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0269 BARNSTABLE ROAD
XU - Town of Barnstable • •. Post�This�Gard So That�tiisUisibte From�the�Street =A roved;=Plans�Must b'e.Retamed on�:Job andathis•Cartl..Must be:Ke t� Building MRN3YACiLE.;• .`:° •�•. :•'•''� .,.. .... •. '. � .�.'a'� � .�S �,: s, ...a' '., � . H�P ,. ' PostedUntil Fi alit .,,.. ••; ... �. e n nspection Has;Been Made +° �Whereaa CertificateofOccu anc :is Re aired such Bwldm haN:Not be>Occu ied until a+:Final Ins "ect�on has:`been.<made. :> Pert �..A,. ;.�a��a ,. ..a �,�p.,. y., ,„.,_,.w q��r '�?����,,.� g.ax�����,�.��..,_s,.,...ap a..�,.. , .-.>��.4... >..,�.�.�p.,.z ..,.,.w„ <.:r .,�:�..... Permit No. B-16-3494 Applicant Name: Cheryl Gruenstern Approvals � Date issued: 01/03/2017 Current Use: Structure Permit Type: Building-Solar Panel Commercial Expiration Date: 07/03/2017 Foundation: Location: 269 BARNSTABLE ROAD,HYANNIS " Map/Lot 310-172 Zoning District: HG Sheathing: i z Vic. , Owner on Record: POYANT, MARCEL R ;Contractor Name SOLAR CITY CORPORATION Framing: 1 Address: 182 GREAT HILL ROAD Contractor Li%cense168572 2 EAST SANDWICH, MA 02537 M E'st_Proiect Cost: $ 19,800.00 Chimney: Description: Install solar panels on roof of existing house with,an �u radesFw ,if Y Pg Perrriit"Fee: $280.18 Insulation: applicable,as specified by PE in Design;To bePuberconnected with 4 home electrical system. 14.04 kW 54 Panels�lB 0263135 & Fee Paid;: $280.18 Final: (e 1/3/2017 Project Review Req: Install solar panels on roof of existing house,with anyupg�rades; - . . if applicable,as'specified by PE in Design,To""tie mterconnected� �'� r Plumbing/Gas with home electrical system. 14.04 kW 54 Panels JB 0263135 t t, Rough Plumbing: J Building Official final Plumbing: �z This permit shall be deemed abandoned and invalid unless the work authorized b this ermit is commenced within six` rnonths after'issuance. �� P Rough Gas: All work authorized by this permit shall conform to the approved application,andithe approved construction documents'for wh�c.h 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 orroad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. a Electrical ,., The Certificate of Occupancy will not be issued until all applicable signatures 6 'th Bu ldm andxFir.'e.Officials�are� rovided on,this-permit" .e P Y PP .Y - . g , P _ . >.. .,-� Service. Minimum of Five Call Inspections Required for All Construction Work: r F ".1 Foundation0 noting Rough: 2.Sheathing Inspection 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 5.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 toIAhe guaranty.fund"(as set forth in MGL c.142A).. Fire Department Building plans are to be available on site Final: Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT OIvL_-rNE 1=Mart_, S)�T a YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you, must clo by M.G.L.-it does not give you permissiori'to operate.] You m'ust-first obtain the necessary signatures on this form'at 200 Main St., Hyannis,• Take the completed form to the Town Clerk's Office;.1 st FI., 367 Main St., Hyannis, MA 02601 (Town*Hall) and get'the Business Certificate that is required by law. DATE:ca Fill in please:. w0rar`., Iwu;k �'�`��` P APPLICANT'S YOUR NAME%S: ✓ d 0 BUSINESS YOUR HOME ADDRESS: 1 8!@ Cn re0—E' 7 ;jp ' �r , 330- �16 c7 �-� �SOtmd t� (� 12► Il�t �J r r��' TELEPHONE # Home Telephone Number a7 it a j: .. �fia il'-•. AME OF O RO ATI C R R . . ,.. . •::..:.:�. .: �.�. .:.' .T1C. .OF':BUSIIVES5:.' BUSINESS, .�_ . NAME OF NEW "' - . _ YES ... . ... ... . ...._ .:•..':...:.. :.c.;:: 5T ISA M CCUP.ATIOIV O E•O 1 N , •'. . .'.H ,. ..... ... ._ . `G. :. .. : i. :.:.. :_ .. '. a:....' -'.y.1,i?'.'• '�1•{• AP ;APDFRESS.:OF�BL�51NES5ti: �: . i?lt:.- ':Pi4RCEL';lyUNiBER (DaG 01 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you.may need. You MUST GO TO 200,Main St. -(corner of Yarmouth Rd. &Main Street) to.make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIO ER'S OFFICE This individu4al has iRw of a pc mi requir ment that pertain to this type of business.LA i . Au orize i natffr *' COMMENTS m� 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: S. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements.that pertain to this type of business. Authorized Signature* COMMENTS: YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$4.0.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: !' Fill in please: f - APPLICANT'S YOUR NAME/S: 'r O h N R. CM-r )e. BUSINESS YOUR HOME ADDRESS: 61)9 --1( -4�s - TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? Y S NO ADDRESS OF BUSINESS j�P/PARCEL NUMBER e I O 13 Q, {Assessing) 10�1-6 01 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO ER'S OFFI This individu I een infomx� d r f y p r it re uirements that pertain to this type of business. 4 ut o ized Signature COMMEN �-ar-.O(t) 2. BOARD OF HEALTH " This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: i . F YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates [cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you, must do by M.G.L.-it does not give you permissiori'to operate.) You must-first obtain the necessary signatures on this form•at_200 Main St., Hyannis, Take the completed form to the Town Clerk's Office;.1 st FL, 367 Main St., Hyannis n, MA 02601 (Tow Hall) and get'the Business Certificate that k required by law. DATE:cat aV-16 Fill in'please: APPLICANT'S- YOUR NAME' S: V. CS TO : ry,b°4 it1.I1Pi ialti. ,. BUSINESS YOUR HOME ADDRESS: l �J (n 1 rA 1 1 u,.'-n`t o ' 3 30- a,16 V E �an,d Ij 9 MUD, TELEPHONE # Home Telephone Number ,;n - 44Qr=) - &16 lartlr'Yl � O RORATIO Si''°NAME OF C R '' N• y ,. ... ., j. ..-,. .y T1C .OE:BUSINESS NAM E OF'NEW BUSINESS4-:- J, d'f -? CC .:AT D V. YE I S A.H O E.O P I l ST U N 7 ssess i� UMBER•.P'• RCEL.IV A,. �.w ADDRESS:OF..,Bl� IN r.. bah 0 l When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town'of Barnstable. This form is intended to assist you in obtaining the information you.may need. You.MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to.make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIO ER'S OFFICE � i ui ent'^that pertain'to this e of bus iness. . 't e r m mt r This Individujel has u�fnC ofaElpeq p type Au orize i natL r *' COMMENTS M� 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: ' YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. l - DATE: - Fill in please: �GA . . , APPLICANT'S YOUR NAME/S:� O h IU �. C_M-rn e 49 BUSINESS YOUR HOME ADDRESS: ' �+ Sbg -•}1 qa s , �. d �NNX � TELEPHONE # Home Telephone Number , NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? Y S NO_� ADDRESS OF BUSINESS X/PARCEL NUMBER �31 O - (Assessing) When starting a new business there are several things you must do in order to bye innccom pliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. � . 1. BUILDING COM ISSIO ER'S OFFndf This individu I een inforAa y p r it requirements that pertain to this type of business. ut o ized Signature COMMEN 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: 112 CENTER STREET HYAN E 188 LONGVIEW DRIVE HYAN 595 OLD POST ROAD COT 4,01 155 SANTUIT-NEWTOWN ROAD MM '` 370 ROUTE.149 - MM 60 WIDGEON LANE WBAR 1� ' 107 SEA VIEW AVENUE OST 5( 4 ARROWHEAD DRIVE HYAN 75 SALTEN POINT ROAD BARN r 1520 OLD'POST,"ROAD(CT&MM) 'MM, 1: 72 HARRISON ROAD CENT �< 351 PHEASANT HILL CIRCLE COT 3800 FALMOUTH ROAD/RTE 28 MM E i 149 SIXTH AVENUE HYAN 1: 80 EVANS STREET OST . 110 SKATING RINK ROAD HYAN 1 BROOKSHIRE ROAD HYAN 4741 FALMOUTH ROAD/RTE 28 COT 311 BEARSE'S WAY HYAN Report/report—view dhtml.aspx?id=... 8/9/2011 Assessor's map and lot number, ... --�ilJ.' I $ - 'NI UST........... . 1I SYSTEM e UST OFTNET�� 83M3S NM01 01 133NNOD 1SAW INSTALLED ,IN COMPLIANT `�P.. Sewage Permit number ............................... ::. WITH TITLE _ Z BARNSTABLE. ENVIRONMENTAL CODE 4%!' 9, MAea � 4 Housenumber ................:.......................................................... TOWN . � OF BARNSTABLE BVILDIHG - INSPECTOR APPLICATION FOR PERMIT TO ...:; . . .. .. ........... ................ ....... ti{....:.. W TYPE OF CONSTRUCTION ............................ :: . .............................. v tr1........Q�.,7.................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................... ....... ........ ............ ......................... ................................... ProposedUse ............................................................................. ........................ ..................... .................... ........... Zoning District ......... .............................................Fire District ..... ... . ...................................... Name of Owner . . .!&sa �.... ..................Address ��� lJ .... .�................... ;&-e.' �l Name of Builder . .. .. .... ........ .. . . .. ... ...............Address ..... 7.. G ..........'% .......... . Name of Architect -...............................Address ......................... .................................................. f m �e ......................................... .Foundation ..................................... ....................................... Number o Roo s ............., .......... Exterior ........................................ ...................f......................Roofing ................................................:................................... Interior ............................:....Floors ....`� 'r ""'........ P..:............:.... .. Heating .............. ............ ........Plumb.ing ........................... ............................................:... . .... .. ..... .... Fireplace .............................. ............................. ....................Approximate. Cost• ..d...Q.Gi. 4„ Definitive Plan Approved by Planning Board ------------------------------19--------• Area Q ... Diagram of Lot and Building with Dimensions' Fee .f.. ................. . a SUBJECT TO .APPROVAL OF BOARD OF HEALTH a u z• OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. . Name ... .��1!/ ....... ........... .......... ....... ................. Construction Supervisor's License 5 T... RENE L. POYANT INC. s , 25250 No Permit for ,,,REMODEL FIRE.. DAMAGE = .......... f E' ... ............... - _ - Location Barnstable Road t Hyannis ........................ .. Owner Rene...L'...Poyant Inc............... h Type of Construction° ...Frame.......................... Plot :j........................... Lot.. ........................ A A r c June 27, 83 Pern�lti Granted .......... 19 a Date of Inspection ...... ...... .............. .......19 - r Dote Completed .................:.✓Y..............19 - ;.� �.. *. 1� � � ` _ ' .. �. - tl ,fir !�• -. Assessor's map and lot number . ......................................... f. .............. '................ gyp%THE Tyr Sewage Permit number ........................................................ Z BARN TSBLS, House number �..................•• °o �e e E... 9 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO r//..L ......... .......... TYPEOF CONSTRUCTION ..........................W..1ny.."I................................................................................. ...... ........c. .. `.................19. ..3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followiyng� information: Location ................................................ .............✓. .411............................ ProposedUse ........... .......................................................................................... .................. .................................... Zoning District .....................�.............................................Fire District ........ 4�? '7 . ............... � � ......f...,. ...... ............................ � f ��-: Name of Owner ..�s...�... . . :x,.,. ..Address � � :�:?r �.:.... .. ................... Name of Builders ...............Address .... I ......!....d.� l e.. ......... ' .............. Nameof Architect * "..................................................................Address .................................................................................... Numberof Rooms ........................./......................................Foundation .............................................................................. Exterior ................................ .........................................Roofing .................................................................................... Floors ` ,. .... /. % ,.............:................................Interior Heating ...................................................................................Plumbing .................................................................................. Fireplace �.................................................Approximate. Cost ......... .. ..U...... ....................... Definitive Plan Approved by Planning Board -------------------------------19--------• Area Diagram of Lot and Building with Dimensions Fee � /. SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 1' Name .................. . ....... ................. Construction Supervisor's License RENE L. POYANT INC. A=310-172 25250 Remodel Fire Damage No .....::.......... Permit for .................................... Single Family Dwelling LocatiorM Barnstable Road Hyannis Owner Rene L. Poyant Inc. ................................I............. r Type of Construction ........... me .. .............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted ........J1 AQ..27..............19 83 Date of Inspection ....................................19 Date Completed ......................................19 G WV! �� 57 F TO BAR LBLE BUILDING PERMIT APPLICATION Map Parcel ��- ,i, Cst� Application Health Division Date Issued Conservation Division �ri`� '� -Application Fee t. Permit Fee PlanningDe p _ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis ) C Project Street Address n S+ab U 0 Village n Owner 7 e-, E hLee— A'A'01Address shoe P") Telephone L4 — q Permit Request 16 i br, f' D ,�� MbV' i-ka 1 n4te—o-✓ A' c C Gr v� B Square feet: 1 st floor: existing(��proposed 2nd floor: existing proposed Total new . /ring District Flood Plain Groundwater Overlay Ject Valuatio Construction Type e 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.) 1601) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing L4 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: O'Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No a Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: O-e�xisting O new'size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: — -a Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ =. Commercial $(Yes ❑ No If yes, site plan review # Ka Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 61e-Y-,g4,,Ae' rA4(-A),_f]MpTelephone Number Address ICec �l�- IQ�'r�iLP - License -CIS 101 _' 4 Fe r A y Z 54a / Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I FOR OFFICIAL USE ONLY r� APPLICATION# BATE ISSUED `. L NAP/PARCEL NO.. - ADDRESS VILLAGE OWNER' DATE OF INSPECTION: ),FO.UNDATION - - FRAME ' INSULATION } FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - .GAS 3 -_ 'ROUGH ' _ 'a <Y< FINAL t � IFINAL BUILDING DATE'CL6SED OUT 1 . . _ J ASSOCIATION PLAN NO. The Com"inonlvealth of Massachusetts Department of Industrial Accidents Office of Investigations ` 600 Washington Street t Boston, MA 02111 . y www.mass.gov/di Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leflibly Name (Business/Organization/Individual): AgAA4A Address: l�j ��( �i C / ��i�QC�—T 4�� r /* 67 City/State/Zip: Phone#: Are you an employer?Check the appropriate box: ` Type of project(required): 1.❑ I am a employer with 4• ❑ I am a general contractor and I 6 ❑New construction * have hired the sub-contractors _ ._ _ __::___. .._ �ployees(frill and/or fart-time). 7,. Remodeling 2-r I am a sole proprietor-or partner- listed on the attached sheet. ❑ These sub-contractors have g• ❑ Demolition ship and have no employees 'employees and have workers' addition working for me in any capacity. 9• ❑ Building [No workers' comp..insurance comp. insurance.$ 10.❑Electrical repairs or additions ired.] 5• ❑ We are a corporation and its 3.❑ I requ qu a homeowner doing all work officers have exercised their l 1.❑ Plumbing repairs or additions Myself [No Workers comp. right of exemption per MGL. 12.❑Roof repairs insurance required.] t G. 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information r� Insurance Company Name: 0 Yl® u � � Policy#or Self-ins..Lie.#: 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 fin 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 covera verification. I do hereby certify der a pains a enalties of perjury that the information provided above is trice a d correct. - Date: Si nature: Phone# !Q% 67�� � 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 Persona Phone#: L i information and fnstructiOns 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 u act of hinder any contrre, 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 foreoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the g receiver'or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more tan three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, constriction 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 etract for the performance of public work until acceptable evidence of compliance with the inSffance nter into any con requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,.a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiUlicense,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(cirren ty or policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in 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 4 617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727-7749 Revised 4-24-07 www.inass.gov/dia �G,.- . {'�J�, Sullivan Engineering Inc. 7 Parker Road,P.O. Box 659 Osterville,MA 02655 Peter Sullivan P.E.Mass Registration No.29733 phone 508428-3344 fax 508428-9617 peter@sullivanengm.com 1 Thomas Perry, Director July 28, 2010 Building Division Town of Barnstable 200 Main Street Hyannis MA 02601 RE: 269 Barnstable Road, Hyannis Dear Mr. Perry Marcel Poyant has asked that I review the present traffic.situation at 269 Barnstable Road to determine if there will be an increase in traffic with a dentist office as a new and' only tenant. Presently at this location there is a medical hearing aid office which has a gross footprint of approximately 1600 sf and a church with seating for 40 to 60 persons also with a gross footprint of approximately 1600 sf. ITE trip generation charts do not cover the specific category of"hearing aid office" so using the zoning by-law parking requirements of 1 space 300 sf for office then the present parking demand is 5 spaces plus employee spaces. It can be concluded that there is 1 hearing exam appointment per hour per space resulting in 5 trips per hour. The Church has services on Wednesday evening, Saturday and Sunday with an average of 50 seats which could represent 25 vehicle trips. - The proposed dentist office will occupy the whole building and will have 4 dentist ' chairs. Given there are 4 chairs,there are then 4 appointments per hour and 4 possible vehicle trips per hour. ITE does have charts for dentist offices and for a dental office of this size it corresponds to the number of chairs and vehicle trips. Therefore it is my opinion that the proposed dentist office will not result in an increase in traffic at this site. If you have any question or require any additional information please do not hesitate to call. V truly yours 6d-I F" tgk ij' mJ Peter Sullivan PE 4 �O. 29733 �° Sullivan Engineering, Inc. cc; Marcel Poyant,Philip Boudreau Members of American Society,of Civil Engineers and Boston Society of Civil Engineers Section l his chuscttcnt of Puh1iC$.ittct� Bo�rrd (rf:Buildirih RejTu)ations ind Stand(rdsR�^ ' .Construction'Supervisor..License Aicense: -S• 101770 Restncted,to ,0(0 i ALEXANDER ACARADIMOS 17 EDDY'-STREET r 'BUZZARDS BAY, MA 02532 Expiration`. 5/22/201:` "('ununi siunc'r Tr#: 1017,70 f eDEP- MassDEP's OnlineFiling System Page 1 of 1 J i MassDEP Home Contact i Feedback I Tour i Privacy Policy MassDEP's Online Filing System Usemame:ACARADIMOS Nickname:ACARADIMOS88 My eDEP J Forms b My. Profile b Help CReceipt dr Forms Signature Payment Receipt Summary/Receipt print receipt JExit , Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP"to see a list of your transactions. DEP Transaction ID: 326142 Date and Time Submitted: 8/6/2010 9:11:38 AM Other Email : Form Name:AQ 06-Construction/Demolition Notification Payment Information DEP code: 47697 Date: 8/6/2010 9:09:22 AM Amount($): 85 Payment Detail: CARADIMOS ALEX—AccountType--AccountNumber ****2702 Confirmation Number: Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab My eDEP MassDEP Home i Contact i Feedback i Tour i Privacy Policy MassDEP's Online Filing System ver.9.8.5.1©2010 MassDEP https://edep.dep.mass.gov/Pages/PrintReceipt.aspx 8/6/2010 EVE Town' of Barnstable gn , ` Regulatory Services" , BARNSPABM ' Thomas F.Geiler,Director ., MASS. 1639- r DMA f Building Division _Bu d g . Tom Perry,Building Commissioner , 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:, 508-790-6230 Property O he r Must. Complete and Sign This Section If Using A Builder F I, MARCEL R. POYANT ,as Owner of the subject property hereby authorize ALEXANDER CARADIMOS to act on my behalf, in all matters relative to work authorized by this building permit application for. - . 269 Barnstable Road, Hyannis, MA`02601 (Address of job) Marcel R. Po ant f. 8/6/10 x Signature of Owner ,; Date MARCEL R. POYANT' Print Name If Property Owner is applying for.permit please complete the Homeowners License,Exemption Form on the reverse,side QTORMS:0"ERPERMISSION - r Town of Barnstable tHWE u "o Regulatory Services ■nertsTas[a Thomas F.Geiler,Director 039. prED MP'I s 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING 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. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. ti The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she'-wil comply with said procedures,and requirements. Signature of Homeowner w Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC 75, COMMERCIAL REAL ESTATE POST OFFICE SQUARE•20F CAMP OPECHEE ROAD,CENTERVILLE, MA 02632 TEL 508.775.0079 RENE L.POYANT 1909-2000 FAX 508.778.5688 MARCEL R.POYANT,President&Treasurer EMAIL poyantl@verizon.net July 29, 2010 RENE M.POYANT,Senior Vice President MA Corp.Brokers Lic.#337 MARY J.POYANT,Vice President BY HAND TO Thomas Perry Building Commissioner Town of Barnstable 200 Main Street, Hyannis, MA 02601eA ) RE: Lease-Marcel R. Poyant to Procare Dental, Inc. —269111arnstable`Road,' 3 0 Hyannis, MA 02601 (Approval of Use) sue: Map 310,Parcel 172 Dear Mr. Perry: " 4 ' I am writing to secure your approval for use of the above building as a dental office under the Zoning Bylaws. As a follow up to your discussion with my attorney, Philip Boudreau on July 23, I have contacted Peter Sullivan of Sullivan,Engineering, Inc. to prepare an analysis of the f impact on the traffic due to the change in use. I have enclosed a copy of his letter dated July 28, 261.0 which concludes that "... the proposed dentist' office will not result in an increase in traffic at this site." Based upon the enclosed letter, I am hopeful that you will approve the use as a dental office so I can sign a lease with the above tenant. I look forward to our meeting at 1:30 P.M Friday so that we can hopefully resolve this matter. I thank you for your time and consideration. Ve ly yo . 1 R. yant MRP/mp Encl (1) Ltr Sullivan dated July 28, 2010 du cc via fax to Procare Dental, Inc. 508-815-1333 cc via fax to Philip M. Boudreau, Esq. 508=771-0722 cc via fax to Peter Sullivan 508-428-9617 "SERVING CAPE COD SINCE 1947" COMMERCIAL PROPERTY MANAGEMENT REAL ESTATE APPRAISING&CONSULTING n ro r Sullivan Engineering Inc. 7 Parker Road, P.O. Box 659 Osterville,MA 02655 Peter Sullivan P.E.Mass Registration No.29733 phone 508-428-3344 fax 508-428-9617 peter@sullivanen m�com Thomas Perry,Director July 28,2010 Building Division Town of Barnstable 200 Main Street Hyannis MA 02601 RE: 269 Barnstable Road, Hyannis Dear Mr. Perry Marcel Poyant has asked that I review the present traffic situation at 269 Barnstable Road to determine if there will be an increase in traffic with a dentist office as a new and only tenant. Presently at this location there is a medical hearing aid office which has a gross footprint of approximately 1600 sf and a church with seating for 40 to 60 persons also with a gross footprint of approximately 1600 sf. ITE trip generation charts do not cover the specific category of"hearing aid office" so using the zoning by-law parking requirements of 1 space 300 sf for office then the present parking demand is 5 spaces plus employee spaces. It can be concluded that there is 1 hearing exam appointment per hour per space resulting in 5 trips per hour. The Church has services on Wednesday evening, Saturday and Sunday with an average of 50 seats which could represent 25 vehicle trips. The proposed dentist office will occupy the whole building and will have 4 dentist chairs. Given there are 4 chairs,there are then 4 appointments per hour and 4 possible vehicle trips per hour. ITE does have charts for dentist offices and for a dental office of this size it corresponds to the number of chairs and vehicle trips. Therefore it is my opinion that the proposed dentist office will not result in an increase in traffic at this site. If you have any question or require any additional information please do not hesitate to call. Vyffy truly yours Peter Sullivan PE t �8afill� �b Sullivan Engineering, NO. 2973C3-Inc. r cc: Marcel Poyant, Philip Boudreau - r Members of American Society of Civil Engineers and Boston Society of Civil Engineers Section 1 ' 1 ^9 a s i £ NE �9 ay. 9 `$ �•u� Wig,.,. z z•., Ai '!d t "� �.-ham:.- ,.„�� �h;"" �a�',i'�y � i_a.. A�.,, 3y"' •,,'1 "`'- a +f� Sullivan Engineering Inc. �f 7 Parker Road,P.O. Box 659 Osterville,MA 02655 Peter Sullivan P.E.Mass Registration No.29733 phone 508-428-3344 fax 508-428-9617 petet@sullivanengin.com Thomas Perry,Director July 28, 2010 Building Division Town of Barnstable 200 Main Street Hyannis MA 02601 RE: 269 Barnstable Road, Hyannis Dear Mr. Perry Marcel Poyant has asked that I review the present traffic situation at 269 Barnstable Road to determine if there will be an increase in traffic with a dentist office as a new and only tenant. Presently at this location there is a medical hearing aid office which has a gross footprint of approximately 1600 sf. and a church with seating for 40 to 60 persons also with a gross footprint of approximately 1600 sf. ITE trip generation charts do not cover the specific category of"hearing aid office'' so using the zoning by-law parking requirements of 1 space 300 sf for office then the present parking demand is 5 spaces plus employee spaces. It can be concluded that there is 1 hearing exam appointment per hour per space resulting in 5 trips per hour. The Church has services on Wednesday evening, Saturday and Sunday,with an average of 50 seats which could represent 25 vehicle trips. The proposed dentist office will occupy the whole building and will have 4 dentist chairs. Given there are 4 chairs,there are then 4 appointments per hour and 4 possible vehicle trips per hour. ITE does have charts for dentist offices and for a dental office of this size it corresponds to the number of chairs and vehicle trips. Therefore it is my opinion that the proposed dentist office will not result in an increase in traffic at this site. If you have any question or require any additional information please do not hesitate to. call. V truly yours. Av- , '38 a , �.: V "� Peter Sullivan PE ' O, �� Sullivan Engineering, Inc. r cc: Marcel Poyant, Philip Boudreau ' - Members of American Society of Civil Engineers and Boston Society of Civil Engineers Section y J4 g'h AJT I. . .• K.L'IC' 4 ------------- I i _ f t _ — i 1.At + : - T -� ' 1�/ ram•+ �:' r w — { r IIII , e r. 1 . y l , , �.i�-- 1� ps4Ij ff , .i t - S _ I R . � � � �. .� C•,.lAt'kf P 7.f.'C .: '.I rT�G F_: di:F.� a �:°� _ .. - - —....—.._. ._. ....... .., .. -_ ---_..___ - • � , . 5n uy it-t ItC -4� L1�1 } f a..:'%s'1' - b ,wa wxn i 269 Barnstable Road,Hyannis, Massachusetts p . , AKRO ASSOCIATES ARCHITECTS k stvi 37 e rtac¢,Marstom Mill,,MR.03696 - el.and far 500-419-1217 - EXHIBIT C PROPOSED ALTERATIONS If z.,`• t. .. 4 � 5ls�in�9an'34P� •. f . Z' mod= ., -,y .�........^".",:�'�cS'rG-.'SAS�?' t EXHIBIT "A" ,SITE PLAN i _ . .. 1.3 NOTE: Scale Approximate Parking subject to change � 1 r b v k, rind ��xr�iy � 'stedUzatian coatsuu dab Pan rc�r�rrr �Zsctf disk ��hatts Qt»e1 r : 0 X64r' _. -O 3 pq i Wei ing.room 1 I tY)AdYr IMMMOM tt3d est I .,. .: .. .. _ Y CIaF `t�f'tS Ftt roomsiw4 rt?U,s^tb e �• ,. i J : m 9 x air,dra n.vacuum, water.In ir�tarra crfrrsuteilara � t.:l�€ast 9'dx9 • r -� a P. All 5 rztrrrsc�r e chary:'; rrn,`xray " . lraliay rs at 1ai i Mk in Ii 5 roof ss lab, t s�in front tleslc 5 r rr�9,is f x9. sten iza Y . Uv c t panprr r do -naeti a lor�a tr>stsrNrzatie�ra xre m axistin two l��n<ficap baths. 4T a FIB. �. iok BURFAII: Y%NNISHRE DEPA IYO-NNIST �E i r IMA 02601 4 �IME Sign , . AB , TOWN OF BARNSTABLE Permit ELARNgfLE MASS. 1639- ♦ , Permit Number: Application Ref: 201406197 20071028 Issue Date: 09/17/14 Applicant: POYANT, MARCEL R Proposed Use: GENERAL OFFICE BUILDING Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 269 BARNSTABLE ROAD Map Parcel 310172 Town HYANNIS Zoning District HG Contractor PROPERTY OWNER Remarks REFACING 2 EXISTING SIGNS FOR GATEWAY DENTAL CARE TOTAL OF 22 SQ FT 1) GATEWAY DENTAL 1)CVC LAW OFFICE Owner: . POYANT, MARCEL R Address: 20F CAMP OPECHEE RD CENTERVILLE, MA 02632 Issued By: SS TIS .v 1BEFROM TIEARDA L t �Cainc-c-� E Town of Barnstable So ., o �A7,NSTAR(.E Regulatory Services m� ( (� Richard V.Scali,Director ;9. Building Division Tom Perry, Building Commissioner -T k0JYL(L 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# 6 () Building Official approving 7 Application for Sign Permit Applicant r{(�`� Assessors No. - Doing Business As: Q (J—)QM ( Telephone No. 6 oz- 1-11 - �I Sl Sign Location i Street/Road: @Crn rf�1��Cc Loa C . aw QtCIok Zoning District Old Kings Highway? Yes/No Hyannis Historic Districts? Yes/No Property Owner Name: Y c P o wm+ Telephone: Address: k }U, O Village: GpL-0vu Zd Ojyj*( i ' Sign Contractor Name: Ca ( mri aSL'IMA Telephone: Mailing Address: mb_!-_ti tro U U • tc-l y I�IV S� 1�11 �2(oV Description Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. Is the sign to be electrified? Yes No (Note.Ifyes, a wiruig permit is required) Width of building face fL x 10= x.10 Check one Reface existing sign (/ or New Total Sq. Ft. of proposed sign (s) Ifyou have additional signs please attach a sheet listing each one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of §240-59 through§240-89 of the Town of B s le Zoning Ordinance. Signature of Owner/Authorized Agent Date L/ SIGNS/SIGNREQU revisedl 10413 r �*VE rq� Town of Barnstable r t Regulatory Services EAMMMn-ss''$ '$ Richard V. Scali,Director ' 'DIED.39. Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 SIGN PERMIT REQUIREMENTS l. A photograph showing the existing facade, on which has been indicated the proposed sign location. The photograph is to include a portion of adjoining stores or building. For a proposed building or new facade, an architect's elevation may be submitted in lieu of a photograph. 2. A scale drawing of the proposed sign. A scale drawing indicating: 1) The type of proposed sign(wall, hanging, free standing) 2) Dimensions of the proposed sign and any designs, logos, or lettering 3) A cross-section with dimensions showing edge detail. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x 11". 3. A scale drawing of the bracket. A colored scale graphic indicating dimensions, showing colors, materials and method of affixing it to the sign and to the building. Minimum scale 1"= 1'. Minimum sheet size, 8.5 x I P. 4. A completed Town of Barnstable Sign Application, including scaled diagram showing location of sign on building or location of free-standing sign. Show dimensions. 5. The width of the building face or the leased area. NOTE: the map/parcel number is required on the application. SIGNS/SIGNREQU revisedl 10413 John Codjoe, DDS Falamos Podugues GATEWAY . DENTAL CARE .. 508 771 77 1 Employment ImmigratiOn i ' ' LAW O .F F I. -C E S O F CARMEN V CODJOE, P.C. 508w827 1076 - a 3 DATE: July 10, 2014 CLIENT: Gateway Dental MIN CONTACT: :Atl la PHONE: FILENAME: gatewayl APPROVED BY: 103 ENTERPRISE RD., HYANNIS, MA 02601 THE ABOVEDESIGN IS THE PROPERTY OF • ISLANDS SIGNS AND MAY • • • OR 508-815-3431 s • •• a A- •- • e • •• - • •• •• John. Codioe, DDS . a a amos ortugues . . ..,� GA-v,!TEWAY, , :� : 508 77 1 "'775 1 .. , ,DENTAL CARE'- 4 . m. p . Oyment, mmigrat O FF10E ' s OF •aW CARMEN V CODJOE, P.C. 508 827- 107-6 �3 ,.. 1.:.,,.. __,_ ;,tF;•�; �it LL:�,3;.Fr.. .� .. ,, ��'. t John ® "®e, DDS Big "UA%S i c Falmos IW A 71=ry>. %J AT E" Ay 508m III 7 x,. DENTAL CARE 15 v. -Emuft 10%,rment Immigration p �+"*$s _' z L A- W O F F I C E S O F000" 'a CARMENV. CODJOE, P C582`7 z 3 4 i�e �� DATE: July 10, 2014 CLIENT: Gateway Dental CONTACT: Atlia PHONE: FILENAME: clatewayl APPROVED BY- 103 ENTERPRISE RD:, NYANNIS, MA 02601 o •.®• o ® • • , ® .<- • o 508-815-343 • o .. • o • e o o e o P t �L L .� T !\R...1•,Fri. Yy'�`�\\.1 Est a. { / ti .0 i y y y ! t ATEW AY � - DENTAL CARE John Codjoe , DDS I Ftila' mos - or tugues r 1 o W A w i E� �t A w TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l oParcel ` t Z ..Application # ,. ..0 Health Division Date Issued Conservation Division :Application Fee fr - Planning Dept. Permit Fee �- Date Definitive Plan Approved by Planning Board � G Historic - OKH Preservation / Hyannis m ; Project Street Address 2t0� �5 Village S Owner �— Address �ff cheE Telephone QS, Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family° '❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other ; Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑-Ye-s ❑ No. c Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn l�'existing Q nevT size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: %' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ a J C) era Commercial Ll Yes 0 No If yes, site plan review# Current Use -�%�' '*Y(/ Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) NamecNfl PaW66vhi � k(_ • Telephone Number 5N_q,_,v-?k0D 3 License# •Address � � C 2 Home Improvement Contractor# �� J Worker's Compensation # W011 ALL'CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO OF Y4421 J 1 SIGNATURE DATE O — ` 1 FOR OFFICIAL USE ONLY f' `APPLICATION# DATEISS.UED isxK — :-MAF_'%.PARCEL N0.. — _ _ — s ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION41 FRAME y . `INSULATION.,z a FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - ' FINAL #�GAS:` ' j ROUGH ' -4' FINAL Y =�3,FJNAL BUI.LDING'L 04T37uA -fl t = ; .DATE CLOSED:OUT: . —'A- ASSOCIATION PLAN NO. The Commonwealth'of Massachusetts y R(` Department of Industrial Accidents +J� Office-of Investigations 600 Washington Street' Boston, MA 02111 ^. www.mass.govAlia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant information Please Print Le ibl Name (Business/Organi-r_ation/Individual) Address: _ SUA /'I City/State/Zip [IF, MAI Phone #: - $000- A y an employer? Check t e appropriate box: Type of project(required): i. re 1 am a employer with 4. ❑ I am a general contractor and employees (full and/or part-time).*- have hired the sub-contractors 6.. ❑ New construction ?.❑ I am a sole proprietor or partner- -listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have. g. ❑ Demolition working for me in any capaciiy. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.' - required.] We are a corporation and its 10.❑ Electrical repairs or additions ,required.] ❑ p � 3.❑ I am a homeowner doing all work officers,have exercised their 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL ' 12 Roof repairs ' c. 152 1 4 and we have no p insurance required.] � � O� q ] l Other employees: [No workers' � _ , comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all-,work and then hire outside contractors must submit a new*davit indicating such. *Contractors that check this box must attached an additional sheet showing the name or the sub-contractors and state whether or niit those entities have employees. Irthe sub-contractors have employees,they must provide their w-orkers',comp.policy number. I am an employer that is providing wo'ders'compensation insurance for my employees. Below is the policy and job site ' information.. Lai o - Insurance Company Name - 501M& 191- ---------- Policy#or Sell=iris. Lic. #:_���. Jt�/�£ Expiration Dater Job Site Address: I . , 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 imprisomnent,as well As civil penalties in the form of a STOP WORK,ORDER and a fine of up to $250.00 a day against the violator. Be advised that'a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ertif' ender tat tins and penalties ofperjury that the information provided above is true and correct. Si nature: Date: Phone 4: `1�$ Official use only. Do not write in this cirea, to be completed by city or town o/Jicial. -' City or Town: 'Permit/Licensee# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk A. Electrical.Inspector'5. Plumbing Inspector 6. Other k - Contact Person: Phone#. Rug 18 11 11 : 41a p. l RUC 18 11 11 :54a SCOTT NEHG •^ vuo ,co r Town of Barnstable NAMRegulatory Services Thomas F.Cet3er,Director Building Division lbomas Perry,CBQ Building Commissioner ' 200 Main Sheet, Hyannis,MA 02601 www.townbarestsble�m.us Office. 508-862-4038 Fax: 509 790-6230 Properly Owner Must Complete and Sign This Section If Using A Builder j MARCEL RENE' POYANT ,as Qwner of the subject property ' hereby authorizeP to act on my behalf, in all tnwners relative to'work authorized by dire building pewit application for. (Address of,)ob) MARCE R. POYANT 8/18/11 Signature of Owner Date MARCEL R. POYANT Print Name r Q-.%WPrILM�M1wtSVniiWinbprnnii f0MIA CPWS Ja Rm'sn020106 �/ae �oorYirernuaea�/z ✓�aaaczc�ieiaelta Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only HOME IMPROVEMENT CO TRACTOR before the expiration date. If found return to: Registration: 8`53 Type: Office of Consumer Affairs and Business Regulation a Expiratio 77/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 SC TT PEACOC, jUILDINk &REMODELING INC s JAMES PEACOCK 1046 MAIN STREETrSUITE',7 OSTERVILLE,MA 02655i r 4 Undersecretary, Not valid without signature F- fV'lassachusctts- Department of Public Sltfct� Board of Building Re ul: ions and Standards ' Construction Su pe isor License License: CS 945M JAMES S PEACOCK PO BOX 171 s ; OSTEVILLE, MA 02632 ' ' Expirat 7/22/2012 f T ('unuuissiuncr' . y 7 r 'C IOR& CERTIFICATE OF LIABILITY INSURANCE DATE,MMI°°�","' �....►� 07/06/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT - NAME: Germani Insurance Agency ac°N o :(508)428-9194 FnAX No: 508 428-3068 " 908 Main Street f, EMAIL -:, ADDRESS:; Osterville,MA 02655 PRODUCER !USTOMER ID#: r INSURER(S)AFFORDING COVERAGE NAIC# INSURED - _ - INSURER A; SAFETY INS CO _ Scott Peacock Building&Remodelling, Inc., INSURERB: P.O.Box 171 „ Osterville,MA 02655 INSURER C: INSURER D: National Union Fire Ins.Comp. INSURER E: - INSURER F: - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR TYPE OF INSURANCE ADDL SUBR - POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MMIDD/YYYY A GENERAL LIABILITY CP00001152 _ 7/5/2011 7/5/2012 EACH OCCURRENCE $ 1,000,000 TO RENT COMMERCIAL GENERAL LIABILITY -DAMAGE PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Anyone person) _ $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ '" 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO-JECT LOC - - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULEDAUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ .. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4 �EDUCTILBI CESSAB CLAIMS-MADE AGGREGATE $ LE t, $ 7C RETENTION $ - t $ _ D WORKERS COMPENSATION C 5815464 -" . 6/22/20 1 /22/2012 VUC STATU- OTH- " AND EMPLOYERS'LIABILITY YIN CRY LIMITS I I ER - ANYPROPRIETOR/PARTNER/EXECUTIVE "-- E.L EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E .DISEASE-EA EMPLOYEF4$ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT• $ 500,000 4� • _ - ` Ili DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ' CERTIFICATE - i HOLDER CANCELLATION Scott Peacock Building&Remodeling,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fax#"508-428-7625 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE1,26 - k ©1988-2009 ACORD CORPORATION. All rights reserved. . ACORD 25(2009/09) The ACORD name and logo are registered marks'of ACORD- ' • OFIKE Jh,. S1g n, ti PermitEIARNST� . TOWN OF BARNSTABLE T MASS. 9� 1639. ATFG a� Permit Number. Application Ref: 201005264 20070517 Issue Date: 10/04/10 Applicant:. POYANT, MARCEL R Proposed Use: GENERAL OFFICE BUILDING Permit Type: SIGN PERMIT Permit Fee $. 75.00 F Location 269 BARNSTABLE ROAD Map Parcel 310172 Town' HYANNIS Zoning District HG ° Contractor PROPERTY OWNER Remarks REFACE EXISTING 24 SQ FREESTD & 11 AWNING GATEWAY DENTAL Owners -POYANT, MARCEL R .Address: 20F CAMP OPECHEE RD CENTERVILLE,-MA 02632 , ,r fi Issued By: POST THIS CARD SO TI3AT IS VISYBLE FR....QM THE STREET I pFIKE ram, Town of Barnstabl (:�A e Regulatory Services / / HA SS. " Thomas F.Geiler,Director MA ' y MAss. _ `�Arfo;ur0. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 / �� www.town.barnstable.ma.us 1 bb`� Office: 508-862-4038 Fax: 508-790-6230 Permit# Building Official approving____________ Application for Sign Permit Assessors D011lg Business AS: n'/P�vY¢y_�P�nI (. ,4----______Telephone No. � - Sign Location 7T Street/Road:-?6 q_JR --�2° -- �4NS_�-/� ---------------- Zoning District: _ Old Kings Highway? Yes/No Hyannis Historic District? Yes/No Property Owner Name:__�I1 4&�---/-------------Telephone:phone:S d=-_`------Y_!�60 Address:- d S-��-^ --D �-It- -- 0�-------------Village:_� ��` �°-_pad 3Z Sign Co actor / Name: _e _----_Tele hone:__6� 2 1 Zg Mailing Address:3/0_CU6--L-A- ey! 6A , 64: 6 � -- - Description Please follow the cover directions.You must have in accurate rendition of sign with dimensions and location. Is die signs to be electrified? Yes/No (Note:I1)es, 1 rTmp'-pel7nitIs Ieg Ili ed) Width of building face AXf ----_____ft. x 10=________x .10=_________ Check one Reface existing sign or New_____Total Sq.Ft.of proposed sign (s) j fe 4- 1 I1 J 0II 111Ve add donna si"71S Please amlc 1 1 shCCt IlStlll,g—cac 1 olIC with dl1 7IelIS101IS � If refacing an existing sign please provide a picture of the existing sign with dimensions. n I hereby certify that I am the.owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of §240;59 through§240 89 of the Town o Barn able Zoning Ordinance. Signature of Owner/Authorized Agent: _ Date �.�]� SIGNS/SIGN REQU i dI Ili .e z. ..x Care �Gf �A s ,��� Cd 6QwN iN 6 a`LLB 6 r2 �� . ���... �/4QAI S��C.� r'��/.. .. . .... L.DO�G�/Ir � SQL/ �r9�ivs Flo t� w DA C V Li A I A ILI OWN s - r- awk 3 r ^+ 0 3•. _ WAN".. d ' .an tem- "a``l � K v � t , t y _ t 269 Barnstable Road Gateway Logo, on white oval 24" high X 70" wide applied onto the 18'X4' awning ` Gatew y ental Care Ex/stingg Sign on Sfeef _ 4•X6• Ligl.fed. - - ReP�aeing 4 ponols 42'•X68••. xyDental Care DENTAL EMERGENCIES •SAME DAY CARE AVALIABLE , { •PRICE GUARANTEE I 00—y 0.0.1,269 flu— isf.Road.Banns Handicap Ramp rr . =w � m "*t � r a d�'$G � y u � Yyl �a .1 l 7 yM bi S "' 4 A ",asp`' s •�. i, OGA* } 4 as 4 t 3 r .ki x'• 5" t - - TeX# #} I � as g y f �F a° "x rtz' M Y t t � � k '4 Ali �i {•y} 7`i` $, st.Fk l.� 7 � F ' ick e .. kf� �5•` �,� F�' eta � m + # ri l— i K 13 74 i ftj S rVV, Y ,1i "Iwka s fl 'k�s y .L F' G. S a� t' �g nX c- Town of Barnstable Building Department - 200 Main Street IAMSTABLE. * Hyannis, MA 02601 F 6 A.��' (508) 862-4038 Certificate of. Occupancy Application Number: 201003715 CO Number: 20100159 Parcel ID: 310172 CO Issue Date: 10/28110 Location: 269 BARNSTABLE ROAD Zoning Classification: HYANNIS'GATEWAY DISTRICT Proposed Use: GENERAL OFFICE BUILDING ~Village: HYAN'NIS Gen Contractor: ' , ALEXANDER, CARADIMOS Permit Type: CC00 •CERTIFICATE OF OCCUPANCY COMM- Comments: GATEWAY DENTAL - Building Department Signature Date Signed r� TO . . N- ARNSTABLE { ti Building Application Ref: 201003715 BARNSTABLE, * Issue Date: 08/10/10 Per'Mit 9 MASS. g x $A 039. Applicant: rFp Mph A' Permit Number: B 20101613 ILocation Proposed Use: GENERAL OFFICE BUILDINGExpiration Date: 02/07/11 269 BARNSTABLE ROAD Zoning District HQ Permit Type: COMMERCIAL ADblTION ALTERATION ,lap Parcel 310172 Permit Fee$ 409.'50 Contractor ALEXANDER, CARADIMOS tillage HYANNIS App Fee$ 100.00, License Num 101770 Est Construction.Cost$ 45,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND INTERIOR ONLY: CREATE 5 EXAM ROOMS FOR DENTIST(DR LEE) THIS CARD MUST BE KEPT POSTED UNTIL FINAL MOVING INTERIOR WALLS ONLY: GATEWAY DENTAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SIJCH ❑er on Record: POYANT, MARCEL R BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL ddress: 20F CAMP OPECHEE RD INSPECTION HAS BEEN MADE. CENTERVILLE, MA 02632 pplication Entered by: PR Building Permit Issued By: HIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY ORPERMANENTLY. CROACHEM ENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. ET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. E ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. IMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: OUNDATION OR FOOTINGS. .ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. ;WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). INSULATION. ` FINAL INSPECTION BEFORE OCCUPANCY. 'HERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR.ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. 'ORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. ERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITH.I.N SIX MONTHS OF ATE THE PERMIT IS ISSUED AS NOTED ABOVE. RSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). a• rIg s - In BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS t Mel rip- I Heating 44pection Approvals Engineering Dept Fire Dept 2 Boa d of Health ILI Q � w � � � _ � � `, o � � �- a i� � FORM FOR ENERGY EFFICICIENCY FOR DENTIAL CONSTRUCTION (780 CMR 61.00) Site Address: Town: Date of Application: �Ijowing two options) TABLE 6107.1 E COMPONENT CRITERIA FOR O-FAMILY BUILDINGS MINIMUM Basement Slab Floor Wall Perimeter . AFUE HSPF SEER ue R-Value R-Value R-Value and Depth - National Appliance,Energy, R-10, Conservation Act(NAECA)of raccessed R-1 O 1987 as amended,minimums or 4 ft. greater as applicable e two versions of RESchech as listed below. ftware analysis must be completed http://www.energycodes.gov/rescheck/ Sullivan,•Engineering Inc. . 7 Parker Road,'P.O. Box 659 Osterville,MA 02655 Peter Sullivan P.E.Mass Registration No:29733 phone 508-428-3344 . ' .fax 508-428-9617 peter@sullivanengm,.com Thomas Perry, Director { f g July 28, 2010 Building Division ,. Town of Barnstable 1 200 Main Street Hyannis NIA 02601 RE: 269 Barnstable Road, Hyannis F W Dear Mr. Perry M _ Marcel Poyant has asked that I review the,present traffic situation-at 269 Barnstable Road to determine*if there will be an increase infraffic with a dentist office~as a new and only tenant. Presently at this location there is a medical hearing aid'office which has a gross footprint of approximately 1600 sf. and a church"with:seating for 40 to 60 persons'.also,.- with a gross footprint of approximately,1600 sf. ITE trip generation charts do.not,cover the specific category of"hearing aid office"' so using the zoning by-law parking requirements of 1 space 300 sf for office then the ° present parking demand is 5 spaces plus employee spaces. It can be:gconcluded that there is 1 hearing exam appointment per hour per;space resulting in 5 trips per hour.The Church has services on Wednesday evening,Saturday and Sunday with,an average of 50 seats which could represent 25 vehicle trips: The proposed dentist office will occupy the whole building and will have.4 dentist chairs. Given-there are 4 chairs,there are then 4 appointments per hour and4possible ' vehicle trips per'hour. ITE does have charts'for dentist offices and for a dental office of s this size it corresponds to the number of chairs and vehicle trips. ' Therefore it is my opinion that the proposed dentist office will not3result in an increase 'in traffic at this site. If you have any question or requireanyadditional information please do not hesitate to call. V truly yours Rw 14 Peter Sullivan PE SLU 9VA r f t Sullivan Engineering, Inc. x' 3 cc: Marcel Poyant, Philip.Boudreau ' s a c Members of American Societyof Civii Engineers and Boston Society of Civil Engineers Section ` a a s j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION F . Map �. I Parcel 1 µ Application# � � � Health Division Conservation Division Permit# Tax Collector Date Issued , Treasurer Application Fe (� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis en A Project Street Address Village Owner Y'L i o�'Yw""� Address Telephone 5,0$= 115- 0 O Permit Request 2. < au-w W w Cr Square feet: 1 st floor:existing proposed 'Ifry-- 2nd floor-existing proposed Total new 0 Zoning District Flood Plain — Groundwater Overlay Project Valuation D00 Construction Type Gtf e Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentatiion. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure �� { Historic House: ❑Yes U No On Old King's F#g6way: ❑Yes 0 No Basement Type: 91-Fail ❑Crawl ❑Walkout ❑Other f Basement Finished Area(sq.ft.) %KOO 4- Basement Unfinished Area(sq.ft) 12- 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: UFG-a—s - ❑Oil ❑ Electric ❑Other Central Air: 3116-s- ❑No Fireplaces:.Existing New Existing wood/coal stove: ❑Yes 11144a- 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 0 Appeal#` Recorded 0 Commercial es ❑N If yes, site plan review# - c � �p- Current Use C � Proposed Use � - BUILDER INFORMATION Name ��PtA41A Telephone Number Sd a�, 7 00 C e L t Address j D L 6 J License# DSO f) Y Home Improvement Contractor# (� S Worker's Compensation# W C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO art SIGNATURE < �2ar/` DATE FOR OFFICIAL USE ONLY PERMIT NO. , s DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER _ DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL • FINAL BUILDING U s DATE CLOSED OUT ASSOCIATION PLAN NO. ,per The Commonwealth ofMassachusetts Department of Industrial Accidents Offcce of Investigations 600 Washington Street Boston,MA 02111 • www.mass.gov1dia Workers" Compensation Insurance.Affidavit: Builders/Contractors(Electr clans/Plumbers Applicant Information j Please Print LeQiblY Name (Business/Organization(Individual):_�)O FQ - &MMdtna , Address: 8!�`Y96� IbnIn City/State/Zip: !Ili. R Phone#:_ Are you an employer? Check the appropriate boa: .Type of project(required):. 1. I am a employer with 4. I am a general contractor and I a " * ",'have hued the sub-contractors. 6. ❑ New construction . employees(full and/or part.time) 1 2.❑ I am a'sole proprietor or partner- "`listed on the•attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8::•.❑ Demolition . working for me in any capacity. employees and have workers'. 9 :❑Building addition [No workers' camp.insurance comp.insurance.$ required.] 5• ❑"We are a corporation and its 10.0 Electrical repairs or additions. 3.❑ I am a homeowner doing all work =officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MG'L myself [No workers comp. 12;❑Roof repairs insurance required.] t 152, 1(4), and we have no _. c: § • employees. [No workers' .13,0 Other comp. insurance required:] • ' `Any 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 subinit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they.must provide their workers'cornp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below isthe policy and job site information. 4 Insurance Company Name: 11M Policy#or Self-ins.Lic.#:fit 114 1,081 "4y-q 2 Expiration Date: ZZ �� Job' Site Address: City/State/Zip Attach a copy of the workers' compensation policy declaratiou'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`bf 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 ofup to$250.00 a day against the violator. Be advised that a copy of this`statemerit maybe forwai:ded to the Office of Investigations of the BIA for insurance coverage verification, I do hereby erti der the p ' sand penalties of perjury that the information provided above is true and correct Simature: e Date:Ur _ Phone#: `'0 2b.., Official use only. Do not write in this area,'to be completed by c:' or town,oJciaL City.or Town:: Permit/U,cerise# Issuing Authority"(circle one): # 1.Board of Health 2.Building Department;3t City%'I'own Clerk 4.Electrical Inspector S.Plumbing Inspector. 6. Other Contact Person: • Phone#• - : ry>} .�,:a^�il.u� } ✓;i' 'r J, r� 1 r i Board of Building Regulations and Standards One ,Ashburton Place - Room. 1301 Boston. Massachusetts 02108 1-101-11e Improvement Contractor Registration Registration: 151853 Type: Private Corporation Expiration: 7/7/2008 SCOTT PEACOCK BUILDING & REIVIODELI JAMES PEACOCK PO BOX 171 OSTERVILLE, IVIA 02655 Update Address and return card. hYa¢I: rcazan lilr I Address Renewal Employment Itu:ull of huillliu tic�ulari()us and titaudard, License or registration valid for indivitlul use()Illy HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: I` 'Jly Bow-tl of Building Regulations and Standards Registration: 15-1853 k Expiration: 7/7/200�� One Ashburton Place Rm 1301 �`•�- { hype: Private Corporation' Boston,Ma.02108 "{.1)i 1 PEACOCK RUI1_DING & REMODELING INC "•� PEACOCK 10,u MAIN S1 hLE SUITE 7 ; .. -J",.,_..... `)S1 ERVI1_L.E, MA 02655 Not valid without si nature. 1)cput�•A¢Iwiuish'ator � ,r � 1 VV. lY/ t.V I I LV rY I 9/14J2007 116 X THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW OSTERVILLE,MA 02855 COMPANIES AFFORDING COVERAGE COMPANY SAFETY INSURANCE A INSURED COMPANY AIG AMI:-:RICAN HOME ASSURANCE CO. SCOTT PEACOCK BUILDING&REMODELING —B -- . ...- PO BOX 171 COMPANY OSTERVILLE, MA 02655 c COMPANY QM ANY 11" 10 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD RA OTHER DOCUMENT WITH RESPECT To WHICH THIS INDICATED,NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED 8 Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR CID TYPE OF INSURANCE POLICY NUMBER DATE(MMIDO(TY) DATE IMM'Mfyyl GENERAL AGGREGATE2,000,000 GENERAL LIABILITYCP00001 152 07/05/07 07105/08 A PROOLICTS-COMPIOP AGG X COMMERCIAL GENERAL LIABILITY ]CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ 17 _!A OCCURRENCE �s ___1,000,000 OWNERS A CONTRACTOR'S PROT FIRE DAMAGE (Anyone fire) MED EXP (Anyone par-ON $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I S ANY AUTO ALL OWNED AUTOS BODILY INJURY (Por parson) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Par a=ldent) NON-OWNED AUTOS PROPERTY DAMAGE 5 TO ONLY-EA ACCIDENT GARAGE LIABILITY L�u _OTHERJ�HtNAYTQQNLY: ANY AUTO EA.CHACCIDiNT I AGGREGATE Ti EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM STATU. H-L WORKER'S COMPENSATION AND WC 687-44-42 06122/07 0612V08 ;0vciIfkImrr8 13 EL EACH ACCIDENT 1001000 EMPLOYFFIV LIABILITY THE PROPRIE70PJ INCL EL DISEASE-POLICY LIMIT_j I 6PQ�000 PARTNERSIEXECUrIVE FL DISEASE-EA EMPLOYEE s 100,000 OPPIC-ERS ARE H EXCL - OTHER L-----------------I.— DESCRIPTION OF OPERATIGKSILOCATIONS/VEHICLFSISPECIAL ITEMS K 1000TA"'W4 SHOULD ANY Or THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, TH19 ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF BARNSTABLE 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, FAX#:508-428-7625 BUT FAILURE To MAIL SUCH NOTICE SHALL IMPOSE No OBLIGATION OR LIABILITY OF ANY KINVL_geON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHOPW REPRESF.NTATIV§ RI ai"ITr1011M License: CONSTRUCTION SUPERVISOR Number: CS 094500 Expires:07/22/2010 Tr.no: v 94500 Restricted: '00 JAMES S PEACOCK - PO:'.JY 171 OSTEVILLE, MA 02632 Commissioner , < T a n [ ! 5 - .�, - a�4 _ to •„ � • ' t• , Sep 21 07 01 : 33p p. 2 orpr c1 Ur U1 : UaP �k Ui I rtnl.ULK bULLUINE3 & SUET 428 '7625 p. 2 Town of Barnstable Regulatory Services njomas F.Geiler,Dkectox , Building Division Tom Fierry, Blulding Commissioner 200 Main Street, Flyaunis,MA 02601 Office: 508-962-4038 Fat_ 508-790-6230 Property Owncr Must Complete and Sign This Scction If Using A, Builder Y, MARCEL R. POYANT , as ow^nex of the subject property hereby authorize !V1 to act on my behalf, in all mutter$relative to work authorized by this building permit application for: (Address of Job) i/gyp/, r� 9/21/07 Signature of Owner % Date MARCEL R. POYANT Pant 1\2tnc r Q:FORMS:O WNEtPERMISSION t Harve y 111dUStT7eS Manufacturing HYANNIS WAREHOUSE QUOTATION 186 BREEDS HILL RD. Tf..........`;��.... HYANNIS, MA 02601-1186 10/21/2007 www.harvwind.com Phone:(508)775-7788 Fax:.(508)'771-3217 BIL1, TO: SHIP TO: III IiIII�I�IIIII�III IIIIIIIIIIII�IIIII SCOTT PEACOCK BLDG& REMODELING INC SCOTT PEACOCK BLDG&REMODELING INC Mr0o0140205051300 1046 MAIN ST.#7 1046 MAIN ST.#7 PO BOX 171 PO BOX 171 Phone:508-428-7600 Fax: 508-428-7625 Phone: Fax: OR t7C�3.�NR➢� 7 -C pl�l ltll➢HI2iVk➢➢ rClk 1tA1A➢Nrik➢La ��FC1� ��N71?n➢Irl*r - -[ ➢aL7NFi I1VriP➢Tit ur ?O�c_i;13 14054 -000 Quote Not Ordered Charge Scott Certified Whse Pickup HYANNTS WAREHOUSE WNIM Ia07 -Ed Grilfin poyant : �,�m4 # V7- . ..:: � 1 . 100-1 Product:White Classic Double IIung-All Operating,Replacement I Viaw 'Alaw Unit Dinn:21. 1/2:x 36 1/4 Ordered AS R O. 21 3/4 x 36 3/4 Glass.Low-E,Standard Strength Grilles: C'Ont011r ln-Glass,Match Frame,Colonial,3W211, iI Screen:Half Screen,Fiberglass Mesh —�--- 1-1.udwnre: Single Locks,Standard 'JI!: Room Location: None Assigned Pricing Details CLASSIC DI-I FULL.W13LD WHITE l— -- LOW-E GLASS GRIDS 6 LI'l'L:. GRIDS o LITE' 11 It'rh ll - 1A SC_ 1,F'I YF3I1l- _ (tit t C aC➢+ _ iI a 6}i rA t) 200-1 Product White Classic Double Hung-All Operating,Replacement 1 I.Inil llim 11 1/7,,h9 1(al « 1 Ordered As lZ O : 33 3/4 x 69 3/4; 1, l Glass Low-E,Standard Strength I' t GrIllcs Contour In Glass,Match frame,Colonial,3W2H, Screen: Hal f Screen Fibergl ass Mesh Hardware.Double Locks,Standard I i i 11 - l Room Location: None Assigned Pricing Details CLASSIC DH FULL WELD WHITE CLASSIC DI W111TE OVER 101 LOW-E GL.ASS 102 TO 124 GRIDS 6 LITE GRIDS 6 LITE -Note'Trip Program Credits Are Not Included On This Quote " 'his rpintjlinn is haserl on nmr iuft:rlur.t,1h m of the inlnnnrahnn pr0viriCil All gnantiti ,sizes,rxfensrnns,grand tJ13I 2I? z totals,arid specifications slimild be verified by the conti-actor prior to his/her bidding or ordering of materials. -.- Harvey Industries,Inc.,is responsible ordy for the items as quoted above. Any changes or addendums will be y subject to a requote. We piopoSe to supply the materials as described above,subject to the tennis and conditions as Page I Of 2 LILssor's Office(1st floor) Map 7j Lot 1172 44�, i li54q � Conservation Office(4th floor) Date.Iss,14ed [ —9 Board of Health(3rd floor)(8:30-9:30/.1:00-2:00) Fee- Engineering Dept.(3rd floor) House#1 Planning Dept.(1st floor/School Admin. Bldg.) BARNBTABLE, Definitive Plan proved Planning Board 19 e �� rEo►M+' TOWN OF BARNSTABLE ; Building Permit Application Project Street A RA P N srA C f '° Village Owner BAR r' E-L— ����..n Address 0-� giC!/I1�1a4 � ��J,_LT�io.N•N� Telephone Permit Request KC'&o Total 1 Story Area(include 1 story garages&decks) 1 D D 0 square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ ),S—D 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Ca/r(Y1 LrYCC) A 7_ Proposed Use CIA Z Construction Type (A)6 o 0 42PA/1)L Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information c� Name P1=11eDne &D S Telephone Number Address 9% )r ), f License# Y 12 Home Improvement Contractor# Worker's Compensation# Z (/y $'r ] NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ,��►( t s�`,R �� 0 L L I SIGNATURE DATE o� � BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. #10498 DATEISSUED Sept 21, 1995 i MAP/PARCEL NO. 310, 172 ADDRESS 269 Barnstable Road VILLAGE Hyannis, MA 02601 ' OWNER Marcel Poyant DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: f ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. f Y ' t Goys CFa � !'yGi6P j'�UCjO�yFytOF � _� _ -rill �Pslr:. 4435 -lap BltC t1iF,yplr ItCF�9FFj` J,t fC0 00 ��f996 F �j.. .61 ljF .r •- Cf jF��pOSB�C�PCSB` Mi Av xx4 fB ¢86 6 3 1 � 1 f, b J The Commonwealth of Massachusetts W:i: -:_==j;_y Department of Industrial Accidents r~ ofice81108SM9,91loos 600 fi'ashi igWir Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit � -a---l--f r j0\Cion-()V DI I 1 a'4 ah0'md\,p&ner`perfbrAinJa1l work:m e f. 0 1 am a sole proprietor and hlqe no one working in any capac i..a3�:._��-�—"�.�w�:'a_._TRler!?ts�aa, :..-� _�.�-:,t;, .t_�^ '�r a'�si ._-_ ._� ...::....ry�..n�+�.e.geT'.+..n.r+e-�•. �ews� I am an employer providing workers' compensation for my employees working on this job. company name: din C .e5 ( I—e) .S• �z RU I tz? < •!dress• ( 1 , Sit) �4lr" Z�S�L�t7�/��.(� // 7r � �:Z .�` phone -�3 6�l��� 1 insurance co I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company.ngme• - address: city. phone#: insurance co policy# -P+ :. .. - �rr.'F[tx r..r -•7t+osn-rr-s•i."terrnsre*��,.�'�"_;rr;+�+ae C�-T�sF�?�•�3.7.!n'4f7�l�ez� ',�9_.' s c6mpam•name.- address: -- - city, phone#- policy# -- :Atiachh addl_tional sheet if'necessAJ'„��;',; ;z..,y„w��_:;_';t;,,"�"r:na: �rs; ,�.;,;:n.+ .;�; :,.;'` :'.:"". _ .,•. �:+�: Failure to secure coverage as required under Sectionf 25A of 51GL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP R'ORK ORDER and a fine of 5100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. I do hereht cerrij under the pain nd penalties perjury that the information provided above is true and/77 . Signature Date 2L Print name sS—e o Phone# {-;;;L2L offcial use only do not write in this area to be compacted by city or town official ►_ ciq or tmye. permit/license# BuildingLicen I]check if immediate response is required [3Selectmen's Office ,. C)Healtb Department r contact person phone#• nOther 6 n..r�..�w�e�s�i• (revised N95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an etytphovee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An enzp/atper 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 dweiiing house having not more than three apartments and who resides therein, or the occupant of the dwclling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rene,oval of a license or permit to operate a business or to construct buildings in the commomvealth for and, applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. • .. - i ..`. ....,t . - '1 .r t > My S .tXi < A 4 ,n�.�v�...""��'.. .ti. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to ;=ive us a call. r,a..,,.,,...,... ._.,,,,.,. .,�....,�..�g..,-r.... •,..•.+,..,...r.-•e -... ,.-.gin.. ,. .,�.....n�+�rarxsT r.•ru..�..,}..•....v...n.o..- 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 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 °= The Town of Barnstable J NABS. �e Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Building Commissioner F= 508 775-33" For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernisation,conversion, improvement,,removal, demolition, or construction of an addition to any pre-erosting Owner oohed building containing at least one but not more than four dwelling units or to sMU=res which are adlaamt to such residence or building be done by registered contractors,with certain exceptions,along with other roquirements Type of Work: Kr Poo P Est Cost LS-D o Address of Work: P t �'4 Q � � ,✓� Owner.Name• Pajg A A� Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work Gccluded by law Job under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITHDNREGISTEHED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. C ar n Date Contractor name Registration No. OR ' Date Owner's name °F THE Tqr,_ The Town of Barnstable wuvsrnaLE, 9� M ,�� Department of Health Safety and Environmental Services' 039. i Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 11, 2000 Rev. Stephen Mathias 304 Strawberry Hill Road Centerville, Ma. 02632 Re: SPR 065-2000, 269 Barnstable Rd,Hyannis (R310-172) Proposal: Establish a church at this location for worship and study sessions. Dear Rev. Mathias; Please be advised that this application was approved at the Site Plan Review hearing on May 4, 2000 with the following conditions: • The applicant shall be limited to Mon. -Fri. Evening hours only(after 5 PM) • Saturday and Sunday without restriction (so long as there is no interference with the primary use of this building). • Congregation and use shall be limited to 60 people. • Use is limited to 1,600 square feet. Sincerely, Ralph Crossen Building Commissioner 1 P��f?Mer TOWN OF BARNSTABLE Office of the Building Inspector riva �Op 16;q. Date June 16, 1995 Fee $50.00 Permit No. #121 PERMIT TO ERECT SIGN IS .HEREBY GRANTED TO Cape & Islands Hearing Centers DIBIA CAPE & ISLANDS HEARING CENTERS LOCATION 269 Barnstable Road, Hyannis, MA 02601 ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF THIS PERMIT Building Inspector _ ,P]RMIT NO. : _ _DATE: GZ7 S TOWN OF BARNSTABLE BUILDING DEPARTMENT 367 MAIN STREET HYANNIS, MA 02601 APPLICATION FOR SIGN PERMIT APPLICANT: Cl+4�'� 't �.5�.���/'s �i nI1V�i• �H r�� S ASSESSOR'S NO.: -; DOING BUSINESS .AS: TELEPHONE:",,--- 771 w q� SIGN LOCATION street/Road: Z a 9 RAn r/ir 13 -t V ZONING DISTRICT: ASS OLD KINGS HIGHWAY DISTRICT? yes no PROPERTY OWNER .p _ Name: TOLJON T PtfA4- L—=S7-jq 7-1=* Addre s Z / city: AAMA1.1s State: Zip: ®2 ri •• 00 7� O� Tel. No.: 77-1 SIGN CONTRACTOR �� Name: Address: City: Tel. No.: State: �t� Zi 02GG 3�� Z72 P: DESCRIPTION DIAGRAM OF LOT SHOWING LOCATION OF BUILDINGS AND EXISTING SIGNS WITH DIMENSIONS, LOCATION AND SIZE OF THE NEW SIGN TO BE DRAWN ON THE REVERSE SIDE OF THIS APPLICATION. Is the sign to be electrified? yes no ._ �e- (NOTE: If yes, a wiring permit is required.) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. Y Aw Date signature of Owner/Autho ized Agent ForO,f.fice Use - - - - - - .- - - - - - - - - - - - - - - - - -_ - - - - - - - - - - Size (Sq. Ft.) pl��y Permit Fee V V• U v Approved ✓ Disapproved Date s ;ae Building Official Mzsc4 tie x, Ing k,4 C /lj Inc. OLD MAIN STREET SOUTH YARMOUTH MASSACHUSETTS 02664 TELEPHONE 508.398-2721 FAX 508.760-3130 Cif i�iia /Loa �. ;f ��iy G 4 The Town of Barnstable perni;t no.�'� Department of Health, Safety and Environmental Ser vices 39. $ Building Division asp- .e date 5 /k1q.Sr 361 Main Strect, Hyannis MA 02601 fee y Application for Sign Permit Applicant: CAPE st& ISLANDS h-EARIM CENTERS, INC. Assessor's no. 310/' 2...1. s Doing Business As :. ra f'ai�c�' TG1 �nr7 c HPari na C`z_T-4 ephon �, Sign Location street/road: 269 Barnstable Road, Hyannisj MA : 02601 Zoning Districtlo � Old King's Highway District? yes ::o Property Owner Name:__T,nvnnTm Qb41QRg Telephone- ���_n 0 n7A Address: 282 Barnstable Road Village_�yanr; Sign Contractor Name: Jordan Sign Co. Telephone 771-4020 Address: 103 Enterprise Road, Village Hyannis, MA 02601 Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. Is the sign to be electrified? yes no x (Note: if yes, a wiring permit is required) Original sign already wired / plastic facing does not need new wiring. I hereby certify that I am the owner`or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. May 18 , 1995 Date Signature of Owner/Authorized Agent Size (sq. fi ) _ �S Perri; Fee Sign Permit was approved-.. / disapproved: Date /Signature of Buil fng 3Z <M (ch%mo FE) Wlfl-Ft� G67761¢f1�16, Mf;RA�N 8it2KG�f�IVD $B�4l�.'• �� � .1�OoT;::' DESIGN .AND PRI6E A� ZSS^YPZ► pA7K?CX SA, CO. opnwslSEROM DESIGN A X so _ 77S 00?9 f r�MA 02MI-MIZ NEW u6 gJ611 '69 M _E �►`ID, 54 • ,>� C.f-i>�wLry,Tjr;[- 1 �,�.0 '" �;:�'�i-.�P,•iitti:��1l'r � 1,i�� - r ,� , �4�� 0 ell sc . ♦. �f�1ti''.�`YaJ dY:w vi �.♦�a?'.�•,s,c .;...-�.:.•09a'/r,��j9�10/Y,: . `:..-sr.•f^;�.. • � i� y •� _ •�•i.r✓oisi�iosns 9r',-1 a'�o ����1i•vo�,.e7;ti t �y- � � r •,�M• %Y/1t7D^oa'dd.D�; `b<��tS,�t::', - - - - - - "-� �Go�/ poi _ ..1;.,3c.. b• L �r .� _ -.i.,�;.��ti A/��..' + ..�+r• W •- .. a�fiL S6 - 'mac �j li•�� i.. fy`?�., �� -� .rK:.:`r_°.` :�.�'`i' ''1.i.v�.-. ^vim.•, ,�► y�:+; ' •n .%.'.trJ�4• �.�'tea:�:`^-+�- - :R'�'':c%wa:i=� y:�t•�i�'-tea +..� uo+, n f� �:.fi.�.•:-ice T.:•+�- ;'tea• '-' _ •?Y�"•:F^ "ti'• f•a`c� �`Tt" _.4r O L i cr'-�._. i 1F,.: a a .c� :_'y1Y\ -J � �5,• �.N R 4.'-t•• - ... _•. � '� Q'..?iYt J.� �/L.ii 3 .t•IFL�! 0.?��� ;_1Y,.V�(_r, }'(s •��'^�\l�'f���f�,!S�-Xw �✓ 0 •'�. • ���,. Kr'j'.[�::',��,•.:c+:fY•.a•x`2t I G J`•;.r,}ly �/YO/ >3�� dJ7: 1�c'� .7. %Y�� - �• ' J _ •'7...-/. '•}y.�f f; `,z;• ♦f.Y �- .i.� nj•�1��."K'�ri ,`!tom'` Y-- •e �! • `I��`]/' 1.�4_�. � � �`i` �C;s .} �~Y� 04ii�'s"p'oii� ti'•`D Es-'4"' -1 • I _ - PyoFtaero�� TOWN OF BARNSTABEE But BdB s Office of the Building Inspector But i639• t am M� Date May 18, 1995 Fee $50.00 Permit No. 86 PERMIT TO ERECT SIGN IS HEREBY GRANTED TO Cape & Islands Hearing Centers, Inc. Cape & Islands Hearing Center DIBIA LOCATION 269 Barnstable Road Hyannis ANY VIOLATION OF THE SIGN LAW WILL CAUSE-IMMEDIATE REVOCATION OF THIS PERMIT Building Inspector TOWN OF BARNSTABLE BUILDING•PERMIT APPLICATION Map FParcel Z ' ; Z�„c/ Permit# �g�� Date Issu Conservation Division Fee Tax Collector ` CT-reasurer; A�k d • Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis CP-rojeet Street�ddress � M'MjL,4l,, R_b 1� 1 CVillage�� �i�'�1-N. t 5 0 nw er �0`6A- ! C 0 Q- 1 I �,1 0& e�a' S t Address 9,b2 13/WAKSTA-i',>L,;i9 0 16 AN t S telephone:~� ;Permit^Reguest---'�C&O (:2,& yP'A e_:i�pn:y` Nit To —\N1N Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION } Z- c e�11c ��'{�r�"S� 0�G � �. C.p� Telephone Number <Address 0 �,t-L- e-j License# C_4;�i Ull�, u lR 0LL-,�3Z Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE- �° , '° - - DATE -r��' OD - _: _ — f [ FOR OFFICIAL-USE ONLY PERMIT NO.j ✓ O U DATE ISSUED (/)aC) MAP/PARCEL NO.� 3 f O / / —�7 t i ' ADDRESS VILLAGE OWNERS DATE OF INSPECTT�N: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL all GAS: ROUGH FINAL ` FINAL BUILDING ; ` DATE CLOSED OUT ASSOCIATION PLAN NO. t ' Y � f ' 1 ' S S a DRIVE UP WOMfa-. ,. OFFICE C NewPlaitorm f �^{ El: $9,11-1f2" / COUNTING T E L L E R S. RECEPTIONIST " MEN Sate HALL �--� ' C� up I IC•�f C��� 3Rs Fin Floor VEST El:90'-0" (Assumed) El: 88'2-3f8" LUNCH LOWER ' ROOM OFFICE B OFFICE A L O B B Y j LEVEL VEST r 0 c Dn 6 Rs SECRETARY I a Areaway Below ; ; Q- R p Up �. 3 ON :r•! ALOE R Enterprises t - ; STANLEY F.ALGER,JR PR POSED 38 LEONARD DRIVE �•;,•• •• OSTERVILLE • MA � AL ERATIONS & ADDIT; `````''`=1`' 02655 2416 to ' P AN C ? j r091792 H' DEPARTMENT OF PUBLIC SAFETY n COMMONWEALTH 11010 COMMONWEALTH AVE. � s OF BOSTON,MASS.02215 MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER LICENSE - FOR REQUIRED FEE, EXPIRATION DATE wgg••p ;GOIY.STR. SUPERV.ISO.R 0`3i�� 1 MADE PAYABLE TO 11130I1992 P EFFECTIVE DATE LIC-NO. F RESTRICTIONS 1113011990 i4355b "COMMISSIONER OF PUBLIC SAFETY" NONE SCOTT tE CROS3Y t. (DO �NDCASH). 30 CROSBY CIRCLE I, �OSTERVILLE MA -02655 PL�fASE NOTE FEE NCREASE PHOTO(BLASTING OPR ONLY) FEE: . II 5 E P 14 199n 100.00 EF!'PECTIVE FEB* ,'1989 HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED-OR-SIGNATURE OF THE COMMISSIONER THIS DOCUMENT MUST BE SIGNAT OF LICENSEE. I SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF THE HOLDER WHEN ENGAG- '/fr�Ds COMMISSIONER OTHERS RIGHT THUMB PRINT ED IN THIS OCCUPATION. 200M•2.87-81429 ............... , HOME IMPROVEMENT CONTRACTOk Registration 103582 Type - DBA Expiration 07/09/94 Peacock & Crosby Builders Scott E. Crosby 62 Crosby Cir. ADMINISTRATOR Osterville MA 02655 Assessor's office(1st Floor): Assessor's map and lot numb IN It>o� Conseniation CJ — 7,2 Board of Health( d floor): 1 Sewage Permit number C_t 7, L �o J W'�� spy ULZ . IL Engineering Department(31d flood �o 1639. House number .2 to E.. A 2NS 7�^� �-'y 2-J 1 ` )+` �o ear►• Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �)'y n/� ;.��� ' ��) �' jam, N D 0 LQ CNAA)bC TYPE OF CONSTRUCTIONg-- i j 1b/ate 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location S /v ✓t/./U J� Proposed Use Zoning District Fire District Name of Owner klrw Lr— c_ �D�/g/V� Address Name of Builder � Gn GY Address_ X�7) Name of Architect S7`A✓v Address `� n,,gr2� rjp t UE, Number of Rooms N/A Foundation PID 1.12,LiD i Exterior W-022 Roofing A.�R kn L� rA�I Al LC Floors A�1 Interior 0,,e Heating A11A Plumbing -Al �J9 Fireplace 414 A Approximate Cos i Area v Diagram of Lot and Building with Dimensions Fee /U V OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License Z . POYANT, RENE L. ►,►p t 35477 REMODEL/CHANGE WINDOWS No Permit For - Commercial Bldg. Location 2'69 ¢Barnstable Road Hyannis ' �~ Owner -{Rene; L. Poyant Type of Construction Frame PIoC L`' Lot i • 5 Permit Granted`�) October 27 , 19. 92 Date of Inspection 19' Date Comp1ted 19 t , i TOWN OF BARNSTABLE , SIGN PERMIT PARCEL ID 310 172 GEOBASE ID 22740 I ADDRESS 289 BARNSTABLE ROAD PHONE HYANNIS ZIP LOT 37A & 5 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 46618 DESCRIPTION THE LIGHTHOUSE OF CAPE COD - 24 SQ. PERMIT TYPE BSIGN TITLE SIGN PERMIT i CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: . $25.00 BOND $.00 Oki CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE P'"C*T'E..-- ; + BARNSrABLE, MASS. i639. BUILDING DIV,ISIO DATE ISSUED 06/07/2000 EXPIRATION DATE ~ . 1TIA7)A-tA-St ®2-&3�-- 0.3 3 y I I CF THE Tp� do The Town of Barnstable A16(,�� Department of Health, Safety and Environmental Services � BARNSTABLL L-'Bu&ing Division 9`b 1659 •�� 367 Main Street,Hyannis MA 02601 Officer 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Tax Collector kle /C� TreasurP \ ma I Application for Sign Permit Applicant:�� 4CLs:VVAnN4 �, Assessors No. Doing Business As:�l1� Come, Telephone No.�- 0353 Sign Location ( 1 Street/Road: 24 N?Aa9,4, c Lk- Zonin District: Old Kings Highway? Ye�o Hyannis Historic District? Yew Propert Owner Name: V`77 0 rut, . P.� �S� Telephone: 603-17 Address: / 102_ .'eD Village: 0-r/kn1t'i t Sign Contractor Name: ( G,tA � Telephone: 9y!" 771 - © 0 .Address: Village: O Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes/No (Note:If yes, a wiring permit is required) I hereby certify that I am the owner or that I have the,authority of the owner to make this application, that the information is correct and that the'use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. p Signature.of Owner/Authorized Agent- - Dater (I 6j Size: i� Permit Fee: Sign Permit was approved: ✓ Disapproved: Signature of Building Offici f Date: to ✓-- Signl.doc rev.8/31198 E d �•. � -- .• ..A. . , . - ..•. _ -�_: - .�;N fit{/T�'�1�� _LII(0 Wimp Z ` _...._..�....._...... . _?" IVFW pax F" � twfm C MMN QM OWES OF ac>nt� ao ANIOIS� 1i TEI..: 'S06-DTI-�1�D 03 • iQ3 E RP $E RD. HY o 6CALE' i�"m CM t FOOT DATECo ` ' r`- &CAIE: 3W @ 1 FOOT C3 E�[tAYNt�8Y: � BC!llE: 11�" i FOOT� WL3RK ORDER NO. 40 THM SCALED DRAWING FOR 1N'tEWED �: - l HEREBYJ4CItC� .F ;• 1i c � a; Mults CN N -.•-� - N •The-.Lessor and•�dessoa approve-the.-Gee: off:, gxr fog the es� "i hee hire-:sai fi.ina�nCia� ar- agnemenis`must-: CD .� be made directly with Steve Hathias. ,k� ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID-INTERTIED VIA A AC ALTERNATING CURRENT UL-LISTED POWER-CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONIC CONCRETE 3. A NATIONALLY-RECOGNIZED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3.` t; (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, ti 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. 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 POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT. GROUND CONDUCTORS. S STAINLESS STEEL . STC, ,STANDARD TESTING'CONDITIONS } - TYP TYPICAL pp 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 PV1 COVER-SHEET PV2 SITE PLAN } PV3 STRUCTURAL VIEWS PV4 UPLIFT CALCULATIONS LICENSE GENERAL NOTES a r PV5 THREE-LINE DIAGRAM - - 4 r_ �`-� 'I Cutsheets Attached GEN #168572 1. ALL WORK TO BE DONE TO THE 8TH EDITION ELEC 1136 MR OF THE MA STATE BUILDING CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING 1w MASSACHUSETTS AMENDMENTS. ` MODULE GROUNDING METHOD: ZEP SOLAR _ ti � - - AHJ: Barnstable VMS!0t �0,P + REV BY DATE COMMENTS MAYy �o�� .0 +t. REV NAME DATE COMMENTS 5 7 REV B BG 1/2 612 0 1 7 module relocation and structure updated. UTILITY: NSTAR Electric (Commonwealth Electric) TOWN OF BARNSTABLE • . :. - � � � J B-0 2 6 313 5 O O PREMISE OWNER: DESCRIPTION: . DESIGN: CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER JOHN COME I ilchrist ����•, • CONTAINED SHALL NOT BE USED FOR THE John Cod Qe RESIDENCE Bradyx PENEFITSH OF ANYONE EXCEPT IN WHOLE INC., �M SYSTEM; AVj SolarGty NOR SHALL IT BE DISCLOSED IN WHOLE OR IN ZS Cd V4 w Flashin -Insert ( `269`BARNSTA$LE RD �/ ►�� PART TO OTHERS OUTSIDE THE RECIPIENTS p 9 - -7 1 3.8 K W P V AR R A I ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES: , MA 0 601 THE SALE AND USE OF THE RESPECTIVE (46) Wanwha Q-Cells #. Q.PEAK-G4.1/SC300 24 St. Martin Drive, Building 2,Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITITIJ INVER q, PAGE NAME SHEET: q REV: DATE -Marlborough,MA 01752 PERMISSION OF SOLARCITY INC. A N1V S P V I C 5 11 2017 T. (650)638-1028 F: (650)636-1029 �9LAREDGE SE1000OA-USOOOSNR2 COVER SHEET / / (BBB)-SOL-CITY(765-248e) wwsdarcityxam PITCH: 35 ARRAY PITCH:35 MP1 AZIMUTH: 185 ARRAY AZIMUTH: 185 MATERIAL: Comp Shingle STORY: 1 Story PITCH: 35 ARRAY PITCH:35 MP2 AZIMUTH:5 ARRAY AZIMUTH: 5 MATERIAL: Comp Shingle STORY: 1 Story c C p `, (Lc l AC 0 -- e e e eLEGEND ;Inv,, ie e e I� (E) UTILITY METER & WARNING LABEL Front Of House Ins INVERTER W/ INTEGRATED DC DISCO 7dW & WARNING LABELS O © DC DISCONNECT & WARNING LABELS L T- I AC AC DISCONNECT & WARNING LABELS { DC JUNCTION/COMBINER BOX & LABELS I mpiw MP1B QD DISTRIBUTION PANEL & LABELS Lc LOAD CENTER & WARNING LABELS A STRUCTURE B O DEDICATED PV SYSTEM METER Q STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR —�� CONDUIT RUN ON INTERIOR GATE/FENCE Q HEAT PRODUCING VENTS ARE RED INTERIOR EQUIPMENT IS DASHED L-�J SITE PLAN N Scale: 1/8" = 1' W E 0 1' 8' 16' ' g " w CONFIDENTIAL OWNER: DESCRIPTION: DESIGN: DENTIAL— THE INFORMATION HEREIN JOB NUMBER: J B-02631 35 00 ilchrist `�`kill SolarCit CONTAINED SHALL NOT BE USED FOR THE JOHN COME John Cod'oe RESIDENCE Bradyy BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: . y � NOR MALL IT BE DISCLOSED IN WHOLE OR.IN ZS Comp V4 w Flashing—Insert 269 BARNSTABLE RD 13.8. KW PV ARRAY PART TO OTHERS OUTSDE THE RECIPIENT'S MODutEs BARNSTABLE, MA 02601 ORGANIZATION, EXCEPT IN CONNECTION WITH 24 St. Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (46) Hanwha Q—Cells # Q.PEAK—G4.1/SC300 PACE NAME: SHEET: REV: DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: T. (650)638-1028 F: (650)638-1029 PERMISSION OF SOLARCITY INC. SERTER: GE sEl0000A—us000sNR2 SITE PLAN PV 2 C 5/11/2017 (888rSOL-CITY(765-2489) w�ww.sdarcity.com S 1 4 �- : 4" 11'-9"' 6 (E) LBWS _ 6 (E) LBW x. a. ' a SIDE VIEW OF .MP16 NTS SIDE VIEW OF MP2 NTS �;: w' MP16 X-SPACING X-CANTILEVER Y-SPACING Y CANTILEVER NOTES MP2 X-SPACING X CANTILEVER Y SPACING Y-CANTILEVER NOTES — SCAPE 48" 24" 39" 0" STAGGERED . LANDSCAPE 48" 24" 39" r. 0 STAGGERED ND LA ... PORTRAIT 48" 20 65" 0" PORTRAIT 48" 20" 65" 0,� x n. ROOF AZI 185" PITCH 35 RAFTER 3"x7-1 4" @ 48"OC ROOF AZI 5 PITCH 35 STORIES: 1 Y RAFTER 3"x7-1/4" @ 48" OC STORIES: 1 _ / ARRAY AZI 5 PITCH 35 ARRAY AZI 185 PITCH 35 CJ. 3"X7-1/4" @48"OC Com Shin le-Solid Sheathing C.1, 3"x7-1/4" @48" OC Comp Shingle-Solid Sheathing k P 9 9 ' PV MODULE 5/16"x1.5" BOLT WITH 5/16" FLAT WASHER K " INSTALLATION ORDER , 5 'ZEP' LEVELING FOOT z LOCATE RAFTER, MARK HOLE r- ZEP ARRAY SKIRT .. (1.) LOCATION, AND DRILL PILOT . a HOLE. :. S1 --————-—— -- — — — ZEP MOUNTING BLOCK ATTACH FLASHING INSERT TO a. J (4) , (2) MOUNTING BLOCK AND ATTACH ZEP FLASHING INSERT - (3) TO RAFTER USING LAG SCREW. 4- (E) COMP. SHINGLE (1) INJECT SEALANT INTO FLASHING (E) ROOF DECKING (2) (3) INSERT PORT, WHICH SPREADS 6 (E) LBW SEALANT EVENLY OVER THE ROOF PENETRATION. 5/16" DIA STAINLESS SIDE VIEW OF 'MP1A NTS LOWEST MODULE SUBSEQUENT MODULES STEEL LAG SCREW � A (2-1/2" EMBED, MIN) INSTALL LEVELING FOOT ON TOP[(4) OF MOUNTING BLOCK & MP1A x-SPACING X CANTILEVER 'Y-SPACING Y-CANTILEVER NOTES (E) RAFTER SECURELY FASTEN WITH BOLT. LANDSCAPE 64" 24" 39" 0" STAGGERED STANDOFF . r { PORTRAIT 48" 20" 65" S 1 _ , RAFTER 2X6 @ 16"OC ROOF AZI 185 PITCH 35 • STORIES: 1 P SCdI2: 1 1/2 — 1 � ARRAY AZI 185 ITCH 35 C 2X6.@24"OC Comp Shingle-Solid Sheathing -° 1 CONFIDENTIAL- THE INFORMATION.HEREIN JOB NUMBER: — PREMISE OWNER: DESCRIPTION: DESIGN: JB 0263135 00 CONTAINED SHALL NOT BE USED FOR THE JOHN COME John .Cod"o6, RESIDENCE Brady Gilchrist �,�•:, • BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �•�.��Oh� '� NOR SHALL IT BE DISCLOSED IN WHOLE OR IN ZS Comp V4 w Flashing—Insert 269 BARNSTABLE RD 13.8. KW RV ,ARRAY ►r _ 1® PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES. BARNSTABLE MA 02601 ORGANIZATION, EXCEPT.IN CONNECTION WITH .y THE SALE AND USE OF THE RESPECTIVE (46) Hanwho Q—Cells # Q.PEAK—G4.1/SC300 24 St SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME:. SHEET: REV: DATE: . Martin Drive,Building 2 Unit.11,- INVERTER: Marlborough,MA 01752 " PERMISSION OF SOLARCITY INC. P V 3 C 5 11 201 Z T. (650)'638-1028 Ft 650)638=1029 SOLAREDGE SE1000OA—USOOOSNR2 STRUCTURAL VIEWS -'. ;_ / / (Bee}sor—clTY,(765-2489 wwwsdarciiy.com UPLIFT CALCULATIONS SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. CONFIDENTIAL THE INFORMATION HEREIN JOB NUMBER: J B-0 2 6 313 5 00 PREMISE OWNER: DESCRIPTION: DESIGN: - . ��\=p CONTAINED SHALL NOT BE USED FOR THE JOHN COME John Codjoe RESIDENCE Brady Gilchrist �, SolarCity BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: oj"; NOR SHALL IT BE DISCLOSED IN WHOLE OR IN ZS Comp V4 w Flashing-Insert 269 BARNSTABLE RD 13.8 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: BARNSTABLE MA 02601 ORGANIZATION, EXCEPT IN CONNECTION WITH 24 St. Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (46) Hanwha Q—Cells # Q.PEAK—G4.1/SC300 SHEET: REV. DATE Madborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME (850)638-1028 F: (650)838-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE sE1000oA—us000sNR2 UPLIFT CALCULATIONS PV 4 C 5/11/2017 (88T:B)-SOL-CITY(7ss-24a9) wwwsdarcitycom GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO TWO (N) GROUND Panel Number:LC304OB1100 Inv 1: DC Ungrounded GEN #168572 RODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number: 99230 Tie-In: Supply Side Connection INV 1 -(1)SOLAREDGE 1 S W, 2 0 V, 97.5 4 w/ LABEL: A -(46)HaV Module; Q-Cells # Q.PEAK-G4.10SC300 ELEC 1136 MR 22 PP Y Inverter; 10 OW, 240V, 97.5% w Unifed Disco andZB,RGM,AFCI PV Module; 300 ,274.5PTC, 4 MM, Black Frame, MC4, ZEP, 1000V Underground Service Entrance INV 2 Voc: 39.76 Vpmax: 32.41 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 125A MAIN SERVICE PANEL SolarCity E; 10OA/2P MAIN CIRCUIT BREAKER A (E) WIRING BRYANT Inverter 1 Load Center CUTLER-HAMMER 10OA/2P 7 Disconnect 6 SOLAREDGE 5 A 1 DC+ - - - B SE1000OA-USOOOSNR2 DC- MP 1: 1x17 6OA/ZP C _ MD EGCzaov ---------q L1 r _B L2pD+N De- I 4 MP 2: 1X12(E) LOADS r- ---- GND ---- ------------------- -GEC DC+ - MP 1: 1x17 Ea c DG EGC_ ------------ ----- ----- -- J L J J - 1 I N I (1)Conduit Kit; 3/4" EMT - EGC/GEC GEc_r-_� TO 120/240V I f SINGLE PHASE l I I UTILITY SERVICE I I I Y PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX*VOC AT MIN TEMP P0I (2)�r,Ld Rod B (I)BRYANT#BR24L7ORP /t, A (1)Solar&p 4J: 4 STRING JUNCTION BOX D� 5 8 x 8, C per Load Center, 70A, 120/24OV, NEMA 3R /-� UNFUSED; GROUNDED, Grey -(2)ILSCO IPC 4�0-#6 -(1) Load BR260 Insulation Piercing Connector; Main 4/0-4, Tap 6-14 Breaker, 60A P, 2 Spaces PV (46)SOLAREDGE�P300-5NM4ZS S SUPPLY SIDE CONNECTION. DISCONNECTING MEANS SHALL BE SUITABLE C (1)CUTLER-HAMMER $DG222URB PowerBox ptimizer300W, ZEP, in`MC4,out MC4 + AS SERVICE EQUIPMENT AND SHALL BE RATED PER NEC. Disconnect; 60A, 24OVac, Non-Fusible, NEMA 3R nd (1)AWG #6, Solid Bare Copper K -(1)CUTLER XMMER B DG100N8 Ground//NNeutral Kit; 60-100A, General Duty(DG) -(1) (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION NO. 2, ADDITIONAL ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE 1 AWG#6, THWN-2, Black 1 AWG#6, THWN-2, Block 1 AWG 18, THWN-2, Black Voc* =500 VDC Isc =30 ADC 2 AND#10, PV Wire, 60OV, Black Voc* =500 VDC Isc =15 ADC O (1)AWG 16, THWN-2, Red ©IgF(1)AWG#6, THWN-2, Red ® (1)AWG #8, THWN-2, Red Vmp 350 VDC Imp=24.53 ADC O (1)AWG#6, Solid Bare Copper EGC ' Vmp =350 VDC Imp=14.38 ADC (I AWG #6, THWN-2, White NEUTRAL Vmp =240 VAC Imp=42 AAC (1)AWG#10, THWN-2, White NEUTRAL Vmp =240 VAC Imp=42 AAC (1)AWG#10, THHN/THWN-2,_Green• EGC,-(1)Conduit. ..;,3/4' EMT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . __ . .-(1)AWG#6,.Solid Bare,Copper. GEC, , . , 0)Conduit.Kit;.3/4'.EMT, _ , , , . . . . , • , • , , . .-(1)AWG#ti,,THWN-2,,Green . . EGC/GEC (1)Conduit.Kit;.3/4'.EMT_ , _ . . (1 AWG#10, THWN-2, Black. Voc* =500 VDC Isc =15 ADC (2)AWG#10, PV Wire, 60OV, Black Voc* =500 VDC Isc =15 ADC O (1)AWG 110, THWN-2, Red Vmp =350 VDC Imp=14.38 ADC O (1)AWG#6, Solid Bare Copper EGC Vmp =350 VDC Imp=10.15 ADC . _ . , .. . (1)AWG#10, THOWTHWN72,.Green, EGC.-(1)Conduit.Kit;.3/4'.EMT, , . ; (2)AWG 00, PV Wire, oc 600V, Block V * =500 VDC Is 15 ADC O (1)AWG #6, Solid Bare Copper EGC Vmp =350 VDC Imp=14.38 ADC �{ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .°. . . CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: PREMISE OWNER: 'DESCRIPTION: DESIGN: - CONTAINED SHALL NOT BE USED FOR THE JB-0263135 00 JOHN COME ' Brad Gilchrist T- 24 % ity BENEFlT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSIEN: John Cod'oe RESIDENCE y ss0lar NOR�iALI IT BE DISCLOSED IN WHOLE OR IN ZS Comp V4 w Flashing-Insert 269 BARNSTABLE RD - -13.8 KW PV. 'ARRAY h� . PART TO OTHERS OUTSIDE THE RECIPIENT'S ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES BARNSTABLE, MA 02601 THE SALE'AND USE OF THE RESPECTIVE (46) Hanwho Q-Cells # Q.PEAK-G4.1/SC300 St Martin Drive,Building 2;Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN ' PAGE NAME. SHEET: REV DATE Marlborough,MA'01752 INVc7tTER: L (650)63B-1028 F: (650)638-1029 PERMISSION of SOLARCITY INC. SOLAREDGE sEl0000A-us000sNR2 ; THREE LINE DIAGRAM' PV 5 C 5/11/2017 (888)'sa-CITY(7s5-248s) `www.solorcityeom 1NARNING ;EHHl � IC PO'r ER$SOURCE -• - WAR/NINE WARNI''NG= ELECTRIC SHOCK HAZARD ELECTRIC SHOCK HAZARD t '• DO NOT TOUCH TERMINALS THE DC'CONDUCTORS.OF THIS ' -•- - TERP/IINALS ON BOTH LINE AND PHOTOVOLT^JCSYSTEM ARE • i LOAD SIDES MAY BE ENERGIZED UNGROUNDED AND ,HOTOVOLTAIC DC a • IN THE OPEN POSITION MAY BE ENERGIZED �• � � D ISCO NNECT •'" R Al &x .•- • • *fir PHOTOVOLTAIC SY�S�T,ENI — A EQUIPPED A RAPID • " OIN T T;CU NGUUR:1 PRR E N I (Irio) � ._ ��_ SHUTDO�NN .•� x ', $ N1�XIRlUR1 P01� R- �POINT /OLT GE(Vrip)_ ' , . MAXIMI' fvl SYSTE IIM VOLTAGE(,ob y r S�OR r CIRCUITi�Az rt CURRENT (IsCm WA R NI N.G INV R I ER OUTPUT • �� wk TyIS OvFRCURRENT n WAR=N'" DEL CTRIC,SHO�'•C 4ZARD�:",`� �� IF�A GROUNDIFF ULT IS INDICATED NO 01 L1�;GROUNDIE ONDUC<I ORS��A�=;Y.�BE' UNGPO 'DEED)ANE) GIZED -•' • - • � AIJTI®N -• _ " PFOTOVOLTAICSYSTEN'1 `� •• CIRC�UIT�ISB�AGKFED •• • KWA�RXING _ ELECTRICAFiOCK H(-�ZGRD •' ,; gD0 NOT TOUC'$fi�T t�l 11N5L"S " �T •�� TERt 11NAI=S'OM B0. OrINE FND x y �t -'" • • LOlDSIDEShiA(3crNEF2GIZED �i'AUTION -• IN�THE OPENPOITION DUAI �O NER SOURCE F. ••- SECOND SOURCE IS DC 101 T^GE IS PFiOTOVOL"<TAIC SYS I EM ' • '��TUJAYS�P�RES�NTwW-1EN��;� EXPtOSED TO",SUNLICFT , ` v',.PHOTOIOLT4IC POINT OFg -- .•- • • INTERCONNECTION � g -_ • PHOTOUOL`-TAIC>A�Cwx z -• XNARNING ELECTRIC-SHOCK-'''el ••' ��� • _ . . w� /A' H4ZPPD-D0 NOT,TOUCH �,r ` DISCONNECT ; •' TERNIINAL'S.TERMINAL SON' _ " a a ". •' BOTH THE LINE AND LOAD SIDE ' -' y'N1FY BE ENERGIZED`IN<THE`OPEN - � � • • POSI I ION. FOR,SERVICE DE-ENERGIZE BOTH SOURCE � AND MAIN BREAKER PV POVVi=R SOUf2CE,,,4 -• -• • �w MhXlr lUr 1 n Yfigv*, ' -• -r IAXIrv1UM AC A r - OP,EPrTItvC CUPP 41 I ® • - OPERATING CURRENT r 1AXIPlurA aC •. , i IAMMUM AC V> x OPERATING OLThG� V OPERATING VOLTAGE -• -• • • • 1 1 /• / / 1 / 1 /• San Mateo,CA 94402 1 1 1 •• /• } 1 • 1 1 � '6101 1' 1 1 7' 1 1 1' 1 -•- 1 1 1 1 1 •/ 1 •1 �' F.. i ugl 4b $o I a r ' Wo - Single Phase Inverters for North America soIar o _ ® � 0 SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ v �� r �� SE7600A-US/SE10000A-US/SE11400A-US '.SE3000A-US SE3800A-US. SE5000A-US 5E6000A-US' SE7600A-US 5E10000A-US SE11400A-US f- _ P {OUTPUT t -. <q_ - i; 9980 @ 208V- SolarEdge Single Phase Inverters �� Nominal AC Power Output 3000 3800 S000 6000.... 7600... 11400 VA r f r: ...i0000"@zaov. :............................ r: 5400 @ 208V 10800 @ 208V - - ' •'r k Max.AC Power Output - 3300 4150 - - 6000 8350 12000 VA For North America s ...... ................................... .............. ........... ..54.... oy............. ........... .�095o.�z4o�. ................ ........ AC Output Voltage Min:Nom:Max!'I rn. a '. 183-208-229 Vac - ✓ - - - ✓ - SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ Vl- :. st` , I� AC Output Voltage Min.Nom.Max"' ✓ ✓ - ✓ ✓ _.✓.'..-. .✓. .. ✓. .. •. y ,Y,?E' * ;' t:. 211-240 264 Vac - - - SE7600A US/SE1000OA US/SE1140OA US ......... ........................ I - AC Frequency Min:Nom:Max!'!.... .. ..... ........... .. 59.3-60 60.5 ....... ... ...... .............. en ~ -'- ",�... t; :r ". 1 ............ ................... . . ...24 @ 208V.. .... .. .. ...48 @ 208V. .. Q ...V Max.ContinuousOutput 21 240V 5 42 240V A Current 12 5 16 2 32 47 5 ....I...............L. .�01...........................I.:.......7......... .�°@...........L....... .... -GFDI Threshold 1 A ... . ......... . ......... .......... .... ..... ...... .............................. ... .................................... ................... ........... Utility Monitoring,Islanding Protection Country Configurable Thresholds Yes Yes - ? � K I INPUT -_..`..__..•.d,_,�,,..�,� n.rra s 'c Yam,,. „r � ,� . . ,f�pverte ,r..'< ,•,- ^`- '- g- 4;' `" LL ;` -�_ Maximum DC Power(STC) 4.050 5100 6750 8100 10250 13500- 15350 W is 12 rt Transformer less,U ng rounded w Yes .m a Is •a> .' �^..r t t.. ti : `, "t x,a.. Max.Input Voltage ................... .... 500 .................. .................... antY , �:J r I - + ............... .. ........ ........... ............. ............ .............. ......... D n ol[ag ..16.5 @ 208V5 @ V/ V ..33 @ 208V Vdc Nom. C I put V e 208 350 @ 240 J J & Max.Input Current') 9 5 13 15.5 240V 18 23 30.5 240V 34.5 •• Adc 3.- -. F ,., -•.. xk ..... ..... ...... ............. ..... .. ....................Q°................... .. ...................@...-.-.. .0 Max.Input Short CircuitCurrent•• 45 "" - -��Adc ' - - r .rren.... .................... ............................. ............................... ............... ......... .............................. :W-, ',a�. r..$.t ;:� >�� 'aF .t• k Polarity Protection ••Yes.:..' .... .... ..... ................................ .......... .................................................. ....... ?", * T-- }; ;,. - .,. :, - s ; ..•,a : = .Ground-Fault Isolation Detection 600ka Sensitivity , .�_.,r_.... .. .. ....... .. .. .. .. .. .. .. ... .... .... .... .... ... rX Maximum Inverter L.Mcienc 97.7 98.2 98.3 98.3 98 98 9S .........V.. ._.......... ........... ... ..... ............. ............ ... ...... .............. ..... 5 � aa CEC Weighted Efficiency 975 - 98- 98@ 240V 97.5 97.5 97S@ 224 V 97.5 .6 _ - - mx3 a ,3, ` �` '' 'r F •a ....,; r Nighttime Power Consumption <2.5 .14 W i ADDITIONAL'FEATURES Supported Communication Interfaces - R5485 RS232;Ethernet ZlgBee(optional) - ",�_ ......... ...... ..... ..... .... .. .. ................ .......................... ............ .................................................... ......... ................................. Optional _ -� - ,s .t _ ,,, "i- .t, > ,,c w •,« F' Rapid Shutdown-NEC 2014 690.12 Yes -• ,' mNh y ISTANDARDCOMPLIANCE MW Rya`, --3 .?^�... t' ", '+ '.:- k1a.r=; '„c..w- .. m '..�•� Safety UL1741,UL17415A,UL1699B,UL399S,CSA 22.2 - - ' ........... .. ... .................................. ........... .... ..... .. ....._...... ......................... Grid Connection Standards ..... ................................... ...... IEEE1547........................................................ - Emissions .. ...FCC partly class B - RINSTALLATION SPECIFICATIONS .� -'�-�-�-.---'�'-'� -w�s 4 �„- -.�•--:�-� ' . AC output conduit size AWG range 3 4 minimum/16 6 AWG 3 4 mnimum 8-3 AWG DC input conduit size/N of strings/ :. ...3/4"minimum/1-3 strings�.:. 3/4"minimum/1-2 strings/16-6 AWG ........................... ..... .......... .............................................................. ••" 14-6 AWG • ••.... .. .. ... 1 n �.t-{"•�y'.; .•w� 6�•., ? y.. S' z ,a mn r "-Dimmensensions 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 '' +✓.'uc ..IHX�P!X9).... 775 x 315 x.260 A s aF T Y Weight with SafetySwitch 51.2 23.2 54.7 24.7, 88"4/40.1 _ lb/k i. - - :�• .gym at $ �-' ;,�. y 1,, '�,$e .= x:`c ............................ ......... .... ..... ...............�................... ...... ...... ............ ................ .. .... Z . . *a* , -"Natural y'5 k' '.roe_ tea.., "-•:., :„ - #a .,•z convection D - _ Cooling - Natural Convection's - and internal Fans(user replaceable)The best choice for SolarEdge enabled systems i , fan(user Specifically designed to work with power optimizers replaceable)•. •••••.••_•. .... .." -• .............................._............ .......'................................................ ', Noise <25 <50 deA .... .................................................:.......t..:......:. ............................................................. ....: Integrated arc fault protection for NEC 2011690.11 compliance niin.-Max.operating"Temperature _13 to+140/-25 to+60(-40 to+60 version availablea°)) •F/-C Rapid shutdown for NEC 2014 690.12 Range•..••••.• . ................................................................................................................. ......... Superior efficiency(98%) Protection Rating NEMA 3R ...................... ........................................................................................................................... . l PI For other regional settings please contact SolarEdge support. Small,lightweight and easy to install on provided bracket Pi A higher current source may be used;the inverter will limit its input current to the values stated. pl Revert g d vert rP/N.SEnnanA-USOOONNR2 Ifo 7600W'nverter.5E7600A-U5002NNR21. Built-in module-level monitoring 40v P/N SEtn zA-USOOONNU4(for 760OWI rt r.5E7600AUS002NNU4). Internet connection through Ethernet or Wireless ., r Outdoor and indoor installatio """ ` � � � " - Fixed voltage inverter,DC/AC conversion only FT, Pre-assembled Safety Switch for faster installation I° a . - Optional-revenue grade data,ANSI C12.1 n sunsv�c O,. USA-CANADA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THENETHERLANDS-UK-ISRAEL-TURKEY-SOUTH AFRICA-BULGARIA Www.solaredge.us . "' t 0ay! ��$130t5 U$� �1]Mt}7r':riirifaalrRfa �" � - P E 4 K- '' e r : •�^ ' } '`<1, i, � - - i ' I \l tQ 'SOIarClty ZepSolar Next-Level PV Mounting Technology `'SOIafClty ZepSolar Next-Level PV Mounting Technology ZS COMP Components r + for composition shingle roofs Mounting Block Array Skirt Interlock Part No.850-1633 Part No.850-1608 or 500-0113 Part No.850-1388 or 850-1613 Listed to UL 2703 Listed to UL 2703 Listed to UL 2703 t f F. Flashing Insert Grip Ground Zep V2 -'. Part No.850-1628 Part No.850-1606 or 850-1421 Part No.850-1511 Listed to UL 2703 Listed to UL 2703 Listed to UL 467 and UL 2703 Y�. OOMPAP/, .�? �F Description PV mounting solution for composition shingle roofs rF, m Works with all Zep Compatible Modules OompPp Auto bonding UL-listed hardware creates structural and electrical bond • ZS Comp has a UL 1703 Class"A"Fire Rating when installed using modules from any manufacturer certified as"Type 1"or"Type 2" Captured Washer Lag End Cap DC Wire Clip Ulr LISTED Part No.850-1631-001 Part No. Part No.850-1509 Specifications 850-1631-002 (L)850-1586 or 850-1460 Listed to UL 1565 850-1631-003 (R)850-1588 or850-1467 • Designed for pitched roofs 850-1631-004 • Installs in portrait and landscape orientations • ZS Comp supports module wind uplift and snow load pressures to 50 psf per UL 2703 • Wind tunnel report to ASCE 7-05 and 7-10 standards • ZS Comp grounding products are UL listed to UL 2703 and UL 467 • ZS Comp 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 Leveling Foot Part No.850-1397 zepsolar.com zepsolar.com Listed to UL 2703 This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of 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#800-1839-001 Rev D Date last exported:April 29,2016 11:22 AM Document#800-1839-001 Rev D Date last exported:April 29,2016 11:22 AM 1 . ' v $o l a r e o o SolarEdge Power Optimizer solar oo a Module Add-On for North America . a . ` rty Mr P30 /P32 /P370 P400 P405 4 SolarEdge Power Optimizer `� �;,... •,« • .; sr n',,`"'1 ga:*^ax, n t"€*''° �.w d.,. :r.+„ _ F# i P370 m ,� P 9 P400 P405 >< r .:.,..r ,.. r:2.'..; -(for higAer power.. a _.:•"T. '. : . 300 ;�V320 ., •f.-- a „ -, = m "„#• :� „- ,(for 60-cell mod- 1,(for high power,' - r(for 72&96-cell =.(for thin Rlm , )•.t t,.3„ r. a} .•,,- ..w, .,,� -c., a` :. *�+60 and 72<ell ,_';? b f r"" w s_ ., . n r .. ti nx4, 1, .. ,t- }y�g�,+ .,,�. . ,y ules �60-cellmodules t r��modules • .. ! ^a,.. �:., 'f „. .„., Tx"`modules) - •r Module Add On For North America ���'�,t ��` ��� �"� �� n t .,m n ;s a'�t •a. iF._ -`s•<� .�e k��,.4c` ,tr �'a�: m$?. '�'r>+`�,n:ms `E � .� - _Rated Input DC Power<!.... :,_,...... 300 320 370 400 405 W P300/ P320/ P370/ P400/ P405 .. .. - ...... ..: .. .. Absolute Maximum Input Volta e temperature?..... ,...z ,. ,a .................... ........ .......... ........... 48.. ........._..... ... .60 .. .80. ... .. ...125.. .. Vdc 4 .F ^ - x `• ` "' I' MPPT Operating Range - 8 48 S 60 - 8 80 .12 5 105 Vdc - _ e .1, Maximum Short Circuit Current llsc): 10 11 .. •• 10.1 .•.. .Adc • - e•._ .. ................................ .. ..... .. .. ... ....... w Input Adc - - n Isc) Maximum DC Current 12 5 - 13 75 12 63 ................... .....: I,........ ..... . ........ ..... Maximum Efficiency .` 99.5 % .....1................................ ........ ........ .... ....... .......... .. ... ..... .... . - -";• Weighted Efficiency - .. 98:8, ... _ • .,. ...,,. ...................................... ...... .... .... ..... ... ....................... .. ... ....... .... .... .... •. {. 1 :- Overvoltage Category � � 11 - ` EOUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING SOLAREDGE INVERTER);`.i',I > �a.n.'; ' °''s"a „F, S. °,,`.` r,: - - ' « '' �'' •�" r" " - Maximum Output Current 15 Adc - - ` - u .............................. ....... .... ... ... ......... .. ...... " Maximum Output Voltage 60 85 Vdc - - ` '"` .s • -' `•> a `+ - �.OUTPUT'DURING STANDBY OPTIMIZER DISCONNECTED FROM SOLAREDGE INVERTER ORSOLAREDGE INVERTER _ Safety Output Voltage per Power - 1 Vdc Optimizer - $ z �STANDARRCOMPLIANCE'fiir..�:a., _ .�a: ,s�x.�.'��": ,.:,.<. ,,. -,ms"�,.�:...z_�_„-'`,v�rns: '< ,w. e,... �t�•? r.-•>.. f ,_, •;'��""^�.,^ .a.;a-'',.,.,.,a..::?��- _,.• ..1�,:`�,+y,�``.?i-.,�.� .. .. • tom: r, 7 "` "�" -�„." EMC FCC Part15 Class B,IEC6100...... IEC61000 6 3 { n T ,Safety IEG62109-1(class II safety),..... ' _ .. .. � wo..= �� �^�,"�s,,.� �d.�*.• ,���Y,.� w. ROHS ... ... .... - Yes ' ... .. I T: ^..' - _ o,,.:•=.;e _0. ' .� , _,--aFF'- a .. -: �• :: . . �,.�.,.+w - ` ; �� ...y .• m .,_ �. . '. INSTALLATIONSPECIFICATIONS'�.,�,• ., ,,.r.nal .,.�..-r,r....tp.,�::sx�ux: :...`�t,�.a,�. a':E��,.w.,�._.. ,-�t'��-,a �, •:,la�•;�,•_., fa;;�': ' ` m ,._ - �` 'ffi. •:, Maximum Allowed System Voltage 1000 Vdc -............... ..... ........... „ :.' - ,* ; _. .;; •b . . . Compatible inverters All SolarEdge Single.Phase and Three Phase inverters ,. -. .................. ........ ..... ...128 x 152 x 35/ .128.... i52 x 50./ .. ... Dimensions W x L x H - - 128 x 152 x 27.5 5 x 5,97 x 1.08 - - mm In r., x, r*:2't"`: ,. .:",. .. ,.•s: :' j' ...... x 1 37- 5 x 5.97 x 1 96 - � Weight(Including cables) 630/1.4 750/1.7 845/1.9 gr/Ib T. t ..._ ......................MC4/. < ,, - .. • ._;,.w - ,�' ,,.� -„. •. .. ' . ;. Input or Compatible - s � Conned � �MC4C ble MC4Compatible' Amphenol AH4 v .`. ..`... -Sf•'. ` ., ...,. ...' -��-;•, �•. ` . ;a ,.��,. , ..: ::. rt: .. - Double Insulated; '. ` st,.x ''*a_ " ' • '� - t T IR• , Output Wire Type/Connector Double Insulated;MC4 Compatible MC4/ - Double Insulated;MC4 Compatible - , a� i': Amphenol AH4 0.95/3.0 - :12/.39 m/ft .-. :,.}.. ., , w „ .,,:. . z,•. _ . ..... ............................................ ............ .... " Operatin Temperature Ran a ,-40 +85/ 40 +185 ................. ..`C/`F.. s...-.�.._.. re'tt... ..<",? ,,, ," ,- ,,, .?= Protection Rating IP68/NEMA6P + xw ............................................... .. .............._... .... .......... .............................. - '"`. Relative Humidity - 0-100 - :..%.: ................ .. ...... .. .. ..... ........ ... ............... . e , :... a'� ex J ' §" '6�•-•- ,. T - (u Rated 7c power of the module.Module of up to+5%Power tole an<e allowed. - ,; g. ... PV SYSTEM DESIGN USING 4 'S,r".,f"k' s#�^m;i :"..•„a:5u ae Y "6; p# .�'�«.. ,.a,::,::r +.�,,,.a.�, � a•,a. sz -�sa wwasrm�:v,T. x• «.a' ' ,t. r ,'�,, SINGLE PHASE'=' 1g' T' THREE PHASE 208V a ' .;'�THH EE`PHASE 480V t" %2 �.ASOLAREDGEINVERTER1al ,_ I"t.0 -< h ,.. 'M; ",7§:.•'^r r..,. m..-:, ,s;.wz�.r�, �z .*.c..~ ,.•�w,.�w. ,w.,....,.~'Y" a..., - PV power optimization at the module-level 1 MinimumStringLength . .. •'--Maximum (.Power Optimizers)............ .... ......... .. ... .. .......10 ........ .. ... .....18 .. .. . . Up to 25%more energy I .... .. 25 ` .. zs so Maximum String Length-Superior efficiency(99.5% (Power Optimizer.).................. . .. .. ....... .. .............. Y Maximum Power per String 5250 „6000 12750 W ......... ........ ................. ..... ............. . _.... ....I..... Parallel Strings of Different Lengths -Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading Yes o.Orientations - - - Flexible system design for maximum space utilization r=I It is not allowed to mix P405 with P3oo/r37o/P400/P600/r7o0m one string. Fast installation with a single bolt z P. u, a ;.t� ,� +i Next generation maintenance with module level monitoring z Module-level voltage shutdown for installer and firefighter safety _�, �,�, y;f � �� � � � � ,�> • r" � �, ;� c ���� k �; USA-CANADA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THENETHERLANDS-UK-ISRAEL-TURKEY-SOUTHAFRICA-BULGARIA-INDIA www.solaredge.us , a , '• $ •� - . _ .. - - � tl.t,. . .tea= :,3w l h�?i T'.�.. >�„m r.',- W •:eiN• ,a�'t# - �' - powered by MECHANICAL SPECIFICATION ` Format 65.7 in x 39.4in x 1.57 in (including frame) (1670mm x 1000mm x 40mm) _ Weigh 44.091bs(20.0kg) _. _. _. .. - ......... ...... mm� .Front Corer 0.13 in(3.2 mm)thermally pre-stressed glass with anti-reflection technology - - ,�,.....�•'^ i� t Back Cora Composite film Black anodized aluminum " --- i Cell 6 x 10 monocrystalline Q.ANTUM ULTRA solar cells~ .�-•"r -�` - !unction box 2.60-3.03 in x 4.37-3.54 in x 0.59-0.75 in (66-77mm x 111-90mm x 15-19mm)_Protection class IP67,with bypass diodes a mN • Cable 4mm2 Solar cable;(+)47.24in(1200mm),W 47.24in(1200mm) °, ,,,,,, - Conmch3i Multi-Contact MC4,IP68... .. _ -_ .--- .�._ ^- .-_---_- __ - -.•..,omm� n,m„ I_E� IQ3>••�°^,M • , ELECTRICAL CHARACTERISTICS !'POWER CLASS y 295 300 305 MINIMUM PERFORMANCE AT STANDARD TEST CONDITIONS,STCI(POWER TOLERANCE+5 W/-0 W) Pmra at MPP- - -- PrrPP [Wl 295_ 300 305 i • • Short Circuit Currem' Ise [A] 9.70 9.77 9.84 E _ -_ _._ . .___ _ _ ._ . _ .__. E Open Circuit Voltage' __ __ Vac_ IV] 39.48 39.76 _---.�, _-40.05 Current at MPP` 61 -[A] -9.17 9.26 9.35 Voltage at MPP` V.PP IV] 32.19 32.41 32.62 The new high-performance module Q.PEAK-G4.1/SC is the Ideal solution ■ Efficiencli" _ n [�] _ a17.7 a18.0 - 2:18.3 .for all applications thanks to Its innovative cell technology Q.ANTUM MINIMUM PERFORMANCE AT NORMAL OPERATING CONDITION S,NOCa ULTRA and a black Zep Compatible TM frame design for improved aesthetics, at WP= PNPP [w] 218.1 221.8 -225.5 easy installation and increased safety. The world-record cell design was Short CircultCurrem' _-� 1.a [A] - -- 7.82 T_ 7.58 -_ 7.94 - - - ' e _ Circuit:� IV] 36.92 37.19 37.46 developed to achieve the best performance under real conditions-even ��'r` - - - --Via`- ---- - - - - - -- -- - -� - - � Current at MPP• 1,,,P [A1 7.20 7.27 7.35 ' with low radiation intensity and on clear, hot summer days. _ Voltage atMPP` - -_VNP;_ IV] 30.3o--_-_��_- 3 0.449 -T 30.67 '1000 W/m',25°C,spectrum AM 1.5G 3 Measurement tolerances STC x3%;NOC % 3% 3800 W/mz,NOCT,spectrum AM 1.513 ^typical values,actual values may differ O CELLS PERFORMANCE WARRANTY - - PERFORMANCE AT LOW IRRADIANCE - _ LOW ELECTRICITY GENERATION COSTS ■ C:10D -o�..s At least 98%of nominal power during first year. a?1O -- ----- ----- Thereafter max.0.6%degradation per year. __ i i 0 95 - ------------------- At least 92.6%of nominal power up to 10 years. ' Higher yield per surface area and lower BOS costs thanks to - ■ W d ..�a At least 83.6%of nominal power up to 25 years. higher power classes and an efficiency rate of up to 18.6%. • s: All data within measurement tolerances. - ----' Full warranties in accordance with the warranty INNOVATIVE ALL-WEATHER TECHNOLOGY terms of the u sales organization of your zao i .m mo e � respective country. ,aa Optimal yields, whatever the weather with excellent low-light IRRADIANCEiwnn3, and temperature behavior. - „a.r,,,,,,�e,,.;.row. a Typical module performance under low irradiance conditions in YEARS comparison to STC conditions(25°C,1000W/m'). J ENDURING HIGH PERFORMANCE TEMPERATURE COEFFICIENTS Long-term yield security with Anti-PID Technology', QCEllS Temperature o [%/K] - +0.04 Temperature a [%/K] __ -0.28 mw°ralwn __ Hot-Spot-Protect and Traceable QualityTra.QTM. .TOP-BRANDPv 'r Temperature Coefficient V [%/K] -0.39 Normal Operating Cell Temperature NOCT [°Fl 113t5.4(45t3°C) ® A RELIABLE INVESTMENT 2016 PROPERTIES-. DESIGN- - - - -- - _ _ Inclusive 12 year product warranty and 25 year rda�®syuemVoltage v„t m 1000(IEC)/1000(UU safety class n x -- - - -. _ . ... - - -.. _.- linear performance guarantee2. Max®®series Fuse Rating _ - [AOCI 20 Fire Rating `--- C(I EC)/TYPE 1(UL) Design load,push(ULY [lbs/Wl 75(3600Pa) Permitted moduleteaperature -40°F up to+185°F QGpMPgT%� Phnfnn on continuous duty (-40°Cupto+85°C) e Al / �a •-- - Design load,pull MY [lbs/N' _ 1 55.6(2666 Pa) 3 see installation manual OCELLS eas<palynyaauiae _«_..--- --- ----- ----- -- _ -- - .••t kz solar module 20I4 QUALIFICATIONS CERTIFICATES PACKAGING INFORMATION ACOMPPS •n.��.. UL 1703;CE-compliant; Numbs of Mloubdes per Pallet 26 _ IEC 61215(Ed.2);IEC 61730(Ed.l)application class A Number of Pallets per 57 CM ama - -._-_-- ---_.. --_ -- -`_32 _ �ononr S w ��� Number of Pallets per ContainerPallet Dimeusims(LxWxContainer26 APT test conditions:Cells at-1500V ® _ - 68.7inx45.3inx46.1in against grounded,with conductive me- c us SOW (1745mm x 1150mm x 1170mm) tal foil covered module surface,25°C, THE IDEAL SOLUTION FOR: 168h Pallet Weight _ _ - _ 1z541bs(569kg) _ z See data sheet on rear for further NOTE:Installation instructions must be followed.See the installation and operating manual or contact our technical service department for further information on approved installation and use Rooftop arrays on information. of this product. g residential buildings Hanwha O CELLS America Inc. 300 Spectrum Center Drive,Suite 1250,Irvine,CA 92618,USA I TEL+1 949 748 59 96 1 EMAIL inquiry®us.q-cells.com I WEB www.q-cells.us Engineered in Germany CELLS Y