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R�"'� .. 0 -, 'r ,./f' .o. .tw. ^,�• �-, "�a,y.l;_,y. .. e �. r"1'P�, ry.�' '� `rr+. iti ,,f.;+' F .� 'mu.'. i'..r:� +l .r .. .. ,..ar"RW�:..._ ':..• _; .._..:r�. kd' a ._n ,., ,... Stk P_ �. .,R,'y6F...T,•,1...ytY ... .:R- 'r'�,.,�:'.:.,"�;,,�0'..:.>r_:Ar„e.v,A, f n�fd `'11A�..7.�'4ia,�,..S .#r,�i' Jf„':�8rA"+n ,rl t7 41 c a_eA, ---tv Ile� (A ImoA 4_7 t /Ito L� AW 0 .d 1 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION k �Ml�tr S Cam' Map I Parcel Application # -A, Health Division Date Issued 2,41 ` Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH Q _ Preservation/ Hyannis Project Street Address sq. n L"", �� �• \� �;o Village Owner IM_ -d �`1V\Ac f .J:e_"cN, Address 690 Telephone r tit yr Permit Request --T�S�rl SD �n��5 zx�� oC' �.5kth1 Ili -C eMn c c� l.�Ll� �. ��6}rt "e.�S Square feet: 1 st floors: existing "— proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay � n Project Valuation ka\, 00-b Construction Type Lot Size Grandfathered: ❑Yes ONo If yes, attach supporting documentation. Dwelling Type: Single Family 'Zf- Two Family ❑ Multi-Family (# units) Age of Existing Structure rS - Historic House: ❑Yes O�No On Old King's Highway: ❑Yes :.No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other WA_ Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing�New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new siz�!�Pool: ❑ existing ❑ new sizes n�Barn: ❑ existing ❑ new size Attached garage: ❑ existing ❑ new siz�U'�ed: ❑ existing ❑ new sizd09 Other:' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ fry Commercial❑Yes No. If yes, site plan review# y Current Use Proposed Use AFQ --3 J w APPLICANT INFORMATION rorvo&�4n_) (BUILDER OR HOMEOWNER)Name vL IC&S-4y) Telephone Number /71� Address �� � �� VIJe S �a_ License # yXvu� 4� Cr3-6G6 Home Improvement Contractor# Email e 0 5'�eAvt .S e_Uka-- Worker's Compensation # (ALL20615- -,/)n ALL CONS UCTION DEBRIS RESU NG OM THIS PROJECT L BE TAKEN TO Q duo, 51ef- . SIGNATURE • i 1r- DATE �a t 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. , SolarCit ., OWNER AUTHORIZATION Job#: C)Z(,2S 9 t -w Property Address: _ �1® Vibes .N !(� (L�ic �►5 ��+' 42G3 Z- I as Owner of the subject property hereby authorize SOLARCITY CORPORATION to act on my behalf, in all matters relative to work authorized by this.building permit application: Signature of Owner: Date: S'OLAR01 T Y. CM. l Board of ouiuring Rrqurstions ind 514jrt4ard! x « rrwe CS-108815 JASON PATRY 821 STEWART DRIVSV Abington MA V, . „ .... 02IM2019 Office of Consumer Affeirs @ tfosium Regnlstloo 'HOME IMPROVEMENT CONTRACTOR f r Registration: 160572 Typo i Expiration: 3W01-r Supplement SOLAR CITY CORPORATION JASON PATRY ' 24 ST MARTIN STREET 8LD 2i1N1 Q L e" AAkBOROUGH,mA mm uNk uereisry e r _ cc� c.�G,,Q• C Office of Consumer Affairs d Business Regulation `10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration t w Registration: 168572 Type: Supplement Card SOLAR CITY CORPORATION . Expiration: 3/8I2017 CHERYL GRUENSTERN 24 ST MARTIN STREET BLD 2UNIT 11 J MARLBOROUGH, MA 01752 - - - Update Address and return card.Mark reason for change. sr:a, t �+ j> Address Renewal ! t Employment ? Lost Card >'/r`f%r arrur nrr rr�11h q. - +w=-="Z!Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation . Registration: 168572 Type: 10 Park Plaza-Suite 5170 Expiration: 318/2017 Supplement Card PP ' `Boston,MA 02116 ' SOLAR CITY CORPORATION CHERYL GRUENSTERN - ` ^w 3055 CLEAR VIEW WAYw. -;t. SAN MATEO,CA 94402 :,;: - •. .,.,.. .-. — }=�------ -----_.-------- • Undersecretary -Not valid without signature r c The Commonwealth of massach.usetEfs Depar!>cod of Indu4trtal Accidents I Congress Street,Suite 100 Boston,MA 02114--201 7 www mass.gav1dla Warkers'Compensation Insurance Affiidmit:Builders/CuntmetordEleetrietans/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. llWcant InfoM111on Please Print Lesibly- NaMe(Ausinoss/t)rgunizafion/[ndividuat): SolarCity Corporation Address: S055 Cleseview Way 4- City/State/Zip; San Mateo,CA 94402 phone#. (888)765.2489 Are your an employer?Cheek the xpproprhatc bat: Type of project(required): 1.01 am a emptoya with 15,000 ernpioyeas(full am dim paq time)-* .7. [:]New construction LQ 1 am a sole proprietor or partnership and We no employees working for ox;in a. Ronnodoling any capacity.[Nor warkers'comp.insatanee required.] 3.(j)am a homeownerdoirg'all work myselE[No workers'comp.insuranceroquired.]t 4 Q Demolition 4.[]l am a Iwnreowaer and wiff be hiring amtraclors to cOMO all work on my property. l Wrl1 10 Building addition ensure that all contractors oiltscr hove-millers'compensation insunmee or are sole 11.❑Electrical repairs or additions Proprietors Klllt no rU1Em10yGt5- 12.[]Plumbing repairs or additions So I am a gencaai,contractor and t have hired the sub-contractors listed on the attached sheet. I3.❑Roof repairs These sub-contracron have employees and hgve workers'comp.insurance.; 14.Dotitet•solar panels 6.Q We are a corpomilon and iia offtcars have exercised their right of excerption per MG1.c. ISZ§1(4) and vie have no employees.[Nor tvod ols'camp.irtsnrartccrequired.l *Any applictbtt titan checks box/if most also nil out the seet'sou below stowing their workers'compensation policy information. P homeowners Who Submit this aftidt<vir iad Mbg bray are doing all wort,and then hire outside.contractors must submit a new Adavit indicating au It konumon that cheek this bore neon o narhnd an a4ditional sheet sh owlM the name of him strb-mwrrtraolor$and state whether Or not those eatI60 have emnloyow. If the gab-eontmeton have cusploycos,they must provide their wancco'comp policy mmtber. Jam an employer that is providing workers'Compensation insurance for my employees. Below,is the paficy and Job site inforlm otc Insurance Company Name:American Zurich Insurance Company Policy#or Self ins.Lic.#: IMCOil321395-0Q Expiration Date: 9/7/201f's Job Site Addmss: 590 L'umbert Mill Road City/State/Zip�Centerville,MA 02632 Attach a copy of the workers'compensation poppy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tender MGL c.152,§25A is a criniinal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerdlk under the pains and penalties of perJury that Me!t(f►ormatMn provided above is true wrd correct. ason Pa p : januag 22,2016 Phone Offichri use only. Do not write bw this area,to be completed by elty or town officiaL City or Town: Per witlLieense# ' Issuing Apthority(Circle one): 1.Board of Health 2.Banding Department 3.City/Tawn Clark 4.Electrical inspector I Plumbing Inspector 6.Other Contact Person: Phone#: t: AC RL7� DATEPAMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE, 08r1712015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURSR(S), AUTHORIZED. REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PROOUCER CONTACT MARSH RISK&INSURANCE SERVICES AMl1; ---._—..._...._........._.... ._..._... .rr pp _....T..._ 345 CALIFORNIA STREET,SUITE 1300 PHONE ........ .. CALIFORNIALICENSE NO.0437153 ADp(i EPII*. , E ;........:. .........__._:..-......_...—. ..............._.....- SAN FRANCISCO,CA 94104 AIIrc Shannon SwIt4t5-743-8334 1t19URER(S)AFFOITDINOCDVERAeE-,.., - ,._._._..,- NAIC$ 998301-STND-GAWUE-15-16 KSURERA;Zurich►m rican instance Company I16535 - INSURED INSURER B:NIA_.... ......................_.. ._. ._...._.-.-... ....... .. .: WA -- SotarGty Corporation 3065 Cleankew Way INSURER C:NIA I\VA San Ma19o,CA 94402' INsuRER D:American Zuncdl Insmnoe Company 40142 INSIiRFR E INSURER F: COVERAGES CERTIFICATE NUMBER. SEA-00271383HO REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INsR�.._ _..._ _.....rADbLTSII ... ......................._.. _._..... ..... •'POLICYEFF POLICY@XP -..—. ..._... ......_.._..... .... . ........ L TYPE OF INSURANCE POLICY NUMBER IMMORIYYYY1 IMWDDffYYV1LIMITS A X 'COMMERCIAL GENERALLIABILRY sGLOM82016-00 0910112D15 09ID1016 EACH OCCURRENCE $ 3,000,000 DAMAGE TO R�PITED F... CLAIMS•b1ADE n OCCUR - PRE 1$E,S X'kgp--. nce,}„ S 3ODD.OD0 X ISIR f250,000 r ti i MEOEXP(Anyale.pecsoni... 5.... _.... ..._.__ �0 PERSONAL&ADV INJURY S-,._ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER- GENERAL AGGREGATE• $ 6,000,000 POLICY JJECT �.....'LOG { PRQDUCTS:cpmP/ PAGG S• 6,000.000 OTHER. r .. $ —. A AUTOMOau.ELIABNTY iBAP01B2017.00 091011201E 109101/2016 COMBINEDSNG LIMIT $ 5000000 X ANY AUTO I BODILY INJURY(Per person) $ X AUTOS ED X S�SSIiLED i BODILY INJURY(Per accident) S X X NON•OWNED i r PROPERTY DAMAGE S HIRED AUTOS AUTOS I ` !tihTll]......_ ............ .. { ctxnPrcoLL DED: 3 55,000 UMBRELLALiAaHCLAIMS4&DE. 00CUR i , EACHOCCURRENCE 5 ` II EXCESSLIA6 l - - AGGREGATE S OED t RETI'3SlTlON - S D tvOticERs COMPENSATION jWG0182014 00(ADS) 09101l1015 R !LIABILITY 1091DII2016 X PTAru> AND EMPLOYERS! YINANY 'WC0182015-DD(MA) o91D1f2015 409l011201fi OFFICER949MAMVXCWDEDEXECUTIVE QMIA!ii i E.L.EACH ACCIDENT 5,..._....._ 1,0M.000 (Mandatary in Nsq 'INC; DEDUCTIBLE 5500,D00 E L.DISEASE.EA EMPLO $ _ 5,000,t]00 If yea,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY I-IMFT $ l : 1 i DESORIPTWN OF OPERATIONS 1 LOCATIONS I V%4t4£S(ACORD fei,AddMonal Remarks Schedule,Maybe Rtrached If mere epaca is requiradl Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SdarCay Corporation SHOULD ANY OF THE:ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3055 Cleafmw Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo.CA 99402 ACCORDANCE VATH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATM of Illamah Risk&Insurance Services Charles Marmotejo I . ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 2512014101) The ACORD name and logo are registered marks of'ACORID � f f Version*53.6-TBD ;;AsolarCot - Y January 20,2016 RE: CERTIFICATION LETTER + y Project/Job# 0262541 Project Address: Jackson Residence 590 Lumbert-Mill Rd Centervil, MA 02632 AHJ Barnstable SC Office Cape Cod ' Design Criteria: -Applicable Codes= MA Res. Code, 8th Edition,ASCE 7-05,and 2005 NDS ' A - Risk Category= II -Wind Speed = 110 mph, Exposure Category C -Ground Snow Load = 30 psf MPl: Roof DL= 13 psf, Roof LL/SL= 20.7 psf(Non-PV Areas), Roof LL/SL= 11.4 psf(PV Areas) - MP2: Roof DL= 13 psf, Roof LL/SL= 20.7 psf(Non-PV Areas), Roof LL/SL = 11.4 psf(PV Areas) ' - MP6: Roof DL= 13 psf, Roof LL/SL= 21 psf(Non-PV Areas), Roof LL/SL= 21 psf(PV Areas) Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.19069 <0.4g and Seismic Design Category(SDC) = 6 < 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. r i 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. 2 MAN Sincerely, _ Digitally signed by HKarlukl K. +Keriuki, P.E. Date: 2016.01.20 13:03:51 o ST uCTURAc Humphrey O No.51933 Professional Engineer -05t00t O T:443.451.3515 FG)STE�``` email:. hkariuki@solarcity:com A1. 3055 Clearview Way -San Mateo,CA 94402 T(650)638-1028 (888)SOL-CITY F'(650)638-1029 AZ R9024$775,CA CSL3 888704.'W F.0 864i,C1'HIS%.0832778,DC t749 71101488,PC HIS711014$8,Ht C1=29770,.MA HIC 1685Z2,.MC IA"C 128948,rW 1 08 CC818D428,PA 077343,TY TaLR 270gS.WA OCU 80LARC'91907.0 F013 SOIWOty.Ail 09ttti'meerved.- - - Version#S3.6-TBD �o�;SolarC�t R 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 68.9% MP2 64" 24" 39" NA Staggered 68.9% MP6 64" 24" 39" NA Staggered 69.5% 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 85.9% MP2 48" 19" 65" NA Staggered 85.9% MP6 48" 18" 65 NA Staggered 86.7% Structure Mounting Plane Framing Qualification Results Type Spacing Pitch Member Evaluation Results MPi Finished Attic @ 16 in.O.C. 380 Member Impact Check OK MP2 Finished Attic @ 16 in.O.C. 380 Member Impact Check OK MP6 Vaulted Ceiling @ 16 in.O.C. 120 Member Analysis 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)SOS-CITY F(650)638-1029 solarcity.com AZ ROC 243771,CACSL8 888104,Co EC 8041,CT HIC 0632778,OC HIC 71-101466,DC HIS 71101488,HI CT-29770,MA HSC 188512,MO MHIC 128948,NJ 13VH04316WD0. OR CC13 180498,F'A 077343:TX 1'0LH 27008.wA GCL SOLARO'91207,D 201$9otorGty,All rlphls res�+rvnU. I 'STRUCTURE ANALYSIS - LOADING_SUMMARY AND MEMBER CHECK- MP1 Member Properties Summary MP1 Horizontal Member Spans Rafter Pro erties Overhang 0.74 ft Actual W 1.50" Roof System Properties San 1 11.72 ft Actual D 5.50" Number of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofing Material Comp Roof ;r San 3 >. .: _ ., _: V,. 4 s• >8.25 in.^2 Re-Roof No San 4 S. 7.56 in.A3 Plywood Sheathing .Yes _ X San 5 �,;. ,:, ." I , F} 20.80 in.A4 Board Sheathing None Total Rake Span 15.81 ft TL Defl'n Limit 120 Vaulted Ceiling "` Yes "` PV 1 Start 1.33 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 11.58 ft Wood Grade #2 Rafter Slope 380 PV 2 Start Fb. 875 psi, Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracing Full PV 3 Start e E ,� 1400000 psi Bot Lat Bracing Full PV 3 End E,„i„ 510000 psi Member Loading.Summary Roof Pitch 10 12 Initial Pitch Adjust Non-PV Areas PV Areas Roof Dead Load DL 13.0 psf x 1.27 16.5 psf 16.5 psf PV Dead Load PV-DLL '3.0 psf 3.8;psf Roof Live Load RLL 20.0 psf x 0.73 14.5 psf Live/Snow Load LL SOII 30.0 psf` x 0.69' 1 x 0.38 20.7 psf- ..11.4 psf. Total Load(Governing LC TL 1 37.2 psf 1 31.7 psf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(Ce)(Ct)(IS)pg; Ce=0.9,Ct=1.1, IS=1.0 Member Design Summary(per NDS Governing Load Comb CD CL + CL - CF Cr D+ S 1.15 1.00 1 1.00 1 1.3 1.15 Member Anal sis Results Summary Governing Analysis Pre-PV Demand Post-PV Demand Net Impact Result Gravity Loading Check 1342 psi 1138 psi 0.85 Pass J " CALCULATION OFDESIGN WIND:LOAD$__MP1__� a Mounting Plane Information Roofing MaterialY T Comp Roof - - _ . �- - -._��._ SolarCity SleekMount"" PV System Type._.__ _ Spanning Vents No - Standoff Attachment Hardware),. "y Comp Mount Type C y- �� - Roof Slope 380 Rafter Spacing ,,, _ a.xr -° n 16"O C. - _ Framin T e Direction Y-Y Rafters. Purlin Spacing.. __ _X-X Purlins Only_ ` „vNA Tile Reveal Tile Roofs Only NA Attachment SysteW__ _ Tile.Roofs Only NA Standin Seam/Trap S acin SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind Designn Method, - � Partially/Fully Enclosed Meiho __ _ ._.__ Basic Wind Speed V + 110 mph� �- -� Fig. 6-1 Exposure Category..._.__�_�.�.. _ � - .. __-- C- - ------•-- -- _ _Section 6.5.6.3 -- Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean'Roof Height'. : ... h . _ _ ,° ... ��, " 15 ft,, . •xis �q: �„ ,:Section 6.2 Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.85 Table 6-3 Topographic Factor "` K _7 777—rl—.00 ` Section 6.5.7- Wind Directionality Factor Kd 0.85 Table 6-4 Importance Factor I 1.0 _"-fable 6-1 Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(VA 2)(I)22.4sf Equation 6-15 Wind Pressure Ext. Pressure Coefficient U GC u -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient(Down)- GG Down ' '0.88 Fig.,6-11B/C/b-14A/B Design Wind Pressure p p= qh(GC) Equation 6-22 Wind Pressure U -21.3 psf Wind Pressure Down Pfdownl 1 19.6 psf A L WABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable,Cantilever - __ Landscape 24 DNA Standoff Confi uration Landscape Staggered Max Standoff Tributary Area _ :_ Trib _,17 sf _- PV Assembly Dead Load W-PV 3.0 psf G - NetrWindjUplift at Standoff • Tactual _ u _,�.".: „- rt 3441bs ; Uplift Capacity of Standoff T-allow and 500 Ibse __-_____ Standoff Dem Ca aci DC� R �' � 68.9% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48" 65" Max Allowable Cantilever _ Portrait _' 19�_, Standoff Confi uration Portrait Staggered Max Standoff Tributary Area __� b-r, � �22 sf�_ PV Assembly Dead Load W-PV 3 0 psf Net Wind Uplift at Standoff_ ; _= yT�actual«.. x 429 lbs - - -- - �- Uplift Capacity of Standoff T-allow 500 Ibs Standoff mand Ca aci DCR -,8 De 5.90/ STRUCTURE ANALYSIS -.LOADING SUMMARY AND MEMBER CHECK W L _ .l Member Properties Summary MP2 Horizontal Member Spans Rafter Pro erties Overhang 0.74 ft. Actual W 1.50" Roof System Pro erties San 1 12.67 ft Actual D 5.50" Number of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofing Material ..Comp Roof San 3. F, A,�' _; 8.25,in.A2 Re-Roof No Span 4 S. 7.56 in.A3 Plywood SheathingYes S' an 5 IG � M4 '"'q I ;A 20.80`in.A4 Board Sheathing None Total Rake S an 17.02 ft TL Defl'n Limit 120 Vaulted Ceiling Yes "` PV 1 Start 1.50 ft Wood Species SPF Ceilina Finish 1/2"Gypsum Board PV 1 End 11.67 ft Wood Grade #2 Rafter Slope 380 PV 2 Start. Fb.-. i., �875 psi, Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracing Full.,, ­- <,PV 3 Start k = Et i` ' 1400000 psi Bot Lat Bracing Full PV 3 End Emi„ 510000 psi Member Loading mary Roof Pitch 10 12 Initial Pitch Adjust Non-PV Areas PV Areas Roof Dead Load DL 13.0 psf x 1.27 16.5 psf 16.5 sf PV Dead Load• *' b'°PV-DLL 3.0 psf z"'1.27' �' . ` � 3.8`psf Roof Live Load RLL 20.0 psf x 0.73 14.5 psf Live/Snow Load LL SL112 30.0 psf x 0.69 1 x 0.38 20.7 psf 11.4 psf.__ Total Load(Governing LC TL 1 37.2 psf 31.7 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=0.9,Ct=1.1;IS=1.0 Member Design Summary(per NDS Governing Load Comb CD CL + CL - CF Cr D+ S 1.15 1.00 1 1.00 1 1.3 1.15 Member Anal sis Results Summary Governing Analysis I Pre-PV Demand Post-PV Demand I Net Impact Result Gravity Loading Check 1570 psi 1338 psi 0.85 Pass I , [CALCU_IATION OF`DESIGNLLWIND LOADS�,MP2__ ,i�'� _���� Mountina Plane Information Roofing Material Comp Roof PV,_System Type __ `_ �_� _ �� Solardty SleekMountT" Spanning Vents _ No Standoff Attachment Hardware '� �-� M.cr 4.e. _',� Wit#"' S.. 'iyiE :°+r. Comp;Mount Type C. Roof Slope 380 Rafter Spacing: ' 11 !�� 16 O C�j - _ Framing Type Direction Y-Y Rafters Purim Spacing -- - — in r, X-X'Purlins Only- "� NA._.: _,Lv Tile Reveal Tile Roofs Only NA Tile Attachme t System Tile Roofs Only NA - r _ ___- .�___._ -- _ _ �.� Standing Seam/Trap Seam/Trap Spacing SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind,Design Method p„ Rartially/Fully_Enclosed Method Basic Wind Speed V 110 mph Fig. 6-1 ExposureCate9O.ry, - -E3 C° ., Section 6.5.6:3 Roof Style Gable Roof Fig.6-11B/C/D-14A/B MeanMean Ro Roof Height— h 17'l" 77 ' °,15 ft =r - Section 6.2, Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.85 Table 6-3 To o ra hic Factor' °;_ K' Z 1.00 .. r. Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Im ortance Factor I - _ s 1.0 _' ``.. T ble 6 1 _ a Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(V^2)(I)22.4sf Equation 6-15 Wind Pressure Ext. Pressure Coefficient U GC u -0.95 Fig.6-11B/C/D-14A/B Ext-Pressure Coefficient Down • GCp Down _ t 0.88 Fig.6-11B/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"��_ 24 w �•. NA Max Allo able Ci art� leve A ti� _ _ � � Standoff Confi uration Landscape Staggered Max Standoff Tributary Area _ Trib ' 17 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff'" -µT actual _ _ -344 Ibs ` Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand/Capacity = DCR � 68.9% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48" 65" Max Allowable. _ '_ Portraits _- NA Standoff Configuration Portrait Staggered Max.StandoffTributary,Area_ _ ____ Trib —1 22sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff T-actual �r 429 Ibs Uplift Capacity of Standoff T-allow 500 Ibs st 5e-miand/Capacity DCR 85.9% 'STRUCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK- MP6 Member Properties Summary MP6 Horizontal Member S ans Rafter Pro erties Overhang 0.74 ft Actual W 1.50" Roof System Properties San 1 11.25 ft Actual D 5.50" Number of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofing Material Comp Roof San 3 A 8.25 in.A2 Re-Roof No San 4 SX 7.56 in.A3 Plywood Sheathing Yes San 5 Ix 20.80 in.A4 Board Sheathing None Total Rake Span 12.26 ft TL Defl'n Limit 180 Vaulted Ceilin Yes'' "PV i Start 0.92 ft Wood Species' SPF Ceilina Finish 1/2"Gypsum Board PV 1 End 10.58 ft Wood Grade #2 Rafter Slope 12°,a P_V 2 Start <a .< =• ? Fe'- ':875 psi. Rafter Spacing 16"O.C. F PV 2 End F„ 135 psi Top Lat Bracing Full PV 3 Start xj. A.. E x:.Ym,. 1400000 psi Bot Lat Bracing Full PV 3 End Emin 510000 psi Member Loading Su ma Roof Pitch 3 12 Initial Pitch Adjust Non-PV Areas PV Areas Roof Dead Load DL 13.0 psf x 1.02 13.3 psf 13.3 psf PV Dead Load PV-DL 3.0 psf x 1.02 3.1 psf Roof Live Load RLL 20.0 psf x 1.00 20.0 psf Live/Snow Load LL SL1,2 30.0 psf x 0.7 1 x 0.7 21.0 psf 21.0 psf Total Load(Governing LC TL 34.3 psf 37.4 psf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(Ce)(C0(IS)p9; Ce=0.91 Ct=1.1, 4=1.0 Member Design Summary(per NDS Governing Load Comb CD CL + CL - CF Cr D+ S 1.15 1.00 1 1.00 1.3 1.15 Member Anal sis Results Summary Governing Analysis Max Demand @ Location Capacity DCR Result Bending + Stress 1237 psi 6.4 ft 1504 psi 0.82 Pass i _ -- [CALQULATION_OF`DESIGN WIND. OADS�MP6"� � � _ 7 Mounting Plane Information Roofing Material Comp Roof PV System Type __ _,..r� _ _ _ _ ._ _ �SolarCity SleekMount'" Spanning Vents No _ —�.__.._- �. Standoff Attachment Hardware ° x: Comp Mount Type C "ro J� Roof Slope __-- _ _._ r._ _ 120 Rafter_Spacing,_____ Framin T e Direction Y-Y Rafters PurlinSpacing _ _X-X,Purlins-Only,_ — NA� Tile Reveal Tile Roofs Only NA Tile Attachment -Tile Roofs Only NA , =gam Standin Seam ra S acin SM Seam Only NA i Wind Design Criteria Wind Design Code ASCE 7-05 Wind,Design Method Enclosed Method_ Basic Wind Speed V 110 mph Fig.'6-1 Exposure Category _�_ _ C ms. Section 6 5.6.3_ Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Height h 25 ft T — Section 6.2 Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.95 Table 6-3 Topographic Factor _ K `_ '100" -' Section 6.5,7 Wind Directionality Factor. Kd 0.85 Table 64 Importance Factor I. ;°; ,: Six 1.0 r_ Table 6-1 Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(V^2)(I) Equation 6-15 24.9 psf Wind Pressure Ext. Pressure Coefficient U GC u -0.88 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient Down -kirv, -,--',;GC[)(Down) 3R ;° 4;, 0.45 , m;` r< ° Fig.6-11B/C/D-14A/B Design Wind Pressure P p= qh(GC ) Equation 6-22 Wind Pressure U -21.8 psf Wind Pressure Down 11.2 psf ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable,Cantileve_r Landscape—� 24" Standoff Confi uration Landscape Staggered _ Max,Standoff Tributary.Area- _ _Trib 17 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff 3_ , T actual � 348 Ibs 1 --Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand Caaaci DCR _ 69.5% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 4811 65" Max Allowable CantileverPortrait Standoff Configuration Portrait Staggered Max Standoff Tributary,Area, ,:;�,_;__Trib'' m 22 sf f.,- L _ate 4. PV Assembly Dead Load W-PV 3.0 psf Net Wind_Uplift pt-Standoff_ _- T actual „ -434 Ibs Uplift Capacity of Standoff _ T-allow 500 Ibs Standoff Demand Ca acity DCR i ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map � � Parcel Off ® BsS 'w Application # ®l q0.- Health Division = ZQj4 ,ALIT, ii 9 E : C,f Date Issued �3 Conservation Division Application Fee Planning Dept. - Permit Fee s,5 DIV y Date Definitive Plan Approved by Planning Board �� s Historic - OKH _ Preservation / Hyannis Project Street Address 510 4Uh9,6f/L7- 041 Z4 Village �°Jy"i �V��-� /V1 4 . Owner fiN e� .-ACj�<SOnN Address SAm e_ Telephone (-7 7Y Z Z8 J Y Permit Request 9b� ° IZOuA-�b °' �ad� A-90J`%y_ &UJUWb sw /rk 1" r� q �e®� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation y Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name_ 4VA d`C/S,p A.V,yny iy 16 r, Telephone Number Address--�--- IC q ��: C� . License # // �Mrt 0771 Home Improvement Contractor# Email Worker's Compensation'# 77dd ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ._DATE -C9 0 8 6 3 FOR OFFICIAL USE ONLY " �. APPLICATION# DATE ISSUED fg' , MAP/PARCEL NO. t ADDRESS VILLAGE OWNER J DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ,r FINAL BUILDING 143 t D,prT-CLOSED OUT ASSQ-CIATION PLAN NO. The Ccannionweaf of tYtassacimens De�artnrent of Inal Accide> Q,f ue Oflnvesdgadons 600 Washington Street Boston,MA 0211.1. tvwnv_mass gov/dia Workers'Compensation Insuramoe AfBdnvltr General Bugkmssa Aoulicant Infemmllon t— Pleas6 Print Lqd ly Business/Organization Name: �QYc150 erlkrpn7 c-s /rl:c_. Addr=: ?0. SU City/Statel p: t Fir a town / ►'}1 . 0 7 VI Phone#: &re-`76%-1 gsI Are you an employe ?Check the appropriate box: Business Type(required) l.d I am a employer with L employees(fun and(. 1 ❑mil or pmftiime).� 6: 0 ReshWiinbSadEatin tEstablishment- 2.❑ T am a sole peoprietor or partnership and Have no 7. 0 Office and(or Sates(ind.ri=l estate,auto;cte) employees worlang for me in any capacity. tNo workers'com m�tt�rnae P rtquirrd} S. 0 Non-profit 3.0 We am a corporation and its offccrs have excr:dscd 9. Q Ent�tinment their right of exemption pore.152,$t(4),and we have 10.. Mmufactur ng' no cmployces.[No workere comp.inst►ranca 4.❑ We area non-profit organization.-staffed by volunteers : ]1_Q Iieti Cate: with no employees(No worketx'`comp,insurance req-1 12.[]Other Any aMlkatn drat dw&s box#1 awa also-Mf ow the swim bekmshowing their tamWr%'can cniQdoa policy iarbinuam m cif tkr caporatc atTwcsa 1►a.c c�ccnysaud ihcnrssacc�tmt the co�r�tinn liar atit�cmptaj�w^c a�wr<+cnc'wm�+^rratiw��wt'tcy.�-� yviml and Ludt nn as&.izalm Am►1d dpxk bm Bt I am an employarLAM Is prov g workers'evmpemadon ttmua t"farmg employees. Delos is die p»llry n Insurance Company Name do'c n ,'ISu M.ILCg,; Corn P y,►3V Insures Addrew 'goo caagno r Lie gbi i S+ W6, City/statem.r. 0 ltyejaM :0k 4W !1 q Polity p oc Scif=its.Lie..# WVJC301351 ItExpiration flatei y 14i 1: O1 S Attacb a copy of the women'compensation policy declaration page(showing the;pdicy number and expiration date). Failure to secure coverage as required umkr Section 25A of MG c.152 can lead to the imposition of criminal pataltics.of a fine up to$1;500:00 artd(or one-year`lmprisonmant*arc tvel!as civit pettalties ia.'tt<e form:of a YMP WORK ORDi R and a fine of up to$M 00 a day aonst the violator: ft advised tttat.a cry of tlus statement may he for wat+ded to the Office of Investigations of the DIA for insurance coverage venftcation errby 1 r Pe! of pt yrrrq that the i'irforrrrdtian provided lded above ht true:aIIW con'wt I doh eerti rraderdm a.nd m Siansuu Date: 91004 Offr'ciaf AW:Mdy.o Do not write fit!Iris arerr to be completed by city or town o,Oi'tctaL.;. ah.,or Towns 1PetaniUlaea # _ - Lssuing Authority(cirde one):: 1.Board,of liieaft Z.Building Dew 3 Cie r/Towu,Cleat! 4: 'Licensing 5: s;tlffifce 6.Other 1as>�iean te@atikn.tom..' Contad Person: Pbone;$: ��rtr.ma#ctyar/die.. Ii �p- t)ATE(MNUDDiYYYY) CERTIFICATE OF LIABILITY INSURANCE, 03/31/2014 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(SL AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the poll ey(les)must tie endorsed. If SUBROGATION'IS WANED,subject to_ the terms and conditions of the policy,cartel n policies may require an endorsement A statement on this certificate does not confer rights to the- certificate holder in lieu of such endorsemen s. PRODUCER CONTACT Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY,INC: 150 SAWGRASS DRIVE PHONE 877-266-6850 F 565-3$9-7426 ROCHESTER,NY 14620 E-MAfL Certs@paychex,com ADDS S INSURER(S)AFFORDING COVERAGE; NAIC# INSURED INSURER A: Wesco insurance Company 25011 NARCISO ENTERPRISES INC. INSURER B: PO BOX 680 EAST FREETOWN,MA 02717 INSURER C.- INSURER Dt 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 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 SUWECT:TO ALL THE-TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY;HAVE BEEN REDUCED BY PAID CLAIMS. m TYPE OF INSURANCE DDL UOR POLICY NUMBER POucYEFF POLICY EXP UM)Tg NSR D 1 (MWDDITYY`r) (MMIDD GENERAL LIABILITY EACH OCCURRENCE- COMMERCIAL GENERAL uABILrrY DAMAGE TO RENTEDISES [::)0LAIMS-MADE[�:jDCCUR MED EXP(kgiXw PwwX) $. PERSONAL&ADV INJURY S GENERAL AGGREGATE $. N`l AGGREGATE UNIT APPLIES PER PRODUCTS,COMP(OP AGG POitCY O PROJECT IAC _ _ AUTOMOBILE LIABILITY - _ - ..., - - . ..:COMBINED SINGLE LIMIT (Ea acdCent) ANY AUTO ::.:. .. BODILY INJURY S AUTOSS NED � '. .(Parpermn)" _ .... BODILY INJURY NIRED Atl'I'OS��.�D_ (Per accideM) _ �i PROPERTY'DAMAGE` $ (Peral) ...... _. . ._. . _.. UMBREL Aupg=,OCCuR. :EACH OCCURRENCE" $ DWESS UAB =CuuMs-MADE AGGREGATE. g.. DED REIEWION E.. WORKERS COM➢ENSATON AND - X WCS ATLL o7H-.. EMPLoVERs•UAMLM WWC3085711:. 04/049/2014 04104/2015 E.L EACH ACCIDENT S 100.000.001. nNYPROPRieTORmA>srNEwE�currvE OFRCERlMEMBER EXCLUDED? �, E.L.DISEASE•EA EMPLOYEES 3 100,000.00. ( ryIn� u NIA EL.OISEASE-POLICY LtMtT $ 600;000.00 n yaa,ewe uodw , DFSCR5gM OF OPERATIONS I LOCATIONS.I VEHICLES(Athwh'ACORD 101 Adt00onai Remarks 1;Ghad1 irmsre space IS - u - "req irad):_ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRi6ED POLICIES BE CANCELLED BEFORE THE EXPIRATION: DATE THEREOF,NOTICE WILL BE DEI IVEREOIN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGA*4 OR LIABILRY OF ANY WN0 UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE f ACORD 25(2010l05) 01!88-2010 ACORD.CORPORATION..:All iighu ieserved: The ACORD name;and logo are registered marks of ACORD: - Town of Barnstable Regulatory Services i HAM LFs Richard V.Scali,Director 1639.,. 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 i Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ` If Using A Builder I, Vrl — , as Owner of the subject property hereby authorize r (DSOBinf�(fir( S (. to act on my behalf, in all matters relative to work authorized by this building permit application for. '9de (Address of Job) t Pool fences and alarms are the responsibility of the'apphcant. Pools a_ are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. i Sig of er Signature of Applicant PriAt Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS i Town of Barnstable Regulatory Services "WE r Richard V.Scali,Director Building Division rt Tom Perry,Building Commissioner Y� i639. ,�� 200 Main Street, Hyannis,MA 02601 ArEO �� www.town.barnstable ma us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE IV TION Please Print DATE: JOB LOCATION: ��b vM (0 4J2� ell I I /c d- L2 yLt.L number street village "HOMEOWNER": t— ­-- -aGk5W V d name home phone work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeo ers"was extended to include er-occupied dwellings of six units or less and to allow homeowners to engage an individua or hire who does not possess license, rovided that the owner acts as supervisor. DEFINIIION O HOMEOWNER Person(s)who owns a parcel of land on hich he/she resides or' ends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached s tures accessory to sue' use and/or farm structures. A person who constructs more than one home in a two-year period shall not be con 'dered a homeowner Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/S shall bexes onsi le for all'such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsib 'ty for cone pliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she un s ds the Town of Barnstable Building Department minimum inspection pro dures and require men and that he/she will comply 'th said procedures and requirements. SignaftA of Homeowner Approval of Building Official. Note: Three-family dwellings containing 35,0 0 cubic fee or larger will be required to comply with the State Building Code Section 127.0 Construction Control. MEOWNER'S WTION The Code states that: "Any homeowner p rforming work r which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of cons ction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that uch Homeowner sh act as supervisor." Many homeowners who use this exemption are unaware that the are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervi rs,Section 2.15) This lack of awareness often results in serious problems, particularly when thel homeowner hires unlicens d persons. In this case,our Board cannot proceed against the unlicensed person as it would r th a licensed Supervisor. he homeowner acting as Supervisor is ultimately responsible.To ensure that the homeowner is fully aw re of his/her responsibilities,in ny communities require,as part of the permit application,that the homeowner certify th t he/she understands the response.ilities of a Supervisor. On the last page of this issue is a form currently used by several to us. You may care t amend and adopt such a form/certification for use in your community. QAV.TFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 ' Office of Consumer.Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston,Massachusetts 02116. Home Improvement Contractor.Registration. ` Registration: 11703t• I . ,N TYpp_ Private Corporation. Expiration: 8/17/2016 Tr# '255683 NARCISO ENTERPRISES; INC M CARLOS NARCISO P.O. BOX 680 EAST FREETOWN,MA 02717 i. Update Address and. card-'Mark mason for change Address Renewal Employment E j:Lost Gard" SCA 1 G ;2OM4)Wll V/ ll T(�P-%It't/IO tt/tlCC1���11 7"�6tiflCdtlt3Crl' - �� •Y , • _ - A 4-•. OfTi.of Coasnmer Affairs&Bush ess Regulntioo License or registration valid for ipdividul-use only L OME IMPROVEMENT CONTRACTOR before the expiration date If Ended retnra ta: e 117031 Type: Office of Consumer Affairs and Business Regulation s1 xpiratiangistration:8/17l2016 Private Corporation 10 Park Plaza-Suite 5170 Bostoa,:11~A 02116 NARCISO ENTERPRISES;-NC CARLOS NARCISO 9 EDNA CIR FREECOWN.MA 02717 - tnderseeretary Not valid' rt "out signature.. 1 m,... _ a L._ oT 5 q o� / o° %xi CL r • �� 9� � �� S� rn.ar�,9�/C3 .Pl9bl-.• . ot.�rie� L E A O UAJA1:. .' LTY y s y --..L . C. t AV&essay.cAPtr-97r a- A07— r � Bt��t aiw� • ��� , sAOk*ww ow r"AW vt.A*,V is L aw 7W& 4sa�� AIRC .VAOIOWw /dApQ&CIA/ ANa 77W$gr I T . �� ` carv/�O QA./ 71D 7?I �a •' tow.Alt ®s--A.oQ#v* a aim rAA-1 770w,v 040r �o. N Q�ST�� {p� 7 oCHN/C 4 : "pj=L oqA AWA/dS cam 71916 • O O 1 Co 'u 9 G vV _ l 1 a k IN t t r rma -19n 4 '- `"' �y. r a TECHNICAL DETAILS - SPECIAL FEATURES Corrugated steel wall; Superior quality galvanized steel Bottom safety track 1 (3/4")0.90 cm) top seat. A unique Trevi design,the double pool support post and stay ' .: assemblies for the oval model are ' designed for superior strength as Galvanized steel Joint plate well as aesthetics. The bottom safety Steel upright track, made of galvanized steel, Galvanized steel support post, provides good stability. >Stay assembly for additional s ,strength.For oval pool STEEL WALL COMO'ONENTS 1. Plasticized SP coating . v. 2. Molten zinc coat 3. Primer coat 4. Application of an alkaline ff: 4 Asa solution to cleanse the oxides N„ 5. Galvanized steel wall core Q w 6. Chromate anti-rust coat . 7. Heat-hardened inlay 8. Ultra-resistant polymer STRUCTURAL ELEMENTS 1. 7" (17.80 cm) steel top seat 2. Steel coping 3. Resin seat cap 4. Steel joint plate 5. Galvanized steel upright R 6. 52" (1.32 m) steel wall TREVICLIP: EXCLUSIVE LINER a Overlap a U-bead" LOCKING SYSTEM Prevents liner setback in case of movement caused by freezing f� or thawing, and increases overall pool stability. (Available only with Plastic coupler J=.F ` "U-bead" liner) Liner Round metal stabilizer Inner Wall t AVAILABLE STYLES Round: 12' (3.66 m), 15' (4.57 m), 18' (5.48 m), }O21' (6.40 m), 24' (7.31 m), 27' (8.23 m), 30' (9.14 m) Oval: 12' x 24' (3.66 m x 7.31 m) 15' x24' (4.57mx7.31m) 15' x30' (4.57mx9.14m) 18' x 33' (5.48 m x 10.06 m) �"E A Town of Barnstable Regulatory Services E MAW. Thomas F.Geiler,Director QED MA'S A,� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 August 8, 2013 Narciso Enterprises, Inc. Attn: Carlos Narciso 9 Edna Circle Fretown, MA. 02717 RE: 590 Lumbert Mill Rd., Centerville Map: 147 Parcel: 085 Dear Mr. Narciso: This letter is in response to application number 201304990 submitted for the purpose of obtaining a building permit for the installation of an above ground pool. The permit application can not be approved at this time because the property has an existing unresolved zoning violation. The property must be brought into compliance and have all required inspections before a building permit can be issued. Thank you for your anticipated cooperation in this matter. Respectfully, AL.�Lauzon Local Inspector (508) 862-4034 j effrey.lauzongtown.barnstable.ma.us I i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7 Parcel Apl5lication# Health Division Date Issued i Conservation Division Application Fee 0 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation /Hyannis Project Street Address J�'1 �,U M Village Owner �-�I,Ill.l Al e_ CVSoti Address Telephone `Permit Request e ,Nd rV % 11N Ve /` et 35_�u /k Wei Am L, Square feet: 1 st floor: existing proposed 2nd floor; existing proposed Total new a Zoning District Flood Plain Groundwater Overlay w Project Valuation 7I 49,4 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attaol upportir doeu entation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) 5- C70 :r Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kin 's Highw Qes LINO i n, CD Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new I Number of Bedrooms: existing _new Total Room Count (not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric. 0 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 0 Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �ZC tS - :PR ��- Tel Number Address ED N A License # � ��� .� 1 Home Improvement Contractor# , \ Worker's Com ensatiori # J �" p ALL CONSTRUCTION DEBRIS ESULTING FROM THIS PROJECT WILL BE TOE SIGNATURE DATE 07�� Y//-3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / -� '2-Parcel d Application # o J� Health Division Date Issued (< < Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic -.OKH Preservation/ Hyannis Project Street Address Z v'h b e t 'l e 7 Village A,4--cJ-., 2 k Owner �. ,�N� Ec.C�S w Address 5 �a zc, Telephone fet. 4- Permit Request Square feet: 1 st floor: existing/,/®0 proposed 2nd floor: existing -proposed Total new Zoning.District Flood Plain Groundwater Overlay Project Valuation 660 Construction Type G Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) too® Basement Unfinished Area (sq.ft) Cb® Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing 'S new First Floor Room Count Heat Type and Fuel: 14Gas ❑ Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Y?s ❑ No Z. c1 Detached garag xisting F❑ new size—Pool: ❑ existing ❑ new size _ Barn C existing -0 new size_ Attached garage. existing ❑ new size _Shed: ❑ existing ❑ new size _ Other--, Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -i - Commercial:.❑Yes— ❑ No �If_ves, site plan review# q Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name tis Telephone Number Address 7 License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER y iu DATE OF INSPECTION: FOUNDATION FRAME INSULATION i- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING SIG DATE CLOSED OUT t { ASSOCIATION PLAN NO. L))) �L The Commonwealth of Massachusetts 1 ( Department of Industrial Accidents t e Office of Investigations +' 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIeetricians(PItimbers Applicant Information Please Print Legibly Name (Business/Organizabon/Individual): ® Address: Do {-> City/State/Zip:_ � P K `S ,�' Phone lbf-- 921_-D$'® S Ar you an employer?Check the appropriate box: Type of project(required): , l I am a employer with 4. ❑ I am a general contractor and I employees(frill 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 1 7• 'Remodeling ship and have no employees .` These sub-contractors have 8. t6 Demolition working for me in any capacity. workers' comp, insurance., ' [No workers' comp. insurance 5. ❑ VW.are a corporation and its . 9 ❑ Building addition required] officers have exercised their ME Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL .l l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no` 12.❑ Roof repairs insurance required.] t. employees. [No workers' comp. insuice.required.] 13.❑ Other *Any applicant that checks box#I must also fill out the section below showing thoir workers'compensation policy information. t Homeowners who submit this afridavit 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 their workers'romp,policy information. I am an employer that is providing workers'compensadon"insurance for my employees. Below is the policy and job site information. ' Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: L d� � City/StaWzip-_QY3 1 , Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator..Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under and penalties of perjury that the information pro vid d ab ve is true and correct.- Siznature: Date: Phone#: . Official use only. Do not write in this area;to be completed by city or fawn nffcial . City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3. City/Town CIerk 4. Electrical Inspect:5.'Plarnbing Inspector. 6. Other Contact Person: Phone#: Information. and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"a individual,partnership,association,corporation or other legal entity, of the foregoing engaged in a j int enterprise,and includin the le g or any two or more g gal representatives of a deceased employer, or the receiver or trustee of an individ partnership, association or other legal entity,employin employees. However the owner of a dwelling house having not more than three apartments and who resides there' or the occupant of the dwelling house of another who employs persons to do maintenance, construction or rep work on such dwelling house or on the grounds or building appurte}tant thereto shall not because of such employme be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency s all withhold the issuance or renewal n wal of a license or permit too opera p .ra a business or to construct buildings ' the commonwealth for any applicant who.has not produced accepts a evidence of compliance with the surance coverage re quired." squired." Additionally,MGL chapter 152, §25C( )sta s"Neither the commonwealth n any of its political subdivisions shall enter into any contract for the performance of blic work until acceptable a ence of compliance with the insurance requirements of this chapter have been presente the contracting authority ' Applicants Please fill out the workers' compensation affidavit co pletely,by chec g the boxes that apply to your situation and,if necessary,supply sub-contracto s names addre PP r( ) ( ), ss(es d phone n ber(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limite LiabiIi P tY ershi s p (LLP with no employees othe partners,are not required to c ) r than the members or P � any workers co ensatio insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavi may a submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be s e sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permi license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding law or if you are required to obtain a workers' compensation policy,please call the Department at the number below. Self-insured-companies should enter their self-insurance license number on the appropriate line. City or Town Officials PIease be sure that the affidavit is complete and printed le ly. The Dep ent has provided a space at the bottom of the affidavit for you to fill out in the event the Office o Investigations h to contact you regarding the applicant Please be sure to fill in the permit(license number which ill be used as a re ence number. In addition, an applicant that must submit multiple permit/license applications in y given year,need o ly submit one affidavit indicating current policy information(if necessary) and under"Job Site A dress"the applicant sho ld write"all locations in (city or town)."A copy of the affidavit that has been officially ped or marked by the c' or town may be provided to the applicant as proof that a valid affidavit is on file for a permits or licenses. A ne affidavit must be filled out each year. Where a home owner or citizen is obtaining a li ense or permit not related to an usiness or commercial venture (Le. a dog license or permit to bum leaves etc.)said erson is NOT required to complete affidavit. The Office of Investigations would Mce to thank yo in advance for your cooperation and sh uld you have any questions, please do not hesitate to give us a call. The Department's address,telephone and,.fax number: The.eo onwealth of Massachusetts De nt of Industrial Accidents ffice of Investigations 600 Washington Street Boston,lviA 02111 Tel. # 617-7�27-4900 ext 406 oz 1-977 -MASSAFE Revised 5-26-05 Fax # 617-727-7749 ww-rVmass.gov/dia Y,(.gTr(Zt�r " Town oarnstable 9 fB ' Regulatory Services Thomas F. Geller,Director Building Division Thomas Perry,,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 'Yew -town.barrastoble.ma..us Office: 508-862-4038 Fax: 508-790-6230. .Property 0 Wner must Complete and Sign This Sect7ori If Using A Builder , I as Owner.of the subject property �--- r hereby authorize tdt J S, to act on:my behalf, in all matters relative to work authorized by this building permit application for: , (Address of Job) Si afore of weer Date P ' t Name 'If Property Owner is.applyingfor permit,please complete the Homeowners License Exemp reverse si d e. tion Farm on the CAUsctsld:coDiklAppDatzU-Oc&AMicrvsofrlWindowslTcmporzry Intcmet FilcslContcnLOuQooktDDV87AA--ExP.RES5.doc Revised 171111 ViE Town of BarngtaWe Regulatory Services Thomas P. Geiler, Director hXURM = a�uxs-rAar..e, 0, ,��' Building Division Tom Perry, Building Co ' issioner 200 Main Street, Hyan se/ , MA 0260I www.ttiwn.barns able.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LI ENSE EXEMPTION PI a Print DATE: JOB LOCATION: number ect village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"w e tended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individ 1 for hire who does not possess a license,provided that the owner acts as sui)rryisor. DE ON OF HOMEOWNER Person(s)who owns a parcel of land on which c/ a resides or intends to reside, on which there is, or is intended to be,.a one or two-family dwelling, attached or. etach d structures.accessory to such use and/or farm structures. A person who constructs iDDre than,one home in a two- ear period shalt not be considered a homeowner. Such" "homeowner"shall submit to the Building 0 cial on form acceptable to the Building Official, that he/she shall tie responsible for all such work performed and the buiI enmrt. (Section I09.I.1) " The undersigned "homeowner"ass=r-s.m- nsibility for mpliarice with the State Building Code and other applicable codes, bylaws, rules and mgulatio s_ The undersigned"homeowner"certifies that he/she understao the Town of Barnstable Building Department minimum inspection procedures and require ents and that he/sh will.comply wits-said•procedures and requirements. Signature of Ho.mnowncr Approval of Building Official Note: Three-family dwellings con 'Wing 35,000 cubic feet or Iarg will be required to comply with the State Building Code Section 127.0 Construe 'on Control. OhM WNER'S EXEMPTION The Code states that; "Any hbmmwner p rming work for which a building permit is ired shall be cxarrpt from the provisidns of this section(Section 109.1.1-U=Wing•of eonstructi•n Supervisors);provided that if the homeo er engages a persoa(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption' unaware that they arc assuming the responsibi -des of a supervisor(see Appendix Q,. Ru)cis&Regulations for Licensing Construction Supervb Drs,Section 215) This lack of awarrness often is in scrious.problerru,particularly when the homeowner hires unlicensed persons. In this e,our Board cannot proceed against the unli person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ulti ly responsible. To cnsare that the homeowner is fully,aware ofhis/her responsibilities,many communities require, part of the permit application, the the homeowner certify that he/she understands the rrspo(�ibilitie;of a Supervisor. On the last page of this t e is a form currently used by scverdl towns. You may taro[.amend and adopt such a f Pcrtification for use in your community. Q:forms:homccxcrnpt _ - Office of Consumer Affairs-&.B sie Regulation License or registration valid for individul use only ~� HOME IMPROVEMENT CONTRACTOR i before the expiration date. If found return to: Registration: 41155997 Type: 1, Office of Consumer Affairs and Business Regulation Expiration: ..5l29L2013 Private Corporatic:o - 10 Park Plaza-Suite,5170 T REALTY GROUP;INC - Boston,MA 0211ti TATE ISENSTADP I1 i 55 LAKE AVE. \T 1 IYANNIS PORT MA 0:2 Undersecretary of valid without signature jN9assachusctts - Dcpartmcnt of Public SafctN 4 Board of Buildin- Regulations and Standards Construction Supervisor License License: CS 98149 -- - -- TATE ISENSTADT _. PO BOX 796 HYANNISPORT, NIA 02647 Expiration: 3/24/2013 ('uumi�ci„nci Tr#: 10982 f TDIRE-1 OP ID: KG ,acoRO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �.� 07/05/11 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). CONTACT PRODUCER 508-771-1632 NAME: Northwood Ins.Agency,Inc. 508-393-2955 PHONE A/C No): E-MAIL 540 Main Street,Suite 9 A/C Ext Hyannis,MA 02601 L ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Liberty Mutual Insurance Co. INSURED TDI Realty Group Inc. - INSURER B:WESTERN WORLD INSURANCE CO P 0 Box 796 INSURER C: Hyannisport, MA 02647 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL SUBR POLICY EFF POLICY EXP INSIR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 NPP8014653 01116/11 01/16/12 DAMAGE RENTED 50,000 B X COMMERCIAL GENERAL LIABILITY PREMISESS(Ea occurrence $ CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY F PRO LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS OOWNED PROPERTY DAMAGE Per accident $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE X GREGATE $ DED RETENTION$ WORKERS COMPENSATION WC CRY LIMITS ER ER AND EMPLOYERS'LIABILITY Y/N 03105/ 1 O3IO5/12 EACH ACCIDENT $CERT WILL FOLLOW FROM CO 100,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE , OFFICER/MEMBER EXCLUDED? N/A 100,000 (Mandatory in NH) WIN 5 DAYS E.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Jackson's ACCORDANCE WITH THE POLICY PROVISIONS. 590 Lumbert Mill Road Centerville, MA 02632 AUTHORIZED REPRESENTATIVE �j�GZL�t��•�if-��b I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Daniel E. RE ($R d�L c Q-�f3:E'CL'C�` �i_C= ,l(7¢ ,p..� - - 89 Harbor Point Rd Gummaq#d. MA 02637-0361 ta z",k Sj�-O . �U • Bow IIA-Ij �Ic5 tC;. _a� __ TCLL3 C"Cc.��'.Lti.�rTL�L.. 6v(ASS S TAT G, � �. zGl _ Am LO 7 r Jam. �_cic_- err rvrr RAMSBEAM V2 . 0 - Gravity Beam Design Licensed to: Dan Braman, P.E. 'J61v': Jackson, 590 Lumbert Mill Steel Code: AISC 9th Ed. SPAN INFORMATION: Beam Size (User Selected) = WlOX15 Fy = 36. 0 ksi Total Beam Length (ft) = 16. 00 Top Flange Braced By Decking LOADS: Self Weight = 0 . 015 k/ft Line Loads (k/ft) : Distl Dist2 DL1 DL2 Pre DL1 Pre DL2 LL1 LL2 0 . 00 16. 00 0 . 195 0 . 195 0 . 000 0 . 000 . 0 . 390 0. 390 SHEAR: Max V (kips) = 4 . 80 fv (ksi) = 2. 09 Fv = 14 . 40 Y MOMENTS: Span Cond Moment @ Lb Cb Tension Flange Comp Flange kip-ft ft ' ft fb Fb fb Fb Center Max + 19.2 8 .0 ' 0 . 0 1 . 00 16. 70 24 . 00 1.6. 70 - 24 . 00 Controlling 19. 2 8 . 0 0 . 0 1 . 00 16. 70 24 . 00 --- --- REACTIONS (kips) : Left Right DL reaction 1. 68 1 . 68 Max + LL reaction 3 . 12 3. 12 Max + total reaction 4 . 80 4 . 80 DEFLECTIONS: Dead load (in) at .8 . 00 ft = -0. 155 L/D— 1239 Live load (in) at 8 . 00 ft = -0 .288 L/D = 667 Total load (in) at 8 . 00 ft = -0 . 443 L/D = 434 - - a 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION k CD Map Parcel Application # Health Division Date Issued r�n Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 10�71t0 Historic - OKH Preservation/ Hyannis Project Street Address Village_ (11r,�rg I Ile Owner ALor dv L-fwry (TkCVU 6 �J Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio A90 Construction Type Lot Size Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family; Two Family ❑ Multi-Family(# units) Age of Existing Structure �'7$ Historic House: ❑Yes �T No On Old King's Highway: ❑Yes ❑ No tl.t Basement Type' APull ❑ Crawl ❑Walkout ❑ Other Basement Fined Area(sq.ft.) 700 Basement Unfinished Area (sq.ft) Numg9r of B tths: dull: existing .3 new Half: existing new Number of B drooms existing�L new C) f— Tot6l,'Room C;Ountkot including baths): existing new First Floor Room Count r Heat Type 4RI F Gas ❑ Oil ❑ Electric ❑ Other c Central Air: kYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ newAsize_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number SbS j2 2.— t& OS— Address P� ® %C7J -7CII License #_�/ MI fT�N S LOCO Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO leh SIGNATURE DATE 01i V d FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME x INSULATION x FIREPLACE ELECTRICAL: ROUGH FINAL -� PLUMBING: ROUGH FINALE . R - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Bostonr MA 02111 �,N ;• 'y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lekibly Name (Business/Organization/Individual): ' Address: t� so� 7ff City/State/Zip: -c�a�• �od4 *`� Phone.#: Ayou an employer? Check�e appropriate box: Type of project(required): LA I am a employ er with w) 4. ❑ I am a general contractor and I 6. ❑New construction employees.(full and/or part-tim.e).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g"�emolition workingfor me in an capacity. employees and have workers' r Y P tY• $ 9. ❑Building addition [No workers' comp. insurance comp.insurance. required.] - 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I l.❑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 (P employees. [No workers' 13.❑other �t^P Du comp.insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �V Policy#or Self-ins.Lic.M �JC " 31 C 1-32 :51�_60 Expiration Date: 3 / Job Site Address: �e►' City/State/Zip: �'�t°v' (49 C4 Pe 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 r fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this state ay be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I dv hereby certify under thepat3&aydpenalties of pe ' that the information provided ab ve is true and correct Signature: Dater I CD Phone#: [thh only. Do write in this area,to be completed by city or town offtciaL n: Permit/License# thority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone#: Information and Instructions j Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in.the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or 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,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a 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-contractor(s)name(s),addresses)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. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as.a reference-number. In addition';an applicant that must submit multiple permitnicense 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 in=_(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or 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,telephone-and'fax number: The Commonwealth of Massachusetts Department of Indusbri.al Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tol. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-72777749 Revised 11-22-06 www.mass.gov/dia OF SHE ro Town of Barnstable Regulatory Services RAR' &I Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must y Complete and Sign This Section If Using A Builder I, LIAVIe- To SUd\ ; 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: S 0 r- 1 (Address of Job) lo �� / /b ig tore of er Date e 0 vi PrintlName If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMIS SION THE Town of Barnstable pF Tp� Regulatory Services IARNSTABLE, ; Thomas F. Geiler,Director 7 MASS. �p 16yg.. Building Division rFD MA'I A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 l Fax: 508-790-6230 HOMEOWNER LICEN E EXEMPTION r ' Please Pr nt DATE: v 6 � - JOB LOCATION: nu stye village "HOMEOWNER": L na a me phone# work phone# CURRENT MAILING ADDRESS: Vna ty/town state zip code The current exemption for" ers"was e ended to include owner-oc ied dwellings of six units or less and to allow homeowners to engdividual f hire who does not possess license,provided that the owner acts as supervisor. D INITION OF HOMEOWNPersons)who owns a parcen whi he/she resides or intend to reside, on which there is,or is intended to be, a one or two-family dweched detached structures acc ssory to such use and/or farm structures. A person who constructs more 'om in a two-year period sh 1 not be considered a homeowner. Such "homeowner"shall submit t Official on a form acc�able to the Building Official, that he/she shall be res onsible for all such wored der the buildingen it. (Section 109.1.1) a � The undersigned"homeowner"assume re `onsibility for co pliance with the State Building Code and other applicable codes,bylaws;rules and re latio 's. The undersigned"homeowner"certi es that he he under'tands the Town of Barnstable Building Department minimum inspection procedures and equiremen ',and thAt he/she will comply with said procedures and 4 requirements. Signature of Homeowner i Approval of Building Official Note: Three-family dwel ings containing 35,) 00 bic feet or larger will be required to comply with the State Building Code Section\127. Construction Cont'ol. HOMED ER'S EMPTION The Code states that: "Any omeowner performing wo k for w a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supe isors);pro i 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 unawa e that they are as ming the responsibilities of a supervisor(see Appendix.Q, Rules&Regulations for Licensing Construction Supervisors,Se ion 2.15) This lac of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case;our oard cannot proceed�gainst 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\homeexempt.DOC Autt�al.. �oalrersCompensation attd ON PAGE Employers Liability Policy 10 SUB ACCT NO. i Liberty Mutual Ittstuance Group/Boston 5323 0000 LIBF,RIYMUTUAI..INSCRANCECO M28 1CYNQ. TDlCD SALES OFFICE COPE SALES CODE N!R 1S"C S-365323-010 i.XX X WES'TON �102 I REPRESENTATIVE 3000 2 YEAR ASSIGNED I ( 2008 j 'Am I Name of T D 1 REALTY GROUP INC insured`... FUN 04.3529499 i= Address PO BOX 796 RISK ID 7M819 HYAISPORT,MA 02647 Status 03-CORPORATION Other workplaces not shown above: SEE.ITEM 4 h1c,Day Yeer 99o.'av Year .---"'— item 2.Policv Period:From 03.05_2010 to 03-054611 . 12:01 AM standard time at the address of the insured as stated herein: Itein 3,Coverage — M A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listen here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. 'Ile timi>< of our E liability under Part Two are. Bodily Injury by Accident 100A00 each accident Bodily lvjury by Disease 500,000 policy limit Bodily Injury by Disease 100,000 each employee C. Other States Insurance.:Part Three of the policy applies to the;rates,if any,listed beret SEE,END WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION OIL LNFORMATION PAGE ' hem 4.Pre.minm- The premium for this policy will be determined by our Manuals of Rules ClaSSifications Rates and Rating Plans. All information required below is subject to verification and change l+y audit PrartiuT&aeu Ratz LINE 114 _ Por Si:_c'`�' Esimarea `pdc F.surr t.d of RE- \t➢ua! CiHSSIth^.a1104S N:% Trial Annual? miutr-e mn nation ' P m_uPtE SEE EXTENSION OF INFORMATION PAGE - Minimum Premium $ 500 (M. A j Total Estimated Annual Premium S. 2,231 Interim adjastment of premium shall be made: ANNUAL This policy,including all endorsements issued therewith,is hereby countersigned by '—' Ri7horlrF:dRetarsentathe note 02-iti<I6 - Lo>.lole ?er1, Opc,. A'idi>Basis Periodic Pay'mert T ER t PniH G ;ome ste I Di v�denu RE1riF.KaL OF:02-24.10 MA i � MU-31S-365323-019 o'c"`!'r' at CcpyrigM 1987 National Council on Cotnoonsation insurance wC 01)w o;a Broker Copy '- • _ . y, ♦ Y Board of Building Regulations and Standards s Construction Supervisor,License u 7 License;CS 98149 i EXpiration 3/24/2011 Tr# 98149 Restriction 00, t i F I TATE ISENSTADT' PO BOX 796 HYANNISPORT,MA02(i47 Commissioner, � f a r Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to; / Board of Building Regulations and Standards Registration: 1559§7- One Ashburton Plac m'1301. Expiration: .5/29/2011 Tr# 283568 P Boston,Ma.02 Type.:.:Private T D I REALTY GROUP INC ` 3 TATE ISENSTADT 55 LAKE AVE. t ;' .�C�'a.n-.`. • `' --- ---------— ---- -- • No valid without signature HYANNIS-PORT,MA 02647` Administrator MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:_ 1 .5 7 , i MA.! Date: >Jt ermit# _.. t 4-- Building1 - ocation �^4-C' f ff L •. •,>�U ..... ....,..,�.",. .�.E.w�v,.� :- Owners Name:.., Type of Occupancy: Commercial j .' Educational I Industrial, Institutional I Residential. r-- ; n • New:!=xss Alteration l A - Renovation:; Replace'ment Plans Submitted: Yes�j No FIXTURES •z w •, cn O W. z > c, J X H W ' rn 0- W �_ � Y � Q Q U) z j �J cn X W o- w rn U) � -i n- X v o m to W a I— z >- � z- c� 0 U a E: L�.. . Q lA Q W .�` W �5 a J `J .Z Q X O O 1— . = z Q . t` o Y Q .z w w w n' Q Q 0 Q O tQ d O X I .. Q Il' 1- O v, SUB BSMT. BASEMENT 1 FLOOR - 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6 IHFLOOR 7 FLOOR 8 FLOOR �-- _ Check.;One.Onl Cctificate# Installing Company Name � j t.+11- L lv-- lu"b `C', _ 34. "�3 •CorporatiarH �O Address: ,vA2 City State r -- _ i Partnership (33 Business Tel: Fak �52ti8 `fad re, Name of Licensed Plumber:i,,,. rn INSURANCE COVERAGE: 3 :CT1 I have a current liabilitV insurance policy or"its substantial equivalent-which meets the requirements of MG=h•'M Yes �p If you have checked Yes, please indicate the type:of coverage by checking the appropriate box below. A liability insurance pollcyl Other type of indemnity I1.W Bond � y - OWNER'S INSURANCE WAIVER: I,am aware that the licensee does not have the insurance coverage required by.-Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives thisrequirement. Check One Only Owner F IAgent Signature of Owner or Owner's'A ent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best.of my . Knowledge and thatall plumbing work and Installations performed under the permit issued.for this application will be in compliance.with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By i _ m. W= Type of License: I .I.,..i Title ✓ Signature of Licensed Plumb _t. Plumber - i Master I ; N , City/Town.,. . .._ _. License Number: 3 3 v Journeyman l APPROVED OFFICE USE ONLY ' "^^^ t , oFWEro Town of Barnstables Regulatory Services BARNS* MASS. E Thomas F.Geiler,Director 1639. �'i0ren,uor°' Building Division ,Tom Perry,Building Commissioner, '200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 18, 2000 Tate Isenstadt PO BOX 796 Hyannisport, Ma. 02647 RE: 590 Lumbert Mill Rd., Centerville, MA, Map: 147 Parcel 085 Dear Mr. Isenstadt: This letter shall serve as notice that,a stop work order has been posted by this*office on. the above referenced property. Be advised that all-work.must'cease until such time that the stop work order is no longer in effect. This includes Lwork being performed under permit number B20101676. This stop work-does not reflect any wrongdoing on your part. It has come to our attention that a zoning violation exists on the property and the stop work will remain in effect until the property has been brought into compliance. Thank you for your attention in this matter. Please do not hesitate to call (508) 862-4034 if you have any questions. Respectfully, r L. Lauzon Local Inspector (508)862-4034 oFIKKE t Town of Barnstable Regulatory.Services * MASSS. Thomas F.Geiler,Director 03n. � Building'Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 - September 18, 2000 Thielsch Engineering Attn: Erik Nerstheimer. 1341 Elmwood Ave: Cranston, RI 02910 RE: 590 Lumbert Mill Rd., Centerville, MA, Map: 147 Parcel 085 Dear Mr. Nerstheimer: This letter shall serve as notice that a stop work order has been posted by this office on the above referenced property. Be advised that all work must cease until such time that the, stop work order is no longer in effect-This includes work being performed under permit number B20101772. This stop work'does not reflect any wrong doing on your part. It has come to our attention that a zoning.violation exists on the property and the stop work will remain in effect until the property has-been brought into compliance. Thank you for your attention in this matter.Please do not hesitate to'call (508) 862-4034 if you have any questions. Respectfully, WeL. auzon Local Inspector (508) 862-4034 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l Parcel Application # y y Health Division Date IssuedU l U Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan'Approved by Planning Board ( M),o Historic- OKH Preservation / Hyannis Project Street Address 590 Lumbert Mill 1i W. f' Village Centerville 11A 6 REC'D Owner Alan Jackson Address UG 2 Telephone 203-721-4330 B Permit Request air sealing, insulate attic space, weatherstrip basement doors, install 6 soffit vents, install a new kneewall space access hatch Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3654 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ., ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Avenue, Cranston, RI License # 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 20-10 Erik Nerstheimer for RISE FOR OFFICIAL USE ONLY ,APPLICATION# DATE-ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER w f• DATE OF INSPECTION: FOUNDATION ,x rn ¢FRAME INSULATION �����► FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:n" ROUGH FINAL FINAL BUILDING DATE-CLOSED OUT ASSOCIATION PLAN NO. `1N. ��� E � G Fc nkr� I! 3 a'b4t3 ' ' Ri�Casw"r:..c I Roo t tsiat3Ooa @f3 4tic A division of�;itisch�angerleeri�et; - _ ,:f59=Co l��a tvl W��tratG r:s ter 1,�lAr7g idPa?,' ---"If A L 106261,20 _ E3411ulraawaod Avenue,Cranston,HLI 112910 TRAC (401}784-3700 E+A1k.(401)TS41-3710 page 2 This+.9roTaic r IS ENTERD IN'TO B 1v&Eld RISC - ENfr7tdr3�RIG A'Na TIP:rua oM:R O WaRK A DEWRIDE0O t , �IvINE�nINC 1 CUSTOMER , ,:.,. ,ti ., _.'r.,. .,. .' . .,: PHONE - _ rA E - Clientk . . - Alan Jackson-: (203)i2�-4330 0/26/2010 " 11 i475 . , SERVICE STREET BILLING STREET - 590 Lumbert Mill 590 Lumbert Mill., SERVICE CITY,STATE,ZIP BILLING CITY,STATE,MP --_---- - Centerville,MA 02632 Centerville,MA 0263 JOB DESCRIPTION $100.00 RISE Engineering will provide labor and materials to install 8/4"X 16"rectangular aluminum soffit vents to increase ventilation in attic areas. $136.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. 43,004.65 { .M1- ..s,. - -...... , - _ Y WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE wrrm ABOVE SPECIFICATIONS.FOR THE SUM OF "**Six Hundeed Forty-Nine&55/100®oilers $649.55 ti _ z UPON FINAL INSP TIO AND ROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT.DUE IN FULL..INTEREST OF 1 Yo,WILL BE CHARGED MONTHLY ON UNpAa)BALANCE 30 DA 8E6 REY€R8E POR IFAPORTANF INF TION 6N Gt1ARANTEffB;'RIGHTS-.OF RECISION,SCNEDULINfY,AND COU'rRACTORREGISTRATION - • _ " DO MOT SIGWTHf$CONTRACT�IF THERE ARfkANV BLANK SPACIES' . . F AUTHORIZED ll 4ATURE-RISE ENGN INEERING - - SAidliryACCEPTANCE -- - NOTE:THIS CON CT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE — ' ACCEPTANCE OF CONTRACT-THE ACOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. - n AS SPECIFIED,PAYMENT WILL BE MADE AS OUTLINED ABOVE s The Commonwealth of Massachusetts Department,of Industrial Accidents Office of Investigations 60O.Washington Street Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eiectricians/Plumbers Applicant Information Please Print Legibly Dame(Business/Organization/Individual): RISE Engineering a division of Thie1sch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone#: (401)'784-3700 or 1-800-422-5365 Are you an employer? Check the appropriate box: . Type of project(required): 1. N i am an employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors ❑Remodeling 2. 0 I am a sole proprietor or partner- listed on the attached sheet. 7. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ required] 5.❑ We are a corporation and its 10. ❑.Electrical repairs or additions 3. 0 1 am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption perm MGL 11. ❑Plumbing repairs or additions insurance required] t c. 152, § 1(4),and we have no 12. 0 Roof repairs „ employees. [no workers' 13. X Other Insulate comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees.Below is thepolicy and job site information. Insurance Company Name: The Preston Agency Policy#or Self-ins.Lic.#: 3730961-00 Expiration Date: 1/I/11 Job Site Address: (� L w/ lkeV� 1 1 I City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration(date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a.day against violator.Be advised that a copy of this statement maybe.forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certi and the ins enalties ofperjury that the information provided above is true and.correct. Sign ture: f Date: Print Name: Erik Nerstheimer Phone#:L01)784-3100 'or 1-800-42 1JE5 3,3 ®fficial use only Do not write in this area to be completed by city or town offilcial � City or Town: 1'elr�.i¢ryac:euse# Issuing-Authority"(circli one): % r. I.Roard of Beath 2. Building Department 3.City/Tovvre Clerk "" 4t,F Plumbing I o€:pecto3 6.(Other r Contact person,,__._ �A � 4 p. — — fla?dfl r ' !4 ACORD CERTIFICATE OF LIABILITY INSURANCE CIPID 47 f DATE(MMIDIDNY'(Y) THIEL-1 09/13/10 PRODUCER THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd" Suite 303 HOLDER".THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFOR"DED BY THE POLICIES BELOW. East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFOR DING COVERAGE NAIC# INSURED -INSURERA: Zurich—American Ins CO. Thielsch Engineering, Inc INSURER 8:. An.r.lcan tusrank.. 6 Ll abl.Cl ty Thielsch Inc. INSURER North American Capacity Hi Tech R6alty alty Inc. p y 19S Frances Avenue wsUR€RD: Hartford Insurance Company Cranston RI. 0291.0 INSURER EI" COVERAGES - THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To THE INSURED"ED ABOVE FOR THE POLICY PERIOD INDICATED.NO IT THSTAnIDIN- ANY RECUIREMENT,TERM OR CONDIT1014OF ANY CONTRACTOR OTHER DOCUMENT`NITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY"rHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - - - IF75R f{00 LTR INSR( TYPE OF INSURANCE POLICY NUM6ER GATE(MM/DDM/) 'GATE( /YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 1 1,000,000 A I X COMMERCIAL GENERAL LIABILITY 3730962=00 04/01/10 01/01/ll PREl'lSEs(Eaoccurence) T 300,'.000 - CLAIMS MADE OCCUR MED EXP(Any.one person)- S 10,000 PERSONAL&ADV INJURY S.11000,000 GENERAL AGGREGATE 4 2,.0 0 0,0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,0 0 D,0 0 0 POLICY X .JEa LOC - - — Enp Ben. 1,000,000 AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT s'2,000„000 A X ANY AUTO 37309*637-00r 04/01/10 O1/Oi/11 (Ea accident) — ALL OWNED AUTOS 80DILY INJURY SCHCDULED AUTOS (Per person) t- HIRED AUTOS r , BODILY INJURY - NON-OVA IED AUTOS ' (Per awdeno S - PROPERTY DAMAGE s '(Per accident) 6 - GARAGE UABILhI' AUTO ONLY-EA ACCIDENT $ - - OTHER TR41 CAA%C $ • AUTO.ONLY: AGG $ -- . EXCESSIUMBRELLALIABILRY EACH OCCURRENCE ;10,000,000 - B X OCCUR EICLAIMS WIDEUMB 9263637-00 04-401/10 01/01/11 AGGREGATE $ 10,000,000 DEDUCTIBLE - X RETENTION S 1D,000 S WORKERS COMPENSATION AND _ ,� X TCRY�I-IMITS EMPLOYERSI.IABILITY - — . ANYPROPRIETOR/PARTNER/EXECUTIVE 3730961-00 04/01/10 01./01/11 E.L.EACHACCIDEIdT i1,000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,0 0 0,0 0 0 ' If yes,tlesC(ibe Under SPECIAL PROV19IONS bolm s El.OISEA.SE-P�LICYLIMIT 11,000,000 OTHER .+ c C Professional Liab DVL000026800 04/01/10 04/01/11 Prof Liab 2,000,000 D , Leased/Rented Eqp 02UUNTD5678 04/01/10 04/01/11 Equipment 100,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1.0 DAYS WRITTEN ?NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL: - IMPOSE NO OBLIGATION OR.IJ ABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR - <. REPRESENTATIVES. .. - AUTHORQB D REPRES r YV,F,� r A..ORD 25(2001/08) r � LDACORG COHF+�!nTITN 1998 s - . .. - Z P, at .. $,r�$w. r.-�. 'w'"M T-g;y..y+i�,i:s++r •�t.:.;:,�:., - 9 OI lce o onsumer aan` esG�s�ulation g 10 Park Plaza - Suite 5170 Boston, ssachusetts 02116 Home Improve&contractor Registration Registration: 120979 Type: Supplement Card z W Expiration: 3/25/2012 THIELSCH ENGINEERING M ERIK NERSTHEIMER 1341 ELMWOOD AVE. ° CRANSTON, RI 02910 o �e 0 Update Address and return card.Mark reason for change. Address 0 Renewal Employment n Lost Card DPS-CA1 0 5OM-04104-G101216 ✓�ie 'Pio�svmaruaea.�l�x o�./�aoaac�i«aella . Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration79 Type: 10 Park Plaza-Suite 5170 Expira - 12 Supplement Card Boston,MA 02116 THIELSCH ENdr l ERIK NERSTHE 9' _ 1341 ELMWOOD CRANSTON, RI 029� ��°� Undersecretary Not valid without signature r agt 1 OI 1 The Official Website of the Executive Office of Public Safety and Security (EOPS) p Mass.Gov Home Public Safety ` Department of Public Safety Licensee C®mplaints License Type Construction Supervisor License## 100459 Restriction WS,IC Name Erik Nerstheimer City, State, Zip North Scituate, RI, 02857 Expiration Date 3/28120 1 2 Status Current No complaints found for this Licensee. Back To Search Board of Building Regulations and Standaril3 Li-Cense or registration valid for individiil use on]}" HOME IMPROVEMENT CONTRACTOR L before the expiration date. If found return to: ! RegistrM 9n-. 120979 Board of Building Regulations and Standards Ezp f_a uYn 3%25/2010 One Ashburton Place Rm 1301 Type S.uppiemerit Card :r�o 021,08 ELSCH ENGfNEEIING K NERSTHEIfV4ER_- 1 ELMWOOD.AVE. \NSTON, RI 02910 -- Admmisti:icor Not valid without sign #ire t . x � FR Ytyy YI�� '" fi�✓t [.f,. fin- , ' �+r r x AIM NAT-24.531 -1 r } z .a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION --ram Map / 17 Parcel �s 'Application # 'Zotn6�4 Health Division "Date Issued ("0 Conservation Division Application Fee Planning Dept. Permit Fee �' 1 Date Definitive Plan Approved by Planning Board ol� $�►��/6 Historic - OKH _ Preservation / Hyannis Project Street Address Village `.p41_A rQ I Owner f��v4W _.�1[VV z 5c> Address Telephone 9 Permit Request �'e``J foo�S �X�eS X 5 �+-5 o I41(o tv Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation / , Construction Type Lot Size Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family { Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes__❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl Walkout ❑ Other o __4 a o Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new --n cn w Number of Bedrooms: existing —new n Total Room Count (not including baths): existing new First Floor Room CounP cn Heat Type and Fuel: ❑ Gas *Oil ❑ Electric ❑ Other w r Central Air: ❑Yes ❑ No Fireplaces: Existing I—New Existing wood/coal stove ❑Tes ❑ 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 Current Use _Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �'�'�L ..s � Telephone Number a "�' 2 2-0��s^ Address �Y 7� License # 1 S S 7,9 7 � `'a'`S ��✓,� w«4 �2b -117 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i i ' FOR OFFICIAL USE ONLY 'APPLICATION# s DATE ISSUED s MAP/PARCEL NO.. _ ! ADDRESS VILLAGE I - OWNER I „ DATE OF INSPECTION: FOUNDATION, > o FRAME INSULATION . r ' FIREPLACE P� ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - ,GAS: `' ROUGH FINAL 1 'rFINAL BUILDINGx'(& )Z 11 r ,c • d DATE CLOSED OUT ASSOCIATION PLAN NO. r Th_e Commonwealth of Massachusetts ' Department ofln,dustria['Accidents P, Office of Investigations 600 Washington Street Boston, MA 02111 f www,mass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers, Applicant Information Please Print Le ibI Name (Business/Or ation/Individual): Address: City/State/Zip: Phone #: j 2 ;�F.G � Are you an employer?-Check the appropriate box:: Type of project(required): 1I am a employer with 4. ❑ f I am a general contractor and h' - - t 6 New co . ❑ nstruction employees-(full and/or part-time).* have'hired the sub-contractors'. _ listed on the attached sheet. 7 jZ Remodeling 2.❑ 1 am a sole proprietor-or partner- These sub=contractors have ship and have no employees yen and have'workers' 8., ❑ Demolition emplo y working for me in any capacity. 9.' ❑ Building addition [No workers' comp. insurance comp.insurance.1 required.] 5. We are a corporation and its 00.❑ Electrical repairs or additions officers have exercised their •1 1.❑ Plumbing repairs or:additions 3.❑ I am a homeowner doing all work myself. [No workers comp.' right of exemption per MOL 12:[] Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No.workers' 1:3.0`0ther comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workcrs'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside-contractors must submit a new affidavil'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,th"cy-must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information [ Insurance Company Name: 4 �`e Policy# or Self-ins.Lic. #: Expiration Date: . ; —717 City/State,/Zip: ' IV6 Job Site Address: [ D " '' Ax-�1 e Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration.date)._ Failure to secure coverage as required under:S6ction 25A'ofMOL c, 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day agai olator. Be advised that a copy of this statement may„be.forwarded to the Office of Investigations of the DI or ur or coverage verification: r 1 do hereby certify u e p" ns and penalties ofperjwy thaf the information provided above is true and correct. Si nature: � _ Ph c Official use only.. Do not write in this+area, d be conipleted by city or town official ? •-� n r. . .it - -y , - .. r Permit/License#. City or Tow" n°: Issuing Authority (circle one): 1. Board of Health Z. Building Department 3' City/Town,Clerk` 4',Electrical Inspector 5.Plu.mbing Inspector 6. Other x` _ - Contact Person: ,Phone#:. 61 Wormatzon and f nstructzODS �. F Massachusetts General Laws chapter 152 requires al] employers to.proy the'sdervice�of anoth P Ur Satioanyocontrac of Jh fees. Pursuant to this statute, an emplo),ee is defined as '.,.every person in express or implied, oral or written." her An employer is defined as"an individual, partnership, association, al rpores'eonlativen or s of aedeceased employer, orgal entity, or any two ofof the foregoing engaged in a joint enterprise,and Including h g p parinership,'associaliiob or other legal entity, employing employees. However the receiver or trustee of an individual 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 constniction 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." ter 152 25C 6 also stales that"every state or local licensing agency shall )Yithhold the issuance or MGL chap § ( ) renewal of a license or permit to operate a business or to construct buildings in the commonwealth for y applicant who has not produced acceptable evidence or compliance with the in y oohs Political rage required." Additionally,MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall entef 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) narne(s), addresses)and phone number(s)along with their cerlificate(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the required to carry workers' compensation insurance- If an LLC or LLP does have members or partners,are not employees, e 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 [own tat•the application for the permit or license is,being requested,not the Department of h Industrial Accidents. Should you have any questions regarding the law or if y� insured compa re required to obtain Should enter their compensation policy,please call the Department at the number listed be W self-insurance license number on the appropriate line, City or Town Officials Please be sure that the affidavit is complete and printed legibly, The Department has provided a space at the bottom of the aff davit 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 pem�iVlicense number which will be used as a.refucrice number. In addition, an applicant that must submit multiple perinitflicense applications in any given year, need only submit one affidavit indicating current oT policy information (if necessary)amd under"lob Site Address" the applicant should write"all locations in town):"'A copy of the affidavit that has been officially stamped or marked by th•e city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must m 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 of permit to burn leaves etc.) said person is NOT required to complete this affidavi I. The Office of Investigations wou�li e ococaperatinn and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-87.7-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia • - i t { Ni. �z h� ` • i. •. a ___-n-+si. .--n_-_ _ V- :.--•S .� d{ '� f- ''__✓tze� � ��/�craoac�ucaP.lta � � . �� � ,� t ' Board of Bu�ldmg Regulations and Standards ;, t Constru Supervisor License ction License• CS 98149 :. t�on 3/ 4/�11. Tr# 98149 ' r, f , �V ik Expiry, Restriction .O.Oy;` ti I ri TATE'ISENSTADT PO BOX 796 ' �.., NISPT MA 02647. Commissioner I HYAN OR +y f M r 617 i�°ryrvrnonurea /f2Qauufuv� 1 License or re istration valid for<individul use only i$ Board of Building Regulatio sand Standards g' };' : HOME IMPROVEMENT CONTRACTOR before,the expiration date, If found return to: t :r .,,. Board of Building Regulations and Standards t Registration 155997 (! One Ashburton Plac m 1301 _ Ex anon 5/29/2011 Tr# 2835613 I( s Boston,.Ma.02. �T T e ;PnV,ate'Corporation Iy = Yp fr, T D I REALTY GROUP_ INC , TATE ISENSTADT,,! 7 t E 55 LAKE AVE '�� f,r ± o valid without signature a - _ ti I N"i-4IS PORT MA 02647 Administrator` 1 zT Town'®f Barnstable Regulatory Services t RARXSTABL$ v MA & Thomas F. Geiler,Director, 0; 16 Building Division ` Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ,.Property OwTZera1/.t-u.st Complete and Sigi Th s Section If Using A Builder I, �� , as'Owner.of the subject property heerby authorize A4't to act`on.my behalf, . a in all matters relative to work authorized by this building permit application f IV (Address of Job) t d.0*%A /4; FF 5igriatke of. er Date Print NaSne F If Property Owner is applyingfor permit please complete the Homeowners License Exemption Form on the-'reverse side. r. Q:FORMS:O WNER.PERMISS]ON 1' Town of Barnstable , : . " Regulatory Services t' Thomas F. Geiler, Director 1659. ,$�' Building Division PrED � Tom Perry, g Buildin Commissioner 200 M_ ain.Street, Hyannis, MA.02601 vvmy.town.barnstable.ma.us Office: 509-962-4038 Fax: 508-790-6230 HO)IEOV NER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: ci /town state zip code The current exemption for"homeowners'was extended to include wner-occu ied dwellings of six units or less and to allow homeowners to engage an individ 1 for hire who does no possess a license,provided that the owner acts as supervisor- DE ON OF HO OWNER Person(s)who owns a parcel of land on which he/s a re en to r sides or P ' tds eside, on which there is, or is intended to be, a one or two-family dwelling, attached or detach e structures accessory to such use and/or farm structures. A person who constrgctsmore than one home in a two-ye period shall not be considered a homeowner. Such "homeowner"•shall'submit to the Building Official on a ac eptable to.the Building Official, that he/she shall be res onsible'for all such work performed under the buildin e t. (Section 109.1.1) 'Ihe undersigned"homeowner"assumes responsibility for co liance with the State Bui1ding­C'od6'aria other applicable codes bylaws,rules and regulations.ons. The undersigned"homeowner"certifies that,he/she unde-rs the own of Barnstable Building Department minimum inspection procedures and requirements and that h /sbe cornply with said procedures and requirements. + t Signatiire of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will e required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNE IS EXEMPTION .The Code states that: "Any homeowner performing work for;which a building permit is requi shall be exempt from the provisions Of this scction,(Section 109.1.1 -Liccnsing'of construction Supervisors);provided that if the homeowner rn ges a pason(s)for hire to do such work,that such Homeowner shall act as supavisor." Many homeowners who use this exemption arc unaware that they arc assuming the responsibilities o a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bft=results i serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed p=o as it would with a licensed Supervisar. The homeowner acting as Supervisor is.ultimiatcly responsible. To ensure that the homeowner is fully aware of his/har responsibilities,many communities require,as part of the permit application., that the homeowner certify that he/she understands the responsibilities V a Supervisor, On the last page of this issue is e form currently used by several towns. You may care t amend and adopt such a fom•Jceruficatim for use in your community. Q:forms:homeexempt �� From:Kathy Geddis FaxiD:Northweod Insurance Page 2 of 2 Date:8M/2010 11:19 AM Page:2 of 2 "or LDATE(MWDD/YY(Yy CERTIFICATE OF LIABILITY IfVSIJFZAIVCE OP ID KG 08/09/10 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. IMMIRTANT: If the certificate holder Is an ADDITIONAL INSURED,the p Icy(les)must be endorsed. S I N 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 lleu of such endorsament(s), PRGDUCER - NAME: Northwood Ins. Agency, Inc. (A)C.No.Ext): ---_ -- I WC,No): 540 Main Street, Suite 9 ADDRESS: Hyannis 14A 02601 cusroE o :_TDIRE-1____—_ — - Phone:508-171-1632 Fax:S08-393-2955 INSURERS)AFFORDING COVERAGE— kAi•7# INSURED INSURER A: Liberty Mtual Insu:arca C., TDI Realty croup Inc. INSURERB: WESTERN WORLD INSURANCE CO P 0 Box 796 -- ------ —I--- Hyannisport MA 02647 INSURERC: --. ._--------------- --------- -- ------ +--- -- INS'JRER D INSURER E INSURER F I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO C=P'.T F'(TWr -THE POL CIE"')F r,SIk:ANCE L STED BEL'W/RAVE SEEN SSf_IED T.1 THE N:S_IRK,NAMED,45C'V_=OR THE POLI''.'i."-%Ef•'li✓D - INDICA:TE_. NJTWiTHSTkNCIhG ANY RE:N RE61EN TERM OR CONDITICN OF AN"C;�NTgA.CT_,POTHER COCUWENT 14174-1 RESPECT'•WHICH THIS C.ERT FICATE MAY BE ISSI IEC OR MA•'PEP-AJN,THE NSURANCE AFFORDEC Si 7HE P01.CIES-ESCRIBED HEREIN IS SUBJECT"r0 AL_THE TERhI.S, Exci_ki*Ns A?JC':o,,n 710KrR OF SUCH PGLIC E3 LIM TS.S'O7J\vA;i-AVF BEEN PE-UCED BY PAID'l-AIMS OL. --.T.P.UCr`f"b'FF_T"POT.TC'4-E7+.P---__-.-.__---�.-.-_._.__-..-.—..- LTR TYPE CF INSURANCE INSR I WV d POLICY PLUMBER (MMV)M'`(i (MKIODi`."M`) -." LIMITS GENERAL LIABILITY '-�' 1 ^�.--r---- ----- -�-- 0 E.+C:11.�JCCU: tIG'(-_ U C II x 1QQQ00 >7rAAGt TJ K-Nitu----t�-------------- B $ CCMYE;CAL GENERA-LA.BIL-'� I I INPP120276$ - '41/16/10 IG1/16i11 �PREMiSES E ;ursn e) - 11 50000 -- C-AINIS-MACE I X OCCI I i �MED<<= AnvoneEs cn 5000 _- -- PEPS_NAL s.."V N.,_v -j;1000000--- i I i GENERALASG.E f.- �;2000000 GFsI'_K4C;*.cG14:(ELIMIIA=PLESFER: I j ,PRODUCTS-CCpWP/OP-,GG 1000000 --- AUTOMOBILE LIABILITY I I,.. C_,M&INEC ShGL=_iidlT (Ea accicont) ANY AUTO ----- - i I I ..F BDLf 11 JF°{ParF ter; . AL..OWNED ALT - ------ i K_L I IH.jUr,•'(Pe! _dla t) SChEDUL_D AIUTO3 PROPERTY DAMAGE - .--_ HIRED Alrr05 ,.'' ..: .• fPer amlert) ` - -_NON-OV^ED A;J._OS I Y —UMBRELLA LIAB 0,_CUP � .. EACH CCCUR7Ef10E ----- -- EXCESS LIAR l CLAIMS-BADE ( AGGREGATE --DEDUC-15LE 3 ----. RETEN?'IC49 S I I ~- --------- $ A S, I IIRT WILL FOLLOW FROM CO 03/05/1C' 03/05/11 T R✓LIMI U_ Fr2AfJD EE6PLOYER LIABILITY :-_L_-_- -IT L- - --'_-- Y'N _ - - ANYPRCPRIFTCR!FART\ER/EXECUTVE ic WIN 5 DAIS Y7 POL # I c EKCHAC:IDE\T g iQQQQQ - GFFI_ER/PdEMBE'r:EX. -,EC%" F1 i a - - (tdeodatcryinNH) I I F:..CISEABE-E3,EMF'LOYE-E 1100000 if yes.dreKf be ender - -----_...-------- ------------- DESCRIPTIONOFOPERATICNSbsbw E.L.CISE.4E-POLC-t-K/7 ?500000 I i DESCRIPTICdJ OF OPERATIONS/LOCATIOW/VEHICLES `Attach ACORD iOl,Additional Remarks Schedule,It more apace is requlred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE A90VE DESCRIBED POLICIes BE cANCEi1E0 BEFORE TOWNBAR THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELI`:ERE:IN ACCORDANCE WITH THE POLICY PROVISIONS. TOWN OF BARNSTABLE AUTHORIZED REPRESENTATIVE 230 14AIN STREET HYANNIS MA D2601 -?Y. 0'1988.20009ACORD CORPORATION. All rights reserved. ACORD 25(2009l09) The ACORD name and logo are registered marks of ACORD ' Pliber f. CE !8l !Y>tu dlD. Wo*ersCompensation and ON PAGE Employers liability Policy r0. SUB ACCI NO. I Lab rWMutualIna ante Gr+oup/BosbDn �s65323 0000 �LIBERTY M1JTUAL LNSURANCF CO 15628 �ICYNO. TDlCDT SALES OFFICE COPE SALES - CODE N!R lS"f s .365-423-010. XX X �WMON 102 I REPRESENTATIVE 3000 2 ' YEAR !_ ASSIGNER em 1 �lame.of-T I)I REALTY GROUPING `. insured EEL\ 04-3529499 Addiess- PO BOX 79tS RISK ID *7:H1&19 NYANNISPORT,MA 02647 Status 03-CORPORATION - ,_, Other workplaces not shmvrt above: SEF.ITEM 4 Mo.Day Year Rio ayYear - hem 2.Policy Period:From 03.05-2010 to 03-05-2011 12-.01 AM standard time at the address of the insured as stated herein. . t Item 3.Coverage�� V A. Workers Compensation insurance: Part One of the policy applies to'the Workers Compematicu Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy,..applies to work in each state listed in item 3.A.The limit`of our liability under Part Two are:. Bodily Injury by Accident 100,000 each accident Bodily lujury by Disease 500,000 policy limit.. „ Bodily Injury by Disease 100,000 each employee C. . Other States Insurance:Part Three of the policy applies to the states,if any,listed here: SEE END WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION OIL TNT'ORMATION PAGE „ item 4.Premium-The premium for this policy will be determined by our Manuals of,Rules Classifications Rates and Rating Plans. All information reed below is subject to verification and change by audit, Pranium Basis i Rat te 1-1 NE 110 Por$i;X' .b Estimaceo Cade Fstvr.ated o`RE- _ Arnua! Cle55it-iC6hous yn.. Trtal Arn a;Prem:urr.+ 7,u r•ratioo PremWnu _ SEE EXIENSION OF LtiFURMAT,ON PAGE z Minimum Premium S Soo (MA j Total Estimated Anr-ual Premium 2,231 Interim adjustment of premium shall he made: ANNUAL This policy,including all endorsements issued therewith,is hereby countersigned by AgihorimaRopresemadw -Date 02-24-20, . Lod.Gore ?er1. 6Pt;. Aldi>Barra Ptr,ddic Pzpmert Rcing Basis Poi.H.G ynY�e Stet-Dive` RENF. 'XL OF: �024-l0 � I NR h$A 'Ci•3!S 36�3a3-tt19 'o Po 4nc. si Copyright 1387 National Courmll on C>moensstion�rtaurance a c w 00 qt A -. .. Broker Copy ' - 1. - - 952" 50 2" 4511 77 452 i 4 - = BIDET-1 -------------------------------------------------------------------------- �I W1W 0DIW SHDOOR-1 - 411:E EXP PAN-1T-'t ti peg 31 2" 60" All dimensions-size designations 20 20 This is an original design and must Designed:7/13/2010 given are subject to verification on TECHNOLOGIES not be released or copied unless Printed:8/4/2010 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. tate lumbert mill down bath.kit All Drawing#: 1 { T ' UP STAIRS BATH TOILET MOVED FROM OPPOSITE ADD CEILING FAN, ELECTRICIAN WALL TO BESIDE NEW BIDET. 102" 59 z 42" m ;a� f mW 04 VM221 .6VF :TOILET-1 BIDET 1 _ _.- - - — MO E E KISTING DOOR AWAY FROM VANITY APPROX. 2" ! W yy W CV) wW - T L 38',, — : 60R-BATH-2 W -4 a c0 M HALL CLOSET TO BE REDUCED - T FIT IN NEW TUB/SHOWER. 332,. , 59 4„ z - NEW DOOR FROM BEDROOM CLOSET. All dimensions_sizerdesignations ZO 2® This is an original design and must Designed: 8/6/2007 given are subject to verification on TECHNOLOGIES not be released or copied,unless Printed: 8/4/2010 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. tate lumbert mill up bath.kit All Drawing#: 1 I Town of Barnstable *Permit# �� 036 7 2 Regulatory Services +� _. gExpee 6 m'O rom i ue date — , ; Thomas F.Geiler,Director Building Division �' Tom Perry,CBO, .Building Commissioner JUI_ 2 ZO10 200 Main Street,Hyannis,MA 02601 www.town.ba_mstable.ma.us -OWN OF SARN Office: 508-862-4038 STASLE- Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint , Map/parcel Number C} , Property Address sidential Value of Work Minimum fee of$A00 for work under$6000.00 Owner's Name&Address ' Cj Q—A Contractor's Name 1 �.: Telephone Number Home Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Che one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name ` Workman's Comp.Policy#_ wk U �0 15 A Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) M46-roof(stripping old shingles) All construction debris will be taken Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Out]ook\QKIH METXPRESS.doc Revised 070110 p s The Conzynonwealth of Massachusetts -- Department of lndustr al Accidents i Office o f Investigation 600 Washington.Street Boston,MA 02111 tPitrtt►mass gov/di a Workers' Compensation Insurance Affidavit:BnildersfContractom lectricians/Plumber-s Applicant Information / Please Print Legibly Name qkWiuess 0XpUiMtion&dividoal): ,p Address: � �,�� City/State/Zip: !�g]L Phone# Are.pttlt an employer?Check the appropriate boa:. Type of project r 4_ I am tiers/conttaetor and I yp p ] (required): 1..ran a employer with ❑ g 6. ❑New construction employees(full and/or part-time)_* ha-%v fired the sub,-contractors 2_❑ I am a sole proprietor or paitaer- listed on the attached sheet: 7-;❑Remodeling ship and have no employees These mb-contractors have 9- ❑Demolition w for me in an capacity. employees and have workers' working y spa -ty- g- ❑Building addition [No workers'camp-insurance comp-insurance.I required-] S_ ❑ we are a corporation and its 10.❑Electrical repairs.or additions, 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp- right of a xe iption per MGL 12. of insurance required.]I c. 152,§1(4),and u,re have.no i employees.[No workers' 13.Ll Other comp.insurance required-]' ;Any appEtant that checks box#1®st also fill out the section below showing their wmkers'compensation policy information_ Homeowners who submit this affida4-it indicating they are doing all'waak and then hire om&e contractors Hoist submit a new affidavit indicating such- Icaat<acmrs that check this box must attached an addidantal sheet showing the name or the sub-counzaars and state whethu or not those entities have employees. Ifthe sib-connectors have employms,-tltey must provide their workers'comp.policy number. I am art employer that is prinidbW itvrkers'conymnsatioti instinuice for iuy eiitjtl 5,ms. Belotw is the policy and job.site ittfDY7tlahOt6 Insurance CompanyName: Policy#or Self-ins.Lie-A: a r id b apiration Irate: Jab Site Address: t)qQ LlJ a 1 bo e�+ ff�l\ C tylStatrJZ.iP: 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 2.5A of MGL c.. 152 can lead to the impo4tion of crimin 1 penalties of a fine up to$$1,500.00 and/or one-year imprisonment,as welt as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-D0 a day against the violator- Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DU for insurance coverage verification. I do hereby certify' under tthepains andpenablas of perjury that the inforinalion protvided a bo-ow is tree mid correct Sitmtature• *65614 Date- f Phone#: Official use only. Do not twrite in this area,ion be completed by city or town official. City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 1.Building Department 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: RightFax N1-1 7/21/2010 6: 08: 40 AM PAGE 2/003 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/21/2010 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE FAX T.EDMUND GARRITY&CO (A/C,No,Ext): FAX (A/C,No): 545 CONCORD AVENUE E-MAIL ADDRESS: PRODUCER CAMBRIDGE,MA 02138 CUSTOMER ID#: 24K2F INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: HARTFORD GROUP INSURER B: LEMON MARK DBA M L CONSTRUCTION INSURER C: INSURER D: PO BOX 423 INSURER E: W HYANNISPORT,MA 02672 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF DATE POLICY EXP DATE TYPE OF INSURANCE POLICY NUMBER (MM%DD\YYYY) (MM\DD\YYYY) LIMITS LTR INSR WVD GENERAL LIABILITY EACH OCCURRENCE. COMMERCIAL GENERAL LIABILITY ?i DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) MED EXP(Any one'person) $p' e PERSONAL&&ADV INJURY $o -I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $,,,, cm POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ r = AUTOMOBILE LIABILITY COMBINED SINGLE: ANY AUTO LIMIT(Ea accident) Co ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) Isy HIRED AUTOS BODILY INJURY �$wr d xT (Per accident) NON-OWNED AUTOS PROPERTY.DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKER'S COMPENSATION AND WC STATUTORY LIMITS OTHER EMPOLYER'S LIABILITY YIN UB-0515N280-10 05/18/2010 05/18/2011 YIN E.L.EACH ACCIDENT $ 100,000 ANY PROPERITOR/PARTNER/EXECUTIVE IN OFFICER/MEMBER EXCLUDED? N E.L.DISEASE-EA EMPLOYEE $ 100,000 (Mandatory in NH) E.L.DISEASE-POLICY LIMIT If yes,describe under $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR LEMON MARK. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE,BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 200 MAIN STREET WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE HYANNIS,MA 02601 Ramani Ayer 80ard.o'r, 1- �epiirtrnen, of p Cstr drn�Rc:ul;ttion� . ublic Satoh: uctipn S Lrce` uPervlsor and Starrdar�/s ., nse: Specialt RestrrctedIto; CS S�r100207 Y license RF,W MARK L . PO EMON :..� BOx 4 .a""WEST Hy 23 +r {. ANN/spORT Mq:0267 ` +i!Ter Exp fratfon; 4✓4/2012 T!#: 100207 {wanr ./e2a6c�cec�ucae�4 License,,,'or registration valid for found retul t o ly before the expiration date. If found return to: office of Consumer Affairs&B smess Regulation � CTOR • Type Office of Consumer Affairs and Business Regul tion HOME IMPROVEMENTrCONTRA WA Registration:,, 13616010 Park Plaza-Suite 5170 Expiration Individual Boston,MA 02116 MON MARK LEMON 490 PITCHERS WAYS w ,�:r ` Undersecretary Not valid without signature HYANNIS,MA 02601�,;—�'�; o�limerGq. sAxxsrnece, ,' ,� Town of Barnstable '0�c Mar" Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, —�J—a C s® V\ ,as Owner of the subject property hereby authorize !i! r I\ �E?m b n to act on my behalf, ~A in all matters relative to work authorized by this building permit application for: �5q 0 L-�u mY kr-� �Cjaa (Address of Job) r 7 1?6 016 Sig0fure of O r Date Q-1 rQtsc Print Nam If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. r_ C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary.Intemet Files\Content.Outlook\QK]H7J6ETEXPRESS.doc Revised 070110 a, F. OF SHETpk, Town of Barnstable *Permit# P� Expires 6 in rs , r issue ate t, S 9 20 Regulatory Services Fee v� ib 39 rti M e ,p Thomas F. Geiler, Director �A ARN �� � '" ren►vta'� �TA��� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 'Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY # 'Not Valid without Red X-Press Imprint , .t. lel7j, Map/parcel Number / /( Property Address Lyi. x, 4- (.k C I j• ���✓Vt'l l t (/�t � 61 e.? Z Residential Value of Work,� 9 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Alt N.a.r 4F__ A1q KJ rya Luµ �ll kr v,�(c c , 0263'3 Contractor's Name / KSo�.� Telephone Number- Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor 1 am the Homeowner ❑ I have Worker,'s Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. ' 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 of doorsIWJ -` Replacement Windows/doors/sliders: U-Value X� (maximum'.44)#of windows *Where required: Issuance of this permit does not exempt compliance,with other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner,Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors Licent is req SIGNATURE: QAWPFILESTO IMPV formslEXPRESS.doc Revised 0701 0 . f 1 i Board or guil ng7 t2�real o ROV g ►atio�ndStand��r's HOME 141PR EMENT CONT 1 t. Registration TRACTOR ' License 155997 'Or registratio Expirat►o - before n valid f n 5/ use Type P Try 283568 ff pne °f Botlding Re date, Iffound return to. Ap I REALTY GROUP_ INC`', gate Corporation t BostWa �2nshburton Plac'gUm 13ns and Standards E ISENSTgpT� ;' Ol55 LgKEqVE �"YgNrVIS PARTMg without sign t�ure'-- � ✓fie �am�naoriciie�r,�bi o���aaaaefivaetta�. I . Bo ar d of B ,wl d�n )tei ul ati on sa g ,g ,. and Standards , Construction Supervisor License f License: CS 98149 I r ExPrahon 3/2412011 "Tr# 98149 I `Restction 001` 4 i TATE ISENSTADT���=1` < � PO BOX 796 frHYANNISPORT,MA 02647'` Commissioner OFIKE x * BARNSTABLE, Town of Barnstable >t67q• �� prFD Mph A - r Regulatory Services Thomas F. Geiler,Director x , Building: Division Thomas Perry;CBO . Building Commissioner- 200 Main Street, Hyannis, MA 02601` www.town.ba'rnstable.ma:us , Office: 508-862-4038 Fax: 508-790-6230 Property`Owner,Must Complete and Sign This Section If Using,A Builder I e a a e TcI, 'SWn as Owner of the subject property F hereby authorize / i , to act on my behalf, in all matters relative to work authorized by this.budding permit application for: (Address o.f Jo.b)- ' Signa0 re of Date, 5/ner ' r. Mks© Pri t Name If Property Owner is applying for permit; please complete the Homeowners License Exemption Form'onthe r reverse side. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 070110 The Commonwealth of Massachusetts --- — Department of Industrial Acc.-ulerrts `— Office o,fInvestigat arcs 600 Washington Street Bostan, M4 02111 Y1!3i71'.rricrss.gov✓rt?ia. Warker.-s' Compensation Insurance_Affidavit: Builders/Conti-actor•s/El.ec:ti-ci tns/Plumbers Appficant Information Please Pt int Legibly Name(BusenessDrg=ationJndividual): /PP,� Address: CityfState/2 p: t1 L ti S . � � Pliobe t4,-- ' f Are you an employer?Check the appropriate box: Type of project(required):. I am a em to yer with 4. ❑ I am,a general contractor and I Nev.,p 3 6- ❑I'e construction employees(full and/or part-time).* have hired the sub-contractor's 2. I am a sole proprietor or partner- listed on the attached sheet 7- Remodeling ship and have no employees These sub-contractors have 8_ ❑ Deawlitiori work for me in any capacity. employees and have workers' ��`- 9. ❑Buildirg.addition [No workers' comp.insurance ,,I 1 comp_insuranr r aired.. < VJe are a corporation and its a 1D.❑'Electrical repairs or additions 3.❑ I am a homeowner doing all vrork officers have exercised their t 1.❑Plumbing repaiz:s or additions myself. [No workers'comp. right afexearptiou per 1GL r: 11EI Roof repairs' insurance required.]T c. 1952, §1(4),and we:have no . . employees.[No workers' 13.❑{Other ' comp:msuranee.required. t, •Any applicant that checks box#I trust also fill out the,section below showing their workers'compensation policy inforLwrion- 1 Homeowners who submit this affidssit indicating they are doing all wwk and then here-outside contractors muv submit a new sffidzvit indicating sncb_ ICantracrors that check this boar must attached an additional sheet showing the nslrea of the sub-contractors and stsie whether or not tbose entities have employees. If the sub-contractors have eanplDyees,they mast provide their workers'comp.polio.number. I am arz employer that is pro-,riding workers'conipenswlion insurance for rrty+errrployees. Belo iv is the_poll(yv and Joib site irtfortnatirrzb Insurance Company Name: Policy#or Self--ins.Lic.4: Expiation Date: Job Site Addre-ss: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and espu ation date). Failure to secure coverage as required under Section.25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or oner}gear imprisonment,as tiveii as ci7vil penalties in the form of a STOP WORK ORDER and a fine of up too$250.00 a day against the violator. Be advise a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance covL r Lion. I do hereby certify under tFre prairts an ofpet dry that the informatzoar prav ded abvi� rs !R an correct: - Phone#_ Official rase only. Do not write in this.ar�a,to be completed by Litt'or tottar� City or Tmim: Perri itlUcense# Issuing Authority(circle one); 1.Board of Health'?.Building Department 3.Cit}/Toxim Clerk 4.Electrical.Fnspkt.or.5.Pluiabitrg Inspector, 6.Other Contact Person: Phone#: _.. _.., u ;6 r Town of Barnstable # Regulatory Services # # BARNSTABLE, # v MASS. $, Thomas F. Geiler,Director �p s63g. ♦0 rE039 p Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 March 14, 2006 Mr. Alan Jackson Abu Dhabi Box 46562 United Arab Emirat Re: Illegal Apartment-590 Lumbert Mill Road that the work is completed Centerville, MA 02632 Dear Mr. Jackson, A woman who just moved out of the house called to report an illegal apartment at your address. She didn't like what went on there as she felt she was paying all the utilities for the entire house. She said there was someone in the apartment and someone else in the house. You must return the property to a single family home. A permit from the town must be applied for to remove the apartment in the basement and upon inspection, this matterw�ihbe resolved. Sincerely,/ coda son esty Program Zoning Enforcement Officer °Ft► l°,,� Town of Barnstable * Regulatory Services * MASS. * Thomas F.Geiler,Director v nss. $ �A i63g. rf1639.�6. Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 February 28, 2006 Mr. Alan Jackson Abu Dhabi P.O. Box 46562 United Arab Emirat Re: Illegal Apartment—590 Lumbert Mill Road Centerville , MA 02632 Map 147 Parcel 085 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal two-family home. Please contact this office immediately to tell us what direction you wish to'take. r Sincer , ind dson esty Program Zoning Officer Building Department gforms:zoning3 I A ^,FROM JACKSONic TAD/FAX PHONE NO. 971+2+6810730 Mar. 14 200E 06:02PM P1 /N ► � Town of Barnstable Regulatory Services � Y It SARMAR � ' Thomas F.Geller,Directm, Building.Division Thomas herry,lluildii}g Comunissiaiar 2601\Wn Street, Hyannis,NIA 02.601 i,vww,t ow n.h a r n st a l)le.lytn.us Office: 506•862.4024 Fzw 509-790-6230 February 28,2006 Mr. Alan 7uckson Abu.Dhabi P.O.Box 46562 Unitcd Arab Ernirut Re: lilcgal Aparimcm—590 Uimbert Mill Road Centerville, MA 02632 Mop 147 Parcel 085 Dear Property Owner: Our rescords 'indicate that.your house at the.above-mferenced location is ciu-rcntly being used as it multi-family hone,which is contrary to Birri'stable honing Ordinances. Violation of Y.oning ordinances is m misdemeanor,oo,iviction for whi.cii remits in a. criminal record. You must contact this office within 1.4 day-s to either: • Apply for a building perinit to restore the pro.;)dty to a'olic-lamiiy bame • Apply to the Amnesty Program. • prove;that this is a lcbal two-family home. Please ccsntact thi oClicc in1rncdiutcly to tell s WI) ce 'on you i✓talt� Sincerely,- w\ r�^� 1t1da Edson Amnosty Program t �`s cll;T(,/ 4►+ ZoningOfficer �' g� r n - Building Department c 5 l f C,OIr f Rain I gforms�nnin�3 -j ev�L Lire FROM JACKSONi c: TAU%F'AX PHONE NO, : 97:+2+6810730 !lar. 23 2006 01:17PP1 P1 �;� .N'AX NAME and ADDRESS. Alan and Lea Jackson DATE a 29K41 ynnj `• -.. •-•-... ..•� �r .Yar Rom• r MlA-0.��0 VNb+dO ABU DHADI Building Division TNITZD ARM MaRATES 20niw= Esnf rcament o f£i.cer SA:I[ :971-�..�eB1ir-,rsu 1F+lax nn9 cnw -.nn cv qn rr a+ W 6.71a—e—WPiV IOV kL%) rj%f.9z I*:.L .971-2-6792526 (0) a-mail : alrjacsn@emisratea.net,ae Attn. Me Linda Edson Have received you.: follow up letter dateri 14"" N.:a,-ch. I liavv_ hceiut Ju LC-IUQ)1 wlt:)L our rpmal ataoT,r inn -;in �...._..�_ �.k�. zv.._ �.e..._ max... ._�.... .......... .. .....,,.x �_..^...�-� anti tYtP hi:^hanri' .;i et r r l ha harmm�r,+ i „r.r t,r. .3a and never has been. information on tha c:ccuF an.cy, you may CO:1taCt our rental agent directly: Dermas Carey, •s,.., ..0 .'. ...1.'Jt aa.A?�. s..ra.,.vi .,vu V, uY uauat: , + . VG.V:J1, znl,I,U:iL WidL LhIs W.111 Close r-ne. Issue. II.Lease co.1111rm. Regards, Alan Jac scan f Edson, Linda From: Jackson [alrjacsn@emirates.net.ae] Sent: Friday, March 24, 2006 2:59 AM To: Edson, Linda Subject: Re: 590 Lumbert Mill Rd Centerville Dear Ms Edson, I replied already to this e mail, but wish to clarify further in case there is any misunderstanding. The house was built in 1979, I believe, and there has been no alterations to it. The property is a single family home, but has a basement with a kitchen, toilet etc. The property complies fully with the zoning regulations, and we are aware that multiple occupancy is not permitted. I wish to stress that there is no way to "restore" the property to single family house. It is already a single family house, unless occupied by more than one family. The basement apartment was not an "alteration", which can be restored, but is the way the house was originally constructed, and presumably received it's building permit on that basis. It is multiple occupancy which would contravene the zoning regulations, not the house. Best regards Alan Jackson Edson, Linda wrote: > Dear Mr. Jackson, > I received your March 23rd email. I can't read most of it. I did > make a visit to the house and see someone is living there. I also saw > the apartment in the basement. You need to apply for a permit to > restore the property to a single family house. Once the work has been > done and an inspection has been made. There will no longer be a > problem. Linda Edson 1 Edson, Linda From: Giangregorio, Robin Sent: Monday, March 27, 2006 4:26 PM To: 'alrjacsn@emirates.net.ae' Cc: Edson, Linda Subject: RE: 590 Lumbert Mill Rd Centerville Dear Mr. Jackson, Although, we are happy to note that you clearly acknowledge the use of your property to be limited to that of a single-family use I am compelled to clarify some misconceptions identified in your email response to Ms Edson dated 3/24/06. I offer the following comments: 1. A certificate of occupancy for the aforementioned property was issued in 1982. 2 . Documentation on file confirms the original construction of the basement was intended to be a typical storage use. 3 . The subject locus is RC - a single family zone. (It is also in the ground water protection overlay district) . 4 . The property contains a second independent living unit complete with a kitchen and bathroom facilities. 5. This work occurred after the original construction and without the benefit of permits or proper inspections. 6. The restoration order refers to the removal of the kitchen unit. This action would restore the single-family status. 7. The names of your last tenants are in the file. It is reported they vacated the premises on 2/15/06. 8. Contary to your fax dated 3/23/06, the former tenants advised that the basement apartment is reserved for your personal use. 9. New tenants resdide in the primary structure. 10. This property has been flagged in our system for an illegal apartment. Should the subject unit be occcupied by anyone (including yourself) fines of up to $300.00 a day may be issued. 11. Noncompliance may result in criminal action. 12 . We can obtain a search warrant in the event that circumstances warrant such action. Please feel free to contact me directly in the event that you require additional information. Robin C. Giangregorio Zoning Enforcement Officer Town of Barnstable 200 Main Street Hyannis, MA 508-862-4027 -----Original message----- From: Edson, Linda Sent: Friday, March 24, 2006 2 :20 PM To: Giangregorio, Robin Subject: FW: 590 Lumbert Mill Rd Centerville -----Original Message----- From: Jackson [mailto:alrjacsn@emirates.net.ae] Sent: Friday, March 24, 2006 2 :59 AM To: Edson, Linda Subject: Re: 590 Lumbert Mill Rd Centerville 1 4 4- Dear Ms Edson, I replied already to this e mail, but wish to clarify further in case there is any misunderstanding. The house was built in 1979, I believe, and there has been no alterations to it. The property is a single family home, but has a basement with a kitchen, toilet etc. The property complies fully with the zoning regulations, and we are aware that multiple occupancy is not permitted. I wish to stress that there is no way to "restore" the property to single family house. It is already a single family house, unless occupied by more than one family. The basement apartment was not an "alteration", which can be restored, but is the way the house was originally constructed, and presumably received it's building permit on that basis. It is multiple occupancy which would contravene the zoning regulations, not the house. Best regards Alan Jackson Edson, Linda wrote: > Dear Mr. Jackson, > I received your March 23rd email. I can't read most of it. I did > make a visit to the house and see someone is living there. I also saw > the apartment in the basement. You need to apply for a permit to > restore the property to a single family house. Once the work has been > done and an inspection has been made. There will no longer be a > problem. Linda Edson 2 I � , a _. `1 ,f v �' N3 17 • q �� .oN LOT. 5 �'�`! v OUNA/. BEING Pc:�9 ! 3 .'� A'A @l x offAr®1✓ 4c&,ff7*i.-Y 7-iV007- 7'"a 4W/AwOZA,140 • �� ` CO.v�©,e=ws Ml 77V iS ; LOW.IE ®a%t.Arvvo O� Tim aaw.v OWN` gc`lgr ,SCE. o N T �NN/G A� F-'L�a/iv/Ndi F�SSOG/A71c-5 Adieu IL ..-.-✓ ��'/��� ...4 S .a., i .,.y.K arc jA. sOfs map and lot number .J. ! ati n <<n �y �,. c� 4 THET�� j Sewd' a P,Er,►nit:"number ..... ..`...,.... .� ... . ; BARISTADLE, • ktbus •.number ................................ MA86 039. `0 TOWN OF RX.STABLE' N A� GUILD�IW 4 G � I1SPECTOR ,� S, % .$ APPLICATION TOR PERMIT TO ....... ..�3 . YPE ^OF CONSTRUCTION 1 r �i ¢ s 3 < . ..... � ............�9: 3 TO THE INSPECTOR OF BUILDINGS: ` H` The under6bed hereby applies fo'+,a mmit c,�ccor- to the following information: Location �., ...... .: ..U...�{le+Xt!?�". 4'..4� }.. . / ./.... .�ol... .... . .1 . ............................... ,* Proposed Use ...... .,�h�l..a�P,�.. t�•.,J:��..../......... . .,5. ............................................................................. Zoning District k 4. Fire District `.••� � s' g .............. ��. ................. ......... ... Name of Owner ..... .!.�L..,l , .. :�.......V.�Q'.1 �/.AddressQ.. : Fl/�ltT/ p�!1..:.,//f „/ /fQ'... } .. ✓ .. +� ' ..Address Name of Builder, . �. Nameof Architect ......................�/................................,.. :...Address ...................... . .... ./../: ............ ,. .:.'::.................. 4. t Number of.Rooms .............{�l/�.........................:........:..Foundation ............... f .... ;.... Exterior ...Roofing ................................ '4. n'v.H.................................... r. Floors a; :.,: l� ............. , .^,Y �.<R" .Inteno'r, ................. ::'I.�� ....:........ Heating ,.. �� PI>Jmbing F,ir place ............. ..........I.... ....... .......... 77 .......... a r� Approximate; Definitive Plah Approved by Planning Board ___________________:_________19_____ . Area �._....: ..:............ t Diagram of Lot and .Building with Dimensions "•r . }`g �`° ' Fee ' 5 SUBJECT TO A,PPRC'VAC-OF BOARD OF HEALTH z tA,e i Yx ^. i w k ' '"'r �s f .., ;.t fs• •it i�`r"m k ,..dL f �?qti' ' A t� t. �� t .4 e 9 e � a:R•�` ,4.+, �,+sSZ9 • °s.. `'St.'•4,{�9 � �b f r�..�p • � �:7Y�TOE. ,...�•i. ,• �, :1, ,, f @.. .94. T, yit 7 �i 4 L: Viz. ?'� -'- "'• `h4,, rA �+ \ ,' •. .+=e, + ,r•:.�"m.r��4ey� 4rR'-. �` 1 a ..a, "+. n 1Y 4 .�,,. 4'Y°,4^ .?.� "'. `° �,, rtq e } ,«p,n P i °,. •=.anR • :t�� „r hit +.sat,� m tv�;`�n � a'.` , � xt},x...� � �'' y. ' 1 � p rm�4 ,:+9r i� 2tP '+n:A 'NIA•�'..9,ygp,. , Y9rvn�,fY:e�`• .,r.....,.. � 9.:t4 -1•'K M,•Y M 'r,,.. _ 4 R � •A• p.s M"..'MY+'n F,nm .n,eo Ar .rn .. .. , � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform,to all the Rules and Regulations of the To Barnstable egarding the above construction. ,''� Name .. ........... Construction Supervisor's Lice se ..... � + ,\ 5 SMITH, CICIL L. 24898 • Permit for ..,INSTAL SwimmincrPool.........,•.......•. ................................................. + Location 590 Lumbert Mill Road. Centerville �- Owner ....Cicil...L.....Smith....... .... <� F ............. Frame Type of Construction .......................................... Plot ......................... Lot ................................. Ile r March 31, 83 PermitYGranted ............................. y .... .19 n r Date of Inspection .................... ., ... .19 i r Date Completed /V....> fi�.z..19 C w • + - ? ; - � + - I.. �Lei �/-�• - J _ Assessor's map and lot number ./1 , - C� S �................ THE Tp� ��'� `��Sewage Permit number '............. ... ..........�.... ............ .. Z 339HH3TSIILE, i I loused number soo M6 9 .ems c 'E mxf a. i TOWN OF BARNSTABLE A t. ti DUILDIN& INSPECTOR APPLICATION FOR PERMIT TO ' _ :.............:.. ! ....................... ....... ' TYPE OF CONSTRUCTION .................. . ......................................... :.:.....:......... :. `..:................... ................ .................. `.............19........ i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................. ............::............... 's` :.''. �",!f /fi .......... ! .............................. ......................... , . Proposed Use ........................'. .... ...-L.. . ............... ..... ......................................................................... ZoningDistrict ...........�.l.... .. f...................Fire District ................0..� `- ............................................ t i .•..`1... ....�..f(�� �fjram, .Address 6� ''� ........................� � "Name of Owner ... ...... X.1.........: t Name of Builder ..'.,. ��.....�r `f..'.r.......... =:. . ;f » ..Address .tjJ ....i.:..�.':..'1.:�.... ...f:..........�. :�`. .4:.:..� 1' f Nameof Architect ...........................Address........................................... ................................:.................................................. Number of Rooms Foundation /....................... ' ................. Exierior ....................................................................................Roofing .................................................................................... i Floors ................................................Interior .................................................................................. ....................................... Heating ..................................................................................Plumbing ................................................................................... rFireplace .................................................................................Approximate Cost ..................................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram`of Lot and Building with Dimensions Fee �Q� ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW. DWELLINGS I hereby agree to conform to all the Rules and Regulations-of the Town of Barnstable regarding the.above construction. f; z" ,x Name ... ...... ..... :................................::. J..� . _ Construction Supervisor's License .................................... SMITH, CICIL L. A=147-85 24898 INSTALL No ................. Permit for .................................... Swimming Pool ............................................................................... Location .... 590 Lumbert Mill Road ............................................................ Centerville . ............................................................................... Owner. ... Civil.....L..............Smith......................... .. .... .. .. .... Type of Construction .......F...r.ame...................... .. ....... ................................................................................ Plot ............................ Lot ................................ Permit Granted .......March...31, 19 83 .. .... .. .. Date of Inspection ....................................19 Date Completed ......................................19 r�1^- .,.:Y^'rx•"+,_.!_:i � 14...�f�r e r „p' r„ r r7 j� 4 _,—i. ywsJ't _�,�„ - �'Te.t { • TOWN OF BARNSTABLE permit No. z73 Bllll(llIlga�llTlBp@CtUr w,t Cash — °"'Y OCCUPANCY` PERMIT, Bond _ >. s ° No,--building nor .structure shall be erected, and nbo land, building or,structure shall be ,used' for as-new, different, 'changed;-oi_..,enlarged:use -without a` Building- Permit-therefor.... first-having;bden obtained'from.the Building Inspector. No building shall'be occupieduntil.h certificate of occupancy'has been issued',by the Building Inspector:"- • f L•, as Fr1ar1 . Issued to. T - 1ot' 5_. SQA .Lumbert..M3:11 Road: Marstom 47i.t11s' t Wirin Ins ctory ` ' In ctloa date. C !� p� _ ./ �✓ess2 •m... sPe..- -Plumbing Inspector Inspection date Gas.Inspector, • ' , _ y pec, on"date' • '" 1'" ' / if r:..` •i. �' Engineering Department l ,1i3 J 'a 'Inspection date; THIS PERMIT-WILL NOT BE• VALID, AND;THE BUILDING•,SHALL. NOT;BE OCCUPIED -UNTIL' SIGNED BY THE BUILDING INSPECTOR ,UPON-,SATISFACTORY •COMPLIANCE WITH TOWN 'REQUIREMENTS. 19 ," Building Inspector F, ssessor's map and lot number ........... .!, . ........A-0 C act �� Cf THE T04 Sewage Permit number ...v....�.9 ..... RLST BE --�--• � C House number -?� ye,TALLED IN CONIPLIAN 9 Basa��LE, i ....... ..:...................................:. �t E 11 STA o • = y�11T1-4 APTIGR-Y �� o,, ie39• A��y 0 uffw A Y CO®� r�►� YFY TOWN OF.. BARN' 1B .h. �: . BUILDING - JASPECTOR APPLICATION FOR PERMIT TO ...........................................................................:..............:.......................:.......:.. TYPEOF CONSTRUCTION ........................................................................................:.:.......................................... `-... 0 ...................... TO THE INSPECTOR OF BUILDINGS: . ' The undersigned hereby applies for a permit according to the following information: ` 1 Location LCr ` .......��JY.Q^ ,............, iLG.... ...................... �i.............. .. ProposedUse ............................................................................................ ZoningDistrict ........................................................... ............Fire District ..............................................q %................................ Name of Owner274.0%A..... C.Address ..1�..?1�.�aC�........[..���1+!L...` Name of Builder ....................................................................Address ............... Name of Architect f 4..C.Address f�r�Q.. ef........ t�9// .5..... ... Number of Rooms ....................Cl...........................................Foundation c2s ..W.5.1...... .4'zzlir,............ Exterior ,fv .. ................................Roofing .... ... f e. -r...................... Floors ....9�:.64PP�.............:........Interior .W.Y...(ev .L................... Heating1, ...... ....................................................Plumbing ...................../...................... .. .... Fireplace ....�.....�.. �G � .. !e� ., .....................Approximate Cost ... / .................................... .................. Definitive Plan Approved by Planning Board -------------------_-----------19--------. Area .. . ...................... Diagram of Lot and Building with Dimensions Fee .....YV.. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1-7 y A n t I hereby agree to conform to all the Rules and Regulations of the Town of rnstable regarding he above construction. Nam .. ......... .. :........... 4. ,- Col,fella, Angelo { q 21273 1 1/2 story 3 o ................. Permit for .................................... t single family dwelling ............................................................................... 590 Lumbert Mill Road Location ................................................................ .a �a Marstons Mills h ............................................................................... Owner ..........................eo J. Dunn Realty, Inc. . Type' of Construction frame ... ........................ Plot ........................ Lot #............... }.. J May 7 79 Permit Granted v . Date of Inspection ... .19 Date Complete/d� ...J.,/J�.... .:� . 19 �� r � rl _.�PERMIT REFUSED c ;� ................................................................ 19 > :....... ............................ ........................... .............................: . ....:....................................... � ........................ ...... ............. Approved ...:...................... • f Assessor's map and lot number ................� ..... � �l '� �' 71 �7NEt Sewage Permit number ........................................................ d� ��7•�' Z BARNSTABLE, ~ House number r.'........ n ,... ®......... 9 NAn6 ....................... GD t639. 60 f' 'E0 MPY 6� TOWN OF BARNSTABLE f F ' `3 BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION --'•..................................................................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: '' "" Location- .,�.......� yr l............/ /LG....., ......................... .,........;: r-1.....;/ �......... �... ProposedUse ............................................................................................. ZoningDistrict ..........,.................................................................Fire District .............................................................................. Name of Owner (-..Address iF.......�r`--k.V Z...t Nameof Builder ....................................................................Address .................................................................................... y Name of Architect s �� iv�t/«•'�►. r �.....( .Address ��� �.2G S.�_�s�� .....a`' �'r Number of Rooms ....................3..........................................Foundation .. ......��<u.�'e� �lee!.-......................... Exierior ("GAP ...��� Sir>Jut L. Roofing .... S'�Ji`L/Q ""...� �1/ ��G. ? ..................... /............................Interior Floors 77VJt.�/�,� �P+ 11)...�`..f`� ?D :r— � �� y.. J/? G...................................................... Heating �/ :....(/e.....................................................Plumbing .................................................................................. Fireplace �1�E��'!�'.. .. �� .....................Approximate Cost % "�� .... ....... .... Definitive Plan Approved by Planning Board -------------------_------------19_______. Area � -r Diagram of Lot and Building with Dimensions Fee -r"/................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH tit 71 ) 2, L I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �l Name............................................... -� Leo J. Dunn Realty, Inc. A=147-85 T` 21273sto No ................. Permit for ........................Y.�'........ r single family dwelling ....... ..... ......... Location 590 Lumbert Mi11. Road � �ry.�..Vie- ................................ ................... ............ Owner Leo J.. nn Realty, Inc........ Type of Construction frame ............. ........................... Plot ............................. Lot .......... 5.................. May 7 Permit Grantees.. ................................19 79 Date of Inspection..................................19 Date Completed .1...................................19 E PERMIT REFUSED ................. ......jI...... .. .1......... ... d�.�.. 19 q0 ............. ......... ............ ........... l .......K� ...... ................ r ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... .f r_ Angelo Colafella 915 Edgell Road 4 Framingham, Mass. 01701 June 17, 1982 Building Inspector Hyannis, MA Re: 590 lumbert Mill Road Centerville, MA This is to confirm that the cellar located i.n the house of the above address will be insulated. This work will be completed on or before June 21, 1982. 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'+ s. ` c � _�f,�0 S" r CO/4✓�O �i�����T19 i��.E' ,t� �a `,� L�211V fit. �,••r� 4 r 1,v x ti (3 t yv r ,e of t' � y}I+'j�R G I t I 1 �- T Lt �f 7r � Y 1 L �� •� � �� 5- � 'X �:rt f y `x b t Q/� ' y/. � :• i. t � y .(y F F 3� R x ; + � 4 + t{ ; f ,y/ ''�' Tr�{►���G�L r���l�r�rl r7V� �S mat�: r 7 �r'"�.s �� >f �' r �D �. ,z �'-- t f y-r4 � � t•�d t�� t. ,� � t k CC �+ :♦�+ t_, �.a q s, s - ,�'` r� a�� s^:E Y :'/f ' �'_' r t ' r { � a � f'` ;00 n } M i #? � � !i� QtO.�� -s-; :v �� + t §gs��.t'��4'e�''F r" -=i{°�,.`d�•��b L-s xi af,9. ,a��r',=...G,.'+r�••,.�,�7-vey' '�� 1� nr kr�r�$ k�r r " � , '�� . � �.. r � ....- ... > r s .. .s•. .. .r..J k ., F F ,"K. r'h.+5: ySj:-`-, S]..n-.. .+*' ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES a • 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. s 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. , 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 - - 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. g1 J f NTS NOT TO SCALE I9: MODULE FRAMES SHALL BE GROUNDED AT THE t _ - 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 r ,, TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER r. Voc VOLTAGE AT-OPEN CIRCUIT r VICINITY MAP w WATT INDEX 3R NEMA 3R, RAINTIGHT Ll JF V1 COVER SHEET V2 SITE PLAN , ." PV3y STRUCTURAL VIEWS PV4 UPLIFT CALCULATIONS ; a LICENSE GENERAL NOTES '}�* PV5 THREE LINE DIAGRAM Cutsheets Attached GEN #168572 1. ALL, WORK TO BE DONE TO THE 8TH EDITION ELEC 1136 MR OF THE MA STATE BUILDING CODE. r 2: ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING , ' MASSACHUSETTS-AMENDMENTS. MODULE GROUNDING METHOD: ZEP SOLAR AHJ: Barnstable. REV BY DATE COMMENTS r , 4. REV A NAME DATE COMMENTS UTILITY: NSTAR Electric (Boston Edison) CONFIDENTIAL- THE INFORMATION HEREIN' JOB NUMBER: J B-0 2 6 2 5 41 O O PREMISE OWNER: DESCRIPTION: Dom. CONTAINED SHALL NOT E USED FOR THE JACK'SON, ALAN JACKSON RESIDENCE Philip Wlss • _ BENEFIT SHALL ANYONE EXCEPT IN 11"OLE INC.; MOUNTING SYSTEM: � SolarC�t NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 590 L- MILL-MILL RD 8.58 KW PV ARRAY r ' PART TO OTHERS OUTSIDE THE RECIPIENTS �� ORGANIZATION, EXCEPT IN CONNECTION WITH [MODULES. CENTERVIL, MA 02632 THE SALE AND USE OF THE RESPECTIVE (33) TRINA SOLAR # TSM-260PD05.18 SOLAR 24 st:Martin Drive, Building 2,unit 11 gTY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME: SHEET: REV. DATE Marlborough,PERMISSION OF SOLARgTY INC. MA 01752 SOLAREDGE # SE760OA—US002SNR2 -NA COVER SHEET - •PV 1 1 20 2016 L (650)638-1028 F'(650)638-1029 , (888)—SOL—CITY(765-2489) www oolarcity:corn PITCH: 38 ARRAY PITCH:38 MP1 AZIMUTH:262 ARRAY AZIMUTH: 262 MATERIAL: Comp Shingle STORY: 1 Story F• PITCH: 38 ARRAY PITCH:38 MP2 AZIMUTH:262 ARRAY AZIMUTH:262 MATERIAL: Comp Shingle STORY: 1 Story � K. � IUKI ST UCTURAL v No.5A33 — O = GIST S/ONAI- STAMPED & SIGNED FOR STRUCTURAL ONLY 3 L F r A PITCH: 12 ARRAY PITCH:12 Digitally signed by MP6 AZIMUTH:82 ARRAY AZIMUTH:82 'MATERIAL: Comp Shingle STORY: 2 Stories HKariuki Date: 2016.01 .20 13:04:12 -05'00' LEGEND 93 • (E) UTILITY METER & WARNING LABEL Front Of House ;o,r Ins INVERTER W/ INTEGRATED DC DISCO 3 & WARNING LABELS N © DC DISCONNECT & WARNING LABELS AC AC DISCONNECT & WARNING LABELS AC IE�Flj O'Inv EE90 DC JUNCTION/COMBINER BOX & LABELS + 0 DISTRIBUTION PANEL & LABELS ~ Lc LOAD CENTER & WARNING LABELS I (E)DRIVEWAY O DEDICATED PV SYSTEM METER STANDOFF LOCATIONS O CONDUIT RUN ON EXTERIOR —�� CONDUIT RUN ON INTERIOR GATE/FENCE Q HEAT PRODUCING VENTS ARE RED INTERIOR EQUIPMENT IS DASHED L_-J SITE PLAN " Scale: 3/32" = 1' IN E 01, 10' 21' S PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: J g-0262541 00 JACKSON, ALAN JACKSON RESIDENCE a SolarGt Philip Wiss y n CONTAINED SHALL NOT BE USED FOR THE /��\ BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MouNTING SYsrEM: 59 0 L U M B E R T—MILL R D 8.5 8 KW PV ARRAY NOR MALL IT BE DISCLOSED IN WHOLE OR IN NE MOUnt Type C CENTERVIL, MA 02632 PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES 24 St. Martin.Drive,Building 2.Unit 11 ORGANIZATION. EXCEPT IN CONNECTION WITH SHEEP: REV: DATE Marlborough,MA 01752 THE SALE AND USE OF THE RESPECTIVE (33) TRINA SOLAR # TSM-260PD.05.1H PAGE NAME: T. (650)638-1028 F: (650)638-1029 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN IMF: NA SITE PLAN PV 2 1/20/2016 (8BB)—SOL—CITY(765-2489) �.adarcltxa«n PERMISSION of soLARaTY INC. SOLAREDGE # SE7600A—US002SNR2 (E) COLLAR. TIE (E) COLLAR TIE y. (E) KNEE WALL (E) KNEE WALL ' ��'( F•kFi�� f • S 1 or K. S1 RIUKI u ST UCTURAL NO.51933 y GIST, �o { CCCCCC SS�ONN. —11 3—10 (E) LBW (E) LBW 12'-8" .- - 'Fl7'lt�i S"STATRUCTURAL �}��..�` (E) LBW k; (E) LBW , ; �• A SIDE VIEW OF MP1 NTS - . SIDE VIEW OF MP2 ~. NTS MP1 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES LANDSCAPE 64" 24" STAGGERED MP2 X-SPACING X CANTILEVER Y-SPACING Y-CANTILEVER NOTES PORTRAIT 48,, 19„ • STAG LANDSCAPE 64" 24" ST ROOF AZI 262 PITCH 38 ;. - PORTRAIT 48„ 19" ARRAY AZI 262 PITCH 38 RAFTER 2X6 @ 16"OC STORIES: 1' RAFTER 2X6 @ 16" ROOF AZI 2OC STORIES: 1 62 PITCH 38 C.j. 2X6 @16"OC Comp Shingle C.I. 2X6 @16"OC ARRAY AZI 262 PITCH 38 Comp Shingle S 1 PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER & FENDER WASHERS ` LOCATE RAFTER, MARK HOLE (E) 2X6 ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT 4„ . ZEP ARRAY SKIRT p (6) HOLE. SEAL PILOT HOLE WITH 11 —3 ZEP COMP MOUNT C (4) (2) POLYURETHANE SEALANT. (E) LBW S VIEW G ZEP FLASHING C 3 (3) INSERT FLASHING..IDE VIEVV OF MPV NTS (E) COMP. SHINGLE (1) (4) PLACE MOUNT. F (E) ROOF DECKING (2) U INSTALL LAG BOLT WITH 5/16" DIA STAINLESS (5) (5) SEALIN WASHER. MP6 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES STEEL LAG BOLT LOWEST MODULE - SUBSEQUENT MODULES INSTALL LEVELING FOOT. WITH LANDSCAPE 64" 24" STAGGERED WITH SEALING WASHER- (6) BOLT &WASHERS. (2-1/2° EMBED, MIN) PORTRAIT 48" 18" (E) RAFTER ROOF AZI 82 PITCH 1z 1 STANDOFF RAFTER 2X6 @ 16 OC ARRAY AZI 82 PITCH 12 STORIES: 2 - y Scale: 1 1/2" Comp Shingle a CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: J B-0 2 6 2 5 41 O O PREMISE OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT E USED FOR THE JACKSON, ALAN JACKSON RESIDENCE PhilipWiss �o�=• BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNRNC SYSTEM I°s SO�aC�t�/" NOR SHALL IT BE DISCLOSED IN WHOLE OR IN. Comp Mount Type C 590• LUMBERT=MILLC ZRD 8.58 KW PV ARRAY r,� PART IZ OTHERS OUTSIDE THE RECIPIENT'S CE N TE R VI L; M A 02 V 32 ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES: �--: THE SALE AND USE OF THE RESPECTIVE (33) TRINA SOLAR # TSM-260PDO5.18 z4 st..Martin Drive, Building 2 Unit 11 'SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME SHEET: REV. DATE Martin Drive, MA 01752 PERMISSION of SOLARCITY INC. SOLAREDGE SE7600A—US002SNR2 NA PV 3 1 20 2016 T. (650)638-1028 R.(650)638-1029 STRUCTURAL VIEWS / / (�)—SOL—CITY(765-2489) www.solarcity.com ,3 UPLIFT CALCULATIONS SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. r e y z I PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL—,THE INFORMATION HEREIN [ERER Jg-0262541 00 JACKSON ALAN JACKSON RESIDENCE PnlrP wiss �\�!s�Oh��'� CONTAINED SHALL NOT BE USED FOR THE WA y BENEFIT OF ANYONE EXCEPT SOLARCITY INC., TEM: 590 LU M B E R T—MILL R D 8.58 K W.P V ARRAY NOR SHALL IT BE DISCLOSED IN WHOLE OR INComp ount Type C PART TO OTHERS OUTSIDE THE RECIPIENTS CENTERVIL, MA 02632 ORGANIZATION, EXCEPT IN CONNECTION NTH 24 St. Martin Drive,Building 2 Unit 11 THE SALE AND USE OF THE RESPECTIVE INA SOLAR # TSM-260PD05.18 PATE NAME: SHEET: REV. DATE Marlborough,MA 50) " SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN T. SDL— 638-105— F: (650)638-1029 PERMISSION of SOLARCITY WI INC. NA UPLIFT CALCULATIONS PV 4 1/20/2016 (eB6}soL-an(ass—zaas) .8daaltraa.n DGE SE7600A—US002SNR2 GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE IN 1 —(1)SOLAREDGE SE7600A-US002SNR� LABEL: A BOND (N) #8 GEC TO ONE (E)`GROUND Panel Number:NoMatch Inv 1: DC Ungrounded (33)TRINA SOLAR A TSM-260PDO5.18 GEN #168572 ROD AND ONE N GROUND ROD AT Meter Number:2266653 ELEC 1136 MR` O t Inverter; 7 OOW, 240V, 97.5X; w Unifed Disco and ZB, RGM, AFCI PV Module; OW, 236.9W PTC,:40MM, Black Frame, H4, ZEP, 1000V PANEL WITH IRREVERSIBLE CRIMP Overhead Service Entrance INV 2 Voc: 38.2 Vpmax: 30.6 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 200A MAIN SERVICE PANEL E� 20OA/2P MAIN CIRCUIT BREAKER (E) WIRING CUTLER-HAMMER Inverter 1 200A/2P Disconnect 3 SOLAREDGEA 1MDC+E LOADSSE7600A-US002SNR2 .MP1,MP2:'1.x18O ---- --- ------- ---- ———-———————— ----� -. I I _ 40A/2P N oG ---- GND -------------—-----------—----------- -EGCI --- DC+ p jA — GEC DG c MP2,MP6: 1x15 ' GND EGC _ - G I N .: } • i 1)Conduit Kit; 3/4':EMT - - - GEC y - - T , TO 120/240V f SINGLE PHASE UTILITY SERVICE I .. _PHOTO,VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* _`MAX VOC AT MIN TEMP POIT (1)CUTLER-HAMM CH24O PV BACKFEED BREAKER e (I CUTLER-HAMMER DG222URB D`, � D� Breaker, 40A 2P, 2 Spaces, Tan Handle /� Disconnect; 60A, 24OVac, Non-Fusible, NEMA 3R AC _ r v )SPoweerrBBoxE Optimmiizerr,30 WS H4, DC to DC, ZEP -(1)Gro qd Roo -(1)OUTLER-HAMMER DG100N6 Sr6 x 8, Copper Ground/Neutral It; 60-100A, General Duty(DG) nd (1)AND$6, Solid Bare Copper -(1)Ground Rod; 5/8' x 6', Capper . (N) ARRAY GROUND PER fi90 47(D). NOTE: PER EXCEPTION NO 2, ADDITIONAL , ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE 1 AWG g8, THWN-2, Black 2 AWG #10, PV Wire,'60OV, Black Voc* =500 VDC Isc =15 'ADC O (1)AWG#8, THWN-2, Red O (1)AWG #6, Solid Bare Copper EGC Vmp =350 VDC Imp=13.2. ADC (I)AND#10. THWN-2, White NEUTRAL Vmp =240 VAC Imp=32 AAC LLL���LLL 1 Conduit Kit; 3 4 EMT .( . ,/'. . . . . . . . . . (1)AWG$8,_iHWN-2,.Green . • EGC/GEC-(1)Conduit Kit;.3/4. ,EMT, , . . . . _ . , _ (2)AWG 0, PV Wire, 600V, Black Voc* =500 VDC Isc =15 ADC O (1)AWG#6, Solid Bare Copper. EGC Vmp =350 VDC Imp=11 ADC 1 Conduit Kit; 3 4 EMT CONFIDENTIAL- THE INFORMATION HEREIN FINVERTER: MBER: J B-0 2 6 2 5 41 O O PREMISE OWNER: DESCRIPTION: DESIGN: �__d CONTAINED SHALL NOT E USED FOR THE JACKSON, ALAN JACKSON RESIDENCE Philip Wlss SolarGt� • BENEFIT SHALL ANYONE EXCEPT SOLARCITY INC., ec srsTEM: 59 0 .LU M B E R T-MILL R D %��� NOR SHALL IT BE DISCLOSED IN WHOLE OR INp Mount Type C p NOR TO OTHERS OUTSIDE THE RECIPIENTS 8.58 KIN P V A R R A Y ��1 _.. ORGANIZATION, EXCEPT IN CONNECTION WITH S CENTERVIL, MA 02632 THE SALE AND USE OF THE RESPECTIVE TRINA SOLAR # TSM-260PDO5.18 24 St. Martin Drive,Building 2,Unit 11 'SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME SHEET: REV: DA7/2 Marlborough, MA 01752 PERMISSION of SOLARCITY INC. AREDGE SE7600A—US002SNR2 NA PV 5 10 21016 (888)—sT- (650)638-1028 F: (650)638 1029 THREE LINE DIAGRAM / oI-GITY(7ss-2489)'Wlnlr.solarcity.corn _ Label Location: Label Location: Label Location: r • 0 0 0 •o o (C)(CB) o (AC)(POI) u o (DC) (INV) Per Code; Per Code: a o ° Per Code: NEC 690.31.G.3 eo o . o o • �• a NEC 690.17.E NEC 690.35(F) Label Location: o�:o ° 0 0 0 ° o• o TO BE USED WHEN o•e e ° '° ° ° • ° INVERTER IS O O O (DC)(INV) Ip -o o ° UNGROUNDED D O Per Code: NEC 690.14.C.2 Label Location: Label Location: 0 0 0 -o Cop (POI) -0 - (DC)(INV) 0 0 o Per Code: o •i' Per Code: •-e °o 0 o NEC 690.17.4; NEC 690.54 NEC 690.53 •_e c•e o 0 Igo • .o 0 0- ' :e o e o. ^Q,.£ I� p mw rl Label Location: o (DC) (INV) Per Code: NEC 690.5(C) 1 Label Location: , (POI) -o e e • ° e ° -o - .o - Per Code: NEC 690.64.B.4 ' Label Location: 1 c (DC)(CB) Per Code: Label Location: • ° "° D POI 0 0 0 o NEC 690.17(4) ( ) (POI) Per Code: o•e off• ]` - e - o_o o -• ° NEC 690.64.B.4 0 oe -0 0 0 Label Location: o ( (POI) Per Code: ° - NEC 690.64.B.7 Label Location: o 0 0 (AC): AC Disconnect O O O (AC) (POI) o ° °• (C): Conduit D O Per Code: a (CB): Combiner Box NEC 690.14.C.2 I (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit Label Location: (INV): Inverter With integrated DC Disconnect AC POI (LC): Load Center CO Per Code: (M): Utility Meter tl Y NEC 690.54 (POI): Point of Interconnection CONFIDENTIAL— THE INFORMATION HEREIN CONTAINED SHALL NOT BE USED FOR ���••rI� 3n Mateo, CA way THE BENEFIT OF ANYONE EXCEPT SOLARGTY INC., NOR SHALL IT BE DISCLOSED San Mateo,CA 94402 •%��� T:(650)638-1028 F:(650)63&1029 IN WHOLE OR IN PART TO OTHERS OUTSIDE THE REGPIENTS ORGANIZATION, Label Set �I� sofa�it (888}SOL-Cm(765-2489)wwwsolarcity.wm EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE ° SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PERMISSION OF SOLARGTY INC. f t Next-Level PV Mounting Technology -` '','So1arGt Ze Solar Next-Level PV Mounting Technology SolarClty I ZepSolar 9 gy y p g Components Zep System for composition shingle roofs to Upt-roof' Lev eling Foot '. Ground Zep Intertock (xcy We shown) �.. Part No.850-1172 LIE 11 ing foot _._r. ,,• . ,�, •. ,R .` , ETL listed to UL 467 ' Zep Competiblc PV Modulc 1 Root Attachment Array skrrt ! Comp Mount Part No.850-1382 Listed to UL 2582 V r Mounting Block Listed to UL 2703 �,� Description OEM% • PV mounting solution for composition shingle roofs a1., FA 0 Works with all Zep Compatible Modules °°mP1'' ' 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" Interlock Ground Zep V2 DC Wire Clip �L LISTED Specifications Part No.850-1388 Part No.850-1511 Part No.850-1448 i - Listed to UL 2703 Listed to UL 467 and 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 Array Skirt,Grip, End Caps Part Nos.850-0113,850-1421, zepsolar.com zepsolar.com 850-1460,850-1467 , Listed to UL 1565 This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zep 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 Zap 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. Document#800-1890-001 Rev A Date last exported: November 13,2015 2:23 PM Document#800-1890-001 Rev A - Date last exported: November 13,2015 2:23 PM - solar " W � Solar " o o SolarEdge Power Optimizer �n Module Add-On for North America lJV P300 / P350 / P400 Q SolarEdge Power Optimizer � P300 P350 P400 Module Add-On or North America (foroOte0 PV (forodule PV (f module PV modules) modules) modules) INPUT, P300 / P350 / P400 ` Rated Input DC Power' 300 W- Absolute Maximum Input Voltage(Voc at.lowest temperature) 48 60 80 Vdc ° MPPT Operating Range ........... .. 8 48... ....8..6�.................... Maximum Short Circuit Current(Isc) ....... .... 10Adt r—� ............................................................:....................................................... ...................................... .... ' Maximum DC Input Curren[ .. Ac rl 11 11 Maximum Efficiency................................................ .................................... 99:5 .................................. d% _ �. ��... We"ghted Efficiency............... 98.8..........................a... .. ..... ... Overvoltage Category II 1 OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) Maximum Output Curren[ ......... .........15. ... ........ ............ ... Adc Maximum Output Voltage 60 Vdc OUTPUT DURING STANDBY(POWER,OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) 1 Safety Output Voltage per Power Optimizer 1 Vdc STANDARD COMPLIANCE f. .. - • FCC Part15 Class B IEC61000 6 2 IEC61000 6 3 Qtlriac! EMC ss II Safety ........ .. ....... .. ....... ....... .. .......... IEC62109 1(cla safety)UL3741 ....... ............. ....... .. .Yes.. _ ROHS •INSTALLATION SPECIFICATIONS J 1DDD yd� - at Maxmum Allowed System Voltage •,•.,..,, + D"mensions(W zLz H) 141x212 x 405/555 x 8.34x 1.59 mm ..... ... ... ....... ........... ...... ... ...........950..z... ...... Weight lmcludmg cables) ......... / ........ ... ...... Input Connector .......... ......... MC4/Ampheno(/Tyco.... .. ,,- Out ut WireT a/Connector ..........•° Double lnsulated;Amphenol ,_,.,.. .. .i Output Wire ....,. 0.95/3.0 m/$ ....... ............................. ...........................................— °; ' -' Operating Temperature Range -00 +85/40 +185 C/F. Protection Raring......... ....... ... ............ ............ . . IP65 Relative HumiditY.. ... ...... ............... .:............ � 0 100 ...... ....... ....%...... R—d srep 11 f ..dpw m ujm fpp fosx ppwHmieao«anpw�a. _ tPV SYSTEM DESIGN USING A SOLAREDGE SINGLE PHASE THREE PHASE THREE PHASE INVERTER. - - 208V 480V PV OOWe�OptIr111Z8L1Or1 8t the tITOdUIE!—IE:VE!I - Minimum String..n*..(....Power Optimizers) 8 10 18 - - .................Leng...(Pow........................ :................................................................................................................ Maximum String Length(Power Optimizers) 25 25 50 .. .. ................................................. ............. ............ ......... ...... ........................ Up to 25%more energy - Maximum Power per String 5250 6000 1.2750 W .................................................................................................... ....... .............. Superior efficiency(99.5%) Parallel Strings of Different Lengths or Orientations ....................................................................................................................Yes...................................................... Mitigates all types of module mismatch losses,from manufacturing toleranceto partial shading _ Flexible system design for maximum space utilization +---_•�-�- - - Fast installation with a single bolt Next generation maintenance with module-level monitoring Y '. t`° + .4 - Module-level voltage shutdown for installer and firefighter safety USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www.solaredge.us 1 m u<• werffie =ma �mr�wfem� •� � -� THE 'frinamount M0DULE'7S*-PD05.18 Mono Multi Solutions DIMENSIONS OF PV MODULE - ELECTRICAL DATA @ STC • + :� ''. 0 941 m - Peak Power Watts PMnx(Wp) I 45 25 '•j._ -.�� - � 0 255-- 260 Power Output Tolerance-Pm (%)r4 _. 0- 3 : _ , r 2 _ _ Maximum Power Voltage-VMPfV) 29.9� 30.3 30.5. 30.6 . JUNCTION W s I. I - O ' .. Maximum Power Current-IMPP(A)� 8.20 8.27' 8.37 8.50 - :. ! _ THE [ �C�tc� Mount -.. : .. .. i, r . �` - NRMEPLFTE _ O . .* V c 37.8 _ ^^ 38.0 38.1 38.2 ,e P.,z c L' on nelsc tA)V 8.75 8.79 8.88 9.00 _ �+ �•Open Circuit Volta _ 0 iNSTnLUNO NDLE Circuit Curr .. - .. _ Sh e ) # .. .,, Module Efficiency m(%) 15.0 15.3 ,L 156..:- , : w f, r, M ' lI I ` �� - -STC:Irradiance 1000 W/m',-Cell Temperature 25°C,Air Mass AM1.5 according to EN 60904-3.. • � •O'D V `F _ Typical efficiency reduction of 4.5%a1 200 W/m2 according to EN 60904-I.. w k ELECTRICAL DATA @ NOCT � u� s y 86µ w - 190Maximum Power-PMxWp) 18 r Y9360 CELL Maximum-Power Voltage-VMP V) 27.6 28.0 F T - 28.1 28.3 .- 3 MULTICRYSTALLINE MODULE a �,.csoUNDwc HOLE Maximum Power Current-IMP (A) 6.59 6.65 6.74 6.84 , - Open Circuit Voltage(V)-Voc(V) 35.1 35.2 35.3 35.4 * .7 WITH TRINAMOUNT FRAME • - r-- - `. '' '` , - Short Circuil.Current(A)-Is (A)- 7.07 7.10 A - 7.17 Z27 e q ' T , e T z DNni ( 'a - NOCT:Irmdliance at 800W/m',Ambient Temperature 20°C.Wind Speedlm/s. - - 2 180 - I a, I 245 260l�! w .. Back View .. r. POWER OUTPUT RANGE i MECHANICAL DATA solar cells- - (aMulticrystalline 1.56 x 156 mm(b inches)' Fast and simple to install through drop in mounting solution W-! ' Cell orientation. -,,F - ®v _ b,' - - •''�.r'a Module dimensions 11 (.650 x 992 x 40 mm 64.95 x 39.05 x 1.57 inches) Weighs 1.3kg(47.0 Ibs)s _ i "' w � t 13 inches,Hi h Transmission,AR Coated Temp, re Glass i - - MAXIMUM EFFICIENCY , Glass m(D. J s p ., .. , .. White ' �2 Bac A A .-�� '`'� - •_ - - Good-aesthetics for reside_ ntial applications _� s - . - : Frame Black Anodized Aluminium Alloy with Trinamount Groove , r E 1 V C OF P U or �. wy.�I � - - _ _ _ _ ; _ CURVES V MODULE(245W)� J-Box _ - IP 65 IP 67 rated ® �/v �'�� z N r '^ - - - Cables'• Photovoltaic Technology cable 4.0 mm-(0.006 inches'). - - :: v - - 0.40 1200 mm(47.2 inches) POWER OUTPUT GUARANTEE 9.°4{ - - , 8 p0 fire Rating ..Type 2 t .. L• r .4 7m �W/m2' - Highly reliable due to stringent quality control f < ,: I • Over 30 in-house tests(UV,TIC,HF,and many more) a As a leading global manufacturer In-house testing goes well beyond.certification requirements s - "' '4.00 TEMPERATURE RATINGS - `: MAXIMUM RATINGS t ' } - of next generation photovoltaic , a 3� c- _ _ " •""� - �>+r 20OW/m2 Nominal Operating Cell Operational Temperature 40-+85 C ` products,we believe close . y , 2.m p g 44°C(+2°c) p p -cooperation With Our partners - _ p _ a I°D P Temperature(NOCTJ Maximum System 1000V DC(IEC) : + : is critical to.success. With local t` a 0'u Temperature Coefficient of P- -0.41%/°C Voltage _ 1000V DC(UL) presence around the globe,Trina is F - ,a _ r - ." - - .Temperature Coefficient of Voc {'-0.32%/°C '- ,.Max Series i 15A a n able to provide exceptional service v. 1--- s, voltage(v) _ c° I O m 30 m m i !Temperature Coefficient of Isc 0 05%/°C - to each customer in each market ,, g g ironmental _ r, . ._,. r` Certified to withstand challen m -env and supplement our innovative, conditions r r .. ki b with th t d bl li reae products we backing • 2400 Pa wind load of Trina as a strong,bankable WARRANTY partner. We are committed • 5400 Pa snow load _ to building strategic,mutually a -' 10 year Product Workmanship Warranty beneficial collaboration with p ( a 25 year Linear Power Warranty _ installers,developers,distributors '' (Please refer ra product wa warranty for details) <' i and other partners as the r CERTIFICATION backbone of our shared success in {_ _ _,_. _ _ ", ._ .,,- u, CATION _ driving Smart Energy Together. LINEAR PERFORMANCE WARRANTY f" PACKAGING CONFIGURATION m 10 Year Product Warranty•25 Year Linear Power Warranty . lri�'al LISTED SASS Modules per box:26 pieces � Z Trina Solar Limited ' z : WWW.trinasolar.com I `y 100% ' y e - , - -*Modules per 40'container:728 pieces 20 dlilogal volue lroM L=� coz i a 90% .-_ Trina Sol L O p Cf'S IJnegr W�rt'anl). CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. _ O0"PAII, - t f1lPl� n-a ar I 4O unwol Chang Trina Solon Limited.All rights reservetl.specifications included in this datasheer are subject to YY �Y Y{Y7lsOIt.11 i 0 80% '. _ �' e_ .,_ ar change without notice: r ry Smart Energy Together - Smart EnergyTogether Years 5 ID - 15 20 25. - g epO .. r ❑Trinastandard I - . _. _, ....... .. '.._, .,, M' THE'Vinamount MODULE TSM-PD05.18 Mono Multi Solutions DIMENSIONS OF PV MODULE ELECTRICAL DATA @ STC unit:mm Peak Power Watts-Pvax(Wp) i 250 4 255 1 260 1 265 941 Power Output Tolerance-Pmnx(%I ii 0-+3 O t Maximum Power Voltage-V-P(V) 1 30.3 l 30.5 30.6 30.8 eox Maximum Power Current-IMPP(A) 8.27 8.37 8.50 8.61 7 HE M 0 Unt HAmEPu�E Open Circuit Voltage-Voc(V) f 38.0 4 38.1 38.2 �< 38.3 0 (Short Circuit Current (A) 8.79 8.88 9.00 9.10 wsruur,c HOEE . /� ��I jr{n'I r� Module Efficiency nm(%) 15.3 4 15.6 i 15.9 16.2 /-t.®® ® STC:Irradiance 1000 W/m'.Cell Temperature 25°C.Air Mass AM1.5 according to EN 60904-3. 1(Il`1Vp 1p1 Typical efficiency reduction of 4.5%at 200 W/m'according to EN 60904-I. o � ELECTRICAL DATA @ NOCT - Maximum Power-PMAx(Wp) ( 1861 190 j 193 f 197 - ® CELL _ !Maximum Power Voltage-VmP(V) 28.0 28.1 28.3 28.4 E IL'la `04 3G0UND1NGHOLE Maximum Power Current-ImPP(A) I 6.65. I 6.74 1 6.84 I 6.93 MULTICRYSTALLINEMQDULE A A (Open Circuit Voltage(V)-Voc(V) 35.2 35.3 35.4 35.5 i PD05.18 ,:-uxAHHaE WITH TRINAMOUNT FRAME Short Circuit Current(A)-Isc(A) 7.10 zv zv 7.35 NOCT:Irradiance at 800 W/m'.Ambient Temperature 20°C.Wind Speed 1 m/s. _ 812 180 - 25 0-26 5 W Back view MECHANICAL DATA POWER OUTPUT RANGE Solarcells I Multicrystalline 156 x 156 mm(6 inches) Cell orientation 60 cells(6•10) i Fast and simple to install through drop in mounting solution Module dimensions l 1650 x 992 x 40 mm(64.95 x 39.05 x 1.57 inches) �/�y/yam../� E Weight 19.6 kg(43.12 Ibs) LJ�/V v Glass 3.2 mm(0.13 inches),High Transmission.AR Coated Tempered Gloss 16. MAXIMUM EFFICIENCY AA Backsheet White �.----�� Frame I Black Anodized Aluminium Alloy j® Good aesthetics for residential applications ,-Box IP 65 or iP 67 rated t `-� Cables Photovoltaic Technology cable 4.0 mm'(0.006 inches'). ®Ind 1200 mm(47.2 inches) O I-V CURVES OF PV MODULE(260W) POSITIVE POWER TOLERANCE Connector H4A ,o.00 ew r000w m� Fire Type � UL 1703Type l 037ype2for Solar City Highly reliable due to stringent quality control - • Over 30 in-house tests(UV,TC,HE and many more) As a leading global manufacturer P ? • In-house testing goes well beyond certification requirements ` m' TEMPERATURE RATINGS MAXIMUM RATINGS of next generation photovoltaic • PID resistant I s� p a 4w Nominal Operating Cell 144°C(±2°C) Operational Temperature -40-+85°C products,we believe close Temperature(NOCT) ) sm 'Maximum System 1o00V DC(IEC) cooperation with our partners z.W Temperature Coefficient of P- -0.41%rc Voltage 1000V DC(UL) ' is critical to success. With local 00 Temperature Coefficient of Voc f-0.32%/°C Max Series fuse Rating 115A presence around the globe,Trina is able to provide exceptional service a.w - -_ ' 1 Certified to withstand challenging environmental 4 �� _� so TemperatureCoefflcientoflsc 0.05%/°C to each customer in each market �°H•ew,n and supplement our innovative, j conditions a reliable products with the backing 2400 Pa wind load WARRANTY 5400 Pa snow load of Trina as a strong,bankable - • partner. We are committed - CERTIFICATION 10 year Product Workmanship Warranty to building strategic,mutually 25 year Linear Power warranty , beneficial collaboration with ` 4L �� (Please refer to product warranty for details) installers,developers,distributors a and other partners as the, usrm a r backbone of our shared success in 6��' r a driving Smart Energy Together. LINEAR PERFORMANCE WARRANTY PACKAGING CONFIGURATION EU-1B WEEE comPUAHr - Modules per box:26 pieces 10 Year Product Warranty•25 Year Linear Power Warranty w Trina Solar limited - - - - t Modules per 40'container:728 pieces www.trinasolar.com W00% Adtl$lo a nal value from Trina 0 90% - ^- SOIOr'S iinegr Warren CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. VcaMP4Tie� . L'I�ryIO �L 62015 Trina Solar Limited.All rights reserved.Specifications included in this datasheet are subject to H 4Po��solar 80% - Y11 unasolar change without notice 9Y 9 Years s 0 IS 20 25 Smart Energy Together Smart Energy Together 'mm"'' Trina standard 13 Indusrrystandarcl solar o Single Phase Inverters for North America r _ O Xo - SE3000A-US/Sf3800A-US/Sf5000A-US/SE6000A-US/ ` • - - ' S o f a .- O C SE7600A-US/SE00A 100 -US/SE1140OA-US J - � � � SE3000A US SE3800A-US SESOOOA-US SE6000A-US SE7600A-US SESOOOOA-US SE11400A-US _ __ 'OUTPUT . p Q p /Y� 9980@ 208V SolarEdge Single Phase I n V�i �i I S 1 p C Nominal AC Power Output 3000 3800 5000 6000 7600 10000�1a 240V 11400 VA -, + r——� - .Nominal Power output ................... ........... ..5400 @ 208V. ...... ......................10800 @ 208V .... - Max.AC Power Output 3300 4150 5450,@240V-- 6000 - 8350 10950-@240V 12000 VA , For North America Output tVol.....Min.No _ 1 �AC Output Voltage Min:Nom Max.tl .. _ 183'-208-229 Vac ...... ....... ...... ........ .. ....... SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ AC Output Voltage Min:Nom Max" r 211-240-264 Vac .... . ...... .... .... ....... . _ - - ... .........nc Yin. -Max.t r ....<. ...... ..... '59.3-60-60.5•(with:Hl country,setting 57-60•,60:5)• ... .Hz _ SE760OA-US/SE1000OA US/SE1140OA US ,, A�FT%q yYin.- om.-M. •...... 24 @ 208V 4i8 @ 208V - Max.Continuous Output Current -' •- .12.5••-.••I• •••-16.:.: L.21,Qv 240V; I. 25......I,,,, :3?,,,,,..I_..42@240V.-.I-..•• 47.5••• .. A _ .. _ 1 ._ -. .................................. .. - .... _ i GFDI Threshold r - 1 Yes - Utility Monitoring,)*landing Protection,Country Configurable Thresholds Yes - _ 1 ;INPUT Maximum DC Power(STC) - •• 4050 5100 6750 8100 10250 13500� 15350 W __ ........ ........................... - ...... c -Transformer-less,U ngrounded........ ...........---Yes........................................................ ... r G fi,m J �cf Max.ln ut Volta a .. .....500... .. ..... .. . ..... .................... Vdc... p.......g........... ........- . . _ 325 @ 208V/350 @ 240V....... .... ,Vdc.... - .. nH t ........ ..... Nom.DC Input Voltage •••' Walla ....._. ..16.5 @ 208V I ....33 @ 208V 1:I 95 13 115.5 240V 18 23 34.5 Adc ..-�••30S@240V-:I ,,,,---, ,,,, Max.Input Current Max.Input Short Circuit Current .45• I . . - x - .. ...... ... .. ......... Reverse Polarity Protection ....... ................................ ... - ........ - - .. .... .. ....... .-... .... ... .. - 600kn Sensitivity Adc .... Yes ... .. '„. _ Ground-Fault Isolation 98 Detection...... ............'...... ..._.... .. ... ... ... - t.. Maximum Inverter Efficiency -97.7 -••• 98.2 98,3 - 98.3•••., ....• 98• ..•• 98- ••••.. - •••%-- . ......., . .................97.5 @ 208V 97 5 97 @ 208V... - - _ .. .. .;. CEC Weighted Efficiency............... .::..97 5 ....I..... 98......I...98:�1a.240y..�. ....97 5 ....I.................. I ...97.5.. ...... .... ... - 97.5 @ 240V .. t+. a Nighttime Power Consumption <2.5 <4 W , ADDITIONAL FEATURES - - RS485,RS232,Ethernet,ZigBee(optional) - _ SupportedCommunication Interfaces ................................................. .... .... ...................... ........... -........................................... ...................................... e , .Revenue Grade Data,ANSI C12.1 ...........:......_Optio...... ........ .................................. .... ......... - - - ..... _ - Rapid Shutdown-NEC 2014 690.12 Functionality enabled when SolarEdge rapid shutdown kit is installed)°I - t� + 1 STANDARD COMPLIANCE .. NW :.; Safety .................._.... ................................ 99B,UL39 ... ......... .1.. .... UC1741:UL16 98,CSA 22 P - ................ ^ 4 I s.a - .' - - Grid Connection Standards ...•••....-•••••-----.--.•...--•--IEEE1547 . .......................... ......... - - Emissions............................. .. ....FCC part15 class B.... ... INSTALLATION SPECIFICATIONS' r t ....... .............. . AC output conduit size/AWG range...... ...... ........ ....3/4„•• m/16 r - minimu 6 AWG .. minimum/8 3 AWG ,J( minimum/1 2 strings /• '- t[4 "n = ' •'' DC input conduit size/1t of strings/. "+}}(, ,,., :._. - P _ 3/4"minimum./1-2 strings/16 6 AWG ran e .....a: .:..................: ........: . ...... ......... .... .. s •. - .. .... _ 4. 30.5 z 12.5 xJ 10.5/ in%••- 3/ Dimensions with Safety Switch. - - - _ 30 .. 775 x 315 x•260.......... mm .. - Sx125x72/775.x 315x184 HzWxD Weight with Safety Switch......,. 51.2/23:?.......:..L. 24.7.. .. ural .... 88 4 40.1 Ib/.kb,? . ..... ... ...... ...... .. Nat • .y! - - - convection - - " - Natural Convection and internal Fans,(user replaceable) - .,-...,, --- .-•r ter.< Cooling - - fan(user - , - :.. - .... .replaceable).... - .... .. The best choice for SolarEdge enabled systems •• . -- :• •. ' Noise <25 < ....... dBA 50 Integrated arc fault protection(Type 1)for NEC 2011 690.11 compliance Min:Max.operating Temperature 13 to+lao/-zs to+s.. -4o to+6o version available('))' F.. c •Rang?............................. ..........................................................:................................ ... ..... ..... Superior efficiency(98%) ProtectionRating NEMA3R......................•••. Small,lightweight and easy to install on provided bracket 1)For other regional settings please contact solarEdge support. pl A higher current source may be used;the inverter will limit its input current to the values stated ia•Revenue grade Inverter P/N:SE—A USD00NNR2(for 760OW Inverter.SE7600A US002NNR2). - .Built-in module-level monitoring - •°I Rapid shutdown kit P/N:SEl000 RSDSl. i5i-40 version P/N:SEx—A-US000NNU4(for 7600W ter:SE7600A-USD02NNU4). Internet connection through Ethernet or Wireless - - - -- ,�-- -- g.. a A .. - Outdoor and indoor installation t — Fixed voltage inverter,DC/AC conversion only Pre-assembled Safety Switch for faster installation Optional—revenue grade data,ANSI C12.1 USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THENETHERLANDS-ISRAEL VVVVVV.SOIaredge.US 11111111111911 10� • • •t a • °•_ t s I I rn S c _ 3 t N r 3 i J• � � _ C r P p P P m Yam' I Aft z I 2 3 I c I P P p + n > N t A n ] p I P m C I t A t I P 1 � I i I rn LP p Copgright @20 1 1 by K5Adesign,.a DRAWN BY: I ]J These plans are protected under Federal PI®n # 1 662 PROJECT: L L r L C rn D Copyright taws.The original purchaser of this �nST AIID[T IOn OT �T eel �PA171 TOC: Jr— plan is authorized to construct one and only I�ENNETN hAI7LE�.I�. Z Z one home using this plan.Modification or 1 �/ f A �// Professional Building Designer � se is permis io of express wri[ten _ AL-AN QnA L/NN� JA6K JON � permission of the Designer. N M KS A d e 51 jYl 5 1, Any diacrep—its,errors and/or omissions LOCATION: In O A IP PR the notes,dimensions.and/or REVISIONS: OFESSIONAL BUILDING DESIGN gscon conta ined e' a on these documents 0 than be er.or to the attention of Gonsi'Ure-Hon IAn lo/27/1 1 COMMERCIAL-RESIDENTIAL thehal'be brought to the commencement P L of--ructibn.Pro aigwith Cape sod-Massachusetts �790 LUmber'f T—JAI F-OAd canetraccion con,ucutes the acceptance Guanaeaste•Costa Rica of meat aoeuments and any capecodek5adesigncom•www.KBadesign.com Generville,MA dlscbecome.hcrerror, nrdl[y oft„llbDs P.O.Box 1 I I I•Hyannis,MA 02a01•506.'190.392 2 building contras tor. n L e �1 1 y 1 V IOID „ a�,.� k 1 .. 77 . ' + Y roo Tx, TO, P � 56 ;. C X R6 a lie LA tO A - �