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Home My WebLink About0825 MAIN ST./RTE 6A(W.BARN.) a 0 I Town of Barnstable Building Post"This Card So That'it is Visible From the Street,-Approved Plans Must be Retained on Job and this Card Must be Kept , M" PostedtUntil Fmehlnspection Has Been Made Permit Where"a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-18-712 Applicant Name: WHITE,SUSAN MEADE Approvals Date Issued: 04/06/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 10/06/2018 Foundation: Location: 825 MAIN ST./RTE 6A(W.BARN.),WEST BARNSTABLE_ Map/Lot: 156-031 Zoning District: RF Sheathing: Owner on Record: WHITE,SUSAN MEADE Contractor Name: Framing: 1 Address: 825 MAIN ST Contractor License: 2 WEST BARNSTABLE, MA 02668 "° �,� Est. Project Cost: $6,000.00 Chimney: Permit Fee: 85.00 Description: Window in rear wall of house to be removed and replace&with 400 $ Series Patio Doors(2) Panel-RO:64"/unit 63 1/4"Width-xR0 Fee Paid: $85.00 Insulation: 80"/Unit 79 1/2",Frame Width=63 1/4, Frame Height=79 1/2 Date 4/6/2018 Final: Project Review Req: Plumbing/Gas I Rough Plumbing: I Building Official l Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on thii permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing N� Rough: 2.Sheathing Inspection L 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ApplicationNumber.......................................... 0 ........................Other Fee........................ ....... �-J ea 6iw vikA VM-6. Fee........ WAS& 165 q Mld oo j b '✓ 3D I Fee Paid.............................................................. ...... TOWNOF El Permit Approval by... ...........On...... TOV 0 BUILDING PERA11(1�a, Map 4& ........�51..................per.......ul.!.......................... A-PPLICATION Section I— Owner's information and Project Location Village 6 Uf VnI's, roj eat Address Owners Name OwnersLegal Address Ci state A zip ty Owners Cell# 17- E-mail Section 2—Use of Structure Use Group. ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet El Single/Two Family Dwelling Section 3 —Type of Permit F] New Construction ❑ Move/Relocate El Accessory Structure E] Change of use El Demo/(entire structure) F-I Finish Basement El Family/Amnesty El Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System F] Addition F] ReWning wall El Solar El Renovation ❑ Pool ❑ insulation Other—Specify Section 4 -Work Description Ste ' ro id®Ts yeA. :?-3z (F. . . .......................... . .......... ...... ..... T-q.qt nndata&2/9/2018 Application Number.................................................... Section 5—Detail .� Cost of Proposed Construction �l Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method 0 MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wining ❑ Oil Tank Storage ❑ Smoke Detectors Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility. I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone,Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard . Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last imdated:2/9/2018 i __ Application Number........................................... Section 9—.Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section-10—Home Improvement Contractor Name Telephone Number Address City State zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.LC... Signature Date Section 11—Home Owners License Exemption Dome Owners Name: Oki'k Telephone Number _ —9 g (�(�'� Cell or Work Number I�understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts§tate Building Code. I understand the construction inspection procedures,specific inspections and documentation required e T_ of 780 CMR and Barnstable. Signature Date { APPLICANT SIGNATURE Signature_,NLO-Y� Date Print Name Asa Telephone Number - j7 14611, E-mail permit to: C M ca. , A e T.-I......i..aa.1 mnn-V o f Section 12—Department Sign-Offs Health Department ® Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if regired) ❑ Fire Department ❑ Conservation �� For commercial work,please take your plans directly to the fire department for approv :1 Section 13—Owner's Authorization I� as of the-subject property hereby a ithorize to act on my behalf in all matters relative to work auth d uilding permit application for: CLAW ddress of job) Signature of Owner LI%4- date c�5a vL Print Name { i { i j; i 1 I Last undated:2192018 The Home `Depot Special Order Quote out Customer Agreement#: H2612-67838 ®l Printed Date: 2/21/2018 Customer: SUSAN WHITE Store: 2612 Pre-Savings Total: g ..$4,2�Q5.� Address: 825 RTE-6A 'Assoclate:?,",�-. Total Savings: ($637.03 W BARNSTBLE, MA 02668 Address: 65 INDEPENDENCE DRIVE Pre-Tax Price: $3;6'06.07 Phone 1: 508-237-9668 HYANNIS, MA 02601 Price Valid Through: Phone 2: 508-237-9668 Phone: 508-778-8948 2/28/2018 Email: S4M4WHITE@COMCAST.N ET All prices are subject to change. Customer is responsible for verifying product selections. The Home Depot will not accept returns for the below products. �> Standard Width = RO: 64" UNIT: 63 WINDOWS-DOORS '� i S Q C C CS : 1 fi'�" 1/4„ Standard Height= RO: 80" UNIT: 79 A encan i�f 1/2° � araa�.,. ....:,., ,,. Frame Width = 63 1/4 i Frame Height= 79 1/2 Catalog verMon 9- go M • ® o o 100-1 400 Series Patio Doors 2 Panel-FWH,Passive Left-Active $3,119.56 $2,651.21 1 ($468.35) $2,651.2'1 Right,63.25 x 79.5,/White- Pine Unfinished 100-2 Trim Set 1:FWH Passive Left-Active Right Covington $475.72 $404.30 1 ($71.42) $404.30 Antique Brass PN:2578938 Version:01/11/2018 "? 100-3 Panel Stop,1:FWH Antique Brass PN:2577520 $25.09 $21.32 1 ($3.77) $21.32 Version:01/11/2018 100-4 —Panel Stop 2:FWH Antique Brass PN:2577520 $25.09 $21.32 1 ($3.77) $21.32 Version:01/11/2018 100-5 Exterior Keyed Lock 1:FWH RH Covington Antique Brass $61.40 $52.18 1 ($9.22) $52.18 PN:2579519 Version:01/11/2018 1 100-6 Insect Screen 1:400 Series Patio Doors 2 Panel-FWH $514.10 $436.92 1 ($77.18) $436.92 FWH5468 Full Screen Fiberglass Hinged Double White PN:2576029 Version:01/11/2018 100-7 Sill Support:FWH 64 Aluminum(Neutral Gray) $22.09 $18.77 1 ($3.32) . $18.77 PN:2550011 Version:01/11/2018 Begin Line 100 Descriptions ----Line 100-1---- 400 Series Patio Doors 2 Panel-FWH Art Glass Series=None Insect Screen Color=White Overall Rough Opening=64",x 80" Full Divided Light(FDL) Z Threshold=None Overall Unit'=63 1/4"x 79 1/2" Colonial S 46(O• Sill Support=Yes Installation Zip Code=02601 Grille Pattern=Colonial p Exterior Trim Style=None U.S.ENERGY STAR®Climate Zone=Northern Grille Bar Width=7/8" Extension Jamb Type=None Search by Unit Code=No. Exterior Grille Color=White Re-Order Item=No Standard Width=RO:64" 1'UNIT:63 1/4" Interior Grille Species=Pine Room Location=Master Bedroom -Standard Height=RO:80' UNIT:79 1/2"• Interior Grille Color=Unfinished Unit U-Factor=0.31 Frame Width=.63 1/4 - 3W5H Unit Solar Heat Gain Coefficient(SHGC)=0.21 Frame Height=79 1/2 Grille Alignment Type=Standard Grille Alignment U.S.ENERGY STAR Certified=No Page 1 of 2 Date Printed:2/21/2018 5:23 PM r I Unit 66cle=FWH5468 Hardware Style=Covington Trim Set 1 Part Number=2578938 Venting/Handing=Passive Left-Active Right Hardware Color/Finish=Antique Brass Panel Stop 1 Part Number=2577520 Exterior Color=White Hinge Finish/Color=Antique Brass Panel Stop 2 Part Number=2577520 Interior Species=Pine Panel Stop/Finishes=Antique Brass Exterior Keyed Lock 1 Part Number=2579519 Interior Finish Color=Unfinished Temporary Construction Trim Set=None Insect Screen 1 Part Number=2576029 Glass Construction Type=Dual Pane Exterior Keyed Lock=Yes Sill Support Part Number=2550011 Glass Option=Low-E4 Lock Cylinder Keyed Alike=No SKU=1000012813 High Altitude Breather Tubes=No Security Sensor Type=None Vendor Name=S/O ANDERSEN LOGISTICS Glass Strength=Tempered Insect Screen Type=Full Screen Vendor Number=60509030 Glass Tint=No Tint Insect Screen Material=Fiberglass Customer Service=(888)888-7020 Specialty Glass=None Insect Screen Frame Type=Hinged Double Catalog Version Date=01/11/2018 Gas Fill=Argon ----Lines 100-2 to 100-7 have the same description as line 100-1---- End Line 100 Descriptions Page 2 of 2 Date Printed:2/21/2018 5:23 PM w i��o� � � �� -� �o use � �e. �a�� a � � � T� . . • 1 , 1 � aj-r. ��... ,, e vt- cxlorr V i-cam$ 1 I , y DaR; r t i ry r S � , Vjew jr AKr ao Vj it 6e. 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H2612-67838 Store 2612 HYANNIS Phone: (508) 778-8948VALIDATION AREA 65 INDEPENDENCE DRIVE Salesperson: AMR5697 HYANNIS, MA 02601 Reviewer: AMR5697 This is only a QUOTE for the merchandise and services printed below. This becomes an Agreement upon payment and'an endorsement by a Home Depot register validation. Name Phone 1 .. - • WHITE SUSAN (508)237-9668 — Address 825 RTE-6A Phone 2 Company Name city W BARNSTBLE yob oes°npn°" Patio door State MA Zip 02668 C0°"ti BARNSTABLE QUOTE is valid for this date:02/26/2018 AP MERCHANDISE AND SERVICE SUMMARY od oc stome 9httolimitthequantities handise — S/O- MERCHANDISE TO BE SHIPPED: S/O ANDERSEN REF# S01 ESTIMATED ARRIVAL DAT -0 18 LOGISTICS '�..:> ; .y ...�d_ , ., ;.;. ,,.. ,,€s �a;,rr�.. �..::r:�v'a, -.` s`,st`,�;:.;`• ,r:"a7 '.. .: Y' '^< ., _,.: t r 4 :., w. rt «,,, DESCRIPl LON _ .,.,- s -. >:; _> PRICE;-EACH :.EXTEN:SI:ON SKU.< � .xG�TY. .... UNI .1 ti.. ,, _ _ S0101 1000-012-813 1.00 EA NA/400 SERIES PATIO DOORS 2 PANEL-FWH , PAS/400 SERIES PATI Y $2,651.21 $2,651.21 DOORS 2 PANEL-FWH #1 S0102 1000-012-813 1.00 EA NA/(CONTINUED)/400 SERIES PATIO DOORS 2 PANEL- A Y $0.00 $0.00 FWH(CONTINUED) CT-FRAME=400 SERIES-DOOR-N RATION PATH=NEW UNIT^CUSTOM INDICATOR=FALSE^B ICING REQUIRED=NO^EXTENSION JAMB WIDTH V AME TYPE=FULL FRAME^LOOKUPTRIMSET-1=APPA^LO ET-2=NONE^LOOKU S0103 1000-012-813 1.00 EA NA/(CONTINUED)/400 SERIES RS 2 PANEL A Y $0.00 $0.00 FWH(CONTINUED) DTH=7/8"^ PACING=3.5^U- FACTOR=0.31^SHGC=O. 1 - TO MATCH BAAN=AIR^GC-GTKT=HP _ NON-IMPACT TEMP R - flGT=N-^GC-GTYP=FDL^GC-GRWD=O^GC -AIRM=ARGON^ LS =3.0^GC-GLST2=3.0^GC-GLST3=N-^GC- LOOKUP Z* 'CONTINUED OfVaNEXT PAGE**" 0 0 O� Check your current order status online at www.homedepot.com/orderstatus (9801) 0100456798 Page 1 of 3 NO. H2612-67838 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Name: WHITE Page 2 of 3 NO. H2612-67838 VENDOR DIRECT SHIP #1 (Continued) TO: CUSTOMER S0104 1000-012-813 1.00 EA NA/(CONTINUED)/400 SERIES PATIO DOORS 2 PANEL- A Y $0.00 $0.00 FWH(CONTINUED) D 3=FALSE^HORIZONTAL SPECIFY 4=11.9894^HORIZONTAL CHANGED 4=FALSE^HORIZONTAL SPECIFY 5=11.9894^HORIZONTAL CHANGED 5=FALSE^HORIZONTAL CHANGED 6=FALSE^HORIZONTAL CHANGED 7=FALSE^HORIZONTAL CHANGED 8=FALSE^H S0105 1000-012-813 1.00 EA NA/(CONTINUED)/400 SERIES PATIO DOORS 2 PANEL- A Y $0.00 $0.00 FWH(CONTINUED) IED 6=YES^VERTICAL APPLIED 7=YES^VERTICAL APPLIED 8=YES^VERTICAL APPLIED 9=YES^VERTICAL APPLIED 10=YES^VERTICAL APPLIED 11=YES^VERTICAL APPLIED 12=YES^VERTICAL APPLIED 13=YES^VERTICAL APPLIED 14=YES^VERTI S0106 1000-012-813 1.00 EA NA/TRIM SET 1: FWH PASSIVE LEFT-ACTIVE RIGH/400 SERIES PATIO A Y $404.30 $404.30 DOORS 2 PANEL-FWHATT TO #1 S0107 1000-012-813 1.00 EA NA/PANEL STOP 1: FWH ANTIQUE BRASS PN:25775/400 SERIES PATIO A Y $21.32 $21.32 DOORS 2 PANEL-FWHATT TO f#1 S0108 1000-012-813 1.00 EA NA/PANEL STOP 2: FWH ANTIQUE BRASS PN:25775/400 SERIES PATIO A Y $21.32 $21.32 DOORS 2 PANEL-FWHATT TO f#1 S0109 1000-012-813 1.00 EA NA/EXTERIOR KEYED LOCK 1: FWH RH COVINGTON/400 SERIES A Y $52.18 $52.18 PATIO DOORS 2 PANEL-FWHATT TO f#1 S0110 1000-012-813 1.00 EA NA/INSECT SCREEN 1: 400 SERIES PATIO DOORS/400 SERIES PATIO A Y $436.92 $436.92 DOORS 2 PANEL-FWHATT TO f#1 S0111 1000-012-813 1.00 EA NA/SILL SUPPORT: FWH 64 ALUMINUM (NEUTRAL G/400 SERIES PATIO A Y $18.77 $18.77 DOORS 2 PANEL-FWHATT TO f#1 S01 FR 0000-297-345 1.00 S/O SCREENTIGHT DELIVERY CHARGE A Y $0.00 $0.00 VENDOR-SPECIAL INSTRUCTIONS: PRODUCT CANNOT BE LEFT UNNATENDED. PLEASE CONTACT CUSTOMER BEFORE DELIVERY. BEST PHONE NUMBER TO CONTACT CUSTOMER PH 508-237-9668 VENDOR WILL SHIP MDSE TO: SUSAN WHITE ADDRESS: 825 RTE-6A CITY: W BARNSTBLE STATE: MA ZIP: 02668 COUNTY: BARNSTABLE SALES TAX RATE: 6.25 • $3 606.02 PHONE: 508 2379668 ALTERNATE PHONE: PAGER: END OF VENDOR DIRECT SHIP Page 2 of 3 NO. H2612-67838 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Name: WHITE Page 3 of 3 NO. H2612-67838 TOTAL CHARGES OF ALL MERCHANDISE & SERVICES Policy Id(PI): • ' • $3 606.02 A: 90 DAYS DEFAULT POLICY; SALES TAX $225.38 TOTAL $3 831.40 BALANCE DUE $3 831.40 'The Home Depot reserves the right to limit/deny returns. Please see the return policy sign in stores for details.' END OF ORDER`No. H2612=67838`: 2 12-678 Customer - Page 3 of 3 NO. H 6 38 Gusto Copy Entries must be completed within 14 days of purchase. Entrants must be 18 or older to enter. See complete rules on website. No purchase necessary. More saving. More doing:" EMAIL ME ABOUT YOUR SHOPPING EXPERIENCE CONOR KENNEDYQHOMEDEPOT.COM 2612 00097 77681 02/26/18 05:38 PM ORDER ID: H2612-67838 RECALL AMOUNT 3606.02 SUBTOTAL 3,606.02 SALES TAX 225.38 TOTAL $3,831.40 XXXXXXXXXXXX4931 HOME DEPOT 3,831.40 AUTH CODE 026534/1972185 TA III I 11111111111111111 2612 97 77681 02/26/2018 8316 THE HOME DEPOT RESERVES THE RIGHT TO LIMIT / DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR DETAILS. BUY ONLINE PICK-UP IN STORE AVAILABLE NOW ON HOMEDEPOT.COM. CONVENIENT, EASY AND MOST ORDERS READY IN LESS THAN 2 HOURS! ENTER FOR A CHANCE TO WIN A $5, 000 HOME DEPOT GIFT CARD! Tell us about your store visit! Complete our short survey and enter for a chance to win at: www.homedepot.com/survey PARTICIPE EN UNA OPORTUNIDAD DE GANAR UNA TARJETA DE REGALO DE THD DE $5, 000! Comparta Su Opinion! Complete la breve encuesta sobre su visita a la tienda y tenga la oportunidad de ganar en: www.homedepot.com/survey User ID: GVMG 158263 155748 Password: _ _ _ _ 18_126 155651 _ _ _ _ Page 1 of 1 The Home Depot Special Order Quote Customer Agreement#: H2612-67838 Printed Date:2/26/2018 Customer: SUSAN WHITE Store: 2612 Pre-Savings Total: $4,243.05 Address: 825 RTE-6A Associate: ANA Total Savings: ($637.03) W BARNSTBLE, MA 02668 Address: 65 INDEPENDENCE DRIVE Pre-Tax Price: $3,606.02 Phone 1: 508-237-9668 HYANNIS, MA 02601 Price Valid Through: Phone 2: 508-237-9668 Phone: 508-778-8948 2/28/2018 Email: S4M4WHITE@COMCAST.N ET All prices are subject to change. Customer is responsible for verifying product selections. The Home Depot will not accept returns for the below products. MENTSARETHECl15TOMER'S 1 Standard Width = RO: 64" UNIT. 63 And r 1/4" WINDOWS a_o „ CHECK THEM BEFORE SIGNING I t • ARDERSCANNOTBERETURNED' , Standard Height= RO: 80" UNIT: 79 .,�.., I ' 1/211 Craltsm ' — Frame Width — 63 1/4 �t ,............. — Frame Height=79 1/2 Catalog Version 9D Number • Quantity TotalTotal 100-1 400 Series Patio Doors 2 Panel-FWH,Passive Left-Active $3,119.56 $2,651.21 1 ($468.35) $2,651.21 Right,63.25 x 79.5,/White- Pine Unfinished 100-2 Trim Set 1:FWH Passive Left-Active Right Covington $475.72 $404.30 1 ($71.42) $404.30 Antique Brass PN:2578938 Version:01/11/2018 100-3 Panel Stop 1:FWH Antique Brass PN:2577520 $25.09 $21.32 1 ($3.77) $21.32 Version:01/11/2018 100-4 Panel Stop 2:FWH Antique Brass PN:2577520 $25.09 $21.32 1 ($3.77) $21.32 Version:01/11/2018 100-5 Exterior Keyed Lock 1:FWH RH Covington Antique Brass $61.40 $52.18 1 ($9.22) $52.18 PN:2579519 Version:01/11/2018 100-6 Insect Screen 1:400 Series Patio Doors 2 Panel-FWH $514.10 $436.92 1 ($77.18) $436.92 FWH5468 Full Screen Fiberglass Hinged Double White PN:2576029 Version:01/11/2018 100-7 Sill Support:FWH 64 Aluminum(Neutral Gray) $22.09 $18.77 1 ($3.32) $18.77 PN:2550011 Version:01/11/2018 Unit 100 0. 0. Begin Line 100 Descriptions ----Line 100-1---- 400 Series Patio Doors 2 Panel-FWH Art Glass Series=None Insect Screen Color=White Overall Rough Opening=64"x 80" Full Divided Light(FDL) Threshold=None Overall Unit=63 1/4"x 79 1/2" Colonial Sill Support=Yes Installation Zip Code=02601 Grille Pattern=Colonial Exterior Trim Style=None U.S.ENERGY STAR®Climate Zone=Northern Grille Bar Width=7/8" Extension Jamb Type=None Search by Unit Code=No Exterior Grille Color=White Re-Order Item=No Standard Width=RO:64" 1 UNIT:63 1/4" Interior Grille Species=Pine Room Location=Master Bedroom Standard Height=RO:80" 1 UNIT:79 1/2" Interior Grille Color=Unfinished Unit U-Factor=0.31 Frame Width=63 1/4 3W5H Unit Solar Heat Gain Coefficient(SHGC)=0.21 Frame Height=79 1/2 Grille Alignment Type=Standard Grille Alignment U.S.ENERGY STAR Certified=No Page 1 of 2 Date Printed:2/26/2018 5:24 PM r .6 Unit Code'=FWH5468 Hardware Style=Covington Trim Set 1 Part Number=2578938 Venting/Handing=Passive Left-Active Right Hardware Color/Finish=Antique Brass Panel Stop 1 Part Number=2577520 Exterior Color=White Hinge Finish/Color=Antique Brass Panel Stop 2 Part Number=2577520 Interior Species=Pine Panel Stop/Finishes=Antique Brass Exterior Keyed Lock 1 Part Number=2579519 " Interior Finish Color=Unfinished Temporary Construction Trim Set=None Insect Screen 1 Part Number=2576029 Glass Construction Type=Dual Pane Exterior Keyed Lock=Yes Sill Support Part Number=2550011 Glass Option=Low-E4 Lock Cylinder Keyed Alike=No SKU=1000012813 High Altitude Breather Tubes=No Security Sensor Type=None Vendor Name=S/O ANDERSEN LOGISTICS Glass Strength=Tempered Insect Screen Type=Full Screen Vendor Number=60509030 Glass Tint=No Tint Insect Screen Material=Fiberglass Customer Service=(888)888-7020 Specialty Glass=None Insect Screen Frame Type=Hinged Double Catalog Version Date=01/11/2018 Gas Fill=Argon ----Lines 100-2 to 100-7 have the same description as line 100-1---- End Line 100 Descriptions Page 2 of 2 Date Printed:2/26/2018 5:24 PM The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Worke>�� Compensation Insurance Affidavit: Binders/Contractors/Electricians/PIumbers A licani information ✓' Please Print Le 'bl Name ! usiness/0rgm&-zfion1bdiv&4: City/State/Zip:I I Y 7YI C'` � 1�i �� Phone tir'e9 3 Are you an employer?Check the appropriate o 'Type of project(required): 1.❑ I am a employer ith 4. I am a general contractor and I 6. ❑Now construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling t_ ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. El Building addition o workers'comp.insurance comp.msurance.t fie_ 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers' comp. right of exemption per MGL 12.❑Roof repairs n,ciTrance required]t C. 152, §l(4),and we have no 13.❑Other employees.[No workers' comp.insurance required] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-cDntactors and state vyhether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. . I am an employer that is providing workers'compensation insurance for my employees. Below the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/ 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 u the pains and e o perjury that the information provided above is true and correct Si attae: Date: Phone# AILU IJ [ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: The Commonwealth of Massachusetts i Department of Industrial Accidents Office of Investigations a) j_)v LAW i ' 600 Washington Street Boston,MA 02111 3 � www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): (z �u. l - YE Address: 1 l e City/State/Zip: 1'It1 Q,7 Phone#: Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.ZY I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' y � t3'• 9. ❑Building addition [No workers'comp.insurance comp.insurance required.] 5. �We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state,,yhether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for inmw ce coverage verification. I do hereby certify u r the and penalties of perjury that the information provided above is true and correct Sianature: Date: Phone#: 6-- �� Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to'do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced'acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificates)of insurance. Limited Liability Companies gl C)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple pmmit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number- The Commwwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Bostan,MA 02111 Tel.#617-727-4900 ext 406 or 1-977-MASSSAFE Fax#617-727-7749 Revised 4-24-07 w.m m gav/dia Barnstable Old Kings Highway Historic District Committee p; 200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 BAPMAILLL BEAM 639. APPLICATION, CERTIFICATE OF APPROPRIATENESS . Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of-Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply, 1. Building_construction: ❑ New ❑ Addition Alteration 2. Tme of Building: House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting,roof ❑ new roof ❑ color/material change,of trim, siding,window, door 4. Sig_: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ' ❑ Flagpole ❑ Retaining wall El Tennis court El Other 6. Pool El Swimming El Other man-made pool 00 Solar panels ❑ Other Type or Print Legibly: Date 3/9/2016 NOTE AU applications must be signed by the current owner Owner(print): _Susan White Telephone#: 508-237-9668 Address of Proposed work: 825 Route 6A (Main St) village West Barnstable Map Lot# 156/031 Mailing Address(if different) same Owner's Signature see attached Description of Proposed Work: Give particulars of work to be done: Install 10 solar panels on the rear (South) facing roof of the house. Agent or Contractor(print): Nathan Tissot/SolarCity Telephone#: 508-640-5389 Address: 112 Great Western Rd South Dennis Ma 02660 Contractor/Agent'signature: For committee use only. This Certificate is hereby APPROVED/DENIED Date Members signatures 1J ro - APR 2 7 2G16 n i i Town 's Hid way C0rnjj1111G . 1 Q:\Boardr and Commissions\Oid Kings Highway\OKH AppLicationA0KH DRAFT 2011 Cert Appropriateness DRAFTdoc CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 5 copies Foundation Type: (Max. 12"exposed)(material-brick/cement,other) Siding Type: Clapboard_ shingle_ other Material: red cedar white cedar • other Color: Chimney Material: Color: Roof Material: (make&style) Color. Roof Pitch(s): (7/12 minimum) (specify on plans for new buildings, major additions) Window and door trim material: wood other material,specify . Size of cornerboards size of casings(1 X 4 min.) color Rakes Ist member 2d member Depth of overhang Window: (make/model) material color (Provide window schedule on plan for new buildings, nuijor additions) Window grills(please check all that apply_: true divided lights_ exterior glued grills_ grills between glass_removable interior None Door style and make: material Color: Garage Door,Style Size of opening Material Color Shutter Type/Style/Material: Color: Gutter Type/Material: Color: Deck material: wood other material,specify Color. Skylight,type/make/model/: material Color: Size: Sign size: Type/Matei-ials: Color: Fence Type(max 6' )Style material: Color: AR Retaining wall: Material: Town 0f Rama*.,ki via King's Highway Committee Lighting,freestanding on building illuminating sign OTHER INFORMATION: Solar panels are black on black THE ATTACHED CHECK LIST M T COMPLETED AND SUBMITTED Please provide samples f p ; t col rs, nufacturers.brochure of windows,doors,garage door,fences,lamp posts etc Signed: (plan preparer) Print Name Nathan Tissot YX QABoards and ConwussionAOld Kings Highwa)AOKH ApplirationAOKII DRAFT 2011 Cert Appropriateness DRAtT.doe Town of Barnstable Geographic Information System March 16,2016 157001 166043 132026003 #640 156013 156042 #146 156052 #49 0 #0 #130 #161 156011 156015 # 156051 660 166012 #742 #694 1#1181 #145 IV 4.156057 #651 156050 156014 #129 w #710 156040 132015 156063 #100 049 #6 ♦ #766 #167 166039 156017 #82 # 67 #820 156048 132016 '56 156038 #97 #28 #695 005 156059002 156062 156016 #40 156035001 #725 #0 #741 #78 156047 156046 #83 132027 156061 #61 #40 #761 0 156060 ?� #15 132021002 ��` 1 9 5 15#30002 # #7f1 1.0 1 O�y 10108 166035002 156058 V 4156032 ��Q 4K #c5� 1#003, ��V #12 156031 156004 156023 #825 #842 #866► 156024001 156056 0 6• #35 OW 156002 _ #69 156033 ♦ ` 156055 156025 1#146 �#50 156030 #21 #960 #837 166029001 156054 179001002 #857 4* #902 #976 156007 #916 60 ♦ #897 ♦ .,ry 166001002 1534 156036 #101 #66 156028 � #881 0 156001001 156029002• r 156026 #20a #35 �#970 156064 179002 155042 #0 #1000 131022 #g 156027 155034 #245 155011 S #905 #0 155024 s 150 ® 155023 i #995 #96 #975' 155012 # 1 9 #0 155039 ® !� • �!@ #132 . #248 155025 15501? W ��O Y 155013' #2606 #999 #147 155005001 '� 15604SA00 155037 165021 ® 155033 155009 #141 #,114 #9999 #p�}A9 4 155 11A" �48 #24 155 0 r� 155005002 # tr;�1541122 155043 #2482 178026 155007004 5 155035•#2469 f 155027 r#10 #121 #2461 #2472 #27 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:156 Parcel:031 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:WHITE,SUSAN MEADE Total Assessed Value:$361300 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map , ;,p� are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:0.39 acres Abutters �* boundaries and do not represent accurate relationships to physical features on the map Location:825 MAIN ST./RTE 6A(W.BARN.) such as building locations. Buffer /s ! t i A-PRESS Pik IT DEC 2 2 2015 Cape Save Inc. TOWN OF BNRNSTABLE 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 12/18/15 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 201507548 Dear Mr. Perry This affidavit is to certify that all work completed for 825 Main St,West Barnstable has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Maprt 6 Parcel 0 3' 1 OF BARNSTABLEAPp (lication # 75Q Health Division '' ',' ,/ d ;j e: -,Date Issued Conservation Division % Application Fee 0'. (r Planning Dept. �� -�� Permit Fee � -00 Date Definitive Plan Approved by Planning Board iG Historic - OKH _ Preservation / Hyannis Project Street Address R S M a".n cS+-fu+ W Village as-r g Owner `s*�G,� -� hiTti. Address_ Sam 2 Telephone 5 6 R a.3 3- Permit Request d� 1'�= 9 ��aS's -I-o �1-� a -C a �I*nr► ,1+ snd �� ' f , , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 0 0 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type:. Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil . ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes X(N 0 If yes, site plan review # Current Use Proposed Use "`- APPLICANT INFORMATION I (BUILDER OR HOMEOWNER) Name i i &C1mke,, / r. ,,P vt, c• Telephone Number 5M 3 4 8 0399 Address -� '"�'� � Avg License # a- C 10&1 -f- 6 ,no_4 k Cf W 6 Home Improvement Contractor# Email Worker's Compensation # W WC 313 G a 9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE < FOR OFFICIAL USE ONLY ' APPLICATION# DATEISSUED „ MAP/PARCEL NO. ADDRESS VILLAGE OWNER ` t DATE OF.INSPECTION: FOUNDATION FRAME INSULATION s: FIREPLACE Y 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' - The Commonwealth of Massachusetts Department`oflndustrialAccidents . I Congress Street,Suite 100 Boston,MA 02114-2617 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ i am a employer with 20 employees(full and/or part-time).* - '], New construction _In I am a sole proprietor or partnership and have no employees working for me in -8, E]Remodeling any capacity.[No workers'comp.insurance-required.] 3.n I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition ' 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition , ensure that all contractors either have workers'compensation insurance or are sole I L Q Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.*- 6.a We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other Insulation 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Wesco Insurance Company Policy#or Self-ins.Lic.#:WWC3136274 Expiration Date-04/09/2016 Job Site Address: 825 Main Street t City/State/Zip: West Barnstable Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded.to the Office of Investigations of the DIA.for insurance coverage verification. I do hereby certify under th pains andpenaldes ofperjury that the information provided above is true and correct Si attire: Date: 11/5/2015 Phone#:508-398-0398 Official use only. Do not write in this area,to be completed by city or town official City or Town; Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACCORV® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYI� 1 111/1.4/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. CONTACT PRODUCER NAME: Colleen Crowley Risk Strategies Company PH�tN E (781)9 8 6-4 4 0 0 AC No: (781)963-4420 15 Pacella Park Drive EMAIL ADDRESS:ccrowley @risk-strata m es.co Suite 240 INSURER(S)AFFORDING COVERAGE NAICi Randolph MA 02368 INSURERA:Selective Ins. of America INSURED iNSuRERs Allmerica Financial Alliance Ins Co 10212 Cape Save, Inc iNsuRERc-.Wesco Insurance Company 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth NA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL15101402127 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER MMl ICY EFF MMOI ICY EXP LTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE Fx-]OCCUR PREMISES iEe occurrence $ 100,000 B1994480 10/16/2015 10/16/2016 MEDEXP(Any oneperson) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[�]ACT Fx-1 LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea accident $ 1,000400 000 B ANY AUTO BODILY INJURY(Per person) $ ALL OS AUTOS E SCHEDULED AU AWRA46796600 I1/6/2015 11/6/2016 BODILY INJURY(Per accident) $ X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ X UMBRELLA LIAB N OCCUR EACH OCCURRENCE _ $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1 o00 000 DED RETENTION Nil S1994480 10/16/2015 10/16/2016 $ WORKERS COMPENSATION officers Included for X I PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE Coverage E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? F NIA (Mandatory In NH) I ! VWC3136274 4/9/2015 4/9/2016 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more apace Is required) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar Electric are all included as Additional Insureds with respects to the General Liability coverage of Named Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis; MA 02601 AUTHORIZED REPRESENTATIVE Michael Christian/CLCr O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I NS025(201401) I Town of Barnstable Regulatory Services • MAIMMUM E �, Riebard*.Sc.A Director � 6 ��0 Building Division TomPerry,wilding Commissioner 200 Maas Street,Tiyannis,:MA 02601 , SP y.town.barflstab1e_nia.us Office: 5087862-4038 Fax: 508 790..6230 Property Owner Must Compk-te,and.Sign'l s Section If Uszng.ABuildeir r 5 �5C". gas.Qwnec:of'the,`stbjecrpxopeny hcmbyauthorize C�iP�- S e-U Q-- to amenmybehalf, in all matters mla&c to vmrkauthorized by this budding permit application for: °{AdaressYof=�oli)�; ""Pool fences and alarms are the iaesponsiibil�of the-applicanti. fools are motto°be'£iUed or utilized before fenee:is installed-and all fiaal inspections are performed and accepted. ignature of Owner S Vi atute•of,Applicant Prima Name Print Naa%e Imo- 71 Date Q:F0RMS:0XVNWE RWSSI0NPools 4 F i ptlI e a n2-wan wealtI o- C'/&JJad u0e&j� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 - - - --- _ - -- Update Address and return card.Mark reason for change. sCA i 0 20M•05111 Address Renewal Employment Lost Card �l/rn niuiiu•rruealG�r!` #"Ja nrxujel/s ..... .. _ . • Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 1i1380 Type: Office of Consumer Affairs and Business Regulation VExpiration:,----3/14401,6 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 I CAPE SAVE INC. - WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 Undersecretary Not vali rthout signature Massachusetts-Department of Public Safety Board of Building Regulations and Standards ConAtrucdori Sunel vasar speiiaiiJ License: CSSL-102776 WILLIAM J MC au� 37 NAUSET ROAD I�'1•t>F West Yarmouth 1.VIA dV Expiration Commissioner 06/28/2017 I Town of Barnstable Building Post This Card So That it is Visible From the Street=Approved Plans Must be Retained on Job and this Card.Must be Kept Mnsa Posted UntilTinal Inspection Has Been Made. Pe 659. Where a Certificate of Occupancy is Required,such.Building shall Not be Occupied until a Final Inspection has been made: Permit _ 1 m 1 y Permit No. B-16-1310 Applicant Name: Nathan Tissot Map/Lot: 156-031 Date Issued: 07/06/2016 Current Use: Zoning District: RF Permit Type: Solar Panel-Residential Expiration Date: 01/06/2017 Contractor Name: SOLAR CITY CORPORATION Location: 825MAIN ST./RTE 6A(W.BARN.),WEST BARNSTABLE_, _. ._Est. Project Cost: $7,000.00 Contractor License: 168572 Owner on Record: WHITE,SUSAN MEADE i Permit Fee `,� $90.00 Address: 825 MAIN ST + Fee Paid: .$0.00 WEST BARNSTABLE, MA 02668 ! Date: 7/6/2016 1 �. i Description: Install solar electric panels on roof of existing house with aIny upgrades,when applicable,specified by Design;To be interconnected with home electrical system. IJB0262437-6.75KW 25Panels Project Review Req : Install solar electric panels on roof of existing'house with any upgrades,when applicable,specified by Design;To be interconnected with home electrical system."J60262437-6.75KW 25Panels Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road a`nd shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: i 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection M� 5.Prior to Covering Structural Members(Frame Inspection) - 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. �!✓L�I-�� "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). �MAyL S OX-7v Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT a��yo?yo 7 opt t Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fees o� • BARNsr/>Btf, • , Mass. e$ Richard V. Scali,Director 1639• AlFD�,t p A � Building Division . Tom Perry,CBO,Building Commissioner - 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number Not Valid without Red X-Press Imprint Q- � 5` �� Property Address O 01 t� n I Vl r n o� Q Residential Value of Work �� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address SU 5&0- , qq Contractor's NamevyL. l— V Telephone Number U ( 6' 1 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) t _ (v `GV.13dEp'o n- 1 Raw XWorkman's Compensation Insurance Check one: OCT 24 2014 I am a sole proprietor T ❑ I am the Homeowner OWN OF BARNSTABLE ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) [r✓]Re-side �/ V se,/Y/� Replacement Windows/doors/sliders.U-Valuej✓t 7 (maximum .35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy f the Home Improvement Contractors License&Construction Supervisors License is requi SIGNATURE: Q:\WPFILES\FORMS\building permit fonns\EXPRESS.doc Revised 061313 i 27te C'omrrxa7nywnI&of Vassachustfts Depw-knenf oInthrstr d Accidents Office of InveSt4zafioTIS 600 Waylr&igfon Street- Boston,MA 021I1 tvtsw raaas--�gvWdia ',orkers' Compensation Lim muce davit:Bui.TdersfConfractorslEiectricianMumbers AppUcant Please Prnat j&igibly �3me()��ue..s�lO�ganizafionFfa�vicinan_ �/� !/i /� A di--ems: CitylstatzJZ1P: e Phoneme Are you an employer?Check tT�appropriatebo-x- Type e�eral c a� of. of (—t r 4-. am , onfractor and I Pr 1 �ee}u'u e�.: 1:.El I zl-n a eluptoyer with � I a 6- ❑New a sfns ea"-loyees{hill anddorpait-time)* have hi-edtlie sub=confr&don. 2_X'I Qrn a sofe pmp6etor or partner- listed on the af,+acEed sheet; 7- ❑Remodeling ship as:d.>zve,no I loyees These sub--contractors have g_ ❑Demnlifioa world-,-4 for rn in .c.1-any pa.c.ity employees and.have workers' � 3 rsvp:, cttr t 4_ ❑Building additionitiadditionR`o.wo_=s.' coy nance comp-inStuance- ezpused_] 5_❑ `,e are a corporation and its 10_0 Ilectrical repairs or additions 3.❑ Jaw a hoar r�n doing all z�or' officers have euerased their 1i�_.❑Plumbing repairs or additions GL myself [No worl�'comp_ right.of 1(4t nd per Have 121.0 Roof repairs ialctrranc�regnired_�i c_ 152,§1(4),and rx e Frsti�e no employees_[No wMicers' 13_.❑Other comp_insurance required: "Azy spp dcnr,fxt ched s box r1---as'slso n-1 oiA tie sec6on b-Lk K-sh—me meir wo:Ren'cos=ensaSion policy mffinm� 9 ir��crrnEs Iran saorat this s-+dzc•-ii i�cs�they are wing:��iuric sad t3im h?rn oadsi�c cogixacmrs amsi subcn�s n�:r�crit md�:ng sarli t ttxcivrs tiL¢t cm k this bar mast sttscJi�ant.dditionsl sieet soon n3D aP ns�o* stilt xheu�er txno:Il se Mies Iu� ErepWy ff 5 Ifth-a sne-coat M Ctats hzt etwioyxs,the}'must grsnue�=r 4.arke;s'comp.policy nun be r_ I am arz s rzp Er iitat is praXridiiz tt orkers'corm atrsrfzizn irLsrtrrutcs for nib:etr}�Z�yees $etotr is tFte paficy and job sr1� 2n,fOYfi{4IiO:!L Laurance CompasryName: Policy fr or Sflf a-s_Lic FxpuationDate: fob Sites address: 3 joll"w CitjIIState/Zip:4,/e-5/L fittacbt a c-cpy of the xmrkers'compensation policy deciarstion page(showing the policy-nzmber an:d Expiration dste). Failure tosEcrue cayerage as requireduuder Sectioa 25 A;of-MGL c- 152 can lead to the imposition of criminal penalties of a fine up to$1,1500.00°andlor one wear impriso xnf,as well as 6--c it penalties iu the form of a STOP WORD ORDER and a fore, of up.to$250.00 a.day against the violator_ Be a4vised that a copy of this statement maybe forwarded to the Office of Lavestigntions of the DIES fw insurance coverage veriEcation._ I dd herelxy cvlti iurder tlzs pains a puss ofpcijary tf!et'the infprnztdrvn prmidRd above is hue anif correct Si> atare: Date: Phone 9- of zciaL use orlLy. Do,not Writs in taus area,to bs campleted by city or town officiaL City. or Town: Permit/Licease AE Issuing Authority(circle one): 1.13aard.ufHcpJt-h 2.BudffingDeparhnent _3-CityffawaClerk 4_ELedrical Lisp ector b'.Plumbingfnspertor 6.Gther Contstct Person: phone#: 6 Information and Instructions Massachusetts General Laws chapter IS2 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, an employee is defined as"_-_every person in the service of another under any contract of hire, express or implied, oral or written.-" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees- However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." M1GL chapter 152, §25C(6)also states that"every state or local licensing agency shall vwithhold the issuance or renewal of a license or permit to operate a business or to construct buildh-igs is the commonrrcaltl,for ar3.y applicautwho has not produced acceptable evidence of compliance-with the i:nsurance.coverage requires,." Additionally, MGL chapter 152, §25C(7)s`2fcs'-Neither the commonwealth nor any of its political s�.ibdiv;sions shall enter into any contract for the performance of public work until acceptable evidence of compliance vrith the insurance requirements of this chapter have been presented to the contracting authority.-' Applicants Please fill.out the workers' compensation a?ildavi.t completely,by chec1ci_n.g the boxes that apply to-cur situation and,i.f necessary,supply sub-contractors)na�ne(s), address(es)and phone iurr_be,-.(s) along with their czrti:ficate:(_)of irsurance. Limited Liability Companies(LC) or Limited Liability Partnerships(I_r P)withZno P-inpioyees other than the members or partners, are not required to carry workers' compensation_,si77ance_ if an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be s:bmifted to the Department of i.ndus�br al Accidents for confirrnation ofinst_*rnce tovenge. Also be sure to sign anal date the of add- t '17 e aff-5-idavit should be returned to the city or town that the application for the permit or license is being requested, not the Depa�ent of Lad-usirial A ccidents. Should you.have any quesrcims regarding the lzrvv or if you are required to obtain a workers' compensation policy,please call tie Depaa t,1r ent ai the number listed below. —Self—insured companies should enter their sell-insurance;license number on :e appropriate line. City or TOMS.officials Please be sure that the affidavit is complete and printed legibly. The Deparlmtnt has provided a spac_-at the bottom of the affidavit for you to ill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to Ell in the permighccuse number which will be used as a reference number. In ad.di Pion,ana applicant that must submit multiple pe itll_icense applications in any given year,need only submit one afIldavit md:icac-ing current policy information (if necessary) and under"Job Site Address'the applicant should w ite"all locations in (cif or town)."A copy of the affidavit that has been officially stamped or marked by I e city or town may be provided to the applicant as proof that a valid aff5r,av'it is on ale for future permit or licenses_ A new affidavit must be filled out each year.Wbere a home owner or citizen is obtaining a license or permit not related to any business or co;nmercial venture (i_e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this afridw;_t. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: ��COL)3mQnCh=p-aT&of Massadaus-ttts Diapa:Etmtiat Gf Industrial Accld en is GMQe of lavesdgatiGns GL� as n,tan Si-�t BB-as ton, 02111 RJ,1-k G l 7721 49-Q-0 e,�L 406 or I-?,7—_vt.AS S._A F Revised 4-24-07 Fax t 617-727-l;t- -wVvW_Mas�gav/Loa a i .._ ...:.•,�:--v��._.....:=7a.:_... .- at:i as:_.—_.,'.`_:�?<:?5�;p:::,•y:;: �... ViteO7IUYl26'/'tUJECLGC/L•O�C%!/GCZddCGC/2LLQCCGJ: .;' s . Office of Consumer Affairs&Business Regulation . License or'regtstratton valid for tndwtd'ul us'e on� ! before the expiration date. If found return to FME IMPROVEMENT CONTRACTOR p ice of Consumer Aff_.+rsaitYl s ne s Regulatior' j ' egistration 115356 Type: i x iration: 2/10/2t}16:; Private Corporaticd; xrk Plaza-Suite 5170 �= p - Boston,MA 02116 WILLIAM FARRINGTQ BUILDING'&-REMOD I WILLIAM 13 DEWEY AVENUE 1 SANDWICH,MA 02563 `�- evi u P� valid without signature i Qassachusetts',: <...;ard 4#gu11d� Partrne fp nt o Con_5tructo9 Ragula}ions.an ubl�Safety. licens ❑SuPefi�sor 1. "1 d Stanards 1665 ' j8DLWE q. FqGa S YAVE_ ON �XPtrat o Q7/072015 . Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991M )of enclosed space. f, Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DP5 , a - 'ME T° Town of Barnstable °M Regulatory Services + BARNSTABLE, MAss. �,, Richard V.Scali,Director 9cb 1639. �0 '�Eo►�yA Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 -� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must _ Complete and Sign This Section If Using A Builder I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this biQng perrnit application for. (Address of Job) Pool fences and alan- s are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and.accepted. /. Signature of Owner Signature of Applicant Print Name Print Name _ Date Q:FORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services ram. ��oF cHe roiyy Richard V.Scali,Director Building Division t saazvsTasrr;. ' Tom Perry,Building Commissioner MASS. 059- �� 200 Main Street, Hyannis,MA 02601 pTEO to www.town.barnstable.ma.us t Office: -50.8-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: y� JOB LOCATION: �5 /%Li number street village ..HOMEOWNER": name home phone# work phone CURRENT MAILING ADDRESS: v��i�til t city/town state Tp code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF ROMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code au.d other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,RuIes&&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 t amend and adopt such a forru/certification for use in your community. Q:\WPFILES\FORMS\building permit fomis\EXPRESS.doc Revised 061313 i H E AT L M, ' SPRAY POLYURETHANE FOAM SO V 00 �2 Installed Insulation Statement Location of Insulation Thickness Total R-value Approximate Sq.Ft. Walls x 7.0= Attic- Floor or Roof Deck(circle one) 4" x 7.0= R-28 325 sq.ft. Cathedral Ceiling x 7.0= X 7.0= x 7.0= i R-value= 7.0 per inch 3 Tensile Strength=45.4 psi Density = 2.1 Ib/ft Compressive Strength=20.6 psi DEMILEc Batch# d0/ .t Cape Cod Insulation 508-775-1214 Company Name Phone mbe Keith DacIey -2 Applicator Name i pplicato Signature Date I ZZ .E 9— rajr Z10Z 1 i AN r lance Spray Foam Insulation Installed Insulation Statement � I Location of Insulation I Thickness Total R value Approximate Sq. Ft. Walls x 4.45= 1 Attic- Floor or Roof Deck circle one)> 5 '/2" x 4.45= R-24.47 460 Cathedral Ceiling x 4.45= x 4.45= x 4.45= I i I R-value= 4.45 per inch Tensile Strength= 3.87 psi Density= 0.6 -0.8 Ib/ft3 Compressive Strength= 1.86 psi DEMILEc Batch o��IOQQ� i Andek Batch# Cape Cod Insulation (ifappticabte� Company Name 508-775-1214 I i Ph�Nuer Keith Dacey lame — .`� L� v Applicture Date 24 Can . z Z .E [!d 9- dill 1191 N� C °d" �NSTgLL��Z TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #od d 16 6 Z.(. Health Division Date Issued 1 Z Conservation Division Application Fee �s Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address //Gs/-��5/ Village Owner �c/ � lire/ Address Telephone Permit Request Square feet: 1 st floor: existing�vproposed v� 2nd floor: existing ZQJ1 proposed zn-0--i Total new" Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type �y i Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure E? . Historic House: ❑Yes ❑ No On Old King's Highway:.9 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new a Half: existing new Number of Bedrooms: existing O new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: YGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: Q Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn.;Efexisting -0 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 # =r Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Y&N n1=2 Telephone Numberll��=-� 7 Address /��r°All"i 50F License# - ome Improvement Contractor# U Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 'SIGNATURE DATE / C� /S- �> . .maw FOR OFFICIAL USE ONLY APPLICATION# } OATE ISSUED MAP/PARCEL N0._, ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION: . FRAME 4 d" INSULATION � 6t : `' m1� SS FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 'ROUGH: FINAL Z f }FINAL BUILDING' D! .'L �7 �? `�— t c • ASSOCIATION PLAN NO. ; 5 f F I 1 4� The Commonwealth of Massachusetts i I Department of Industrial Accidents V; x� 6 Office of Investigations 600 Washington Street � iV�lis Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: /87 P P City/State/Zip: W" Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ ? ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] of 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] fAny applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation.insurance for my employees. Below is the policy and job site information. ,A _ Insurance Company Name: Policy#or Self-ins. Lic.#: Z 75 I✓ Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der thepains �and penalties of perjury that the information provided above is tr a and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town:. Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house i or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely;by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bott6m of the affidavit for you to fill out,in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant . that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 611-727-4900 ext 406 or 1-877-MAS.SAFE Revised 5-26-05 Fax # 617-727-7749 www.mass..gov/dia u- Massachusetts- Department of Public Safety Board of Building Re-ulations and Standards Construction Supervisor License License: CS 61665 Rt:stricted to: 00 P WILLIAM E FARRINGTON 18 DEWEY AVE S: NDWICH, MA 02563 Expiration: 7/12011 ('onunissi nn•r Tr#: 19T76 .—... .• .. . ✓>'ie inanrz�zza•�zcuaall� c�'✓��aaaac�rrae� ' License or registration valid for individul use only Office of Consumer Affairs&Business Regulation :. before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation _,. Registrations 115356 10 Park Plaza-Suite 5170 Expiration%_ I10/2012 Tr# 292942, Boston,MA 02116 Type};...=Private Coiporation 4 WILLIAM FARRINGTOO BUIEDING&REMOD .� WILLIAM FARRINGTON`_-. i 18 DEWEY AVENUE;`:__': SANDWICH,MA 02565. "` Undersecretary I valid without signature yoFtHEr�y Town of Barnstable Regulatory Services I Y + BAWSIABL.E, Muss. Thomas F.Geiler,Director E b - a�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-62-' Property-Owner Must Complete anad Sign.This Section If Using A Builder JI, , as Owner of the subject property hereby authorize to act on my behalf, m all matters relative to work authorized by this adding permit application for. (Address of Job) �a - 15 v Signature of Owner Date �Gl.SGLh W�LI `�('i Print Name If Property Owner is applying forpermYt please complete the Homeowners License Exemption.Form on the reverse side. Q:FORMS:0 WNERPERMISS10N Town of Barnstable F THE rp�y , o Regulatory Services BARNSTAHLE, Thomas F. Geiler, Director MASS $ Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 wwiv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ---------- HOMEOWNER LICENSE EXEMPTION Please Print DA TE: JOB LOCATION: _ number street village "HOMEOWNER": name home phone# work phone# CURRENT MAfLING ADDRESS: 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 supervisor. DEFINITIW 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 tyro-family dwelling,attached or detached structures accessory,to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall.submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for a11-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 i applicable codes, bylaws, rules and regulations. The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner ,f 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 EXEIITPTION 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 I09.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowncr 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 Kith a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is hilly aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner ecrtify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. i REScheck Software V erslan 4.4.0 ell Compliance Certificate Energy Code: 2009 IECC Location: Barnstable,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent Designer/Contractor: 825 RL 6A - Farrington Building&Remodeling Inc. Barnstable,MA 02630- 18 Dewey Ave. Sandwich,MA 02563 a� ;=3 .:."f.' •rs�,cxx:�,5' '...��`�-� �s.�"_� - _"'_.�'.�ctT.:i�.� �•�'�' .��>� .a�'h�.._v.e Y. aS��.J..�','� .'`z..-)=M=�S�:<;�:s,:F•,w.; ''.^.iuS::,,:.,..+�� K��3s..`!�,��rr,:�,`°fi?;:i?s�.n;r :�,.4_-_�„ .�-. �. - �,� v:--x�z�..�.•�s.t, Compliance:0.8%Better Than Code Maximum Uk-120 Your UA:119 The%Better or worse Than Code index reflects how dose to compliance the house is based on code tradeoff odes. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code tame. __ ' - "_ _ v .. F _��N. .�. �':7•. dgy� Jam'. xR :;iwq� ': - � r e� i - •a 4 a a'� P��a s s Ceiling 1:Cathedral Ceiling(no attic) 460 24.8 0.0 19 Wall 1:Wood Frame, 16"o.c. 752 15.0 3.5 34 Window 1:Other 113 0.320 36 Door 1:Solid 20 0.270 5 Door 2:Glass 40 0.320 13 Floor 1:All-Wood JoistlTruss:Over Unconditioned Space 360 28.0 0.0 12 Compliance Statement. The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.4.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: Report date: 12/16/10 Data filename: Untitied.rck Page 1 of 4 r 3- 4.ma-rr d: c,"s Software lersi xs'ce'�='. �`Aoo'��'a`S'.9 Inspection Checklist 6 p Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-24.8 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16°o.c.,R-15.0 cavity+R-3.5 continuous insulation Continuous insulation specified for this above-grade wall has consistent R-value rating across full area of the wall. Comments: Windows: ❑ Window 1:Other,U-factor.0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Themnat Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor:0.270 Comments: ❑ Door 2:Glass,U-factor:0.320 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-28.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are seated with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier.Instatled on outside of as-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. Project Title: Report date: 12/16/10 Data filename: Untitled.rck Page 2 of 4 (� Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showersitubs and exterior wall. Sunrooms: Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. 0 Insulation R-values and glazing U-factors are dearly marked on the building plans or specifications. Duct Insulation: Cj Supply duds in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: Ej Building framing cavities are not used as supply ducts. All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal dud connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect Continuously welded and locking-type longMAnal joints and seams on duds operating at less than 2 in.w.g.(500 Pa). Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 28.8 cfm(8 cfm per 100 ft2 of conditioned floor area). (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 43.2 cfrn"(12 cfm per 100 ft2 of conditioned floor area)pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 21.6 cfm(6 cfm per 100 ft2 of conditioned floor area) when tested at a pressure differential of 0.1 inches w.g. (4)Rough4n total leakage test without air handler installed:Less than or equal to 14.4 cfm(4 cfm per 100 ft2 of conditioned floor area). Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: i Where public health standards require continuous pump operation. When:pumps operate within solar-and/or waste-heat-recovery systems. i Project Title: Report date: 12/16/10 Data filename: Untitied.rck Page 3 of 4 1 Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-6 or smaller diameter linear fluorescent (c)40 lumens per waft for lamp wattage—15 (d)50 lumens per watt for lamp wattage>15 and—40 (e)60 lumens per waft for lamp wattage>40 Other Requirements: Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,.b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement's').. Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) I Project Title: Report date: 12/16/10 Data filename: Untilled.rck Page 4 of 4 ewu%;Z-1, M.%.P fu Ceiling I Roof 24.75 Wall 18.50 Floor/Foundation 28.00 Ductwork(unconditioned spaces): Window 0.32 0.34 Door 0.32 0.34 Heating System: Cooling System: Water Heater: Name: Date: Comments: [ ] [R156 031 . ] LOC] 0825 ROUTE 6-A CTY] 05 TDS] 500 WB KEY] 89031 ---MAILING ADDRESS------- PCA] 1091 PCS] 00 YR] 00 PARENT] 0 WHITE, SUSAN MEADE MAP] AREA] 8 8AB JV] MTG] 2 0 01 825 W MAIN ST SP1] SP21 SP31 UT11 UT21 . 39 SQ FT] 1620 W BARNSTABLE MA 02668 AYB] 1930 EYB] 1970 OBS] CONST] 0000 LAND 27900 IMP 80000 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 107900 REA CLASSIFIED #LAND 1 27, 900 ASD LND 27900 ASD IMP 80000 ASD OTH #BLDG (S) -CARD-1 1 59, 400 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG (S) -CARD-2 1 20, 600 TAX EXEMPT #PL 825 ROUTE 6A W BARNS RESIDENT'L 107900 107900 107900 #RR 1387 0095 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE106/93 PRICE] 1 ORB18602/229 AFD] I F LAST ACTIVITY] 07/26/93 PCR] Y I .4 i R156 031 . A P P R A I S A L D A T A KEY 89031 WHITE, SUSAN MEADE LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 27, 900 80, 000 2 A-COST 107, 900 B-MKT 104 , 400 BY 00/ BY /00 C-INCOME PCA=1091 PCS=00 SIZE= 1620 JUST-VAL 107, 900 LEV=500 CONST-C 0 ----COMPARISON TO CONTROL AREA 88AB -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 88AB WEST BARNSTABLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 279001 LAND-MEAN +Oo 1079001 97303 IMPROVED-MEAN -180-o 2506 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] I I i R156 031 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 89031 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. 1 CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAIN (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING P01 POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT W WATT 3R NEMA 3R, RAINTIGHT 6A PV1 COVER SHEET PV2 PROPERTY PLAN PV3 SITE PLAN PV4 STRUCTURAL VIEWS LICENSE GENERAL NOTES PV5 UPLIFT CALCULATIONS PV6 THREE LINE DIAGRAM GEN 168572 1. ALL WORK TO BE DONE TO THE 8TH EDITION PV7 ELEVATION # ELEC 1136 MR OF THE MA STATE BUILDING CODE. PV8 RENDERINGS 2. ALL ELECTRICAL WORK SHALL COMPLY WITH Cutsheets Attached THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: ZEP SOLAR AHJ: Barnstable REV BY DATE COMMENTS REV A NAME DATE COMMENTS a s , UTILITY: NSTAR Electric (Commonwealth Electric) J B-0 2 6 2 4 3 7 O O PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL — THE INFORMATION HEREIN NDMBER: SUSAN WHITE `\��SOI��VI CONTAINED SHALL NOT E USED FOR THE Susan White RESIDENCE Deepak Krishnaraju J ` , BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �•.�`.� Y NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 825 RTE-6A 2.7 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: W BARNSTBL MA 02668 ORGANIZATION, EXCEPT IN CONNECTION VATH 24 St. Martin Drive,Building 2, Unit 11 THE SALE AND USE OF THE RESPECTIVE (10) AU Optronics # PM060MOO-27OW SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PACE NAME: SHEET: REV: DATE: Marlborough, MA 01752 } PERMISSION OF SOLARCITY INC. INVERTER: 5082379668 PV 1 3 3 2016 T: (650)638-1028 F: j650) 638-1029 SOLAREDGE SE3000A—USOOOSNR2 COVER SHEET / / (888)-SOL-CITY(765-2489 www.solarcity.com I I I I , I I I I I i ,ore 0\ c� PROPERTY PLAN N Scale:1" = 20'-0' w E 0 20' 40' S CONFIDENTIAL TIAL- THE INFORMATION HEREIN �B NUMBER PREMISE OWNER: DESORPTION: DESIGN: CONTAINED SHALL NOT USED FOR THE J B-0262437 00 gut,MOUNTING SYSTEM: ■ SUSAN WHITE Susan White RESIDENCE Deepak Krishnoraju SolarC�ty. BENEFIT OF ANYONE EXCEPT SOLARg1Y INC., �.�� NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 825 RTE-6A 2.7 KW PV ARRAY ►, PART TO OTHERS OUTSIDE THE RECIPIENTS MaoutEs W BARNSTBL MA 02668 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE (10) AU OptFonics # PMO60M00_270W sa St. Martin Dom,Building z Unit n PAGE NAME ��' DATE a SOLARgTY EQUIPMENT, WITHOUT THE WRITTEN R��, T: (650)638-1 28 F. (650)638-129 PERMISSION OF SOLARCITY INC. SOLAREDGE # SE3000A—USOOOSNR2 5082379668 PROPERTY PLAN PV 2 3/3/2016 (866)-SOL-CITY(765-2489) www.edarcity.corn PITCH: 18 ARRAY PITCH:18 MP1 AZIMUTH:222 ARRAY AZIMUTH: 222 82 ain St MATERIAL: Comp Shingle STORY: 2 Stories (E)D WAY O K. � O RIUKI ■"► '�•'mow v s-r UCTURAL A.—lip i�W 7, NO.51999 +J FSTE��° �OIIYA APR 2 7 2016 C Town of Barnstable STAMPED & SIGNED old Com Highway Committee FOR STRUCTURAL ONLY Digitally signed by Humphrey LEGEND Kariuki Date: 2016.03.08 09:51 :51 Q (E) UTILITY METER & WARNING LABEL -051001 by & WARNING LAB INTEGRATED DC DISCO ELS Front Of House DG DC DISCONNECT & WARNING LABELS LEM AC DISCONNECT & WARNING LABELS 0 DC JUNCTION/COMBINER BOX & LABELS Q DISTRIBUTION PANEL & LABELS / D ' LG LOAD CENTER & WARNING LABELS L�_ AC ® O DEDICATED PV SYSTEM METER re"ce Unlocked Gated t Inv O STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR --- CONDUIT RUN ON INTERIOR GATE/FENCE p HEAT PRODUCING VENTS ARE RED r,_ INTERIOR EQUIPMENT IS DASHED SITE PLAN x Scale: 3/32" = 1' AO1, 10' 21' CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER J B-0262437 00 PREIIISE OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE SUSAN WHITE Susan White RESIDENCE J Deep ak Krishnora u � t, BENEFIT OF ANYONE EXCEPT SMMC11Y INC., MWNTING SYSTEM: wo"'Sola ity. NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 825 RTE-6A 2.7 KW PV ARRAY ►�� PART TO OTHERS OUTSIDE THE RECIPIENTS MoouLEs W BARNSTBL MA 02668 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE (10) AU Optronics # PM060M00-270W 24 St. Martin Drive,Building 2,Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME: SHEET: REV DATE Marlborough,MA 01752 PERMISSION OF SOLARCITY INC INVERTER: 5082379668 PV 3 3 3 2016 T: (650)638-1028 F: (650)638-1029 SOLAREDGE SE3000A—USOOOSNR2 SITE PLAN / / (8B8)-sa-CITY(765-2489) BolarcIt•c«n i j S 1 PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER (E) 2X6 & FENDER WASHERS LOCATE RAFTER, MARK HOLE ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT ZEP ARRAY SKIRT (6) HOLE. (4) Q2) SEAL PILOT HOLE WITH ZEP COMP MOUNT C POLYURETHANE SEALANT. 13 -1" ZEP FLASHING C (3) (3) INSERT FLASHING. (E) LBW (E) COMP. SHINGLE • (1) (4) PLACE MOUNT. i SIDE VIEW 0 F M P 1 NTS (E) ROOF DECKING (2) (5) INSTALL LAG BOLT WITH A 5/16" DIA STAINLESS (5) SEALING WASHER. STEEL LAG BOLT . LOWEST MODULE SUBSEQUENT MODULES INSTALL LEVELING FOOT WITH MP1 . X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES WITH SEALING WASHER (6) BOLT & WASHERS. LANDSCAPE 72" 24" STAGGERED (2-1/2" EMBED, MIN) PORTRAIT 48" 19" 1 (E) RAFTER STANDOFF RAFTER 2X8 @ 24" OC ROOF AZI 222 PITCH 18 STORIES: 2 S 1 ARRAY AZI 222 PITCH 0 Comp Shingle F K. z IUKf ST UCTURAL v NO.514-13 O FGIST6�� STAMPED & SIGNED .�� FOR STRUCTURAL ONLY PQF� gamstabav - pad G°mm��te CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: J B-0262437 00 PREMISE OWNER: DESCRIPTOR: DESIGN: CONTAINED SHALL NOT BE USED FOR THE SUSAN WHITE Susan White RESIDENCE Deepak Krishnaraju BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �•.�r SO�af C�t�/NOR SHALL IT BE DISCLOSED IN WHOLE OR IN 825 RTE-6A 2.7 KW PV ARRAY ►VA PART OTHERS OUTSIDE THE RECIPIENT Comp Mount Type c 'S MODULES: W B A R N S TB L M A 0 2 6 6 8 ORGANIZIZ ATION, EXCEPT IN CONNECTION WITH � ` THE SALE AND USE OF THE RESPECTIVE (10) AU Optronics # PM060MOO-27OW za St Martin Dom, Building 2,Unit 11 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER PAGE NAME' REV. DATE T: (650)6038-1 28 F:borou , A(650)636-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE # SE3000A—USOOOSNR2 5082379668 STRUCTURAL VIEWS PV 4 3/3/2016 (BB8)_SOL-CITY(765-2489) www.solarcity.com UPLIFT CALCULATIONS rAPR 272016 Old Kip t sarnsta 9's b/e Co�rnitteenl lay SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: PREMISE OWNER: DESCRIPTION: DESIGN: JB-0262437 00 SUSAN WHITE CONTAINED SHALL NOT BE USED FOR THE Susan White RESIDENCE Deepak Krishnoraju �SolarCity BENEFIT OF ANYONE EXCEPT SCLARCITY INC., MOUNTING SYSTEM: Ah NOR MALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 825 RTE-6A 2.7 KW PV ARRAY �� PART TO OTHERS OUTSIDE THE RECIPIENT'S MooutEs W BARNSTBL MA 02668 ORGANIZATION, EXCEPT IN CONNECTION WITH ' 24 SL Martin Drim Building Z Unit 11 THE SALE AND USE OF THE RESPECTIVE (10) AU Optronics # PM060M00-270W SCLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME. SHE: REV DATE. T: (650)638-1028,F: 01752 638-1029 ` PERMISSION OF SOLARCITY INC. ISOLAREDGE # SE3000A—USOOOSNR2 5082379668 UPLIFT CALCULATIONS PV 5 3/3/2016 (BBB)-SOL-CITY(765-2489) .•w•edaTai►yaam GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO TWO (N) GROUND Panel Number:NoLabel Inv 1: DC Ungrounded GEN #168572 RODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:44014155 INV 1 —(1) erter;SOLAREDGE SE3000A—USOOOS�2 LABEL: A —(10)AU O Module; 27 PMO60M00�70W ELEC 1136 MR Inverter; 3000W, 240V, 97.5% w Unifed Disco and ZB,RGM,AFCI PV Module; OW, 243.1 PTC, MC4, 40mm,BlackonBlack, ZEP, 1000V, 50P F Overhead Service Entrance INV 2 Voc: 38.5 Vpmax: 31.8 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 100A MAIN SERVICE PANEL E� 10OA/2P MAIN CIRCUIT BREAKER Inverter 1 (E) WIRING CUTLER-HAMMER 10OA/2P Disconnect 2 SOLAREDGE SE3000A-USOOOSNR2 (E) LOADS A za L1 ov �— L2 N 20A/2P PIG EGG --- DC+3) 6 IGEC N OG MP 1: 1x10 ---------- ----------------t� N 1 o EGGGEC_ I I I 1 I - GEC TO 120/240V SINGLE PHASE In UTILITY SERVICE I I � ZG16 1 1 APR 2 Tovm of Barnstable Old Comm ttteewaY PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP POI (1)SQUARE D B Q9220 PV BACKFEED BREAKER A (1)CUTLER-HAMMER 0 DG221URB n C PV (1o)SOLAREDGE�300-2NA4AZS DC Breaker, A 2P, 2 Spaces, Plug-On Disconnect; 30A, 240Vac, Non-Fusible, NEMA 3R /-� PowerBox iimizer, 30OW, H4, DC to DC, ZEP —(2)Gro qd Rod —0)CUTLER-{1AMMER 4 DGO30NB Sr8 x 8, Copper GrarndX.Wu al Kit; 30A, General Duty(DG) nd (1)AWG 06, Solid Bare Copper —(1)Ground Rod; 5/8' x 8', Copper (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION NO. 2, ADDITIONAL ELECTRODE MAY NOT BE.REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE O� 1 AWG#10. THWN-2, Block (2)AWG #10, PV Wire, 60OV, Black Voc* =500 VDC Isc =15 ADC Ise(1)AWG#10, THWN-2, Red O LPL(1)AWG #6, Solid Bare Copper EGC Vmp =350 VDC Imp=7.61 ADC (1)AWG#10, THWN-2, White NEUTRAL Vmp =240 VAC Imp=12.5 AAC . . . . . . . . .. . (I)Conduit Kit;.3/4',EMT .. . . .. . . . . . . . . . ... . . . . . . . . . .. . . . . .. .. .. . , . .-(1)AWG g8,.TH_WN-2,.seen . . EGC/GEC,-(1)Conduit.Kit;.3/47_EMT. . . . . . . . . . CONFIDENTIAL - THE INFORMATION HEREIN JOB NUMBER J B-0 2 6 2 4 3 7 00 PREMISE OWNER DESCRIPTION: DESIGN CONTAINED SHALL NOT BE USED FOR THE SUSAN WHITE -Susan White RESIDENCE Deepak Krishnaroju ' BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: SolarCty.l NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 825 RTE-6A 2.7 KW PV ARRAY PART OTHERS THE RECIPIENTS Comp W BARNSTBL MA 02668 ORGANIZATION, EXCEPT IN IN CONNECTION WITH r THE SALE AND USE OF THE RESPECTIVE (10) ALI Optronics #- PM060M00-27OW, 1 24 St Martin Drive,Building 2,Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME SHEET: REV: DATE Marlborough,MA 01752 PERMISSION OF SOLARCITY INC INVERTER 5082379668 PV 6 3 3 2016 T. ( )638 1028 F: (650)638-1029 SOLAREDGE SE3000A—US000SNR2 THREE LINE DIAGRAM / / ( )-SOL-�(765-2489) www.sclarcit.com RIDGE APR 2 7 2016 Town of Barnstable Old Kings Highway Committee y 21 7D-Y 16-T L BACK OF THE HOUSE SCALE Y4" = 1 '0" _ J B-0 2 6 2 4 3 7 0 O PREMISE OWNER: DESCRIPTION: DESa� CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: \r\SolarCity- NOR CONTAINED SHALL NOT BE USED FOR THE SUSAN WHITE Susan White RESIDENCEDeepak Krishnaraju SHTAOF ANBYONE EXCEPET N WHOLE ORCITY C., MOUNTING S'STEW 825 RTE-6A fi PART TO OTHERS OUTSIDE THE R WHOLE Comp Mount Type C 2.7 KW PV ARRAY ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES: W BARNSTBL, MA 02668 2a st.Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (10) AU Optronics # PM060M00_27OW PAGE NAME SHEET REV DATE Marlborough,MA 017L2 SOLARgTY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PERMISSION OF SOLARgTY INC SOLAREDGE SE3000A—USOOOSNR2 5082379668 ELEVATION PV 7 3 3 2016 T: SOLO)538-105— F: (sso)s3B- Y (Ii88}SQL—q1Y(7s5-24Bg) —.solarcd can I SATELLITE 130H I Ilk 1,1 yy i 9 J B-0 2 6 2 4 3 7 O O PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL THE INFORMATION HEREIN ae NUMBER: SUSAN WHITE Susan White RESIDENCE Deepok Krishnoroju �.=,So�arCit x CONTAINED SHALL NOT E USED FOR THE /•.r`` BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: 825 RTE-6A NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type c 2.7 KW PV ARRAY 1 PART OTHERS OUTSIDE THE RECIPIENTS MODULES: W BARNSTBL MA 02668 ORGANIZATION, EXCEPT IN CONNECTION WITH , THE SALE AND USE OF THE RESPECTIVE (10) AU Optronics # PM060MOO_270W 24 St. Martin Drive, Building 2, Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME: SHEET: REV: DATE: Marlborough, MA 01752 PERMISSION OF SOLARCITY INC. INVERTER: NAME: SE300OA—USOOOSNR2 5082379668 RENDERINGS PV 8 3/3/2016 (888)-SOL-)CITY(765-2489)6ww solarcitycom WARNING:PHOTOVOLTAIC POWER SOURCE Label ' •n: Label Location: .• • • WARNING WARNING ' Per Code: Per Code: Per Code: NEC Woo HAZARD690.31.G.3 RMINALSNEC - THE DC COND NEC 690.35(F) - • • T H LINE AND PHOTOVOLTAIC SYSTEM ARE •ENERGIZED� SITION N1AY BE ENERGIZED UNGROUNDED • NEC DISCONNECT IS Code: .•0 Label- Label L• • PHOTOVOLTAIC POINT OF AIAXIMUNI P01NER- INTERCONNECTION A D WARNING: ELECTRIC SHOCK Code: POINT CURRENT(Imp}— Per Code: HAZARD.DO NOT TOUCH •' 690.54 MAXIMUM P01NER —V NEC • TERMINALS.TERMINALS ON POINT VOLTAGE(Vmp) • i BOTH THE LICE AND LOAD SIDE NIAXINIURA SYSTENI_v N1AY BE ENERGIZED IN THE OPEN 0.53 VOLTAGE(Voc) POSITION. FOR SERVICE SHORT-CIRCUIT_A DE-ENERGIZE BOTH SOURCE CURRENT(Isc) AND N1AIN BREAKER. PV PO�AIER SOURCE MAXIAtUNiAC TO"of _ OPERATING CURRENT A • ' • w ay MAXIMUM AC • Label • • OPERATING VOLTAGE V WARNING Code:Per NEC ELECTRIC SHOCK HAZARD IF A GROUND FAULT IS INDICATED '' NORMALLY GROUNDEDLabel L• • CONDUCTORS NiAY BE CAUTION UNGROUNDED AND ENERGIZED - — DUAL POWER SOURCE Per ••- NEC SECOND SOURCE IS 690.64.13.4 PHOTOVOLTAIC SYSTENI Label • • WARNING ' Per Code: Label Location: ELECTRICAL SHOCK HAZARD DO NOT TOUCH TERMINALSNEC 690.17(4) CAUTION ' • TERMINALS ON BOTH LINE ANDPer Code: NEC LOAD SIDES MAY BE ENERGIZED PHOTOVOLTAIC SYSTEM 690.64.13.4 IN THE OPEN POSITION CIRCUIT IS BACKFED DC VOLTAGE IS ALWAYS PRESENT WHEN SOLAR MODULES ARE EXPOSED TO SUNLIGHT Label • • WARNING '• Per ..- INVERTER OUTPUT Label • - • CONNECTIONNEC • ' 4.13.7 PHOTOVOLTAIC AC DO NOT RELOCATEDisconnect DISCONNECT Per :Code: THIS ODEVICERRENTConduit •Combiner• NEC (D): Distribution Panel (DC).-. DC Disconnect Label Location: (IC): Interior Run Conduit MAXIMUM AC (AC)(PO I) (INV): Inverter With Integrated DC Disconnect A OPERATING CURRENTLoad Center Code: NIAXIMUNI AC OPERATING VOLTAGE V (M): Utility Meter NEC • 90.54 (POI): Point of Interconnection San mateo,CA 94402 EPA • i "�SoiarCity ®pSOlar Next-Level PV Mounting Technology *SoiarCity I ®pSolar Next-Level PV Mounting Technology Components Zep System ��y for composition shingle roofs ,� Up-roof Leveling Foot ` Interlock �0�d Leveling Foot ma's de''a`"t Part No.850-1172 Y �, - ----- ETL listed to UL 467 Zaocomoadbk PV KoduW q\e Pe ay 6 �pu•'t�/.l;\C.l�\\�e Zep Wrowe - _ ova God _ 0 Rod Atradnmern �� -•'` A.m,SIM*"t Comp Mount Part No.850-1382 Listed to UL 2582 Mounting Block Listed to UL 2703 COMVATj �? a� Description ~ j PV mounting solution for composition shingle roofs „ ~FIN. m Works with all Zep Compatible Modules MPpr Auto bonding UL-listed hardware creates structural and electrical bond • Zep System has a UL 1703 Class"A"Fire Rating when installed using modules from any manufacturer certified as"Type 1"or"Type 2" �L LISTED ' Interlock Ground Zep V2 DC Wire Clip Specifications Part No.850-1388 .Part No.850-1511 Part No.850-1448 Listed to UL 2703 Listed to UL 467 and UL 2703 Listed to UL 1565 • Designed for pitched roofs • Installs in portrait and landscape orientations • Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 • Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and UL 467 WEE • Zep System bonding products are UL listed to UL 2703 • Engineered for,spans up to 72"and cantilevers up to 24" • Zep wire management products listed to UL 1565 for wire positioning devices • Attachment method UL listed to UL 2582 for Wind Driven Rain Array Skirt,Grip, End Caps Part Nos.850-0113,850-1421, zepsolar.com zepsolar.com 85ted to L 156567 Listed to UL 1565 This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of ZepSolar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. responsible for verifying the suitability of ZepSolar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. Document#800-1890-001 Rev A Date last exported: November 13,2015 2:23 PM Document#800-1890-001 Rev A Date last exported: November 13,2015 2:23 PM f APR 2 7 2r16 Town of 0/c/K,'nc Earnsfablo Commfn e�waY � SolarEdge Power Optimizer solar=@a solar=@e P Module Add-On for North America P300 / P350 / P400 SolarEdge Power Optimizer P300 P350 P400 Module Add-On For North America (for 60-cell PV (for 72•cell PV (for 96•cell PV modules) modules) modules) P300 / P350 / P400 INPUT .Rated Input DC Powedo 300 350 400. W Absolute Maximum Input Voltage(Voc at lowest temperature) 48 60 80 Vdc MPPT Operating Range........................................................8..48.....................8 60 8 80 Vdc............................................... . Maximum Short Circuit Current(Isc) 10 Adc Maximum DC Input Current 12.5 Adc ...................................................................................... ...................................... . .... Maximum Efficiency ..............................99:5 % ._- .;_ Weighted Efficiency...........................................................................................98:8 .... ...... 96 Overvoltage Category II - :.OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) _ Maximum Output Curren[ ...............................15. _ ...Adc..... ..Maximum Output Voltage..................................................... 60......................... Vdc / OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) Safety Output Voltage per Power Optimizer 1 Vdc ..,r .STANDARD COMPLIANCE - �� EMCf!�:ri9 ' ....... 63 ............ ....... .................................................................................. 4 ...... -, ` r c Safety........................................................................................IEC62109;1(class II safety);UL3741................... . .K c ROHS Yes _ `.INSTALLATION SPECIFICATIONS _ .'" Maximum Allowed System Voltage 5000 Vdc Dim ensions(W x L x H) 141x212x40.5/5.55x8.34x1.59 mm/in - Weight(including cables)..................................................................................950/2.1 gr/...... Input Connector ..............MC4/Amphenol/TyrA I. Output Wire Type%ConneQor. ..............................................................Double Insulated Amphenol....................... ...... ....... .... .: Output Wire Length............................................................ /3:U .� .........................1 2/3 9 m/h.... Operating Temperature Range.....................................................................40:+85/-40;+185 ...CF.... ' Protection i!ti q........................................................................................1!6 0EMA4 - Relative Humidity........................................................................I...................�.:100 ...%...... 'xerce sn:oo.cro,me moo�m.maamc a�n m.sx�,�omr,-c.iw d. • JPV SYSTEM DESIGN USING A SOLAREDGE THREE PHASE THREE PHASE t INVERTER SINGLE PHASE 208V_ _ _ _ 480V PV power optimization at the module-level Minimum Strin Length(Power Optimizers) 8 10 18 Up to 25%more energy Maximum String Length(Power Optimizers) 25 25 50 ' ............................................................................................................................................................................. Maximum Power per S[ring 5250 6000 12750 W — Superior efficiency(99.S%) P.a...a.11.e...... .................... .................................... ........... ............ Yes — Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading """"""""""""""""""""".."""""""'' """""""""""'.""""""""'"""""". — Flexible system design for maximum space utilization - Fast installation with a single bolt — Next generation maintenance with module-level monitoring — Module-level voltage shutdown for installer and firefighter safety — USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www.solaredge.us I i GreenTriplex GreenTriplex PM060M00 (Zbo -- 270wP) . Electrical Data Dimensions mm[inch] PM060MOO Typ.Nominal Power PH 260 W 265 W 270 W Prontview (39>ro) v aigntew -�•-ti� Typ.Module'Efficiency 16.1% 16.4% 16.8% II Typ.Nominal Voltage Vmp M 30.8 31.3 31.8 Mono-Crystalline Typ.Nominal Current Imp(A) 8.45 8.48 8.50 = _ _ f.� Typ.Open Circuit VoltageVoc M 38.0 38.2 38.5 Photovoltaic Module _ Typ.Short Circuit Current Isc(A) 8.96 8.98 9.01 - - - 1 •�_ - _ Maximum Tolerance of PN 0/+3% 16-5 C •� .Y'�� •.. ~r - •Abova dam are the eff-,dv.measurement ac standard T s Conditions(STC) 4, • ..~.� •ST01madance 1000 W/W.spectral distribution AM 1.5,temperature 25 t 2•C,in accordance w rh EN 60904-3- r • ,. ,•,� _� •The given electrical dam am nominal.slues which account for basic measurements and manufacturing tolerances of 1:1 OX with the al"�� ..y +y - O Power Range exception of P...The classic dons Is performed according m P. �� s �,g,+��.� ..•• �.�"` • 260-270 Wp •27OW mod,des will be a ihble from Q2 2014 - - -- - � ZZ Temperature Coefficient NOCT 46t2°C _ T Tem erature Coefficient of PN -0.44%/K +^�" a Highly Strengthened Design yP- P 928• T Tem erature Coefficient of Voc -0.30%/K Backview 13. w w""•'� �- .a.. Module complies with advanced loading tests to yp' P (Dis n between-Mmmdng H'Im) �s„k�.,w`+„•+.`' . =� ................ meet 2400 P loading requirementsicements TemperatureCoefficient 006 q/K j(0.45] NOR:Normal tion CUT tore.m ri conditions:irradiance 800 W/m'.AM IS.airtem 32f1Junction Box Optia' pets rag pOraturc 20'CwiM speed)Ms (1291J Mechanical Characteristics t .•�w�� IP IP-67 Rated function Box Dimensions(L x W x H) 1639 x 983 x 40 mm(64.53 x 38.70 x 1.57 in) Advanced water and dust proof level 1200 35 (�] Weight 19.Skg(431bs) [47.24] i [I38J� Front Glass High transparent solar glass(tempered),3.2 mm(0.13 in) [38j0) F o.-n Cross Seed- Cell 60 monocrystalline solar cells,156 x 156 mm(6"x 6') Integrated Racking Solution � !I "4* y0-. g g Cell Encapsulation EVA MWnag Simplifies installation process and reduces labor Mdesx4 Back Sheet Composite film(Black) (-) (- b r �T Frame Anodized aluminum frame(Black) �sy' M �L ]unction Box IP-67 rated with 3 bypass diodes Dri Connector Type&Cables MC KST4/KBT4:1 x 4 mm'(0.04 x 0.16 in'),Length:each 1.2 m(47.24 in) "Holes x1"w �� tsI-V Curve PV CYCLEIN curve vs dill.irradiance'� o Operating Conditions 9.o coMppr OperatingTemperature 40-+85°G 8.0 -I000fw/ms- - 4 7.0 •��+.�.,�.>*�y"`v� j Ambient Temperature Range -40-+45°C g^ 6.0 890 wJa'' :�.....� Max.System Voltage UL IOOOV S s.o ..'s.�•t...,.� • .. 4.0 Serial Fuse Rating I S A .0 400 w/ms •:ate..r.+ ^'`tea•. - 00VVJms 2 Maximum Surface Load Capacity Tested up to 2400 Pa according to UL1703 .0 ! .��. };�. •" r' Warranties and Certifications o.o o s 10 1s 20 ss 30 35 40 s ---�+•• J„� - - ` Product Warranty Maximum 10 years for material and workmanship voltage M `.a • ,r�EJ- - Curmndvoltage characteristics with dependence on irradiance and module cemperawre. Performance Guarantee Guaranteed output of 90%for 10 years and 80%for 25 years Certifications According to UL 1703 guidelines,Fire Rating Type 2•2 •Z •I:Please refer w waancy I—for dem11 r •2:Hesse rtconfirm other certifications with official dealers a . ,. Packing configuration _ N ' Container 20'GP 40'GP 40'HQ -;.r _��-�� "ram-' • Pieces per pallet 26 26 26 Pallets per container 6 14 28 Pieces per container 156 364 728 Dealer Stamp AU Optronics Corporation No.1,Li-Hsin Rd.2,Hsinchu Science Park,Hsinchu 30078,Taiwan BenQ r Tel:+886-3-500-8899 E-mail:BenQSolar@auo.com www.BenQSolarcom ra BenQ Solar Q BenQ Solar is a division of AU Optronies This daatheet I.Oral with 5ey Ink Solar ®Copyright May 2013 AU Opamim Corp.A0 rights,w,m d.l"f dot.may change v th,,t rwtica APR 2 7 211316 =ee Single Phase Inverters for North America Town of Old ,Earnst abl e US/SE3800AUS/SE5000AUS/SE6000AUS Co- s HighwaysoIar SE3000A mmitteesoIar SE760OA-US/SE1000OA-US/SE1140OA-US SE3000A-US SE380OA-US I SE5000A-US SE6000A-US I SE760OA-US I SE1000OA-US SE11400A-US OUTPUT SoIarEdge Single Phase Inverters • 99800 980 @ 208V Nominal AC Power Output 3000 3800 5000 6000 7600 990208 11400 VA • Max.AC Power Output 33dO 4150 5400 @ 208V 6000 8350 10800 @ 208V 12000 VA For North America ........ ... ..... ....... ......... ......... ....545.o@?42y... ........... ................ 1095D.@�4oy. . AC Output Voltage Min:Nom.Max 01 ✓ ✓ SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ AC Output ..................... ................ ................................................ .................................. ... . . ....... ......... ... AC Output Voltage Min:Nom:Max.l'1 211-240-264 Vac ✓ J J J ✓ J J SE760OA-US/SE1000OA-US/SE1140OA-US AC Frequency Min:Nom:Max. 59.3-60-60.5(with HI country setting 57-60:60:5) Hz Max.Continuous Output Current. .. .. 12:5•.•••.I• ••' . •.,I...21@240V.... .2...... I........ .......42@240V,,, ... .... A GFDIThreshold 1 A Utility Monitoring,Islanding Protection,Country Configurable Thresholds Yes Yes „W..»•.,, INPUT 4werte� f Maximum DC Power(STC) 4050 5100 6750 8100 10250 13500 15350 W •.• ........................................... ................ .................................... ................. ...... ...... .. Transformer-Iess,Ungrounded ...Yes . ••„•„••„•,••..•••-••.•_..-...•..••.._..-..... ..., f 66 ...................... ........................................................................ ..... '- Max.Input Voltage 500 Vdc r tq 1 rears om.................................... ........................................................................................................................ .... ... 1 '�' wartantY; Nom.DC Input Voltage 325 @ 208V/350 @ 240V Vdc 16.5 @ 208V 33 @ 208V i�,!aliehQ� Max.Input Current(2) 9.5 13 18 23 34.5 Adc 15.S,�a,240V ,305@24ov ,,,,,,,,,, ........................................... ................ ................ ................. ............. i Max.Input Short Circuit Current ..........................................................45 Adc • 9 Reverse-Polarity Protection Yes ' _ Ground-Fault Isolation Detection...... .. .... .. ...., .• 600kn 5ensitivi[y.................... ........ .... ... ..., .• ... ..M�xii..•m Inverter fficienc- - .97.7 ..98.2 98.3 •. .98.3. - 98 98 98• ....%.. ax muEfficiency 97.5 @ 208V 97 @ 208V CEC Weighted Efficiency 97.5 98 97.5 97.5 97.5 % ....... ..................... ..... .................98,�p,240V.................. ..................975 @,240V.. .................. ........... Nighttime Power Consumption <2.5 <4 W ADDITIONAL FEATURES j Supported Communication Interfaces R5485,RS232,Ethernet,ZigBee(optional) ........................................... .................................................................�.................................................................... ' Revenue Grade Data,AN 51 C12.1 Optional - - ........................................... ...................... ......... . ................................. y { Rapid Shutdown—NEC 2014 690.12 Functionality enabled when SoIarEdge rapid shutdown kit is installed(4) 4 STANDARD COMPLIANCE UL3741,UL36998,UL1998,CSA 22.2 ........................................... ..................................................................................................................................... { . .Grid.Connection.Standa.. rd..............s IEEE1547 ... ............ ... .... ..................................................................................................................................... Emissions FCC partly class B _ t INSTALLATION SPECIFICATIONS `, AC output conduit size/AWG range... ...........................3/4"minimum/16:6 AWG..,.•.,,••.•••••,••,••-,.•..,•••3/4"minimum/8-3 AWG................ DC input conduit size/p of strings 3/4"minimum/1-2 strings/16-6 AWG ' % 3/4"minimum/1-2 strings/ t i *C .AWG rang?............................. .............14,-6 AWG........................ Dimensions with Safety Switch 30.5 x 12.5 x 10.5/ in/ }_. 30.5 x 12.5 x 7.2/775 x 315 x 184 ................................ .............................................................................................775 x 315 x,260.............min.... i Weight with Safety Switch............. ............1,2/23.2..........I...................54:7/24.7.. ............................88:4 40.1.............Ib/.kg... Natural -- — convection Cooling Natural Convection and internal Fans(user replaceable) fan(user The best choice for SoIarEdge enabled systems .......................................... ................................................................... .Feplageab[e)................................................. Noise <25 <50 dBA - Integrated arc fault protection(Type 1)for NEC 2011690.11 compliance Min:Max.Operating Temperature 13 to+140/-25 to+60(40 to+60 version available(sl) F/'C — Superior efficiency(98%) FaRB?................................... ............ Protection Rating ..............................................NEMA 3R — Small,lightweight and easy to install on provided bracket I11 For other regional settings please contact SoIarEdge support. ul A higher current source may be used;the inverter will limit its input current to the values stated. — Built-in module-level monitoring pi Revenue grade Inverter P/N:SE.-A-USOOONNR2(for 760OW Inverter.SE7600A-US002NNR2). ' t°I Rapid shutdown kit P/N:SEI000-RSo'S.. I — Internet connection through Ethernet or Wireless 01-40 version P/N:SEAoaA-USOOONNU41tor 760OW InverterSE760DA-US002NNU41. 1 — Outdoor and indoor installation — I I — Fixed voltage inverter,DC/AC conversion only j — Pre-assembled Safety Switch for faster installation — Optional—revenue grade data,ANSI C32.1 F na RoHS USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL www.sol aredge.us i L Ln r L 1 f� NO CNANGE� PROPOSED ,> REAR ELEVATION � SCALE: 1/4" = V-0" V1 w W ILuLu �l IT] w W o � zLt] ILL t-11 I O NO CNANGE� -1 PROPOSED Lo W (y W LEFT ELEVATION SCALE: 1/4" = V-0" SHEET 1 OF 4 r JOB: 1015 'D:RAWN BY: KW DATE: 9/23/10 �Y i . 0 g t � a Effl ilffl NO CHANGE PROPOSED FRONT ELEVATION SCALE: 1/4" = V-0" ;i FIFE LIH ❑a❑ NO CNANGE� PROPOSED RIGHT ELEVATION SCALE: 1/4" V-0" II UP II //0 I I II II I I 4 r � YwY — _ -�........ ..__. -- — T :`(f.J' �Y��r Y "cXX:�,� .•:\ Y_44�t�-�yt�S 7� I �y. � O 2'—0n I I W w ' m X N v �J V �.. - 7Nmy�V.��n"yN x�:l-775'S2C'Y �St EXISTING FIRST FLOOR PLAN SCALE: 1/2" V-0" Y i Y w: I I i ye x L - - - � 5EDROOM 1 DPI. "T 40" KNEE MALL 3t .r ;✓y ,may, �vw �v�; ��k r'''3" ?.5 .tix ��YY tom` ,n"44�'3'+�� .�`,t ��` � r�:`s�t�''�` � `�,> � ,k ,�_.. �` -EXISTING SECOND FLOOR PLAN SCALE: 1/2" = V-0" ti