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HomeMy WebLinkAboutBld-20-0043 • ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department or tt 1146 Route 28, South Yarmouth,MA 02664-4492 �' !� 508-398-2231 ext. 1261 Fax 508-398-0836 �. ��� Massachusetts State Building Code, 780 CMR i . Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number :1. O " , ¶f)ate Applied Iirrs Building Official(Print Name) Si ature Date SECTION 1 SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers S Z12-es" 2°1 2 Q 1.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public CI Private 0 —Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2 PROPERTY OWNERSHIP' 21 Owner'of Record: r�\ '-fit U• y w2.c vsti +ma CYLCD1 e(Print) City,State,ZIP No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Cl Owner-Occupied ❑ Repairs(s) 0 Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other X Specify: SC Brief Description of Proposed Work2: knSlvrt_upt-no 9j #ci _ 2c YYY\J tR1`c1� n 3 18,c no, 1 1m-u 263,S&F SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 22Sb 1. Building Permit Fee:$/ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 38 30 0 Total Project Costa Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ f 4.Mechanical (HVAC) $ List:. 5.Mechanical (Fire Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ (ROM0 Paid in Full 0 Outstanding Balance Due: er SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) la0013 S ( I 2-I2- �ToS��� License Number Expiration Date Name of CSL Holder c List CSL Type(see below) 5 ,SUuMmaa.ST No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) EEn('lST°3WICN O22LO`"i R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances SO "(.! L -(CRN I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 13 ' 1 G> 2,a� -61 c<ve J �3oat� Z HIC C pany Name or HIC Registrant Name HICe Registration Number Expiration Date tree IT 2 1(�1i`(�\ M�V►��r'1\Ve Q l�t� • N A. and`�1.N '(l�\ rrA 6)(1.(60 (ScI-(o.14(-S Ste{ Ettrdil address C�M City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Iv`U} ()�~- —N2A:1/44-1 O tv J to act on my behalf,in all matters relative to work authorized bytes building permit application. )u t l i z0 Print Owner's Name((Electronic Signature) Date • SECTION 7b: OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. �� ulsE I AV20 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) , Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: (617) 727-3200 ext. 25239 You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. Attachment A. THIS PROPOSAL IS SUBMITTED IN DUPLICATE. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES, SUBMITTED: My Generation Energy, Inc. ACCEPTED: Owner(s) SIGNED: (My Ge ation Energy) (System Owner) Corey Sprague,as Trustee,for the Sprague Trust NAME: /4-.g 720,11-- David Sprague DATE: / /7 12/21/19 3 i•� r //i/rj//// .. (/ iFi r//r ..r/ /rr/„ 4', r///, , .;..ri/i %/r P/ �j n ///,r/ /'r r�.: g r t u�i i • ,a ?v, may/ wZ„�, � br, r r '% / �� /' ,"2'�i rG/y i.: / 4. ear' r r%/ :i( ' ,/ /'/ / -r . .:-.. 4----//�/%, ,r/qr%/0/ r//ir/7::qr .:ti i/i,. /,;!,/, fir'j/r $,' ",.;-. 4.$6f,(74x,,,k,,,,,,,,pe•-",v.,%w,oktii9AV-4itatt ''.:• ,,,,,,o.:I- ,' - •--', ;i:::.'-- ,I.. ,:t„ .• ' r v. fr/r� � fit' /// %//ij , /i iO r r / //i r y. • ,,,9 i/ r j%fir j/� jj/ �/ / m j / //jr /p • ppe id-/ a//,r" r.rrir R/ j/Q rc n& b y tLiz eamowev-wAead."0/. - 4e/xi, Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, M,y --chusetts 02118 Home Improve e,., .ntractor Registration Type: Corporation 1,4 Registration: 163006 MY GENERATION ENERGY,INC. , Expiration: 05103/2021 3 DIAMONDS PATH UNIT 2 SOUTH DENNIS,MA 02660 ` "A° ,' Update Address and Return Card. SCA 1 0 200,4A,�-05/(117 /�/ .7/2;3 {;�lWlt."9�i.!YJLI�'!,°17.(JJ3 l/, Cdnf.)b l ,fet Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only �' Corporation before the expiration date. If found return to: i * E , t ESKIMOS Office of Consumer Affairs usiness Regulation -#-w 05/03/2021 1000 Washington Street - 710 /... Boston,MA 0211E MY GENERA �_.W " ANDREW WADE,, 3 DIAMONDS PAS ksigesist a.1 Not id out signatureSOUTH DENNIS,MA'c gp Undersecretary The Commonwealth of Massachusetts •G Department of Industrial Accidents • ?fit_ 1 Congress Street,Suite 100 •= f ^,7 Boston,MA 021 14-201 7 Y ,suers, www-ntass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WiTH THE PERMITTING AL"THORiTY. Aanlicant Information Please Print Legibly Name(Business/Organization/Individual): s\l C1t N (:Q—ec io r I✓A�F.(L(�y Address: 3 t.,A“,,b-Nybe; rp K , U,N';i 2- City/State/Zip: S. ,NN'kS IN\ Cri Pic Phone#: 'pt- ( - - Arc you an employer?Cheek the appropriate box: Type of project(required): In I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.01 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required] 9. Demolition 30 I am a homeowner doing all work myself[No workers'comp insurance required.]' 10❑Building addition 4.al 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. 12CiPlumbing repairs or additions 5�l am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13toof repairs These sub-contractors have employees and have workers'comp.insurance 6.0 We arc a corporation and its officers have exercised their right of exemption per MGL c 14 F210ther SQ LA(2" 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, lithe sub-contractors have employees,they must provide their workers'comp.policy number. �. .... �._ a �. .� ... .. .d.._ . ._. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Deland Gibson Policy#or Self-ins.rLic.#: WC231S605824029 ._...._.._.._ Expiration Date: 7/31/20 Job Site Address: 1S J 11Et3Q\ 2 City/State/Zip: \/ 2ANt\uK Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do hereby certify under Ade, *, and penalties of perjury that the information provided above is true and correct. - l Signature: Date: 1-S, 6C) Phone#: Official use only. Do not write in this area,to be completed by city or town official i 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#: d I Construction Supervisor Form Job Location, m aQ N l Property Owner 'iir\\I AC-Lt_F Construction Supervisor :x.5 License Number Iotc,0'11 Address S sL Arnim. rerk o uit i Phone Licensed Designee (if applicable) • . •. ityfor Work: R5.2.15.1 The license holder shall be fully and completely responsible for all work for which he/she is supervising. He/she shall be responsible for seeing that all work is done pursuant to 780 CMR and the drawings as approved by the Building Official. > •; • to Supervise Work: R5.2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving structural elements of the buildings and structures only pursuant to the State Building Code and all other applicable laws of the Commonwealth, even though the license holder is not the permit holder but a subcontractor or contractor to the permit holder. Notification of Violations: 5.2.15.3 The license holder shall imnmediatey notify the building official In writing of any violations which are covered by the building permit. Willful Violations: 5.2.15.4 Any licensee woo violates the State Building Code, shall be subject to revocation or suspension of license by the Board of Building Regulations and Standards. Permit Applications: 5.2.18 All bd.', .. permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those engaged in construction, reconstruction, alteration, repair, removal or demolition as regulated by 780 CMR 1*t-.3.5 and 780 CMR R5. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a new licensee is substituted on the records of the building department. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with the State Building Code_ I understand the construction inspection procedures and the specific inspections as celiac for the by bung official. � r Signature_ / Workers' Compensation Subcontractor List Homeowner or Contractor Job Location D.BA. C-1,Pc C.GM-x. +tiyw.� ". Print name Print name of business Will be working for the contractor or homeowner at the location listed above. I am an employer that is providing workers'compensation insurance for my employees Insurance Company c2)c"'0e0 . Su11`.1CLx'\� Policy# „wc,531S3111412.4o27 If I have not provided the insurance information requested above I am a sole proprietor or partnership and have no employees working for me in any capacity. i do hereby certify under the pains and penalti per' that the information Aro '. •• is true and correct.Signature Date � 3( 20 D.B.A. _ -- Print name Print name of business Will be working tnr the contractor or homeowner at the location listed above. i am an employer that is providing workers'compensation insurance for my employees Insurance Company _ Policy# If I have not provided the insurance information requested above I am a sole proprietor or partnership and have no employees working for me in any capacity. I do hereby certify under the pains and penalties or perjury that the information provided is true and correct.SignatureDate _.. D.S.A. Print name Print name of business Wilt be working for the contractor or homeowner at the location listed above, am an employer that is providing workers' compensation insurance for my employees Insurance Company....._. _... _.__._.�..,w.w.. Policy 110 If I have not provided the insurance information requested above I am a sole proprietor or partnership and have no employees working for me in any capacity. I do hereby certify under the pains and penalties or perjury that the information provided is true and correct. Signature _.Date._ _............._. _..__..._ _._ -.—+mN MYGENER-01 LRANDAZZOI A R� CERTIFICATE OF LIABILITY INSURANCE DA1/30/2020 TE Y) 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 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 License#1780862 CONTACT NAME: HUB International New England jc"no,Ext):(781)792-3200 �(A/CC,No):(781)792-3400 600 Longwater Drive L Norwell,MA 02061-9146 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Atain Specialty Insurance Company 17159 INSURED INSURER B:Evanston Insurance Company 35378 My Generation Energy,Inc.Luminous Solar,LLC INSURER C: 3 Diamond Path,Unit 2 INSURER D: South Dennis,MA 02660 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER /YPOLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DDYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X CIP398126 1/21/2020 1/21/2021 °PREMISES(EaEoccur ence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JERCOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: BI/PD Deduct $ 1,000 AUTOMOBILE LIABILITY Ea accidentSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTEO�S ONLY AUTOS � p BODILY INJURY(Per accident) $ AUTOS ONLY ACTOE ONL Y PROPERTY DAMAGE Per accident) $ $ B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE EZXS3019503 1/21/2020 1/21/2021 AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY OFFICER/MEMBER E/PARTNER/EXCLUDEDX?ECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers compensation certificate to be provided separately from carrier. Certificate holder is included as additional insured with respect to the general liability,when required by written contract.Blanket waiver of subrogation in favor of additional insured with respect to the general liability,when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1146 MA-28 South Yarmouth,MA 02664 AUTHORIZED�/�� REPRESENTATIVE 9—?/*P'55 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACQRD® CERTIFICATE OF LIABILITY INSURANCE • 08/27/2019 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 CONTNAME:ACT Meghan Peterson DELAND GIBBON INSURANCE ASSOCIATES INC (a�"N, ); (781)239 7653 FAX No): A MAIL m eterson deland ibson.com ADDRESS: P G g 36 WASHINGTON ST INSURER(S)AFFORDING COVERAGE - NAIC# WELLESLEY HILLS MA 02481 INSURER A: LIBERTY MUTUAL FIRE INS CO 23035 INSURED INSURER B: MY GENERATION ENERGY INC INSURERC: INSURER D: 3 DIAMONDS PATH INSURER E: SOUTH DENNIS MA 02660 INSURER F: COVERAGES CERTIFICATE NUMBER: 441757 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD W1(D POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO JECT -LOC PRODUCTS COMP/OP AGG $ — — OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ NON-OWNED AUTOS J N PROPERTY DAMAGE $HIRED AUTOS AUTOS (Per accident) $ ---.- UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A i AGGREGATE $_ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE EOTH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A WC231S605824029 07/31/2019 07/31/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 MA-28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 Daniel M.CroWiey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Sears, Tim From: Sears, Tim Sent: Tuesday, February 18, 2020 10:20 AM To: 'jamie@mygenerationenergy.com' Subject: 15 Bradford Rd Jamie, I have reviewed your application for 15 Bradford Rd, and the letter from the engineer does not specify that the existing roof can support the added weight of the solar panels. Please update and submit for review. Thank you Timothy Sears CBO Building Inspector Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsears@yarmouth.ma.us 1 4 ENGINEERS August 6,2019 SnapNrack 775 Fiero Lane,Ste.200 San Luis Obispo,CA 93401 TEL:(877)732-2860 Attn.:SnapNrack-Engineering Department Re:Report#2018-11940.03—SnapNrack Ultra Rail Solar Photovoltaic Racking System with UR-60 Rail Subject: Engineering Certification for the State of Massachusetts PZSE, Inc.—Structural Engineers has provided engineering and span tables for the SnapNrack Ultra Rail Racking System with UR- 60 Rail,as presented in PZSE Report#2018-11940.03,"Engineering Certification and Span Tables for the SnapNrack Ultra Rail Solar Photovoltaic Racking System". All information,data,and analysis therein are based on,and comply with,the following building codes and typical specifications: Building Codes: 1. ASCE/SEI 7-10,Minimum Design Loads for Buildings and Other Structures,by American Society of Civil Engineers 2. 2015 International Building Code,by International Code Council,Inc. 3. 2015 International Residential Code,by International Code Council,Inc. 4. AC428,Acceptance Criteria for Modular Framing Systems Used to Support Photovoltaic(PV) Panels,November 1,2012 by ICC-ES 5. Aluminum Design Manual 2015,by The Aluminum Association,Inc. 6. ANSI/AWC NDS-2015,National Design Specification for Wood Construction,by the American Wood Council Design Criteria: Risk Category II Seismic Design Category=A-E Basic Wind Speed(ultimate)per ASCE 7-10:up to 190 mph Ground Snow Load=0 to 120(psf) This letter certifies that the loading criteria and design basis for the DIGITALLY SIGNED SnapNrack Ultra Rail Racking System with UR-60 Rail Span Tables are in compliance with the above codes. ' SH M4ssq AUL K. I 'CHER 'UCTURAL If you have any questions on the above,do not hesitate to call. o.50100 G/S7E¢� Prepared by: PZSE, Inc.—Structural Engineers Roseville,CA 8150 Sierra College Boulevard,Suite 150, Roseville, CA 95661 916.961.3960 916.961,3965 www.pzse,com Sprague Site Photos 15 Bradford Road, West Yarmouth /"' ,i~ y // lei 7,000 j %/ p -00 �Il i /� w, Location of 11 panels. -,40011. / , r x *,,,,, i My Generation Energy Andrew Wade — ' I Sprague Site Photos 15 Bradford Road, West Yarmouth ice/ //% % // r - 7 / ,,/ //�¢t�� � , „.., / „„2,// ,.. .. . ,k,,. , ,, p , ,,e,, ; ' , ,,, . s # i, „ ,,,,/ ,. /%,#7 , ' '''-'-'-'4111ki, '‘ '44,45 ,0' . . s ,fix zes tit ii vq, / d yfitf ' °f ��� %� , /fir a ,. ,.+' 40 , / My Generation Energy Andrew Wade — Sprague Site Photos 15 Bradford Road, West Yarmouth 4 pitch roof, rafters are 2x8 16 on center. ax F t P f G/ / �/ / kvii r l// �l/ y 4 ,W H /d /• i i/,/ t/ /ii/c i/ ./ f '00 4. aPi Via lateia z/ P � . la I' ' /�,,... tkOM/i :',,,,',%.:, ice✓ • My Generation Energy Andrew Wade — i 1 Sprague Site Photos 15 Bradford Road, West Yarmouth Solar panel = 37 lbs per module 11 Modules =499.41bs Inverter =4.4 lbs per module Projected Area of Array = 203.5sf Associated hardware = 4 lbs per module Added dead load =2.61psf Total =45.4 lbs per module Ground snow load =30 psf ra� r . S1 ; RAF TER SPANS FOR COWC04 LOUSE R SPEC ES c*4 i 2s'fi 2Aq k a 10 2 a 2zt4 240 Zigt4 a la mn vt1. iP4C q €1 + C ,ate,. dig . I .+ Iape n . . C IOC x, . ,ras„,4 " -rJJ4as b n rb t ;syr?ootkf I .m.40, ! ,lC"At °tr.%" r I q%v "' r .. ....,, ma Posidal Maw SS;' 4I 144 144,1$; F;,1..0 I:,. b 1 1 t, V.* 41_ 4-* 11444$11,44 .441401 41 1E* I",'- I44,.2 tx4,9 :w I: Y-14 11•* 14- 17-* F-1 ter, *%fit-Loch rah 1I-f 1 15 1 lis-S 1-', '. 1:,,I Ekffe4444 6z.l g -k 1144 I`_.,II I .y *1'; t.I 1 ," I;'.o-, I1 Wm-ftp LSD A-"` 1;.,",. I, 1,-, . : .. I4.s, I°.i .1;, ,,1., w x1,, 114=tar 41 n < 1 .5 1*44 k=4 11 I 1E..1 1 ,>. I4..1! Ittro.ar 4." 11-.% 14,11 ta_ 21 1 I,;.s 11 $ 1r, ' I* 1' tip+-kil 41. m a-;j II-, 1's.1l If ? 5..1, -1 l a I r, Ia t'‘ 16 44o44114err pow SS' 01 I l 14 1 I* ' b' %4.11 14,-1 I -f, ,?;.v, N t $4$pow 01 It.,'« 114 11141 Z1 r5 , A:# 1ry-1t us-,.' t`+-' I fowolbr en l 1"..t, I I .,;t ': -" 1 >, 11,='. i4.,.a I'.. Simla*tnp .3 4, 9-4. IY-4 14_' 1'4 S_1„ A.A. I1-0 tI..t 14_4, S 1 M-M'-rat s A-q 11-a 17-S = ,"%-I } .- + :5 1"1,t4 I -.! 1 -`,+ �"* 1,< SIracr c.1"i€ 41- A„m I1-11 1s•1 14,.E ?I,t '>.)i 1€44 Iz..,.a, I,;ti.. o, -iaa `� A li-I1 1ti 1*.s "1-s 7,; 11.$ 11111 ` r .+ t -to 1;3 r� t, II S I.iall Ih o f t I4 f Maximum allowable span-13-6 ;y. Actual maximum span — 11'9" My Generation Energy Andrew Wade — Sprague Site Photos 15 Bradford Road, West Yarmouth Solar panel = 37 lbs per module 11 Modules =499.41bs Inverter =4.4 lbs per module Projected Area of Array = 203.5sf Associated hardware =4 lbs per module Added dead load =2.61psf Total = 45.4 lbs per module Ground snow load=30 psf Calculations for array (6 panel run or greater) pnet(psf)=AKztI pnet30 pnet(psf)=Design Wind Load A=adjustment factor for height and exposure category Kzr=Topographic Factor at mean roof height h(ft) I=Importance Factor pnco(psf)=net design wind pressure for Exposure B, at height=30, I=1 pnet3o(psf)=18.1 Downforce - 21.8 Uplift A=1 Krt=1 I=1 poet(psf)=18.1&21.8 P(psf)=1.0D+1.053.(downforce(df)case 1) =35 P(psf)=1.00+ 1.0pnet(df case 2)= 23.1 P(psf)=1•00+n.7551+a.75pnet(df case 3) 36.5 P(psf)=0.60+1.0pner(uplift)= 24.8 D=Dead Load(psf)=5 c-rent=,t.,,rr/rep-2n w=PB/2= 98.5(downforce)66.96(uplift) P=36.5(downforce)&24.8(uplift) 8-5.4 ft(length of panel) L=3.7 Maximum Point Load Ribs) =PLB/2= (36.5X3.7x5.4)/2= 364.6(downforce) (24.8x3.7x5.4)/2=247.75(uplift) For 5/l6p lag into SPF#2 205 lb per inch(pull out capacity) of engaged thread Engaged thread=2.75"(for 4"lag) Pull out strength - 2.75x205 = 563.75 r � My Generation Energy Andrew Wade — Roof Attachments SNA, C14 CEBB1323 TIM L FOOT \ CHANNE L NUT '',.\ \ T k, k. ; itt.:1:4,7,:totriii ::,,,,,,,,,,,,,,,,, . 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