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Home My WebLink AboutBLD-23-002231 -Y`qR (1,a 1"'" I U) 1 Il!L� j Office Use Only � Permit# (i O . _ H !Amount COO o (J ` MATTACtI ESE 4 `*.Poo i.0 :-d Permit expires 180 days from i issue date £ 17- Z3-,jZ23) EXPRESS BUILDING PERMIT APPLICATION C E I V E D TOWN OF YARMOUTH _.__�. m—— Yarmouth Building Department onT o 2Q 2 1146 Route 28 South Yarmouth, MA 02664 BUILDING DEPARTMENT (508) 398-2231 Ext. 1261 By CONSTRUCTION ADDRESS: 3 "ait C4 alz_-,4 kig: ,-7)0110.-0W -,..771- ASSESSOR'S INFORMATION: Map: / p, �n Parcel:Parcel:OWNER: ✓711 ✓ s<4 14 t W i 771 `,134 N PRESENT ADDRESS TEL. # CONTRACTOR: NAME MAILING ADDRESS TEL.# Residential ❑Commercial Est.Cost of Construction$ 5- 6 Home Improvement Contractor Lic.# Construction Supervisor Lic.# Workman's Compensation Insurance: (check one) ❑ I am the homeowner ❑ I am the sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp.Policy# WORK TO BE PERFORMED' Tent Duration (Fire Retardant Certificate attached?) 40iiiiwd Stove Siding: #of Squares Replacement windows: # Replacement doors: # Roofing: #of Squares ( )Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing *The debris will be disposed of at: Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief I understand that any false answer(s) will be just cause for deni r vocation of my ns d for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: /KIXDate: /a/Xs taaW— Owners Signature(or a chment) i Date: Date: / t Approved By: Building Offici r des' ee) EMAIL AD SS: Zoning District: Historical District: ❑ Yes ❑ No Flood Plain Zone: ❑ Yes ❑ No Water Resource Protection District: Within 100 ft.of Wetlands: ❑ Yes ❑ No ❑ Yes ❑ No . '��, The Commonwealth of Massachusetts Air r Department of Industrial Accidents Wm, 1 Congress Street, Suite 100 Boston, MA 02114-2017 1, 4. www.mass.gov/dia ..r Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): i/�y c� ffct�" " 7e/ Address: a - I 3 -, City/State/Zip: (I). Ode.73 Phone #: -(. 6, - 77l Are you an employer?Check t appropriate box: Type of project(required): 1.0 I am a employer with employees(full and/or part-time).* 7. _New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity. [No workers'comp.insurance required.] 9. ❑ Demolition 3.[Vam a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 — Building addition 4.E I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.] Electrical repairs or additions proprietors with no employees. - 12.0 Plumbing repairs or additions 5.D I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs . These sub-contractors have employees and have workers'comp. insurance.* 14.[]Other pe.e A6,./': 6_E We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees. [No workers'comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ' Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby e tify under th pains nd penalties of perjury that the information provided above is truce�'and correct. SiQnatur . UiirliA-"----,..,_ _�' Date: /0 ,90 Phone#: �0 � �i ( / Official use only. Do not write in this area, to be completed by thy 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#: Operator's Manual HP505 Pellet Stove AUTOMATIC SAFETY FEATURES $pE;CIFICATIONS POWER OUTAGE During a power outage,the stove will shut down safely. Model Number HPSOS Do not open the main door or ash door.During a BTU/hour output(1) 15.425Btu/hr-36.449 Btu/hr(2) power failure the exhaust fan will not run.Keeping the Heating Capacity(3) 1200sq.ft doors sealed will allow the exhaust vent to draft out Electrical Rating 115 volts.60Hz naturally. When the power is restored,the stove will Efficiency 85.4% (HHV) not restart. If the exhaust temperature is still 120 CO Emissions(g/hr)(4) 3.8(min)-19.5(max) degrees Fahrenheit when power is restored,the particulate Emissions 1.511 g/hr exhaust and convection fans will continue to run until Power Consumption 525 Watts ignition 75 Watts operating the stove cools. See lighting instructions to restart Fuel Storage Capacity 55 lbs stove. Install at least one smoke detector on each floor of your home Flue Size 75mm to ensure your safety.They should be located away from the Width 513mm heating appliance and close to the sleeping areas. You should have another CO monitors for areas near the stove. Height 870mm OVERHEATING Depth 632mm Over Fire Protection:If the stove is being over fired or Weight 108kg burning too hot, the high limit switches will automatically shutdown the stove to avoid damage to (1)Heat output will vary,depending on the brand,type and quality of fuel and the moisture content.Consult your components. If the temperature on the hopper dealer for best results. reaches 200 degree Fahrenheit, the auger will (2)This wood heater has a manufacturer-set minimum automatically stop and the stove will shut down. The low burn rate that must not be altered.It is against exhaust fan will continue to run until the proof of fire federal regulations to alter this setting or otherwise operate this wood heater in a manner inconsistent with switch cools. Allow stove to cool before attempting operating instructions in this manual." to re-ignite. See lighting instructions (3)Based on post 1982 home construction,requiring 35 BTU/Hr.per Sq.Ft. (4)CO Emissions will vary,depending on the feed level, AWARNING burning time and fuel.Consult your dealer for best results. GLASS SPECIFICATIONS If the unit is modified,it will not be compliant with This stove is equipped with ceramic glass.Replace glass only EPA regulations. with Qualified ceramic glass. UNPACKING A WARNING Your stove will come fully assembled.Remove all packing material and tape from the inside of the firebox.Remove any tape on the outside of the glass.Open the hopper,remove all If you call see"black smoke"at the end of the chimney,the NOTE:MAKEg SURE and d power THo HOPPER IS FREE OF ALL FOREIGN emission maybe have been abnormal. You should check: MATTER BEFORE FILLING WITH FUEL.FOREIGN MATERLAL WILL CAUSE AUGER JAMS AND WILL VOID STOVE 1) If there is an serious clinker in the burnpot. WARRANTY. 2) If there are some leakages on the stove for example the glass door 3) The exhaust channel have been blocked partially. The input voltage is abnormal 8 Operator's Manual HP5OS Pellet Stove INSTALLATION It is recommended the stove be installed and serviced by A authorized professionals. WARNING Proper installation of this stove is necessary for safe and efficient operation. Installing this product improperly may READ THIS ENTIRE MANUAL BEFORE YOU INSTALL AND result in a house fire and personal injury.All applicable building USE THIS STOVE. FAILURE TO FOLLOW THE AND IN- codes for your location must be followed. In areas where STRUCTIONS MAY RESULT IN PROPERTY DAMAGE, building codes require additional steps to the installation of this BODILY INJURY,OR EVEN DEATH. product not included in this manual, the building codes will DO NOT INSTALL A FLUE DAMPER IN THE EXHAUST take precedent and must be followed. Contact your local VENTING SYSTEM OF THIS UNIT. building inspector to obtain any necessary permits or DO NOT CONNECT THIS UNIT TO A CHIMNEY FLUE inspection guidelines before installing the product. SERVING ANOTHER APPLIANCE. STOVE PLACEMENT CHILDREN AND ADULTS SHOULD BE ALERTED TO THE HAZARDS OF HIGH SURFACE TEMPERATURES. AND Sketch out a plan for installing the stove including dimensions SHOULD STAY AWAY TO AVOID BUMPS TO SKIN AND/ before permanent placement.When determining the location OR CLOTHING. for the stove, wall stud location is critical.You may need to YOUNG CHILDREN SHOULD BE CAREFULLY SUPER- adjust the location of the stove to avoid trying to vent through a VISED WHEN THEY ARE IN THE SAME ROOM AS THE wall stud.Before placing the pellet stove,connect the vent and STOVE. allow for minimum clearance to combustible walls. CLOTHING AND OTHER FLAMMABLE MATERIALS FLOOR PROTECTION REQUIREMENTS SHOULD NOT BE PLACED ON OR NEAR THIS UNIT. The stove must be installed on a noncombustible floor, with proper floor protection,or on a masonry hearth. When a clean out t-vent is installed in the inside of a home,the floor protector A CAUTION must extend 2 beyond rear oft-vent.SEE FIGURE 1. When stove SEE FIGURE 1 When stove is vented straight through THIS STOVE SHOULD NOT BE USED AS THE ONLY SOURCE the wall and the clean out t-vent is on the exterior of OF HEAT IN THE HOUSE.POWER OUTAGES AND PERIODIC the home,the minimum clearance is 2 from the back MAINTENANCE WILL RESULT IN A TOTAL LOSS OF HEAT. of the stove to the wall. SEE FIGURE 2. The CONTACT LOCAL BUILDING OR FIRE OFFICIALS ABOUT minimum floor protector material is 24 GA sheet RESTRICTIONS AND INSTALLATION INSPECTION metal REQUIREMENTS IN YOUR AREA. CONTACT YOUR LOCAL AUTHORITY(SUCH AS MUNICIPAL BUILDING DEPARTMENT,FIRE DEPARTMENT,FIRE PREVENTION BUREAU,ETC.)TO DETERMINE THE NEED FORA PERMIT. KEEP COMBUSTIBLE MATERIALS(SUCH AS GRASS, LEAVES,ETC.)AT LEAST 3 FEET AWAY FROM THE FLUE OUTLET ON THE OUTSIDE OF THE BUILDING. INSTALLATION AND REPAIR OF THIS PELLETSTOVE SHOULD BE DONE BY A QUALIFIED SERVICE PERSON.THE APPLIANCE SHOULD BE INSPECTED BEFORE y7 sfli NN$JiNNNNH Vi FiI 13 16i�4 AN64 NF*FNNgip!W ui, USE AND AT LEAST ANNUALLY BY A QUALIFIED SERVICE a A„_:a s fr t a itt I •a ! tr PERSON.IT IS IMPERATIVE THAT CONTROL ic II fl G E 4 � imi COMPARTMENTS,FIRE BOX,AND CIRCULATING AIR ' PASSAGEWAYS OF THE STOVE BE KEPT CLEAN. • Fignnr:: Figures Figures,anti e:PrUet Mo..floor p d clearance 9