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RECEIVED
ONE & TWO FAMILY ONLY- BUILDING PERMIT JAN 3 0 2023
Town of Yarmouth Building Department
1146 Route 28,South Yarmouth,MA 02664-4492 'j N't
� G DEPARTMENT
508-398-2231 ext. 1261 Fax 508-398-0836 �
Massachusetts State Building Code,780 CMR
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: ell.D 3 - 0 b ail I Date Applied:
Building O rime) Signature Date
SEC ON 1 SITE INFORMATION
I.I Property Address: 1.2 Assessors Map&Parcel Numbers
9 Sleighbell Ln 89 45
1.1 a 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 I Provided Required Provided Required 1 Provided
Jf
1.6 Water Supply:(M.G.L c.40,i 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone?
— Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Lisa Cormier Yarmouth MA 02664
Name(Print) City,State,ZIP
9 Sleighbell Ln (508)280-4132 lisabby@comcast.net
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building Owner-Occupied Vi Repairs(s) 0 Alteration(s)VI Addition 0
Demolition 0 1 Accessory Bldg.0 Number of Units i Other Specify: Roof Mounted Solar
Brief Description of Proposed Work':
Installation of a interconnected, roof mounted, photovoltaic solar energy system consisting of 14_ solar
panelsproducing 5.46 Kw DC. NO ESS
SECTION 4:ESTIMATED CONSTRUCTION COSTS •
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 3079 1. Building Permit Fee:S Indicate how fee is determined:
2.Electrical $ 7185 0 Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: S
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ '
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 10264 0 Paid in Full 0 Outstanding Balance Due: —
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-040622 08/01/2023
Stephen Kelly License Number Expiration Date
Name of CSL Holder U
16 Parkway Rd. List CSL Type(see below)
No.and Street Type Description
Stoneham MA. 02180 U Unrestricted(Buildings up to 35,000 cu.ft.)_
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
4M Masonry
RC I Roofing Covering
WS I Window and Siding
SF Solid Fuel Burning Appliances
978 793-7881 eastmapermits@sunrun.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HISunrun Installation Services Inc.! Stephen Kelly - 180120 10/13/20
p HIC R Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
21 Worlds Fair Dr. eastmapermits@sunrun.com
No.and Street 978 793-7881 Email address
Somerset, NJ, 08873
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 f No 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT �f
I,as Owner of the subject property,hereby authorize Sunrun Installation Services Inc./Stephen Kelly
to act on my behalf,in all matters relative to work authorized by this building permit application.
Lisa Cormier See Attached Contract 1/27/2023
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.
Stephen Kelly a 1/27/2023
Print Owner's or Authorized Agen s Nam lcctronic Signature) Date
NO ,S:
I. 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.aov/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"