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0107 HERRING RUN DRIVE
�: � D � .����c n�rr k ..� a k �' � �`. - F �.. � M .. ... _ .. .. _ ,. - �. .,' r.„.o 5 - r � .� a �. .. . s:, �. �;. � � + I a ° ^ . k .� r q, ,. .. . o �" ' j F ;� - fl- '• y . - ,. - . i � ,� P ., n t. i Town of Barnstable Post,This Card So That�t iShed sVis�ble From the Street Approved,;Plans Must be Retained on Job andah�s Card Must be Kept + �A MAC'ABi.B, ,� •z ; ,� dg : 'far l� a` ,a 6 Posted Until Final Inspection Has'Been Made �;, _� a _. ,:. ._. A Registration I. Fad Where a�Ce aVf Occupancy is Requ�red,�such Building shall Notabe Ocupeduntila Fanal Inspection has been madev g �, Registration Number: B-20-925 Applicant Name: HURLEY,JOHN P III,TR Approvals Date Issued: 04/03/2020 Current Use: Structure Permit Type: Building-Shed-Residential-200.sf and under Expiration.Date: 10/03/2020 Foundation: Location: 107 HERRING RUN DRIVE,CENTERVILLE Map/Lot 229-050 Zoning District: RD-1 Sheathing: Owner on Record: HURLEY,JOHN P III,TR k tt> Contractor Namea`� Framing: 1 CLse Address: 107-HERRING RUN DRIVE � � ;� _ ontractor, ic cen 2 CENTERVILLE, MA 02632 Est Project Cost: $0.00 Chimney: Permit Fee: Description: 8x12 shed � � $35.00 V`, Fee Paid:•' $35.00 Insulation: Project Review Re SHED REGISTRATION ONLY. MINIMUM 30 FEET-OFROM J q Date ' 4/3/2020 Final PROPERTY LINE AT ROAD. r ' ' � .: i ._.. Plumbing/Gas h Rough Plumbing: Building Official h Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved appl�cat�on andltheapproved construction documents whic This permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. g This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ` v' The Certificate of Occupancy will not be issued until all applicable signatures by the B Iding and Fire Ofricials r provided this permit. Electrical ' - Minimum of Five Call Inspections Required for All Construction Work: „a ;; Service: 1.Foundation or Footing �I 2.Sheathing Inspection " Rough: 3.All Fireplaces must be inspected at the throat level before firest flue liningis installed "` s 4.Wiring&Plumbing Inspections'to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable BUILDING DEPT. Building Department Services Brian Florence,CBO MAR 2 7 2020 RAIDWMIX * Building Commissioner 'a 9. � 200 Main Street, Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# "o o(.' FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less �1�,.rrinOi Run Dr, Location of shed(address) J Village � n Pq1ir1e, 1ffJ 5o9 - 7 5 - I��q Property owner's name Telephone number � �X l a ` � A ct - 0,50 Size of Shed Map/Parcel#- / E-Mail I p III Signa Date ! Hyannis Main Street Waterfront Historic District? (� Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway Conservation Commission(signature is required) A/r, Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:08/6/17 O b ® 0 0 0 o Legend 0 Parcels Town Boundary 229028 � µRailroad Tracks —#123 Buildings 229042 229043 a Buildings x.Building 229044 -#8 Painted Lines 229041 #74 4. C� ;� . 94 #68 o Parking Lots Paved 229029 j 229045 0 Unpaved #131 r 1 #100 Driveways '- Q Paved Unpaved ed Oft 229051 Roads #85 13 Paved Road N 13 Unpaved Road L ..• 0 Bridge 229130 O Paved Median _ #43 — Streams Marsh 13 Water Bodies 22 9030 229049 P�25#141 #137 7 ,,a 229052 229046 #110 ': 229093 ' J t? #-34 22903 1 #147 �¢ >Ft1N _�-�- t- • I I 229047 #120 229048 #d5 2.29032 _�--- "'� 228039003 1 � 157 22 � 2281420 1 25 228039001 #11 Map printed on: 3/25/2020 This map is for illustration purposes only.It is not Parcel lines shown on this map y graphic are only a hi Town of B arllstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are i Feet regulatory interpretation.This ma gul ry rp p does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi `J 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 508-862-4624 i reflect current conditions,and may contain such as building locations. pprox.Scale: I inch= 83 feet cartographic errors or omissions. gis@town.barnstable.ma.us F Anderson, Robin From: Florence, Brian Sent: Monday,January 13, 2020 8:48 AM y To: Anderson, Robin Cc: Carter,Jeff Subject: FW:Job site on herring run dr. Hi Robin, Can you please enter this and assign it appropriately. Probably should be inspected right away(priority) if the Town's catch basins are getting damaged. Thanks, -Brian From:jphiii2654 [mailto:jphiii2654@gmail.com] - Sent: Sunday, January 12, 2020 3:42 PM To: Florence, Brian p Subject: Job site on herring run dr. This job is making a mess ofthe road sand and mud has spread all the way down the road and is silting up the catch basin who is going to clean up this mess up my tax dollars somebody needs to do their job and clean it up thank you john hurley 107 herring run dr. Centerville Sent from my Sprint Samsung Galaxy Phone. CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe[ i .3./� � i 1 y i '� C� �0� � '7 }} �" �i +� t{' 1. �t �E ` � �� _ '� _ �' {. � ��l 9 _ 1� - ��' r e ; • �J aa N 7• v �"f '1 i� .� TQWN OF 8 20 JAM 13 AN4. Q2 ION r 3 k Io Application number... . ... .a .. DateIssued..............................t.............................. "M,► `L ° SEP 26 2019 a6 Building Inspectors Initials...W........I............... RFD MA'S a n', — 'uSYABLE Map/Parcel......�.z.`.1.......S5?57 0....................... 35 TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: o 7 I-1frr;,rj S gwn Dr' C,P.-6rr, NUMBER STREET VILLAGE Owner's Name: 3 Phone Number Email Address: Cell Phone Number Project cost S L(A I(,S — Check one Residential Commercial OWNER'S.AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: See F\4c cf, c gA-fra,-4- Date: TYPE OF WORD 0 Siding Windows(no header change)# 0 Insulation/Weatherization Doors(no header change)# Z Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to tJc.SfP CONTRACTOR'S INFORMATION Contractor's name ,,J Home Improvement Contractors Registration(if applicable)# 4k 2 0,2 S (attach copy) Construction Supervisor's License# 07 2-7 7 L-' (attach copy) Email of Contractor w ee e ,, (.C a rn Phone number 7 9'/ — 5 3 Z.- ALL PROPERTIES THAT HAVE STRUCTURES OOER 75 YEARS OLD OR IF THE SUBJECT PROPERTY/S IN A HISTORIC DISTRICT, YOU!MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. a . APPLICATION NUMBER............................................................ *For Vents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent . X X , X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s)of each tent df food is being served at your event please obtain a health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4e30pm. Commercial events may require Fire department approval *WOOD/COAL/PELLE'T STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S NER'S LICENSE EXEWTION Homeowner's Name: Telephone Number Cell or Work number I understand nay responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 Clot and the Town of Barnstable. Signature Date LgCAN 8 9 S SIGNATURE @J R Signature _ Date 1—Z S- N All perm�ia 'ons are subject to a building official's approval prior to issuance> Windo�(u World.of.Boston :MA HiC Registration Offices&ShotiurotsmB Number. 016A Cummings Park 0 205 Old Oak,Street 01000 Boston Tumplke 166026 Woburn,-MA 01801 Pembroke,MA 02369 Shrewsbury,MA01646 Federal ID# (781)932 4805 (781)828.6281 (608)845.6676 62-4848432 (� www.WindowWoridofBoston,conn Customer:zoN f'>/[l.�ZAFZ Phone(h),SdB-77s-/Y79 InetellAddress:/0 7iYitl 71i� Phone(o) city C�n/ �t/Cc statg:MA ap 0263Z E•man WINDOW WORLD GLASS OPTIONS .1000 Serles Singie-hung All-Weld $249 __SOIarZone Elhe-Dual Pane $129 _2000 Series DH All-Weld $269 _4000 Series OH All-Wold $289, —Triple Pane $289 �6000 Ssriss-DFtAIFWeld 43309:. TIO •-_213teSilder " '$428 :; VVINQOW_pR, N.S _3UteSllder ur%u%im nravaim $edit GlassBreakede Warranty(40D016000):41Cill'1CLUDEb I _Picture/Fixed Life (0.83.Uq :$419:, la8cresne $gINCLUDED _Picture/Fhted Life (8443(Y U1) $638 Foem trtsulatlon onJem(2s end Head $t 1 INCCt10ED Avunlrtg ''' ` ;$S5J tiouhleSlrength lesq(40tj0/6000} $Is INCLUDED I :. .. .. ,Casefent. .:.('lus$.49 tOH.Sesti Ftai).$378 _Doubie,Lockq:(5;28'"` $5ItVCLUDED I ,2 Lite Casement s659 Full Screens $26:. _3Ltecesement nG,fAvrl tia.rmvq $102g, ^_•goforllofCxrlds(Contoured(F10g •, _ .$85 _B680m; ntHdpper ,S4e9: .$ZB.•1 _Bay Window-Soffit Mount IINS:Seat-$2859T SlinUlated;pNltlBdLRO= 1&2 �:.;.::. _Bow Window-'Soft$Mount(INS*10:$2999°''^ ' Tem�r2�ei1:[f 1:Sas)%�BSO)'(i3oj Gordon Window ...:,...--.:,Obscure 41ass{BSO)(rS0) _ Say,Bow,t3arden Oversize (+109 UI)$979 Oriel Style(40)60 or 60140) $75 Bulge/Almond $49 — Interior Foam•EnhancedFrerne Woadaiaksfnte (Was 4006 isobo citly)-$'1.00`: �--•-- (Ugfrt Oakl Dark Oald Chany 1 Fox Wood PRB 197fi BVII.THOM59(PRPSAFE HEiJ A7/0 " Rkh Map/a) MY HOME WAS BUILT IN THE YEAR/059'I vm (i1Hl _BroExterlorOrch•Brenze/AmedcanTar(a)$10D ,:..x,.• �Oaslgrlsr.ColorJMderior. $i79 MISCELLANEO 45 , Speciality Window" $ Custom Exteilor Aluminum Cladding(1Wo.lind), —❑Textureid$90 0 G4 8mootll$90 +_ Window Color ! Facing Cotof Mulll-BandCladding $20 NOi�CU T01V!``DOORS _Install lnteriotJtAorlor Stops VMYIRaUkrgPatioDoop:,5R.oe6tF - St218• . - _Install Interior Casing Starts At $95 ::i-. VlnytRpfltfrg FraUtrpoorBa:• $ts29 `Repair Sill,Jernb or replace sill nosinit.; diobes Ada�iteefeiCiiA(oriiiolpijgotiooi 3t26ti` Fun Sub-Sill(Single)replacement $i76 .;, =French Rats Sliding Patio Door 5ft.Graft. Stan - ; insulate Weight Boxes $20T_ _French Raa3lidklg Pado'OogrBiG w:+Fr:::'r:$1eg9. —Mull to Fo'rin Muitl Unit $bQ Freitcf Reii3h8thg PaN3"dcdi sit ".' 1yas'": — �CrrstorirErileilordoid ng s900 Mullion Removal $50 8olarZone Elite Mullet Window Removal $15 ____�Qlds Pado•Door $2i6 New Construction Vinyl Removal $176 _Woo9grari}'Ifiterlots ;$99 —New Condit.Fxt,Pietro Fit $150' PxlattorDeglgne7cotore $Q89 :•..• Roof for Bay/BowWindows $500 =ntettorCastitg'2r+r 31n g279 —Removal of F$Wttho Say/Elow "•$250 iHandtesef Dgturrle :$ 8ay10rnnr Conyeralon Ekt Pietro Fit $480 lmetior.811nds;(elx toot only) - 386a- '(New Siding MINI f Match) FNouNa erli�os� rtiiffvltigtacpgl�! i Door Colo .f✓N,r ... 1 !TE c If tCF((drenti4R4>�eslcl(I�dsbi�alY �� 1v lie; :OlRerde; Custom#i dQallthes exte lbr yr h (A er zt}(ftds rAhtt q( r g() INsltoterdta-�119�f`G :::� ;s; o �rdnl.rY >,U szx ?�' fl($F(91E1EB grstamerlslespo totthe(ot�yvin0ln eoonoclloft with lids eaprabL Peladklp:Siglils Alapn4yatem dlecWint aporplyrt:BrJd9e fes in.. excess of$25,00,Homeowner no or Coale Association Approval,libtipf0 Olstrld Approval,Chyof BosWa parking&sldewalkPetmA(tog in.onmeetlonwNrlpatalatkn. NO EXTRA WORK IF NOT IN WRITINQI customer agrees to Ilia terms of. ayment as o lows: Extra Labor&Materials S Ofi � $0e Set Up,Permit,Disposal&Delivery Fees$. TotalAmRuAt $"2Z�fT �• Custom Order Deposit'3316 $: Ck# Project Start Payment 33%•$ Balance Due Day ofdnstaliation- .x..::r.:.,.. . Arh uAt F1'ancild $ Window World of Boston an lolpates dealing this work on* and being substantially aomplded bV_lfeys Seour�interest Yes No,L Any deposit wi dred'imddvallce d:Ilie alartoNhework 3N 4 eKCM 14%of the total vantract price orthe•eetuat cast Only mile"or aquTpnectA spP Motdaror custom made namra;.whichmustbiordstedOradvanceofthastartoltheworittoassurethatihepro(ectwslproceedoaacbMale.NoMatpayment shall be demanded umU the cogtrant is aompletedtp tb4$al�facilwofb0tb-parties. : Aft home.knprovirmt Msoghaolols:arid.etNOpr>tr4C►ote s)tatJ he re01o.1ete0fid.thal any inqquits;;.ibWt a conirao►or.mt"oeolot retafinp top re01s0aUon should.be directed to:Office or Consumer Affairs and Fastness RoWillah,ten Park Plaza,Sunb 5170 aceton,htA 021ta.Phone:(8t7)aY5•gT00 No Weill shell begin prior to the aagning no the contract and tra timinel to rho owner Bin copy of such contract IMndeW World of llostan,unde[P.ro1WQ0 0(,Ch@pier 14�t1 of a a I falya is requ4e0 to appl1yY for add obtain pJf,Fpnstr4Qtlar relatedpermge,.Wlgdow Wend of Boston sbal not deaRio4teSpodslpTe talldpja] jii Ujd vrtuii pli 11 this atpaalttedj.caeFad.bjr reyWatoiy Qrinllf prdeUtitjsgedoies aidhJrU(es�o[iadlytduals. iii flaf{eer8ilirit'ORCHABER($y3lteidrhlYovrdSd(1etAtdllanh(Aledpe}1al�atarlkeViorkdeeeribedSiader1h16ApreementariteatiwA ralftapietdralwnbaetora. the POflCHAtIER($)'[a'herebyaldyiset4ti(0K Ehe @'9`f of 0 dlsgals%'>vatdkrent ehd natryeymet�,'.'fhd PBACNAS'#R(B►WlO rtdtbb eWd}Jto tnhke a Qldlel or aclteallon tram lice guafatity faad oQltibpchby cfleljit You the bulfor me Y teasel s trallsablion'at$n'pine prltirsO mfd0 gh o f e t d uh thus aK.a,et,tdedrite of th tfansas orr,. Notice ot•sancepati,;Mustbe[rf ;.ling.pag.1 afkeA to later than midalghiof lhs.tQljhwiffp Tllyrd businesg a iy. TNeyAndawWodd'Falldhiadle'bW6' dehU bwiledandtl ' ed L&PBostoft eradn' 1 "undocUcensetrumWiadovrWa 'Uld, Ownor: not sign If there ore any blank spaces, Dilliii i Qele,w,ewr rlw stood .ee .nrr♦1•n4 wne,.nw .,w I1,•rwr•nw.,w,w,•w,,,,......•........�,.w4....... n.,. i I I f " W9nifow_Wo'rlit'af�8ostoh 'MA'H1C Iteglstrattati , '• [' W1696&Showrooms Number: U 15A Cummings Park 9 295 Old Oak Street 188025. Wobum,MA 01801 Pembroke,MA 02359 Federal ID-* �it"I�t�iLtV (701)832-4805 (781)828.628t 8248!}8432 wwvv WindoWWorldoiBoston,com Customer: =061AI f 4--X-A Phone(h):�-776 14479 Install Address: Phone(w): �Q� iP / G �L//�.� - Phone(a): Bill Address: - �cE' :••• � A o263Z E-mail: ENTRY DOORS HINGING f Single Door ❑Double Door INSWIN .(INSIDE VIEW) O Door w/One Sidollte ❑Door w/Two Sidelite 0 Double Patio Door-(7:9'w Frame Helght} Model Number: Carving Style&Color„ '. AG.:. OtJT'SWING:(OUTSIDE VIEW) Stde Ute Model�Numbr�t?� 4 �r i'L'°-�f r'^ - I Door Width: :O37r'r(NO"). � ( f1 j.r�A Height: Standard 8154'(79'N•)D Custom Side Lito.-W Nj: 94t1" Q;12", ..Q.1Q':..-.. Jamb Material fDura Fram'(No Fxt P,ahit/3iaelyColl Color DOOR ItiNk3H. �;Pa1nt D.Staln..; •O Both Int r Jamb((Q f7' �` Ii d9 Ctiior Paintable/Stainabfe h7arneilNeSelia( outsfdeotor :• Color: (VIQ4DINJQ�. Fr)rried �lUnfi(sh'ed'...©Finished. Jamb Size.. : .idClisiPr►► O:CleunsheN O CoitSni�F: DDUBLEdDORB'(ON12 '^` Sze 2� . : .,:•:cQlot> ;..- Astragal Materiat/Finfah inactive Door:O Single Bore ❑Doubts Bore U None :,;•;,_,, :_:;.>;,,ROTES HIDt11FAFt ' Knob&Deadbolt? ='''.:O'Leer:,&feadEii3lt;iL C1 Handle Sel-VISe Style Color /(ate' .` •, ALL pQQ1100DENSYAKEG WEEKS'Y6f1HDElj,' AddltlonaFHardware LOFt�Ei(St WINDOW WORLD DAREES Hinge Cofo6 ✓' _ St.Jude Children's Research Hospital $ fUtLINAA!) }S{lSXEItUNq(iGKfiN1J1?i11'!(iPRLYCAR$lUI!lTfifl)INTgfNEIJyISNWIELVDIODRIGIRALfIN15NWARltAIyZY This is i3 wtilttitl agtdtl(lfdfij �tWa�itlNtnbw�l�hd a(ai}Yolj th@ I ltohier{ihlyselvii e�:ifeted'an this agrestneni wilt lre�le(formf us omen agrats to t 'e t rms o peyinent as o ows i NO EXTFIA WORK IF N0T IN WRltl 01 ' F_itti'B:I:abot`&'Mflt9rlets•$ � :: '.!<�:c'%4;'::' site Set Wp Perirnw,disposal&Delivery Fees$ Total Amount .$ Custom Order Deposit.33% 5'ggCk# Pro)edStartPayment:3a%:$6"w" Baiance Due Day oflnstalladon ACE Amount•filnau]ced Window World of Boston anticipates starting this work onN and befog substandally cempfeted t days.Secunty efa§I;es No Any deposit requked fo advpnoe of.the start of Ihe.work& ALL Nff 4T,0teed 331/3%of the total contract pike or: e•Sctgat cost of.any mateilal:or.equ pment'as; sppedal ardor or custom made nature wtich must be ord8red:in advance bf the start of the work io assure that the prolact w(8 emceed on schedule•No ilrlal payment, sha0 be demanded urt8f the comract is corrydeted to the saffsfaotton of both parties, 1UI home impraveme0t coptracNfs.l rid st3tcen6aclMs.0g1l.be registered And that any inquires about a contract or subcontractor relaling.to a registration should be directed tri;Otfica af:¢pnfrulner Attefra and Bu$jdasa Repullijan,Ten PaIR11 ia,Suite 5170 Boston,MA 02116,Phone:(617)973.8700 -•No-wgrk Alt qif 9 So-lT� gnl e) n fti��eti1 :fit a3#@ 2 e0 q� 00 of AT h tf q eJ Will cu IS d !o aitdnsheQne hdd�elne 1> f)dsl>ta11d•prt3•df3Gt Easy bed(nl>tisag{y8rit� s s. by )8t¢ryj�Qihtttgianif ape( ,a, 04@:}o itlNotice:If the Pull ABER(S)obtefdahisui 'I refitefi1`�atmitefotlttrluoikdsls�lAfeifiitldBfthle�feedtBdtur eaTetill►egtal'000Mnlraoata, the Fulic ASER(S)Is here0y advised that in the event of a dispute,judgement and nonpayment,the PORCIiASEB(s)win not be enittl'ed`to'makb dWli*iv eogecilomtrgmrbe,QuRr@gtyaupp.aRteblishpObyabepter1.43A M;GIs'•;,'._.::`: ::::.,...:. :.:`.: :, ,;-:.>.:. Youthe tl)re ro -c 4--- iS tran+ra.t on a(afV)It mt}dr Ar to m nighro 1 0'! .P s(te $ y a et. a .b s rdnsaclftirl Hollce 81 Qpncellatfdn tlinsl 6e 1A Wiliuig pa tM rJl>#tkndiaterlhan tnitli)7p11tGtthe fgilnwiilg thlydfilisiliess dDy s Window rid rip se;s:lhde eddlnlYDwila as operate.,:4:&P'BOatonOperafggl .tn r c owner Elp not algn It there are eh juts NCe aeti§;`-: oat i aleeman:bo'ddt!' •er8"aIVhlaaR'epsem ate - OwnB'r:Do`nQt-e*nt(th8i9'6FrienytSlaak'4pai:e0:' beie am,an DowOat Wtiltb Copy=OilglAWi`Ye'ilawdoPy-FIIa 0ink&0y=Custdmei'-..•.: ..;.-'::•::. NryW PAIG,gp5g6agtlte i I i i I i Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction SupervtS-or CS-072772 Expires: 04/07/2020 JEFF C STEE] 24 SHERWOOD AVE DANVERS MA 01923 Commissioner ''T/n 1(Y.'Nl7lrRlrUtf(EII�r �trn�.:rrc�uaa/f.: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:LLC RR@91nExpkw 165025 04/11/2020 WINDOW WORLD OFBOSTON,LLC. JEFF C,STEELE 15A CUMMINGS PARK WOBURN,MA 01801 UntiersecrOWN f 1 �e Comuron".'4 ealiIZ Department of Industrial Accidenn.3 >t I Congress Street, Suite 1110 Boston,AL4 02114-2017 �.� �t www.mass.gov/dia Tt'orkers' Compensation Insurance Affidavit:Builders/Contractors/ElectriciansiPlumbers. TO BE FILED WTTH THE PERMITTING AUTHORITY. Applicant Information Please Print Le rib/ly Name (Business/Orgaaization/Individual):,_-//-;� S/on 6JP 14 r Znr. �giq r✓ii�aw s,J�r/a�d��D r 11 Address: 1 5 fk (ft )rn rn City/State/Zip: W MA D I k 0 1 Phone#: 7,?I - aj S Z-141 n s Are yoy an employer?Check the appropriate box: Type of project(required): 1. II am a employer with 11 0 employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp.insurance required.] 3.F_J I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition Q4.❑I am a homeowner and will be hiring contractors to conduct all work ou my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.71 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance..' �-�/� o.❑We are a corporation and its officers have exercised heir right of exemption per MGL c. 14.�""filler c(a,t" 152,31(4),and we have no employees.[No workers'comp.insurance required.] r e_ I *Any applicant that checks box.41 must also fill out he section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those-entities have employees, If the sub-contractors have employees,they must provide their workers'comp:policy cumber. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. r Insurance Company Name: A sane i 0-4e G �i•�oI uyPr 5 Policy#or Self-ins.Lic.#: WG c- -5 Utz- So! �O�'I- Z O I qr�- Expiration Date: L/—_�. Z O Job Site Address: 107 44err , r. City/State/Zip: ✓' .4 Attach a copy of the workers'compensa on policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 1bIGL 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 Aolator.A co o tbis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verific 'on. I do hereby cent* and he pa' a enaldes of perjury that the information provided above is true and correct Signature: Date Phone#: Official use o not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: A4 RE> CERTIFICATE OF LIABILITY INSURANCE r (MMIDDfYYYY)ATE 4ae. ' 03/26/19 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 have ADDITIONAL INSURED provisions or 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 GUNIACT NAME; amy roberts M.P.Roberts Insurance Agency Inc. PHONE o AX Exe: 978-683-8073 Arc No): 978-6833147 1060 Osgood Street -MA L North Andover, MA 01845 ADDRESS: amy@mprobertsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: WESTERN WORLD INS COMPANY INSURED INSURER8: MERCHANTS INS COMPANY L&P BOSTON OPERATING,INC INSURER c: ASSOCIATED EMPLOYERS DBA WINDOW WORLD OF BOSTON INSURER0: 15A CUMMINGS PARK WOBURN,MA01801 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDD/YYYY MMIDONYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR O PREMISES a occurrence $ 100,000 MED EXP oneperson) $ 5,000 A NPP8525379 04/05/19 04/05120 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JECT LOC PRODUCTS-COMP/OP AGG $ 1,000 OOO POLICY❑ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED MCA1002569 04/05/19 04/05/20 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OVIINED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE AN065362 04/05/19 04/05120 AGGREGATE $ 1,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION /� SPER TATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICERIMEMBER EXCLUDED? 7N N/A WCC-500-5018609-2019A 04/05/19 04/05/20 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 [(;as.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached 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 EVIDENCE OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP E*TATIVVEE OO 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD t4n FAT Town of Barnstable *Permit# 7 �� OExpires 6 months from is ree/ Regulatory Services Fee > v� xnss. �' Richard V.Scali,Director DEC O 6 2017 'Building Division TOWN OF Ei RfVSTl�&g Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY iVtap/parcel Number Z 2. 1 q G 5_ d Not Valid without Red Y Press Imprint // Property Address��Z lhet// 5 Y l ,Cj -J� ��'t'r✓t l� [residential Value of Work S T `'r 7_ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address d to Y Contractor's Name W jpj�DW wl0h` .JGFF S_7iF,L,IF Telephone Number 7£s1— ?3Z DF r3OG-VA-) Home Improvement Contractor License#(if applicable) I fob OZ.�6' Email: Construction Supervisor's License#(if applicable) 67 2-7 7 2 Yvorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance ,C i Insurance Company Name iIN'RT- `�l f?,"t: �1USLtZA x— nt Workman's Comp. Policy# 22 W G•C-1--T 24/ 5S Copy of Insurance Compliance Certificate must accompany each permit. Pen-nit 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) 2Replacement e-side Windows/doors/sliders.U-Value Z (maximum.32)#of windows 5 #of doors: , r ❑ 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 equired. SIGNATURE: C:\Users\Deco)1 ata\ c.'1W1icroso md.,vs\Temporary intemet Files\Content.OuttookLPIOI DHR\EXPRESS.doc . Revised 040215 fl'Window World of Boston, LLC Nu►HfC Registration Offices&Showrooms Number: III Q 15A Cummings Park ❑295 Old Oak Street 166025 dJ Woburn,MA 01801. Pembroke,MA 02359 Federal 1D# "Simply the Best for Less" (781)932-4805 (781)826-6281 27-1481665 wvvw.WindowWorldotBaston.com Customer. _ — - C� Phone(h) Install Address:A.07 f�r�-t/G e/NJ>.� Pfronea)71�Qjjfj- L6 city:Cf State:MA Zip O Z E-mail— WINDOW WORLD GLASS OPTIONS 1000 Series Single-hung All-Weld $189 -j6 SolarZone Elite $119 7/�f 2000 Series DH Mech/Welded Sash $215 _Triple Glazed T02* $195 4000 Series OH AM-Weld $225 L70 ("Series 6000Only) 6000 Series DH All-Weld $260 WINDOW OPTIONS 2 Lite Slider $354 Glass Breakage Warranty $15INCLUDED _3LiteSfidey lva.va.vm pr4,vz,v4) $545 1/2SCreens $91NCLUDED _Picture/Fixed Ute $354 Foam Insu ion on Jambs and Head $11 INCLUDED _Awning $280 Double St, gth Glass $15 INCLUDED _Casement $310 *Double Loc s(>261) $5 INCLUDED 2 Lite Casement $595 iFull Scree $22 3 Lite Casement hnnunrsl tv+,ua.uq $880 —Colonial Grids(Contoured/FI $45 �BeeetmentHopper $33 _Prairie Grid $51 Bay Window-Soffit Mount/INS Seat$2660 Diamond Gr cis $69 _Simulated D vided Lite $182 _Bow Window-Soffit Mount/INS Seat$2785 _Tempered D 4 Sash(BSO)(TSO) $65 _Garden Window $2040 _Obscure Gloss(BSO)(TSO) $35 _Spec fatty Window $ _Orlel Style(0160 or 60/40) $30 —Beige/Almond $40 _Foam Enhanced Frame $35 _Wood Grain Interior(Series 400016000 only)$100 PRE 1978 BUILT HOMES(EPA LEAD SAFE RENOVATION) (ihtOaklllark0ak/Cherry/fox Wood R �LeadSale cticesRequired $30 Z92 Rich Maple) MY HOME WAS B JILT IN THE YEAR Init ai {R. _Brawn Exterior(Arch.Bronze I American Terta)$100 Cesigner Color Exterior $175 MISCELLANEOUS ./ _Custom Ext for Aluminum Cladding Window Color r{/ft/ I Nf�/ OTextured 075 OSmooth$75 $ Inside outside FacingColar NON CUSTOM DOORS _Metal Whrido N Removal $50 Vinyl Roping Patio Door tin.or 61t. $1099A02f 5 Now Construc ion Vinyl Removal $175 _V'myl Railing Patio Door att. $1195 _Specialty WI idow SQerior Trim $ Add to base gricekr Custom Railing Pado Door$1250 _Mulito Form Multi Unit $30 French Rail Slldng Patio Door Sit.or Eft. $1395 f7�Install Interlo/Exterior Stops $50 _French Rail Sliding Patio Door all. $1495 _Install Interlo Casing Starts At $95 _French Rail Sliding Patio Door St. $1595 _Insulate Wei Boxes $20 Custom Exterior Cladding $160 _Roof for Bay Bow Windows $500 TSalorzone Elite or ETC Glass $205 O _Existing Ne Coned.Ext.Retro Fit $150 _Grids Patio Door $149 _Removal of ing Bay/Bow $250 _waodgrain Inteiiars $295 ,Repair Sill,J mb or replace sill nosing $50 _ExtarorDesignerColors $395 Full Sub-Sill Single)replacement $150 _7—fntarior Casing 2+ +re $1752M Z Mullion Rem vat $30 _Handleset Op6ans $ Bay/Bovi Co version Ext.Retro Fit $MO (New Srdulg Ill Not Match) Door Color * fr R il�ffd VY utpR 1CAe Inside Outside A� � � 1'� 1` IES .��; a ch�l�eelf"�' eati��g4ptl�l �� ;:3 Customer declines exterior wrap and understands painting and/or repair may be required Initial Customer declines grids on windowsldoors Initial DISCLAIMER:Customer is responsible for the following in connectirn with this contract Painting,Snining,Alarm System diseonnecyrewmrect Buildfag permitfees to excess of;25.U0,Homeowner and or Condo Association Approval,Hiistode District Approval.City of Boston parlu'ng&sidewalk Permutes in connection with installation. NO EXTRA WORK IF NOT IN WRITING! Customer agrees to the terms of payment as follows: �s Extra Labor&Materials $ 3,ql� D Site Set Up,Permit,Disposal&Delivery Fees$ $389.00 ANE Total Amount $ 3 7— 64wMa-�-7w. Custom Order Deposit 50% $—1-117 Ck# 1714 O�,CS'Z Balance Paid to Installer upon Completion $ Amount Financed $ ZOO Window World of Boston andclpalrs starting fNs wade on 6'�,(�s and being substantially completed hit Zdays.Security Interest Yes No Any deposit required in advance of the start of the work SMALL NOT exceed 331/3%of the tmal contract price or He actual cost of any material or equipment of a special order or custom made nature,which must be ordered in advance of the start of the work to assure Ihatthe project will proceed on schedule.No float payment shall be demanded unu7 the contract is complated to the satisfaction of both pardes. All home Improvement contractors and subcontractors shall be registered and Drat any inquires about a contract or subcontractor relating to a registration should be directed to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170 Briton,NA 02116.Phone:(617)973.8700 Us walk shall begin prior to the signing of The contract and transmittal to The owner Of a Copy 01 snch Canlrast. Window World of Boston under provision of Chapter 142A of the genital laws is required to apply for and obtain all construction-related permits.Window World of Boston shall not be deemed responsible fordo ag in the work described inthis agreement caused by regulatory,permit granting agencies,authorities ar individuals. Notice:11 the PURCHASERS)obtains his awn construction related p9narls for the work descrihed onderthis agreement or deals with unregistered contractors, the PURCHASER($)is hereby advised float in the event 618(1ispute,iudgement and nonpayment,the PURCHASERIS)will not be anlMled to make a claim or collection tram the guaranty fund eclablished by chapter 142A,M.G.L. You the buyer may cancel Ibis transaction at any time prior to mt rg 1 of Ile Ihlrd business day after the date of Ibis transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORD1ER_U2=R r 11gs Window Wand'Ranchise ie independently owned and operated by Window World of Boston,LLC.under license from Window We Inc, ( /i z 1 Own no not sign Ifiliarerare an lank spaces. Oa n. — 7 Salesman:0 0 oat n e are any blank spaces. ate owner:Do not slgn If there are any blank spaces. Date aerenoz-t7 whtiteCopy-Original YellewCopy-Pile Pink Copy-Customer MeyeyPKmineae66y>.ir1e Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-072772 .onv,uctton Suoeriiscr JEFF C STEELE 24 SHERWOOD AVE # ^s DANVERS MA 01923 ^^�� ✓�� Expiration: ommissioner 04/07/2018 Office of Consumer Affairs&Business Regulation ?HOME IMPROVEMENT CONTRACTOR Registration: 166025 Type: Expiration: 4112/2018 LLC WINDOW WORLD OF BOSTON,.LLC. JEFF STEELS 24 CUMMINGS PARK SUITE 15-A WOBURN,MA 01801 Undersecretary License or registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 of valid without signature ` The Commonwealth of Massachusetts Department of Industrial Accidents o 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia lVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information / Please Print Leeibly Name (Business/Organization/Individual): (aZnd6 u/ 6J,9 rld O,C Address: /-5'f1 City/State/Zip: lod n 0190 1 Phone#: -78 ► = 3 2- - UR o 5- Are you an employer?Check the appropriate box: Type of project(required): 1.[9 I am a employer with, 0 mployees(full and/or part-time).* 7. New construction 2.F_1 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] IFJ I am a homeowner doingall work myself t 9. El Demolition y [No workers'comp.insurance required.) 4.❑ 10 Q Building addition I am a homeowner and will be hiring contractors to conduct all work on my property. I will - ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the a . attached sheet. 13 ❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. I 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Fg'Other W 1 e) O LJ S 4 CEO U 152,§1(4),and we have no employees.[No workers'comp.insurance required.] l Q Gt CQ//t e/1"7S *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. I Insurance Company Name: P F if Tn S J RA/V C f- G© . Policy#or Self-ins.Lic.#: Z Z_ W rr C L.1,2,a _S Expiration Date: /- Z 7— IS Job Site Address: In 7 'Herr►ll $ 'I Z u r1 City/State/Zip:�7,P/Vr<l e— tf A 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 a 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 s tement may be forwarded to the Office of Investigations of the DIA for insurance coverage verif lion. I do hereby cer ' under a pain erjury that the information provided above is true and correct. Si ature: Date: 2 - - Phone#: — J 2— OS a use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I WINDO-2 OP ID: Hl ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 0510 412 0 1 Y ) 05/04l2017 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 cONT NAMEA:c'r Carli Witcher CISR,CBIA, CIC Marsh&McLennan Agency-GSO PHONE FAx { 3625 N.Elm St aC Nd Ext:336-272-7161 a,No 336-346-1397 I Greensboro,NC 27455 AD DRESS RD Ess:Carli.Witcher@marshmma.com I C.Timothy Ward,CPCU,CIC INSURERS AFFORDING COVERAGE NAIC INSURER A:Hanover Massachusetts Bay 122306 i INSURED Window World of Boston, LLC INSURER B:Allmerica Financial Benefit I 118 North Wilkesboro, NC 28659 Shaver Street INSURERC:Hartford Fire Insurance Co. 19682 No 4 INSURER D: I INSURER E: I INSURER F: I I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TC CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOC INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TC WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TC ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' TYPE OF INSURANCE DLISUBR POLICY EFF POLICY EXP LTR i1NSD'4VIID POLICY NUMBER (MMIDDIYYW) (MMlDD/YYYY) LIMBS A X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR 1OD6790252708 04101/2017 041011201E. DAMAGE TO R(Ea oNTEDnce, 500.00d PREMISES i -MED EXF(ArK,one person) 5.0001 PERSONAL E ADV INJURY _ 1.000,0001 GEr-%AGGREGATE LIMG APPLIES PER: GENERAL AGGREGATE S 2.000,0061 PRO- LOC PRODUCTS-COMP/OF AGG S L.000,OOO;POLIC`' JECT . OTHER AUTOMOBILE LIABLITY COMBINED SINGLE LIMI? fEaaccdent) S 1,000,000 B X ANY AUTC AW68757615 06!16(2016 06!1fi12097 BODILY INJURY(Per person; ALL OVVNEL' SCHEDULED _ AUT05 AUTOSBODILY INJURY(Per accident) S j NON-OINNEE - - PROPERTY DAMAGE - - I HiRECAUT CS AUTOS (Peraccidentl )( UMBRELLA ilAB X OCCUR EACH OCCURRENCE S L,000,000I j A EXCESS LIAR CLAIMS-MADE IODS790252708 04/0112017 04/01/2018 ,AGGREGATE S I DED RETENTION S WORKERS COMPENSATION _ X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER- ' C ANY PROPRIETOR/PARTNER/EXECUTIVE ',22WECLJ2635 01/27/20 i D1127/2016 :EL.EACH ACCIDENT S 506,000: ,N r A OFFICERIMEMBER EXCLUDED? i_' - I (Mandatory In NH) E.L..DISEASE-EA.EMPLOYEE 5 SOG,000' I:Yes.describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT S 500.000:• I i i i j DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached 1.more space Is required) j I i I i I CERTIFICATE HOLDER CANCELLATION i SHOULZ ANY OF THE ABOVE DESCRIBED POLICIES BE CANCISLLEC BEFORE 1 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3 ACCORDANCE WITI THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 �Q� I C 19BB-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ° \ 9' Town of BarnstableBuildin \o 11;41 Post This Card So That it is Visible.From the Street,Approved Plans Must be Retained on Job and this Card Must be.Kept 13AR^i`3Y'AL'LE.,�, - ����� Posted Until Final inspection Has Been Made. Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been.made. Permit No. B-17-4127' Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC. Approvals Date Issued: 11/30/2017 Current Use:; Structure ' Permit Type: Building=Sid ing/Windows/Roof/Doors Expiration Date: 05/30/2018 Foundation: Location: 107 HERRING RUN DRIVE,CENTERVILLE Map/Lot: 229-050, Zoning District: RD-1 Sheathing:. Owner on Record: LOPEZ,JANE L TR Contractor Name: . BRIAN D DENNISON Framing: 1 Address: HURLEY TRUS T T Contractor License: CS-095707 2 CENTERVILLE, MA 0.2632 Est. Project Cost: $ 11,377.00 Chimney: Description: REPLACE 5 WINDOWS&1 DOOR .29 U-VALUE Permit Fee: $58.02 Insulation: Fee Paid: $ 58.02 Project Review Req: _ , Date: 11/30/2017 Final: Ga PI m in s u b g Rough Plumbing: g Building Official Final Plumbing: - This within six months after issuance. Rough`Gas: i permit is com menced t b this e h work authorized mi hall be deemed abandoned and invalid thep � This permit sY P n for which this permit has been ranted. rm he approved application and approved construction documents p g , All work authorized b this permit shall conform to pp pp . Y P pp All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion.of the same. Electrical -The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable Y *Permit# Gipires 6 mmults frone issue date ' Regulatory Services Fee y 4 IIAWMBLS. 9$ NAM �a Richard V.Scali,Director,' i63q. �0 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 PE&MIIT APPLICATION '- RESEANTIAL ONLY Not Valid witlrout Red X-Press Intpdut Map/parcel dumber Property Address /O 7 14err'tn R yn�/ ���GT ,f✓t l 1 e identia[ Value of Work S ` Minimum fee of$35.60 for work under S6000.00 [ Res _ Owner's Name&Address .Jo Gl VA I-1 v r l e 0 7 ��2 r�t� I l J✓1 r �on 7�ClV/��C ✓� ��(0 3 2— Contractor's Name ,7JQJ - Telephone Number(Yo l Z Z 91—51 LO d Home Improvement Contractor License#(if applicable) / �3.2_14 s Email:. ' Construction Supervisor's License#(if applicable) n-� 7 Q U Vorkman's Compensation Insurance Clieck one: ❑ I am a sole proprietor ❑ Xm the Homeowner LY I have Worker's Compensation Insurance Insurance Company Name F; r am EQSL9 G Workman's Comp.Policy# \A/C 8 31 5 8 7 2 9 r 2-o 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) ❑ Re-side _ S R"Replacement Windows/doors/sliders.U Value .Zc (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. . rNhere required: issuance of this permit does not cecmpt compliance with other town department regulations,i.e-Historic,Conservation,etc. ***Note: Property .weer must sign Property Owner Letter of Permission. - - A copyte Home Improvement Contractors License&Construction Supervisors License is copy require a �. SIGNATURE: C:\Users\Decollik\AppData\LocaNMicrosoft\Windows\Tempomry Internet Files\Content.0utlook\2P101 DHR\EXPRESS.dcc kevised 04,0215 ., Renewal Agreement Document and Payment Terms Andersen. dba:Renewal B Andersen of Southern New England Y gl John Hurley Legal Name:Southern New England Windows,LLC. 107 Herring Run Drive 1021 RI#36079, MA#173245,CT#0634555,Lead Firm#1237 _ Centerville,MA 02632 WINDOW qE :ncernEgr 10 Reservoir Rd I Smithfield,RI 02917 - - - H:(508)775-1479 Phone:866-563-2235 1 Fax:401-633-6602 I sales®renewalsne.com C:(774)836-3496 Buyer(s)Name: John Hurley Contract Date: 1.1/10/17 Buyer(s)Street Address: 107.He,rring Run.Drive, Centerville,MA 02632 Primary Telephone Number: (508)775-1479 Secondary Telephone Number: (174)836-3496 Primary Email: hurleycAl07@gmail.COm Secondary Email: Buyer(s)hereby jointly and severally agrees to.purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement . Document and Payment Terms;any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). . Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement.- . Total Job Amount: $11,377 By signing this Agreement;you.acknowledge that:the Balance Due;and the Amount Financed must be'made by personal check;bank check,credit card,or cash. Deposit Received: . $p Balance Due: $71,377 _ Estimated Start: Estimated Completion:. Amount Financed: 8-10 weeks 8-10 weeks $11,377 Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on ..,the date in which:we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date.Rain and extreme weather are the most common causes for delay Notes: 50%DEP 50%ON COMP TAXES PD IN CENTERVILLE MA Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that.there are no verbal. understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement: . NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF l 1/14/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER:SEETHE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.: - Legal Name:Southern New England Windows,LLC - dba;Renewal B,y Andersen of Sourhern New England ' Buyer(s) Signature of Sales Person Signature Signature Eric Woods John Hurley Print Name ofSales Person Print Name:• Print Name r UPDATED: 11/10/17. . Page 2 / 11 Massachusetts Department of Public Safety -€ Board of Building Regulations and Standards License: CS-095707 Construction Supervisor f, BRIAN D DENNISON ' 7 LAMBS POND CIRCLE CHARLTON MA 01507 F S Expiration: Commissioner 09/08/2018 -�' Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement;Contractor:Registration Registration: 173245 Type: .Supplement Card SOUTHERN NEW ENGLAND WIND O /SJaL `'f Expiration: 9/19I2018 BRIAN DENNISON 26.ALBION RD {--1 LINCOLN,RI 02865 Update Address and return cord.Mark reason for chafe. ScAr e,20M-0511i Ej Address -[Renewal ❑Employment Lost Card A e-Jla�nue�eniuo�«/(/�fcyriirur/�i;eCl,. ' ta(�Tm of Consumer Alfuirs-&:Basioess Regulation Registration valid for individual use only before the f10ME.l ROVEtdENT CONTRACTOR expiration'date.If found return to: Office of Consumer Affairs and Business Regulation - MRegistrat 1732q,5 ..Type: 10.Parl:Plaza•Spite 5170 Expirdtlon g/1g/20:1,8: Supplement Card Boston,MA 02116 SOUTHERN NEW iN` ND;i IND� OWS U-C. RENEWAL BY ANDERSON_"s`_--�° BRIAN DENNISON _ 26 ALBION RD LINCOLN,AI 02865 d Not valid Without signagne The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/ContractorsiElectricians/Plumbers. TO BE FILED WITH THE PER-WTTUNG ALTTHORITY. Applicant Information Please Print Le "bly Name (Business!Organizaiion/Individual): e V E-Av Of ii �rtlJs Address: .2& .4LALQJD Civy/Slate/Zip: /J Phone i�: Are you an employer?Cbeck the appropriate box: Type of project(required): l.Kl am a employer uZir Z®temployees(full and/or par-time).' 7. New construction 2❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling am capacky.[No workers comp.insurance required.) 0. ❑Demolition l am a homeowner doing a,!work mvse--LQqo workers'comp.insurance reouired. I 0 Building addition 4.R,am a homeowner and wit:be hiring contractors to conduct all work on my proper.. I will ensure that al:contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors uri&nc employees. IZ.QPlumbing repairs or additions 5.7 1 air,a general contractor and I have hired the sub-contractors listed or.the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have worker'comp.insurance.= E.R We are a corporation and iL ofEtcers have exercised their right or exemption.per MGI_c. 14.[ Other/,,)i n4w 57.f l.(4).and we have nc employees.[No workers'comp.insurance required.j i re p lanell"e- S 'r ny applicant that checks box C must also fill out the section below showing then workers'compensador policy information.. Homeowners whc submit thus affidavit indicating they are doing all work and then.hire outside contactors must submit a ne>r affidavit indicating such. 'Contractor that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those ernitie<have employees. If the sub-contractor`have employees;they must provide their worker'comp.policy number. I am an emplover that is providing workers'compensation insurance for my employees. Below is the pokier and job site information Insurance Company Name: rBF>° !�� s PS. 69 — Polic} or Self-ins.Lic.i: v1�V A z 2— Expiration Date: I O Job Site Address: 1 0 7 -1 rr i n G 'M Un 1�:'r City/State%Zip: -IP.r i t Attach a cope of the workers' compensation policy declaration page(showing the policy number and expir tion date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S12500.00 and/or one-year imprisonment.as well as civil penalties,in the form of a STOP WOR1{ ORDER and a fine of up to S250.00 a day against the violator_A copy ofthis statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. I do hereby cer*!under th ains and penalties of perjure°than the information provided above is true and correct Sip-nature: n Date: eww Phone t: 2-2. T gyp Official use only. Do not write in this area,to be completed by cill'or town officiaL Citv or Town: Per-mit/License# Issuing Authority(circle one): i.Board of Health 2.Building Department 3.Cityfroym Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone k: ` ESLERCO-01 SANDERSO • ` -� DATE lM►�D�"Y1 ACORO CERTIFICATE OF LIABILITY INSURANCE owo7i2o17 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER ME COBiz Insurance,Inc.-CO PHONE FAX 303 988-0804 1401 Lawrence St,Ste.1200 (A/C,Ne,Erd):(303)988-0446 (Alc,No):( ) Denver,CO 80202 E-MAIL CO��Maii@cob7rzinsurance.com ADDRESS INSURERS AFFORDING COVERAGE NAIC k ws'.ERA:Acadia Insurance Company31325 INSURED INSURER B:Firemens Insurance Company of WA D.C. 21784 Southern New England Windows,LLC.dba Renewal by INSURER c-Liberty Surplus Insurance 10725 Andersen of Southern New England 26 Albion Road,Suite 1 INsuRER D Lincoln,RI 02865 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' ADDL SUBR POLICY EFF POLICY EXP LIMITS L I TYPE OF INSURANCE INSD IMV` POLICY NUMBER MMIDp MMIDD A i X I COMMERCIAL GENERAL LlAB1UTY 1,OOD,000 !—•i EACH OCCURRENCE 5 I I CLAIMS-MADE OCCUR CPA3158728 01/01/2017 01/0112018 MIDAIVI ETORENTED 300,000, �— PREMI E Ea occurrence) 5,000I MED EXF lAny one Person, 1,000,000•. i I PERSONAL S ADV INJURY 5 I GEN'L AGGREGATE LIMIT APPLIES PER: i GENERAL AGGREGATE 5 2,ODO,000I _ 2,000,000 X POLICY �I JE� CI LOC PRODUCTS-COMPIOF AGG !S EBL AGGREGATE 5 2.000,QOQI OTHER: COMBINED SINGLE LIMIT S 1,000,ow A AUTOMOBILE LIABILITY Ea amtleM j 1C I Ar>t.Aurp CPA3158728 01/01/2017 01/01/2018 BODILY INJURY Per erson� •5 *UMBRELLA ED SCHEDULED BODILY INJURY Peracadent S S ONLY AUTOS PROPERTY DAMAGE ID NON-OWNED Per aCGd 1 OS ONLY AUTOSONLYRELLA LIAR X OCCUR EACH OCCURRENCE1,000,OOOI E$$L)AB OCCURCLAIMS�IIADE CPA3158728 01/01/2017 01/01/2018 AGGREGATE0 Aggregate 1,000,000 X RETENTION S I OTH-COMPENSATION X STATERLOYERS'LIABILrrYylry WCA3158729-20 01101/2017 01/01/2018 RIETORIPARTNERILXECUTIVE E.L.EA ACCIDENT MEMBER EXCLUDED? L I NIA 1,000,000 ndatory in BER E.L.DISEASE-EA EMPLOYEE 5 esdescribeunder 1,000,000 E.L.OISEASE-POLICY LIMIT 5SCRIPTION OF OPERATIONS belaa• 1,000OOOorker's Compensatio WCA3158730-20 01/01/2017 01/01/2018 FnFA117 01/01/2017 01/0112018 1,000,OOOI N F OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [ID7�1LCOP'VpVorkeos CP=nation Includes-All states except ND,OH,WA,WV,WY I 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 POLJE'Y PROVISIONS. II AUTHORIZED REPRESENTATIVE T ! IFOR Info I n t r ©1988 2015 ACORD CORPORATION All rights reserved ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD f SOnruln, OF BAR Sunrurr-nc 1855.4iSUNRUN sunrun_.co.in'` DIVISION Town of Barnsta.hl.e Building Dept _ 2:00 Main ST Hyan.rft..Ma .02601 . To Whom h rn it,May Concern,. The.purpose of this letter is to request the cancellation.Permit:TB 17-:306"for:the p,hotovoltalc solar, project located:at 1.07 Herring, Run Drive as it was permitted in the; incorrect homeowner name; Ce►1a i Anew contract was:signed and a new permit appl'i`caton was-submitted on March 23, 2017 with p"roper Ihomeowner name, Jane Lopez. The new permit number, B-17=804, should, replace TB-1'7 306:. Please cancel out B,uild',ing Permit'#TB=17=306 Thank you for your consideration. Regards; reta Masiell'p; 97:8-872-4294 Greta:inasiel'Io@sunrunh'orne:com , r TOWN OF BARNkSTABLE BUILDING PERMIT APPLICATION Q Map Parcel (�Jr(� Application Health Division Date Issued 3- Conservation Division Application F Planning Dept. Permit.Fee. il gd DU Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 101 f 4 err Ro, Dc"Ye- Village '11te- Owner L z Address G1e,yi Ka5l,Q_ &r,-Ve, Telephone l-77c1 ) 833Co q k Permit Request /—ti;g�c,I Lq--,a,, at, ne e.k a V-OOQ6-A :S( l iG r DU S4,3 b-WI bW,-o �&An it PA oAuW_S /•5(a kW �l Square feet: 1 st floor: existing vk__ T_ proposed 2nd floor: existing /� C. proposed � C Total new Zoning District - Flood Plain Groundwater Overlay Project Valuation $1 [ct(v o_ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure q%As5, Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 5 Number of Baths: Full: existing_ new - — Half: existing new Number of Bedrooms: existingtlCnew t3UjL®1NG �� Total Room Count (not including baths): existing 7 new Firs t��� r Room Count Heat Type and Fuel: M Gas ❑ Oil ❑ Electric ❑ Other � 2 3 2017 �.,, - /- N®BRA s Central Air: ❑ 23 Yes No Fireplaces: Existing New �/� Existing woo)W/c%oa'kSStaye: ❑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 C c Telephone Number ( 7 8) 713 ' 8$5q Address 7 L1 &est S�OnA 'q00 License # 05- 08003 q 1bQLV-*1_bQVc3ejr_kA O Home Improvement Contractor# Email cY r h l.. YtlYl w.a. . C-0 wt Worker's Compensation # WC 13LQq Co GCW',L ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO !S Au Kvy s 6Y- 7314 Foy-es+- t. oils )- SIGNATURE DATE -3 D FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ~ ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GA:S: ROUGH FINAL FINAL BUILDING 0k, 0�qhl anleik DATE CLOSED OUT ASSOCIATION PLAN NO. 03/23/2017 14:01 Sunruny Inc. OW). P.0011001 c R& CERTIFICATE OF LIABILITY INSURANCE ' DATE(MMfDDlr" 9/29/2018 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: H the csrtlficdte holder Is an ADDITIONAL INSURED,the pollcypes)must be endorsed. If SUBROGATION IS WANED,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 certlfE ate holder In 110Y of such sa emsn e. PRODUCER MTACT Arthur J.Gallagher 8 Co. PHONE .415-646-9300 PAx 415-536-8499 Insurance Brokers of CA. Inc.License 90726293me 1255 Battery Street#450 San Francisco CA 94111 INSURE s AFFORDING COVERAGE NAIL 0 MURERA:Zudch American Insurance Company_ 16535 INSURED SUNRINC-01 oau 0;James River Insurance Company 12203 Sunrun Installation Services,Ina iNsuitmc:Houston Casualty Company 2374 775 FlarLuis Obispo,CA 93401 o Lane,Suite 200 San Luis nl� ura D.Endurance Risk Solutions Assnce 30 � '" RER E: ' wsuRERF• COV S C LATE NUMBER:1728273535 REVISION N THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTMTHSTANDING 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 CONDn10Ns OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INN L TYPE OF INBYRANCB POLICYL MR NUMBER RPIMID Y LIMITS B X COMMERCIAL GENERAL LIABILITY 000041242 10/1/2019 10/l/2017 EACHOCCURRENCE $1,000.000 CLAIM&MADE X❑OCCUR PR aoewnronos $300000 MED EXP one anon) 310,000 PERSONAL 6 ADV INJURY $1,000 000 " OEM AGGREGATE LIMITAPPLffS PER: GENERAL AGGREGATE $2 000 000 X POUCY 1:1 JECT LOG PRODUCTS-COMPIOP AGO $2 000 000 OTHER! Total Polley L;mlt $10,000,000 AU TOMOBILE tJAeeJTY ANYpAUU`rO BODILY INJURY(Par person) S AUT08 -- N CEO BODILY INJURY(Par aeddeM) S ` HIREDAVTOS AUTOS 3 m�1 _ I C UMWdAL►LIAB X OCCUR HIOXC5023204 10/1/2016 10/1/2017 EACH _RE 55000,000 D X EXCnA L1A8 EXC30000101000 10/1/2018 1011/2017 _i CLAMS-MADE AGGREGATES SS 000,000n DED ION A ANDMP`YMVUABI�Lrry WC013098002 10/112010 10/l/2A17 X E ANY PROPAICTOR/PARTNERIMCU"A YIN WC013608102 1011/2010 1011/2017 OFF933MI ABM EXCLUDED? NIA EL EACH ACCIDENT $1000,000 (Mandatory aMbe under ISE E.L.DASE-El EMPLOYE v,000,00� If a de - _ IPTION OF OP N8 Debw EL DISEASE.�OUCY umrr .S* oo0de o rn DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addidonal Ramnks S NO Wa,may be aW:ohed IF more spade Is required) W0013696002-$25,000 Deductible;WC013696102-FL,HI,MA,NJ,NY,OR,VA,WI only. Named Insureds:Sunrun Inc.,Sunrun Installation Services Inc.,Sunrun South LLC,AEE Solar,Inc., Clean Energy Experts LLC,Sunrun Solar Electrical Corporation ` Re:Permitting within Jurisdiction. CERTIFICATE HOLDER CANCELLATION Town of Barnstable EXPIRATION ANY OF THE ABovE DESCRIBED POLICIES Be CANCELL®BEFORE 367 Main ar THE EXPON DATE THIEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE Vim THE POLICY PROVISIONS. Hyannis MA 2601 AUTHORCM Rl1PRESENTATIVE 01988-2014 ACORD CORPORATION. All rights reserved, ACORD 26(2014/01) The ACORD name and logo are registered tnarlw of ACORN . .. The Commonwealth of Massachusetts = W Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMTTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Sunrun Address:775 Fiero Lane, Suite 200, City/State/Zip:San Luis Obispo, CA 93401 Phone#:978-549-9438 Are you an employer?Check the appropriate box: Type of project(required): 1.[Z]I am a employer with 35 employees(full and/or part-time). 7. ❑New Construction 2.[—]I am a sole proprietor or partnership and have no employees working for me in 8. [j Remodeling any capacity.[No workers'comp.insurance required.] 3.E]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring.contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole I L Electrical repairs or additions proprietors with no employees. 12.[j Plumbing repairs or additions 5.E]I 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. Roof repairs 6Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other Rooftop Solar 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:Zurich American Insurance Company Policy#or Self-ins.Lic.#:WC013696002 &WC013696102 Expiration Date:10/01/2017 Job Site Address:107 Herring Run Drive City/State/Zip:Barnstable MA 02632 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 andpenalties perjury that the information provided above is true and correct Signature: Date: Phone#: Official use onl . Do not write in this area,to be completed by city or town official City or.Town: Permit/License# Issuing Authority(circle one): . 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ice of Consumer Affairs cwacrc &Business Re ��"�' 'r ME IMP gulation _ e IMPROVEMENT CONTRACTOR License or gistraUon iz8937 before the a x�stration valid for individual ExpirafigR Office of PiratiOn date If fours use only SUNRUN INC. 6621ff@ ' Type' Consumer d return to: Of Card 20 Park Plaza_ Affa►rs and Business Re Boston,MA 021 16ite Sf 70 grtlation: CRAIG ORN A 595 MARKET ST 29TIi FL SAN ERANCISCp CA 94f05 Un i _ .. dersecretary Not id without e signatu� I I 1/26/2017 image001.png Massachusetts Department of Public Safety t Construction Supervisor . Board of Building Regulations and Standards ` Restricted to: License: CS-080034 unrestricted-Buildings of arty use group which contain less than 35.000 cubic feet( 91 cubic meters)of Construction Supervisor 5 enclosed space. CRAIG MORN s 73 WALNUT ST . OXFORD MA 01540 i t Failure to possess a current edition of the Massachusetts Expiration:. 1 State Building Code is cause for revocation of this license. Commissioner 0/122/2019 DPS Licensing information visit:WWW.MA S S.GOVIDPS httPs J/m ai l.googl e.com/mail/tgotM nbox/159db3eO53bd6413?projector=l 1/1 ru n -s March 21, 2017 Subject: Structural Certification for Proposed Residential Solar Installation. Job Number: 221R-107LOPE; Plan Set: Rev A, Dated 3/14/17 Client:Jane L Lopez Address: 107 Herring Run Dr, Barnstable, MA, 02632 Attn:To Whom It May Concern A field observation was performed to document the existing framing of the above mentioned address. From the field observation,the existing roof structure was observed as Composition Shingle roofing over roof plywood supported by 2x4 Truss @ 24" OC. The roof is sloped at approximately 23 degrees and has a max truss top chord span of 6' 8" between truss web members. Design Criteria: - • 2009 International Building Code w/780 CMR • Basic Wind Speed Vult= 110 mph (Vasd =85 mph), Exposure B • Ground Snow Load = 30 psf After review of the field observation report,the existing roof framing supporting the proposed solar panel layout has been determined to meet or exceed the requirements based on our structural capacity calculations in accordance with applicable building codes. Therefore, no structural upgrades are required. If you have any further questions on the above for mentioned, please do not hesitate to call. Sincerely, P Z Sage Lopez, P.E. _:_o__ GIVI.. � 1 J ' Civil Engineer ' NO. ago co) Y Sunrun,Inc AS�},- /STERN ►�`� �UNAt Ems'\�,, �'►1, 133 Technology Dr., Suite 100, Irvine,CA 92618 1 P 949.393.0993 sun run w� Structural Calculations for the Jane L Lopez Residence PV Installation Date: 3/21/2017 Job Address: 107 Herring Run Dr Barnstable, MA, 02632 Job Number: 221R-107LOPE Scope of Work These calculations are for the existing roof framing which supports the new PV modules as well as the attachment of the PV system to existing roof framing. All PV mounting equipment shall be designed and installed per manufacturer's approved installation specifications. Calculation Index , Sheet Description a 2 Structural Geometry, Live Load,Snow Load,Wind Load,& Dead Load 3 Roof(1) Framing Check 4 Roof Attachment Check,Seismic Check, &Scope of Work Engineering Calculations Summary Code: 2009 International Building Code w/780 CMR ASCE 7-05 Snow Load: S= 30 psf Live Load: LL= 20 psf Wind: Wind Speed ASD (V) = 85 mph Exp.= B PV Dead Load: DPV= 3.0 psf Sincerely, Sage Lopez, P.E. F VV,��-Z� 1 tss #� Civil Engineer Sunrun, Inc P z �, s �� o GIVI A� No. 470 • I roNAI E�'�,�� , ►►�r 133 Technology Dr.,Suite 100, Irvine,CA 92618 1 P 949.383.0993 Y i � , Engineer:SVL s u 1 n 1 r V Date: 1/0/1900 �e Job: 221R-107LOPE �- ' � .,. '.,�.. Address: 107 Herring Run Dr e 0 � Barnstable, MA,02632 2of4 Structrure Geometry: Mean Roof Height,hn = 21 ft Eave Height,he = 18 ft Buiding Length,L = 25 ft Building Width,B 30 ft Module Area = 20 ft2 Roof Pitch,B = 23 degrees Live Load: Roof Live Load,Lr = 20.00 psf Equation 4.8-1 Snow Load: Ground Snow Load,pg = 30 psf Fig.7-1 Snow Importance Factor,Is = 1 Table 1.5-1 Thermal Factor,Ct = 1.1 Table 7-3 Exposure Factor,Ce, = 0.9 Table 7-2 Roof Slope Factor,Cs = 0.86 Figure 7-2c Flat Snow Load,Pf = Sloped Roof Equation 7.3-1 . Sloped Roof Snow Loads,Ps = 17.83 psf Equation 7.4-1 Is the width of the roof>20ft? Yes Drift Height,hd _ 1.44 ft Figure 7-9 Roof slope for a rise of one,S 2.36 Unbalanced Width = 5.87 ft Fig 7-5 y = 18 pcf Equation 7.7-1 Unbalanced Snow Load = 34.57 psf Fig 7-5 Wind Load- Basic Wind Speed(3s-gust),V 110.0 mph Figure 26.5-1A VASD = 85 mph Building Occupancy Category = 2 Table 1.5-1 Exposure Category = B Sec 26.7.3 Topographic Factor,Kzr = 1.00 Equation 26.8-1 Adjustment Factor,A = 1.00 Figure 30.5-1 Edge Zone,a = 3.00 ft Figure 30.5-1 Uplift(0.6W) Zone 1(psf) Zone 2(psf) Zone 3(psf) Pnet30 = -19.40 -31.90 -47.90 Figure 30.5-1 Pnet=0.6 x A x Kzr x Pnet30) _ -11.64 -19.14 -28.74 Equation 30.5-1 Downward(0.6W) Zone 1(psf) Zone 2(psf) Zone 3(psf) Pnet3o = 11.40 11.40 11.40 Figure 30.5-1 Pnet 0.6 x X x Kzr x Pnet30 = 9.60 9.60 9.60 Equation 30.5-1 Dead Load: Roof 1 Roof Walls-Exterior Composition Shingle 3.0 psf Wood 5.0 psf 5/8 OSB Sheathing 2.0 2x4 Studs @ 16' 2.0 2x4 Truss @ 24"OC 1.0 Gypsum 3.0 Misc.(Ceiling,Insulation,etc.) 1.0 Misc.(Insulation,etc.) 2.0 PV System,Ppv 3.0 Total Roof DL= 10.0 psf Total Wall DL= 12.0 psf 133 Technology Dr.,Suite 100, Irvine,CA 92618 P 949.393.0993 c r Engineer:SVL J u I n 1 [ u Date: 1/0%1900 -- _ Job: 221R-107LOPE Address: 107 Herring Run Dr Barnstable, MA,02632 3 of 4 Roof(1)Framing Check: Roof Framing = 2x4 Truss @ 24"OC Timber Species = Spruce-Pine-Fir#1/#2 Max Beam Span 6.67 ft b 1.50 in d = 3.50 in Moment of Inertia,Ix = 5.36 in Section Modulus,Sx = 3.06 in' Bending Stress,Fb = 875 psi Elastic Modulus,Emin = 510000 psi CD(Wind) CD(Snow) CLs CM Ct Wood Adjustment Factors: 1.60 1.15 ..00 1.00 1.00 CL CF Cfu Ci Cr 1.00 1.5 1.00 1.00 1.15 PV Tributary Width,Wpv = 2.75 ft PV Tributary Length,Lpv = 4.00 ft PV Tributary Area,At = 11.00 ft2 PV Dead Point Load,PD=Ppvx At = 30 lb Roof Distributed Load,wDL = 13 plf Load Case: 0.6DL+0.6W (CD=1 6) Roof Zone — 1 Pup=Pnet x At+0.6 x PD X cos(8) = 110 lb Mb(wind_up) = 123lb-ft Fb'(wind)=Fb XCD XCLS XCM XCt XCL XCF xCfu xCi xCr = 2415 psi Mallowable=Sx x Fb'(wind) = 616 lb-ft > 123 OK Load Case: DL+0.6W (CD=1.6) Pdown=Pnet x At+PD X cos(8) = 136 lb " Mb(wind_down) = 236lb-ft Fb'(wind)=Fb XCD XCLS XCM XCt XCL XCF XCfu XCi xCr = 2415 psi Mallowable=Sx x Fb'(wind) = 616 lb-ft > 236 OK Load Case: DL+0J5(0.6W)+0J5S (CD=16) Roof Snow Distributed Load,wSL = 36 plf Psnow=Ps x At = 181 lb Mb(wind_snow) = 387lb-ft Fb'(wind)=Fb XCD XCLS XCM XCt XCL XCF XCfu XCi xCr = 2415 psi Mallowable=Sx x Fb'(snow) = 616 lb-ft > 387 OK Load Case: DL+Sj(CD=1.15) Roof Snow Distributed Load,wSL = 36 plf Psnow=Ps X At = 181 lb Mb(snow) = 340lb-ft ` Fb'(snow)=Fb XCD XCLS XCM XCt XCL XCF XCfu XCI xCr = 1736 psi } Mallowable=Sx x Fb'(snow) = 443 lb-ft > 340 OK { " -133 Technology Dr.,Suite 100, Irvine,CA 92618 P 949.393.0993 Engineer:SVL y sunrun - Date: 1/0/1900 Job:221R-107LOPE Address: 107 Herring Run Dr ••� A ' . Barnstable, MA,02632 4of4 Rafter Attachments:0.6D+0.6W(Zone 2) Puplift=At x Pnet(2) = 192 lb Connector Uplift Capcity per SnapNRack Test Results = 500 lb > 192 OK 5/16"Lag Screw Withdrawl Value = 205 lb/in Table 11.2A-NDS Lag Screw Penetration = 2.5 in Allowable Capacity with CD = 820 lb > 192 OK Seismic Check: Existing Dead Load: Solar Dead Load: Arodexisting = 750 ftZ Wpanel = 42 lb Wrodexisting = 5250lb NUmpanel = 27 Awallexisting = 1980 ftZ Wpanel_tot = 1134 lb Wwallexisting = 23760lb Wbos = 265lb Wtotal = 29010lb Warray = 1399lb %Increase=(Wtotal+Warray)/Wtotal = 30409 *100%-100% = 4.82% ** 29010 **The increase in weight as a result of the solar system is less than 10%of the existing structure and therefore no further seismic analysis is required. a Limits of Scope of Work and Liability We have based our structural capacity determination on applicable building codes,professional engineering inspection and design experience,opinions and judgments.The calculations produced for this dwelling's assessment are only for the proposed solar panel installation referenced in the stamped plan set and were made according to generally recognized structural anlaysis standards and procedures. #� 133 Technology Dr.,Suite 100, Irvine,CA 92618 P 949.393.0993 i DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 By signing below, you acknowledge that you have reviewed and received the Agreement without any blanks. Such Agreement shall be the complete understanding between the Parties. SUNRUN INCDocesigeed by: Signatur &t' dt, C'5510AC21MEOC Print Name: All i e Gaude Date: 2/28/2017 Title: Pr�j�ct nnPrationc Federal Employer Identification Number: 26-2841711 IF YOU CHOOSE TO PAY BY CHECK, MAKE CHECKS OUT TO SUNRUN INC. NEVER MAKE A CHECK OUT TO A SALES REPRESENTATIVE. OUR SALES REPRESENTATIVES ARE NOT AUTHORIZED TO RECEIVE CHECKS IN THEIR OWN NAMES. YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE TENTH BUSINESS DAY AFTER THE EFFECTIVE DATE. PLEASE REVIEW THE ATTACHED NOTICES OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT. DO NOT SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES. Customer i n�m71 Holder Secondary Account Holder(Optional) F ane opez Signature z/zz z017 . Date rent ame . Email Address*.- janelopersolar@gmail.com Mailing Address: 107 Herring Run Dr Barnstable, MA 02632 Phone: null Emai/addresses wi//be used by Sunran for ofcia/correspondence,such as sending month/ybi//s or other invoices. Sales Consultant By signing below I acknowledge that 1 am Sunrun accredited, that I presented this agreement according to -Siw" Code of Conduct, and that I obtained the homeowner's signature on this agreement. �t},gLt�a*iVt,2ggR6 v ctlufC - Benjamin Otto Print Name 7619249257 Sunrun ID number SUNRUN INC. 595 Market Street,29th Floor, San Francisco, CA 94105 1888.GO.SOLAR MA HIC Registration No.. 178937 Contract Version: 1.0 Generation Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H 21 DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 Exhibit A Monthly Payment Schedule and Prepayment Pricing When you sign the Agreement, you will pay Sunrun a Deposit of$0. At the start of installation of the Solar System, you will pay Sunrun an Initial Payment of $0. Together, these payments comprise the Upfront Payment ("Upfront Payment"). Each Monthly Payment shown below is for the previous year. Each of your first 12 Monthly Payments will be in the amount of $77.95. The Monthly Payments shall increase by 2.9% annually during the Initial Term of the Agreement (the "Annual Increase"), effective as of the Monthly Payment that covers any calendar month that includes an anniversary of the In-Service Date (and such increase would not apply to any part of a Monthly Payment that covers the days in a calendar month leading up to an anniversary of the In-Service Date). The Monthly Payments shown below are before any applicable taxes and include a $15.00 discount for paying through Automated Clearing House (ACH) withdrawal. If you do not elect automatic payment through ACH withdrawal from your checking or savings account, you will not receive this discount and each monthly payment will be $15.00 greater. For simplicity, the table below is based on the assumption that the In- Service Date will occur on the first day of the month. Upon each anniversary of the In-Service Date, Sunrun will issue you a refund if Actual Output is less than Guaranteed Output to date. Please see Section D of the Agreement for additional information, including certain limitations. SUNRUN INC. 595 Market Street,29th Floor, San Francisco, CA 94105 (888.GO.SOLAR MA HIC Registration No. 178937 Contract.Version: 1.0 Generation Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H P 22 DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 Year Monthly Payment Performance Refund per RWf if Estimated Bstimated (including the Annual Guarantee (kWh Guaranteed Prepayment Cash Increase)* Output to Date) Output is Not Met Purchase Price Purchase Price 16;828 kw $0.137 $15;90� $34,753 2 $80. 13 6-22 wh $0.1 2 $-j0,641 $30,723 3 $82.54 20,382 kWh $0.146 $15,3 3 $26,655 $83 2 ,10-=�8 cFwh $0.1 $15,0 5 $22, 46 5 $8 .40 337800 wh $0.1`5-7, 14,623 $18,394 6 $89.93 40,459 kw $`0.162 $14;196 1 ,196 7 $92.5 47,085-Rwh ,720 T 3,720 8 $95.22 53,678 wh $0`�. 73 $13, 93 $T3;1-93 9 $97.98 60 237 wh $0. -79 $12,6 1 $ 2,61 0 $100.83 66, 64 kwh $0.18 $1 ,97 $ 1,97 $ 03.75 73,258 kwh $0.1 2 ,2 0 $ ,270 12 $ 06.76 9,72OFkwh $0.198 $1T,—504 $10,504 13 $ 09.8 86, 9 kw 50.205 $9,669 9,669 14 13.04 92,5 kw 0.212 8,762 $8,762 5 $I I 6.32 98,9 2 w IT $0.219i— $777 8 $7, 778 6 $I I 9.69 10 ,24 w 0.222J7 $6, 3 $6,7 3 7 $I 23.16 1 ,5 7 Tw $0.234 62 $ , 8 P126.to 117,81 w $0.24 $-4;332`b $-2F 9 $130. 124, 6 kw $0.2 1 T�2—.983 $2,983 20 $ 334. 9 —130,26 wh $0.2 9 , 45 ,545 *These Monthly Payments assume an Annual Increase of 2.9% 'At any time,you may prepay the balance of your estimated obligations under this Agreement. Please see Section B for additional information. Twenty (20) years after the In-Service Date, you will have the option to purchase the Solar System for the greater of the fair market value (FMV) as determined at that time or the cash purchase price as set forth above in year 20. After the Initial Term, if this Agreement is renewed in accordance with Section G(1), Sunrun shall, on each anniversary of the In-Service Date, establish a new price per kWh that is equal to ten percent (10%) less than the "Average cost of electric energy" as established by your Utility or its successor. "Average cost of electric energy" shall be the price you would otherwise pay for electric energy to your Utility or its successor for the 12 months preceding the start of each Renewal Term. SUNRUN INC. 595 Market Street, 29th Floor, San Francisco, CA 94105 888.GO.SOLAR MA HIC Registration No. 178937 Contract Version: 1.0 Generation Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H 23 DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 EXHIBIT B LEGAL NOTICES I SUNRUN INC. 595 Market Street, 29th Floor, San Francisco, CA 94105 888.GO.SOLAR MA HIC Registration No. 178937 Contract Version: 1.0 Generation Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H 24 DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 EXHIBIT C NOTICE OF CANCELLATION DATE OF AGREEMENT: YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN TEN (10) CALENDAR DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENT MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN 10 CALENDAR DAYS FOLLOWING RECEIPT BY SUNRUN INC. OF YOUR CANCELLATION NOTICE AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO SUNRUN OR THE CONTRACTOR, OR A SUNRUN DESIGNEE AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF SUNRUN INC. REGARDING THE RETURN SHIPMENT OF THE GOODS AT SUNRUN INC. 'S EXPENSE AND RISK. 'IF YOU DO MAKE THE GOODS AVAILABLE TO SUNRUN INC. AND SUNRUN INC. DOES NOT PICK THEM UP WITHIN TWENTY (20) DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO SUNRUN INC., OR IF YOU AGREE TO RETURN THE GOODS TO SUNRUN INC. AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE, OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO SUNRUN INC. AT 595 MARKET STREET, 29TH FLOOR, SAN FRANCISCO, CA 94105, PH: 1-855-478-6786, CANCELLATIONS@SUNRUN.COM, NOT LATER THAN MIDNIGHT OF' (DATE). HEREBY CANCEL THIS TRANSACTION. CUSTOMER SIGNATURE: DATE: , k SUNRUN INC. 595 Market Street, 29th Floor, San Francisco, CA 94105 1 888.GO.SOLAR MA HIC Registration No. 178937 Contract•Version: 1.0 Generation Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H .25 DocuSi n Envelope ID:07BF26CD-4 9 P ED2-4750-AAC3-44B2EB2E7345 EXHIBIT C DUPLICATE COPY NOTICE OF CANCELLATION DATE OF AGREEMENT: YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN TEN (10) CALENDAR DAYS FROM THE ABOVE DATE, IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENT MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN 10 CALENDAR DAYS FOLLOWING RECEIPT BY SUNRUN INC. OF YOUR CANCELLATION NOTICE AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO SUNRUN OR THE CONTRACTOR, OR A SUNRUN DESIGNEE AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF SUNRUN INC. REGARDING THE RETURN SHIPMENT OF THE GOODS AT SUNRUN INC.'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO SUNRUN INC. AND SUNRUN INC. DOES NOT PICK THEM UP WITHIN TWENTY (20) DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO SUNRUN INC., OR IF YOU AGREE TO RETURN THE GOODS TO SUNRUN INC. AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE, OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO SUNRUN INC., AT 595 MARKET STREET, 29TH FLOOR, SAN FRANCISCO, CA 94105, PH: 1-855-478-6786, CANCELLATIONS@SUNRUN.COM, NOT LATER THAN MIDNIGHT OF (DATE). HEREBY CANCEL THIS TRANSACTION. CUSTOMER SIGNATURE: DATE: t . SUNRUN INC.'j 595 Market Street, 29th Floor, San Francisco, CA 94105 888.GO.SOLAR ( MA HIC Registration No. 178937 Contract Version: 1.0 Generation Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H 26 DocuSign Envelope ID:07BF26CD-4ED2 P -4750-AAC3-4462EB2E7345 EXHIBIT D Payment Forms As a Sunrun customer, you agree to pay your monthly bill with recurring automatic electronic payments. If you choose not to select the automatic payment option, then you will lose the discount set forth in Section B and Exhibit A, and you will be required to pay your monthly Sunrun bill by check drawn on a US bank account or by money order. You will receive all invoices via email unless you contact Sunrun directly by phone at 855-478-6786 or by email at customer.care@sunrun.com to request invoices be sent through the US mail. • SUNRUN INC. 1 595 Market Street,29th Floor, San Francisco, CA 94105 1 888.GO.SOLAR ( MA HIC Registration No. 178937 Contract Version: 1.0 Generation Date:2/8/201.7 Proposal ID: PKKRVF6ACA7L-H 27 DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E 7345 ACH Deposit Form BY ACCEPTING THE TERMS AND CONDITIONS FOR RECURRING PAYMENTS BELOW AND CONDITIONS AND ENROLLING IN THE AUTOMATIC ELECTRONIC PAYMENT OPTION, YOU ARE AUTHORIZING SUNRUN TO AUTOMATICALLY DEDUCT YOUR MONTHLY INVOICE AMOUNT FROM THE BANK ACCOUNT YOU HAVE DESIGNATED. SUNRUN WILL ADVISE YOU BY MONTHLY INVOICE OF THE AMOUNT AND DATE OF THE PAYMENT THAT WILL BE AUTOMATICALLY DEBITED. 1. Sunrun will provide you with a monthly electronic statement of your account. You agree to review each invoice you receive for any errors. Under federal law, you have the right to hold up or stop an electronic funds transfer provided you give your financial institution notice of at least three business days before the scheduled transfer date. If you inform Sunrun that an error exists on your statement, Sunrun will attempt to correct that error prior to your next statement to the extent permitted by law. Sunrun shall bear no liability or responsibility for any losses of any kind that you may incur as a result of an erroneous statement or due to any delay in the actual date on which your account is debited. 2. If any changes occur in the information on your application, you must immediately notify Sunrun in writing of such changes. If Sunrun incurs charge-back fees as a result of inaccurate information you provide, then Sunrun shall bill you for those fees. 3. If you either do not notify Sunrun in writing of such changes or do so in an untimely fashion; Sunrun shall bear no liability or responsibility for any losses incurred to the extent permitted by law: Sunrun's sole liability to you shall be Sunrun's obligation to make any appropriate changes once in receipt of your written notification. The actual settlement date (or date the ACH transaction occurs against your checking or savings account or is charged to your check) will be no earlier than three (3) days before the invoice due date. 4. You agree to ensure that there are sufficient funds in your designated account on the settlement date to pay the amount of the debit. If Sunrun incurs charge-back fees as a result of insufficient funds in your designated account, then Sunrun shall bill you for those fees. 5. Sunrun reserves the right to change these conditions at any time. Notice may be given on or with your bill or by other methods. Either Party may terminate this arrangement at any time by giving the other Party written notice reasonably in advance'of the date of termination or any scheduled settlement date. You may also terminate this arrangement by calling Sunrun Customer Care at 1-855-478-6786 or by changing your billing preference in the Sunrun Customer Portal. Termination shall not prevent a debit transaction authorized before any notice of termination and does not terminate the Agreement or your obligation to make payments as required by the Agreement. 6. You agree to be bound by any rules your financial institution requires for pre-authorized electronic funds transfer.. 7. Check with your financial institution to see if there are any fees associated with the pre-authorized payment option. You will be responsible for all such fees. By my signature below, I authorize automatic electronic payments and accept these Terms and Conditions and acknowledge that I will receive a separate electronic request to securely enter my bank account information. rFcount Holder Secondary Account Holder (Optional) um - ane oyez Signature 2/22/2017 Date rent Name • SUNRUN INC. - NC. i 595 Market Street 29th Floor San Fr Y 178937 Contract Version: 1.0 Generation Date:2/8/2017cProposal D:PKKRVF6ACA7L HR i MA HIC Registration. 'No. DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 Check/Money Order Deposit Form" Sunrun customers paying Deposits or Monthly Payments by check or money order must (i) enclose this document with each payment and (ii) include your Sunrun Customer ID number in the memo line of your check. Please send payments to: Sunrun Inc. P.O. Box 511612 Los Angeles, CA 90051-810 Customer Name: Customer/Proposal ID #: Customer Address: Amount Enclosed: $ Description of Payment: 0 Deposit O Initial Payment O Monthly Lease Payment O January O February O March O April 0 May O June O July O August -0 September O October O November O December Date: Notes: For Accounting Purposes Only Account Coding: Fund: SUNRUN INC. 595 Market Street,29th Floor, San Francisco, CA 94105 888.GO.SOLAR ( MA HIC Registration No. . 178937 Contract Version: 1.0 Generation,Date:2/8/2017 Proposal ID: PKKRVF6ACA7L-H 29 DocuSign Envelope ID:07BF26CD-4ED2-4750-AAC3-44B2EB2E7345 My Custom Solar Design Prepared by David RyaLL, 02/08/2017 - My Information Jane L Lopez 107 Herring Run Dr Barnstable, MA 02632 Annual Usage: 6,944 kWh Estimated System Size: 6.44 kWp Energy Offset: 93°ij Approval I have reviewed My Custom Solar Design and approve of the placement of solar panels identified above. I understand that the actual number of panels and their precise placement may vary based on engineering, installation, and solar energy production considerations, including roof type,shade, and other factors. [DocuSigned by: _ ` [6pu'� 2/22/2017 FECSl3172D2EE414_. Customer Signature Date Town of Barnstable R¢ ii 200 Main Street, Hyannis.MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-498 Date Recieved: 2/23/2017 Job Location: 107 HERRING RUN DRIVE,CENTERVILLE Permit For: Building-Insulation-Residential Contractor's Name: Carl J Rebello State Lic. No: CS-084358 Address: Swansea, MA 02777 Applicant Phone: (508) 567-4109 (Home)Owner's Name: LOPEZ,JANE L TR Phone: (508)774-1479 (Home)Owner's Address: 37 GLEN EAGLE DRIVE, CENTERVILLE,MA 02632 Work Description: Insulation,Air sealing&door weatherstrips. .tee j -T 03 c� Total Value Of Work To Be Performed: $3,962.00 ae i Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Carl Rebello 2/23/2017 (508)567-4109 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees ' Total Project Cost : $3,962.00 Date Paid ...^ Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 2/23/2017 $85.00 Paypal _.._ ..:...Paypal _ ......... .....- ...... ................................................... . .......... ........ ......... ......... Total Permit Fee Paid: $85.00 TOWR of Barnstable Vault'.RegWator QfAT a -y Services Fee luchard V.Sc*Interiau ISirectoa Tom Perry,CDO,Bmil C�olmmrssroaer PERMIJ 200 Main Street,Hyannis;NIA 4?tS�o '� 2�16 www.town banxtable ma ns o re: 508-862-443� TOWN OF BABNSTABL&:508-790'-6230 REENTML ONLY N�apigarcelNumber ZZ9 — (�-`, NotVaNdsMaatRedX-PressFmpriat Property Address-Z 0 7 - 8rr�,i C r c o✓1 �,r' (- n /,erV,'1 bL- " Residential Value of Work_ J`��1 2J Aft um:fee of S35.00 for work wader S090.00 Owner's Name&Address r jo vi' I to .M,4 OL A Conbar:WfsName n l v a�v Te honeNrrmber Nome Improvement Couttactor License#(if applicable)�(� �'� 3 Email. Construction Supervisoer,License#(if applicable)_ /0 / 0 Z 7 (�Worlaman's Compensation hW3nnce y Check one. ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's CoWensation Insurance Insruance Company-NameCo WO& Man's Comp.Polk.,; 0/-T�l Copy of Insurance Compliance CerMea&must accompany each p eimiE Permit Re (checkbox) / Re-roof(hnrrieaae nailed)(stripping old shingles) All construction debris wM betaken to bVQ s t e lgai G�en� ❑Re-roof(hurricane nailed)(not stripping Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/cliders,.0 Value (nrwdmtrm 35)#ofwindows #of doors: ,❑ Smoke/Carbon Monoxide deteMm 4 floor plans marked with red Sand insp"ims requ4reiL o Separate Electrical&Dire Permft regrdrmL T%umxoftln'spermitdom=exempt camgli�Cewith o�erto�m departmenr regulations.i.e.grstaric„t:,s►nsereation,eDe. hlo$e Property eAr gn Property Owner Letter of Permission. A coP of H Imp►rovemmt Contrscton Incense&Const m iion supervisorsI.acense is requirtai T:TKEV1N D)BM1ftg doe Revised 061313 , HOME IMPROVEMENT CONTRACT Sold,Furnished and Installed by: PLEASE READ THIS CONTRACT THD At-Home Services,Inc. d/b/a The Home Depot At-Home Services 908 Boston Turnpike Unit 1,Shrewsbury,MA 1545 Branch Name: Boston North Date:8/3/2016 Toll Free 8779033768;Fax 8009863610ME Lic#C 02439 RI Cont.Lic#16427 Branch No: 33 CT Lic#HIC.0565522 MA Home Improvement Contractor Reg.#126893 Federal ID# 75-2698460 Installation Address: 107 herring run dr. CENTERVILLE MA 02632 City State Zip Purchaser(s): Work Phone: Home Phone: ` Cell Phone: Mrs. Carol Friel (508)775-1479 774 836-5457 Mr.John Hurley 508 775-1479 Home Address: 107 herring run dr.t CENTERVILLE MA 02632 (If different from Installation Address) City. State Zip E-mail Address (to receive project communications and Home Depot updates):jphiii2654(a),gmail.com Marketing emails will not be sent from The Home Depot. Proiect Information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to buy,and THD At-Home Services,Inc.("The Home Depot")agrees to furnish,deliver and arrange for the installation("Installati on")of all materials described on the below and on the referenced Spec Sheet(s),all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary(where applicable)attached hereto and any Change Orders(collectively,"Contract"): Job#:(Internal Reference) Products: Spec Sheet(s): Project Amount 9046073 Roofing 9046073 $5,931.30 Minimum 25% Deposit of Contract Amount Total Contract Amount $5,931.30 due upon execution of this contract Customer agrees that,immediately upon completion of the work for each Product,Customer will execute a Completion Certificate(one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns, pricing errors or because work required to complete the job was not included in the Contract. Payment Summary' • The Payment Summary# 9046073 ,included as part of this Contract,sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). 06117/14SA Page 1 of 6 j K'► HOME IMPROVEMENT CONTRACT PLEASE READ THIS CONTRACT NOTICE TO.CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time of sign.Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor, expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth in this Agreement or allowed under applicable law.THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVER OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Contract is the entire a eement between Customer and The Home Depot with regard to the products and installation services and supersedes all prior discussions and agreements, either oral or written,relating to said products and installation.This Contract cannot be assigned or amended except by a writing signed by Customer and The Home Depot. Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has received a copy of this Agreement. You are entitled to a paper copy of this Agreement if you choose. If you consent to an emailed copy,your consent applies only to this Agreement.By contacting sales office (g77)903- 768 ,you may update your email address,withdraw your consent,or obtain a paper copy of the Agreement at no charge. By signing below,you confirm the following: • You consent to receive only an entailed copy of this Agreement • You have access to a computer that can receive and open emails and PDF(Adobe Reader Version 10.1.4 or later)formatted documents. • Your email address is correctly listed on the Home Improvement Contract Submitted by: Accepted by: Mrs.Carol Fflej(Aug 3, 15,. $j Ply) Sales Consultant Christopher G.Read' Customer Signature: - License Name. (877)903-3768 Customer Telephone No. Signature: Sales Consultant License No. (as applicable) Accepted by:Christopher Read(Aug 3,2016,5:51 CANCELLATION:CUSTOMER MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION Bl DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT.THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE 06117114SA Page 6 of 6 a � A+�assa�lt�tts C3epartmenf o�Public Sa�e�y �' , 8oarcf via, g Regula€�as�atrci�tandar+35 ;, RONgLDQ SOLANO : 7$S W�[VERLY$TREE� A ��' ' FRAMiNGHl4M t�tfA QtT02�� �' � 3�� 1.2 Y y � Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114 2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeEiblv Name(Business/Organization/Individual): Address: 7 oer ly , City/State/Zip: t 6170Z Phone#: 3°� _ Are you an employer?Chec the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a'general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.XI am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling shipand have no employees These sub-contractors have 8. n Demolition working for me in any capacity. employees and have workers' insurance. 9 ❑Building addition comp.[No workers' comp.insurance P• required.] 5.- We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.[]Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[]Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy infornradon. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 3Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job'site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00.and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK-ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurancepayerage verification. I do hereby c u e t e pains a altdes o e 'u that the information provided above is true and correct Si afore: Phone#: Official use only. Do not write in this area,to be completed by.chy or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M The Commonwealth of Massachusetts Department of Industrial1!ecidents Office of Investigations I Congress Street, Suite 100 V Boston, M4 02114-201? www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ContractorsiElectricians(Plumbers A-Dolicant Informatio I I Please Print Leeibiy Name (,susiness/Orgattizatioty'Individual): The Home Depot At-Home Services ' Address: 908 Boston Tpk City/State/Zip: Shrewsbury,MA 01545 Phone#: 508-962-6942 Are you an employer? Check the appropriate bog: Type of project(required): 4. ❑ I am a general contractor and I 1.0 1 am a employer with 200+ 6."❑New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. :❑Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have g. ❑Demolition ship and have no employees employees and have workers' working for me in any capacity. comp. insurance.: 9. '❑Building addition [No workers' comp. insurance 10:❑ Electrical repairs or additions required.] 5� ❑ We are a corporation and its ;.❑ I am a homeowner doing all work officers have exercised their 11:❑Pt brag repairs or additions myself. [No workers' comp. right of exemption per MGL I2: Roof repairs c. 152, §1(4) and we have no insurance required.] ; employees. [No workers' li;[J Other comp. insurance required.] *Any applicant that checks box 41 must also till out the section below showing their workers'compensation policy information. 1 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. sheet showing the name of the sub-contractors and state.whether or not those entities have =Contractors that check this box must attached an additional erriptoyees:�If th'e"pub=coatiactuts have etupl'ogees,they must provide theirwvorkers'-comprpolicynumUer: I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: New Hampshire Insurance Company _ WC 015519215 Expiration Date:3i1rzo17 Policy#or Self-ins. Lic. #: n 1 City/State/Zip:/State/Zi C T '����.MA- Job Site Address: 0 7 fAP/;►^I n e �r r' p Pn Pry` 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 MT GL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ins ance coverage verification. f do hereby certify under t pat s and penalties of perjury that the information provided'above is true and correct Si ature: Date: Phone#: 401-714-6 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation - = 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improven��,, t:Contractor Registration Registration: 126893 J Type: Supplement Card Expiration: 8/3/2018 THD AT HOME SERVICES, INC. - W ANDREW SWEET = A 2455 PACES FERRY ROAD, HSC G ( /4 ATLANTA, GA 3033914 Update Address and return card.Mark reason for change. ❑ ❑ Employment ❑ Lost Card to ment Address ❑ Renewal P Y SCA 1 20M-05/11 - =` trice of Consumer Affairs&Business Regulation License or registration valid for individual use only _—(.a OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ` Office of Consumer Affairs and Business Regulation • Type: 10 Park Plaza-Suite 5170 RegistrationQ 2689 ExpiratiofiA g/3 2/2/ 01S' Supplement Card Boston, Not vali without signature NIA 02116 THD AT HOME SERV CES ING THE HOME DEPOT`AT_HOME SERVICES ANDREW SWEET \ �: 2455 PACES FERRY ROAD�:HSC AT12ANTA,GA 30339 Undersecretary DATE(MWDDIYYYY) ACORV CERTIFICATE OF LIABILITY INSURANC 0 211 812 01 6 THIS CEGHTS UP RTIFICATE IS ISSUED AS A MAJOR OF R NEGATIVELYTE HOLDER.THIS AMEND, EXTEND OR ALTER TIHE COVERAGE AFFORDED ABY THE POLICIES CERTIFICATE DOES NOT AFFIRMATIVELY BELOW. THIS CERTIFICATE CE INSURANCE AND HE CENT CE NO RTIFICATE HOLDER. it A CONTRACT BETWEEN THE ISSUING INSURER(5, REPRESENTATIVE OR PRODUCER, les must be endorsed. if SUBROGATION IS WANED,subject to IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the Policy( ) the berms and conditions of the policy,certain Policies may require an endorsement. A statement on this certificate does not confer rights to the cerllFcate holder in lieu of such endorsement(s). CONTACT .NAME: FAX PRODUCER PHONE MARSH INC. �Aall TWO ALLIANCE CENTER AppREss: w►Ic a 3560 LEVOX ROAD,SUITE 2400 INsuaE g AFFORDING covERAGE ATLANTA,GA 30326 26387 INSURER A:Steadfast Insurance Company t6535 1 W492-HorneD-GAW-16.17 INSURER e:Zurich American Insurance Co New Hampshire Ins Co 3841 INSURED TTHDDAAT-HOME SERVICES,INC. INsuREx C: 3817 DBA THE HOME DEPOT AT-HOME SERVICES INSURER 0,INinois Na6onai insurance Company 2690 CUMBERLAND PARKWAY,SUITE 300 INSURER E: ATLANTA,GA 30339 INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003746646-14 REVISION NUIMBER:6 CH IS THIS I&TO CERTIFY THAT T THE ALLAY REQUIREMECIES OF NT,TERM OR CONDIUE TION OF HAVE BAN THESPOLICIES DESCRIBED OHE NAMED SNT ASUBJECT TH TO ALL TPECT TO HE TERMS INDICATED. NOTUNTHSTAND CERTIFICATE MAY BE ISSUED'OR MAY PERTAIN,THE INSURANCE AFFORDED 8 POLICYEFF POLIb9�VDDlYY P LeullTs EXCLUSIONS.AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED,BY PAID CLAIMS. ILTR POLICY NUMBER 9.000,000 TYPE OF INSURANCE i�0488771406 0310112016 I03(0112017 EACH OCCURRENCE $ - 1 000,000 A. X -COMMERCIAL GENERAL LIABILITY i D. S , P ISES EXCLUDED CLAIMS MADE MITS OF POLICY XS 9,000.000 OCCUR I MED'EXP(Any one rson) $ LI ( I OF SIR:$1M PER OCG I PERSONAL&ADV INJURY S i $ 9'M.000 GENERAL AGGREGATE i 9,000,000 GEN T_AGGREGATE LIMIT APPUIE{S.PER: PRODUCTS-COMWOP AGG $± X POLICY JE O- El LOC I PR ( I , $ 0310112016 �0310112017 COMBINED SINGLE LIMIT $, 1,000,000 OTHER: BAP 293886343 Ea acadent B AUTOMOBILE LIABILITY I BODILY INJURY(Per person) `$ X ANY AUTO ` BODILY INJURY(Per accident)`S ALL CEO j,,SCHEDULED ( I SELF INSURED AUTO PHY DMG PROPERTY DAMAGE S H QED. _... __, �._.. _ _ er.accld ___. . (` Ig HIRED AUTOS_._._ _..AUTOS I I } rI EAe orCURRENCE $ UMBRELLA LIAR OCCUR AGGREGATE S EXCESS L)AB CLAIMS-MA. I S OTH- DED RETENTION'S WC01551a215(AOS) 0310112015 0310112017 X C WORKERS COMPENSATION 0310112016 0310112017 $ 1,000.000 AND EMpLoyERS'tIABILITY YIN WC01S519217(AK,KY,NH,NJ,Vi) E'L'EACH �� 1,000.000 C ANY pROPRIETORPARTNERE)eCUTIVE N NIA 03101/2015 03/0112017 EJ-DISEASE-EA EMPLOYE S 1,000,000 OMCERIMEMBER EXCLUDED? i WC015519216(FL) I E.L.DISEASE-POLICY LIMIT i$ D (Mandatory in NH) Conitnued on Additional Page It yes,desaibe,a,der OESORIonON OF OPERATIONS below i OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Adddiorel Remarks Scnedule,may be a8Ad n more space Is required) DESCRIPTION OF OPERA t EVIDENCE OF INSURANCE i iff I i CANCELLATION' Y CERTIFlCATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICES CANCELLED BEFORE THD AT-HOME SERVICES,INC. THE EXPIRATION DATE THEREOF, NOTICE WILLLL Be DELIVERED IN DBA THE HOME DEPOT AT-HOME SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. 2455 PACES FERRY ROAD i ATLANTA,GA WM AUTHORED REPRESENTATIVE 1 . 01 Marsh USA Inc i Manashi Mukherjee - ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25(2014101.) I }) } • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel P�RNISTA�LE Application # -�1 Health Division F Date Issued 3 lz5 Conservation Division Application Fee Planning Dept. Permit Fee , Date Definitive Plan Approved by Planning BG16 Historic - OKH _ Preservation / Hyannis Project St re t Address Village Owner Address 7 &i�nk 71,4� Telephone ©� 125— 417q Permit RequestI a' -e- Gr&tilt 6 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation RIM 60 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family We Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authoriz tion ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ _ - - v Name ✓., A Telephone Number / 0 �/ "e/ [ /`/ Address d License # Home Improvement Contractor# Email 117SAland kt MOMd,Wt Worker's Compensation # VW 6101VI /a26i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE �"� /��- FOR OFFICIAL USE ONLY •APPLICATION# ' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE E ` OWNER : DATE OF INSPECTION: FOUNDATION FRAME, INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ` ' FINAL GAS: ROUGH FINAL FINAL BUILDING DATE,CLOSED OUT' AISAOCIATION PLAN NO. i ` Federal ID#05-WS629 RISE Engineering RI Contractor Registration No 8186 I MA Contractor Registration No 120979 A division or Thielsch Engineering CT Contractor Registration No 620110 25 Mid-Tech Drive,Suite H,West Yarmouth, CONTRACT 508-568-1926 X-6205 FAX 508-568-t933 Page 1 R I S PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT/ WORK ORDER John P Hurley (508)775-1479 09/03/2014 148803 00003 SERVICE STREET BIWNG STREET 107 Herring Run Drive 107 Herring Run Drive SERVICE CITY,STATE,LP T�y BILUNO CITY,STATE,LP Centerville,MA 02632 Centerville,MA 02632 JOB DESCRIPTION Weatherization work at your home cannot proceed until a Carbon Monoxide detector is in place. $0.00 Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your.home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements,,attached garages and other unheated areas(windows are not generally addressed.) (12)working hours. $924.00 Provide labor and materials to install a 12"layer of R-42 Class I Cellulose added to(960)square feet of open attic space. $1,401.60 Slash the vapor barrier,flip,or re-position(960)square feel of insulation in the attic area. $240.00 ATTIC ACCESS:Provide labor and materials to insulate the back of(I)attic hatch with 2"rigid Thermax board.Weatherstrip the perimeter. $42.50 Provide labor and materials to make(1) temporary access to an attic area through the roof. The opening will be closed with materials similar to those existing.Roofing will be sealed properly when insulation work is complete. $92.42 Provide labor and materials to install ventilation chutes in(40)rafter bays to maintain air Flow. $139.60 Homeowner is responsible for the removal of the stored items blocking the installation of weatherization work in the basement. Removal must occur prior to the scheduled work start. $0.00 Homeowner is responsible for the removal of the stored items blocking the installation of weatherization work in the crawlspace. Removal must occur prior to the scheduled work start. $0.00 CRAWLSPACE:Provide labor and materials to install (192)square feet orR-10 rigid Thermax insulation to the crawlspace perimeter wall up to the sill and against the band joist. $794.88 BASEMENT CEILING:Provide labor and materials to install(108)linear feet of R-19 unlaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. $236.52 Provide labor and materials to install(216)square feet of 6 ml polyethylene over open ground in designated crawispace/earfhen basement areas. $166.32 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently, for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$4,000 per calendar year,and an incentive of 100%for the Air Sealing measures. Federal10 0 05.0406629 .RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 A division of 1'Melseh Engineering CT Contractor Registration No 620120 25�Ittl:l'ucl►Drive.Sidle 11.Nest Varnullllh. CONTRACT 508-568-1926 X-62115 FAX 508-569.1933 �s Page 2 �y{ PROGRAM THIS CONTRACT 10 EN19RED INTO BETWEEN 1118E I �•I C�.,�^-1t�S ENOINEERINO AND THE CUSTOMER FOR WORK AS ENGINEERING DescRlaeD BELOW CUSTOMER PHONE DATE CLIENTS WORK ORDER 101111 P Hurley (508)775-1470 09/0 3/2014 148803 00003 SERVICE STREET BILLING STREET 107 Flerring Run Drive 107 Herring Run Drive SERVICE CITY.STATE,ZIP BILLING CITY.STATE.ZIP Centerville. MA 02632 Centerville.MA 02632 .JOB DESCRIPTION For the safety and health of your home's uuloor uir quality,we will he conducting a hlcmcr door diagnostic or the available air Ilow•in your hone both betbre the work is begun.and tiller die weatherization work is complete.We will also Conduct n I'ull ussessment of dte combustion salMy of your heating system and wiper hewer.This hay 11 value ol'$90 and is at Ito cost to you. ' $9(LOfi N Total: $4,127.84 Program Incentive: $3,169.38 Customer Total, $958.46 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Nine Hundred Fifty-Eight&46/100 Dollars $968.46 UPON FINAL INSPECTION AND APPROVAL BY RISE ENOINEERINO.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF I%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 00 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION, �► r� NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES JC/011E.F� AUTHORIZED A URE•RIS GINEERIN4 CU ACCEPTA CE NOTE:THIS CONTRACT MAY at WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE `' ACCEPTANCE OF CONTRACT•THE o PRICE ,SPECIFICATIONS AND CONDITIONS ARE 3�ti SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK V GAYS, AS SPECIFIED,PAYMENT WILL BE MADE AS OUTLINED ABOVE ��.•+sssa•-,. ,yw•r w,.::'*— s•:I�i•'+r.. II•� ',` t"•',_�,,.,...�r. .... ,.L+/�/c�D)Jd11)0)J.IIIC//IN 0/'A�l�rl.L1fIC/L.1ollJ S{/ use ' OMCC or Consumer Affairs&Buftess RegulatloA L9cellso or �. aaoT OMB lMPROV«M�E�N,,,. C fl1MCOR ae>tpi26s�. Type hefora t 0alfs and 395 Pvate corpor ation rrE 4;016 A piration 6.1f2oCfl ��--- �os�ton,l�d� I is MJCHAEL T.MCMAHON;.0•C3N!00. EL MCMAHOIV' M1CMA • � e'` i •t,� 19 FIELDSTONE WA'f,•:;. •.... •• ' PLYMOUTH,MA 02380 Undersecretary t less 35,00 c;abio feet(9 ', :I mm m>imT Ag,OL"S n editinnoftheMB ir,C13uSE�S� �,�,��y, �arn�`� _•,s• u,__ ire to possess a�rre ;e Budding Cade is coos ffor revocation ofr �qs license 7p5Lfeensin5trtfarnaYlon sir. wvw.nnass.G3;o/bW5 1 ,� ,..._. -------•; I.I r b I • I .i r; 1 • DATE(NMIDCVYYYV) ® CATS OF LIABILITY INSURANCE 12 9 14 ACORD CERTIFICATE TE LD T THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R(HE COVERAG AFFORDED AB TOE POLIC EIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER HE ISSUING INSURER(S), AUTHOR BELOW. THIS CERTIFICATE OF INSURANCE DOER NOT CONSTITUTE A CONTRACT BETWEEN TIZED RODUCER,AND THE CERTIFICATE REPRESENTATIVE OR PCATE HOLD t be en dorsed. {f SUI3R CATION IS RIVED,sub eCt to IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poft,(les) mus the terms and condlUons of the policy,certain poiiclss may require an endorsement. A statement on thi s certificate does not Confer rights to the certificate holder in Ileu of such endorsemen PRODUCER PHONE (781) 335-9792 . 7al 3 5-1sso ThompSor� Insurance JJTins@ComCast.net and F nancial S®rvic®s ano�R s : NAIL 369 Union Street INsuRE S Al FFORDINO COVERAGE -- Weymouth, MA 02190-316 _ _ _ _ _ _.. _ ()g�R A;Trage.•ers -- — _ INSURER B.AIM Mutual INSURED MT MaMahon and Son Inc. INSURER C:WQstern World Insurana6a Co. 19 rieldstone Way INBURERD:TO 118 N n ri rari A Cam_.__ Plymouth, MA 02360 INSURER E: --- INSURER F; REVISION NUMBER: COVERAOE8 CERTIFICIOD ATE NUMBER: THIS IS TO NOTTiMTHSTANDNG POLICIES REOF INMENTNTERM OR Zj- CONDITIONOF ANY CONTRACT OR OTHER DOCUMEN WITBEEIIH RESPECT RESPECT TOLWHICH�THIS INDICATED. CERTIFICATE ANNIAOYCONDITIONS OF SUCH POU PERTAIN, CIES.LIMITS SHOWN MAY HAVE BEEN REDUCED_BY PAID DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ______ LIMITS L ,000,000 TR Ty POLICY NUMBER MM/DDIY MM C GENERAL LIABILITY NPP8202464 9/16/14 9/16/15 EACHOCCURRENCE $ 1 C DAMA E $ 100 000 COMMERCIAL GENERAL LIASIUTY MED EXP(Ary One perecn) $ 5 00 CLAIMS-MADE OCCUR PERSONALBADVINJURY S 1 000 00 _ GENERALAGGREGATE $ O OO -- PRODUCTS-OOMP/OPAGG $ 1 O GEN'LAGGREGATE LIMIT APP LIES PER S POLICY PRo• LOC AUTOMOBILE LIABILITY HA 2C882729 8/31/14 8/31/157 aaccident SODILY INJURY(Per person) $ ANY AUM BODILY INJURY(Per accident) $ ALLOWNED X SCHEDULED R-_ fD _hArG P § _AUTOS NON-OWNED dX X HIREDAUTOS X AUTOS $ UMBRE[LALIAB OCCUR 80313L140ALI 11/24/14 11/24/15 EACHOCCURRENCfi S 1,000,000 D AGGREGATE s 1 000 000 X EXCESSLIAa CLAIMS•MAOE $ WORKERS COMPENSATION VWC-100-6014109-203. 12/8/14 12/6/15 WOCCSTATU. X OTH- B AND EMPLOYERV LIABILITY YIN L.EACH A DENT —500�000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A OFFIC-eRMIEMBER EXCLUDED? E.L ICFev^a_EA EMPLOYE� rJOO OOO (MetWaODry In NH) E.L.DISEASE-POLICY LIMIT S 500,00 If Yyes deau'Ibe undef DE9 RIP ION OPE I NSb low DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Renarka Schedule,IT more apace Is n3gdred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BZMK ACCORDANCE WITH THE POLICY PROVISIONS. AUIMORM90 REPR96ENTATIVE John J. Thompson ©1888-2010 ACORD CORPORATION. All rights reserved. wnnen ..e,„e�„a ineo are realstered marks of ACORD r c OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at 07 (Property Address) -CAM . M tA oz. 3Z (Property Address) M L I hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. owners Signature /// Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 1 Congress Street, Suite 100 v,�r< Boston,AM 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ley-ibly NatT10 (Business/Organization/Individual): M.T. McMahon and Son, Inc Address: 19 Fieldstone Way City/State/Zip:Plymouth , Ma 02360 Phone#:781-831-1234 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 9 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑■ Other Weatherization comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Aim Insurance Policy#or Self-ins. Lic. #:VCW-100-6014109-201 Expiration Date: 12/08/2015 Job site Address: 107 Herring Run Drive City/State/Zip:Centerville, Ma 02632 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the vains and penalties of perjury that the information provided above is true and correct. Signature• Date: Phone#: 7818311234 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i Town ®f Barnstable Permit: ( S�S� Regulatory Services Date: 'fjil/o �Op114E rok Thomas F. Geiler, Director Building Division Fee: BARNSTABLE, Tom Perry, Building Commissioner /�.�.. MASS. x- v� 039. ��� 200 Main Street, Hyannis, MA 02601 ArFDM a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: /'� Phone: ( U Install at: Q 7�1( -- Village: Map/Parcel: - ` V Date: ((�0 Stove .� A. Ne)/ Used C j�C e. �-� A; B. 'hype: Radiant/ Circulatin ��` `�' fire C. Manufacturer: R�ob CA Lab. No. D. Model No.: — Chimney A. New/ Existing (If existiy, please note date of last cleaning) B. blue Size C. Are other appliances attached to Flue? A a D. Pre-fab Type and Manufacturer F. Masonry: Lined/Unlined Hearth A. Materials: kj� tR4 s ( ,'r j '1 B. Sub Floor Construction: 94- Installer� � �� I /�/7J Name: Address: Phone: Al Location of Installation: H.I.0 Registration # rn _ Construction Supervisor# ~° OR-check/, 'Homeowner Installing, no license required APPLICANTS SIGNATURE / APPROVED BY: N Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,'photographed, and approved by the Building Inspector Q:forms:stove Rev 103107 t Town of Barnstable mot THE r � Regulatory Services sat;xszAs Thomas F.Geiler,Director MA-3 ,�� Building Division PjEO 1�`�a Tom Perry,Building Commissioner. 200 Main Street, Hyannis, MA 02601 wym.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 )IONIEOWNER LICENSE EXEMPTION fl Please Print DATE: JOB LOCATION: U r `- D fi number eet / village / 7� HOMEOWNER �� 9,jr � ✓� / / � 7 Icy /I� `� �✓ d /7 name home phone# „ work phone# CURRENT MAILING ADDRESS: city/town state zip code The current.exemption for"homeowners"was extended to include owner-occupied dwellin>rs of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEON'VNER 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 fivo-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signer re of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions" of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such " work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q," Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure.that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner.certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is,a form currently used by several towns. You may care t amend and adopt such.a formlcertification for use in your community. °p1HEt, Town of Barnstable r Regulatory Services ` seaxsresLe, hcwss. Thomas F. Geiler, Director -q � Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Z , as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of rob) Signature of Owner Date Print Name if Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. I: . r Assessor's map and lot number ....... ... T F Sewage Permit number ./�....... . .. d • , BASHn3 eT�LE, i House number :.` ... .� ................................ . .......... vo 1 p 039. \e� TO: N OF - �BARNSTABLE BUKDING;- INSPECTOR APPLICATION FOR PERMIT TO ..!-. ............:..�,?................... .Cl...:......... .............../.:.../ ...................... TYPE OF CONSTRUCTION ....... ! .d.Q.. ..... I ...................................:......:................................... - ............... .. ...ii�l..................19.13 TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a .4 permit according,to-the /f�ollowing information: Location ...�Q..7.... .:���n! ?'..... UN....�.(Q1.m CO.,41 r, 1lIL.......................................... ..................... Proposed Use ............. .........W..111.........................................'.................................. . ... Zoning District .....................................................................:..Fire District .......................... Name of Owner N..a..:..Hq ................Addredg!z...1.!.q.)?fl4 n..!q(V......ap...:6��- Name of Builder �....4,4.01 ..... ..Address 3i... ...... Name of Architect 'V 0 N� :Address................................. ..........................:.................,....................................... /? c_ Number of Rooms ...D.1.l F.................... ..............Foundation . .............. . ... .................... .. ....................:......... PP .,........Roofing Q p Exterior ........... � .lYL. ......Cad 0 ......... l S.PH!�LT Floors �.�?i. .rt fL. .............:..................................Interior ........:Y �.....® /Q t.............................................. ............ ........ Heating .......................Plumbing ......................,.......................:...............:................... ............®..... .......................... n. � Fireplace fv Approximate Cost' OQ 0�0.. ............................................... .........�:......d....V.. .... ...Definitive Plan Approved by Planning Board ________________________________1.9__-_____. Area . .... ..!.... Diagram of Lot and Building with Dimensions Fee ... ................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH L 19CA( - PrT TI o dtf 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. 4 Name .. ........... ......, ..... ....................... Construction Supervisor's License .001.310...... 1 HURLEY, JOHN P. 25227 Enclose Porch R ' Permit for _ ............. �. Location .1.0.7...Eeaxxi g...R.Lia-Dr.l;Ve........ r r Centerville .... .. ....... ............. ,s -. f"�^ ....- ` .... John- P. Hurley Owner .. ............................................................... y Type of Construction Frame............................. ........................................_ .. ................................... ✓ r..^' _ .,'""� .. 3 •^a�^ .� PIOt Lot♦~y.............................. June 21 ' - Permit Granted a........ 19 83 r �, Date of Inspecti6�k 1 Date Completed ./.. :'. ...... 1+l:9 '�`/ _� .. ..^� r's. � -• �� yam, �� fI :. �r / t Assessor's map and lot number ........ �..�.. .... /! ! '' THE Sewage Permit number �....... . . . ., � x ..... d� °� Z 2AUSTAIDLE, i House number ......... ) 0 ......... yo NA66 � 1.,.... ................................ .r o 1639. \00 C a MPY TO N OF BARNSTABLE BUILDING . INSPECTOR c ��� APPLICATION;FOR PERMIT TO ..!4r. ...............5............!...�..�. /. / 7 TYPEOF CONSTRUCTION ...... .............................................................................. .......... ..................19. .Cd 3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...4P.1.... ..�1�.1 k7....goy....dRld4''�C . . .i?...., 1Py/4.. '............... ProposedUse .C? ............1......`................. ..!....................................................................... ZoningDistrict ........."................................................................Fire District ............................................................................... Name of Owner .�!..Q,fl/�....... .!.l.t^I:..Y..................Addredq!Z...��L,1�,91��?- 190A/......�R.... ........ itC Name of Builder 4 !7... ...Address 3/...�!!1� +��lf�. ...pig!. . ./1 ......................... Name of Architect' .. `.... ..:....................Address A.0.'yie.......... .................................................................................... Number of Rooms ... .........................................Foundation . T........................................................................ Exterior w). l ,ri L,dc �J®�,� � �.J��1yJ ............................................................ . .....................Roofing .... Floors .........C.i%. . ...�:...................................................Interior ..............��, t� . .................................................................... Heating '� ...........Plumbing /".�o........".�G.:.......................................... .............................................................................. Fireplace ......,...�kow?z...................................................Approximate Cost lKga , 0 ........................... ........................ C?,W6C ��A Definitive Plan Approved by Planning Board ________________________________19________. Area f�o , l.................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL- OF BOARD OF HEALTH OCCUPANCY] PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......... ........i�2..................... Construction Supervisor's License .� ..!.. .../... ..... A HURLEY, JOHN P. A=229-050 25227 Enclose Porch No ................. Permit for ........:........................... i Family Dwelling ........... 107 Herrin Run Drive Location ............................ .................................. Centerville.................................. 1 _ Owner ........John...P.....Hurley..................... ..E `� , 7R ; Type of Construction .....rame.•,•,••••,,.,.•,_..••...,. r ............... ....... .................................................. 'z Plot ............................ Lot ................................ = June 21, Permit Granted ........................................19 83 Date of Inspection ....................................19 Date Completed ............................. .......19 A � a / • -t 7 . _ t SCOPE OF WORK '„ GENERAL NOTES LEGEND AND ABBREVIATIONS TABLE of CONTENTS PAGE# DESCRIPTION • SYSTEM SIZE: 7560W DC,6480W AC • ALL WORK SHALL COMPLY WITH 2O17 NEC, 2009 IBC, MUNICIPAL CODE,AND SE SERVICE ENTRANCE' SOLAR MODULES PV-1.0 COVER SHEET • MODULES: (27)REC SOLAR: REC280TP BLK ALL MANUFACTURERS'LISTINGS AND INSTALLATION INSTRUCTIONS. ® RAIL PV-2.0 SITE PLAN • INVERTER(S): • PHOTOVOLTAIC SYSTEM WILL COMPLY WITH 2O17 NEC. ' (27),ENPHASE ENERGY: M250-60-2LL-S2X • ELECTRICAL SYSTEM GROUNDING WILL COMPLY WITH 2O17 NEC. Mp MAIN PANEL PV-3.0 LAYOUT • RACKING: SNAPNRACK SERIES 100 UL; FLASHED L FOOT. • PHOTOVOLTAIC SYSTEM IS.UNGROUNDED. NO CONDUCTORS ARE SOLIDLY . PV-4.0 ELECTRICAL SEE PEN D01. GROUNDED IN THE INVERTER. • MODULES CONFORM TO AND ARE LISTED UNDER UL 1703. , SP SUB-PANEL STANDOFFS& PV-5.0 SIGNAGE • INVERTER CONFORMS TO AND IS LISTED UNDER UL 1741. FOOTINGS • RACKING CONFORMS TO AND IS LISTED UNDER UL 2703: CHIMNEY • CONSTRUCTION FOREMAN TO PLACE CONDUIT RUN PER 690.31(G). LC PV LOAD CENTER • ARRAY DC CONDUCTORS ARE SIZED FOR DEBATED CURRENT. • 9.44 AMPS MODULE SHORT CIRCUIT CURRENT. Q ATTIC VENT • 14.75 AMPS DERATED SHORT CIRCUIT CURRENT(690.8•(A)&690.8(13)). SM SUNRUN METER FLUSH ATTIC VENT PM DEDICATED PV METER o PVC PIPE VENT INVERTER(S)WITH INTEGRATED DC ® METAL PIPE VENT INV DISCONNECT,AND AFCI ® T_VENT AC AC DISCONNECT(S) 0 SATELLITE DISH DC DC DISCONNECT(S) FIRE SETBACKS r CB COMBINER BOX' HARDSCAPE F -I INTERIOR EQUIPMENT -PL- PROPERTY LINE L SHOWN AS DASHED ` Sunrun SCALE: NTS a m A AMPERE ' AC ALTERNATING CURRENT AFCI ARC FAULT CIRCUIT INTERRUPTER #180120 AZIM AZIMUTH VICINITY MAP r ` - _ �` - � COMP COMPOSITION . _ 734 FOREST STREET it400,MARLBOROUGH.MA 01752 DC DIRECT CURRENT - PHONE 666.657.6527 '• ti (E) EXISTING FAxeosszes7ol EXT EXTERIOR ED FRM FRAMING - CUSTOMER RESIDENCE: rF'~tl JANE L LOPEZ �' INT INTERIOR r � �Y _ • LBW - LOAD BEARING WALL . 2632 107 HERRING RUN DR, • MAG MAGNETIC cm) BARNSTABLE MA 0 107 Herein Run Drive MSP MAIN SERVICE PANEL • TEL. 774 #:636-3496APN 229 05_ 0 9 HYAWS - r )S T/TO SCALE ®��� � � NT NO PRO ECT NUMBER: y g �, OC ON CENTER ;�� PRE-FAB PRE-FABRICATED �AQ 303.942.2571 PSF POUNDS PER SQUARE FOOT hl� �JZ DESIGNER: PV PHOTOVOLTAICN�-�A�,LEAN HOLTON aA ' TL TRANSFORMERLESS QF DRAFTER: gETERV7lLE f `Y• r 'w tl' V P TYPICAL To VOLTS LEAH HOLTON W - WATTS SHEET a' REV NAME DATE COMMENTS COVER SHEET REV:A 3/14/2017 PAGE . PV-1 .O SITE PLAN -SCALE_1/64"=1'0" - PITCH TRUE 'WAG; PV AREA AZIM AZIM (SQFT) ® PL AR-01 23° 276° 290° 159.7- PL AR-02 23° 96° 1100 319.3 PL J �MP a - LC SM AC • 4A •d • - _ • ♦ 4 J a 4 a d , (N)ARRAY AR-01 d e • • . �-' tL 4 z - sunrun • •• • llJ _ #180120 " b ,r ", .. ;,, ., f _ •. 4 _ 734 FOREST STREET I)400 M ARLBOROU ,MA 01752 - J • < "" PHONE 888.657.6527. GH O_. • d • • ♦ d•. - • FAX 805.528.9701 14 (E)RESIDENCE a .4 4 A 4. a CUSTOMER RESIDENCE: JANE L LOPEZ 107 HERRING RUN DR, (N)ARRAY AR-02 BARNSTABLE, MA, 02632 TEL.(774)836-3496APN#:229_050 a PROJECT NUMBER: - 221 R-107LOPE r DESIGNER: 303.942.2571 x LEAH HOLTON DRAFTER: av . LEAH HOLTON a SHEET SITE PLAN PL PL REV:A 3/14/2017 PL _ PAGE PV-2.0 ROOF• FRAME FRAME MAX FRAME OC ROOF EDGE MAX RAIL MAX RAIL DESIGN CRITERIA ROOF TYPE ATTACHMENT ROOF HEIGHT FRAME TYPE EXPOSURE MATERIAL SIZE SPAN SPACING ZONE SPAN OVERHANG MODULES: AR-01 COMP SHINGLE FLASHED L FOOT. SEE PEN D01. TWO STORY ATTIC WOOD CARPENTER TRUSS 2 X 4 6' 8" 24" N/A. 4'-0" 2'- 1" REC SOLAR: REC280TP BLK AR-02 COMP SHINGLE FLASHED L FOOT. SEE PEN D01. TWO STORY. ATTIC WOOD CARPENTER TRUSS 2 X 4 6'-8" 24" N/A 4'-0" 2'- 1" MODULE DIMS" 65.5 x 39"x 1.5 D1 -AR-01 -SCALE: 3/16"= 1'-0" _ MODULE CLAMPS: PITCH: 230 12'-9" 19'-9" - 1� Portrait: 8.2"- 16.4" AZIM: 276° - .. Landscape:4.9"-9.8". MAX DISTRIBUTED LOAD: 3 PSF ® F6" SNOW LOAD: 30 PSF WIND SPEED: — 110 MPH 3-SEC GUST. LAG SCREWS: TYP- - 5/16"x3.5": 2.5" MIN EMBEDMENT NOTE: INSTALLERS TO VERIFY RAFTER -8 -e SIZE, SPACING AND SLOPED - 11' SPANS,AND NOTIFY E.O.R. OF AN CARPENTER TRUSS Y 1 -fl . Y DISCREPANCIES BEFORE ". IS SISTERED WITH - PROCEEDING. 2X6S 9'-10" PENETRATION SPACING: FULLY STAGGERED 2'-4" I T 4 D2-AR-02-SCALE: 3/16"= 1'-0•' , PITCH: 23° sunrun AZIM• 96° _ _ . 29'-7" #180120 1, 734 FOREST STREET#400 MARLBOROUH.MA 01752 G ' 6" - - `PHONE 888.657.6527 V _ FAX 805.528.9701- -4'TYP- CUSTOMER RESIDENCE: -. JANE L LOPEZ . e- e- e-- 107 HERRING RUN DR, 11' t "BARNSTABLE, MA, 02632 TEL.(774)836 3496APN#:229_050 PROJECT NUMBER: 221 R-107LOPE CARPENTER TRUSS 8- 8- 8- DESIGNER:- 303.942.2571 s - }• IS SISTERED WITH e LEAN HOLTON 2X6S 2'�" DRAFTER: LEAH HOLTON SHEET LAYOUT REV:A 3/14/2017 PAGE PV-3.0 120/240 VAC SINGLE PHASE (N)60A ENPHASE SERVICE AC COMBINER BOX .MAX 16 MICRO-INVERTERS PER BRANCH CIRCUIT_ METER#: [WITH (3)PRE-INSTALLED .MULTIPLE BRANCH CIRCUITS IN PARALLEL OEVERSOURCE(MA)2267705 20A PV BREAKERS AND .ENPHASE MULTI-PIN CONNECTORS-- 1ST AC CONNECTOR AT ENVOY COMMUNICATION EACH BRANCH CIRCUIT IS A SUITABLE DISCONNECTING MEANS. _ UTILITY GATEWAY] .DO NOT DISCONNECT/CONNECT UNDER LOAD GRID SUPPLY SIDE TAP f f f REC SOLAR: REC280TP BLK MODULES 4 �1 +�ff •ENPHASE ENERGY: JUNCTION BOX M250-60-2LL-S2X OR EQUIVALENT I EXISTING 100A AND MICRO-INVERTER PAIRS ,' • (27)REC SOLAR: REC280TP BLK � ` (N)LOCKABLE _ (1)BRANCH OF, ,_ MAIN BREAKER BLADE TYPE (N)SUN RUN —^ - \1 FUSED 9 MICRO-INVERTERS AC DISCONNECT ENTRON 4G ./� s; (1)BRANCH OF M JUNCTION BOX. METER _ (9) MICRO-INVERTERS EXISTING - OR EQUIVALENT 3 3 2 1 (1)BRANCH OF 100A c��. O �� y (9)MICRO-INVERTERS i� MAIN ._- FACILITY •— PANEL LOADS FAciurr 35A FUSE caouNo 250V METER SOCKET SQUARE D 125A CONTINUOUS& 20A BREAKER(A) - D222NRB 240V METER 20A BREAKER(B) 3R, 60A 20A BREAKER C 120/240VAC 200A, FORM 2S ( ) R NOTES TO INSTALLER: CONDUIT SCHEDULE 1. INSTALL NEW 60 AMP ENPHASE AC COMBINER BOX WITH(3)PRE-INSTALLED # CONDUIT CONDUCTOR NEUTRAL GROUND 20A BREAKERS. 2. CONNECT SYSTEM VIA INSULATION PIERCING'ON SUPPLY SIDE OF MAIN sunrun 1 NONE (2) 12 AWG ENGAGE CABLE (1) 12 AWG ENGAGE CABLE (1) 12 AWG ENGAGE CABLE BREAKER IN MAIN PANEL ENCLOSURE. CONDUCTORS ARE FIELD INSTALLED. PER BRANCH CIRCUIT PER BRANCH CIRCUIT PER BRANCH CIRCUIT 2 1"EMT OR EQUIV. (6) 10 AWG THHNrrHWN-2 (3) 10 AWG THHN/THWN-2 (1)8 AWG THHNfrHWN-2 - #180120 3 3/4"EMT OR EQUIV. (2)8 AWG THHN/THWN-2 (1) 10 AWG THHN/THWN-2 (1)8 AWG THHN/THWN-2 4 3/4" EMT OR EQUIV. (2)6 AWG THHN/THWN-2 (1)6 AWG THHN/THWN-2 (1)8 AWG THHNlTHWN-2 734 PHONE FOREST STREET oo,naAaLeoRoucH,naAo,752 PHONE 888.657.6527 . _ » FAX 805.528.9701 r CUSTOMER RESIDENCE: JANE L LOPEZ 107 HERRING RUN DR, R B 4 .. • - BA NSTA LE, MA, 02632 ~ TEL.(774)836-3496APN#:229 050 - - PROJECT NUMBER: MODULE CHARACTERISTICS 221 R-107LOPE REC SOLAR: REC280TP BLK: 280 W OPEN CIRCUIT VOLTAGE: 39.2 V DESIGNER: 303.942.2571 MAX POWER VOLTAGE: 31.9 V LEAH HOLTON SHORT CIRCUIT CURRENT: 9.44 A + DRAFTER: ( LEAH HOLTON �. SHEET ELECTRICAL REV:A 3/14/2017 PAGE PV-4.0 D DANGER ., ELECTRICAL SHOCK HAZARD FC%M MUFCE LABEL LOCATION: LABEL LOCATION: AC DISCONNECT(S),PHOTOVOLTAIC SYSTEM POINT OF DO NOT TOUCH TERMINALS. INTERIOR AND EXTERIOR DC CONDUIT EVERY 10 FT,AT EACH TURN,ABOVE AND INTERCONNECTION. TERMINALS ON BOTH THE LINE BELOW PENETRATIONS,ON EVERY JB/PULL BOX CONTAINING DC CIRCUITS. PER CODE(S):CEC 2016:690.54,NEC 2017:690.54,NEC PER CODE(S):CEC 2016:690.31(G)(3),690.31(G)(4),NEC 2017:690.31(G)(3), 2014:690.54,NEC 2011:690.54 AND LOAD SIDES MAY BE 690.31(G)(4),NEC 2014:690.31(G)(3),690.31(G)(4),NEC 2011:690.31(E)(3), ENERGIZED IN THE OPEN 690.31(E)(4),IFc 2012:605.11.1.4 POSITION NOTES AND SPECIFICATIONS: P ~ •SIGNS AND LABELS SHALL MEET THE REQUIREMENTS OF THE CEC 2016 AND LABEL LOCATION: NEC 2014 ARTICLE 110.21(B),UNLESS SPECIFIC INSTRUCTIONS ARE REQUIRED C S C COMBINER PANEL BY SECTION 690,OR IF REQUESTED BY THE LOCAL AHJ. - R S AC DISCONNE T A M INVERTE ( ), ( ), p S p .SIGNS AND LABELS SHALL ADEQUATELY WARN OF HAZARDS USING EFFECTIVE IF APPLICABLE).( ) D DO WORDS COLORS AND SYMBOLS. • PER CODE(S):NEC 2017:692.17 •LABELS SHALL BE PERMANENTLY AFFIXED TO THE EQUIPMENT OR WIRING - WARNING 0 p ^, e p METHOD AND SHALL NOT BE HAND WRITTEN,UNLESS PORTIONS OF LABELS OR 1`"�11�1J, .MARKINGS ARE VARIABLE,OR THAT COULD BE SUBJECT TO CHANGES,SHALL BE PERMITTED TO BE HAND WRITTEN AND SHALL BE LEGIBLE. POWER SOURCE OUTPUT •LABEL SHALL BE OF SUFFICIENT DURABILITY TO WITHSTAND THE ENVIRONMENT INVOLVED. CONNECTION LABEL LOCATION: •SIGNS AND LABELS SHALL COMPLY WITH ANSI Z535.4-2011,PRODUCT SAFETY DO NOT RELOCATE THIS ON OR NO MORE THAN 1 M(3 FT)FROM THE SWITCH. SIGNS AND LABELS,UNLESS OTHERWISE SPECIFIED. PER CODE(S):NEC 2017:690.56(C)(3) •DO NOT COVER EXISTING MANUFACTURER LABELS. OVERCURRENT DEVICE ' LABEL LOCATION: ADJACENT TO PV BREAKER(IF T APPLICABLE). PER CODE(S):NEC 2017:705.1 2(B)(2)(3)(b) SOLAR PV SYSTEM EQUIPPED OWARNING - DUAL POWER SUPPLY WITH RAPID SHUTDOWN sunrun SOURCES: UTILITY GRID AND PV SOLAR ELECTRIC SYSTEM LABEL LOCATION: TURN RAPID #180120 UTILITY SERVICE METER AND MAIN SHUTDOWN SWITCH V ITCH TO SERVICE PANEL. - -- � - 734 FOREST STREET#400,MARLBOROUGH,NW 01752 SOLAR ELECTRIC PHONE 888.657.6527 PER CODE(S):CEC 2016:705.12(D)(3), t FAX 805.528.9701 NEC 2017:705.12(B)(3),NEC 2014: THE "OFF" POSITION TOZ� f PV PANELS ' 705.12(D)(3),NEC 2011:705.12(D)(4) IDENCE _ 'j, _ CUSTOMER RES - - - -- - - � SHUT DOWN V N PV _ - JANE L LOPEZ WARNING SYSTEM AND REDUCE: ti.: 107 HERRING RUN 026 ` BARNSTABLE, MA, 02632 THIS EQUIPMENT FED BY SHOCK HAZARD IN THE -- - TEL.(774)836-3496APNa:229_050 - _ MULTIPLE SOURCES. TOTAL PROJECT NUMBER: RATING OF ALL ARRAY. 221 R-107LOPE OVERCURRENT DEVICES - DESIGNER: 303.942.2571 EXCLUDING MAIN SUPPLY } LEAH HOLTON OVERCURRENT DEVICE SHALL - LABEL LOCATION: DRAFTER: NOT EXCEED AMPACITY OF ON OR NO MORE THAT 1 M(3 FT)FROM THE SERVICE' LEAH HOLTON BUSBAR. DISCONNECTING MEANS TO WHICH THE PV SYSTEMS v ` ARE CONNECTED. SHEET r+ r+ LABEL LOCATION: PER CODE(S):NEC 2017:690.56(C)(1)(a) SIG NAG E UTILITY SERVICE METER AND MAIN SERVICE PANEL. PER CODE(S):CEC 2016:705.12(1))(2)(3)(c),NEC 2017: - 705.12(1))(2)(3)(c),NEC 2014:705.12(D)(2)(3)(c),NEC REV:A 3/14/2017 2011:705.12(D)(4) PAGE PV-J.O