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HomeMy WebLinkAbout0160 GLENEAGLE DRIVE -y 4 w a4 . ,r n w n - ` a ti n { s a • n , , y ' •�• ., -• � i ; � ..., y t:_ � sly , , 4 + a , q y y a � ' i, �. _ - _ � - 6 -. .. �. - �.r.. _.. ... a � �- - y .. ♦ '` .. .' ,� ... - � - r. a ..� .. _ .. 'Y � .. .. � .: .. t .. _ �. m ._ � - a.. ,. -. .. r. - - ....,;. . -R .. .. .. ... .: z �C - .. _ .. a -..� .. .: ,. � .. .. ;. � .. ,r �,. r. t :. � , :. � �:. .: ,. .,. C. _., ,.. ,. , ,, ,, `. _, - � ,� • �, .F ,. ;.. c a _, '; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . Map Parcel 5 a Application,# Health Division Date Issued _ I 3► /S Py— Conservation Division Application Fee Planning Dept. Permit Fee ©� Date Definitive Plan Approved by Planning Board aff0PRESS' i Historic - OKH AFV — Preservation/ Hyannis _��° 212015 Project Street Address /1 lenea, (c 1"t tre : _ n TABLE Village Owner 6h c e, mac- Address /�j c e�c /c r�uz Telephone nn• Lk-c 1 kW Permit Request :-n4zL b ne'(S tny cuL hW W..-( ( dqk c �, I )'Leu,61 e s%r cr ee� i,,) ,. �' , e t OEM- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new `— Zoning District ° Flood Plain Groundwater Overlay — L Project Valuation`5@G, Construction Type _3 Lot Size Grandfathered: ❑Yes ,,No If yes, attach supporting documentation. Dwelling Type: Single Family , Two Family ❑ Multi-Family(# units) Age of Existing Structure 17a VFS . Historic House: ❑Yes ANo On Old King's Highway: ❑Yes ;8(No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other °-- Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new v 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 sizA Pool: ❑ existing ❑ new sizA/W Barn: ❑ existing ❑ new siz� Attached garage: ❑ existing ❑ new sizShed: ❑ existing ❑ new size/12-0ther: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes DNo If yes, site plan review# Current Use )qeSAAe-ah Proposed Use i�) Ir APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A4C aP111 ater /4007 Telephone Number Address {-1 i� mac ��S'K-�v� 24,4 License #— 0:5r Lb3&/57 �jn,(.-K n k 5 M 4- 034o to Home Improvement Contractor# �S�a Email 04 mev)54e.^ 6 4A.C_� 14 , c.6*— Worker's Compensation # ALL CO TRUCTION DEBRIS/ ESULTA FROM THIS PROJECT WILL BE TAKEN TOEV��rD� SIGNATURE DATE lO �!S! p .y FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED _ MAP/ PARCEL NO. • t ADDRESS VILLAGE r OWNER r DATE OF INSPECTION: t FOUNDATION i FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 3 ! ^AK � c . 4 t c ® AMOMMM Y as OWIM ofdo utod 1 t sn o ! Mc g n i aa�Wig„to actan m�► bed ®all matten m �:lD�a� by fas beet rt ood h a signed combacL owUW ■Y�IMM�O/•� • s • �r F 'k 'z1xn�grt� L 1 } k 4 e d Matfrscnu�nte l�ei�+nn�erd�f pub�e firfel� Gomm of iltmo t0 R"#A#rwno a"Sf :tint# CS-108818 • }k JA50N PATRY 82i STEWART DRIVE >, .. MlInom MA MUI OffiteofCommerAfrifn&Beslamf aledon *HOME IMPROVEMENT CONTRACTOR � Replrneon: jam Tm Expfratfom 3MO17 SuppbneWl SOLAR CM r CORPOR ONM JASON PATRY 24 ST MARTIN STREET 8LD 2UN1 �.. _— kf.B=UGH.MA 01752 Uademerelery The Commonwealth of 11<Massachmsetts Depw neent of Industrial Accidents I Catgrleas Street,Suite 100 Bogen,MA. 02114-2017 ;;► mamgav/dla Workers'Compensation Insursom Afridatft Builders/ContmetorafEleetrie oat Plumbers. TO BE FILET)WITH THE PERMITTING AUTHORITY. Apnlicant Information Please Print L al Name(Business/Drpwzation/truiividuat): $olerCity Corporation Address: 3055 Cfearview Way City/State/Zip: San Mateo,CA 94402 phone#: (888)765-24$9 Are you as emploger?Cheek tie xpprap&te box: Type of project(required): 1.01 am acntft,m v t 15,000emloyccs(fW)audlor pa44imc). 7, []New construction 2.01 am asoie praOetoror podwship and haee no aralhloyces working,for olc in 8. Q Remodeling any capacity.(No vw kim'cam.insatatrce tecltimodl 3.JJt am a immeow•acrdoing-all work nWscdf.lNuworkets'comp.intsurancerequircdl t 9. Q Demolition 4.D 1 am x hauneowaw and will be tiring amtzwAm to conduct all work on my property. 1 will ICE)Building addition share drat an auaw=s oitha have wort:ew compensation n sunmMorare sole 11.0 El=h ieul repah or addition poprinn's Wilk no tutployem 12.[]Plumbing repairs or additions So 1 am a general,coautactor mid t have Mmd the snh*contmo[om listed on the attached street. Thee sub-eor=ctom have cmpfoyses and have works'come insurasne t 14.�Agofscdarepairs G.Q rpo We are a corporation and its offwers have exercised their right of exemption per MGL c. 4.poth� �ar panel 15Z§1(4) aad we have no employees,[No wodcw'cotnp.insurance requim&I *Any applicant tits checks box 91 mast also rd1 out the seaioa below snowing their workers'cwape,nation policy tnforrwon. *I lomeowamwho submit this ttfrsdwh k0fting they are doing all work and then hire outside.contractors mm sabrrdL a new atlldavit indicating sutit :Coutractons that check this tax nmast attached an anklitionat sheet showing the name of tho sub-eontrociorti and Hate whether or not those ent]Hes have employees. 1f the have anployccs,they most provide their wdrkcrs`comp policy mm►f er. I am as emptoyer that is pravvidmg workers'comWensation insurancefor my employ= Vdvw is the policy and jab site iirformartion. Insurance Company Name:American Zurich Insurance Company Policy#or Self--ins.Lic.#: WC0182015-00 Expiration Date: 911=16 Job Site qdd„ s. 160 Gleneagle Drive _ y ip; Centerville,MA 02632 Attach a copy of the workers'compensation polity declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL c. 152,¢25A is a eftinal violation punishable by a fine up to S 1,500.00 and/or one-year imprisonment,as wet I as civil penalties in the form of STOP WORK ORDER and a rule of up to S250.00 a . day against ltte violator.A copy of this statement may be forwarded to the Office ofinvestibations of the DIA for insurance coverage verification. I do hereby certi unifer the paints and penalties of p4ury that the Information provided above is true and carrect. ason Pa December 18,2015 e . Ojlicki use only. Donal write in this mve,re be rornpleted by L4(p or tow»offie aL City or Town: Permit/Licease B Isssing Apthority(caste one): 1.Board of Health 2.Building Departmamt 3.CdyyITown Clark 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone M. CERTIFICATE OF LIABILITY INSURANCE DATE(M Ofi117Y111015 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 poNCy(les)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an eodorsemonL A statement on this certificate does not confer rights to the certificate holden In Neu of such endo►sement(s). PRODUCER CONTACT MARSH IR C&INSURANCE SERVICES - 345 CALIFORNIA STREET,SUITE 1300 PHONE 1 jANo CALIFORNIA LICENSE NO.0437163 SANFRANCISCO,CA 94104 -......... .._.... Alin;ShmionSwIt416-743.8334 _._....... _...........IN9IJREFgS}AFFORDINOCOVERABE- _—._.. NAIL# 9MI-STNIICAWUE-15-16 — - WURERA'ZWkhAmt;icanl,IsurdneColnpany 116535 INSUMM Sd WCsty C-pmatl- w+SURHe a:. A A 3055 Clew*w Way INSURER C:NIA A SanMaleo,GA94402' --..._—...._._.....__....... ..."..... .. _..._.._.._. INSURER D:AffOk n Zunch Insurance Canny A0142 — M18l1RER F: COVERAGES CERTIFICATE NUMBER: SEA-00271383" REVISION NUMBER 4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEAN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERRA 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 WAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE .... _.....iADDLTBU.. ... .........POLICY NUN R .. .... "POUCY EFF POLICY EXV L — rLIMITS A X 'COANAERCIAL GENERAL LIABRJTY GLOD182016.00 ON112015 00112016 EACH OCCURRENCE SNTED 3.000,000 CLAIM64AADE I. ..1 OCCUR PRE I,$ETO RE _.._.. ._......_ ... 3.00D.000 X SIR:$2000 t MEDFXP ale 5.... _....... --- I PERSONAL&ADV INJURY S_ 3,000,OM GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 6.000.900 x PotuY I.....j JEc ..... LOc 6.000,040 OTHER. I A AUTOMOBILELumITY SAP0162017.00 09101fmli OR0112016 COMBIKED SINGLE LIMrr S 5,000,030 X ANY AU70 I a0b4.Y MMY(Per Person) S ALL OWNED SCHEDULED X. AUTOS AUTO i BODILY INJURY(Per flEYft) S X X NONOAPd D PROPERTY DAMAGE S - _._ HIRED AUTOS AUTOS ._....---- 1 COFdPICOLi t)Ei): - S $5,OW UMBRELLA LIAR , OCCUR f ) EACH OCCURRENCE 1i EXCESSLIAB HCLAIMSIAADE l AGGREGATE S Ow I RETENTIONS S D VyORRERScobtPEAISATroN ; 09101Q015 E09101R016 X PTgTuif - OR _ _ AND EMPLOYERS!LIA29M TH- A ANY PROPRIETOR/PARTNERIEXECU'TIVE YIN ;W=82015-W(MA) 09MI 015 .091D1=6 EL EACH ACCIDENT S 1.000.�0 fICER/1,tENIi3Cit EXCLUDED? ®N1Aj -- -._....._ ............. (Idandatary in wq WC DEI)UCT1BLE-$500,000 E L.DISEASE-EA EMPLOYEE S 190ff M Yyeess,,describe widerRIPTION OF OPERATIONSberaw E.LDISEASE-POLICY LIMIT S �,ODDX I i DESCRIPTION OF OPERATIONS I LOCATIONS 1 V8*CLES(ACORD iei,AddfflwW Remarks Sdwdure,may be aUaehud R mace apace Is regWredi EvldenceDTklsurance. CERTIFICATE HOLDER CANCELLATION SdarCRy Corporation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3055 Clean4ew Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo,CA 99404 ACCORDANCE WITH THE POLICY PR.OWSIONS. AUTHOMWO RCPRESENTATIVE of Marsh Risk&Inwrence Services Churles Marmolejo 01989-2014 ACORD CORPORATION. All rights reserved. ACORD 2512014101) The ACORD name and logo are registered marks of ACORD Version#53.6-TBD IWAI SolarCit Y, December 17, 2015 RE: CERTIFICATION LETTER Project/Job#0262407 Project Address: Terry Residence 160 Gleneagle Dr Centervil, MA 02632 AHJ Barnstable SC Office Cape Cod Design Criteria: -Applicable Codes= MA Res.Code,8th Edition,ASCE 7-05,and 2005 NDS - Risk Category = II -Wind Speed = 110 mph, Exposure Category C -Ground Snow Load = 30 psf - MPl: Roof DL= 10.5 psf, Roof LL/SL= 21 psf(Non-PV Areas), Roof LL/SL = 13.8 psf(PV Areas) Note: Per IBC 1613.1; Seismic check is not required because Ss=0.19069 < 0.4g and Seismic Design Category(SDC) = B<D To Whom It May Concern, ' A jobsite survey of the existing framing system of the address indicated above was performed by a site survey,team from SolarCity. Structural evaluation was based on site observations and the design criteria listed above. Based on this evaluationI certify that the existing structure directly supporting the PV system is adequate to withstand all loading indicated in the design criteria above based on the requirements of the applicable existing building and/or new building provisions adopted/referenced above. Additionally,I certify that the PV module assembly including all standoffs supporting it have been reviewed to be in accordance with the manufacturer's specifications and to meet and/or exceed all requirements set forth by the ASCE 7 standards for loading. The PV assembly hardware specifications are contained in the plans submitted for approval. Additionally a summary of the structural review is provided in the results summary tables on the following page. Sincerely, o K. Digitally signed by HKariuki � R,UKI � Humphrey Kariuki, P.E. Date: 2015.12.18 06:52:53 ST uCTgy3►- No.5 Professional Engineer 05'00' � RFcisTE�``� T: 443.451.3515 email: hkariuki@solarcity.com ` TONAL 3055 Clearview Way San Mateo,CA 94402 T(650)638-1028 (888)SOL-CITY F(650)638-102 AZ ROC 243771,OA CSL8 888104,0O EC 8041,CT HUG 0832778,DC HIC 71101486,DC HIS 71101488,Ht1 CT 29770,MA HIC.168572,MO MHO 128948,Ni'13VH06160600, OR CCB 180408,r1A 077343,TY TDIP 27006,WA QCL(SOLARC'91907.0 2013.SoinrQtty.AtI rights roserveri, - - i ��a• Version#53.6-TBD �pa;5olarCit ® E y HARDWARE DESIGN AND STRUCTURAL ANALYSIS RESULTS SUMMARY TABLES Landscape Hardware-Landscape Modules'Standoff Specifications Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MPi 64" 24" 39" NA Staggered 68.4% Portrait Hardware-Portrait Modules'Standoff Specifications Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MPi 48" 19" 65" NA Staggered 85.3% Structure Mounting Plane Framing Qualification Results Type Spacing Pitch Member Evaluation Results MP3 Stick Frame @ 161n.O.C. 310 Member Impact Check OK Refer to the submitted drawings for details of information collected during a site survey. All member analysis and/or evaluation is based on framing information gathered on site.The existing gravity and lateral load carrying members were evaluated in accordance with the IBC and the IEBC. 3055 Clearview Way San Mateo,CA 94402 T(650)638-1028 (888)SOL-CITY F(650)638-1029 solarcity.com AZ ROC 243771,CA CSL8 888104.CO EC 8041,CT HIC 0632778T DC HIC 71101486.DC HIS 71101488.HI CT-29770,MA HIC 168572.MD MHIC 128948,NJ 13VH06160600. - OR CCB 180498,PA 077343,TX TOLR 27006,WA GCL:SOLARC491907.O 2013 Soler0ty.All rights reserved. y t STRUCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK- MP1 Member Properties Summary MPi Horizontal Member Spans Rafter Pro erties Overhang 0.99 ft Actual W 1.50" Roof System Pro erties i vS'an 1` s 10X,;,° 13.90 ft, ; Actual D '�% Number of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofing Material Comp Roof. , San 3 IL mow% . Al- o 10.88 in^2 Re-Roof No Span 4 S. 13.14 in.A3 PI ood Sheathing Yes San 5 I 47.63 in.A4 Board Sheathing None Total Rake Span 17.37 ft TL Defl'n Limit 120 Vaulted Ceiling No PV 1 Start 0.92 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 13.83 ft Wood Grade #2 Rafter Slope ',r 310 tl. PV 2 Start _ u,. R, Few -:, 'IQ 875 psi, Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracing ; ^' Full'° m PV,3 Start' a "E 1400000'i si Bot Lat Bracing At Supports I PV 3 End Emin 510000 psi Member Loading mary Roof Pitch 7 12 Initial Pitch Adjust Non-PV Areas PV Areas i Roof Dead Load DL 10.5 psf x 1.17 12.2 psf 12.2 psf PV Dead Load -,PV-DL, 3.0 psf ,r - x .1.17 ;1 .3.5 psf Roof Live Load RLL 20.0 psf x 0.85 '17.0 psf Live/Snow Load LL SL1,2 30.0 psf x 0.7 ,� x 0.46 1 21.0 psf "13.8 psf Total Load(Governing LC TL 1 33.2 psf 29.5 psf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(Ce)(CO(IS)p9; Ce=0.91 Cr=1.1,IS=1.0 Member Design Summary(per NDS Governing Load Comb CD CL + CL - CIF Cr D+ S 1.15 1.00 0.38 1.2 1.15 Member Anal sis Results Summary Governing Analysis Pre-PV Demand TOS:t_PVDemandj Net Im act• Result Gravity Loading Check 969 psi 860 psi 0.89 Pass CALCULATION OF DESIGN WIND LOADS=MP1 i Mounting Plane Information Roofing Material Comp Roof PV System Type SolarCity_Sleek'Mount'"' Spanning Vents No Standoff Attachment Hardware Comp m6unf Type'C Roof Slope 310 Rafter_Spacing_ - - - -- - _16"O.C. Framing Type Direction Y-Y Rafters' - Purlin Spacing__ ;:_X-X.Purlins Only NA � Tile Reveal Tile Roofs Only NA Tile Attachment Sy ie.Ro _ NAsm T Standing Seam/Trap Seam/Trap Spa in SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind D iesiesgn Method -; r Partially/Fully,Enclosed Method uE ,~ Basic Wind Speed V 110 mph Fig. 6-1 _Exposure Category. . : +x� ;, g ;,. Se_coon 6 5.65 -- C _ _ Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Hei ht ' ' i y .� � hm;,, +- �� �-• �� f „�.. # Y15 ftr7, 7,7 - � xr, ; Section 6:2�' Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.85 Table 6-3 Topographic:Factor _ Krt "' "1.00 Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Im ortance Factor °' �' I" 1.0 _ Table 6-1 - Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(VA 2)(I) Equation 6-15 22.4 psf Wind Pressure Ext, Pressure Coefficient U GC -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient" Down " a' -UGC 9wn)T "". .a % T' Fig:°`6-116/C/D-14A/B Design Wind Pressure p p= qh (GC) Equation 6-22 Wind Pressure U -21.3 psf Wind Pressure Down 19.6 psf ALLOWABLE STANDOFF SPACINGS - X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable Cantilever _Landscape 24" NA -- Standoff Configuration Landscape Staggered Max Standoff Tributary-Area Trib �17 sf PV Assembly Dead Load W-PV 3.0 psf Net W Uplift at Standoff -T=actual 4j 342 Ibs s Uplift Capacity of Standoff T-allow 500 Ibs Stando'�ff D mand Ca aci ;k' -0 DCR `. "' 68.4%= X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48" 65" Max Allowable Cantilever - Portrait 191, NA_ Standoff Configuration Portrait Staggered Max Standoff Tributary Area _ Trib 22 sf PV Assembly Dead Load W-PV 3.0 psf Net On_d.Uplift at! T-actual " 427_lbs Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand Ca aci ' DCR ' 85.3% i r -w ALTERNATIVE I� — aWEATHERIZATION • -, r Date Town of Barnstable Building Division v 200 Main St. h + ' ;` ";:'�•' Hyannis,MA 02601 The insulation work at lete accotir ;lff7$OGMR has been camp d In _ , 1. � � _ 1 y •.,••y'• .l rr.[ 4 '/ �:_... "• ':2 fly.i:tt•2:.ye 11 F^.ar..`•�'V �.? iIV othy Ca' President CSL 105454 ; r! 58 DIC KINSON STREET I FALL RIVER;MA 02721 I r. (508)567-4240, I ALTERNATIVEWEATHERIZATION®GMAILC4M TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel Application'v/s Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board / Historic - OKH _ Preservation/ Hyannis B" Project Street Address 1 (00 Village -c1'y�f, , Owner RLI Address o Telephone- - I yclaZ Permit Request Mlb 0 '6A'- f VaAi-s l-c- IQ, 7,Q, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation il�OSh� 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-' 'Highway�-�❑Y-6s ❑ No I f- Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other I Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft' Number of Baths: Full: existing new Half: existing newT 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` 1 vn C6 rAk-4 Telephone Number Address & LQr(L - License # L lJJ fS� Gt,U h-r�9 dc�" l Home Improvement Contractor# `� oC Email ��► ►yp�� l dzoL �@�Jha.i� CUm Worker's Compensation # 65(.2U,?,66F d 9,o/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN Td:;��&e-S /-Vf3 SIGNATU E DATE 'i L2.1�'�� FOR OFFICIAL USE ONLY APPLICATION# -DATE ISSUED` - , MAP/PARCEL NO. ADDRESS VILLAGE OWNER . DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts y Department of Industrial Accidents o 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 LeEibly Name (Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC. Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone #:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): I.❑✓ I am a employer with 14 employees(full and/or part-time).* 7. New construction 2. I am a sole or partnership and have no employees workin for me in proprietor P Pg 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition IM 1 am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.M 1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. ]3.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance..• 6.7 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.QOther INSULATION 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:ACE AMERICAN INSURANCE CO. Policy#or Self-ins.Lic.#:6S62UB5B918901 Expiration Dater J Job Site Address: -City/State/Zip:� I Attach a copy of the workers'compensation lYolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under h ns an al s o p jury that the information provided above is true and correct. Si nature: Date: Phone#:508-567-424 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I Ripqtfax C1-1 4/7/2015 6:23:53, AM PAGE 17/020 Fax Server i�� DATE R1� aaa-r-2045 CERTIFICATE OF LIABILITY IN .. NC E THIS CERTIFICATE' t$SIJED AS A MATTER OF WFOR4VIPiTI I ONLY AM CONFERS:NO;RIGHTS`UPON!THE CERTIFICATE HOLDER. THIS CER11F7CJiTE DOES NOT'AFFIRMATIVELY OR.NEGATIVELY AgIENU,_EIFrEIyID OR ALTER THE COVERAGE AFFORDED B PF}Y THE MES BELOW. THIS CERTiE1CATE.t�INSVPjk�E DOES=NOT CON$TiTtiTE A,CONTRACT BETWEEN THEISSWW IWAIRE 2(S),AUlMOP ZED REPRESENTATIVE OR PROCIIGEft,AND THE CER IFICATE HOLDER. IMPORTANT: It the cerMicate Folder is an ADDITIONAL-l?&J ED;the.PCHO{Ses#must.be endorsed. WSUBROGATION IS WAIVED. subjectto:the tense and o6ttitioni of the poky,ce Wn policles.may reRuiffe an endcrsemerd.A statement on this cerocete does not sorrier rights to the Bert fiats holder in lieu of such endorsemengs). PradcucER NAMEco CT IVEIROS INSURANCE AGCY PHONE FAX aic 375 AIRPORT RD L FALL RIVER MA 02720 INSURERISYAFFORO)NG COVERAGE NA)C S - RISURERA ACE AMEMAN INSURANCE COMPANY IMF= INSURER B' ALTERNATIVE WEATHERIZATION INC MURERC: 1446 STAfFORD RD FALL RIVER,MA 02721 INSURER D: INSURER E MURERF• COVERAZES E UMBER- 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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W17H 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 SY PAID CLAIMS. I<dsR TYPr OFB80RANCE 8t18 POLICY NU POLCYEFP POLICY 0 �S LTR 6VSR VM (SAL LEMArrY EAgH OCCURRENCE S I COADAERtXAL GENERAL.LLABOXY a>—2 S fILA7ADE occuR MEDEiIP( «r on) s PERSONAL S ADV INR)RY S _ GENERAL AGGREGATE S GENE.AGGREGATE UNIT APPLES PER: PRODUCTS-COMMID AGG S POL)CY ,L-,T LOc S t7ABi1J'rT l4 SINGLE L"T S ANY AUTO BODILY INJURY(Per P9*M) S • ALL OWNED SCHEDULED f 8WLY INJURY raracad") S AUIOS AUTOS NONUWNED AMAGE S HSREDA6= AUTOS - S LIMUtEL ALFA6 OOCUR EACH.00CURREhIOE S DCCESB LWS CLAIMS.MADE AGGREGATE S OE6, RETronpN S S . WOF49MCOMPOMATION X WCSTATU-I OTH. AND ELLYEWLIASRM YIN TORY UM)TS ER ANY PROPR=RJPARTNE E.L.EACH ACCIDENT $S0O,000 OFFICER LWMBEREX=DED7 �NIA 6S62UB 04-05-2015 jMw4aamyinNN) 5$9f8901 EJrDIsEASE-EAEMPLOYEE SS00,000 r yes.aeser a =der � DE�a'ITON of OF—TIONs Below El_msEASE-PaucY uMrr $500,Q00 DESCR neN OP OPERATM I LoCATI m i wwas IArraoh ACORD tot,Addiftang PmwIm SaodWe,I1 mare space is rewreIA NATIONAL GRID SKWLD ANY OF THE, ABOVE DESCRIBED POLICIES B 40 WASHINGTON ST., CANCELLED BEFORE THE EXPIRATION DATE THEREOF, WESTBOROUGH,MA 01551 NOTRCE WILL BE I3RNERED IN ACCORDANCE VM THE POUCY.:PROWSIONS. AUTHOtidlFD REP WgWATIVE 0 48M4040:A0ORD CORPORATIow,,A6 rights reserved. ACORD 25 tffi10" The ACORD name and logo are registered marks of ACORD i i 77 Office of Consumer Affairs and Business Regulation J 10 Park Plaza- Suite 5110 Boston, Massachusetts 02116 ' Home Improvement Contractor Registration Registration: 175683 Type: Corporation Expiration: 5/29/2015 Tr# 241009 ALTERNATIVE WEATHERIZATION, INC. TIMOTHY CABRAL 1440 STAFFORD RD. FALL RIVER, MA 02721 Update Address and return card.Mark reason for change. scn t 0 tam-Wil ` Address �, Renewal J Employment 17 Lost Card ':Tkl ur�ur•rriiYrrlf�c�^llr �ir�ii:r// Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistrati r 175683 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 xpiration: 5l2912015 Corporation Boston,MA 02116 ALTERNATIVE WEATHERIZATION,INC. TIMOTHY CABRAL ' +►� �' 1440 STAFFORD RD. � ,�--_ FALL RIVER,MA 02721 Undersecretary At vali out signature f _CB ^sa: M105464 TIM®1I'HY CABRAL 58 DICKEIMSoN ST Pall River MA 02721 - - 05/08/2015 I i CONTRACTFOR Conser atlon PRODUCTS f SERVICE WORK Services Group This service is brought to you through support from your local utility This�4greemen#�s r»ade by.and ameng '. and i ioh:A Terp3'. :: Attu Staon .: Co ervlces roue 1G0G1.eneagle Dr:;.: ::;:..:::. 5.0,Washington.,Street,Suite 3000;...::: ..; Ceniervtlle,MA'02632 2319 W.estliorough,:MA 01581. Site W,.SOOQ02278M55 : $eg No . '73484 Project:1D 1'0000¢284189 Federal ID No.222457170 Customer ID:G60000288454 (Mail completed contract to address above) . Contract.Il?:20141013 ASBAL. .'.....` . :. 1. DESCRIPTION OF WORK TO BE PERFORMED Contractor will perforce or cause to be performed the following work on these"Prenvses"in a professional manner and in accordance with the terms of I this Contract,including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated herein by reference: Description Quantity Location 1' Door_Sweep .................$46.36.......:.................... Exterior Door Weather Strippin ........ ? NIA. ........... $5518 Perform Air Sealing at Estimated 62.5 GFM50 Per Hour.. . 1? L►ving Space $1 Sub Total: $1,113.38 Utility Incentive-Share $1,113.38 Cusforner.Contribution $0.00 ,i P 1 of 2 For office use only Frfnted:10/93t2014 age II. PAYMENT as a De osit. Customer agrees to pay Contractor for the Work,@re Customer Share of the Contract Price as follows:Payment t $ � P payable to CSG upon signing the Contract(not to exceed 1/3 of the total retail costs).Mall check&conhact to CSG„Attu:RCS,50 Washington St.,Ste. 3000,Westborough,MA 01581.banal Payment;$ � as the final payment for the Work shall be,payable to:the Independent Installation Contractor("IIC")upon satisfactO letion of the Work Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount.of$ r s Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. III. DISPUTE RESOLUTION « The IIC and O�rstomer hereby mutually agree in advance that in the event that the IIC has a dispute concerning this Contract,the IIC may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Busuress Regulation and Customer shall be required to submit to such arbitration as provided in M.G:L c IV2A. You may cancel this agreement if it,has been signed by a party at a,place other than an address of the seller, provided you notifythe:seller in writing by ordinary mail posted, by telegram,sent or by delivery; notr later-than midnight of the third >;7 ,btx�ir�e S day following the signing of this agreement. DO NOT SIGN'THIS CONTRACT lF THERE A NY BLANK SPACES. . Apnr 11, 2015160 Gleneagle Drive �T .,.John Terry(Apr 11,ftl5) Y Glrsto •e Date Indicate ou'f sel ted here,if ap licable (OR) Initial here if you want the Program to assign a Participating Contractor CSG Signature ' Date Name of CSG Representative{Printed) 3/14 TERms ANiD-CONDI7l` ONS APPEAR ON THE REVERSE. AW Or. - C Conser anon PRODUCTS / SER ICE WORK Services Group Thisservice is brought to you through;support from your local utility This Agreement 1s made'by and among w w f F x Conservatson Servl�es i28 Group-_( John Terry s �A S k xr _. •,.s ttn RAC L60 Glenesgie Dr Y- 5aVasY0ngton Street,Suite-3000 Centerville,MA�'d2b32 2319 k � Westboxollgh;MA OAl'581 StteIID 50000227355 Reg No't734i34- ProJe-t ID P00000284189 � Customer ID C00000288454 Federal ID No 222457170 „_ Contract ID 20141013 -WORK 0. (Mail completed contract to address above)' I. DESCRIPTION:OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the.following work on these"Prenuses"in a professional-manner and.in accordance with the terms of this Contract,including the attached recommendations/Workorder describing the work in detail(the"Work')whicli are incorporated herein by'xeference: Description Quantity Location Propave�!., or 4' 62 Attic _ Damming._._N,_m_ fi7 N/A_ $146.73 Insulate f3tm Joist with 6 26'Fiberglass Batting _...... :. _._`..� 96 _ LivinBtiSPace _, _ y,_ $230;40 Install Aluminum Soffit vent(4 x18) 14_ Attic $436 94 Attic Floor O en Blow Cellulose 4 _ 1 344 $1;800;86 Sub Total: $21;852A9 Utility:Incentive Share $2,000.00 Customer Contribution $852.49 I C For office.:use only Printed:11.011312014 Page-2 of 2 I , II. PAYMENT Customer agrees to pay Contractor for the Work,the Customer.Share.of the Contract Price as follows:Payment#1:$ as a Deposit payable to CSG upoti signing the Contract{not to exceed -'the total retail costs).Mail check&contract`to CSG;,Attn:RCS;50 Washingtow$t.,:Ste. 3000,Westborough,MA.01581.Final Payment:$ as the final payment-for the Work shall be payable to-the Indeperident.Installation. Contractor("IIC")uponsatisfact�S compietion.of a Work.Customer understands that he/she will not'be,irquired to pay the-Utility Incentive.Share of-the Contract price in the amount.of$ ^r M Changes to individual line items and/or previous incentives maybcxease or decrease the sue of the Utility Incentive Share. III. DISPUTE:RES:OLILITION the IIC and Customer hereby mutually'agree in advance'ihatm the eventthat the 11C has a dispute.conceming tMs;.ConhacI;the:IIC may submit such dispute'to a piivate arbitration service which has been approved by the'Office of Consumer_Affaus and Business Regulation and Customer sha1be required to submit to such arbitration-as provided in M.G.L.c-142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the:-seller, provided you notify,he seller in.wr`ting by ordinary mail posted, by telegram sent or by delivery, not`later than mi.dnight.of the third business ` foll win signing-of this agreement. DO NOT SIGN THIS CONTRACT IF'THERE,AR:E ANY'BLANK SPACES;. Y t 13 Custome`S afire Dat Ind' a your ele ed her applicable (OR) Initial here if you want. rrY� e5.�""— the Program to assign a Participating Contractor CSG S' n tine. Date Name of CSG.Representative:(Printed TERMS.AND C®1OT16ET ONS APPEAR.ON THE REVERSE. 3114 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f � � Map pp` Parcel Application Health Division Date Issued /2 311Y Conservation Division r Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation/ Hyannis Project Street Address 61ey'"a, Le b . Village Aew 2 6 3 Z Owner e6s Address O �(e��� , J Telephone �v�� 4Z� - ( S �� e Permit Request �c� S� � 1tAa -S� 54,w- � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain (' Groundwater Overlay Project Valuation d� Construction Type �r Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family di-- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ._ On Old King's Highway: ❑Yes el-No Basement Type: mull ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) °Number of Baths: Full: existing new Half: existing `e new .Z- Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Ra m Count. Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric " ❑ Other --r Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo coal stove: 'es Q.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 5Z-=� � Proposed Use APPLICANT INFORMATION (B DER OR HOMEOWNER) (�, qName Telephone Number � V r)<P -1(�S Address «� �� 5l� to License# C 5 (0t, JS� YJ Home Improvement Contractor# Email Cos Q) ate`s , Ccl""4dorker's Compensation # C 6 Z ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �SIGNATUR DATE FOR OFFICIAL USE ONLY APPLICATION# g f .i DATE ISSUED MAP/PARCEL NO. s , ADDRESS VILLAGE t. OWNER- DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 1 DATE CLOSED OUT ASSOCIATION PLAN NO. • The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations 600 Washington Street k kip Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Levi bI Name(Business/orsmization/Individval): E.B Norris &Son, Inc. Address: 138 Osterville W. Barnstable Road City/State/Zip: Osterville, MA 02655 Phone#: `508-428-1165 Are you an employer?Check the appropriate box: Type of project(required): I.Q I am a employer with 20 4, ❑ I am a general contractor and I employees(full and/or part=time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet: 7. x❑Remodeling ` f ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp. insurance comp. insurance.: 9. [3 Building addition required;] S. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers' comp. right of exemption per MGL 12.Q Roof repairs = insurance required.]t c. 152, §1(4),and we have no 3 a.❑ I am a homeowner acting as a employees.[No workers' 13.❑Other general contractor(refer to#4) pomp,is,m„ar,re ] •Amy applicant that checks box#1 must also fiU out the section below showing&eir woricery compemsadorti lsoucy informetim t Homeowners who submit taus ailid:vit indicating they arc doing all work and then hire outside contractors must submit a new at$devit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-eontrw ars and state whether or not those entities have employees If the sub-coatractots have employees,they must provide their workers'comp.polity number. I an an employer that is prvviding workers'compensation insurance for sty employees Below is the policy and fob site information Insurance Company Name: Acadia Insurance - Policy#or Self-ins.Lie.#: WCA021246417 Expiration Dom: 05/03/2015 Job Site Address: 160 Glenea le Drive City/State/zip.' Centerville, MA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required snider Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK'ORDER and a fine Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby t der the pains and penal of pm*y that the informadon provided above It true and correct i Date-�5 12-2-14 50 -428-1165 OftWd use only. Do not write in this area,to be completed by city or town o aL City or Town: f, Permifi/L[cense# Issuing Authority(circle�one): - 1.Board of Health 2.Building Department 3. City/Town CIerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person• Phone#: Client#: 646400 2NORRISEB ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/27/2014 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: Dowling &O'Neil H NN,Ext:508 775-1620 jaX No:'5087781218 Insurance Agency I E-MAIL ADDRESS: 973 lyannough Rd., PO BOX 1990 INSURER(S)AFFORDING COVERAGE NAIL# Hyannis, MA 02601 INSURER A:Acadia Insurance INSURED ' E. B. Norris &Son., Inc. INSURER B: 138 Osterville-West Barnstable Road INSURER C Osterville, MA 02655 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS , A GENERAL LIABILITY CPA005234525 05/03/2014 05/03/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $250,000 CLAIMS-MADE 51 OCCUR ° MED EXP(Any one person) $5,000 _ f PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 KEN'L AGGREGATE LIMIT APPLIES PER: t r PRODUCTS-COMPIOP AGG $2,000,000 POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS - ( ) NON-OWNED PROPERTY DAMAGE . HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WCA021246417 05/03/2014 05/03/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TOY IMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $SOO,000 OFFICER/MEMBER EXCLUDED? 7 N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.C.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms, conditions, exclusions, other limitations and endorsements. Nothing contained in the.certificate of , insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. *' CERTIFICATE HOLDER {' CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA-02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) -1,of 1 The.ACORD name and logo are registered marks of ACORD $C14nQ1S/M14f141d - I C1 Office of Consumer Affairs and Business Regulation 10 Park_Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration ,. Registration:. 102014 Type:-' Private Corporation Expiration: 6/30/2016 Tr# 252322 t ERNEST B. NORRIS & SON INC Craig Ashworth ,r, = } . 138 Osterville W. Barnstable rd. Osterville, MA 02655 z, ,a-/ }Update Address and return card.Mark reason for change. Address 0 Renewal. [j Employment Lost Card SCA 1 0 20M-05/11 - License or registration valid for individul use only Office of Consumer Affairs&Business Regulation. before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR egistration: 102014 Type: Office of Consumer Affairs and Business Regulation x iration r 6/3Q/213-161 Private Corporation 10 Park Plaza-Suite 5170 p Boston,MA 02116 ERNEST B.NORRIS`f,- S.ON I ' 4 AM— Ogg t Craig Ashworth .r 138 Osterville W.Barnstabre rd Osterville,MA 02655 Undersecretary Not valid without signature i QF tME rp, Town of Barnstable. Regulatory Services sniuNSTUBrr;, Thomas F.Geller,Director 9 .�0 .......................:..... _.. __....�_.. ._....Buiicliug-Ditsion................... ................................... ....... ...... r 200 Main Street, Hyannis,MA 02601 www.town,barnstable.ma.us Office: '508-8624038 ...........................:......,........ ....... : .._........... ...... ._ Fax;_.SQ8:-79.... ............ Property Owner Must ' Complete and Sign This Section If Using ABuild�er I, John Terry ,as Owner of the subject property' herebyauthorize^^ E.B Norris&Son, Inc. to act on my behalf, is all matters relative to worts authorized byd is building permi't.application for: . i 160 Gleneagle Drive, Centerville,MA (Address of job) Signature of"Owner'' ate Jpinn Print Name Q:F0RMs!0WNE"BRM1S3i0N Massachusetts -Department of,Public Safety Board of Building Regulations and Standards Construction Supervisor f� License: CS-015851 �. CRAIG N ASHWOkTH 138 OST W BARNSTABLE�' I OSTERVHJ, NFA O >r,f Expirationf Commissioner 09/28/2015 . I . .1. 1 0hZho oFrF,rr 'own of Barnstable �O it0 �5�`(3 ti Expires 6 months r issue dare Regulatory'Services Fee 1�gRVS1ABi E, " y )tAS4. 1619- � Thomas F. Geller, Director Building Division X-PRESS P pp Tom Perry, CBO, Building Commissioner ERM5T 200 Main Street, Hyannis, MA 02601 O C T www.town.barns tab le.ma.us Office: 508-862-4038 TOlNRIr Rp6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL.ONLY ..Not Vaiiri rvithoW Red X-Press Imprint Map/parcel Number Property A d d ress � .,,[.45t4 _jAGt.5 Vpuye 0YUKvi 1/U_5LO 'i L . Residential Value of Work_ 1 Jpj7o. Minimum fee of$35.00 for work under$6000.00 Owner's Nam e & Address TER RY t J 0 j) a1 E(..LSD bI2 G�n11Ry ( tom M Ft 026' 3Z Contractor's Narne EI2J�OT � N D (ly �j p� i )9 Telephone Number . p Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 5 58Sf o c� ❑Workman's Compensation Insurance . -n Check one: 00 co ❑ I am a sole proprietor. ❑ I am the Homeowner cn I have Worker's Compensation Insurance Insurance Company Name , RfipIA �N�jU��I (V �G r- Workman Comp. Policy# 07 D 10 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(hurricane.naiaed) (stripping old shingles)4All construction debris will be taken to Ej Re-roof(hurricane nailed)(not stripping., ,Going over existing layers of rood ❑ Re-side #of doors Replacemen Windows oors/sliders. U-Value• A (maximum .JS)# of windows 3 *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,.etc. ***Note: Property Owner,must sign Property Owner Letter of Perm Z.ission. A copy of the Home'Improvement Contractors icense & Construction Supervisors License is required, . 3IGNATURE; - )Wprn FQ1F0RMS,bui1din2 Dermit fnrimk[7YPRFC4Z rtnr The Commonwealth of Massachusetts _ Department of Industrial Accidents _ Office of Investigations ' a 600 Washington Street Boston,MA 02111 w4 `� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information , Please Print Legibly Name(Business/Organization/Individual): �P,�`r f,7 , 1J 8 S e?0 Address: 13J� n toJ &9:6S-1ff PSuf V-10; City/State/Zip: V� �L1.1,�� Phone.#: —11 vir Are you an employer? Check the appropriate box: Type of project(required): 1�Q I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-tim.e).* have hired the sub-contractors 6. El New construction 2:El I am a sole proprietor or partner listed on the attached sheet. 7. .❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• 9. ❑Building addition [No workers'comp..insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t -c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *My applicant_that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. M PO-1 Or.1 Z.N7 d110 Expiration Dater (�✓r Job Site Address: l l�� (� � V �� i' City/State/Zip: r� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage.as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of.a. fine rip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certify un pains and penalties of at tli 'formation provided above is true and correct Signature:Ql Date: '�. "to - Phone#: 11 b S Official use only. Do not write in this area,to be completed by city or town official City or Town: - Permit/License#: s Issuing Authority(circle one): 1.Board of Health 2.Building Department I City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �a Inforn atio�rand-Instfau ti-o-ns------ - Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for then employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract 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 more of the foregoing engaged in a joint enterprise,and including the legal representatives of a oeceased`emp oYei,-or e - receiver or trustee 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 another who employs persons to do maintenance,construetio'n or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of.such employment be deemed to,be an employer." MGL chapter 152, §25C(6)also,states that-"every state or local licensing agency shall withhold theissuance or renewal of a license 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 of public work until acceptable evidence of compliance with the 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance.coverage. Also be sure to sign 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 law 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. Thd 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 permit/license number which will be used as a reference number.-'.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)`and under"Job Site Address"the applicant'should write"all locations ui,. —(city or town)."..A copy of the affidavit that has been officially stamped or marked by the city or town maybe 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 citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like 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;ftelephone,and:fax number: The Commonwealth of Massachusetts Department of lndusttxal Accidents ` ° Y. Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-72777749 . Revised 11-22-06 - www.mass.gov/dia OF THE + BARNSTA MASS, i679, Town of Barnstable + rfD►ripe A , :.- Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CB0 Building Commissioner 200 Main Street; Hyannis, MA 02601 www town.barnstable.ma.us Office: 508-862-4638 Fax: 508-790 6230 Property ®cyder Must Complete and Sign This Section 1 If Using A Builder as Owner of the,subject property hereby authorize Q��G1T 1 ,I�►1��.�-1�7 �'z7 D , i INC, µ to act on my.behalf, in all matters relative to work authorized by this building permit application for; (Address of Job) r . qe Owner 6ate Print Name If Property Owner is applying for permit, please complete the-Homeowners License Exemption Forrra on the reverse side. Q:\WPFILESIF0RMSlbui1ding permit formsTXPRESS.doC . Revised 072110 P�0 HWE Town of Barnstable Regulatory Services M M sw�'srnatr, wss. ' Thomas F. Geiler, Director y �+, .o ,639. A�� � Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: 518-862-4038 Fax: 508-790-6230 --------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER" name home phone# work phone N CURRENT MAILNG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six,units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF 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,pers;on,who constructs more than one home in a two period shall not be considered a homeowner. Such "homeowner"shall submit,to7the`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 d 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 pf Barnstab-le Building,.Department miniin6m inspection procedures and requirements and that he/she will comply with,'said prbceclure,and requirements.'' Signature of 1-Iomeowncr Approval of Building Official Note: Three-family dwellings containing 35,000,ctibic'feet bi larger will be required to comply with the State Building Cade Section.127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing ofconstruction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 0721 10 r Client#:646400 2NORRISEB ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0DATE(MMJDD1YYYY) 5/26/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyannough Rd., PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURERA: Acadia Insurance E.B.Norris&Son.,Inc. INSURER B: 138 Osterville West Barnstable Road :. wsuReR a Osterville, MA 02655 INSURER D: INSURER E: COVERAGES 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 POLICIESDESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MMIDD/YY LIMITS A GENERAL LIABILITY BINDER307009 05/03/10 05/03/11- EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $250 000 CLAIMS MADE F OCCUR MED EXP(Any one person) $5 OOO PERSONAL&ADV INJURY $1 OOO 000. GENERAL"AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,O00 POLICY 7 PRO- JECT LOC A AUTOMOBILE LIABILITY BINDER307008 05/03/10 05/03/11: COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $1 OOO OOO X SCHEDULED AUTOS (Per person) r r X HIRED AUTOS BODILY INJURY $1 OOO OOO X NON-OWNEDAUTOS (Per accident) r PROPERTY DAMAGE $500,000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO - OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESSIUMBRELLA LIABILITY BINDER307011 05/03/10 05/03/11 EACH OCCURRENCE $10 000 000 X OCCUR CLAIMS MADE - AGGREGATE $1 O OOO OOO $ DEDUCTIBLE - $ X RETENTION $O $ A WORKERS COMPENSATION AND BINDER307010 05/03/10 05/03/11 X OR STATUS OTH- EMPLOYERS'LIABILITY _ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? NO E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER v DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION 10 Da s for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S69611/M69610 CR © ACORD CORPORATION 1988 r • y "IMassachusetts- Depai huent of Public Safety Board of Buildinh Regulations and Standards � { Construction Supervisor License 'License` CS ' 15651 Restricted to: 00 M. CRAIG N ASHWORTH 3 138 OST W BARNSTABLE OSTERVILLE, MA 02655 Expiration: 9/28/2011 Commissioner Tr': 3091 - y. r - J`;/k Office of Consumer Affairs and" usihess Regulation 'IMf 10 Park'Plaza - Suite 5170 _ Boston, Massachusetts 02116 Home Improvement Contractor Registration Req istration: 102014 . Type: Private Corporation ' Expiration: 6/30/2012 Tr# 200714 ERNEST B. NORRIS & SON INC , Craig Ashworth 138 Osterville W. Barnstable rd - Osterville, MA 02655 Update Address and return card.Mark reason for change. Address ❑ Renewal ❑ Employment ❑ Lost Card DPS-CA1 is 50M-04/04-G10011Q216 ' Office o�coE mO47 e'rAff-s�V'BVin6s Yee Pion License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: r,102014 Type: Office of Consumer Affairs and Business Regulation W Expiration: 10 Park Plaza-Suite 5170. „ p ation: 6/30/2012 Private Corporation Boston,MA 02116 ER181 ST B. N0RRIS&:SO:N INC Craig Ashworth 138 Osterville W Barnstable rd 4� r Osterville, MA 02655 Undersecretary Not valid without signature . 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map'E �9� Parcel -2- Permit# Health Division . �t1 Date Issued ConservAl on Division4ig Fee0. o Tax Collector c/ Application Fee Treasurer `' #PPYY Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis 5 Project Street Address d Village ����a���s G� _ Address ��® Owner Telephone Permit Request c)"lumd /d2x/� /oZ ��, a� a&,JQL4 quare feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new aluation 1 Zoning District Flood Plain Groundwater Overlay Construction Type A Lot Size t Grandfathered: Cl Yes ❑ No If yes, attach supporting documentation. .� P Dwelling Type: Single Family CY/ Two Family ❑ Multi-Family(#units) Z__ ' Age of Existing Structure Historic House: Cl Yes . ❑No On Old King's Higrw Y: ❑Y65 dl% w Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing nq ; Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count r Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other el 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: v J Zoning Board of Appeals Authorization ❑ Appeal# Recorded Commercial Cl Yes ❑No If yes, site plan review# Current Use Proposed Use lfaA4G".10)u AZ&4) BUILDER INFORMATION Name Telephone Number ta6'm��� Address ".4_d� .,1Ave 1 License# �� �,-/X A:t" 0;5-f7 Home Improvement Contractor# �W Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ,/oT s FOR OFFICIAL USE ONLY ' 4 PERMIT NO. DATE ISSUED , V MAP/PARCEL NO. ' ADDRESS VILLAGE • OWNER i DATE OF INSPECTION: FOUNDATION ,f FRAME= INSULATION r r FIREPLACE ELECTRICAL: ROUGH' FINAL PLUMBING: ROUGH FINAL � GAS: ROUGH FINAL 7 FINAL BUILDING d o f DATE CLOSED OUT f �" ASSOCIATION PLAN NO. F oFT Town of Barnstable Regulatory Services ` Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 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:,kL&&jEV2Z AN /4� Estimated Cost . Address of Work; ('( Owner's Name: 'CA/ Date of Application: I hereby certify that: Registration is not required for the following reason(s): FlWork excluded by.law []Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora permit as the agent of the owner: Date Contractor Name Registration No. w OR Date Owner's Name Q:forms:homeaffidav -----pp- ------- --_— —._-_�. — �` ..ifie "Vcanrirzanusea�(.iz d��aczc�zccGec�b • Board of Building Regulations and Standards V' HOME IMPROVEMENT CONTRACTOR Registration: .148574 Expiration 10/6/2007 Type Supplement Card Patio Rooms(dba)BetterLiving Sun — NTFc'k Stevens ------ 781 Turnpike Rd. �_ — ✓ Westboro,MA 01581 Administrator , w _.. _ � ✓/ze-Pomvrreo7,,weall� a�.:�aoaczc%�ae�a i k j BOARD OF BUILDING,REGULATIONS License: CONSTRUCTION,.$UPERVISOR �q& t x s Number CS 081580 . Expires 02/19/2006 Tr.no: 81605 Restncted 00 PATRICK A STEVEMS PO BOX 1068 ' ,s STERLING, MA Administrator c .. i r �t� �r�IDIL View Document Page 1 of 1 OCT-31-2005 10:40 AM EETTERLIVING 1 508 870 5756 P.04 Property Owner Must Complete and Sign This Section If Using A Builder 1 . ,as Owner of the subject property hereby authorize Bette g Patio Rooms(d.b.a. Patio Rooms of America) to act on ray behalf,in aP_�matters relative to work aufrorized by this building permit application or(address of job) ( Signa o wn , , Date ------------------------------------------------ !'r.;s sec!?,,n tU Ice co;%plelad.y nLrre.living vJf.c..Slc�.rj Owner or Builder(ns agent of Owner)Must Complcte and Sign This Section 0•xner/Authorized Agent hereby declare that the statements a:-rd information 4r the-Foregoing application.for (address of job) o ,C�/�u.�Q/ are true and accurate;to the best of my k owledga a�rd belief. 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Of 3 auild:ng pt.-mit"fo+ a prC11eCC tC .^r"" Bt 1rSC:U9{g "suny7 addit Ons LC P:i exW*irz residentia :iu. l `vUi101P.g^. 'in ecccrda:ice 'with 11ix i' +iCL111CD`�, L+SC JS%Cibi.St2llOd 12':'tv)'BCIiP.t)��IeCi2CS t�1it 3:1`.li�'C i1?S '.Lad e I -Crmption is t':-i5 4JGSirCIO:;t COri:B�il:,�o7�rOrJil:':F`i:SiO':an,! conservAti:n. itl, ' i�r• �la'L Sir�latLra o:r.cn..sW2 i_„illd.r.� /•-.d'a¢^ �•� t ib:?di'i'i r "0f9�'�;C'1'?rr1C� Ownvrf.ddr3SS ii i:,CrentiFan 'lj: - , Print This Page http://pra.patios.comfViewDocuments.asp?image=l0-31-2005-3-24-14-Consumer-Form.j... 11/10/2005 L -. View Document Page 1 of 2 a- OCT-31-2005 10:42 AM BETTERLIVING 1 508 870 5756 P.07 I' Contractor negmrn—....a..,..., stt,,aletum Patla Roam Massachusetts-No.148574 ` Home improvement Contract s,<p taor~In suNROOMS Patio Rooms of America,Inc.•7 Turnpike Ind•Westborough,NIA 01591•Phoone:5508)87f�r19900•Fax:(SOB)870.5757 Contract Date: Product Manager: "(Iwliie MOM �:p4Stiuil Owner's Names t State: Zi t Street Address: Ci Pfowe: home Phone: -+ Da Ylme Phones E•Mail Address Job Site Address(If different Materials to he provided and work to be performed by Betterlivin Sunrooms("Contractor"): I One stnheated Be erlivin24t S R m Color• White © St Sand ❑Brown vle;PLStudict LT'A"Frame ❑ Fill-In - S[�e to be anoroxlmatelVt.�—a.—x x _ Ail alasa to ba: ©SINGLE PANE %,Double Pane hisulated A-Wall:❑Tempered Doors)&Screen(s) %Tempered Window(s)&Screen(s) r ❑ Ra ld ❑ )3ettertriew 18"' ❑Other olio ❑()lass B Wsll:0 Tempered Door(s)&Scroen(s) �§-Tempered Window(s) Screen(s) Irons ❑Rapid ❑Bettenriew Kn : t1.18" 00ther j4olld ❑class a a: ❑ Full Glass w/transoms on A&C ❑ Glass w/6"fill block on ends C We11t�ZTempered Doors)&Screen(s) .Tempered W'indow(s)&Screen(s) Tramoln ❑Rapid ❑Betterview Knetwal,OJ8.. ❑Other ,Solid OClass CUSTOM Wall:(if applicable-give details): Rooft CFoam Built-in(cutter S•stem 1pbermal"H" - hite/White ❑Sand!'Saad Room to be built on: ❑ov lner's existing deck if properly footed and up to code-Contractor to add sub-floor and upgrades needed to meet code. mn:8y doing upirrada Contractor wkl wdrrenry owner's txWJng dttk jar r year R b Foundation built by Contractor includes sub-floor ❑St s to grade off wall s Additional eck/Additional Work dor ers,open dock description,etc.): i Work not to be done: t t Required Permits-A plot plan is required by all cities and towns to obtain u' Entire Agreement:This CBalragt and the G taco Off ge The night Root ptnnit. If Owner cannot provide Contractor wlttt a valid plot plan within five 1 constitute site cnflrc agreement between Owner and Contractor. Owner (5)days of tha Contract Date,Contractor will order a plot plan of Owner's agrees to be bound by the terms of this Contrast as written. There arc no other expcost totaling $500.00. C'onvaetor agrees to obtain all bulldinu permits understandings between Owner and Contractor,either orally or in witting.Two requited,but if the permit fce:zee 5300.00,any additional costs will be the identical copies of the Contract are to be completed andpigned. Ora copy is to m5ponsibllltyefOwner. be retained by Owner and tho other copy by Controctur. Do not sign this Customer must initial;X X_ Contract it there are any bigek spaces or If It does not Include everything agreed upon. ti li project Completion:Customer agrees to be pment od final day of room These TENTATIVE dates assume no unforeseen permitting. completion to complete Mal la -o a tad deliver ntw payment financing,or weather delays. See terms&conditions. Customer must Initial: X X Work Is tentatively scheduled to lteglro 77 CONTRACT PRICE INCLUDES ALL APPLICABLE D18000NT9 Work tentatively a tiled to be substantialgTco loted by- AND PROMOTIONAL CONSIDERATION'S CASH CONTRACT DANCE CONTRACT 1.Contract price:$ %L�n I.Contract Price S 2,Initial Deposit:(1!3)S 1716n? _ 2.Initial Deposit: i 3.Material Ordered installment:(113)S 3.Material Orders tallmenl:(60%)S 4.Balance Due Upor.Completion:(1/3)$ 4.Balance D pen Completion,(35%)S DO NOT SIGN THIS DOCUMENT IF THERE ARE ANY BLANK SPACES ! Patio Rooms of America,I d/b/a Betterliving Sunrooms ,I By. iPro act Manager Owner I natur t it o.nd....•Monannr rArin/Ngmel Owner Sl1 nature http://pra.patios.com/ViewDocuments.asp?image=l0-31-2005-3-24-14-Contract.jpg 11/10/2005 SUN ROOMS Adding Value to your Home & Life' The enclosed permit package is for the proposed building,of a three season,sunroom on an existing wood deck. Included in this Permit Package: • Plot Plan and septic diagram if applicable + Deck Framing Plan • Plans for sunroom • Homeowner permission to represent then in securing this permit • Signed customer information form for sunrooms • Proof of Workers Compensation Coverage • License • Debris Removal Plan • Contract Thank you in advance for your assistance. Please call if additional information is needed. Best Regards t Elaine Johnson + Customer Rep. 508-870-1900 ext 221 With Offices bz Eastern Massachusetts Western Massachusetts New Hampshire Upstate NY 78 Turnpike Rd 317 Meadow Street 1 Action Blvd. 70 Cohoes Ave. Westborough,MA 01581 Chicopee,MA 01013 Londonderry,NH 03053 Island Park,Green Island,NY 12183 Phone:(508 870-1900 Phone:(413)420-0140 Phone:(603)537-9256 Phone:(518)687-2337 FAX:(508)870-5756 Fax:(413)420-0147 Fax:(603)537-9258 Fax:(518)687-2338 PROPOSED NEW DECK ITA5'(APPROX) I,2XIO Pf I' ME @ 16"D.C. 2.LEDGER BOLTED I/2"X5 LA65 52"O.C. 5.J015T NANGE75 PCIM EN195 el lb 9.'2X&.0 TP.IPLE END REAM(HIDDEN) n, ( � 5.1761,51DE JOISTS 67(4VI4"0-X'98"=M—P FI65-W/-ANCHOI?5 3 OP TECHNIC)P055 7.1/2"Pf T&G PLY OVMAY B.6X6 PO5T5 PPOP05EI7 5 SEASON PORCH 12'X I5'(APPROX) 5TUDIO 5111.E ENCL05(.Il c 5"EP5+ H ROOF 5Y5TEM (12'SPAN) i F' I NEW 6'POOR FROM PORCH i NEW 6'190M FROM PORCH (NOT 5HOWN IN TH15 VIEW) 1=111� KIII=TI-1 r 1=1 LIIEI 1- Q 1=11L1J �."JPf-lHf-l= —I r�V I�1=1 1-III=1Ti=1 1=1 1=1-1Ti=111=Til I II�IIIIIHE H—IIIE ill ��Ililllllli III �I11111111111111. 6151 1111111i111= ='�Illllla �I�IIIIIIIIIIIIIIIIIIIILIIilllill�IIIIIIIllll�ll I_I I I III—III_ III III—III— I I_I I—I i h I I�11 III-' —III III-1 —III III I I�I I_n�11611 1111— _I (=_III—I —"I 11 I I' '-11 —� 'rl j l I I IJ n- —'n=11 —nLJ LJ L- LJ=' LJ 111 NOTE: ® ALL 170OP5 TO 13E PINNED O SHUT,OWNER TO GUILD OPEN DECK&/OR 51AIR5 AT THE COMPLETION OF 5UN1?OOM. Project: Scale:1/8" 1'-0" Drawirq: Betterliving bnY P�51P�ma SUNROOMS 16oGLENEAGLEDRIVE A—) CENTERVILLE,MA 02632 78 Turnpike Road,Westborough,MA 01581 Phone(508)870-1900 Fax(508)870-5756 Date:11/10/05 Sheet I of I N,aY-10-2005 02 :36 PM EASTP0UND->LAND->SURVEYING 508 477 6411 P.03 103.50, co) LP PROPOSED TANK 43�UNROO ° 4.5.13' F} h N N EX. ~` DKELLING MAP 191, PARCEL 152 CEONTERWUE MAGLENEAGLER 103.50' GLENE'A GLE DR. LOT AREA 1%031 SF SEPT?c SYSTEM SHOW EX DMILINO AREA- f 762 SF IS DRAWN FROM AS-BUILT EX. LOT COVERAGE- }1.SX ON FILE AT THE TOW PROP. LOT COVERAGE- }Z9X HEALTH DEPARTMENT CERTIFIED E.D PLOT PLAN EDDY RESIDENCE I CERAFY THAT THE IMPROVEMENTS SHOWN Of 1160 GLENEAGLE DR. NAVE BEEN LOCATED WIN AN INSTRUMENT �i �s�� CENTERW AMA SURVEY. ROBB DATANOV. B,NO 2005 SYKES M SCALE:I"-30' JOB 10 EOW$2 NO' 1° EASTBOUND ,d IS LAND SURVEYING$ INC. P.0 BOX 442 ROBB SYKES, P. S DATE FORESTDALE, MA 02644 508-477-4,511 l4LJr4r4Ct.1IUN VC 1 7YPJCAL 51DE WALL CONNECTION 67r_.- L.S -._ =i. . m . 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Department of Health Safety and Environmental Services MASS. 4 TED MP+01 Building Division 367 Main Street,Hyannis,MA 02601 )ffice: 508-862-4038 pax: 508-790-6230 PLAN REVIEW I , Owner: 13r t00A _� 4 Map/Parcel: 9 [ 6 2 Project Address: I L"U Q ev\2o l —D r . Builder:a-4 I e S f QUe n S The following items were noted on reviewing: I ssu I ,09r� Reviewed by: Date: n•hnildin v:fnrms:review aQsn o PROPOSED NEW DECK 12'XI5'(APPROX) 1.2XI0 Pf FRAME @ 16"O.C. 2,LEDGER POLTED I/2"X5"LAGS 32"O.C. 3.JO15f HANGER5"END5 ZY, 4.2XBPf TRIPLE END BEAM(HIDDEN) 5.17Lt 51M JO15f5 l 6.(A) 12"O X 48"DEEP FIGS W/ANCHORS OR TECHNO PO5f5 a " 7.1/211 Pf f&G PLY OVERLAY 8.6X6 1`O55 r 5 . c PROPOSED 5 SEASON PORCH 12'X 15'(APPROX) SfuDlo STYLE ENCLOSURE 3"EP5+ H ROOF 5Y5TEM (12'SPAN) E t NEW 6'DOOR FROM PORCH NEW 6'DOOR FROM PORCH (NOT 5Hm IN TH15 VIEW) vS • I I p I I-I I (-11 I-I L I I J I 111-I I I L-I I C I �-I I1=1I I - �1LI-1J �Iml itI�II� �II Ir �TF11=I�If-1TI_ I�Ii�I�I �,I - I-III �I lIP�IJ�" 1=11-I I I-I I�11 I I Ih 411I�i1 �111 I � nH I rrr�1 I�� -I 11— J', LJ' LJ' LJ=" - LJ -Iji- NOTE: ® ALL DOORS f0 DE PINNED O SHUT,OWNER fO GUILD OPEN DECK&/OR 5fA1R5 Af THE COMPLETION OF SUNROOM. s } Project: 5rale:l/8"<I'-0" Dra m: etterl ivi ng �nnY P�sipmN AGLE DRIVE S U N ROO M S 160 aENE CENTERVILLE,MA 02632 / 78 Turnpike Road,Westborough MA 01581 Phone(508)870-1900 Fax(508)870-5756 Date:I1/10/05 Sheet I of I i NOV-1 0-2005 02 :36 PM EASTBOUND3LAND4SURVEY I NG 509 477 6411 P. 03 (0 UN9 d LA PROPOSED WAS' Fol], TANK SUNROD 43 38' 4.5.13' H N tNl EX. 'd DWELLING MAP 191, PARCEL 152 6CENTERWLL� R�MA GLENEA GLE DR. LOT AREA 14031 sy` �PT1C SYSTFAI SHOWW EX. DWELLING AREA-- 7762 SF S FROM A S�BUILT EX. LOT COVERAGE- 11,5X DON FRA DRAM AT THE 7S- PROP. LOt COVERAGE 12.91K OM HEALTH DEPARTMENT E'ER TIFIED PL 0 T PLAN EDDY RESIDENCE I CERTIFY 7HA T ME IMPROVEMENTS SHOWN Of �4s kt80 GLENEACLE DR. HAVE BEEN LOCATED MTH AN INSTRUMENT CENTERW MA SURVEY. Roes DAM NOV. a, 2005 DRAWroe 1,Eooeaz "Mst SCALE:1"-30' No. 3541a RASTDOUND !S LAND SURMING, INC. P.O. BOX 442 ROB, SWES, MIS DA T£ FORESTDAL& MA 02644 508-477-4511 DEC=02-2005 12 : 18 PM BETTERLLVING. 1 508 870. 5756 P.03 Lu Gil K h Z + a aw a+uouv N I '� u t� I •j. < n z w 3 �o Z o m uj �rw f HAW OR 0. 5 z Z. ,{I �$'� :� u�f��7��L�'� ` ;;%+'�I+`` ! -- � i �sa,�� 11��itij�;�s����"• � ;�� ,�'� ��5 v'1 4' �,` �' l � ��t �• a ���� � �- 9� mw�s �t I A 2i let V. 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'dE161N•SEII�'Jr!CX 6 'j. I ssT. 1 `y t �n J.•C}.• IA1:7 J- AM lA I �L'(J X F s•nEactf stcs}. = v:3nfk ent°� lam ,�+'!pX; o.tr-�r:EM— l '. '` � � a :i;LbtTF[fPNIfJ.S ACE GAotf ut-AE tsi-:ONLY. r5f-rout mlS&rc17f � '-f� N[i7� fit —__. _ ---- � 5111 E)K)SkIc !KE ti rim rat_tlf!J:r,nrtia P=Pt31E6 ?- . J6i: 'AWIlile g JfhC,fJ -+ _ �i• AMAriLIMAIL&l 4,.E#� r'�`fm;P=fi'" „ems-reG! .� GCi 31 F=n f r E1'F U? _ 0 !V - I © ` U A•� NWP`o°THE The. Town of Barnstable RARE. Department of Health Safety and Environmental Services 9 MASS. e i639. �0 PTfp pg.A•1"• Building Division - 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: r i ca�A L. et Map/Parcel: 1, Ql 1 Project Address: Ilo 0 Builder: I-:a.4 S� Q Ve n S i I The following items were noted on reviewing: �. C'-� -+b to LV) I � UV- oU�- )1 rtQ �J e c;Y e-- C—Cb-4 l 4 ( a-� (J ISS'v � � II i D r� �, c »n vim . Reviewed by: Date: q:building:forms:review t Town of Barnstable *Permit#O?OOM&/ Expires 6 months from issue date Sr, Regulatory Services Fee C2,5. 00 - �' Thomas F.Geiler,Director Building Division MAR 2 2007 Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address V�e tn> —,a- �1 Residential Value of Work 0 Minimum fee of$.25.00 for work under$6000.00 Owner's Name&Address D Contractor's Name - .ri� c_ fI'elephone Number • CS Home Improvement Contractor License#(if applicable) IS L- - Construction Supervisor's License#(if applicable) C ` - ❑Workman's Compensation Insurance Cbftck one: rvi jXJ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: o rty Owner must s Pr erty Own r Letter of Permission. o e Impr vement icense ' required. SIGNATURE: Q:Fonns:expmtrg Revise071405 i STAB Town of Barnstable 039. p.�� Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 50 - -8 790 6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize ' -� _ to act on my behalf, in all matters relative to work authorized by this building permit application for: bQ9 A ( ddress of Job) Sign 7hire of Owner Date Print Name Q:Forms:expmtrg Revise071405 f DEC-8-2006 10:32A FROM:SCHLEGEL SCHLEGEL IN 15087710663 TO:15087900020 P.1 I i ACORD CERTIFICATE OF LIABILITY INSURANCE DATHIMMIDDNYYY) 09/29/2006 PRODUCER THIS CERTI ICATE IS ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSURANCE ONLY AND! CONFERS NO RIGHTS UPON THE CERTIFICATE 34 MAIN ST HOLDER. T41S CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WEST. YARMOUTH, MA 02673 INSURERS AFF9RDING COVERAGE NAIC# INSURED Randy Hughes INSURER A, PRE X MUTUAL DHA RR CONTRACTING INSURER B:AIMmlm—� INSURER C: MEETING HOUSE RD INSURERIX I MA$HPEE, MA 02649 INSURERS: COVERAGES 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 �O ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRD TYPE OF INSURANCE POLICY NUMBER p CYFXPIRATIDN- IMFFFECT1 ;'DATE(MMIDDIM LIMITS A GENERAL LIABILITY CPP0707407 10/18/2006 �0/18/2007 EACHOCCURRENCE $1 000,000 _ COMMERCIAL GENERAL LIABILITY - E A .GE70'RENTEU"`-- .---_1----- PREMISES(Edoccumnce) 550,000 CW M8 MADE [X]OCCUR e- MED EXP(My one person) 35,000 ° PERSONAL SADV INJURY 31,000,000 ' GENERAL AGGREGATE s2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: gg PRO- ° i PRODUCTS•COMPfOP AGO s2,000,000 , POLICY ,ECT LOC g AUTOMOBILE LIABRJTY ANY AUTO COMBINED SINGLE UNIT(Ea awmard) i 1 ALL OWNED AUTOS y SCHEDULED AUTOS S (Perppemn)�Y S HIRED AUTOS I , aNON-OWNED AUTOS BODILY INJURY I(Pereeddent) 6 h� V PROPERTY DAMAGE - - ! (Par ecNdenl) 5 GARAGE LIABILITY AUTOONLY-EAACCIDENT S ANY AUTO E EA ACC S . ! OTHERTHAN ---"-- -- _---- .. I AUTO ONLY' AGO S EXCEBSIUMBRELLA LIABILITY I EACH OCCURRENCE i OCCUR ❑CLAIMS MADE - �'. AGGREGATE 8 - i � S DEDUCTIBLE I q $ RETENTION S - I s B WORKERS COMPENSATION AND VWC6004827012005 11/02/2006 �1/02/2007 Xwc E TORY OMITS j ER MPLOYERS'1JABBd1Y j ANY PROPRi E.L.EACH ACCIDENT $100,' tTORIPARTNERlEfCECIITIVE I OOO OFFICEWMEMBER 2XCLUDEDT R If yea,desatea under E.I,DISEASE•EA EMPLOYEE {ZOO,OOO SPECIAL PROVISIONS SON3lwfor - ! E.I.DISEASE-POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED DY ENDORSEMENT./SPECIAL PROVISIONS - RANDY HUGHES IS EXCLUDED FROM HIS WORKERS COMPENSATION COVERAGE N I CERTIFICATE HOLDER CANCELLATION DAVID L LLEWLYN DBA SHOULD ANY OF fTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CAPE WIDE CONSTRUCTION DATE THEREOF, THE ISSUNG INSURER WILL ENDEAVOR TO MAIL 21 DAYS WRITTEN 15 STANDISH WAY NOTICE TO THE gERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO Be SHALL IMPOSE NO OBL4ATION OR UASIUTY OF ANY KIND THE INSURER, ITS AGENTS OR W. YARMOUTH, MA 02673 REPRESENTATIVES.' AUTHORIZEDREPRESE E t ACORD 26(2DB1fDe) 6 ®ACORD CORPORATION 1988 Board of Building Re Regulations�nclfStandar�. - --- Lice•se or registration valid for individul use only } - _ HOME IMPROVEMENT CONTRACTOR befo a the expiration date. If found return to:' Registration: 148154 itoai I of Building Regulations and Standards - Expiration 9/9/2007. U►l;e. \slrliurton Place Rm 1301 Bo3t n .02108 Type,,,DBA / CAPE WIDE CO'NSTRUCTION - DAVID LLEWELYN ' 11 STANDISH WAY WESTYARMOUTH,MA 02673 Administrator ` Not valid without ig at re +r; ©nwEalth t7f 1WTA 1 ' rl i 51yt ' F'oomvr,¢o7useczll6 oyOaaaszolauaetla Qry''of Ptofessionai to ensure "' v REGULATIONS License: CONSTRUfC 1ON SUPERVISOR ��p 5 G673x � Numbers 09046$ � - ,. 6 R ,ti § F4 1 fCp�t;�S.. 329� 08 Tr.no: 9(J468 , i ` ' `'� %• ` ; I R$St Iat�d��00 >� 11_ �TlYN". 4fW�L�}�i1F � DAVID L LLEWE �'1 5�ANIS lNA;f l 15 STA.fVp1SFi WAl(` c7 /y ,' �t�it Al�Nldb�HMA;D26T `! W YARIVIOt1TH, MA bP673 J 1 E Commissioner M{ +, L�l e�isedlRe�l Ftatw 5�lesper$on S L� , ,,y ( � 441 # N R grs� TNEtO�♦ TOWN OW ®F BARNST A1JL i BL • i BJHBSTAE, i j 9 69 BUILDING ` INSPECTOR �p MAY Or• w - APPLICATION FOR PERMIT TO �°e0 .......... ; TYPE OF CONSTRUCTION ...... I ... . .............................................. 4; TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following inf mation: Locationh.1.... . ............ 0............... ��:,: .�� ..:..... ............................. ProposedUse .-,. /. ..... ...................................................................... Zoning District .............................. ..............................Fire District Name of Owner .. / ....... ...,.,. .. .....'..........Address �/,� 0.5�e.e ....&*Arowfae Name of Builder .......... .........Address Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...:........................................ foundation s ... ... .. .... `! . c Exierior ®(0,V,41 . Roofing rf` . ..... ................................. FloorsCy ��� �.............._...................................,....._..Interior .smM .... ... ......... ........................ Heating /•. ............. .................................Plumbing .._. ............... ..:. f Fireplace .......... .......................................................Approximate Cost ... 7,01 .. ......................................... Definitive Plan Approved by Planning Board _-----------19_ / Diagram of Lot and Building with Dimensions / SUBJECT TO APPROVAL OF BOARD OF HEALTH J co 2 ® ' da' ar- 00 LLJ X_ e l 0 (0. ' C3 Ca . �. — .:o a - - - \ Xv 2� ui 071- 7` 2 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ',� Name . . .......................... Seagrove, .Inc. � � - ` - one story No Permit for ' — --'.7 ~ ' ~_'`g_- -_--_y _'--__-g -----^---------'-----------' //�M xu~~ Gleneagle Drive ( Location ........................ ......................_----.. Centerville ----'---------------------- � � Zrmc ' Owner -----.�������.��—__..�______.. i frame ` Type of Construction .......................................... _ � - -------------------------- ' Plot ...... Lot Lo� -----.'.......--- - ` ~ � ' �� �� ^ Permit Granted --- . lg `- �.�`-------.. . � = ! Dote of Inspection - lV uote Completed 19 we%1WW- ' . ^ ^ PERMIT REFUSED � ..................... 19 ' . . � ~---------------'---------- ' -..------..------~.-----------. ` � .-----..----~._—.~..--....—..---, .------.----~~.--------.—.—.—Approved . � ................................................. lA ) �. ( ^ ---'--'--------~-----~—^---' ----------------------'--^^'' \ \ } | / ,*THE'TD�y+► TOWN OF 'BAR.NSTABLE i BAHBSTADLE• i "b qam a,•� - BUILDING ' .INSPECTOR O W st APPLICATION FOR PERMIT TO &D..........OAIC.........:� 4...... ........ ......................... ......... TYPE OF CONSTRUCTION ......... ... . 4. . ... P ......9 v, TO THE rINSPECTOR OF BUILDINGS: iy The undersigned hereby applies 'for permit according to the following informatio Location ../0 .......s .. ....... t. f�!, ...... .`L"'--�.............. ProposedUse . ®A&S. . ... ................................:.......................................................................... ZoningDistrict ................................................ ... ..........Fire District .......:...................................................t.................. Name of Owner ? .... .. ... .........Address ... .y Name of Builder ......................Address ...... .. . .I ..r ...............................:... Name of Architect ..........Address Number of Rooms ............. .......................... ....... ...Foundation !� �. .. Exterior . .... ......� �. ... .. offing .. . . ........................................... Floors ... .. . '� .Interior .® ,. .+ . ............ ........................................................... ....... ... .. Heating ........C.�. ....Plumbing ................ Fireplace ...........�f .................................................. ..........Approximate Cost ... Definitive Plan Approved by Planning .Board --- C _-- Diagram of Lot and Building with Dimensions . SUBJECT TO APPROVAL OF BOARD OF HEALTH I N Ccl 4q t 10 �a 6-/ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......... ' Inc. ' _-_�~_.-^ . - - ` ` 10624 one story No ........:........ Permit for .................................... . ^ ` single fami3.y dwelling '----------------------.---.. � ` \ ^' Gleneagle Drive . / Location ----.---.---...--------.. Centerville . ( � ----------------- --------- / ]��: Owner ......... ���������---�--.______ Type of Construction ----- ----.. . / ................. - ` �`w� Plot --------_. Lot --..���-----.. ' - �9 �� ' Permit Granted .............-�-- lV '~ ^ ..-------- ` . . ' ^ ~ ^Dote of |n~r�^'~^' — lA � Date Completed --.*!!�4/ ~. � C-1:5°w«~LVM ' - � ` ]REFUSED _-------._---+'-------.. lA . � -------.--.---.-------------. ' � ' ........................................................... - .,----------..----------..--.. _ ~ .-------------.----....-.---... � � Approved ................................................. 19 ' � . ( ^ ---------------'----^--~-~~' \ � ` -------`-----------^-'-~-~^^' Conser c Services Grroupoup CERTIFICATE OF COMPLETION 50 Washington St.Suite 3000 Westborough,MA 01581 John Terry Phone(Eve): 508-534-9492 160 Gleneagle Dr Phone(Day): 508-775-0298 Centerville,MA 02632-2319 E-Mail: pastor@federatedchurch.org SitelD: S00002278355 Combustion Safety Test Completed Y/N Pre Blower Door# (If applicable) Post Blower Door# (if applicable) Contract ID: 20141013_ASEAL Company: Alternative Weatherization Inc Sub-contractor Work Order#: S78355P84189C338 Location�.q, „. .y �.,Descri tion _.,.. , r. �' � ,: iW m d-V Liantl ,A ,'JnSt6IIed Door Sweep 2 Living Space Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 Exterior Door Weather Stripping 2 Contract ID: 20141013 WORK Sub-contractor Work Order#: S78355P84189C338 Location _ Descri tion=£= - 4, Quanti Installe Attic Propavent 2'or 4' 62 Attic Install Aluminum Soffit Vent(4"x16") 14 Living Space Attic Floor Open Blow Cellulose 4" 1,344 Living Space Insulate Rim Joist with 6:25" Fiberglass Batting 96 Damming 67 f:j j PLEASE NOTE:The Inspection of the house is for the purpose of finding CUSTOMER AUTHORIZATION OF CERTIFIED WORK out whether the Contractor completed the work. , I confirm that the measures listed above have been completed to my CUSTOMER SHOULD NOT RELY ON THE INSPECTION FOR satisfaction. I have received a copy of the Certificate of Completion and ASSURANCE THAT THE CONTRACTOR'S WORK NECESSARILY hereby authorize the release of any final payments to the Contractor. I COMPLIES WITH ALL LAWS AND STANDARDS RELATED TO understand that this Authorization of Completed Work does not in any SAFETY. manner void any`warranties provided to me by the Contractor. It was the Contractor's sole responsibilty to assure that the measures were installed properly and safely. In addition, this Post-Installation Inspection does not replace inspections by licensed inspectors where required by state or local law. It is the duty of the Customer to obtain such required inspections. Contractor's Signature Customer's Signature Date Date Conservation Services Group-50 Washington Street Suite 3000-Westborough,MA 01581 -(508)836-9500 0% Residential Air Sealing Work Order Printed: 4/21/2015 Pg: 2 Conser ation Services Group 50 Washington St Suite 3000 Westborough,MA 01581 Customer/site Details: John Terry 160 Gleneagle Dr Centerville, MA 02632-2319 Contractor,Notes ob°Information „ 3, Start time: Stop time: AS Techs: Pre CFM 50: Post CFM 50: CFM 50 Reduction: Combustion Safety Test Completed? Yes No Pass or Fail? CONTRACTOR WORK ORDER -Conser ation Services Group 50 Washington St.Suite 3000 Printed: 4/22/2015 Westborough,MA 01581 Work Order Id: S78355P84189C338 Contractor Information Custliiiier/Site Details rt - --------------- Alternative Weatherization Inc John Terry Email: pastor@federatedchurch.org 1440 Stafford Road 160 Gleneagle Dr Phone(Eve): 508-534-9492 Phone(Day): 508-775-0298 Fall River,MA 02721 Centerville,MA 02632-2319 Site ID: S00002278355 7_ T µ TM '.Total Installed Measures Location Description Quantity Unit$ Total$ Door Sweep 2 $23.18 $46.36 Living Space Perform Air Sealing at Estimated 62.5 CFM50 12 $84.32 $1,011 84 Exterior Door Weather Stripping 2 . $27.59 $55.1,8 Attic Propavent 2'or 4' 62 $3.83 $237.46 Attic Install Aluminum Soffit Vent(4"x16") 14 $31.21 $436.94 Living Space Attic Floor Open Blow Cellulose 4" 1,344 $1.34 $1,800.96 Living Space Insulate Rim Joist with 6.25"Fiberglass Batting 96 $2.40 $230.40 Damming 67 $2.19 $146.73 Installed Measures Total $3,965.87 a� .7 ,WorkOrder,Notes Payments gpg Incentive Payments Air Sealing Incentive $1,113.38 Weatherization Incentive $2,000.00 Total Incentive Payments $3,113.38 Customer Share Total Customer Share $852.49 Less Deposit Of $352.49 Customer Share Balance(Due Contractor) $500.06 Conservation Services Group-50 Washington Street Suite 3000-Westborough,MA 01581 -(508)836-9500 John Terry 160 Gleneagle Dr Centerville,MA 02632-2319 Site ID:S00002278355 Project ID:P00000284189 Customer ID:C00000288454 Contract ID:20141013 ASEAL • J Descrlptlon Quantity Location Door Sweep 2 N/A $46.36 Exterior Door Weather Stripping 2 NIA $55.18 Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 Living Space $1,011.84 Sub Total: $1,113.38 Utility Incentive share $1,113.38 Customer Contribution $0.00 For office use only Printed.,MI 12014 Pagel of 2 r CONTRACT FOR PRODUCTS SERVICE WORK Conser ation Services Group This service is brought to you through support from your local utility This agreement is made by and among and Sohn Teeey Conservation Services Graup(CSG) 160 Gleneagle Dr Attu RCS ! 50 Washington Street,Su1te 3000 Centcrv111e,MA'02632 2319 ! Westborough,MA 01581 Site ID 50000227i3355 $eg TOT®;173484 Project ID i'00000284189 Customer ID C00000288454 Federal ID No :2224571.70 (&Tail completed contract to address above) ContractID 20141013_ASEAL I. DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the following work on these"Premises"in a professional manner and in accordance with the terms of this Contract,including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated herein by reference: Description Quantity Location Door$weep...:.... 2.. .. NIA $46.36 ......... . Exterior_Door Weather StripPiP9......... _...................._..__....._.._............ _..........__ ........_.N/A..._........_...._.....__. .... $55.1 B _..-Stripping _.............. 5 .16 - Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 Living Space.. ..„ $1,011.84 Sub Total: $1,113.38 Utility Incentive Share $1,113.38 Customer Contribution $0.00 Eli] 91 For office use only Printed:10113/2014 Page 1 of 2 II. PAYMENT Customer agrees to pay Contractor for the Work,@1e Customer Share of the Contract Price as follows:Payment#1:$ as a Deposit payable to CSG upon signing the Contract(not to exceed 1/3 of the total retail costs).Mail check&contract to CSG,Attie RCS,50 Washington St.,Ste. 3000,Westborough,MA 01581.Mnal Payment:$ /- as the final payment for the Work shall be payable to the Independent Installation Contractor("IIC")upon satisfac o oletion of the Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of$i_f Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share, III. DISPUTE RESOLUTION The IIC and Customer hereby mutually agree in advance that in the event that the IIC has a dispute concerning this Contract,the IIC may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L.c 142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third un ess day following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE A'�ANY BLANK SPACES. John Terry(Apr 11, 015) Apr 11, 2015160 Gleneagle Drive • T Custo ature Date Indicate qt-irsel ted here,if ap licable (OR) Initial here if you want the Program to assign a r �� �'�• � � 9 - �(, ` ""'� -1 Participating Contractor CSG Signature Date Name of CSG Representative(Printed) TERMS AND CONDITIONS APPEAR ON THE REVERSE. 3/14 i ;.. C ;. Conner atlon PRODUCTS / SEA°VICE WORK Services Group This service is brought to you through support from your local utility This Agreement is made by and among and Conseryation S&O es Group (CSG) John Terry Attn.RCS 160 Gleneagle Dr Centerville,MA 02632-2319 50 Washington Street;,Suite 3000 Site CD:54000227z3355 Westborough,MA 01581 Project ID:P00000294189 gib•N9- 173484 r CustomerlD:G00000288454 Federal ID No.;2224v7170 Contract ID:2014101'3: WORK (Mail completed contract to address above)" L DESCRIPTION OF WORK TO RE PERFORMED Contractor will perform or cause to be performed the following work on these"demises."in a professional-manner and in.accordance with the terms of this Contract,including the attached recommendations/work order describing the work in detail(the"Work"),which are incorporated herein by reference: Description Quantity Location Propavent 2'or 4' _ 62. Attic $?$T 6 Damming.. ... _ _ _ ....�__,. , .. .. ._ _. 67.,.._-N1A Insulate Rim Joist with 6.25"Fiberglass Batting 96 Livldg�SpBce _- . ,�„— ,ry_ _ $230,40 Install Aluminum Soffit Vent(4"x18") _ _ •_„_ T 14 Attic v_ �_• $436.94 Attic Floor O en Blow Celluulose 4" 1,344 Living�Space_� __. P _ -- -- Sub Total: $2,852.49 Utility Incentive Share $2,000.00 Customer Contribution $852.49 W For office use only Printed:1011312014 Page 2 of 2 II. PAYMENT Customer agrees to pay Conti-actor for the Work„the Customer Share,of the Contract Price as follows:Payment 4L$ 3 5 d� � �as a Deposit payable to CSG upon signing the Contract(not to exceed the total retail costs).Mail check&contract to CSG,Attn:RCS,50 Washington St.,Ste. 3000,Westborough,MA 01581.nial Payment:$ as the fmal payment for the Work shall be payable to the Independent Installation Contractor("IIC")upon satisfact y completion off�rk.Customer understands that he/she will not be required to pay the Utility Incentive.Share of the Contract price in the amount of$ t 090.Changes to individual line items and/or previous incer tives.may Increase or decrease the size of the.Utility Incentive Share. III. DISPUTE RESOLUTION The IIC and G'rstomer hereby mutually agree irr advance that:in the event that the IIC has a dispute concerning this,Contract,the IIC may subu-dt such dispute"to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to-submit to such arbitration as provided in M.G.L.c 142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify th seller in writing by ordinary mail posted, by telegram sent or bydelivery, not later than midnight of the third business foll win signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Custom e•Si atrue Date,- Indicate yaiu ele ed IIC Men aoplicablle (OR) Initaal here if you want life? 5 the Program to assign a. Participating Contractor CSG Si ha�e Date Name of CSG Representative(Printed Residential Air Sealing Work Order Printed: 4/21/2015 Pg: 1 Conser ation Services Group 50 Washington St Suite 3000 Westborough,MA 01581 Customer/Site Details - -. John Terry Phone(eve): 508-534-9492 160 Gleneagle Dr Phone(day): 508-775-0298 Centerville, MA 02632-2319 Site ID: ' S00002278355 Home Information ,.�., Heating Fuel: Natural Gas Building Volume: 12,096 BAS cfm50: 1,270 Distribution Type: Boiler-Baseboard Existin Conditions .Existing Insulation: Fiberglass Batts Depth: 5.5 Existing Insulation: Fiberglass Batts Depth: 8.0 Truss Construction: Can Blower Door Be Completed? Yes �. el Area Notes Attic Basement/Crawlspace All Accessible Penetrations: Yes Exterior Penetrations: Yes Therma-Dome: No Ceiling Penetrations: No w/carpentry: No Exterior Door Weatherstrip: No WHF Box: No Vapor Barrier(Sgft): No Additional Areas of Concern... Additional Areas of Concern... 1 Garage Living Space All Penetrations: Yes Plumbing: Yes Weatherstrip Door to Living Space: Yes Weatherstrip Exterior Doors: Yes Additional Areas of Concern... Additional Areas of Concern... one and one one and one Conservation Services Group-50 Washington Street Suite 3000-Westborough, MA 01581 -(508)836-9500 I -- Customer Name: John Terry Site ID: 2278355 Date: 10/13/14 Mass Save Customer Disclosure and Preparation Requirements At your Home Energy Assessment your Energy Specialist has reviewed and identified applicable cost-effective opportunities,potential health and safety concerns as well as any customer required actions to facilitate improvements in your home. Your Energy Specialist is trained to evaluate and propose appropriate site-specific improvements that will reduce energy consumption and improve comfo e following conditions were noted at the time of the Home Energy Assessment: Combustion Safety: Ini are During Building Performance Institute(BPI)Combustion Safety Testing it was discovered that your Heating System&DHW(Worst Case Only)is not creating sufficient Draft(exhaust gases are not moving through the chimney at a fast enough rate(Pa).Draft Example:Minimum acceptable draft 30F outside-2.0 pa /60F outside-1.25 pa/90F outside-0.5 pa.It is recommended that you consult with a qualified licensed repair technician to address the issue.These conditions must be corrected prior to any program work in your home(unless noted"Worst Case Only,"or Carbon Monoxide(CO)levels are below 100 PPM,in which case corrective action is recommended). Combustion Appliances: Initial Here No Issues Detected at Assessment Pipe Disclaimer: Initial Here No Issues Detected at Assessment Moisture Concerns: ..Initial Here No Issues Detected at Assessment Customer Weatherization Preparation Requirements: ❑ storage Removal ❑ Platform Buildup ❑ Co Detector Flooring Removal [] Specified Measures Agreement(SMA) Customers are responsible to complete any noted required actions in order to be eligible for program weatherization work at their home. The participating Contractor will be confirming the completion of these required actions prior to scheduling Initial Here an installation date. This notice does not constitute an endorsement or warranty regarding the presence or absence of other real or potential health and safety hazards that may exist at this address or premises.If you have questions regarding this Information,or to schedule a follow-up inspection after the noted conditions have haen corrected,please call our Customer Service at 800-480-7472. Customer Signature: Date: ' 14 r4 U 41 1 O� Energy Specialist: Mich AlcPherson-112 Pho 508-962-3371 Email: Michael.McPhe►son@csgrp.com M Conservation ervices Group a 50 Washington Street,Suite 3000 a Westborough,MA 01581 RCS PLANVIEW DIAGRAM Customer: �O�`ti �e-/`!`a.� ` Home Phone: ( )- - Address: f �o CDG'�E'�n /G--�t t•Q __ Work Phone: ( Town: Cam•, �r ✓1 t [2 Cell Phone: ( )- - Any limitations for access by large truck? No_ Yes If yes,describe: Any specific directions or landmarks? No_ Yes If yes,describe: Site ID: P 70 un nergy Specialist: n4C_d04"ay7 Reviewed by: ® 9 e G" F I!3 Da r 3> 7 S ay � if L �� ( Y 1 J For Office Use Only Bushes Ladder Neighbor Proximity Pocket Doors Insert Radiators Fence(s) Existing Conditions X=Access ❑=Vents Note Inside Square R=Roof S=Soffit G=Gable RV=Ridge Vent CS=Continuous Soffit CDE=Continuous Drip Edge T=Triangle Install O=New Access Note in Circle C=Ceiling W=Wall S=Sheathing Temp Unless Noted Otherwise Q=Vents Note in Triangle R=8"Roof S=Soffit G=Gable M=12"Mushroom For Access Rev 1/14 f r � V �+ 9 C r C r t r � �l 1 ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A . AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING - DC DIRECT CURRENT . LABORATORY SHALL LIST ALL EQUIPMENT IN. EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE . GND GROUND MULTIWIRE BRANCH.CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. o- CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER - COMPLY WITH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC f i LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAIN (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. ' NTS NOT TO SCALE _ : 9. MODULE FRAMES SHALL BE GROUNDED AT THE J OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL PROPERTY.LINE MANUFACTURER USING UL LISTED GROUNDING POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. . MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT'GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD, TESTING CONDITIONS - TYP TYPICAL UPS UNINTERRUPTIBLE POWER,SUPPLY • _ � _« = - III V VOLT t Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT /� W -WATT ., 313 NEMA 3R, RAINTIGHT I PV1 COVER SHEET - _ PV2 SITE PLAN - PV3 STRUCTURAL VIEWS • PV4 UPLIFT CALCULATIONS ' LICENSE GENERAL NOTES Pv5 THREE LINE DIAGRAM i GEN #168572 1. ALL WORK TO BE DONE TO THE 8TH EDITION Cutsheetss Attached ELEC 1136 MR OF THE MA STATE BUILDING CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH • THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: AHJ: Barnstable REV BY DATE COMMENTS REV A NAME DATE COMMENTS UTILITY: NSTAR Electric (Commonwealth Electric) — PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN Boa NUMBER: J B-0262407 00 TERRY, JOHN TERRY RESIDENCE Danielle StowaterTd CONTAINED SHALL NOT E USED FOR THE .,,SolarC�tBENEFlT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTQI: � .� G- NOR MALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 160 GLENEAGLE DR 10.4 KW PV`ARRAY PART IZ TI N, E OUTSIDE THE RECIPIENT'S MODULES: CENTERVIL MA 02632 ORGANIZATION, EXCEPT IN CONNECTION WI1H , THE SALE AND USE OF THE RESPECTIVE (40) TRINA SOLAR # TSM-260PDO5.18 24 St. Marty Drive,Building 2, Unit 11 �} 01752 LMIBEQUIPMENT. IWITHOUT THE WRITTEN INVERTER: ff PAGE NAME SHEET: REW DATE T: (650)638-1028<F:A(650)638-1029 PERION SOLAREDGE SE7600A-US002SNR2 .(508) 534-9492 1 COVER SHEET PV 1 12/17/2015 (868)—SOL—CITY(765-2489) www.solarcitycom PITCH: 31 ARRAY PITCH:31 MP1 AZIMUTH: 101 ARRAY AZIMUTH: 101 F. MATERIAL: Comp Shingle STORY: 1 Story O K. RIUKI v ST UCTURAL N0.51933 Front Of House GISTb��° STAMPED & SIGNED FOR STRUCTURAL ONLY ODigitally signed by HKariuki Lc�I Date: 2015.12.18 06:53:14 AC © 01 p �nV ----, LEGEND (E) UTILITY METER & WARNING LABEL ® lnv INVERTER W/ INTEGRATED DC DISCO. & WARNING LABELS DC DISCONNECT & WARNING LABELS FAC MPLEOJ AC DISCONNECT & WARNING LABELS O DC JUNCTION/COMBINER BOX & LABELS DISTRIBUTION PANEL & LABELS _ LC A LOAD CENTER & WARNING LABELS f ODEDICATED PV SYSTEM METER - Q STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR CONDUIT RUN ON INTERIOR GATE/FENCE O HEAT PRODUCING VENTS ARE RED INTERIOR EQUIPMENT IS DASHED L_J SITE PLAN Scale: 1/8" = 1' Z 0 1' 8' 16, PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER J B-0 2 6 2.4 0 7 00 CONTAINED SHALL NOT BE USED FOR THE TERRY, JOHN TERRY RESIDENCE Danielle Stowater ;SolarCity. BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: ar NOR ALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 160 GLENEAGLE DR 10.4 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES CENTERVIL MA 02632 ORGANIZATION, EXCEPT IN CONNECTION NTH , 24 St Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (40) TRINA SOLAR # TSM-260PD05.18 PACE NAME SHEET: REV DAIS Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER T: (650)638-1028 R (650)638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE # SE760OA—US002SNR2 (508) 534-9492 SITE PLAN PV 2 12/17/2015 (888)—SOL—CITY(765-2489) www.solarcity.aam si K. IUKI 4" M V ST UCTURAL N0.51933 r o , �FG/S r (E) LBW - SSlONp�, A SIDE VIEW OF MPI N T�S y STAMPED & .StGNE[3 FOR STRUCTURAL ONLY MPj X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER ' NOTES r LANDSCAPE 64" 24" STAGGERED PORTRAIT 48" 19" RAFTER .. 2X8 @ 16"OC ROOF AZI 101 PITCH 31 STORIES: 1 ARRAY AZI 101 PITCH 31 C.I. 2x8 16"OC Comp Shingle . . , , PV MODULE' • 5/16" BOLT WITH LOCK INSTALLATION ORDER & FENDER WASHERS _. LOCATE RAFTER, MARK HOLE r ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT ZEP ARRAY SKIRT (6) HOLE. SEAL PILOT HOLE WITH (4) (2) , I + POLYURETHANE SEALANT. . ZEP COMP MOUNT C ZEP. FLASHING C (3) �3) INSERT FLASHING. (E) COMP. SHINGLE (E) ROOF DECKING V (2) Y,c INSTALL LAG BOLT WITH ,.. 5/16" DIA STAINLESS (5) (5) SEALING WASHER. STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES INSTALL LEVELING FOOT WITH WITH SEALING WASHER (6) (2-1/2" EMBED, MIN) BOLT & WASHERS. (E) RAFTER STANDOFF - - � r -_ • S1 i. PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN [INVERTER: B NUMBER: J B-0 2 6 2 40 7 00 Nm TERRY, JOHN TERRY RESIDENCE �,��SolarCity CONTAINED SHALL NOT BE USED FOR THE Danielle Stowater +, BENEFIT OF ANYONE EXCEPT SOLARCITY INC., OUNTING SYSTEM: �.��a NOR SHALL IT BE DISCLOSED IN WHOLE OR INomp Mount Type C 160 GLENEAGLE DR 10.4 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS ol,lEs CENTERVIL MA 02632 ORGANIZATION, EXCEPT IN CONNECTION WITH , 24 St. Martin Drive,Building Z Unit 11 THE SALE AND USE OF THE RESPECTIVE 40) TRINA SOLAR # TSM-260PD05.18 PAGE NAME SHEET: REV. DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN T: (650)638-1028 R (650)638-1029 PERMISSION OF SOLARCITY INC. OLAREDGE sE7sooA—usoo25NR2 (508) 534-9492 STRUCTURAL' VIEWS PV 3 12/17/2015 (6B8)-SOL-aTY(765-2489) www.adarcitycom UPLIFT CALCULATIONS SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. J B-0262407 00 PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: \\\ CONTAINED SHALL NOT BE USED FOR THE TERRY, JOHN TERRY RESIDENCE Danielle Stowater -'. BENEFIT OF ANYONE EXCEPT SOLARCITY INC.. MDUNTMG SYSTEM: �. ,,So�arCity NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 160 GLENEAGLE DR 10.4 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULES CENTERVIL MA 02632 ORGANIZATION. EXCEPT IN CONNECTION WITH , 24 St Martin Drive.Building 2.Unit 11 THE SALE AND USE OF THE RESPECTIVE (40) TRINA SOLAR # TSM-260PD05.18 SHEET: REV. DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT. WITHOUT THE WRI LIEN MVERTER: PAGE NAME T: (650)638-1028 F: (650)638-1029 PERMISSION of SOLARCITY INC. ISOLAREDGE SE7600A—US002SNR2 (508) 534-9492 UPLIFT CALCULATIONS PV 4 12/17/2015 (666)—SOL—CITY(765-2489) .nw.solaraityaam GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO (E) LIFER AT PANEL Panel Number: Inv 1: DC Ungrounded INV 1 -(1)SOLAREDGE ## SE760OA-US002SNR LABEL: A . -(40)TRINA:SOLAR TSM-260PDO5.18 GEN #168572 WITH IRREVERSIBLE CRIMP Meter Number:43948242 Tie-In: Supply Side.Connection Inverter; 76'OOW,•24OV, 97.57; w/Unifed Disco and'ZB, RGM, AFCI PV Module; AOW, 236.9W PTC, 40MM, Black Frame, H4, ZEP, 1000V ELEC 1136 MR Underground Service Entrance INV 2 Voc: 38.2 Vpmax: 30.6 - . INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 125A MAIN SERVICE PANEL E� 10OA/2P MAIN CIRCUIT BREAKER , trr (E) WIRING BRYANT InVE'I"tt'_r 1 r Load Center CUTLER-HAMMER _ 100A/2P 4 Disconnect 3 SOLAREDGE 1 DC+ A SE760OA-US002SNR2 DC_ MP1:,1x20 40A/2P g r-------- -----=---- --- ------------ ecC------------------ A Li : _ - EG21(E) LOADS - D - - MGN ------------------------- GEC P1: 1X20 N , r- Z �I GND -- EGC-- ----------- ----- "5.--- G -- --- ------- --- t� N I (1)Conduit Kit; 3/4' EMT F- o EGC/GEC - 11 GEC---T , TO 120/240V I .. SINGLE PHASE I r . UTILITY SERVICE PHOTO VOLTAIC SYSTEM EQUIPPED WITH-RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP P0I (2)ILSCo#IPC 4/O-j6 A (1)BRYANT$BR24L70FGP 4n ( (40)SOLAREDGE 300-2NA4AZS Insulation Piercing Connector; Main 4/0-4, Tap 6-14 food Center, 70A, 120/24OV, NEMA 1, Main Lug, 1 e, 2 Spaces 4 Cirg Gn hM PowerBox. ptimizer, 30OW, H4, DC to DC, ZEP DC -(I)CUTLER-HAMM BR240 SSCSUPPLY SIDE CONNECTION. DISCONNECTING MEANS SHALL BE SUITABLE Breaker, 40A 2P, 2 Spaces 1)AWG" 6, Solid Bare Copper -AS SERVICE EQUIPMENT AND SHALL BE RATED PER NEC. Q (1)CUTLER-HAMMER g DG222URB (1)Ground Rod; 5/8' x 8'. Copper v Disconnect; 60A, 240Vac, Non-Fusible, NEMA 3R (1)CUTLER-{iAMMER N D NOTE: PER EXCEPTION NO. 2, ADDITIONAL - A � Ground eutral Kit; O ARRAY GROUND PER 690.47O•DG100NB 60-100A, General Duty(DG) ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF E O ELECTRODE 1 AWG #6, THWN-2, Black 1 AWG#B, THWN-2. Black 2 AWG #10'PV Wire, 60OV, Black Voc* 500 VDC Isc =15 ADC ® (1)AWG6, 1HWN-2, Red O (1)AWG y8, THWN-2, Red O (1)AWG6, Solid Bare Copper EGC ` Vmp =350" VDC Imp=14.66 ADC (1)AWG#6,THWN-2, White NEUTRAL VmP =240 VAC Imp=32 AAC (1)AWG#10, THWN-2, White NEUTRAL VmP =240 VAC Imp=32 AAC " 1 Conduit Kit; 3/4':EMT• , . . THWN-2, Green EGC GEC- i Conduit Kit; 3 4 EMT (2)AWG 0, PV Wire,600V, Black .Voc*"=500 •VDC Isc =15 ADC -(1)AWG�G..Solid Bare,Copper. GEC. . . .-(1).Conduit•Kit:.3/.4�.�+?. . . . . . . . . . . . . . . . .-(1)AWG$D. . . . . . . . . . . . .. . ./. . . .(.). . . . . . . . . ./7. . . . . . . . . . . . . s O (1)AWG#6, Solid Bare Copper EGC Vmp =350 VDC Imp=14.66 ADC • • • • • • . • (1?Conduit Kit; 3/4'_EMT CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER PREMISE OWNER:. DESCRIPTION: DESIGN: JB-0262407 00 CONTAINED SHALL NOT E USED FOR THE TERRY; JOHN TERRY RESIDENCE Danielle Stowater �,,, Ohr�' BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �..� • + NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 160 GLENEAGLE DR 10:4 KW PV ARRAY ty. PART ORGANIZATION, OTHERS COUTSIDE IN THE RECIPIENTS MODULES: CENTERVIL MA 02632 THESALE AN EXCEPT T CONNECTION WITH 24 St. Martin Drive,Building 2,Unit 11 THE SALE AND USE T, THE RESPECTIVE (40) TRINA SOLAR # TSM-260PD05.18 SHEET: REV DATE Marlbordr MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME Ti{650)636-1028 F: (650)638=1029 PERMISSION OF SOLARCITY INC. 'SOLAREDGE SE760OA-US002SNR2 (508) 534=9492 THREE LINE DIAGRAM PV `J 12/17/2015 (BBB)-SOL-ciTY(765-2489) www.sulurcitycom Label Location: Label Location: r {`u -` .{ ,1 'Y I't Label Location: �. 0 OF.o -\\-1,:•�� �,r�l�: j I ��ll�k�7 ',��r,,Y®��§�� }r�•klar�l`� .IIiY 'P^ (C)(CB) o �f (AC)(POI) h l (DC)(INV) Per Code: Per Code: '" ��• _ Per Code: NEC 690.31.G.3 •o o - o o ° NEC 690.17.E • o e o o •o• ° NEC 690.35(F) Label Location: :o • . - o 0 0 TO BE USED WHEN (DC) (INV) °•°� ° Qj-o o ° -o ° • • INVERTER IS n ® Per Code: - UNGROUNDED NEC 690.14.C.2 , . . Label Location: Label be Location: POI( ) (DC) (INV) Per Code: Per Code: o ••�' � " . )� o o y � � NEC 690.17.4; NEC 690.54 , NEC 690.53 v e"o -n f; e o•o a o �A ° Label Location: rt (DC) (INV) Per Code: ® • • • NEC 690.5(C) o -o • e' e Label Location: (POI) - fr • u,.• u-o - o Per Code: NEC 690.64.B.4 b� Label Location: Per Code: Label Location: eo o ..'o_ o • NEC 690.17(4) - ;. (D) (POI) • o :b e " � ,. Per Code: NEC 690.64.B.4 • i t ill -- ��- �. � Label Location: ® � ¢ (POI) . -* o Per Code: r, Label Location: tea. o o =xr NEC 690.64.B.7 (AC) (POI) LLa e o - • ••: (AC): AC Disconnect Per Code: (C): Conduit © ' NEC 690.14.C.2 ° •n ter'' (CB): Combiner Box (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit k' yy Label Location: -(INV): Inverter With Integrated DC Disconnect 3 (AC) (POI) (LC): Load Center Per Code: (M): Utility Meter NEC 690.54 (POI): Point of Interconnection CONFIDENTIAL- THE INFORMATION HEREIN CONTAINED SHALL NOT BE USED FOR ����r � 3055 Clearview Way THE BENEFIT OF ANYONE EXCEPT SOLARCITY INC., NOR SHALL IT BE DISCLOSED �► San Mateo,CA 94402 IN WHOLE OR IN PART TO OTHERS OUTSIDE THE RECIPIENT'S ORGANIZATION, Label Set T:(650)638-1028 F:(650)638-1029 EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE I� O'� ' (888)-SOL-CrrY(765-2489)www.solarcity.com SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PERMISSION OF SOLARCITY INC. 0 a ® r ® - ''SO�afClty I ZepSolar Next-Level PV Mounting Technology '�SOIBfCIty• ZepSolar Next-Level PV Mounting Technology. Components Zep System for composition shingle roofs • n- , k p-roof t - v i ..Le eI•ng Foot - Ground Zep Interlock (Key side sheen) - - •' '' • - < Lemltrre Poot -___,� Part No.850-1172 ETL listed to UL 467 \' , - Zep compatible PV Module _ f" . 1 Zep Gro. —•:re°�^' ;.c,. - _ _ _ • - T� _-- Rool ArtaakmeM .g _ - •e Army skirt Comp Mount Part No.850-1382 Listed to UL 2582 ��� .� • Mounting Block Listed to UL 2703' , ' pOMPATj _ ti e�,n Description PV mounting solution for composition shingle roofs 'm Works with all Zep P Com atible Modules A O r dMPP Auto bonding UL-listed hardware creates structural and electrical bond •_" • • Zep System has a UL 1703 Class"A"Fire Rating when installed using modules from any manufacturer certified as"Type 1"or"Type 2" „ UL LISTED O " ' ' Interlock and Zep V2 DC G Wire Clip ' Part No.850-1388 Part No,850-1511 Part No.850-1448 Specifications ' „ 4 Listed to UL 2703 'Listed to UL 467 arld UL 2703• Listed to UL 1565' ` Designed for pitched roofs • Installs in portrait and landscape orientations • Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 . • Wind tunnel report to ASCE 7-05 and 7-10 standards - • Zep System grounding products are UL listed to UL 2703 and UL 467 - • Zep System bonding products are UL listed to UL 2703 • Engineered for spans up to 72"and cantilevers up to 24" • Zep wire management products listed to UL 1565 for wire positioning devices Attachment method UL listed to UL 2582 for Wind Driven Rain i •'. g Array Skirt,Grip, End Caps Part Nos.850-0113,850-1421, ' 850-1460,850-1467 zepsolar.com zepsolaccom Listed to UL 1565 his documen does no crea a any express warren y by Zap Solar or abou i s produc s or services.Zep Solar's sole warran y is con wined in he wri an produc warran y for This document does not create any express warranty by Zap Solar or about its products or services.Zap Solar's sole warranty is contained in the written product warranty for each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely - responsible for verifying the suitability of ZepSolar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com, responsible for verifying the suitability of ZepSolar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. Documen#800-1890-001 Rev A Da a las expor ad: November 13,2015 2:23 PM Document#800-1890-001 Rev A _ Date last exported: November 13,2015 2:23 PM - solar=0 " so I a�'=ooSolarEdge Power Optimizer n Module Add-On for North America P300 / P350 / P400 JR SolarEd a Power Optimizer 9 .P300 P3SO P460...4 Module Add-On For North America (for 60-cell PV (for 72-cell PV (fur 96-cell'PV. , f r7•,` "j,' .`' r s,�,$§ modules) modules) modules) ; --.b" >-`,. ,` says p'k pt - JINPUT P300 /T350 / P400 � ` t Rated Input DC Power) 30U 350 400 W ........ .................................................................................. ............ Absolute Maxmum Input Voltage(Voc at lowest temperature) 48 60 80 Vdc +` -4" t' ' � � MPPT Operatlng Range 8 48 8 60 8 80 Vdc r-z Maximum Short Circuit Current Isc . A 1 ) 10 dc r. �r ya: „e., - Maximum DC InputCurrent:................................:.................. 12:5 .Ad 1. - �' "" "•v5%n�.- - .Maximum Effiaency ........................... ........................ 99 5 % .... 4'� nV t' r Weighted Efficiency............................... ......... .....................................98.8........ ... ......... ..%... ' [.OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) .. ..', r j r"2c,. `zS'Fh,c * •: ., 1 Adc , Maxrmum Output Current 5 ...................I.. Maximum Output Voltage....... ....... ......... ........ ......... .....GU .................... .. .. ...Vdc.... 1OUTPUT DURING STANDBY(POWER OPTIMZER I DISCONNECTED FROM INVERTER OR INVERTER OFF) I Safety Output Voltage per Pow _ 1_ Vdc � I er0 amizer .. P (STANDARD COMPLIANCE - '; �;Y�'+' EMC FCC Part15 Class B IEC61000..2 IEC63000 6 3 ."' •'w a ,a 4 n �` Safety . IEC62109 1(class II safety).UL3741 - " �'inJaCMR�7" ;wg,Pee".. ...... .... ......... ... .... ...... .......... .. ... .... ..... �,. Jana,,' arcH-vw."m°3 * zv*aupro mi kLr.� sa[a;,, RoHS ....-. Yes (INSTALLATION SPEal4a T10N5 Maximum Allowed System Voltage ......................... .........,..... 1000 ........ ... .Vdc ....................................... ................................................. Dimensions(W x L x H) 141 x 212 x 40.5/5.55 x 8.34 x 159 mm/in is 7 `- { �, - ,;�- Weight(including cables) 950/2.1 gr./Ib ...... ....................................................... Input Connector.................................................... ................... ...MC4/Amphenol./,Tyco.. ................. ........... "� -`^ �- ;;; *' :J .t ' ^t Output Wue Type/Connector Double Insulated Amphenol '. ar. f'. 'a•:i3k`B ,.. .... ... .............................................. ......... ..... .. ......... .. .... .............. .. .. .. Length.:..... 0.95/3.0 1.2/3.9.. m./ft - ......................................................... ....................................... ..................... .. ... - .. t _ •• - O eratin Tem erature Rana -40 +85 40-+185.. ..-C/'F ................................................ ........................... :.....�40... ................... .. ...... ` .r"lz r.�{ 0 x c •aa ° `;'" ;. P" - .. Protection Rating ..IP65/.NEMA4 - g ,'^-3r';; - - Relative HumidrtY........... ....................... .. .............. ...........:..0 100........................ .. %..... 0 Rana moawn mmam A M-1, p , po�.t.an ai— r "u.- ., - ......... .. ..or ro sx a ._... ., .....-...._-_.. - PV SYSTEM DESIGN USING A SOLAREDGE THREE PHASE THREE PHASE .INVERTER SINGLE PHASE 208V 480V PV power optimization at the module-level Minimum stun Len h Power Optimizers) 8 10 18 ....................................................................................... Up to 25%more energy Maximum String Length(Power Optimizers) 25 25 50 ..'imu nSt'....eng.................................................................................................................................................. Maximum Power per String 5250 6000 12750 W - Superior efficiency(99.5%) .................g.................... .................................................................................................................................... Parallel Strin s of Different Len hs or Orientations .Yes - Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading _ """"""'""""""""""""""""-"""""""""" """"" """"""""""""""' "" - Flexible system design for maximum space utilization _ - Fast installation with a single bolt - - r -' '- _• ^ - - -�..^ - xz - Next generation maintenance with module-level monitoring Module-level voltage shutdown for installer and firefighter safety USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www.solaredge.us n a. n TH E "Ye�namounry 't'MODULE TSM-PDO5.18- Mono Multi Solutions ' DIMENSIONS OF PV MODULE �•' ELECTRICAL DATA @ STC'' -I - unit:mm Peak Power Watts (WpJ .245250 255 �^ w 260 O J 94t - - . Power Output Tolerance-PMax(%) t 0-t+3 _ Maximum Power Vollage-VMr(V) I 29.9 30.3 f 30.5 30.6THE aximum Power CuURNE - Moun-t l�.Mr— N ( I r e Open Circuit Voltage-Voc(V) t 37.8 f 38.0 38.1 38.2 Short Circuit Current-Isc(A) 8.75 8.79 8.88 9.00 11 i srauiNeNae 3 Module.Efficiency qm(%) I5.0 15.3 15_6 15.9 ^a MODULE J# ro_._ w -, -�a �. S7C Irradiance 1000 W/m2.Cell Temperature 250C,Air Mass AM1.5 according to EN 60904-3. Typical efficiency reduction of 4.5%at 200 W/m2 according to EN 60904-1. ' ELECTRICAL DATA.®NOCT • O CELL _ • Maximum Power-PMnx Wp) 7 �182 ��~ 186 �.. -,190 Maximum Power Voltage-VMr(VJ 27.6 28.0 28.1 28.3 MULTICRYSTALLINE MODULE ee43anourro--U t Maximum Power Current-IMrr(A) I 6.59 1 6.65 6-74 , 6.84 WITH TRINAMOUNT FRAME NarE n trot - 7.1 ,,.oaa,N A A Open Circuit Voltage(V)Voc(V) 35.1 35.2 3 35.4 Short Circuit Current(A)-Isc(A) 7.07 .7,10 7.17 7.27 p. �.T �� � NOCT:Irradiance at 800 W/m2,Ambient Temperature 20-C,Wind Speed 1.m/s. - 245-660 V V PD05.18 t . . 812 tao t r ' Backview t POWER OUTPUT RANGE MECHANICAL_D ATA •-[Solar cells •-ter Multicrystallme 156 x 156 mm(6 inches) I Fast and simple to install through drop in mounting solution cell orientation a 60 cells(6 x 10) d t 1 g 9 --! - - Weight dimensions 21.3 kg(47.0 Ibs)m ( .95 39.05 1.5 d' m 64 x x 7inches) I - Glass mm(0.13 inches),High Transmission,AR Coated Tempered Glass } MAXIMUM EFFICIENCY A-A Backsheet - White Good aesthetics for residential applications Frame - /A - 1 Black Anodized Aluminium Alloy with Trinamount Groove - -. �A J-Box IP 65 or IP 67 rated y/ I-V CURVES OF PV MODULE(245W) r «. O rw+3/ V - - - •• - Cables - Photovoltaic Technology cable 4.0 mm2(0.006 inches'), - - Ca es • • to..m _ 1200 mm(47.2 inches) t, POWER OUTPUT GUARANTEE 9m - Fire Rating Type 2 8.00 8WW/m2 L 111 Highly reliable due to stringent quality control <6.m sw m i Over 30 in-house tests-(UV,TIC,HF,and many more) .t s.°° „ As a leading global manufacturer O In-house testing goes well beyond certification requirements a.m W/ TEMPERATURE RATINGS MAXIMUM RATINGS of next generation photovoltaic a.m -,t 2o0w/m2 Nominal Operatin Cell r Operational Temperature 40-+85°C products,we believe close 2m g 44^C(+2°CI a. Temperature(NOCT) I� cooperation with our partners '°° Maximum system t000v DCpEC) _ is critical to success. With local - - } Temperature Coefficient of P- -0.41%/°C Voltage - 1000V DC(UL) - presence around the globe,Trina is +" o l0 Voltage(V) Temperature Coefficient of Voc -0.32%/'C' Max Series Fuse Rating 5A o.m 20 m 3o m 4p m t# able to provide exceptional service m 1 " to each Customer in each market Certified to withstand challenging environmental Temperature Coefficient of Isc o.os%/^c and supplement our innovative, ® conditions reliable products with the backing 2400 Pa wind load of Trina as a strong,bankable a * WARRANTY partner. We are committed 5400 Pa snow load } �- t0 building strategic,mutually ! _ 716 year Product Workmanship Warranty -1' tr 25 year Linear Power Warranty beneficial collaboration with t � 4_.._ - installers,developers,distributors f ( (Please refer to product warranty for details) and other partners as the o backbone of our shared success in _- 1 CERTIFICATION driving Smart Energy Together. LINEAR PERFORMANCE WARRANTY ( PACKAGING CONFIGURATION ' i 10 Year Product Warranty•25 Year Linear Power Warranty i `, a spus f Modules per box:26 pieces Trina Solar Limited - - - www.trinasolar.com 010o% Adtllfjary e" T 44.IV _=71 g Modules per 40'container.728 Pieces of _ `_ mm•runHr -- - O 0 90% - 7/o1u_-efror`n rflrya SOlaps fjryLao!M'Glfpry� - t O. CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. -OOMPA*, I% I� �` L^ ®2014 Trina Solar Limited.All rights reserved.Specifications included in this datasheet are subject to �fPo��solar 7 80% �_ , _ ._w ,_ Ti en-asolal changewithoutnotice. g _ Smart Energy Together rears s o Is = 20 25_. Smart Energy Together °or4Pnt`o s^ T Trinastandard Industry standard - - a j - a r THE `PPinamount MODULE TSM-PD05.18 Mono Multi Solutions DIMENSIONS OF PV MODULE - ELECTRICAL DATA @ STC unit:mm 1' Peak Power watts-PNlnx.(WpJ 1 250 255� 260 I 265 941 O - Power Output Tolerance-Pnwx(%) 0-+3 ',�ItI�7n'' R - - ■■■p- r,�■■ -JI .,■Aw-■■ 'Maximum Power Voltage-VM (V) 30.3 130.5 30.6 30.8 T1! 11E ��0: E ■,. ■ ■O V ■ ■ mNcnaN c:- r )Rox Maximum Power Current-IMRR(A) 8.27 8.37 8.50 6.61- _. _ - NnNErun Open Circuit Voltage-Voc(V) 38.0 1 38.1 ( 38.2 i 38.3 o NsrAluxG NOLE Short Circuit Current-Isc(A) 8.79 8.88 9.00 9.10 ' MODULE `2r I 111 Module Efficient T ®®� LJ 8 .,.-. _..n Y 9m cell r..' 15,3 .a .t. car � 15,9 ..16.2 r - . T . t STC�Irrad once 1000 W/m'.Cell Temperature 25"C.Air Mass AM1.5 according to EN 60904-3. Typical efficiency reduction of 4.5%at 200 w/m'according to EN 60904-I. O e .ELECTRICAL DATA @ NOCT �[ CELL 1I 1I { Maximum Power.P-(Wp) »r 986 ! 190 j 193 ^.1 µ197 r 6® {L _E 11 11 4 �Maximum Power Voltage-v w(V) 28.0 28.1 28.3 28.4 I VVrr \I\VII `L�- L'a LLa L 111 MULTICRYSTALLINE MODULE o Power a t-IMRR(A) 4 6.93 p t maximum Po Curr n 6 65 ' 6.74 f - 6 8 1, '7 6013 GROUNDING HDLE 1 .I PD05.18 n DRnINN E A A 7 Open Circuit Voltage(V)-Voc(V) 35.2 35.3 35.4 35.5 WITH TRINAMOUNT FRAME r i Short Circuit Current(A)-Isc(A) 7.10 7.17^ L}7.27 _ 7.35� ' NOCT:Irradiance at 800 w/m':Ambient Temperature 20°C.Wind Speed 1 m/s 12 25O -265W ' ..� -, . �' _) �Back View �` MECHANICAL DATA POWER OUTPUT RANGE -I Solar cells - �)Mugicrystalline 156 x 156 mm(61nchesl a ~• Fast and simple to install through drop in mounting solution Cell orientation 60 cells(6 x 10)t - - Module dimensions �1650 x 992 x.40 mm(64.95 x 39.05 x 1:57 Inches) 1 0 1 Weight 19.6 kg(43.121bs) 16.2% c .. f 0 � •iGlass 3.2mm(0.13 inches),High Transmission,AR Coated Tempered Glass MAXIMUM EFFICIENCY A-A IBacksheer !!!White Frame Black Anodized Aluminium Alloy Good aesthetics for residential applications t J-sax IP 65 orIP 67 rated (�, I - I f Cables �(Photovoltaic Technology cable 4.0 m '(0.0061nches'),�. ® 1200 mm(47.2 inches) rn ��-3 I O (- I•V CURVES OF PV MODULE(260W) I r POSITIVE POWER TOLERANCE o.00 d connector _ H4Amphenol ' � Op roaDW m' t fire Type � �UL 1703 Type 2 for Solar City e Highly reliable due to stringent quality control • Over 30 in-house tests(UV,TC,HF,and many more) As a leading global manufacturer • In-house testing goes well beyond certification requirements , a 600 m' TEMPERATURE RATINGS MAxIMUM RATINGS of next generation photovoltaic • PID resistant E s� ? 4 ' `- t products,we believe close 8 4.ao 1 Nominal Operating Cell Operational Temperature 1-40 - p )Temperature(NOCT) 44°C(±2°C) : cooperation with our partners - - - Soo -- 9 Maximum 1000V DC(IEC) , r IS critical to success. With local - - zoo Temperature Coefficient of Prvx -0.41%/°C l Voltage 1000V DC(UL) I Y - - presence around the globe,Trina is I iliiii Temperature Coefficient of Voc 0 32%/oC ffff Max Series Fuse,Rating 15A able to provide exceptional service D.00 w w C Temperature Coefficient of Isc 0 059/°C _ to each customer in each market Certified to withstand challenging environmental 0 o zD ao i - -and supplement our innovative, ® conditions L vwme°ry reliable products with the backing • 2400 Pa wind load of Trina as a strong,bankable • 5400 Pa snow load WARRANTY partner. We are committed _ - 10 year Product Workmanship Warranty ( to building strategic,mutually CERTIFICATION ` beneficial C011abOfatiOn With _ �25 year Linear Power Warranty installers,developers,distributors I 1, -1 c 4L us GSA�s (Please refer io product warranty for details) Q and other partners as the 1 backbone of our shared success in t driven Smart Energy TO ether. PACKAGING CONFIGURATION o COM g gv g LINEAR PERFORMANCE WARRANTY i,.:. � 10 Year Product Warranty•25 Year Linear Power Warranty """"r Modules per box:26 pieces w 1 Trina Solar limited - www.trinasalor.com Modules per 40'container:728 pieces Additional value ho a rn Tri i{ o 90% - -- $Olar S llr,epr Warrant), CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. 'A%P4Tx ` O� ry0 �` m 2015 Trmo Solar Limped.All rights reserved.Specifications Included in this datosheet are subject to B�i� i "HIM-asolar >80% a,, ,.,, �Y �YY�JOIar change without notice. 9 P I Smart Energy Together I Smart Energy Together A m Years 5 10 IS 2D 25 4'ottpp� {}j t i_., .13 Trfnastandard [3,fndustrygcndard­ ` Single Phase Inverters for North America bllbr OXo - SE760OA-USSE3000A-US/SE380OA-US/SE5000A-US/SE6000A-USa r _SE3000A-US E30A-US SEOOOA-US 000A-US 0 E76 OA-US SE - - , } E10000A-US SE31400A-US I as ay tOUTPUT ) �' 4y a Nominal AC Power Output - 3000 3800 5000 6000 7600 9980 @ 208V 11400' VA SolarEdge Single Phase Inverters ' ° d ...... >0000�?40�. .-.......* $ .... ...... ... Max.AG,Power Output 3300 .-4150 6000 8350 1085 208V 12000. VA'. •- 5400 @ 208V @ • - ,»i'" b} 1> x'Y ,r.. s, :} s r•-'.: .'.:::..... ..::......_.......... :...... .....:....... .. ....5450,4a1,240y.: :. ..........10950-(a?.240y. ......:.....t... .... .. - For North Americaa� "`,. AC Output Voltage Min:Nom:Max.1 _ 'g;. xt - 183-208-229 Vac - ✓ _ _ - »... ........................................... ... SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ } ' I, AC Output Voltage Min:Nom-Max.i3i ss 211-240-264 Vac - SE7600A US/SE1000OA-US/SE1140OA-US v` ....... ..... ... .. .. 0-6.5( setting ...... .... ^ �� `4,?. q' - zT'„ AC Frequency Mln:Nom:Maxl.!.. .. ._. 593 60-60.5(with HI setting 57..60 605) ' ,..,.• .- Hz-•,. .. ...24 @ 208V .. ...48 @ 208V . Max.Continuous Output Current 12 5 18 :21 32. 47 5 A � , I P I :I... l ... I.:. Ov I......... ¢: �: � � N * ....... ::....... ...... z1 @ zaov az @ 2a 't - GFD r • ,w..z "' € &+ :•, �f�......` +>�•: ......I Threshold.. ..:...... ... .... ... 1. ... .. ....... .......... .. ..... A - Y Utility Monitoring,Islanding Protection,Country Configurable'Thresholds Yes - Yes � eI INPUT �pverte�''e; .Maximum-0C Powec(STC) 4050 5100 6750 8100 30250 13500 - 15350 W .,. • �i"�:f �`."^,` ` -is'- � „',. v"'k� r,.-Y,-. -. .:. `�s ..,:,•a. �`'`; i:. Transformer-Iess,Ungrounded .... .. -Yes ... .. i .. .r - .. .. -.......... k, gti $ "^ Max.Input Voltage 500 .. u ,�,, :.,.,;... :lid j ................:.... �,...,,; .....:..: . ....:..:. :...... ... .. ... .. ..... 'o WartantY; t � V e. :•:- - :. �a .a.:= , `: t _ ". Nom:DC Input Voltage...... ..... .......... ...... .. 325 @ 208V/350 @ 240V..... ... .Vdc..... at�eN ^€ - z .. 5 @ 208V 208V -sr. Max.Input Current(t) ...9 5 ..... ... ..13 .. ....... ...........18 ... .... ..23............. .... ..:.34.5. ..Adc... •stirsT` �*z'. ' utyf� 4 'n F}. ..... .: ......... ........ - .. - I 15.5(al 240V I ... I 30.5 240V I .... ..Max.Input-Short Circuit Current - 45 - Adc Yes Polarity Protection ........... ............ . Yes ............. ......... .:. ^ �:. �; �'+ <�t:• ^ _. . Ground-Fault Isolation Detection 600kso Sensltivrty,,. 't . 1 f .1,t4.t;4 .a ! 7*il •" f>. 'B- r ....a. me_"µ _ # _•-^zt"�;a`...,F.:: 't,-`_ *_ . '( .• t -u Y,r y t,fttr .tyft^ L.Tti. Po' ;.,.: ff:. - . ... veefi . I 3 I - 98 97S @ 240V 98 / ................ ...... .......... ........ ....... 97.5 @ 97@ 208VL ....... ... .. CEC Weighted Efficiency 975.,MxmumIn y 208V 97.5 97.5 97.5 6 .................. ............. ......98...... :.... ..... ... ...... Nighttime Power Consumption <2.5 <4 W j ADDITIONAL FEATURES F ,�M R !••' - ;Supported Communication Interfaces R5485 RS232,Ethernet zigBee(optional) Revenue Grade Data,ANSI-C12,1 .. •.. optional(3) Rapid Shutdown-NEC 2014 690:12 Functionality enabled when SolarEdge rapid shutdown kit is mstalledl41 ---• k sk M STANDARD COMPLIANCE UL1741,UL1699B,UL1998 CSA 22 2....... - --...-. Grid Connection Standards.. IEEE1547 - ?"-' '^�-M"^- 3 ' • Emissions _ ..'..FCC partlS class B•• `'.- INSTALUITION SPECIFICATIONS R"T3'.7 f air .' "" a ` ' _.�..,...:. �• , `' ` .w " '� AC output conduit size/AWG ran e - - 3/4 minimum/16 6 AWG 3/4 minimum/8 3 AWG - `'`""" — • • DC input conduit size #o,f strip s - 3/4'.minimum 1-2 strings/ P / g / 3/4"mimmum/1-2 strings%16-6 AWG / - . . .. � ��• s ��4 _a., .. ,AWG•ran&?.............�. .-.14:6AWG.:.. Dimensions with Safety Switch - - 30.5 x 12.5 x 10.5/ .i 's . - ,,,.' 305 x 125 x 7.2/775 x 315 x 184 ' 'n::..e, .t= s • • (HxWxD).. ...:._. ... ..... +...775 x 315 x 260 mm Weight with Safety Swtch_ ....._.51,2/23.2.... I. ... 54.7/24.7 88.4/,40.1.. .. Ib/:kg:.: ..... ...... ..... `Natural.. ... ..... convection a Cooling_ Natural Convection and internal .Fans(user replaceable) fan(user - .f. _ . ' ... ..... :replaceable).... he best choice for SolarEdge enabled systems Nose <25 <so dBA .. . . _... . - Integrated arc fault protection(Type 1)for NEC 2011 690.11 compliance Min-Max:Operatingremperetur,e i3 ••.,s,,. Yo+140/ 25 to+60(40[o+60 Vernon available ) F/ C — Superior efficiency(98%) Range Protection Raring -- NEMA 3R ... ... ..... ... ....... ....... ....... ......... ......... ......... ... ..... .. .. . ........ ....... ... — Small,lightweight and easy to install on provided bracket For other regional settings please contact SolarEdge support. {{ Ri A higher current source may be used;the inverter will limit its input current to the values stated. — Built-in module-level monitoring 4 .ill Revenue grade inverter P/N:SExxz AUS0D0NNR2(for 7600W inverter:SE7600A-US002NNR2). - :. Rapid shutdown kit P/N:SE3000-RSD Sl. - - - Internet connection through Ethernet.or Wireless - lsl-00vers,onP/N:SE—A-US000NNU4(for 760OW inverter5E7600A-Us002NN1.14).- — Outdoor and indoor installation ° 41 � `� ._ u �a. ,, 77 — Fixed voltage inverter,DC/AC conversion only x — Pre assembled Safety Switch for faster installation - - f.. "q Y• , * > �R Tyr — Optional—revenue grade data,ANSI C12.1 *,. sunsaE � ��"�`� ;�` �f `� `� • ' .r. . - .a�. USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THENETHERLANDS-ISRAEL :Soldfedge.USm I.