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HomeMy WebLinkAboutBLD-23-005915 .l1NF & TWO FAMILY ONLY- BUILDING PERMIT R '"` E, ° t „, Town of Yarmouth Building Department � 46 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 I-. . /i APR 2023 Massachusetts State Building Code,780 CMR B ' ing Permit Application To Construct, Repair, Renovate Or Demolish L171d� DEPARTMENT ��''`:.:' Bu ia One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: /3 L-j) -ni3 - 60-1/3' Date Applied: Building Official(Prin ame) S' ature Date SECTIO 1: ITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 16 Adrienne Dr So Yarmouth, MA 02664 91 135 1.1 a Is this an accepted street?yes x 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 Supp y: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal El On site disposal system O Check if yesD SECTION 2: PROPERTY OWNERSHIP 1 2.1 Ownerl of Record:Albert Mercado So.Yarmouth, MA 02664 Name(Print) City,State,ZIP 16 Adrienne Dr 978-870-0734 1976a1bert.mercadoegmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WQRK2(check.all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 I Repairs(s) 0 Alteration(s) 0 I Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: Install 6.480 kw solar panels will not exceed roof panels but will add 6" to roof height. 16 panels total SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: (Labor and Materials) OfficiaallTJse Only 1.Building $3,000.00 1. Building Permit Fee:$ i i11.1 _Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $37,000.00 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $0 2. Other Fees: $ p��- �p� J� 4.Mechanical (HVAC) $0 List: C1 D �✓ 5.Mechanical (Fire $ Suppression) Total All Fees:$_ Check No. Check Amount: Cash Amount: 6.Total Project Cost: S40,000.00 0 Paid in Full ❑Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSFA-067961 07/13/24 Bruce A Junior License Number Expiration Date Name of CSL Holder 20 Patterson Brook Rd Unit 1 List CSL Type(see below) R No.and Street Type Description W Wareham, MA 02576 U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling n M Masonry RC Roofing Covering • WS Window and Siding permits.wareham@trinity-solar .com SF Solid Fuel Burning Appliances 508-291-0007 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 170355 10/11/23 Bruce A Junior HIC Registration Number Expiration Date HTC Company Namur MC Re istrant Name 20 Patterson rook Rd Unit 1 permits.wareham@trinity-solar.com No.and Street W Wareham, MA 02576 508-291-0007 Email address 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 B7 No ❑ 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 Bruce A Junior to act on my behalf,in all matters relative to work authorized by this buildlinglsennit application. Albert Mercado 04/19/2023 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 ac to t)i owledg d understanding. Bruce A Junior 04/19/2023 Print Owner's or Authorized Agent's Name(Electronic Signatur 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 ua 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. 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ACG CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `""% 5/13/2022 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 CONTACT Arthur J.Gallagher Risk Management Services, Inc. PHONE Mark Grasela FAX 4000 Midlantic Drive Suite 200 lac.No.Est):856 482-9900 (A/C,No):856-482-1888 Mount Laurel NJ 08054 ADDRESS: CherryHill.BSD.CertM@AJG.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Gotham Insurance Company 25569 INSURED TRINHEA-03 INSURER B:National Union Fire Insurance Company of Pittsburg 19445 Trinity Solar Inc. 20 Patterson Brook Road, Unit 1 INSURER c:Liberty International Underwriters W.Wareham, MA 02576 INSURER D: INSURER E: 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 SUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/ODrYYYIn LIMITS A X COMMERCIAL GENERAL LIABILITY GL202100013378 6/1/2021 6/1/2023 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $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 JE C LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY CA 2960145 6/1/2022 6/1/2023 (Ea aoadeDn SINGLE LIMIT $2,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ CA UMBRELLA LIAB X OCCUR EX202100001871 6/1/2021 6/1/2023 EACH OCCURRENCE $5,000,000 C X EXCESS LIAB ELD30006989101 6/1/2022 6/1/2023 CLAIMS-MADE 1000231834-06 6/1/2022 6/1/2023 AGGREGATE $5,000,000 DED RETENTION$ B WORKERS COMPENSATION Limit x of$5,000,000 $19,000,000 WC 13588108 6/1/2022 6/1/2023 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTN ER/EXECUTI VE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $1,000,000 (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 B Automobile CA 2960145 6/1/2022 6/1/2023 All Other Units $250/500 Comp/Collusion Ded. Truck-Tractors and Semi-Trailers $250/500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Insurance AUTHORIZED REPRESENTATIVE oftQai ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • '� The Commonwealth of Massachusetts cr-=* iDepartment oflndustrialAccidents Io 1 Congress Street,Suite 100 1.4_" Boston, MA 02114-2017 -.ir,,,Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Buiiders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A_pplicant Information Please Print Legibly Name (Business/Organization/Individual): Trinity Solar Inc Address: 2211 Allenwood Rd City/State/Zip: Wall, New Jersey Phone#: 732-780-3779 Are you an employer?Check the appropriate box: - Type of project(required): I,j I am a employer with employees(full and/or part-time).* 7. New construction 2.E I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling ' any capacity.[No workers'comp,insurance required.] 3E 1 am a homeowner doing al!work myself.[No workers'comp, insurance required.]r 9. Demolition 4.0 my property,I am a homeowner and will be hiring contractors to conduct all work on i will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.L Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp, insurance,t 13._Roof repairs 60 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. 1 Other Install Solar 152,§I(4),and we have no employees.[No workers'comp,insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing ah 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. lam 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 H or Self-ins.Lie.#: WC 13588107 Expiration Date: 06/01/2023 Job Site Address: 16 Adrienne Drive So.Yarmouth, MA 02664 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to 31,500.00 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. Ido hereby certibi under the pains and penalties of perjury that the information provided above is true and correct. Signature: Bruce A Junior Date: 04/19/2023 Phone#: 508-291-0007 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#: gilt I NJ,Electrical Contractor business permit number 34EB01547400 NJ,HIC reg.It 13VH01244300 SOLAR For other jurisdictions,please visit:http://www.trinity-solar.com/about-us/locations-and-licenses HOMEOWNERS AUTHORIZATION FORM Nicolas Mercado (print name) am the owner of the property located at address: 16 Adrienne Dr South Yarmouth MA (print address) I hereby authorize Trinity Heating & Air, Inc. DBA 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 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 solar incentive program. 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 solar 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 solar transaction and are not a condition of the related solar 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.: Name on Electric Utility Account: Nicholas Mercado c Nicolas Mercado Print Name 3/29/23 Date Corporate Headquarters 1-877-SUN-SAVES 2211 Allenwood Road Ph: 732-780-3779 Wall, New Jersey 07719 Fax: 732-780-6671 www.trinity-solar.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. §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 16 Adrienne Drive So. Yarmouth, MA 02664 Work Address Is to be disposed of oat the following location: Trinity Solar Inc Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. Ill, §150A. 4/19/2023 Signature of Applic Date Permit No. • SOLAR Yarmouth, MA April 11, 2023 Town of Yarmouth1146 Route 28 S.Yarmouth, MA 02664 RE: MERCADO, NICOLAS Trinity Solar No. 16 Adrienne Dr 2023-03-846991 So Yarmouth, MA 02664 To the Building Official: The following information constitutes a summary of the relevant design criteria and recommendations for the support of a new photovoltaic [PV]system on the existing roof framing components at the above-referenced location. Criteria is as follows: 1. Existing roof framing: Conventional roof framing at R1 is 2x8 at 16 o.c.; existing rafter span= 12'6"; (horizontal projection) 2. Roof Loading: • 3.0psf dead load(pounds per square foot-PV panels, mounting rails&hardware) • 6.3psf-existing roof loads(2.3 psf-2x8 framing, 1.5psf roof sheathing,2.5 psf shingles) • Ground Snow Load-30psf-per AHJ (Authority Having Jurisdiction) • Wind criteria-Exposure Category B, 140 mph wind 3. Existing Roof modification-none required;existing roof framing is acceptable for PV installation. This installation design is in general conformance with the manufacturers'specifications and complies with all applicable laws, codes,and ordinances—specifically the International Building Code(2015 edition)and the International Residential Code(2015 edition), including all Massachusetts regulations and amendments. The spacing and fastening of the mounting brackets is a maximum of 48"o.c. between mounting brackets(staggered)and is secured using 5/16"diameter corrosive-resistant steel lag bolts.A minimum of 2Y"of penetration(embedment)per lag bolt is required,which will resist all stated loads above—including wind shear. Per NDS Section 12.1.4, clearance holes-equal to the diameter of the shank-need to be bored into a primary framing member for the full-length of the threaded portion of the bolt to avoid splitting of the framing member. 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I r. o I F LA o g. n a w O ,w/e,e 0.#1,,/,/,,17;/— /./ iff rem. w•e�,�t,n 4rnv-nvo r-oe•+•+o r�aoo� -�'"""— TM' Surl�oaaol4ocr eo9otanteerarcao I. ,..n. .V(� Easy OwnbPl �ii� �'f'�urchase HOMEOWNER NICOLAS MERCADO DATE ISSUED 3/27/2023 7:18 AM ADDRESS 16 ADRIENNE DR INSTALLATION 16 ADRIENNE DR SOUTH YARMOUTH, MA 02664 LOCATION SOUTH YARMOUTH, MA 02664 SUNNOVA SOLAR SERVICE DETAILS With balanced monthly payments,you'll always know what you'll pay for your Sunnova solar service. FinancialSummary Project Cost Monthly Payment3 Total Project Cost $40,017.64 Term of Agreement 25 Years Total System Cost $40,017.64 Interest Rate 3.99 (solar system only) Initial 18 Months $147.70 Optional Down Payments $0.00� Additional Payment's 005.29 ($0.00) (optional pa . ,' ' Rebate' ($0.00) Contract Frig Beginni • ' , 19 $147.70 $40,017.64 (• • r'f. •I P: • , made) Begin =g i •. • $217.31 (if/A, ,' : - .t made) .ro Sola e. x. „. b .-j 'x r System Size 6.4; kW u Year-1 Estimated P ••. ction 8 kWh ' ` f Estimated Utility •' ' _ ". " 00°l0 47 er x Product N ,e Quantity Y Contract Price 1 Depending on your agreement with the contractor,rebates may be paid either directly to you or the contractor.Creditor does riot guarantee any rebate amount.If your actual rebate is lower than the amount estimated here,your actual Contract ice will be higher. total sales price if financed will include interest payments.See Truth in Lending Statement for more details /our monthly payment includes interest and a$10/month discount or credit as an incentive for using auto-pay from your checking account. If you do not select auto-pay,your interest rate will increase,and your monthly payment will be$10/mor gher. Sunnova makes no guarantee regarding system am customer eligibility for any federal tax credit,local incentives,or SREC.For Sunnova incentives,see participating dealers for details or view the full Reward Program Terms and Conditions a tpssunnova.com/legal/sunnova-reward-program.To qualify for the tax credit,you must have federal income tax liability at least equal to the value of the tax credit.Additional tax credits may also be available for homeowners in certain aces.Tax incentives are subject to change or termination by executive,legislative or regulatory action.Sunnova does not provide tax advice.Contact your personal tax advisor for eligibility requirements. lee Power Production Guarantee table in your Limited Warranty Agreement for specific details. and Service rewards dependent upon local programs.If eligible,your program will be subject to specific terms and conditions. "^Nth, JJ•rl.ct.. .-v-tv-rWO i-OC'++. IU DD.o.) �`" "�� TM Sumnov�ad a a�awari eoil `� „•!, a Easy Own`'PeI ' i fi urchase HOMEOWNER NICOLAS MERCADO DATE ISSUED 3/27/2023 7:18 AM ADDRESS 16 ADRIENNE DR INSTALLATION 16 ADRIENNE DR SOUTH YARMOUTH, MA 02664 LOCATION SOUTH YARMOUTH, MA 02664 AGREEMENT AND INSTALLATION DETAILS Congratulations on going solar! Here are some key agreement terms and installation details: • Installation: Trinity Solar Trinity Solar will install a • Payments: Payments will begin the earlier of 30 days 6.480-kilowatt solar power system on your home. after the interconnection date or 60 days after the installation date. We'll send you a written not . to • Estimated Production: Your System is estimated to confirm your payment due date and -"ount. produce 8,839 kilowatt hours in the first year of service. • Utility Bill: Because you will ill nee . co ,ected • Cancellation: You have 7 business days to cancel this to the electrical grid, you 'I rive • m agreement without any penalty electricity bills:one vers e : ergy` erly NSTAR Electri . pany) -nd o Sunn. a. • Activation: Your installer will obtain the necessary building permits and utility approval for interconnection of • Arbitra n: 's a. ent requires the parties to your System. Once your System is installed, it must pass resolve -ir to arbit rather than by utility inspection before it may be turned on. This process lawsuits cou ry t . ass actions. could be delayed by factors out of your installer's control. • • -tte When e electric grid goes down, your • Savings: Depending on the term of your agreement, y. Syste t shut off because it cannot send power back may have received a savings estimate. Any '•.s to the gn. a uring this time, you will not have backup estimate is dependent on your utility rat:- - -• the power unless you purchase storage. usage information you provided us c ge you usage, or if the utility changes its -, that w affect • Transfer: Provided that the new homeowner your savings. meets Sunnova's credit requirements, you may transfer your agreement upon the sale of your home. Please • Coverage: Your Li ed Warra A, ement read your agreement for details and restrictions. The contains i • ••atio bout your S em lintenance warranty coverage will transfer to the new homeowner. If and co .•-. ou rchased a Optional Services, you purchased a new roof in connection with this you be provided -•arat: :rranty for those Agreement, you may transfer your rights and obligations servi. under this agreement to the person who will be buying your home, upon payment of the portion of your balance • Term: -ars. owed under the credit agreement attributable to the roofing project, subject to our approval and consent. In The pricing provided in this Easy Own PIanTM equipment some cases, the warranties for the roof and any other purchase agreement is valid until April 25, 2023 optional services may not be transferable to a new homeowner. Please consult the manufacturer's warranty for eligibility and restrictions. I have reviewed, understand, and agree with the above agreement terms and process. HomerMees Initials Homeowner's Initials