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HomeMy WebLinkAboutBLDX-23-12541 PERMIT /z 1/ ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department "y 1146 Route 28,South Yarmouth,MA 02664-4492 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: pj LAD IC-'ow -Oslo Date Applied: Building Official(PrintName) Signature - Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 54 t ray Farm Rd N 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 Provided Required Provided Required Provided NA 1.6 Water Supply:(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 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' ?,. Oivnef'1-�ecord._ ar es 1 Harris-Warren Yarmouth Port,MA 02675 Name(Print) City,State,ZIP 54 Bray Farm Rd N (774) 487-2239 harwar@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building❑ Owner-Occupied 0 I Repairs(s) 0 Alteration(s) ❑ I Addition 0 Demolition 0 I Accessory Bldg.0 Number of Units Other 6 Specify: solar Brief Description of Proposed Work': Install roof top solar PV system rated @ 18.4kW 46 panels.Install 2Tesla powerwalls rated @ 13.5kwh each, in utility closet SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) I.Building $ 9000.00 1. Building Permit Fee:S i SO Indicate how fee is determined: 2.Electrical $ 33000.00 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ �y Q 4.Mechanical (HVAC) $ List l w 4 o •" O W 5.Mechanical (Fire • Suppression) Total All Fees:$ 42000.00 Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 101687 9/13/2024 Daniel FOnzi License Number Expiration Date Name of CSL Holder 125 John Hancock Rd List CSL Type(see below) No.and Street Type Description Taunton MA 02780 U ( Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R -- Restricted 1&2 Family Dwelling l4I Masonry RC Roofing Covering • WS Window and Siding SF Solid Fuel Burning Appliances 978-420-2476 dl-southshoreoffice@tesla.com I - Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) Tesla Energy 168572 3/7/2025 HIC man•�y ame or istrant Name HIC Registration Number Expiration Date 125 JohnnyHancock d1-southshoreoffice@tesla.com 'and Street. 'IA 02780 781-6352-1030 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 No D SECTION 7a:OWNER AUTHORIZATION TO BE COUPLE 1'L;U WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Tesla Energy to act on my behalf,in all matters relative to work authorized by this building permit application. see attached contract 5/15/2023 Print Owner's Name(Electronic Signature) Date • SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my n...e belo' here./•'• .t under the pains and penalties of perjury that all of the information contained in •.pli . ion i tt! .d accurate to the best of my knowledge and understanding. 5/15/2023 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.sov/oca Information on the Construction Supervisor License can be found at www.mass.eov/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" The Commonwealth of Massachusetts Department of Industrial Accidents ; _ Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Tesla EnergyO Operations Inc. _ Address:901 Page Avenue City/State/Zip: Fremont, CA 94538 Phone #:781-635-1030 Are you an employer? Check the appropriate-box: Type of project(required) I.❑ I am a employer with 1500 4. [Lam a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. n New construction 2.El I am a sole proprietor or partner- listed-on-the attached sheet. 7. ❑ Remodeling These sub-contractorshave ship and have no employees 8. El Demolition working for me in any capacity. employees and have workers' 9. (l Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ 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 solar 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: American Zurich Insurance Company Policy#or Self-ins. Lic. #:WC 1074584-04 Expiration Date: 10/31/2022 Job Site Address: 54 Bray Farm Rd N City/State/Zip: Yarmouth Port,MA 02675 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 under the pains and penalties of perjury that the information provided above is true and correct. Signature: Paizzie fivb Date: 5/15/2023 Phone#: 781-635-1030 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): lDBoard of Health 20 Building Department 3.0City/Town Clerk 4.0 Electrical Inspector 5.Ilumbing Inspector 6.DOther Contact Person: Phone#: ACORD CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE DATE(M022D/YYYY) 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 MARSH RISK& INSURANCE SERVICES NAME: FOUR EMBARCADERO CENTER,SUITE 1100 (NCC,Nr o,Ext.): FAX Not CALIFORNIA LICENSE NO.0437153 E-MAIL SAN FRANCISCO,CA 94111 ADDRESS: Attn:SanFrancisco.Certs@marsh.com I FAX 212-948-0398 INSURER(S)AFFORDING COVERAGE - NAIC# CN104275261-STND-10M-22-23 INSURER A:Zurich American Insurance Company 16535 INSURED _ INSURER B:Steadfast Insurance Company 26387 Testa,Inc. 3500 Deer Creek Road INSURER C:American Zurich Insurance Company _ 40142 Palo AIto_CA 94304 __—- ____ INSURER D:Allianz Gtobat Risks-US Insurance Company 35300 INSURER E: --- -_-- ------- -- -- - INSURER F: __. . COVERAGES ______ _ CERTIFICATE NUMBER: SEA-003520244-22 REVISION NUMBER: 0 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 I ADDL'SUBR', POLICY EFF POLICY EXP LTR TYPE OF INSURANCE 1 INSD WVD POLICY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) LIMITS A X I COMMERCIAL GENERAL LIABILITY GLO1074588-05 .10/31/2022 I10/31/2023 ';EACH OCCURRENCE I$ 5,000,000 I ' DAMAGE TO RENTED I CLAIMS-MADE ^X j OCCUR Includes Host Liquor Liability' 1 PREMISES(Ea occurrence) $ 2,500,000 X 1I SIR.$1,000,000 I I 5,000 111 MED EXP(Any one person) i$ X I Tort Contrac Lab,No XCO Excl j , PERSONAL&ADV INJURY I$ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 I GENERAL AGGREGATE $ 5,O�O,O�� X , POLICY 111 PRO- �.,'`JI LOC 1 'I . PRODUCTS-COMP/OP AGG III$ 5,000,000 OTHER: 1 I$ A AUTOMOBILE LIABILITY ,BAP 1074586-05 10/31/2022 I10/31/2023 I COMBINED SINGLE LIMIT ' I(Ea accident) I$ 5,000,000 X ANY AUTO '.� BODILY INJURY(Per person) I$ AWNED I SCHEDULED I BODILY INJURY(Per accident $ AUTOS ONLY AUTOS � �� � ) I HIREDUTOS ONLY I1 ! —NAON-OWNEONLY D 1 PROPERTY DAMAGE (Per accident) I$ AUTOS l $ D 1X UMBRELLA LIAR 1 X OCCUR I USL00544222 10/31/2022 10/31/2023 EACH OCCURRENCE 1$ 5,000,000 l EXCESS LIAB II CLAIMS-MADE; AGGREGATE $ 5,000,000 DED f I RETENTION$ I$ C WORKERS COMPENSATION WC 1074583-05(AOS) 10/31/2022 I 110/31/2023 X I PER 1 x I oRH- A Y/N AND EMPLOYERS'LIABILITY 11 10/31/2022 10I31I2023)WI,MA(WC 1074584-05i STATUTE I 1,000,000 IANYPROPRIETOR/PARTNER/EXECUTIVE A 1 OFFICER/MEMBEREXCLUDED? N ''1....N/A 1 E.L.EACH ACCIDENT '' $ (Mandatory in NH) 1 CA XSWC EWS 1074585-05($50M is XS 1 10/31/2022 10/31/2023 1,000,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under '$10M SIR;$1M EE/EA is XS$10M SIR) 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B I Contractors Professional'jab. EOC 1074906 05 I 10131,2022 10/31/2023 Limits apply per pp y claim 1 10,000,000 &Contractors Pollution Liab. I SIR$500.000 I I Policy Aggregate 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Issued as Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION Testa,Inc.and all its SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE domestic subsidiaries THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3500 Deer Creek Road ACCORDANCE WITH THE POLICY PROVISIONS. Palo Alto,CA 94304 AUTHORIZED REPRESENTATIVE I Nova ea&9 worouree Sauteed ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD O l(r > m cnm" -4 � Oom> > o ZoOZ m -1 ; m 4 z n = D rr C1) 0 mc,0 Cam a)o -< $ oo ' cnm5 0 A m 3 3 Z m o co �m m x p m co .fir N o 41, N O s+', Q a O N _ CD 2 � n CD 7 cn O O O z 9 o O � K • fA C 13m rn o�, 4K /1 , r 1t� 1, - S iii fr CD t m: � D -3 , c m -1 MN 10411111 %. .N-' CO jto = aim c .-:.< C fD a o o-o cu O 73 (n vWa= a D = CD 6 off o m CD m 3 D o�� C -� .. H a w�c O)s o CI) N Mt N 0 co N N cT O C mN CCD Fir p CTI 7 W co n m a n F..,. §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 54 Bray Farm Rd N,Yarmouth Port,MA 02675 Work Address Is to be disposed of oat the following location: No debris generated Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §15 . 5/15/2023 Signature of Application Date Permit No. en9 ONE or TWO FAMILY— BULDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE Address of Proposed Work: 54 Bray Farm Rd N,Yarmouth Port, MA 02675 Scope of Proposed Work: Install roof top solar PV system rated @ 18.4kW 46 panels. Install 2 Tesla powerwalls rated @ 13.5kWh each (27 kWh total),in utility closet. Date: 5/15/2023 Based on the scope of work described above,the applicant is required to obtain approval sign- offs from the following departments as checked-of below: Health Dept.—508-398-2231 ext. 1241 Conservation—508-398-2231 ext. 1288 Water Dept.—99 Buck Island Road, 508-771-7921 Old Kings HWY. Hist. Comm. —508-398-22631 ext. 1292 Engineering Dept.—508-398-2231 ext. 1250 Fire Dept.—Kevin Huck/Scott Smith, 96 Old Main Street,SY Note: Please call Fire Department for an appointment. 508-398-2212 Other Appropriate plans and/or application shall be provided to each departments checked-off above. Each of these regulatory authorities has their own requirements outside the jurisdiction of the Building Department. All applicable approvals shall be obtained prior to submitting a building permit application to the Building Dept. Thank you for your cooperation. Receipt Acknowledgement: Z7a. i7P G 5/15/2023 Applicant's Signatu ' Date Rev.Jan. 2019 7 4�7p .. _;. s _ .. — �4 '' F"' xt��, t ^" r..0.,10A0A 00�,•erg 1 0 � r' ` ' � � .. r r y ���� . ;y Z � '' } ;. > - 0 �,' , . : ., r - « � �. .. � g ��t - i ': �F` 3 P Y h 2�' , k ..Eve 4, g -T^E "*" .� 5'�S 5S -. fi{'9x- dr -- xr ks .. - - " #• - - c'`- - ... -- , _ .. ' I :. .. Y:. .__.. - -. - - _ _- - - " }.; - - - L.... a - -"-. — " -� "T - — `g - - 'S„ ' - - Oklp-}` Y 9 _ . kK '- _ - *t'. - ._.- ' 5 - - . r. �Y. .,._ .. @ h x � - - - - N'tlitira-*•144411;:''' n . • �.�99 R U 12 c CO U W w O 0 c 1.0 v .O - 0 N R .. 1° O mNo a w 0) - Q l�C)e 0) Q V CO co co Oco co 'B T-estow 47- iiiC •C 3wm .y Q 11 0_O o O. -cs .+ D c = . ., aaw -4 cc m 3 'Cn vy � .1 `` ,,,,,,,,,, o a -c m sF 3 O '� •4 t... t6 d N r Na,0 a+ Oo 0 A FIli a� OLQ Z _ , y� # 1 1— r € Iitt' iiiitittOO!!t*- H ` d c f ! ,fstta;titit ga .. 67.a°p Ul . x-p O 1 i co z E oo 2 inQOE L cOm — c OO N c O U ,— m° �� v U o � R N U w3 W O = z j m 0 c _U ui 1 N v 0 O tnct- W Z HE a�1-a e .f- 11,1.11:riliiiiiiiirre °px z Y 2 'WZ O ; OQcr, o c w w 0Ce g F=-E w �OOZ• LO 00 I-- 0.-O)� r f�E m�. 19 ? 2? 1 TOWN OF YARMOUTH `1 1 � 1140 f<OU I F 2d, SOU l I I YAt<MOU fti, MA 02664 'l4';1 tAHMOU'i"t t i lelepbune O0ti)398 2231 Ext. 1292--Fax(508)398-U836 OLD KlJti1 Hi ING'S HIGHWAY HISTORIC DISTRICT COMMITTEE APPLICATION FOR CERTIFICATE OF APPROPRIATENESS Application is hereby made for issuance of a Ceitificate of Appropriateness under Section 0 of Chapter 470, Acts of 1913 as amended, for proposed work as described below&on plans,drawings, photographs, &other supplemental info acconlpartyirry this application. PLEASE SUBMIT 4 Copies OF SPEC SHEET(S),ELEVATIONS,PHOTOS,&SUPPLEMENTAL INFORMATION. Check All Cateelories That Appl yi : Indicate type of Building: Commercial ©_Residential 1)Exterior Buildind Construction: New Building ii Addition Iterations III Reroof nGarage Shed I Solar Panels _Other; 2)Exterior Painting: _ ,Siding _ Shutters j I Doors trim Other: 3) Signs/t3illboards: New Sign Change to Existing Sign 4)Miscellaneous Structures: _,Fence . Wall .Flagpole .I [Pool __Other" Please type or print legibly: Address ut prupused work, 54 bray Farm Rd North Map/Lot it1 b1/29 Owner(s): CHARLES HARRIS WARREN ANNE f3ABICH ELIZABETH , All a hcationa roust be submitted phone I! 774� }487-2239 pp by owner or accompanied by letter from owner approving submittal of application. Mailing address: 54 BRAY FARM RD NORTH YARMOUTH PORT, MA 02675 year built_ 1991 EmaiLharwar@corncast.net net Preferred notification method: _ Phone (mail Ayenticontractur. Tesla Energy/Nathan Tissot 781-635-1030 Phone it: Mailing Address: 125 John Hancock Rd Taunton MA 02780 Email: ntissot@tesla.com Preferred notification method.,__11] Phone © Email Description of Proposed Work: Install 30 black solar panels on the roof of the existing home. Signed(Owner or agent): atKas�� �t- 9/15/2022 w Date_ Ownericontracturiagent is aware that a permit is required from the Building Department.(Check other departments,also.) If application is approved,approval is subject to a 10-day appeal period required by the Act. r This certificate is good for one year from approval date or upon date of expiration of Building Permit.whichever dale shall be later, ;: All new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections, For Committee use only: fpproved A roved with Modifications —�-____ pp _._. - Deniecf Rcvd Date II l/ ',, Reason for Denial: ' Amount _.. _.`1Lq W cash/C,K# _ � 11 1 4' U fs Signed: l Rcvd by: f `AINVIC r)?" i / 45 Days' __ t..1�a ai r t.PG , ,t Date Signed: /,‘„ j Z. , -`',7 Z, __ 1 3?--Al i APPLICATION It: TOWN OF YARMOUTH ;. t g 1146 ROUTE 28,SOUTH YARMOUTH, MA 02664-4451 a_a m�3c: i x� +-��ti"t _f' 1 Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 Apr, i p KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE fA IVIUU f r, APPLICATION FOR pj, ` rfi- Y 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 X Solar Panels Other: 2)Exterior Painting: Siding Shutters Doors iTrim 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: 54 Bray Farm Rd N,Yarmouth Port,MA 02675 Map/Lot# 151/29 Owner(s): Charles M Harris-Warren Phone#: (P4)487-2239 AS applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 54 Bray Farm Rd N,Yarmouth Port,MA 02675 Year built 1991 Email: harwar©corncast.net Preferred notification method: Phone Email Agent/contractor Testa Energy/Nathan Tissot Phone#: 781-635-1030 Mailing Address: 125 John Hancock Rd Taunton MA 02780 Email nbssot@tesla.com Preferred notification method: Phone X Email Description of Proposed Work: Add an additional 16 roof top solar panels to originally approved design(22-A113) Signed(Owner or agent): Al / Date: 3/31/2023 A Owner/contractortagent is aware that a permit is required from the Building Department.(Check other dep _ D If application is approved,approval is subject to a 10-day appeal period required by the Act. li�� > This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichev s A All new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site framing&final inspections. For m y- ,n : 1/ A proved MAY F Approved with_Modifications Denied Rcvd Date: (A€MC?l1T i, Reason for Denial; OLD KIN ,S HIGHW I Amount Ow.�}60 Cash1CK ft:c?1fS +)5 - Signed: „A (, d OF Rcvd by: t r -'.tii11 45 Days: 0 , ir Air Date Signed:6 ;fir e fir �� 1 3-6-A-a 43 APPLICATION#: • Energy Purchase Terms Thanks for your purchase! Now that we have completed your order for your Solar System, including any Tesla Powerwall(s) you also ordered(all of which we call your"System" below), the next step is to prepare for and schedule installation of your System. In the meantime, below are some basic terms we need you to agree to in order to make sure we are on the same page(and along with this document are some required disclosures for you to review as well). We look forward to working with you and are excited that you are joining our effort to transition the world to sustainable energy! 1. Your Purchase Price.You have agreed to purchase your System at the price described in your Price Sheet. Your Price Sheet,which is considered part of these purchase terms,includes taxes.You have 7 days after you receive the price Sheet and these purchase terms to reject them. If you don't reject them,or if you move forward with scheduling your installation,that means you are agreeing to the Price Sheet and these purchase terms. 2. -Updates to Price Sheet.Even though we have compled the initial design of your System,we might need to make - - changes to that design, which also means we might need to update the pricing or System size based on a variety of factors,such as installation complexity or product availability. If that happens,we will update the Price Sheet.You have 7 days after you receive the updated Price Sheet to reject it. If you don't reject it, or if you move forward with scheduling your installation, that means you are agreeing to the updated Price Sheet and authorize us to develop and submit permit packets and otherwise prepare for your upcoming installation.The updated Price Sheet replaces any prior Price Sheet and is considered part of these purchase terms that you are agreeing to(unless you rejected the update). Tesla can also decide to increase the size of your Solar Roof at no additional cost to you. 3. Cancellation. At any point prior to the time when we deliver materials to your home in preparation for your installation,either of us can cancel your order for any reason provided that we let the other know in writing(so there is no misunderstanding).If we are responsible for canceling your order,we will return any deposits and upfront fees you have paid. If you cancel or cause us to cancel.your order,your deposit and upfront fees are non-refundable. 4. Permission to Operate. Payment of your purchase price in full for your System includes Tesla ensuring that your System obtains"Permission to Operate"(or"PTO")from your utility, provided that PTO is required for your System. There can sometimes be delays in obtaining PTO. Tesla will work with you and your utility to try to minimize such delays. 5. Home Owner's Association. If your home is governed by a home owner's association or similar community organization,you are responsible for getting any required approvals and authorizations for your System. 6. Installation. We will contact you to schedule installation of your System. During installation, we might choose to make minor repairs commonly needed to install the System at no additional cost to you(like simple electric upgrades and roof preparation).We promise to repair or pay for damage we directly cause to your home or your property during installation of your System. If we fail to do that, please let us know, and we will make the repair(or have someone repair it)at our cost(and that will be your only remedy). But you need to let us know in writing and within a certain amount of time following the damage: within 10 years for Solar System installations, 4 years for Powerwall installations and 1 year for anything else. 7. Equipment Limited Warranties.Your solar panels and inverter come with a warranty from their manufacturers.The solar panel warranty will be at least 25 years and will guarantee at least 80%of nameplate capacity for at least 25 years. Your inverter warranty will cover defects for at least 10 years. You agree we can make warranty claims for you for your solar panels or inverter. If your order includes Powerwall(s),your Powerwall(s)are covered by the Testa` Powerwall Limited Warranty.These warranties are considered part of these purchase terms. 8. Remote Monitoring and Firmware Upgrades.You agree that Tesla can access your System remotely to monitor its performance, perform diagnostics and upgrade firmware. 9. Grid Services. We might contact you about ways in which your System can support the reliability of the electrical grid and you agree we can contact you for that reason. 10. Tesla Intellectual Property.Testa owns all patents,trademarks,copyrights,trade secrets and any other intellectual property rights associated with your System. Tesla gives you a limited, non-exclusive, license to use any software Solar Purchase Agreement V 11.0.0..10106/2022 Tesla,Inc. 10096082 The schedule of progress payments must specifically describe each phase of work,including the type and amount of work or services scheduled to be supplied in each phase, along with the amount of each proposed progress payment. IT IS AGAINST THE LAW FOR A CONTRACTOR TO COLLECT PAYMENT FOR WORK NOT YET COMPLETED, OR FOR MATERIALS NOT YET DELIVERED. HOWEVER,A CONTRACTOR MAY REQUIRE A DOWNPAYMENT. Approximate in Ration Start Date 7-90 days from contract signing Approximate Completion Date 7-90 days from the day installation begins Signed by Your signature Charles M Harris-Warren Tessa,Inc. Name: Charles M Harris-Warren r ` Date: 1/31/2023 8:23:27 PM +00:00 Name:Tyler Moragne Title:Director,Residential Energy Operations You are entitled to a completely filled in copy of this Agreement, signed by both you and Testa, before any work may be started. Solar Purchase Agreement V 11.0.0..10/06/2022 Tesla,Inc. 10096082 • T June 11, 2019 Re: Tesla Retrofit PV Structure Qualification Certification Letter Tesla's Retrofit PV product is an assembly consisting of Tesla mounting hardware for comp shingle or tile roof coverings and PV modules using the Zep Compatible frame. Please refer to the product data sheets, UL listing,andinstatlation documentation for further information. — The Tesla Retrofit PV assembly does not exceed 3.5psf. Installation of the Tesla Retrofit PV _- assembly offsets load in areas of the roof designed to support a roof live load and provides a lower-friction surface than the existing roof She weight of the offset live load or difference in accumulated roof snow load as a result of reduced surface friction (in regions where the roof snow load is greater than the roof live load)will exceed the weight of the PV assembly. Consequently, the net additional loading impact to existing gravity load resisting elements is less than 5%for the framing of pitched roof structures with existing roofing material comprised of comp shingle or tile. Note that this assessment does not apply to structures with existing metal roof coverings in regions where roof snow load is greater than roof live load. 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