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0065 MILLSTONE WAY
fJ p.. �. .. 1.. .. ... � �' � - - �� ,' :. Y .. .. ,. .. y ,. �. � y -, ,. � n t ., , _. � , w _ ':, �,,, - r, ,; E. .: � � 6.. �, .. �-. t .. n ... a i � i .' � .� .. e.-. d. �' 4 x 4 ' � 'i a �e. �.:. :.. _ .. � u •C �. a. t .' '.,. .... .. � �v} � � ,.. ;. .. .- -. .. _. .. u - � .. .. �� _. � :. ,' :, .. q, ,. `. - " <: ,. �. � ., .. .. ,o- .� _ � -. e 't_.. �, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel d C Application # 6` Health Division Date Issued Z < Conservation Division .'Application Fee Planning Dept. ; .Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address Village U,4u y ole ,_ MA 0 26 3Z Owner 30_NMe s U a n4Z. Address 611 M f P_ 1 Telephone q-7-s. 7q � / e� /� � G DPermit Request I4S -,4L4- r4AS _ � M��, I A) L0 STo R �n1Gf AJ fC- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio 3 0 Construction Type Woo D r/Li4/r1j�- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) /Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Cull ❑ 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: -A Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION vn (BUILDER OR HOMEOWNER) 9 Name JC50r) 41ST00 k Telephone Number _5N® 7151 1 3 D 5 y � Address 12d c6r,e. _5- License# ®Z� Home Improvement Contractor# Worker's Compensation # cc5ac2%q 1c)17zo ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� �1 t, ti t FOR OFFICIAL USE ONLY 4 ti i APPLICATION# r 1 DATE ISSUED = r MAP/PARCEL NO._, [r1 S ADDRESS VILLAGE " r OWNER 1 DATE OF INSPECTION: FOUNDATION; ` FRAME s _ INSULATION FIREPLACE s ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:` 'rU'—�-" ROUGH -y, : — FINAL FINAL BUILDING a R 1 t `} DATE CLOSED OUT : ASSOCIATION,PLAN NO. t s_ The Com,.monwealth ofMassachuseits Departnnent of Industrial Accidents � M Office o•f Investigations L rk` 600 Washington Street ' Boston;Mass 02111 www.fnass gov1dia Workers' Compensation Insurance Affidavit; Builders/Con Alicant Information tractors/Eiec> cians/Plnmbers Please Print Legibly Name(Business/oTmuzation/Indi idual): Address: 12U C ,r•4Y ;-_ 11 City/State/Zip: i t.j �s ; (11y G`�PCs► Phone#: t�gS Are you an employer?Check the appropriate box: 1. I am an employer with 7 4.(= I am a general contractor and I Type of project(required): employees(fill and/or part time)_` have hired the sub-contractors 6_L New construction 2.= I am a sole proprietor or partner- listed on the attached sheet- 7.0 Remodeling ship and have no employees These sub-contractors have working for me in any capacity_ employees and have workers' s- 0 Demolition [ I�io workers'comp.insurance comp_insurance_; 9.G Building addition required) 5.0 We are a corporation and its 3. I am a homeowner doing all work officers have exercised their 10:iJ Electrical repairs or additions myself [No workers-comp. right of exemption perm MGL 11_ Plumbing repairs or additions insurance required] C. 1522§ 1(4),and we have no �- 1_ 0 Roof repairs employees.[no workers' comp.insurance required.] 13.XOther SJ l ae *.4ng applicant that checks box f1 must also fill out the section below shoving their workers'compensation oli A Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors lacy i b rma new affidavit indicating such. Contactors that check this box mast attach 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 information vrsurance for my employees Below is t/iepolicy and job site Insurance Company Name: � r=i�e'J�.nfa o% ��r�l••� 3 i ��}Curn nCr_ Policy's or Self-ins.Lic.# C Expiration Date:_G� Job Site Address: .J (V(.. -r0%1f i, City/State/Zip:4 1iAll' tVI 41,J� A# 02-6/37— 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 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 $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for c23Leracre verification. 1 do Herby certi under the pains-and penalties ofpeFjury that the information provided above is true and correct. Signature: # Date. Print Mame: 4,j c ,r. ( -'�-� Phone 3,=: i 3%5 Of use only Do not write in this area to be completed by city oi•town official City or Town: Permit/license#• Issuing_Authority(circle one): LBoard of Heath 2. Building Department 3.City/Town Clerk 4_Electrical Inspector 5_Plumbing Inspector 6.Other Contact person: Phone#: Client#: 18348 2E2S0 ERTIFICATE OF LIABILITY INSURANCE DATE(MAAIDD/r 071251201-- _ IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS OES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES S'CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED NTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. RTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to e 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 NAME: Dowling&O'Neil PHONE 508 775-1620 FAX,No: 5087781218 ac No,Ext Insurance Agency EEMLSS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIL# Hyannis,MA 02601 INSURER A:Acadia Insurance INSURED INSURER B:Associated Employers Insurance E2 Solar,Inc. INSURER C: Jason Stools INSURER D: 120 Chase Street INSURER E: Hyannis, MA 02601 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS I CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MWDD MM/DD A GENERAL LIABILITY CPP033453211 4122/2011 04/22/201 EACH OCCURRENCE $1 00O 000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea ocwnence $25O 000 CLAIMS MADE �OCCUR MED EXP(Any one person) s5,000 �I PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 {) GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PR' LOC $ COMBINED SINGLE LIMIT 1 000,000 A AUTOMOBILE LIABILITY MAA033967111 4/22/2011 04/22/201 Ea accident $ . ANY AUANEDHE4DULED BODILY INJURY(Per person) $ ALL OWEDULED BODILY INJURY(Per accident) $ AUTOSS PROPERTY DAMAGE OWNED Peracddent 1 X HIRED S $ A X UMBRCCUR CUA033453411 4/2212011 04/22/201 EACH OCCURRENCE $1 000000 EXCESLAIMS-MADE AGGREGATE $1 OOO 000 DED $ WORKERS COMPENSATION TO Y LI OTH- B WCC5008041012011 3/16/2011 03/16/ b1 X u AND EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $500 000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y N/A E.L.DISEASE-EA EMPLOYEE $500 000 (Mandatory in NH) If yes,describe under EL.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Alison Alessi and Gregory Gorman are excluded from the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. .' Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the �. coverage provided by the policy provisions. - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Scott Schofield THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 45 Partridge Way ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #SB3912/M83906 LS1 F � .t':.. S:a!•7s tw '•`4 r t. ,.F stn. r;,`a 9t,,,r.') pryt , p "r rn iFA �-�l'Az t t�•'.•S 'F7 'S This is to certify. that Jason St:oots t : ! 120 Chase Street, Hyannis, MA 02601 has successfully completed the:8-hour course , a fr Renovator Initial - English ,I Pursuant'to 40 CFR Part 745.225 r;« ' Course Location r` .Shepley Window Showcase 75 Ben Franklin Way Hyannis, MA 02601 ` June 7, 201.0 June 07, 2010 =f IFt Course Dates Ex a . kk r s v ` R-1-18398-10-06939 Jane CZ7r: 2015 _ �� Certificate Number C p ation Date Training Director �) i ti I�F �I 'i6 Upton Drive, Wilmington, Pn ° U I �s7 � ,i +r)r or 8S �%' 1 ,'; � ', � , .;•ii +�� `•37t� ;�5 l2 srowi lees l akns coin ..�...,,. 1 x,r:. ...,., r , a....r.c k ,, t:,. .:• +. _ ..,It -. ., -p., ! ,..., , l•l,.-. ,9.. .... ,.t +t ,c , It t ! ,,;t+ .. f;`,: ,.:! .,.,,,... ...... ..-:....,.; '.rs:r-. „e.'.. :.6,.. _.,19. i ,e,i,�r f:� ., ...�. � '„1, .'c, 1,".m1 v, s��✓-: :t .).4>:; � r .r „Y'M ,..N.fii � 4r. „y fr'; ,.. hr ,. '.�..! e., Jai y,. :::r. 1 .., . ".Y• ..r. t -, t l 5`,S.t f' 7 4. f ,,', i r -1: ! ,:+ ,r r J 1r- { +,{ '�, t r'�,• rr .3,a v4 f,. } -1 t{ S ,,.! Y y.fSiW r1 i ,:ti p. ik. _.��. :�d r, , ._= a {da 5 .. x�+�,zs,- y�p_R�� t,. - » c• ✓lte 'C/)NI?L!)70ltUJ6CtGl� -41(CLJiarlZftOe a t' • ,� Office of Consumer Affairs&BJsincss Regulation i 1 i%nse.or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return,t"� Registration: z160360Type: i Office of Consumer Affairs and Business Re Pation Expiration 7/r16%2012 DBA 1.UtPark Plaza-Suite 5170 F t Boston,MA 02116 E2 OLAR ` JASON STOOTSt� f k,0 t ti�w. 120 CHASE`ST — (. HYANNIS, MA 02601 y Undersecretary No lid without signature 1 i4, �=. NIass;tchust tts- Department of Public SafctN 4 JASON STOOTS Buurd of Builclin!- Re!gula'tions ;tnd Standards �A Construction Supervisor License r' License: CS 90293 Inc Restricted to: 00 . -A �� � Photovoltaic Installations �. 120 Chase Street JASON D-STOO_TS MA CS License 090293 Hyannis MA 02601 120 CHASE ST NABCEP# 938085 cell:508.237.3892 HYANNIS, MA 02601 Noah Amv;can Board of office/Um 508.775.1385 r .�.- jason@e2solarcapecod.com „ www.e2solarcapecod.com Expitation: 4/28/2012 ('4nunis iuuci Tr# `20887 . lar , Photovoltaic_Installations: E2 SOLAR INC 120 Chase Street Hyannis, MA 02601 (508) 237-3892 CS License#CS090293 Nome Improvement Contractor's Lic.# 160360 e2SolarPV@gmail.com Contract for Photovoltaics (Sunpower Lease) OWNER'S NAME: James Ruane PROJECT ADDRESS: 65 Millstone Way Centerville MA 02632 1. PARTIES: This contract (hereinafter referred to as "Contract") is made and entered into on this 24th day of October, 2011 by and between James Ruane (hereinafter referred to as "Owner"); and E2 SOLAR INC. (hereinafter referred to as"E2Solar" or"Contractor"). WHEREAS, Owner seeks to have one (1) 8.28 DC KW grid tie solar photovoltaic (PV) system, hereinafter called "the system" professionally designed and installed at the above-named project address. WHEREAS, Contractor agrees to install the systems in accordance with all local code requirements and in accordance with current National Electric Code. WHEREAS, Contractor agrees to install the systems in a professional and courteous manner, leaving the job site secure and clean at all times. THEREFORE, In consideration of the mutual promises contained herein, Contractor agrees to perform the following work: t 2. GENERAL SCOPE OF WORK DESCRIPTION 2.1.) System Specifications: The 8.28 do Watt PV system will consist. of thirty-six (36) Sun Power 230 Watt photovoltaic modules mounted to south facing roof area. The photovoltaic modules will be mounted to the roofs using Unirac mounting system. All roof penetrations will either meet or exceed the local building requirements. In addition the system will consist of Two (1) UL listed SunPower inverter to be installed adiacent to electrical panel. The AC disconnect will be located on the exterior the house, near the service entrance, with all appropriate signage posted as required by the utility. This system will connect to the electrical grid via the grid tie inverter. This system will not include a battery back up system, meaning the system will not produce power in the event of a power outage. THE EXPRESS WARRANTIES CONTAINED HEREIN ARE IN-LIEU OF ALL,OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, HABITABILITY, OR FITNESS FOR A PARTICULAR USE OR PURPOSE THIS LIMITED WARRANTY EXCLUDES CONSEQUENTIAL AND,, INCIDENTAL DAMAGES AND LIMITS THE DURATION OF IMPLIED WARRANTIES TO THE FULLEST EXTENT PERMISSIBLE UNDER STATE AND FEDERAL LAW.: 8_S PEG Contractor agrees to apply for and secure the necessary local building and electrical permits required to perform this work. AN work.performed will be done In compliance with the requirements of the local of ials. 9. ENTIRE AOREEIIAENL SEYERABILiTY.AND MQPJEIGaON This Agreement represerds and contains the entire agreement between the partiea Prior discussions. verbal representations or written memoranda of any kind by Contractor or Owner that are not contained or referenced in this Contract are not a part of this Contract. in the event that any provision of this Contract is at any time held by a Court to be invalid or unenformble, the parties agree that all other provisions of this Contract will remain in tug force and effec L Any future modification of this Contract must be made in writing and executed by. Owner and Contractor in order to be valid and binding upon the parties. The parties have read and understood, and agree to, all the terms and conditions oontained in this Agreement. D J Stocis for olar Inc, Contractor mes Ruane Phdavottsic Contract Page 8 of 8 V solar Inc.,coavacor Jaen=Rune,0W= GENERAL NOTES: 1. PANELS ARE ATTACHED TO EXT'G ROOF STRUCTURE WITH 1-"X 5" SST HEX LAGS,48"OC.TYP. 0 tL 2. ALL RAIL AND MOUNTINGS ARE RATED FOR 125 MPH WIND p c LATERAL LOADS g m M 3. EXISTING ROOF FRAMING CONSISTS OF 2X8s 16"OC a N Q c`a H m c N EXT'o 2X8 RAFTERS p 06 O > y N Z o a) •— a� t 13 "SPAN p E c (36)PROPOSED a Cac`nOU SUNPOWER 230 WATT ODULES,TOTAL TITLE: ARRAY:8.28 kW PLANS & 3 PARTIAL EAST ELEVATION ELEVATIONS — s/32•�r—o• E E8 E w 00�U nuiM 0 =Z P.:n m m 0 z N r o (36)PROPOSED o¢co . SUNPOWER 230 WATT = A d MODULES,TOTAL 2 PARTIAL SOUTH ELEVATION ARRAY:8.28 kW — 3/32•=,'-0" (36)PROPOSED SUNPOWER 230 WATT MODULES,TOTAL ARRAY:8.28 kW �L Date: 11.17.2011 Sheet: PARTIAL ROOF PLAN A- 1 s - a p a m SCLARNOUNr WILaIN an _ To aide � �e IIse a 3�te�de4fi� 's �� �ad��ure 24s ' Amn d rl EMUSIM ��offtvatses�uz-�� s'a�dt��, - - SCOWS_ Lag ON)im41"IMEM s MmLft ftSmith 0.46 2n 3b9 WS :ems 2W � ifsc-c' , suewhan Fbe ass _ 769 . -%7 3m SpramM%Rr Spsao��rr 5� COME& Na�[� �6eiu aura r A U N .a" iijlE�%�F3k '' `g'a'y C.-(v? u e�� _�:o r�'„�_ar �t!=. - �- - • L-Foot material:One of the following extruded aluminum alloys:6005- T5,6105-T5,6061 T6 • Ultimate tensile:38ksi,Yield:35 ksi • Finish:Clear or Dark Anodized C L-Foot weight:varies based on height-0.215 Ibs(98g) _ • Allowable and design loads are valid when components are Bead assembled with SolarMount series beams according to authorized Bolt UNIRAC documents L-Foot . • For the beam to L-Foot connection: •Assemble with one ASTM F593 MV-16 hex head screw and one errated ;_ ASTM F594'/"serrated flange nut Flange Nu •Use anti seize and tighten to 30 ft Ibs of torque Y Resistance factors and safety factors are determined according to part. \' 1 section 9 of the 2005 Aluminum Design Manual and third-party test Y results from an[AS accredited laboratory d . X NOTE: Loads are given for the L-Foot to beam connection only;be sure,to check load limits for standoff,lag screw,or other h attachment method poi Applied Load Average Safety Design Resistance Direction Ultimate Allowable toad Factor, Load Factor, Ibs(N) Ibs(N) FS Ibs(N) - zoi = Sliding,Z± 1766(7856) 755(3356) 2.34 1141 (5077) 0.646 Tension,Y+ 1859(8269) 707(3144) 2.63 1069(4755) 0.575 Dimensions specified in inches unless noted Compression,Y- 3258(14492) 1325(5893) 2.46 2004(8913) 0.615 Traverse,X± 486(2162) 213(949) 228 323(1436) 0.664 I STANDARD RAIL L FOOT 3/8-16 X 3/4 HEX HEAD BOLT 3/8-16 FLANGE NUT O 48' O00 MD 00 Installation Detail 2608 UNIRAC, INC. SolarMount Rail 1411 $ROADWAY BLVD NE L-Foot Connection &BUQUERQUE, NM 87102 USA PHONE 505.242.6411 UNIRAC.COM URASSY-0002 FLANGE NUT i - l END CLAMP 0 2______TOP MOUNTING FLANGE NUT CLAMP MID CLAMP T-BOLT 0 UGC-1 CLIP T-BOLT SOLAR MOUND RAIL �---T-BOLT UGC-1 CLIP -RAIL 000UK O -) A 00 00 C Installation Detail ©2008 UNIRAC, INC. SolarMount Rail t&II 6ROADWAV 9LVD NE AMQUERQiIE� NM 87102 USA Top Mounting Clamp Uw�.COM 242 64,1 Universal Grounding Clips URASSY-0006 S:\tuioCad Detail Library D\UR"SSY-000E._Solor hiount Rail-UGC-1 Clip—Top Iicunt Clamp_dxvg, 8/22/2008, 9:4?:5-3 AM Maximum Span Calculator for Joists&Rafters Page i of 1 Maximum Span Calculator for Wood Joists & Rafters www.awc.or Species ,Hem-Fir__ Size r2x8" � Grade Select Structu'ralLL�'_�� Member Type ,Rafters(Snow,Loadj Deflection Limit 7U360_- Spacin Wet service conditions? fo 1 Exterior Exposure Incised lumber? Snow Load (psf) 25 Dead Load (psf) [is' � - Calculate Maximum Horizontal Span 1 Go to Span Options Calculator for Wood Joists&Rafters i LIMITS OF USE f` HELPff RESTART Span Calculator for o o Wood Joists and Rafters f available for the Whone. The Maximum Horizontal Span is:. 15 ft. 0 in. with a minimum bearing length of 0.66 in. re uired at each end of the member. Property IlValue Species Hem-Fir Grade IlSelect Structural Size 12x8 Modulus of Elasticity (E) j11600000 psi Bending Strength (Fb) 2221.8 psi. Bearing Strength (Fcp) 405 psi. Shear Strength (Fv) 172.5 psi While every effort has been made to insure the accuracy of the information presented, and special Comments? info@awc.org. effort has been made to assure that the information reflects the state-of-the-art, neither the American Wood Council nor its members assume any responsibility for any particular design prepared from this Online Span Calculator. Those using this Online Span Calculator assume all liability from its use. http://www.awc.org/calculators/span/calc/timbercalcstyle.asp?species=Hem-Fir&size=2x... 11/23/2011 BENEFITS Highest Efficiency SunPowerl",Solar Panels are the most ®® efficient photovoltaic panels on the market today. More Power ®. Our panels produce more power in ®.�® the some amount of space tipto.50% more than conventional designs and. ° 100/° more than thin'#ilm s0lar an •® els Reduced Installation Cost '. ®® More power per panel means fewer panelsper install. This saves.both time. and money... Reliable and Robust Design_ Proven materials,.tempered front glass, and a sturdy,anodized frame allow The SunPower"'A 230 Solar Panel provides today's highest efficiency and panel to operate reliably in multiple performance. Utilizing 72 all back-contact solar cells,the SunPower mounting configurations: 230 delivers a total panel conversion efficiency of 18.5%.The panel's reduced voltage-temperature coefficient and exceptional low-light performance attributesprovide outstanding energy delivery per peak power watt. SunPower's High Efficiency Advantage-Up to Twice the Power Thin Film Conventional SunPower Peak Watts/Panel 65 170 r 230 Efficiency 9.0% 13.0% 18 5°/ Peak Watts/ft'(m2) 8 90 �. •,: _._ i II' ( J 12(130) �� 17(185) ' About sunPower SunPower designs, manufactures and delivers high-performance solar electric technology worldwide. Our high-efficiency solar cells generate up to 50% more power than conventional solar cells. Our high-performance solar panels, roof tiles and trackers deliver significantly more energy than competing systems. SPR 230 WHT U c UL us ® ® o top As zit Electrical Data 1-V"Curve Measured of stm¢6rd Tes Condemns pq:irrsd'a of t000W/m?.AM 13,m,d cd b,,ac 2.T C Peak Power(+/-5%) Pmax 230 W 7,0 Rated Voltage Vmpp 41.0 V 6,0 ter' in Ul Rated Current Impp 5.61 A 5,0 1000 W/m= Q 4,0 E 3 Open Circuit Voltage Voc 48J V Short Circuit Current Isc 5.99 A 3,0 - - 2 0 t Maximum System Voltage UL 600 V r Temperature Coefficients 1,0 200 W/m°0,0 Power -0.38%/K 0 10 20 30 40 . 50 60 Voltage(Voc) -132.5mV/K Voltage(V) Current(Isc) 3.5mA/K Current/voltage characteristics with dependence on irradiance and module temperature. NOCT 45'C+/-2°C Series Fuse Rating 20 A - Tested QperGtin9 Conditions Temperature -40a F to+1 BY F(-40'C to+BY C) Mechanical.Data _ Max load 113 psf 550kg/m2(5400 Pa)front—e.g.snow, Solar Cells 72 SunPower all-back contact monocrystalline 50 psf 245kg/m2(2400 Pa)front and back—e.g.wind Front Glass High transmission tempered glass Impact Resistance Hail 1 in(25 mm)at 52mph(23 m/s) Junction Box IP-65 rated with 3 bypass diodes Dimensions:32 x 155 x 128(mm) 1Narranfies and Certifications Output Cables 1000mm length cables/MultiContact(MC4)connectors Warranties 25 year limited power warranty Frame Anodized aluminum alloy type 6063(black) 10 year limited product warranty rWeight__ 33.Llbs..(15.0 kg) Certifications Tested to UL 1703.Class C Fire Rating Dimensions anon t.t: {i_^k 1 i s �—_-.,Ir i.. r l I i I -•� .: j T T T• I -,,) i Iy f (t I I 4 - I t gum-- CAUTION:READ SAFETY AND INSTAUATION INSTRUCTIONS BEFORE USING THE PRODUCT, Visit scrnpowercorp<com for details SUNPGWERand*mSUNPOWERIogooretmdema&mregiam—dtradenmr6ol Swft er Corporaticn. - sunpowercorp.com ®2009 March SunPower eerporatlon.AD rights roerved.spmificmions included in this datashwt are sabred to char ge s n'thaP rwfim. - - ' D—m..1#00"2190 R-'A/rkEN a - oPE .A r(Town of Barnstable *Perm It# 0 Expires 6 ma from issue dale ' �I ` ' 2011 Regulatory Services Fee + A�RIVRT,Rr�R * - �AT� F. Geiler,Director. Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION "- RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 2—S C) t r1 y Property Address coJ �\�S T�sy W 2 K��41 0 Residential Value of Work S U© Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address A A-M C'-9 SA Q�— (� Contractor's Name \.&P_ Telephone Number .d� Home Improvement Contractor License#(if applicable)_ C:> construction Supervisor's License#(if applicable) orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance isurarice Company NameT sk,A V�—�Q_v\s 'orkman's Camp. Policy# WC- opy of Insurance Compliance Certificate must accompany each permit :rmit Request(check bbx) { Re-roof(stripping.old shingles) All construction debris will be taken to V .�L �- ' YQ ❑ Re-roof(not stripping. Going-over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations i.c.Historic,Conservation etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Lre py of th Improvement Contractors License & Construction Supervisors License is ired. MATURE: PMESTORMSIbuilding permit fnrmslEXPR- SS.doc r: �-r ISSUE DATE V —...._ � A lU/?;2011 THIS CER'Y'IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRALITIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED ' REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed,if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT - NORTHWOOD ESHBAUGH INSURANCE AGENCY NAME: PHONE FAX INC (A/C,No,Ext): (AIC,No): 540 MAIN STREET E-&WL ADDRESS: HYANNIS,MA 02601 PRODUCER CUSTOMER ID A INSURED INSURERS)AFFORDING COVERAGE ETC DEAN F STANLEY BUILDING CONTRACTOR INC INSURER A TRAVELERS PROPERTY CASUALTY 359 CAPT LIJ AHS ROAD I COMPANY OF AMERICA CENT'ERVILLE,MA 02632 INSURER B INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:. REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAbIED ABOVE FOR THE POLICY PERIOD INDICATED. NOT`,X=TANDING ANY REQUII2ElAENT,TERM OR CONDITION OF ANY CONTRACT OR OTIiER D0CUNI ENT RTIT3 RESPECT TO WHICH THIS CERTIFICATE ZtiLAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERf•LS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIRbIIT'S SHORTY IvL4Y HAVE BEEN REDUCED BY PAID CLAIALS. INSR TYPE OF INSURANCE 4DDL SUBR POLICY-NUMBER POLICY EFF POLICY EXP LI IITS LTR INSR wS'D (\IM/DDlYYYZ) (NI1,I(DD1YYYZ) GENERAL LIABILITY EACH OCC�TrP,FNCE S DA)A AGE TO R.rI= S O COMf.-PCIAL GEIdEP-.L LIABILrry PPE1 LSES%a � occarcence MED.E-ER`TSE(Any one S ICJ CL MASMADE 0 OCCUR. Person PEP,SONAL&ADV. S 0 IITJUF.Y GENET LAGGREGATE S 0 GENL AGGREGATE LIMIT APPLES PER: PRODUCTS-COW/0)? S 0 POLICY 0 PP.OSECr 0 LOC AGG AUTOMOBILE LIABILITY 4�C01,S11TED SIIIGLE S (Ea accident) BODET Y INIUP.Y S 0 ANi'AUTO (Per F'erser,) BODILY INJURY S . 0 ALL OWPTaj AUTOS (Per Accident) PROPERTY DA Q,(, $ SCHEDULED AUTOS Per accident) S 0 HIP.ED AUTOS 0 NOPT-O)AKED AUTOS S 0 0 U1aFE,i.LALL* 0OCCUR EACHOCCU-U,&TCE S 0 EYCESS 1.1AB. 0 CLAM-I&..DE. AGGREGATE S 0 DEDU`IIBLZ S f:ETEl•TITOId£ S WORIMRS'CONIPENSATION wC A AND EAIPLOYERS LIABILITY IVA- EUKII IY)RY Y1N LII`TS ANY"PP.OPR1ETOR/PARTNEP.! El'ECUTnrEOFFICEPJIvIE1rfBER Y NIA 4864P081 10i05/2011 10i05i20I2 r.L.EACH ACCIDEI 17 S100,000 E_i-CLUDED9 . (MANDATORY INNH) E.L.DISE:AM—EACH s500,000 ' .. - NPLC'YEE If yes,describe under DESCRIPTION OF E1-DISEASE-POLICY s10Q000 OPEPATTONS below - LA'IIT DESCRIPTION OF OPERATIONS..f OCATIONSNEHICLES(Attach A•^_ORD 101,Additional R-emarl-s Schedule;if more space is required) THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO TBE CERTIFICATE HOLDER AFFECTING WORKERS COW COVERAGE. L'ERTIFIATE FOLDER :. :C�IVGELI 4TIUiI TOWN OF BARNSTABLE BUILDING_DEPT 200 NIAII�T STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN HY:ANNIS,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUMORIZD RFFRFSENUAMT Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: HOME IMPRQ�EMENT CONTRACTOR Registration 5132149 Type: Office of Consumer Affairs and Business Regulation Ex iration 11/28/212 Individual 10 Park Plaza-Suite 5170 0 Boston,MA 02116 DEAN F.STANLEY s - f DEAN STANLEY _ 359 CAPT.LIJAH RD 6 Not valid'•without signatureCENTERVILLE;MA 02 Nlassachusctts- Depailment of Public SafetN Board of Buildin- Re-ulations and Standards Construction Supervisor License License: CS 35037 Restricted to: 00 ' DEAN.F STANLEY 359 CAPTAIN LIJAH RD CENTERVILLE, MA 02632 c--�-- —�! Expiration: 1/19/2012 CI Tr#: 12334 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington'Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibI Name(Business/Organization/Individual): s�1f1 jam\ e: Address: City/State/Zip: Nr&V. A .-e JV\A55- Phone.#: Are you an employer?Check the appropriate box: Type of project(required):: L& I am a employer with 2:)— 4. ❑ 1 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' 9. ❑Building addition [No workers' comp.insurance comp,insurance.$ required.] 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions. 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. o workers' co right of exemption per*MGL y � �• 12.0Roof 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#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. e� Insurance Company Name: Policy#or Self-ins.Lic.#: �� r���D� �O .\ Expiration Date: l Job Site Address: c0 \ d�N. City/State/Zip: -eT�Y� �� A4 Attach a copy of the workers' compensation policy declarati ge(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL a 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 InvestiF4ations of the DIA for insu;axce cove a e verification. I do hereby c rti under th i alties of perjury that the information provid bove is true and correct: Si ature: Date: VZ& 0�?1� Phone#: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person.in the service of another under any contract of hire, express or implie oral or written." An employer is de d as"an individual,partnership,association, corporation or other,legal entity,or any two or more of the foregoing 4 in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an ftkdividual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house aving not more than three apartments and who resides therein,or the occupant of the dwelling house of another wh, employs persons to do maintenance,constructicyn or repair work on such dwelling house or on the grounds or building ap urtenant thereto shall not because of such e /loyment be deemed to be an employer." MGL chapter 152, §25C(6)also sta s that"every state or local licensing�/ ency shall withhold the issuance or renewal of a license or permit to op ate a business or to construct bu''dings in the commonwealth for any applicant who has not produced,accep able evidence of compliance v h the insurance coverage required." Additionally,MGL chapter 152, §25C(7) fes"Neither the co we lth nor any of its political subdivisions shall enter into any contract for.the performance o public work until accepta le evidence of compliance with the insurance requirements of this chapter have been present to the contracting au ority." Applicants Please fill out the workers'compensation affidavit co letely,by hecking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses) d pho number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limite iab' ' Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'come ation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit ay be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be s to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pe t o 'cense is being requested,not the Department of Industrial Accidents. Should you have any questions regard' g the 1 w or if you are required to obtain a workers' compensation policy,please call the Department at the Horn er listed b low. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed 1 gibly. The Departme t has provided a space at the bottom of the affidavit for you to fill out in the event the Office f Investigations has to c ntact you regarding the applicant. Please be sure to fill in the permit/license number whic will be used as a reference umber. In addition,an applicant that must submit multiple permit/license applications ' any given year,need only sumit one affidavit indicating current policy information(if necessary)and under"Job Site ddress"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officiall stamped or marked by the city or wn maybe provided to the applicant as proof that a valid affidavit is on file for ture permits or licenses. A new affi vit must be filled out each year.Where a home owner or citizen is obtaining a 'cense or permit not related fo any bus' ss or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this a davit. The Office of Investigations would like to tha ou in advance for your cooperation and should u have any.questions, please do not hesitate to give us a call. The Department's address,telephone-and fax umber:. The omznonwealth of Massachusetts ' Be artmont of Industrial Acoidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. ##�17-'27-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 'Fax#�617-727-7749 www.ma.ss..gov/dia THE Tpy, Town of.BarnstAle Regulatory Services 9iaxxsTastE ,Thomas'F.Geiler,Director` Mass. _ �A 1639. Tsn MaI s Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabIe.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete.and Sign This Section If Using A Builder I, V ''/1� � � : . - ; as Owner of the sub ect property, J P P rt3' hereby authorizes to act on my behalf, in all matters relative to work authorized b ' buildingfpermityapplication for (Address of Job) Sidnature of Owner` Date Print Name If Property Owner is applying for pern- it please complete the Homeowners License Exemption Form on the reverse side. Q TORM&OWNERPERMIMION Y Town of Barnstable P��F THE TO�'4 o� Regulatory Services BAMSTABLE, ; Thomas F.Geiler,Director 9 MASS. g 1639. �. Building Division rfn �a Tom Perry,Building Commissioner s �\ 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508�862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': na a home phone# work phone# CURRENT MAILING AD RESS: city/town state zip code The current exemption for omeowners"was extended to inclu eowngir-occupied dwellings of six units or less and to allow homeowners to eng a an individual for hire who does of possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of 1 d on which he/she resides Pr intends to reside,on which there is,or is intended to be, a one or two-family dwelling, ttached or detached structures accessory to such use and/or farm structures. A person who constructs more than on home in a two-year penod shall not be considered a homeowner. Such "homeowner"shall submit to the Bui ing Official on a fo acceptable to the Building Official,that he/she shall be responsible for all such work erforme under the buildin ermit. (Section 109.1.1) The undersigned"homeowner"assumes re onsibility fo compliance with the State Building Code and other applicable codes,bylaws,rules and regulatio_ The undersigned"homeowner"certifies that he/ he un rstands the Town of Barnstable Building Department minimum inspection procedures and requirements d at he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic fee or larger will be required to comply with the State Building Code Section 127.0 Construction 1ontrol. . HOMEOWNER'S EXEMPTIO The Code states that: "Any homeowner performing work for which a building pe it 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 argil unaware that they are assuming the res onsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awarenes\Tequ' sults in serious problems,particularly when the homeowner hires unlicensed persons. In this c e,our Board cannot proceed against the. ed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultifately responsible. To ensure that the homeowner is fully awarelof his/her responsibilities,many communi e,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of th' .issue is a form currently used by several towns. You may care t amend and adopt such form/certification for use in your community. Q:forms`.homeexempt / i t. oFtt , Town of Barnstable *Permit# _ P� Expires 6 monthsfront issue date Regulatory Services Fee • sAaMSTASLE, Mass. Th F. Geiler,Director 1639 -Thomas recor bll�ll� �TFD MAt a Building Division Tom Perry,CBO, Building Commissioner' . 200 Main Street,Hyannis,MA 02601 www.to,wn.bamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION = RESIDENTIAL ONLY Not Palid without Red X-Press Imprint . Map/parcel Number / r Zential Address ✓I lQi t/v>�Value of Work Minimum fee of$2S.00 for work under$6000.00 Owner's Name&Address Rv1":Y • x Contractor's Name,�/�/)')eS. ,/'/00/!� Telephone Number Home Improvement Contractor License#(if applicable) Const ction Supervisor's License#(if applicable) _ �. 'Q1 '�) �Of1.A Workman's Compensation Insurance Check one: JU�I : 2010 ❑ I am a sole proprietor MeT—ain'the Homeowner QUUN OF BARNSTAK I have Worker's Compensation Insurance Insurance Company_Name �' �L� Workman's Comp.Policy# Q Copy of Insurance Compliance Certificate must accompany each permit. t Permit Request(check box) ❑ Re-roof(stripping old shingles) All constrtiction debris will be taken.to ❑Re-roof(not stripping. Going over existing layers of roofl 0 Re- ' e m s j #of doors Re lace -p ment Windows/doors/ 'der U-Value �, (maxiinum.44)#of windows *Where required: Issuance of this peanit 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 Hwne Improvement Contractors License&Construction Supervisors License is required SIGNATURE: Q.\WPFLLES\FORMS\building permit forms\EXPRESS.doC Revised 090909 i The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information A please Print Le ibl Name(Business/Organization/Individual). Address: Cit /State/Zip: Phone#: ���01—q7 �t� Y Are u an emplo'yer?'C_ h&WKk the appropriate box: Type of project(required): 1. I am a employer with _ 4. 1 am a general contractor and 1 employees(full and/or part-tune). * have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- have on the attached sheet. 7: emodeling ship and have no employees These sub-contractors Have g, Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. �Building addition [No workers' comp. insurance comp.insurance.$ . required.] 5. We area corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbin re airs or additions 3.El am a homeowner doing all work g P myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no 13,❑ Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have 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: kkVX,- t/v City/State/Zip:C /1/►1/(L Attach a copy of the workers'compensation policy d ration 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 pains and penalties ofperjury that the information provided above is true and correct. Signature -"s1-,.- _� Date ~` ( /D Phone# � f 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#: 1 �- w�a % a sa swr—a s ws r.ar aa.vsara a • .0w.. wa es uevaa.e MOONA-1 05/07/10 PRODUCER/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 Old River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville RI 02838-0001 Phone: 401-769-9500 Fax:401-769-9502 INSURERS AFFORDING COVERAGE NAIC# INSURED Moon Associates Inc. Nti ERA! National Grange Insurance Co 14788 DBA Gutter Helmet - DBA Renewal by Andersen of RI !'dSL'PER.B: Beacon Hutual Insurance Co. DBA Gutter Helmet Roofing DBA Moon Works - 1137 Park East Drive !n URERD: Woonsocket RI 02895 _- !teSUPER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOT`NITHST4NDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTPACT OR OTHER DOCUMENT',N IITH RESPECT TO byYICH THIS CE—R71FICA.TE MAY BE ISSUED OR M,ke PERTAIN,THE INSUPANCE AFFORDED BY THE POLICIES DESCP,i3ED HERE14 IS SUBJECT TO ALL THE TEPreSS,EXCLUSIONS AND CONDI1 iONS OF SUCH POLICIES.AGGPEGATE LIMITS SHOWN MAY HAVE BEEN PEDUCED BY PAID CLAMS. POLICY NUMBER LIMITS LTR NSRd TYPE OF INSURANCE (DATE{MMft?D7511'Y} DATE tMhtiDQlYlt'Y) GENERAL LIABILITY EACH OCCURRENCE $1000000 A X COMERC!ALGENERALLIABILIT�' MPS26619 09/16/09 09/16/10 PREMISES v. eEaxcurence) '$500000 CLAit45 MinE OCCUR MEi F,(P(Any or',e person) $10000 PERSONAL aADVINJURY $ 1000000 GENERALA.GGREGa.TE s 2000000 GENIAGGREG ATE LIMIT APPLIES PER, PPOCUCTS-COMPIOPA.GG $2000000 POLICY jE LOC I AUTOMOBILE LIABILITY COMBINED itCG E LIMIT AX ANrvura B1S26619 09/16/09 09/16/10 (Eaao,ident) 1000000 ALL CAIVNED AUTOS BODILY INJURY (Per pF.rson) - SCHEDULED ALIT OS HIRED AUTOS BODILY INJURY s (Per accident) $ - NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) i GARAGE LIABILITY AUTO ONLY-EA.ACCIDENT $ ..__...... ANY AUTO OTHER THAN EA ACC $ AUTO Ot,LY: AGG $ EXCESS i UMBRELLA LIABILITY EACH OCCURRENCE $1000000 A ioc--Lp CLAIM.sMADE CUS26619 09/16/09 09/16/10 AGGREGATE +� 1 $ DEDUCTIBLE X RETENTION $10000 $ WORKERS COMPENSATION L ' 'R AND EMPLOYERS'LIABILITY X TOPY LIr�ITS ER YIN B ANY PROPPIETOPrPAPTNER/EXECUlIVE F-� 28586 10/01/09 10/01/10 E.L.EACH ACCIDENT $500000 OFFICERJMEMBER EXCLUDED'? (Mandatory In NH) E.L-DISEASE-EA EMPLOYEE $500000 It yes,describe under SPECIAL PRO;'I-SIGNS beir„v E L-DISEASE.-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOPI REmwAL DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Renewal By Anderson REPRESENTATIVES, 1137 Park East Drive AUTHORI' O REPRESENTATIVE Woonsocket RI 02895 ACORD 25(2009101) O 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and toga are registered marks of ACORD -'��.,aa 7 t!NTR 3' f . 019— _VOW AMOK-NOON ` 3 -, ��tt�ersecre.tary _ - t 1 cash #< ed#t,i art#Q f 3 SissRoe y& aT - :. 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Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family !/ Two Family Multi-Family Age of Existing Structure o7 S-}— Basement Type: Finished Historic House Unfinished Old King's Highway 06 Number of Baths " No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel F ao Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other / ��phone ion ✓ Name Number ,/--Address "License# ! C40me Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDI NS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ✓ �O BUILDING PERMIT DENIED FO E FOLLOWING REASON(S) r,� q FOR OFFICIAL USE ONLY j PERMI'i NQ,' D TE -SUID MAP/PARCEL NO. ADDRESS VILLAGE = _ OWNE r - DATE F II PECTION: ii99 R i 4 FOUNI iATION FRAME i . INSULATION - _ i • i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH v : FINAL = ' FINAL BUILDING i DATE CLOSED OUT. ASSOCIATION PLAN NO. i f i TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION P ease print. DATE JOB LOCATION umber Street address Section of town "HOMEOWNER" F _ 1 )Name Home phone Work phone - - ' 1 f• ; PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupie dwellinqs of six units or less and to allow such homeowners to engage an in- dividual-for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to re side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Offic. on a form accp-ptable to the Building Official, that he/she shall be responsi for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirementE and that he/she will comply ith said procedures and requirements. HOMEOWNER'S SIGNATURE ' APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. L HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person (s) for hire to do such work, that such Home Owne shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction' Supervisors, Section 2. 15) . This lack of awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home 'bwner act- as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, rx:. communities require, as part of the permit application, that the Home Owner; certify that he/she understands the responsibilities of a supervisor. On th. last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. I 3 v Assessor's:Office(19i floor) Map Parcel Pehnit# R/ 3 - r -mot Date Issued Fee *6�6 671 /ngineering Dept. (3rd floor H use# �1NE BARNSTABLE. • . MASS. 059, TOWN OF BARNSTABLE Building Permit Application' ; Project ee ddr s ;/Village F ,//Cwner Address - �elephone — 7/ /�ermit Request ' a,,r, •V li 4 i !'+r.,/i /'!�+Z,e /. 0 c,4a- 2 QQG.�v'-l..Pl1i•' '\.�2¢1 (�✓i �/ b Q- V. ^� A4 First Floor N ' CGS square feet Second Floor r✓v CX Z-- e square feet Estimated Project Cost /• G 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Build r Informa ion Name J'7— /�l//�C S �� T elephone Numbera Address 1600 ,/License# 6 ; Z/12 'Z V_ (2: YX, 0263 cR Home Improvement Contractor# 100 141 7 Worker's Compensation# GUI--_P06(J b� NEW CONSTRUCTION.OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO GZ,� 1� ! S SIGNATURE DATE,/ /i S BUILDING PERMIT DE IED FOR THE FOLLOWING REASON(S) . FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _ + MAP/PARCEL NO. i a ADDRESS' E VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULv/AT/ION` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL Y - GAS: Y ROUGH FINAL - FINAL BUILDING t DATE CLOSED OUT ASSOCIATION PLAN NO. i k