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I OxibrcF NO.1521/3 ORA WE w USA i$F ESSELTE l 7 c OPl A. v W A In i ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map r Parcel Application 4Fee Health Division Date IssuedConservation Division Application Planning Dept. - Permit FeeA �Z _w Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address n y41 's LYl Village `Z�ShVblp_ II- �� Owner �Ohyn 6r!1Y"R_ Address Ap'o bh _C Lin Telephoned - ` )Y— JAP Permit Request "o6"(E l(yh d n of rbo-� kzu.,' eo� U�4i.O fL3 °C {�Ap t;2 cc)�-4 � ()()G Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �(O,OMB Construction Type N 0' Lot Size H42 4c,1+ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 2/ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 31N0 On Old King s Mighway:i_O Yet ❑ 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 I 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 Telephone Number Address. 70 hj b License # aQ(o 7 J12 Home Improvement Contractor# 170(3y?l Email b if ai 1 @ V;V�n,d %&S-. C �M.�- Worker's Compensation # - (�C�/3t ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE L ` FOR OFFICIAL USCONLY APPLICATION# a DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER 1 1 s DATE OF INSPECTION: 1 ` FOUNDATION FRAME t• Y , INSULATION FIREPLACE z' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ,- - FINAL BUILDING i - 1 DATE CLOSEED OUT Y ASSOCIATION PLAN NO. ACO 12I05/2014RO® CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) 2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA INC. NAME' 122517TH STREET,SUITE 1300 A/CNr o Ext: aC No): DENVER,CO 80202.5534 E-MAIL Attn:Denver.CertRequest@marsh.00m Fax:212-9484381 ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# INSURER A:Evanston Insurance Company 35378 INSURED Vivint Solar,Inc: INSURER B:Zurich American Insurance Company 16535 Vvint Solar Developer LLC INSURER C:American Zurich Insurance Company 40142 3301 North Thanksgiving Way INSURER D: Suite 500 Lehi,UT 84043 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002520219-01 REVISION NUMBER:2 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. ILTRR TYPE OF INSURANCE ADDL SUER POLIClbMILAULL POLICY NUMBER MM DDY EFF POLICMMIDDY EXP LIMITS A GENERAL LIABILITY 14PKGWE00274 11/01/2014 11/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAj X COMMERCIAL GENERAL LIABILITY PREMISES RENTED 50,000 PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 X $5,000 Ded.BI&PD PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ B AUTOMOBILE LIABILITY BAP509601500 11/01/2014 11/01/2015 COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS X HIRED AUTOS N NON-OWNED PROPERTY DAMAGE $ AUTOS Per a.dent A UMBRELLA LIAB X OCCUR 14EFXWE00088 11/01/2014 11/01/2015 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ $ C WORKERS COMPENSATION WC509601300(CA,HI,MD,NJ,NY,OR,UT) 11/01/2014 11/01/2015 X I wC STATU- OTH- AND EMPLOYERS'LIABILITY CultI ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N WC509601400(MA) 11/01I2014 11/01/2015 1,000,000 OFFICERIMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Errors&Omissions& 14PKGWE00274 11/01/2014 1110112011 LIMIT 1,000,000 Contractors Pollution DEDUCTIBLE 5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 02601-4002 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Kathleen M.Parsloel4�luix @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD J The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,ALL 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Vivint Solar Developer, LLC Address:3301 North Thanksgiving Way,Suite 500 City/Stateqi :Lehi, UT 84043 Phone 0i 841-377-9111 A,ree,yy9wan employer?Check the appropriate boa,: Type of project(required): L I atn a employer with Jtq 4. [] 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 []New construction 2.[ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have S. [-]Demolition working for me in any capacity. employees and have workers' 9. E]Building addition [No workers'comp.insurance comp.insurance.; 10.�Electrical repairs or additions required..) 5. n We are a corporation and its 3. I am a homeowner doing all work officers have exercised:theta 1 LE]Plmmbing repairs or additions myself:[No workers'comp. right of exemption per MGM 12.. Roof repairs insurance required.)t c. 152,$1(4)„and we have no � Sty Installation [No!workers' 13.0 Other comp.insurance required-]1 'RRY appficant that checks box#h mast also fdt out the section betow shawfng their workers'eompamationi policy information. f Homeowners who submit this afftdavd indfeating they are doing all work and then hire:outside,contractoas must submit a new affidavit indicating such. ;Contractors that chuck this box must attached an additional sheet sliming the name of the sub-cornacton and state whether or not those entities have employees. if the sub-contractors have employees,they mast provide their workers'comp.policy number. ' lam arc employer that is provMag workers'corapewation arsumnee for my evW[ayees Bdow its the policy and job site information: Insurance Company Name:Zurit.h American Insurance Company Policy#or Self-ins.Lic.#t:WC 5I09601300 Expiration Date:11/1/2015 Job Site Address: I b i2m,L V1 % Ln 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 and penalties of perjury that the information provided above is true and correct Signature: Date• 1/4/2014 Phone#: 801-2296459 Offldal 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#: Offfice of Consumer Affairs End Business Regulation 10 Park Plaza - Suite 5170 Boston,, Massachusetts 02116 Home Improvement Contractor Registration Regiata�bw 17GW Type-.. Supo6meat.Card V[VINT SOLAR DEVELOPER LLC.. BRIEN LANGIL 4931 NORTH 300 WEST, PROVO, UT W,04 Tjl'pftte Adkbez ad re&wz ewd.I.&*remon fog cAmigo- SCA 1 0 20M-05/11- [I]i Ad*m Q Rmm d 0, 1 Fog0oyang Last-Ow..f we,,r ommamr Aft"*.&Mmw 3ev"Obw fautow ay r4sam"00 Val"&'r ladhoad am ftljy yet irwr- E**Jdm; 11&2016 a,*d, lAwla. PROVO.,UT WW4 Not ridid y. Massachusetts -Department of Public Safety Board of Building Regulations and Standards License:CS40667.5 BRIEN LANGRL..!r 312 UNION STREET -I; Hanover MA 02339 Expiration Commissioner 01109/2017 v'v'nt. SO I a 1 3301 North Thanksgiving Way, Suite 500 Structural Group TO IvniLehi, UT 84043 O BARNSTABLE P: (801) 234-7050 Scott E. Wyssling, PEj.5 Senior Manager of Engineering r scott1wysslingCa)vivintsolar.com revised ed Septemust 26 ber 015--�' Mr. Dan Rock, Project Manager Vivint Solar 3301 North Thanksgiving Way, Suite 500 Lehi, LIT 84043 Re: Structural Engineering Services Ferine Residence 16 Jenkins Ln, West Barnstable MA S-4540862 5.2 kW System Dear Mr. Rock: Pursuant to your request, we have reviewed the following information regarding solar panel installation on the roof of the above referenced home: 1. Site Visit/Verification Form prepared by a Vivint Solar representative identifying specific site information including size and spacing of members for the existing roof structure. 2. Design drawings of the proposed system including a site plan, roof plan and connection details for the solar panels. This information was prepared by the Design Group and will be utilized for approval and construction of the proposed system. 3. Photovoltaic Rooftop Solar System Permit Submittal identifying design parameters for the solar system. 4. Photographs of the interior and exterior of the roof system identifying existing structural members and their conditions. Based on the above information we have evaluated the structural capacity of the existing roof system to support the additional loads imposed by the solar panels and have the following comments related to our review and evaluation: Description of Residence: The existing residence is typical wood framing construction with the roof system consisting of the following: • Roof Section 1: Roof section is composed of 2x10 dimensional lumber at 16" on center with 2x8 collar ties every 16" and knee wall supports 8' from the ridge. The attic space is unfinished and photos indicate that there was free access to visually inspect the size and condition of the roof members. • Roof Section 2: Roof section is composed of 2x8 dimensional lumber at 16" on center with 2x8 collar ties every 16". The attic space is unfinished and photos indicate that there was free access to visually inspect the size and condition of the roof members. All wood material utilized for the roof, system is assumed to be Spruce-Pine-Fir #2 or better with standard construction components. The existing roofing material consists of composite shingle. Our review of the photos of the exterior roof does not indicate any signs of settlement or misalignment caused by overstressed underlying members. Stability Evaluation: A. Wind Uplift Loading 1. Refer to attached Ecolibrium Solar calculations sheet for ASCE/SEI 7-10 Minimum Design Loads for Buildings and other Structures, wind speed of 110 mph based on Exposure Category B and 45 and 22 degree roof slopes on the dwelling areas. Ground snow load is 30 PSF for Exposure B, Zone 3 per(ASCE/SEI 7-10). 2. Total area subject to wind uplift is calculated for the Interior, Edge and Corner Zones of the dwelling. , vivi nt. solar I r ' Page 2of2 B. Loading Criteria 10 PSF= Dead Load (roofing/framing) 30 PSF= Live Load 3 PSF= Dead Load (solar panels/mounting hardware) Total Dead Load= 13 PSF The above values are within acceptable limits of recognized industry standards for similar structures and in accordance with the 2009 International Residential Code. Analysis performed on the existing roof structure utilizing the above loading criteria indicates that the existing members will support the additional panel loading without damage, if installed correctly. C. Roof Structure Capacity 1. The photographs provided of the attic space and roof rafters show that the framing is in good condition with no visible signs of damage caused by prior overstressing. D. Solar Panel Anchorage 1. The solar panels shall be mounted in accordance with the most recent "Ecolibrium Solar Installation Manual", which can be found on the Ecolibrium Solar website (ecolibrium solar.com). If during solar panel installation, the roof framing members appear unstable or deflect non-uniformly, our office should be notified before proceeding with the installation. 2. The solar panels are 1 Yz" thick and mounted 41/2" off the roof for a total height off the existing roof of 6". At no time will the panels be mounted higher than 6"above the existing plane of the roof. 3. Maximum allowable pullout per lag screw is 205 Ibs/inch of penetration as identified in the Nation Design Standards (NDS) of timber construction specifications for Spruce-Pine-Fir assumed. Based on our evaluation, the pullout value, utilizing a penetration depth of 21/2", is less than the maximum allowable per connection and therefore is adequate. 4. Roof Sections (1 and 2): Considering the roof slopes, the size, spacing, condition of the roof, the panel supports shall be placed at and attached no greater than every fourth roof member as panels are installed perpendicular across members and no greater than the panel length when installed parallel to the members (portrait). No panel supports spacing shall be greater than four (4) spaces or 64"o/c, whichever is less. 5. Panel support connections shall be staggered to distribute load to adjacent members. Based on the above evaluation, with appropriate panel anchors being utilized the roof system will adequately support the additional loading imposed by the solar panels. This evaluation is in conformance with the 2009 International Residential Code, current industry standards and practice, and the information supplied to us at the time of this report. Should you have any questions regarding the above or if you require further information do not hesitate to contact me. V truly yours, �y�N OF `~e sc SLIN VIL Scott E. Wyssli , PE No.�507 MA License No. 505 A9o�9Fc/sTEP� C, ON AL�N6 b hvff in t. S O I a r TM 4931 North III West,Provo,UT 84104 Employer Identification No.: 80-0756438 VIVI1'1t.. so i a r Phone:(877)404-4129 Fax:(801)765-5758 Massachusetts HIC License Igo.: 170848 E-Mail: support@vivintsolar.com /15� O 6 www.vivintsolar.com AR No.: '�( RESIDENTIAL POWER PURCHASE AGREEMENT This RESIDENTIAL POWER PURCHASE AGREEMENT(this "Agreement") is entered into by d between VIVINT SOLAR DEVELOPER, LLC, a Delaware limited liability company("We","Us","Our")and the undersigned Customer(s)("You", `Your"),as of the Transaction Date set forth below. Full Name(First Last) Full Name(First,MI,Last) ryOwaer: Yes ❑No S ProperryOwner: ❑Yes ❑No Customer(s): Proper Telephone No.: 5 @$ . 60 E=Mail: C-C- � O b v+n0. co Property Street Address: Lin Address: City,County,State,Zip: W R o,r si-ok ©'Z 6 6$ 1.SERVICES A. DESIGN AND INSTALLATION. We will design,install,service and maintain a solar photovoltaic system on Your Property,which will include all solar panels,inverters,meters,and other components(collectively,the"System"),as further described in the Customer Packet and the Work Order that We will provide to You hereafter. All material portions of the System will be installed by Our employed technicians and electricians, and not subcontractors. With Your coo eration, We will (i) design, install and connect the System in material compliance with all applicable laws; (ii)complete all required inspections;andp(iii)obtain all required certifications and permits. In order to design a System that meets Your needs,You agree that We may obtain Your electrical usage history from Your electric utility(the"Utility")and You shall provide Us with copies of Your Utility bills as We may reasonably request. Other than the activation fee described in Section 1.B We will design and install the System at no cost to You. B. ACTIVATION. You agree to pay Us a one-time activation fee in the amount of$ We will interconnect the System with the Utility,and cause the System to generate energy measured in kilowatt hours ("kWh") (the "Energy' nstillation of the System generally takes one day and is anticipated to begin and be substantially complete between two(2)and six(6)weeks hereafter. . C. OWNERSHIP OF SYSTEM. We shall own the System as Our sole personal property. You will have no property interest in the System. D. OPERATIONS AND MAINTENANCE. We will operate and maintain the System(i)at Our sole cost and expense;(ii)in good condition;and(iii)in material compliance with all applicable.laws and permits and the Utility's requirements. E. INSURANCE. We carry commercial general liability insurance,workers' compensation insurance,and property insurance on the System. For more information concerning Our insurance,and to obtain a copy of Our certificate of insurance,please visit: www.vivintsolar.com/insurance. 2.TERM,PRICE,PAYMENTS,AND FINANCIAL DISCLOSURES A. ENERGY PRICE. For all Energy produced by the System,You shall pad Us$0. l!• $ per kWh(the"Energy Price"),plus applicable taxes. The Energy Price shall increase each year by two and nine-tenths percent(2.9/o)). A goo faith estimate of the System output,measured in mate hours, will be provided to You in the Customer Packet. THIS AGREEMENT IS FOR THE SALE OF ENERGY BY US TO YOU AND NOT FOR THE SALE OF A SOLAR ENERGY DEVICE. B. TERM. This Agreement shall be effective as of the Transaction Date and continue until the twentieth(20`h)anniversary of the In-Service Date(the "Term"). The"In-Service Date"shall be the first day after all of the following have been achieved: (i)the System has been installed and is capable of generating Energy,(ii)all permits necessary to operate the System have been obtained,(iii)the System has been interconnected with the Utility,and(iv)all inspections and certificates required under applicable law or by the Utility have been completed or received. C. PAYMENTS. Beginning with the first month following the In-Service Date and throughout the Term We will send You an invoice reflecting the charges for Energy produced by the System in the previous month. You shall make monthly payments to Us by automatic payment deduction from Your designated checking account or credit card. It is Your responsibility to ensure that there are adequate funds or adequate credit limit. There is no financing charge associated with this Agreement. For all pa ents more than ten(10)days past due,We may impose a late charge equal to Twenty-Five Dollars($25) l and interest at an annual rate of ten percent(1 %Tplus applicable taxes. If You continue to fail to make any payment within ten(10)days after We give You written notice,then We may exercise all remedies available to Us pursuant to Section 13(b). D. RENEWAL. At the end of the Term,You may elect to(i)continue with this Agreement on a year-to-year basis;(ii)enter into a new Agreement with Us and cancel this Agreement; (iii)purchase the System at the end of the Term and cancel this Agreement the "Purchase Option"); or(iv)cancel this Agreement and have the System removed at no cost to You. You will need to notify Us in writing concerning our election sixty(60)days prior to the end of the Term. If You elect the Purchase Option, the "Purchase Option Price" will be the then-current fair market value of the System based on an independent appraiser's valuation of similarly sized photovoltaic systems in Your geographic region. The appraiser's valuation will be provided to You in writing and will be binding. If We receive Your payment of the Purchase Option Price,costs of the appraisal,applicable taxes,and all other amounts then owing and unpaid hereunder,We will transfer ownership of the System to You at the end of the Term on an"As Is,Where Is"basis. If You elect to have the 'System removed,We will remove the System from Your Propertywithin ninety(90))dayys after the end of the Term. IF YOU DO NOT NOTIFY US OF YOUR ELECTION TO CANCEL BY SENDING'A WRITEN NOTICE 1`O US, THEN THIS AGREEMENT WILL AUTOMATICALLY RENEW ON A YEAR-TO-YEAR BASIS UNTIL YOU NOTIFY US IN WRITING OF YOUR ELECTION TO CANCEL AT.LEAST SIXTY(60) DAYS PRIOR TO THE END OF THE RENEWAL TERM. E. CREDIT CHECK. In connection with the execution of this Agreement and at any time during the Term,You hereby authorize Us to(i)obtain Your credit rating and report from credit reporting agencies; (ii) to report Your payment performance under this Agreement to credit reporting agencies; and (iii)disclose this and other information to Our affiliates and actual or prospective lenders,financing parties,investors,insurers,and acquirers. WE MAY HAVE PRESCREENED YOUR CREDIT. PRESCREENING OF CREDIT DOES NOT IMPACT YOUR CREDIT SCORE. YOU CAN CHOOSE TO STOP RECEIVING "PRESCREENED" OFFERS OF CREDIT FROM US AND OTHER COMPANIES BY CALLING TOLL-FREE (888) 567-8688. SEE PRESCREEN & OPT-OUT NOTICE(SECTION 29)BELOW FOR MORE INFORMATION ABOUT PRESCREENED OFFERS. 3.LIMITED WARRANTY A. LIMITED INSTALLATION WARRANTY. We provide a workmanship warranty that the System shall be free from material defects in design and workmanship under normal operating conditions for the Term. We further warrant that all rooftop penetrations We install shall be watertight as of the date of installation. We do not provide any warranty to You with respect to any component of the System. Any manufacturer's warranty is in addition to,not in lieu of, this limited installation warranty. This warranty does not cover problems resulting from exposure to harmful materials and chemicals, fire, flood, earthquake,or other acts of god,vandalism,alteration of system by anyone not authorized by Us,or any other cause beyond Our control. B. MANUFACTURERS' WARRANTIES. The System's solar modules carry a minimum manufacturer's warranty of twenty(20) years as follows: (a)during the first ten(10)years of use,the modules'electrical output will not degrade by more than ten percent(10%)from the originallly rated output;and b during the first twenty(20)years of use, the modules' electrical output will not degrade by more than twenty percent(20%)from the originally rated output. The System's inverters carry a minimum manufacturer's warranty of ten 00)years against defects or componetiit breakdowns. During the Term,We will enforce these warranties to the fullest extent possible. C. DISCLAIMER OF WARRANTY. EXCEPT AS SET FORTH IN THIS SECTION 3, WE MAKE NO OTHER WARRANTY TO YOU OR ANY OTHER PERSON, WHETHER EXPRESS, IMPLIED OR STATUTORY, AS TO THE MERCHANTABILITY OR FITNESS FOR ANY PURPOSE OF THE EQUIPMENT, INSTALLATION, DESIGN, OPERATION, OR MAINTENANCE OF THE SYSTEM, THE PRODUCTION OR DELIVERY OF ENERGY, OR ANY OTHER ASSOCIATED SERVICE OR MATTER HEREUNDER, ALL OF WHICH WE HEREBY EXPRESSLY DISCLAIM. OUR LIABILITY FOR ANY BREACH OF ANY WARRANTY IS LIMITED TO REPAIRING THE SYSTEM OR YOUR PROPERTY TO THE EXTENT REQUIRED UNDER THIS AGREEMENT. YOU ACKNOWLEDGE THAT WE ARE RELYING ON THIS SECTION 3.C. AS A CONDITION AND MATERIAL INDUCEMENT TO ENTER INTO THIS AGREEMENT. THERE ARE NO WARRANTIES WHICH EXTEND BEYOND THE DESCRIPTION OF THE FACE HEREOF. 4.REMOVAL OF THE SYSTEM You shall not make anv Alterations(as defined in Section 9(c))to the Svstem. If You want to make renairs or imnrovements in Vnnr Pronerty that re fire. (i)any-aspect of the relationship between You and Us,whether based in contract,tort,statute or any other legal theory;(ii)this Agreement or A any other agreement concerning the subject matter hereof; (iii) any breach, default, or termination of this. Agreement; and (iv)the interpretation,validity,or enforceability of this Agreement, including the determination of the scope or applicability of this Section 5(each,a "Dispute")). Prior to commencing arbitration,a party must first send a written"Notice of Dispute'via certified mail to the other party. The Notice of Dispute must describe the nature and basis for the Dispute and the relief sought. If You and We are unable to resolve the Dispute within thing (30) days, then either party ma commence arbitration. The arbitration shall be administered by JAMS pursuant to its Streamlined Arbitration Rules and Procedures available at: http://www.jamsadr.com/rule4streamlined-arbitration, the"JAMS Rules')and under the rules set forth in this Agreement. The arbitrator shall be bound by the terms of this Agreement. No matter the circumstances,the arbitrator shall not award punitive, specjai, exemplary, indirect, or consequential damages to either party. If You initiate arbitration, You shall be responsible to pay $250. All attorneys' fees, travel expenses; and other costs of the arbitration shall be borne by You and Us in accordance with the JAMS Rules and applicable law. The arbitration shall be conducted at a mutually agreeable location near Your Property: Judgment on an arbitration award may be entered in any court of com etent jurisdiction. Nothing in this Section 5 shall preclude You or We from seeking provisional remedies in aid of arbitration from a court of competent jurisdiction. NOTICE: BY INITIALING IN THE SPACE BELOW YOU ARE AGREEING TO HAVE ANY DISPUTE ARISING OUT OF THE MATTERS INCLUDED IN THE "ARBITRATION OF DISPUTES" PROVISION DECIDED BY NEUTRAL ARBITRATION AS PROVIDED BY APPLICABLE LAW AND YOU ARE GIVING UP ANY RIGHTS YOU.MIGHT POSSESS TO HAVE THE DISPUTE LITIGATED IN A COURT OR JURY TRIAL. BY INITIALING IN THE SPACE BELOW YOU ARE GIVING UP YOUR JUDICIAL RIGHTS TO DISCOVERY AND APPEAL. IF YOU REFUSE TO SUBMIT TO ARBITRATION AFTER AGREEING TO THIS PROVISION, YOU MAY BE COMPELLED TO ARBITRATE. YOUR AGREEMENT TO THIS ARBITRATION PROVISION IS VOLUNTARY. YOU HAVE READ AND UNDERSTAND THE FOREGOING AND AGREE TO SUBMIT DISPUTES ARISING OUT OF THE MATTERS INCLUDED IN THE "ARBITRATION OF DISPUTES" PROVISION TO NEUTRAL ARBITRATION. CustornyQ Initials: I/WE AGREE TO ARBITRATION AND WAIVE THE RIGHT TO A JURY TRIAL: 6.NOTICE TO CUSTOMERS A. LIST OF DOCUMENTS TO BE INCORPORATED INTO THE CONTRACT: (i)this Agreement, (ii) the A VditioalTerms and Conditions,(iii)the Customer Packet,and(iv)the Work Order. These documents are 2xpressly incorporated into this Agreement and apply to the relationship between You and Us. B. IT IS NOT LEGAL FOR US TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REMOVE GOODS INSTALLED UNDER THIS AGREEMENT. C. DO NOT SIGN THIS AGREEMENT BEFORE YOU HAVE READ ALL OF ITS PAGES. You acknowledge that You have read and received a legible copy of this Agreement, that We have signed the Agreement, and that You have read and received a legible copy of every document that We have signed during the negotiation. D. DO NOT SIGN THIS AGREEMENT IF THIS AGREEMENT CONTAINS ANY BLANK SPACES. You are entitled to a completely filled in copy of this Agreement,signed by both You and Us,before any work may be started. E. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO THE LATER OF: (1)MIDNIGHT OF THE THIRD (3RD)BUSINESS DAY AFTER THE TRANSACTION DATE,OR((HIi))THE START OF INSTALLATION OF THE SYSTEM. SEE THE NOTICE OF CANCELLATION BELOW FOR AN EXPLANATION OF THIS RIGHT. VIVINT SOLAR DEVELOPER,LLC CUSTOMER(S): By: By: Printed Name: Printed Name: Title: By: Printed Name: Transaction Date: A Kq 4 ZO l 5 FOR INFORMATION ABOUT CONTRACTOR REGISTRATION REQUIREMEN , CONTACT THE MASSACHUSETTS OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATION: TEN PARK PLAZA, SUITE 5170, BOSTON, MA 02116, (617)973-8700 OR 888-283-3757. [NOTICE OF CANCELLATION S 1) Oar Transaction Date: u 4 ZO 5 AR No.: l G O YOU MAY CANCEL TIUS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE (3) BUSINESS DAYS OF THE ABOVE DATE, OR (IF LATER) UNTIL THE .START OF INSTALLATION OF THE SYSTEM. IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE, OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY(20) DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM,TO VIVINT SOLARDEVELOPER,LLC,AT 4931 N 300 W,PROVO,UT 84604 PRIOR TO THE LATER OF: (1) MIDNIGHT OF THE THIRD (3 BUSINESS DAY AFTER THE TRANSACTION DATE, OR(II) THE START OF INSTALLATION OF THE SYSTEM. I HEREBY'CANCEL THIS TRANSACTION: Date: Customer's Signature: i a x iv < o � . 0 m s= o � cm/) Z N - - - m - - F , I I I � I L 1 c3mz I m �� mrz m mAn 3� 'm, O mr Fn z I mo 0 m , I A D O n r1 z 0 CAIO z 0z � o z zm 0 I ' 3 z 0 I Z� C � 00 Ov I I rF i m in .-0 F Z E Z O A tr CND 00 I =7� m z i /A z00Hr/� D I m=X , D= pm0 39 I ; J P'T7 N I O ` m C I y I 0 w � w N Ziff m oo T m Coo O U) 1 o - m Um_ _ _ _ _ _ _ _ _J Z C_ >m INSTALLER:VIVINT SOLAR m ! INSTALLER 404429 Ferine Reside VIVInceITE m 16 Jenkins LnPV 1.0 mm S HMA LICENSE:MAHC 170848 ti I A PLAN DRAWN BY:JV AR 4540862 Last Modified:8/25/2015 UTILITY CCOUNTS NUMBER:01426 6 445 0041 r m Z 0 O Nm Wm w� AAA 0 o O vA SCCD �n NN N 20 J 1 I I I �G 3 y O-1 0X CZ m0 Cn;t o RNO �O N C D C r cn \1 -< v, cn 0M rn CZ m0 II m cn� X - -O O Q O n v i z 0 r Z m C i D[A, INSTALLER:VIVINT SOLAR • • Ferine Residence m ROOF m m INSTALLER NUMBER:1.877.404.4129 �'�'�� Ln PV 2.0 p m m MA LICENSE:MAHIC 170848 West Barnstable,MA 02668 PLAN DRAWN BY:JV AR 4540862 Last Modified:8/25/2015 UTILITY ACCOUNT NUMBER:1426 445 0041 CLAMP MOUNTING a) SEALING (� PV3.0 DETAIL WASHER c ^' N LOWER =a cr SUPPORT N y m m ^,W___io ® NYGn 1.1� y Z LL�%z PV MODULES, TYP. MOUNT "~ .: :,.,. y...,.<.„x., m0 U OF COMP SHINGLE ROOF, FLASHING L 3Q PARALLEL TO ROOF PLANE 2 1/2" MIN L 5/16"P1 x 4 1/2" PV ARRAY TYP. ELEVATION MINIMUM STAINLESSSTEEL LAG SCREW NOT TO SCALE TORQUE=13±2 ft-Ibs CLAMP ATTACHMENT NOT TO SCALE N N N CLAMP+ ATTACHMENT •� CANTELEVER U4 OR LESS COUPLING L=PERMITTED CLAMP ECO SPACING SEE CODE COMPLIANT COMPATIBLE LETTER FOR MAX ALLOWABLE N MODULE CLAMP SPACING. a N PERMITTED COUPLING m a v CLAMP+ CLAMP o ATTACHMENT SPAC IN CLAMP F w y COUPLING PHOTOVOLTAIC MODULE Z w .. mIxn > J J Z 00 W U_ F J fn fn Q m. . Z z � o SHEET NAME: 11-2PORTRAIT CLAMP SPACING , Z ECO p CLAMP SPA I MODULE PV SYSTEM MOUNTING DETAIL SHEET CLAMP SPACING NUMBER: .- MODULES IN PORTRAIT/LANDSCAPE NOT TO SCALE 1 M NOT TO SCALE • Q. DC Safety Switch Notes: Rated for max operating condition of inverter NEC 690.35 compliant g `opens all ungrounded conductors L5 Notes: SE6000A-US-U Inverter Specs:CEC w ALL CONDUCTORS AC 240V N«z AC Operating Voltage 240V N Z Continuous Max Output 25A E Z SHALL BE COPPER DC Maximum Input Current 18A U Solar Edge Optimizer Specs: N P300 DC Input Power 300W LL DC Max Input Voltage 8-48V DC Max Input Current 12.5A Design Conditions: DC Max Output Current 15A ASHRAE 2013 Max String Rating 5250W i.� Highest Monthly 2%DEI Design Temp 35.6eC. Module Specs: 20 PV MODULES PER INVERTER=5200 WATTS STC Lowest Min.Mean Extreme DES -17'C Trina Solar TSM-260PD05.08 1 STRING OF 10 PV MODULES VOC Temp coefficient V/eC 1 STRING OF 10 PV MODULES SOLAREDGE Short Circuit Current(Isc) 9.00A SE6WDA-U&U Open Circuit Voltage(Voc) - 38.2V INVERTER System Specs: Operating Current(Imp) 8.50A 'F a Max DC Voltage 500V Operating Voltage(Vmp) 30.6V C s - o , o tD RED Nominal DC Operating Voltage 350V Max Series Fuse Rating 15A E SWITCH Max.DC Current per String 15A STC Rating(Pmax) 260W ts - - - - Nominal AC Current 25A Power Tolerance -0/+3% SOLAREDGE •It—mJ•I+�1 m_o a o—�J.6 1. m Lt L2 N P300 OP TIMIZERS SUPPLY-SIDE d SOLAR TAP EXISTING NEC 705.12(A) M ENTRANCE 2 e e e 08 to CONDUCTORS o RATED: 100A N U a — — �+ Q _ 1 Siemem eLNF222R SI.—#GF222R Z M i 80N240V UNFUSED 60A240V FUSED NEMA3 > Z o 0 0—0 J _ i NEMA70R EOUNALENT OR EOUNALENT 1 W Ix2 m SOLAREDGE VuionM.1.6% w P300 0PTIMIZERS t00A V2&2S Q 40A Z Z M O EXISTING SHEET NAME: 240V/100A AC Q ----- LOAD-CENTER z jr SRE VISIBLE J METERTER LOCKABLE Q 'KNIFE'AM 2 DISCONNECT !� SHEET NUMBER: PV WIRE IN FREE AIR INTO THWN-21N 3/4"EMT MINIMUM B AWG CU WIRE(RATED 90 DEG CI IN 3/4"EMT CONDUIT.KEEP UNDER 2%VOLTAGE DROP.MINIMUM ^/ CONDUIT.Ll,L2,AND NEUTRAL;8 AWG GROUND WIRE. 9 O 30 AWG CU WIRE EACH(RATED 90 DEG C).6AWG BARE KEEP UNDER 1.5%VOLTAGE DROP. - COPPER EGC. LLJ N o COMP.SHINGL V m m� A\ mN rj O C Q d cl) cy� 4 � y mEz - - 0 s 4: eiE. C-.V' •L t N Alt 3 OOF SECTION 2 MODULES LL qf - x - w - �•' 4 - r op r z t� yi N L � m _ a � m c Q 0 Z coQ 5 5 Z) M Z 1�1 fir' W W Z m J w -. �! � •-Y.�,r:� OOFSECTIONI S ¢ J v 18 MODULES y U) < Q SHEET �► .,; NAME: �0 w WOULD REQUIRE TRENCHING 0 J SHEET NUMBER: USAGE CONSTRAINT 91%CUSTOMER USAGE OFFSET EcolibriumSolar Customer Info Name: 4540862 Email: Phone: Project Info Identifier: 46859 Street Address Line 1: 16 Jenkins Ln Street Address Line 2: City: West Barnstable State: MA Zip: 02668 Country: United States System Info Module Manufacturer: Trina Solar Module Model: TSM 260-PD05.08 Module Quantity: 20 Array Size (DC watts): 5200.0 Mounting System Manufacturer: Ecolibrium Solar Mounting System Product: EcoX Inverter Manufacturer: SolarEdge Technologies Inverter Model: SE6000A-US (240V) Project Design Variables Module Weight: 43.0 Ibs Module Length: 65.0 in Module Width: 37.0 in Basic Wind Speed: 100.0 mph Ground Snow Load: 40.0 psf Seismic: 0.0 Exposure Category: B Importance Factor: II Exposure on Roof: Partially Exposed Topographic Factor: 1.0 Wind Directionality Factor: 0.85 Thermal Factor for Snow Load: 1.2 Lag Bolt Design Load - Upward: 820 Ibf Lag Bolt Design Load- Lateral: 288 Ibf EcoX Design Load - Downward: 722 Ibf EcoX Design Load- Upward: 765 Ibf EcoX Design Load - Downslope: 297 Ibf EcoX Design Load- Lateral: 233 Ibf Module Design Moment—Upward: 3655 in-lb Module Design Moment—Downward: 3655 in-lb Effective Wind Area: 20 ft2 Min Nominal Framing Depth: 2.5 in Min Top Chord Specific Gravity: 0.42 f EcolibriumSolar Plane Calculations (ASCE 7-10): Roof 1 Roof Shape: Gable Edge and Corner Dimension: 3.0 ft Roof Type: Composition Shingle Stagger Attachments: Yes Average Roof Height: 15.0 ft Include Snow Guards: No Least Horizontal Dimension: 24.0 ft Roof Slope: 45.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 33.6 33.6 33.6 psf Slope Factor 0.46 0.46 0.46 Roof Snow Load 15.5 15.5 15.5 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -20.7 -24.3 -24.3 psf Net Design Wind Pressure Downforce 19.4 19.4 19.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -20.7 -24.3 -24.3 psf Design Wind Pressure Downforce 19.4 19.4 19.4 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.6 2.6 2.6 psf Snow Load 15.5 15.5 15.5 psf Downslope: Load Combination 3 9.5 9.5 9.5 psf Down: Load Combination 3 9.5 9.5 9.5 psf Down: Load Combination 5 13.5 13.5 13.5 psf Down: Load Combination 6a 16.3 16.3 16.3 psf Up: Load Combination 7 -11.3 -13.5 -13.5 psf Down Max 16.3 16.3 16.3 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 83.4 83.4 83.4 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 80.0 80.0 80.0 1 in Max Cantilever from Attachment to Perimeter of PV Array 27.8 27.8 27.8 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 63.0 63.0 63.0 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 21.0 21.0 21.0 in r EcolibriumSolar Layout t I i i I I i i I f I I 1 f ILI I J , I I j 1 i I i I i I i o I Skirt Coupling Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal expansion and contraction. See Installation Guide for details. O Clamp Warning: PV Modules may need to be shifted with respect to roof trusses to comply with 0 Bonding Jumper maximum allowable overhang. l f EcolibriumSolar Roof Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 18 Weight of Modules: 774 Ibs Weight of Mounting System: 62 Ibs Total Plane Weight: 836 Ibs- Total Plane Array Area: 301 ft2 Distributed Weight: 2.78 psf Number of Attachments: 31 Weight per Attachment Point: 27 Ibs EcolibriumSolar Plane Calculations (ASCE 7-10): Roof 2 Roof Shape: Gable Edge and Corner Dimension: 3.0 ft Roof Type: Composition Shingle Stagger Attachments: Yes Average Roof Height: 15.0 ft Include Snow Guards: No Least Horizontal Dimension: 20.0 ft Roof Slope: 16.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 33.6 33.6 33.6 psf Slope Factor 0.99 0.99 0.99 Roof Snow Load 33.3 33.3 33.3 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Net Design Wind Pressure Downforce 11.4 11.4 11.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Design Wind Pressure Downforce 16.0 16.0 16.0 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.6 2.6 2.6 psf Snow Load 33.3 33.3 33.3 psf Downslope: Load Combination 3 9.5 9.5 9.5 psf Down: Load Combination 3 33.2 33.2 33.2 psf Down: Load Combination 5 12.1 12.1 12.1 psf Down: Load Combination 6a 32.7 32.7 32.7 psf Up: Load Combination 7 -10.2 -17.7 -27.3 psf Down Max 33.2 33.2 33.2 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 58.5 58.5 58.5 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 19.5 19.5 19.5 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 44.2 44.2 44.2 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 32.0 32.0 32.0 in Max Cantilever from Attachment to Perimeter of PV Array 14.7 14.7 14.7 in EcolibriumSolar Layout i { i Skirt o Coupling Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal expansion and contraction. See Installation Guide for details. O Clamp Warning: PV Modules may need to be shifted with respect to roof trusses to comply with 0 Bonding Jumper maximum allowable overhang. . EcolibriumSolar Roof Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 2 Weight of Modules: 86 Ibs Weight of Mounting System: 62 Ibs Total Plane Weight: 148 Ibs Total Plane Array Area: 33 ft2 Distributed Weight: 4.43 psf Number of Attachments: 31 Weight per Attachment Point: 5 Ibs r Ecolibr�umSolar Bill Of Materials Part Name Quantity ECO-001_101 EcoX Clamp Assembly 31 ECO-001_102 EcoX Coupling Assembly 26 ECO-001_105B EcoX Landscape Skirt Kit 2 ECO-001 105A EcoX Portrait Skirt Kit 4 ECO-001_103 EcoX Composition Attachment Kit 31 ECO-001_116 EcoX Flat-Tile Flashing 0 ECO-001_117 EcoX S-Tile Flashing 0 ECO-001_118 EcoX W-Tile Flashing 0 ECO-001_363 EcoX Lower Support-Tile 0 ECO-001_109 EcoX Electrical Assembly (optional) 2 ECO-001_106 EcoX Bonding Jumper Assembly 4 ECO-001_104 EcoX Inverter Bracket Assembly 0 ECO-001 338 EcoX Connector Bracket 0 ECO_001-359 EcoX Lower Support- Low Slope 0 R TOWN OF BARNSTABLE,BUILDING PERMIT,APPLICATION t Map Parcel` PP A lication 42 mrnf • Health Division ' ` Date Issued Conservation Division ` Application Fee L 4K Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address Village n 1 Owner Address Lo - Telephone Z8 -1a Lo Permit Request d 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 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 I Q Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood coal sto e) ❑Xeres ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing fl newf size— Attached n G!7 Attached garage: ❑ existing ❑ new size _Shed: ❑ existing (new size 100( 3ther: N Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION 7 (BUILDER OR HOMEOWNER) Name'S, _ �el A"�� Telephone Number gslD Address � Pfl�(1 License# ` L Home Improvement Contractor# /&Dq Worker's Compensation #(kpCC gs,y gg� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOQb-7q t�)L)eCn AnrV SIGNATURE DATE L 4 P ° FOR OFFICIAL USE ONLY APPLICATION# c DATE ISSUED MAP/PARCEL NO. ! ADDRESS I VILLAGE = OWNER DATE OF INSPECTION: ; FOUNDATION vvX FRAME INSULATION FIREPLACE 6 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH 'FINAL GAS: ROUGH FINAL - FINAL BUILDING I `. DATE CLOSED OUT I ASSOCIATION PLAN`NO. 1 I 03/10/2010 13:14 5084301115 PINE HARBOR PAGE 01/01 v The Commonwealth of Massachusetts" ,Department of IndustrlalAcctdents _ -Office of lnvestibattons:;- 600 Wasiti grton Street Boston,MA 02111 • www mass.gov/dia ! ' Workers' ComPensafion Insurance Affidavit:Builders/Contrac'tots/Electricians/Plumbers Applicant Information i Please Print Legibly Name(Bu3iness/0r9Wdzatiorzl)ndtvtdyal) �� d A Address. •u � {\ \ ? •\ \\ 1C...`: t�u. '.' y" '�b: �•� ?�" City/State/Zin.1 (,,h - � � Phone#: �� 1�c 'tam Are you an employer?Check the appropriate box: type of project(required): 1.Rfam a employer with 4• ❑ I am a general contractor and 1 . employees(full an(/or part-tithe).* have hired the sub-contractors 6 ❑New construction R listed on the attacbed sheet. �. ❑ emodeling 2.❑ I am a sole proprietor or partner- i ship and havo no employees These sub-contractors have 8. ❑Demolition working for me in'any capacity. employees and hive workers' ❑Building addition [No workers'comp.insurance Comp'° surance. ts 10.[]Electrical repairs or aMiiic as required i 1 S. ❑ We are a corporation and 3.❑ 1 am a homeowner doing all work b5cers have exercised their )l.❑Plumbing repairs or additi myself.[No workers'comp. right of exemption per MOL 12.Q Roof repairs insurance required.]t c. 152,§1(4),and we have no !mployees,[No workers' 3.❑Other con ,Wsurance required) *My applicant that checks box 61 must also till out the section below showing their workers'compensation po4cy infomu;tion. 1 Homeowners who submit this affidavit indicating they are doing all vvork'snd thou bite outside contractors mns it svbrnir a new affidavit indicating such. tCont metors that check this box must attaaged ap �hxt.�hq�y �h`,v+u?!�P�Iib?4 whe�haioI clot those entities have employees. If the subcontractors have have aoloyees,they must provide their workers*comp.policy number- I y I ant an eo plover that is providing workers'eonvensation Insurance for mly employees.;Below is the policy andlob sire informations insurance Company Nance: 1'= Policy#or Self-ins.Lie.#: 4'�71C �i Bxpiration D Job Site Address, ��� ` �� City/StOzip� �' (� �� coca-0"S Attach a copy of the workers'compensation policydeclpration page(sbowing the pojkicy number and:e�pitratioa dat ). Failure to secure covdrage as required under Section 25A of MGL e: 152 can lead to the Oposition of criminal penalties ol a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form ,f a STOP WORK ORDER and a fuse 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 Investiizations of tho DIA for insurance cover a verification. I do hereby cer ' der the part'andpenamA of perjury that the Wormation providgd above Is true and'corr= store �" e Date• one 70—p—M use only. Do not wrue in this area,to a Congo eted by coy or town of ciaL City or Town: permittLicense# Issuing Authority(circle one): 1.Board of Health`2.Building Drepartment 3. City/Town Clerk 4.Electrical In.Vector 5.Plumbing Inspector ' 6.Other Contact Person' Phone M I s Date:-4/20/2010 Time: 9:49 AM To: 9,15087717070 Rogers & Gray Ins. Page: 002 T.. Client#:20245 MCGRPOS ACORD,. CERTIFICATE OF LIABILITY INSURANCE704120110°°""") 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 P.O.Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Dennis, MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Prop.Casualty Co.of Amer McGrath Post Beam Corp INSURERS: ACE Property&Casualty Ins.Co. dba Pine Harbor Wood Products INSURERC: 259 Queen Anne Rd INSURER 0: Harwich,MA 02645 INSURERE: 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 I NSA TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MMIODIYY DATE MMIDDIYY LIMBS A GENERAL LIABILITY 16602016N498TIA10 01/31/10 01/31/11 EACH OCCURRENCE $1 000 000 )( COMMERCIAL GENERAL LIABILITY DAMAGE TMae,.) RENTED PREMISES occurre ca $100 000 CLAIMS MADE a OCCUR MED EXP(Any one person) $5 000 PERSONAL 8 ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY F1 PRO LOC JECT A AUTOMOBILE LIABILITY BA4487B68610SEL 01/31/10 01/31/11 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ X NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (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 G45779944 07/08/09 07/08110 X WC nRYsTATuIMIT- FR EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $100,000 ANY PROPRIETORIPARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE:John Ferine,16 Jenkins Lane,W.Barnstable,MA CERTIFICATE HOLDER CANCELLATION .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S50706/M50572 MEE o ACORD CORPORATION 1988 r 03/1.0/2010 12:49 5084301115 PINE HARBOR PAGE 01/01 I Boar o • ui Mg egu ff s an 11l " s One Ashburton Place Rohm 130i o�ton, Mass c1 Us 02108 Construction ' .' pis-0r:Lizeri e'. .... ' IVlussuchuSetts-Acp:trtnncnt G F Public Safet} M • Board of Building; Rc4rulation and Standard: Y Construction Supervisor icense N R W iLlcense: CS 738W JAMES"R MCGRATH - d Resttyctedto: 1G 204 CRANVIEW RD BREWSTER, MA 02631 JAM.=s R MCGRATH e 204 CRANVIZW RD e�M vgti` BREWSTER, MA0263.1 0P5-cA1 0 SOLW/07-Pc8490 — ^ � Expira ion: 3A42012 C'umna�sioncr r#: 19385 rA2 .Board of Building Regulalibils and Sta6dards ' One Ashburton Place - Room 1301 Boston.-Massachusetts 02108 Home ContractozrR6�istration Registration: 132935 Type: Private Corporation " :Expiration; 10/31/2010 Tr# . 5309 McGRATH POST & BEAM CO. . • . JAMES MCGRATH ; _.:. :... .. : ... . - ---._...._.. 259 QUEEN ANNE FAD_ ;. . . . _ _. .. HARWICH, MA 02645 ` Update Address and return card.Mark reason or change. Address '; Renewal '. Employment Lost Card c_.. D1-8CAI 0 50M-OV08-PIC649a ✓ �t6 rpp�)tostrylu[K� o�✓�Za40QCh�lldf ` Boardof Building Regulatidns and Standards License or registration valid for individul use only DOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registi-4- 132935 Board of Building Regulatiofis and Standards I=Xpir t ohr• 10/31/2010 Tr# 275309 One Ashburton Place Rrii 13.01 I?itvate Co tlon• - ,, Boston,Ma.02108 McGRATPO A�11fQ, {:, Ni!?.il�7,T?tt ;q Cl H S7 JAMES McGRAr-H* 259 QUEEN ANNE,RCk:.,• ' r r i HARWICH•MA 02645' Administrator " ' t valid without signature U. r 07/06/2009 12:32 5064301115 PINE HARBOR PAGE 01/01 ., 326 Xaxtoutki.IZd. kiXANN'IS 50g^777-500 • ' hyanM6*pixie11axb r.colxi : . 259 Quben,Axe 6 R I•• H,A.RWI(:H.• 508•-430- 800 PIN E 'HARBOR .. izt�o�iix<eharbor.c�in ' 'OVOOD PRODUCTS � � • It's all about she wood� • . 800-368-SHED'(�433)� •www:pin�harb r.com Owner Authcrizatidn ;. as own Ar`of•tlie'propetty located a (Property address authorize I #O.act Qn.'rriy'behaff (Name cif contractor/agent) in all matters•rel'ative'to work aAtborized b' huildin permit-appil -bon. . .� Owrt�r's Signature: . • � • . V. .Date: �.� I 3 297.69' ` DRAINAGE EASEMENT a o W N W O T. , 4 N 4 ® 0 n '� 43,799 s f \ O,F 148.0' 36co 68 2 ^ L� 0 �� Of o 60, J�� L=219.02' s 2*00--- w 4+00 (so, I wipF� 3+Op k LAIN a 1 10 19 89 INITI"tE CF ' N0. DATE DES THIS PLAN IS NEITHER INTENDED AS-BUILT FOUNDAT i FOR, NOR SHALL IT. BE' USED FOR �NKINSMORTGAGE LOAN PURPOSES: . . "HARNSTABLE, MGREENBRIER DEVE SCALE: 1' 50' JOB N0. 1120/11204oeb Z� ChG � PA U L A. 0 50 100 'I 'CERTIFY THAT .THE FOUNDATION Z LEVY ., SHOWN ON THIS PLAN IS LOCATED No. 10617 " I S INDIC ON THE GRO IM KORB 't i(AGIP ASSOr�ATFS��C. yUmBCIPL.pm 11 m (l —� cEliT6RVIIla MA 02632 DA RE IS RED LAN SURVEYOR ese >�s'r UATM t, PINE OR Framin : WOOD PRODUCTS g 2x4 Rafters @ 2' on center 326 Yarmouth Road • Hyannis, MA 02601 • 508-771-5007 • hyannis@pineharbor.com (2X6 for larger buildings) 259 Queen Anne Road • Harwich,MA 02645 • 508-430-2800 • infoQpineharbor.com 800-368-SHED (7433) • www.pineharbor.com I x6 Gussets 2x4 Collar ties 1X6 GUSSETS (2x6 for larger buildings) 2X6 RAFTERS 4x4 Top plates (4x6 for larger buildings) 2X6 COLLAR TIES 4x5:Corner & Center posts 4X6 TOP PLATES 2x4 Purlins 2x4 Door & Window frame 4X4 ANGLE BRACES 4x4 Angle bracing 2x6 P.T Floor frame 4X5 CORNER POSTS 2x4 P.T Ledger board 2X4 PURLINS 5/8 Floor & Roof plywood 5/8 PLYWOOD 1 x 12 S 1 S Pine board siding Note: 2X6 P.T FLOOR FRAME Rafters fastened with simpson H2.5A clips 2X4 P.T LEDGER Or 3 timberlok screws - ;� '$�F 4X5 CENTER POSTS Beams fastened to posts using simpson AC,ACE, or LCE post caps (depending on if the post 2X4 DOOR 8: WINDOW FRAME Is midspan or at end) installed in accordance with the Simpson C-2008 catalog o� ;,r, Vertical posts to'be connected to sono tubes using h1c. `NZ1 Simpson ST HD 8RJ straps installed in accordance wit] � j' u: 3 The simpson C-2008 catalog t�F�G/S7 P���4%"•�li(l0� All purling, angle braces, and other minor elements to Be connected to posts,or beams using a minimum of 3 Timberlok screws Pine Harbor sheds from 6x8 to 12x24 with roof pitches up to 12:12 L FRAMING— lei t ..OF4 Dirnemion Pine) INE2"2 6 Rafters z'oacenters FIARBOR CLASSIC CAPE FOOD PRO.1�L CTS :' •. (xx for iz':shed widths) POST AND BEAM SHED • 2"x 4"Loft Joists O 4'on centers 16-dll about the wood-" 6x6.for 'shed widths) • 4"x 4"Top Plate Beams • 4"x.4"Center Support Posts ,,,�s.�- '- 4 • 4"X S"Comer Posts are 6?tall• x 4"Corner Braces • 2- `z4"Wall Purlins ,' �" • 2»z 4"Door and, frames r , S/"71 d flooring . d is optional • z"z 6"PT Floor Joists 0 i6"o.c. - -•, (zx8 PT for'&shed widths) \, ^sa =* %:`` • Rough Pine Trim(primed pine or x r, red cedar is optional) • .8"x 8"Aluminum Louvei Vents • Standard Board-and Batteai Siding clapboards or white cedar-sliiiigles .l are optional ROOFING: 5/8".CDX roof rhea • Choice of shingles and colors . w;tr _ Yss ,;,- , • FREE Pressure-Treated Ramp. :=" "• �� : ':w4"""' '-` ''= NOTES. • Stock and Custom doors- and-windows are available • Concrete Block or,optional -Sonoube footings are available T pith a roof pitch of ro%,and including a 4 foot storage loft,•this is the perfect style for the"pack rat" The loft provis storage space f or small and seasonal items such as beach.chairs and hoses,-mobile maintaining optimal Wall and floorspace..This deign adds New England character! J ' FRAMINGi ..(F R IIimension Pine) SINE � �OR CLASSIC CAPE ''2"cam forxafters zvi WOOD PRODL CTS s ' e� dths) + Its rt11 about the ic>ood" POST AND BEAM SHED • 2"It 4"I,oftJoists 0.q:''on centers ' Czc6.for&shed widths) • 4"x 4"Top Plate Beams' • 4"x 4"Center Support Posts NI 4 • 4".z 5"Comef Posts are 6Y tall x . J Corner Braces , 3 4 f ,,: • z"g 4"Wail Puffins r '" ~:; • e z 4"Door and V�mdow frames r' "M: • 5/81 CCDX d flooring ' •. Y. ~f µ+wJY14�ted is 6pti6m]) y , �, 4 • 2" 6"PT Floor joists 0 W o c. R �PT for.r2 Shed Wl r. Rough Pine Trim(primed pine or { red cedar is optional) ' • 8"x 8"Alumiiium Louvei-Vents ' • Standard Board-and Battey Siding . — clapboards or jute ced rrdmrgles .are optional 'r ROOFING. . 5/8"CDX roofiheath • Choice of shingles and colars . FREE PressuareTreated Ramp :,r. NOT +'S• 7�1 =.�• Stock and Custom.doQrs•and windows are available ~ Goncrtte Block or optional .Sonofube footings are available With a roofpiiab of io/iz,and including a4 footstorage 10ft,.6rs u the perfectstyle.for zhe"pack rat" The loftprovi&s storages formz�tll and seasonal stems such as beach.chairs and hoses,-.-while-maintavung optimal wall and floor space. This design adds New-England cha=ter.. -t FRAMING- .(Pull Dimension Pine) PINOR CLASSIC CAPE 2" 4"Raftems c�z'omrcenters WOOD PRODi:CTS i (zx6 for=2':shecl wic}tlis) It 'r 11 about the mood"'It AND BEAM SHED • 2"x e Loft joists 0 4'-on centers (2x6.for F-z'shed'widths) . 4"x 4"Top Plate Beams • 4".x.4"Center Support Posts o �,, _ 4 • 4".z S"Comer Posts are Of tall f x Comer Braces ,,: • z. x4 Wall Ptu ins J • • ;e x 4"Door and'Wmdow frames 5' .z r' . r' • S�8p C�X d flooring . r L EPiessureP d is optioaaA . `r^ ' ;, • z"'t6"PT F1oo=Joists 0 W o c. : C=8 PT for l&shed wi • Rough Pine Trim(primed pine or t k red cedar is optional) V • 8"x 8"Aluminum,Louver•Vents . _• Standard Board and Bath Siding clapboards orwJ)ite cedar•sliiitgles -are optional f. ROOFINGr r `b • $/8"CDX roofsheathing,- : • Choice of shingles and colors . MEE Pressure'Freated Ramp NOTES: . • Stock and Customn.doors.and windows are available • Goncrete Block or.optional -Sonoiube footings are available with a roofpitch'of"/z2,and including a 4 foot storage loft,.this is the perfect-style.for the"pack rat". The loftprovides storage space for-mall and seasonal items such as beach.chairs and hoses,:while maintaining optimal wall and floorsp xe This de ign adds Ne2v England ehameter=! f s - 5 . Pi. .HARBOR ' i WOOD PRODUCTS. It's all about the wood"' ' N ti CH�4TH�4M LOFT SHED - 10 x 16' (Elevations - Scale: 114" = 1) LEFT REAR 16' x16 l + o i, , - L L HL 2, , FRONT FLOOR F ING.SPECIFICATIONS - (2 X.8 Pressure Treated @ 16" o.c.) RIGHT 7 - 1 . I. PINIR fIARBOR .' WOOD PRODUCTS,, It's all about the wood ` N C14AT14AM LOFT SHED - 10 x 16" (Elevations - Scale: 114" = 1) LEFT REAR 16' , x16 LI FRONT FLOOR FR"ING.SPECIFICATIONS (2 X.8 Pressure Treated @ 16" ac.) RIGHT PIHARBOR ' WOOD PRODUCT. It's all about the wood r N C14AT14AM LOFT SHED - 10 (Elevations - Scale: 114" = '0 LEFT REAR 'L 16' x16 0 J FRONT FLOOR FRAMING'SPECIFICATIONS (2 X.8 Pressure Treated @ 16" ac.) { RIGHT .. k i`7N_.YiY 'tea' ,_,. -_ .. ..- ..s.. ,: .-. . ..�^...• , ,. �� � �,-a 1: ,11N0 SNOI1dlN3S3Hd3U OIHdV80 Sad S31abaNnos 130HVd :310N 86/ZZ/6:31da 1NI8d lINn 'S'I'J 319d1SN8VG d0 NMOl Vr \ \;`_ r1�r~`\�✓,�,yam �"!•.-,,.ri��A / f C)� \ 'a� .'J /' !�'�/r-`,` `3ay� \` ..... // ��si �// +` \ \ , It Ntl Lk Yll 1 , .max• / /% - `"i ��% ( �` ��--'-��'``'\` �� � }I�, � -i' L_ ��•^ ;�\ �v ^ '\`l _.-• ..-•.-._...�"\ �\ ``,�Ilhk� /�'%.r r'//i.' -\ 1 \ \ �'$rri. .' r= •;�i' 1 � 7,!' / -_$",--- `` � "� )/ 1 . �---'__ \\ ;.:.' �/, � -.•-_�••/ �- bJ ���--- � ice, ,- �'`' ( 1 �' —i :•� ;t`,+•�;1�� °.��` \ tR_.: �• �>`i j\1\�1�! .-1 �i;%�i„�, r 1\ � � — ,1��-•\� 'w/ �,r ` ~\` \/ ,'//�11/�/l•' ''} � �\� � 1' ` ��. r• �-': I /!,dl. /li• %�' �i j'1'i / I '' '� ^', ,�'vY t�t• ��`\ .�; •'II�,�;'- ,......__�..,..:%;�;� .�� ;��.��� 1,.��!t� •I(�/.�I 1 \,\, J1 , f r /';' •� ;/•� O � •1 � ! )9 c�r 1! /. f `�'' ;� x� t.• 1. •/• l�• I; / ,//' J `\_ ) '/ (/:\•=-ter ,� r �J 1��``�,�\ \� �i /) � .rr—�`" ��\\\`-_.-.. \"-•-�"�') -� / �i,' ' // ////' // /,� ��//,�/,r�/. 1W N l.;:!i. •.�)`/�i�--��\..\,� \�� �-•a.' t `^\-�.`{� ;/ `\�` \`1 JII ._ �% ..�'.rr! j Z//� 1 M c •'•i.�_•/"r :'�' �=_.`-- �•\:.` \�\` •,\ ._ ----- � 'l, /,/ �// I tip - /•• "/ ..t ! f��d � at �� ��5 �''� _� ,•�sv-`=r ; `*51 '`'X1� '`�'`c�,�✓�`�` "fir. ,, � ��"�+`}fir, r:c },« "W°.Y�'`-. 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Ord floor House# r!i o��+�AL UST 13E NCE 19 p (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) TOWN OF BARNSTABLE ' Building Permit Application Project Street Address Villa 02, 9,41ZAI Fire District Chvncr Gdl P79S l` b/ C_4 k//S Address CL��MIS Telephonc Permit Rcguest• -776 Zoning District / t T Flood Plain Water Protection Lot Size d`1 C:_ (I�7_ Grandfathered Zoning Board of ApMls Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling Type: Single Family v Two family Multi-family Age of structure S— Y P-S Basement type Historic House Finished Old King's Highway Unfinished Number of Baths No. of Bedrooms Total Room Count not including baths) First Floor Heat Tyne and Fuel}1Y"G¢-!z — Central Air do Fireplaces U Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone number Address License# Home Improvement Contractor# Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO / �(00' Project t -/0 0 9 D-C) Fee c��• SIGNATURE O-�L� ' DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) }, BPERM T FOR OFFICE USE ONLY 4/25/95 37668 128.004.006 ADDRESS 16 Jenkins Lane VILLAGE W. Barnstable Costas Yalanis OWNER t _ DATE OF INSPECTN: FOUNDATION .FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE CLOSEDaQUT: �^^ ASSOCIATE PL'ANNO. 4 ' �_: The Commonwealth of Massachusetts — Department of Industrial Accidents . . '- = oxceOf/BYCSI/gBdOOS - - 600 Washington Street ---- ,3 Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself. . ❑ I am a sole etor and have no one worlds in M VIEW /%% % %%/%%%%%%%/��%%%%%%%%%%%%%/G% %/ %%%/%%%%%%%%%%%/G%%%%%%%%/////%/%////%O�%%%%%%%%%%%%%/O////////////�%/� �'�/1��, ❑ I am an employer providing workers' compensation for my employees working on this job. :::>::»::>::;::>::>::::::»::;::>: : ......Ii..........................."""'.::::::1M.-- ... .. :>.:.:>.::;.::::::.;:.i<:.: ;::: :::»::::::::.;;:.;:.;:<.;:.;:.;:.;;;::«:::>;::» 'iz' of&ee#'> '':::':: :< ;,<.:: .::............................:.....:.:::::.::......................................... .:.:::.:::::::::..::: :::::.., lrisuraitceco.:::::::;:::.1...... . ...... ...d.............. ..........................:::.... olicv;#:.;:<;.:;;.::::;:; .:: ;:::>:::::>::: t� <: ::> :. :<:>::::::::>:<:>:«<:::»:>;:_ ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have . the following workers' compensation polices: ................................ ............:....................:::::.::.:::.:.::::::::::::.::.:::::::::::::::::::::::.:.....'::::::::.:::............................................................... ............:................................... .::......................................................,........,....:.... �'`.: rid' :::`:''..����:;f< :: `:`«.,.` `'.''> ':< < '> '< ><<>'>« ><< < . 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LJ:2?i::::4:it??>.vii::�:i:<?ti'r?jj:iii y}•;.}y;;^::^iiiCbiii:•iii' n� Fafiure to seeose coverage as required under Section 25A of MGL 152 can had to the imposition of criminal penalties of a fine up to S1,500.00 amlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand fat a copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification. I do hereby certify raider e p ' mid p o that the informadon provided above is true-and coned signawre Date ,P'I-P-gI� . . Print name Phone# h'�`—?9a-9 . official use only do not write in this area to be completed by city or town oiHdal • ' IRM city or town: pera�/license# ❑Building Department ❑dieckifimmediate response isrequired ❑Sete tme Board ❑Sebxlrnen's Oise ❑Health Departmed contact person phone#; -- ❑Other Owned 9/95 PJA) r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any corn --c—. 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 receive:c- trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do 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 section 25 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, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and —supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation-and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number- The Commonwealth Of Massachusetts Department of Industrial Accidents amce of invesugadons 600 Washington Street Boston-,' Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 PROPOSED DRAINAGE EASEMENT \ 5 3 / v LOT 4 V---4-43 , 799 SF SJ�P " DRIVE PECK µQ, 18 -. IN a2 0 A\S A MORTGAGE LOAN INSPECTION MLI1 171 SAGAMORE SURVEY ASSOCIATES SCALE: 1 IN.= . 60 FT. P.O. BOX 28 DATE: JULY 20, 1998 -'tA SAGAMORE BEACH, MA. 02562 (508) 888 8667 I CERTIFY TO NORTH AMERICAN MORTGAGE COMPANY ;-:fit arONTS AN THAT THE LOCATION OF THE BUILDING SHOWN HEREON CONFORMS " A No.34314 TO THE ZONING OF THE TOWN OF WEST BARNSTABLE 1 �0 't, r' FES5i0 I CERTIFY THAT LOCUS DOES NOT LIE WITHIN THE FLOOD HAZARD ZONE AS DELINIATED ON MAP 0015C COMMUNITY NO. 250001 PLAN REFERENCE:, BARNSTABLE REGISTRY OF DEEDS BOOK/PAGE: PLAN BOOK 444, PAGE 030 LOT NO.: 4 PLAN BY: LEVY, ELDREDGE & WAGNER ASSOCIATES, INC. DATED: SEPTEM BER 1 , 1987 THIS INSPECTION NOT MADE FROM AN INSTRUMENT SURVEY AND IS NOT TO BE USED FOR FENCES, HEDGES OR TO ESTABLISH LOT LINES. FOR USE OF BANK ONLY. o�7M� TOWN OF BARNSTABLE 33410 .Permit No. . a BUILDING DEPARTMENT OWN OFFICE BUILDING Cash .. 7 .Ya T 670• HYANNIS.MASS:02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #4, 16 .Jenkins Lane West Barnstable, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED.UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. January 17, 19....90........ ...... .... .��................... Bui ding Inspector I4 ��.,� °•.ew TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 '�o cur a• MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized b BuildingPermit #...........& 5... ................................ A . _..........................................�........�....... issued to ................. 1 // -fh/L� ��G% < ... ,mil/,/ /` ••............... ._..._._.._ .�. . ..... _._._..._.. _..__ Please release the performance,bond. //'I BUILDING PERMIT NO. 3 3`//D DATE C JA t) ASSESSORS PARCEL N0. IQE- —1/6-" CONTINUATION OF ROAD BOND The undersigned owner/contractor hereby agree to maintain their road bond in force until .the following work items are completed to the satisfaction of the Engineering Section of the Department of Public works: loan and seed shoulders as soon as weather permits: other (explain) LOCATION;: 1 oT J l .Jc—Zk"wS ,C�q. •�i9lC�C.� SIGNED. (0;y«Et CONT C:OR) (print name 2-d-4 c';GIivEEI .G AL'ii:QRIZAT TZON . . �_ .qs v' rTiON OF BARNSTABLE, MASSACHUSETTS BOIL IN A=128-004-Y1OO' DATEt eC er 11, 19 89 PERMIT NO.NQ 3341.0 .}.I I APPLICANT Greenbrier Corp. ADDRESS Bo} 510 Centerville 00] 397 • ,- _ (NO.) (STREET) (CONTR'S LICENSEI well 'n ! ) STORY single FamlFamilyDwells NUEBLRNG UNITS PERMIT TO Build D (TYPE OF IMPROVEMENT) - -NO. (PROPOSED USE) ' low AT (LOCATION) LOt '"#4 j - '16 Jenkins Lane, ' W. Barnstable ZONING T— -(NO ) (STREET) f BETWEEN ' } ! AND (CROSS STREET) - (CROSS STREET)LOT l ` 'SUBDIVISION -' LOT BLOCK SIZE ' y BUILDING IS TO BE FT.`WIDE BY r FT LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION t ;TO TYPE USE GROUP~' BASEMENT.WALLS OR FOUNDATION (TYPE) _ REMARKS: 'Sewage• 489- 53 -'- Bond .AREA OR '-•' - 864 $t^l•.: .fit•: ,.'. - .. .. e. 45•OOO. 00- FEE' $. 69•�S u VOLUME 4 ESTIMATED COST $ (.CUBIC/SOUARE FEET) 77 OWNER 'Greenbrier COrg. 7 ADDRESS Box 510, Centerville BUILDING DE PT.. OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING(INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I �co, 2 z P115 3- qfa 3 HEATING INSPECTION APPROVALS ENGINEERING DEPART ENT rd l;+va�Lz OTHER BOARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'N!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. OF BARNSTABLE, MASSACHUSETTS =128-004-W00 DATE Decoc,wber 11, 19 89 NQ 33�41.0 PERMIT NO. APPLICANT Greenbrier Corp. - ADDRESS Boa 510 Centerv-1 i i r-, 001 397 ► IN0.) (STREET) (CONTR'S LICENSEI 11ui1C1 UWe111ITGi 1 NUMBER OF PERMIT TO _ (,�) STORY Single Family W i 17 II(YELIJNG•UNITS i. (TYPE OF IMPROVEMENT) NO. (PROPOSED USE , Lot #4 16 Jenkins Lane. ZONING AT (LOCATION) / W. Barnstable(N0.) (STREET) DISTRICT O �,. BETWEEN AND i:. (CROSS STREET) (CROSS STREET) ' SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS:TO'SE FT. WIDE BY F.T. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONS TRUCTIC I . TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: (;pw_-AcIP #Ro _7,'A s Bond AREA OR 864 q . I,�' •''VOLUME • ft. ESTIMATED COST y� 45. 000. 00 PERMIT 69. 25 FEE' (CUBIC/SO DARE FEET) � : .T- OWNER Greenbrier crirp, .� BUILDING DEPT. ADDRESS Box 5 10. Ceilterv' I I P BY 1 OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. 1"6t'f'Icll MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPL CABLE SEPARATE I INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI To LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS pi lJ 3 cJ, HEATING INSPECTION APPROVALS ENGINEERING DEPART ENT 1 &zT- ry 6 OTHER BOARD OF HEALTH /oz7 , WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED THE VARIODUS STAGES OF [W0, RK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRIT1 CONSTRUCTION. RMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. BUILDING PERMIT NO Dni ASSESSORS PARCEL Py0.J Q,,- -4Z,1L 6t CONTINUATION OF ROAD BOND The undersigned owner/contractor .hereby agree to maintain their road band in ' force until the following work items are completed to the satisfaction of .the r Enginesring Section of the Department of Public worts: loan and seed shoulders as soon as weather permits: other (explain) i i LO CATIO:,:_ I.c r 4,J l .Jc-� I�-S �,q. l EAWAj. } SlG�.E7 (GvivER/COST CTOR) (print name- 5 c Gl:vtE=.I`,G AC7r.ORIZ:2110N J l i s 3 297.69' DRAINAGE 0 EASEMENT LOT 4 a 43,799 sq: ft.f ' 41 N� 119,51 148.0' 161•� 13 V O 6� c 88 29 O ,I 60 J�� � C,21g 02, o L S' 2*00� (SO. 4+00 +00— 8 THIS PLAN IS NEITHER INTENDED NO. D1 10 A as INITIAL ISSUE cF ATE DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR AS—BUILT FOUNDATION PLAN—LOT 4 MORTGAGE ,LOAN PURPOSES. JENKINS LANE _ BARNSTABLE, MASSACHUSETTS GREENBRIER DEVELOPMENT CORP. SCALE: 1' 50' JOB NO. 1120/11204aeb I CERTIFY THAT THE FOUNDATION PAUL A. 0 so too SHOWN ON THIS PLAN IS LOCATED LEVY- _�� u No. 10617 "+ ON THE GRO " D S INDIC im �; �,'T" �� LEVY, EUREDGE & ■AGNER ASSOCIATES INC. 0. DA RE IS RED LANO SURVEYOR / acute ummncmm R� uex0m 889 WWT MAW STRM CENMU M3 )U 02632 J • I r- —.ter .r_.:. � _ f*+•s►N'I•=- , I I I I IL F-1.aY- ' .. I I '' - 9�Ie• `lib• I �• .Lr•w t 1 •ice. b�•..rG�•F�t cetwic I I - C t— _ L- l-- •. 1_.._J I I _ y1MR�r Wi J u• I 1;7.A)yt`,c✓ i /�.-�4'��'td:�-(►o lstft) I .3 I ._-Alf eRe- .I � a= i-- � I Flo_ - =:...��• �e= 1 I I� G.c-ss.rs t ,,lew o►l •iL•r fJ' .=ar�c>7'hJ�Y_•6�.SrBhng•+tA { ! — pt�iy9ldf af•i VXFit�!'.�4�iD � _1d — r7 f1�.) . 1 APPRO" O OTE CHA. G TOWN O AR STABLE '� •..�- ""'��`"a' Building Ins ecd'0n Department 1 £ L i� o 46 V. t s f 7�IL V j ® :} 0� I I�u _ z 31 it i I . ................. .. � �� i I. `: II- -- - -- � i � � . . � � I � II � I I � � � � C� I ) � l.l-- -- --- _. �_ . I i I � I � . I :. ..�� �� :,::� . � � � � . 07 4� I �� ,� • l ►� j ( ( �+'y I � � �' �i g - 'I I " h 1 N v9 � � �I � �; � � i � i� � � � � � � . i . � � � ; i � . i ------- II I I II �1 - - -- z e 1 t • I I Ar , � R I I a. • ; c I I s ` J � I I � 1 1 �► a I I I••— ,� I I I IJ I I _ I P sLr • ,may , F r,T`P a ZVI . *fe 4 i9-s3.._.__ M41 �++!!/r1 V++n+w./�+�n s-trw ►Lx` ` ,,,�_w.�.� �.�-� s++�s ,,� say o riyy:S, -i� �y.,y Y Z r+ti •e 4 -i�/1�:/,OZ.'-. - i'1'�•yi7:t. rM'rl _� ,�. S�1a _ /7L lr�r�iie eM•J�SI' � -— Neu�+ly�t - r„�•arn+r+�►�� �.r`�"u�....'�fir_ _ .. .._ .. fir! y�1' -- VL i ! i e OIL is ,��� ,ry i= . © ' •" o n ! I 7 i � �. r— — - - -- i . ! , i . i ( . . li II .� I . � I . II � � �� . ; II j �r-- -- - li I � . l l i :�::� , , . I , . ® . 4� � � I, i ,� a II � � � �I ... 4 'I I �+ .� � z - l i� i ,,� �� , '. i '� = I � - -- � � i • �t II '� II I , 000 II , I I DOWI • I � III �� �' • II I Ir- - - - 1 Assessors otfioe (1st floor): FnC SYSTEM MUST BE F THE T QQ - W4 Assessor's ma and .lot number ..�Zv...... .a. .....'.......... �o o� p � —INSTALLED IN CCE�,�PL!�C��CE �Q Board of Health (3rd floor): �+ WITH TITLE 5 � a re � Sewage Permit number .... . .. . e ................ '. _._ •6 ... �,.. �. . r�� pry p�� /gyp ��aa 1 E6��:EROMMENTAL COO : BaBa9TsnLE, Engineering Department (3rd floor): Jf� �i_j �o raea House number �..0, -1. • T®°EA REGaiflJli`.AM ��b}9•��0 .................;............... . ................... 0 YPY APPLICATIONS PROCESSED '8:30`-9:30 A.M. .and 1:00-2:00 P.M. only TOWN OF 'BARNSTABLE BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO ..'..... ... n .......... .,�,� 1.... TYPE OF CONSTRUCTION ..................../14.1. p .................................. • ......................` .. ....?..........19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �j Location .... T...`7.... ...' .... '. � ........ ..� ....(/V�.., ....... ....../l. . . .... ProposedUse ....... . ....( Ce.....A..•.. I.............................................................................................. f ......................Fire District iZoning District .............. ............................:...... .............................................................................. Name of Owner ......... & ..Address .......� ..... l/.1' - ....... Nameof Builder ......................j_Aq...............................Address ....................................................................:............... Nameof Architect ......................... .....................................Address .....:.............................................................................. ............. Number of Rooms .........(F. ....................................................Foundation ....Ax- 4z d..... `• Exlerior .... .. .....(51/.11 ... ... Q .S...Roofing .I � W..'......... Floors ........V �. .�..... .... .. .. .. :..........................Interior i Heating .....�7,...!!`%.T..1........� ... .�w.............................Plumbing ............... 6 . Nd Fireplace ..................................................................................Approximate Cost .•..............`Z .. .........:....................... Definitive Plan Approved by Planning Board ----/P?--_-7----------19 p Area ........ �. s......:. Diagram of Lot and Building with Dimensions Fee (0 / .s SUBJECT TO APPROVAL OF BOARD OF HEALTH �� 36 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......... ...... •Construction Supervisor's License ..........0�.1.. .�'.�. GREENBR 'ER CORP. No 33410.... Permit for ....1 ...St or';'............ ` 3 .ngl.e...F.am .ly Dwell.�:n9........... Location ...IJOt....#.4......16 jenk1ns Lane ........................ W. Barnstable Owner ..........................................rp.,.................... Type Of'Construction ..Frame .... .................................................................. Plot ............................ Lot .............:.................. PermiteG'ranted .:Decembe ,,,l1,,.,.,,,,;1-9 €39 r Date .of Inspection ..../..............Q..............19 Date Co m leted ...1.....� —F................19 � v - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Od. O G Permit# \Health Division ., Date Issued \Conservation Division Fee. Tax Collector !0n, '' �7A?tSEPTIC SYSTEM MUST BE Treasurer )OPQ1 Id INSTALLED,IN COMPLIANCE WITH TITLE 5 _w ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address G/l/ Village COO L.?Yax�w Owner — /� a/ Address j� icy / L.� 4-1 ilw Telephone Permit Request r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed '3y�Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type h6G D Lot Size Grandfathered: ❑Yes o If yes, attach supporting documentation. Dwelling Type: Single.Family Two Family ❑ Multi-Family(#units) Age of Existing Structure /a f/tr Historic House: ❑Yes a Co On Old King's Highway: ❑Yes 01N.o Basement Type: Full O Crawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) /liOrt.r 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 6 new ,� First Floor Room Count Heat Type anZes 4-Gas 0 Oil ❑ Electric ❑Other Central Air: 0 No Fir aces. Existing New Existing wood/coal stove: 0 Yes El No Detached garage:0 existing new sized Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing O new size Shed:0 existing 0 new size Other: Zoning Board of Appeals Aut rization ❑ Appeal# Recorded❑ Commercial 0 Yes CWNo If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE • I FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO., ADDRESS VILLAGE OWNER. DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE6 ELECTRICAL: ROUGH.r ra= FINAL PLUMBING: ROUGH FINAL i- cr .W. GAS: ROUG FINAL FINAL BUILDING rn n lJ 1rV0 DATE CLOSED'OUT ASSOCIATION PLAN NO. r .. TME Department of Health Safety and Environmental Services ' Building Division a i s uv&�'�' ' 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: /��4 7/ 7 f ?� JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRES&R-0,. 44 a!/ city/town 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 su eervisor. 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 faun 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 minimum inspection procedures an r uirements and that he/she will comply with said procedures and requirem Signature of meowner ` i 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 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 to amend and adopt such a form/certification for use in your community. Q:FORM&EXEMPT 1 " The Town of Barnstable A"& $ De�arimeat of Healfi-Safety and Environmental Services `'..' Building Dlvtsloa 367 Main Street,Hyannis MA MG I Ralph Crass= Offuc ?08��790-6ZZ7 Huiidiag COM=i=: F= =-790-6z0 For oiIICe use only permit no. Dace AFFIDAVIT HOME MWROEME1 V *CONTRACTOR LAW SUPPLEMENT TO PERMIT APPUCA77ON uires that the on=nstraction, moons+ renovation, re vationpair, modera �IIGL,e. I42A reali=.zsion. conversion. Improvement..removal, demoiltion, ar construction of as addition to any pre-es'st'119 Omer occupied building containing at few we but not more than tbur dwelling units err to sgractnre s which are adjacent to such residence or building be done by registered contractors, with e:UT=C=ptions.along with other requirements. Type of Work:_ /Q`S'� T/CY✓ Est.Cast Address of Work: /6 T/%Nr� ti ti Owner's Nam Date of Permit App licailon: I hereby certify that: . Registration is not required for the following reason(s): Wor'it mduded by law Job under SIAOa t umug ttot owner~o®pied Owner puiling own permit Notice is hereby given that: OWN PERMIT OR DEALING WrM MGMGIS EM ER5 OV4�N pULLII�iG THEIR _ COIYi'ItACrORS �ITRAPTION WORK 00 NOT HAVE APPLICABLE OR GUARANTY FUND UNDER MGL 142A ACCM TO TM ARBITRATION ZGNM UNDER FMALTIFS OF PERIURY t mb}'nPPY � i for a.Pf the agent of the owner. Cantrsctor Ma= Bea Na Dasec OR 01 o,vR s Name Date L� Assessor's offioe (1st floor): "`' Assessor's map and lot number ...... . . . Q i taE T ` /,28 -.O U � o� ........ . . ............ . ............. Board of Health (3rd floor): � J M Sewage Permit number ....... �" �. .r..... •.. . ....••. Z B6Hd9?ADLE. i Engineering Department (3rd floor): 1/ YA°a House number (� o i639 �e........................................................................ .. ''�o ray a• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ . �`��G ...... ?u.t., .............................................. TYPE OF CONSTRUCTION ...................(1V. ......Y„!t...X......................................................................... ......................17 .. ............19...�/,__ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....(..! C ..5.......6�t-.CL-1 �!.�� / %if/Y1.,, Proposed Use ..........51n.dl... ....... �ll/1!iM. .......................................................................................................... i ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ......... I ............................. . . ....4. .. %..Address ...... X...... ./�.. �/� /�� (, .......... I. Nameof Builder ..................... ...............................Address .........:.......................................................................... Nameof Architect ........./.........................................................Address ....................................../.....................n..C.. . ................. Number of Rooms ........t/ ........Foundation ....f!1.�1.. .,Q..!. ....( ! ,.(-7,c(0(Q..w............... Exterior ....( 5....Roofin ........... �.�... -�/( �1�...�►M�.t!/rt"......... �. ,,..... g Floors (.. . .!...../..1.....lu�lYc.... ..............................Interior `\, �J /. lL............... . ....................................... Heating J'I r �.... -�..............................Plumbing ..............1�...... /. ................................... ............................:....... Fireplace /V dApproximate � .j.................................................................................. Cost ...............Y.." Definitive Plan Approved by Planning Board ---/�Z_-_7----------190__ Area ....... .. ........ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH c. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS K . I hereby agree to-conform to all the Rules and Regulations of the Town of Barnstable regarding"the above construction. j, Name ....... 1........,/.:C� '�:J.// Construction Supervisor's License ......... ..>l.. .. GREENBRIER CORP. A=z128-004--"Woo No ... Permit for .112...StO.KY............. .......... Location Lot 4. .......1.6....Jenkins...Lane West Barnstable ............................................................................... Ownew Greenbrier. r ...................................Corp ................... Type of Construction .....Frame...... ......................... .............................................................. ................ Plot ............................ Lot ................................ -, Permit Gran*ed .... December 11 ,....................................19 8 0 Date of Inspection ....................................19 Date Completed ......................................19 TOWN OF BARNSTABLE � • , BUILDING DEPARTMENT HOMEOWNER LICENSE .EXEMPTION Please print. . DATE JOB. LOCATION J�.[K[.iC( 4,A1 S L -Number Street address Section of town "HOMEOWNER"O� Y,4 j , Name Home phone Work phone PRESENT MAILING ADDRESS �7'"�y�irclf A1A4 Z City town State Zip code The-current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual 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 re- side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm A person who constructs mor structures. e than one home in a two-year period shall not be considered a homeowner. Such "homeowner". shall submit to the Building Officij on a form acgp-ptable to the Building Official, that he/she shall be responsib: for all such work performed under the building permit. (Section 109.1. 1) The undersigned "homeowner" assumes ,responsibility for compliance with the Sti Building Code -and other applicable codes, by-laws, 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. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet,. or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. 11/02'94 17:02 V6177277122 DEPT IND ACCID 'Z oo- j l..oi:un.onitlealtli o/ )Wa,4dacffiusettJ ' alJaParf,�tenf o�.�r:du�frial✓Qeei�e,e�s 600 Wc,.l�Ion Stmet .lames J.Campbell &ton, ///aMac" 02!11 Commissioner Workers' Compensation '[nsurance Affidavit 1, witha principal place of business at: (Gcyisrswzla) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. 0 Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (arcle on and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Humber Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number ( I am a homeowner performing all the work myself. I undersund th:t a copy of this slternent will be forv:arded to the Office of Invesdrations of the DiA for coverage verification and that failure to secure ccverage as ree:ired under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consistine of a fine of up to S 1,500.00 and/or cr. years' imprisonment as well as civil penalties form cf a STOP WORK ORDER and a tine of S 100.00 a day against me. Signed this S day of . &246V— Ucensee/1`60ittee Building Department Licensing Board Selectmens Office 7 6� Health Department .� TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 -- The Town of Barnstable • BARM MX- MAS& Department of Health Safety and Environmental Services 1659. �e + " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph C rossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,'. improvement, remo%al, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or'to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:_ Est 4Xa 0(� Address of Work/� LX/ LP 9 d4,0. Owner Name: e0_r17- —S Date of Permit Application:_ I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied t,::::�wner pulling own permit Noticc is hereby giycn that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR Date Owner's x P� .y 297.69' DRAINAGE ae M EASEMFNT LOT 4 a 43,799 sq: ft.f 29.38, S •5' ate, 7l o p67 148.0' 361� cV 88 n' 00 7; _ I 60 19.02 �4+00' . 3 - ' a f,+ �iLt-'`k•.r� r _.[ Y Tt' G 3 y r 1 A S•T7.1t J r .,s ,4 > x, ' i� i):. tT: 49 � r!` ; , uy s � ` e yt t �. .: �! •�c -i R a r �-,.��j�l!)3 w t.:e xJ:y�-�� - �''�[5�.���'�e���ar t '� i C,r• �. 7' L � s �a � t .fi�- f i r. _ - ai�}F s a, y� •.:s�; �'".s a1i! n ,�"•t I 'r t1 rs:. 54 t ,i y l d- a -,ai c: r 7 ` < Y,n �b. X r f.h. {�•r s ) r! L 's .! -.n - { t cva s x} r �yey` t-v :rl ri t,�. .f .. .z. i ar.-.,.'e:•t:::: '�, ,. .i r .,..`.. y r w�s-S'i s+ ;-• ! t 1 r.. .ri. ! �, T � i r1 j�' F�� i �!-, - i f n� t 'r<.�.'J, i. t 4t! r♦ s_ i wi ct .r< , .t 7�' J' its { �. 4 7. 4 1 ;. 1 ti•J I j 1 y 7 f ,• 4�.5 < �._ r tl .f < y 7 ;5-� {. 4 y��.� a = r • tit - - Z. r � r. _; 3�>:?r.a}L I'Yt ! , .1 y �.iA xt r s r i �r '1 4 L 7 '. :! r ?- : of�..:s.r ,C ,�Ly.s�-�tt�4x•" i. •• J � (�•.Y_ yf'+ fls; i... C ) t '� r. ! ' .. ;� L� !•. �._v�'l ..:! fi•1 lL���S �s� t. .,Y'�!`^r!l > �1 { 'S . :. Z i .t .t..,lC .4, <t i t. y Y»�iJ�4�.r3 t x....'` < - i r`7't Xt:'L�'•J�s.+:.• Y� l � ! r3 s F7 ) r, s-1�Y t..�. ;y...- .�:. c E < 1 10 f 9 MAL }, THIS; PLAN' IS NEITHER INTENDED �' rr�i' N0. <ME .. ; ..a,.�.t::DESdiIPl10N f ">�^••. 8Y NOR 'SHALL 'IT BE= USED FOR. ' i+i , t'; °AS ,-BUILT FOUNDATION PLAN,IAT4`` 'MORTGAGE LOAN PURPOSES r " + Y� JE) It�tS LANE r 1 fir, i :y .jlt X !r sit;,�rM BARNSTABLE,r;l[ASSACHUSETTS, err ' �t•tVkOr.4 GREENBRIER DEVEIAPMENT CORP J •.. 3 c ) i � 3_y f *'k - 7 � -e�.� �' p'.. ,. ♦ I t.. � •t �.l r L3. -i h r r gE. e�y\t SCAIF 1 SO %�, i? SOB N0.h 1120/'11204osb�,# r I •;CERTIFY` TfiAT THE FOUNDATION` ! tr! F :PAUUA.' teat.x 50n' � F2 �: " THIS;PLAN �l .LOCATED IENY', �� �� �sY'L,o }�'.��t, �%��;c�•4. xt;',fi���Y�'�4 .:�< ��., SHOWN ON.,;' S ry ;Nc 1G517 �9 a "xri xRil d k t' ON 1THE 4GR0 S INDI 4' , , . ��1, ;�v ;`x t •� t ' ! 1_ ;� r', �i�r'r�x,�-- ,.T"+' {'a'af y -Y '• ? tCj. .}iY��fv/ �s ,. ��( �. >1E91y=ELDRBDGB z;&,�AGIIBR°115S4CiA1ffi INC. ` A RE IS RED LAN SURVEYOR ees'1�l►3?`�i�IIdiBTBEE'! �``'ccmrais Y�► orasY }� ti.� ' `' ♦ ! �„- � l« ! ! -�.i�<�st?!*!e`f'�il. .,it. ��r ��1s �. �'}t i'>.r�, 4�L� !F�' -.t .. ... a'I'411�!�:-*1. .i'! !c F"! :. -_ - ty-,__-`_ ° •� ...__�._.........___..,.�...�.., % - ,.. •,-• �+-ien..- e Y : r r)G vie y 1 �ST . - r - _• ..:`J y r�bic,7�'a�+-,(q f�•a"E 5•A. a � 36 cV qri'mod' - w ...... 7 ' - �" 'i ff C_°'-calf/.-.v'^�3-,`•� K �_29-02 = 00 . TOWN OF BARNSTABLE 33410 Permit No. . BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 7 .Yl .6�9• HYANNIS,MASS.02601 Bond ..... j CERTIFICATE OF USE AND OCCUPANCY i Issued to Greenbrier Corp. Address Lot #4, 16 . Jenkins Lane West Barnstable, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. January 17, 90 19................. ...... ..�. .................... Bui ding Inspector .. _. - - ,, __ • _ _ .. _. i. _ _ .. i