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0009 BLACK VALLEY ROAD
.. ,. z �. � � � � � � � � eo � � � - .. _ � .. G � F �, � , a 4 �� �. '. - �� ,. �. y . ,. o �E � _ �. o - ,. n y �� _ � ..,, ..., ... TOWN OF BARNSTABLE BUILDING PERMIT APPL N Map I Parcel Application # Health Division Date Issued / 2.. )3 4 �- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 9 Q hc.K V41[e v Ro a d Village 6cn4e.rv�IIe, Owner Jo h r\ KCL.y e. Address Qlgc% ycdk✓ Ro a d Telephone 612 YG o q/13 Permit Request Shy+Qlla};�� of. 3a . LU Solar. /10Jktc.1 2a0wa4 -(�Sk MO44ecl ors ree-r o:r<' &ijJivi . UK, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 35,0 Construction Type Lot Size i 36 g(�: Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure NW Historic House: ❑Yes *(No On Old King's Highway: ❑Yes Id No N Basement Type: Full ❑ Crawl ❑Walkout ❑ Other �� Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑`existing U-new maize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 0, Y = v Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# 5-2 Current Use Proposed Use APPLICANT INFORMATION (BUILDER:OR HOMEOWNER) N Name A/C.Q HolyN �c Soles I�isi� LLG Telephone Number Address License # Aia3 ec, /4A Q 6q 9 Home Improvement Contractor# 17559? Email mfcp SWorker's Compensation # Q G- E66 22 Win'/ ALL CONSTRUCTION ARIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Garms- •au ��QMSt�� Sfa Jioy\ SIGNATURE DATE J'Y S 'r FOR OFFICIAL USE ONLY ` L APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION r , FRAME INSULATION 3 FIREPLACE ELECTRICAL: ROUGH FINAL .., PLUMBING: ROUGH FINAL AS: ROUGH FINAL FINAL BUILDING t DATE CLOSED OUT 1 ASSOCIATION PLAN NO. R 1 S i r7 Properiy Owner Consent form, Owner: John Kaye Address: 9 Black Valley Road TOWN: 'Clanterville State: MA Zip: 02632 Phone:. a17466 4.1331 I hereby'give permission to Solar•R sing:11 az�cl their L-epr sentatives to pull the required permits for a solar installation on my property. roperty r D.a Solar Rising Date Tom. Petersen Architects Planners Construction Official November 16,2015 Building Department for project at: November 2'),2015 revised 9 Black Valley Road Centerville, MA 02632 Re: Solar Panel Installation Kaye Residence 9 Black Valley Road Centerville. MA 02632 Dear Sirs, I've reviewed the proposed solar panel installation at this location to evaluate the existing roof structure and-the connection of the panels to the roof. Criteria: Applicable codes: 81h EditionResidentia.l Code.(2009 International Residential Code with Massachusetts Amendments) 2001 Wood Frame Construction Manual Design roof load: 35 psf live load, 10 psf dead load, 45 psf total load Design wind load: 1 10 mph, 35 psf; Exposure Category `B' My findings are as follows. I. The new solar panels will imply an additional dead load of 3 psf. The existing roof structure (2x8 roof rafters @ 16"o.c,,with 2x4 collar ties and 2x10 ridge, span =+/- 12'-2") is sufficient to bear this additional load. 2. The solar panels are attached to the roof with time SolarMount-I rack system by UNIRAC. The rack system,roof connections and connection spacing are rated for 1 10 mph. This project requires the larger Solar Mount 1-2.5 beam(2.5"high)and spacing of Flange foot connection to roof at 48"o.c.maxim-num. Flange footingconnections to the rail are not required to be staggered. — q gg The flange foot connections to the roof are 5/16"diameter x 4"long lag bolts. I therefore certify that this installation complies with the applicable codes and design loads mentioned above and is acceptable for approval. Please let me know if you have any questions on this information. Thanks! ��EtED gRCy Si rely yours, `O P5 F. a o No.31621 z HOWEL Tom PetersenQ NJ �y Cc: Neal 1-lolmgren, Solar Rising LLC �h� {T"OF MP-2 PGA 6 Country Lane•Howell, New.Jersey 07731 Telephone 732-730-:1763, Fax 73.2-730-1783 i Llfe's Good 0 0 aD T-M , M b ®_ t IL- LIS280S1LG27;IL 5S1 C 63/ LG270S1 C B3 LG265S1 C 63 MonoXT"series are LG Electr&hi high-quality monocrystall ne module brands The quality is the result of our strong"commitment 1 61 developing a module to improve benefits for.customers. Features of.:MonoX`"'senes include higher efficiency antl durability than LG previous models convenient installation and aesthetic exterior. - _ APPROVED PRODUCT:--: -- - °�E C uL us_ W564573- BSEN615'I P� ('F 'ovoiWK"Mnd es "`43y isisky' LIGHT AND ROBUST ® ® CONVENIENT INSTALLATION ® With a weight of just 16.8 kg(36,96 lb),LG LG modules are carefully designed to benefit installers Light Weight modules are proven to demonstrate outstanding by allowing quick and easy installations throughout the durability against external pressure up to 5400 Pa. convenient carrying,grounding,and connecting stages of modules. Installation 100%EL TEST COMPLETED THE EXTRA 290 POWER All LG modules pass Electroluminescence inspection. To minimize losses due to mismatch,LG produces 3 groups I% AM EL Testop This EL inspection detects cracks and other 0' of solar modules which are sorted by its current class. imperfections unseen b the naked eye. This enables MonoXTM to maximize the system's output by P Y Y current so,ti.9 around 2%based over the theoretical calculation. RELIABLE WARRANTIES POSITIVE POWER TOLERANCE - LG stands by its products with the strength of a LG provides rigorous quality testing to solar modules u��ar warr„>,ty P 4 q Y 9 global corporation and sterling warranty policies. ° to assure customers of the stated power outputs of all LG offers a 10 year product limited warranty and eoT modules,with a positive nominal tolerance starting at 0%. a 25 year limited linear output warranty. About LG Electronics LG Electronics is a multinational corporation committed to expanding its capacity with solar energy business as its future growth engine.Our solar energy source research program was launched in 1985,backed by LG Group's rich experience in semi-conductors,LCD,chemistry and electronic materials industry.We successfully released the first MonoXTM series to the market in 2010 which was sold in 32 countries in 2 years.In 2013,MonoXTM �. NeON won"IntersolarAward",which proved its leading innovation in the industry. MECHANICAL PROPERTIES ELECTRICAL PROPERTIES(STC*) Cells 6x10 LG280S1C-B3 LG275S1C-B3 LG270S1C-B3 LG265S1C-B3 Cell vendor LG Maximum power at STC(Pmpp) 280 275 270 265 Cell type Monocrystaltine MPP voltage(Vmpp) 31.9 31.7 31.5 31.3 Cell dimensions 156.5 x 156.5 mm/6 x 6 int MPP current(Impp) 8.78 8.68 8.58 8.49 a of busbar 3 Open circuit voltage(Voc) 38.8 38.7 38.5 38.3 Dimensions(L x W x H) 1640 x 1000 x 35 mm -- 64.57 x 39.37 x 1.38 in Short circuit current(Isc) 9.33 9.26 9.17 9.11 Static snow load 5400 Pa/113 psf Module efficiency to 17.1 16.840-+90 16.5 16.2 Static wind load 2400 Pa/50 psf Operating temperature(°C) Weight 16.8±0.5 kg/36.96±1.1 lb Maximum system voltage(V) ___ 1000(IEC),600(UL) Connector type MC4 connector IP 67 Maximum series fuse rating(A) 15 Junction box IP 67 with 3 bypass diodes Power tolerance(%) 0-+3 Length of cables 1000 mm/39.37 in *STC(Standard Test Condition):Irradiance90O0 W/nr,module temperature 2S"C,AM 1.5 Glass High transmission tempered glass *The nameplate power output is measured and determined by LG Electronics at its sole and absolute discretion. Frame Anodized aluminum ELECTRICAL PROPERTIES(NOCT*) CERTIFICATIONS AND WARRANTY LG280S1C-B3 LG275S1C-B3 LG270S1C-83 LG265S1C-83 Certifications IEC 61215,IEC 61730-1/-2, Maximum power at STC(Pmpp) 205 202 198 195 Salt Mist Corrosion Test(IEC61701), MPP voltage(VmpP) 29.3 29.1 29.0 28.8 DLG-Fokus Test"Ammonia Resistance", MPP current(Impp) 7.00 6.92 6.84 6.77 UL 1703,ISO 9001 Open circuit voltage(Voc) 36.0 35.9 35.7 35.5 Product warranty 10 years Short circuit current(Isc) 7.52 7.46 7.39 7.34 Output warranty of Pmax Limited Linear Warranty* Efficiency reduction <4.5% (measurement Tolerance±3%) (from 1000 W/m'to 200 W/m') *1)1 st year 975',,2)After 2nd year 0.7%p annual degradation,3)80.2%for 25 years *NOCT(Nominal Operating Ceti Temperature):Irradiance 800 W!m',ambient temperature 20"C,wind speed 1 m/s TEMPERATURE COEFFICIENTS DIMENSIONS(MM/IN) NOCT 45.0±2°C 1000M37 5.5•4.0(x.;ewl o.ain h¢len(4e,) W:e¢r en¢n aee) Pmpp -0.43%/°C a.ozsn e) 96O/3T80 Drain holea(4ea) (Dintmtt batvaen m¢unNng hales) 18l0.71 Voc -0.31%/°C aeA a9 ml Isc 0.04%/°C A l2-04.3 CHARACTERISTIC CURVES 8.08.u(2Mun1000w e800 WY 7 5 600 w E E a 4 400 W a 3 n 200 W E V 2 e `¢ t 1 0 5 10 15 20 25 30 35 40 Voltage(V) 94a/37.17 I ^ 140 120 -------- ---- ----------------------------------------------- e'i 1 v ---------I > Isc D v md Voc ao ------------------------------------------------------- ----- -�`---- 3Sn.3a 10l0.40 10/0.40 60 Pmax 4.010.16 5.510.22 08/031 m m m DetailX D-HY Detell 2 28/1.10 22/0.87 0 -40 -25 0 25 50 75 90 Tem re" Lung side frame " s"defiame Pelatu (CO *The distance between the renter of the m°unting/grounding holes. North America Solar Business Team Product specifications are subject to change without notice 51�4 / LG Electronics U.S.A.Inc "LG Ufe's Good"is a registrated trademark of LG Corp. Marnril. 1000 Sylvan Ave, All other trademarks are the property of their respective owners.LU Y Englewood Cliffs,NJ 07632 DS A3 60 C US F EN 30829 With LG,It's all possible T11 Life's Good Contact:ig.soiar@tge.com Copyright©2014 LG Electronics.All rights reserved. t www.lgsolarusa.com 05/01/2013 Grid Tied Photovoltaic System DC Dating 9.6kW John Kaye 9 Black Valley Load Site Details: All Work To be in Compliance with: Solar Rising Shall install a 9.6 kW Grid-tied 2014-National Electrical Code (NEC) Photovoltaic system comprised of(32) LG 300 21 C- 2009 International Residentall Code (IRC) B3 Modules with (32) Enphase Energy M250-60-2LL 2009 International Building Code (IBC) Micro-Inverters. The Modules will be flush mounted to the 2012 International Fire Code (IFC) Asphalt roof. MA 780 CMR 811 Edition ASCE/ANSI 7-05 Minimum Design Loads for Buildings and other Structures. Equipment Specifications: Modules; (32) LG Solar 280N1C=A3 Inverters: (32)Enphase Energy M25040-2LL Racking: Unirac Solar Mount Attachments: EcoFasten Flashing with 4" Stainless Steel Lag Bolts Tj Roof Specifications "id: f n Roof `•'� �� m ^ �Q� s � �at ac ,� "-., r � r�-+w .,�--'ems � �+wSM tY Asphalt m 2X8 Rafters 16" Pitch: 25" Azimuth: 2400 - � �. ��4 " '; & <3.+i. �'� �r a4 .gym rn♦ ' � . y.€$' w '8' r Site Specifications: 17 Occupancy: 11 " Design Wind Speed: 110 MPHx Mann Roof Height: 12ffi A 5 f "� ��3 w.nNe , 5 t �s ,-11'' Ground Snow Load: 35 PSi W'W t> ,• .dA ,^, 463 .{pyTu up. aJ. �m _ Solar Rising LLC Project: - John Kaye Solar Rising Building Permit Plans SO r 508-744-6284 Reviplon: 1119/15 PO Box 2623 9 Black Valley Road Sca110: None r i r7 Mash pee, Ma 02649 p Centerville, IAA 02632 Drawn By: Neal Holmgren t t *i•.» tVPA a d m s t u as fi N Fla t �'�tf El •Quantity of attachments = 42 @ 48" O.C. -Maximum UniRac Rail span = 48"O.C. -Maximum Allowable Cantilever = 16" -Racking and Attachment` UniRac Solar Mount with Snap and Rack Corrugated Saddle Block with -lag screw, Hex Head, 18-8 SS 5/16" x 4" Length -Array Installed According to the UniRac Solar Mount bode-Compliant Installation Manual. Solar Rising LLC Project: .John Kaye Solar Rising Building Permit Plan Ua' 508-744-6284 - Revision: 11/9115 r 9 Black Valle Road PO Box 2623 y Scale: None Mashpee, Ma 02649 Centerville', MA 02632 Drawn By: Neal Holmgren Y �- Specles�:_.'Spruce Pine F,P ;v r; v I Grade: No 2 1 Aiember[}peR�fters "'PIP oyd) kY.' Denection Limit'' Spa¢iug(1n) 16� it � . .. Wet,Ser ice conditions? ;ND ' lv', Exterior Exposure; Incised lumber: 12 Snore Load(Psi)' '357777 7-77 Dead Lord(Pst)i to v; ._�„ CCaiulake TMaxi(tnim Hors ixantai Span 2x1 2 The Maximum Horizontal Span is: 1ft. with a minimum bearing.length of 0.67 ia, required at each end of the member. raperty VsEiae jSpestes ... .......... 5pivee Pme Fu .,{. . •; 'f Grade Size 2x3:' !.Modulus of Ehasticity(E) 14Q0000 psr;; 3 BepdSig.Strength(Fb) • i Bearws Stisngdl(Fcp) 425ps� !Shear Strmgth(F„) iSti 2S psl -z Solar Rising LLC Project: John Kaye Solar Rising Building Permit Plans 508-744-6284 Revision: 11/9/15 SOW`- - 9 Black Valley Road _ rPO Box 2623 Scale: None - Mashpee, Ma 02649 Centerville, MA 02632 Drawn By: Neal Holmgren ,k4 WRsien:GE. i"'Aa6uoe WSheCrOl-L F4^ li ( 0 h.� f. w uau i � � lid ... ,. 5 iA Y A � ' t » ., ... _ ; T a�,A mi # Arr 'c are q� awe r NA SECTION A-A �' �P,-5, '� �; ST 'sty .3j�1S9,iU t4a'u�Ct.cht Yx.vwdPvm]tEMi-A:WdGTy:u q�A'4m.xPlkw�toa�rv.A4,5�mMmt:IQl.t. •, .v , � Solar Modules to be flush mounted to existing roof structure and set above shingles 4" Solar Rising Building Permit plans Solar Rising LLC Project: John Kaye . S 508-744-6284 Revision: 11/9/15 _ r 9 laQk Valle Road PO Box 2623 y Scale: None kF " ' Mashpee, Ma 02649 Centerville, MA 02032 Drawn By: Neal Holrngren r, Grid Tied Photovoltaic System DC Rating 9AW John Kaye 9 13166k Valley Road Site Detail : All Work To be in CoMpli nce with: Solar Rising Shall install a 9.6 kW Grid-tied 20%National Electrical Code (NEC) Photovoltaic system corhorised of(32) LG 300 21 C- 2009 International Residentail Code (IRC) B3 Modules vwith.(32) Enphase Energy M250-80-2LL 2009 international Building Code (18C) Mioro-Inverters: The Modules will be flush mounted to the 2012 International Fire Code (IFC) Asphalt roof. MA 7$0 CMR 811 Edition ASCE/ANSI 7-05 Minimum Design Loads for Buildings and other Structures. E uipi elr t Specificati ns: Modules; (32) LG Solar 26QN1043 Inverters! (32) Enphase Energy M25040-2 RaGking; U2irae Soler Mount Attachments: EcoFesten Flashing with 4" Steinl :ss Steel Leg BoltsISI - �f pef�iB.��i l®II-Ia '�° s �' a /f .. 'V '1,4 \ Roof.. -. ... , a .. As 2X8 Rafters 10" r- Pitch: 26" Azimuth: 240° w. Site Specifications Occupancy: it Design Wind Speed: 110 MPH . Moan Roof Height: 12ftr � xRto � Ground Snow Load: 35 5 m aT � r ..a, � •6',:� ` �� a Soler Rising Bulldi.ng permit Plans SoI r I teing ll- C project; John Kaye a S, I -a* r508.744.6284 Revlelon: 11/9/15 Po Boxzs23 9I�ck VIIy Read scale; None M , Centerville MA 02632 Drawn By: Neal Holmgren 7 #kA S 1 1 n�' '� 4 �'�,� �b �t G' r�a, sp '� �=•---�1 > �y . P � �'' 'ghy aw J M �y, . ad t �� 1 1�2 � '� ''.: � � rr - . ..,: .�. .,,..,.'. �. P,{..��?°.r,cn<• 3 s��,rk , try r��l r.�, m:Gi�. ,�a�„k ,r., a,a "1aM �,3* �'v a:,' cr w �:s�a,.,4r�:n.,�3, i -Quantity of attachments 42 @ 48" O.C. gMaximom UniRac Rail span = 48"b.C. -Maximum Allowable Cantilever= 16" -Racking and-Attachment, UniRac Solar MoUri.t with $hap and Rack Corrugated Saddle Block with •I49 screw, Hex Head, 18"8 SS 5/16" x 4" Length fAtray Installed Ace9rding to the UniFtac Solar Mount Code,!Compliant Installation Manual Solar Rising iL C Project:$; John Kaye Solar Rising Building Permit Plan S, I r 1 508,74476284 Revision: 11/9/15 9 Black VaIIe Road r P.O BOX 2623 „ Y Scale: None Mashpee, Ma 02649 Celntervill ; MA 02632 Drawn By: Neal Molmgren Species ','Spruce Ping , " F Slze 2X8 Gradei�No a < Member Type�'.Refiers(Snow Load) � Aenection L►mit k(180 4� m -x Spdaiu�(ia); '16 i Vet service conditions? No 1v 1:sterlorEaposure Incised lumber's ' bow tioad(pit) �35 bead Load(psn ';�0 F ` '.`:'Galculak®Ma>rlina�m'Horiztrntat Span. 'd 2x1 The Maximura Horizontal Span is: with .Miilimunl;boriag length of 0. 7 in.: requu eci at each end of the membet. Ptap�rty Vila e Species S�pru—ce—Pme�Fu Site _ 2sc8; tviodulus o£I~lastinr {>r) 14001}d0 psx ; Bccling'Strenglh(Fb}` 1388 62 pin Hearw Stacntth(Fcp)` +25 psi ShearStreggrh(�v) 15>`'�ypsi'°,, Solar Ring LILC Project: John KayeSolar Rising Building Permit Plans 508-744-6284 Revision: 11/9115 9 lack Valley Road PO Box 2623 Scaiec None Mashpee, Ma 02649 Centerville, MA 0632 Drawn By: Neal Holm gren 4 srr�I i 4 s. x 4 ;.. u. Toots a agn a tm omem It r4�1,��Gre�+Fastm Get Poduttua�p Cm<I>eetsGfl•t x�„ ' q + ITT P.:3 j1lk• _ !3 tJ y y r------_ —_—j ,� r;� i j F— Fig- �mmiml w en' m. F bt 4. F e eyl.L•.a� �.e _ �� '�.a j ; SECTION A-A 01 ,yw'F:4V� buy 1 l �0 �A�� r ���� ��,x?�+•�,;A'`{�, �,• yz��''�'�'r,u�t+ac�r�a�r�e srcxd+mr�a..<m.uitncvtu acrsn.rer„ec'u�gxo..p;hmKuw:.�P;,, v ,' :Y:6ddva+ewm>F•M+: a.eni,. Solar Modules to be flush mounted to existing roof structure and set above shingles 4" S®!fir Rising LLC Project: John Kaye Solar Rising Building Permit Plans 50 af OIB 74.4 -f284 Revision: 11/9/15 PO Box 2623 9 flack Valley Road Scale: None e Mash pee, Ma Q2649 p- Centerville, MA 02632. Drawn By: Neal Holmgren I The Commonwealth of Massachusetts r Department of Industrial Accidents I Congress Street;Suite 100 4. Boston,, M4 02114-2017 j evWW.mass,-ov/dirt ',t"ats�ters'�<ra��e�asati���sisst�nee:�i4�sdas•�t ;� Q:t•sl�enetors,'i�Jectr-ica�aasf�lQ�ahrrs: �'tb �;3I1)�'�3'�]•�"tr��:t?�t:�Y�7'1?1:���1;�'1�O�hd�'�'. ' Apnl[cant Information Please Print Legibly Name(Business,'Or;anizationiindividual}: Solar Rising LLC Address: 759 Falmouth Road Unit 8 City,'/St1te/Zap: Mashpee toll 02640 Phone N: 508 744 6284 Are you an employer?Check tfie approprbte box: 06 ro(ee6.(req is et#; i, l am a employer with:employees(Foil anc or parmtme),* 7. New construction i i I I am a We proprietor or partnership and have no employees working For me in 8. Remodeling any capacity,[No workers'comp,insurance required.1 3.01 am a homeowner doing all work myself.[?Yo workers comp insurance required.]' 9. [�Demolition -1; [ J3, ta}k;add4tion; 01 am a homeowner and wi l'be hiring contractors to conduct ail ivoik on my proper,+ Iwilt ensure that all contractors either have workers'compensarion insurance or are sole 1 LE]Electrical repairs or additions proprietors with no employers.- t?0 Plumbing relliairs or additions a` .i am a gawall cog v'", and't itae e:l:ired t1 e up.the;ttaL+ed shect. �,M i.: Roof raies inese sun-cucriraciijrs have empiuy'acs and'naxe eyori:crs�comp tnsurau3ce.-. u- 6.Q we are a corporation and its officers have exercised their right of exemption per hiGL c 14.100ther. Solar 152.§1(4).and we have no employees.[No workers'comp insurance required.) *An,,°applicant-that checks box 91 must also fill out the section below showing their workers`compensation policy information. t.�or;u�..ner3 cc��v suYtrti�:Efitis a!~ucEdyc_ rdtc�tiiigtfiev arc,itatng aElwac�.:s d=ter ht c.uicfc e�rtray:tar Tusr:s,.cmit a tt'Fsr r2iddYit rndjcatiiar Facet: Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provider their workers'comp. polies number I Tana an employer that is providing.workers'compensation insurance for net;employees. Below is,the polio and job site coal vi rausccuae. • Insurance Company Name: Travelers Indemnity Company Policy#or Self-ins.Lie,9i UB-513677050-15 Expiration Date: 11/02/16 Job Site Address: ! �I�t�kvG ����drl Ctty/State/Zip: C,—*,V'I�c" Attach a copy of the workers'compensation'p6laey declaration page(showing the policy etctmber and expiration datej. Failure to secure coverage as required under'U G&c. 152,§25.A is a criminal vsio)ation..punishable by a fine up to SI,3WOO ,.ar ir.�_ :e „t.;�,. ; �w,; � c C r'(No tlr(10V 4NDANC0 .,,,.4.,V.—.,P— V f4M A L„e-3+eW. p^',� D — , d,...�—11—,_..,...0 ..,...— uY 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 ce ' under the pains and penralties.of eilitty°that the informadfon provided above is true and correct Sim atitre: -`3 Date: 1'f02115 Phone1i: (OAg-f �' IDf�ri»t sscu nwl�• dl�vs snn0 rerriPo in PEeie noon to ha��twe»laSurB Ar•avhr nr ssi�urp�i�nrn/ City or 'own: Permit/License# Issuing Authority(circle one): arrlea3t3x: BtaiJtin;Je`prrttte ,33Ciz> owsr° >r�i+ t: ectia1 Jnsiector. ?i?'Jtgxtseg#or-. 4.Other Contact Person: Phone#: t}.].5 5.,a2.56.�AM PAG ;?1,100'2 r fj, rger04 CERTIF.IGrkVi �� • � �,e O L ABILIT1f NSURM E ° GATE Is ISSUED AS'A MATTERpFINFORA0AT10N ONRYAND':CONFERS NO RIGHTS UPON THECERTIFICATE OLDER�THIS ,LATE DOES NOT AFFIRMATIVELY OR NEGATIVELYFAMEND;E7(7END QR�ALTER TI E CO�/ERAGE AFFORDED i3Y TtiE POLICIES BELOW ` ,GEHTIFICATE OF INSURANCE DOES NOT CONSTiI E A EONTRACT BETdifEEN TH IS9UING';flVS11RER(S�AIllHOR12ED REPRESENT/111VE B ` AAPORTANT:If the certificate holder is-'in ADDITIdNAL`INSURED the oltles must be eedorsed if SUBROGATION=1S iN1UVED s ect to ` he terms and conditions of the policy,certale policies mA p j yxrequlreand.endotsementAstatement.onsthf�s certtfiptedoes no#confer r_tgMs to he certificate holder In lieu of such endorseinen sue, PRODUCERx CONTACTu � PAUL PETERS AGENCY INC 680 FALMOUTH ROAD a = r � � �,,.:(A/C,No Ext)� ,� 'g a ��''� , (AlCNo) �� ;4 •, MASHPEIw MA 02649 fADD E-MAIL RESs � ,.• `r�s � � r 8 ;4.€` f: lam' " 4 CM 28LBR INSURER(S)AFFORDING COVERAQE�� a ' NAIL If 3 y: INSURED iNSURERA TRAVEL.ERSINDfiMN1TYCOMppNYOFAMERICA SOLARRISINGLLC INSURER B INSURER C: t-x kr s a PO BOX 2623 INSURERD: INSURER E: §4 s, r� MASHPEE,MA 02649 INSURER F.- COVERAGES CERTIFICATE NUMBER: REVISIONTHIS ISTO NUMBERo 4 .. . A CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW 14AVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDX:ATED. NOTWrrHsTANDING $ _{ ANY REQUIREMENT,TERM Oq CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAE9,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 REDUCER PAm CLAIMS. W8R ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (I/lN40D1YYYY) (MMDDIYYYY) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. DAMAGE TO RENTED $ REMISES(Ea occurrence) MED EXP(Any one person) $ r GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ GENERAL AGGREGATE S POLICY El PROJECT❑LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY ANYAUTO 1 LIMIT accident) $ LIMIT{Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILYINJURY $ NON-OWNED AUTOS (Par accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE _ $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ $ T". RKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYEMB LIABILITY Y/N UB-59677050-1S 1110212D15 11/02DIS LIMITS ANY PROPERITOR/PARTN CUTIVE � OF t NIA E.L EACH ACCIDENT $ 1,000,000 FlCERMIEMBER EXCLUDED? 1•• � Is,des(Mandatory in and E.L.DISEASE-EA EMPLOYEE $ 1,000,000 n Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/,RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE LSSDED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE INSURED'S MA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY TEM INSURED'S MA EMPLOYEES IN STATES OTHER THAN MA. NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MA IF THE INSURED HIRES.OR HAS HIRED EMPLOYEES OUTSIDE OF MA. THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. CERTIFICATE HOLDER CANCELLATION , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED. IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT .VE ACORD 25(2010/05) The ACORD name and to o are re ist """�'""""• „•.„ g 9 eted marks of ACQRD 1988 2010 ACOR' 4 - D CORPORATION. All rights reserved. - t = ice of Consumer`Aff and Business Regulation 10 Park Plaza -Suite 5170 Boston, Massachusetts 02116 Dome Improvement Contractor Registration Registration: 175578 Type: Supplement Card Expiration: .5/28/2016 SOLAR RISING.LLC. VEAL HOMGREN 759 FALMOUTH RD MASHPEE; MA 02649 Update Address and return card:Mark reason for change. oPs•CA1 0 SOM•04104-G101216 Address Renewal [] Employment C.� Lost Card �te`Coo'Jtt•!)tu.tras•crlf�'n�����lJdaC�tt6e�3 Olftice of Consumer Affairs&Business RegulationLicense or registration valid for individui use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1 4�f1 / Registration: 175578 Type: 1€i.Parlc-PIaaB-5tiite 5170 Expiration: 5/28l2016 Supplement Card Boston,MA 02116 SOLAR RISING I.I.C. NEAL HOMGREN l J P.O.BOX 2623 MASHPEE,MA 02649 undersecretary r Not valid without signature .F Massachusetts Department of Public Safety ' Board of Building Regulations and Standards License: CS-M921 µ constriacfon supprvisol NEAL F HOLMGREN 76 SPRING HILL RDA �� EAST SANDWICH MA OUT a j �-/,__ Expiration: Coil3missioner 09/18/2017 i ' j Species' Spruce Pine-Fir _. Size 2x8 _ ED � Grade Ptb s A v: ��¢ R cy r Member T3 pe Rafters(Snowy t oad) ��(�O�Q$ F' PFr� i Deflection Limit i L/160 n Fes- No:31'6'21 z in Spacing(in) 16 11'tt Seri-ice conditions' 3. Ho WE LL, ,_.. —— -.-..,:, w o NJ y Exterior Exposure NO v ty� pGs. Incised lumber' N 12 .. ........ Snows Load(psO 35 Dead Load(p:t)' 16 Calculate Maximum Horizontal Span V� 2x12 The Maxinlutn Horizontal Span is: 14 ft. 3 in. with.a minimum bearing leneth of O.67 in. required at each end of the melnl)er: Pr�iperttr fVaIne ; (SPcats ISpruce Pipe Fir ;Size e5 ;Modulus of Elastrcit}tF) 11400000 psi 'Bending,Strength(74) t iSS.67 psi s, �Bearing Strength(Fcp) i 2,�,pal Shear Sucngtlt(F'rtr: a x5}is ' } g 1 y _ - sin . Build!n.. Permit Pla Solar Rising l,.�.0 Project: John Revision 9 9 no n Kaye Solar Rising Solar,)508-744-6284 9 Black Valle Road ,,/9/,s PO Box 2623 Scale None Mashpee, Ma 02649 Centerville, MA 02632 - _ .. - - Drawn By: Neal Holmgren I Town of Barnstable 593 Expires 6 months from issue date Regulatory Services Fee * anxtvsTass, KAM t639 Richard V.Scali,Interim Director s63q �� ��En�° ,�sll►y Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,.Hyannis,MA 02601 www.town.bamstableima.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY O Not Valid without Red X-Press Imprint Map/parcel Number Property e Address i r y (�rack Vc,l►c.� �2 rA �O i �r NfResidential Value of Work$ y Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address U G�n -4 _:to y C e, 1C th y -C C1 6?CtC1c •vu 11-t 2A ce �,Ye.-v; J(ce Contractor's Name 1-1,0"^eL s (3uT 1 P✓ Telephone Number 5 0 Fr ? 6 6 9-3 7 Home Improvement Contractor License#(if applicable) 11 9 777 Email: GO n St✓a G /� G�w+ckS ri h Construction Supervisor's License#(if applicable) G 7 O 4 Workman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor JAN, 2 9 2014 ❑ L2M the Homeowner I have Worker's Compensation Insurance Insurance Company Name FaI'rvt Fq M; 4 6 a k S r;.r� TOWN OF BARNSTABLE Workman's Comp.Policy# aO i I t. G 33 S 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) 0'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 required. SIGNATURE: } T:\KEVIN_D\Building Changes\EXPRESS PERMIT\EXPRESS.doc " Revised 061313 R i CERTIFICATE OF LIABILITY INSURANCE """DD1/"Y' 18 GERTIRCATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHtrtH uPOM THE Ol/29/2D14 CBRTIpCATE AFFIRMATIVELY OR NEGATIVELY AMEND, HXTEND OR ALTER THE COVERAGE RRTtFICATE HOLDER TNtB BELOW. THISDOES NOT AF CERTIFICATE OF I IPLI RANM DOW NOT CONSTITUTE A CONTRACT r AFFOORDED BY THE PDLMM UCER.AND THE CERTIFICATE HtoLDeIL REPRESENTATIVE OR PROD THE ISSUING NtBURERf3). AU►NORIZED e ee rUS an AODITIOKft SURM, t" po tIIS the terms end WIWMI-m Of the polky, oartaln Policies mpr reqube an ando+s 11011L A 86ft neat on Bib oertlNeete do" not eoMa COfd oft holder In Also of Such�) dgllM eo the PRoou�t BLAIR AGUNCY,INC NAre RICHARD J BLAIR 145 SO RSAMN STRUT �� 509-966-9150 29N,F508-066-5334 CARVER, MR 02330 Pools. "Mum)AFFOW MMo COl1ER"m INSURED 41nRmeA:23UN FAIffLY Ch8CERLTY INIS CO THOMAS J BOTLm bah CONTRACTING S3RVICRS wIBRBR0: 1 CaRDaN,DR BRURIBI C: Wf1A®11D� CARVER, MR 02330-1202 BrsIR�tE: COI/ERAGES P CERTIFICATE NUMBER: REVISION NUMBER! THIS IS TO CERTIFY THAT THE POLICIES OF MSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THr= POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOthT, MENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUrN1Eld1 WRIT R'SPECT TO WHICH THIS CERTIFICATE MAY K ISSUED OR MAY PERTAW, THE INSURANCE AFFORDED BY THE POLICIES DESCRJBED MERFJN IS 3UIMECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UMIT9 SHOWN MAY NAVE OEM REDUCED BY PAID CLAMS. LTR TYPE OF INSURANCE BRIT wYD w .PpJCr Is�eeal pNlormrn peBDOVr►rr► Yen? NuWISRAL LIABUTY EACH OCOURREHGB 3 1,000,000 OOMMERCIAL GENERAL UAe0.RY 2012XO156 r� pREW6E41��nAoi► i CwNawADE U OCCUR 11/01/ 11/01/2014 Man E p wj em Pe. 1 - 5,000 % PERSONAL A ADV INJURY s INCLUDED GENERAL AGGREGATE i 2,000,000 GEN'L AGGREGATE UNIT APPLI[SPER PROM=M-COMPIOPAM a 2,000,000 S Poucv PR�a LOC i - . AUTONOB LE UADRM ANY AUTO — ALL0VWM ��I,EO B0031Y NAM IF-pw—) �TOB AVMS eoogrB3JUIFv(Perm90cnp s - HIRED AtrroB NON-Owmm - 3 AUTOS ooewent � 3 ' UMBRELLA LIAR aoCUN EACH OCCURRENCE i LQIOEdi LIAR CLNMSaIADE AOGREc3AATa DID RETT_MION i a 1MDR3IJIIq rnrt�IIBAIIpN "a emm9y el UXIMLI:Y YIN $ TORY LIMBS ER A ANY 10/04/2 10/04/2014 EL EACH ACCIDENT i 100,000 oFFlcewIlEUBe3ExtxuOm� OInNIR Y❑ MIA 201ZIIr6335 (MegO"v In NN) If yea,aeemme wider EL DISEA F--FA P.MPLOYEE r 10 0,0 0 0 DESCRIPnoNOFOPEW,nONBDebw ELDKWAsE-F(XrYUMIT 3 500,000 DESCP"ON OF OPE RArON1 I LOrAT*W I V (INIac}I ACOM M,AGellloml Reowrb BNwdule,R MM spies M RIQI IW OPERATIONS PERFORIOD BY NAMD INSVRED. TAOM&S BUTLER IS NOT INCLUDED IN THE WORIERB CCWMSATIgN P CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLIC SHOULD ANY OF THE ABOVE DEI)CMIM POLICIES BE CANCELLED REt:eRE AIMG DEPT, THE EKPRATMN DATE TMEM01<, NOTICE ssaL DELMEREM IN 367 NAIN BTMET ACOORDANCE WATH THE POLICY PRCVMKW& BARNSTABLE, MA, 026307 ATrvE rAx$ 508-7' 90-6230 ® 0 ACOR0 CORPORATION. AI dghta nma.d. ACORD Y5(z0taws) The ACORD name and logo are , red merits Of ACOR r The Conrcmonwealth of Massachusms D partoaent of Indarsoial Accidera ' f 'Office of Inve-stigadons 600 Washinglon.Street Boston,ATA 021H wnnv.mas&gm,1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please:Print I�ib1y Name(Businesdoxgaaizationlladividnao: INN JI "►ALS ��l���✓" )7 Q�- GQ 41�Y�t�!✓1 S' S Prvl��.� Address: G—u �-1✓I 1 Jr ✓.e! City/StateJZip: CAr✓e.- M K- U)-33y Phone** ?4 6 q 7 Are n an employer?Check the appropriate box; , T of project 4. I a�a general contractor and i YID p J ( �e� 1.LI I am a employer with ❑ g 6- ❑New construction employees(full and/or pact-time)_* havehired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees Thy sob-contractors have 8. ❑Demolition wracking for me in any capacity- , employees and have workers' 9- ❑Budding addition [No workers'comp-insurance comp-insurance./ required-] 5- ❑ We are a corporation and its 10.❑Electrical repairs or additions 3-❑ I am a homeowner doing all wank officers have exercised their 11-El Plumbing repairs or additions myself[No workers'comp_ right of exemption per MGL 12.❑Roof repairs insurance required.] r c_1.52,§1(4� and we have no employees-[No workers' 13-0 Other comp-insurance required-] ;Any applicant that dhecks box#1 mars#also fill out the section below showing tr&woikets'oampeasadon policy imbnnataan- HomteoEvners who submit this affidavit int cating they are doing aU mama$Bad then hire outside contractors must submit a new affidavit indicatigg such. IC©u=tors that chEa this box mast attached an additinaal_ih.m showing the name of fae sub-oemtta mTs and state whether or not those entities have employees. If the sub-contrsctots.have a*Wees,dwy must provide t7 ilr workers'ramp.policy number. --lain art elnplogw that ispmvidhzg workers'coiigwnsatian insurance for ray enyzk yeaL Balow is thepo&cy and job site information. Insurance Company Name: Fa/M Fit Cel,K s 1;ry Policy 4 or Self-ins.Lie.#: 10 11 ko� '6 3 3-5 Expiration Date: Job Site Address: g f3 I cs c k V ej I f e V. � Qty/State/Zip_ L e o tdr v l,1 l,i�: tr,LI Attach a copy of the workers'compensation policy'declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition of criminal penalties of a fine up to S 1,500-00,and/or one-year imprisow rent,as well as civil penalties in the form of a STOP WORK ORDER and.a fine of up to$250_DO a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for inauurance coverage verification. I do hereby cetWA under the pains and pena hies of pedurry thaztthe ire,forunT&n protdded.above is trite and correct Signature: 4�� //� Date: 1 /17 �/y Phone#: sa/- r e 6 q y-37 Official rase only. Do Trot woito in this area,to be completed bye city or totaar official. • City or Totiva• Permitffikense Liming Authority(circle one.): 1.Board of Health 2.Budding Department 3.CitytTowrn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t . e t%e�poawnzootcaeall�o�-� /�aaaac�u�ella� QN Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR - egistration: 129777 Type: expiration ;11/3/2015; DBA Contracting Services Thomas Butler 1 Garden Drive Carver,MA 02330 Undersecretary Massachusetts -Department of Public Safety ' Board of Building Regulations and Standards Construction Super-,i%or I & ? Family License: CSFA-057047, THOMAS J BUTL$R ll 1 GARDEN DR s CARVER MA 0230 4' Expiration 06/26/2015 Commissioner I Jan 271408:29p Contracting Services 5088669837 p.5 • enaxsrnei.$, • , 9MAW 'own of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www-town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder r Z J67 ,as Owner of the subject propeM, hereby authorize Th am 6L� —J, to act on my beh f, in all matters relative to work authorized by this building permit application for: ` 9 8 o %ell (Address f Job) ApatureOw er 1Date VPtinitame If Property Owner is applying for permit,please complete the Homeowners License Exemption F rm on the reverse side. TAKEVIN_plBuilding Changes\EXPRESS PERM]1MXPRESS.doc Revised 061313 t' a a `-PRESS PERMIT Town of Barnstable *Permit# . SEP 2 5 2006 Expires 6 months from issue date Regulatory Services Fee TOWN OF BARNSTABLE Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 1 �® Property Address 4F 8 L,+c1c V L b• esidential Value of Work 3001 C)C) Minimum fee,of$25.00 for work under$6000.00 Owner's Name&Address fj ffA4 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) J Q(p o �licable,� • ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner , F3'1—have Worker's Compensation Insurance Insurance Company Name #rLA4V'7,C— CHj ZT-C-A Workman's Comp.Policy# 1 a Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to L3,AIW 5'fIA6 L ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum ,44) *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. . Home Improvement Con actors License is required. SIGNATURE: s Q:Forms:expmtrg Revise071405 TYNDALL ROOFING � ,��.sw�y rr,,8 Prop o t 1t1hks�� /e'� 11'1L5 AnA, 02(p'l 508 420-4456 Page No. of Pages PROPOSAL SUBMITTED TO PHONE DATE STREET If JOB NAME -3_0ttNq- CITY,STATE AND ZIP CODE JOB LOCATION S ARCHITECT . DATE OF PLAN JO PHONE j(?1FX�,p V11,L �, o�� a ao - as 7S We hereby submit specifications and estimates for: Furnish and install new Class""A" Roofing as Follows: A. Strip existing roofing and remove debris. B. Check all boarding and nail as necessary. C. Check all flashing. D. Install aluminum drip edge. ,f PNTF-.b E. Includes ice and water shield to be adhered to roof 18" along entire.lower edge of roof to prevent ice leaks also around chimneys, skylights, roof stacks, and roof valleys. F. Apply shingle under layment - (felt paper). G. Includes new flashing around all roof stacks. H. Apply customers choice of shingle. et Tf nrT,� 1,IgobS'C* r VAS AC[*;7-ZC7 At_ I. Apply continuous ridge ventilation. Any unforeseen rot that may be uncovered during construction, the owner will be informed and made aware of the'extra cost. V QPayment to be ade sfofIows: ! //�',�,.,` / ) All checks to be made payable to TYNDALL ROO G All work to be completed in a sub- stantial workmanlike manner according to specifications submitted, per standard Authorized Practices. Any alteration or deviation from above specifications involving extra $ignaI costs will be executed only upon written orders,and will become an extra charge tur over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire, tornado and other necessaryin- Note:This proposal may be surance.Our workers are fully covered by workmen's Compensation Insurance, withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and concli- tions are satisfactory and are hereby accepted.You are authorized to do the work' ork �i as specified.Payment will be made as outline above. / Signature " 'c c.�/ �� Date of Acceptance:_ � /Icsignature � z F 11 co. N Atlantic Charte a � uCaozao �' _ o.:29211 r Insur � �.�0t nee Company VDgC INSURED; Robert Tyndall Policy Number:. Prior Polic WCV00643001 30 Jillians Way y Number: WCV00643000 Marston Mills, MA 02648 Federal ID.Nu Producer: mber:174560293 Fredericks Insurance A ;usiness Type: Risk ID Number: Inc. gency Individual 1046 Main Street Ither Named Insured: Osterville, See WCE106 SIC:9999 MA 02655 Other Work Places: NONCLASSIFIABLE 'OCICY P - See WCE107 ESTABLISHMENTS ERIOD: The Policy Period Is From: :OVERAGES: To. . 4/6/2007 12:01 A.M. Standard Time iVorkers Compensation Insurance: at The Insured Mailing Address here: ► A Part One of the policy applies to the Workers Compensation:mployers Liability Insurance: Part Two of the Law iability under Part Two are: of the states listed Policy applies to work in each Bodily Injury b state listed in item 3A. The limits of our Y y Accident $ 100,000 Bodily Injury by Disease `her States Insured: P Bodily Injuryb $ 500,000 each accident art Three of the y Disease $ 100,000 Policy OVERAGE.REPLACED po1icy a limit BY ENDORSEMENT to.the states, if an each employee RSEMENT WC 20 03 06A y listed here: > All states except Monopolistic State Fund States Policy includes these endorsements and schedules: VVCE105 ERAGES; The premium for this _ _ Rating Plans. pO%�Y wil!be determined b Al/information required below is subfect to verifi y our Manual of Rules, Classifications, assifications Code Premium Basis Tot a) cation and change b Rates& No. Estimated Annual Rate Per Y audit. - Remuneration $100 of Estimated - Remuneration Annual Premium 00 00 01 Premium: Deposit Premium; - $516 - - diustment: Annually Office: hardon Street Estimated Premium (Minimum P A 02114-4721 Surcharge remiums) ) $500 I Premium Total Pr a Surcharge(s) 16 9/2006 Countersigned B • -- $516 council on Corn y..—__ pensation Insurance ---- _,_.__Da R 2 r �✓G�� aa ons and Standards License or registration valid for individul use c Board of Building Regulati before the expiration date. If found return to:. HOME IMPROVEMENT CONTRACTOR Boar.3 of Building Regulations and Standards Registrations,, 116064 One Ashburton Place Rm 1301 E cpir'tid 5115i2008 Boston,Ma.02108 Type Ltd�Jability Corporation TYNDALL ROOFi1G LLC ROBERT TYNDA,L`L 30 JILLIANS WAY ,,:•.,•-,. ��"'�" " Not valid without signa ure MARSTONS MILLS MA 02648 Deputy Administrator i Department of hidttstrial Accidents Office ofInvestigations* 600 Washington Street Boston,1VIAOZIII- . . . Wvw.mass.gov/dia Workers' Compensation Insurance Affidavit: ]Binders/Contractors/Electricialiss/Plunabers ApOcant Information ]Please Print Legibly Name usines Organization/Individual)• /� �C �.. Address:_ W A--V City/State/Zip:Mk 5M �/� l ZCS�I� (�� ,➢ Phone#: y t f413-(a Are you an employer? Check the appropriate box:. 1.R';I am a•employer with J 4. ❑ I am a general' contractor and I Type of project(required):- ' . employees (fall'and/or part time).* have hired the siib-contractors 6. ❑Now construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers' comp. insurance. o workers' co 9 ❑ BLS addition [N comp. insurance 5. ❑ We are a corporation and its • required.] officers have exercised their 10❑ Electrical repairs or.additions 3.❑ I am a homeowner doing ail work right of exemption per MGL 11.❑ Phunbing repairs or additions myself-[No workers' comp. c. 152, §1(4),and we have no 12, Roof repairs insurance required.].t ❑ employees. [No workerss comp.insurance required.] 13•0 Other��— Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy t Homeowners who submit this affidavit indicating they ate doing all work and then him outside contractors information:tContractnrs thatcheckthis.box must attached sn additional sheet showing the name of the sub-contractors must submit a new affidavit indicating and their workers' such I am an employ comp.policy information. er that is providing workers'compensation insurance for my information. employees Below is the policy andjob site Insurance.Company Name: Policy#or Self-ins. Lic.#: (7 Expiration Date: y Q Job Site Address:Attach a City/State/Lwip' copy of the workers, compensation po cy declaration page(showing the policy number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c. 15.2 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP�WORK ORDER and a fine of up to$250.00 a day'against the violator. Be advised that a copy of this statemenf may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. I do hereby certify er the pains and penalties of perjury that the Information provided above is true and come Si afore: Date:•• D (p Phone#: (, — L(20- 14 f Official use only. Do not write in this area,to be completed by city or town gffuial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Qty/Town Clerk 6.Other 4..Electrical Inspector 5.Plumbing Inspector Contact Person: Phone#: I �f®r atio and Instructions : to provide workers' compensation for their employees. Massachusetts General Laws chapter 152 requires all employerscontract of hire, em 1 ee is defined as"...every person in the service�of another under any x Pursuant to this statute, an ,p oy . .. •• . r express or implied, oral or written." «' association,Forporation or other legal e�itity,or any two or more er is defined as::pn � a�-PartpersbuP', to er,or the An employ a joint enterprise,and including the legal representatives of a deceased emp y of the foregoing-engaged � J , association or other legal entity,employing employees. Hower�er:tlie receiver or trustee of an individual, mo than wee apartments and who resides therem,wor.he o dwt Ofelling the g house owner of a dwelling oou to persons to do maintenance,construction or repair to er." dwelling house of another who employs p entbe deemed to be an emp y or on the grounds or building appurtenant thereto shall not because of such eruploym d the ce or 152 25C(6)also states that"every state or local licensing incy the call ommonwehhol alth for any MGL chapter § permit to operate a business or to construct buildings renewal of a license or ' nt who has not Produced acceptable evidence-of compliance�noz�of�poll�subdrvi�sions shall apphca ter 152, §25C(7)states"Neitherthe co Additionally,MGL chap . table evidence of compliance with the insurance enter into any contract for the perhave been pce of public r sented to the contracting authority." . hav P ' chapter . requirements ofthis P APPlic=ts1 to our situation and,if e workers' compensation affidavit completely,by checking theboxes�, their rtiyour s s)of the s al out number g ease fill and hone () please address es necessary,supply sub-contractors)narne(s), ( ) P s with no employees other than the LC or Limited Liability Partnership (L•LP) iabilitY COmpanies(L ) LLC or LLP does have . insurance Limiteed�L are not required to carry workers' compensation insurance. If an arts , submitted to the Department of Industrial bets orp ' ma be subrm mein aired. Be advised that this affidavit maybe a olicy is req and date the affidavit. The affidavit should ees to Sign employees, P Iron of insurance coverage. Also be sure gin . Accidents for confirms . application for the permit or license is being requested,not the DeparEment of be returned to the city°r town that the app the law ' if you are required to obtain a workers' industrial Accidents. Should you have any questions regarding companies should enter their lease call the Department at the number listed below.. Self-insured compensationpolicy,please on the appropriate line. self-insurance license numb City or Town Officials . lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bou regarding the bt�m P applicant' of the affidavit for you to out in the event the 0 loch will bee used as has number n addition,an Please be sure to fill in the permit/hcense number w le ermit/license applications in any given year,need only submit one affidavit indicating current that must submit nru P and under"Job Site Address"*&e applicant should write"all locatiions the or policy information(if necessary) ed or marked by the city or town may provided. � )„A copy of the•.�davit that has been officially stamp or'licenses..Anew affidavit must be filled out.each applicant proof Ihat.a valid affidavit is on file for;future peirnitrs ay business or commercial venture year.Where a home owner or bum n is obUiningg a licinse or permit not related to 2: leaves etc.)said person is NO required to complete this affidavit. (i.e. a dog license or pit t0 b � ' The Office of Im'estigations would like to thank you in advance for you copg eration 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 . - Llepazh�ent of Industrial Accidents �Me of jnvesdgaflons ,• 600 Washington Street, . BOston,MA 02111 'Tel.#617-727-4900 ext 406 or'1,877-MASSAFE Fax#617-727-7749 Revised 5-26.05 www.mass.gov/ilia �_�___, I �� ��,,� � ��U� ��� �� �--s , � �5��� �-� �@ �- � . _ _ __ _. __ f Al The Town of Barnstable Department of Health, Safety and Environmental Services • BAMMABM = Building Division KAM 1659. 16 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: a14 G /1 17 Village:Address: �G � P� A00/ Type of Business: 74 ZZ& IV �,� Jy/ �� Map/Lot: /�� INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor, no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes,and no increase in air or groundwater pollution. - After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. 4�, • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. �— Gr Applicant: mate: /!� s •.:. •BE. 4 q SEPTIC SIPSTEM M Assessor's offioe.(Ist floor). Assessor's map and lot number ...... .... .:....... i'ASTALLED IN CO Board of Health (3rd floor)::' ,w. WITH TIT �^ Sewage Permit number ........... .......:.���. f ri' ®ItiI�E(�1'r� ��`SIR Engineering Departments (3rd floor): G� , �� ���� House number ..:.'...:.:....:.:......................../......? /�7 ,:... n •k �® c way ale APPLICATIONS PROCESSED 8:30 9:30 A.M, and 1:00 2:00 yP.M. only N OF BARN TABLE TOW S t B#1LDING INSPECTOR h F . APPLICATION FOR PERMIT TO �................. ............. .... . ' TYPE OF CONSTRUCTION ........ .. 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to .the' following,information: - rd �� r Location ............ ...... ...... ................. .. ......... ProposedUse ....:...... ............ ..... ...........................................::.. :................................................................ Zoning District ....... Fire District ...:... ................ ..... l./........ .... .............. ................ Nameof Owner . ........... .... ...........................Address ..........:...............;:........................................................ • Name of Builder ....:..................:::..........::..............................Address' ..........:.:......:...,:............................ ............................... _ Name of. Architect ...............................................:...................Address .......................................:.............................................. Number of Rooms .................................... ....Foundation ......... Exterior ...... .................Roofing .:........... '!� .... ......_......... ........................... ..... Floors � .....•............Interior ...... (F� Heating .:•e ............................... ..Plumbing .... .... r Fireplace ... .... ............................. ...................... ........ ......:..Approximate Cost ., .��`-'�... ...�.....: v 6 `Definitive Plan Approved by anning Board_______ ---------- ------19 _ . Area ..... Diagram of Lot and Building with Dimensions . Fee ............. !`.................. SUBJECT TO APPROVAL OF BOARD OF HEALTH �� r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS w I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin he above construction. . ,Name . ..... ....................... ... .................. • Construction Supervisor's License � 7�� ....... -: SMALL, ALAN � � � , 71 3�1`113 One Story No .. Permit for .............................. . ..... Location .. Lot 1 #66.6 , 9 Bl' ck Valley Road. t Centerville , - ........ ............................................... r Aland'Small tiOwner ............. ....... .. ............ .......... f .Frame ,• �` r T f Constr t' . . .................. ......:!n....... r.. ` .... a s N Plot. ...`.. .. 'X .. f Lof, t_ .r > t Permit Granted ....August 2.1.!:........a9 �> 7 _ , Date of Inspection .22..••.. . .. .......19 �s Date .Completed �!;�3/ .....19�� ra_ Assessor's offioe (1st floor): HE � � Assessor's_anap and lot number ........ G� Q of T To Board of Health (3rd floor): �......_._/ d� o� Sewage Permit number i BAHdsTADLE, Engineering-Department (3rd floor): rHouse number ............:...:..........................//............................ ' DMA a• ^, APPLICATIONS PROCESSEDr;8:30-9:30,A..M• and 1:00-2:00 P.M. only t TOWN OF BARNSTABLE BUILDING INSPECTOR � v APPLICATION FOR PERMIT TO : . TYPE OF CONSTRUCTION ........ .. .. ................................................................................................ j 19n TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information A Location ..... '..:F . ..... ............... ............ . 3 ProposedUse ......... .... .................................... ....:................................................................ A.10-x� . r" ( ( 41) `' ZoningDistrict ..........................� :..........:.....: '......................Fire District ...:: ...ti,.......:........................................................ Name of Owner ....Address .................................................................................... rL a. l ' f w Nameof Builder ....................................................................Address; ....'............................................................................... Nameof Architect ...................................................:.. ........Address .................................................................................... Number of Rooms, ..................................Foundation .. ........... ................................................... Exterior ........���:,.:: ::<.....f.......................................................Roofing - r am/ ............... ...................................................................... Floors -.'.`::!r.................. ......................................Interior ,..... ° ../;......................................................... ` .f r Heating ... � ...._., 'f ! Plumbing ?,L ................................. ...................s. -......................................................... O Fireplace .. . :,... .: . PP Aroximate Cost . : �... � fit .................... .. . :_.. by/ `___ _Definitive Plan A rovedlannin Board _______________ __ ___ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH { a � t e l K I �7 k J e r , ' y OCCUPANCY PERMITS REQUIRED FOR NE W EW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding%the above construction. Name ... ........... ..'4............................. l Construction Supervisor's License ���..z.�..,.�...�........ ,v' SMALL, ALAN A=170-189 I q No 31113 Permit for ...Pale...St9rY......... .......S.ing.le, Familv...Dwel,lgng......... Location ..Lot.,,#,666........ .,Black...Valley Road .................. .Qnt e.x v i.].a,e................................. Owner. .......AIAA... mall$M411................................ Type of Construction ..........F1Z1 l.................... ............................................................................... Plot ............................ Lot ................................ t Permit Granted ..:.........August 21 , 19 87 Date of Inspection ....................................19 Date Completed ......................................19 , . � � . .. � .. n X.. J• S'^ 7`my".r T � �vr,i.e � .. y 'y."�. ,r �T' � i '.T: .. ., f. I TOWN OF BARNSTABLE 31113 o � Permit No. ................. BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .............MCIHYANNIS,MASS.02601 Bond 007 CERTIFICATE OF USE AND OCCUPANCY Issued to Alan Small Address Lot #666, 9 Black Valley Road Centerville, Nass. 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. August 31 , 87 ,�- � ............................ 19................. .s..,.. ..... �......... ............. Building Inspector ..�°•. TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING 7 MYl � HYANNIS, MASS. 02601 i. �`OIUY►• v 0 t MEMO TO: Town Clerk I FROM: Building Department DATE: An Occupancy Permit has{ been issued for the building authorized by BuildingPermit $k...... a�� �... ..».. ............................................................................... .........................._......... ...All .. ...» ... issued to /. */'Gf............../.{ 1/�'.//............... .. �! i » C� t � Please release the performance bond. "' TOWN OF BARNSTABLE, MASSACHUSETTS BUILD I N G PERMIT , August 21 87 A�170-169 DATE_ _ 19 PERMIT D�®i APPLICANT OwnerADDRESS ' 015757 IND.) ; (STREET) (CONTR'S LICENSE) PERMIT TO Build dwelling 11 ) STORY Single family dwelling NUMBEDWELLRNG UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 10L #666 9 Black Valley Road, Centerville ZONING TtC AT (LOCATION') DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION F; (TYPE) , REMARKS: Bewage #86-9 30 ' BOND ; AREA OR 2500 sq. it. 150,000 PERMIT 125.00. VOLUME ESTIMATED COST $ FEE $ ,- (CUBIC/SQUARE FEET)OWNER - Alan Small en ervi e, 4 BUILDING DEPT. ADDRESS BY I A THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB,AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED.UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND - I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. k POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 Ora// Y . 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1 OTHER 2 y BOARD OF HEALTH VVORK S4ALL NOT PROCEED UNTIL THE INSPEC- i PERMIT 'W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STATED WITHIN SIX-MOWTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT IS ISSUED•A;Nff ED ABOVE. NOTIFICATION. v _ sox Io;;u:NE 1l CH l i r t /a3; 1 Y 1 N � M------------ i L�r 41 67 fi 6SoS. F. - T� -- - Al DA t t 0 , r , 11Na r y�^+^�^z`.'--'- t - t t • f r l r - T-c—.L� J!/�/ .� /. /,� q, 3 4y���� :im RQ/'S. I E•r '-t .:ti _l - t r fi CERTIFIED PLOT PLAN LOCATION CC� I, CERTIFY THAT THE FOUIVI?Ai oK) t :SHOWN HEREON . COMPLYS WITH SCALE _ ,o r,, DATE IL-- THEI SIDELINE AND SETBACK d . REO•UIREMENTS ' OF THE TOWN OF PLAN REFERENCE z_Q Liz— LOCATED :ST'fA'F3AND IS AfNoT � WITHIN THE \FLOODPLAIN. 6 1' f • Fs jc� BATE : 6`L5-87 ' Jca�. ,i, BAXTER NYE IN C. C. THIS PLAN IS. NOT BASED ON AN REGISTERED LAND SURVEYORS INSTRUMENT- SURVEY AND THE o�FS'ETS`SHOWN_ S"HOULD—NOT BE USED TO DETERMINE LOT LINES, APPLICANT ALA ki