certification Mark should be considered as being covered by UL's Certification and Follow-Up Service. U2 S/4 S/4 Look for the UL Certification Mark on the product. Short Bar S ! S Clamping Area sS/4 L 31 S/8s Clamping Area sS/4 Note 1)The certified mounting method is bolting method by TUV Rheinland. 2)The Mounting method has been qualified by Hyundai Heavy Industries,and the mechanical load tests are based on IEC61215 ed.2. �a •� =�ao •om+ate u� �mmww„µ ma,m.,rew,N.mxauwn�.+.n a,ow.a msauu.etar>.ry wm"naa uu,a..aii:wrm,.m.a.... Sales Office Page 15 of 15 Factory - - 12th R'.Hyundai Bldg., 313,Sd-ro.Soi•myeon,Eumseong-gun, 75.YJgoR-ro,Jongno•gu, Chungeheongbuk-do 369-872,Korea Page 1 of 1 - - Sseu1 110.793,Korea solar=@@ Single Phase Inverters for worth America solar SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ SE760OA-US I SE10000A-US/SE I1400A-US -�SE3000A-UST 9E3800A-US gE5000A•US SE600_OA-US I 9E7600A_US I SEIOOOOA-US SE11 OUTPUT 9980 @ 208V SolarEdge Single Phase Inverters • Nominal AC Power Out put 3000 " 3600' 5000 6000 7600 1. .@2�V 1740D VA For North America Max.AC Power Output 3300 alw saoo @ iosv 600o 8350 10800 @ 208v 2000 vA ......................................................................saSQ.@.zaov...................................io?so.@?991.............................. AC Output Voltage Min:Nom:Max."l 183.208-229 Vac ............. .................... ....... .............. .............. .............. ..............�............... ................ ................... SE3000A-US/SE3800A-US/SE5000A-US/SE6000A-US/ . AC Output. Voltagetage Mln:No Nom:Max c" J J l � � � SE7600A-US/SE10000A-US/SE1140OA-US 211::4D:3�?�a=............... .I....................... ..........................I.................... .. ............................6060 AC frequency MIn.Nom:Mex.m 59.3-60.60.5(with MI country senin857:60.60.5) Mz Ma[.Continuous Ou[Put Current• 12.5•. 1, 2a @ 208V 25 32 46 206V 47.5 A ...................... .... ........71.@.240y.................................... `..�••, GFDI Threshold i A �•��---••-•- .............h....................................................-.........................-................................................. - ' UHlit Monitori ,Islandin Protection Count Con unable Thresholds Yes Yes INPUT a050 5300.........................................I........... .................... .............................. ..• .....- enter 1 Maalmum OC Power ISTCI•.,,..,•.•,_,_ ..•..6750�_,,.•8100...•,.•,.10250 ..,,,..13500•...•,•.,•15350.,,•••, W ' y•� � Transformer•less,Un rounded Yes ` ' r Max.Input Volta a ........................... ... .. `�� {'F Nom.De input vonagie,..._•.................................... 3zs@2oav/350@zaw ......vdc 16.5 @ 208V @ 2 elreeoY Max.Input Current*. 9.5 • • 13 30.5 240 .. ... .18 23 3. Ads .............................. .. .............. 15.5 2a0V 0. ....... Max.lnput Short Cires+lt Current aS Adc .......................................................................................................es............................................................... �;` Revers¢•Polarl Protection Y 1: Ground-Fault Isolation Detection IiWk SensiHvftT ............................................................................................................ ............................................... ' Maximum Inverter Efiiclenq 97.7 98.2 98.3 98.3 98 96 98 % ........................................................................................................... { t CEC Weigh Power Consum•.,H•on-•,. 97.5 '•• 2.ao8yV.............5...... .7..5....... 7s@ 2 .... ... "' 97.5@ 17 ...... ..997 �,z0apv _ ......97.5 ........... 2.5NI httime .....%....... .. <a W ADDITIONAL FEATURES _ ®� Supported Cammunicatlon Interfaces .. R5a85.RS232.Ethernet.ZI�Bee(optional)................................................. iRevenue Grade Data,ANSI C32.1���•• •............... - .................. Optional+ 1 ..... ............................................................................................................................... n-NEC 201a 690. Functional' enabled when SolarE e rapid shutdown kit is instilled'" Rapid Shutdown 12 ry dB r w STANDARD COMPLIANCE Safe ..,•..-•,U117a1.UL1699B,,UL1998t CSA 221.................................................... ............................... I jf{ Y................................... 1 Grid Connection Standards IEEE1547 - ................................................................................................................................................................................ Emissions FCC partly doss 8 INSTALLATION SPECIFICATIONS r ' AC outpu[condult size{AWGran o 3 a'minimum/]6.6 AWG i DC Input conduit site/A of strings/ 3/4'minimum/1-I strings/ t 3/a•minimum/1-2.... /]6.6 AWG �. Dimensions with Safety Switch 30.5a 12.5x 10.5/ In/ '..�. 30.5x12.5x7.2/775z 315x 184 • ��.:. ..M,Wxo)............................................................... .. 775 x 3F5 K.=�.............m^?.... we)gnt w¢n safety swum.......................s12/23z....................................sa:i./ °:Z.................................... oi. )b%Eg... .................. � i IJ onvecdon ���_ _ c Cooling Natural Convection and internal Fans loser replaceable) tan(use r e la<eame The best choice for SolarEdge enabled systems l .............................................:................................................................r.R.........).........-....................................... ' ...............................................................I.. 25.........................................................................................dBA.... Integrated arc fault protection(Type 1)for NEC 2011690.11 compliance MIn:MaxAperating Temperature -13 to.1a0/-25 to.60(•a0 tot60 version avallableut) 'F/'C Ran6S......... Superior efficiency(98%) � ...... ............................................................................................................................................................. Protection flatind............... NEMA 3R Small,lightweight and easy to Install on provided bracket l ............................................................................................................................................ Built-in module-level monitoring - .e.mwnn oiresr......Iso""nnaruy rrmwmwm.anaroa�tnro:ex�ul. "o°�;.II".mP"se.ewauia°0'mnNwiia>aopv�mw,.,sErrmmvsmrurrval. - Internet connection through Ethernet or Wireless � M. -Outdoor and indoor installation t Fixed voltage inverter.DC/AC conversion only Pre-assembled Safety Switch for faster installation Optional-revenue grade data,ANSI C32.1 sunspec RoHS USA-GERMANY-ITALY-FRANCE-JAPAN•CHINA-AUSTRALIA-THENETHERLANDS-ISRAEL www.solaredge.us AUTHORIZATION TO MARK AUTHORIZATION TO MARK Product: Utility Interactive Inverter /This authorizes the application of the Certification Mark(s)shown below to the models described in the Product(s)) Brand Name: SolarEd e Covered section when made in accordance with the conditions set forth in the Certification Agreement and Listing Report.This authorization also applies to multiple listee model(s)identified on the correlation page of the Listing Models: ( models:Mowed ,SE3300,SE3800,SE5000,SE etc.) SE7000,SE7600 Report. (Option:followed by A to indicate Interface board,etc.) This document is the property of Intertek Testing Services and is not transferable.The certification mark(s)may be j applied only at the location of the Party Authorized To Apply Mark. _ Applicant: SolarEdge Technologies Ltd Manufacturer: Jabil Circuit(Guangzhou)LTD DEV EAST DISTRICT Address: 6 Ha'Harash Street 45240 - Address: 128 JUN CHENG RD Hod Hasharon GUANGZHOU GUANGDONG 510530 CHINA Country: Israel Country: China Contact: Mr.Oren Bechar or Contact: Elaine Ouyang Mr.Mair Adest +972 9 957 6620#293 or Phone: +972 9 957 6620#131 Phone: 020-2805-4025/135-7023-5852 FAX: +972 9 957 6591 FAX: NA Email: OREN.B@SOLAREDGE.COM Email: Elaiine.ouyang@jabil.com Party Authorized To Apply Mark: Same asManufacturer Report Issuing Office: Cortland, NY 13045 S Control Number: 4004590 Authorized by: /or Thomas J.Patterson,Certification Manager 1 ETA us 1 _ Intertek This document supersedes all previous Authorizations to Mark for the noted Report Number. ml.annorbmlon m MmY b w tro wmewe a.e a looney.c5mn elm b Prwaatl pm.uvm m me carwouon olVeenlonl emoan mmna am a.CNmt.loaner.roaw am�ry.m wel5n o.e 5n:ma m mo tom.ena oanaYmma tm�roorrom.mmmY e.eama.m ibamr Io em rom.mror men m mo cNm1 in er�tlenae wn mo e(Poa,ront,b.nr lea+.e.Pmoa or mltvpe o�.mnotl M Iro mD a mb a,mmumim m wn.Dory Iro clmm b aummcaa to Dem+1 aawum a amrlewon a Ime nmroruelmn Io wn ena Iran omy m m amaar.l)m a Imenao ConllkolYn non b rmNiaatl m Ne wmnione LIm W N No epramm,a aM b V,b gmrorLvlian Io Man.em Imllm uee a mo ImmmY,we la Iro W a etlrenuemm,l a Iro loebtl Itmlarim,potlum a emrn mot Np ro oPpwod In xNep nr IntoneY.Innbl Goody Nmunanb eM uD SamYm oC la Ilm Dmpoeo a a ..eppraprble utmpe of Iro Certif lion maM1 n ovuNom:e.wn Iro epraomom.Nw ero onto No W nMaae a poEucNn eua5ry oonnol nd entl tla m1 relb+a Ina C5on1 Iro4 a oWpeSon.N Ihis impact. Intertek Testing Services NA Inc. 545 East Algonquin Road,Arlington Heights,IL 60005 Telephone 800-345-3851 or 847.439.5667 Fax 312-283.1672 UL 1741 Standard for Safety for Inverters,Converters,Controllers and Interconnection System Equipment for Use With Distributed Energy Resources,Second Edition Dated:January 28,2010 CSA C22.2 107.1 Issue:2001/09101 Ed:3 General Use Power Supplies -(R2011) Standard(s): UL SUBJECT 1699B,Outline of Investigation for Photovoltaic(PV)DC Arc-Fault Circuit Protection-Issue No.2,2013/01/14 CSA TIL M-07,Interim Certification Requirements for Photovoltaic(PV)DC Arc-Fault Protection-Issue No.1,2013/03/11 ATM for Report 3188027CRT-001a Page 1 of 8 ATM Issued:13-Nov-2014 ATM for Report 3188027CRT-001a Page 2 of 8 ATM Issued:13-Nov-2014 EC 15 3.15(1Jem1]I MmlDamry Ea 1e•3.15(1-13)Martle(ory ® 3933 US Route 11 Cortland,NY 13D45 Telep�te: (607)753.6711 Facsimile: (607)756-9891 —.mlertek.com SolarEdge Technologies Ltd Letter Report 101703554CRT-001 June 20,2014 Letter Report No.101703554CRT-001 June 20",2014 Project No.G101703554 • 3-ph Inverters: W Meir Adest Ph:+972.9.957.6620 0 SE9KUS/SEIOKUS/SE20KUS when the SolarEdge rapid shutdown cable labeled"MCI-CB-xxxxx- SolarEdge Technologies Ltd email:meir.a@solaredge.com x"which is part of kit SE1000-RSD-xx is installed in the inverter Safety Switch where xxxxx-xx is 6 Ha'Harash St. HOD HASHARON,ISRAEL any number;inverter part number may be followed by a suffix Subject: ETL Evaluation of SolarEdge Products to NEC Rapid Shutdown Requirements This letter report completes this portion of the evaluation covered by Intertek Project No.G101703554. Dear Mr.Meir Adest, If there are any questions regarding the results contained in this report,or any of the other services offered by This letter represents the testing results of the below listed products to the requirements contained in the following Intertek,please do not hesitate to contact the undersigned. standards: Please note,this Letter Report does not represent authorization for the use of any Intertek certification marks. National Electric Code,2014,Section 690.12 requirement for rapid shutdown. Completed by: Radhe Patel. Reviewed by: Howard Liu This investigation was authorized by signed Qtiote 500534459 dated 06/10/2014.Rapid shutdown test were Title: Engineering Team Lead Title: Staff Engineer perform at SolarEdge Technologies Ltd,6 Ha'Harash St HOD HASHARON,ISRAEL and witness by Intertek � 21 /-�j�.r•o/� personal on 06/17/2014. (!� Signature: �- Signature The evaluation covers installations consisting of optimizers and inverters with part numbers listed below. Date June 20',2014 Dale: June 20",2014 The testing done has verified that controlled conductors are limited to not more than 30 volts and 240 volt- amperes within 10 seconds of rapid shutdown initiation. Applicable products: - • Power optimizers: o PBxxx-yyy-zzzz;where xxx is any number,0-9,up to a maximum value where xxx=350;yyy could be AOB or TFI;and zzzz is any combination of four letters and numbers. o OP-XXX-LV,OP-XXX-MV,OP-XXX-IV,OP-XXX-EV;where xxx is any number,0-9. o Paaa,Pbbb,Pccc,Pddd,Peee;where aaa,bbb,ccc,ddd,eee is any number,0-9 to a maximum upto aaa=300,bbb=350 ccc=500,ddd=600,eee=700. o Pxxx,Pyyy,Pzzz,Pmmm,Pnnn and P000;where xxx,yyy,zzz is any number,0-9 to a maximum up to xxx=300,yyy=350,zzz=500;where mmm,nnn,000 is any number,0-9 to a maximum up to mmm=405,nnn=300,000=350 • 1-ph Inverters: o SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/SE760OA-US/SE1000OA-US/ SE1140OA-US when the SolarEdge rapid shutdown cable labeled"MCI-CB-xxxxx-xe which is part of kit SE1000-RSD-xx is installed in the inverter Safety Switch where xxxxx-xx is any number; inverter part number may be followed by a suffix Page 1 a12 11u roper:ra uw awa.p em a Inbnvk.apt ma b povtJv4 wmmm tp lro wrro�m ror..om ImpnaY pn4 0.abm.Intalekk rmpmdeely ow weunmp un•ea 1p tro tan. entl mrYtilialk a iro egramvnt.IaanoY pswms np IloWlry loam pvM.eba tron w Iro Gbnl In pawreerm wun ew vprmmvnl,br oM Ime.e•pmw w 4aroao omoviawe M Inp um _ d trek rgwrt.QJy ele QYN b wlMbatl b Wmk mpyky a NtlenWim al Ika rvpM oro Ilan axy b IM1 emiary.Arry uw d Iro laenpk naro a aw d ks rmM b W ub a 1 e by tl n d ale bae4lrawml,a 14 a'WW mat aN ro oppwaa b rNkp M ImmpY.Tlw oWarretivra aM lest raueb In 1NY wpm prp relevpre a4y tllp unple IeYa4.TNv copal eY awn ape.ml Wryly loot tro rmtp4a,proeucl of smrho b a ne.ma rom uMa en INmek apw lbn I*eawm. OO •W.. ® aeA� ,ImeneA¢ Page 2o12 kYtttlNc Inttttek Mrertek lntenek Intrnek Intatek Imertek Teetirg Services NA.Ix. So 12.1.2(11111110)Informative InfeMk Testing Servxres NA,tm. So 12A.2(I III Mot IMormo/ba • solar=a@ solar=a@SolarEdge Power Optimizer Module Add-On for North America P300 / P400 / P405 SolarEdge Power Optimizer P300 P400 P405 lfor 60•cell module) Ifor 73 is96-cell modules) if.,thin Blm module,) Module Add-On For North America INPUT Rated Input DC Powertu ..................................300 ...............W .............Q�...................W...... P300 / P400 / P405 Absolute Maximum Input Voltage • 4g 80 125 Vdc (Voc at lowest temperature)......................................... _ MPP70perating Rangp.......................................8.:48...........................8..$..........................125.305...............Vdc..... Maximum Short Circuit Current fist) 70 Adc Maximum OC Input Current 12.5 Adc • Maximum EfficiencY...............................................................................99.5 .........................-..............I.........% WeightedEfBclen<Y.................................................. ..............95:8 ..................................................�....................... .... ... Overvoltage Category ll OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) _ Maximum Output Current 15 Adc .... ........................... .................................................................................................. Maximum Output Voltage 60 I 85 VAc OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) 7 Safety Output Voltage per Power Optimizer 1 Vdc �+ STANDARD COMPLIANCE FCC Vart15 Class B I 61000 - I 1� EMC �•EC.. 6 2,EC6 000-6-3 ;! Safe IEC62]09.1(class II safety UL1747 .......!Y ................................................ ..... ..... .... .. .. .i:......................... ......... RoHs Yes _ '`eV]aJtNtA'f INSTALLATION SPECIFICATIONS 4.. Maximum Allowed System VoltaQe.............................................................1000....................................................Vdc.... Pxxx12 series 141 x 212 x 40.5%555 x 8.34 x 1.59 ........................,mm/i.n .................................................. Dimensions Wx LxH 128x 1S2 Pxxx-5 series x27.5/ 128x152x35/ 128z152 x48/ I I in./in 5 x5:97x 1:08...............•5 z5:97x 1.37,.-,.•,. ..•,..,Sx5.97z1;89 Weight(including cables) Pxxz,2 series....................................................950/2:?.................................................8!�fib... Pxzz•5 series ..........770./1.7 I' ........930/,2:05...........I..........930/2:05.............$!�Ib-,- ........................................................ .................-. Input Connector .................MCO Compatible Output Wire Type Double/Connector..........•...................•......,,....,,.•.... e Insulated Amphenol . r........................................................ .Output Wire Length.........................................0:95.�.3:0 ..........1,2/39 Operating Temperature Range.........................................................:40:+85/:40;,185........................................./.F... Protection Raring Pxxx'2 series IP65%NEMA4 pr%Ib ...............................-•Pxxx:S series-,-,•- IP68/NEMA6P Relative HumiditY................................................................................R-100 ...:%...... 4�M Sr<pa.e.e1 e.e module.Meluk pl up m,5•pwar�Waierce,lbud. SOLAREDGE INVERTER"'EM DESIGN USING A SINGLE PHASE THREE PHASE 208V THREE PHASE 480V A SOLA Minimum String Length g 10 16 (Power Optimizers)............................................................................................................................................................... PV power optimization at the module-level Maximum String Length 2s 25 so (Power Optimizers)................................................................................................... ............................................... ............ - P t0 more energy Maximum Power per String..................................5250............................6000...........................12750.................W...... I — Superior efficiency(99.5%) Parallel Strings of Different Lengths 1 — Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading or Orientations.•,....•.......................•... Yes - Flexible system design for maximum space utilization tu,m"e-+^mm�.wrc-+u,woaprsap+au.muprmmpe..pno- - Fast installation with a single bolt - 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 /A�IRONRIDGE Roof Mount System AUTHORIZATION TO MARK 1 This authorizes the application of the Certification Mark(s)shown below to the models described in the Product(s) I Covered section when made in accordance with the conditions set forth in the Certification Agreement and Listing I .. I Report.This authorization also applies to multiple listee model(s)identified on the correlation page of the Listing I Report. This document is the property of Intertek Testing Services and is not transferable.The certification mark(s)may be r applied only at the location of the Party Authorized To Apply Mark. Applicant: IronRidge,Inc. Manufacturer. IronRidge,Inc. 1495 Zephyr Ave 1435 Baechtel Road Address: Hayward,CA 94544 Address: Willits,CA 95490 Country: USA Country: USA -., Contact: Yann Schwarz Contact: Jim Norsworthy Phone: (800)227-9523 Phone: (800)227-9523 (510)225-0973 FAX: (707)459-1833 FAX: (707)459-1833 r _ Email: yschwarz@ironridge.com Email: iorsworthy@ironddge.com • Party Authorized To Apply Mark: Same as Manufacturer �I(Report Issuing Office: Lake Forest,CA ( u Control Number: 4007559 Authorized by: for Thomas J.Patterson,Certification Manager _�-,P_— -: .• En CLASSIFIED \ �I us Buik for solar's toughest roofs. -- Intertek This tloeument supersedes all previous Authorizations to Mark for the noted Report Number. IronRidge builds the strongest roof mounting system in solar.Every component has been tested to the limit rmm4 maa lam(mm mmovna OiaeperttarLL YHmF aamearonmiYymary P".mer Pw,b me0oa nmoa4a,mwm Ne rommic Iw my bv,mpeuaoav,apeararmea and proven in extreme environments. wm.m.am..wm�am�.Mawa. ba .�m,anr��a�aam. p�mwb .mm�aH�4a�..uba ... .� m aeemme a.vuau moo nm.ro�..na nm.arm m amx nylmmn uce a an o¢enexn,,,o w ae w,aaa<Nwn.a a erm.n4 mmaw ooaa w.a.�.mw ttarpo.M n wiWp M mMk Nhl Fmvrn®mmn.m rm«wsen®aee m mo womoa a.vmm�woom+o mooaumeonemuon meN neo:waemwm va m.a�am. Our rigorous approach has led to unique structural features,such as curved rails and reinforced(lashings,and move..bum.�ao,mew.w�a.,mo.,a,aobnbo�a.amo.moaa�nmw,m„a is also why our products are fully certified,code compliant and backed by a 20-year warranty. Intertek Testing Services NA Inc. 545 East Algonquin Road,Arlington Heights,IL 60005 Telephone 800-345-3851 or 847439-5667 Fax 312-283-1672 Strength Tested PE Certified UL Subject 2703 Outline of Investigation for Rack Mounting Systems and Clamping Devices for Flat-Plate All components evaluated for superior Pre-stamped engineering letters StandarStandards): photovoltaic Modules and Panels,Issue Number.1,October 4,2010 structural performance. available in most states. Product•. xR Rails with Integrated Grounding. Brand Name: NIA Models: 51-61GD-005,51.61GD-005B,51-5000-0Ot,and 51�5-0Of © Class A Fire Rating Design Software Certified to maintain the fire resistance ® Online tool generates a complete bill of rating of the existing roof. materials in minutes. Integrated Grounding 20 Year Warranty ® UL 2703 system eliminates separate Twice the protection offered by module grounding components. competitors. ATM for Report 101541132LAX-002 Page 1 of 3 ATM Issued:10-Nov-2014 FD 10]15 n.m,U)4mbtpy /fir IRONRI®GE Integrated Grounding System Installation Overview aInstall Roof Attachments Simplified Grounding 1 Install appropriate roof flashing and/or standoff for roof type. For Greater Safety& Lower Cost Attach L-Feet to flashing or standoff. �_•- Traditionally,solar modules are grounded by attaching -v lugs,bolts or clips to the module frame,then connecting Prepare Rail Connections these to a copper conductor that runs throughout the © �f.Q `- array.This process adds time and cost to the installation, Insert splice into first rail,then secure with Grounding Strap and and often results in improper grounding,creating self-drilling screw. \ ,V , significant long-term safety risks. Slide second rail over splice,then secure with opposite end of ` � p The IronRidge Integrated Grounding System solves these Grounding Strap and self-drilling screw. challenges by bonding modules directly to the mounting rails.This approach eliminates separate module Mount&Ground Rails grounding hardware,and it creates many parallel grounding paths throughout the array,providing Attach rails to L-Feet and level rails. a r„ Grounding Mid Clamp Install one Grounding Lug per row of modules. ' Each Grounding Mid Clamp pierces through the greater safety for system owners. ' anodized coatings nge of Clan the module frame and •Connect Grounding Lug to grounding conductor.the mounUng rail to form secure electrical bonds• which are repeated throughout the array. Install Modules&Clamps Install first module using End Clamps and Grounding Mid Clamps. ._'S5 Install additional modules using Grounding Mid Clamps. Finish row with a second pair of End Clamps. Testing&Certification The IronRidge Integrated Grounding re7 Module Frame Compatibility System has been tested and certified to Dimension Range UL 2703 by Intertek Group plc. A 31.Omm-51.Omm UL 2703 is a proposed UL standard B 5.08mm(minimum) w� �• for evaluating solar module mounting Any module frames whose parameters we not listed in the and clamping devices.It ensures these provided table have not been tested for compatibility. o , devices will maintain strong electrical and 3 mechanical connections over an extended ` _ = period of time in extreme outdoor The Grounding Clamp has proven robust in grounding 60 cell and 72cell solar module frames with box construction and a range of environments. anodization thicknesses. �J 2I +� The testing process closely mirrors that All solar modules listed to UL 1703 and with frame construction Grounding Strap ' r of UL 1703,the solar module testing within the parameters stated above are compatible with the bondGrou ralrtg sbepe are tionsed,o standard,including temperature and IronRidge Integrated bond roll-to-rail connections, �� Grounding Lug eg ated Grounding System. They are only required on d,e humidity cycling,electrical and mechanical c single Grounding Lug _ rail with me grounding ma `� load testing, g quality co and manufacturing ualit O Go to ironridge.com/ig of PV modules to the reviews. grounding conductor. I //�_ Em Telephone: Murphy 08.8Drive sm_Middleton,W153562 USA Starling Madison Lofquist, Inc. Telephone:608.831.9279 Consulting Srsuctural and Forensic r.ngineers Farsimlle: 608.831.9279 w y.imertek.com . _'i/N r— 5224 South 39'Street,Phoenbt,Arizona 85040 Test Verification of Conformity tel:(602)438-2500 fax:(602)438-2505 www.smieng.com IronRidge June 16,2014 In the basis of the tests undertaken,the sample(s)of the below product have been found to comply with the requirements of 1495 Zephyr Ave Page 1 of 1 I the referenced specifications at the time the tests were carried out. Hayward,CA 94544 Applicant Name&Address: IronRidge,Inc. Attn:Mr.David F.Taggart,Vice President Products -149S Zephyr Ave. Hayward,CA 94544 Subject: IronRidge XR 10 Rail,Roof Flush Mounting System-Structural Analysis USA Product Description: XR Rails with Integrated Grounding. ` Dear Sir: Ratings&Principle Fire Class Resistance Rating: Characteristics: -Flush Mount(Symmetrical).l Class A Fire Rated for Low Slope applications when using Type 1,2 We have analyzed the IronRidge XR 10 Rail for the Subject solar module support system and and 3,listed photovoltaic modules. Class A Fire Rated for Steep Slope applications with Typel, determined that,for the configurations and criteria described below,it is in compliance with the 2 and 3,listed photovoltaic modules.Tested with a S"gap(distance between the bottom the applicable sections of the following Reference Documents: module frame and the roof covering),per the standard this system can be installed at any gap allowed by the manufacturers installation Instructions. No perimeter guarding is required. Codes:ASCE/SEI 7-10 Min.Design Loads for Buildings&Other Structures International Building Code 2012 Edition Models: 51-61GD-005,51-61GD-0056,51-5000-001 and 51-65-001 California Building Code 2013 Edition Brand Name: IronRidge Roof Mount. Other: AC428,Acceptance Criteria for Modular Framing Systems Used to Support PV Relevant Standards: UL 2703(Section 15.2 and 15.3)Standard for Safety Mounting Systems,Mounting Devices, Modules,dated Effective November 1,2012 by IMES aamping/Retention Devices,and Ground Lugs for Use with Flat-Plate Photovoltaic Modules Aluminum Design Manual,2010 Edition _ and Panels,First Edition dated Jan.28,2015 Referencing UL1703 Third Edition dated Nov.18, , 2014,(Section 31.2)Standard for Safety for Flat-Plate Photovoltaic Modules and Panels. The IronRidge XR 10 Rail is an extruded aluminum section with an overall depth of 1.75 in.and a net Verification Issuing Office: Intertek Testing Services NA,Inc. area of 0.363 sq.in. The mils are Used to support solar modules,typically,on the roof of a building. 8431 Murphy Drive See Exhibit A-attached. The mils are clamped to aluminum angle brackets that are either attached Middleton,WI 53562 directly to the roof framing or attached to a stand that is screwed to the roof framing. The rails are Date of Tests: 08/27/2014 to 03/17/2015 Test Report Number(s): 101769343MID-001rl,101769343MID-001a,101915978MID-001&101999492MID-001arl-crl. mounted across the slope with a small clearance(flush mounting)to the underlying roof structure. This verification Is part of the full test reports)and should be read In conjunction with them.This report does not automatically The installed solar modules are at the saute slope as the underlying roof structure. Imply product certification. All loads are transferred to the roof framing through the angle brackets by simple bi-axial Flexure of Completed by: Chad Naggs Reviewed by: Gregory Allen the rails. The maximum span of the rails is governed by either the mid-span Flexural stresses or the Title: Technician 11,Fire Resistance Title: Engineering Team Lead,Fire Resistance deflection requirement that the rail not come into contact with the roof. J-e g 1 1 Signature: B'"_J n 7 Signature: u� � The effect of seismic loads(far all design categories A-F)have been determined to be less than the Date: 03/30/2015 Date: 03/30/2b15 effect due to wind loads in all load conditions and combinations. "therefore,the maximum allowable I spans for common load cases are shown in Tables I,2&3 below for 0-6 degree slopes,Tables 4,5, &6 below for 7-27 degree slopes,and Tables 7,8&9 below for 28-45 degree slopes. This Verification Is for the exclushm use of lntertek's client and is provided pursuant ro the ogreemem between Intertek Arid lts client.IntertrA''s responsfbiliny and liability nee limitedto the termsandconditionsoftheagreement.Intertek assumes no Ifab(flty to any party,otherman.,he Cient In eacordlmce wfth lh agreement,foranyloss,expense or domage—ioned by the use ofthis Verif—ion.Only the Client is—Inuitrd to permit copying or diadbolm,ofthi,Verificotion.AnV use of the lntenel:name or our of ins mocks Jortherole orodvertlsemenlofthetestedmamnol,productors immustfirstbeapprovedinwdtingby Intertek The ob—lionsand test/Inwettlon results Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers referenced m this Ve icatfon ore relevant only to the sample mtedlInspected.This Vedweatlon by Itself does not Imply then the motel 1,product-ice is or has ever been underan Intertek certiifl—h n p.9— GFT-OP-11a(24-MAR-2014) IronRidge June 16,2014 IronRidge June 16,2014 Mr.David F.Taggart Page 5 of 1 I Mr.David F.Taggart Page 6 of I I IronRidge XR 10 Rail,Roof Flush Mounting System—Structural Analysis IronRidge XR 10 Rail,Roof Flush Mounting System—Structural Analysis Table 4-MAXIMUM SPANS(inches)-Roof Slope 7 to 27 Degrees-Wind Zone 1 Table 5-MAXIMUM SPANS(inches)-Roof Slope 7 to 27 Degrees-Wind Zone 2 XR10 Wind Ground Snow Load XR10 Wind Ground Snow Load Rail Speed Rail Speed Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 sf sf sf sf sf sf sf sf sf sf psf PSI psf Psf psf psf PSI psf 100 75 65 55 49 43 39 35 33 31 29 100 72 65 55 49 43 39 35 33 31 29 105 75 65 55 49 43 39 35 33 31 29 105 69 65 55 49 43 39 35 33 31 29 110 75 65 55 49 43 39 35 33 31 29 1 110 66 65 55 49 43 39 35 33 31 29 120 75 65 55 49 43 39 35 33 31 29 120 60 60 55 49 43 39 35 33 31 29 CateBory 130 75 65 55 49 43 39 35 33 31 29 CateBgory 130 56 56 55 49 43 39 35 33 31 29 140 71 65 55 49 43 39 35 33 31 29 140 52 52 52 49 43 39 35 33 31 29 150 66 65 55 49 43 39 35 33 31 29 150 49 49 49 49 43 39 35 33 31 29 160 62 62 54 48 43 39 35 33 31 29 160 46 46 46 46 43 39 35 33 31 29 170 59 59 53 47 43 39 35 33 31 29 170 43 43 43 43 43 39 35 33 31 29 100 75 65 55 49 43 39 35 33 1 31 29 100 61 61 55 49 43 39 35 33 31 29 105 75 65 55 49 43 39 35 33 31 29 105 58 58 55 49 43 39 35 33 31 1 29 110 75 65 55 49 43 39 35 33 31 29 110 56 56 55 49 43 39 35 33 31 29 120 70 65 55 49 43 39 35 33 31 29 120 51 51 51 49 43 39 35 33 31 29 Category 130 65 64 54 48 43 39 35 33 31 29 CateCgory 130 48 48 48 48 43 39 35 33 31 29 140 60 60 53 48 1 43 39 35 33 31 29 140 1 44 44 44 44 43 39 35 33 31 29 150 56 56 52 47 43 39 35 33 31 29 150 41 41 41 41 1 41 39 35 33 31 29 160 53 53 51 46 42 39 35 33 31 29 160 39 39 39 39 39 39 35 33 31 29 170 50 50 50 45 41 38 35 33 31 29 170 36 36 36 36 36 36 35 33 31 29 100 75 65 55 49 43 39 35 33 31 29 100 56 56 55 49 43 39 35 33 31 29 105 73 65 55 49 43 39 35 33 31 29 105 54 54 54 49 43 39 35 33 31 29 110 70 65 55 49 43 39 35 33 31 29 110 52 52 52 49 43 39 35 33 31 29 120 64 1 64 1 54 48 43 39 35 33 31 29 120 47 47 47 47 43 39 35 33 31 29 CatD ory 130 60 60 53 47 43 39 35 33 31 29 CatD ory 130 44 44 44 44 43 39 35 33 31 29 140 55 55 52 46 42 39 35 33 31 29 140 41 41 41 41 41 39 1 35 33 31 29 150 52 52 50 46 42 39 35 33 1 31 29 150 38 38 38 38 38 38 35 33 31 29 160 49 49 49 45 41 38 35 33 31 29 160 36 36 36 36 36 36 35 33 31 29 170 46 46 46 44 40 37 35 33 31 29 170 33 33 33 33 33 33 33 33 31 29 Notes—see page I I Notes—see page I I Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers S- -6- IronRidge June 16,2014 IronRidge June 16,2014 Mr.David F.Taggart Page 7 of 1 1 Mr.David F.Taggart Page I 1 of I I IronRidge XRIO Rail,Roof Flush Mounting System—Structural Analysis IronRidge XR10 Rail,Roof Flush Mounting System—Structural Analysis Table 6-MAXIMUM SPANS(inches)-Roof Slope 7 to 27 Degrees-Wind Zone 3 Notes—Tabulated values are based on the following criteria: XR10 Wind Ground Snow Load I. Building mean roof height=30 R Rail Speed - t0 20 30 40 50 60 70 80 90 2. Risk Category Exposure mph 0 pst sf sf sf sf sf sf sf sf sf 3. Solar module long dimension=67.5 in 100 59 59 55 49 43 39 35 33 31 29 4. Provide 2 in.clear between roof and rail 105 56 56 55 49 43 39 35 33 31 29 5. End cantilever span(max)=0.40 x maximum span from above tables ' 110 54 54 54 49 43 39 35 33 31 29 6. No rail splices in end spans 120 49 49 49 49 43 39 35 33 31 29 7. No rail splices in middle 1/3 of interior spans Category B 130 46 46 46 46 43 39 35 33 31 29 8. Single simple span(s). Spans listed in the tables above may be multiplied by 1.08 for 140 42 42 42 42 42 39 35 33 31 29 continuous rails of 3 or more spans. 150 40 40 40 40 40 39 35 33 31 29 1 00 37 37 37 37 37 37 35 33 31 29 170 35 35 35 35 35 35 35 33 31 29 Our analysis assumes that the rails,including the connections and associated hardware,are installed 100 50 -50 50 49 43 39 35 33 31 1 29 in a workmanlike manner in accordance with the"IronRidge Roof Mount Installation Manual'by 105 48 48 48 48 43 39 35 33 31 29 IronRidge and generally accepted standards of construction practice.Additional information is 110 45 45 45 45 43 39 35 33 31 29 available at the IronRidge web site,IronRidge.com. Verification of PV Module capacity to support 120 42 42 42 42 42 39 35 33 31 29 the loads associated with the given array shall be the responsibility of the Contractor or Owner and Category 130 39 39 39 39 39 39 35 33 31 29 not lronRld ge or Starling Madison Lof uisl. C 140 36 36 36 36 36 36 35 33 31 29 q 150 33 33 33 33 33 33 33 33 31 29 160 31 31 31 31 31 31 31 31 31 29 The adequacy of the supporting roof framing is to be determined by others. 170 29 29 29 29 29 29 29 29 1 29 1 29 100 46 46 46 46 43 39 35 33 31 29 105 44 44 44 44 43 39 35 33 31 29 Please feel free to contact me at your convenience if you have any questions. 110 42 42 42 42 42 39 35 33 31 29 120 38 1 38 1 38 38 1 38 38 35 33 31 29 CateDgory 130 35 35 35 35 35 35 35 33 31 29 Respectfully yours, 140 33 33 33 33 33 33 33 33 31 29 150 31 31 31 31 31 31 31 31 31 29 ASK o L•Ia•/lp� 160 29 29 29 29 29 29 29 29 29 29 RES J. sa 170 27 27 27 27 27 27 27 27 27 27 WARNER Tres Warner,P.E. o CIVIL Notes—seepage I I Design Division Manager " q o.494320 F4S/ONAL Ct�r' -E Z e E" Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers -7- 11- -8431 Murphy Drive EM Middleton,W153562 USA sm_ Starling Madison Lofquist, Inc. Telephone:6G8.836.4400 Consulting Structural.and ForeOsic fisgincers Facsimile: 608.831.9279 ww. r� wmtenek.com - ��^ 1 5224 South 391 Street,Phoenix,Arizona 85040 Test Verification of Conformity tel:(602)438-2500 fax:(602)43872505 www.smleng.com IronRidge June 16,2014 In the basis of the tests undertaken,the sample(s)of the below product have been found to comply with the requirements of 1495 Zephyr Ave Page I of 1 I the referenced specifications at the time the tests were tarried out. Hayward,CA 94544 Applicant Name&Address: IronRidge,Inc. Attn:Mr.David F.Taggart,Vice President Products 1495 Zephyr Ave. Hayward,CA 94544 Subject: IronRidge XR 10 Rail,Roof Flush Mounting System—Structural Analysis USA Product Description: XR Rails with Integrated Grounding. Dear Sir: Ratings&Principle Fire Class Resistance Rating: Characteristics: I-Flush Mount 5 m etrical).1 Class A Fire Rated for Low Slope applications when using Type 1,2 We have analyzed the IronRidge XR 10 Rail for the subject solar module support system and and 3,listed photovoltaic modules.Class A Fire Rated for Steep Slope applications with Typel, determined that,for the configurations and criteria described below,it is in compliance with the 2 and 3,listed photovoltaic modules.Tested with a 5"gap(distance between the bottom the applicable sections of thefollowing Reference Documents: module frame and the roof covering),per the standard this system can be Installed at any gap allowed by the manufacturers installation instructions. No perimeter guarding is required. Codes:ASCE/SEI 7-10 Min.Design Loads for Buildings&Other Structures International Building Code 2012 Edition Models: 51-61GD-005,51-61GD-OOSB,51-5000.001 and 51-65-001 California Building Code 2013 Edition Brand Name: IronRidge Roof Mount Other: AC428,Acceptance Criteria for Modular Framing Systems Used to Support PV Relevant Standards: UL 2703(Section 15.2 and 15.3)Standard for Safety Mounting Systems,Mounting Devices, Modules,dated Effective November 1,2012 by ICC-ES Clamping/Retention Devices,and Ground Lugs for Use with Flat-Plate Photovoltaic Modules Aluminum Design Manual,2010 Edition and Panels,First Edition dated Jan.28;2015 Referencing UL1703 Third Edition dated Nov.18, 2014,(Section 31.2)Standard for Safety for Flat-Plate Photovoltaic Modules and Panels. The IronRidge XR IO Rail is an extruded aluminum section with an overall depth of 1.75 in.and a net Verification Issuing Office: Intertek Testing Services NA,Inc. area of 0.363 sq.in. The tails are used to support solar mod Liles,typically,on the roof of a building. 8431 Murphy Drive See Exhibit A—attached. The rails are clamped to aluminum angle brackets that are either attached Middleton,cal 53562 directly to the roof framing or attached to a stand that is screwed to the roof framing. The rails are Date of Tests: 08/27/2014 to 03/17/2015 Test Report Number(s): 101769343MID-OOlrl,101769343MID-001a,101915978MID-001&101999492MID-001arl-crl. mounted across the slope with a small clearance(flush mounting)to the underlying roof structure. This verification Is part of the full test report(s)and should be read In conjunction with them.This report does not automatically The installed solar modules are at the same slope as the underlying roof structure. Imply product certification. All loads are transferred to the roof gaming through the angle brackets by simple bi-axial flexure of Completed by: Chad Naggs Reviewed by: Gregory Allen the rails. The maximum span of the rails is governed by either the mid-span flexural stresses or the Title: Technician 11.Fire Resistance Title: Engineering Team Lead,Fire Resistance deflection requirement that the rail not come into contact with the roof. 1 Signature: Signature: The effect of seismic loads(for all design categories A-F)have been determined to be less than the Date: 03/30/2015 Date: 03/30/2Zb35 effect due to wind loads in all load conditions and combinations. Therefore,the maximum allowable spans for common load cases are shown in Tables I,2&3 below for 0-6 degree slopes,Tables 4,5, &6 below for 7-27 degree slopes,and Tables 7,8&9 below for 28-45 degree slopes. This Velificanonis Jar Mew'Clusive use of lmr eks Client and 4 provided pursuant lathe agreementber—it Intertekand Rs Client Intertek's responsibility andliabiIlly are Rmlted to the terms and conditions of the agreement.Intertek assumes no liability to any party,other than to the Client in accordance with the agreement,for any loss,erpense ordamage occasioned by the use of this Verification.Only the Client is outhonred to permit mpying or distribution of this Verification.Any—of the lntertaknameorone ofits marks for the sale or odverteement of the tested material,product or service must first be approved in writing by Intertek.The observations and resonWorl n results Snarling Madison f ofquisy Inc. Consulting Structural and Forensic Engineers referenced in this Verification ore relevant only to the sample rested/inspected.This Verification by Itself does not imply that the materiot product,or sen,ke is*rho;ever been underon lntevrek certification program. GFT-OP•11a(24•MAR-2014) IronRidge June 16,2014 lion Ridge June 16,2014 Mr.David F.Taggart Page 8 of I 1 Mr.David F.Taggart Page 9 of I I IronRidge XRIO Rail,Roof Flush Mounting System-Structural Analysis IronRidge XR1O Rail,Roof Flush Mounting System-Smlctural Analysis Table 7-MAXIMUM SPANS(inches)-Roof Slope 28 to 45 Degrees-Wind Zone 1 Table 8-MAXIMUM SPANS(inches)-Roof Slope 28 to 45 Degrees-Wind Zone 2 XR10 Wind Ground Snow load XR10 Wind Ground Snow Load Rail Speed Rail Speed Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 Exposure mph 0 psf 10 20 30 40 50 60 70 80 90 sf sf sf sf sf sf st sf sf sf psf psf psf psf psf psf psf psf 100 72 66 57 51 45 41 38 35 33 31 100 72 66 57 51 45 41 38 35 33 31 105 72 66 57 51 45 41 38 35 33 31 105 72 66 57 51 45 41 38 35 33 31 110 71 65 57 50 45 41 38 35 33 31 110 71 65 57 50 45 41 38 35 33 31 120 67 63 55 49 45 41 38 35 33 31 120 67 63 55 49 45 41 38 35 33 31 CateBgory 130 64 61 54 48 44 41 38 35 33 31 Category 130 64 61 54 48 44 41 38 35 33 31 140 61 59 52 47 43 40 38 35 33 31 140 60 59 52 47 43 40 38 35 33 31 150 58 57 51 46 43 40 37 35 33 31 150 56 56 51 46 43 40 37 35 33 31 160 55 55 49 45 42 39 37 35 33 31 160 53 53 49 45 42 39 37 35 33 31 170 53 53 48 44 41 38 36 34 33 31 170 50 50 48 44 41 38 36 34 33 31 100 68 63 55 50 45 41 38 35 33 31 100 68 63 55 1 50 45 41 38 35 33 31 105 66 62 54 49 45 41 38 35 1 33 1 31 105 66 62 54 49 45 41 38 35 33 31 110 64 61 54 48 44 41 38 35 33 31 110 64 61 54 48 44 41 38 35 33 31 120 60 58 52 47 43 1 40 38 35 33 31 120 59 58 52 47 43 40 38 35 33 31 CateCgory 130 57 56 50 46 42 39 37 35 33 31 CateCgory 130 55 55 50 46 42 39 37 35 33 31 140 54 54 48 44 41 39 37 35 33 31 140 51 51 48 44 41 39 37 35 33 31 150 51 51 47 43 40 38 36 34 33 31 150 48 48 47 43 40 38 1 36 34 33 31 160 48 48 45 42 39 37 35 33 32 31 160 45 45 45 42 39 37 35 1 33 32 31 170 46 46 44 41 38 36 34 33 31 30 170 43 43 43 1 41 38 36 34 33 31 30 100 64 61 54 48 44 41 38 35 33 31 100 64 61 54 48 44 41 38 35 33 31 105 62 60 53 48 44 41 38 35 33 31 105 62 60 53 48 44 41 38 35 33 31 . 110 60 58 52 47 43 1 40 38 35 33 31 110 59 58 52 47 43 40 38 35 33 31 120 56 56 50 46 42 39 37 35 33 31 120 55 55 50 46 42 39 37 35 33 31 CateDgory 130 53 53 48 44 41 39 36 35 33 31 CateDgory 130 51 51 48 44 41 39 36 35 33 31 140 50 50 46 43 40 38 36 34 32 31 140 47 47 46 43 40 38 36 34 32 31 150 47 47 45 41 39 37 35 33 32 31 150 44 44 44 41 39 37 35 33 32 31 160 45 45 43 40 38 36 34 33 31 30 160 42 42 42 40 38 36 34 33 31 30 170 43 43 41 39 37 35 33 32 31 29 170 39 39 39 39 1 37 1 35 1 33 1 32 1 31 29 Notes-see page 1 1 Notes-see page I 1 Starling Madison Lofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison Lofquisy Inc. Consulting Structural and Forensic Engineers 8 9 IronRidge June 16,2014 IronRidge June 16,2014 Mr.David F.Taggart Page 10 of 1 I Mr.David F.Taggart Page I I of I I IronRidge XR10 Rail,Roof Flush Mounting System-Structural Analysis IronRidge XR10 Rail,Roof Flush Mounting System-Structural Analysis Table 9-MAXIMUM SPANS(inches)-Roof Slope 28 to 45 Degrees-Wind Zone 3 Notes-Tabulated values are based on the following criteria: XR30 Wind Ground Snow Load I. Building mean roof height=30 It Rail Speed to 20 30 40 50 60 70 80 90 2. Risk Category Exposure mph 0 psf sf PSI PSI psf PSI PSI psf sf psf 3. Solar module long dimension=67.5.in 100 72 66 57 51 45 41 38 35 33 31 4. Provide 2 in.clear between roof and mil 105 72 66 57 51 45 41 38 35 33 31 S. End cantilever span(max)=0.40 x maximum span from above tables 110 71 65 57 50 45 41 38 35 33 31 1 6. No rail splices in end spans 120 67 63 55 49 45 41 38 35 33 31 7. No rail splices in middle 1/3 of interior spans Category 130 64 61 54 48 44 41 38 35 33 31 8. Single simple span(s). Spans listed in the tables above may be multiplied by 1.08 for 6 140 60 59 52 47 43 40 38 35 33 31 continuous rails of 3 or more spans. 150 56 56 51 46 43 40 37 35 33 31 160 53 53 49 45 42 39 37 35 33 31 170 50 50 48 44 41 38 36 34 33 31 Our analysis assumes that the rails,including the connections and associated hardware,are installed 100 68 63 55 50 45 41 38 35 33 31 in a workmanlike manner in accordance with the"IronRidge Roof Mount Installation Manual"by 105 66 62 54 49 45 41 38 35 33 1 31 IronRidge and generally accepted standards of construction practice.Additional information is 110 64 61 54 48 44 41 38 35 33 31 available at the IronRidge web site,IronRidge.com. Verification of PV Module capacity to support 120 59 58 52 47 43 40 38 35 33 31 the loads associated with the given array shall be the responsibility of the Contractor or Owner and. Category 130 55 55 50 46 42 39 37 35 33 31 not IronRidge or Starling Madison Lof uist. C 140 51 51 48 44 41 39 37 35 33 31 g q 150 48 48 47 43 40 38 36 34 33 31 160 45 45 45 42 39 37 35 33 32 31 The adequacy of the supporting roof framing is to be determined by others. 170 43 43 43 41 38 36 34 33 31 30 100 64 61 54 48 44 41 38 - 35 33 31 105 62 60 53 48 44 41 38 35 33 31 Please feel free to contact me at your convenience if you have any questions. 110 59 58 52 47 43 40 38 35 33 31 120 55 1 55 1 50 46 42 39 37 1 35 33 31 Category 130 51 51 48 44 41 39 36 35 33 31 Respectfully yours, 140 47 47 46 43 40 38 36 34 32 31 150 44 44 44 41 39 37 35 33 32 31 1N S 4.4 /y 160 42 42 42 40 38 36 34 33 31 30 3 WARNER J. cym 170 39 39 39 39 37 35 33 32 31 29 Tres Warner,P.E. o` CIVIL Notes-see page I 1 Design Division Manager A•9 o.494920 sb�Forsys NAI Starling Madison L.ofquist,Inc. Consulting Structural and Forensic Engineers Starling Madison LoCquisy Inc. Consulting Structural and Forensic Engineers -10- 11- E-Mount Lag I QMSE - LAG E-Mount Lag Installation Instructions _ Installation Tools Required:tape measure,roofing bar,chalk line,stud finder,caulking gun,sealant compatible with roofing materials, R DESCRIFrION OTT./BOX EM T./BOX drill with 7/32"long-style bit,drill or impact gun with 1/2"socket. THIS EDGE TOWARDS ROOF RIDGE No. _ I FLASHING.9"X 17'X.040,5052,MILL 1 2 OBLOCK.CLASSIC,A360.1 CAST AL,MILL 1 3 PLUG.SEALING,5116'X 7/9".EPDM/I"SS I r 4 LAG SCREW.HEX HEAD,5/16"x5-1/7%I8.8 SS I 5 WASHER,FENDER.5/16"IDX I-1/4"OD.I"SS, I ;7Z RACKING COMPONENTS IL NOT INCLUDED 1 3'00 Locate,choose,and mark centers of rafters to be Carefully lift composition roof shingle with roofing Insert flashing between tst and 2nd course.Slide - mounted.Select the courses of shingles where bar,Just above placement of mount Remove nails up so top edge of flashing Is at least 3/4'higher _L mounts will be placed. as required.See"Proper Flashing Placement"on than the drip edge of the 3rd course and lower A.SU— _� next page. gashing edge is above the drip edge of 1st course. 9()0. ; Mark center for drilling. ---- _I Quick _.T. U AVAILABLE IN MILL,AND QMSE-LAG:QMPV E-MOUNT BRONZE ANODIZED FINISHES WITH LAG BOLT _ SIZE aRAx7NBY: om REV A l�DATE' nearaa.=14mrnla7l 5..0 4 3 2 I 54or ..� La c.1 pull-out(withdrawal)caimcities(113s)in typical luinber: Using drill with 7/32u bit drill pilot hole into roof Clean off any sawdust,and fill hole with sealant Slide the flashing into position.Insert the rubber Lag Son Specifications and rafter,taking care to drill square to the roof compatible with roofing materials. plug into the OBlock cavity. Do not use mount as a drill guide.Drill should be sa�om27 V16'—do.rrm-dmph w-_nPm ruve,ra a.Mn long style bit:aka'a ircraft extension bit'to d Oil a Ouunba Fr,carve .5o Ina 25e I W deep hole into rafter. w,oln Fn,smn .4e 7os xas E_-nn 4Fu-.L4daaaala N-lMSR 1-1a hi,.,) A4 705 235 1—IR .4J 636 212 �� ot.,, • lino.F1(Nanh) .46 7. 234 al. ` ' • aardharn Poe .55 -t W7 aqua.Paw,FY AI BtS 2n5 I b iY( 51nrr-,PYr,R(E dlrMlfon pdaM lrblm yvm.d MSR and MEU 50 ]65 286 �r /� � ,Y..W1�4 r�i��L7;��Y�,� Sw,c-:Anlerkan Wand CWWIt Nos 2005.Table 111 A.1132 A Not-: 1 ._'7",..-L 11Thlead must he embedded in a lahar m olMl stlucluml rod member. • •• II See NDSTeble IIS.IC for.eq,i,dedgedivames. _ GOD QuickMount PIVII Slide the washer and the L-foot(not included)onto Using a 1/2 inch socket on an Impact gun drive RESPECT THE ROOF the lag screw. the lag screw until the ClBlock stops rotating easily. DO NOT over-torque. BI 7.23.31 Sep-2014,Rev 1 BI 7.2.3-31 Sep-2014,Rev 1 Locus Product Datasheet DIAGRAM-TYPICAL CONFIGURATION eweear �n mmm __..noun Shielde0 CATS mmm ww_ INTERNET r= =in LGate • RESIDENTIAL SOLAR MONITORING SOLUTION 45 The LGate • • • • MLE�BD�f•L ���s>• ELECTRICAL for •te monitoring of • photovoltaicin. r_� SERVICE \ �' rim INVERTER(5) LGATE120 • • • - • • IV \\ ARRAY solartransmit meter data overcellular of,Ethernet networks allowing system owners and operators to easily manage distributed DIMENSIONS SOCKET METER 1 METER BASE LOCUS ENERGY METER MODULE COMM MODULE tt v v v I 6.951n The LGate 120 combines a revenue-grade,solid-state power meter with an advanced communications gateway. 6.31 in These components work in conjunction to remotely monitor the performance of residential solar energy installation regardless of panel or inverter type.The LGate 120 is a one-piece completely under glass meter which installs easily using a standard socket base.Performance data is uploaded in near real-time to the Locus Energy SolarOS e monitoring platform which provides a suite of tools and analytics for asset managers. 5.46 in =6.00 in—1 7.30 in —•I DATA COLLECTION - -- - - - - - -- -- AC energy data is collected by the meter and passed to the communications module.Additional system performance data can be collected directly from meteorological sensors and supported inverters via available RS-485 or Zigbee Connections.All data is stored in non-volatile memory and then automatically uploaded to the SolarOS and SPECIFICATIONS SolarNOC platforms. Proe—d, ARM9 embedded CPU Accuracy ANSI 12.20(Class 0.2%) OS Custom version of Linux 2.6,OTA firmware updates voitago Inputs 120-480 VAC NETWORK CONNECTIVITY Memory 178 MB RAM Maa.Cmrentinput 2DOA The communications gateway inside the LGate 120 supports plug and play connectivity through a Cellular or available DbDIar LCO screen service Type Single Phase.60 Na 1 Sake[type 25 t Ethernet network connection.Once the unit is installed and powered on.it will immediately begin transmitting data -'— "- - without any Configuration.For maximum reliability.the communications gateway will automatically route.uploads Enclosure NEMA 3R Type between the wireless and wired connections if either of the networks are unavailable. Weight B at ANSI 12.20 class 0.2% Dimensions 6.95'.6.5'x 7.3• FCC Part 15B Environment -20 to 60C.ell-waather c PTCRS f Wananly 5 year limited warranty AT&T Carrier Compliance FEATURES -• - ANSI C12.20 power meter Easy,low cost installation • RS•485 and Zigbee inputs Doesn't require entrance into the building NoeM Numbr Lm[erso-w. Lcer.vo-acy Lce[M:oac: Cellular-3G GSM J ✓ ✓ • GSM Cellular or Ethernet Connectivity Plug and play activation RS-4852 and 4 wire ✓ • Over the air firmware updates LCD display MPdbas ✓ Ziobee J - Ethernet Rj.4510/100.OMCP/Static J i Single Meter Sockets -Without Bypass Single Meter Sockets -Without Bypass 125&200 Amp 125&200 Amp Application • Single meter position .NN-; Receive ANSI C12.10 watthour meters •F • Surface or flush mount(see chart) .tf Construction Oil F-Rush Mount ng type (U)204 MS68.2'Conduit Hub to=th NIEMAT e3R O (U1207 MS68A-MS73+MS68 2A='h'-W' YP 4F=2'-12.,I'A-I � •ANSI 61 gray Ecoat finish 927 MS73-AL Screw Type fling 4G=21h.'-2"-Ph'-ru •Aluminum snap ring included SF-Semi Flush Mount Tap Provision=See Chan SS-Stainless Steel Standards Accessories _ • UL 414 Listed 5th Jaw Kit-50365 •ANSI C12.7 200ATriplex Ground-ET8200 Knockout Layouts 011(closed) U204(open) AW Hub PartA1PC catalog Amp service Co...ca".. - Fig:1 Fig.2 Number Number Hating Jew. Type Awass Line Load Neuoal 78205142000 011 125 4 10/3Yy OH/UG 014-2/0 114-2/0 114-2/0 Top Provision -_Top Provision 78205142040 011 F 125 4 1013W OH/UG 014-2/O 014-2/O 014.2/0 ,•78205142U45 011 MS73 _ 125 4 10/3W OH/UG 114.2/0 114.2/0 - 014-2/0 78205142M 011 SF 125 4 10/3W OH/UG 014.2/0 114-2/0 #14.2/O 78205144030 921 100 7 30/4W OH/UG 014-1/0 014 1/0 014-2/0 •720515600 204 200 4 103W OH 6.250MCM 06-250MCM 06-350MCM 7020.5156070 204F 73 200 '4 10/1 # 3W OH 6-250MCM i6-250MCM 6.350MCM 78205156030 1 204 F MS73 200 4 10/3w OH 16-250MCM r6-250MCM 6-350MCM - •78205156g40 2114 MS68 _ 200 4 _10/3W OH d6-250MCM 06.250MCM A-350MCM _ 78205156035 204 MSFiBA 200 4 1013W OH 16.250MCM 06.250MCM 06.350MCM 78205108490 204 MS73 200 4 10/3W OH 06-250MCM 16.250MCM 16.350MCM 78205156005 U204 200 4 10/3W UG 06-250MCM 16.250MCM /6-350MCM 4F 4F �'4F 78205156045 U204F 200 4 _ 10/3W UG, 16-250MCM 16.250MCM_ 16-.350MCM 4F 78205156060 UM4 FMS73 200 4 10/3W UG 16-250MCM 06-250MCM 16.350MCM O 1A `« 78205156070 U204 MS73 200 4 10/3W UG #6.250MCM 16.250MCM #6-350MCM Ol/ AF /O 0. 78205156140 U207 200 7 30/4W OH/UG 06.250MCM #6.250MCM 06-250MCM 'to .78205156170 U297F 200 7 30/4W UG t6.250MCM 06-250MCM 06-250MCM 78205156180 11207 MS73 700 7 30/4W OH/UG 16.250MCM Atli.250MCM 16.250MCM PartAJ Corning, -Overall Oimension.- Top Knockout .. Number Number Haight Width Oomh Provision Layout Fig.3 - Fig.4 7820514200 12' 8' 4s/e Top Provision AW Hub Fi.1 �--J 7820514204 On 0 On F 12' 8' 41/e' 2'ntax K0 Fig.I - 78205142045 011 MS73 12' 8' O AW Hub Fig.1 -Top Provision 78205142050 011 SF 12' 8' Oh" 2'max KO Fig,1 78205144MO 927 -- 17` 8' Oh' AW Hub Fig.1 7MIS6000 204 15' 8' OX AW Hub Fig.2 - 78205156020 204 F 15' 8' 6' 2'max KO Fig.2 O \� 78205156030 200 F MS73 15- a' fi' 2'max KO Fig.2 7820515SD40 204 MS68 15' 6' 4s/a' AW/2'Hub Fig.2 4F 7620515M 204 MS6aA 15'_ 8" 4a/e'_ AW/2'Hub Fig.2 �4G 78MIMA90 204 MS73 15' a' 0/i Naie _ _ -Fig.2 78205156005 U204 15' 12' dye' None Fig.3 78205156045 U204 F 15' _ W 6' 12)2'rrax KO Fig.3 413 1 4F 4G 43 78205156060 U204 F MS73 15" 12' 6' None Fig.3 - I^� y 4F g$r^ 4G 78205156070 1.1204 MS73 15' 12' 4/. None Fig.3 78205156140 U267 18" 12' S' AW Hub Fig.4 AIC Note. 78205156170 U207 F 18' 12" 5' 2t/i max KO Fig.4 For snort circuit current 1 W 4G' 2A 78205156180 U207 MS73 IB' 12' S' AW Hub Rg.4 mbrgs see papa 131. � �- B-Li ne Data subject to change without notice Consult local utility for area acceptance.All dimensions are m inches. Data subject to change without notice.Consult local utility for area occomance.All dimensions are in intl as. B-Line by E.T•N 5 Meter Mounting Equipment Meter Mounting Equipment 6 by.E:T•N. P.Ocus ENERGY October 22n°,2013 This letter is to certify that the LGate 120 and LGate 320 are communication boards built into the Vision Meter 2S CL200 and 16S CL320 socket meters,respectively. Each of these meters was certified to the ANSI C12.20(class 0.2%)standard by Underwriters Laboratory on June 7,2013 as part of the Vision Meter Family(Project Number 12CA71134,Job Number 1001541515,and Report Number R12CA71134- ANSI). ANSI C12.20 is currently recognized as the industry standard for electrical socket meters in both utility and PV monitoring applications.These tests cover both meter accuracy as well as several safety standards including electrical and environmental safety,as well as resistance to various types of mechanical shock.As electrical socket meters are generally installed and maintained by trained and certified professionals,rather than consumers,they do not fit the typical criteria for additional types of UL or IEC certification. If you have any further questions regarding the product certification of any Locus Energy LGate-branded device,please contact us at support@locusenerev.com. The Locus Energy Team Locus Energy,tLC —locusenergy.com Ciassic Conduit Composition Mount QMCC Classic Conduit Mounting Instructions Installation Tools Required:tape measure,roofing bar,chalk line,stud finder,caulking gun,1 tube of appropriate sealant,drill with REM NO. DESCRIPTION 1/8'bit,drill or impact gun with 7/16"deep socket. Ott. THIS EDGE TOWARDS ROOF RIDGE I FLASHING.7'%17'K.04d'.5052.MILL I • • f MiRILIN ] OBLOCK.CONDUIT.S/Ib",6061-T6.MILL 1 WASHER.SEALING,1/4"ID K 7/a'OD.EPDM 0 BONDED SS 4 LAG SCREW.HEX HEAD.1/4'x2-1/7.I&&TS 1 '+"h ';�✓ t„�,Aa, ' _- AVAILABLE IN MILL.CLEAR ANODIZED. 79 AND BRONZE ANODIZED FINISHES. } 1. 12.0 e CONDUITCLAMP e NOT INCLUD1.3 4 43 Choose placement ofconduit mounts along path Lift composition roof tile with roofing bar,just Slide conduit mount into desired position.Remove 2.6 of condult Select location over center of rafter. above placement of conduit mount. any nalls that conflict with getting the mount flush 3 with front edge of shingle course.Mark cernter for drilling. 77 4.5 2 �. . 1 � .79 Quick Mount PNt L. '' TOLE: QMCC:CLASSIC CONDUIT COMPOSITION MOUNT L o jP. SUE oaawN ar: ar,o REV v .„4:w4 A DAVE: 9/24IM13 4 �". ."•'•1 .,,p,,.., '2n.,,...,a.as<..o,...': ""'"^'"""4O1t"'""""" 01iJ iC'Q 0F"""' �.rtt n.ctperau,.�n ecur.n wucm.o.r Kn se ol, Using drill with 1/8"long b14 drill pilot hole Into Clean off any sawdust and fill hole with roof Lift shingle and slide conduit mount Into place. s 4 3 2 1 roof and rafter,taking care to drill square to the manufacturees approved sealant. Prepare lag bolt with sealing washer and single hole roof. clamp(lot included)as shown.Insert lag through hole in block and position clamp over conduit Lag Boil Specifications Spoon,G,cry 1/4-WApa 1 y4-INe44 d4p1h II.-asset-I--d4pm Dagles F.,le,tA .50 ]41 Us All roofing manufacturers'writ- Do.&....an .40 ]5] 202 y.. ten instructions Must also be En.--3p,ucp.laapapda Paw 4a$R 10501 a hlpha) +a ]S] 201 followed by anyone modifying a Ilan,Fa .4] 313 ITB roof system.Please consult the lepm,FY(Nalh) .a0 ]!O 202 roof manufacturer's specs and Sa4h4m Pkr ,sS 455 LED Spurn.Pkn,F1 .42 ]01 ITT instructions prior to touching the roof. Spura,Paa,Po(Etl2nilm pal ord hbha p,u4wdMSR and MEL) .W W] 31S So—,:Amerkan Wood CwmiL NDS 200S.Tabk 111 A 11J.2 A Notes: 11Thread must be embedded Ina rafter or oche,onamw rod member. 21 See RKlor,e4ubededgedlnarces. Insert lag through hole In block and position IMPORTANT:To maletaln wate,pmofing It is knportant that theMumlrwm flashing firm 1)Is prope,ly placed under one lull course above the re—lirl block with at least sane of the clamp over conduit.Using drill with 7/16'sucket fl,shing a terding up unde,the cwrseebwe tM1-1—n—1-.ulrtlnna..n—k drive lag until block is tight Quick Mount PV`- Quick Mount WD 925-478-8269•www.quickmountpv.com info@quickmountpv.com RESPECT THE ROOF 2700 Mitchell Dr.,Bldg2•Walnut Creek,CA 94598 81 7.2.3-8 Aug-2014,Rev 4 Bt 7Z3.8 Aug•2014,Rev 4 02013 by Quick Mount PV.All rights reserved. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizatiom4ndividual): Skyline Solar LLC Address: 124 Turnpike Street Suite 10 City/State/Zip:West Bridgewater, MA 02379 phone #:732-354-3111 Are you an employer? Check the appropr' Type of project(required): 1.8 I am a employer with 60 (am a general contractor and I employees (full and/or part-time).* ave hired the sub-contractors 6. 0 New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling ship and have no employees These sub-contractors have g. C] Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. $ 9. ® Building addition required.] 5. ® We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.® Roof repairs insurance required.] t c. 152, §1(4), and we have no PV Solar employees. [No workers' 13.8 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:A.I.M. Mutual Insurance Company Policy#or Self-ins. Lic. #:VWC-100-6018336-2015A Expiration Date:3/8/2016 194 Tower Hill Rd Osterville, MA 02655 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 hereby ct fy nd r the pains and penalties of perjury that the information provided above is true and correct. 6/5/15 Si nature. Date: Phone#: -35 111 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#: ,aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/11/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: The Hamilton Group, LLC PHONE FAX 3 Wing Drive E-MAIL - -2292 A/C No): Cedar Knolls NJ 07927 ADDRESS: INSURERS AFFORDING COVERAGE NAIC i INSURER A:SeleCt*Ve Way Ins 26301 INSURED SKYLI-3 INSURER B:SleCtaVe Ins Co of the S. East 39926 Skyline Solar LLC INSURER C:A.I.M. Mututal Insurance Company 3758 124 Turnpike Street, Ste 10 INSURER D: West Bridgewater MA 02379 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1089928575 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD MM/DD LIMITS B_ GENERAL LIABILITY S 2106548 6/2015 /6/2016 EACH OCCURRENCE $1,000,000 i X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $100,000 CLAIMS-MADE IT] OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 NIPOLICY L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 PRO X LOC $ B AUTOMOBILE LIABILITY A 9093015 /24/2015 /24/20168 NED SINGLE LIMIT Ea accident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X AU SCTOS HEDULED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per aaident $ A X UMBRELLA LIAB X OCCUR S 2000480 0/11/2014 0/11/2015 EACH OCCURRENCE $5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$10,000 $ C WORKERS COMPENSATION VWC-100-6018336-2015A 3/8/2015 3/8/2016 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000.00 OFFICER/MEMBER EXCLUDED? Y❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000.00 B Installation Floater S 2106548 /6/2015 /6/2016 Any One Occurrence $25,000 Property Business Property $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Assessor's map and lot number j� �o`r :....................y . ............ THE t0 /•��/.i�' 4Q O swage Permit number ................ d 1; 33ARISTABLE, i SYSTEM EM ML-,j v Maria 'rouse number .....,11�j.f...............:....................................... INSTALLEDn�a 1� �C311�:r l.fA1'dCE° a�pY.or' �O� TOWN OF BARN AT �1: .�: BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..��.<?��!/�•0��:. ..... 4NJ�C"...................................:................................ TYPE OF CONSTRUCTION .......� �C............'..... .�1 �=...... .................... ............................................... v:......... ............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .:19. ..r�/l•! 2... .......�,� ................................................................ ProposedUse ....... ...........................................................�........................... .-.......•.�......................... Zoning District ........ /-?......C.................................................Fire District .. `��..1 'K !!l f f�'••" l..-�,P'!.4 a."'..Ll.. /c�'.... Name of Owner f-.✓...}.ke1Z1—=41N=..... ?V.p �Z.......Address I..... .... Name of Builder _ %� ................................. .. .. ..... .�/.lsir.1.t.'.1.—./..�-�'.�.:... ...1=/.l`....�...........:.Address ............ ...�........................ Nameof Architect ............................................!.....................Address .......... .....................................'...1. ...............Pw........ Number of Rooms .........X �..F .......................Foundation Cx=I 6�.A,. ... �..��.Cff ............................... ................................ Exterior lk l..OP....-... /r•% /`l ....f/ /..1..0r�4�,�..X.........Roofing ....... ....... ......... Floors `✓..G!.G' ............. Interior . .........../ /C.......................................... Heating ........./...=.�..... /— dt/ ......................................................Plumbing .............. !`.®...................................... Fireplace .........A.o..............................................................Approximate Cost .........�j`, .°...................... ................. Definitive Plan Approved by Planning Board -----------_------_-----------19________ . Area ..... .... .................... Diagram of Lot and Building with Dimensions ti ft�5'........................Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH v� 1 � 7 a �� 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. Construction Supervisor's License .................................... LEANDER, LAWRENCE 24585 ADDITION No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location 194 Tower Hill Road ................................................................ aOsterville ............................................................................... Owner Lawrence Leander .................................................................. Type of Construction Frame .......................................... .......................................................................... Plot ............................ Lot ................................ November 24, 82 Permit Granted ..........................................I Date of Inspection ....................................19 Date Completed ........ 19 Assessor's map cs�u-iot number ....'......�............. ................. JL Sewage Permit number ...... /�/0/�IL ............. t t Z BARiSTADLE, i Douse number ...../.9.�.................................................. rasa ... Op i 6}q• `00� TOWN OF BARNSTABLE - BUILDIHG INSPECTOR APPLICATION FOR PERMIT TO .. ......../, /0 !.... ..........G•�i�......... ...................:................................... TYPE OF CONSTRUCTION ...... rJ :..... /r? .................................................................:................ ........ .............Iqf. Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..I9 y TOCr,�2 A//C 4...../24 D OI Ti=l21</C G ......... .... ,........... ......................... ................................... ProposedUse .......f�/..t11. N��.... Q�.!!'°........................................................................................................................... //��,, / Zoning District � Fire District C'l�. r v/�/� — V..'......................................... �, . .. ..V�..... ....... Name of Owner!.?.....l?............... ..............Address y 4�!L=..........................• ,j' Name of Builder - , ..�Y/P/—. ...! /=/f`/I!/�.1.!�......Address .................................. . ..:.............................................. ! � 'Name of Architect ............�.'........................... .'.....................Address ............................� Number of Rooms ........ — F/V7 �L U C/C "........................................Foundation /..—. ................................................................ Exterior4<55.GA......CF_-/JA ..........Roofing �,f e:�7zfk. 7-......../X../N.... I...L.......... ........ ' _ I Floors Q G� Q J.0.....................................Interior ......5�/7� `✓. ...... ....................�`. -.....................�......................................... Heating .... /��. .......................................................Plumbing ....................�......................................................... ............ Fireplace .........� ................................................................Approximate Cost ......../..C��1 .!........Lf Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .... ... TR......................... Diagram of Lot and Building with Dimensions Fee ............................................. i SUBJECT TO APPROVAL OF BOARD OF HEALTH v 70 7 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. \ -`..... ...............am . . .. .............�: . ys ` Construction Supervisor's License .................................... 4�� LEANDER, LAWRENCE A=142-14 ' 2 4585 ADDITION �i No ................. Permit for .................................... Single. Family Dwel i ng................. - ........... Location .............. -....R ...................;....... . ........... OsterVille ...................................;.............. ............................ Lawri�nci§ Leander .Owner ...................... ..Lea'�� ................................ Type of Construction. .......F.V.-.. ..M ...................... . ................................................................................. Jt�. ........ Plot .................... eh?'................................ N Permit Granted I..ov.emb'6r 24........ 19 82 ............... .. Date of Inspectiorl ...... .....19 Date Completed ... .......19 j K" ell Assessor's map and lot number ....� ..'".:�:�`....� � ��' /0G� — Sewage Permit number :n?.....:.....Q. K .. C�....... , c T"ET°�y TOWN OF BARNSTABLE i 1339HBSTAIIII ° d7 BUILDING INSPECTOR icy MAR nC1A1•��R1Tf'T ��TNlaT.P. ('AR GAR,q F, APPLICATION FOR PERMIT TO ............:..................:._........................................,.................................................. TYPE OF CONSTRUCTION '-.'OOD ',RA';E . ..................................................................................................................................... ...... ARCH...........5.r..............19.. 7. TO THE INSPECTOR OF BUILDINGS: t • The undersigned hereby applies for a permit according to the following information: Cocgtion 1)4 'TU,ER KILL ROAD, QoT2`itVI.-11.,E ....................................................................................................................................................................................... G ARxL E ProposedUse ............................................................................................................................................................................. Zoning District ....:.-.. :.... T�'......:............................'..............Fire District ....PF.1.,...'.............:........ :..`�........ �j. .H>i �Tn::�....TtII. �H.rt� �`RvTr .. .................. EVELYN C. & Name of Owner ...Ta A4'>' .H�t!j('F r; K,.F Q 1 .!': ..................Address ...19.4...... '(.;1 ;R li :T:1a..:K�)A. :.... !P'r? V7 T;LE - Name of Builder • LA WRENC E E.wFAN i)t,,F it...............n.......... n ...............if .............................. . ?:..................Address ....... ......................... ........... LA',',fR NCE E'.KEANL.�R* n n ii n n Nameof Architect ...................................................................Address ..................................................................................... 014B CEMENT BLOCK - Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ...DJ SIDL'G .............Roofing ASPHALT SHINGLES .................................................................................. Qt'r' .Interior UNFINISHED Floors .................................................................................. ........................................ Heating ......A!?;4. .................................................................Plumbing NQiVT Fireplace ...............................Approximate Cost 0s.w Definitive Plan Approved by Planning Board -------------------_-----------19________ , Area .,6.q.......gq,....ft.......... Diagram of Lot and Building with Dimensions Fee .........Fr .... ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Linden Lane. Proposed Garage Property- of Property of - Albert Williams Kenneth Powers J' Do f ' bwel' ?1ng 4 351 � L0 � 003 Ak 210 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding, the above construction. Nam r..Q............... ..,/f.. .............. Keander+ 'Lawrence E. 14 ILIA No .0.QU.. Permit for ,.,garage ................................... Location .19.4.3.9me-1;..Hi 11„Road ' Os.texvi.1.J. ................................................ j Owner Law7re7olQCJ. ...Keander Type of Construction .Aopd•.f:Kame ................................................................................ Plot ............................ Lot ................................. • Permit GranteclMar.d!..16........................19T7 Date of Inspection 19 Date .Completed ...................:..................19 PERMIT REFUSED ..... ... ... 19 ,�. .. • ................ .................... ....................................................... m .............. ................................ .......................................................................... Approved..,.,............._................................ 19 i ..................... ......................................................... s s Assessor's map and lot number ... ............ SEPTIC SYSTEM MUST BE a cv y �" INSTALLED IN COMPLIANCE Sewage Permit numer ........... � ..� G � � ' Permit_nu WITH ARTICLE II S"„,TI: SANITARY CODE AND TOWN TOWN OF BARNSTXB .UjU 89HH9TdDLE, 9 oMAY BU LDIHG INSPECTOR C) �O 639 i • `0� �� A, s APPLICATION'FOR ZPERMIT TO ..........CO.N.S>TRU..C.T...S.IX.G..T2...C.AR...GA,RAGS......................................... R TYPE OF CONSTRUCTION ......... OOD FRAME ............................................................................................................ ca ' h �� MARCH 5, 19..7 T w ............. ............. n TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1.94 TOWER HILL ROAD, OSTERVILLE ....................................................................................................................................................................................... Proposed Use GARAGE ............................................................................................................................................................................. Zoning District ....RE5.T.DWI&L...........................................Fire District .....CEXTERV.ILLS-QST.ERVILLE............. EVELYN C. & Name of Owner ...L.A.WRESIC.F..E...KEARD:ER..................Address ..19.4......T-Q.WFR..HT.LL...13.Q,AD,...OS.TERTILLE' Name of Builder .I+.AWRCT'i..k'i... 'AHD��R..................Address �� " .� �� r� .................................................................................... LAWRENC E E.KEANDER it n It if It Nameof Architect ..................................................................Address ..................................................................................... ONE CEMENT BLOCK Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ..WOOD SIDING.........................................................Roofing ASPHALT SHINGLES .................................................................................... Floors ONE....................................................................Interior ..UNFINISHED ................. .................................................................. Heating NONE ...............................................................Plumbing ........NONE ........:.......... ............................................................... ......Approximate Cost 750.00 Fireplace ......�TQN.E........................................................... pp .................................................................... Definitive Plan Approved by Planning Board -----------_____—-----------19_______ . Area M.....sg,,....ft;t......... Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH Linden Lane. r Proposed Garage -F- Proper.-ty of Property of Albert Williams Kenneth Powers Present ti " Dwell3-irri FrraoM 96U.0 i IL 3 S 1 O C1, 07- 1001 ,r 210 I1 I JV1s 4 TOMLPR NTT T ]Jn A D I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam res ,1-�..��%��-:� �.� ...C���2�........ ' Keandwr" Lanmrenca E. � - ` . � i � � �� --'_/,r;AK..gAiK � - �_��_'_—_.~—....Locohon1�4-T»wmz..8A'l1..Rd^. � ' .......Omtanmx1l.................................................. . CJv,ne, ...Lanocommmc..E~..Keand.ex------' ' � Type of Construction wood-frame------' � � ` ^ ^ . -------------------------- � � ^ Plot ............................ Lot ................................ - i . Parmli-Gib-h*yd —.. ...1.6..................lV 77 Date of Inspection ------lV . ^ � /m7« ' � Dote Completed ..'+_—�y---~�-----]P / PERMIT REFUSED � ' .............................. 19 . � � '-------------------------- ~ ----'-------------'--------' .-------..------------.—.---. � � � | _---.-------.—.—...—...------.. Approved ............................................... 19 ^ ---------------.----------- � � - -------`----------------'-- - | THE TOWN OF BARNSTABLE 1 33 3 rAB X - 63 9' - INSPECTOR BUILDING APPLICATION FOR PERMIT TO ....C.O..NST.RUCT ADD I.T I.ON TO RESIDENCE ...................................................... .................................... .. .. .... .. .. TYPE OF CONSTRUCTION .......2BLAME.................................................... ........................................ ..................... '.....AU.G.T JS.T..U.t.19.12.....ig........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........19.4.......T.OWER....HILL;...ROAD.........O.STERVI.-L.LE................;...................................................................... . .. .......... ..... ..... .......... . .. ............... .. ..... Proposed Use .........CLQ5BT....SPAC.E.................................................................................................................................... .......... ... Zoning District ..........Fire District CENTERVILLE—OSTERVILLF, .............................................................................. Name of Owner ...L.A.WRE.NC.E...E...KEAN.D.ER....................Address J.94 TOWER HILL ROAD,OSTERVI-ILE,MA. .. .. ....... .... ... .. . .......... .. ..... ......................................................................;........ LAWRENCE E.KEANDER SAME Nameof Builder ..............................* .....................................Address ...................................................................................... Name of Architect ..LA#4ENC.................- E.KEANPER,..............Address ................SAME........................................ .. ..... ........ .. ....... Number of Rooms .....ONE .....Foundation .....CEMENT...BLOCK................................. ....... ........ ....... ..... Exterior ...CEPAR...S.H..ING..LE...S...........................................Roofing ...........ASPHALT SHINGLES .................................................................. Floors MATCHED SPRUCE,PLYWOOD &- STICK TYPE TILE. "MASONITE" PANELING ........................................................................InTenor ......................................................... MAIN HOUSR NO ADDITIONAL NONE Heating k'RQK ......................................................................Plumbing ................................................6............................... Fireplace ....NO................................................. .......................Approximate Cost .......511Q I'M).......................... ................. Definitive Plan Approved by Planning Board -----------—-——----------- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH AAkil5s, r S 0 C OVVT I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. e . ............................ . ...... .... ........................... ....... Keander, Lawrence E. 15436 add to single No ................. Permit for .................................... dwelling ..........family... .................................... Location ......1.94..T.ower..Dill Road .. .... .. ........ .... .... ......... Osterville .................................... Lawrence E. Keander Owner .................................................................. Type of Construction .................frame,.......................... ................................................................................ Plot ............................ Lot ................................. Permit Granted ....... .............ig 72 Date of Inspection ...... t } + ( ; .......19 Date Completed ... *.i........19 PERMIT REFUSED ................................................................. 19 ................................................................................ ................................................................................ I .. . ..................................... ........................... ...... ............................................................................... Approved ................................................ 19 ............................................................................... ................................................................................ oa a 9' 5iitp5oei5trong-Tie 1410" d �,p r� �" e, "s X c A.v c IJP �tJ F—C E tL S �tl F, v/c- <Iwa-f P�5 es '� • I F 11 I � I - li a C i — /6 SO4)06 OF ®SAL rE . 86rpsor9doeq�-1la.a' .- � 6`F+ A U 4 4- v 71 E f� c kn i� ; 44, ILI .� f L 6'-j 3/16" � I ' = xisting bedro -"'� /�� ^i , a i Existingkitchen / col ---'------- §'-3 i' 3'-9 5/16" i �. /��- - - - - - - - - - - - - - - - - - 01 I Existing Diningom QR isti 'be-r M ' — — Existing Living Room I I I I 9 o removed 11 3/4"x14"Lam Beam '-o"w \� ' ' — — — — ^/ ' sta/' led over I I 13R x O"r 10-o I I 19'-1 1/2" " �I 1 - - - - - - 44 - - - - - - - i i� 4'-01/4" I u; a�5/i g r s diR . 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