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0005 HARRINGTON WAY
5f�''`a..�,r��s�, w� I Town of Barnstable BufldIlng a Post This Card So That it is visible:From the Street Approyetl Plans Must be Retained on Job and this Card Must be Kept f Ag{g ♦ g' .S �,'vr "§ �' 4sa '*Fg s4ia�i,. .kv. W, O PostedlUntiITIr6l Inspection Has Been Made fi /[\� Ty' 'I '',, fit'... „w. :, "yn,*,.kk^; ..� .,, n�.�o .� '�e.:::;?� :tia�'* ."'` '..,: .. ,,. .rva r,,t Vi/ -mit Where a Certificateof Occupancy is Required,such Building shall Not be.Occupi until a_Finahlnspection"hasbeen made. Permit No. B-20-2052 Applicant Name: Steve Spengler Approvals Date Issued: 07/31/2020 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 01/31/2021 Foundation: Location: 5 HARRINGTON WAY,HYANNIS Map/Lot:�288-092 Zoning District: RB Sheathing: Owner on Record: SYLVIA,RAY A&CELESTE C Contractor Name,-STEPHEN J SPENGLER Framing: 1 Contractor License: CS`071546 Address: 5 HARRINGTON WAY 2 HYANNIS, MA 02601 Est Project Cost: $ 12,760.00 Chimney: Description: Installation of roof mounted photovoltaic solar systems;1$panels Permit Feb: $ 115.08 Insulation: 5.85kW Fee Paid-, $ 115.08 Project Review Req: ,j Date:. 7/31/2020 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized.by this permit is commenced-withm slxmonths afte i'; %. icia Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. rI Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and-Fire-Officials-are provided on this,permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing f'`� Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue limng is installed Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of BarnstableX A .",:-F P; BU11Cllrig This Card Sofihat�tisVtsible Fro ;,the Sheet .A , ro�edPlans=,Must be Retain,edon Joband.this Card,Mustt;be Kept :�,'/ARNtTfilHl$ ' POSt Pp�,, Permit Where a�Gert�ficate of Occu; anc .;s;Re,ured,�such Bar dmgshall Nol,be Occupied until a Finalllnspect�onyhas been ma.d_ Permit No. B-18-1285 Applicant Name: TIMOTHY CABRAL Approvals Date Issued: 05/18/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 11/18/2018 Foundation: Location: 5 HARRINGTON WAY, HYANNIS Map/Lot 288 092 Zoning District: RB Sheathing: Owner on Record: SYLVIA, RAY A&CELESTE C .', Contr ctor Name ,,ALTERNATIVE WEATHERIZATION, Framing: 1 INC. Address: 5 HARRINGTON WAY i 2 Contractor Lice 45683 HYANNIS, MA 02601 Chimney: nse Description: Air Sealing.Weatherstrip and sweep on Door $town in�Cellulose for EstProfect Cost: $3,359.00 Attic.86 Propa Vents, FG for Damning aroundcat wyv ,vent bath Permi Fee: $85.00 Insulation: alk fans,insulate hatch, Blower Door and CST/ Final: Fee Paid: $85.00 W . Project Review Req: *� k Date 5/18/2018 Plumbing/Gas FIT Rough Plumbing: Final Plumbing: .... Building Official Rough Gas: This permit shall be deemed abandoned and invalid unless the work authonzed,,by this permit is commenced within six onths after issuance. g � Y p All work authorized by this permit shall conform to the approved appli anon and Me' pproved construction documents#orWhich this permit has been granted. Mi All construction,alterations and changes of use of any building and strUdbres shall be in compliance with the local zoning by laws and codes. twnFinal Gas: This permit shall be displayed in a location clearly visible from access street or oad and shall be maintained open for publinspect Old for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatureby the Building and Fire®fficials are�provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:`, � R 1.Foundation or Footing " Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �c� �► Application Number... ?...,. .. . ..��d............... �' �ARdYJ'PABLE, MASS, Permit Fee............:..........................Other Fee...................1639.. Total Fee Paid... O TOWN OF BARNSTABLE Permit Approval by, ... On BUILDING PERMIT Map........................................Parcel.....,...,...........:....................... APPLII✓ATLt)N Section 1 -Owner's Information a" Project Location" Project-Address Ahca k�w Village 14V�.4f _1J Owners Name 116W S iOwners Legal Address rl 4fLay lCity 0_4VA,E S State /- y 1 zip Oc+'6 D 1 ?Owners Cell#j(J$- 3a7—�2� ,S_5 E-mail r • Sectioni—Use of Structure Pse Group 6 Zola ❑ Commercial Structure over 35,000 cubic feet APR 2 ❑ Commercial Structure under 35,000 cubic feet TOWN O BARN STA3LE ® Single/Two Family Dwelling Section 3--Type of Permit New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition Retaining wall ❑ Solar Renovation ❑ Pool ❑ Insulation A ?ther—Specify ,ulk Section 4 - Work Description Last updated:3115/2018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction c3 S �,(/7 Square Footage of Project Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design Section 6--Project Specifics (] Wising ❑ Oil Tank Storage ❑ Smoke Detectors C] Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District [] Hyannis Historic District F� Old Kings Highway Debris Disposal Facility: I am using a crane E Yes ❑ No Section 7--Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8--Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required. Proposed Rear Yard. Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated:3/15/2018 Application Number........................................... Section 9- Construction Supervisor Name . Telephone Number_ 7' Ya `f() Address ,S'� City I'C-GI )�N&'- State /VIA Zip 6;n6z.� License Number , 5 ( License Type Expiration Date Contractors Email OVAU'/►&hyewe1 h1 ,2cJiEre 9 (.Cell ll 4V V- '?F9 V V ' I understand my responsibilities under the rules and regulations for Licensed Constrktion Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required . 0 CMR a 4h To fBarnstable.Attach a copy of your license. Signature Date G Section 10--Home Improvement Contractor Namel"1 Ley214� ��1.� P �z-� U7�-Telephone Number �fo2 Q Address a City V- State�_Zip D,�►7a J Registration Number Expiration Date as lj 9 I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts t Building C e I u stand the construction inspection procedures,specific inspections and documentation require y CM f. To n f Barnstable. Attach a copy of your H.I.C... Signature Date Z/ Section 11 -Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable, Signature Date APPLICANT SIGNATUn-v Signature Date*- al� Print Name I P"W hone r p Number &q-�7-11c&D Telephone E-mail permit to: Ql}fin �-►ll e w ee, her t zaf-��� @ n l Fast updated:3/15/2018 r� Section 12 — Department Sign-Offs Health Department Zoning Board (if required) Historic District ❑ Site Plan Review(if required) El Fire Department Conservation For commercial work,please take your plans directly to there department for approval Section 13 — Owner's Authorization L S fC.., , as Owner of the subject property hereby authorizV to act on my behalf, in all matters relative to work akhorized by this building permit application for: S (A dress of job) Signature of Owner date Print Name Last updated:3115/2018 r DocuSign Envelope ID:B1513D12-9E52-466A-A37F-8DC7A5AAA8AA Town of Barnstable Regulatory lakes Ruilding Division. Tom ferry,Ruil€ing Ca aa Ir 200 Main Street,Hyannis,MA 02601 wivVy.town.barnstable—ma.us Property Owner MustComplete-and gaThis Se,ctioil i Ray Sylva; F?s ovmer bj 'Y. hereby ado ze�q.. 1 C�/ -LV Q�'1'�"� 'l!!A _l y—to ao..p ii any'behalf,. m9JI mamers relative to work authorized by this Odin permit application for 5harrington way yak. a ate.�z s a the te-sp6 �y t i c to ' 1 are 1 130 1 t W.bh Me or utilized tye- oie fence _s` wed and,all . ins .ecri s are performed and aco�ptcd_ Foocusiyn�by: � sy�ta v of,Ap�lka�n Ray Sylvia PITim Name, Punt CS 4/13/2018 1 6:30 PM EDT Date .......... . f - The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electriciaus/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeL-ibly Name (Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC. Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): I.E]I am a employer with 16 employees(full and/or part-time).* 7. New construction I am a sole proprietor or partnership and have no employees working for me in 8. E] Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.Fj I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E] Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.E]Other INSULATION 6.F�We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:STAR INSURANCE COMPANY Policy#or Self-ins.Lic.#:0849257 00 Expiration Date:4/4/19 Job Site Address City/State/Zip �0_4,AJ.T Attach a copy of the workers' compidsation policy dec ration page(showing the policy n ber and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t e pains and pen 'es of jury that the information provided above is true and correct. Signature: Date: 6 f Phone#:508-567-42 0 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: h f f a { �✓v ..�;.: � !•~%��,�? � f'i?�2�?'t�C�/1�Z;�,t.�'�t/l/��2 , � ��i���fi G`��2.�1,�i�� �' Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, M ss husetts 02116 Horne lmprovem tractor Registration Type: Corporation R ALTERNATIVE WEATHERIZATION,INC istration: 175683 rut tf 2 LARK ST t` -�-` Expiration:' 05/28/2019 FALL RIVER,MA 02721 L .- Update Address and return card. Mark reason for change, _,... ...,_ �i1...��{3LE.4�..,n.'�t'SS£L►da1 n Ftn ...... . .............,..........................._........ ............,.......�.. ._, -'ry Office at Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Cor=abon before the expiration date. If found return to: ff s4trolon 9xWnitim Office of Consumer Affairs and Business Regulation ,µ % 17b683 05128/2019 10 Park Plaza-Sufis 5170 ALTERNATIVE WERTHERIZATION,INC. 5n;,MA 02116 TIMOTHY CABRAL ---- 2 LARK ST FALL RIVER,MA 02721 Undersecretary O't V fltl#Si BhJ I I ALTEWEA-01 SNERONHA CERTIFICATE OF LIABILITY INSURANCE °A 03/231201 231201 "' 8 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 B1'THIE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED 1 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. ' If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). 'PRODUCER CT Christine Costa .Mason&Mason Insurance Agency,Inc. PHONE FAX 458 South Ave. (AIC,No,Ext):(781)447-6531 c No):(781)447-7230 :Whitman,MA 02382 ;was:ccos"masoninsure.com INSURENS)AFFORDING COVERAGE NAIC N INSURER A:Evanston Insurance Co. 135378 INSURED (INSURER B:Safety Indemnity 33618 Alternative Weatherization,Inc. INSURER C:Star insurance Company 118023 2 Lark Street 'INSURER 0: ~ Fall River,MA 02721 i INSURER E INSURER F: v i COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AC}St.iSUBR POiJCY EFF POLICY EXP TYPE OF INSURANCE INSO!WVD POLICY NUMBER IMMIDD/Yyyy)i LIMITS A ' X I COMMERCIAL GENERAL LIABILITY ?c 1,000,000 EACH OCCURRENCE I S C AiMS•MADE '" X OCCUR { 3C4208$ `0$10712017,0610712018,DAMAGE TO RENTED 100,000! i _ X i X PREMISES(Fa occurrence) s, ME (Any Any one person) is 5,0001 PERSONAL&ADV INJURY is 1,000,000i GEN'LAGGREGATE LIMIT APPLIES PER I i GENERAL GGREGATE I s 2,000,0001 POLICY P � W LOG 2,000,000i JCT •_- i I 1 PRODUCTS-COMPIOPAGG $ '.,._,. OTHER. B f AUTOMOBILE LIABILITY i f ,COMBINED SINGLE LIMIT 1,000,000� — ANY AUTO }( j i6237702 04/08/201$104/0$12019 j BODILY INJURY(Pet person) 's OWNED FX.SCHEDULED II AUTOS ONLY , AUTOS i I BODILY INJURY Per accddeni S I i X 'HI 's(NON.O�lvEO i ` ; I PROPERTY DAMAGE a AUTS ONLY AUTOS Di�H I ; {Per I ' s 1,000,000 A l UMBRELLA LIIA13 X OCCUR I EACH OCCURRENCE i s µX EXCESS LAB — CLAIMS-MADE X X IXOBW7126517 0610712017 10610712018;AGGREGATEa W W 1,000,000 i DEO i RETENTIONS I I is C i WORKERS COMPENSATION j X i STATUTE I ERH i AND EMPLOYERS'LIABILITY YIN WC0$d9257 04/04/2018 i 0410412019' S00 0001 j ANY PROPRIETORIPARTNERIEXECUTIVE - I ? E.L.EACH ACCIDENT NT i s .., ' . FriCER MEMg£R EXCLUDED, N I I.N I A Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE,S if yes,descries sataer ± 500 OflO; —..� DESCRIPTION OF OPERATIONS below I f-- 1 E.L.DISEASE-POLICY LIMIT is , I i i I I i i I 1 I 3 � � I + I DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES(ACORO 101,Additional Ranmrks Scheduie,nmy be attached I(more space is required) ;Action Inc.and NGRID USA,its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary& :Noncontributory basis per the terms and conditions of form CG2001(04113),for Ongoing Operations per the terms and conditions of form CG2010(04113),for ;Completed Operations per the terns and conditions of form CG2037(W13)and Waiver of Subrogation applies per the terms and conditions of form MEGLO241.01(04-11). I 1 ' :Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02116). `Excess Liability is a following form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NGRID USA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 40 Sylvan Road ACCORDANCE WITH THE POLICY PROVISIONS. Waltham,MA 02461 , j AUTHORIZED REPRESENTATIVE ACORD 25(2016103) I ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD -ALTERNATIVE .5ho k VOW WEATHERIZATION Date co Town of Barnstable -o jPM 200 Main 5t. -o Z Hyannis,MA 02601 y, UJ �p Re: Permit W . C,A, rl �S The insulation work at has been completed in accordance with 790 Agency work performer)for E � Reprds Timothy Cabral; ; President CSL-105454 58 I)rKINSON STREET I FALL RIVER,MA 02721 I (5W)5674240 I AUERNATNEwEXHE R1ZAMON@GNWL.COM I Town of Barnstable .Permit#�;LI-T&5q) Expires 6 rmontlrsfront issue date a a Replatory Services Fee a � SARNSTAHIY, a '""9. Richard V.Scali Interim Director (n Building Division ` Tom Perry,CBO,Building Com is3iong, pr- 200 Main Street,Hyannis,MA 02601 I� www.town.bamstable.ma.us NOV 0 8 2017 Office: 508-862-4038 r Fax: 508-790-6230 EXPRESS PERMT APPLICATION - RE A .A Not Valid without Red X-Press Imprint Map/parcel Number $g — 00 Z, , p Property`-Address (Residential Value of Work S 1 3, (p S Minimum fee of S35.00 for work under$6000.00 , Owner's Name&Address A Y S Y ✓t G� C��°�"�� Sy�✓i a� f{i to-n vtd/t /11 S Contractor's Name? OAT Q-�w Telephone Number lot-Ill`6.W i Home Improvement Contratlor License'(if applicable)//2 7 g� Email: Construction Supervisor's License'#(if applicable) Xvorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name . 1Q4T1VA#L 1 / joAJ Worktnan's Comp.Policy ii s s Copy of Insurance Compliance Certificate must accompany each permit. Y Permit Requ t(check box) / Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 39e A/1 Gt /nV 4 i ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ` ❑ Re-side ❑ Replacement-Windows/doors/sliders.U Value (maximum 33).9 of windows of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 4heie required Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ,.--Note: Pope caner must sign Property Owner Letter of Permission. o y f the Home Improvement Contractors License&Construction Supervisors License is it SIGNATURE: Q:IWHILESWORWbuilding pe ' fo E 1 TRESS.d c _ Revised 0613 U 1�� '�3 f Home Depot Contractor License Numbers: MA: 107774, 112785 Salesperson Name and Registration Number: Christopher G. Read : R-1-073-13-00024 Home Improvement Agreement Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Customer Information: Ray Sylvia lvia [New England South 10473643 First Name Last Name Branch Name Lead# 5 harrington way hyannis ma [�Hyannis MA 02601 Customer Address city State Zip 1(508) 827-7959 Home Phone# Work Phone# Cell Phone# nantucketcowboy@comcast.net Customer E-mail Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address city State Zip or Email CustomerCancellationNorthEast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A different CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR PROFESSIONAL, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Ackno dged by: X 10/27/2017 Fu—stomer's Sigkaffire V Date 1 f!}P T F3oar ar Biai� fissgta "sons aidasis R�MALDO:SOLAN.0 763'iNAYERLY$t RED FRAMINGHAM MA 01703 Department of Industrial Accidents Office of Investigations 1 Congress Stree4 Suite 100 Boston,MA 02114--2017 >www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant.Information Please Print Lem'b Name(Business/Organizatongndividual), Address: 74,3A City/State/Zip: l 6170'Z Phone#: Are you an employer?Che%2V the appropriate box: 'Type of project(required):L❑ I am a employer with . 4• ❑ 1 am a'general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' ,. insurance.$ q ❑Building addition comp.[No workers' comp.insurance required.] 5:❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 I.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 1-2.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.❑Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: .t I Job Site Address: 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 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 verage verification. I do hereby c u t e airs a4f&axes 2cmum that the in ormation provided above is ue and correct Signature: - _ _ Date L j 7 Phone#: ,5Z B- MO -I f3 qg Official use only. Do not write in this area,to be completed by.city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M `,. The Commonwealth of Massachusetts Department of Industrial Accidents r, Office of Investigations W-0 1 Congress Street, Suite I00 I: Tt=.`' Boston,MA 02II4-2017 www mass.gov/dia Workers' Compensation Insuraumbers uce�idavit: �uaiders/Coaatractors/Ele�Please Print Le ibiv Applicant I>aforanation - The Home Depot At-Home Services Name (Businessloreanization/Individual): Address: 908 BOSTON TPK City/State/Zip: SHREWSBURY,: MA 01545 Phone 4: (508)942-6942 Are you an employer? Check the appropriate box: Type of project(required): 200+ 4. I am a general contractor and I 5 New construction 1`-(I am a employer u�th have hired the sub-contractors L.�J employees (full and/or part-time)-* 7. ❑Remodeling listed on the attached sheet. 2.❑ I am a sole proprietor or partner- These sub-contractors have 8. (]Demolition ship and have no employees employees and have workers' 9 Building addition working for me in any capacity. comp- insurance [No workers' comp. insurance s co area corporation and its 10.[]Electrical repairs or additions required.] officers have exercised their 11.p) um ng repairs or additions - I am a homeov�mer doing all work rigltt of exemption per MGL l 2. Roof repairs myself. [No workers' comp- c- 152: §1(4).and we have no ,]= 13.❑Other insurance required employees. [No workers' comp. insurance required.] »Anv applicant that checks box"I must also fill out the section below showing their workers-compensation policy information. it Homeo«mers who submit this affidaa attached an additional dicating they are sheet sho�non the name of the sub-contractors and state woing Ihetherrk and then hire outside contractors must submit a eor nog those rentities ha such. =Contractors that check this box muolio°number- employees. If the sub-contractors have employees.they must provide their workers comp.p I am an employer that is providing workers'compensation insurance for my employees. Below is the police and job site information. -. NATIONAL UNION FIRE INSURANCE COMPANY Insurance Company Name: XWC 65831 45 (QSI) Expiration Date: 03/01/2018 Policy#or Self-ins-Lic.#: �� • (C 1� 0 Y1 W� City/State/Zip:/-r\l�n/« Job Site Address: expiration date). Attach a copy of the workers' compensation policy eclaration page(showing, policY to the on ion of criminal penalties of a Failure to secure coverage as required under Section 25A well MGL c- 152 can lead e form of a STOP WORK ORDER and a fine Fa - ,� aloes m fine up to$1,500.00 and/or one-year imprisonment as well as civil pen e violator. Be advised that a copy of this statement may of up to$?50.00 a day aga be forwarded to the Office of Investigations of the D r in ce coverage verification. I do hereby certify untlze gins a Td f perjury that the information provided above is true and correct • � Date: � 9_ 1 Simature: ` Phone#: EeDnly. Do not write in this area,to be completed.by city or town official. Permit/License# Town- Issuinghority(circle one): Health Z.lguilding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Phone#: rson: f Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Update Address and return card. Mark reason for change. ❑ Address ❑Renewal ❑Employment ❑ Lost Card __- -- office of Consumer Affairs&Business Regulation --— HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SuDQlement Card before the expiration date. If found return to: •. Reciistration Expiration , Office of Consumer Affairs and Business Regulation =_ 112785 04/22/2019 10 Park Plaza-Suite 5170 ROME DEPOT USA INC Boston,MA 02116 ANDREW SWEET 2455 PAGES FERRY.RD C 11 HSC C d ithoU signature ATLANTA,GA 30339 Undersecretary p I DATE(MMIDDIYYYYI ACC)R ® CERTIFICATE OF LIABILITY INSURANCE ozvr l7 TE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND OR CON ALTER THE C S No RIGHTS OVERAGE AFFPON THE ORDED ByTHE PO GIES CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, gELpW. 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, In Policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). cONTACT PRODUCER NA MARSH USA INC. PHONE a No TWO ALLIANCE CENTER � No.A 3560 LENOX ROAD,SUITE 24DO I ATIANTA.GA 3M26 INWRERIS)AFFORDING COVERAGE NAIC I old Reps tikImMIlm CO 124147 1004 92-HmneD GAW-17-18 INSURER A: y 2757 INSURER St A9"Ger�1 Insurance Company INSURE THE HOME DEPOT,INC. 123841 INSURER a:New Hampshire Ills Co HOME DEPOT U.S.A.,INC. 2455 PACES FERRY ROAD INSURER D: BUUING G20 INSURER E ATLANTA,GA 3D339 INSURER F COVERAGES CERTIFICATE NUMBER: ATL-W3746387-14 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CERTNI).fi MAY SED NOTWITHSTANDING Y REQUIREMENT. TERM OR INSURANCE AF AFFORDED BY THE PANY ITION OFNTOLLIICIES DESCRIBED CT OR OTHER HERE N IS UMENT WITH B SUBJECT TO ALL O HE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCJOUED F PAID CY CLAIMS. umrm ILSSR TYPE OFINSURANCE POLICY NUMBER I M MMIDDIYYYY � MWZY 310022 03MIrM7 03MI12018 EACH OCCURRENCE s A X COMMERCIAL GENERAL LIAeILITY 1,00iI,00D PREMISES Eoo=mncal S CLtuMSMADE �OCCUR LIMITS OF POLICY XS ME FXP(A,er one person) S EXCLUDED PcRSONAL 8 ADV INJURY S 9,ODD OOD QF SIR 51M PER OCC 9,OOD,D00 GENERAL AGGREGATE S GENL AGGREGATE UM:T APPUFS PER: .RODUCTS-COMPIOP AGG S 9,000,ODO X POLICY JJEECOT LOC S OTHER' MWT6310021 031012D17 031p112D18 161NED SI LIMIT s 1 OOO,D00 Ee artraa A AUTOMOBILE LWAILIl'Y BODILY INJURY(Per Pelson) S X ANY AUTO BODILY INJURY(Per a¢hdem) S ALL OWNEO SCHEDULED SELF INSURED AUTO PHY DMG PROPERTY DAMAGE .AUTOS s AUTOS NON-0WNED F8r HIREDAUTOS AUTOS - s EACH OCCURRENCE s I UMBRELLA LIAR OCCUR AGGREGATE S r EXCESS LAB CLAIMS-MADE S DEp RETENTIONS p310112D17 ONI12DIB X PER SEA ERH B WORKERS COMPENSATION VA AND C49112300(TN) 1,0pp,ODD AND EMPLOYERS!LABILITY Y 1 N WC OB102423(AKNHAJ,Vn D3N112017 031D112D18 E L EACri ACC►D3Ji S C .ANY PROPRIETOWARTNOWExECUrn1E .a NIA I TA112018 1,UD00 OFFICERMIFMBEP EXCLUDED? WCM102424(W C (Mandatory InNiq 1,000,DD0 yyeess Cen6nued an Addi�rml Page .E L DISEASE-POLICY LIMri S DESCRI O OPERATIONS emow DESCR CEON OF OPERATIONS f LOCATIONS 1 VEFUCLES(ACORD 1a1,Auunjona,Remake Schedule,maybe at®thed It more abate ffi requked) EVIDENCE OF INSURANCE CANCELLATION CERTIFICATE HOLDER HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE 'THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WETH THE POLICY PROVISIONS. ATLANTA,GA 30339 i AUTHORIZED REPRESENTATIVE of Marsh USA Inc Manashi Mukheryee l ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 100492 LOC#: Atlanta ACC ADDITIONAL REMARKS SCHEDULE Page 2 of s k.—� AGENCY NAMED INSURED MARSH USA,INC. HOME DEPOT U.SA,INC. DOA THE HOME DEPOT POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C•20 ATLANTk GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE Certificate of Liability Insurance Workers Compensation Continued: Carrier:Indemnity Insurance Company of North America Policy Number.WLR C49112294(AL ARFL ID,IA,KS,KY,LA.MS,MO,NE NM,ND,OK,SC,SD,WV,WY) Effective Data:03101017 Expiration Date:03101018 (EL)Limit S1,000,000 Cartier:New Hampshire Insurance Company Policy Number.WC 023102422(DC,DE HI.IN,MD,MN,MT,NY,Fd) Effective Dale:031012017 Expiration Date:03ro1r1018 (EL)Limit S1,0D0,000 Cartier.ACE American Insurance Company Policy Number.WCU C49112292(QSI)(AZ,CA,IL NC,OR,VA,WA) Effective Date:03101017 I s t Expiration Date:03f0112018 (EL)Limit S1,0D0,0M SIR$1,0D0,000 SIR for the states of AZ,CA,IL NC.OR VkWA Cartier.National Union Fire Insurance Company Policy Number.XWC 6583144(QSl)(CO,CT,GA,ME,MI,NV,OH,PkUT) Effective Date:03101/2017 Expiration Date:030018 (EL)Ludt:51.000,000 S1,000,000 SIR for the states of CO,ME,NV,MI,OH,PA,UT S750,000 SIR for tits state of GA S350,000 SIR for the stale of CT Cartier.National Union Fire Insurance Company Policy Number.XWC 6583,45(OSI)(MA) y _ Effective Date:031012077 /t Expiraton Date:031012018 (EL)Limit S1,000,IRID SIR 5500.000 TX Employers XS Indemnity: Canierllfinws Union Insurance Company Policy Number.TNS C48613202(TX) Effective Date:03/012017 Expiration Date:03101/2018 (EL)Limit S10.000,000 SIR 51,000,000 ACORD 101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD n Cps� rt� •? � ..F.- .s: � - :: Town of Barnst b le vAV )�Uildins el t,eet�A� . dPlans,llllust be.Retained ari` ' , p�,o � >�,. y.;.. .:,.. >.,.�. A , �: ,:: .ks -,rz•:; _ '_�, ,..: ,x 46 Pos ed Untii Fi.al i;s .ectionHas - ., �,, PCrmit.No B-17 3315 Applicant Name. CAPE COD INSULATION, INC: ._.. ,.. _... _.._.. _.._....._...__, Approvals Date Issued: 10/13/2017 Current Use = Structure n Perinit`lype. 'Building Insulation-Residential " Expiration Date: "-'04/13/2018 Foundation: Wcation 21:HARRINGTON WAY,HYANNIS Map/Lot 288 091 Zoning District:- R13 . Sheathing: Owner on Record: MAGEE,RICHARD A " ,�; Contractor Names CAPE COD INSULATION,INC Framing: 1 Address: 21 GODDARD ST Contractor License '153567 2 QUINCY, MA 02169 Est Protect Cost: $4,400.00 Chimney: Description: weatherization Pe`rmrt Fee: $85.00 Insulation: -Project Review Req: Fee Pald $85.00 Date 10/13/2017 Final: 77 IF r yd, ., y -: Plumbing/Gas Rough gh Plumbing: 'n uu F i Building:uildin Official Final Plumbing: This permit shall be,deemed abandoned and invalid unless,the work authorized by this permit is commenced within s�x"rnonths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applitat on ndthe approved construction documents 6?Which this permit has been granted. � k �@ � .,. Final Gas: All.construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. _ This permit shall be displayed iri a location,clearlyvisible,from access streetor.road and shall be maintained open for public ct n for the entire duration:of the work until the completion of the same. + � z Electrical � a The Certificate Occupancyof. will not be issued until-ail;applicable signatures by the 13uiIiIding 5nd Fire Officials are`'prouided on this permit. � � Service:. Minimum of Five Call Inspections Required for All Construction Work Rough: 1.Foundation or Footing _ ,,. . ,. .r 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) - -- -- - 6.Insulation Low oFinal: 7.Final Inspection before Occupancy. ., -_ L Voltage Health pp pPlumbing,and Mechanical Installations. Where:a licable;separate permits are required for Electrical, , , Work shall:not.proceed until the lnspector:has approved the various stages of construction - . Final:.,,- until rPe r Fire De artment 4., rso:ns;contracting wlth:unregl$teree�eontractors,do.:not.hJii6 access to the guaranty€untl (as set forth in MGL c:142A). P Final: Building plans are to be available on site :._. . .,, All.Permit`Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 13 1�1� 16y 1 4?15 Map $ Parcel 04 1 ..c &.)7-Application # Health Division: SEP.2 2g, Date Issued D 3 Conservation Division TOWW p,_ �, ^ 7 Application Fee l�, Planning Dept. Permit Fee ' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 9?I �r9/2 Village Owner 0 iCXylio d Wd j? tee. Address Telephone Permit Request /dzrJ25dZ1 bq S ,I' / Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District, Flood Plain Groundwater Overlay Project Valuation Q b fQConstruction 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 ;Y-No On Old King's Highway: ❑Yes ONo 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 /' � ' �� �s.��o�� v/� Telephone Number ✓ 22 5� Z/ 9L Address �/ ,zi"/—J 44fL- License # Home Improvement Contractor# 1-4 "_3 5% 1-7 Email Worker's Compensation #�G��d/J 44-`7/ro Z, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 10A.1-)2i v SIGNATURE DATE ZZ/ 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. Town of Barnstable ,Regulatory Services _ crew = Riebard V.scab,Director i6s9' DaUding Division Tom Perry,Building Commissioner 200 Maas Street,Hyannis.MA 02601 viww.town.banniable.mmus 01E= 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Scction If Usin A W- dex 1, (fi•'(,h po gn ff- -)- as Owner of the subject nropeny hereby authorize _ to act on mybehalf, in all matters relative to work authorized by this binding permit application for. (Address of job) f "Pool.fences and alarms are the responsibility of the applicant.Pools are not to be fled or utilized before fence is installed and all final inspections are,pedormed and accepted. S*M==o Owner - Signature of.Applicant 9. C.AjQ rQ M�? Print Name Print Name of � Q:P0RM:0WNix MtMWI0NPWM r i The Commonwealth Of Massachusetts Department of 1'ndustrlal Accldents kv 1 Congress Street, Sulre 100 Boston, MA 02114-2017 www,ma=gov/dla Workers, Compensation Insurance Affidavlo Builders/Contractors/Electrlcians/Plumbers, t InNrma don TO BE FILED WITH THE PERMIT`t'IN0 AUTHORITY, Name (Busmess/Organization/Individual); Cape Cod Insulation le se P Address: I8 Reardon Circle City/Statellp; South Yarmouth,MA 02664 Phone #; 608-775-1214 Art you an employer?Check the appropriate bozr ----.� lQl am a employer with 48 employees(NII and/orpm-time),o Type of project (required); 2,[]1 am 11611 proprietor or partnership ertd have no empioyees.working forme In �. [] Now construction any capacity,(No workers'oomp,irouranoe roquired,) $, [] Remodeling 3,❑I am a homeowner doing all work myselt;1(No workers'comp,Inmranoe required.)t Q, ❑ Demolition 4,[]1 am a homeowner and will be hiring contraotora to conduot all work on my property, I will 10 Building addition ensure that ul oontraoton either have workera'compensation Insurance or are sole Proprietors with no srnployses, 11,[] Electrical repairs or additions S,[]1 am a general oontraotor and I have hired the sub-contractors listed on the aluohed aheet, 12,❑plumbing repairs or additions These subaontraotors hays omployoes and hays workers'comp,Insuranoo,t 13, Roof repairs 6,M we are a oorporedon and Its of';loers have exercised their rlght of sxem on par MOL o, 152,1)(4),and we hays no om to ees, p 14, Other Weatherize-- P Y No worker"oomp,insurance roqulred,) +Any applloerl th o ohecks�x l must also f111 out the section below showinMe ir workers'oompensstlon policy Information t Ilomeownen who e k tW t davit 1ndl"Ing they are doing all work and then hire outalde oontmotore must submit a new gfYidavlt lndlosttng such tConaaorors that check this box mwt attached an additional shoot showing the name of the sub.00ntraoto>s and state whether w not those entities have em Ioyom lithe sub�contraown have emplo ees moat rovide their workers'oom , lioy number, 1 am an employer'Chat is providln8 Workers I coVewatlon Insurance far my employees, Blow is the policy and 'irformution, p cy Job site Insurance Company Name; Atlantic Charter ' Policy#or Self Ins,Llo, #1 WCE00431902 Expiration Date 06/30/2018 Job Site Addresst L �� fp 4 a l Attach a copy of the workers' compensation policy declaration page(;bowinghe Policy num b nd�� Failure to seoure oovsrage as required under MOL o, xpiration date), ;,at1d/or one-year lmprlsonment, as well as alvll penalties n he form of a STOP WO1RK punishable Rp ble by a fine up to $1,500,00 day agalnst-the violator, A copy of this statement may be forwarded to the Offloa of Invest{ silo std a Inc of up to$2S0 00 a oovorage verl9oation, $ of the DIA for Insurance t do h¢reby car der t s and penaltles of perjury that the I orm.atton provldfd above is true and correct He M�'+y I 1 W I I �IWIM N r�NVYlw1'Iuw�MMM W IM 508.77 -1214 ' EContact only, Do not write In this area, to be completed by city or town o,/ylela4 nt PermIVUcense 0 thority(circle one)l Health 2, Building Department 3,City/Town Clerk 4, Electrical Inspector. Si Plumbin Ins e t g p c or rsons Phone#t moo � E�: QHy_ A in gm �m ZQ 3 ✓ � � om�� �m p Q =_ m n i Z� O U m -�e •: N v o o a a O p O Q m= 4-aX r - m -�aIJiT m m m � � � : v D7om s� m m fo Da a w a o zo cm __may 3 a l_ O Q = N �Q D3� _� m �c•-t-� O p o�-� - 3� Q AD L _t o�� � D N�ZI!O �- -�o � 3ta �C a C � -(p� o o o o zs O tQ r al i d 34 I 3f_► [ � m_ O O a � N�� - O m O � d i O 7 - m 3,, m f AC�, CAPECOD•27 KDOYLE CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDOER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or 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 Ileu of such endorsement a . PRODUCER P%JACT Rogers&Gray Insurance Agency,Inc. PHONE 434 Rte 134 A/C No Ext816.2156 South Dennis,MA 02660 mall ro ers ra .com F DN COVERAGE NAICk INSURED JNVRER ER Peerless Insur nce Com an 24198 8:Safet In urance Com an39454 Cape Cod Insulation,Inc. ER C:Endurance American Speclalt Insurance Company 41718 18 Reardon Circle South Yarmouth,MA 02884 N RER •Atlantic Charter Insurance Company 44326 INSURER E INSURER F: COVERAGES CERTI IC E NUMBER: E ISI N NUM BE : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP A X COMMERCIAL GENERAL LIABILITY LIMITS CLAIMS-MADE OCCUR EACHO OCCURRENCE 1,000,000 CBP8263063 04/01/2017 04/01/2018 DAMAGE TO RENTED 100,000 ME DEXP An n n 5,000 E NAL AD 110001000 E 'LAGGRE TELIMITAP ES PER; N A AGGREGATE 2,000,000 X POLICY�M- El LOC OTHER: P D T OMPI PA 210001000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO 6232707 COM 02 04/01/2017 04/01/2018 BODILY INJURY Per arson WNED SCHEDULED IURTEODS ONLY X AUOTNOOSWNED X AUTOS ONLY X AUTOS ONLY B DILY IN URY Per eccidenl I�e�eccRdenl AMAOE C' UMBRELLA LIAR X OCCUR X EXCESSLIAB CLAIMS•MADE EXC10006635002 EACH C URREN E 2,000,000 04/01/2017 04/01/2018 2,000,000 DED RETENTION$ -6QQREGATE D WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY �Y'LNj� X OTH- A�FFICER MeIMBOERIEXCLUDED?ECUTIVE I :N I N I A R/O WCE00431902 06/3012017 08/3012018 (Manila cry in ) L"`JI EACH D T 1,000,000 Ilyes,'escr1be under E.L. •E MPL EE 1,000,000 DES RIPTI N OF OPERATION below E.L.DISEASE-POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Addltlonal Remarks Schedule,maybe attached If more space Is required) Workers Compensation Includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, CE IFICAT Q LDE C C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Thlelsch Engineering Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 195 Frances Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Cranston,RI 02910 AUTHORIZED REPRESENTATIVE ACORD 26 2016/03 ( ) ®1988.2016 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD Ple ry it �W Town of Barnstable *Permit# Z6,156 7 Z Z Expires 6 months from issue date �7 Regulatory Services Fee w snxxsrnsie, % �oA� M"�' Richard V. Scali,Director s63q. . D® .erFO�p Building Division Nov 1 14 Tom Perry,CBO,Building Commissn, 0 6?®'�f 200 Main Street,Hyannis,MA 02601 ,,UU F BA RI UJ TABLE r p www.town.bamstable.ma.us `E Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ��/ G� Not Valid without Red X-Press Imprint Map/parcel Number by 0- _ ` ` Property Address N]Residential Value of Work$ fl 0 QQQ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name ��T J(U!L�11 u(� Wyr1�U I y&Telephone Number 5-OR 4 7/4 m Home Improvement Contractor License#(if applicable) 174 % / ® Email: 1A)fiU)?,-r,#7-Ra L 0g ' W Construction Supervisor's License#(if applicable) / Qq f Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# ,�(/� �'J %Q Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. \*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 co of the Home Improvement Contractors License&Construction Supervisors License is re red. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 1 Ile Commoniveaith o,f Vassachusetts Department of Industrial Accidents - Office of fm cstigations 600 Washingion Street :. Boston,MA 02111 wym namgovIdia Workers' CampensatiGn Insurance Affidavit:BunildersiC+antractursJEIectricians/Plumbers Applicant Infai—.atian Please Print f;eQibly Name�sos�esst�Drganizabon�ndividUa4}: T/�'T�FJ �11�L���� �eT 1'l�ryY� � Address: 77 —k Lc= L3 , So e H City/statelzip.: k�S T CVV1 S h6 ©V620phone,� 9)3 Zr 7/ C/1/ Are you an employer?Check the appropriate box: Type of project(required).:1. am a employes xRtb 2/, 4. ❑I am a general contractor and I employees(full and/or part-time)-* have lured.the sub-contractors 6. ❑Idew construction 2.❑ I am a sole proprietor or partner- listed on the attached sheen. 'I- ❑Remodeling ship and have no employees. . These sub-contractors,have g. ❑Demolition woddn; few me in any capacity. employees and have workers' [NO Workers,Camp. rac�xanre Crimp_insurance,1 �. ❑Building addition required-] i 5. ❑ We are a corpora ion and its 10_❑Electrical repairs or additions 3.❑ I am.a homeoumer doing all work officers have exercised their 11-❑Plumbingrepairs or'additions m3rsel€ [No workers'comp- right of exemption per MGL try.❑Roof repairs insurance required.]'s c.152,§1(4X and we have n6 employees-[No workers' 13.❑other camp.insurance required.] 'Any WKcsatfat checks box 01 must also fal cut the sectionbelawshov ing iheirwaAeW compeasatiaupaHcyinformauc� I Iiomeowzwzs who suborn this d5d2tft indicating they are doing all wcA anti then bare ouCside contractors mast submit anew affidavit indicating such- fCantrwtors that check This bra must attached an additional sheet shovrffig the name of the sub-cars and state whether ar not those entities hue employees.If the sub-contactors have empIoyees,they mnstpmvvide their workers'ramp.policy number. I am an eutployer that isprmiding workers'congwisatfon fimirauce,for iny enrplvywes Below is the policy ar d job rigs fnfor madfom Insurance Company Name: -FRO r a Policy 4 or Self-ins.Lic.9: � U —�3��d _4—/� F-kpindo n Date: S/2o/,r, Job Site Address: � W-WIV6 /Uo U/R- City/State/Zip- ��Uy�s � �1� 0,?e,0� Attach a copy of the workers?compensation policy declaration page(showing the policy number and expiration date). Failure to secum coverage as required.under Section 25A of MGL c- 15-can lead to the imposition of criminal penalties of a fine up to$1,500-00 and.'or one-Dear imprisonment,as well as chril penalties,in the form of a STOP WORK ORDER and a RM 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 Invest gations.ofthe DIA for insurance coverage verification. I do IterRby c�erhf}�, er tF artd peiiabies ofper,jury that fire information ptvi ided/abo v is erne arrd correct Sitaahsre: Date: Phone 9: J`/t) `f 7r Offleiai use only. ,Do not write in this area,to be camplated by city orfown official, City or Tomm: PertmitlLkense if Issuing A,nthor€ty(circle one): 1.Board of Health, 2.Budding Department 3.Citp/Town Clerk 4.Electrical Inspector S.Plumbing Inspector G.Other Contract Person: Phone it: Information and Instructions Massachusetts Gebeaal Laws chapter 152 req¢ires all eroployers to provide warmers'compensation for their employees. es. this Mute-,.an.=q7I°3'r---is deed as."_.every person in the sea vice of another udder any contract of hire, � express or implied,oral or written_" An ezrTFayEr is defined as"an individual,partnership,association,corporation or other legal errtdy,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 tie.occupant of the - dwelliug house of another who employs persons to do mafi ttmce,construction or repair work on such dwelling house or on the grounds or building appurtenant thtmt o shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(S)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 edmpliance with the insurance.coverage required." Additionally.MGL chapter 152, §25C(7)states"Neither the commaaw•ealth nor any of its political subdivisions shall ce. ce o ubIic work until table evidence of compliance with the Tn�**� . i for the erfonnan f as;cep enter into any contract p p r ents of this chapter have been presented to the contacting aufhc>dty." A.ppficants Please fill out the workers'compensation affidavit completely,by checking tht boxes that apply to your situation and,if ec nessary,supply sub-contractor(s)name(s), address(es)and phone numbers)along with their certif cate(s) of Liability Companies or Limited Liability Partnerships(LLP)with no employees other than the T„c-r�rt:e. Limited .� mp (LLC� members or partners,are no required d to cagy workers' compensation insurance. If an LLC or LLP does have . • this affidavit maybe submitted to the Department of Industrial employees,.a policy is required. Be advised-ed that. Accidents for confirmation ofmsurance coverage. Also be sure to sign and date tie affidavit The affidavit should be refrrmed to the city or town that the application for the permit or license is being requested,not the D epartm.eat of In ri-r,ctri aT Accidents. Should you have any questions rega-ding the law or if you are requ iced to obtain a workers' compensation policy,please call the Department at the number listed below. Self-instized companies should enter their ce license number on the self-m�� apProPriatr.line. City or Town Officials . t - Please be store that the affidavit is complete and pried legibly. The Department has provided a space at the bottom 'ons has to contact you ding the applicant e affidavit for you to fill out in the event the Office of Investigafr Y �'u' _ of ffi . . Y Please be sun-e to fill in the pen it/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit Ucense applications in any given year,need only submit one affidavit indicating current policy inffbrmation(if necessary)and under"Job Site Address"the applicant sh0T1 d write"aII locations n (cit or town)_"A copy of the•affidavit that has been officially stamped or mmiced by.the city or town may be provided to the applicant as proof that a valid affidavit is on file for firttae peamiis 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 rvIah-ed to complete this affidavit: The Office of Investigations would at 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 Gaunt lth of Massachusi--tts Department cif lzidustdal A 0i dents Of tee of kve&ti9atio.� 60G,wasbivml Strut Qstan,MA U2111 Te,-L 4 617 727-4900 Qxt 4-06 car 1--9 MASSAFF Fat 617-727 7749 Revised-¢24-07 mass-gavldia. r o� • RAJWsz.+al.E. 9� ' ,m� Town of Barnstable ArED MA'1� Regulatory Services Richard V.Scali,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 a Prop rty Owner Must Complete and Sign This Section. If Using A Builder as Owner of the subject property hereby authorize 2k) /2 VIE Ta1— iT/AI 30/4,RIV& to act on my,behalf in all matters relative to work authorized by this building permit application for: (Address of Job) Pot" a— igna f er Date 46 Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable Regulatory Services IHE rO Richard V.Scali,Director Building Division * snxxsrasr.E Tom Perry,Building Commissioner MAM 1659. �� 200 Main Street, Hyannis,MA 02601 prEO www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: - city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner - a Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fonms=RESS.doc Revised 040215 f e Lnrranzty�eue���l1¢ C- �a �cafccreCta License or registration valid for individul use only .C\-. Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR Type Office of Consumer Affairs and Business Regulatii - istration: 176970 10 Park Plaza-Suite 5170 expiration: „10/1812017 Corporation Boston,MA 02116 TATRA BUILDING COMPANY INC.. - JAN KVIETOK 775 RTE 28 SUITE H Not vali without signature WEST DENNIS,MA 02670 Undersecretary I Department of public Safety I Massachusetts - P t 4 Standards Board of Building Regulations a Construction Supenisor +, :+ } Licenser CS-�t9�9 JAN KV ETOK - s 32 IACKw OOD DR SOM DFNNLSMA - Expiration 2016 Commissioner 1 CERTIFICATE OF LIABILITY INSURANCE DATE(MNUDDm Fos/Os NY /2o1ss THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEOATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE QF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: IF the certificate hojW is An ADD ONAL INSURED, the policy(o3n? must bC godorsed. If SUBROGATION IS WAIVED, subjoct t0 the terms and conditions of the polity, certain Policies may require an endorsement A statement on this certificate does not confer fights to the certificate holder in lieu of such endmement(s). PRODUCER 7 PAUL SGFIL�GEII SOHLEGEL INSURANCE BROKERS INC NAME: PHONE- 508-771-8381 771-0663 34 MAN STREET q - • M, ADORESE.: SCBLEGELINSUR1WCE@Cb=L_COM WEST YAFalIbUTH MA 02673 WSUKER151 APFOROP4 COVERAGE NAIL P *MREFIA;NGM INSURANCE COMPNAY 1478B INSURED Tatra Building Co Inc [!11:RFF:B:TRAVELERS F:c: 775 haute 28 Suite H IMUREF:D: INBURESI E: A95t Dennis, MA02670 INBUREFI F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE. POL=CIES OF INSURANCE L15TED 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 PERTA)N, 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 FAID CLAIMS. A OF INSURANCE "MR ID 4rvo POLICY NUMBER (MMoNYY (M 1ry MIOONMI, LIMBS �► GE"EwuLIABIWTY HTv MPT7810M D3/19/201503/19/2016 EACH OCCURRENCE $11,000,000 X COMIERCIAL GENERAL LIABILITY PREMISES(Ea omirranca) $ 500,000 ClAlMB•MADE OCCUR MED SXP(Arry we person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 OEML AGGREGATE LIMIT APPLIES P61k: PRODUCT$-CONPIOP AOG S 2,000,000 POLICY. T LOG JEC C AUTOMo&LE LIABIL(TY MIT0170J D5/01/201 05J01/2016 anrvauro (Ee eceL1wl s 300,000 ALL ALL OWNED X SCHEDULED BODILY INJURY(Pgrp&taon) b AVrO_B BODILY INJURY(PstsoWenq 5 HM HIRED AU AVT 1rd TOS N�0PROPERTYVAMAW Ui06 (Poracdderrt) $ $ UMBRELLA 73A9 OC CjjR EAchIOCCURRENCE 5 EXCESS LIAB HCLAIMS-MAD-r AGGREGATE 5 DEO RETENTION $ $ WORKERS COMPENSATION 6TCU8-5s38009-a-12 oT. AND EMPLOYERS'LIABILITY Y td 06/05/20 06/0.5/2616 DTORY LIMITS ER ANY PROPRIETORFIFARTNeR`IEMCUTIVE E.L.EACH ACCIDENT $ 10Q,QQQ OFPIGER1MEMOPR EXCLUDED? ❑ Iff yes, NJA I yes,VM doeG5orlbe uMer In rand EL,DISEASE-EA EMPLOYEE S 1001,000 DESCRIPTION OF OPERATIONS below E.L.DWABE-P0610YLIMIT a 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEIOCLES(Attach ACORO 191,A"ItIonol Romorko gohWula,if mom"me III mgalraal JAN KVIETOK HAS ELECTED TO BE COVERED UNDER Xj$ CtlIItRENT WMI..MRS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION PAUL LT SULLIVAN 120 HAX1'ER$ PATH SHOULD ANY OF THE ABOVE (IMRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SOUTH YARbMTR MA 0266a ACC:IRDANCE WITH THE POLICY PROVISIONS. AUTHOFgZED REPREB TA nvE 508-534-1415 781-322- 008 01988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010M) The ACORD name and logo are registered me cPACORD Town of Barnstable *Permitoo/1 0064 7 Expires 6 m d me Regulatory Services Fee i s + aLL BANWABIJ& • taasa. $634. Richard V.Scali,Interim Director A�0 Mtn Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid withortt Red X--Press Imprint M'ap/parcel Number 2 8a' 0r9 2- Property Address �� N��ri n�"r0�'1 �Jrn.Y (`C Ya n/1 S (Residential Value of Work$ 3 5 ,g O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 'Ra SY 1 V CA Arrr"O!!, fo n uA —fl /4 t72-b 0 Contractor's Name ZJb Telephone Number ���' ® `6 Home Improvement Contractor License#(if applicable) ®off�o &"�.3 Email: Construction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: OCT Q El am a sole proprietor ���� ❑ I am the Homeowner TOWN OF BARNST I have Worker's�Compensation insurance ® ABLE Insurance Company Name ' Workman's Comp.Policy# 0 Y t?/0 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. G6ing'over existing layers of roof) ❑ e-side _ Q Replacement Windows/doors/sliders.U-Value . 30 (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required_ Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property er sign Property Owner Letter of Permission. A copy of H Improvement.Contractors License&Construction Supervisors License is required` 1 SIGNATURE: TAKEVIN DBuilding ChangeslE O S RESS.doc �. Revised 061313 HOME IMPROVEMENT CONTRACT �7 PLEASE READ THIS /t-�� Sold,Furnished and Installed by: Branch Nam:Boston North&South Date: - c./ THD At-Home.Services,Inc. d/b/a The Hurrc Depot At-Home Services Branch Number:31.and 33 908 Boston Turnpike.Unit 1.Shrewsbury,MA 01545 Toll Frei:877-90373768 Federal ID#75-2698460;ME Lie#C 02439;RI Cont.UC#16427 CT Lie#HIC.0565522;MA Home Improvement Contract Reg.#126893 Inartallation Address: r r irl W d �l ® ryA State Zip Purchaser(s)s Work Phone: Fiume Phone: Cell Plmn_e: [ 1 [ ] Jr , 1 Home Address: (If different from Installation Address) City State Zip E-mail Address(to receive project communications and Home Depot updates): ❑1 DO NOT wish to receive any marketing emails from The Home Depot 'Wde-t information: Undersigned("Customer"),the owners of the property located at the above installation address,agi-ca%to buy, and THD At-Home Services,Inc_("The Home Depot")agrees to furnish,deliver and arrange for the installation("Installation")of all materials described on the below and on the referenced Spec ShLet(s), all of which are incorporated iglu lttis Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(erlle:tivcly, '.Contract"): Job#'v-umv wrm P darts: S Shee s #: Project Amount } Ron ins Siding Windows ff lnsulation ✓ `V ❑Gutters/Covers Envy ikxars ❑ �b Rox>fine LJSiding 0 Todo—w-s-0 Insulation $ ❑Guucrs/Covers ❑Enntry Doors ❑ Rioting 09idinoo U Windows LJ insulation ❑Gutters/Covers ❑Entry Doors❑__.__.... Roofing Siding Windiwg Ll Im-ulatrenl ❑Gutters/Covers ❑Envy Doom [I $ Minimum 25%Deposit of Contract Amount due upon exeartian of this contracL Total Contract Amount $ Maine Purdiasers may not deposit more than one-Wrd of the Contain Amour Customer agrees that, immediately upon completion of the work for each Product,Customer will e.xe cute:a Completion Certiti.eate (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder_ The Home Depot reserves the right to issue a Change Order or leaminate this Contract or any individual Products)included bereln,,at its discacticnt,if The Home Depot or its authorized service provides determines that it Cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other Safety conLerus,.prieang errors or.because work required to complete the job was not included in the ContraeL Payment Surmim : The Payment.Summary#_ f�� / _� included as part of this Contract, sets fortli the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you-sign. Do not sign a•Completion'Certillcate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work an that,Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the crxAs of materials,labor.,expense: and services provided by The Home Depot or Authorized Service Provider tbrough the date of termination,phis any other amounts set forth in this Agreement or allowed under applicable law. THE HOME.DEPOT MAY WITHHOi.D AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT' PAYMENT OR OTHER PAYMENTS MADE., WiTHOL)'f LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. MTh and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer e Horde Depot wit regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and The Hume Depot,Customer acknowledges and agrees that Customer has read,understands,voluntarily accept~the terms of and has received a copy of this Agreement. Accepts Submit hy: �• X. J Gusto 5 Signet a Date Sales C sultant/s�Signature inns X Telephone No. Customer's Signature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THIS (as applicable) AGREEMENT WITHOUT PF,NALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATrACIIED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE,:ADDITiONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE.SIDE AND ARE,PART Or,THIS t'ONTRAI.'t' 05-14-15 White-Branch File. Yellow-Customer Tel Wti0Z:8 ZTOZ 9Z %MW TLZZZ9280S: 'ON XUJ Pe6wer: W08A f Massachusetts -Oepalment of Pubise Safety Board of Budding RsgWatrons and Standards ;:�, ��,19MIfF1�rrM�C7 �i9oFJ�fwr � n,,. Lacenae: CS-070M JSMi1 t,DVAR)-E`� rtx y r 15 FALL ST ✓ ,"` WARE pp(f MA7 7 R' i �yy� s *0 lift ., Wrmry of Conwmer A1100:R 040mi ski st ly rtjo + .Registration "132 9 � 1=xparation: 1o1 , a�'loifiNh . JC40PA Owe � F 15 mall St. Watetsarn,ma 0471 r _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-201 7 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationdndividual): Address: 1 S WIL-so AJ City/State/Zip: ! b0 & � y� Phone#: 7 7� 76L 23 Z.� Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I:nn a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 5. ❑New construction 2 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑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.❑ElectrcaI repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 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 employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submir this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such: lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insuray Company Name: Policy#or Self-ins.Lie.4: Expiration Date: Job Site Address: 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 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,4nder the paips and penaVes of er u that the in ormation provided above is true and correct Si ature: Date " Phone#: �/__777" Z 3Z Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 5.Other Contact Person: r Phone#• The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 www massg . ov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name (Business/Organization/Individual): y/ame- A 6?1 <�,cJjce S Address: qo City/State/Zip: yew s(ou r .5 Phone#: S Off - 6,19 4 Z Are you an employer?Check the appropriate box: Type of project(required): am a general contractor and I 1.[�I a>in a employer with z0t 4. ❑ I g 6. New construction employees (full and/or part-time).*_ have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. ins_urance.t 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 LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.[T16rtheritbridoki 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: L(,,:N-4a,-J1 p S i -e_ C'o Policy#or Self-ins. Lic.#: (A/C-,Q/7 7 1 y q 3 Expiration Datei 3- 1-�_c) I �_ Job Site Address: • i�ldrl_-1)4V1 (IJ6tv City/State/Zip: bf varm i S , ,A 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 aga. s violator. Be advised that a'copy of this statement may be forwarded to the'Office of Investigations of the DIA o in rance coverage verification. I do hereby certify and tl ainj and a jury hat the information provided above is true and correct Signature: Date: 1 - 7— / Phone#: - Official use only. o not write in this area,to be completed by city or town official. ti= City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r I. � Office of Consumer A hairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration -- _- - — Registration: 126893 Type: Supplement Card THD AT HOME SERVICES, INC. -- Expiration: 8/3I2016 ANDREW SWEET 2690 CUMBERLAND PARKWAY SUITE-*500 -- ATLANTA, GA 30339 - - Update Address and return card.illark reason for change. =c"' '-' 20v-0sli1i Address ,=1 Renewal i_- Employment i j Lost Card V/Le CfJNrivrJrl1?tcUea�f�a��/�GtcJJCGc�crde Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . Re istration Office of Consumer Affairs and Business Regulation 9 126893: Type: 10 Park Plaza-Suite 5170 Expiration 8!3l2016,-- Supplement Card Boston,MA 02116 THD AT HOME SERVICES INC N.`. THE HOME DEPOT Af HOME SERVICES ANDREW SWEET,-.,---:,, 2690 CUMBERLAND PARKNVAY S - a" t34`A,GA 30339 Undersecretary Nov t wit ut signature !! ® DATE( YID `� 1YY !hi ����l�l�� � ®� LIABILITY mn5Q015no,5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON.THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA,INC_ PHONE FAX TWO ALLIANCE CENTER AI No Ext AI No 3560 LENOX ROAD,SUITE 2400 -ADDRESS. ATLANTA,GA 3D326 INSURER(S)AFFORDING COVERAGE NAIL 9 100492.HomeD-GAW'-15-t6 INSURER A:Steadfast Insurance CogMrty 26387 INSURED THD AT-HOAfE SERVICES,INC. INSURER 8:ZUndl Alnencan Insluance Co 16535 DBA THE HOME DEPOT AT-HOME SERVICES INSURER C:New Hampshire Ins Co 23841 2690 CUMBERLAND PARKWAY,SUITE 300 INSURER D IQnais Natiorol 1tL5luance Company 17 ATLA�TA,GA 30339 �4 INSURER E i k INSURER F• ' I COVERAGES CERTIFICATCNUMBER: AIL-CM746646.13 ' REVISION NUMBER:e 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. ��R TYPE OF INSURANCE AOD S — ' POLICY EFF I POLICY EXP LIMITS INSD WV POLICYNUMBER I MMIDD MMIDD A I X COMMERCIAL GENERAL LIABILITY �GLO4887714-05 iO3)0112015 D3101@016 EACH OCCURRENCE S 9,OOD.000 CLAIMS•IAADE �OCCUR I i PRhAGE TO RENTW EM SES Ea occurrence S 1,00D,000 IUMITS OF POLICY XS l MED EXP(Any one person) S EXCLUDED ! 'OF SIR:SIM PER OCC 9.000.000 ' PERSONAL S ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: i - GENERAL AGGREGATE S 9.W0.00D X POLICY FRO- JECT LOC i PRODUCTS-COMP/OPAGG 5 - 9.000.000 OTHER: I7 1 I 5 B AUTOMOBILE LIABILITY I iBAP 2938868-12 10TOWD15 10302016 CFa a s d�SINGLE LIMIT S 1,000,000 X ANYAUTO I ! I BODILY INJURY(Per person) Is nuro OWNED ISCHEDULED I ;SELF INSURED AUTO PHY DMG BODILY INJURY(Peracffilent)!S AUTOS HIRED AUTOS , NON-OWNED I PROPERTYDAMAGE S AUTOS II eraccident I i i S J�UMBRELLA LIAB . I f OCCUR � EACH OCCURRENCE 5 i EXCESS LIAR CLAIM -MADE AGGREGATE 5 I DED RETENTIONS C JwoRKERs coMPENsAnON WC017731493(AOS) 031012015 03I012016 X PER OTH- i AND EMPLOYERS'LIABILITY STATULE ER C ANY PROPRIETOR/PARTNERIEXECUTIVE YIN W'017731495(AK,KY,NH,NJ,VT) �031012015 03(01)2016 1,000,00D D OFFICERIMEMBER EXCLUDED? �N/A EL EACH ACCIDENT S (Mandatory 1n NH) WC017731494(FL) 1031012015 03/012016 E.L.DISEASE-EA EMPLOY S 1,000,000 It yes,describe under Conitnued on Additional Pa a 1,Q00,000 DESCRIPTION OF ORERA31ONS below I 9 EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached If more space Is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION THD AT-HOME SERVICES,INC_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DBA THE HOME DEPOT AT-HOME SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2455 PACES FERRY ROAD ACCORDANCE W(Tkl THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc ManashiMultherjee - 3�laLvm:7l ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 09 a Application #cull/S6 (3c)SS Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee .7/, 7 Date Definitive Plan Approved by Planning Board / Historic - OKH O _ Preservation / Hyannis Ay Project Street Address Village //�� Owner c_e (cS C.• r IV Address 3 ��- Telephone 50`� a, Permit Request �S n-n (�C�c r',,Ae � L� s S c c Is PE t,-� q q,ee_ c G 6 �d-c..►m . $.�t, K l Pin c SquaEe.4feet 1-1 st floor: existing — proposed — 2nd floor: existing proposed Total new Zoning- istrict k Flood Plain Groundwater Overlay Proje�T:Valuation 1 bD Construction Type Lot Size = Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single,Family 21�_ Two Family ❑ Multi-Family(# units) Age of-Existing Structure s� L f5 • Historic House: ❑Yes &No On Old King's Highway: ❑Yes 6lo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other A//}- 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 I✓A' Central Air: ❑Yes ❑ No Fireplaces: Existing A✓A'New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new sizefi�lbol: ❑ existing ❑ new size A<+Barn: :existing ❑'news=size_ Y r Attached garage: ❑ existing ❑ new sizeI�hed: ❑ existing ❑ new size ��Other .-•„ -�, Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes j .Alo If yes, site plan review# , Current Use c5 a e � � Proposed Use 0 k,h APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name G.L bls )�614A C.� Telephone Number Address J�rcot� W4e�)�e� " C= License # C J J b 0&& 3 ` Wr- 0�-&&r) Home Improvement Contractor# Email Cb&A C- • c Worker's Compensation # VW 766 b¢66 aG�ba ALL CON RUCTTIION DEBRIS RESULTING FR M THIS PROJECT WILL BETAKEN TO Q,_d'Arng5� CA- - 5. SIGNATURE DATE FOR-OF FICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. I ADDRESS VILLAGE OWNER DATE OF INSPECTION: a FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. OWNER AUTHORIZATION Job iD: TB ` 0 2 d Location: AR R,TA &T6 ti 1/Vi4 y, y ✓��S 0 Z��� I � 1/ `/ '' as Owner of the subject property J P P Y hereby authorize_SOIREGII Corn—MC 168572/ MA Lic 1136 NM to act on my behalf, in all matters relative to work authorized by this building permit application and signed contract. S Siviture,of ner: Date: 24 St Martin Dive. Eudding 2 Unit 11 .;.a;Iburuu�!r,?:1A 01752 T (888)SOL-C!T`! F{508)460-0318 SOLARCITY.COM KC 2<3771.CA CSL E S?&:G;..CC•EC ztg1.CT HIC oF.3;77E.Df•HI.71 101d?6.K HIS 711014S;,HI CT•2977-i. , 104 HIS.16E572.1dC IdH1C 12?'.X5.WJ k'i iYG33%d4111 1 OF CCE 1'049&PA 077i13•TX TDLF 27011•0•l:d MAPC'91401 ... "�,�f�s� C!"?l�i�.•�t��`�itrr��rr��� r���w •'��r�t:lrtr�`rttJQ.,�, ' Office of Consumer Affair and Business k6 ulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement.Card SOLAR CITY CORPORATION Expiration: 3/8/2017 CRAIG ELLS - 3055 CLEARVIEW WAY SAN MATEO, CA 94402 Update Address and return card.stark reason for change. Address. Renewal * Employment I.ost Card �M1� ryes:++tt+its:rw)ir�%x e(` lleit sir l}+R wi/�J Office of Consumer Affairs&0utiness kcgulalion License or registration valid for individel use only R. expiration(late. If found return to:before the ea HOME IMPROVEMENT CONTRACTOR P k Registration: 168572 Type: Office of Consumer Affairs and Business Regulation 10 Park I la7a-Suite 5170 Expiration: 3/812017 Supptement Card Boston.NIA 02116 SOLAR CITY CORPORATION CRAIG ELLS t I ;, 24 ST MARTIN STREET BLD 2UN1 ��-.t—r'.��:_ �,•�.,. ,F ITAAIL80ROUGH,MA 01752 Undersecretary Not valiJwithuut signature - � � iit..i1C1 G�i�s:aRrf,tpil +�ivil�,±a�'e¢sn� i eat� �d�J-item •.#�.«.• GS-107053 CRAIC ELLS 206 BAKER STREM, Keene NII 03431 wens e1• a r 08f1912017 f 1`1-= <.:� n/�?•t'1 ,• te Office of Consumer Affairs nd Busss Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement.Contractor Registration ' Registration: 168572 Type: Supplement Card SOLAR CITY CORPORATION fir: Expiration: 3/8/2017 C H E RYL GRUENSTERN ---------._. -------. --- _--- F 24 ST MARTIN STREET BLD 2UNIT 11 _- MARLBOROUGH, MA 01752 _ ...... --- -- - ------- - ----- Update Address and return card.Mark reason for change. sca i t; 20M-05!11 ° Address Renewal Employment r-1 Lost Card A =%�r Y r-nrurr,irrrcrr�/�r Xrc:v//.; Office of Consumer Affairs&Business Regulation g License or registration valid for individul use only before the expiration date. If found return to: 7 ME IMPROVEMENT CONTRACTOR � P ' I < Office of Consumer Affairs and Business Regulation 'Registration: 168572 Type: 10 Park Plaza-Suite 5170 = ' Expiration: 302017 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION CHERYL GRUENSTERN 3055 CLEARVIEW WAY SAN MATEO,CA 94402 - — -- -- Undersecretary -Not valid without signature r r The Commonwealth ofMassachusetts `Q Departntefrt of Industrial Accidents t� 1 Congress Street,Suite 100 Boston,MA 02114-2017 wwMMas&gov/dia Workers'Compensation Insurance Affidavit:Burlders/Contracte s/Electriciansll'umbers. TO BE FILED WITR THE PU MiTTING AUMORITY. , Apgrant Informatiog Please Print L gdbjv Name(Busin=/OfgrmirationRndividnal): SolarCit Corporation Address: 3055 Clearview Wa City/State0p: San Mateo,CA 94402 Phone M 888-765-2489 Are you an employer?Check the ttppraprlate bnt: Type of project r YP P !ect(required): f.®t am a omplayorwitb 9000 cmployccs(full and/orparWi=e.• 7. ❑New construction 2E][am a sole proprictoror partnership and have no employees working for me in $. Remodelin tray cape6ty.[No workers'comp.insurance required.) ❑ g 3.[J 1 am a homeowner doing all work myscrf.[No workers'comp.insurance requircd.]* 9, ❑Demolition 4.Q 1 em a homeowner and will be hiring contractor to conduct all work on,,v prop.:ny. I will 10❑Building addition ensure that all contractors tiller have workers'compensation imourantce or are sole I(,❑Electrical repairs or additions proprietors with no employers. 12.E]Plumbing repairs or additions 5.[3 1 am a general contractor aad i have hired the sub-contractors listed an the attadsed slant. These sub,cantatcetashm wooyees and have workers'comp.htsuraaccl 13.oRoof repairs 6.❑We area cagwration and its officers have exorcised dick right of exemptism.per MGL c. 14.®Other solar panels „ 152,f 1(4) and we have no employees,]No workcra'camp,insurance required.] - vAny applicam that chocks boot Nl trout also fill out the saalan below showing dv*workers'eompersatian policy information. +Hosucowners wlm autuait this affidavit latikastiall they are doing elf work and than hire outside contractors must submit anew affidavit indicating such. lContractors that check this lox must attached an additional short allowing the name of the sub-contractors and state whither or not these entities hang employees. If the sub•contraetom lave employees,they most provide their workers'comp.policy number. I awl an employer drat is providing workers'eampomation insarawe for my employees Below is the policy anif Job.site information Insurance Company Name; Libea Mutual Insurance Comp an Policy#or Self-itts.Tie.#: WA766DO66265024 Expiration Date: 9/01/2015 5 Harrington Way Hyannis,MA 02601 Jab Site Address: L'itY!ytet^/'Gip; Attach a cagy of the workers'cofapengatlon policy declaration page(showing the policy number and expiration date). Failure to secure covtstaga as required under MOL c. 152,§25A is a criminal violation punishable by a fine up to$1,500,00 and/or one-yeor impiisoinimt,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2.50.00 a day against the violator.A copy of this staternmt may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ramify uad w fho minx and m wakes of perf sw that the fiaformadva proyMed above is true and wrr= Immature: �` �� �� te' May 27,2015 Phone • 781-816-7489 Offlclal asr oely, Do not write iw Yhis area,to be completed by city or town of)'kiaL City or Town: Permit/Ucau se# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: �►c R� CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTMATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENb, EXTEND OR Amp THE COVERAt3E AFFORDED RY THE POLJCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE IS8UING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: If the ceAtf GG holder Is an ADDITIONAL INSURED,the poft(fes)mist be endorsed If SUBROGATION 18 WAIVED,subject to the ts■ms and conditions of the policy,cortatn poUcles may require an andomemaet. A statement on We eartiBcate dow not confer rights to the aortlflcate holder In Ieu of such erldolsemeno PRODUCER MARSH RISK A INSURANCE SERVICES MFCT 346CALIF01144A STREET,SUITE 1=1 CALIFORNIA LICENSE NO.0437153 SAN FRANC,CA 94104 eWW-R{�_AFF"Dgr CQVHtAC+� NAIL M 9 1�57NDGJtYIR1E-1415 INSURERA: A4&WF41slr�suwmCwpM low INSURI Php0)9Ii3.5100 B.UhBrlyhW0=Corpai90 Sda C40o pOrom INSURER C.NIA WA 3D55 Cmw*w W2y RMAIR:R D: San Nift,CA PM2 r- COVERAGES CERTIFICATE NUMBER. SFX=4MS(12 REVISION Nt MBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED MAMED ABOVE FOR THE POLICY PEMOO INDICATED. NOTWUITHSTANDING ANY REQUIREIMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEW WITH RESPECT TO WHICH THIS CERTIFICATE L4hY 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. AUX mSK TYPE OF INSURANCE im mum.m AnPOIJCY Nuxa[�e PDLICr� Alon2mm IJRIY6 A eEmmAL uABRJRY TB2.66146626"14 031 0% ORM15 EACH OCCURRCNCE s 1.w wo X COl1MERCIAL GENERAL LIABILITY 3 Cm opmum melS IODMD IMS CLA -MADE X OCCUR 10.00D PEft80NAL B ADV ndJURY $.. __...• 1,000A 0 CofAERALAfiGREGATE $_ 2.�AOO GENLAGGREGATELMITAPPLIESPEW PRODUCTS-COMNOPAGG $ 2=000 x POuCY X PRo LOC OE4Bc1 $ 25AM A AuroMoelLE La►eluTY ASMtOEW444 09tl01014 09A11 15 r� c.. „s�_—_...._ 2. ... 1 UOO.OAD ANY AUTO BODILY INJURY(PorpowmN S �pV AUTOS LED 9ODILY MAW(Per acdded) $ x HIRmAVfOs XsRTIEtIOPET DAMAGEAUTO s X Phys.Dmnaga COMPICOLLDED $ $1OI10!$1,900 UNERE"UA6 OCCUR _ EACHOCCURREME $ 0C9cS um CL/UM&NADE AGGREGATE I , p S $ p WOwmRs ODLiP8mTION IWA-7-MMM ON112015 X1wC sTaTL1 oTH AND EMPLOYERS'UAMUTY - B ANY Pkf�FBETORIPARI4�XEGUTIYE YIN :WG7$61 066265-034(WQ 09A1Pl014 09A1f2015 EL.EACH ACCIDENT S I,C 8 OFFICERIMInNH)EXClUDc'D/ ala WC DEDUCTIBLE 1AROW tmO�ddowbourmw 9rScM NRI EL DNSEA9E•E A EMPLOYEE S RIONI AERATION EL DISEASE•POLICY LIMB' S 1 DESCRlnpN OF OPERATIONS I LOCAMNS/ MICL ES{IUgNI ACORD 101.AdMMS Remake Se iaMs,Noore spas Is reg01rpd1 Cvwatm al4rsumm C.I:RT1F)CAT�HOLDQt CANC64AT70N sdwcilY co"m6un SHOULD)ANY OF THE ABOVE DESCRIBED POUG1153 M GANGELLED BEFORE 3055CIBaMervWay THE 17MATiON DATE THEREBF. NOTVE Will BE DELIVERED. B4 Sao MBIEO,CA 34d02 ACCORDANCE WITH TIIE POLICY PROWSM& AUTHORQED REPREWMATIYL W fllsl�RM G bwofdnee Serrlws 01988.2610 ACORD CORPORATION. All r10 is reserved. ACORD 25(2010105) The ACORD name and tog*are registered rnaft of ACORD " s \\` Version#44.7 SolarCity. May 12,2015 WKUW� 3 Ko.I'loan Project/Job#026938 �p RE: CERTIFICATION LETTER �CtgtR' Project: Sylvia Residence 5 Harrington Way Hyannis, MA 02601 ;I,k01eo. To Whom It May Concern, A jobsite survey of the existing framing system was performed by a site survey team from SolarCity. Structural review was based on site observations and the design criteria listed below: Design Criteria: -Applicable Codes= MA Res. Code, 8th Edition,ASCE 7-05, and 2005 NDS - Risk Category = II -Wind Speed = 110 mph, Exposure Category C -Ground Snow Load = 30 psf - MP1: Roof DL=.7.5 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= 0.18757 < 0.4g and Seismic Category Design = B < D 9 rY(SDC) On the above referenced project,the components of the structural roof framing impacted by the installation of the PV assembly have been reviewed. After this review it has been determined that the existing structure is adequate to withstand the applicable roof dead load, PV assembly load,and live/snow loads indicated in the design criteria above. I certify that the structural roof framing and the new attachments that directly support the gravity loading and wind uplift loading from PV modules have been reviewed and determined to meet or exceed structural strength requirements of the MA Res. Code,8th Edition. Please contact me with any questions or concerns regarding this project. Digitally signed by William A.Eldredge Jr. Date:2015.05.13 17:55:57-04'00' 'Sincerely, William A. Eldredge, P.E. Professional Engineer T: 888.765.2489 x58636 t email: weldredge@solarcity.com 3055 Clearview Way San Mateo,CA 94402 T(650)638-1028 (888)SOL-CITY F(650)638-1029 solarcity.com AZ SOC243771 CA CSLO 888104,CO FC 8041,CT HIC 0632778,DC Htr,.71101486,DC HIS 71101468,H1 CT 29770.MA HIC 10857Z PAD MHIC 128948.W 13VH06160600, 013 CC8 180408,PA 077343,TX TOM 27006,VVA GCL:SGL,Afie'91907.0 2013 Sohi,Cit y.All nghM reee,vecl. r 05.12.2015 �' - Version#44.7 �,;SolarCit ® PV System Structural y Design Software PROJECT INFORMATION &.TABLE OF CONTENTS Project Name: -, -k i�Sylvia;Residence. j . _ AHJ: ,4 -g Barnstable, Job Number: 026938 Building Code MA Res Code, 8th Edition -. Customer Name: r Sylvia;Ceieste Y. Based On IRC 2009'/•IBC 2009 � _ Address: 5 Harrington Way ASCE Code: ASCE 7-05 City/State: __ _-Hy_annis,.� MA Risk Category_--IC -- Zip Code 02601 Upgrades Req'd? No Latitude j on itude., .640060_ . 70.302405:. ' � �9 41_— - �,: Stamp Req'd? ;:�: SC Office: Cape Cod PV Designer: Rueben Sosa Sosa Calculations: `' JustiriArbuckle EOR: T ^William A.Eldred e E - Certification Letter 1 Project Information,Table Of Contents, &Vicinity Map 2 Structure Analysis (Loading Summary and Member Check) 3 Hardware Design (PV System Assembly) 4 Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.18757 < 0.4g and Seismic Design Category(SDQ = B < D 1/2-MILE VICINITY MAP 10 A • -0 'b i q66 . , i i0 • ee Of 5 Harrington Way,,Hyannis, MA 02601 Latitude:41.64006,Longitude: -70.302405,Exposure Category:C I STRUCTURE'ANALYSIS - LOADING SUMMARY AND MEMBER CHECK MP1 Member Properties Summary MP1 Horizontal Member Spans Upgraded Rafter Properties Overhang 0.99 ft Net W 1.50 Roof System Properties San 1 ,,. �A3.10'ft;,, �"E uiv D �i <*, ..5.50 Number of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofing Material �4 Comp Roof San 3 - a'A 1�=8.25 in:^2 Re-Roof No San 4 S. 7.56 in.A3 Plywood Sheathin � P,_�, f 1", � Yes"'' -4 `�`"` .Span'5'�,., �,_�_ �, PA,. sI n.a 20.80 in.A4 a. Board Sheathing None Total Span 14.09 ft TL DR-1 L Limit 120 Vaulted Ceiling No` PV 1 Start 1.42 ft ` Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 13.42 ft Wood Grade #2 Rafter Slope 280 PV 2 Start Fb m x 875 psi. 1 Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracing x,, u, u. • =Full.::- PV,3Start,, - a§ ,E. 1400000'psi 10, Bot Lat Bracing At Supports PV 3 End Emi„ 510000 psi Member Loading mary Roof Pitch 7 12 Initial Pitch Adjust Non-PV Areas PV Areas Roof Dead Load DL 7.5 psf x 1.13 8.5 psf 8.5 psf PV Dead Load PV-DL 3.0 psf .. t x 1. 1 3.4 sf Roof Live Load ' RLL 20.0 psf x 0.88 17.5 psf Live/Snow Loads !v - � LL° SL''Z y �30.0`psf x 0.7 1 x 0:7 ` `" { 21 0 psf #' � 21.0 psf Total Load(GoverningLC TL 29.5 psf 32.9 psf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2) 2. pf=0.7(Ce)(Cr)(Is)py; Ce=0.91 Ct=1.1,Is=1.0 Member Design Summa (per NDS Governing Load Comb CD CL + CL - CF Cr D+ S 1.15 1.00 1 0.50 1. 1.3 1.15 Member Anal sis Results Summary Maximum Max Demand @ Location Capacity DCR Load Combo Shear Stress 50 si 1.0 ft. 155 psi 0.32 D+S Bending + Stress " 1472 psi 7.6 ft. 1504 psi 0.98 D+ S ,Bending - Stress -39 psi 1.0 ft. -745 psi 0.05 D+S Total Load Deflection . 1.26 in: 141. _7.6 ft. fu,. .1.48 in, 1,.L1120, . 0.85 ,73� Ak, A, A° . a . `r�` t CALCULATION OF DESIGN WIND LOADS=MP1 �. -- � Mountina Plane Information Roofing Material Comp Roof P).system:Type, SO rCity STI MountT"' Spanning Vents No Standoff Attachment Hardware _, , Comp Mount Tvoe C s _ Roof Slope 2 _ Rafter S acm I - , ��t 1� :� 6�8 _ - � ,.r 1 J40.C. � . Framin Type Direction Y-Y Rafters Purlin S p acing X-X Purlins Only "NA' Tile Reveal Tile Roofs Only NA Tile Attachment-System, Tile Roofs Only NA- Standin Seam ra S cing I SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind,Des gn Method _ Partially/Fully Enclosed'Method _ Basic Wind Speed V V _ 110 mph Fig. 6-1 Exposure _Category C _Section 6 5.6.3 �� . a;�,: ,�_ � - � �e. ,. Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Hei ht' "°� h' 25 ft Section 6.2 .a Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 0.95 Table 6-3 Topographic Factor K -- — fi. 1.00 - Section 6.5.7 ' A Wind Directionality Factor Kd 0.85 Table 6-4 Importance Factor., <_ I 1.0 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 -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient Down GC Down 0.87 Fig.6-11B/C/D-14A/B Design Wind Pressure p p= qh(GC) Equation 6-22 Wind Pressure U „ -23.6 psf Wind Pressure Down 21.8 psf ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing- Landscape 64 39" Lnd sc able " N—A- Standoff Configuration Landscape Staggered Max!Standoff Tributary Area PV Assembly Dead Load W-PV 3.0 psf Net Wind lJplift a_t_Standoff" T-actual Uplifpacity of Standoff T-allow 500 lbs Standoff Demand/Capacity DCR 77.2% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 48 66" Max Allowable Cantilever Portrait_ — _17" _ NA_ Standoff Configuration Portrait Staggered Max 8tandofUributa y,Area - Tr b_ PV Assembly Dead Load W-PV 3.0 psf Net Wind'Uplift at Standoff` T-actual.__ _ ; • -482Ibs Uplift Capacity of Standoff T-allow 500 Ibs Sta d ff Dmand Ca aci DCR 96.5% r. : ,: ' r DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 SolarCity. Power Purchase A reement Here are the key terms of your SolarCity Power Purchase Agreement Date: 3/11/2015 0 115 00 20years A 4 I System installation cost ;e Electricity rate per kWh , Agreement term Our Promises to You • We insure,maintain,and repair the System(including the inverter)at no additional cost to you,as specified in the agreement.AA • We provide 24/7 web-enabled monitoring at no additional cost to you,as specified in theagreement. • We warranty your roof against leaks and restore your roof at the end of the agreement,as specified in the agreement. ! • The rate you pay ,for electricity,exclusive of taxes,will never increase by more than 2.90% p year. i • The pricing in this PPA is valid for 30 days after-3/11/20.15. • We are confident that we deliver excellent value and customer service As a result,youu�are free to cancel anytime at no charge prior to construction`on your home. .n Estimated First Year Production _ ,6,266 kWh,. Customer's Name & Service Address Exactly as it appears on the utility bill 'Customer Name and Address Customer Name ,; `�/� Installation Location Celeste Sylvia r° r _. �f Ray Sylvia •` 5 Harrington Way 5 Harrington Way ✓. `-. ram' Hyannis, MA 02601 Hyannis, MA 02601 ;. , A. r Options for System purchase and transfer: Options at the end of the 20 year term • If you move,you may transfer this agreement nmt to the purchaser of your • SolarCity will remove the System at no cost to you. Home,as specified in the agreement. '' " p g • You can upgrade to a new System with the latest solar • At certain times,as specified in the agreement,you may purchase the technology under a new contract. System. • You may purchase the System from SolarCity for its fair • These options apply during the 20 year term of our agreement and not market value as specified in the agreement. beyond that term. You may renew this agreement for up to ten(10)years in two(2)five(5)year increments. 3055 CLEARVIEW WAY, SAN MATEO, CA 94402 888.SOL.CITY 888.765.2489 SOLARCITY.COM MA HIC 1685721EL-1136MR Document Generated on 3/11/2015 ❑E �■ 614429 r DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 1. Introduction. System;or(iv)your System is not reporting production to This Power Purchase Agreement(this"Power Purchase SolarCity(e.g.you have disconnected the PowerGuide system or the Internet connection at your Home goes down on the Agreement"or"PPA")is the agreement between you and reporting day),then SolarCity will reasonably estimate the SolarCity Corporation(together with its successors and assigns, " amount of power that would have been delivered to you during SolarCity"or"we"),covering the sale to you of the power produced by the solar panel system(the"System")we will install such System or reporting outages or reduced production at your home. SolarCity agrees to sell to you,and you agree to periods("Estimated Production")and shall consider Estimated buy from SolarCity,all of the power produced by the System. The Production as actual production for purposes of this paragraph. In the first year of the Term,Estimated Production System will be installed by SolarCity at the address you listed will be based on our production projections. After the first above(the"Property"or your"Home.") This Power Purchase year of the Term,Estimated Production will be based on Agreement is eight(8)pages long and has up to three(3)Exhibits depending on the state where you live.SolarCity provides you historical production for that month in the prior year. If we bill with a Limited Warranty(the"Limited Warranty"). The Limited you for Estimated Production because your System is not Warranty is attached as Exhibit 2.If you have any questions reporting production to SolarCity,and we subsequently determine that we have either overestimated or regarding this Power Purchase Agreement,please ask your SolarCity sales consultant. underestimated the actual production,then we will adjust the next bill downward(to refund overbilling)or upward(to make 2. Term. up for lost billing). You will not be charged for Estimated SolarCity agrees to sell you the power generated by the System Production when the System is not producing electricity due toSolarCity's fault,or if it's due to grid failure or power outages for 20 years(240 months),plus,if the Interconnection Date is not caused by someone"other than you. on the first day of a calendar month,the number of days left in that t partial calendar month. We refer to this period of time as the 5. Power Purchase Agreement Obligations. "Term." The Term begins on the Interconnection Date. The ' \ (a) System;Home and Property Maintenance "Interconnection Date"is the date that the System is turned on and -. M H generating power. SolarCity will notify you when your System is You agree to: ready to be turned on. (i) M only have the System repaired pursuant to the Limited 3. Intentionally Left Blank. ar --®Warranty and reasonably cooperate when repairs are being made; r 4. Power Purchase Agreement Payments;Amounts. .., ., I 'IV 00 keep trees,bushes and hedges trimmed so that the (a) Power Price. During the first year of the term,you are 44 . System'receives as much sunlight as it did when purchasing all of the power the System produces for$0.1250 ,\ SolarCity installed it; per kWh. After the first year,the price per kWh will increase , (iii) of modify your Home in away that shades the by 2.90/o per year.There are no installation costs. (. t � System; (b) Payments. (iv) be responsible for any conditions at your Home that Your monthly payments will be the product of(A)the price per ' ";, , affect the installation(e.g.,blocking access to the roof, kWh multiplied by(B)the actual'kWh output for the calendar, _ �` or removing a tree that is in the way,prior work you month("Monthly Payments"). Invoices for Monthly Payments have done on your home that was not permitted); will be mailed or emailed no later than ten(10)days after the (v) not remove any markings or identification tags on the end of a calendar month.If you are paying your invoice by! System; automatic debit from your checkirig or savings account(ACH) (vi) permit SolarCity,after we give you,reasonable notice, we will debit your bank account on or'a6out the 1 It day of the to inspect the System for proper operation as we next month following invoice(e.g.January invoices are sent in reasonably determine necessary; early February and debited on or about March 1).Monthly (vii) use the System primarily for personal,family or Payments will change as your price per kWh changes over the household purposes,but not to heat a swimming pool; Term of this PPA and as System production varies(e.g., summer has higher production).You will have regular access (viii) not do anything,permit or allow to exist any condition to the System's production via your SolarCity online account. or circumstance that would cause the System not to Payments due upon installation,if any,are due immediately operate as intended at the Property; prior to commencement of installation.You will make no (ix) notify SolarCity if you think the System is damaged or Monthly Payments if you are fully prepaying this PPA. In appears unsafe;if the System is stolen;and prior to this case,you will pay only the amounts listed in the key changing your power supplier; terms summary on page one of this PPA. (x) have anyone who has an ownership interest in your (c) Estimated Production. If(i)the System is shut down for more Home sign this Power Purchase Agreement; than seven(7)full twenty-four(24)hour days cumulatively (xi) return any documents we send you for signature(like during the Term because of your actions;or(ii)you take some incentive claim forms)within seven(7)days of action that significantly reduces the output of the System;(iii) receiving them;and you don't trim your bushes or trees to their appearance when (xii) maintain and make available,at your cost,a functioning you signed this PPA to avoid foliage growth from shading the indoor internet connection with a router,one DHCP Solar Power Purchase Agreement version 8.3.3 614429 a DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 enabled Ethernet port with intemet access and standard (i) Automatic Payment Discount: All prices include a AC power outlet close enough and free of interference to $7.50 monthly discount for allowing us to automatically enable an intemet-connected gateway provided by debit your checking or savings account for payments. SolarCity to communicate wirelessly with the system's You will not receive a$7.50 monthly discount if you do inverter(typically this is 80 feet,but may depend on site not allow the automatic debit; conditions). See section 2(c)of the Limited Warranty for 0i). Returned Check Fee:$25(or such lower amount as details;and required by law)for any check or withdrawal right that is (xiii) if your home is governed by a home owner's association returned or refused by your bank;and or similar community organization,obtain all approvals (iii) Late Payments:accrue interest at the lesser of twelve and authorizations for the System required by that percent(12%)annually or the maximum allowable by organization and advise us of any requirements of that applicable law. organization that will otherwise impact the System,its installation or operation. (e) Taxes (b) System Construction,Repair,Insurance and Your SolarCity electricity rate of$0.1250 per kWh is SolarCity's obligations: composed of an electricity rate of$0.1250 plus current taxes of$0.0000.You agree to pay any changes in the SolarCity agrees to: applicable taxes related to this PPA. Thus,if tax rates 0) schedule the installation of the System at a mutually change,your SolarCity electricity rate will change to reflect convenient date and time; this rate change.If this PPA contains a purchase option at 00 construct the System according to written plans you the end of the Term,you agree to pay any applicable tax on the purchase price for the System. You also agree to. review; pay as invoiced any,applicable personal property taxes on (iii) provide you with a web-enabled meter to accurately the System that your local jurisdiction may levy. measure the amount of power the System delivers to , you; (f) No Alterations (iv) provide you with a home energy evaluation; You agree that you will not make any modifications, (v) notify you if the System design has to be materially r improvements,revisions o'r additions to the System or take . changed so that you can review any such changes; any.other action that could void the Limited Warranty on the Sysi6r without SolarCity's prior written consent. If you (vi) clean up after ourselves during the construction of the make any modifications,:in'provements,revisions or NO insure the System against all damage or loss unless-�-" ` , additions to`the System,they will become part of the y 9 9 System and shall be SolarCity's property. (A)that damage or loss is caused by your gross r ti ` negligence;or(B)that damage or loss is caused by,f ri (g) Access to the System (0 ball strikes;or(C)you intentionally damage the,` You grant to SolarCity and its employees,agents and System; °' �I F r contractors the right to reasonably access all of the (viii) repair the System pursuant to the Limited Warranty and Property as necessary for the purposes of(A) reasonably cooperate with you when scheduling. -8 installing,constructing,operating,owning,repairing, repairs; (4 removing and replacing the System or making any } additions to the System or installing complementary (ix) create a priority stream ,of operation and maintenance y g p ry payments to provide enough cash flow in our financing technologies on or about the location of the System; transactions to pay for the Limited Warranty obligations (B)enforcing SolarCity's rights as to this Power and the repair and maintenance o_ fthe.System in Purchase Agreement and the System;(C)installing, accordance with this PPA even if SolarCity ceases to using and maintaining electric.lines and inverters and operate;and meters,necessary to.interconnect the System to your (x) not put a lien on your Home or Property. electric system at the Property and/or to the utility's electric distribution system;or(D)taking any other action reasonably necessary in connection with (c) Home Renovations or Repairs installing,constructing,operating,owning,repairing, If you want to make any repairs or improvements to the removing and replacing the System.This access right Property that could interfere with the System(such as shall continue for up to ninety(90)days after this repairing the roof where the System is located),you may Power Purchase Agreement expires to provide only remove and replace the System pursuant to the SolarCity with time to remove the System at the end Limited Warranty. of the Power Purchase Agreement. SolarCity shall provide you with reasonable notice of its need to (d) Automatic Payment,Late Charges,Fees access the Property whenever commercially reasonable. In addition to the other amounts you agree to pay in this 00 During the time that SolarCity has access_ri rights you Power Purchase Agreement,you agree to pay the following:. 9 y 9 y shall ensure that its access rights are preserved and shall not interfere with or permit any third party to Solar Power Purchase Agreement version 8.3.3 614429 iC DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 interfere with such rights or access. You agree that to confirm the suitability of the Property for the the System is not a fixture,but SolarCity has the right construction,installation and operation of the System; to file any UCC-1 financing statement or fixture filing (i i) approval of this Power Purchase Agreement by one of that confirms its interest in the System. SolarCity's financing parties; (h) Indemnity (iii) your meeting the applicable credit score; To the fullest extent permitted by law,you shall indemnify, (iv) confirmation of rebate,tax credit and renewable defend,protect,save and hold harmless SolarCity,its energy credit payment availability in the amount used employees,officers,directors,agents,successors and to calculate the Monthly Payments set forth in this assigns from any and all third party claims,actions,costs, Power Purchase Agreement; expenses(including reasonable attorneys'fees and (v) confirmation that SolarCity will obtain all applicable expenses),damages,liabilities,penalties,losses, benefits referred to in Section 9; obligations,injuries,demands and liens of any kind or nature arising out of,connected with,relating to or (vi) receipt of all necessary zoning,land use and building resulting from your negligence or willful misconduct; permits;and provided,that nothing herein shall require you to indemnify (vii) completion of any renovations,improvements or SolarCity for its own negligence or willful misconduct.The changes reasonably required at your Home or on the provisions of this paragraph shall survive termination or Property(e.g.,removal of a tree or necessary roof expiration of this Power Purchase Agreement. repairs to enable us to safely install the System). (i) Payments (viii) if your home is governed by a home owner's association or similar community organization,your SUBJECT TO SECTION 4(b)ABOVE,YOU AGREE THAT receipt of all approvals and authorizations for the THE OBLIGATION TO PAY ALL PAYMENTS AND ALL System required by that organization and advising us of OTHER AMOUNTS DUE UNDER THIS PPA SHALL BE, any,requirements of that organization that will otherwise ABSOLUTE AND UNCONDITIONAL UNDER ALL impact the System;its installation or operation. CIRCUMSTANCES AND SHALL NOT BE SUBJECT TO A, SolarCity may terminate this Power Purchase Agreement . ANY ABATEMENT,DEFENSE,COUNTERCLAIM, �' 'without liability if;in its reasonable judgment,any of the SETOFF,RECOUPMENT OR REDUCTION FOR ANY above listed conditions(i)through(vii)will not be satisfied REASON WHATSOEVER, IT BEING THE EXPRESS INTENT OF THE PARTIES THAT ALL AMOUNTS ✓ I ( for reasons beyond its reasonable control. Once SolarCity PAYABLE BY YOU HEREUNDER SHALL BE,AND starts installation,however;it may not terminate this Power Purchase Agreement for your failure to satisfy conditions CONTINUE TO BE,PAYABLE IN ALL EVENTS INCLUDING BY YOUR HEIRS AND ESTATE AND, ,/- \(i)though(vii)above. EXCEPT AS SET FORTH BELOW IN SECTIONS 6;'2211 1 (b) Amendments. . AND 23,YOU HEREBY WAIVE ALL RIGHTS YOU MAY �, t The System's initial estimated production is set forth in this HAVE TO REJECT OR CANCEL�THIS-PPA,,TO REVOKE ' The After System design,the estimated production is ACCEPTANCE OF THE SYSTEM,OR TO GRANT A '-. -f likely to change and we will share those changes with you SECURITY INTEREST IN THE SYSTEM. �. prior to installation. If the estimated production increases (j) Credit Check or decreases by more than twenty percent(20%),we will i 1 document that change in an amendment.. You authorize SolarCity,or Its designee,to obtain your credit report now and in the future,check your credit and You authorize SolarCity to make corrections to the utility employment history,answer questions others may ask paperwork to conform to this PPA or any amendments to regarding your credit and share your credit information with this PPA we both sign. SolarCity's financing partners.You certify that all 7 Warranty information you provide to us in connection with checking your credit will be true and understand that this information YOU UNDERSTAND THAT THE SYSTEM IS WARRANTED must be updated upon request if your financial condition SOLELY UNDER THE LIMITED WARRANTY ATTACHED AS changes. EXHIBIT 2,AND THAT THERE ARE NO OTHER 6. Conditions Prior to Installation of the System;Chang REPRESENTATIONS OR WARRANTIES,EXPRESS ORe IMPLIED,AS TO THE MERCHANTABILITY,FITNESS FOR ANY Orders. PURPOSE,CONDITION,DESIGN,CAPACITY,SUITABILITY OR (a) SolarCity's obligation to install the System and sell you the PERFORMANCE OF THE SYSTEM OR ITS INSTALLATION. power it produces is conditioned on the following items 8. Transfer. having been completed to its reasonable satisfaction: SolarCity will assign this PPA to one of its financing partners. You thorough physical(i) completion of inspection of the Property,(A)the engineering site audit(a agree that SolarCity may assign,sell or transfer the System and this Power Purchase Agreement,or any part of this Power including,if applicable,geotechnical work),(B)the Purchase Agreement or the exhibits,without your consent. This final System design,and(C)real estate due diligence assignment does not change SolarCity's obligation to maintain and repair your System as set forth in the Warranty. to a Solar Power Purchase Agreement version 8.3.3 614429 DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 9. Ownership of the System;Tax Credits and Rebates. 00 at any time after the five(5)year anniversary of the You agree that the System is SolarCity's personal property under beginning of the Term,when you sell your Home; the Uniform Commercial Code. You understand and agree that and this PPA is not a contract to sell or lease the System to you. (iii) if SolarCity ever ceases its operations. SolarCity owns the System for all purposes,including any data In each of(i),(ii)and(iii)above,the price you will pay for the generated from the System. You shall at all times keep the System will be the System's fair market value(°FMV").A third System free and clear of all liens,claims,levies and legal party independent appraiser will be retained to compute the processes not created by SolarCity,and shall at your expense System's FMV. SolarCity's maintenance and repair obligations protect and defend SolarCity against the same. under the Limited Warranty(Exhibit 2)will continue when you YOU UNDERSTAND AND AGREE THAT ANY AND ALL TAX purchase the System until what would have been the end of the CREDITS,INCENTIVES,RENEWABLE ENERGY CREDITS, original Term. GREEN TAGS,CARBON OFFSET CREDITS, UTILITY REBATES 11. Renewal. OR ANY OTHER NON-POWER ATTRIBUTES OF THE SYSTEM If you are in compliance with your PPA,you have the option to ARE THE PROPERTY OF AND FOR THE BENEFIT OF renew your PPA for up to ten(10)years in two(2)five(5)year SOLARCITY,USABLE AT ITS SOLE DISCRETION.SOLARCITY renewal periods. We will send you renewal forms three(3)months SHALL HAVE THE EXCLUSIVE RIGHT TO ENJOY AND USE prior to the expiration of the Term,which forms shall set forth the ALL SUCH BENEFITS,WHETHER SUCH BENEFITS EXIST new Monthly Payments due under the renewal PPA,based on our NOW OR IN THE FUTURE. YOU AGREE TO REFRAIN FROM assessment of the then current fair market value of the System. If ENTERING INTO ANY AGREEMENT WITH YOUR UTILITY you want to renew,complete the renewal forms and return them to THAT WOULD ENTITLE YOUR UTILITY TO CLAIM ANY SUCH BENEFITS. YOU AGREE TO REASONABLY COOPERATE us at least one(1)month prior to the end of the PPA. In the event WITH SOLARCITY SO THAT IT MAY CLAIM ANY TAX that you do not agree'to the new Monthly Payments this PPA shall CREDITS,RENEWABLE ENERGY CREDITS,REBATES, expire by its terms on the termination date. If you don't send us CARBON OFFSET CREDITS OR ANY OTHER BENEFITS FROM anything in writing after we send you the renewal forms,then this THE SYSTEM.THIS MAY INCLUDE TO THE EXTENT PPA shall renew.for an additional one(1)year term at ten percent ALLOWABLE BY LAW,ENTERING INTO NET METERING (10%)Tess than the then-current average rate charged by your local utility and shall continue to renew for one(1)year terms at the same AGREEMENTS, INTERCONNECTION AGREEMENTS,AND k FILING RENEWABLE ENERGY/CARBON OFFSET CREDIT rate as yo'ur,first renewal until(i)you give us notice at least thirty REGISTRATIONS AND/OR APPLICATIONS FOR REBATES (30)days prior,to a renewal term that you do not wish to renew;or FROM THE FEDERAL,STATE OR LOCAL GOVERNMENT OR A (ii)we send you a notice terminating the PPA. LOCAL UTILITY AND GIVING THESE TAX CREDITS, '" 12.Selling Your Home. RENEWABLE ENERGY/CARBON CREDITS,REBATES OR," OTHER BENEFITS TO SOLARCITY. If sell your Home you can: You understand that solar renewable energy credits(SRECs)and ! (i) Transfer nsfer this Power Purchase Agreement and the certain incentives and associated data cannot be generated or �,, Monthly Payments earned without internet.As such,you agree to-maintain and make° ,,� If the person buying your Home meets SolarCity's credit available,at your cost,a functioning Indoor Internet connection - requirements,then where permitted by the local utility,the with the understanding that Wi-Fi hotspotting,tethering and,,\ person buying your Home can sign a transfer agreement intermittent Internet connection will notsatiisfy this obligation.You assuming all of your rights and obligations under this also agree to cooperate with SolarCity as necessary to provide Power Purchase Agreement. any other information required to generate SRECs or,earn/ (ii) Move the System to Your New Home incentives and troubleshoot monitoring issues.Your failure to Where permitted by the utility(s),the System can be cooperate with SolarCity with respect to Internet requirements will moved to your new home pursuant to Section 4 of the result in your obligation to compensate SolarCity for all lost SREC Limited Warranty.You will need to provide the same rights or incentive revenue and related costs,subject to a monthly to SolarCity as provided for in this PPA and provide any charge of no less than$10.00(ten dollars)per month until third party consents or releases required by SolarCity in adequate Internet monitoring is implemented or restored. connection with the substitute premises. 10. Purchasing the System Prior to the End of the Term. (iii)Prepay this Power Purchase Agreement and Transfer In addition to purchasing the System at the end of the Term,you only the Use of the System have the option to purchase the System prior to the end of the At any time during the Term,you can prepay this Power .Term as detailed below. To exercise this option you must be in Purchase Agreement in full by paying SolarCity the good standing under this Power Purchase Agreement and you expected remaining payments(estimated future production need to give us at least one(1)month's,but not more than.three during the rest of the Term multiplied by the average kWh. (3)months'prior written notice. You can purchase this System: . rate during the rest of the Term)at a five percent(5%) discount rate.The person buying your Home will only need (i) on the five(5)year anniversary of the beginning of to sign a transfer agreement to assume your rights and the Term and every annual anniversary after the five non-Monthly Payment obligations under this PPA. The (5)year anniversary;and System stays at your Home,the person buying your Hn-- ❑0 �'� ■� Solar Power Purchase Agreement version 8.3.3 614429 DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388. does not make any Monthly Payments and has only to (b)Actual Damages comply with the non-Monthly Payment portions of this EXCEPT FOR CLAIMS UNDER SECTION 5(H),NEITHER PPA. PARTY'S LIABILITY TO THE OTHER WILL EXCEED AN (iv)Purchase the System(see Section 10) AMOUNT EQUAL TO THE MAXIMUM AMOUNT THAT (b) You agree to give SolarCity at least fifteen(15)days but not COULD BE PAYABLE BY YOU UNDER SECTION 16(H). more than three(3)months prior written notice if you want DAMAGES TO YOUR HOME,BELONGINGS OR PROPERTY someone to assume your PPA obligations. In connection RESULTING FROM THE INSTALLATION OR OPERATION with this assumption,you,your approved buyer and SolarCity OF THE SYSTEM ARE'COVERED IN SECTION 6(C)OF THE shall execute a written transfer of this PPA. LIMITED WARRANTY. (c) If you sell your Home and can't comply with any of the 15. Default. options in subsection(a)above,you will be in default under You will be in default under this Power Purchase Agreement if any this Power Purchase Agreement. Section 12(a)includes a Home sale by your estate or heirs. one of the following occurs: (d) Free Assumability.This agreement is free of any restrictions (a) you fail to make any payment when it is due and such failure that would prevent the homeowner from freely transferring continues for a period of ten(10)days; their home("Property").SolarCity will not prohibit the sale, (b) you fail to perform any material obligation that you have conveyance or refinancing of the Property.SolarCity may undertaken in this PPA(which includes doing something you choose to file in the real estate records a UCC-1 financing have agreed not to do,like alter the System)and such failure statement("Fixture Filing")that preserves their rights in the continues for a period of fourteen(14)days after written notice; System.The Fixture Filing is intended only to give notice of f '` its rights relating to the System and is not a lien or (c) you or your guarantor have provided any false or misleading encumbrance against the Property.SolarCity shall explain financial or other information to obtain this Power Purchase the Fixture Filing to any subsequent purchasers of the Agreement; F Property and any related lenders as requested.SolarCity (d) you assign,transfer,'encumber,sublet or sell this PPA or any shall also accommodate reasonable requests from lenders or part of the System without SolarCity's prior written consent;or title companies to facilitate a purchase,financing or refinancing of the Property. (e) you or any guarantor makes an assignment for the benefit of / !creditors admits in writing its insolvency,files or there is filed (e) EXCEPT AS SET FORTH IN THIS SECTION,YOU WILL against you or it a voluntary petition in bankruptcy,is NOT ASSIGN,SELL,PLEDGE OR IN ANY OTHER WAY adjudicated bankrupt or insolvent or undertakes or TRANSFER YOUR INTEREST IN THE SYSTEM OR THIS,.. `°°,experiences any substantially similar activity. PPA WITHOUT OUR PRIOR WRITTEN CONSENT,WHICH SHALL NOT BE UNREASONABLY WITHHELD. -� -,16. Remedies in Case of Default. t If this Power Purchase Agreement is in default,we may take any ,., t one or more of the following actions. If the law requires us to do 13. Loss or Damage. �-" <}so,we will give you notice and wait any period of time required (a) Unless you are grossly negligent,you intentionally damage t before taking any of these actions. We may: System,or damage or loss to the System is caused by ball (a) terminate this PPA; strikes,SolarCity will bear all of the risk of loss,damage,theft, (b) take any reasonable action to correct your default onto prevent destruction or similar occurrence to anygir all of the System. Except as expressly provided in this,PPA;.no loss;damage, our loss;any amount we pay will be added to the amount you theft or destruction will excuse you from your obligations under owe us and will be immediately due; this PPA,including Monthly Payments. (c) require you,at your expense,to return the System or make it (b) If there is loss,damage,theft,destruction or a similar available to us in a reasonable manner; occurrence affecting the System,and you are not in default of (d) proceed,by appropriate court action,to enforce performance this PPA,you shall continue to timely make all Monthly of this PPA and to recover damages for your breach; Payments and pay all other amounts due under the PPA and, cooperate with SolarCity,at SolarCity's sole cost and expense, (e) disconnect,turn off or take back the System by legal process to have the System repaired pursuant to the Limited Warranty. or self-help,but we may not disturb the peace or violate the law; 14. Limitation of Liability. - (f) report such non-operational status of the System to your utility, (a) No Consequential Damages informing them that you are no longer net metering; SOLARCITY'S LIABILITY TO YOU UNDER THIS POWER (g) charge you a reasonable reconnection fee for reconnecting the PURCHASE AGREEMENT SHALL BE LIMITED TO DIRECT, System to your utility or turning your System back on after we' ACTUAL DAMAGES ONLY. YOU AGREE THAT IN NO disconnect or turn off the System due to your default; EVENT SHALL EITHER PARTY BE LIABLE TO THE OTHER FOR CONSEQUENTIAL,INCIDENTAL,PUNITIVE, (h) recover from you(i)a payment equal to the purchase price as EXEMPLARY,SPECIAL OR INDIRECT DAMAGES. set forth in this agreement plus(ii)all taxes,late charges, M Solar Power Purchase Agreement version 8.3.3 614429 Y DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388. " penalties,interest and all or any other sums then accrued or Only Disputes involving you and SolarCity may be addressed in the due and owing;or arbitration.Disputes must be brought in the name of an individual (i) use any other remedy available to us in this PPA or by law. person or entity and must proceed on an individual(non-class,non- representative)basis.The arbitrator will not award relief for or We may submit to credit reporting agencies(credit against anyone who is not a party.If either of us arbitrates a bureaus)negative credit reports that would be reflected on your Dispute,neither of us,nor any other person,may pursue the credit record if you do not pay any amounts due.under this PPA as Dispute in arbitration as a class action,class arbitration,private required. attorney general action or other representative action,nor may any You agree to repay us for any reasonable amounts we pay to such Dispute be pursued on your or our behalf in any litigation in correct or cover your default.You also agree to reimburse us for any court.Claims regarding any Dispute and remedies sought as any costs and expenses we incur relating to the System's return part of a class action,class arbitration,private attorney general or resulting from early termination.By choosing any one or more of other representative action are subject to arbitration on an these remedies,SolarCity does not give up its right to use another individual(non-class,non-representative)basis,and the arbitrator remedy.By deciding not to use any remedy should this Power may award relief only on an individual(non-class,non- , Purchase Agreement be in default,SolarCity does not give up.our representative)basis.This means that the arbitration may not right to use that remedy in case of a subsequent default. address disputes involving other persons with disputes similar to the Disputes between you and SolarCity. 17. System Removal;Return. The arbitrator shall have the authority to award any legal or At the end of the Term or the termination of this PPA,if you have equitable remedy or relief that a court could order or grant under not renewed this PPA or exercised your purchase option(if any) this agreement.The arbitrator,however,is not authorized to and you have not defaulted,then within ninety(90)days you change or alter the teens of this agreement or to make any award agree to call SolarCity at the telephone number listed in Section 7 that would extend to any{transaction other than yours.All statutes of Exhibit 2 to schedule a convenient time for SolarCity to remove of limitations that are applicable to any dispute shall apply to any the System from your Home at no cost to you. arbitration between:us The arbitrator will issue a decision or award in writings briefly,stating the essential findings of fact and 18.Applicable Law:Arbitration. conclusions of law. � t w:6-tit, illl!'N PLEASE READ THIS SECTION CAREFULLY.ARBITRATION " REPLACES THE RIGHT TO GO TO COURT,INCLUDING THE BECAUSE�YOU AND WE HAVE AGREED TO ARBITRATE ALL IIDISPUTES NEITHER OF US WILL,"HAVE THE RIGHT TO RIGHT TO A JURY AND THE RIGHT TO PARTICIPATE IN A CLASS ACTION OR SIMILAR PROCEEDING. IN ARBITRATION, LITIGATE THAT DISPUTE IN COURT,OR TO HAVE A JURY A DISPUTE IS,RESOLVED BY AN ARBITRATOR INSTEAD OF A TRIAL ON.THAT DISPUTE,OR ENGAGE IN DISCOVERY EXCEPT AS PROVIDED FOR IN THE RULES.FURTHER,YOU JUDGE OR JURY. V WILL NOT4 VE THE RIGHT TO PARTICIPATE AS A a REPRESENTATIVE OR MEMBER OF ANY CLASS PERTAINING The laws of the state where your Home is located shall govern this ,, i PPA without giving effect to conflict of laws principles.We agree .,TO ANY ,,,DISPUTE.THE ARBITRATOR'S DECISION WILL BE that any dispute,claim or disagreement between us(a"Dispute ,FINAL AND BINDING ON THE PARTIES AND MAY BE ENTERED shall be resolved exclusively by arbitratlon � AND ENFORCED IN ANY COURT HAVING JURISDICTION, *EXCEPT TO THE EXTENT IT IS SUBJECT TO REVIEW IN The arbitration,including the selecting of the arbitrator,will,be ACCORDANCE WITH APPLICABLE LAW GOVERNING administered by JAMS,under its Streamlined Arbitration Rules(the ARBITRATION AWARDS.OTHER RIGHTS THAT YOU OR WE "Rules")by a single neutral arbitrator ag eed on by the paities WOULD HAVE IN COURT MAY ALSO NOT BE AVAILABLE IN within thirty(30)days of the commencement of the arbitration:, ARBITRATION. The arbitration will be governed by the Federal kbitratlon Act(Title :a ,. ,kr 9 of the U.S.Code).Either party may initiate the arbitr'ation process 19.Waiver. by filing the necessary forms with JAMS.To learn more about Any delay or failure of a party to enforce any of the provisions of arbitration,you can call any JAMS office or review the materials at this PPA,including but not limited to any remedies listed in this www.jamsadr.com.The arbitration shall be held in the location that PPA,or to require performance by the other party of any of the is most convenient to your Home.If a JAMS office does not exist provisions of this PPA,shall not be construed to(i)be a waiver of. within 50(fifty)miles of your Home,then we will use another such provisions or a party's right to enforce that provision;or(ii) accredited arbitration provider with offices close to your Home. affect the validity of this PPA. If you initiate the arbitration,you will be required to pay the first $125 of any filing fee. We will pay any filing fees in excess of$125 and we will pay all of the arbitration fees and costs. If we initiate the arbitration,we will pay all of the filing fees and all of the arbitration fees and costs. We will each bear all of our own attorney's fees and costs except that you are entitled to recover your attorney's fees and costs if you prevail in the arbitration and the award you receive from the arbitrator is higher than SolarCity's last written settlement offer. When determining whether your award is higher than SolarCity's last written settlement offer your attorney's fees and costs will not be included. �■ �■ Solar Power Purchase Agreement version 8.3.3 614429 a DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 20. Privacy/Publicity You grant SolarCity the right to publicly use,display,share,and , advertise the photographic images,Project details,price and any other non-personally identifying information of your Project. SolarCity shall not knowingly release any personally identifiable information about you or any data associating you with the Project location.You may opt-out of these publicity rights by giving us written notice and mailing it to:SolarCity Corporation,Attention: Publicity Opt Out,3055 Clearview Way,San Mateo,CA 94402. 21. Notices. All notices under this PPA shall be in writing and shall be by personal delivery,facsimile transmission,electronic mail,overnight courier,or certified or registered mail,return receipt requested. 22. Entire Agreement:Changes. This PPA contains the parties'entire agreement regarding the sale and purchase of power generated by the System. There are no other agreements regarding this PPA,either written or oral. Any change to this PPA must be in writing and signed by both parties. If any portion of this PPA is determined to be unenforceable,the remaining provisions shall be enforced in accordance with their terms or shall be interpreted or re-written so as to make them enforceable. REST OF PAGE INTENTIONALLY LEFT BLANK a}-o Solar Power Purchase Agreement version 8.3.3 614429 Y DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486C66388 23. NOTICE OF RIGHT TO CANCEL. I have read this Power Purchase Agreement and the Exhibits in their YOU MAY CANCEL THIS CONTRACT AT ANY TIME PRIOR TO entirety and I acknowledge that I have received a complete copy of this MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE Power Purchase Agreement. YOU SIGN THIS CONTRACT. SEE EXHIBIT 1,THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN Customer's Name:Celeste Sylvia EXPLANATION OF THIS RIGHT. Docuftned by: 24.ADDITIONAL RIGHTS TO CANCEL. Signature: F27A3WFC134AC... IN ADDITION TO ANY RIGHTS YOU MAY HAVE TO CANCEL THIS PPA UNDER SECTION 23,YOU MAY ALSO CANCEL Date: 3/11/2015 THIS PPA AT NO COST AT ANY TIME PRIOR TO COMMENCEMENT OF CONSTRUCTION ON YOUR HOME. 25. Pricing The pricing in this PPA is valid for 30 days after 3111/2015. If you Customer's Name: Ray Sylvia don't sign this PPA and return it to us on or prior to 30 days after 770r-E +gfed by. 3/11/2015,SolarCity reserves the right to reject this PPA unless Signature: _�you agree to our then current pricing. 387CF5aa,E... Date: L 3/11/2015 l!; SolarG Power Purchase Agreement SOLARCtTIf APPROVED 4 *k Signature: ~'��� LYNDON RIVE, CEO (PPA) Power Purchase Agreement %;i•'501s11 Citu Dater 3/11/2015 Solar Power Purchase Agreement version 8.3.3 614429 DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 EXHIBIT 1 (SOLARCITY COPY) NOTICE OF CANCELLATION STATUTORILY-REQUIRED LANGUAGE Notice of Cancellation Date of Transaction:The date you signed the Power Purchase Agreement. You may CANCEL this transaction,without any penalty or obligation,within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in,any payments made by you under the contract or sale and any negotiable instrument executed by you will be returned within TEN DAYS following receipt by the seller(SolarCity Corporation)of your cancellation notice,and any security interest arising out of the transaction will be canceled. If you cancel,you must make available to the seller(SolarCity Corporation)at your residence,in substantially as good condition as when received,any goods delivered to you under this contract or sale,or you may,if you wish,comply with the instructions of the seller(SolarCity Corporation)regarding the return shipment of the goods at the seller's (SolarCity Corporation's)expense and risk. If you do make the goods available to the seller(SolarCity Corporation)and the seller (SolarCity Corporation)does not pick them up within 20 days of the date of your notice of cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller(SolarCity Corporation),or if you agree to return the goods to the seller(SolarCity Corporation)and fail to do so,then you remain liable for performance of all obligations under the contract. '_ To cancel this transaction,mail or,deliver a signed and dated copy of this cancellation notice,o`r any other written notice,or send a telegram to SolarCity Corporation,Document Receiving,6611 Las Vegas Blvd.S.,Unit 200,Las Vegas,NV 89119 NOT LATER THAN MIDNIGHT of the date that is THREE BUSINESS DAYS from the date you signed the Power Purchase Agreement. I,Celeste Sylvia,HEREBY CANCEL THIS TRANSACTION on �'�. '[Date]. Customer's Signature: ' Customer's Signature: r l { Solar Power Purchase Agreement version 8.3.3 614429 a iPTA DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 EXHIBIT I (CUSTOMER COPY) NOTICE OF CANCELLATION STATUTORILY-REQUIRED LANGUAGE Notice of Cancellation Date of Transaction:The date you signed the Power Purchase Agreement. You may CANCEL this transaction,without any penalty or obligation,within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in,any payments made by you under the contract or sale and any negotiable instrument executed by you will be returned within TEN DAYS following receipt by the seller(SolarCity Corporation)of your cancellation notice,and any security interest arising out of the transaction will be canceled. If you cancel,you must make available to the seller(SolarCity Corporation)at your residence,in substantially as good condition as when received,any goods delivered to you under this contract or sale,or you may,if you wish,comply with the instructions of the seller(SolarCity Corporation)regarding the return shipment of the goods at the seller's (SolarCity Corporation's)expense and risk. If you do make the goods available to the seller(SolarCity Corporation)and the seller (SolarCity Corporation)does not pick them up within 20 days of the date of your notice of cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller(SolarCity Corporation),or if you agree to return the goods to the seller(SolarCity Corporation)and fail to do so,then you remain liable for performance of all obligations under the contract. 'l� To cancel this transaction,mail or deliver a signed and dated copy of this cancellation notice,or any other written notice,or send a telegram to SolarCity Corporation,Document Receiving,6611 Las Vegas Blvd.S.,Unit 200,Las Vegas;NV 89119 NOT LATER THAN MIDNIGHT of the date that is THREE BUSINESS DAYS from the date you signed the Power Purchase_Agreement. I,Celeste Sylvia,HEREBY CANCEL THIS TRANSACTION on Customer's Signature: t � Customers Signature: xe, k r . [oil D 0 Solar Power Purchase Agreement versior:,8.3.3 614429 a . . DocuSign Envelope ID:7175A38F-2B9F40B4-9389-543486CC6388 EXHIBIT 2 PERFORMANCE GUARANTEE AND LIMITED WARRANTY 1. INTRODUCTION This Performance Guarantee and Limited Warranty(this"Limited Warranty")is SolarCity's agreement to provide.you warranties on the System you are hosting pursuant to our PPA. The System will be professionally installed by SolarCity at the address you listed in the PPA.We will refer to the installation location as your"Property"or your"Home." This Limited Warranty begins when we start installing the System at your Home. We look forward to helping you produce clean,renewable solar power at your Home. 2. LIMITED WARRANTIES (a) Limited Warranties SolarCity warrants the System as follows: (1) System Warranty fn` During the entire Power Purchase Agreement Term,under normal use and service conditions,the System will be free from defects in workmanship or defects in,or a breakdown of,materials or components(the"System Warranty"); (ii) Roof Warranty When we penetrate your roof during a System installation we will warrant roof damage we cause due to our roof penetrations. This roof warranty will run the longer of(A)one(1)year following the completion of the System installation;and(B)the length of any existing installation warranty or new home builder performance standard for your roof(the"Roof Warranty Period");and (III) Repair Promise During the entire Power Purchase Agreement Term,SolarCity will honor the Warranty and will repair or replace any defective part,material or component or correct any defective workmanship°at no cost or expense to you(including all labor costs), when you submit a valid claim to us under this Limited Warranty.,If we damage your Home,your belongings or your Property we will repair the damage we cause.or pay you for the damage we cause as described in Section 6.SolarCity may use new or reconditioned parts whenfimaking repairs or replacements.'SoiarCity may also,at no additional cost to you,upgrade or add to any part of the System to erisure that it performs according to the guarantees set forth in this Limited Warranty. Cosmetic repairs that do not involve safety or,performance shall be made at SolarCity's discretion. (b) Warranty Length m r (1) The warranties in Sections 2(a)(i)°and 2(a)(iii)above will start when we begin installing the System at your Home and continue through the entire Power Purchase Agreement Term.Thus,.for as long as you host the System from SolarCity under a PPA,you will have a System Warranty and our Repair Promise. (ii) The Roof Warranty Period may be shorter than the System Warranty,as described in Section 2(a)(ii)above. (iii) If you have assumed an existing PPA,or purchased the System during the Term of your PPA,then this Limited Warranty will cover you for the remaining balance of the existing PPA Term. (c) Performance Warranties and Guarantee (I) Performance Guarantee SolarCity guarantees that during the Power Purchase Agreement Term the System will operate within manufacturer's specifications and if it does not that SolarCity will repair or replace any defective part and restore System performance. : o a• . Solar Power Purchase Agreement version 8.3.3 614429 DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 (ii) PowerGuideTM Solar Monitoring During the Power Purchase Agreement Term,we will provide you at no additional cost our PowerGuide Solar Monitoring Service ("PowerGuide"). PowerGuide is a proprietary monitoring system designed and installed by SolarCity that captures and displays historical energy generation data over an Internet connection and consists of hardware located on site and software hosted by SolarCity. If your System is not operating within normal ranges,PowerGuide will alert us and we will remedy any material issues promptly. (d) Maintenance and Operation (i) General When the System is installed,SolarCity will provide you with a link to its Solar Operation Guide.This Guide provides you with System operation instructions,answers to frequently asked questions,troubleshooting tips and service information. SolarCity will perform all required System maintenance. (ii) PowerGuide PowerGuide requires a high speed Internet line to operate.Therefore,during the Power Purchase Agreement Term,you agree to maintain the communication link between PowerGuide and the System and between PowerGuide and the Internet. You agree to maintain and make available,at your cost,a functioning indoor internet connection with a router,one DHCP enabled Ethernet port with intemet access and standard AC power outlet close enough and free of interference to enable an internet-connected gateway provided by SolarCity to communicate wirelessly with the system's inverter(typically this is 80 feet,but may depend on site conditions). This communication link must be a 10/100 Mbps Ethernet connection that supports common Internet protocols(TCP/IP and DHCP). If you do not have and maintain a working high speed Internet line we will not be able to monitor the System and provide you with a performance guarantee or provide PowerGuide. Further,if PowerGuide is not operational,SolarCity will be required to estimate your power usage as set forth in the PPA. (e) Making a Claim;Transferring this Warranty , �y } 1, `i (i) Claims Process ,` , " You can make a claim by: _ `, A. emailing us at the email address in Section 7;below; B. writing us a letter and sending it overnight mail with a well-known service;or.' C. sending us a fax at the number in Section 7 below. (ii) Transferable Limited-Warranty `` SolarCity will accept and honor any valid and properly submitted Warranty claim made during any Term by any person who either purchases the System from you or to whom you properly transfer the PPA. (f) Exclusions and Disclaimer The limited warranties and guarantee provided in this Limited Warranty do not apply to any lost power production or any repair,replacement or correction required due to the following: (i) someone other than SolarCity or its approved service providers installed,removed,re-installed or repaired the System; (ii) destruction or damage to the System or its ability to safely produce power not caused by SolarCity or its approved service providers while servicing the System(e.g.,if a tree falls on the System we will replace the System per the Power Purchase Agreement,but we will not repay you for power it did not produce); (iii) your failure to perform,or breach of,your obligations under the Power Purchase Agreement(e.g.,you modify or alter the System); (iv) your breach of this Limited Warranty,including your being unavailable to provide access or assistance to us in diagnosing or repairing a problem; ❑EMR■ Solar Power Purchase Agreement versior.8.3.3 614429 1 DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 (v) any Force Majeure Event(as defined below); (vi) shading from foliage that is new growth or is not kept trimmed to its appearance on the date the System was installed; (vii) any system failure or lost production not caused by a System defect(e.g.,the System is not producing power because it has been removed to make roof repairs or you have required us to locate the inverter in a non-shaded area); (viii) theft of the System(e.g.,if the System is stolen we will replace the System per the Power Purchase Agreement,but we will not repay you for the power it did not produce);and (ix) damage or loss to the System due to ball strikes. This Limited Warranty gives you specific rights,and you may also have other rights which vary from state to state.This Limited Warranty does not warrant any specific electrical performance of the System other than that described above. Snow or ice may accumulate on rooftops and on solar panels during snow storms.Accumulated snow or ice may slide or fall,resulting in property damage or bodily harm.If and when conditions safely allow you to remove accumulated snow or ice,you should do so to reduce the likelihood of excess snow sliding or falling. THE LIMITED WARRANTIES DESCRIBED IN SECTIONS 2(a)and(c)ABOVE ARE THE ONLY EXPRESS WARRANTIES MADE BY SOLARCITY WITH RESPECT TO THE SYSTEM. SOLARCITY HEREBY DISCLAIMS,AND`ANYBENEFICIARY OF THIS LIMITED WARRANTY HEREBY WAIVES,ANY WARRANTY WITH RESPECT TO ANY COST SAVINGS FROM USING THE SYSTEM. 3. SOLARCITY'S STANDARDS For the purpose of this Limited Warranty the standards for our performance will be(i)normal professional standards of performance,within the solar photovoltaic power generation industry in the relevant market;and(ii)Prudent Electrical Practices. Prudent'Electrical Practices"means those practices,as changed from time to time,that are engaged in or approved by.a significant portion of the solar power electrical generation industry operating in the United States to operate electric equipment lawfully and with reasonable safety,dependability,efficiency and economy. 4. SYSTEM REPAIR,RELOCATION OR REMOVAL (a) Repair. You agree that if(i)the System needs any rep la rs that are not the re ponsibility.of SolarCity under this Limited Warranty,(ii)the system needs to be removed and reinstalled to facilitate remodeling of your Home or.(lii)the system is being relocated to another home you own pursuant to the Power Purchase'Agreement,you will,have SolarCity,'or another similarly qualified service provider,at your expense, perform such repairs,removal and reinstallation,or relocation:- ` ' (b) RemovaVMoving. SolarCity will remove and replace the System"from your roof while roof repairs are being made for a payment of$499. You will need to provide storage space for the System during such time.Where permitted under the PPA,SolarCity will work with you to move the System to your newhome as follows:(i)SolarCity will conduct an audit of your existing Home and new home to determine if a move is commercially feasible\This audit will cost$499. If SolarCity determines that a move is commercially feasible,it will then move the System for an additional payment-of$499:"`""" / (c) Retum.If at the end of the Term you want to return the System to SolarCity under Section 17 of the PPA then SolarCity will remove the System at no cost to you. SolarCity will remove the posts,waterproof the post area and return the roof as close as is reasonably possible to its original condition before the System was installed(e.g.ordinary wear and tear and color variances due to manufacturing changes are excepted). SolarCity will warrant the waterproofing for one(1)year after it removes the System. You agree to reasonably cooperate with SolarCity in removing the System including providing necessary space,access and storage,and we will reasonably cooperate with you to schedule removal in a time and manner that minimizes inconvenience to you. 5. FORCE MAJEURE If SolarCity is unable to perform all or some of its obligations under this Limited Warranty because of a Force Majeure Event,SolarCity will be excused from whatever performance is affected by Force Majeure Event,provided that: (a), SolarCity,as soon as is reasonably practical,gives you notice describing the Force Majeure Event; Solar Power Purchase Agreement version 8.3.3 614429 DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 • (b) SolarCity's suspension of its obligations is of no greater scope and of no longer duration than is required by the Force Majeure Event(i.e., when a Force Majeure Event is over,we will make repairs);and (c) No SolarCity obligation that arose before the Force Majeure Event that could and should have been fully performed before such Force Majeure Event is excused as a result of such Force Majeure Event. "Force Majeure Event"means any event,condition or circumstance beyond the control of and not caused by SolarCity's fault or negligence. It shall include,without limitation,failure or interruption of the production,delivery or acceptance of power due to:an act of god;war(declared or undeclared);sabotage;riot;insurrection;civil unrest or disturbance;military or guerilla action;terrorism;economic sanction or embargo;civil strike, work stoppage,slow-down,or lock-out;explosion;fire;earthquake;abnormal weather condition or actions of the.elements;hurricane;flood; lightning;wind;drought;the binding order of any governmental authority(provided that such order has been resisted in good faith by all reasonable legal means);the failure to act on the part of any governmental authority(provided that such action has been timely requested and diligently pursued);unavailability of power from the utility grid,equipment,supplies or products(but not to the extent that any such availability of any of the foregoing results from SolarCity's failure to have exercised reasonable diligence);power or voltage surge caused by someone other than SolarCity including a grid supply voltage outside of the standard range specified by your utility;and failure of equipment not utilized by SolarCity or under its control. 6. LIMITATIONS ON LIABILITY (a) No Consequential Damages , YOU MAY ONLY RECOVER DIRECT DAMAGES INCLUDING THOSE AMOUNTS DUE PURSUANT TO SECTIONS 2(c)AND 6(C) UNDER THIS LIMITED WARRANTY,AND IN NO EVENT SHALL SOLARCITY OR ITS AGENTS OR SUBCONTRACTORS BE LIABLE TO YOU OR YOUR ASSIGNS FOR SPECIAL,INDIRECT,PUNITIVE,EXEMPLARY,INCIDENTAL OR CONSEQUENTIAL DAMAGES OF ANY NATURE. SOME STATES DO NOT ALLOW THE EXCLUSION OR LIMITATION OF INCIDENTAL OR CONSEQUENTIAL DAMAGES,SO THE ABOVE LIMITATION MAY NOT APPLY TO YOU. (b) Limitation of Duration of Implied Warranties t ✓ ANY IMPLIED WARRANTIES,INCLUDING THE IMPLIED WARRANTIES OF,�FITNESS FOR A PARTICULAR PURPOSE AND MERCHANTABILITY ARISING UNDER STATE LAW,SHALL IN NO EVENT EXTEND PAST THE EXPIRATION OF ANY WARRANTY PERIOD IN THIS LIMITED WARRANTY. SOME STATES�DO.NOT'ALLOWIIMITATIONS ON HOW LONG AN IMPLIED WARRANTY LASTS,SO THE ABOVE LIMITATION MAY NOT APPLYJO YOU. 'Al (c) Limit of Liability d Notwithstanding any other p jovision of hi Limited Warranty to the contrary,SolarCity's total liability arising out of relating to this Limited Warranty shall in no event: (i) For System Replacement: exceed the greater of(a).the sum of the Monthly Payments over the Term of the Power Purchase Agreement and(b)the original cost of the System;and (ii) For damages to your Home,Belongings and Property: exceed two million dollars($2,000,000). 7. NOTICES All notices under this Limited Warranty shall be made in the same manner as set forth in the Power Purchase Agreement to the addresses listed below: TO SOLARCITY: SolarCity Corporation 3055 Clearview Way San Mateo,CA 94402 Attention: Warranty Claims Telephone: 650-638-1028 Facsimile: 650-638-1029 Email: customercareesolarcity.com TO YOU: At the billing address in the Power Purchase Agreement or any subsequent billing address you give us. ❑� I Solar Power Purchase Agreement version 8.3.3 614429 a . r DocuSign Envelope ID:7175A38F-2B9F-40B4-9389-543486CC6388 8. ASSIGNMENT AND TRANSFER OF THIS LIMITED WARRANTY SolarCity may assign its rights or obligations under this Limited Warranty to a third party without your consent,provided that any assignment of SolarCity's obligations under this Limited Warranty shall be to a party professionally and financially qualified to perform such obligation. This Limited Warranty protects only the person who hosts the System. Your rights and obligations under this Limited Warranty will be automatically transferred to any person who purchases the System from you or to whom you properly transfer the Power Purchase Agreement.This Limited Warranty contains the parties'entire agreement regarding the limited warranty of the System. 0 0 Solar Power Purchase Agreement version 8.3.3, 614429 1� , i� c I E "'w,a cok Engineering Dept. (3rd floor) Map Parcel FZ-Jf'Permit# Q4-bg-3 . House# Date Issued I —�6 Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) 177 7 9 Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) US'T.BE Planning Dept. (1st floor/School Admin. Bldg.) 10 SY Defi ' ' e Approved by Planning Board 19 INVALLV) �! � TOWN OF BARNSTABI. ®�� Building Permit Applicatign r 0 Project Street Address N ,� a� Village � o Owner K6 C)ad 4 Address 06 9 V6 Telephone -2-0.3 Permit Request pq �� vtfi ����N�'t/l mfoz C��� �:� �� J✓�'l� �1�G Le nJ�� SOoi! ��c�✓� �"p�Z_ C��� First Floor . "square feet Second Floor square feet Construction Type Estimated Project Cost $ f),Z ®®© Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Id Two Family ❑ Multi-Family(#units) Age of Existing Structure cRO f6 S0 Historic House ❑Yes /�:No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other �,l ec r1J Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) " ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No ((If ,es, site plan review# - Current Use u 'r�M f1_ IAWA)Ave, Proposed Use - ��'�e ���� fu Builder Information Name(o(�d §%Ip �t)gh Telephone Number /, — Address R /tea License# i� G.&W e S OP b 01 Home Improvement Contractor# t Worker's Compensation# ( NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDIN PERMIT DENIED FOR THE OLLOWING REASON(S) T '. r FOR OFFICIAL USE ONLY e' r" PERMIT NO. r r DATE ISSUED ' 4 , MAP/PARCEL NO. ADDRESS VILLAGE , OWNER 1 I r DATE OF INSPECTION: FOUNDATION FRAME INSULATION r _ FIREPLACE I ELECTRICAL:' ROUGH FINAL PLUMBING: ROIJGW�, FINAL , F t GAS: ,' GIIJGHi FINAL FINAL BUILDING. ME DATE CLOSED,otf tj "}; ASSOCIATIOW+^ N N j- a e 1 O � � me's � aw r O : z O ~ O X 70 �t _ i Ma 70 /n iJ r. r a i Ir 1 R ar r: i3+ if, 1 !_ 1 - F---. _ r i` I i�`ii,_ i 5tE ifit _1 F.lT1ON z . � EWE DATE iR1Fd Ofi 1 A ¢ i. t } t 9 s y:�*JG# +it :"y �y yA T' 3{ �' �3x r7F^;!I-S��eqPTER-n�ryteCAT a� 1p�. tof Kihi'Y�.^4bi'c bR„°£ >�t ES, �A 7 �a5�' ;'�r4�� "t�141'A L}�D B E 1640 y� ,'j}�pq:�+y' a s- 9 v ,aA§•t o §'t 't^^x. c E�s o 13 2 fi t"$'k '3,�;�1MT7 ,jAyannis, HA b" 92# . . " i try s { �:k: a con soma �� t l 1 .,.v. 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Try- ltiav ed H�i.jE 1��,r.R .l..�1.;. ...__�,:-,i. ,�..1.�3.. .k` 25 i 'Fy' O t a,Yt rt 're 3ail.'.l rt�it:liZ 'MA ff��Q1 r-T - .. - •r -4} cldln 7lp !=,;G41 oil •" 'q.~� i',�v;ii �, ,. 6slh16 ��:f r 7. f (j?�r�r wo,kpi^L:Bu r1^' yCIU'trri s`J.+�rE� "f! � 7 t ' , 1i@ p i{' ?:lW i tl'CS7i .¢ _I, :; tv y: r 1 F. roe rt ri,�rr=e f; l(`.tt•ve.'.e, s+I.t, Lromp. t�.-f+? Law'.hl MgS�.rahe Wed yore.A, INOrIZ fri PC 1 r}. Employers 1-!a°.Mvy Pen tv;•q pt }p wYR; fi) �:.4..,t �}_S.d�:5I..�4�iC�ils �✓.• i4 �!iitlt& r f"" f' }G"4 kS1° by A."! tii It f' r } } t„� t��it ? !�G ty, 1010 ca,...}'?`:r-,,t:+ TV+crr,`. 'M41:3P �iciGd 5 kfu r J X*�ErC YiFf 0,fi'1e t9 jhafli: " { (�?J1[•t a r i Avid"MA, b - . - '6#"Itz+CiT�+tt.Ys ��Gfab�e{� �3�,�� Je S�tt.,f`k t 4'� er i 3�'R�it`.•��t,��f.{1 Ott.�y1C'� ..,...r-�l.-�a..,.�+ —_,_ram_,,,,..>•y.� - ^F.•ti.. r � .. S L 1 M 5 ,„.3.4n'A.S- " #""k' 41, d` C. ALA t' It UN e x{ 11 , 14 rTvwj a �! 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Irci,da3 cv y, E �` r tz• � I :: a � � CRC : The Town of Barnstable g Department of Health Safety and Environmental Services g Buildin Division two 367 Main Street,Hyannis MA 02601 Office: 508-790-6n7 Ralph C.rossea Fax: 508 775-3344 Budding Commis: For office use only Permit no._ Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstmcdon,alterations,renovation,.repair,modernization,conversion, improvement, removal, demolition. or construction of an addition to any pte-cxisng owner Occupied building containing at least one but not mom than four dwelling units or to saucdues which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other Type of Work: ��� Est.Cost 4V Address of Work: Owner.Name: �2,107&A Date of Permit Application: �7` I hereby certify that: Registration is not required for the following reason(s): Work cmduded by law ' Job under S1,000 Building not owneroccupied Owner pulling own permit Notice is hereby green that: OWNERS PULLING THEIR OWN PERMIT OR DEALING VMM UNREGISTERED CONTRACTORS FOR APPLICABLE HOME zeROVFMENr WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contra name Registration No. OR Date Ownei s name CERTIFICATE OF INSURANCE (X} ISSUE DATE07/25/W FRIUCER This certificate is issued as a matter of information only and confers O'Brien's Centerville Ins Agcy no rights upon the certificate holder. This certificate does not amend, 259 Pine Street extend or alter the coverage afforded by the policies below. P. 0. Box 610 Centerville, MA 02632 COMPANIES AFFORDING COVERAGE CODE 326 SLE-CODE Co. Ltr. A ; Hingham Mutual Fire Ins. fINSURE11:3 Co. Ltr. B a Daniel Lindberg Co. Ltr. C a 697 Shoot Flying Hill Rd. Co. Ltr. D e Centerville, MA 02632 Co. Ltr. E a # CO)ERAGES This is to certify that policie5 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, al the terms, exclusions, and conditions of such policies. Limits shown may have been reduced by paid claims. Cb Type of Insurance Policy Number Policy Policy All Limits In Thousands Ltr Eff Date Exp Date A GENERAL LIABILITY ART9500039 01/26/95 01/26/96 General Aggregate $ 300 (X) Ccoviiercisl General Liability Products-Comp/Ops Aggregate $ 300 (X) ( ) Claims Made (X) Occur. Personal & Advertising Injury $ 300 ( } Owner's R Contractors Protective Each Occurrence $ go ( ) Fire Damage (Any One Fire) $ ( ) Medical Expense (Any One Person) $ 5 AUTOMOBILE LIABILITY ( } Any Auto CSL $ ( ) All Owned Autos Bod i ly Injury ( ) Scheduled Autos (Per Person) $ ( ) Hired Autos Bodily Injury ( ) Non-Ck-fined Autos (Per Acc i dent) $ ( ) Garage Liability Property Damage $ t ) EXCESS LIABILITY Each t ) Umbrella Form Occurrence Aggregate ( ) Other than Umbrella Form $ $ -------------------------- --------- Statutory ----------- --_ WOWERS' COMPENSATION $ (Each Accident) AND $ (Disease Policy Limit) EMPLOYERS' LIABILITY $ (Disease Each Employee) OTHER I --- Description of Operations/Locations/Vehicles/Restrictions/Special Items -------------------- _- Residential Carpentry **Subject to Policy Terms & Conditions** # CERTIFICATE HOLDER ################################ CANCELLATION ######### ###### ########################################### Robert Negri Should any of the above described policies be cancelled before the 5 Harrington Way expiration date thereof, the issuing comipany wiII endeavor to Hyannisport, MA 02647 mail 10 days written notice to the certificate holder named to, the lef t, but failure to mail such notice shall impose no obligation or I i ab i I i ty of any k i nd upon the company its agents or representat ives. PUTHORIZED REPRESENTATIVE 11:o2/94 IT:02 $8177277122 DEPT IN'D ACCID C0j)UnojzwPa1dz. ol Mamachudeffi ' .,U�a�tssaf o�.�`ndud[r�✓lfccidorttJ 600 UUaaltaji sty 4ames,J.Campbell U &04 Vaaaadtcm& 02f f . Commissioner Workers' Compensation Ittsutance Affidavit c 1, (aotaseeJpahm®ee► . with a principal place of business at; � �srshaysta� t do hereby certify under the pains and penalties of penury, that: Q I am an employer provid'mg workers' compensation coverage for my employees workin this lob. Insurance Company ' Policy dumber O I am a sole proprietor and have no one worsting for me in any capacity. () I am a sole proprietor, general cocinractor or homeowner (drde one) and have hired tf actors ,sted below who have the following workers' compensation policies: Codfractor V Insurance Company/Policy Hum: Contractor insurance Company/Policy Num: Contraaor insurance Company/Policy Num: O I am a homeowner performing all the work myself. I unt:ersand t s coF•t of this=vnent will be fonnrded to the office,of imamiptions of the 01A for coverage verifiation and that failure ca:er:ge zi recsired under Section ZSA of MGL I sl can lead to the imposition of criminal penalties cottsessine of a fine of up to S 1,500.00 years'1m;risa r-ent as well as civil penalties in the form of a STOP WORK ORDER:nd a Me of S 100.00 a day apinst me. Signed this day of �J� , 19 Uc see/Permitt Building Department Licensing Board Selec mens Office Health Department -- -- --- — _ -- _ - - _ �o%av wnr►A 1/Af1? AAA Ant_ Ann �7 e � A Assessor's Office(1st floor) Map Lot � rmit# f Conservation Office(4th floor) Date Issued %_115 Board of Health(3rd floor)(8:30-9:30/1:00- 2:00) Fee rd ' 0� engineering Dept. (3rd floor) House#1 (4 t Planning Dept.(1st floor/School Admin. Bldg.) ' Defi ' an Approved by Planning Board 19 6 9 .� TOWN OF-BARNSTABLE Building Permit Ap lication -# Pro a Address \5 6)�c 2,142 Village ' Owner e2AA < Address 'Telephone Permit Request -'— — Total 1 Story Area(include 1 story garages&decks) square feet / Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ Zg t-- Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Buil Information Name � `� elephone Number 7 7 -0 F`� d dressd&& icense# Home Improvement Contractor# 00' Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 4 k1 DATE �9 BUILDING PERMIT DE FOR THE/FLLOWING REASON(S) n � FOR OFFICIAL USE ONLY PERMIT NO. 9 3 81•, ' DATE ISSUED 7/2 7/9 5 f » MAP/PARCEL NO. 288 092 5 Harrington"Way,Y iHyannis ADDRESS .; ;, .� VILLAGE - Robert & Jeanne.�Negri " OWNER _ , DATE OF INSPECTION: FOUNDATION -, FRAME INSULATION } , FIREPLACE r ELECTRICAL: ROUGH FINAL _. - 1 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A t. ` AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. " CONIC 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 P'4. HOG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(8). 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. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES; RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT W WATT 3R NEMA.3R, RAINTIGHT PV1 COVER SHEET PV2 PROPERTY PLAN PV3 SITE PLAN PV4 STRUCTURAL VIEWS LICENSE GENERAL NOTES PV5 UPLIFT CALCULATIONS � PV6 THREE LINE DIAGRAM 1. ALL WORK TO BE DONE TO THE 8TH EDITION X Cutsheets Attached GEN #168572 - ELEC 1136 MR OF THE MA STATE BUILDING CODE. ' + 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. i MODULE GROUNDING METHOD: ZEP SOLAR • AHJ: Barnstable REV BY DATE COMMENTS REV A NAME DATE COMMENTS UTILITY: NSTAR Electric (Cambridge Electric Light) CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: J B-0 2 6 9 3 8 00 PREMISE OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE SYLVIA, CELESTE SYLVIA RESIDENCE Rueben Soso Sosa 7StMartin larCit BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: y NOR SHALL IT BE DISCLOSED IN WHOLE OR IN CompMount Type C 5 HARRINGTON WAY 5.46 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES: H YA N N I S, MA. 02601 TM K OWNER: THE SALE AND USE OFJHE RESPECTIVE (21) Hanwha Q—Cells #Q.PRO G4/SC 260 M * t ve,Bulding.2;,Unit.11SOLARCITY EQUIPMENT, WITHOUT THE WRITTENPAGE.NAME SHEE�P�:1REV:' DATE gh,MA 01752. PERMISSION OF SOLARCTY INC. MVTRTER' SO88277959 P V 1 5 11 2015 28 F: (650)638=10�9 SOLAREDGE SE5000A—USOOOSNR2 COVER SHEET / / -248g) www.solorcity.com F PROPERTY PLAN N Scale:l" = 20'-0' W E 0 20' 40' _ S CON J B-0 2 6 9 3 8 00 PREMISE OWNER. DESCRIPTION: DESIGN: CONFIDENTIALTHE INFORMATION HEREIN d08 NUMBER:—CONTAINED SHALL NOT BE USED FOR THE SYLVIA, CELESTE SYLVIA RESIDENCE Rueben Sosa Sosa �.,;SO�arC■�ty. BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MWNTING SYSTEM: a" NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 5 HARRINGTON WAY 5.46 KW PV ARRAY PART TO.OTHERS OUTSIDE THE RECIPIENT'S MOWS H YAN N I S M A 02601 ORGANIZATION, EXCEPT IN CONNECTION NTH 24 SL Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (21) Hanwha Q—Cells #Q.PRO G4/SC 260 SHEET: REV: DATE: Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME T. (650)638-1028 F: (650)638-1029 SOLAREDGESE5000A—USOOOSNR2 PERMISSION OF SOLARCITY INC. I"" 5088277959 PROPERTY PLAN PV 2 5/11/2015 (666)-SOL-CITY(765-2469) www;solarcity.com " PITCH: 28 ARRAY PITCH:28 MPi AZIMUTH: 173 ARRAY AZIMUTH: 173 # MATERIAL:Comp Shingle STORY: 1 Story Front Of House O --� LEGEND M � � - AC Q (E) UTILITY METER & WARNING LABEL 0 INVERTER W/ INTEGRATED DC DISCO by & WARNING LABELS DC • t o DC DISCONNECT & WARNING LABELS OPi AC DISCONNECT & WARNING LABELS O DC JUNCTION/COMBINER BOX & LABELS A Q DISTRIBUTION PANEL & LABELS - 11 Lc LOAD CENTER & WARNING LABELS OF DEDICATED PV SYSTEM METER WXUAM& Q STANDOFF LOCATIONS EU)REDGEJR $ Ho.Sow CONDUIT RUN ON EXTERIOR --- CONDUIT RUN ON INTERIOR +s � - GATE/FENCE wnLrc Q HEAT PRODUCING VENTS ARE .RED ;� IN11_RIOR EQUIPMENT IS DASHED. L_ J Digitally signed by William A. Eldredge Jr. Date: 2015.05.13 17:56:24 -04'00' SITE PLAN N STAMPED &. 0 1' 8' 16' SIGNED Scale: 1' W FOR STRUCTURAL ONLY E S' CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: J B—O 2 6 9 3 8 00 . PREMIX OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THESYLVIA, CELESTE SYLVIA RESIDENCE Rueben Soso Soso � SolarCit BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: �� NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 5 HARRINGITON WAY 5.46 KW PV ARRAY PART IZ OTHERS OUTSIDE THE RECIPIENT'S MODULES H YAN N I S M A 02601 : ORGANIZATION, EXCEPT IN CONNECTION WITH � ) 24 St. Martin Drive,BuOding.2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (21) Hanwha Q-Cells #Q.PRO G4/SC 260 SHEET: REV DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME 9• PERMISSION OF SOLARCITY INC. INVERTER: T: (650)638-1028 ,F: (650)638-1029 SOLAREDGE SE5000A-USOOOSNR2 5088277959 SITE PLAN PV 3 5/11/2015 (ase)-soL-CITY(7ss-lass) wwW.edorcttycam-: S1 70, (E) LBW - A SIDE VIEW OF MP1 NTs MP1 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES 71 LANDSCAPE 64" 24" STAGGERED s PORTRAIT 48" RAFTER 2X6 @ 16" OC ROOF AZI 173 PITCH 28- STORIES: 1 ARRAY AZI 173 PITCH 28 C.J. 2X8 @16" OC Comp Shingle PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER & FENDER WASHERS LOCATE RAFTER, MARK HOLE ZEP LEVELING FOOT (1) : LOCATION, .AND DRILL PILOT ZEP ARRAY SKIRT (6) HOLE. SEAL PILOT HOLE WITH ' (4) (2) POLYURETHANE SEALANT. ZEP COMP MOUNT C - ZEP FLASHING C (3) (3) INSERT FLASHING. WILUAMA, � (E) COMP. SHINGLE MDREM JFL (1) C(4)F PLACE MOUNT. 3 �0.500�7 (E) ROOF DECKING (2)� INSTALL LAO BOLT WITH 5/16" DIA STAINLESS (5) (5) SEALING WASHER. STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES INSTALL LEVELING FOOT WITH WITH SEALING WASHER (6) BOLT & WASHERS. lilt, (2-1/2" EMBED, MIN) (E) RAFTER STANDOFF- STAMPED.& SIGNED S1 FOR STRUCTURAL ONLY J`B-0 2 6 9 3 8 0 0 PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL- THE INFORMATION HEREIN FINVMTEBR: �c`!r CONTAINED SHALL NOT BE USED FOR THE SYLVIA,. CELESTE SYLVIA RESIDENCE Rueben Sosa Sosa �,;SolarCity. BENEFIT OF ANYONE EXCEPT SOLARCITY INC., TEM: _ NOR SHALL IT BE DISCLOSED IN WHOLE OR INount Type C 5 HARRINGTON WAY 5.46 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS YP H YAN N I S M A 02601 ORGANIZATION,EXCEPT IN CONNECTION WITH 24 St Martin Drive,Building Z Unit 11 THE SALE AND USE OF THE RESPECTIVE nwha Q—Cells #Q.PRO G4/SC 260 SHEET: - REV: DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME T. (650)638-1028 F. (650)638-1029 PERMISSION OF SOLARCITY TY INC. 5088277959 PV 4 5 11 2015 (888)-SOL—CITY(765-2489) www.sdarcity.com DGE SE5000A-USOOOSNR2 STRUCTURAL VIEWS / / f UPLIFT CALCULATIONS SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. CONFIDENTIAL THE INFORMATION HEREIN JOB NUMBER: JB-026938 00 PREMISE OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE SYLVIA, CELESTE SYLVIA RESIDENCE '' Rueben Sosa Sosa BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: � NOR SHALL IT BE DISCLOSED IN WHOLE OR IN CompMount Type C 5 HARRINGTON .WAY 5.46 KW PV ARRAY .,,SOlarCity. PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULES: HYAN N I S M A. 02601 ORGANIZATION, EXCEPT IN CONNECTION WITH , - THE SALE AND USE OF THE RESPECTIVE (21) Hanwha Q—Cells #Q.PRO G4/SC 260 24 St Martin Drive, Building Z Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME SHEET: REV: DATE Marlborough, MA 01752 PERMISSION OF SOLARCITY INC. INVERTER: 5088277959 PV 5 5 11 2015 T: sm— w(765— F:;650)638-1029 SOLAREDGE SE500OA—USOOOSNR2. !' UPLIFT CALCULATIONS / / ( )—SOL-pTY(785-2489 wwwsolardtycom GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO (E) GROUND ROD Panel Number: Inv 1: DC Ungrounded INV 1 —(i)SOLAREDGE ##SE5000A-USOOOSNR LABEL: A —(21)Hanwho Q-Cells #Q.PRO G4/SC 260 GEN #168572 AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:44014716 Inverter; 5000W,'240V, 97.57.; w/Unifed Disco and ZB,RGM,AFCI PV Module; 260W 236.5W PTC, 40mm, Blk Frame, MC4, ZEP, 600V ELEC 1136 MR Underground Service Entrance INV 2 Voc: 37,77 Vpmax: 30.46 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 125A MAIN SERVICE PANEL E; 10OA/2P MAIN CIRCUIT BREAKER Inverter 1 (E) WIRING CUTLER-HAMMER I 10OA/2P Disconnect 3 SOLAREDGE - Dc. - - SE5000A-US000SNR2 Dc MP 1: 1x10 - --------—--------- V— E2G C Ll (E) LOADS A N DG I 30A/2P ----------------------- EGci . MP. .. 1: lxllA GEC GGND — ------------ -------_—-- - _♦ -�lI y N ('1)Conduit Kit; 3/4" EMT u GEC,.., T . u,- F e 1 • , TO 120/240V _ .. r SINGLE PHASE _ I - UTIUTY.SERVICE :o PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN • i r Voc* MAX VOC AT MIN TEMP TT (1)SQUARE D �gy HO 2100 PV BACKFEED BREAKER (1)CUTLER-HAMMER N DG221UR8 - "A,: _ (21)SOLAREDGE ox O1 Breaker, 10OA�2P, 2 Spaces a LAR 2 S Disconnect; 30A, 24OVac, Non-Fusible, NEMA 3R AC = P V EDGE�3 NA4AZ ower8 ptimizer, 300W H4,DC to DC ZEP -(1)CUTLER- AMMER #DG030N8 K' � DC Ground leutral it; 30A, General Duty(DG) nd (1)AWG 6 pp Solid Bare Copper - 1)Ground Rod; 5/8° x 8', Copper \. ( _ (N) ARRAY GROUND PER 690.47(D)..NOTE: PER EXCEPTION NO. 2, ADDITIONAL ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE 1 AWG #10, THWN-2, Black. (2)AWG 10,PV Wire, 600V, Black Voc* =500 VDC Isc 15 . ..ADC O 14F-(1)AWG #10, THWN-2, Red O � (1)AWG#6, Sold are Copper GC Vmp =3 VD Imp=7 3 II���.LL i B E 50 C 3 ADC ' (I)AWG #10, THWN-2, White NEUTRAL Vmp -240 VAC Imp=21 AAC . , , ,_ • . (1 Conduit Kit; 3/4' EMT - ;' -(i)AWG B,.T}LWRJ-2,_Green . . EGC/GEC.-(1)Conduit.Kit;.3/47 EMT,, , . . :. . . . (2)AWG g10, PV Wire, 600V, Black Voc* -500 VDC Isc 15 ADC O (1)AWG#6, Solid Bare Copper EGC Vmp =350 VDC Imp=8.07 ADC (1)Conduit Kit.3/4�.EMT. .. . . .. :. ..... . ... . . .. . . . . . . .. . . .. .... . . Q PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: J B-O 2 6 9 3 8 00 r ����e CONTAINED SHALL NOT BE USED FOR THE SYLVIA, CELESTE. SYLVIA RESIDENCE Rueben. Sosa Sosa ;,;SO�a�city BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: A'"` NOR SHALL IT BE DISCLOSED IN WHOLE OR IN CompMount Type C 5 HARRII�NG1,TON WAY 5.46 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES HYANNIJ MA 02601 ORGANIZATION, EXCEPT IN CONNECTION NTH � 24 St.Martin Drive,Building 2,Unit 11 , THE SALE AND USE OF THE RESPECTIVE (21) HanWha Q-Cells #Q.PRO G4/SC 260. SHEET- REV: DATE Marlborough,MA 01752 - SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME T: (650)638-1028 F: (650)638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGESE5000A—USOOOSNR2 5088277959 THREE LINE DIAGRAM PV- 6 5/11/2015 (888)-SOL—CITY(765-2489) www.sdarcitycom • e o o •o o Label Location: MM Label Location: Label Location: . (C)(CB) W� (AC)(POI) . (DC) (INV) Per Code: rdurd Mg. ._ Per Code: - - Per Code: NEC 690.31-.G.3 °o 0 o O _ • ° NEC 690.17.E NEC 690.35(F) Label Location: TO BE USED WHEN (DC)(INV) o ° -o o ° -o ° ° • o • INVERTER IS D O Per Code: UNGROUNDED NEC 690.14.C.2 Label Location: Label Location: pro ° e -o w (POI) (DC) (INV) •_ - o - o o Per Code: Per Code: °o e o NEC 690.17.4; NEC 690.54 low_o o • -° NEC 690.53 e ee a o•° s _e e MEMO A Label Location: •' JAM, • �d . o (DC)(INV) Per Code: NEC 690.5(C) Label Location: o ° o- w•` (-� O (POI) Per Code: NEC 690.64.6.4 e e o Z Label Location: (DC)(CB) o ,.° Per Code: Label Location: NEC 690.17(4) . ` (D)(POI) Per Code: W ° •x. I 'e a (F3:• ° NEC 690.64.B.4 Label Location: (POI) POI Per Code` Label Location: o e NEC 690.64.13.7 O O O (AC)(POI) o0 0 (AC):AC Disconnect = QD O Per Code: ° (C): Conduit NEC 690.14.C.2 ,. (CB): Combiner Box > (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit Label Location: ` (INV): Inverter With Integrated DC Disconnect Arm (AC) (POI) (LC): Load Center •' Per Code: , NEC 690.54 (M): Utility Meter (POI): Point of Interconnection - CONFIDENTIAL- THE INFORMATION HEREIN CONTAINED SHALL NOT BE USED FOR w Way 3055 Clearvie THE BENEFIT OF ANYONE EXCEPT SOLARCITY INC., NOR SHALL IT BE DISCLOSED �� San Mateo, ie Way 4402 IN WHOLE OR IN PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION, Label Set ��� T:(650)638-1028 F:(650)638-1029 EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE • solalu � (888)-SOL-CM(765-2489)www.s6larcity.com SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PERMISSION OF SOLARCITY INC. o i ® Next-Level PV Mounting Technology ''^SOIafClt ® Solar Next-Level PV Mounting Technology ^•SolafCity I ZepSolar 9 gY y I p Zep System Components for composition shingle roofs _'�__,Up-roof - ground Zep Interlock PLY side shown) - � F Zep CompatMe PV Module - s .. - '�.•^? Zep Orowe. ,. .._-,,,.,,,s Roof Attachment .. _ Array SkVt - .. . QGOMVATj Description . �'- Fp/a PV mounting solution for composition shingle roofs CdMFpt� Works with all Zep Compatible Modules • Zep System UL 1703 Class A Fire Rating for Type 1 and Type 2.modules Auto bonding UL-listed hardware creates structual and electrical bond V� LISTED Comp Mount Interlock Leveling Foot Part No.850-1345 Part No.850-1388 Part No.850-1397 Listed to UL 2582, Listed to UL 2703 Listed to UL 2703 Specifications Mounting Block to UL 2703 ^ C I Designed for pitched roofs .,E Installs in portrait and landscape orientations —1 • Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 r- Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and ETL listed to 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 Ground Zep Array Skirt,Grip,End Caps DC Wire Clip • Attachment method UL listed`to UL 2582 for Wind Driven Rain - Part No.850-1172 Part Nos.500-0113, Part No.850-1448 Listed to UL 2703 and 850-1421,850-1460, Listed UL 1565 ETL listed to UL 467 850-1467 zepsolar.com zepsolar.com Listed to UL 2703 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 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 each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. - responsible for verifying the suitability of Zep Solar's products for each use..Specifications are subject to change without notice.Patents and Apps:zspats.cem. 12 22 14 ZS for Comp Shingle Cutsheet Rev 02.pdf Page: 1 Of 2 12 22 14 ZS for Comp Shingle Cutsheet Rev 02.pdf - Page: 2 of 2 solar=oo solar=ooSolarEdge Power Optimizer f.�11 Module Add-On for North America i1T-V P300 / P350 / P400 SolarEdge Power Optimizer {0 P300 P350 P400 - Module Add-On For North America ( 5,V (for V (for V (fomodulet P300 / P350 / P400 Pa INPUT • Rated Input DC Power�'� 300 350 400 W o. Absolute Maximum Input Voltage(Voc at lowest temperature) 48 60 80 Vdc - _ ............................... .............. ...... ......................... ............. ._ MPPTOperatingRange 8-48 8-60 8-.. Vdc ............................................................................... .............. .... ................................................................ Maximum Short Circuit Current(Isc) - 10 _ Adc '^anon' Maximum DC Input Current 12.5 Adc �. ................ ...... ............... ......... .............................................................. .. .. .. Maximum Efficiency ....................99:5..............................................%.e...... WeightedEfficency .. ............................ ....................................... ...................................... % .-. - Ovemoltage Category II OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) Maximum Outpu[Current 15 Adc Maximum Output Voltage 60 Vdc OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) - �• ���aa Safety Output Voltage per Power Optimizer 1 Vdc STANDARD COMPLIANCE . Part15 Class B IEC61000 6.2,IEC61000 Safety IEC62109-1(class II safer :UL1741 - - RoHS Yes ' n _ INSTALLATION SPECIFICATIONS Maximum Allowed System Voltage .. 1000 Vdt DlmenslonslW.x .. .. . ...................141x212 x 40:5/S.SS x 8.34 x 1,59 min/in Weight(including cables)„.,.,..„.. 950/2.1 ................................... .......................... ....................................................... il- Input Connector MC4/Amphenol/Tyco ................................................................ ....... ........ .................................................. Output Wue Type/Connector Double Insulated;Amphenol Output Wue leng[h.................................................... .......0:95/.. .... I.................... ..2/3:9........... ........ ..m..ft... - OperatingTemperatureRange............................... ......................40:+85/,:40;+185 'C/ F - . - Protection Rating IP65/NEMA4 - - Relative Humidity 0 S00 % o�xxea sre rope.arm.mmme moan eor eo ro«sx oew<r rm...e<e,ow<a. PV SYSTEM DESIGN USING A SOLAREDGE - THREE PHASE THREE PHASE - SINGLE PHASE 'INVERTER 208V 480V PV power optimization at thy!module-(eve( NJinimum String Length PowerO timizers 8 10 18 P P — Up to 25%more energy _ : - • Maximum String Length(Power Optimizers)................... ......•...25. .... 25 .... S0 ....• .. - ................... ............................... .. Superior efficiency(99.5%) Maximum Power per String 5250 .. 6000 ,•12750 W - ........ ................................... Parallel Strings of Different Lengths or Orientations Yes — Mitigatesalltypesofmodulemismatchlosses,frommanufacturingtolerancetopartialshading - - Parallel ..........••••••••••.•...... •••..-... —.-. -... — Flexible system design for maximum space utilization _ < Next maintenance with module-level monitoring Fast installation with a single bolt r *._° 477 Ne g .,.. � :� • v saris , Module-level voltage shutdown forinstallerand firefighter safety 'r`m' r(''n{ - (9 0 USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA WWW.SOlaredge.u5 •� ,,�,�, M we Gila �m�.x mbarQSeltp�.ztltUralSe em6aw'.,,i6.t+ ar•aR aII.� 3^bml�r! r 3 .-mow W i 4 � ] Single Phase Inverters for North America e e Syr >O O I r e 0Uo SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ Solar O O r : SE7600A-US/SE10000A-US/SE11400A-US tin Mira ; #�sy `g{""^^` SE3000A-US SE3800A-US SESOOOA-US SE6000A-US SE7600ArU5 SE10000A-US SE11400A:U5 fix rJx * +t � y .,• . r .OUTPUT z - 9980 @ 208V SolarEdge Single Phase Inverters a„ Nominal AC Power Output 3000 3800 5000 6000 7600 10000@240V 11400 VA • -'—(ll.n (� Power Output 3300 4150 6000 8350 12000 VA - - For North America Max AC ..... . sash@zaw 1�9sq@zaw ...... ......... = AC Output Voltage Min:Nom:Max. - SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ 183-208-229Vac ....✓ ... ............... .. ........ ............ ........... .............. • AC Output Voltage Min:Nom:Max.' SE760OA-US/SE10000A-US/SE1140OA-US 211-240-264Va ........... . .... ... ..... . ... ..�.... . ..... �. .... .... .................. "'�rv;," AC Frequency •••••.•.•.-•- •..••••.••••. 59.3-60 60.5•(with HlcountrysetHng•57..60-60.5)••••••.•...•.....•..•••••.••. _H..,•:• .L..24 @ 20SV L ............ .. L..48 @ 208V I .. Max Continuous Output Current 12.5 16 25 32 - 47.5 A �. I. 21 @ 240V I.. ...42 @,240V ............. .... „- ................................... .............. .. Utility ..... ....... ...... ........... ..................... .................................1........................ ............................ ......... . .A 'i Monitoring,Islanding _ Protection,Country Configurable Yes �wertej _ Thresholds INPUT ^^':-�-' �^w •� 01 1 ice` a Recommended Max.DC Power'" - - All Id feats ?_.' , 3750 4750 1250 7500 9500 12400 14250 W_ - c.' ..... .... .............. ........... ..... ...... ...... . .... . ......... .............. ......... ...... y, Wananry ems,° (STC) .,: .....�. -`.! „ ' �. ;;; .•:+'• •Transformer-less,Un rounded ......................................................... Yes .......................... ........................ ... , - - a '7•-�•' Max.Input Voltage ................ ...... 500................................................ ... Vdc ... • '"' "' C Input Voltage 325 @ 208V/350 @ 240V Vdc _ „m NomD ............ ......... ....... .... ............ .............. ......... .. .., .'`.. Max.Input Current••' 9 5 13 16.5 @ 208V• .. 18 .. .. 23 .. ...33 @ 208V..... 34.5 .. ..Adc - _ ....................................... . ......... ............. I. ............. .............. .............. .......�°..? ..................... .. . . (.. v I 13 v 15.5 @ 240 0.5 40 c - _... Max.Input Short Circuit Current 30 45 •Adc. . _ ,.. - :. . .. - .. .......................................... .........................�......................................... ............................. }, "•r Reverse Polarity Protection Yes Ground Fault Isolation Detection 6001to Sensitivity .• - a - - Maximum Inverter Efficiency 97.7 98.2 98.3 98.3 98 98 98 .. _ T' ............................... ........ ............ " - CEC Weighted Efficiency 97.5 I 98 7.5 @ 208V 97 5 97.5 97 @ 208V ... _ 97.5 .. % 9 98 @ 240V ........... ..... .... ............ Nighttime Power Consumption... .............. ..............<2.5 . . ... ........ <4 ADDIT AL URES Support)drCommE Communication ation Interfaces ............................................. ..................................RS485,.RS232,.Ethernet ZigB.ee(optional).................................... ......... .. ....... .... . .` c - Revenue Grade Data AN51 C12.1 Optional s i STANDARD COMPLIANCE I -...�.--3w...as. -- SafetY.................................. .... 1. ................ ............................... Gnd Connection Standards.......... .............. .......... ....... 161EEE1547 9 ..... ............ .................... ......... " ,°„ �°. �r ^``�"� • •�� sr Emissions FCC partlSclas 8B CS U L1741, 1'cf INSTALLATION SPECIFICATIONS - ;1':: '' "''' • AC output conduit size/AWG range 3/4 minimum/246AWG 3/4 minimum/83AWG - -.,.. ... ....... ....... .. .. ....... .. ..... .... ........... .................. ......... i of strings s - _ , ., • DC input conduit size/# in s/ 3/4" um/1 rings/24 3/4"minimum/1 2 rings/14 6 AWG minim 2 t 6AWGstrings e .:• AWG range......................._.... ................... .... ... ... ....... ... ...... ... .................................................. - ,. Dimensions with AC/DC Safety 30.5 x 12.5 x 7/ 30.5 x 12.5 x 7.5/ - in-; - =_ 30.5 x 12.5 x 10.5/775 x 315 x 260 Switch f H yW p)....................... .......775 x 315 x 172....... ........775 x 315 x 191...... ......... .... .. .. ... ............. .min. .. - .w,.. Weight with AC/DC Safety Switch..... ..........51.2./.232..........I...........547/•247. .......- .........:..........88..4/40:1..................... .Ib/.kg... - _ - Cooling Natural Convection Fans(user replaceable) ................................... .................... _ Noise ......... ......<25.. ......................... .........................<50................. dBA The best choice for SolarEd a enabled systems .main••. •Temperature ............... . .. ..... g - y - - Min.Max.Operating Temperature °F/'C -13 to+140/-25 to+60(CAN version*--40 to+60) Integrated arc.fault protection(Type 1)for NEC 2011 690.11 compliance Ran&?................................. ................................................... ............... ................_..._...... ......... Superior efficiency(98%) Protection Rating .... ............ .. ....................................................................................................... ..... ........ " •For other regional settings please contact 5olarEdge support. _ . Small,lightweight and easy to install on provided bracket - ••Limited to 125%for locations where the yearly average high temperature's above 77•F/25'C and to 135%for locations where it is below 77'F/25'C. For detailed information,refer to htto-//wwwsolaredge us/files/odfs/inverter do oversidne guide odf Built-In module-level monitoring •�•A higher current source may be used;the Inverter will limit its input current to the values stated. •••CAN P/Ns are eligible for the Ontario FIT and miaoFIT(microFlT eac.SE11400A-Us-CAN). Internet connection through Ethernet or Wireless Outdoor and indoor installation W d Fixed voltage inverter,DC/AC conversion only r I Pre-assembled_AC/DC Safety Switch for faster installation. Optional'—revenue grade data,ANSI C12.1 sI?nsac r USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL W W W°sOlaredge.US - - � r3{Yi1E.. � � y�7 F igy�rel. amtin¢ dW msv giF , s , SPECIFICATION Format 65.7 in x 39.4in x 1.57 in(including frame) - 'r (1670 mm x 1000 mm x 40 mm) -• -- Weight 44.091b(20.0 kg) - . . r' Front Cover 0 in(3.2 tom)thermally pre-stressed glass-Mll � --.,,.ram,,,•. � - �, - with anti reflection technology � r . . - -Sr i Bach Cover Composite film �,,,,,,,.••�` frame Black anodized 7_EP compatible frame ..,�� Cell 6 x 10 polycrystalline solar cells !unction box Protection class IP67,with bypass diodes Cable 4 mmP Solar cable;(+)a47.24 in(1200 mm),(-)a47.24in(1200 mm) - Connector MC4 UP 68)or H4 OP68) i PERFORMANCE AT STANOARO TEST CONDITIONS(STC:1000 W/m2,25"C,AM 1.5G SPECTRUM)' POWER CLASS(+5W/-OW) - [WI 255 260 265 Nominal Power Pam, [Wl 255 260 265 • , • L ' ` • ' ' Short Circuit Current Ise [A] 9.07 9.15 9.23 - Open Circuit voltage -Vu IV] 37.54 37.77 - 38.01 Current at Po, Ir" [A] 8.45 8.53 8.62 - Voltage at P_ V_ IVl 30.18 30.46 30.75 The new Q.PRO-G4/SC is the reliable evergreen for all applications,with - - Efficiency(No min al Power) rl 1%] a15.3 a15.6 a15.9 a black Zep Compatible TM frame design for improved aesthetics, opt!- PERFORMANCE AT NORMAL OPERATING CELL TEMPERATURE(NOCT:800W/ma,45*VC.AM 1.5 G SPECTRUM)' try POWER CLASS(+5W/•OW) IWI 255 260 265 - mized material usage and increased safety.The 4 solar module genera- 95.7 tion from Q CELLS has been optimised across the board: improved output Short Circuit Power. P1. [VIl 17.31 17.38 17.44 P p p Short Circuit Curtest ISL [A] 7.31 7.38 7.44 yield,higher operating reliability and durability, quicker installation and Open Circuit Voltage Va IV] 34.95 35.16 35.38 more intelligent design. i' current at Pn, Ip, LA] 6.61 6.68 6.75 _ Voltage at Po,- V_ [VI 28.48 28.75 29.01 - 'Measurement tolerances STC:x3%(P„mr);x 10%0,V_I_,V.,,) 'Measurement tolerances NOCT.x 5%(Pmw);x 10%0_Vim,Ire,,V„p°) � 1 INNOVATIVE ALL-WEATHER TECHNOLOGY PROFIT INCREASING GLASS TECHNOLOGY o CELLS PERFORMANCE WARRANTY PERFORMANCE AT LOW IRRADIANCE •Maximum yields with excellent low-light •Reduction of light reflection by 50%. At least 97%er nominal power during - and temperature behaviour. plus long-term corrosion resistance due _ first year.Thereafter rnax.0.6%degra- a wmb..d.v..•n- a�ab.,� w � - ---------- -- dation per Year. •Certified fully resistant to level 5 salt fog to high-quality At least 92%of nominal power a „ • R m --_--------------- 10 years. Sol-Gel roller coating processing. _ At least 83%of nominal po wer after c � ENDURING HIGH PERFORMANCE o z years. ,s i - _ •Long-term Yield Security due to Anti EXTENDED WARRANTIES Au data antis measurement with t tolerances. m m - - - - - - Full warranties in accordance with the PI D Technology',Hot-Spot Protect, •Investment security due to 12-year y warranty terms of the Q CELLS sales IRRADaNCEw1.9 organisation of your respective country. and Traceable Quality Tra.QTM. product warranty and 25-year linear a The typical change in module efficiency at an irradiance of 200 W/m=in relation n vises to 1000 W/mv(both at 25`C and AM 1.5G spectrum)is-2%(relative). •Long-term stability due to VDE Quality performance warranty". s Tested-the strictest test program. - TEMPERATURE COEFFICIENTS(AT 1000W/M2,250C,AM 1.5G SPECTRUM) . a ClCELLS Temperature Coefficient of lu a [%/I(7 +0.04 Temperature Coefficient of V. It [%/H) -0.30 S SAFE ELECTRONICS I,TOP BRAND Iv murrrmr. Temperature coefficient of Pm, Y [%/Bl -0.41 NOCT VF) 113 x 5.4(45 t 3'C) •Protection against short circuits and PRO ORDESIGN thermally induced power losses due to 2014 Maximum system voltage v,,, Iv] 1000(IEC)/600(UL) Safety class n breathable junction box and welded i Maximum series Fuse Rating [A OCI 20 Fee Rating C/TYPE 1 E Max Load(ULY fibs/ft21 50(2400 Pa) Permitted module temperature -40°F up to+185°F - - Cables. �' on continuous duty i (-40°C up to+85°C) - r �Dhnfn» ` Load Rating(UL)" fibs/fF] 50(2400 Pa), z sec installation manual - oumruty Tesroa - r�oLlls - - - L r r t• t ®' - • INa rnb•r mlt. h , fv1a .d°b201s UL 1703;VDE Quality Tested;CE-pliant; - Number of Modules per Pallet - '•"""1q1-^+tea •'rem IEC 61215(Ed.2);IEC 61730(Ed.1)application class A. THE IDEAL SOLUTION FOR: to.4003;5s7 Number of Pallets per 5a'Container 32 s 0NP4laE^ Number of Pallets per 40•Container 26 Rooftop arrays on V Ae oMPgr D E C E �" / Pallet Dimensions(L x W x H) 68.5 in x 44.5 in x 46.0 in y f (1740 x 1130 x 1170 mm) g residential buildings - QG iB - . -Pallet Weight - - 125416(569 kg) _ r e+irgOv .M, NOTE:installation instructions must be followed.See the installation and operating manual or contact our technical service department for further information on approved installation and use of - APT test conditions:Cells at-1000V against grounded,with conductive metal foil covered module surface. - - COMPPr this product.Warranty void if non-HP-certified hardware is attached to groove m module frame. - y f .. 25°C,168h - - - r- r See data sheet on rear for further information. Hanwho O CELLS USA Corp.- - - 8001 Irvine Center Drive,suite 1250,Irvine CA 92618.USA I TEL+1 949 748 59 961 EMAIL q�ells-usa®q-cells.com I WEB www.q-cells.us E LLS c� Engineered in Germany (MC Engineered in Germany � CE L LS A'� ry ��•�` ��a'�e ate �^ 1 � c,Kdry � � !. BR �X y a JAJ qA ?'� f • 14 s s R r r �r i r s -w, . t • �� � � t .,._ .�:-_� sd+��#�w Tom- f �������. • A � y Home improvement b ! j specialists z ! ." t y: ' of cape toe! l SCALE '` APPROVED DRAWN BY DRUM"INSAW ti t w, ���:.: - dF F�-a.� 'ti.- .�i;'�: �' F. f ! "'1•> - T. r - s .'.i Y ::t, d4A. r"C .y: � �.• �• �' Ms. .�b ".(�...�+ a Ni...9��. �• `d ,�,tr rfi(�R�' ..5 .,tom t4 _� 'rR21 1. '{„�.: 'K ✓ y;R 2, "1✓ 1,�,..�._ i y,. ,yb ;. `'-trs1� ..:� '� -,..`'.• �x� ,}..: �• ,1 ^y, '!f.„, .: �+.,:+Py :* '5��-s.�s�,f �:off._:.` a s; _ ... .!',s„�- ..,... ,.. ,. -_ .�`_.,� "4�L. 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