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0088 LONGVIEW DRIVE
£�8 /..a�l��iE�J ,l>b�eN��, Town of Barnstable Building t ... P rThis"Card So`"Th`at i<isUisibleFrom the Street A roved�Plans Must be�Reta"med on�Job-and thisCardjMust,;beKept �., enxtrta;cw.e�a ;most °�' t • M" 70, stel►nt F� yam el jjil� herea.,.Certificate of Occup y q, k Permit No. B-19-1302 Applicant Name: Francis Sheehan Approvals Date Issued: 04/22/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 10/22/2019 Foundation: Location: 88 LONGVIEW DRIVE, HYANNIS Map/Lot: 251 07,2 Zoning District: RC-1 Sheathing: Owner on Record: FREEDMAN, REBECCA B , ` Contractor Name " FRANCIS S SHEEHAN Framing: 1 Address: 88 LONGVIEW DR Contractor cense GSSL-105941 2 ..� CENTERVILLE, MA 02632 I, E �Prolect Cost: $4,400.00 Chimney: Description: 80 Sq Ft FGB to attic,220 SgFt R-44 Cellulose to�Att�;;680.Sq ft R-19 Pe`rmit�Fee: $85.00 Insulation: Cellulose to attic,AirSealing,90 Sq Ft R-8 To basement,40 Sgft R-19 FGB to Basement. FeePaid $85.00 "" Date 4/22/2019 Final: - "`. Project Review Req: K Plumbing/Gas � t.�L - Rough Plumbing: ; F BuildingOfficial ` Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sixmonthsafter issuance. All work authorized by this permit shall conform to the approved application and the'approved construction docume'riiii r�whichthis permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures-,thd1k,,be in compliance with the local zoning by laws and codes. This permit shall be displayed in a location clear) visible from access street o'°r o"ad and shall be maintained open for public inspect o for the entire duration of the Final Gas: pY 1 work until the completion of the same. 5 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by.the Bwldmg and`Fire Officials are provided on this"permit. Minimum of Five Call Inspections Required for All Construction Work ; a x Service: 1.Foundation or Footing ' 2.Sheathing Inspection ' • . Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: a w wave- -�.��-•. --- 1 � � � � �"�. � �.� . . ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION l , Map G ^, ` Parcel plicatio�h # Health Division Date Issued 11 Conservation Division Application Fee Planning Dept. Permit Fee / Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village _ 1J JV.T� F+ 0 ner anm Addressn�mP., TlephoneES69' -7 D® ©t`"1 Q Permit Request WiKd®IX� CbC,*)h-WYr\ W" •a.rQeT V1ae Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuations M. 06 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 ❑ No On Old Kings Highway❑Y2' ❑ No r Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ` ' Basement Finished Area (sq.ft.) Basement Unfinished Area (sgft) f:3 CIO 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 ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 9 'Name�c�cr�t' t- �fr� �+Y1SQ61 Telephone NumberO�" 7�1f�"®11� Address License # /.MCeAky ; e VAVN- ro Home Improvement Contractor# Email JAC-aesY , y%tA7 Worker's Compensation # ALL CONSTRUCTION``DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1and AIR 1t SIGNATURE DATE � '�, FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0: r ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' R FOUNDATION f . FRAME t INSULATION ' r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASS' IATION PLAN NO. Hw Commoammith of V'assachrseffs Diparftnent ofhtdkstaial Acadenfs - Office of invesagofions 600 Masshington,meet Boston,,MA 02H1 wH.m masmgovldia W--arkers' Campensafiau Insurauce Affidavit-Builders/Con"ctarsMectriciansMumhers tpL;rant Informafia a , i Please Priaf I ihFy Dame(Busiitessl �7&02(- h A- owws driF ss � YIAj'1�t� D-6 ste r 4_ I-ate s, confractos and'I 1_El am a employer with ,f���� � 6_ ❑Neur�� employees(ad'andtorpart-#ime)* *- havehiredthe trzctors. 2:❑ I am a sole proprietor or partner- listed an the attached sheet 7- ❑Remodeling ship and haze no employees These sub-contractors have g- ❑Demolition w for me in an capacity employees and have workers' offing y capa. � 9_ El Building addition i [No workers'comp-insurance camp_ nsurarxg l ❑ V%te are a corporation and its 10-0 Electrical repairs or additions 3 �I am a homeowner chin;all work offir�sn exercised their ILo Plumbing repairs or additions, tnyset€[No workers'comp- fit:ofexamption per MGL 1Zo Roof repairs c-15Z§1(4),and we have no insuiance required_]$ employees- o wo&ess' 13_0 Other comp_insara+t+p required.1- tAay agapliumt that checks boa*1 must also fill out the section below shoal*v their wooleis'cnmpeussdoa pour}�t�aiv i IEnmeownefs who submit this siEdssit in-dicstinr dney are doig aR vral k sad tllen hi re outside COn$aCMM mu sorb lcantcRcturs that aecik this box mast sttached ma additimal sheet shmring the name of{he sus--canfr2aba and state Whether ornut'ffmse entities have mployees- If the sub-contactors ham emplbyees,they must provide their workers'comp.policg number I am am employer ilia;isprm icbkg tt,orke--rs'cos risalinn inrrrrartce for rity anWEoyem Helots is the policy arrd}ob seta irrjormatir�n. Insurance Company Name: Policy 9 ar Self-ins.Lic-4-- ExpiratibnDate: Job Sitm Address: CitylState/2 ip: Attach.a copy of the zsorkers'compensation policy-dedaration page(showing the policy number and cq1n-ation date). Failure to secure coverage as regairedander Section 25A o€M-GL c 152 can Lead to the imposition ofcriminai penalties of a fine up to$1,500.OD 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 bsI,esirgations of the DIA fhr insurance coverage yr r�Scatlon_ I da hereby _ tinder thgpains andpe es ofper�ury thatthe irr,forrrmateonprin i&dabove is tnm and correct Signature: Gt Date: Phone#- �� 7)5 tzWEdal use only. Eta not Write in this area,#rr be coxrpleted by chfv or town o,f,�4'ciaL City or Town:. Pern&VUcense it Issuing Authority(drde one): 1.Board of Health ?.Building Department 3.Citylrown(Jeri. 4-Electrical.Inspector S.Plumbing Inspector 6.Other Contact Person.: Thane 9- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth,`.or 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 inciTTance 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 sit iaiion 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 orLLP does have employees,a policy is required- Be advised that this affidavit may be submitted to the Department of Indusft i.al Accidents for confirmation of insurance Coverage. Also be sure to sign and date the a idavit 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. Sells 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 perrnit1ce_rse 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 maybe provided to the applicant as proof that a valid affidavit is on file for futrlre 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 ca1L The Department's address,telephone and fax number. fie Commonv, alth of Massachusetts Depaitcnent of Industdal Accxd een Office of fuvestinfioas 600 Washingtaa Siz-e4tt Boston.,MU 02111 Tel.A 617 727--49GO W 4-06 or I-9 MASWE Revised 4-2"7 Fax N 6I7-727-7749 WWW.maSs.govjdi'a Town of Barnstable Regulatory Services �oF'ME Tolty� Richard V.ScaIi,Director P ° Building Division 4 * * snxxsTAsr Tom Perry,Building Commissioner xrn_cs. r� 1639- ��� 200 Main Street, Hyannis,MA 02601 'lFn rr a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE.—�� �� 14 JOB LOCATION: l Ih1iq\-\-e_W bikVe— • � � number street village MEOWNER": o i-1 namZrJ home phone# work phone# CURRENT MAILING ADDRES S: � 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 p - and requirements an e/she will comply with said procedures and requirements. Sign re 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 t amend and adopt such a form/certification for use in your community. Q:\WPFII.ES\FORMS\building permit forms\EXPRESS.doc Revised 061313 TME ram, Town of Barnstable * Regulatory Services 9aaxN LEA Richard V.Scali,Director 1639. �0 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 I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for- (Address of Job) """Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:O WNERPERMISSIOhTPOOLS i I JAW, f + Mid-.Cape South Dennis `' 465 Route 134 P.O. Box 1418 South Dennis, MA 02660 SOLD TO SHIP TO MARIE E CREONTE-HANSON 88 LONGVIEW DRIVE CENTERVILLE, MA 02632-0752 508-790-0179 IIIIIII Ill II Ill II Ill II Ill 11 Ill 11 Ill 11 Ill 11 Ill 1111111 Ill 11111 Shipment #: 1 ACCOUNT# CUSTOMER P O# TERM$ ORDER# ORDER DATE: SLSMN INVOICE# WUOICEDATE;; 70082 41116806 08/19/10 • 999 ORDERED BACKORDERED' SHIPPED U/M bESCRIPTION PRICE- AMOUNT 508-790 0179 1 0 1` EA 45101 ADVANCED TRIMWRIGHT 1117.684 1117.68 INGLE SHOWER ENCLOSURE ;SINGLE-SHOWER/EXP 0 # 4185937 VEND # 2426 Qty 1 Expected 09/10/10 INCLUDES 2 - SIDE PANELS 1 - DOOR DOOR HINGES AND LATCH HARDWARE 2 - POST W/ DECORATIVE CAPS PVC' OUNTING PIPES INSTALLATION HARDWARE AND INSTRUCTIONS . QUOTE-28781 Locations: 5301 A-6 TOP THE ORDER TOTAL OF 1187.54 HAS SEEN REDUCED BY TH PAYMENTS DESCRIPTION REFERENCE AUTH CODE DATE OUNT VISA 1324838 00 Gz123/10 1187.54 A balan e of $0 00 is due on this shipment. .. SHIPPING::z;INSTRUCTIONS..; ********* *********** * t***** t*** after 1 am plea e: / Marie w i11 be there /"zz thisis. to go with order# 4 ©85938 September 23, 2010 11:46 :3 OT:488 4 / 0 MERCHANDISE 1117.68 FILLED BY RIVER WAY OTHER 0.00 * PICK TICKET * TA6 XX *************** PAGE 1 OF 1 .2500 69.86 Expect 09/25/10 Mid Mo CREONTE-HANSON, MARIE - FREIGHT 0.00 Signature: South Dennis TOTAL 1187 .54 ALL RETURNS AND CLAIMS MUST BE MADE WITHIN 30 DAYS WITH THIS INVOICE. RETURNS ARE SUBJECT TO A SERVICE CHARGE. SPECIAL ORDERS ARE NON-RETURNABLE AND SUBJECT TO STORAGE CHARGES. OFFICE COPY L . Mid ..Cape South Dennis 465 Route 134 P.O. Box 1418 South Dennis, MA 02660 SOLD TO SHIP TO MARIE E CREONTE-HANSON MARIE HANSON 88 LONGVIEW DRIVE CENTERVILLE, MA 02632,-0752 508-790-0179 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Shipment -#: 1 ACCOUNT# CUSTOMER P.O.# TERM$ ORDER# _ ORDER DATE; SLSMN INVOICE# iNVQIcE DA7E ...... .........._..._.... 7.0082 41085938 06/25/10 999 ORDERED BACKORDERED SHIPPED U/M' bESQ ION;' PRICE;; AMOUNT 508-790 0179 \ UOT MARIE 1 0 1., EA 001-DHR.O. 38 1/41-W X 37 1/411 156'.947 156.95 IT SIZE 37 3/4" X 36 3/ 11 ;,3001-DH/SILVERLINE 0 # 4184162 VEND #,-0776 Qty 1 Expected 07/12/10 Locations: 5401 E-25 ` THE ORDER TOTAL OF 166 .76 HAS BEEN REDUCED BY THE FOLLOWING PAYMENTS: DESCRIPTION REFERENCE AUTH CODE DATE OUNT VISA 1324849 .............. 0 09_/23/10 166.76 A balan e of $0 00 is due n this shipment SHIPPING::. INSTRUCTIONS this order is go to with o der# ::41116806 ::: . . : September 23',- 2010 11:46 :1 OT:488 4 / 0 MERCHANDISE 15.6 .95 V9Y WAY OTHER a 0.00 * PICK TICKET * XX *************** PAGE 1 OF 1 TA6 .250% 9.81 Expect 09/25/10 Mid Mo CREONTE-HANSON, MARIE FREIGHT 0.00 Signature: South Dennis TOTAL 166 .76 ALL RETURNS AND CLAIMS MUST BE MADE WITHIN 30 DAYS WITH THIS INVOICE. RETURNS ARE SUBJECT TO A SERVICE CHARGE. SPECIAL ORDERS ARE NON-RETURNABLE AND SUBJECT TO STORAGE CHARGES. OFFICE COPY Kid-Cape South Dennis " 465 Route 134 P.O. Box 1418 South Dennis, MA 02660 MARIE E CREONTE-HANSOM MARIE HANSOM 88 LONGVIEW DRIVE CENTERVILLE, MA 02632-0752 508-790-0179 Shipment #: 1 70082 0 CASH 41085938 06/25/10 999 ? 508-790-0179 QUOTE 420 MEE - 1 0 1 EA 3001-DHR.O. 38 1/4"W % 37 1/4" 156.947 156.95* UNIT SIZE 37 3/4" X 36 3/4ff ;3001-DB/SILVERLINE PO# 4184162 VEND# 0776 Qty 1 Expected : 07/12/10 cation 4 0 4 BU EXTRA R+R WHITE CEDAR SHINGLES 28.175 112.70* RESQUARED+REBUTTED WCXBAS 4� August.19, 2010,09:54:56 OT:488 210 269.65 * ************ 0.00 * PICK TICKET **********+**** PAGE 1 OF 1 6.250% 16.85 Delivery Not Scheduled CREONTE-HANSOM, MARIE 0.00 Signature: South Dennis 286.50 ri ` - Kid-Cape South Dennis 465 Route 134 P.O. Box 1418 South Dennis, MA 02660 MARIE E CREONTE-HANSOM 88 LONGVIEW DRIVE CENTERVILLE, MA 02632-0752 , 508-790-0179 Shipment #: 1 70082 0 CASH 41116806 08/19/10 999 2 508-790-0179 1 0 1 EA #5101 ADVANCED TRIMWRIGHT 1117.684 1117.68* SINGLE SHOWER ENCLOSURE ;SINGLE-SHOWER/EXP INCLUDES 2 SIDE PANELS 1 - DOOR DOOR HINGES AND LATCH HARDWARE 2 - POST W/ DECORATIVE CAPS PVC MOUNTING PIPES INSTALLATION HARDWARE AND INSTRUCTIONS. QUOTE-28781 August 19,"2010,09:53:41 OT:488 2 / 0 1117.68 0.00 * PICK TICKET *************** PAGE 1 OF 1 6.250% 69.86 Delivery Not Scheduled CREONTE-HANSOM, MARIE 0.00 Signature: South Dennis 1187.54 r F i � • 1 i CDf , g i + a I i i 00 .01 wi 1 c w blloz f f �•. f ,::7r. � - _v. .e:����2.�sM :°'j°:�." . +.. _ }.�.:_. ,,....a - ... �s�+,.�,✓L iswx�`w:` .�i.F�'"iC�,#°w"�.a�, -n�H-a..rig:.. .r.t'$i,:..':m.,Y..,.«, ":w.., n..>.a �"ark:Qd; ::t_ ,!rn..., 3n:s: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 5 1 Map Parcel V Application # 1 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address L.a V �ca.J �2• �," Village t-v-U e 1 Owner 'i- Address 1AA Telephone U 0-9) 790 1,. O 1 7 ? n Permit Request d'e�S�ww�,¢. t.ac� k L30-U of �10-rm� tplace- c,J'u,. kkeoo,4q f�_Place ex i4i-� b1J, Lz oon w c a9 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Totaltnew t �... Zoning District Flood Plain Groundwater Overlay s Project Valuation l 0 .wa Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family N Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 2No On Old King's Highway: ❑Yes ®.No Basement Type: ®.Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing .5 new First Floor Room Count S Heat Type and Fuel: 3 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes XLNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes hNo Detached garage:Xexisting ❑ 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 MNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) n( , Name �l u��cY0 Ili, 1 l kt k14 Telephone Number 3 ISS -7 3 8 3 Address License # C 51, IS 7 1 01� , AAA, Home Improvement Contractor# Worker's Compensation # d►.7 CR Z'3 ! S'3 'Sgtt l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY 'APPLICATION# DATE ISSUED i MAP/PARCEL NO. r r ADDRESS VILLAGE OWNER DATE OF INSPECTION: 4` FOUNDATION a FRAME INSULATION r t FIREPLACE f _ • ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL ; GAS: ROUGH FINAL r 7 R f' FINAL BUILDING DATE'CLOSED'OUT ASSOCIATION PLAN NO. F. 1 t r1 y The Commonwealth of Massachusetts Department of Industrial Accidents 1 - Office of Investigations 600 Washington Street s� Boston, MA 02111 H www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 731 6 Address:_5 ,a� ��vJ wov'E p✓'� AA A . . d Z,IFS City/State/Zip: Phone #- So 8 3 8 S 3 V 3 Are you an employer? Check the appropriate box: Type of project(required): 1.ElI 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. I am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling These sub-contractors have Demolition ship and have no employees 8• ❑ working for me in any capacity. employees and have workers' 4. ❑ Building addition [No workers' comp. insurance comp. insurance.# required.],, 5. ❑ We are a corporation and its 10.® Electrical repairs or additions 3.❑ I am ah6meowner doing all work officers have exercised their I LN Plumbing repairs or additions myself'[No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy_and job site information. 1 Insurance Company Name: t '� OtAUror Policy#or Self-ins. Lic. #: L 2 '�� '3 ��7 S fl e Expiration Date: 4 I; 2.v 1 Job Site Address: City/State/Zip: �!t 0��3Z Attach a copy of the workers' compensati&n 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. Ldo he eby certify&uthepai nd pe Iti s of perjury that-the information provided above is true and correct. Signature: Date: 2-6 d 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#: ' t 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 thew.orkers' 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 pen-nit/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 De`parfinent's address„telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington Street Boston, MA 02111 Te4;.9:617-727-4900 ext 406 or 1-877-MASSAFE Ih Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia R� Of THE ram, f 4 f EI,t3M R MASS. Town of Barnstable QED MiA'�� Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO 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 I, as Owner of the subject property hereby authorize 7kc,-1- aA iXa:. ; au AL-^ (. to act on my behalf, in all matters relative to work authorized by this building permit application for: Address of Job) Signature of Owner Date ICJ-rt� 1'1G-Vl$O�1 Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 .r r Town of Barnstable HE Regulatory Services ' Thomas F.Geiler,Director BARNSTABLE,NAM ,�� Building Division RFD 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: JOB LOCATION: number street village "HOMEOWNER": �) 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 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 witlr,said procedures and requirements. Signature of Homeowner Approval of Building Official r ' 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 :vutssacnusetts - ucpal-trncnt Or rtJD11C Board of.Buildin- Red-ulations and Standards ,rF Construction Supervisor License License: CS 87194 Restricted to: 00 PETER D WALL fi 57 LONGFELLOW RD YARMOUTHPORT, MA 02675 --�- �` Expiration: 8/18/2011 Commissioner Tr#: 19966 y� ��ie (oominzovzuseaLC� ° `/�aaaac�ivaelta ' License or registration valid for individul use only �\ Office of Consumer Affairs& usiness Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration:%k'-,164111 i 10 Park Plaza-Suite 5170 Expiration 8/31/2011 Tr# 288114 Boston,MA 02116 Type, DBA r/i . WALL BUILDING PETER WALL 57 LONGFELLOW DR - f" YARMOUTHPORT MA.02675' Undersecretary Not valid witho t signature 1 •DATE(MM/DDIYYYY) A� CERTIFICATE OF LIABILITY INSURANCE 5172011 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 endorsement(s). PRODUCER Dowling &O'Neil Insurance Agency CONTACT NAME: 973 IYANNOUGH ROAD 2ND FLOOR PHONE o E 508 775-1620 A/C No: 508 778-1218 Hyannis, MA 026011990 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual Group INSURED WALL BUILDING LLC INSURERB: 57 LONGFELLOW DR INSURERC: YARMOUTH PORT MA 02675 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 10202606 _ 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea RENTED $ CLAIMS-MADE F—IOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1-1 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE P acci HIRED AUTOS AUTOS er d ent $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ $ A WORKERS COMPENSATION WC2-31 S-377554-011 4/17/2011 4/17/2012 WC STATU- OT�- AND EMPLOYERS'LIABILITY YIN TOR Y LIMITS E ANY PROPP.IETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 500000 OFFICER/MEMBER EXCLUDED? �Y tJ/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Compensation Insurance:Part One of the policy applies only to the Workers Compensation Law of the State of MA PETER WALL IS INCLUDED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MID CAPE/NICKERSON CO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: DAWN JOHNSON ACCORDANCE WITH THE POLICY PROVISIONS. 225 WHITES PATH SOUTH YARMOUTH MA 02664 AUTHORIZED REPRESENTATIVE Jeff Eldridge ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/06) The ACORD name and logo are registered marks of ACORD CERT NO.: 10202606 CLIENT CODE: 1478627 Deb Derochemont 5/17/2011 4:52:31 AM Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates. y rt-- - a t LIVING AREA 0 ..�y- Y2- . E r \} 1 i b LIVING AREA 0q ft �a fdl, • . --------------- , f i i s � t a i �`� '..J,t �.;.:,dl)ri��� �- � i1��' �-- �� � wad-C,.l�\ ••��.,�,1, IAMEy;. (, Ii a 1 iP � Ian z� r� , 'Town of Barnstable ermit: s-7 73 Regulatory Services ate: FtHe tpk, Thomas F.Geiler,Director f Ai'lsSfABLE - e: Building Division r r BARNsza9LE. MASS. 27 � 9� ��► 7r►Perry, Building Commissioner g,,�� �i,i 1639. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-40 8 �1ViS1�4I Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: Gr12� �S S6n Phone: E —7 qo-®nq __�WQX j — `1 � Install at: $ `V--� 'lac' Village: t��nl,��ki�� y" � J Map/Parcel: .2-5 1 OTj.?— Date: 10 1 a5 I bS Stove A. New d sa B. Type: Radiant/ Circulating C. Manufacturer: WeW (2zL$A Lab. No. D. Model No.: <<r C a Chimney A. New/ . (If existing,please note.date of last cleaning) B. Flue Size /.0 If C. Are other appliances attached to Flue? � D. Pre-fab Type and Manufacturer E. Masonry: ine nliried Hearth A. Materials: B. Sub Floor Construction: rla.., Installer Name.- Address: Phone: Location of Installation: H.I.0 Registration# Construction Supervisor# OR check '!Homeowner Installing, no license required APPLICANTS SIGNATURE A kl&4L�� APPROVED BY: Please make checks payable to the Town o Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev103107 (3e ' gF/tiwKe-F f� SAP - 79a - 0 �'79 ❑ Owner's name &address ❑ Contractor's"name, address &telephone number ❑ Site Plan Review.Number ❑ Contractor's signature Plot'Plan ❑ Workman's Comp. form. Copy of Insurance Complia ❑ Construction Super's License OR ❑ Co -Check expiration date -Unrestricted (Not 1G) ❑ Road Bond(5-2.1 Zoning Ordinances) ❑ Application Fee ❑ Permit Fee (S8.i0/51000 of value) ❑ Property Owner must sign Property Owner Letter of P q-forms:permi is l rev.0630044 - I t CUSTOMER BAC SALES THIS PRODUCT FABRICATED BY: O� PART NO. PAC OR, INC. ' 333 Rising Sun Roadtown,NJ 08505-(809)324-1100 PA CF1230E-3MIL Borden 1 G�pSS/,p� 333 Rising Sun Road,Bordentown,NJ 08505 If � �O QUANTITY 62*5OPERATOR DATE RUN (609)324-L100 PROCESSED BATTS AND BLANKETS REFER TO MANUFACTURER'S MSDS Contents not over 400 Sq.Ft. Form H ( ) Issue No.EL-8 PREVIOUSLY PROVIDED BY PACOR 347 O ,Ott SURFACE BURNING CHARACTERISTICS 7 WORK ORDER # 016581 FHC 25/50 PRODUCT SAFETY INFORMATION RENSEIGNEMENTS SUR I.A SECU:RITE-DES PRODUITS INFORMACION SOBRE SE:GURIDAD DE PRODUCTO REFRACTORY CERAMIC F113ER PRODUCT PRODUIT DE: FIBRE CE:RAMIQUE REFRACTAIRE PRODUCTO DE FIBRA CERAMICA REFRACTARIA This product contains refractory ceramic fiber,which ATTENTION: CE PRODUIT CONTIENT DES FIBRES DE : ESTE PRO CTO CONTIE E F E RA CR MICA has been identified by the International Agency for Research on CERAMIQUE REFP,ACTAIRES OUE LE CENTRE INTERNATIONAL DE REFRACTARIA,LA CUAL HA SIDO IDENTIFICADA POR LA AGENCIA ma Cancer(IARC)as possibly carcinogenic to humans. RECHERCHE SUR LE CANCER(CIRC)A IDENTIFIEES COMME INTERNACIONAL DE INVESTIGACIONES SOBRE EL CANCER(AIIC) Avoid breathing tiber,particulates and dust CANCEROGENES POSSIBLES POUR LES HUMAINS. COMO POSIBLE CANCER(GENO A LOS HUMANOS. low RISKS: low EVITEZ OE RESPIRER LES PARTICULES DE FIRE ET LA POUSSIf RE EVITP RESPIRAR EL POL VO Y LAS PART7CULAS DE F18 R RA CEAMICA •Possible cancer hazard by inhalation. 11 RISQUES: RIESGOS: •RISQUE POSSIBLE DE CANCER PAR 1!INHALATIOPI. •POSIBLE RIESGO DE CANCER POR INHALACIt9N. . •May cause temporary mechanical irritation to eyes, skin,nose -PEUT CAUSER LINE IRRITATION MECANIQUE TEMPORAIRE DES YEUX,DE LA •PUEDE CAUSAR IFIRITAC16N MECANICA TEMPORAL DE LOS and/or throat. PEAU,DU NEZ ET/OU DE LA GORGE. OJOS, P)EL,NARIZ Y/O GARGANTA. PRECAUTIONARY MEASURES: MESURES PREVENTIVES: MEDIDAS DE PRECAUCION: •Minimize airborne:particulates and dust with engineering controls. •MINIMISE-[LES PARTICULES ET LA POUSSIERE EN SUSPENSION DAMS:LAIR PAR," .:MINIMIZAR LA CONCENTRAC16N DE PARTICULAS Y.POLVO EN •Wear a NIOSH certified respirator. DES MECANISMES TECHMOLIES. EL AMBIENTE POR MEDIO DE CONTROLES DE INGEN)ERIA- •Wear longsleeved,loose-fitting clothing,eye protection,and loves. 'PORTEZ UN RESPIRATEUR CERTIFIE PAR NIOSH.1 9 f)• Y P g •USE UN RESPIRADOR CERTIFICADO POR.NIOSH. •Wash work.clothingseparately and rinse washing machine after 'PORTEZ DES DES G NTS AMPLES A MANCHES LONGUES,UNE PROTECTION P Y � DcuLAIRE ET DES GaNrs. ) -USE ROPA HOLGADA Y DE IVIANGAS LARGAS,PROTECCION use. •LAVEZ-LES VETEMENTS DE TRAVAIL SEPAREMENT ET RINCEZ LA MACHINE - PA�RA LOS OJOS,Y GUANTES, FIRST AID MEASURES: APRES CHAOUE UTILISATION. - • LAVE LA ROPA DE TRABAJO SEPARADAMENTE DE LA OTRA Eyes: Flush with water. PREMIERS SOINS: ROPA Y ENJUAGUE BIEN EL AREA DE LAVADO. WaSKwith soap and warm water, YEUX- RINCEZ ABONDAMMENT AVEC DE UEAU: Skirt: p PEAU: LAVEZAVEC DU SAVON ET DE L'EAU rlEae- MEDIDAS DE PRIME:ROS AUXILIOS: Inhalation: 'Remove to fresh.clean air. INHALATION,. DEPLACEZ LA PERSONNE A LAIR PROPRE ET.FRAIS. - bJO� . . LAVA CON CON N V A UA CLIMPIA. PEEL: LAVA CON JABON Y AGUA CALIENTE. If any of the above irritations persist.Seek medical attention. SI LES IRRITATIONS MENTIQNNEFS PERSISTENT,CONSULTE7 Ura MEDECIN. INHALACION: RESPIRE AIRE FRESCO Y LIMPIO. FOR ADDITIONAL PRODUCT INFORMATION AND WORK PRACTICES, POUR OBTENIR DES RENSEIGNEMENTS COInPLEMENTAIRES SUR LES SI PERSISTE CUAL.QUIERA DE LAS IRRITAC1614ES MENCIONADAS,BUSOUE REFER TO THE MATERIAL SAFETY DATA SHEET(MSDS). PRODUITS ET LES PRATIQUES DE TRAVAIL VEUILLEZ VOUS REPORTER AUX ATENCION MEDICA. MiloFICHES SIQNALETIQUE'(FS), BRE THERMAL CERAMICS - PARA MAYOR€NFORMACION SO LOS PRODUCTOS Y NORMAS DE TRABAJO CONSULTE LA HOJA DE DATOS DE SEGURIDAO DE MATERIALES(MSDS). THERMAL CERAMICS. - ' P.O.'BOX 923 MS R300 . no P.O:BOX 923 MS#300 - .- AUGUSTA,GA 30903-0923 USA - THERMAL CERAMICS _ 722-5681 AUGUSTA,.GA 30903-0923 USA P.O.BOX 923 MS#300 -. (800) (706)796-4200 AUGUS'TA,-GA 30903-0923 USA Conadian'WHMIS Clnss 0-2A: r!latoria€causing other toxic effects. sag 91 (T CLASSE D-2A:MATERIEL CAUSA.NT D'AUTRES EFFETS TOXIOUES. (706)795-4200 Label No,: 1-0993(Rev.6212Q00) ', N-D'ETIOUETTE: 1-0991(REV.0212000) ETIQUETA W.: 1-0091 (REV.02/2000) I f YOUR LOCAL BUILDING OR FIRE00 ARO[H a f4UORS.gNLf IIySiALI�fTION M YOU.>:RKR msTaLL,WI H IOIN(- INSTALL WCEN THE MW41EARANCE TO m FL RIME 1p i . . MANUFACTU�'INIS TINS 40AWL BUILOING TAR .3 M1 lIA WAILS AS.SHOWN, or S. 24 GAU.6iIr,i ... SKEET METAL OR�r CHIMNEY 1'IfP"E. a tlt+N' FIR '1'jo TER, ..,`. EQO1iiALE 1 �� i:APPRQVED CEAS ' EBkkAwEU11N;E ` it CHININfIf NECfiO i�Nf1 H 4 MUl�lf taw .INSTJWAT 36' Y`W�yarLiAN >1n1011ll #rf" � ,ry.$., `1 ...p �+Y. .. T�,�iFli 1 .5• yq�vteaf,� p[�f�i�a�flf�rl! , 1.(�,. r, ���`_ �,'. I I^V VIYWA - x AND 6- ry, ■(y��y�y,// \� ss" MOKL. TI ASTLE00 CORNER-INST., ! ;� y 11 gs,F Srt LI v I �' , e,�Pt�C�� q 5.,tP.9 _i.._��. tt .`,'+r ''.lf,",_ _.�''._a,.f.C-. ..�_R.,. . ..l.:ia...:".._�.A✓ r YOUR LOCAL Wfl[j1NG ox I!1itt pfftci 1s 4ww RES' icT10NIS AND ifts I ATQN INYWR AREA PRFO HOM EIRES INSTALLWITH IJINI• INSTALL ANOtr.t4NCY INPACCORi)IINfCE V iH THE MUM ELEARANCE TO FLOOR NTECTION MANUF �NSTRQCTIONS A14LWL BUILDING P_ _ WALLS AS SHOWN. TO BE,3,/'B"MINE4AL COC@S. WID OYtlt 24 GAUGE SHEET METAL OR CHIMNEYIi f:. flll(tlf�!UM�!(tEFfOrAMETER, �6 EQUIVALENt4 ,APPROVED CUM I FOR Att M. Afl .IARC�ES. CHIMNEY CD`iWiCTOR. il�Ci�D1A1VCk`T i'MINIMUM n, tmia 2 INvat AT c1 AST 24 obt FROfM J 6 WALL A.0,24'[NiCHEVROM°CEIL{f+k(i •X _ �, SPf:GIAt��S'A�E•iIEI?lf1�tE�WNEN''PI1'SstNP o� g„ � �f 51f9tffllL-RACKWAtt AMONA-WALL 00 CtllINt.`SEE'tNSfRIldjgf#S INSTALL A rlo" AND BURDINis Gfff)ES, o � 9s CORPORA mm StigET HY.Ur1Nlt5, MA. 02601 p s MODEL flows ` -Do N4iAfkN'H TESTED tffFA COA@ANCOfflt Uta A�Cll10KE ' F SFAS .fNt'Itlr r AND GtSffa f3'Y ft.f.4EI6SER ` �►� ` . CORNM 1NSTAUAVON IfillT AS911C 111ES TESTING tASORATOwtt 7T�' R r,PPf IDf ` Cerablanket Products on The al Ceramics Page 1 of 1 Search Catalog ------------ By Keyword -- - - MUM V] All Categories Cerablanket Products `A Categories>Blankets>Cerablanket>Cerablanket Products>View Items c El a Printable-.Page E3 Em-a-H-This Page d Save-To-Fa-vorites Cerabianket Products Check up to five results to perform an action. Cerablanket® r x- T` Cerablanket is produced from exceptionally pure oxides of alumina and silica using the spinning process.The resultant quality spun fibers have been optimized for high handling strength,with on average the highest tensile strength of any Thermal Ceramics ceramic fiber blanket. Cerablanket is available in a wide variety of densities and sizes. Cerablanket is air laid into a continuous mat and mechanically needled for added strength and surface integrity.Cerablanket does not contain organic binders and provides excellent resistance to chemical attack. larger.image Cerablanket offers excellent handleability and high temperature stability.This allows it to meet a wide range of hot face and backup insulation applications in furnaces,kilns and other equipment requiring high temperature heat containment. CONTINUOUS USE TEMPERATURE LIMIT-2150OF/1177"C CLASSIFICATION TEMPERATURE RATING-2400°F/1315^C The values given are typical average values obtained in accordance with accepted test methods and are subject to normal manufacturing variations.They are supplied as a technical service and are subject to change without notice. Thermal Ceramics is a trademark of Morgan Crucible,plc.Cerablanket is a trademark of Thermal Ceramics Inc. Results per Page-, 25 .__ _ Results 1-18 of 18 1 Product ID Product Name Density Thickness Size.-Description Unit Qty.Per Unit Qty Disco_.un; Unit-Price LJ 825-4806-004.-0D-00 Cerablanket 4 lb. 1" 300"x 24" Carton 50 SF Y $180.50 J 825=4806-005-00-00 Cerablanket 4lb. 1.5" 300"x 24" Carton 50 SF Y $271.00 LI 825-4806_006-00=00 Cerablanket 4 It, 2" 300"x 24" Carton 50 SF Y $353.50 L 825-4807-004-00-0.0 Cerablanket 4 lb. 1" 300"x 48" Carton 100 SF Y $361.00 825.-4807-005._0.0:00. Cerablanket 4 lb. 1.5" 300"x 48" Carton 100 SF Y $542.00 El 825-4816:021-0.0 00. Cerablanket 4 lb. 2" 300"x 48" Carton 60 SF Y $424.20 J 825-6806-004-00-00 Cerablanket 6 lb. 1" 300"x 24" Carton 50 SF Y $248.00 i`ii 825-6806-005-0.0-00 Cerablanket 6 lb. 1.5" 300"x 24" Carton 50 SF Y $375.50 iJ 825-6806_006-00-00 Cerablanket 6 lb. 2" 300"x 24" Carton 50 SF Y $492.50 D 825-6807.004-00-00 Cerablanket 6 lb. 1" 300"x 48" Carton 100 SF Y $496.00 IEJ 825-68.07-005-00-00 Cerablanket 6lb. 1.5" 300"x 48" Carton 100 SF Y $751.00 J 825.:6816.-_0.21.-00_00 Cerablanket 6 lb. 2" 300"x 48" Carton 60 SF Y $591.00 f 825-880.6.-004-00.00 Cerablanket 8 lb. 1" 300"x 24" Carton• 50 SF Y $344.00 [I 825-8806-.005-00_.-00 Cerablanket 8 lb. 1.5" 300"x 24" Carton 50 SF Y $516.00 fJ 82578806-006-0-0.00 Cerablanket 8 lb. 2" 300"x 24" Carton 50 SF Y $717.00 825.8807-004-0.0-001 Cerablanket 8 lb. 1" 300"x 48" Carton 100 SF Y $688.00 J 8.25--8807=005-0_.0-00. Cerablanket 8 lb. 1.5" 300"x 48" Carton 100 SF Y $1,032.00 825-881.6-021.00-00 Cerablanket 8 Ib, 2" 300"x 48" Carton 60 SF Y $860.40 Results 1-18 of 18 1 http://thermalceramics.thomasnet.com/viewitems/cerablanket/cerablanket-products?&for... 11/10/2008