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0038 LAKEWOOD DRIVE
� t Town of BarnstableBuildin a r Post This Card So That it is Vlslble•From the Street Approved Plans Must be Retained on Job and this Card Must be Kept a Posted JL Until'Final Inspection Has Been.IVlade g � .✓` P eoe ° IWhere a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been maermit de Permit No. B-19-3843 Applicant Name: Henry Cassidy Approvals Date issued: 11/14/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 05/14/2020 Foundation- Location:. 38 LAKEWOOD DRIVE,CENTERVILLE Map/Lot: 212-002 Zoning.District: RD-1 Sheathing: Owner on Record: KRUSELL,ERIC H&ANNE M TRS = Contractor Name: CAPE COD INSULATION INC framing: 1 Address: 72 CEDAR STREET Contractor License: .153567 2 SCITUATE, MA 02066 Est Project Cost: $3,200.00 Chimney: Description: Insulation/Weatherization Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid:X S 85.00 Date,, .fr 4 11/14/2019 Final: � JiiAf J .'f7 --._ Plumbing/Gas v Rough Plumbing: t Building Official Final Plumbing:' This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application=and the'approved construction documents for which"this permit has been granted. Rough Gas: 6 All construction,alterations and changes of use of any building and structures'shall be in compliance with the local zoriing'by laws ar%d codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electricals The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fire Officials are provided on;this,:permit. Service: Minimum of Five Call Inspections Required for All Construction Work W. 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ESICCMo�t Widely Accepted a-nd Trusted SERVICE RESEARCH LABS • ' - port ESR-4322 .• • This report is subject to renewal 09/2019 DIVISION: 07 00 00-THERMAL AND MOISTURE PROTECTION SECTION: 07 21 00-THERMAL'INSULATION REPORT HOLDER: LAPOLLA INDUSTRIES INC. EVALUATION SUBJECT: LAPOLLA FOAM-LOK FL 750 1CC ICC �� ICC PMG LISTED "2014 Recipient of Prestigious Western States Seismic Policy CouncilNTER■�� WSSPC Award in Excellence" (CODE OUNCI ATIONAL � � A Subsidiary of caoecouncir ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use. /. There is no warranty by ICC Evaluation Service, LLC, express or implied, as to any finding or other matter in this report, or as to an product covered b the report. IEo/IE0,700 P Y h Y h Product cor0flcedon Body 01000 Copyright° 2018 ICC Evaluation Service, LLC. All rights reserved. ESICC Most Widely Accepted and Trusted IMES Evaluation Report ESR-4322 Issued September 2018 This report is subject to renewal September 2019. www.icc-es.orq (800) 423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council° DIVISION: 07 00 00—THERMAL AND MOISTURE under the IRC; and in Types I through IV construction PROTECTION - when installed in accordance with Section 4.5. Section: 07 21 00—Thermal Insulation The attribute of the insulation has been verified as REPORT HOLDER: conforming to the provisions of ICC 700-2008 Section 703.2.1.1.1(c) as an air impermeable insulation. Note that LAPOLLA INDUSTRIES, INC. decisions on compliance for those areas rest with the user of this report. The user is advised of the project-specific EVALUATION SUBJECT: provisions that may be contingent upon meeting specific conditions, and the verification of those conditions is LAPOLLA FOAM-LOK FL 750 outside the scope of this report. These codes or standards often provide supplemental information as guidance. 1.0 EVALUATION SCOPE 3.0 DESCRIPTION 1.1 Compliance with the following codes: 3.1 Foam-Lok'FL 750: ■ 2015, 2012 and 2009 International Building Code®(IBC) The Lapolla Foam-Lok FL 750 foam plastic insulation is ■ 2015, 2012 and 2009 International Residential Code® two-component, low density, open cell, spray-applied, (IRC) foam plastic with a nominal-density of 0.7 pcf (11 kg/m3). The polyurethane foam is produced by combining a ■ 2015,2012 and 2009 International Energy Conservation polymeric isocyanate (A component) and proprietary resin, Code®(IECC) Foam-Lok FL 750 (B component). When stored at ■ 2013 Abu Dhabi International Building Code(ADIBC)t temperatures between 50°F (10°C) and 100°F (38°C), the components have a shelf life of twelve months. tThe ADIBC is based on the 2009 IBC.2009 IBC code sections referenced in this report are the same sections in the ADIBC. 3.2 Surface Burning Characteristics: Properties evaluated: When tested in accordance with ASTM E84/UL 723, at a ■ Surface burning characteristics thickness of 4 inches (152 mm) and a nominal density of 0.7 pcf (11 kg/m ), Lapolla Foam-Lok FL 750 has a flame ■ Physical properties spread index of 25 or less and a smoke-developed index of ■ Thermal performance(R-values) 450 or less. There is no thickness limit when installed behind a code-prescribed thermal barrier, except as noted ■ Attic and crawl space installation in Section 4.3.2 and Table 2. ■ Air permeability 3.3 Thermal Resistance: ■ Exterior walls of Types I—IV construction Lapolla Foam-Lok FL 750 .has thermal resistance 1.2 Evaluation to the following green standard: (R-values)at a mean temperature of 750F(24°C)as shown 2008 ICC 700 National Green Building Standard TM in Table 1, (ICC 700-2008) 3.4 Air Permeability: Attributes verified: Lapolla Foam-Lok FL 750 is considered air-impermeable See Section 2.0. insulation in accordance with 2015 IBC Section 1203.3 and 2015 and 2012 IRC Sections R202 and R806.5 (2009 IRC 2.0 USES Sections R202 and R806.4), at a minimum thickness of Lapolla Foam-Lok FL 750 is used to- provide thermal 2 inches (51 mm) based on testing in accordance with insulation in buildings and to seal areas such as plumbing ASTM E2178. and conduit penetrations against air infiltration. The 3.5 Intumescent Coatings: insulations are for use in wall cavities and floor assemblies; 3.5.1 DC 315 Coating: 'DC 315 coating (ESR-3702), and in attic and crawl space installations as described in manufactured by International Fireproof Technology, Section 4.4. international Inc. / Paint To Protect Inc., is a water-based The Foam-Lok FL 750 insulation is for use in non-fire- intumescent coating supplied in 5-gallon (19L)- pails and resistance-rated construction under the IBC and dwellings. 55-gallon (208L) drums. The coating material has a shelf ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use.There is no warranty by ICC Evaluation Service,LLC,express or implied,as �`�:� to any finding or other matter in this report,or as to any product covered by the report. Copyright©2018 ICC Evaluation Service;LLC. All rights reserved. Page 1 of 5 ESR-4322 I Most Widely Accepted and Trusted Page 2 of 5 life of 12 months when stored in factory-sealed containers utilities, an ignition barrier must be installed in accordance at temperatures between 50OF(10°C)and 80OF (270C). with IBC Section 2603.4.1.6 and IRC Sections R316.5.3 4.0 INSTALLATION and R316.5.4, as applicable. The ignition barrier must be consistent with the requirements for the type of 4.1 General: construction required by the applicable code and must be installed in a manner so that the foam plastic insulation.is The manufacturer's published installation instructions and not exposed. Lapolla Foam-Lok FL 750 may be installed in this report must be strictly adhered to.A copy of these unvented attics when the foam plastic is applied at a instructions and this evaluation report must be available on minimum thickness of 2 inches(51 mm)in accordance with the jobsite at all times during installation. 2015 IBC Section 1203.3,` 2015 and 2012 IRC Section 4.2 Application: R806.5 or 2009 IRC Section R806.4,as applicable. 4.2.1 General: Lapolla Foam-Lok FL 750 foam plastic 4.4.2 Application with a Prescriptive Ignition Barrier: insulation must be applied on the jobsite using two- Where Lapolla Foam-Lok FL 750 insulation is installed in component, 1-to-1 ratio, spray equipment specified by accordance with Sections 4.4.2.1, 4.4.2.2, and 4.4.2.3, the Icynene, Inc. The foam plastic must not be sprayed onto a following conditions apply: substrate that is wet, or covered with frost or ice, loose 1. Entry to the attic or crawl space is to service utilities, scales, rust, oil or grease. The foam plastic insulation must and no storage is permitted. not be used in electrical outlet or junction boxes or in contact with rain or water, and must be protected from the 2. There are no interconnected attic or crawl space weather during and after application. Where the insulation areas. is used as air-impermeable insulation, such as in unvented. 3. Air in the attic or crawl space is not circulated to other attic spaces regulated by 2015 IBC Section 1203.3 or IRC parts of the building. Section R806, the insulation must be installed at a minimum thicknesses noted in Section 3.4. The insulation 4_ Combustion air is provided in accordance with IMC can be installed in one pass to the maximum thickness. Section 701. Where multiple passes are required,the cure time between 5. Attic ventilation is provided when required by IBC passes is negligible. Section 1203.2 or IRC Section R806, except when The insulation may be used in areas where the maximum air-impermeable insulation is permitted in unvented service temperature is no greater than 180°F (82°C). The attics in accordance with 2015 IBC Section 1203.3 or insulation must be applied when the temperature is at or, 2015 and 2012 IRC Section R806.5 or 2009 IRC above 14°F (-10°C) and be protected from the weather Section R806.4,as applicable. during and after application. 6. Under-floor(crawl space)ventilation is provided when 4.3 Thermal Barrier: required by 2015 IBC Section 1203.4 (2012 and 2009 IBC Section 1203.3) or IRC Section R408.1, as 4.3.1 Application with a Prescriptive Thermal Barrier: applicable. Lapolla Foam-Lok FL 750 foam plastic insulation must be separated from the interior of the building by an approved 4.4.2.1 Attics: In attics, Lapolla Foam-Lok FL 750 thermal barrier, such as 1/2-inch (12.7 mm) gypsum insulation may be spray-applied to the underside of the wallboard installed using mechanical fasteners in roof sheathing and/or rafters,the underside of wood floors, accordance with the applicable code, or an equivalent and vertical surfaces, as described in this section. The thermal barrier complying with the applicable code. When thickness of the foam plastic applied to the underside of installation is within an attic or crawl space as described in the top of the space must not exceed 14 inches(356 mm). Section 4.4, a thermal barrier is not required between the The thickness of the spray foam plastic insulation applied foam plastic and the attic or crawl space, but is required to vertical wall surfaces must not exceed 8 inches between the foam plastic insulation and the interior of the (203 mm). The foam plastic insulation must be covered on building. There is no thickness limit when installed behind all exposed surfaces with DC315 intumescent coating at a a code-prescribed thermal barrier, except as noted in minimum thickness of 4 wet mils (0.1 mm) [3 dry mils Section 4.3.2 and Table 2. (0.08 mm)]; applied at a rate of 0.25 gallon (0.95 L) per 100 square feet (9.2 m2). The coating must be applied 4.3.2 Application without a Prescriptive Thermal over the Lapolla Foam-Lok FL 750 insulation in Barrier or Ignition Barrier: The prescriptive 15-minute accordance with the coating manufacturer's instructions thermal barrier or ignition barrier may be omitted when and this report. Surfaces to be coated must be dry, clean, installation is in accordance with the following and free of dirt, loose debris and other substances that requirements: - could interfere with adhesion of the coating. The coating is. 4.3.2.1 The insulation must be covered on all surfaces applied in one coat with low-pressure airless spray with a fire protective coating at the minimum thickness set equipment. forth in Table 2. The coating must be applied when ambient and 4.3.2.2 The maximum installed thickness of the insulation substrate temperature is at least 60°F (16°C) and no more must not exceed the thicknesses set forth in Table 2. than 95°F (35°C). All other surfaces (including glass) must be protected against damage from the coating. 4.3.2.3 The coating must be applied over the insulation in Lapolla Foam-Lok FL 750 insulation may be installed in accordance with the coating manufacturer's instructions unvented attics when the foam plastic is applied at a and this report. minimum thickness of 2-inches (51 mm) as described in 4.4 Attics and Crawl Spaces: this section, in accordance with 2015 IBC Section 1203.3, 4.4.1 Application without a Prescriptive Ignition 2015 and 2012 IRC Section R806.5 or 2009 IRC Section Barrier: When Lapolla Foam-Lok FL 750 is installed up to R806.4,as applicable. a maximum thickness of 4 inches (102 mm)within attics or 4.4.2.2 Crawl Spaces: In crawl spaces, Lapolla Foam- crawl spaces where entry is made only for service of Lok FL 750 insulation may be spray-applied to.vertical ESR-4322 I Most Widely Accepted and Trusted Page 3 of 5 walls and the underside of floors,-as described in this 5.8 Jobsite certification and labeling of the insulation must section. The thickness of the foam plastic applied to the comply with 2015 IRC Sections N1101.10.1 and underside of the floors must not exceed 14 inches N1101:10.1.1 (2012 IRC Sections N1101.12.1 and (356 mm). The thickness of the spray foam plastic N1101.12.1.1 or 2009 IRC Sections N1101.4 and insulation applied to vertical wall surfaces must not exceed N1101.4.1) and 2015 and 2012 IECC Sections . 8 inches (203 mm). The insulation must be covered with C303.1.1, C303.1.1.1, R303.1.1 and R303.1.1.1 DC-315 coating as described in Section 4.4.2.1. (2009 IECC Sections 303.1.1 and 303.1.1.1), as 4.4.2.3 Use on Attic Floors: Lapolla,Foam-Lok FL 750 applicable. insulation may be installed at a maximum thickness of 5.9 A vapor retarder must be installed in accordance with 13 inches (330 mm) between joists in attic floors. The the applicable code. insulation must be separated from the interior of the 5.10 Lapolla Foam-Lok FL 750 foam plastic insulation is building by an approved thermal barrier. The insulation manufactured under a quality control program with does not require an ignition barrier or a coating. inspections by[CC-ES. 4.5 Exterior Walls in Type I,II,III and IV Construction: 6.0 EVIDENCE SUBMITTED 4.5.1 General:When used on exterior walls of Types I, II, 6.1 Data in accordance with the ICC-ES Acceptance III or IV construction, the assembly must comply with IBC Criteria for Spray-applied Foam Plastic Insulation Section 2603.5 and this section, and the Foam-Lok FL 750 (AC377), dated April 2016 (editorially revised April insulation must be installed at a maximum thickness 2018). described in Table 3. The potential heat of Foam-Lok FL 750 insulation is 1963 Btu/ftz (22.1 MJ/m2) per inch of 6.2 Report of tests in accordance with AC377 Appendix thickness when tested in accordance with NFPA 259. X. 4.5.2 Specific Wall Assemblies: Wall assemblies 6.3 Test report on air leakage rate in accordance with complying with Section 4.5 must be as described in ASTM E2178. Table 3. 6.4 Reports of room corner fire testing in accordance with 5.0 CONDITIONS OF USE NFPA 286. The Lapolla Foam-Lok FL 750 spray-applied polyurethane 6.5 Test report in accordance with NFPA 285,and related foam plastic insulation described in this report complies engineering analysis. with, or is a suitable alternative to what is specified in, 6.6 Report of testing in accordance with NFPA 259. those codes listed in Section 1.0 of this report, subject to the following conditions: 6.7 Report of fire testing in accordance with ASTM E970. 5.1 This evaluation report and the manufacturer's 7.0 IDENTIFICATION published installation instructions, when required by 7.1 All packages and containers of Foam-Lok FL 750 the code official, must be submitted at the time of insulation must be labeled with the Lapolla, Inc., permit application. name and address; the product name; component 5.2 The insulation must be installed in accordance with designation (A or B); the flame spread index and the the manufacturer's published installation instructions, smoke-developed index; the expiration date; the this evaluation report and the applicable code. If there name of the inspection body (ICC-ES); and the is a conflict between the installation instructions and evaluation report number(ESR-4322). this report,this report governs. The international Fireproof Technology, Inc. / 5.3 The insulation must be separated from the interior of Paint To Protect Inc. DC 315 coating described in the building by an approved thermal barrier, except as Section 3.5.1.,is identified with the manufacturer's. noted in this report. name and address, the product trade name, date 5.4 The insulation must not exceed the thicknesses and of manufacture,. shelf life or expiration date, the densities noted in this report. manufacturer's application instructions and the evaluation report number(ESR-3702). 5.5 The insulation must be protected from the weather 7.2 The report holder's contact information is as follows: . during and after application. 5.6 The insulation must be applied by licensed dealers LAPOLLA INDUSTRIES, INC. and installers certified by Lapolla, Inc. 15402 VANTAGE PARKWAY.EAST SUITE 332 6.7 Use of the insulation in areas where the probability of HOUSTON,TEXAS 77032 termite infestation is "very heavy" must be in (281)219-4100 accordance with IRC Section R318.4 or IBC Section www.icynene-lapolli.com 2603.8, as applicable. ESR-4322 Most Widely Accepted and Trusted Page 4 of 5 TABLE 1—THERMAL RESISTANCE(R-VALUES) THICKNESS R-VALUE THICKNESS R-VALUE THICKNESS R-VALUE (inches) (°F•ft2•h/Btu) (inches) ('F•ft2•h/Btu) (inches) (°F•ft2•h/Btu) 1 4.0 5.5 22 9.5 38 2 8.0 6 24 10 .40 3 12 7 28 11.5 42 3.5 14 7.5 30 13.5 54 4 16 8 32 14 56 5 20 . 9 36 — For SI: 1 inch=25.4 mm, 1°F•ft2•h/Btu=0.176 110°K•m2AN. 'R-values are calculated based on tested K values at 1-and 3.5-inch thicknesses. 2R-values greater than 10 are rounded to the nearest whole number. TABLE 2—USE OF INSULATION WITHOUT A PRESCRIPTIVE THERMAL BARRIER' INSULATION TYPE MAXIMUM MAXIMUM FIRE-PROTECTIVE COATING MINIMUM THEORETICAL TEST THICKNESS(in.) THICKNESS(in.) 'MINIMUM THICKNESS& APPLICATION SUBMITTED (Walls&Vertical (Ceilings,Underside of Roof TYPE(Applied to all Foam RATE OF FIRE- Surfaces) Sheathing/Rafters&Floors) Surfaces)2 PROTECTIVE COATING' FOAM-LOK FL 760 61/2 102 20 mils WFT 313 mils DFT 1.26 gal/100 ft2 NFPA 286 For SI: 1 inch=25.4 mm;1 mil=0.0254 mm;1 gallon=3.38 L; 1 ft2=0.093 m2. 'See Section 4.3.2. ZSee Section 3.5.1. 3As reported in the manufacturer's application instructions.Actual application rate,based on specific project conditions,must be in accordance with the manufacturer's application instructions. ESR-4322 I Most Widely Accepted and Trusted Page 5 of 5 TABLE 3—NFPA 285 COMPLYING EXTERIOR WALL ASSEMBLIES WALL COMPONENT MATERIALS Base Wall System— 1 Concrete wall. Use either 1.,2 or 3 2— Concrete masonry wall. 3— Minimum 35/8-inch-deep (92 mm), No. 20 gage, C-shaped.steel studs, spaced a maximum of 24 inches on center with lateral bracing every 4 feet(1219 mm)as required by code.Sheathing shall be a described in Exterior Sheathing below. Floorline Firestopping Minimum 4 pcf mineral wool in each stud cavity at each floorline,attached with Z-clips.Thickness must match stud cavity depth. Cavity Insulation— 1— None. Use either 1,2,3,4 or 5 2— Partial cavity fill with a maximum air space of 2 inches(51 mm)or full cavity depth not exceeding 75/8 inches (194 mm) of Lapolla Foam-Lok FL 750; Icynene MD-R-210 (ESR-3493); Icynene MD-C-200(ESR-3199);or Icynene Proseal(ESR-3500). 3— Any insulation qualified as noncombustible in accordance with ASTM El36. 4— Glass fiber batt insulations. 5— Mineral fiber insulations. Insulation must comply with the applicable requirements of 2015 or 2012 IBC Section 720.2 (2009 IBC Section 719.2). Exterior Sheathing— 1— Minimum'/2-inch-thick(12.7 mm),),glass mat gypsum sheathing complying with ASTM C1177. Only for Base Wall System No.3— 2 — Sheathing shall be attached with No. 6, 11/4- inch-long (32 mm)self-tapping screws located Use either 1 or 2 8 inches(203 mm)on center along the perimeter and 12 inches 302 mm)on center in the field of wallboard. Joints must be taped and treated with joint compound in accordance with ASTM C840 or GA-216. Exterior Insulation Maximum thickness of 51/2 inches(140 mm)of Icynene Proseal Eco(MD-R-210)(ESR-3493)or Icynene Proseal(ESR-3500). Exterior Wall Covering— 1— Brick - standard nominally 4-inch-thick (102 mm) clay brick; brick veneer anchors — standard Use either 1,2,3,4,5,6 or 7 types installed a maximum of 24 inches OC vertically on each studb. 2— Stucco - minimum 3/4-inch-thick (19.1 mm), exterior cement plaster and lath with a secondary water-resistive barrier may be installed between the exterior insulation and the lath. 3— Natural stone(limestone,granite,marble,sandstone),minimum 2-inch-thick(51 mm)`. 4— Cast artificial stone, minimum 11/2-inch-thick (38 mm), complying with AC51 and subject of a current ICC-ES evaluation report`. 5— Terracotta cladding,minimum of 11/4-inch-thick(32 mm)`. 6— Precast concrete panels,minimum of 1'/2—inch-thick(32 mm)`. 7— Concrete masonry units(CMU),minimum of 11/2—inch-thick(38 mm)`. The maximum air gap between exterior insulation and cladding shall be 2 inches(51 mm). Any standard non-open-jointed installation technique such as ship-lap,etc.,may be used. FOAM-LOK® 750 F0AMwR.6)X"M High Yield OC Spray Foam SPRAY FOAM INSULATION ICC ESR-4322 Product Use and Design FOAM-LOKI 750 is a High Yield OC spray applied foam when Material Shelf Life: installed following application guidelines, adheres tenaciously to Twelve(12)months when stored within recommended temperature range. framing members and substrates. FOAM-LOKI 750 is a low den- Optimum hose pressure and temperature may vary as a function of the sity,open celled,flexible, 100%water-blown polyurethane foam type of equipment,ambient and substrate conditions and the specific insulation. It is capable of being installed in unvented attics with- application.It is the responsibility of the applicator to properly interpret out an ignition barrier or coating. equipment technical literature, particularly information that relates acceptable combinations of gun chamber size, proportioner FOAM-LOKI 750 forms a completely sealed air barrier in wall output and material pressures. cavities and can be used to fill 2"x 6" stud wall construction in a single application or any critical insulation areas. Its performance Physical Properties is superior to commonly used fiber-glass batt or blown-in insulation. It adheres well to most building materials and will provide a co.ntin- Properties uous barrier against air infiltration for the life of the building. As a Requirements component of a "systems"approach to proper building envelope Aged"R"Value ASTM C518 4 per inch construction in both residential and Type V commercial construction, Core Density ASTM D1622 0.7 lbs./ft3 FOAM-LOK® 750 provides exceptional performance in reducung heat transfer. Air Permeance ASTM Ezns <0.019 L/s.mZ at 2 inches Dimensional Stability:28 ASTM D2126 1.7% Recommended Product Applications daysat158°F,97%RH • Unvented and Vented Attics Water Vapor ASTM E-96 20.7 Perm at 2" • Cavity Walls Permeance Class III Vapor Retarder at 4.5" • Critical InsulationAreas Water Absorption ASTM D2842 5% Recommended Processing Parameters Credentials/Certifications Processing • • • ICC ESR-4322 Equipment Static Pressure 1,100-1,500 psi FOAM-LOK®750 is a Class I formulation,as Tested per ASTM E84 Ambient Temperature 20°F-120°F (-6-49•C) . ASTM E84 Class I Preheat Temperature(A&B/Hose) 130-155°F (54-65°C) Flame Spread <25 Drum Preheat Temperature 50-90°F (10-32°C) Smoke Development <450 (prior to use) Drum Storage 60-85OF (15-290C) Room Corner Fire Testing(Without Prescriptive Thermal Barrier)* Temperature(warehouse) 11 _ __ GNFPA286 Processing Mixing Requirements �=; :Location,,' SPFThickness* Wall Up to 8.5 inches(216 mm) Ceilings Up to 14 inches(356 mm) Recommended Drum r'"✓ Expanding Blade Bung-Mounted High r Agitator%Miter'� viscosityAgitatokw *20 Wet mils/13.Dry mils D,C315 Intumescent Coating Required • Graco(part#.26C150) Recommended Agitator Speed 500 rpm Limited Access Unvented;Attic Max Agitator Working Pressure 100 si r t- a j 9 - r v .. A lication LocationUnc`oatedSPF'Thickness* ' Recommended,Air Compressor" 19 cfm or rated higher � PP 9t' 1� ;p r w k"(568 .N)u { Underside of Roof Sheathin U-lto 20 Hn�ches(508"rnm)� 1�4Piocessing Application Method Attic Walls Up toj20 inches(508mm)" Recommendations • ' • 1 UNVENTED ATTICS SprayGun [I C� U F Sion AP Spray Guii aor Equivalent Lapolla's FOAM-LOK® FL 750 can;be applied to the.underside MixChamber(s I( ., { ( AR 42/42 or 52/52) f of the'`roof deck to a maximum of-20 inches and be left ba re,if its thickness is a minimum of 31/2 inches at roof deckingl Consult • f2:1ttransfer pumps are recommended:for}material transfer from container to Lapolla's Technical Department for details. the�proportioner.a i.k :_ �'' >,�-'*n r� rT r"c", �ry � B t"'^"'1 it I - - _ . LH • NCAUTION Extreme care7lmust be Oaken when removing and reinstalling- Ventilation Rate Re-Entry Period For: Re Occupancy Period drum transfer pump s so$s NOT to_reverse-the"A"and B"components. ro 0 i )i illI i,I��7 I� F►r ' I " iI sprayers,Helpers,Informed. 1 • DonotcirculateormixothersuppliersyA or'Bcomponentinto FOAM-LOK'"'r (Air Trade Workers&Contractors; FurAI(Others i containers. `' At 10.0 ACH 4 Hours_ , 24 Hours • The plural component proportioner must be capableRof supplying each component within±2%of the desired 1:1 mixing ratio by volume. • Lapolla Industries,Inc.115402 Vantage Parkway East,Suite 322 Houston,Texas 77032 1(888)4-Lapolla I lapolla.com FOAM-LOK7750 . FOAMmL6)m TM High Yield OC Spray Foam ICC ESR-4322 SPRAY FOAM INSULATION Bev.Date 09/13/2018 Start-Up Procedure FOAM-LOKI' 750 material drum temperature should be no less than Wear chemical safety goggles and rubber gloves when handling or working with 50OF and should not exceed 900F. Recommended temperature of 80OF these materials.In case of eye contact,immediately flush with large amounts of for optimum processing to occur. Temperature in excess of 90OF may water for at least fifteen minutes.Consult a physician immediately.In case of skin decrease performance and produce cosmetic defects within the foam contact,wash area with soap and water.Wash clothes before reuse.Applicators structure and surface. should ensure the safety of the jobsite and construction person-nel by posting ® appropriate signs warning that all "hot work" such as welding,soldering, For additional FOAM-LOK 750 start-up procedures, see Mixing & and cutting with torches should take place no less than 35 feetfrom any Application Guide. exposed foam. If "hot work" must be performed all spray p ppoIy-urethane Flushing Procedure foam should be covered with an appropriate fire or welder's blanket, ® and a fire watch should be provided. Before FOAM-LOK 750 is introduced to any equipment, purge any previous material from your system. Turn off and disconnect air to all In Case of Spills or Leaks transfer pumps.Remove the drum pumps from the ISO and Resin drums and wipe pumps and dip tubes clean. Ensure Resin drum pump housing . Utilize appropriate personal protective equipment is emptied. Place the drum pumps and dip tubes in.Lapolla's LPA-ISO . Ventilate area to removevapors and FOAM-LOK8 750 drums. Reconnect or turn on the air to the drum Contain and cover spilled material with a loose,absorbent material pumps. Use the drum pumps to purge the ISO and Resin supply and such as oil-dry,vermiculite,sawdust or Fuller's earth recirculation hoses back to their respective drums or into containers for . Shovel absorbent waste material into proper waste containers reuse. One to two gallons of material are normally purged,depending . Wash the contaminated areas thoroughly with hot,soapy water on hose length. When finished and changing into another system,flush . Report sizeable spills to proper environmental agencies the"B"Side(resin side)with 3-4 gallons of water. *THESE VALUES REFER TO THE TOTAL THICKNESS OF THE PRODUCT TESTED In Case of Fire NOT THE MAXIMUM THICKNESS ALLOWED PER PASS OR APPLICATION.THE Extinguishing Media: Dry chemical extinguishers such as mono ammonium FOAM SHOULD BE ALLOWED TO COOL FOR 10 TO 20 MINUTES OR UNTIL THE phosphate, potassium sulfate, and potassium chloride. Additionally, carbon SURFACE TEMPERATURE HAS RETURNED TO AMBIENT BEFORE ADDITIONAL AP- dioxide,high expansion(proteinic)chemical foam,or water spray for large fires. PLICATIONS OF FOAM ARE ATTEMPTED.FOAM APPLIED IN EXCES OR WITH-OUT ALLOWING FOR COOLING MAY RESULT IN, BUT NOT LIMITED TO EXCESS Positive pressure ventilation of the work area is recommended to minimize BUILD-UP AND COULD RESULT IN FIRE OR THE GENERATION OF OFFENSIVE the accumulation of vapors in the work area during the application.Improper ODORS THAT MAY NOT DISSIPATE WITH TIME. application techniques of this foam system must be avoided.This includes excessive thickness,off ratio material,and spraying into rising foam.The potential Thermal Barrier results of improperly applied materials may include but is not limited to excessive IRC and IBC codes require that SPF be separated from the interior of a building by heat build-,up,and may result in a fire or offensive odors which may not dissipate an approved fifteen(15)minute thermal barrier,such as 1/2"gypsum wall board or with time and/or poor product performance due to improper density of the equivalent,installed per manufacturer's instructions and corresponding code require- applied material.Large masses of sprayed materials should be avoided.When ments. There are exceptions to the thermal barrier requirement: (1) Code author. large masses are generated they should be removed from the area,cut into small ities may approve coverings based on fire tests specifi�e to the=SPF applicationFor on inleces and ay result in l a fireowedtlt is cool oemomen bfre ldedsth taalfireuretext�nlguisher be located in ow this anexample,covering systems that successfully,pa8s large scale tests may be�approved�easily accessible portion of the work area. by code authorities in lieu of a thermal barrier;(2)SPF!protected,by t,tt-k ck' on mas ry does not need a thermal barrier.Certain materials that offer.protection from ignition, called "ignition barriers,';-may noVb—e considered as thermal barrier alternatives DISCLAIMER unless they comply;with�NFPA 286 0 other simila(full scale tests.Applicators should The data,presented herein is not intended for use by non-professional appli- request test_data•and'code body approvals or otkheer written indications of accept- cators,or thosePersons\who do not purchase or utilize this product in the normal .tability'undi4 the code to be sure that the product selected offers code-compliant course of their bu"slness The;potential user must perform any pertinent tests protections. - p 4niorder to;determiniet�he,p oducts.performance and suitability in the ntended application,since finali'determina`tionMof'fitness,of'the.product for any'p"a�cular Safety and Handling � ��o fiche eta use is the responsibility of the buyer. Respiratory protection,is MANDATORY Lapolla;requires that supplied air.andra full face mask be used during the application oflany spray applied;foamtsystem?Con act All guarantees and warranties ias to fp o,ucttss\ssuupplied by,Lapolla Industries rlapolla Industries for a copy of the Model Respiratory Protection Program developed shall have only those guarraantee{s and warrantties�eexpressed`in writing by the i y p y g p i---manufacturer.The buyers sole remmeedy�as to"ranyfmaterial claims will be against b CPI or visit their web site at www. of urethane.or Persons with-known res ira- tort'-allergies.should avoid.exposure t�o-the"'A component'�The A comp the applicator of the prodb-;'Tyhe aforemen�tlon d�data,on this product is to nent'contains_-`reactive isocyanate groups. The materials=must be handled be used as a guide and is suli)ectfochange witfiout-notice.The information herein is l and used;with adequate ventilation.the,vap''ors must not exceed the TLV(0.02 parts believed.to be reliable,but unknown risks may be present. i per•million) for,isocyanates Avoid breathing vapors. Wear a NIOSH approved respirator., If inhalation ofvapors`occur.Femove victim from contaminated area NO WARRANTIES, EXPRESSED OR IMPLIED;INCLUDING PATENT WARRAN- and'administeriozygemif breathingis difficult.Call a physician immediately Avoid TIES OR,WARRANTIES OF MERCHANTABILITY OR FITNESS,FOR GUSE, ARE contact-;with skin,reyes,i and rclothing :Open containers carefully,allowing any" MADE BY LAPOLLA WITH=RESPECT TO OUR'PRODUCTS OR'INFORAA' TION pressureto be relieved slowly and safely:'°'` SET FORTH HEREIN. To the;best of ourknowledge,the technical data contained herein is true and accurate at the date of issuance and is subject to change without prior notice.User must contact Lapolla: Industries Inc.to veofycorrectness before specifying or drdenng"No guarantee ofaccuracyis given or implied Weguarantee ourproducts to conform to Lapolla Industries;tne,'s qualdy control. —gyp y g __ j g Imo- ----- Weayss e no res onsibilit-foccovera e,performance or in urie§resulln a[om.use. Copyright®2018 Lapolla Industries,Inc.5�11 rights reserved.Lapolla®and Foam-LOK®are trademarks of Lapolla Industries,Inc.in the US and other countries. • Lapolla Industries,Inc.115402 Vantage Parkway East,Suite 322 Houston,Texas 77032 1(888)4-Lapolla I lapolla,com Commonwealth of Massachusetts Ll 9 Sheet Metal Permit Map. Parcel W Date: °Permit# I 1 Estimated Job Cost:$ MAR 2 0 2011 Permit Fee: $ (�00 1I O� 6AHNSTA�LE Plans Submitted: YES NO ans Reviewed: YES NO Business License-# Applicant License# � Business InfoIInation: Property Owner/Job Location Information: Name:�i�il J 4� �,������ rName: /�I�� Street: Street: _1W� GCJCJ City/Town: &Af 2"y�4.1 c City/Town: Ile— Ww Telephone: e— ;9 2 2d? Telephon f��—oZ�y-� V2 Photo I.D. required/Copy of Photo I.D. attached: YES N0 sfaff Initial J-1 M-1 estricted.license J-2/.M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft./2-stories or less Residential: 1-2 familyk Multi-family. Condo/Townhouses :Other` Commercial: Office Retail Industrial Educational Fire Dept.Approval Institutional_, Other Square Footage: under 10:000 sq.ft. over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work. .- ' Renovation: T HVAC Metal Watershed Roofing Kitchen Exhaust,System - Metal Chimney Vents Air Balancing' Provide detailed description of work to be done:'' 0ev C>&PL AGE CJ `r r� SURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch.112' Yes J4 No ❑' If you have checked YM, indicate the type"of coverage by checking the appropriate box.below: A liability insurance policy ® Other type of indemnity [� Bond ❑ e thatthe licensee1. the insurance coverage required by Chapter 112 of the • .a away ,des not have OWNER'S INSURANCE WAIVER. I m Massachusetts General Laws, and that my signature on this permit application wajyes this requirement. Check One Only / Owner.,W' Agent ❑ Sign re of Owner or Owner's Agent ' By checking this box , I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metalwork and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and'Chapter 112 of the General Laws. _ Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments r Final Im-D.ection Date. Co= t TWe of License; By. (Master: Title ❑Master-Restricted - Cityrrown ❑Joumeyperson Signature of Licensee Permit ❑Joumeyperson-Restricted �3 License Number. Fee$ ` Check at��^•^Ar mass.aov/dl�l Erhail: Inspector Signature of Permit Approval OIVIMONY Fi OF SALT MASSAGHUS f • ETTS ' � SHEET. BOARl1 pp I 13S METgL Wp } , k VES THE ERS F RIC amity 'LLOVyING r MASTER LfCENs� , NNRESTRICTED� L Igryl L pHOTOs � »ar =J ` x I� SBNCH ST45la 9�CITUAT z 02066 2549 {r . . . 'p a28/2020 437871 IF J 1 - � IE�, s � CommonWealth of Massachusetts Class A Large Capacity y a G.L.c.140,§131) .Y Firearms(M. License to Carry oration Date: r.;�• � 4� �8, �R € License Number. Date of Issue: '� 025 ... /y 2 0310212019 Jv ° 12866534A B ry ,���, - g 1' ��/� � issuing CitY/rown: SCITUA�E—P� _I L , '"' Restrictions:None PHOTOS ,W LLIAM STREEN HC t r t a RAN SCITUATE,MA 588 02069 '. I 4'SQIgTMA 02066 g s ZZIfii any (4 Y( $-"M1" r 'r �sHcr4 01 � of Town,of Barnstable Building Department Services` sAaN^TABLF = $Tian Florence,CBO RASS. 2639. Building Commissioner ED MFj� 200 main Street;Hyannis,IuIA 02601 � www;town.barnstable.ma.us �. Office: 508-862-4038 Fax: 508-790-6230 Propert r.,Owner,Must` Complete`and Sign This Section if Using A Builder` I (,L kir U..J e "/ ,as Ownet of the subject property r p. hereby authorize to act on my behalf in all triattets felat v-e.to work authorized by this building permit application fog (Address of Job) 'k Pool fences and alAt4n are the responsibility of the applicant Pools ate flot to be fined or utilized before fence is i-astaRed and all fin2i itispections are perfogned Md:accepd.te Signature of Owner Signature plicant Print Name Print Name R Date s Q--'ORI B:0WNERPERNMSI0NP00IS Rev:08/16117 Town of Barnstable ' Building Department Services Brian Florence, CBO o B'Iding Commissioner T 200 Main Street, Hyannis,MA 02601 XAse www.town.barnstable.ma.ns 1659. Office: 508-862-4038 Fax: 508-790-6230 HOi MOWNMLIMSE EXEMMON Please Print DATE: JQB LOCATION: number strut, village "HOMEOWNER name home phone# : . work phone# CDRRF�1`lT MAILING ADDRESS: city/town. state zip code The current exemption for"homeowners"was eaten d to iacl a owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who doe not pas ss a license,provided that the owner acts as supervisor. D OFHOMEOWNEH Person(s)who owns a parcel of land on which he/she r ide r intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures*access such use and/or fay structures. A person coast acts more than one home in a two-year period shall not be considered a horn er. Such"homeowner"_shall submit to the Building Official on a form,___ rrcep�ie o e Bmi! 0M=A t�her'she s 'be r cnisib'6 for ail Su ch or euomed under the building ems. (Section 109.1.1) The undersigned`homeowner"assumes responsibility or c pliance whit the State Building Code and other applicable codes, bylaws,rules and regulations. The zmdersigned-homeowner"certifies that he/she. the Town of Barnstable Building Department mimTnmu inspection procedures andregnirements and that he/she will c ly with 'd procedtnes and requirements. . Sign ai�e of Homeowner. . Approval of Building Official Dote: Three-family dwellings co g 35,000 cubic feet r larger will be required to comply with the State Bm7ding Code Section 127.0 Construction Control - HOMEOWNER'S aN The Code states that: "Any hom owner performing work,far which a building permit is required shall be exempt from the provisions of this section'(Secti 109.L1-Licensing of,construction Supervisors);provided that.if the homeowner engages a person(s)for hire to.do such rk,that such Homeowner shall act as supervisor." Many homeowners who use exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations or Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particul y when the homeowner hires unlicensed-persons. In this case,our Board cannot proceed against the unlicensed perso as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeo' er is fully aware of his/her responsibilities,many,communities require,as part of the permit application,that the homeo er certify that helshe understands the responsibilities of a_Supervisor. On the last page this issue is a form currently used several towns. You may care toamend and adopt such a formlcertification for use in your community. Q.IWPFTLES\'FOAMSIbuldingpemiitfn=\=RESS.doc 08/16/17 - 0—we a 'tea tarty 600 WashhWbn&-eet Baystor4 MA 02111 • � ' �v�urxt�gfrv�`dia WiarjM s' C=PMI�I•as =c�Affidavit B�afl&rsJ traciarsMechicbn&Tlmbers j�f'�.�-minas' Pl eftATrplka� E,e Nana CE Ac f Pi lu /- Are yGu an employer?Cfie&the agprogrlate ba= ' Type of project(ried): L❑ I am a einpl zs w E I am a general c6:dmctoi and I 6- []New caasE Flatfizlla�fa:parrtime * avelv=ettfhe sub-come I am a sgle grnp�ieta�arga of listed flnthe aftacbed s•1 ❑ °° � s and >co Empi Zes T;sese=Lb-cb�ad=have g,,ElDemal�g waddng for me ia ay y wee f or3cers' �- $ xdd i comp `�'�' jNu w osm'�P- e " MLEJ Ek#d ai repaim cr amens .. 5- [] Wease a cnaparat�uaarl7fs € d 1. officers have etP ed fbf�r' 1LE]131zmbiu9repa=or adf"'.us 3.❑ I am:a homeowner doing aU work af per 1�t�L o wuik� �F jigbt g F L O Z a regain �sicrtsanre re Esi=efiJ 1 nll oluer exaplcryees.[�O WQt�' S' comp_in uc�r�q�rea� •g-mY%Pp mac cbed�6az�l atsu fill cr�tire sectr�berusv •�A 9i� 3ceb'®�safigapa�c�*i � #home ,dm submit c�dtEeah�natsi�e c samst sabmit an�cv:�a�-est fl sacb I crosm�rhxlr$tin 6ux Pest sv sddvTi®sl sheers gtbea�s of t3�e sum c �i sty�h�3hec arnvt ffinsa�z sbZve .7fthesnb rrtashcsh�c a tm�i45ida sc 'mmp.paS�e asm3bet am an vrspIoparirrtispraM*Hrrg svrrrkers'rosssr �rrt mmranna�vr zrz}�sasFlal�ees. J3ela�v is f7sd7iiy m�jai sia i�corr+iaiiou Inuzanfe companyarae Pofie},4 or Self-m J io_a aaDa Job Sit-- Address - _ _ Ciwst2czet ap teach a copy c tine tisorkuL e.: peas �sxpoTi Te ratiozi page(shawisg the poficp ssber asrd p on ). Fa�lnre t o sec=caveFage as gniss clnade�Se�g 25A of MCIT c-1�c=lead tQ I ie imposition of cdmfilg pesMttaes of a fine up to$14 17�}andJ esr asiaearimpsisa as w�Il as ciVl.ps me fa�c a ss STOP WORK{1%DF:Rsad s#me ,of up to$25Q-€0 a clay Rgaite .via9� Be aAvised t a copy-of ►is s snap be�.fa the Office of. IvvesEga#iozss c the DIA for ias=nce covage VeEiScafi= .IrIa rlvm- y cam,fir-,. ofFar,j-itly thd—liB i atrrra r� rrm alien i bars c d cmr�t Si�at> �7 � c Asa C-n].!y IJa rirl#�it�a�tT�of�a,.�a Fie-c umpLetad 5y city artairu��crtrL Fe,-rrcrffT,cpFssE� . I-Board 0firea h I 3. 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I .i••.•! u[a • i71 r\ •u .f J of■:+ - _ ■■n - ■••a r • w1■i.a 4 ■1 r.■nm• ..If •1 ■...... a■ .u.f n .0• ■■ u.. a .■uw r w. •rues ••• .ail - • ■wm 1 u f u■a rn rf a ■:+w•19 A ara Iu .n a .uun - - ■n .�■•. ■ i• ■ 1 va•.um - a■ ■ n u_u. •■ a .a•.n. OR ■u .•alwru•■ .u■ ■■■ ■ •■■ a. a ■a:.•m All �■ f a sea nut •al w r e e m .0■ r.■ utua•r ■- •1r:ar a_r•tea: u a �=wr: ■ a�w,aa, /•7.1■.■ km&Lil;glxala n3:.y1•. rw a:ia a. •�� ��.w11a11' f a■ 1 � It �a Iia .i .�, all ' ••,• ae. •-a • war Town of BarnstableBuilding Posh?his„Car h '�t isU�s�tile From the Street A�""roved PlansM,ust beRetairied onJob,a^dthis Card Must,be Ke ,t„ • d So T at pp p - M' Posted UntilFinalxlns ection Has"BeenMade� x Permit 1634 s -` try ', r a z Where",a:.Certificate,ofOccu anc is;"Re u�red;suchBuildm shallNot be Occupied until a Final Inspectio„ ,hasbeen made ,.' r _ ,> ... p � TM OM :�... Permit No. B-18-2680 Applicant Name: KRUSELL, ERIC_H &ANNE M TRS Approvals Date Issued: 09/07/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 03/07/2019 Foundation: rok Id-q hso Location: 38 LAKEWOOD DRIVE,CENTERVILLE Map/Lot 212 002 Zoning District: RD-1 Sheathing: Owner on Record: KRUSELL, ERIC H &ANNE M TRS Contr ctor Name Framin t1 l so " iJy Contractor License:, = ; �J .. a". Address: 72 CEDAR STREET ' � ,. � 2 SCITUATE, MA 02066 Est Protect Cost: $60,000.00 Chimney: Description: REMOVE EXISTING ELL OF HOUSE AND CONSTRUCT4 24 X25'6" Permit Fee: $356.00 t 9 �= insulation: I ADDITION IN ITS PLACE CONSISTING OF 3 BED,ROOM$AND;BATHS. fi Fee Paid $356.00 REMOVE AND REPLACE WINDOWS IN EXISTING,HOUSE NEW SIDING y Date 9/7/2018 Final: v °� . . Project Review Req: CRAWL SPACE. FRAME WILL REQUIRE ARCHITECT APPROVAL o �. ,f �i Plumbing/Gas Rough Plumbing: Building Official _... _ .... � Final Plumbing: t. Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application andthe approved construction documentsfor which this permit has been granted. All construction,alterations and changes of use of an building and structures shall be m compliance with the localezonmg by laws:56cl codes. g Y g Electrical This permit shall be displayed in a location clearly visible from access street or road andshhall be ma1,tamed open"for public mspection for the entire duration of the work until the completion of the same. ti � � �_ - Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided"on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: :r .. .�. . 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: s E]m Q l�9 co p� 0Application Number. ... • fABNSPABI�. • �P ., .LL Permit Fee............. .......................Other Fee:....................... MA88. 039. (' R, a Total Fee Paid....... ....... .......'..................................... ...... ...on.....` h. TOWN OF BARNSTABLE Permit Approval by..... ............:.. ... ..._. BUILDING PERMIT' ...DUD. lvtap. ( '................. ....Parcel... APPLICATION Section I Owner's informationand Project Location Project Address. 9- e t-oar P i� Village Ge'--k rys Owners Name .1 i s d l°f V S e Owners Legal Address >� C- t Sr a zip State City, 16��k k Owners Cell#: ��' �y E-mail rR I C.k1l�/I�� foz ra*1 Section 2 Use of Stractare ' Use Group ❑ Commercial Structure over 35,000 cubic feet ` ❑ Commercial Structure under 35,000 cubic feet ❑; Single./Two.Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑' Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System Addition ❑ Retaining wall ❑ Solar Renovation ❑ Pool ❑ Insulation Other Specify. Section.4 Work Description s avf .2 �2- 6 ' a 0.0 " is ..% C-g— T Act undated.2/9/201 9 Application Number..........................................:. Section 5—Detail Cost of Proposed Constriction. O Odd Square Footage of Project Age of Structure F6 8 Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed') 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6-Project Specifics ' (� Wiring ❑ Oil Tank Storage 0 Smoke Detectors 0 Plumbing ❑ Gas ❑ Fire Suppression Heating System ❑ Masonry Chimney - Add/relocate bedroom Waxer Supply . Public ❑ Private Sewage Disposal ❑ Municipal 5• On Site Historic District ❑ Hyannis Historic District ❑ old Kings Highway Debris Disposal Facility: 6� ! .f I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,'coastal bank? - 'Yes No ❑ Section 8—Zoning Information Zoning District Proposed Use I=n Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage ® #of Dwelling Units (on site) Setbacks Front Yard .' Required Proposed Rear Yard 'Required Proposed SCE Side Yard Required 10 Proposed o2 0 Has this property had relief from the Zoning Board in the past?. ❑ Yes [ No ` Last undated:2/9/2019 14 --- -- I-- r -- - - -- - - - .--- == - DEC 032018 :]Tr TOWN OF 13A'RNSTA i.. I - Arme" P 0DR�oM l: oo -- - -- __ — --- -` An� VI �. A s _ ok Ar_ tilt D Lot V 1 t!/G a-LA P6 C 3 20lg t 1 �►." /Zooms► � lf_A� POMP -(I,) 1 "x � �°���Pill ' �k b r •i 1 No lip �l•furl � �! � y�y,; r _ _ ---- < ............._ - - ---- - _ F f -4 12 *P: 4 lI ollr4 02 r i LA fT V/LL9 RED ARC !� did do Sp tvz -• •��� Off' �` `` � ` \ 1�'' ., —'— _ t °mac �O op . Ou �G�<c;• NAY$,4r.FS ���� . f Bank_-__ _ __- -__ ,__` 38 PRO POS b. G�l a� --40 t s8./t 'r BQ' � 10 Q. al A_ �G yJ --46 CV Ip 1 POP of *Alf) A r 001 S 1" _ 20 � PpC llilk Pyy AI � e,0 f�Olt OP `w o wgrF S� f dbc3it .` a { 5 &Otto ; ---34 NO --- S rr t -'36 s*AK E p pv Tp' - f Bonk- 38 PRO POS �, ���� TREEt ,•.'' J.� �j� Qs ajQ':$��5��401� 9tr . � ,�•, v. 4b ao K t t 3116 pia� • . .�"�l'�11 T" � 5$ �t ► ;�.f 4� �p , }�' ;` I{N E so ��! y C 1 � O �e -48 03 -5D 13-1 ,. x a i �.00l j ,s H : CAI r s: t y " r bn Fo�� RiGN1 si P4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individuai): j _r ).e Address: City/State/Zip: Phone#: 9? Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 2.]�,I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling // ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'comp.insurance comp.irnurance. required] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152, §1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Amy 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 notthose entities have employees, if the sub-contractors have employees,they must provide their workers'comp,policy number. 1 am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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 D1A for insurance coverage verification I do hereby certify der the airs and penalties of perjury that the information provideZ ve is true and correct Si ature: Date: T lu Phone# Official use only. Do not write in this area,to be completed by city or town ofjkial City or Town: PermitJLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town,Clerk 4.Electrical-Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that`_`every state or local licensing agency shall withhold the issuance or renewal of a license or permii to operate a business or to construct buildings in the commonwealth for any applicant who has not produced'acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any,questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permMicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture required to complete this affidavit. leaves etc. said person is NOT p (i.e.a dog license or permit to bum ) p �' The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. ne Commonwealth of Massachusetts Dement of Tmdustrlat Accidents Office of Investigations 60Q Washington Street Bostan,MA 02111 Tel,#617-727-4900 ext 446 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.M=,gav/dla Application Number........................................... Section 9-.Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section.10 —Home Improvement Contractor ' Name lk Telephone Number Address City State Zip y Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.LC... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: f i L V sq- Telephone Number-�)e9l—.2 T% 0 2/2 Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation req ' ed by 78-0 CMR and the Town of Barnstable. Si `✓ c� �� .Date APPLICANT SIGNATURE Signature Date 6 /� Print Name �5trZ ](V\L e. Telephone Number 3)efl S - 1)2Y.-.� E-mail permit to: I • T..oF.....i..sea.IN innnt o Section 12 —Department Sign-Offs y ' Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization L , 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 for: (Address of job) Signature of Owner daze Print Name Last undated:2/92018 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . Map c� Parcel Permit# 9 Y Health Division t tl Date Issued h-1 ` Conservation Division Fee. Tax Collector t Treasurer (e �5�r� Planning Dept. F Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address g LlqeeeGc.le� avz - Village Ae ,Owner �2M wi G-e� Address Telephone Permit Request - �P ,, S> X sic c� W� r Square feet: 1 st,floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost %3000 Zoning District Flood Plain Groundwater Overlay. Construction Type Lot Size randfathered: ❑Yes ❑No 'If yes,attach supporting documentation. Dwelling Type: Single Family �TwoFamily ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No 'Basement Type: ❑Full : ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms:- existing new Total Room Count(not including baths):existing new First Floor,Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove:. ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing 0 new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 'Zoning Board of Appeals Authorization ❑'Appeal# Recorded❑ . Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION ' Name-' FRASER (_r*"iA STRt MT111At Telephone Number Address 71 TARAGON CIR. License# - COTUIT MA 02635 Home Improvement Contractor# 508) 428.-2292 Worker's Compensation# 6—r Sys yg,�) 56 3 0/1'7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,�,��-t.. SIGNATURE DATE 571811 ' FOR OFFICIAL USE ONLY - PERMIT NO.'r' DATE ISSUED1. s L 4 r MAP/PARCEL NO. 1 tF • •.S • ` ! i } W �.a. few �h. r , ADDRESS. �.. ..; VILLAGE Cia OWNERS . r DATE OF INSPECTIOMI. ` t u FOUNDATION FRAME INSULATION FIREPLACE , •- - e.� - '• L ,_ . •• ,` � , r ELECTRICAL: ROUGH FINAL T I. PLUMBING: _ ROUGH FINAL I t ° GAS: " ROUGH FINAL FINAL BUILDING ; DATE CLOSED OUT f } ASSOCIATION PLAN NO. ? The Town of Barnstable m Department of Health Safety and Environmental Services Building.Division 367 Main Street,Hyannis MA M601 , Office: 508.8624038 Ralph Crosson Fax: 508-790-6230 Building'Conrmissioner Permit no. . . . Date AFFIDAVIT SOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that dw"reconstxvction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pro-existing owner-occupied huilding containing at least one but not more than four dwelling units or to amcm s which are adjacent to such residence or building be done by registered contractonr,with certain exceptions,along with other requirements. Type of Work: Estimated Cost Address of Work: 31 ®OZ Owner's Name: Date of Applkastion: 9 -- I hereby cart*that Registration is not required for the following reason(s): Mork excluded by law (3Job Under 51,0W pBu Wb*not omw-% upied p0wner pulling own permit Notice Is hereby given Oft OWNERS PULLING THEIR OWN PERMIT OR DEALING WITS UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142 4. SI MNBD UNDER PENWIES OF PERJURY I hereby apply for a permit as the agent of the owner: all, C Dare ConnowName Registration No. OR Date Owner's Name q..*ms:Affldnv The Commonwealds of Massachusetts ...: Tj_. -_ Department ojlntlustrial Accidents 600 Washing ton Street Boston,Mass. 02111 Workers' Coen ensation Insurance davit name: FRASER CONSTRUCTION 71 TARA►GON CIR. ocat p : lull MA 026' city 16041 42R 22-en phone it V j: - ASS.-4 ❑ I am a homeowner perE`ormtng all woik myself. ❑ I am a sole ro rietor and have no one worlddn in atn►ca�acity I am an employ on for my employees working on this job. wmgnnvname. 73 raRaa4,GON GIR address: COTUlT MA 02635 :: ..08) 428-2292 dtv: phone#: nsurance ca. L, hoa iu AJrQ 011cv#I 1A AGO // /////Y/i ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comnanv name: - address: dtv: --— phone# 7 . insurance ctr lieu t! ......... :: •..:. :,,.:,,.. company name: address. dtv: ... :...: "hope#: insurance eo .:•.;.:.....lieu# ::;:;•;:, Failure to secure coverage as required under Section 25A of 11GL 152 can lead to the imposition of erhmdod penalties of s One up to S1,500.00 and/or one years'Imprisonment as well as civil penalties in the form ore STOP WORK ORDER and a One of S100.00 a day against me. I understand that a copy of this statement-may be forwarded to the Of ee of Investigations of the DIA for eover ep verification. I do hereby cerd the sins enaltles oI perjury that the injomudon provided above is&w..and coma Si tune Daft: i� _ Print name 2,)P—ps� Alp Phone d Q��C Ccontactperson: se only do not write in this area to be completed by city or town of&W wn: per"Mcense 0 Mudding Department 7_ [3Ltcensi"g Board itimmediate response!,requited ❑Seieetmdi'a OlOee �Bleait!►Depar"nent phone H: QOther ... .. . (!Hied 9195 PlA) p � cop ` SMOKE DETECTORS REVIEWED R tiLRTMENT DING D T. DATEE DATE ��M ` r BQTN SIGNATURES ARE REQUIRED FOR PERMITTING _._ -...-.... .. _...._ _..... . -- _ --._ .Dept. e - Approved by. -- perm t . jjl ew An- NOW Way i _ — vVIMPAVA rt��a�V C� f" I'7 O r P.-r '1'va 'Zr� '1� 01 rogArt., ice - Cis, A4 *vv*c4w e.7Y CT .46,o) o�4 N I-�1% �ERED ARcy/ y: c, No. 6978 • CD SCITUATE �o MA <ycT . r 4-41A. etlWi PH-O&AP Mfg .AX' 4o' V.OPrIv#n, 4'� i 'LAB GUI Go eouo4 An $V�lPI� Wes/ `'�,�•���4M�r I,r�_/ r . Jvt" P�"bU W�Ybt�'i - G �cr�w) lei(I t --Al -WAl ?fin mil"+- �.r, VI.f� T_ . Alk .►Y'- PAW- 2 4- W dri"O,Nt G, r �A �n�ya�r .� d�:hwc r IVY AWLIM. i Ate_ ,�. X -�,ry� 4mlo,,1+ DNF 2�� JOld'� '• 1s'11'JI P-6/li n f'I �iW+Gpf t01� teo a.!'' Or eumJ A, t)e a �,�+�Ci i'V l7t ply t�3tTW� vd� Ct"�(C3 C o< o 4 01" 0 ._. i p•�t fad , Poker f a'� . S��RED ARC, c� No. 6978 r SCITUATE � 'v` MA Y w i G�cNi"►V�J - �•fi let V 1 N!j PWM YLE 4(1 NO 6978 or s 1 } SCITUATEMA — jj� � '/� "a I�—pw � 2� ` q�N o j 4 5 P A-c� M — .G�t�1 pr. Pvt�'7f/ i I !v h P I I w rfi1` t T- t 4- I , ' h ld ol IL c� No. 6972 � � 7L\ 1 O !Tl_IATE - — A ,