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BP-86969 VOID TOWN OF DARTMOgH - BUILDING DEPARTMENT RECEIPT ': J 8 PHONE'508-910.1820 FAX: 5088-�-}}910.1838 Nam filij ,(7,/ k 3 ,_- , /,- 7(4-. Property Owner: %( Y.4)(iL'%) Date: l i . O 7 Job Location: 1)11 (i Al, `'/ i ',f v l a Map: 7/ Lot: Description General Ledger#'s Ref. # to?DARr�Amount Building & Building Misc. 01000-44105 ` ;\�Gl P V *? _. — Electrical 01000-44106 NOV 0 3 2017 / j Plumbing & Gas 01000-44107 i/ Trench Safety 01000-44129 ' 1 *COnLE�% Other Department Revenue =: 01000-42420 `, white-Collectors Office Yellow Copy-Customers Receipt Pink Copy-Building Department Received By /' /--- ," _ ' ,d, THIS IS NOT A PEBMITILICENSE FOR BUILDING, ELECTRICAL,PLUMBING OR GAS RESIDENTIAL 0 Phased Approval(R106.3.3) $25.00 APPLICATION FEE IS NON BE-FUNDABLE&NON-TRANSFERABLE c DATE RECEIVED ou p .ate."rgt+JN DARTMOUTH BUILDING DEPARTMENT -It I m 1< 400 Slocum Road, P.O. Box 79399 e f h. Dartmouth, MA 02747 /A . Y r Phone: 508-910-1820 Fax: 508-910-1838 www.town.dartmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: BUILDING PERMIT NUMBE I9 9 DATE ISSUED: SIGNATURE: DATE: Building Commissionedlnspector of Buildings Zoning District: J ��l Proposed Use: ®�191 Zone: 0 X ❑ B A 0 V Aquifer Zone: �/) THE FOLLOWING AGENCI SHOULD BE • ❑Board of oard of 0 Cons. 0 Demo 0 DPW ❑Elec. ❑Energy Report Appeals Health Commissio• Affidavit Card Sent: Cut Off Follow-up" ❑Fire ❑Gas ❑Planning 0 Sewer Card 0 Water Card ❑Zoning ❑Other Chief Cut Off Board Cut Off Cut Off *REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. D PAR MENT VAL / 7 Board of Health: Signature: Date: f 6 / / Conservation Commission: Signature: )' �4s 1 Other: Signature: g= Signature: Date: Signature: Date: Brief description of work being performed: la t^ ) i IF SECTION !\ ,SITE INFORM: ON / 1.1 Property Address: T'�v f aid Ft(I kiv r 1` "_ 1.2 Assessors Map&Lot Number: 6/ Lot Area (sf.) Frontage Map I/ Lot - Required Provided Front Yard 1.3 Historical District 0 Yes l�No Side Yard Year Built Rear Yard Q Altering more than 25%per side of building litWater Supply(MGL c40 s54): 115 Sewage Disposal System: Has application been sqbmitted to the Historl'icCommission? Municipal ❑Private Well Municipal ❑ On Site Disposal System ❑Yes No Date:��___ 77 Reviser"nrfl ■'` ,tMIONST UCTION PLANS 0SITE PLAN} 0 ENERGY REPS s i _Coker, A(*LIi' .U,( 7 7 6 766 — 0 5- t5 1 ) I RESIDENTIAL SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner Record: Zjhvi 1 Gxicvi ftct old Fail ( ivrr Voad tee)r� r�lri5 Name(print) Contact Address Phone Number 22 Authorized Agent: la r —Michael o4rl i`cr 51 Gi�C(rCt Load wlt- (ei�iSS,7lc1-) Na (print) Contac ddress o 160 I Phone Number SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor/Specialty License: License Numbera Oqqt Company Name/Contractor Name:M i vtCtrr ( n4?I Cr1 Address: c 91" 0a j Cl(CAC_ L LJCj,�1rvt / , nilQt D I Expiration Date: Signature: .��JJ� Telephon4C�jj7(cI—c5g / tta 3.2 Homeowner Exemption-One&Two Family Only Section 110,125.1.3.1 Exception: FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT Exception: Any Homeowner performing work for which a Building Permit is required shall be exempt from the provisions of this section;provides that if a Homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor. For the purposes of this section only,a"Homeowner'is defined as follows: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be.a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a Homeowner. If you are applying under this section sign below: Signature: i SECTION 4-WORKER'S COMPENSATION INSURANCE AFFIDAVIT(MGL c 152§725) , Worker's Compensation Insurance Affidavit must be completed and submitted with this application. Failure t¢provide this 1 affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: Yes 0 No SECTION 5-DESCRIPTION OF PROPOSED WORK(Check all applicable) ❑ Deck 0 Pool 0 Repairs 0 Alteration 0 Chimney/Fireplace ❑/Woodstove/Pellet Stove ❑ New Construction* 0 Accessory Bldg. 0 Roofing/Siding 'Other 3day, [frfro 1 (Energy report required) (Shed/Garage) (Specify below) ) i0 ❑Addition 0 Replacement window/door ❑ Demolition C,(t`n n (Energy report required) No.of windows— Doors_ (Specify below) rt'� Y 1 if new construction, please complete the following: Single Family: No.of Bedrooms No. of Baths Two Family: No of Bedrooms Unit 1 No. of Baths Unit 1 No of Bedrooms Unit 2 No. of Baths Unit 2 ❑Furnace(hot air)-fuel gas(natural or propane),fuel oil,electricity,other(specify): ❑Boiler(heating)-fuel gas(natural or propane),fuel oil,electricity,other(specify): i 0 HVAC(combined unit)-primary fuel,natural gas,propane,electricity,other(specify): ❑Air conditioning-(separate unit) ❑None of the above to be provided 0 Hot Water: Gas Electric Fuel Oil Other SECTION 6-ESTIMATED CONSTRUCTION COST Item Estimated Cost($)to be completed by permit applicant r. 1. Building 2. Electrical ( Q ,IT19-T) j Jy-r A� . 3. Plumbing 4. Mechanical(HVAC) 5. Total=(1 +2+3+4) Sr)" SECTION 7A-OWNER AUTHORIZATION (to be completed when owner's agent or contractor applies for building permit) (Please Print) ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 78-OWNER/AUTHORIZED AGENT DECLARATION I, MI it r i6 1 {CC ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Sign urat a of Owner/Fut d?ized Agent Date SECTION 8-OFFICE/INSPECTOR'S NOTES 'et Application Fee:$25.00 Remaining Balance: $ Total Permit Fee:$ 75 _ Other$Amount$ Gross Area-New Construction total sq.ft. Gross Area-Alteration total sq.ft. Permit Issued to: ,�/'4v1-e a.. 3 C G`Qra�-eL AJ fr' roam eit- 2ylvr ,Y"e. /2 , Y6 Xkc) SECTION 9-ADDITIONAL COMMENTS/SKETCHES t t- .� ,. 1' � � F`4 7, tz c e—s (/ �hr� a3 • • • CF2e Wintmanwectag oIG ciaaackiaet2 Office of Consumer Affairs&Business Regulation A"- i HOME IMPROVEMENT CONTRACTOR e MEIN> ,,-TYPE: Supplement Card • 1 -fi Registration Expiration YAH POWEA1 T 140041cORP. is"r tj MIKE DEFELICE 21 BOND ST J SPENCER;MA 01562 • Undersecretary • Scanned by CamScanner AcoROe CERTIFICATE OF LIABILITY INSURANCE 1 DATE owtort""".'_ _I y 1 12/20/16 THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION OILY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TIE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUrHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. WIPOR ANT: if the certificate holder is an ADDiTiONAL INSURED,the poiicyfie6)must be endorsed. if StUBl(OGAI1ON 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($. PRODUCER ACT NAME: Matt Davison Davison Insurance Agency Inc. PHONE FAX INC ND Exit: (781) 646-6880 I RAIL Ng: (781) 646-6886 DraFR 1 Park Ave Ext y L Arlington, MA 02474-263 Fa: mdavisonl?davisoninaTlrance.com INSURERS)AFFORDING COVERAGE HAIL e INSURE A:Safety Insurance INSURED INSURER B:Atain Specialty Ins Co Rayah Power integration Corp. INaURERc:Travelers Property Casualty Co 21 Bond Street INSURER D: Spencer, MA 01562 INSURERS: INSURER F: COVERAGES CERTTncAT€G NUMBER: ncv"eta" NVAIOCR: THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDNG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTFICATE MAY BE ISSUED OR MAY PERTAN,THE INSURANCE AFFORDED BY TI-E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDTIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI AWLISUBRI I POIJCY EFF I PeUCY E(P Ile TVPF_[_1_C I_N_G_I_I_R_!_N_(F once mw RN_ Id_ W_IOC_D YYfANVW\ /Y_ue_, IWW LINTS B GENERAL LIABILITY Y CIP199018001 12/6/16 12/6/17 EACH OCCURRENCE S 1,000,000 X COMMERCE/U.GENERAL LIABIUTY DAMAGE TO RENTED PREMISES(Ea omrrenca) $ 100,000 CLAWS-MADE X OCCUR WED DP(Ary one pear) $ 5,000 PERSONAL S ADV INJURY $ 1 000,000 I GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LI,STAPP LIES PER PRODUCTS-COMP/OP AGG $ 2.000,000 POLICY II ECT LOC S A AUTOMOBILE LABILITY Y 6229561 6/30/17 6/30/18 Vie,eah ELPnn S 1 000,000 ANY AUTO ROUX'?WURY(Per person) $ ALLOWED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X AUTOSED er PRODtiRTY DPMAGE $ • $ IumNac leltaR I _._..,,,,..._.,_ _ OwUR car,,TI000 .crCc i EXCESS LAB CLAIMS-MADE AGGREGATE S DED RETENTION$ $ C WORKERS COMPENSATION 7PJOB-8D8 6439-8-14 12/16/16 12/16/17 y T CSTARA °Fa AND EMPLOYERS'LABILITY NWPROPRETOReARTNER/EXEUJTNE Y 1 NIA E.L.EACH ACCIDENT S 1,000.000 OFFICERMEM6ER EXCLUDED? (MsrcYbry in NH) El.DISEASE-EAaMVLOYEE $ 1,000,000 I deecibe urMN DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 B Inland Marine CIP199018001 12/6/16 12/6/17 50,000 1 I I I I I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Adalkn&Remarks Sc eAes.If mon mace Smirked) CERTIFICATE HOLLDER r!AMCCI I ATIAN Town of Dartmouth SHOULDANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE 400 Slocum Road THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N ACCORDANCE WITH THE POLICY PROVISCNS. Dartmouth, MA 02747 AUTHORIZED RE 01988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACCIRD name and logo are registered marks of ACORD Phone: Fax: E-Mail: The Commonwealth of Massachusetts - = Department of Industrial Accidents I_y = t Office of Investigations 1_ Congress Street, Suite 100 .— Boston,MA 02114-2017 ... www mass.eov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Rayah Power Integration Cop., d.b.a Rayah Solar Address:21 Bond St. City/State/Zip:Spencer, MA Phone#:617-564-3159 _ Are you an employer? Check the appropriate box: Type of project(required): I.ID I am a employer with 11 4. ❑ I am a general contractor and I 6. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. El Building addition 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.17 Other Solar employees. [No workers' I cutup. insurance required.] i l *My 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. tContractors 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:Traveler's Insurance Policy#or Self-ins. Lie.#:7PJUB-8D86439-8-14 Expiration Date: 12/16/2017 Job Site Address: 569 OLD FALL RIVER RD City/State/Zip:DARTMOUTH, MA 02747 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 DU 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: 1er- Date:10/30/17 Phone#: 617-564-3159 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# II Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other IIContact Person: Phone#: II .l R�lichael A DeFelice JR _^,: Authorize Rayah Power Integration Corp, DBA Rayah Solar To pull' permits using my 3 � CS License# CS-099871. Any questions please call me at (978) 761-0588 Michael A DeFelice JR ppyy las i =Joiic Safety Bpi Board s and StandardsaS v license CS-099871 rz, ._ te rasa. MICHAEL A DEFELICE JR 54 DAY CIRCLE WOBURN MA 01801 Expiration. Commissioner 06128/2018 4 �L h + i'i.Yy Ts.l51"Rv-m1F0�3' st S.-.ae t-c-sad ,f / ) V ( 5 /oy. 7 ) A i • 1_._ — —_ _.. I it,: nary - �� ct7,::) \\ R, �I V P1 � r \:\ - D rirEyr 1t 3' \ NI i)i1i ay' S'_l_ly !'X/ST. Iv,EGL 141 1r.:'"/ •`=' /0 C / : /I-'op'5 -0 a:,'xi; J `.. II I i 1 A 41- / L, 4I c • .8 �+ 9s.0 A;o r - rfir.! C. 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MICHAEL ti f ITZUERALt10D y /j4/F_ SANG V,: .. i c. -✓'F• F0 'n='_ CSIl✓ �.J J �. r L: kno_c\y, 15315 7 ` , r 'l _ '-7?R /10VERT TA J.t •.'2 v..." .7/2G/72 \'. ��.1" ,-'. /, LE/Jc::• ARL.9 7O L3F_ E.'C.9:'s 72.-2^ r- E . 9L.5- °e�vvadam EL.. W O ,9,4.'.^. -;'C:'F'LLCO /4//TN c 45-D9."' ['L/I%-CCCE' GRA,-C'-. O.) :„d':vr:". - 4/0.N,c- J. 8 OINOEe.' SO!! STF/Jy_�!______ S4)7 4_,L9 F-?.1 ,477/'✓r4 .Fn gr' .V L74,Qr,v GOl N MA5S ,vo LEDGE ,,,n-.-c-n m n o , 1. n�ifr _��. `iI/e Wt�iy�2:Yywnwe id ?\�.o12.critwea i Office of Consumer Affairs and Business Regulation 4_ it 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration - _ - Registration: 179962 c;. Type: Corporation Expiration: 9/25/2018 Trlt 291317 RAYAH POWER INTEGRATION CORP — BRADFORD STOLER — 320 NEVADA STE 30 ,. NEWTON, MA 02460 `,�„-,1 Update Address and return card.Mark reason for change. --t 0 Address 0 Renewal 0 Employment 0 Lost Card SCA 1 0 20M 05/11 "gibe Y mnemuoea�/t o/rJ a:ucerx!/a _ -L�- Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the k i HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: 9 Registration: 179962 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 3r,,,,,di Expiration: 9/25/2018 Corporation Boston,MA 02116 RAYAH POWER INTEGRATION CORP. BRADFORD STOLER 320 NEVADA STE 30 _ \p to NEWTON,MA 02460 dersecretary Not valid without signature Scanned by CamScanner 11-13-'17 15:17 FROM-Ed of Health/ConCom 508-910-1893 T-164 P0001/0001 F-689 sIaENTIAI O Phased Approval(R1 08.3.3) $25:00 APPLICATION FEE IS NON RE.FONDAHLE&NON-TRANSFEMARLII,•.,•..;,.-;;,, DARTMOUTH BUILDING DEPARTMENT - if m i 400 Slocum Road, P.O. Box 79399 L 1 Dartmouth, MA 02747 9 . > Phone: 508-910 1820 Fax: 508 910-1638 ,f ,/if •%/, i www,town.dadmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: BUILDING PERMIT NUMBE"4 DATE ISSUED: • SIGNATURE: DATE Building CommIssloneranspector of Buildings Zoning District: p "'-- Use; Zone: CI X 0 B O A V Aquifer Zone: THE FOLLOWING AGENCI-=.4HOULL)BE •TIFIED: a \ t C1 Board of • rd of 0 .ns. 0 Demo D DPW 0 Elec. D Energy Report Appeals \ .• ealth ommission Affidavit Card Sent: Cut Off Follow-up' ❑Fire ■ Gas O Planning ❑Sewer Card 0 Water Card 0 Zoning D Other Chief Cut Off Board Cut Off Cut Off '' • IRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. 1 DEPARTMENTAL APPROVAL t oars of Health: ,' n Signature: fit• v ��.,b+0� I Date: /I riFitiTo ic— . Conservation Commission: Signature: CLfr wvDate: 400 Other: Signature: Date: Signature: • Date: Signature: Date: Brief description of work being performed: A' " " 7 :,f?i' s SECTION •SITE INFORM ON • 1.1 Property Address:;1O9 old FQL[I_ Rjvr r' _ 1.2 Assessors Map&Lot Number. / /a Pt a Lot Area(sf.)-�51 f Frontage Map I/ Lot 0 Required Provid d Front Yard 1.3 Historical District O Yes ItiNo Side Yard Rear Yard Year Built 0 Altering more Than 25%per side of building 1. Water Supply(MOL c40 854): 175 Sewage Disposal System: Has application been s lted to the Histor' ommission9 ip CI Private Well Municipal O On Site Disposal System 0 Yes No Date: �tra. rti!s ..� ',�. ,' CAN!;+". y,4:>,: Revis 10n1 A w, ON iM , ITE PLAN 0 ENERGY REPORT r It to G tta 7 O O aL cyC C 'C O ; H as �on0 . v, o a a� 3 0 z [a ,' ... ' 0 3Z rA0 7 A m + W a 0 o 2 ' z =4. 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E@ °"` E ., OOa=O izmamo — z c .- ° . . 0 o. t o = � c7 a 3 4 0 W u 2 v _ o.- ° h U o o `o_ `o v°. F >a.M M .. X x .0- d w o 90 c u v o o ."v. & `v n d H. -a -a 'a 3 m r� u o CL j Y. U h C �^F. L g` x x o o U o 0 0 0 0 .� U U 0.`. Q m F m m Q t1, , y c. en O W W a = S -°, .-°, -E x S ¢ F H F F F W SC W rn'3 m Gu 2 RESIDENTIAL ❑ Phased Approval(R106.3.3) $25:00 APPLICATION FEE IS NON RE-FIINBABLE &NON-TRANSFERABLE DATE RECEIVED UTN:" 160••==.��,/ > DARTMOUTH BUILDING DEPARTMENT fiC--__ -*,' 400 Slocum Road, P.O. Box 79399 I t _ � Dartmouth, MA 02747 // ���;�;' Phone: 508-910-1820 Fax 508-910-1838 14/ -.-- www.town.d a rtmou th.m a.u s APPLICATION TO CONSTRUCT, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY // J RECEIVED BY: BUILDING PERMIT NUMBEQ1 16/ DATE ISSUED: 4�%i SIGNATURE: DATE: Building Commissioner/Inspector of Buildings Zoning District: Prop. -• Use: Zone: ❑X ❑ B O A CV Aquifer Zone:_ THE FOLLOWING AGENCt-'.SHOULD BE N aTIFIED: 0 Board of '! B,-rd of ❑ •ns. 0 Demo ❑DPW ❑ Elec. ❑ Energy Report Appeals - -'earth ommission Affidavit Card Sent: Cut Off Follow-up" ❑Fire • Gas 0 Planning ❑Sewer Card ❑Water Card ❑Zoning ❑Other Chief Cut Off Board Cut Off Cut Off " IRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL la rd of Health: Signature: (✓Gv� iY�-.i'r� LLirr� Date: I I/7/i ^7 Conservation Commission: ignature: Date: Other: Si.nature: Date: Si a nature: Date: "... Signature: Date: Brief d cription of , eing . •donned: o 9 C.I. ECTION -SITE INFORM ON 1.1 Property Address, f, q I F U IV I" 1.2 Assessors MapJ&Lot Number: Lot Area(sf.) \`� Frontage Map I/ Lot _- Required Provided Front Yard 1.3 Historical District ❑Yes S No Side Yard Year Built Rear Yard O Altering more than 25%per side of building 1. Water Supply(MGL c40 s54): 116 Sewage Disposal System: Has application been stflSmitted to the Histor�C Commission? .. • ' l\O Privvaate Well I Municipal ❑ On Site Disposal System ❑Yes I(1 No Date:��t r ^, ! t ' ! _ Revised 10111 0 i ..tl ONS UCTION PLANS ❑ ITE PLAN ❑ ENERGY REPORT 55 y G O , `'• v rzO pm m � W0 n' c O �4 sp - z r z zv r3 - m p m , S` &p1m. m m p C r- Sp — '' t y> m Qm �a p G1Tnn* J U. In _. 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Garrett, Conservation Officer Subject: Building Signoff Report for Residential Ground Mounted Solar Panels—569 Old Fall River Road Date: November 8, 2017 The Conservation Department is very familiar with this site as we have dealt with some violation issues at the location in the recent past.The site supports a fair amount of altered and non-altered wetlands to the immediate north and east that has never been delineated as a matter of public record.A review of the "Solar Design Packet" provided indicates that these panels are proposed on or near the extent of wetlands and within the floodplain as depicted on MapGEO (see attached sketch). Given the potential for activities within jurisdictional wetland resources, regulated Buffer Zone, and with the site's previous history; I am not in a position to signoff on this proposed project at this time. I believe that an Order of Conditions (OOC) is required in this case, but at a minimum a Wetland Al Inspection could also be completed. However the completion of the Al will probably not alleviate the need for the OOC. RESIDENTIAL 0 Phased Approval(R106.3.3) $25.00 APPLICATION FEE IS NON RE-FUNDABLE &NON-TRANSFERABLE _ DATE RECEIVED "r;��' DARTMOUTH BUILDING DEPARTMENT j Ate ;�'` 400 Slocum Road, P.O. Box 79399 [[[/ 4 e .i Dartmouth, MA 02747 / �,, ,fi" �' Phone: 508-910-1820 Fax: 508-910-1838 0'/ 414,9a'iC+l �,� www.town.dartmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: BUILDING PERMIT NUMBE ' 97.�C/ DATE ISSUED: SIGNATURE: DATE: Building Commissioner/Inspector of Buildings Zoning District: po Use: Zone: O X O B O A O V Aquifer Zone: THE FOLLOWING AGENCI .SHOULD BE N TIFIED: ,, ❑Board of , B rd of 0 ns. ❑Demo ❑DPW 0 Elec. 0 Energy Report Appeals "\, ealth ommission Affidavit Card Sent: Cut Off Follow-up' ❑Fire Gas 0 Planning ❑Sewer Card ❑Water Card 0 Zoning 0 Other Chief Cut Off Board Cut Off Cut Off IRES INSPECTORS REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL 1 Board of Health. 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L u� r" a r§ E.Er ' a 4€9Wlm!P£ti'Cgg Z, i N M 1 3 c 1 p sw8-€ LLg a , , D i EEt 2 -ei daE gg,§ a S E `1 ;99N 335t o r!. :,i x3J E J8 � 8a '� [5:.. /N ® ®t ®n:®. � \\ # .. ❑ I , Deli , e gc r kxn� rt � ty� , d 4\ ✓ $ \tau *.,t �. I r'�%:, c 't L4 z� r ayN� .. i s .eii 11 i �?1 �)) y e 0. �Y ( L i " I � f r -s* a r 0 if 1 a ix "c,� " d, "j 1 � ca, Ic3 Ss a- • L < 4 'i Y ¢ �:- ..l L At y a 42 ( �� t»� S f c c -- I t; - ti� a „ �. E $ c 4 1! s ¢ 2 E E c o0 o 1' i E r 3 m P o iI ! ; « e o n E f➢t v o v o g o . 5 y 'DocuSigri Envelope ID:E9634FA1.40F4-4B79-A34F-03049553C1 EE • A - BERYO b N Dear John, We are pleased to submit the following Solar Agreement for your solar electric energy system. Solar electric systems are environmentally friendly and reduce your reliance on energy from the utility company. Instead of buying your electricity from your utility, you can now own your own clean energy production. At Rayah Solar we go to great lengths to provide outstanding customer service. In fact, "Rayah," is the Hebrew word for"friend." That is why we provide you with your own Solar Consultant and Project Manager. Your Project Manager will provide you with frequent updates and be your point person during the permitting process. We are committed to a quality installation, and to ensuring your total satisfaction with our products and services. We look forward to helping you achieve energy independence, make a positive environmental impact, and make a great investment! Please feel free to follow up with your Solar Consultant or contact us at 617-564-3159 or by email at infoh>rayahsolar.com with any questions or comments. Welcome to the Rayah Experience! Sincerely, ti The Rayah Team lat cyaRayah Power Integration Corp. 21 Bond Street, Eat Spencer, MA 01562 ��f1�� /� in fo(i rayahs (anon lt � nfo4iirayahsolar.com Office: (617) 564-3159 Rayah Power lntegradon Corp, 21 Bond Street,Spencer,MA 01562 1 617-564-3159I info@rayahsolar.com 'DocuSign Envelope ID:E9634FA1-40F4-4879-A34F-03049553C1EE -A R r AS POWER I N T E G R A T I O N Photovoltaic (PV) Solar Agreement Contact Information COMPANY CUSTOMER INFORMATION Rayah Power Integration Corp. John Bowden 21 Bond Street 569 Old Fall River Rd Spencer, MA 01562 Dartmouth, MA 02747 Phone: 617-564-3159 Email: info@ rayahsolar.com Project Description & Major Components PV Panels: Qty. 39—SunPower X21-345-C-AC Panels Inverter(s): SunPower Equinox w/SunPower AC Modules System Size: Size: 13.46 kW DC Standard Solar panels, inverter(s), racking and mounting components per Uniform Building Code.AC Components: and DC disconnects per National Electric Code and Utility. Wiring, conduit and overcurrent protection per National Electric Code. Turnkey Solar Installation -Scope of Work: Includes all design, engineering, permitting, construction,utility interconnect and a Statement of Qualification (SOQ)to the Department of Energy Resources (DOER) for SREC's. Construction includes solar panels, inverter, mounting and all electrical appurtenances necessary for a completely functioning solar power system. Permitting includes submission of building, electrical and utility permits and post installation inspections. Terms &Conditions General Provisions 1. Introduction: You are entering into an Agreement ("Agreement") with Rayah Power Integration Corp., DBA: Rayah Solar, (Company). You(Owner)or(Customer)represent that you are at least eighteen(18)years of age,and owner of sited property. This Agreement is for the installation of a solar system(Solar System)or(Solar Facility)or(Project)on the property(Property)or (Premises)of the Owner. 2. Design and Installation: The design for the Solar Facility will be presented to you prior to installation. You will have three (3) business days following this presentation to request a change or accept the design. Following this period you will be deemed to have approved the Solar Facility design.If you wish to change the design,Company will use commercially reasonable efforts to accommodate your request. 3. Deposit: A deposit of$500 is required to execute this Agreement. The deposit will be refunded if the Agreement is terminated pursuant to Section 5 and/or if Property fails to meet required structural or electrical requirements for the installation of the solar array. Further deposits terms are wholly separate for Cash Customers and Company Finance Customers. These terms are as follows: a. Cash Customer: The deposit will be credited to the Total System Cost and will be viewed as your first installment payment of$500. Rayah Power Integration Corp. 21 Bond Street,Spencer,MA 01562 2 617-56431S9 I info@ayahsolar.com �DocuSign Envelope ID:E9634FA1-40F4-4B79-A34F-03049553C1EE �A R A M POWER I N T E 6 R 1 1 O N b. Company Finance Customers: At the completion of the solar project, the $500 deposit will be returned upon final payment disbursement from Financial Lending Partner to Company. 4. Payment: The Solar Facility will have a "Total System Cost"that includes all costs necessary for the installation of the Solar Facility. Payment Terms are wholly separate for Cash Customers and Company Finance Customers.These tens are as follows: a. Cash Customers:Owner financed projects require a$500 deposit with a payment of 65%of the Total System Cost at the submission of the Building Permit, and payment of the balance due at Electrical Inspection Sign-Off.If payment is not made when due, Company may suspend work on the job until remittance of payment.The solar system must be paid in full prior to final Utility Interconnect. Solar systems will not be tuned on until full payment is received. A failure to make a scheduled payment shall be deemed a material breach of this Agreement. b. Company Finance Customers: "Company Finance Customers," is defined as customers who received project financing from a Company"Financial Lending Partner." Company Finance Customers are required to pay a$500 deposit,to be returned upon project completion and payment disbursement from Financial Lending Partner to Company. The Financial Lending Partner will pay the Total System Cost to the Company per the agreed upon terms between Company and Financial Lending Partner.Company Finance Customers agree to sign all paperwork from Financial Lending Partner to release payment to Company within five (5) days of receipt. Should Customer owe additional monies to Company(project costs not covered by the Financial Lending Partner)the Customer will pay Company in full at the time of electrical inspection sign-off. The Solar System must be paid in full prior to final Utility Interconnect. Solar systems will not be turned on until full payment is received.A failure to make a scheduled payment or failure to sign any paperwork from Financial Lending Partner to release payment within five(5)days shall be deemed a material breach of this Agreement. 5. Right to Cancel:You have the right to cancel this agreement at any point within three(3)days of the execution of this agreement (exceptions stated in Section 2 and Section 8). After three(3)days,Company can charge a minimum of$500 cancellation fee for expenses incurred on behalf of your project. A Project that fails to meet the required structural or electrical requirements (as deemed by the Company) for the installation of the Solar Facility will be deemed as cancelled at no fault of either party and the deposit will be returned in full to the Customer. 6. Start Date:There is an estimated 90-day time frame for the system to be installed and interconnected,from the Purchase Agreement signed date.No work shall begin prior to the signing of the Purchase Agreement(and transmittal to the owner of a copy of such contract),nor prior to utility and municipal permit approval. 7. Timelines:Upon receiving materials on site,the work to be performed by Company pursuant to this Agreement shall commence within a timely manner,and shall be substantially completed within a timely manner.Net meter installation is conducted by the utility following the electrical inspection sign-off Work schedules are subject to weather condition and material availability. Owner will be notified of timeline changes. 8. Changes to the Agreement:Prior to installation,the following conditions may materially change the expected costs and benefits of the solar facility to Owner and/or Company: a. Change to the design of your Solar Facility(number of solar panels)may be required. b. An Electrical Upgrade:Consisting of an enlargement of the main service panel(MSP),or an upgrade of the MSP. If any of these conditions occur,the Company may choose to modify the terms of this Agreement or cancel the Agreement. If Company modifies the terms,Company will notify the Owner in writing with a Change Order and the Owner will have five(5) calendar days to accept the Change Order or cancel this Agreement. If the Owner does not respond within five(5)calendar days, it will be concluded the Owner accepts the Change Order and the Agreement,as modified,shall remain in effect. 9. Materials: Upon delivery of materials on site it will be deemed the property of the Property Owner, although Company will maintain insurance against theft and damages of materials until installation is complete. 10. Monitoring:The purchase of your Solar Facility includes Twenty-five(25)years of system monitoring at no additional cost. 1 I. Warranty:Company provides a 10-year limited warranty that the system will be free from defects in material and workmanship. The warranty applies to the solar installation and transfers upon the sale of the home. Additionally,the Company will provide normal maintenance for the system for a ten-year period. Maintenance includes the replacement and/or repair of equipment not performing as intended, provided that the replacement and repair is necessitated by a defect in materials or workmanship or normal wear and tear. Damage caused by extreme weather or animals is not considered normal wear and tear. Company will use commercially reasonable efforts to replace items with like equipment,however Owner acknowledges that due to parts availability and other factors,this may not be possible. a. SunPower Warranty (If Applicable): SunPower provides a 25/25/25 warranty; 25 Year Product Warranty, 25 Year Performance Warranty, 25 Years Labor Warranty. This warranty includes SunPower solar panels (including AC Rayah Power integration Corp. 21 Bond Street,Spencer,MA 01562 3 6I7-564-3159I info@rayahsalar.com 'DocuSign Envelope ID:E9634FA1-40F4-4B79-A34F-03049553C1EE 40-A a s n =w POWIR INTEGPATION modules with integrated inverters),and racking.The SunPowcr warranty supersedes the Company 10-year warranty.For further details,see SunPower Warranty. 12. Workmanship: All work shall be completed in a workman-like manner and in compliance with all building codes and other applicable laws. To the extent required by law individuals duly licensed and authorized by law to perform said work shall perform all work. Company agrees to remove all debris and leave the premises in broom clean condition.Company shall not be liable for any delay due to circumstances beyond its control including weather, strikes, casualty, or general unavailability of materials. 13. Any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston,MA 02116 Phone: (617) 973-8700 14. Insurance:Company warrants it is adequately insured for injury to its employees and others incurring loss or injury as a result of the acts of Company or its employees or subcontractors. 15. Access Rights: You agree to grant Company or sub-contractors access to your property for the purpose of designing, installing, operating, maintaining and testing the solar facility. Customer agrees to remove anything obstructing arrrss to the main service panel prior to the scheduled installation date.Company agrees to give you reasonable notice when Company needs to access your Property and will endeavor to restrict such access to normal business hours. Owner grants Company access to property to shutoff solar system in the event of non-completion of payment paperwork or for non-payment of any invoiced amount within ten(10) calendar days of receipt of the invoice. 16. Validity: This agreement is valid for five(5)days from the above date. Agreement execution will take effect upon returning this Agreement to Company,and confirmation of countersignature.This Agreement may be considered null and void if not executed and returned to the Company within five(5)days,unless otherwise agreed by the Company. 17. Promotional Materials:Owner agrees to allow Company the rights to use the solar installation and any collateral,testimonials and other materials for any marketing and promotional activities. 18. System Performance: The Owner understands and agrees that the information and projections provided to the Owner by the Company prior to the execution of this agreement were based upon the Company's best estimates at the time and do not constitute a warranty or guaranty. All proposal projections of solar incentives are based on public information and in no way represent guaranties by Rayah.Please consult your tax professional.The only warranty or guaranties provided are as set forth in Section 11. 19. Dispute Resolution: Both parties agree to settle any disputes as quickly and amicably as possible in order to avoid undue expenses. If Company has to file suit to collect any unpaid fees, costs and/or expenses for services and/or goods provided, all claims must be brought in a court of competent jurisdiction in the Commonwealth of Massachusetts and apply Massachusetts' law. Both parties specifically waive any objections to jurisdiction,venue and choice of law provisions. If Company is successful in a claim,then it can recover all of its attorneys' and expert fees as well as costs associated with the prosecution of an action, including pre-ligation costs and fees. 20. Severability/Survival: The Parties intend this Agreement to be enforced as written. If any portion or provision of this Agreement shall to any extent be declared illegal or unenforceable by a duly authorized court having jurisdiction, such portion or provision shall be modified by such a court so as to make it enforceable,if possible,and the remainder of this Agreement shall be enforced to the fullest extent permitted by law. 21. Entire Agreement: This Agreement represents the entire agreement between the parties and replaces any other oral or written agreements or understandings. 22. Amendments: All amendments to this Agreement must be in writing,executed by both parties. 23. Assignment: Owner may not assign its rights or obligations under this Agreement without the express, written consent of Company. Company may assign its rights or obligations hereunder at any time without prior consent or approval of Owner. 24. Knowing And Voluntary: The Parties hereby acknowledge that they have read this Agreement carefully, have been afforded a sufficient amount of time to consider and accept the terms of this Agreement,have been advised by proper counsel on all of the terms of this Agreement, are voluntarily entering into this Agreement, and that no party (or its, his, her or their agents or representatives)has made any representations inconsistent with the terms and effects of this Agreement. 25. Counterparts: This Agreement may be executed in counterparts, each of which will be deemed an original, but all of which together will constitute one and the same instrument. Facsimile or electronic signatures shall be deemed as good as the original. Rayah Power Integration Corp. 21 Bond Street,Spencer,MA 01562 4 617-564-3159 I info@rayahsolar.com D`ocuSigr.Envelope ID:E9634FA1-40F4-4B79-A34F-03049553C1 EE POWER INTEGRAIION Adak?'"o$a*ms(Initial): • 5� _Tree Removal:Although cutting or trimming trees may not be required to go solar,Customer understands that if it is ....,.,...mended to cut trees to improve efficiency, it is the Customer's responsibility to perform all tree work Customer understands that all production estimates were based on the shading analysis taken at the time of this agreement,and any cos tes or guarantees are based on the maintenance of this solar access. • \ _Weather Protocol:If your installation needs to be rescheduled due to adverse weather,it will be rescheduled on the next available rain date/maintenance day.Please note,rain date/maintenance days are pre-scheduled and may not occur the ' os' (lowing your originally scheduled installation date. Multiple days of adverse weather may result in limited scheduling. • it, _ Internet Access: You agree that you will maintain high-speed Internet connection with the Solar Facility to allow company to monitor Solar Facility.If the Solar Facility will not connect to the Internet,you agree to use all reasonable efforts, working with Company,to reestablish Internet connection.If you choose to not have Internet access,you agree that Company reserves the right to charge a minimum $500 fee for each service call that you request after your system has been interconnected by the utility. Rayah Solar John Bowden Homeowner Name p—Oocuslgne by: " Company Representative Name i ,7& Nwet w - l SE27B90 C5734Aa.. Homeowner Signature Company Representative Signature 9/29/2017 Date Title Date Rayah Power Integration Corp. 21 Bond Street,Spencer,MA 01562 rJ 617-564-31591 info@rayahsolar.com DocuSign Envelope ID:E9634FA1-40F4-4B79-A34F-03049553C1 EE 44ii 9ATEE ' ON Notice of Right to Cancellation Date: 9/29/2017 (Enter date of transaction) YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. The Notice of Cancellation,regarding your right to cancel this Agreement,is attached hereto and made a part to this Agreement. You may cancel this transaction,without any penalty or obligation,within three business days from the above date. If you cancel,any payments made under the Agreement,the Company of your cancellation notice will return any negotiable instrument executed by you within 3 days following receipt. Additionally,any security interest arising out of the transaction will be canceled. To cancel this transaction,mail or deliver a signed and dated copy of this cancellation notice,or any other written notice to: Rayah Power Integration Corp.,21 Bond Street,Spencer, MA 01562:Phone: 617-564-3159: Email: info@rayahsolar.com. 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N _ _ .. ,t II .„ i/ PnGV am^•fs yY t 7C Iii [ i b p �O , , O < zrnmm m ? rini rn * z ' -< aom0z (A v Pi; p m � tn v O 1-1 T rn • n3 z r^n CA lvrn n 0l m ID W l0 `A ^.;. o cn CR A 0 0 * a —I i n 0 ul IZ I j I D i r (A L _ m L___I IRONRIDGE Bowden1495 ZEPHYR AVE,HAWWARD,CA 94544 GROUND-BASED Project Details • NAME Bowden DATE 2017-11-07 LOCATION North Dartmouth,MA,2747 TOTAL MODULES 39 MODULE SunPower:X21-345(46mm) TOTAL WATTS 13,455 DIMENSIONS 61.4"x 41.2'x 1.8"(1mm x 1mm x 46mm) TILT 25 deg CONFIGURATION 3-Up Load Assumptions Foundation Requirements WIND EXPOSURE B TYPE Concrete WIND SPEED 110 mph HOLE DIAMETER 12 in. GROUND SNOW LOAD 30 psf MIN HOLE DEPTH 48 in. Substructure Requirements Foundation Loads PIPE SIZE 3" SHEAR 1,016 lbs. DIAGONAL BRACING No MOMENT 2,541 ft-lbs. UPLIFT -1,260 lbs. 3rd Party Substructure Materials TOTAL PIPE 215' 11.7" TOTAL CONCRETE 1.40 yd 3 Array Details Config Repeats Modules Per Pier Total Piers South Piers North Piers Cross Pipes Cantilever Total Pipe Length 3x13 1 3.25 12 6(5'2") 6(8'8") 2(66'5.9") 0' 12" 215' 11.7" • aShint.-) /1-4/A TILE COPY Last updated by AliYah Chidubem on 2017-11-07 10:12:22-0800 Page 1 of 5 IRONRIDGE Bowden1495 ZEPHYR AVE.HAWiARD.CA 94544 GROUND-BASED Plan View 12'10.8" 76" _._.. I, Icy PIPE .c Side View p63 6'68" vouTH EDbE EA RAVCE 5'12" A8ovE 25° L T6" - r:-s rnR,i.olar, 12" r191E oinnrrrER Note:The Images displayed In this report are meant to represent one portion of the array.The use of a break line indicates that the array may continue on beyond that point. Page2of5 IRONRIDGE Bowden1495 ZEPHYR AVE,I IAWJARD,CA 94544 GROUND-BASED Pipe Fittings Detail _--� UNIVERSAL FASTENING OBJEC -----��\ PV MODULE - PV MODULE V �XRi DDO RAIL - XR1000 RAIL 3"RAIL CONNECTOR `' E - 3"RAIL CONNE(TOR Y� III .c v 3"PIPE/TUHING 3"TOP CAP / \ 3'TOP CAP ) 3'"PIPE/TU BIN c Front View Side View Clamp Detail PV MODULE _ - UNIVERSAL -RAIL �\ STOPPER -` FASTENING 1 SLEEVE FRAME / OBJECT I PV MODULE UNIVERSAL ///I I FRAME \ FASTENING r_ i_ UNIVERSAL —� FA OBJECT FASTENING PV MODULE f OBJECT iIp FRAME ' UNIVERSAL 7 ,..:EI i _ it 1 OBJECTING � I OBJECT RAIL RAIL PV MODULE / _ �_� - STOPPER SLEEVE FRAME Mid Clamp,Plan Mid Clamp,Front End Clamp,Plan End Clamp,Front Page 3 of 5 IRONRIDGE Bo w d en 1495 ZEPHYR AVE,HAW.'ARD,CA 94544 GROUND-BASED Grounding Diagram III III g COO i O UFO Clamp i i 3 Fault Current Ground Path i i< l® ()=4) • Grounding Lug f i<1 i iCross Pipe :a + -I _ _ _ Min10CopperWire i l i i is i • i< 1 1 i< -I . 0 C)=C� 1< < i A i y i 0 rI O=C) I I+ t iq i 1 1 i Cross Pipe i 1 1J _ _ _ 1 n- r-n - - - 1 r.I I i I I I< I< tOptional Cross CB IYV Brace 1 W 5 O OHO 0 Bonding Points E— Fault Current I I III III *Grounding Lugs and Wire are not required in systems using certain Enphase microinverters. Plan View Side View Only one Grounding Lug required per continuous subarray Page 4 of 5 1 eit TOWN OF DARTMOUTH - BUILDING DEPARTMENT RECEIPT - ''..)'0 0 8 PHONE: 508-910-1820 FAX: 508-910-1838 �Q / l l�Name I r//d) -(5` " ' Property Owner f)( 22,9 Date i /7 f/ i ) /v7 !j✓ Job Location: /271 ] L!I ,f//2/ U �' Map: 7/ Lot: Sl i Description General Ledger#'s Ref. # Amount Building& Building Misc. 01000-44105 r p DART`� — Electrical 01000-44.106 .1/41 PM 'y\ I - Plumbing & Gas 01000-44107 NOV OS 2011 Trench Safety I. 01000-44129 Other Department Revenue 01000-424410 %' ;, eOLLE9;�/ / tip, l '. 1 ", ti _B t ( �- , White Collemoc's Office Yellow Copy-Customer's Receipt Pink Copy=•Bud�Btng Department Received By�/� „��! f�.�/y THIS IS NOT A PERMITILICENSE FOR BUILDING,ELECTRICAL;PLUMBING OR GAS TOWN OF DARTMOUTH - BUILDING DEPARTMENT RECEIPT o 9 PHONE: 508-910-1820 FAX: 508-910-1838 Name: ) I; e/j ei' Property Owner 3--)j) � Dat f//A 7 Job Location: 9,0 J Ge l%� /7-/%/,4p Gr`:p -7 Le) Description General Ledger#'s R DART/07- Amount Building & Building Misc. 01000-44105 1 PM c Electrical 01000-44106 p$ 101 4, 2 1 �SZ� Plumbing & Gas 01000-44107 Trench Safety 01000-44129 l 0,,' CQt�E Other Department Revenue 01000-42420„ . m, n r White-Collector's Office Yellow Copy-Customer's Receipt Pink Copy-Lildmg Department , Received By ( , THIS IS NOT A PERMITILICENSE FOR BUILDING, ELECTRICAL;`�'MBING OR GAS f.�� e o �9... ° Dartmouth Building Department i0 =i ti i - _- yy:I 400 Slocum Road (508)910-1820 o \\\\ Llfifi� -s� Dartmouth,MA 02747 (508)910-1887 REQUIRED INSPECTIONS e_r r__w , _. 1 . READ ME. The applicant is responsible for L1CAN' '3 PP P etPY calling this office when scheduling inspections. Please refer to the list below for required inspections. Address S 6 7 G4 D Real Rlv'z A Date //- 17 *FOUNDATION (as-built needed): Notice *BEFORE INSPECTION,FOUNDATION BRACING MUST BE INSTALLED. *SONO-TUBE INSPECTION: • *INSPECTION IS NEEDED BEFORE THE CONCRETE IS POURED. *ROUGH/FRAME (with approved plans): *AFTER ALL ELECTRICAL&PLUMBING HAS BEEN INSTALLED&INSPECTED - FIREPLACE: ❑ Footing(If separate) 0 Throat ❑ Before cap is installed - INSULATION (with approved energy report): — NOTE: N.F.R.C.LABELS MUST BE ON ALL WINDOWS AND DOORS OR USE DEFAULT CHART VALUES. — RECHARGE SYSTEM/OTHER: FINAL (with approved plans and energy report): e:lwpdocslformslinspreq.wpd Revised August 28,2012 NJ k a D�' vou, < , O m. m O O. O a N CO a 0 ai m m Z vl11 O N a : �CV r2Er" R a 0 XI in 143 ` tn � 4D In m O 0 O La r-r " Di a\ 73, 1W-` .rg I-. 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