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I!, '.tl "p41 .,A 'I t Ile,;xAo"j, IT A 'I 4h * -1 " '114�,j- A r'e, "Ilk U, ,vt 't, i I"L 1 '.11,1 '1 1 A 1 1,,I I If 0 fn J�4 ',o �1� :1�s I, —.1, j. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map jV7 Parcel. �� Application # o?L)f 5 S Health,Division Date Issued 9 2-3 1 - Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic = OKH _ Preservation/ Hyannis Project Street Address Village �'Gh/ �� di Ile Owner_Eo "Ie Address Telephone�7®J�".2 L 7$L_KL7 Permit Request / ��/yc/ y:.� dS'c y yf /2 2/ CzoS� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation -,4-Z .0 G> Construction Type l Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ONo On Old King's Highway: ❑Yes A 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 ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Y as ., Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use -�p .g APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name�'�� e-1,� /l/v�f� ot� Telephone Number -5o�7���/�'� Address License # Ghr.� Home Improvement Contractor# f���S' - Email Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE.,_�f��S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE 4 OWNER f DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL FINAL BUILDING s DATE CLOSED OUT ASSOCIATION PLAN NO. MasyachuSetts Department.of Public Safety .:Board°of Building 130gulations and Standards Con.strnction Supervisor ~ License: CS-100988 :r HENRY E CASSIDY ;� h 8 SHED ROW WEST YARMOU?TH " 3 Expiration Commissioner 11/11/2015 Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite'5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type:' Private Corporation Expiration: 12/15/2016 TO 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 - Update Address and return card.Mark reason for change. sCA 1 45 20M-05/11 Address 'Ej Renewal Employment Lost Card V/ie cpan�n�aoracvealC�a�C� cu�gac�ccaeCi �Z\ Office of Consumer Affairs&Business Regulation License`or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date.-If found return to: egistration: 1,53567, Type: Office of Consumer Affairs and Business Regulation j xpiration 1.2115/2016 Private Corporation 10 Park Plaza-Suite 5170. Boston,MA 02116 CAPE COD INSULATION INC HENRY CASSIDY 18 REARDON CIRCLE - S0.YARMOUTH, MA 02664 Undersecretary QNO/valid `Air" The Commonwealth of Massac'huseits Department of Industrial Accidents Y ". Offce of Investigations r 600 Washington Street F. Boston, MA 02111 www.mass.gov%dia' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AP licant Information ,q"� ;Please Print Le ibl Name (Business/Organization/Individual): '�} j �'� 1 1! ?/�✓ ' Address: City/State/Zip: /�, y f a Phone #:•1j -1115 Are you an employer,? Check th- appropriate box: Type of project(required): , 1. I am a employer with �� 4..❑ I am&general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 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 mein any capacity. '' employees and have workers' com insurance.$ 9. ❑ Building addition [No workers comp. insurance .p• required.] - 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions } officers have exercised their 3.❑ 1 am a homeowner doing all work 11.❑ Plumbing repairs or additions myself. [No workers'.comp. right of exemptiod per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have.no - employees. [No workers' 13. Other mu - comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees;they must provide their`workers'comp.policy number, I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site' information. 4 Insurance Com Name:an P y Policy # or Self-ins: Lic. #: 0j . ` Expiration Dater s�! I, 1 Job Site Address: ' s J�D X,�?Zw __:04 4�e lfil�i� City/State/Zip:.Ary;w j z ?z 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 STOPMORK 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 Investi ations of the DIA for insurarw.%covera e verification. I do hereby certify d the pai an penalties'of perjury that the information provided above is true and correct.' Si nature: ° ! — Date: Phone#: Official use only. Do not write in this area, to.be completed by city or town official. 4 City or Town: Permit/License# Issuing Authority (circle one): • a 1. Board of Health 2.Building Department;3. City/Town Clerk 4. Electrical Inspector 5:Plumbing Inspector 6. Other Contact Person: Phone#: 4ti • CAPECOD-27 BDELAWRENCE ACORO DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/30/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, z IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement..A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). - PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAx 434 Rte 134 a A/c No E c; Alc No;(877)816-2156 South Dennis,MA 02660 EMAIL ADDRESS:" INSURER(S)AFFORDING COVERAGE NAIC N. INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED - INSURERB;ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURERC: 18 Reardon Circle INSURER D: - South Yarmouth,MA 02664 INSURER E e INSURER F i COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR TYPE OF INSURANCE AULJL R POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYY MMIDD LIMITS - A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063 '04/01/2016 04/01/2016 PREMDA ISA13E TO RENT ES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY•• $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES:RER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT FLOC PRODUCTS.•COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY ,e ,o - - - .COMBINED SINGLE LIMIT $ Ea accident _ ANY AUTO. BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE, $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431901 06/30/2015F6/3�0/2016 E.L.EACH ACCIDENT. $ 1,000,000 OFFICER/MEMBER EXCLUDED? N 1 A ' (Mandatory in NH) E.L.DISEASE.EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below 'a E.L.DISEASE-POLICY LIMIT $ - 1,000,000 s DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES"(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors. 1 - Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, CERTIFICATE HOLDER `' CANCELLATION• = SHOULD ANY OF„THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE' THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 18 Reardon Circle South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION,_All rights reserved,, ACORD 25(2014/01) The ACORD name avid logo are registered,marks of ACORD Town-of Barnstable , ' , Regulatory Services 8, Richard.' .Scat,Director Buiidivag Division Tom Perry,Building Commissioner 200 Main Strect,Hyannis.:MA 02601 w4v.t6svn.6rnstable:IIi2.o5" ` Office: 508-862-403$ Fa)u'508-790'6230 a Property Owner Must $" Co tx�plete and ..i�g :Tbis' Sec ion p, as of tlie,nkjecc ro n ff —j- p I� Y ., • .. . . hereby.aut orim QCl 1 'O v+. to act on mybekialf, ; in aII matters ielativ+e to.a rk aixt6o17p by this binding peimitapplication.for. r. SocJ (Adchtss of jofi ""Pool fences and awn s are the r�espOAS ibili�of l�e'applicant Poo15 3 are not:tu be.filled or utilized-before fence i 'installed-and all final uupections'are peafonned.and,accepted. Signature of Owner V Signature.of Appkaat 4 arne _--�-� print,Narxie Print.N < �� .� Q:F0RMS-0WN'F:, MffSSIQNPQ0LS tt , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,. Map Parcel Application Health Division Date Issued: ` c. Conservation Division Application Fee Tax Collector Permit Fee Treasurer Planning Dept. t. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address (io `Y�(' C Village �.Xt l� Owner _A[ Address a, u ' Telephone Permit Request cN w—seoiDira Square feet: 1 st floor:existing proposed 2nd floor:existing proposed i Total new Zoning District Flood Plain Groundwater Overlay Project Valuation °� Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes � On Old King's Highway: ❑Yes .OTNo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)C.7�o ? C Number of Baths: Full:existing new Half:existing - neW Number of Bedrooms: existing new w c Total Room Count(not including baths):existing new First Floor RoomCount E5 Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other v r` 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:0 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 D � ;�dJ� In L Telephone Number So ?? �q q. gQ�'s(1 Address _ � License# (?)q q 1 LQ Y,. IS Home Improvement Contractor# 1��� '�'� Worker's Compensation# y_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PRGJJT 1WILL BE TAKEN TO 11 SIGNATURE DkTIll FOR OFFICIAL USE ONLY APPLICATION# --. DATE ISSUED ti R• MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: r � I FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' r z d OWNER AUTHORIZATION FORM (Ow er's Name) owner of the property located at (Property Address) Cu-rT��2.V 1 L-t.G ,mil/t 02 iP 3 2— (Property Address) hereby authorize (Subcontractor) { an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date 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/Individual): ns 61 ixvc , Address:�l � hLe eQA..in City/State/Zip: Phone#: Are you an employer?Chec the appropriate box: Type of project(required): lam a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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' [No workers'comp.insurance comp. insurance.: 9. ❑Building addition 10. Electrical repairs r additions 5. We are a co oration and its ❑ o required.] ❑ corporation p . 3.❑ I am a homeowner doing all work officers have exercised their I Ln 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' comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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 thepolicy and job site, information. Insurance Company Name: fax no Policy#or Self ins.Lic.#:5� (g)V7"c rJq Expiration Date: Job Site Address:��"1 ( City/State/zip: VI 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$250.0oa4,ay against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigation of a IA r insurance coverage verification. I do hereby erti u r the pains and penalties of perjury that the information provided above is true and correct. Sip-nature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town.officiaL City or Town: Permit/License# 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 permit 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 number(s)along with their certificate(s)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 permit/license 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-copyof 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 (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia r t3iStitt ni 0f public S til:trat:hu�ctt•_Oct Boas tl tst BuilQin��R,,ulation and titatutartl Construction SuperV'asor License Licrie: CS. 8491fi . < U ;:x MALL J }IOPKLNS BOX 231 gQ YARMOU_K:MA 02W Expiration: 4aa013 Tr=: 14504 .. t ii liPY#f^ztUi�YY' Office Xsume '�}`a sZF'$ifsineshet"_A 60 Lictfnse-orregistiation valid 'for►ndiyiduluse;onlp HOME IMPROVEMENT CONTRACTOR before the expir-ation date. If'found returt> Regtstratiop. 161773. Type: Office-of Consumer.Affairs:and.Business ltegttilaon Expiration• 11l20/2o12 Private Corporation 10-Park Plaza -Suite 5170 N. i 13ostoa.:x-o 6. Mfi HOPKINS BUILDER$IPIC3. NIALL HOPKINS 21 G FRUEAN AVE -SOUTH YARMOUTH MA 02664 ---- Undersecretary �Iot val' nhthoytsigoatur-e, ^ a A400 CERTIFICATE OF LIABILITY INSURANCE TDATE(MMIDD/YYYY) `...� 09/09/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NAME: Mark Sylvia Insurance Agency PNCNrE �: 508 428-0440 FAX 508 20 9227 771 Main Street Arc No. E-MAIL ADDRESS:markCZDmarksylviainsuranoe.com OSterville,MA 02655 INSURE S AFFORDING COVERAGE NAIC# INSURER A:Farm Family Casualty Insurance INSURED INSURER B: - - Niall Hopkins Builders,Inc. 118 Lakefield Road INSURER C: PO Box 231 INSURER D: South Yarmouth,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE D BR POLICY NUMBER MPOUCY EFF POLICY EXP LIMITS A GENERAL LIABILITY 20011_6275 10/30/2010 10/30/2011 EACH OCCURRENCE s 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100 000 PREMISES Ea occurrence CLAIMS MADE ❑x OCCUR MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: .PRODUCTS-COMPIOP AGG $ 1,000,000 X POLICY PRO- LOC $ A AUTOMOBILE LIABILITY 2001 C53575A 6/25/2011 6/25/2012 GEOaMBIINED'enijSINGLE LIMIT $ ANYAUTO BODILY INJURY(Per person) $ 1,000,000 ALL OWNED SCHEDULED BODILY INJURY(Per accident) 8 AUTOS X AUTOS 1,000,000 NON-OWNED PRO PER TYOAMAGE $ 1,000,000 HIRED AUTOS AUTOS Peracadent UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE 8 DED RETENTION$ $ A WORKERS COMPENSATION 2001 W6459 9/8/2011 9/8/2012 wC STAT LIMU- X oTH- AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? FN N/A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Carpentry,Electrical _ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1146 RIB 28 ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION{. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD :1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel . .Application # l CCov Health Division L 2v6 YZ bate Issued 'Conservation Division Application Fee Planning.Dept. ; Permit Fee, f5 Date Definitive Plan Approved by Planning Board k �Il�Ioy, Historic =OKH Preservation / Hyannis Project Street Address `7/1 so W t 4 4//.V S Village Y, Trk Owner MD — y) g q� Le k T Address � - `_L'' Telephone CZ/2•- 91-S_ �- i v Permit Request Y �/ �� '��, Y �� , a Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 10, 0012 Construction Type Lot Size Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Q Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes 10 No Basement Type: M Full ❑ Crawl W Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing. i 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: 0 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes 4111 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:IN existing ❑ new size—Pool: ❑existing ❑ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name KGV M A-575n Telephone Number ,/--s-C.P'a g-66 0 L Address 91 IT OLv,4 4D -Sr 7-fL 8 QyR® License# K J VV I S-ro Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO N t� TA U Vk 11b vsr✓1 SIGNATURE DATE :3/ 2 .3 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATIO 0 111/01 _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 0/ )0 DATE CLOSED OUT ASSOCIATION PLAN NO. F ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street T Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):�L'u i 1/1 j¢j y'JC �J Ana 9,(G'9 z, -A g 1(L- 4 t,���t2LXVollaIi Address: R1 AdGMX5:;Z1 S 7` t/ City/State/Zip: �� ?� Phone#: d ~,;?a22 P 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.IN I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ 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 1 LM Plumbing repairs or additions o myself. workers' right of exemption per MGL y � comp. 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.]p q ed.] *Any applicant that checks box#I 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. t Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: V z IrLAM10146 , ro 4 Policy#or Self-ins.Lic.#: IV �,��_,� / ' Expiration Date: Job Site Address: ��/ c7D p✓�/�i/f7 .� City/State/Zip: 01!�-li/ te f//G L Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and pena ies of perjury that the information provided above is true and correct Si ature: Date: A Phone#: e3r Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# 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 M 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 permit 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." 1 Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)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 permit/license 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 (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. 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: t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 1 www.mass.gov/dia 1 ,1 �'lre �ammo�uueal�/ a�/�aa°ac�u�aelta Board of Building Regulations and Standards Licensee ezg'►ration date if found r turn to oril� 'beforet p, HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registratto-:,157846 One Ashburton Place Rm 130.1 EiIration a /8/2009.- Tr# 261360 Boston,Ma.02108 3 t7? i �y, Type DBA� 1;. AMERICAN CARlF47EN-T£RY4ANDMODELING ` . KEVIN MASTON i - nature . 21 HOLMAN ST4 ! t_ ^^"Q4'' ' Not valid with t Sig ATTCEBORO,MA 02703 �.F, ' Board of Building Regulations and Standards Construction Supervisor been, ` + i ) License• CS 95547 1 t� ,1< Birthdate -4/-5%1955 4 r -91 ^ u � pirtionF 4/1s5%2010 Tr# 95547 1 Restric ion I � I_ KEVIN .MASTON �t r I 21 HOLMAN STREET ATTLEBORO,MA 02703 �y Commissioners . s"�rorti Town of Barn-stable • f Regulatory Services BAMSTAUM ►HAss. Thomas F.Geiler,Director 39. E0 ��� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstabTe.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, eyG as Owner of the subject property �hereby authorize ��j �,� j//�P eu''57—,o A, to act on my behalf, in all matters relative to work authorized by this building permit application for: Ll A) S I C�,1 TC'n2 y1L1-6:: (Address of Job) Signature of Owner. Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:F0 RMS:0 WNERPERMISS I0N ��oF t�ray Town of Barnstable y� o Regulatory Services BAPKs.,BL ; Thomas F. Geiler,Director Muss. . 019. A•e� Building Division i Tom Perry,Building Commissioner 200 Main-Street,_Hyannis,MA 02601. www.town.barnstable.ma.us i Officer 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": I name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as Supervisor. DEFINITION OF HOMEOWNER 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 constrgets more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that,he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she_will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." j 14-any homeowners who use this exemption are unaware that they an assurning the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application., that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a.form currently used by several towns. You may care t amend and adopt such a form/certifhcation for use in your community. Q:forrns:homcexcmpt ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: �q5 ro Site Address: �� , SD I'!57— nr;nr Town: . � o76-/2 Applicant Phone: /—�S�d 1P—R0?R—04co 00 Applicant Signature: �„/� �L Date of Application: NEW CONSTRUCTION: choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors _ R-Value R-Value Wall R-Value AFUE HSPF . SEER R-Value R-Value and Depth National Appliance Energy .35 R-3 8 R-1.9- R4 9 R-10 R-10, Conservation Act(NAECA)of 4 ft. 1987 as amended;minimums or greater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. Option 2: REScheck Version.4.1,2 or later .variant software analysis must be completed (780 CMR 6107.3.2) REScheck—Web which can be accessed at http://www.energ_ cy odes.gov/rescheek/ ADDITIONS OR ALTERA.TIONS.TO EXISTING BUILDINGS OVER,5 YEARS OLD*.. *Buildings under 5 years old must use option#1.or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall& Ceiling Area equals. Formula: (100 x b - a) s'0 SF 100 x �� . _ % of glazing '(b) Glazing area equals D SF b a y . o If glazing is_40/a use.the chart below: -_ If glazing is> 40 a% proceed to_ SUNROOM" section 78.0 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter Fenestration Wall Floor Basement Wall Exposed floors : R-Value U.-factor R-Value R-value R-Value R-Value and Depth. .39 R-37�a R-13 R-19 R710 R-10, 4.'feet a R-30 ceiling insulation maybe used in place of R=37 if the insulation achieves the full R=value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access openings). SUNROOM-An addition or alteration to an existing building/dwelling unit where the total glazing.area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fiffout Consumer.Information Form (found in Appendix 120.P) Aai(A� (70 iz:9� AIVC Guide to iVood Cortsttwctiott iu Hi lt.1Virtd Areas; .110,ttiph {•Viral Zone Massachusetts Checklist for Compliance (780 CAMR 5301:2.1.1)� Check _ Compliance 1.1 SCOPE WindSpeed (3-sec. gust).....................................................:............ ......................................... ....... 110 mph Wind Category Exposure P 9 ry.............................................'.................... .............................................................B Wind Exposure Category.................Engineering Required For Entire Project ........................................C 1.2 APPLICABILITY Number of Stories (a roof which exceeds 8 in 12 slope shall be considered a story)_�stories 5 2 stories Roof Pitch ....:.....................::.............:...:...:.:........... (Fig 2) ... ..... ............ ` 5 12:12 Mean Roof Height .................................................. ....(Fig 2). .... ................. ft 5 33' / Building Width, W ...............................................:.........:..,..(Fig 3).:.:..,.......................................:..-�ft 5 80' Building Length, L ...................................... :...(Fig 3).........................: ..... ..... ft`5 80' Building Aspect Ratio(UW) ......................, ...(Fig 4).......................... ..../900 :53:1 Nominal Height of Tallest Opening2 .....:.............................(Fig 4)......................................:......... 6v, 1.3 FRAMING CONNECTIONS General compliance with framing connections..:....:........:....(Table 2)..........:......,..:..............................:. ... ..... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete..........,................:...............,....:..::...,. :.......................:..................._.................... . ConcreteMasonry.................................................................... ............................................................... 2.2 ANCHORAGE TO FOUNDATION"', 5/8"Anchor Bolts-imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ...................... ..............(Table 4)..................................... ...... .. n. Bolt Spacing from end/joint of plate ...... :. :............(Fig 5)...... ............................. Bolt Embedment-concrete.........................................(Fig 5)........................:....:..................._in.>_7" Bolt Embedment—masonry................... ................... (Fig 5)............ .................._............J�in.>_ 15" jam' Plate Washer..`......... ............:.................................::....(Fig 5):.:...........................................>_3"x 3,.x'/<" �/" 3.1 FLOORS Floor framing member spans checked ......................(per 780 CMR Chapter 55) ........................... Maximum Floor Opening Dimension..... ................._........(Fig 6)............................... ................. ft< 12' 'Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall (Fig 6)..................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)....................................................0 ft 5 d Jz Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall...:....:.......(Fig 8).................................................... ft s d Floor.Bracing at Endwalls...... (Fig 9).................................................... ....... Floor Sheathing Type .......... ........:...................... ..........(per 780 CMR Chapter 55).............I...... Floor Sheathing Thickness ... (per 780 CMR Chapter 55) :.:................. ' in. Floor SheathingFastening (Table 2).. d nails at in edge/ i field 9.... �— 4.1 WALLS Wall Height. „ Loadbearing walls..........: ......... .....,.....................(Fig 10 and Table 5).................... ....7 ft <_ 10' U Non-Loadbearing walls`................................................. (Fig 10 and Table 5),.................. 5 ft 20' W811 Stud Spacing ..... .. ................:............(Fig 10 and Table 5) Ik. ....:.�in, 5 24"o.c. Wall Story Offsets .....................................................(Figs 7&8)......... .................... ........... D ft <_d 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls ..... ... ........ .................(Table 5).. .............2x . -, 7 ft in. V Non Loadbearing walls.... ... :....:........... .................(Table 5)..............................2x - ft in. Gable End Wall Bracing Full Height Endwall Studs ....................(Fig 10)'..........:.........................:................... ..'....:. WSP Attic Floor Length.... . .. .... ....... : ....................(Fi 11 ft_W/3 'Gypsum CeilingLength if WSP'not used ....:..:.........:.(Fig 11 and 2;x 4 Continuous Lateral Brace,@ 6 ft. o.c. .. (Fig 11).............................................................. or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Double Top Plate Splice Length ......:......:. . . .....:..........(Fig 13 and Table 6) :......... �ft 'Splice Connection no. of 16d.common nails)..............(Table 6)................... tQ s1 A RV Chicle to Wood Corrstr•uetioii hi fl,gh 14"Me ,,Iwias 110 iiiph ll'irrrt%rae. NlassacIiusetts Check]ist for Compliance (780 c:�IR 5301.2.1.1)' / Loadbearing Wall Connections / Lateral(no.of 16d common nails)................................(Tables 7)..................................................... V Non-Loadbearing Wall Connections . Lateral (no.of 16d common nails)................................(Table 8).........,............................................. . Load Bearing Wall Openings(record'largest opening but check all openings for compliance to Table 9) HeaderSpans .........................................................(Table 9).........:........................ a ft 0 in. :5 11' Sill Plate Spans ...............:........................................(Table 9)....................................aft 0 in. <_ 11' Full Height Studs (no. of studs)....................................(Table 9)...................:................................... Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) w / Header Spans.............................................................(Table 9)...................................Zft"t in. 1512' Vim' Sill Plate Spans.... .......................................................(Table 9).........!........................._o ft 0 in.:5 12" Full Height Studs (no.of studs).....:..............................(Table 9)......... .................................... ..... (� Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 j Minimum Building Dimension, W Nominal Height of Tallest Opening2 SheathingType..............................................(note 4)........... .......................................... / Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ in: Field Nail Spacing..........................................(Table 10)........'........................I.............. .. Shear Connection (no. of 16d common nails)(Table 10)........ ....:......................................... Percent Full-Height Sheathing...................:...(Table 10).................................................... 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).................... Maximum Building Dimension, LVVII Nominal Height of Tallest Opening2......................................................................... 6'8' SheathingType..............................................(note 4)..................................................... Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................ in. Field Nail Spacing..........................................(Table 11)........!................................,.......--C,in. Shear Connection(no. of 16d common nails)(Table 11)........:............................................... Percent Full'-Height Sheathin Table 11 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... Wall Cladding / Ratedfor Wind Speed?.............................................................. ..........I.................................................... / 5.1 ROOFS. V Roof framing member spans checked?........................(For Rafters use AWC Span Tool, see BBRS Website) ...............................(Figure 19 1� ft 5 smaller of 2'or L/3 Roof Overhang ................... ( g } .... ........� Truss or Rafter Connections at Loadbearing Walls i Proprietary Connectors Uplift................................................(Table 12)........:...................................U= I�� plf Lateral.............................................(Table 12)..............................................L= Flo plf Shear....................................:..........(Table 12)......... ...............................S=-Z plf . Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T=_jC�)_plf Gable Rake Outlooker........................ . (Figure 20 6' ft:5 smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors i Uplift...................I............................(Table 14).........!..................................U= lb. Lateral(no. of 16d common nails)...(Table 14).......................................L= Ib. Roof Sheathing Type................:..................................(per 780 CMR Chapters 58 and 59) ............. Roof Sheathing Thickness........................................... . ...............................:............3�in. >_7/16"WSP Roof Sheathing Fastening............................................(Table 2)........... ............................................. Notes: 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per.the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft. shall be permitted when 5% is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in .exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. i Y �r r r AIVC G►i de to {food Coi►st► tctio►r in Hi,( h 1Yi►id A►•eas: 110 u►ph Whid Zolie Massachusetts Checklist for Compliance (7/80 GLAIR 5301.2_1:1)' 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio, determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs: ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to.band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below: Vertical and Horizontal Nailing for Panel Attachment 5. Glazing protection: a)new house or horizontal addition—required if project is 1 mile or closer to shore(generally,south of Rte. 28 or north of Rte. 6) b)vertical addition—not required unless there is extensive renovation to the first floor c)replacement windows-needs energy conservation compliance only(chap 93) 6. Wood Frame Construction Manual (WFCM)for 110 MPH, Exposure B may be obtained from the American Wood Council (AWC)website. --MEN THIS.EDGE RESTS ON FRAMING USE Ed NAIZ AT5"os- „ Q a .l 16?^ 1 Z.4 ( 11 Il 1 1 t1 It 11 1 Z ♦li 11 1 it 1 4 1 1 d cad I 1 - 17 11 1 O_ l- - a t0 O ME 1 r Q i i i i 1 1 1 FRAAAING MBERS i - i� EDGE 6JTE_RMEDIAT£ 11 1t 11 w I:- l(j 1 1 1 a. IJ 3"MIN. i r•� 1.1 r`I 1 1 - 1 ` 1 �DOUIaLEEDGE ---- �`,l STAGGERED 3"MMJ NAILSPACRJG l NML PATTERN PANEL •' PANEt_ a � 4 PANEL EDGE DOUBLE NAIL EDGE SPAC 4G DErAL See Detail on Next Page - Detail Vertical and Horizontal, j r Vertical and Horizontal Nailing for Panel Attachment for Panel Attachment f � t 1 ' f { 4 �Y 44 # t. { i t i t I . , ." ~ � ;:i✓-' (/ .. _ e , n a ;?m gym,. _ Row CO\rco2L�i`L FO u A v/3--ri&M alb. 86 � =-► ><cp do r °0 s -t1A P�6�ct:.�� �r��� �aAi� E.4 Cp ^ x •N Aj i Fd �` o `�• /� } �QED c�� ®gin - 1s t ?coo P_':N L.. `7r - . ,• L� s tj s S fox ' V# T' �to 2+ �,� S c L4 a y G/l so u 7 I • �oF Town of Barnstable *Petrmit# 2 S� rxp&a 6 M570akfrom iaaue date Regulatory Services Fee Thomas F.Geilery Director Building Division Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 �� �,° Office: 508-862-4038 ®� Fax, 508-790-6234 2005 EXPRESS PERNIIT APPLICATION - RESIDENTIAL;OI Not VaW without Red X Press Imprint 2ap/parcel Number OkU f o _ 'ropertyAddress JResidential Value of Work$ Z • 350• U 0 Minimum fee of•$25.00 for work under$6000.00 ?,%mer's Name&Address :ontractor_s_14-=e . V k LTelephone Number Q `►" Rome Iniprovemcnt Con{ractor-Licensa#.(if app cable)... Construction ervisor's License#Vapplicable :]Workmen's Compensation Insurance agn one: a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workmen's Comp,Policy# Copy of Insurance Compliance Certificate must be on file. Pezmit Request(check box) WP,C-,Oof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side (] Replacement windows. U Value (maxim .44)- 'Where required: Issuance of this permit does not exempt congUance with other tows depataaent regulations,i.e.Historic,Conservatism,etc, ***Note: Property Owner roust sign Property Owner Letter of Permission, In=ov,- Contractors License is required, Signature Q:Ferms:expmtrg Revise063004 l IJ /,� e istration valid for individul use only Gff� �an� on ` If found return to: License or r gitiou date. before the exp $egulations and Standards gegulations and Standards of Building Board of Building CTOR Board 1301 OVEMENT CONTRA one Ashburton place Rm HOME 1 24310 Boston,Ma.02108 Re istrati�n• 007 z -- `"kidual a � re s Curley = ut signs Jame - Not valid witho James Curley 287 Fuller Rd. Administrator Centerville,MA 02632 v ' t E A. Town of Barnstable Regulatory Services MA° sax�ys:ras�. ' Thomas F.Geiler,Director 'OrfD Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property _ hereby authorize \J to act on my behalf, in all matters relative to work authorized by this building permit application for: -. 4 I g a W" &Nffvdt L (Address of Job) 41�gnef A05XT'I Date Print ame Q:FORMS:OWNERPEPOM SION Assessor's map and lot `number I l"�:O...V...:..F,..:...� � ' SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Se`wage. Permit number ..........,11�dr�-t WITH ARTICLE II STATE c ' -Skl,�'ITAIRY CODE AND TOWN CFATIrNN THET� TOWN O "DAR \ ST�.�ll�BLT - 2639. DUIL I I SPA T �p i6S9• , 01 r, u �� •_ C''U rrE a i APPLICATION FOR PERMIT 'TO ........... ........................................ ` TYPE OF CONSTRUCTION ' ti ...............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location1... .....1.......... ....................... .��L.u.t'.. ............................................................................................. .... ProposedUse ....... ... ..... ..................... •.�......................................... ........................................................... Zoning District .............................................................. .......Fire District ....: Name of Owner ... ............ .. ............................................Address ...4 Name of Builder ..... ...........Address ... 'f`S ' "— Name of Architect ....../!�!!' -�...............................:.......Address ....... .............................:......0...1.,.,... ............................... I. .........Foundation . . ...... — G�J Number of Rooms ............ ........................................... ............................... ............................... Exlerior ........ .. ....Roofing ...... a Floors ...........................................................Interior .......:.................... ....................................................... Heating ...... .......................................................................Plumbing ......................... ........................................................ i Fireplace ................. ............................................Approximate Cost ....... ..9................. ...... e . Definitive Plan Approved by Planning Board --------------------------------19--------- , Area .. ...� .. .(`-�Y�.......... . .'... Diagram of Lot and Building with Dimensions g g C Fee ............./...:. ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...................m..Y......... . .............. ...................... ' Shannon, Raymond 18588 e4ma4ld @. � No .................'Permit for .................................... ' mocImae porch ' -------------------`------- .. . - 419 South Main Street � Location --.----------_________ . - Centerville . ............................................... Raymond � Shannon _ Owner --------______________ � frame Type of Construction .......................................... _---..---------------------. ` - . 'Plot --z------.� Lot ----------.. ' . . l3 76 -' ^ Permit Granted --..������------lV . ) . Date of Ihspechon ....... ................ ' 'Date Completed . --�---lg , . - - ' PERMIT REFUSED ` .,----.-------------..—. lV " . ' .\ -------^^~----------------' ~1 . ' .----~-----^—'---'—^~--------^ .-...�--...—.—.------------.--.--, .. --------`'----`~^''----------'' . ^ 'Approved ............................................... 19 ~----------------------~---. ' ' ' ---------------.-------.—.—.. . ~ . - | Assessor's map and lot number ..!...!...!.... ....... ........ ,. Sewage `Permit number ......... a .\..(?a QyofT"Ero�o � TOWN OF BARNSTABLE i I STADLE; i +, "b q p" DUILDMA . INSPECTOR �0 MPY �. APPLICATION'FOR'PERMIT TO ..... ..�......... ......... .................... ...................................................... • S TYPE 'OF CONSTRUCTION .:................................................................................................................................... r `, ................................................19........ -- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies ,for �}a- permit according to the following information: Location t 3 ` i ^-'� ..... �',i 1 Proposed Use l_rN ................. "fig! , :�::�`- ' ZoningDistrict .......1.�.................�....................Q...... ... r... . . Fire District ".........:.................................................................... ..1.,A, Name of Owner . .:.Address - ' ' J _ Nameof Builder ....�.............................................................Address ... ..................................................................... i Name of Architect ......:IMA)`1�........................................Address .......AA-V-k--$" ........................................................................ ........................ Numberof Rooms ............k.....................................................Foundation .�' ✓� ................................................... . ......................Exierior ........ � 4, At Roofng ...................Floors ........:. ...........................................................................Interior . ............................. ...................................................... Heating ..' ..: ?'-a'" ...................................................Plumbing ..........................,..:,:.............. j Fireplace ...................kki,' jL..............................................Approximate Cost ............... ..... ........ :......................... t... :Definitive Plan Approved by Planning Board ________________________________19________ . Area .�, . L. k 0 Diagram of Lot and Building with Dimensions Fee .'�................... SUBJECT TO APPROVAL OF BOARD OF HEALTH f hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................ ...................... Shannon, Raymond A=207-65 18580 rebuild and No ................. Permit for ..................... enclose porch .................................... ............. ........ ...... 419 So�th Main Street Location ......................I.......................................... Centeryille ............................................................................... Owner ............Ra.ymo�d Shannon .... ..... ........................................... frame Typ�e of Construction .......................................... ....................................i.......................................... Plot .......................... Lot 44 Permit Granted .......4jq§�...�g.............19 76 Date of Inspection .....................................19 Date Completed ......... ...........................19 T1 PERMI TIUID ...................................... ,......I.............. 19 .......................... i)W ..... ... ..................... .................................. . ............................................................................... Approved ................................................ 19 . ............................................................................... ........................................................... ................... f ' C / 1 S0- KIM r, 3/7 EA 1 Wo�- i T f A P)u, Q eW S To U GRDVTffD a A4 �- ..�..�-. _ / // 'r s 10, 9 i t C I I W I _R too< �^p�� All G� At L L CE LL' S icy tB& t * _, y r n` United States/ • • • • Canada RESIDENTIAL. Dow Building Solutions FROTH-PAKTM FS Foam Insulation Kit FROTH-PAKTM Foam Sealant Kit FROTH-PAK'"FS Foam Insulation SIZES INSTALLATION Kit and FROTH-PAK"Foam FROTH'PAK"foam is typically Complete operating instructions Sealant Kit are two-component, sold as a complete portable kit are provided with each quick-cure polyurethane foams that includes pressurized "A" FROTH-PAK"product purchase. that quickly expand to fill cavities and"B"tanks,plus dispensing Read all information and cau- and penetrations (2"/50 min or gun/hose assembly and accessories.** tions before application. greater)through walls, floors For residential applications, two and plates for pipes,vents and FROTH-PAK"FS Foam Insulation Note:Avoid overfilling restricted wiring. FROTH-PAK FS has a Kits and four FROTH-PAK"Foam spaces.Chemicals exert force during flame spread index of 25 or Sealant Kits are offered in. reaction, and expansion of foam E less (Class_1)., qua�g it as an standard sizes, based on may result in substrate deformation. effective insulation at maximum theoretical yield. Refer to Table 1 2"(50 mm)thickness as well as to select the kit suitable for FROTH-PAK"FS Foam Insulation an air sealant. FROTH-PAK Foam your application. Larger sizes, and FROTH-PAK`"Foam Sealant _ Sealant is ideal for air sealing including refillable systems, are contain isocyanate,hydrofluoro- smaller areas that do.not require also available. Consult your . carbon blowing agent and polyol. a flame spread rating of 25, e.g., Dow representative for more Read the Material Safety Data , as insulation might. In addition details. to blocking out air infiltration, TABLE 1 FROTH-PAK products help seal out moisture, dust, smoke, ' • Foam Se alant OUYSlde noise and 1nSeCYS. Key P Product, j,Theoretical Yleld°�,.bd ft(rri') Product ,Theoretical>Yieldo),bd It(m')" areas to seal inside the home FROTH-PAKTM FROTH-PAKTM include penetrations, rim joists FS-180 160(.38) 1z 12(.03) and band jO1SYS, stud wall cavities, FROTH-PAKTM FROTH-PAKTM FS-600 1540(1.27) 120 j 120(.30) �® Ceilings/attics, crawl spaces and FROTH-PAKTM basements,floors above garages 180 200(.47) and bathtub framework. I FG00 TH-PAKTM 600(1.41> (1)Available in the United States only. Properties (2)Actual yield will depend on various factors of the application and the environment,including temperature, T®� foam thickness,number of foam spray passes,the specific nozzle used,etc. (� Unlike one-component foam, A TABLE 2 which uses moisture as a curing agent, FROTH-PAKC'foams are Features and Benefits of FROTH-PAK chemically cured, significantly • •' reducing Curing time. FROTH-PAK yFeature" ,. ' ' "i 'Benefit (� dispenses, expands and becomes High yield I Enhances efficiency tack-free in seconds.The product Numerous kit configurations Extensive choice of sizes,densities and reaction times for will skin over in 30-40 seconds flexibility and Will be completely cured in Bonds to Wood,rigid foam,masonry, Effective in many applications P y metal and more minutes.* Flexible hoses One-step application;variety of lengths'clear for easy L.L �p®p FROTH-PAK foams can be Used monitoring of usage and product flow,moisture barrier V in either interior or exterior settings. I that protects chemical stability V) If used idan exterior setting, a INSTA-FLOT"'dispensing spray gun Throttle type for user comfort;precise metering; IL IL coating or paint must be applied } excellent application control Specialized nozzles Widest selection in the industry for ultraviolet protection. Exclusive internal check valve(nozzle) Eliminates chemical crossover FROTH-PAK foams exhibit ,portable kit No power or air pressure required;handle attaches two ph sical properties as indicated y r p p tanks for enhanced portability;easy to remove tanks in Tables 3 and 4 when tested as from box in wet or humid conditions i e represented. Temperature indicator on tank Approximates product temperature;provides product consistency and quality ` V mTrademark of The Dow Chemical Company("Dow")or an affiliated company of Dow .. ' - *Actual cure time will depend on temperature. **The chemical weights of the most commonly used FROTH-PAK kits are 26 lbs(11.82 kg)for FROTH-PAK FS-180 and 29 Ibs(13.18 kg)for FROTH-PAK 180 Foam.Sealant. hi Sheet carefully before use. Wear TABLE 3 protective clothing,gloves,goggles Typical Physical Properties • and proper respiratory protection. 4 Property and Test Method jj Volpe Supplied air oI an approved air- Flame Spread/Smoke Developed""",ASTM E84 j 25/450 purifying respirator equipped Nominal Density,ASTM D1622,Ib/ft'(kg/m') 2.0(32) with an organic vapor sorbent Thermal Resistance per in.(25 mm),ASTM C518, I and a particle filter is required to ft2•h•°F/Btu(m2•°C/W) R-Value(RSI)III,min. Aged 180 days @ 72°F(22'C),50%R.H. ! 4.6(0.81) maintain exposure levels below Water Vapor Permeance,ASTM E96,perm at 1"(ng/Pa•s•m2 @ 25 mm)i 1.06(60) " ACGIH, OSHA, WEEL or other Compressive Strength,ASTM D1621,lb/in'(kPa),parallel j 31.8(219.2) applicable exposure limits. Maximum Service Temp.,°F('C) j 240(116) Provide adequate ventilation. (1)Tested at 2'(50 mm)thickness,full coverage For more specific instructions, (2)This numerical flame spread rating is not intended to reflect hazards presented by this or any other material under actual fire conditions. contact a local Dow representative (3)R means resistance to heat flow.The higher the R-value or RSI,the greater the insulating power. or access the literature library at: l www.sprayfoamatdow.com. TABLE 4 Typical Physical Properties of FROTH-PAK T" Foam Sealant CODE COMPLIANCES/ iPrdoertyandTest.Methud "} value "EVALUATION REPORTS -Nominal Density,ASTM D1622,fb/ft'(kg/m') j 1.75(28) FROTH-PAKr"FS Foam Insulation: Thermal Resistance per in.(25 mm),ASTM C518, i • ICC ES Le aC Re oit ER-3974 ft2•h•'F/Btu(m2•°C/v0,R-Value(RSI)III,min. g y p Aged 180 days @ 72'F(22'C),50%R.H. ! 5.3(0.93) • Underwriters Laboratories, Inc. Water Vapor Penneance,ASTM E96,perm at 1"(ng/Pa•s•m2 @ 25 mm).! 1.6(90) (UL)Classified, see Classification Compressive Strength,ASTM D1621,lb/in'(kPa),parallel j 15.1(104) Certificates R7813 and R13655 Maximum Service Temp.,'F('C) 1240(116) FROTH-PAK'"Foam Sealant: (1)R means resistance to heat flow.The higher the R-value or RSI,the greater the insulating power. • CCMC 13074-R • Underwriters Laboratories, Inc. (UL) Classified, see Classification Certificate R13655 Contact your Dow sales rep- " resentative or local authorities T. for state/provincial and local building code requirements and related acceptances. k. R •For Technical Information:1-866-583-BLUE(2583) •For Technical Information:1-866-583-BLUE(2583)(English);1-800-363-6210(French) •For Sales Information:1-800-232-2436 •For Sales Information:1-800-232-2436(English);1-800-565-1255(French) THE DOW CHEMICAL COMPANY r DOW CHEMICAL CANADA INC. •Dow Building Solutions•200 Larkin•Midland,MI 48674 •Dow Building Solutions•Suite 2100•450—1 st St.SW•Calgary,AB T2P 5H7 www.sprayfoam atd ow.iom NOTICE:No freedom from any patent owned by Dow or others is to be inferred.Because use conditions and applicable laws may differ from one location to another and may change with time,Customer is responsible for determining whether products and the information in this document are appropriate for Customer's use and for ensuring that Customer's workplace and disposal practices are in compliance with applicable laws and other government enactments.Dow assumes no obligation or liability for the information in this document.NO WARRANTIES ARE GIVEN;ALL IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE EXPRESSLY EXCLUDED. COMBUSTIBLE:The foams produced by FROTH-PAKT"17S Foam Insulation and F'RCTH-PAKT Foam Sealant are organic and combustible and may constitute a fire hazard.Do not expose foam to flame or temperatures above 240T(I16'C).Local building codes may require a protective or thermal harrier.For more information,consult MSDS,call Dow at 1-866-583-BLUE(2583)or contact your local building inspector.In an emergency,call 1.989-636-4400 in the U.S.or 1.519.339-3711 in Canada. NOTE:FROTH-PAKr"FS Foam Insulation and FROTH-PAKTM Foam Sealant contain isocyanate,hydrofluorocarbon blowing agent and polyol.Read the Material Safety Data Sheet carefully before use.Wear protective clothing,gloves,goggles and proper respiratory protection.Supplied air or an approved air-purifying respirator equipped with an organic vapor sorbent and a particle filter is required to maintain exposure levels below ACGIH,OSHA,WEEL or other applicable exposure limits.Provide adequate ventilation. - Building and/or construction practices unrelated to building materials could greatly affect moisture and the potential for mold formation.No material supplier including Dow can give assurance that mold will not develop in anypecific system. �.� Seal and® Insulate - 1�' HabltBt „ ENERGY STAR - for Humanity' Printed in U.S.A. ®"Trademark of The Dow Chemical Company Form No.179-07391X-1007P&M ("Dow")or an affiliated company of Dow 178-00842X-1007P&M ' Habitat for Humanity is a registered service mark owned by Habitat for Humanity International j. United States/ � • • • Canada RESIDENTIAL „ Dow Building Solutions RESIDENTIAL APPLICATIONS USING FROTH-PAKTM FS Foam Insulation Kit 3 . and FROTH-PAKTM Foam Sealant Kit l6rll, v According to the Air Barrier Association of America(ABAA), a typical 2,500 ftJ home has , over 1/2 mile of cracks and crevices. For a closer look at these problem areas and how c•� FROTH-PAK'"products can close the gap, see pages 2-4. s d'}p0 sills/ joists slabs Figure 1 141 FROTH-PAK"FS Foam Insulation used to insulate along sill plate, ACIValltdgeS Kit*and FROTH-PAK"Foam rim joist and band joist areas, as Sealant Kit are easy-to-install; well as wall cavities. FROTH-PAK FROTH-PAK"FS Foam 1 ° portable solutions to help reduce FS may also be used as an air. Insulation and FROTH-PAK'"Foam a drafts and moisture intrusion, a sealant. Both FROTH-PAK FS and Sealant can effectively protect major cause of a home's energy FROTH-PAK Foam Sealant may against air infiltration,which f w loss, compromised indoor air be used in wood frame accounts for about 40 percent of quality and structural damage as construction as fire-blocking at' a home's energy loss. FROTH-PAK a result of trapped moisture. openings around vents, pipes, products also help seal out mois- ' FROTH-PAK'"products are ducts, cables and wires at ceiling tore, dust, smoke, outside noise 4' two-component, quick-cure and floor level.' and insects. _s polyurethane foams that expand FROTH-PAK products are offered , Key areas to seal include: when applied to fill interior/ in a wide selection of kits with • Ceilings/attics exterior cavities, penetrations theoretical yields from 12 to'600 • Chases/soffits/drop ceilings and gaps 2" (50 mm)or greater.** j'_ board feet (03 to 1.41 cubic + Stud wall cavities FROTH-PAK"Foam Sealant is meters). • Crawl spaces and basements used primarily as an air sealant. • Floors over unheated areas such FROTH-PAK'"FS Foam Insulation Note:Before using FROTH-PAK . foam, read and follow the instructions as garages has a flame spread index of 25 provided with each FROTH-PAK , • Bathtubs(for support/insulation) or less (Class 1) and may be product purchase. • Penetrations through walls, floors and plates for pipes, - ®-Trademark of;The Dow Chemical Company("Dow")or an affiliated company of Dow - •FROTH-PAKT"FS Foam Insulation is available in the United States only. Vents and wlnng .: *'For exterior applications,a coating must be applied for ultraviolet(UV)protection. • Sill plates/rim joists/band,joists 'Check with your local code official. - - I r •` �f 1�5� FROTH-PAKTM Sealing wall-ceiling joints Sealing around attic hatch Fills the Void - FROTH-PAK"Foam Sealant and 4 - FROTH-PAK'"FS Foam Insulation help to quickly put an end to air leakage paths that lead to energy loss and accompanying moisture problems. See Figures 2, 3,4, 7 and 9 for examples of air-sealing applications where either FROTH-PAK"Foam Sealant or FROTH-PAKK'FS Foam Fvvr�..` - -y Insulation may be used. Figure 3. g Due to its Class 1 rating, Figure 2 ure FS; g 1S -FS FROTH-PAK FS can be used as both an insulation and air sealant,helping reduce energy Sealing hidden wall cavity loss in both of these ways. See APPLICATION TIP utility penetrations Figures 5, 6, 8, 10 and 12 for FROTH-PAKK' FS Foam .� r'' yr: Insulation is approved at 2 examples of FROTH-PAK FS �: s p (5.0 mm)thickness for full insulation applications. For coverage applications. 41 structural support and insulation 1 y applications, see Figures 6,, 10 and 12. CEILINGS/ATTICS Using FROTH-PAK'"Foam " Sealant in the ceiling and attic helps prevent air escape and entry from these areas: - • Wall-ceiling joints(Figure 2) • Attic hatch (Figure 3) ' ' ckin • Attic perimeter,penetrations Figure a S -FS and ductwork • Light fixtures • Plumbing penetrations Insulating around attic perimeter/penetrations/ductwork (through ceiling and roof) before adding fiberglass batt or blown-in insulation • Interior partitions ; • Hidden wall cavity utility penetrations (Figure 4) APPLICATION TIP For maximum value and to �ylfi' enhance performance of <t•, >. batt/blown-in insulation, spray FROTH-PAK'Foam V. Sealant around exterior wall ': penetrations to block air leakage,moisture and outside ` ` — — allergens:Add insulation to ,• `�� Achieve desired R-value(RSI)tt KEY FROTH-PAK"Foam Sealant Figure 5 FS, FS FROTH-PAK"FS Foam Insulation ®r'"T•rademark of The Dow Chemical Company("Dow")or an affiliated company of Dow "R means resistance to heat flow.The higher the R•value or RSI,the greater the insulating power. - - - - • y F .. - s WALLS Sealing stud wall cavities FLOORS ABOVE GARAGES FROTH-PAK`"FS Foam Insulation Floors that have an uncondi- is an effective insulation and air tioned(not heated or cooled) sealant for stud wall cavities space below provide the following (Figure 6). It may also be used to areas for sealing with FROTH-PAK" insulate along sill plate/rim joist Foam Sealant: areas (Figure 10). •Wall-ceiling joints (Figure 2) According to the 2006 •Penetrations for electrical wire International Residential Code and plumbing(Figure 4) f (IRC), Section R314.5.11, and Lam;; ;g •Rim joists/sill late(Figure Fi re 9)Underwriters Laboratories, Inc. p (UL) Classification Certificate Additional sealant opportunities R7813, FROTH-PAK FS Foam ��� include support posts and columns, Insulation up to 2" (50 mm)thick ductwork and plumbing passes may be left exposed without a Figure z FS (to minimize vibration noise). thermal barrier on sill plates and rim joist headers. Other wall m joists plate/rim Insulating sill pla insulation applications require Insulating around pipe within Imaximum 2" la mri thickness) FROTH-PAK FS Foam Insulation wall cavity to be separated from the interiory� by a thermal barrier. To simply air seal cracks, crevices and penetrations within cavities, use FROTH-PAK" Foam Sealant. As a best practice, spray " — - FROTH-PAK Foam Sealant in a J �� "picture frame"fashion in the wall \` cavity before installing batt insulation to block out drafts and enhance insulation performance ° (Figure 7). Use FROTH-PAK Foam Sealant to air seal wall- ceiling joints, around utility Fire-blocking p Figure 10 FS penetrations and along band joist, sill plate and rim joist Figures LSD-:FS areas. See Figures 2, 4 and 9. Sealing sill plate/rim joists Insulating stud wall cavities (maximum 2" [50 mm]thickness) < ` `i/1 r Figure 9 i s! Fs_ Figure 6' FS;, . v ©(Trademark of The Dow Chemical Company("Dow")or an affiliated company of Dow - i BATHTUBS insulating behind bathtub Additional FROTH-PAKT"FS Foam Insulation (maximum 2' [50 mm]thickness) can be used to insulate air seal t _ .aT Information and seal fire-blocking penetrations For more specific instructions, behind the tub, sides of studs and contact a local Dow representa- bottom plate of the wall. five or access the literature library FROTH-PAK FS can also provide ( at:www.sprayfoamatdow.com. support for the tub(Figure 11) << z and can be used to insulate the tr entire wall cavity behind the tub r> at 2" (50 mm)maximum foam thickness(Figure 12). Supporting bathtub (maximum 2"[50 mm]thickness) Figurel2 FS More Foams for the `job Y " = For cavities, cracks and penetrations.less than 2" (50 mm), Dow recommends,GREAT STUFF PRO-..Gaps & Cracks Insulating Foam Sealant. —r For window and door framework, use low piessure-build, ; minimal-expanding GREAT STUFF PROT Window,& Door, is Insulatiiq Foam;Sealant; which is proven not to distort or bowl , / the framework when installed properly. o,- 1" For large jobs,STYROFOAM'"Spray,Polyurethane Foam'(SPF) I Insulation,(2 lb/ft') provides seamless,protection against air Figure 11 FS and moisture infiltration. y •For Technical Information:1-866-S83-BLUE(2S83) •For Technical Information:1-866-S83-BLUE(2S83)(English);1-800-363-6210(French) •For Sales Information:1-800-232-2436 •For Sales Information:1-800-232-2436(English);1-800-565-1255(French) THE DOW CHEMICAL COMPANY DOW CHEMICAL CANADA INC. •Dow Building Solutions•200 Larkin•Midland,MI 48674 •Dow Building Solutions•Suite 2100•450—1 st St.SW•Calgary,AB T2P 5111 www.sprayfoamatdow.com NOTICE:No freedom from any patent owned by Dow or others is to be inferred.Because use conditions and applicable laws may differ from one location to another and may change with time,Customer is responsible for determining whether products and the information in this document are appropriate for Customer's use and for ensuring that Customer's workplace and disposal practices are in compliance with applicable laws and other government enactments.Dow assumes no obligation or liability for the information in this document.NO WARRANTIES ARE GIVEN;ALL IMPLIED WARRANTIES OF • MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE EXPRESSLY EXCLUDED. COMBUSTIBLE:The foams produced by FROTH-PAKT"FS Foam Insulation and FROTH-PAKT"Foam Sealant are organic and combustible and may constitute a Fire hazard.Do not expose foam to Flame or temperatures above 2400P(I 160C).For more information;consult MSDS,call Dow at 1-866-583-BLUE(2583)or contact your local building inspector.In an emergency,call 1.989-636-4400 in the U.S.or 1.519-339-:17I1 in Canada. - - NOTE:FROTH-PAKT"FS Foam Insulation and FROTH-PAKTm Foam Sealant.contain isocyanate,hydrofluorocarbon blowing agent and polycl.Read the Material Safety Data Sheet carefully before use.Wear prot Live clothing,gloves,goggles and proper respiratory protection.Supplied air or an approved air-purifying respirator equipped with an organic vapor sorbent and a particle filter is required to maintain exposure levels below ACGIH,OSHA,WEEL or other applicable exposure limits.Provide adequate ventilation. , Building and/or construction practices unrelated to building materials could greatly affect moisture and the potential for mold formation.No material supplier including Dow can give assurance that mold will not develop in any specific system. ............. ' Seal and mInsulate • with y Habitat ` ,; ENERGY STAR . for Humanity" - - Printed in U.S.A. ®*"Trademark of The Dow Chemical Company Form No.179-07394-1107P&M ("Dow")or an affiliated company of Dow 178-00836-1107P&M Habitat for Humanity is a registered service mark owned by Habitat for Humanity International , - FROTH-PAK(TM)600 B 25FS NCFC Polyuretbane Spray Foam System MATERIAL SAFETY DATA SHEET 1) PRODUCT AND COMPANY IDENTIFICATION THE DOW CHEMICAL COMPANY ` Midland Michigan 48674 k USA 24.-lour Emergency Phone Number: 989-636-4400' Can itomer Service:800-366-4740 PRODUCT NAME :FROTH-PAK(TM)600 B 25FS NCFC Polyurethane Spray Foam System , M,,%SERIAL TYPE:Polyol blend ISS JE DATE:07/19/2007 Rli:I gSION DATE :03/10/2006 2) COMPOSITION/INFORMATION ON INGREDIENTS Ingre!i lient CAS Number 0/0 Polyol; Mixture 30-60/o o Diethy ene Glycol 111 46-6 Trieth• I Phosphate 78-40-0 °* . 1-5% Flame Retardants' Mixture 5-10% 1,1,1,",3-Pentafluoropropane 460-73-1 7-13% 1,1,1,2•Tetraflluoroethane .811-97-2 107300% 3) K4 ZARDS IDENTIFICATION EMERi 3ENCY OVERVIEW CAUTI- N! Contents under pressure. Vapor; reduce oxygen. available`for breathing and are :he'aVier:than air'. May cause slight temporary ,eye irritation.. May, cause skin irritation if skin is abra.:_iled. When heated, may cause thermal burns and heated mist may cause respiratory irrit:iition. Avoid contact with strong acids and oxidizers and un-intended contact-with isocy,:pates. EYE y . May cause slight temporary eye irritation. €' SKIN Prolonged or repeated exposure not likely to cause significant skin irritation. May cause: more severe response if skin` is. abraded; scratched or cut. A sir:.gle prolonged exposure is not ..likely to result in the materialrrbeing ab§orbed .througli 'the skin in harmY.t1 _amounts. Material may be handled at elevated temperatures; " contact with heatec material may cause-thermal burns. INGES-1 ION Single dose oral toxicity is,>'considered to -be low.,6`Small amounts swallowed incidental . . to no:-mat" handling gperations are 'not likely to cause 'injury; swall3wing amounts larger than that may cause injury. INHAL,A TION, Exposure to fluorocarbons at high concentrations may effect. the nerdous system: and produc° a rapid anesthetic effect.' The 'dense" vapor of this..- material an reduce the oxygen available for breathing ,and produce symptoms .such 'as headachy::: dizziness, drowsiiess, cyanosis and lack "of muscle control followed by collaspe. Prolonged . exposixce to an oxygen-deficient atmosphere may be fatal. Inhalation of this material may cause an increase in the sensitivity,of -the heart to adrenaline;, whicl could result in" ir:r gular`-heart beats and reduced heart function'.' At rook temperatures, vapors are minimal due to physical properties; a single exposure or(R) ndicates a Trademark of The Dow Chemical Company Page 1 of 7 FROTH-PAK(TM)600 B 25FS NCFC Polyurettsane Spray Foam System MATERIAL SAFETY DATA SHEET is lot likely to be hazardous. ' If material% is heatedi or mist: is produced, cone>_ntrations may be attained that are sufficient to-cause respiratory :'irritation. SYSI EMIC EFFECTS Excessive exposure to fluorocarbons may effect the central nervous system and produce `anes:.hetic and narcotic-like symptoms. F 4) FI RST-AID MEASURES' EYE ` Immra!iately flush "eyes with plenty of water. Remove- contacts after first few minutes and continue washing. . SKIN Remc,N a r materia l from skin immediately by washing wit h soap and plenty of water. Remove contaminated clothing and. shoes while washing. Seek medical atten persists. tion• if irritation INGE!TION If a.vallowed, seek medical attention. Do not induce vomiting unless dixected to do so by medical personnel. INHAL ATION Remove to fresh air if effects occur*.-'.Consult a Physician NOTE" TO PHYSICIAN ' No sp?cific antidote. Supportive care. Treatment based on judgment ofthe physician in respo ise to reactions of the patient.' 5) MIR E-FIGHTING MEASURES HAZA VDOUS COMBUSTION PRODUCTS Incor-iplete combustion may lead to the build-up of toxic pyrolysis products.^ Complete combi.u,tion will result in: Carbon oxides, Nitrogen oxides, Water, Ammonia'. and trace amounts of Hydrogen Cyanide. M. Addit:.:onal combustion products may include hydrogen fluoride, hydrogen chloride acid chlor:ne. Addit_'onal combustion products may include hydrogen bromide.and/or bromine OTHER FLAMMABILITY INFORMATION y Violert steam generation or eruption may 'occur upon application of direct mater stream` to hct liquids. Spills of these organic liquids on- hot fibrous insulatio:;:Ls may lead to lowering of the autoignition temperatures possibly resulting in spontaneo:.s combustion, ' ' Surni.r.g liquids may be extinguished by 'dilution with water: Do not use: direct water streatr, it may spread fire EXTIN-G UISHING MEDIA ;. '. Use r..i rbon dioxide; ^ dry chemical; foam;{ water fog- or fine spray. Alco;nol resistant foams (ATC type) are preferred if ,available. . General purpose synthetic foams (including AFFF) or protein foams may;rfunction, but' much. less effective.- Do, not use r direct water stream ,which-can spread fire`. ' FIRE FI1 3HTING;INSTRUCTIONS a Keep people away. Isolate fire area and deny .unnecessary;entry: 'Stay upwind-' Keep out wheres of log areas gases (fumes) can accumulate. Water i's 'not recommended but may be , applie'3 in verylarge quantities as a -fine spray when other extinguishing agents are not a�r,i.ilable. Contain ,fire water run-off• if possible. Do not use -direct water stream. May sh-ead fire_ Fight• fire from protected,' location or. safe distance. Consider use of unmanni:d. hose holder or , monitor . nozzles. Use water, spray , to cool fire, exposed contaALers and fire affected zone until fire is out: Immediately withdraw all persoru:el from area. in • case of rising 'sound -from venting' safety devices or Page 2 of 7 FROTH-PAK(TM)600 B 25FS NCFC Poiyureth ine Spray Foam System MATERIAL SAFETY DATA SHEET discoloration of the containers: Move containers from fire -area if this 'is possible with gut hazard. PRO"ECTIVE EQUIPMENT-FIRE FIGHTERS Wear positive-pressure self-contained breathing apparatus (SCBA) and protective fire fig:li.ing•clothing (includes fire fighting helmet, coat, pants, boots, and gloves)_'.: If prot,!ctive equipment is' 'not available or not used, fight fire from or soLfe distance. a Pro_ected location` 6)AMIDENTAL,RELEASE MEASURES PROT ECT PEOPLE Iso].zte area. May be a'slipping hazard. Wear ad equate`personal protect:i.ve equipment PRO'T:CT THE ENVIRONMENT Contain material to prevent contamination of ground a6d surface water: Spills should - be ccllected to prevent, contamination of waterways. • Recover if -possible, or`dispose"of• according, to applicable regulations. CLENI 1-UP Spills should be contained by, and covered with large quantities of ,sand, earth or any,',other readily available absorbent material', which is then brushed in vigorously, to'assis_ absorption. ' The mixture can then be collected into drums and removed for 'disposal. Wash residues from area with soap and water and rinse down. Contaminated water should be retained, not being allowed. to flow into ground or surfaC.: water.' 4 7) HA LADLING AND STORAGE HANDLING , - f CAUT.:a>N: Contents under ,pressure. Avoid open flames. Do not puncture or• inc nerate. Avoid contact .of this product with water at all times during handling anti .storage., Use only vith .adequate ventilation:, Keep equipment clean: Use disposable ontainers and tools where possible. DoInot:eat, drink, or smoke, in,working area. x STORAGE Store in a dry place between 7.5F-105F ;(24C-.41C)-":'; Keep containers •tightly closed , not ii. use. Protect from atmospheric moisture. Maintain a nitrogen atmo;:: . closed, d, when o note store product contaminated with water'-to prevent-potentially hazardous reaction. 8) EXPOSURE CONTROUPERSONAL PROTECTION + ENGINEERING CONTROLS Use only with adequate ventilation.. Local exhaust ventilation may be 'nece; sary for some operations. EYE/R4,'E PROTECTION Use a:iemical' goggles: If vapor •exposure causes eye discomfort, use a full-face respirator. Eye wash fountain should be located••in,immediate work area. SKIN F:'F;OTECTION k Use cf: oves impervious to this- material. Wear ,.clean, long-sleeved, body cloth:i;ig. After work and before-eating, drinking or smoking wash _and clean .covering n yourself e( caref•.i .ly with : soap and water. Contaminated clothing ,should' be washed and/or dry cleant before re-use. RESPIR.kTORY PROTECTION For mcst conditions, . no respiratory protection is needed; however, if handling at elevated temperature without sufficient ventilation° or' in presence of aer::osols, use an approved air-purifyiri respirator. g p Atmospheric p c levels should be ma intaii:.ed below the . exposi:.i a guideline. , EXPOSL RE GUIDELINES(S) Page 3 of 7 FROTH-PAK(TM)600 B 25FS NCFC Polyurethane.Spray Foam System MATERIAL SAFETY DATA SHEET , 1,1;: ,3,3 pentafluoropropane:- 300 ppm TWA set by manufacturer. Diet:.t.ylene glycol: 10 mg/m3 TWA8 AIHA WEEL and Interim SHG (aerosol) 50 ppm TWA8 lriterim IHG (aerosol and vapor) 9) Pt•YSICAL AND CHEMICAL PROPERTIES ; APPII=,'+RANCE/PHYSICAL STATE, liquid SOLU 31LITY IN WATER not d=termined SPEC:I FIC GRAVITY not ,3°termined 10)SUABILITY AND REACTIVITY CHEP4 CAL STABILITY , Stably under recommended storage 'conditions:=% CON DI TIONS TO AVOID , Prod-.z,;t can oxidize or decompose at elevated temperatures: INCON PATIBILITY WITH OTHER MATERIALS Avoid contact with oxidizing materials 'and-strong acids. Avoid unintended contact `with isocar<mates. The reaction of polyols and isocyanates generates heat. HAZA,F DOUS DECOMPOSITION PRODUCTS None under normal conditions of storage and use.' HAZAF DOUS POLYMERIZATION ". Will i.ot occur by itself. 11)T C iXICOLOGICAL INFORMATION U TOXICOLOGICAL INFORMATION Assesnents may be based on studies of the individual components or on families., of, chemicals. ACUTE Inhalation LD50-for diethylene glycol' is >4.4 mg/1 forl'4 hours (rat) .` Excessive exposure to ' 1,1,1,2-tetrafluoroethane may cause ' irritatic)n to upper, -� respizatory tract (nose and throat)'. Acute inhalation toxicity of 1,1,1, 2-tetrafluoroethane.. is low, but exposure to high concentra._ions causes asphyxiation. 1,1,1, 3,3-pentafluor6propane: acute inhalation LC50 in rats >200;000 ppm• (4 hours) .,--No lethality at 200,000 ppm. Evidence of transient anesthetic effect. Acute inhalation in mice >100,000 ppm (4 hours) . No lethality at 100,000 ppm;• evidence of transient undera�tivity .during,exposure. SKIN Polyol: ,LD50 inrrabbits is .>2000 mg/kg. LD50 :E)r diethylene glycol is 12510 mg/kg (rabbit) . 1,1,1., l,3-pentafluoropropane. Dermal LD50 in.'.rabbits >2000 mg/kg: INGEST ON PolyoI LD50 in rats is '>2000"mg/kg. Human .ethal dose of dietlylene•glycol is approx. 2 ounces (65 ml) (1/4 cup),.c LD50 for diethylene glycol is 25244 mg/kg (rat) ' k Page 4 of 7 FROTH-PAK(TM)600 B 25FS NCFC Polyureth::ine Spray Foam System MATERIAL SAFETY DATA SHEET 12) ECOLOGICAL INFORMATION ' ECC L OGICAL INFORMATION The ;stratosphere ozone depletion potential (ODP)'' of 1,1;1;2-tetraflucroethane, ,relative to CPC-11 and CFC-12 (ODP=1) is 0. MOVE MENT&PARTITIONING No 1:):oconcentration of the polyof, is expected. 1,1,: ,2-tetrafluoroethane volatilization from water to air is expected. DEGRADATION&PERSISTENCE Prol:iietary flame retardant is persistent in the environment. ,- Base: on information for . 1,1;1,2-tetrafluoroethane: material is expected to be very, stable in the environment. Because of.-low biodegradability, the pro.-luct should be prevented from reaching water or soil. EEcar)XICITY Fire retardant: Avoid releasing to the environment. The*OLC50 "for a structurally similar compound in Gluegill Sunfish (96H) 12 mg/L (NOEC <10 mg/L) . 13) D SPOSAL CONSIDERATIONS DISP0 SAL . DO Nor DUMP INTO ANY SEWERS, ON THE, GROUND, OR INTO' ANY, BODY OF'' WATER. All disposal ' methois must be in 'compliance with all Federal, State/Provincial and :Local' laws sand regul.itions. Regu::.,ktions may vary in different locations. Waste characterizations ::nd compliance " with applicable laws are the responsibility solely pf the waste genera_or. THE DOW CHEM.I:t'AL COMPANY HAS NO CONTROL OVER THE . MANAGEMENT PRACTICES OR MANUFACTURING PROCE:ISES OF PARTIES HANDLING OR USING THIS MATERIAL. 'THE :INFORMATION PRESENTED HERE ' PERTA:NS ONLY TO THE PRODUCT AS SHIPPED •IN ITS'INTENDED CONDITION AS DESCRIBED "IN MSDS SECTION 2 (Composition/Information On Ingredients) . FOR CNUSED & UNCONTAMINATED PRODUCT, the, preferred options include , sending to a devicic ev .ed, permitted: , recycler, 'reclaimer, incinerator or other. thermal destruction e . As a 7fervice to its customers, Dow can provide names of information 'rescurc6s to help identify waste management companies and..other facilities which recycle, reprocess or manage chemicals or plastics, and that manage used drums. Telephone Dow's Customer Information Center -at 800-258-2436 or 989-832-1556 for further details. 14)TIIi ANSPORT INFORMATION US D.O.T. This product is not regulated when pressures are less than 40 psi. When` gi:eater than 40 psi, the classification ' . is'. Compressed Gases, N.O.S.. TetrafLuoroethane) , 2.2 UN1956. (Pentai`luoropropane,, CANAD AN TDG This }>: oduct is not regulated when pressures are less than. 40 psi. When. greater than 40 psi, the classification is: Compressed Gases, N.O.'S. (Pentaf Tetra:E:.uoroethane) , 2.2 UN1956. � . , .luoroprop ane, . 15) REF 33ULATORY INFORMATION Page 5 of 7 FROTH-PAK(TM)600 B 25FS NCFC Polyurethane Spray Foam System MATERIAL-'SAFETY DATA -SHEET NOl•I1:E r The _nformation herein is .presented in good faith and.,believed to be accurate as of the , effe.:tive date shown above. However, no warranty, , expressed `or imp];ied , is given. Regu..atory requirements are subject .to change and may differ• from, o:rle location `to another; it is the buyer's responsibility* to ensure that '-its, activit'•'es comply with fede:•al, state or provincial, and local laws. The. following specific information is made for the purpose of complying with numerous federal, state or provin: ial,- and local ' laws and regulations. See other sections for health and .safety information. REGI LATORY INFORMATION U.S, REGULATIONS --- ----------- _ SARI. 313 INFORMATION: .This product contains the following subject to thereporting regtt: rements of Section 313 of Title" III of the ,Superfund .'amendments and Reauthorization Act of 1986 and,40,CFR,Part 372: CHEM=CAL NAME CAS NUMBER , ------ ------------------------------------ --------------- None SARI?, HAZARD CATEGORY: This product ;has been 'reviewed, *according to '.ttie EPA "Hazard Cate::cories" promulgated under -Sections 311' and-, 312 ' of' the Superfund Amendment and Reauthorization Act of 1986 ,•(SARA Title III) : and is considered, under applicable defi.ritions, to meet the following categories: An inmediate health hazard 4 A delayed health hazard TOXIC SUBSTANCES CONTROL ACT (TSCA) c f All ingredients are on the TSCA inventory. • CALIEORNIA Prop 65: Thin"product contains the following- chemicals- known to the State-of California to cause cancer or other reproductive harm: Residsal 1,4 dioxane, CAS# 123-91-11'amount: 0.500'ppm in di ethylene glycol Residial Ethylene' glycol monomethyl ether, CAS# 109-86-4 amount: <0.050ppm in diethVlene glycol .- . Flame retardant PENNSILVANIA STATE RIGHT TO`KNOW Hazardous 'or Environmental Hazardous'RSubstance: , Diet'a(lene glycol I CAS: 111-46-6 Amount'!:" 1-5%_ �. Resid.jal Ethylene glycol monomethyl ether CAS # 109-86-4 amount: <0.050 ppm in dietia rlene glycol , OSHA :RZARD COMMUNICATION STANDARD: This, product is a :"Hazardous Chemical'! 'as..defined by; the .OSHA Hazard Communication Stand,ird, '29 CPR 1910.1200. COMP1a:;HENSIVE ENVIRONMENTAL RESPONSE COMPENSATION. AND 'LIABILITY ACT: (CERCLA, or SUPER:'UND) This product contains the .following substances) listed" as ; "Hazardous, Substances',! Page 6 of 7 y FROTH-PAK{TM)600 B 25FS NCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET und:.:. CERCLA which may require reporting of-releases: Cat: -Tory Chein-cal Name CAS# RQ _--- ------------------------- -- --------•-- NON; CANADIAN REGULATIONS -------------------- WHMI3 INFORMATION: The Canadian Workplace Hazardous. Materials Information ;System (WHMIS) Classification for this product is:, r D2B eye or skin irritant Refer elsewhere in the MSDS ,for-specific..warnings and safe handling information. Refer to the employer's workplace education program. CPR STATEMENT: This product has been classified in',accordance with the hazard criteria of 1.he Canadian Controlled Products' Regulations (CPR) and the MSDS contains all the, information required by the CPR. Y• HAZFRDOUS PRODUCTS ACT INFORMATION: This product contains-`the following` ingredients which. are Controlled Products and/orA,on 'the Ingredient Disclosure—Lis_ (Canadiin HPA section 13 and 14) COVI ONENTS: CAS # Tri.ethyl Phosphate 18-40-'0.. . . .,: . CA13 DIAN ENVIRONMENTAL PROTECTION ACT (CEPA) : Thi.: product contains some substances NOT• ::listed, on the Canadian Domestic Substances Liett (DSL) 16) NHER INFORMATION OTIi_R INFORMATION EPP. intends to promulgate a SNUR (Significant New Use Rule) restric-:ing the use of 1',1., 1,3,3 pentafluoropropane.'- Use, as a blowing agent is one of the 'approved uses. The: Canadian EPA )has imposed Managerial ' Condition 12088 .upon the use of 1,1,1,3,3 pentafluoropropane. These ;conditions must be met before the product. c&a be ordered and usec in Canada. No c ther ,information. (TM) , *, or (R)I.Indicates a Crademark .of ,The `Dow Chemical Company: Page 7 of 7 s FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET- 1) PIA ODUCT AND COMPANY IDENTIFICATION THE DOW CHEMICAL COMPANY Midland Michigan 48674 USA 244 our Emergency Phone Number: 989-636-4400 Cu s:omer Service:800-366-4740 PRC DUCT NAME :FROTH-PAK(TM)600 A 25FS HCFC Poyurethane Spray Foam System' MATERIAL TYPE:isocyanate ISSI IE DATE:07/19/2007 RE%ISION DATE :03/04/2004 2) C,C,MPOSITION/INFORMATION ON INGREDIENTS IngrEt ient CAS Number % Polyrn.ethylene polyphenyl isocyanate 009016-87-9 60-100% contaii iing 4,4'methylene bisphenyl isocya late CAS#101-68-8 at apprru imately 40-50% Chlorc Jifluoromethane 75-45-6 5-10% 3) H.A ZARDS IDENTIFICATION EMER 3ENCY OVERVIEW CAUTION! Contents under pressure. _ Vapozs reduce oxygen available for breathing and are'heavier than air. May cause moderate eye irritation. . Spraped or heated material harmful if. inhaled.. May cause allergic skir.., reaction, May cause allergic respiratory reaction and lung injury. Avoid temperatures above 105F (41C:) . Toxic flammable gases and heat are released under decomposition conditions. Toxic fumes may be released in fire situations. Reacts slowly with water, releasing carbcn dioxide, which can cause pressure buildup and rupture of closed *containers. Elevated temperatures accelerate this process. EYE May cause moderate. eye irritation. May cause very slight transient (temi.orary) corneal ' injury. SKIN Prol.cnged or repeated exposure may cause slight skin irritation. May cause ' allergic skint reaction in susceptible individuals.. Animal studies have shown that skin contact with isocyanates may play a role in respiratory sensitization. May : tain . skin. A , single prolonged exposure is not likely to result in the material. being 'absorbed in harmful amounts. INGHt TION Single dose oral' toxicity is considered to be low. No hazards anticipated from_ small-owing small amounts, incidental, to 'normal handling operations. INHAI ATION {' .At a-uom temperature, vapors are .minimal due to low vapor pressure. Hciwever,: certain operations may generate vapor or aerosol concentrations sufficient to cruse irritation or : •.her adverse' effects. Such` operations include those in which the material, is heatEd, sprayed •or otherwise mechanically dispersed such 'as drumming, venting or pumping. Excessive exposure may cause irritation .to upper respiratory t:>.:act and lungs, and )ulmbnary edema (fluid in the lungs) . May cause respiratory sE!:zsitization in susceptible individuals. MDI concentrations below the exposure guidelines may cause ""' or R) indicates a Trademark of The Dow Chemical Company Page,1 of 8 FROTH-PAK(TM)600 A.25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET alle::•gic respiratory reactions in individuals already sensitized. Symptoms may in cout-thing, difficult breathing and a •feeling of tightness in the chest. Effects may be dela,,ed. Decreased lung function has been associated with overex o p sure Leo isocyanates. SYS'f--MIC EFFECTS Tisrn.e injury in the upper respiratory tract,and lungs has been observed in laboratory animm.ls after repeated excessive exposures to MDI/polymeric MDI aerosols. TERATOLOGY In laboratory animals, MDI/polymeric MDI did not cause birth defect:;; other fetal effe<ts occurred only at high doses which were toxic to the mother. CAW ER INFORMATION Lunq tumors have been observed in laboratory animals exposed to aerosol, droplets of MDI/Iolymeric MDI (6 mg/m3) for their lifetime. Tumors occurred concurrently with, respiratory irritation and lung injury. Current exposure guidelines -a.:re expected to protect against these effects reported for MDI. 4) FII;ST-AID MEASURES EYE Irritate with flowing water immediately and continuously for 15 minutes.- 'Remove contacts after first five minutes and continue washing. Consult medical personnel. SKIN Remove material from skin immediately by washing with soap and plenty oi' water.. Remove contaminated clothing and shoes while-washing. Seek medical attention if irritation persists. An MDI skin decontamination study demonstrated that a polyglycol-based skin cleanser or corn oil may be more effective than soap and,water. , INGESTION If aaallowed, seek medical attention. Do not induce vomiting unless dire>eted to do so by mefticai personnel. INHAL 4TION Remove to fresh air. If not breathing, give artificial respiration. If breathing ;is diff:i :ult, oxygen should be administered by qualified personnel. Call physician or trans,>ort to a medical facility. NOTE;; f O PHYSICIAN No specific antidote. .Provide supportive care. Treatment based on judgment of . the physi-.-ian in response, to reactions of the patient. May cause respiratory sensitization or aethma-like symptoms. Bronchodilators, expectorants, and antitussives., may be of, - help_ Respiratory symptoms, including: pulmonary edema, may be delayed. Persons rece::.•,ing significant exposure should be observed for 24-48 hours for signs 'of resp .:•atory distress. 5) FIIIi E-FIGHTING MEASURES FLANIA IABLE PROPERTIES 4 FLASH POINT: >400F, >204C METHgI,l USED: PMCC, ASTM D93 AUTO;:(NITION TEMPERATURE: >1100F, 600C FLAMILIBILITY LIMITS LFL: Pot applicable. UFL: lot- applicable. . HAZAIR DOUS COMBUSTION PRODUCTS J Durinc a fire, smoke may contain the .original material in addition to unidentified toxic and/or irritating compounds. Hazardous combustion products may include but are Page 2 of 8 FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET not limited to: nitrogen oxides, isocyanates, hydrogen cyanide, carbon monoxide, and , car:bin dioxide. Addi--ional combustion products may include ammonia, hydrocholoric acid, hydrofluoric acid. chlorine, fluorine, phosgene and phosphorous oxides. . OTFtI R FLAMMABILITY INFORMATION Prod'ict reacts with ,water. Reaction may produce heat and/or gases, eaction may be viol,!nt. Container may rupture from gas generation in a fire situation, violent steam genes:.-ation or eruption may occur upon application of direct water stream to hot liqu..ds. Dense smoke is produced when product burns. Spills of these organic liquids on hot `ibrous -insulations may lead to lowering of the atoignition temperatures possibly res ..ting in spontaneous combustion. EXTIP GUISHING MEDIA F,` Use carbon dioxide, dry chemical, foam, water,- fog or fine spray. Alcohol resistant foaro (ATC type) are preferred if available. General purpose s,.,nthetic foams (inc:uding AFFF) or protein foams may function, but much less effective: Do not use direct water stream which can spread•fire. FIRE:I`IGHTING INSTRUCTIONS Keep people away. Isolate fire area and deny unnecessary entry. Stay upwind. Keep out of low areas where gases (fumes) can, accumulate. Water is not recommended but: may be applied in very large quantities as a fine spray when other extinguishing agents-are not available. Contain fire water run-off if possible. Do not use direc<: water stream. May Epread fire. Fight fire from protected location or safe distance. Consider use of unmanned hose holder or monitor nozzles. Use water spray to cool fire exposed containers and fire affected zone until , fire ` is out. Immediately withdraw all personnel from area in case of rising sound from venting safety devices. or discoloration of the containers. Move containers from fire area if this-is possible with.ont hazard. PRO1'1:CTIVE EQUIPMENT-FIREFIGHTERS Wear positive-pressure self-contained breathing apparatus (SCBA) and p:-otective fire fighting clothing (includes fire fighting helmet, coat, pants, boots, and gloves) . Avoid contact with this material during fire fighting operations. If contract is likely, change to full chemical resistant clothing with SCBA. If his will: . not provide suffa?ient fire protection; consider fighting fire from, a remote location. 6)AC CIDENTAL RELEASE MEASURES PROT'E',CT PEOPLE Avoid any contact. Barricade area. Clear non-emergency personnel from area.` Keep upwind Of SIP .11. Ventilate area of leak or spill. The area must be evacuated and reentered by persons equipped for decontamination. Use, appropriate safety equipment. If available, use :fcaam to suppress vapors PROTE CT THE ENVIRONMENT Conta:c: n liquid to prevent contamination of soil, surface water or ground water. Keep out c;>:` ditches, sewers,- and _water,supplies:'Should the product enter sew !rs. or drains, it should be pumped into a covered, vented container; the cover shoL.cld be placed• loose'y on the container but not made pressure tight. Move to a well-ventilated area. Emergency services may need to be. called to assist in the cleanup operaticn'' CLEAN-UP Supplies of suitable decontaminant should always be. kept available. .Absorb with material such as: sawdust,, vermiculite, dirt, sand, clay, cob grit, -Vilsorb. Avoid materials such as cement powder. Collect material in suitable and pro'perl-V labeled OPEN. containers. Do not place in sealed container. Prolonged contact with water- re_sults ,in a chemical reaction which may :result in rupture of the container. Place in: polylined fiber pacs, plastic drums,., or •properly, labeled metal containers. Remove to a_, well ventilated area. Clean up floor Areas.* Attempt to neutralize by suitable decontaminant Page 3 of 8 FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET solu:ion: Formulation 1: sodium carbonate^5-10s liquid detergent 0.2-2$:; water to make up to 100%. OR Formulation 2:. Concentrated ammonia solution 3-8%; liquid detergent 0.2- ?%; water to make up to 1000. If ammonia is used, use ..good ventilation•to `prevent vapor exposure. If you have any questions on how to neutralize call The Dow Chemical Comp iny. r 7) H,WDLING AND STORAGE HAM[1LING CAUT:ON: Contents under pressure. Avoid open flames'.. Do not puncture oi• incinerate. Avo.:_:I contact of this product withfwater at all- times during handling and storage. Use only with adequate ventilation. Keep equipment clean. Use disposable containers and, tool:, where possible. Do not eat, drink, or-smoke in working area. STORAGE Sto:ra! in a dry place between 75F-105F- (24C-41C) . Keep .containers tightly closed when` not ..n use. Protect from atmospheric moisture. Maintain a nitrogen atmosphere.. Do not stor(: product contaminated with water to prevent potentially-hazardous r,_:action. 8) E);POSURE CONTROL/PERSONAL PROTECTION ENGII IEERING CONTROLS Use only with adequate ventilation. Provide general and/or local exha..at ventilation to c)ntrol airborne levels below the ,exposure guidelines. Exhaust sye::ems should be des'..cned to move the air away from the source of vapor/aerosol generation and the people working at this point. Odor is inadequate warning of excessive exposure. EYE?F ACE PROTECTION a; Use chemical goggles. SKIN .IROTECTION , Use protective clothing impervious to this material. Selection of specific items such As °tceshield, gloves, boots; apron, or full-body suit will depend c:n operation. Consideration of all chemicals involved, time and the dexterity needed to safely complete the job must be considered. Solvents .can significantly change the permeation" of a chemical through a barriei. Work with your safety equipment supplier to obtain the test Personal Protective Equipment 'for .the job. '- Nitrile gloves are 'often found to` be appropriate for work with MDI. Butyl rubber, PVCk,and neoprene are also often chosen. . Remove contaminated clothing ' immediately, wash skin area with _soap ar_d 'water (warm A water if available) and launder clothing before reuse. Items which cannot be decontaminated, such as shoes, belts and watchbands, should be removed and,destroyed. RESPI RATORY PROTECTION AtmesDheric levels should be maintained° below the exposure guideline. When at levels may exceed- the exposure guideline, use an approved air-purifying respirator equioped with an organic vapor sorbent. and a particle filter. For situations where the atmospheric levels„ may exceed 'the level for which an air-purifying,. respirator is effe::=ive, use a positive-pressure air-supplying respirator (airline or self-contained breatiing apparatus).. For emergency response or -for situations where the atmospheric level is unknown, use an approved positive-pressure self-contained breathing apparatus. EXPO,4IURE GUIDELINES(S) Chlor)fluoromethane . (HCFC-22) :. ACGIH Threshold Limit Value (TLV). is :1.000 ppm- TWA-8 hours.' - Methylene bisphenyl isocyanate` (MDI)_: ACGIH TLV is 0.005 ppm TWA and os:.L PEL is 0.02 ' ppm Ceiling. PELs are in .accord with those recommended by OSHA, as in the 1989 revis on of PELa. Page 4 of 8 FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET 9) Fit IYSICAL AND CHEMICAL PROPERTIES APPE ARANCE/PHYSICAL STATE Broi,n, liquid. ODOF: s slicll.tly musty. VARC R PRESSURE <1 10(-5) mm Hg @ 25C VAP+C R DENSITY 8.5 air = 1) BOIL.I JG POINT 410 F (210 C) 5 mm Hg SOLIJ 31LITY IN WATER Inscluble in water; reacts, with evolution of CO2. SPEC FIC GRAVITY 1.24 Q 20C i 43 TABILITY AND REACTIVITY CHEM ICAL STABILITY Stable under recommended storage conditions. INCOP IPATIBILITY WITH OTHER MATERIALS Avoid contact with acids, water, alcohols, amines, ammonia, bases, moist air, and strong oxidizers. Avoid contact witfi metals such as aluminum, brass, copper, galvanized metals, tin, zinc. Avoid.:contact.with moist organic absorbents. Reaction with water will generate carbon dioxide and heat. Generation of,gas can cause pressure buildup in , closed systems. Avoid unintended contact with polyols. The reaction c::f polyols and isocy�.nates generate heat. Diisocyanates react with many materials and the rate of reaction increases with temperature as-well as increased contact; these reactions can beco.ns violent. Contact is increased by stirring or if the 'other mater:;_al mixes with the eiisocyanate. Diisocyanates are not soluble in water and are denser than water and Eink to the bottom, but react slowly at the interface. The reaction forms carbon dioxide gas and a layer.of ,solid polyurea. k° HAZ/!d tDOUS DECOMPOSITION PRODUCTS Hazardous decomposition products depend upon temperature, air supply and the presence of osier materials. Gases are released during decomposition. HAZAI IDOUS POLYMERIZATION Can occur. Polymerization can be catalyzed by: strong bases and water. Can react with itsel ` at temperatures above 320F (160C) . 11)TOXICOLOGICAL INFORMATION - ACUTE Exce!33ive exposure .to HCFC-22 (Chlorodifluoromethane) .j may depr_ssion of the centr,il nervous system, or possible asphyxiation. SKIN MDI: "he LDS for skin absorption in rabbits is > 2000 mg/kg, ; t INGE,S n6k - - MDI: The oral LD50 for' rats is > 10,000 mg/kg. MUTA iENICITY MDI:. Wutagenicity data on MDI are inconclusive. MDI• was.-:weakly pos::.tive in some - Page 5 of 8 FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET in- r.tro (test tube) studies; othe:• in-vitro studies were negative. A mutagenicity'.study in animals,w :s negative. 12) ECOLOGICAL INFORMATION k ` MOVEMENT&PARTITIONING BaseC on information for MDI and polymeric MDI. In the aquatic! 'or terrestrial envi.;"onment, movement is expected to be limited by its reactivity,witk;. water forming predominantly insoluble polyureas. VOlcllilization from water to air is expected for HCFC-22, chlorodifluoromethane. DEGF ADATION&PERSISTENCE Base(. on information for MDI and polymeric MDI.' In the aquatic and terrestrial envi>onment, material reacts with water forming predominantly insoluble* polyureas. which . appe::z r to be stable. In the atmospheric environment, material is expected to have a short tropospheric half-life, based on calculations and by analogy with related dii:>c cyanates. ECO MICITY , Base( on information for MDI and polymerc MDI. The measured ecotoxicity is that of the hyda:clzed product, generally under conditions maximizing production of sc>luble species. Material is practically non-toxic to aquatic organisms on an acute- basis (LC50/EC50 > 100 iig/L in .most sensitive species) . The;LC50 in earthworm Eisenia foes ida is > -1000 mg/kc 13) 10ISPOSAL CONSIDERATIONS DISF'C SAL CONSIDERATIONS FOR 7NUSED & UNCONTAMINATED PRODUCT, the preferred options include sending, to a licensed, permitted: recycler, reclaimer, incinerator or 'other -thermal destruction device. As a. service to its customers, Dow can provide names of information reicurce to help identify waste management companies and other facilities which recycle;' reprocess or manace chemicals or plastics, and that manage. used drums. Telephone Dow's Customer Infornation Center at 800-258-2436 or 989-832-1556 for further details. DISPC SAL DO ACT DUMP INTO ANY SEWERS, ON THE GROUND, .OR INTO ANY BODY OF WATER. All disposal meth.cis must be. in compliance with all Federal, State/Provincial and- local laws and regulations. Regulations may vary in different locations. Waste characterizations and compliance with applicable laws are the responsibility solely of the waste generator. THE EDW CHEMICAL COMPANY HAS NO CONTROL OVER THE MANAGEMENT PRACTICES 01R MANUFACTURING PROCESSES OF PARTIES HANDLING' OR USING THIS MATERIAL. THE INFORMATION PRESENTED HERE PERTACNS ONLY TO THE PRODUCT AS SHIPPED IN. ITS INTENDED' CONDITION AS DESCRIBED IN MSDS SECTI)N 2 (Composition/Information On Ingredients) . 14)11'1?ANSPORT INFORMATION US D.O.T. This )roduct is not regulated when pressures are less than 40„psi. When greater, than 40 psi, the classification is: Compressed Gases, N.O.S. ( chlorodifluoriPmethane) , 2.2 UN195 i. CANAI MAN TDG This >roduct is not regulated when g pressures are ess than 40 psi. When greater than 40 psi, the classification -is: Compressed Gases, N.O.S. ( chlorodifluorc:methane) , 2:2 UN19!i i. e �a=�-��4TARY INF-AI�MhTIAN _ Page 6 of 8 FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET NOTI1:E The :.nformation herein is presented in good faith and believed to be accurate as of the effe4!tive date shown above. However, no warranty, :expressed or implied is given. Regu..atory requirements are subject to change and may differ from one location to ano•::lier; it is the buyer's responsibility to ensure that its activities comply with fede:•al, state or provincial, •and .local laws. The following specific information is made for the purpose of complying with numerous federal, state or provincial, and local lawn and regulations. See other sections for health and safety informati•_,n. RECII LATORY INFORMATION U.S. REGULATIONS ------- ----------- SARA 313 INFORMATION: This product contains .the following subject tc the reporting requ:rements of Section 313 of Title III of the Superfund P mendments and Rear.rt.horization Act of 1986 and 40 CFR Part'372: CHEM: CAL NAME CAS NUMBER Methl,lene bis(pheylisocyanate) '(MDI) 101-68-8 Pol},rieric Diphenylmethane diisocyanate 9016=87-9 Chlorodifluoromethane 75-45-6 SARA HAZARD CATEGORY: This product has been reviewed according to the EPA "Hazard Cate:cories" promulgated under Sections 311 and 312 of the Superfund Amendment and Reauthorization Act of 1986 (SARA Title III) and is' considered, under applicable defii.itions, to meet the following.categories: An irimediate health hazard A de-ayed health hazard TOXI( SUBSTANCES CONTROL ACT (TSCA) : f ,� All 'ngredients are on the TSCA inventory or are-not required to be liste' d on'the TSCA invea tort• . OSHA HAZARD COMMUNICATION STANDARD: + 'e Thies. product is a "Hazardous Chemical" as; defined by the OSHA Hazard. Communication " Star:.c ard, 29 CFR 1910.1200. COMPFEHENSIVE ENVIRONMENTAL RESPONSE COMPENSATION AND LIABILITY ACT (CERCLA,or SUPF:F FUND) Thia product contains the following substances) listed;as' "Hazardous Sut:rstances"under ` CERCIA which may require reporting of releases: Catecory: Chemical Name CAS#k RQ ------- ---------------- ------------------------ ---------------=---------------- Meth}lene Bis(phenylisocyanate) 101-68z--.8 5000 lbs r STATE RIGHT TO KNOW Pennsylvania Hazardous Substance r Methylene. Bis(phenylisocyanate) 101-68-8 Page 7 of 8` FROTH-PAK(TM)600 A 25FS HCFC Polyurethane Spray Foam System MATERIAL SAFETY DATA SHEET Chl6i odifluoromethane 75-45-6 CANj!J IIAN REGULATIONS ---.,.. --------------- WHM:i::: INFORMATION: The Canadian Workplace Hazardous Materials Information Sys;.o:m (WHMIS) Classification for this 'product is: D2A respiratory tract sensitizer.. D2B eye or skin irritant f 02B skin sensitizer A - ,ompressed gas ' Refe.- elsewhere in the MSDS for specific warnings and safe handling information. Refer to Cie employer's workplace education program. r - CPR STATEMENT: This product has been classified in -accordance with the :hazard criteria. of the Canadian Controlled Products Regulations .-(CPR) and the MSDS contains, all the information required by the CPR. HAZAZDOUS PRODUCTS ACT INFORMATION: This product contains the follow.ng. ingredients whici are Controlled Products and/or on.the Ingredient Disclosure .List:. (Canadian HPA section 13 and 14) : COMPONENTS: CAS'# Meth(lene bis(pheylisocyanate), (MDI) f 101-68-8 CAN.ADIAN ENVIRONMENTAL PROTECTION ACT .(CEPA) : , All substances in this product are listed on the Canadian Domestic ,Substances List (DSL) or are not required to be listed. 16) OTHER INFORMATION OTHI iR INFORMATION No cther information.' (TM) , *, or (R) Indicates a trademark of The Dow Chemical Company. Page 8 of,8 P t 1 Lq /� a k U J1 o w { ( p� AZA) 5 le 101, .� v rag / ®Gl cuo LCX15 7- UtINb ` ; o f �! 1 W'.ov r~ v_Ae r o yl i 4� 1`t� 11