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0480 SKUNKNET ROAD
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Day_�/r� Time _ �l�/S� P.M. e Mh,+� Of Phone FAX Area Code Number Extension MOBILE Area Code. Number Extension Telephoned Returned your call RUSH Came to see you Please call ` Special attention Wants to see you Will call again Caller on hold 0 Message 9 s Signed T r o universal"48023 . __� LITHO IN I S.A. NOTES ----- --- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel r r. ., ..• r Permit# g � Health Division '— '�� Date Issued129 /dL Conservation Division , Application Fee Tax Collector i A t Permit Fee 4�zy, 00 Treasurer .fiSICo! Planning Dept. EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TC OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address �� �11ni �( Z e T C (' avvT-tY V, Me-- �1� Village 01NoS1c,6/0- Owner me, Address Telephone �S__Ogj L o® - �f Permit Request Odd row OF e,-0 c(eongAce FIttQ C Square feet: 1st floor: existing �i�0 proposed 2nd floor: existing proposed Total new Zoning District flood Plain Groundwater Overlay - Project Valuation 4 acoo Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structup Historic House: ❑Yes D No On Old King's Highway: ❑Yes 0 No Basement Type: IFull ❑Crawl O 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: Cad Gas ❑Oil ❑Electric ❑Other Central Air: 0 Yes U/N o Fireplaces: Existing New Existing wood/coal stove: ❑Yes V<o Detached garage:❑existing O new size Pool:0 existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing 0 new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial 0 Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name (�WN e-Y Telephone Number �,L/) Address - License# r Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE v DATE 1 �/Q FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. J ADDRESS VILLAGE y r OWNER DATE OF INSPECTION: FOUNDATION FRAME (ll�i5' �'' ?,: INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL X GAS: ROUGH FINAL FINAL BUILDINGS tc) Kip DATE CLOSED OUT S ASSOCIATION PLAN NO. r tv, i i ,, •, 1 The Commonwealth of Massachusetts ` Department of Industrial Accidents 600 g'ashin,aton Street _ xa Boston,Mass. 02111 Workers' Com ensaaattion Insurance Affidavit-General Businesses /� ame .. •�'Y✓r� Q ' address: ci state: work site-location full address): am a sole proprietor and have no one Business Type: D Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Ofice❑Sales(including Real Estate,Autos etc.) ❑I am an em loyer with ein to ees(full& art time). ❑Other / %//�%%/�% ///%%/W/y%/%/////y%///////%%///%/ r%/%/% //% %%/%///%%/%/%%%%%/%%///// / I am an em�leyer providing workers' compensation for my employees wOr 9 On this job, com env name: address:' • `'.., ,�,;',•�;` `',,•. ., •• ' hone#• ' city: ' , .;. . ..• ... .. °:G, .,�:•` • . .Ynstirance.ebd': .:: .;'�..�:'�:�.'. .. .... . . . ..... I am a sole proprietor and haye hired the independent contractors listed below who have the following workers' compensation polices: ; coin en name: address: • `1 .,• �,�-.a•: hone#�• ' '.• .'•+ _ insurance co. comp any l3elIte-d• .. .. address: ciEi i, _ hone# i ev Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of cral penalties of a fine up to$1,500.00 and/or. one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that g copy of this statement may be forwarded to the Office of Invntigations of the DIAfor coverage verification. I do hereby c nd a ins and penalties of perjury that the information provided above is true and correct Date Signature . . . Print name ''L � i�S Phone# 9/� � - M- Wz { official we only do not write in this area to be completed by city or town official permittlicense# ❑Building Department ? city or town, ❑Licensing Board �+ ❑Selectmen's Office ❑check if immediate response is required ❑Realth Department g',,•, contaetperson: phone#; ❑Other jse (revised Sept 2003) ---- -- -- - �'�•a_*•�,.zo-ar�.. r '..' ��.��!,�= '"'" "..,ate - J_ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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,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. MEMO Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to.your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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 listedbelow. City or Towns Please be sure,that the affidavit is complete and printed legibly. The Departmenthas.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 pernit/license number which will be used as a reference number. The affidavits.maybe-retumed to. .. or FAX unless other arrangements have been made.- the Department by mail The Office of Investigations would•hlce to thank ybu in.advance for you 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 Once of IMs08tlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext:406 7 oFIME ray, Town of Barnstable do Regulatory Services BARNST"B Mass. Thomas F.Geiler,Director 94'prE03 .�0. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 7A S J.&,.q Pr r.A F%rc place Estimated Cost 2000 Address of Work: `J 8o s f(tyT•Kx R d e e-4,-1, Ile 06 0263 7 Owner's Name: 19V Date of Application: 11 J P/o'f I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Ner ding not owner-occupied pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. R 1 i/?Co Date Q:forms:homeaffidav L tME Town of Barnstable OF �W Regulatory Services 4. STAB; - Thomas,F.:Geiler,-Director !1 J 4 MASS. - t639. A10 9� � ., 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 _. ._ - -- HOMEOWNER LICENSE EXEMPTION - Please Print DATE: ,�J�cg�e/ C r` �j 1 JOB LOCATION: "T 0 C? S/'►UN/1/F-e 7 RC/ I number street village .HOMEOWNER": �e�, C9UQI,i U-000) '11Q- 2/90 SOR2 77/- 9600 name home phone# work phone# CURRENT MAILING ADDRESS: LIPO S r1f�Owff Nd 2U C env�f ry,Ile /4 o) 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 constructs 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. Signa a of mweo e 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 person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming 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/certification for use in your community. Q:forms:homeexempt i N LoTd'� x�_ x Fact �1 -1 X ,�11 �, N� is�3Z S�. LT •� \ V R� � I I �D eta e>, 7 73- I certify that this property is Sl3411 PC located in Flood Hazard Zone C (out- side the 500 year flood) as identified P� by the Department of Housing and Urban Development (HUD) . Date �-jg� i� /y y'rJ P�-�H OF � �: CERTIFIED PLOT PLAN cDlM1l{R�J LOCATIONf-�.!� AQ� SCALE . / .r3a i DATE Reg. �' d t�rve i'pr PLAN REFERENCE . 47e7lvC..4. #Z I I e c rtify to its title insurance company • that there are no visible encroachments I CERTIFY THAT THE &71s72 1.0 or easements except as shown and that this SHOWN ON THIS PLAN IS LOCATED ON THE GROUND plan was prepared under my immediate AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF j supervision. . . .WHEN CONSTRUCTED. L G /S DATE / T ��ifl1�Z Bey PEA REGISTERED LAND SURVE R Model No.EM-41 Serial No. 101359 98197 INST.JBUIrATION AND OPERATING INSTRUCTIONS � 3 Em 41 These Hadels are Q.L. Seste&and Listed to =-=7 (in the Caned States) and Ramat Sersey Tested and Listed to Q=- SQO/OS-=7 Gin Canada and the United States), C0VGRa1QLaSZO►':1 Sou bare parChased a Quality, G.L. Listed Hest-9-610 fireplace engineered for safety and durability. Correct and proper inxtanati n of lc= fizepum is the Most isportaat step —==A g yeas of sate sad ooat1moas =a- Please Bead all Sastrsetiaas betora ixtaL *ng your fireplace. EAunre to fireplace axordiw ta�stall these instru c t i on s v=-void yo= eatraazy and could cause a fire w,z4.•w_ Use only , Q.L. Listed Gin the United States) or xarnoek Hersey Listed (in the United States sad Csaadw =s'-ff-=0 tistp7 Moe parts and accessories with your fireplace. 'For proper opemtioa of 70ur DLO Fireplace Systen, refer to {AfWMCIC eeseY the Cpe=ttLW Mutsneticm found in ycar - Installation YL Off-fflow,A HEKT-N H=-N-Glo F=;g=Products.Inc- 6665 weary sa��,r�srr ss�s 9 8` rr- Aa=r---i Ac��-s m T 7%4 4 4-1 3b — -�' 394 «,ate as gc.�ss FIG_ 16 DIMNSIONS OF Em4l _gyp_ 4 t. TABLE 1 F'TREP� DIIIENSI0NS ESCX=-ON HST-38 T-42 RST-48 EH4 EM41 42 BAY GZTC. DOOR 0" I 2 24" 21 3/8" /8" 19" 9" 19" GLASSVr DOOR 1/2" 2" 4 36"wnm 6 3 T HEIGHT 8" 8^ 9/lb " 38 1/4" 1 9 39 i 39 1/2" W= 37 4" /4" 48" 48" 41" 2 " 37" �NIT DEPTH 1/4" 5 1 25 1/ 25" 21 1/2" 2 " 23 1/4" 23 1/4" ny a C-2 FRAMING A. .DETF�IING WEEN TO INSTALL FR.�I�IING Fireplace framing can be built before or after the fireplace is set in place. Fig.19 and Table 2 show the minim nn framing Aimaneions. B. B= FR ENG A The fireplace framing should' be C% constructed of 2 x 4 lumber or heavier. Refer to Fig. 10 through Fig. 1g and Table 1• for basic fireplace dimensions E that will affect the framing dimensions. p The header may rest on the fireplace o C. standoffs. Framing should be positioned to / F accommodate wall covering and fireplace facing material (see section D-5. �. 19 DIl��NSIONS Finishing for typical arrangements) . T 1)i S (y) Table 2 FRAMING DIMENSIONS ESCRIPTION Lr= ' HST-38 HST-42 HST-42CF HST-48 am EM41 2 IS ? CLEARANCE (NORCCwIIST,r LF-' A 1/2" 3^ (12" 1/ 3 3 1/2" S 3 3^ 3" ONLY) FRAMING DLL&- /4" /4^ 38 1/ 46 3/4" 3 " 38 112" 4 /4 9 3/ 39 3/4" /4" SIONS (HE=) SIONSFRANa(WIDTH) C 39^ 43 1/2" 1/2" /4^ 1 " 42^ 4 CLEARANCE TO SIDE WALL FROM D 12 I2^ 12" 10" 1 22^ 22^ UNIT SIDE SIDE 5 BAM Ae CLEARANCE 112" 1/2" 1/2" 1/2" 1/2" 1 it " /A DISTANCE TO PAnATJ!: var* F 0" 0" 48" 4 48" R MIN. MANT%-- H GET FROM TO? OPENING -12- + C. INSTALLATION IN A CHASE C3.INSULATING FIREPLACE ENCLOSURE FOR COLD CLIMATES A chase is a vertical enclosure for the fireplace and/or chimney that may start In cold climates, insulation of the at the basement floor line, the first enclosure around the fireplace is level or at some point on the side of critical to avoid future problems with the wall and is attached to the outside cold air. The following steps are of the house (see Fig•20 ) • suggested to eliminate potential cold air problems. NOTE: Local building codes should be checked when planning . a chase to A. INSULATE BASE OF FIREPLACE determine requirements. A chase should be constructed like any Insulate the base of the fireplace with other exterior wall in the structure. a non-combustible insulation rated for a minimum of 300 degrees F. This step is The •10 Foot Rule' should be used to particularly important for outside wall installations over. concrete slab floor determine the required height of a c construction. If a platform is used to chased in chimney above the roof (see section D-2-A-Preparation For Chimney raise the fireplace, the insulation Installation under Installation should t placed on top of the platform Instructions for Details) . before the fireplace is set (see Fig. 2,1 ) D• SIDE WALL CLEARANCE AND AIR SPACE DATA FLAT.HARD All JMlT-N-GLO fireplaces can be located S(JRRiC>= directly a flat hard surfaced combustible floor- or on a wooden platform without air space from combustible construction. Some protection, however, is required for adjacent surfaces as detailed in • Fig.19 and Table 2. WARNING: THE MINIMUM AIR SPACE-TO- � COMMSTIBLES REQUIREMENTS FOR ALL MODEL FIREPLACES AND CHIMNEY SECTIONS MUST BE MAINTAINED. CATION / STORM • COLLAR . CAP FLASHING CHIIMIEY FIRESTOP visuLAnoN SPACER Y•� ,/' PUITF" IREPLACE Fig.21 insulation between p1a1b=and fireplace. . LID TYPE 6• INSPECT JOINTS INSULATION Inspect joints of the fireplace as well SOLID SUR- as the points of sealing between the ACE (CONTINUOUS) fireplace and the finishing materials. Any cracks should be sealed with non- INSULATION combustible caulking or insulation. See Section Sealing Joints (under . - OLID-FOUNDATION Finishing section of this manual) for details of sealing spaces between the fireplace and finishing materials. FIG.20 CHASE INSTALLATION (TYPICAL COLD CLIMATE) —13- 1 D. INSTALLATION INSTRUCTIONS STUD wsuLA ION D7.1. INSTALLING THE FIREPLACE A. CEECK EOW ACCESSORIES ARE INSTALLED �v Determine where selected accessories fit into this fireplace installation procedure by checking the installation instructions provided with each accessory. Glass doors must be installed after fireplace is finished. See instructions packaged inside the door carton. See Accessory Parts Section. NM. : -The•-outside air system and wiring for blowers typically cannot be installed after the fireplace completely Fig. 22 Sealeng spaces between fuepUwe and rmWii g installed. materials. C. INSULATION OF ENCLOSURE S- DETERMINE FIREPLACE LOCATION When a fireplace is installed on. an The fireplace should be installed on a outside wall, the enclosure should be solid, Continuous surface. Do not insulated lire any other wall of the install your fireplace on a floor home. Insulation should be installed on covered with carpeting.. vinyl or similar the inside wall as well as the outside soft combustible material; however, the wall(s) . Install a firestop ac. the fireplace may be installed directly on first ceiling level above the fireplace plywood, particle board or other solid and close the framing with sheeting combustible material. Before securing material. Insulation may then be the fireplace, it should- be properly installed above the sheeting material to leveled or the glass doors may nor fit assure the space around the fireplace is properly. totally protected. See Fig. 23 ' for additional details of suggested When determining the location of the insulating methods. fireplace, consider ceiling and roof rafters that may require cutting, CAUTION: WHILE INSTALLING A FIREPLACE plumbing and any wiring that may be IN AN INSULATED ENCLOSURE, BE SURE ALL needed or requires, moving. The location MARKED AIR SPACES ARE MAINTAINED. you have chosen must maintain proper clearances found in the Specifications, WARNING: DO NOT PACK REQUIRED AIR Reference and Framing Data section of SPACES WITH INSULATING OR OTHER this manual. t ATERIAI.S. L- DETERMINE THE ROUTING OF THE CHIT = Determine the routing of the chimney to the roof, including necessary offset WSUL1MQN and/or chase. when determining the amount of pipe you need, note that the •••.-' installed length of each chimney section is less than its total length due to the overlapped joints (see-Fig. 24 ) If you need assistance, contact your •local I1EAT-N-GLO dealer for details (see SANG Section - INSTALLING THE CHIMNEY). MATERIAL It=LAnON i C°I VAT: SECTION PART NiTMM o�eesoKs u was AL IICF + 2 wau isw 7y/ llCF4l N�� HM NMI Im is MIS s 16% HE// t�CFBs to �H84 • Fig.241nsalled lengths of chimney sections. FFg. 23 Additional insulating methods. —14— D. INSTALL FIREPLACE Thoroughly clean intended fireplace location area. Move fireplace to the location where it is going to be installed. Lift fireplace front tr slightly to slide metal safety strips(s) ' under front bottom and side edges about. 1 112 inches, allowing the remainder to extend out in front and sides of the fireplace. Overlap the strips at least 2/2 inch to provide a positive joint (see Fig.25 ) (Safety strips are packed / with fireplace) . NOTE: Metal safety strips.ase. required under any glass paneled front, side or rear. When positioning the fireplace on all mounting surfaces, the metal safety strips must be installed as described ' t above to provide protection to combustible (burnable) surfaces in front and sides of the fireplace. NOTE: Safety strip is not required over non-combustible floors where all NAILS OROTHER supports at the base of the fireplaceSUMASLE are non-combustible. FASTENERS FASTENING UN TURNED DOWN E. ANCHOR FIREPLACE IN POSITION To prevent shifting of the fireplace and FIg.26 Fasten fireplace in position using the Tastenfrlg to maintain sealing when finishing the , installation, anchor the fireplace by using the bottom nailing tabs• or fastening brackets (not provided) (see D-2. INSTALLING THE CHIMNEY Fig.26 ) . The fireplace can then be secured within the vertical framing A. PREPARATION FOR CHIMNEY INSTALLATION members. Refer to Framing and Finishing Section. Determine the desired height for your chimney installation. Offsets may be CAUTION: BE SURE THAT THEE FIREPLACE IS necessary to avoid plumbing, wiring, SQUARED AND LEVEL BEFORE SECURING IT IN roof joist, etc. ITS FINAL POSITION. WARNINGS: .% 1. NEVER INSTALL TWO ELBOWS TOGETHER TO •� MAKE A 60 DEGREE OFFSET. 2. THE MAXIMUM OFFSET DISTANCE IS 8 FEET. 3. ONLY USE 1 PAIR OF 30 nEGREE ELBOWA PER SYSTEM FOR MODEL EM42. MODELS EST-38, HST-42, HST-48, EM41, EM48, W BAY, PIER, AND OASIS MAY USE 2 PAIR OF 30 DEGREE ELBOWS PER SYSTEM. 1YA 4. ALWAYS ATTACH ALL FOUR ELBOW SUPPORT STRAPS. tys. 5. ALWAYS MAINTAIN THE MINIMQM REQUIRED TMp AIR SPACE TO COMBUSTIBLES. TYR 6. ALWAYS SECURE OFFSET SECTIONS WITH A ti, � MINIMUM OF TWO SEEET METAL SCREWS. (1.2 or 3 PIECES EACH SIDE) Fig..2.51nstan meta!strips under front,back and sides of tueptace. _15_ when determining the desired height of Thought should be given to the proposed your Location of the chimney outlet on the, ad"chimney installation, the '20 Foot roof. Objects such as trees Rule should be used to determine the jac required height of the chimney above the buildings or embay that are too o o close to the chimney can create air I roof. circulation problems during wind I 10 FOOT RULE: If chimney is within 10 weather that could affect the way the feet of roof peak, the top should extend fireplace draws air. After careful a -t^ -,— of 24 inches above the roof consideration, choose the location for pear. When more than 10 feet from roof your fireplace to achieve the simplest peak, the top of the chimney should be installation for maaimttm efficiency. positioned so that it is 10 feet or more Your fireplace is listed for use with from the closest point on roof in .a the BEAT-N-GLO or Majestic/Equus/xajco horizontal direction and a minimum of 24 chimney system. Each chimney component inches above the point, but never less must display the BEAT-N-(MO or than 3 feet in height .above the roof at Majestic/Equus/Majco brand name and the the center line of:the�stitmaey. U. L. Listed label. TABLE 3 CHIMNEY PARTS Double wag Double wag Triple wan {Butt 00) OX13-=00) 0Z13318 00) Pat rltf FArltio H SK part Nil R CF Part Na Part No. k6en i<�lion 0'TO 10' pcF 1 4 CM }{81 PipePipe t�faot aaFFB ASFMB k CF818 K 818 poe t8 kWh nGF3 HSK83 14CF83 1483 Pipe3 t00t RSK84 9 CF84 H 84 P%W4 foot RSKC836 44 CFC8t2 y RT8C Trz008 RTT2008 VTr2008 ChawTbp e+alksa:k� Tt 2008 —' H CF rmcs H TTacs Adapter Kilwp= li t=3o/Z" N SK830Q' 14 CF8302' p WQa* Chkoney Ell - - p CS 9 scSB R TCS8 4;TCSS Ctlimney Support 3'UK 8-4-12. H 86-12 44 8tr12 R 8.12.12 C.ontempowry ftshhtg r UML- i f t.88 R FL88 H FL88 H Fi88 Chase Top Fbstdrq DS-SA 14 088A $1 DB-8A 9 DB6A Stara Coda 3'l 4. FS-2A 14 SKFS-2A if FSaA X FSZA SKF56A k FS6A H F86A Fk�.. REI RENCE POINT 2'Mft ps-bR . N .lam�t is wrier.elbows are ka �to back. "Mobile Fame Fit op Thimble is Part NoBQXRSM Fig.27 Ten toot foie tot cticmey height. NOTF-Rw-3slaem st be straight pipe kmtalbtton wtM a minimum height of 12'6"for mobile home installation. TABLE a CHI?i_NEY SPEC IFIC1TrOSS ffiT-42CF BST-38 EST-42 EM48 Ea•12 Bay Pier Oasis Straight ght 45' _ 90' 47' ' 90 ' 9 15' 8" 14' 8 8' 1 6' 13' 'TZ 3. 4' 6 Elb Se' Max. 45' 38' 43' 0' 2" lbow Min. 1 21' 15' 8' 14. 6" 8' 4' 6" 14° 1 6' ffse ise Max. 84- (Ve ca tan 31' 1 ??'3 171 1 n 13 set stance .4 4 1 io• t opt Hoc atal) 1Q1 101 101 1 E wed Heightt-411 ax. t2416rt 90' 90' 90' 0' elbows) ia. u* y+ 24' S' — ?�' 6 24' 9' 6' FM-48 ZM41 sTRAcQur PF-cvr. r•sax. 4s' 90' s�t3oJEo WaaRr r�4X• 4s' 90' OFFSET RISE MAX. 1?r3�t 173 (VEWrl4AL oFrSET otSTA&JC-: (4oQ1�oaTAL) MAX. !O /o f.AowCn uE1GKT r9 AX. 451 901 (4 r-Lbo.>S) .2A -6 24'b 16- B.. LOCATE THE CENTER POINT OF THE D. Frame the Ceiling dole C LIMNEY Frame the ceiling chimney hole as shown Drop a plumb line from the ceiling in Figure28. . It is advised to use directly above the fireplace and locate framing lumber that is the same size as the point directly above the flue outlet the ceiling joists. on the top of the fireplace and mark the ceiling cc establish the chimney center The inside dimensions of the frame must point. allow for the required air space between the outside diameter of the chimney and In order to clear an obstruction, it may the edges of the framed hole. be necessary co. offset the chimney from the vertical plane. This is done using . elbpws. 17W t7W Determine the offset-.distance. of .your chimney arrangement from the center line of the fireplace to the center line of CHIMNEY the chimney where it is to pass through HOLE 'the first ceiling. 'Measure your offset dimension from the straight up chimney center point on the ceiling. SUN, C. CUT CEILING CHIMNEY HOLE NEW FRAMING MEMBERS The size of the ceiling chimney hole will vary with the angle at which the �� �NGJOWS ehimuey passes through the ceiling, the pitch of the roof, and the size of your Fig.28 Typical frame for ceiling Chimney hole, framing lumber. Refer to Table 5 for minim— ceiling chimney hole sizes. E. Znstall .Firestop Spacer Firestop spacers are required for safety.The hole sizes Cover the opening of the fireplace listed in TabierW angled rh estcp spacers provide the collar. Cut the chimney hole through the minimum required air space to the d*nney pipe for ceiling. Recheck the hole to be sure it ceding thiclt71835e6 up to 8 CBS,When the COim led is the proper size. The size of the thickness of the ceiling material,celirg join and floor- opening must allow a 1 1/2" M1931CH ing material exceeds 8 inches,adjusMwM mast be clearance for Model HSK Pipe and a 2" made in the framing to assure that the minimum air minimum clearance for Models HCF and S spaces to the chimney are makdained. pipe. If the area above the ceiling Is not an attic,position the fires3op spacer with the flange on the ceiling side and the Table 3 Sizes of ceiling chimney hole. dished or angled portion extending up into the hole.If the area above the ceiling is an attic position the fr2stop S&W of Angle or chimney at cefttg spacer with the flange on the top of the framed hole and Chimney scat , the dished or angled portion extending down into the hole.(See Ffgr-29 & 30). 8"Flue 17%x 171/2 17A x 29% Nal each comer at the frestop spacer to the flaming members of the ceding hole.NOTE.A firestop spacer is not required at the roof. �—.JOIST ACSUNG DISH®FFES'TCP t (RRESit)P SPACER) BAILS(4 Regrtged) Fig�9 Position of fimstop when area above ceding is not an attic. To achieve further offset, you may ins`..all various lengths of Pipe between the elbows. NAILS(4 Required) _. Supports G. .Attach Necessary Chimney Su ' RAFTER If the fireplace chimney height exceeds i i r F 30 ft., chimney supports are required. Locate chimney supports at ceiling holes or other structural framing at 30 ft. heights. Spacing between chimney supports must not exceed 30 ft. Support provided by elbow straps fulfills the support requirement only if they are spaced as required above. RRESTOP SPACER Angled chimney runs require support CEILING every 6 ft, in addition to elbow straps. F'9.30 position of f restop when area above ceifmg Nail chimney support straps to adjacent is an attic. structural framing. he sure the straps IMRN=G: A MINIMUM' OF 1 1/2" AIR SPACE are tight in order to support the CLEARANCE MUST BE M;L=An= FROM HSR chimney system. CBIMIEY PIPE TO ALL COMBUSTIBLES, }(� Locate and Cut Second Chimney Hole A MnTnMM OF 2" AIR SPACE CLEARANCE MUST If You are to the roof level, turn to BE MAINTAINED FROM HCF, 11CF, AND S section D-a.Exterior Installation. CM3*MY PIPE TO ALL COMBUSTIBLES. F. Attach Chimney Sections Follow steps D-z•13 and D-2.0 to locate and cut the second chimney hole. Frame the Attach the first straight chimney section to the fireplace ceiling hole and install the firestop coW or elbow if offset installation. according to steps D-2.0and D Z.E. Mount the Rue pipe first,using the buW4n snap4odc tastermrs. Then mount the additional _• Continue Installing Chimney Sections pipe(s):position each pipe section so the direction arrow is pp�g UP Following steps D-2.F and fl-Z.C., continue installing chimney sections as required Make sure each pipe is finatiy snapped and locked until the chimney is just short of the together as It is mounted. roof. Opntinue Ong chimney sections until ONE SECTION (ail pipes)extends up through the ceiling hole To extend 1>-3, EXTERIOR INSTALLATION through the ceiling,it may be necessary to assemble all pipes,push them up through the ceifng hole and then A_ Locate Chimney Centerpoint at Roof vide elem down one at a time to connect them. Follow step D 2.8 to locate and mark the centerpoint of the chimney hole at the NOTE: When the fireplace chimney height roof. The chimney system must be vented exceeds 30 ft. a pipe stabilizer, piece out-doors and end in a HEAT-N-CLO must be used. The support section approved termination. should be secured to the framing members. See the next section for B. Cut and Frame the Chimney Roof Hole installation instructions. Determine the proper size of— chimney When offsets are desired, install the roof hole including the mj required elbows in the following manner. install air Space between the outermost chirmzey the offset elbow on top of the firebox section walls and adjacent combustible or chimney section and point the upper materials. Consult Section D-2. C. when half in the direction you require the determining the necessary roof opening chimney to incline. size for your roof and incline. Adjust the inner section , of the elbow Cover the opening of the installed into the inside of the inner collar of chimney. the firebox or the inner section of the chimney pipe. Cut the roof hole. Frame using framing Adjust the outer section of the elbow lumber that is the same size as the rafters. over the outer section of the flue collar or outer section of the chimney - C. Install Remainder of Chimneys ' pipe. Simultaneously snaplock all Sections sections permaneatly,ineo place. t To achieve the minimum offset attach Using the 10 foot rule ' discussed'=in . w. Section D-2.A, determine the minimum the return elbow to the first elbo . " chimney height above the roof. f` Install the necessary chimney sections he 1 u through t roof hole. ,1 1 D. INSTALL CEIMI= TOP HOUSING , Install flashing. Pull the flashing 10. If the fireplace is installed in a down Over the chimney until it rests on mobile home with a cathedral the roof and mark the spot where ceiling, the firestop thimble pipe flashing overlaps the roof., Make sure and shield extensions must be the minimum required air space is employed. maintained. Remove the necessary roofing. Renail all shingles into .11. The mobile home termination pipe position. must be secured with three sheet • Install storm collar. Slide storm metal screws. Always remove thissection of pipe and the chimney cap collar over the end of the pipe and when mobile home is being secure with tab slots. Seal the entire transported. seam around the roof .flashing and roof with a waterproof--mastic =moo -prevent ...•-=12.: When. *ransporting, cover open leaks' chimney section with plastic to prevent rain or debris from entering To complete the exterior installation, pipe. Secure plastic to prevent it install the chimney cap. from blowing off. Do not remove until you are ready add additional E. MOBILE HOME INSTALLATION pipe sections and chimney cap. Heat-N-Glo Model HST-38HE is UL Listed 13. A11 mobile home installations for use in mobile homes. Mobile home require that the fireplace be installations should be identical to installed with outside air and glass permanent structure installations with doors. For mobile home the following exceptions and installation, follow the same precautions: methods of installing optional outside air as described in Section AIARNING: D-4.A. 1. Never install a fireplace in a sleeping room of a mobile home. l4. A mantel of combustible material may 2. Secure the fireplace to the floor of be installed a minimum of 16 inches the mobile home with the steel above fireplace opening, straps supplied. 3. Always "Ground" the fireplace to the mobile home. CAUTION: 4. The structural integrity of the mobile home (walls, ceiling and roof) must be maintained. 5. The total over-the-road installed height of the fireplace chimney must not exceed 13 ft. 6 in. additional sections of chimney pipe and a site chimney cap must be installed at he r pemanent site of the mobile home. 6. The minimum installed height of the chimney above the roof of the mobile home must be 3 ft., including the chimney cap. See Figure 27 Ten Foot Rule. 7. The total minimum mobile 'home fireplace system is 12 ft. 6 in. S. A21 mobile home installations require a firestop thimble. 9. If the mobile home ceiling/roof joist is larger than 7 in., thimble extension pipes, part no. ESKMESPA, must be used. The thimble extension should be installed inside the firestop thimble tube and cut to the desired length so that it extends through the entire ceiling joist, attic and roof area. 9 II B-q. INSTALLATION OF ACCESSORIES A. INSTALLATION OF OUTSIDE AIR KIT All Heat-N-Glo fireplaces axe equipped to accept outside combustion air if desired or required by local code. By using outside combustion air you will be used for combustion_ It is.recammended that the outside air system be used xbenever practical. The Model BK-22-5 (AK-MT) Outside Air System Kit consists of one house vent,. two.plastic ties and one starting collar. CL Listedfle-r4l-je air duct should be installed ed to bring outside air shinst f== the exterior of the structure to the fireplace. The house neat should be installed on, the exterior of the re. structu ._and Tocated so that the vent attic space, garage or other area that may contain combustible fumes. Skis kit must be installed before the fireplace is enclosed. Detailed installation instructions are included Frith the kit. g=: 2lodel HST-38MS requires 6- duct for outside air. -24- f W K2 cti, 42;6s M,CURA4P o dki ' TablaALlb huagdve P2eika6a for Qae acid TWO-FamdY ItnWkedd Bdtdbw Sated with Food Fada SUM MWQ4lUM �8 8 caing Wan Floor Batemm 94b Ressm6lCooWsB Am'(%) U-v im? Rrvahm, R-vW=' Rwaiucl . Wan F�a�ry' Package R-wic ' 5701 to 6600 Heatfa>;Degree Days' Q 12% OAO 36 J 13 19 10 6 No=ai R 120A 032 30 19 19 .10 6 NOm S I2•DA 0.30 33 13 19 10 6 U AF[JE T 13% 036 3E U 2S WA WA Normc U J5% "6 3a 19 19. . —10 6 1 Nonmd AFM W lsys _<0.32 30. --19 19 -10 6 is AETJE 1c n - -- 13 25 WA : WA Now Y IVA 0.42 _ Z 129/. 1 0.42 3; 13 19 10 6 90 AFi1E M 1>s w 0.50 30 19 19 10 6 90 AFM 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: r 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL:. YES: NO: q-forms-f980303a f _ a 780 CMR Appendix J Footnotes to Table J5Z.1 b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 it,of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. 3 The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression,.R-30 insulation may be substituted for R-38 insulation and R 38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing.must be placed between me conditioned space outs iue ycu-u'.a po•::on;,f tha roo: 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R-19'requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to woad-fiame or mass.(concrete,masonry,log)wall constructions,but do not apply to metal-fiame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire'opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements'are for unheated slabs.Add an additional R 2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Lsulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(Le.,may have a U-value grater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 . Y � ._ era- -+�. eG -n� L-5 !`! ZK lzi Xl. it i m � OD ]0 tD D CA 9 mv,a�.:. S Sl m 9 N m D kD S m 9 Broom CD to n 31 w il cn n cn n m D cn n IDIOM- Fl D 0 m n Li v I n9" Rooms Mar tc r% - ,- x d P-o o m m ri W t m V m 01) tc (31 01) Ul 15 Dining Room L I -ving - _ ROOM Ow _._ A tl m _ OD I l � Ca .... C9 i m ._ UI - — m m c� Siwdrao CJI j 1 W m - X15 [n rn m Ci Area _ - D - o ' 1 tCO�__L� L1S j i !� f 4111 -- �:� iV4 -- tri " I[ r i • I ;< _ s 1 j I / 1 % �S I I I 10 t II 1 I i y ,4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Ilk Health Division Date Issued aO Conservation Division Z�; p - Fee )�1 OC) Tax Collector 7 SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Treasurer. �� WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND TOWN REGULATIONS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �� �/ �/V��� ,, c A Village U14"'f kx Owner u.� l/ C�� Address LIU S�A)pk (��rJl`+ fl�i t-04Akn i 8u Telephone (S oz ) 440 °e491 q ' Permit Request :::7olel4�&4. z�po Pm (rwu)ko . 3 LL. ITS 6 e 0o W_ e `E ICTr m UIREM Square feet: 1st floor: existing fi propase• to e i �iNp�o�ed : Total new �- THE A DITIONOF A Valuation . �� N EVt�o�� �?�c��t�n LIo�dRPI * Groundwater Overlay AN Construction Type JP aF THE SMOKE DETECTGERORS T E Vt/ 0 E S Lot Size a 35 re r6f t�rNW gAgU go Y9AJatW Torting documentation. ND ELECTRICIAN HAVE YOUR TAKE p T T E.S PROPRIATE Dwelling Type: Single Family E � I; FIk` � _ Existing of Age Structure f C g g �•4• -. :Historic Hou e:• ❑Yes No On-Old..King's Highway: ❑Yes ❑ No Basement Type: Full ❑'Crawl ❑Walkout ❑Other / Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Y Number of Baths: Full: existing � new _ Half:existing new Number of Bedrooms: existing c _ new Total Room Count(not including baths): existing new_��� First Floor Room Count i Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes J*No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Xo Detached garage:0 existing U new size Pool:❑existing O new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals.Authorization ❑ Appeal# Recorded 00 �O l Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use S`E BUILDER INFORMATION Name Telephone Number Address License# Home.Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO k 1`aA4� it,, y DATE SIGNATURE �1,0�a u,�i�� � -aG � ��'� FOR OFFICIAL USE ONLY YIT NO. � -) DATE ISSUED ~ MAP/PARCEL:NO. ` � wit 1 i • .. ' L 1 . - ` _• '` '� ADDRESS �. VILLAGE OWNERA 4 DATE OF INSPECTION: FOUNDATION FRAME , E-- 1 ` l s•✓� s . — — tz' n Fes^ INSULATIONcr,. rn in Lj Ri rti FIREPLACE ELECTRICAL: ROUGH ""° _ FINAL - 3'{ % PLUMBING: ROUGH: FINAL GAS: ROUES FINAL +3 c1: co Uz m FINAL BUILDING a C - tcr � ,! 1 i t DATE CLOSED'OUT F ASSOCIATION PLAN NO. CF 1HE 1p� The Town of Barnstable sAxtysTMet.E, S. �0�' Regulatory Services 1639. 39.t A Thomas F. Geiler, Director Building Division Ralph Crossen, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax:" 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization'conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than.four.dwelling units of to structures which are adjacent to _ - -- such residence or building be-done by registered contractors;with certain exceptions,along with other requirements. ; Type of Work: U2t$�t�Q �- �yvL' 4 Q" t1�YL0_ Estimated Cost�� •lam`» Address of Work: `l'�U SIC�c 9n(e_pr n,Q. - C9-t - 0\= Yr/U-\ 0-?- Owner's Name: J ti Date of Application: OO I hereby certify that: Registration is not required.for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑ uilding,not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. ,OR -ag 0D Date Owner' Name q:forms:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents <-: ° -_= OIfiCCOflOYBSI%gB�IOHS ;y 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name �,p t.� in�•�2'6n location: city r�'b OZb hone# I am a homeowner performing all work myself. ❑ I am a sole fro rietor and have no one working in aav ca achy «„- I am an employer providing workers' compensation for my employees working on this job _.. ... cotnannv name: address: city: ..:_ . .. hone#.� insurance co. //////i%///%%///%//%////%/////////%%/ ////Mont/!=ct/or, amasoleproprietor, gener or homeowner(circle one)and have hired the contractors listed below who have the pllo«1ng workers' compensation polices: comoanv name: address:. .. : hone.#. •: ..:: city insurance co / .........:..... comnanv name: :•:::::.::.:.::..;;:::::::::::::.:.:.::.:.:.. ::..:::.: address: .: ... one City:' _ ;:•;;:.;;::;:>:.::;•:: :>:<:> ><:::_ iirCi 4>:>> <::.. .. irisurnnce co. a of criminal penalties of a fine up to S1,500.00 and/or Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of SI00.00 s day against ma I understand that a COPY of this statement may be forwarded to the OtIIce of Investigations of the VIA for coverage veadicatlom I do hereby certify under the pains and penalties of perjury that the information provided above is tnso and correct r Date L Signature Pri nt name p . - �� ,`� r. Phone# v�V�e c" otficiai use only do not write in this area to be completed by city or town otIIcial permit/license# ❑Building Department a city or town: ❑Licensing Board ❑Selectmen's O}$ce check if immediate response is required ❑Health Department contact person: phone#; ❑Other. 3. ..... ...:::.: Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employe t provide serviceeof anothercompensation under f ny employees. As quoted from theperson ��- "law";an employee is defined as every 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 c= the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the re=ve: 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 therem, 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 c PP building appurtenant t em hereto shall not because of such employment be deed to be an employer. .. . . . . MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or reneF of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who h: not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall ender into any contract for the performance of public work u acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the con= =—,-- authority. u / ^ �a Applicants � 1F Please fill in the workers comp- _ ensation affidavit completely,by checlang the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be ;} a Also be sure to sign and submitted to the Department of Industrial Accidents for confirmation of insurance coverage. or town that the application for the permit or license is date the affidavit. The affidavit should be returned to the citY the"law"or if rc being requested, not the Department of Industrial Accidents. Should you have nay questions mBar S are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of t you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please affidavit for be sure to fill in the peiaut/license number which will be used as a reference member. The affidavits maybe t^ the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you is advance for you 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 0MC0 of IwBsduations 600 Washington Street _ Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 llhe 'j,own- o °F tHE l Department of Health Safety and Environmental Services Building Division &uwsrABu& = 367 Main Street,Hyannis MA 02601 MASS. Ralph Crossen Office: 508-862-403 8 Building.Commissioner Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: (9� JOB LOCATION: L-{�O S tiL� C n WA number street ( village "HOMEOWNER": �2. ,'1Q.�n I�,n t—I name r c v home phone# e work phone# CURRENT MAILING ADDRESS: An C, � 3 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,provide d that the owner acts as supervisor. DEFINITION OF HOMEOWNER Pefson(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. 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. S�W cure 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 person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN r m 9 tD D N J . - (Sp Sl m D =� U n m r aD Xl cn A cn n 01) LTI n #aM ML air- C9 9 :=mix m n � o rq n t S C Mas +.C-p Sedpoom X34 -u _ o n GJ � m OD Joe N3 - m m CD cn cn m U1 0 _t Am m -v cmDom ving R Ll nq : x13 17 ' i . . . .. m A I _ m 01) N LO f .. ' m m ao A W Ln cn r CD OD ro � �- it m NO IN 1-111 c� low a I Area G� - m b m m MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 . 0 Q:fz Y" (ni ecke y/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE : 9-20-2000 DATE OF PLANS : TITLE: COMPLIANCE: PASSES Required UA = 86 Your Home = 86 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 800 30 . 0 0 . 0 28 WALLS : Wood Frame, 16" O.C. 464 15 . 0 0 . 0 36 GLAZING: Windows or Doors 54 0 .400 22 ---------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code . The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 DATE: 9-20-2000 Bldg. Dept . Use CEILINGS : [ ] 1 . R-30 Comments/Location WALLS : [ ] 1 . Wood Frame, 16" O.C. , R-15 Comments/Location WINDOWS AND GLASS DOORS : [ ] 1 . U-value : 0 .40 For windows without labeled U-values, describe features : ## Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings =in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0 . 5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter .side of all non-vented framed ceilings, walls, and floors . MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications . DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-8 . 0 . DUCT CONSTRUCTION: = [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts . The HVAC system must provide a means for balancing air and water systems . t TEMPERATURE CONTROLS: r [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS : [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . ----NOTES TO FIELD (Building Department Use Only) ------------------------- 5 I i � �. TOWN OF BARNSTABLE Permit No. ------------------------- ���� Building Inspector • Cash -------------------- ��OA•670• P OCCUPANCY PERMIT Bond ----___---------- • "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address �d�1 Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ........................................I............., 19..._. _ ................................................................................_......._...................._ Building Inspector St a,.1G.t_'✓ tr Q,MtLr� - 3 �f�eooM � , �a �A28AG4✓ Gtzt+.tta�z. �' � I tFLOw = Ito .4 3 3so.r IS G %A * 4q 5 tm.P.n. V t J Ste- t 00� 6d4L-. 2 LG Irk j]15PDSA1. PIT uSE lOc:�o G/11.. •I , 'A � ♦ L.7Z'� ` .,UP-9/ALL AZE.A, - :tSo s.t=. N t sr ,e ors �.��. J a IL M�IJ N TOTAL 'C>ESl6Q = •4SS 6.•PD IOTA L •vat L-( FLo%,v t 3w 6.rm. -�I PEWcaL&,•Tto0 O&TE , t"iQ SAMIJ* Ov- Wis. fir C. f PQL. t - '1 f�CJ�✓ �•AJ �/ _ `. 1 KJ O� 1►J �1.cJ'SUI"�iLK YM - �,PPs ivoo tMr. 4rAPP- DID Iw• GA.L. sb6wiL 'sox Gs�j Sepnc t c ioao ° (t �4 � lmt/, tw. • W t't'�.1 •i GAL. ef �� � w.as►,tas� u �1 SY'O+.afw ,off5 . GEZTtF1ED Pt_bT N - Pr oF't L_I L oCAT t C)" LLC,k 1� r CWZTtP�,( Tb4Ar TFlt-- fit.-, FVU+jp 5N /►J Pt a� RL-t=iREF.IGE. WIZ;,Q Go►_3 G( wtr'LVS W MA TNr: P -5l DG=' U aE-- ��a - StTC;.�t_tL 1ti'�QtJt�\'lrR�tc=b-LTS OF TNT �C�A.�..j 'FCJf� �(...1�11�1 �. S��IL 6r v 1r t2GGtS i'Cz_(:ED 1..�►-cG SU2v�.YveS TWIS PI-A" IrS WOT LASC'� 0" A" oszt=�a/►LtL- o titASS. Y , Cjl�{t rci t)e T c M t u t:= Lea Y' t.t N`•� - Assessor's map and lot number ..... ��. THE Qypf Tp� pp Sewage Permit number ...C50 --2✓.<......���/.�... `a d`` °� Z EAR33TADLE, i House: number ........... ...:4 ......... Naas .I.... 9 6 t 0� L �O,o� 39• �0 �F�MPY a' j! TOWN OF BARNSTABLE t BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......Construct S Single a 1 e Fain i t y Re s i elQncp„ „ TYPE OF CONSTRUCTION 4lood frame .................:............................................ . ....................................................................... .........7tv.. ............................19.... f?t) TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...Lo.t 2 Skunknet , ............... ..................................Road...........Centerv............i.....11e................................................................................................ Proposed Use ........S ine le 1:am i lv ....................:......................................................................................................................................... Zoning District ......Residential Fire District ...... Name of Owner ..games K� S.m i th ><ipn.nt hb: .......................... .....................................................Address .............. Name of Builder damps K# Sm ...............................ith.....................................Address ............. r.A.„h.,,.P............................. ...................... Name of Architect .........Ll.on ................Address ............................................................ ................................. ........................ Number of Rooms f our. .................Foundation ......Fr nMed...0 nnm;te........................................ Exterior ......��at..boarc .. 1'111. ...Roofing A.s,. . .........:....::................................................ ..................................................................... ��Ih,: 1h �h�nnlra� Wall to wall Interior ►lr�r�.a 1 � Floors ...................:1eA........................................................... Heating Electric Plumbing One...bath ...... ............................................................... Fireplace None ..................................Approximate Cost Sao-non ..:............................................. .......:.............. .............................................. f Definitive Plan Approved by Planning Board _______________________________I g Area .�-�y .................... Diagram of Lot and Building with Dimensions 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 ...0 (l V........... ........................................ A�=I69 93 oruTo uAMEo K. - ' ------CI�Xltexvu ------' . ' Owner .....J.ame.s... . ./------- ' . . Type of Construction ~~ Plot ............................ /Lot ................................ Permit Granted ......./V, -_- of Inspection` 19Date Completed _ PERMITIIX ` � _. lA '-----'-'tY'--' r-'`-'-----'' _ » -'---^'^'--~^' I ---^^---^'----'--' � ..--.---.-...;-...--~...-,...'...---. � - -'-----^^-'-'-'--`^^-'--~'- . - � Approved ................................................ lV ----~---~-^~^'^^'-^-`---~-' ----~------'---^^-^^''--~-' 1 1 Ass�s'sor's rna acid lot number / 0,,= .- SEP''rtC SYSTEM MUST `7 E Tory ./.Sewage Permit number .... ..®..'. G.... ..��.���'.=..�r . `. w INSTALLED IN CiOMpLIANe fO�` •1.. o� WITH TITLE a Z PARNSTAnLE, HouseYnumber. ........... ...... ..........................:......... r'ENVIR41�IItt9ERlTAL CODE �N® '°o rb 9 TOWN REGULATIONS' � TOWN OF BA':R,NSTA LE z' BUILDING JNSPECTOR Construct Sin l Famil Residenc APPLICATION FOR PERMIT TO ...................................g....e... ...................................................... ................... TYPE OF CONSTRUCTION .............. ... Wood f,rame. ........ ...................................................................................... . ........ .. ......... .........................19...8(1 TO. THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot 2 Skunknet Road, Centerville :.............. ............................................................................................................................................................... ProposedUse .... Single Fam i lY........................................ ................................................................................................. Zoning District ..,,,Residential „•,,,,,,,,,,,,,,,,,,,,Fire District Can.terx�.1.��r.QS.G��.Y.3��£............... .................................. ...... .......... Name of Owner ,.,James... . Smith lm..................................................Address ............ as.Cab.1e..............:.................................... Name of Builder .James K...Smith. . ....................................Address ............&amS.tab.le................................................... .... . .... Name of Architect ........None. ..................................................Address .................................................................................... .... ... Number of Rooms .....,four....................................................Foundation ......Poure.d..Coact te........................................ C 1 apboard & T.111 Exierior ....................................................................................Roofing .........../!R''phaLt..skiing.les..................................... FloorsWall to wall ................................Interior ...........JDrywall.................................................................. ............................................. Heating ectric ......Plumbing .........One ba .................El............................................................ .....th......................................................... Fireplace None.............................................................Approximate Cost ......$.3.04000.............................................. Definitive Plan Approved by Planning Board ____:___________________________19________. Area $.1.6..... .................... p, Diagram of Lot and Building with Dimensions Fee IO `. 5-'....... . .. ............................ SUBJECT TO,APPROVAL OF BOARD OF HEALTH 1 J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ... .Cl!:Yv �...Y..t...Al.w............................. • SMITH, JAMES K. N-ulo 2-2.1.7.6..... Permit for .....QA.Q..s=KY....... ....................9 Sinle Family Dwell ' ........................................Rcj.......... Location Lot..2... ...�)�unknet Road ............................... ............. ............................................... Owner J.ameg..K.....Smi.t..h............................ V Type `6f Construction .,.Frame... .................. . . ................................................................................. Plot ............................. Lot ................................ C, C� Permit Granted .....May 5 , 1 80 ......................... 19 Date of, Inspection ............ .......r19 Date Completed J0..........................19 rev M > 10- — ',.PERMIT REFUSED cc .................................... 19 t: r L: V II T, .................................. ................... fn C. N ................................................. ............. ................................................... Approved ................................................ 19 ............................................................................... ............. ................................. ..............I.... Assessor's office(1st Floor): Q -s Assessors map arid lot number -! e ` 61� of THE>o Conservation(4th Floor): - /C/9SEPTIC SYSTEM Ay w Board of Health(3rd floor): INSTALLED IN COMP grant e Sewage Permit number WITH TITLE 5 v639r..a Engineering Department(3rd floor):.' . , asp`* House number P I D ENVIRONMENTAL CODE Definitive Plan Approved by Planning Board s t 19 , TOWN REGULATIONS APPLICATIONS PROCESSED 8:30=9:30 A.M.:and 100-2:00 P.M.only TOWN , OF BARNSTABLE r SUII DING INSPECTOR APPLICATION FOR;PERMIT TO l TYPE OF CONSTRUCTION. 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location J�GI t$Jr"�// i. �. Ti l I T1,t L/i l�(.✓L ; r'VJ° Proposed Use Zoning District , I� C Fire District Name of Owner �© h I- n�a�t2f 6�I- �,1 K Address q8C��Ll Ji✓�kj r,-=i Name of Builder (f�i,d►.L��L Address � C�/�T(�© Name of Architect 2T 7— Address Number of Rooms D l �PA45 / 9401— Foundation Exterior (YAP� 4P8l 'S 6QA—r'5-3TnRoofing �• Misr- Floorsors � - -_- - _- ___-_- Interior Heating � Plumbing &ZWW /FiZ'Y/341 Z ki`�A Fireplace A/ AZ 7:7-09 S Approximate Cost Area Diagram of Lot and Building with Dimensions fza�o s I Fuc— E 1 Zlp � r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Bar -e re ing the above co truction. Na \ Construction Si ipervisor's License _ - HANRIGHT, JOHN F. 269 093 . 002 No -Permit For ADD 2ND FLOOR TO DWELLING ` 0 Skunknet Rd. ' + Location 48 ' Centerville • 1 r 1 ! Owner•John F. Hanright, Jr. Type of Construction `1 Plot Lot - - Permit Granted June 6 i9 94 Date of Inspection: Frame 19• `' � Insulation ti 19 - Fireplace 19 , Date Completed 19 r ' f W , Tw x! to Era f� TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION; .z Please print. k Yh DATE 2 JOB LOCATION Numbelr�, Street Address ection 'Of`IT/own "HOMEOWNER" Name Home Phone Work. Phone PRESENT 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 such 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 to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. 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, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Depa tment inimum inspection procedures and requirements P HOMEOWNER'S SIGNATURE i \j APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or 'larger, will be required to comply with State Building Code Section 127.0, Construction Control. MISCS f .rt AA : i LL i ' I i } , I , • ntv £ r 1A4--- RE { r;' —__NEB--L1_X�_S�.H�tZ-S F��szr-�, q '. T ...� �� . .- ._ _.. - �_ �, ;-,--y '{ /;;- � ��� hGi /� € � ! ��� �_ .- i ; , � ., , _ �1-.t�.t Zx i_O��T"1[o'�-.__- -. ._ � 5T1.� ..2?c-(�-.1(o-"O.G_._ �;' - i�Q►�25 _.. - .0 . -t�q� _ ,, - I _ / - ---- .i l .- j _ ,. . -�S-LL�'_bL �c��r-r w � .� �� ( . . '� �:� f . . � - g.,pc I li - � { �' _ ,�'. - ,. -.. �. - ;.;., ... - . .,w : - �• - i s i I i IC) i I i i I i, r;r ,