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HomeMy WebLinkAbout22-A078 135 Union StreetRECEIVED Yeo TOWN OF YARMOUTH JUN Z�22 :y 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 2 7 Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836 ;'A " LUXIMG'S HIGHWAY HISTORIC DISTRICT COMMITTEE APPLICATION FOR CERTIFICATE OF APPROPRIATENESS Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as amended, for proposed work as described below & on plans, drawings, photographs, & other supplemental info accompanying this application. PLEASE SUBMIT 4 Copies OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION. Check All Categories That Apply: Indicate type of Building: Commercial Residential 1) Exterior Building Construction: New Building Addition _Alterations Reroof Garage Shed _ Solar Panels V Other: 2) Exterior Painting: Siding Shutters Doors _Trim Other: 3) Signs/Billboards: New Sign Change to Existing Sign 4) Miscellaneous Structures: Fence Wall Flagpole Pool Other: Please type or print legibly: Address of proposed work: 135 Union Street, Yarmouth, MA Map/Lot # 115 1 164 Owner(s): Caroline Tasha Phone #: (508) 744-7450 All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 135 Union Street, Yarmouth, MA Yearbuilt: 1978 Email: Preferred notification method: Phone Email Agenticontractor: Bruce A Junior _ Phone #: 508-291-0007 Mailing Address: 20 Patterson Brook Rd. Unit 1 W. Wareham, MA 02576 _ Email: permits.wareham@trinity-solar.com Preferred notification method: Phone Email Description of Proposed Work: Install 4.40kw solar panels on roof. Will not exceed roof panel, but will add 6" to roof height. 11 total panels to be located on back of roof and to be partially visible from public way. Signed (Owner or agent): Date: 06/22/2022 Owner/contractor/agent is aware that a permit is required fro a wilding Department. (Check other departments, also.) > If application is approved, approval is subject to a 10 -day appeal period required by the Act. This certificate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later. > All new construction wilt be subject to inspection by OKH. OKH-approved plans MUST be available on-site for framing & final inspections. ■: Rcvd Date: �tf/yfr�f�� Amount f o' (" Cash/CK #: — Rcvd by: I-` -4A 45 Days: Date Signed: Approved Approved with Modifications Denied Reason for Denial: Signed: 1 APPLICATION #:rAbT 6�r�.-[ n I' f I / 0 SOLAR June 21, 2022 MA, Master Electric Contractor# 21233A MA, Home Improvement Contractor # 170355 Rhode Island Contractors' Registration and Licensing Board Registration No. 39372 Rhode Island Renewable Energy Prof REPC-126 For other jurisdictions, please visit: http://www.trinity-solar.cc)m/about-us/locations-and-licenses Tristan Souza Applications Specialist 20 Patterson Brook Rd. Unit 1 W. Wareham, MA 02576 (732) 722-1278 Tristan.Souza@trinity-solar.com RE: Permit Application for Solar Installation Building Department: Town of Yarmouth Historic District Commission 1146 Route 28 South Yarmouth, MA 02664 RECEIVED JUN 2 7 2022 YAHMOUT i Enclosed please find an application and check for 135 Union St. building and electric permits. If you have any questions, please contact me at 508-291-0007 x1231. Check attached Very truly yours, Very Tristan Souza Applications Specialist Wareham, MA and Rhode Island Offices 1 -877 -SUN -SAVES 20 Patterson Brook Road, Unit 1 Ph: 508-291-0007 Wareham, Massachusetts 02576 Fax: 508-291-0040 www.Trinity-Solar.com GENERAL SPECIFICATION SHEET Proiect Address: FOUNDATION: Material: Exposure (Not to exceed 18"): CHIMNEY: Material/Color: GUTTERS: Material/Color: ROOF: Material: asphalt Pitch (7/12 min) 4112 Height to Ridge: Calor: Gray SIDING: Material/Style: Front: Sides/Rear: COLOR CHIPS Color: Front: Sides/Rear: TRIM: All windows & doors to be trimmed with: 1x4 1x5 (Circle one.) Material: Color: DOORS: Qty: Material: Color: Style/Size (if not listed/shown on elevations): STORM DOORS: Qty: Material: Color: EfR7ECEIVED GARAGE DOORS: Qty: Mat]: Style: Color:WINDOWS: t /side:: Front: Left: Right: Rear: Color: Y Manufacturer/Series: Material: Grilles (Required): Pattern (616, 211, etc.) Grille Type: True Divided Lite: Snap -In: Between Glass: Permanently Applied: Exterior Interior STORM WINDOWS: Qty: Material: Color: SHUTTERS: MatT Style: Paneled Louvered Color: SKYLIGHTS: Qty: Fixed Vented Size Color: DECK: Size: Decking MatT Color: Railing MatT. Style: Color: WALLS/FENCES* (Max 6' height): Height: MatT Style: Color: (Show running footage & location on plot plan.) *Finished side of fence must face out from fenced in area. UTILITY METERS/HVAC UNITS: Location: Screening: LIGHTS: Qty: Style: Color: Location(s): LIGHT POSTS: Qty: _ Location(s): Additional information: Material: Color: 2 -General _ APPLICATION #. TOWN OF YARMOUTH OLD KING'S HIGHWAY HISTORIC DISTRICT COM Applicant's (Owner) Name: Property Address/Location: Hearing Date: 'I) 2S19.)_ ABUTTERS' LIST Caroline Tasha 135 Union Street, Yarmouth, MA FD VED JUN 2 7 2022 YH!-[ivlolrl.� Notices must be sent to the Applicant and abutters (including owners of land on any public or private street or way) who's property directly abuts or is across the street from the Applicant. Please provide the Assessor's Tax Map and Lot numbers only. The OKH Office will send out notices using the addresses as they appear on the most recent applicable tax list. Note: Instructions for obtaining the abutters Map and Lot numbers can be found on the Old King's Highway Department page on the Town website: www.yarmouth.ma.us Map Number Lot Number Applicant Information: Abutter Information: Application #: 2?'yoff7�- 8.2018 3 �y Ln Ln J Cy d r E ui n o A T4 ?qFa N Z LM T-4 T -I TH ui TN LM RECEIVED JUN 2 7 2022 Ln n YARMUU l h (D LA OLD KING'S HIGHWAY L r+- U) LO u -i c") 6� ko LnZ M IV1 vn TH TSI h LA T4 ,1 4 T^I u -i un 00 N � fT} O N 5Ln T -r c T•Y � 0 K ata, �► Z Ln a` r E ui n o A T4 ?qFa N Z LM T-4 T -I TH ui TN LM RECEIVED JUN 2 7 2022 Ln n YARMUU l h (D LA OLD KING'S HIGHWAY L r+- U) LO u -i c") 6� ko LnZ M IV1 vn TH TSI h LA T4 ,1 4 T^I u -i un 00 N � fT} O N 5Ln T -r c T•Y � ,4 ���f CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY} .� 511 312 02 2 TIAIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICII�4DOES NOT,'AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BfiLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPOR �Njk? �tp;gt�r ifliaate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If :§U8 OGATION-lS 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 Mark GraSela NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE Fax — -- 4000 Midlantic Drive Suite 200 INC. No Ext): 856-482-9900 Arc li 856-482-1888 ADDRESS: CherryHilLBSD.CertM@AJG.com Mount Laurel NJ 08054 DAMAGE TO RENTED INSURER(S) AFFORDING COVERAGE NAIL # CLAIMS -MADE OCCUR INSURER A: Gotham Insurance Company _ _ _ 25569 INSURED TRINHEA-03 INSURER B: National union Fire Insurance Company Of Pittsburg19445 Trinity Solar Inc. — 20 Patterson Brook Road, Unit 1 INSURER C: Liberty International Underwriters INSURER D: W. Wareham, MA 02576 INSURER E: MED EXP (Any one person) . S5.000 INSURER F: COVERAGES CERTIFICATE NUMBER: 590414193 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 ! ADDL;SU9Rt - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM1DD -4MM1DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY ; GL202100013378 611/2021 611/2023 EACH OCCURRENCE $_2,000_,000 X DAMAGE TO RENTED CLAIMS -MADE OCCUR _PREMISES (Ea occurrence _. $ 100,000 MED EXP (Any one person) . S5.000 PERSONAL&ADV INJURY 51,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S2,000,000 POLICY X PRO JEGT LOC PRODUCTS-COMPIOPAGG $2,000,000 OTHER: $ 13 AUTOMOBILE LIABILITY CA2960145 611/2022 6/1/2023 COMBINED SINGLE LIMIT 52,000,000 . (Ea accident) _ X ANY AUTO BODILY INJURY (Per person) S OWNED �� SCHEDULED BODILY INJURY (Per accident)! $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident I _ $ A UMBRELLA LFABX EX202100001871 6!1!2021 6/1/2023 EACH OCCURRENCE E 5,000,000 .00CUR C ELD30006989101 611/2022 611/2023 C X EXCESS LIAB CLAIMS -MADE 1000231834-06 1 6/1/2023 AGGREGATE 55,000,000 _ DED RETENTION S - Limit x of $5,008000 $ 19,000,000 B WORKERS COMPENSATION WC 135881 DS 611/2022 611/2023 X STATUTE ORH AND EMPLOYERS' LIABILITY YIN ; -_ _ --- _ -LEDIEtA ANYPROPRIETORIPARTNERIEXECUTIVE H ACC $ 1,OD0,000 OFFICERIMEMBER EXCLUDED? - N 1 A - - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) It yes. describe under �IDENT �----"—"`- - - - - - DESCRIPTION OF OPERATIONS below POLICY LIMIT $ 1,000,000 B Automobile CA 2960145 611/2022 6,1112023 All Other Units $250/500 Compf Collusion Died. Truck -Tractors and Semi -Trailers $250/500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Insurance It 11 Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE � r -f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ECEIVED The Commonwealth of Massachusetts JUN 2 7 2022 Department of Industrial Accidents Office of Investigations YARMOU-1 r Lafayette City Center OLD KING'S HIGHWAY 2Avenue de Lafayette, Boston, MA 02111-1750 wwt►. mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print,Leelibly Name (Business/Organization/Individual): Trinity Solar Inc Address: 2211 Allenwood Road Wall, New Jersey 07719 Phone #: Are ou an employer? Check the appropriate box: l .I am a employer with 300 4. ❑ I am a general contractor and employees (full and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. ship and have no employees 'hese sub -contractors have working for me in any capacity, employees and have workers' [No workers' tamp, insurance camp. insurance. required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.) r c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] 780-3779 Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9.❑ Building addition 10.WElectrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13 . ❑ Other. 'Any applicant that checks box N l 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. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: American Guarantee and Liability Ins Co Policy 4 or Self -ins. Lic. #: Job Site Address WC 13588108 135 Union Street Expiration Date: 06/01/2023 City/State/Zip: Yarmouth, MA 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. Ido herebvexdj�;Vn r the pains and penalties of perjury that the information provided above is true and correct. (508) 291 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # 06/22/2022 Issuing Authority (check one): 113Board of Health 20 Building Department 300ty/Town Clerk 4.0 Electrical Inspector 5EIVlumbing Inspector 6.❑0ther Contact Person Phone #: 11 RECEIVED JUN 2 7 /U// YAHQOUIh ) $ 2 ■ 2:1 ■ k §� 3 2§2 �_.2 &�IZ ]�kkcc »aa$k I;o� « 20,02 ��on .go�Ja¢ |oe2 �) &�§ 2�v kkK\«] ®=zu 2 _■ o®moo — Lu� ««>®§ U 0'--� ■ 2 4n E CL §;t2[u■ ;E ■ Ko ■u■ X62 \/ ¥e 32 �§ �/ §d t k a 'a � z 1 2 § /®/ m q $/i cn ± $ kCLk Y3 @: \/ P'= « E3© 2u q < o 2 ti $| L 2 $ $ D 2�2�\,! ui � / ® C \ g 2 ) >. O � % 2%3R U E ƒ _ L) £ O ) $ 2 ■ 2:1 ■ k §� 3 2§2 �_.2 &�IZ ]�kkcc »aa$k I;o� « 20,02 ��on .go�Ja¢ |oe2 �) &�§ 2�v kkK\«] ®=zu 2 _■ o®moo — Lu� ««>®§ U 0'--� ■ 2 4n E CL §;t2[u■ ;E ■ Ko ■u■ X62 \/ ¥e 32 �§ �/ §d t k a 'a � z 1 RECEIV.D JUN 2 7 2022 Y AhIVIUU i h ® Commonwealth of Massachusetts KING'S HIGHWAY Division of Professional Licensure Board of Building Regulations and Standards Constructio�$br�6Wi4oe .1 & 2 Family CSFA-067961 i E�Kpires:0711312022 BRUCE A JUNIOR ,- S SOMERVII-q Si MARSHFIEID MA 0 t Commissioner AD -70 NJ, Electrical Contractor business permit number34EB01547400 NJ, HIC reg. # 13VH01244300 S OLA R For other jurisdictions, please visit: http://www.trinity-solar.cam/about-us/locations-and-licenses RECEIVED HOMEOWNERS AUTHORIZATION FORM JUN 2 7 2022 I Mark Tasha (print name) KINYAHG'S HIGHWAY am the owner of the property located at address: ] KiNG'S ,r{IGHWAY P P Y 135 Union Street Yarmouth Port MA (print address) I hereby authorize Trinity Solar Inc. ("Trinity Solar") and its employees, agents, and subcontractors, including without limitation, , to act as my Agent for the limited purpose of applying for and obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System, Battery System, roofing or other Trinity Solar offerings located on my property, applying and obtaining permission and approval for interconnection with the electric utility company, and registration with any state and/or local incentive program(s). This authorization includes the transfer/re-administering, and/or cancellation of any existing permits on file for the purpose of updating/applying with an alternate subcontractor. Without limitation to the generality of the foregoing I specifically authorize Trinity Solar et al. to populate technical details, fill-in, edit, compile, attach drawings, plans, data sheets and other documentation to, date, submit, re -submit, revise, amend and modify application, submission and certification documents ("Approvals Paperwork"), including those for which signature pages are included herewith for my signature, in furtherance of the related transaction, and I am providing any signatures to Approvals Paperwork for purposes of the foregoing. Trinity Solar will provide copies of Approvals Paperwork when submitted. My authorizations memorialized herein shall remain in full force and effect until revoked. I acknowledge that these authorizations are not required to proceed with the transaction and are not a condition of the related agreement included herewith but are being given for my own convenience and benefit in order to expedite the approvals processes. Electric Utility Company: EVersource Electric Utility Account No.: 14721670033 Name on Electric Utility Account: Caroline Tasha ouaft Customer Signature Mark Tasha Print Name 4/302022 Date Corporate Headquarters 2211 Allenwood Road Wall, New Jersey 07719 1 -877 -SUN -SAVES Ph: 732-780-3779 Fax: 732-780-6671 www.trinity-solor.com FOR INFORMATION ABOUT CONTRACTORS AND THE CONTRACTORS' REGISTRATION ACT, CONTACT THE NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY, DIVISION OF CONSUMERS AFFAIRS AT 1-888-656.6225. ;g -,PW -7K � mo � W • J s O a� 3� 3 W N W d) 0 00 Z F ¢ 2 of IL °o z ? 0 w�u)cnz 6i¢ � Hz �❑C7Up Z_ Z {�a �0Z �V) to ❑0❑� Luzzz¢ �gooL)x cc F- Z X LLJ LL 0 w p O O J J J d REC:HIGH\N]AY z ����w¢ w Nm;L? 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