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0026 SQUARE RIGGER LANE
/ ,r ---- _----T- _ _ __�-- -- i f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION _- Map- Parcel t, � Application Health Division Date Issued : 3 0 Conservation Division Applica ' n Fee Planning Dept. Per t Fee bate Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis �✓r' az L S Project Street Address ♦ f Y �1 Village '" / ic4-Yv M S Owner / �- Address �i -510arc- Rf"Or Du Telephone r Permit Request 'TO t-x`ry v4cF,v-, 1'ti- 13 Ae> .M P-Vu •r 1 ryGko Q o Vv�. i in 0,30✓n PC-WC9_ I-/ (boo 0-1 Square feet: 1 st floor: existing ��5�proposed 0, 2nd floor: existing'75 0 proposed O Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type Looc& Lot Size 0, 1 a( Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes J No On Old King's Highway: ❑Yes No Basement Type: 0 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.)Pr0f p6 Gz'a M0 Basement Unfinished Number of Baths: Full: existing_ new Half: existing f new 2 7 Number of Bedrooms: existing / new - WN OF Total Room Count (not including baths): existing new �- FirstFl or Room Count Heat Type and Fuel: W Gas ❑ Oil ❑ Electric ❑Other Central Air: kYes ❑ No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:`*existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - - _- - (BUILDER OR HOMEOWNER) Name I-Et-n-y w, C-6vur A K) Telephone Number _,!R29-al?0 - 5_07?R Address � �pi�.�vw ey S � License# C, ,Ti-7 CC -fo, 1 AAA- a6 3 Z Home Improvement Contractor# Email( *,❑ lit-maLki. A ( torn c-nat Worker's Compensation #WUo-570-S'o161L13--RVkG l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YMM SIGNATURE IJI III DATE `z FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED I MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION i! a FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 'I FINAL BUILDING I DATE CLOSED OUT ASSOCIATION PLAN NO. DeParh r=t qfI k&bidAcddm& ' Office of hrpcsft�gaawif. Boston,MA OMI •. wrvwa.m� dia: Warlm& Campens.a fm Insurmwe AfEd it Smade7d ers , Iufarmaf Please Prim f�e Q C0�r �' tee= ph fVw�� ` a. City/St9VziF- i-..rull IVI;q 0 Phono Are you an employer?:Checkthe appropriate btu' Type of project(reqidxed}- 1-0 I am a employer uift 4. 0 I ant a general contmetar and I ' G. New conskocEan employees(fB11 anlfot:part-fime)-* lsave hired the sub-cows 2.❑ I am a slrle psopsietm orpartner- listed amthe afitsehel sheet '/-XRemoderiug. ' and have no 1 ees Them=b-oon'tractars have P �P & ❑Demol6bn waging for me in any capadtg emPlares aadbave wodzre LNO 'comp.i ce comp_m Mn0-#- 9_.❑Building addition -1 5. We are a tmporatiflm.and its 10-❑Electoral repairs or a,dfffions- oTw=have emrised.i�ir 3_❑ 1<am.afiomeoRmerdaiug all wa� 1L0P1umbragregaissarRdditiams mym4f[No zvuarkm'oomp. right of egempf m per M L 12.El Roof repai s imsmancerequired.]i c.M,J1{4k and we lave no . emplogees.[No workers 1311_-o then caamp-msrrtance Wised.] '�.ag Bsac cied6 bos�l angst a]sc artha sec�oa be7atr�ov �e¢wa ' �•�++,,• i�oimaa�maw Pa�F #�eeam�wt7o satin&s sffidava`i dtey*RM dais zU Wa k an4&m bi E ontsi&contm=swst auttmit a 7tEW affid t" AW=xa=* C,I-7<t m b=777ast sltaehed�s7[sddi at 5i7eet SbOAFIIg ttlEr�3IQ.E:Of 117E �sd st�E Whether of IIQCtt7n5E eal esl employees.��^'L CkII:11H�--b2CE ElII�tTOf�'S,�lErffiSC�IGL'I�Ef�SI R'�'iQ�.PQ�Lf lII�7EZ . - . lam aFi eUip/apar dm�is prauiduag n<orkers'catr es�fion gasriranca for is employ er Selcev is flts pa8cp artd jab srta i��arrraakas. ' Issmsfl'�eCompany Name- Al y I , 9 P Job Mte Addre &o 82 it L A ivy. CrtglSkafel g:��yA w S dyl K� [��(0 0/ Atach a copy of the wore chmpeusatieapolicp declaration gage,(showing the poncy nmuber and e3piration date). Fame to secum coverage as tequneduader Sez ion 25A of MQ.m 152 caa lead to the imtposilion of esimmal peualti of a fine up to 51,5a0-OQ mWar ofle-gewim�mment as Well as civil peuahies ll 93e foam of a STOP WORK 4ADER and a#ram of up hs$25OM a day against the violattsr. Be advised drat a copy of tbtis shkmmt maybe forwarded to the Office of Iavesttaboms ofthe DIA for coverage vedficfffiam_ Ma hereby cgn*under ties pains Of$erk,ty ihatthe i farma€iaaprov& d abatrs is tram acid correct S+iEnatar - Matte -2 ass anly. Do nat Ivret8 in dots area to be compkIAd by cfty arfoirm gjoTdrat City or Taw= ease# ,. Issuing Auf ao-ridy(Cir�one): ; L surd of Heal& I Duffiling Dqmtment 3.QtyIrmm C[erk 4.Electrical I'uspectar S:Pk6biug Tutor &Other Coact Ferran: MOW* 6 I 1 11 i f 1 I 1 l ! ! �/: Y JI■/.�Jff ■ .a:•■it �•a■t�.- I jinn ••�.•. 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I _ , a � Town of Barnstable X t. Regulatory Services . f PIAM Richard V.Sca14 Director. : %639. Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner`Must Cofnplete.and Sign This Section If Using A Builder as Owner of the subject property' hereby authorize �e r to act on my behalf in all matters relative to work authorized by this building permit application for S (Address of, **Pool fences and alarrns are'the,responsibility of the applicant Pools , are not to be filled or utilized before fence is installed and all final . inspections are performed and accepted. r Signature of Suture of Applicant, Print Name Print Name' D to Y a SI NPOOLS _ IItMIS O n RMS:OR'NERP Q :FO Town of Barnstable Regulatory Services f oft Richard V.Scali, Director Building Division RARNIM'3 ` Paul Roma,Building Commissioner K 16,1 & 200 Main Street, Hyannis,MA 02601 Tip 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: cityRown state zip code The current exemption for"homeowners"was extended to include owner-occu ied dwellings of six units or less an p �- d to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. ( 1, " ' 1 DEFINMON 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_perrm (Section 109.1.1) r 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 Note: Three-family dwellings containing35,000 cubic feet or larger will be required to comply with the g � PY State Building Code Section 127.0 Construction Control. HOMEOWNER'S OWNE S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required . shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a.form/certification for use in your community. ALL. Mutua l AIA Mutual Insurance-Company Massadwsetts Employers Insurance Company New Hampshire Employers Insiirance Company INSURANCE COMPANIES Associated En. ployens Insurance Company NOTICE OF REINSTATEMENT OR WITHDRAWAL OF CANCELLATION Conrad Remodeling Jeff Conrad 11/15/2016 535 Phinney's Lane Centerville,AAA 02632 Effective Date of Cancellation: 111241*6 Insured: Jeff Conrad Policy Number: WCC-500-5016143-2616A Policy Term: 6/2412016. to W241201T The Notice of Cancellation which we issued on the above date is hereby withdrawn.The policy listed above remains in full force. tfyou have any.guesfians regarding this procedure, please call Pabicia Deviltr at(781)27041716. Sincerely, w RobertR.Celta Vice President-Operations Placing Office: 500-115-2 - 54 Third Avenue. P.O.Box 4070 Burlington,_MA 01803-D970•Tel:781.221.1600 W6.876.2765fax:-781.270.5599 BRIDGEWATER•BURLINGTON•CONCORD,NH•HOLYOKE•MARLBOROUGH 4aansuredbyAzodatadIrtt/ush*sofMn%?d usztis Massachusetts Department of Public Safety Board of Building Regulations and Standards - License: CS-009857 Construction Supervisor JEFFREY M CONRAD 635 PHINNEYS LN CENTERVILLE MA 02632 expiration: Commissioner 12123/2017 i T A he We' aar ejeolll o O[ice of Consumer Affairs&Husiness,Regnlatios p License or registration valid for individul use only . ME IMPROVENtENT CONTRACTOR, before the expiration date. If found return tn: e{ stratton : 12g074 Type.:- Office of Consumer Affairs and Busineit Regulation Expiration "579/2077--_. " DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 Conra&R.6,odeling7 .Jeffrey Conrad 535 PHINNEI'S;N n ENTERVIME;MA 02632 -- e �- Unif rsec etm'y:: Not alid without signature - I r Town of Barnstable *Permit# Expires 6 months from issue date �T Regulatory Services Fee 71L— ` @[ ,� i63 S s` Richard V.Scali,Director lI FD MIS Building Division AUG9 Tom Perry,CBO,Building Commissioner 1 Zo1� 200 Main Street,Hyannis,mTOWN OF 8 www.town.barnstable.ma.us AHNSTABLE Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY '�] _ 0 of Valid without Red X-Press Imprint Map/parcel Number C � J Property Address �j S9/GfC�t/� q q P.y G�/'�- �O S r ZWesidential Value of Work$ 2117 1 S Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 97 6t G/�e l3e 6( 4a'?ell Za.r-o Gp-n�.� Gym O Contractor's Name -v Telephone Number 7 7(f .SZ f' 2a5'- 5r Home Improvement Contractor License#(if applicable)��S^3 $ $ Email:SU s �. bn�GL4 I Co Construction Supervisor's License#(if applicable)/O ❑Workman's Compensation Insurance J21Chec ne: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) E2'Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\Dewllik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 3 Massachusetts Department of Public Safety MF Board of Building Regulations and Standards I License: CSSL-106081 1 Construction Supervisor Specialty EVtaENYSUSHICO 41 PINEWOOD ROAD i WEST YARMOUTH MA 02673 - f . CK j l,/�-- Expiration: Commissioner 05/0812020 1. a - Office of Consumer Affairs and Business Regulation 10 Park Plaza.- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration_ 18088 > Type: DBA 4 `? Expiration: 6/7i2018 Tr# 289241 SUS HOME IMPROVEMENT `=: EUGENY S: SASHKO 41 PINEWOOD RD. r• WEST YARMOUTH, MA 02673 Update Address and return card.Mark reason for change. SCA 1 cs 20td1-05N1 - Address Renewal Employment Lost Card ��r�iririirannrcrr�l�r.�^illri:ric�n�c((i � - ��— ° .- Office of Consumer Affairs&Bntiness Regulation License or registration valid for individual use only F before the expiration date. If found return to-. ,HOME IMPROVEMENT CONTRACTOR P Registration: '•185388 Type: Office of Consumer Affairs and Business Regulation l Expiratron 6/7/2018 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 SUS HOME IMPROVEMENT EUGENY S. SASHKO 41 PINEWOOD RD. WEST YARMOUTH,MA 02673 Undersecretary Not valid ignatum The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114 2017 www mass govAlia Workers'Compensation Insurance Affidavit:Builders/Contractors/Elects icians/Plumbers. TO BE FILED WITH THE PERNHTMG AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Evgeny Sushko Address: 41 Pinewood Rd City/State/Zip:W. Yarmouth, MA 02673 Phone#: 1-(774) 521-2054 Are you an employer?Check the appropriate box: Type of project(required): L [am a employer'with employees(fiull and/or part-time).* 7. ❑New construction2. am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑BuildDemoing II 4.❑I am a homeowner and wr71 be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I I.[]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.; 13.Woof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[�'Othei S/ /h J 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. [Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employers. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that uprOndmg workers'compensation insurance for my employees Below is the pokcy andjob site 'I- --,jWformadon. Insurance Company Name: Policy#or Self-ins.Lic.M 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 MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. . I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sigpature: � Date: Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk- 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: SUS HOME IMPROVEMENT 41 Pinewood Rd, West Yarmouth, MA 02673 Tel: (774) 521-2054 WHITE CEDAR SIDING PROPOSAL May 1, 2016 STACIE PEUGH 26 SQUARE RIGGER LANE HYANNIS, MA 02601 SUS HOME IMPROVEMENT herby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and haul Away All of the Old WOOD SIDE WALL SHINGLES FROM li SELECTED AREAS. RE Nail All plywood Sheathing as Needed. Supply and Install WHITE CEDAR CLEAR SQUARED AND RE-CUT SHINGLES. @ Average of 5" Exposure with Galvanized Staples and/or Stainless Steel Ring Shank Nails. Supply and Install TYPAR SYNTHETIC UNDERLAYMENT PAPER. Supply and Install ALUMINUM WINDOW & DOOR FLASHING. Supply and Install 1"X8'X8 White Body Guard Mounting Blocks for Accessories. Supply and Install AIR VENT SHINGLE VENT II RIDGE VENT on the Entire Main Ridge. Aluminum and Neoprene Soil Pipe Flashing. Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT------------$ 2,995.00 PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Siding Proposal and the Final payment for the Balance is Due Immediately Upon Completion. i WORK SCHEDULE: All Siding Work is Normally Scheduled for Completion Within 45 Days of Acceptance and Receipt of Deposit Providing the Materials are Available. SUS HOME IMPROVEMENT Warranties the Shingles and Labor for 10 Years. SUS HOME IMPROVEMENT Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: ACCEPTED BY: �=. � S STACIE PEUGH EVGENY SUSHKO HOMEOWNER SUS HOME IMPROVEMENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map e�9a Parcel OI Application # 7 33�) Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee �ful Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 0(0 -' t'r e Village r Owner G� e u Address Sc cti n P Telephone 0,)-b0 Permit Request 1 o u an t tt_ FS W ef�Cc. e,4 �� low k W nel Square feet: 1 st floor: existing —proposed 2nd floor: existing proposed Total new — Zoning District Flood Plain Groundwater Overlay =-- �L Project Valuation ,b16,M6 Construction Type - 3 Lot Size Grandfathered: ❑Yes )4No If yes, attach supporting documentation. Dwelling Type: Single Family Af Two Family ❑ Multi-Family (# units) Age of Existing Structure 1-5 Historic House: ❑Yes ,&No On Old. King's Highway: ❑Yes 2 -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 W/1— Central Air: ❑Yes ❑ No Fireplaces: ExistinNew Existing wood/coal stove: ❑Yes ❑ No 'Detached garage: ❑ existing ❑ new sizwPool: ❑ existing ❑ new sized Barn: ❑ existing ❑ new size" Attached garage: ❑ existing ❑ new sizeWhed: ❑ existing ❑ new size Other: ' 2 C) Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ � Commercial ❑Yes ;KNo If yes, site plan review# q Current Use y IG{r_V1 Proposed Use u - vy APPLICANT INFORMATION n / (BUILD 741y'-/ Telephone R HOMEOWNER) Name �U� U1 .17 Number �b Ste, Address 11,;2 X License # h + - 60-L GO Home Improvement Contractor# A,3 2.� Email 5 L 6"- Worker's Compensation # ALL COJTRUCTION DEBRIS RESULTI FROM THIS PROJECT WILL BETAKEN TO6�ajrz C-C SIGNATUR DATE__��'l �`�. aid/ FOR OFFICIAL USE ONLY APPLICATION# t4 DATE ISSUED MAP/PARCEL NO. k ADDRESS VILLAGE X OWNER ti DATE OF INSPECTION: FOUNDATION FRAME s INSULATION f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. QMo„SolarCit OWNER AUTHORIZATION Job#: D2( 170f " 00 Property Address: 2 �. SCe U/4 x F as'Owner of the subject property hereby authorize SO CITY CORPORATION to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner: ate: S a . SOLARCITY.COM AZRWW7741ROG2 6S5W',OC1F}.7AU,C&UCE WO4.,C f=041,GTHiC:063171$a0C1?,6td4>a i1q M117Q1A�SWECC9D?585.MU£T•2J'1TlT',MA PAC 1 $i'2/fsWFlAd3(StviR,MD M.HC 1 W48; - NJM.N 113V4Q616000QrJ4M01M?W,OR C91604G8/C58"110ZPAHK#310773",3.SXTEOL270M M=AAVDi90L00IAFC,, 5R@20v SO.AFCRYCARPORATION.ALLRIGMi3Rfa,BM. . MMti[N4tlBti 1w1lbMfttgl+H p/Pub1rG SsSet �oattl of�Erip'bep�tlltxMt+��W 3iAtt ', CS-108815 JASON PATRV 821 SMWART DRIVE Abington NA 02751 too :un.. . ;., 02J08/YO18 ti. • r 1 • �- Oftke of Couauttr AtTib!@ 0ostaas ReealrNon (, HOME RAPROVENENTCONTRACTOR � Reliftb tlon•, lam 7ype7�7 ExpImU*n: 31 =17 SUppTemiM C _ SOLARWY CORPORATION, JASON PATRV 24 ST MARTIN STREET 8L0 2UNI: �.�•--,Er I bAkMOUGK NIA 01751 Uodermrebry ! # �` r%�rf� ��n�1i��r�ic��llGU(��r'I�/a��; � f������:1:1c�C����G�/i✓1 Office of Consumer.Affairs d Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement.Contrador Registration Registration: 168572. :e Type: Supplement Card Expiration: 3/8/2017 SOLAR CITY CORPORATION CHERYL GRUENSTERN - - - -- - - 24 ST MARTIN STREET BLD 2UNIT 11 MARLBOROUGH, MA 01752 Update Address and return card.Mark reason for change. SGA 1 0 24 r ;: /f .-,,,Address .Renewal Employment r ? Lost Card C't-lililf'il#lvvr�/ f�'�Ifr! ff#ke..iti//; Mce of Consumer Affairs&Business Regulation License or registration valid for individui use only t""t OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: t " Office of Consuiner Affairs and Business Regulation -. Registration: 168572 Type: 10 park Plaza Suite 5170 Expiration: 3/8/2017 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION I {. CHERYL GRUENSTERN 3055 CLEARVIEW WAY SAN MATEO CA 40 � — -- --•-----'-- --- 2 Undersecretary -Not valid withoutsignature � j� 1 Tito Commonwealth of M wachuseits Deparmlent of Industrial Accidence wi I Congress Street,Strife IOfii Region,M4 02114 201 7 www.mas&gav1dia W arkers'Compensation Insurance Aftidmvit,Buil4udContractors/Eleett'ie6WP[ambem TO BE FILED WITH THE PERMITTING AUTHORITY. AnnllcsntInforvnat{on Plevtse Print ��Y Name(Businm lOrganizolien/ttuiividual): SularCity Corporaflon Address: SOM Muirview Way City/State/Zip: San Mateo,CA 9"(.12 Phone#: (888)765-2489 Are ymrao employer?Cheek the appropriate box: Type of project(required): L®I am a emplo v wldi 12,500 employees(full audlorpart tim).x 7. []New construction 201 am a sole proprietor or partnership and htn a no cMloyces terming for me in 8. [3 Remodoling any capacity.[No w-urkrrs'comp.instance requked.j 3.C31 asnalmmeownerdoipgall work m nnr ysctr.[Nomgskess'co .:inssssanoor'equired.l t 4 ❑Demolition 4.[]!am a Ironseowner and will be hiring contractorstracontractorsto conduct all work on my proncrtg, [will IO D Building addition - assure that all rsmitactors oidser have urorkw.'cDmpcasaiiw insurance or are sole I I.(]Mactrical repairs or additions proprietors with no otgdoyecs. t 12.0 Plumbing repairs or additions 5.[31 am a genam1,coturaetor and I have hired the sub-amlmvtom listed on the attached shcer. I3.❑Roof repairs These sub-contsuctoa have employees and have%aims'coop.assurance# 14400tlrersalarpanels 6.1J We are a corporaan and its offiom have exercisat their rightof exemption per MOL c. 152,§1(41 and we have no employees,[No workers'to".insurance r quired.l. *Any applimt dim checks box A roast also rill out the sectism below showing their workisis'compertsatiort policy ihtionualim. •l lornUm-ners tt ho suNnil this atlidavii indicKing they are doing all work and then hire outside.vase mtors must submit a new 11Cdavit iadicating susit tComettors dust chcxk thin box snug altachrd an ackritional sheet showing the name of life sub-contractors and state whether or not those entilles lave e mloyea. if the ssub-contmotors have employees,they nrust'provide their W drkcts'trump.policy number. 14m an employe'that is providing workers'compensation insurance for my agslayees. Below/s the palicy and job site fuforsnaCson. Insurance Company Name:American Zurlch Insurance Company Policy#or Self ins.Lic.#: WC0182015-00 Expiration Date. 9/1/2016 26 Square Rigger Lane Hyannis,MA 02601 Job Site Address: Ciy/StaterLip: y Attach a copy of the workers' cormpeagatioa policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to S 1,500.00 and/or one-year imprisonment,as wet as civil penalltes hi the form ofa STOP WORK ORDER and a fine of up to.S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations o f the DIA for insurance covard&e Verification. I do hereby certl unAr the purAs mid penalties of perjury that the irsforma ion provided above is True surd correct, (Jason Pa . October 27,2015 one Ofjichd use oaly. Do not write is this area,to be completer)by rlty or town offlela City or Town: Permit(License# Issuing Apthority(circle ore): 1.Board of Health 2.Banding Departmaat 3.Cityfrown Clerk 4.Electrical Inspector S.Plumbing inspector 6.Other r Contact Person: Phone#e AC RDA ` CERTIFICATE OF LIABILITY INSURANCE W170015 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(les)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may roWlTo an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT MARSH RISKS INSURANCE SERVICES PHONE p� 346 CALIFORNIA STREET,SUITE 1300 1t!!16. CALIFORNIA LICENSE NO.0437153 E-MAIL . SAN FRANCISCO,CA 94104 RR n.P .ir41;........... :..........._.._..::_.._..:_...—.—. __...._ AOtG Shannon St»tt415.743-8334 ............. _.......:...1"!k ER(S)AFFORDING COVERAGE-.... .- ..__.-,. NA of _ 9983G1-STND-GAWUE-15.16 _: _._... .INSURERa.:ZurldlAMETICan inswance Company (16535 INSURED INSURER B°WA WA _ 3065 a rvlaw y INsum C:NIA TA 3065ClearviewWay ... _..._.._-.._. San Malso,CA 94402' tNSURER D American Zun&lnsuranoe Company. - y 0142 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: SEA-00271383M REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH Im 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- IL ..- TYPE OF INSURANCE `..._ TA156LTSU' POLICY NUMBER POIIGY ETF PNOLIGY EKP LIMITS NOT' A X 'COtLAtERCIIU GENERAL LJABRITY CiL0018Z016-00 0910112016 09JOtCd016 EgCH OCCURRENCE - DAMAGE TO RENTO r iCLAIM6•M O nOCCUR PREN!..$. SP(EikW-wenSe},,; 5--....._.__._ 3,0DD,0D0 F L X SIR E250,000 I MEO EXP(Any on"rsonl.. S. 5.000 - PERSONAL R ADV INJURY S -- 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 4 �PMERALAGGREGATE $ 6,00000 X�POLICY J C �... LOC PRODUCTS-COMPIOPAGO S- OTHER. S A AUromoatmuAstuTY 1BAP01B2017.00 0910112015 109M112D16 COMBINED SIN LEUIMrr y 5000000 X ANY AUTO I R£D0.Y INJURY(Pet person) S .. .. ...... —-- X ALL OWNED X SCHEDULED BODILY INJURY(Par acddent) S .X. AUTOS AUTOS X NONO'ARaED � � (. PROPERTY DAMAGE S - HIRED AUTOS AUTOS I I i •@T.@f+Jr.01 .,_. ............. .... ._._._.... ._...._.._ COMPICOLL DED:. S $5,00p UMBRELLA LiAB EACH OCCURRENCE S - . EXCESS LIAR - CLAIMS MADE I AGGREGATE ._ ._._........_ S —-- 1 - OED RETENTIONS S D IWORKERSCOMPERSATION IWC0182014 DQ(AOS) 0910112015 1091D1Q016 X I PER OT AND _.1BTATU-T€- -_-iR„ _ _.._...._._ A YIN I/yC0182015 00 MA 09f011�15 �09 01r1016 ANY PROPRIErORIPARTNEAIEXECLMVE I , E.L.EACH ACCIDENT S 1,01i .= OFfICERRREMAEREXCLUDED7 MIA! iMandatory In NH) WC DEDUCTIBLE S500,000 E L.DISEASE-EA pMPLOY S.._....._ i'Mo'w E H ea.dasm under j RIPTION OF OPERATIONS heiaw j El DISEASE-POUCY LMArr 5 1,000 000 I � . DESCRIPTION OF OPERATIONS I LOCATIONS I VERCLES IACORD"I,AddlRsnal Remarks Scfiedm1%maybe aMachsd U moee space(a requhed) Evidence of tnwwce. CERTIFICATE HOLDER CANCELLATION SdarrAy Corporation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEo BEFORE 3055 Clearviex Way THE EXPIRATION.DATE THEREOF, NOTICE WILL BE DELIVERED IN Son Mateo,CA 99A02 ACCORDANCE IAfITH THE POLICY PROVISIONS. AUTHORIZED REPREWATATI149 of Marsh Risk&IAsurance Services Charles Marmolejo 01080-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD /o- z 3CD(01T Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee ,'� • BAMSTABM '""M Thomas F.Geiler,Director i639. ♦� ArED��h Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 3k (-j,, L Not Valid without Red X-Press Imprint Map/parcel Numbei;? Property Address Ki Q,<%10—C �61, bllclnli ❑Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address e i L Contractor's Name Uicl, C Telephone Number 7n 7 22 0.) '2 Z Home Improvement Contractor License#(if applicable)_ 'a 3 �L, Email: Construction Supervisor's License#(if applicable) ❑Workn's op ensation Insurance Ittis PEFIAR8 E one: afm sole proprietor O C T 2 — 2013 am the Homeowner am Worker's Compensation Insurance Insurance Company Name TOWN OF 13AIINSTA13LE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ t(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to opin/A-�,_ L , ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side , ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is requir SIGNATURE: ii z Q0,TFILESTORM \building permit forms\EXWSS.doc Revised 060513 Email® The Commonwea h ofMassachusetts DDewftne et of Indmstrial Accidents Office ofl'mntgatians IF .600 Washington Street Boston,MA 02111 wnwa nasmgoWdia Workers' Compensation lusarance Affidavit:Builders/Contractors/Flectricians/Rambers Applicant Information Please Print Legibly i Name Musinessorganizafionf.h&vidmo: n f P-a 12G✓i Ad&m. : 71 8-a 1^i(l2 �d City/Stat&Zip: Phone#: 7Z2- o512 2 Are you an employer?Check the appropriate bope, T of project r 4_ am a contractor and I JIB �] (required): I_❑ I am a employer with l 6_ ❑Nett construction employees(full andlorpart4ime).* have hired the subcontractors 2:❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-oontractors 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..❑Electrical repairs or additions. required] officers hnvae exercised their 11_. P1 airs or additions, 3_❑ I am a homeowner doing all work g repairs myself [No workers'comp- right.of exemption per IViGL 12_. -L�f�of repairs insurance ]y c.152,§1(4),and weha%mno employees'-[No work' 13.❑Other comp-inm=ce required.]; *Any appH that checks boa#1=w also f M out the sectioa below shawmg rhea wad me comva=don policy infnrmz&m fi Homeaw cm who submit this affidavit m cstmg thiey use doing all mut smd then hue ouwd a contactors—st submit a new affidscit iadirstm srarh_ TCbnizactors that check this bac mast attached as additinual shfet showing the name of the sub-cam raoWn and state whether arim these eriities have employees. If the snb-cont;actors have employees,they most provide thew warkers'comp-policy number lam an employer that is prm�WRg ii orkets'compenmuion irtsura, me for my angWayees Bellow is thepadicy and job site information. Insurance Company Name: Policy 9 or Self-ins.Lic_#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcrimiaal 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 cerhfy under the pains d panadtiss a that the informationprotrided above is tnte and correct Si tare: Date: 40, — 3 Phone#: Z �� OREciad use only. Do not write in this area,to be completed by city or town offtciat City or Town: PermitUcense# Issuing Authority(tdrele one): 1.Board of Health 2.Building Department 3.City1rojwn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 f Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuautto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or-on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and;if necessary,supply sub-contractor(s)name(s),address(es)and hone numbers along with their certificates of P ( ) g ( ) 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 insu=ce 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 lime. 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 permitAicease number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is oa file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture _ (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would lice 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 1ndustcial Accidents Office of investigations 600 Washingtort Street Boston,IAA.02111 TeI.A 617-727-4900 ext 406 or 1-977-MASSAFE Revised 4-24-07 Fax# 617-727-7749 - www.mass_gov/dia ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE(MNWDYYYY) O1/24/2013 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: Joanne Bretton Southeastern Insurance Agency, Inc. Hcc0NoExI; 508-775-5154 a No.508-790-0557 641 Main Street - EMAIL - - ADDRESS: Hyannis, MA 02601 PRODUCER INSURER(S)AFFORDING COVERAGE NAIC 9 INSURED INSURER A: Arbella Mutual Ins Co - 17000 All Cape Exterior Remodeling LLC INSURERB: AEIC Insurance INSURER C: - 67 SEA STREET APT A4 INSURER D: Hyannis, MA 02601 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2013 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 UBR POLICY EFF POLICY EXP LTR INSR VWD POLICY NUMBER MM/DL(MMfDDNYM LIMBS GENERAL LIABILITY 8500041933 01/14/2013 01/14/2014 EACH OCCURRENCE $ 1,000 i 00 - X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,00( PREMISES occurrence CLAIMS-MADE �OCCUR - MED EXP(Any one person) $ 5,00 A PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00( fi POLICY ET LOC - 9 - - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS - BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS ' (Per accident) $, I a - NON-0WNEDAUTOS $ $ - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE - $ - RETENTION $ - $ RKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN WCC500789601201 01/14/2013 01/14/2014 X TORVLIMTI`rls ER ANY B OFFICER/MEMBER/PEXCLUDED ARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ 1,000,00 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 19000,000 If yes,describe under DESCRIPTION OF OPERATIONS below OWNER INCLUDE - E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule;If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE di play purposes only Joanne'Bretton ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009/09) The ACORD name and logo are registered marks of ACORD r. 1 ACORP. AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Southeastern Insurance Agency, Inc. All Cape Exterior Remodeling LLC POLICY NUMBER 67 SEA STREET APT A4 Hyannis, MA 02601 CARRIER NAIL CODE '.EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORMTITLE: ACORD Certificate of Liability Insurance Garage Liability - INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD - POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDDNY) LIMITS AUTO ONLY-FA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTOONLY: AGG $ Automobile Liability INSR ADD'L - - POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDD/YY) Excess/Umbrella Liability INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD POLICY NUMBER DATE(MMIDD/YY) DATE(MMIDDIYY) LIMITS I Other Liability INSR POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDDIYY) LIMITS 9 ACORD 101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD J Massachusetts Department of Pubifc Safety Board of Building Regulations and Standards Construction SI'Ven isor SjrrcialtA License-_GSSL''-10595Lr PATRICK CLIFFq, 1`` 12 DALDW IN ROAD I?. = . Dennis —0263� ?9 je `.. `�. . mw Expiration` 1,•�-� 66102J206. COMMissioner, 2 r. ` , I License or registration valid for indivrdul use only ((�ar�vrradrzcoe�ilf� before the expiration date If found;return to: Office of ConsumerAflairs&BUs1 ess�egulation Office of Consumer Affa�rs,and Business Regulation';'` l' �. ' OME IMPROVEMEN7:CON:TRACTOR' 10.Park Playa-Suite 5170 egistration Boston;MA 02116 �' ^t9` - Type 4 ; xpirat►pn - 9/1'U20M4; DBA t UREY AND COREY,CONSTRU�TION All PATRICK CLIFFOR V 1 { ;12jBALDWIN RD r 1 Not valid witho signature 81\1 NIS,.MA 02638 '� . " r secret Under ary* j e ' COR, EY & COREy CONSTRUCTION 1672 FALMOUTH RD-#117, CENTERVILLE, MA 02632 PHONE -508 -775-8240 CE.RTAINTEED LANDMARK LIFETIME ALGAE RESISTANT ARC;HITECTU'RAL. STYLE: PARTIAL. R.E - ROOFING PROPOSAL September 20,2013 STACIE PEUGH 26 SQUARE RIGGER LANE EM: sapeugh@aol.com HYANNIS,MA Tel: 508-558-8673 COREY & COREY hereby propose to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and Haul Away All of the Old Asphalt Roofing Shingles Except the Lower Rear Porch. Supply and Install CERTAINTEED LANDMARK : LIFETIME WARRANTY, 10 YEAR SURE START PROTECTION,CLASS A FIRE RATED,COPPER/CERAMIC STONES for a FULL15 YEAR WARRANTY AGAINST ALGAE CONTAMINENT,240 POUND,EXTRA HEAVY WEIGHT, 130 MPH WIND WARRANTY,CATEGORY III HURRICANE,STORM/HURICANE NAILED (6 NAILS PER SHINGLE), MULTI-LAYERED,LAMINATED ARCHITECTURAL STYLE,FIBERGLASS BASED ASPHALT SHINGLES. COLOR:"`�� MOIRE BIJ`ACK��• & Supply and Install CERTAINTEED WINTER-GUARD(Ice&Water Shield)WATERPROOF UNDERLAYMENT SYSTEM on Roof Eaves,Valleys,Under the Step Flashing on the Skylights,Chimney,Gable Walls and 100% Total Coverage on the Entire Rear Second Floor. Supply and Install 415-BLACK SATURATED FELT ROOFING PAPER . Supply and Install AIR VENT SHINGLE VENT H RIDGE VENT on All Four Main Ridges. Supply and Install ALUMINUM&NEOPRENE SOIL PIPE FLASHING Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT ------------- $ 7225.00 V ~ COREY &' ,COREY. ,. CONSTRUCTION POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing,Side Walling or Any Other Carpentry Needing Replacement' < will be done and charged for as an Extra: Materials Plus Labor at the Rate of S 80.00 per Hour. PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. _ WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 45 Days of Acceptance and Receipt of Deposit providing the Materials are Available. • ; Please Make`Checks Payable to: -.COREY'& COREY COREY & COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and.the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a CATEGORY III HURRICANE-130 MPH WIND WARRANT. CERTAINTEED Warrants the Shingles to be Algae Resistant for a Full 10 Years. COREYw& COREY carries Workman's Compensatioon and Public Liability Insurance on the above work DATE OF ACCEPTANCE: �� 3 ACCEPTED BY: ' SUBMITTED BY: STACI + EUG] - CHARLES CO Y, C SULTANT HOMEOWNER COREY & CO NSTRUCTION _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2. 2 Parcel 60 — Permit# Health Division . ml� " �� � � Date Issued Conservation Division �Ji �/` 161 Fee o�_9°0 �-- Tax Collectorfp(Ip/ /P . Treasurer /, r ►,�- 1AMICAR MUST oaTAM A.SEWER F { CON'"ECTION PERMIT FROM THE Planning Dept. iNurXzERING'DIVISION PRIOR T 'Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis .ram �o F 112 Project Street Address � � 4 v W�� R ,��- L Wvw\, Village An rraauy 'HI"M Owner tMv%-s A C)fZ v nyo-rj S Address oZCc Sgc:twy-e oo , L.WwV-,. 4 Telephone L,^- Permit Request �e�,p Je )e 0 ?9 13-L X aR-6 % l.y C-�h W l 3, � X l S-� � oo f=�7 i4wal Sc�e.e�e� ►��e.� O� \►'A-� yy E_�w rJ�cK Square feet: 1 st floor: existing O proposed -- 2nd floor: existing 40 5-D proposed — Total new Valuation 912 —' Zoning District Flood Plain Groundwater Overlay Construction Type Vv 000 1=t A"F Lot Size�,, 3 'j Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family %L Two Family 0 Multi-Family(#units) Age of Existing Structure // Historic House: ❑Yes No On Old King's Highway: ❑Yes JQ No Basement Type: AFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) — Basement Unfinished Area(sq.ft) I D 32 Number of Baths: Full: existing _new Half: existing - new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: $J Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes J(No Fireplaces: Existing ( New Existing wood/coal stove: ❑Yes No Detached garage: ❑existing ❑new size Pool: 0 existing ❑new size Barn:0 existing ❑new size —' Attached garage:0 existing 0 new size Shed:0 existing 0 new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ , l Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use - -d a� . BUILDER INFORMATION Name 3E.EE Goyvi,wrJ Telephone Number _P a PO ., Psi 7 9 Address_/D 1-n r License# CZ 6 091 V S 7 k/ wvv w 5 M/9- Home Improvement Contractor# 1 oZ 1-1 O 7L.1 Worker's Compensation# L-1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO \/J4"f'M0 04t 7r AwS P,-.r SIGNATURE DATE �� r FOR OFFICIAL USE ONLY PERMIT NCf'k DATE ISSUED MAP/PARCEL NO: ADDRESS> VILLAGE OWNER'' - y DATE OF INSPECTION FOUNDATION L-) b) 3 ' FRAME" r INSULATION y FIREPLACE - r ELECTRICAL: ROUGH F FINAL PLUMBING: ROUGH ;" FINAL a GAS: ROUGH '= FINAL FINAL BUILDING , = DATE CLOSED:OUT r "_ ASSOCIATION.PLAN NO. "s ° The Town of Barnstable 9="M g Regulatory Services 1659• }`° Thomas F. Geiler, Director QED MP'� Building Division Elbert Ulshoeffer, Building Commissioner 367 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 requirements. * � Go; era cr ew A� Estimated Cost- Type of Work: ;L D t..? Address of Work:A(v 5`u�►,re-R�`-��erI-.`a�"� �y)4ww g V WV Owner's Name: M P L r/��rS n Date of Application:_ 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 DO OT VE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT 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 owne}: g C1011 ..J(ll lG* z o7 D to Contractor Name Registration No. OR Date Owner's Name q:fbnns:Affidav The Commonwealth of Massachusetts _ = - Department of Industrial Accidents == Office Of/OYBSt/g8�%OiiS = t 600 Washington Sheet 'Boston,Mass. 02111 J=�} Workers' Compensation Insurance Affidavit name 7,C '� location f7 O LV — S �� city /T\-�4,oi YV L 5 yhone#�2E-2 O F'72 ❑ I am a homeowner performing all work myself. lain a sole r %r and have no tor one worku anv capacity in %//%% %%%/%%%%%%%%%%%/%%%%%%%%//%%%%/%%/%/%%%%%%/G%%%%%/O�%%%/%%%%%%//%%/�%//O%%%%%%%%%%�%%%%%/�O%%/ ❑ I am an employer providing workers' compensation for my employees working on this fob coat`an name:;: address:.. :;.. ..: ff ci 'hone# oltcv instirance co' > ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have orkers' compensation polices: w ........the following ,. ... P ,..; com an:.name:. ;: ..:... ....... addressz ...................:::.:::::::.:.::::......... . ci ............ c an .name:: : ......:.::.:..::::.:.:::. :address. _. one'# ......... <'>:;S i.'` iS v';i:,'::!Y?%`;i:.S .... ;%;:::.;%; :. oli W. gaibae to aecare coverage as required ender Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment a'wells,dvfi 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 may be fot�arded to the Office of Investigations of the DIA for coverage verification. I do hereby certify the pains and pe es of p 'ury that the information provided above is true and correct Date A Signature ' Print name /YI CD VU V:SI`O Phone# s70 f� official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑Selectmen's Office ❑dneckif immediate response is required ❑Health Department contact person: phone#; - ❑Other (fevieed 9/95 PJtu Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any 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. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers.along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is not the D artmeent of Industrial Accidents. Should you have any questions regarding the"law"or if you being eP emg requested, 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 re,bvr id 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. �%%%///�///%//// 'The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents office of Imlesdoadens 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 FEE VALUE WORKSHEET LIVING SPACE (2000 sq ft or greater) square feet x$115/sq.foot.= (less than 2000 sq ft) square feet x$96/sq.foot= (affordable housing) square feet x$57/sq.foot= (4013 or low income) GARAGE(UNFINISHED) square feet x$25/sq.foot= PORCH square feet x$20/sq.foot= DECK 77 square feet x$15/sq.foot ALTERATIONS/RENOVATIONS �r OF EXISTING SPACE !�'t�7. cost 5. . . . . . . . . . . 7 n s 1�voF -i- SG 36a Total Project Fee Value Office Use Only Permit Fee projcost 7. 4isid<�`Mw1r�.e.=•+... ;J�t@�0977A1µf07tUI85 0 �/�.eae�aelta BOARD:'OF BUIt,DtNG REGt1tATtOfI�S �• Lkensi CONSTRt=OK''St)VEfLV" F Humber. GS 009867 :..{ Rj Y Birfifda�s: 42/23l4956 EXOr-es i2/23=1'-, Tr 13457 Reatrf d'T r00 a �dEFFRE �,�iD w # rFtYANNIS0260t gdrtirtator ✓fie i�Jairr�inoaizu�ec��e o�✓�aoaac�u�4eQ� E Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR. r Registration:: 124074 Expiration:.M/09/2003 $Type:°'DBA " Conrad Remodeling Jeffrey Conrad 10 Locust St f Hyannis,MA 02601 �`� � ' Administrator ''X°�!' ;'1.t�►`�w�+=�.�++�ryw►.� . .� .: . �� .. -"' � t7�1i`'P���' trc�+P` :�.t`�`�nt�`rv. O,THE>, TOWN OF BARNSTABLE 32476 � .Permit No. . BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING Yl '9 bso• HYANNIS.MASS.02601 Bond X..� CERTIFICATE OF USE AND OCCUPANCY Issued to Capricorn Realty Trust Address Lot #112, 26 Square Rigger Lane Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 18, 19 89 .� ......... ilding Inspector r . a'fy��•'. TOWN OF BARNSTABLE BUILDING DEPARTMENT _ »°T ' TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 �o rn�►. MEMO TO: Town Clerk FROM: Building Department DATE: /��0�" �• k. i s A. An Occupancy Permit has been issued for the building authorised by r BuildingPermit $k.... . ._-�. ' ........................................................_._. �? ........... ..._...... ......... ..». ... issued to 11 /�/ &' / /�....._!�:................... /�..vQ.. -� .� ...`r-�� .�- �, / Please release the performance bond. ,=?r••s r.T+'1[,*"a r ^,:. c�y-� " '"" ` a ;i,jb:sa...><S�A•r° �r- 9*n Sti>.:*��s-'•c� s7:P� IP VRN.STABLE, MAS5ACHUSETT�Sr � y � " S ! sJtwn-aaa+• as r �+rr. w `, ,.r•. 'r'Fs+ .9 �// Dcccinbe 1 "d ' ' P4 OATE g y ,a PERMIT Fraiacc� R L'• Sh �W( APPLICANT` UE ADDRESS 7 b�' },s::�ISlf3L1��I� �Oc1�1 1�i71�111 wO 0;Y9 fr •{ .. (NO.) (STREET) s r• .Ji.sul.ld 1J�7(iL.l.•L ll�.-Y r 1 _ - y r• ,-I (CONTR 5 LICEN9E) k1 t, PERMIT TO ( 1 I:.STORY �—n( �C� �� �!n� lYEC}NUMBER OF r � Y µ ri :•. � ���'� DWELLING UNITS rL ,•,*�... .;yi ;..n TYPE OF,IMPROVEMENT) (PROPOSED USE) i! ALOCATION) 4r itl G'� $d>?G �C�1L$ �? FZ .r;gui. LEti1E3( �1N0 ) (STREET) ` +5r _slv t r }qk " r F 4rla q j a trey BETWyEN Arm- g 1 yA.F z c KANDy Y 3 t nt vat i - i f l i ✓ -C` C 4 -.(CR OSS STREET)) ;s}+ _ .y[2z rrt c'Ss A i I +'> 'T I , aI S.UBD I V I S I OWILI 3 � yl trrtixf• LOT ` BLOCK r`'_ }xrswLOT•4 a kr aapa t ^+ °ft 1 r+ '°ti Y y i %, 11 _ .dF„r,r,,,s A ,;,,, C�• L 5 .,I'•,3.s+7` t .t �T S I Z E• ILD�NG'IS TO BE r ° FT: WIDE BY � t FT.'L NG BY a #k��i} h t i ^ UCT I( i f. +� �d: tT'� O T IN HEIGHT •AND:SFIALL CONFORM IN,CONSTR Vit ;ts- c Mt r? a ta:c fit 4 ;F � r J. 5 �' 3` •y YPE USE GROUP :r BASEMENT WALLS OR FOUNDATION riIRt -- a` s":wa(1(;:. d7`� {^ TWA r3 a (TYPE v. EMARKS t+• a."i �rsE,,,,��a�y��,� ���`"'Ctf� x.,' 1:'kj + SC,r,i i , 4 a„k a ., •.,_ y�ta1 •.I rc;�kai!f�^�rYu.fir,. ':' �, �.t`A 't;`')1 � � ° d 4 r...r 6�.�'��p�' y.X'"�� t,�• ' u♦• a t t K�+ , i� try•• 74 :-� +� , Auf 9 �t v r ' ��Y I�c �A+w�'.V•S l� i.'M 4 i G.;Y`r � A t 51i � �,t s� 1�i'I�tJ ! , �: yG * .�.�,t :. Y� ti, '} ) '#• 'rG! r 7 + < t s' �S(.>1 lU r�Yk , AREA OR ".•.!-".' V o .;�.�'".,e lat 1tk > VOLUME t 50100.00. LTO �X � PERMIT ESTIMATED COST /.. 1 (C,USIC/SO DARE FEET) c ,-t� n E ri h SIT E �. W ,c •.. � 3 + „ a r xc, ro v+a+e G d 1 E++•f+J`L.�. T)f.:, 1 l 1'iY,2• r.. "di 3i't' .t} L fit=!•;`�l'' SK OWNER r +.11[iuLlL l Gc1 " / txlitl BUILDING DE A 1qq"L t �'65 `p l _ ••i Y�`'I„A d;.3 Cr h'...' E h r i /°Agd E,.Fyn 1 ) tr 3( sp7HIS 'PERMIT tpNVEY51N0 RIGHT .TO OCCUPY ANY STREET, ALLEY OR SIDEWALKOR":ANY PART;THEREOR EIT,MER TEMPORARI C j PERM AN ENTLY'••ENCROACHMENTS ON PUBLIC- PROPERTY, NOT SPECIFICALLY PERMITTED'UNDER THE'•BUILDING"COD E, MUST,BE'`"AI yy p yPROVED?BY"TF1E-JURISDICTION. STREET ORIALLEY GRADES AS WELL AS DEPTH'AND LOCATION OF PUBLIC'SEWERS MAY BE,OBTAINE t.I �InFROM THE DEPARTMLNT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DO �RELEAE,�T,HE APPLICANT-FROM THE CONDIT,IOP 1s p �O�FtANY16,A?LICABLE SUBDIVISION RESTRICT NS. zJ! g�eINSMiN ECTI OF-`REQ IR CALL NS MUST BE RET.AINE ft•,. O; NO THIS WHER CA«BLE•.SEPARATE Ts' INSPECTIONS'REQUIRED FOR'. 'a'' 7 BALL-CO STRUCTION WORKt ' rNA E ED UNTIL FINAL INSIDE ' S BEEN 'PERMI '.'REQUIRED,',FOR ELEC ,LUMBIN6 AND,:, �• aC r •S 1 ,F,O.dNDATIONS OR FOOTINGS. ERTIFICATE OF OC�CU, ' Y IS RE- ME CH `t LATIONS.^ qTI S i� 2 PRIOR TO.00VERING STRUCTUUC DING SHALL NOT BE?OGIGU IED UNTIL ✓} t � F «MINAL RS INSPECTION TO BEFORE IDE HAS BEEN MADE y "�'',}7• ��IC•I r�r"�•+� j 9�FINAL INSPECTION BEFORE t' < r' .3 14OCCUPANCY.w Se' w� ti4 r i lma BOO U4 0s BUILDING INSPECTION APPRO i yq rl PLUMBING INSPECTION APPROVALS ELECTRICA ION APPROVALS ;'.?•, vi t Z r -« . � 1 n Ira° F 2 9 j fin, INSPECTIkV a t x ti� f l OTHER 2 BOARD 0'HEALTH {fit F�'��,r'4,� .�«•W ♦ f ,r�.t'�'S,,�Y`dl'� •, [$ +.5kt °gy2'x �^a• � i f;'. . . .'t ..':y, - y'• r '•yrpi'in »''�MvSy �`M�t•.1.1 `Jt � r � 4�5.41j.IJFT`YSY r..,.,'!•.:i :S N x t 4'{'fYdj WORK SHALL NOT PROCEED UNTIL THE INSPEC• �?E RM I T WILL BECOME NULL AND V01 D I F,CONSTRUCT 10 jJ INSPECTIONS INDICATED ON THISrCARD CAN .,,,TOR HAS APPROVED THE VARIODUS STAGES OF 'WORK IS NOT STARTED WITHIN SIX M0. S OF DATE THE CONSTRUCTION ARRANGED FOR BY TELEPHONEIOR WRITS PERMIT IS ISSUED AS NOTED ABOVE- �k 7 S az n g a 3 ^,. NOTIFICATION i n l :v• kt -r da Y.S�• (a .µ Z ,? r�•Il, t ' .y r i41t � y 'w , M� p.\ d i .,. ., ., ^My.S• t 'jjl✓•4 1. ya '.l �'Y f yt'- Sy' 4( CTvS n'Sl^S� � } � i$- a MYypu" q f rga�.jµss4t.;�.aJ' ,,,q�, .n• ' �«Tf� � i "` 54(° .ram �� d a :s., Ti 'c'f`'r E• t,�. +y Sv'3' •'xta"9 .tit�' 'sRyr.'�Lt `'« 4 ' .�aXkfl .?' `'` "�ia�,._[::_a..,t..:... '. - �..-�•.. ' 'a^.i'NC*' t' ,E.hrt.'': '.c...�t_;R �s.t`Ci'Fh•Iwa ^' •_ `ids T,t', � -7, Assessior's offioe (1st floor): / Assessor's map and lot number ...�..�. .��.CC7.. .-0t 7 t �oFTHEto�` ' Q Board of Health (3rd floor): _�_�� �20fIUST CONNECT TO TOWN SEWER • Sewage Permit number .... . ..... �.. B6SII9TLDLL, Engineering Department (3rd floor): 163 rues House number ..............................................!v...................... aVaYa` 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 ..construct a...single...family dwelling TYPE OF CONSTRUCTION .......... ood frame ................................................................................................................. ..................Marc-h.........1.......19.8.8-- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....L.A.t...112......................... quare...Rigger Lane........................... yanni.sa...M ................................ ProposedUse ............................................................................................................................................................................. Zoning District R•B........................................................Fire District Hyannis ........................................................ Name of Owner ....Capricorn...Re a. .....1.6.5. Falmouth„Road,.... annis, MA Name of Builder ,.Franco.. R .E....De ...C .jc. ,..._.Address ....765 Falmouth Road.,_ ynis.s_ .v . . . .. MA Nameof Architect ..................................................................Address ..................................................................................... Number of Rooms ...........E4.9.1.t..........................................Foundation ......P,C. Exierior-.:..Clapboard and/or shingles................Roofiing ....Asphalt,.,Sh.ing,les................„.................... Floors Carpet I......, I .Interior .....$he.etrock Heating Gas—F.W..A......................................................Plumbing ..T.w.Q.7nQ0.P.Pe-.r.................................................... Fireplace ..Y. es............. r.......................................... Approximate Cost ....$50.j.00... 00 . . , �.... V t r Definitive Plan Approved by Planning Board ________________________________19-------- . Area ,sk9'!�' ".Sq..... .t........... J B Diagram of Lot and Building with Dimensions Fee `!— SUBJECT TO APPROVAL OF BOARD OF HEALTH $600 ' b� 3� .o•� � � 2 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. a m ... Construction Supervisor's License .....0 0 0 9 8 9 CAPRICORN REALTY TRUST L Permit for ......0... ...St ry........... Sin.g.je....F a.m.i 1 v...D.well.i.ag.............. .. .... .. ....— .. .... .. .. . Location ..Lot..............#112, 26 Square Ri56,er Lane Hyannis W. .................... ................................................ Owner Scp?�icorn Realty Trust ..................................................... . Type of Construction ..Frame........................................ ................................... ............................................ Plot ............................ Lot ................................ Permit Granted ..De.c.emb.er....1.............19 88 .... .. ....... .... Ir Date of Inspection ........... 19 Date .......D 19 C-D C\) TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION !dap rParcel Db 14 ©/ 7 Permit# Health Division / oa 3ia� DI H P-AR S6419 sued Conservation Division > �< ��`��3/0 Z— 2002 DEC 23 /�pl' ion Fee Tax Collector 0//�/_ �� ��/� Permit Fee _ Treasurer '� Lt _trfStO Planning Dept. EN NC '6BT�p� �R Date Definitive Plan Approved by Planning Board LANs p OR R To Historic-OKH Preservation/Hyannis Project Street Address A tUV Village 1,4-YVW , Owner MO $-MfISo Address C, Sr..u�� �� n�-� �,94w•e �Telephone % 79 0— 1-1 l6'1 J Permit Request o 1P CSC� e�yj Square feet: 1st floor: existingl®:SZ proposed 2nd floor: existing .. Oct proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation i 74 000 Construction Type k.s_>0oQ FDOAMS- Lot Size b \ f Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I yrS r Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: 4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Q Basement Unfinished Area(sq.ft) 102 2— Number of Baths: Full: existing new Half: existing C new Number of Bedrooms: existing new '0 Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: 4WGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes A�No Fireplaces: Existing I — New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size —` Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:Aexisting ❑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 Name P CanK po�-f3 Telephone Number g` f U — 29 1 P AddressS36— PF,r rvvu�s 1..vy C-e 'v'\VE License# CS Home Improvement Contractor# Worker's Compensation#LW 00 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Q1+0 tug, , SIGNATURE 7 DATE Z a ( ' FOR OFFICIAL USE ONLY .... r 1 ` ty PERMIT-NO. DATE ISSUED - MAP/PARCEL'NO. ADDRESS r �; { 1 VILLAGE ;} c OWNER ' DATE OF INSPECTION: ' FOUNDATION 't FRAME I � t'3 INSULATION f r FIREPLACE I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL '•? GAS: ROUGH FINAL ; FINAL BUILDING DATE CLOSED OUT �r ASSOCIATION PLAN NO. 1 - ' T s e RESIDENTIAL: SHEDS !. POOLS -DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WO -KS ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.) >120 sf-500 sf $35.00 $ >500 sf-750 sf 5000 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 >1500 sf—USE NEW BUILDING PERMIT APPLICATION x$30.00= $ DECKS (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ O �� Q:forms:dkcost eff:082301 The commonwealth ofMassachusetts Department of Industrial Accidents _- - Office o�ln�esttg'St�ans• - •. 600 Washington Street Boston, Mass, 02111 Yorkers' Com ensation Insurance Affidavit / / :!Cnatew-ro - C,�Q„J �..i � hone ❑ •I am a homeowner performing all work myself I am a sole ro rietoz and have no one w0,16n ini��i� � c aci � �iir��iii��riiiiiiii�r.��iii�ii�iiii�ii��ii�oie.�i��iii��i.�� • din workers' compensationfor mp em�Ioyees worl�g onthis fob. rove { n.. { fC••r2Y Y{r,,S: "k•w.:;';}Y:n'!.r.:'::E rt i u: 2:7}:a k75?.t?�C�2;{Nh Y''fi �: an em lUpCr-D g •{•:a•t. xGKgt:$:a::•{?rCyr:j}x.}":{:•a::f'a�S.."••:•';:": �'sJ?`..nt.:.n:,4.,,+::rr G:},..n.r..::::.i•:+::::}:::•.. .•:.�•'3.t• •xrr r.;•:r.i• I am P ...F.. :•;tn;:++:r•a}}}:r,{;;:^:::?;::FFS2•::::�:'Y$-::�•..,f,',•.F n•T:::'r}i:+•:.::. tv.4.: {.,•�•:r:•+:r::$+,v:?•:a:•:�i.•,+.$} '':?:•?:.a::u:•:,. ❑ ..f•:{?3:a:•+:{<::+,•}:r.....,.. ..}•.F..� n.jir;�;•.}:nS;:v;.2;}r..:.f'n,}:,{•.}•}:+:3 .:.+v r,':: }:y :•'{{<'{•r.v.::+•.•. ...+.::..}',•::.2t::•..:::.;:.. .}:.a.+::.. .f}.n. ,..fi•.•..{.}.t:./.,••.. nF}.�:r:,•:tt•:::.R. ,;•Y •,j,},'r}:;5•ri'?r�.tv;];t•.•}.•.:,r% v:.};n•!+.yx•}t}:¢:: $.a..:k`.••::n:. 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I des hereby he-•aires-an f J / Date C 72- ' SignatureJV ;: ;• :' ,,,.. , (`� � 7 �� �� ��q�• "Phone# Priest name `e ` R ofRcSalwe only do not write in this area to be completed by dty or town oMdal . - permif%license# [3SdinpDepartmenf city or town: ❑Licensing Boar& ❑SdeCEMe:t s Onic_ contra p en ow. ' A Information and.instructions [assachusetts General Laws chapterlSZ section 25 requires all employers ide e any for their � outract oted from toe"law , an employee is.defined as every p „soam.the service of another under ire,'express or inxplie oralor m empToy� defined individual, partnership, association, corporation or other legal entity, or any two or more of se foregoing engaged in a joint enterprise,-and including the Iega1 representatives of a deceased employer, or the receiver or rustee o£an individual partnership, association or other legal entity, employing employees. Hofih edwe owner.ofa .., elfin house having not more thanthree apartments and who zeSides therein; or the occupant of the dwelling house J. . 1w g such soother who employs persons to do maintenance, construction oer�repairb work be aademployer,ouse or on the�oinicls or )��g appurtenant thereto'shall oat because of such employm MC chapter�152 section 25 also states that every state orcobu ldinnsiin the commonwealth for any applicant who has ng agency shall withholdof a license or peanut.to operate a business or to constru g neither the' not produ-ced acceptable evidencesubdivis subdivisions shall enter into any contract for the rith the insurance coverage 1peerfoAnuance of public work until commonwealth nor any of its Political acceptable evidence Of compliance with the insurance requirements of this chapter have been presented to the contracting y Applicants , your situation Please fill.In the workers' compensation affidavit completely,by checking the of insurance as all affidavits maybe j supplying company names, address and phone numbers along with a cerhfi _-. _ b � the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and the affidavit. The affidavit should•be retaumed to the city or town that the application for r �e permit oral censee is- date ens o f indus�Accidents. Should you have any quests regarding being requested,not the Departm eat atthe number•liited below:: . d,to obtain a workers' campeasatiaixpolioy,pleasb call`'Ee Depaitm ate regcure =: City or Towns the . space at the bottom o� eD artMenthas pro-vide a spa . that the affidavit is complete and prutted legibly, Tb. ep P • Please be sure fill t the Office of Investigations has to contact you regarding the applicant. Please you to, Olt � �.•• �� affidavrtfo ttie.pe Tcensariuznbeiwliichwiltbeusedasarefereace;num -er.� e.affidavitsmay ie'r be suie to is have been made. - b or FAX the Dep eiit unless other artangemen would like to thank you in advance for you cooperation and should you have an cat Investigations w , �..y. The Office of vestig .,• .,, • .. .. ,. .. please do not hesitate to give us a call. 02 FEW 's address,telephone and faxnumber: The Depar�ent • :., r ThCCommonwealthrOf Massachusetts ' Department of Industrial Accidents office of inYestigadans 6N Washington Street y °F,ME,° Town of Barnstable Regulatory Services � r * BARMMMB ' Thomas F.Geiler,Director � nsnss F16,39. 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 requirements. Type of Work: Estimated Cost Dd Address of Work: a� Owner's Name: • ��lY!' V'�`�S Date of Application: `�— I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ate Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffi day. • _ y 0 1 • ! ` f i4y ----- -_ .� . ..._._....... 43-6 - - ....._..__._. . i J yyh f _ t I ............. a: `6i4" _ a,(o 69bow+-c. R: per_ 1-v\3 . . �YO (gyp rLln I-1 y �,n,w s S axles Le0(>�r' i I i . I � • i i ax o lb o,c, r Rrx��e� AND `5r c�e.erv�p O V � . a I ale -F'omv�nau�ea�C � � ; BOARD OF BUILp'ING REGULATIONS Licenses O-STRUCTION SUPERVISOR Numbe =CS 009857 Tr.no . 13275 j Ana ♦i��;.. Resat JEFF.REY M CONR/�D��` 10 LQ;CUST S. 4� :Li HYANNIS, MA 0260 .__ • Administrator ' a ; , ..� ., Board of Bu;!c�ng Rclions and StandaF HOME IMQR6VLM64' CONTRACTOR; Re!istron 14t74 Ezp�rata � 2003 Conrad Remodelitr �l Jeffrey Conrad 1 G Locust St Hy{anf"S_MA,02601 irt#stratcr 'Assessor's offioe (1st floor): ^ C/ T E Assessor's map and lot number CF H t0 Board of Health (3rd floor): `� Sewage Permit number J— 7—���. ....................... 2 BABNSTABLE, S ...................... ...�. o� C.T. Engineering Department (3rd floor): /_ �o rues 1p O i639• �0 Housenumber ........................................................................ 0 YRT a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..construct a single family dwelling ................ .. TYPEOF CONSTRUCTION ...........Wood....frame..... ........................................................................................................ ..................March.. --..I......19.8$.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot 112........................Square Rigger Lane Hyannis, MA ........................................................................................ ProposedUse ................................................................................................................ Zoning District R•B .....................................Fire District Hyannis Ca ricorn Realt Trust 765 Falmouth Road H annis MA Nameof Owner P................................Y.........................Address ..................................................!........................!......... Name of Builder ..Franco R.E. Dev.Co. Inc......Address ....765 Falmouth Road, Hyannis..... , MA ...................................................... ...... Nameof Architect ..................................................................Address .............................................................:................................. Number of Rooms ...........Ti.0h ..........................................Foundation ......P P.C. ....................................................: ........ Exterior ..Clapboard and/or...shingles....... ......Roofing ...,Asphalt Shingles doors Ca>�pet .t t .Interior ....Sheetrock �_; ................ ...................... �. . ................... .......................................................... , I . Heating Gas-F.W.A. ....................Plumbing ..TWO--COtaper....................................:.;................ ,.. � ...Fireplace Yes. ..... J.....................................................Approximate Cost .....$.50, 000. 00 .. ... .. Definitive Plan Approved by Planning Board---------------------------------19________ . Area ...1002...Pgt...ft, ......... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH D" OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. fNam � �X!.. ......./.../... 000989 Construction Supervisor's License ...... CAP'RICORN REALTY TRUST A=272-004-017 • 11 Story No ...32.4.7.6.. Permit for .....�..............Y............. Single Family_..Dwel,ling....... Location ..Lot... #,112.1.......2 6 Sguare,,,)Rigger Lane ................HY.ann i s............. Owner ...Capricorn Realty,,,;-.Trust„ Type of Construction ...Frame.......................... ............................................................................... Plot ............................ Lot .................:.............. Permit Granted ....,December.. 1.i.......19 88 ; Date of Inspection ....................................19 Date Completed ......................................19 } e� t PTPt ax . f Li 13 c. ..__.\ 1.E_V f�'F'1_Q ._.._.--_-- ---- C3 ___.__ _._.._.-_____.____-._.__.._---___��___.�____.._.-_-_._._.__ _ ._.___...:__� _ l�•�.;�,xS,ixv.�:..�.-__. fit_ r ' G ' S r. Li �4 Sx. CIE I - (�t F ! r t, i - i w 0 00 i L1rt - ---- - - =- ----- --------,_;.---------_--__ ���_�- _�_-_ r _ a n i�f------------- sc, t[ , SEPIT r I - - g } P P } we s 0 3 �w Lie 13 ,. r t } _ r s' w n -611 �l -74 177 Lis it - rr � E 1 _aft_ -�=�_� 4L_.,_�.. �_ U_oT .-_ . ._._... - _ .._ -r- _ .._ .. _....._ .. _ - - M _ G 1 S�' t '10� � •��� W , Q X - C3--6 r �- . P•B.4aS fl�•a9 . . Sv Went " R1 �C"E`e ll t3 Z O g cb 0 0 14.0c) z.° JI 0 3C 13.19 CoiuC. F f�n7. n) i4 0) �b A o h � O I N 3 3 7 -S 2 \�0.,3OF o _ Sg 1 e.�lAQt • FRANK w/wn77 HI // TOWN OF BARNSTABLE ZONING `, „�%'.C�'i: z�•, BY--LAWS DATED SEPT 14 1987 ZONE: RC-- 1 SETBACKS (oPEll� sPf�c�7 FRONT 20' ' Z/GG/K y/�GLILG/Xfl)L a_/ G ..SIDE _ 7.5 REAR a 7.5 1 PROPERTY LINES SHOWN HEREON WERE COMPILED FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT N0. 3.3035.20 AN ACTUAL SURVEY ON THE GROUND. THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED PLOT PLAN ON THE GROUND BY SURVEY .ON NOVEMBER 10 1988 in AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION'. BARNSTABL_E MASS . THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND . SCALE: 1" 20' NOVEMBER 28 1988 SHOULD NOT BE USED FOR ANY OTHER PURPOSE. so ,9 ero THE BSC GROUP-CAPE COD' INC / ROUTE 28 MADAKET PLACE B 12 DATE PROFESSIONAL LAND SURVEYO L MASHPEE, MA 02649 (508) 477-2525 SMOKE DETECTORS REVIEWED ---------- DABLE BUILDING DEPfi ®ACE®APE I ,FIRE DEPARTMENT BOTH SIGN ARE REQUIRED POR REl�M/f71 ATURES 1V0 j d 10 f ,, it 7- 7-0 fzt'4. tv ------------ ------------ f W3`�� ' io�e9l # �'c .>v✓L 'Ftf?4�R { _ - -- 4F - y- — ---- ----------_ _..------ - -.._.-- - - _.._�_.__. _ 2 ` - O�BPRNS�AB�� TOW0 N 8 ! t ' - x, r, >r ; i - r i s 1 � , L��vvu r�r•, a j f ' i ? j; i i Z i Y I S _.. _... .,. .. .... . . .... �.. _.._..__._._..-..,.�_ 14 ............ a _ i _ _._._.. L 1 {• r j{f �` � , C!5- —vim ',�•` ` �r? � ,`ss Y; �u �c, mod. -�_�+ '�� .rc �. ' .,Y '' 't � _._. _ . .. _.. �},� / � •4-.� 1, is tom: 1 ~i er , --------------- - 9 1, �r 1 • 7 � � �_�"' �5..[.�`�.�._...����y..__�.,_,�.'.L'yrT�`V' � .�l�ti�j�x 5 L'�.J�� �r_-_,.-..�.�! --.. ._ � __.. � .. .j .. .. ._ _._... •_ .-.�-.__...___._.. .-_ r ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES .A AMPERE 1. THIS SYSTEM IS GRID-INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. a, 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. 1,10.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECT RICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE f GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY r 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). v Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR 4- 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 UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER VICINITY MAP c_ INDEX Voc VOLTAGE AT OPEN CIRCUIT W WATT 3R NEMA A .RAINTIGHT PV1 COVER SHEET +9 PV2 SITE PLAN • PV3 STRUCTURAL VIEWS - PV4 UPLIFT CALCULATIONS LICENSE GENERAL NOTES cut hTHREEt tac e°DIAGRAM GEN #168572 1. ALL WORK TO BE .DONE TO THE 8TH EDITION ELEC 1136 MR OF THE MA STATE BUILDING CODE. • •" y 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING r MASSACHUSETTS AMENDMENTS. i • ' MODULE GROUNDING METHOD: M REV BY DATE COMMENTS AHJ: Barnstable 0 REV A NAME DATE COMMENTS UTILITY: NSTAR Electric (Commonwealth Electric) CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER J B-0 2 619 01 00 PREMISE OWNER: 11 DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE PEUGH, STACIE ► PEUGH RESIDENCE Bertha Paz �;�, • BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: '' ����SolarCrt v NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 26 SQUARE-RIGGER LN 6.5 KW PV ARRAY ►r y ' PART TO OTHERS OUTSIDE THE RECIPIENT`S ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES HYANNIS, MA 02601 TMK OWNER: THE SALE AND USE OF THE RESPECTIVE. 1 ( ) # /tVAI fV 25 TRINA SOLAR TSM-260PDo5.18 7��y�: SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME: SHEET: REV' DATE: Marlborough,MA 01752 PERMISSION OF SOLARCITY INC. INVERTER: T' (650)638-1028 F: (650)638 SOH558H6/3 PV 1 10 25 2015 -1029 SOLAREDGE` SE5000A—USOOOSNR2 COVER SHEET (888)—SOL—CITY(765=2489) wwrsolarcit.cam ~ PITCH: 22 ARRAY PITCH:22 MP1 AZIMUTH: 101 ARRAY AZIMUTH: 101 MATERIAL: Comp Shingle STORY: 2 Stories Front Of House AC D O LEGEND Q (E) UTILITY METER & WARNING LABEL lav INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS M 1 FDC 1DC DISCONNECT & WARNING LABELS a E�3 AC DISCONNECT & WARNING LABELS Q DC JUNCTION/COMBINER BOX & LABELS A Q STAMPEDDISTRIBUTION PANEL & LABELS & SIGNED FOR STRUCTURAL ONLY Lc LOAD CENTER & WARNING LABELS A' O DEDICATED PV SYSTEM METER Q STANDOFF LOCATIONS o JA Sdf 1P'IL IAtti� CONDUIT RUN ON EXTERIOR J f TOM►!N --- CONDUIT RUN ON INTERIOR 0 { 0 STRUCTURAL 4 GATE/FENCE No 61554 Q HEAT PRODUCING VENTS ARE RED L_,J INTERIOR EQUIPMENT IS DASHED FPS/ NAL • y Jason Toman SITE PLAN Date:2015.10.26 23:14:37-07'00' Scale: 1/8" = 1' z 0 1' 8' 16' _ rn J B-0 2 619 01 00 PREMISE OWNER' DESCRIPTION: DESIGN: CONFIDENTIAL S — THE INFORMATION HEREIN JOB NUMBER ,,,SOIarCIt CONTAINED SHALL NOT BE USED FOR THE PEUGH, STACIE PEUGH RESIDENCE Bertha Paz BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: I•., NOR SHALL IT BE DISCLOSED IN WHOLE OR IN CompMount Type C 26 SQUARE—RIGGER LN 6.5 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULES: H YAN N I S MA 02601 ORGANIZATION, EXCEPT IN CONNECTION WITH 24 St.Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (25) TRINA SOLAR # TSM-26OPDO5.18 SHEET: REV: DATE: Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME INVERTER' T. (650)638-1028 F: (650)638-1029 PERMISSION OF SOLARCITY INC. 5085588673 PV 2 10 25 2015 (888)—SOL-CITY(765-2489) mn.selarcitycom SOLAREDGE SESOOOA-USOOOSNR2 SITE PLAN - / / S1 12'-7" (E) LBW SIDE VIEW OF MP1 NTS MP1 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES STAMPED &" SIGNED LANDSCAPE 64" 2411 STAGGERED FOR STRUCTURAL ONLY PORTRAIT 48" 19" RAFTER 2X8 @ 16" OC ROOF AZI 101 . PITCH 22 STORIES: 2 ARRAY AZI 101 PITCH 22 C.J. 2x6 @16" OC Comp Shingle JASON WIL M TOMAN STRUCTURAL v PV MODULE No.51554 5/16 BOLT WITH LOCK INSTALLATION ORDER GrSTIr�'' �' •' & FENDER WASHERS _ �'At.�'��� LOCATE RAFTER, MARK HOLE DI y Jason Toman ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT Date:2015.10.26 23:14:45 -07'00' ZEP ARRAY SKIRT (6) HOLE. ^ (4) (2) SEAL PILOT HOLE WITH _ POLYURETHANE SEALANT. ZEP COMP MOUNT C , ZEP FLASHING C (3) (3) INSERT FLASHING. (E) COMP. SHINGLE (4) PLACE MOUNT. (E) ROOF DECKING (2) (5) INSTALL LAG BOLT WITH 5/16" DIA STAINLESS (5) SEALING WASHER. ` STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES WITH SEALING WASHER @6) INSTALL LEVELING FOOT WLTH BOLT & WASHERS. (2-1/2- EMBED, MIN) (E) RAFTER - S PREMISE OWNER: DESCRIPTION: CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: DESIGN:- CONFIDENTIAL 00 PEUGH RESIDENCE Bertha Paz T24 CONTAINED SHALL NOT BE USED FOR 7HE PEUGH, STACIE ■BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: SolarCiNUR SHALL IT BE DISCLOSED IN WHOLE OR IN 26 SQUARE=RIGGER LN 6.5 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENT'SComp Mount Type CORGANIZATION. EXCEPT IN CONNECTION WITH MODULES HYANNIS, MA 02601 THE SALE AND USE OF THE RESPECTIVE (25) TRINA SOLAR # TSM-260PD05.18 . Martin D►ive, Building 2, Unit 11SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME SHEET REV. DATE Marlborough,MA 01752 PERMISSION OF SOLARCITY INC. 91VEftTER 50855886730)638-1028 F: (650)638-1029SOLAREDGE SE5000A—USOOOSNR2 STRUCTURAL VIEWS PV 3 10/25/2015 -aTY(765-2489) wnwsdarcRy.com UPLIFT CALCULATIONS SEE .SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. J B-0 2 619 01 0 O PREMIX OWNER: DESCRIPTION: DESIGN CONFIDENTIALS A THE INFORMATION HEREIN JOB NUMBER: I ��I V CONTAINED SHALL NOT BE USED FOR THE PEUGH, STACIE PEUGH RESIDENCE Bertha Paz Q a '�y BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �;1 NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 26 SQUARE—RIGGER LN 6.5 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULE ' H YAN N I S M A 02601 ORGANIZATION, EXCEPT IN CONNECTION NTH � 24.Si.Martin Drive, Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (25) TRINA SOLAR # TSM-260PDO5.18 PAGE NAME SHEET. REV DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: T. (650)638-1028 F: (650)638-1029 4 PERMISSION OF SOLARCITY INC. SOLAREDGE SE5000A—USOOOSNR2 5085588673 UPLIFT CALCULATIONS PV 4 10/25/2015 (BBe�-SOL-CITY(765-2489) .wr.8daraitYoorn R - RTE, SP ECS P IN EC LICENSE GROUND SPECS MAIN PANEL SPECS GENERAL NOTES S MODULE SPECS S BOND N 8 GEC TO TWO N GROUND Panel Number: Inv 1: DC Ungrounded GEN #168572 O # O INV 1 —(1)SOLAREDGE#SE5000A—USOOOSNR� LABEL: A —(25)TRINA SOLAR TSM-260PDO5.18 RODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:43968023 Inverter, 5000W, 240V, 97.5%a w Unifed Disco and ZB,RGM,AFCI PV Module; OW, 236.9W PTC, 40MM, Black Frame, H4, ZEP, 1000V ELEC 1136 MR Underground Service Entrance INV 2 Voc: 38.2 Vpmax: 30.6 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 200A MAIN SERVICE PANEL E� 20OA/2P MAIN CIRCUIT BREAKER, Inverter 1 (E) WIRING CUTLER—HAMMER fD 20OA/2P Disconnect 3 _ SOLAREDGE - +SE5000A-USOOOSNR2 - MPl: 1x13 (E) LOADS A ---------------zaov ----------------- ------------ C �z r----- , DC+ N DG I Z 30A/2P EGC/ x DC: - - - ---- GND A - --------�— — GEC .---TN DG C MPl: 1X12 EGC -- ———-———————---------- --———-——-———— G --— -- ---t—I N i (1)Conduit Kit; 3/4' EMT _ EGC/PEC J ' = - - . . " • µ z tr5 • - GEC _ TO 120/240V SINGLE PHASE I _. UTILITY SERVICE PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP POI (1)CUTLER-HAMMEJ2 BR230 PV BACKFEED BREAKER" A (I)CUTLER-HAMMER #DG221UR8 /�C y PV (25)SOLAREDGE 300-2NA4AZS DC Breaker, 30A 2P, 2 Spaces Disconnect; 30A, 240voc, Non-Fusible,�NEMA 3R /"� PowerBox ptimizer, 300W, H4, DC to DC, ZEP -(2)Gro qd Rod ={1)CUTLER-�IAMMER t�DG030N6 Sr8 x 8, Copper Ground/Neutral Ki4; 30A, General Duty(DG) - nd (1)AWG6, Solid Bare Copper -(1)Ground Rod; 5/8' x 8'. Copper (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION NO."2, ADDITIONAL ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF'`(E) ELECTRODE 1 AWG10, THWN-2, Black (2 AWG �10, PV Wire, 600V, Block VoC* =500 VDC Isc '15 ADC O (1)AWG#10. THWN-2, Red O (1)AWG #6, Solid Bare Copper EGC Vmp =350 VDC Imp=9.53 ADC (1)AWG#10, THWN-2,White NEUTRAL Vmp =240 VAC Imp=21 AAC (1)Conduit Kit; 3/4' EMT -(1)AWG 8,.TFtWN-2,.Green . . EGC/GEC•-(1)Conduit,Kit;.3/4",EMT, , . . . . . . �2)AWG #10, PV Wire, 60OV, Block Voc* =500 VDC Isc =15' O OAWG #6, Solid Bare Copper EGC Vmp -350 VDC Imp-$-13 ADC ,. (1)Conduit Kit.3/4'•EMT. . . . . . . . . . . . . . . . . . . . . . :. . . . .. . . . . . . . . . . CONFIDENTIAL-THE INFORMATION HEREIN JOB NUMBER: PREMISE OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE J B-0261901 OO PEUGH, STACIE PEUGH RESIDENCE Bertha Paz BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MWNTING SYSTEM: �.•,.SO�a�C�ty NOR SHALL IT BE DISCLOSED IN WHOLE OR IN CompMount Type C 26 SQUARE-RIGGER LN 6.5 KW PV ARRAY I. PART TO OTHERS OUTSIDE THE RECIPIENTS � ORGANIZATION, EXCEPT IN CONNECTION WITH MODULEs H YAN N I S, MA 02601 THE SALE AND USE OF THE RESPECTIVE (25) TRINA SOLAR # TSM-260PDO5.18 24 St. Martin Drive,Building 2,Unit 11 , SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME: SHEET: REV: DATE Marlborough;MA 01752 PERMISSION OF SOLARCITY INC. INVERTER' 5085588673 PV 5 10 25 2015 T: (650)638-1028 8 (650)636-1029 SOLAREDGE SE5000A—USOOOSNR2 - THREE LINE DIAGRAM / / ( )-sa-CITTY 765-2489) wrn..eolarelt:aam Label Location: Label Location: s� � ' , • o 0 0 •o � o �y � Label Location: (DC) (INV) Per Code: _ -e Per Code: R �- o _e Per Code: NEC 690.31.G.3 00 0 0 0 NEC 690.17.E ® .0 a a. ® NEC 690.35(F) Label Location: - mm :o • e - o o e TO BE USED WHEN o•o s e INVERTER IS ■ p p ® �!� (DC) (INV) • _ o Per Code: r UNGROUNDED NEC 690.14.C.2 Label Location: o ob�u o -o o POI Label Location: (POI) o = t (DC) (INV) k,= �� o *` ' ti Per Code: • o -- Per Code: NEC 690.17.4; NEC 690.54 -e - � �; -e o o' o �o NEC 690.53 r$ "'lac io 0 Label Location: so o • o d (DC) (INV) Per Code: NEC 690.5(C) Label Location: u 0 0 0- 0 o e • a 0 o o - o - fi Per Code: NEC 690.64.B.4 Label Location: (DC) (CB) 4< x 0 Per Code: Label Location: 00 0 0 NEC 690.17(4) 0 }; (D) (POI) Per Code: NEC 690.64.13.4 ;} Label Location: (POI) Per Code: Label Location: = 06467 n � '`� o Igo i;r � : NEC 69 A (AC) (POI) .o 0 0 ;- o =: (AC): C Disconnect ( ® w Per Code: ®e n ): Conduit C NEC 690.14.C.2 .. (D):)D stribbtion Panel fi r _ (DC): DC Disconnect (IC): Interior Run Conduit Label Location: (INV): Inverter With Integrated DC Disconnect (AC) (POI) (LC): Load Center •" • Per Code: (M): Utility Meter NEC 690.54 (POI): Point of Interconnection CONFIDENTIAL— THE INFORMATION HEREIN CONTAINED SHALL NOT BE USED FOR �,�••e,� 3055 Clearview Way THE BENEFIT OF ANYONE EXCEPT SOLARGTY INC., NOR SHALL IT BE DISCLOSED �• ■ San Mateo,CA 94402 IN WHOLE OR IN PART TO OTHERS OUTSIDE THE RECIPIENT'S ORGANIZATION, Label Set ��11 T:(650)638-1028 F:(650)638-1029 EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE of SolarCit (888)-SOL-CITY(765-2489)www.solarcity.com SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PERMISSION OF SOL.ARCITY INC. ° "i^SOIafClty ZepSolar Next-Level PV Mounting Technology ". �^SolafCity- ZepSolar Next-Level PV Mounting Technology Zep System Components _ for composition shingle roofs " - Up-roof ..' . Snt•rlock ' Ground Zep (KYu$.,hw ) .. LevelkrG Foot .. ., e , Zep Compatible PV Module - .. - ,,.•`�"" 2eP Grown - Roof AtWch mr - - Arrayskirl - - - - ' ppt4P4rO _ a`"; Description rW PV mounting solution for composition shingle roofs F`cGMPPt�w Works with all Zep Compatible Modules • Auto bonding UL-listed hardware creates structual and electrical bond • Zep System has a UL 1703 Class"A"Fire Rating when installed using V� LISTED modules from any manufacturer certified as"Type 1"or"Type 2" Comp Mount Interlock Leveling Foot Part No.850-1382 Part No.850-.1388 Part No.850-1397 Listed to UL 2582& Listed to UL 2703 Listed to UL 2703 ' Specifications Mounting Block to UL 2703 Designed for pitched roofs. Installs in portrait and landscape orientations • Zep System supports module wind uplift and snow load pressures.to 50 psf per UL 1703 t • Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and ETL listed to UL 467 • Zep System bonding products are UL listed to UL 2703 • Engineered for spans up to 72"and cantilevers up to 24" V Zep wire management products listed to UL 1565 for wire positioning devices' Ground Zep Array Skirt,Grip,End Caps DC Wire Clip • Attachment method UL listed to UL 2582 for Wind Driven Rain Part No.850-1172 Part Nos.500-0113, Part No.850-1448 Listed to UL 2703 and 850-1421,850-1460, Listed UL 1565 ETL listed to UL 467 850-1467 zepsolar.com zepsolaccom Listed to UL 2703 his documen does no crea a any express warren y by Zep Solar or abou i s produc s or services.Zep Solar's sole warren y is con dined in,he wri en produc warren y for This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for - each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats:com. 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf Page: 1 of 2 - 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf _ Page: 2 of 2 h., l�J Ny C-r solar=oo solar=ooSolarEdge Power Optimizer �,` . _ Module Add-On for North America x� n :, P300 / P350 / P400 SolarEd a Power Optimizer 9 P P300 P350 P400 , Module Add-On For North America (for (fd�72-ce °� ,f°r96ee �� {P - modules) modules) modules) .�77 `r5'. fI Q ?INPUT - I 'f P300 / P350 / P400 m n., Rated Input DC Powers 300 350 W .... " Absolute Mazlmum Input Voltage(Voc at lowest temperature) 48 60 80 Vdc a, Y, MPPT Operating Range:............................................. ........8..48....................a..60............ .....$..$Q........ ...Vdc..... Maximum Short Gi curt Current(Isc) 10 Adc t 1� M ..... ... .. ... ........................... ......... ........ .... .. .� Imum DC Input Current................................ ............................ 12.5 ...Adc ..Maximum Efficiency... .. ...99.5 .... ..%...... ... ....................... .. .... .......... ........... ...................98.8.. ...... ...... ........ ... ..%..... I,.� ,c. - ....................... .. ..................................... ................................................. ...... ....... ... ...... r $ 'a# Overvoltage Category II s - s .. .. - .,. )OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) ) N �. JS?"S 'w s .�a `� Maximum Output Curren[ 15 Ad[ Maximum Output Voltage .. ....... ........ .................60......... ............... .. ...Vdc ! Q :OUTPUT DURING STANDBY(POWER.OPTIMIZER.DISCONNECTED.FROM INVERTER OR INVERTER OFF) _ 4 Safety Output Voltage per Power Optimizer 1 Vdc • " z �^ ' - SSTANDARDCOMPLIANCE i. • : i EMC .,. ., ..... .......................... ... ....... �,,�,fwfi►� } ....... .. ........ ..... ...... ........ ... n. s ,.. ..Safy.... .. ... ........ .. .......................... ...... P,IEC62109,1(lass 11 safety),.UL1741................. ..........' .......et .. ...... .. .W ... ... ......... FCC ROHS Yes - - ,. � -"w•4. ,.„,,,a„"" �. - "" (INSTALLATION SPECIFICATIONS Allowed System Voltage ...,..., ......., ..., 1000............... ............. ..Vdc.... • ,�'`` _ ., R, ' £aa .................................. .. ......... .. ............. .. , dgr*' ............. ...... Dimensions(W xLx H) 141 x.212x405/555x834x159 mm/in .. ........... ...... .... 1 4 950 2.1 r Ib Welght(including cables) / g / Input Connector MC4/Amphenol/Tyco .................................................................... ........ ................. ........... ;ex}, 3,,,yub;' :; - Output Wue Type/Connector Double Insulated;Amphenol :.... ..... ...... .. .. ......... ..................... ....... .. ...... ... .. ................. .. ... ................. ... .. *•r,r'sF�y" 'a Outpu[Wlre Length....... 0.95./3.0......L........ ...1.2/,3.9.. ..m./ft....... ...... .... .... ...... ..................... .. ... . a`^'3.'� Operating Temperature Range .................................. 40 +85 40 +I85 �C f '�w r f'r"' Protection Rating........... ........................ .......... ................IP65/.NEMA4............................. .. ..... Y ..Relative Humldrty ............................................. 0 100 %, RaLLM SrC power of the moEule MOEole 0.p5%power Mleran¢IR d Fg.9.&YS' Yv`.tRr 3x '*-#k 'k 5t ay` 4jJ�� ` W +F, r^N 1 � • - IPV SYSTEM DESIGN USING A SOLAREDGE THREE PHASE THREE PHASE INVERTER SINGLE PHASE PV power optimization at the module-level Mimmom StringLengthh(Power O Optimizers) 8 to .. ............ .... ..... ..... ........ ... ..... ......... 1.8..Maximum String Length(Power Optimizers) 25 25 50 , Up to 25%more energy .............................................., Maximum Power per String 5250 6000 12750 W • Superior efficiency(99.5%) ............................................................................................................................................................................. Parallel Strings of Different Lengths or Orientations - Yes Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading . . - """""""...... """""""""""'"""""""""""""""""""_""""""""""""""""""""""""""""""' - _. — Flexible system design for maximum space utilization _ - - Fast installation with a single bolt - 4 as -.Next generation maintenance with module-level monitoring _ _ ,.. �. , — Module-level voltage shutdown for installer and firefighter safety - - - �; a�,• r�"' �i ' "` s... .� ~zsA. - ',"` - USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA wWW.Solaredge.u5 • THE Vinamount MODULE TSM-PD05.18 Mono Multi Solutions a DIMENSIONS OF PV MODULE ELECTRICAL DATA @ STC - ---• - unit:mm. .Peak Power watts-P-(Wp) I 245 , 250 255 .f, 260 f. 941 - - - OPower output Tolerance-PMAX(%) 0-+3 f _ THE mbul i Maximum Power Voltage-Vv(V29.9 30.3 30.5 30.6 C?�n1 = xcna c tit eo Maximum Power Current-IMVP(A) 7 8.20 8.27 8.37 8.50 1 - _ - eAMrvurc c Open Circuit Voltage-Voc(V) 1 37.8 � 38.0 4 38.1 � 38.2 '•" �. t A t Circuit h Sorrcuit Current-Isc( ), � 8.75 t 8.79 8.88 9.00 rt+srnu He Hote ¢ ) I Module Efficiency qm(%). 15.0 15.3 - 15.6 _ 15.9 - O D L E STC:Irradiance 1000 W/m2.Cell Temperature 250C,Air Mass AM1.5 according to EN60904-3. iiii Typical efficiency reduction of 4.5%at 200 W/m'according to EN 60904-1. e o F ELECTRICAL DATA @ NOCT �® CELL " I3 1Maximum Power-PmAx(Wp) ii �182� 1' 186- - 190 193 4. j Maximum Power Voltage-VMv(V) �27.6 28.0 mi 28.3 ! - son caoueumc Ho.v 444 Maximum Power Current-IMvv(A) 1 6.59 - 6.65 1 6.74 6.84 MULTICRYSTALLINE MODULE A A i L WITH TRINAMOUNT FRAME12 Open Circuit Voltage(V)-Voc(V) 35.1 35.2 35.3 35.4 . Short Circuit.Current(A)-tsc(A) } 7.07 _ 7.10 !. -7.17 _..A - 7.27 NOCT:Irradionce at 800 W/M'.Ambient Temperature 20-C,Wind Speed I m/s. _ _ 2�5-Z6O� PD05.18 180 l 8t2 Back View POWER OUTPUT RANGE MECHANICAL DATA Solar cells (Multi crystalline 156•156 Trim(b inches) Fast and simple to install through drop in mounting solution y! Cell orientation 60 cells(6 x 10) ' Module dimensions 1650 x 992 x 40 Trim(64.95 x 39.05 x 1.57 inches) k . 5 - Weight 21.3 kg(47.0 Ibs) i kkk MAXIMUM,EFFICIENCY _ _ Glass !3.2 min(0.13 inches),High Transmission,AR Coated Tempered Glass q - - - -- A-A t Backsheet White f Good aesthetics for residential applications `Frame !Black Anodized Aluminium Alloy with TrinamoantGroove t - f-V CURVES OF PV MODULE(245W) 1' I J-Box IP 65 or IP 67 rated _ ®� ■ 3� �� tt - - Cables Photovoltaic Technology cable 4.0 mm2 10.006 inches°), - - to.01 t, - 1200 min(47.2 inches) - POWER OUTPUT GUARANTEE } 9'° { Fire Rating .Type 2 f Highly reliable due to stringent quality control ¢6m �oW/m € 1 • Over 30 in-house tests(UV,Ti and many more) 1 s.- As a leading global manufacturer • In-house testing goes well beyond certification requirements tj 402 , TEMPERATURE RATINGS MAXIMUM RATINGS of next generation photovoltaic , 1 3.. «- _ -_ _ ._ _ _ {{ 2m 200W/m2 1. !Nominal Operating Cell 44°C +2 C F +Operational.Temperature -40-+g5°C products,we believe close 3 I :Temperature(NOCT) (- ° I 1 cooperation with our partners + ( {{ Maximum System 1006V DC(IEC) i 00° Temperature Coefficient of P- 0.41%/°C 1 Voltage 1000V DC(LIQ is critical to success. With local - 0.°0 10.°0 20.m 30.Q1 40.°p -' 111 !! {{{ presence around the globe,Trina is voltage(v) 1 Temperature Coefficientof Voc i-0.32%/°C 1 Max Series Fuse Rating 15A able to provide exceptional service Tem erature 5%/°C to each customer in each market Certified to withstand"challenging.environmental } p Coefficient of Isc 0.0�.-- and supplement our innovative, (970 conditions reliable products with the backing S of Trina as a strong,bankable i • 2400 Pa wind load WARRANTY • 5400.Pa snow load partner. We are committed I� _ - 10 year Product workmanship Warranty to building strategic,mutually + 25 year Linear Power Warranty beneficial collaboration with - installers,developers,distributors (Please refer to product warranty for details) a l and other partners as the` o backbone of our shared success in (`�""'-�" -'- - y-' Y-�" - CERTIFICATION iI} driving Smart Energy.Together. LINEAR PERFORMANCE WARRANTY [ PACKAGINGCONFIGURATIO_N i 10 Year Product Warranty•25 Year Linear Power Warranty eLEMBB a$pus Modules per box:26 pieces wI Trina Solar Limited PP AModules per 40'container.728 pieces } + www.trinasolar.com W00% Ad { 6 I a dltiohgl ydl III EU-38 WEEE Ue korl'1 Trlr+O SOIOr'S Ilneqr !� cornPupr•r 1. - ' ( o MrCrrpAt - CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING TH E PRODUCT. GaMPgT�e I a `o 'ta e 0 0 201 Tina Solar Limited.All rights resew Specifications included in this datasheet are subject to _I 4 r d. I ri h} ed.S e ti (° t7 80% change without notice. ��a�n�solar _ v ��on�asolar _ 1 Smart Energy Together ( Years a 10 15 20 25 Smart Energy Together 4 Trina standard Mdusnystandard THE Trio-amount MODULE TSM-PDO5.18 Mono Multi Solutions - DIMENSIONS OF PV MODULE ELECTRICAL DATA @ STC unit:mm Peak Power Wotts-P-(Wp)- ? 250 255 , 260 265 O - 947_ , Power Output Tolerance-P-(%) 0-+3 Maximum Power Voltage-V.,r(V) s 30.3 t 30.5 F 30.6 30.8 THEV�0 M 0 Unt Maximum Power Current-ImrP(A) 8.27 8.37 8.50 8.61 _ c Open Circuit Voltage-Voc(V) ( 38.0 ( 38.1 t 38.2 38.3 1 L c Noce Short Circuit Curreni-Isc(A) 8.79 8.88 - 9.00 9.10 I srnuw � - ®®� $ - ,Module Efficiency qm(%) * 15.3 I5.6_ 1 15.9 16.2tt STC:Irradiance 1000 w/m'.Cell Temperature 25°C,Air Mass AM1.5 according to EN 60904-3. /�► Typical efficiency reduction of 4.5%a1200 W/m'according to EN 60904-I. e � 0 - ELECTRICAL DATA @ NOCT ® Maximum Power Volt ge-V. 28. C P 8.1- 1 . ( .197 CELL _ �Maximum Power Voltage-VMr(V) 28.04 28.1 28.3 ` 28.4 -. . - Maximum Power Current-l-(A) 1 6.65 _6.74 6.84 I 6.93 _...M. - 604 0°NDINO E • 1 PD05.18 MULTICRYSTALLINE MODULE n a �OpenCircuitVoltage(V)-Voc(V) 35.2 35.3 35.4 35.5 1:.oxnlN No,E WITH TRINAMOUNT FRAME Short Circuit Current(nj-hc(A) I 710 7.17 7.27 a 7.35 . NOCT:Irradiance at 800 W/m',Ambient Temperature 20°C.Wind Speed 1 m/s. 250-2�5l�! � 8,2 ,Bo l Bock Vmw MECHANICAL DATA POWER OUTPUT RANGE Solar cells Mulhcrystduine 156.156 mm(6 inches) .-L(j Fast and simple to install through drop in mounting solution - cell orientation 60�ell5(b ,o) { , Module dimensions 1650•992 N 40 min(64.95><39:05 N 1:57 inches) {. •/�� l\�-f � 1 Weight 1�19.6 kg(43.121bs)1. I G/� Glass i 3.2 mm(0.13 inches),High Transmission,AR Coated Tempered Glass MAXIMUM EFFICIENCY Backstreet White ) A-A Frame Black Anodized Aluminium Alloy ® Good aesthetics for residential applications J-Box IP 65 or IF 67 rated ' t 'Cables Photovoltaic Technology cable 4.0 min'(0.006 inches'); ®--+3� I 1200 min(47.2 inches) i-V CURVES OF PV MODULE(260W) POSITIVE POWER TOLERANCE Connector T H4 Amphenoi y.m roa°w m' Fire Type UL 1703 Type 2 for Solar City - - Highly reliable due to stringent quality control I a.00 R • Over 30 in-house tests(UV,TC,HF,and many more) a As a leading global manufacturer • In-house testing goes well beyond certification requirements # s'00 �w m TEMPERATURE RATINGS- MAXIMUM RATINGS of next generation photovoltaic L_ • PID resistant e soo 1 u', 4.00 °.Nominal Operating Cell 'Operational Temperature 40-+85°C j products,we believe close 4 Temperature(NOCT) as°C(±2°q tt 1! cooperation with our partners 100 ( Maximum system 1000V DC(IEC) zao Temperature Coefficient of P.- -0.41%/°C Voltage _ 1000V DC(UL) is critical to success. With local. � ! presence around the globe,Trina is - '00 Temperature Coefficient of Voc -0.32%/°C Max Series Fuse Rating ; 15A - 1 able to provide exceptional service to each customer in each market Ichallenging o 0 20 °o .° so rem erature Coefficient of Isc o.os%/°c Certified to withstand environmental - _ P _ 'C Certified vwmq°M and supplement our innovative, ! Conditions reliable products with the backing \� 2400 Pa wind load ) WARRANTY of Trina as a strong,bankable _- 5400 Pa snow load partner. We are committed r 10 year Product workmanship Warranty to building strategic,mutually ! CERTIFICATION beneficial collaboration with 25 yedr Linear Power Warranty 9 installers,developers,distributors I L I cOBs C• (Please ref og a�+-^a- � sper to product warranty for details) a and other partners as the - a backbone of our shared success in driving Smart Energy Together. ( t LINEAR PERFORMANCE WARRANTY t i�a EEE PACKAGING CONFIGURATION F f co.4runNr 10 Year Product Warranty•25 Year Linear Power Warranty Modules per box:26 pieces w Trina Solar Limited '! - - - - _ - - - - Modules per 40'container:728 pieces www.trinasolar.com I m 100% a7-_ Additional vat Ilurei fro am rrin I a 9o% _. _ aSolor'slineartCAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. baMP4TjeO a o2015 Trino Solar Limited.All rights reserved.Specifications Included m this dotsheet are subject to (4�oim-asolar v v 4Po��solar (�80% - change without notice. t Smart Energy Together rears s to Is 20 2s Smart Energy Together <roO Trina standard. E lndusrry standard - ` w � •"ii ;gym i 4�' fia. `�:.. - .. S0'a r' - Mo - Single Phase Inverters for North America OI - 0W SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ SE7600A US/SE10000A-US/SE11400A US � -4 , SE3000A-US SE380OA-US SE5000A-US SE6000A-US SE760OA-US SE10000A-US SE1140OA-US `f# Y`fx : s a r,�'as �"y "S�{vx:: !. I.OUTPUT Nominal AC Power Output 3000 3800 5060 6000 7600 9980 208V 11400, - VA SolarEdge Single Phase Inverters 5400...208V... .......... 1080zo8 @ @ .Max AC Power Output 3300 4150 ' 5450 Ala 240V 6000 - 8350 10950 @240V 12000 VA For North America , � k ................................ ........... ................ ... ................... AC Output Voltage Min:Nom.Max.l31 _ ................ '<'• r ' r - - - s '4 _ ,,,,: y S ` ,3 to I'r 183.208 .229 Vac ✓ .. ............ ......✓...... .............. ......... SE3000A-US/SE3800A US/SE5000A US/SE6000A US/ ...Outp...................................tVoltagen.-N ................ ................ x k 't r AC Output Voltage Min:Nom:Max.l'I fs' 2 • ) 211-240 264 Vac_ ✓ ✓ ✓ ✓. ✓ ✓ ✓ . SE760OA-US/SE10000A-US/SE1140OA-US ) . . a aw`{ ACFreq uency Mln,.Nom:Max.t3l:..• „•„ „••, „•• „ 593 60-60.5(with HI country setting 57-60-60.5) •• ...•, r Hz, 4 �••4E•;iii ' {- Max.Continuous Output Current 12.5 - 16 I's2 @ 208V - 25 32 - @ 47.5 A ..... ... .:.: .. ..... .............. ...............1.21 @ 240V......... .. ............ ...4z @ 240V.. .............. ....... - - - s Y� .. •..' _',<s• :.•E .>' >a a, GFDI Threshold. ..1... A k;7 .... z. _ .............. .. ............ ............................. .... ................ .... , ,� � Utility Morntoring,dslanding Protection,Country Configurable Thresholds Yes Yes t:t A INPUT - verte a Maximum DC Power(STC) 4050 5100 6750 8100 10250 - 13500 15350 W a " ,.t•�\ .,.v .t. .... .... ..... .. ....... .... .. ......... ...... .... .................. ... ...... .. ot,. 4 x :.r,i• " `` • °,a ;; .. . Transformer-Iess,Ungrounded...... ............ ...... ... Yes _ A ............... ... .......... .. ... ... ...... - �. ........... ....... ..... ...... .. ... - rf �.4 n�ra 'i ' 'n 'k,:: Max.Input Voltage S00 ........ .... .............. Vdc ... : •, w fin' atta �.�f �, '' ,>i .'-. t ^+''.. 2?'* " -q,F Nom.DC Input voltage - _ 325@208V/350@240V.:.. ._ Vdc p�Y1 °Q4a t+3 ., " c a:h w., sJ t,§ s r'.> v..........,•-.,.,,> i o4;� � ,. 3.> # , .., zi- t �, .� - P ..16.5 @�208V 33.@ 208V.. ... Max.Input Currentl3l 9.5 13 18 23 .34.5 Adc _ - .,» ......................... .. ... .......... ....I.15,S.�a1.240y..I....... ... ................I..30S @ 240V..L................ - _ Max.Input Short Circuit Current ..................................................... 45.................................. .Adc.... ............_............................................ .... t Reverse-Polarity Protection Yes tl. }�::. ,x,a se£ .z+F• ..}'kk..�a E•�..> `,. ��,': ,.i«• 4. ,il!: ,.;. '�. ....-.. ... ................ ................... ..................... ..-.... ...... .......... .... ,.,., �•.. -.yttr..»'irwf.-:. " : >",f!*"•, -'w t �e,E; pi M•.' - Ground-Fault Isolation Detection. .. .. .. .. 600kn Sensitivity,., ... .. .... .... .... ... .. - �.�._._,._..�-.-. .................... ..... .... ................ ..... ..... .. ..... .. ... .. - .. »u > » ,. :,, Maximum In Efficiency .. 97.7• 98.2 .95.3•. 98.3 .98 ..98. 98 %. r '.fin• .. ,�. ............................. .. ..... ...... ... .. +... i »�,:i✓."' x .. .. ..... .. .. ..97.5 @ 208V. ... .. .. ..:97 @ 208V... ...... .... ......... .. _ #.�__�-- af:. .,,� �_,•_ ,. ,�. �. q,.a-, �� .,.,_ CEC Weighted Efficiency 97.5 98 98 240V •• 97.5 97.5 97.5 240V 97.5 % - - ............ I .. ...... ............. .............. ......@.........I................................ ................ ....... .... ..I ..,.�° f+ �• x-, a'.. � t � .ir^ Y ' Nighttime Power Consumption - <2.5 _ <4....... i.... .... - _ (ADDITIONAL FEATURES i j { .�` �k,..: "„ '`r'r 2 ''•' ',' r Supported Communication Interfaces RS485,RS232 Ethernet ZlgBee(optional) • •- - - . *I•� ,++ ......... ...... ..... ..... ...... .. .. ........ ............................. .. ......... .......................... .............. ...... ...... "''` .',-" °- g'; - •`r°-" , - Revenue Grade Data,ANSI C12.1 Optionall3l ..... ........................................... ...................... Rapid Shutdown-NEC 2014 690.12 - Functionality enabled when SolarEdge rapid shutdown kit is Installed)°I _ ✓. :_ ':'` - •� i STANDARD COMPLIANCE ` --- - - ; `�' °`-^ '°'•f''"� ': �'i -'' #tom �F Safety UL1741,UL1699B,UL1998,CSA 22.2 - S' .................... .... ............ .................. ........ ............... 3dc • .a ' '.= •'`�` �''.`f:,`5£t s. `_ si ` �'»: Grid Connection Standards ... .._ .IEEE1547 { '' ` a `• d' 4� -'"� ^'� '�*� x ;�� Emissions - FCC part15 class B tINSTALLATION SPECIFICATIONS - • -. _.- ( ° -5- �t :-*' , .`� '� � ,�<. `. "� x<`S,^. AC output conduit size/AWG range 3/4 minimum/16-6 AWG 3/4 minimum//8 3 AWG . input conduit size strings/ 3/4"minimum/12srings DC inp / .. AWG ran a •.3/4"minimum/1-2 strings/16-6 AWG _ ..... ................ ..... ...................... ...................... . . ..g.... - : 14-6 AWG. ... itch.., {y[ .:-� - ,q.?=2� ,. f �•>., f� ,, y{• � -r,,,'--� f•„ '�;.�" ,� �,:,: `�° Dimensions with Safety 5w'•• ��30.S x�12.5x7.2 775x315x184 �.30.Sx12.5x10.5�%•� ••m/� - :y '»,:::x:. !.. :fl t .s,'d..,r'.' ,`.r• :> gW ` '•a'.-. r,.r +.r,.,_. s"`+f ,`,: ,.re' HxWxD / 775x'315x 260 mm I ' -' Sr •• ;•# *,, 'y„ ..,'- ° .L t "!,-. Weight with Safety Switch 51.2/23.2 54.7/24.7 - ' P. � ...ter.•,:^-. :h ..,....� �'"�"��' m..' ... Natural 884/40.1 Ib/k •• i. Cooling convection and g - ,. internal Fans(user replaceable) - �- .. fan(user _ ` _ ..................:.........................................:...... .replac -. ........................................ .................................. eable)... The best choice for SolarEdge enabled systems Norse <25 ..........so „.,...:,dBA,,,, ................................. ....... Integrated arc fault protection(Type I)for NEC 2011 690.11 compliance Min.-Max.Operating Temperature -13 to+140/-25 to+60(-40 to+60 version avallablelsl) "F/`C Superior efficiency(98%) Rang?................................... .....................................*................................................................................. Protection Rating NEMA 3R Small,lightweight and eas to install on provided bracket n y p For other regional settings please contact SolarEdge support. ' Itt A higher current source may oe used;the inverter will limit its input current to the values stated. - - Built.-in module-level monitoring F I3IR-nue grade Inverter P/N:SExxz U5000NNR2(for7600Winert-SE7600AU5002NNR2). - (4)Rapid shutdown kit P/N.SE3000-11SO-S1. - - - Internet connection through Ethernet or Wireless _ M-40 version P/N:SExxxxA-USOOONNU4(for 760OW inverter:SE7600A-US002NNU4). , - Outdoor and indoor installation "_ �_; Fixed voltage inverter,DC/AC conversion only ! - - Pre-assembled Safety Switch for faster installation '' - Optional-revenue grade data,ANSI C12.1 3 _ _ v t SUf15PEC t - �As ¢ tR USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THENETHERLANDS ISRAEL WWW.SOIdrEC(ge..US � r � Ty t a f r r � sC3 , u ,n I A. h i U M i ffi I Q� u ?� 8,05 00 O �G a W pp _ Z 0 �e. Z i i Co 0 uj q„ N N � a N N' n f n 1 N - I VL 557 1 r I rr i f I i � fC .� �RANK y tau uv� TOWN OF BARNSTABLE ZONING BY--LAWS DATED SEPT 14 1987 c ZONE: RC_ 1 ccOdrvisrmiSi ,irr�c �`L9-e� ✓ SETBACKS �oPEN SPRc�� /ze �uc�u FRONT 20' o SIDE = 7.5 czn YD" �/ r REAR _ 7.5' I PROPERTY LINES SHOWN HEREON WERE COMPILED FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT NO. 3.3035.20 AN ACTUAL SURVEY ON THE GROUND. THE. STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED PLOT PLAN ON THE GROUND BY SURVEY ON NOVEMBER 10 1988 in AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. BARNSTABE._E MASS THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND � SCALE: i ' _ 20' NOVEMBER 28 1988 SHOULD NOT BE USED FOR ANY OTHER PURPOSE. _...__.__ �_.:.:__ .:._ _.-_ : ..::: .Yo✓, 0 9 a THE BSC GROUP—CAPE COD INC ROUTE 28 MADAKET PLACE B12 DATE PROFESSIONAL_ LAND SURVEYO� MASHHPEE, MA 02649 (508) 477-2525 i i � I p.e.4as flbl•a9 C s� wlnt S P jq Pe�u,4T� L=7 3 4/ 9ti 1'7 2 U tk o Oe Gv W-•oo z' 0 3C i3.gy CoAUC, F 0 0. I itj � LL o - ¢ ,9 iJUN 0�rk a — •o,,, g. `a 2 I UF s z� 4.� C. s\` FR NK �= (V�lt�ill`ti�3(� TOWN OF BARNSTABLE ZONING }�J 1'4 j'u. .G I..JV BY--LAWS DATED SEPT 14 1987 ZONE: K- 1 SETBACKS SpRctE) FRONT 20' SIDE = 7.5' �j REAR 7.5' PROPERTY LINES SHOWN HEREON WERE COMPILED FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT NO. 3.3035.20 AN ACTUAL SURVEY ON THE GROUND. THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED PLOT PLAN ON THE GROUND BY SURVEY ON NOVEMBER 10 1988 in AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. 1 BARNSTABLE MASS . THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE: 1" a 20' NOVEMBER 28 1988 SHOULD NOT BE USED FOR ANY OTHER PURPOSE. THE BSC GROUP-CAPE COD INC ROUTE 28 MADAKET PLACE B 12 DATE PROFESSIONAL. LAND SURVEYO;r i MASHPEE, MA 02649 (508) 477-2525