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Home My WebLink About0225 LITTLE RIVER ROAD i lip I I' r Town of Barnstable kzo � Building Department Services /NG oe Brian Florence CBO 0 enaxsena Building Commissioner fi' `0$ 200 Main Street, Hyannis,MA 02601 02� A o www.town.barnstable.ma.us DNS TqB Office: 508-862-4038 Fax: 1508-790-6230 PERMIT# _i FEE: $35.OU SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less 25 kit v� Wow/ Co-�-u•"V Location of shed(address) Village Q� a `reaCey ,arockc./ q08-&06-03q.;3 Property owner's name Telephone number tqz F-f) 05 DOZoOS Size of Shed Map/Parcel# g E-Mail �O ' 3 I « 120 CO✓►l 01 gnaturle Date Hyannis Main_Street Waterfront Historic District? o Old King'.57Highway Historic District Commission jurisdictionl? / You must file with Old King's Highway' —'—� Conservation Commission(signature,is required) Sign off hours for Conservation'8:00-9:30&3:30-4:30 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 — rA Legend Ilk IL Lb m El Parcels ' •'"�° � Town Boundary -� , 054006006 Railroad Tracks 054002007 � �-"` �t #25 Buildings #255 1 Approx.Building .�-'"'"� y.,; •"` �Buildings —Painted Lines Parking Lots w M Paved 054006005 ( Unpaved #234 Driveways 13 t a-� ;Y Paved 054002010 '` ds Unpaved ! 054002006 Roa .- 13 Paved Road #241 t dfa t Unpaved Road Bridge Paved Median Streams M Fa, Marsh ~' 13 Water Bodies E � 54006004 04 054002011 054002004x � #205 05400200-3' 054�aa vv --r-- — 0#189 , #81/ Map printed on: 3/16/2020 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MAo26oi O 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 83 feet cartographic errors or omissions. gis@town.barnstable.ma.us TOWN OF PROPERTY r r r Y r Legend + + e �i ❑Parcels Town Boundary 05400600 Railroad Tracks 05400,2007 . - "`"Y ##250 - Buildings #2;55 y � - - ID Approx.Building 0 Buildings W Painted Lines { �1 { Parking Lots s »^ M Paved ..,. f 054006005 ( Unpaved ` T {: 0234 Driveways 13 Paved 054002010 - �w Unpaved #120 054002006 Roads 241 13 Paved Road x ri Unpaved Road Bridge Paved Median streams a M rsh ' Water Bodies " 054006004054002005 e , • #22a 054aa�0�� . X #2O4 054002011 ti, 4 1 1 ##60 054002004 #205 { -EO �61�-�J 054005 0540020O3 054002001----- 169 #81/ Map printed on: 3/16/2020 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit a adequate for legal boundary determination or representations of Assessor's tai6parcels.They are i Feet regulatory interpretation.This map does not represent not true property boundaries and do not'represent 367 Main Street,Hyannis,MA o26oi O 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 83 feet 0 cartographic errors or omissions. gis@town.barnstable.ma.us yy J .l ASSACHUSETTS UNIFORM APPLICATION FORA PERMIT TO PERFORM.PLUMBING WORK CITY Barnstable MA DATE PER # f JOBSITE ADDRESS 225 Little River Road OWNER'S NAME Brochu POWNER ADDRESS see above TEL 973-738-6295 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL. PRINT CLEARLY NEW: RENOVATION: 'REPLACEMENT: PLANS SUBMITTED: YES : NO.,- FIXTURES- FLOOR- KM 1 2 3 4 5 6 7 8 9 10 11 12 13 14- BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM : . . DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN - FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK. w ' LAVATORY y.wq ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET ` - URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES X ``4I WATER PIPING OTHER INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YE NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information,I have submitted or entered regarding this application are true a accurate to the t of•my knowledge and that all plumbing work and installations perfor ed under the permit issued for this application will be in compli ce with a erti e t roviss' n of the Massachusetts State Plumbing Code and Chapter"142 of the General Laws. PLUMBER'S NAME -John C Nerolich LICENSE# 17087 G SIG AT RE MP JP CORPORATION # PARTNERSHI # LLC # COMPANY NAME Aqua Plumbing ADDRESS 98 Lake Drive CITY Pocasset STATE MA ZIP 02559 TEL FAX CELL 508-524-3083 EMAIL d' 000 .6 d�s- �- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PER ORM PLUMBING WORK CITY S L MA DATE l ZL- t PERMIT#� JOBSITE ADDRESS 2z 1 t�- le-` gt red OWNER'S NAME -t'r 4ce 13ra c-h o. P OWNER ADDRESS TEL 9Q8-GOS- _C13_J3 FAX TYPE OR . OCCUPANCYTYPE COMMERCIAL E-1 EDUCATIONAL El RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES® NOD— FIXTURES I FLOOR- BSM 1 2 3 4 5 6 7 .6 9 10 1 11 12 1 13 14 BATHTUB CROSS CONNECTION DEVICE. DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED.GRAY WATER SYSTEM _ DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN — INTERCEPTOR(INTERIOR) _ KITCHEN SINK - -- - - LAVATORY -_ _ -_ ROOF DRAIN - -- -- - - - - -- SHOWER STALL SERVICE/MOP SINK ---- _-- -'- --..-...-- -.. _ _ _-..._ _.__--- _ . _...._. TOILET L -� _ URINAL WASHING MACHINE CONNECTION "' WATER HEATER ALL TYPES WATER PIPING OTHER a' INSURANCE COVERAGE: ` I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES[eNO [71 IF YOU CHECKED YES,PLEASE INDICATYTH TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY E] BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER EI AGENT El SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge .and that all plumbing work and installations performed under the permit issued for this application wil in compli nc it all P e t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMB R'S NAME 4 b. G t` 6� ram. LICENSE# 6 1 SIGNATURE MP _- JPQ CORPORATION# PARTNERSHIP# LLCF-I# COMPANY NAME V< _t n 5 ADDRESS (�� fG(�2��( t�» — _ __ ...... CITY 1�IG,,��b Yl' - _►� � :. ._ STATE ZIP _ TEL ��.'L- FAX CELL EMAIL _ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY Barnstable 'MA. DATE April52013 ' PERMIT JOBSITE ADDRESS 225 Little.River Road OWNER`S NAME. Richard&Tracy Brochu OWNER ADDRESS .225 Little River Road TEL 973-738-6295 FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL CLEARLY NEW:`'. RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES 7 FLOORS- BSM 1 2 3 4': 5' 6 7 8 ' 9 10 11 12 13 . 14 BOILER ,BOOSTER' CONVERSION BURNER-. COOK STOVE X DIRECT VENT HEATER DRYER X FIREPLACE X FRYOLATOR FURNACE GENERATOR x GRILLE INFRARED HEATER r LABORATORY COCKSti . MAKEUP AIR UNIT OVEN i POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT. TEST X UNIT HEATER ✓I N 6_ UNVENTED ROOM HEATER WATER HEATER OTHER INSURANCE COVERAGE have a current liability insurance policy or its substantial equiva lent which meets the,requirements of MGL.Ch.142 YES NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage_required by Chapter142 of the Massachusetts General Laws,and that,my signature.on this permit application waives this requirement: CHECK ONE ONLY: OWNER. AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this applicatioQaret and accuhe best of my knowledge and that all plumbing work and installations performed under the permit issued for•this application will be rn I n with J�in t r{�ovis on o the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Christopher L Menslage LICENSE# 3871 SIGNATURE MP MGF JP JGF LPGI CORPORATION # PARTNERSHIP # LLC # COMPANY NAME: All Gas Heating&Cooling,Inc. ADDRESS 15 Jan Sebastian Drive B2 CITY Sandwich STATE MA ZIP 02563 TEL 5pa.833.5088 FAX 508.833.7588 CELL 508-274-0831 EMAIL info@allgasheat.com �� r— v ✓ C— IT TO PERFORM GAS FITTING WORK MASSACHUSETTS UNIFORM APPLICATION FOR A PERM a .. 3 hV CITY Barnstable MA DATE June k 2013 - PERMIT#� JOBSITE ADDRESS 225 Little River Road OWNER'S NAME Brochu GOWNER ADDRESS same as above TEL 973-738-6295 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL -� PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES 7 FLOORS-- BSM 1 2 3 4 5 6 7 a 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE P`°,I c__ =M INFRARED HEATER "' v LABORATORY COCKSUj - MAKEUP AIR UNIT OVEN POOL HEATER µ ROOM/SPACE HEATER y. ROOFTOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER x OTHER INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY v OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT _ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this applicatio are a and accest of` y knowledge and that all plumbing work and installations performed under the permit issued for this application will b=k�herjb t rovison of e Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Christopher L Menslage LICENSE# 3871 SIGNATURE MP MGF JP JGF LPGI CORPORATION # PARTNERSHIP # LLC # COMPANY NAME: All Gas Heating&Cooling,Inc. ADDRESS 15 Jan Sebastian Drive B2 CITY Sandwich STATE MA ZIP 02563 TEL 508.833.5088 FAX 508.833.7588 CELL 508-274-0831 EMAIL info@allgasheat.com , CAB aolQ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , Ma Parcel Dfl 2D4 Application # P pp Health Division Date Issued Conservation.Division Application Fee Planning Dept. Permit'Fee 2 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address Village J� Owner-- ----trocr fro c8i we Address Z ZS� AtJ,�/ CB 1V " dZG�� Telephone Permit Request 1�S �mh- u/ a-✓®o�-�vtDyct So�iV°' S � �. k�S t �Fski, C,,v o wad TX 1ZP,�- � ca. 14 ktv crvtkP-0 u a, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation t1-16 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 Historic House: ❑Yes UKo On Old King's Highway: ❑Yes W<o 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: 0=existing 0 new ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -� en Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION JBCUILDER OR HOMEOWNER) Name J o�4 VIM- 14c4� — ��0IV-- Telephone Number Address P.O. Y°Ic- t�q s License# 64 (26 )1' Bel h ©W T Home Improvement Contractor# 19 C 2 Email; Go�VJSaI*r'•Cym, Worker's Compensation # 4`� ALL C/jO/�N�STRU%C/}TION DEBRIS RESUBLTI G FROM THIS PROJECT WILL BE TAKEN TO �I/✓�' �(� lY SIGNATURE DATE �� 6— �� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED r MAP/ PARCEL NO. ADDRESS VILLAGE R OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 3 GAS: ROUGH FINAL } FINAL BUILDING DATE CLOSED OUT 1 ' ASSOCIATION PLAN NO. i; _ . _ _.... ...... �0 :4iassachusetts-Department of Public Safety " iQoard of Building Regulations.and.Standards , Cnnoruction Supen!vor License:CS-107947 JOHN VREE L.APfp ... 48 QUASIiNET ROAD Uw Mashpce MA 02649jf:' , Comninissiener 04/251201$.' ,'+rt"r' COMMONWEALTH OF MASSAGHt3SETT5 " r s ELiCTRICIANS 1 x ISSUES T.HE FOLLOWING(LICENSE REGISTERED MASTER ELECT-Al FIR gNCIS;J BRADY JR '" f COTUiT SOLAR.LLC y 12 MANWELL RD ` CIiELM5FORD,MA 01824 1624 a r ' g2b069 A ` O1/3112019 t69149 n ar -{ � r � q. it Iwv,,i�'x1b.f✓, Office of Consumer I�ffalrs end Business Regulation r 10 Park Plaza - Suite 5170 -Boston, Massachusetts 02116 Horne lmprovement Contractor Registration Registration: 146276 Type: Supplement Card . 441 Expiration: 4/812017 OHN VREELAND:: "+.. '+ P.O. BOX 89 COTUIT,MA 02635 Zy `a Update.Address and:return Bard.M9 rk reason for;chanee. . . scA 1 G "M-M at Address Renewal Employment (—I Lost Card: :. ... /fir T.r.,YOINN/ullFu�l� r:.^,y FCIIJJrICYtrrf%fr.. :. .. •. .. .. Atroee of Consoluer Affairs R Bifsiness Regulation. License or registration validforindividul use only q. before the expiration date. I.f found return to ;: f ME IMPROVEMENT CONTRACTOR - ` �t Office of Consumer Affairs and Business Regulation dleglstration: 146278, 'TYPO- 10 Park Plaza-Suite 5170 (Expiration: 41&2017 - Supplement Card .Boston,MA 021,16 COTUIT SOLAR :.. .._L JOIiN VIZEELAND 3800 FALMOUTH R0. MARSTONS MILLS,MA 02648 Uudersecretgry Nnt valid withouesiL+naturc �:.. ... w. :Town of Barnstable Mid _..... ....... .... Regulatory Services . .. Richard V.Scali;Interim Director Building Division:. Thomas Perry;CBo Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us. .. Offim 508-862-4038 Fax:.508-790-6230 _.... Pro a :Owner Must .: :: P rtY Complete and Sign This Section : If Using A Builder I Trac Brochu Y ,as Owner of the subject property hereby authorize- Cotutt Solar lohri Vreeland to act on my behalf; w. in all matters relative to work authorized by this building permit application for: 225 Little.River Rd. Gotuit,MA.02635 (Address of job) 9/20/16 : ... . Si e f Ow Date _. Tracey Brochll Print Name _. If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side T:UCEVtN I)�Building Changes�EXPRESS PERMITIEXPRESS.doc . . Revised 061313 _..... The Commonwealth of Massachusetts Department of Industrial Accidents A I.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 PERMITTING AUTHORITY. :. Applicant Information Please Print Legibly Name(Business/Organization/Individual):COtgit Solar LLC p. Address. P.O. Box 89 : ..... City/State/Zip:Cotuit, MA 02635 _ Phone#:508-428-8442 Are you an:employer?Check the appropriate box: T e of r0 ect(required)-. yP P J ( 9 )- IQ I:am a employer.with 12 employees(full and/or part-time). ]. 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.] . - itl 3.Fj I am a homeowner doing all.work myself:[No workers'comp.insurance:required.]t: . 9 'on. 10❑Building addition 4.R 1 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.: t 1'2. Plumbing repairs or a( i ions; 5. 1:am a general contractor and I have hired the sub-contractors liedst on the attache d see. ❑ 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. Sol ar PV Installation 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other: 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. :Contactors 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. - Travellers Insurance Insurance Company Name:. . . Policy or Self-ins.Lic.#:6HUB-4988P868-16 Expiration Date:3-26-2017 Job'Site Address: ZS `�� r►)UP/'0`G'� City/State/ZiwcotA 1 Y'`� ©-0 Attach a copy of the workers'compensation:policy declaration page(show.ing 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 cerd nder the p 'ns and penalties of perjury that the information provided above is true and correct Si nature: :. Date:.. i Phone#:508-428-8442 Official use only. Do not write in this area,to be completed by city or town official p. _. 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#: : : AC ® DATE(MM/DD/YYYY) `� CERTIFICATE OF LIABILITY INSURANCE 03/18/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT-NAME: ONTACTNAME: Lauren DON BUNKER INS. AGENCY a/c°No EXt: (781)312-7206 A/C No: E-MADDRESS: Lauren@donbunkerinsurance.com P,Q BOX 221 INSURER(S)AFFORDING COVERAGE NAIC A HANOVER MA 02339 INSURER A: TRAVELERS INDEMNITY CO OF AMERICA(THE) 25666 INSURED INSURER B: COTUIT SOLAR LLC INSURERC: INSURER D: 3800 FALMOUTH RD INSURER E: MARSTON MILLS MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER: 38425 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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF LTR MM/DD/YYYY /YYYY MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occur ence) $ MED EXP(Any one person) $ 6 N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ JECTPRO ❑ LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: $ AUTOMOBILE LIABILITY EaINED acccdentSINGLELIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION X I STATUTE I I EERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? N/A NIA N/A 6HUB4988P86816 03/26/2016 03/26/2017 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Conrad Geyser ACCORDANCE WITH THE POLICY PROVISIONS. 3800 Falmouth Rd AUTHORIZED REPRESENTATIVE Marston Mills MA 02648 C Daniel M.Cro4 jey,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(12014/01) The ACORD name and logo are registered marks of ACORD Cotuit Solar LLC Project: System: 9.6kW DC (STC) Site Plan 508-428-8442 Tracey Brochu 30 - 320w modules Revision: October 11, 2016 PO Box 89 225 Little River Rd. 30 — DC optimizers Eversource ISA#: 2171063 COTUIT SOLAR Cotuit MA 02635 Cotuit, MA 02635 7.6kW SolarEdge inverter WE --� _ . 1. Warning: Dual Power Source Second.Source is PV System. . (15) LG 320:W hotovolt. P aic AC Disconnect Modules 2 Voc=40;1 V, Isc=9.93A Revenue Grade.. 15 SolarEdge P320 PV Meter: DC Optimizers Outside Voc 48, Isc 11.0 Utility - - UL 1741/IEEE 154 Disconnect(2) 60 Am p u tility . . ... Serv�ce (15) LG 320 W . .. ... . . .. #a r fig"d .. Modules.: Voc=40.1 V, Isc=9.93A. Roof To . 2#10,#6gnd p 3#6 romex: :15 SolarEdge P320: Junction Box SolarEdg S DC Optimizers .... Voc 48, Isc 11.0 SE7600-U UL 1741/IEEE 154' Inverter_ Inter or :4#10#6gnd .. Disconnect 3i c :. 200A AC 60A 'Main Panel_(1). ..200A Main 1 e Line=s'd tap Breaker . <10' Cotuit Solar:LLC ;. Project: System: 9.6kW DC (STC): Electrical Diagram 508-428-8442 Trace Brochu y. 30 320w modules Revision: October 11, 2016 - PO Box 89 225 Little River Rd. . 30 — DC o0timizers Eversource ISA#: 2171063 .COTUIT SOLAR,,,, Cotuit MA 02635 : : Cotuit, MA 02635 7.6kW:SolarEdge inverter JAMES� A,:-�' CLANCY.,., PROFESSIONAL ENGINEER .601 AS BURY AV7EEl�T NATIONAL PARK, NJ.08063:.: (8W.358-1125 FAX: (856) 58 1511 Construction Code Office:. Date:... October 12,:2016... . . .. . . .... ....... ... ..... Re: Cotuit Solar LLC,3800 Falmouth Rd.,Marston Mills,MA 02648 Subj: .Tracey Brochu Residence,225.Little River Road,:Cotuit,MA 02635.:: We have provided an inspection and.review :of the residence roof construction of the above named property in regards to verifying the capacity of the existing roof for installation of a new Solar Panel Array. We.have found the residence to be of wood:frame construction bearing walls with a rafter framed roof: system. The main roof is of 2x10 @_16" o.c. and.is sheathed with 1/27 ext-ply sheathing and a single layer_:of composite shingles..:;The existing roof.structure,bears directly upon ahe:exterior:stud framed wall :system. The existing rafters:as installed meet the required load/span ratings :with sufficient capacity,to carry.the minor additional load of 4#/sf imposed by the prop osed:solar array per the details _ . below. Installation of solar rack systems shall be as follows: Each panel row shall be supported upon .2 mounting rails. Rails shall ber screw anchored through.roof and directly to rafters below.:: Rail attachment points to rafters shall be staggered each row with exception to the first fastener row from the gable end which is attached to two adjacent rafters. Silicone caulk shall be:applied between the:angle foot of:the mounting system-and the'existing: - roof shingles:ateach foot location: : :: Typical mounting detail sketch attached. When installed per:the above specifications the system shall exceed.110 MPH.wind & 30 PSF snow loads as required by Massachusetts 780 CMR table 1604.41. Should you have any further question or comment please feel free.to contact our office. Respectfully, H OF Agq MEs A. . Ncv ..:. . .46775 y A�b �sT ►�° lames A. Clancy �a Professional Engineer-: ttOWWAL ..... .. MA License#4677$ i Sog.AR liopme P9ww MC TOW >teont a.w'MP Jr/16" SS! twx Raw 11s� x 1`/a IYs'x 1'fb I 9ttel►'Rt�eiy p tav: UC? ---� RIkFTWO TY P�kt� M suN'T�G F TV PM+q .a/ PR•s.u�. R��6 J S A. N� CY James A. Clancy, PE 601 Asbury Avenue National Paek, NJ 08063 Massachusetts PE Lic#46775 Cotuit Solar.LLC Project: .. System: 9.6kW DC (STC) . Attachment Plan 508-428-8442 Tracey B:rochu 30- 32Ow modules : .. Revision October 12, 2016:: PO Box 89 225 Little River Rd. 30 — DC optimizers Eve rsource ISA#: 2179063 �OTUIT.S:oLAR,« Cotuit MA:02635 Cotuit :MA 02635 7.6kW SolarEd e::inverter (W: LG Lifes Good p. J. - LG NeON„2 LG's new module,LG NeONT" 2,adopts Cello technology.,:: 9Y.:: ' technology rep laces 3 busbars with 12 thin wires _.. 9Y laces P T nppaoveDpeooucr to enhance power output and reliability.LG NeONT""2 E1� demonstrates LG's efforts to increase customer's values 60.cell OVE C E Y P P ua _ . beyond efficiency.It features enhanced.warranty,durability, Intertek - .KM Boa>?3 a�r:N of:1 t. performance under real environment,and aesthetic design suitable for roofs. 1: . _. _. Enhanced Performance,Warranty Ila High Power OutputLGN60NT""2 has an enhanced performance warranty. Compared with previous models,the LG NeONTM 2 The annual degradation has fallen from-0.7%/yr:to has been designed to significantly enhance its output 0.6%/yr.Even after 25 years,the cell guarantees 2.4%p efficiency,thereby making it efficient even in limited space. more output than the previous LG NeONT.modules: .: Aesthetic Roof ® Outstanding Durability LG NeONTM 2 has been designed with aesthetics in mind,. Wrth.its newly reinforced frame design,LG has extended .. thinner wires that appear all black at a distance. the warranty of the LG NeONTM 2 for an additional The.product may help increase the value of 2 years.Additionally,LG NeONT"2 can endure a front a property with its modern design....:.: load:up to 6000.Pe,and a rear load up to 5400.Pa.:.' Better Performance on a Sunny Day, Double-Sided Cell Structure LG NeONT'2 now performs better on sunny days thanks The rear of the cell used in LG NeONT"d 2 will contribute to to its improve8aemperature coefficiency generation;just like the front;the light beam reflected from . .. the rear of the module is reabsorbed to generate a great amount of additional power.. About LG Electronics LG Electronics is a global player who has been committed to expanding its capacity,based on solar energy business as.its future growth engine.We embarked on a solar energy source research program in 1985, -supported by LG.Group's cich experience in semi-conductor,LCD,chemistry,and materials industry.We.successfully released first Mono X°series to the market in 2010,which were exported to 32 countries in. the Following 2 years,thereafter.In 2013,NeON^'(previously known as Mono X®NeON)&201 S NeON2with CELLO technologywon"Intersotar Award",which proved LG]is the leader of innovation in the .: '...industry. ...:.: ...... ... .... ...... _ ... LG NeONT`2 Mechanical Properties Electrical Properties(STC ' :Cells 6x10 a Module Type:. "- "" 320W- .. ... :Cell Vendor LG" ': MPP Voltage(Vmpp) 33.6 Cell Type Monocrystalline/N-type MPP Current(Impp) - 9,53 Cell Dimensions" 156.75 x 156.75 mrn 16 inches Open Circuit Voltage(Voc) 40.9 " ... ... .o of Busbar--- ... 12(Multi Wire Busbar) Short Circuit Current(Isc).-. Dimensiods(L x W s H)' 1640 x 1000 x 40mm Module Efficient :19.5 64.57x39:37x1'.57inch :OperatingTemperature("C) :' -40-+90 Front Load 6000 Pa/125 psf } Maximum System Voltage(V) 1000 Rear Load 5400 Pa/113 psf :Maximum Series Fuse Rating(A) 20 Weight, ... 17.0 t 0.5 kg. /37,48 t 1.1 lbs.. Power Tolerance %). 0-+3 Connector Type: - MC4,MC4 Compatible,IP67 STC(scanderd t st toad ton):o-rad'ar,ee 100 o VvW,kladule To. po,atura_s°C,AM Is : - :Junction Box : IP67 with 3 Bypass Diodes I e d'ere'The nameplate pov er output s measured and dece� d by LG EI ct - s s 1 andabsoluc Yon, �"��"�� - ��":'T,ehp'cal change'n module e`ficiency a[200 W/ ' .elation co 1000 W,m a-201.,. � �"" -- Length of Cables 2 x 1000 mm/2 x 39.37 inch Glass High Transmission Tempered Glass Frame '... Anodized Aluminum". .._ Electrical Properties(NOCT ) CertifitatiOns and:Warranty Module Type no W 'Maximum Power(Pmak): - .:.: ..234 ... Certifications IEC 61215 IEC 61730-1/-2: :MPP Voltage(Vmpp) 30.7 :.IEC 62716"(Ammonia Test) :. "MPP Current(Impp) :. : T60 - "' IEC 61701(Salt Mist Corrosion Test) Open Circuit Voltage(Voc) ISO 9001 Short Circuit Current(Isc) 8.10 UL 1703 - - 'NOCT(Nominel Operating Cell Temperature):Irradiance$06 Wim',ambient temperature 20°C,wind speed t m/s :.. .. Module Fire Performance(USA) Type 2(UL 1703) . Fire Rating(for CANADA) :. Class C(ULC/ORD C1703). Dimensions(mm/10) - - Product Warranty - 12 years Output Warranty of Pmax: ::.Linear warranty*:,0 ...... ....... �t)1st 9895,2 After 2nd'ear.0.6➢6 � ...... .. ...... Temperature Characteristics NOCT ... 46 3 3°C ... ... ..Pmpp -0.38%/"C t aa�a NOC ..... 028//°C Isc 0.63%/°C Characteristic Curves avow. .. .. .. 6W 600W ., vwmy�M a•. .. -. vdrayc N) 00o soo ,000 rs.00 soo:o oo .. o ao:oo ns.os � _aa,00 3so h i .. .. .. -. ..Rnax .. .. .. .. .. ... ... .. ... ... .. ... a ------------ -no -,s o s so 15 so to •The distance between the center of the mounting/grounding holes. " North America Solar business Team Product specifications are subject to change without notice. ®.LG LG Electronics U S A.Inc DS N2 60-C-G-F-EN-50427 Q Lifes Good 1000 Sylvan Ave,Englewood Cliffs,NJ 07632 Copyright©2016 LG Electronics.All rights reserved. Innovation fora Better Life Contact Ig.solar@a solar@lge.com : 01/01/2016 .. .. .. www1gsolarusa,mm Solar SolarEdge. Power Optimizer Module Add-On For North America P300 / P320 / P400 t P405 m WaRan�N F t PV power optimization at the module-level Up to 25%more energy ....... ..... Superior efficiency(99.5%) Mitigates all types.of module mismatch losses,from manufacturing tolerance to partial shading i — Flexible systemdesign for maximum space utilization — fast installation with a single bolt Next generation maintenance with module-level monitoring - Module-level voltage:shutdown for installer and firefighter safety USA..CANADA-_G.ERMANY-ITALY-FRANCE-.JAPAN=CHINA-AUSTRALIA-.THE'NETHERLANDS-UK-ISRAEL_ ., WWW.SOIayredge.us- �r _. SolarEdge Power .Optimizer Solar=@s 'Module Add-On for North America . P300.. P320 .�.:P400 /. P405 P300:: P320 P400 P405 (for high-power (for 72&96-cell (forthin film - (for 60-cell modules) 60-cell modules) modules). modules) :INPUT Rated Input DC Powerl'I 300 320 400 405, W ...............:.... . ..... ... ....... ..... .... ........ .... Absolute Maximum Input Voltage (Voc at lowest tem erature 48 80 Vdc 125 P.......... ........... ....................................................................................... ............................ . ............ MPPT.Operating Range 8.-48 8 80 12.5 105. Vdc .....................:. ....:....................... .:....::...... Maxlmum Short Grcwt Current(Isc) 10 11 10 1 Adc ............................................................... ..... ............................... Maxlmum DC Input Current 12.5.: 13.75 12 63 Adc Maximu Efficiency 99.5. %n m WeightedEfficiency....................... .:..........................:.... ..........:..... 98 8.....:..........:....:...........:.:.._:..........:....: .......°.:.... Overvoltage Category OUTPUT DURING:OPERATION:(POWER OPTIMIZER CONNECTED TOAPERATING SOLAREDGE INVERTER):' Maximum Output Current - 15 - Adc Maximum Output Voltage 60 l 85 Vdc OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED.FROM SOLAREDGE INVERTER OR SOLAREDGE INVERTER OFF.) Safety Output Voltage per Power 1Vdc Optimizer...::: _.:.: _. STANDARD COMPLIANCE EMC - FCC Part15 Class B,IEC61000-6-2,IEC61000-6-3 ...................................................................................................................... 741 Safety �m . .. . . ...:................... ..........:....................................................... y ......................................... ... .... RoHS Yes: INSTALLATION SPECIFICATIONS Maximum Allowed System Voltage 1000 Vdc ......................................................................................................... Compati e Inverters AILSoIarEdBe Single Phase and Three Phase inverters .... . .... ............... 128x152x27.5/ 128x152x35/ 128z152x48/ Dimensions(W x L x H) - mm/in. . 5x5.97x1.08 5x5.97x1.37 5x5.97x1.89 . ................. ............................................... ....................................................................................... ............................ .............. .Weight(including cables). 760/1.7 830/1.8 _1064/2.3........... ... . ............... ...... .... .. Input Connectar MC4 Compatible ............................................... ........................................................................................................................I. .............. output Wire Type/Connector Double Insulated MC4 Compatible ......... .. ...-........ ... Output Wire Length. ........... ...... ..................... 0 95/3 0..................:. ..�....... 1.2/3:9... m j ft ... .......I........... ...... Operating Temperature Range .........40 +85/-40-+185 ..Protection Rating:.:..........: ..... ....................................::::.:......IP68:/,NEMA6P.............................................. Relative Humidity 0-100.. % . ...................... ........................................................................... ...... ...... ...... n)Rated STC power of the module.Module of up to+S%power tolerance allowed: '....:.: ....:.: ....:.: ....; ....:.: ...... .. ... PV SYSTEM DESIGN USING SINGLE PHASE THREE PHASE 208V.. . . THREE.PHASE 480V A SOLAREDGE INVERTEV) Minimum String Length 8 (Power.0 timiiers) .... _. 10 18 Maximum String Length 25 _ 25 - 50 . (Power O timizers - p.........1....................... ............................ .::... .....:.::. _......... .... . . Maximum Power per String 5250 6000............... 12750............... W .................................... ....... ...... Parallel Strings of Different Lengths or Orientations Yes M It is not allowed to mix P405 with P300/P400/P600/0700 m one string. CE I&% O OPTIMIZED BY SOLAREDGE are tradernafks or of •larEdge Technologies, wf solar=ev z . SolarEdge Single Phase Inverters For North America SE3000A=US/ SE380OA-US/ SE5000A-US/ SE6000A-US / SE760OA-US / SE1000OA-US / SE1140OA-US .a - i �� w _�:.x�.a. .°,-,....�...o;r=•+•- •, ° carte �' wr u �:,�� R 5 ( A 'R a � ��o WacranH i b ,I wr.+i.+ y+ $ � N eN 44 The bestfch x�c1 f0ir-s6 a r ge. e�at�led �'.Integrated`arc.-fault pfoteciiori-(Type 1)16r NEC-2011690 11 compliance, .,r ✓- ;r < .•.. a - is ,r n-'' 4 ,,« '€., x" .- r.. a O y-. 'Mx �;v.�t ew sa ee. ,a :., ' 'A :' +sr ,. k.s s r:w '✓f` Superior efFrciency(98/} z Small lightweight and'easy to instal(on provided bracket 3 � .Built in module-level monitonng � Y x §X 4; - -Internet connection through Ethernet or Wireless '` # `` Outdoor and indoor installation • - r rg 'Fixed.voitage inverter,`DC/AC conversion only Pre-assembled Safety Switch for faster'installation -' Optional-revenue grade data;ANSI C12.1 USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL www.solaredge.us solar=9 " Single Phase Inverters for North America SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ SE760OA-US/SE10000A-US/SE1140OA-US SE3000A-US SE3800A-US -.SES000A U5- SE6000A-US 'SE7600A US SE10000A`US' SE•11400A US; s OUTPUT7-7 t Nominal AC Power Output 3000 3800 5000 6000 7600 9980 @ 208V 11400 VA ........................................... ................. ............... ................. .. .............. . .................. ........... Max.AC Power Output 3300 4150 5400 @ 208V 6000 8350 10800 @ 208V 12000 VA - ............... .:5450.@.240V. . 10950•rY?240V. .................. ........... ............... .. . AC Output Voltage Min:Nom.-Max 1�1 183-208-229 Vac ................................... ................ ............... AC Output Voltage Min:Nom:Max.l'I 211-240-264 Vac ........................................... ................ .......:........ ................. ................................. .................. .................. ........... AC Frequency Min.-Nom:.Max.l'I 59.3-60-60.5(with HI country setting 57-60-60.5) Hz Max Continuous Output Current .. 12.5......I......16......I...?1.G?.240V...I.......ZS..:....I......32.......I...42 (.......47.5....... ....A..... GFDI Threshold 1 A Utility Monitoring,Islanding Protection,Country Configurable Thresholds Yes Yes 1 INPUT Maximum DC Power(STC) 4050 5100 6750 8100 10250 13500 15350 W ...................................... ........... ........... Transformer-less,Ungrounded Yes ..Max..Input.. ....Volt...age 500 Vdc ..... .. . ....................... .......................................................................................................................... ........... Nom:DC Input Voltage 325 @ 208V/350 @ 240V Vdc Max.Input Current 9.5 13 18 x. 23 34.5 Adc ..Input.....Short....Circui.'r1.. ..Curre......n.t...... ................ 240V..I................I................I..30 e2240Y..1.................. ........... Mat 45 Adc........................................... ........................................................................................................................... ........... Reverse-Polarity Protection Yes ........................................ .....................................................................Y.................................................... ........... Ground-Fault Isolation Detection - 600ksa Sensitivity ........................................... ............. .. ............... . Maximum.lnverterEfficiency 97.7 98.2 98.3 I 98.3 I 98 98 I 98.•.•.•. % ... ..Weighted Efficiency.............. .9......... ......98......I.998 2 O$V..I......9..... ..I.....97.5...... ....... 20 OV.. ......97.5....... /• ................. ........... CEC 7.5 Nighttime Power Consumption <2.5 <4 W 'ADDITIONAL FEATURES Supported Communication Interfaces RS485,RS232,Ethernet,ZigBee(optional) .......................................... ...................... ........... Revenue Grade Data,ANSI C12.1 Optional0) Ra Id Shutdown—NEC 2014 690.12 Functionality enabled when SolarEdge rapid shutdown kit is installed I.STANDARD COMPLIANCE.: Safety . .•....••.••.......•,•-•.•---- •...UL1741,UL16996,UL1998:CSA 22.2 Grid Connection Standards IEEE1547 ....................................... ............................................. ..................................................................... ........... Emissions FCC part15 class B INSTALLATION SPECIFICATIONS- ; AC output conduit size/AWG range 3/4"minimum/16.6 AWG 3/4"minimum/8-3 AWG . ............................ ....................................... ......................... .... ........... DC input conduit size/#of strings/ 3/4"minimum/1-2 strings/ AWG ran e 3/4"minimum/1-2 strings/16-6 AW6 $.............................. .................................................................................... .............14;6AWG............. ........... Dimensions with Safety Switch 30.5 x 12.5 x 10.5/ in/ -HxWxD 30.5x12.5x7.2/775x315x384 (.......)............................. 775 x 315 x 260 mm ............ .... .g.. Weight with Safety Switch 51.2/23.2 54.7/24.7 88.4/40.1 Ib k....................... .............. ................ ..................................... ........... Natural convection Cooling Natural Convection and internal Fans(user replaceable) fan(user ........................................... ......................'.. re laceable .......................................... ...P............ ...........................-......... . ................................... •.....<25 <50 d8A Min:Max.Operating Temperature 13 to+140 J-25 to+60(40 to+60 version avail.abl.els. ....................:..:....... l) ( `F/°C ......................... Range......... . ................................................................................... .. .. . ........... Protection Rating NEMA 3R I'I For other regional settings please contact SolarEdge support. Rl A higher current source may be used;the inverter will limit its input current to the values stated. lal Revenue grade inverter P/N:SExxxxA-USOOONNR2(for 7600W inverter:SE7600A-US002NNR2). i4I Rapid shutdown kit P/N:SE1000-RSD-S1. Isl A0 version P/N:SEx—A-USOOONNU4(for 7600W inverter.SE760OA-US002NNU4). V Off HIM � o O Sola,Edge Technologies.[tic.All rights reseived.SOLAREDGE, OPTIMIZED BY SOLAREDGE Date: professional ET� us - Prdolar®:RoofTrac® SOLAR sE Intertek Bonding and Grounding Gui e productsi nc. 4007217. - ... .. UL2703 Patent Pending) _... _. rad®an e® Applies to GroundT d SolarWedg w utilize oo mounting systems which ut'I' a the R 1Trac® a rail/clamp design. 1. a For RoofTrac®Rail Bonding Splice les m o Irwin.. No buss bar Drill 1/2"ho at.botto of,rails 1/2"."10 1 i Unibit®using the rail support as a hole location guide.. Insert o 0• I rt 5/16"bolt through support holes and hand a: thread into thread rail splice insert. Fasten to 15 ft-lbs. For Bonding Module Frame and Clamps to Support Rail . Green lock assembly dul • Fasten,pre-assembled mid-clamp ass bly to module: washer indicates frame,:to 15 ft-lbs. electrical bond : — — Module.Frame Design double wall,aluminum, 1.2" 2.0"tall,0.059" 0.250" thickness, UL1.703,or equivalent tested module. 1JL467 standard tested bonding equipment for use with Professional Solar Products(ProSolar°)supportrail. Bondingof module to.RoofTra&rail via ProSolarO rail channel nut using:buss bar. Bonding of RoofTrac°rail to RoofTra&rail via ProSolar® UL467.tested universal splice kit(splice insert and: . .. . . splice support):.. . . . . Assembled Self-bonding Self-bonding Mid Mid Clamp With SS Bus Bar Clamp Fastened on Rail Grounding of RoofTrac°rail via Ikea SGB-4 rail lug. (solar module not shown) ... System to be grounded per National;Electrical Code(NEC).. See NEC and/or Authority Having Jurisdiction (AHJ)for grounding requirements prior.to:installation..See final run(racking to.ground electrode)grounding equipment installation instructions for.specific installation information. COPYRIGHT PROFESSIONAL SOLAR PRODUCTS 2015:All information contained in this manual is property of Professional Solar Products(PSP). TileTra&is a registered trademark for PSP and is covered under U.S.patent#5,746;029.RoofTrac®and Fastink®are registered trademarks for PSP and are covered under.U.S.patent#6,360,491.RoofTra&bonding designs patent pending.,. ProSolar®UL2703 Bonding and Class A Fire Rating Page 1 of 4 : professional SOLAR Pr Solaro RoofTruc® productsi�, - Bonding and Grounding Guide (Patent Pending 11 I m l: Can be placed �. I of under module to —111 hide connection if desired For Grounding Connection • ILSCO SGB-4 rail ground connection Basic Wiring Diagram RoofTrac°Universal Rail Bonding Splice Grounding Lug Grounding Lug COPYRIGHT PROFESSIONAL SOLAR PRODUCTS 2015:All information contained in this manual is property of Professional Solar Products(PSP). TileTrac®is a registered trademark for PSP and is covered under U.S.patent#5,746;029. RoofTraO and Fast lack®are registered trademarks for PSP . .. . . and are.covered under.U.S.patent#6,360,491.RoofTra&bonding designs patent pending.,. I ProSolar@)UL2703 Bonding and Class A Fire Rating Page 2 of 4 ' Listing Constructional Data Report (CDR) 1.0 Reference and Address Report Number 100779407LAX-003 Original Issued: 14-Se -2012 Revised: 28-A r-2015 Standard(s) UL Subject 2703-Outline of:lnvestigation Rack.Mounting Systems and Clamping Devices for Flat-Plate Photovoltaic.Modules and Panels..Issue#2:2012/11/13.: Applicant Professional Solar Products, Inc. Manufacturer Professional SolarProducts,Inc. 1551 S. Rose Avenue. 1551 S. Rose Avenue Address Oxnard; CA 93033 � := Address, Oxnard, CA'93033 Country USA Country USA Contact Stan Ullman Contact Stan.Ullman Phone (805)486-4700 Phone (805)48674700 FAX (805)486-4799 FAX (805)486-4799 Email stjorosolar.com Email s@prosolar.com . q. d. .. _. Page 1 of 63 This report is for the exclusive use of Intertek's Client and is provided pursuant to the agreement between Intertek and its Client. Intertek's responsibility and liability are limited to the terms and conditions of the agreement. Intertek assumes no liability to any party, other than to the Client in accordance with the agreement,for any loss,expense or damage occasioned by the use of this report.Only the Client is authorized to permit copying or distribution of this report and then only in its entirety.Any use of the Intertek name or one of its marks for the sale or advertisement of the tested material, product or service must first be :approved in writing by Intertek:The observations and test results in this report are relevant only to the sample tested.This report by itself:does not imply.that the material,product,or service is or has ever been under an Intertek certification program. ProSolar@ UL2703 Bonding and Class A Fire Rating Page 3 of 4 Report No;100779407LAX-003 Page.2 of 63 Issued.:.14-Sep-2012 Professional Solar Products, Inc. Revised: 28-Apr-2015 2.0 Product Description Product Photovoltaic.Racking.System Brand name. ProSolar The product covered by this listing report is a rack mounting system. It is designed to be installed on a roof. It will be secured by means of Fast Jack or Tile Trac attachments, depending on the type of roof it is intended to be installed upon. The Rooftrac mounting system is comprised of support.rails and top-down clamping hardware..This device can be used:on most standard construction residential roof-tops. This system is in compliance with the mountin bonding and.grounding ortions of Subject y P� . .. 9,.. 9 9 9 P. J.. . . 270..3.This system has the following:fire class resistance ratings: Class A for Steep Slope Applications when using Type 1 or Type 2, Listed Photovoltaic Modules. Class A:for Steep Slope Applications when using Type 2, Listed Photovoltaic Modules with or without the wind skirt. Class.A'for Low Slope Applications.when using Type 1,Listed Photovoltaic:Modules when a minimum of 12 gap between the roof surface and the bottom of _:. the module is maintained. Class A for Low Slope Applications when using Type 2, Listed Photovoltaic Modules when a minimum of 14".gap between the:roof surface and the bottom of the module is maintained: RoofTrac has different types of bonding and grounding, below is a list of them: Bonding of module-to-Roof Trac rail via:Weeb PMG Description Bonding of module-to-Rooftrac rail via ProSolar rail.channel nut using buss bar Bonding of.rhodule-to-Roof Trac-rail via Ilsco SGB-4 Iugs: .. ..: Bonding of Roof Trac rail-to-Roof Trac rail via Weeb:Bonding Jumper-6.7 Bonding of Roof Trac rail-to-Roof Trac rail via Ilsco SG64 Lugs Bonding of RoofTrac rail-to=RoofTracrail via ProSolar UL 467 tested universal splice kit(Splice Insert and Splice Support) ..:.: _..: Issuance of this.report is based on testing to PV.module frames with a.height of 1..1/4 inch tot inches6. The grounding of the entire system is intended to bean accordance with the latest edition of the National Electrical Code, including NEC 250:_Grounding:and Bonding, and NEC 690: Solar Photovoltaic Systems. Any local electrical codes must be adhered in addition to the:: national electrical codes. . ..:.: _... This product investigation was performed only with respect to s ecific ro erties; a limited 9.. . . P.. . . P P. P p .. . . range of hazards, or.suitability for:use under:limited or special conditions. The:following risks and other properties of this product have not been evaluated'. electric:shock, Ultraviolet light exposure. Models RoofTrac... Model Similarit N/A _. Fuse rating: 20 A Mechanical Load::30 PSF _. . Fire Class.Resistance Rating: Ratings Class A for Steep Slope Applications when using Type 1 and Type2, Listed Photovoltaic . Modules: Class A for Low Slope Applications when using Type 1 and Type 2; Listed:Photovoltaic Modules .. Mechanical load was tested using 60 Cell Canadian Solar.Modules model CS6P with 40mm frame height and maximum span of 48 inches using 4 inch and 6 inch TileTrac or FastJack Other Ratings posts with1-1/2 inch tall RoofTrac rail:And maximum span of 72 inches using 4 inch and 6-inch TileTrac or FastJack with 2-1/2 inch tall RoofTrac rail. ProSolar@ UL2703 Bonding and Class A Fire Rating Page 4 of 4 eo 16. .1 ( -Jan- ) dat ry 3 5 1 13 Man o w 04 14 01:28p Tupper Corn 15087785010 p.1 G LSE COIV s-FRUCT ION .CO. L.Lc 546A Higgins Crowell Rd,WEST YARMOUTH,MA 02673 PHONE: 508-778-0111 FAX: 508-778-5010 1MNW.TUPPERC0.COM Date: l J� I Town of Barnstable :Thomas Perry CB® 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that.all work completed for permit application Issued on g �� yj/� has been inspected by a certified Building Performance Institute (BPI) inspector. All.work performed meets or exceeds Federal and State. requirements. Sincerely, Permit#: � Q Ad dress: 5 ( iFichard Tupper License # CS--69058 w I :+ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel a Application #2—® q� 18(o Health Division Date Issued Conservation Division Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address _ --2 - e Village c114-- Owner Address Telephone U,U J- / (./ O/U Permit Request � GL�.! / C / /® n J4(14A917 9 t 17 �i1 /17 V -� 'A T'/lip `i (IX / 1 r 10, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation N06�y Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0'*� Two Family ❑ Multi-Family (# units) 521 0- Age of Existing Structure _ZWHistoric House: ❑Yes ❑ No On Old King' hway: q Yeses❑ Noy. Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other COS . Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing newer Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ErGas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes tNo 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 Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number �J v0 770ry�r Address 7rZ M1/j t_ ,b License # �f" ()(09 OJ `1`) . 72 Home Improvement Contractor# 7� -3 Email GC�%�h f'J ��v � Worker's Compensation # CSS 00 ' ALL CONSTRUCTI DE J7&<_/r-)htJY? ULTING FROM THIS PROJECT WILL BE TAKEN TO � 1W N--6 Z� SIGNATURE DATE 1 ! E FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: Y FOUNDATION r ' FRAME k INSULATION s FIREPLACE -- kF ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT. ASSOCIATION PLAN NO. { f[ty .lsafiw...M.. J r` j� The Commonwealth of MasS&e11useqS Department of IndustrialAceideno Qjftce of Investigations 1 Congress Street,,Suite 100 , Bost©n,MA 02114-2017 www.mass.gov/"na 'witrkers'Compensation tnsurance.Affidavit: Builders/ContractorslElectricians/Plumbers: Ap>alicai t.Information Please Print Legibly alTie:(Business/Organization/Individual): Tupper Construction Address:79B Mid Tech Dr City/State/Zip:West Yarmouth, MA 02673 Phone#.508-778-01`'11' Are you an employer?Check the appropria- te ro rate box: Type of project(required): am a employer withi 4. Q 1 atn a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑ \New construction ® I am a sole proprietor or partner-. listed on the attache sheet;: 7. 0'.Remodeling; .ship and have no employees These sob-contractors have g• ;Demolition working for me in.any capacity: employees and have workers' .[No workers' comp.insurance comp.insurance 9. ❑'Building addition' required:) 5. [] 'We area corporation and its: I 0❑:Electrical repairs or additions. 3 El I am a homeoumer doing all work officers have.exercised their o l l vD Plumbuig repairs or:additions. myself [No workers' comp. right of exemption per M15L. c. 152, 12.D Roof mpairs atas`arance required.) §1(4),and the have no employees:.[No workers' 13. Qdaer Weath'erizatior / .. comp.insurance required-) nsu a ion "Any applicant that checks box""#t must also fill out the section below showing their workers compensation policy information:: Homeowners Nvho submit this affidavit indicating they are doing all mark and then hire outside contractors.tnust submit a new 8ff davit indicating such;. tConttactors that check this box must attached an additional sheet showing the name of the sub-contractors and.state whether or not(hose entitieshaue` employees If the sub-oontracto s have employees,they must provide thew workers'Comp:I obey number. 1'attt an employer that is rrovidng workers'compe;7satio,r insurance fvr my employees. Seloty Bs the policy and job situ ir3fern:anon. Insurance Col ipany Name:AEIC Policy 1#or Sell=ins. Lic. WCC5005593012007` J . . Expiration Da#et 10/3f14 Job-Site Address: !} Ctty/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and eatpiration date): A Failure to secure coverage:as required under Section 25A of MGL c. 152 can lead'to the.:mposition of criminaI penalties of a, fine up to$1,500.00 and/or`one-year imprisonment,as well as civil penalties in the form of a S i QA WORK 4RUE1t and a fitie of up to$2-5b.a0 a day sit the violator: Be advised that a copy of this statetiient may bei forwarded'to the pt;ce df` bfv.eAgations ofth IA for institance coverage verification. t.da lierehy.cer!`. n t au+s andpenalties sf perjrtry that.-the fit,formationprovided above is True rr d correct. Si -attire:: . ' l5hone#: 50$7. 7 1`1 Offidirl:use only. Do nut-write in this area,to be completed bV city or town,official. City dr Uwn: Permit/License;# Issuing Authorty.(circie one}i 1 :Board of Health 2.,]Building Department 3:City/Town Clerk 4.Electrical Inspector ;5.Phtmbing Inspector± 6,:L7thsr - , .T Cont=acf Person Ponc:#3 E Mgssxtiusetts-Dtpanmrnr:o#Public Safety toy qwnw p4wd suft-71,3 + Board of-Svtiditt x 1412 .NY z 9,Regulations and Stand tds f 18771 27+t t2?s f,ail.=ru,t�,,n'lwvr•i:,-r .. i_tce„rw Cs•o69058 'FFICHARD S TUPPER 79 B,tiYWT[CIH'bR. 3 WEST YARMOVI i 11 73; ffthtd Tupper' xplrattan a'(WRAW�EsQ.FOR o SrcwtsiMAMrirau,rou W46'� Lrmrnasssri�e�: 12131t2014 Peapfe Relp€ng;PeapteSuild a Safer World- { �fEb;1816 Richard Tupper f, Tupper Construction Building Sit*Proressianat Member#:815811 R Exp:4/3012014 a rf�G hGurletc=7nrcut/1�c�`-F�L<tr,JCr�fu3�C/'. •, -_ . .. `=`• Office;of Consumer Affairs&Business Regulation License.or.registration valid for,individu!use only TOME IMPROVEMENT CONTRACTOR before the expi` date. If found return to: 13egistration: 178434 Type Office of C ffairs and BusinessRegulati,on Expiration: ,411612016 LLC 10 Par aza-.Su' a 5170 ' Bo MA 021 TUPPER CONSTRUCTION CO,LLC. RICHARD TUPPER 79 B MID-TECH DR. Vd.YARMOUTH,.MA 02673 Undersecretary No l tthout signature. I_ _ i ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 't 12/03/2613 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,EXTENVOR ALTER THE COVERAGE AFFORDED BY THE POLICIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN,THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les).must be endorsed. If:SUBROGATION I5 WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A,statementon this certificate.does not confer rights to the i certificate holder in lieu of such endorsement(s)- PRODUCER NAME:ON ACT Lora Lowe Southeastern Insurance Agency, Inc. (A",2NN �. (508)997-6061 FAX + 439 State Rd. E-MAIL ADDRESS: P.O, Box 79398 PRODUCER .. CUSTOMER ID# N. Dartmouth, MA 02747 INSURER(S)AFFORDING COVERAGE NAICd INSURED INSURER A.: Arbel.la. Protection :Insurance ? Tupper Construction Co LLC INSURER8: AEIC wsURERC: CNA Surety 27 Roberta Drive INSURER`1) West Yarmouth, MA 02673 INSURERE:. I ,.SURER F _ COVERAGES CERTIFICATE NUMBER:2013/14/1 REVISION NUMBER: $ THIS IS TO CERTIFY THAT THE POLICIES.OF INSURANCE.LISTED BELOW HAVE BEEN ISSUED TO THE1NSURED'NAMED ABOVE FOR THE POLICY PERIOD INDICATED'. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS s CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED 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. ` .. .. MWDD -.MM/DD . . LIMITS - ILTR TYPE OF INSURANCE INSR SWUD-. POLICY NUMBER+ POLICY EFF POLICY EXP GENERAL [ABILITY 850000874 11101/201.3'-1110112014. EACH OCCURRENCE • $ 1,000,00 X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurrence) S 100,00 CLAIMS-MADE 7X OCCUR MED EXP(Any one person) s S,00 A PERSONAL SADVINJURY S 19000,00 GENERAL AGGREGATE S 2,000,00 GEN'L AGGREGATE:LIMIT APPLIES PER: PRODUCTS-COMPfOP.:AGG- S 2,000_,00 POLICY. PERCOT El LOC $ AUTOMOBILE LIABILITY 5666240000 12101°/2013 -12101/2014 COMBINED SINGLE LIMIT- S ANY AUTO (Ea accident) _ 1,000 00 :BODILY INJURY(Per person):--,S ALLOWNED'AUTOS .BODILY INJURY.(Peraccideno S A X SCHEDULEDAUTO5 PROPERTY DAMAGE X HIRED AUTOS (Per accident):- $ INC NON-OWNED AUTOS: - - $ UMBRELLA LIAB X OCCUR 460005836. 11/011201.3 11101/2014 EACH OCCURRENCE S 1,U00,:OO EXCESS LIAB CLAIMS-MADE AGGREGATE s 1,000,00. A DEDUCTIBLE S RETENTION $ .; WORKERS COMPENSATIONWCC5005S9301200. 101031201:3 10/03/2014. X ORYLI y N MTS X T ...AND£MPLOYERS'LIABILITY - ANY PROPRIETOR/PARTNER/EXECUTIVE RICHARD TUPPER IS EL EACH:ACCIDENT $: 1,000,O0 B OFFICERIMEMBER EXCLUDED? NIA _ , (Mandatory in NH) I LUDED' FOR .WC COVERAGE E-LDISEASF-EA EMPLOYE S 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S 1,060,000 DESCRIPTION OF OPERATIONS I LOCATIONS/.VEHICLES(Attach ACORD101,Additional Remarks Schedule,If`more space is required) - CERTIFICATE HOLDER: CANCELLATION, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION' DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "For Information Purposes Only" Tupper Construction Co LLC AUTHORIZED REPRESENTATIVE ` N Roberta Drive W Yarmouth, MA 02673. Lora Lowe ©1988-2009 ACORD CORPORATION. All"rights,reserved. ACORD 25(2009109) The ACORD name and Iogo are registered marks of ACORD i OWNER AUTHORIZATION FORM ACF y ax0cpic') (Owner's Name) owner of the property located at s 100D( (Property Address) Ct1dC-1 A oab35 (Property Address) hereby authorize �'j topef "'Lald (Subcontra an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature 0-7 a�ZLO Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 06 Parcel00 -OD6 . ��tio(fin # Health Division �( '�� Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address oQ0 V&Q Village C�D%lJ /% Owner r`7 /� GAY 6-10Gflo Address 1-1 m-E R/Ve,<R46 Telephone QG — Q5 —O 3 43 Permit`Request : Com IP(r*7T7 orJ 0 F_ 1)NFi N 1 S H" /V U.S' RGO✓n A160ye- G AI2A"�� A-gipi/\/_� St Y-vK4_ b/J CA &AJ 1 i N RDOrn Square feet 1 st floor: existing X proposed 2nd floor: existing 'proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 151000 Construction Type Lot Size Grandfathered: ❑Yes WNo If yes, attach supporting documentation. Dwelling Type: Single Family �ir Two Family ❑ Multi-Family (# units) Age of Existing Structure 0 S yies Historic House: ❑YesA No On Old King's Highway: ❑Yes No Basement Type: XFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 0 Basement Unfinished Area (sq.ft) 131 G Number of Baths: Full: existing cP- new _ Half: existing new Number of Bedrooms: .3 existing new Total Room Count (not including baths): existing _ 7 new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑ Other r)21 SR ..� c? Central Air: )q Yes ❑ No Fireplaces: Existing 1 New Existing wood/coal shove: D;Yes No -, Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn�0 existing)❑ new size_ Attached garage existing ❑ new size _Shed existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes A No If yes, site plan review# � m Current Use SPA Proposed Use lgc, M APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name J CA" lam' —"eff l ephone Number qC6 05—C) Address °tea 5 l`" /� License # (fO-1V I 11— ✓✓l�k 0 aG'&5 Home Improvement Contractor'# Email '" b��=�Us@ ko+yVh AJ - LO Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /FJIN►� ��CJ�'� SIGNATURE DATE a`J � FOR OFFICIAL USE ONLY r ,,APPLICATION# DATE.ISSUED MAP•/PARCEL NO. ADDRESS VILLAGE OWNER I - DATE OF INSPECTION: FOUNDATION { FRAME INSULATION CO -7i )l Y FIREPLACE ELECTRICAL: ROUGH FINAL E. - i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING s D'ATE:CLOSED OUT ' ASSOGIiON PLAN NO. ''' 21a Commosxruarl&afMassachrae it D4wr&ventvf1wrdmbfidAcddea Office -&Pds*�Vw ' 600 WmMueon Meek Rvsfarj,.HA 02M Wftq'V.7FitTSs;.�-O#�1Tr12 ' W rker.e Campe-nsaf auEmuu c davit$uifders/CnntmcttlrsMectricianslPlnniber- i4dw' tt fnf'armatimn Please P�-nat hhr rr / 6&C-A(w L-1 rrz-s ( v&oe 67v t i ✓n1-oab 35. - fsphone A- A;re yrau an,employer?Checkthe appropriate bo= Typ*of project€requi ed): k❑ I am a employer with 4. ❑I ama Vital contractor and I G_ �]New oou;fruction employees(€all andlorpart-#ime5* ha�el�iretl.the sub conffac4zs ❑ I am.a sole proprietor orpattnrrr- Iisted on the attached sheet� y- ❑Remodeling shy and have no employees fit:sub-contactors have S_ ❑Ilem,olitiom working for me in my capacity. employees and have wodmrs' 9- 0 Buildmg addition [No wndmrs`camp.instu-ance comp_iasocam 10 Bletttical additions I 5. ❑ We are a cotporatibmand its -❑ rig 3 I—am-a homeoumer doing all-Work officxrs have eanrdsed their 11-0`Phunbiag repairs or additions ri of tioa er MG1. myself[No worloets' 3 e P F -0 12 Roof repairs rnmM nce��1 Y C-152,§1(4),andwe,Euwa no employees-[Nowodm 13-0 Ofber comp-instttance r equired.1 . *A-ay appbom-t fiWche&sb=f1 nmstalso Mourthe sectioahelotvslmvang theawa6ze mtnpensatioapoHLT 1Ha—vrhosabnutthisafdavemdustmgtheyarmdamggIInmaksad&eahaeomridecoutoictoes— snbeuta new af5daskmdirstisarh 7Camncros$st cfieck his boat mast attached m sdditinnzl sheet sh otvurg the name of tfie 5st>zaa and state vrhether ocnot�sase have 1 emfilayees. If the 6 hate employees,they nmrt provide their wod ae comp policy mmhe2 - - I nm an empinyer that is pmtfid€ag workers'comps utdian iumirance for nzy earg£�yea .SeZgiv is thepaac}and}ob sits inf0twatialL IrtsmMce CompatxyName: Policy 9 or SelfLiras_Lim# FxgiratiouI3ate: Job Sife Address Cifj�stxwzip: Etch a ropy of the workers'compensation policy declaration page(shmvintg the policy iramber and ration date). Failure to secant;cavvrage as mgdr c ruder Section 25A of MGL r~ 152 can lead to the aupasitiou ofcrim in.1 pies of a fine up to$L50Q.0U and/or one-yearimpriso as well as dvil 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 cop-of this statement maybe forwarded to the Office of Inves#ptiom of the DIA for rrmmance coverage vsifiration_ 1 da Taareby aerhfy the pains attdpsnoItias af tcry t3tatfha info ra pnni&£ahov is h7m and correct ��--�^ ram•,�, l}; ciul use milt'. Da not writer in th&area,to ba congAtesd by tatty or town afficiaL City or Town: PermwUcense# Ismui�clvdhuntg(circle one)- L.Board of Health.2.BuffTmg I lepar ment 3:CitSfrcvwu Cl=k 4.Electrical bnspector S.Ph=binp lhspector 6.Clthrr - Confact Persan: Phan g: 6 . ti Information. and Instructions Massachusetts General Laws chapter 152 inquires all employers to provide workers'compensation for their emPY-Io ees. Pursuantto this statute,an anpkgyee is defined as 1`__every person in the seavice of another under any contract ofhire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,.or the receiver or trastee of an individual,partnaQhip,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the . dwelling house of another who employs persons to do mai„te:,,anCe,construction or repair work on such dwelling house or on the grounds or budding appurtenant thereto shall not because of such employment be deemed to bean employer." ..MGL chapter 152, §25C(6)also states that"every state or local Licensing agency shall withhold the issuance or renewal of a licenise or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance,coverage required," Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with time insurance requirements of this chapter have been presented to the contracting authority.- Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractmr s)name(s),addresses)and phone numbers)along with their certificates) of. insurance., Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)With DO employees other than the members or partners,'are not required to carry workers'compensation mmir-mce. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of incnranc6 coverage.. Also be sure to sign and date the affidavit The affidavit should be retumcd to fhe city or-town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the Iaw or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below, Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the pemmitllicense,number which will be used as a reference number. In addition,an applicant that must submit multiple pem itlliumse applications is any given year,need only submit one affidavit indicating current policy information(ifn(-,cessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses:A new affidavit must be filled out each year_Where a home owner or"citizeu is obtaiaiag a license or permit not related to any business or commercial venture (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would Mce to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address;telephone and fax number: - The CoMMQnWeRTth of Massachusetts Depai�mcmt of Indmlftia A(�cidenis off1M Of kve�. tFGM 640 Wa mutan B MA G21II TeL A 617,."27-49Q4(�)t 4-€16 Qr I-W-hLA.3 Revised 4 24-07 Fax#617-727- 49 Town of Barnstable - Regulatory Services . . - oFti Richard V.Scab,Interim Director Building_Division R1RxcrARTR - �' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 QED www.town.barnstable.ma.us Office: 508-862-403 8 Fax.: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print JOB 106AnOX I ee� .p;�,q-3"HOMEOWNER": . name a; —,.— —•-�- ��.home 0�..�_�.� c --03�J�.._work phone_#_ G ADDRESS: cuRRENT MA>t mr �U/T lyi A- U cityftown'^�----� �state„'"""•�e�•��.+,vsr+r.;,.._�"'".z�p code•..=-,�.�•r,u��^^��_. The current exemption for"homeowners:".-was extended to include owner-Occupied"dwellings of`snc-less-and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) M1 - 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 ofBamstable Building Department minimum inspection proce and requireme d that he/she will comply with said procedures and requirements.. afore 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 EXIAf ION 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 IO .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,Runes&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness_often results in serious problems,.particularly when the homeowner hires unkensed'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 form/certification for use in your community ti�.fmr.rr r_cmm��rtnt�.s:......:r...:1•i...+..eIRYPRFCC jinn r �'MEr, Town of Barnstable �} Regulatory Services SS Richard V.Sca%Interim Director s639. �r�tips" Building Division Tom Perry,Building Commissioner 200 Main Street Hyaffiis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete.and Sign This Section If Using A Builder I ,as Owner of the subject propetty heteby authorize to act on ray behalf, in all matters relative to work authorized by this building permit (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or.utilized before fence is installed and all final inspections are performed and accepted. Signature of Ownet Signature of Applicant Print Name Print Name Date IlV rn o� J� + IV I` \ \A SMOKE DETECTORS REVIEWED I S BUILDING DEPT. DATE 2-2-5 L►TrLE.- j2 Vf-j2 � FIRE DEPARTMENT DATE CO 7j 1 IT , 26 5- BOTH SIGNATURES ARE REQUIRED FOR PERMITTING � • , � ,A y �l�� rmSlOTFP a vv * co i tJ ► /t�ik 2S - )®15 3 �w� 6A�l T �V fir,r-JI con,) rr� nA P� i z , 0w) 2,/q/Nr r CONSTRUC IO CO. etc N 79B MID-TECH DRIVE,WEST YARMOUT�F4Ar026-73-3 I; -9 PHONE: 508-778-0111 FAX: 508-778-5010 WWW.TUPPERCO.COM OINtx Date: t I Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application Issued on l��1 `f has been inspected by a certified Building Performance Institute (BPI) inspector_ All work performed meets or exceeds Federal and State requirements. Sincerely, Permit #. Address: 5 �' Richard Tupper License # CS-69058 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 05 Parcel G 5' Application � 5A/ Health Division Date Issued l Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �a 5 / 1r e c p Village Owner t Kb [MC e V 9ff0C.h(X Address as S U ?LL4� Telephone Permit Request fJ U Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /5 � �( (Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King ighwarr�:a❑Yp ❑ No F_ C.7) Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sqM) t, Number of Baths: Full: existing new Half: existing new to Number of Bedrooms: existing _new r71) €ry Total Room Count (not including baths): existing �0 new First Floor Room Count Heat Type and Fuel: 2GaS ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes @-Nu 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 Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - _ (BUILDER OR HOMEOWNER) Name �� Telephone Number Address //� �� T. License # �i� VCR gas Home Improvement Contractor# Worker's Compensation #WSc z ij ALL NSTRUCTION rISSULTING FROM TH S PROJECT WILL BETAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. F ADDRESS VILLAGE OWNER t DATE OF INSPECTION: FRAME INSULATION;_ t FIREPLACE ELECTRICAL: ROUGH FINAL ,f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING' r` DATE CLOSED OUT :r ASSOCIATION PLAN NO. j s i OWNER AUTHORIZATION FORM T1* v (Owners Name) owner of the property located at Z -de Tf Ve (Property Address) (Property Address). hereby authorize (Subcontractor) J an authorized subcontractor for RISE Engineering, to act on.my behalf to obtain a building permit and to perform work;on my property. Owne''s Signat e h r y20 Date i "ACOR , CERTIFICATE OF LIABILITY INSURANCEFIV03/M13 DATE(MMIDolYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If.SUBROGATION IS 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 AME T Lora Lowe Southeastern Insurance Agency, Inc. P o Arc No wy (508)997-6061 439 State Rd. EaI Arc-No:(508)990-2731 P.O. Box 79398 ADDRE PRO CER - - N. Dartmouth, MA 02747 ME - - - (S)AFFORDING COVERAGE -INSURED INSURER NAIC# INSURERA: Arbella Protection Insurance Tupper Construction Co LLC INSURER AEIC " . - - INSURERC: CNA Surety 27 Roberta Drive INSURER D West.Varmouth, MA: 02673 INSURER E: - - INSURE-RF: COVERAGES CERTIFICATE NUMBER: 2013/14/1 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED.NAMED ABOVE FOR THE POLICY PERIOD' INDICATED:NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,.THE.INSURANCE AFFORDED 13Y 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." ADC Ue fl- - IL TYPE OF INSURANCE. IN3R VIVO POLICY NUMBER - am EFF MIW] �(P - -- LIMITS GENERAL LIABILITY - A 8S0000874 11/01/201.3 11/01/2014 EACHOCCURRENCE S 1.,000,00 X -COMMERCIAL GENERAL LIABILITY� � � � � - CLAIM"ADE a.000UR PREMIS Ea oowme ce S 100,00 A MED EXP(Any one parson) S S 000 PERSONAL a ADV INJURY S 1 000,000 . GENERAL AGGREGATE $ 2,000,06( rE EGATE LIMIT APPLIES PER: - G JPRO. LOC PRODUCTS-COMPIOPAGG $ 2,000, E LIAIDLITY /2014 .COMBINED SINGLE LIMIT TO - - - - . . . .- (Ea acadent) g . 5666240000 .1?J01/2013 12/01 1,000 0 NEDAUTOS - - - BODILYINJURY(Parperson) S - ULED AUTOS * _ BODILYINJURY(Peracgderm s._ UTOS PROPERTY DAMAGES(Peracadent) NED AUTOS _ - INC s S . UMBRELLA X OCCUR 46000S836 11/01/2013 11/01/2014 EACH OCCURRENCE g . 1,000 00 TR EXCESS LIAB CIAIMS.MADE :- - - DEDUCTIBLE . .. : : ' :1 000 00AGGREGATE RETENTION g S KERS COMPENSATION YIN. WCC500559301200 10103/2013 10/03/2014 XT MI X ERs EMPLOYERS`UAe1LITY STAU- OTFi-PRopRIETORIPARTNERIEXECUTIVE RICHARD TUPPER.CERIMFMBER EXCLUDED? N r AIman E.L.EACH ACCIDEYT $" 1 0�Vlea,desa In NN) I ELIDED FOR WC COVERAG E.L.OtsEAse:EA EMPLOYE s 1,000 00 . IF es,woly I B lender - "DESCRIPTION OF OPERA ,00 TIONS below * . . . . . . E.L.DISEASE-POLICY'LIMIT S - _ 1,000. O0 OESCRIP710N OF OPERATi0N81 LOCATIONS/VEHICLES.(Mftr*"ACORD 101,Additional Remarks Schedule;if mom space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BE DELIVERED 1 THE EXPIRATION.DATE THEREOF, NOTICE WILL EIIVE ED N ACCORDANCE WITH THE POLICY PROVISIONS. ,:Far Tnformation Purposes 061y Tupper Construction'C,O LLC - - - - AUTHORMED REPRESENTATIVE 27 Roberta Drive W Yarmouth, MA .02673. Lora Lowe . ACORD 28 2009l09 01986-2009 ACORD CORPORATION. All rights reserved. - } The ACORD name and logo are registered marks OfACORD i lsfUtWNi3 t+tie�-i�ItMAi4i:lG t1YiS i i t tf i f,tNC 11 Mass 'hasetts-De t 107i Awd.Suft :i0 + partment of Pubiic�Safety.. NY 1202p Board of i3uilding Regulatians and Standards (877)274-1274 n.rruru n "WIM'N IN,jr wwir.ppe(xxir �, license: CS969058. ` R)cHARD S TUB PIER - 79 s mw-TECH BR WEST YA.RMOUTH �3 T J sm Expiration tsffRfviR5E SM FOR OLe"Ttetssixnfxwannonaj S; Cor+xtussionef 92/31/2074 � ,. cz lAt L,�7�M�1�fl�e�♦ 7l1(iiii ,"... t�ffire ofCoasurner Af ain&6usinto ftiklatle Peopte Helping People 8gitd a Safer Wilil d- A= HOME IMPROVEMENT CONTRACTOR 3 t it� ` Raetstration: g Type: ° MERl13t:R % Explmtlon: t4. . individual r }n RiC14ARD TUPPER F. �Richard;Ttapper t -Tupper;Construction ' RICMARD TUPPER x € - t' 2$notierla OnvB Building Safety Professional tf W.VARML3UTN.MA 02618 w underxeeretary Member#;81581,19,° sExp 430/20'14 ' i The Common,3Veflitla of Masstachusetto. W� 4a Department of IiIdlisittad 4cctderits�d Office Of nve-ViioldtiJot78_ I Cotagf ess street,Saute 100 IV a3osaorz,MA 02114.-201 Jinv;4.nuass.govldia. Workers'Compengfltioer<Inguraraae Affidavit:Bu ders/C�tatz (Meant Informatian Ptease Print.Legibly Nainc(pu:;iness/Organization/lndividtial): Tupper Construction Co.. Inc Address: 708 Mid Tech Drive . C i�•/Stag/.7i� Wast yarrnouth, IIi'A.02673.' Pllone:#:(608)7 t8-0 i 11 - - 1.: _ i .Ai a you an employer?Check the appropriate boa — --- - �. l ain a employer,with 4. I,am u�encra contractor and I YPe of project(required)- ! . ztnplovees('full and/or pari-rime)Y'. have hired ilie scab-contracture 6. New construction _.[] I am.a sole prgprietor or paruur listed on the gteched sheet. ._0 Retnadelitig:_. shin and have no employees TlreSe;tt6-cr)iltractors.11aye. . . g_ Demolition .,vorkin- for me in airy t apacit_�'; ernpto�ces and hart:;rorkcr,' ! [No workers'comp: insurance IComp: insurance. 9• Bu ldine addition. rz<�uired:f 5.: 7:.We area Lorporatio��tttd-ita 10.0 Lleetrical repairs of idditiaits 3:.0 Tani a humeoknier-doing all.work officers fiate exercised 1;6e4r iI Plumbing additions iniself. [No wvrkLts,.comp. ri0Tht of 0,-ernpEion pc.\4(3L,: insurance re c uircd.'"' c. 152.§I(4 1211 Roof repairs ! r ' ), tall vvc have u� Lire°u5ees. [No woil,ers' l:i.[].OQt2f . . cOmp. instu trace required.) fin.•appticanc thnrchccks box s)I n,u,i eisaiiH uut tine s cLimi Ilanw shu'viiiy dwlrworkvrs,compcns:iiion poix in.'cm)atitsn, Homwwncrs who subnlu this iatidat it ir•(livaung they ai ininr,1 ll work and ilia)hire:mn i&cantracwrs must snbmn urocw a Friclavitindicating such: -(9nit�LtorS That check tliis box nnwsi.ntt,ichcd m additional Sneer stxnving the;rainr of ttie i40-contractors and siate w•t)cthcr or not Ihwc entities hart . 7i00,&kK Ifthc wb•contraca)r,hove enfplvyics.they 111113t provide Il4eir w.(ikia•s'cirmp..pniicy nkiniber: I aFn tin e1)1P10)'e,-that is Prot'iditia workers COI111)el2S!ltdOn trl$rdt'll11L'G' nr n11+err In ce¢ .Be1o4v it the irtinrrttutinrr: 1r . . Ia. .Y pnliiy a d.jirh site {nsurance Company Narne: AEiC Policy.#or Self ins.Lie.#: WCC 5QJ55030i 2007 F xpiratioil Date. job Site Address: 225 Little River Rd , - —City/state/zig. Cotuit MA 02635 �t4aeh a o>,�f of tree wri4 kee s' cvrnpensadon policy declaration t,agc (sliu�s'ing tilepU91Cy nuttibe3 and expitahun:date): F:ii1i ie ,secure covera-e as required ander.S&tioii;25A Uf RICrL c. 152 can lead:to the imposition a.f c frill;tl-penal+ of it ' h is up to S11500.00 o-inti/or one-year it 7�ttisan7xtent,ps well as.eic-il renalric.� ii>the fn>nt of a ;Q;a WonK.dRi7iR ia,id a fine tii u,�to 5250.00 a clay agttinsl'the 17t11atui. .Be advised ihat a copy.0 this statement 4nav be loraarded to the C)%lice of �n viestigatio>i,of t$e o \suranCe covera;e verification. i do hereby i cif rinde the lritls ltirlllselralttes n} erjtrty 111011u'inf0iMution prd t ideil ahrre rs;t4-ue und.co47 eci �i„naetu�: .12/18/13 Phone r:` .508-77.8-0111- . - .+�fier[Zl,use OtilV•.Do.1,01`r4 rite it,this.area,:to be eo1f2feted-Gy Citlt yr 2ort'n.offr•iu1, - J� ( City or Town: t _ i'er•nrf€!S.<icense $SGitin€T,Authority(drete one): S.13u3ic4 of Hcalth Z Build ing Department 3.Cit>.,Town Clerk 4.Electrical 7nspecto-r 5.Pininvtng Fnspecfor C tither ll 'Contact Person: t Phone#: � t TOWN OF BARNSTABLE CERTIFICATE izQ F OCCUPANCY PARCEL ID 054 002 005 GEOBASE ID 40175 ADDRESS 225 LITTLE RIVER ROAD PHONE COTUIT ZIP LOT 22 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 42651 DESCRIPTION .. . PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: THE BOND $.00 CONSTRUCTION COSTS $.00 i 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P:�C#i B MASS. � i639. A1� FD BUILD IN :I IS BY DATE ISSUED 11/24/1999 EXPIRATION DATE _1-TOWWOF BARNSTABLE BUILD1% .PERMIT :,- ',RCRL ID 054 002 005 GEOBASE ID 40175 i)DPESS 225 LITTLE RIVER WAD _ Pit COTUIT ZIP i3T 22 BLOCK LOT SIZE .A DEVELOPMENT DISTRICT CT T,RMIa 3537 �( D SCRIPtiON SIMGLR FAMILY MOME SEPTIC 140.99--262 � EMIT TYPE BUILD/ , TITLE Nz� RESIDENTIAL 13TZG PMT a_o. Department of.Health� Safe TRAG '®RS BAYSIDE BUILDING I �� ."CHITECTS: and Environmental Service ITAL' FVMSS: $357.43 = pk D s.6O ,per qi► r TSTRL3G ION COSTS $11.8;525,Off? �Y 01 qS1 I GLU; FAM .HOB�;`.T'. OHM 1. PRI VATT P' BI.E. +' r` MASS. 1 a. D MICI - BUILDING DIVISION BY, DATE ISSUED9�J� �`lDAB HIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN: 'ROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER;THE BUILDING CODE,-MUST BEAPPROVED BY THE JURISDICTION.STREET OF ,'LEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC P VERS MAYf`BE'OgBTAINED-FROM' DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS ?ERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDI'' 'JS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. i MINIMUM OF FOUR CALL INSPECTIONS REQUIRED i FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE,.SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 3 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED;SUCHjBUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. .00CUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. . 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD • IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS' PLUMBING NSOECTIONIAPPRO%ALS, ELECTRICAL INSPECTION APPROVALS-- 1 1 , �y? .. 1 • �. ?Cl °gyp. 2f ,A/Qz/wl� 3 _ 1 , HE ING INSPECTI A ROVALS -mot ENGINEERING DEP RTMENT 2 _ C='fJ- BOAR OF HEALTH OTHER: s SITE PLA EVIEW APPROVAL ��O � T � WORK SHALL NOT PROCEED.UNTIL PERMIT WILL BECOME NULL AND VOID W.CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS.NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS FATE THE PERMIT IS ISSUED AS 'OELN PHONE OR WRITTEN NOTIFICA- TION. NOABOVE. BUILDING.- , PERMIT e � q T Tow *Permit n of Barnstable C� D- # HERMIT Regulatory Services Thomas F.Geiler,Director 2013 Building Division OIL I Z//-7 s Tom Perry,CEO, Building Commissioner TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 ww-w.townbarnstable.ma.uu Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTLAL ,ONLY rr�� T�'wilhotrt Red X-Press Imprint Map/parcelNumber V� ProperryAddress Z Olt ZVvv �P n sidential Vahie ofWork S / < ��6 Minimum fee of S35.00 for work underS6000.00 Owner's Name&s Address t dhCNfL-1;?zVCJ6V\v -.— r Contraciar's Name ! 1�(a� C 1 6li ur N n. (, Telephone Number Home InVrovement Contractor L icense?I-. (ifappkab le) 063 1 Construction Supervisor's License#(ifappBcable) Woria a s CompensationInsvrance Check one: ❑ I am sole proprietor ❑,Pamthe Homeowner [� I have Worker's (ensation Insurance Insurance CompanyNarrr 3fafp In-Suravi6e Col. Workr an's Conp.Policy# W o I . Copy of Insurance Compliance Certificate must accompany each permit. Pern*Request(check box) Re-roof(hurricane nailed)(stripping old shades) All construction debris wAlbe taken to ❑Re-roof(hurricane nailed)(not stripping. Going over - existing layers ofroof) ❑ Re-side ❑ Replacemem Windows/doors/sliders.U-Value .35)4 ofwindows n ofdoots~ ❑ Smoke/Carbon Monoxide detectors 4 floorplans marked vvith red S and inspections required. Separate Electrical&Fire Permits requind. *Where required:IssL=e ofthis permit dots not exempt convIia=e wah other town departmeatregulaziam.ie.Historic,Conservation,etc. **Note: Property Owner nmstsignProperty OwnerLetterofPermission. A copy of a Home Improvement Contractors License&Construction Supervisors License is required: SIGNATURE: C.\Users�decoM,AppDataNLocat,Microso:ft\aidowslTemporaryTntrraaF21es\C=e33tOuthokNER76BDZrAMXPRESS.doc. Revised 061313 t W =° Fraser Construction LLC �19CONSTRUCTION � P.O. Box 1845, Cotu t MA. 02635 ROOFING SIDING Email: info-@fraserconstru-ctioncapecod,.com www.fraserconstructioncapecod.com 5�8-4Z$-Z292 FAX 1-508-428-0123 HICL#112536. CS#97668 RE-ROOFING PROPOSAL ADDENDUM 1 DATE: November 11,2013 PHONE: 908-605-0343 NAME: Richard Brochu EMAIL: thebrochus@hotmail.comJ MAIL ADDRESS: JOB ADDRESS: 225 Little River Rd. Cotuit, MA 02635 ,1 ERASER CONSTRUCTION hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. FraserConstruction will include a 4 Star Upgraded warranty with the selection of any 30 year shingles or any Lifetime shingles. CertainTeed SureStart Plus- The extra measure of protection when a credentialed . company installs an Integrity Roof System. 4 Stag wa rra ntieS have a 50 year Non-Prorated Coverage for any lifetime shingles, which will cover incase of any in warranty repair, Labor and Materials, any Tear-Off, and any Disposal Fees. Upgraded wind warranty available on the following products when special application methods are used. See description below and in the CertainTeed SureStart plus brochure enclosed. 1 f ASK US ABOUT OUR OVERHEAD CARE CLUB! Supply and Install - CERTAINTEED LANDMARK PRO: Lifetime Warranty CLASS A FIRE RATED, ALGAE Resistant,.Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15 Year Warranty against ALGAE Containment. Landmark PRO is engineered to outperform ordinary roofing in every category, keeping you comfortable, your home protected, and your peace-of-mind intact for years to come with a transferable warranty that's a leader in the industry. With Max Def colors, a new dimension is added to shingles with a richer mixture of surface granules. You get a brighter, more vibrant, more dramatic appearance and depth of color. And the natural beauty of your roof shines through. With a SureStart Plus upgrade customer will receive 15 year 130 mph wind-resistance warranty with six nails in common bond area, Fraser construction includes six mails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: MAX � Mb( &PRICE-$14,975 Initial Price includes Ice and Water on entire low pitched back Dormer and right side addition in preparation for solar panels. . * Price includes removal and reinstallation of Gutter Helmet.. * Price includes removal of rotted section of Rake Boards and installation of Azek PVC using Cortex Hidden Fastening System. Approximately 10 lineal feet. * Price includes removal and installation of Azek PVC on trim in problem Cricket area on back addition tie into main house. Product Installation .Details Supply 8y Install- (Soffit Venting) Hick's Ventilated Drip Edge or 2 f 8" Aluminum Drip,Edge with existing.soffit vents. Smart vents over white drip edge. Protection against damage.to the roofing materials and structure. The most effective system is a balance of air intake and exhaust that creates a uniform flow of air through the attic. This system creates a condition in which the roof temperature is equalized from top to bottom, supplying a uniform air flow along the . entire underside of the roof deck. Supply & Install- CertainTeed Winter Guard or Carlisle WIP: (Ice & Water shield) ( VIP- Water & Ice Protections) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) Water and Ice Protection (WIP) is a self-adhering roofing underlayment used on.critical roof areas such as eaves, rakes, ridges, valleys, dormers and skylights to protect roofing structures and interior spaces from water penetration caused by wind-driven rain and ice dams. WIP may also be used as covering for the entire roof to prevent moisture or water entry: Supply & Install- Surround Underlayment.(A Typar Brand) A smart alternative to felt, it is water's toughest opponent, creating a secondary water barrier that reduces the incidence of leaks caused by storm damage, wind-driven rain, ice dams and worn roofing materials. It is a waterproof, synthetic polymer material that will protect your home against moisture intrusion. Supply& Install- CertainTeed Swift Start 3 With self- adheringasphalt star p ter course on all eves, and rake edges. CertainTeed requires this product for Integrity Roof Systems and upgraded wind warranties. Supply & Install-Aluminum & Neoprene Soil Pape Flashing Supply & Install- Ridge Vent - Shingle Vent II High performance ridge vent with external baffle. (As recommended by CertainTeed) Supply & Install- Pre-Cut CertainTeed Hip & Ridge shingles Shingle Ridge meets the hip and ridge accessory requirements for the CertainTeed Integrity Roof System which is comprised of underlayment, shingles, accessory products and ventilation all working together. The Integrity Roof System is designed to provide optimum performance--no matter how bad the weather conditions are. (As recommended by CertainTeed) Clean & Remove - Debris from work area daily. Additional Work 1) Remove and replace of White Cedar shingles on front facing Cheek.,Install Ice and Water underlayment up vertical wall and install Copper Faced Step Flashing. Price: $325 Initial: 4 Additional Work A4 Lau, Roof over shed b W rt�01 Price: $200 Initial: PAYMENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION. 1/3 initial payment, remainder to be paid upon completion. All above pricing includes tax and permit Payments accepted are: CASH - CHECK- MASTERCARD -VIS -AMERICAN EXPRESS *Any payments not immediately paid upon job completion wi arge . o ery day after the given 5 day grace period upon day of job completion. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to,the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour, plus 20% mark-up materials. FRASER CONSTRUCTION Warranties the labor for LIFETIME of roof. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 15 years. 6 CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: l I (3 4 500 Homeowner Fraser Construction, LLC f ` ,��:�I_`, �IZ.P �(_?.!lrl•J1.r r?2CCif�C�t'If� G• ' NA `�='=' b ,L Office of Consumer Affairs and Busine'ss Regulation = 'i'Fa= _ I0Tark Plaza - quite 170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 112536 Type: DBA FRASER CONSTRUCTION CO. Expiration: 323l2015 Tr—" 237ass DEAN FRASER P.O. BOX 1845 COTU IT, MA 02635 Update Address and,return card_Mark reason for change. s`;4' a �r s�;:, G Address Renewal [I Employment Lost Card Officc of Coasumer (rq�&gam Rc6uLltion License or registration Valid for indirvidul use only a.--t,FiOM=1MPROVEMEW CONtTRACraR before the expiration date. If found return to: g " :�2 istration_ Type: Office of ConsumerAf i s and Business Regulation `� :;Expiralian: 323/2015 DBA 10)Park Plain-Suite 5170 -. Boston,MA 0-.116 ERASER CONSTP,UC7ION CO. DEAN FRASER 104 TwtNN VlEV1!LAME �� 1 E FALMOUTH,MA 02536 Uadersecretary Not valid w' ithaut signature � •' UIF Massaci�usett5 -IJepa�#ment of i;•ut•�iic Safety Board of Building Regulations and Standards Construction Salmrrisn[• i License: CS-097668 MAN C FRASER-` 1041`WAVN MW EAST FAzmLOUAR#y A,� r_rpiration Commissioner 06/07/2015 FRASCON-01 PAAS �- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 911912013 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOL DER. 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 508 676-0309 CONTACT Viveiros Insurance Agency,Inc. ( NAh1E: Ashley PalYa 375 Airport Road a�cN o Exr: 508-576-0309 127 rP (AIc,No>: 508-324-9147 Fall River,MA 02720 ADDRESS:APaiva Viveirosinsurance.com INSURER(S)AFFORDING COVERAGE NAIC R INSURER A:Granite State Insurance CO INSURED Fraser Construction LLC INSURERS: PO Box 1845 INWRERC: COtuit,MA02635 FNSURERD: INSURER E: INSURER F: - COVERAGE$ 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. NOTIAIITHSTAN DING 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 LTR TYPE OF INSURANCE IN R VWD POLICY NUMBER MIDD MM(DD EXP LIMBS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE MED EXP(Anyone person) $ PERSONAL&ADV N_IRY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COtAP10?.AGG $ " POLICY I PROECT- LOC AUTOMOBILE LIABILITY M I SIN LMI Ea accident) $ AL '" BODLYINJURY(Perperson) $ ALL OWNED SCHEDULED AUTOS AUTOS BODLYINJURY(Per accidenq $ HIREDAUr05 NONAWNED AUTOS Per acciderU A A .. $ UMBRELLA L1A6 OCCUR EACHOCCURRENCE $ EXCESS LiAB CLgIMSMADE AGGREGATE $ DIEDRETENTION $ WORKERS COMPENSATION T $ YfN ORY LIM I TS AND EMPLOYERS'LIABILITY WC OTH- IM ER A ANY PROPRIETORlPARTNEREcXECUTIVE WC009930601 9/26/2013 9/26/2014 OFRCERIMEMBER EXCLUDED ❑ NIA E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) V yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION Or OPERATIONS below E.L.DISEASE-POLICY LIMA' $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable.Building Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601- AUTHORIZED REPRESENTA nVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05j The ACORD name and logo are registered marks of ACORD y— fire Cornnzo.awealth 0f Massachusetts —� Deparlment of Industrial Accidents 0,7fce o�lrvestigatio, c -- 1 500 Washington Street .Boston, A 0211.1 mass.gov%dia Worker•s compeusation.ftlsmrance Affidavit:Bailders/Contracto.s/Electrieiamsfpiiimbers Applicant Information Please Print Legibly Name (Business/Organization/1ndi-,idual): f Address: - - city/state/zip: ,� oa c�35 Pho 601 - a�- xl.e�#: 2W4� .Are you an employer?Chwk the appropriate box. Q n Type of project(required.): 1- L'�J I am a employer with_D __ Ll 1 a a general contractor and I have 5. lea, - employees(full and/or art-time'.,- hired the sub ccLsCaehon P� 1 or,tracEors list d on Remodelin 7, g 2. the t�zd>siieet ❑ b 1 am a sole proprietor or partnership These sub-contractors have 8. Demolition and have no employees wotldng for employees and have workers,comp. 9. Building addition mein any capacity.[No workers' insurance.$ comp insurance required.] 5.E We are a corporation and its 10•❑Electrical repairs or additions nn officers have exercised their right of 11 Plumbing repairs or additi ons 3 L_I I am a homeowner doing all work exemption per MOL c.152§(4),and 12.Q Roof repairs myself.Mo workers'comp, we have no employees.[No workers' insurance required] comp.insurance required.] 13.❑ Othe" *n y applicant that checks box Tl tr.Lst also fill out the section below showing their w rkers'.comperrtion policy i orrsuiot. 13oneonners who submit:his affidavit indicating they an doi:g all work and then hive onside contractors must submit P new afGdavir indicaen�S. Con tractors that ebeck this box must attach au additional sheet showing the name of the sub-contramo.-a and state whethe±or not those anti5as have z1oh' .;f the sub-coa=tws have anployees,they ntrst provide brir:�otkers comp.policy number. I ant arc employer that is providing tivorlcers'co rnpematfon insurance for my employees.Below is the policy and job site irzforrtuttiort_ Insurance Company Natne: ,�1In o Policy Y or SeL ins.Lic.ih ��f V�C D , �/ Ezpkration Date. Job Site Address: ZZ�l�7I[ IG%11�� potyJte!ltp: — ^�— Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirafioII date), I ai!uze to secure coverago as requirrd Lncer.Section 25A.of MOL c.152 can lead to the imposition of crnminal one-y ar itrsptisonn,eat,as we31 as civil peaaltics irr the form of a STOP WORK ORDER,lid a fine Of an to$256 CCO Hof a fino up to$l�o(I.QQ antL'ar that a copy of this std e-ment may be forwarded to the Office o_Investigations of the DIA for insurance caverPge.v mast tue violator.Be advised .16 hereby certif- the 't vialties of perjury t3cat the information r vided/above is true and correct. Signature: Date: Ph3one#: 02 j Official use only.Do not write in this area,to be completed by city or town official I City or Town: Permit/License n Issuing Authority(circle one): t 1.Board of Ilealth 2.Building Department 3.City/Town Clerk 4.Electrical Ins J 6.Other pector 5.PlumbingIn spector J� Contact person: Phone : r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -Parcel Oaa OQ� "A_ Permit# Health Division ii e �t� � ` r " Date 4ssued 1� Conservation Division _ WiTH T1 Fee 367 y3 ENVIIRONMENT AND Tax Collector SOWN RED Treasurer Planning Dept. + Date Definitive Plan Approved by Planning Board v �' ✓ S.v`P/��`j Historic-OKH Preservation/Hyannis tot ..� Project Street Address 4/7-4,F— R_ I VjgX, L) Village CO Ty. /T Owner 1521C 0 /J555LF1e- Address 74 0,-*Y5,(D6 OLDC Telephone Permit Request •/U 60415 TIQ647 S/AM,3 l4 -F99_M/11 Y Square feet: 1 st floor: existing proposed AMP, 2nd floor: existing proposed 3 Total new-2/,S 5 Estimated Project Cost 5 Zoning District R f' Flood Plain Groundwater Overlay Construction Type_6000,6 FRAME 'Lot Size /,(SSAC d 3 W64Mn Grandfathered: ❑Yes 2'90 If yes, attach supporting documentation. Dwelling Type: Single Family &(' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 4K On Old King's Highway: ❑Yes QlkNo Basement Type:. C9'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) / 6 a?, Number of Baths: Full: existing new Half: existing new / Number of Bedrooms: existing new -3 Total Room Count(not including baths): existing new :Z• First Floor Room Count Heat Type and Fuel: ©"Gas ❑Oil ❑ Electric 0 Other' 4 Central Air: 2<6s ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes dN0 Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ( new size�tyxa3 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 11 o If yes, site plan review# Current Use V RCAN7' L 4 T Proposed Use 5/'r,FA/C4_:7 BUILDER INFORMATION Name-. Telephone Number 77/ — /D`lh Address License# DQ S6 VS- C _X)TF/Z V IUZ' 44 A Oa?43.�, Home Improvement Contractor# Worker's Compensation#7C 9 O/J V lV I Q'/( ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ,30119 f_ L1N2t 11_L - SIGNATURE / DATE FOR OFFICIAL USE ONLY _ PERMIT NO. 3 c A DATE ISSUED MAP/PARCEL NO. { ADDRESS VILLAGE OWNER - . DATE OF'INSPECTION: FOUNDATION FRAME INSULATION j. FIREPLACE .r r ELECTRICAL: ROUGH -FINAL L. ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 2 DATE CLOSED OUT ASSOCIATION PLAN NO. r' ' '4l S L. J TTL� �� v'r Imo) i U t CERTIFIED PLOT PLAN THAT THE FOUNDATION SHOWN ON THIS IS LOCATED ON FOR THE GROUND AS SHOWN HEREON AND 225 LITTLE RIVER RD., COTUIT, MA. THAT IT CONFORMS TO THE MINIMUM LOT 22—LCP#17287 E BUILDING SETBACK REQUIREMENTS OF c THE TOWN OF BARNSTABLE. PREPARED FOR BAYSIDE BUILDING INC. `o% �" � Y SCALE: 1" = 60' AUGUST 12, 1999 � 'Ma ` Weller & Associates v- 16 -Ci 1645 Falmouth Rd. —Suite 4C Centerville, Ma. 02632 (508) 775-0735 G G 9 G 9 si, G # G D G �zz G y G y G y Western Surety Co ; G y G y G y F LICENSE AND PERMIT BOND G y G For County, City,Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract, ; Performance,Maintenance,Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. G y KNOW ALL MEN BY THESE PRESENTS: BOND No. L&P- 4 291 48 7 5 G 6 That we, —Ba)tSi rla "Building, Tnr, of the vi 1 1 ggp of Centerville , State of NassaEl}usetts , as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do business in the State of MaGGachuset*� , as Surety, are held and firmly bound unto the Town of $arras tables , State of M..r,_r.,Phu .�— , Obligee, in the amount (Valid only when a County, City,Town or Village is named as liOb gee) of Rix HiinrlrPrl and 00/100********* ************** * * **DOLLARS ($6 00. ), (NOT VALID FOR MORE THAN$25,000) lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed to ronStritrt a single family d` allinsat 225 Little Riv ei- Read, Cotuit, MA 02635 150 feet fr-enta�o by the Obligee. NW , FORE, if the Principal shall faithfully perform the duties and comply with the, laws and orc �z ,(a all amendments), pertaining to the license or permit, then this obligation to be void, o� vu�"`set a �� n full force and effect for a period commencing on the 10th day of _ •.aY , 1999 , and ending on the loth day n May I , 2000 , unless renewed by continuation certificate. bi 1bgn ayq.b "rminated at any time by the Surety upon sending notice in writing to the Obligee and to Ae 'r c1 1, in ca "f the Obligee or at such other address as the Surety deems reasonable, and at the expira- tioi� tY- days from the mailing of notice or as soon thereafter as permitted by applicable law, which� es r`this bond shall terminate and the Surety shall be relieved from any liability for any subsequent acts or omissions of the Principal. Dated this 10 th day of May 1999 Principal Principal Countersigned WESTERN S U E T Y CO A N Y F 7T G G f B B G y Y Resid t gent President G G G G AC EDGMENT OF SURETY G STATE OF SOUTH DAKOTA l (Corporate Officer) ; County of Minnehaha f ss On this day of ,before me,the undersigned officer,personally appeared Stephen T.Pate ,who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY,a corporation,and that he as such officer,being authorized so to do,executed the foregoing instrument for the purpose therein contained,by signing the name of the torpor 'on by himself as such officer. ; R IN WITNESS WHEREOF, I have hereunto set my hand and official se G J. RHONE T NOTARY PUBLIC SEAL SOUTH DAKOTA sL otary Public, South Dakota G My Commission Expires 6-12-2004 Western Surety Company • 101 S. Phillips Ave. G Form 849-A--12-97 `'0'��`'y ��'�� + Sioux Falls, SD 57104 • 1-605-336-0850 d Ili L F c ll ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) ; F 9 F STATE OF F ss County of F a F ' � GOn this day of ,before me personally appeared f G 9 F F G � F F J F u e l id i r known to me to be the individual— described in and who executed the forgoing instrument and G G ! 9 acknowledged to me that_he_ executed the same. F G F My commission expires Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) STATE OF ss s County of On this day of ,before me, personally appeared , who acknowledged himself to be the of , a corporation, and that he as such officer being authorized so to do, executed the foregoing instrument for the pur- poses therein contained by signing the name,of the corporation by himself as such officer. My commission expires Notary Public r• F F ` F r � I I f I F I � n n a n F .Ui G o qA n F u F G Z 7� a 'y 0 G C: O Z z 46 9 fi PA b 4 U C 4. ' a f rn w -d F , 6 f ft DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted To: 11 BRIAN T DACEY 61 fERNBROOK LM CENTERVILLE, MA 12632 l 0170 Restricted To: 11 i BB - 35,111 cf enclosed space I (M6t C.I12 S.61L) 1A - Masonry only 16 - 1 6 1 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. COMMONWEALTH OF MASSACHUSETTS -- _-c DErAI( MENT OF LNDUSTRIALACCIDENTS 600 WASHINGTON STREET ames Car-=e1; BOSTON, MASSACHUSFM 02111 Cor-:'nasicne• WORKERS' COMPENSATION INSURANCE AFFIDAVIT 1, Oiccnscr/permincc) with a principal place of business/residence ar: (City/Snrc/Zp) do hereby certify, under the pains and penadties of perjury, that: 1q/1-2m an employe: providing the following workers' compensarion coverage for my emplovecs working on this job. Icq oa lq/ /6y / Insurance Company Policy Number [ � 1 am a sole proprietor and have no one working for me- [ ) I am a sole proprietor, gent:-] contractor or homeowner (circle onc) and have hired die contractors listed be:cW who have the following workers' compensation insurnce police: Y S lICi� v le- bAC16 IAA T C. 'q( DO / �1 / �� `0 Name of Conrneror Insumnee Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contactor Insuranec Company/Policy Numbc: 1 am a homcownc. performing all the work myself. NOM Pleuc be aware that while homeowners who employpersoes to do maintenance, construction or repair work on dwelling of not more than three uniu in whicb the homeowner also resices or on the grounds appurtenant thereto are not generally considcrecr to be ernplovers under the Workers' Compensation Act(GL C 152,sect-.1(5)), application by a homeowner for a licecsc or permit may evidence the Icgal status of an employer under the Workers'Compensation Act 1 unde-st:.-id that a copy of this starement will be forwarded to the Depar^er.:of Industrial Acddena'Ofnce of Insurance for cove::_: vCr.-ic;;ion and th;t failure to secure coverage as rc9uircd undo Sccdon 25A ol-.MGL 152 can lead to the imposition of criminal per.z:a consisting of a fine of up to S1500.00 and/or imprisonment of up to one yc:and ciQ penalties in the form of a Sto;Work Order a-.c : fine of S 100.00 a d:v 2g2ins: mc. Signcd this dry of , 19 -T f31014 AI 7. F� Lic--:iscc!Pcrmirtcc Lice:rsor/Purnicror r e SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 WELLER & ASSOC: (L) NAT'L GRANGE MUT.- MSP45246 EXCAVATTON & SEPTIC: ROBERT J. OUR (L) U S F & G - 1MP30109550901 (W) U S F & G - 771521_695 DECO CONSTRUCTTON (L) TRAVELERS - 660364IC8342 (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS : ROBERT DORRER: (L) TRAVELERS - W680526K991TTA9 (W) AETNA - 006C0023972416C „ MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CIIAVES ELECTRIC: (L) HANOVER INS. - LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: I3AT.'PTC SECURITY: (L) FTRST FINANCTAL - FF0131 G400831 (W) COMMERCIAL UNION - CB07.43379 CENTRAL VAC: VACUUM MOUSE: MERRIMACK MUTUAL - SBP1608045 INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442 14 & R CARPENTRY (L) MARYLAND INS. GRP- SCP30235965 (W) CIGNA PROP & CAS.- C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PATNTING: CAMPBELL PAINTING: (L) TRAVELERS - .168025IK4083COF (W) AMERICAN POLICY - WCC 186604 GARAGE DOORS: ALL CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301. (W) COMMERCIAL UNION - CB11573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA - MPOO2101-4146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 TILE INSTALLER: TONY AVERTNOS : (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING: CAPE COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS : (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 w c/ MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 . 0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-7--1999 DATE OF PLANS : 5/6/99 TITLE: GIESSLER PROJECT INFORMATION: LITTLE RIVER RD. COMPANY INFORMATION: BA.YSIDE BUILDING, INC. COMPLIANCE: PASSES neauired UA = 535 Your Home = 464 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA -- ----------------------------------------------------------------------------- CEILINGS 1500 30 . 0 0 . 0 53 WALLS: Wood Frame, 24" O.C. 2828 19 . 0 3 . 0 149 GLAZING: Windows or Doors 489 0 . 350 171 (';LAZING: Skylights 22 0 . 600 13 DOORS 21 0 . 350 7 FLOORS : Over Unconditioned Space 1500 19 . 0 '71 COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building., and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found _-n the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in ;sections 780CMR 1310 and J4 .4 . B,Uilder/Designer Date _` r MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 GIESSLER DATE: 5-7-1999 Bldg. Dept . Use CEILINGS: [ ] 1 . R-30 Comments/Location WALLS: ] 1 . Wood Frame, 24" O. C. , R-19 + R-3 Comments/Location WINDOWS AND GLASS DOORS: ] 1 . U-value: 0 . 35 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location SKYLIGHTS : 1 . U-value: 0 . 60 For skylights without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: i J 1 . U-value: 0 . 35 Comments/Location FLOORS : [ ] 1 . Over Unconditioned Space, . R-19 Comments/Location AIR LEAKAGE: ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type. IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0 . 5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors . MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building• plans or specifications . k' DUCT INSULATION: ] , Ducts in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-8 . 0 . _r DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts . The HVAC system must provide a means .for balancing air and water systems. TEMPERATURE CONTROLS : [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the. heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS : Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . ---NOTES TO FIELD (Building Department .Use Only) ----------------=-------- - ry 4 TEST HOLE LOG • DATE: r SOIL EVALUATOR: WITNESS:_ PERC RATE:._ Z 1 f i.0mcw y r Z 2. o 57; o �� 3" o 0 Z.:ry ; 9y z,.5r y * G� /E- Y C Mao. .59•+� iytrA�S�tO Aw DESIGN DATA DAILY FLOW: (3)BDRMS.z 110 GPD=-330 GPD SEPTIC TANK:3,3o GPD z 200%a "-0 GPD USE:/.So o GALLON PRECAST SEPTIC TANK LEACHING FACILITY: USE: . X8._SXZ� CAPACITY: s ,p,P f I _ • o�� s4c SIDEWALL ._ Z X o X /Z .--- �� BOTTOM' W • o N .. TOTAL::-" •j 5.3..0_. .. °err,• ... �.d8 _, Cl C. f/l1c>cr-.�o TbV 4a S_04._5,l. r_�E ,9 C o •- ---�- _ -` - -- --__ . _ .__.. _.- . ��_-... - - - _ _ • .� .. _ .� �. ��i� ,cam�`,�,.� �� i NOTES: l 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. 2. PIPE TO BE LAID LEVEL FOR 2'OUT OF DISTRIBUTION BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 6"OF FINISH GRADE. 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEE. 2•LAYER OF 313'PEASTONE OVER 3/4•-1 1/2•WASHED STONE ALL AROUND TOP OF FOUND. eke 38.a . Z,�3y3 ZS 3G•oa 17 SEPTIC SYSTEM PROFILE SITE SEWAGE PLAN GENERAL NOTES ; FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR [DbATE: /TTG �/1� Z �.O CaT'v/T" TO ANY EXCAVATION OR CONSTRUCTION. Z2.CGf � E �� Z-S 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH PREPR 310 CMR 15,00:TITLE V, 0 YS��U 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. .-,jl�l_A�_/J�/y^9� SCALE: ' f�S._�aT_.�7o, S. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQU I INSPECTIONS. • ��,\SH Of�y,�9 , A IEL E. �yGN � CIVILv No.32666C y A��(�•C a�O�tQ' " } WELLER & ASSOCIATES _ FT1645FALMOUTH ROAD CENTERVILLE, MA. 02632EL: (508)775-0735 FAX: (508)775-0754 . APPROVED BY: � _Ell Tf/ .�.• /i-tea o ;'� ,DC-<A �l T ....� D p a J. o oe a �1v � �l A -Q%-u/AIVQL.JM GIlTT07i �-LEAO�Rs It i I II �i •' L I'I L ;i , , ; I. . I I I -- i --- -- — _ AI tvA1NU/A..-GUTTE _l-EA.Q.EfL°i FF - - --- if I;Li Ic - J SAY S i o E ,'S u I L I7-1.N.CS".�d..1A1G . I I rL_erzv.LL.L E- tZ N. 4 ELEVQT l.c�N SCALE: APPROVED BY: DRAWN BT DATE:IG ✓O REVISED ...1 O - -- - - - - - --- - -- - -I- - =.-- --- -- -- - ---- -- -- - '- 4MAWtNO NUMBQI SL1nr5'E.VENTS Z i I IN, \ � ' ASP"At-T 2oap.__5ut$►&L o G2o♦ /A00t.0 1 N C.-.o1.)_1 x 0 x '�\ Li _A)-Utn,_G u r--re-U.:_lr-Lc&CLw- of L t . 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F'po;rA)Cs4 SECTr o IJ rro 4 0•' To/nIP Ki N,.�3 .. . 158- _33 •Is l ` i� • , I 5 -z'�`� D E S I G N ENGINEERING & SURVEYING www.bssdesign.com BSS Design, Incorporated 164 Katharine Lee Bates Rd Falmouth Massachusetts 02540 508.540.8805 FAX 608.548.8313 LOT 10 cn 39I- 4 E , I••v L 0r _ (0 Z 0 = C) o N Q U z lop, ;AXIS LOT 9 cs `t�IMMIN of � J 6 0,43 9 S F �- cn Of Q R w _ 197.9' (1 . 39 AC ES) GAS 0 METER — p EXISTING y J w ` � 0 PATIO F J w SEPTIC SYSTEM / c G Q PER EXL,TIN INSTALLERS / PORCH HG�JSEOf n _I Q w CARD 234 Jz 0 155.4' �-- 168.E W � z,. EXISTING 32 E L.e Q ry 2 .� . .�t,i�fDH iiG�iS � Q� W _ w LP SHED N � � a? � O ' O t0 O LIJ . O O? Z LL 2 1 Q _ 'f E N7 8 2g scale -� LOT 8 1 3 0 date I CERTIFY TH THE STRUCTURES ARE LOCA N LOT AS SHOWN. JAN 7 2014 2 9 o 'I � �v � drawn 5• ti �SOaj' 2 6 � BUNK>rR � TJB EJP NO. (J5 . PROF SIONAL-LAN .SURVEYOR checked r� 5 ISM Q 8 Zo t � �� DATE: Nq L L ANC ,,. job number 13014 NOTES. revisions 1. LOCUS IDENTIFICATION: HOUSE No. 234 LITTLE RIVER ROAD ASSESSORS No. 54 006 005 LOT 9 PB 485 PG 61 2. LOCUS IS WITHIN: ZONING DISTRICT: RF FLOOD ZONE: C BUILDING CODE WIND EXPOSURE CATEGORY: B LEGEND AQUIFER PROTECTION OVERLAY DISTRICT PROPERTY LINE �- NATURAL HERITAGE PRIORITY HABITAT PH401 (PARTIALLY) ) 3. LOCUS IS NQ1 WITHIN: WIND—BORNE DEBRIS REGION EXISTING STRUCTURES ZONE II OF A PUBLIC WATER SUPPLY 4. LOT COVERAGE BY STRUCTURES: EXISTING: 2,309 SF, 3.82% 0' 30' - 60' 90' SWIMMING POOL: 611 SF, 1.01% 5. SEPTIC SYSTEM WAS DRAWN AS OUR INTERPRETATION OF AS-BUILT SKETCH BY INSTALLER. drawing number B21 -36 CPP