HomeMy WebLinkAbout303 Route 6A - building permit solar wolfONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yormouth Buildlug Department
I 146 Route 28, South Yarmouth, MA 02664-4492
508-398-2231 ext. l25l Fax 508-398-0836
Massachusetts Statc Building Code, 780 CMR
Building Permit Application To Consn'tol, Repair, Renovate Ar Demolish
a One- or Two-Famrly Dwelling
This Section For O(Ecial Use Only j--to- zzDate Applicd:Building Permit Number: AL'l\ -,el-005qq4
Buildin g Offi cial (Print Name)Signaturc I .\L.\rE
tr---SDCTION 1; SITD INT'ORIIATION
1.2 Assessors M8p & Parcel Numbers
Map Number ParcclNumber I
l.l Propcrty Addrcss:\GUGA
l.l a Is this an accepted street? yes_ no_
IVED
2022
RTMENT1.4 Property Dimensions:
Lot Arca Gq ft)F ontage (ft)
1.3 Zonir|g Information:
ZoniqgDistrict ProposcdUse
1.5 Building Setbocks (ft)
Sidc Yards ReaJ YardFront Yard
RcquircdProvidedRequircdProvidcd ProvidedRcquircd
1.7 Flood Zore Information:
Zone:- _ Outsidi Flood Zone?
Chcck ifycstr
1.8 SelYagc Disposal System:
Ivlunicipal tr On sitc dislosal system tl
1.6 Water Supply: (M.G.L c.40, {5a)
Public tr Private tr
SDCTION 2: PROPERTY OWNERSHIPT
Tcl.ohone Email Addressffildtt*t
tn,.{A-l AC AIL) t
Namc (Print)
ao4., Rr (,q
2.1 Ownerr ofRecord:M(n/rl hr"
City, Statc, ZIP
5i2';ii"9tcl
SECTION 3: DESCRIPTION OF PROPOSED woRK! (check all that sPply)
Alteration(s) tr Addition trExisting Building tr Owner-Occupied o I Repair($ o
Accessory Bldg. tr l*rOther P Spcci&;Demolition tr
f A(+c\ltr_i,rr\ cJ Zrl <l\W S( 4r Db),l|IDescription of Proposed WorkBriefh
Estimated Costs:
(Labor and Materials)Offrciat tlse Only
l. Building $lY t{5\ .\rt
2. Electrical $ l) ,5U9. Lr-t
$3. Plumbing
4. Mechanical (IWAC)
$5. Mechanical (Fire
Supprcssion)
3i, V2Y$
-suilains permit Fee, S 15" hdicate how fee is <.letermined:
Slardard City/To\ryn Applicatioo Fee
tr Total Project Cosf (Item 6) x Bultiplier
-
x
-
CheckNo- ChcckAmoEt Cash AEoust
Totat All FEes: $
1.
tr
tr outstandiog Balance Due:tr Paid in Fu1l
2. Other fc€s: S
List:
MAR 2
I I'U ILUING OElev:_--
(;ehnqus@ rY\s4. coM
New Construction tr
Number of Units
SECTION .I: ESTIMATED CONSTRUCTION COStS.
Item
$
6. Total Project Cost:
a3 f*bAddress of Proposed Work:
Scope of Proposed Work:vl \6H{
-lo -fn-hr c, Y,0\{ r!^J N+ro sctA/' sw+(,4
Date:\-t0.11
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. -508-398-2237 ext. 724t
_Conservation - 508-398-2231 ext. 1288
_Water Dept, - 99 Buck lsland Road, 5oU77 L-792t
_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
Not€: Please call Fire Department for an appointment. SO8-398-22L2
Other
Appropriate plans and/or application shall be provided to each departments checked-off above
Each ofthese 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 Acknowled en t:
3 - to-zz-
Rev. Jan. 2019
Date
ONE or TWO FAMItY- BULDING PERMIT
APPLICATION REGULATORY APPROVALS NOTICE
5
Applicant's Signature
SIR1rICES5SECTIONNSTRcoONUCTI
0S-Cr.J'iqqt L-tq-zcz
Expiration Dstc
u
List CSL Typc (scc bclow)
Liccnse NumbE
Dcscription
to 35 cu,
Rcslrictcd l&2 Fami
tvt
RC
ws
Solid Fucl Bumiog liances
I Insulstion
5.1 Com-tructlo! Supon,lsor Llceosc (CSL)
1<ct sktru rY;
No. and Strcei
rlt$/5
q
5
ZIPCiv/fown,
,/
Namc ofCSL Holdcr
-S
Ul"r,t1 0J
r!.,p
%? [r)u
D Dcmolition
5.2 Reglstered Eome Improycment Contractor (HIC)
E?., sic .1Yui
ZP e
HIC Company Namc or HIC
No. and Strcet
S
o
NJ(r
rtr
t Name
fiStrt 9 .f @ sor- u.t..,tr414
| 610 Ll00 tt lbl2z
HIC Registation Numbcr
Email address
11
Expiration Date
INSURANCECTIONSE6WORKERS'COMPEN TISAON AT'FIDAYIT G c.L.152or.$25C(o
permit.
orkers affidaCompensation must cobe atrd withsubmittedmpleted this lication Failure toapP providerhisaffldavirwiUresultthemdenialoftheIssuancefobtbeitdul.0g
SigLcd Afiidavit Attached? Ycs.......... tr No ..... tr
ONSECTI OWNER A TIUTEORIZAON oT BE COIVIPLETED IYHENwlIERoAENTGRoNTRACORcToFORA}PLIES PERJVITBUILDING
all Datters relative to work authorized by this building permit applicatiou.
Print Oiroer's Nornc (Elccrronic Sigrafurc)
I, as Orvuer of0rc srbject properry, hereby authorize lt(,l
to act on ray bebalf, in
SlrlCLc r i
\-t$'22
Da(c
[r/\,t hcdl [-,iq t ^crv
OWNERJ AUTEOR AORIZED DGNNTECLARA oTIN
I herBby attest under the pains and penalties of perjuy that all of the iuformation
is t99-and accurate to the best ofmy lororvledge aad undentanding.
Print Owncr's or Ageot's NaIIlc (El?ctonic Signaurc)
7'to'qZ
By entering my name below,
couained in this app
NOTES:
obtains buildiag
willProgram),itratioo
infonnation
I-nformation
oAnwqel rvho a dto hisltero onmpeErit ano,lvhoorralerwork,AEhires uruegistered
re then Home(not gistered ContractorImprovement (rxc)accqssbave theto arbnol
or underfirnd GM.,L.4?4.prcgram guaranty 0n HIthe Procimportant cao be found atgram
otr Cotrstructiotrwww.mass.gov/oca tsor canLicense be found atSuperv wwrv.mass.eov/dps
plaaned,
)
2. WIen substantial wort is provide the infomntion bclow:
(including garage, finished basement/anics, decks or porch)
Gross living area (sq. ft.
Nunber of
Number ofbathrooms
Habitable .oom colEt
Number of bedrooms
Number ofhalflbaths
Type ofheating system
Type of cooling system
Number ofdeckV porchcs
Enclosed pcn
-
'Total Project Square Footage" may be substituted for .,Total3 Project Cosf'
(C tl
TY-R
(u .>
R
Masol|Iy
Roofing Covering
Wiudov aqd Sidinc
Iasurance
Date
7a:
SECTION 7b:
I contractor
c.Other
the
Total floor area (sq. ft.)
The Co mnto nweatt h of MassaLctt usefis
D epartment of Industrlal Accideats
1 Congress Strcet, Suite 100
Boston, MA 02111-201?
\\:o.kers, compensation ,rrr.r".u11f;ffl,';grif/uXjlont.n.to.r/Erectricirns/plumbers.
TO BE FILED WITH TEE PERMTTTNG .4.UTHORTTY.
AoDIicnnt In orma tio
1",r8
-PleaseName (Busincss/OBmizrrlon/lndlvidual)
Address:
City/State/Zipi Phone #:
ny applicsnr dlat checks box # I mlst also fill oul the section bclow showing rlrcir,ro*erJ compcnsation policy infolrnatio[Homeowners who submit this xfridavit indicaring lhcy arc doirB all $rork and ttlcn hirc outstdr conEactoE must submit a ncw afiidavit indicating suctr"lContracton tlut chcck 0ris box mu$ attached an additional shccr showing lhr l18rn! of
Ar. you l|n cmployGr? Ch.cl( th. !pprop.iatc bori
l.! I am a cmploycr with _cmployecs (tull rnd/or prn-dcr)..
2.! I tm r solc pmpricEr or patuarship .nd hava no cmployecs norking for mc inrny capacity, [No \r,orkcrs'comp. insurancc rcquircd.]
3.! I am a homcowncr doing sll work mysclt [No workcrs. comp. insurancc rcquircd.] ,
4.[ I arn a homcorvncr andwill be hiring c.ot-acto.s to cooduct all work on my prooerry. I willansuac thit all conu-acbas eith.r havc workals, corrlp"nsuion i*ur"n". or'*" solaproprictors with no cmploycca.
5.f] I srn I gen ral conE-acror and I have hir.d thc srb-conrrsctors lisr.d on thr aaac.hcd shcctThcsc su[cootnctors havc cmployccs and hsvi wort
"rs, *mp i**_""i--"'-
6.Wa !E a corporition ond its officcr! havc cxercised thair rigll! ofexcrrption Drr MGL c.
I 52, S I (1), ond we havc no cmploycrs. [No wo*.rs, comp: ins;;;;q;lfil : -.
Type of project (required):
7. f] New construction
8. ! Rcmodcling
9. D Demolition
l0 ! Building addition
I l.E Electricai repain or additions
12. flPlumbing repairs or additions
13.! Roof repairs
14n Other
. lfthe sub-conEactors hrva cmoloyces, thcy oust provide their
Lhe sub-contracors and state whether or not those cntities havc
I an an ernployer that is proyiding v,orkers'
in formalio n,
Insurance Compauy Name
workcn' comp. poticy number
compensation irrsurance for my employees- Below is the poliey and job site
Policy # or Self-ins. Lic. #Expiration Date:
I rlo hereby certify uttdi tlze pains and penalties of perjury thdt the inlormation provid.ed above k trae and conecL
Job Site Address:---
o,,r.o u .oo, or tlltil;,*r",_*
"*,r"".*",.railure to secure coverage as required.under MGL c. 152, $25A is a criminal violation punishable by a fine up !o $i,500.00and'/or one-year imprisonment, as well as civil penalties in the rorm oia STop WORKbRDER aja finc orup to $250.00 aday against thc violator' A copy of this statement may re rorwuaei io rle office or rnvestilation, of ti.'on ro, ioru.uo".coverage verification.
Do not *'rite in this arcd, to be complzted by city or tovn ol/icial
l: 3:i:l "''""t0 2' Building Departmetrt 3. citv/Tow. crerk 4. Erectrical rnspector 5. plumbing Inspector
PermiVlicense #
Phone #:
OfJicial ue only.
Contrct Persoo:
Issuing Authority (circle one):
City or Town:
,l
FRODUCERLe:lb Xnsurarrce
537 Park Avenue
Worcester, !{A 01603
INSURED
SOL}N WOIJF, ENENoY
77], WASHTNGION BT
JIUBURN }'A
*iI. :', ,,.:,lt'-r , ,, , ,
GERTIFICATE OF INSURANCE
The ACORD name and logo are r.eglstered marks of ACORD'
SHolrLo ANY oF THE ABol,E DESCRIBEO POLICIES ee cA!'lCEuEO-aEiqne
nii-exl,iiilrrbi oAre THEREoF, NorlcE wLL -BE IELTvERE-D lN
a-Cconoalrce wrH THE PoucY PRovlslol{s'
YAR$OIXTE TOW![ rrA+
1145 nOIrrE 28
YARrtorrrE PORI, t(A 02664
Lo/2021
NO'RIGHTS UPON THE CSRTIFICATE
BYAFFORDEDCOVERAGE'THE
156UINGTHE,BETWEEN rNsuRER(s),,I
ONLY
NEGATIVELYAFFIRMATIVELY
ANDINFORMATIONASISSUEDMATTERAOFtsCERTIFICAIETr{rs AMENO,EXTENDORNOTDOESCERTIFICATEACONSTITUTENOTDOESINSURANCEOFCERTIFICATETHlSBELOW.HOLDER.CERNFrcATEANDTHEORATIVEPRODUCER,REPRESENT,
POLTCIES
THIS
A statement on
$ranpollcy,policles may requlre anoftermsthecondltionsandtotsSUBROGATIONsubjectWAIVED,lf llouln of
s08 -792 -0411
NAUf,IIJUS
ITIBERIY lfiIfUAIi
CERTIFICATE
EXCLUSIONS
IS TO WHICH THIS
THE TERMS,INDICATEO.
OF 0qIxO 100,000 i
5 000EXP
L,ADV
2 , 000, 000
2 000 000
5
o6/08l2O2LN
x
APPI.IES PER:fl.*LIMIT
PRO-JECT
GENERALUABILITY
CLAIMg.i,AOE OCCUR
A
$
$BO0ILY INJURY (Par PeBn)
BOoILY lNJUFlf (P€r aeident)
I
$.
OWNED
AUTOS ONLY
HIREO
AUTOS ONLY
SC}IEDULEDAUTOS
NON.OWNEO
AUTOS ONLY
AUTOiIOBILE LiABIL]TY
AI.IYAUTO
OCCURUilBRELLALIAB
E'(GESS LIAB
1,000,000
1, 000 , 000EAE.L.
:., o00,000
08lLOl2022oa/Lol2021,N'A wc2 - 31S-614936- 020
AND EMPLOYERII' LIABIL]TY
Y
E
'tti
be lttachad f mm 39ee i6 rcquindl(ACORD lO1. Addluonal Remttt schedule. mryDESCRIPTION OF OPTRATIONS
'
LOCATIONS 'VEHIGI..ES
ACORD 25 (2016103)
All rlghts
OF
BY THE HEREIN IS SUBJECT TO ALLMAY
NNl207723
ll
commonwealth of Massachusett
Division of Professional Licensur$r
Board of Building Regulations and stand*
C o n s t r.uctibA $Sup,efv
i s o r
$
W
cs-087491 ryr Jtrrp ires: AUlgl}01zry
TED C STRZELECKI
582 WAUWINET RD
BARRE MA d{pos
rd,a
Fr(
/t\.V
I r'ii.
'&q,r
s
K Ve*,-!r*
r
EE
i
I
l
r Commissioner d*fi^
U
I
/
,%,az/,'%a#a,./id?-/r)-
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 021 18
Home lmprovement Contractor Registration
Type:
Registration:
Expiralion:
Corporatlon
't86400
11t06t2022SOLAR WOLF ENERGY INC.
77,1 WASHINGTON STREET
AUBURN, MA 01501
Upd.te Address and Return Card.
scA r 6 20u{5/17
. )), /,..,,.,,"...,.,1t,.,/ /1.: )...,,,,,, /...
Ofllcs ot Coffium€r Alt lE a Ausin.3. R.gut tloo
HOME IM PROVEiI ET.IT COITRACTOR
TYPE: CorDolelionReolslrrtlon Explrrdon186400 11lMnO22
SOLAR WOLF ENERGY INC
Registration valid tor individual use only
bofo.e tho sxpiratlon dat6. lf found rcturn to:
OIfice ofCon6um6. Affalrs and Buslnels R€gulation
1000 Washlngton Street - Sufte 710
Boston,lrA 02118
Not valid without signature
TED STRZELECKI )
77r WASHTNGToN STREET ttnnA /&a4AUBURN- MA OI5O1 -::-
L, ndersecretary
*}*NhUS't'\S\L UJffiVtr \J
TOTI'I{ OF YARIfiSUTH
11{8 B0{JTE ,fr, $OtlTti YARhtfrlrTt*, ll[A 02frfi{,fi$1
Tel*phone {6{*l }*&2tiI Err t3*t*f ar {5O8} 3CE+B36
OLT} K}il{G'S }TISHUIJ.AY HI$TOR}C EISTRICT GOilIT{ITTHE
APF*-!CAT|S[, FfiR
narxby med* kr r$su&nca of e Csrtll$$B d fiFF{ryjabflx** undfr Ss{ii6t! S sf Crra@ 47CI^ S6h of 1$7S aspt0***ed {s& tt de*E?t+d b6*tr, * srr Fhn*.dxlrnt96, p@nphr.3 o$*r srm*nrental *r* acconperrying &uaxpp**r!*n F{"E**H fi$ElltT * CAqie.E OF $F,EC $HEEr{*1,+l*tFsfrf,tAYlsr{
AsF,*Eahficr ta
wrrnded, b
1) Erlerior Buildrrs Conrtructionf-l** H=*,Faneh *th*r:
3) gxter*sr Pr*rsingr
3) $lgmrfBiilboardx:
ffr** fh* ff**
ffiffiiJ* Il*,*,*i illis{Blbnaffur $kurtures :
Ft*M *ps sr ndnt l*gbfy;
WmE
Adclres* s4 propsssd r+ort 303 Rtuts 6A kt*s[st#12t.77
fi,rulert*l frdisl-uat *tiehnar:Phone f $t*-94s410!
All il*fHr*tlo{r* nrrsl, k,* **krnifi*d by aryynes sr *c**mp*nird hy ktirrfr*m swffi f,fprolrlnf Buhfiisttrl ol rp$.lnltlm.
[,!ailrrrg asdress 3fi3 Houto ts* Yannmrlhport" f,*a 0?fr75 ynpl fopill 1635
g*u;1 Klehnaus&m**.com Prsbrred nptifie*fi on rnalhotl fJ -;;n*
ffi-u*"u
Fslsns f $fi9-gsB-2t22Ag€fl$Ss{$rf$er S*t*rWo{f Enarry
**e*eng &d#asa IIt Washing{un $t *xlbum. Ma S1$S1
rro* rli*F'v& F**prrsnutfieaamrna*, [J phss L# rsns*
Dctcrrotlon od prooocod wor*: Fob*dno$6cetmma** il pi'o* ffi e'
lrwteNlation sf a S"B4kW roof rncxrnted eolEr Bnay rlsing g4 SPR 335W pansls with bullt-in ffiicrsinyerterr
sftd s $tdi{RT rn6t*r
Si$fl#d $h*dwr mr s$*fltl
Lppr*md ... ... Appru,iBd r*lH . . tilorrir*s&effi
H**ron ior f{fltal.
$ryn+d
Fat*
_tl*nmrX
& &/rsrrsr1i&r$*t sg6il ir *rn*w llaal * pen66 s resjf[d Fom ltre Bul6{r0 Dspa&rw$ ffihs{*( 0gt{f dep{rrfi,r(dr. Ss Il tl #F$arl,*r fr rppr$rrd. {0prffiil { &*fd ir { t04ry rffi, $sriM ,,qbind }? the **,y TH* t&rt#€f;Sa l* 0s$d t0{ {{t* y*# **{t rySre{v* d*k $r upe} dd* fil *n$#rliufl * gtseB$ FgIum, c*ri{l'!rE}ier {&r,!o rruu il* ulr&t3 At nerr rt{tq$r*{iln*tfi &* &.q*d }t r'n!@}!rt &? *(li Ot{t{*pp# &n6 }'ll"{S? k m@eh o*,,am i*r trwurq il k!# trxsFBftknt
Rfd sdre -t FilU4rhr I
As+u# *::lLt.**--
rr*tvcx I llffi$R'.dS f,\l -
tlfi *ryx:
&etr $rytrd d :"I*"d L {
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1 #l-
The Commonwealth of Massachusetts
Department of I ndustrial Accidents
Ollic e of I n v e s t igat io ns
Lalayette City Center
2 Avenue de Lafayette, Boston, MA 02111-1750
www.moss.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianslPlumbers
Name (BusinesJorganizatiory'lndi Solar Wolf Energy
Address: 771 WashinqtqO St
,4,-((- \..!* -\
Auburn, Ma 01501 Phone #:
*Any applicant that checks box f I must also fill out the section below showing their workers' compcnsation policy information.t Homeowners rvho submit this a{Iidavit indicating they are doing alt wort< and then hire outside contraclors must submit a new affidavit indicating such.
tContractors lhat check this box must atlached an additional sheet showing the namc of&e sub+ontractors and statc whether or not those entities have
employees. lf the sub+ontractors have anployees, thcy must provide their worken' comp. policy numbcr.
I am an employer that is providing workers' compensation insurancefor my employees. Below is lhe poliqt and job site
itdormalion.
Insurance Company Name: Leib Insurance
Are you an employer? Check the appropriate box:
t.E tamaemployerwith 6 4. E Iamageneralcontmctorandl
employeei lfutt ana/or part-time;rr, have hired the sub-contractors
Z. I f am a sole proprietor or partner- listed on the attached sheet.
ship and trave no employees These sub-contractors have
working for me in any capacity. employees and have workers'
[No workers' comp. insurance
-
comp' insurance'l
reouired.l 5. ! We are a corporation and its
:. E f am a homeor"ner doing all work officers have exercised their
myself. [No workers' comp. right of exemption per MGL
insurance required.] t c' 152, $l(4), and we have no
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ! New construction
7. flRemodeling
8, flDemolition
9. I Building addition
10.[ Electrical repairs or additions
I l.E Plumbing repairs or additions
l2.fl Roof repairs
l 3. E orherSo!Al[0sta!!a!!o.n_
'i r,-JobSiteaaar.rr. -'Cj tl I L 5
citytstatetzip, ,,',,*'r-\,-lL ,$D - 2L ))
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 fonrarded to the Office of
Investigations ofthe DIA for insurance coverage verification.
I do hereby certify under the pains of perjury that lhe informalion provided obove is true and correct.
j- tc'zL
Phone #:
Official use only. Do not write in this areo, to be completed by cigt or town oflicial.
l'ffifriJtJffllrf;tfi;H[ing Deparrment s.flcityrrown cterk 4.EEhctricar rnspector SDtumbing
PermiULicense #
Phone
lnspector 6.f]Ottrer
Contact
City or Town:
Policy # or Self-ins. Lic. #: WC2-315-614936:020 _ Expiration Darc 0811012022
4.
TOWN OF YARMOUTH
BUILDING DEPARTMENT
1146 Route 28, South Yannouth, MA 02664 508-398-2231 ext. 1"261
HOMEOWNER LICENSE D{EMPTION
PLEASE PRINT:
DATE:
3Og (i,u-< GA , 9Arnno"tr".a,a
.,HON,IEOWNER''NAME
M,c t'r,t I U,rhnr^.,
STREETADDRESS5,2- o.v(,,-qlo,SECTION OF TOWN
NAIVIE
PRESENT MAILING ADDRESS
HOMEPHONEjr(laA
WORKPHONE
2
CITY ORTOWN STATE ZIP CODE
The current exemption for 'Homeowner' was extended to include owner - occuoied dweliines of one or two units
and to allow such homeowners to engage an individual for hire who does not possess a license, orovided that such
homeowner shall act as supervisor, (State Building Code Sectioo 110R5.1.3.1)
Definition of Homeowner:
Person(s) who owns a parcel of land on which he / she resides or intends to reside, on which tlrcre is or is intended to
be, a one or two famiiy attached or detached structure assessory to sucb use and / or farm suuctures. A person who
constructs morc than one home in a two-year period shall not be considered a homeowner; such "homeowner" shail
submit to the building official, on a form acceptable to the buitding official, that he / she shall be responsible for all
such work oerformed under tlre building permit. (Section 1 10 R5.1.3.1)
The undersigued 'homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes, by-laws, rules and regulations.
The undersigned 'homeowner' certifies that he / she understatrds the Town of Yarmouth Buildiug Department
minimum inspection procedures and requirgments and that he / she will comply with said procedures and
rcquirements .
APPROVAI OF BUILDINC OFFICIAL
INSIIRANCE COVERAGE:
I have a curretrt liability insurance policy or its substantial equivalent, which meets the requirements of MGLCh.l42. lYeP
If you have chicked
No
ves, please indicate the tr/pe coverage by checking the appropriate box.
A liability insurance poliry
OWNER'S INSURANCE WAIVER I am a
Chepter 142 of the Mass. General Laws and
Oqrner or Owner's Agent
Other rype of indemdty Bond
warc that the licensee does not have the insurance coverage requircd by
that my signature on this permit application waives this requircment.
Check one:
Owners
h: hoBeowffIicereop
JOB LOCATION:
HOMEOWNET'S SIGNATURE
)
$TOWN OF YABMOUTH
1146 Route 28n South Yarmouth, MA 02664
508-398-223[I ext. 1261 Fax s08-398-0836
Office of the Building Commissioner
BUILDING DEPARTMENT
DEMO LITION DEBRIS DISPOSAL Af,'FIDAVIT
Pursuant to M.G.L. Ch. 40, $54 and 780 CMR - Section 105'3'1' #4'
I hereby certifi that the debris resulting from the proposed worlc/demolition to be
conducted at ArMq/ln
WorkAddress
Is to be disposed of oat the following lesadsn; '7 ) I [wth,s.)fi,lb"t'^ iAl
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
ch. lll, $l5oA.
oi (r b*
7-ta' ?L
Signature of Application Date
PennitNo.
-,u EV
ENGINEERS
p r oiects @ ev en gineersn et. com
http://www.evengineersnet.com
276-220-0054
tI
3hOl2O22
RE: structural certification for lnstallation of Residentlal solar
MICHAEL KIEHNAU:303 ROUTE 5A , YARMOUTH PORT' MA 02675
Attn: To Whom lt MaY Concern
16 and 45 degrees
Design Criteria
2015 IRC (ASCE 7-10)-cMR 780 gth Ed
Th|sLetterisfortheexistin8roofframingwhichsupportsthenewPvmodulesaswellastheattachmentofthe
PV system to existing roof framing. from the fietd observation report' the roof is made of Asphalt Shingle
roofing over roof plywood suppoied by 2x8 Rafters at 15 inches. The slope of the roof was approximated to be
Afterreviewofthefieldobservationdataandbasedonourstructuralcapacitycalculation,theexistingroof
traminB has been determined to be adequate to support the imposed loads without structural upgrades'
contractor shall verify that existin; framing is consisient with the described above before install' should they
findanydiscrepancies,awrittena"pprovatfromsEoRismandatorybeforeproceedingwithinstall'capacity
calculations were done in accordance with applicable building codes'
Code
Risk cateEorv
Roof Dead Lo
PV Dead Load
Roof Live Load
G round Snow
d 10 psf
3 psf
20 psf
30 psf
Wind Load (component and cladding)
V 141 mPh
Exposure CDr
DPV
Lr
s
lf you have any questions on the above, please do not hesitate to call'
STRU
ONL
Sincerely,
Vincent Mwumvaneza, P.E.
EV Engineering, LLC
ro ects even nee net.m
http:venslneersnet.com
VINCENT
MWUMVANEZA
clvlL
7lL
-.t-\-,
projects@evengineersnet.com
http://www.evengineersnet.com
276-220-0cF,4
Structural Letter for PV lnstallation
3/70/2022
Job Address: 303 ROUTE 6A
YARMOUTH PORT, MA 02675
Job Name: MICHAEL I(IEHNAU
Job Number: 22O3LOMx
Scope of Work
This Letter is for the existing roof framing which supports the new PV modules as well as the attachment of thePV system to existing roof framing. All PV mounting equipment shall be designed and installed permanufacturer's approved installation specifications.
Table of Content
sheet
Cover
Attachment checks
Snow and Roof Framing Check
Seismlc Check and Scope of work
Engineering Calculation s Summary
1
2
3
4
2015 tRc (AscE 7-10)-cMR 780 9th Ed
d Load
PV Dead d
Roof Live load
Groun Snow
f Dr
DPV
Lr
s
I
10 psf
3 psf
20 psf
30 psf
Wind Load
References
Sincerely,
(component and Claddinc)V 141 mphExposure C
NDS for Wood Construction
STRU
ONL
s
VINCENT
MWUMVANEZA
ctvtL
ur
EV
ENGINEERS
Code
Risk catesorv
Vincent Mwumvaneza, p.E.
EV Engineering, LtC
proiects@evenqineersnet.com
htto://www.evengineersnet.com
Tq.\E
-
ENGINEERS
projects@evengineersnet.com
http://www.evengineersnet.com
wind Load cont.
Risk Category =
Wind Speed (3s gust), V =
Roughness =
ExPosure =
Topographic Factor, KzI=
Pitch =
Adjustment Factor, J\ =
a=
141 mph
1.00
45.0 Degrees
1.3 5
ASCE 7-10 Table 1.5-1
ASCE 7-10 Figure 25.5-1A
ASCE 7-10 Sec 26.7.2
ASCE 7-10 Sec 25.7.3
AsCE 7-10 sec 26.8.2
c
ASCE 7-10 Figure 30.5-1
ASCE 7-1.0 Figure 30.5-1
where ai 10% of l€ast horizontal dimension or O 4h, whichever is smaller, but not less than 4% of least
horizontal dimension or 3ft (0.9m)
Uollft (0.5w1
Pnet30=
Pnet = 0.5 x )rx KZT x Pnet3o)=
Downpressule (0.6W1
Pnet30=
Pnet= 0.6 xlx KZTx Pnet3o)=
Zone 1 (ps0
-29.7
24.O9
zone 1 (ps0
32.5
25.35
zone 2 (psfl
-35.8
29.O1
zone 2 (psf)
32.5
26.35
Figure 30.5-1
Equation 30.5-1
Figure 30.5-1
Equation 30.5-1
Rafter Attachments: 0.6D+0.5W (CD=1.5
Connection check
Attachement max. sPacing=
Lag Screw Penetration
Prying Coefficient
Allowable CaPacitY=
neZo Trib width
0.5D{0.6W DPV+0.6W
Area (ft! Upllft (lbsl Down (lbsl
11.0 245.2 322.9
11.0 299.3 322.9
8.3 224.5 242.1
Max= 299.3 < 750
co Ecnoil t5 0K
1. Pv seismic dead weight is negligible to result in significant seismic uplift, therefore the wind uplift
governs
2. Embedment is measured from the top of the framing member to the tapered tip of a lag screw.
Embedment in sheading or other material does not count.
4
4
3
1
2
3
t/t
27 6-220-0064
c
4.s0 ft
Zone 3 (psf)
-35.8
29.01
zone 3 (psf)
32.5
26.35
slr6" tasScrew Withdrawal Value=
4ft
266 lbs/in
2.5 in
L.4
760
Table 12.2A - NDS
DFL Assumed
-t
!I\
-
projects@evengineersnet.com
http://www.evengineersnet.com
276-220-OOt4.
ENGINEERS
Vertical Load Resisting System Design
Roof Framing
Pg= 30 psf
Ce= o.9
q= 1.1
l, = 1.0
Max Len8th, L =
Tributary Width, Wr =
Dr=
PvDL =
ASCE 7-10, Section 7,2
ASCE 7-10 , Table 7-2
ASCE 7-10, Table 7-3
ASCE 7-10 , Table 1.5-1
10ft
16 in
l0 psf 13.33 plf
3 psf 4 plf
OK
Conservatively
588 tb-ft
30 plf
334 lb-ft
1738 lb-ft 334 lb-ft OK
Max Shear, V,=wt /2+Pv Point Load = 410 lbs
Member Capacity
DF-L No.1
2X8 Design Value cL cr Kr +T
Fb 1000 psi t.2 1.0 1.15 2.54 1380 psi
F,=N/A 1.0 N/A 2.88 0.8 180 psi
1700000 psi N/A N/A 1.0 N/A N/A N/A N/A 1700000 psi
Emrn N/A N/A 1.0 N/A L.76 N/A 520000 psi
Depth, d =
width, b =
Cross-Sectonal Area, A =
Moment of lnertia, ltr =
Section Modulus, S,, =
7.25 in
1.5 in
10.875 in2
47.5348 tn
,313.1406 rn
DCR=Mu/Mar =
DCR=V,Aarr =
Satlsfactory
satlsfactory
0.23 < 1
0.31 < 1
t/t
27 psf
prmtn. = 25.0 psf
P, = 25 psf
Cs 0.417
13.9 plf
Load Case: DL+0.6W
Pnet+ Prcos(8)+Po,= 52.5 plf
Max Moment, Mu = 583 lb-ft
Pv max Shear 322.9 lbs
Max Shear, V,=wU2+Pv Point Load = 410 lbs
Load Case: DL+O.75(0,5w+sll
0.75(pnet+ps)+pevcos(0)+por= 53plf
Mao*n= 588 lb-ft
Load Case: DL+S
Ps+ pe,cos(e)+pDr=
Mao*n=
Mallowable = Sx x Fb' (wind)=
Rafters
CF ci Adjusted Value
1.0 0.85 0.8
180 psi N/A 0.75
E=
620000 psi 0.85
Allowable Moment, M,1= tor$,, =
Allowable Shear, V", = 2/3t,'A =
1511.2 lb-ft
130s.0 lb
I.'--. ENGINEERS
proiects@evengineersnet.com
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276-270-0064
Siesmic Loads Check
Roof Dead Load 10 psf
% or Roof with Pv
Dpv and Racking
Averarage Total Dead Load
lncrease in Dead Load
t7%
3 psf
10.5 psf
2.0% oK
The increase in seismic Dead weight as a result of the solar system is less than 10% of the existing structure and
therefore no further seismic analysis is required.
limits of Scope of Work and Liabilitv
We have based our structural capacity determination on information in pictures and a drawing set titled PV plans -
MICHAEL KIEHNAU. The analysis was according to applacable building codes, professional engineering and design
experience, opinions and judgments. The calculations produced for this structure's assessment are only for the
proposed solar panel installation referenced in the stamped plan set and were made according to generally
recognized structural analysis standards and procedures.
t/L
SOLAR WOLF
inc.
100 Davis Street
Douglas, MA 01516
Office 1: (888) 8784396
Oflice 2: (5O8) E39 -2222
Owner Authorization Form
We the undersigned, hereby authorize Solar Wolf Energy Inc to act on our
behalf in all manners relating to the installation of a photovoltaic system
at the location 303 Route 6A Yarmouth Port, Ma 02675 . This
includes but is not limited to financing paperwork, interconnection
documents, building & electrical permit applications, applicable rebate
applications, etc.
This authorization is valid only for items pertaining to the installation
and commissioning of a solar power system to be installed by Solar
Wolf Energy lnc.
Sigred under the pains and penalties of perjury.
4il,.1 (.1^a4 Ja*n (iAr-t
Signature of Owner
09 t 02 I 2021 09 t02 t 2021
Date
Doc lD: 0bbb63b2b884o72e9f4ecdooe8bb8456e7cc2186
TOWN OF YARMOUT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664.4451
Telephone (508) 398-2231 Ext. 1292-Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT CO
APPLICATION FOR
Application is hereby made for the issuance of a Certificate of Exemption under Seclions 6 and 7 of Chapler 470 of
Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Tvpe or print leqiblyj
Address of proposed work. 303 MA-6A Map/Lot # 122.77
owner{s). Michael D Kiehnau _-Phone #. 512-g4g-4101
All applications musl be submitted by owner or accompanied by letter frorn owner approving submittal of application.
Mailing address:303 Rte-6A Yarmouth Port 02675 Year built 1835
Email kiahnaus(Om$n.co Preferred nolifrcation method: _Phone X Emait
Agenucontractor: Solar Wolf Energv.Phone #: 509-g39-2222
Mailing Address: 771 Washington StAuburn Ma 01501
g.r,, alisha.v@solarwoffenergy.com Preferred notification method
P,qgsriptio{i of Btoposed Work (Additional pages mav be attached lf necessary}:
We will be replacing the brown colored roof with an onyx black roof to prepare for
Phone
s o la ld5st+ l,g,lr-9:, i
)I,
Signed (Owner or egent):
or," ilf ,{:r
Arnount ?(1.il
cashrcK u, \lb'{i, I
Rcvd by:
Date i;lalr*r
> Owner/contractor/agenl is eware lhal a permil may be required from the Building Deparlment. (Check oth€r deparlmenls, afso.)> rhis cerliftCate i$ good for one year rrom approvat date or upon date of expiration of
'Building
Permit. lvhichever {,ale shall be latef
For Committee use onlv:
/ ooo,.o*o Approved with changes _Denied
Reason for denial:
v5.20 1 7
Signed *t at{x tl,.t,l g*Y) 31 1 APPLI6AISN # .J { "{i l${'
Hi ffixffiryaiiwr* iti
a
0ate Signed: