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0087 BISHOPS TERRACE
r,\�/s^/y��\J \/(,lam/(/�/ � ,,//�!! r ,wI" -13 Iq , P� Town of Barnstable "Permit# Regulatory Services Fee 65 Richard V.Scali,interim Dhrector, -P Building Division Tom Perry,CBO,Building Commissioner MAY — 1 2014 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 TOWN OF UK--P PO &MMMuMMP A Not Valid"%*V rt End X-Pheas bt MapIparcel Number o?S'tZ2e 3 Property Addres P?kesidentiai Value of Wank$ j, II�. . Minimum fee of SA00 for work ender$6000.00 Owner's Name 8t > 0201 3�'?IAiJ Fiv c� �Y(JJ Coutnac tor's Name Sou.- ,erP UeWa*L4&4 0100606 Telephone Number'9� Home Improvement Contractor License#(if applicable) 173 2-Yje'_ Email: Construction Supervisor's License#(if applicable) �570 �Workman's Compensation Insurance . \\ Check one: ❑ I am a sole proprietor I am the homeowner I" I have Worker's Compensation Insurance Insurance Company Name�, 1�(�AWT `/V-S ' Workman's Comp.Policy# Al(iQa WOr2_ 3 Fy Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) Al construction debris will be taken to Re-roofurrite nailed)(not stripping. Going over existing layers of roof) ent Windows/doors/sliders.U-Value ay (maximum.35)#of ' a #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. •Where req►ma lmwme of Uric pemut does not eX=pt Compliance with other town depa m W moms.i.e.HiAmm,Consmatim etc. *""Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is uired. r SIGNATURE: TMEVIN Dftflding amw SS PEtNffrJDi M5&doc Revised 061313 .m�.i•ti�"� Renewal Rr.Liuiuc WW79 �Ftndersen. RENEWAL BY ANDERSCN �4t t&Ase#0 7354:' CT ideanse rE0G3aa5D ivraoow Ra►uieawaar .,ma c ,ter 1fi Nbion•Road-• Lincoln,RI 02865 - toad Fim�a 1237 ^ Pli6del!66.363,2235-Tax 401 633.6602 tedamr r=toa4i -ossrs?u 0 � f/I/LS Southern New England Windows,LLC d/b/a '^ CIA A Renewal by Andersen of Southern New Eog�and Gl/3 (l� - CUSTOM WINDOW AND DOOR REMODELiNGAGREEMENT &ger(s)N r_4Je,,&o /� D: .w ' _Dited,,gMen,rrc_ 16 y &"Its)scnee.Mirm.QW Sat...W Sip cede I AO-S. ,/fit j z6o/ Sod ��/-3J55 r E.Pt�a.Addressc HaneTelephone NumO�p:� VrakTelephmie NumEer.. Buyer(s)hit by jointly and severally agrees to.ptircliase the products and/or sc%ices of Sotiihem:Nett Fngland'N nd6m LI C d%b/a'Renewal in•Andersen of Southern NewEngland("Contractor"),in.accordance with the term's and conditions desriib6d.oh thc7ront and the k%crse'af ' this agreement and on thcattached specification sheets)(coticcuirly,.this`Agrcancne). 0 Mistoric, ❑Condo O HOA? .Total JobAmoune /I Z_ Bdmaud sorting Dam Method of Payment:.0 Check rJ Cam Q"Financed » peposit Received(33%):_�f lie I.C. ` Credit Cards are accepted for deposit only-maximum 113 of the Balance at Start of Job(33%):�/ G project cose(Wease see Credit Cord fbpment Form)By wing this �°"g Ca"pletian Oaf Agreement you uknaivledge that the Balance'at Startof.job and the Balance on Substantial �/ • twl Balarrce on Substimial,Completion of job cinn&be'mide by credit: �,i>!G __G _k_ Completion of Job(33%): card and must be made by.personal check;bar&chedr,or cash Buyer(s)agrees and understands that this Agreement constitutes the.entire understanding_between the parties,and that there are no verbal understandings changing any of the,terms of this A —sneut 11- s)"acltnowiedges.that Buyers) (1)has read this Agreement,understands the terms'of this;Agreement,and lies received a cgmpleted;signed,,and dated-. copy of this Agreement,including the two attached Nodees of Cancellation,on the date first written above and(2)was orally informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE'ANY BLANKSPACES. (Rhode Island Sales Only)Notice to Buyer(1)Do notsigu ts Agre ement hi if any of the spaces,intended for the agreed terms to the.eateut of then available'inform.stion are left Blank.(2)You arevatitled to a copy of ibis Agreement at the, you sign It.(3)You may at any-time payoff the fall unpaid balance due under this Agreement;,and in so doing you.maybe:eudded to receive a partial rebate of`the 6n'ance.'and insurance charges.(4)Tlae:eeller-has no right to unlawfully"enter lyonr premises or commit any breach of the peace to repossess goods"purchased tinder this A";e14 ate(S)You tray cancel this Agreement if it:has.not been signed.at-die main office or a branch oiliceof.theseller,provided you,notify the seller.at his-or her main. office or branch office shown in theAgreemeat by registered or testified mail,whicb"sball be posted notlater than midnight of the third calendar day after the day on which the Is signs die Ageeentent;ext hiding Sunday and any holiday oq which regular mail deliveries are notox de.See the accompanying notice.of;-cancellation form for an esplaaatioa of buyer's-rights. Buver(s)received the consumer educapon materials provided=by the Rhode Island Contractors Registration Board. (i3rner's Initials) Renewal by Andersen of Southern New England Buyers) Buyers) Br- Siturc qfVwduct.i4lanagcr '* Si urc Signature. - PrinIlk rM69 U t\ante of Pr'aduct Manager Prini N unc Piint Name r YOU,THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BNES USIS.DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE;OF CANCEU ATION FORMFOR AN EXPLANATION OF THIS RIGHT. OTC O C LAT O �f NIOTICE OF CANCELLATION' Date of Traosataion You may cancel Date of Transaction .You may cancel this transaction,without a or obligation,within I` this-transaction,without any penalty or obligation,within three business days from the above date.If you cancel,any 1 three business days>fram thw above date.If you cancel;any property traded in,any payments made by you under the I property traded in;any payments made by you under the Contract,Or Sale,and:any negotlablei instrument executed I Contract Or Sale;and.any negotiable"instrument executed by you will be returned.within ten business days following 1 by you will be returne d within ten business days following receipt by the Seller of your cancellation notice,and any I receipt br the;Seller of your cancellation notice,and any security Interest arising out of the transaction will be security iinterest arising Out.of the .transaltiort"will be canceled.If you cancel,you must snake available to the Seller I 'canceled.If you cancekyyoou must make available to the Seller atyourresidencein substantlally.as good condition as when I at your,residence,in substantially as good condition as"when received,any goods delivered to you under this Contract or I received,any goods delivered to you under this Contractor Sale;or you may,if you`wish,comply with the instructions of I 'Sale;or you-may,if you wish,comply with the instructions of the Seller regarding the return shipment of the L goods at the the Seller regarding the return shipntent'of the goods at the Seller's expense and risk.if you do make the-goods available X Seller's expense and risk If you do make the goods available toe Seller and the Seller does not pick them up within I to the Seller and the Seiler does not pick them up within twenty days of the date cancellation, of cancellation,you may retain or I twenty days of the date of you may retain or dispose of the goods without any further obligation If you I dispose of the.goods without a"further obligation.If you WI to make the goods available to the Seller,or If you agree i fail to-make the goods available to the Seller,or if you agree ` to return the goods to the Seller and fail to do.so,then you ',r to return the goods to the Seller and fail to do so,then.you remain liable for performance of all obligations under the . remain liable,for performance of all obligations•under the Contrata.To cancel this transaction,mail or deliver•a signed I Contract.To-cancel this transaction,mail or deliver a signed and dated copy of this cancellation notice,or.any other I and dated. copy of this.cancellation notice or any other written notice,orsend a telegram to Renewal " An ersen of I written nodce;or send a telegram to Renewal byAndersen.of` ^ Southern New England at 26 Albion R n 865,..i ,Southern New England at 26 Albion Road,Lincoln,RI 02865 . NOT LATER"THAN MIDNIGHT OF .,t NOT'LATER THAN MIDNIGHT OF Date Date � 3, 1 HEREBY CANCELTHISTRANSACTIO 1 HEREBY CANCELTHISTRANSACTION au"es stgnan" prom Naiaa data Buyer%Sknapo+ PAnt Name: 'RbA Copy.White Buyer Copy.Yellow BuyerCopy Pink P G Southern New England Windows d.b.a Renewal by Andersen of SNE 1('10 Massachusetts Department of P:ubhc Safety Board of 8uildmg Regulations and Standards;: -onstrurtion Superv°icon License 0§4'0407 BRIAfD DENMSdN: ' '1 I:A1VD3.S POND+EIR� � _ 'C6arttoa MA U15i1'1 - J,�,.,, Ezplration Commissioner 09708/2014 Offi�ff Coffairs Bss e' aUon 10 Park Plaza=Suite 5170 Boston,'Massachusetts 02:116 Home Improvement;11c,ontmdor Registration =' �Rf;gistrahon; 173245 Type:. SuPdemeit Card _ SOUTHERN NEW ENGLAND WINDOWS_.'LL4 F iranon:. snsaata DENNISON BRIAN 1137 PARK EAST DRIVE F.s WOONSOCKET,RI 02895z Update Address and return cord.Mark re—for change.. seA1 0.2M4ZMI O Address []—I D Emptaymmt 0 Lost.C- e of Cons mer ARa'aa A Bosines Regalatlea Li-- or registradon vaild for fadividal we only E RIPROVEaIENt'CONTRACTOR. before the expiration dat&.u found return to Office of ConmmerAffairs sad Boar Regulation ReglaJrafbn 173245 TYPO: 10Partt Plam-:Sui1e5170 ' fely)itat{on 9t1!)2t114r, Sttpplenenll Bosion,MA 02116 S011TFIERN NEW EN81AN0 WINDOWS LLC.. RENEWAL BY ANDERS_ON!�^ DENNIS A <:. 11J7PAfiRK EAST DRIVE - � WOONSOCKET,RI02095 Uoderaecrefory Not voild aftboutrignsture Clle0:30124 SOUTNEiIIf AWRO." CERTIFICATE OF -L- LABILITY INSURANCE DAT 013 Yl THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIITELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed.tf SUBROGATION IS WAIVED,Subject to the terns 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 ;NAppE; Anita Little Willis of Now Jersey,Inc. °NH 856 114-4660 No"; 856-914.1881 1015 Briggs Road,PO Box 6005 £ REs : anita.little@wiltis.com PO Box 5005 I INSgnRM AFFORDING COVERAGE NAIC at Mount Laurel,NJ 08054 INSURER A Selective Insurance Co of the S 39926 : INSURED INSURER a Argonaut Insurance Co. 19801 Southern New England Windows LLC INsumc:Beacon Mutual Ins.Co. 24017 D/B/A Renewal by Andersen INSURER D- 26 Albion Road INSURER E Lincoln,RI 02865 INSURER F t 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN LispRpE�D�UCED BY PAID CLAIMS, IN AR TYPE OF INSURANCE POLICY NUMBER MIDDYOW%! LIMAS AK GENERAL LIABILITY S202945900 08110rA113 f 0 811 0/20 1 4 EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY I $100 000 CLAIMS MADEI OCCUR ( f�NE�D E^XP(Any Onepan;on) $1 Q OOO i f PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s3,000,000 GENI AGGREGATE UMIT"PLIES PER: i `PRODUCTS-COMP/OP AGG $3,000000 POLICY PRO-ACT LOC i S A AUTOMOBILE LIABILITY S202945900 3t 0/2013 O8/10/2p1 Es accident) E LIMIT 1,000,000 Ix ANY AUTO IIBODILY INJURY(Parparson) $ALL OWNED SCHEDULED 3 BODILY INJURY(Per acddent) $ AUTOS HIRED AUTOS FX NOWOWNED AUTOS111' PPROr PPE T DAMAGEAUTOS $ — A X UMBRELLA LIAB OCCUR S202945900 WIOJ2013 08M 0/201A EACH OCCURRENCE $ 000,000 EXCESS LIAR �CLAIMS-MADE AGGREGATE $51000,000 DED s I RETENTION I $ C WORKERS COMPENSATION 10000068028-RI 8f2112013 08/21MI4 X AND EMPLOYERV LIABILITY B ANY PROPRIETORIPARTNEhEXECUTIVE YIN I AIC927818352394 81;112013 08121/2011 E.L.EACH ACCIDENT S7 QQQ QQQ OFFICER/MEMBEREXCLUDED? NlAj (Mandatory In NH) I I E.L.DISEASE-EA EMPLOYEE $1 00Q 000 If yes d,uw be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 QOQ QOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addilonal Remarks Schedule,S lnom spans is required) 4 CERTIFICATE HOLDER CANCELLATION Southern NE LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26 Albion Road ACCORDANCE WITH THE POLICY PROVISIONS. Lincoln,RI 02865 AUTHOFaED REPRESENTATNE I 1988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD ;1S2151091M215068 AXL f K The Commonwealth of Maysachusetis Department of Industrial Accidents Office of Investigadons 600 Washington Street Boston,MA 02111 www.massgov/dfa Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibl Name(Business/Organization/Individual): �N Ltc Address: o*2 (o loll/ /CD p City/State/Zip: I-LAICO& WF165' Phone#: yoz f dDQ Are you an employer?Check the appropriate box: Type of project(required): 1.1 I am a employer with A 0 4. El am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' comp.insurance. 9 ❑Building addition [No workers' comp.insuranceP• required.] 5. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ILEI Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c.152,§1(4),and we have no employees.[No workers' 13. Other comp.insurance required.] 'Any applicant that checks box#I must also 5ll out the section below showing their workers'compensation policy 16rmation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors mustsubmit a new affidavit indicating such. tContr;ctors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: WIFy 1 Policy#or Self-ins.Lic.#: � Expiration Date• a� Job Site Address: s S Qj� I �_City/State/Zip: /�/¢ Attach a copy of the workers'compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certi under the pains and penalties of perjury that the information provided abov is true d correct Signature: Date: �� Phone Official use only. Do not write in tlris area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): t 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Ins=&'�lumbing6.Other Contact Person: Phone#: b Y e .a of0oa3ati °F1 •Tmwn o_f Barnstable . *Permit# Expires 6 months f on:issue,da Regulatory Services Fee w BARNSTABLE. TQ MASS.39 � Thomas F. Geiler,Director w Building Division . � g Tom Perry,CBO; Building Commissioner 200 Main Street,Hyannis,MA 02601 x www.town.barnstable,ma.us": Office:. 50S-8624038 Fax: 508-790=6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X Press Imprint Map/parcel Number �' 'a to Property Address L�'Residential Value of Work Minimum fee of$2S.00 for work under$6000.00 p,, Owner's Name&Address G yY Contractor's Name Telephone Number' !/�� 7�'b 0 . p ( applicable); Home Im Improvement Contractor License# if gyp- ' Cons etion Supervisor's License#(if applicable) �. U " ly y ` orkman's Compensation Insurance 't n Check one ❑ I am a sole proprietor, 6 ❑ 'the Homeowner �Y I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance'Compliance Certificate'must accompany each permit. ' Permit Req nest ) 'check box A t r ( Re-roof(stripping old shingles),All construction debris will be taken to 0 Re-roof(n stripping. Going,over y existing,layer's of roof) U _ ot bs 0 Re`-side` , of doors Replacemen Wintdrc /doors/sliders.U-Value_ Q, (maximum-.44)#of windows *Where regwred. Issuance of.this permit does not exe. compliance with other town department regulations i.e."Historic,Conservation etc s. ***Note:• Property Owner must sign Property Owner:Letter of Permission. ,. TA copy of the Home'lmprovement:Contractors License& Construction.Supe"rviso"rs License is required. , x i SIGNATURE QAWHIL:ESTORMS\buildingpermitforms\EXPRESS.doc Revised 090809 ,, The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations 600 Washington Street Boston, MA 02111 ' www.mass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information NO '47'— Please Print Le ibl Name(Business/Organizati ndividual): V JdG. twc Address: CitY/State/ZiP: n) (� �S� Phone.#: Are an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑Ne construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling . ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. [] Building addition [No workers' comp. insurance comp. insurance.$ 5.` We are a corporation and its 10.0 Electrical repairs or additions required.]3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.[1 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new davit indicating such. lContractors that check this box must attached an additional sheet showing the name of he 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'compensatio ura ce for y employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: tJ Expiration Date: Lo� 0 r-- City/State/Zip: 5 Job Site Address: Attach a copy of the workers' compensation policy declaration page(showing the policy nu! er and e.piratio.n date). Failure to secure coverage as required.under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. --� Signafore: - Date: Phone# �!/ 06-V Offcial use only. Do not write in this area, to he completed by city or town official City or Town: Permit/License# Issuing Authority(.circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: t,.+CK 1 It'tl..H I C 111" LIHtS[LI 1 T IIVJU!'<HIVK,►C OP ID av MOONA-1 05/07/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 Old River Road, P.O. Box`,1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville RI 02838-0001 Phone: 401-769-9500 Fax:401-76979502 INSURERS AFFORDING.COVERAGE.- NAIC INSURED Moan Associates Inc. DBA Gutter Helmet n INSURER A: flatiaal Grange In.urance Co 14788 DBA Renewal by Andersen of RI INSURER 6: Beacon Fzutual Insurance Co. t DBA Gutter Helmet Roofing INSURER C' DBA Moon Works 1137 Park East Drive INSURERD: Woonsocket RI 02895 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,T HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRN TYPE OF INSURANCE POLICY NUMBER DATE MWDDIYYYY) DATE(MMfDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X C0 MERCIAL GENERAL LIABILITY MPS26619 09/16/0 9 0 9/16/10 PREMISES(Ea oocurenoe) $500000 CLAIMS MADE ®OCCUR MED EKP(Any one person) $ 10000 PERSONAL&ADV INJURY. $ 10 0 0 0 0 0 �$ ,•, GENERAL AGGREGATE $290000p KEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $2 O 0 0 0 O 0 . PRO- POLICY JECT LOC` AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO B1S26619 09/16/09 09/16/10 . (Ea accident) $ 1000000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident} PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ ". '• OTHER THAN AUTO ONLY: AGO $ EXCESS I UMBRELLA LIABILITY. EACH OCCURRENCE $ Q Q Q Q Q Q A X OCCUR El CLAIMS MADE CUS26619 09/16/09 09/16/10 AGGREGATE $-- -- DEDUCTIBLE X RETENTIOSN $10 0 0 0 $ WORKERS COMPENSATION i AND EMPLOYERS'LIABILITY YIN X TORY LIMITS I ER B ANY PROPRIETOPJPAP.TNERIEXECUTIVE 28586 -l0/01/09 .10/01/10 E.L.EACH ACCIDENT $500000 OFFICER(MEMBER EXCLUDED? El (Mandatory in NH) E,L.DISEASE-EA EMPLOYEE $500000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED.POLICIES BE CANCELLED BEFORE THE EXPIRATION RENEWAL 'DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL . 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION,OR LIABILITY OF ANY KIND UPON THE INSURER,I M AGENTS OR Renewal By Anderson REPRESENTATIVES. , 1137 Park East Drive AUTHOR D REPRESENTATIVE Woonsocket RI 02895 ACORD 5 c 2 (2009/()1} 01988.2U09 ACORD CORPORA TION. All rights reserved The ACORD name and logo are registered marks of ACORD 9, to +� (erg }q ¢ �{' .{ e - .. f'-i.• ?1 p 10 '#��.7�j l�`.?,���{ Jude tyThu dv ws ME _ . Pam. a cvt tQ hr tie M. . t r Customer Name: ` � Year Built: genew,al by Andersen of Rhode Island& Customer IDS: Ca Cod — Address; _ — / �t� �-� — C.us u pp�� > order Number: I t 7 1 ark East Drive {R��e��wl,�^�/�� Sales Agreement cry.State,Zip: __ /rs t� I Woopuecka.R102895 "]/"Vr��. �C--, Phone-Home: D 7 g wlnoow REPLAC.m.Nr .L of�Date: anAru4 rnC;arymnY Irhanr-Work: — ["+ar: _ license a R1-30839 RI- 12259 MA- J 19535 CT-562725 t:ntaiL u- fr�ge7 T I Meas ure GR►l LES aritd edorlr. w UNITS trrme.sian a el '� �� SPRt�S � N it � a $ 3S 3 1 — t�>� t �arW D jox 3 N -3 ffll" B .l �_ �'3 3 c 0 Nf Co— �� d 34f y Fw 3 M���ellp�� Credtts r Eapp��reses Sub Total(flwl) �I�Ttlent Method Ptopo.al:A1!„!'rAeqbane whnlr m U•Pnr,IJpd drr r1a ndot arraruro pbrw!n the p!{rrr m•nr.l Vn ($uining Wrap tint Repair.l�mmrpMn etc.) q pn5'!,ul Drill rcmpin wdd l!a Nf 14 a w Nr cry,rnnca jp lx,d, umnr pnJ Rc,awxl In Amk rmt Narpslt Ke+ Sub TOW W110.101N pn,p,pkJ re /I/ t)enxripdrtn I Nvccr E I'rt« .Subtotal VAfti ,r„ 1/� ;,f 9 4 �UGt/C/ T—i f �QS/ /rl/ /COr ($ / Iryrc Rmu. nkrxn.akp t4gvu•aforlvc Si ma• Crtdk Card Mist:Credks ar Cu.ayma Aeee s V<u arc txrkrr wrMr�peA a fuenlsh p l w+w4 w+am1 da n n+p d n,n mrl,he rhip F :yKr•cmcnr r:a Mhieh o wvlcrurprad apttex rn pay e1w xnn nmp Maud Ia,hip nyVrec,m•nt ami acamll,gt n�rbe ramp heteel. ��OC4�l J tal f i j Total Sea Revtreo Side Ibr'l�elliime d Condi one of gale.Xou,the buyer,may cancer eJ this tmnsac on at nnanyy trine or to mi niQttt o son To f 11 thirt�bnaitteaa iiay aftor the date of a teonoaction, a an,t�aeheaa n o c Iladoti for w —Toth Minad1ill Credits or F-%Pcnxx work km*COA explanati O • wr,u"I,o mitt.rrcpllr/eayrnpr,damn at rlKhp) cMM er Not epMry . Psesi 4torm Ow Acre{n d Dare •r r Sil l Order Notts Total Amww or Apruenst" 5 y Caldron Pnur OW •�tnplpd flirtiln' N!t t/'etld!/I��rr 1>an• Rtnwal trY Adlrrw NA I mane A Apm�,Pemn9 nM4par avaapabYAmMf.r � tad rtimYlaten fMwmfl��.orrw merrwnkmand on ro.NMnq '� OaHlrrce tAw on CarnplB� w,dp,pwlnp Mach mc/ dflesrml PraNMwtlb m a�q•uemeen darnaoe.mr�arata eflY r?necn dap�w M' nr•Luke),bur,materials,Mnullatinn• 6e aedrda rotedudra rddaiPul wires polar Wr�a Illry of N67mvned Qaingo �rnY compau w drit ,never u�ders av,ar�4r dear rera rtpR da curropw redrn trd rhupe yw br dN repN,t Woe year cpPmd. rcmuval,and dlrpotpl of ptadurxp rcplixed. „, ak„�pa me imWNd. Othso re�1d. nl tnd d dr IeE dl wavueuon drM rKtoNrer removed mrd mrt alllrben yaorapt end YYhitt•Rtrrewal OY Ardersdn Yetaw-4rttallallon P' rr CLftMK! t.YSMpprep ©� C fir-j/.� 1nP IMipik➢an ami. - Inhi.b: lasws; G wt1.u: �/ .a.,.�i.,k,4M.�Wa.a.mwi,aN.r<��w,R��.�,.•.n.,r.,w.,.�r:..n.,....,�pM+�....r.,4w,ar.,yen«..,,re,m wwa�ar ap,n • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- Parcel C "7 ��3 Application # r Health Division Date Issued Conservation Division '.Application Fee Planning Dept. Permit Fee- Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address C.YASC S-r MaWAIIS o Village *11A01 5 Owner �A5ml S 7o-0 / .S Address 6=114-sle 41,4 I S M 4 Telephone 0--6v Permit Request fi2r I,?ok,&T Ft-%4 S t� IMP o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio. 000. Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family I Two Family ❑ Multi-Family (# units) Age of Existing Structure 30 k 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 C11a r z Total Room Count (not including baths): existing new First Floor Room Count.- ,F ; Heat Type and Fuel: ' Gas ❑Oil ❑ Electric ❑ Other �� � Central Air: ❑Yes 4No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No J Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing �ne\q size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded-❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ���}SuV �/ �_rS Telephone Number Address /2 0 Cl-14 Sr 5-r License # ;&; IygAIW1 S, 0 Home Improvement Contractor# / 6 Sea Worker's Compensation # G(/c-5,00 0WO)2n/d ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_�Gj��I� SIGNATURE DATE © / x FOR OFFICIAL USE ONLY +' APPLICATION# DATEISSUED MAP/PARCEL NO. _ t ADDRESS r •` VILLAGE f OWNER r 1 DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL "= PLUMBING: ROUGH FINAL'` GAS: ROUGH FINAL , "FINAL BUILDING , DATE CLOSED OUT , ASSOCIATION PLAN NO. r 41 The Commonwealth of Massachusetts _ Department of Industrial Accidents ' Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 145 o,J (_ ®_Ta Address: 1 a ® C-q, ,rt T City/State/Zip: Phone#: Yo fry 7,z 5 f :7 � S Are yo n employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work -officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.�'Other Set 2 employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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 job site information. Insurance Company Name: ['/i try C 4L MY t L Policy#or Self-ins.Lic.#: ���L /Id90y/vf Expiration Date: !o Job Site Address: T City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage.verification. I do hereby certify nder the pains and penalties ofperjury that the information provided above is true and correct. Si ature: - Date: 30 Ila Phone#: U 2 3-7 —3 9 9-Z_ Official use only. Do not•write in this area,to be completed by city or town ofciaL City>or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: Client#:18348 2E2SO ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(M[oYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 9731yannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURER A: Acadia Insurance E2 Solar,Inc. INSURER B: Associated Employers Insurance Jason Stoots INSURER C: 120 Chase Street INSURER D: Hyannis,MA 02601 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN R DD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMITS A GENERAL LIABILITY CPAOM4532 04/22/10 W22/11 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES DAMAGE To RENTED occurrence) $1 OO OOO CLAIMS MADE F xJ OCCUR - MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 OOO 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC JECT A AUTOMOBILE LIABILITY MAA0339671 . 04/22/10 04/22/11 COMBINED SINGLE LIMIT ANY AUTO - (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY' X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) ~ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT_ $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY CUA0334534 04/22/10 04/22/11 EACH OCCURRENCE $1 000 000 X OCCUR CLAIMS MADE AGGREGATE $1 OOO 000 DEDUCTIBLE - - $ RETENTION $ - $ B WORKERS COMPENSATION AND WCC5008041012010 03/16/10 03/16/11 X wC sTAru- 0ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT -$5OO OOO OFFICER/MEMBER EXCLUDED? YES - E.L.DISEASE-EA EMPLOYEE $500,000 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE.-POLICY LIMIT $500,000 OTHER -. . DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - Certificate holder and Massachusetts Clean Energy Technology Center are named additional insured for general liability on a primary non contributory basis per written contract.General Liability and Umbrella policies include coverage for independent or subcontractors and"Residential Work". Insurance coverage is limited to the terms,conditions,exclusions,other (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Alison Alessi DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 134 Chase Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL` Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE. - - ACORD 25(2001/08)1 Of 3 #S68855/M68144 LS1 © ACORD CORPORATION 1988 ✓jie Vovrvinoou�sea�i .�/laaoacluiaela ' Board of Pudding Regulatio s and Standards Lict rise or.�egistration valid for individul use oul! HOME IMPROVEMENT CONTRACTOR Wore the expiration date. If found return tw i -oar of Building Regulations and Standards Registration:. 160360 One Ashburton Place Rm 1:.101 Expt 16/2010 Tr" e ston A'[a.02108: SOi';R ,iASON STOOTS 120 CHASE ST HYANNIS,MA 02601 - Admihistralur_._: t valid. tthout sfignatuYe Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License:.CS 90293 Restricted to::..00 JASON D STOOTS 120 CHASE`ST HYANNIS, MA 02601 Expiration: 4/28/2012 C nun i,c.iun+r` Tr#: 20887 JASON STOOTS i J inc Renewable Energy energy efficiencyphot 120 Chase Street solar t o anal Hyannis MA 02601 solar thermal cell:508.237.3892 W'thrma cena . _ fax:508.775.1385 177 ` jason@e2solareapecod.com www.e2solarcapecod.com OFTWE POD Town of Barnstable O^, Regulatory Services yBA nNinssBLF- Thomas F. Geller,Director 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 Properly Owner Must Complete and'Sign This Section If Using A Builder +SU J 's-no 7S , as Owner.of the subject property hereby authorize V 5 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) S ignatiff Owner Date I Sraz, rs Print Name If Properly Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION Town of Barnstable OFT HE,TOty o Regulatory Services * * Thomas F. Geiler,Director • swsxsTABLE, MAS& 1639. ,�� Building Division ATfot� 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 j 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 buifding'permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws;rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official a 4.r-`��r� Note: Three-family dwellings containing 3.5,000 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 fornr/certifrcation for use in your community. Q:\WPFILES\FORM S\homeexempt,DOC age alsdWaviod Need help etroosing a 23W&CWWLtdm TnpoVrw s-ianr product?Cfick the Ids below to view a Ifshn9ianded�rAooucts es 230M Construction TrIPOIYm9r S88MM , expaft,or feel free to call our Custorner Support Center at • CARS VOC canptiant OM 348-7616. • Adheres to wet or ovy sudaces matedels • Stays ruble- pAdMApPICaVm Srtperior ultravit"resistance • Appfms in • paw.-Me-cmrtamsnosiftOne -- . 6U-yearservice Y ! • o Color match • AvaW*in crystal dear.colors.and sPed* designed meat roof odors.Fora ROM Of To fmd the Sedard COW part un tuber troPutar metal ro��m match.use the drop down menu balm that nuftim your siding, window.or door needs•select the mangy r�J the . Exert adhesion+to most twlliding materrats menu below includ'mg painted(Kymn"metal 230Q®Constrttct€ar►T' er Sealant Color Match: Select a Manuteccu(er npotym Or,enter your Patt number for saM an exact match. PDF Documents Fart No.: _ Tech Date Adobe Aft 6.0 or hWm is reytrked for viewing pdf gm&For a free davmload. click the Get Adobe ReadeP bullon and follow the instructions. This product works Crest for these apPocabons- Materials Asphalt f , . BdWip Rooting(BUR) . Concrete Wmred.tick) It 4 =6/2W9 �pJ/wvv�w.go�icfp '�lP _ POWER RAIL, 1N�STALL TION QUIDELINES • $IDE V_IEW-FOR POWBR,� ipxH U��qq_; NO CANTILEVER NO SPAN BETWEEN NO CANTILEVER GREATER THAN 32 SUPPORTS GREATE R THAN 80' GREATER THAN 32 20%22%OF I 889i 4o%OF 2096-M OF L OVERALLLENGTH ' - --OVERALL LENGTH OVERALL LENGTH AID E VIEW•FOR ROWER RAIL LE M OVER 144"AND UP�� Ar NO SPAN BETWEEN NO SPAN 6BETWEEN =-Noal Vqwmm SUPPORTS GREATER THAN 80" SUPPORTS GREATER THAN 80°'�"'� ®�G �- i6%-22%OF 38%28%OF 4..� ��. 30%2i%OF � 10%-22%OF L OVERALL LENGTH OVERALL LENGTH OVERALL OVERALL LENGTH LENGTH 61DE VIEW.FOR POWER RAN.LFmOVER ne AND Ut rn w-, O NO SPAN BETWEEN NO SPAN BETWEEN } SUPPORTS GREATER THAN w SUPPORTS GREATER THAN SVI SUPPORTS GREATER THAN 80"" 'G WEEN 0 EATERTK 1096.1196 OF ' 27%0%OF ,� �, 279628%OF ( ���� 27%46%OF ,r, 'IM11%t OVERALL LENGT OVERALL LENGTH OVERALL LENGTH H OVERALL LENGTH OVERALL IS POWER RAIL IS DESIGNED AND WARRANTED POWER�p PHOTOVOLTAIC FOR LOADS UP TO 60 LBS/SQ.FT, H MODULE WHEN INSTALLED AS SHOWN. FOR INSTALLATIONS IN AREAS MouNtING WITH MAXIMUM DESIGN WIND SPEEDS OF 90 MPH THE POWER RAIL. DISTANCE BETWEEN SUPPORTS CAN BE INCREASED TO 96" � OF 20%-25% 2096 26% MODULE LWITH A MAXIMUM CANTILEVER OF 36" LENGTH MODS �EN� SHOWN WITH STANDARD MOUNTING FEET(OTHER OPTIONS ARE AVAILABLE) NOTEI THE MOUNTING FEET MUST BE ATTACHED TO THE BUILDING RAFTERS DIRECT POWER&WATER CORPOW OR FRAMING(NOT JUST THE ROOF DECKING).USE 8118"OR 3/8'DIAMETER TOM POWER RAIL INSTALLATION LAG BOLTS AND DRILL A PILOT HOLE.00 THE FINAL TIGHTENING BY HAND, . EACH LAG BOLT MUST HAVE A 2 ,m,mm.'s OR STRUCTURAL WNW mompeR PAM WILLG. JS 4 4_.2_n r MIN0 s . sMOUNTING SOLAPMOUW u.S.andollm P Lag Screw Specifications Inst dkWon 3uppjwmt2o3.2 iie�et CB&le4firo�t s . I e � - 2ft SakwNDURWOdc ) - tjm1 i2t4atwww ffmpAom<hrataes vwfu=bmbermdtbebg sue. 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ES-A SERIES 200, 205 & 210 w photovoltaic panels Best power tolerance available i A range of high quality String Ribbon TM solar panels offering exceptional.performance, cost effective - installation and industry-leading environmental E credentials made with our revolutionary wafer technology. t ��, ` •No power below nameplate Never pay for power you're not getting •Get up to 5W more than nameplate* - I I For enhanced field performance •Industry's lowest voltage per watt rating III Delivers the most cost-effective installs i • UL4703 certified cables I I For use with the highest efficiency transformer-less inverters 9 • New extended length cables i Eliminates home-run wiring { •New lockable connectors**` 1 ' Complies with the latest codes for accessible arrays • Most extensive range of mounting options = I Allows installs virtually anywhere and anyhow ! •Smallest carbon footprint of any manufacturer For the greenest of the green i � I I •100%cardboard-free packaging I i Minimizes job site waste and disposal costs •5 year workmanship and 25 year power warranty*** I Born in the USA *Maximum power,up to 4A9 W above nameplate rating;'*Locking sleeve not supplied with the panel. ***For full deteils seethe Evergreen Solar Limited Warranty available on request or online This product is designed to meet UL 1703,UL 4703,:UL Fire Safety Class C,IEC 6f215 Ed.2 and IEC 61;730 Class A standards. String Ribbon is a patented technology and mgistered'traderriark of Evergreen Solar Inc'. S:t i t s. ® _ Electrical Characteristics Mechanical Specifications i I Standard Test Conditions(STC)' PANEL ID LABEL ES-A-200 ES-A-205 ES-A-210 ° -fa2* -fa2* =fat* ~I 2.2 4.4.9 Pmp2 200 205 210 W ° m Pt°ler _ -0/+4.99 -0/+4.99 -0/+4.99 W I JUNCTION BOX i (IP65) Bx G0.16 ROUPANEL NDING Pmp,max 204.99 209.99 214.99 W - - SERIAL NUMBER HOLE ° °Pmp:min 200.00 205.00 210.00 W I 11min 12.7 13.1 13.4 % q ° CABLES i 1 Pptc3 180.6 185.2 189.8 W (10 AWG.UL4703, ° PV-WIRE) I Vmp 18.1 18.4 18.7 V I Imp 11.05 11.15 11.23 A o I 1 V 1 V°c 22.5 22.8 23.1 V o o ° 10.0.26 I Lc 12.00 12.10 12.20 A PANEL MOUNTING HOLE ID LABEL FOR Y.'BOLT I Nominal Operating Cell Temperature Conditions(NOCT)4 ° - - MC-LOCKABLE TNOCT 44.8 44.8 44.8 0C ° CONNECTORS ° (TYPE 4) ` Pmax 146.4 150.1 153.7 W ° 0 (+) Vmp 16.7 16.8 17.6 V o N j 1Ii i Ix CLEAR E12x FRAM b mP 8.76 8.93 9.04 A HOLEAE ° °Voc 20.5 20.7 21.0 r V 35.9 9.60 9.68 9.76- A I 1� 8(+0.02/-0) 37.5(+/-B.1 { E 1000 w/m=,25°C cell temperature,AM 1.5 spectrum; Y All dimensions in inches;panel weight 41 Ibs 'Maximum power point or rated power (. At PV-USA Test Conditions:1000 W/m',20°C ambient temperature,1 m/s wind speed Product constructed with 114 poly-crystalline silicon solar cells, anti-reflective 4 B00 w/m2,20°C ambient temperature,1 m/s wind speed,AM 1.5 spectrum s 'tempered solar glass,EVA encapsulant,polymer back-skin and a double-walled f-framed,a-low voltage,2-man blue(textured)cells anodized aluminum frame.Product packaging tested to International Safe Transit Association(ISTA)Standard 213. All specifications in this product information sheet Low Irradiance conform to EN50380. See the Evergreen Solar Safety,Installation and Operation The typical relative reduction of module efficiency at an Manual and Mounting Design Guide for further information on approved installa- irradiance of 200W/m2 both at 25°C cell temperature and ; tion and use of this product. spectrum AM 1.5 is 0%. Due to continuous innovation,research and product improvement,the specifica- tions in this product information sheet are subject to change without notice. No rights can be derived from this product information sheet and Evergreen Solar j Temperature Coefficients_ assumes no liability whatsoever connected to or resulting from the use of any I a Pmp -0.45 %/°C information contained herein. I ` a Vmp -0.43 %/°C Partner, a Imp -0.02 %/°C a Va -0.32 %/°C a Lc -0.003 %/°C System Design Series Fuse Ratings 20 A Maximum System Voltage(UL) 600 V 5 Also known as Maximum Reverse Current. QELECTRICAL EQUIPMENT CHECK WITH YOUR INSTALLER ES-A_200_205_210_US_010908;effective September 1 n 2008 L "Worldwide;Headquarters: <Customer Service Americas and`Asia 138 Bartlett Street,,Marlboro,MA 01752 USA 138 Bartlett Street,Marlboro,MA'01752 USA Evergreen Solar,Inc.; T,+1 508.357.2221 F.+1 508. 9 207147 J.+1.508.357.2221! F:.+1 508.229.0747 www:evergreensolar.com info@evercIribensolar.com., sales@6vergreensolar.com (30)YINGLI YL 175 WATT PV MODULES ° z 0 h F 3 We . U Ww � ¢ vim (30)YINGLI YL 175 ° z = z WATT PV MODULES o U z a ¢ cw.= EXT'G 2X6 RAFTERS 16"OC TITLE: 13'-1"SPAN PLANS & ELEVATIONS 2 PARTIAL SOUTH ELEVATION PARTIAL WEST ELEVATION E 2 245 TRUE SOUTH E d h Q °�' E N N v � g GENERAL NOTES: W N_� ui 1. PANELS ARE ATTACHED Z 0 TO METAL STRUCTURE WITH _2 DPW HEAVY DUTY RAIL. 2. ALL RAIL AND MOUNTINGS ARE RATED FOR 125 MPH . WIND LOADS. (30)YINGLI'YL 175 PROPOSED AC r---� WATT PV MODULES DISCONNECT EX'TG METER `yam LOCATION PROPOSED INVERTER LOCATION (IN BSMNT) o Dele: 02.14.2010 EXT'G shaa': SERVICE PANEL 3 LOCATION (IN PLAN +/e•- BASEMENT) A 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Parcel ' Permit# R Yq Health Division ?=�G1/ Date Issued P4 Conservation Division 6,113 Fee Tax Collector o � , _ Application fee Treasurer Planning Dept. Checked jn8y,�: Date Defi6itive Plan Approved by Planning Board �,� ,jA�proved-B}�`V Historic-OKH Preservation/Hyannis g s Project Street Address Village r � nn W 4•_ Owner G Address 'i_S niD �14 f2 ACC. Aa,n iS Telephone - 6 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed =Total new�'�O 00 � . Valuation 5 600 • Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes X)No If yes, attach supporting documentation. Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure 33 y2 Historic House: ❑Yes l(No On Old King's„Highway: , 0 Yes- X 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 Fl -new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ItLGas ❑Oil ❑ Electric ❑Other Central Air: XYes ❑No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn: ❑existing 0 new size Attached garage:❑existing ❑new size Shed:N existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ — Commercial ❑Yes 4 No If yes, site plan review# '. Current Use Proposed Use _ BUILDER INFORMATION Name e:J qL,n a Telephone Number "Address -License# - Home Improvement Contractor# Worker's Compensation# _ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �, SIGN TUR DATE 1 FOR OFFICIAL USE ONLY y > PERMIT NO. DATE ISSUED MAPS PARCEL NO. f€ ADDRESS R 1 VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE I } ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH // FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services BARMMIX Thomas F.Geiler,Director en Nw't" Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW _ SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: (1,A C4- P6 yJ Estimated Cost Soap. Address of Work: Owner's Name: Date of Application: O 5 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied` Owner pulling own permit Notice is hereby given that: ` OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. R Da wner's Name Q:forms:homeafdav The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations 600 )Washington.Street, 7`h Floor Boston,Mass. 02111 Workers'Com ens on Insurance.Affidavit:Building/Plumbing/Electrical Contractors- name: address: 42 Q"::tL-.S b,,Z:]aa AC 9-, City t state- - zi G O hone,# — work site location(full address): I am a homeowner performing all work myself. Project Type: ❑New Construction[]Remodel I am a sole proprietor and have no one workin m an capacity. l Building Addition I.. p�'am. y '�,gyµ� (.y.�};•� n'11. •',' �iJ` a♦♦,,mmr} }P ar. �,pt• r,{� �•rar•,• p v�y Q-,r+..�.•q�[y�x" rf.Yt .Y' n'r. u' x• v.�,r. �i:7'- '1! •::f^'•S�'•'-.� *w� .Z'•?i•.:i.. t.0 rr':`•`.+ .�` •: 7✓R' r ••.� 'a' A [i S4"�. / �p �.•..\�e'.. L.'vr•:}:'A'A.G <..i,'•�[iu{ I am,an employer providing workers'compensation for my employees working on this job. company name: address:' city phone#• insurance co. DOUCY ss•rt�i'a•;3ino6'�k::�7 �dr�5r�d�+;u',ba+7E icyda;SS: is.4°�D;ca.+x�e-g�"`„cast'•� �t%�:3ti1'F�si3;��:ri:��:W:�a�k?!�`_�'.[3�u�4;1"y�yL<:[:4G#'•'orb".,cfsc;;r:ii#:�'J�E�-:•SiiFic `�'9:�efiu's`'•'�i�a'. " .. ❑ 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 name., address- city: phone#: insurance co olic # '`s�i'�M%-.�", '.:�.;:5�'r`�:�r :t'�ic'X,�k:'=:�,�i1�% .. . ... .Pa5:d�,'�;,£:'i?'�t` %t"%•3t"�,`��,,i�•sv'r.r,c��dw`•i-f�":.f..'''�.`.',:i.{r'•,: .�.. ���..r-„ „ K:, ,..r•••r^:' < °ra;';-ar•� . �A. d:«t.' �+. .+.�•�:aF•i°8 ��.c.r4•' /rJ":i d:.•. .r-r'�,. 'company name: address: city phone#•. insurance co. I)olicy# AFMMi~L"MM..t� y€ssa :&a sJe1[a� P �62r 'r ' iit^:." ka ice,..a.t Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1;500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a• copy of this statement maybe forwarded to the Office of investigations of the DIA for coverage verification. ' I do hereby certify u der the pains and penalties of per'u hat the information provided above is true and correct Sign Date �rint nam Phone# .:5A official use only do not write in this area to be completed by city or town official city or town: permit/llcense# ❑Building Department CILicensing ❑ oard check if immediate response is required ❑Selectmen'Bs Office ❑Health Department contact person:' phone#; ❑Other. (reviscd Sept 2003) t Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all-employers to provide workers' compensation fot their . employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. . An employer is defined as an individual,partnership,association,corporation or other legal'entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds. or building appurtenant thereto shall not because of such employment be deemed-to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance,requirements of this chapter have been presented to the contracting authority. 4, } . F .d .(rr .,J 5• qq((�' � 5 J 5'hi3�. NaY �I^'�:`)!+ Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law." or if you are required to obtain a workers' compensation policy,please call the Department at the number listed.below. 1. e�P1P' BY �.w:.I,wE••.••,S �ir''!r, e. .s �fv �".x;� Mi' w•,pt„�s:.. -�.' .'i, .'.'�wrej,iK•.iJll 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 give us a call. !•!' " at x�i _ •r .,�. .vi ''if- .ti- r}` +�`, 7�s�;: a-.. .!{i,� r p:=T;t•v ns j , .(S 5S 1 D•. �f !. p a L $. 1. Fn' •,. o .S,�aF. �.'• 5'I6Y Y?St7b. �. _i9' h2ii4TR• wY7':?.igliG '4 `.t: Tf"�.t+�%r..: .The Department's address,telephone and fax number: The Commonwealth Of Massachusetts- . Department of Industrial Accidents Office of Investigations 600 Washington Street,7'h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)7274900 ext.406 . t r oft � Town of Barnstable Regulatory Services Thomas F.Geiler,Director � "AM e A�m� Building Division RFD MA'1 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: 5 c number I street village 1 "HOMEOWNER d o _ j— 5� 8— 5-3 1 I name Q home phone# work phone# CURRENT MAUING ADDRESS: 1 D &K Io1S J� -�Q� �.L� ��A• U2.6o�-1a.55 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 suyervisor. 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and Qrequirements. / afore of H er 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 fomi/certification for use in your community. Q:for_ms:homeexempt i MA QZGJO 1 � F�zO� v\EvJ . L.XL`.• CG�ti'ITS EVP-Q4 -s �h; as S Fr: zxc,.iir CEvrs . V�.orC. `oO-JJt-A s E' w¢c�l FP.S/ \.....,.: .__ ct�T � f-ix�i��M' TC-N O��z� CCpAQ 5w�►�csLriS`; i! `li' vD I. i i • 6 , it t i I 7 44 42. 40 131 .00 LOT 43 0 45 0 o_- 41 Lo u i r NO. 87 3S( Lu Gaf- a a 131 .00 BISHOPS. TERRACE MORTGAGE LOAN INSPECTION MLI976 SAGAMORE SURVEY ASSOCIATES SCALE: 1 .IN.= 30 FT. P.O. BOX 28 DATE: EPTEMBER , 199 y4µ�F�4s�ti SAGAMORE BEACH, MA. 02562 THOh9Ass9��G (508) 888 8667 C. m I CERTIFY TO CITIZENS MORTGAGE CORPORATION PONT13RIAND THAT THE LOCATION OF THE BUILDING SHOWN HEREON CONFORMS Nc.34314 TO THE ZONING OF THE TOWN OF . BARNSTABLE (HYANNIS) 'eRoFESSlo`'Pv I CERTIFY THAT LOCUS DOES NOT LIE WITHIN THE FLOOD HAZARD 4�,o�uAv��oP ZONE AS DELINIATED ON MAP 0005C COMMUNITY NO. 250001 PLAN REFERENCE: BARNSTABLE REGISTRY OF DEEDS REGISTRY OWNER: BOOK/PAGE: L.C. NO...25306-8, SH. 3 LOT NO.: 43 PLAN BY: BUYER: DATED: THIS INSPECTION. NOT MADE FROM AN" INSTRUMENT SURVE,YaAND IS NOT TO BE USED FOR FENCES, HEDGES OR TO ESTABLISH LOT LINES. FOR USE OF BANK ONLY. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map .1-S 1 Parcel 273 Permit# a ,41 S °� Health Division , � �LyL � ? 0 B�'=`�`'f�'&te Issued L& ,o Conservation Division 2001 APR 16 Aid j 1;Application Fee � Tax Collector (7f7� �J - t��- yMe/0 Permit Fee Treasurer C2 M L 3 � 5i0N Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address g f7 1;3 Village 14M&,o nt S Owner CUv�lam/ 1 12-r-A1 Address �`7 a 15, Ana" —I Telephone -7 7 s'- ?i-711 Permit Request .1 rn srA-tf on e, w yo o Aj rQ�f / v, k Are., - 10 57 i( 40r/Je 1' (Q-Ce-1-1e--T � +fl�ti L.J &V ) i r rJ/ace Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new \ Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes VNo On Old King's Highway: ❑Yes ®<O Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other o 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 0 Heat Type and Fuel: ❑Gas Cl Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing 0 new size Barn:❑existing ❑new size Attached garage:Cl existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial ❑Yes Cl No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name CPC i22 %. �✓ne_ �w►r�roJt-mC -Telephone Number. Li 2e Address 1& +5' AJ Ewe LvAJ �"t�, License# c-4 S 037 7 a 3 Z Home Improvement Contractor# l bo-7` o �ue�ral �►�S�rr�,c-e �o c Worker's Compensation# 0-AtA)01 c>1 ® 4 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO yprg-vno,�,-ra LAo SIGNATURE DATE • FOR OFFICIAL USE ONLY ,r e '^ F PERMIT NO. DATE ISSUED - y MAP/PARCEL NO. ADDRESS - VILLAGE OWNER DATE OF INSPECTION: r FOUNDATION /;t FRAME - r - INSULATION _ FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 ' `'139 �O�D y C INC • ,l b `V SPECIF', AGE 1 OF 3 CAPIZZI OME IMPROVEMENT - PRO OSAL► Established 1976 , Serving the Cape for 26 Years Registration #100740 1645 Newtown Road ��� �7y7j �/8��(�� -/L`�/�%3 !vZ✓ 3l3/f03 Cotuit , Massachusetts 02635 508-428-9518 1-800-262-5060 Fax 508-428-1547 Date: Name: C\f e.�� ►�� 0 Job Address : Address : Town: S ►� ►''`'� City: �-7 t ^'Ska1 S j CCU I .Home Phone: 'c N�'J-'5 M I Other Phone: ' PUPS /zSS, r�n�S I 800 2tr`7-`7/b3 Estimator: Yr\ tip' 2 Job No. : We hereby submit specifications and estimates to furnish and install J— roof window as follows: a. Strip exterior roofing as needed. b. Cut opening and frame for window size. C. Install window. d. Install Ice & Water Shield around full perimeter of window and onto curbing. e. Install flashing system. f . Install shingle. g. Install insulation around full perimeter of unit(+/) with fiberglass batt and replace any disturbed insulation. h. Repair , replace and install sheetrock around window well and frame as needed to complete installation , ready for painting. Including metal corner bead on edges of wel I . Note: Finish painting not included . Note: Not including any electrical or plumbing work. Choice of : - Velux # I CXI— Roof Windows) LABOR & MATERIALS $ OR Velux # Skylight(s) LABOR & MATERIALS $ Location of window(s) : Existing 'roof and ceiling style: Is skylight reachable by hand or is a ole needed? 5 _ OPTION : Furnish and .install new clear pine trim around well and casing of unit . k LABOR & MATERIALS $ ACCEPTED BY DATE -,2�-D-� THIS PAGE IS PART OF ANE IN CON ORMANCE WITH PROPOSAL # r �0*1ME,, Town of Barnstable Regulatory Services BAMSMLA NAM Thomas F.Geller,Director 9`bprfp�;.tA`�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other� L ns?�� Gh� requirements. Tlus fi7•►ri Dam s�y/.jl►.T- �,,, ,Cj•kf�en. �cf �� MEN 6b wi.t� r..d i n ®f�`+�4 ?� Type.of Work: �r r S:� Estimated Cost 7 Y,, Address of Work: 817 9>.r5,A4P. 'TEk xe Owner's Name: Ue-1 L,.cJ 6—AD Date of Application: L/b, 6 3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME RATROVEMENT 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 o e owner: /!o �76 D to Contract - Registration No. OR Date Owner's Name r �4\ ��Q �00!)NlrOlrtlMa.U/b O��/N.Q�tUAt� , t' Board or Building Regulatlons and Standards HO E IMPROVEMENT CONTRACTOR Registration: 100740 v� Expiration: 6/23/2004 Type: Private Corporation , CAPIZZI HOME IMPROVEMENT, I Aomas Capizzi,jr. 11645 Newton Rd. Cotuit,MA 02635 Administrator j1y ✓fie VJo>rr�llroluueal/� o�./liaak>'c�ueel�e Q66 BOARD OF 13UILDING REGULATIONS License: CONSTRUCTION SUPERVISOR 5' Number: CS 057032 t �., Blrlhdalo: U9/2G/1963 Expires: 09/26/2UU3 Tr.no: 579U Restricted: 00 TI IOMAS X CAP17-Z1 JR 280 PERCIVAl-DR W BARNSTABt.E, MA 02660 Administrator . ,x. - - 7 h e Ctmitmoit health of Massachusetts 13 6 Department of Itrdustrial Accidents Atice OIIflyesUU8U0//s 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit location city L-ki'� (�l S N�� S 1 t ��1i✓. PU phone# s-3°l ► 1 am a hotheowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity I am an employer providing woikcrs' compensation for my employees working on this job. MPro Vt ,fitt.Ili` ' f insstranc U G' .. —R,�(�rG/tC� !'G11po i,y V I am a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who hu.: the following workers'compensation polices: company name: address• phone N. insuratzcro: policy N company name• �r �tIY' phone ff: InanfantYSO policy H ..Y Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to SI.500.00 and,o, one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. do he by ce nder the pains and penalties of perjure,that the information provided above is true and correct. . c_ Signature Date �7 /d [riot name i��i T lj �e ' a L ,",��� Phone# official use only do not write in this area to be completed by city or town official city or town: permit/licensc N hHuilding Department g (3Liccnsing Board F: check if immediate response is required (]Selectmen's Office OlIcalth Department y contact person: phone N; rlOther �y (.r„,d V95 PtAt ' PRODUCT DATA To assist you in your planning, these charts provide the data useful for specification and installation of your VELUX VSE. Models VSE 101 104 Vd106 L&LI108 611304 306 °\V' 308 K 601 U606 in. 21'/x 27/ 21'/2 x 38'/2' 21'/2 x 46% 2l'A x 55 30'/x 38%2 30%x 46'/ 30%x 55 44'/,x 27/ 44'/.x 46% Outside frame (wx h) mm (548 x 699) (548 x 978) (548 x 1178) (548 x 1398) (778 x 9781 (778 x 11781 (778 x 1398) (1138 x 6991 (1138 x 1178) Finished frame (wxh) in. 20%x 26/. 20Y2 x 37'1i6 2092 x 45'& 20'/2 x 53/. 299/16 x 37'h6 29%6 x 45%6 29%6 x 53'/, 43'/.x 26% 43'/.x 45A6 dimension mm (521 x667) (521 x945) (521 x 1145) (521 x 1365) (751 x945) (751 x 1145) (751 x 1365) (1111 x 667) (1111 x 1145) Rough opening for (wxh) in. 21'/2 x 28 21'/2 x 39 21'/2 x 408 21'/x 55'A 30'/2 x 39 30%2 x 46% 30%x 55'h 44'/.x 28 44'/x 462/ EDL/EDW/EDM mm 1548 x 711) (548 x 9911 (548 x 1191) (548 x 14111 (775 x 991) (775 x 11911 (775 x 1411) (1138 x 7111 (1138 x 1191) Rough opening for (wx h) in. 21'/2 x 34'/2 21'/2 x 46''A 2 VA x 54'/ 21'V2 x 63% 30%2 x 46% 30'/2 x54'/2 30h x 63'/2 44/.x 34% 44%x 54% ECX Flat Roof Curb mm (548 x877) 1548 x 1172) (548 x 1383) (548 x 1615) (775 x 1172) (775 x 13831 1775 x 1615) (1138 x 877) (1138 x 13831 Rough opening for (wxh) in. 21'/2 x 30'/. 21'/x 41% 21'/x 49'/A 21'/x 58A 30'/2 x 41% 30'/x 49% 30'h x 58i1 44%x 30'/+ 44'/.x 49% EMX Roof Curb mm (548 x768) (548 x 1051) (548 x 1254) (548 x 1477) 1775 x 10511 (775 x 1254) (775 x 1417) (1138 x 7671 (1138 x 1254) Daylight area(glass)(w x h) in. 16%x209h6 10x3V4 16'/.x39'/. 16%x48''A 25%Ax3IA 25Ax39'/. 25Ax48A 40x20"/6 40x39'/. Daylight area sq.It. 2.4 3.7 4.6 5.6 5.7 7.1 8.7 5.8 11 Ventilation area(opening) sq.It. 1.08 3.58 4.11 4.17 4.24 4.77 5.33 1.73 5.76 Net weight(with temp.glass) lbs. 39 49 56 63 61 70 80 67 94 Note:Impact VSE should be specified as Type 0099 69.The following blinds and shades are available for all sizes of the VSE: PRODUCT TESTING Blinds and Shades CODE COMPLIANCE ACCESSORY PRODUCT CODE COLOR VELUX VSE meets the general requirements of all model building codes including the Standard Building Code(SBCCI), Lightblock'Shades DMA Electric 1025-white International One and Two Family Dwelling Code, Uniform Cellular Shades FMA Electric 1040-White Building Code(ICBO), and National Building Code(BOCA). Venetian Blinds PMA Electric 9150-Eggshell White (See NES Evaluation Report NER-216.) In addition, all VELUX Awning MMA Electric 5060-Charcoal electrical components are UL/CSA approved. MODEL VSE TEST RESULTS The following flashings are available for all sizes of the VSE: AIR INFILTRATION' 1.57 psf 75 Pa Flashing Systems J25 mph) (40 km/h) EDL°Step Flashing(Roof Pilch 15°-85°) 0.17 Cfm/ft2 0.86 1/s/m' EDL Copper step Flashing WATER RESISTANCE` ZZZ 165 Additional Step Flashing Pieces 2.86 psf 140 Pa EDW"High Profile Flashing(Roof Pitch 15'-85') (33 mph)@ 5 US gal/ft'/h (53 km/h)@ 3.4I/m2/min EDM'Metal Roof Flashing(Roof Pitch 15'-85,) - No Entry No Entry ECX®Roof Curb(Roof Pitch 0'.10"l - THERMAL PERFORMANCE (Complete unit values.) EM)V"Roof Curb(Roof Peak 10'-15°1 All thermal performance SHGC,Vt values for VELUX Skylights are NFRC certified,labeled and listed in the NFRC Product ZOZ 121 Roofing Underlayment Directory;(In accordance with NFRC procedures.) @VELUX,VELUX logo,EDL,ECX are registered trademarks. GLASSr Comfort(75) ComfortPlus(74) "EDW,EDM,EMX,VSE,Comfort,ComfoftPlus,Heall3lock,LightBlock are trademarks of VELUX GROUP. Tempered,Low-E', Laminaled,Low-E', Printed in U.S.A. Argon Argon Gas-filled Gas-filled U-Factor(R-Factor) °0 40(-2,, 0) 0.41 (2.4) 4) SHGC of29 0.29 Vt 0.44 0.43 o FADING PROTECTION% GLAZING CLASSICAL UV TOTAL FADING ""( PROTECTION% PROTECTION% VELUX America Inc. AComfort(751 87% 75% 450 Old Brickyard Road ""�d y n6M's� ComfodPlus(74) 99.9% 83% f PO Box 5001 1 Greenwood, SC 29648 5001 STRUCTURAL PERFORMANCE" Phone: 1-800-888-3589 :� C U�, US DOWNWARD LOAD WIND UPLIFT Laminated, 12 75(psQ 22-96(psf) Fax: 1-864-943-2631 HealStfen Ihened I laminated, 108-182(psQ 27-A6(psQ Internet: htip://www.veluxusa.coin Tempered B O C A fe,iad in accoidnnce wiih AAMA/WOMA 1600/I.S7 2000,VOIUNIARY SI'I:CI(ICAIION rOR SKYLIGr115.Siie 606 unit lasiod aI a 15"root Pilch. V-USA-2056.1202 See.Nalionol Evaluation Servico Repo No.NER 216 mid ICBO ES Ror-1 ER 6075.Modal 02002 VELUX GROUP VSE is;DMA Hallmark cerliliod.See Hallmark Report No.426. r MISCELLANEOUS Vinyl New Construction Windows RV�/NUUSTR7ES - tx Garden Window & U Values WHOLESALE PRICING VINYL NEW CONSTRUCTION GARDEN WINDOWS Product features include: •Aluminum reinforced, fusion welded, solid vinyl frame f • 3/4 Insulating glass - Double strength glass used in top lite • Operating casement flankers I • 4 9/16" Jamb standard • 3/4" Maintenance-free vinyl sill plate .. • One white vinyl-coated wire shelf - not installed • Slim lines and virtually maintenance-free �y 3'0" x 3'0" 11246363601 3'4" x 3'4" 11246404001 " (7 Vn Note:Above units are buck sizes. For custom sizes and additional options see page 244. U-Values Clear Low E Low-E/Argon • Vicon Double Hung (Welded Sash and Frame) 0.52 0.37 0.34 • Vicon Single Hung 0.52 0.37 0.34 • Classic Double Hung (Mechanical) 0.51 0.40 0.35 • Classic Double Hung (Welded Sash) 0.51 0.39 0.35 • Classic Double Hung (Welded Sash and Frame) 0.49 0.38 0.34 • Roller- 2 Lite & 3 Lite 0.50 0.38 0.35 • Casement/Awning 0.47 0.36 0.33 • Picture Window 0.46 0.32 0.28 • Designer Shapes 0.49 0.32 0.29 Harvey Patio Door. Temp. Clear Temp. Low-E Temp.Argon • Solid Vinyl Patio Door 0.50 0.41 0.38 • Based on residential sizes • Whole window values • U-Values in accordance with NFRC - 100 - • R-Values = 1 divided by U-Value •The use of tempered Low-E glass may effect ENERGY STAR'qualification in your region. • U-Values are subject to-change without notice Not all products stocked at all locations.Call your local branch for availability. Pricing and information are subject to change without notice&may vary from region to region. For current pricing, call your local branch or visit www.harveyind.com. Effective 3/17/03 230 1611