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HomeMy WebLinkAbout2250 FALMOUTH ROAD/RTE 28 j f . 1, Q it rd [��f t, it ./ �,7r. Yy�,�}`7T""�" ()�,,,,.,y.; 1 xi '�� ;p' e,„ r.}/..:;:. t, ,d,": ,. ',ry'/'lr��t tJlr i rrEtB ,Y F f'1) "err rvi P � M � " 1 - } a io k p �y RY J 1.r -.t.kr «Nk�.�; n ,„ .' :d.,'�.4.i'� ;d ',. , .,,N r. .d, f ,,H yn r.�, 'rt t e�. r h�rG: ,Y• :': i"(}' `!/w' y' fi'. ._ 0 t E iP ,N r,�r u d, 4 , �kx�;`I Ji . P., td a y::„ a �►,w J.1 �_'` .1iJ1. . .� "t"t�J � a , „ I, L ,tM ,..x. .qni n - .. ,g'.� '�,g.'v: �� m{ ,n" ."AN'�°�dSW �y •'•G7, tr � g�fl1, �r4 a kd I. I . " r, r f �b1Lti � fit.' f r �s aa,�p xi : a r r r � 4 ,5,' .Ar rn ,y, ,t.' .i+}i t ,nl., i .e �.,, t, y t, q. l r v '- •. }` r tir J.''= ', ,Yl :.�; '"fl'.. �i�. r. -+r�.+{ "Dy, c ❑a m '�i'p r ,J n,1i. 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'il i ,d s, 4x ' Y'-' 11. rr t, it I k r ,, + v', ! y A 1 n ,`o i : t k' 'I y N: t 7} O° NOW 1'r ,A 1 Ir �gvYYit 1'. qh r, d, -,l y� ry t i 9A, 'i L ,k� ,� A�t ..1E i' C.�: {ii _ i 1t ,'d:04 tiRAW: 'J^. J11t AAil ''! :r �j 1 4 r'' 1:1, �I' { G „2 J• s s11 n l `'' fl Si .rt.r '�. wf!1 1 ''�; 1.1t p n i1. 4:� ���- d f ` + :i S i a i 5',.1- 4 - dD, k -,i: .- , 3 .z+.. F•.' itt i ,,� r ;h:�, .1" 11 ;ll , 4 '' i it 0 fl r .: ,'.:. , x f/ t .k,, i :,:t i t..�:.; r i.ifs .,t:. t1 J ,rN. {x, J�, 4t' _ n ..n �5 Jiii E.11'1,�� "" t} F ...I': ,1, a" ,1 ;'.T r' t1 '',<A /rJ ,'h.; °r :$,`ri k. 'A A i e tl ":'f, �'. J lid 'D� too! A C�v :.7• �f'#tl F 'y r'"• , . x. .. , t 1 r ,: r //z' Town of Barnstable Re: Transfer of CSL License ` Dear Building Official: We appreciate your willingness to continue working with Vivint Solar as we move to become a more operationally efficient and quality driven organization. As our landscape changes, so too has some of our organizational chart. In meeting these changes, we respectfully request to transfer the license of our former licensed construction supervisor David Precourt on the following permits as he no longer is working for nor representing Vivint Solar as of 4/8/2016. In replacement of Mr. Tobin construction license, we would like to continue operating in compliance within your jurisdiction under the following attached license. Mr. Emmanuel Mello III will be taking over the permits. 2250 Falmouth Rd Centerville B -16-688 Again, we certainly want to thank you in advance for your support and Understanding. Please feel free to contact me directly if needed. Jeremy Sabin Director of HR Vivint Sow.-;;;;;" Brendan Smith VP of Operations Vivint Solar. . s €ffic off' Cons er �. a �s ������� ��� e ����a,� q' 10 Par Plaza Suite 5 1 70 Boston.,, Massachusetts 02116 Home Improvement Contractor Registration R`eg�f�clra�fii 1I THTB'�� Type-: Sw!pOewment Card Expiration: 115 2013' CGIVGNT SOLAR DEV LOPER LLC.. EMMANUEL MIELLO • f&gd:asle r���ses����retat��r�e ;tl.�a9r�.u�easrnn?.€q�c�i�a�t�:. • SrA n a mstn� t Adder �I i wat Ell,E'mployme€t G_Lost Clard /�%i7(% �,rygF/T:�.hr ure:C<=Ldit.��! 7�i�zJlfi✓d7,r¢<.� - - . - lrue of ass sres Afl irs Business Reg de6on tieensew registration wand for kdwi6d we usly E NPROVEME:NT COWTRACTCR Woffe the expiratxou dale- If iemad return tw: Office of Consumer?kllfait s and gasiness: egti io:n 7 FPi�toatltrre: 374S9 Type:,. 1ar 'Gaaa-Suite 3170. :n Expiratan: F 5p0-,8'' S'uppiementC—,-rd V1VtNT SOLAR DEVELOPER,LLC. r fI EMMANUEL MELLO i ✓ .� /° 3301 N THANKSGIVING WAY SU1 w z ✓`� :✓�� i �'�1j// "'�/�.�- IIE`1JT84043 �;A/ rr�f'� f�'�`.�, ✓ �� Undersetretaa-y '4r=,`vafid without signature ., 12 Thompson Rd Webster MA 01570 www.RRPEPA.com 508 826.5757 19 Massachusetts -Department of Public Safety Certificate of Attendance and Completion , ctiCll#1 her Renovator per 40 CYR part 745.22 Board of Building Regulations and Standards # Lead-safe Renovator-supervisor SUBEt viSO ,ua Emmanuel Mello III License: CS-065607 endefle Rd. t Jefferson MA 01522 EMMANUEL T 1VPL =' - :` Coarse&Exam Date:04/1715 P®Bog 326 1 Expiration Date:04/17/20 Jefferson. A 0E522 Certificate R-R-18867-15-00228 %. Expiration Commissioner 05/03/2017 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (Business/Organization/individual); V, e: I , Address: 3 3U i a City/State/Zip: Ve,A e..t 7— sl`(o k 3 Phone k qV t - Z 1.1 S l Are you an employer?Check the appropriate box: Type of project(required): 1. 1 I am a employer with 4. ❑ I am a general contractor and 1 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working; for me,in any capacity, workers' comp. insurance. q• ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner dakno all work right of exemption,per MGL 11.❑ Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have.no 12.[] Roof repairs insurance required.]t employees. [No workers' !3_❑Other comp. insurance requirediJ 'tiny applicant that.checks box tf I must also rift out the se:ciign below skewing their workers'compensation p6liey KontiAion. t H,orneowners who Sub"die this affidavit indi�in tlhey arz Juing all wnr.Fc and tfiori-hire outside contractors.inu5t subrh ai new aft c�,vit indicating such. 'Contmetr,rs that cK this box mtkst attached an adstiddo al sl M showing the na ne o6.the sub-contaactors and tleeir worker comp..policy ih(f rneitlon. /tint aiT employer drat is providing workers'compensation.insurance for»ay e�loyees. Belmtf is the policy and jub site information. Insurance Company Name: t,t r:tm e r G av% Ln c Go ►.t�r tl Policy h or Self-ins. Lic.li: V'✓L. S O'Y 60 / <J-j' Expiration Date: t ( r t Z a/ Job Site Address: City/State/Zip:WAWA _ Attach a copy of the work e 'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage a. equired under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well-as civil penalties in the form of a STOP WORK-OR-DER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si nature: i' Z--- Date: ! 1 - 7— - Phone#: Z. Z y S 5' Official use only. Do not write in this area, to be completed by city or town official. *, City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector . 6. Other Contact Person: Phone#: AClORO® CERTIFICATE OF LIABILITY INSURANCE UATE(12016 ""' ov27r2o1s 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 MARSH USA INC. NAME: -- -- 122517TH STREET,SUITE 1300 AIc Nr o Ext: alc No):- DENVER,CO 80202-5534 E-MAIL Attn:Denver.CedRequest@marsh.com I Fax:212-948-4381 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Axis Specialty Europe INSURED INSURER B;Zurich American Insurance Company 16535 Vivint Solar,Inc: — --� Vivint Solar Developer LLC INSURER C:American Zurich Insurance Company 40142 Vivint Solar Provider LLC INSURER D:NIA NIA 3301 North Thanksgiving Way,Suite 500 Lehi,UT 84043 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002920068-04 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE.BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY IXP - L71t TYPE OF INSURANCE WVD POLICY NUMBER MMIDDIYYYY MIW D LIMITS A X COMMERCIAL GENERAL LIABILITY 3776500116EN -01/29/2016 01129/2017 EACH OCCURRENCE $ 25,000,000 CLAIMS-MADE C OCCUR - RENTEDDAMAGE TO PREMISES(Ea occurrence) $ 1,000,000 MED EX_P(Any one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 25,000,000 X PRO- POLICY CIS ECT LOC PRODUCTS-COMP/OP AGG $ 25,000,000 r OTHER: -- $ B AUTOMOBILE LIABILITY BAP509601501 11l0112015 11101/2016 COMBINED SINGLE LIMIT . ident $ 1,000,000 Ea acc X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTYDAMAGE $ AUTOS Per accident Comp/Coll Ded $ 1,000 UMBRELLA LIAR HOCCUR - EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE - AGGREGATE $ DED I I RETENTIONS $ C WORKERS COMPENSATION WC5M1301 11101/2015 11/01/2016 X PER' OTH- AND EMPLOYERS'LIABILITY YIN - - STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE AZ,CA,CT,HI,MD,NJ,NY,NV,NM, E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA - (Mandatory in NH) OR,PA,UT E.L.DISEASE-EA EMPLOYE $ 1,000,000 B If yes,describe under WC509601401(MA) 11101/2015 11/01/2016 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 02601.4002 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Kathleen M.Parsloer, 7X-f�talsL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p BLE ,� • Map Parcel- /3 Application tax Health Division r,-i F5 ;; I Date Issued I (� r� A ' Conservation Division Application Fee / Planning Dept. Permit Fee Date Definitive Plan Approved by Planning€Board Historic - OKH _ Preservation/ Hyannis f= MAZK7L SST Project Street Address Village Aa Owner Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation* 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's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Z Aoor�ee/ Telephone Number 5- Address License # C S'• /.�/! Home Improvement Contractor# 6We 'Ili l/ih �,gh Co/'r1 Email Worker's Compensation #a&( Of(W442 ALL CONSTRUCTION DEBRIS RESULTI FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED .j MAP/PARCEL NO. ADDRESS VILLAGE ` OWNER a DATE OF INSPECTION: FOUNDATION FRAME INSULATION . FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ILIMAnI SOlar' RESIDENTIAL SOLAR POWER PURCHASE AGREEMENT Customer Name and Contact Information: Transaction Date 2016-03-09 Name(s) SIRLENE GONCALVES Sevice No. 4851810 Installation Location Address 2250 FALMOUTH RD Approximate Start and Completion Date 2250 FALMOUTH RD CENTERVILLE MA 02632 2016-09-05 CENTERVILLE MA 02632 Home Phone 7742283755 Cell Phone 7742283755 E-Mail Sirlenegoncalvez765@iclo jj Our Promises + We will design,install,maintain,repair, + We will not place a lien on Your Property. monitor,and insure the System at no additional cost to You. + You are free to cancel any time prior to Our commencement of installation work at Your + We warranty all of Our work for the Property. initial 20-year term. + The Energy Price includes a$5 monthly + Your Energy Price will not increase by discount for paying by automatic debit from more than 2.9%per year. Your bank account. + We will fix or pay for any damage We + You will not be responsible for any property may cause to Your Property or belongings. tax assessed on the System: Your Commitment Pay for the Energy produced by the System. • Maintain a broadband internet connection. • Keep Your roof in good condition throughout • Continue service with Your Utility for any the Term. energy used above and beyond the System's production. • Respond to Our sales and support teams when scheduling and completing paperwork. At the End of Your Initial Term • You can renew the Agreement for a . You can request that We remove the subsequent terry'; System at no additional cost. • You can purchase the System;or If You Move • We guarantee You can transfer the Agreement • You can relocate the System to Your to the new owner,regardless of credit rating; new home;or . You can prepay the Agreement; • After the sixth anniversary,You can purchase the System. WE MAY HAVE PRESCREENED YOUR CREDIT. PRESCREENING OF CREDIT DOES NOT IMPACT YOUR CREDIT SCORE. YOU CAN CHOOSE TO STOP RECEIVING"PRESCREENED"OFFERS OF CREDIT FROM US AND OTHER COMPANIES BY CALLING TOLL-FREE 888.567.8688. SEE PRESCREEN &OPT-OUT NOTICE BELOW FOR MORE INFORMATION ABOUT PRESCREENED OFFERS. The Notice of Cancellation may be sent to this address support@vivintsolar.com I vivintsolar.com 3301 Thanksgiving Way, Suite 500 Lehi, UT 84043 Phone 877.404.4129 1 Fax 801.765.5758 Copyright©2011-2015 Vivint Solar Developer,LLC All Rights Reserved PPA(11/2015,v3.2)I Page 1 NOTICE TO CUSTOMERS A. LIST OF DOCUMENTS TO BE INCORPORATED INTO Agreement, signed by both You and Us, before any THE CONTRACT: work may be started. a. Residential Solar Power Purchase Agreement, G. CUSTOMER'S RIGHT TO CANCEL. YOU MAYCANCEL b. Exhibit A—Notice of Cancellation, THIS CONTRACT AT ANY TIME BEFORE THE LATER OF: c. Exhibit B—State Notices and Disclosures, (1) MIDNIGHT OF THE THIRD (3RD) BUSINESS DAY d. Exhibit C—Certificates of Insurance, and AFTER THE TRANSACTION DATE, OR (11)THE START OF e. Customer Packet. INSTALLATION OF THE SYSTEM OR ANY OTHER These documents are expressly incorporated into this INSTALLATION WORK WE PERFORM ON YOUR Agreement and apply to the relationship between You PROPERTY. IF YOU WISH TO CANCEL THIS CONTRACT, and Us. YOU MUST EITHER: (1) SEND A SIGNED AND DATED B. WE HAVE NOT GUARANTEED, PROMISED OR WRITTEN NOTICE OF CANCELLATION BY REGISTERED OTHERWISE REPRESENTED ANY REDUCTION IN OR CERTIFIED MAIL, RETURN RECEIPT REQUESTED; OR ELECTRICITY COSTS IN RELATION TO THE SYSTEM THAT (2) PERSONALLY DELIVER A SIGNED AND DATED WILL BE INSTALLED ON YOUR PROPERTY. WRITTEN NOTICE OF CANCELLATION TO: VIVINT C. IT IS NOT LEGAL FOR US TO ENTER YOUR PREMISES SOLAR DEVELOPER, LLC, 3301 N THANKSGIVING WAY, UNLAWFULLY OR COMMIT ANY BREACH OF THE SUITE 500, LEHI, UT 84043, ATTN: PROCESSING PEACE TO REMOVE GOODS INSTALLED UNDER THIS DEPARTMENT. IF YOU CANCEL THIS CONTRACT AGREEMENT. WITHIN SUCH PERIOD, YOU ARE ENTITLED TO A FULL D. DO NOT SIGN THIS AGREEMENT BEFORE YOU REFUND OF YOUR MONEY. REFUNDS MUST BE MADE HAVE READ ALL OF ITS PAGES. You acknowledge that WITHIN 30 DAYS OF OUR RECEIPT OF THE You have read and received a legible copy of this CANCELLATION NOTICE. SEE THE ATTACHED NOTICE Agreement, that We have signed the Agreement, and OF CANCELLATION FOR AN EXPLANATION OF THIS that You have read and received a legible copy of every RIGHT. DO NOT SIGN BELOW UNLESS WE HAVE GIVEN document that We have signed during the YOU THE "NOTICE OF CANCELLATION." WE ARE negotiation. PROHIBITED FROM HAVING AN INDEPENDENT E. YOU RISK THE LOSS OF ANY PAYMENTS MADE TO COURIER SERVICE OR OTHER THIRD PARTY PICK UP A SALES REPRESENTATIVE. YOUR PAYMENTATYOUR RESIDENCE BEFORETHE END F. DO NOT SIGN THIS AGREEMENT IF THIS OF THE CANCELLATION PERIOD. AGREEMENT CONTAINS ANY BLANK SPACES. You are H. You have the right to require Us to have a entitled to a completely filled in copy of this performance and payment bond. ✓ BY CHECKING THIS BOX, YOU AGREE TO RECEIVE ELECTRONIC RECORDS AS FURTHER DESCRIBED IN SECTION 7(m),AND AGREE THIS CHECKBOX CONSTITUTES YOUR ELECTRONIC SIGNATURE. BY CHECKING THIS BOX,YOU AGREE AND OPT-IN TO RECEIVING TEXT MESSAGES AS FURTHER DESCRIBED IN SECTION 7(n),AND AGREE THIS CHECKBOX CONSTITUTES YOUR ELECTRONIC SIGNATURE. ✓ BY CHECKING THIS BOX,YOU AGREE TO ARBITRATION AND WAIVE THE RIGHTTO AJURY TRIAL AS DESCRIBED IN SECTION 6(e),AND AGREE THIS CHECKBOX CONSTITUTES YOUR ELECTRONIC SIGNATURE. VIVINT SOLAR DEVELOPER, LLC CUSTOMER(S)- Signature: Signature: Printed Name: Marcos cintra Printed Name: SIRLENE GONCALVES SolespersonNo.: a1m16000007N2WAK Signature: Printed Name: Copyright© 2011-2015 Vivint Solar Developer, LLC. All Rights Reserved. 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I � ( r t 0 ' I t 1'l l is 'I i;. . 1 I -,I l�)lif I'ii�I j ,�I r(y r I. r� ` � � fi Ist�tlon 117UMB i 1 ' ft I I T e 'SupPlementCard r ) I! i i't, •IlIli I 1 .�I rill �' I !4 �� 4! �{ .I�' I{ j YD _ , VIVINT SOLAR'DEVELOPERI,!LLC I S; EzpvaUon' Itlsnol8 I" I it (J II I '. , v DAVID 'PRECOURT ' `l "If iIII. t II�'1 r r9 l� luil G � i{ f7I jltl a 1"I!I'll 3301 N THANKSGIVING WAYISUI �i� LEHI,:.U' 84043 I +'' , lj1 Ij'r II it y I f Ij�1I f�, rI I rllll,II11 Ij NI',i ij�,I I'ii.it� ,!t ,.nr: AJdrgspnd rcrotard Mow.rrason foreltaupc -- sbAt �ft I!Ii', j'a:AdJresfi,Il�,'Renewal ("�Empioymcnt-"L�Lost Card _ II'�II lI�ii�I i.+lf II II,I i1,111, ' � raofConsawerAllslrs•&Aoitne% atmroa il� 11 iI1 {,{I tr'I II�t f_Illltt+ill)+I iI l', I , �—_ rR I ,i , I I I Itcnse or regist hon nird for iodi�ldnl use onl f `.. „� � .t , 1 , •it I i{ I �, I I 1 1 II �ul •,n n, ! Y HO�11E IMPROVEMENT CONTRACTOR { I " ! I' ,More the expintwn ate..](found returnito �1 t S7 I1, l i I i i 'I OtficetufonsumelAffalrvi a�d!�uanecv Rcgulehoa �islration: 1708d8 { Iri I TYPe '!1 ,11 i ,I Ill I y�10PukFl�z�rSm41�17U4!f +'"lllr 't -- Pt t/520i8;. Supplement Card I I Roston VMNT SOLAR DEVELOPER LLC { ti'i l i I!i,i 'I' 11I! I i IIII.II' irlfl'I f I' I� , r I,; I l � fl 1 ( �-1 DAVIO PRECOt1RT I I I Ij IlI II II II I, IIiI, 3301NTHAN(sGIVIN G WAY+SUI ! l IC V I�Il illrll 4 1 I',I I i L'�EFr�IT 84043 ,!I ri 1 i r ' I, Uit dtrit elf�I ?III I j I i it 'll! i`I Vot dalld t\Ithout"ggature j t'I I r - .1.ii.11uaa{I••1,'lij.�=11II+IIiiIIINI ' ' I"1.!. L..I,F - - .d. .0.11F II Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-013119 Construction Supervisor ->� 1 t ii, t s a DAVID A PRECOURT � 'r 4 411 97 FREEMAN STD , NORTON MA 02766.. t. ^AA Expiration, Commissioner 08/0712017 11% CERTIFICATE OF LIABILITY INSURANCE FDaTEcMM1DwY�Y► `� ov27r2o1s 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 MARSH USA INC. NAME: FAX 122517TH STREET,SUITE 1300 AIC Ro Ext: AIC No): DENVER,CO 80202-5534 E-MAILDR Attn:Denver.CedRequest@marsh.cwm Fax:212-948-4381 INSURERS AFFORDING COVERAGE NAIL q _ INSURER A:Axis Specialty Europe INSURED Vivint Solar,Inc: INSURERS:Zurich American Insurance Company 16535 Vivint Solar Developer LLC INSURER C:American Zurich Insurance Company 40142 Vivint Solar Provider LLC INSURER D:NIA N/A 3301 North Thanksgiving Way,Suite 500 Lehi,UT 84043 INSURER E, INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002920068-04 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL BR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDPOLICY NUMBER MM/DD/YYYY MWDD LIMITS A X COMMERCIAL GENERAL LIABILITY 3776500116EN 01/29/2016 01/29/2017 EACH OCCURRENCE $ 25,000,000 CLAIMS-MADE C OCCUR PREMISES(Ea DAMAGE TO occurrence) $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,0W GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 25,000,000 X POLICY CI IRO- LOC JECTPRODUCTS-COMPIOP AGG $ 25,000,000 OTHER: $ B AUTOMOBILE LIABILITY BAP509601501 11/01/2015 11/01/2016 COa accidentMBINED SINGLE LIMIT $ 1,000,000 E X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) X HIREDAUTOS X NON-OWNED PROPERTYDAMAGE $ AUTOS Per accident Comp/Coll Ded $ 1000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ C WORKERS COMPENSATION WC50960MI 11101/2015 11/01/2016 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N ,CA,CT,HI,MD,NJ,NY,NV,NM, OFFICER/MEMBER EXCLUD NIA A E.L.EACH ACCIDENT $ 1,000,000 ED? N (Mandatory in NH) OR,PA,UT E.L.DISEASE-EA EMPLOYEE $ 1,000,000 B If yes,describe under DESCRIPTION OF OPERATIONS below WC509601401(MA) 11101/2015 11/01/2016 E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 026014002 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Kathleen M.Parsloeity(la,�xht, jQyd(arc, ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD s The Commonwealth of Massachusetts �F Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass gov/dia N1 orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name(Business/Organization/individual): Vlylnt Solar INC Address: 33 1 N Thankstaivinps Way Suite 500 City/State/Zip: Lehi LIT 84043 Phone#: 801 6246459 Are you an employer?Check the appropriate box:. Type of project(required): I 1.®1 am a employer with employees(full and/or part-time).* 7. ❑New construction 2. I am a sole proprietor or partnership and have no employees working for me in $, Remodeling any capacity.[No workers'comp.insurance required.] 3.❑l am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions i proprietors with no employees. t 12.❑Plumbing repairs or additions 1 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'camp.insurance? 6.Q We are a corporation and its officers have exercised their right of exemption per i4tGL C. 14.®Other SOLAR 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Zurich American Insurance Policy#or Self-ins.Lic.#: WC509601401 Expiration Date!- 11/1/16 Job Site Address: 2250 Falmouth Road City/State/Zip: Centerville Ma 02632 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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 1 do hereby certrfy under the pains and enafdies of per'u ,thtttthe information provided above is true and correct Sianature'' / ---� `�!:iL:r'" .,' - Date: 3/22/16 Phone#: 508-776-6235 Official use only. Do not write in this area,to be completed by city or town offteiaL 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#: V u V u nl solar 3301 North Thanksgiving Way, Suite 500 a Structural Group Lehi, UT 84043 P: (801) 234-7050 Scott E. Wyssling, PE Senior Manager of Engineering scott.wyssling@vivintsolar.com March 15, 2016 Mr. Dan Rock, Project Manager Vivint Solar 3301 North Thanksgiving Way, Suite 500 Lehi, UT 84043 Re: Structural Engineering Services Goncalves Residence 2250 Falmouth Rd, Centerville MA S-4851810 4.16 kW Dear Mr. Rock: Pursuant to your request, we have reviewed the following information regarding solar panel installation on the roof of the above referenced home: 1. Site Visit/Verification Form prepared by a Vivint Solar representative identifying specific site information including size and spacing of members for the existing roof structure. 2. Design drawings of the proposed system including a site plan, roof plan and connection details for the solar panels. This information was prepared by the Design Group and will be utilized for approval and construction of the proposed system. 3. Photovoltaic Rooftop Solar System Permit Submittal identifying design parameters for the solar system. 4. Photographs of the interior and exterior of the roof system identifying existing structural members and their conditions. Based on the above information we have evaluated the structural capacity of the existing roof system to support the additional loads imposed by the solar panels and have the following comments related to our review and evaluation: Description of Residence: The existing residence is typical wood framing construction with the roof system consisting of the following: • Roof Section 1: Roof section is composed of 2x6 dimensional lumber at 16" on center and a single layer of roofing. The attic space is unfinished and photos indicate that there was free access to visually inspect the size and condition of the roof members. All wood material utilized for the roof system is assumed to be Spruce-Pine-Fir #2 or better with standard construction components. The existing roofing material consists of composite shingle. Our review of the photos of the exterior roof does not indicate any signs of settlement or misalignment caused by overstressed underlying members. Stability Evaluation: A. Wind Uplift Loading 1. Calculations for uplift are based on ASCE/SEI 7-10 Minimum Design Loads for Buildings and other Structures, a wind speed of 110 mph based on Exposure Category B and 40 degree roof slopes on the dwelling areas. Ground snow load is 30 PSF for Exposure B, Zone 1 per(ASCE/SEI 7-10). 2. Total area subject to wind uplift is calculated for the Interior, Edge and Corner Zones of the dwelling. vodon1 solar Page 2 of 2 B. Loading Criteria 10 PSF = Dead Load (roofing/framing) 30 PSF = Live Load (ground snow load) 3 PSF = Dead Load (solar panels/mounting hardware) Total Dead Load= 13 PSF The above values are within acceptable limits of recognized industry standards for similar structures and in accordance with the 2009 International Residential Code with Massachusetts Amendments. Analysis performed on the existing roof structure utilizing the above loading criteria indicates that the existing members will support the additional panel loading without damage, if installed correctly. C. Roof Structure Capacity 1. The photographs provided of the attic space and roof rafters show that the framing is in good condition with no visible signs of damage caused by prior overstressing. D. Solar Panel Anchorage 1. The solar panels shall be mounted in accordance with the most recent "Ecolibrium Solar Installation Manual", which can be found on the Ecolibrium Solar website (ecolibriumsolar.com). If during solar panel installation, the roof framing members appear unstable or deflect non-uniformly, our office should be notified before proceeding with the installation. 2. The solar panels are 1 '/2'thick and mounted 4 '/2' off the roof for a total height off the existing roof of 6". At no time will the panels be mounted higher than 6"above the existing plane of the roof. 3. Maximum allowable pullout per lag screw is 205 Ibs/inch of penetration as identified in the Nation Design Standards (NDS) of timber construction specifications for Spruce-Pine-Fir assumed. Based on our evaluation, the pullout value, utilizing a penetration depth of 2 '/z", is less than the maximum allowable per connection and therefore is adequate. 4. Roof Section 1: Considering the roof slopes, the size, spacing, condition of the roof, the panel supports shall be placed at and attached no greater than every fourth roof member as panels are installed perpendicular across members and no greater than the panel length when installed parallel to the members (portrait). No panel supports spacing shall be greater than four (4) spaces or 64"o/c, whichever is less. 5. Panel support connections shall be staggered to distribute load to adjacent members. Based on the above evaluation, with appropriate panel anchors being utilized the roof system will adequately support the additional loading imposed by the solar panels. This evaluation is in conformance with the 2009 International Residential Code with Massachusetts Amendments, current industry standards and practice, and the information supplied to us at the time of this report. Should you have any questions regarding the above or if you require further information do not hesitate to contact me. V truly yours, ���OF • a`'� s suN • i!L 2t Scott E. Wyssling, P NO 507 MA License No. 5 7 A�o��FcrsTEQe \a��2 FSSIONAL w5wh o solar .� PV SYSTEM SIZE: T0'P.1 OF BARNSTABLE U 4.160 kW DC pp /c: {{ ( N 00 .. N� L O W JUNCTION BOX ATTACHED TO o 2 m ARRAY USING ECO HARDWARE TO E ai=) • m �,;,,.,,,,. ..,a, ,,,,, P<� *_�'°'°"°""'�' KEEP JUNCTION BOX OFF ROOF Z o a2i Z t' (16)JKM260P-60 MODULE N c°i 00 25'OF 1"PVC CONDUIT c v FROM JUNCTION BOX TO ELEC PANEL U < F———————————— Lh I I I I I I I O I Lh N I I 9 00 9y I J N 4 O_ � O I ( gaoOc U U a Z m Q > Z W Q m T W W Z m J J V _ _ _ _ j J Q Z Z 2 p PV INTERCONNECTION POINT, - SHEET INVERTER,ANSI METER LOCATION, NAME: LOCKABLE DISCONNECT SWITCH, &UTILITY METER LOCATION Z � � J Ua SHEET NUMBER: 2250 Falmouth RD, Centerville MA 02632 PV SYSTEM SITE PLAN o 1T SCALE: 1/16"= 1'-0" > a 71"R U /C� o W N N N t0 NW�o� L V O<m E 2 ti=) !n u.'Z r z CS N 0 O UU U a C � O COMP.SHINGL ' TIE INTO METER# 2231667 C 12 N - 09 00 9 �J N � O W 5 Boa O of a U � U H uJ Z m Q >_ :0 > Z o � in Roof Section 1 W Z Roof Azimuth:191 KYLIGHT(S) 4 ¢ U V STRING#1: Roof Tilt:40 z z g 16 MODULES SHEET NAME: LL Q J SHEET NUMBER: PV SYSTEM ROOF PLAN N SCALE: 3/16"= V-0" d CLAMP V o MOUNTING SEALING � N PV3.0 DETAIL WASHER LOWER SUPPORT E D li Z fnLL zZ N�(DZ PV MODULES, TYP. MOUNT ~. .n:.,.:.<.�:. �N"0 � 0 FLASHING OF COMP SHINGLE ROOF, (Oj PARALLEL TO ROOF PLANE / C J O 5/16"0 x 4 1/2" MINIMUM STAINLESS PV ARRAY TYP. ELEVATION STEEL LAG SCREW NOT TO SCALE TORQUE= 13±2 ft-Ibs CLAMP ATTACHMENT NOT TO SCALE s 09 CANTELEVER L/4 OR LESS �� g COUPLING L=PERMITTED CLAMP ECO SPACING SEE CODE COMPLIANT m COMPATIBLE LETTER FOR MAX ALLOWABLE a MODULE CLAMP SPACING. c o co PERMITTED COUPLING g _�q o CLAMP CLAMP U) a r w = SPACING PHOTOVOLTAIC MODULE COUPLING z uia .. 0: m > w w z m J J V z J 47 F- Q SHEET NAME: L=PORTRAIT U) CLAMP SPACING I.-: Q o ECO p COMPATIBLE SHEET L=LANDSCAPE MODULE PV SYSTEM MOUNTING DETAIL NUMBER: CLAMP SPACING MODULES IN PORTRAIT/LANDSCAPE NOT TO SCALE M NOT TO SCALE � r O Conduit and Conductor Schedule (ALL COPPER CONDUCTORS) DC Safety Switch Notes: Solar PV System AC Point of connection AC Output Current Tag Description Wire Gauge #of Conductors Conduit Type Conduit Size Rated for max operating condition of inverter Accoding to Nec 19.79 Amps 1 Solar Edge Cable 10 AWG 2(V+,V-) N/A-Free Air N/A-Free Air 690.8(B)(1) N NEC 690.35 compliant Nominal AC Voltage 240 Volts U 1 Bare Copper Ground(EGC/GEC) 6 AWG 1 N/A-Free Air N/A-Free Air opens all ungrounded conductors C S 10 AWG 2 V+,V- PVC 1" p g THIS PANEL FED BY MULTIPLE SOURCES 2 THWN-2 ( ) (UTILITY AND SOLAR) N 2 THWN-2-Ground 8 AWG 1 PVC 1" ' N ,0AWG 3 1-L1,1-L2,1-N PVC V, Notes: SE3800A-US-U Inverter Specs: �o�� 3 THWN-2 ( ) 1" 3 THWN-2-Ground 8 AWG 1 PVC Wire size and breaker calculations dependent upon CEC Efficiency 98% S m inverter Continuous Maximum Output. AC Operating Voltage 240 V E 5) Example:SE38000A-US-U Max Output=16A N m d z <20A. Therefore a 20A solar breaker will be needed for Continuous Max Output 16 A it z each SE380OA-US-U inverter. Wire Gauge should also DC Maximum Input Current 13 A >N mp be determined with 16A Max for each inverter. 0 U Solar Edge Optimizer Specs: < ALL CONDUCTORS P300 DC Input Power 30 c SHALL BE COPPER DC Max Input Voltage 848V DC Max Input Current 12.5A Design Conditions: DC Max Output Current 15A ASHRAE 2013 Max String Rating 5250W Highest Monthly 2%DB Design Temp 35.6°C. Module Specs: ra 16 PV MODULES PER INVERTER=4160 WATTS STC Lowest Min.Mean Extreme DB -17°C 1 STRING OF 16 PV MODULES VOC Temp coefficient V/°C JKM260P-60 Short Circuit Current(Isc) 9.00A $ stem Specs: Open Circuit Voltage(Voc) 37.8V y p Operating Current(Imp) 8.47A Max DC Voltage 500V Operating Voltage(Vmp) 30.7V JUNCTION BOX Nominal DC Operating Voltage 350V Max Series Fuse Rating 15A �tza 0 l� o 0 0 15 16 WITH IRREVERSIBLE LE GROUND SPLICE Max.DC Current per String 15A STC Rating(Pmax) 260W - - - - Nominal AC Current 16A Power Tolerance -0/+3% *CONFORMS TO ANSI C12.1-2008 / - - - - - L1 L2 N I a 1\ SOLAREDGE $ m m \P300 OPTIMIZERS SOLAREDGE SE3800A-US-R g0 m c v INVERTER' N K U Square D#DU221RB j p SOLAREDGE 30A/240V UNFUSED Z O ti DC SAFETY NEMA3 200A W M� OR EQUIVALENT W W Z m SWITCH J J W Z Q . 3 20A ? ? O SHEET EXISTING NAME: 240V/200A AC Z Qq L---------------- -------------------- c LOAD-CENTER � Q 2 VISIBLE WITH 1-2 POLE 20A A g KNIFE A//C SOLAR BREAKER 3 DISCONNECT 3 _ SHEET NUMBER: O LV USAGE CONSTRAINT 96.5% CUSTOMER USAGE OFFSET U C 0 N N (V C THIS ROOF SECTION'S TILT/AZIMUTH ARE (1)LLNfY UNABLE TO PRODUCE MIN 800 SUN HOURS Nr¢w LL Ef2 O�Z ANCELED ROOF SECTION BELOW MINIMUM REQUIREMENTS. 2ED Z /N d0 CANCELED ROOF SECTION BELOW MINIMUM REQUIREMENTS. (MODULES RANGE FROM 623-757 SUN HOURS) O v (MODULES RANGE FROM 634-665 SUN HOURS) U � c J ,t` �,+y.3 �a� yk. � to � ♦^ ,.� r v ., rAw O THIS ROOF SECTION NOT USED.USAGE �r WAS REACHED WITH OTHER SECTIONS. 4 o W M O Q w ice ¢ a ' m .. w J Q Z Z m o UNABLE TO FIT THE REQUIRED MINIMUM-] OOF SECTION 1 SHEET NUMBER OF MODULES ON THIS SECTION Az:191 Ti:40 NAME: 16 MODULES @ 1072 SUNHOUR Z V 0 OMP.SHINGLE (n O W J SHEET NUMBER: - O . �lct -./> N' PV SYSTEM SIZE: v 4.160 kW DC W/�^+ -) N V N N N ^'-N7 toW JUNCTION BOX ATTACHED T ~'o m ARRAY USING ECO HARDWARE TO E m KEEP JUNCTION BOX OFF ROOF U)i0 z i=z �:::\ . N 25 (16)JKM260P-60 MODULE c�Ov 25'OF 1"PVC CONDUIT U FROM JUNCTION BOX TO ELEC PANEL V a F I I I 0B� (P I I 0 N v O� y 1 I I N O � N cq L U r w 1 I > in z Li � a w w z m — — — — — — — — — — — L 3 z z PV INTERCONNECTION POINT, SHEET INVERTER,ANSI METER LOCATION, NAME: LOCKABLE DISCONNECT SWITCH, &UTILITY METER LOCATION LJJ Z F- J SHEET NUMBER: 2250 Falmouth RD, Centerville MA 02632 PV SYSTEM SITE PLAN o SCALE: 1/16"= V-0" d Q) U p C/ o W N i � N h N R •A10 N� Ntp� 1i Ohm E � Cn d Z r W up:Z N C 0 �NVO CU U Q U � J 'On D COMP.SHINGL V ri I TIE INTO METER# 2231667 p N 09 00 9 p � a gmo � ^ p � U Q Z m 4 Q Z w w Z T W Z coRoof Section 1 W Z Roof Azimuth:191 KYLIGHT(S) F r 7 V STRING#1: Roof Tilt:40 U) N 16 MODULES 9.Z.2 SHEET NAME: LL Z 0a SHEET NUMBER: PV SYSTEM ROOF PLAN o N SCALE: 3/16"= V-0" a CLAMP U m MOUNTING SEALING N PV3.0 DETAIL WASHER LOWER SUPPORT Lr-/a m ® E � (n °°'z w ZH W uoi:z PV MODULES, TYP. MOUNT . >N0o FLASHING U < OF COMP SHINGLE ROOF, C it PARALLEL TO ROOF PLANE / ff0n V � 5/16"0 x 4 1/2" PV ARRAY TYP. ELEVATION s IMUM EL LAG SCR WS E NOT TO SCALE TORQUE= 13±2 ft-Ibs '04ap CLAMP ATTACHMENT NOT TO SCALE 0 N N CANTELEVER L/4 OR LESS OG COUPLING L=PERMITTED CLAMP ECO SPACING SEE CODE COMPLIANT COMPATIBLE LETTER FOR MAX ALLOWABLE N MODULE CLAMP SPACING. It o PERMITTED COUPLING g m m maa CLAMP CLAMP u0i jr L) a w - SPACING PHOTOVOLTAIC MODULE z in 2 COUPLING z 2 a ui .. w w m co w w z coJ V z F � J fA to Q Z Z -7 mt7 1 U SHEET NAME: L=PORTRAIT U) CLAMP SPACING ? Q 7U U LLJ ECO 2 jo COMPATIBLE SHEET L=LANDSCAPE MODULE PV SYSTEM MOUNTING DETAIL NUMBER: CLAMP SPACING MODULES IN PORTRAIT/LANDSCAPE NOT TO SCALE M NOT TO SCALE n p Conduit and Conductor Schedule(ALL COPPER CONDUCTORS) DC Safety Switch Notes: Solar PV System AC Point of Connection TagDescription Wire Gauge #of Conductors Conduit Type Conduit Size AC Output Current P 9 YP Accodin to Nec 19.79 Amps Rated for max operating condition of inverter 9 1 Solar Edge Cable 10 AWG 2(V+,V-) N/A-Free Air N/A-Free Air 690.e(B)(1) N NEC 690.35 compliant Nominal AC Voltage 240 Volts IJ 1 Bare Copper Ground(EGC/GEC) 6 AWG 1 N/A-Free Air N/A-Free Air o ens all ungrounded conductors S 2 THWN-2 10 AWG 2(V+,V-) PVC 1" p g THIS PANEL FED BY MULTIPLE SOURCES (UTILITY AND SOLAR) N 2- THWN-2-Ground 8 AWG 1 PVC 1" 3 THWN-2 I 10AWG 3(1-1-1,1-L2,1-N) PVC 1 Notes: SE380OA-US-U Inverter Specs: �D Na 3 THWN-2-Ground 8 AWG 1 PVC 1^ Wire size and breaker calculations dependent upon CEC Efficiency 98% ¢m inverter Continuous Maximum Output. 5 AC Operating Voltage 240 V E Z Example:SE38000A-US-U Max Output=16A NLL=z <20A. Therefore a 20A solar breaker will be needed for Continuous Max Output 16 A a).it z each SE3800A-US-U inverter. Wire Gauge should also DC Maximum Input Current 13 A >N 0 be determined with 16A Max for each inverter. a Solar Edge Optimizer Specs: v ALL CONDUCTORS P300 DC Input Power 300W c F SHALL BE COPPER DC Max Input Voltage 8-48V c) Design COr1dItIOr1S: DC Max Input Current 12.5A g DC Max Output Current 15A ASHRAE 2013 Max String Rating 5250W Highest Monthly 2%DB Design Temp 35.6°C. Module Specs: 16 PV MODULES PER INVERTER=4160 WATTS STC Lowest Min.Mean Extreme DB -17°C 1 STRING OF 16 PV MODULES VOC Temp coefficient V/°C JKM260P-60 0 Short Circuit Current(Isc) 9.00A System Specs: Open Circuit Voltage(Voc) 37.8V y p Operating Current(Imp) 8.47A Max DC Voltage 500V Operating Voltage(Vmp) 30.7V JUNCTION BOX Nominal DC Operating Voltage 350V Max Series Fuse Rating 15A �e 9 o 0 0 16 F166-1 WITH IRREVERSIBLE GROUND SPLICE Max.DC Current per String 15A STC Rating(Pmax) 260W �O - - - - - Nominal AC Current 16A Power Tolerance -0/+3% 0 0 *CONFORMS TO ANSI C12.1-2008 / - - - - - 1_1 L2 N m a o_ \� SOLAREDGE g P300 OPTIMIZERS SOLAREDGE 1 SE38OOA-US-R 5 INVERTER' y 7 U_ Z m = Bpuare D MDU221 RB j ❑ SOLAREDGE 30A240V UNFUSED > Z Q ti DC SAFETY NEMA3 200A K 0_ w M; SWITCH OR EQUIVALENT J J z m W z �3 J N N Q 20A SHEET EXISTING NAME: 240V/200A AC z ——— — -- — — c LOAD-CENTER z 2 VISIBLE WITH 1-2 POLE 20A A Q coNIFeac SOLAR BREAKER 3 DISCONNECT 3 _ SHEET NUMBER: � I W USAGE CONSTRAINT 96.5% CUSTOMER USAGE OFFSET W N N N a THIS ROOF SECTION'S TILT/AZIMUTH ARE mNa: UNABLE TO PRODUCE MIN 800 SUN HOURS ��v/c Q w LLEmm U)m v z w.2 C- ANCELED ROOF SECTION BELOW MINIMUM REQUIREMENTS. \�\a-°'•Z - /N dQ CANCELED ROOF SECTION BELOW MINIMUM REQUIREMENTS. (MODULES RANGE FROM 623-757 SUN HOURS) _ (MODULES RANGE FROM 634-665 SUN HOURS) F U U • U a C A !ter p �F 1 r^ J t� v WA q m N d .Q `4 R THIS ROOF SECTION NOT USED.USAGE WAS REACHED WITH OTHER SECTIONS. o m Q Zm = r a z Lii Lu Lu wwzm w Z U �Q 2 2 Q UNABLE TO FIT THE REQUIRED MINIMUM SHEET NUMBER OF MODULES ON THIS SECTION L—ROOF SECTION 1 Az:191 Ti:40 NAME: 16 MODULES @ 1072 SUNHOUR Z V OMP.SHINGLE (7 W 0 SHEET NUMBER: O EcolibriumSolar Customer Info Name: Email: Phone: Project Info Identifier: 4851810 Street Address Line 1: Street Address Line 2: City: State: Zip: Country: System Info Module Manufacturer: Jinko Solar Module Model: JKM260P-60 Module Quantity: 16 Array Size (DC watts): 4160.0 Mounting System Manufacturer: Ecolibrium Solar Mounting System Product: EcoX Inverter Manufacturer: SolarEdge Technologies Inverter Model: v.SE3800A-US (240V) Project Design Variables Module Weight: 41.88778 Ibs Module Length: 64.960665 in Module Width: 39.0551392 in Basic Wind Speed: 110.0 mph Ground Snow Load: 0.0 psf Seismic: 1.5 Exposure Category: B Importance Factor: I Exposure on Roof: Partially Exposed Topographic Factor: 1.0 Wind Directionality Factor: 0.85 Thermal Factor for Snow Load: 1.2 Lag Bolt Design Load - Upward: 820 Ibf Lag Bolt Design Load - Lateral: 288 Ibf Module Design Moment—Upward: 3655 in-lb Module Design Moment—Downward: 3655 in-lb Effective Wind Area: 20 ft2 Min Nominal Framing Depth: 2.5 in Min Top Chord Specific Gravity: 0.42 EcolibriumSolar Plane Calculations (ASCE 7-10): South Roof 2 Roof Shape: Edge and Corner Dimension: 3.289374674874265 ft Attachment Type: Stagger Attachments: Yes Average Roof Height: 20.0 ft Include Snow Guards: No Least Horizontal Dimension: 32.8937467487427 ft Include North Row Extensions: No Roof Slope: 40.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 0.0 0.0 0.0 psf Slope Factor 0.55 0.55 0.55 Roof Snow Load 5.0 5.0 5.0 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -20.7 -24.3 -24.3 psf Net Design Wind Pressure Downforce 19.4 19.4 19.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -20.7 -24.3 -24.3 psf Design Wind Pressure Downforce 19.4 19.4 19.4 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.4 2.4 2.4 psf Snow Load 5.0 5.0 5.0 psf Downslope: Load Combination 3 4.0 4.0 4.0 psf Down: Load Combination 3 4.8 4.8 4.8 psf Down: Load Combination 5 13.5 13.5 13.5 psf Down: Load Combination 6a 12.8 12.8 12.8 psf Up: Load Combination 7 -11.3 -13.5 -13.5 psf Down Max 13.5 13.5 13.5 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 75.0 75.0 75.0 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 64.0 64.0 64.0 in Max Cantilever from Attachment to Perimeter of PV Array 25.0 25.0 25.0 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 62.0 62.0 62.0 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 20.7 20.7 20.7 Fin-] EcolibriumSolar Layout ' I t f ro q § I k rT` A if 5 � C � s c µ, k °{ l Skirt o Coupling o End Coupling 0- O Clamp O End Clamp Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal expansion and contraction. See Installation Guide for details. North Row Extension Warning: PV Modules may need to be shifted with respect to roof trusses to comply with Q Bonding Jumper maximum allowable overhang. EcolibriumSolar Roof Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 16 Weight of Modules: 670 Ibs Weight of Mounting System: 58 Ibs Total Plane Weight: 728 Ibs Total Plane Array Area: 282 ft2 Distributed Weight: 2.58 psf Number of Attachments: 29 Weight per Attachment Point: 25 Ibs Roof Design Variables Design Load - Downward: 918 Ibf Design Load - Upward: 720 Ibf Design Load- Downslope: 460 Ibf Design Load - Lateral: 252 Ibf EcolibriumSolar Bill Of Materials Part Name Quantity ES10195 EcoX Base, Comp Shingle 29 ES10197 EcoX Flashing, Comp Shingle 29 ES10144 EcoX Junction Box Bracket 1 (Optional) ES10132 EcoX Power Accessory Bracket 16 ES10184 PV Cable Clip 80 ES10103 EcoX Clamp Assembly 22 ES10136 EcoX End Clamp Assembly 7 ES10201 EcoX Bonding Jumper 3 ES10121 EcoX Coupling Assembly 17 ES10146 EcoX End Coupling 3 01012A995 11:43 91508790623E PAGE 01 T Wnl d Barnstable *Permit#ems FjFhW 6 monthsJiwm laaue dote t .rwst:, Regulatory Services Fee t Th comas F.Geller,Director Budding Division Tom i Perry, Building Commissioner 200 Msin Street; l+rmis,MA 02601 Office: 508462-4038 Fax: 508-790-6230 . EXPIMSS PEWW APPLICATION__- RESIDENTIAL ONLY M t tvatW without Ked X PreaaImprinr Maplparoel Nuu0w ? Property Address (�-V7EY--Af It,LC 0 Residential Vslue of Work , , Miuhmnm fee of$25.00 for work under$6000.00 a Owner's Name&Address cot. 1141 Contractor's NameTelepLone Number Notes Improvement Contractor License#(if appli(able) Construction Supervisor's License#(if applicable) OTIMUWI Compensation Insurance ---- Chook one: ❑ I am a sole proprietor [� I have eption Isure ace Insurance Company►Name ���` Warkman's Comp.Policy# Copy of Insurance Compliance Cef"deatimust be on file. Permit Request(check box) [� Rr roof(stripping old shingles) All c instruction debris will be taken to ❑Re-roof(not strwiug, Going over__existing lsye"of root) i eplacement Windows. U-Value ( .44) *Where requited: Inuance of thv pan-At does note,ampt conwrMuca-ith other tm dcpert—t-gu]a—,Le.Himio.Conservation.ete. Permission. ***Nr117 Owaa siJ Prope Owner Letter.of � pro Coi ticae a is Fegttired, - Signa ure Q:Farme:mxpmtrg - � 1 4, i ;, AAc 1�1FtC0.1 8f9flCfl ditlC ✓ .. 'I 1331 Grafton Street --�'1 J�raaetai,:utA J'wd 1y, 1 i TH15 CV Vito tno^. _.day ar ar' �A , ewkngland Sash,Inc.and ! P l Cf.—... 1Dv1R� �I'�A f'1•�l"YfA. I !8Usm?:PNn�tE) y a 5�—. ria It 'W.dFLO�➢ 4 US. 1tTf „ lsA1>, (ZIP) An wj it ttlla V7r,.nct.+M wcRM M.I+of Mk mfa,To tdaw Eettlamtl aeon,6l^.and!fila-Ma 4 � Y1A.IX'a �r.avNln n0 rabr l r.a er m0!na"6!y to Iroatt tho iollowl p ddaoltol whduwti R:a ,_ "�lYinin[9!naf YNI^ 'mod! ]la LaN E Ma't" qa9 [.1 Npan qWi — 00 Tyr rang naoemumt , UMIt Style: tbtal Unitrt. ' Orlda !M WlRdaw lbttlr ry�eyPl�t: p DCuMa Hung Unftel � 7-7 I yNna Total CcrAmct'eneridlNm..Orn aNann_ronw,tw e'r alra;aA.oa. . _ 8Fi981kAt: 1" .1hilnc un11e; - vnling IJnita; , 1-Ales 2-Ilfb Caaemtnt Unlw 1-)fla: 2-htw 9dha; Baw Unfk:DW!CS: 4Jaa Total d Y 3-Ate; A-IIt9N 6-iilb: price. _ Qq.rclan uwndowel I �.__ 'i Ulwc 4d1!ei 5-Illtr: , Do 6 tp or Fk,;ah; sit RaJJ o8rt TIPW P adtlon 6re _ _4th Or — --, !of wlee cicBta:Y�N. VYlth C}a9r .. I EmbAy Doan: -- I Stool Flaw' Bsienca Dust -. "W.—t}u>ret A,Jm Wood Coro 5itan i `- Jldlna,rasa Coors: t �...- ----�—. ---i---- EAIelnnOe.Ode" 1. ' . Capp1 v i �,t 'T fstpping Gpirr Upon First Instoli: - [ Addhla ] r Ca AL s , I - DEFDsrr wrn4 QRUER a I CASH CHeCK 7t BALANCE DUE 67 CA&H 9-F'1N1IIICE y!v.l Agree to pity=S'a"CrE ln. a flre lone ahatnh alCom or,If your crydlt Is approved,to algn a nola imiftu tyr Ut for paymerif of the&"Ijmk due.You ono agrap to r.!gn a n mnplelion Oere"mic ui In conowrin rlf the(walk,If You W to mnha)ttymePAS mien thaY am min,then w*way Imnedjaln,r atop wpry„Jp.,+.1c,r ctvo:fl to nut Start VANdel a9nln tlnfv ynU Pm eu; tot rlth tfno Pd?r Ilte and we rod avovrc In obtardnq ore AmdlrtMp paymatm.Il ln"III tlhY ecipp"at whim(ChA,rA IVy Cra•udrp, etTh del ohuil awomrm¢oey p Kilt me data of oubaltaut1w[a'unptelm, TP1w!Re18 strop wN tog'n on of i! Out S r Iv'eC .d 1 and to U b9 eJ31fistlohY car,rpktaa N:ar aDatri-�, h b underamca by yn,.lam the irl,lvrmg".onringewdab eeufd m, minty change ine 1e14Motod wo*wkm Ante state]abrrvn:antv,r,ai Ifl whty to obtain or qWry twr pnetlolnr7 Fsl ornant v)anlrar. r!Knn or nitrar rang nitetlCRem 71-ov11014bil ty m!RRtena4l:seta of God. 1 We mnranant tow nit rarry Ph 1. s'cortlpma68100 AM PubP.o Uab'.h:y InPor"oe In fhe om mit of¢i nr,gG?1ADO,Ot)Q. ". f YOU MAY O01LL'L THIS AGAV IIFNI IF!?FiAS BEEN 8LSlEO WV A 1'AATY 151BAEYo AT A 1PLACE OTWCA?WAN AN AOOp6,rP.OP T'NE SELLkR WHICH MAY GE rIG MAIN OFFICE OR SPANOff TWE EOC,pACk;cEO YOU NOTIPY 1+LE 88.1,M IN iNRrr!NG AT mS k4APH OFFICE OR V"CH BY ORDINARY MAIL POSTER FN TELEGRAM SeNt OR RY OFUv W,,NOT LATER TmAN mVMHT OF TILE TRIRD F11.1,11MBS DAY COLLOWING THE 91GN1NQ OF THIS AGPIEEN". , i By GIGNIW6 BELOW,YrjV AGK '1WLEOUE THAT YOU AWN TIE A130I1 1`1110r—C7'7Y ANB TNr%T YOU AGREE TO ALL W THE T-_R S DF THIB CONtiia4`r,rNa{,NO- �. INg THE ADQITIONAL tEF1aA9 rCATEO N tHE REV6�15 9pt9g QC TFNB PAVE,Yc1u Ar,30 ACKh`9WL®fie THAT YOU HAVE FECETI�'JA FULLY C:CI!�tpL.ETEO COPY OF TFlrr.CONTMOT AN f TWO PiF..fFq 00"M OF THE N7trCE OF;�ANCPLLATIOK AND THAT YOU HkYr BE'FN 45CALL'✓11�FORM OC Y0lJt3 PIG'Wt � 1 LI-111.0-71— AATHE CONFAACT leTNCA iaWo alW 61JLkWf raaAet�: IN f'ISnattNy Btic . daY ofsl `ivAQ*.�-led:Now @ngbele Reeh,Me. f E,y AU?.!-i;]R2En RGi61nTi�1! - TITLE NOTicE OF CANCELLAt ION _;1L P YOATE(OF TA AN6ACTLOr1) `T'OU MAY CANCEL AM PROPRAV TRADED IN,ANY PAYMENTS MADE BY YOU UNDER T'NE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EiR VTED BY YOU WILL BE RETURNED WITHIN 70 11USINESS DAYS FOLLOW- 'No RECEIPT BY THE E :,LER OF YOUR CANCELLATION NOTICE,AND ANY SECURED INTEREST ARISINQ OUT OF THE TRANSACTION W L BE CANOELED. �r TO CANCEL TPItS TRAM 3ACTION,MAIL OR DELMER A SIGNICD AND DATED COPY OF THIS CANCELLATION NOTICE to' OR ANY OTHER LV"' N NOTICE,OR SEND A TELEGRAM TO NOW LNGLAND U& [NO,,1331 OiAFT N STREET,MA Q10f,1 T L ThAN MIDNIIGHT OF: r' , l' l. �CATC IGUNAAvt1? IW f!klW� �`' Ir I FiEriERY CANCEL tMa r, IANSACTION. II; tlUYvte alllAlaTlRE �'••.— _' 6�` _.... ' t"iW!tf-ORIOPFi �?'I`IF'Y yELL01A-CUSTOMER 8 CUFY PINK-,SFCE COPY fj3LL1ENh0D-CSIRTQMpg12 Itopy - I;' I i t I t I I i i 7 ! ucc rx , V%A AL ENDER N**FiraesMpycrs NAME"TRIPLE CL42£ C CRNA 4�V0F1LLEa• LOW E2 f RES 97 EIV RdGY PEfdFORN�APVCE RAT'UVt3$ j a at Heat Gain coo P6ieient 0.22 0.29 UNAL PERFORMANCE Ra4'TjNG.S tfteibte Tranent ttance f ! { �fiHi101aCtU19PSHpu�t831ri�these rafh� � Met odorRurco p 01 Olt,n b appunabfa M proms tor om �etermRtv np whole p A9 dre d9�fRtitfBd tot 8 fixed Bet of sm�l(ollmenf�f uac6ifi4l l t $ � apecffic orodurx a'ue.CoReuR tnanutacfurers Ilhrafury for afher product partorRram�lr!gmnrticn. I iVWWRho i i I i i I. I I I i I i . I . I i { i i u lre4 af'-Awav6ee7 ' Board of Buttdi@tg Regufattmas and Standards HOME IMPROVEMENT CONTRACTOR Rsglstretio.ri: 104096 Expii�to��71312008 Yp®• Sapplgment Card NEW ENGLANDUS:N 4NC I RICH POUPOLLO 1331 Grafton Stntet - a Worcester,MA 01604 a Adndnb trator i i J � Nam wlvt-Tt 1�-vOE�ss �T �.IS' 'Engineering Dept. (3rd floor) Map / Z Z Pircel dd Z�BPS. Permit# 70l r House# 8 S Date Issued Board of Health(3rd floor)(8:15 9:30/4:00-4:30) oor - 9:30/1:00=2:00) _ 'N .��'ic.SYS lannmg ep . s oor coo min. g. STAGE t UST BE W W LIMCE Definitive Tian 19 �NVjRON lF T® N R E AND TOWN OF BARNSTABLE: / ®NS w Building P rmit A plication &7 V �-'Project S et ress , Village y9 / OwnerQ&& Address I Telephone 0 S70 to Permit Request o0Z/41 1 "-First Floor square feet Second Floor square feet Construction Type ' Estimated Project Cost $ A/ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) - ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information e Telephone Number l 7 �� $ � �_ Address za �4, License# ' �!L-C- h ,�� Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDIN ERMIT DENI OR THE FOLLOWING REASON(S) T ` T FOR OFFICIAL USE ONLY q PERMIT NO. DATE ISSUED — - t. Y MAP/PARCEL NO. _. ADDRESS ' VILLAGE ` T - OWNER DATE OF.INSPECTION: FOUNDATION ;{ FRAME ' INSULATION 4 t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ' RO JH FINAL _ GAS: f �tOi i3 f FINAL , a FINAL BUILDI1 r ' DATE CLOSEDsw O 1- O , ASSOCIATION ARN t1 c i t - T�IL' CU/1tIt1IJt111'Cllltl! of:)1Qssuchusell.S --_-t.�_ D��P[Jr1111L'Jtt of Industrial Accide its pflicPa11AVii lgativ&- rt j?�ii{.__; :_�` �• 608 If a.vIihigium Strea �s-; �" BttstuJl..91uas 03111 %%Iori;crs' Compensation insurance AMd:ti•it entiittJm rniaatinn / /Plense PRINT i -imvr�/�� name ,1i�1 `��/PC `!�l!/1 l CCt / �% r 14-17 Ire Inc tint ��� C �ot'�•� � � ` • �n t �• t _ > G� 1 S'1 �l S Z1 7 I[ I am a homeowner performing all work myself. r �( I am a sole proprietor and have no one workin_� in any capacity ; I am an empinver providing ,%workers' compensation for my employees working on this job. cnnrtrnn%- n•rmv- • A •ttirlrrcc- nhnnc#• incrrrnnrr ^n nt►iict t! am a soic proprietor. general contractor, or homeowner circle oizc) and have hired the contractors listed beiow who the oilowing workers' compensation polices: cmm�•tn� nnrnr• 'ttirlrrc•• . cir nhnnc�• in,nr^ncr rn nniicV cmmnin: .nnrnr gddrr— rite•• nhnnc iJ•_ incrtr^nrc rn - nniin•d - - Attach additional sheet if neM311-` -- .;:c -- �' :�Y.;;.- -... .......,_.. _.........,.....�: .. �...::- "---•—. . F:r,iurc it,secure cmer-ice as required un cr tecnon Z.SA of AIGL 152 can lead to the imposition of crimmal penalties of a tine up to SI. 0U.UU anurur unc:cars' imprisonment :o %cell :ts cicii penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that cop) of thi.N ntatcntcut mai be furs nrdcd in the Office of 1nvcstirntions of the DIA for coverage Verification. I do hercnr crrrifr untier fire hilts alid penalties Of Pc at the information prorided above is true and correct. Si^^.aturc Datc Print n __Phone (i ' official sc univ du not ii•rite in this area to be completed by city or torn otTcw [ cin•or town permit/license it r't;uildin_Department C:Liccnsinc onard L scicetmcn'+ORcc C i.. cocci if imint iiatc respunsc is required C]ticaith Ucpartmcnr P is r c phone d• r'Uthcr i_ cont.-.cr ncrctrn: Information and Instructions w °r M0SsaC111.1SCItS General Laws chapter 152 section 25 requires all employers to provide workers cc:III Pel:s:tci0►t he "ta��'". an cnrpturec is defined as every person in the service of anotlier urtdc:— emnlm cgs. As quoted loom t contract ofhire, express or implied. oral or wrincii. An enip/r,mer is defined as an individual. partnership. association. corporation or other Icual entity. or any IWO or the foreumMU, en-11_s:d iti a joint enterprise. and including the legal representatives of a dcccascti employer. or rccciN•cr or tntstee of an individual . partnership. association or other legal entity, employing employees. Ho«e•. , owner of a dwelling house hn•ina not mart than three apartments and who resides therein. or the occupant of:he • N ern l&s persons to do maintenance ;construction or repair work on such dwc-ir: d��`c!1►n_ boost ofanrnh�r �h� p P - or on the _rounds or building appurtenant thereto shall not because'ofsuch employment be deemed to be ::n MGL chanter 152 section 25 also states that every state or local licensing agency shall withhold the issu`ancr c. crate a business or to construct buildin,s in the commonwealth for Lin)- ran o - •ti�•• permit r.cl �rf: license or �crm t t c 1 l' ic::nt Who leas not produced acceptable evidence of compliance with the insurance co��erage requircu. •Aar-:tonally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the pert�rmc::ce of public work unlit acceptable evidence of compliance with the insurance requirements of this ci:cc: he-:: prcz_:acd to the contracting authority. A pp.►cants P!trig `iii in the workers' compensation affidavit completely, by checking the box that applies to your situation c:- succ!vIn« cofnpaS]\• names- address and phone numbers as all affidavits may be submitted to the Department of ncu tna! ,accidents for contirmation of insurance coverage. Also be sure to sign and date the afiidati'it. The ,:t it should be returned to the cin, or town that the application for the permit or license is being requester. r :l c Derartntem of•industrial Accidents. Should you have any questions regarding the "law" or if you are rec :: .O ob:;:ra a workcrs' compensation policy. ple=se cell the Department at the number listed below. Cify or 17wi ns Ple��e �e urc that the :,ffidaV it is complete and printed legibly. The Department has provided a space at the bor,:,- the ::�- aa� it for %,ou to fail out !n the el,ent the Office of Investigations has to contact you regarding the applicant. be _ : to fill in the permit/license number which will be used as a reference number. The affidavits may be rmum,. 'ne D,=rtment by mail or FAX unless other arrangements have been made. The trice of Investigations would like to thank you in advance for you cooperation and should you have any quest piecse do not !tesitate to _give us a ca11. The Departments address. teiepnane and fax number- The Commonwealth Of Massachusetts Department of Industrial Accidents - �Off!cc of Investigations 600 «'ashington Street Boston, Ma. 02111 fax n: (6I7) 727-7749 attune =. 6 i—) —2---'900 406. 109 l , Assessor's office (1st floor): �pFTHETo� Assessor's map and lot number fB.oardlof Health Ord floor): 6 fO " ti i rSewage Permit number ....................`.. ........:............ ! BAHB9Tl►DLE, i Engi.nee'ring Department (3rd floor): 'oo H�q, .House number a .( � oV� 16 \ ......................r.�............................................. �D UP a• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR { APPLICATION FOR PERMIT TO .......(�. .F,L5....(r�..LlC:..!................................................................................. TYPE OF CONSTRUCTION .............. ......�.. � ............................................................. .��..Y...19A/J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L.(.) ..... G1 �� '�T {r �! I,, �C �1 .' .......... Proposed Use .....K. '. . ,C(• '• .C':t.�...•.....��..(..4.��..!.:f:.......T`C�...�/�!1..f.�l/ �w �' t � � (�V y ] nn(. ........ ........................ Zoning District ......... •.:..�...........................................•..........Fire District � C J ...................... ... .......... Name of Owner .. �. ...1:.�! .� !�..1..[!�....`!: d if 1 �`f' �(I��Q�c�dre�s !`� I '.t�.`!...,....Y...!. j„�i�•� U� .. .. Name of Builder .C �!�.... �. 6 �� s .....� .:..'7.C1... .... ............� ,. .�^.... ..... f �. p......................�.. V 3(o D Nameof. Architect ..................................................................Address ...................,.........................))......................................... Number of Rooms G/ Foundation .... .1�.?�... .. .�fJ. ��.��,�-c....C/U}�.��•�4..! 1.... i2 NG/ (-r ArIG{�" ,p r t /.�[(. �, l' �Crifv!„�!,. 1; �,� C/f C. �� a,�. � ...r �� i.;�i,.. ...�. ...�1/ ( F`7Cj e Exier�o. ... ............... � ` � ......�.....� . �...1 . ' .Roofing ......f..../..... �... ........✓/. ............. Floors ..aVyo ► ' C!�%.V. �J.e !) ..Interior .....1C�.../ C� 7r. /....... .............` -t .. !..o..... Heating `.{�.�1��`�/ I ' ..::....... ` Plumbing 5T(.1 .N....�.A ���................................... S. ........... ...... Fireplace .... ................................ti;.....................................Approximate Cost ......._7�® 0...... y Definitive Plan Approved Fy Planning Board ._------ -----_ ------------19 ------- . Area � Q.... � ....... ,3 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH f 1 ` tj OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ' " I hereby agree to conform to all the Rules and'Regulations of the Town of Barnstable regarding the above construction. Name . Construction Supervisor's License ......ram........ . PLYMOUTH BAY DEVELOPMENT A=169-011-001 No ..,, 9971._ Permit for ...11„Story Single Family Dwellin ............................................$...................... Location Lot #55, 2250 Falmouth Road Centerville Owner ,.,,Plymouth... ... Bay Development . ...... ...... .... Type of Construction .........Frame ................................ ............................................................................... Plot ............................ Lot ................................ g Permit Granted ............September 26, 19 86 ............................ Date of Inspection ............:.......................19 Date Completed ......................................19 �• t c0 Q Az -Engineering Dept. (3rd floor) Map Parcel l t�� Permit# House# c Date Issued r 2 board of Health(3r oor)(8:15 -9:30/1:001:0 4- 6 — • 4 / ee 4 ' ..- - ;Conservation Office(4th floor)(8:30-9:30/1:00-2:00) A,t 6,41 -J SFnPTIC SYSTEM MUST BE Planning Dept.(1st floor/School Admin. Bldg.) INSTALLED LIANCE Definitive Plan Approved by Planning Board 19 u r' �� LNVIRON B E AND n� TOWN OF-BARNSTABLE' TOWN a0N,S Building Permit Application Project Stree ddress Z Z,5 6 —A- Village T _x v .4- O 2(o ' z � iP 5 Owner S 1 L ��v /+� C�0 N�L��y`zrAc. Add s A%'�,.✓ � ,Telephone Permit Request �a ��z .r-v f ,n.�-�-c �4n-A") I rz d, ) G LI;c� o l ��F "«, c� 1 per, c3-C7 �. yi,dti e L A r U 4 L k r�c o cr °1� �—(C4 t 'First FloorJ��` square feet Second Floor 3 square feet ,.Construction Type Estimated Project Cost $ 1 q; `2- 1 30 4-& m+ , Zoning District Flood Plain kio Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family a7' Two Family ❑ Multi-Family(#units) Age of Existing Structure i.°& Historic House ❑Yes p-l'fo" On Old King's Highway ❑Yes 2< Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other `.3(" Basement Finished Area(sq.ft.) OtDcu-c, Basement Unfinished Area(sq.ft) Number of Baths: Full: `Existing ?-- New t acr-tti¢ Half: Existing New No.of Bedrooms: Existing - New Q(D W E 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Attached(size) 24 �0, ❑Barn(size) ❑None ❑Shed(size) - ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Na e ���-�Lip L AJ�S fi C�- T lephone Number �8 3 4�( F 3 � 3 Address It (.c�r�c�-4 �•� is se# 0 L{ U 3 '9 - ✓`' �'L M�} 2co 3 y- ^ Home Improvement Contractor# 1 O 3 y 3 8 t,,'4rker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATURE DATE 'z C �� g UP a BUILDING PERMIT DENIED FOA T FOLLOWING REASON(S) Aw I A, ®. z x FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED' MAP%PARCEL NO. I ` b ADDRESS i VILLAGE i t a OWNER t :_ i ' I A r DATE OF INSPECTION:, 4. FOUNDATION r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL . PLUMBING: ',_ROUGH FINAL GAS: ROUE:) FINAL w - FINAL,BUILDING C.) - i DATE CLOSED Oi , a ASSOCIATION PL�4N NO. , • r `apTHE► ~�� The Town of Barnstable BARM��e.� Department of Health Safety and Environmental Services 059. �0 prFo �. Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection AJIA-1 Location 2�-50 �.,.,,,. ��. Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items needcorrecting: / ( 1 .' I ^�-J!n✓ CAD I-.CO) �.:�c J Af S� �a1 �� •' "°� sll�c7✓�_ (.J I c�2 �_ -) � ) �o S CIO .� rt� l rI—I K J wtiCt..r vt w 1 ' f.� Please call: 508-862-4038 for re-inspection. Inspected by ( U Date t / `a0 Y 9 R RON IIIPROVE�tfli Lvn, ,� i '� Registration 103430 �! iYPe 4BA ov oloo fxvirat.ion w FA�R1fK IAIICASTER CARPEIIfER (5 uncaster d Patrick E- GC'ee+r� �TyelYSTRALC� egtnstable, 04 f /+rrA nr t crIT ;r cn =r frtpslt•rc�tPR,onr�Erren� �?fPRcF' , I CJ - � rTCll!': PirLhaA�o; oa01 i 5 P.esLClC'2d ta: �.'• Gf cn rt r taor0.s3sE o - ; t P.1FR°rq�t:l?. tiA aa��a N LD co \✓ f]r CO rll � CD 1.0 L : m . - m CV CJ If7 - m r 1 tic, NN .. • -�, � §� a 4 \1 \ _ � a - too y Y , i . q tip' Y iJ i j7� I Q � t Ali, 0 h '4 f r a774pG 71. d r � �- 3z JL f t h t a many tf 4 fit' � fi x s -01 ,is S dj- F� ° t r ' 'Vzl � t - r }9 ty 4OMAN tt! .� .1.,..,q .:,L ... - ..P .. {} ,,'Sj�. i.%;V:e': _, s ,. .: .: . . .1" 1-1 yr,Y'K. -. .. y X; .. % .. . . . i .: .... 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'- i S 1 ': a ' . ; j \. _ 7 f t " +. ..�I r r.:.'.,....I.:......-I....-r.�'.�...,.:-.....'.,I-..'.'I.'6.�.,,e.�.�.I��.-.,�...,..'-..�.I.I.-.:,".-':'r*..�:,....�r�:.II.��I.­.�.,.�:I1_...�X...�1.�.I.....,,�...—.F..%.I�...��..�..r�.',.-..�­.�,4..:_I;.- .,, .. .4..—- , ..�',,..,.-.�,.9�.,'7.,�...:',...,"!=,.�-...'.-,,I�'.'o.6\....*I,r..r6 I-....I..�."�'\.',�I-'..-\'*..�q..',,,.'.I,.�;.�.,�r..-.,..A..I.���.,.,;',.-.�,..�v'...I,..,'.�..�-:��...%�,,_;�"�-�....�.i:....I.:1�,....r..%lf l�.�-.'",.�� r r koy _ y' �, .. 4 ..r, vnxxe sy }; , t.. t --f ,;<. F E a. \ .: .., _ .R... .. �`4Y ' j- '�J, + '. o ,r I vt..:, ' _. .v, .. . y r.;. -fvir f a,:.sZ . 'off'".. .. :a E, ' .. '�;.r - . .. . . - - s;,N'., A R"Z_a.EIEVATIAPL C 9,4 i o.•). +. _ _,..:. .,ap;. ti,'. _ ewx` \ 1. - ..5 S. .\- i l t s' c' ° Cti o). + R3l� TtOt�71R nx r i , r .�v&6 vik ou ,, , 'r �i, . . `g ;�.t - y�� e - is n�!ect -, } ' ':t J . 4 _ .: - i .��,Ste_ ... .. - - . . . e.... ...�.. J . � .T :.:). , ., r _ .. -. .. ..,,. ,- r. •y- b ' •f. F i i , k T .•lA MISSION .. .. ,: s r i J f � t % _ alp 1 � Sh w .. :;o l r a' rt ��' Wo Ell NV n Ij } �{ I � Inn plot t 3 • Nf y <� L��` ���X'f�R'✓1 A '�.' ��'�Yy ��.i ik � i->, '" a�N9 � 1'4 a�.. 4 _ _'� _.� � f, Y .. j q St 2 $ S,+ 7;"1�f y S �' r .i '�'b s�_ t W�i r v r f�i aF �vsf ., aye 3 4 - F,d .t�♦ 0 \\ g , q Y 6. 4 Xvivo I' 0A Al Oki It' h. r s w - I s , n M °F LME . .� The Town of Barnstable snBr sTABM • 9q� � Department of Health Safety and Environmental Services pPEDNIo'�A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: —A-1 a AfLAc.4. /,,ror7 t ji Estimated Cost N Address of Work: ?-Z-7y \=A(_^^u%o p-, (Lp A,() Z � I/ Owner's,Name: `J$L t n/A G, 0-)C,`� v S ate of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PQ: _TIES PE Y I hereby apply for a permit as the agent of the own Date Contra for Name Registration No. OR Date Owner's Name q:forms:Affidav ' �- TI:e.Communwealth of MqsSacJIusetts Department of Industrial Accidents ONCE atlmresd attoos 600 Washington Street ' 4'' Boston,Mass. 02111 Workers' Co!t Mensation Insurance davit V11——If Mtn am mme- city phone Q am a homeowner performing all work myself. ' I am a sole proprietor and have no h one woridn in any achy ❑ I am an employer providing workers' compensation for my employees working on this job. 7"' eomaanv name: address: city. Phone#: insurance co. 2011cV a ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who ye the following workers' cbramsaton polices: .... .. com anv name: address: dtv r phone insarance to eom any name. » address: dtv- phone If. lm 'r..r.... ..K.y:: c::`r:t'.n. iSL!.�:... i1..:.1.OptI..' ;'d i{:..:AaW .. •.Ii.�#' , r ..•.nY•+iwF'..:'. t2.illt'y insurance cn`r Faitttrr co aseaas m W era-o as required under Section 2SA of 11GL 1S2 can lead to tha iugmwon of c imiod peoait es of a am up to S1300A0 suWar one yeas+tmpsi>o.tmeat as well w dra pmdtles in the fora of a STOP WORK ORDER and a tine of SI00.00 a day again"me. I mtderstaad that s copy of this statement may be forwarded to the Oaks of Leradgaeions of the DIA for coverage yerincasim 1 do hereby the alas acid allies ofpt1lw'ghat the myormauan provided above is trw and coned Sigaamt+e Dart - l?riatcame Phaue� oincial use ody do not write in this area to be eompieted by city or town olIIdal city ortown: Persadfilceasso Mundins Deparuneut • 0I1censins Board ❑chedcuimmedlate response is regaired Osawanews oIDee Meam Deparummt contact person: (terra 9195 PIA! Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law",an employee is defined as every person in the service of another under any caatr' of hire, express or implied, oral or written. , An employer is defined as an individual. partnership, association, corporation or other legal entity, or any two or sore of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the re" = ===of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of &0 o.... ie"re p�na to do maintenance , construction or repair work on such dwelling house or on the grounds o: ---�r building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe commomvealth nor nay of its political subdivisions shall enter into any contract for the perfoanance of public work unta acceptable evidence of compliance with the insurance requireaeus of this chapter have been presented to the coaaacting authority. _ Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to yoursrtttatian and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of ladusaial Accidents for confirmation of insurance coverage. Also be sure to saga and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of industrial Accidents. Should you have any questions regarding the`9aw"or if gnu are required to obtain a workers' compensation policy,please call the Department at the number listed below. r _ . . City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at•the bottom of the affidavit for you to fill out is the event the Office of gations has to contact you ngardmg the applicant. Please be sure to fill is the permiNicense number which will be used as a reference number. The affidavits may be returned fo the Depar=eat by mail or FAX unless other anangem-ats have bees made. The Office of Investigations would Me to thank you in advance for you cooperation and should you have any gnestions- please :m not hesitate to give us a call. The Department's address,telephone and fax munber. The Commonwealth Of Massachusetts Department of Industrial Accidents OMC8 of invesdoadons 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat 406.1 409 or 375' } 1 yOF FF THE}� TOWN OF BARNSTABLE Permit No. ..29971,,,,,, BUILDING DEPARTMENT E D°H1 TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to PlYmouth Bay Development Address Lot 1;55, 2250 Falmouth Road Ccatcrvi lla, blassdGhusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED-BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. F�hruar 17, 87 ` Building Inspector e TOWN OF BARNSTABLE BUILDING DEPARTMENT Z asaaer :nut TOWN OFFICE BUILDING HYANNIS, MASS. 02601 a■AY 16' MEMO TO: Town Clerk FROM: Building Department DATE: ,;�7—/7` 0 An Occupancy Permit has been issued for the building authorized by BuildingPermit #.. ..............:............................................................... »....... .................................»». issued to Ta%///I11,41,�„/� / 1 .... t, I.;!YYI,(......�e »...»...»......................»..»».»»».». Please release the performance bond. 4 : � 5, t6W. .WOF-BARNSTABLE, MASSACHUSETTS BUILDING PERMIT_ t-log- ol I=;)Ji7� •- DATE 19 PERMIT APPLICANT fsPak:3i4 t n ADDRESS c .. .`. (NO.) (STREET) - (CONTR S LICENSEI "'�`' NUMBER OF PERMIT TO R( Y 1 el (MP t ( T C1;jSTORY :. DWELLING UNITS (TYPE OF IMPROVEMENT) - NO (PROPOSED USE) »•"' AT (LOCATION) 1 .1r ; '� -:I r s•• _ ZONING DISTRICT (NO.) (STREET) .. ` BETWEEN % '`' AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE - FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE ,. 3 USE GROUP BASEMENT WALLS OR FOUNDATION .:+ (TYPE). REMARKS. { AREA OR x 3 Cad VOLUME ESTIMATED COST $ -�z >v''" U FEEMIT (CUBIC/SQUARE FEET) , t«af Q*T OWNER E t� Clays„ Si�4 BUILDING DEPT. r ADDRESS i Ll.:t y c�, BY iFe rat - " 4t,i '• - .:, _ .,.y .. , T ..w. �TH18<PERMIT: CONVEY.S,-NO.'RIGHT{rT0 ACCUPY ANY STREET, AALLEY OR SIDEWALK OR -ANY PART THEREOF.'EITHER TEMPORARILY OR ?PERMANENTLY. ENCROACHMENTS...ON,.PUBLTC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER. THE BUILDING. CODE, MUST BE AP- 1 D�PROVED,{BY-THE,JURISDICT[ON.,.SrREET.-OR ALLEY GRADES AS WELL AS. DEPTH AND LOC-A'TION OF PUBLIC SEWERS MAY BE OBTAINED - t FROM THEL OEPARTMENT'OF, P.UB*LIC.WORKS.,THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM T:HE'.CONDITIONS OFF'A.NY, A�R.L,ICAB-L'F„j 9.61VISION"RESTRIC•TIONS. - MINIMUMO THREE C LL <.k APPROVED;PLA S MUST BE.RETAINED ON JOB AND TH#I pis 0 CfiYON gQUI,R,ED�OR1 N IS WHERE APPLICABLE SEPARATE AL�e, ONSTR1l(gT�IpNl.*0RK CARD KEPT POSTED,UNTIL FINAL INSPECTION HAS BEEN. PERMITS ARE REQUIRED FOR �- - ^A ELECTRICAL PLUMBING.* AND ��-P--"• {'R P`O'O't.'7t@g — _ NICAL IflL$TAL ATIONS �....A- ft - I 2R(,Os�YfdOry�E1Np'STR1�CTURALsQUJ Eb'?SUII�UILDING'SHPILL NOT BE OCCUPIED UNTIL a= j tdMEMSIREADY TO LATH) RINAI..INSPECTION HAS/BEEN MADE. 3 FIN'�EIN'SFEfO''I'ION- BEFORE �.p,, PwrN'C4_i' S'"'b`•, c s y i .3'jdt .,,fir,. I } YtiPOST,ATHlS :CARD` 50 IT. IS :VISIBLE FROM 'STREET 1. ° BUILDING INSPECTION�APPROVALS: . — ? h y PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION,APPROVALS Y GLJ 2 x /.. BOARD OF HEALTH 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT j 1 f. OTHER r 1, 2 BOARD OF HEALTH j WORK SHALL'NOTzPROCEED UNTIL THE 'NSPEC 1 °E^I it WILL BECOME NULL AND VOID)F CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE j TOR HAS APPROV€D THE VARIODUS STAGES OF LL I WORK IS NOT STARTED WITHIN SI,. MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN 4 CONST UCTIOI ,+ AS NOTE .:ABOVE. PERMIT IS ISSUED. NORFICATION. 14 ow J - WEBYCERTIFY rH,4r WS.4Or/S NOr.,kOCATEO,�IN FL000 H,4ZAROO,.ZONE; - "AS SHOWN ON THE'FERE'RA4 . FLOOD INSURANCE RATE AAP FOR THE'< TON!N OF COiG1iMI&I7y PANEL ;,NO, ' -EFFECT E,.DATE' j..rt ROB ERT. E. RAYA90NP, S `PATE,; NOTE: NORTH ARROW NOT PTO y}� tid.6E USEP FOR SOLAR PURPOSES y(1Z1�, 1AZ7 E e3 LINE BEARING. DISTANCE p5. 1 N_:78'22'08"W 4,'30. 2A� 2 N 11'37'52"E 6.30 sY y 3 N 78'22'08"W 5.30 \ 4 S 11'37'52"W 6.30 ' ,y 23.00 N rS r�;x �� V•NO * F e > a: 4 LOT m o J � � o y rn FOUNPA_TION 1,OCATION PLAN THIS PLOT P1,AN WAS PARE FROM AN NS7'iP411YENT SURVEY ANP:IS FOR THE , USE OF THE BANK ONI,Y l/NPER NO FXL.MO -- CIRCUMSTANCES ARE OFFSETS MBE.. - - USEO OR, FENCES, WAI L,5,_.HEPGES, ETC. . U7t�l <. - ON of Mgs�'`y� . ARROW ENGINEERING INC 60 EAST fALMOUT'H.HIGHWAY . E. EXST.F4LMOUTH,'MA:-' 02536 ROMOND N 90 No.21583p a4 SCALE: ' PATE? SHEET, 0 n;4o OR,4WN.8Y: OTCirfPBY APPR BY. PLAN NO. �� ICE, Sri3as sor's office (1st floor): y Assessor's map and lot number .....................r. ... .:. e Q �pF TN E TO Board of Health (3rd floor): , �h�T. d d� o� m Sewage Permit number ...............g. '.. . ....... ........... u Ci0MPL1A�('rE Z BABBSTODLE. ALL Engineering Department (3rd floor): 900 639 a.�� )7)..06.1 ENVIRONMENTAL 5 M House .number ....................... .................. .... ............... MENTAL CODE AND 0 MAR a� APPLICATIONS PROCESSED 8:30-9:30 A.M. and; 1:00.2:00 P.M. only! 'lei -WN REGULATIONS A. n''s,PR0VED , 'ON: 'OF BARNSTABLE ;:�able Conservation m i .� �,) ILDING - yItNSPECTOR Signed Date j APPLICATION FOR PERMIT TO ...... .5 . ..:.wr........................:........................... .......................... TYPE OF CONSTRUCTION .............. w :.l!........(:...1`a. .. ................................................................. ......re..k ruaq.... i 9A� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin inforr(mation. Location ......... � ..�. FC{,.�. U"� ..... �.:.... .1.. f.�.V...t.>'J... .. �-............. , ... l �.... ................... Proposed Use ..... .::►.-6- A... ... ..(.. *......... .................. Zoning District .........1�. ...................................................Fire District ............. ................ ... Name of Owner .. J.. .�M. ......!U .1..J�..GIl(c .Yets�i lk.... :..�1..`t.. ....V...! ..!'1.�..!.L /�i' v� ... a 3 6 k-i Name of Builder .. . ..1.". ... .. ...?•1./.a4q)).1!.V��2�fess .....t '..`1..` ... .....�. *,0 .�...�. `I `� r Nameof Architect ..................................................................Address .................................................................................... � r Number of Rooms ....I......................................................... Foundation a � `7 .Pm.�e�C. �r�L ExteriorY4� �. .. GC!�L�. �/1.(�..".�.�i. .L��IXtQ�G. k�C�Roofing ......... 9.�.p�.?CL.L ..... 11.6 d1�1.�/� ............ y . Floors J C ..P Cam-.(./..��.� .Interior .....U/1.f.6a!q.C�1.., ............ �, / ..................... Heating ` .. . ,,.......................................................Plumbing ....L 1. ' ' ................................... Fireplace ... o.......................................................................Approximate Cost ......,. J�®.�r..d.�.�.. . ... ................................... Definitive Plan Approved by Planning Board ------� _-_______1 Area 76G1. . ,, Diagram of Lot and Building with Dimensions Fee �q� SUBJECT TO APPROVAL OF BOARD OF HEALTH �f t'SS L �l .> OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable, egarding the above construction. Name .... ..... . .. .. .... ......... Construction Supervisor's License i i*,IOUTH BAY DEVELOPMENT . No ..=29971... Permit for 1 2' ;S_torY............... e Sin Famil ~ Single Dwel�ln ' .....-...................................Y......... . . $................ _ •_ Lot #55 2250 Falmouth Road'�. Location ...................a........................................... ,r .Centerville 1 Owner Plymputh_.Bay..pf vytlopment, Type of Construction .........Fran4 ...................... .......... .3. ........................ • Plot ............................. Lot ................................ ' V. r y ., a ^~ September. 26, 86 Permit Granted ........................................19 t Date of Inspection ) Q J 19 Date Completed ....pC �� '.0. ..19 r ' IS t"t! _ r a F _ BOG 25f r EDGE OF (BOG 4�P d . cn .LOT sz.z 56 LOT 55 Q w DRIVEWAY o EASEMENT o 0 r a L'2�d•47'. T-C i O RES. ZOA'L'. "At" This M.01-16'I'GAGE INSPECTION Plan Is For !HOOD ZONE- "C" Bank Use Only TOWN: _.CFLV_UR_1L�_----------_ REGISTRY OWNER: DEED RI F: -----------BUYER: __..V VA DES--------- ----------- ------ DATE: _ 24194---------------- - r PLAN REF: _�9� DO _--__ ______ I HEREBY CERTIFY TO SAA22-ECF1 HAM'— `tiN OF Mq THAT THE BUILDING �y>'� �qc YANKEE SURVEY aHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS `' CAL THE CONSUL ,'HOWN AND THAT ITS POSITION DOES ---- CONFORM A. �^ TO THE ZONING LACY SETBACK REQUIREMENTS OF THE Mi- ITHEW N 143 ROUTE 149 �> TO w.N OF RARNSTABLF ___ N 140. 3209e Q __AND THAT a MARSTONS MILLS, MA. 02648 IT DOE9__AQ_T LIE WITHIN TIIE SPECIAL FLOOD HAZARD (� ,-ffFiQSTER� �,`` TEL: 428-0055 ARIA A , SHOWN ON THE H.U.D. MAP DATED 61-191-0 _ At [AN u- li'.AX: 420-5553 Cc�► r nunil --Panel 250001 0015 C Iti. �' ____ THIS PLAN NOT MADE FROM AN INSTRUMENT' 14027 DPG I'AU n !;II }2ITH ,v1 PIS 1¢``r SURVEY NOT TO BE USED FOR FENCES ETC.