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0116 WINTERGREEN CIRCLE
Ij (p Wi ►4e tee" G � r, �► 1 TO*N OF BARNSTABLE BUILDING PERMIT APPLICATION , Map Parcel Application }� Health Division Date Issued I v 1 Conservation Division Application Fee Planning Dept. Permit Feer�i, 70 Date Definitive Plan Approved by Planning Board ��-- Historic - OKH C) _ Preservation/Hyannis Project Street Address y o �✓�'�(' rt� G Village- C ,t5-kr U i �(C_p Own C ykiAle-, L l _eoa :sy�Address �o � r- rccd Telephone (,9 • �joq Permit Request D /:5-t t H, �n •ll. a'�C l� Q, c a.� c�, � � � j Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain - ((-�� Groundwater Overlay Project-Valuation Construction Type 1�'3 Lot Size Grandfathered: ❑Yes N�No If yes, attach supporting documentation. Dwelling Type: Single Family )4 Two Family ❑ Multi-Family (# units) Age of Existing Structure eS • Historic House: ❑Yes %No On Old King's Highway: ❑Yes ,KLNo 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 -n Central Air: ❑Yes ❑ No Fireplaces: Existingyd--New Existing woodfAlal stove.:nLJ Y:�§ ❑ No ;;aDetached garage: ❑ existing ❑ new site/p,Pool: ❑ existing ❑ new size *Barn: ❑ e isting 0 new5�izhoL_ Attached garage: ❑ existing ❑ new sizShed: ❑ existing ❑ new sizeOther: e� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XNo If.yes, site plan review # Current Use l/1-r Proposed Use n - - APPLICANT INFORMATION (BUILDE7,:rl R HOMEOWNER) Name �.1//YlTelephone Number Address License # C< ' �S O Home Improvement Contractor# ( � J Email Worker's Compensation # 14�(' 6_6 ALL CO RUCTION DEBRIS RESULTI FRV THIS PROJECT WILL BE TAKEN T C ��d SIGNATURE DATE �bve 1"A kr .7, o-Dl�`� f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE• + OWNER . DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE = ELECTRICAL: ROUGH FINAL r ' . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL } FINAL BUILDING t �lS`��i -DATE CLOSED OUT ASSOCIATION PLAN NO. r • i 'C%���cscr� ,cc�G/Is Office of Consumer Affairs taid Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card SOLAR CITY CORPORATION Expiration: 3/8/2017 CHERYL GRUENSTERN -- --- - - - - - 24 ST MARTIN STREET BLD 2UNIT 11 •---- - ----- - -- MARLBOROUGH, MA 01752 Update Address and return card.Mark reason for change. sea 20 a c�is Address Renewal ' ( Employment �_'l Lost Card "//, Y'rw u.rnrcrvr/(X F Qflice of Consumer Affairs&Business Regulation License or registration valid for individul use only O OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1Registration: 168572 Type: 10 Park Plaza-Suite 5170 Expiration: 3/8/2017 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION F CHERYL GRUENSTERN 3055 CLEARVIEW WAY SAN MATEO,CA 94402 —' Undersecretary .. �~iVot valid without signature 1 77te Commonwealth ofmassackgwft . Depurbnent of Industrial Accldenft I Congfess Street,Suite 100 Boston,MA 02114-2017 www.mass gov/din Rrarkers'Compensation Insurance Affidavit:Seilders/Centracloss/Eleetriciansfflumbem TO BE FILED WITH THE PE11MI ITING AUTHORPFY. A20cantIndarmi'dian Please print L.eui[_hly Name(Bwdnc&'ftanhmlionRndlviduaq: SaletCity Corporation Address: 3055 ClearVIOW Way City/Stategip: Sara Mateo,CA 94402 phone#: (808)765-2489 Are rmarn emplow?Chc&the xpprop0atc box: Type of project(required): 1.01 am aOMMOV wah 12,500 etnployas(full emdkrpwWme).x .7. ❑New construction 201 am a sole proprietor or partnenhip and hove no employees workics for ow in 8. Remodoling any capachy.[No works'comp.insutanca iequhed.[ 9. ❑Demolition 3.CJ1 mnahareeownerdoinAl work mysdr..[Nowarkers'camp.inswaneenqubed.]t 10[]Building addition 4.[][era a lu mowaar and will behirinb a afteciors to eondod all workon my property. l will awn thol all wAtmtors oldw have uurtm,,'eotntamsalion trrsumm erare sole 1 I.a Electrical repairs or addi(ions proprietors whh no anployem 12.E]Plumbing repairs or additions 5.01 am a Wnaai•cmur wtot mad t have himl the sob-ammidom lined on the aitadrcd stet. I3.[:]Roof repairs These saNcmuaetom hm attphiyees and have wwl:eas.comp,nzun w t &J J We are a corponaion and its of mm have mmisdd rhe.k tight of exemption per Mill.c. 14.❑� Other solar panels 152,§1(41 and we have no eatpioyms.[No workers'camp.fmwence regntrod] *Any applicant that chwbs box 91 mast also fill out the sadioa below showing their wakahs'conTsa ation policy k&nnatioo. •l lamwwim whe"*fail this 11114wit indiirariing they are doing all wank and then hire outside,contractors met submit a new ofidwii indicating such ZContmc as the check this box must atodhs:d as additional sheet showing dho name of alto sub•owamci rs end stale whelber or na those enlilles have cmployt>es, if the aatb�niraatOrs have nnployoes they nW provide their wmkets'amntp.policy rarntber. 1 am an employer tisal is providing workers'Compensation 1►>amneefor my employees. Below is the policy and job site Inforntt an; Insurance Company Name:Anwrican Zurich Insurance Company Policy#or Self ins.i.ic.4: WC0182015-00 Expiration Date: 911i2016 Job Site Addt+eas: 116 Wintergreen Circle City/StatalZip: Osterville,MA 02655 _ - - -- _ - _----- Attach s copy of the workeW Cmpensation polky declaration page(showtag the policy number and expiration date} Failure to secure coverage as required under MOL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/ar one-year imprisonment,as well as civil ptsrtalties in the form ofa STOP WORK ORDER and a irme of up to S O-00 a day against the violator.A copy of tbis statement may be forwarded to the Office of investigations of the DIA for insurance coverage varifscation. I do kereby cer#&an0w the pains aml penalties of'perjury that the hl/Wwatdon provdded above is ttuc turd correct. ason Pa . November 5,2015 Phone Of tcdat use only. Do not write in this area,to be evmpieded by city or ewer offidaL City or Town: PermiULicense# Issuing Apthority(ctrele one): 1.Board of li•Iealth 2.Building Department 3.City/Town Clark 4.Meettricai Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: • ACDD� DA`TE 4MMMcmYh �� CERTIFICATE OF LIABILITY INSURANCE 011070015 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 pollCy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certahr policies may require an endorsement. A statement on this cortificato does net Confer rlghts to the certificate holder In lieu of such endorsemeM . PRODUCER CONTACT MARSH RISK&INSURANCE SERVICES PHONE —..._._—._._...... ._..._... ..q�c..... . . ._...-- -....—..T-- 345 CALF 2NIA STREET.SUITE 1300 L!!� CALFORNIA LICENSE N0.0437153 SANFRANCISCO,CA 94104 R91411 . .......... __.._...__..._..—.— _....__.._ Attn:Shannon Scoft 415-743-M34 _..........:msuReR{s)a al:owo covew►se..... .. ..__._.. NAIC s 996301-STND-GAWUE-15-16 —.-_---- wsuRERA.;Z �11�s eCampany 1i6535 INSURED WBUR4R B.NIA. ._............................. ._ ._...._..... ..._.. .. .__._ ` A ShcarGty Corparduon 3065 ClearAew WayVIA INSURER C:NIA -- _._._. ..._....... San Ma1w,CA 9002 INSURER p Amera Zurich Insurance Canparry ... _. 142 INSURERF., COVERAGES CERTIFICATE NUMBER-. SEA-00271383301 REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,- EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS INS'.._ TYPE OP INSURANCE '-..._ -....'TA1S11L10 •. ......••.........•VNUIdBER- LIMITS A x COMMERCAL GENERAL LIABI ITY GL001620164)0 00112015 09I012016 EACH OCCURRENCE s._.._.. ._.3.000_000 tDOMAGE TO i aCLAIMS4!AM MOCCUR PREp11SE�S(ems)... S._.......__._ 3.006.000 ` X SIR$250,DD0 I MED EJ(P V rke.P.elsa!) PERSONAL&ADV INJURY S 8.000,0W GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL ACiGREOATE S. 6.0D0,000 x IPOLICY Loc PRoptXJrS-COEAP/OPAGG S-•• -•---•- 6,0D0_000 OTHER. A wromOBU.ELiAMUTY BAP01B2017.00 09101016 109MI016 D $ X ANY AUTO I I SOMY INJURY(Per person) S —-- x_. ALL OOSWNED X AS EDDULED I MDN Y INJURY(Pet acddent) s NONO'ANED I { PROPERTY DAMAGE —..................._.•..... X HIRED AUTOS X.. AUTOS I I I _ 1...... ............ .5... ._._...—.... ._....._.._ 1 COMPIcou MO: s UMBRELLA LtAOHcocvcjm:-06ADE 1 EACH OCCURRENCEEXCESSL1A1 1 I , AGGREGATE __._........ S.._..._.............. DED j RETLJRION I f D WORKERS cOMPENSATION ; IWC0182014-M(AOS) 091012015 (09)01./2016 X TER ATLf� R� AND ENFLOYERS LIABILITY A YIN IWCOI82015M(MA). NMMD15 �09;D12016 F-L EACH ACCIDENT S 11000,000 OOFFft"FUE 19ER E%C UDEER CLmvE a x I A I i (Mandatary In Mq WC DEDUCTIBLE:SSW,000 E L DISEASE.EA EMPLOYEE S, 1000.QD0 )11 desaft uder E.L.DISEASE-POUCYLIMIr $ RIPTIONO TtONS i DESCRIPTION OF OPERATIONS I LOCATIONS I VS4C.ES IACORD"I.AddUlonal Remarks Sd wdulo,may be athwhad If mace space(a r"L*ed) Evidence of insurance. CERTIFICATE BOLDER CANCELLATION SdzrCdy Cerpora0on SHOULD ANY OF THE ABOVE DESCRIBED POLICIES DE CANCELLED BEFORE 3055CIeanriewWay THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo.CA 99402 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Match Risk&Insurance Services CharlesMamlole)o 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1 " Version#52.8-TBD 4106o;SolarCit y � of M November 4, 2015 o CKSON CIVIL. to RE: CERTIFICATION LETTER No.51873 A90 9FQ/SIT �'4 Project/Job #0262173 TONAL Project Address: Jacobson Residence 116 Wintergreen Cir I;,, Digitally signed by Kyle Jackson Osterville, MA 02655 Kyle- Dr1:do=local,dr—SolarCiry, �ou=5olarCity Users,ou=Denver, AHJ Barnstable c,,_, ,,ckson, SC Office Cape Cod Jackson, email=kjackson@solarcity.com p Date:2015.11.041310:49-08'00' Design Criteria: -Applicable Codes = MA Res. Code,8th Edition,ASCE 7-05, and 2005 NDS - Risk Category = II -Wind Speed = 110 mph, Exposure Category C -Ground Snow Load = 30 psf - MPl: Roof DL= 13.5 psf, Roof LL/SL= 21 psf(Non-PV Areas), Roof LL/SL= 12.3 psf(PV Areas) Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.19053 < 0.4g and Seismic Design Category(SDC) = B < D To Whom It May Concern, A jobsite survey of the existing framing system of the address indicated above was performed by a site survey team from SolarCity. Structural evaluation was based on site observations and the design criteria listed above. Based on this evaluation, I certify that the existing structure directly supporting the PV system is adequate to withstand all loading indicated in the design criteria above based on the requirements of the applicable existing building and/or new building provisions adopted/referenced above. This review relies on the roof's structural system having been originally designed and constructed in accordance with the+building code requirements and having been maintained to be in good condition. Additionally, I certify that the PV module assembly including all standoffs supporting it have been reviewed to be in accordance with the manufacturer's specifications and to meet and/or exceed all requirements set forth by the ASCE 7 standards for loading. The PV assembly hardware specifications are contained in the plans submitted.for approval. Additionally a summary of the structural review is provided in the.results summary tables on the following page. 3055 Clearview Way San Mateo,CA 94402 T(650)638-1028 (888)SOL-CITY T(650)638-1029 solarcity.com AZ ROC 243771.CA CSLB 888104,CO EC 804 t,CT HIC 0832778.DC HIC 71101486,DC HIS 71101488,HI CT-29770,MA HIC 168572,MO MHIC 128948.NJ INH08160600. OR CCB 180498.-PA 077343,TX TDL:R 27006.WA GCL:SOLARC'91907.®2013 SolarOily.All rights recorvsd. S i M o`�Sa version#52.8-TBD , SolarCit y HARDWARE DESIGN AND STRUCTURAL ANALYSIS RESULTS SUMMARY TABLES Landscape Hardware-Landscape Modules'Standoff Specifications Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR. MP3 64" 24" 39" NA . Staggered 77.0% Portrait Hardware-Portrait Modules'Standoff Specifications Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MP3 48" 17" 65" NA Staggered 96.1% .Structure, Mounting Plane Framing Qualification Results Type Spacing Pitch Member Evaluation Results MP3 Finished Attic @ 16 in.O.C. 350 Member Impact Check OK Refer to the submitted drawings for details of information collected during a site survey. All member analysis and/or evaluation is based on framing information gathered,on site.The existing gravity and lateral load carrying members were evaluated In accordance with the IBC and the IEBC. 3055 Clearview Way San Mateo,CA 94402.T(650)638-1028 (888)SOL-CITY F(650)538-1029 solarcity.com AZ ROC 243771,CA CSLB 888104,CO EC 8041,CT HIC 0632778.DC WIC 71101466.DC HIS 71101488.HI C•G29770.MA HIC 168572,MD MHIC 128948.NJ 13WI06160600, OR CCB 180498,PA 077343,TX TDLR 27008.WA GCL:SOLARC'01907.O 2013 Soles Clly.All rights resom d. STRUCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK - MPi Member Properties Summary MPi Horizontal Member Spans Rafter Pro erties Overhang 0.66 ft Actual W 1.50" Roof System Pro erties San 1 13.98 ft Actual D 7.25" Number of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofino Material Comp Roof San 3 A 10.88 in,^2 Re-Roof No San 4 S. 13.14 in.^3 PI wood Sheathing Yes San 5 I 47.63 in.^4 Board Sheathing None Total Rake Span 17.87 ft TL Defit Limit 120 Vaulted Ceiling Yes PV 1 Start 2.25 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 15.50 ft Wood Grade #2 Rafter Sloe .350 PV 2 Start Fb 875 psi Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracing Full PV 3 Start E 1400000 psi Bot Lat Bracing Full PV 3 End Emig 510000 psi Member Loading mary Roof Pitch 9 12 Initial Pitch Ad'ust Non-PV Areas PV Areas Roof Dead Load DL 13.5 psf x 1.22 16.5 psf 16.5 psf PV Dead Load PV-DL 3.0 psf x 1.22 3.7 psf Roof Live Load . RLL 20.0 psf x 0.78 15.5 psf Live/Snow Load LL SL1,2 30.0 psf x 0.7 1 x 0.41 21.0 psf 12.3 psf Total Load Governin LC TL 1 1 37.5 psf 1 32.4 psf Notes: 1. ps=Cs*pf; Cs-roof,Cs-pv per ASCE 7(Figure 7-2] 2. pf=0.7(Ce)(CO(IS)pg; Ce=0.9,Ct=1.1,Iis=1.0 Member Desi n Summa (per NDS Governing Load Comb CD CL + CL - CF Cr D+S 1.15 1.00 1.00 1 1.2 1 1.15 Member Anal sis Results Summary Governing Analysis I Pre-PV Demand Post-PV Demand Net Im act Result GravityLoadingCheck 1111 psi _ 962 psi 0.86 Pass (CALCULATION OF DESIGN WIND LOADS.=M. Mounting Plane Information Roofing Material Comp Roof NSystem Type _ SolarCity_Sle-kMountT'" Spanning Vents No Standoff Attachment Hardware Comp Mount Type C Roof Slope 350 Rafter pacing _ 16"O.C. Framing Type Direction Y-Y Rafters Purlin Spacing _X-X Purlins Only NA Tile Reveal Tile Roofs Only NA Tile Attachment System Tile Roofs Only NA Standin Seam/Trap Seam/Trap Spacing �SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind Design Method Partially/Fully Enclosed_Method Basic Wind Speed V 110 mph Fig. 6-1 Exposure:Category_ _ C _Section_6.5.6.3 Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Height h 25 ft Section 6.2 Wind Pressure Calculation Coefficients Wind Pressure Exposure K= 0.95 Table 6-3 Topographic Factor Krt 1.00 Section 6.5.7 Wind Directionality Factor ICd 0.85 u Table 6-4 Importance Factor I 1.0 Table 6-1 Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(V^2)(I)24.9sf Equation 6715 Wind Pressure Ext. Pressure Coefficient U G u -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient Down GC 0.88 Fig.6-11B/C/D-14A/B Design Wind Pressure p p=qh(G ) Equation 6-22 Wind Pressure U -23.7 Ps Wind Pressure Down 21.8 psf ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allow able.Cantilever� Landscape_.._ 24" NA Standoff Configuration Landscape Staggered Max Standoff Tributary.Area Trib 17 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff T=actual 385 His ( Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand Ca aci DCR 77.0% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48" 65" Max Allowable_Cantilever _ -_-_Portrait 17" NA Standoff Configuration Portrait Staggered Max Standoff Tributary Area Trib 22 sf PV Assembly Dead Load W-PV 3.0 psf NLA Wind Uplift at Standoff k T-actual -480 Ibs Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand Ca aci DCR 96.10/b Mpasxn�setta tlsoatmaM o�PubtiG$ata+r Down or Oulorwo ROgboAtws Ina Sitndamm CS-108616 JASON PATKV 821 STEWART WU1 Zjq Abington MA 02551 �itsfe�• L o w s I}W n ..+.+....„ .; 02MW2019 OMee of Coanmer Attain&13eslnm Rftaladoo F HO11E RAPROVENENT CONTRACTOR RegtOhaUon: 168572 typo " ExpbatWn: 3f=I? Supplement SOLAR CftY CORPORATION JASON PATRY 24 ST MARTIN STREET 13L02UM -a*— kAkBOR000KMA01752 Undenft"rr 14olarCity OWNER AUTHORIZATION Job#: Property Address: O G K-4 g need, C.,, o jam,, l�i Jam, Lo" as Owner of the subject prope ere authorize SOLARCI TY CORPORATION to act on my behalf, in al m tte rela 've to work authorized by this building permit application. - // z ,s Signature of -r. Da w!hRvi v.v�i•i! r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 6 L4 Application Health Division 1 Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner CS�i/ ��c,�So•�l Address Telephone w/ 7 -674 ,?ca iPermit Request Square feet: 1 st floor: existing proposed 2nd floor`existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation L ODO-00 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 Number of Bedrooms: existing _new c 0 Total Room Count (not including baths): existing new First Floor'Room Cou+ Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stow: ❑ems ❑ No I Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ Listing '%6 ne\1' 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) cName� '� �l� � ��� Telep no eh no eh Number_ w/7 510 7Q95 fAddress - ✓�� ��/ License # Home Improvement Contractor# Worker's Compensation # ALL CONSI qUCON�DEB R ULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE_� Zo<l t_ 4 b ' • FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED " MAP/PARCEL NO. t i `z ADDRESS VILLAGE OWNER. DATE OF INSPECTION: FOUNDATION w FRAME Cgg INSULATION 1, l FIREPLACE I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL " ` GAS: ROUGH FINAL FINAL BUILDING Q (e h DATE CLOSED OUT " ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents i Office of Investigations 600 Washington Street Uif ;1 Boston,MA 02111 www muss gov/dia Workers' Compensation tnsarance Affidavit: Builders/Contractors/Electricia.ns/PIumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): e r"I Address: City/State/Zip: (0(5kf071t 4 -OP4537Phone #:' Co 17S/0 7V(99 Are you an employer?Check the appropriate b Type of project(required): 1.❑ I am a employer with 4. r'I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction ,+ 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work 'right of exemption per MGL 11.❑ P umbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.Woof repairs insurance required] t. employees. No workers' 13.❑ Other comp. insurance required.] *Arty 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. �Contracwrs that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. ram an employer that isproviding 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: ret [' C Q��/7i��� iffAfi!2t6otity/State/Zip: Attach a co r ' compensation policy declaration page(showing the policy number and expiration date). Fail secure cov age eq ' ed under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fin up to$1,500.0 o e-y impris nment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of u to$250.00 day aga' the iolator, a advised that a copy of this statement may be forwarded to the Office of Inve ations o e D or ins ance erage verification. ---------------------------- I do hereby u er p penalties of perjury that the informatio:provided abo ais a and correctSi afor .� 20 Ph one#: Official use only. Do not write in this area,to be completed by city or town officiaC City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: r 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 permittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the•applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i_e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would.like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The-Commonwealth of Massachusetts- :, Department of Industrial Accidents G- Mee of Investigations 600 Washington Street Boston,MA G2111 Tel. # 617-72-7-4900 ext 406 or 1-9.77-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia Jun. 16. 2011 1 :06PM Palumbo Insurance No. 0024 P. 1 '`� � ® CERTIFICATE OF LIABILITY INSURANCE 6/16/2011 t s 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 endoreed. 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 Anne Belanger William Palumbo Insurance Agency, Inc. PHONE (508)428-1943 Ne:(50e)429-4474 4527 'Falmouth Road A DRES31g1ar►QElr@williampalumbo.awn PRODUCERcusTomEgluff 00063583 COtuit MA 02635 INSURERS AFFORDING COVERAGE NAILS INSURED INsuRERA-Main Street America Asauranca 29939 INsuxwa:Hartford Casualty Insurance Co 9424 Eldredge and Sons Construction Inc INSURERC: PO SOX 572 INSURERD: INSURER E: WEST BARNSTABLE MA 02668-0572 INSURERF: COVERAGES . CERTIFICATE NUMBER:CL1161628656 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. NOTWTHSTANDING 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. NS TV AD L P40LICYNUMBER M SUOR MIL MMA7D LIC EYP LIMITS OENERALLIABILITY EACH OCCURRENCE 3 1,000,000 DAMAGE X COMMERCIAL GENERAL LIABILITY PREMISES o�mence 3 500,000 A CLAIM84MOE a OCCUR MP150962 /7/2011 /7/2o12 MEOEXP ft aria posor) 3 10,000 PERSONAL&ADV INJURY 3 1,000,000 GENERAL AGGREGATE S 2,000,000 OEMLAGGAEGATEUMIYAPPuE8PER: PRODUCTS-COMPtOPAGG $ 2,000,000 X POLICY PE O LOC 3 AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ (Es aocldeod) ANY AUTO BODILY INJURY(Per person) $ ALL OVVNED AUTOS 8001LY INJURY(Per accident) S SCHEDULED AUTOS PROPERTY DAMAGE 3 VIREO AM03 (per aac dera) NON•OWNEO AUTOS 8 a UMBRELLA LIA9 �EorUR EACH OCCURRENCE S EXCESS VABMS•MAOE AGGREGATE $ DEDUCTIBLE S RETENTION 3 3 B W014KERS COMPENSATION WC STATU• OTM- ANo EMPLOYERS'LIAeILITY YIN ANY PROPRIETOWPARTNERIEXECUTNE E.L EACH ACCIDENT $ 100 0 OFPCERtMEMBEREXCLUOED7 � NIA OBWECVTO812 /7/2011 /7/2012 (Mandatory to NHI E.L DISEASE-FA EMPLOYEE 3 100,000 If yes,desofte under DESCRIPTION OF OPERATIONS Wow E.L.DISEASE-POLICYLdUIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES(Attach ACORD 101,AddHienal Ramada Schedule,It mote apace Is requited) CERTIFICATE HOLDER CANCELLATION (508)413-2607 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES VE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rubs Jacobson ACCORDANCE WITH THE POLICY PROVISIONS. 116 Wintergreen Dr Oaterville, MA 02655 AUTNORIiEOREPRESENTATTVE J LaRocca, Sr/ABELAN ' czl` �"-' ACORD 26(2009109) 01006-2009 ACORD CORPORATION, All rights reserved. INS025(2W90e) The ACORD name and logo are registered marks of ACORD r Town of Barnstable Regulatory Services tttrtsr,�st E Thomas F. Geiler, Director ' cm ' BuiIding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.t6wn.barristable.ma.us Office: 508-862-4038 Fax: 509-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1� // JOB LOCATION: II c, &Jj&&5/ate+ CVe le �7etill le nu ber� l street �j 7 village "HOMEOWNER": 07/ �tDvl 6 17.E !O �S 3--c_ name home phone# work phone# CURRENT MAILING ADDRESS: , city/town ' state zip code The current exemption for"bomeowners"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 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 co is more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" all mit to ttormed uilding Official on a form acceptable to the Building Official, that he/she shall be r nst a 11 uch work under the building ennit. (Section 109.1.1) The ders geed a wne assumes responsibility for compliance with the State Building Code and other app cable ode ,byl w ,ru and regulations_' The de rs' "h er"certifies that he/she understands the Town of Barnstable Building Department in t do pr ures and requirements and that he/she will comply with-said procedures and requir Si 01 0 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 hbwc:Dwner performing work for which a building permit is required shall be exempt from the provisions of this section(Section )09.).)-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 czerrption-are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2-)5) This lack ofawarenczs often results in scrious.problams,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 certify that he/she understands the responsibilitiep of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care i amend and adopt such a form/cer-tification for use in your cornmunity. Q:forms:homccxcmpt otter P� 0 nt nit nor t Town of Barnstable Regulatory Services Thomas F. Geller,Director Building Division Thomas Perry, CED Building Commissioner 200 Main Street, Hyannis,MA.02601 www.town.b arns to b le.m a,us Office: 508-862-403 8 Fax: 508-790-6230. Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Naive If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. C:1UscrsldccollikV+ppDataU.oc&AMicrosofilWindowslTcmporrry lntcmct FilcslContcnt.0utlooklDDV97AAZ1EXPREss•doc Revised 072110 • _ _ — — —— —• - 506 752 8895 r-e1'�j1 T GROUP I NC. �v-23-2009 09�06 MORTGAGE INSPSC7lON PLAN �E BAN RUS!116LV4 EL & MICHE�-�-E ]ACOBSON >lkai �Y- � SURVEYORS NAME TERGREEN CIRCLE ►� REGISTERED —TREET - FLOOR 2 LOCATION IN 75 HAMMOND 5 _ ca WORCESZER50 A 7D52 888523 OS rERVILLE MA p PHONE: DATE 11-20-09 aD FAX: 508-752-8895 „ ^�0 RMT®FtSTGROUP.NET Jtnc SCA3•E 1459/119 O S. & T. Groups DEso eo01W+�e e0 A Division of H. 176/79 Y SARNSTABLE ew(BOOK/Fw' REGISTR Aw.' "m"`pTME AP uvoN DOOLMENTAT�ON pRDV�EO Rp�QU1RfO NE/SURE �N QF"+M p11D O,Rg l BNOwN WS CEAT7Ff TVAT T!(e eul sFR MAD lNv: N6 wme mot t IE F=f-,4•o+O 1&01N EM) SPEUAL itAOD N nD oNTs PIORT�IN9C68awl,AND, !ARENOVIOy;FIONS DANIEL OTD07-02^92 VMOUE EAS[I�e �pEQARDING 6TR�CfUPES Ta vMPw1TM 16 D OF taNINO RpQUI S DFHEAwU:C IOOTQD IN DRAWING+ J. SAND MS GUN OVEMWED W SCALE All" 0 uN.O�PSF�'S(JNLE9 �BO,,,,,,UNONOOLS DRVMAis. y�ygplAt6ARE NOTE:t+�N NO ED Am'T[ON9 TAU;D;A K04TGq° u9e TD 11V W , FIOOo NazAAo RASE VltQfiL•CFFf aR SNEDS wn NarA�+,NsrA MIWT WRN&'.Do t� t) 4 No. 047 e� IS NOT N pWLY ACa1 <t nN7�oL suRrei J4 rNsof f011 PLAN{ CF",OR 70 PLANT f11NE 1SbVED OY MJD AND/OR.A UFiCi7CA ERECT FWCES,0714 e0uN0atV�(S)5140"t�tB A Pv P6RF'DA+�ED�rRetiSF:eLeVATI0M9 GNNDT a®o6T�t'ONED• INRUBS. NCE MRTN L Oc:L LL�6 PDN-"0RL•LwefOFFS l Ta AEQwa"Op s,OR IS URT,Vn Cw,e."SIC.7 UNLCSS ACTION UNOlR h AMON p���TMr - oTNEWISENDrED. OLEPAIE AND TNAS'TROME4UA<, TTw?INFOL-TA"VR°�nD 'Cgl NENTS UStD AW, ,RATPLT IpdilA IN REIATLON ro THE 0R0PERTT uNe5- CERTIFIED TO: RUSSEnJFE HOME LOANS a MICHE L E JACOBSON WINTERGREEN CIRCLE / AKA VALLEY ROAD / P,-160°43' / =28.00' R=545,34' L-119.52' / I LOT 7 23,700 S.F.t LLA / N ~ 1 n LO ~ N �S MOUSE o / r 116 z El 1 . 1af4.00' 5 86032.10"6 DRAWN v*CPM RBVHM7DQ Olr=:sPILLANO b tPILLANE CJ[RCJJPA BY. . n�rn(F eT: TOTAL P.01 'Rig! Vo. HOW Rn. Ask", Agskl ZA� Iff HE FMH A 00 L ® ® ® �� 00 o1� L L < r ------------------- .5----------- ----- L --------------------- 4. 1p ----------- in .r) � -------------------------- -------------- - ------- I R (D .3, -U .1 CRANING TYPE: I[,,,Fn S.eCT NUMBER: b lift WHY C6 yy yyj E L E 4i LU I IL in tM M� 0. 9i XN Tbi mt= M7 2T It DR MNG TYPE; rr MLS Report Flyer(218) Page 1 of 2 _ff?JUG _10 C X, . a�lcRrcr,-r�s�w.s Page 1 s A • ; ep Y 11���f•�. i4� as �iX��. 116 Wintergreen Cir Osterville, MA 02655 $469,000 At. ady Gone 11 wners Have Moved to there New Home.Large Cape.Wait!ng for Your Ambiance.Many Many Possibilities.Custom Built f•r Owners by rney of Rogers&Mamey Building Company.Very Deceiving from Front.Must see Inside.Family Room with Full Bath and Cider Leading to a Patio.Generous Size 2nd Floor Bedroom with Half Bath and Bonus Room Plus Expansion Possibilities for Two More Rooms over Family Room&Garage.Sprinkler&Alarm Systems.In-Law Apartment was Started in Lower Level-Large Entertainment Room (kitchen never completed).Spacious Front&Rear Yard with Gorgeous Mature Plantings for Side Line Borders.Updates Include Roof- Septic-Gas Heating System.Stroll Down on Main Street or to Joshua's&Micah's Pond.Don't Miss Out-You Will be Amazed 1 I Directions: Pond Street to Wintergreen Circle . Listing#_20705947 _Year BLit:1Q7_1 Approx Square Feet- - -2104-Assessors Records-- Property Type Single Family Lot Sq Ft(approx) 23522 Property SubType Single Family Lot Acres(approx) 0.540 Tax ID 119-46-0-0-BARN County Barnstable Beds:4 Baths FH :3 2 1 Presented By: Paul W Gallagher Realty Executives Primary:508-362-1300 x24 1330 Phinney's Lane Secondary:508-280-9777 Hyannis,MA 02601 W "i Other: 508-362-1300 E-mail:pgallagher@realtyexecutives.com Fax:508-362-1313 Web Page:hftp://PaulWGailagher.com See our listings online: http://www.capecodschoice.com or see individual agent site Au ust 2007 The above featured property may not be listed by the office/agent presenting this brochure. Information has not been verified,is not guaranteed,and is subject to change.Copyright 2006 Cape Cod&Islands Multiple —• Listing Service,Inc.All rights reserved - - Copyright©2007 Rapattoni Corporation.All rights reserved. The listing contract has not yet been validated by MLS Staff. http://ccimis.rapmis.com/scripts/mgrqispi.dll /23/2007 NMS Report Flyer(218) Page 1 of 2 -lixlhtiL7SF' .S F.�?'EfiIFNZ'.E Page 1 �irrr[ir% a 5, 116 Wintergreen Cir Osterville, MA 02665 $469,000 Already Gone I!Owners Have Moved to there New Home.Large Cape Waiting for Your Ambiance.Many Many Possibilities.Custom Built for Owners by Marney of Rogers&Mamey Building Company.Very Deceiving from Front.Must see Inside.Family Room with Full Bath and Slider Leading to a Patio.Generous Size 2nd Floor Bedroom with Half Bath and Bonus Room Plus Expansion Possibilities for Two More Rooms over Family Room&Garage.Sprinkler&Alarm Systems. In-Law Apartment was Started in Lower Level-Large Entertainment Room (kitchen never completed).Spacious Front&Rear Yard with Gorgeous Mature Plantings for Side Line Borders.Updates Include Roof- Septic-Gas Heating System.Stroll Down on Main Street or to Joshua's&Micah's Pond.Don't Miss Out-You Will be Amazed!I Directions:Pond Street to Wintergreen Circle Listing#:20705997 Year Built: 1971 Approx Square Feet 2104 Assessors Records Property Type Single Family Lot Sq Ft(approx) 23522 Property SubType Single Family Lot Acres(approx) 0.540 Tax ID 119-46-0-0-BARN County Barnstable Beds:4 Baths FH :3 2 1 Presented By: Paul W Gallagher Realty Executives Primary:508-362-1300 x24 1330 Phinney's Lane - = Secondary:508-280-9777 Hyannis,MA 02601 Other: 508-362-1300 E-mail:pgallagher@realtyexecutives.com Fax:508-362-1313 ,j Web Page:http://PaulWGailagher.com See our listings online: http://www.capecodschoice.com or see individual agent site Au ust 2007 The above featured property may not be listed by the office/agent presenting this brochure.113 A Information has not been verified,is not guaranteed,and is subject to change.Copyright 2006 Cape Cod&Islands Multiple Listing Service,Inc.All rights reserved Copyright©2007 Rapattoni Corporation.All rights reserved. The listing contract has not yet been validated by MLS Staff. http://ccimis.rapmis.com/scripts/mgrqispi.dll /23/2007 J No................ FEs.... .: .... THE COMMONWEALTH OF MASSACHUSETTS -- BOARD F HE -TH �. ...........oF.................................... L------................----- Appliratiun for DiipuuFal Works Tomitrurtiun 11amit Application is hereby made for a Permit to Construct ( ) or Repair (4-7--an Individual Sewage Disposal System at: .. ._.. A Locati Address or Lot No. ------------------------------------------------- --.-------------.-------------• -------------.--.----•••-•---. Q� Owner Address W ...................... -in n-• ........................................ Ins ller Address Type of Building Size Lot.................... .....Sq. feet U Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers — Pr yP g ----------•----------------- P ( ) Cafeteria ( ) Pa Other fixtures ..............••----•--------•-- - W Design Flbw............................................gallons per person per day. Total daily flow............._..•------------.._._..._......gallons. WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width..................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit_................. Depth to ground water........................ Lt, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil-. ! f O( f..... -- V .-------••••••••-•••.....•---•-----------------•-. --•-•- U Nature of Repairs or Alterations—Answer when applicable._,1G.0_P....___ ......42W..2 .... Q.. ............. ..................•---------•---------•----•----•--•----•-----------.....•--•-•--••----........-•---•-•---•-----•--•-•-----••••••--................................... ------••-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en issue by the board of health. Si • •. ------. Date Application Approved By----- � ,. Date Application Disapproved for the following reasons:..................................... -•----------•----------•.............................. -------------- Permit No........................................................... Issued--- ---.,---` `-f Date Parcel Detail Page 1 of 3 fJ] j { 4 a i.&AI1.A$TARUE— - aid `: -,y "` N._ NIAZI Logged In As: Parcel Detail Tuesday, August 28 2007 Parcel Lookup Parcellnfo Developer Parcel ID 119-046 Lot Location 116 WINTERGREEN CIRCLE I Pri Frontage 150 I ............... _......_. .... - ............_....... _.............. .. ._..,. Sec I Sec Road Frontage village OSTERVILLE I Fire District'C-O-MM I Sewer Acct; Road Index G ^A Interactive L"'P Map — Owner Info Owner'AMARAL, JOSEPH F & MARIA A Co-Owner ___.__...__._.. _... ..._ .__....e.... ...... .... __...._ ..... _.._._�.. _._, _,. _._ ._ _ _. .... ......... T Streets 99 POND ST Street2 City OSTERVILLE I State MA zip02655 Country USA Land Info __ . Acres 10.54 use,Single Fam MDL 01 zoning RC Nghbd ;0107 .— Topography .Level Road Paved _,... . ..__ .... ..... .. .....- ..............._............ ... ..... utilities Public Water,Gas,SeptiC Location I Construction Info Building 1 of 1 Year ..,...... .. . . Roof I....._ .-__.__, Ext Built'1971 Struct iGable/Hip I Wall Wood Shingle Effect ........ ____..... Roof ...-._ .................... AC i Area 2222 _) Cover jAsph/F GIs/Cmp TYPe;,None Int Bed I' Style;Cape Cod I wall!Drywall I Rooms 4 Bedrooms Model ;Resid 99 ential _I Floor 1 Bath Rooms 2 Full + 1 H I_._. F _..__.... _.... .---_.. ......... Heat Total Grade Average Plus I Type!Hot Water I 17 Rooms Rooms http://issgl/Intranet/propdata/ParcelDetail.aspx?ID=7222 8/28/2007 4 -42OX31 SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE WITH R TICLE II STATE TOWN of BARNST��(TI�T�jO. AND TOWN �OF THE T� TOWN l� ESI j BAHBST/IDLE, i 039 BUILDING INSPECTOR 90O i659 \�00 �ED MPS a' APPLICATIONFOR PERMIT TO ..... ............................................ ..............................:...................................... TYPE OF CONSTRUCTION ..................................................................................................................................... .................5.......................19. .... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .4rlM! .`. .....'.`...........................................4.................................................................................................... ProposedUse ....411- .: .......................................................................................................................................... I e. ZoningDistrict ...................................................Fire District................. .............................................................. s Nameof Owner . .......v............................................................Address .................................................................................... Nameof Builder 1411, .................................................................................... Name of Architect ............. '!r ".'.`......................................Address ..............A...ra..-wR ,a.................................................. Numberof Rooms ............ ....................................................Foundation ...................................................... Exterior ......4.........................+ups.....................................................Roofing ..... ...........I..!. . .............................................. Floors ......................................................................................Interior .................................................................................... t F Heating ......................................................Plumbing .... I,.I..s.................................................................... Q�. s ) Fireplace ..................................................................................Approximate Cost .... .V. .. .. ......... ...................... Definitive Plan Approved by Planning Board -----------_______-----------19________. 0 d..........a� Diagram of Lot and Building with Dimensions /� Q SUBJECT TO APPROVAL OF BOARD OF HEALTH VA 4 S � I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. Amaral, Joseph No 16813... Permit for ......add...to...s.i.ngle. ....... ...... .... . . ........ dwelling .......... .................................................... ....... ..... .........Wintergreen Ci-rel. . ......... Locati n. .......... . ...... . . .. ........... Osterville ........................... Ownerl ..............Joseph Amaral`'....................... .... . ...... .. Type of-!Construction ..................frame.........,,, . ............ ................................................................. Plot ... ................... Lot ................................ Permit dranted .........De.&ember 20 .....19 73 Date of Inspection -.Date Completed ...V1i 1/4 .... PERMIT REFUSED ........ ....................................................... 19 ........................................... ......................... ................................................................................. ............. ......... .............................................. .............. ................... Approved ............................................... 19 ............................................................................... ................................................................................. Town of Barnstable C- P rmit Expires if months from issue date Regulatory Services Fee Thomas F.Geiler,Director Building.Division 7/�/uB�. Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number <1�'(�(a b 1 Property Address E �Y rR-01 ' QCI '/Residentia] Value of Work 5 I Minimum fee of$25.00 for work.under$6000.00 Owner's Name&Address Contractor's Name �l�J 1.L Telephone Number• Home Improvement Contractor License#(if applicab e) I`d""f f 0 Construction Supervisor's License#(if applicable) 9 113�) . ❑Workman's Compensation Insurance c c PERM ,h one: J•7 F [�I am a sole proprietor ❑ I am the Homeowner J`•j L y, 2. ❑ I have Worker's Compensation Insurance TOWS OF gARNSTA6LE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ri,-K-roof(stripping old shingles) All construction debris will be taken to AAA Dl kkr & . ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'Whcrc required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pro Owner must sign Property Owner Letter of Permission. cop o ome Improvement Contractors License is required. SIGNATURE: Q:Forms:cxpmtrg Revise061306 - ' The Commonwealth of Massachusetts Department of IndustrialAdcidents Offcce ofInvestigattons a 600 Washington Street Boston,MA 02111 ' y ww.m ass..gov/dia Workers"Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers • 'Applicant Information .Please Print Le 'bi Name (Business/Organization/Individual): • Address: K City/State/Zip: �n�S, Q�pt( phone.#: 19 - `�✓� CJ Are you an employer? Check the appropriate box: 1.❑ I am a employer with 4. ❑ I am a general contractor and I Type of project(required): mployees (full an d/orpart.time).* have hired the sub-contractors 6. El 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 g, ❑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.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself; [No workers' comp. right bf exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12. 00f repairs employees. [No workers' . .13.0 Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below sbowing(heir Workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and 7bcn hire outside contractors must submit a new af5davit indicating such. 1Contractm that check this box must attached an additional'Arct sbowing this name of the sub contractors and state whether or not those entities have employees. If the sub-contractors lave cmployccs,they must pravidr;their workers'comp.policy nurnors I am an employer that is providing workers'com information. pensation insurance for my employees Below is_the policy and joh site Insurance Company Name: Policy#or Sclf-ins.Lic.##: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration pag v a as ze e(showing the policy number and e xpiration date), Failure_to secure coers g quired 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 penaltirs 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 maybe forwarded to the Office of Investigations ations ofthe 17IA r ins overa e verification, I do her y certr rn r the in a enalb ofperjrcr)r that the information provided above s true and colrectr Sienature: O ' Date: Phonc #: — Official use only. Do not write in this area,'tb be completed by city or town o�ciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2,Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: r �ns er Alfa ess Regulation License or registration valid for individul use only �\ Office of Consumer Affairs&Business Regulation g Y _ ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ,tt�egistration: 124310 Type: Office of Consumer Affairs and Business Regulation ^!expiration: 6/1/2013 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 James Curley James Curley 287 Fuller Rd. Centerville, MA 02632 Undersecretary Not valid without signature L• IYIassachusetts- Department of Public Safely Board of Building, Regulations and Standards Construction Supervisor Specialty License r License: CS SL 99138 . Restricted.to: RF,WS _ IJAMES CURLEY i s i 287 FULLER ROAD.. 1 CENTERVILLE, MA 02632 i I Expiration: 1/28/2012 Commissioner Trn: 99138 Boa d of Building R gulAtions-xnd.:SL�ndards—�� ._ -' , Licet-Me or gis ration valiq for indi 1-du•1 use only ~HO E IMPROVEM NT CONTRACT R before the ePiration date. n found eturn to: Re stratiiin a243 0 _.. Board-of But diT-R'ff1•tfi6 -s'and-Standards E it"a'4iori One Ashburt Place Rm 130' _.6( F2. 'g"��rTr# 1 0873 Boston,Ma.0 108 Wid al James urley James urley 287 Full r:Rd. . " `- e, A 02632 Administrator of ah without ure .__.... ���Y _gib _._ Town of Barnstable. Regulatory Services • : :�sTeer�, y MASS. Thomas F. Geller,Director �1% Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,Iv1A 02601 wT w.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508--790-6230 Propettv Owner Must Complete and Sign This Section If Using A Builder as Owner of the subje ct property berebyauthorizeQS' I to act on my behalf, in all matters relative to work authorized bytbis building permit application for: G re ( dress of Job) � as ll Signature of r Date Print Name QTOR.M&OWNERPERMIS SION ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY . HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER21 kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS'�R kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC ;a; = LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). ? ; MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAjN rT (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIREDIBY NEUT NEUTRAL UL LISTING. == NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED ATITHE 5-1 OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE e PL PROPERTY LINE MANUFACTURER .USING UL LISTED GROUNDING rn POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT WATT W W WATT 3R, RAINTIGHT FV1 COVER SHEET PV2 SITE PLAN _ PV3 STRUCTURAL VIEWS PV4 THREE LINE DIAGRAM LICENSE GENERAL NOTES Cutsheets Attached GEN #168572 1. ALL WORK TO BE DONE TO THE 8TH EDITION ELEC 1136 MR OF THE MA STATE BUILDING CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: ZEP SOLAR REV BY DATE COMMENTS AHJ: Barnstable REV A NAME DATE COMMENTS • : s a .4 + UTILITY: NSTAR Electric (Commonwealth Electric) CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER J B-02 6 217 3 00 PREMISE OWNER: DESCRIPTION: DESIGR \\, CONTAINED SHALL NOT BE USED FOR THE BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SY : JACOBSON JACOBSON RESIDENCE Cris Flores w�'c NOR MALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 116 WINTERGREEN CIR 6.76 KW PV ARRAY r,,So�arCity. PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES OSTERVILLE MA 02655 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE (26) TRINA SOLAR # TSM-260PD05.18 Marlborougli,MA 24 St. Martin Drive,Building 2 Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER PAGE NAME: SHEET: REY. DATE T: (650)638-1 28 R (650)638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE SE6000A-USOOOSNR2 (617) 510-7209 COVER SHEET PV 1 11/3/2015 (8B8)-SOL—Cm(765-2489) www.sdarcityeom L— ' _ • 'Digitaltysigned by Kyle Jackso Kyle DN.dc PITCH: 35 ARRAY PITCH:35 =local,dc=Solarcity, MP1 AZIMUTH: 176 ARRAY AZIMUTH: 176 ou=SolarCity Users,ou=Denv , cn=Kyle Jackson, MATERIAL: Comp Shingle STORY: 2 Stories Jackson mil=kjackson@solarcity.co Front Of House Dare:2°,5.,,.�,3:z,:46 as �N OF M CKSON v CIVIL H No.51873 A909FQI TS 4'Q AC AC � Inv -.711 STAMPED & SIGNED FOR STRUCTURAL ONLY 'LEGEND Q (E) UTILITY METER & WARNING LABEL MP1 0 INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS © DC DISCONNECT & WARNING LABELS AC AC DISCONNECT & WARNING LABELS DC JUNCTION/COMBINER BOX & LABELS a Q DISTRIBUTION PANEL & LABELS Q LOAD CENTER & WARNING LABELS N A O DEDICATED PV SYSTEM METER • 0 STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR --- CONDUIT RUN ON INTERIOR,, GATE/FENCE 0 . HEAT PRODUCING VENTS ARE RED r,_-1 L��J INTERIOR EQUIPMENT IS DASHED SITE PLAN ' N r Scale: 1/8" = 1' E 0 1' 8' 16' yy ' S CONFIDENTIAL- THE INFORMATION HEREIN tO8 NUMBER J B-0 2 6 217 3 00 PREMISE OWNER: DESCRIPTION: DESIGN: ., CONTAINED SHALL NOT BE USED FOR THE JACOBSON, RUSSELL J � JACOBSON RESIDENCE Cris Flores BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: .�� NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 116 WINTERGREEN CIR 6.76 KW PV ARRAY ,SolarCity. PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES ORGANIZATION, EXCEPT IN CONNECTION WITH OSTERVILLE MA 02655 24 St Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (26) TRINA SOLAR # TSM-260PD05.18 PAGE NAME SHEET: REV DATE. Marlborough,Ma ons2 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: T. (650)638-1028 F. (650)638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE SE6000A—USOOOSNR2 (617) 510-7209 SITE PLAN PV 2 11/3/2015 (888)-SOL-CITY(765-2489) www.Warcity.com �i OF�+ .,a CKSON v CIVIL ti No.51873 �90 9�QISTE � SIOtIAt STAMPED & SIGNED (E) COLLAR TIE FOR STRUCTURAL ONLY (E) KNEE WALL PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER & FENDER WASHERS LOCATE RAFTER, MARK HOLE. ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT S1 ZEP ARRAY SKIRT (6) HOLE. (4) (2) SEAL PILOT HOLE WITH POLYURETHANE SEALANT. ZEP COMP MOUNT C " ZEP FLASHING C (3) (3) INSERT FLASHING. 14' (E) COMP. SHINGLE (4) PLACE MOUNT. (1) (E) LBW (E) ROOF DECKING (2) INSTALL LAG BOLT WITH 5/16" DIA STAINLESS (5) (5) SEALING WASHER. SIDE VIEW OF MP1 NTS STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES ALL LEVELING FOOT WITH A WITH SEALING WASHER C(6)7BOLT & WASHERS. MP1 I X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES (2-1/2° EMBED, MIN) LANDSCAPE 64" 24" STAGGERED (E) RAFTER STANDOFF r PORTRAIT 48" 17" RAFTER 2x8 @ 16"OC ROOF AZI 176 PITCH 35 STORIES: 2 ARRAY AZI 176 PITCH 35 C.]. 2x8 @16"OC Comp Shingle CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER J B-0 2 6 217 3 00 PREMISE OWNER. DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE JACOBSON, RUSSELL J JACOBSON RESIDENCE Cris Flores SO�afC�t BENEFIT OF ANYONE EXCEPT SOLARgTY INC., MOUNTING SYSTEM: NOR MALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 116 WINTERGREEN CIR 6.76 KW PV ARRAY 'i;. PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES OSTERVILLE MA 02655 ORGANIZATION, EXCEPT IN CONNECTION WITH , THE SALE AND USE OF THE RESPECTIVE (26) TRINA SOLAR # TSM-260PDO5.18 24 St. Martin Drive,Building Z Unit 11 SOLARCITY EOUIPMENT, WITHOUT THE WRITTEN INVERTER PAGE NAME: SHEET: REV.. DATE T. (�)Maarou8'F:A(61752 638-1029 PERMISSION OF SOLARgTY INC SOLAREDGE sE600oA—us000sNR2 (617) 510-7209 STRUCTURAL VIEWS PV 3 11/3/2015 (eee)-soL-aTY(765-2489) ....Balarci►Yean, , s GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO TWO (N) GROUND Panel Number:NoMatch Inv 1: DC Ungrounded GEN #168572 Meter Number: INV 1 -(1)SOLAREDGE ��E6000A-USOOOSNR LABEL: A -(26)TRINA SOLAR TSM-260PD05.18 RODS AT PANEL WITH IRREVERSIBLE CRIMP 2234260 Tie-In: Supply Side Connection Inverter; 6000W, 240V, 97.59q w/Unifed Disco and ZB,RGM,AFCI PV Module; 25OW, 236.9W PTC, 40MM, Black Frame, H4, ZEP, 1000V ELEC 1136 MR Underground Service Entrance INV 2 Voc: 38.2 Vpmax: 30.6 INV 3 1 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 100A MAIN SERVICE PANEL E; 100A/2P MAIN CIRCUIT BREAKER Inverter 1 CUTLER-HAMMER .. Disconnect CUTLER-HAMMER jDC+ 10OA/2P 4 Disconnect 3 SOLAREDGE A 35A SE6000A-USOOOSNR2 Da MP 1: 1x18 zaov ------ ---------- EGC------------------ II A L1 -------------- l I I B L2 DC+ I I N DG I 2 I V(E) GND ____ GND ____ EGG DC+ - --------------------- -�� ---TN Da MP 1: 1x8 I - r---J GND -- EGC--- ------------ -------- ------------- G -----t� I N I (1)Conduit Kit; 3/4' EMT - o EGC GEC_ Z ZS l I I - GEC TO 120/240V SINGLE PHASE I I UTILITY SERVICE i I I I _ I I I I ' I I PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX .VOC AT MIN TEMP POI (2)Graygd Rod A (1)CUTLER-HAMMER III DG222NRB /fj C j PV (26)SOLAREDGE�300-2NMAZS DC r 8 x 8, per Disconnect; 60A, 24OVac, Fusible, NEMA 3R /y PoxerBox timizer, 30OW, H4, DC to DC, ZEP -(2)ILSCO+IPC 4C0-/6 -(1)CUTLER- AMMER DG100N8 Insulation Piercing Connector Main 4/0-4, Tap 6-14 Graund�Neutralt; 60-100A General Duty(DG) nd (1)AWG�6, Solid Bare Copper (1)- CUTLER-HAMMER DS16FK SS SUPPLY SIDE CONNECTION. DISCONNECTING MEANS SHALL BE SUITABLE pass R Fuse Kit -(1)Ground Rod; 5/87 x 8'. Copper AS.SERVICE EQUIPMENT AND SHALL BE RATED PER NEC. -(2)FERRAZ SHAWMUT TR35R PV BACKFEED OCP Fuse; 35A. 25OV, Class RKS (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION N0. 2,ADDITIONAL B (I)CUTLER-HAMMER g oG222URB ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE Disconnect; 60A, 24OVac, Non-Fusible, NEMA 3R -0)CUTLER- AMMER DGIOONB GroundAttral t; 60-100A, General Duty(DG) 4 O (1)AWG (l)AWG #5, THWN-2, Black 1 AWG gB, THWN-2, Block 2 AWG#10, PV Wre, 60OV, Block Voc* =500 VDC Isc =15 ADC IcnF (1)AWG #6, THWN-2, Red O LPL(1)AWG#B, THWN-2, Red T (1)AWG g6, Solid Bare Copper EGC Vmp =350 VDC Imp=13.2 ADC (1)AWG #6, THWN-2, White NEUTRAL Vmp =240 VAC Imp=25 AAC (1)AWG #10. THWN-2, White NEUTRAL Vmp =240 VAC Imp=25 AAC . . . (1)Conduit Kit; 3/4'.EMT -(1)AWG/6,•Solid Bare.Copper. GEC. • , • •-(1)Conduit.Kit;'.3/4'.EMT. . .•• •. .. . . • • , •'• •-(1)AWG#8,:TI1W!N-2,•Green . . EGC/GEC-(1)Conduit,Kit;,3/4',EMT• . . . .• • . .• (2)AWG$10, PV Wire, 666V, Bladc Voc* =500 VDC Isc =15 ADC O (1)AWG Q6, Solid Bare Copper EGC Vmp.=350 VDC Imp=5.87 ADC . (I)Conduit Kit 3/4' EMT . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. .. . . .. CONFIDENTIAL- THE INFORMATION HEREIN [INVERTER. B NUMBER PRFIDSE OWNER DESCRIPTION: DESIpk CONTAINED SHALL NOT BE USED FOR THE _ J B-0262173 00 JACOBSON RUSSELL J Cris Flores NOOF JACOBSON. RESIDENCE SolarCity. R SHHALL IT BEDISCLOSED N MOLE OR INComp SYSTEM: 116 WINTERGREEN C I R �i� PART TO OTHERS OUTSIDE THE RECIPIENTS omp Mount Type C 6.76 KW PV ARRAY ORGANIZATION, EXCEPT N CONNECTION WITH DULES: OSTERVILLE, MA 02655 r 24 St.Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE 26) TRINA SOLAR # TSM-260PDO5.18 PACE NAME: SHEET: REV: DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN T: (650)638-1026 F: (650)638-1029 PERMISSION OF SOLARCITY INC. OLAREDGE SE6000A-US000SNR2 (617) 510-7209 THREE LINE DIAGRAM PV 4 11/3/2015 (888)-SOL-CITY(765-2489) www.solor°Ry.com el INARNING: Label Location: •• ' • .Label Location: PHOTOVOLTAIC POWER SOURCE ,_ Code: WARNING ',_ ;'_ WARNING Code: ELECTRIC SHOCK HAZARD ELECTRIC SHOCK HAZARD NEC 690.31.G.3 DO NOT TOUCH TERMINALSNEC THE DC CONDUCTORS OF THIS LabelNEC 690.35(F) TERMINALS ON BOTH LINE AND PHOTOVOLTAIC SYSTEM ARETO BE USED WHEN INVERTERIS PHOTOVOLTAIC DC LOADN TDHE OPEN POS TIONIZED MAY BEOENDERGIZED UNGROUNDED DISCONNECT NEC .•0 LabelLabel Location: • • PHOTOVOLTAIC POINT OF MAXIMUNI POWER- INTERCONNECTION A � WARNING: ELECTRIC SHOCK POINT CURRENT(Imp) ••- HAZARD.DO NOT TOUCH •' 174 NEC 690.54 MAXIMUM POWER- VNEC 690.53 BOTH THE LINE AND LOAD SIDE MAXIMUNI SYSTEM_V MAY BE ENERGIZED IN THE OPEN Label Location: VOLTAGE(Voc) POSITION. FOR SERVICE SHORT-CIRCUIT A DE-ENERGIZE BOTH SOURCE CURRENT(Isc) AND MAIN BREAKER. PV POWER SOURCE R4AXIMUM AC A OPERATING CURRENT MAXIMUM AC OPERATING VOLTAGE V WARNING ' Per ..- ELECTRIC SHOCK HAZARD IF A GROUND FAULT IS INDICATED NEC '' NORMALLY GROUNDEDLabel L• • CONDUCTORS MAY BE CAUTION UNGROUNDED AND ENERGIZED DUAL POWER SOURCE ••- SECOND SOURCE IS NEC 690.64.13.4 PHOTOVOLTAIC SYSTEM Label • • WARNING ' Per Code: Label Location: ELECTRICAL SHOCK HAZARD DO NOT TOUCH TERMINALSNEC 690 CAUTION ' P' TERMINALS ON BOTH LINE ANDPer Code: NEC LOAD SIDES MAY BE ENERGIZED PHOTOVOLTAIC SYSTENI •' IN THE OPEN POSITION CIRCUIT IS BACKFED DC VOLTAGE IS ALWAYS PRESENT WHEN SOLAR MODULES ARE EXPOSED TO SUNLIGHT Label • • Per WARNING ..- INVERTER OUTPUT Label Location:. CONNECTION NEC ' ' PHOTOVOLTAIC AC (POI) DO NOT RELOCATEDisconnect DISCONNECT •'" THISODEVCERRENT •uit NEC •.0 :. (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit Label AC A Load OPERATING CURRENTPer C (M): Utility Meter odw R4AXIMUM AC VNEC 690.54 • of • • OPERATING VOLTAGE IFINZ1211IN I IFJ 4=111,19 INV:' 1:0 Zi 412 WC11 fill N 1 1 woul 1 3055 San Mateo,CA 94402 LabelSet29 1 1 1 1 1 1 7 1 i '7• t/ 1 1 •r Next-Level PV Mounting Technology r $olarCity I ®pSolar Next-Level PV Mounting Technology ' $OlafClty I ®p$olar Zep System components _ for composition shingle roofs y r -- Vp-roof IND Ground Zep Interlock (x y W.&-.N tevelug root . S ep Ce�atfae PV J Zep G— . I Roof Aoxt— a Array Sktrr `GMpgT' Description PV mounting solution for composition shingle roofs CGMppUm Works with all Zep Compatible Modules • Auto bonding UL-listed hardware creates structual and electrical bond • Zep System has a UL 1703 Class"A"Fire Rating when installed using U` LISTED modules from any manufacturer certified as"Type 1"or"Type 2" Comp Mount Interlock. Leveling Foot Part No.850-1382 Part No.850-1388 Part No.850-1397 Listed to UL 2582& Listed to UL 2703 Listed to UL 2703 Specifications Mounting Block to UL 2703 Designed for pitched roofs ( � Installs in portrait and landscape orientations �1,1 J Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 • Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and ETL listed to UL 467 • Zep System bonding products are UL listed to UL 2703 Engineered for spans up to 72"and cantil6mrs up to 24" • Zep wire management products listed to UL 1565 for wire positioning devices Ground Zep Array Skirt,Grip,End Caps DC Wire Clip Attachment method UL listed to UL 2582 for Wind Driven Rain Part No.850-1172 Part Nos.500-0113, Part No.850-1448 Listed to UL 2703 and 850-1421,850-1460, Listed UL 1565 ETL listed to UL 467 850-1467 zepsolar.com zepsolar.com Listed to UL 2703 This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for each product The end-user documentation shipped with Zep Solar•s products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf Page: 1 of 2 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf Page: 2 of 2 c solar=@ " solar ' • • SolarEdge Power Optimizer Module Add-On for North America P300 / P350 / P400 SolarEdge-Power Optimizer P300 P3SO P400 Module Add-On For North America (for 60•cell PV (for 72-cell PV (for 96•cell PV modules) modules) modules) P300 / P350 / P400 • (INPUT Rated Input DC Power<'� : 30D.....•.••.............. 350.......•...............40.0 .._ ...... Absolute Maximum In ut Volta a Voc at lowest[em eroture 48 60 80 Vdc MPP70Perotin&Range........................................................8:48 ..........8..60.....................8-80......... ...Vdc..... • Maximum Short Circuit Current(Isc) 10 Adc Maximum DC Input Curren[ 12:5 Adc ....................... ............................................................ ...................................... . ..... Maximum Efficien ..............................99:5 ..... Weighted Efficiency ....................................................................................................................98:8...................................... ............. .. Overvoltage Category L II !.OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) _ Maximum Output Current .......,.•.••,••••••••........15. •..AIF._... Maximum Output Voltage 1 60 Vdc ' • OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) 1 , - Safety Output Voltage per Power Optimizer 1 _ Vdc *' STANDARD COMPLIANCE i J (�r�,w•�. EMC FCC Part15 Class B,IEC63000-6-2,IEC61000-6 3 ' •`'.'�, .................................................................................................................................................. Safety IEC62109-1(class II safety).UL1741 RoHS Yes INSTALLATION SPECIFICATIONS I Maximum Allowed System Voltage..........................................................................1000 Vdc_.... s DmensionslWxLz H) 141x212x40.5/S.SSx8.34x1s9 mm/m _r Weight lincludinQ cablesl.................................................................................. .....................: gr/Ib.... Input Connector .....,MC4/Amphenol/.Tyco.......................... Output Wue Type/Connector Double Insulated Amphenol .. ............................................................................... Output Wue Length.............. ......0:95/3:0.......L......................1.2/39 ...................................... .............................. n)/h.... OperotinQ Temperature Range.....................................................................40.. 85/.40.a18.5............................ ..../.F.... Protection Ratln� ..................................IP65/•NEMA4 • Relative HumiditY................................................:........................................... ...%...... m xarce src o�m me moa�ne.rxoawe ww�o.sx w-�+,drnncc airo..e. +y PV SYSTEM DESIGN USING A SOLAREDGE THREE PHASE - THREE PHASE 1 INVERTER SINGLE PHASE 208V 480V PV power OPt1rr112aL1Or1 at the module-level Minimum string L........... Optimizers) 8' 10 18 ...................................8.................................................................................. Up to 25%more energy Maximum String Length(Power Optimizers) 25 25 50 ...................engt................nizer................................:......................................................................................... 'Maximum Power per String ..••.•...5250.....•..••,•••,••,••,6000 .........12750.......•..,•.•W•„•• - Superior efficiency(99.5%) .................g.................... .................................... ............ • Parallel Strin s of Different Len hs or Orientations Yes — Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading ""'""""""""""""""""""""""""""" "' '••'"••"••••"•'• — Flexible system design for maximum space utilization — 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 THE Trinamount MODULE TSM-PD05.18 ° Mono Multi Solutions DIMENSIONS OF PV MODULE ELECTRICAL DATA Q STC unif:mm Peak Power watts-P-(Wp) 71 245 1 250 7 255 260 • 941 Power Output Tolerance-Pwx(%) 0-+3 ""1AEP1A1E Maximum Power (V) . ) 30.6 1 2THE Timamount Maximum Power Current-lM (A) 8. 0 8.27 8.37 8.50 I Open Circuit Voltage-Voc(V) 37.8 1 38.0 38.1 38.2 o Short Circuit Current-Isc(A) 8.75 8.79 8.88 9.00 { sr•umc� o tt MODULE D ^ 8 Module Efficiency qm(Ce _ .Air - 15.r 14-3 15.9 CL STC:Irratlionce 1000 W/m'.Cell Temperature 25°C.Air Mass AMI.S according to EN 60904-3. Typical efficiency reduction of 4.5%of 200 W/m2 according to EN 60904-1. so o � o ° ELECTRICAL DATA®NOCT 60 CELL Maximum Power-Pwa(Wp) T -182 1 186 t 190 193 � I i RMaximum Power Voltage-Vav(VI 27.6 28.0 28.1 28.3 MULTICRYSTALLINE MODULE _ se. amu mwcwe Maximum Power Current-Iwx(A) 6.59 ' 6.65 6.74 6.84 WITH TRINAMO'UNT FRAME 12.dwx eae. I " I Open Circuit Voltage(V)-Vac(V) . 35.1 35.2 35.3 35.4 ~- Short Circuit Current(A)-Isc(A) 1 7.07 7.10 ± 7.17 I 7.27 NOCT:Irradiance at 800 W/m',Ambient Temperature 20°C.Wind Speed I m/s. 245-26OW PD05.18 812 180 Bock view POWER OUTPUT RANGE MECHANICAL DATA Solar cells Multicrystalline 156 x 156 mm(6 inches) , Fast and simple to install through drop in mounting solution ( ) Cell orientation •60 cells 6 x 10 1 (�J Module dimensions 1650 x 992 x 40 mm(64.95 x 39.05 x 1.57 inches) 0 `Weight 21.3 kg(47.0 Ibs) MAXIMUM EFFICIENCY Glass 3.2 mm(0.13 inches).High Transmission.AR Coated Tempered Glass A-A I Backsheet White I Good aesthetics for residential applications Frame Black Anodized Aluminium Alloy with Trinamount Groove -As I-V CURVES OF PV MODULE(245W) J-Box IP 65 or IP 67 rated 0 ti+37 t Photovoltaic Technology cable 4.0 mm2(0.006 inchei2). Cables to.02 1200 mm(47.2 inches) POWER OUTPUT GUARANTEE 9.m 00B" Fire Rating Type 2 t 87.� 8WW/m2 Highly reliable due to stringent quality control <'_6m • Over 30 in-house tests(UV,TC,HE and many more)_ d 5m As a leading global manufacturer # �i I • In-house testing goes well beyond certification requirements 5 a.°° EIOWhn' TEMPERATURE RATINGS MAXIMUM RATINGS of next generation photovoltaic 3m 200W/m' Nominal Operating T Operational Temperature T-40-+85°C • products,we believe close 2.m g as°c(f2°c) Temperature(NOCT) j cooperation with our partners { 1. 11_ Maximum System IOOOV DC(IEC) is critical to success. with local om Temperature Coefficient of P -0.41%/°C I Voltage 1000V DC(UL) om tom tom 3o.m 40.m 111 t II presence around the globe,Trina is ( Temperature Coefficient of Voc -0.32%/°C Max Series Fuse Rating f 15A valoge(v) [Temperature able to provide exceptional service { Coefficient of Isc 0.05%/°C to each customer in each market Certified to withstand challenging environmental and supplement our innovative, conditions reliable products with the backing ;• 2400 Pa wind load of Trina as a strong,bankable WARRANTY } partner. We are committed • 5400 Pa snow load 1 10 year Product Workmanship Warranty to building strategic,mutually beneficial collaboration with ' [25 year Linear Power Warranty installers,developers,distributors (Please refer to product worranty for details) a and other partners as the backbone of our shared success in -" '' - -` 1 CERTIFICATION driving Smart Energy Together. f LINEAR PERFORMANCE WARRANTY PACKAGING CONFIGURATION E 10 Year Product Warranty•25 Year'llnear Power Warranty `mow .sP Modules per box:26 pieces w Trina Solar Limited • k F www.trinasolor.com ; y100% dltla `��' I•Modules per 40'container:728 pieces t a A y nol value to-v wttT 1 0 4rorn Trina S cor,rwxr m 90% olor'S Il 1 I a near Nrarrartly CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. �otsvbr�a Y I o 02014 Trina Solar Limited.All rights reserved.Specifications included in this datasheet are subject to Trinasolar 80� Trinasolar change without notice. g 1 Smart Energy Together rears s to _ Is 20 zs Smart Energy Together `bbstv►� 1 Trina standard Industry standard r, • THE Temamount MODULE TSM-PD05.18 Mono Multi Solutions ` DIMENSIONS OF PV MODULE ELECTRICAL DATA 0 STC unit:mm Peak Power watts-Pwa(Wp) 250 - 255 260 265 • 941 �Power Output Tolerance-PMex(%) 0-+3 THETinnamount Maximum Power Voltage-Vw(V) 30.3 30.8 8.37 8.50 8.61 eox k Maximum Power Current-IMrP(A) 8.27 8.37 8.50 8.61 rus,Evu*E u, Open Circuit Voltage-Vac(V) 38.0 38.1 t 38.2 38.3 0 Short Circuit Current-Isc IA) 8.79 8.88 9.00 9.10 -nnuwc HOLE O D E Module Efficiency qm(%) .Air 1 15.6 1 ! 16.2 STC:Irradiance 1000 W/m'.Cell Temperature 25"c Air Mass AM1.5 according to EN 60904-34-3. Typical efficiency reduction of 4.5%at 200 W/m'according to EN 60904-1. m � � o ELECTRICAL DATA®NOCT 6 O CELL Maximum Power-Pnux(Wp) � 186 1 190 � 193 197 I Maximum Power Voltage-V-IV) 28.0 28.1 28.3 28.4 MULTICRYSTALLINE MODULE iMaximum Power CurrentjIl P (A) 6.65 6.74 6.84 6.93 °¢a amuxonc rwEE PD05.18 A A Open Circuit Voltage(V)-voc(V) 35.2 35.3 35.4 35.5 WITH TRINAMOUNT FRAME 2. E Short Circuit Current(A)-Isc(A) 7.10 7.17 7.27 7.35 NOCT:Irradiance at 800 W/m',Ambient Temperature 20aC.wind Speed 1 m/s. ( 8,2 ,BD 250-265W Bock view MECHANICAL DATA POWER OUTPUT RANGE + Solar cells Multicrystalline 156 x 156 mm(6 inches) I Cell orientation 60 cells(6•10) Fast and simple to install through drop in mounting solution Module dimensions 1650 x 992 x 40 mm(64.95 x 39.05 x 1.57 inches) 16./1� I Weight 19.6 kg(43.121bs) LGlass 3.2 mm(0.13 inches),High Transmission.AR Coated Tempered Glass MAXIMUM EFFICIENCY j Ba�ksheet White AA ( Frame Black Anodized Aluminium Alloy ® Good aesthetics for residential applications J-Box IP 65 or IP 67 rated -As�v/y Cables Photovoltaic Technology cable 4.0 mm2(0.006 inches'), 0 lw+3 1200 mm(47.2 inches) a ao POSITIVE POWER TOLERANCElam t•v cuevEs OF Pv MODULE t260w1 l Connector H4 Amphenol a,m saaow m' Fire Type UL 1703 Type.2 for Solar City Highly reliable due to stringent quality control • Over 30 in-house tests(UV,TC,HF,and many more) T'°° As a leading global manufacturer • In,house testing goes well beyond certification requirements a 8'00 TEMPERATURE RATINGS MAXIMUM RATINGS of next generation photovoltaic - PID resistant 4m Nominal Operating Cell Operational Temperature 40-+g5°C products,we believe close 44-C(32°C) P as Temperature(NOCT) !Maximum System 1000V DC(IEC) cooperation with our partners ' is critical to success. With local zoo i Temperature Coefficient of Pwsx -0.41%/°C i Voltage 1000V DC(UL) presence around the globe,Trina i5 '•00 Temperature Coefficient of Voc -0.32%/°C Max Series Fuse Rating 15A able to provide exceptional service o o o zo su w so Temperature Coefficient o 05 f Isc 0. %/°C to each customer in each market Certified to withstand challenging environmental L _ __ _ . and supplement our innovative, ® conditions °o�°'M I reliable products with the backing • 2400 Pa wind load of Trina as o strong,bankable WARRANTY • 5400 Pa snow load partner. We are committed CERTIFICATION 10yeorProduct Workmanship Warranty to building strategic,mutually beneficial collaboration with 25 year Linear Power warranty installers.developers,distributors rr� VL,� c$(►� .!Please refer to product warranty for details! N1 backbone of our shared drriivingSmartEnergyT getheessin LINEAR PERFORMANCE WARRANTY l gel' ® S PACKAGING CONFIGURATION o' and other partners as the _ Eu.2B w EE - 1. 10 Year Product Warranty•25 Year Linear Power Warranty CO"""r Modules per box:26 pieces z Trino Solar Limited i f I��Modules per40_container 728pieces www.trinasolar.com _ F Additional value 60 0 90% ni TlIhO SOIOr'S ljnear Walranty �yt' CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT, "P14P4r1e Trinasolar TrinaSOltll 02015 Trina Solar Limited.All rights reserved.Specifications included in this dotosheet are subject to O 80% change without notice. o Smart Energy Together Years s ID I5 20 25 Smart Energy Together 4oRPnn _■Trinastandard I:3 Industrystandard t- solar=@@ Single Phase Inverters for North America soIar SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ SE7.60OA-US/SE1000OA-US/SE1140OA-US SE3000A-US SE380DA-US I SESOOOA-US I SE6000A-US I SE760OA-US I SE10000A-US I SE1140OA-US OUTPUT SolarEdge Single Phase Inverters • Nominal AC Power Output 3000 3800 5000 6000 7600 9980 @ 208V 11400 VA ........................................... ................ ...:............................................ . i0000,@z4ov s400 @ 208V 10800 @ 208V • Max.AC Power Output 3300 4150 5450(.1p,240V. 6000 8350 10950 @240V 12000 VA For North America ..... ................. ....... ...... AC Output Voltage Min:Nom:Max!'l SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ 183-208-229Vac . ....-208-229......................... ................ ........ AC Output Voltage Min:Nom Max.": 211-240-264 Vac SE760OA-US/SE1000OA-US/SE1140OA-US :.......... .......................vo......................... ..... ......................................................... . / AC Frequency Min..Nom:Max!'1 59.3-60-60.5(with HI country setting 57-60:60.5) Hz Max Continuous Output Current 12.5 16 24 @ 208V 25 32 48 @ 208V 47.5 A ....... ..... .. ......... ........ ... .. .... ........ ..21.(d 240V ..... . .....42 @ 240V GFDI Threshold 1 A ........................................... ..................................................................................................................................... .R� Utility Monitoring,Islanding Protection,Country Configurable Thresholds Yes _ Yes I INPUT � werre�a i` Maximum DC Power(STC) 4050 5100 6750 8100 10250 13500 15350 W ,.� �7`'e Transformer-less,Ungrounded Yes Z5 c ! ........................................... ...................................................:........... .............................................. ...... .... ... — - ---" -teatsMax.In ut Volta e m ' P 8 - 500 ......... Vdc... - e°i Nom.DC Input Voltage 325 @ 208V/350 @ 240V Vdc ........................................... ................ ... .. + •- - 2 16.5 33 @ 208V..................... •+a ieh�.° Max.Input Currenti I................... ......9.........I......13......I.15:5.�240y..I......18......I......23.......I..30;5,�p),240V..I......34.5..........Adc.... 2r _ m Max.Input Short Circuit Current 45 Adc Reverse.Polarity Protection Yes Ground-Fault Isolation Detection 600kc.Sensitivity .Maximum Inverter Efficiency•,:..•.. ••.97.7•..• ...98.2.•. --.98.3 --. .. --98.- -- ......98 ..., ..%..-.. ........ .................... .. .. ..... .. .. ..... ................................... .................................... ..... 97.5 @ 208V 97 @ 208V CEC Weighted Efficiency 97.5 98 97.5 97.5 97.5 % ........................................ . ......... .................98.�°.240V .................975 @ 240V............................... t. Nighttime Power Consumption- <2.5 <4 W — ADDITIONAL FEATURES I I Supported Communication Interfaces RS485,RS232,Ethernet,ZigBee(optional) ........................................... .................................................................I.........................:.......................................... -. Revenue Grade Dafa,AN51 C12.1 Optional Rapid Shutdown-NEC 2014 690.12 Functionality enabled when SolarEdge rapid shutdown kit is Installed)° STANDARD COMPLIANCE i 5afetY.......... ........ .................•.-..-••..-••.....-..•.UL1741,UL16998,UL3998,CSA22.2 Grid Connection Standards IEEE1547 ........................................... ....................................................... .............................................................. Emissions FCC part1S class B INSTALLATION SPECIFICATIONS ± o s AC output conduit size AWG ran e 3 4"minimum 16-6 AWG 3 4"minimum 8-3 AWG ?................1...........g.... .....................:,.....!..............!.............................................i......................................... DC input conduit size/#of strings/ 3/4-minimum/1-2 strings/ IIIIII 3/4"minimum/1-2 Stnngs/16-6 AWG AWG range........... 14-6 AWG t - Dimensions with Safety Switch 30.5 x 12.5 x 10.5/ in/ _� ( 3 30.5x12sx7.2/775x315x184 ................................ .............................................................................................775 x 315 x 260.............mm.... ( Weight with Safety Switch............. ..........51.2/23:?..........I...................54.7/24.7.. ............................88:4./40.1.............lb if .. ... a. ...... .♦ Natural convection ' Cooling Natural Convection and internal Fans(user replaceable) fan(user The best choice for SolarEdge enabled systems ............................................ ................................................................... .realm?010... ................................................ Noise <25 <50 dBA - Integrated arc fault protection(Type 1)for NEC 2011'690.11 compliance Min.-Max.Operating Temperature -13 to+140/-25 to+60(-40 to+60 version availablelsi) 'F — Superior efficiency(98%) gauge-.........- . . ...................... ....:................................................................................................................................ Protection Rating NEMA 3R ........................................... ..................................................................................................................................... — Small,lightweight and easy to install on provided bracket For other regional settings please contact SolarEdge support. M A higher current source may be used;the inverter wilt limit its Input current to the values stated. — Built-In module-level monitoring tit Revenue grade Inverter P/N:SEs:ouA-US000NNR2(for 760OW ImerterSE7600A-U5002NNR2). 0 Rapid shutdown kit P/14:5E100D-RS651. — Internet connection through Ethernet or Wireless p'•40 version P/N:SE—A-USOOONNW(for 760OW InverterSE7600A-U5002NN1.14). — Outdoor and indoor installation — Fixed voltage inverter,DC/AC conversion only — Pre-assembled Safety Switch for faster installation — Optional—revenue grade data,ANSI C12.1Dc, suns RoHS USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL www.solaredge.us 0 solarEdge Technologies.Inc.All lights reserveirl.SWREDGE.the SolarEdge logo.OPTIMIZED BY are trademarks otireg,scred trademarks of SolafEdge technologies.Inc.All other I,ademart.s mentonod heri,in are trademarks of their respective owners.D.Ite�12/2014.Vol.subject 10 ChangeIhov!notice t ,