8 FAIRMOUNT STREET - BUILDING JACKET 8 Fairmount St.
No. � 7 City of Salem Ward
/ �0/\g
x
APPLICATION ,
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT•Applicant to complete all items in sections:1, It, III, IV,and IX.
f
I.
AT(LOCATION) ( �n/vtflOu tT
ZONING
907
LOCATION 6Ta�0 e
OF BETWEEN AND SX M 92 In C11 S
( OSSSTRUT) (CROSS STREET)
BUILDING LOT
SUBDIVISION LOTBLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A-D
A. TYPE OF IMPROVEMENT D. PROPOSED USE•FOR"DEMOLITION"USE MOST RECENT USE
1 ❑ New building Rseldential Nonresidential
2 ® AtltlH18 Amusement.recreationalbn(If residential,enter number of new 12 One family ❑
housing units added,9 any,in part D.13) 19 ❑ Chruch,other religious
13 ❑ Two or more family•Enter number 20 ❑ Industrial
3 ❑ Alteration(See 2 above) of units ................_._._.__.__...............
21 ❑ Parking garage
4 ❑ Repair replacement 14 ❑ Transient hotel,motel,or dormitory-
Enter number of units ........................... 22 ❑ Service station,repair garage
5 ❑ Wracking(it multifamily residential,enter number 23 ❑ Hospital,institutional
of units in building in Part D,13) 15 ❑ Garage 24 ❑ Office,bank.professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
26 ❑ School,library,other educational
7 ❑ Foundation only 17 Other-specify
27 ❑ Stores,mercantile
B.OWNERSHIP 28 ❑ Tanks,towers
8 0/private(individual,corporation,nonprofit
institution,etc.) 29 Other-Specify
❑
9 ❑ Public(Federal,State,or local government
C.COST (Omif cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
10. Cost of improvement .........................................._._.._._... $ W 00 parochial school,parking garage for department store,rental office building.office building
at industrial Plant If use of existing building is being charged,enter proposed use.
To be installed but not included
in the above cost
a. Electrical......................................_.................._...............
b. Plumbing......................._...._........................_...............
c. Heating,air conditioning.-•..•-- ._.._...._.........
d. Other(elevator,etc.)................................_...._...........
11. TOTAL COST OF IMPROVEMENT $
111. SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions,complete Parts E-L;demolition,
complete only Parts J&M, all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40 . Public or private company Will there be central air
31 .Wood frame 36 0 Oil 41 ❑ Private(septic tank etc.) conditioning?
32 ❑ Structural steel 37 ❑ Electricity 44 ❑ yes 45 ❑ No
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Other-Specify 39 ❑ Other-specify 42 Public or private company 46 ❑ Yes 47 ❑ No
43 ❑ Private(well,cistem)
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
4e. Number of stories ............................................................
uare feet of
dg Total
flloors.based on enda
enor
alHas Approval from Historical Commission been received
dimensions _............................. .............. for any structure over fifty(50)years? Yes_ No_
50. Total land area,so.If....................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed .......... ....................
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
sz. Outdoors............. Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed ........... Electric:
Gas:
54. Number of Full........................................... Sewer:
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial--.--............................ BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No-�-/--(If yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ No (If yes, please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No_
Is property located in the S.R.A. district? Yes_ No_
Comply with Zoning? Yes_ No (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No_ (If yes,submit documentationAf no, submit.Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No_
Is Architectural Access Board approval required? Yes_ No_ (If yes,submit documentation)
Massachusetts State Contractor License# O $ %/ Salem License # 13,3,7
Home Improvement Contractor 9 1/)OR 0) Homeowners Exempt form(if applicable) Yes_ No
CONSTRUCTION TO BE COMMENCED WITHIN SIX (6)MONTHS OF ISSUANCE OF BUILDING PERMIT
CONSTRUCTION IS TO BE COMPLETED BY: If an extension is necessary, please submit
in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Name ` Mailing address-Number,street,city,and state ZIP Code Tel.No.
Owner or ii'r��Z. lJDtic�/19nC� /G /� O�H2f✓SI- P 17t;4. S.3o2-SC�tf.
Lessee QI�(ECFi
2. 4,A 'T.s 4
Contractor
Builder's
Ucense No.
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature o ppli nAddress , Application date
i
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building / Y7 C) ( / FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued / J 19
h �II Fire Grading
Bending
Permit Fee $ Live Loading
Certificate of Occupancy $ Approved by: Occupancy Load
Drain Tile $
Plan Review Fee $
TITLE
NOTES AND Data•(For department use)
w,e f <\,%c- i c
PERMIT TO BE MAILED TO:
DATE MAILED: a //,5 /
Construction to be started by: Completed by:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN •For Applicant Use
O N
The Conn lomscalth of NIJSSaChusetu
I'c tl:
t y Board Of Budding Repilations and Standards Mt Nl( II'-vlJ Il
N1assaihusetts Suue Building Code. 7511 (T4R, 7ih cditiu°
Building Permil Application TO Construct. Repair, Renovate Or Demolish a Rerr.,r,l looms,
IP (bte- OrTv-Fami Dr elhn,G -urw'u l.
l'hi. . ection For Official Use Only
Building PCIout Nun her: Date Applied: —_ ----------_._._..�
onunissiuner/ Inspr ,r of i gs Da
SECTION I: SITE INFORMATION
LI Pro citylr Address: 1.2 .-assessors Map & Parcel Numbers
B � m�Unt �s}yee� ------
hlu Number Parcel A'wnbcr
I.1a Is this an accepted sweet? yes_ no
P
1.3 Zoning Information: 1.4 Property Dimensions:
Lot Area Isy It Frontage(It)
Zoning District Proposed Use .
1.5 Building Setbacks (ft)
Front Yard Side Yards - Rear Yard
Required Provided Required Provided Required Pl"vIJCLi -
L6 Water Supply: (M G L c.40, §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone:' Municipal ❑ On site disposal system ❑
Public ❑ Private❑ Check if yes❑
SECTION 2: PROPERTY OWNERSHIP"
2.1 Owner"of cor $ �tlrma)n+ Sere �i
'Nltnnl � �I�anv�P BGKP,r
Name (P'�� Address for Service:
�Numc (Pr r
(") -M- 4 -e1l8
S lure Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK' (check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ \ddition El
Demolition ❑ Accessory Bldg. ❑ 1 Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
lnst/a�l one () ) re-olocam nt Qnfi� �Dor
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs: Official Use Only
Item (Labor and Materials)
I. Building S 1. Building Permit Fee: S Indicate haw tee is Jelct nined: l
❑ Sumdard City/Town Application Fee
2. Electrical S ❑ Total Project Costa (Item 6) x multiplier x _
3. Plumbing S 2. Other Fees: $
J. Mechanical (Hb':1C) S List: --.—.-
----
5. Mechanical (Fire S
Torl :\II Fees: S
SUppressi ur)
Check No. Cheek :\mount C.i.h
j b. Folal Project Cost: S ' �58. 0 Paid in Full ❑ Outstanding Bal:uice Due:_-- -
SECTION ;: CONSTRUCTION SERVICES
5.1 Licensed Cmtstruction Supervisor (CSL) 5-77 - 5�
_-Chn 4TD.phe-r ZDrN _ Liccnw N'umher I( 1111aw n Daw '
Name of C'SI_- Holder �
hC , 1_1,1 CSL Tclre I>ee helmk) _
\JJrrs J e Desrri ruon
C ('nrestncted nl l to 3i.1100 Cu. H.i
R Resu'icied I.@'_ Famils Drrelhn_
Scnatm • /I )q Nlamnln Unto
IN 7r'l I' a-14 RC ROsIdenual Hauling (lrr en ng
lelephone A1'S Re,ld:uoal AC1nJm1 _Ind Sidul,
SP Re,ideml,d Solid Fuel Bununc A 1 rllaui: In.I,ilLunn�
D Relldcuual De1n011tIU11
5.2 Registered m Home Improveent Contractor 011C)
A G A �jf i ,it'rp.`� InC. 1 ---
11IC Company Name or 1. I 'gistrant i ue Regutruuun Number
MA l�12
Ad re. In
(crQ2k-1I-D��� -
E<nlrall Uatc
Sig a 'e - 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 io pnlvide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached'? Yes .......... No ...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, ov, Vi r as Owner of the subject property hereby
authorize r to act on my behalf. in all matters
il,,I,tive t ork authorized y this building permit application.
u� _
ature UI Owner Da1C
h SECTION7b: OWNEW OR AUTHORIZED AGENT DECLARATION
I• r_l l���r {� , as Owner or Authorized Agent hereby decku'e
that the statements and information on the for going application are true and accurate, to the best of my knowledge and
beh ff-
Prin
Signature of Owner oF Authorized Agent cat
(Signed under the pains and penalties of perjury)
NOTES:
I. An Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistere:�ontractor
(nut registered in the Home Improvement Contractor(HIC) Program), will not haveaccess tothe arbitrprogram or guaranty fund under M.G.L. c. 142A. Other important intilrmation on the HIC Progr; in :md
Construction Supervisor Licensing(CSL) can be found in 780 CMR Regulations I IO.R6 and 110,R5. rly.
' When substantial work is planned, provide the information below:
Total floors-area(Sq. Ft.) (including garage, finished hasement/attics.. decks nr porch) j -
Gross living aura (Sq. Ft.) Habitable room count
Number of fireplaces - Number of bedrnlrm. -----
Number of h:ihruoms Number or hal1/hath.
f vpe of heating system - Number(It decks/ III Itches --------- --
Typc of coolingSyslem Enclosed
3. 'Total Project Square Footage- may be Substituted fur "Ioml Project Cost'' �
_J
ir5 - I LA - 11o5-1) 1 (o t C z s(4ci
The Commonwealth of Massachusetts
}I, Board of Building Regulations and Standards CITY OF
S`E, Massachusetts State Building Code,780 CMR SALEM
Revised.Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Da Applied:
Building Official(Print Name) Signature Date
SECTION l:SITE INFORMATION
1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers
��C'r, �YYYlP1r'l� S
L l 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 11) Frontage(11)
1.5 Building Setbacks(ft)
Front Yard Side Yards [tear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage DisposAd.sp.s_a
Public❑ Private❑ Zone: _ Outside Flood Zone?Check ifyes❑ Municipal❑ On site
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'ofRecord: David Baker m
Salewl MA
Name(Print City,State,ZIP m
Fairmount St 978-744-01 18 CordesbakerC)comcV.ne o
IVI
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction wner-Occupied ❑ 1 Repairs(s) ❑ I Alteration(s) ❑ 1 Additi;T❑ N
Demolition ❑ Accessory Bldg.❑ 1 Number of lJnits_ Other ❑ Specify:
Brief Description of Proposed Work: S
DWrfyV n t+alC. solar 5NS4rmS
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building $Ol .0U 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $a ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) otal All Fees:$
Gn /� Check No._Check Amount: Cash Amount:_
6.Total Project Cost: $W`� • T 0paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.11_Construction Supervisor License(CSL) O�-3 2 5 4 �$
w1P� )nPJ Y-VL0-t 1 License Number Ez anon ate
Name of CSL Holder
p I �kcun StY� l L List CSL Iype(see below) U
No...a_ p and Street Tye Description
Sea KkA Qj C]l D LO U Unrestricted(Buildings up to 35,000 cu.ft.
_ R Restricted 1&2 Family Dwellin
City/Town,Is "/..IP M Mason
ry
RC Roofing Covering
WS Window and Siding
_ ' •�C• ',�^ SF Solid Fuel Burning Appliances
- 13 lfll f�/la��P—VIU tv syU I Insulation
Telephone Email address � D Demolition
5.2 Registered Home Improvement Contractor(HIC)
-\Lw-(v± Soko-rDey�lO ey— LLC_ t--Io�srat8 1
MC Registration Number E,pira[on Dale
HIC Cotn any Name or HIC R gistranl Name
4gaPr t moo v.! 'nnLiSol0.r@VtvtvlA-so r
No.and Street Email address Cam
Provo $ k1p04 "l$13053o1p5
City/Town,Slate,ZIP I ele hone
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..........A 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 VI V 11t StOct-y'
to act on my behalf,in all mailers re•tive to work authorized by this building permit application.
10/8/14
Pnnt Owner's Name(Electronic Signature) Dale
SECTION 7b:OWNEW 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 III' pl Iion is true and accurate to the best of my knowledge and understanding. ( 1
Print Ow s tr rized Agent's Name(Electronic Signature) Date
NOTES:
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.pov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dR
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. 0.) 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"
Page 2 of 2
B. Loading Criteria
10 PSF= Dead Load roofing/framing 40 PSF=Live Load (around snow load)
5 PSF=Dead Load solar panels/mounting hardware
Total Dead Load=15 PSF
The above values are within acceptable limits of recognized industry standards for similar structures. Analysis
performed of the existing roof structure utilizing the above loading criteria indicates that the existing rafters will
support the additional panel loading without damage, if installed correctly.
C. Roof Structure Capacity
1. The photographs provided of the attic space and roof rafters show that the framing is in good condition
with no visible signs of damage caused by prior overstressing.
D. Solar Panel Anchorage
1. The solar panels shall be mounted in accordance with the most recent "Ecolibrium Solar Installation
Manual", which can be found on the Ecolibrium Solar website (ecolibriumsolar.com). If during solar panel
installation, the roof framing members appear unstable, deteriorated, structurally compromised or deflect
non-uniformly, our office should be notified before proceeding with the installation.
2. Maximum allowable pullout per lag screw is 235 Ibs/inch of penetration as identified in the National Design
Standards (NDS) of timber construction specifications for Hem-Fir (North Lumber) assumed. Based on
our evaluation, the pullout value, utilizing a penetration depth of 2 MY% is less than what is allowable per
connection and therefore is adequate. Based on the variable factors for the existing roof framing and
installation tolerances, using a thread depth of 2 Yi' with a minimum size of 5/16" lag screw per
attachment point for panel anchor mounts should be adequate with a sufficient factor of safety.
3. Considering the roof slopes, the size, spacing, condition of roof, the panel supports shall be placed at and
attached to no greater than every third roof rafter as panels are installed perpendicular across rafters and
no greater than the panel length when installed parallel to the rafters (portrait). No panel supports spacing
shall be greater than three (3) rafter spaces or 57.6"o/c, whichever is less.
4. Panel supports connections shall be staggered to distribute load to adjacent rafters.
Based on the above evaluation, it is the opinion of this office that with appropriate panel anchors being utilized the
roof system will adequately support the additional loading imposed by the solar panels. This evaluation is based on
information supplied to us at the time of this report and current industry standards and practices.
Should you have any questions regarding the above or if you require further information do not hesitate to contact me.
ery truly yours,
)F Sq
C
r-'W EYScotty ling, cvi
MA License No.
o Sg
90� Fcis1EPE
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V G A MA LICENSE:MAHIC 170848 Salem,MA 01970
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MICRO-INVERTER AT YES NO XNA E�
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YES NO XNA ShorlAircuit Current gsc) B.BB Amps Y ¢
3.)SIZE PHOTOVOLTAIC POWER SOURCE DC)CONDUCTORS Max Series Fuse(OCPD) 15 Amps �./�
BASED ON MAX CURRENT ON NEC 690.53 SIGN OR 01 Nominal Maximum Parceled STC(Pmax) 255 Wells W
MICROINVERTER CONNECTION RATING AT DISCONNECT. Maximum System Voltage 100XIEC,V60o(UL) j
TO ENGAGE TRUNK CABLE 4.)SIZE INVERTER OUTPUT Act CONDUCTORS ACCORDING Voe Temperature CoeRoknl -0.32 Yd'C
^ TO INVERTER OCPD AMPERE RATING(S.Guide Section 9).
lJ 5.)TOTAL OF 2 INVERTER OCPOGL ONE FOR EACH NOTES FOR ARRAY CIRCUIT WIRING I(l Sactlon 6 and a and Appendix 0),
PV CIRCUIT.DOES TOTAL SUPPLY BREAKERS COMPLY _
WITH 120%SUSBAR EXCEPTION IN 1.)Lmest expanded ambient temperature based on ASHRAE minimum mean extreme
NEC690.64(B)(2)(a)? XYES NO Cry,bulb temperature for ASHRAE location most similar to installation location: -19-C t
(G BAREROUNDIN GROUND ,
(GROUNDING ARRAY) Signs(See Guide S6Cl1007) temperature
urfor Continuous ambienttemperature to don ASHRAE highest 39onth 2%tlry bulb ,
temperature for ASHRAE location most similar to installation location: 39'C (
Sign for inverter OCPD and AC Disconnect 3.)2005 ASHRAE fundamentals 2%design temperatures do not exceed 47-C In the
United States(Palm Springs,CA is 44.1-C).For less than 9 current-carrying Conductors tf,
Solar PV System AC Point of Connection in mcf-mounted audit Conduit at least 0.5"above roof and using the outdoor design
ACOulput Curren+ 15.zg0000 Amps temperature of 47-C or less(all of United States). •
Nei AC Vereaga 240 Ve s R)12 AWG,90-C Conductors are generally acceptable for modules with Ise of 7.68 Amps v
or less when protected!by a 12-Amp or smaller fuse. P
THIS PANEL FED By SCPLESOURCES
AND SO bJ 10 AWE,90-C Conductors are generally acceptable for modules with lac of 9.6 Amps x�•
(UTILITY AND IAR) or less when potti by.1 5-Amp at,smaller fuse. •��
NOTE: NEUTRAL CONDUCTOR(S)OMITTED FOR CLARITY
ALL INVERTER OUTPUT CIRCUITS WILL HAVE A NEUTRAL CONDUCTOR •�
�J
m
PV CIRCUIT 1: 9 MODULES/PARALLEL ENVOY BOXto
ad
goefie m 0
OO O to It
RWP
1 = ad
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MURRAY POINT OF DELIVERY > w
'r COMBINER AND INTERCONNECTION w w w de
PANEL 125A/240V SIEMENS a a o
LWO04NR 60AI240V r I— M ¢
UNFUSED NEMA3 p z z ¢ ¢
9\N(t`20 OR EQUIVALENT M o
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PV CIRCUIT 2: 9 MODULES/PARALLEL \f�FL t SREC/ANSI EQUIVALENT SHEET
j O,o\F,p METER NAME
:
I \�O EXISTING
9 00
240V/200A W
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I SHEET
_ NUMBER'
\ MILBANK VISIBLE/LOCKABLE �_ O
'! JUNCTION BOX '2 \\ 3 1ODA OR 3 'KNIFE'A/C 3
WITH IRREVERSIBLE \ EQUIVALENT DISCONNECT
NEC 2014 Compliant - GROUND SPLICE E 1'0 \ E 1.0 U5934-XL-BLG E 1.0 E 1.0 w
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Di9tributed Weight (All Planes) EcolibriumSolar
In Conformance with Solar ABC's Expedited Permit Process for PV System (EPP)
Weight of Modules: 734 Ibs
Weight of Mounting System: 60 Ibs
Total System Weight: 794 Ibs
Total Array Area: 317 ft2
Distributed Weight: 2.51 psf
Number of Attachments: 30
Weight per Attachment Point:26 Ibs
Bill Of Materials
Part Name Quantity
ECO-001_101 EcoX Clamp Assembly 30
ECO-001_102 EcoX Coupling Assembly 16
ECO-001_105B EcoX Landscape Skirt Kit 5
ECO-001 105A EcoX Portrait Skirt Kit 0
ECO-001_103 EcoX Composition Attachment Kit 30
ECO-001_109 EcoX Electrical Assembly 1
ECO-001_106 EcoX Bonding Jumper Assembly 6
ECO-001_104 EcoX Inverter Bracket Assembly 18
ECO-001 338 EcoX Connector Bracket 18
$qa c�-- 3iq-S
The Commonwealth of Massachusetts CITY OF
Board of Building Regulations and Standards
Massachusetts State Building Code, 780 CMR SALEM
�.' Revised X Iar 2011
M Building Permit Application To Construct, Repair, Renovate Or Demolish a
M One-or Two-Family Divelling
This Section For Official Use Only
Building Permit Number: Date A plied: -
9 Building Official(Print Name) Signature Date
(� SECTION 1: SITE INFORMATION
LI ro rty Address: 1.2 Assessors Map & Parcel Numbers
1.1a 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 fin Frontage(fin
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (,vLG.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1. Own ri of Record:
Da V t Z akx-✓ 5,1Z , /14,it D 1 of-7 y
Name Print) City, State,ZIP
'ROhOtAvc—[Slf— 913- '1i V-0f18'
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ 1 Addition ❑
Demolition ❑ 1 Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Prroposed k rk': - --tom_U LjO
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
L Building $ L Building Permit Fee: $ Indicate how fee is determined:
2. Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: $.. -
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ (Q1 •1 ❑ Paid in Full ❑ Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) _
Llj.y-r 5 Gc�✓-7,1 License Number Expiration Date
Name of CSL— Holder �
/ZS �O List CSL Type(see below)
No. and Street Type Description
U Unrestricted(Buildings u2 to 35.000 cu. ft.)
City/Town, State,ZIP R Restricted 1&2 FamilyDwelling
M iMasonry
RC Roofing Covcrin
WS Window and Siding
G SF Solid Fuel Burning Appliances
c{-3-V I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
(1 'd` C HIC Registration Number Expiration Date
HIC Compan�Namz or I-IIC Registrant Name
// 1 n/0 S t
No. nd Street
a C`w\ Email address
City/Town, State, ZIP l 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 .......... IRl No........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIESS FOR BUILDING PERMIT
I, as Owner of the subject property, hereby authorize r ll i S G C✓2
to act on my behalf, in all matters relative to work authorized by this building per it application.
G, (o � �� APR 0 5 2016
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
Bye ring my name below, 1 hereby attest under the pains and penalties of perjury that all of the information
coot d this application is true and accurate to the best of my knowledge and understanding.
rr APR 052016
Print Owner's or Authorized gent's Name(Electronic Signature) Date
NOTES:
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.gov/dpS
v/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"